From 9a220677730938214639bf30e571696104d70a4b Mon Sep 17 00:00:00 2001 From: jteijema Date: Thu, 26 Sep 2024 12:46:56 +0200 Subject: [PATCH] update examples with prior template --- examples/prior_example/README.md | 92 + .../prior_example/data/prior_Smid_2020.csv | 2628 ++++++ .../prior_example/data/van_de_Schoot_2018.csv | 4545 +++++++++++ .../generated_data/dataset_with_priors.csv | 7172 +++++++++++++++++ .../generated_data/dataset_without_priors.csv | 4545 +++++++++++ examples/prior_example/jobs.sh | 35 + examples/prior_example/scripts/get_plot.py | 119 + .../scripts/merge_descriptives.py | 79 + .../prior_example/scripts/merge_metrics.py | 84 + examples/prior_example/scripts/merge_tds.py | 90 + 10 files changed, 19389 insertions(+) create mode 100644 examples/prior_example/README.md create mode 100644 examples/prior_example/data/prior_Smid_2020.csv create mode 100644 examples/prior_example/data/van_de_Schoot_2018.csv create mode 100644 examples/prior_example/generated_data/dataset_with_priors.csv create mode 100644 examples/prior_example/generated_data/dataset_without_priors.csv create mode 100644 examples/prior_example/jobs.sh create mode 100644 examples/prior_example/scripts/get_plot.py create mode 100644 examples/prior_example/scripts/merge_descriptives.py create mode 100644 examples/prior_example/scripts/merge_metrics.py create mode 100644 examples/prior_example/scripts/merge_tds.py diff --git a/examples/prior_example/README.md b/examples/prior_example/README.md new file mode 100644 index 0000000..b06aef9 --- /dev/null +++ b/examples/prior_example/README.md @@ -0,0 +1,92 @@ +# Simulation study + +*This project was rendered with ASReview-Makita version 0.9.3.dev33+g89c72db.* + +This project was rendered from the Makita-prior template. See [asreview/asreview-makita#templates](https://github.com/asreview/asreview-makita#templates) for template rules and formats. + +The template is described as: 'Prior comparison simulations template'. + +## Installation + +This project depends on Python 3.7 or later (python.org/download), and [ASReview](https://asreview.nl/download/). Install the following dependencies to run the simulation and analysis in this project. + +```sh +pip install asreview>=1.0 asreview-insights>=1.1.2 asreview-datatools +``` + +For generating wordclouds, install the following dependencies. + +```sh +pip install asreview-wordcloud +``` + +## Data + +The performance on the following datasets is evaluated: + +- data\prior_Smid_2020.csv +- data\van_de_Schoot_2018.csv + +## Run simulation + +To start the simulation, run the following command in the project directory. + +```sh +sh jobs.sh +``` + +## Structure + +The following files are found in this project: + + 📦Makita + ├── 📜README.md + ├── 📜jobs.sh + ├── 📂data + │ ├── 📜prior_Smid_2020.csv + │ ├── 📜van_de_Schoot_2018.csv + ├── 📂generated_data + │ ├── 📜dataset_with_priors.csv + │ ├── 📜dataset_without_priors.csv + ├── 📂scripts + │ ├── 📜get_plot.py + │ ├── 📜merge_descriptives.py + │ ├── 📜merge_metrics.py + │ ├── 📜merge_tds.py + │ └── 📜... + └── 📂output + ├── 📂simulation + | ├── 📂descriptives + | | ├── 📜data_stats_dataset_with_priors.json + | | └── 📜data_stats_dataset_without_priors.json + | ├── 📂state_files + | | ├── 📜sim_with_priors_`x`.asreview + | | ├── 📜sim_without_priors_`x`.asreview + | | └── 📜... + | └── 📂metrics + | ├── 📜metrics_sim_with_priors_`x`.json + | ├── 📜metrics_sim_without_priors_`x`.json + | └── 📜... + ├── 📂tables + | ├── 📜data_descriptives.csv + | ├── 📜data_descriptives.xlsx + | ├── 📜tds_sim_prior_Smid_2020.csv + | ├── 📜tds_sim_prior_Smid_2020.xlsx + | ├── 📜tds_sim_van_de_Schoot_2018.csv + | ├── 📜tds_sim_van_de_Schoot_2018.xlsx + | ├── 📜tds_summary.csv + | ├── 📜tds_summary.xlsx + | ├── 📜metrics_sim_prior_Smid_2020_metrics.csv + | ├── 📜metrics_sim_prior_Smid_2020_metrics.xlsx + | ├── 📜metrics_sim_van_de_Schoot_2018_metrics.csv + | ├── 📜metrics_sim_van_de_Schoot_2018_metrics.xlsx + | ├── 📜metrics_summary.csv + | └── 📜metrics_summary.xlsx + └── 📂figures + ├── 📈wordcloud_dataset_with_priors.png + ├── 📈wordcloud_dataset_without_priors.png + ├── 📈wordcloud_irrelevant_dataset_with_priors.png + ├── 📈wordcloud_relevant_dataset_with_priors.png + ├── 📈wordcloud_irrelevant_dataset_without_priors.png + ├── 📈wordcloud_relevant_dataset_without_priors.png + └── 📈plot_recall_sim.png diff --git a/examples/prior_example/data/prior_Smid_2020.csv b/examples/prior_example/data/prior_Smid_2020.csv new file mode 100644 index 0000000..9fbb7f1 --- /dev/null +++ b/examples/prior_example/data/prior_Smid_2020.csv @@ -0,0 +1,2628 @@ +doi,title,abstract,label_included +https://doi.org/10.1002/9780470723586,Statistical Issues in Drug Development,"Drug development is the process of finding and producing therapeutically useful pharmaceuticals, turning them into safe and effective medicine, and producing reliable information regarding the appropriate dosage and dosing intervals. With regulatory authorities demanding increasingly higher standards in such developments, statistics has become an intrinsic and critical element in the design and conduct of drug development programmes. Statistical Issues in Drug Development presents an essential and thought provoking guide to the statistical issues and controversies involved in drug development. This highly readable second edition has been updated to include: Comprehensive coverage of the design and interpretation of clinical trials. Expanded sections on missing data, equivalence, meta-analysis and dose finding. An examination of both Bayesian and frequentist methods. A new chapter on pharmacogenomics and expanded coverage of pharmaco-epidemiology and pharmaco-economics. Coverage of the ICH guidelines, in particular ICH E9, Statistical Principles for Clinical Trials. It is hoped that the book will stimulate dialogue between statisticians and life scientists working within the pharmaceutical industry. The accessible and wide-ranging coverage make it essential reading for both statisticians and non-statisticians working in the pharmaceutical industry, regulatory bodies and medical research institutes. There is also much to benefit undergraduate and postgraduate students whose courses include a medical statistics component. © 2007 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1007/s11031-015-9499-5,Kindness reduces avoidance goals in socially anxious individuals,"Social avoidance goals have been linked to negative social outcomes and may contribute to the social impairment experienced by socially anxious individuals. In this study, we examined whether engaging in acts of kindness, a technique designed to increase happiness, decreases social avoidance goals in socially anxious participants and whether social anxiety reduction and hedonic enhancement (i.e., increased positive affect) mediate this effect. Socially anxious undergraduates were randomly assigned to three conditions: performing acts of kindness (AK; N = 38); exposure only (EO; N = 41); and recording life details (LD; N = 36), a neutral control condition. Participants engaged in these activities for 4 weeks. AK resulted in the greatest decrease in social avoidance goals by post-intervention. EO also reduced avoidance goals over time relative to LD. The effect of task condition on avoidance goals over time was fully mediated by social anxiety reduction over time. Neither AK nor EO increased positive affect. Implications for social anxiety treatment are discussed. © 2015, Springer Science+Business Media New York.",0 +https://doi.org/10.1016/j.healthplace.2014.08.009,Individual and province inequalities in health among older people in China: Evidence and policy implications,"This paper uses multi-level modelling to analyse data from the nationally-representative Chinese Health and Retirement Longitudinal Study (CHARLS) in order to investigate the characteristics associated with poor health among older people, including individual and household characteristics as well as the characteristics of the provinces in which the older person lives (contextual effects). The results show that older Chinese women, rural residents, those with an education level lower than high school, without individual income sources, who are ex-smokers, and those from poor economic status households are more likely to report disability and poor self-rated health. Differentials in the health outcomes remain substantial between provinces even after controlling for a number of individual and household characteristics.",0 +https://doi.org/10.1002/hec.804,Comprehensive decision analytical modelling in economic evaluation: a Bayesian approach,"Decision analytical models are widely used in economic evaluation of health care interventions with the objective of generating valuable information to assist health policy decision-makers to allocate scarce health care resources efficiently. The whole decision modelling process can be summarised in four stages: (i) a systematic review of the relevant data (including meta-analyses), (ii) estimation of all inputs into the model (including effectiveness, transition probabilities and costs), (iii) sensitivity analysis for data and model specifications, and (iv) evaluation of the model. The aim of this paper is to demonstrate how the individual components of decision modelling, outlined above, may be addressed simultaneously in one coherent Bayesian model (sometimes known as a comprehensive decision analytical model) and evaluated using Markov Chain Monte Carlo simulation implemented in the specialist software WinBUGS. To illustrate the method described, it is applied to two illustrative examples: (1) The prophylactic use of neurominidase inhibitors for the prevention of influenza. (2) The use of taxanes for the second-line treatment of advanced breast cancer. The advantages of integrating the four stages outlined into one comprehensive decision analytical model, compared to the conventional 'two-stage' approach, are discussed.",0 +https://doi.org/10.1007/s11336-008-9101-0,"On the Use, the Misuse, and the Very Limited Usefulness of Cronbach’s Alpha","This discussion paper argues that both the use of Cronbach's alpha as a reliability estimate and as a measure of internal consistency suffer from major problems. First, alpha always has a value, which cannot be equal to the test score's reliability given the interitem covariance matrix and the usual assumptions about measurement error. Second, in practice, alpha is used more often as a measure of the test's internal consistency than as an estimate of reliability. However, it can be shown easily that alpha is unrelated to the internal structure of the test. It is further discussed that statistics based on a single test administration do not convey much information about the accuracy of individuals' test performance. The paper ends with a list of conclusions about the usefulness of alpha.",0 +https://doi.org/10.1016/j.jmp.2010.08.009,The form of the forgetting curve and the fate of memories,"Psychologists have debated the form of the forgetting curve for over a century. We focus on resolving three problems that have blocked a clear answer on this issue. First, we analyzed data from a longitudinal experiment measuring cued recall and stem completion from 1 min to 28 days after study, with more observations per interval per participant than in previous studies. Second, we analyzed the data using hierarchical models, avoiding distortions due to averaging over participants. Third, we implemented the models in a Bayesian framework, enabling our analysis to account for the ability of candidate forgetting functions to imitate each other. An exponential function provided the best fit to individual participant data collected under both explicit and implicit retrieval instructions, but Bayesian model selection favored a power function. All analysis supported above chance asymptotic retention, suggesting that, despite quite brief study, storage of some memories was effectively permanent.",0 +https://doi.org/10.1016/j.jspi.2003.09.026,A class of shrinkage priors for the dependence structure in longitudinal data,"We review a general class of priors for the dependence in longitudinal (temporal) data in settings where a parametric form is often assumed and place them in the context of the literature. The idea is to embed priors on the parameters of the structure within a richer, more flexible class of priors. These priors are shown to contain standard objective priors for structured and unstructured dependence models as special cases under certain conditions and parameterizations. Recommendations and specific details regarding their use are provided.",0 +https://doi.org/10.1016/j.paid.2015.02.023,Examining the association between psychological wellbeing with daily and intra-individual variation in subjective wellbeing,"Abstract A number of studies identify distinct dimensions of psychological and subjective wellbeing. However, few investigations have examined how these distinctive wellbeing dimensions may be related over time. The present study aimed to contribute to this growing body of research by adopting a measurement burst design to examine the association between psychological functioning with daily and intra-individual variation in affect over a 14-day period, controlling for personality. Participants ( N  = 45) comprised a sample of Australian adults from Canberra, Australia who were observed on up to 14 days over a 2-week period (Mobs = 10.9 (SD = 3.1)). Maximum Likelihood (ML) estimates from a multi-level structural equation model identified psychological functioning as only weakly associated with daily positive affect, and unrelated to daily levels of negative affect and intra-individual variation in both affect domains when adjusting for demographic, personality and daily stressors. Positive and negative daily events were most strongly associated with positive and negative feelings, respectively. Post-hoc analysis within a Bayesian context confirmed our ML results whilst a Monte Carlo simulation identified sufficient statistical power of significant parameters. Overall, evidence for an association between psychological functioning and daily affect was not identified.",0 +https://doi.org/10.3758/bf03200523,RTSYS: A DOS application for the analysis of reaction time data,"RTSYS is a menu-driven DOS application for the manipulation, analysis, and graphical display of reaction time data. It can be used either in a single-task environment under DOS, with access to a set operating system commands, or as an application under Windows. All functions have context-sensitive help. RTSYS fits the ex-Gaussian distribution to reaction time data without the difficulties usually associated with numerical parameter estimation. Distribution fitting and flexible censoring and rescaling options allow RTSYS to address the problems of reaction time distribution skew and outlying responses with reasonable sample sizes. RTSYS can automatically process multiple input files from experiments with arbitrary designs and produce formatted output of statistics for further processing by graphical and inferential statistical packages. The present article reviews and explains techniques used by RTSYS and provides an overview of the operation of the program.",0 +https://doi.org/10.1080/10705510709336745,Comparison of Approaches to Constructing Confidence Intervals for Mediating Effects Using Structural Equation Models,"Abstract Mediators are variables that explain the association between an independent variable and a dependent variable. Structural equation modeling (SEM) is widely used to test models with mediating effects. This article illustrates how to construct confidence intervals (CIs) of the mediating effects for a variety of models in SEM. Specifically, mediating models with 1 mediator, 2 intermediate mediators, 2 specific mediators, and 1 mediator in 2 independent groups are illustrated. By using phantom variables (Rindskopf, 1984), a Wald CI, percentile bootstrap CI, bias-corrected bootstrap CI, and a likelihood-based CI on the mediating effect are easily constructed with some existing SEM packages, such as LISREL, M plus, and Mx. Monte Carlo simulation studies are used to compare the coverage probabilities of these CIs. The results show that the coverage probabilities of these CIs are comparable when the mediating effect is large or when the sample size is large. However, when the mediating effect and the sam...",0 +https://doi.org/10.1080/10705511.2014.935266,Inference and Interval Estimation Methods for Indirect Effects With Latent Variable Models,"Although much is known about the performance of recent methods for inference and interval estimation for indirect or mediated effects with observed variables, little is known about their performance in latent variable models. This article presents an extensive Monte Carlo study of 11 different leading or popular methods adapted to structural equation models with latent variables. Manipulated variables included sample size, number of indicators per latent variable, internal consistency per set of indicators, and 16 different path combinations between latent variables. Results indicate that some popular or previously recommended methods, such as the bias-corrected bootstrap and asymptotic standard errors had poorly calibrated Type I error and coverage rates in some conditions. Likelihood-based confidence intervals, the distribution of the product method, and the percentile bootstrap emerged as leading methods for both interval estimation and inference, whereas joint significance tests and the partial poster...",0 +https://doi.org/10.1198/108571108x273160,Bayesian multivariate process modeling for prediction of forest attributes,"This article investigates multivariate spatial process models suitable for predicting multiple forest attributes using a multisource forest inventory approach. Such data settings involve several spatially dependent response variables arising in each location. Not only does each variable vary across space, they are likely to be correlated among themselves. Traditional approaches have attempted to model such data using simplifying assumptions, such as a common rate of decay in the spatial correlation or simplified cross-covariance structures among the response variables. Our current focus is to produce spatially explicit, tree species specific, prediction of forest biomass per hectare over a region of interest. Modeling such associations presents challenges in terms of validity of probability distributions as well as issues concerning identifiability and estimability of parameters. Our template encompasses several models with different correlation structures. These models represent different hypotheses whose tenability are assessed using formal model comparisons. We adopt a Bayesian hierarchical approach offering a sampling-based inferential framework using efficient Markov chain Monte Carlo methods for estimating model parameters. © 2008 American Statistical Association and the International Biometric Society.",0 +https://doi.org/10.2307/2533273,Robust Restricted Maximum Likelihood in Mixed Linear Models,"SUMMARY Definitions of robust maximum likelihood (robust ML) and robust restricted maximum likelihood (robust REML) are introduced, and the definitions are applied to data from biological and chemical experiments. A simulation study is undertaken to investigate the asymptotic properties of robust ML and robust REML in small samples and to examine the advantages of using robust methods. 1. Introduction and Definitions Linear models with multiple sources of error are widely used in designed experiments across many scientific fields. An example of such an experiment is described by Patterson and Nabugoomu (1992), from Patterson and Silvey (1980). Six varieties of wheat were grown at ten centres that formed a sample of the main types of growing area for wheat in Scotland, and the yields in tonnes/hectare were recorded. The experiment is unbalanced because, of 60 possible variety-centre combinations, only 46 were used. At seven centres, four varieties were grown and at the remaining three centres, all six varieties were grown. In this paper we fit the simplest mixed linear model proposed for this data by Patterson and Nabugoomu, namely:",0 +https://doi.org/10.1207/s15327906mbr3304_5,Multiple Imputation for Multivariate Missing-Data Problems: A Data Analyst's Perspective,"Analyses of multivariate data are frequently hampered by missing values. Until recently, the only missing-data methods available to most data analysts have been relatively ad1 hoc practices such as listwise deletion. Recent dramatic advances in theoretical and computational statistics, however, have produced anew generation of flexible procedures with a sound statistical basis. These procedures involve multiple imputation (Rubin, 1987), a simulation technique that replaces each missing datum with a set of m > 1 plausible values. The rn versions of the complete data are analyzed by standard complete-data methods, and the results are combined using simple rules to yield estimates, standard errors, and p-values that formally incorporate missing-data uncertainty. New computational algorithms and software described in a recent book (Schafer, 1997a) allow us to create proper multiple imputations in complex multivariate settings. This article reviews the key ideas of multiple imputation, discusses the software programs currently available, and demonstrates their use on data from the Adolescent Alcohol Prevention Trial (Hansen & Graham, 199 I).",0 +https://doi.org/10.1016/j.paid.2015.08.009,Associations of self-compassion and global self-esteem with positive and negative affect and stress reactivity in daily life: Findings from a smart phone study,"The present study examined trait self-compassion and trait self-esteem in relation to positive (PA) and negative affect (NA), as well as their associations with stress reactivity in daily life. One hundred and one subjects completed questionnaires on perceived stress and affect twice a day for 14 consecutive days on smart phones. Results indicated that self-compassion and global self-esteem were positively related to PA and negatively to NA. After controlling for self-esteem, self-compassion remained significantly associated with PA and NA, whereas self-esteem was no longer associated with PA and NA after controlling for self-compassion. Furthermore, results indicated that self-compassion buffered the effect of stress on NA, whereas this was not the case for global self-esteem. Neither self-compassion nor self-esteem moderated the relation of stress on PA in separate models. The results of the present study add to the growing literature regarding beneficial relations of self-compassion and psychological well-being and further emphasize the distinction of self-compassion and global self-esteem.",0 +https://doi.org/10.1080/10705511.2011.557337,Testing Measurement Invariance: A Comparison of Multiple-Group Categorical CFA and IRT,"This study investigated two major approaches in testing measurement invariance for ordinal measures: multiple-group categorical confirmatory factor analysis (MCCFA) and item response theory (IRT). Unlike the ordinary linear factor analysis, MCCFA can appropriately model the ordered-categorical measures with a threshold structure. A simulation study under various conditions was conducted for the comparison of MCCFA and IRT with respect to the power to detect the lack of invariance across groups. Both MCCFA and IRT showed reasonable power to identify the noninvariant item when differential item functioning (DIF) was large. The false positive rates were relatively high in both methods, however. The adjustment of critical values improved the performance of MCCFA by reducing false positive rates substantially and yet yielding adequate power. Alternative model fit indexes of MCCFA were also examined and they were found to be reliable to detect DIF, in general.",0 +https://doi.org/10.1080/10705510701301602,The Model-Size Effect on Traditional and Modified Tests of Covariance Structures,"According to Kenny and McCoach (2003), chi-square tests of structural equation models produce inflated Type I error rates when the degrees of freedom increase. So far, the amount of this bias in large models has not been quantified. In a Monte Carlo study of confirmatory factor models with a range of 48 to 960 degrees of freedom it was found that the traditional maximum likelihood ratio statistic, T ML , overestimates nominal Type I error rates up to 70% under conditions of multivariate normality. Some alternative statistics for the correction of model-size effects were also investigated: the scaled Satorra–Bentler statistic, T SC ; the adjusted Satorra–Bentler statistic, T AD (Satorra & Bentler, 1988, 1994); corresponding Bartlett corrections, T MLb , T SCb , and T ADb (Bartlett, 1950); and corresponding Swain corrections, T MLs , T SCs , and T ADs (Swain, 1975). The empirical findings indicate that the model test statistic T MLs should be applied when large structural equation models are analyzed and th...",0 +https://doi.org/10.1348/000711009x480640,Coping with stress through decisional control: Quantification of negotiating the environment,"Coping with stress through 'decisional control' - positioning oneself in a multifaceted stressing situation so as to minimize the likelihood of an untoward event - is modelled within a tree-structure scenario, whose architecture hierarchically nests elements of varying threat. Analytic and simulation platforms quantify the game-like interplay of cognitive demands and threat reduction. When elements of uncertainty enter the theoretical structure, specifically at more subordinate levels of the hierarchy, the mathematical expectation of threat is particularly exacerbated. As quantified in this model, the exercise of decisional control is demonstrably related to reduction in expected threat (the minimum correlation across comprehensive parameter settings being .55). Disclosure of otherwise intractable stress-coping subtleties, endowed by the quantitative translation of verbal premises, is underscored. Formalization of decisional stress control is seen to usher in linkages to augmenting formal developments from fields of cognitive science, preference and choice modelling, and nonlinear dynamical systems theory. Model-prescribed empirical consequences are stipulated.",0 +https://doi.org/10.1177/014662168100500212,Using Simulation Results to Choose a Latent Trait Model,"A latent trait model goodness-of-fit statistic was defined, and its relationships to several other com monly used fit statistics were described. Simulation data were used to examine the behavior of these fit statistics under conditions similar to those found with real data. The simulation data were generated for 36 pseudo-items and 1,000 simulees using three-, two-, and one-parameter logistic latent trait models. The data were analyzed using three-, two-, and one-parameter models. Between-model comparisons were made of the fit statistics, trait es timates, and item parameter estimates. The three generating models produced clearly different pat terns of results. The simulation results were com pared to results for real data involving seventh- and eighth-grade students' performance on eight achievement tests. The achievement test results ap peared most similar to the simulation results based on data generated with the three-parameter model. Some practical problems that can result from using an inappropriate model with multiple-choice tests are discussed.",0 +https://doi.org/10.3102/1076998607302631,The D-Optimality Item Selection Criterion in the Early Stage of CAT: A Study With the Graded Response Model,"During the early stage of computerized adaptive testing (CAT), item selection criteria based on Fisher’s information often produce less stable latent trait estimates than the Kullback-Leibler global information criterion. Robustness against early stage instability has been reported for the D-optimality criterion in a polytomous CAT with the Nominal Response Model and is shown herein to be reproducible for the Graded Response Model. For comparative purposes, the A-optimality and the global information criteria are also applied. Their item selection is investigated as a function of test progression and item bank composition. The results indicate how the selection of specific item parameters underlies the criteria performances evaluated via accuracy and precision of estimation. In addition, the criteria item exposure rates are compared, without the use of any exposure controlling measure. On the account of stability, precision, accuracy, numerical simplicity, and less evidently, item exposure rate, the D-opt...",0 +,Latent growth mixture modeling : a simulation study,"Latent growth curve modeling (LGM) combined with the latent classes (LGMM) in the SEM context, is the method under investigation in this study. This dynamic way of analyzing longitudinal data takes an increasingly central position in the social sciences, e.g. in psychology. Despite twenty years development of the theory behind the LGM and LGMM, these are novel methods in analyzing data in practice. With limited sample size the functionality of the model is unknown. The aim of this dissertation was to examine the functionality of the linear LGM model with four repeated measurements, which is a typical case in longitudinal research. LGMM parameters were estimated using maximum likelihood estimation with robust standard errors (MLR). The effect of differences between latent classes in mean values of latent components with varying sample sizes is examined in this study. Other affecting factors examined are reliability of observed variables, number of repeated measures, model construct and additional measurement points. The functionality of LGMM was approached from three different viewpoints: 1) problems in estimation of model parameters expressed as number of failed estimations and as the number of negative variance estimates, 2) the ability of AIC, BIC and aBIC information criteria and VLMR, LMR and BLRT statistical tests to decide the number of latent classes, and 3) good parameter estimation, which was evaluated using four different criteria: MSE, proportion of bias in MSE, bias of standard error, and 95 % coverage. The results of Monte Carlo simulations suggest that from information criteria AIC, BIC aBIC and VLMR and LMR tests, BIC is most useful with small sample sizes ( ) and aBIC with large sample sizes ( ). The few results suggest that the BLRT test could be useful in any situation. More investigation is needed to further support the functionality of this test. The study reveals that the estimation of LGMM fails only in a few cases, and problems in estimation appear mainly in the negative variance estimates. The results of the simulations suggest that it is possible to identify the true two-latent classes when SMD is at least 2, in which case reliability of observed variables should be high and the sample size should be relatively large. In that case estimation produce good parameter estimates. When SMD is 4 or 5, the probability in identifying the right two-latent-class solution instead of the wrong one-class solution is greater than .70 with the smallest sample size (n=50) using BIC in models with high reliability. To achieve reliable results in estimation, the sample size should be greater than 50. 500 < n 500 ≥ n",0 +https://doi.org/10.1177/004005999202400310,Curriculum-Based Oral Reading Fluency Norms for Students in Grades 2 through 5,,0 +https://doi.org/10.1037/a0015858,Evaluating model fit for growth curve models: Integration of fit indices from SEM and MLM frameworks.,"Evaluating overall model fit for growth curve models involves 3 challenging issues. (a) Three types of longitudinal data with different implications for model fit may be distinguished: balanced on time with complete data, balanced on time with data missing at random, and unbalanced on time. (b) Traditional work on fit from the structural equation modeling (SEM) perspective has focused only on the covariance structure, but growth curve models have four potential sources of misspecification: within-individual covariance matrix, between-individuals covariance matrix, marginal mean structure, and conditional mean structure. (c) Growth curve models can be estimated in both the SEM and multilevel modeling (MLM) frameworks; these have different emphases for the evaluation of model fit. In this article, the authors discuss the challenges presented by these 3 issues in the calculation and interpretation of SEM- and MLM-based fit indices for growth curve models and conclude by identifying some lines for future research.",0 +https://doi.org/10.1007/s10742-012-0079-9,Variation in New Zealand hospital outcomes: combining hierarchical Bayesian modeling and propensity score methods for hospital performance comparisons,"Two major statistical issues confronting comparative analyses of hospital outcomes are adequacy of case-mix adjustment and proper accounting for random variation. Hierarchical modeling has been proposed to improve precision and reduce the impact of random variation but becomes difficult to implement when there are numerous case-mix factors to control. In this paper we formulate the problem of hospital performance comparisons within the framework of potential outcomes and illustrate an approach to hospital comparisons which combines multiple category propensity score methods for the control of case-mix variations with hierarchical Bayesian modeling of case-mix adjusted summaries. The approach is similar to that proposed by Huang et al. (Health Serv Res 40:253-278, 2005) but extends their approach by using a Bayesian model to accommodate hospital level attributes and to facilitate joint modeling of performance for multiple outcomes. The analytical approach is illustrated by a comparison of 30 day post admission mortality risks for patients treated for acute myocardial infarction, pneumonia or stroke in 34 New Zealand public hospitals. In a small simulation study, reported in electronic supplementary material, hierarchical models outperformed non-hierarchical models, achieving both better credible interval coverage and shorter average interval lengths for measures of between hospital variation based on contrasts between the 90th and 10th percentiles of the mortality risk distribution. Simulation performance of hierarchical and non-hierarchical models in detecting unusual performance was similar. © 2012 Springer Science+Business Media, LLC.",0 +https://doi.org/10.1177/1094428110391814,More Statistical and Methodological Myths and Urban Legends,"The study of urban legends represents the application of concepts developed in the academic study of traditional folktales to stories circulating in the modern world. Vandenberg adapted the notion of ‘‘urban legends’’ into the area of organizational research methods and coined the term statistical and methodological myths and urban legends (SMMULs) to refer to the collection of various rules of thumb and other ‘‘received doctrines’’ that often guide researchers’ scientific behavior. Various SMMULs have been examined over 7 years in a number of symposia at scientific conferences, in a previous Feature Topic in Organizational Research Methods (2006), and in an edited book. This Feature Topic continues this tradition by presenting five new SMMULs.",0 +https://doi.org/10.1207/s15327930pje7704_9,Methodological Advances in the Analysis of Individual Growth With Relevance to Education Policy,"The purpose of this article is to demonstrate how recent methodological developments in the analysis of individual growth can inform important problems in education policy. Specifically, this article focuses on a method referred to as growth mixture modeling. Growth mixture modeling is a relatively new procedure for the analysis of longitudinal data that relaxes many of the assumptions associated with conventional growth curve modeling. In particular, growth mixture modeling tests for the existence of unique growth trajectory classes through a combination of latent class analysis and standard growth curve modeling. Antecedent predictors of the latent classes can be incorporated as well as relations from the latent classes to specific outcomes. This article applies growth mixture modeling to data from the Early Childhood Longitudinal Study-Kindergarten class of 1998-1999. The specific policy question posed in this article focuses on the estimation of latent growth trajectory classes in reading proficiency ...",0 +https://doi.org/10.1016/j.cct.2017.06.009,Increasing the efficiency of oncology basket trials using a Bayesian approach,"With the rapid growth of targeted and immune-oncology therapies, novel statistical design approaches are needed to increase the flexibility and efficiency of early phase oncology trials. Basket trials enroll patients with defined biological deficiencies, but with multiple histologic tumor types (or indications), to discover in which indications the drug is active. In such designs different indications are typically analyzed independently. This, however, ignores potential biological similarities among the indications. Our research provides a statistical methodology to enhance such basket trials by assessing the homogeneity of the response rates among indications at an interim analysis, and applying a Bayesian hierarchical modeling approach in the second stage if the efficacy is deemed reasonably homogenous across indications. This increases the power of the study by allowing indications with similar response rates to borrow information from each other. Via simulations, we quantify the efficiency gain of our proposed approach relative to the conventional parallel approach. The operating characteristics of our method depend on the similarity of the response rates between the different indications. If the response rates are comparable in most or all indications after treatment with the investigational drug, a substantial increase in efficiency as compared to the conventional approach can be obtained as fewer patients are required or a higher power is attained. We also demonstrate that efficacy again decreases if the response rates vary considerably among tumor types but it is still better than the conventional approach.",0 +https://doi.org/10.3389/fnint.2012.00063,Temporal-order judgment of visual and auditory stimuli: modulations in situations with and without stimulus discrimination,"Temporal-order judgment (TOJ) tasks are an important paradigm to investigate processing times of information in different modalities. There are a lot of studies on how temporal order decisions can be influenced by stimuli characteristics. However, so far it has not been investigated whether the addition of a choice reaction time (RT) task has an influence on TOJ. Moreover, it is not known when during processing the decision about the temporal order of two stimuli is made. We investigated the first of these two questions by comparing a regular TOJ task with a dual task (DT). In both tasks, we manipulated different processing stages to investigate whether the manipulations have an influence on TOJ and to determine thereby the time of processing at which the decision about temporal order is made. The results show that the addition of a choice RT task does have an influence on the TOJ, but the influence seems to be linked to the kind of manipulation of the processing stages that is used. The results of the manipulations indicate that the temporal order decision in the DT paradigm is made after perceptual processing of the stimuli.",0 +https://doi.org/10.1002/sim.6342,Statistical methods for dealing with publication bias in meta-analysis,"Publication bias is an inevitable problem in the systematic review and meta-analysis. It is also one of the main threats to the validity of meta-analysis. Although several statistical methods have been developed to detect and adjust for the publication bias since the beginning of 1980s, some of them are not well known and are not being used properly in both the statistical and clinical literature. In this paper, we provided a critical and extensive discussion on the methods for dealing with publication bias, including statistical principles, implementation, and software, as well as the advantages and limitations of these methods. We illustrated a practical application of these methods in a meta-analysis of continuous support for women during childbirth. Copyright © 2014 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1167/14.7.9,Quantifying the effect of intertrial dependence on perceptual decisions,"In the perceptual sciences, experimenters study the causal mechanisms of perceptual systems by probing observers with carefully constructed stimuli. It has long been known, however, that perceptual decisions are not only determined by the stimulus, but also by internal factors. Internal factors could lead to a statistical influence of previous stimuli and responses on the current trial, resulting in serial dependencies, which complicate the causal inference between stimulus and response. However, the majority of studies do not take serial dependencies into account, and it has been unclear how strongly they influence perceptual decisions. We hypothesize that one reason for this neglect is that there has been no reliable tool to quantify them and to correct for their effects. Here we develop a statistical method to detect, estimate, and correct for serial dependencies in behavioral data. We show that even trained psychophysical observers suffer from strong history dependence. A substantial fraction of the decision variance on difficult stimuli was independent of the stimulus but dependent on experimental history.We discuss the strong dependence of perceptual decisions on internal factors and its implications for correct data interpretation.",0 +https://doi.org/10.3758/brm.40.1.61,Diffusion model analysis with MATLAB: A DMAT primer,"The Ratcliff diffusion model has proved to be a useful tool in reaction time analysis. However, its use has been limited by the practical difficulty of estimating the parameters. We present a software tool, the Diffusion Model Analysis Toolbox (DMAT), intended to make the Ratcliff diffusion model for reaction time and accuracy data more accessible to experimental psychologists. The tool takes the form of a MATLAB toolbox and can be freely downloaded from ppw.kuleuven.be/okp/dmatoolbox. Using the program does not require a background in mathematics, nor any advanced programming experience (but familiarity with MATLAB is useful). We demonstrate the basic use of DMAT with two examples.",0 +https://doi.org/10.1111/ajps.12001,How Many Countries for Multilevel Modeling? A Comparison of Frequentist and Bayesian Approaches,"Researchers in comparative research increasingly use multilevel models to test effects of country-level factors on individual behavior and preferences. However, the asymptotic justification of widely employed estimation strategies presumes large samples and applications in comparative politics routinely involve only a small number of countries. Thus, researchers and reviewers often wonder if these models are applicable at all. In other words, how many countries do we need for multilevel modeling? I present results from a large-scale Monte Carlo experiment comparing the performance of multilevel models when few countries are available. I find that maximum likelihood estimates and confidence intervals can be severely biased, especially in models including cross-level interactions. In contrast, the Bayesian approach proves to be far more robust and yields considerably more conservative tests.",1 +https://doi.org/10.1037/1082-989x.4.1.84,Sample size in factor analysis.,"The factor analysis literature includes a range of recommendations regarding the minimum sample size necessary to obtain factor solutions that are adequately stable and that correspond closely to population factors. A fundamental misconception about this issue is that the minimum sample size, or the",0 +https://doi.org/10.1016/j.bbi.2010.11.018,Adoptive transfer of peripheral immune cells potentiates allodynia in a graded chronic constriction injury model of neuropathic pain,"► Intraperitoneal adoptive transfer of peripheral immune cells potentiates chronic constriction injury-induced allodynia . ► Peripheral immune cells only capable of potentiating existing allodynia, rather than establishing allodynia. ► Intraperitoneal adoptive transfer of high pain splenocytes may induce the migration of host-derived immune cells from the spleen to the CNS. ► Intrathecal transfer of “pain-activated” CD45 + cells results in potentiated allodynia. Recent evidence demonstrates that peripheral immune cells contribute to the nociceptive hypersensitivity associated with neuropathic pain by infiltrating the central nervous system (CNS). We have recently developed a rat model of graded chronic constriction injury (CCI) by varying the exposure of the sciatic nerve and control non-nerve tissue to surgical placement of chromic gut. We demonstrate that splenocytes can contribute significantly to CCI-induced allodynia, as adoptive transfer of these cells from high pain donors to low pain recipients potentiates allodynia ( P < 0.001). The phenomenon was replicated with peripheral blood mononuclear cells ( P < 0.001). Adoptive transfer of allodynia was not achieved in sham recipients, indicating that peripheral immune cells are only capable of potentiating existing allodynia, rather than establishing allodynia. As adoptively transferred cells were found by flow cytometry to migrate to the spleen ( P < 0.05) and potentiation of allodynia was prevented in splenectomised low pain recipients, adoptive transfer of high pain splenocytes may induce the migration of host-derived immune cells from the spleen to the CNS as observed by flow cytometry ( P < 0.05). Importantly, intrathecal transfer of CD45 + cells prepared from spinal cords of high pain donors into low pain recipients led to potentiated allodynia ( P < 0.001), confirming that infiltrating immune cells are not passive bystanders, but actively contribute to nociceptive hypersensitivity in the lumbar spinal cord.",0 +https://doi.org/10.1890/08-0219.1,"Upper respiratory tract disease, force of infection, and effects on survival of gopher tortoises","Upper respiratory tract disease (URTD) caused by Mycoplasma agassizii has been hypothesized to contribute to the decline of some wild populations of gopher tortoises (Gopherus polyphemus). However, the force of infection (FOI) and the effect of URTD on survival in free-ranging tortoise populations remain unknown. Using four years (2003-2006) of mark-recapture and epidemiological data collected from 10 populations of gopher tortoises in central Florida, USA, we estimated the FOI (probability per year of a susceptible tortoise becoming infected) and the effect of URTD (i.e., seropositivity to M. agassizii) on apparent survival rates. Sites with high (> or = 25%) seroprevalence had substantially higher FOI (0.22 +/- 0.03; mean +/- SE) than low (< 25%) seroprevalence sites (0.04 +/- 0.01). Our results provide the first quantitative evidence that the rate of transmission of M. agassizii is directly related to the seroprevalence of the population. Seropositive tortoises had higher apparent survival (0.99 +/- 0.0001) than seronegatives (0.88 +/- 0.03), possibly because seropositive tortoises represent individuals that survived the initial infection, developed chronic disease, and experienced lower mortality during the four-year span of our study. However, two lines of evidence suggested possible effects of mycoplasmal URTD on tortoise survival. First, one plausible model suggested that susceptible (seronegative) tortoises in high seroprevalence sites had lower apparent survival rates than did susceptible tortoises in low seroprevalence sites, indicating a possible acute effect of infection. Second, the number of dead tortoise remains detected during annual site surveys increased significantly with increasing site seroprevalence, from approximately 1 to approximately 5 shell remains per 100 individuals. If (as our results suggest) URTD in fact reduces adult survival, it could adversely influence the population dynamics and persistence of this late- maturing, long-lived species.",0 +https://doi.org/10.1111/j.2044-8260.2011.02021.x,The dynamic interplay between negative and positive emotions in daily life predicts response to treatment in depression: A momentary assessment study,"Although the treatment of depressive illness aims to restore the imbalance between an excess of negative affect (NA) and a shortage of positive affect (PA), no study has examined how NA and PA may influence each other in depression. This study examines how NA and PA dynamically influence each other in depression and how this may impact on treatment response.Depressed help-seeking individuals participated in the Experience Sampling Method (ESM), which enables visualization of subtle dynamic alterations of momentary affective states over time. Thereafter, participants received a combination of antidepressant treatment and psychotherapy, and were followed up each month.NA and PA were assessed during ESM at 10 random moments per day for 6 days. Depressive symptoms were assessed at baseline and at monthly intervals during treatment.Future response to treatment was associated with altered baseline NA-PA dynamics in individuals with previous depressive episodes. Their daily life boosts of PA were followed by a stronger suppression of NA over subsequent hours than in other depressed groups or controls.Subtle individual differences in daily life emotional dynamics predict future treatment outcome in depression.",0 +https://doi.org/10.1002/9781118358887,Basic and Advanced Bayesian Structural Equation Modeling,"This book provides clear instructions to researchers on how to apply Structural Equation Models (SEMs) for analyzing the inter relationships between observed and latent variables. Basic and Advanced Bayesian Structural Equation Modeling introduces basic and advanced SEMs for analyzing various kinds of complex data, such as ordered and unordered categorical data, multilevel data, mixture data, longitudinal data, highly non-normal data, as well as some of their combinations. In addition, Bayesian semiparametric SEMs to capture the true distribution of explanatory latent variables are introduced, whilst SEM with a nonparametric structural equation to assess unspecified functional relationships among latent variables are also explored. Statistical methodologies are developed using the Bayesian approach giving reliable results for small samples and allowing the use of prior information leading to better statistical results. Estimates of the parameters and model comparison statistics are obtained via powerful Markov Chain Monte Carlo methods in statistical computing. Introduces the Bayesian approach to SEMs, including discussion on the selection of prior distributions, and data augmentation. Demonstrates how to utilize the recent powerful tools in statistical computing including, but not limited to, the Gibbs sampler, the Metropolis-Hasting algorithm, and path sampling for producing various statistical results such as Bayesian estimates and Bayesian model comparison statistics in the analysis of basic and advanced SEMs. Discusses the Bayes factor, Deviance Information Criterion (DIC), and $L_\nu$-measure for Bayesian model comparison. Introduces a number of important generalizations of SEMs, including multilevel and mixture SEMs, latent curve models and longitudinal SEMs, semiparametric SEMs and those with various types of discrete data, and nonparametric structural equations. Illustrates how to use the freely available software WinBUGS to produce the results. Provides numerous real examples for illustrating the theoretical concepts and computational procedures that are presented throughout the book. Researchers and advanced level students in statistics, biostatistics, public health, business, education, psychology and social science will benefit from this book. © 2012 John Wiley & Sons, Ltd. All rights reserved.",0 +https://doi.org/10.1111/1467-9868.00384,Posterior bimodality in the balanced one-way random-effects model,"Summary. Although some researchers have examined posterior multimodality for specific richly parameterized models, multimodality is not well characterized for any such model. The paper characterizes bimodality of the joint and marginal posteriors for a conjugate analysis of the balanced one-way random-effects model with a flat prior on the mean. This apparently simple model has surprisingly complex and even bizarre mode behaviour. Bimodality usually arises when the data indicate a much larger between-groups variance than does the prior. We examine an example in detail, present a graphical display for describing bimodality and use real data sets from a statistical practice to shed light on the practical relevance of bimodality for these models.",0 +https://doi.org/10.2307/2983325,League Tables and Their Limitations: Statistical Issues in Comparisons of Institutional Performance,"SUMMARY In the light of an increasing interest in the accountability of public institutions, this paper sets out the statistical issues involved in making quantitative comparisons between institutions in the areas of health and education. We deal in detail with the need to take account of model-based uncertainty in making comparisons. We discuss the need to establish appropriate measures of institutional 'outcomes' and base-line measures and the need to exercise care and sensitivity when interpreting apparent differences. The paper emphasizes that statistical methods exist which can contribute to an understanding of the extent and possible reasons for differences between institutions. It also urges caution by discussing the limitations of such methods.",0 +https://doi.org/10.1111/j.0006-341x.1999.00117.x,A General Maximum Likelihood Analysis of Variance Components in Generalized Linear Models,"This paper describes an EM algorithm for nonparametric maximum likelihood (ML) estimation in generalized linear models with variance component structure. The algorithm provides an alternative analysis to approximate MQL and PQL analyses (McGilchrist and Aisbett, 1991, Biometrical Journal 33, 131-141; Breslow and Clayton, 1993; Journal of the American Statistical Association 88, 9-25; McGilchrist, 1994, Journal of the Royal Statistical Society, Series B 56, 61-69; Goldstein, 1995, Multilevel Statistical Models) and to GEE analyses (Liang and Zeger, 1986, Biometrika 73, 13-22). The algorithm, first given by Hinde and Wood (1987, in Longitudinal Data Analysis, 110-126), is a generalization of that for random effect models for overdispersion in generalized linear models, described in Aitkin (1996, Statistics and Computing 6, 251-262). The algorithm is initially derived as a form of Gaussian quadrature assuming a normal mixing distribution, but with only slight variation it can be used for a completely unknown mixing distribution, giving a straightforward method for the fully nonparametric ML estimation of this distribution. This is of value because the ML estimates of the GLM parameters can be sensitive to the specification of a parametric form for the mixing distribution. The nonparametric analysis can be extended straightforwardly to general random parameter models, with full NPML estimation of the joint distribution of the random parameters. This can produce substantial computational saving compared with full numerical integration over a specified parametric distribution for the random parameters. A simple method is described for obtaining correct standard errors for parameter estimates when using the EM algorithm. Several examples are discussed involving simple variance component and longitudinal models, and small-area estimation.",0 +https://doi.org/10.1002/eat.1016,A randomized trial of a dissonance-based eating disorder prevention program,"As psychoeducational eating disorder prevention programs have not been shown to reduce bulimic pathology, we developed and evaluated a dissonance-based intervention for high-risk populations.Young women (N = 87) with body image concerns were randomized to this intervention, which involves verbal, written, and behavioral exercises requiring them to critique the thin-ideal, or to a healthy weight management control group. Participants completed a baseline, termination, and 4-week follow-up survey.Participants in the dissonance intervention reported decreased thin-ideal internalization, body dissatisfaction, dieting, negative affect, and bulimic symptoms at termination and at 4-week follow-up. Unexpectedly, participants in the healthy weight management control group also reported some benefits.Taken in conjunction with past findings, these preliminary results suggest that the dissonance intervention, and to a lesser extent the healthy weight management intervention, may reduce bulimic pathology and risk factors for eating disturbances.",0 +https://doi.org/10.1016/j.visres.2009.09.021,How do amplitude spectra influence rapid animal detection?,"Amplitude spectra might provide information for natural scene classification. Amplitude does play a role in animal detection because accuracy suffers when amplitude is normalized. However, this effect could be due to an interaction between phase and amplitude, rather than to a loss of amplitude-only information. We used an amplitude-swapping paradigm to establish that animal detection is partly based on an interaction between phase and amplitude. A difference in false alarms for two subsets of our distractor stimuli suggests that the classification of scene environment (man-made versus natural) may also be based on an interaction between phase and amplitude. Examples of interaction between amplitude and phase are discussed.",0 +https://doi.org/10.1111/j.2517-6161.1995.tb02031.x,Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing,"SUMMARY The common approach to the multiplicity problem calls for controlling the familywise error rate (FWER). This approach, though, has faults, and we point out a few. A different approach to problems of multiple significance testing is presented. It calls for controlling the expected proportion of falsely rejected hypotheses -the false discovery rate. This error rate is equivalent to the FWER when all hypotheses are true but is smaller otherwise. Therefore, in problems where the control of the false discovery rate rather than that of the FWER is desired, there is potential for a gain in power. A simple sequential Bonferronitype procedure is proved to control the false discovery rate for independent test statistics, and a simulation study shows that the gain in power is substantial. The use of the new procedure and the appropriateness of the criterion are illustrated with examples.",0 +https://doi.org/10.3102/1076998610396895,Mixed and Mixture Regression Models for Continuous Bounded Responses Using the Beta Distribution,"Doubly bounded continuous data are common in the social and behavioral sciences. Examples include judged probabilities, confidence ratings, derived proportions such as percent time on task, and bounded scale scores. Dependent variables of this kind are often difficult to analyze using normal theory models because their distributions may be quite poorly modeled by the normal distribution. The authors extend the beta-distributed generalized linear model (GLM) proposed in Smithson and Verkuilen (2006) to discrete and continuous mixtures of beta distributions, which enables modeling dependent data structures commonly found in real settings. The authors discuss estimation using both deterministic marginal maximum likelihood and stochastic Markov chain Monte Carlo (MCMC) methods. The results are illustrated using three data sets from cognitive psychology experiments.",0 +https://doi.org/10.1177/0003122416632212,The Theory of Legal Cynicism and Sunni Insurgent Violence in Post-Invasion Iraq,"We elaborate a cultural framing theory of legal cynicism—previously used to account for neighborhood variation in Chicago homicides—to explain Arab Sunni victimization and insurgent attacks during the U.S. post-invasion occupation of Iraq. Legal cynicism theory has an unrecognized power to explain collective and interpersonal violence in international as well as U.S. settings. We expand on how “double and linked” roles of state and non-state actors can be used to analyze violence against Arab Sunni civilians. Arab Sunnis responded to reports of unnecessary violent attacks by U.S./Coalition soldiers with a legally cynical framing of the U.S./Coalition-led invasion and occupation, the new Shia-dominated Iraqi state, and its military and police. A post-invasion frame amplification of beliefs about state-based illegitimacy, unresponsiveness, and insecurity made it not only possible but predictable that Arab Sunni insurgent attacks would continue against U.S./Coalition forces and transfer to Shia-dominated Iraqi government forces. Violence in Iraq persisted despite U.S. surge efforts to end the Arab Sunni insurgency.",0 +https://doi.org/10.1007/978-3-642-20074-8_3,Computerized Adaptive Testing in Computer Assisted Learning?,"AbstractA major goal in computerized learning systems is to optimize learning, while in computerized adaptive tests (CAT) efficient measurement of the proficiency of students is the main focus. There seems to be a common interest to integrate computerized adaptive item selection in learning systems and testing. Item selection is a well founded building block of CAT. However, there are a number of problems that prevent the application of a standard approach, based on item response theory, of computerized adaptive item selection to learning systems. In this work attention will be paid to three unresolved points: item banking, item selection, and choice of IRT model. All problems will be discussed, and an approach to automated item bank generation is presented. Finally some recommendations are given.Keywordsitem-based computer assisted learningcomputer adaptive testingitem bankingitem response theoryitem selection",0 +https://doi.org/10.1086/680171,Do Attitudes toward School Influence the Underachievement of Turkish and Moroccan Minority Students in Flanders? The Attitude-Achievement Paradox Revisited,"While many ethnic minority students underachieve compared with their ethnic majority peers, they often hold very positive school attitudes. Mickelson (1990) explained this attitude-achievement paradox by the existence of a double set of attitudes. Abstract attitudes reflect the dominant ideas about schooling, while concrete attitudes refer to a person’s perceptions of reality and originate from the educational benefits people expect to obtain on the labor market. According to Mickelson, only students’ concrete attitudes influence achievement. Applying Mickelson’s theory in Flanders, regarding students of Turkish and Moroccan descent, we could not find evidence that abstract and concrete attitudes play a role in the achievement of ethnic minority students. Qualitative research suggests that this could be due to distinct interpretations of success and ways of dealing with perceived constraints. This contrasts with ethnic majority students, who are more likely to end the school year unsuccessfully if they hold pessimistic concrete attitudes.",0 +https://doi.org/10.1590/s0103-90162011000200015,Bayesian analysis of autoregressive panel data model: application in genetic evaluation of beef cattle,"The animal breeding values forecasting at futures times is a relevant technological innovation in the field of Animal Science, since its enables a previous indication of animals that will be either kept by the producer for breeding purposes or discarded. This study discusses an MCMC Bayesian methodology applied to panel data in a time series context. We consider Bayesian analysis of an autoregressive, AR(p), panel data model of order p, using an exact likelihood function, comparative analysis of prior distributions and predictive distributions of future observations. The methodology was tested by a simulation study using three priors: hierarchical Multivariate Normal-Inverse Gamma (model 1), independent Multivariate Student's t Inverse Gamma (model 2) and Jeffrey's (model 3). Comparisons by Pseudo-Bayes Factor favored model 2. The proposed methodology was applied to longitudinal data relative to Expected Progeny Difference (EPD) of beef cattle sires. The forecast efficiency was around 80%. Regarding the mean width of the EPD interval estimation (95%) in a future time, a great advantage was observed for the proposed Bayesian methodology over usual asymptotic frequentist method.",0 +https://doi.org/10.1037/met0000028,Meaningful aspects of change as novel random coefficients: A general method for reparameterizing longitudinal models.,"A fundamental goal of longitudinal modeling is to obtain estimates of model parameters that reflect meaningful aspects of change over time. Often, a linear or nonlinear model may be sensible from a theoretical perspective, yet may have parameters that are difficult to interpret in a way that sheds light on substantive hypotheses. Fortunately, such models may be reparameterized to yield more easily interpretable parameters. This article has 3 goals. First, we provide theoretical background and elaboration on Preacher and Hancock's (2012) 4-step method for reparameterizing growth curve models. Second, we extend this method by providing a user-friendly modification of the structured latent curve model in the third step that enables fitting models that are not estimable with the original method. This modification also allows researchers to specify the mean structure without having to determine which parameters enter nonlinearly and without needing to solve complex matrix expressions. Third, we illustrate how this general reparameterization method allows researchers to treat the average rate of change, half-life, and knot (transition point) as random coefficients; these aspects of change have not before been treated as random coefficients in structural equation modeling. We supply Mplus code for illustrative examples in an online supplement. Our core message is that growth curve models are considerably more flexible than most researchers may suspect. Virtually any parameter can be treated as a random coefficient that varies across individuals. Alternative parameterizations of a given model may yield unique insights that are not available with traditional parameterizations.",0 +https://doi.org/10.1371/journal.pone.0129293,Advanced Insights into Functional Brain Connectivity by Combining Tensor Decomposition and Partial Directed Coherence,"Quantification of functional connectivity in physiological networks is frequently performed by means of time-variant partial directed coherence (tvPDC), based on time-variant multivariate autoregressive models. The principle advantage of tvPDC lies in the combination of directionality, time variance and frequency selectivity simultaneously, offering a more differentiated view into complex brain networks. Yet the advantages specific to tvPDC also cause a large number of results, leading to serious problems in interpretability. To counter this issue, we propose the decomposition of multi-dimensional tvPDC results into a sum of rank-1 outer products. This leads to a data condensation which enables an advanced interpretation of results. Furthermore it is thereby possible to uncover inherent interaction patterns of induced neuronal subsystems by limiting the decomposition to several relevant channels, while retaining the global influence determined by the preceding multivariate AR estimation and tvPDC calculation of the entire scalp. Finally a comparison between several subjects is considerably easier, as individual tvPDC results are summarized within a comprehensive model equipped with subject-specific loading coefficients. A proof-of-principle of the approach is provided by means of simulated data; EEG data of an experiment concerning visual evoked potentials are used to demonstrate the applicability to real data.",0 +https://doi.org/10.1002/sim.1113,"Estimation of bivariate measurements having different change points, with application to cognitive ageing","Longitudinal studies of ageing make repeated observations of multiple measurements on each subject. Change point models are often used to model longitudinal data. We demonstrate the use of Bayesian and profile likelihood methods to simultaneously estimate different change points in the longitudinal course of two different measurements of cognitive function in subjects in the Bronx Aging Study who developed Alzheimer's disease (AD). Analyses show that accelerated memory decline, as measured by Buschke Selective Reminding, begins between seven and eight years before diagnosis of AD, while decline in performance on speeded tasks as measured by WAIS Performance IQ begins slightly more than two years before diagnosis, significantly after the decline in memory.",0 +https://doi.org/10.1177/0962280207088026,Optimal Designs for Empirical Bayes Estimators of Individual Linear and Quadratic Growth Curves in Linear Mixed Models,"Many studies on optimal designs for linear mixed model analysis of repeated measures data have focussed on estimating the fixed effects. The present study investigates the optimal number of time points and subjects in case random effects have to be estimated. Linear mixed models with a linear or quadratic trend across equidistant time points are studied. Given a particular cost function, we examine which designs minimise the expected average squared prediction error. Robustness of the optimal design, important when one does not know the underlying model, is also treated.",0 +https://doi.org/10.3389/fpsyg.2015.00615,The benefits of looking at intraindividual dynamics in cognitive training data.,"Over the last decade, the prospect of improving or maintaining cognitive functioning has provoked a steadily increasing number of cognitive training studies. Central target populations are individuals at risk for a disadvantageous development, such as older adults exhibiting cognitive decline or children with learning impairments. They rely on cognitive resources to meet the challenges of an independent life in old age or requirements at school. To support daily cognitive functioning, training outcomes need to generalize to other cognitive abilities. Such transfer effects are, however, highly discussed. For example, recent meta-analyses on working memory training differed in the conclusion on the presence (Au et al., 2015; Karbach and Verhaeghen, 2014) or absence of transfer effects (Melby-Lervag and Hulme, 2013). Usually training-specific design factors such as type, intensity, duration, and feedback routines are discussed as reasons for such inconsistent findings. However, even individuals participating in exactly the same training regime highly differ in their training outcomes. We argue that it is time to study the individual development during trainings to understand these differential outcomes. It is time to have a closer look at the intraindividual training data.",0 +https://doi.org/10.1111/j.1467-985x.2011.00685.x,Assessing variance components in multilevel linear models using approximate Bayes factors: a case-study of ethnic disparities in birth weight,"Racial/ethnic disparities in birthweight are a large source of differential morbidity and mortality worldwide and have remained largely unexplained in epidemiologic models. We assess the impact of maternal ancestry and census tract residence on infant birth weights in New York City and the modifying effects of race and nativity by incorporating random effects in a multilevel linear model. Evaluating the significance of these predictors involves the test of whether the variances of the random effects are equal to zero. This is problematic because the null hypothesis lies on the boundary of the parameter space. We generalize an approach for assessing random effects in the two-level linear model to a broader class of multilevel linear models by scaling the random effects to the residual variance and introducing parameters that control the relative contribution of the random effects. After integrating over the random effects and variance components, the resulting integrals needed to calculate the Bayes factor can be efficiently approximated with Laplace's method.",0 +https://doi.org/10.1016/j.jmva.2012.11.010,Bayesian modeling of the dependence in longitudinal data via partial autocorrelations and marginal variances,"Many parameters and positive-definiteness are two major obstacles in estimating and modelling a correlation matrix for longitudinal data. In addition, when longitudinal data is incomplete, incorrectly modelling the correlation matrix often results in bias in estimating mean regression parameters. In this paper, we introduce a flexible and parsimonious class of regression models for a covariance matrix parameterized using marginal variances and partial autocorrelations. The partial autocorrelations can freely vary in the interval (-1, 1) while maintaining positive definiteness of the correlation matrix so the regression parameters in these models will have no constraints. We propose a class of priors for the regression coefficients and examine the importance of correctly modeling the correlation structure on estimation of longitudinal (mean) trajectories and the performance of the DIC in choosing the correct correlation model via simulations. The regression approach is illustrated on data from a longitudinal clinical trial.",0 +https://doi.org/10.1007/978-1-4939-2104-1_42,A Review of Multilevel Modeling: Some Methodological Issues and Advances,"Multilevel modeling is a recently new class of statistical methods to handle nested data. Mainly thanks to the wide range of applicability and the great increase of statistical softwares, in the last decades multilevel modeling has enjoyed an explosion of published papers and books in both methodological and application field. Currently, there is a need to not only develop the research on multilevel approach for the analysis of complex data, but also to have instructions to properly address the usage. This work aims at summarizing methodological aspects related to multilevel models, illustrating good-practices, advantages, and limits by reviewing applications in various fields, such as socio-economic, educational, health, and medical sciences. We further focus our attention on the latest advances of multilevel modeling towards, e.g., the inclusion of latent variables and the Bayesian approach.",0 +https://doi.org/10.2202/1557-4679.1350,Meta-Analysis of Observational Studies with Unmeasured Confounders,"Meta-analysis of observational studies is an exciting new area of innovation in statistical science. Unlike randomized controlled trials, which are the gold standard for proving causation, observational studies are prone to biases including confounding. In this article, we describe a novel Bayesian procedure to control for a confounder that is missing across the sequence of studies in a meta-analysis. We motivate the discussion with the example of a meta-analysis of cohort, case-control and cross-sectional studies examining the relationship between oral contraceptives and endometriosis. An important unmeasured confounder is dysmennoreah, which is an indication for oral contraceptive use. To adjust for unmeasured confounding, we combine random effects models with probabilistic sensitivity analysis techniques. Information about the unmeasured confounder is incorporated into the analysis via prior distributions, and we use MCMC to sample from posterior.",0 +https://doi.org/10.1016/j.electstud.2016.01.008,Strange bedfellows: Coalition makeup and perceptions of democratic performance among electoral winners,"We argue that the partisan makeup of governing coalitions affects perceptions of democratic performance among those who voted for a government party. We introduce ambivalence toward the governing parties as the mechanism that drives this relationship, and we argue that such ambivalence, which occurs when favorability ratings of the parties vary, will be more common where the parties are more ideologically diverse. After advancing our theory, we test our expectations with post-election survey data from several countries. Evidence demonstrates that coalition ambivalence is greater where governing parties are ideologically divergent, and, even when controlling for this ideological divergence, ambivalence leads to more negative perceptions of democratic performance, bringing the attitudes of electoral winners closer to those of individuals who did not vote for a party in government.",0 +https://doi.org/10.1177/0049124194022003002,Hierarchical Regression Models for Interviewer and Respondent Effects,"It is generally recognized that interviewers may have an important effect on the quality of the data collected in survey research. This article presents an application of the hierarchical regression model in the analysis of interviewer effects. The hierarchical regression model offers an elegant way of analyzing the simultaneous effects of specific interviewer and respondent characteristics. It is especially attractive if the research design does not provide for a random assignment of respondents to interviewers, because it allows the researcher to use statistical rather than experimental control by modeling the interviewer effects conditional on the respondent effects.",0 +https://doi.org/10.1161/circgenetics.113.000299,Analysis of Circulating Cholesterol Levels as a Mediator of an Association Between ABO Blood Group and Coronary Heart Disease,"Background— Non-O type of ABO blood group has been associated with a predisposition to coronary heart disease. It is thought that this association is partly mediated by increased cholesterol levels in non–O-type individuals. In this study, we sought to estimate the mediation effect size. Methods and Results— In a group of individuals (n=6476) undergoing coronary angiography, we detected associations of non-O type with significant coronary artery disease with >50% stenosis in ≥1 coronary arteries (odds ratio, 1.24; 95% confidence interval, 1.10–1.39; P =2.6×10 −4 ) and with prevalent or incident myocardial infarction (odds ratio, 1.22; 95% confidence interval, 1.09–1.37; P =1.2×10 −3 ). Subjects of non-O type had higher levels of total cholesterol, low-density lipoprotein cholesterol, and non–high-density lipoprotein cholesterol (mean [SEM] in mmol/L: 4.931[0.021], 3.041 [0.018], and 3.805 [0.020] in non-O type compared with 4.778 [0.026], 2.906 [0.021], and 3.669 [0.024] in O type; P =3.8×10 −7 , P =1.5×10 −7 , and P =3.1×10 −7 , respectively). Mediation analyses indicated that 10% of the effect of non-O type on coronary artery disease susceptibility was mediated by increased low-density lipoprotein cholesterol level ( P =7.8×10 −4 ) and that 11% of the effect of non-O type on myocardial infarction risk was mediated by raised low-density lipoprotein cholesterol level ( P =2.0×10 −3 ). Conclusions— In a model in which it is presumed that cholesterol is a mediator of the associations of ABO group with coronary artery disease and myocardial infarction, around 10% of the effect of non-O type on coronary artery disease and myocardial infarction susceptibility was mediated by its influence on low-density lipoprotein cholesterol level.",0 +https://doi.org/10.1079/9780851990002.0235,Estimation of genetic parameters.,,0 +https://doi.org/10.1111/j.1460-9568.2005.04470.x,"An initial investigation of spinal mechanisms underlying pain enhancement induced by fractalkine, a neuronally released chemokine","Fractalkine is a chemokine that is tethered to the extracellular surface of neurons. Fractalkine can be released, forming a diffusible signal. Spinal fractalkine (CX3CL1) is expressed by sensory afferents and intrinsic neurons, whereas its receptor (CX3CR1) is predominantly expressed by microglia. Pain enhancement occurs in response both to intrathecally administered fractalkine and to spinal fractalkine endogenously released by peripheral neuropathy. The present experiments examine whether fractalkine-induced pain enhancement is altered by a microglial inhibitor (minocycline) and/or by antagonists/inhibitors of three putative glial products implicated in pain enhancement: interleukin-1 (IL1), interleukin-6 (IL6) and nitric oxide (NO). In addition, it extends a prior study that demonstrated that intrathecal fractalkine-induced mechanical allodynia is blocked by a neutralizing antibody to the rat fractalkine receptor, CX3CR1. Here, intrathecal anti-CX3CR1 also blocked fractalkine-induced thermal hyperalgesia. Furthermore, blockade of microglial activation with minocycline prevented both fractalkine-induced mechanical allodynia (von Frey test) and thermal hyperalgesia (Hargreaves test). Microglial activation appears to lead to the release of IL1, given that pretreatment with IL1 receptor antagonist blocked both fractalkine-induced mechanical allodynia and thermal hyperalgesia. IL1 is not the only proinflammatory cytokine implicated, as a neutralizing antibody to rat IL6 also blocked fractalkine-induced pain facilitation. Lastly, NO appears to be importantly involved, as l-NAME, a broad-spectrum NO synthase inhibitor, also blocked fractalkine-induced effects. Taken together, these data support that neuronally released fractalkine enhances pain via activation of spinal cord glia. Thus, fractalkine may be a neuron-to-glia signal triggering pain facilitation.",0 +https://doi.org/10.1016/j.jspi.2005.01.002,Complex elliptical distributions with application to shape analysis,"We introduce a general class of complex elliptical distributions on a complex sphere that includes many of the most commonly used distributions, like the complex Watson, Bingham, angular central Gaussian and several others. We study properties of this family of distributions and apply the distribution theory for modeling shapes in two dimensions. We develop maximum likelihood and Bayesian methods of estimation to describe shape and obtain confidence bounds and credible regions for shapes. The methodology is illustrated through an example where estimation of shape of mouse vertebrae is desired.",0 +https://doi.org/10.1037/1082-989x.12.4.434,Allowing for correlations between correlations in random-effects meta-analysis of correlation matrices.,"Practical meta-analysis of correlation matrices generally ignores covariances (and hence correlations) between correlation estimates. The authors consider various methods for allowing for covariances, including generalized least squares, maximum marginal likelihood, and Bayesian approaches, illustrated using a 6-dimensional response in a series of psychological studies concerning prediction of exercise behavior change. Quantities of interest include the overall population mean correlation matrix, the contrast between the mean correlations, the predicted correlation matrix in a new study, and the conflict between the existing studies and a new correlation matrix. The authors conclude that accounting for correlations between correlations is unnecessary when interested in individual correlations but potentially important if concerned with a composite measure involving 2 or more correlations. A simulation study indicates the asymptotic normal assumption appears reasonable. Because of potential instability in the generalized least squares methods, they recommend a model-based approach, either the maximum marginal likelihood approach or a full Bayesian analysis.",0 +https://doi.org/10.1177/0146621615591094,Detecting Intervention Effects in a Cluster-Randomized Design Using Multilevel Structural Equation Modeling for Binary Responses,"Multilevel modeling (MLM) is frequently used to detect group differences, such as an intervention effect in a pre-test–post-test cluster-randomized design. Group differences on the post-test scores are detected by controlling for pre-test scores as a proxy variable for unobserved factors that predict future attributes. The pre-test and post-test scores that are most often used in MLM are summed item responses (or total scores). In prior research, there have been concerns regarding measurement error in the use of total scores in using MLM. To correct for measurement error in the covariate and outcome, a theoretical justification for the use of multilevel structural equation modeling (MSEM) has been established. However, MSEM for binary responses has not been widely applied to detect intervention effects (group differences) in intervention studies. In this article, the use of MSEM for intervention studies is demonstrated and the performance of MSEM is evaluated via a simulation study. Furthermore, the consequences of using MLM instead of MSEM are shown in detecting group differences. Results of the simulation study showed that MSEM performed adequately as the number of clusters, cluster size, and intraclass correlation increased and outperformed MLM for the detection of group differences.",0 +https://doi.org/10.1002/sim.4780121802,Reporting bayesian analyses of clinical trials,"Many clinicians wrongly interpret p-values as probabilities that treatment has an adverse effect and confidence intervals as probability intervals. Such inferences can be validly drawn from Bayesian analyses of trial results. These analyses use the data to update the prior (or pre-trial) beliefs to give posterior (or post-trial) beliefs about the magnitude of a treatment effect. However, for these methods to gain acceptance in the medical literature, understanding between statisticians and clinicians of the issues involved in choosing appropriate prior distributions for trial reporting needs to be reached. I focus on two types of prior that deserve consideration. The first is the non-informative prior giving standardized likelihood distributions as post-trial probability distributions. Their use is unlikely to be controversial among statisticians whilst being intuitively appealing to clinicians. The second type of prior has a spike of probability mass at the point of no treatment effect. Varying the magnitude of the spike illustrates the sensitivity of the conclusions drawn to the degree of prior scepticism in a treatment effect. With both, graphical displays provide clinical readers with the opportunity to explore the results more fully. An example of how a clinical trial might be reported in the medical literature using these methods is given.",0 +https://doi.org/10.1348/014466603322595248,Acting on intentions: The role of anticipated regret,"Three studies tested the hypothesis that anticipated regret (AR) increases consistency between exercise intentions and behaviour. Study 1 employed a longitudinal survey design (N = 384). Measures specified by the theory of planned behaviour, past behaviour, and AR were used to predict self-reported exercise behaviour 2 weeks later. AR moderated the intention-behaviour relationship such that participants were most likely to exercise if they both intended to exercise and anticipated regret if they failed to exercise. Study 2 used an experimental design to examine the effect of focusing on AR prior to reporting intentions (N = 229). Exercise was measured 2 weeks later and the AR-focus manipulation was found to moderate the intention-behaviour relationship in a similar manner to that observed in Study 1. In Study 3 (N = 97), moderation was replicated and was shown to be mediated by the temporal stability of intention.",0 +https://doi.org/10.1002/sim.2575,Bayesian meta-analysis and meta-regression for gene–disease associations and deviations from Hardy–Weinberg equilibrium,"Violation of Hardy–Weinberg equilibrium (HWE) can raise doubts about the validity of the conclusions from genetic association studies. However, for most currently performed gene–disease association studies, the available tests have low power to detect deviations from HWE. We consider this issue from a meta-analysis perspective, and suggest an approach to estimate the deviation and investigate its relationship with the observed genetic effects. Different degrees of deviation from HWE have previously been proposed as a potential source of heterogeneity across studies. We present a hierarchical meta-regression model that can be applied to test this assumption, using the concept of the fixation coefficient. We re-analyse seven meta-analyses to illustrate these methods. The uncertainty in the genetic effect estimate tended to increase once the fixation coefficient was taken into account. Dependence of the genetic effect size on the deviation from HWE was found in one meta-analysis, while in the other six examples, deviations from HWE did not clearly explain between-study heterogeneity in the genetic effects. The proposed hierarchical models allow the synthesis of data across gene–disease association studies with appropriate consideration of HWE issues. Copyright © 2006 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1080/10705510902751275,Bayesian Analysis of Multivariate Latent Curve Models With Nonlinear Longitudinal Latent Effects,"In longitudinal studies, investigators often measure multiple variables at multiple time points and are interested in investigating individual differences in patterns of change on those variables. Furthermore, in behavioral, social, psychological, and medical research, investigators often deal with latent variables that cannot be observed directly and should be measured by 2 or more manifest variables. Longitudinal latent variables occur when the corresponding manifest variables are measured at multiple time points. Our primary interests are in studying the dynamic change of longitudinal latent variables and exploring the possible interactive effect among the latent variables.Much of the existing research in longitudinal studies focuses on studying change in a single observed variable at different time points. In this article, we propose a novel latent curve model (LCM) for studying the dynamic change of multivariate manifest and latent variables and their linear and interaction relationships. The proposed LCM has the following useful features: First, it can handle multivariate variables for exploring the dynamic change of their relationships, whereas conventional LCMs usually consider change in a univariate variable. Second, it accommodates both first- and second-order latent variables and their interactions to explore how changes in latent attributes interact to produce a joint effect on the growth of an outcome variable. Third, it accommodates both continuous and ordered categorical data, and missing data.",0 +https://doi.org/10.1016/s0197-2456(96)00043-8,Comments on Bayesian and frequentist analysis and interpretation of clinical trials,"In this commentary I will advance opinions about the role and usefulness of Bayesian statistical methods in randomized clinical trials (RCTs). This commentary deals with RCTs to establish the efficacy of a treatment-what are often categorized as phase III trials in the U.S. Food and Drug Administration (FDA) regulatory setting. Both frequentist and Bayesian trial designs represent “moving targets”; furthermore, the meaning of frequentist or Bayesian methods has different meanings to different individuals. I shall use the term Bayesian here to refer to methods that use the subjective probability assessments of individuals (often based on considerable data). Thus I will not be speaking to any proposals that would (1) use empirical Bayes prior distributions or (2) use standardized diffuse, improper, minimum information or “noninformative” prior distributions. Such methods of analysis I will call “stylized Bayesian methods” and will address briefly at the end of this commentary. Savage [ll presents a compelling argument that humans should behave in a Bayesian fashion unless (when forced to make bets) one wants to be in a losing position for every possible true state of affairs (i.e., a “state of nature”). Such Bayesian behavior is “coherent“ in Savage’s terminology. Otherwise behavior is “incoherent.” The psychological literature (which is referenced somewhat in the following) refers to “normative” behavior. Here normative means “of, relating or conforming to, or prescribing norms or standards” [21. For reasoning involving probabilities the norm used is that of the usual calculus of probability. In a situation with prior distributions the norm involves an appropriate use of Bayes’s theorem. Speck, quoted above, apparently does not believe that humans follow this normative behavior.",0 +https://doi.org/10.1016/s0167-7152(00)00182-6,On the propriety of a modified Jeffreys's prior for variance components in binary random effects models,"This paper proves that a modified Jeffreys's prior on the variance components in binary random effects models is integrable under mild conditions on the link function. These conditions are shown to be satisfied for two commonly used link functions, the logit and probit functions.",0 +https://doi.org/10.1186/2046-4053-1-61,Pharmacologic interventions for painful diabetic neuropathy: an umbrella systematic review and comparative effectiveness network meta-analysis (Protocol),"Neuropathic pain can reduce the quality of life and independence of 30% to 50% of patients with diabetes. The comparative effectiveness of analgesics for patients with diabetic neuropathy remains unclear. The aim of the current work, therefore, was to summarize the evidence about the analgesic effectiveness of the most common oral and topical agents used for the treatment of peripheral diabetic neuropathy.We will use an umbrella approach (systematic review of systematic reviews) to identify eligible randomized controlled trials (RCTs) for the most common oral or topical analgesics for painful diabetic neuropathy. Two reviewers will independently determine RCT eligibility. Disagreement will be solved by consensus and arbitrated by a third reviewer. We will extract descriptive, methodological and efficacy data in duplicate. Results will be pooled and analyzed using classic random-effects meta-analyses and network meta-analyses to compute the absolute and relative efficacy of therapeutic options. We will use the I2 statistic and Cochran's Q test to assess heterogeneity. Risk of bias and publication bias, if appropriate, will be evaluated, as well as overall strength of the evidence.This network meta-analysis aims to synthesize available direct and indirect evidence of effectiveness of analgesics in the treatment of painful diabetic neuropathy. The network approach will offer the opportunity to generate a ranking based on efficacy and along with known side effects, costs, and administration burdens will enable patients and clinicians to make choices that best reflect their preferences for treatment of painful diabetic neuropathy.",0 +https://doi.org/10.2307/2095413,Does Arrest Really Deter Wife Battery? An Effort to Replicate the Findings of the Minneapolis Spouse Abuse Experiment,"In this paper we try to replicate the findings from the Minneapolis Spouse Abuse Experiment (Sherman and Berk, 1984). Using longitudinal data from the criminal justice system on 783 wife-battery incidents, an ex post factor design coupled with a propensity-score analysis reveals that arrests substantially reduce the number of new incidents of wife battery. In addition, the reductions are greatest for batterers whom the police would ordinarily be especially inclined to arrest. Policy and theoretical implications are discussed. (abstract Adapted from Source: American Sociological Review, 1985. Copyright © 1985 by the American Sociological Association) Domestic Violence Intervention Arrest Effects Domestic Violence Offender Spouse Abuse Offender Spouse Abuse Intervention Deterrence Male Offender Male Violence Adult Male Adult Offender Adult Violence Law Enforcement Intervention Offender Arrest Violence Against Women Partner Violence California Replication Studies 11-01",0 +https://doi.org/10.1177/0020715215587772,Work experience during higher education and post-graduation occupational outcomes: A comparative study on four European countries,"This article examines the relationship between work experience acquired during higher education and post-graduation labour market outcomes in four European countries: Germany, Italy, Norway and Spain. A theoretical framework that shows in which institutional contexts work experience may be a ‘competitive advantage’ for young graduates is developed. In the empirical analysis, data from the Higher Education and Graduate Employment in Europe (CHEERS) and Research into Employment and Professional Flexibility (REFLEX) surveys are used to examine the effect of a typology of student employment (accounting for both length and coherence of work experience with the field of study attended) on several occupational outcomes 4–5 years after graduation. The empirical results show that, in Italy and especially in Spain, work activities during tertiary education are associated with better labour market positions after graduation: any type of work experience increases employability and reduces the risk of unemployment, and furthermore, previous work experience – especially when coherent with the field of study – decreases the probability of skill mismatch in future occupations. The effect of student employment, however, is smaller for most outcomes in Germany and negligible in Norway.",0 +https://doi.org/10.1016/s0169-7161(06)26021-8,21 Assessing the Fit of Item Response Theory Models,"Publisher Summary Item response theory (IRT) provides a framework for modeling and analyzing item response data. Assessing IRT model fit to item response data is one of the crucial steps before an IRT model can be applied with confidence to estimate proficiency or ability levels of examinees, to link tests across administrations, and to assess adequate yearly progress. Assessing model fit is an important part of the test validation process. It is multifaceted and, as in the verification of any scientific theory, it is an ongoing process where only through the accumulation of empirical evidence can one be confident of the appropriateness of IRT for the solution of a particular measurement problem. The procedures for assessing model–data fit described in this chapter have the potential for addressing the vexing problem of determining if the measurement procedures used are appropriate for addressing the practical measurement problems faced by practitioners.",0 +https://doi.org/10.1007/s004170000243,An explicit no response instead of time-out in automated visual-field testing,"Background: To evaluate the effect of response-acquisition technique on psychometric performance in visual-field testing, the conventional one-button yes/time-out method was compared with a two-button yes/no method for responding whether or not the stimulus was detected. There are a number of situations in which the single-button technique leads to ambiguous results. In this study, we thus expected the yes/no method to reduce tendencies towards habituation and automatic responding. Our hypothesis was that the two-button technique could reduce the rate of erroneous responses. Methods: Luminance-difference sensitivity for bright stimuli (32′) on a photopic background was evaluated at 26 locations within the central visual field (30°) using a specially equalised video display unit and a modified 4/2-dB staircase strategy (six reversals, maximum-likelihood threshold estimation). Sixty-one ophthalmologically normal subjects (aged 20-30 years) were examined twice with each method. Results: Mean sensitivities with the two-button yes/no method were found to be, on average, 0.13 dB above those measured with the one-button yes/time-out technique - a difference without clinical relevance. Within-subject variability did not differ between the two methods. However, the less intuitive two-button yes/no method had a slightly higher number of false responses in catch trials. Conclusion: Compared to the conventional one-button yes/time-out method, the two-button yes/no method in normal young subjects thus showed little difference in mean sensitivities and equivalent within-subject variabilities. Concerning our initial hypothesis, the yes/no method is of somewhat higher complexity and is not able to reduce the rate of erroneous responses. The one-button yes/time-out method fared a little better in error rate. In summary, the yes/no method is an alternative and additional possibility of response acquisition in visual-field testing, which is worthy of being tested in a clinical study with elderly subjects.",0 +https://doi.org/10.1121/1.4757740,Bayesian three-dimensional reconstruction of toothed whale trajectories: Passive acoustics assisted with visual and tagging measurements,The author describes and evaluates a Bayesian method to reconstruct three-dimensional toothed whale trajectories from a series of echolocation signals. Localization by using passive acoustic data (time of arrival of source signals at receptors) is assisted by using visual data (coordinates of the whale when diving and resurfacing) and tag information (movement statistics). The efficiency of the Bayesian method is compared to the standard minimum mean squared error statistical approach by comparing the reconstruction results of 48 simulated sperm whale (Physeter macrocephalus) trajectories. The use of the advanced Bayesian method reduces bias (standard deviation) with respect to the standard method up to a factor of 8.9 (13.6). The author provides open-source software which is functional with acoustic data which would be collected in the field from any three-dimensional receptor array design. This approach renews passive acoustics as a valuable tool to study the underwater behavior of toothed whales.,0 +https://doi.org/10.1186/s12874-016-0130-6,Mechanisms and mediation in survival analysis: towards an integrated analytical framework,"A wide-ranging debate has taken place in recent years on mediation analysis and causal modelling, raising profound theoretical, philosophical and methodological questions. The authors build on the results of these discussions to work towards an integrated approach to the analysis of research questions that situate survival outcomes in relation to complex causal pathways with multiple mediators. The background to this contribution is the increasingly urgent need for policy-relevant research on the nature of inequalities in health and healthcare.The authors begin by summarising debates on causal inference, mediated effects and statistical models, showing that these three strands of research have powerful synergies. They review a range of approaches which seek to extend existing survival models to obtain valid estimates of mediation effects. They then argue for an alternative strategy, which involves integrating survival outcomes within Structural Equation Models via the discrete-time survival model. This approach can provide an integrated framework for studying mediation effects in relation to survival outcomes, an issue of great relevance in applied health research. The authors provide an example of how these techniques can be used to explore whether the social class position of patients has a significant indirect effect on the hazard of death from colon cancer.The results suggest that the indirect effects of social class on survival are substantial and negative (-0.23 overall). In addition to the substantial direct effect of this variable (-0.60), its indirect effects account for more than one quarter of the total effect. The two main pathways for this indirect effect, via emergency admission (-0.12), on the one hand, and hospital caseload, on the other, (-0.10) are of similar size.The discrete-time survival model provides an attractive way of integrating time-to-event data within the field of Structural Equation Modelling. The authors demonstrate the efficacy of this approach in identifying complex causal pathways that mediate the effects of a socio-economic baseline covariate on the hazard of death from colon cancer. The results show that this approach has the potential to shed light on a class of research questions which is of particular relevance in health research.",0 +https://doi.org/10.1177/1094428115588570,Multilevel Latent Polynomial Regression for Modeling (In)Congruence Across Organizational Groups,"This article addresses (in)congruence across different kinds of organizational respondents or “organizational groups”—such as managers versus non-managers or women versus men—and the effects of congruence on organizational outcomes. We introduce a novel multilevel latent polynomial regression model (MLPM) that treats standings of organizational groups as latent “random intercepts” at the organization level while subjecting these to latent interactions that enable response surface modeling to test congruence hypotheses. We focus on the case of organizational culture research, which usually samples managers and excludes non-managers. Reanalyzing data from 67 hospitals with 6,731 managers and non-managers, we find that non-managers perceive their organizations’ cultures as less humanistic and innovative and more controlling than managers, and we find that less congruence between managers and non-managers in these perceptions is associated with lower levels of quality improvement in organizations. Our results call into question the validity of findings from organizational culture and other research that tends to sample one organizational group to the exclusion of others. We discuss our findings and the MLPM, which can be extended to estimate latent interactions for tests of multilevel moderation/interactions.",0 +https://doi.org/10.1007/bf02296339,Bayesian factor analysis for multilevel binary observations,"Multilevel covariance structure models have become increasingly popular in the psychometric literature in the past few years to account for population heterogeneity and complex study designs. We develop practical simulation based procedures for Bayesian inference of multilevel binary factor analysis models. We illustrate how Markov Chain Monte Carlo procedures such as Gibbs sampling and Metropolis-Hastings methods can be used to perform Bayesian inference, model checking and model comparison without the need for multidimensional numerical integration. We illustrate the proposed estimation methods using three simulation studies and an application involving student's achievement results in different areas of mathematics.",0 +https://doi.org/10.1080/03610739208253917,Modeling incomplete longitudinal and cross-sectional data using latent growth structural models,"In this paper we describe some mathematical and statistical models for identifying and dealing with changes over age. We concentrate specifically on the use of a latent growth structural equation model approach to deal with issues of: (1) latent growth models of change, (2) differences in longitudinal and cross-sectional results, and (3) differences due to longitudinal attrition. This is a methodological paper using simulated data, but we base our models on practical and conceptual principles of modeling change in developmental psychology. Our results illustrate both benefits and limitations using structural models to analyze incomplete longitudinal data.",0 +https://doi.org/10.1016/s0191-8869(99)00251-2,Working memory capacity — facets of a cognitive ability construct,"Abstract Working memory capacity is differentiated theoretically along two dimensions: contents and functions. The resulting 3×3 matrix was operationalized by 23 tasks sampled from the literature. Data for these tasks from 128 participants were analyzed by exploratory and confirmatory factor analysis. Regarding the content facet, spatial working memory was clearly distinct from the other two content categories. A distinction between verbal and numerical working memory was not warranted. On the functional dimension the postulated categories of simultaneous storage and transformation and of coordination could not be separated. The third category was clearly separate from the first two functions. This factor could be interpreted to reflect a mixture of variance due to mental speed and to supervisory functions of the central executive.",0 +https://doi.org/10.1037/a0029801,Extracting the truth from conflicting eyewitness reports: A formal modeling approach.,"Eyewitnesses often report details of the witnessed crime incorrectly. However, there is usually more than 1 eyewitness observing a crime scene. If this is the case, one approach to reconstruct the details of a crime more accurately is aggregating across individual reports. Although aggregation likely improves accuracy, the degree of improvement largely depends on the method of aggregation. The most straightforward method is the majority rule. This method ignores individual differences between eyewitnesses and selects the answer shared by most eyewitnesses as being correct. We employ an alternative method based on cultural consensus theory (CCT) that accounts for differences in the eyewitnesses' knowledge. To test the validity of this approach, we showed 30 students 1 of 2 versions of a video depicting a heated quarrel between 2 people. The videos differed in the amount of information pertaining to the critical event. Participants then answered questions about the critical event. Analyses based on CCT rendered highly accurate eyewitness competence estimates that mirrored the amount of information available in the video. Moreover, CCT estimates resulted in a more precise reconstruction of the video content than the majority rule did. This was true for group sizes ranging from 4 to 15 eyewitnesses, with the difference being more pronounced for larger groups. Thus, through simultaneous consideration of multiple witness statements, CCT provides a new approach to the assessment of eyewitness accuracy that outperforms standard methods of information aggregation.",0 +https://doi.org/10.1002/sim.4326,An informed reference prior for between-study heterogeneity in meta-analyses of binary outcomes,"It is well known that when a Bayesian meta-analysis includes a small number of studies, inference can be sensitive to the choice of prior for the between-study variance. Choosing a vague prior does not solve the problem, as inferences can be substantially different depending on the degree of vagueness. Moreover, because the data provide little information on between-study heterogeneity, posterior inferences for the between-study variance based on vague priors will tend to be unrealistic. It is thus preferable to adopt a reasonable, informed prior for the between-study variance. However, relatively little is known about what constitutes a realistic distribution. On the basis of data from the Cochrane Database of Systematic Reviews, this paper describes the distribution of between-study variance in published meta-analyses, and proposes some realistic, informed priors for use in meta-analyses of binary outcomes. It is hoped that these priors will improve the calibration of inferences from Bayesian meta-analyses.",0 +https://doi.org/10.1007/bf02295132,Multidimensional adaptive testing with constraints on test content,"The case of adaptive testing under a multidimensional response model with large numbers of constraints on the content of the test is addressed. The items in the test are selected using a shadow test approach. The 0-1 linear programming model that assembles the shadow tests maximizes posterior expected Kullback-Leibler information in the test. The procedure is illustrated for five different cases of multidimensionality. These cases differ in (a) the numbers of ability dimensions that are intentional or should be considered as ""nuisance dimensions"" and (b) whether the test should or should not display a simple structure with respect to the intentional ability dimensions.",0 +https://doi.org/10.1016/j.pscychresns.2013.01.009,An application of item response theory to fMRI data: Prospects and pitfalls,"When using functional brain imaging to study neuropsychiatric patients an important challenge is determining whether the imaging task assesses individual differences with equal precision in healthy control and impaired patient groups. Classical test theory (CTT) requires separate reliability studies of patients and controls to determine equivalent measurement precision with additional studies to determine measurement precision for different levels of disease severity. Unlike CTT, item response theory (IRT) provides estimates of measurement error for different levels of ability, without the need for separate studies, and can determine if different tests are equivalently difficult when investigating differential deficits between groups. To determine the potential value of IRT in functional brain imaging, IRT was applied to behavioral data obtained during a multi-center functional MRI (fMRI) study of working memory (WM). Average item difficulty was approximately one standard deviation below the ability scale mean, supporting the task's sensitivity to individual differences within the ability range of patients with WM impairment, but not within the range of most controls. The correlation of IRT estimated ability with fMRI activation during the task recognition period supported the linkage of the latent IRT scale to brain activation data. IRT can meaningfully contribute to the design of fMRI tasks.",0 +https://doi.org/10.1037/0033-295x.84.1.1,"Controlled and automatic human information processing: I. Detection, search, and attention.","A 2-process theory of human information processing is proposed and applied to detection, search, and attention phenomena. Automatic processing is activation of a learned sequence of elements in long-term memory that is initiated by appropriate inputs and then proceeds automatically-without S control, without stressing the capacity limitations of the system, and without necessarily demanding attention. Controlled processing is a temporary activation of a sequence of elements that can be set up quickly and easily but requires attention, is capacity-limited (usually serial in nature), and is controlled by the S. A series of studies, with approximately 8 Ss, using both reaction time and accuracy measures is presented, which traces these concepts in the form of automatic detection and controlled search through the areas of detection, search, and attention. Results in these areas are shown to arise from common mechanisms. Automatic detection is shown to develop following consistent mapping of stimuli to responses over trials. Controlled search was utilized in varied-mapping paradigms, and in the present studies, it took the form of serial, terminating search. (60 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1977 American Psychological Association.",0 +https://doi.org/10.1198/jasa.2009.ap09068,Hierarchical Spatial Process Models for Multiple Traits in Large Genetic Trials,"This article expands upon recent interest in Bayesian hierarchical models in quantitative genetics by developing spatial process models for inference on additive and dominance genetic variance within the context of large spatially referenced trial datasets of multiple traits of interest. Direct application of such multivariate models to large spatial datasets is often computationally infeasible because of cubic order matrix algorithms involved in estimation. The situation is even worse in Markov chain Monte Carlo (MCMC) contexts where such computations are performed for several thousand iterations. Here, we discuss approaches that help obviate these hurdles without sacrificing the richness in modeling. For genetic effects, we demonstrate how an initial spectral decomposition of the relationship matrices negates the expensive matrix inversions required in previously proposed MCMC methods. For spatial effects we discuss a multivariate predictive process that reduces the computational burden by projecting the original process onto a subspace generated by realizations of the original process at a specified set of locations (or knots). We illustrate the proposed methods using a synthetic dataset with multivariate additive and dominant genetic effects and anisotropic spatial residuals, and a large dataset from a scots pine (Pinus sylvestris L.) progeny study conducted in northern Sweden. Our approaches enable us to provide a comprehensive analysis of this large trial which amply demonstrates that, in addition to violating basic assumptions of the linear model, ignoring spatial effects can result in downwardly biased measures of heritability.",0 +https://doi.org/10.1007/s11121-007-0070-9,How Many Imputations are Really Needed? Some Practical Clarifications of Multiple Imputation Theory,"Multiple imputation (MI) and full information maximum likelihood (FIML) are the two most common approaches to missing data analysis. In theory, MI and FIML are equivalent when identical models are tested using the same variables, and when m, the number of imputations performed with MI, approaches infinity. However, it is important to know how many imputations are necessary before MI and FIML are sufficiently equivalent in ways that are important to prevention scientists. MI theory suggests that small values of m, even on the order of three to five imputations, yield excellent results. Previous guidelines for sufficient m are based on relative efficiency, which involves the fraction of missing information (gamma) for the parameter being estimated, and m. In the present study, we used a Monte Carlo simulation to test MI models across several scenarios in which gamma and m were varied. Standard errors and p-values for the regression coefficient of interest varied as a function of m, but not at the same rate as relative efficiency. Most importantly, statistical power for small effect sizes diminished as m became smaller, and the rate of this power falloff was much greater than predicted by changes in relative efficiency. Based our findings, we recommend that researchers using MI should perform many more imputations than previously considered sufficient. These recommendations are based on gamma, and take into consideration one's tolerance for a preventable power falloff (compared to FIML) due to using too few imputations.",0 +https://doi.org/10.1037/a0033656,Can’t get it out of my mind: Employee rumination after customer mistreatment and negative mood in the next morning.,"Drawing on cognitive rumination theories and conceptualizing customer service interaction as a goal attainment situation for service employees, the current study examined employee rumination about negative service encounters as an intermediate cognitive process that explains the within-person fluctuations in negative emotional reactions resulting from customer mistreatment. Multilevel analyses of 149 call-center employees' 1,189 daily surveys revealed that on days that a service employee received more (vs. less) customer mistreatment, he or she ruminated more (vs. less) at night about negative encounters with customers, which in turn led to higher (vs. lower) levels of negative mood experienced in the next morning. In addition, service rule commitment and perceived organizational support moderated the within-person effect of customer mistreatment on rumination, such that this effect was stronger among those who had higher (vs. lower) levels of service rule commitment but weaker among those who had higher (vs. lower) levels of perceived organizational support. Theoretical and practical implications of these findings are discussed.",0 +https://doi.org/10.1177/0013164408322026,On the Use of Nonparametric Item Characteristic Curve Estimation Techniques for Checking Parametric Model Fit,"The purpose of this study was to assess the model fit of a 2PL through comparison with the nonparametric item characteristic curve (ICC) estimation procedures. Results indicate that three nonparametric procedures implemented produced ICCs that are similar to that of the 2PL for items simulated to fit the 2PL. However for misfitting items, especially nonmonotone items, the greatest difference is between the 2PL and kernel smoothing procedures. In general, the differences between ICCs from the nonparametric procedures and the 2PL are reduced as both sample size and test length increase. The false positive rate of the test for model fit is promising for nonparametric ICC estimation methods. Power to detect misfitting items simulated with 4PL is low. Power to detect nonmonotone items is generally much higher. Power is best for kernel smoothing but also good for isotonic regression in the medium to large sample sizes and longer test length conditions. Power for the smoothed isotonic regression is uniformly low.",0 +https://doi.org/10.1111/j.2044-8317.1991.tb00966.x,Scaled test statistics and robust standard errors for non-normal data in covariance structure analysis: A Monte Carlo study,"Research studying robustness of maximum likelihood (ML) statistics in covariance structure analysis has concluded that test statistics and standard errors are biased under severe non-normality. An estimation procedure known as asymptotic distribution free (ADF), making no distributional assumption, has been suggested to avoid these biases. Corrections to the normal theory statistics to yield more adequate performance have also been proposed. This study compares the performance of a scaled test statistic and robust standard errors for two models under several non-normal conditions and also compares these with the results from ML and ADF methods. Both ML and ADF test statistics performed rather well in one model and considerably worse in the other. In general, the scaled test statistic seemed to behave better than the ML test statistic and the ADF statistic performed the worst. The robust and ADF standard errors yielded more appropriate estimates of sampling variability than the ML standard errors, which were usually downward biased, in both models under most of the non-normal conditions. ML test statistics and standard errors were found to be quite robust to the violation of the normality assumption when data had either symmetric and platykurtic distributions, or non-symmetric and zero kurtotic distributions.",0 +https://doi.org/10.1177/1094428111428356,How Can Significance Tests Be Deinstitutionalized?,"The purpose of this article is to propose possible solutions to the methodological problem of null hypothesis significance testing (NHST), which is framed as deeply embedded in the institutional structure of the social and organizational sciences. The core argument is that, for the deinstitutionalization of statistical significance tests, minor methodological changes within an unreformed epistemology will be as unhelpful as emotive exaggerations of the ill effects of NHST. Instead, several institutional-epistemological reforms affecting cultural-cognitive, normative, and regulative processes and structures in the social sciences are necessary and proposed in this article. In the conclusion, the suggested research reforms, ranging from greater emphasis on inductive and abductive reasoning to statistical modeling and Bayesian epistemology, are classified according to their practical importance and the time horizon expected for their implementation. Individual-level change in researchers' use of NHST is unli...",0 +https://doi.org/10.1177/0013164408324460,Item Selection in Computerized Classification Testing,"Several alternatives for item selection algorithms based on item response theory in computerized classification testing (CCT) have been suggested, with no conclusive evidence on the substantial superiority of a single method. It is argued that the lack of sizable effect is because some of the methods actually assess items very similarly through different calculations and will usually select the same item. Consideration of methods that assess information across a wider range is often unnecessary under realistic conditions, although it might be advantageous to utilize them only early in a test. In addition, the efficiency of item selection approaches depend on the termination criteria that are used, which is demonstrated through didactic example and Monte Carlo simulation. Item selection at the cut score, which seems conceptually appropriate for CCT, is not always the most efficient option. A broad framework for item selection in CCT is presented that incorporates these points.",0 +https://doi.org/10.1016/j.jml.2006.08.009,A formal model of capacity limits in working memory,"A mathematical model of working-memory capacity limits is proposed on the key assumption of mutual interference between items in working memory. Interference is assumed to arise from overwriting of features shared by these items. The model was fit to time-accuracy data of memory-updating tasks from four experiments using nonlinear mixed effect (NLME) models as a framework. The model gave a good account of the data from a numerical and a spatial task version. The performance pattern in a combination of numerical and spatial updating could be explained by variations in the interference parameter: assuming less feature overlap between contents from different domains than between contents from the same domain, the model can account for double dissociations of content domains in dual-task experiments. Experiment 3 extended this idea to similarity within the verbal domain. The decline of memory accuracy with increasing memory load was steeper with phonologically similar than with dissimilar material, although processing speed was faster for the similar material. The model captured the similarity effects with a higher estimated interference parameter for the similar than for the dissimilar condition. The results are difficult to explain with alternative models, in particular models incorporating time-based decay and models assuming limited resource pools.",0 +https://doi.org/10.2307/1912934,A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity,"This paper presents a parameter covariance matrix estimator which is consistent even when the disturbances of a linear regression model are heteroskedastic. This estimator does not depend on a formal model of the structure of the heteroskedasticity. By comparing the elements of the new estimator to those of the usual covariance estimator, one obtains a direct test for heteroskedasticity, since in the absence of heteroskedasticity, the two estimators will be approximately equal, but will generally diverge otherwise. The test has an appealing least squares interpretation.",0 +https://doi.org/10.1207/s15327906mbr4001_1,A Comparison of Methods to Test for Mediation in Multisite Experiments,"A Monte Carlo study extended the research of MacKinnon, Lockwood, Hoffman, West, and Sheets (2002) for single-level designs by examining the statistical performance of four methods to test for mediation in a multilevel experimental design. The design studied was a two-group experiment that was replicated across several sites, included a single intervening variable and outcome, and assumed that the effects of the treatment and mediator were constant across sites. The findings provide new evidence of the benefits of and further support for using the asymmetric confidence limits approach to test for mediation. In addition, the authors provide further support for using confidence intervals to assess if treatment effects are completely mediated, as using traditional hypothesis testing may lead to erroneous conclusions.",0 +https://doi.org/10.1002/pst.1741,Bayesian robustness in meta-analysis for studies with zero responses,"Statistical meta-analysis is mostly carried out with the help of the random effect normal model, including the case of discrete random variables. We argue that the normal approximation is not always able to adequately capture the underlying uncertainty of the original discrete data. Furthermore, when we examine the influence of the prior distributions considered, in the presence of rare events, the results from this approximation can be very poor. In order to assess the robustness of the quantities of interest in meta-analysis with respect to the choice of priors, this paper proposes an alternative Bayesian model for binomial random variables with several zero responses. Particular attention is paid to the coherence between the prior distributions of the study model parameters and the meta-parameter. Thus, our method introduces a simple way to examine the sensitivity of these quantities to the structure dependence selected for study. For illustrative purposes, an example with real data is analysed, using the proposed Bayesian meta-analysis model for binomial sparse data. Copyright © 2016 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1002/jrsm.1167,Automated generation of node‐splitting models for assessment of inconsistency in network meta‐analysis,"Network meta-analysis enables the simultaneous synthesis of a network of clinical trials comparing any number of treatments. Potential inconsistencies between estimates of relative treatment effects are an important concern, and several methods to detect inconsistency have been proposed. This paper is concerned with the node-splitting approach, which is particularly attractive because of its straightforward interpretation, contrasting estimates from both direct and indirect evidence. However, node-splitting analyses are labour-intensive because each comparison of interest requires a separate model. It would be advantageous if node-splitting models could be estimated automatically for all comparisons of interest. We present an unambiguous decision rule to choose which comparisons to split, and prove that it selects only comparisons in potentially inconsistent loops in the network, and that all potentially inconsistent loops in the network are investigated. Moreover, the decision rule circumvents problems with the parameterisation of multi-arm trials, ensuring that model generation is trivial in all cases. Thus, our methods eliminate most of the manual work involved in using the node-splitting approach, enabling the analyst to focus on interpreting the results.",0 +https://doi.org/10.1111/j.2041-210x.2011.00131.x,On thinning of chains in MCMC,"Summary 1. Markov chain Monte Carlo (MCMC) is a simulation technique that has revolutionised the analysis of ecological data, allowing the fitting of complex models in a Bayesian framework. Since 2001, there have been nearly 200 papers using MCMC in publications of the Ecological Society of America and the British Ecological Society, including more than 75 in the journal Ecology and 35 in the Journal of Applied Ecology. 2. We have noted that many authors routinely ‘thin’ their simulations, discarding all but every kth sampled value; of the studies we surveyed with details on MCMC implementation, 40% reported thinning. 3. Thinning is often unnecessary and always inefficient, reducing the precision with which features of the Markov chain are summarised. The inefficiency of thinning MCMC output has been known since the early 1990’s, long before MCMC appeared in ecological publications. 4. We discuss the background and prevalence of thinning, illustrate its consequences, discuss circumstances when it might be regarded as a reasonable option and recommend against routine thinning of chains unless necessitated by computer memory limitations.",0 +https://doi.org/10.1002/0471746096,Latent Curve Models,"Preface. 1 Introduction. 1.1 Conceptualization and Analysis of Trajectories. 1.2 Three Initial Questions About Trajectories. 1.3 Brief History of Latent Curve Models. 1.4 Organization of the Remainder of the Book. 2 Unconditional Latent Curve Model. 2.1 Repeated Measures. 2.2 General Model and Assumptions. 2.3 Identification. 2.4 Case-By-Case Approach. 2.5 Structural Equation Model Approach. 2.6 Alternative Approaches to the SEM. 2.7 Conclusions. Appendix 2A: Test Statistics, Nonnormality, and Statistical Power. 3 Missing Data and Alternative Metrics of Time. 3.1 Missing Data. 3.2 Missing Data and Alternative Metrics of Time. 3.3 Conclusions. 4 Nonlinear Trajectories and the Coding of Time. 4.1 Modeling Nonlinear Functions of Time. 4.2 Nonlinear Curve Fitting: Estimated Factor Loadings. 4.3 Piecewise Linear Trajectory Models. 4.4 Alternative Parametric Functions. 4.5 Linear Transformations of the Metric of Time. 4.6 Conclusions. Appendix 4A: Identification of Quadratic and Piecewise Latent Curve Models. 4A.1 Quadratic LCM. 4A.2 Piecewise LCM. 5 Conditional Latent Curve Models. 5.1 Conditional Model and Assumptions. 5.2 Identification. 5.3 Structural Equation Modeling Approach. 5.4 Interpretation of Conditional Model Estimates. 5.5 Empirical Example. 5.6 Conclusions. 6 The Analysis of Groups. 6.1 Dummy Variable Approach. 6.2 Multiple-Group Analysis. 6.3 Unknown Group Membership. 6.4 Conclusions. Appendix 6A: Case-by-Case Approach to Analysis of Various Groups. 6A.1 Dummy Variable Method. 6A.2 Multiple-Group Analysis. 6A.3 Unknown Group Membership. 6A.4 Appendix Summary. 7 Multivariate Latent Curve Models. 7.1 Time-Invariant Covariates. 7.2 Time-Varying Covariates. 7.3 Simultaneous Inclusion of Time-Invariant and Time-Varying Covariates. 7.4 Multivariate Latent Curve Models. 7.5 Autoregressive Latent Trajectory Model. 7.6 General Equation for All Models. 7.7 Implied Moment Matrices. 7.8 Conclusions. 8 Extensions of Latent Curve Models. 8.1 Dichotomous and Ordinal Repeated Measures. 8.2 Repeated Latent Variables with Multiple Indicators. 8.3 Latent Covariates. 8.4 Conclusions. References. Author Index. Subject Index.",0 +https://doi.org/10.1093/pan/mpm006,A Bayesian Multilevel Modeling Approach to Time-Series Cross-Sectional Data,"The analysis of time-series cross-sectional (TSCS) data has become increasingly popular in political science. Meanwhile, political scientists are also becoming more interested in the use of multilevel models (MLM). However, little work exists to understand the benefits of multilevel modeling when applied to TSCS data. We employ Monte Carlo simulations to benchmark the performance of a Bayesian multilevel model for TSCS data. We find that the MLM performs as well or better than other common estimators for such data. Most importantly, the MLM is more general and offers researchers additional advantages.",0 +https://doi.org/10.1037/0278-7393.19.5.1024,Proactive interference and the dynamics of free recall.,"Proactive interference (PI) has long been recognized as a major cause of forgetting. We conducted two experiments that offer another look at the subject by providing a detailed analysis of recall latency distributions during the buildup of and release from PI. These functions were accurately characterized by the convolution of the normal and exponential distributions (viz., the ex-Gaussian), which previously has been shown to describe recognition latency distributions. Further, the fits revealed that the increase in recall latency associated with the buildup of PI results from a slowing of the exponential retrieval stage only. The same result was found even when a short retention interval was used (and recall probability remained constant). These findings suggest that free-recall latency may be a sensitive index of the increased search set size that has often been assumed to accompany the buildup of PI. A central insight emerging from the memory literature of the 1950s and 1960s was that previously learned information can result in the rapid forgetting of more recently learned information. Underwood (1957) argued that this phenomenon, termed proactive interference (PI), was by far the major cause of forgetting in everyday life. Indeed, even in laboratory experiments, the degree of retroactive interference encountered over the course of hours or days was assumed to pale in comparison with the degree of proactive interference resulting from years of prior learning. Although its preeminent (and still unexplained) role in the process of forgetting continues to be recognized, interest in the subject of PI has waned in recent years. The present article contributes a new empirical analysis of this important subject and pursues a detailed theoretical exploration into its underlying nature. In a typical PI experiment, subjects receive blocks of Brown-Peterson trials involving words from a single category (Wickens, 1972). Within a block, free-recall performance declines with each successive trial (the buildup of PI) but recovers each time a new category is introduced (release from PI). In most cases, the dependent variable used in these experiments was the percentage of correct free-recall responses. However, in the research to be presented here, we focus on latency to free recall. Research on free-recall latency in any context is very limited, and in the study of PI it is almost nonexistent. Why might free-recall latency be an interesting variable to investigate? Because such a measure provides important information about the process of retrieval that is likely to be missed by static measures, such as probability of recall. Before addressing the question of exactly what that information might be, we review the scant literature pertaining to the more general and purely empirical question of whether these",0 +https://doi.org/10.1016/j.jmp.2012.06.002,Cultural Consensus Theory: Comparing different concepts of cultural truth,"Abstract Cultural Consensus Theory (CCT) is a model-based approach to aggregating the responses of informants (respondents) to questions (items) about some domain of their shared cultural knowledge. The purpose of CCT is to allow a researcher to discover consensus knowledge in cultural groups. This paper compares and contrasts two CCT models for items requiring a dichotomous, true/false answer. The first model is the General Condorcet Model (GCM). A special case of the GCM is already in wide use, especially in cultural anthropology, and this paper generalizes that version and provides new mathematical and statistical results for it. The character of the GCM is that of a general signal detection model, where the item-trial type (signal or noise) as well as the respondents’ hit and false alarm rates, are latent rather than observable. The second model, the Latent Truth Model (LTM), is a new model that allows cultural truth to assume continuous values in the unit interval rather than the two-valued truth assumption of the GCM. Both models are compared analytically, and hierarchical Bayesian inference for each is developed. A posterior predictive model check is established for both models that bears directly on the assumption that there is a single consensus truth. In addition, the similarities and differences between the models are illustrated both with mathematical and statistical results, as well as by analyzing real and simulated data sets, and a second posterior predictive check that tends to differentiate the models is also provided.",0 +https://doi.org/10.1037/1196-1961.51.3.181,On the locus of the word frequency effect in visual word recognition.,"Abstract The pattern of factor effects on response time (RT) performance in multi-factor experiments provides a powerful technique for inferring the structure of underlying mental processes. The results of the present lexical decision experiment show that additive effects of stimulus quality and word frequency are observed in mean RTs, variances, and the exGaussian parameters of the RT distribution. These findings are consistent with the conclusion that word frequency and stimulus quality affect separate stages of processing. This is consistent with the conclusion that word frequency effects reflect mapping operations between stages, but, when taken in conjunction with other reports in the literature, is inconsistent with the received view in many activation models that word frequency exerts its effect within the word detector level of representation. Resume Le schema des effets du facteur sur l'execution du temps de reponse (TR) dans les experiences a multiples facteurs fournissent une technique efficace pour fixer la structure des processus mentaux sous-jacents. Les resultats de la presente experience de decision lexicale montrent que les effets additifs de la qualite du stimulus et de la frequence du mot sont observes dans les TR moyens, les variances et les parametres ex-gaussiens de la distribution du TR. Ces conclusions confirment que la frequence du mot et la qualite du stimulus influencent les phases separees du traitement. Elles confirment egalement que les effets de la frequence du mot refletent les operations de correspondance entre les phases, mais, lorsque comparees a d'autres rapports, les conclusions ne correspondent pas a la vision etablie dans plusieurs modeles d'activation qui veut que la frequence du mot exerce ses effets au niveau de representation du detecteur du mot. It is well established that a word's frequency of occurrence in printed English is a strong determinant of performance in word recognition tasks such as lexical decision. For example, high frequency words such as CAT are typically recognized more quickly than lower frequency words such as VAT (e.g., Forster & Chambers, 1973; Frederiksen & Kroll, 1976; see also Monsell, 1991, for a review). One account of this word frequency effect is given by a number of models in the Activation class. Thus, models such as Morton's (1969) logogen model and variants of McClelland and Rumelhart's (1981) interactiveactivation model (e.g., Coltheart, Curtis, Atkins, & Haller, 1993; Grainger & Jacobs, 1996) all assume a word level of representation in the form of orthographic and phonological word detectors for each word the reader knows. These word detectors accumulate activation over time, and both models assume that low frequency words take longer to reach a threshold than do high frequency words. The models differ in that the interactive-activation model assumes that high frequency words start with a higher resting level of activation than do low frequency words whereas the logogen model assumes a common resting level of activation but different recognition thresholds for high and low frequency words One difficulty with the activation explanation is that a simple main effect of word frequency in lexical decision does not allow one to determine the locus of the effect; it merely informs us that word frequency affects performance in this task. A number of investigators have therefore applied Sternberg's (1969) additive factors logic to this issue by manipulating word frequency in conjunction with other factors that affect performance in lexical decision because predictions can be derived from the models as to how the effects of these factors on response time (RT) should combine (e.g., Becker & Killion, 1977; Besner & Smith, 1992; Besner & Swan, 1982). WORD FREQUENCY, STIMULUS QUALITY, AND CONTEXT It is well documented that stimulus quality affects word recognition: Clearly presented stimuli are recognized more quickly than degraded ones. …",0 +https://doi.org/10.1111/j.0006-341x.2001.00126.x,A Covariance Estimator for GEE with Improved Small‐Sample Properties,"In this paper, we propose an alternative covariance estimator to the robust covariance estimator of generalized estimating equations (GEE). Hypothesis tests using the robust covariance estimator can have inflated size when the number of independent clusters is small. Resampling methods, such as the jackknife and bootstrap, have been suggested for covariance estimation when the number of clusters is small. A drawback of the resampling methods when the response is binary is that the methods can break down when the number of subjects is small due to zero or near-zero cell counts caused by resampling. We propose a bias-corrected covariance estimator that avoids this problem. In a small simulation study, we compare the bias-corrected covariance estimator to the robust and jackknife covariance estimators for binary responses for situations involving 10-40 subjects with equal and unequal cluster sizes of 16-64 observations. The bias-corrected covariance estimator gave tests with sizes close to the nominal level even when the number of subjects was 10 and cluster sizes were unequal, whereas the robust and jackknife covariance estimators gave tests with sizes that could be 2-3 times the nominal level. The methods are illustrated using data from a randomized clinical trial on treatment for bone loss in subjects with periodontal disease.",0 +https://doi.org/10.1177/1536867x0200200403,Estimation of Average Treatment Effects Based on Propensity Scores,"In this paper, we give a short overview of some propensity score matching estimators suggested in the evaluation literature, and we provide a set of Stata programs, which we illustrate using the National Supported Work (NSW) demonstration widely known in labor economics.",0 +https://doi.org/10.1002/sim.3043,"Comments on ‘Trying to be precise about vagueness’ by Stephen Senn, Statistics in Medicine 2007; 26 :1417-1430",http://onlinelibrary.wiley.com/doi/10.1002/sim.3043/epdf,0 +https://doi.org/10.1111/j.1744-6570.2009.01147.x,USING A META-ANALYTIC PERSPECTIVE TO ENHANCE JOB COMPONENT VALIDATION,"This paper develops synthetic validity estimates based on a metaanalytic-weighted least squares (WLS) approach to job component validity (JCV), using position analysis questionnaire (PAQ) estimates of job characteristics, and the Data, People, & Things ratings from the Dictionary of Occupational Titles as indices of job complexity. For the general aptitude test battery database of 40,487 employees, nine validity coefficients were estimated for 192 positions. The predicted validities from the WLS approach had lower estimated variability than would be obtained from either the classic JCV approach or local criterion-related validity studies. Data, People, & Things summary ratings did not consistently moderate validity coefficients, whereas the PAQ data did moderate validity coefficients. In sum, these results suggest that synthetic validity procedures should incorporate a WLS regression approach. Moreover, researchers should consider a comprehensive set of job characteristics when considering job complexity rather than a single aggregated index. Over half a century ago, Lawshe (1952) coined the term “synthetic validity,” inspired by the analogous engineering process of “synthetic time.” As applied to selection, synthetic validity involves inferring the validity of a selection tool for a specific job based on job analysis data from a variety of other jobs. In other words, synthetic validity facilitates the creation of test batteries and selection systems without the need to conduct a criterion validity study in every situation. Synthetic validity promises many advantages over local validation studies, including drastically reduced costs, improved selection of qualified candidates, and greater legal defensibility (e.g., Hoffman, Rashkovsky, & D’Egidio, 2007; Johnson, 2007; Steel, Huffcutt, & Kammeyer-Mueller, 2006). Synthetic validity can also estimate the validity of a battery of selection instruments for jobs in which there are no incumbents yet. Over the decades since synthetic validity was first proposed, a variety of estimation methods have been designed, with mixed success (Guion, 2006; Scherbaum, 2005). One of",0 +https://doi.org/10.3389/fpsyg.2015.01914,Examining the Dynamic Structure of Daily Internalizing and Externalizing Behavior at Multiple Levels of Analysis,"Psychiatric diagnostic covariation suggests that the underlying structure of psychopathology is not one of circumscribed disorders. Quantitative modeling of individual differences in diagnostic patterns has uncovered several broad domains of mental disorder liability, of which the Internalizing and Externalizing spectra have garnered the greatest support. These dimensions have generally been estimated from lifetime or past-year comorbidity patters, which are distal from the covariation of symptoms and maladaptive behavior that ebb and flow in daily life. In this study, structural models are applied to daily diary data (Median = 94 days) of maladaptive behaviors collected from a sample (N = 101) of individuals diagnosed with personality disorders (PDs). Using multilevel and unified structural equation modeling, between-person, within-person, and person-specific structures were estimated from 16 behaviors that are encompassed by the Internalizing and Externalizing spectra. At the between-person level (i.e., individual differences in average endorsement across days) we found support for a two-factor Internalizing-Externalizing model, which exhibits significant associations with corresponding diagnostic spectra. At the within-person level (i.e., dynamic covariation among daily behavior pooled across individuals) we found support for a more differentiated, four-factor, Negative Affect-Detachment-Hostility-Disinhibition structure. Finally, we demonstrate that the person-specific structures of associations between these four domains are highly idiosyncratic.",0 +https://doi.org/10.1017/cbo9781107587991,Counterfactuals and Causal Inference,"In this second edition of Counterfactuals and Causal Inference, completely revised and expanded, the essential features of the counterfactual approach to observational data analysis are presented with examples from the social, demographic, and health sciences. Alternative estimation techniques are first introduced using both the potential outcome model and causal graphs; after which, conditioning techniques, such as matching and regression, are presented from a potential outcomes perspective. For research scenarios in which important determinants of causal exposure are unobserved, alternative techniques, such as instrumental variable estimators, longitudinal methods, and estimation via causal mechanisms, are then presented. The importance of causal effect heterogeneity is stressed throughout the book, and the need for deep causal explanation via mechanisms is discussed.",0 +https://doi.org/10.1167/8.2.10,Integration of ordinal and metric cues in depth processing,"J. Burge, M. A. Peterson, and S. E. Palmer (2005) reported that ordinal, configural cues of familiarity and convexity influence perceived depth even when unambiguous metric information in the form of binocular disparity is available. In their study, a shape that was both convex and familiar (i.e., a face) increased perceived depth in random dot stereograms if the shape was shown in the foreground and decreased perceived depth if it was shown in the background. It is generally assumed that luminance cues are necessary for pre-figural shape representation to influence figure-ground computations in this way (M. A. Peterson & B. S. Gibson, 1993); thus, Burge et al. (2005) had used a luminance edge. In this research, we asked whether configural cues need to be defined by luminance, contrast, or neither. For a sufficiently large disparity pedestal (about 2.5 arcmin), configural cues influenced perceived depth both for second-order contours and for contours defined only by disparity. The integration of ordinal and metric cues seems to be driven by the general saliency of the contours and not only by luminance information. This challenges the notion that the integration of such cues always needs to arise during figure-ground organization through early combinations of luminance-defined shape and binocular disparity.",0 +https://doi.org/10.1080/00273171.2013.784862,A Bayesian Approach for Estimating Mediation Effects With Missing Data,"Methodologists have developed mediation analysis techniques for a broad range of substantive applications, yet methods for estimating mediating mechanisms with missing data have been understudied. This study outlined a general Bayesian missing data handling approach that can accommodate mediation analyses with any number of manifest variables. Computer simulation studies showed that the Bayesian approach produced frequentist coverage rates and power estimates that were comparable to those of maximum likelihood with the bias-corrected bootstrap. We share a SAS macro that implements Bayesian estimation and use two data analysis examples to demonstrate its use.",0 +,Whose Vote Should Count More: Optimal Integration of Labels from Labelers of Unknown Expertise,"Modern machine learning-based approaches to computer vision require very large databases of hand labeled images. Some contemporary vision systems already require on the order of millions of images for training (e.g., Omron face detector [9]). New Internet-based services allow for a large number of labelers to collaborate around the world at very low cost. However, using these services brings interesting theoretical and practical challenges: (1) The labelers may have wide ranging levels of expertise which are unknown a priori, and in some cases may be adversarial; (2) images may vary in their level of difficulty; and (3) multiple labels for the same image must be combined to provide an estimate of the actual label of the image. Probabilistic approaches provide a principled way to approach these problems. In this paper we present a probabilistic model and use it to simultaneously infer the label of each image, the expertise of each labeler, and the difficulty of each image. On both simulated and real data, we demonstrate that the model outperforms the commonly used Majority Vote heuristic for inferring image labels, and is robust to both noisy and adversarial labelers.",0 +https://doi.org/10.1016/j.ecolmodel.2006.07.005,Species distribution models and ecological theory: A critical assessment and some possible new approaches,"Given the importance of knowledge of species distribution for conservation and climate change management, continuous and progressive evaluation of the statistical models predicting species distributions is necessary. Current models are evaluated in terms of ecological theory used, the data model accepted and the statistical methods applied. Focus is restricted to Generalised Linear Models (GLM) and Generalised Additive Models (GAM). Certain currently unused regression methods are reviewed for their possible application to species modelling. A review of recent papers suggests that ecological theory is rarely explicitly considered. Current theory and results support species responses to environmental variables to be unimodal and often skewed though process-based theory is often lacking. Many studies fail to test for unimodal or skewed responses and straight-line relationships are often fitted without justification. Data resolution (size of sampling unit) determines the nature of the environmental niche models that can be fitted. A synthesis of differing ecophysiological ideas and the use of biophysical processes models could improve the selection of predictor variables. A better conceptual framework is needed for selecting variables. Comparison of statistical methods is difficult. Predictive success is insufficient and a test of ecological realism is also needed. Evaluation of methods needs artificial data, as there is no knowledge about the true relationships between variables for field data. However, use of artificial data is limited by lack of comprehensive theory. Three potentially new methods are reviewed. Quantile regression (QR) has potential and a strong theoretical justification in Liebig's law of the minimum . Structural equation modelling (SEM) has an appealing conceptual framework for testing causality but has problems with curvilinear relationships. Geographically weighted regression (GWR) intended to examine spatial non-stationarity of ecological processes requires further evaluation before being used. Synthesis and applications: explicit theory needs to be incorporated into species response models used in conservation. For example, testing for unimodal skewed responses should be a routine procedure. Clear statements of the ecological theory used, the nature of the data model and sufficient details of the statistical method are needed for current models to be evaluated. New statistical methods need to be evaluated for compatibility with ecological theory before use in applied ecology . Some recent work with artificial data suggests the combination of ecological knowledge and statistical skill is more important than the precise statistical method used. The potential exists for a synthesis of current species modelling approaches based on their differing ecological insights not their methodology.",0 +https://doi.org/10.1007/978-1-4612-4976-4_7,Alternative Methods for Solving the Problem of Selection Bias in Evaluating the Impact of Treatments on Outcomes,"Social scientists never have access to true experimental data of the type sometimes available to laboratory scientists.1 Our inability to use laboratory methods to independently vary treatments to eliminate or isolate spurious channels of causation places a fundamental limitation on the possibility of objective knowledge in the social sciences. In place of laboratory experimental variation, social scientists use subjective thought experiments. Assumptions replace data. In the jargon of modern econometrics, minimal identifying assumptions are invoked.",0 +https://doi.org/10.3389/fpsyg.2014.00311,A longitudinal multilevel CFA-MTMM model for interchangeable and structurally different methods,"One of the key interests in the social sciences is the investigation of change and stability of a given attribute. Although numerous models have been proposed in the past for analyzing longitudinal data including multilevel and/or latent variable modeling approaches, only few modeling approaches have been developed for studying the construct validity in longitudinal multitrait-multimethod (MTMM) measurement designs. The aim of the present study was to extend the spectrum of current longitudinal modeling approaches for MTMM analysis. Specifically, a new longitudinal multilevel CFA-MTMM model for measurement designs with structurally different and interchangeable methods (called Latent-State-Combination-Of-Methods model, LS-COM) is presented. Interchangeable methods are methods that are randomly sampled from a set of equivalent methods (e.g., multiple student ratings for teaching quality), whereas structurally different methods are methods that cannot be easily replaced by one another (e.g., teacher, self-ratings, principle ratings). Results of a simulation study indicate that the parameters and standard errors in the LS-COM model are well recovered even in conditions with only five observations per estimated model parameter. The advantages and limitations of the LS-COM model relative to other longitudinal MTMM modeling approaches are discussed.",0 +https://doi.org/10.3758/bf03211637,Extracting thresholds from noisy psychophysical data,"Psychophysical studies with infants or with patients often are unable to use pilot data, training, or large numbers of trials. To evaluate threshold estimates under these conditions, computer simulations of experiments with small numbers of trials were performed by using psychometric functions based on a model of two types of noise: stimulus-related noise (affecting slope) and extraneous noise (affecting upper asymptote). Threshold estimates were biased and imprecise when extraneous noise was high, as were the estimates of extraneous noise. Strategies were developed for rejecting data sets as too noisy for unbiased and precise threshold estimation; these strategies were most successful when extraneous noise was low for most of the data sets. An analysis of 1,026 data sets from visual function tests of infants and toddlers showed that extraneous noise is often considerable, that experimental paradigms can be developed that minimize extraneous noise, and that data analysis that does not consider the effects of extraneous noise may underestimate test-retest reliability and overestimate interocular differences.",0 +https://doi.org/10.3758/brm.42.4.930,Estimating individual treatment effects from multiple-baseline data: A Monte Carlo study of multilevel-modeling approaches,"While conducting intervention research, researchers and practitioners are often interested in how the intervention functions not only at the group level, but also at the individual level. One way to examine individual treatment effects is through multiple-baseline studies analyzed with multilevel modeling. This analysis allows for the construction of confidence intervals, which are strongly recommended in the reporting guidelines of the American Psychological Association. The purpose of this study was to examine the accuracy of confidence intervals of individual treatment effects obtained from multilevel modeling of multiple-baseline data. Monte Carlo methods were used to examine performance across conditions varying in the number of participants, the number of observations per participant, and the dependency of errors. The accuracy of the confidence intervals depended on the method used, with the greatest accuracy being obtained when multilevel modeling was coupled with the Kenward-Roger method of estimating degrees of freedom.",0 +https://doi.org/10.1037/a0023322,Samples in applied psychology: Over a decade of research in review.,"This study examines sample characteristics of articles published in Journal of Applied Psychology (JAP) from 1995 to 2008. At the individual level, the overall median sample size over the period examined was approximately 173, which is generally adequate for detecting the average magnitude of effects of primary interest to researchers who publish in JAP. Samples using higher units of analyses (e.g., teams, departments/work units, and organizations) had lower median sample sizes (Mdn ≈ 65), yet were arguably robust given typical multilevel design choices of JAP authors despite the practical constraints of collecting data at higher units of analysis. A substantial proportion of studies used student samples (~40%); surprisingly, median sample sizes for student samples were smaller than working adult samples. Samples were more commonly occupationally homogeneous (~70%) than occupationally heterogeneous. U.S. and English-speaking participants made up the vast majority of samples, whereas Middle Eastern, African, and Latin American samples were largely unrepresented. On the basis of study results, recommendations are provided for authors, editors, and readers, which converge on 3 themes: (a) appropriateness and match between sample characteristics and research questions, (b) careful consideration of statistical power, and (c) the increased popularity of quantitative synthesis. Implications are discussed in terms of theory building, generalizability of research findings, and statistical power to detect effects.",0 +https://doi.org/10.1007/s10648-014-9287-x,The Effect of Small Sample Size on Two-Level Model Estimates: A Review and Illustration,"Multilevel models are an increasingly popular method to analyze data that originate from a clustered or hierarchical structure. To effectively utilize multilevel models, one must have an adequately large number of clusters; otherwise, some model parameters will be estimated with bias. The goals for this paper are to (1) raise awareness of the problems associated with a small number of clusters, (2) review previous studies on multilevel models with a small number of clusters, (3) to provide an illustrative simulation to demonstrate how a simple model becomes adversely affected by small numbers of clusters, (4) to provide researchers with remedies if they encounter clustered data with a small number of clusters, and (5) to outline methodological topics that have yet to be addressed in the literature.",0 +https://doi.org/10.3402/ejpt.v6.25216,Analyzing small data sets using Bayesian estimation: the case of posttraumatic stress symptoms following mechanical ventilation in burn survivors,"Background : The analysis of small data sets in longitudinal studies can lead to power issues and often suffers from biased parameter values. These issues can be solved by using Bayesian estimation in conjunction with informative prior distributions. By means of a simulation study and an empirical example concerning posttraumatic stress symptoms (PTSS) following mechanical ventilation in burn survivors, we demonstrate the advantages and potential pitfalls of using Bayesian estimation. Methods : First, we show how to specify prior distributions and by means of a sensitivity analysis we demonstrate how to check the exact influence of the prior (mis-) specification. Thereafter, we show by means of a simulation the situations in which the Bayesian approach outperforms the default, maximum likelihood and approach. Finally, we re-analyze empirical data on burn survivors which provided preliminary evidence of an aversive influence of a period of mechanical ventilation on the course of PTSS following burns. Results : Not suprisingly, maximum likelihood estimation showed insufficient coverage as well as power with very small samples. Only when Bayesian analysis, in conjunction with informative priors, was used power increased to acceptable levels. As expected, we showed that the smaller the sample size the more the results rely on the prior specification. Conclusion : We show that two issues often encountered during analysis of small samples, power and biased parameters, can be solved by including prior information into Bayesian analysis. We argue that the use of informative priors should always be reported together with a sensitivity analysis.",1 +https://doi.org/10.1080/10705511.2012.659614,Measurement and Structural Model Class Separation in Mixture CFA: ML/EM Versus MCMC,"Parameter recovery was assessed within mixture confirmatory factor analysis across multiple estimator conditions under different simulated levels of mixture class separation. Mixture class separation was defined in the measurement model (through factor loadings) and the structural model (through factor variances). Maximum likelihood (ML) via the EM algorithm was compared to a Markov chain Monte Carlo (MCMC) estimator condition using weak priors and a condition using tight priors. Results indicated that the MCMC weak condition produced the highest bias, particularly with a weak Dirichlet prior for the mixture class proportions. Specifically, the weak Dirichlet prior affected parameter estimates under all mixture class separation conditions, even with moderate and large sample sizes. With little knowledge about parameters, ML/EM should be used over MCMC weak. However, MCMC tight produced the lowest bias under all mixture class separation conditions and should be used if tight and accurate priors can be plac...",1 +https://doi.org/10.3168/jds.2010-3836,A Bayesian approach to analyze energy balance data from lactating dairy cows,"The objective of the present investigation was to develop a Bayesian framework for updating and integrating covariate information into key parameters of metabolizable energy (ME) systems for dairy cows. The study addressed specifically the effects of genetic improvements and feed quality on key parameters in current ME systems. These are net and metabolizable energy for maintenance (NE(M) and ME(M), respectively), efficiency of utilization of ME for milk production (k(L)) and growth (k(G)), and efficiency of utilization of body stores for milk production (k(T)). Data were collated from 38 studies, yielding 701 individual cow observations on milk energy, ME intake, and tissue gain and loss. A function based on a linear relationship between milk energy and ME intake and correcting for tissue energy loss or gain served as the basis of a full Bayesian hierarchical model. The within-study variability was modeled by a Student t-distribution and the between-study variability in the structural parameters was modeled by a multivariate normal distribution. A meaningful relationship between genetic improvements in milk production and the key parameters could not be established. The parameter k(L) was linearly related to feed metabolizability, and the slope predicted a 0.010 (-0.0004; 0.0210) change per 0.1-unit change in metabolizability. The effect of metabolizability on k(L) was smaller than assumed in present feed evaluation systems and its significance was dependent on collection of studies included in the analysis. Three sets of population estimates (with 95% credible interval in parentheses) were generated, reflecting different degrees of prior belief: (1) Noninformative priors yielded 0.28 (0.23; 0.33) MJ/(kg(0.75)d), 0.55 (0.51; 0.58), 0.86 (0.81; 0.93) and 0.66 (0.58; 0.75), for NE(M), k(L), k(G), and k(T), respectively; (2) Introducing an informative prior that was derived from a fasting metabolism study served to combine the most recent information on energy metabolism in modern dairy cows. The new estimates of NE(M), k(L), k(G) and k(T) were 0.34 (0.28; 0.39) MJ/(kg(0.75)d), 0.58 (0.54; 0.62), 0.89 (0.85; 0.95), and 0.69 (0.60; 0.79), respectively; (3) finally, all informative priors were used that were established from literature, yielding estimates for NE(M), k(L), k(G), and k(T) of 0.29 (0.11; 0.46) MJ/(kg(0.75)d), 0.60 (0.54; 0.70), 0.70 (0.50; 0.88), and 0.80 (0.67; 0.97), respectively. Bayesian methods are especially applicable in meta-analytical studies as information can enter at various stages in the hierarchical model.",0 +https://doi.org/10.1080/0267257x.2011.609653,Using student-choice behaviour to estimate tuition elasticity in higher education,"Prior research on student response to changes in university prices (tuition) finds that demand is inelastic. We present results, based on separate models for 11 colleges (n = 5606) at a major US un...",0 +https://doi.org/10.1016/j.jmp.2009.06.007,Beta-MPT: Multinomial processing tree models for addressing individual differences,"Abstract Traditionally, multinomial processing tree (MPT) models are applied to groups of homogeneous participants, where all participants within a group are assumed to have identical MPT model parameter values. This assumption is unreasonable when MPT models are used for clinical assessment, and it often may be suspect for applications to ordinary psychological experiments. One method for dealing with parameter variability is to incorporate random effects assumptions into a model. This is achieved by assuming that participants’ parameters are drawn independently from some specified multivariate hyperdistribution. In this paper we explore the assumption that the hyperdistribution consists of independent beta distributions, one for each MPT model parameter. These beta-MPT models are ‘hierarchical models’, and their statistical inference is different from the usual approaches based on data aggregated over participants. The paper provides both classical (frequentist) and hierarchical Bayesian approaches to statistical inference for beta-MPT models. In simple cases the likelihood function can be obtained analytically; however, for more complex cases, Markov Chain Monte Carlo algorithms are constructed to assist both approaches to inference. Examples based on clinical assessment studies are provided to demonstrate the advantages of hierarchical MPT models over aggregate analysis in the presence of individual differences.",0 +https://doi.org/10.1155/2014/945253,Integrative Genomics and Computational Systems Medicine,"The exponential growth in generation of large amounts of genomic data from biological samples has driven the emerging field of systems medicine. This field is promising because it improves our understanding of disease processes at the systems level. However, the field is still in its young stage. There exists a great need for novel computational methods and approaches to effectively utilize and integrate various omics data.",0 +https://doi.org/10.1007/s11222-008-9110-y,A tutorial on adaptive MCMC,"We review adaptive Markov chain Monte Carlo algorithms (MCMC) as a mean to optimise their performance. Using simple toy examples we review their theoretical underpinnings, and in particular show why adaptive MCMC algorithms might fail when some fundamental properties are not satisfied. This leads to guidelines concerning the design of correct algorithms. We then review criteria and the useful framework of stochastic approximation, which allows one to systematically optimise generally used criteria, but also analyse the properties of adaptive MCMC algorithms. We then propose a series of novel adaptive algorithms which prove to be robust and reliable in practice. These algorithms are applied to artificial and high dimensional scenarios, but also to the classic mine disaster dataset inference problem. © 2008 Springer Science+Business Media, LLC.",0 +https://doi.org/10.1207/s15327906mbr4103_4,Bayesian Analysis of Structural Equation Models With Nonlinear Covariates and Latent Variables,"In this article, we formulate a nonlinear structural equation model (SEM) that can accommodate covariates in the measurement equation and nonlinear terms of covariates and exogenous latent variables in the structural equation. The covariates can come from continuous or discrete distributions. A Bayesian approach is developed to analyze the proposed model. Markov chain Monte Carlo methods for obtaining Bayesian estimates and their standard error estimates, highest posterior density intervals, and a PP p value are developed. Results obtained from two simulation studies are reported to respectively reveal the empirical performance of the proposed Bayesian estimation in analyzing complex nonlinear SEMs, and in analyzing nonlinear SEMs with the normal assumption of the exogenous latent variables violated. The proposed methodology is further illustrated by a real example. Detailed interpretation about the interaction terms is presented.",0 +https://doi.org/10.1007/s10260-012-0216-1,On the use of MCMC computerized adaptive testing with empirical prior information to improve efficiency,"The paper deals with the introduction of empirical prior information in the estimation of candidate's ability within computerized adaptive testing (CAT). CAT is generally applied to improve efficiency of test administration. In this paper, it is shown how the inclusion of background variables both in the initialization and the ability estimation is able to improve the accuracy of ability estimates. In particular, a Gibbs sampler scheme is proposed in the phases of interim and final ability estimation. By using both simulated and real data, it is proved that the method produces more accurate ability estimates, especially for short tests and when reproducing boundary abilities. This implies that operational problems of CAT related to weak measurement precision under particular conditions, can be reduced as well. In the empirical examples, the methods were applied to CAT for intelligence testing in the area of personnel selection and to educational measurement. Other promising applications would be in the medical world, where testing efficiency is of paramount importance as well. © 2012 Springer-Verlag Berlin Heidelberg.",0 +https://doi.org/10.2501/ijmr-53-6-831-857,Market Share Predictions: A New Model with Rating-Based Conjoint Analysis,"Conjoint Analysis (CA) is a technique heavily used by industry in support of product development, pricing and positioning, and market share predictions. This generic term CA encompasses a variety of experimental protocols and estimation models (e.g. rating-based or choice-based), as well as several probabilistic models for predicting market share. As for the rating conjoint, existing probabilistic models from the literature cannot be considered as reliable because they suffer from the Independence of Irrelevant Alternatives (IIA) property, in addition to depending on an arbitrary rating scale selected by the experimenter. In this article, after a brief overview of CA and of models used for market share predictions, we propose a new model for market share predictions, RFC-BOLSE, which avoids the IIA problem, yields convergent results for different rating scales, and outputs predictions that match regression reliability. The model is described in details and simulations and a case study on truck tyres will illustrate the reliability of RFC-BOLSE.",0 +https://doi.org/10.1080/10705511.2012.687669,On Obtaining Estimates of the Fraction of Missing Information From Full Information Maximum Likelihood,"Fraction of missing information λ j is a useful measure of the impact of missing data on the quality of estimation of a particular parameter. This measure can be computed for all parameters in the model, and it communicates the relative loss of efficiency in the estimation of a particular parameter due to missing data. It has been recommended that researchers working with incomplete data sets routinely report this measure, as it is more informative than percent missing data (Bodner, 2008 Bodner, T. E. 2008. What improves with increasing missing data imputations?. Structural Equation Modeling, 15: 651–675. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]; Schafer, 1997 Schafer, J. L. 1997. Analysis of incomplete multivariate data. London: Chapman & Hall.. [Crossref] , [Google Scholar]). However, traditional estimates of λ j require the implementation of multiple imputation (MI). Many researchers prefer to fit structural equation models using full information maximum likelihood rather than MI. This article demonstrates how to obtain an estimate of λ j using maximum likelihood estimation routines only and argues that this estimate is superior to the estimate obtained via MI when the number of imputations is small. Interpretation of λ j is also addressed.",0 +https://doi.org/10.1214/06-ba122,Deviance information criteria for missing data models,"The deviance information criterion (DIC) introduced by is directly inspired by linear and generalised linear models, but it is not so naturally defined for missing data models. In this paper, we reassess the criterion for such models, testing the behaviour of various extensions in the cases of mixture and random effect models.",0 +https://doi.org/10.1007/s10869-013-9300-2,Meta-analytic Reviews in the Organizational Sciences: Two Meta-analytic Schools on the Way to MARS (the Meta-analytic Reporting Standards),"Purpose: The purpose of this study was to review the Meta-Analysis Reporting Standards (MARS) of the American Psychological Association (APA) and highlight opportunities for improvement of meta-analytic reviews in the organizational sciences. Design/Methodology/Approach: The paper reviews MARS, describes ""best"" meta-analytic practices across two schools of meta-analysis, and shows how implementing such practices helps achieve the aims set forth in MARS. Examples of best practices are provided to aid readers in finding models for their own research. Implications/Value: Meta-analytic reviews are a primary avenue for the accumulation of knowledge in the organizational sciences as well as many other areas of science. Unfortunately, many meta-analytic reviews in the organizational sciences do not fully follow professional guidelines and standards as closely as they should. Such deviations from best practice undermine the transparency and replicability of the reviews and thus their usefulness for the generation of cumulative knowledge and evidence-based practice. This study shows how implementing ""best"" meta-analytic practices helps to achieve the aims set forth in MARS. Although the paper is written primarily for organizational scientists, the paper's recommendations are not limited to any particular scientific domain. © 2013 Springer Science+Business Media New York.",0 +https://doi.org/10.1002/sim.5709,A bias correction for covariance estimators to improve inference with generalized estimating equations that use an unstructured correlation matrix,"Generalized estimating equations (GEEs) are routinely used for the marginal analysis of correlated data. The efficiency of GEE depends on how closely the working covariance structure resembles the true structure, and therefore accurate modeling of the working correlation of the data is important. A popular approach is the use of an unstructured working correlation matrix, as it is not as restrictive as simpler structures such as exchangeable and AR-1 and thus can theoretically improve efficiency. However, because of the potential for having to estimate a large number of correlation parameters, variances of regression parameter estimates can be larger than theoretically expected when utilizing the unstructured working correlation matrix. Therefore, standard error estimates can be negatively biased. To account for this additional finite-sample variability, we derive a bias correction that can be applied to typical estimators of the covariance matrix of parameter estimates. Via simulation and in application to a longitudinal study, we show that our proposed correction improves standard error estimation and statistical inference.",0 +https://doi.org/10.1007/bf02291366,Simultaneous factor analysis in several populations,"This paper is concerned with the study of similarities and differences in factor structures between different groups. A common situation occurs when a battery of tests has been administered to samples of examinees from several populations. A very general model is presented, in which any parameter in the factor analysis models (factor loadings, factor variances, factor covariances, and unique variances) for the different groups may be assigned an arbitrary value or constrained to be equal to some other parameter. Given such a specification, the model is estimated by the maximum likelihood method yielding a large sample x2 of goodness of fit. By computing several solutions under different specifications one can test various hypotheses. The method is capable of dealing with any degree of invariance, from the one extreme, where nothing is invariant, to the other extreme, where everything is invariant. Neither the number of tests nor the number of common factors need to be the same for all groups, but to be at all interesting, it is assumed that there is a common core of tests in each battery that is the same or at least content-wise comparable. © 1971 Psychometric Society.",0 +https://doi.org/10.4135/9781446247600.n31,Point-Referenced Spatial Modeling,,0 +https://doi.org/10.1007/978-1-4614-1599-2_23,Multilevel Modeling,"Mortality is the most frequently modeled outcome in injury research. It is easy to recognize, relatively free from measurement error, and fundamentally interesting. Injury researchers in public health or clinical medicine have become familiar with logistic regression as a standard way to model a binary outcome like mortality (or alternatively survival). Many other outcomes encountered in injury research can also be considered binary, such as the occurrence of a serious complication or an extended length of stay in hospital. © Springer Science+Business Media, LLC 2012. All rights reserved.",0 +https://doi.org/10.1016/j.tree.2008.10.008,Generalized linear mixed models: a practical guide for ecology and evolution,"How should ecologists and evolutionary biologists analyze nonnormal data that involve random effects? Nonnormal data such as counts or proportions often defy classical statistical procedures. Generalized linear mixed models (GLMMs) provide a more flexible approach for analyzing nonnormal data when random effects are present. The explosion of research on GLMMs in the last decade has generated considerable uncertainty for practitioners in ecology and evolution. Despite the availability of accurate techniques for estimating GLMM parameters in simple cases, complex GLMMs are challenging to fit and statistical inference such as hypothesis testing remains difficult. We review the use (and misuse) of GLMMs in ecology and evolution, discuss estimation and inference and summarize ‘best-practice' data analysis procedures for scientists facing this challenge.",0 +https://doi.org/10.1167/6.11.13,Spatial four-alternative forced-choice method is the preferred psychophysical method for naive observers,"H. R. Blackwell (1952) investigated the influence of different psychophysical methods and procedures on detection thresholds. He found that the temporal two-interval forced-choice method (2-IFC) combined with feedback, blocked constant stimulus presentation with few different stimulus intensities, and highly trained observers resulted in the ""best"" threshold estimates. This recommendation is in current practice in many psychophysical laboratories and has entered the psychophysicists' ""folk wisdom"" of how to run proper psychophysical experiments. However, Blackwell's recommendations explicitly require experienced observers, whereas many psychophysical studies, particularly with children or within a clinical setting, are performed with naïve observers. In a series of psychophysical experiments, we find a striking and consistent discrepancy between naïve observers' behavior and that reported for experienced observers by Blackwell: Naïve observers show the ""best"" threshold estimates for the spatial four-alternative forced-choice method (4-AFC) and the worst for the commonly employed temporal 2-IFC. We repeated our study with a highly experienced psychophysical observer, and he replicated Blackwell's findings exactly, thus suggesting that it is indeed the difference in psychophysical experience that causes the discrepancy between our findings and those of Blackwell. In addition, we explore the efficiency of different methods and show 4-AFC to be more than 3.5 times more efficient than 2-IFC under realistic conditions. While we have found that 4-AFC consistently gives lower thresholds than 2-IFC in detection tasks, we have found the opposite for discrimination tasks. This discrepancy suggests that there are large extrasensory influences on thresholds--sensory memory for IFC methods and spatial attention for spatial forced-choice methods--that are critical but, alas, not part of theoretical approaches to psychophysics such as signal detection theory.",0 +,Random effects models.,,0 +https://doi.org/10.1007/bf02294241,A comparison of the efficiency and accuracy of BILOG and LOGIST,"Comparisons are made between BILOG version 2.2 and LOGIST 5.0 Version 2.5 in estimating the item parameters, traits, item characteristic functions (ICFs), and test characteristic functions (TCFs) for the three-parameter logistic model. Data analyzed are simulated item responses for 1000 simulees and one 10-item test, four 20-item tests, and four 40-item tests. LOGIST usually was faster than BILOG in producing maximum likelihood estimates. BILOG almost always produced more accurate estimates of individual item parameters. In estimating ICFs and TCFs BILOG was more accurate for the 10-item test, and the two programs were about equally accurate for the 20- and 40-item tests. © 1987 The Psychometric Society.",0 +https://doi.org/10.1007/978-1-4613-0893-5_17,Dynamic but Structural Equation Modeling of Repeated Measures Data,"The term “dynamic” is broadly defined as a pattern of change. Many scientists have searched for dynamics by calculating df/dt: the ratio of changes or differences d in a function f relative to changes in time t.This simple dynamic equation was used in the 16th and 17th century motion experiments of Galileo, in the 17th and 18th century gravitation experiments of Newton, and in the 19th century experiments of many physicists and chemists (see Morris, 1985). I also use this dynamic equation, but here I examine multivariate psychological change data using the 20th century developments of latent variable structural equation modeling.",0 +https://doi.org/10.1186/s12918-015-0190-y,Genome-scale metabolic model of Rhodococcus jostii RHA1 (iMT1174) to study the accumulation of storage compounds during nitrogen-limited condition,"Rhodococcus jostii RHA1 growing on different substrates is capable of accumulating simultaneously three types of carbon storage compounds: glycogen, polyhydroxyalkanoates (PHA), and triacylglycerols (TAG). Under nitrogen-limited (N-limited) condition, the level of storage increases as is commonly observed for other bacteria. The proportion of each storage compound changes with substrate, but it remains unclear what modelling approach should be adopted to predict the relative composition of the mixture of the storage compounds. We analyzed the growth of R. jostii RHA1 under N-limited conditions using a genome-scale metabolic modelling approach to determine which global metabolic objective function could be used for the prediction.The R. jostii RHA1 model (iMT1174) produced during this study contains 1,243 balanced metabolites, 1,935 unique reactions, and 1,174 open reading frames (ORFs). Seven objective functions used with flux balance analysis (FBA) were compared for their capacity to predict the mixture of storage compounds accumulated after the sudden onset of N-limitation. Predictive abilities were determined using a Bayesian approach. Experimental data on storage accumulation mixture (glycogen, polyhydroxyalkanoates, and triacylglycerols) were obtained for batch cultures grown on glucose or acetate. The best FBA simulation results were obtained using a novel objective function for the N-limited condition which combined the maximization of the storage fluxes and the minimization of metabolic adjustments (MOMA) with the preceding non-limited conditions (max storage + environmental MOMA). The FBA solutions for the non-limited growth conditions were simply constrained by the objective function of growth rate maximization. Measurement of central metabolic fluxes by (13)C-labelling experiments of amino acids further supported the application of the environmental MOMA principle in the context of changing environment. Finally, it was found that the quantitative predictions of the storage mixture during N-limited storage accumulation were fairly sensitive to the biomass composition, as expected.The genome-scale metabolic model analysis of R. jostii RHA1 cultures suggested that the intracellular reaction flux profile immediately after the onset of N-limited condition are impacted by the values of the same fluxes during the period of non-limited growth. PHA turned out to be the main storage pool of the mixture in R. jostii RHA1.",0 +https://doi.org/10.1007/bf02293789,A study of algorithms for covariance structure analysis with specific comparisons using factor analysis,"Several algorithms for covariance structure analysis are considered in addition to the Fletcher-Powell algorithm. These include the Gauss-Newton, Newton-Raphson, Fisher Scoring, and Fletcher-Reeves algorithms. Two methods of estimation are considered, maximum likelihood and weighted least squares. It is shown that the Gauss-Newton algorithm which in standard form produces weighted least squares estimates can, in iteratively reweighted form, produce maximum likelihood estimates as well. Previously unavailable standard error estimates to be used in conjunction with the Fletcher-Reeves algorithm are derived. Finally all the algorithms are applied to a number of maximum likelihood and weighted least squares factor analysis problems to compare the estimates and the standard errors produced. The algorithms appear to give satisfactory estimates but there are serious discrepancies in the standard errors. Because it is robust to poor starting values, converges rapidly and conveniently produces consistent standard errors for both maximum likelihood and weighted least squares problems, the Gauss-Newton algorithm represents an attractive alternative for at least some covariance structure analyses. © 1979 The Psychometric Society.",0 +https://doi.org/10.1037/1082-989x.9.1.30,The Role of Coding Time in Estimating and Interpreting Growth Curve Models.,"The coding of time in growth curve models has important implications for the interpretation of the resulting model that are sometimes not transparent. The authors develop a general framework that includes predictors of growth curve components to illustrate how parameter estimates and their standard errors are exactly determined as a function of receding time in growth curve models. Linear and quadratic growth model examples are provided, and the interpretation of estimates given a particular coding of time is illustrated. How and why the precision and statistical power of predictors of lower order growth curve components changes over time is illustrated and discussed. Recommendations include coding time to produce readily interpretable estimates and graphing lower order effects across time with appropriate confidence intervals to help illustrate and understand the growth process.",0 +https://doi.org/10.1037/1082-989x.3.3.328,Power estimation in social relations analyses.,"This article is intended for investigators interested in applying the Social Relations Model (SRM) to the study of dyadic processes. On the basis of theory and simulation, the authors provide practical advice concerning optimal number of persons per research group, number of research groups, type of research design, and significance testing method. Power depends more on group size than on number of groups. Power also is greater with the round-robin design than with the block design and greater with an asymptotic test of significance than with the test usually used. The authors discuss the effect of skew on theoretical power.",0 +https://doi.org/10.1007/bf02294770,Efficient nonparametric approaches for estimating the operating characteristics of discrete item responses,"Rationale and the actual procedures of two nonparametric approaches, called Bivariate P.D.F. Approach and Conditional P.D.F. Approach, for estimating the operating characteristic of a discrete item response, or the conditional probability, given latent trait, that the examinee's response be that specific response, are introduced and discussed. These methods are featured by the facts that: (a) estimation is made without assuming any mathematical forms, and (b) it is based upon a relatively small sample of several hundred to a few thousand examinees. Some examples of the results obtained by the Simple Sum Procedure and the Differential Weight Procedure of the Conditional P.D.F. Approach are given, using simulated data. The usefulness of these nonparametric methods is also discussed.",0 +https://doi.org/10.1080/10409289.2015.1012188,"Boys Might Catch Up, Family Influences Continue: Influences on Behavioral Self-Regulation in Children From an Affluent Region in Germany Before School Entry","Research Findings: Behavioral self-regulation is crucial for school success. Although behavioral self-regulation typically grows rapidly during the preschool period, children in this age group vary widely in their behavioral self-regulation capacities. The present study investigated 3 potential determinants of growth rates in behavioral self-regulation in children from an affluent region in Germany: family educational resources, child gender, and child negative affectivity. Using a longitudinal design, we observed children (N = 60) during the last 2 years before school entry. Children from families with relatively fewer educational resources started off with a lower level of behavioral self-regulation and did not catch up with their more advantaged peers. Boys showed poorer initial behavioral self-regulation than girls, but their gains in behavioral self-regulation were greater over time compared to girls’. Negative affectivity influenced neither the initial level of nor growth in behavioral self-regulati...",0 +https://doi.org/10.3102/1076998612461831,A Semiparametric Model for Jointly Analyzing Response Times and Accuracy in Computerized Testing,"The item response times (RTs) collected from computerized testing represent an underutilized type of information about items and examinees. In addition to knowing the examinees’ responses to each item, we can investigate the amount of time examinees spend on each item. Current models for RTs mainly focus on parametric models, which have the advantage of conciseness, but may suffer from reduced flexibility to fit real data. We propose a semiparametric approach, specifically, the Cox proportional hazards model with a latent speed covariate to model the RTs, embedded within the hierarchical framework proposed by van der Linden to model the RTs and response accuracy simultaneously. This semiparametric approach combines the flexibility of nonparametric modeling and the brevity and interpretability of the parametric modeling. A Markov chain Monte Carlo method for parameter estimation is given and may be used with sparse data obtained by computerized adaptive testing. Both simulation studies and real data analysis are carried out to demonstrate the applicability of the new model.",0 +https://doi.org/10.3758/bf03192848,Multilevel models for the experimental psychologist: Foundations and illustrative examples,"Although common in the educational and developmental areas, multilevel models are not often utilized in the analysis of data from experimental designs. This article illustrates how multilevel models can be useful with two examples from experimental designs with repeated measurements not involving time. One example demonstrates how to properly examine independent variables for experimental stimuli or individuals that are categorical, continuous, or semicontinuous in the presence of missing data. The second example demonstrates how response times and error rates can be modeled simultaneously within a multivariate model in order to examine speed-accuracy trade-offs at the experimental-condition and individual levels, as well as to examine differences in the magnitude of effects across outcomes. SPSS and SAS syntax for the examples are available electronically.",0 +https://doi.org/10.1177/0013164416652441,Fitting Residual Error Structures for Growth Models in SAS PROC MCMC,"In behavioral sciences broadly, estimating growth models with Bayesian methods is becoming increasingly common, especially to combat small samples common with longitudinal data. Although M plus is becoming an increasingly common program for applied research employing Bayesian methods, the limited selection of prior distributions for the elements of covariance structures makes more general software more advantages under certain conditions. However, as a disadvantage of general software’s software flexibility, few preprogrammed commands exist for specifying covariance structures. For instance, PROC MIXED has a few dozen such preprogrammed options, but when researchers divert to a Bayesian framework, software offer no such guidance and requires researchers to manually program these different structures, which is no small task. As such the literature has noted that empirical papers tend to simplify their covariance matrices to circumvent this difficulty, which is not desirable because such a simplification will likely lead to biased estimates of variance components and standard errors. To facilitate wider implementation of Bayesian growth models that properly model covariance structures, this article overviews how to generally program a growth model in SAS PROC MCMC and then demonstrates how to program common residual error structures. Full annotated SAS code and an applied example are provided.",0 +https://doi.org/10.1214/aos/1176348671,Affinely Invariant Matching Methods with Ellipsoidal Distributions,"Matched sampling is a common technique used for controlling bias in observational studies. We present a general theoretical framework for studying the performance of such matching methods. Specifically, results are obtained concerning the performance of affinely invariant matching methods with ellipsoidal distributions, which extend previous results on equal percent bias reducing methods. Additional extensions cover conditionally affinely invariant matching methods for covariates with conditionally ellipsoidal distributions. These results decompose the effects of matching into one subspace containing the best linear discriminant, and the subspace of variables uncorrelated with the discriminant. This characterization of the effects of matching provides a theoretical foundation for understanding the performance of specific methods such as matched sampling using estimated propensity scores. Calculations for such methods are given in subsequent articles.",0 +https://doi.org/10.1002/bimj.201400232,Augmented Beta rectangular regression models: A Bayesian perspective,"Mixed effects Beta regression models based on Beta distributions have been widely used to analyze longitudinal percentage or proportional data ranging between zero and one. However, Beta distributions are not flexible to extreme outliers or excessive events around tail areas, and they do not account for the presence of the boundary values zeros and ones because these values are not in the support of the Beta distributions. To address these issues, we propose a mixed effects model using Beta rectangular distribution and augment it with the probabilities of zero and one. We conduct extensive simulation studies to assess the performance of mixed effects models based on both the Beta and Beta rectangular distributions under various scenarios. The simulation studies suggest that the regression models based on Beta rectangular distributions improve the accuracy of parameter estimates in the presence of outliers and heavy tails. The proposed models are applied to the motivating Neuroprotection Exploratory Trials in Parkinson's Disease (PD) Long-term Study-1 (LS-1 study, n = 1741), developed by The National Institute of Neurological Disorders and Stroke Exploratory Trials in Parkinson's Disease (NINDS NET-PD) network.",0 +https://doi.org/10.3758/bf03203075,Maximum-likelihood psychometric procedures in two-alternative forced-choice: Evaluation and recommendations,"Several new adaptive psychometric procedures have been proposed that use maximum-likelihood methods to estimate points on a subject’s psychophysical function. These developments are summarized, and some psychometric situations that pose special problems for the new approaches are examined. The problem areas include the effects of threshold changes during the testing session, the impact of errors made by the subject, and differences between yes-no and two-alternative forced-choice situations. Data are presented from both human subjects and computer simulations. Strengths and weaknesses of the new procedures are identified and recommendations are made for their use.",0 +https://doi.org/10.1037/10244-013,Psychometric procedures for administering CAT-ASVAB.,,0 +https://doi.org/10.1201/b14835-15,Hypothesis testing and model selection,,0 +https://doi.org/10.1002/sim.991,A comparison of generalized linear mixed model procedures with estimating equations for variance and covariance parameter estimation in longitudinal studies and group randomized trials,"Response data in longitudinal studies and group randomized trials are gathered on units that belong to clusters, within which data are usually positively correlated. Therefore, estimates and confidence intervals for intraclass correlation or variance components are helpful when designing a longitudinal study or group randomized trial. Data simulated from both study designs are used to investigate the estimation of variance and covariance parameters from the following procedures: for continuous outcomes, restricted maximum likelihood (REML) and estimating equations (EE); for binary outcomes, restricted pseudo-likelihood (REPL) and estimating equations (EE). We evaluate these procedures to see which provide valid and precise estimates as well as correct standard errors for the intraclass correlation coefficient or variance components. REML seems the better choice for estimating terms related to correlation for models with normal outcomes, especially in group randomized trial situations. Results for REML and EE are mixed when outcomes are continuous and non-normal. With binary outcomes neither REPL nor EE provides satisfactory estimation or inference in longitudinal study situations, while REPL is preferable for group randomized trials.",0 +https://doi.org/10.1111/rssa.12018,Synthesis of evidence on heterogeneous interventions with multiple outcomes recorded over multiple follow-up times reported inconsistently: a smoking cessation case-study,"Health technology assessment requires the synthesis of evidence from multiple sources to assess the cost-effectiveness of competing interventions. However, the format of the available reported evidence is often complex. We present a case-study of electronic aids to smoking cessation, which raises various methodological challenges. The evidence base evaluated highly complex and diverse interventions, reporting one or both of two different, but related, outcome measures. Furthermore, there were differences between studies in the number and timing of follow-up times reported, whereas 12-month continuous abstinence is required in the cost-effectiveness analysis. We develop a categorization system to evaluate the interventions, and we use network meta-analysis of time-to-relapse model parameters to estimate coherent intervention effects for any pair of categories. We compare the fit of alternative time-to-relapse models and explore the effect of joint models for both outcome measures, which can be used to estimate treatment effects when a given outcome is not reported, so that all the available evidence can be combined. © 2013 Royal Statistical Society.",0 +https://doi.org/10.1093/aob/mct176,Highly local environmental variability promotes intrapopulation divergence of quantitative traits: an example from tropical rain forest trees,"In habitat mosaics, plant populations face environmental heterogeneity over short geographical distances. Such steep environmental gradients can induce ecological divergence. Lowland rainforests of the Guiana Shield are characterized by sharp, short-distance environmental variations related to topography and soil characteristics (from waterlogged bottomlands on hydromorphic soils to well-drained terra firme on ferralitic soils). Continuous plant populations distributed along such gradients are an interesting system to study intrapopulation divergence at highly local scales. This study tested (1) whether conspecific populations growing in different habitats diverge at functional traits, and (2) whether they diverge in the same way as congeneric species having different habitat preferences.Phenotypic differentiation was studied within continuous populations occupying different habitats for two congeneric, sympatric, and ecologically divergent tree species (Eperua falcata and E. grandiflora, Fabaceae). Over 3000 seeds collected from three habitats were germinated and grown in a common garden experiment, and 23 morphological, biomass, resource allocation and physiological traits were measured.In both species, seedling populations native of different habitats displayed phenotypic divergence for several traits (including seedling growth, biomass allocation, leaf chemistry, photosynthesis and carbon isotope composition). This may occur through heritable genetic variation or other maternally inherited effects. For a sub-set of traits, the intraspecific divergence associated with environmental variation coincided with interspecific divergence.The results indicate that mother trees from different habitats transmit divergent trait values to their progeny, and suggest that local environmental variation selects for different trait optima even at a very local spatial scale. Traits for which differentiation within species follows the same pattern as differentiation between species indicate that the same ecological processes underlie intra- and interspecific variation.",0 +https://doi.org/10.1037/h0026141,Statistical significance in psychological research.,"Most theories in the areas of personality, clinical, and social psychology predict no more than the direction of a correlation, group difference, or treatment effect. Since the null hypothesis is never strictly true, such predictions have about a SO-SO chance of being confirmed by experiment when the theory in question is false, since the statistical significance of the result is a function of the sample size. Confirmation of a single directional prediction should usually add little to one's confidence in the theory being tested. Most theories should be tested by multiple corroboration and most empirical generalizations by constructive replication. Statistical significance is perhaps the least important attribute of a good experiment; it is never a sufficient condition for claiming that a theory has been usefully corroborated, that a meaningful empirical fact has been established, or that an experimental report ought to be published. In a recent journal article Sapolsky (1964) developed the following substantive theory: Some psychiatric patients entertain an unconscious belief in the theory of birth which involves the notions of oral impregnation and anal parturition. Such patients should be inclined to manifest eating disorders: compulsive eating in the case of those who wish to get pregnant and anorexia in those who do not. Such patients should also be inclined to see cloacal animals, such as frogs, on the Rorschach. This reasoning led Sapolsky to predict that Rorschach frog responders show",0 +https://doi.org/10.1007/s11162-011-9232-5,Effect Sizes and Statistical Methods for Meta-Analysis in Higher Education,"Quantitative meta-analysis is a very useful, yet underutilized, technique for synthesizing research findings in higher education. Meta-analytic inquiry can be more challenging in higher education than in other fields of study as a result of (a) concerns about the use of regression coefficients as a metric for comparing the magnitude of effects across studies, and (b) the non-independence of observations that occurs when a single study contains multiple effect sizes. This methodological note discusses these two important issues and provides concrete suggestions for addressing them. First, meta-analysis scholars have concluded that standardized regression coefficients, which are often provided in higher education manuscripts, constitute an appropriate metric of effect size. Second, hierarchical linear modeling (HLM) analyses provide an effective method for conducting meta-analytic research while accounting for the non-independence of observations, and HLM is generally superior to other proposed methods that attempt to remedy this same problem. A discussion of how to implement these techniques appropriately is provided. © 2011 Springer Science+Business Media, LLC.",0 +https://doi.org/10.1080/00273171.2011.540475,A Systematic Review of Propensity Score Methods in the Social Sciences,"The use of propensity scores in psychological and educational research has been steadily increasing in the last 2 to 3 years. However, there are some common misconceptions about the use of different estimation techniques and conditioning choices in the context of propensity score analysis. In addition, reporting practices for propensity score analyses often lack important details that allow other researchers to confidently judge the appropriateness of reported analyses and potentially to replicate published findings. In this article we conduct a systematic literature review of a large number of published articles in major areas of social science that used propensity scores up until the fall of 2009. We identify common errors in estimation, conditioning, and reporting of propensity score analyses and suggest possible solutions.",0 +https://doi.org/10.1214/aos/1176325625,Estimation of a Covariance Matrix Using the Reference Prior,"Estimation of a covariance matrix $\sum$ is a notoriously difficult problem; the standard unbiased estimator can be substantially suboptimal. We approach the problem from a noninformative prior Bayesian perspective, developing the reference noninformative prior for a covariance matrix and obtaining expressions for the resulting Bayes estimators. These expressions involve the computation of high-dimensional posterior expectations, which is done using a recent Markov chain simulation tool, the hit-and-run sampler. Frequentist risk comparisons with previously suggested estimators are also given, and determination of the accuracy of the estimators is addressed.",0 +https://doi.org/10.1016/j.jcp.2016.02.056,Bayesian estimation of Karhunen–Loève expansions; A random subspace approach,"One of the most widely-used procedures for dimensionality reduction of high dimensional data is Principal Component Analysis (PCA). More broadly, low-dimensional stochastic representation of random fields with finite variance is provided via the well known Karhunen–Loève expansion (KLE). The KLE is analogous to a Fourier series expansion for a random process, where the goal is to find an orthogonal transformation for the data such that the projection of the data onto this orthogonal subspace is optimal in the L 2 sense, i.e., which minimizes the mean square error. In practice, this orthogonal transformation is determined by performing an SVD (Singular Value Decomposition) on the sample covariance matrix or on the data matrix itself. Sampling error is typically ignored when quantifying the principal components, or, equivalently, basis functions of the KLE. Furthermore, it is exacerbated when the sample size is much smaller than the dimension of the random field. In this paper, we introduce a Bayesian KLE procedure, allowing one to obtain a probabilistic model on the principal components, which can account for inaccuracies due to limited sample size. The probabilistic model is built via Bayesian inference, from which the posterior becomes the matrix Bingham density over the space of orthonormal matrices. We use a modified Gibbs sampling procedure to sample on this space and then build probabilistic Karhunen–Loève expansions over random subspaces to obtain a set of low-dimensional surrogates of the stochastic process. We illustrate this probabilistic procedure with a finite dimensional stochastic process inspired by Brownian motion.",0 +https://doi.org/10.1177/014662169602000303,A Global Information Approach to Computerized Adaptive Testing,"Most item selection in computerized adaptive testing is based on Fisher information (or item information). At each stage, an item is selected to maximize the Fisher information at the currently estimated trait level (θ). However, this application of Fisher information could be much less efficient than assumed if the estimators are not close to the true θ, especially at early stages of an adaptive test when the test length (number of items) is too short to provide an accurate estimate for true θ. It is argued here that selection procedures based on global information should be used, at least at early stages of a test when θ estimates are not likely to be close to the true θ. For this purpose, an item selection procedure based on average global information is proposed. Re sults from pilot simulation studies comparing the usual maximum item information item selection with the pro posed global information approach are reported, indicat ing that the new method leads to improvement in terms of bias and mean squared error reduction under many circumstances. Index terms: computerized adaptive testing, Fisher information, global information, infor mation surface, item information, item response theory, Kullback-Leibler information, local information, test in formation.",0 +https://doi.org/10.1007/978-3-658-06550-8,Intangible Values in Financial Accounting and Reporting,"Academics and practitioners argue that intangible values have become significant value drivers of today's economy. Major production inputs no longer comprise of property, plant and equipment, but rather of brands, knowledge and other technological innovation. Based on this notion, information on such phenomena is supposedly crucial for existing and potential capital providers in making decisions whether to allocate resources to a company. This thesis examines the information use and needs of financial analysts with respect to intangible values. The purpose is to shed light on the usefulness of such information from the perspective of one of the primary user groups of IFRSs. © Springer Fachmedien Wiesbaden 2015.",0 +https://doi.org/10.1080/10705510802561402,Modeling Dynamic Functional Neuroimaging Data Using Structural Equation Modeling,"The aims of this study were to present a method for developing a path analytic network model using data acquired from positron emission tomography. Regions of interest within the human brain were identified through quantitative activation likelihood estimation meta-analysis. Using this information, a ""true"" or population path model was then developed using Bayesian structural equation modeling. To evaluate the impact of sample size on parameter estimation bias, proportion of parameter replication coverage, and statistical power, a 2 group (clinical/control) × 6 (sample size: N = 10, N = 15, N = 20, N = 25, N = 50, N = 100) Markov chain Monte Carlo study was conducted. Results indicate that using a sample size of less than N = 15 per group will produce parameter estimates exhibiting bias greater than 5% and statistical power below .80.",0 +https://doi.org/10.2307/1247354,"Survey Design and Analysis: Principles, Cases, and Procedures",,0 +https://doi.org/10.1016/j.pbb.2013.04.012,Peripheral kappa and delta opioid receptors are involved in the antinociceptive effect of crotalphine in a rat model of cancer pain,"Cancer pain is an important clinical problem and may not respond satisfactorily to the current analgesic therapy. We have characterized a novel and potent analgesic peptide, crotalphine, from the venom of the South American rattlesnake Crotalus durissus terrificus . In the present work, the antinociceptive effect of crotalphine was evaluated in a rat model of cancer pain induced by intraplantar injection of Walker 256 carcinoma cells. Intraplantar injection of tumor cells caused the development of hyperalgesia and allodynia, detected on day 5 after tumor cell inoculation. Crotalphine (6 μg/kg), administered p.o., blocked both phenomena. The antinociceptive effect was detected 1 h after treatment and lasted for up to 48 h. Intraplantar injection of nor-binaltorphimine (50 g/paw), a selective antagonist of κ-opioid receptors, antagonized the antinociceptive effect of the peptide, whereas N , N -diallyl-Tyr-Aib-Phe-Leu (ICI 174,864, 10 μg/paw), a selective antagonist of δ-opioid receptors, partially reversed this effect. On the other hand, D-Phe-Cys-Tyr-D-Trp-Orn-Thr-Pen-Thr amide (CTOP, 20 g/paw), an antagonist of μ-opioid receptors, did not modify crotalphine-induced antinociception. These data indicate that crotalphine induces a potent and long lasting opioid-mediated antinociception in cancer pain. • We investigate the antinociceptive effect of crotalphine in cancer pain. • Crotalphine inhibits hyperalgesia, allodynia and spontaneous pain induced by tumor. • Crotalphine induces a potent and long-lasting (2 days) antinociceptive effect. • Peripheral kappa and delta opioid receptors are involved in the antinociceptive.",0 +https://doi.org/10.1007/s00231-013-1213-0,Incorporating engineering intuition for parameter estimation in thermal sciences,"This paper proposes a new method of incorporating priors based on engineering intuition for solving inverse problems. The thesis of this paper is that if an asymptote can be found to a problem in applied sciences or engineering, estimation of parameters can be first done for this asymptotic variant, which in principle should be simpler, since one or more parameters of the original problem may vanish for the asymptotic variant. Even so, by solving the inverse problem associated with the asymptotic variant, estimates of key parameters of the full problem can be obtained. This information can then be quantitatively incorporated as priors in the estimation of parameters for the full version of the problem which we call as prior generation through asymptotic variant. The goal is to see if this methodology will significantly reduce the uncertainties in the resulting estimates. To demonstrate this methodology, the classic problem of unsteady heat transfer from a one dimensional fin is chosen. The inverse problem is posed as the simultaneous estimation of the temperature dependent transfer coefficient (h θ ) and the thermal diffusivity (α) of the fin material, given experimentally measured temperature-time histories at various locations along the fin. The asymptotic variant θ (x,t) is the steady state problem where the influence of thermal diffusivity vanishes. Using surrogate temperature data generated from assumed values of h θ, first the asymptotic variant of the problem is solved using the Markov Chain Monte Carlo method in a Bayesian framework to generate an estimate of h θ . The estimate of h θ is then used as an informative prior for solving the inverse problem of determining h θ and α from θ (x,t), and the effect of prior is quantitatively assessed by performing estimation with and without the prior. Finally, for purposes of validation, in-house experiments have been done where θ (x,t) is generated using liquid crystal thermography and these data are used to estimate h θ and α. A comparison of experimentally measured temperatures with those that are simulated by using estimated values of (h θ, α) to solve the governing equation to the problem is also done. © 2013 Springer-Verlag Berlin Heidelberg.",0 +https://doi.org/10.1371/journal.pone.0025635,Bayesian Hierarchical Models Combining Different Study Types and Adjusting for Covariate Imbalances: A Simulation Study to Assess Model Performance,"Bayesian hierarchical models have been proposed to combine evidence from different types of study designs. However, when combining evidence from randomised and non-randomised controlled studies, imbalances in patient characteristics between study arms may bias the results. The objective of this study was to assess the performance of a proposed Bayesian approach to adjust for imbalances in patient level covariates when combining evidence from both types of study designs.Simulation techniques, in which the truth is known, were used to generate sets of data for randomised and non-randomised studies. Covariate imbalances between study arms were introduced in the non-randomised studies. The performance of the Bayesian hierarchical model adjusted for imbalances was assessed in terms of bias. The data were also modelled using three other Bayesian approaches for synthesising evidence from randomised and non-randomised studies. The simulations considered six scenarios aimed at assessing the sensitivity of the results to changes in the impact of the imbalances and the relative number and size of studies of each type. For all six scenarios considered, the Bayesian hierarchical model adjusted for differences within studies gave results that were unbiased and closest to the true value compared to the other models.Where informed health care decision making requires the synthesis of evidence from randomised and non-randomised study designs, the proposed hierarchical Bayesian method adjusted for differences in patient characteristics between study arms may facilitate the optimal use of all available evidence leading to unbiased results compared to unadjusted analyses.",0 +https://doi.org/10.1002/sim.3594,Addressing between-study heterogeneity and inconsistency in mixed treatment comparisons: Application to stroke prevention treatments in individuals with non-rheumatic atrial fibrillation,"Mixed treatment comparison models extend meta-analysis methods to enable comparisons to be made between all relevant comparators in the clinical area of interest. In such modelling it is imperative that potential sources of variability are explored to explain both heterogeneity (variation in treatment effects between trials within pairwise contrasts) and inconsistency (variation in treatment effects between pairwise contrasts) to ensure the validity of the analysis.The objective of this paper is to extend the mixed treatment comparison framework to allow for the incorporation of study-level covariates in an attempt to explain between-study heterogeneity and reduce inconsistency. Three possible model specifications assuming different assumptions are described and applied to a 17-treatment network for stroke prevention treatments in individuals with non-rheumatic atrial fibrillation.The paper demonstrates the feasibility of incorporating covariates within a mixed treatment comparison framework and using model fit statistics to choose between alternative model specifications. Although such an approach may adjust for inconsistencies in networks, as for standard meta-regression, the analysis will suffer from low power if the number of trials is small compared with the number of treatment comparators.",0 +https://doi.org/10.2217/cer.14.29,Using indirect comparisons to compare interventions within a Cochrane review: a tool for comparative effectiveness research,"Aim: Assessing relative performance among competing interventions is an important part of comparative effectiveness research. Bayesian indirect comparisons add information to existing Cochrane reviews, such as which intervention is likely to perform best. However, heterogeneity variance priors may influence results and, potentially, clinical guidance. Methods: We highlight the features of Bayesian indirect comparisons using a case study of a Cochrane review update in asthma care. The probability that one self-management educational intervention outperforms others is estimated. Simulation studies investigate the effect of heterogeneity variance prior distributions. Results: Results suggest a 55% probability that individual education is best, followed by combination (39%) and group (6%). The intervention with few trials was sensitive to prior distributions. Conclusion: Bayesian indirect comparisons updates of Cochrane reviews are valuable comparative effectiveness research tools.",0 +https://doi.org/10.1207/s15327906mbr4103_5,A Comparison of Single Sample and Bootstrap Methods to Assess Mediation in Cluster Randomized Trials,"A Monte Carlo study examined the statistical performance of single sample and bootstrap methods that can be used to test and form confidence interval estimates of indirect effects in two cluster randomized experimental designs. The designs were similar in that they featured random assignment of clusters to one of two treatment conditions and included a single intervening variable and outcome, but they differed in whether the mediator was measured at the participant or site level. A bias-corrected bootstrap had the best statistical performance for each design and was closely followed by the empirical-Mtest, either of which is recommended for testing and estimating indirect effects in multilevel designs. In addition, consistent with previous research, the commonly used z test had relatively poor performance.",0 +https://doi.org/10.1111/j.1541-0420.2010.01547.x,Generalized Causal Mediation Analysis,"The goal of mediation analysis is to assess direct and indirect effects of a treatment or exposure on an outcome. More generally, we may be interested in the context of a causal model as characterized by a directed acyclic graph (DAG), where mediation via a specific path from exposure to outcome may involve an arbitrary number of links (or ""stages""). Methods for estimating mediation (or pathway) effects are available for a continuous outcome and a continuous mediator related via a linear model, while for a categorical outcome or categorical mediator, methods are usually limited to two-stage mediation. We present a method applicable to multiple stages of mediation and mixed variable types using generalized linear models. We define pathway effects using a potential outcomes framework and present a general formula that provides the effect of exposure through any specified pathway. Some pathway effects are nonidentifiable and their estimation requires an assumption regarding the correlation between counterfactuals. We provide a sensitivity analysis to assess the impact of this assumption. Confidence intervals for pathway effect estimates are obtained via a bootstrap method. The method is applied to a cohort study of dental caries in very low birth weight adolescents. A simulation study demonstrates low bias of pathway effect estimators and close-to-nominal coverage rates of confidence intervals. We also find low sensitivity to the counterfactual correlation in most scenarios.",0 +https://doi.org/10.1080/00949655.2012.690763,Adaptive fitting of linear mixed-effects models with correlated random effects,"Linear mixed-effects model has been widely used in longitudinal data analyses. In practice, the fitting algorithm can fail to converge due to boundary issues of the estimated random-effects covariance matrix G, i.e., being near-singular, non-positive definite, or both. Current available algorithms are not computationally optimal because the condition number of matrix G is unnecessarily increased when the random-effects correlation estimate is not zero. We propose an adaptive fitting (AF) algorithm using an optimal linear transformation of the random-effects design matrix. It is a data-driven adaptive procedure, aiming at reducing subsequent random-effects correlation estimates down to zero in the optimal transformed estimation space. Simulations show that AF significantly improves the convergent properties, especially under small sample size, relative large noise and high correlation settings. One real data for Insulin-like Growth Factor (IGF) protein is used to illustrate the application of this algorithm implemented with software package R (nlme).",0 +https://doi.org/10.1007/bf02296131,On the estimation of polychoric correlations and their asymptotic covariance matrix,A general theory for parametric inference in contingency tables is outlined. Estimation of polychoric correlations is seen as a special case of this theory. The asymptotic covariance matrix of the estimated polychoric correlations is derived for the case when the thresholds are estimated from the univariate marginals and the polychoric correlations are estimated from the bivariate marginals for given thresholds. Computational aspects are also discussed. © 1994 The Psychometric Society.,0 +https://doi.org/10.1348/000711009x475187,Bayesian analysis of mixtures in structural equation models with non-ignorable missing data,"Structural equation models (SEMs) have become widely used to determine the interrelationships between latent and observed variables in social, psychological, and behavioural sciences. As heterogeneous data are very common in practical research in these fields, the analysis of mixture models has received a lot of attention in the literature. An important issue in the analysis of mixture SEMs is the presence of missing data, in particular of data missing with a non-ignorable mechanism. However, only a limited amount of work has been done in analysing mixture SEMs with non-ignorable missing data. The main objective of this paper is to develop a Bayesian approach for analysing mixture SEMs with an unknown number of components and non-ignorable missing data. A simulation study shows that Bayesian estimates obtained by the proposed Markov chain Monte Carlo methods are accurate and the Bayes factor computed via a path sampling procedure is useful for identifying the correct number of components, selecting an appropriate missingness mechanism, and investigating various effects of latent variables in the mixture SEMs. A real data set on a study of job satisfaction is used to demonstrate the methodology.",0 +https://doi.org/10.1002/sim.650,A comparison of statistical methods for meta-analysis,"Meta-analysis may be used to estimate an overall effect across a number of similar studies. A number of statistical techniques are currently used to combine individual study results. The simplest of these is based on a fixed effects model, which assumes the true effect is the same for all studies. A random effects model, however, allows the true effect to vary across studies, with the mean true effect the parameter of interest. We consider three methods currently used for estimation within the framework of a random effects model, and illustrate them by applying each method to a collection of six studies on the effect of aspirin after myocardial infarction. These methods are compared using estimated coverage probabilities of confidence intervals for the overall effect. The techniques considered all generally have coverages below the nominal level, and in particular it is shown that the commonly used DerSimonian and Laird method does not adequately reflect the error associated with parameter estimation, especially when the number of studies is small.",0 +https://doi.org/10.2307/2532845,A Modified EM Algorithm for Estimation in Generalized Mixed Models,"Application of the EM algorithm for estimation in the generalized mixed model has been largely unsuccessful because the E-step cannot be determined in most instances. The E-step computes the conditional expectation of the complete data log-likelihood and when the random effect distribution is normal, this expectation remains an intractable integral. The problem can be approached by numerical or analytic approximations; however, the computational burden imposed by numerical integration methods and the absence of an accurate analytic approximation have limited the use of the EM algorithm. In this paper, Laplace's method is adapted for analytic approximation within the E-step. The proposed algorithm is computationally straightforward and retains much of the conceptual simplicity of the conventional EM algorithm, although the usual convergence properties are not guaranteed. The proposed algorithm accommodates multiple random factors and random effect distributions besides the normal, e.g., the log-gamma distribution. Parameter estimates obtained for several data sets and through simulation show that this modified EM algorithm compares favorably with other generalized mixed model methods.",0 +https://doi.org/10.1111/bmsp.12051,Multilevel multidimensional item response model with a multilevel latent covariate,"In a pre-test-post-test cluster randomized trial, one of the methods commonly used to detect an intervention effect involves controlling pre-test scores and other related covariates while estimating an intervention effect at post-test. In many applications in education, the total post-test and pre-test scores, ignoring measurement error, are used as response variable and covariate, respectively, to estimate the intervention effect. However, these test scores are frequently subject to measurement error, and statistical inferences based on the model ignoring measurement error can yield a biased estimate of the intervention effect. When multiple domains exist in test data, it is sometimes more informative to detect the intervention effect for each domain than for the entire test. This paper presents applications of the multilevel multidimensional item response model with measurement error adjustments in a response variable and a covariate to estimate the intervention effect for each domain.",0 +https://doi.org/10.1007/bf02310555,Coefficient alpha and the internal structure of tests,"A general formula (α) of which a special case is the Kuder-Richardson coefficient of equivalence is shown to be the mean of all split-half coefficients resulting from different splittings of a test. α is therefore an estimate of the correlation between two random samples of items from a universe of items like those in the test. α is found to be an appropriate index of equivalence and, except for very short tests, of the first-factor concentration in the test. Tests divisible into distinct subtests should be so divided before using the formula. The index\(\bar r_{ij} \), derived from α, is shown to be an index of inter-item homogeneity. Comparison is made to the Guttman and Loevinger approaches. Parallel split coefficients are shown to be unnecessary for tests of common types. In designing tests, maximum interpretability of scores is obtained by increasing the first-factor concentration in any separately-scored subtest and avoiding substantial group-factor clusters within a subtest. Scalability is not a requisite.",0 +https://doi.org/10.1534/g3.115.019299,Using Bayesian Multilevel Whole Genome Regression Models for Partial Pooling of Training Sets in Genomic Prediction,"Training set size is an important determinant of genomic prediction accuracy. Plant breeding programs are characterized by a high degree of structuring, particularly into populations. This hampers the establishment of large training sets for each population. Pooling populations increases training set size but ignores unique genetic characteristics of each. A possible solution is partial pooling with multilevel models, which allows estimating population-specific marker effects while still leveraging information across populations. We developed a Bayesian multilevel whole-genome regression model and compared its performance with that of the popular BayesA model applied to each population separately (no pooling) and to the joined data set (complete pooling). As an example, we analyzed a wide array of traits from the nested association mapping maize population. There we show that for small population sizes (e.g., <50), partial pooling increased prediction accuracy over no or complete pooling for populations represented in the training set. No pooling was superior; however, when populations were large. In another example data set of interconnected biparental maize populations either partial or complete pooling was superior, depending on the trait. A simulation showed that no pooling is superior when differences in genetic effects among populations are large and partial pooling when they are intermediate. With small differences, partial and complete pooling achieved equally high accuracy. For prediction of new populations, partial and complete pooling had very similar accuracy in all cases. We conclude that partial pooling with multilevel models can maximize the potential of pooling by making optimal use of information in pooled training sets.",0 +https://doi.org/10.1177/0146621610392565,Marginal Maximum A Posteriori Item Parameter Estimation for the Generalized Graded Unfolding Model,"A marginal maximum a posteriori (MMAP) procedure was implemented to estimate item parameters in the generalized graded unfolding model (GGUM). Estimates from the MMAP method were compared with those derived from marginal maximum likelihood (MML) and Markov chain Monte Carlo (MCMC) procedures in a recovery simulation that varied sample size, questionnaire length, and number of item response categories. MMAP item parameter estimates were generally the most accurate and had the smallest standard errors on average. In contrast, the accuracy and variability of MML estimates suffered substantially when the number of item response categories was small and the true item locations were extreme. MMAP estimates were also more computationally efficient than corresponding MCMC estimates. Consequently, the MMAP procedure is recommended for estimation of GGUM item parameters.",0 +https://doi.org/10.1162/003465304323023697,Finite-Sample Properties of Propensity-Score Matching and Weighting Estimators,"The finite-sample properties of matching and weighting estimators, often used for estimating average treatment effects, are analyzed. Potential and feasible precision gains relative to pair matching are examined. Local linear matching (with and without trimming), k-nearest-neighbor matching, and particularly the weighting estimators performed worst. Ridge matching, on the other hand, leads to an approximately 25% smaller MSE than does pair matching. In addition, ridge matching is least sensitive to the design choice.",0 +https://doi.org/10.1038/377059a0,Neural computation of log likelihood in control of saccadic eye movements,"The latency between the appearance of a visual target and the start of the saccadic eye movement made to look at it varies from trial to trial to an extent that is inexplicable in terms of ordinary 'physiological' processes such as synaptic delays and conduction velocities. An alternative interpretation is that it represents the time needed to decide whether a target is in fact present: decision processes are necessarily stochastic, because they depend on extracting information from noisy sensory signals'. In one such model, the presence of a target causes a signal in a decision unit to rise linearly at a rate r from its initial value s, until it reaches a fixed threshold θ, when a saccade is initiated, One can regard this decision signal as a neural estimate of the log likelihood of the hypothesis that the target is present, the threshold being the significance criterion or likelihood level at which the target is presumed to be present, Experiments manipulating the prior probability of the target's appearing confirm this notion: the latency distribution then changes in the way expected if so simply reflects the prior log likelihood of the stimulus.",0 +https://doi.org/10.1080/03637751.2010.498791,Adolescents' Use of Sexually Explicit Internet Material and Sexual Uncertainty: The Role of Involvement and Gender,"Research has shown that adolescents' use of sexually explicit Internet material (SEIM) is positively associated with an important characteristic of the developing sexual self, sexual uncertainty. However, the causal relation between SEIM use and sexual uncertainty is unclear. Moreover, we do not know which processes underlie this relation and whether gender moderates these processes. Based on a three-wave panel survey among 956 Dutch adolescents, structural equation modeling revealed that more frequent SEIM use increased adolescents' sexual uncertainty. This influence was mediated by adolescents' involvement in SEIM. The impact of SEIM use on involvement was stronger for female than for male adolescents. Future research on the effects of SEIM may benefit from greater attention to experiential states during SEIM use.",0 +https://doi.org/10.1037/a0037744,An information capacity limitation of visual short-term memory.,"Research suggests that visual short-term memory (VSTM) has both an item capacity, of around 4 items, and an information capacity. We characterize the information capacity limits of VSTM using a task in which observers discriminated the orientation of a single probed item in displays consisting of 1, 2, 3, or 4 orthogonally oriented Gabor patch stimuli that were presented in noise for 50 ms, 100 ms, 150 ms, or 200 ms. The observed capacity limitations are well described by a sample-size model, which predicts invariance of ∑(i)(d'(i))² for displays of different sizes and linearity of (d'(i))² for displays of different durations. Performance was the same for simultaneous and sequentially presented displays, which implicates VSTM as the locus of the observed invariance and rules out explanations that ascribe it to divided attention or stimulus encoding. The invariance of ∑(i)(d'(i))² is predicted by the competitive interaction theory of Smith and Sewell (2013), which attributes it to the normalization of VSTM traces strengths arising from competition among stimuli entering VSTM.",0 +https://doi.org/10.1177/0962280210391076,A review of causal estimation of effects in mediation analyses,"We describe causal mediation methods for analysing the mechanistic factors through which interventions act on outcomes. A number of different mediation approaches have been presented in the biomedical, social science and statistical literature with an emphasis on different aspects of mediation. We review the different sets of assumptions that allow identification and estimation of effects in the simple case of a single intervention, a temporally subsequent mediator and outcome. These assumptions include various no confounding assumptions including sequential ignorability assumptions and also interaction assumptions involving the treatment and mediator. The understanding of such assumptions is crucial since some can be assessed under certain conditions (e.g. treatment–mediator interactions), whereas others cannot (sequential ignorability). These issues become more complex with multiple mediators and longitudinal outcomes. In addressing these assumptions, we review several causal approaches to mediation analyses.",0 +https://doi.org/10.1037/a0017057,"Perceiving others’ personalities: Examining the dimensionality, assumed similarity to the self, and stability of perceiver effects.","In interpersonal perception, ""perceiver effects"" are tendencies of perceivers to see other people in a particular way. Two studies of naturalistic interactions examined perceiver effects for personality traits: seeing a typical other as sympathetic or quarrelsome, responsible or careless, and so forth. Several basic questions were addressed. First, are perceiver effects organized as a global evaluative halo, or do perceptions of different traits vary in distinct ways? Second, does assumed similarity (as evidenced by self-perceiver correlations) reflect broad evaluative consistency or trait-specific content? Third, are perceiver effects a manifestation of stable beliefs about the generalized other, or do they form in specific contexts as group-specific stereotypes? Findings indicated that perceiver effects were better described by a differentiated, multidimensional structure with both trait-specific content and a higher order global evaluation factor. Assumed similarity was at least partially attributable to trait-specific content, not just to broad evaluative similarity between self and others. Perceiver effects were correlated with gender and attachment style, but in newly formed groups, they became more stable over time, suggesting that they grew dynamically as group stereotypes. Implications for the interpretation of perceiver effects and for research on personality assessment and psychopathology are discussed.",0 +https://doi.org/10.1080/01621459.1977.10480613,The Efficiency of Cox's Likelihood Function for Censored Data,Abstract D.R. Cox has suggested a simple method for the regression analysis of censored data. We carry out an information calculation which shows that Cox's method has full asymptotic efficiency under conditions which are likely to be satisfied in many realistic situations. The connection of Cox's method with the Kaplan-Meier estimator of a survival curve is made explicit.,0 +https://doi.org/10.1016/s0169-7161(05)25020-4,Bayesian Thinking in Spatial Statistics,"In the sections below we review basic motivations for spatial statistical analysis, review three general categories of data structure and associated inferential questions, and describe Bayesian methods for achieving inference. Our goal is to highlight similarities across spatial analytic methods, particularly with regards to how hierarchical probability structures often link approaches developed in one area of spatial analysis to components within other areas. By choosing to highlight similarities, we focus on general concepts in spatial inference, and often defer details of several interesting and current threads of development to the relevant literature. We conclude with a listing of some of these developing areas of interest and references for further reading.",0 +https://doi.org/10.1007/s10531-014-0741-3,How much are stranding records affected by variation in reporting rates? A case study of small delphinids in the Bay of Biscay,"Marine vertebrate strandings offer an opportunistic sampling scheme that can provide abundant data over long periods. Because the stranding process involves biological, physical and sociological parameters, confounding complicates the interpretation of results. The statistical analysis of these data relies on generalized linear or additive models in order to infer long-term trends, but does not easily account for drift or variation in reporting rates. Here, we capitalized on county-level (administrative) variation following the passing of a law for compulsory reporting of stranded marine mammals in France to investigate how variation in reporting rates may affect the observed trend in stranded small delphinids in the Bay of Biscay. Using a time-series spanning more than 30 years across eight administrative counties, we built variance partitioning models for the analysis of count data. We discussed the choice of an appropriate likelihood to conclude the Negative Binomial useful and interpretable in the context of small delphinid strandings. We expanded the model with a recent methodology to detect structural breaks in the time series, focusing on overdispersion. We performed statistical robustness checks with respect to variations in reporting rates and discuss their causal interpretation in the context of observational data. Stranding frequencies increased on average 7-fold over 30 years. We conclude that reporting rates to the French stranding network have been stable since the early 1990s, and the average 3-fold increase in stranded small delphinids observed in the Bay of Biscay since 1990 is due to other factors, including bycatch. Codes and data are available to replicate the analysis to other national stranding networks. © 2014 Springer Science+Business Media Dordrecht.",0 +https://doi.org/10.1177/01466216000241003,Likelihood-Based Item-Fit Indices for Dichotomous Item Response Theory Models,"New goodness-of-fit indices are introduced for dichotomous item response theory (IRT) models. These indices are based on the likelihoods of number-correct scores derived from the IRT model, and they provide a direct comparison of the modeled and observed frequencies for correct and incorrect responses for each number-correct score. The behavior of Pearson’s X 2 ( S- X 2 ) and the likelihood ratio G 2 ( S- G 2 ) was assessed in a simulation study and compared with two fit indices similar to those currently in use ( Q1- X 2 and Q 1 - G 2 ). The simulations included three conditions in which the simulating and fitting models were identical and three conditions involving model misspecification. S- X 2 performed well, with Type I error rates close to the expected .05 and .01 levels. Performance of this index improved with increased test length. S- G 2 tended to reject the null hypothesis too often, as did Q 1 - X 2 and Q 1 - G 2 . The power of S- X 2 appeared to be similar for all test lengths, but varied depending on the type of model misspecification.",0 +https://doi.org/10.1136/bmj.319.7208.508,Methods in health service research: An introduction to bayesian methods in health technology assessment,"This is the third of four articles Bayes's theorem arose from a posthumous publication in 1763 by Thomas Bayes, a non-conformist minister from Tunbridge Wells. Although it gives a simple and uncontroversial result in probability theory, specific uses of the theorem have been the subject of considerable controversy for more than two centuries. In recent years a more balanced and pragmatic perspective has emerged, and in this paper we review current thinking on the value of the Bayesian approach to health technology assessment. A concise definition of bayesian methods in health technology assessment has not been established, but we suggest the following: the explicit quantitative use of external evidence in the design, monitoring, analysis, interpretation, and reporting of a health technology assessment. This approach acknowledges that judgments about the benefits of a new technology will rarely be based solely on the results of a single study but should synthesise evidence from multiple sources—for example, pilot studies, trials of similar interventions, and even subjective judgments about the generalisability of the study's results. A bayesian perspective leads to an approach to clinical trials that is claimed to be more flexible and ethical than traditional methods,1 and to elegant ways of handling multiple substudies—for example, when simultaneously estimating the effects of a treatment on many subgroups.2 Proponents have also argued that a bayesian approach allows conclusions to be provided in a form that is most suitable for decisions specific to patients and decisions affecting public policy.3 #### Summary points Bayesian methods interpret data from a study in the light of external evidence and judgment, and the form in which conclusions are drawn contributes naturally to decision making Prior plausibility of hypotheses is taken into account, just as when interpreting the results of a diagnostic test Scepticism about large treatment effects can be formally …",0 +https://doi.org/10.1080/00273171.2015.1065398,A Comparison of Inverse-Wishart Prior Specifications for Covariance Matrices in Multilevel Autoregressive Models,"Multilevel autoregressive models are especially suited for modeling between-person differences in within-person processes. Fitting these models with Bayesian techniques requires the specification of prior distributions for all parameters. Often it is desirable to specify prior distributions that have negligible effects on the resulting parameter estimates. However, the conjugate prior distribution for covariance matrices-the Inverse-Wishart distribution-tends to be informative when variances are close to zero. This is problematic for multilevel autoregressive models, because autoregressive parameters are usually small for each individual, so that the variance of these parameters will be small. We performed a simulation study to compare the performance of three Inverse-Wishart prior specifications suggested in the literature, when one or more variances for the random effects in the multilevel autoregressive model are small. Our results show that the prior specification that uses plug-in ML estimates of the variances performs best. We advise to always include a sensitivity analysis for the prior specification for covariance matrices of random parameters, especially in autoregressive models, and to include a data-based prior specification in this analysis. We illustrate such an analysis by means of an empirical application on repeated measures data on worrying and positive affect.",0 +https://doi.org/10.1080/00273171.2013.816235,A New Procedure to Test Mediation With Missing Data Through Nonparametric Bootstrapping and Multiple Imputation,"This article proposes a new procedure to test mediation with the presence of missing data by combining nonparametric bootstrapping with multiple imputation (MI). This procedure performs MI first and then bootstrapping for each imputed data set. The proposed procedure is more computationally efficient than the procedure that performs bootstrapping first and then MI for each bootstrap sample. The validity of the procedure is evaluated using a simulation study under different sample size, missing data mechanism, missing data proportion, and shape of distribution conditions. The result suggests that the proposed procedure performs comparably to the procedure that combines bootstrapping with full information maximum likelihood under most conditions. However, caution needs to be taken when using this procedure to handle missing not-at-random or nonnormal data.",0 +https://doi.org/10.3310/hta16110,Management of frozen shoulder: a systematic review and cost-effectiveness analysis.,"Frozen shoulder is condition in which movement of the shoulder becomes restricted. It can be described as either primary (idiopathic) whereby the aetiology is unknown, or secondary, when it can be attributed to another cause. It is commonly a self-limiting condition, of approximately 1 to 3 years' duration, though incomplete resolution can occur.To evaluate the clinical effectiveness and cost-effectiveness of treatments for primary frozen shoulder, identify the most appropriate intervention by stage of condition and highlight any gaps in the evidence.A systematic review was conducted. Nineteen databases and other sources including the Cumulative Index to Nursing and Allied Health (CINAHL), Science Citation Index, BIOSIS Previews and Database of Abstracts of Reviews of Effects (DARE) were searched up to March 2010 and EMBASE and MEDLINE up to January 2011, without language restrictions. MEDLINE, CINAHL and PsycINFO were searched in June 2010 for studies of patients' views about treatment.Randomised controlled trials (RCTs) evaluating physical therapies, arthrographic distension, steroid injection, sodium hyaluronate injection, manipulation under anaesthesia, capsular release or watchful waiting, alone or in combination were eligible for inclusion. Patients with primary frozen shoulder (with or without diabetes) were included. Quasi-experimental studies were included in the absence of RCTs and case series for manipulation under anaesthesia (MUA) and capsular release only. Full economic evaluations meeting the intervention and population inclusion criteria of the clinical review were included. Two researchers independently screened studies for relevance based on the inclusion criteria. One reviewer extracted data and assessed study quality; this was checked by a second reviewer. The main outcomes of interest were pain, range of movement, function and disability, quality of life and adverse events. The analysis comprised a narrative synthesis and pair-wise meta-analysis. A mixed-treatment comparison (MTC) was also undertaken. An economic decision model was intended, but was found to be implausible because of a lack of available evidence. Resource use was estimated from clinical advisors and combined with quality-adjusted life-years obtained through mapping to present tentative cost-effectiveness results.Thirty-one clinical effectiveness studies and one economic evaluation were included. The clinical effectiveness studies evaluated steroid injection, sodium hyaluronate, supervised neglect, physical therapy (mainly physiotherapy), acupuncture, MUA, distension and capsular release. Many of the studies identified were at high risk of bias. Because of variation in the interventions and comparators few studies could be pooled in a meta-analysis. Based on single RCTs, and for some outcomes only, short-wave diathermy may be more effective than home exercise. High-grade mobilisation may be more effective than low-grade mobilisation in a population in which most patients have already had treatment. Data from two RCTs showed that there may be benefit from adding a single intra-articular steroid injection to home exercise in patients with frozen shoulder of < 6 months' duration. The same two trials showed that there may be benefit from adding physiotherapy (including mobilisation) to a single steroid injection. Based on a network of nine studies the MTC found that steroid combined with physiotherapy was the only treatment showing a statistically and clinically significant beneficial treatment effect compared with placebo for short-term pain (standardised mean difference -1.58, 95% credible interval -2.96 to -0.42). This analysis was based on only a subset of the evidence, which may explain why the findings are only partly supportive of the main analysis. No studies of patients' views about the treatments were identified. Average costs ranged from £36.16 for unguided steroid injections to £2204 for capsular release. The findings of the mapping suggest a positive relationship between outcome and European Quality of Life-5 Dimensions (EQ-5D) score: a decreasing visual analogue scale score (less pain) was accompanied by an increasing (better) EQ-5D score. The one published economic evaluation suggested that low-grade mobilisation may be more cost-effective than high-grade mobilisation. Our tentative cost-effectiveness analysis suggested that steroid alone may be more cost-effective than steroid plus physiotherapy or physiotherapy alone. These results are very uncertain.The key limitation was the lack of data available. It was not possible to undertake the planned synthesis exploring the influence of stage of frozen shoulder or the presence of diabetes on treatment effect. As a result of study diversity and poor reporting of outcome data there were few instances where the planned quantitative synthesis was possible or appropriate. Most of the included studies had a small number of participants and may have been underpowered. The lack of available data made the development of a decision-analytic model implausible. We found little evidence on treatment related to stage of condition, treatment pathways, the impact on quality of life, associated resource use and no information on utilities. Without making a number of questionable assumptions modelling was not possible.There was limited clinical evidence on the effectiveness of treatments for primary frozen shoulder. The economic evidence was so limited that no conclusions can be made about the cost-effectiveness of the different treatments. High-quality primary research is required.",0 +https://doi.org/10.1007/s00417-006-0474-4,The Freiburg Visual Acuity Test-Variability unchanged by post-hoc re-analysis,"Background: The Freiburg Visual Acuity and Contrast Test (FrACT) has been further developed; it is now available for Macintosh and Windows free of charge at http://www.michaelbach.de/fract.html. The present study sought to reduce the test-retest variability of visual acuity on short runs (18 trials) by post-hoc re-analysis. Methods: The FrACT employs advanced computer graphics to present Landolt Cs over the full range of visual acuity. The sequence of optotypes presented follows an adaptive staircase procedure, the Best-PEST algorithm. The Best-PEST threshold obtained after 18 trials was compared to the result of a post-hoc re-analysis of the acquired data, where both threshold and slope of the psychometric function were estimated via a maximum-likelihood fit. Results: Testing time was 1.7 min per run on average. Test-retest reproducibility was ±2 lines (or ±0.2 logMAR) for a 95% confidence band (using 18 optotype presentations per test run). Post-hoc psychometric fitting reproduced the Best-PEST result within 1%, although the individual slopes varied widely; test-retest reproducibility was not improved. Conclusions: The FrACT offers advantages over traditional chart testing with respect to objectivity and reliability. The similarity between the results of the Best-PEST vs. post-hoc analysis, fitting both slope and threshold, suggest that there is no disadvantage to the constant slope assumed by Best PEST. Furthermore, since variability was not reduced by post-hoc analysis, for high reliability more trials should be employed than the 18 trials per run used here. © Springer-Verlag 2007.",0 +https://doi.org/10.1016/0042-6989(79)90136-6,Probability summation over time,"Abstract Frequency-of-seeing and sensitivity-duration curves were collected for temporal signals of limited spectral extent. A comparison of the two sorts of data suggests that a stimulus is detected whenever the excursions of its linearly filtered, noise-perturbed temporal waveform exceed some fixed magnitude.",0 +https://doi.org/10.3758/bf03195574,"QMPE: Estimating Lognormal, Wald, and Weibull RT distributions with a parameter-dependent lower bound","We describe and test quantile maximum probability estimator (QMPE), an open-source ANSI Fortran 90 program for response time distribution estimation. QMPE enables users to estimate parameters for the ex-Gaussian and Gumbel (1958) distributions, along with three ""shifted"" distributions (i.e., distributions with a parameter-dependent lower bound): the Lognormal, Wald, and Weibul distributions. Estimation can be performed using either the standard continuous maximum likelihood (CML) method or quantile maximum probability (QMP; Heathcote & Brown, in press). We review the properties of each distribution and the theoretical evidence showing that CML estimates fail for some cases with shifted distributions, whereas QMP estimates do not. In cases in which CML does not fail, a Monte Carlo investigation showed that QMP estimates were usually as good, and in some cases better, than CML estimates. However, the Monte Carlo study also uncovered problems that can occur with both CML and QMP estimates, particularly when samples are small and skew is low, highlighting the difficulties of estimating distributions with parameter-dependent lower bounds.",0 +https://doi.org/10.3758/bf03194544,"The psychometric function: I. Fitting, sampling, and goodness of fit","The psychometric function relates an observer's performance to an independent variable, usually some physical quantity of a stimulus in a psychophysical task. This paper, together with its companion paper (Wichmann & Hill, 2001), describes an integrated approach to (1) fitting psychometric functions, (2) assessing the goodness of fit, and (3) providing confidence intervals for the function's parameters and other estimates derived from them, for the purposes of hypothesis testing. The present paper deals with the first two topics, describing a constrained maximum-likelihood method of parameter estimation and developing several goodness-of-fit tests. Using Monte Carlo simulations, we deal with two specific difficulties that arise when fitting functions to psychophysical data. First, we note that human observers are prone to stimulus-independent errors (or lapses). We show that failure to account for this can lead to serious biases in estimates of the psychometric function's parameters and illustrate how the problem may be overcome. Second, we note that psychophysical data sets are usually rather small by the standards required by most of the commonly applied statistical tests. We demonstrate the potential errors of applying traditional chi2 methods to psychophysical data and advocate use of Monte Carlo resampling techniques that do not rely on asymptotic theory. We have made available the software to implement our methods.",0 +https://doi.org/10.1177/0049124110371312,Analysis of a Two-Level Structural Equation Model With Missing Data,"Structural equation models are widely used to model relationships among latent unobservable constructs and observable variables. In some studies, the data set used for analysis is comprised of observations that are drawn from a known hierarchical structure and involves missing entries. A two-level structural equation model can be used to analyze such data sets. Direct maximum likelihood methods for analyzing two-level structural equation models are available in software, such as LISREL and Mplus. These software programs also have options to handle missing observations. The authors develop an alternative procedure that uses an expectation maximization (EM) type algorithm. Using appropriate approximations, the procedure can be implemented using simple statistical software in combination with a basic structural equation modeling program. The authors address the implementation of the procedure in detail and provide syntax codes in R, which is available in the public domain, to implement the proposed procedure. The discussion of the procedure is made with reference to the analysis of a data set that studies job characteristic variables. The authors also use simulation studies to examine the performance of the proposed procedure. The results indicate that the proposed method, which is easily accessible to users, represents a reliable alternative for analyzing two-level structural equation models with missing data.",0 +https://doi.org/10.1111/j.2517-6161.1953.tb00135.x,New Light on the Correlation Coefficient and its Transforms,,0 +https://doi.org/10.1007/bf02294746,Latent curve analysis,"As a method for representing development, latent trait theory is presented in terms of a statistical model containing individual parameters and a structure on both the first and second moments of the random variables reflecting growth. Maximum likelihood parameter estimates and associated asymptotic tests follow directly. These procedures may be viewed as an alternative to standard repeated measures ANOVA and to first-order auto-regressive methods. As formulated, the model encompasses cohort sequential designs and allow for period or practice effects. A numerical illustration using data initially collected by Nesselroade and Baltes is presented. © 1990 The Psychometric Society.",0 +,Market Segmentation: Conceptual and Methodological Foundations,Part 1: Introduction. 1. The Historical Development of the Market Segmentation Concept. 2. Segmentation Bases. 3. Segmentation Methods. 4. Tools for Market Segmentation. Part 2: Segmentation Methodology. 5. Clustering Methods. 6. Mixture Models. 7. Mixture Regression Models. 8. Mixture Unfolding Models. 9. Profiling Segments. 10. Dynamic Segmentation. Part 3: Special Topics in Market Segmentation. 11. Joint Segmentation. 12. Market Segmentation with Tailored Interviewing. 13. Model-Based Segmentation Using Structural Equation Models. 14. Segmentation Based on Product Dissimilarity Judgements. Part 4: Applied Market Segmentation. 15. General Observable Bases: Geo-demographics. 16. General Unobservable Bases: Values and Lifestyles. 17. Product-specific observable Bases: Response-based Segmentation. 18. Product-Specific Unobservable Bases: Conjoint Analysis. Part 5: Conclusions and Directions for Future Research. 19. Conclusions: Representations of Heterogeneity. 20. Directions for Future Research. References. Index.,0 +https://doi.org/10.1002/jrsm.1153,A Bayesian missing data framework for generalized multiple outcome mixed treatment comparisons,"Bayesian statistical approaches to mixed treatment comparisons (MTCs) are becoming more popular because of their flexibility and interpretability. Many randomized clinical trials report multiple outcomes with possible inherent correlations. Moreover, MTC data are typically sparse (although richer than standard meta-analysis, comparing only two treatments), and researchers often choose study arms based upon which treatments emerge as superior in previous trials. In this paper, we summarize existing hierarchical Bayesian methods for MTCs with a single outcome and introduce novel Bayesian approaches for multiple outcomes simultaneously, rather than in separate MTC analyses. We do this by incorporating partially observed data and its correlation structure between outcomes through contrast-based and arm-based parameterizations that consider any unobserved treatment arms as missing data to be imputed. We also extend the model to apply to all types of generalized linear model outcomes, such as count or continuous responses. We offer a simulation study under various missingness mechanisms (e.g., missing completely at random, missing at random, and missing not at random) providing evidence that our models outperform existing models in terms of bias, mean squared error, and coverage probability then illustrate our methods with a real MTC dataset. We close with a discussion of our results, several contentious issues in MTC analysis, and a few avenues for future methodological development.",0 +https://doi.org/10.3758/bf03196751,Modeling individual differences in cognition,"Many evaluations of cognitive models rely on data that have been averaged or aggregated across all experimental subjects, and so fail to consider the possibility of important individual differences between subjects. Other evaluations are done at the single-subject level, and so fail to benefit from the reduction of noise that data averaging or aggregation potentially provides. To overcome these weaknesses, we have developed a general approach to modeling individual differences using families of cognitive models in which different groups of subjects are identified as having different psychological behavior. Separate models with separate parameterizations are applied to each group of subjects, and Bayesian model selection is used to determine the appropriate number of groups. We evaluate this individual differences approach in a simulation study and show that it is superior in terms of the key modeling goals of prediction and understanding. We also provide two practical demonstrations of the approach, one using the ALCOVE model of category learning with data from four previously analyzed category learning experiments, the other using multidimensional scaling representational models with previously analyzed similarity data for colors. In both demonstrations, meaningful individual differences are found and the psychological models are able to account for this variation through interpretable differences in parameterization. The results highlight the potential of extending cognitive models to consider individual differences.",0 +https://doi.org/10.1002/cjs.11245,Pseudo-empirical Bayes estimation of small area means based on James-Stein estimation in linear regression models with functional measurement error,en,0 +,History and rationale of longitudinal research,,0 +https://doi.org/10.1037//1082-989x.7.1.83,A comparison of methods to test mediation and other intervening variable effects.,A Monte Carlo study compared 14 methods to test the statistical significance of the intervening variable effect. An intervening variable (mediator) transmits the effect of an independent variable to a dependent variable. The commonly used R. M. Baron and D. A. Kenny (1986) approach has low statistical power. Two methods based on the distribution of the product and 2 difference-in-coefficients methods have the most accurate Type I error rates and greatest statistical power except in 1 important case in which Type I error rates are too high. The best balance of Type I error and statistical power across all cases is the test of the joint significance of the two effects comprising the intervening variable effect.,0 +https://doi.org/10.1177/001316448004000213,Maximally Reliable Composites for Unidimensional Measures,"A general approach to obtaining weights and reliability coefficients of maximally reliable composites is offered for a variety of test theoretic models which assume a single common underlying dimension. The reliability maximizing weights are related to the theoretically specified true score scaling weights to show there is a constant relationship between them that is invariant under separate linear transformations on each variable in the system. Furthermore, an argument is made that test theoretic relations should be derived for the most general model available and not for unnecessarily constrained models.",0 +https://doi.org/10.1037/h0040633,A theoretico-historical review of the threshold concept.,"This paper traces the concept of threshold from its classical beginnings and shows the relation of the concept to selected issues in contemporary psychology. Emphasis is placed on 3 main problems: the designation of the origin point on a psychological continuum; the interpretation of the sensory threshold as an intervening variable and the issue of sensory continuity-noncontinuity; and the specification of the response threshold as a dependent variable of behavior, rather than an index of organismic sensitivity. Reference is made to adaptation level theory and the theory of signal detection as possible approaches to the development of a complete psychophysics which does not start from the concept of threshold. (74 ref.) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1963 American Psychological Association.",0 +https://doi.org/10.1177/01421602026002007,An EM Approach to Parameter Estimation for the Zinnes and Griggs Paired Comparison IRT Model,"Borman et al. recently proposed a computer adaptive performance appraisal system called CARS II that utilizes paired comparison judgments of behavioral stimuli. To implement this approach,the paired comparison ideal point model developed by Zinnes and Griggs was selected. In this article,the authors describe item response and information functions for the Zinnes and Griggs model and present procedures for estimating stimulus and person parameters. Monte carlo simulations were conducted to assess the accuracy of the parameter estimation procedures. The results indicated that at least 400 ratees (i.e.,ratings) are required to obtain reasonably accurate estimates of the stimulus parameters and their standard errors. In addition,latent trait estimation improves as test length increases. The implications of these results for test construction are also discussed.",0 +https://doi.org/10.1177/0193841x9301700202,Estimating Mediated Effects in Prevention Studies,The purpose of this article is to describe statistical procedures to assess how prevention and intervention programs achieve their effects. The analyses require the measurement of intervening or mediating variables hypothesized to represent the causal mechanism by which the prevention program achieves its effects. Methods to estimate mediation are illustrated in the evaluation of a health promotion program designed to reduce dietary cholesterol and a school-based drug prevention program. The methods are relatively easy to apply and the information gained from such analyses should add to our understanding of prevention.,0 +https://doi.org/10.1027/1614-2241/a000162,Pushing the Limits,"Abstract. Longitudinal developmental research is often focused on patterns of change or growth across different (sub)groups of individuals. Particular to some research contexts, developmental inquiries may involve one or more (sub)groups that are small in nature and therefore difficult to properly capture through statistical analysis. The current study explores the lower-bound limits of subsample sizes in a multiple group latent growth modeling by means of a simulation study. We particularly focus on how the maximum likelihood (ML) and Bayesian estimation approaches differ when (sub)sample sizes are small. The results show that Bayesian estimation resolves computational issues that occur with ML estimation and that the addition of prior information can be the key to detect a difference between groups when sample and effect sizes are expected to be limited. The acquisition of prior information with respect to the smaller group is especially influential in this context.",1 +https://doi.org/10.1080/10503309112331335511,Meta‐Analysis of Therapist Effects in Psychotherapy Outcome Studies,"In a meta-analysis, we examined factors that could account for the differences in therapist efficacy evidenced in psychotherapy outcome studies. The factors investigated were: (1) the use of a treatment manual, (2) the average level of therapist experience, (3) the length of treatment, and (4) the type of treatment (cognitive/behavioral versus psychodynamic). Data were obtained from fifteen psychotherapy outcome studies that produced 27 separate treatment groups. For each treatment group, the amount of outcome variance due to differences between therapists was calculated and served as the dependent variable for the meta-analysis. Each separate treatment group was coded on the above four variables, and multiple regression analyses related the independent variables to the size of therapist effects. Results indicated that the use of a treatment manual and more experienced therapists were associated with small differences between therapists, whereas more inexperienced therapists and no treatment manual were a...",0 +https://doi.org/10.3390/su71215810,Firm Sustainability Performance Index Modeling,"The main objective of this paper is to bring a model for firm sustainability performance index by applying both classical and Bayesian structural equation modeling (parametric and semi-parametric modeling). Both techniques are considered to the research data collected based on a survey directed to the China, Taiwan, and Malaysia food manufacturing industry. For estimating firm sustainability performance index we consider three main indicators include knowledge management, organizational learning, and business strategy. Based on the both Bayesian and classical methodology, we confirmed that knowledge management and business strategy have significant impact on firm sustainability performance index.",0 +https://doi.org/10.1111/j.1475-6811.2009.01211.x,Attachment avoidance and commitment aversion: A script for relationship failure,"Do avoidantly attached individuals, with fears of closeness and dependency, expect their relationships to fail? Moreover, do they expect specific events that will lead to failure? Canadian students outlined their expectations for a new romantic relationship by ordering a series of dating events using a card sorting procedure. Avoidance was associated with both expectations of relationship failure and commitment aversion (the absence of positive commitment-enhancing events and presence of negative commitment-undermining events). Commitment aversion mediated the relationship between avoidance and expected failure, and a multiple mediation model showed unique paths for positive and negative events. This suggests that avoidantly attached individuals enter into new relationships with detailed scripts for commitment aversion that lead them to expect relationship failure.",0 +https://doi.org/10.1016/j.jmva.2012.05.010,A criterion-based model comparison statistic for structural equation models with heterogeneous data,"Heterogeneous data are common in social, educational, medical and behavioral sciences. Recently, finite mixture structural equation models (SEMs) and two-level SEMs have been respectively proposed to analyze different kinds of heterogeneous data. Due to the complexity of these two kinds of SEMs, model comparison is difficult. For instance, the computational burden in evaluating the Bayes factor is heavy, and the Deviance Information Criterion may not be appropriate for mixture SEMs. In this paper, a Bayesian criterion-based method called the L v measure, which involves a component related to the variability of the prediction and a component related to the discrepancy between the data and the prediction, is proposed. Moreover, the calibration distribution is introduced for formal comparison of competing models. Two simulation studies, and two applications based on real data sets are presented to illustrate the satisfactory performance of the L v measure in model comparison.",0 +https://doi.org/10.1523/jneurosci.23-03-01026.2003,Spinal Glia and Proinflammatory Cytokines Mediate Mirror-Image Neuropathic Pain in Rats,"Mirror-image allodynia is a mysterious phenomenon that occurs in association with many clinical pain syndromes. Allodynia refers to pain in response to light touch/pressure stimuli, which normally are perceived as innocuous. Mirror-image allodynia arises from the healthy body region contralateral to the actual site of trauma/inflammation. Virtually nothing is known about the mechanisms underlying such pain. A recently developed animal model of inflammatory neuropathy reliably produces mirror-image allodynia, thus allowing this pain phenomenon to be analyzed. In this sciatic inflammatory neuropathy (SIN) model, decreased response threshold to tactile stimuli (mechanical allodynia) develops in rats after microinjection of immune activators around one healthy sciatic nerve at mid-thigh level. Low level immune activation produces unilateral allodynia ipsilateral to the site of sciatic inflammation; more intense immune activation produces bilateral (ipsilateral + mirror image) allodynia. The present studies demonstrate that both ipsilateral and mirror-image SIN-induced allodynias are (1) reversed by intrathecal (peri-spinal) delivery of fluorocitrate, a glial metabolic inhibitor; (2) prevented and reversed by intrathecal CNI-1493, an inhibitor of p38 mitogen-activated kinases implicated in proinflammatory cytokine production and signaling; and (3) prevented or reversed by intrathecal proinflammatory cytokine antagonists specific for interleukin-1, tumor necrosis factor, or interleukin-6. Reversal of ipsilateral and mirror-image allodynias was rapid and complete even when SIN was maintained constantly for 2 weeks before proinflammatory cytokine antagonist administration. These results provide the first evidence that ipsilateral and mirror-image inflammatory neuropathy pain are created both acutely and chronically through glial and proinflammatory cytokine actions.",0 +https://doi.org/10.1016/j.cmpb.2006.02.006,Using SAS to conduct nonparametric residual bootstrap multilevel modeling with a small number of groups,"In multilevel modeling, researchers often encounter data with a relatively small number of units at the higher levels. As a result, of this and/or non-normality of the residuals, model parameter estimates, particularly the variance components and standard errors of parameter estimates at the group level, may be biased, thus the corresponding statistical inferences may not be trustworthy. This problem can be addressed by using bootstrap methods to estimate the standard errors of the parameter estimates for significance testing. This study illustrates how to use statistical analysis system (SAS) to conduct nonparametric residual bootstrap multilevel modeling. Specific SAS programs for such modeling are provided.",0 +https://doi.org/10.1214/aoms/1177732541,On the Frequency Function of $xy$,"Given the distribution function of x and y, what can be said of the distribution of the product xy? The author has had two inquiries during the last two years, one from an investigator in business statistics and the other from a psychologist, concerning the probable error of the product of two quantities, each of known probable error. There seems to be very little in the literature of mathematical statistics on this question. If x and y are independent and are each distributed according to the same normal frequency law, it is well known that the distribution function of",0 +https://doi.org/10.1212/wnl.37.6.963,A controlled study of progabide in partial seizures: Methodology and results,"The results of a multicenter, double-blind, placebo-controlled clinical trial of the efficacy and safety of progabide (PGB) in the treatment of partial seizures are presented. This study was performed with a number of rigorous controls not usually present in clinical trials. These included uniform co-medication in which all patients received only phenytoin and carbamazepine; concentrations of these two drugs were maintained within narrow, predefined concentration ranges. There was no statistically significant difference between PGB and placebo in seizure frequency and seizure duration for most of the analyses performed. One patient was withdrawn from the study because of hepatotoxicity. PGB was associated with a significant inhibition of phenytoin but not carbamazepine clearance. The results of this study indicate that PGB was not a potent antiepileptic drug in this population of persons with intractable epilepsy.",0 +https://doi.org/10.1002/bimj.201100055,Hierarchical Bayesian modeling of heterogeneous cluster- and subject-level associations between continuous and binary outcomes in dairy production,"The augmentation of categorical outcomes with underlying Gaussian variables in bivariate generalized mixed effects models has facilitated the joint modeling of continuous and binary response variables. These models typically assume that random effects and residual effects (co)variances are homogeneous across all clusters and subjects, respectively. Motivated by conflicting evidence about the association between performance outcomes in dairy production systems, we consider the situation where these (co)variance parameters may themselves be functions of systematic and/or random effects. We present a hierarchical Bayesian extension of bivariate generalized linear models whereby functions of the (co)variance matrices are specified as linear combinations of fixed and random effects following a square-root-free Cholesky reparameterization that ensures necessary positive semidefinite constraints. We test the proposed model by simulation and apply it to the analysis of a dairy cattle data set in which the random herd-level and residual cow-level effects (co)variances between a continuous production trait and binary reproduction trait are modeled as functions of fixed management effects and random cluster effects.",0 +https://doi.org/10.1002/9780470609927,"Survey Methods in Multinational, Multiregional, and Multicultural Contexts",This book provides up-to-date insight into key aspects of methodological research for comparative surveys. It discusses methodological considerations for surveys that are deliberately designed for ...,0 +https://doi.org/10.1016/0022-2496(75)90053-x,The relative judgment theory of two choice response time,Choice reaction times and response probabilities are analyzed in terms of a random walk decision process. The theory of relative judgment which gives rise to this analysis assumes that a presented stimulus is compared by the subject to an internal psychological standard or referent. Discrepancies between the stimulus and the referent are accumulated until one or the other of two response thresholds is exceeded. Results from three experiments are examined in detail. In each experiment a particular feature of the theory is tested and shown to be supported by the data. Methods of estimating the two parameters of the theory are given and an appendix presents a summary of theoretical results.,0 +https://doi.org/10.1016/j.jretconser.2011.09.003,"Message content in keyword campaigns, click behavior, and price-consciousness: A study of millennial consumers","Abstract Building upon the expectancy theory, this study suggests that message content in keyword advertising influences click behavior. The moderating role of price consciousness is also examined. An online experiment using an ex-post filter sampling method is implemented (final n=165). The results of binary logistic regressions indicate that descriptive message content is more clicked than commercial. Price-consciousness appears to moderate the relationship, with high price-conscious consumers being more influenced by descriptive content than less price-conscious consumers. The obtained results are meaningful and significant for the millennial consumers under study.",0 +https://doi.org/10.1109/tnsre.2003.816874,Pattern identification as a function of stimulation on a fingertip-scanned electrotactile display,"Two studies were conducted to determine the effect of stimulation current on pattern perception on a 49-point fingertip-scanned electrotactile (electrocutaneous) display. Performance increased monotonically from near chance levels at the lowest sub-threshold current levels tested to approximately 90% at the highest comfortable current levels. This suggests the existence of a tradeoff between spatial performance and usable ""gray scale"" range in electrotactile presentation of graphical information.",0 +https://doi.org/10.1007/bf02294660,Structural equation models with continuous and polytomous variables,"A two-stage procedure is developed for analyzing structural equation models with continuous and polytomous variables. At the first stage, the maximum likelihood estimates of the thresholds, polychoric covariances and variances, and polyserial covariances are simultaneously obtained with the help of an appropriate transformation that significantly simplifies the computation. An asymptotic covariance matrix of the estiates is also computed. At the second stage, the parameters in the structural covariance model are obtained via the generalized least squares approach. Basic statistical properties of the estimates are derived and some illustrative examples and a small simulation study are reported. © 1992 The Psychometric Society.",0 +https://doi.org/10.1348/000711003321645331,A method of moments technique for fitting interaction effects in structural equation models,"The desire to fit structural equation models containing an interaction term has received much methodological attention in the social science literature. This paper presents a technique for the cross-product structural model that utilizes factor score estimates and results in closed-form moments-type estimators. The technique, which does not require normality for the underlying factors, was originally introduced in a very general form by Wall and Amemiya (2000) for any polynomial structural model. In this paper, the practical implementation of this method, including standard error estimation, is presented specifically for the cross-product model. The procedure is applied to an example from social/behavioural epidemiology where the flexibility of the cross-product model provides a useful description of the underlying theory. A simulation study is also presented comparing the method of moments for the cross-product model with three other procedures.",0 +https://doi.org/10.1155/2009/537139,The Rise of Markov Chain Monte Carlo Estimation for Psychometric Modeling,"Markov chain Monte Carlo (MCMC) estimation strategies represent a powerful approach to estimation in psychometric models. Popular MCMC samplers and their alignment with Bayesian approaches to modeling are discussed. Key historical and current developments of MCMC are surveyed, emphasizing how MCMC allows the researcher to overcome the limitations of other estimation paradigms, facilitates the estimation of models that might otherwise be intractable, and frees the researcher from certain possible misconceptions about the models.",0 +https://doi.org/10.1037/a0035904,Determining the impact of prenatal tobacco exposure on self-regulation at 6 months.,"Our goal in the present study was to examine the effects of maternal smoking during pregnancy on infant self-regulation, exploring birth weight as a mediator and sex as a moderator of risk. A prospective sample of 218 infants was assessed at 6 months of age. Infants completed a battery of tasks assessing working memory/inhibition, attention, and emotional reactivity and regulation. Propensity scores were used to statistically control for confounding risk factors associated with maternal smoking during pregnancy. After prenatal and postnatal confounds were controlled, prenatal tobacco exposure was related to reactivity to frustration and control of attention during stimulus encoding. Birth weight did not mediate the effect of prenatal exposure but was independently related to reactivity and working memory/inhibition. The effect of tobacco exposure was not moderated by sex.",0 +https://doi.org/10.1017/s0003055411000414,Unpacking the Black Box of Causality: Learning about Causal Mechanisms from Experimental and Observational Studies,"Identifying causal mechanisms is a fundamental goal of social science. Researchers seek to study not only whether one variable affects another but also how such a causal relationship arises. Yet commonly used statistical methods for identifying causal mechanisms rely upon untestable assumptions and are often inappropriate even under those assumptions. Randomizing treatment and intermediate variables is also insufficient. Despite these difficulties, the study of causal mechanisms is too important to abandon. We make three contributions to improve research on causal mechanisms. First, we present a minimum set of assumptions required under standard designs of experimental and observational studies and develop a general algorithm for estimating causal mediation effects. Second, we provide a method for assessing the sensitivity of conclusions to potential violations of a key assumption. Third, we offer alternative research designs for identifying causal mechanisms under weaker assumptions. The proposed approach is illustrated using media framing experiments and incumbency advantage studies.",0 +https://doi.org/10.1016/b978-044452044-9/50018-5,Nonlinear Structural Equation Modeling as a Statistical Method,"Structural equation analysis allows exploring and modeling relationships among latent variables. The most traditional analysis deals only with linear relationships. However, in applied problems, relevant research questions can be associated with some form of nonlinear relations. Also, from a statistical modeling or data analysis point of view, capabilities to address unrestricted nonlinear relations would be welcome. A review is given for the existing approaches that have been developed and designed for specific nonlinear models. Then, a statistical formulation of general nonlinear structural equation analysis is introduced, and a general model fitting procedure applicable under weak assumptions on latent variable distributions is developed. An example with a nonpolynomial nonlinear structural model is discussed using the new method.",0 +https://doi.org/10.1080/01621459.1982.10477856,The Well-Calibrated Bayesian,"Abstract Suppose that a forecaster sequentially assigns probabilities to events. He is well calibrated if, for example, of those events to which he assigns a probability 30 percent, the long-run proportion that actually occurs turns out to be 30 percent. We prove a theorem to the effect that a coherent Bayesian expects to be well calibrated, and consider its destructive implications for the theory of coherence.",0 +https://doi.org/10.1146/annurev.soc.25.1.659,THE ESTIMATION OF CAUSAL EFFECTS FROM OBSERVATIONAL DATA,"▪ Abstract When experimental designs are infeasible, researchers must resort to the use of observational data from surveys, censuses, and administrative records. Because assignment to the independent variables of observational data is usually nonrandom, the challenge of estimating causal effects with observational data can be formidable. In this chapter, we review the large literature produced primarily by statisticians and econometricians in the past two decades on the estimation of causal effects from observational data. We first review the now widely accepted counterfactual framework for the modeling of causal effects. After examining estimators, both old and new, that can be used to estimate causal effects from cross-sectional data, we present estimators that exploit the additional information furnished by longitudinal data. Because of the size and technical nature of the literature, we cannot offer a fully detailed and comprehensive presentation. Instead, we present only the main features of methods that are accessible and potentially of use to quantitatively oriented sociologists.",0 +,Estimation of a covariance matrix,,0 +https://doi.org/10.1097/ajp.0b013e3182201983,Effect of Tapentadol Extended Release on Productivity,"To compare the effects of tapentadol-extended release versus oxycodone-controlled release for pain relief on productivity by combining evidence from different sources.Multiparameter evidence synthesis. Three sources were used. The first consisted of 3 randomized double-blind controlled trials that evaluated the efficacy and safety of tapentadol and oxycodone for the management of chronic pain. The second was published data on the incidence of constipation in patients exposed to opioids, and the third was a published survey that evaluated the effect of opioid-induced constipation on productivity. In the trials, a patient was classified as constipated if constipation was reported at any time during the 15 weeks of double-blinded assessment after randomization. In the survey, the effect of constipation on productivity was measured using the Work Productivity and Activity Impairment Questionnaire. All analyses were performed using Bayesian Markov chain Monte Carlo simulations in WinBUGS.The odds of developing constipation were 60% lower with tapentadol than with oxycodone (odds ratio=0.40, 95% credible interval, 0.32-0.50). Tapentadol was associated with less time missed from work, less impairment while working, and a lower overall loss in work productivity compared with oxycodone. The gain in overall work productivity with tapentadol was 1.92% compared with oxycodone (95% credible interval, 1.32-2.59), which translates to a gain of almost 1 hour per week worked.Tapentadol was associated with increases in all productivity dimensions compared with oxycodone. Multiparameter evidence synthesis capitalizes on available evidence, so that better informed medical decisions can be made.",0 +https://doi.org/10.1186/s40337-014-0028-9,Optimizing prediction of binge eating episodes: a comparison approach to test alternative conceptualizations of the affect regulation model,"Although a wealth of studies have tested the link between negative mood states and likelihood of a subsequent binge eating episode, the assumption that this relationship follows a typical linear dose-response pattern (i.e., that risk of a binge episode increases in proportion to level of negative mood) has not been challenged. The present study demonstrates the applicability of an alternative, non-linear conceptualization of this relationship, in which the strength of association between negative mood and probability of a binge episode increases above a threshold value for the mood variable relative to the slope below this threshold value (threshold dose response model).A sample of 93 women aged 18 to 40 completed an online survey at random intervals seven times per day for a period of one week. Participants self-reported their current mood state and whether they had recently engaged in an eating episode symptomatic of a binge.As hypothesized, the threshold approach was a better predictor than the linear dose-response modeling of likelihood of a binge episode. The superiority of the threshold approach was found even at low levels of negative mood (3 out of 10, with higher scores reflecting more negative mood). Additionally, severity of negative mood beyond this threshold value appears to be useful for predicting time to onset of a binge episode.Present findings suggest that simple dose-response formulations for the association between negative mood and onset of binge episodes miss vital aspects of this relationship. Most notably, the impact of mood on binge eating appears to depend on whether a threshold value of negative mood has been breached, and elevation in mood beyond this point may be useful for clinicians and researchers to identify time to onset.",0 +,Family community ethnic identity and the use of formal health care services in Guatemala.,In this paper we investigate family choices about type of prenatal care and assistance at delivery (childbirth) and the use of childhood immunizations in Guatemala during the early and mid-1980s. Our objective is to investigate the reasons underlying relatively low use of formal health care services in Guatemala particularly among the large indigenous population. (EXCERPT),0 +https://doi.org/10.1198/1085711032291,A Bayesian hierarchical model for risk assessment of methylmercury,"This article uses a Bayesian hierarchical model to quantify the adverse health effects associated with in-utero exposure to methylmercury. By allowing for study-to-study as well as outcome-to-outcome variability, the approach provides a useful meta-analytic tool for multi-outcome, multi-study environmental risk assessments. The analysis presented here expands on the findings of a National Academy of Sciences (NAS) committee, charged with advising the United States Environmental Protection Agency (EPA) on an appropriate approach to conducting a risk assessment for methylmercury. The NAS committee, for which the senior author (Ryan) was a committee member, reviewed the findings from several conflicting studies and reported the results from a Bayesian hierarchical model that synthesized information across several studies and for several outcomes. Although the NAS committee did not suggest that the hierarchical model be used as the actual basis for a methylmercury risk assessment, the results from the model were used to justify and support the final recommendation that the risk analysis be based on data from a study conducted in the Faroe Islands, which had found an association between in-utero exposure to methylmercury and impaired neurological development. We consider a variety of statistical issues, but particularly sensitivity to model specification. © 2003 American Statistical Association and the International Biometric Society.",0 +https://doi.org/10.1177/1525822x13520280,Bayesian Cultural Consensus Theory,"In this article, we present a Bayesian inference framework for cultural consensus theory (CCT) models for dichotomous (True/False) response data and provide an associated, user-friendly software package along with a detailed user’s guide to carry out the inference. We believe that the time is ripe for Bayesian statistical inference to become the default choice in the field of CCT. Unfortunately, a lack of publications presenting a practical description of the Bayesian framework in the context of CCT models as well as a dearth of accessible software to apply Bayesian inference to CCT data has so far prevented this from happening. We introduce the Bayesian treatment of several CCT models, focusing on the various merits of Bayesian parameter estimation and interpretation of results, and also introduce the Bayesian Cultural Consensus Toolbox software package.",0 +https://doi.org/10.1111/1467-9868.00236,Bayesian latent variable models for clustered mixed outcomes,"A general framework is proposed for modelling clustered mixed outcomes. A mixture of generalized linear models is used to describe the joint distribution of a set of underlying variables, and an arbitrary function relates the underlying variables to be observed outcomes. The model accommodates multilevel data structures, general covariate effects and distinct link functions and error distributions for each underlying variable. Within the framework proposed, novel models are developed for clustered multiple binary, unordered categorical and joint discrete and continuous outcomes. A Markov chain Monte Carlo sampling algorithm is described for estimating the posterior distributions of the parameters and latent variables. Because of the flexibility of the modelling framework and estimation procedure, extensions to ordered categorical outcomes and more complex data structures are straightforward. The methods are illustrated by using data from a reproductive toxicity study.",0 +https://doi.org/10.1007/s11336-010-9172-6,Hierarchical Bayes Models for Response Time Data,"Human response time (RT) data are widely used in experimental psychology to evaluate theories of mental processing. Typically, the data constitute the times taken by a subject to react to a succession of stimuli under varying experimental conditions. Because of the sequential nature of the experiments there are trends (due to learning, fatigue, fluctuations in attentional state, etc.) and serial dependencies in the data. The data also exhibit extreme observations that can be attributed to lapses, intrusions from outside the experiment, and errors occurring during the experiment. Any adequate analysis should account for these features and quantify them accurately. Recognizing that Bayesian hierarchical models are an excellent modeling tool, we focus on the elaboration of a realistic likelihood for the data and on a careful assessment of the quality of fit that it provides. We judge quality of fit in terms of the predictive performance of the model. We demonstrate how simple Bayesian hierarchical models can be built for several RT sequences, differentiating between subject-specific and condition-specific effects. © The Psychometric Society 2010.",0 +https://doi.org/10.5665/sleep.2004,Deterioration of Neurobehavioral Performance in Resident Physicians During Repeated Exposure to Extended Duration Work Shifts,"Although acute sleep loss during 24- to 30-h extended duration work shifts (EDWS) has been shown to impair the performance of resident physicians, little is known about the effects of cumulative sleep deficiency on performance during residency training. Chronic sleep restriction induces a gradual degradation of neurobehavioral performance and exacerbates the effects of acute sleep loss in the laboratory, yet the extent to which this occurs under real-world conditions is unknown. In this study, the authors quantify the time course of neurobehavioral deterioration due to repeated exposure to EDWS during a 3-week residency rotation.A prospective, repeated-measures, within-subject design.Medical and cardiac intensive care units, Brigham and Women's Hospital, Boston, MA.Thirty-four postgraduate year one resident physicians (23 males; age 28.0 ± 1.83 (standard deviation) years)Residents working a 3-week Q3 schedule (24- to 30-h work shift starts every 3(rd) day), consisting of alternating 24- to 30-h (EDWS) and approximately 8-h shifts, underwent psychomotor vigilance testing before, during, and after each work shift. Mean response time, number of lapses, and slowest 10% of responses were calculated for each test. Residents also maintained daily sleep/wake/work logs. EDWS resulted in cumulative sleep deficiency over the 21-day rotation (6.3 h sleep obtained per day; average 2.3 h sleep obtained per extended shift). Response times deteriorated over a single 24- to 30-h shift (P < 0.0005), and also cumulatively with each successive EDWS: Performance on the fifth and sixth shift was significantly worse than on the first shift (P < 0.01). Controlling for time of day, there was a significant acute (time on shift) and chronic (successive EDWS) interaction on psychomotor vigilance testing response times (P < 0.05).Chronic sleep deficiency caused progressive degradation in residents' neurobehavioral performance and exacerbated the effects of acute sleep loss inherent in the 24- to 30-h EDWS that are commonly used in resident schedules.",0 +https://doi.org/10.3758/bf03194546,Fast and accurate measurement of taste and smell thresholds using a maximum-likelihood adaptive staircase procedure,"This paper evaluates the use of a maximum-likelihood adaptive staircase psychophysical procedure (ML-PEST), originally developed in vision and audition, for measuring detection thresholds in gustation and olfaction. The basis for the psychophysical measurement of thresholds with the ML-PEST procedure is developed. Then, two experiments and four simulations are reported. In the first experiment, ML-PEST was compared with the Wetherill and Levitt up-down staircase method and with the Cain ascending method of limits in the measurement of butyl alcohol thresholds. The four Monte Carlo simulations compared the three psychophysical procedures. In the second experiment, the test-retest reliability of MLPEST for measuring NaCl and butyl alcohol thresholds was assessed. The results indicate that the ML-PEST method gives reliable and precise threshold measurements. Its ability to detect malingerers shows considerable promise. It is recommended for use in clinical testing.",0 +https://doi.org/10.1007/978-3-658-08385-4,Therapist Effects on Attrition in Psychotherapy Outpatients,Dirk Zimmermann illustrates that some therapists significantly differ concerning their average dropout rates. He points out that initial impairment is a strong predictor of early termination. Different dropout criteria as well as various explaining variables on patient and on therapist level were assessed. Premature treatment termination is a common phenomenon in psychotherapy with mean dropout rates of about 20%. Therapist effects account for 3%-4% of the variation in dropout. © Springer Fachmedien Wiesbaden 2015.,0 +https://doi.org/10.1002/psp4.12041,The Many Flavors of Model-Based Meta-Analysis: Part I-Introduction and Landmark Data,Meta-analysis is an increasingly important aspect of drug development as companies look to benchmark their own compounds with the competition. There is scope to carry out a wide range of analyses addressing key research questions from preclinical through to postregistration. This set of tutorials will take the reader through key model-based meta-analysis (MBMA) methods with this first installment providing a general introduction before concentrating on classical and Bayesian methods for landmark data.,0 +https://doi.org/10.1080/01621459.1986.10478354,Statistics and Causal Inference,"Abstract Problems involving causal inference have dogged at the heels of statistics since its earliest days. Correlation does not imply causation, and yet causal conclusions drawn from a carefully designed experiment are often valid. What can a statistical model say about causation? This question is addressed by using a particular model for causal inference (Holland and Rubin 1983; Rubin 1974) to critique the discussions of other writers on causation and causal inference. These include selected philosophers, medical researchers, statisticians, econometricians, and proponents of causal modeling.",0 +https://doi.org/10.1177/0013164410387340,How Are the Form and Magnitude of DIF Effects in Multiple-Choice Items Determined by Distractor-Level Invariance Effects?,"This article explores how the magnitude and form of differential item functioning (DIF) effects in multiple-choice items are determined by the underlying differential distractor functioning (DDF) effects, as modeled under the nominal response model. The results of a numerical investigation indicated that (a) the presence of one or more nonzero DDF effects implies a nonzero DIF effect; (b) the magnitude of the DDF effects creates an upper bound to the magnitude of the resulting DIF effect; (c) the presence of a large DDF effect does not necessarily imply a large DIF effect; (d) under the condition of constant DDF effects the resulting DIF effect is independent of other item properties (i.e., location and discrimination parameters), but under the condition of varying DDF effects the resulting DIF effect magnitude is dependent on other item properties; and (e) although crossing DIF can only exist with divergent (varying in sign) DDF effects, divergent DDF effects do not always yield crossing DIF. Implications of these findings for evaluating DIF effects and interpreting the causes of DIF effects are discussed.",0 +https://doi.org/10.1080/10705511.2011.582408,Advanced Nonlinear Latent Variable Modeling: Distribution Analytic LMS and QML Estimators of Interaction and Quadratic Effects,"Interaction and quadratic effects in latent variable models have to date only rarely been tested in practice. Traditional product indicator approaches need to create product indicators (e.g., x 1 2, x 1 x 4) to serve as indicators of each nonlinear latent construct. These approaches require the use of complex nonlinear constraints and additional model specifications and do not directly address the nonnormal distribution of the product terms. In contrast, recently developed, easy-to-use distribution analytic approaches do not use product indicators, but rather directly model the nonlinear multivariate distribution of the measured indicators. This article outlines the theoretical properties of the distribution analytic Latent Moderated Structural Equations (LMS; Klein & Moosbrugger, 2000) and Quasi-Maximum Likelihood (QML; Klein & Muthen, 2007) estimators. It compares the properties of LMS and QML to those of the product indicator approaches. A small simulation study compares the two approaches and illustra...",0 +https://doi.org/10.1007/978-3-642-12079-4_15,Cultural Consensus Theory: Aggregating Continuous Responses in a Finite Interval,"Cultural consensus theory (CCT) consists of cognitive models for aggregating responses of “informants” to test items about some domain of their shared cultural knowledge. This paper develops a CCT model for items requiring bounded numerical responses, e.g. probability estimates, confidence judgments, or similarity judgments. The model assumes that each item generates a latent random representation in each informant, with mean equal to the consensus answer and variance depending jointly on the informant and the location of the consensus answer. The manifest responses may reflect biases of the informants. Markov Chain Monte Carlo (MCMC) methods were used to estimate the model, and simulation studies validated the approach. The model was applied to an existing cross-cultural dataset involving native Japanese and English speakers judging the similarity of emotion terms. The results sharpened earlier studies that showed that both cultures appear to have very similar cognitive representations of emotion terms.",0 +https://doi.org/10.1007/s11336-015-9492-7,Generalized Fiducial Inference for Binary Logistic Item Response Models,"Generalized fiducial inference (GFI) has been proposed as an alternative to likelihood-based and Bayesian inference in mainstream statistics. Confidence intervals (CIs) can be constructed from a fiducial distribution on the parameter space in a fashion similar to those used with a Bayesian posterior distribution. However, no prior distribution needs to be specified, which renders GFI more suitable when no a priori information about model parameters is available. In the current paper, we apply GFI to a family of binary logistic item response theory models, which includes the two-parameter logistic (2PL), bifactor and exploratory item factor models as special cases. Asymptotic properties of the resulting fiducial distribution are discussed. Random draws from the fiducial distribution can be obtained by the proposed Markov chain Monte Carlo sampling algorithm. We investigate the finite-sample performance of our fiducial percentile CI and two commonly used Wald-type CIs associated with maximum likelihood (ML) estimation via Monte Carlo simulation. The use of GFI in high-dimensional exploratory item factor analysis was illustrated by the analysis of a set of the Eysenck Personality Questionnaire data. © 2016, The Psychometric Society.",0 +https://doi.org/10.3402/ejpt.v6.27516,Using Bayesian statistics for modeling PTSD through Latent Growth Mixture Modeling: implementation and discussion,"After traumatic events, such as disaster, war trauma, and injuries including burns (which is the focus here), the risk to develop posttraumatic stress disorder (PTSD) is approximately 10% (Breslau & Davis, 1992). Latent Growth Mixture Modeling can be used to classify individuals into distinct groups exhibiting different patterns of PTSD (Galatzer-Levy, 2015). Currently, empirical evidence points to four distinct trajectories of PTSD patterns in those who have experienced burn trauma. These trajectories are labeled as: resilient, recovery, chronic, and delayed onset trajectories (e.g., Bonanno, 2004; Bonanno, Brewin, Kaniasty, & Greca, 2010; Maercker, Gäbler, O'Neil, Schützwohl, & Müller, 2013; Pietrzak et al., 2013). The delayed onset trajectory affects only a small group of individuals, that is, about 4-5% (O'Donnell, Elliott, Lau, & Creamer, 2007). In addition to its low frequency, the later onset of this trajectory may contribute to the fact that these individuals can be easily overlooked by professionals. In this special symposium on Estimating PTSD trajectories (Van de Schoot, 2015a), we illustrate how to properly identify this small group of individuals through the Bayesian estimation framework using previous knowledge through priors (see, e.g., Depaoli & Boyajian, 2014; Van de Schoot, Broere, Perryck, Zondervan-Zwijnenburg, & Van Loey, 2015).We used latent growth mixture modeling (LGMM) (Van de Schoot, 2015b) to estimate PTSD trajectories across 4 years that followed a traumatic burn. We demonstrate and compare results from traditional (maximum likelihood) and Bayesian estimation using priors (see, Depaoli, 2012, 2013). Further, we discuss where priors come from and how to define them in the estimation process.We demonstrate that only the Bayesian approach results in the desired theory-driven solution of PTSD trajectories. Since the priors are chosen subjectively, we also present a sensitivity analysis of the Bayesian results to illustrate how to check the impact of the prior knowledge integrated into the model.We conclude with recommendations and guidelines for researchers looking to implement theory-driven LGMM, and we tailor this discussion to the context of PTSD research.",0 +https://doi.org/10.1007/s11336-010-9163-7,Nested Logit Models for Multiple-Choice Item Response Data,"Nested logit item response models for multiple-choice data are presented. Relative to previous models, the new models are suggested to provide a better approximation to multiple-choice items where the application of a solution strategy precedes consideration of response options. In practice, the models also accommodate collapsibility across all distractor categories, making it easier to allow decisions about including distractor information to occur on an item-by-item or application-by-application basis without altering the statistical form of the correct response curves. Marginal maximum likelihood estimation algorithms for the models are presented along with simulation and real data analyses. © 2010 The Psychometric Society.",0 +https://doi.org/10.1214/088342304000000080,Incorporating Bayesian Ideas into Health-Care Evaluation,"We argue that the Bayesian approach is best seen as providing additional tools for those carrying out health-care evaluations, rather than replacing their traditional methods. A distinction is made between those features that arise from the basic Bayesian philosophy and those that come from the modern ability to make inferences using very complex models. Selected examples of the former include explicit recognition of the wide cast of stakeholders in any evaluation, simple use of Bayes theorem and use of a community of prior distributions. In the context of complex models, we selectively focus on the possible role of simple Monte Carlo methods, alternative structural models for incorporating historical data and making inferences on complex functions of indirectly estimated parameters. These selected issues are illustrated by two worked examples presented in a standardized format. The emphasis throughout is on inference rather than decision-making.",0 +,Discrete and Continuous Representations of Unobserved Heterogeneity in Choice Modeling,"We attempt to provide insights into how heterogeneity has been and can be addressed in choice modeling. In doing so, we deal with three topics: Models of heterogeneity. Methods of estimation and Substantive issues. In describing models we focus on discrete versus continuous representations of heterogeneity. With respect to estimation we contrast Markov Chain Monte Carlo methods and (simulated) likelihood methods. The substantive issues discussed deal with empirical tests of heterogeneity assumptions, the formation of empirical generalisations, the confounding of heterogeneity with state dependence and consideration sets, and normativesegmentation.",0 +https://doi.org/10.1348/000711003770480075,A general class of latent variable models for ordinal manifest variables with covariate effects on the manifest and latent variables,Previous work on a general class of multidimensional latent variable models for analysing ordinal manifest variables is extended here to allow for direct covariate effects on the manifest ordinal variables and covariate effects on the latent variables. A full maximum likelihood estimation method is used to estimate all the model parameters simultaneously. Goodness-of-fit statistics and standard errors are discussed. Two examples from the 1996 British Social Attitudes Survey are used to illustrate the methodology.,0 +https://doi.org/10.1111/j.2517-6161.1991.tb01849.x,On the Relationship between Bayesian and Non-Bayesian Interval Estimates,"SUMMARY Let Y1,..., Y, denote independent observations each distributed according to a density depending on a scalar parameter 0. Suppose that we are interested in constructing an interval estimate for 0. One approach is to construct a confidence region with a specified coverage probability based on the likelihood ratio test statistic. Another approach is to construct a highest posterior density region with a specified posterior probability. The goal of this paper is to study the relationship between these two approaches. In particular, we derive asymptotic expansions for the posterior probability of confidence regions based on the likelihood ratio test statistic and for the coverage probability of highest posterior density regions. Conditions under which the two methods lead to identical regions, at least approximately, are also given.",0 +https://doi.org/10.1007/s10071-011-0465-7,The psychophysics of uneconomical choice: non-linear reward evaluation by a nectar feeder,"Uneconomical choices by humans or animals that evaluate reward options challenge the expectation that decision-makers always maximize the return currency. One possible explanation for such deviations from optimality is that the ability to sense differences in physical value between available alternatives is constrained by the sensory and cognitive processes for encoding profitability. In this study, we investigated the capacity of a nectarivorous bat species (Glossophaga commissarisi) to discriminate between sugar solutions with different concentrations. We conducted a two-alternative free-choice experiment on a population of wild electronically tagged bats foraging at an array of computer-automated artificial flowers that recorded individual choices. We used a Bayesian approach to fit individual psychometric functions, relating the strength of preferring the higher concentration option to the intensity of the presented stimulus. Psychometric analysis revealed that discrimination ability increases non-linearly with respect to intensity. We combined this result with a previous psychometric analysis of volume perception. Our theoretical analysis of choice for rewards that vary in two quality dimensions revealed regions of parameter combinations where uneconomic choice is expected. Discrimination ability may be constrained by non-linear perceptual and cognitive encoding processes that result in uneconomical choice.",0 +https://doi.org/10.1016/j.neuroimage.2017.02.083,Bayesian switching factor analysis for estimating time-varying functional connectivity in fMRI,"There is growing interest in understanding the dynamical properties of functional interactions between distributed brain regions. However, robust estimation of temporal dynamics from functional magnetic resonance imaging (fMRI) data remains challenging due to limitations in extant multivariate methods for modeling time-varying functional interactions between multiple brain areas. Here, we develop a Bayesian generative model for fMRI time-series within the framework of hidden Markov models (HMMs). The model is a dynamic variant of the static factor analysis model (Ghahramani and Beal, 2000). We refer to this model as Bayesian switching factor analysis (BSFA) as it integrates factor analysis into a generative HMM in a unified Bayesian framework. In BSFA, brain dynamic functional networks are represented by latent states which are learnt from the data. Crucially, BSFA is a generative model which estimates the temporal evolution of brain states and transition probabilities between states as a function of time. An attractive feature of BSFA is the automatic determination of the number of latent states via Bayesian model selection arising from penalization of excessively complex models. Key features of BSFA are validated using extensive simulations on carefully designed synthetic data. We further validate BSFA using fingerprint analysis of multisession resting-state fMRI data from the Human Connectome Project (HCP). Our results show that modeling temporal dependencies in the generative model of BSFA results in improved fingerprinting of individual participants. Finally, we apply BSFA to elucidate the dynamic functional organization of the salience, central-executive, and default mode networks-three core neurocognitive systems with central role in cognitive and affective information processing (Menon, 2011). Across two HCP sessions, we demonstrate a high level of dynamic interactions between these networks and determine that the salience network has the highest temporal flexibility among the three networks. Our proposed methods provide a novel and powerful generative model for investigating dynamic brain connectivity.",0 +https://doi.org/10.1198/jasa.2010.ap09237,Bayesian Spatial Quantile Regression,"Tropospheric ozone is one of the six criteria pollutants regulated by the United States Environmental Protection Agency under the Clean Air Act and has been linked with several adverse health effects, including mortality. Due to the strong dependence on weather conditions, ozone may be sensitive to climate change and there is great interest in studying the potential effect of climate change on ozone, and how this change may affect public health. In this paper we develop a Bayesian spatial model to predict ozone under different meteorological conditions, and use this model to study spatial and temporal trends and to forecast ozone concentrations under different climate scenarios. We develop a spatial quantile regression model that does not assume normality and allows the covariates to affect the entire conditional distribution, rather than just the mean. The conditional distribution is allowed to vary from site-to-site and is smoothed with a spatial prior. For extremely large datasets our model is computationally infeasible, and we develop an approximate method. We apply the approximate version of our model to summer ozone from 1997-2005 in the Eastern U.S., and use deterministic climate models to project ozone under future climate conditions. Our analysis suggests that holding all other factors fixed, an increase in daily average temperature will lead to the largest increase in ozone in the Industrial Midwest and Northeast.",0 +https://doi.org/10.1037/1082-989x.8.2.164,How many IRT parameters does it take to model psychopathology items?,"The authors compared the fit of the 2- and 3-parameter logistic models (2PLM; 3PLM) on 15 unidimensional factor scales derived from the Minnesota Multiphasic Personality Inventory--Adolescent item pool. Log-likelihood chi-square deviance tests indicated that a 3PLM provided an improved fit. However, residual statistics indicated that the difference in fit between the 2 models was negligible. An unexpected finding was that from 10% to 30% of the items had substantial lower asymptote parameters (c > or = .10) when the scales were scored in the pathology or nonpathology directions. The authors argue that the large lower asymptote parameters are attributable to item-content ambiguity possibly caused by item-level multidimensionality. These findings suggest that the direction of scoring can critically affect an item response theory analysis.",0 +https://doi.org/10.1177/0049124113494575,Under What Assumptions Do Site-by-Treatment Instruments Identify Average Causal Effects?,"The increasing availability of data from multisite randomized trials provides a potential opportunity to use instrumental variables (IV) methods to study the effects of multiple hypothesized mediators of the effect of a treatment. We derive nine assumptions needed to identify the effects of multiple mediators when using site-by-treatment interactions to generate multiple instruments. Three of these assumptions are unique to the multiple-site, multiple-mediator case: (1) the assumption that the mediators act in parallel (no mediator affects another mediator); (2) the assumption that the site-average effect of the treatment on each mediator is independent of the site-average effect of each mediator on the outcome; and (3) the assumption that the site-by-compliance matrix has sufficient rank. The first two of these assumptions are nontrivial and cannot be empirically verified, suggesting that multiple-site, multiple-mediator IV models must be justified by strong theory.",0 +https://doi.org/10.1007/s10651-009-0119-y,Addressing among-group variation in covariate effects using multilevel models,"Multilevel models are used to model processes associated with hierarchical data structures. Despite infrequent use in the biological and environmental sciences, the use of these models with hierarchically-structured data conveys multiple advantages. These include the assessment of whether covariate effects differ among groups or clusters, and separate estimation of covariate effects by hierarchical level (thereby addressing atomistic and aggregation fallacy concerns). We illustrate these advantages using larval mayfly count data derived from annual surveys on the Mississippi River and a continuous covariate (water depth). © 2009 Springer Science+Business Media, LLC.",0 +https://doi.org/10.1046/j.0039-0402.2003.00255.x,"Testing homogeneity in a random intercept model using asymptotic, posterior predictive and plug-in p-values","In this paper three statistics and three discrepancy measures with which homogeneity in the random intercept model can be investigated will be evaluated. The first two can be used to test the homogeneity of level one residual variances across level two units and the third can be used to test whether effects should be fixed or random. Each statistic and discrepancy measure will be evaluated using asymptotic (if available), posterior predictive and plug in p-values. A simulation study will be used to investigate the frequency properties of these p-values. In the discussion it will be indicated how the results obtained for the random intercept model with one explanatory variable can be useful during the construction of general two level models.",0 +https://doi.org/10.1111/1467-9868.00230,Standard errors for EM estimation,"The EM algorithm is a popular method for computing maximum likelihood estimates. One of its drawbacks is that it does not produce standard errors as a by-product. We consider obtaining standard errors by numerical differentiation. Two approaches are considered. The first differentiates the Fisher score vector to yield the Hessian of the log-likelihood. The second differentiates the EM operator and uses an identity that relates its derivative to the Hessian of the log-likelihood. The well-known SEM algorithm uses the second approach. We consider three additional algorithms: one that uses the first approach and two that use the second. We evaluate the complexity and precision of these three and the SEM in algorithm seven examples. The first is a single-parameter example used to give insight. The others are three examples in each of two areas of EM application: Poisson mixture models and the estimation of covariance from incomplete data. The examples show that there are algorithms that are much simpler and more accurate than the SEM algorithm. Hopefully their simplicity will increase the availability of standard error estimates in EM applications. It is shown that, as previously conjectured, a symmetry diagnostic can accurately estimate errors arising from numerical differentiation. Some issues related to the speed of the EM algorithm and algorithms that differentiate the EM operator are identified.",0 +https://doi.org/10.1002/(sici)1097-0258(19980615)17:11<1261::aid-sim846>3.0.co;2-z,Extending the simple linear regression model to account for correlated responses: An introduction to generalized estimating equations and multi-level mixed modelling,"Much of the research in epidemiology and clinical science is based upon longitudinal designs which involve repeated measurements of a variable of interest in each of a series of individuals. Such designs can be very powerful, both statistically and scientifically, because they enable one to study changes within individual subjects over time or under varied conditions. However, this power arises because the repeated measurements tend to be correlated with one another, and this must be taken into proper account at the time of analysis or misleading conclusions may result. Recent advances in statistical theory and in software development mean that studies based upon such designs can now be analysed more easily, in a valid yet flexible manner, using a variety of approaches which include the use of generalized estimating equations, and mixed models which incorporate random effects. This paper provides a particularly simple illustration of the use of these two approaches, taking as a practical example the analysis of a study which examined the response of portable peak expiratory flow meters to changes in true peak expiratory flow in 12 children with asthma. The paper takes the reader through the relevant practicalities of model fitting, interpretation and criticism and demonstrates that, in a simple case such as this, analyses based upon these model-based approaches produce reassuringly similar inferences to standard analyses based upon more conventional methods.",0 +https://doi.org/10.1002/1097-0258(20010215)20:3<435::aid-sim804>3.0.co;2-e,Bayesian methods for cluster randomized trials with continuous responses,"Bayesian methods for cluster randomized trials extend the random-effects formulation by allowing both the use of external evidence on parameters and straightforward relaxation of the standard normality and constant variance assumptions. Care is required in specifying prior distributions on variance components, and a number of different options are explored with implied prior distributions for other parameters given in closed form. Markov chain Monte Carlo (MCMC) methods permit the fitting of very general models and the introduction of parameter uncertainty into power calculations. We illustrate these ideas using a published example in which general practices were randomized to intervention or control, and show that different choices of supposedly 'non-informative' prior distributions can have substantial influence on conclusions. We also illustrate the use of forward simulation methods in power calculations with uncertainty on multiple inputs. Bayesian methods have the potential to be very useful but guidance is required as to appropriate strategies for robust analysis. Our current experience leads us to recommend a standard 'non-informative' prior distribution for the within-cluster sampling variance, and an independent prior on the intraclass correlation coefficient (ICC). The latter may exploit background evidence or, as a reference analysis, be a uniform ICC or a 'uniform shrinkage' prior.",0 +https://doi.org/10.1177/014662169001400104,Bias and the Effect of Priors in Bayesian Estimation of Parameters of Item Response Models,"The effectiveness of a Bayesian approach to the es timation problem in item response models has been sufficiently documented in recent years. Although re search has indicated that Bayesian estimates, in gen eral, are more accurate than joint maximum likelihood (JML) estimates, the effect of choice of priors on the Bayesian estimates is not well known. Moreover, the extent to which the Bayesian estimates are biased in comparison with JML estimates is not known. The ef fect of priors and the amount of bias in Bayesian esti mates is examined in this paper through simulation studies. It is shown that different specifications of prior information have relatively modest effects on the Bayesian estimates. For small samples, it is shown that the Bayesian estimates are less biased than their JML counterparts. Index terms: accuracy, Bayesian estimates, bias, item response models, joint maximum likelihood estimates, priors.",0 +https://doi.org/10.15288/jsa.2004.65.105,Adolescents' alcohol and drug use trajectories in the year following treatment.,"Beyond the initial relapse episode, little is known about short-term patterns of alcohol and other drug use in treated adolescents. This study characterized treated teens' short-term alcohol and other drug use trajectories over 1-year follow-up.Adolescents (N = 110, ages 12-18, 65% male, 94% white) recruited from addictions treatment, with a current DSM-IV alcohol diagnosis, reported on daily alcohol and other drug use in monthly telephone contacts over 1-year follow-up using the Timeline Follow-Back procedure. Latent class mixture modeling identified trajectories based on maximum number of consecutive abstinent days per month, separately for alcohol and other drugs.Four alcohol trajectories were identified: high abstinence (53%), decreasing abstinence (10%), increasing abstinence (16%) and low abstinence (21%). The alcohol trajectories were distinguished by gender, age, readiness to change substance use and alcohol-related coping. To characterize changes in alcohol abstinence in relation to abstinence from other drugs, four other drug trajectories were identified: high (59%), decreasing (12%), increasing (14%) and low (15%) abstinence. Cross-classification of the alcohol and drug trajectories indicated a moderate level of concordance (kappa = 0.49).Multiple pathways of short-term change in alcohol and other drug use were identified. Although changes in abstinence from alcohol and other drug use tended to co-occur, exceptions were observed. Differences between alcohol trajectories in readiness to change substance use and use of substance coping suggest the potentially positive impact of targeted and effectively timed interventions that focus on motivational enhancement and on improving substance coping for certain adolescent subgroups.",0 +https://doi.org/10.1016/j.ssresearch.2014.08.011,Instrumental variables estimates of peer effects in social networks,"• Instrumental variables play a crucial role in estimating causal peer effects in social networks. • Measurement error in smoking can lead to both under- and imprecise estimates of peer effects. • The analysis shows consistent and robust evidence for peer effects on smoking. • Sharing cigarettes is a plausible mechanism for peer effects on smoking. Estimating peer effects with observational data is very difficult because of contextual confounding, peer selection, simultaneity bias, and measurement error, etc. In this paper, I show that instrumental variables (IVs) can help to address these problems in order to provide causal estimates of peer effects. Based on data collected from over 4000 students in six middle schools in China, I use the IV methods to estimate peer effects on smoking. My design-based IV approach differs from previous ones in that it helps to construct potentially strong IVs and to directly test possible violation of exogeneity of the IVs. I show that measurement error in smoking can lead to both under- and imprecise estimations of peer effects. Based on a refined measure of smoking, I find consistent evidence for peer effects on smoking. If a student’s best friend smoked within the past 30 days, the student was about one fifth (as indicated by the OLS estimate) or 40 percentage points (as indicated by the IV estimate) more likely to smoke in the same time period. The findings are robust to a variety of robustness checks. I also show that sharing cigarettes may be a mechanism for peer effects on smoking. A 10% increase in the number of cigarettes smoked by a student’s best friend is associated with about 4% increase in the number of cigarettes smoked by the student in the same time period.",0 +https://doi.org/10.1080/10508422.2014.951720,Mechanisms of Moral Disengagement in the Endorsement of Asylum Seeker Policies in Australia,"Moral disengagement is a process whereby the self-regulatory mechanisms that would otherwise sanction unethical conduct can be selectively disabled. The present research proposed that moral disengagement might be adopted in the endorsement of asylum seeker policies in Australia, and in order to test this, a scale was developed and was validated in two studies. Factor analysis demonstrated that a 2-factor, 16-item structure had the best fit, and the construct validity of the scale was supported. Results provide evidence for the use of moral disengagement in the context of asylum seekers as a means of rationalizing conduct that may otherwise be sanctioned.",0 +https://doi.org/10.1080/00273171.2010.498292,Assessing Mediational Models: Testing and Interval Estimation for Indirect Effects,"Theoretical models specifying indirect or mediated effects are common in the social sciences. An indirect effect exists when an independent variable's influence on the dependent variable is mediated through an intervening variable. Classic approaches to assessing such mediational hypotheses ( Baron & Kenny, 1986 ; Sobel, 1982 ) have in recent years been supplemented by computationally intensive methods such as bootstrapping, the distribution of the product methods, and hierarchical Bayesian Markov chain Monte Carlo (MCMC) methods. These different approaches for assessing mediation are illustrated using data from Dunn, Biesanz, Human, and Finn (2007). However, little is known about how these methods perform relative to each other, particularly in more challenging situations, such as with data that are incomplete and/or nonnormal. This article presents an extensive Monte Carlo simulation evaluating a host of approaches for assessing mediation. We examine Type I error rates, power, and coverage. We study normal and nonnormal data as well as complete and incomplete data. In addition, we adapt a method, recently proposed in statistical literature, that does not rely on confidence intervals (CIs) to test the null hypothesis of no indirect effect. The results suggest that the new inferential method-the partial posterior p value-slightly outperforms existing ones in terms of maintaining Type I error rates while maximizing power, especially with incomplete data. Among confidence interval approaches, the bias-corrected accelerated (BC a ) bootstrapping approach often has inflated Type I error rates and inconsistent coverage and is not recommended; In contrast, the bootstrapped percentile confidence interval and the hierarchical Bayesian MCMC method perform best overall, maintaining Type I error rates, exhibiting reasonable power, and producing stable and accurate coverage rates.",0 +https://doi.org/10.1177/2158244015605160,Do Men and Women Exhibit Different Preferences for Mates? A Replication of Eastwick and Finkel (2008),"Evolutionary theory predicts that men will prefer physically attractive romantic partners, and women will prefer wealthy, high-status partners. This theory is well-supported when examining ideal hypothetical partner preferences, but less support has been found when people interact face-to-face. The present study served as a direct replication of results reported in Eastwick and Finkel (2008). We recruited 307 participants and utilized a speed-dating methodology to allow in-person interactions, then administered follow-up surveys to measure romantic interest over 30 days. Data were analyzed using multilevel modeling and were aggregated using meta-analysis. Consistent with previous findings, our results showed that participants were more romantically interested in potential partners if they were viewed as attractive and good potential earners, and these associations were not moderated by gender. Results suggest that gender differences predicted by evolutionary theory may not hold when people interact with potential romantic partners face-to-face. However, we discuss these results in light of some general methodological limitations and evidence from other lines of research.",0 +https://doi.org/10.1002/sim.1470,Modelling the random effects covariance matrix in longitudinal data,"A common class of models for longitudinal data are random effects (mixed) models. In these models, the random effects covariance matrix is typically assumed constant across subject. However, in many situations this matrix may differ by measured covariates. In this paper, we propose an approach to model the random effects covariance matrix by using a special Cholesky decomposition of the matrix. In particular, we will allow the parameters that result from this decomposition to depend on subject-specific covariates and also explore ways to parsimoniously model these parameters. An advantage of this parameterization is that there is no concern about the positive definiteness of the resulting estimator of the covariance matrix. In addition, the parameters resulting from this decomposition have a sensible interpretation. We propose fully Bayesian modelling for which a simple Gibbs sampler can be implemented to sample from the posterior distribution of the parameters. We illustrate these models on data from depression studies and examine the impact of heterogeneity in the covariance matrix on estimation of both fixed and random effects.",0 +https://doi.org/10.1007/s11336-013-9381-x,Hierarchical Approximate Bayesian Computation,"Approximate Bayesian computation (ABC) is a powerful technique for estimating the posterior distribution of a model's parameters. It is especially important when the model to be fit has no explicit likelihood function, which happens for computational (or simulation-based) models such as those that are popular in cognitive neuroscience and other areas in psychology. However, ABC is usually applied only to models with few parameters. Extending ABC to hierarchical models has been difficult because high-dimensional hierarchical models add computational complexity that conventional ABC cannot accommodate. In this paper, we summarize some current approaches for performing hierarchical ABC and introduce a new algorithm called Gibbs ABC. This new algorithm incorporates well-known Bayesian techniques to improve the accuracy and efficiency of the ABC approach for estimation of hierarchical models. We then use the Gibbs ABC algorithm to estimate the parameters of two models of signal detection, one with and one without a tractable likelihood function.",0 +https://doi.org/10.1007/bf00225903,Variance component estimation techniques compared for two mating designs with forest genetic architecture through computer simulation,"Computer simulation was used to compare minimum variance quadratic estimation (MIVQUE), minimum norm quadratic unbiased estimation (MINQUE), restricted maximum likelihood (REML), maximum likelihood (ML), and Henderson's Method 3 (HM3) on the basis of variance among estimates, mean square error (MSE), bias and probability of nearness for estimation of both individual variance components and three ratios of variance components. The investigation also compared three procedures for dealing with negative estimates and included the use of both individual observations and plot means as the experimental unit of the analysis. The structure of data simulated (field design, mating designs, genetic architecture and imbalance) represented typical analysis problems in quantitative forest genetics. Results of comparing the estimation techniques demonstrated that: estimates of probability of nearness did not discriminate among techniques; bias was discriminatory among procedures for dealing with negative estimates but not among estimation techniques (except ML); sampling variance among estimates was discriminatory among procedures for dealing with negative estimates, estimation techniques and unit of observation; and MSE provided no additional information to variance of the estimates. HM3 and REML were the closest competitors under these criteria; however, REML demonstrated greater robustness to imbalance. Of the three negative estimate procedures, two are of practical significance and guidelines for their application are presented. Estimates from individual observations were always preferable to those from plot means over the experimental levels of this study. © 1994 Springer-Verlag.",0 +https://doi.org/10.1037/0021-9010.62.5.529,Development of a general solution to the problem of validity generalization.,"U. S. Civil Service Commission andGeorge Washington UniversityJohn E. HunterMichigan State UniversityPersonnel psychologists have traditionally believed that employment test valid-ities are situation specific. This study presents a Bayesian statistical modelwhich allows one to explore the alternate hypothesis that variation in validityoutcomes from study to study for similar jobs and tests is artifactual in nature.Certain outcomes using this model permit validity generalization to new settingswithout carrying out a validation study of any kind. Where such generalizationis not justified, the procedure provides an improved method of data analysisand decision making for the necessary situational validity study. Application tofour distributions of empirical validity coefficients demonstrated the power ofthe model.A recent study (Schmidt, Hunter, & Urry,1976) addressed the belief, dominant in per-sonnel psychology, that meaningful empiricalvalidation studies are possible for most, if notall, jobs in most organizations. This studyshowed that, because of range restriction andless than perfect criterion reliability, thesample sizes necessary to provide adequatestatistical power are usually much larger thanhas typically been assumed, This finding leadsto the conclusion that empirical validitystudies are technically feasible much lessfrequently than the profession has assumed.The present study is addressed to another ofthe orthodoxies of personnel psychology: thebelief that test validity is generally highlysituation specific. Considerable variabilityfrom study to study is observed in raw valida-tion results even when jobs and tests appearto be similar or essentially identical (Ghiselli,1966). The explanation usually advanced forthis phenomenon is that the factor structureof job performance is different from job tojob and that the human observer or job ana-lyst is simply too poor an information receiver",0 +,Methods for Meta-Analysis in Medical Research,PART A: META-ANALYSIS METHODOLOGY: THE BASICS Introduction: Meta-analysis: Its Development and Uses Defining Outcome Measures used for Combining via Meta-analysis Random Effects Models for Combining Study Estimates Exploring Between Study Heterogeneity Publication Bias Study Quality Sensitivity Analysis Reporting the Results of a Meta-analysis Fixed Effects Methods for Combining Study Estimates PART B: ADVANCED AND SPECIALIZED META-ANALYSIS TOPICS Bayesian Methods in Meta-analysis Meta Regression Meta-analysis of Different Types of Data Incorporating Study Quality into a Meta-analysis Meta-analysis of Multiple and Correlated Outcome Measures Meta-analysis of Epidemiological and other Observational Studies Generalised Synthesis of Evidence - Combining Different Sources of Evidence Meta-analysis of Survival Data Cumulative Meta-analysis Miscellaneous and Developing Areas of Applications in Meta-Analysis Appendix I: Software Used for the Examples in this Book,0 +https://doi.org/10.1207/s15327906mbr4104_7,Fitting Partially Nonlinear Random Coefficient Models as SEMs,"The nonlinear random coefficient model has become increasingly popular as a method for describing individual differences in longitudinal research. Although promising, the nonlinear model it is not utilized as often as it might be because software options are still somewhat limited. In this article we show that a specialized version of the model can be fit to data using SEM software. The specialization is to a model in which the parameters that enter the function in a linear manner are random, whereas those that are nonlinear are common to all individuals. Although this kind of function is not as general as is the fully nonlinear model, it still is applicable to many different data sets. Two examples are presented to show how the models can be estimated using popular SEM computer programs.",0 +https://doi.org/10.1007/s11336-017-9587-4,Bayesian Sensitivity Analysis of a Nonlinear Dynamic Factor Analysis Model with Nonparametric Prior and Possible Nonignorable Missingness,"Many psychological concepts are unobserved and usually represented as latent factors apprehended through multiple observed indicators. When multiple-subject multivariate time series data are available, dynamic factor analysis models with random effects offer one way of modeling patterns of within- and between-person variations by combining factor analysis and time series analysis at the factor level. Using the Dirichlet process (DP) as a nonparametric prior for individual-specific time series parameters further allows the distributional forms of these parameters to deviate from commonly imposed (e.g., normal or other symmetric) functional forms, arising as a result of these parameters' restricted ranges. Given the complexity of such models, a thorough sensitivity analysis is critical but computationally prohibitive. We propose a Bayesian local influence method that allows for simultaneous sensitivity analysis of multiple modeling components within a single fitting of the model of choice. Five illustrations and an empirical example are provided to demonstrate the utility of the proposed approach in facilitating the detection of outlying cases and common sources of misspecification in dynamic factor analysis models, as well as identification of modeling components that are sensitive to changes in the DP prior specification.",0 +https://doi.org/10.4324/9780203864746-20,Developing a Random Coefficient Model for Nonlinear Repeated Measures Data,,0 +https://doi.org/10.1037/0021-9010.91.1.1,"Statistical power and parameter stability when subjects are few and tests are many: Comment on Peterson, Smith, Martorana, and Owens (2003).","Comments on the original article ""The impact of chief executive officer personality on top management team dynamics: One mechanism by which leadership affects organizational performance"", by R. S. Peterson et al.. This comment illustrates how small sample sizes, when combined with many statistical tests, can generate unstable parameter estimates and invalid inferences. Although statistical power for 1 test in a small-sample context is too low, the experimentwise power is often high when many tests are conducted, thus leading to Type I errors that will not replicate when retested. This comment's results show how radically the specific conclusions and inferences in R. S. Peterson, D. B. Smith, P. V. Martorana, and P. D. Owens's (2003) study changed with the inclusion or exclusion of 1 data point. When a more appropriate experimentwise statistical test was applied, the instability in the inferences was eliminated, but all the inferences become nonsignificant, thus changing the positive conclusions.",0 +https://doi.org/10.1097/mlr.0b013e3180546867,"Comparison of Meta-Analytic Results of Indirect, Direct, and Combined Comparisons of Drugs for Chronic Insomnia in Adults: A Case Study","Our Center recently conducted a systematic review of the manifestations and management of chronic insomnia in adults. The efficacy and safety of benzodiazepines and nonbenzodiazepines, relative to placebo, were compared indirectly.Determine how the results of indirect comparisons made in the review compare with the results of direct comparisons, as well as with estimates derived from Bayesian mixed treatment comparisons. Establish general appropriateness of the use of results of indirect or mixed treatment comparisons.Treatments were compared using frequentist direct, indirect, and combined methods, as well as Bayesian direct and mixed methods.Estimates for comparisons tended to be clinically and statistically similar across methods. Estimates obtained through indirect comparisons were not biased and were similar to those obtained through direct analysis.Results of indirect comparisons made in the review, accurately reflected the current evidence. Frequentist and Bayesian methods of analysis of indirect comparisons should be considered when performing meta-analyses.",0 +https://doi.org/10.1207/s15328007sem0704_3,"The Performance of ML, GLS, and WLS Estimation in Structural Equation Modeling Under Conditions of Misspecification and Nonnormality","This simulation study demonstrates how the choice of estimation method affects indexes of fit and parameter bias for different sample sizes when nested models vary in terms of specification error and the data demonstrate different levels of kurtosis. Using a fully crossed design, data were generated for 11 conditions of peakedness, 3 conditions of misspecification, and 5 different sample sizes. Three estimation methods (maximum likelihood [ML], generalized least squares [GLS], and weighted least squares [WLS]) were compared in terms of overall fit and the discrepancy between estimated parameter values and the true parameter values used to generate the data. Consistent with earlier findings, the results show that ML compared to GLS under conditions of misspecification provides more realistic indexes of overall fit and less biased parameter values for paths that overlap with the true model. However, despite recommendations found in the literature that WLS should be used when data are not normally distribute...",0 +https://doi.org/10.1111/j.1467-9868.2004.05304.x,Probabilistic sensitivity analysis of complex models: a Bayesian approach,"Summary.  In many areas of science and technology, mathematical models are built to simulate complex real world phenomena. Such models are typically implemented in large computer programs and are also very complex, such that the way that the model responds to changes in its inputs is not transparent. Sensitivity analysis is concerned with understanding how changes in the model inputs influence the outputs. This may be motivated simply by a wish to understand the implications of a complex model but often arises because there is uncertainty about the true values of the inputs that should be used for a particular application. A broad range of measures have been advocated in the literature to quantify and describe the sensitivity of a model's output to variation in its inputs. In practice the most commonly used measures are those that are based on formulating uncertainty in the model inputs by a joint probability distribution and then analysing the induced uncertainty in outputs, an approach which is known as probabilistic sensitivity analysis. We present a Bayesian framework which unifies the various tools of prob- abilistic sensitivity analysis. The Bayesian approach is computationally highly efficient. It allows effective sensitivity analysis to be achieved by using far smaller numbers of model runs than standard Monte Carlo methods. Furthermore, all measures of interest may be computed from a single set of runs.",0 +https://doi.org/10.1037/e576972011-002,Measuring Prestige of Journals in Industrial-Organizational Psychology,,0 +https://doi.org/10.1111/j.2517-6161.1994.tb01985.x,Estimation of Finite Mixture Distributions Through Bayesian Sampling,"SUMMARY A formal Bayesian analysis of a mixture model usually leads to intractable calculations, since the posterior distribution takes into account all the partitions of the sample. We present approximation methods which evaluate the posterior distribution and Bayes estimators by Gibbs sampling, relying on the missing data structure of the mixture model. The data augmentation method is shown to converge geometrically, since a duality principle transfers properties from the discrete missing data chain to the parameters. The fully conditional Gibbs alternative is shown to be ergodic and geometric convergence is established in the normal case. We also consider non-informative approximations associated with improper priors, assuming that the sample corresponds exactly to a k-component mixture.",0 +https://doi.org/10.1076/1380-3611(200003)6:1;1-i;ft083,Evaluating Educational Interventions Using Multilevel Growth Curves: The Case of Reading Recovery,"Educational interventions are notoriously difficult to evaluate. This article describes an application of multilevel modelling to repeated measures as part of an evaluation of Reading Recovery in England. Growth curve and multivariate models are applied to the within and between school aspects of the design, which also included a phonological intervention. Reading Recovery is shown to be effective in the short term but not in the long term. A measure of social disadvantage is a powerful predictor of reading growth in the long term.",0 +https://doi.org/10.2307/2531905,Estimation and Comparison of Changes in the Presence of Informative Right Censoring by Modeling the Censoring Process,"In the estimation and comparison of the rates of change of a continuous variable between two groups, the unweighted averages of individual simple least squares estimates from each group are often used. Under a linear random effects model, when all individuals have complete observations at identical time points, these statistics are maximum likelihood estimates for the expected rates of change. However, with censored or missing data, these estimates are no longer efficient when compared to generalized least squares estimates. When, in addition, the right-censoring process is dependent on the individual rates of change (i.e., informative right censoring), the generalized least squares estimates will be biased. Likelihood-ratio tests for informativeness of the censoring process and maximum likelihood estimates for the expected rates of change and the parameters of the right-censoring process are developed under a linear random effects model with a probit model for the right-censoring process. In realistic situations, we illustrate that the bias in estimating group rate of change and the reduction of power in comparing group differences could be substantial when strong dependency of the right-censoring process on individual rates of change is ignored.",0 +https://doi.org/10.1093/ser/mwv017,Can informal economic activities be explained by social and institutional factors? A comparative analysis,"Empirical literature on informal activities often builds on macro-economic country estimates, which impedes testing behavioural hypotheses. The European Social Survey (ESS), documenting self-reported tax evasion in 26 countries, allows us to test individual and institutional factors simultaneously. We model the effect of institutional and social capital factors affecting informal transactions. We predict that informality is fostered by social relations and trust, and curbed by institutional trust. Regulation and taxation fuel informal transactions, while effective enforcement inhibits them. These predictions are simultaneously tested with individual-level data from the ESS, complemented with country-level data on regulation, taxation levels and enforcement. Multilevel binary and multinomial logit, fixed effects, Markov chain Monte Carlo method and adaptive Gaussian quadrature regressions confirm the predictions regarding social capital, trust and tax burden. Contrary to much prior research, we find weak and inconsistent effects of regulation and enforcement, which may also be due to the limited variation of our country sample. © The Author 2015.",0 +https://doi.org/10.3758/brm.41.2.372,Making treatment effect inferences from multiple-baseline data: The utility of multilevel modeling approaches,"Multiple-baseline studies are prevalent in behavioral research, but questions remain about how to best analyze the resulting data. Monte Carlo methods were used to examine the utility of multilevel models for multiple-baseline data under conditions that varied in the number of participants, number of repeated observations per participant, variance in baseline levels, variance in treatment effects, and amount of autocorrelation in the Level 1 errors. Interval estimates of the average treatment effect were examined for two specifications of the Level 1 error structure (sigma(2)I and first-order autoregressive) and for five different methods of estimating the degrees of freedom (containment, residual, between-within, Satterthwaite, and Kenward-Roger). When the Satterthwaite or Kenward-Roger method was used and an autoregressive Level 1 error structure was specified, the interval estimates of the average treatment effect were relatively accurate. Conversely, the interval estimates of the treatment effect variance were inaccurate, and the corresponding point estimates were biased.",0 +https://doi.org/10.1007/978-0-387-73186-5_12,Multilevel Structural Equation Modeling,,0 +https://doi.org/10.1007/s10182-007-0035-0,On the inefficiency of propensity score matching,"Propensity score matching is now widely used in empirical applications for estimating treatment effects. Propensity score matching (PSM) is preferred to matching on X because of the lower dimension of the estimation problem. In this note, however, it is shown that PSM is inefficient compared to matching on X. Hence, matching on X should be considered as a serious alternative.",0 +https://doi.org/10.1207/s15328007sem1301_7,On Multilevel Model Reliability Estimation From the Perspective of Structural Equation Modeling,A covariance structure modeling perspective on reliability estimation can be used to construct a formal approach to estimation of reliability in multilevel models. This article presents a didactic discussion of the relation between a structural modeling procedure for scale reliability estimation and the notion of reliability of observed means in unconditional multilevel models. The utility of the method is demonstrated as an alternative means for conceptualizing multilevel modeling reliability. The relationship between the underlying two reliability notions is illustrated on a set of hierarchical data.,0 +https://doi.org/10.1037/a0018719,The importance of covariate selection in controlling for selection bias in observational studies.,"The assumption of strongly ignorable treatment assignment is required for eliminating selection bias in observational studies. To meet this assumption, researchers often rely on a strategy of selecting covariates that they think will control for selection bias. Theory indicates that the most important covariates are those highly correlated with both the real selection process and the potential outcomes. However, when planning a study, it is rarely possible to identify such covariates with certainty. In this article, we report on an extensive reanalysis of a within-study comparison that contrasts a randomized experiment and a quasi-experiment. Various covariate sets were used to adjust for initial group differences in the quasi-experiment that was characterized by self-selection into treatment. The adjusted effect sizes were then compared with the experimental ones to identify which individual covariates, and which conceptually grouped sets of covariates, were responsible for the high degree of bias reduction achieved in the adjusted quasi-experiment. Such results provide strong clues about preferred strategies for identifying the covariates most likely to reduce bias when planning a study and when the true selection process is not known.",0 +https://doi.org/10.1007/s11577-013-0233-6,Religiöse Diversität und Sozialintegration im internationalen Vergleich,"Following Robert D. Putnams (2007) thesis that ethnic diversity weakens social cohesion, this study addresses the social consequences of religious diversity. Instead of contrasting social-psychological mechanisms it takes a macro-sociological perspective that focuses on different structural forms of religious diversity and relates them to the trust relations within a population. The empirical results based on a cross-national comparison of 41 European and Non- European societies show that religious macro-structures are indeed related to social trust. But contrary to Putnam's ""hunkering down"" thesis religious diversity does not lead to social anomia and isolation but has different effects on social trust toward religious in- and out-groups. Key is the result that different macro-structural forms of religious diversity have different consequences for social cohesion. The question, whether religious diversity poses a threat or opportunity for the social integration of society, therefore crucially depends on its concrete form. © 2013 Springer Fachmedien Wiesbaden.",0 +https://doi.org/10.1002/cjs.10096,Likelihood-based inference for correlated diffusions,"The authors address the problem of likelihood based inference for correlated diffusions. Such a task presents two issues; the positive definite constraints of the diffusion matrix and the likelihood intractability. The first issue is handled by using the Cholesky factorisation on the diffusion matrix. To deal with the likelihood unavailability, a generalisation of the data augmentation framework of Roberts and Stramer (2001 Biometrika 88(3), 603-621) to d-dimensional correlated diffusions, including multivariate stochastic volatility models, is given. The methodology is illustrated through simulated and real datasets.",0 +https://doi.org/10.3758/app.71.7.1664,Applications of nonparametric adaptive methods for simple reaction time experiments,"Adaptive methods are commonly used in psychophysical research for detection and discrimination (see Leek, 2001; Treutwein, 1995, for reviews). In recent years, researchers have investigated via simulations some asymptotic and small-sample properties of two nonparametric adaptive methods—namely, the fixed-step-size up-down (García-Pérez, 1998, 2001) and the (accelerated) stochastic approximation (Faes et al., 2007). In the present article, we extend both methods to the simple reaction time (RT) situation for the measure of signal intensities that elicit certain (fixed) RT percentiles. We focus on extending the following four methods: the stochastic approximation of Robbins and Monro (1951), its accelerated version of Kesten (1958), the transformed up-down of Wetherill (1963), and the “biased coin design” of Durham and Flournoy (1994, 1995). In all simulations, we assume that the RT is Weibull distributed and that there is a linear relationship between the mean RT and its standard deviation. The convergences of the asymptotic and small-sample properties for different starting values, step sizes, and response criteria are systematically investigated.",0 +https://doi.org/10.1186/s12879-015-0855-6,Systematic review and mixed treatment comparison meta-analysis of randomized clinical trials of primary oral antifungal prophylaxis in allogeneic hematopoietic cell transplant recipients,"BackgroundAntifungal prophylaxis is a promising strategy for reducing invasive fungal infections (IFIs) in allogeneic hematopoietic cell transplant (alloHCT) recipients, but the optimum prophylactic agent is unknown. We used mixed treatment comparison (MTC) meta-analysis to compare clinical trials examining the use of oral antifungals for prophylaxis in alloHCT recipients, with the goal of informing medical decision-making.MethodsRandomized controlled trials (RCTs) of fluconazole, itraconazole, posaconazole, and voriconazole for primary antifungal prophylaxis were identified through a systematic literature review. Outcomes of interest (incidence of IFI/invasive aspergillosis/invasive candidiasis, all-cause mortality, and use of other antifungals) were extracted from eligible RCTs and incorporated into a Bayesian hierarchical random-effects MTC.ResultsFive eligible RCTs, randomizing 2147 patients in total, were included. Relative to fluconazole, prophylaxis with itraconazole (odds ratio [OR]: 0.52; interquartile range [IQR]: 0.35–0.76), posaconazole (OR: 0.56; IQR: 0.32–0.99), and voriconazole (OR: 0.46; IQR: 0.28–0.73) reduced incidence of overall proven/probable IFI. Posaconazole (OR: 0.31; IQR: 0.17–0.58) and voriconazole (OR: 0.33; IQR: 0.17–0.58) prophylaxis reduced proven/probable invasive aspergillosis more than itraconazole (OR: 0.68; IQR: 0.42–1.12). All-cause mortality was similar across all mould-active agents.ConclusionAs expected, mould-active azoles prevented IFIs, particularly invasive aspergillosis, more effectively than fluconazole in alloHCT recipients. The paucity of comparative efficacy data suggests that other factors such as long-term tolerability, availability of intravenous formulations, local IFI epidemiology, and drug costs may need to form the basis for selection among the mould-active azoles.",0 +https://doi.org/10.1108/s0147-912120140000039004,How Do Exit Rates from Social Assistance Benefit in Belgium Vary with Individual and Local Agency Characteristics?,"Abstract The administration of social assistance benefits is devolved to local agencies in Belgium, which raises questions about how much variation in spell lengths of benefit receipt is associated with differences across agencies. We address this issue by analysing the monthly hazard of benefit exit using administrative record data for 14,270 individuals in 574 welfare agencies. Our random-effects model allows for differences in both the observed and unobserved characteristics of beneficiaries and of local agencies. There are large differences in median benefit duration for individuals serviced by different welfare agencies: the range is from two months to more than 24 months. We find strong associations between beneficiary characteristics (sex, age, foreign nationality, citizenship acquisition, work history and being a student) and spell length. The estimates show higher odds of exiting social assistance receipt in bigger municipalities and in agencies which provide more generous supplementary assistance, and also strong evidence of shorter episodes in agencies where active labour market programme participation rates are higher.",0 +https://doi.org/10.1002/sim.5821,Avoiding zero between-study variance estimates in random-effects meta-analysis,"Fixed-effects meta-analysis has been criticized because the assumption of homogeneity is often unrealistic and can result in underestimation of parameter uncertainty. Random-effects meta-analysis and meta-regression are therefore typically used to accommodate explained and unexplained between-study variability. However, it is not unusual to obtain a boundary estimate of zero for the (residual) between-study standard deviation, resulting in fixed-effects estimates of the other parameters and their standard errors. To avoid such boundary estimates, we suggest using Bayes modal (BM) estimation with a gamma prior on the between-study standard deviation. When no prior information is available regarding the magnitude of the between-study standard deviation, a weakly informative default prior can be used (with shape parameter 2 and rate parameter close to 0) that produces positive estimates but does not overrule the data, leading to only a small decrease in the log likelihood from its maximum. We review the most commonly used estimation methods for meta-analysis and meta-regression including classical and Bayesian methods and apply these methods, as well as our BM estimator, to real datasets. We then perform simulations to compare BM estimation with the other methods and find that BM estimation performs well by (i) avoiding boundary estimates; (ii) having smaller root mean squared error for the between-study standard deviation; and (iii) better coverage for the overall effects than the other methods when the true model has at least a small or moderate amount of unexplained heterogeneity.",0 +https://doi.org/10.3168/jds.2007-0107,"Cow, Farm, and Management Factors During the Dry Period that Determine the Rate of Clinical Mastitis After Calving","The purpose of the research was to investigate cow characteristics, farm facilities, and herd management strategies during the dry period to examine their joint influence on the rate of clinical mastitis after calving. Data were collected over a 2-yr period from 52 commercial dairy farms throughout England and Wales. Cows were separated for analysis into those housed for the dry period (8,710 cow-dry periods) and those at pasture (9,964 cow-dry periods). Multilevel models were used within a Bayesian framework with 2 response variables, the occurrence of a first case of clinical mastitis within the first 30 d of lactation and time to the first case of clinical mastitis during lactation. A variety of cow and herd management factors were identified as being associated with an increased rate of clinical mastitis and these were found to occur throughout the dry period. Significant cow factors were increased parity and at least one somatic cell count > or = 200,000 cells/mL in the 90 d before drying off. A number of management factors related to hygiene were significantly associated with an increased rate of clinical mastitis. These included measures linked to the administration of dry-cow treatments and management of the early and late dry-period accommodation and calving areas. Other farm factors associated with a reduced rate of clinical mastitis were vaccination with a leptospirosis vaccine, selection of dry-cow treatments for individual cows within a herd rather than for the herd as a whole, routine body condition scoring of cows at drying off, and a pasture rotation policy of grazing dry cows for a maximum of 2 wk before allowing the pasture to remain nongrazed for a period of 4 wk. Models demonstrated a good ability to predict the farm incidence rate of clinical mastitis in a given year, with model predictions explaining over 85% of the variability in the observed data. The research indicates that specific dry-period management strategies have an important influence on the rate of clinical mastitis during the next lactation.",0 +https://doi.org/10.1111/aphw.12011,Predicting Psychological Needs and Well-Being of Individuals Engaging in Weight Management: The Role of Important Others,"Background: Using the self-determination theory (SDT) framework, we examined how significant others might support or thwart psychological needs of people with weight management goals, and in turn might affect their psychological well-being and weight control behaviors. Design: Longitudinal design with three sets of questionnaires administered over a 6-month period. Methods: One hundred and fifty-six eligible participants (age = 31.01 ± 13.21 years) were asked to complete questionnaires of SDT-based constructs, weight management behaviors, and psychological well-being. Hypotheses were tested using Bayesian path analysis. Results: Perceived autonomy support from significant others was related to psychological need satisfaction, while controlling behaviors by others were associated with need thwarting. In turn, need satisfaction was associated with some beneficial outcomes such as life satisfaction, and need thwarting was related to some maladaptive outcomes such as higher levels of depressive symptoms and increases in unhealthy diet behaviors. Conclusions: Our findings indicate that the quality of interactions between individuals engaged in weight management and their significant others matters in terms of predicting the psychological needs and well-being of the former.",0 +https://doi.org/10.1177/0047287515588593,Unobserved Heterogeneity in Hospitality and Tourism Research,"Despite the growing complexity of structural equation model (SEM) applications in tourism, it is surprising that most applications have estimated these models without accounting for unobserved heterogeneity. In this article, we aim to discuss the concept of unobserved heterogeneity in more detail, highlighting its serious threats to the validity and reliability of SEMs. We describe a Bayesian finite mixture modeling framework for estimating SEMs while accounting for unobserved heterogeneity. We provide a comprehensive description of this model, and provide guidance on its estimation using the WinBUGS software. We illustrate the importance of unobserved heterogeneity and the finite mixture modeling framework using a didactic application on brand equity where heterogeneity is likely to play an important role because of the differences in how consumers perceive the different dimensions of brand equity. We compare between various models and illustrate the differences between the standard and heterogeneous SEM and discuss the implications for research and practice.",0 +https://doi.org/10.1287/deca.1080.0126,A Comparison of Two Probability Encoding Methods: Fixed Probability vs. Fixed Variable Values,"We present the results of an experiment comparing two popular methods for encoding probability distributions of continuous variables in decision analysis: eliciting values of a variable, X, through comparisons with a fixed probability wheel and eliciting the percentiles of the cumulative distribution, F(X), through comparisons with fixed values of the variable. We show slight but consistent superiority for the fixed variable method along several dimensions such as monotonicity, accuracy, and precision of the estimated fractiles. The fixed variable elicitation method was also slightly faster and preferred by most participants. We discuss the reasons for its superiority and conclude with several recommendations for the practice of probability assessment.",0 +https://doi.org/10.1016/j.jmp.2009.04.002,"Stochastic dynamics of stimulus encoding in schizophrenia: Theory, testing, and application","Abstract Cognitive processing among schizophrenia participants, entailing encoding of presenting stimulation into a format facilitating collateral processes (e.g., memory search), is examined in light of stochastic mathematical models of performance. Results implicate additional encoding operations (encoding subprocesses) as the source of schizophrenia encoding-process elongation. Convergent evidence for this inference, including that from auxiliary neuro-connectionist simulations, are brought forth. Developments from initial, fixed-parameter accounts include random-parameter mixtures, and their Bayesian extensions, formally mediating group-level results to assessment of individual performance. Outgrowths bear on model-selection methodology, according to coherence of group-level and individual-level model functioning (in part addressing the issue of “small-trial-sample model testing”); longitudinal monitoring of encoding-specific treatment response; evaluation of treatment-regimen efficacy with respect to encoding efficiency; and specification of times of measurement interest, in fMRI. The symptom significance of encoding elongation, strongly hinted at by model developments, along with a model-endowed window on exacerbating effects of stress, are drawn out.",0 +https://doi.org/10.1080/10705511.2014.919828,Fitting Nonlinear Latent Growth Curve Models With Individually Varying Time Points,"Individual growth trajectories of psychological phenomena are often theorized to be nonlinear. Additionally, individuals’ measurement schedules might be unique. In a structural equation framework, latent growth curve model (LGM) applications typically have either (a) modeled nonlinearity assuming some degree of balance in measurement schedules, or (b) accommodated truly individually varying time points, assuming linear growth. This article describes how to fit 4 popular nonlinear LGMs (polynomial, shape-factor, piecewise, and structured latent curve) with truly individually varying time points, via a definition variable approach. The extension is straightforward for certain nonlinear LGMs (e.g., polynomial and structured latent curve) but in the case of shape-factor LGMs requires a reexpression of the model, and in the case of piecewise LGMs requires introduction of a general framework for imparting piecewise structure, along with tools for its automation. All 4 nonlinear LGMs with individually varying ti...",0 +https://doi.org/10.1016/j.brainres.2010.07.064,Influences of intra- and crossmodal grouping on visual and tactile Ternus apparent motion,"Previous studies of dynamic crossmodal integration have revealed that the direction of apparent motion in a target modality can be influenced by a spatially incongruent motion stream in another, distractor modality. Yet, it remains to be examined whether non-motion intra- and crossmodal perceptual grouping can affect apparent motion in a given target modality. To address this question, we employed Ternus apparent-motion displays, which consist of three horizontal aligned visual (or tactile) stimuli that can alternately be seen as either 'element motion' or 'group motion'. We manipulated intra- and crossmodal grouping by cueing the middle stimulus with different cue-target onset asynchronies (CTOAs). In unimodal conditions, we found Ternus apparent motion to be readily biased towards 'element motion' by precues with short or intermediate CTOAs in the visual modality and by precues with short CTOAs in the tactile modality. By contrast, crossmodal precues with short or intermediate CTOAs had no influence on Ternus apparent motion. However, crossmodal synchronous tactile cues led to dominant 'group motion' percepts. And for unimodal visual apparent motion, precues with long CTOAs shifted apparent motion towards 'group motion' in general. The results suggest that intra- and crossmodal interactions on visual and tactile apparent motion take place in different temporal ranges, but both are subject to attentional modulations at long CTOAs.",0 +https://doi.org/10.1214/11-ba609,Sensitivity analysis in Bayesian generalized linear mixed models for binary data,"Generalized linear mixed models (GLMMs) enjoy increasing popularity because of their ability to model correlated observations. Integrated nested Laplace approximations (INLAs) provide a fast implementation of the Bayesian approach to GLMMs. However, sensitivity to prior assumptions on the random effects precision parameters is a potential problem. To quantify the sensitivity to prior assumptions, we develop a general sensitivity measure based on the Hellinger distance to assess sensitivity of the posterior distributions with respect to changes in the prior distributions for the precision parameters. In addition, for model selection we suggest several cross-validatory techniques for Bayesian GLMMs with a dichotomous outcome. Although the proposed methodology holds in greater generality, we make use of the developed methods in the particular context of the well-known salamander mating data. We arrive at various new findings with respect to the best fitting model and the sensitivity of the estimates of the model components.",0 +https://doi.org/10.1509/jmkr.39.4.479.19124,An Empirical Comparison of Logit Choice Models with Discrete versus Continuous Representations of Heterogeneity,"Currently, there is an important debate about the relative merits of models with discrete and continuous representations of consumer heterogeneity. In a recent JMR study, Andrews, Ansari, and Currim (2002 ; hereafter AAC) compared metric conjoint analysis models with discrete and continuous representations of heterogeneity and found no differences between the two models with respect to parameter recovery and prediction of ratings for holdout profiles. Models with continuous representations of heterogeneity fit the data better than models with discrete representations of heterogeneity. The goal of the current study is to compare the relative performance of logit choice models with discrete versus continuous representations of heterogeneity in terms of the accuracy of household-level parameters, fit, and forecasting accuracy. To accomplish this goal, the authors conduct an extensive simulation experiment with logit models in a scanner data context, using an experimental design based on AAC and other recent simulation studies. One of the main findings is that models with continuous and discrete representations of heterogeneity recover household-level parameter estimates and predict holdout choices about equally well except when the number of purchases per household is small, in which case the models with continuous representations perform very poorly. As in the AAC study, models with continuous representations of heterogeneity fit the data better.",0 +https://doi.org/10.1016/j.joi.2008.09.003,How to detect indications of potential sources of bias in peer review: A generalized latent variable modeling approach exemplified by a gender study,"Abstract The universalism norm of the ethos of science requires that contributions to science are not excluded because of the contributors’ gender, nationality, social status, or other irrelevant criteria. Here, a generalized latent variable modeling approach is presented that grant program managers at a funding organization can use in order to obtain indications of potential sources of bias in their peer review process (such as the applicants’ gender). To implement the method, the data required are the number of approved and number of rejected applicants for grants among different groups (for example, women and men or natural and social scientists). Using the generalized latent variable modeling approach indications of potential sources of bias can be examined not only for grant peer review but also for journal peer review.",0 +https://doi.org/10.3758/bf03193560,Comparing and unifying slope estimates across psychometric function models,"The psychometric function relating stimulus intensity to response probability generally presents itself as a monotonically increasing sigmoid profile. Two summary parameters of the function are particularly important as measures of perceptual performance: the threshold parameter, which defines the location of the function over the stimulus axis (abscissa), and the slope parameter, which defines the (local) rate at which response probability increases with increasing stimulus intensity. In practice, the psychometric function may be modeled by a variety of mathematical structures, and the resulting algebraic expression describing the slope parameter may vary considerably between different functions fitted to the same experimental data. This variation often restricts comparisons between studies that select different functions and compromises the general interpretation of slope values. This article reviews the general characteristics of psychometric function models, discusses three strategies for resolving the issue of slope value differences, and presents mathematical expressions for implementing each strategy.",0 +https://doi.org/10.1207/s15328007sem1203_2,"The Relation Among Fit Indexes, Power, and Sample Size in Structural Equation Modeling","The relation among fit indexes, power, and sample size in structural equation modeling is examined. The noncentrality parameter is required to compute power. The 2 existing methods of computing power have estimated the noncentrality parameter by specifying an alternative hypothesis or alternative fit. These methods cannot be implemented easily and reliably. In this study, 4 fit indexes (RMSEA, CFI, McDonald's Fit Index, and Steiger's gamma) were used to compute the noncentrality parameter and sample size to achieve certain level of power. The resulting power and sample size varied as a function of (a) choice of fit index, (b) number of variables/degrees of freedom, (c) relation among the variables, and (d) value of the fit index. However, if the level of misspecification were held constant, then the resulting power and sample size would be identical.",0 +https://doi.org/10.1080/00273171.2014.1003770,Bayesian Causal Mediation Analysis for Group Randomized Designs with Homogeneous and Heterogeneous Effects: Simulation and Case Study,"A fully Bayesian approach to causal mediation analysis for group-randomized designs is presented. A unique contribution of this article is the combination of Bayesian inferential methods with G-computation to address the problem of heterogeneous treatment or mediator effects. A detailed simulation study shows that this approach has excellent frequentist properties, particularly in the case of small sample sizes with accurate informative priors. The simulation study also demonstrates that the proposed approach can take into account heterogeneous treatment or mediator effects without bias. A case study using data from a school-based randomized intervention designed to increase parent social capital leading to improved behavioral and academic outcomes in children is offered to illustrate the Bayesian approach to causal mediation in group-randomized designs.",0 +https://doi.org/10.1016/s0047-2727(01)00167-0,Does 401(k) eligibility increase saving?,"By comparing 401(k) eligible and ineligible households’ wealth, this paper estimates that, on average, about one half of 401(k) balances represent new private savings, and about one quarter of 401(k) balances represent new national savings. Responses to eligibility vary considerably, however, with households who normally save the most largely contributing funds they would have saved anyway. This paper improves on previous research by: (1) employing propensity score subclassification to control more completely for observed household characteristics, (2) controlling for more household characteristics, including several correlated with unobserved savings preferences, and (3) adjusting the observed measure of households’ wealth to reduce measurement error.",0 +https://doi.org/10.1007/bf02294846,Analysis of structural equation model with ignorable missing continuous and polytomous data,"The main purpose of this article is to develop a Bayesian approach for structural equation models with ignorable missing continuous and polytomous data. Joint Bayesian estimates of thresholds, structural parameters and latent factor scores are obtained simultaneously. The idea of data augmentation is used to solve the computational difficulties involved. In the posterior analysis, in addition to the real missing data, latent variables and latent continuous measurements underlying the polytomous data are treated as hypothetical missing data. An algorithm that embeds the Metropolis-Hastings algorithm within the Gibbs sampler is implemented to produce the Bayesian estimates. A goodness-of-fit statistic for testing the posited model is presented. It is shown that the proposed approach is not sensitive to prior distributions and can handle situations with a large number of missing patterns whose underlying sample sizes may be small. Computational efficiency of the proposed procedure is illustrated by simulation studies and a real example.",0 +https://doi.org/10.1534/genetics.115.186114,Simple Penalties on Maximum-Likelihood Estimates of Genetic Parameters to Reduce Sampling Variation,"Abstract Multivariate estimates of genetic parameters are subject to substantial sampling variation, especially for smaller data sets and more than a few traits. A simple modification of standard, maximum-likelihood procedures for multivariate analyses to estimate genetic covariances is described, which can improve estimates by substantially reducing their sampling variances. This is achieved by maximizing the likelihood subject to a penalty. Borrowing from Bayesian principles, we propose a mild, default penalty—derived assuming a Beta distribution of scale-free functions of the covariance components to be estimated—rather than laboriously attempting to determine the stringency of penalization from the data. An extensive simulation study is presented, demonstrating that such penalties can yield very worthwhile reductions in loss, i.e., the difference from population values, for a wide range of scenarios and without distorting estimates of phenotypic covariances. Moreover, mild default penalties tend not to increase loss in difficult cases and, on average, achieve reductions in loss of similar magnitude to computationally demanding schemes to optimize the degree of penalization. Pertinent details required for the adaptation of standard algorithms to locate the maximum of the likelihood function are outlined.",0 +https://doi.org/10.1177/0013164413496812,Piecewise Linear–Linear Latent Growth Mixture Models With Unknown Knots,"Latent growth curve models with piecewise functions are flexible and useful analytic models for investigating individual behaviors that exhibit distinct phases of development in observed variables. As an extension of this framework, this study considers a piecewise linear–linear latent growth mixture model (LGMM) for describing segmented change of individual behavior over time where the data come from a mixture of two or more unobserved subpopulations (i.e., latent classes). Thus, the focus of this article is to illustrate the practical utility of piecewise linear–linear LGMM and then to demonstrate how this model could be fit as one of many alternatives—including the more conventional LGMMs with functions such as linear and quadratic. To carry out this study, data ( N = 214) obtained from a procedural learning task research were used to fit the three alternative LGMMs: (a) a two-class LGMM using a linear function, (b) a two-class LGMM using a quadratic function, and (c) a two-class LGMM using a piecewise linear–linear function, where the time of transition from one phase to another (i.e., knot) is not known a priori, and thus is a parameter to be estimated.",0 +https://doi.org/10.1111/j.2517-6161.1993.tb01466.x,Bayesian Computation Via the Gibbs Sampler and Related Markov Chain Monte Carlo Methods,"The use of the Gibbs sampler for Bayesian computation is reviewed and illustrated in the context of some canonical examples. Other Markov chain Monte Carlo simulation methods are also briefly described, and comments are made on the advantages of sample-based approaches for Bayesian inference summaries",0 +https://doi.org/10.1177/1754073915590619,Modeling Affect Dynamics: State of the Art and Future Challenges,"The current article aims to provide an up-to-date synopsis of available techniques to study affect dynamics using intensive longitudinal data (ILD). We do so by introducing the following eight dichotomies that help elucidate what kind of data one has, what process aspects are of interest, and what research questions are being considered: (1) single- versus multiple-person data; (2) univariate versus multivariate models; (3) stationary versus nonstationary models; (4) linear versus nonlinear models; (5) discrete time versus continuous time models; (6) discrete versus continuous variables; (7) time versus frequency domain; and (8) modeling the process versus computing descriptives. In addition, we discuss what we believe to be the most urging future challenges regarding the modeling of affect dynamics.",0 +https://doi.org/10.1111/j.1541-0420.2007.00924.x,An Application of a Mixed-Effects Location Scale Model for Analysis of Ecological Momentary Assessment (EMA) Data,"For longitudinal data, mixed models include random subject effects to indicate how subjects influence their responses over repeated assessments. The error variance and the variance of the random effects are usually considered to be homogeneous. These variance terms characterize the within-subjects (i.e., error variance) and between-subjects (i.e., random-effects variance) variation in the data. In studies using ecological momentary assessment (EMA), up to 30 or 40 observations are often obtained for each subject, and interest frequently centers around changes in the variances, both within and between subjects. In this article, we focus on an adolescent smoking study using EMA where interest is on characterizing changes in mood variation. We describe how covariates can influence the mood variances, and also extend the standard mixed model by adding a subject-level random effect to the within-subject variance specification. This permits subjects to have influence on the mean, or location, and variability, or (square of the) scale, of their mood responses. Additionally, we allow the location and scale random effects to be correlated. These mixed-effects location scale models have useful applications in many research areas where interest centers on the joint modeling of the mean and variance structure.",0 +https://doi.org/10.1111/1467-9248.12176,Calling European Union Treaty Referendums: Electoral and Institutional Politics,"Many European integration treaties – most notably the failed Constitutional Treaty – have faced ratification by referendum in various member states. Although the literature on voting behaviour in these referendums in now well established, the reasons why these referendums were held in the first place is under-scrutinised. This article examines the reasons EU member states decide to call referendums in order to ratify EU treaties and argues that they do so primarily as a result of domestic political pressure arising from three sources: electoral pressure when the EU is unpopular and elections are close, rules governing the use of referendums, and domestic institutional veto players. This theory is tested using a combination of single and multi-level logistic regression analysis, which finds support for the hypotheses developed here.",0 +https://doi.org/10.1207/s15328007sem0903_2,The Impact of Categorization With Confirmatory Factor Analysis,"This study investigated the impact of categorization on confirmatory factor analysis (CFA) parameter estimates, standard errors, and 5 ad hoc fit indexes. Models were generated that represented empirical research situations in terms of model size, sample sizes, and loading values. CFA results obtained from analysis of normally distributed, continuous data were compared to results obtained from 5-category Likert-type data with normal distributions. The ordered categorical data were analyzed using the estimators: Weighted Least Squares (WLS; with polychoric correlation [PC] input) and Maximum Likelihood (ML; with Pearson Product-Moment [PPM] input). ML-PPM-based parameter estimates reported moderate levels of negative bias for all conditions, WLS-PC-based standard errors showed high amounts of bias, especially with a small sample size and moderate loading values. With nonnormally distributed, ordered categorical data, ML-PPM-based parameter estimates, standard errors, and factor intercorrelation showed high...",0 +https://doi.org/10.1111/1467-9868.00353,Bayesian measures of model complexity and fit,"Summary. We consider the problem of comparing complex hierarchical models in which the number of parameters is not clearly defined. Using an information theoretic argument we derive a measure pD for the effective number of parameters in a model as the difference between the posterior mean of the deviance and the deviance at the posterior means of the parameters of interest. In general pD approximately corresponds to the trace of the product of Fisher's information and the posterior covariance, which in normal models is the trace of the ‘hat’ matrix projecting observations onto fitted values. Its properties in exponential families are explored. The posterior mean deviance is suggested as a Bayesian measure of fit or adequacy, and the contributions of individual observations to the fit and complexity can give rise to a diagnostic plot of deviance residuals against leverages. Adding pD to the posterior mean deviance gives a deviance information criterion for comparing models, which is related to other information criteria and has an approximate decision theoretic justification. The procedure is illustrated in some examples, and comparisons are drawn with alternative Bayesian and classical proposals. Throughout it is emphasized that the quantities required are trivial to compute in a Markov chain Monte Carlo analysis.",0 +https://doi.org/10.1002/sim.5380,Estimation of mediation effects for zero-inflated regression models,"The goal of mediation analysis is to identify and explicate the mechanism that underlies a relationship between a risk factor and an outcome via an intermediate variable (mediator). In this paper, we consider the estimation of mediation effects in zero-inflated (ZI) models intended to accommodate 'extra' zeros in count data. Focusing on the ZI negative binomial models, we provide a mediation formula approach to estimate the (overall) mediation effect in the standard two-stage mediation framework under a key sequential ignorability assumption. We also consider a novel decomposition of the overall mediation effect for the ZI context using a three-stage mediation model. Estimation of the components of the overall mediation effect requires an assumption involving the joint distribution of two counterfactuals. Simulation study results demonstrate low bias of mediation effect estimators and close-to-nominal coverage probability of confidence intervals. We also modify the mediation formula method by replacing 'exact' integration with a Monte Carlo integration method. The method is applied to a cohort study of dental caries in very low birth weight adolescents. For overall mediation effect estimation, sensitivity analysis was conducted to quantify the degree to which key assumption must be violated to reverse the original conclusion.",0 +https://doi.org/10.2307/2669750,Asymptotic Distribution of P Values in Composite Null Models,"We investigate the compatibility of a null model H0 with the data by calculating a p value; that is, the probability, under H0, that a given test statistic T exceeds its observed value. When the null model consists of a single distribution, the p value is readily obtained, and it has a uniform distribution under H0. On the other hand, when the null model depends on an unknown nuisance parameter θ, one must somehow get rid of θ, (e.g., by estimating it) to calculate a p value. Various proposals have been suggested to ""remove"" θ, each yielding a different candidate p value. But unlike the simple case, these p values typically are not uniformly distributed under the null model. In this article we investigate their asymptotic distribution under H0. We show that when the asymptotic mean of the test statistic T depends on θ, the posterior predictive p value of Guttman and Rubin, and the plug-in p value are conservative (i.e., their asymptotic distributions are more concentrated around 1/2 than a uniform), with the posterior predictive p value being the more conservative. In contrast, the partial posterior predictive and conditional predictive p values of Bayarri and Berger are asymptotically uniform. Furthermore, we show that the discrepancy p value of Meng and Gelman and colleagues can be conservative, even when the discrepancy measure has mean 0 under the null model. We also describe ways to modify the conservative p values to make their distributions asymptotically uniform.",0 +https://doi.org/10.1016/j.csda.2008.03.029,On Bayesian estimation and model comparison of an integrated structural equation model,"In this paper, we introduce a Bayesian approach to the estimation and model comparison of an integrated two-level nonlinear structural equation model with mixed continuous, dichotomous, and ordered categorical data that may be missing at random. This general model can accommodate nonlinearities of latent variables and the effects of fixed covariates on measurement and structural equations in within-groups and between-groups models. A sampling-based algorithm that combines the Gibbs sampler and the Metropolis-Hastings algorithm is proposed for posterior simulation. A procedure that utilizes path sampling is implemented to compute the Bayes factor for model comparison under the framework of the proposed integrated model. Empirical performances of Bayesian methodologies are illustrated via analysis of a real example.",0 +https://doi.org/10.1207/s15327906mbr3502_3,Bayesian Interval Estimation of Multiple Correlations with Missing Data: A Gibbs Sampling Approach.,"A Bayesian method for obtaining an interval estimate of the population squared multiple correlation from an incomplete multivariate normal data set is described. The method is applicable to data sets where values are missing on any combination of the dependent and independent variables. Further, the missing data need not be missing in a completely random fashion. The estimates are constructed using a Markov Chain Monte Carlo procedure known as Gibbs Sampling. The important issues of the convergence properties of the Gibbs sampler, the effect of the choice of a reference prior, and the empirical coverage probabilities of the estimates are considered in detail. Investigations using simulated data suggest that the proposed method can yield accurate interval estimates of the population squared multiple correlation.",0 +https://doi.org/10.1080/10705511.2011.607714,General Growth Mixture Analysis of Adolescents' Developmental Trajectories of Anxiety: The Impact of Untested Invariance Assumptions on Substantive Interpretations,"Substantively, this study investigates potential heterogeneity in the developmental trajectories of anxiety in adolescence. Methodologically, this study demonstrates the usefulness of general growth mixture analysis (GGMA) in addressing these issues and illustrates the impact of untested invariance assumptions on substantive interpretations. This study relied on data from the Montreal Adolescent Depression Development Project (MADDP), a 4-year follow-up of more than 1,000 adolescents who completed the Beck Anxiety Inventory each year. GGMA models relying on different invariance assumptions were empirically compared. Each of these models converged on a 5-class solution, but yielded different substantive results. The model with class-varying variance–covariance matrices was retained as providing a better fit to the data. These results showed that although elevated levels of anxiety might fluctuate over time, they clearly do not represent a transient phenomenon. This model was then validated in relation to m...",0 +https://doi.org/10.1111/j.2044-8295.1990.tb02372.x,A ‘sheep-goat effect’ in repetition avoidance: Extra-sensory perception as an effect of subjective probability?,"Performance on extra-sensory perception (ESP) and on subjective random generation (SRG) has been shown independently to differ along a number of personality dimensions. One of the variables known consistently to influence ESP performance but not studied yet in SRG experiments is belief in the paranormal. We report three experiments on subjective randomness as a function of belief in ESP: (1) a retrospective analysis of randomness in multiple choice answers of a telepathy experiment revealed that believers in ESP (‘sheep’) avoided repetitive responses significantly more than non-believers (‘goats’); (2) in an experiment where subjects had to produce random strings of the digits 1−6, sheep avoided repetitions significantly more than goats; (3) in an experiment where subjects had to compare equiprobable short random sequences, sheep underestimated the number of mathematically expected repetitions significantly more than goats. In all three experiments a stronger bias against the incidence of direct repetitions was found for subjects believing in ESP than for those denying its possibility. This may indicate that believers are more prone to an illusion of causality in the face of everyday coincidences. We suggest that effects of subjective probability and, particularly, of subjective randomness should be considered in future studies concerned with individual differences in ESP scoring.",0 +https://doi.org/10.1002/sim.1264,Multilevel modelling of medical data,This tutorial presents an overview of multilevel or hierarchical data modelling and its applications in medicine. A description of the basic model for nested data is given and it is shown how this can be extended to fit flexible models for repeated measures data and more complex structures involving cross-classifications and multiple membership patterns within the software package MLwiN. A variety of response types are covered and both frequentist and Bayesian estimation methods are described.,0 +https://doi.org/10.1002/bimj.200390021,Small Sample Correction for the Variance of GEE Estimators,"When clustered multinomial responses are fit using the generalized logistic link, Morel (1989) introduced a small sample correction in the Taylor series based estimator of the covariance matrix of the parameter estimates. The correction reduces the bias of the Type I error rates in small samples and guarantees positive definiteness of the estimated variance-covariance matrix. It is well known that small sample bias in the use of the Delta method persists in any application of the Generalized Estimating Equations (GEE) methodology. In this article, we extend the correction originally suggested for the generalized logistic link, to other link functions and distributions, when parameters are estimated by GEE. In a Monte Carlo study with correlated data generated under different sampling schemes, the small sample correction has been shown to be effective in reducing the Type I error rates when the number of clusters is relatively small.",0 +https://doi.org/10.1007/s11336-014-9417-x,Get Over It! A Multilevel Threshold Autoregressive Model for State-Dependent Affect Regulation,"Intensive longitudinal data provide rich information, which is best captured when specialized models are used in the analysis. One of these models is the multilevel autoregressive model, which psychologists have applied successfully to study affect regulation as well as alcohol use. A limitation of this model is that the autoregressive parameter is treated as a fixed, trait-like property of a person. We argue that the autoregressive parameter may be state-dependent, for example, if the strength of affect regulation depends on the intensity of affect experienced. To allow such intra-individual variation, we propose a multilevel threshold autoregressive model. Using simulations, we show that this model can be used to detect state-dependent regulation with adequate power and Type I error. The potential of the new modeling approach is illustrated with two empirical applications that extend the basic model to address additional substantive research questions.",0 +https://doi.org/10.1139/cjfr-2012-0268,Population-averaged predictions with generalized linear mixed-effects models in forestry: an estimator based on Gauss−Hermite quadrature,"Data in forestry are often spatially and (or) serially correlated. In the last two decades, mixed models have become increasingly popular for the analysis of such data because they can relax the assumption of independent observations. However, when the relationship between the response variable and the covariates is nonlinear, as is the case in generalized linear mixed models (GLMMs), population-averaged predictions cannot be obtained from the fixed effects alone. This study proposes an estimator, which is based on a five-point Gauss−Hermite quadrature, for population-averaged predictions in the context of GLMM. The estimator was tested through Monte Carlo simulation and compared with a regular generalized linear model (GLM). The estimator was also applied to a real-world case study, a harvest model. The results showed that GLM predictions were unbiased but that their confidence intervals did not achieve their nominal coverage. On the other hand, the proposed estimator yielded unbiased predictions with reliable confidence intervals. The predictions based on the fixed effects of a GLMM exhibited the largest biases. If statistical inferences are needed, the proposed estimator should be used. It is easily implemented as long as the random effect specification does not contain multiple random effects for the same hierarchical level.",0 +https://doi.org/10.3102/1076998614546494,Modeling Heterogeneous Variance–Covariance Components in Two-Level Models,"Applications of multilevel models to continuous outcomes nearly always assume constant residual variance and constant random effects variances and covariances. However, modeling heterogeneity of variance can prove a useful indicator of model misspecification, and in some educational and behavioral studies, it may even be of direct substantive interest. The purpose of this article is to review, describe, and illustrate a set of recent extensions to two-level models that allow the residual and random effects variance–covariance components to be specified as functions of predictors. These predictors can then be entered with random coefficients to allow the Level-1 heteroscedastic relationships to vary across Level-2 units. We demonstrate by simulation that ignoring Level-2 variability in residual variances leads the Level-1 variance function regression coefficients to be estimated with spurious precision. We discuss software options for fitting these extensions, and we illustrate them by reanalyzing the classic High School and Beyond data and two-level school effects models presented by Raudenbush and Bryk.",0 +https://doi.org/10.1111/j.1365-2729.2010.00368.x,Adaptive item-based learning environments based on the item response theory: possibilities and challenges,"The popularity of intelligent tutoring systems (ITSs) is increasing rapidly. In order to make learning environments more efficient, researchers have been exploring the possibility of an automatic adaptation of the learning environment to the learner or the context. One of the possible adaptation techniques is adaptive item sequencing by matching the difficulty of the items to the learner's knowledge level. This is already accomplished to a certain extent in adaptive testing environments, where the test is tailored to the person's ability level by means of the item response theory (IRT). Even though IRT has been a prevalent computerized adaptive test (CAT) approach for decades and applying IRT in item-based ITSs could lead to similar advantages as in CAT (e.g. higher motivation and more efficient learning), research on the application of IRT in such learning environments is highly restricted or absent. The purpose of this paper was to explore the feasibility of applying IRT in adaptive item-based ITSs. Therefore, we discussed the two main challenges associated with IRT application in such learning environments: the challenge of the data set and the challenge of the algorithm. We concluded that applying IRT seems to be a viable solution for adaptive item selection in item-based ITSs provided that some modifications are implemented. Further research should shed more light on the adequacy of the proposed solutions.",0 +https://doi.org/10.1159/000351642,Statistical Power of Multilevel Modelling in Dental Caries Clinical Trials: A Simulation Study,"Outcome data from dental caries clinical trials have a naturally hierarchical structure, with surfaces clustered within teeth, clustered within individuals. Data are often aggregated into the DMF index for each individual, losing tooth- and surface-specific information. If these data are to be analysed by tooth or surface, allowing exploration of effects of interventions on different teeth and surfaces, appropriate methods must be used to adjust for the clustered nature of the data. Multilevel modelling allows analysis of clustered data using individual observations without aggregating data, and has been little used in the field of dental caries. A simulation study was conducted to investigate the performance of multilevel modelling methods and standard caries increment analysis. Data sets were simulated from a three-level binomial distribution based on analysis of a caries clinical trial in Scottish adolescents, with varying sample sizes, treatment effects and random tooth level effects based on trials reported in Cochrane reviews of topical fluoride, and analysed to compare the power of multilevel models and traditional analysis. 40,500 data sets were simulated. Analysis showed that estimated power for the traditional caries increment method was similar to that for multilevel modelling, with more variation in smaller data sets. Multilevel modelling may not allow significant reductions in the number of participants required in a caries clinical trial, compared to the use of traditional analyses, but investigators interested in exploring the effect of their intervention in more detail may wish to consider the application of multilevel modelling to their clinical trial data.",0 +,Back to the Future: Effects of Olfaction induced Episodic Memories on Consumer Creativity and Innovation Adoption,,0 +https://doi.org/10.1027/1015-5759.23.4.258,Assessing Mood in Daily Life,"Abstract. The repeated measurement of moods in everyday life, as is common in ambulatory monitoring, requires parsimonious scales, which may challenge the reliability of the measures. The current paper evaluates the factor structure, the reliability, and the sensitivity to change of a six-item mood scale designed for momentary assessment in daily life. We analyzed data from 187 participants who reported their current mood four times per day during seven consecutive days using a multilevel approach. The results suggest that the proposed three factors Calmness, Valence, and Energetic arousal are appropriate to assess fluctuations within persons over time. However, calmness and valence are not distinguishable at the between-person level. Furthermore, the analyses showed that two-item scales provide measures that are reliable at the different levels and highly sensitive to change.",0 +https://doi.org/10.1002/sim.2934,Recent developments in meta-analysis,"The art and science of meta-analysis, the combination of results from multiple independent studies, is now more than a century old. In the last 30 years, however, as the need for medical research and clinical practice to be based on the totality of relevant and sound evidence has been increasingly recognized, the impact of meta-analysis has grown enormously. In this paper, we review highlights of recent developments in meta-analysis in medical research. We outline in particular how emphasis has been placed on (i) heterogeneity and random-effects analyses; (ii) special consideration in different areas of application; (iii) assessing bias within and across studies; and (iv) extension of ideas to complex evidence synthesis. We conclude the paper with some remarks on ongoing challenges and possible directions for the future.",0 +https://doi.org/10.1007/bf02294363,On the relationship between item response theory and factor analysis of discretized variables,"Equivalence of marginal likelihood of the two-parameter normal ogive model in item response theory (IRT) and factor analysis of dichotomized variables (FA) was formally proved. The basic result on the dichotomous variables was extended to multicategory cases, both ordered and unordered categorical data. Pair comparison data arising from multiple-judgment sampling were discussed as a special case of the unordered categorical data. A taxonomy of data for the IRT and FA models was also attempted. © 1987 The Psychometric Society.",0 +https://doi.org/10.1162/089892999563571,Aging and Recognition Memory: Changes in Regional Cerebral Blood Flow Associated with Components of Reaction Time Distributions,"Abstract We used H2 15O positron emission tomography (PET) to measure age-related changes in regional cerebral blood flow (rCBF) during a verbal recognition memory task. Twelve young adults (20 to 29 years) and 12 older adults (62 to 79 years) participated. Separate PET scans were conducted during Encoding, Baseline, and Retrieval conditions. Each of the conditions involved viewing a series of 64 words and making a two-choice response manually. The complete reaction time (RT) distributions in each task condition were characterized in terms of an ex-Gaussian model (convolution of exponential and Gaussian functions). Parameter estimates were obtained for the mean of the exponential component (τ), representing a task-specific decision process and the mean of the Gaussian component (μ), representing residual sensory coding and response processes. Independently of age group, both μ and τ were higher in the Encoding and Retrieval conditions than in the Baseline condition, and τ was higher during Retrieval than during Encoding. Age-related slowing in task performance was evident primarily in μ. For young adults, rCBF activation in the right prefrontal cortex, in the Retrieval condition, was correlated positively with μ but not with τ. For older adults, rCBF changes (both increases and decreases) in several cortical regions were correlated with both μ and τ. The data suggest that the attentional demands of this task are relatively greater for older adults and consequently lead to the recruitment of additional neural systems during task performance.",0 +https://doi.org/10.1111/1365-2745.12421,Fuels and fires influence vegetation via above- and belowground pathways in a high-diversity plant community,"Summary Fire strongly influences plant populations and communities around the world, making it an important agent of plant evolution. Fire influences vegetation through multiple pathways, both above- and belowground. Few studies have yet attempted to tie these pathways together in a mechanistic way through soil heating even though the importance of soil heating for plants in fire-prone ecosystems is increasingly recognized. Here we combine an experimental approach with structural equation modelling (SEM) to simultaneously examine multiple pathways through which fire might influence herbaceous vegetation. In a high-diversity longleaf pine groundcover community in Louisiana, USA, we manipulated fine-fuel biomass and monitored the resulting fires with high-resolution thermocouples placed in vertical profile above- and belowground. We predicted that vegetation response to burning would be inversely related to fuel load owing to relationships among fuels, fire temperature, duration and soil heating. We found that fuel manipulations altered fire properties and vegetation responses, of which soil heating proved to be a highly accurate predictor. Fire duration acting through soil heating was important for vegetation response in our SEMs, whereas fire temperature was not. Our results indicate that in this herbaceous plant community, fire duration is a good predictor of soil heating and therefore of vegetation response to fire. Soil heating may be the key determinant of vegetation response to fire in ecosystems wherein plants persist by resprouting or reseeding from soil-stored propagules. Synthesis. Our SEMs demonstrate how the complex pathways through which fires influence plant community structure and dynamics can be examined simultaneously. Comparative studies of these pathways across different communities will provide important insights into the ecology, evolution and conservation of fire-prone ecosystems.",0 +https://doi.org/10.1016/j.csda.2010.03.008,Default Bayesian model determination methods for generalised linear mixed models,"A default strategy for fully Bayesian model determination for generalised linear mixed models (GLMMs) is considered which addresses the two key issues of default prior specification and computation. In particular, the concept of unit-information priors is extended to the parameters of a GLMM. A combination of Markov chain Monte Carlo (MCMC) and Laplace approximations is used to compute approximations to the posterior model probabilities to find a subset of models with high posterior model probability. Bridge sampling is then used on the models in this subset to approximate the posterior model probabilities more accurately. The strategy is applied to four examples.",0 +https://doi.org/10.1037/1082-989x.8.3.364,Mixture or Homogeneous? Comment on Bauer and Curran (2003).,"D. J. Bauer and P. J. Curran (2003) raised some interesting issues with respect to mixture models of growth curves. Many useful lessons can be learned from their work, and more can be learned by extending the inquiry in related directions. These lessons involve the following issues: (a) what a mixture distribution looks like, (b) the meaning of the term homogeneous distribution, (c) the importance of model checking, (d) advantages and disadvantages of using mixtures and similar procedures to approximate complicated distributions, and (e) intrinsic versus nonintrinsic transformability.",0 +https://doi.org/10.1037/0022-006x.74.3.500,A comparison of girls' and boys' aggressive-disruptive behavior trajectories across elementary school: Prediction to young adult antisocial outcomes.,"Multiple group analysis and general growth mixture modeling was used to determine whether aggressive- disruptive behavior trajectories during elementary school, and their association with young adulthood antisocial outcomes, vary by gender. Participants were assessed longitudinally beginning at age 6 as part of an evaluation of 2 school-based preventive programs. Two analogous trajectories were found for girls and boys: chronic high aggression- disruption (CHAD) and stable low aggression- disruption (LAD). A 3rd class of low moderate aggression- disruption (LMAD) for girls and increasing aggression- disruption (IAD) for boys also was found. Girls and boys in analogous CHAD classes did not differ in trajectory level and course, but girls in the CHAD and LAD classes had lower rates of antisocial outcomes than boys. Girls with the LMAD trajectory differed from boys with the IAD trajectory.",0 +https://doi.org/10.1016/j.jenvrad.2015.05.007,Foliar interception of radionuclides in dry conditions: a meta-analysis using a Bayesian modeling approach,"Uncertainty on the parameters that describe the transfer of radioactive materials into the (terrestrial) environment may be characterized thanks to datasets such as those compiled within International Atomic Energy Agency (IAEA) documents. Nevertheless, the information included in these documents is too poor to derive a relevant and informative uncertainty distribution regarding dry interception of radionuclides by the pasture grass and the leaves of vegetables. In this paper, 145 sets of dry interception measurements by the aboveground biomass of specific plants were collected from published scientific papers. A Bayesian meta-analysis was performed to derive the posterior probability distributions of the parameters that reflect their uncertainty given the collected data. Four competing models were compared in terms of both fitting performances and predictive abilities to reproduce plausible dry interception data. The asymptotic interception factor, applicable whatever the species and radionuclide to the highest aboveground biomass values (e.g. mature leafy vegetables), was estimated with the best model, to be 0.87 with a 95% credible interval (0.85, 0.89).",0 +https://doi.org/10.1207/s15328007sem1302_2,On the Performance of Maximum Likelihood Versus Means and Variance Adjusted Weighted Least Squares Estimation in CFA,"This simulation study compared maximum likelihood (ML) estimation with weighted least squares means and variance adjusted (WLSMV) estimation. The study was based on confirmatory factor analyses with 1, 2, 4, and 8 factors, based on 250, 500, 750, and 1,000 cases, and on 5, 10, 20, and 40 variables with 2, 3, 4, 5, and 6 categories. There was no model misspecification. The most important results were that with 2 and 3 categories the rejection rates of the WLSMV chi-square test corresponded much more to the expected rejection rates according to an alpha level of. 05 than the rejection rates of the ML chi-square test. The magnitude of the loadings was more precisely estimated by means of WLSMV when the variables had only 2 or 3 categories. The sample size for WLSMV estimation needed not to be larger than the sample size for ML estimation.",0 +https://doi.org/10.1177/1065912913491464,Traits versus Issues,"As female candidates may face greater challenges in establishing their “qualifications” for office, coverage of their personal traits may be pernicious, because it tends to de-emphasize substantive qualifications. This study focuses on relative amounts of trait and issue coverage of contests with and without women candidates. We find that races with female candidates yield more coverage of traits than male versus male contests and races with female candidates are less likely to generate issue coverage than trait coverage. Candidate gender and office interact; female gubernatorial candidates are most likely to garner trait coverage and least likely to engender issue coverage.",0 +https://doi.org/10.1124/jpet.114.222315,Selective Monoacylglycerol Lipase Inhibitors: Antinociceptive versus Cannabimimetic Effects in Mice,"The endogenous cannabinoid 2-arachidonoylglycerol (2-AG) plays an important role in a variety of physiologic processes, but its rapid breakdown by monoacylglycerol lipase (MAGL) results in short-lived actions. Initial MAGL inhibitors were limited by poor selectivity and low potency. In this study, we tested JZL184 [4-nitrophenyl 4-[bis(2H-1,3-benzodioxol-5-yl)(hydroxy)methyl]piperidine-1-carboxylate] and MJN110 [2,5-dioxopyrrolidin-1-yl 4-(bis(4-chlorophenyl)methyl)piperazine-1-carboxylate], MAGL inhibitors that possess increased selectivity and potency, in mouse behavioral assays of neuropathic pain [chronic constriction injury (CCI) of the sciatic nerve], interoceptive cannabimimetic effects (drug-discrimination paradigm), and locomotor activity in an open field test. MJN110 (1.25 and 2.5 mg/kg) and JZL184 (16 and 40 mg/kg) significantly elevated 2-AG and decreased arachidonic acid but did not affect anandamide in whole brains. Both MAGL inhibitors significantly reduced CCI-induced mechanical allodynia with the following potencies [ED50 (95% confidence limit [CL]) values in mg/kg: MJN110 (0.43 [0.30-0.63]) > JZL184 (17.8 [11.6-27.4])] and also substituted for the potent cannabinoid receptor agonist CP55,940 [2-[(1R,2R,5R)-5-hydroxy-2-(3-hydroxypropyl)cyclohexyl]-5-(2-methyloctan-2-yl)phenol] in the drug-discrimination paradigm [ED50 (95% CL) values in mg/kg: MJN110 (0.84 [0.69-1.02]) > JZL184 (24.9 [14.6-42.5])]; however, these compounds elicited differential effects on locomotor behavior. Similar to cannabinoid 1 (CB1) receptor agonists, JZL184 produced hypomotility, whereas MJN110 increased locomotor behavior and did not produce catalepsy or hypothermia. Although both drugs substituted for CP55,940 in the drug discrimination assay, MJN110 was more potent in reversing allodynia in the CCI model than in producing CP55,940-like effects. Overall, these results suggest that MAGL inhibition may alleviate neuropathic pain, while displaying limited cannabimimetic effects compared with direct CB1 receptor agonists.",0 +https://doi.org/10.1016/0030-5073(76)90022-2,Task complexity and contingent processing in decision making: An information search and protocol analysis,"Abstract Two process tracing techniques, explicit information search and verbal protocols, were used to examine the information processing strategies subjects use in reaching a decision. Subjects indicated preferences among apartments. The number of alternatives available and number of dimensions of information available was varied across sets of apartments. When faced with a two alternative situation, the subjects employed search strategies consistent with a compensatory decision process. In contrast, when faced with a more complex (multialternative) decision task, the subjects employed decision strategies designed to eliminate some of the available alternatives as quickly as possible and on the basis of a limited amount of information search and evaluation. The results demonstrate that the information processing leading to choice will vary as a function of task complexity. An integration of research in decision behavior with the methodology and theory of more established areas of cognitive psychology, such as human problem solving, is advocated.",0 +https://doi.org/10.1007/bf00994135,Latent class metric conjoint analysis,"A latent class methodology for conjoint analysis is proposed, which simultaneously estimates market segment membership and part-worth utilities for each derived market segment using mixtures of multivariate conditional normal distributions. An E-M algorithm to estimate the parameters of these mixtures is briefly discussed. Finally, an application of the methodology to a commercial study (pretest) examining the design of a remote automobile entry device is presented.",0 +https://doi.org/10.1109/whc.2013.6548417,Tactile flash lag effect: Taps with changing intensities lead briefly flashed taps,"A brief flash, presented in spatial alignment with a moving object, appears to lag behind the moving object. This illusion has been known as the visual flash lag effect. Sheth et al. (2000) demonstrated that when observers compared the colors of a linear array of flashing circular disks with that of a concurrently-flashed disk of the same color, the former was perceived to lead the latter. An analogous tactile flash-lag illusion is reported here. A sequence of tactile taps with increasing (or decreasing) intensity was presented on one finger. The temporally-middle tap in the sequence was perceived to be weaker in both cases than a synchronous single tap on another finger. This illusion could be accounted by a mechanism of temporal compensation and tactile masking.",0 +https://doi.org/10.1348/000711000159303,Statistical analysis of nonlinear structural equation models with continuous and polytomous data,"A general nonlinear structural equation model with mixed continuous and polytomous variables is analysed. A Bayesian approach is proposed to estimate simultaneously the thresholds, the structural parameters and the latent variables. To solve the computational difficulties involved in the posterior analysis, a hybrid Markov chain Monte Carlo method that combines the Gibbs sampler and the Metropolis-Hasting algorithm is implemented to produce the Bayesian solution. Statistical inferences, which involve estimation of parameters and their standard errors, residuals and outliers analyses, and goodness-of-fit statistics for testing the posited model, are discussed. The proposed procedure is illustrated by a simulation study and a real example.",0 +https://doi.org/10.1111/j.1467-8721.2009.01619.x,The New Person-Specific Paradigm in Psychology,"Most research methodology in the behavioral sciences employs interindividual analyses, which provide information about the state of affairs of the population. However, as shown by classical mathematical-statistical theorems (the ergodic theorems), such analyses do not provide information for, and cannot be applied at, the level of the individual, except on rare occasions when the processes of interest meet certain stringent conditions. When psychological processes violate these conditions, the interindividual analyses that are now standardly applied have to be replaced by analysis of intraindividual variation in order to obtain valid results. Two illustrations involving analysis of intraindividual variation of personality and emotional processes are given.",0 +https://doi.org/10.1108/ijebr-06-2015-0142,The impact of transitions into wage-employment for satisfied and unsatisfied entrepreneurs,"Purpose – Should unsatisfied/satisfied entrepreneurs transition into wage-employment? The purpose of this paper is to investigate the financial, physical, social and emotional consequences of the decision. Design/methodology/approach – The paper uses an Australian, nationally representative panel for two Bayesian multivariate regressions. Findings – Unsatisfied entrepreneurs that transition from self- to wage-employment improve their income, life and job satisfaction. For satisfied entrepreneurs, continuing or transitioning makes little difference: job and life satisfaction develop similarly. The health of continuing entrepreneurs suffers regardless of whether they are satisfied or unsatisfied. Research limitations/implications – Unobserved heterogeneity is only addressed within cohorts, not across cohorts. It is possible, that transitioning entrepreneurs are inherently different from continuing entrepreneurs. Further research could include a more fine-grained study of entrepreneurship’s negative health implications or include work-family balance as return to self-employment. Practical implications – The findings offer clear advice to entrepreneurs that are unsatisfied with their venture: they will likely benefit from transitioning to wage-employment. In addition, it offers a warning to individuals with existing health issues who are considering self-employment. Originality/value – Academic interest in entrepreneurship exit is growing. This paper is the first to study the financial, physical, social and emotional life consequences of both satisfied and unsatisfied entrepreneurs. It contributes to the discussion of what motivates entrepreneurs to become and remain self-employed.",0 +https://doi.org/10.1080/15374416.2013.777917,Effects of Video Feedback on Early Coercive Parent–Child Interactions: The Intervening Role of Caregivers’ Relational Schemas,"We examined the effect of adding a video feedback intervention component to the assessment feedback session of the Family Check-Up (FCU) intervention (Dishion & Stormshak, 2007). We hypothesized that the addition of video feedback procedures during the FCU feedback at child age 2 would have a positive effect on caregivers' negative relational schemas of their child, which in turn would mediate reductions in observed coercive caregiver-child interactions assessed at age 5. We observed the caregiver-child interaction videotapes of 79 high-risk families with toddlers exhibiting clinically significant problem behaviors. A quasi-random sample of families was provided with direct feedback on their interactions during the feedback session of the FCU protocol. Path analysis indicated that reviewing and engaging in feedback about videotaped age 2 assessment predicted reduced caregivers' negative relational schemas of the child at age 3, which acted as an intervening variable on the reduction of observed parent-child coercive interactions recorded at age 5. Video feedback predicted improved family functioning over and above level of engagement in the FCU in subsequent years, indicating the important incremental contribution of using video feedback procedures in early family-based preventive interventions for problem behaviors. Supportive video feedback on coercive family dynamics is an important strategy for promoting caregiver motivation to reduce negative attributions toward the child, which fuel coercive interactions. Our study also contributes to the clinical and research literature concerning coercion theory and effective intervention strategies by identifying a potential mechanism of change.",0 +https://doi.org/10.3758/s13428-013-0361-y,Fixed- and random-effects meta-analytic structural equation modeling: Examples and analyses in R,"Meta-analytic structural equation modeling (MASEM) combines the ideas of meta-analysis and structural equation modeling for the purpose of synthesizing correlation or covariance matrices and fitting structural equation models on the pooled correlation or covariance matrix. Cheung and Chan (Psychological Methods 10:40-64, 2005b, Structural Equation Modeling 16:28-53, 2009) proposed a two-stage structural equation modeling (TSSEM) approach to conducting MASEM that was based on a fixed-effects model by assuming that all studies have the same population correlation or covariance matrices. The main objective of this article is to extend the TSSEM approach to a random-effects model by the inclusion of study-specific random effects. Another objective is to demonstrate the procedures with two examples using the metaSEM package implemented in the R statistical environment. Issues related to and future directions for MASEM are discussed. © 2013 Psychonomic Society, Inc.",0 +https://doi.org/10.1348/000711004849259,Bayesian analysis of two-level nonlinear structural equation models with continuous and polytomous data,"Two-level structural equation models with mixed continuous and polytomous data and nonlinear structural equations at both the between-groups and within-groups levels are important but difficult to deal with. A Bayesian approach is developed for analysing this kind of model. A Markov chain Monte Carlo procedure based on the Gibbs sampler and the Metropolis-Hasting algorithm is proposed for producing joint Bayesian estimates of the thresholds, structural parameters and latent variables at both levels. Standard errors and highest posterior density intervals are also computed. A procedure for computing Bayes factor, based on the key idea of path sampling, is established for model comparison.",0 +https://doi.org/10.1007/978-1-4612-0919-5_30,Estimation with Quadratic Loss,"It has long been customary to measure the adequacy of an estimator by the smallness of its mean squared error. The least squares estimators were studied by Gauss and by other authors later in the nineteenth century. A proof that the best unbiased estimator of a linear function of the means of a set of observed random variables is the least squares estimator was given by Markov [12], a modified version of whose proof is given by David and Neyman [4]. A slightly more general theorem is given by Aitken [1]. Fisher [5] indicated that for large samples the maximum likelihood estimator approximately minimizes the mean squared error when compared with other reasonable estimators. This paper will be concerned with optimum properties or failure of optimum properties of the natural estimator in certain special problems with the risk usually measured by the mean squared error or, in the case of several parameters, by a quadratic function of the estimators. We shall first mention some recent papers on this subject and then give some results, mostly unpublished, in greater detail.",0 +,Asymptotic accuracy of distribution-based estimation of latent variables,"Hierarchical statistical models are widely employed in information science and data engineering. The models consist of two types of variables: observable variables that represent the given data and latent variables for the unobservable labels. An asymptotic analysis of the models plays an important role in evaluating the learning process; the result of the analysis is applied not only to theoretical but also to practical situations, such as optimal model selection and active learning. There are many studies of generalization errors, which measure the prediction accuracy of the observable variables. However, the accuracy of estimating the latent variables has not yet been elucidated. For a quantitative evaluation of this, the present paper formulates distribution-based functions for the errors in the estimation of the latent variables. The asymptotic behavior is analyzed for both the maximum likelihood and the Bayes methods.",0 +https://doi.org/10.1111/j.2044-8317.2011.02036.x,Parameter estimation of multiple item response profile model,"Multiple item response profile (MIRP) models are models with crossed fixed and random effects. At least one between-person factor is crossed with at least one within-person factor, and the persons nested within the levels of the between-person factor are crossed with the items within levels of the within-person factor. Maximum likelihood estimation (MLE) of models for binary data with crossed random effects is challenging. This is because the marginal likelihood does not have a closed form, so that MLE requires numerical or Monte Carlo integration. In addition, the multidimensional structure of MIRPs makes the estimation complex. In this paper, three different estimation methods to meet these challenges are described: the Laplace approximation to the integrand; hierarchical Bayesian analysis, a simulation-based method; and an alternating imputation posterior with adaptive quadrature as the approximation to the integral. In addition, this paper discusses the advantages and disadvantages of these three estimation methods for MIRPs. The three algorithms are compared in a real data application and a simulation study was also done to compare their behaviour.",0 +https://doi.org/10.1002/sim.4073,The analysis of very small samples of repeated measurements I: An adjusted sandwich estimator,"The statistical analysis of repeated measures or longitudinal data always requires the accommodation of the covariance structure of the repeated measurements at some stage in the analysis. The general linear mixed model is often used for such analyses, and allows for the specification of both a mean model and a covariance structure. Often the covariance structure itself is not of direct interest, but only a means to producing valid inferences about the response. Existing methods of analysis are often inadequate where the sample size is small. More precisely, statistical measures of goodness of fit are not necessarily the right measure of the appropriateness of a covariance structure and inferences based on conventional Wald-type procedures do not approximate sufficiently well their nominal properties when data are unbalanced or incomplete. This is shown to be the case when adopting the Kenward-Roger adjustment where the sample size is very small. A generalization of an approach to Wald tests using a bias-adjusted empirical sandwich estimator for the covariance matrix of the fixed effects parameters from generalized estimating equations is developed for Gaussian repeated measurements. This is shown to attain the correct test size but has very low power. Copyright © 2010 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1080/10361149651274,"National Uniformity, and State and Local Effects on Australian Voting: A Multilevel Approach","The existence and extent of influences arising within spatial contexts is an important issue in the study of voting behaviour. This paper extends previous Australian research by using the relatively new technique of multilevel analysis to draw together individual survey data from the 1993 Australian Election Study and ecological census data to investigate the question. The results show that, once individual voter characteristics are taken into account, influences on first preference voting for the ALP at the 1993 election were quite uniform nationally, with relatively small spatial variations. Moreover, those spatial variations which were present were at the divisional, not the state, level and can be almost completely explained by a very small number of sociotropic factors, especially a local economic prosperity influence and the well-known rural-urban cleavage. As far as influences on voting at the 1993 election at the level of individual voters are concerned, these multilevel analyses provide some new ...",0 +https://doi.org/10.1207/s15328007sem1103_7,"To Bayes or Not to Bayes, From Whether to When: Applications of Bayesian Methodology to Modeling","This article presents relevant research on Bayesian methods and their major applications to modeling in an effort to lay out differences between the frequentist and Bayesian paradigms and to look at the practical implications of these differences. Before research is reviewed, basic tenets and methods of the Bayesian approach to modeling are presented and contrasted with basic estimation results from a frequentist perspective. It is argued that Bayesian methods have become a viable alternative to traditional maximum likelihood-based estimation techniques and may be the only solution for more complex psychometric data structures. Hence, neither the applied nor the theoretical measurement community can afford to neglect the exciting new possibilities that have opened up on the psychometric horizon.",0 +https://doi.org/10.1006/ssre.1999.0653,"Collinearity, Bias, and Effect Size: Modeling “the” Effect of Track on Achievement","Abstract The estimated effect of any factor can be highly dependent on both the model and the data used for the analyses. This article presents an example of the estimated effect of one factor in two different data sets under three different forms of the standard linear model using the effect of track placement on achievement as an example. Some relative advantages and disadvantages of each model are considered. The analyses demonstrate that, given collinearity among the predictor variables, a model with a poorer statistical fit may be useful for some interpretive purposes.",0 +https://doi.org/10.1080/03610929208830774,Analysis of structural equation models with Incomplete Polytomous Data,"A two-stage estimation procedure is developed to analyze structural equation models of polytomous variables based on incomplete data. At the first stage, the partition maximum likelihood approach is used to obtain the estimates of the elements in the correlation matrix. It will be shown that the asymptotic distribution of these estimates is jointly multivariate normal. The second stage estimates the structural parameters in the correlation matrix by the generalized least squared approach with a correctly specified weight matrix. Asymptotic properties of the second stage estimates are also provided. Extension of the theory to multisample models, and some illustrative examples are also included.",0 +https://doi.org/10.1214/15-ba953,A Two-Component G-Prior for Variable Selection,"We present a Bayesian variable selection method based on an extension of the Zellner’s g-prior in linear models. More specifically, we propose a two-component G-prior, wherein a tuning parameter, calibrated by use of pseudo-variables, is introduced to adjust the distance between the two components. We show that implementing the proposed prior in variable selection is more efficient than using the Zellner’s g-prior. Simulation results also indicate that models selected using the method with the two-component G-prior are generally more favorable with smaller losses compared to other methods considered in our work. The proposed method is further demonstrated using our motivating gene expression data from a lung disease study, and ozone data analyzed in earlier studies.",0 +https://doi.org/10.1037/0003-066x.40.1.73,Rationality in psychological research: The good-enough principle.," This article reexamines a number of methodological and procedural issues raised by Meehl (1967, 1978) seem to question rationality of psychological inquiry. The first issue concerns asymmetry in theory testing between psychology and physics and resulting paradox that, because psychological null hypothesis is always false, increases in precision in psychology always lead to weaker tests of a theory, whereas converse is true in physics. The second issue, related to first, regards slow progress observed in psychological research and seeming unwillingness of social scientists to take seriously Popperian requirements for intellectual honesty. We propose a principle to resolve Meehl's methodological paradox and appeal to a more powerful reconstruction of science developed by Lakatos (1978a, 1978b) to account for actual practice of psychological researchers. From time to time every research discipline must reevaluate its method for generating and certifying knowledge. The actual practice of working scientists in a discipline must continually be subjected to severe criticism and be held accountable to standards of intellectual honesty, standards are themselves revised in light of critical appraisal (Lakatos, 1978a). If, on a metatheoretical level, scientific methodology cannot be defended on rational grounds, then metatheory must be reconstructed so as to make science rationally justifiable. The history of science is replete with numerous such reconstructions, from portrayal of science as being inductive and justificationist, to more recent reconstructions favored by (naive and sophisticated) methodological falsificationists, such as Popper (1959), Lakatos (1978a), and Zahar (1973). In last two decades psychology, too, has been subjected to criticism for its research methodology. Of increasing concern is empirical psychology's use of inferential hypothesis-testing techniques and way in which information derived from these procedures is used to help us make decisions about theories under test (e.g., Bakan, 1966; Lykken, 1968; Rozeboom, 1960). In two penetrating essays, Meehl (1967, 1978) has cogently and effectively faulted use of traditional null-hypothesis significance test in psychological research. According to Meehl (1978, p. 817), the almost universal reliance on merely refuting null hypothesis as standard method for corroborating substantive theories [in psychology] is a terrible mistake, is basically unsound, poor scientific strategy, and one of worst things ever happened in history of He maintained it leads to a methodological paradox when compared to theory testing in physics. In addition, Meehl (1978) pointed to apparently slow progress in psychological research and deleterious effect null-hypothesis testing has had on detection of progress in accumulation of psychological knowledge. The cumulative effect of this criticism is to do nothing less than call into question rational character of our empirical inquiries. As yet there has been no attempt to deal with problems raised by Meehl by reconstructing actual practice of psychologists into a logically defensible form. This is purpose of present article. The two articles by Meehl seem to deal with two disparate issues--null-hypothesis testing and slow progress. Both issues, however, are linked in methodological falsificationist reconstruction of science to necessity for scientists to agree on what experimental outcomes are to be considered as disconfirming instances. We will argue methodological paradox can be ameliorated with help of a good-enough principle, to be proposed here, so hypothesis testing in psychology is not rationally disadvantaged when compared to physics. We will also account for apparent slow progress in psychological research, and we will take issue with certain (though not all) claims made by Meehl (1978) in this regard. Both methodological and progress issues will be resolved by an appeal to (sophisticated) methodological falsificationist reconstruction of science developed by Lakatos (1978a), an approach with which Meehl is familiar but one he did not apply to psychology in his articles. January 1985 • American Psychologist Copyright 1985 by American Psychological Association, Inc. 0003-066X/85/$00.75 Vol. 40, No. 1, 73-83 73 Meehl's Asymmetry Argument Let us develop Meehl's argument. It is his contention improved measurement precision has widely different effects in psychology and physics on success of a theory in overcoming an observational hurdle. Perfect precision in behavioral provides an easier hurdle for theories, whereas such accuracy in physics makes it much more difficult for a theory to survive. According to Popperian reconstruction of science (Popper, 1959), scientific theories must be continually subjected to severe tests. But if social are immanently incapable of generating such tests, if they cannot expose their theories to strongest possible threat of refutation, even with ever-increasing measurement precision, then their claim to scientific status might reasonably be questioned. Further, according to this view of research in social sciences, there can be no question of scientific progress based on rational consideration of experimental outcomes. Instead, progress is more a matter of psychological conversion (Kuhn, 1962). Let us look more closely at standard practice in psychology. On basis of some theory T we derive conclusion a parameter 6 will differ for two populations. In order to examine this conclusion, we can set up a point-null hypothesis, Ho: = 0, and test this hypothesis against predicted outcome, H~: 6 4: 0. However, it has also been recognized (Kaiser, 1960; Kimmel, 1957) another question of interest is whether difference is in a certain direction, and so we could instead test directional null hypothesis, I-I~: 6 ~ 0, against directional alternative, H*: ~ > 0. In such tests, we can make two types of errors. The Type I error would lead to rejecting Ho or H~ when they are indeed true, whereas Type II error involves not rejecting Ho or HJ when they are false. The conventional methodology sets Type I (or alpha) error rate at 5% and seeks to reduce frequency of Type II errors. Such a reduction in Type II error rate can be achieved by improving logical structure of experiment, reducing measurement errors, or increasing sample size. Meehl pointed out in behavioral sciences, because of large number of factors affecting variables, we would never expect two populations to have literally equal means. Hence, he concluded An earlier version of this article was read at 1983 meeting of American Educational Research Association. The authors are grateful to Robbie Case, Joel R. Lcvin, and Leonard Marascuilo for reading earlier drafts, and to Crescent L. Kringle for her help with manuscript. Requests for reprints should be sent to Ronald C. Serlin, Department of Educational Psychology, University of Wisconsin, Madison, Wisconsin 53706. point-null hypothesis is always false. With infinite precision, we would always reject Ho. This is perhaps one reason to prefer directional null hypothesis H~. But Meehl then conducted a thought experiment in which direction predicted by T was assigned at random. In such an experiment, T provides no logical connection to predicted direction and so is totally without merit. Because H0 is always false, two populations will always differ, but because direction in H~ is assigned at random, with infinite precision we will reject HJ half of time. Hence, Meehl concluded that effect of increased p r e c i s i o n . . , is to yield a probability approaching 1/2 of corroborating our substantive theory by a significance test, even i f theory is totally without merit (Meehl, 1967, p. 111, emphasis in original). Meehl contrasted this state of affairs with in physics, wherein usual situation involves prediction of a point value. That which corresponds to point-null hypothesis is value flowing as a consequence of a substantive theory T. An increase in statistical power in physics has effect of stiffening experimental hurdle by 'decreasing prior probability of a successful experimental outcome if theory lacks verisimilitude, is, precisely reverse of situation obtaining in social sciences (Meehl, 1967, p. 113). With infinite precision, and if theory has no merit, logical probability of it surviving such a test in physics is negligible; in social sciences, this logical probability for H~ is one half. Perhaps another way of describing asymmetry in hypothesis testing between psychology and physics is to note that, in psychology, point-null hypothesis is not what is derived from a substantive theory. Rather, it is a straw-man competitor whose rejection we interpret as increasing plausibility of T. In physics, on other hand, theories entail point-null statistical hypotheses are very ones physicists take seriously and hope to confirm. If 0 is a predicted outcome of interest, and 0 is its logical complement, then depiction of null and alternative statistical hypotheses in two disciplines can be written as follows:",0 +https://doi.org/10.1016/j.jbusres.2013.11.012,Salesperson CLV orientation's effect on performance,"Abstract Previous studies show how strategies based on the customer lifetime value (CLV) can lead to an increase of profitability for a firm. In this context, marketing serves the purpose of maximizing CLV and customer equity (the CLV of current and future customers). For most types of service firms, salespeople are direct participants in implementing the CLV concept. However, prior research does not answer the question of whether or how salesperson CLV orientation can enhance profits. Using data on salespeople in a large Chilean retail bank, this study shows that the effect of salesperson CLV orientation on salesperson performance follows an S-shaped function (which is first convex and then concave). Additionally, data does not support the idea that the optimum level of CLV orientation depends on salesperson customer orientation, salesperson adaptive selling behavior, or salesperson experience (i.e., CLV-oriented behaviors could be effective across a wide range of salespeople). As such, this study addresses an important concern among researchers and managers that is related to how to increase the salesperson performance. The findings of this study suggest that firms need to monitor individual salesperson CLV orientation more closely.",0 +https://doi.org/10.1371/journal.pone.0038306,Bayesian Cohort and Cross-Sectional Analyses of the PINCER Trial: A Pharmacist-Led Intervention to Reduce Medication Errors in Primary Care,"Medication errors are an important source of potentially preventable morbidity and mortality. The PINCER study, a cluster randomised controlled trial, is one of the world's first experimental studies aiming to reduce the risk of such medication related potential for harm in general practice. Bayesian analyses can improve the clinical interpretability of trial findings.Experts were asked to complete a questionnaire to elicit opinions of the likely effectiveness of the intervention for the key outcomes of interest--three important primary care medication errors. These were averaged to generate collective prior distributions, which were then combined with trial data to generate bayesian posterior distributions. The trial data were analysed in two ways: firstly replicating the trial reported cohort analysis acknowledging pairing of observations, but excluding non-paired observations; and secondly as cross-sectional data, with no exclusions, but without acknowledgement of the pairing. Frequentist and bayesian analyses were compared.Bayesian evaluations suggest that the intervention is able to reduce the likelihood of one of the medication errors by about 50 (estimated to be between 20% and 70%). However, for the other two main outcomes considered, the evidence that the intervention is able to reduce the likelihood of prescription errors is less conclusive.Clinicians are interested in what trial results mean to them, as opposed to what trial results suggest for future experiments. This analysis suggests that the PINCER intervention is strongly effective in reducing the likelihood of one of the important errors; not necessarily effective in reducing the other errors. Depending on the clinical importance of the respective errors, careful consideration should be given before implementation, and refinement targeted at the other errors may be something to consider.",0 +https://doi.org/10.1016/j.lisr.2011.07.004,Factorial invariance of LibQUAL+® as a measure of library service quality over time,"Abstract LibQUAL+® is an instrument purported to measure three dimensions of library service quality: service affect, library as a place, and information control. After changes were made to the instrument in 2003, however, no confirmatory factor analyses have been published in peer-reviewed journals affirming the three-factor structure of LibQUAL+®. These deficiencies were addressed by testing the hypothesized three-factor structure and the stability of that structure over time. Specifically, data from three samples (n = 550; n = 3261; n = 2103) were collected over a five-year period and analyzed using a multi-group confirmatory factor analysis. Results suggest that the theoretical model fit the data across the three samples and demonstrates factorial invariance over time. Multicollinearity between affect of service and information control, however, indicate that service quality may be measured as two dimensions rather than three, providing a more parsimonious explanation of service quality.",0 +https://doi.org/10.1037/1082-989x.8.3.338,Distributional Assumptions of Growth Mixture Models: Implications for Overextraction of Latent Trajectory Classes.,"Growth mixture models are often used to determine if subgroups exist within the population that follow qualitatively distinct developmental trajectories. However, statistical theory developed for finite normal mixture models suggests that latent trajectory classes can be estimated even in the absence of population heterogeneity if the distribution of the repeated measures is nonnormal. By drawing on this theory, this article demonstrates that multiple trajectory classes can be estimated and appear optimal for nonnormal data even when only 1 group exists in the population. Further, the within-class parameter estimates obtained from these models are largely uninterpretable. Significant predictive relationships may be obscured or spurious relationships identified. The implications of these results for applied research are highlighted, and future directions for quantitative developments are suggested.",0 +https://doi.org/10.1523/jneurosci.4741-13.2014,Oscillatory Brain State Predicts Variability in Working Memory,"Our capacity to remember and manipulate objects in working memory (WM) is severely limited. However, this capacity limitation is unlikely to be fixed because behavioral models indicate variability from trial to trial. We investigated whether fluctuations in neural excitability at stimulus encoding, as indexed by low-frequency oscillations (in the alpha band, 8-14 Hz), contribute to this variability. Specifically, we hypothesized that the spontaneous state of alpha band activity would correlate with trial-by-trial fluctuations in visual WM. Electroencephalography recorded from human observers during a visual WM task revealed that the prestimulus desynchronization of alpha oscillations predicts the accuracy of memory recall on a trial-by-trial basis. A model-based analysis indicated that this effect arises from a modulation in the precision of memorized items, but not the likelihood of remembering them (the recall rate). The phase of posterior alpha oscillations preceding the memorized item also predicted memory accuracy. Based on correlations between prestimulus alpha levels and stimulus-related visual evoked responses, we speculate that the prestimulus state of the visual system prefigures a cascade of state-dependent processes, ultimately affecting WM-guided behavior. Overall, our results indicate that spontaneous changes in cortical excitability can have profound consequences for higher visual cognition.",0 +https://doi.org/10.1037/a0023028,Investigating spousal influence using moment-to-moment affect data from marital conflict.,"Gottman and colleagues proposed using a dynamical systems model to study dyadic interaction in marriage. In this model, each spouse's affect in each 6-s window is described as a function of an uninfluenced linear steady state and a nonlinear influence function of the partner's affect in the previous window. Recently, an alternative parameter estimation procedure for the equations of marriage was introduced, which is based on threshold autoregressive models. We apply this estimation procedure to data from a study of couples (N = 124) and newlyweds (N = 130) to compare different forms of spousal influence using the Bayesian information criterion. Although results show some statistically significant evidence for influence, this is only slightly greater than what would be expected by random association. One model of influence does not fit all couples. This suggests that for many people initial state and emotional inertia dictate the outcome of the conflict discussion far more than the moment-to-moment affect of the spouse. This latter finding is in conflict with most models of couples' interaction, which suggest that the outcome of conflict discussions are determined by the nature of the couples' mutual influence processes.",0 +https://doi.org/10.1214/ss/1177010123,Bayesian Computation and Stochastic Systems,"Markov chain Monte Carlo (MCMC) methods have been used extensively in statistical physics over the last 40 years, in spatial statistics for the past 20 and in Bayesian image analysis over the last decade. In the last five years, MCMC has been introduced into significance testing, general Bayesian inference and maximum likelihood estimation. This paper presents basic methodology of MCMC, emphasizing the Bayesian paradigm, conditional probability and the intimate relationship with Markov random fields in spatial statistics. Hastings algorithms are discussed, including Gibbs, Metropolis and some other variations. Pairwise difference priors are described and are used subsequently in three Bayesian applications, in each of which there is a pronounced spatial or temporal aspect to the modeling. The examples involve logistic regression in the presence of unobserved covariates and ordinal factors; the analysis of agricultural field experiments, with adjustment for fertility gradients; and processing of low-resolution medical images obtained by a gamma camera. Additional methodological issues arise in each of these applications and in the Appendices. The paper lays particular emphasis on the calculation of posterior probabilities and concurs with others in its view that MCMC facilitates a fundamental breakthrough in applied Bayesian modeling.",0 +https://doi.org/10.1080/00273171.2014.933762,Ignoring Clustering in Confirmatory Factor Analysis: Some Consequences for Model Fit and Standardized Parameter Estimates,"In many situations, researchers collect multilevel (clustered or nested) data yet analyze the data either ignoring the clustering (disaggregation) or averaging the micro-level units within each cluster and analyzing the aggregated data at the macro level (aggregation). In this study we investigate the effects of ignoring the nested nature of data in confirmatory factor analysis (CFA). The bias incurred by ignoring clustering is examined in terms of model fit and standardized parameter estimates, which are usually of interest to researchers who use CFA. We find that the disaggregation approach increases model misfit, especially when the intraclass correlation (ICC) is high, whereas the aggregation approach results in accurate detection of model misfit in the macro level. Standardized parameter estimates from the disaggregation and aggregation approaches are deviated toward the values of the macro- and micro-level standardized parameter estimates, respectively. The degree of deviation depends on ICC and cluster size, particularly for the aggregation method. The standard errors of standardized parameter estimates from the disaggregation approach depend on the macro-level item communalities. Those from the aggregation approach underestimate the standard errors in multilevel CFA (MCFA), especially when ICC is low. Thus, we conclude that MCFA or an alternative approach should be used if possible.",0 +https://doi.org/10.1016/s0169-7161(05)25018-6,Variable Selection and Covariance Selection in Multivariate Regression Models,This article provides a general framework for Bayesian variable selection and covariance selection in a multivariate regression model with Gaussian errors. By variable selection we mean allowing certain regression coefficients to be zero. By covariance selection we mean allowing certain elements of the inverse covariance matrix to be zero. We estimate all the model parameters by model averaging using a Markov chain Monte Carlo simulation method. The methodology is illustrated by applying it to four real data sets. The effectiveness of variable selection and covariance selection in estimating the multivariate regression model is assessed by using four loss functions and four simulated data sets. Each of the simulated data sets is based on parameter estimates obtained from a corresponding real data set.,0 +https://doi.org/10.1080/00401706.1975.10489269,The Nelder-Mead Simplex Procedure for Function Minimization,"The Nelder-Mead simplex method for function minimization is a “direct” method requiring no derivatives. The objective function is evaluated at the vertices of a simplex, and movement is away from the poorest value. The process is adaptive, causing the simplexes to be continually revised to best conform to the nature of the response surface. The generality of the method is illust'rated by using it. to solve six problems appearing in the May 1973 issue of Technometrics.",0 +https://doi.org/10.1016/j.jmp.2013.01.004,Cultural consensus theory for multiple consensus truths,"Abstract Cultural Consensus Theory (CCT) is a popular information pooling methodology used in the social and behavioral sciences. CCT consists of cognitive models designed to determine a consensus truth shared by a group of informants (respondents), and to better understand the cognitive characteristics of the informants (e.g. level knowledge, response biases). However prior to this paper, no CCT models have been developed that allow the possibility of the informant responses to come from a mixture of two or more consensus answer patterns. The major advance in the current paper is to endow one of the popular CCT models, the General Condorcet Model (GCM) for dichotomous responses, with the possibility of having several latent consensus answer patterns, each corresponding to a different, latent subgroup of informants. In addition, we augment the model to allow the possibility of questions having differential difficulty (cultural saliency). This is the first CCT finite-mixture model, and it is named the Multi-Culture GCM (MC-GCM). The model is developed axiomatically and a notable property is derived that can suggest the appropriate number of mixtures for a given data set. The model is extended in a hierarchical Bayesian framework and its application is successfully demonstrated on both simulated and real data, including a new experimental data set on political viewpoints.",0 +https://doi.org/10.1207/s15328007sem1204_5,Applications of Multilevel Structural Equation Modeling to Cross-Cultural Research,"Multilevel structural equation modeling (MSEM) has been proposed as an extension to structural equation modeling for analyzing data with nested structure. We have begun to see a few applications in cross-cultural research in which MSEM fits well as the statistical model. However, given that cross-cultural studies can only afford collecting data from a relatively small number of countries, the appropriateness of MSEM has been questioned. Using the data from the International Social Survey Program (1997; N = 15,244 from 27 countries), we first showed how Muth�n's MSEM procedure could be applied to a real data set on cross-cultural research. Given a small country-level sample size (27 countries) we then demonstrated that results on the individual level were quite stable even when using small individual-level sample sizes, whereas the group-level parameter estimates and their standard errors were affected unsystematically by varying individual-level sample sizes. Use of the findings for cross-cultural researc...",0 +https://doi.org/10.3168/jds.2012-6115,Association between somatic cell count early in the first lactation and the longevity of Irish dairy cows,"Reduced longevity of cows is an important component of mastitis costs, and increased somatic cell count (SCC) early in the first lactation has been reported to increase culling risk throughout the first lactation. Generally, cows must survive beyond the first lactation to break even on their rearing costs. The aim of this research was to assess the association between SCC of primiparous cows at 5 to 30 days in milk (SCC1), and survival over a 5-y period for cows in Irish dairy herds. The data set used for model development was based on 147,458 test day records from 7,537 cows in 812 herds. Cows were censored at their last recording if identified at a later date in other herds or if recorded at the last available test date for their herd, otherwise, date of disposal was taken to be at the last test date for each cow. Survival time was calculated as the number of days between the dates of first calving and the last recording, which was split into 50-d intervals. Data were analyzed in discrete time logistic survival models that accounted for clustering of 50-d intervals within cows, and cows within herds. Models were fitted in a Bayesian framework using Markov chain Monte Carlo simulations. Model fit was assessed by comparison of posterior predictions to the observed disposal risk for cows aggregated by parameters in the model. Model usefulness was assessed by cross validation in a separate data set, which contained 144,113 records from 7,353 cows in 808 herds, and posterior predictions were compared with the observed disposal risk for cows aggregated by parameters of biological importance. Disposal odds increased by a factor of 5% per unit increase in ln SCC1. Despite this, posterior predictive distributions revealed that the probability of reducing replacement costs by >€10 per heifer calved, through decreasing the herd level prevalence of cows with SCC1 ≥ 400,000 cells/mL (from an initial prevalence of ≥ 20 to <10%) only exceeded 50% for less than 1 in 5 Irish herds. These results indicate that the effect of a reduction in the prevalence of cows with SCC1 ≥ 400,000 cells/mL on replacement costs alone for most Irish dairy herds is small, and future research should investigate other potential losses, such as the effect of SCC1 on lifetime milk yield.",0 +https://doi.org/10.3141/2076-20,Influence of Transportation Access and Market Dynamics on Property Values,"This paper presents housing price models by using multilevel modeling techniques. The key motivation of using the multilevel modeling technique is that it clearly identifies and differentiates between-cluster heterogeneity (i.e., intrinsic differences across aggregated units) and heterogeneity between units of analysis that are nested within aggregated clusters. Two different specifications are tested: two-level spatial and mixed two-level spatiotemporal random effects models. Whereas the first specification assumes that dwelling units are nested within spatial clusters (i.e., neighborhoods), the second specification hypothesizes that dwelling units are nested within spatiotemporal clusters (neighborhoods in a given time period). The unique contribution of this paper is that it accounts for temporal heterogeneity simultaneously with spatial heterogeneity in the housing price models. The study uses an extensive sample of more than 250,000 housing property transactions in 1987–1995 in the Greater Toronto Area of Canada. The paper examines the functional form of the hedonic price model and chooses a semilogarithmic model for subsequent multilevel housing price modeling. The results suggest that the spatiotemporal model performs better in terms of explanatory power and parameter estimates.",0 +https://doi.org/10.1111/j.1745-3984.1987.tb00274.x,Item Clusters and Computerized Adaptive Testing: A Case for Testlets,"It is observed that many sorts of difficulties may preclude the uneventful construction of tests by a computerized algorithm, such as those currently in favor in Computerized Adaptive Testing (CAT). In this essay we discuss a number of these problems, as well as some possible avenues of solution. We conclude with the development of the “testlet,” a bundle of items that can be arranged either hierarchically or linearly, thus maintaining the efficiency of an adaptive test while keeping the quality control of test construction that is possible currently only with careful expert scrutiny. Performance on the separate testlets is aggregated to yield ability estimates.",0 +https://doi.org/10.1037/0021-9010.88.2.234,Effectiveness of training in organizations: A meta-analysis of design and evaluation features.,"The authors used meta-analytic procedures to examine the relationship between specified training design and evaluation features and the effectiveness of training in organizations. Results of the meta-analysis revealed training effectiveness sample-weighted mean ds of 0.60 (k = 15, N = 936) for reaction criteria, 0.63 (k = 234, N = 15,014) for learning criteria, 0.62 (k = 122, N = 15,627) for behavioral criteria, and 0.62 (k = 26, N = 1,748) for results criteria. These results suggest a medium to large effect size for organizational training. In addition, the training method used, the skill or task characteristic trained, and the choice of evaluation criteria were related to the effectiveness of training programs. Limitations of the study along with suggestions for future research are discussed.",0 +https://doi.org/10.1016/j.jmp.2007.11.001,The parameters in the near-miss-to-Weber's law,"Abstract Many empirical data support the hypothesis that the sensitivity function grows as a power function of the stimulus intensity. This is usually referred to as the near-miss-to-Weber's law. The aim of the paper is to examine the near-miss-to-Weber's law in the context of psychometric models of discrimination. We study two types of psychometric functions, characterized by the representations P a ( x ) = F ( ρ ( a ) x γ ( a ) ) (type A), and P a ( x ) = F ( γ ( a ) + ρ ( a ) x ) (type B). A central result shows that both types of psychometric functions are compatible with the near-miss-to-Weber's law. If a representation of type B exists, then the exponent in the near-miss is necessarily a constant function, that is, does not depend on the criterion value used to define “just noticeably different”. If, on the other hand, a representation of type A exists, then the exponent in the near-miss-to-Weber's law can vary with the criterion value. In that case, the parameters in the near-miss co-vary systematically.",0 +https://doi.org/10.1016/s0042-6989(96)00310-0,Principles of an Adaptive Method for Measuring the Slope of the Psychometric Function,"Recent developments in the efficient estimation of threshold are here extended to the problem of how best to estimate the slope of the psychometric function. An adaptive method is described for selecting stimulus intensities that are optimal for slope estimation. A two-dimensional array of probabilities of different thresholds and slopes is used to calculate the stimulus intensity for the next trial; this array is updated after the trial, using Bayes' theorem to incorporate information from the subject's response. The practical implementation and efficiency of the method are demonstrated and discussed. © 1997 Elsevier Science Ltd.",0 +https://doi.org/10.4135/9781483349428,Computational Modeling in Cognition: Principles and Practice,Preface 1. Introduction 1.1 Models and Theories in Science 1.2 Why Quantitative Modeling? 1.3 Quantitative Modeling in Cognition 1.4 The Ideas Underlying Modeling and Its Distinct Applications 1.5 What Can We Expect From Models? 1.6 Potential Problems 2. From Words to Models: Building a Toolkit 2.1 Working Memory 2.2 The Phonological Loop: 144 Models of Working Memory 2.3 Building a Simulation 2.4 What Can We Learn From These Simulations? 2.5 The Basic Toolkit 2.6 Models and Data: Sufficiency and Explanation 3. Basic Parameter Estimation Techniques 3.1 Fitting Models to Data: Parameter Estimation 3.2 Considering the Data: What Level of Analysis? 4. Maximum Likelihood Estimation 4.1 Basics of Probabilities 4.2 What Is a Likelihood? 4.3 Defining a Probability Function 4.4 Finding the Maximum Likelihood 4.5 Maximum Likelihood Estimation for Multiple Participants 4.6 Properties of Maximum Likelihood Estimators 5. Parameter Uncertainty and Model Comparison 5.1 Error on Maximum Likelihood Estimates 5.2 Introduction to Model Selection 5.3 The Likelihood Ratio Test 5.4 Information Criteria and Model Comparison 5.5 Conclusion 6. Not Everything That Fits Is Gold: Interpreting the Modeling 6.1 Psychological Data and The Very Bad Good Fit 6.2 Parameter Identifiability and Model Testability 6.3 Drawing Lessons and Conclusions From Modeling 7. Drawing It All Together: Two Examples 7.1 WITNESS: Simulating Eyewitness Identification 7.2 Exemplar Versus Boundary Models: Choosing Between Candidates 7.3 Conclusion 8. Modeling in a Broader Context 8.1 Bayesian Theories of Cognition 8.2 Neural Networks 8.3 Neuroscientific Modeling 8.4 Cognitive Architectures 8.5 Conclusion References Author Index Subject Index About the Authors,0 +https://doi.org/10.1177/0956797613480187,The Relative Trustworthiness of Inferential Tests of the Indirect Effect in Statistical Mediation Analysis,"A content analysis of 2 years of Psychological Science articles reveals inconsistencies in how researchers make inferences about indirect effects when conducting a statistical mediation analysis. In this study, we examined the frequency with which popularly used tests disagree, whether the method an investigator uses makes a difference in the conclusion he or she will reach, and whether there is a most trustworthy test that can be recommended to balance practical and performance considerations. We found that tests agree much more frequently than they disagree, but disagreements are more common when an indirect effect exists than when it does not. We recommend the bias-corrected bootstrap confidence interval as the most trustworthy test if power is of utmost concern, although it can be slightly liberal in some circumstances. Investigators concerned about Type I errors should choose the Monte Carlo confidence interval or the distribution-of-the-product approach, which rarely disagree. The percentile bootstrap confidence interval is a good compromise test.",0 +https://doi.org/10.4324/9780203848852.ch8,Bayesian Estimation of Multilevel Models,,0 +https://doi.org/10.1037/0012-1649.44.4.1148,Life satisfaction shows terminal decline in old age: Longitudinal evidence from the German Socio-Economic Panel Study (SOEP).,"Longitudinal data spanning 22 years, obtained from deceased participants of the German Socio-Economic Panel Study (SOEP; N = 1,637; 70- to 100-year-olds), were used to examine if and how life satisfaction exhibits terminal decline at the end of life. Changes in life satisfaction were more strongly associated with distance to death than with distance from birth (chronological age). Multiphase growth models were used to identify a transition point about 4 years prior to death where the prototypical rate of decline in life satisfaction tripled from -0.64 to -1.94 T-score units per year. Further individual-level analyses suggest that individuals dying at older ages spend more years in the terminal periods of life satisfaction decline than individuals dying at earlier ages. Overall, the evidence suggests that late-life changes in aspects of well-being are driven by mortality-related mechanisms and characterized by terminal decline.",0 +https://doi.org/10.2307/2532087,Nonlinear Mixed Effects Models for Repeated Measures Data,"We propose a general, nonlinear mixed effects model for repeated measures data and define estimators for its parameters. The proposed estimators are a natural combination of least squares estimators for nonlinear fixed effects models and maximum likelihood (or restricted maximum likelihood) estimators for linear mixed effects models. We implement Newton-Raphson estimation using previously developed computational methods for nonlinear fixed effects models and for linear mixed effects models. Two examples are presented and the connections between this work and recent work on generalized linear mixed effects models are discussed.",0 +https://doi.org/10.1207/s15327906mbr1802_2,Cross-Validation Of Covariance Structures,"This paper examines methods for comparing the suitability of alternative models for covariance matrices. A cross-validation procedure is suggested and its properties are examined. To motivate the discussion, a series of examples is presented using longitudinal data.",0 +https://doi.org/10.1177/014662169301700105,EQUATE 2.0: A Computer Program for the Characteristic Curve Method of IRT Equating,,0 +https://doi.org/10.1177/014662169602000201,Monte Carlo Studies in Item Response Theory,"Monte carlo studies are being used in item response theory (IRT) to provide information about how validly these methods can be applied to realistic datasets (e.g., small numbers of examinees and multidimensional data). This paper describes the conditions under which monte carlo studies are appropriate in IRT-based re search, the kinds of problems these techniques have been applied to, available computer programs for gen erating item responses and estimating item and exam inee parameters, and the importance of conceptualizing these studies as statistical sampling experiments that should be subject to the same principles of experimen tal design and data analysis that pertain to empirical studies. The number of replications that should be used in these studies is also addressed.",0 +https://doi.org/10.1287/mnsc.48.10.1350.272,Augmenting Conjoint Analysis to Estimate Consumer Reservation Price,"Consumer reservation price is a key concept in marketing and economics. Theoretically, this concept has been instrumental in studying consumer purchase decisions,competitive pricing strategies,and welfare economics. Managerially,knowledge of consumer reservation prices is critical for implementing many pricing tactics such as bundling,tar get promotions,nonlinear pricing,and one-to-one pricing,and for assessing the impact of marketing strategy on demand. Despite the practical and theoretical importance of this concept, its measurement at the individual level in a practical setting proves elusive. We propose a conjoint-based approach to estimate consumer-level reservation prices. This approach integrates the preference estimation of traditional conjoint with the economic theory of consumer choice. This integration augments the capability of traditional conjoint such that consumers' reservation prices for a product can be derived directly from the individuallevel estimates of conjoint coefficients. With this augmentation,we can model a consumer's decision of not only which product to buy,but also whether to buy at all in a category. Thus, we can simulate simultaneously three effects that a change in price or the introduction of a new product may generate in a market: the customer switching effect,the cannibalization effect,and the market expansion effect. We show in a pilot application how this approach can aid product and pricing decisions. We also demonstrate the predictive validity of our approach using data from a commercial study of automobile batteries.",0 +https://doi.org/10.1111/j.1744-6570.2010.01186.x,VALIDATING SYNTHETIC VALIDATION: COMPARING TRADITIONAL AND SYNTHETIC VALIDITY COEFFICIENTS,"We describe a unique application of a synthetic validation technique to a selection system development project in a large organization. Job analysis data were collected from 4,725 job incumbents and 619 supervisors, and were used to identify 11 job families and 27 job components. We developed 12 tests to predict performance on these job components and conducted a concurrent validation study to collect test and job component data for 1,926 incumbents. We created a test composite for each job component and then chose a test battery for each job family based on its relevant job components. Synthetic validity coefficients were computed for each test battery and compared to traditional validity coefficients that were computed within job families with large sample sizes. The synthetic validity coefficient was very close to the within-family validity coefficient for most job families and was within the bounds of sampling error for all job families. Validities tended to be highest when predictors were weighted according to the number of job components to which they were relevant and job component criterion measures were unit weighted.",0 +https://doi.org/10.5860/choice.45-1510,Structural equation modeling: a Bayesian approach,About the Author. Preface. Chapter 1. Introduction. Chapter 2. Some Basic Structural Equation Models. Chapter 3. Covariance Structure Analysis. Chapter 4. Bayesian Estimation of Structural Equation Models. Chapter 5. Model Comparison and Model Checking. Chapter 6. Structural Equation Models with Continuous and Ordered Categorical Variables. Chapter 7. Structural Equation Models with Dichotomous Variables. Chapter 8. Nonlinear Structural Equation Models. Chapter 9. Two-level Nonlinear Structural Equation Models. Chapter 10. Multisample Analysis of Structural Equation Models. Chapter 11. Finite Mixtures in Structural Equation Models. Chapter 12. Structural Equation Models with Missing Data. Chapter 13. Structural Equation Models with Exponential Family of Distributions. Chapter 14. Conclusion. Index.,0 +https://doi.org/10.1123/jpah.10.4.581,Advancing Science and Policy Through a Coordinated International Study of Physical Activity and Built Environments: IPEN Adult Methods,"Background: National and international strategies to increase physical activity emphasize environmental and policy changes that can have widespread and long-lasting impact. Evidence from multiple countries using comparable methods is required to strengthen the evidence base for such initiatives. Because some environment and policy changes could have generalizable effects and others may depend on each country’s context, only international studies using comparable methods can identify the relevant differences. Methods: Currently 12 countries are participating in the International Physical Activity and the Environment Network (IPEN) study. The IPEN Adult study design involves recruiting adult participants from neighborhoods with wide variations in environmental walkability attributes and socioeconomic status (SES). Results: Eleven of twelve countries are providing accelerometer data and 11 are providing GIS data. Current projections indicate that 14,119 participants will provide survey data on built environments and physical activity and 7145 are likely to provide objective data on both the independent and dependent variables. Though studies are highly comparable, some adaptations are required based on the local context. Conclusions: This study was designed to inform evidence-based international and country-specific physical activity policies and interventions to help prevent obesity and other chronic diseases that are high in developed countries and growing rapidly in developing countries.",0 +https://doi.org/10.2307/2944713,Bayesian Inference for Comparative Research,"Regression analysis in comparative research suffers from two distinct problems of statistical inference. First, because the data constitute all the available observations from a population, conventional inference based on the long-run behavior of a repeatable data mechanism is not appropriate. Second, the small and collinear data sets of comparative research yield imprecise estimates of the effects of explanatory variables. We describe a Bayesian approach to statistical inference that provides a unified solution to these two problems. This approach is illustrated in a comparative analysis of unionization.",0 +https://doi.org/10.1177/096228029200100203,Structural equation models in medical research,"Structural equation modelling (SEM) is a modern statistical method that allows one to evaluate causal hypotheses on a set of intercorrelated nonexperimental data. The sample variances and covariances, and possibly the means, are compared to those predicted by a theory-based hypothetical model after optimal estimation of the parameters of the model. The goodness-of-fit of the empirical data to the hypothesized model is evaluated statistically. This review describes the underlying statistical theory and rationale of SEM. Both confirmatory factor analysis and latent variable path models are discussed. The applicability of SEM to assessment of reliability and validity is noted. A detailed example is provided, and several examples from the medical literature are briefly reviewed. Cautions regarding the possible misuse or misinterpretation of the technique are also mentioned. Possible future directions for the use of SEM in medical research are suggested. Two appendices provide more technical details.",0 +https://doi.org/10.3758/s13414-013-0613-z,An objective measure of auditory stream segregation based on molecular psychophysics,"Auditory stream segregation is an important paradigm in the study of auditory scene analysis. Performance-based measures of auditory stream segregation have received increasing use as a complement to subjective reports of streaming. For example, the sensitivity in discriminating a temporal shift imposed on one B tone in an ABA sequence consisting of A and B tones that differ in frequency is often used to infer the perceptual organization (one stream vs. two streams). Limitations of these measures are discussed here, and an alternative measure based on the combination of decision weights and sensitivity is suggested. In the experiment, for ABA and ABB sequences varying in tempo (fast/slow) and duration (long/short), the sensitivity (d′) in the temporal shift discrimination task did not differ between fast and slow sequences, despite strong differences in perceptual organization. The decision weights assigned to within-stream and between-stream interonset intervals also deviated from the idealized pattern of near-exclusive reliance on between-stream information in the subjectively integrated case, and on within-stream information in the subjectively segregated case. However, an estimate of internal noise computed using a combination of the estimated decision weights and sensitivity differentiated between sequences that were predominantly perceived as integrated or segregated, with significantly higher internal noise estimates for the segregated case. Therefore, the method of using a combination of decision weights and sensitivity provides a measure of auditory stream segregation that overcomes some of the limitations of purely sensitivity-based measures. © 2014 Psychonomic Society, Inc.",0 +https://doi.org/10.1080/10705511.2015.1062730,Causal Mediation Analysis With a Binary Outcome and Multiple Continuous or Ordinal Mediators: Simulations and Application to an Alcohol Intervention,"We investigate a method to estimate the combined effect of multiple continuous/ordinal mediators on a binary outcome: 1) fit a structural equation model with probit link for the outcome and identity/probit link for continuous/ordinal mediators, 2) predict potential outcome probabilities, and 3) compute natural direct and indirect effects. Step 2 involves rescaling the latent continuous variable underlying the outcome to address residual mediator variance/covariance. We evaluate the estimation of risk-difference- and risk-ratio-based effects (RDs, RRs) using the ML, WLSMV and Bayes estimators in Mplus. Across most variations in path-coefficient and mediator-residual-correlation signs and strengths, and confounding situations investigated, the method performs well with all estimators, but favors ML/WLSMV for RDs with continuous mediators, and Bayes for RRs with ordinal mediators. Bayes outperforms WLSMV/ML regardless of mediator type when estimating RRs with small potential outcome probabilities and in two other special cases. An adolescent alcohol prevention study is used for illustration.",0 +https://doi.org/10.1037/ccp0000034,The trajectory of fidelity in a multiyear trial of the family check-up predicts change in child problem behavior.,"Therapist fidelity to evidence-based family interventions has consistently been linked to child and family outcomes. However, few studies have evaluated the potential ebb and flow of fidelity of therapists over time. We examined therapist drift in fidelity over 4 years in the context of a Family Check-Up prevention services in early childhood (ages 2-5 years).At age 2, families engaging in Women, Infants, and Children Nutritional Supplement Program services were randomized and offered annual Family Check-Ups. Seventy-nine families with a child in the clinical range of problem behaviors at age 2 years were included in this analysis.Latent growth modeling revealed a significant linear decline in fidelity over time (M = -0.35, SD = 0.35) and that steeper declines were related to less improvement in caregiver-reported problem behaviors assessed at ages 7.5/8.5 years (b = -.69, p = .003; β = -.95, 95% CI [-2.11, -0.22]).These findings add to the literature concerning the need to continually monitor therapist fidelity to an evidence-based practice over time to optimize family benefits. Limitations and directions for future research are discussed.",0 +https://doi.org/10.3758/pbr.15.6.1201,A hierarchical approach for fitting curves to response time measurements,"Understanding how response time (RT) changes with manipulations has been critical in distinguishing among theories in cognition. It is well known that aggregating data distorts functional relationships (e.g., Estes, 1956). Less well appreciated is a second pitfall: Minimizing squared errors (i.e., OLS regression) also distorts estimated functional forms with RT data. We discuss three properties of RT that should be modeled for accurate analysis and, on the basis of these three properties, provide a hierarchical Weibull regression model for regressing RT onto covariates. Hierarchical regression model analysis of lexical decision task data reveals that RT decreases as a power function of word frequency with the scale of RT decreasing 11% for every doubling of word frequency. A detailed discussion of the model and analysis techniques are presented as archived materials and may be downloaded from www.psychonomic.org/archive. © 2008 Psychonomic Society, Inc.",0 +https://doi.org/10.1177/0010414009332136,The Politicized Participant,"Modern liberal democracies demand high and equal levels of political action. Unequal levels of political action between ideological groups may ultimately lead to biased policy. But to what extent do citizens’ ideological preferences affect their likelihood to participate politically? And does the institutional environment moderate this relationship? From rivaling theories, the authors construct hypotheses regarding the relationship between ideological preferences and participation and those regarding the moderating effect of state institutions. They test them for six modes of political action—voting, contacting, campaigning, cooperating, persuading, and protesting—through multilevel analyses of 27 elections in 20 Western democracies. First, they find that citizens’ ideological preferences are an important determinant political action. Second, they find that majoritarianism outperforms consensualism: In majoritarian systems, political action is more widespread and not less equal across the crucial factor of ideological preferences. The field should therefore reconsider Lijphart’s conclusions about the superiority of consensualism.",0 +https://doi.org/10.1093/pan/mps040,Identification and Sensitivity Analysis for Multiple Causal Mechanisms: Revisiting Evidence from Framing Experiments,"Social scientists are often interested in testing multiple causal mechanisms through which a treatment affects outcomes. A predominant approach has been to use linear structural equation models and examine the statistical significance of the corresponding path coefficients. However, this approach implicitly assumes that the multiple mechanisms are causally independent of one another. In this article, we consider a set of alternative assumptions that are sufficient to identify the average causal mediation effects when multiple, causally related mediators exist. We develop a new sensitivity analysis for examining the robustness of empirical findings to the potential violation of a key identification assumption. We apply the proposed methods to three political psychology experiments, which examine alternative causal pathways between media framing and public opinion. Our analysis reveals that the validity of original conclusions is highly reliant on the assumed independence of alternative causal mechanisms, highlighting the importance of proposed sensitivity analysis. All of the proposed methods can be implemented via an open source R package, mediation .",0 +https://doi.org/10.3102/10769986026003307,A Rasch Hierarchical Measurement Model,"In this article, a hierarchical measurement model is developed that enables researchers to measure a latent trait variable and model the error variance corresponding to multiple levels. The Rasch hierarchical measurement model (HMM) results when a Rasch IRT model and a one-way ANOVA with random effects are combined ( Bryk & Raudenbush, 1992 ; Goldstein, 1987 ; Rasch, 1960 ). This model is appropriate for modeling dichotomous response strings nested within a contextual level. Examples of this type of structure include responses from students nested within schools and multiple response strings nested within people. Model parameter estimates of the Rasch HMM were obtained using the Bayesian data analysis methods of Gibbs sampling and the Metropolis-Hastings algorithm ( Gelfand, Hills, Racine-Poon, & Smith, 1990 ; Hastings, 1970 ; Metropolis, Rosenbluth, Rosenbluth, Teller, & Teller, 1953 ). The model is illustrated with two simulated data sets and data from the Sloan Study of Youth and Social Development. The results are discussed and parameter estimates for the simulated data sets are compared to parameter estimates obtained using a two-step estimation approach.",0 +https://doi.org/10.1016/j.jneumeth.2009.10.006,A novel method for modeling facial allodynia associated with migraine in awake and freely moving rats,"Migraine is a neurovascular disorder that induces debilitating headaches associated with multiple symptoms including facial allodynia, characterized by heightened responsivity to normally innocuous mechanical stimuli. It is now well accepted that immune activation and immune-derived inflammatory mediators enhance pain responsivity, including the trigeminal system. Nociceptive (""pain"" responsive) trigeminal nerves densely innervate the cranial meninges. We have recently proposed that the meninges may serve as a previously unidentified, key interface between the peripheral immune system and the CNS with potential implications for understanding underlying migraine mechanisms. Our focus here is the development of a model for facial allodynia associated with migraine. We developed a model wherein an indwelling catheter is placed between the skull and dura, allowing immunogenic stimuli to be administered over the dura in awake and freely moving rats. Since the catheter does not contact the brain itself, any proinflammatory cytokines induced following manipulation derive from resident or recruited meningeal immune cells. While surgery alone does not alter immune activation markers, TNF or IL6 mRNA and/or protein, it does decrease gene expression and increase protein expression of IL-1 at 4 days after surgery. Using this model we show the induction of facial allodynia in response to supradural administration of either the HIV glycoprotein gp120 or inflammatory soup (bradykinin, histamine, serotonin, and prostaglandin E2), and the induction of hindpaw allodynia in our model after inflammatory soup. This model allows time- and dose-dependent assessment of the relationship between changes in meningeal inflammation and corresponding exaggerated pain behaviors.",0 +https://doi.org/10.1080/00273171.2013.787870,Regime-Switching Bivariate Dual Change Score Model,"Mixture structural equation model with regime switching (MSEM-RS) provides one possible way of representing over-time heterogeneities in dynamic processes by allowing a system to manifest qualitatively or quantitatively distinct change processes conditional on the latent ""regime"" the system is in at a particular time point. Unlike standard mixture structural equation models such as growth mixture models, MSEM-RS allows individuals to transition between latent classes over time. This class of models, often referred to as regime-switching models in the time series and econometric applications, can be specified as regime-switching mixture structural equation models when the number of repeated measures involved is not large. We illustrate the empirical utility of such models using one special case-a regime-switching bivariate dual change score model in which two growth processes are allowed to manifest regime-dependent coupling relations with one another. The proposed model is illustrated using a set of longitudinal reading and arithmetic performance data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 study (ECLS-K; U.S. Department of Education, National Center for Education Statistics, 2010).",0 +https://doi.org/10.1111/j.2517-6161.1972.tb00885.x,Bayes Estimates for the Linear Model,,0 +https://doi.org/10.1207/s15328007sem0901_1,Comparison of Methods for Estimating and Testing Latent Variable Interactions,"Structural equation modeling methods for estimating and testing hypotheses about an interaction between continuous variables were investigated. The methods were (a) Bollen's (1996) 2-stage least squares (TSLS) method, Ping's (1996) 2-step maximum likelihood (ML) method, and Jaccard and Wan's (1995) ML method for the Kenny-Judd model (Kenny & Judd, 1984); (b) a 2-step ML procedure and ML estimation of the Joreskog-Yang model (Joreskog & Yang 1996); and (c) ML estimation of a revised Joreskog-Yang model. The TSLS procedure exhibited more bias and lower power than the other methods. Under ML estimation of the Joreskog-Yang model, Type I error rates were not well controlled when robust standard errors were used. Among the remaining procedures, the Jaccard-Wan procedure and ML estimation of the revised Joreskog-Yang procedure were most effective, with the latter having some small advantages over the former.",0 +https://doi.org/10.1111/mec.13447,The aggregate site frequency spectrum for comparative population genomic inference,"Understanding how assemblages of species responded to past climate change is a central goal of comparative phylogeography and comparative population genomics, an endeavour that has increasing potential to integrate with community ecology. New sequencing technology now provides the potential to perform complex demographic inference at unprecedented resolution across assemblages of nonmodel species. To this end, we introduce the aggregate site frequency spectrum (aSFS), an expansion of the site frequency spectrum to use single nucleotide polymorphism (SNP) data sets collected from multiple, co-distributed species for assemblage-level demographic inference. We describe how the aSFS is constructed over an arbitrary number of independent population samples and then demonstrate how the aSFS can differentiate various multispecies demographic histories under a wide range of sampling configurations while allowing effective population sizes and expansion magnitudes to vary independently. We subsequently couple the aSFS with a hierarchical approximate Bayesian computation (hABC) framework to estimate degree of temporal synchronicity in expansion times across taxa, including an empirical demonstration with a data set consisting of five populations of the threespine stickleback (Gasterosteus aculeatus). Corroborating what is generally understood about the recent postglacial origins of these populations, the joint aSFS/hABC analysis strongly suggests that the stickleback data are most consistent with synchronous expansion after the Last Glacial Maximum (posterior probability = 0.99). The aSFS will have general application for multilevel statistical frameworks to test models involving assemblages and/or communities, and as large-scale SNP data from nonmodel species become routine, the aSFS expands the potential for powerful next-generation comparative population genomic inference.",0 +https://doi.org/10.5641/027013605x13080719841239,Aging and Tennis Playing in a Coincidence-Timing Task With an Accelerating Object: The Role of Visuomotor Delay,"The purpose of the present study was to determine whether playing a specific ball sport, such as tennis, could maintain the coincidence-timing (CT) performance of older adults at a similar level to that of younger ones. To address this question, tennis players and nonplayers of three different age ranges (ages 20-30, 60-70, and 70-80 years) performed a simple CT task consisting of timing their response (pressing a button) to coincide with the arrival of a stimulus at a target. The stimulus moved at either an accelerating, constant, or decelerating velocity. As expected, all participants were affected by the velocity manipulation, which led to late and early responses to accelerating and decelerating stimuli, respectively. Whereas this response bias was increasingly pronounced with advancing age in nonplayers, no difference was found among player groups of different ages. Finally, we showed that the length of the visuomotor delay could explain the effect of nonconstant velocities. ©2005 by the American Alliance for Health, Physical Education, Recreation and Dance.",0 +https://doi.org/10.1017/cbo9780511802461.012,Bayesian multilevel modelling of cosmological populations,"Introduction Surveying the Universe is the ultimate remote sensing problem. Inferring the intrinsic properties of the galaxy population, via analysis of survey-generated catalogues, is a major challenge for twenty-first century cosmology, but this challenge must be met without any prospect of measuring these properties in situ. Thus, for example, our knowledge of the intrinsic luminosity and spatial distribution of galaxies is filtered by imperfect distance information and by observational selection effects, issues which have come to be known generically in the literature as 'Malmquist bias'. Figure 11.1 shows schematically how such effects may distort our inferences about the underlying population since, in general, these must be derived from a noisy, sparse and truncated sample of galaxies. There is a long (and mostly honourable!) tradition in the astronomical literature of attempts to cast such remote surveying problems within a rigorous statistical framework. Indeed, it is interesting to note that seminal examples from the early twentieth century (Eddington 1913, 1940; Malmquist 1920, 1922) display, at least with hindsight, hints of a Bayesian formulation long before the recent renaissance of Bayesian methods in astronomy. Unfortunately, space does not permit us to review in detail that early literature, nor many of the more recent papers which evolved from it. A more thorough discussion of the literature on statistical analysis of survey data can be found in, e.g., Hendry and Simmons (1995), Strauss and Willick (1995), Teerikorpi (1997) and Loredo (2007). © Cambridge University Press, 2010.",0 +https://doi.org/10.1146/annurev.soc.30.012703.110629,Panel Models in Sociological Research: Theory into Practice,"A selection of panel studies appearing in the American Sociological Review and the American Journal of Sociology between 1990 and 2003 shows that sociologists have been slow to capitalize on the advantages of panel data for controlling unobservables that threaten causal inference in observational studies. This review emphasizes regression methods that capitalize on the strengths of panel data for consistently estimating causal parameters in models for metric outcomes when measured explanatory variables are correlated with unit-specific unobservables. Both static and dynamic models are treated. Among the major subjects are fixed versus random effects methods, Hausman tests, Hausman-Taylor models, and instrumental variables methods, including Arrelano-Bond and Anderson-Hsaio estimation for models with lagged endogenous variables.",0 +https://doi.org/10.1016/j.brat.2015.11.008,Increasing clinicians' EBT exploration and preparation behavior in youth mental health services by changing organizational culture with ARC,"Clinician EBT exploration and preparation behavior is essential to the ongoing implementation of new EBTs. This study examined the effect of the ARC organizational intervention on clinician EBT exploration and preparation behavior and assessed the mediating role of organizational culture as a linking mechanism.Fourteen community mental health agencies that serve youth in a major Midwestern metropolis along with 475 clinicians who worked in those agencies, were randomly assigned to either the three-year ARC intervention or control condition. Organizational culture was assessed with the Organizational Social Context (OSC) measure at baseline and follow-up. EBT exploration and preparation behavior was measured as clinician participation in nine separate community EBT workshops held over a three-year period.There was 69 percent greater odds (OR = 1.69, p < .003) of clinicians in the ARC condition (versus control) attending each subsequent workshop. Workshop attendance in the control group remained under two percent and declined over three years while attendance in the ARC condition grew from 3.6 percent in the first workshop to 12 percent in the ninth and final workshop. Improvement in proficient organizational culture mediated the positive effect of the ARC intervention on clinicians' workshop attendance (a × b = .21; 95% CI:LL = .05, UL = .40).Organizational interventions that create proficient mental health agency cultures can increase clinician EBT exploration and preparation behavior that is essential to the ongoing implementation of new EBTs in community youth mental health settings.",0 +https://doi.org/10.1002/9780470583333.ch6,A Bootstrap Test of Shape Invariance Across Distributions,,0 +https://doi.org/10.1016/b978-044452044-9/50004-5,Covariance Structure Models for Maximal Reliability of Unit-Weighted Composites,"Abstract When developing or evaluating scales, the internal consistency reliability of the scale based on its items or parts is always an important issue. The growth of structural modeling has allowed the easy computation of model-based estimates of reliability. These are typically touted as replacements for coefficient alpha, which remains the most widely used measure of internal consistency. Among model-based estimates, coefficients based on a 1-factor model have been most widely recommended. However, when the 1-factor model does not fit the data, the meaning of such a coefficient is unclear. A new identification condition for factor analytic models is proposed that assures the composite can be modeled with only one common factor even if the components are multidimensional. This common factor is maximally correlated with the composite, and the reliability of the composite is the maximal internal consistency coefficient for a unit-weighted composite. The coefficient also describes k-factor reliability, the greatest lower bound to reliability, and reliability for any composite from a latent variable model with additive errors. Reliability coefficients for differentially-weighted composites are also described, and differentially-weighted maximal reliability is contrasted with unit-weighted maximal reliability. Computational methods for these coefficients are described.",0 +https://doi.org/10.1177/0013164414565007,Assessing Spurious Interaction Effects in Structural Equation Modeling,"Several studies have stressed the importance of simultaneously estimating interaction and quadratic effects in multiple regression analyses, even if theory only suggests an interaction effect should be present. Specifically, past studies suggested that failing to simultaneously include quadratic effects when testing for interaction effects could result in Type I errors, Type II errors, or misleading interactions. Research investigating this issue has been limited to multiple regression models. Contrarily, structural equation modeling is a more appropriate analysis when hypotheses include latent variables. The current study utilized Monte Carlo simulation to investigate whether quadratic effects should be included in the latent variable interaction model. Consistent with previous research, it was found that including latent variable quadratic effects in the model successfully reduced the frequency of spurious interaction effects but at a cost of low power to detect true interaction effects, inaccurate parameter estimates, inaccurate standard error estimates, and reduced convergence rates. Based on findings from the current study, we recommend that researchers hypothesizing interactions between latent variables should test for these relations using the latent variable interaction model rather than the interaction quadratic model. If researchers are concerned about spurious interactions, then they may want to consider including quadratic effects in the model, provided that they have sample sizes of at least 500 and high indicator reliability. We caution all researchers to base higher order effects models on theory.",0 +https://doi.org/10.1214/aos/1176342360,A Bayesian Analysis of Some Nonparametric Problems,"The Bayesian approach to statistical problems, though fruitful in many ways, has been rather unsuccessful in treating nonparametric problems. This is due primarily to the difficulty in finding workable prior distributions on the parameter space, which in nonparametric ploblems is taken to be a set of probability distributions on a given sample space. There are two desirable properties of a prior distribution for nonparametric problems. (I) The support of the prior distribution should be large--with respect to some suitable topology on the space of probability distributions on the sample space. (II) Posterior distributions given a sample of observations from the true probability distribution should be manageable analytically. These properties are antagonistic in the sense that one may be obtained at the expense of the other. This paper presents a class of prior distributions, called Dirichlet process priors, broad in the sense of (I), for which (II) is realized, and for which treatment of many nonparametric statistical problems may be carried out, yielding results that are comparable to the classical theory. In Section 2, we review the properties of the Dirichlet distribution needed for the description of the Dirichlet process given in Section 3. Briefly, this process may be described as follows. Let $\mathscr{X}$ be a space and $\mathscr{A}$ a $\sigma$-field of subsets, and let $\alpha$ be a finite non-null measure on $(\mathscr{X}, \mathscr{A})$. Then a stochastic process $P$ indexed by elements $A$ of $\mathscr{A}$, is said to be a Dirichlet process on $(\mathscr{X}, \mathscr{A})$ with parameter $\alpha$ if for any measurable partition $(A_1, \cdots, A_k)$ of $\mathscr{X}$, the random vector $(P(A_1), \cdots, P(A_k))$ has a Dirichlet distribution with parameter $(\alpha(A_1), \cdots, \alpha(A_k)). P$ may be considered a random probability measure on $(\mathscr{X}, \mathscr{A})$, The main theorem states that if $P$ is a Dirichlet process on $(\mathscr{X}, \mathscr{A})$ with parameter $\alpha$, and if $X_1, \cdots, X_n$ is a sample from $P$, then the posterior distribution of $P$ given $X_1, \cdots, X_n$ is also a Dirichlet process on $(\mathscr{X}, \mathscr{A})$ with a parameter $\alpha + \sum^n_1 \delta_{x_i}$, where $\delta_x$ denotes the measure giving mass one to the point $x$. In Section 4, an alternative definition of the Dirichlet process is given. This definition exhibits a version of the Dirichlet process that gives probability one to the set of discrete probability measures on $(\mathscr{X}, \mathscr{A})$. This is in contrast to Dubins and Freedman [2], whose methods for choosing a distribution function on the interval [0, 1] lead with probability one to singular continuous distributions. Methods of choosing a distribution function on [0, 1] that with probability one is absolutely continuous have been described by Kraft [7]. The general method of choosing a distribution function on [0, 1], described in Section 2 of Kraft and van Eeden [10], can of course be used to define the Dirichlet process on [0, 1]. Special mention must be made of the papers of Freedman and Fabius. Freedman [5] defines a notion of tailfree for a distribution on the set of all probability measures on a countable space $\mathscr{X}$. For a tailfree prior, posterior distribution given a sample from the true probability measure may be fairly easily computed. Fabius [3] extends the notion of tailfree to the case where $\mathscr{X}$ is the unit interval [0, 1], but it is clear his extension may be made to cover quite general $\mathscr{X}$. With such an extension, the Dirichlet process would be a special case of a tailfree distribution for which the posterior distribution has a particularly simple form. There are disadvantages to the fact that $P$ chosen by a Dirichlet process is discrete with probability one. These appear mainly because in sampling from a $P$ chosen by a Dirichlet process, we expect eventually to see one observation exactly equal to another. For example, consider the goodness-of-fit problem of testing the hypothesis $H_0$ that a distribution on the interval [0, 1] is uniform. If on the alternative hypothesis we place a Dirichlet process prior with parameter $\alpha$ itself a uniform measure on [0, 1], and if we are given a sample of size $n \geqq 2$, the only nontrivial nonrandomized Bayes rule is to reject $H_0$ if and only if two or more of the observations are exactly equal. This is really a test of the hypothesis that a distribution is continuous against the hypothesis that it is discrete. Thus, there is still a need for a prior that chooses a continuous distribution with probability one and yet satisfies properties (I) and (II). Some applications in which the possible doubling up of the values of the observations plays no essential role are presented in Section 5. These include the estimation of a distribution function, of a mean, of quantiles, of a variance and of a covariance. A two-sample problem is considered in which the Mann-Whitney statistic, equivalent to the rank-sum statistic, appears naturally. A decision theoretic upper tolerance limit for a quantile is also treated. Finally, a hypothesis testing problem concerning a quantile is shown to yield the sign test. In each of these problems, useful ways of combining prior information with the statistical observations appear. Other applications exist. In his Ph. D. dissertation [1], Charles Antoniak finds a need to consider mixtures of Dirichlet processes. He treats several problems, including the estimation of a mixing distribution, bio-assay, empirical Bayes problems, and discrimination problems.",0 +https://doi.org/10.1007/s10464-013-9570-x,Improving Classroom Quality with The RULER Approach to Social and Emotional Learning: Proximal and Distal Outcomes,"The RULER Approach to Social and Emotional Learning (""RULER"") is designed to improve the quality of classroom interactions through professional development and classroom curricula that infuse emotional literacy instruction into teaching-learning interactions. Its theory of change specifies that RULER first shifts the emotional qualities of classrooms, which are then followed, over time, by improvements in classroom organization and instructional support. A 2-year, cluster randomized controlled trial was conducted to test hypotheses derived from this theory. Sixty-two urban schools either integrated RULER into fifth- and sixth-grade English language arts (ELA) classrooms or served as comparison schools, using their standard ELA curriculum only. Results from multilevel modeling with baseline adjustments and structural equation modeling support RULER's theory of change. Compared to classrooms in comparison schools, classrooms in RULER schools exhibited greater emotional support, better classroom organization, and more instructional support at the end of the second year of program delivery. Improvements in classroom organization and instructional support at the end of Year 2 were partially explained by RULER's impacts on classroom emotional support at the end of Year 1. These findings highlight the important contribution of emotional literacy training and development in creating engaging, empowering, and productive learning environments.",0 +https://doi.org/10.1177/0081175014529767,An Extended Cultural Consensus Theory Model to Account for Cognitive Processes in Decision Making in Social Surveys,"In recent decades, cultural consensus theory (CCT) models have been extensively applied across research domains to explore shared cultural knowledge and beliefs. These models are parameterized in terms of person-specific cognitive parameters such as abilities and guessing biases as well as item difficulties. Although psychometric test theory is also formalized in terms of abilities and item difficulties, a quality that clearly sets CCT models apart from other test theory models is their specification to operate on data in which the answer key is latent. In doing so, CCT models specify the answer key as parameters of the model, and also involved with this specification are procedures to verify the integrity of the answer key that is estimated. In this article, the authors develop the following methods to propagate the application of these CCT models in the field of social surveys: (1) by extending the underlying cognitive model to be able to account for uncertainty in decision making (“don’t know” responses), (2) by allowing covariate information to be entered in the analysis, and (3) by deriving statistical inference in the hierarchical Bayesian framework. The proposed model is fit to data describing knowledge on science and on aging to demonstrate the novel findings that can be achieved by the approach.",0 +https://doi.org/10.1016/j.cmpb.2010.05.003,A Bayesian multilevel model for fMRI data analysis,"Bayesian approaches have been proposed by several functional magnetic resonance imaging (fMRI) researchers in order to overcome the fundamental limitations of the popular statistical parametric mapping method. However, the difficulties associated with subjective prior elicitation have prevented the widespread adoption of the Bayesian methodology by the neuroimaging community. In this paper, we present a Bayesian multilevel model for the analysis of brain fMRI data. The main idea is to consider that all the estimated group effects (fMRI activation patterns) are exchangeable. This means that all the collected voxel time series are considered manifestations of a few common underlying phenomena. In contradistinction to other Bayesian approaches, we think of the estimated activations as multivariate random draws from the same distribution without imposing specific prior spatial and/or temporal information for the interaction between voxels. Instead, a two-stage empirical Bayes prior approach is used to relate voxel regression equations through correlations between the regression coefficient vectors. The adaptive shrinkage properties of the Bayesian multilevel methodology are exploited to deal with spatial variations, and noise outliers. The characteristics of the proposed model are evaluated by considering its application to two real data sets.",0 +https://doi.org/10.3758/bf03194547,Converting between measures of slope of the psychometric function,"The psychometric function's slope provides information about the reliability of psychophysical threshold estimates. Furthermore, knowing the slope allows one to compare, across studies, thresholds that were obtained at different performance criterion levels. Unfortunately, the empirical validation of psychometric function slope estimates is hindered by the bewildering variety of slope measures that are in use. The present article provides conversion formulas for the most popular cases, including the logistic, Weibull, Quick, cumulative normal, and hyperbolic tangent functions as analytic representations, in both linear and log coordinates and to different log bases, the practical decilog unit, the empirically based interquartile range measure of slope, and slope in a d' representation of performance.",0 +https://doi.org/10.1111/biom.12299,Bayesian function-on-function regression for multilevel functional data,"Medical and public health research increasingly involves the collection of complex and high dimensional data. In particular, functional data-where the unit of observation is a curve or set of curves that are finely sampled over a grid-is frequently obtained. Moreover, researchers often sample multiple curves per person resulting in repeated functional measures. A common question is how to analyze the relationship between two functional variables. We propose a general function-on-function regression model for repeatedly sampled functional data on a fine grid, presenting a simple model as well as a more extensive mixed model framework, and introducing various functional Bayesian inferential procedures that account for multiple testing. We examine these models via simulation and a data analysis with data from a study that used event-related potentials to examine how the brain processes various types of images.",0 +https://doi.org/10.1162/003465304323023705,"Using Matching to Estimate Treatment Effects: Data Requirements, Matching Metrics, and Monte Carlo Evidence","We compare propensity-score matching methods with covariatematching estimators. We first discuss the data requirements of propensity-score matching estimators and covariate matching estimators. Then we propose two new matching metrics incorporating the treatment outcome information and participation indicator information, and discuss the motivations of different metrics. Next we study the small-sample properties of propensity-score matching versus covariate matching estimators, and of different matching metrics, through Monte Carlo experiments. Through a series of simulations, we provide some guidance to practitioners on how to choose among different matching estimators and matching metrics.",0 +https://doi.org/10.1371/journal.pone.0075946,"A Structural Equation Model Analysis of Relationships among ENSO, Seasonal Descriptors and Wildfires","Seasonality drives ecological processes through networks of forcings, and the resultant complexity requires creative approaches for modeling to be successful. Recently ecologists and climatologists have developed sophisticated methods for fully describing seasons. However, to date the relationships among the variables produced by these methods have not been analyzed as networks, but rather with simple univariate statistics. In this manuscript we used structural equation modeling (SEM) to analyze a proposed causal network describing seasonality of rainfall for a site in south-central Florida. We also described how this network was influenced by the El Niño-Southern Oscillation (ENSO), and how the network in turn affected the site's wildfire regime. Our models indicated that wet and dry seasons starting later in the year (or ending earlier) were shorter and had less rainfall. El Niño conditions increased dry season rainfall, and via this effect decreased the consistency of that season's drying trend. El Niño conditions also negatively influenced how consistent the moistening trend was during the wet season, but in this case the effect was direct and did not route through rainfall. In modeling wildfires, our models showed that area burned was indirectly influenced by ENSO via its effect on dry season rainfall. Area burned was also indirectly reduced when the wet season had consistent rainfall, as such wet seasons allowed fewer wildfires in subsequent fire seasons. Overall area burned at the study site was estimated with high accuracy (R (2) score = 0.63). In summary, we found that by using SEMs, we were able to clearly describe causal patterns involving seasonal climate, ENSO and wildfire. We propose that similar approaches could be effectively applied to other sites where seasonality exerts strong and complex forcings on ecological processes.",0 +https://doi.org/10.1007/s10880-015-9423-x,Parenting Stress Related to Behavioral Problems and Disease Severity in Children with Problematic Severe Asthma,"Our study examined parenting stress and its association with behavioral problems and disease severity in children with problematic severe asthma. Research participants were 93 children (mean age 13.4 ± 2.7 years) and their parents (86 mothers, 59 fathers). As compared to reference groups analyzed in previous research, scores on the Parenting Stress Index in mothers and fathers of the children with problematic severe asthma were low. Higher parenting stress was associated with higher levels of internalizing and externalizing behavioral problems in children (Child Behavior Checklist). Higher parenting stress in mothers was also associated with higher airway inflammation (FeNO). Thus, although parenting stress was suggested to be low in this group, higher parenting stress, especially in the mother, is associated with more airway inflammation and greater child behavioral problems. This indicates the importance of focusing care in this group on all possible sources of problems, i.e., disease exacerbations and behavioral problems in the child as well as parenting stress.",0 +https://doi.org/10.1080/03610920903009376,Assessing Differential Area Mortality Trends via Bayesian Random Effects,"Changes in area mortality are important for assessing spatial health inequality. They are likely to be differentiated by age as well as spatially and may vary by demographic strata (e.g., gender, ethnic group). A simple approach assumes linear improvement in log mortality risks, with noninteracting area and age coefficients. By contrast, this article considers parsimonious models for mortality change allowing nonlinear trends and interactions between ages and areas in mortality levels and trends. A case study considers trends in mortality in 32 London boroughs over the 8-year period 1999–2006 for deaths data disaggregated by age, sex, and area.",0 +https://doi.org/10.1186/s12939-015-0217-4,"Social inequality in morbidity, framed within the current economic crisis in Spain","Inspired by the 'Fundamental Cause Theory (FCT)' we explore social inequalities in preventable versus relatively less-preventable illnesses in Spain. The focus is on the education-health gradient, as education is one of the most important components of an individual's socioeconomic status (SES). Framed in the context of the recent economic crisis, we investigate the education gradient in depression, diabetes, and myocardial infarction (relatively highly preventable illnesses) and malignant tumors (less preventable), and whether this educational gradient varies across the regional-economic context and changes therein.We use data from three waves of the Spanish National Health Survey (2003-2004, 2006-2007, and 2011-2012), and from the 2009-2010 wave of the European Health Survey in Spain, which results in a repeated cross-sectional design. Logistic multilevel regressions are performed with depression, diabetes, myocardial infarction, and malignant tumors as dependent variables. The multilevel design has three levels (the individual, period-regional, and regional level), which allows us to estimate both longitudinal and cross-sectional macro effects. The regional-economic context and changes therein are assessed using the real GDP growth rate and the low work intensity indicator.Education gradients in more-preventable illness are observed, while this is far less the case in our less-preventable disease group. Regional economic conditions seem to have a direct impact on depression among Spanish men (y-stand. OR = 1.04 [95 % CI: 1.01-1.07]). Diabetes is associated with cross-regional differences in low work intensity among men (y-stand. OR = 1.02 [95 % CI: 1.00-1.05]) and women (y-stand. OR = 1.04 [95 % CI: 1.01-1.06]). Economic contraction increases the likelihood of having diabetes among men (y-stand. OR = 1.04 [95 % CI: 1.01-1.06]), and smaller decreases in the real GDP growth rate are associated with lower likelihood of myocardial infarction among women (y-stand. OR = 0.83 [95 % CI: 0.69-1.00]). Finally, there are interesting associations between the macroeconomic changes across the crisis period and the likelihood of suffering from myocardial infarction among lower educated groups, and the likelihood of having depression and diabetes among less-educated women.Our findings partially support the predictions of the FCT for Spain. The crisis effects on health emerge especially in the case of our more-preventable illnesses and among lower educated groups. Health inequalities in Spain could increase rapidly in the coming years due to the differential effects of recession on socioeconomic groups.",0 +https://doi.org/10.1037/a0035666,Differences in within- and between-person factor structure of positive and negative affect: Analysis of two intensive measurement studies using multilevel structural equation modeling.,"The Positive and Negative Affect Schedule (PANAS) is a widely used measure of emotional experience. The factor structure of the PANAS has been examined predominantly with cross-sectional designs, which fails to disaggregate within-person variation from between-person differences. There is still uncertainty as to the factor structure of positive and negative affect and whether they constitute 2 distinct independent factors. The present study examined the within-person and between-person factor structure of the PANAS in 2 independent samples that reported daily affect over 7 and 14 occasions, respectively. Results from multilevel confirmatory factor analyses revealed that a 2-factor structure at both the within-person and between-person levels, with correlated specific factors for overlapping items, provided good model fit. The best-fitting solution was one where within-person factors of positive and negative affect were inversely correlated, but between-person factors were independent. The structure was further validated through multilevel structural equation modeling examining the effects of cognitive interference, daily stress, physical symptoms, and physical activity on positive and negative affect factors.",0 +https://doi.org/10.1111/j.1467-9574.2005.00279.x,Bayesian model selection using encompassing priors,"This paper deals with Bayesian selection of models that can be specified using inequality constraints among the model parameters. The concept of encompassing priors is introduced, that is, a prior distribution for an unconstrained model from which the prior distributions of the constrained models can be derived. It is shown that the Bayes factor for the encompassing and a constrained model has a very nice interpretation: it is the ratio of the proportion of the prior and posterior distribution of the encompassing model in agreement with the constrained model. It is also shown that, for a specific class of models, selection based on encompassing priors will render a virtually objective selection procedure. The paper concludes with three illustrative examples: an analysis of variance with ordered means; a contingency table analysis with ordered odds-ratios; and a multilevel model with ordered slopes.",0 +https://doi.org/10.3758/bf03202828,Quest: A Bayesian adaptive psychometric method,"An adaptive psychometric procedure that places each trial at the current most probable Bayesian estimate of threshold is described. The procedure takes advantage of the common finding that the human psychometric function is invariant in form when expressed as a function of log intensity. The procedure is simple, fast, and efficient, and may be easily implemented on any computer.",0 +https://doi.org/10.1177/0047287507299576,Perceptions-Based Analysis of Tourism Products and Service Providers,"Perceptions-based analysis is a general framework for analyzing tourist choice alternatives involving large sets of perceived attributes. Its development in tourism research was encouraged as tourism is characterized by multifaceted choice alternatives such as destinations and other experiential “products” that the tourists cannot succinctly evaluate with a small number of attributes. PBA differentiates between the generic perceptions of a class of choice alternatives (destinations, product/service providers; e.g., “metropolitan city”; “tour operator”), the perceptual profiles of a specific choice alternative (“San Francisco”; “Thomas Cook”), and the profiles of the choice alternatives preferred or actually selected. It condenses the attribute profiles into distinguished perceptual positions and analyzes their competitive relationships by diagnosing the perceptual strengths and weaknesses of the choice alternatives. Further analysis reveals the number of choice decisions made in favor of a uniquely positioned choice alternative or one sharing its position with others. An empirical example for tour operators illustrates the various data processing steps and discusses their policy implications.",0 +https://doi.org/10.1177/0013161x11419653,Toward an Organizational Model of Change in Elementary Schools,"Purpose: This study explored a theoretical model that links teachers’ perceived uncertainty and teachers’ sense of collective efficacy with organizational learning mechanisms (OLMs) in elementary schools. OLMs serve as a mediator construct. Research Design: For testing the primary theoretical model, 801 teachers from 61 elementary schools (33 urban and 28 suburban) in Israel’s largest district responded to the research instruments. The authors used structural equation modeling to determine whether OLMs mediate between teachers’ perceived uncertainty and their sense of collective efficacy. Findings: A significant model, which included direct and indirect effects of teachers’ perceived uncertainty on teachers’ sense of collective efficacy, emerged for the urban school context. Although OLMs (storing, retrieving, and putting to use of information) served as a prominent mediating variable in the urban school context, OLMs did not play a mediating role in the research model for the suburban school context. Conclusions: This study strengthens the feasibility of the OLMs framework, based on information processing, to provide a concrete description of organizational learning processes in schools. The study provides a deeper understanding of how OLMs can serve as a significant link between the dynamic school environment and teachers’ attitudes, which may ultimately improve teachers’ work and students’ learning.",0 +https://doi.org/10.1037/a0020957,Evaluating expectations about negative emotional states of aggressive boys using Bayesian model selection.,"Researchers often have expectations about the research outcomes in regard to inequality constraints between, e.g., group means. Consider the example of researchers who investigated the effects of inducing a negative emotional state in aggressive boys. It was expected that highly aggressive boys would, on average, score higher on aggressive responses toward other peers than moderately aggressive boys, who would in turn score higher than nonaggressive boys. In most cases, null hypothesis testing is used to evaluate such hypotheses. We show, however, that hypotheses formulated using inequality constraints between the group means are generally not evaluated properly. The wrong hypotheses are tested, i.e.. the null hypothesis that group means are equal. In this article, we propose an innovative solution to these above-mentioned issues using Bayesian model selection, which we illustrate using a case study.",0 +https://doi.org/10.3758/bf03196299,Quantile maximum likelihood estimation of response time distributions,"We introduce and evaluate via a Monte Carlo study a robust new estimation technique that fits distribution functions to grouped response time (RT) data, where the grouping is determined by sample quantiles. The new estimator, quantile maximum likelihood (QML), is more efficient and less biased than the best alternative estimation technique when fitting the commonly used ex-Gaussian distribution. Limitations of the Monte Carlo results are discussed and guidance provided for the practical application of the new technique. Because QML estimation can be computationally costly, we make fast open source code for fitting available that can be easily modified to use QML in the estimation of any distribution function.",0 +https://doi.org/10.1097/meg.0000000000000376,Comparative effectiveness of antiviral treatment for hepatitis B,"A wide variety of competing drugs are available to patients for the treatment of chronic hepatitis B. We update a recent meta-analysis to include additional trial evidence with the aim of determining which treatment is the most effective.Twelve monotherapy or combination therapy were evaluated in treatment-naive individuals with hepatitis B e antigen (HBeAg) positive or negative patients. Databases were searched for randomized controlled trials in the first year of therapy. Bayesian random effects network meta-analysis was used to calculate the pairwise odds ratios, 95% credible intervals and ranking of six surrogate outcomes.In total, 22 studies were identified (7508 patients): 12 studies analysed HBeAg-positive patients, six analysed HBeAg-negative patients, and four evaluated both. Tenofovir was most effective at increasing efficacy in HBeAg-positive patients, ranking first for three outcomes and increased odds of undetectable levels of hepatitis B virus (HBV) DNA compared with seven other therapies (such as lamivudine: odds ratio 33.0; 95% credible interval 7.0-292.7). For HBeAg-negative patients, the large network (seven therapies) ranked entecavir alone or in combination with tenofovir highly for reduction in HBV DNA and histologic improvement. In the smaller network (three therapies), tenofovir ranked first for undetectable HBV DNA and histologic improvement. No data existed to directly or indirectly compare these treatments.For HBeAg-positive patients tenofovir is the most effective at increasing efficacy, whereas for HBeAg-negative patients, either tenofovir or entecavir is most effective. Further research should focus on strengthening the network connections, in particular comparing tenofovir and entecavir in HBeAg-negative patients.",0 +https://doi.org/10.1093/esr/jcu049,"Gen(d)eralized Trust: Women, Work, and Trust in Strangers","This article deals with the question as to whether gender equality in labour force participation affects generalized trust. Following the seminal work of Rothstein and Uslaner, a first hypothesis m ...",0 +https://doi.org/10.1177/01461672012711014,Conscientiousness and the Theory of Planned Behavior: Toward a more Complete Model of the Antecedents of Intentions and Behavior,"Two studies explored the relationship between past behavior, personality traits, intentions, and behavior. Study 1 (N = 181) considered intentions to engage in goal-directed activity (health protection). Cognitions specified by the Theory of Planned Behavior were examined as mediators of the relationship between past behavior, personality, and intentions. The effect of conscientiousness on intention was partially mediated by cognitions, whereas the effect of past behavior was partially mediated by cognitions and conscientiousness. Study 2 (N = 123) examined predictions of intentions and self-reported behavior in relation to both health protection and exercise, a more specific behavior. In both cases, the effect of conscientiousness on intention was totally mediated, whereas the effect on behavior was partially mediated. Similarly, the effects of past behavior on intentions were totally mediated, whereas the effects on behavior were partially mediated by cognitions and conscientiousness. Thus, combining personality traits and cognitions provided a more sufficient account of the determinants of intentions and behavior.",0 +https://doi.org/10.4324/9780203775851-19,Pulling the Sobel Test Up By Its Bootstraps,,0 +https://doi.org/10.1080/10705511.2016.1185723,Assessing and Controlling Acquiescent Responding When Acquiescence and Content Are Related: A Comprehensive Factor-Analytic Approach,"This article proposes procedures for assessing and controlling acquiescence in personality scales when acquiescence is related to the content that the scale intends to measure. Our proposal is comprehensive in that it can be applied to different item response formats fitted with response models that can be parameterized as factor-analytic models. In the calibration stage, our proposal makes joint use of a balanced scale and a set of markers for acquiescence, and consists of 2 sequential procedures: a direct semirestricted solution, and a restricted solution with minimal identification constraints. In the scoring stage, we discuss how the information given by the acquiescence–content relation can be used to obtain Bayes expected a posteriori scores. The robustness of the direct procedure is assessed both analytically and by simulation. A free, user-friendly program that implements the procedures proposed is made available. Practical issues of use and interpretation are discussed and illustrated with an emp...",0 +https://doi.org/10.1080/01621459.1989.10478848,Choosing among Alternative Nonexperimental Methods for Estimating the Impact of Social Programs: The Case of Manpower Training,The recent literature on evaluating manpower training programs demonstrates that alternative nonexperimental estimators of the same program produce a array of estimates of program impact. These findings have led to the call for experiments to be used to perform credible program evaluations. Missing in all of the recent pessimistic analyses of nonexperimental methods is any systematic discussion of how to choose among competing estimators. This paper explores the value of simple specification tests in selecting an appropriate nonexperimental estimator. A reanalysis of the National Supported Work Demonstration Data previously analyzed by proponents of social experiments reveals that a simple testing procedure eliminates the range of nonexperimental estimators that are at variance with the experimental estimates of program impact.,0 +https://doi.org/10.1007/s11336-015-9461-1,Profile Likelihood-Based Confidence Intervals and Regions for Structural Equation Models,"Structural equation models (SEM) are widely used for modeling complex multivariate relationships among measured and latent variables. Although several analytical approaches to interval estimation in SEM have been developed, there lacks a comprehensive review of these methods. We review the popular Wald-type and lesser known likelihood-based methods in linear SEM, emphasizing profile likelihood-based confidence intervals (CIs). Existing algorithms for computing profile likelihood-based CIs are described, including two newer algorithms which are extended to construct profile likelihood-based confidence regions (CRs). Finally, we illustrate the use of these CIs and CRs with two empirical examples, and provide practical recommendations on when to use Wald-type CIs and CRs versus profile likelihood-based CIs and CRs. OpenMx example code is provided in an Online Appendix for constructing profile likelihood-based CIs and CRs for SEM. © 2015, The Psychometric Society.",0 +,Conditional logit analysis of qualitative choice behavior,,0 +https://doi.org/10.1198/016214507000001409,Bivariate Binomial Spatial Modeling of Loa loa Prevalence in Tropical Africa,"We present a state-of-the-art application of smoothing for dependent bivariate binomial spatial data to Loa loa prevalence mapping in West Africa. This application starts with the nonspatial calibration of survey instruments, continues with the spatial model building and assessment, and ends with robust, tested software intended for use by field workers for online prevalence map updating. From a statistical perspective, we address several important methodological issues: building spatial models that are sufficiently complex to capture the structure of the data but remain computationally usable, reducing the computational burden in the handling of very large covariate data sets, and devising methods for comparing spatial prediction methods for a given exceedance policy threshold.",0 +https://doi.org/10.1007/s10198-013-0524-x,Equity in specialist waiting times by socioeconomic groups: evidence from Spain,"In countries with publicly financed health care systems, waiting time - rather than price - is the rationing mechanism for access to health care services. The normative statement underlying such a rationing device is that patients should wait according to need and irrespective of socioeconomic status or other non-need characteristics. The aim of this paper is to test empirically that waiting times for publicly funded specialist care do not depend on patients' socioeconomic status. Waiting times for specialist care can vary according to the type of medical specialty, type of consultation (review or diagnosis) and the region where patients' reside. In order to take into account such variability, we use Bayesian random parameter models to explain waiting times for specialist care in terms of need and non-need variables. We find that individuals with lower education and income levels wait significantly more time than their counterparts. © 2013 Springer-Verlag Berlin Heidelberg.",0 +https://doi.org/10.1111/j.1467-9868.2007.00612.x,Order-free co-regionalized areal data models with application to multiple-disease mapping,"Summary. With the ready availability of spatial databases and geographical information system software, statisticians are increasingly encountering multivariate modelling settings featuring associations of more than one type: spatial associations between data locations and associations between the variables within the locations. Although flexible modelling of multivariate point-referenced data has recently been addressed by using a linear model of co-regionalization, existing methods for multivariate areal data typically suffer from unnecessary restrictions on the covariance structure or undesirable dependence on the conditioning order of the variables. We propose a class of Bayesian hierarchical models for multivariate areal data that avoids these restrictions, permitting flexible and order-free modelling of correlations both between variables and across areal units. Our framework encompasses a rich class of multivariate conditionally autoregressive models that are computationally feasible via modern Markov chain Monte Carlo methods. We illustrate the strengths of our approach over existing models by using simulation studies and also offer a real data application involving annual lung, larynx and oesophageal cancer death-rates in Minnesota counties between 1990 and 2000.",0 +https://doi.org/10.1037/a0014990,Editorial.,"The Journal of Applied Psychology is the oldest and largest top-tier journal publishing theory and research relevant to industrial and organizational psychology, organizational behavior, and human resources management. The primary emphasis of this journal is the publication of original investigations that advance theoretical understanding and create new knowledge for applied psychology within the broad scope of the organizational sciences. We are primarily interested in publishing empirical research and conceptual articles that enhance understanding of psychological phenomena in human and organizational systems. This editorial also covers the expectations and review process that the Journal of Applied Psychology has for manuscripts submitted to the journal. (PsycINFO Database Record (c) 2009 APA, all rights reserved).",0 +https://doi.org/10.1080/07350015.2015.1052457,Unobserved Heterogeneity in Income Dynamics: An Empirical Bayes Perspective,"Empirical Bayes methods for Gaussian compound decision problems involving longitudinal data are considered. The new convex optimization formulation of the nonparametric (Kiefer–Wolfowitz) maximum likelihood estimator for mixture models is employed to construct nonparametric Bayes rules for compound decisions. The methods are first illustrated with some simulation examples and then with an application to models of income dynamics. Using panel data, we estimate a simple dynamic model of earnings that incorporates bivariate heterogeneity in intercept and variance of the innovation process. Profile likelihood is employed to estimate an AR(1) parameter controlling the persistence of the innovations. We find that persistence is relatively modest, ρ^≈0.48, when we permit heterogeneity in variances. Evidence of negative dependence between individual intercepts and variances is revealed by the nonparametric estimation of the mixing distribution, and has important consequences for forecasting future income trajecto...",0 +https://doi.org/10.1080/00273171.2014.1003772,"A Multilevel AR(1) Model: Allowing for Inter-Individual Differences in Trait-Scores, Inertia, and Innovation Variance.","In this article we consider a multilevel first-order autoregressive [AR(1)] model with random intercepts, random autoregression, and random innovation variance (i.e., the level 1 residual variance). Including random innovation variance is an important extension of the multilevel AR(1) model for two reasons. First, between-person differences in innovation variance are important from a substantive point of view, in that they capture differences in sensitivity and/or exposure to unmeasured internal and external factors that influence the process. Second, using simulation methods we show that modeling the innovation variance as fixed across individuals, when it should be modeled as a random effect, leads to biased parameter estimates. Additionally, we use simulation methods to compare maximum likelihood estimation to Bayesian estimation of the multilevel AR(1) model and investigate the trade-off between the number of individuals and the number of time points. We provide an empirical illustration by applying the extended multilevel AR(1) model to daily positive affect ratings from 89 married women over the course of 42 consecutive days.",0 +https://doi.org/10.3758/bf03203007,A quadrature method for Bayesian sequential threshold estimation,"For two-alternative forced-choice (2AFC) sequential threshold estimation, a finite Bayesian method (Emerson, 1986b) has been found to perform better than a closely related maximum-likelihood (ML) method. The comparison was especially apt because the two methods used all the same computations (Shelton, 1983) in maintaining and updating the representation of the log-likelihood function. This representation was in the form of a finite discrete array of about 50 equally spaced numerical elements in computer memory. The updating consisted of a series of offset lookups and additions from either of two precomputed arrays representing the log-likelihoods of correct and incorrect responses on a single trial. The difference between the ML and Bayesian methods was in the way the updated log-likelihood array was used to obtain the new estimate of the threshold after each trial. For the ML method, the array was merely scanned for its maximal element. For the Bayesian method, each element was exponentiated and the results were treated as unnormalized probabilities. These were then summed, with and without a multiplicative factor of the array index, to obtain the Bayesian normalizing constant and expected value of the threshold. These additional computations made the Bayesian method considerably slower than the ML method. Real-time use of that finite Bayesian method requires a compiled version of the program, rather than interpretive BASIC, and one of the faster PC-class computers. Statistically, the Bayesian estimates were generally better than the ML in that (1) there was no general negative bias, (2) biases toward the initial estimate decreased rapidly with increasing trials in the run, (3) variances were generally smaller, and (4) the biases and variances depended much less on the location of the true threshold in the assumed stimulus range.",0 +https://doi.org/10.1016/0167-8116(94)90033-7,Commercial use of conjoint analysis in Europe: Results and critical reflections,"Abstract We report the incidence of conjoint analysis applications by European market research suppliers. Based on responses to a survey, we document about 1,000 commercial projects over a five-year period and show breakdowns by product category, study purpose, and other characteristics such as study design, data collection, and data analysis. The results are compared with information collected for an earlier time period in the United States. We also discuss recent conjoint research results, identify issues that warrant further study, and suggest how the current practice of conjoint analysis can be improved.",0 +,Evaluation of suspected measles incidence rate trend in Iran and the affecting factors: Negative-Binomial mixed model,"Introduction: The identifying incidence rate trend of disease and its changes lead to update response of surveillance system. Syndromic surveillance system is based on the suspected cases, so it has high speed in detecting outbreaks. This study aimed to evaluate trend of fever and rash incidence rates and detect affecting factors. Materials and Methods: This study was a retrospective cohort study and the data included the suspected measles cases in provinces of Iran in 1977-2012, which extracted from surveillance system of vaccine preventable diseases. We fitted Poisson and Negative-Binomial regression models with random effect. Modeling and inferences were based on a Bayesian algorithm. We used R and OpenBUGS software. The fitted models were compared based on Deviance and Chi-square goodness of fit statistics. Results: Interaction effect between year and immunization campaign was statistically significant (95% CrI:1.083,1.737), after immunization campaign, trend was increasing. The variance of random component in model was statistically significant (95% CrI: 0.219,0.430). On the other hand, province-specific characterizes found affecting factor on suspected incidence rate. Conclusion: In attention to increasing trend of this incidence in Iran, especially in recently years, and affecting of province-specific characterizes on suspected incidence rate, We found that more accurate control and improvement of quality vaccination is essential. © 2015, Semnan University of Medical Sciences. All rights reserved.",0 +https://doi.org/10.1111/j.1745-3984.2006.00015.x,Comparing Methods of Assessing Differential Item Functioning in a Computerized Adaptive Testing Environment,"Mantel-Haenszel and SIBTEST, which have known difficulty in detecting non-unidirectional differential item functioning (DIF), have been adapted with some success for computerized adaptive testing (CAT). This study adapts logistic regression (LR) and the item-response-theory-likelihood-ratio test (IRT-LRT), capable of detecting both unidirectional and non-unidirectional DIF, to the CAT environment in which pretest items are assumed to be seeded in CATs but not used for trait estimation. The proposed adaptation methods were evaluated with simulated data under different sample size ratios and impact conditions in terms of Type I error, power, and specificity in identifying the form of DIF. The adapted LR and IRT-LRT procedures are more powerful than the CAT version of SIBTEST for non-unidirectional DIF detection. The good Type I error control provided by IRT-LRT under extremely unequal sample sizes and large impact is encouraging. Implications of these and other findings are discussed.",0 +https://doi.org/10.1186/1471-2288-11-77,Logistic random effects regression models: a comparison of statistical packages for binary and ordinal outcomes,"Abstract Background Logistic random effects models are a popular tool to analyze multilevel also called hierarchical data with a binary or ordinal outcome. Here, we aim to compare different statistical software implementations of these models. Methods We used individual patient data from 8509 patients in 231 centers with moderate and severe Traumatic Brain Injury (TBI) enrolled in eight Randomized Controlled Trials (RCTs) and three observational studies. We fitted logistic random effects regression models with the 5-point Glasgow Outcome Scale (GOS) as outcome, both dichotomized as well as ordinal, with center and/or trial as random effects, and as covariates age, motor score, pupil reactivity or trial. We then compared the implementations of frequentist and Bayesian methods to estimate the fixed and random effects. Frequentist approaches included R (lme4), Stata (GLLAMM), SAS (GLIMMIX and NLMIXED), MLwiN ([R]IGLS) and MIXOR, Bayesian approaches included WinBUGS, MLwiN (MCMC), R package MCMCglmm and SAS experimental procedure MCMC. Three data sets (the full data set and two sub-datasets) were analysed using basically two logistic random effects models with either one random effect for the center or two random effects for center and trial. For the ordinal outcome in the full data set also a proportional odds model with a random center effect was fitted. Results The packages gave similar parameter estimates for both the fixed and random effects and for the binary (and ordinal) models for the main study and when based on a relatively large number of level-1 (patient level) data compared to the number of level-2 (hospital level) data. However, when based on relatively sparse data set, i.e. when the numbers of level-1 and level-2 data units were about the same, the frequentist and Bayesian approaches showed somewhat different results. The software implementations differ considerably in flexibility, computation time, and usability. There are also differences in the availability of additional tools for model evaluation, such as diagnostic plots. The experimental SAS (version 9.2) procedure MCMC appeared to be inefficient. Conclusions On relatively large data sets, the different software implementations of logistic random effects regression models produced similar results. Thus, for a large data set there seems to be no explicit preference (of course if there is no preference from a philosophical point of view) for either a frequentist or Bayesian approach (if based on vague priors). The choice for a particular implementation may largely depend on the desired flexibility, and the usability of the package. For small data sets the random effects variances are difficult to estimate. In the frequentist approaches the MLE of this variance was often estimated zero with a standard error that is either zero or could not be determined, while for Bayesian methods the estimates could depend on the chosen ""non-informative"" prior of the variance parameter. The starting value for the variance parameter may be also critical for the convergence of the Markov chain.",0 +https://doi.org/10.17645/pag.v4i1.458,Context Matters: Economic Voting in the 2009 and 2014 European Parliament Elections,"Using the 2009 and 2014 European Election Studies (EES), we explore the effect of the economy on the vote in the 2009 and 2014 European Parliament (EP) elections. The paper demonstrates that the economy did influence voters in both contests. However, its impact was heterogeneous across the two elections and between countries. While assessments of the economy directly motivated voters in 2009 by 2014 economic appraisals were conditioned by how much responsibility voters felt the national government had for the state of the economy, implying a shift in calculus between the two elections. The analysis suggests that voters in 2009 were simply reacting to the economic tsunami that was the Global Financial Crisis, with motivations primarily driven by the unfavourable economic conditions countries faced. But in 2014, evaluations were conditioned by judgments about responsibility for the economy, suggesting a more conscious holding to account of the government. Our paper also reveals cross-country differences in the influence of the economy on vote. Attribution of responsibility and economic evaluations had a more potent impact on support for the government in bailout countries compared to non-bailout countries in 2014. Our findings demonstrate the importance of economy on vote in EP elections but also highlight how its impact on vote can vary based on context.",0 +https://doi.org/10.1080/10705511.2012.659612,Diagnostic Procedures for Detecting Nonlinear Relationships Between Latent Variables,"Structural equation models are commonly used to estimate relationships between latent variables. Almost universally, the fitted models specify that these relationships are linear in form. This assumption is rarely checked empirically, largely for lack of appropriate diagnostic techniques. This article presents and evaluates two procedures that can be used to visualize and detect nonlinear relationships between latent variables. The first procedure involves fitting a linear structural equation model and then inspecting plots of factor score estimates for evidence of nonlinearity. The second procedure is to use a mixture of linear structural equation models to approximate the underlying, potentially nonlinear function. Targeted simulations indicate that the first procedure is more efficient, but that the second procedure is less biased. The mixture modeling approach is recommended, particularly with medium to large samples.",0 +https://doi.org/10.1198/106186005x63185,Nonparametric Bayesian Modeling for Multivariate Ordinal Data,"This article proposes a probability model for k-dimensional ordinal outcomes, that is, it considers inference for data recorded in k-dimensional contingency tables with ordinal factors. The proposed approach is based on full posterior inference, assuming a flexible underlying prior probability model for the contingency table cell probabilities. We use a variation of the traditional multivariate probit model, with latent scores that determine the observed data. In our model, a mixture of normals prior replaces the usual single multivariate normal model for the latent variables. By augmenting the prior model to a mixture of normals we generalize inference in two important ways. First, we allow for varying local dependence structure across the contingency table. Second, inference in ordinal multivariate probit models is plagued by problems related to the choice and resampling of cutoffs defined for these latent variables. We show how the proposed mixture model approach entirely removes these problems. We ill...",0 +https://doi.org/10.1111/j.2517-6161.1995.tb02017.x,Fractional Bayes Factors for Model Comparison,"Bayesian comparison of models is achieved simply by calculation of posterior probabilities of the models themselves. However, there are difficulties with this approach when prior information about the parameters of the various models is weak. Partial Bayes factors offer a resoIution of the problem by setting aside part of the data as a training sampIe. The training sampIe is used to obtain an initiaI informative posterior distribution of the parameters in each model. Model comparison is then based on a Bayes factor calculated from the remaining data. Properties of partial Bayes factors are discussed, particularly in the context of weak prior information, and they are found to have advantages over other proposed methods of model comparison. A new variant of the partial Bayes factor, the fractional Bayes factor, is advocated on grounds of consistency, simplicity, robustness and coherence",0 +https://doi.org/10.1002/sim.2849,Estimating and testing interactions in linear regression models when explanatory variables are subject to classical measurement error,"Estimating and testing interactions in a linear regression model when normally distributed explanatory variables are subject to classical measurement error is complex, since the interaction term is a product of two variables and involves errors of more complex structure. Our aim is to develop simple methods, based on the method of moments (MM) and regression calibration (RC) that yield consistent estimators of the regression coefficients and their standard errors when the model includes one or more interactions. In contrast to previous work using structural equations models framework, our methods allow errors that are correlated with each other and can deal with measurements of relatively low reliability. Using simulations, we show that, under the normality assumptions, the RC method yields estimators with negligible bias and is superior to MM in both bias and variance. We also show that the RC method also yields the correct type I error rate of the test of the interaction. However, when the true covariates are not normally distributed, we recommend using MM. We provide an example relating homocysteine to serum folate and B12 levels.",0 +https://doi.org/10.1007/bf02293687,Simulating multivariate nonnormal distributions,"A method for generating multivariate nonnormal distributions with specified intercorrelations and marginal means, variances, skews, and kurtoses is proposed. As an example, the method is applied to the generation of simulated scores on three psychological tests administered to a single group of individuals. © 1983 The Psychometric Society.",0 +,Some latent trait models and their use in inferring an examinee's ability,,0 +https://doi.org/10.1007/s10802-011-9516-4,"Prospective Relations Among Fearful Temperament, Protective Parenting, and Social Withdrawal: The Role of Maternal Accuracy in a Moderated Mediation Framework","Early social withdrawal and protective parenting predict a host of negative outcomes, warranting examination of their development. Mothers' accurate anticipation of their toddlers' fearfulness may facilitate transactional relations between toddler fearful temperament and protective parenting, leading to these outcomes. Currently, we followed 93 toddlers (42 female; on average 24.76 months) and their mothers (9% underrepresented racial/ethnic backgrounds) over 3 years. We gathered laboratory observation of fearful temperament, maternal protective behavior, and maternal accuracy during toddlerhood and a multi-method assessment of children's social withdrawal and mothers' self-reported protective behavior at kindergarten entry. When mothers displayed higher accuracy, toddler fearful temperament significantly related to concurrent maternal protective behavior and indirectly predicted kindergarten social withdrawal and maternal protective behavior. These results highlight the important role of maternal accuracy in linking fearful temperament and protective parenting, which predict further social withdrawal and protection, and point to toddlerhood for efforts of prevention of anxiety-spectrum outcomes.",0 +https://doi.org/10.1093/biomet/93.1.179,A shrinkage estimator for spectral densities,"SUMMARY We propose a shrinkage estimator for spectral densities based on a multilevel normal hierarchical model. The first level captures the sampling variability via a likelihood con structed using the asymptotic properties of the periodogram. At the second level, the spectral density is shrunk towards a parametric time series model. To avoid selecting a particular parametric model for the second level, a third level is added which induces an estimator that averages over a class of parsimonious time series models. The estimator derived from this model, the model averaged shrinkage estimator, is consistent, is shown to be highly competitive with other spectral density estimators via simulations, and is computationally inexpensive.",0 +https://doi.org/10.1016/j.electstud.2014.06.008,Who supports minority rights in popular votes? Empirical evidence from Switzerland,"Recent research shows that well-educated citizens are more supportive of minority rights in direct democratic votes than people with less education. This article however suggests that educational effects on minority rights only emerge under certain conditions. A Bayesian multilevel analysis of 39 referendums and initiatives on minority rights in Switzerland (1981–2009) shows that educational effects are particularly strong when the rights of lesser-known cultural minorities are to be extended. They are entirely absent, however, when referenda address the curtailment of rights for well-known minority groups. • We study educational effects on minority rights in direct democratic votes. • We use individual data (surveys) from 39 referendums and initiatives on minority rights in Switzerland (1981–2009) and conduct a Bayesian multilevel analysis. • We show that the relationship between education and pro-minority voting behaviour is very strong when a ballot proposition aims at expanding the rights of out-group minorities (e.g. foreigners). • Educational effects are absent when referenda address the curtailment of rights for well-known minority groups (e.g. disabled persons).",0 +https://doi.org/10.1093/biomet/71.3.545,An analysis of correlation matrices: Equal correlations,"SUMMARY We study the large-sample joint distribution of Z, the -fp(p - 1) Fisher z-transforms of the elements in a p variable correlation matrix. Under the null hypothesis of equal population correlations the variance matrix of Z has just three projector matrices in its spectral decomposition. These define three mutually orthogonal invariant subspaces of sample space, or 'error strata' as they would be called in the analysis of variance. The squared lengths of the projections of the sample vector onto each of these subspaces, when divided by the stratum variance, provide a natural partition for the large-sample chi-squared test for equality of correlations. A linear model is given which provides a statistical interpretation for the error strata, and hence the components in the partition. As well as providing a simple test for equality of correlations, the procedure indicates how familiar techniques in the spirit of analysis of variance can be used to investigate correlation matrices.",0 +https://doi.org/10.1016/j.csda.2012.04.016,A Bayesian approach for generalized random coefficient structural equation models for longitudinal data with adjacent time effects,This paper proposes a generalized random coefficient structural equation model for analyzing longitudinal data by incorporating the correlated structure due to adjacent time effects and by allowing structural parameters to vary across individuals. The coregionalization for modeling multivariate spatial data is adopted to formulate the correlated structure between adjacent time points. A Bayesian approach coupled with the Gibbs sampler and the Metropolis-Hastings algorithm is developed to obtain the Bayesian estimates of unknown parameters and latent variables simultaneously. A simulation study and a real example related to an emotion study are presented to illustrate the newly developed methodology.,0 +https://doi.org/10.1348/000711008x374126,A Box-Cox normal model for response times,"The log-transform has been a convenient choice in response time modelling on test items. However, motivated by a dataset of the Medical College Admission Test where the lognormal model violated the normality assumption, the possibilities of the broader class of Box-Cox transformations for response time modelling are investigated. After an introduction and an outline of a broader framework for analysing responses and response times simultaneously, the performance of a Box-Cox normal model for describing response times is investigated using simulation studies and a real data example. A transformation-invariant implementation of the deviance information criterium (DIC) is developed that allows for comparing model fit between models with different transformation parameters. Showing an enhanced description of the shape of the response time distributions, its application in an educational measurement context is discussed at length.",0 +https://doi.org/10.7326/m14-0511,Pharmacologic Interventions for Painful Diabetic Neuropathy,"Multiple treatments for painful diabetic peripheral neuropathy are available.To evaluate the comparative effectiveness of oral and topical analgesics for diabetic neuropathy.Multiple electronic databases between January 2007 and April 2014, without language restriction.Parallel or crossover randomized, controlled trials that evaluated pharmacologic treatments for adults with painful diabetic peripheral neuropathy.Duplicate extraction of study data and assessment of risk of bias.65 randomized, controlled trials involving 12 632 patients evaluated 27 pharmacologic interventions. Approximately one half of these studies had high or unclear risk of bias. Nine head-to-head trials showed greater pain reduction associated with serotonin-norepinephrine reuptake inhibitors (SNRIs) than anticonvulsants (standardized mean difference [SMD], -0.34 [95% credible interval {CrI}, -0.63 to -0.05]) and with tricyclic antidepressants (TCAs) than topical capsaicin 0.075%. Network meta-analysis showed that SNRIs (SMD, -1.36 [CrI, -1.77 to -0.95]), topical capsaicin (SMD, -0.91 [CrI, -1.18 to -0.08]), TCAs (SMD, -0.78 [CrI, -1.24 to -0.33]), and anticonvulsants (SMD, -0.67 [CrI, -0.97 to -0.37]) were better than placebo for short-term pain control. Specifically, carbamazepine (SMD, -1.57 [CrI, -2.83 to -0.31]), venlafaxine (SMD, -1.53 [CrI, -2.41 to -0.65]), duloxetine (SMD, -1.33 [CrI, -1.82 to -0.86]), and amitriptyline (SMD, -0.72 [CrI, -1.35 to -0.08]) were more effective than placebo. Adverse effects included somnolence and dizziness with TCAs, SNRIs, and anticonvulsants; xerostomia with TCAs; and peripheral edema and burning sensation with pregabalin and capsaicin.Confidence in findings was limited because most evidence came from indirect comparisons of trials with short (≤3 months) follow-up and unclear or high risk of bias.Several medications may be effective for short-term management of painful diabetic neuropathy, although their comparative effectiveness is unclear.Mayo Foundation for Medical Education and Research.",0 +https://doi.org/10.1111/j.1744-6570.1982.tb02203.x,SYNTHETIC VALIDITY AND ITS APPLICATION TO THE UNIFORM GUIDELINES VALIDATION REQUIREMENTS,"The Uniform Guidelines for Employee Selection Procedures have served to create an urgent need for efficient validation methods that can be generalized to a class of occupations. The one method currently authorized for such a purpose by the Guidelines is synthetic validation. (The Guidelines erroneously describe the synthetic validity paradigm as construct validity.) Approaches to synthetic validity employed by Lawshe, Guion, McCormick, and Primoff are described. Their extent of conformance to the Guidelines validation requirements is noted. Primoff's J-Coefficient approach is recommended for two reasons; it meets the Guidelines requirements and under certain circumstances it permits the test user to estimate the traditional validity coefficient. An illustrated example of Primoff's method is presented.",0 +https://doi.org/10.1177/0956797610397956,Hierarchical Encoding in Visual Working Memory,"Influential models of visual working memory treat each item to be stored as an independent unit and assume that there are no interactions between items. However, real-world displays have structure that provides higher-order constraints on the items to be remembered. Even in the case of a display of simple colored circles, observers can compute statistics, such as mean circle size, to obtain an overall summary of the display. We examined the influence of such an ensemble statistic on visual working memory. We report evidence that the remembered size of each individual item in a display is biased toward the mean size of the set of items in the same color and the mean size of all items in the display. This suggests that visual working memory is constructive, encoding displays at multiple levels of abstraction and integrating across these levels, rather than maintaining a veridical representation of each item independently.",0 +https://doi.org/10.1515/jos-2016-0009,Bayesian Predictive Inference of a Proportion Under a Twofold Small-Area Model,"Abstract We extend the twofold small-area model of Stukel and Rao (1997; 1999) to accommodate binary data. An example is the Third International Mathematics and Science Study (TIMSS), in which pass-fail data for mathematics of students from US schools (clusters) are available at the third grade by regions and communities (small areas). We compare the finite population proportions of these small areas. We present a hierarchical Bayesian model in which the firststage binary responses have independent Bernoulli distributions, and each subsequent stage is modeled using a beta distribution, which is parameterized by its mean and a correlation coefficient. This twofold small-area model has an intracluster correlation at the first stage and an intercluster correlation at the second stage. The final-stage mean and all correlations are assumed to be noninformative independent random variables. We show how to infer the finite population proportion of each area. We have applied our models to synthetic TIMSS data to show that the twofold model is preferred over a onefold small-area model that ignores the clustering within areas. We further compare these models using a simulation study, which shows that the intracluster correlation is particularly important.",0 +,Sulla determinazione empirica di una legge di distribuzione,,0 +https://doi.org/10.1177/1073191111411658,How Much Power and Speed Is Measured in This Test?,"An old issue in psychological assessment is to what extent power and speed each are measured by a given intelligence test. Starting from accuracy and response time data, an approach based on posterior time limits (cut-offs of recorded response time) leads to three kinds of recoded data: time data (whether or not the response precedes the cut-off), time-accuracy data (whether or not a response is correct and precedes the cut-off), and accuracy data (as time-accuracy data, but coded as missing when not preceding the time cut-off). Each type of data can be modeled as binary responses. Speed and power are investigated through the effect of posterior time limits on two main aspects: (a) the latent variable that is measured: whether it is more power-related or more speed-related; (b) how well the latent variable (of whatever kind) is measured through the item(s). As empirical data, we use responses and response times for a verbal analogies test. The main findings are that, independent of the posterior time limit, basically the same latent speed trait was measured through the time data, and basically the same latent power trait was measured through the accuracy data, while for the time-accuracy data the nature of the latent trait moved from power to speed when the posterior time limit was reduced. It was also found that a reduction of the posterior time limit had no negative effect on the reliability of the latent trait measures (of whatever kind).",0 +https://doi.org/10.1111/1467-9868.00267,Improved small sample inference in the mixed linear model: Bartlett correction and adjusted likelihood,"Summary. The mixed linear model is a popular method for analysing unbalanced repeated measurement data. The classical statistical tests for parameters in this model are based on asymptotic theory that is unreliable in the small samples that are often encountered in practice. For testing a given fixed effect parameter with a small sample, we develop and investigate refined likelihood ratio (LR) tests. The refinements considered are the Bartlett correction and use of the Cox-Reid adjusted likelihood; these are examined separately and in combination. We illustrate the various LR tests on an actual data set and compare them in two simulation studies. The conventional LR test yields type I error rates that are higher than nominal. The adjusted LR test yields rates that are lower than nominal, with absolute accuracy similar to that of the conventional LR test in the first simulation study and better in the second. The Bartlett correction substantially improves the accuracy of the type I error rates with either the conventional or the adjusted LR test. In many cases, error rates that are very close to nominal are achieved with the refined methods.",0 +https://doi.org/10.1016/b978-0-12-742780-5.50011-1,Small N Justifies Rasch Model,The usual Birnbaum item response function requires the determination of three parameters for each item; the Rasch model requires only one. It would be useful to know how large the sample of examinees must be before it is worthwhile to use a two- or three-parameter item response model in preference to the Rasch model. The answer to this question depends on the purpose to be served. This chapter answers this question only for the two-parameter logistic model and only for one very limited situation. It points out the problem to indicate a method of solution and to provide some numerical results indicating the sample size required when there is no guessing.,0 +https://doi.org/10.1037/a0038280,Hindrances are not threats: Advancing the multidimensionality of work stress.,"The challenge-hindrance framework has proved useful for explaining inconsistencies in relationships between work stressors and important outcomes. By introducing the distinction between threat and hindrance to this framework, we capture the potential for personal harm or loss (threat) associated with stressors, as distinct from the potential to block goal attainment (hindrance) or promote gain (challenge). In Study 1, survey data were collected from 609 retail workers, 220 of whom responded 6 months later. The results supported a 3-factor threat-hindrance-challenge stressor structure and showed that threat stressors are associated with increased psychological distress and emotional exhaustion, and reduced dedication, whereas hindrance stressors undermine dedication but may not be related to distress or exhaustion with threats included in the model. Study 2 utilized a diary study design, with data collected from 207 workers over 3 workdays. Findings revealed that the threat, hindrance, and challenge appraisals of individual workers are statistically distinct, and associated with stressors and well-being as anticipated: threats with role conflict and anxiety, hindrances with organizational constraints and fatigue, and challenges with skill demands and enthusiasm. Overall, moving to a 3-dimensional challenge-hindrance-threat framework for stressors and stress appraisals will support a more accurate picture regarding the nature, processes, and effects of stressors on individuals and organizations, and ensure prevention efforts are not misguided.",0 +https://doi.org/10.1207/s15327906mbr3604_03,Fitting Item Response Theory Models to Two Personality Inventories: Issues and Insights,"The present study compared the fit of several IRT models to two personality assessment instruments. Data from 13,059 individuals responding to the US-English version of the Fifth Edition of the Sixteen Personality Factor Questionnaire (16PF) and 1,770 individuals responding to Goldberg's 50 item Big Five Personality measure were analyzed. Various issues pertaining to the fit of the IRT models to personality data were considered. We examined two of the most popular parametric models designed for dichotomously scored items (i.e., the two- and three-parameter logistic models) and a parametric model for polytomous items (Samejima's graded response model). Also examined were Levine's nonparametric maximum likelihood formula scoring models for dichotomous and polytomous data, which were previously found to provide good fits to several cognitive ability tests (Drasgow, Levine, Tsien, Williams, & Mead, 1995). The two- and three-parameter logistic models fit some scales reasonably well but not others; the graded response model generally did not fit well. The nonparametric formula scoring models provided the best fit of the models considered. Several implications of these findings for personality measurement and personnel selection were described.",0 +https://doi.org/10.1007/bf02294761,Specifying optimum examinees for item parameter estimation in item response theory,,0 +https://doi.org/10.1109/cvpr.2005.16,A Bayesian Hierarchical Model for Learning Natural Scene Categories,"We propose a novel approach to learn and recognize natural scene categories. Unlike previous work, it does not require experts to annotate the training set. We represent the image of a scene by a collection of local regions, denoted as codewords obtained by unsupervised learning. Each region is represented as part of a theme. In previous work, such themes were learnt from hand-annotations of experts, while our method learns the theme distributions as well as the codewords distribution over the themes without supervision. We report satisfactory categorization performances on a large set of 13 categories of complex scenes.",0 +https://doi.org/10.1371/journal.pone.0074144,"Weber’s Law, the Magnitude Effect and Discrimination of Sugar Concentrations in Nectar-Feeding Animals","Weber's law quantifies the perception of difference between stimuli. For instance, it can explain why we are less likely to detect the removal of three nuts from a bowl if the bowl is full than if it is nearly empty. This is an example of the magnitude effect - the phenomenon that the subjective perception of a linear difference between a pair of stimuli progressively diminishes when the average magnitude of the stimuli increases. Although discrimination performances of both human and animal subjects in various sensory modalities exhibit the magnitude effect, results sometimes systematically deviate from the quantitative predictions based on Weber's law. An attempt to reformulate the law to better fit data from acoustic discrimination tasks has been dubbed the ""near-miss to Weber's law"". Here, we tested the gustatory discrimination performance of nectar-feeding bats (Glossophaga soricina), in order to investigate whether the original version of Weber's law accurately predicts choice behavior in a two-alternative forced choice task. As expected, bats either preferred the sweeter of the two options or showed no preference. In 4 out of 6 bats the near-miss to Weber's law provided a better fit and Weber's law underestimated the magnitude effect. In order to test the generality of this observation in nectar-feeders, we reviewed previously published data on bats, hummingbirds, honeybees, and bumblebees. In all groups of animals the near-miss to Weber's law provided better fits than Weber's law. Furthermore, whereas the magnitude effect was stronger than predicted by Weber's law in vertebrates, it was weaker than predicted in insects. Thus nectar-feeding vertebrates and insects seem to differ in how their choice behavior changes as sugar concentration is increased. We discuss the ecological and evolutionary implications of the observed patterns of sugar concentration discrimination.",0 +https://doi.org/10.1123/jsep.24.1.3,A Meta-Analytic Review of the Theories of Reasoned Action and Planned Behavior in Physical Activity: Predictive Validity and the Contribution of Additional Variables,"The aim of the present study was to examine relations between behavior, intentions, attitudes, subjective norms, perceived behavioral control, self-efficacy, and past behavior across studies using the Theories of Reasoned Action (TRA) and Planned Behavior (TPB) in a physical activity context. Meta-analytic techniques were used to correct the correlations between the TRA/TPB constructs for statistical artifacts across 72 studies, and path analyses were conducted to examine the pattern of relationships among the variables. Results demonstrated that the TRA and TPB both exhibited good fit with the corrected correlation matrices, but the TPB accounted for more variance in physical activity intentions and behavior. In addition, self-efficacy explained unique variance in intention, and the inclusion of past behavior in the model resulted in the attenuation of the intention-behavior, attitude-intention, self-efficacy-intention, and self-efficacy-behavior relationships. There was some evidence that the study relationships were moderated by attitude-intention strength and age, but there was a lack of homogeneity in the moderator groups. It was concluded that the major relationships of the TRA/TPB were supported in this quantitative integration of the physical activity literature, and the inclusion of self-efficacy and past behavior are important additions to the model.",0 +https://doi.org/10.1002/sim.3747,Bayesian methods of analysis for cluster randomized trials with count outcome data,"Bayesian approaches to inference in cluster randomized trials have been investigated for normally distributed and binary outcome measures. However, relatively little attention has been paid to outcome measures which are counts of events. We discuss an extension of previously published Bayesian hierarchical models to count data, which usually can be assumed to be distributed according to a Poisson distribution. We develop two models, one based on the traditional rate ratio, and one based on the rate difference which may often be more intuitively interpreted for clinical trials, and is needed for economic evaluation of interventions. We examine the relationship between the intracluster correlation coefficient (ICC) and the between-cluster variance for each of these two models. In practice, this allows one to use the previously published evidence on ICCs to derive an informative prior distribution which can then be used to increase the precision of the posterior distribution of the ICC. We demonstrate our models using a previously published trial assessing the effectiveness of an educational intervention and a prior distribution previously derived. We assess the robustness of the posterior distribution for effectiveness to departures from a normal distribution of the random effects.",0 +https://doi.org/10.1177/014662169101500205,The Measurement of Latent Traits by Proximity Items,"A probabilistic parallelogram model for the mea surement of latent traits by proximity items (the PARELLA model) is introduced. This model assumes that the responses of persons to items result from proximity relations: the smaller the distance between person and item, the larger the probability that the person will agree with the content of the item. The model is unidimensional and assigns locations to items and persons on the latent trait. The parameters of the PARELLA model are estimated by marginal maximum likelihood and expectation maximization. The efficiency of the estimation procedure is illustrated, a diagnostic for the fit of items to the model is presented, and the PARELLA model is used for the analysis of three empirical datasets.",0 +https://doi.org/10.1371/journal.pone.0074815,Four Theorems on the Psychometric Function,"In a 2-alternative forced-choice (2AFC) discrimination task, observers choose which of two stimuli has the higher value. The psychometric function for this task gives the probability of a correct response for a given stimulus difference, Δx. This paper proves four theorems about the psychometric function. Assuming the observer applies a transducer and adds noise, Theorem 1 derives a convenient general expression for the psychometric function. Discrimination data are often fitted with a Weibull function. Theorem 2 proves that the Weibull ""slope"" parameter, β, can be approximated by β(Noise) x β(Transducer), where β(Noise) is the β of the Weibull function that fits best to the cumulative noise distribution, and β(Transducer) depends on the transducer. We derive general expressions for β(Noise) and β(Transducer), from which we derive expressions for specific cases. One case that follows naturally from our general analysis is Pelli's finding that, when d' ∝ (Δx)(b), β ≈ β(Noise) x b. We also consider two limiting cases. Theorem 3 proves that, as sensitivity improves, 2AFC performance will usually approach that for a linear transducer, whatever the actual transducer; we show that this does not apply at signal levels where the transducer gradient is zero, which explains why it does not apply to contrast detection. Theorem 4 proves that, when the exponent of a power-function transducer approaches zero, 2AFC performance approaches that of a logarithmic transducer. We show that the power-function exponents of 0.4-0.5 fitted to suprathreshold contrast discrimination data are close enough to zero for the fitted psychometric function to be practically indistinguishable from that of a log transducer. Finally, Weibull β reflects the shape of the noise distribution, and we used our results to assess the recent claim that internal noise has higher kurtosis than a Gaussian. Our analysis of β for contrast discrimination suggests that, if internal noise is stimulus-independent, it has lower kurtosis than a Gaussian.",0 +https://doi.org/10.1007/978-3-642-29047-3_7,Cultural Consensus Theory: Aggregating Signed Graphs under a Balance Constraint,"Cultural Consensus Theory (CCT) consists of cognitive models for aggregating the responses of experts to test questions about some domain of their shared cultural knowledge. This paper proposes a new CCT model for a situation where experts judge the ties in a complete signed graph. New to CCT is that the model imposes a side constraint on the aggregation process that requires that the consensus signed graph satisfy the social network property of structural balance. Balanced signed graphs require that the nodes can be partitioned into two sets with positive ties between nodes in the same set and negative ties between nodes in different sets. While the balance constraint is imposed on the consensus aggregation, it is not assumed that each expert's responses satisfy balance because they may be error-prone or biased. The model is presented in terms of signal detection assumptions that allow heterogeneity in expert ability and item difficulty. Bayesian inference of the model is developed using a specially designed Markov Chain Monte Carlo sampler. It is shown that the sampler can recover parameters from simulated data, and then the model is applied to interpret experimental data. Of particular interest is that the model aggregation reveals a single consensus balanced signed graph with a high posteriori probability despite the fact that none of the experts' responses satisfy the balance constraint.",0 +https://doi.org/10.1177/0146621602026003007,Recovery of Item Parameters in the Nominal Response Model: A Comparison of Marginal Maximum Likelihood Estimation and Markov Chain Monte Carlo Estimation,"Markov chain Monte Carlo (MCMC) methods, such as Gibbs sampling, present an alternative to marginal maximum likelihood (MML) estimation, which offers some promise for parameter estimation particularly with complex models, in small sample situations, and for other applications where MML algorithms have not been established. MCMC circumvents the problems associated with implementing an estimation algorithm for complex, multidimensional probability distributions by sampling the parameters from each of the one-dimensional conditional posterior distributions at each stage of the Markov chain. In this article, the authors compared the quality of item parameter estimates for MML and MCMC with one type of complex item response theory model, the nominal response model. The quality of item parameter recovery was nearly identical for both MML and MCMC. Both methods tended to produce good estimates, even for short tests and relatively small sample sizes. Parameter recovery was best for items of moderate dif.culty (i.e., items matched to the latent trait distribution); recovery was worst for items that were extremely easy or dif.cult. The quality of item parameter recovery improved as test length increased from 10 to 30 items, but did not change as test length increased from 20 to 30 items. MCMC estimation takes substantially longer but appears to be a good surrogate for MML for those situations for which an MML algorithm has not been developed.",0 +https://doi.org/10.1207/s15327906mbr3103_6,Mixed-effects Models in the Study of Individual Differences with Repeated Measures Data,Nonlinear mixed-effects models are used to describe each person's set of scores from a longitudinal design or repeated measures study by a function that includes an overall group effect plus an effect for the individual. The model is ideal for many kinds of behavioral data. Some characteristics of mixed models are reviewed in this article and illustrated by a series of examples.,0 +https://doi.org/10.1016/j.jneumeth.2010.08.025,A novel animal model of graded neuropathic pain: Utility to investigate mechanisms of population heterogeneity,"The mechanisms underlying neuropathic pain are not well understood, resulting in unsatisfactory treatment outcomes for many patients. Animal models underpin much of the current understanding of pain mechanisms due to their perceived ability to mimic pain hypersensitivities; however, are limited by their binomial approach (pain vs. control), which does not reflect the clinical heterogeneity in nociceptive hypersensitivity. We modified the chronic constriction injury model by varying the number of sciatic nerve chromic gut sutures. Each Sprague Dawley rat received 4 pieces of chromic gut to control for the inflammatory challenge posed by the gut. Treatment groups were neuronal sutures (N), subcutaneous sutures (S) N0S0, N0S4, N1S3, N2S2 and N4S0. At postoperative (PO) day 29, there was a 'dose-response' relationship between the number of perineural sutures and von Frey threshold (N0S40.9) and associated in the dorsolateral funiculus (DLF; P=0.10, r(2)>0.8) at PO day 14. Astrocyte GFAP expression was positively associated with graded allodynia in the ipsilateral dorsal horn (P=0.18, r(2)>0.6) and ipsilateral DLF (P<0.05, r(2)>0.9). DLF glial activation may represent a contributor to contralateral pain. Our novel graded model has a dynamic range, allowing sensitive detection of interactions and subtle influences on neuropathic pain processing.",0 +https://doi.org/10.1016/j.foodqual.2015.05.005,Modeling target group heterogeneity in experimental consumer studies,"Abstract Acceptance of a product by a consumer may result from a convoluted interplay between product attributes and individual characteristics of that consumer. Different methods that systematically combine product properties with consumer groups segmented on such characteristics have provided unprecedented insight, but ignore heterogeneity in acceptance within each consumer group. Although such knowledge is invaluable for targeted marketing, dedicated methods for consumer group heterogeneity are lacking. The authors aim to fill this gap by the Individual Differences (InD) method, which models differences between consumers within the same target group. The method scores the ‘diffusion’ within each group, shows how much each consumer contributes to that, and relates this information to product properties. Thereby also novel groups may be discovered, with attributes not covered in the consumer segmentation. The illustrative consumer study on apple juice reveals how young women differ in their price-consciousness and their acceptance on specific preparation technologies more than older women. Although men exhibit heterogeneity on the same product attributes, their mutual variability is considerably lower and they thereby form more homogeneous target groups.",0 +https://doi.org/10.1111/jsbm.12067,Antecedents of Entrepreneurial Intention among Laid-Off Individuals: A Cognitive Appraisal Approach,This study contributes to our understanding of why laid‐off individuals might explore entrepreneurial careers. Findings among 838 laid‐off individuals suggest that financial strain is associated wi...,0 +https://doi.org/10.1198/073500103288619449,An Empirical Bayes Procedure for Improving Individual-Level Estimates and Predictions From Finite Mixtures of Multinomial Logit Models,"Unobserved heterogeneity in random utility choice models can be dealt with by specifying either a multinomial or a normal distribution of the coefficients, leading to finite mixture logit and mixed logit models. Focusing on the former, we show that individual-level estimates and predictions of finite mixtures estimated by maximizing the likelihood function can be improved through integration over the estimation error of the hyperparameters, using an empirical Bayes approach. We investigate the conjecture that this approach is more robust against departures of the underlying assumptions of the finite mixture model in two Monte Carlo studies. We show that our approach improves the performance of the finite mixture model in representing individual-level parameters and producing hold-out forecasts. We illustrate with two examples that our approach may offer advantages in empirical applications involving the analysis of heterogeneous choice data.",0 +https://doi.org/10.1348/000711007x255336,MCMC estimation for the p2 network regression model with crossed random effects,"The p2 model is a statistical model for the analysis of binary relational data with covariates, as occur in social network studies. It can be characterized as a multinomial regression model with crossed random effects that reflect actor heterogeneity and dependence between the ties from and to the same actor in the network. Three Markov chain Monte Carlo (MCMC) estimation methods for the p2 model are presented to improve iterative generalized least squares (IGLS) estimation developed earlier, two of which use random walk proposals. The third method, an independence chain sampler, and one of the random walk algorithms use normal approximations of the binary network data to generate proposals in the MCMC algorithms. A large-scale simulation study compares MCMC estimates with IGLS estimates for networks with 20 and 40 actors. It was found that the IGLS estimates have a smaller variance but are severely biased, while the MCMC estimates have a larger variance with a small bias. For networks with 20 actors, mean squared errors are generally comparable or smaller for the IGLS estimates. For networks with 40 actors, mean squared errors are the smallest for the MCMC estimates. Coverage rates of confidence intervals are good for the MCMC estimates but not for the IGLS estimates.",0 +https://doi.org/10.1002/env.873,Space—time zero-inflated count models of Harbor seals,"Environmental data are spatial, temporal, and often come with many zeros. In this paper, we included space-time random effects in zero-inflated Poisson (ZIP) and ‘hurdle’ models to investigate haulout patterns of harbor seals on glacial ice. The data consisted of counts, for 18 dates on a lattice grid of samples, of harbor seals hauled out on glacial ice in Disenchantment Bay, near Yakutat, Alaska. A hurdle model is similar to a ZIP model except it does not mix zeros from the binary and count processes. Both models can be used for zero-inflated data, and we compared space-time ZIP and hurdle models in a Bayesian hierarchical model. Space-time ZIP and hurdle models were constructed by using spatial conditional autoregressive (CAR) models and temporal first-order autoregressive (AR(1)) models as random effects in ZIP and hurdle regression models. We created maps of smoothed predictions for harbor seal counts based on ice density, other covariates, and spatio-temporal random effects. For both models predictions around the edges appeared to be positively biased. The linex loss function is an asymmetric loss function that penalizes overprediction more than underprediction, and we used it to correct for prediction bias to get the best map for space-time ZIP and hurdle models. Published in 2007 by John Wiley & Sons, Ltd.",0 +https://doi.org/10.1016/j.conb.2010.03.005,Discrete capacity limits in visual working memory,"The amount of information we can actively maintain ‘in mind’ is very limited. This capacity limitation, known as working memory (WM) capacity, has been of great interest because of its wide scope influence on the variety of intellectual abilities. Recently, there has been an ongoing debate about how this capacity should be best characterized. One viewpoint argues that WM capacity is allocated in a discrete fashion with an upper limit of three to four representations. An alternative viewpoint argues that the capacity can be allocated in a continuous fashion with no upper limit in the number of representations. In this article, we will review recent neurobiological and behavioral evidence that has helped shape the debate regarding one of the more central mechanisms in cognitive neuroscience.",0 +https://doi.org/10.1111/j.1745-3984.2005.00007,A Mixture Model Analysis of Differential Item Functioning,"Once a differential item functioning (DIF) item has been identified, little is known about the examinees for whom the item functions differentially. This is because DIF focuses on manifest group characteristics that are associated with it, but do not ex plain why examinees respond differentially to items. We first analyze item response patterns for gender DIF and then illustrate, through the use of a mixture item re sponse theory (IRT) model, how the manifest characteristic associated with DIF of ten has a very weak relationship with the latent groups actually being advantaged or disadvantaged by the item(s). Next, we propose an alternative approach to DIF as sessment that first uses an exploratory mixture model analysis to define the primary dimension(s) that contribute to DIF, and secondly studies examinee characteristics associated with those dimensions in order to understand the cause(s) of DIF. Com parison of academic characteristics of these examinees across classes reveals some clear differences in manifest characteristics between groups. Differential item functioning (DIF) can be attributed to the presence of nuisance dimensions intruding on the ability intended to be measured (Ackerman, 1992). DIF is typically investigated by examining the relationship between some manifest ex aminee characteristic, such as gender or ethnic group membership, with differential performance on the item. Unfortunately, this strategy is not ideal for understanding the root causes of DIF. One problem with this approach is that it focuses on the examinee characteristic of interest, not on the dimension causing the DIF. Conse quently, when differences are found, it is not so readily apparent who is primarily being advantaged or disadvantaged by the DIF items. We illustrate the limitations of this strategy by first using a standard DIF detection approach to identify DIF items on the basis of a manifest characteristic, in this case, gender. Results of the DIF analysis are used to define a two-group mixture IRT model with groups defined by gender, and only gender DIF items are allowed to assume different parameters across groups. We proceed next by assuming that the actual respondents advantaged or disadvan taged by the items may be better regarded as latent classes in the data. Holding the estimates of the multigroup IRT model as fixed, we classify examinees (irrespective of gender) into the group for which their response patterns are most similar. We then demonstrate that membership in these latent classes may be only slightly associated with gender. In the second study, we illustrate an alternative approach. The strategy first identifies the latent groups of examinees for whom DIF is greatest. We begin by fitting a mixture item response theory (IRT) model to the data so as to identify content classes of examinees for which the test performs most differentially. Then",0 +https://doi.org/10.1002/hec.1141,Predicting costs over time using Bayesian Markov chain Monte Carlo methods: an application to early inflammatory polyarthritis,"This article focuses on the modelling and prediction of costs due to disease accrued over time, to inform the planning of future services and budgets. It is well documented that the modelling of cost data is often problematic due to the distribution of such data; for example, strongly right skewed with a significant percentage of zero-cost observations. An additional problem associated with modelling costs over time is that cost observations measured on the same individual at different time points will usually be correlated. In this study we compare the performance of four different multilevel/hierarchical models (which allow for both the within-subject and between-subject variability) for analysing healthcare costs in a cohort of individuals with early inflammatory polyarthritis (IP) who were followed-up annually over a 5-year time period from 1990/1991. The hierarchical models fitted included linear regression models and two-part models with log-transformed costs, and two-part model with gamma regression and a log link. The cohort was split into a learning sample, to fit the different models, and a test sample to assess the predictive ability of these models. To obtain predicted costs on the original cost scale (rather than the log-cost scale) two different retransformation factors were applied. All analyses were carried out using Bayesian Markov chain Monte Carlo (MCMC) simulation methods.",0 +https://doi.org/10.1214/aos/1176325622,Posterior Predictive $p$-Values,"Extending work of Rubin, this paper explores a Bayesian counterpart of the classical $p$-value, namely, a tail-area probability of a ""test statistic"" under a null hypothesis. The Bayesian formulation, using posterior predictive replications of the data, allows a ""test statistic"" to depend on both data and unknown (nuisance) parameters and thus permits a direct measure of the discrepancy between sample and population quantities. The tail-area probability for a ""test statistic"" is then found under the joint posterior distribution of replicate data and the (nuisance) parameters, both conditional on the null hypothesis. This posterior predictive $p$-value can also be viewed as the posterior mean of a classical $p$-value, averaging over the posterior distribution of (nuisance) parameters under the null hypothesis, and thus it provides one general method for dealing with nuisance parameters. Two classical examples, including the Behrens-Fisher problem, are used to illustrate the posterior predictive $p$-value and some of its interesting properties, which also reveal a new (Bayesian) interpretation for some classical $p$-values. An application to multiple-imputation inference is also presented. A frequency evaluation shows that, in general, if the replication is defined by new (nuisance) parameters and new data, then the Type I frequentist error of an $\alpha$-level posterior predictive test is often close to but less than $\alpha$ and will never exceed $2\alpha$.",0 +https://doi.org/10.2307/2986113,Informative Drop-Out in Longitudinal Data Analysis,"A model is proposed for continuous longitudinal data with non-ignorable or informative drop-out (ID). The model combines a multivariate linear model for the underlying response with a logistic regression model for the drop-out process. The latter incorporates dependence of the probability of drop-out on unobserved, or missing, observations. Parameters in the model are estimated by using maximum likelihood (ML) and inferences drawn through conventional likelihood procedures. In particular, likelihood ratio tests can be used to assess the informativeness of the drop-out process through comparison of the full model with reduced models corresponding to random drop-out (RD) and completely random processes",0 +https://doi.org/10.1017/s0003055409990177,"Legislative Involvement in Parliamentary Systems: Opportunities, Conflict, and Institutional Constraints","In parliamentary systems, the need to preserve the political agreement that sustains the executive often motivates legislative involvement in policymaking. Institutional arrangements regulating executive–legislative relations and ministerial autonomy also structure parliamentary participation. However, empirical evidence of these effects remains limited to a few policies and countries. European Union legislation provides the opportunity to test expectations about legislative involvement for different types of measure across various institutional arrangements, across multiple policy areas, and across time. In this article, we investigate legislative involvement in the transposition of 724 directives in 15 member states from 1978 to 2004. Our results confirm that involvement increases as conflict between the responsible minister and her coalition partners intensifies. The discretionary scope embedded in the directive further inflates this effect. Additionally, parliamentary involvement decreases as the government's institutional advantage over the legislature increases, especially if intracoalitional conflict deepens.",0 +https://doi.org/10.1080/00273171.2010.498290,Quantifying and Testing Indirect Effects in Simple Mediation Models When the Constituent Paths Are Nonlinear,Most treatments of indirect effects and mediation in the statistical methods literature and the corresponding methods used by behavioral scientists have assumed linear relationships between variables in the causal system. Here we describe and extend a method first introduced by Stolzenberg (1980) for estimating indirect effects in models of mediators and outcomes that are nonlinear functions but linear in their parameters. We introduce the concept of the instantaneous indirect effect of X on Y through M and illustrate its computation and describe a bootstrapping procedure for inference. Mplus code as well as SPSS and SAS macros are provided to facilitate the adoption of this approach and ease the computational burden on the researcher.,0 +https://doi.org/10.1177/01466216000241001,A General Item Response Theory Model for Unfolding Unidimensional Polytomous Responses,"The generalized graded unfolding model (GGUM) is developed. This model allows for either binary or graded responses and generalizes previous item response models for unfolding in two useful ways. First, it implements a discrimination parameter that varies across items, which allows items to discriminate among respondents in different ways. Second, the GGUM permits response category threshold parameters to vary across items. Amarginal maximum likelihood algorithm is implemented to estimate GGUM item parameters, whereas person parameters are derived from an expected a posteriori technique. The applicability of the GGUM to common attitude testing situations is illustrated with real data on student attitudes toward abortion.",0 +https://doi.org/10.1002/bimj.201100134,The empirical coverage of confidence intervals: Point estimates and confidence intervals for confidence levels,"Many confidence intervals calculated in practice are potentially not exact, either because the requirements for the interval estimator to be exact are known to be violated, or because the (exact) distribution of the data is unknown. If a confidence interval is approximate, the crucial question is how well its true coverage probability approximates its intended coverage probability. In this paper we propose to use the bootstrap to calculate an empirical estimate for the (true) coverage probability of a confidence interval. In the first instance, the empirical coverage can be used to assess whether a given type of confidence interval is adequate for the data at hand. More generally, when planning the statistical analysis of future trials based on existing data pools, the empirical coverage can be used to study the coverage properties of confidence intervals as a function of type of data, sample size, and analysis scale, and thus inform the statistical analysis plan for the future trial. In this sense, the paper proposes an alternative to the problematic pretest of the data for normality, followed by selection of the analysis method based on the results of the pretest. We apply the methodology to a data pool of bioequivalence studies, and in the selection of covariance patterns for repeated measures data.",0 +https://doi.org/10.1177/0010414007313113,The Sensitive Left and the Impervious Right,"Recent years have seen increased attention to integrating what we know about individual citizens with what we know about macro-level contexts that vary across countries. This article discusses the growing literature on how people's interpretations, opinions, and actions are shaped by variable contextual parameters and provides a novel substantive application. Using surveys conducted in 20 European democracies, the authors examine the effect of income inequality on people's attitudes about the functioning of the political system and trust in public institutions. They find that citizens in countries with higher levels of income inequality express more negative attitudes toward public institutions. Moreover, they show that the negative effect of inequality on attitudes toward the political system is particularly powerful among individuals on the political left. In contrast, inequality's negative effect on people's faith in the system is muted among those on the right.",0 +https://doi.org/10.1037/1082-989x.9.3.275,Structural Equation Models of Latent Interactions: Evaluation of Alternative Estimation Strategies and Indicator Construction.,"Interactions between (multiple indicator) latent variables are rarely used because of implementation complexity and competing strategies. Based on 4 simulation studies, the traditional constrained approach performed more poorly than did 3 new approaches--unconstrained, generalized appended product indicator, and quasi-maximum-likelihood (QML). The authors' new unconstrained approach was easiest to apply. All 4 approaches were relatively unbiased for normally distributed indicators, but the constrained and QML approaches were more biased for nonnormal data; the size and direction of the bias varied with the distribution but not with the sample size. QML had more power, but this advantage was qualified by consistently higher Type I error rates. The authors also compared general strategies for defining product indicators to represent the latent interaction factor.",0 +https://doi.org/10.1080/00031305.2014.955211,Are Nonprofit Antipoverty Organizations Located Where They Are Needed? A Spatial Analysis of the Greater Hartford Region,"The geographic distribution of nonprofit antipoverty organizations has important implications for economic development, social services, public health, and policy efforts. With counts of antipoverty nonprofits at the census tract level in Greater Hartford, Connecticut, we examine whether these organizations are located in areas with high levels of poverty with a spatial zero-inflated-Poisson model. Covariates that measure need, resources, urban structure, and demographic characteristics are incorporated into both the zero-inflation component and the Poisson component of the model. Variation not explained by the covariates is captured by the combination of a spatial random effect and an unstructured random effect. Statistical inferences are done within the Bayesian framework. Model comparison with the conditional predictive ordinate suggests that the random effects and the zero-inflation are both important components in fitting the data. All three need measures—proportion of people below the poverty line, ...",0 +https://doi.org/10.1080/13691058.2014.989265,Prevalence and correlates of young people's sexual aggression perpetration and victimisation in 10 European countries: a multi-level analysis,"Data are presented on young people's sexual victimisation and perpetration from 10 European countries (Austria, Belgium, Cyprus, Greece, Lithuania, the Netherlands, Poland, Portugal, Slovakia and Spain) using a shared measurement tool (N = 3480 participants, aged between 18 and 27 years). Between 19.7 and 52.2% of female and between 10.1 and 55.8% of male respondents reported having experienced at least one incident of sexual victimisation since the age of consent. In two countries, victimisation rates were significantly higher for men than for women. Between 5.5 and 48.7% of male and 2.6 and 14.8% of female participants reported having engaged in a least one act of sexual aggression perpetration, with higher rates for men than for women in all countries. Victimisation rates correlated negatively with sexual assertiveness and positively with alcohol use in sexual encounters. Perpetration rates correlated positively with attitudes condoning physical dating violence and with alcohol use in men, and negatively with sexual assertiveness in women. At the country level, lower gender equality in economic power and in the work domain was related to higher male perpetration rates. Lower gender equality in political power and higher sexual assertiveness in women relative to men were linked to higher male victimisation rates.",0 +https://doi.org/10.1007/bf02221049,Growth curves of deviant behavior in early adolescence: A multilevel analysis,"Multilevel growth curve models provide a means of analyzing individual differences in the growth of deviance, allow a number of theories to be integrated in a single model, and can help to unify research on deviant/delinquent/criminal careers at different stages of the life cycle. Building on the distinction between ""population heterogeneity"" and ""state dependence"" as alternative explanations of persistent individual differences in deviance (Heckman, 1981; Nagin and Paternoster, 1991), we show that models with two levels can be used to represent and analyze a variety of criminological theories. The first level (level 1) uses repeated measurements on individuals to estimate individual-level growth curves. The second level treats the level 1 growth curve parameters (e.g., slope, intercept) as outcome variables and uses time-invariant factors to explain variation in these parameters across individuals. We illustrate this approach by estimating a model of growth in deviance drawn from Gottfredson and Hirschi's deviant propensity theory. An innovative feature is the assumption that adolescents' expected growth curves of deviance follow a classical Pearl-Verhulst logistic growth model (Pearl, 1930). The results suggest that five risk factors - parental psychiatric problems, lack of parental support, living arrangements with zero or one parent in residence, low family income, and male gender - have strongly positive effects on deviant propensity. For example, adolescents with no supportive parents, and no other risk factors, have expected asymptotic levels of deviance (peak levels attained at about age 18) that are about twice as high as those of adolescents with no risk factors. Yet more than two-thirds of the individual-level variability in growth curves is unexplained by the five risk factors. This unobserved heterogeneity would remain hidden in analyses using conventional structural equations models and the same explanatory variables. © 1997 Plenum Publishing Corporation.",0 +https://doi.org/10.1002/wrcr.20445,Accounting for seasonal dependence in hydrological model errors and prediction uncertainty,"[1] Streamflows often vary strongly with season, and this leads to seasonal dependence in hydrological model errors and prediction uncertainty. In this study, we introduce three error models to describe errors from a monthly rainfall-runoff model: a seasonally invariant model, a seasonally variant model, and a hierarchical error model. The seasonally variant model and the hierarchical error model use month-specific parameters to explicitly account for seasonal dependence, while the seasonally invariant model does not. A Bayesian prior is used in the hierarchical error model to account for potential variation and connection among model parameters of different months. The three error models are applied to predicting streamflows for five Australian catchments and are compared by various performance scores and diagnostic plots. The seasonally variant model and the hierarchical model both perform substantially better than the seasonally invariant model. From a cross-validation analysis, the hierarchical error model provides both the most accurate prediction mean and the most reliable prediction uncertainty distribution in most situations. The use of the prior to constrain the model parameters in the hierarchical model produces more robust parameter estimation than the other two models.",0 +https://doi.org/10.1002/0470036486,Longitudinal Data Analysis,"Longitudinal data analysis for biomedical and behavioral sciences. This innovative book sets forth and describes methods for the analysis of longitudinaldata, emphasizing applications to problems in the biomedical and behavioral sciences. Reflecting the growing importance and use of longitudinal data across many areas of research, the text is designed to help users of statistics better analyze and understand this type of data. Much of the material from the book grew out of a course taught by Dr. Hedeker on longitudinal data analysis. The material is, therefore, thoroughly classroom tested and includes a number of features designed to help readers better understand and apply the material. Statistical procedures featured within the text include: Repeated measures analysis of variance; Multivariate analysis of variance for repeated measures; Random-effects regression models (RRM); Covariance-pattern models; Generalized-estimating equations (GEE) models; Generalizations of RRM and GEE for categorical outcomes. Practical in their approach, the authors emphasize the applications of the methods, using real-world examples for illustration. Some syntax examples are provided, although the authors do not generally focus on software in this book. Several datasets and computer syntax examples are posted on this title's companion Web site. The authors intend to keep the syntax examples current as new versions of the software programs emerge. This text is designed for both undergraduate and graduate courses in longitudinal data analysis. Instructors can take advantage of overheads and additional course materials available online for adopters. Applied statisticians in biomedicine and the social sciences can also use the book as a convenient reference. © 2006 by John Wiley & Sons, Inc. All rights reserved.",0 +https://doi.org/10.1111/j.2044-8317.1992.tb00975.x,A comparison of some methodologies for the factor analysis of non-normal Likert variables: A note on the size of the model,"This paper expands on a recent study by Muthen & Kaplan (1985) by examining the impact of non-normal Likert variables on testing and estimation in factor analysis for models of various size. Normal theory GLS and the recently developed ADF estimator are compared for six cases of non-normality, two sample sizes, and four models of increasing size in a Monte Carlo framework with a large number of replications. Results show that GLS and ADF chi-square tests are increasingly sensitive to non-normality when the size of the model increases. No parameter estimate bias was observed for GLS and only slight parameter bias was found for ADF. A downward bias in estimated standard errors was found for GLS which remains constant across model size. For ADF, a downward bias in estimated standard errors was also found which became increasingly worse with the size of the model.",0 +https://doi.org/10.1086/224533,Issues in Multiple Regression,"Controlling for variables implies conceptual distinctness between the control and zero-order variables. However, there are different levels of distinctness, some more subtle than others. These levels are determined by the theoretical context of the research. Failure to specify the theoretical context creates ambiguity as to the level of distinctness, and leads to the partialling fallacy, in which one controls for variables that are distinct in terms of appropriate theory. Although this can occur in using any control procedure, it is especially likely to occur in multiple regression, where high-order partial regression coefficients are routinely obtained in order to determine the relative importance of variables. Four major ways in which these regression coefficients can be seriously misleading are discussed. Although warnings concerning multicollinearity are to be found in statistics texts, they are insufficiently informative to prevent the mistakes described here. This is because the problem is essentially one of substantive interpretation rather than one of mathematical statistics per se.",0 +https://doi.org/10.1111/biom.12294,Multilevel quantile function modeling with application to birth outcomes,"Infants born preterm or small for gestational age have elevated rates of morbidity and mortality. Using birth certificate records in Texas from 2002 to 2004 and Environmental Protection Agency air pollution estimates, we relate the quantile functions of birth weight and gestational age to ozone exposure and multiple predictors, including parental age, race, and education level. We introduce a semi-parametric Bayesian quantile approach that models the full quantile function rather than just a few quantile levels. Our multilevel quantile function model establishes relationships between birth weight and the predictors separately for each week of gestational age and between gestational age and the predictors separately across Texas Public Health Regions. We permit these relationships to vary nonlinearly across gestational age, spatial domain and quantile level and we unite them in a hierarchical model via a basis expansion on the regression coefficients that preserves interpretability. Very low birth weight is a primary concern, so we leverage extreme value theory to supplement our model in the tail of the distribution. Gestational ages are recorded in completed weeks of gestation (integer-valued), so we present methodology for modeling quantile functions of discrete response data. In a simulation study we show that pooling information across gestational age and quantile level substantially reduces MSE of predictor effects. We find that ozone is negatively associated with the lower tail of gestational age in south Texas and across the distribution of birth weight for high gestational ages. Our methods are available in the R package BSquare.",0 +https://doi.org/10.1080/01621459.1990.10474930,A Monte Carlo Implementation of the EM Algorithm and the Poor Man's Data Augmentation Algorithms,"Abstract The first part of this article presents the Monte Carlo implementation of the E step of the EM algorithm. Given the current guess to the maximizer of the posterior distribution, latent data patterns are generated from the conditional predictive distribution. The expected value of the augmented log-posterior is then updated as a mixture of augmented log-posteriors, mixed over the generated latent data patterns (multiple imputations). In the M step of the algorithm, this mixture is maximized to obtain the update to the maximizer of the observed posterior. The gradient and Hessian of the observed log posterior are also expressed as mixtures, mixed over the multiple imputations. The relation between the Monte Carlo EM (MCEM) algorithm and the data augmentation algorithm is noted. Two modifications to the MCEM algorithm (the poor man's data augmentation algorithms), which allow for the calculation of the entire posterior, are then presented. These approximations serve as diagnostics for the validity o...",0 +https://doi.org/10.1037/met0000162,Prior sensitivity analysis in default Bayesian structural equation modeling.,"Bayesian structural equation modeling (BSEM) has recently gained popularity because it enables researchers to fit complex models and solve some of the issues often encountered in classical maximum likelihood estimation, such as nonconvergence and inadmissible solutions. An important component of any Bayesian analysis is the prior distribution of the unknown model parameters. Often, researchers rely on default priors, which are constructed in an automatic fashion without requiring substantive prior information. However, the prior can have a serious influence on the estimation of the model parameters, which affects the mean squared error, bias, coverage rates, and quantiles of the estimates. In this article, we investigate the performance of three different default priors: noninformative improper priors, vague proper priors, and empirical Bayes priors-with the latter being novel in the BSEM literature. Based on a simulation study, we find that these three default BSEM methods may perform very differently, especially with small samples. A careful prior sensitivity analysis is therefore needed when performing a default BSEM analysis. For this purpose, we provide a practical step-by-step guide for practitioners to conducting a prior sensitivity analysis in default BSEM. Our recommendations are illustrated using a well-known case study from the structural equation modeling literature, and all code for conducting the prior sensitivity analysis is available in the online supplemental materials. (PsycINFO Database Record",1 +https://doi.org/10.3758/pbr.16.5.798,Psychological interpretation of the ex-Gaussian and shifted Wald parameters: A diffusion model analysis,"A growing number of researchers use descriptive distributions such as the ex-Gaussian and the shifted Wald to summarize response time data for speeded two-choice tasks. Some of these researchers also assume that the parameters of these distributions uniquely correspond to specific cognitive processes. We studied the validity of this cognitive interpretation by relating the parameters of the ex-Gaussian and shifted Wald distributions to those of the Ratcliff diffusion model, a successful model whose parameters have well-established cognitive interpretations. In a simulation study, we fitted the ex-Gaussian and shifted Wald distributions to data generated from the diffusion model by systematically varying its parameters across a wide range of plausible values. In an empirical study, the two descriptive distributions were fitted to published data that featured manipulations of task difficulty, response caution, and a priori bias. The results clearly demonstrate that the ex-Gaussian and shifted Wald parameters do not correspond uniquely to parameters of the diffusion model. We conclude that researchers should resist the temptation to interpret changes in the ex-Gaussian and shifted Wald parameters in terms of cognitive processes. Supporting materials may be downloaded from http://pbr.psychonomic-journals .org/content/supplemental.",0 +https://doi.org/10.1177/1471082x0901000404,A Bayesian model for repeated measures zero-inflated count data with application to outpatient psychiatric service use,"In applications involving count data, it is common to encounter an excess number of zeros. For example, in the study of outpatient service utilization, the number of utilization days will take on integer values, with many subjects having no utilization (zero values). Mixed distribution models, such as the zero-inflated Poisson and zero-inflated negative binomial, are often used to fit such data. A more general class of mixture models, called hurdle models, can be used to model zero deflation as well as zero inflation. Several authors have proposed frequentist approaches to fitting zero-inflated models for repeated measures. We describe a practical Bayesian approach which incorporates prior information, has optimal small-sample properties and allows for tractable inference. The approach can be easily implemented using standard Bayesian software. A study of psychiatric outpatient service use illustrates the methods.",0 +https://doi.org/10.1111/j.2044-8317.2011.02032.x,A latent trait model for response times on tests employing the proportional hazards model,"For computer-administered tests, response times can be recorded conjointly with the corresponding responses. This broadens the scope of potential modelling approaches because response times can be analysed in addition to analysing the responses themselves. For this purpose, we present a new latent trait model for response times on tests. This model is based on the Cox proportional hazards model. According to this model, latent variables alter a baseline hazard function. Two different approaches to item parameter estimation are described: the first approach uses a variant of the Cox model for discrete time, whereas the second approach is based on a profile likelihood function. Properties of each estimator will be compared in a simulation study. Compared to the estimator for discrete time, the profile likelihood estimator is more efficient, that is, has smaller variance. Additionally, we show how the fit of the model can be evaluated and how the latent traits can be estimated. Finally, the applicability of the model to an empirical data set is demonstrated.",0 +https://doi.org/10.1177/0013164411408412,On the Reliability and Validity of a Numerical Reasoning Speed Dimension Derived From Response Times Collected in Computerized Testing,Data from 181 college students were used to assess whether math reasoning item response times in computerized testing can provide valid and reliable measures of a speed dimension. The alternate forms reliability of the speed dimension was .85. A two-dimensional structural equation model suggests that the speed dimension is related to the accuracy of speeded responses. Speed factor scores were significantly correlated with performance on the ACT math scale. Results suggest that the speed dimension underlying response times can be reliably measured and that the dimension is related to the accuracy of performance under the pressure of time limits.,0 +https://doi.org/10.1207/s15328007sem1204_2,Estimation of Reliability for Multiple-Component Measuring Instruments in Hierarchical Designs,"A method for estimation of reliability for multiple-component measuring instruments with clustered data is outlined. The approach is applicable with hierarchical designs where individuals are nested within higher order units and exhibit possibly related performance on components of a scale of interest. The procedure is developed within the framework of multilevel covariance structure modeling. The described method is useful for point and interval estimation of the degree of consistency of measurement with congeneric composites in hierarchical populations, and is illustrated with an empirical example.",0 +https://doi.org/10.1214/06-ba117,A comparison of Bayesian and likelihood-based methods for fitting multilevel models,"We use simulation studies, whose design is realistic for educational andmedicalresearch(aswellasotherfleldsofinquiry),tocompareBayesianand likelihood-basedmethodsforflttingvariance-components(VC)andrandom-efiects logistic regression (RELR) models. The likelihood (and approximate likelihood) approachesweexaminearebasedonthemethodsmostwidelyusedincurrentap- plied multilevel (hierarchical) analyses: maximum likelihood (ML) and restricted ML(REML)forGaussianoutcomes,andmarginalandpenalizedquasi-likelihood (MQL and PQL) for Bernoulli outcomes. Our Bayesian methods use Markov chain Monte Carlo (MCMC) estimation, with adaptive hybrid Metropolis-Gibbs sampling for RELR models, and several difiuse prior distributions (i i1 (†;†) and U(0; 1 ) priors for variance components). For evaluation criteria we consider bias of point estimates and nominal versus actual coverage of interval estimates in re- peated sampling. In two-level VC models we flnd that (a) both likelihood-based and Bayesian approaches can be made to produce approximately unbiased esti- mates, although the automatic manner in which REML accomplishes this is an advantage, but (b) both approaches had di-culty achieving nominal coverage in smallsamplesandwithsmallvaluesoftheintraclasscorrelation. Withthethree- levelRELRmodelsweexamineweflndthat(c)quasi-likelihoodmethodsforesti- mating random-efiects variances perform badly with respect to bias and coverage intheexamplewesimulated,and(d)Bayesiandifiuse-priormethodsleadtowell- calibratedpointandintervalRELRestimates. Whileitistruethatthelikelihood- based methods we study are considerably faster computationally than MCMC, (i) steady improvements in recent years in both hardware speed and e-ciency of MonteCarloalgorithmsand(ii)thelackofcalibrationoflikelihood-basedmethods insomecommonhierarchicalsettingscombinetomakeMCMC-basedBayesianflt- tingofmultilevelmodelsanattractiveapproach,evenwithratherlargedatasets. Other analytic strategies based on less approximate likelihood methods are also possible butwouldbeneflt fromfurtherstudy ofthe type summarized here.",1 +https://doi.org/10.1007/s11336-003-0974-7,"Cronbach’s α, Revelle’s β, and Mcdonald’s ωH: their relations with each other and two alternative conceptualizations of reliability","We make theoretical comparisons among five coefficients - Cronbach's α, Revelle's β, McDonald's ω h, and two alternative conceptualizations of reliability. Though many end users and psychometricians alike may not distinguish among these five coefficients, we demonstrate formally their nonequivalence. Specifically, whereas there are conditions under which α, β, and ω h are equivalent to each other and to one of the two conceptualizations of reliability considered here, we show that equality with this conceptualization of reliability and between α and ω h holds only under a highly restrictive set of conditions and that the conditions under which β equals ω h are only somewhat more general. The nonequivalence of α, β, and ω h suggests that important information about the psychometric properties of a scale may be missing when scale developers and users only report α as is almost always the case. © 2005 The Psychometric Society.",0 +https://doi.org/10.1214/09-aoas250,Hierarchical spatial models for predicting tree species assemblages across large domains,"Spatially explicit data layers of tree species assemblages, referred to as forest types or forest type groups, are a key component in large-scale assessments of forest sustainability, biodiversity, timber biomass, carbon sinks and forest health monitoring. This paper explores the utility of coupling georeferenced national forest inventory (NFI) data with readily available and spatially complete environmental predictor variables through spatially-varying multinomial logistic regression models to predict forest type groups across large forested landscapes. These models exploit underlying spatial associations within the NFI plot array and the spatially-varying impact of predictor variables to improve the accuracy of forest type group predictions. The richness of these models incurs onerous computational burdens and we discuss dimension reducing spatial processes that retain the richness in modeling. We illustrate using NFI data from Michigan, USA, where we provide a comprehensive analysis of this large study area and demonstrate improved prediction with associated measures of uncertainty.",0 +https://doi.org/10.1037/a0025814,A time-varying effect model for intensive longitudinal data.,"Understanding temporal change in human behavior and psychological processes is a central issue in the behavioral sciences. With technological advances, intensive longitudinal data (ILD) are increasingly generated by studies of human behavior that repeatedly administer assessments over time. ILD offer unique opportunities to describe temporal behavioral changes in detail and identify related environmental and psychosocial antecedents and consequences. Traditional analytical approaches impose strong parametric assumptions about the nature of change in the relationship between time-varying covariates and outcomes of interest. This article introduces time-varying effect models (TVEMs) that explicitly model changes in the association between ILD covariates and ILD outcomes over time in a flexible manner. In this article, we describe unique research questions that the TVEM addresses, outline the model-estimation procedure, share a SAS macro for implementing the model, demonstrate model utility with a simulated example, and illustrate model applications in ILD collected as part of a smoking-cessation study to explore the relationship between smoking urges and self-efficacy during the course of the pre- and postcessation period.",0 +https://doi.org/10.1007/s11336-009-9113-4,Using Threshold Autoregressive Models to Study Dyadic Interactions,"Considering a dyad as a dynamic system whose current state depends on its past state has allowed researchers to investigate whether and how partners influence each other. Some researchers have also focused on how differences between dyads in their interaction patterns are related to other differences between them. A promising approach in this area is the model that was proposed by Gottman and Murray, which is based on nonlinear coupled difference equations. In this paper, it is shown that their model is a special case of the threshold autoregressive (TAR) model. As a consequence, we can make use of existing knowledge about TAR models with respect to parameter estimation, model alternatives and model selection. We propose a new estimation procedure and perform a simulation study to compare it to the estimation procedure developed by Gottman and Murray. In addition, we include an empirical example based on interaction data of three dyads.",0 +https://doi.org/10.1002/sim.3441,Meta-analysis of diagnostic test studies using individual patient data and aggregate data,"A meta-analysis of diagnostic test studies provides evidence-based results regarding the accuracy of a particular test, and usually involves synthesizing aggregate data (AD) from each study, such as the 2 by 2 tables of diagnostic accuracy. A bivariate random-effects meta-analysis (BRMA) can appropriately synthesize these tables, and leads to clinical results, such as the summary sensitivity and specificity across studies. However, translating such results into practice may be limited by between-study heterogeneity and that they relate to some 'average' patient across studies.In this paper we describe how the meta-analysis of individual patient data (IPD) from diagnostic studies can lead to clinical results more tailored to the individual patient. We develop IPD models that extend the BRMA framework to include study-level covariates, which help explain the between-study heterogeneity, and also patient-level covariates, which allow one to assess the effect of patient characteristics on test accuracy. We show how the inclusion of patient-level covariates requires a careful separation of within-study and across-study accuracy-covariate effects, as the latter are particularly prone to confounding. Our models are assessed through simulation and extended to allow IPD studies to be combined with AD studies, as IPD are not always available for all studies. Application is made to 23 studies assessing the accuracy of ear thermometers for diagnosing fever in children, with 16 IPD and 7 AD studies. The models reveal that between-study heterogeneity is partly explained by the use of different measurement devices, but there is no evidence that being an infant modifies diagnostic accuracy.",0 +https://doi.org/10.1016/j.jmp.2005.02.004,A Bayesian approach to testing decision making axioms,"Abstract Theories of decision making are often formulated in terms of deterministic axioms, which do not account for stochastic variation that attends empirical data. This study presents a Bayesian inference framework for dealing with fallible data. The Bayesian framework provides readily applicable statistical procedures addressing typical inference questions that arise when algebraic axioms are tested against empirical data. The key idea of the Bayesian framework is to employ a prior distribution representing the parametric order constraints implied by a given axiom. Modern methods of Bayesian computation such as Markov chain Monte Carlo are used to estimate the posterior distribution, which provides the information that allows an axiom to be evaluated. Specifically, we adopt the Bayesian p -value as the criterion to assess the descriptive adequacy of a given model (axiom) and we use the deviance information criterion (DIC) to select among a set of candidate models. We illustrate the Bayesian framework by testing well-known axioms of decision making, including the axioms of monotonicity of joint receipt and stochastic transitivity.",0 +https://doi.org/10.1093/biomet/74.4.817,A fast scoring algorithm for maximum likelihood estimation in unbalanced mixed models with nested random effects,On decrit un algorithme qui utilise des formules explicites pour l'inverse et le determinant de la matrice de covariance donnee par La Motte (1972) et evite l'inversion des grandes matrices,0 +https://doi.org/10.1080/01621459.1983.10477920,Parametric Empirical Bayes Inference: Theory and Applications,"Abstract This article reviews the state of multiparameter shrinkage estimators with emphasis on the empirical Bayes viewpoint, particularly in the case of parametric prior distributions. Some successful applications of major importance are considered. Recent results concerning estimates of error and confidence intervals are described and illustrated with data.",0 +https://doi.org/10.2307/1167125,The Analysis of Multilevel Data in Educational Research and Evaluation,,0 +https://doi.org/10.1037/0021-9010.89.1.36,The Forgotten Ones? The Validity of Consideration and Initiating Structure in Leadership Research.,"This study provided a meta-analysis of the relationship of the Ohio State leadership behaviors--Consideration and Initiating Structure--with leadership. Overall, 163 independent correlations for Consideration and 159 correlations for Initiating Structure were analyzed. Results revealed that both Consideration (.48) and Initiating Structure (.29) have moderately strong, nonzero relations with leadership outcomes. Consideration was more strongly related to follower satisfaction (leader satisfaction, job satisfaction), motivation, and leader effectiveness, and Initiating Structure was slightly more strongly related to leader job performance and group-organization performance. Validities did vary by leadership measure, but in most cases validities generalized regardless of the measure used. Overall, the results provide important support for the validity of Initiating Structure and Consideration in leadership research.",0 +https://doi.org/10.3102/1076998614547577,Design-Comparable Effect Sizes in Multiple Baseline Designs,"In single-case research, the multiple baseline design is a widely used approach for evaluating the effects of interventions on individuals. Multiple baseline designs involve repeated measurement of outcomes over time and the controlled introduction of a treatment at different times for different individuals. This article outlines a general framework for defining effect sizes in multiple baseline designs that are directly comparable to the standardized mean difference from a between-subjects randomized experiment. The target, design-comparable effect size parameter can be estimated using restricted maximum likelihood together with a small sample correction analogous to Hedges’s g. The approach is demonstrated using hierarchical linear models that include baseline time trends and treatment-by-time interactions. A simulation compares the performance of the proposed estimator to that of an alternative, and an application illustrates the model-fitting process.",0 +https://doi.org/10.1016/j.leaqua.2004.09.009,Applying multilevel confirmatory factor analysis techniques to the study of leadership,"Statistical issues associated with multilevel data are becoming increasingly important to organizational researchers. This paper concentrates on the issue of assessing the factor structure of a construct at aggregate levels of analysis. Specifically, we describe a recently developed procedure for performing multilevel confirmatory factor analysis (MCFA) [Muthen, B.O. (1990). Mean and covariance structure analysis of hierarchical data. Paper presented at the Psychometric Society, Princeton, NJ; Muthen, B.O. (1994). Multilevel covariance structure analysis. Sociological Methods and Research, 22, 376–398], and provide an illustrative example of its application to leadership data reflecting both the organizational and societal level of analysis. Overall, the results of our illustrative analysis support the existence of a valid societal-level leadership construct, and show the potential of this multilevel confirmatory factor analysis procedure for leadership research and the field of I/O psychology in general.",0 +https://doi.org/10.3758/s13414-015-0834-4,Effect of Decision Load on Whole-Display Superiority in Change Detection,"Visual short-term memory (VSTM) refers to our ability in remembering visual information for a limited amount of time. In the VSTM literature, mixed findings have been reported regarding whether items are encoded individually or globally in the context of other items. This study adopted a color change detection task and manipulated color and spatial relations of the items on display to test whether inter-item relational information and processing can facilitate change detection performance. Results showed that only when a post-cue was presented to reduce decision load (Experiments 1 and 3), both color and spatial relations facilitated color change detection. However, when there was no post-cue to lessen the decision load, preserving spatial relations at test impaired color change detection (Experiment 2). Furthermore, spatial and color relational processing interactively affected color change detection. Benefit of the spatial relations was observed only when color grouping cues can aid change detection, and the utilization of color relations was optimized when spatial relations were preserved to cue the retrieval of color relations. Our results support the hierarchical representation hypothesis, which assumes that both individual items and item relations are encoded and maintained in VSTM. The amount of cognitive resources for retrieving different levels of representations is highly constrained by the decision load.",0 +https://doi.org/10.1080/01621459.1994.10476829,The Collapsed Gibbs Sampler in Bayesian Computations with Applications to a Gene Regulation Problem,"Abstract This article describes a method of “grouping” and “collapsing” in using the Gibbs sampler and proves from an operator theory viewpoint that the method is in general beneficial. The norms of the forward operators associated with the corresponding nonreversible Markov chains are used to discriminate among different simulation schemes. When applied to Bayesian missing data problems, the idea of collapsing suggests skipping the steps of sampling parameter(s) values in standard data augmentation. By doing this, we obtain a predictive update version of the Gibbs sampler. A procedure of calculating the posterior odds ratio via the collapsed Gibbs sampler when incomplete observations are involved is presented. As an illustration of possible applications, three examples, along with a Bayesian treatment for identifying common protein binding sites in unaligned DNA sequences, are provided.",0 +https://doi.org/10.1080/0267257x.2012.698637,Customer-perceived value in business-to-business relationships: A study of software customers,"Abstract Despite the importance of relationships in business-to-business (B2B) contexts, there is limited research as to what customers expect and value from relationships in industrial contexts. This study, therefore, seeks to understand customer-perceived value better by investigating actual and prospective customers in the software industry. A two-level analysis of customer perspectives on relationship attributes was conducted. First, semi-structured interviews were conducted with customers of a micro software firm. Insights from these interviews were then used to inform the second stage of the study, an online survey using Adaptive Conjoint Analysis, to identify the relative significance of these attributes. A total of 256 industrial buyers completed the survey. A new Customer Relationship Attributes Model (CRAM) is presented which encapsulates major attributes that current and prospective customers consider when entering into a relationship with their software supplier. The CRAM identifies five produ...",0 +https://doi.org/10.1167/10.2.24,Distortions in recall from visual memory: Two classes of attractors at work,"In a trio of experiments, a matching procedure generated direct, analogue measures of short-term memory for the spatial frequency of Gabor stimuli. Experiment 1 showed that when just a single Gabor was presented for study, a retention interval of just a few seconds was enough to increase the variability of matches, suggesting that noise in memory substantially exceeds that in vision. Experiment 2 revealed that when a pair of Gabors was presented on each trial, the remembered appearance of one of the Gabors was influenced by: (1) the relationship between its spatial frequency and the spatial frequency of the accompanying, task-irrelevant non-target stimulus; and (2) the average spatial frequency of Gabors seen on previous trials. These two influences, which work on very different time scales, were approximately additive in their effects, each operating as an attractor for remembered appearance. Experiment 3 showed that a timely pre-stimulus cue allowed selective attention to curtail the influence of a task-irrelevant non-target, without diminishing the impact of the stimuli seen on previous trials. It appears that these two separable attractors influence distinct processes, with perception being influenced by the non-target stimulus and memory being influenced by stimuli seen on previous trials.",0 +https://doi.org/10.1097/psy.0b013e3182736971,Multilevel Modeling in Psychosomatic Medicine Research,"The primary purpose of this study is to provide an overview of multilevel modeling for Psychosomatic Medicine readers and contributors. The article begins with a general introduction to multilevel modeling. Multilevel regression modeling at two levels is emphasized because of its prevalence in psychosomatic medicine research. Simulated data sets based on some core ideas from the Familias Unidas effectiveness study are used to illustrate key concepts including communication of model specification, parameter interpretation, sample size and power, and missing data. Input and key output files from Mplus and SAS are provided. A cluster randomized trial with repeated measures (i.e., three-level regression model) is then briefly presented with simulated data based on some core ideas from a cognitive-behavioral stress management intervention in prostate cancer.",0 +https://doi.org/10.1027/1614-2241.1.3.86,Sufficient Sample Sizes for Multilevel Modeling,"Abstract. An important problem in multilevel modeling is what constitutes a sufficient sample size for accurate estimation. In multilevel analysis, the major restriction is often the higher-level sample size. In this paper, a simulation study is used to determine the influence of different sample sizes at the group level on the accuracy of the estimates (regression coefficients and variances) and their standard errors. In addition, the influence of other factors, such as the lowest-level sample size and different variance distributions between the levels (different intraclass correlations), is examined. The results show that only a small sample size at level two (meaning a sample of 50 or less) leads to biased estimates of the second-level standard errors. In all of the other simulated conditions the estimates of the regression coefficients, the variance components, and the standard errors are unbiased and accurate.",0 +https://doi.org/10.1016/j.jpain.2013.10.001,Suppression of Voluntary Wheel Running in Rats Is Dependent on the Site of Inflammation: Evidence for Voluntary Running as a Measure of Hind Paw-Evoked Pain,"

Abstract

Decreased voluntary wheel running has recently been proposed as a preclinical pain measure for inflammatory pain, but whether this reflects pain evoked by use of the affected limbs is unknown. To assess the role of inflammation site as a determinant of this measure, complete Freund's adjuvant (CFA), formalin, or equivolume vehicle was subcutaneously injected into the plantar surface of the hind paws (bilateral) or L1 dorsum dermatome (leaving paws unaffected) of male Sprague Dawley rats. CFA-induced hind paw mechanical allodynia (P < .001) did not correlate with reduced voluntary wheel running. Intraplantar formalin did not attenuate voluntary running, despite eliciting robust licking/writhing/flinching behavior and hind paw mechanical allodynia (P < .001). Subcutaneous L1 dorsum dermatome formalin, but not CFA, induced licking/writhing/flinching behavior (P < .001), but neither induced hind paw mechanical allodynia or attenuated voluntary running. That voluntary running is decreased by hind paw CFA, but not by L1 dorsum CFA, implies that the behavior is a measure of CFA-induced pain evoked by use of the affected limbs rather than supraspinal pain processing that is independent of inflammation site. Furthermore, the results suggest that interpretation of voluntary wheel running data cannot simply be explained by correlation with mechanical allodynia.

Perspective

Whether decreased voluntary running is dependent on inflammation site is unknown. We show that intraplantar, but not L1 dorsum, CFA suppressed voluntary running and formalin-induced licking/writhing/flinching behavior but had no effect on voluntary running. These data suggest that suppressed voluntary running by CFA likely reflects pain evoked by use of the affected limbs.",0 +https://doi.org/10.1037//0021-9010.87.4.797,Relationship of personality to performance motivation: A meta-analytic review.,"This article provides a meta-analysis of the relationship between the five-factor model of personality and 3 central theories of performance motivation (goal-setting, expectancy, and self-efficacy motivation). The quantitative review includes 150 correlations from 65 studies. Traits were organized according to the five-factor model of personality. Results indicated that Neuroticism (average validity = -.31) and Conscientiousness (average validity = .24) were the strongest and most consistent correlates of performance motivation across the 3 theoretical perspectives. Results further indicated that the validity of 3 of the Big Five traits - Neuroticism, Extraversion, and Conscientiousness - generalized across studies. As a set, the Big Five traits had an average multiple correlation of .49 with the motivational criteria, suggesting that the Big Five traits are an important source of performance motivation.",0 +https://doi.org/10.1177/014662169301700402,Detection of Differential Item Functioning in the Graded Response Model,"Methods for detecting differential item func tioning (DIF) have been proposed primarily for the item response theory dichotomous response model. Three measures of DIF for the dichotomous response model are extended to include Samejima's graded response model: two measures based on area differences between item true score functions, and a χ 2 statistic for comparing differences in item parameters. An illustrative example is presented.",0 +https://doi.org/10.1080/03610919508813280,Small sample characteristics of generalized estimating equations,"The aim of this study was to investigate the Type I error rate of hypothesis testing based on generalized estimating equations (GEE) for data characteristic of periodontal clinical trials. The data in these studies consist of a large number of binary responses from each subject and a small number of subjects (Haffajee et al. (1983), Goodson (1986), Jenkins et al. (1988)) Computer simulations were employed to investigate GEE based both on an empirical estimate of the variance-covariance matrix and a model-based estimate. Results from this investigation indicate that hypothesis testing based on GEE resulted in inappropriate Type I error rates when small samples are employed. Only an increase in the number of subjects to the point where it matched the number of observations per subject resulted in appropriate Type I error rates",0 +https://doi.org/10.1214/07-aos501,Objective priors for the bivariate normal model,"Study of the bivariate normal distribution raises the full range of issues involving objective Bayesian inference, including the different types of objective priors (e.g., Jeffreys, invariant, reference, matching), the different modes of inference (e.g., Bayesian, frequentist, fiducial) and the criteria involved in deciding on optimal objective priors (e.g., ease of computation, frequentist performance, marginalization paradoxes). Summary recommendations as to optimal objective priors are made for a variety of inferences involving the bivariate normal distribution. In the course of the investigation, a variety of surprising results were found, including the availability of objective priors that yield exact frequentist inferences for many functions of the bivariate normal parameters, including the correlation coefficient.",0 +https://doi.org/10.3102/1076998606298041,Combining Correlation Matrices: Simulation Analysis of Improved Fixed-Effects Methods,"The originally proposed multivariate meta-analysis approach for correlation matrices?analyze Pearson correlations, with each study's observed correlations replacing their population counterparts in its conditional-covariance matrix? performs poorly. Two refinements are considered: Analyze Fisher Z-transformed correlations, and substitute better estimates of correlations in the conditional covariances. Fixed-effects methods with and without each refinement were exam ined in a Monte Carlo study; number of studies and the distribution of within study sample sizes were varied. Both refinements improved element-wise point and interval estimates, as well as Type I error control for homogeneity tests, especially with many small studies. Practical recommendations and suggestions for future methodological work are offered. An appendix describes how to trans form Fisher-Z (co)variances to the Pearson-v metric.",0 +https://doi.org/10.1086/208812,Effects of Prior Knowledge and Experience and Phase of the Choice Process on Consumer Decision Processes: A Protocol Analysis,Effects of prior knowledge and experience and phase of the choice on decision processes were investigated using a protocol coding scheme. Consumers with moderate knowledge and experience did more processing of available information than did the high or low groups. More knowledgeable consumers tended to process by brand. Consumers tended to use attribute-based evaluations in early and brand-based evaluations in later phases of choice.,0 +https://doi.org/10.1177/0149206313501200,Bayesian Estimation and Inference,"This paper introduces the “Bayesian revolution” that is sweeping across multiple disciplines but has yet to gain a foothold in organizational research. The foundations of Bayesian estimation and inference are first reviewed. Then, two empirical examples are provided to show how Bayesian methods can overcome limitations of frequentist methods: (a) a structural equation model of testosterone’s effect on status in teams, where a Bayesian approach allows directly testing a traditional null hypothesis as a research hypothesis and allows estimating all possible residual covariances in a measurement model, neither of which are possible with frequentist methods; and (b) an ANOVA-style model from a true experiment of ego depletion’s effects on performance, where Bayesian estimation with informative priors allows results from all previous research (via a meta-analysis and other previous studies) to be combined with estimates of study effects in a principled manner, yielding support for hypotheses that is not obtained with frequentist methods. Data are available from the first author, code for the program Mplus is provided, and tables illustrate how to present Bayesian results. In conclusion, the many benefits and few hindrances of Bayesian methods are discussed, where the major hindrance has been an easily solvable lack of familiarity by organizational researchers.",0 +https://doi.org/10.1002/sim.3577,A multivariate CAR model for improving the estimation of relative risks,"Disease mapping studies have been widely performed at univariate level, that is considering only one disease in the estimated models. Nonetheless, simultaneous modelling of different diseases can be a valuable tool both from the epidemiological and from the statistical point of view. In this paper we propose a model for multivariate disease mapping that generalizes the univariate conditional auto-regressive distribution. The proposed model is proven to be an effective alternative to existing multivariate models, mainly because it overcome some restrictive hypotheses underlying models previously proposed in this context. Model performances are checked via a simulation study and via application to a case study.",0 +https://doi.org/10.1191/1740774505cn076oa,Design and analysis of clinical trials with clustering effects due to treatment,"Where patients receive therapy as a group, there are good theoretical reasons to believe that variation in the outcome will be smaller for patients treated in the same group than for patients treated in different groups. Similarly, where different therapists treat different groups of patients, outcome for patients treated by the same therapist may differ less than outcome for patients treated by different therapists. Clinical trials evaluating such therapies need to consider this potential lack of independence. As with cluster-randomized trials, this has implications for the precision of treatment effects estimates and statistical power. There are nevertheless differences between clustering due to the organization of treatment and that due to randomization. In cluster-randomized trials the distribution of cluster sizes in each treatment arm should be similar as a consequence of randomization unless there is differential loss to follow-up. With clustering due to therapy group or therapist, cluster size may differ systematically between treatment arms, due to size of therapy groups or differing health professional caseload. Intra-cluster correlation may also differ between treatment arms. The implications of differential cluster size and intracluster correlation for design and analysis will be illustrated by data from two trials, the first comparing nurse practitioner care with general practitioner care, and the second comparing a group therapy with individual treatment as usual. The special case where a group therapy or therapist is compared with an unclustered treatment is examined in detail using a simulation study. The implications of differential clustering effects for sample size and power are addressed. It is argued that the design and analysis of this type of trial should take account of possible heterogeneity in cluster size and intracluster correlation.",0 +https://doi.org/10.1198/016214501753381841,Crossed Random Effect Models for Multiple Outcomes in a Study of Teratogenesis,"Human teratogens often manifest themselves through a broad spectrum of adverse effects. Although often not serious when considered individually, such outcomes taken together may represent a syndrome that can lead to serious developmental problems. Accordingly, studies that investigate the effect of human teratogens on fetal development typically record the presence or absence of a multitude of abnormalities, resulting in the data of multivariate binary form for each infant. Such studies typically have three objectives: (1) estimate an overall effect of exposure across outcomes, (2) identify subjects having the syndrome, and (3) identify those outcomes that constitute the syndrome so that doctors know what to look for when diagnosing the syndrome in other exposed newborns. This article proposes the use of a logistic regression model with crossed random effect structure to address all three questions simultaneously. We use the proposed models to analyze data from a study investigating the effects of in uter...",0 +https://doi.org/10.1016/j.brat.2013.10.009,Applying the Quadruple Process model to evaluate change in implicit attitudinal responses during therapy for panic disorder,"This study explored the automatic and controlled processes that may influence performance on an implicit measure across cognitive-behavioral group therapy for panic disorder.The Quadruple Process model was applied to error scores from an Implicit Association Test evaluating associations between the concepts Me (vs. Not Me) + Calm (vs. Panicked) to evaluate four distinct processes: Association Activation, Detection, Guessing, and Overcoming Bias. Parameter estimates were calculated in the panic group (n = 28) across each treatment session where the IAT was administered, and at matched times when the IAT was completed in the healthy control group (n = 31).Association Activation for Me + Calm became stronger over treatment for participants in the panic group, demonstrating that it is possible to change automatically activated associations in memory (vs. simply overriding those associations) in a clinical sample via therapy. As well, the Guessing bias toward the calm category increased over treatment for participants in the panic group.This research evaluates key tenets about the role of automatic processing in cognitive models of anxiety, and emphasizes the viability of changing the actual activation of automatic associations in the context of treatment, versus only changing a person's ability to use reflective processing to overcome biased automatic processing.",0 +https://doi.org/10.2307/1926450,Multicollinearity in Regression Analysis: Comment,"In recent paper this REVIEW,' Farrar and Glauber (hereafter FG) revisit problem of regression analysis. Viewing problem of as both facet and symptom of poor experimental design, 2 FG propose a three-stage hierarchy of increasing detailed tests presence, location, and pattern, 3 of multicollinearity. The first this series of three tests, on which other two are conditional, is desigped provide useful first measure of presence and severity of multicollinearity 4 sample on hand. Bartlett's well-known statistic testing joint distribution of sample correlations under assumption of vanishing parent correlations between variables is used by FG detecting multicollinearity. Bartlett shows that (natural) logarithm of intercorrelation determinant computed from sample drawn from multivariate, ortho-normal distribution, multiplied by factor k, is approximately distributed as Chi Square with v 1/2 n (n 1) degrees of freedom, where k = -[N 1 1/6 (2n + 5)], N is sample size and n is number of variables considered. If investigator concludes from first stage that exists and that it is severe enough warrant some action, FG propose regress consecutively each explanatory variable on remaining ones. The rp'silting F statistics will test for dependence of particular variables on other members 5 of set of explanatory variables. Finally, patterns of interdependence among independent variables are examined by testing significa-nce of partial correlations of every pair of explanatory variables, all other variables held constant. The main pillar of this three-level test is, of course, Bartlett's test which is properly used making inferences,6 under null hypothesis that all population correlations are zero. Since FG claim, however, that they are not interested drawing inferences from sample population (inferences from sample population . . . are possible . . . however, little importance is attached properties of population from which set of data has been drawn. Attention focuses largely, if not entirely, on sample itself 7), their use of Chi-Square statistic is questionable. Moreover, it is neither practical nor necessary assume orthogonality between parent economic variables, 4f one wishes make such inferences. Here we come heart of problem of multicollinearity. One may agree with FG that it is preferable think of in terms of [its] severity rather than its existence or nonexistence. 8 If one agrees with this approach, natural way proceed is indeed to define terms of departures from hypothesized statistical condition. 9 But what is this hypothesized condition? For FG this condition is the requirement that explanatory variables be truly independent of one another. 10 However, there is no such requirement least-squares solution. On contrary, least squares solu* I share with D. C. Farrar and R. R. Glauber my indebtedness Professor John R. Meyer who introduced us problem, and I am grateful his comments on an earlier draft. I am also grateful Professors J. Johnston, N. Wallace, D. Farrar, and R. Glauber valuable discussions. I am particularly thankful D. Farrar who did not spare his efforts order dig out old forgotten data, which enabled me recompute his regression equations. 1D. C. Farrar and R. R. Glauber, Multicollinearity Regression Analysis: The Problem Revisited, this REvIEw, XLIX (Feb. 1967). 2Ibid., p. 93. 3 Ibid., p. 104. ' Ibid., p. 101. BIbid., p. 104. Bartlett has originally developed this statistic order test number of meaningful components that can be extracted from set of variables. concise statement is given by Bartlett: A Note on Multiplying Factors Various x2 Approximations, Journal of Royal Statistical Society (B), XVI, no. 2 (1954), pp. 296-298. 7D. C. Farrar and R. R. Glauber, op. cit., 100. 8Ibid., p. 106. 9 Ibid., p. 92. 10Ibid., pp. 92 and 100.",0 +https://doi.org/10.1037/a0035815,Linear and nonlinear associations between general intelligence and personality in Project TALENT.,"Research on the relations of personality traits to intelligence has primarily been concerned with linear associations. Yet, there are no a priori reasons why linear relations should be expected over nonlinear ones, which represent a much larger set of all possible associations. Using 2 techniques, quadratic and generalized additive models, we tested for linear and nonlinear associations of general intelligence (g) with 10 personality scales from Project TALENT (PT), a nationally representative sample of approximately 400,000 American high school students from 1960, divided into 4 grade samples (Flanagan et al., 1962). We departed from previous studies, including one with PT (Reeve, Meyer, & Bonaccio, 2006), by modeling latent quadratic effects directly, controlling the influence of the common factor in the personality scales, and assuming a direction of effect from g to personality. On the basis of the literature, we made 17 directional hypotheses for the linear and quadratic associations. Of these, 53% were supported in all 4 male grades and 58% in all 4 female grades. Quadratic associations explained substantive variance above and beyond linear effects (mean R² between 1.8% and 3.6%) for Sociability, Maturity, Vigor, and Leadership in males and Sociability, Maturity, and Tidiness in females; linear associations were predominant for other traits. We discuss how suited current theories of the personality-intelligence interface are to explain these associations, and how research on intellectually gifted samples may provide a unique way of understanding them. We conclude that nonlinear models can provide incremental detail regarding personality and intelligence associations.",0 +https://doi.org/10.3102/10769986027003271,Modeling Incomplete Scaled Questionnaire Data with a Partial Credit Hierarchical Measurement Model,"The partial credit hierarchical measurement model (HMM) results when a partial credit IRT model and a hierarchical linear model are combined ( Bryk & Raudenbush, 1992 ; Masters, 1982 ). This combined model enables the standard errors of parameters to be estimated accurately. The partial credit HMM is illustrated using a subset of data from the Sloan Study of Youth and Social Development, a five-year longitudinal project studying the career aspirations of adolescents. The data used for this study consisted of a subset of students’ responses to multiple administrations of an attitudinal questionnaire, as well as student-level covariates. Using student responses to seven seven-point semantic differential items tapping student mood, the partial credit HMM was used to explore the effects of gender and classroom activity upon student mood as students were engaged in a mathematics classroom. Gibbs sampling and the Metropolis-Hastings algorithm were used to impute values for the missing data and to estimate the parameters of the model. The results of the data analysis indicated that female students had lower mood than male students did for all classroom activities.",0 +https://doi.org/10.1097/fbp.0b013e32834eafbc,The peripheral L-arginine–nitric oxide–cyclic GMP pathway and ATP-sensitive K+ channels are involved in the antinociceptive effect of crotalphine on neuropathic pain in rats,"Crotalphine, a 14 amino acid peptide first isolated from the venom of the South American rattlesnake Crotalus durissus terrificus, induces a peripheral long-lasting and opioid receptor-mediated antinociceptive effect in a rat model of neuropathic pain induced by chronic constriction of the sciatic nerve. In the present study, we further characterized the molecular mechanisms involved in this effect, determining the type of opioid receptor responsible for this effect and the involvement of the nitric oxide-cyclic GMP pathway and of K⁺ channels. Crotalphine (0.2 or 5 μg/kg, orally; 0.0006 μg/paw), administered on day 14 after nerve constriction, inhibited mechanical hyperalgesia and low-threshold mechanical allodynia. The effect of the peptide was antagonized by intraplantar administration of naltrindole, an antagonist of δ-opioid receptors, and partially reversed by norbinaltorphimine, an antagonist of κ-opioid receptors. The effect of crotalphine was also blocked by 7-nitroindazole, an inhibitor of the neuronal nitric oxide synthase; by 1H-(1,2,4) oxadiazolo[4,3-a]quinoxaline-1-one, an inhibitor of guanylate cyclase activation; and by glibenclamide, an ATP-sensitive K⁺ channel blocker. The results suggest that peripheral δ-opioid and κ-opioid receptors, the nitric oxide-cyclic GMP pathway, and ATP-sensitive K⁺ channels are involved in the antinociceptive effect of crotalphine. The present data point to the therapeutic potential of this peptide for the treatment of chronic neuropathic pain.",0 +https://doi.org/10.1038/nature06860,Discrete fixed-resolution representations in visual working memory,"Limits on the storage capacity of working memory significantly affect cognitive abilities in a wide range of domains, but the nature of these capacity limits has been elusive. Some researchers have proposed that working memory stores a limited set of discrete, fixed-resolution representations, whereas others have proposed that working memory consists of a pool of resources that can be allocated flexibly to provide either a small number of high-resolution representations or a large number of low-resolution representations. Here we resolve this controversy by providing independent measures of capacity and resolution. We show that, when presented with more than a few simple objects, human observers store a high-resolution representation of a subset of the objects and retain no information about the others. Memory resolution varied over a narrow range that cannot be explained in terms of a general resource pool but can be well explained by a small set of discrete, fixed-resolution representations.",0 +https://doi.org/10.1007/bf02293896,A bayesian approach to confirmatory factor analysis,"Confirmatory factor analysis is considered from a Bayesian viewpoint, in which prior information on parameter is incorporated in the analysis. An iterative algorithm is developed to obtain the Bayes estimates. A numerical example based on longitudinal data is presented. A simulation study is designed to compare the Bayesian approach with the maximum likelihood method. © 1981 The Psychometric Society.",0 +https://doi.org/10.1080/01621459.1984.10478078,Reducing Bias in Observational Studies Using Subclassification on the Propensity Score,"The propensity score is the conditional probability of assignment to a particular treatment given a vector of observed covariates. Previous theoretical arguments have shown that subclassification on the propensity score will balance all observed covariates. Subclassification on an estimated propensity score is illustrated, using observational data on treatments for coronary artery disease. Five subclasses defined by the estimated propensity score are constructed that balance 74 covariates, and thereby provide estimates of treatment effects using direct adjustment. These subclasses are applied within sub-populations, and model-based adjustments are then used to provide estimates of treatment effects within these sub-populations. Two appendixes address theoretical issues related to the application: the effectiveness of subclassification on the propensity score in removing bias, and balancing properties of propensity scores with incomplete data. © 1984 Taylor & Francis Group, LLC.",0 +https://doi.org/10.1111/j.1756-8765.2008.01010.x,A Bayesian Account of Reconstructive Memory,"It is well established that prior knowledge influences reconstruction from memory, but the specific interactions of memory and knowledge are unclear. Extending work by Huttenlocher et al. (Psychological Review, 98 [1991] 352; Journal of Experimental Psychology: General, 129 [2000] 220), we propose a Bayesian model of reconstructive memory in which prior knowledge interacts with episodic memory at multiple levels of abstraction. The combination of prior knowledge and noisy memory representations is dependent on familiarity. We present empirical evidence of the influences of prior knowledge at multiple levels of abstraction, showing that the reconstruction of familiar objects is influenced toward the specific prior for that object, while unfamiliar objects are influenced toward the overall category.",0 +https://doi.org/10.1002/0471264385.wei0218,Growth Curve Analysis in Contemporary Psychological Research,"The term “growth curve” is used to describe data where: (1) the same entities are repeatedly observed, (2) the same procedures of measurement and scaling of observations are used, and (3) the timing of the observations is known. Growth curves are now common in many areas of psychological research, and some of these are presented here. The term “growth curve analysis” denotes the processes of describing, testing hypotheses, and making scientific inferences about the growth and change patterns in a wide range of time-related phenomena. In this sense, growth curve analyses are a specific form of the larger set of developmental and longitudinal research methods, but the unique features of growth data permit unique kinds of analyses. Formal models for the analysis of growth curves which have been developed in many different substantive domains are described here in five sections: (1) An introduction to growth curves, (2) linear models of growth, (3) multiple groups in growth curve models, (4) aspects of dynamic theory for growth models, and (5) multiple variables in growth curve analyses. We conclude with a discussion of future issues raised by the current growth models.",0 +https://doi.org/10.1523/jneurosci.0076-11.2011,Caudal Granular Insular Cortex Is Sufficient and Necessary for the Long-Term Maintenance of Allodynic Behavior in the Rat Attributable to Mononeuropathy,"Mechanical allodynia, the perception of innocuous tactile stimulation as painful, is a severe symptom of chronic pain often produced by damage to peripheral nerves. Allodynia affects millions of people and remains highly resistant to classic analgesics and therapies. Neural mechanisms for the development and maintenance of allodynia have been investigated in the spinal cord, brainstem, thalamus, and forebrain, but manipulations of these regions rarely produce lasting effects. We found that long-term alleviation of allodynic manifestations is produced by discreetly lesioning a newly discovered somatosensory representation in caudal granular insular cortex (CGIC) in the rat, either before or after a chronic constriction injury of the sciatic nerve. However, CGIC lesions alone have no effect on normal mechanical stimulus thresholds. In addition, using electrophysiological techniques, we reveal a corticospinal loop that could be the anatomical source of the influence of CGIC on allodynia.",0 +https://doi.org/10.1080/10705510701575396,Deciding on the Number of Classes in Latent Class Analysis and Growth Mixture Modeling: A Monte Carlo Simulation Study,"Mixture modeling is a widely applied data analysis technique used to identify unobserved heterogeneity in a population. Despite mixture models' usefulness in practice, one unresolved issue in the application of mixture models is that there is not one commonly accepted statistical indicator for deciding on the number of classes in a study population. This article presents the results of a simulation study that examines the performance of likelihood-based tests and the traditionally used Information Criterion (ICs) used for determining the number of classes in mixture modeling. We look at the performance of these tests and indexes for 3 types of mixture models: latent class analysis (LCA), a factor mixture model (FMA), and a growth mixture models (GMM). We evaluate the ability of the tests and indexes to correctly identify the number of classes at three different sample sizes (n = 200, 500, 1,000). Whereas the Bayesian Information Criterion performed the best of the ICs, the bootstrap likelihood ratio test ...",0 +https://doi.org/10.1037/1082-989x.11.1.36,Local solutions in the estimation of growth mixture models.,"Finite mixture models are well known to have poorly behaved likelihood functions featuring singularities and multiple optima. Growth mixture models may suffer from fewer of these problems, potentially benefiting from the structure imposed on the estimated class means and covariances by the specified growth model. As demonstrated here, however, local solutions may still be problematic. Results from an empirical case study and a small Monte Carlo simulation show that failure to thoroughly consider the possible presence of local optima in the estimation of a growth mixture model can sometimes have serious consequences, possibly leading to adoption of an inferior solution that differs in substantively important ways from the actual maximum likelihood solution. Often, the defaults of current software need to be overridden to thoroughly evaluate the parameter space and obtain confidence that the maximum likelihood solution has in fact been obtained.",0 +https://doi.org/10.1148/radiol.2015150034,Diagnosis of Calcific Tendonitis of the Rotator Cuff by Using Susceptibility-weighted MR Imaging,"To evaluate the diagnostic performance of susceptibility-weighted imaging (SWI) and standard shoulder joint magnetic resonance (MR) sequences in comparison to that of conventional radiography for the identification of calcifications in the rotator cuff in patients with calcific tendonitis.The institutional review board approved this prospective study. Written informed consent was obtained from all subjects. Fifty-four patients clinically suspected of having calcific tendonitis of the rotator cuff were included. On radiographs (the standard of reference), 27 patients had positive calcification findings, and 27 did not. Standard MR sequences and SWI, including magnitude and phase imaging, were performed. The diameter of calcifications was measured to assess intermodality correlations. Sensitivity, specificity, and intra- and interobserver agreement were calculated. Phantom measurements were performed to assess the detection limit of SWI.Fifty-six calcifications were detected with radiography in 27 patients. Most (55 calcifications, 98%) could be identified as calcifications by using SWI. Standard T1- and T2-weighted sequences were used to identify 33 calcifications (59%). SWI yielded a sensitivity of 98% (95% confidence interval [CI]: 0.943, 1) and specificity of 96% (95% CI: 0.886, 1) for the identification of calcifications when compared with radiography. Standard rotator cuff MR sequences yielded a sensitivity of 59% (95% CI: 0.422, 0.758) and specificity of 67% (95% CI: 0.493, 0.847). Diameter measurements demonstrated a high correlation between SWI and radiography (R(2) = 0.90), with overestimation of lesion diameter at SWI (mean ± standard deviation for SWI, 7.6 mm ± 5.4; for radiography, 5.3 mm ± 5.1). SWI yielded higher interobserver agreement (R(2) = 0.99, P < .001; 95% CI: 0.989, 0.996) compared with standard MR sequences (R(2) = 0.67, P = .62; 95% CI: 0.703, 0.899). In phantom experiments, SWI and computed tomography were used to identify small calcifications that were missed at radiography.SWI enables the reliable detection of calcifications in the rotator cuff in patients with calcific tendonitis by using conventional radiography as a reference and offers better sensitivity and specificity than standard rotator cuff MR sequences.",0 +https://doi.org/10.1214/088342305000000016,Markov Chain Monte Carlo Methods and the Label Switching Problem in Bayesian Mixture Modeling,"In the past ten years there has been a dramatic increase of interest in the Bayesian analysis of finite mixture models. This is primarily because of the emergence of Markov chain Monte Carlo (MCMC) methods. While MCMC provides a convenient way to draw inference from complicated statistical models, there are many, perhaps underappreciated, problems associated with the MCMC analysis of mixtures. The problems are mainly caused by the nonidentifiability of the components under symmetric priors, which leads to so-called label switching in the MCMC output. This means that ergodic averages of component specific quantities will be identical and thus useless for inference. We review the solutions to the label switching problem, such as artificial identifiability constraints, relabelling algorithms and label invariant loss functions. We also review various MCMC sampling schemes that have been suggested for mixture models and discuss posterior sensitivity to prior specification.",0 +https://doi.org/10.1177/0049124103260222,Autoregressive Latent Trajectory (ALT) Models A Synthesis of Two Traditions,"Although there are a variety of statistical methods available for the analysis of longitudinal panel data, two approaches are of particular historical importance: the autoregressive (simplex) model and the latent trajectory (curve) model. These two approaches have been portrayed as competing methodologies such that one approach is superior to the other. We argue that the autoregressive and trajectory models are special cases of a more encompassing model that we call the autoregressive latent trajectory (ALT) model. In this paper we detail the underlying statistical theory and mathematical identification of this model, and demonstrate the ALT model using two empirical data sets. The first reanalyzes a simulated repeated measures data set that was previously used to argue against the autoregressive model, and we illustrate how the ALT model can recover the true latent curve model. Second, we apply the ALT model to real family income data on N=3912 adults over a seven year period and find evidence for both autoregressive and latent trajectory processes. Extensions and limitations are discussed.",0 +https://doi.org/10.1016/j.ssresearch.2014.05.011,"Homonegativity among first and second generation migrants in Europe: The interplay of time trends, origin, destination and religion","• There is few previous research into approval of homosexuality among migrants. • We analyze time trends, and the influence of origin, destination and religion. • A specific HAPC model is developed. • Homonegativity declines both over time as across cohorts. • Migrants conform to levels of homonegativity in the host society. Previous studies reported declining disapproval of homosexuality in Europe but have simultaneously identified the decelerating effect of religiosity and the higher disapproval of homosexuality among migrants. In this paper, we address disapproval of homosexuality among first- and second-generation migrants in Europe by assessing (1) period and cohort changes, (2) origin and destination country influences and (3) the role of religiosity. We develop a specific cross-classified multilevel design enabling us to simultaneously examine these influences. We test hypotheses using a subsample of the European Social Survey (ESS), containing 19,878 first and second generation migrants. The analyses lead to three important conclusions. Firstly, disapproval of homosexuality is declining both over time and across cohorts. Secondly, migrants conform to levels of disapproval of homosexuality among natives in the destination country, and this explains the decline among migrants over time. Thirdly, religion has a multi-faceted influence on levels of disapproval of homosexuality among migrants.",0 +https://doi.org/10.1037/0022-3514.37.10.1742,A new round robin analysis of variance for social interaction data.,"Experimental social psychology has dealt primarily with situations that are not true social interactions; in a typical study, a subject responds to a fixed, artificial social stimulus such as a photograph, written description, or performance by a confederate. Although these artificial social stimuli provide experimental control over independent variables and can be analyzed using the types of statistical models originally developed for nonsocial experimental research, they provide little or no information about the interactive aspects of social behavior—the reciprocity or mutual contingency of the behavior of interaction partners. This paper describes a nonexperimenta l design specifically tailored to social interaction data that provides more information about individual differences and social influence in social interactions: a round robin design in which each person interacts with every other person. After a brief review of available models, a new and more general model for the analysis of social interaction data is presented, with an empirical demonstration using vocal activity data.",0 +https://doi.org/10.5209/rev_sjop.2012.v15.n1.37348,Computerized Adaptive Testing: The Capitalization on Chance Problem,"This paper describes several simulation studies that examine the effects of capitalization on chance in the selection of items and the ability estimation in CAT, employing the 3-parameter logistic model. In order to generate different estimation errors for the item parameters, the calibration sample size was manipulated ( N = 500, 1000 and 2000 subjects) as was the ratio of item bank size to test length (banks of 197 and 788 items, test lengths of 20 and 40 items), both in a CAT and in a random test. Results show that capitalization on chance is particularly serious in CAT, as revealed by the large positive bias found in the small sample calibration conditions. For broad ranges of θ, the overestimation of the precision (asymptotic Se) reaches levels of 40%, something that does not occur with the RMSE (θ). The problem is greater as the item bank size to test length ratio increases. Potential solutions were tested in a second study, where two exposure control methods were incorporated into the item selection algorithm. Some alternative solutions are discussed.",0 +https://doi.org/10.1080/01621459.1987.10478472,Asymptotic Properties of Maximum Likelihood Estimators and Likelihood Ratio Tests under Nonstandard Conditions,"Abstract Large sample properties of the likelihood function when the true parameter value may be on the boundary of the parameter space are described. Specifically, the asymptotic distribution of maximum likelihood estimators and likelihood ratio statistics are derived. These results generalize the work of Moran (1971), Chant (1974), and Chernoff (1954). Some of Chant's results are shown to be incorrect. The approach used in deriving these results follows from comments made by Moran and Chant. The problem is shown to be asymptotically equivalent to the problem of estimating the restricted mean of a multivariate Gaussian distribution from a sample of size 1. In this representation the Gaussian random variable corresponds to the limit of the normalized score statistic and the estimate of the mean corresponds to the limit of the normalized maximum likelihood estimator. Thus the limiting distribution of the maximum likelihood estimator is the same as the distribution of the projection of the Gaussian random v...",0 +https://doi.org/10.1093/biomet/86.3.677,Joint mean-covariance models with applications to longitudinal data: unconstrained parameterisation,"SUMMARY We provide unconstrained parameterisation for and model a covariance using covariates. The Cholesky decomposition of the inverse of a covariance matrix is used to associate a unique unit lower triangular and a unique diagonal matrix with each covariance matrix. The entries of the lower triangular and the log of the diagonal matrix are unconstrained and have meaning as regression coefficients and prediction variances when regressing a measurement on its predecessors. An extended generalised linear model is introduced for joint modelling of the vectors of predictors for the mean and covariance subsuming the joint modelling strategy for mean and variance heterogeneity, Gabriel's antedependence models, Dempster's covariance selection models and the class of graphical models. The likelihood function and maximum likelihood estimators of the covariance and the mean parameters are studied when the observations are normally distributed. Applications to modelling nonstationary dependence structures and multivariate data are discussed and illustrated using real data. A graphical method, similar to that based on the correlogram in time series, is developed and used to identify parametric models for nonstationary covariances.",0 +https://doi.org/10.1093/aje/kwq332,Odds Ratios for Mediation Analysis for a Dichotomous Outcome,"For dichotomous outcomes, the authors discuss when the standard approaches to mediation analysis used in epidemiology and the social sciences are valid, and they provide alternative mediation analysis techniques when the standard approaches will not work. They extend definitions of controlled direct effects and natural direct and indirect effects from the risk difference scale to the odds ratio scale. A simple technique to estimate direct and indirect effect odds ratios by combining logistic and linear regressions is described that applies when the outcome is rare and the mediator continuous. Further discussion is given as to how this mediation analysis technique can be extended to settings in which data come from a case-control study design. For the standard mediation analysis techniques used in the epidemiologic and social science literatures to be valid, an assumption of no interaction between the effects of the exposure and the mediator on the outcome is needed. The approach presented here, however, will apply even when there are interactions between the effect of the exposure and the mediator on the outcome.",0 +https://doi.org/10.1016/s0377-2217(01)00147-3,Real world performance of choice-based conjoint models,"Conjoint analysis is one of the most important tools to support product development, pricing and positioning decisions in management practice. For this purpose various models have been developed. It is widely accepted that models that take consumer heterogeneity into account, outperform aggregate models in terms of hold-out tasks. The aim of our study is to investigate empirically whether predictions of choice-based conjoint models which incorporate heterogeneity can successfully be generalized to a whole market. To date no studies exist that examine the real world performance of choice-based conjoint models by use of aggregate scanner panel data. Our analysis is based on four commercial choice-based conjoint pricing studies including a total of 43 stock keeping units (SKU) and the corresponding weekly scanning data for approximately two years. An aggregate model serves as a benchmark for the performance of two models that take heterogeneity into account, hierarchical Bayes and latent class. Our empirical analysis demonstrates that, in contrast to the performance using hold-out tasks, the real world performance of hierarchical Bayes and latent class is similar to the performance of the aggregate model. Our results indicate that heterogeneity cannot be generalized to a whole market and suggest that aggregate models are sufficient to predict market shares. (author's abstract)",0 +https://doi.org/10.1093/ser/mwu039,Between exclusion and calculating solidarity? Preferences for private versus public welfare provision and the size of the informal sector,"This article examines how the informal sector, as a group of potential 'free riders' for public welfare goods, relates to individual social policy preferences in low- and middle-income countries. The exclusion hypothesis proposes that a large informal sector lowers the preferences from formal workers and the middle- and high-income groups for social services to be provided by the state, and raises these groups' preferences for public welfare goods to become club goods. In contrast, the prospect hypothesis argues that formal workers, particularly the middle-income group, ally themselves to the informal sector to insure against the risk of future employment in informality. The study examines individual preferences for the provision of pensions and health care by either the state or private enterprises. The two competing hypotheses are tested with a hierarchical model using survey data from Latin America for 1995, 1998 and 2008. The findings offer support for the exclusion hypothesis. © The Author 2015.",0 +https://doi.org/10.1198/tech.2009.08161,Partitioning Degrees of Freedom in Hierarchical and Other Richly Parameterized Models,"Hodges & Sargent (2001) developed a measure of a hierarchical model's complexity, degrees of freedom (DF), that is consistent with definitions for scatterplot smoothers, interpretable in terms of simple models, and that enables control of a fit's complexity by means of a prior distribution on complexity. DF describes complexity of the whole fitted model but in general it is unclear how to allocate DF to individual effects. We give a new definition of DF for arbitrary normal-error linear hierarchical models, consistent with Hodges & Sargent's, that naturally partitions the n observations into DF for individual effects and for error. The new conception of an effect's DF is the ratio of the effect's modeled variance matrix to the total variance matrix. This gives a way to describe the sizes of different parts of a model (e.g., spatial clustering vs. heterogeneity), to place DF-based priors on smoothing parameters, and to describe how a smoothed effect competes with other effects. It also avoids difficulties with the most common definition of DF for residuals. We conclude by comparing DF to the effective number of parameters p(D) of Spiegelhalter et al (2002). Technical appendices and a dataset are available online as supplemental materials.",0 +https://doi.org/10.1198/106186006x160050,Sampling Correlation Matrices in Bayesian Models With Correlated Latent Variables,"Hierarchical model specifications using latent variables are frequently used to reflect correlation structure in data. Motivated by the structure of a Bayesian multivariate probit model, we demonstrate a parameter-extended Metropolis-Hastings algorithm for sampling from the posterior distribution of a correlation matrix. Our sampling algorithms lead directly to two readily interpretable families of prior distributions for a correlation matrix. The methodology is illustrated through a simulation study and through an application with repeated binary outcomes on individuals from a study of a suicide prevention intervention.",0 +https://doi.org/10.1160/th11-08-0586,"Network meta-analysis of prasugrel, ticagrelor, high- and standard-dose clopidogrel in patients scheduled for percutaneous coronary interventions","Summary Since novel antiplatelet treatments (prasugrel, ticagrelor, high-dose clopidogrel) have been predominantly tested against standard-dose clopidogrel, data on direct comparisons between these therapies are scarce. We therefore indirectly compared their efficacy and safety in patients undergoing percutaneous coronary intervention. Electronic databases were searched systematically to identify head-to-head randomised controlled trials (RCTs). Network meta-analysis was performed using generalised linear mixed models with adjustment for length of follow-up. Findings were corroborated by mixed treatment comparison through Bayesian methods. Fourteen RCTs were identified and included in the analysis (high- vs. standard-dose clopidogrel: 9 trials, prasugrel vs. high-dose clopidogrel: 2 trials, prasugrel vs. standard-dose clopidogrel: 2 trials, ticagrelor vs. standard-dose clopidogrel: 1 trial). No significant differences were found for efficacy outcomes except for stent thrombosis favouring prasugrel (vs. ticagrelor: odds ratio [OR] 0.63, 95% confidence interval [CI]: 0.42, 0.94; vs. high-dose clopidogrel: OR 0.70, 95%CI: 0.48, 1.01). Prasugrel exhibited a similar bleeding risk as high-dose clopidogrel, but more major (OR 1.43, 95%CI 1.07, 1.90) and major or minor bleeding (OR 1.36, 95%CI 1.09, 1.69) compared to ticagrelor. Ticagrelor was also associated with less major or minor bleeding compared to high-dose clopidogrel (OR 0.81, 95%CI 0.69, 0.96). No differences were seen for non CABG-related major bleeding between the three strategies. Results were corroborated in a subgroup analysis comprising only patients with acute coronary syndromes. In the absence of head-to-head clinical trials, network meta-analysis suggests potentially relevant differences in efficacy and bleeding risk among novel antiplatelet treatments and may thereby advance understanding of their differential therapeutic properties.",0 +https://doi.org/10.1080/03050629.2014.948154,"Political Trust, Corruption, and Ratings of the IMF and the World Bank","There are only a handful of studies that examine public support for the IMF and World Bank. Public opinion data on attitudes to the economy feature prominently in these studies. Utilizing data from the Afrobarometer survey, we find that evaluations of the economy, ideology, and a range of sociodemographic factors including age, gender, employment status, health, education, and living conditions are not significantly related to ratings of effectiveness. Rather, we find that political trust and corruption—two very important concepts in the wider literature on individual-level attitudes toward international relations and foreign policy issues—are strongly associated with ratings of effectiveness.",0 +https://doi.org/10.1007/978-3-319-19977-1_24,Mediation Analysis with Missing Data Through Multiple Imputation and Bootstrap,"A method using multiple imputation and bootstrap for dealing with missing data in mediation analysis is introduced and implemented in both SAS and R. Through simulation studies, it is shown that the method performs well for both MCAR and MAR data without and with auxiliary variables. It is also shown that the method can work for MNAR data if auxiliary variables related to missingness are included. The application of the method is demonstrated through the analysis of a subset of data from the National Longitudinal Survey of Youth. Mediation analysis with missing data can be conducted using the provided SAS macros and R package bmem.",0 +https://doi.org/10.1093/bioinformatics/btw207,Sparse group factor analysis for biclustering of multiple data sources,"Abstract Motivation: Modelling methods that find structure in data are necessary with the current large volumes of genomic data, and there have been various efforts to find subsets of genes exhibiting consistent patterns over subsets of treatments. These biclustering techniques have focused on one data source, often gene expression data. We present a Bayesian approach for joint biclustering of multiple data sources, extending a recent method Group Factor Analysis to have a biclustering interpretation with additional sparsity assumptions. The resulting method enables data-driven detection of linear structure present in parts of the data sources. Results: Our simulation studies show that the proposed method reliably infers biclusters from heterogeneous data sources. We tested the method on data from the NCI-DREAM drug sensitivity prediction challenge, resulting in an excellent prediction accuracy. Moreover, the predictions are based on several biclusters which provide insight into the data sources, in this case on gene expression, DNA methylation, protein abundance, exome sequence, functional connectivity fingerprints and drug sensitivity. Availability and Implementation: http://research.cs.aalto.fi/pml/software/GFAsparse/ Contacts: kerstin.bunte@googlemail.com or samuel.kaski@aalto.fi",0 +https://doi.org/10.1016/j.jmva.2009.04.014,Bayesian predictive densities based on superharmonic priors for the 2-dimensional Wishart model,Bayesian predictive densities for the 2-dimensional Wishart model are investigated. The performance of predictive densities is evaluated by using the Kullback–Leibler divergence. It is proved that a Bayesian predictive density based on a prior exactly dominates that based on the Jeffreys prior if the prior density satisfies some geometric conditions. An orthogonally invariant prior is introduced and it is shown that the Bayesian predictive density based on the prior is minimax and dominates that based on the right invariant prior with respect to the triangular group.,0 +https://doi.org/10.1016/0749-5978(91)90020-t,The theory of planned behavior,"Research dealing with various aspects of* the theory of planned behavior (Ajzen, 1985, 1987) is reviewed, and some unresolved issues are discussed. In broad terms, the theory is found to be well supported by empirical evidence. Intentions to perform behaviors of different kinds can be predicted with high accuracy from attitudes toward the behavior, subjective norms, and perceived behavioral control; and these intentions, together with perceptions of behavioral control, account for considerable variance in actual behavior. Attitudes, subjective norms, and perceived behavioral control are shown to be related to appropriate sets of salient behavioral, normative, and control beliefs about the behavior, but the exact nature of these relations is still uncertain. Expectancy— value formulations are found to be only partly successful in dealing with these relations. Optimal rescaling of expectancy and value measures is offered as a means of dealing with measurement limitations. Finally, inclusion of past behavior in the prediction equation is shown to provide a means of testing the theory*s sufficiency, another issue that remains unresolved. The limited available evidence concerning this question shows that the theory is predicting behavior quite well in comparison to the ceiling imposed by behavioral reliability. © 1991 Academic Press. Inc.",0 +https://doi.org/10.4135/9780857020994.n22,Maximum Likelihood and Bayesian Estimation for Nonlinear Structural Equation Models,,0 +https://doi.org/10.1007/bf02294002,Estimation for structural equation models with missing data,"A direct method in handling incomplete data in general covariance structural models is investigated. Asymptotic statistical properties of the generalized least squares method are developed. It is shown that this approach has very close relationships with the maximum likelihood approach. Iterative procedures for obtaining the generalized least squares estimates, the maximum likelihood estimates, as well as their standard error estimates are derived. Computer programs for the confirmatory factor analysis model are implemented. A longitudinal type data set is used as an example to illustrate the results. © 1986 The Psychometric Society.",0 +https://doi.org/10.1123/jsep.2013-0043,A Point-by-Point Analysis of Performance in a Fencing Match: Psychological Processes Associated with Winning and Losing Streaks,"This study aimed to revisit the complex nature of serial dependency of performance during a match, examining the prospective associations between psychological processes and subsequent performance at the within-person level of analysis, and explore whether psychological processes are associated with the likelihood of winning series of points. A process-oriented sequential approach was used with 16 elite fencers during a simulated competition. Multilevel regression analyses revealed that serial dependency of performance fluctuates within a match. Results of a Bayesian multilevel structural equation model showed that prior performance subsequently influenced psychological processes. Although psychological processes did not predict performance in the subsequent point, successive winnings were associated with higher perceived control and task-oriented coping and lower negative affectivity compared with both losing streaks and nonstreaks. Overall, serial dependencies of performance are nonstationary during a match whereas psychological processes significantly differ in episodes of winning after winning versus losing after losing.",0 +https://doi.org/10.1037/a0029856,An ideal observer analysis of visual working memory.,"Limits in visual working memory (VWM) strongly constrain human performance across many tasks. However, the nature of these limits is not well understood. In this article we develop an ideal observer analysis of human VWM by deriving the expected behavior of an optimally performing but limited-capacity memory system. This analysis is framed around rate-distortion theory, a branch of information theory that provides optimal bounds on the accuracy of information transmission subject to a fixed information capacity. The result of the ideal observer analysis is a theoretical framework that provides a task-independent and quantitative definition of visual memory capacity and yields novel predictions regarding human performance. These predictions are subsequently evaluated and confirmed in 2 empirical studies. Further, the framework is general enough to allow the specification and testing of alternative models of visual memory (e.g., how capacity is distributed across multiple items). We demonstrate that a simple model developed on the basis of the ideal observer analysis-one that allows variability in the number of stored memory representations but does not assume the presence of a fixed item limit-provides an excellent account of the empirical data and further offers a principled reinterpretation of existing models of VWM.",0 +https://doi.org/10.1002/job.529,"To prosper, organizational psychology should … overcome methodological barriers to progress","Progress in organizational psychology (OP) research depends on the rigor and quality of the methods we use. This paper identifies ten methodological barriers to progress and offers suggestions for overcoming the barriers, in part or whole. The barriers address how we derive hypotheses from theories, the nature and scope of the questions we pursue in our studies, the ways we address causality, the manner in which we draw samples and measure constructs, and how we conduct statistical tests and draw inferences from our research. The paper concludes with recommendations for integrating research methods into our ongoing development goals as scholars and framing methods as tools that help us achieve shared objectives in our field. Copyright © 2008 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1007/s11336-013-9379-4,Hierarchical Bayesian Modeling for Test Theory Without an Answer Key,"Cultural Consensus Theory (CCT) models have been applied extensively across research domains in the social and behavioral sciences in order to explore shared knowledge and beliefs. CCT models operate on response data, in which the answer key is latent. The current paper develops methods to enhance the application of these models by developing the appropriate specifications for hierarchical Bayesian inference. A primary contribution is the methodology for integrating the use of covariates into CCT models. More specifically, both person- and item-related parameters are introduced as random effects that can respectively account for patterns of inter-individual and inter-item variability. © 2013, The Psychometric Society.",0 +https://doi.org/10.1080/00273171.2010.531230,Nonlinear Structured Growth Mixture Models in Mplusand OpenMx,"Growth mixture models (GMMs; Muthén & Muthén, 2000; Muthén & Shedden, 1999) are a combination of latent curve models (LCMs) and finite mixture models to examine the existence of latent classes that follow distinct developmental patterns. GMMs are often fit with linear, latent basis, multiphase, or polynomial change models because of their common use, flexibility in modeling many types of change patterns, the availability of statistical programs to fit such models, and the ease of programming. In this paper, we present additional ways of modeling nonlinear change patterns with GMMs. Specifically, we show how LCMs that follow specific nonlinear functions can be extended to examine the presence of multiple latent classes using the Mplus and OpenMx computer programs. These models are fit to longitudinal reading data from the Early Childhood Longitudinal Study-Kindergarten Cohort to illustrate their use.",0 +https://doi.org/10.1177/0958928715573478,Attitudes towards student support: How positive feedback-effects prevent change in the Four Worlds of Student Finance,"This article provides a detailed analysis of individual preferences towards public financial aid to students from low-income families. Who favours/opposes such aid? What are the determinants of the respective preferences? I argue that three sets of factors jointly shape these preferences: materialistic self-interests, political attitudes, and the status quo of the higher education subsidy systems by generating positive feedback-effects. Results of multilevel ordered logit models utilizing the International Social Survey Program (ISSP) data for up to 22 countries over two decades indicate that self-interest matters: students strongly favour subsidies as do their parents, while those paying for the spending and those not expecting to benefit oppose such aid. Moreover, political attitudes are important: Supporters of redistribution and of increased public education spending in general, as well as leftwing voters, are much more likely to support students. On the macro-level, the findings suggest that positive feedback-effects exist: in countries with generous subsidy systems, public support for subsidies is higher. This article is the first to systematically analyse preferences towards higher education subsidies across countries and time and demonstrates how positive feedback-effects increasingly lock-in countries’ tuition-subsidy paths, making the systems resistant to (radical) change. As such, it speaks to the literature on the political economy of skill formation, the welfare state, public opinion and the public opinion–policy link.",0 +https://doi.org/10.1080/10705511003659425,A Bayesian Approach for Nonlinear Structural Equation Models With Dichotomous Variables Using Logit and Probit Links,"Analysis of ordered binary and unordered binary data has received considerable attention in social and psychological research. This article introduces a Bayesian approach, which has several nice features in practical applications, for analyzing nonlinear structural equation models with dichotomous data. We demonstrate how to use the software WinBUGS and R2WinBUGS to obtain Bayesian estimates of the unknown parameters, estimates of latent variables, and the Deviance Information Criterion for model comparison. An illustrative example with an artificial data set is provided. Finally, simulation studies are conducted, not only to reveal the empirical performance of the Bayesian approach, but also to show that incorrectly treating binary data as ordinal, and vice versa, would produce misleading results.",0 +https://doi.org/10.1080/00273171.2014.955604,Effects of Modeling the Heterogeneity on Inferences Drawn from Multilevel Designs,"This article uses Monte Carlo techniques to examine the effect of heterogeneity of variance in multilevel analyses in terms of relative bias, coverage probability, and root mean square error (RMSE). For all simulated data sets, the parameters were estimated using the restricted maximum-likelihood (REML) method both assuming homogeneity and incorporating heterogeneity into multilevel models. We find that (a) the estimates for the fixed parameters are unbiased, but the associated standard errors are frequently biased when heterogeneity is ignored; by contrast, the standard errors of the fixed effects are almost always accurate when heterogeneity is considered; (b) the estimates for the random parameters are slightly overestimated; (c) both the homogeneous and heterogeneous models produce standard errors of the variance component estimates that are underestimated; however, taking heterogeneity into account, the REML-estimations give correct estimates of the standard errors at the lowest level and lead to less underestimated standard errors at the highest level; and (d) from the RMSE point of view, REML accounting for heterogeneity outperforms REML assuming homogeneity; a considerable improvement has been particularly detected for the fixed parameters. Based on this, we conclude that the solution presented can be uniformly adopted. We illustrate the process using a real dataset.",0 +https://doi.org/10.1037/a0015825,Estimation of IRT graded response models: Limited versus full information methods.,"The performance of parameter estimates and standard errors in estimating F. Samejima's graded response model was examined across 324 conditions. Full information maximum likelihood (FIML) was compared with a 3-stage estimator for categorical item factor analysis (CIFA) when the unweighted least squares method was used in CIFA's third stage. CIFA is much faster in estimating multidimensional models, particularly with correlated dimensions. Overall, CIFA yields slightly more accurate parameter estimates, and FIML yields slightly more accurate standard errors. Yet, across most conditions, differences between methods are negligible. FIML is the best election in small sample sizes (200 observations). CIFA is the best election in larger samples (on computational grounds). Both methods failed in a number of conditions, most of which involved 200 observations, few indicators per dimension, highly skewed items, or low factor loadings. These conditions are to be avoided in applications.",0 +https://doi.org/10.1016/j.csda.2010.04.015,Alternating imputation posterior estimation of models with crossed random effects,"Generalized linear mixed models or latent variable models for categorical data are difficult to estimate if the random effects or latent variables vary at non-nested levels, such as persons and test items. Clayton and Rasbash (1999) suggested an Alternating Imputation Posterior (AIP) algorithm for approximate maximum likelihood estimation. For item response models with random item effects, the algorithm iterates between an item wing in which the item mean and variance are estimated for given person effects and a person wing in which the person mean and variance are estimated for given item effects. The person effects used for the item wing are sampled from the conditional posterior distribution estimated in the person wing and vice versa. Clayton and Rasbash (1999) used marginal quasi-likelihood (MQL) and penalized quasi-likelihood (PQL) estimation within the AIP algorithm, but this method has been shown to produce biased estimates in many situations, so we use maximum likelihood estimation with adaptive quadrature. We apply the proposed algorithm to the famous salamander mating data, comparing the estimates with many other methods, and to an educational testing dataset. We also present a simulation study to assess performance of the AIP algorithm and the Laplace approximation with different numbers of items and persons and a range of item and person variances.",0 +https://doi.org/10.1214/105051606000000510,Harris recurrence of Metropolis-within-Gibbs and trans-dimensional Markov chains,"A ϕ-irreducible and aperiodic Markov chain with stationary probability distribution will converge to its stationary distribution from almost all starting points. The property of Harris recurrence allows us to replace “almost all” by “all,” which is potentially important when running Markov chain Monte Carlo algorithms. Full-dimensional Metropolis–Hastings algorithms are known to be Harris recurrent. In this paper, we consider conditions under which Metropolis-within-Gibbs and trans-dimensional Markov chains are or are not Harris recurrent. We present a simple but natural two-dimensional counter-example showing how Harris recurrence can fail, and also a variety of positive results which guarantee Harris recurrence. We also present some open problems. We close with a discussion of the practical implications for MCMC algorithms.",0 +https://doi.org/10.1002/cjs.5550350108,Measuring the complexity of generalized linear hierarchical models,en,0 +,Structural equation models of latent interaction and quadratic effects.,,0 +https://doi.org/10.1111/rssc.12013,Hierarchical longitudinal models of relationships in social networks,Summary Motivated by the need to understand the dynamics of relationship formation and dissolution over time in real world social networks we develop a new longitudinal model for transitions in the relationship status of pairs of individuals (‘dyads’). We first specify a model for the relationship status of a single dyad and then extend it to account for important interdyad dependences (e.g. transitivity—‘a friend of a friend is a friend’) and heterogeneity. Model parameters are estimated by using Bayesian analysis implemented via Markov chain Monte Carlo sampling. We use the model to perform novel analyses of two diverse longitudinal friendship networks: an excerpt of the Teenage Friends and Lifestyle Study (a moderately sized network) and the Framingham Heart Study (a large network).,0 +https://doi.org/10.1007/s11135-011-9503-4,Integrated analysis of content and construct validity of psychometric instruments,"Establishing adequacy of psychometric properties of an instrument involves acquisition and evaluation of evidence based on item content and internal structure. Content validity evidence consists of subject matter experts providing quantitative ratings of the extent to which items are a representative sample of targeted domain. Evidence of internal structure includes factor analytic studies and examination of item interrelationships based on item responses from participants. Although subject matter expert ratings and participant response data are traditionally analyzed separately, each serves to inform the other in important ways. We propose integrating subject matter experts' and participants' data seamlessly to establish a unified model of validity evidence. The approach is applied to an instrument designed to measure nursing home culture change (i. e., resident-centered care). The proposed method has been demonstrated to be useful with a posterior distribution resulting in stable estimates of psychometric parameters superior to traditional analytic approaches. To illustrate the efficacy of the methodology, we present a simulation study and discuss its place in psychometric methods. © 2011 Springer Science+Business Media B.V.",0 +https://doi.org/10.1287/mksc.19.4.328.11789,A Hierarchical Bayesian Methodology for Treating Heterogeneity in Structural Equation Models,"Structural equation models are widely used in marketing and psychometric literature to model relationships between unobserved constructs and manifest variables and to control for measurement error. Most applications of structural equation models assume that data come from a homogeneous population. This assumption may be unrealistic, as individuals are likely to be heterogeneous in their perceptions and evaluations of unobserved constructs. In addition, individuals may exhibitdifferent measurement reliabilities. It is well-known in statistical literature that failure to account for unobserved sources of individual differences can resultin misleading inferences and incorrect conclusions. We develop a hierarchical Bayesian framework for modeling general forms of heterogeneity in partially recursive structural equation models. Our framework elucidates the motivations for accommodating heterogeneity and illustrates theoretically the types of misleading inferences that can result when unobserved heterogeneity is ignored. We describe in detail the choices that researchers can make in incorporating different forms of measurement and structural heterogeneity. Current random-coefficient models in psychometric literature can accommodate heterogeneity solely in mean structures. We extend these models by allowing for heterogeneity both in mean and covariance structures. Specifically, in addition to heterogeneity in measurement intercepts and factor means, we account for heterogeneity in factor covariance structure, measurement error, and structural parameters. Models such as random-coefficient factor analysis, random-coefficientsecond-order factor analysis, and random-coefficient, partially recursive simultaneous equation models are special cases of our proposed framework. We also develop Markov Chain Monte Carlo (MCMC) procedures to perform Bayesian inference in partially recursive, random-coefficient structural equation models. These procedures provide individual-specific estimates of the factor scores, structural coefficients, and other model parameters. We illustrate our approach using two applications. The first application illustrates our methods on synthetic data, whereas the second application uses consumer satisfaction data involving measurements on satisfaction, expectation disconfirmation, and performance variables obtained from a panel of subjects. Our results from the synthetic data application show that our Bayesian procedures perform well in recovering the true parameters. More importantly, we find that models that ignore heterogeneity can yield a severely distorted picture of the nature of associations among variables and can therefore generate misleading inferences. Specifically, we find that ignoring heterogeneity can result in inflated estimates of measurement reliability, wrong signs of factor covariances, and can yield attenuated model fit and standard errors. The results from the consumer satisfaction study show that individuals vary both in means and covariances and indicate that conventional psychometric methods are not appropriate for our data. In addition, we find that heterogeneous models outperform the standard structural equation model in predictive ability. Managerially, we show how one can use the individual-level factor scores and structural parameter estimates from the Bayesian approach to perform quadrantanalysis and refine marketing policy (e.g., develop a one-on-one marketing policy). The framework introduced in this paper and the inference procedures we describe should be of interest to researchers in a wide range of disciplines in which measurement error and unobserved heterogeneity are problematic. In particular, our approach is suitable for studies in which panel data or multiple observations are available for a given set of respondents or objects (e.g., firms, organizations, markets). At a practical level, our procedures can be used by managers and other policymakers to customize marketing activities or policies. Future research should extend our procedures to deal with the general nonrecursive structural equation model and to handle binary and ordinal data situations.",0 +https://doi.org/10.1037/a0032138,Reliability estimation in a multilevel confirmatory factor analysis framework.,"Scales with varying degrees of measurement reliability are often used in the context of multistage sampling, where variance exists at multiple levels of analysis (e.g., individual and group). Because methodological guidance on assessing and reporting reliability at multiple levels of analysis is currently lacking, we discuss the importance of examining level-specific reliability. We present a simulation study and an applied example showing different methods for estimating multilevel reliability using multilevel confirmatory factor analysis and provide supporting Mplus program code. We conclude that (a) single-level estimates will not reflect a scale's actual reliability unless reliability is identical at each level of analysis, (b) 2-level alpha and composite reliability (omega) perform relatively well in most settings, (c) estimates of maximal reliability (H) were more biased when estimated using multilevel data than either alpha or omega, and (d) small cluster size can lead to overestimates of reliability at the between level of analysis. We also show that Monte Carlo confidence intervals and Bayesian credible intervals closely reflect the sampling distribution of reliability estimates under most conditions. We discuss the estimation of credible intervals using Mplus and provide R code for computing Monte Carlo confidence intervals.",0 +https://doi.org/10.1177/0022343314551080,A dangerous discrepancy,"This study aims to uncover how horizontal inequality affects support for violent and nonviolent resistance among Palestinians in the West Bank and Gaza. National survey data are introduced to operationalize the mechanisms proposed in the horizontal inequality literature on the individual level. Results point to the operation of political and economic horizontal inequality mechanisms in the Palestinian case. Higher perceived status of civil and political rights is associated with a lower probability of supporting violent over nonviolent resistance. Individuals are also more likely to support violent over nonviolent resistance the larger the difference in household expenditure and consumer durable ownership between their own region and the closest Israeli subdistrict. Corresponding differences in educational attainment have no corresponding effect. The results demonstrate how economic and political horizontal inequality can increase the risk that an individual becomes part of the mobilizational potential of violent social movements. This can lead to participation in a wide range of supportive actions that increase the viability of such movements, ranging from material support to direct participation in violence. The level of public support for violent resistance in key constituencies could also influence public opinion sensitive actors like Hamas in their choice between violent and nonviolent resistance strategies.",0 +https://doi.org/10.1080/01621459.1989.10478868,Optimal Matching for Observational Studies,"Abstract Matching is a common method of adjustment in observational studies. Currently, matched samples are constructed using greedy heuristics (or “stepwise” procedures) that produce, in general, suboptimal matchings. With respect to a particular criterion, a matched sample is suboptimal if it could be improved by changing the controls assigned to specific treated units, that is, if it could be improved with the data at hand. Here, optimal matched samples are obtained using network flow theory. In addition to providing optimal matched-pair samples, this approach yields optimal constructions for several statistical matching problems that have not been studied previously, including the construction of matched samples with multiple controls, with a variable number of controls, and the construction of balanced matched samples that combine features of pair matching and frequency matching. Computational efficiency is discussed. Extensive use is made of ideas from two essentially disjoint literatures, namely st...",0 +https://doi.org/10.1093/acprof:oso/9780199533022.001.0001,"Bayesian Smoothing and Regression for Longitudinal, Spatial and Event History Data","Several recent advances in smoothing and semiparametric regression are presented in this book from a unifying, Bayesian perspective. Simulation-based full Bayesian Markov chain Monte Carlo (MCMC) inference, as well as empirical Bayes procedures closely related to penalized likelihood estimation and mixed models, are considered here. Throughout, the focus is on semiparametric regression and smoothing based on basis expansions of unknown functions and effects in combination with smoothness priors for the basis coefficients. Beginning with a review of basic methods for smoothing and mixed models, longitudinal data, spatial data, and event history data are treated in separate chapters. Worked examples from various fields such as forestry, development economics, medicine, and marketing are used to illustrate the statistical methods covered in this book. Most of these examples have been analysed using implementations in the Bayesian software, BayesX, and some with R Codes.",0 +https://doi.org/10.1002/sim.4780110104,Bayesian subset analysis in a colorectal cancer clinical trial,"Subset analysis is the examination of treatment comparisons within groups of patients with restricted levels of patient characteristics. Such analyses are vulnerable to multiplicity effects. We examine the problem in the context of a proportional hazards model with terms for treatment, each of several dichotomous covariates representing the patient characteristics of interest, and treatment-by-covariate interaction effects. Parametrically, a subset-specific treatment effect is equal to the treatment effect term plus a linear combination of the interaction terms. We present Bayesian point and interval estimates under the assumption that the interaction terms are exchangeable and the prior distributions for the other regression parameters are locally uniform. This produces a shrinking of the estimated interaction effects towards zero, thereby discounting them and dealing in a natural way with multiplicity. We illustrate the method using results of a recent North Central Cancer Treatment Group/Mayo Clinic study in advanced colorectal cancer.",0 +https://doi.org/10.1037/1082-989x.9.3.334,Structured Latent Curve Models for the Study of Change in Multivariate Repeated Measures.,"This article considers a structured latent curve model for multiple repeated measures. In a structured latent curve model, a smooth nonlinear function characterizes the mean response. A first-order Taylor polynomial taken with regard to the mean function defines elements of a restricted factor matrix that may include parameters that enter nonlinearly. Similar to factor scores, random coefficients are combined with the factor matrix to produce individual latent curves that need not follow the same form as the mean curve. Here the associations between change characteristics in multiple repeated measures are studied. A factor analysis model for covariates is included as a means of relating latent covariates to the factors characterizing change in different repeated measures. An example is provided.",0 +https://doi.org/10.1080/10705510709336743,On Fitting Nonlinear Latent Curve Models to Multiple Variables Measured Longitudinally,"This article shows how nonlinear latent curve models may be fitted for simultaneous analysis of multiple variables measured longitudinally using Mx statistical software. Longitudinal studies often involve observation of several variables across time with interest in the associations between change characteristics of different variables measured within individuals. Other applications involve repeated measures for distinguishable individuals nested within small groups, such as families, with interest in the associations between change characteristics in variables for individuals within groups. This article shows how Mx can be used to carry out analysis of multiple variables measured over time where at least one variable is described by a function that includes one or more parameters that enter the model nonlinearly. An example is provided.",0 +https://doi.org/10.1002/sim.2713,Bayesian analysis of structural equation models with multinomial variables and an application to type 2 diabetic nephropathy,"There is now increasing evidence proving that many complex diseases can be significantly influenced by correlated phenotype and genotype variables, as well as their interactions. Effective and rigorous assessment of such influence is difficult, because the number of phenotype and genotype variables of interest may not be small, and a genotype variable is an unordered categorical variable that follows a multinomial distribution. To address the problem, we establish a novel nonlinear structural equation model for analysing mixed continuous and multinomial data that can be missing at random. A confirmatory factor analysis model with Kronecker product is proposed for grouping the manifest continuous and multinomial variables into latent variables according to their functions; and a nonlinear structural equation is formulated to assess the linear and interaction effects of the independent latent variables to the dependent latent variables. Bayesian methods for estimation and model comparison are developed through Markov chain Monte Carlo techniques and path sampling. The newly developed methodologies are applied to a case-control cohort of type 2 diabetic patients with nephropathy.",0 +https://doi.org/10.1016/j.jmp.2003.12.003,Mental architectures with selectively influenced but stochastically interdependent components,"Abstract The way external factors influence distribution functions for the overall time required to perform a mental task (such as responding to a stimulus, or solving a problem) may be informative as to the underlying mental architecture, the hypothetical network of interconnected processes some of which are selectively influenced by some of the external factors. Under the assumption that all processes contributing to the overall performance time are stochastically independent, several basic results have been previously established. These results relate patterns of response time distribution functions produced by manipulating external factors to such questions as whether the hypothetical constituent processes in the mental architecture enter AND gates or OR gates, and whether pairs of processes are sequential or concurrent. The present study shows that all these results are also valid for stochastically interdependent component times, provided the selective dependence of these components upon external factors is understood within the framework of a recently proposed theory of selective influence. According to this theory each component is representable as a function of three arguments: the factor set selectively influencing it, a component-specific source of randomness, and a source of randomness shared by all the components.",0 +https://doi.org/10.3310/hta4380,Bayesian methods in health technology assessment: a review.,"Bayesian methods may be defined as the explicit quantitative use of external evidence in the design, monitoring, analysis, interpretation and reporting of a health technology assessment. In outline, the methods involve formal combination through the use of Bayes's theorem of: 1. a prior distribution or belief about the value of a quantity of interest (for example, a treatment effect) based on evidence not derived from the study under analysis, with 2. a summary of the information concerning the same quantity available from the data collected in the study (known as the likelihood), to yield 3. an updated or posterior distribution of the quantity of interest. These methods thus directly address the question of how new evidence should change what we currently believe. They extend naturally into making predictions, synthesising evidence from multiple sources, and designing studies: in addition, if we are willing to quantify the value of different consequences as a 'loss function', Bayesian methods extend into a full decision-theoretic approach to study design, monitoring and eventual policy decision-making. Nonetheless, Bayesian methods are a controversial topic in that they may involve the explicit use of subjective judgements in what is conventionally supposed to be a rigorous scientific exercise.This report is intended to provide: 1. a brief review of the essential ideas of Bayesian analysis 2. a full structured review of applications of Bayesian methods to randomised controlled trials, observational studies, and the synthesis of evidence, in a form which should be reasonably straightforward to update 3. a critical commentary on similarities and differences between Bayesian and conventional approaches 4. criteria for assessing the reporting of a Bayesian analysis 5. a comprehensive list of published 'three-star' examples, in which a proper prior distribution has been used for the quantity of primary interest 6. tutorial case studies of a variety of types 7. recommendations on how Bayesian methods and approaches may be assimilated into health technology assessments in a variety of contexts and by a variety of participants in the research process.The BIDS ISI database was searched using the terms 'Bayes' or 'Bayesian'. This yielded almost 4000 papers published in the period 1990-98. All resultant abstracts were reviewed for relevance to health technology assessment; about 250 were so identified, and used as the basis for forward and backward searches. In addition EMBASE and MEDLINE databases were searched, along with websites of prominent authors, and available personal collections of references, finally yielding nearly 500 relevant references. A comprehensive review of all references describing use of 'proper' Bayesian methods in health technology assessment (those which update an informative prior distribution through the use of Bayes's theorem) has been attempted, and around 30 such papers are reported in structured form. There has been very limited use of proper Bayesian methods in practice, and relevant studies appear to be relatively easily identified.Bayesian methods in the health technology assessment context 1. Different contexts may demand different statistical approaches. Prior opinions are most valuable when the assessment forms part of a series of similar studies. A decision-theoretic approach may be appropriate where the consequences of a study are reasonably predictable. 2. The prior distribution is important and not unique, and so a range of options should be examined in a sensitivity analysis. Bayesian methods are best seen as a transformation from initial to final opinion, rather than providing a single 'correct' inference. 3. The use of a prior is based on judgement, and hence a degree of subjectivity cannot be avoided. However, subjective priors tend to show predictable biases, and archetypal priors may be useful for identifying a reasonable range of prior opinion.",0 +https://doi.org/10.1016/s0169-7161(05)25028-9,Bayesian Analysis of ROC Data,"This chapter highlights Bayesian analysis of ROC data. When measured on a dichotomous scale, the performance of a diagnostic test can be summarized by two quantities: the false positive fraction (FPF) and the true positive fraction (TPF). The FPF is defined as the fraction of “healthy” subjects who test positive, but who do not have the condition that the test is designed to detect. The TPF is the fraction of subjects, who are correctly diagnosed as having the condition. An ROC curve describes the tradeoff between FPF and TPF as the disease threshold is changed. More specifically, an ROC curve can be defined as the curve defined by the set of points. Moreover, the choice of a threshold determines the relative tradeoff between false positive rates and true positive rates. Receiver operating characteristics (ROC) methodology provides a framework for analyzing this tradeoff as the threshold applied to the diagnostic test is varied. The most common application of ROC methodology arises in the comparison of new diagnostic technologies. Finally, this chapter explores that ROC methodology is especially prevalent in the evaluation of radiological devices, where it has been used extensively to determine whether one imaging modality is superior to another.",0 +https://doi.org/10.1080/01621459.1987.10478490,Empirical Bayes Confidence Intervals Based on Bootstrap Samples,"Abstract Consider the model with data generated by the following two-stage process. First, a parameter θ is sampled from a prior distribution G, and then an observation is sampled from the conditional distribution f(y | θ). If the prior distribution is known, then the Bayes estimate under squared error loss is the posterior expectation of θ conditional on the data y. For example, if G is Gaussian with mean μ and variance τ2 and f(y | θ) is Gaussian with mean θ and variance σ2, then the posterior distribution is Gaussian with mean B μ + (1 – B)y and variance σ2(1 – B), where B = σ2/(σ2 + τ2). Inferences about θ are based on this distribution. We study the application of the bootstrap to situations where the prior must be estimated from the data (empirical Bayes methods). For this model, we observe data Y T = [Y 1, …, Y K]T, each independent Y K following the compound model described previously. As first shown by James and Stein (1961), setting each θk equal to its estimated posterior mean, where , and , pr...",0 +https://doi.org/10.1186/1742-2094-11-92,Improvement of spinal non-viral IL-10gene delivery by D-mannose as a transgene adjuvant to control chronic neuropathic pain,"Peri-spinal subarachnoid (intrathecal; i.t.) injection of non-viral naked plasmid DNA encoding the anti-inflammatory cytokine, IL-10 (pDNA-IL-10) suppresses chronic neuropathic pain in animal models. However, two sequential i.t. pDNA injections are required within a discrete 5 to 72-hour period for prolonged efficacy. Previous reports identified phagocytic immune cells present in the peri-spinal milieu surrounding the i.t injection site that may play a role in transgene uptake resulting in subsequent IL-10 transgene expression.In the present study, we aimed to examine whether factors known to induce pro-phagocytic anti-inflammatory properties of immune cells improve i.t. IL-10 transgene uptake using reduced naked pDNA-IL-10 doses previously determined ineffective. Both the synthetic glucocorticoid, dexamethasone, and the hexose sugar, D-mannose, were factors examined that could optimize i.t. pDNA-IL-10 uptake leading to enduring suppression of neuropathic pain as assessed by light touch sensitivity of the rat hindpaw (allodynia).Compared to dexamethasone, i.t. mannose pretreatment significantly and dose-dependently prolonged pDNA-IL-10 pain suppressive effects, reduced spinal IL-1β and enhanced spinal and dorsal root ganglia IL-10 immunoreactivity. Macrophages exposed to D-mannose revealed reduced proinflammatory TNF-α, IL-1β, and nitric oxide, and increased IL-10 protein release, while IL-4 revealed no improvement in transgene uptake. Separately, D-mannose dramatically increased pDNA-derived IL-10 protein release in culture supernatants. Lastly, a single i.t. co-injection of mannose with a 25-fold lower pDNA-IL-10 dose produced prolonged pain suppression in neuropathic rats.Peri-spinal treatment with D-mannose may optimize naked pDNA-IL-10 transgene uptake for suppression of allodynia, and is a novel approach to tune spinal immune cells toward pro-phagocytic phenotype for improved non-viral gene therapy.",0 +https://doi.org/10.1177/1948550611407689,Your Best Self Helps Reveal Your True Self,"How does trying to make a positive impression on others impact the accuracy of impressions? In an experimental study, the impact of positive self-presentation on the accuracy of impressions was examined by randomly assigning targets to either “put their best face forward” or to a control condition with low self-presentation demands. First, self-presenters successfully elicited more positive impressions from others, being viewed as more normative and better liked than those less motivated to self-present. Importantly, self-presenters were also viewed with greater accuracy than control targets, being perceived more in line with their self-reported distinctive personality traits and their IQ test scores. Mediational analyses were consistent with the hypothesis that self-presenters were more engaging than controls, which in turn led these individuals to be viewed with greater distinctive self–other agreement. In sum, positive self-presentation facilitates more accurate impressions, indicating that putting one’s best self forward helps reveal one’s true self.",0 +https://doi.org/10.1016/s0006-8993(00)02050-3,"Thermal hyperalgesia and mechanical allodynia produced by intrathecal administration of the human immunodeficiency virus-1 (HIV-1) envelope glycoprotein, gp120","Astrocytes and microglia in the spinal cord have recently been reported to contribute to the development of peripheral inflammation-induced exaggerated pain states. Both lowering of thermal pain threshold (thermal hyperalgesia) and lowering of response threshold to light tactile stimuli (mechanical allodynia) have been reported. The notion that spinal cord glia are potential mediators of such effects is based on the disruption of these exaggerated pain states by drugs thought to preferentially affect glial function. Activation of astrocytes and microglia can release many of the same substances that are known to mediate thermal hyperalgesia and mechanical allodynia. The aim of the present series of studies was to determine whether exaggerated pain states could also be created in rats by direct, intraspinal immune activation of astrocytes and microglia. The immune stimulus used was peri-spinal (intrathecal, i.t.) application of the Human Immunodeficiency Virus type 1 (HIV-1) envelope glycoprotein, gp120. This portion of HIV-1 is known to bind to and activate microglia and astrocytes. Robust thermal hyperalgesia (tail-flick, TF, and Hargreaves tests) and mechanical allodynia (von Frey and touch-evoked agitation tests) were observed in response to i.t. gp120. Heat denaturing of the complex protein structure of gp120 blocked gp120-induced thermal hyperalgesia. Lastly, both thermal hyperalgesia and mechanical allodynia to i.t. gp120 were blocked by spinal pretreatment with drugs (fluorocitrate and CNI-1493) thought to preferentially disrupt glial function.",0 +https://doi.org/10.3758/bf03194548,Invariance of the psychometric function for character recognition across the visual field,"The psychometric function for recognition of singly presented digits as a function of digit contrast was measured at 2 degrees steps across the horizontal meridian of the visual field, under monocular and binocular viewing conditions. A maximum-likelihood staircase procedure was used in a 10-alternative forced-choice recognition paradigm to gather the data Both the Weibull and the logistic psychometric functions provide excellent fits to the observed data. The slopes of these functions at their point of inflection ranged from 4.0 to 5.0 proportion-correct/log10-unit contrast, for both monocular and binocular viewing and for all loci in the visual field. These slope values correspond to short-term measurements (around 30 trials, or 1 min) and do not include performance variations of longer duration; the latter are estimated to increase slope by a factor of about 1.5. A single psychometric function shape, centered around a threshold value, therefore describes recognition performance at all retinal loci and binocularity. An empirical comparison of slope results across the literature shows that the function's slope is about twice that reported for a number of detection tasks. The comparison of recognition contrast thresholds, percentage correct values, and other performance measures across studies requires the knowledge of the psychometric function's slope, and our results thus provide a firm basis for the study of low-contrast character recognition.",0 +https://doi.org/10.1111/j.1745-3984.2002.tb01146.x,Item Parameter Estimation Under Conditions of Test Speededness: Application of a Mixture Rasch Model With Ordinal Constraints,"When tests are administered under fixed time constraints, test performances can be affected by speededness. Among other consequences, speededness can result in inaccurate parameter estimates in item response theory (IRT) models, especially for items located near the end of tests (Oshima, 1994). This article presents an IRT strategy for reducing contamination in item difficulty estimates due to speededness. Ordinal constraints are applied to a mixture Rasch model (Rost, 1990) so as to distinguish two latent classes of examinees: (a) a “speeded” class, comprised of examinees that had insufficient time to adequately answer end-of-test items, and (b) a “nonspeeded” class, comprised of examinees that had sufficient time to answer all items. The parameter estimates obtained for end-of-test items in the nonspeeded class are shown to more accurately approximate their difficulties when the items are administered at earlier locations on a different form of the test. A mixture model can also be used to estimate the class memberships of individual examinees. In this way, it can be determined whether membership in the speeded class is associated with other student characteristics. Results are reported for gender and ethnicity.",0 +https://doi.org/10.1017/cbo9781139941433.011,State space modeling for analysis of behavior in learning experiments,"Introduction: During the process of learning the brain undergoes changes that can be observed at both the cellular and systems level. Being able to track accurately simultaneous changes in behavior and neural activity is key to understanding how the brain learns new tasks and information. Learning is studied in a large number of experimental paradigms involving, for example, testing effects on learning of brain lesions (Whishaw & Tomie 1991; Dias et al. 1997; Dusek & Eichenbaum 1997; Wise & Murray 1999; Fox et al. 2003; Kim & Frank 2009; Kayser & D'Esposito 2013), attentional modulation (Cook & Maunsell 2002; Hudson et al. 2009), optogenetic manipulation (Warden et al. 2012) and pharmacological interventions (Stefani et al. 2003). Studies are also performed to understand how learning is affected by aging (Harris & Wolbers 2012), stroke (Panarese et al. 2012) and psychological conditions including autism (Solomon et al. 2011) and synesthesia (Brang et al. 2013). The learning process is also studied in relation to changes in neural activity in specific brain regions (Jog et al. 1999; Wirth et al. 2003; Suzuki & Brown 2005; Brovelli et al. 2011; Mattfeld & Stark 2011). In most cases, the response accuracy of a subject is binary, with a one representing a correct response and a zero representing an incorrect response. In its raw form, binary response accuracy can be difficult to visualize, especially if the time series is long, and the exact time when learning occurs can be difficult to identify. Typically, an experimenter is interested in deriving two things from the learning data: a learning trial and a learning curve. The first item is the time point at which responses significantly change relative to a baseline value such as chance performance. The second is estimation of a curve that defines the probability of a correct response as a function of trial. From these estimates, it is possible to compare changes in learning with other measurements such as, for example, localized brain oxygen consumption (via fMRI) or electrical activity. © Cambridge University Press 2015",0 +https://doi.org/10.1037/a0025046,Emotional inertia prospectively predicts the onset of depressive disorder in adolescence.,"Emotional inertia refers to the degree to which a person's current emotional state is predicted by their prior emotional state, reflecting how much it carries over from one moment to the next. Recently, in a cross-sectional study, we showed that high inertia is an important characteristic of the emotion dynamics observed in psychological maladjustment such as depression. In the present study, we examined whether emotional inertia prospectively predicts the onset of first-episode depression during adolescence. Emotional inertia was assessed in a sample of early adolescents (N = 165) based on second-to-second behavioral coding of videotaped naturalistic interactions with a parent. Greater inertia of both negative and positive emotional behaviors predicted the emergence of clinical depression 2.5 years later. The implications of these findings for the understanding of the etiology and early detection of depression are discussed.",0 +https://doi.org/10.1037/a0027539,A comparison of methods for estimating quadratic effects in nonlinear structural equation models.,"Two Monte Carlo simulations were performed to compare methods for estimating and testing hypotheses of quadratic effects in latent variable regression models. The methods considered in the current study were (a) a 2-stage moderated regression approach using latent variable scores, (b) an unconstrained product indicator approach, (c) a latent moderated structural equation method, (d) a fully Bayesian approach, and (e) marginal maximum likelihood estimation. Of the 5 estimation methods, it was found that overall the methods based on maximum likelihood estimation and the Bayesian approach performed best in terms of bias, root-mean-square error, standard error ratios, power, and Type I error control, although key differences were observed. Similarities as well as disparities among methods are highlight and general recommendations articulated. As a point of comparison, all 5 approaches were fit to a reparameterized version of the latent quadratic model to educational reading data.",0 +https://doi.org/10.3102/1076998611417628,Profile-Likelihood Approach for Estimating Generalized Linear Mixed Models With Factor Structures,"In this article, the authors suggest a profile-likelihood approach for estimating complex models by maximum likelihood (ML) using standard software and minimal programming. The method works whenever setting some of the parameters of the model to known constants turns the model into a standard model. An important class of models that can be estimated this way is generalized linear mixed models with factor structures. Such models are useful in educational research, for example, for estimation of value-added teacher or school effects with persistence parameters and for analysis of large-scale assessment data using multilevel item response models with discrimination parameters. The authors describe the profile-likelihood approach, implement it in the R software, and apply the method to longitudinal data and binary item response data. Simulation studies and comparison with gllamm show that the profile-likelihood method performs well in both types of applications. The authors also briefly discuss other types of models that can be estimated using the profile-likelihood idea.",0 +https://doi.org/10.3758/pbr.15.4.713,Assessing individual differences in categorical data,"In cognitive modeling, data are often categorical observations taken over participants and items. Usually subsets of these observations are pooled and analyzed by a cognitive model assuming the category counts come from a multinomial distribution with the same model parameters underlying all observations. It is well known that if there are individual differences in participants and/or items, a model analysis of the pooled data may be quite misleading, and in such cases it may be appropriate to augment the cognitive model with parametric random effects assumptions. On the other hand, if random effects are incorporated into a cognitive model that is not needed, the resulting model may be more flexible than the multinomial model that assumes no heterogeneity, and this may lead to overfitting. This article presents Monte Carlo statistical tests for directly detecting individual participant and/or item heterogeneity that depend only on the data structure itself. These tests are based on the fact that heterogeneity in participants and/or items results in overdispersion of certain category count statistics. It is argued that the methods developed in the article should be applied to any set of participant x item categorical data prior to cognitive model-based analyses.",0 +https://doi.org/10.1080/09585192.2011.561227,Does pay for performance diminish intrinsic interest?,"One concern with pay for individual performance (PFIP) is that it may undermine intrinsic interest, thus having little or no positive net influence on performance. A major basis for this concern is cognitive evaluation theory [CET; Deci and Ryan (1985), Intrinsic Motivation and Self-Determination in Human Behavior, New York: Plenum Press]. Most evidence on CET, however, comes from non-work settings and, even in that arena, there is debate regarding the undermining effect of PFIP. There is little workplace-based evidence on the validity of the undermining hypothesis and none that makes use of data on between-employer differences in PFIP. Also, a close reading of CET, reinforced by recent developments, suggests that PFIP plans could, under common workplace conditions, have a positive, rather than negative, influence on intrinsic interest. To our knowledge, there is no research that examines between-organization differences in PFIP and how they relate to employee intrinsic interest. There is also no research on whether employees having a preference for PFIP plans are likely to gravitate to organizations using such plans. To the extent such attraction–selection–attrition or sorting processes take place, the likelihood of detrimental consequences (e.g. diminished intrinsic interest) of PFIP plans due to mismatches between how the organization pays and how the employees are motivated should be less likely. We find no evidence of a detrimental effect of PFIP plans on intrinsic interest. Instead, intrinsic interest is actually higher under PFIP. We also find that organizations placing greater emphasis on PFIP plans tend to have employees with motivation orientations matching their PFIP plans, which may reduce the probability of a detrimental effect of PFIP.",0 +https://doi.org/10.1093/biomet/82.3.639,A note on the existence of the posterior distribution for a class of mixed models for binomial responses,SUMMARY Necessary and sufficient conditions are given for the existence of the posterior distribution of the variance components in a class of mixed models for binomial responses. The implications of our results are illustrated through an example.,0 +https://doi.org/10.1136/lupus-2015-000110,Perceptions of racism in healthcare among patients with systemic lupus erythematosus: a cross-sectional study,"Racial disparities in the clinical outcomes of systemic lupus erythematosus (SLE) exist. Perceived racial discrimination may contribute to disparities in health.To determine if perceived racism in healthcare differs by race among patients with SLE and to evaluate its contribution to racial disparities in SLE-related outcomes.163 African-American (AA) and 180 white (WH) patients with SLE were enrolled. Structured interviews and chart reviews were done to determine perceptions of racism, SLE-related outcomes (Systemic Lupus International Collaborating Clinics (SLICC) Damage Index, SLE Disease Activity, Center for Epidemiologic Studies-Depression (CES-D)), and other variables that may affect perceptions of racism. Serial hierarchical multivariable logistic regression models were conducted. Race-stratified analyses were also performed.56.0% of AA patients compared with 32.8% of WH patients had high perceptions of discrimination in healthcare (p<0.001). This difference remained (OR 4.75 (95% CI 2.41 to 8.68)) after adjustment for background, identity and healthcare experiences. Female gender (p=0.012) and lower trust in physicians (p<0.001) were also associated with high perceived racism. The odds of having greater disease damage (SLICC damage index ≥2) were higher in AA patients than in WH patients (crude OR 1.55 (95% CI 1.01 to 2.38)). The odds of having moderate to severe depression (CES-D ≥17) were also higher in AA patients than in WH patients (crude OR 1.94 (95% CI 1.26 to 2.98)). When adjusted for sociodemographic and clinical characteristics, racial disparities in disease damage and depression were no longer significant. Among AA patients, higher perceived racism was associated with having moderate to severe depression (adjusted OR 1.23 (95% CI 1.05 to 1.43)) even after adjusting for sociodemographic and clinical variables.Perceptions of racism in healthcare were more common in AA patients than in WH patients with SLE and were associated with depression. Interventions aimed at modifiable factors (eg, trust in providers) may reduce higher perceptions of race-based discrimination in SLE.",0 +https://doi.org/10.1186/1471-2458-4-48,"The ProActivetrial protocol – a randomised controlled trial of the efficacy of a family-based, domiciliary intervention programme to increase physical activity among individuals at high risk of diabetes [ISRCTN61323766]","BackgroundIncreasing prevalence of obesity and disorders associated with sedentary living constitute a major global public health problem. While previous evaluations of interventions to increase physical activity have involved communities or individuals with established disease, less attention has been given to interventions for individuals at risk of disease.Methods/design ProActiveaims to evaluate the efficacy of a theoretical, evidence- and family-based intervention programme to increase physical activity in a sedentary population, defined as being at-risk through having a parental family history of diabetes. Primary care diabetes or family history registers were used to recruit 365 individuals aged 30–50 years, screened for activity level. Participants were assigned by central randomisation to three intervention programmes: brief written advice (comparison group), or a psychologically based behavioural change programme, delivered either by telephone (distance group) or face-to-face in the family home over one year. The protocol-driven intervention programme is delivered by trained facilitators, and aims to support increases in physical activity through the introduction and facilitation of a range of self-regulatory skills (e.g. goal setting). The primary outcome is daytime energy expenditure and its ratio to resting energy expenditure, measured at baseline and one year using individually calibrated heart rate monitoring. Secondary measures include self-report of individual and family activity, psychological mediators of behaviour change, physiological and biochemical correlates, acceptability, and costs, measured at baseline, six months and one year. The primary intention to treat analysis will compare groups at one-year post randomisation. Estimation of the impact on diabetes incidence will be modelled using data from a parallel ten-year cohort study using similar measures.Discussion ProActiveis the first efficacy trial of an intervention programme to promote physical activity in a defined high-risk group accessible through primary care. The intervention programme is based on psychological theory and evidence; it introduces and facilitates the use of self-regulatory skills to support behaviour change and maintenance. The trial addresses a range of methodological weaknesses in the field by careful specification and quality assurance of the intervention programme, precise characterisation of participants, year-long follow-up and objective measurement of physical activity. Due to report in 2005, ProActivewill provide estimates of the extent to which this approach could assist at-risk groups who could benefit from changes in behaviours affecting health, and inform future pragmatic trials.",0 +https://doi.org/10.1002/sim.3648,Flexibility of Bayesian generalized linear mixed models for oral health research,"Many outcome variables in oral research are characterized by positive values and heavy skewness in the right tail. Examples are provided by many distributions of dental variables such as DMF (decayed, missing, filled teeth) scores, oral health impact profile score, gingival index scores, and microbiologic counts. Moreover, heterogeneity in data arises when more than one tooth is studied for each patient, due to the clusterization. Over the past decade, linear mixed models (LMEs) have become a common statistical tool to account for within-subject correlation in data with repeated measures. When a normal error is reasonably assumed, estimates of LMEs are supported by many statistical packages. Such is not the case for skewed data, where generalized linear mixed models (GLMMs) are required. However, the current software available supports only special cases of GLMMs or relies on crude Laplace-type approximation of integrals. In this study, a Bayesian approach is taken to estimate GLMMs for clustered skewed dental data. A Gamma GLMM and a log-normal model are employed to allow for heterogeneity across clusters, deriving from the patient-operator-tooth susceptibility typical of this clinical context. A comparison to the frequentist framework is also provided. In our case, Gamma GLMM fits data better than the log-normal distribution, while providing more precise estimates compared with the likelihood approach. A key advantage of the Bayesian framework is its ability to readily provide a flexible approach for implementation while simultaneously providing a formal procedure for solving inference problems. Copyright © 2009 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1111/1475-6765.12088,Valence and satisfaction with democracy: A cross-national analysis of nine Western European democracies,"In recent studies, scholars have highlighted factors that influence citizen satisfaction with democracy, with particular emphasis on the role played by the institutional features of political systems, and ideology. This article presents the first empirical study of whether changes in important party characteristics can affect individuals’ satisfaction with democracy. Using a measure of parties’ character-valence derived from content analysis of news reports, evidence is presented that when governing parties’ images decline with respect to important valence-related attributes such as competence, unity and integrity, then citizen satisfaction with democracy similarly declines. However, this relationship is conditional on the performance of opposition parties. These findings are relevant to studies of regime support, political representation, democratic accountability and voter behaviour.",0 +https://doi.org/10.1016/s0005-7894(02)80004-1,Testing for group membership effects during and after treatment: The example of group therapy for smoking cessation,"Behavioral interventions often are administered in groups, yet the effects of group membership rarely have been evaluated. The current research examined 33 groups of clients ( M = 5.5 clients per group, SD = 2.5) volunteering for a group smoking cessation intervention. The intervention consisted of 6 group therapy sessions over an 11-day period. Attendance at the sessions and smoking behavior during the 11-day period were the dependent variables. Hierarchical linear modeling (HLM) revealed a statistically significant ( p",0 +https://doi.org/10.1198/jcgs.2010.08181,Computational Aspects Related to Inference in Gaussian Graphical Models With the G-Wishart Prior,"We describe a comprehensive framework for performing Bayesian inference for Gaussian graphical models based on the G-Wishart prior with a special focus on efficiently including nondecomposable graphs in the model space. We develop a new approximation method to the normalizing constant of a G-Wishart distribution based on the Laplace approximation. We review recent developments in stochastic search algorithms and propose a new method, the mode oriented stochastic search (MOSS), that extends these techniques and proves superior at quickly finding graphical models with high posterior probability. We then develop a novel stochastic search technique for multivariate regression models and conclude with a real-world example from the recent covariance estimation literature. Supplemental materials are available online.",0 +https://doi.org/10.3758/bf03210858,Estimating psychometric functions in forced-choice situations: Significant biases found in threshold and slope estimations when small samples are used,"When a theoretical psychometric function is fitted to experimental data (as in the obtaining of a psychophysical threshold), maximum-likelihood or probit methods are generally used. In the present paper, the behavior of these curve-fitting methods is studied for the special case of forced-choice experiments, in which the probability of a subject's making a correct response by chance is not zero. A mathematical investigation of the variance of the threshold and slope estimators shows that, in this case, the accuracy of the methods is much worse, and their sensitivity to the way data are sampled is greater, than in the case in which chance level is zero. Further, Monte Carlo simulations show that, in practical situations in which only a finite number of observations are made, the mean threshold and slope estimates are significantly biased. The amount of bias depends on the curve-fitting method and on the range of intensity values, but it is always greater in forced-choice situations than when chance level is zero.",0 +https://doi.org/10.1093/jeg/lbu005,Stylised fact or situated messiness? The diverse effects of increasing debt on national economic growth,"This article reanalyses data used by Reinhart and Rogoff (2010c, American Economic Review, 100: 573–78—RR), and later Herndon et al. (2013, Cambridge Journal of Economics, online, doi: 10.1093/cje/bet075) to consider the relationship between growth and debt in developed countries. The consistency over countries and the causal direction of RR’s so called ‘stylised fact’ is considered. Using multilevel models, we find that when the effect of debt on growth is allowed to vary, and linear time trends are fully controlled for, the average effect of debt on growth disappears, whilst country-specific debt relations vary significantly. Additionally, countries with high debt levels appear more volatile in their growth rates. Regarding causality, we develop a new method extending distributed lag models to multilevel situations. These models suggest the causal direction is predominantly growth-to-debt, and is consistent (with some exceptions) across countries. We argue that RR’s findings are too simplistic, with limited policy relevance, whilst demonstrating how multilevel models can explicate realistically complex scenarios.",0 +https://doi.org/10.1016/j.jneumeth.2011.10.025,BSMac: A MATLAB toolbox implementing a Bayesian spatial model for brain activation and connectivity,"We present a statistical and graphical visualization MATLAB toolbox for the analysis of functional magnetic resonance imaging (fMRI) data, called the Bayesian Spatial Model for activation and connectivity (BSMac). BSMac simultaneously performs whole-brain activation analyses at the voxel and region of interest (ROI) levels as well as task-related functional connectivity (FC) analyses using a flexible Bayesian modeling framework (Bowman et al., 2008). BSMac allows for inputting data in either Analyze or Nifti file formats. The user provides information pertaining to subgroup memberships, scanning sessions, and experimental tasks (stimuli), from which the design matrix is constructed. BSMac then performs parameter estimation based on Markov Chain Monte Carlo (MCMC) methods and generates plots for activation and FC, such as interactive 2D maps of voxel and region-level task-related changes in neural activity and animated 3D graphics of the FC results. The toolbox can be downloaded from http://www.sph.emory.edu/bios/CBIS/. We illustrate the BSMac toolbox through an application to an fMRI study of working memory in patients with schizophrenia.",0 +https://doi.org/10.3758/bf03192809,Using the open-source statistical language R to analyze the dichotomous Rasch model,"R, an open-source statistical language and data analysis tool, is gaining popularity among psychologists currently teaching statistics. R is especially suitable for teaching advanced topics, such as fitting the dichotomous Rasch model--a topic that involves transforming complicated mathematical formulas into statistical computations. This article describes R's use as a teaching tool and a data analysis software program in the analysis of the Rasch model in item response theory. It also explains thetheory behind, as well as an educator's goals for, fitting the Rasch model with joint maximum likelihood estimation. This article also summarizes the R syntax for parameter estimation and the calculation of fit statistics. The results produced by R is compared with the results obtained from MINISTEP and the output of a conditional logit model. The use of R is encouraged because it is free, supported by a network of peer researchers, and covers both basic and advanced topics in statistics frequently used by psychologists.",0 +https://doi.org/10.1017/s0266466600011646,On Consistency and Inconsistency of Estimating Equations,"The primary concern is to establish a fairly general framework in which estimators resulting from estimating equations g nθ = 0 are not consistent. This leads on to consistency by an intuitive route. Asymptotic distributions of consistent estimators are also touched upon, and the results are applied to various examples.",0 +https://doi.org/10.1111/bmsp.12041,Properties of hypothesis testing techniques and (Bayesian) model selection for exploration-based and theory-based (order-restricted) hypotheses,"In this paper, the performance of six types of techniques for comparisons of means is examined. These six emerge from the distinction between the method employed (hypothesis testing, model selection using information criteria, or Bayesian model selection) and the set of hypotheses that is investigated (a classical, exploration-based set of hypotheses containing equality constraints on the means, or a theory-based limited set of hypotheses with equality and/or order restrictions). A simulation study is conducted to examine the performance of these techniques. We demonstrate that, if one has specific, a priori specified hypotheses, confirmation (i.e., investigating theory-based hypotheses) has advantages over exploration (i.e., examining all possible equality-constrained hypotheses). Furthermore, examining reasonable order-restricted hypotheses has more power to detect the true effect/non-null hypothesis than evaluating only equality restrictions. Additionally, when investigating more than one theory-based hypothesis, model selection is preferred over hypothesis testing. Because of the first two results, we further examine the techniques that are able to evaluate order restrictions in a confirmatory fashion by examining their performance when the homogeneity of variance assumption is violated. Results show that the techniques are robust to heterogeneity when the sample sizes are equal. When the sample sizes are unequal, the performance is affected by heterogeneity. The size and direction of the deviations from the baseline, where there is no heterogeneity, depend on the effect size (of the means) and on the trend in the group variances with respect to the ordering of the group sizes. Importantly, the deviations are less pronounced when the group variances and sizes exhibit the same trend (e.g., are both increasing with group number).",0 +https://doi.org/10.1111/1467-9868.00239,Inference for multivariate normal hierarchical models,"This paper provides a new method and algorithm for making inferences about the parameters of a two-level multivariate normal hierarchical model. One has observed J p-dimensional vector outcomes, distributed at level 1 as multivariate normal with unknown mean vectors and with known covariance matrices. At level 2, the unknown mean vectors also have normal distributions, with common unknown covariance matrix A and with means depending on known covariates and on unknown regression coefficients. The algorithm samples independently from the marginal posterior distribution of A by using rejection procedures. Functions such as posterior means and covariances of the level 1 mean vectors and of the level 2 regression coefficient are estimated by averaging over posterior values calculated conditionally on each value of A drawn. This estimation accounts for the uncertainty in A, unlike standard restricted maximum likelihood empirical Bayes procedures. It is based on independent draws from the exact posterior distributions, unlike Gibbs sampling. The procedure is demonstrated for profiling hospitals based on patients' responses concerning p = 2 types of problems (non-surgical and surgical). The frequency operating characteristics of the rule corresponding to a particular vague multivariate prior distribution are shown via simulation to achieve their nominal values in that setting.",0 +https://doi.org/10.1186/s12874-015-0031-0,Meta-analysis of incidence rate data in the presence of zero events,"When summary results from studies of counts of events in time contain zeros, the study-specific incidence rate ratio (IRR) and its standard error cannot be calculated because the log of zero is undefined. This poses problems for the widely used inverse-variance method that weights the study-specific IRRs to generate a pooled estimate.We conducted a simulation study to compare the inverse-variance method of conducting a meta-analysis (with and without the continuity correction) with alternative methods based on either Poisson regression with fixed interventions effects or Poisson regression with random intervention effects. We manipulated the percentage of zeros in the intervention group (from no zeros to approximately 80 percent zeros), the levels of baseline variability and heterogeneity in the intervention effect, and the number of studies that comprise each meta-analysis. We applied these methods to an example from our own work in suicide prevention and to a recent meta-analysis of the effectiveness of condoms in preventing HIV transmission.As the percentage of zeros in the data increased, the inverse-variance method of pooling data shows increased bias and reduced coverage. Estimates from Poisson regression with fixed interventions effects also display evidence of bias and poor coverage, due to their inability to account for heterogeneity. Pooled IRRs from Poisson regression with random intervention effects were unaffected by the percentage of zeros in the data or the amount of heterogeneity.Inverse-variance methods perform poorly when the data contains zeros in either the control or intervention arms. Methods based on Poisson regression with random effect terms for the variance components are very flexible offer substantial improvement.",0 +https://doi.org/10.1017/s113874160000514x,Sampling Plans for Fitting the Psychometric Function,"Research on estimation of a psychometric function Ψ has usually focused on comparing alternative algorithms to apply to the data, rarely addressing how best to gather the data themselves (i.e., what sampling plan best deploys the affordable number of trials). Simulation methods were used here to assess the performance of several sampling plans in yes–no and forced-choice tasks, including the QUEST method and several variants of up–down staircases and of the method of constant stimuli (MOCS). We also assessed the efficacy of four parameter estimation methods. Performance comparisons were based on analyses of usability (i.e., the percentage of times that a plan yields usable data for the estimation of all the parameters of Ψ) and of the resultant distributions of parameter estimates. Maximum likelihood turned out to be the best parameter estimation method. As for sampling plans, QUEST never exceeded 80% usability even when 1000 trials were administered and rendered accurate estimates of threshold but misestimated the remaining parameters. MOCS and up–down staircases yielded similar and acceptable usability (above 95% with 400–500 trials) and, although neither type of plan allowed estimating all parameters with optimal precision, each type appeared well suited to estimating a distinct subset of parameters. An analysis of the causes of this differential suitability allowed designing alternative sampling plans (all based on up–down staircases) for yes–no and forced-choice tasks. These alternative plans rendered near optimal distributions of estimates for all parameters. The results just described apply when the fitted Ψ has the same mathematical form as the actual Ψ generating the data; in case of form mismatch, all parameters except threshold were generally misestimated but the relative performance of all the sampling plans remained identical. Detailed practical recommendations are given.",0 +https://doi.org/10.3389/fpsyg.2014.00181,Evaluation of model fit in nonlinear multilevel structural equation modeling,"Evaluating model fit in nonlinear multilevel structural equation models (MSEM) presents a challenge as no adequate test statistic is available. Nevertheless, using a product indicator approach a likelihood ratio test for linear models is provided which may also be useful for nonlinear MSEM. The main problem with nonlinear models is that product variables are nonnormally distributed. Although robust test statistics have been developed for linear SEM to ensure valid results under the condition of nonnormality, they were not yet investigated for nonlinear MSEM. In a Monte Carlo study, the performance of the robust likelihood ratio test was investigated for models with single-level latent interaction effects using the unconstrained product indicator approach. As overall model fit evaluation has a potential limitation in detecting the lack of fit at a single level even for linear models, level-specific model fit evaluation was also investigated using partially saturated models. Four population models were considered: a model with interaction effects at both levels, an interaction effect at the within-group level, an interaction effect at the between-group level, and a model with no interaction effects at both levels. For these models the number of groups, predictor correlation, and model misspecification was varied. The results indicate that the robust test statistic performed sufficiently well. Advantages of level-specific model fit evaluation for the detection of model misfit are demonstrated.",0 +https://doi.org/10.1037/1082-989x.8.3.369,Statistical and Substantive Checking in Growth Mixture Modeling: Comment on Bauer and Curran (2003).,This commentary discusses the D. J. Bauer and P. J. Curran (2003) investigation of growth mixture modeling. Single-class modeling of nonnormal outcomes is compared with modeling with multiple latent trajectory classes. New statistical tests of multiple-class models are discussed. Principles for substantive investigation of growth mixture model results are presented and illustrated by an example of high school dropout predicted by low mathematics achievement development in Grades 7-10.,0 +https://doi.org/10.14257/ijsh.2016.10.1.15,A Improved Statistical Model Analysis the Mental Health of Rural-to-Urban Migrants in China,"The mental health of rural-to-urban migrants in China is a critical issue. The aim of this study was to test the migrants' mental health. The findings drawn from this qualitative study of 769 migrants in Wuhan in 2012 based on the Bayesian structural equation model. Overall, the survey found that leisure plays the greatest positive role in migrants' mental health, as well as work, interpersonal relationships, and health status have a negative role in migrants' mental health. Thus, the government must set relevant regulations to help migrants establish a better life and work values to work energetically. China is an agricultural country, and farmers comprise more than 75% of the total population. A large number of farmers have poured into the cities over the past 30 years, which caused the rapid growth of the migrant population in China. The sixth census data released by the National Bureau of Statistics show that the number of migrants in China has reached 0.26 billion, which are the largest scale of labor migration in the history of mankind (CNBS, 2011). According to the National Bureau of Statistics, rural-to-urban migrants are those who migrate from the countryside to cities to seek more job opportunities and higher quality of life, but they have no permanent urban residency (CNBS, 2001). These migrants who migrated from rural to urban areas are affected by the limitations of the traditional urban-rural dual structure. Farmers can live and work in the cities, but they are not included in the city Hukou. Therefore, they are not included in the welfare and public distribution system of the city, and they do not enjoy the same treatment as the city residents in terms of labor and social security, health insurance, and children's education. They are the targets of social discrimination and are isolated in the edge of urban communities(Yang, Li, & Wang,2006; Wang et al., 2010; McGuire, Li, & Wang, 2009), causing their mental health to become a common issue of concern. The characteristics and demands of migrants have changed since China's 30-year economic reform. Young migrants occupy a large proportion of the total numbers (Liu,2007). This new generation of migrants usually aims for social mobility, with more prominent laddering migration characteristics. They are sensitive, self-recognized, and have a higher education level. They are different from their parents who are a tough breed and only pursue income. Young migrants aspire for a high quality of life and hope to enjoy the same social status as their peers in the cities. New factors may appear as migrants change in the 21 st century.",0 +https://doi.org/10.1080/10485250802613558,A Bayesian nonparametric method for model evaluation: application to genetic studies,"Statistical models applied to genetic studies commonly assume linear relationships (between disease and risk factors) and simple distributional forms (by relying on asymptotic methods) for inference. However, when the sample size is small, inference using traditional asymptotic models can be problematic. Moreover, the gene-disease relationship is not always linear. In this article, we present a new nonparametric Bayesian method for model assessment, and we demonstrate the advantages of this approach particularly when the sample size is small and/or the true model is non-linear. We evaluate our approach on simulated data and find that it performs substantially better than alternative models. We also apply our method to two real studies: diagnosis of conventional high-grade non-metastatic osteosarcoma, and survival in Burkitt's lymphoma.",0 +,Latent variable scores and their uses,,0 +https://doi.org/10.1080/19466315.2013.852617,A Quantitative Process for Enhancing End of Phase 2 Decisions,"The objectives of the phase 2 stage in a drug development program are to evaluate the safety and tolerability of different doses, select a promising dose range, and look for early signs of activity. At the end of phase 2, a decision to initiate phase 3 studies is made that involves the commitment of considerable resources. This multifactorial decision, generally made by balancing the current condition of a development organization's portfolio, the future cost of development, the competitive landscape, and the expected safety and efficacy benefits of a new therapy, needs to be a good one. In this article, we present a practical quantitative process that has been implemented for drugs entering phase 2 at Amgen Ltd. to ensure a consistent and explicit evidence-based approach is used to contribute to decisions for new drug candidates. Broadly following this process will also help statisticians increase their strategic influence in drug development programs. The process is illustrated using an example from the pancreatic cancer indication. Embedded within the process is a predominantly Bayesian approach to predicting the probability of efficacy success in a future (frequentist) phase 3 program.",0 +https://doi.org/10.1023/a:1011098109834,,"Most large-scale secondary data sets used in higher education research (e.g., NP-SAS or BPS) are constructed using complex survey sample designs where the population of interest is stratified on a number of dimensions and oversampled within certain of these strata. Moreover, these complex sample designs often cluster lower level units (e.g., students) within higher level units (e.g., colleges) to achieve efficiencies in the sampling process. Ignoring oversampling (unequal probability of selection) in complex survey designs presents problems when trying to make inferences-data from these designs are, in their raw form, admittedly nonrepresentative of the population to which they are designed to generalize. Ignoring the clustering of observations in these sampling designs presents a second set of problems when making inferences about variability in the population and testing hypotheses and usually leads to an increased likelihood of committing Type I errors (declaring something as an effect when in fact it is not). This article presents an extended example using complex sample survey data to demonstrate how researchers can address problems associated with oversampling and clustering of observations in these designs.",0 +https://doi.org/10.1214/11-sts358,Covariance Estimation: The GLM and Regularization Perspectives,"Finding an unconstrained and statistically interpretable reparameterization of a covariance matrix is still an open problem in statistics. Its solution is of central importance in covariance estimation, particularly in the recent high-dimensional data environment where enforcing the positive-definiteness constraint could be computationally expensive. We provide a survey of the progress made in modeling covariance matrices from two relatively complementary perspectives: (1) generalized linear models (GLM) or parsimony and use of covariates in low dimensions, and (2) regularization or sparsity for high-dimensional data. An emerging, unifying and powerful trend in both perspectives is that of reducing a covariance estimation problem to that of estimating a sequence of regression problems. We point out several instances of the regression-based formulation. A notable case is in sparse estimation of a precision matrix or a Gaussian graphical model leading to the fast graphical LASSO algorithm. Some advantages and limitations of the regression-based Cholesky decomposition relative to the classical spectral (eigenvalue) and variance-correlation decompositions are highlighted. The former provides an unconstrained and statistically interpretable reparameterization, and guarantees the positive-definiteness of the estimated covariance matrix. It reduces the unintuitive task of covariance estimation to that of modeling a sequence of regressions at the cost of imposing an a priori order among the variables. Elementwise regularization of the sample covariance matrix such as banding, tapering and thresholding has desirable asymptotic properties and the sparse estimated covariance matrix is positive definite with probability tending to one for large samples and dimensions.",0 +https://doi.org/10.1177/0146621604271495,Controlling Item Exposure and Test Overlap in Computerized Adaptive Testing,"This article proposes an item exposure control method, which is the extension of the Sympson and Hetter procedure and can provide item exposure control at both the item and test levels. Item exposure rate and test overlap rate are two indices commonly used to track item exposure in computerized adaptive tests. By considering both indices, item exposure can be monitored at both the item and test levels. To control the item exposure rate and test overlap rate simultaneously, the modified procedure attempted to control not only the maximum value but also the variance of item exposure rates. Results indicated that the item exposure rate and test overlap rate could be controlled simultaneously by implementing the modified procedure. Item exposure control was improved and precision of trait estimation decreased when a prespecified maximum test overlap rate was stringent.",0 +https://doi.org/10.3389/fnint.2012.00100,Adaptation to visual or auditory time intervals modulates the perception of visual apparent motion,"It is debated whether sub-second timing is subserved by a centralized mechanism or by the intrinsic properties of task-related neural activity in specific modalities (Ivry and Schlerf, 2008). By using a temporal adaptation task, we investigated whether adapting to different time intervals conveyed through stimuli in different modalities (i.e., frames of a visual Ternus display, visual blinking discs, or auditory beeps) would affect the subsequent implicit perception of visual timing, i.e., inter-stimulus interval (ISI) between two frames in a Ternus display. The Ternus display can induce two percepts of apparent motion (AM), depending on the ISI between the two frames: ""element motion"" for short ISIs, in which the endmost disc is seen as moving back and forth while the middle disc at the overlapping or central position remains stationary; ""group motion"" for longer ISIs, in which both discs appear to move in a manner of lateral displacement as a whole. In Experiment 1, participants adapted to either the typical ""element motion"" (ISI = 50 ms) or the typical ""group motion"" (ISI = 200 ms). In Experiments 2 and 3, participants adapted to a time interval of 50 or 200 ms through observing a series of two paired blinking discs at the center of the screen (Experiment 2) or hearing a sequence of two paired beeps (with pitch 1000 Hz). In Experiment 4, participants adapted to sequences of paired beeps with either low pitches (500 Hz) or high pitches (5000 Hz). After adaptation in each trial, participants were presented with a Ternus probe in which the ISI between the two frames was equal to the transitional threshold of the two types of motions, as determined by a pretest. Results showed that adapting to the short time interval in all the situations led to more reports of ""group motion"" in the subsequent Ternus probes; adapting to the long time interval, however, caused no aftereffect for visual adaptation but significantly more reports of group motion for auditory adaptation. These findings, suggesting amodal representation for sub-second timing across modalities, are interpreted in the framework of temporal pacemaker model.",0 +https://doi.org/10.1214/aos/1176344064,Bayesian Inference for Causal Effects: The Role of Randomization,"Causal effects are comparisons among values that would have been observed under all possible assignments of treatments to experimental units. In an experiment, one assignment of treatments is chosen and only the values under that assignment can be observed. Bayesian inference for causal effects follows from finding the predictive distribution of the values under the other assignments of treatments. This perspective makes clear the role of mechanisms that sample experimental units, assign treatments and record data. Unless these mechanisms are ignorable (known probabilistic functions of recorded values), the Bayesian must model them in the data analysis and, consequently, confront inferences for causal effects that are sensitive to the specification of the prior distribution of the data. Moreover, not all ignorable mechanisms can yield data from which inferences for causal effects are insensitive to prior specifications. Classical randomized designs stand out as especially appealing assignment mechanisms designed to make inference for causal effects straightforward by limiting the sensitivity of a valid Bayesian analysis.",0 +https://doi.org/10.3758/bf03193597,Recognition memory for realistic synthetic faces,"A series of experiments examined short-term recognition memory for trios of briefly presented, synthetic human faces derived from three real human faces. The stimuli were a graded series of faces, which differed by varying known amounts from the face of the average female. Faces based on each of the three real faces were transformed so as to lie along orthogonal axes in a 3-D face space. Experiment 1 showed that the synthetic faces' perceptual similarity structure strongly influenced recognition memory. Results were fit by a noisy exemplar model (NEMO) of perceptual recognition memory. The fits revealed thatrecognition memory was influenced both by the similarity of the probe to the series items and by the similarities among the series items themselves. Nonmetric multidimensional scaling (MDS) showed that the faces' perceptual representations largely preserved the 3-D space in which the face stimuli were arrayed. NEMO gave a better account of the results when similarity was defined as perceptual MDS similarity, rather than as the physical proximity of one face to another. Experiment 2 confirmed the importance of within-list homogeneity directly, without mediation of a model. We discuss the affinities and differences between visual memory for synthetic faces and memory for simpler stimuli.",0 +https://doi.org/10.1016/j.neuroimage.2014.07.022,Interregional alpha-band synchrony supports temporal cross-modal integration,"In a continuously changing environment, time is a key property that tells us whether information from the different senses belongs together. Yet, little is known about how the brain integrates temporal information across sensory modalities. Using high-density EEG combined with a novel psychometric timing task in which human subjects evaluated durations of audiovisual stimuli, we show that the strength of alpha-band (8-12 Hz) phase synchrony between localizer-defined auditory and visual regions depended on cross-modal attention: during encoding of a constant 500 ms standard interval, audiovisual alpha synchrony decreased when subjects attended audition while ignoring vision, compared to when they attended both modalities. In addition, alpha connectivity during a variable target interval predicted the degree to which auditory stimulus duration biased time estimation while attending vision. This cross-modal interference effect was estimated using a hierarchical Bayesian model of a psychometric function that also provided an estimate of each individual's tendency to exhibit attention lapses. This lapse rate, in turn, was predicted by single-trial estimates of the stability of interregional alpha synchrony: when attending to both modalities, trials with greater stability in patterns of connectivity were characterized by reduced contamination by lapses. Together, these results provide new insights into a functional role of the coupling of alpha phase dynamics between sensory cortices in integrating cross-modal information over time.",0 +https://doi.org/10.1027/1614-2241/a000062,How Low Can You Go?,"Whereas general sample size guidelines have been suggested when estimating multilevel models, they are only generalizable to a relatively limited number of data conditions and model structures, both of which are not very feasible for the applied researcher. In an effort to expand our understanding of two-level multilevel models under less than ideal conditions, Monte Carlo methods, through SAS/IML, were used to examine model convergence rates, parameter point estimates (statistical bias), parameter interval estimates (confidence interval accuracy and precision), and both Type I error control and statistical power of tests associated with the fixed effects from linear two-level models estimated with PROC MIXED. These outcomes were analyzed as a function of: (a) level-1 sample size, (b) level-2 sample size, (c) intercept variance, (d) slope variance, (e) collinearity, and (f) model complexity. Bias was minimal across nearly all conditions simulated. The 95% confidence interval coverage and Type I error rate tended to be slightly conservative. The degree of statistical power was related to sample sizes and level of fixed effects; higher power was observed with larger sample sizes and level-1 fixed effects.",0 +https://doi.org/10.1016/s0047-259x(02)00053-2,Estimating the covariance matrix: a new approach,"In this paper, we consider the problem of estimating the covariance matrix and the generalized variance when the observations follow a nonsingular multivariate normal distribution with unknown mean. A new method is presented to obtain a truncated estimator that utilizes the information available in the sample mean matrix and dominates the James–Stein minimax estimator. Several scale equivariant minimax estimators are also given. This method is then applied to obtain new truncated and improved estimators of the generalized variance; it also provides a new proof to the results of Shorrock and Zidek (Ann. Statist. 4 (1976) 629) and Sinha (J. Multivariate Anal. 6 (1976) 617).",0 +https://doi.org/10.1177/1740774507083434,The intermediate endpoint effect in logistic and probit regression,"Background An intermediate endpoint is hypothesized to be in the middle of the causal sequence relating an independent variable to a dependent variable. The intermediate variable is also called a surrogate or mediating variable and the corresponding effect is called the mediated, surrogate endpoint, or intermediate endpoint effect. Clinical studies are often designed to change an intermediate or surrogate endpoint and through this intermediate change influence the ultimate endpoint. In many intermediate endpoint clinical studies the dependent variable is binary, and logistic or probit regression is used. Purpose The purpose of this study is to describe a limitation of a widely used approach to assessing intermediate endpoint effects and to propose an alternative method, based on products of coefficients, that yields more accurate results. Methods The intermediate endpoint model for a binary outcome is described for a true binary outcome and for a dichotomization of a latent continuous outcome. Plots of true values and a simulation study are used to evaluate the different methods. Results Distorted estimates of the intermediate endpoint effect and incorrect conclusions can result from the application of widely used methods to assess the intermediate endpoint effect. The same problem occurs for the proportion of an effect explained by an intermediate endpoint, which has been suggested as a useful measure for identifying intermediate endpoints. A solution to this problem is given based on the relationship between latent variable modeling and logistic or probit regression. Limitations More complicated intermediate variable models are not addressed in the study, although the methods described in the article can be extended to these more complicated models. Conclusions Researchers are encouraged to use an intermediate endpoint method based on the product of regression coefficients. A common method based on difference in coefficient methods can lead to distorted conclusions regarding the intermediate effect. Clinical Trials 2007; 4: 499—513. http://ctj.sagepub.com",0 +https://doi.org/10.1007/bf00844756,The pattern of influence of perceived behavioral control upon exercising behavior: An application of Ajzen's theory of planned behavior,"The aim of the present studies was to verify the basic assumptions underlying the theory of planned behavior for the prediction of exercising intentions and behavior among adults of the general population (study 1) and a group of pregnant women (study 2). In both studies, baseline data were collected at home with trained interviewers and with the use of paper-and-pencil questionnaires. The self-report on behavior was obtained 6 months (study 1) and between 8 and 9 months (study 2) after baseline data collection. In study 1, perceived behavioral control influenced behavior only through intention. In study 2, none of the Ajzen model variables was associated to exercising behavior. Nonetheless, intention was influenced by attitude, habit, and perceived behavioral control. The results of the present studies suggest that perceived behavioral control contributes to the understanding of intentions to exercise but not to the prediction of exercising behavior. © 1993 Plenum Publishing Corporation.",0 +https://doi.org/10.1037/11383-021,Longitudinal Methods.,,0 +https://doi.org/10.1371/journal.pone.0096606,Guilt in Bereavement: The Role of Self-Blame and Regret in Coping with Loss,"Despite the apparent centrality of guilt in complicating reactions following bereavement, scientific investigation has been limited. Establishing the impact of specific components associated with guilt could enhance understanding. The aim of this study was to examine the relationships between two guilt-related manifestations, namely self-blame and regret, with grief and depression. A longitudinal investigation was conducted 4-7 months, 14 months and 2 years post-loss. Participants were bereaved spouses (30 widows; 30 widowers); their mean age was 53.05 years. Results showed that self-blame was associated with grief at the initial time-point and with its decline over time. Such associations were not found for depression. Initial levels of regret were neither associated with initial levels of grief and depression, nor were they related to the decline over time in either outcome variable. These results demonstrate the importance of examining guilt-related manifestations independently, over time, and with respect to both generic and grief-specific outcome variables. A main conclusion is that self-blame (but not regret) is a powerful determinant of grief-specific difficulties following the loss of a loved one. Implications for intervention are considered.",0 +https://doi.org/10.1093/oxfordhb/9780199233281.013.0020,Disorders of the auditory brain,"© Oxford University Press, 2010. All rights reserved. This article is concerned with the disorders of the auditory system and their clinical assessment. It shows the importance of obtaining the history and neurological examination before detailed psychophysical testing. The assessment of disorders of the central auditory system in clinic is a multidisciplinary exercise, involving a key collaboration between neurology and audiological medicine. Patients with a suspected disorder of the central auditory system require audiological evaluation of middle ear and cochlear function. Continuous EEG is sometimes needed to seek evidence of abnormal epileptic activity that might be associated with auditory processing disorders. The article considers disorders defined on the basis of positive auditory symptoms. It also discusses abnormal auditory cognition in common clinical disorders in which the auditory features do not define the disorder. It aims to define auditory deficits in terms of the level in the system at which they are caused.",0 +https://doi.org/10.1080/01402382.2014.887878,The Non-Procedural Determinants of Responsiveness,"This article starts from the remarks by Peter Mair on the growing gap between responsiveness and responsibility – or middle-run responsiveness – and the declining capacity of parties to bridge that gap. It focuses on the empirical analysis of the association between economic and substantive democratic dimensions and responsiveness, which are highly relevant to the way in which parties compete and govern within contemporary democracies. Following an introduction of the topic, the second section puts forward key concepts and hypotheses; the third presents the operationalisation of the variables and the applied method; the fourth and primary empirical section of the article analyses the non-procedural determinants of political and economic responsiveness, including freedom and equality as well as several key economic structural factors. The concluding remarks recapitulate the main empirical findings and submit a number of aspects that party leaders ought to take into account when addressing the thorny issue ...",0 +https://doi.org/10.1002/hec.1781,ACCOUNTING FOR BETWEEN-STUDY VARIATION IN INCREMENTAL NET BENEFIT IN VALUE OF INFORMATION METHODOLOGY,"Previous applications of value of information methods for determining optimal sample size in randomized clinical trials have assumed no between-study variation in mean incremental net benefit. By adopting a hierarchical model, we provide a solution for determining optimal sample size with this assumption relaxed. The solution is illustrated with two examples from the literature. Expected net gain increases with increasing between-study variation, reflecting the increased uncertainty in incremental net benefit and reduced extent to which data are borrowed from previous evidence. Hence, a trial can become optimal where current evidence is sufficient assuming no between-study variation. However, despite the expected net gain increasing, the optimal sample size in the illustrated examples is relatively insensitive to the amount of between-study variation. Further percentage losses in expected net gain were small even when choosing sample sizes that reflected widely different between-study variation.",0 +https://doi.org/10.1177/01466210122031984,An Evaluation of a Markov Chain Monte Carlo Method for the Rasch Model,"The accuracy of the Gibbs sampling Markov chain monte carlo procedure was examined for estimating item and person ( .) parameters in the one-parameter logistic model. Four datasets were analyzed using the Gibbs sampling method, conditional maximum likelihood, marginal maximum likelihood, and joint maximum likelihood. Maximum likelihood and expected a posteriori. estimation methods were used with marginal maximum likelihood estimation of item parameters. Item parameter estimates from the four methods were almost identical;. estimates from Gibbs sampling were similar to those obtained from the expected a posteriori method.",0 +https://doi.org/10.1093/oxfordhb/9780199934874.013.0013,Matching and Propensity Scores,"The popularity of matching techniques has increased considerably during the last decades. They are mainly used for matching treatment and control units to estimate causal treatment effects from observational studies or for integrating two or more data sets that share a common subset of covariates. In focusing on causal inference with observational studies, we discuss multivariate matching techniques and several propensity score methods, like propensity score matching, subclassification, inverse-propensity weighting, and regression estimation. In addition to the theoretical aspects, we give practical guidelines for implementing these techniques and discuss the conditions under which these techniques warrant a causal interpretation of the estimated treatment effect. In particular, we emphasize that the selection of covariates and their reliable measurement is more important than the choice of a specific matching strategy.",0 +https://doi.org/10.4135/9781412986311.n19,Latent Variable Analysis: Growth Mixture Modeling and Related Techniques for Longitudinal Data,,0 +https://doi.org/10.1111/j.1745-3984.2005.00012.x,Infeasibility in Automated Test Assembly Models: A Comparison Study of Different Methods,"Several techniques exist to automatically put together a test meeting a number of specifications. In an item bank, the items are stored with their characteristics. A test is constructed by selecting a set of items that fulfills the specifications set by the test assembler. Test assembly problems are often formulated in terms of a model consisting of restrictions and an objective to be maximized or minimized. A problem arises when it is impossible to construct a test from the item pool that meets all specifications, that is, when the model is not feasible. Several methods exist to handle these infeasibility problems. In this article, test assembly models resulting from two practical testing programs were reconstructed to be infeasible. These models were analyzed using methods that forced a solution (Goal Programming, Multiple-Goal Programming, Greedy Heuristic), that analyzed the causes (Relaxed and Ordered Deletion Algorithm (RODA), Integer Randomized Deletion Algorithm (IRDA), Set Covering (SC), and Item Sampling), or that analyzed the causes and used this information to force a solution (Irreducible Infeasible Set-Solver). Specialized methods such as the IRDA and the Irreducible Infeasible Set-Solver performed best. Recommendations about the use of different methods are given.",0 +https://doi.org/10.1037/a0031541,A probabilistic clustering theory of the organization of visual short-term memory.,"Experimental evidence suggests that the content of a memory for even a simple display encoded in visual short-term memory (VSTM) can be very complex. VSTM uses organizational processes that make the representation of an item dependent on the feature values of all displayed items as well as on these items' representations. Here, we develop a probabilistic clustering theory (PCT) for modeling the organization of VSTM for simple displays. PCT states that VSTM represents a set of items in terms of a probability distribution over all possible clusterings or partitions of those items. Because PCT considers multiple possible partitions, it can represent an item at multiple granularities or scales simultaneously. Moreover, using standard probabilistic inference, it automatically determines the appropriate partitions for the particular set of items at hand and the probabilities or weights that should be allocated to each partition. A consequence of these properties is that PCT accounts for experimental data that have previously motivated hierarchical models of VSTM, thereby providing an appealing alternative to hierarchical models with prespecified, fixed structures. We explore both an exact implementation of PCT based on Dirichlet process mixture models and approximate implementations based on Bayesian finite mixture models. We show that a previously proposed 2-level hierarchical model can be seen as a special case of PCT with a single cluster. We show how a wide range of previously reported results on the organization of VSTM can be understood in terms of PCT. In particular, we find that, consistent with empirical evidence, PCT predicts biases in estimates of the feature values of individual items and also predicts a novel form of dependence between estimates of the feature values of different items. We qualitatively confirm this last prediction in 3 novel experiments designed to directly measure biases and dependencies in subjects' estimates.",0 +https://doi.org/10.1080/10705511.2012.634712,Small Sample Properties of Bayesian Multivariate Autoregressive Time Series Models,"The aim of this study was to compare the small sample (N = 1, 3, 5, 10, 15) performance of a Bayesian multivariate vector autoregressive (BVAR-SEM) time series model relative to frequentist power and parameter estimation bias. A multivariate autoregressive model was developed based on correlated autoregressive time series vectors of varying lengths (T = 25, 50, 75, 100, 125) using Statistical Analysis System (SAS) version 9.2. Autoregressive components for the 5 series vectors included coefficients of .80, .70, .65, .50 and .40. Error variance components included values of .20, .20, .10, .15, and .15, with cross-lagged coefficients of .10, .10, .15, .10, and .10. A Monte Carlo study revealed that in comparison to frequentist methods, the Bayesian approach provided increased sensitivity for hypothesis testing and detecting Type I error.",1 +https://doi.org/10.1177/0149206314539351,Social Influence Interpretation of Interpersonal Processes and Team Performance Over Time Using Bayesian Model Selection,"The team behavior literature is ambiguous about the relations between members’ interpersonal processes—task debate and task conflict—and team performance. From a social influence perspective, we show why members’ interpersonal processes determine team performance over time in small groups. Together, over time, dissenting in-group minorities who share information (via debate) with majorities, who selectively engage with them to consider their alternative proposals (via conflict), can improve their team performance (via innovation). The context/comparison model of social influence and its leniency contract extension to the special case of in-group minorities suggest a pattern of members’ interpersonal processes that unfolds over time to reconcile factions with the same social identity who hold different approaches to shared projects. Conditional on typical levels of task debate, we predict that (a) in early episodes, task conflict increases the relation between task debate and team performance; (b) in middle episodes, task conflict decreases the relation; and (c) in late episodes, task conflict increases the relation again. We explore our thesis using a longitudinal design with a sample of 60 student teams (360 individuals) working together for course credit over 5 months (21 weeks) to write a first business plan for a new venture. We use a multilevel structural equation modeling approach with Bayesian estimation. We found support for our theory expressed in informative hypotheses using Bayesian model selection. These results were not evident from conventional graphing and post hoc statistical probing of simple slopes against the null hypothesis.",0 +https://doi.org/10.1007/bf00554126,Experimental analysis of choice,"Our paper reviews and summarizes the state-of-the-art in the design and analysis of consumer choice experiments. We emphasize experiments involving discrete choices, but also review related work on the design and analysis of ranking and resource allocation experiments. Major topics include 1) Choice experiments and conjoint analysis, 2) Random utility and constant utility probabilistic discrete choice models as a theoretical foundation for choice experiments, and 3) The design of choice experiments. Other topics include a) Experimental procedure, b) Model specification, c) Model estimation, and d) Model validation. Suggestions for future research are made with respect to each topic. © 1991 Kluwer Academic Publishers.",0 +https://doi.org/10.1111/j.1745-3984.1999.tb00557.x,Multiple Objective Test Assembly Problems,"Mathematical programming techniques for optimal test assembly are discussed. Most methods optimize a single objective: for instance, the amount of information in a test, subject to a number of constraints. However, some test assembly problems have multiple objectives. A recent example in the literature is the problem of assembling test that measure multiple traits, where the amount of information in the test about each different trait has to be maximized. The present paper proposes methods appropriate for solving multiple objective test assembly problems. An overview of multiple objective optimization methods is given. The impact of the method on the optimality of the solution is shown and the appropriateness of the methods is discussed. The methods are illustrated using an empirical example of a test assembly problem for a two-dimensional mathematics item pool.",0 +https://doi.org/10.2333/bhmk.29.81,Beyond SEM: General Latent Variable Modeling,"This article gives an overview of statistical analysis with latent variables. Using traditional structural equation modeling as a starting point, it shows how the idea of latent variables captures a wide variety of statistical concepts, including random effects, missing data, sources of variation in hierarchical data, finite mixtures. latent classes, and clusters. These latent variable applications go beyond the traditional latent variable useage in psychometrics with its focus on measurement error and hypothetical constructs measured by multiple indicators. The article argues for the value of integrating statistical and psychometric modeling ideas. Different applications are discussed in a unifying framework that brings together in one general model such different analysis types as factor models, growth curve models, multilevel models, latent class models and discrete-time survival models. Several possible combinations and extensions of these models are made clear due to the unifying framework.",0 +https://doi.org/10.3758/bf03214357,How to fit a response time distribution,"Among the most valuable tools in behavioral science is statistically fitting mathematical models of cognition to data-response time distributions, in particular. However, techniques for fitting distributions vary widely, and little is known about the efficacy of different techniques. In this article, we assess several fitting techniques by simulating six widely cited models of response time and using the fitting procedures to recover model parameters. The techniques include the maximization of likelihood and least squares fits of the theoretical distributions to different empirical estimates of the simulated distributions. A running example is used to illustrate the different estimation and fitting procedures. The simulation studies reveal that empirical density estimates are biased even for very large sample sizes. Some fitting techniques yield more accurate and less variable parameter estimates than do others. Methods that involve least squares fits to density estimates generally yield very poor parameter estimates.",0 +https://doi.org/10.1111/j.1460-2466.2006.00317.x,"Democracy Based on Difference: Examining the Links Between Structural Heterogeneity, Heterogeneity of Discussion Networks, and Democratic Citizenship","This study explores the direct and indirect links between structural heterogeneity, network heterogeneity, and political participation. We review the often conflicting scholarship on discussion network heterogeneity and political participation and place it within a multilevel conceptual framework of heterogeneity. Based on this integrated theoretical model, our study uses a combination of macro-level and individual-level survey data from various sources. First, we use a cross-sectional national data set, based on a telephone survey with a probability sample of almost 800 adults. Second, we combine these individual-level data with county-level data on religious, political, and racial heterogeneity. Based on these data sets, we develop a path model linking structure, context, and networks into an integrated pathway to evaluate the direct and indirect effects of heterogeneity on political participation. Our results show positive links between structural and network heterogeneity that are both direct and indirect, that is, mediated through various communication processes.",0 +https://doi.org/10.1007/bf02296961,An alternative two stage least squares (2SLS) estimator for latent variable equations,"The Maximum-likelihood estimator dominates the estimation of general structural equation models. Noniterative, equation-by-equation estimators for factor analysis have received some attention, but little has been done on such estimators for latent variable equations. I propose an alternative 2SLS estimator of the parameters in LISREL type models and contrast it with the existing ones. The new 2SLS estimator allows observed and latent variables to originate from nonnormal distributions, is consistent, has a known asymptotic covariance matrix, and is estimable with standard statistical software. Diagnostics for evaluating instrumental variables are described. An empirical example illustrates the estimator.",0 +https://doi.org/10.1111/joop.12104,Data-analytic strategies for examining the effectiveness of daily interventions,"Interest in the use of ecological momentary interventions – that is, interventions that are implemented in participants' everyday lives – to change experiences and behaviours has grown rapidly in recent years. In particular, EMIs in which the intervention is delivered on a daily basis (daily interventions) can be easily combined with daily diary studies to analyse intervention effects on dependent variables (DVs) that fluctuate over time. This article first provides a typology of research designs to classify daily intervention studies according to (1) the type of assessment of the DV (global assessment on a small number of fixed occasions, daily assessment, and repeated assessment within days) and (2) the type of control (within-subjects vs. between-subjects designs) used in the studies. We then demonstrate how multilevel models can be used to examine the effects of a daily intervention on the mean levels of the DV. We differentiate between general effectiveness, differential effectiveness, and conditional effectiveness and show how these effects are represented in the models. As an illustration, we apply some of the models to data from a daily intervention workplace study (N = 51 full-time employees) that focused on the effects of savouring exercises on calm mood and vigour",0 +https://doi.org/10.1177/1094428112457829,The Time Has Come,"The use of Bayesian methods for data analysis is creating a revolution in fields ranging from genetics to marketing. Yet, results of our literature review, including more than 10,000 articles publi...",0 +https://doi.org/10.1177/0022022111430254,Unpacking Cultural Differences in Alexithymia,"The current study provides a cultural examination of alexithymia, a multifaceted personality construct that refers to a general deficit in the ability to identify and describe emotional states, and that has been linked to a number of psychiatric illnesses. Though this construct has been critiqued as heavily rooted in “Western” norms of emotional expression, it has not received much empirical attention from a cultural perspective. Recently, Ryder et al. (2008) found that higher levels of alexithymia among Chinese versus Euro-Canadian outpatients were explained by group differences in one component of alexithymia, externally oriented thinking (EOT); they proposed that Chinese cultural contexts may encourage EOT due to a greater emphasis on social relationships and interpersonal harmony rather than inner emotional experience. The current study examined the hypothesis that EOT is more strongly shaped by cultural values than are two other components of alexithymia, difficulty identifying feelings (DIF) and difficulty describing feelings (DDF). Euro-Canadian ( n = 271) and Chinese-Canadian ( n = 237) undergraduates completed measures of alexithymia and cultural values. Chinese-Canadians showed higher levels of EOT than Euro-Canadians ( p < .001). EOT, and not DIF or DDF, was predicted by Modernization and Euro-American values in both groups. Furthermore, cultural values mediated the effect of group membership on levels of EOT. These results suggest that cultural differences in alexithymia may be explained by culturally based variations in the importance placed on emotions, rather than deficits in emotional processing. The study also raises questions about the measurement and meaning of EOT, particularly from a cross-cultural perspective.",0 +https://doi.org/10.1207/s15327906mbr4004_4,Discrete Latent Markov Models for Normally Distributed Response Data,"Van de Pol and Langeheine (1990) presented a general framework for Markov modeling of repeatedly measured discrete data. We discuss analogical single indicator models for normally distributed responses. In contrast to discrete models, which have been studied extensively, analogical continuous response models have hardly been considered. These models are formulated as highly constrained multinormal finite mixture models (McLachlan & Peel, 2000). The assumption of conditional independence, which is often postulated in the discrete models, may be relaxed in the normal-based models. In these models, the observed correlation between two variables may thus be due to the presence of two or more latent classes and the presence of within-class dependence. The latter may be subjected to structural equation modeling. In addition to presenting various normal-based Markov models, we demonstrate how these models, formulated as multinormal finite mixtures, may be fitted using the freely available program Mx (Neale, Boker, Xie, & Maes, 2002). To illustrate the application of some of the models, we report the analysis of data relating to the understanding of the conservation of continuous quantity (i.e., a Piagetian construct).",0 +https://doi.org/10.1111/j.1744-6570.1996.tb01801.x,USING RANDOM RATHER THAN FIXED EFFECTS MODELS IN META-ANALYSIS: IMPLICATIONS FOR SITUATIONAL SPECIFICITY AND VALIDITY GENERALIZATION,"Combining statistical information across studies (i.e., meta-analysis) is a standard research tool in applied psychology. The most common meta-analytic approach in applied psychology, the fixed effects approach, assumes that individual studies are homogeneous and are sampled from the same population. This model assumes that sampling error alone explains the majority of observed differences in study effect sizes and its use has lead some to challenge the notion of situational specificity in favor of validity generalization. We critique the fixed effects methodology and propose an advancement–the random effects model (RE) which provides estimates of how between-study differences influence the relationships under study. RE models assume that studies are heterogeneous since they are often conducted by different investigators under different settings. Parameter estimates of both models are compared and evidence in favor of the random effects approach is presented. We argue against use of the fixed effects model because it may lead to misleading conclusions about situational specificity.",0 +https://doi.org/10.1890/11-1899.1,A generalized approach to modeling and estimating indirect effects in ecology,"The need to model and test hypotheses about complex ecological systems has led to a steady increase in use of path analytical techniques, which allow the modeling of multiple multivariate dependencies reflecting hypothesized causation and mechanisms. The aim is to achieve the estimation of direct, indirect, and total effects of one variable on another and to assess the adequacy of whole models. Path analytical techniques based on maximum likelihood currently used in ecology are rarely adequate for ecological data, which are often sparse, multi-level, and may contain nonlinear relationships as well as nonnormal response data such as counts or proportion data. Here I introduce a more flexible approach in the form of the joint application of hierarchical Bayes, Markov chain Monte Carlo algorithms, Shipley's d-sep test, and the potential outcomes framework to fit path models as well as to decompose and estimate effects. An example based on the direct and indirect interactions between ants, two insect herbivores, and a plant species demonstrates the implementation of these techniques, using freely available software.",0 +https://doi.org/10.1080/03610919708813451,Information and other criteria in structural equation model selection,"This article presents the results of a simulation study evaluating information criteria in conjunction with other well-known criteria for model selection in structural equation modeling (SEM). Two sets of simulation experiments were performed. In both sets, sample sizes of n = 100,400,1000,6000 were used and the performance of 18 criteria was assessed by the frequency with which each of five analytic models was selected as best by each criterion in 500 replications. In the first set of experiments correctly specified analytic models (noncentrality parameter 0) were entertained in combination with misspecified ones, while in the second set all five models were misspecified. In both sets of experiments, we found that the information criteria perform better than the other criteria overall, but that Cudeck and Browne's cross-validation index ( CVI) remains an attractive option. Within the class of information criteria, Akaike's information criterion (AIC) is found to show some overfitting tendency. We demonst...",0 +https://doi.org/10.1016/j.jrp.2013.09.004,The Mini-IPIP6: Tiny yet highly stable markers of Big Six personality,"Abstract We assessed the stability of a short-form six-factor personality measure over a one-year period in a large national probability sample (N = 4289). Personality was assessed using the Mini-IPIP6—a short-form measure assessing Extraversion, Agreeableness, Conscientiousness, Neuroticism, Openness to Experience, and Honesty-Humility. Standardized estimates calculated using Bayesian Structural Equation Modelling (BSEM) indicated that all six personality dimensions were extremely stable. An alternative model using Maximum Likelihood estimation, in which residual item variances were associated over repeated assessments, yielded similar findings. These results highlight the stability of personality in the general population, even when assessed using short-form scales. The use of Bayesian models to examine the stability of personality and their application for study of change in specific developmental periods is discussed.",0 +https://doi.org/10.1177/0146621611427898,A Comparison of the LR and DFIT Frameworks of Differential Functioning Applied to the Generalized Graded Unfolding Model,"Recently, applied psychological measurement researchers have become interested in the application of the generalized graded unfolding model (GGUM), a parametric item response theory model that posits an ideal point conception of the relationship between latent attributes and observed item responses. Little attention has been given to considerations for the detection of differential item functioning (DIF) under the GGUM. In this article, the authors present a Monte Carlo simulation meant to assess the efficacy of the likelihood ratio (LR) and differential functioning of items and tests (DFIT) frameworks, two popular ways of detecting DIF. Findings indicate a marked superiority of the LR approach over DFIT in terms of true and false positive rates under the GGUM. The discussion centers on possible explanations for the poor performance of the DFIT framework in detecting DIF under the GGUM and addresses limitations of the current study as well as future research directions.",0 +https://doi.org/10.1121/1.399058,Stimulus selection in adaptive psychophysical procedures,"In adaptive psychophysical procedures, the stimulus should be presented at a relatively high level rather than near the middle of the psychometric function, which is often defined as the ""threshold"" value. For some psychometric functions, the optimal stimulus placement level produces 84% to 94% correct responses in a two-alternative forced-choice task. This result is disquieting because the popular two-down one-up rule tracks a relatively low percentage of correct responses, 70.7%. Computer simulations and a variety of psychometric functions were used to confirm the validity of this analysis. These simulations also demonstrate that the precise form of the psychometric function is not critical in achieving the high efficiencies. Finally, data from human listeners indicate that the standard deviation of threshold estimates is indeed larger when the stimulus presented on each trial is at a stimulus level corresponding to 70.7% rather than 94% correct responses.",0 +https://doi.org/10.1016/j.schres.2006.01.022,Switch and maintenance of task set in schizophrenia,"Task set maintenance and switching deficits are robust in schizophrenia. However, little is known about how these constructs are related to one another. The development of an improved understanding of set switching and maintenance deficits in schizophrenia requires that these constructs be explicated in terms of elementary cognitive processes rather than grouped into broad psychological concepts like executive functioning. A relevant dichotomy has been proposed in which sensory and perceptual (""attentional"") processes are distinguished from decisional (""intentional"") processes in task maintenance and switching; however, the contributions these processes make to performance deficits in schizophrenia is not known. In the present study, 30 participants with schizophrenia and 27 healthy comparisons completed a cued attentional set switching task. In addition to analyses of mean response times, the contributions of attentional and intentional processes to task performance were estimated using an ex-Gaussian distributional analysis. Schizophrenia was associated with a set maintenance deficit that was accounted for by an attentional, rather than intentional, dysfunction. Both groups showed significant switch costs that could be attributed to attentional processes, but there was no evidence for an attentional set switching deficit in schizophrenia. The findings suggest that set switching and set maintenance may reflect distinct cognitive deficits in schizophrenia and that they may be associated with unique information processing mechanisms.",0 +https://doi.org/10.1080/03610918.2014.983648,Clustered data with small sample sizes: Comparing the performance of model-based and design-based approaches,Two classes of methods properly account for clustering of data: design-based methods and model-based methods. Estimates from both methods have been shown to be approximately equal with large sample...,0 +https://doi.org/10.1080/10705511.2014.994744,A Specification Error Test That Uses Instrumental Variables to Detect Latent Quadratic and Latent Interaction Effects,"The relations between the latent variables in structural equation models are typically assumed to be linear in form. This article aims to explain how a specification error test using instrumental variables (IVs) can be employed to detect unmodeled interactions between latent variables or quadratic effects of latent variables. An empirical example is presented, and the results of a simulation study are reported to evaluate the sensitivity and specificity of the test and compare it with the commonly employed chi-square model test. The results show that the proposed test can identify most unmodeled latent interactions or latent quadratic effects in moderate to large samples. Furthermore, its power is higher when the number of indicators used to define the latent variables is large. Altogether, this article shows how the IV-based test can be applied to structural equation models and that it is a valuable tool for researchers using structural equation models.",0 +https://doi.org/10.3758/s13428-016-0823-0,Performance of growth mixture models in the presence of time-varying covariates,"Growth mixture modeling is often used to identify unobserved heterogeneity in populations. Despite the usefulness of growth mixture modeling in practice, little is known about the performance of this data analysis technique in the presence of time-varying covariates. In the present simulation study, we examined the impacts of five design factors: the proportion of the total variance of the outcome explained by the time-varying covariates, the number of time points, the error structure, the sample size, and the mixing ratio. More precisely, we examined the impact of these factors on the accuracy of parameter and standard error estimates, as well as on the class enumeration accuracy. Our results showed that the consistent Akaike information criterion (CAIC), the sample-size-adjusted CAIC (SCAIC), the Bayesian information criterion (BIC), and the integrated completed likelihood criterion (ICL-BIC) proved to be highly reliable indicators of the true number of latent classes in the data, across design conditions, and that the sample-size-adjusted BIC (SBIC) also proved quite accurate, especially in larger samples. In contrast, the Akaike information criterion (AIC), the entropy, the normalized entropy criterion (NEC), and the classification likelihood criterion (CLC) proved to be unreliable indicators of the true number of latent classes in the data. Our results also showed that substantial biases in the parameter and standard error estimates tended to be associated with growth mixture models that included only four time points.",0 +https://doi.org/10.1177/0001699315579923,Reciprocity as a trigger of social cooperation in contemporary immigration societies?,"While the system stabilizing function of reciprocity is widely acknowledged, much less attention has been paid to the argument that reciprocity might initiate social cooperation in the first place. This paper tests Gouldner’s early assumption that reciprocity may act as a ‘starting mechanism’ of social cooperation in consolidating societies. The empirical test scenario builds on unequal civic engagement between immigrants and nationals, as this engagement gap can be read as a lack of social cooperation in consolidating immigration societies. Empirical analyses using survey data on reciprocal norms and based on Bayesian hierarchical modelling lend support for Gouldner’s thesis, underlining thereby the relevance of reciprocity in today’s increasingly diverse societies: individual norms of altruistic reciprocity elevate immigrants’ propensity to volunteer, reducing thereby the engagement gap between immigrants and natives in the area of informal volunteering. In other words, compliance with altruistic reciprocity may trigger cooperation in social strata, where it is less likely to occur. The positive moderation of the informal engagement gap through altruistic reciprocity turns out to be most pronounced for immigrants who are least likely to engage in informal volunteering, meaning low, but also highly educated immigrants.",0 +https://doi.org/10.1007/bf02295291,The robustness of estimates of total indirect effects in covariance structure models estimated by maximum,"The large sample distribution of total indirect effects in covariance structure models in well known. Using Monte Carlo methods, this study examines the applicability of the large sample theory to maximum likelihood estimates oftotal indirect effects in sample sizes of 50, 100, 200, 400, and 800. Two models are studied. Model 1 is a recursive model with observable variables and Model 2 is a nonrecursive model with latent variables. For the large sample theory to apply, the results suggest that sample szes of 200 or more and 400 or more are required for models such as Model 1 and Model 2, respectively. © 1990 The Psychometric Society.",0 +https://doi.org/10.1007/978-1-137-56077-3_9,Climate Change and Reproductive Intentions in Europe,"The harsh impacts of climate change and its related hazards are increasingly being felt across the world. A large consensus has emerged among natural scientists about the nature and the impact of climate change. It is recognized that climate change is largely anthropogenic and that, in turn, a continuous worsening of environmental conditions has strong impacts on populations’ and individuals’ well-being (Lutz, 2010).",0 +https://doi.org/10.1080/15305058.2013.870903,Factorial Structure of the Family Values Scale From a Multilevel-Multicultural Perspective,"In cross-cultural research, there is a tendency for researchers to draw inferences at the country level based on individual-level data. Such action implicitly and often mistakenly assumes that both the measuring instrument and its underlying construct(s) are operating equivalently across both levels. Based on responses from 5,482 college students sampled from 27 countries, we took a structural equation modeling approach to addressing this issue of level equivalence. Purposes of the study were: (a) to validate the hypothesized two-factor structure of the Family Values Scale (FV Scale; Georgas, 1999) within a multilevel framework that took individual- and country-level information into account; (b) to test equivalence of the FV Scale across individual and country levels; and (c) to evaluate relations between the FV Scale and three possibly important covariates—gender at the individual level, and affluence and religion at the country level. Implications of findings and importance of multilevel equivalence in...",0 +https://doi.org/10.1111/j.0006-341x.2001.01173.x,Shrinkage Estimators for Covariance Matrices,"Estimation of covariance matrices in small samples has been studied by many authors. Standard estimators, like the unstructured maximum likelihood estimator (ML) or restricted maximum likelihood (REML) estimator, can be very unstable with the smallest estimated eigenvalues being too small and the largest too big. A standard approach to more stably estimating the matrix in small samples is to compute the ML or REML estimator under some simple structure that involves estimation of fewer parameters, such as compound symmetry or independence. However, these estimators will not be consistent unless the hypothesized structure is correct. If interest focuses on estimation of regression coefficients with correlated (or longitudinal) data, a sandwich estimator of the covariance matrix may be used to provide standard errors for the estimated coefficients that are robust in the sense that they remain consistent under misspecification of the covariance structure. With large matrices, however, the inefficiency of the sandwich estimator becomes worrisome. We consider here two general shrinkage approaches to estimating the covariance matrix and regression coefficients. The first involves shrinking the eigenvalues of the unstructured ML or REML estimator. The second involves shrinking an unstructured estimator toward a structured estimator. For both cases, the data determine the amount of shrinkage. These estimators are consistent and give consistent and asymptotically efficient estimates for regression coefficients. Simulations show the improved operating characteristics of the shrinkage estimators of the covariance matrix and the regression coefficients in finite samples. The final estimator chosen includes a combination of both shrinkage approaches, i.e., shrinking the eigenvalues and then shrinking toward structure. We illustrate our approach on a sleep EEG study that requires estimation of a 24 x 24 covariance matrix and for which inferences on mean parameters critically depend on the covariance estimator chosen. We recommend making inference using a particular shrinkage estimator that provides a reasonable compromise between structured and unstructured estimators.",0 +https://doi.org/10.1214/ss/1032280214,Bootstrap confidence intervals,"This article surveys bootstrap methods for producing good approximate confidence intervals. The goal is to improve by an order of magnitude upon the accuracy of the standard intervals $\hat{\theta} \pm z^{(\alpha)} \hat{\sigma}$, in a way that allows routine application even to very complicated problems. Both theory and examples are used to show how this is done. The first seven sections provide a heuristic overview of four bootstrap confidence interval procedures: $BC_a$, bootstrap-t , ABC and calibration. Sections 8 and 9 describe the theory behind these methods, and their close connection with the likelihood-based confidence interval theory developed by Barndorff-Nielsen, Cox and Reid and others.",0 +https://doi.org/10.1002/sim.4172,Multivariate meta‐analysis: Potential and promise,"The multivariate random effects model is a generalization of the standard univariate model. Multivariate meta-analysis is becoming more commonly used and the techniques and related computer software, although continually under development, are now in place. In order to raise awareness of the multivariate methods, and discuss their advantages and disadvantages, we organized a one day 'Multivariate meta-analysis' event at the Royal Statistical Society. In addition to disseminating the most recent developments, we also received an abundance of comments, concerns, insights, critiques and encouragement. This article provides a balanced account of the day's discourse. By giving others the opportunity to respond to our assessment, we hope to ensure that the various view points and opinions are aired before multivariate meta-analysis simply becomes another widely used de facto method without any proper consideration of it by the medical statistics community. We describe the areas of application that multivariate meta-analysis has found, the methods available, the difficulties typically encountered and the arguments for and against the multivariate methods, using four representative but contrasting examples. We conclude that the multivariate methods can be useful, and in particular can provide estimates with better statistical properties, but also that these benefits come at the price of making more assumptions which do not result in better inference in every case. Although there is evidence that multivariate meta-analysis has considerable potential, it must be even more carefully applied than its univariate counterpart in practice.",0 +https://doi.org/10.1016/j.jbusvent.2011.01.001,Corporate effectuation: Entrepreneurial action and its impact on R&D project performance,"Abstract Innovative products are widely recognized as an important source of competitive advantage. However, many companies have difficulties finding efficient and successful approaches to different types of R&D projects, particularly those that involve a high level of innovativeness. Therefore, the present study moves effectuation theory from the entrepreneurial context to R&D research. First, the characteristics of an effectual approach in the context of R&D projects are developed and differentiated from those of conventional prediction-based strategies (causation). Second, using a thorough qualitative and quantitative scale-development process to capture particularities of effectual and causal dimensions in the R&D context, expert interviews and a pilot study (123 R&D projects), the study develops a multi-factor measurement model of effectuation and causation. These measures are validated in a follow-up study with a larger sample of 400 projects. Third, the new measures are applied to test two central hypotheses: (a) effectuation is positively related to success in highly innovative contexts, (b) causation approaches are beneficial in projects with low levels of innovativeness. Overall, this study moves the effectuation logic from the entrepreneurial to the corporate R&D context, captures its particularities, and investigates its performance outcomes.",0 +https://doi.org/10.1177/0049124194023002003,Estimator Conditioning Diagnostics for Covariance Structure Models,This article studies the utility of a general set of diagnostics for assessing conditioning problems in the covariance structure modeling framework. The diagnostics are based on extensions of the condition index and variance decomposition proportions advanced by Belsley and are based on using the covariance matrix of the estimates. A series of simulations with a variety of covariance structure models as well as a real data example show that these diagnostics are useful for gauging the sensitivity of parameter estimates to conditioning problems arising from collinearity in the raw data. The relationship between ill-conditioning and local identification as it pertains to the proposed diagnostics is also discussed. It is suggested that these diagnostics be implemented in existing covariance structure modeling software.,0 +https://doi.org/10.1093/biomet/92.2.419,Hierarchical models for assessing variability among functions,"SUMMARY In many applications of functional data analysis, summarising functional variation based on fits, without taking account of the estimation process, runs the risk of attributing the estimation variation to the functional variation, thereby overstating the latter. For example, the first eigenvalue of a sample covariance matrix computed from estimated functions may be biased upwards. We display a set of estimated neuronal Poisson-process intensity functions where this bias is substantial, and we discuss two methods for account ing for estimation variation. One method uses a random-coefficient model, which requires all functions to be fitted with the same basis functions. An alternative method removes the same-basis restriction by means of a hierarchical Gaussian process model. In a small simulation study the hierarchical Gaussian process model outperformed the random coefficient model and greatly reduced the bias in the estimated first eigenvalue that would result from ignoring estimation variability. For the neuronal data the hierarchical Gaussian process estimate of the first eigenvalue was much smaller than the naive estimate that ignored variability due to function estimation. The neuronal setting also illustrates the benefit of incorporating alignment parameters into the hierarchical scheme.",0 +https://doi.org/10.1037/0021-9010.92.5.1394,Choosing the best method for local validity estimation: Relative accuracy of meta-analysis versus a local study versus Bayes-analysis.,"This study assessed the relative accuracy of 3 techniques--local validity studies, meta-analysis, and Bayesian analysis--for estimating test validity, incremental validity, and adverse impact in the local selection context. Bayes-analysis involves combining a local study with nonlocal (meta-analytic) validity data. Using tests of cognitive ability and personality (conscientiousness) as predictors, an empirically driven selection scenario illustrates conditions in which each of the 3 estimation techniques performs best. General recommendations are offered for how to estimate local parameters, based on true population variability and the number of studies in the meta-analytic prior. Benefits of empirical Bayesian analysis for personnel selection are demonstrated, and equations are derived to help guide the choice of a local validity technique (i.e., meta-analysis vs. local study vs. Bayes-analysis).",0 +https://doi.org/10.1207/s15328007sem0803_7,An Illustration of Second-Order Latent Growth Models,"Methods of latent curve analysis (latent growth modeling) have recently emerged as a versatile tool for investigating longitudinal change in measured variables. This article, using higher order factor models as suggested by McArdle (1988) and Tisak and Meredith (1990), illustrates latent curve analysis for the purpose of modeling longitudinal change directly in a latent construct. The construct of interest is assumed to be indicated by several measured variables, all of which are observed at the same multiple time points. Examples with simultaneous estimation of covariance and mean structures are provided for both a single group and a two-group scenario.",0 +https://doi.org/10.1371/journal.pone.0081823,Publication Bias in Recent Meta-Analyses,"Positive results have a greater chance of being published and outcomes that are statistically significant have a greater chance of being fully reported. One consequence of research underreporting is that it may influence the sample of studies that is available for a meta-analysis. Smaller studies are often characterized by larger effects in published meta-analyses, which can be possibly explained by publication bias. We investigated the association between the statistical significance of the results and the probability of being included in recent meta-analyses.For meta-analyses of clinical trials, we defined the relative risk as the ratio of the probability of including statistically significant results favoring the treatment to the probability of including other results. For meta-analyses of other studies, we defined the relative risk as the ratio of the probability of including biologically plausible statistically significant results to the probability of including other results. We applied a Bayesian selection model for meta-analyses that included at least 30 studies and were published in four major general medical journals (BMJ, JAMA, Lancet, and PLOS Medicine) between 2008 and 2012.We identified 49 meta-analyses. The estimate of the relative risk was greater than one in 42 meta-analyses, greater than two in 16 meta-analyses, greater than three in eight meta-analyses, and greater than five in four meta-analyses. In 10 out of 28 meta-analyses of clinical trials, there was strong evidence that statistically significant results favoring the treatment were more likely to be included. In 4 out of 19 meta-analyses of observational studies, there was strong evidence that plausible statistically significant outcomes had a higher probability of being included.Publication bias was present in a substantial proportion of large meta-analyses that were recently published in four major medical journals.",0 +,A parameterization for individual human growth curves.,,0 +https://doi.org/10.1037/0033-295x.85.2.59,A theory of memory retrieval.,"A theory of memory retrieval is developed and is shown to apply over a range of experimental paradigms. Access to memory traces is viewed in terms of a resonance metaphor. The probe item evokes the search set on the basis of probe-memory item relatedness, just as a ringing tuning fork evokes sympathetic vibrations in other tuning forks. Evidence is accumulated in parallel from each probe-memory item comparison, and each comparison is modeled by a continuous random walk process. In item recognition, the decision process is self-terminating on matching comparisons and exhaustive on nonmatching comparisons. The mathematical model produces predictions about accuracy, mean reaction time, error latency, and reaction time distributions that are in good accord with experimental data. The theory is applied to four item recognition paradigms (Sternberg, prememorized list, study-test, and continuous) and to speed-accuracy paradigms; results are found to provide a basis for comparison of these paradigms. It is noted that neural network models can be interfaced to the retrieval theory with little difficulty and that semantic memory models may benefit from such a retrieval scheme.",0 +,Bayesian Analyses of Mediational Models for Survival Outcome,,0 +https://doi.org/10.1207/s15327906mbr3001_1,The Effect of Different Forms of Centering in Hierarchical Linear Models,"Multilevel models are becoming increasingly used in applied educational social and economic research for the analysis of hierarchically nested data. In these random coefficient regression models the parameters are allowed to differ over the groups in which the observations are nested. For computational ease in deriving parameter estimates, predictors are often centered around the mean. In nested or grouped data, the option of centering around the grand mean is extended with an option to center within groups or contexts. Both are statistically sound ways to improve parameter estimation. In this article we study the effects of these two different ways of centering, in comparison to the use of raw scores, on the parameter estimates in random coefficient models. The conclusion is that centering around the group mean amounts to fitting a different model from that obtained by centering around the grand mean or by using raw scores. The choice between the two options for centering can only be made on a theoretical basis. Based on this study, we conclude that centering rules valid for simple models, such as the fixed coefficients regression model. are no longer applicable to more complicated models, such as the random coefficient model. We think researchers should be made aware of the consequences of the choice of particular centering options.",0 +https://doi.org/10.2307/2171961,Nonparametric Tests of Stochastic Dominance in Income Distributions,"Tests for stochastic dominance, based upon extensions of the Goodness of Fit Test to the nonparametric comparison of income distributions, are proposed, implemented, and compared with indirect tests of second order stochastic dominance currently utilized in income distribution studies.",0 +https://doi.org/10.2307/270723,Asymptotic Confidence Intervals for Indirect Effects in Structural Equation Models,"For comments on an earlier draft of this chapter and for detailed advice I am indebted to Robert M. Hauser, Halliman H. Winsborough, and Toni Richards, several anonymous reviewers, and the editor of this volume. I also wish to thank John Raisian, Nancy Rytina, and Barbara Mann for their comments and Mark Wilson for able research assistance. The opinions expressed here are the sole responsibility of the author.",0 +https://doi.org/10.1080/00031305.2013.817357,Logistic Regression With Multiple Random Effects: A Simulation Study of Estimation Methods and Statistical Packages,"Several statistical packages are capable of estimating generalized linear mixed models and these packages provide one or more of three estimation methods: penalized quasi-likelihood, Laplace, and Gauss–Hermite. Many studies have investigated these methods’ performance for the mixed-effects logistic regression model. However, the authors focused on models with one or two random effects and assumed a simple covariance structure between them, which may not be realistic. When there are multiple correlated random effects in a model, the computation becomes intensive, and often an algorithm fails to converge. Moreover, in our analysis of smoking status and exposure to antitobacco advertisements, we have observed that when a model included multiple random effects, parameter estimates varied considerably from one statistical package to another even when using the same estimation method. This article presents a comprehensive review of the advantages and disadvantages of each estimation method. In addition, we compare the performances of the three methods across statistical packages via simulation, which involves two- and three-level logistic regression models with at least three correlated random effects. We apply our findings to a real dataset. Our results suggest that two packages—SAS GLIMMIX Laplace and SuperMix Gaussian quadrature—perform well in terms of accuracy, precision, convergence rates, and computing speed. We also discuss the strengths and weaknesses of the two packages in regard to sample sizes.",0 +https://doi.org/10.2307/271084,Direct and Indirect Effects: Classical and Bootstrap Estimates of Variability,"The decomposition of effects in structural equation models has been of considerable interest to social scientists. Finite-sample or asymptotic results for the sampling distribution of estimators of direct effects are widely available. Statistical inferences about indirect effects have relied exclusively on asymptotic methods which assume that the limiting distribution of the estimator is normal, with a standard error derived from the delta method. We examine bootstrap procedures as another way to generate standard errors and confidence intervals and to estimate the sampling distributions of estimators of direct and indirect effects. We illustrate the classical and the bootstrap methods with three empirical examples. We find that in a moderately large sample, the bootstrap distribution of an estimator is close to that assumed with the",0 +https://doi.org/10.2307/2983328,Improved Approximations for Multilevel Models with Binary Responses,"SUMMARY This paper discusses the use of improved approximations for the estimation of generalized linear multilevel models where the response is a proportion. Simulation studies by Rodriguez and Goldman have shown that in extreme situations large biases can occur, most notably when the response is binary, the number of level 1 units per level 2 unit is small and the underlying random parameter values are large. An improved approximation is introduced which largely eliminates the biases in the situation described by Rodriguez and Goldman. Keywortis: �BINARY RESPONSE; GENERALIZED LINEAR MODEL; HIERARCHICAL DATA; MARGINAL MODEL; MULTILEVEL MODEL; QUASI-LIKELIHOOD; UNIT-SPECIFIC MODEL",0 +https://doi.org/10.1080/10629360600903866,Plausibility of multivariate normality assumption when multiply imputing non-Gaussian continuous outcomes: a simulation assessment,"Multiple imputation under the assumption of multivariate normality has emerged as a frequently used model-based approach in dealing with incomplete continuous data in recent years. Despite its simplicity and popularity, however, its plausibility has not been thoroughly evaluated via simulation. In this work, the performance of multiple imputation under a multivariate Gaussian model with unstructured covariances was examined on a broad range of simulated incomplete data sets that exhibit varying distributional characteristics such as skewness and multimodality that are not accommodated by a Gaussian model. Behavior of efficiency and accuracy measures was explored to determine the extent to which the procedure works properly. The conclusion drawn is that although the real data rarely conform with multivariate normality, imputation under the assumption of normality is a fairly reasonable tool, even when the assumption of normality is clearly violated; the fraction of missing information is high, especially w...",0 +https://doi.org/10.1016/j.lindif.2012.10.002,Exploring gains in reading and mathematics achievement among regular and exceptional students using growth curve modeling,"Abstract Using four-wave longitudinal reading and mathematics data (4th to 7th grades) from a large urban school district, growth curve modeling was used as a tool for examining three research questions: Are achievement gaps closing in reading and mathematics? What are the associations between prior-achievement and growth across the reading and mathematics domains? Is there an association between the receipt of additional services (special education, English-as-second-language, free and reduced lunch program) and reading and mathematics achievement? Results showed that rates of growth in achievement diminished over time and achievement gaps closed in reading, but not mathematics. Reading ability was directly related to gains in mathematics. Analysis of the time-varying covariates showed that there tended to be positive effects of the receipt of English-as-second language instruction on both reading and mathematics achievement, whereas students receiving special education and free and reduced lunch programs consistently had lower academic achievement levels. Implications for the achievement literature are discussed.",0 +https://doi.org/10.1006/jmps.1994.1001,Stochastic Dependencies in Parallel and Serial Models: Effects on Systems Factorial Interactions,"Abstract This paper examines the behavior of stochastically dependent serial and parallel processing models in the setting of a 2 x 2 factorial experiment. Interactions found in factorial experiments can provide insight into the underlying mental architecture operating in a given psychological task. Recent theoretical results classify mental networks according to the types of factorial interaction they predict when selectivity of the factors is assumed. When one allows this selectivity to break down through a stochastic dependence between processes, the characteristic patterns associated with distinct architectures are disturbed. We investigate the relationships among: (a) parallel and serial architectures, (b) positive, negative, and zero dependencies, and (c) types of mean reaction time factorial interaction. In particular, we show that in some cases, observable symptoms of a stochastic dependence arise. One of these, which we term a single factor reversal of mean processing times, arises as a result of a negative dependence under certain circumstances. Another characteristic of dependent systems that may contribute to their identifiability is that the interactions can be subadditive for some levels of the factors and superadditive at other levels. This change in contrast is not possible for independent serial and parallel models with selective influence.",0 +,A stochastic unfolding model derived from the partial credit model,,0 +https://doi.org/10.3102/1076998609332752,An Integrated Bayesian Model for DIF Analysis,"In this article, an integrated bayesian model for differential item functioning (DIF) analysis is proposed. The model is integrated in the sense of modeling the responses along with the DIF analysis. This approach allows DIF detection and explanation in a simultaneous setup. Previous empirical studies and/or subjective beliefs about the item parameters, including differential functioning behavior, may be conveniently expressed in terms of prior distributions. Values of indicator variables are estimated in the model, indicating which items have DIF and which do not; as a result, the data analyst may not be required to specify an “anchor set” of items that do not exhibit DIF a priori to identify the model. It reduces the iterative procedures that are commonly used for proficiency purification and DIF detection and explanation. Examples demonstrate the efficiency of this method in simulated and real situations.",0 +https://doi.org/10.1037/a0033950,Indirect effects of fidelity to the family check-up on changes in parenting and early childhood problem behaviors.,"This study examines observations of client in-session engagement and fidelity of implementation to the Family Check-Up (FCU) as they relate to improvements in caregivers' positive behavior support (PBS) and children's problem behavior in the context of a randomized prevention trial. The psychometric properties of fidelity scores obtained with a new rating system are also explored.The FCU feedback sessions of 79 families with children with elevated problem behavior scores at age 2 were coded by trained raters of fidelity, who used an observational coding system developed specifically for this intervention model.Path analysis indicated that fidelity to the FCU results in greater caregiver engagement in the feedback session, which directly predicts improvements in caregivers' PBS 1 year later (β = 0.06, 95% CI [.007, .129]). Similarly, engagement and PBS directly predict reductions in children's problem behavior measured 2 years later (β = -0.24, 95% CI [-.664, -.019]).These results suggest fidelity within the context of this randomized intervention trial. Ratings of fidelity to the FCU covary with observed improvements in parenting and children's problem behavior in early childhood. Overall reliability of the fidelity scores was found to be acceptable, but some single-item reliability estimates were low, suggesting revisions to the rating system might be needed. Accurately assessing fidelity and understanding its relationship to change during intervention studies is an underdeveloped area of research and has revealed some inconsistent findings. Our results shed light on the mixed conclusions of previous studies, suggesting that future research ought to assess the role of intervening variable effects, such as observed engagement.",0 +https://doi.org/10.1016/j.jeconom.2004.04.012,Practical propensity score matching: a reply to Smith and Todd,"Abstract This paper discusses propensity score matching in the context of Smith and Todd's (Does matching overcome Lalonde's critique of nonexperimental estimators, J. Econom., in press) reanalysis of Dehejia and Wahba (J. Am. Statist. Assoc. 97 (1999) 1053; National Bereau of Economics Research working Paper No. 6829, Rev. Econom. Statist., 2002, forthcoming). Propensity score methods require that a separate propensity score specification be estimated for each treatment group-comparison group combination. Furthermore, a researcher should always examine the sensitivity of the estimated treatment effect to small changes in the propensity score specification; this is a useful diagnostic on the quality of the comparison group. When these are borne in mind, propensity score methods are useful in analyzing all of the subsamples of the NSW data considered in Smith and Todd (Does matching overcome Lalonde's critique of nonexperimental estimators, J. Econom., in press).",0 +https://doi.org/10.1093/acprof:oso/9780195173444.003.0006,Multilevel Autoregressive Modeling of Interindividual Differences in the Stability of a Process,"Most psychological phenomena have been studied through the consideration of data gathered at relatively few occasions of measurement over time. However, a current wave of diary-based studies has generated many databases with more intensively collected longitudinal data. The number of occasions can be greater than those gathered in a normal panel study, but less than the very high numbers of occasions typically found in the time-series domain. The same types of questions that could be answered based on a smaller number of occasions could also be proposed for these longer time series. Normally, scientific questions for which longitudinal data have been collected have been the focus with change and stability.",0 +https://doi.org/10.1515/sagmb-2016-0051,A Bayesian semiparametric factor analysis model for subtype identification,"Abstract: Disease subtype identification (clustering) is an important problem in biomedical research. Gene expression profiles are commonly utilized to infer disease subtypes, which often lead to biologically meaningful insights into disease. Despite many successes, existing clustering methods may not perform well when genes are highly correlated and many uninformative genes are included for clustering due to the high dimensionality. In this article, we introduce a novel subtype identification method in the Bayesian setting based on gene expression profiles. This method, called BCSub, adopts an innovative semiparametric Bayesian factor analysis model to reduce the dimension of the data to a few factor scores for clustering. Specifically, the factor scores are assumed to follow the Dirichlet process mixture model in order to induce clustering. Through extensive simulation studies, we show that BCSub has improved performance over commonly used clustering methods. When applied to two gene expression datasets, our model is able to identify subtypes that are clinically more relevant than those identified from the existing methods.",0 +https://doi.org/10.1002/hec.1198,Multilevel models for estimating incremental net benefits in multinational studies,"Multilevel models (MLMs) have been recommended for estimating incremental net benefits (INBs) in multicentre cost-effectiveness analysis (CEA). However, these models have assumed that the INBs are exchangeable and that there is a common variance across all centres. This paper examines the plausibility of these assumptions by comparing various MLMs for estimating the mean INB in a multinational CEA. The results showed that the MLMs that assumed the INBs were exchangeable and had a common variance led to incorrect inferences. The MLMs that included covariates to allow for systematic differences across the centres, and estimated different variances in each centre, made more plausible assumptions, fitted the data better and led to more appropriate inferences. We conclude that the validity of assumptions underlying MLMs used in CEA need to be critically evaluated before reliable conclusions can be drawn. Copyright © 2006 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1177/0013164409355693,The Multilevel Crossed Random Effects Growth Model for Estimating Teacher and School Effects: Issues and Extensions,"This article examines the multilevel linear crossed random effects growth model for estimating teacher and school effects from repeated measurements of student achievement. Results suggest that even a small degree of unmodeled nonlinearity can result in a substantial upward bias in the magnitude of the teacher effect, which raises concerns about its appropriateness for estimating teacher effects. To address this issue, a piecewise linear crossed random effect growth model is proposed. A comparison with the linear growth form shows that the piecewise specification provides more accurate estimates of teacher effects when achievement growth departs from linear growth across grade levels or over summer, which are prevalent conditions. Fitted examples using nationally representative data and Bayesian estimation methods are provided.",0 +https://doi.org/10.1027/1614-2241/a000029,Sample Size and Accuracy of Estimates in Multilevel Models,"In a multilevel framework several researches have investigated the behavior of estimates in finite samples, particularly for continuous dependent variables. Some findings show poor precise estimates for the variance components. On the other hand, discrete response multilevel models have been investigated less widely. In this paper we analyze the influence of different factors on the accuracy of estimates and standard errors of estimates in a binary response 2-level model, through a Monte Carlo simulation study. We investigate the hypothesis of: (a) small sample sizes; (b) different intraclass correlation coefficients; (c) different numbers of quadrature points in the estimation procedure. Standard errors of estimates are studied through a noncoverage indicator. In all instances we have considered, the point estimates are unbiased (even with very small sample sizes), while the variance components are underestimated. The accuracy of the standard errors of variance estimates needs a very large number of groups.",0 +https://doi.org/10.1007/s11336-012-9262-8,A Two-Step Bayesian Approach for Propensity Score Analysis: Simulations and Case Study,"A two-step Bayesian propensity score approach is introduced that incorporates prior information in the propensity score equation and outcome equation without the problems associated with simultaneous Bayesian propensity score approaches. The corresponding variance estimators are also provided. The two-step Bayesian propensity score is provided for three methods of implementation: propensity score stratification, weighting, and optimal full matching. Three simulation studies and one case study are presented to elaborate the proposed two-step Bayesian propensity score approach. Results of the simulation studies reveal that greater precision in the propensity score equation yields better recovery of the frequentist-based treatment effect. A slight advantage is shown for the Bayesian approach in small samples. Results also reveal that greater precision around the wrong treatment effect can lead to seriously distorted results. However, greater precision around the correct treatment effect parameter yields quite good results, with slight improvement seen with greater precision in the propensity score equation. A comparison of coverage rates for the conventional frequentist approach and proposed Bayesian approach is also provided. The case study reveals that credible intervals are wider than frequentist confidence intervals when priors are non-informative.",0 +https://doi.org/10.1007/bf00170145,Analysis of longitudinal data using the hierarchical linear model,"The hierarchical linear model in a linear model with nested random coefficients, fruitfully used for multilevel research. A tutorial is presented on the use of this model for the analysis of longitudinal data, i.e., repeated data on the same subjects. An important advantage of this approach is that differences across subjects in the numbers and spacings of measurement occasions do not present a problem, and that changing covariates can easily be handled. The tutorial approaches the longitudinal data as measurements on populations of (subject-specific) functions.",0 +https://doi.org/10.1111/1467-9574.00060,What are the advantages of MCMC based inference in latent variable models?,"Recent developments in Markov chain Monte Carlo [MCMC] methods have increased the popularity of Bayesian inference in many fields of research in economics, such as marketing research and financial econometrics. Gibbs sampling in combination with data augmentation allows inference in statistical/econometric models with many unobserved variables. The likelihood functions of these models may contain many integrals, which often makes a standard classical analysis difficult or even unfeasible. The advantage of the Bayesian approach using MCMC is that one only has to consider the likelihood function conditional on the unobserved variables. In many cases this implies that Bayesian parameter estimation is faster than classical maximum likelihood estimation. In this paper we illustrate the computational advantages of Bayesian estimation using MCMC in several popular latent variable models.",0 +https://doi.org/10.1123/jsep.2014-0330,Bayesian Structural Equation Modeling in Sport and Exercise Psychology,"Bayesian statistics is on the rise in mainstream psychology, but applications in sport and exercise psychology research are scarce. In this article, the foundations of Bayesian analysis are introduced, and we will illustrate how to apply Bayesian structural equation modeling in a sport and exercise psychology setting. More specifically, we contrasted a confirmatory factor analysis on the Sport Motivation Scale II estimated with the most commonly used estimator, maximum likelihood, and a Bayesian approach with weakly informative priors for cross-loadings and correlated residuals. The results indicated that the model with Bayesian estimation and weakly informative priors provided a good fit to the data, whereas the model estimated with a maximum likelihood estimator did not produce a well-fitting model. The reasons for this discrepancy between maximum likelihood and Bayesian estimation are discussed as well as potential advantages and caveats with the Bayesian approach.",0 +https://doi.org/10.1016/j.tvjl.2013.03.010,Effect of extended cefquinome treatment on clinical persistence or recurrence of environmental clinical mastitis,"The effectiveness of antibiotic treatment of clinical mastitis (CM) is classically evaluated using bacteriological cure, which provides a concise and objective way of assessing efficacy but does not reflect the situation in the field where persistence or recurrence of clinical signs lead to perceived treatment failure. If clinical signs persist or recur, intramammary (IMM) treatment is often extended or supplemented with parenteral therapy in the expectation of a more efficient elimination of clinical signs or a lower probability of recurrence. The objective of this study was to evaluate the efficacy against clinical persistence or recurrence of three cefquinome treatment regimes, standard 1.5-day intramammary (SIMM), 5-day extended intramammary (EIMM) and combination of EIMM plus 5-day extended parenteral (ECOMBO) treatment. The study was conducted on three dairy farms with a high recurrence rate of environmental mastitis. Efficacy was evaluated using a multi-level model at the quarter and at the cow level, based on the persistence or recurrence of clinical signs at any time during a 105-day period following the end of the initial treatment, independent of pathogen. The most prevalent pathogens were E. coli (16.9%) and S. uberis (11.97%). EIMM and ECOMBO significantly decreased the persistence or recurrence of CM by 8% and 6% at the quarter level and by 9% and 8% at the cow level, respectively. ECOMBO may not reduce the persistence or recurrence of CM beyond EIMM. Whilst extended treatment regimens offered an improved outcome in this study, the producer and practitioner need to carefully consider such regimens from the perspective of prudent antibiotic use.",0 +https://doi.org/10.1287/mnsc.1100.1161,Assessing Joint Distributions with Isoprobability Contours,"We present a new method for constructing joint probability distributions of continuous random variables using isoprobability contours—sets of points with the same joint cumulative probability. This approach reduces the joint probability assessment into a one-dimensional cumulative probability assessment using a sequence of binary choices between various combinations of the variables of interest. The approach eliminates the need to assess directly the dependence, or association, between the variables. We discuss properties of isoprobability contours and methods for their assessment in practice. We also report results of a study in which subjects assessed the 50th percentile isoprobability contour of the joint distribution of weight and height. We use the data to show how to use the assessed contours to construct the joint distribution and to infer (indirectly) the dependence between the variables.",0 +https://doi.org/10.4324/9781315092614-6,Two-Stage Least Squares Estimation of Interaction Effects,"This chapter provides a largely nontechnical description of an alternative technique to include interactions of latent variables in structural equation models. It also provides a generic description of a model with interactions of latent variables with multiple indicators. The chapter presents the two-stage least squares (2SLS) method to model such interactions. It discusses the D. A. Kenny and C. M. Judd and related methods for handling such interactions. If the new measurement equations and nonlinear constraints are included, Kenny and Judd showed that the coefficients for the nonlinear variables could be consistently estimated with generalized least squares estimation. The chapter compares the two techniques with the simulation and empirical data that Kenny and Judd provided in their original paper. It focuses on a 2SLS method to handle interactions of latent variables that have multiple indicators. The chapter concludes with comments and contrasts the alternative methods and their properties.",0 +https://doi.org/10.1371/journal.pone.0087597,Modelling Pathways to Rubisco Degradation: A Structural Equation Network Modelling Approach,"'Omics analysis (transcriptomics, proteomics) quantifies changes in gene/protein expression, providing a snapshot of changes in biochemical pathways over time. Although tools such as modelling that are needed to investigate the relationships between genes/proteins already exist, they are rarely utilised. We consider the potential for using Structural Equation Modelling to investigate protein-protein interactions in a proposed Rubisco protein degradation pathway using previously published data from 2D electrophoresis and mass spectrometry proteome analysis. These informed the development of a prior model that hypothesised a pathway of Rubisco Large Subunit and Small Subunit degradation, producing both primary and secondary degradation products. While some of the putative pathways were confirmed by the modelling approach, the model also demonstrated features that had not been originally hypothesised. We used Bayesian analysis based on Markov Chain Monte Carlo simulation to generate output statistics suggesting that the model had replicated the variation in the observed data due to protein-protein interactions. This study represents an early step in the development of approaches that seek to enable the full utilisation of information regarding the dynamics of biochemical pathways contained within proteomics data. As these approaches gain attention, they will guide the design and conduct of experiments that enable 'Omics modelling to become a common place practice within molecular biology.",0 +https://doi.org/10.1177/0146621612461727,The Influence of Item Calibration Error on Variable-Length Computerized Adaptive Testing,"Variable-length computerized adaptive testing (VL-CAT) allows both items and test length to be “tailored” to examinees, thereby achieving the measurement goal (e.g., scoring precision or classification) with as few items as possible. Several popular test termination rules depend on the standard error of the ability estimate, which in turn depends on the item parameter values. However, items are chosen on the basis of their parameter estimates, and capitalization on chance may occur. In this article, the authors investigated the effects of capitalization on chance on test length and classification accuracy in several VL-CAT simulations. The results confirm that capitalization on chance occurs in VL-CAT and has complex effects on test length, ability estimation, and classification accuracy. These results have important implications for the design and implementation of VL-CATs.",0 +https://doi.org/10.1016/j.neuroscience.2009.09.046,Evidence for a role of heat shock protein-90 in toll like receptor 4 mediated pain enhancement in rats,"Spinal cord microglial toll-like receptor 4 (TLR4) has been implicated in enhancing neuropathic pain and opposing morphine analgesia. The present study was initiated to explore TLR4-mediated pain modulation by intrathecal lipopolysaccharide, a classic TLR4 agonist. However, our initial study revealed that intrathecal lipopolysaccharide failed to induce low-threshold mechanical allodynia in naive rats, suggestive that TLR4 agonism may be insufficient to enhance pain. These studies explore the possibility that a second signal is required; namely, heat shock protein-90 (HSP90). This candidate was chosen for study given its known importance as a regulator of TLR4 signaling. A combination of in vitro TLR4 cell signaling and in vivo behavioral studies of pain modulation suggest that TLR4-enhancement of neuropathic pain and TLR4-suppression of morphine analgesia each likely require HSP90 as a cofactor for the effects observed. In vitro studies revealed that dimethyl sulfoxide (DMSO) enhances HSP90 release, suggestive that this may be a means by which DMSO enhances TLR4 signaling. While 2 and 100 microg lipopolysaccharide intrathecally did not induce mechanical allodynia across the time course tested, co-administration of 1 microg lipopolysaccharide with a drug that enhances HSP90-mediated TLR4 signaling now induced robust allodynia. In support of this allodynia being mediated via a TLR4/HSP90 pathway, it was prevented or reversed by intrathecal co-administration of a HSP90 inhibitor, a TLR4 inhibitor, a microglia/monocyte activation inhibitor (as monocyte-derived cells are the predominant cell type expressing TLR4), and interleukin-1 receptor antagonist (as this proinflammatory cytokine is a downstream consequence of TLR4 activation). Together, these results suggest for the first time that TLR4 activation is necessary but not sufficient to induce spinally mediated pain enhancement. Rather, the data suggest that TLR4-dependent pain phenomena may require contributions by multiple components of the TLR4 receptor complex.",0 +https://doi.org/10.1080/87565640801982486,Longitudinal Associations Between Reading and Mathematics Achievement,"The association between early reading skills and changes in mathematics was examined in a large, low-income sample to determine whether students who have a greater level of reading skills in early elementary school exhibit more rapid gains in tests of mathematics. The longitudinal associations between third grade reading comprehension and changes in three components of mathematics achievement (Problem Solving and Data Interpretation, Mathematical Concepts and Estimation, Mathematical Computation) from third through eighth grade were examined. Latent growth models were fit to the repeated assessments of each mathematics component and the students' third grade reading and global mathematics scores were included as predictors of the intercept and slope. Gender, poverty status, and ethnicity were included in the models as control variables. The results showed males and African-American students tended to have shallower rates of change than females and non-African-American/non-Hispanic students. In terms of the effect of reading on changes in mathematics, third grade reading comprehension was found to be a positive significant predictor of change for each component of mathematics, suggesting students with a greater level of reading achievement in early elementary school change more rapidly in mathematics skills controlling for prior mathematics skills and student characteristics. The largest effects were shown for the Problem Solving and Data Interpretation test, a test focused on the applications of mathematics knowledge, and the Mathematical Concepts and Estimation test. Negligible effects were found for changes in Mathematical Computation. Thus, early reading comprehension was shown to be related to a conceptual understanding of mathematics and the application of mathematics knowledge. These findings lend support for the notion that early reading skills are important for success in mathematics.",0 +https://doi.org/10.1007/bf02294733,Markov chain estimation for test theory without an answer key,"This study develops Markov Chain Monte Carlo (MCMC) estimation theory for the General Condorcet Model (GCM), an item response model for dichotomous response data which does not presume the analyst knows the correct answers to the test a priori (answer key). In addition to the answer key, respondent ability, guessing bias, and difficulty parameters are estimated. With respect to data-fit, the study compares between the possible GCM formulations, using MCMC-based methods for model assessment and model selection. Real data applications and a simulation study show that the GCM can accurately reconstruct the answer key from a small number of respondents.",0 +https://doi.org/10.1207/s15327906mbr3502_1,Design and Analysis of Monte Carlo Experiments: Attacking the Conventional Wisdom,"The design and analysis of Monte Carlo experiments, with special reference to structural equation modelling, is discussed in this article. These topics merit consideration, since the validity of the conclusions drawn from a Monte Carlo study clearly hinges on these features. It is argued that comprehensive Monte Carlo experiments can be implemented on a PC if the experiments are adequately designed. This is especially important when investigating modern computer intensive methodologies like resampling and Markov Chain Monte Carlo methods. We are faced with three fundamental challenges in Monte Carlo experimentation. The first problem is statistical precision, which concerns the reliability of the obtained results. External validity, on the other hand, depends on the number of experimental conditions, and is crucial for the prospects of generalising the results beyond the specific experiment. Finally, we face the constraint on available computer resources. The conventional wisdom in designing and analysing Monte Carlo experiments embodies no explicit specification of meta-model for analysing the output of the experiment, the use of case studies or full factorial designs as experimental plans, no use of variance reduction techniques, a large number of replications, and ""eyeballing"" of the results. A critical examination of the conventional wisdom is presented in this article. We suggest that the following alternative procedures should be considered. First of all, we argue that it is profitable to specify explicit meta-models, relating the chosen performance statistics and experimental conditions. Regarding the experimental plan, we recommend the use of incomplete designs, which will often result in considerable savings. We also consider the use of common random numbers in the simulation phase, since this may enhance the precision in estimating meta-models. The use of fewer replications per trial, enabling us to investigate an increased number of experimental conditions, should also be considered in order to improve the external validity at the cost of the conventionally excessive precision.",0 +https://doi.org/10.1214/aos/1176346785,Bayesianly Justifiable and Relevant Frequency Calculations for the Applied Statistician,"A common reaction among applied statisticians is that the Bayesian statistician's energies in an applied problem must be directed at the a priori elicitation of one model specification from which an optimal design and all inferences follow automatically by applying Bayes's theorem to calculate conditional distributions of unknowns given knowns. I feel, however, that the applied Bayesian statistician's tool-kit should be more extensive and include tools that may be usefully labeled frequency calculations. Three types of Bayesianly justifiable and relevant frequency calculations are presented using examples to convey their use for the applied statistician.",0 +https://doi.org/10.1093/biostatistics/kxp032,Modeling between-trial variance structure in mixed treatment comparisons,"In mixed treatment comparison (MTC) meta-analysis, modeling the heterogeneity in between-trial variances across studies is a difficult problem because of the constraints on the variances inherited from the MTC structure. Starting from a consistent Bayesian hierarchical model for the mean treatment effects, we represent the variance configuration by a set of triangle inequalities on the standard deviations. We take the separation strategy (Barnard and others, 2000) to specify prior distributions for standard deviations and correlations separately. The covariance matrix of the latent treatment arm effects can be employed as a vehicle to load the triangular constraints, which in addition allows incorporation of prior beliefs about the correlations between treatment effects. The spherical parameterization based on Cholesky decomposition (Pinheiro and Bates, 1996) is used to generate a positive-definite matrix for the prior correlations in Markov chain Monte Carlo (MCMC). Elicited prior information on correlations between treatment arms is introduced in the form of its equivalent data likelihood. The procedure is implemented in a MCMC framework and illustrated with example data sets from medical research practice.",0 +https://doi.org/10.1111/j.1541-0420.2005.00377.x,Doubly Robust Estimation in Missing Data and Causal Inference Models,"The goal of this article is to construct doubly robust (DR) estimators in ignorable missing data and causal inference models. In a missing data model, an estimator is DR if it remains consistent when either (but not necessarily both) a model for the missingness mechanism or a model for the distribution of the complete data is correctly specified. Because with observational data one can never be sure that either a missingness model or a complete data model is correct, perhaps the best that can be hoped for is to find a DR estimator. DR estimators, in contrast to standard likelihood-based or (nonaugmented) inverse probability-weighted estimators, give the analyst two chances, instead of only one, to make a valid inference. In a causal inference model, an estimator is DR if it remains consistent when either a model for the treatment assignment mechanism or a model for the distribution of the counterfactual data is correctly specified. Because with observational data one can never be sure that a model for the treatment assignment mechanism or a model for the counterfactual data is correct, inference based on DR estimators should improve upon previous approaches. Indeed, we present the results of simulation studies which demonstrate that the finite sample performance of DR estimators is as impressive as theory would predict. The proposed method is applied to a cardiovascular clinical trial.",0 +https://doi.org/10.1037/1082-989x.5.2.230,Testing for robustness in Monte Carlo studies.,"Monte Carlo studies provide the information needed to help researchers select appropriate analytical procedures under design conditions in which the underlying assumptions of the procedures are not met. In Monte Carlo studies, the 2 errors that one could commit involve (a) concluding that a statistical procedure is robust when it is not or (b) concluding that it is not robust when it is. In previous attempts to apply standard statistical design principles to Monte Carlo studies, the less severe of these errors has been wrongly designated the Type I error. In this article, a method is presented for controlling the appropriate Type I error rate; the determination of the number of iterations required in a Monte Carlo study to achieve desired power is described; and a confidence interval for a test's true Type I error rate is derived. A robustness criterion is also proposed that is a compromise between W. G. Cochran's (1952) and J. V. Bradley's (1978) criteria.",0 +https://doi.org/10.2202/1557-4679.1195,Estimating Multilevel Logistic Regression Models When the Number of Clusters is Low: A Comparison of Different Statistical Software Procedures,"Multilevel logistic regression models are increasingly being used to analyze clustered data in medical, public health, epidemiological, and educational research. Procedures for estimating the parameters of such models are available in many statistical software packages. There is currently little evidence on the minimum number of clusters necessary to reliably fit multilevel regression models. We conducted a Monte Carlo study to compare the performance of different statistical software procedures for estimating multilevel logistic regression models when the number of clusters was low. We examined procedures available in BUGS, HLM, R, SAS, and Stata. We found that there were qualitative differences in the performance of different software procedures for estimating multilevel logistic models when the number of clusters was low. Among the likelihood-based procedures, estimation methods based on adaptive Gauss-Hermite approximations to the likelihood (glmer in R and xtlogit in Stata) or adaptive Gaussian quadrature (Proc NLMIXED in SAS) tended to have superior performance for estimating variance components when the number of clusters was small, compared to software procedures based on penalized quasi-likelihood. However, only Bayesian estimation with BUGS allowed for accurate estimation of variance components when there were fewer than 10 clusters. For all statistical software procedures, estimation of variance components tended to be poor when there were only five subjects per cluster, regardless of the number of clusters.",0 +https://doi.org/10.1002/sim.2530,Bayesian analysis of latent variable models with non-ignorable missing outcomes from exponential family,"To provide a comprehensive framework for analysing complex non-normal medical and biological data, we propose a Bayesian approach for a non-linear latent variable model with covariates, and non-ignorable missing data, under the exponential family of distributions. The non-ignorable missing mechanism is defined via a logistic regression model. Based on conjugate prior distributions, full conditional distributions for the implementation of Markov chain Monte Carlo methods in simulating observations from the joint posterior distribution are derived. These observations are used in computing the Bayesian estimates, as well as in implementing a path sampling procedure to evaluate the Bayes factor for model comparison. The proposed methods are illustrated using real data from a study on the non-adherence of hypertension patients.",0 +https://doi.org/10.1111/j.1540-5907.2006.00187.x,"The Institutional Context of Tolerance for Ethnic Minorities: A Comparative, Multilevel Analysis of Western Europe","Drawing on recent insights in the nationalism and citizenship regime literatures, this article develops a macrotheoretical framework for understanding cross-national variations in tolerance of ethnic minorities. Specifically, it tests the hypothesis that the degree to which the dominant ethnic tradition or culture is institutionalized in the laws and policies of a nation-state affects citizen tolerance of ethnic minorities. Employing a multilevel regression model, it systematically tests the framework, as well as competing individual and country-level explanations, for all member states of the European Union in 1997. Results confirm a strong relationship between the laws governing the acquisition and expression of citizenship, that is, citizenship regime type, and individual tolerance judgments. Moreover, citizenship regime type has a strong mediating effect on three individual-level variables previously shown to predict tolerance: ingroup national identity, political ideology, and satisfaction with democracy.",0 +https://doi.org/10.1177/0013164410366693,Improving Cognitive Diagnostic Computerized Adaptive Testing by Balancing Attribute Coverage: The Modified Maximum Global Discrimination Index Method,"This article proposes a new item selection method, namely, the modified maximum global discrimination index (MMGDI) method, for cognitive diagnostic computerized adaptive testing (CD-CAT). The new method captures two aspects of the appeal of an item: (a) the amount of contribution it can make toward adequate coverage of every attribute and (b) the amount of contribution it can make toward recovering the latent cognitive profile. A simulation study shows that the new method ensures adequate coverage of every attribute, which improves the validity of the test scores, and defensibility of the proposed uses of the test. Furthermore, compared with the original global discrimination index method, the MMGDI method improves the recovery rate of each attribute and of the entire cognitive profile, especially the latter. Therefore, the new method improves both the validity and reliability of the test scores from a CD-CAT program.",0 +https://doi.org/10.1016/j.ecresq.2014.05.010,A typical morning in preschool: Observations of teacher–child interactions in German preschools,"Abstract The study examined the applicability and generalizability of the Classroom Assessment Scoring System Pre-K (CLASS Pre-K; Pianta, La Paro, & Hamre, 2008) and the associated conceptual Teaching through Interaction framework to understand classroom processes in the German early education system. Three broad domains describe effective teacher–child interactions: Emotional Support, Classroom Organization, and Instructional Support. In the present study, we observed teacher–child interactions in 63 classrooms drawn from 26 different preschools using the CLASS Pre-K. Consistent with research from the United States, CLASS Pre-K scores demonstrated that the quality of teacher–child interactions varied widely. Data indicated that the levels of Emotional Support and Classroom Organization were moderate. In contrast, the level of Instructional Support was rather low and even decreased over the course of the morning. Furthermore, Emotional Support was found to decrease over the day in classrooms with a higher child–teacher ratio. Results have important implications for policy and practice with regard to the quality of care and education in German preschools.",0 +https://doi.org/10.1016/j.compedu.2015.05.005,Becoming more specific: Measuring and modeling teachers' perceived usefulness of ICT in the context of teaching and learning,"Studies on teachers' acceptance and use of information and communication technology (ICT) have revealed perceived usefulness to be a crucial determinant for integrating ICT in classrooms. In consequence, the present study focuses on teachers' perceived usefulness of ICT for teaching and learning and is aimed at describing its structure and relations to self-efficacy, ICT use, and teachers' age. By means of Bayesian analysis, we specified confirmatory factor-analytic and structural equation models to a large-scale data set of N?=?1190 Norwegian teachers. Our results supported the hypothesized four-factor structure of teachers' perceived usefulness of ICT, signifying different facets of ICT-related teaching goals in classrooms. Moreover, it was possible to disentangle general and specific components of the construct in nested factor models. In support of existing research, we found positive relations to self-efficacy and ICT use, but a negative relation to teachers' age. Our study provides evidence on a multidimensional conceptualization of teachers' perceived usefulness of ICT for teaching and learning, and verifies the relations to teacher-related characteristics. Implications for the measurement and modeling of the construct, and future research directions are discussed. Teachers' perceived usefulness of ICT for teaching and learning is multifaceted.A general factor and specific factors can be distinguished.Bayesian models with cross-loadings represent the structure of the construct.Perceived usefulness is positively related to self-efficacy and ICT use.Perceived usefulness is negatively related to teachers' age.",0 +https://doi.org/10.1080/00220973.2015.1027805,The Impact of Sample Size and Other Factors When Estimating Multilevel Logistic Models,"The design of research studies utilizing binary multilevel models must necessarily incorporate knowledge of multiple factors, including estimation method, variance component size, or number of predictors, in addition to sample sizes. This Monte Carlo study examined the performance of random effect binary outcome multilevel models under varying methods of estimation, level-1 and level-2 sample size, outcome prevalence, variance component sizes, and number of predictors using SAS software. Mean estimates of statistical power were influenced primarily by sample sizes at both levels. In addition, confidence interval coverage and width and the likelihood of nonpositive definite random effect covariance matrices were impacted by variance component size and estimation method. The interactions of these and other factors with various model performance outcomes are explored.",0 +https://doi.org/10.1007/bf00162520,Accelerating Monte Carlo Markov chain convergence for cumulative-link generalized linear models,"The ordinal probit, univariate or multivariate, is a generalized linear model (GLM) structure that arises frequently in such disparate areas of statistical applications as medicine and econometrics. Despite the straightforwardness of its implementation using the Gibbs sampler, the ordinal probit may present challenges in obtaining satisfactory convergence. We present a multivariate Hastings-within-Gibbs update step for generating latent data and bin boundary parameters jointly, instead of individually from their respective full conditionals. When the latent data are parameters of interest, this algorithm substantially improves Gibbs sampler convergence for large datasets. We also discuss Monte Carlo Markov chain (MCMC) implementation of cumulative logit (proportional odds) and cumulative complementary log-log (proportional hazards) models with latent data. © 1996 Chapman & Hall.",0 +https://doi.org/10.2307/2983178,Bayesian Analysis of Realistically Complex Models,SUMMARY Models with complex structure arise in many social science applications and appear natural candidates for the use of Markov chain Monte Carlo methods for inference. Conditional independence assumptions simplify the model specification and make estimation using Gibbs sampling particularly appropriate. Two examples are discussed: random effects models for repeated ordered categorical data and sensitivity analysis to assumptions concerning the mechanism underlying informative drop-out in a longitudinal study. The use of a program BUGS is demonstrated.,0 +https://doi.org/10.1002/jsid.233,Measurement of minimum angle of resolution (MAR) in the stereoscopic display using the optotype of stereoscopic stimuli,"In stereoscopic images, the crossing point of the viewing directions of the two eyes determines the perceived depth. Assuming that accommodation is affected by the positions of the crossing point, the effect of crossing point on minimum angle of resolution (MAR) was investigated. For 40 participants, MAR was measured by two-alternative forced choice where Snellen optotype E of up and down directions were used as two kinds of stimuli. As the crossing point of the viewing direction of the left and right eyes moves farther from the sample display, the ability to identify the direction of letter E decreases at the optotype of the same line thickness. The change of MAR shows linear trends with respect to the optical power change that are the reciprocal of the distance from the participant to the crossing points located out of screen and on screen.",0 +https://doi.org/10.1016/j.neuroimage.2017.01.052,Bayesian longitudinal low-rank regression models for imaging genetic data from longitudinal studies,"To perform a joint analysis of multivariate neuroimaging phenotypes and candidate genetic markers obtained from longitudinal studies, we develop a Bayesian longitudinal low-rank regression (L2R2) model. The L2R2 model integrates three key methodologies: a low-rank matrix for approximating the high-dimensional regression coefficient matrices corresponding to the genetic main effects and their interactions with time, penalized splines for characterizing the overall time effect, and a sparse factor analysis model coupled with random effects for capturing within-subject spatio-temporal correlations of longitudinal phenotypes. Posterior computation proceeds via an efficient Markov chain Monte Carlo algorithm. Simulations show that the L2R2 model outperforms several other competing methods. We apply the L2R2 model to investigate the effect of single nucleotide polymorphisms (SNPs) on the top 10 and top 40 previously reported Alzheimer disease-associated genes. We also identify associations between the interactions of these SNPs with patient age and the tissue volumes of 93 regions of interest from patients' brain images obtained from the Alzheimer's Disease Neuroimaging Initiative.",0 +https://doi.org/10.1016/j.ijresmar.2003.04.001,Retention of latent segments in regression-based marketing models,"Abstract Product design and marketing mix decisions for segmented markets depend crucially on the correct specification of marketing models used as input to these decisions. With real-world data, the true number of segments in a market is unknown. Current evidence from simulation studies suggests that the accuracy of commonly used criteria for determining the number of segments in a market depends on the usage context, including the type of distribution being used to describe the data, the model specification, and the characteristics of the market. This study investigates via simulation the performance of seven segment retention criteria used with finite mixture regression models for normal data. This is one of the most important analysis contexts in marketing research since regression models are used, for example, in conjoint analysis and market response analysis, yet no previous study in either the marketing or statistics literatures explores the segment retention problem for mixture regression models. The study shows that one criterion, Akaike's Information Criterion (AIC) with a per-parameter penalty factor of 3 (AIC3), is clearly the best criterion to use across a wide variety of model specifications and data configurations, having the highest success rate and producing very low parameter bias. Currently, this criterion is rarely, if ever, used in the marketing literature.",0 +https://doi.org/10.1002/(sici)1097-0258(19990715)18:13<1587::aid-sim141>3.0.co;2-z,Analysing repeated measurements data: a practical comparison of methods,"A variety of methods are available for analysing repeated measurements data where the outcome is continuous. However, there is little information on how established methods, such as summary statistics and repeated measures analysis of variance (RMAOV), compare in practice with methods that have become available to applied statisticians more recently, such as marginal models (based on generalized estimating equation methodology) and multilevel models (that is, hierarchical random effects models). The aim of this paper is to exemplify the use of these methods, and directly compare their results by application to a clinical trial data set. The focus is on practical aspects rather than technical issues. The data considered were taken from a clinical trial of treatments for asthma in 240 children, in which a baseline and four post-randomization measurements of outcomes were taken. The simplicity of the method of summary statistics using the post-randomization mean of observations provided a useful initial analysis. However, fixed time effects or treatment-time interactions cannot be included in such an analysis, and choice of appropriate weighting when there is substantial missing data is problematic. RMAOV, marginal models and multilevel models generally provided similar estimates and standard errors for the treatment effects, although in one example with a relatively complex variance structure the marginal model produced less efficient estimates. Two advantages of multilevel models are that they provide direct estimates of variance components which are often of interest in their own right, and that they can be naturally extended to handle multivariate outcomes.",0 +https://doi.org/10.1016/j.jpain.2006.11.006,Walker 256 Tumor-Bearing Rats as a Model to Study Cancer Pain,"An animal model of cancer pain induced by injection of Walker 256 carcinoma cells into the plantar surface of rat hind paw is described. Tumor growth and the occurrence of metastasis were investigated by histopathological analysis. Tumor cell growth was also analyzed plethysmographically by the increase in paw volume. For characterization of pain symptoms, hyperalgesia, allodynia, and spontaneous pain were evaluated 5 to 8 days after cell injection. The volume of the inoculated paw started to increase on day 2 after inoculation, being 40% higher on day 5 after injection. At this time, there was a marked proliferation of tumor cells, with the presence of anaplastic and pleomorphic cells, nucleoli, and atypical mitotic features. On days 7 and 8 after injection, histopathological analysis of popliteal lymph nodes showed the presence of tumor cells. The intraplantar injection of Walker 256 cells caused hyperalgesia at day 5 after cell inoculation. Low-threshold mechanical allodynia was significant 2 days after cell injection, being increased on day 5. In addition, inoculation of tumor cells induced gross behavior, characterized by a significant increase in licking and lifting of the injected paw 5 days after injection. The pain-enhancing effect caused by cell inoculation was partially inhibited by indomethacin on day 2 after cell injection, whereas morphine blocked allodynia on days 2 and 5. These results indicate that intraplantar injection of Walker 256 cells cause pain symptoms characteristic of cancer pain. This experimental model can then be used to investigate new analgesic or anti-tumor drugs.This article presents a new animal model for studying cancer pain and metastasis. This model could help in understanding the mechanisms involved in cancer pain symptoms and may be used for the investigation of new analgesic or anti-tumor drugs.",0 +https://doi.org/10.1037/met0000145,A comparison of Bayesian and frequentist model selection methods for factor analysis models.,"We compare the performances of well-known frequentist model fit indices (MFIs) and several Bayesian model selection criteria (MCC) as tools for cross-loading selection in factor analysis under low to moderate sample sizes, cross-loading sizes, and possible violations of distributional assumptions. The Bayesian criteria considered include the Bayes factor (BF), Bayesian Information Criterion (BIC), Deviance Information Criterion (DIC), a Bayesian leave-one-out with Pareto smoothed importance sampling (LOO-PSIS), and a Bayesian variable selection method using the spike-and-slab prior (SSP; Lu, Chow, & Loken, 2016). Simulation results indicate that of the Bayesian measures considered, the BF and the BIC showed the best balance between true positive rates and false positive rates, followed closely by the SSP. The LOO-PSIS and the DIC showed the highest true positive rates among all the measures considered, but with elevated false positive rates. In comparison, likelihood ratio tests (LRTs) are still the preferred frequentist model comparison tool, except for their higher false positive detection rates compared to the BF, BIC and SSP under violations of distributional assumptions. The root mean squared error of approximation (RMSEA) and the Tucker-Lewis index (TLI) at the conventional cut-off of approximate fit impose much more stringent ""penalties"" on model complexity under conditions with low cross-loading size, low sample size, and high model complexity compared with the LRTs and all other Bayesian MCC. Nevertheless, they provided a reasonable alternative to the LRTs in cases where the models cannot be readily constructed as nested within each other. (PsycINFO Database Record",0 +https://doi.org/10.1016/j.envsoft.2013.10.006,"Exploring the application of participatory modeling approaches in the Sonora River Basin, Mexico","This study presents the results from evaluation of a hydrologic modeling workshop for 46 water resource decision makers in Hermosillo, Mexico. This region has serious, ongoing water quantity and quality problems. Our goals were to assess participants' perceptions of our workshop and associated hydrologic and water quality models and to learn whether it changed their perceptions of local water resource-related problems, causes, and solutions. We administered on-site pre-and post-workshop surveys to assess any changes and to collect evaluations of the workshop and models. A few about water quality problems changed significantly over the course of the workshop, but most measured perceptions did not. On average, participants rated the workshop highly and believed that the presented models could assist their future decision-making. These results could contribute to future watershed modeling workshop efforts. A participatory watershed modeling workshop in Hermosillo, Mexico was evaluated.Pre and post workshop surveys assessed changes in participants' perceptions.A few perceptions regarding water quality problems changed significantly.Participants believed that the models presented could assist future decision making.",0 +https://doi.org/10.1207/s15324818ame1804_2,Bayesian or Non-Bayesian: A Comparison Study of Item Parameter Estimation in the Three-Parameter Logistic Model,"Through a large-scale simulation study, this article compares item parameter estimates obtained by the marginal maximum likelihood estimation (MMLE) and marginal Bayes modal estimation (MBME) procedures in the 3-parameter logistic model. The impact of different prior specifications on the MBME estimates is also investigated using carefully selected prior distributions. The results indicate that, in general, the MBME provides more accurate item parameter estimates than the MMLE procedure. The impact of different priors on the Bayesian estimates is modest when the examinee sample size is not extremely small.",0 +https://doi.org/10.1176/appi.ajp.2007.07040704,Prevalence of Mental Illness in Immigrant and Non-Immigrant U.S. Latino Groups,"Although widely reported among Latino populations, contradictory evidence exists regarding the generalizability of the immigrant paradox, i.e., that foreign nativity protects against psychiatric disorders. The authors examined whether this paradox applies to all Latino groups by comparing estimates of lifetime psychiatric disorders among immigrant Latino subjects, U.S-born Latino subjects, and non-Latino white subjects.The authors combined and examined data from the National Latino and Asian American Study and the National Comorbidity Survey Replication, two of the largest nationally representative samples of psychiatric information.In the aggregate, risk of most psychiatric disorders was lower for Latino subjects than for non-Latino white subjects. Consistent with the immigrant paradox, U.S.-born Latino subjects reported higher rates for most psychiatric disorders than Latino immigrants. However, rates varied when data were stratified by nativity and disorder and adjusted for demographic and socioeconomic differences across groups. The immigrant paradox consistently held for Mexican subjects across mood, anxiety, and substance disorders, while it was only evident among Cuban and other Latino subjects for substance disorders. No differences were found in lifetime prevalence rates between migrant and U.S.-born Puerto Rican subjects.Caution should be exercised in generalizing the immigrant paradox to all Latino groups and for all psychiatric disorders. Aggregating Latino subjects into a single group masks significant variability in lifetime risk of psychiatric disorders, with some subgroups, such as Puerto Rican subjects, suffering from psychiatric disorders at rates comparable to non-Latino white subjects. Our findings thus suggest that immigrants benefit from a protective context in their country of origin, possibly inoculating them against risk for substance disorders, particularly if they emigrated to the United States as adults.",0 +https://doi.org/10.1080/10705511.2014.937322,Evaluation of a Bayesian Approach to Estimating Nonlinear Mixed-Effects Mixture Models,"The growth mixture model has become increasingly popular, given the willingness to acknowledge developmental heterogeneity in populations. Typically, linear growth mixture models, based on polynomials or piecewise functions, are used in substantive applications and evaluated quantitatively through simulation. Growth mixture models that follow inherently nonlinear trajectories, referred to as nonlinear mixed-effects mixture models, have received comparatively little attention—likely due to estimation complexity. Previous work on the estimation of these models has involved multistep routines (Kelley, 2008), maximum likelihood estimation (MLE) via the E-M algorithm (Harring, 2005, 2012), Taylor series expansion and MLE within the structural equation modeling framework (Grimm, Ram, & Estabrook, 2010), and MLE by adaptive Gauss–Hermite quadrature (Codd & Cudeck, 2014). This article proposes and evaluates the use of Bayesian estimation with OpenBUGS (Lunn, Spiegelhalter, Thomas, & Best, 2009), a free program, a...",1 +https://doi.org/10.1111/j.1745-3984.1990.tb00746.x,The Construction of Customized Two-Stage Tests,"In this paper mixed integer linear programming models for customizing two-stage tests are given. Model constraints are imposed with respect to test composition, administration time, inter-item dependencies, and other practical considerations. It is not difficult to modify the models to make them useful in constructing multistage tests.",0 +https://doi.org/10.1109/tpami.1984.4767596,"Stochastic Relaxation, Gibbs Distributions, and the Bayesian Restoration of Images","We make an analogy between images and statistical mechanics systems. Pixel gray levels and the presence and orientation of edges are viewed as states of atoms or molecules in a lattice-like physical system. The assignment of an energy function in the physical system determines its Gibbs distribution. Because of the Gibbs distribution, Markov random field (MRF) equivalence, this assignment also determines an MRF image model. The energy function is a more convenient and natural mechanism for embodying picture attributes than are the local characteristics of the MRF. For a range of degradation mechanisms, including blurring, nonlinear deformations, and multiplicative or additive noise, the posterior distribution is an MRF with a structure akin to the image model. By the analogy, the posterior distribution defines another (imaginary) physical system. Gradual temperature reduction in the physical system isolates low energy states (``annealing''), or what is the same thing, the most probable states under the Gibbs distribution. The analogous operation under the posterior distribution yields the maximum a posteriori (MAP) estimate of the image given the degraded observations. The result is a highly parallel ``relaxation'' algorithm for MAP estimation. We establish convergence properties of the algorithm and we experiment with some simple pictures, for which good restorations are obtained at low signal-to-noise ratios.",0 +https://doi.org/10.1016/j.jmva.2009.04.015,Modeling covariance matrices via partial autocorrelations,"We study the role of partial autocorrelations in the reparameterization and parsimonious modeling of a covariance matrix. The work is motivated by and tries to mimic the phenomenal success of the partial autocorrelations function (PACF) in model formulation, removing the positive-definiteness constraint on the autocorrelation function of a stationary time series and in reparameterizing the stationarity-invertibility domain of ARMA models. It turns out that once an order is fixed among the variables of a general random vector, then the above properties continue to hold and follows from establishing a one-to-one correspondence between a correlation matrix and its associated matrix of partial autocorrelations. Connections between the latter and the parameters of the modified Cholesky decomposition of a covariance matrix are discussed. Graphical tools similar to partial correlograms for model formulation and various priors based on the partial autocorrelations are proposed. We develop frequentist/Bayesian procedures for modelling correlation matrices, illustrate them using a real dataset, and explore their properties via simulations.",0 +https://doi.org/10.1037/a0030543,Bayesian parametric estimation of stop-signal reaction time distributions.,"The cognitive concept of response inhibition can be measured with the stop-signal paradigm. In this paradigm, participants perform a 2-choice response time (RT) task where, on some of the trials, the primary task is interrupted by a stop signal that prompts participants to withhold their response. The dependent variable of interest is the latency of the unobservable stop response (stop-signal reaction time, or SSRT). Based on the horse race model (Logan & Cowan, 1984), several methods have been developed to estimate SSRTs. None of these approaches allow for the accurate estimation of the entire distribution of SSRTs. Here we introduce a Bayesian parametric approach that addresses this limitation. Our method is based on the assumptions of the horse race model and rests on the concept of censored distributions. We treat response inhibition as a censoring mechanism, where the distribution of RTs on the primary task (go RTs) is censored by the distribution of SSRTs. The method assumes that go RTs and SSRTs are ex-Gaussian distributed and uses Markov chain Monte Carlo sampling to obtain posterior distributions for the model parameters. The method can be applied to individual as well as hierarchical data structures. We present the results of a number of parameter recovery and robustness studies and apply our approach to published data from a stop-signal experiment.",0 +https://doi.org/10.3758/pbr.16.1.80,Integrating episodic memories and prior knowledge at multiple levels of abstraction,"Prior knowledge can have a large influence on recall when the memory for the original event is error prone or incomplete. We investigated the interaction between memory and prior knowledge in a recall task involving natural objects such as fruits and vegetables. We first quantified prior knowledge for the sizes of objects in a norming experiment. We then assessed the influence of prior knowledge in a memory experiment in which we compared the actual size of objects shown during a study phase with the reconstructed size of an object during the test phase. Recall was biased both by the mean size of the specific object studied and by the mean size of all objects in the category. This result suggests that the influence of prior knowledge can come from multiple, hierarchically related levels of representation, such as the object-category and superordinate-category levels.",0 +https://doi.org/10.1007/s10182-011-0168-z,Longitudinal dynamic analyses of cognition in the health and retirement study panel,"The purpose of this paper is to highlight some classic issues in the measurement of change and to show how contemporary solutions can be used to deal with some of these issues. Five classic issues will be raised here: (1) Separating individual changes from group differences; (2) options for incomplete longitudinal data over time, (3) options for nonlinear changes over time; (4) measurement invariance in studies of changes over time; and (5) new opportunities for modeling dynamic changes. For each issue we will describe the problem, and then review some contemporary solutions to these problems base on Structural Equation Models (SEM). We will fit these SEM to using existing panel data from the Health & Retirement Study (HRS) cognitive variables. This is not intended as an overly technical treatment, so only a few basic equations are presented, examples will be displayed graphically, and more complete references to the contemporary solutions will be given throughout.",0 +https://doi.org/10.1586/14737167.5.5.531,Self-perceived health status of schizophrenic patients in Spain: analysis of geographic differences,"This report explores the use of regression models for estimating health status of schizophrenic patients from a Bayesian perspective. The aims are: to obtain a set of values of health states of the EQ-5D based on self-assessed health from a sample of schizophrenic patients; and to analyze the differences in the health status and in patients' perceptions of their health status between four mental health districts in Spain. The authors develop two linear models with dummy variables. The first model seeks to obtain an index of the health status of the patients using a visual analog scale as a dependent variable and the different dimensions of EQ-5D as regressors. The second model enables analysis of the differences between the self-assessed health status in the different geographic areas and also the differences between the patients' self-assessed health states, irrespective of their actual health state, in the different geographic areas. The analysis is done using a Bayesian approach with Gibbs sampling (computer program WinBUGS 1.4). Data concerning self-assessed EQ-5D with visual analog scale from four geographic areas of schizophrenic patients were obtained for the purposes of this analysis. The health status index for this sample was obtained and the differences for this index between the four geographic areas were analyzed. The study reveals variables that explain the differences in patients' health status and health state assessment. Four possible scenarios are considered.",0 +https://doi.org/10.1348/000711003321645403,Bayesian model selection for mixtures of structural equation models with an unknown number of components,"This paper considers mixtures of structural equation models with an unknown number of components. A Bayesian model selection approach is developed based on the Bayes factor. A procedure for computing the Bayes factor is developed via path sampling, which has a number of nice features. The key idea is to construct a continuous path linking the competing models; then the Bayes factor can be estimated efficiently via grids in [0, 1] and simulated observations that are generated by the Gibbs sampler from the posterior distribution. Bayesian estimates of the structural parameters, latent variables, as well as other statistics can be produced as by-products. The properties and merits of the proposed procedure are discussed and illustrated by means of a simulation study and a real example.",0 +https://doi.org/10.1177/01466216980222005,An Investigation of the Item Parameter Recovery Characteristics of a Gibbs Sampling Procedure,"The item parameter recovery characteristics of a Gibb's sampling method (Albert, 1992) for IRT item parameter estimation were investigated using a simulation study. The item parameters were estimated, under a normal ogive item response function model, using Gibbs sampling and BILOG (Mislevy & Bock, 1989). The item parameter estimates were then equated to the metric of the underlying item parameters for tests with 10, 20, 30, and 50 items, and samples of 30, 60, 120, and 500 examinees. Summary statistics of the equating coefficients showed that Gibbs sampling and BILOG both produced trait scale metrics with units of measurement that were too small, but yielding a proper midpoint of the metric. When expressed in a common metric, the biases of the BILOG estimates of the item discriminations were uniformly smaller and less variable than those from Gibbs sampling. The biases of the item difficulty estimates yielded by the two estimation procedures were small and similar to each other. In addition, the item parameter recovery characteristics were comparable for the largest dataset of 50 items and 500 examinees. However, for short tests and sample sizes the item parameter recovery characteristics of BILOG were superior to those of the Gibbs sampling approach.",0 +https://doi.org/10.1007/978-1-4757-3692-2,Observational Studies,,0 +https://doi.org/10.1016/0167-9473(96)82296-1,"A review of two different approaches for the analysis of growth data using longitudinal mixed linear models: Comparing hierarchical linear regression (ML3, HLM) and repeated measures designs with structured covariance matrices (BMDP5V)","Abstract In this paper we review two approaches for the analysis of growth data by means of longitudinal mixed linear models. In these models the individual growth parameters, (most often) specifying polynomial growth curves, may vary randomly across individuals. This variation may in turn be accounted for by explaining variables. The first approach we discuss, is a type of multilevel model in which growth data are treated as having a hierarchical structure: measurements are ‘nested’ within individuals. The second is a version of a MANOVA repeated measures model employing a structured (error)covariance matrix. Of both approaches we examine the underlying statistical models and their interrelations. Apart from this theoretical comparison we review software by which they can be applied for real data analysis: two multilevel programs, ML3 and HLM, and one repeated measures program, BMDP5V. The programs are described and discussed with respect to several more general criteria, such as data setup and handling, implemented numerical routines and user friendliness, and, in particular, with respect to their application in longitudinal situations, i.e. their capabilities for the analysis of data on growth. Two data sets are used to compare the results of analyses performed by the three programs. Although both ways of specifying growth curve models show some shortcomings, each appears to be a fruitful method to handle growth data, theoretically, as well as in a practical sense. For the most part, shortcomings are induced by the accompanying software, developed within different scientific traditions. Applied to comparable problems, the three programs produce equivalent results.",0 +https://doi.org/10.1016/j.jmp.2004.01.002,A note on the sampling properties of the Vincentizing (quantile averaging) procedure,"Abstract To assess the effect of a manipulation on a response time distribution, psychologists often use Vincentizing or quantile averaging to construct group or “average” distributions. We provide a theorem characterizing the large sample properties of the averaged quantiles when the individual RT distributions all belong to the same location-scale family. We then apply the theorem to estimating parameters for the quantile-averaged distributions. From the theorem, it is shown that parameters of the group distribution can be estimated by generalized least squares. This method provides accurate estimates of standard errors of parameters and can therefore be used in formal inference. The method is benchmarked in a small simulation study against both a maximum likelihood method and an ordinary least-squares method. Generalized least squares essentially is the only method based on the averaged quantiles that is both unbiased and provides accurate estimates of parameter standard errors. It is also proved that for location-scale families, performing generalized least squares on quantile averages is formally equivalent to averaging parameter estimates from generalized least squares performed on individuals. A limitation on the method is that individual RT distributions must be members of the same location-scale family.",0 +https://doi.org/10.1177/0146621606291571,Test Design Optimization in CAT Early Stage with the Nominal Response Model,"The early stage of computerized adaptive testing (CAT) refers to the phase of the trait estimation during the administration of only a few items. This phase can be characterized by bias and instability of estimation. In this study, an item selection criterion is introduced in an attempt to lessen this instability: the D-optimality criterion. A polytomous unconstrained CAT simulation is carried out to evaluate this criterion's performance under different test premises. The simulation shows that the extent of early stage instability depends primarily on the quality of the item pool information and its size and secondarily on the item selection criteria. The efficiency of the D-optimality criterion is similar to the efficiency of other known item selection criteria. Yet, it often yields estimates that, at the beginning of CAT, display a more robust performance against instability.",0 +https://doi.org/10.1016/j.jclinepi.2014.08.012,Predictive distributions were developed for the extent of heterogeneity in meta-analyses of continuous outcome data,"Estimation of between-study heterogeneity is problematic in small meta-analyses. Bayesian meta-analysis is beneficial because it allows incorporation of external evidence on heterogeneity. To facilitate this, we provide empirical evidence on the likely heterogeneity between studies in meta-analyses relating to specific research settings.Our analyses included 6,492 continuous-outcome meta-analyses within the Cochrane Database of Systematic Reviews. We investigated the influence of meta-analysis settings on heterogeneity by modeling study data from all meta-analyses on the standardized mean difference scale. Meta-analysis setting was described according to outcome type, intervention comparison type, and medical area. Predictive distributions for between-study variance expected in future meta-analyses were obtained, which can be used directly as informative priors.Among outcome types, heterogeneity was found to be lowest in meta-analyses of obstetric outcomes. Among intervention comparison types, heterogeneity was lowest in meta-analyses comparing two pharmacologic interventions. Predictive distributions are reported for different settings. In two example meta-analyses, incorporating external evidence led to a more precise heterogeneity estimate.Heterogeneity was influenced by meta-analysis characteristics. Informative priors for between-study variance were derived for each specific setting. Our analyses thus assist the incorporation of realistic prior information into meta-analyses including few studies.",0 +https://doi.org/10.1002/sim.6737,Variational methods for fitting complex Bayesian mixed effects models to health data,"We consider approximate inference methods for Bayesian inference to longitudinal and multilevel data within the context of health science studies. The complexity of these grouped data often necessitates the use of sophisticated statistical models. However, the large size of these data can pose significant challenges for model fitting in terms of computational speed and memory storage. Our methodology is motivated by a study that examines trends in cesarean section rates in the largest state of Australia, New South Wales, between 1994 and 2010. We propose a group-specific curve model that encapsulates the complex nonlinear features of the overall and hospital-specific trends in cesarean section rates while taking into account hospital variability over time. We use penalized spline-based smooth functions that represent trends and implement a fully mean field variational Bayes approach to model fitting. Our mean field variational Bayes algorithms allow a fast (up to the order of thousands) and streamlined analytical approximate inference for complex mixed effects models, with minor degradation in accuracy compared with the standard Markov chain Monte Carlo methods.",0 +https://doi.org/10.1080/00273170802034810,Evaluating Group-Based Interventions When Control Participants Are Ungrouped,"Individually randomized treatments are often administered within a group setting. As a consequence, outcomes for treated individuals may be correlated due to provider effects, common experiences within the group, and/or informal processes of socialization. In contrast, it is often reasonable to regard outcomes for control participants as independent, given that these individuals are not placed into groups. Although this kind of design is common in intervention research, the statistical models applied to evaluate the treatment effects are usually inconsistent with the resulting data structure, potentially leading to biased inferences. This article presents an alternative model that explicitly accounts for the fact that only treated participants are grouped. In addition to providing a useful test of the overall treatment effect, this approach also permits one to formally determine the extent to which treatment effects vary over treatment groups and whether there is evidence that individuals within treatment groups become similar to one another. This strategy is demonstrated with data from the Reconnecting Youth program for high school students at risk of school failure and behavioral disorders.",0 +https://doi.org/10.3402/ejpt.v6.27503,Latent Growth Mixture Models to estimate PTSD trajectories,"No abstract available. (Published: 2 March 2015) Citation: European Journal of Psychotraumatology 2015, 6 : 27503 - http://dx.doi.org/10.3402/ejpt.v6.27503 This paper is part of the Special Issue: Estimating PTSD trajectories . More papers from this issue can be found at http://www.ejpt.net",0 +https://doi.org/10.1093/ije/dyq248,A proposed method of bias adjustment for meta-analyses of published observational studies,"Interpretation of meta-analyses of published observational studies is problematic because of numerous sources of bias. We develop bias assessment, elicitation and adjustment methods, and apply them to a systematic review of longitudinal observational studies of the relationship between objectively measured physical activity and subsequent change in adiposity in children.We separated internal biases that reflect study quality from external biases that reflect generalizability to a target setting. Since published results were presented in different formats, these were all converted to correlation coefficients. Biases were considered as additive or proportional on the correlation scale. Opinions about the extent of each bias in each study, together with its uncertainty, were elicited in a formal process from quantitatively trained assessors for the internal biases and subject-matter specialists for the external biases. Bias-adjusted results for each study were combined across assessors using median pooling, and results combined across studies by random-effects meta-analysis.Before adjusting for bias, the pooled correlation is difficult to interpret because the studies varied substantially in quality and design, and there was considerable heterogeneity. After adjusting for both the internal and external biases, the pooled correlation provides a meaningful quantitative summary of all available evidence, and the confidence interval incorporates the elicited uncertainties about the extent of the biases. In the adjusted meta-analysis, there was no apparent heterogeneity.This approach provides a viable method of bias adjustment for meta-analyses of observational studies, allowing the quantitative synthesis of evidence from otherwise incompatible studies. From the meta-analysis of longitudinal observational studies, we conclude that there is no evidence that physical activity is associated with gain in body fat.",0 +https://doi.org/10.3758/bf03211350,Statistical properties of forced-choice psychometric functions: Implications of probit analysis,"Probit analysis was applied to the problem of threshold estimation from psychometric functions derived from the two-alternative forced-choice (2AFC) method of constant stimuli. Threshold estimates from 2AFC experiments are surprisingly poor: They are about twice as variable as corresponding estimates based on the traditional yes-no method of constant stimuli, and their asymmetrical confidence limits are not readily predicted from conventional standard error formulas. All of these faults are exacerbated in small samples. Computer simulations demonstrated that, for small samples, the probit analysis equations do not give a valid estimate of threshold variability. The variability of staircase estimates of threshold cannot be less than the variability of threshold estimates derived from the method of constant stimuli given an optimum placement of trials. Hence our findings also define the minimum variability of all staircase estimators under the assumptions of probit analysis.",0 +https://doi.org/10.1007/s11336-011-9215-7,Item Selection in Multidimensional Computerized Adaptive Testing—Gaining Information from Different Angles,"Over the past thirty years, obtaining diagnostic information from examinees' item responses has become an increasingly important feature of educational and psychological testing. The objective can be achieved by sequentially selecting multidimensional items to fit the class of latent traits being assessed, and therefore Multidimensional Computerized Adaptive Testing (MCAT) is one reasonable approach to such task. This study conducts a rigorous investigation on the relationships among four promising item selection methods: D-optimality, KL information index, continuous entropy, and mutual information. Some theoretical connections among the methods are demonstrated to show how information about the unknown vector θ can be gained from different perspectives. Two simulation studies were carried out to compare the performance of the four methods. The simulation results showed that mutual information not only improved the overall estimation accuracy but also yielded the smallest conditional mean squared error in most region of θ. In the end, the overlap rates were calculated to empirically show the similarity and difference among the four methods. © 2011 The Psychometric Society.",0 +https://doi.org/10.1080/08957340701796464,Investigation of a Nonparametric Procedure for Assessing Goodness-of-Fit in Item Response Theory,"Tests of model misfit are often performed to validate the use of a particular model in item response theory. Douglas and Cohen (2001) introduced a general nonparametric approach for detecting misfit under the two-parameter logistic model. However, the statistical properties of their approach, and empirical comparisons to other methods, have not been examined. In the present study, a Monte Carlo simulation study was used to examine the empirical Type I error rates and power of two nonparametric statistics based on the Douglas and Cohen (2001) approach. The procedures are compared to two commonly used goodness-of-fit statistics, S-X 2 (Orlando & Thissen, 2000) and BILOG's G 2 (Mislevy & Bock, 1990), across conditions varied by test length, sample size, and the percentage of misfitting items. Overall, the nonparametrically based statistics controlled the Type I error rate and exhibited the most power across all conditions. Due to its close association with a graphical representation of the item response func...",0 +https://doi.org/10.1080/15332861.2015.1080056,A Conceptual Framework for Measuring E-fulfillment Dimensions: A Consumer Perspective,"The purpose of this study is to propose a conceptual framework for measuring the key dimensions of the e-fulfillment process and its relationship with online shopping satisfaction in pure e-tailing. The key dimensions relevant to the e-fulfillment process are explored in the literature during the first part of the study. These dimensions are categorized into three distinct processes of e-fulfillment: order procurement, order fulfillment, and product returns. In the second part of the study, the authors propose a conceptual framework and develop hypotheses to understand the relationship between the key dimensions of the e-fulfillment process, including e-business quality, product quality, availability, timeliness, condition, billing accuracy, ease of return, and online shopping satisfaction. Furthermore, the constructs in the proposed framework were empirically tested. This study will help e-tailers, academicians, and practitioners understand the consumers’ expectations regarding the key dimensions of the ...",0 +https://doi.org/10.1287/mksc.1040.0070,Multicollinearity and Measurement Error in Structural Equation Models: Implications for Theory Testing,"The literature on structural equation models is unclear on whether and when multicollinearity may pose problems in theory testing (Type II errors). Two Monte Carlo simulation experiments show that multicollinearity can cause problems under certain conditions, specifically: (1) when multicollinearity is extreme, Type II error rates are generally unacceptably high (over 80%), (2) when multicollinearity is between 0.6 and 0.8, Type II error rates can be substantial (greater than 50% and frequently above 80%) if composite reliability is weak, explained variance (R 2 ) is low, and sample size is relatively small. However, as reliability improves (0.80 or higher), explained variance R 2 reaches 0.75, and sample becomes relatively large, Type II error rates become negligible. (3) When multicollinearity is between 0.4 and 0.5, Type II error rates tend to be quite small, except when reliability is weak, R 2 is low, and sample size is small, in which case error rates can still be high (greater than 50%). Methods for detecting and correcting multicollinearity are briefly discussed. However, since multicollinearity is difficult to manage after the fact, researchers should avoid problems by carefully managing the factors known to mitigate multicollinearity problems (particularly measurement error).",0 +https://doi.org/10.1210/jc.2013-3450,Efficacy of Vitamin D Supplementation in Depression in Adults: A Systematic Review,"Randomized controlled trials (RCTs) investigating the efficacy of vitamin D (Vit D) in depression provided inconsistent results.We aim to summarize the evidence of RCTs to assess the efficacy of oral Vit D supplementation in depression compared to placebo.We searched electronic databases, two conference proceedings, and gray literature by contacting authors of included studies.We selected parallel RCTs investigating the effect of oral Vit D supplementation compared with placebo on depression in adults at risk of depression, with depression symptoms or a primary diagnosis of depression.Two reviewers independently extracted data from relevant literature.Classical and Bayesian random-effects meta-analyses were used to pool relative risk, odds ratio, and standardized mean difference. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool.Six RCTs were identified with 1203 participants (72% females) including 71 depressed patients; five of the studies involved adults at risk of depression, and one trial used depressed patients. Results of the classical meta-analysis showed no significant effect of Vit D supplementation on postintervention depression scores (standardized mean difference = -0.14, 95% confidence interval = -0.41 to 0.13, P = .32; odds ratio = 0.93, 95% confidence interval = 0.54 to 1.59, P = .79). The quality of evidence was low. No significant differences were demonstrated in subgroup or sensitivity analyses. Similar results were found when Bayesian meta-analyses were applied.There is insufficient evidence to support the efficacy of Vit D supplementation in depression symptoms, and more RCTs using depressed patients are warranted.",0 +https://doi.org/10.1016/0167-7152(90)90100-l,Full maximum likelihood analysis of structural equation models with polytomous variables,Abstract This paper is concerned with the analysis of structural equation models with polytomous variables. Identification conditions for the basic model are discussed. Theory for the full simultaneous maximum likelihood estimation of the thresholds and the covariance structure parameters is developed. An example is presented to illustrate the method.,0 +https://doi.org/10.1027/1614-2241/a000083,A Hierarchical Bayesian Model With Correlated Residuals for Investigating Stability and Change in Intensive Longitudinal Data Settings,"The present paper’s focus is the modeling of interindividual and intraindividual variability in longitudinal data. We propose a hierarchical Bayesian model with correlated residuals, employing an autoregressive parameter AR(1) for focusing on intraindividual variability. The hierarchical model possesses four individual random effects: intercept, slope, variability, and autocorrelation. The performance of the proposed Bayesian estimation is investigated in simulated longitudinal data with three different sample sizes (N = 100, 200, 500) and three different numbers of measurement points (T = 10, 20, 40). The initial simulation values are selected according to the results of the first 20 measurement occasions from a longitudinal study on working memory capacity in 9th graders. Within this simulation study, we investigate the root mean square error (RMSE), bias, relative percentage bias, and the 90% coverage probability of parameter estimates. Results indicate that more accurate estimates are associated with a larger sample size. One exception to this tendency is the autocorrelation parameter, which shows more sensitivity to an increasing number of time points.",0 +https://doi.org/10.1002/9780470035948,Bayesian Statistical Modelling,"Bayesian methods combine the evidence from the data at hand with previous quantitative knowledge to analyse practical problems in a wide range of areas. The calculations were previously complex, but it is now possible to routinely apply Bayesian methods due to advances in computing technology and the use of new sampling methods for estimating parameters. Such developments together with the availability of freeware such as WINBUGS and R have facilitated a rapid growth in the use of Bayesian methods, allowing their application in many scientific disciplines, including applied statistics, public health research, medical science, the social sciences and economics. Following the success of the first edition, this reworked and updated book provides an accessible approach to Bayesian computing and analysis, with an emphasis on the principles of prior selection, identification and the interpretation of real data sets. The second edition: Provides an integrated presentation of theory, examples, applications and computer algorithms. Discusses the role of Markov Chain Monte Carlo methods in computing and estimation. Includes a wide range of interdisciplinary applications, and a large selection of worked examples from the health and social sciences. Features a comprehensive range of methodologies and modelling techniques, and examines model fitting in practice using Bayesian principles. Provides exercises designed to help reinforce the reader's knowledge and a supplementary website containing data sets and relevant programs. Bayesian Statistical Modelling is ideal for researchers in applied statistics, medical science, public health and the social sciences, who will benefit greatly from the examples and applications featured. The book will also appeal to graduate students of applied statistics, data analysis and Bayesian methods, and will provide a great source of reference for both researchers and students. Praise for the First Edition: ""It is a remarkable achievement to have carried out such a range of analysis on such a range of data sets. I found this book comprehensive and stimulating, and was thoroughly impressed with both the depth and the range of the discussions it contains."" - ISI - Short Book Reviews. ""This is an excellent introductory book on Bayesian modelling techniques and data analysis"" - Biometrics. ""The book fills an important niche in the statistical literature and should be a very valuable resource for students and professionals who are utilizing Bayesian methods."" - Journal of Mathematical Psychology. © 2006 John Wiley & Sons Ltd. All Rights Reserved.",0 +https://doi.org/10.1037/1040-3590.19.1.88,Constructing personality scales under the assumptions of an ideal point response process: Toward increasing the flexibility of personality measures.,"The main aim of this article is to explicate why a transition to ideal point methods of scale construction is needed to advance the field of personality assessment. The study empirically demonstrated the substantive benefits of ideal point methodology as compared with the dominance framework underlying traditional methods of scale construction. Specifically, using a large, heterogeneous pool of order items, the authors constructed scales using traditional classical test theory, dominance item response theory (IRT), and ideal point IRT methods. The merits of each method were examined in terms of item pool utilization, model-data fit, measurement precision, and construct and criterion-related validity. Results show that adoption of the ideal point approach provided a more flexible platform for creating future personality measures, and this transition did not adversely affect the validity of personality test scores.",0 +https://doi.org/10.1177/0022146514557332,"Education, Mental Health, and Education-Labor Market Misfit","Higher-educated people experience enhanced mental health. We ponder whether the mental health benefits of educational attainment are limitless. At the individual level, we look at the impact of job-education mismatch. At the societal level, we hypothesize that diminishing economic returns on education limit its mental health benefits. Using a subsample of individuals aged 20 to 65 years (N = 28,288) from 21 countries in the European Social Survey (ESS 2006), we estimate the impact on depressive symptoms of characteristics at both the employee level (years of education and job-education mismatch) and the labor market/country level (the gap between the nontertiary and tertiary educated in terms of unemployment risks and earnings). The results show that educational attainment produces mental health benefits in most European countries. However, in some of the countries, these benefits are limited or even completely eliminated by education-labor market misfit.",0 +https://doi.org/10.1080/01621459.1993.10476426,Bayesian Analysis for the Poly-Weibull Distribution,"Abstract In this article Bayesian analysis for a Poly-Weibull distribution using informative priors is discussed. This distribution typically arises when the data is the minimum of several Weibull failure times from competing risks. To perform the Bayesian computations, simulation using the Gibbs sampler is suggested. This can be used to find posterior moments, the marginal posterior probability density function, and the predictive risk or reliability.",0 +https://doi.org/10.2307/1937887,Multicollinearity in Regression Analysis: The Problem Revisited,"T O MOST economists, the single equation least-squares regression model, like an old friend, is tried and true. Its properties and limitations have been extensively studied and documented and are, for the most part, wellknown. Any good text in econometrics can lay out the assumptions on which common versions of the model are based and provide a reasonably coherent perhaps even a lucid discussion of problems that arise as particular assumptions are violated. A short bibliography of definitive papers on such classical problems as non-normality, heteroscedasticity, serial correlation, feedback, etc., completes the job. As with most old friends, however, the longer one knows least squares, the more one learns about it. An admiration for its robustness under departures from many assumptions is sure to grow. The admiration must be tempered, however, by an appreciation of the model's sensitivity to certain other conditions. The requirement that explanatory variables be truly independent of one another is one of these. Proper of the model's classical problems ordinarily involves two separate stages: detection and correction. The DurbinWatson test for serial correlation, combined with Cochrane and Orcutt's suggested first differencing procedure, is an obvious example.' Bartlett's test for variance heterogeneity followed by a data transformation to restore homoscedasticity is another.2 No such treatment has been developed, however, for problems that arise as multicollinearity is encountered in regression analysis. Attention will focus here on what we consider to be the first step in a proper of the multicollinearity problem its detection, or diagnosis. Economists are coming more and more to agree that the second step, correction, requires the generation of additional information.3 Just how this information is to be obtained depends largely on the tastes of an investigator and on the specifics of a particular problem. It may involve additional primary data collection, the use of extraneous parameter estimates from secondary data sources, or the application of subjective information through constrained regression, or through Bayesian estimation procedures. Whatever its source, however, selectivity and thereby efficiency in generating the added information requires a systematic procedure for detecting its need i.e., for detecting the existence, measuring the extent, and pinpointing the location and causes of multicollinearity within a set of independent variables. Measures are proposed here that, in our opinion, fill this need. The paper's basic organization can be outlined briefly as follows. In the next section the multicollinearity problem's basic, formal nature is developed and illustrated. A discussion of historical approaches to the problem follows. With this as background, an attempt is made to define multicollinearity in terms of departures from a hypothesized statistical condition, and * The authors are Associate Professor of Finance at the Sloan School of Management, M.I.T., and Assistant Professor of Business Administration at the Harvard Business School, respectively. We are indebted to Professor John R. Meyer for introducing us to the multicollinearity problem and for advice and encouragement during the present effort to place it in perspective, and to Professors John Lintner and Robert Schlaifer for their comments and criticisms. Responsibility for specific interpretations, especially erroneous ones, remains our own. This research was supported by the Institute of Naval Studies, of which both authors were members at the time the work was conducted, and by grants from the Ford Foundation to both the Sloan School of Management and the Harvard Business School. Computation time and facilities were provided by the Computation Centers of Harvard and M.I.T. 1J Durbin and G. S. Watson, Testing for Serial Correlation in Least Squares Regression, Biometrika, 37-38, (1950-1951); and C. Cochrane and G. H. Orcutt, Application of Least Squares Regression to Relationships Containing Autocorrelated Error Terms Journal of the American Statistical Association, 44 (1949). 2F. David and J. Neyman, Extension of the Markoff Theorem on Least Squares, Statistical Research Memoirs, II (London, 1938). 'J. Johnston, Econometric Methods (McGraw-Hill, 1963), 207; J. Meyer and R. Glauber, Investment Decisions, Economic Forecasting, and Public Policy (Division of Research, Graduate School of Business Administration, Harvard University, 1964), 181 ff.",0 +,The function of the vibrissae in the behavior of the white rat,,0 +https://doi.org/10.1177/002224379503200401,"Psychometric Methods in Marketing Research: Part I, Conjoint Analysis",,0 +https://doi.org/10.4324/9780203848852-8,Beyond multilevel regression modeling: Multilevel analysis in a general latent variable framework.,"The outline of the chapter is as follows. Section 2.2 discusses two extensions of two-level regression analysis, Section 2.3 discusses two-level path analysis and structural equation modeling, Section 2.4 presents an example of two-level exploratory factor analysis (EFA), Section 2.5 discusses two-level growth modeling using a two-part model, Section 2.6 discusses an unconventional approach to three-level growth modeling, and Section 2.7 presents an example of multilevel growth mixture modeling.",0 +https://doi.org/10.1177/0146621602239475,Small Sample Estimation in Dichotomous Item Response Models: Effect of Priors Based on Judgmental Information on the Accuracy of Item Parameter Estimates,"Large item banks with properly calibrated test items are essential for ensuring the validity of computer-based tests. At the same time, item calibrations with small samples are desirable to minimize the amount of pretesting and limit item exposure. Bayesian estimation procedures show considerable promise with small examinee samples. The purposes of the study were (a) to examine how prior information for Bayesian item parameter estimation can be specified and (b) to investigate the relationship between sample size and the specification of prior information on the accuracy of item parameter estimates. The results of the simulation study were clear: Estimation of IRT model item parameters can be improved considerably. Improvements in the one-parameter model were modest; considerable improvements with the two- and three-parameter models were observed. Both the study of different forms of priors and ways to improve the judgmental data used in forming the priors appear to be promising directions for future research.",0 +https://doi.org/10.1016/j.ijresmar.2003.11.002,Capturing consumer heterogeneity in metric conjoint analysis using Bayesian mixture models,"Abstract We address unobserved preference heterogeneity within an omitted variable framework which provides a theoretical rationale for more continuous preference distributions, multivariate normal in the limit. A comparison of the random coefficients model (RCM) and the latent class model (LCM) using simulated data illustrates that the RCM dominates the LCM if the underlying distribution is strictly continuous. The LCM dominates the RCM if the underlying distribution is strictly discrete once the sample is informative enough to support the true number of classes. The simulation further documents that the optimal number of classes in an LCM is an unrestricted function of the sample size if the underlying distribution is continuous. Finally, we present an application to the mineral water market, where a finite mixture with random effects model with two components performs best. All models are estimated fully Bayesian, and model comparisons are based on model likelihoods and analyses of holdout data.",0 +,On the performance of multiple imputation for multivariate data with small sample size,,0 +https://doi.org/10.1111/j.1745-3984.2011.00145.x,Restrictive Stochastic Item Selection Methods in Cognitive Diagnostic Computerized Adaptive Testing,"This paper proposes two new item selection methods for cognitive diagnostic computerized adaptive testing: the restrictive progressive method and the restrictive threshold method. They are built upon the posterior weighted Kullback-Leibler (KL) information index but include additional stochastic components either in the item selection index or in the item selection procedure. Simulation studies show that both methods are successful at simultaneously suppressing overexposed items and increasing the usage of underexposed items. Compared to item selection based upon (1) pure KL information and (2) the Sympson-Hetter method, the two new methods strike a better balance between item exposure control and measurement accuracy. The two new methods are also compared with Barrada et al.'s (2008) progressive method and proportional method.",0 +https://doi.org/10.4324/9780203142738,New Participatory Dimensions in Civil Society,"1. Introduction: Democracy, Professionalization and Participation Jan W. van Deth and William A. Maloney Part 1: Professionalization and Democratic Politics 2. How to Domesticate Civil Society by Public-Private Partnerships: Evidence from German Local Health Policy Matthias Freise 3. Entrepreneurial Participation in International Local Politics: The Case of Marseille, European Capital of Culture for 2013 Nicolas Maisetti 4. New Issues, New Forms of Action? Climate Change and Environmental Activism in Britain Christopher Rootes 5. The Professionalization of EU's Civil Society: A Conceptual Framework Sabine Saurugger 6. The Democratic Contribution of Professionalized Representation William A. Maloney 7. Professionalized Supply-Side Mobilization: Are Financial Contributors 'Meaningful Participants'? Grant Jordan Part 2: Changing Democratic Engagement 8. New Modes of Participation and Norms of Citizenship Jan W. van Deth 9. A Remedy for Unequal Participation? How Welfare States Impact on Social and Political Engagement Isabelle Stadelmann-Steffen 10. Peripheral Participants: The Activation of the Politically Less Engaged in Advanced Democracies Eline A. de Rooij 11. Surrogates for the Underrepresented? Ideology and Participatory Inequality in Personal and Professional Political Action Tom W.G. van der Meer 12. The Stability of Individualized Collective Action: Results of a Panel Study among Belgian Late Adolescents Ellen Quintelier and Marc Hooghe 13. Youth Participation from the Top-Down: The Perspectives of Government and Community Sector Decision-Makers in Australia Ariadne Vromen 14. Conclusions: How Democratic is Professionalized and Individualized Political Action? Jan W. van Deth and William A. Maloney",0 +https://doi.org/10.1348/000711007x230937,Incorporating randomness in the Fisher information for improving item-exposure control in CATs,"The most commonly employed item selection rule in a computerized adaptive test (CAT) is that of selecting the item with the maximum Fisher information for the estimated trait level. This means a highly unbalanced distribution of item-exposure rates, a high overlap rate among examinees and, for item bank management, strong pressure to replace items with a high discrimination parameter in the bank. An alternative for mitigating these problems involves, at the beginning of the test, basing item selection mainly on randomness. As the test progresses, the weight of information in the selection increases. In the present work we study, for two selection rules, the progressive methods (Revuelta & Ponsoda, 1998) and the proportional method (Segall, 2004a), different functions that define the weight of the random component according to the position in the test of the item to be administered. The functions were tested in simulated item banks and in an operative bank. We found that both the progressive and the proportional methods tolerate a high weight of the random component with minimal or zero loss of accuracy, while bank security and maintenance are improved.",0 +https://doi.org/10.1037/a0034860,To thine own self be true: Psychological adjustment promotes judgeability via personality–behavior congruence.,"Well-adjusted individuals are highly judgeable in that their personalities tend to be seen more accurately than the personalities of less adjusted individuals (Colvin, 1993a, 1993b; Human & Biesanz, 2011a). The mechanisms behind this effect, however, are not well understood. How does adjustment facilitate judgeability? In the present video-perceptions study, we examined potential mechanisms through which adjustment could promote judgeability at 3 stages of the Realistic Accuracy Model (RAM; Funder, 1995): (a) cue relevance, (b) cue availability, and (c) cue detection. We found that well-adjusted individuals were more judgeable because they provided more relevant cues: Specifically, well-adjusted individuals behaved more in line with their distinctive personalities, which in turn led them to be seen more accurately. In contrast, neither cue availability nor detection could sufficiently account for the link between adjustment and judgeability. In sum, well-adjusted individuals are more judgeable because to their own selves, they are true.",0 +https://doi.org/10.1214/aoms/1177729991,Heuristic Approach to the Kolmogorov-Smirnov Theorems,"Asymptotic theorems on the difference between the (empirical) distribution function calculated from a sample and the true distribution function governing the sampling process are well known. Simple proofs of an elementary nature have been obtained for the basic theorems of Komogorov and Smirnov by Feller, but even these proofs conceal to some extent, in their emphasis on elementary methodology, the naturalness of the results (qualitatively at least), and their mutual relations. Feller suggested that the author publish his own approach (which had also been used by Kac), which does not have these disadvantages, although rather deep analysis would be necessary for its rigorous justification. The approach is therefore presented (at one critical point) as heuristic reasoning which leads to results in investigations of this kind, even though the easiest proofs may use entirely different methods. No calculations are required to obtain the qualitative results, that is the existence of limiting distributions for large samples of various measures of the discrepancy between empirical and true distribution functions. The numerical evaluation of these limiting distributions requires certain results concerning the Brownian movement stochastic process and its relation to other Gaussian processes which will be derived in the Appendix.",0 +https://doi.org/10.3758/bf03198390,An analysis of latency and interresponse time in free recall,"In four experiments, subjects freely recalled previously studied items while a voice key and computer recorded each item’s recall latency relative to the onset of the recall period. The measures of recall probability and mean recall latency were shown to be empirically independent, demonstrating that there exists no a priori relationship between the two. In all four experiments, latency distributions were fit well by the ex-Gaussian, suggesting that retrieval includes a brief normally distributed initiation stage followed by a longer exponentially distributed search stage. Further, the variation in mean latency stemmed from the variation in the duration of the search stage, not the initiation stage. Interresponse times (IRTs), the time elapsed between two successive item recalls, were analyzed as well. The growth of mean IRTs, plotted as a function of output position, was shown to be a simple function of the number of items not yet recalled. Finally, the mathematical nature of both free recall latency and IRT growth are shown to be consistent with a simple theoretical account of retrieval that depicts mean recall latency as a measure of the breadth of search.",0 +https://doi.org/10.1007/s11222-007-9030-2,Bayesian parsimonious covariance estimation for hierarchical linear mixed models,"We consider a non-centered parameterization of the standard random-effects model, which is based on the Cholesky decomposition of the variance-covariance matrix. The regression type structure of the non-centered parameterization allows us to use Bayesian variable selection methods for covariance selection. We search for a parsimonious variance-covariance matrix by identifying the non-zero elements of the Cholesky factors. With this method we are able to learn from the data for each effect whether it is random or not, and whether covariances among random effects are zero. An application in marketing shows a substantial reduction of the number of free elements in the variance-covariance matrix.",0 +https://doi.org/10.1037/a0017808,"Context, learning, and extinction.","A. Redish et al. (2007) proposed a reinforcement learning model of context-dependent learning and extinction in conditioning experiments, using the idea of ""state classification"" to categorize new observations into states. In the current article, the authors propose an interpretation of this idea in terms of normative statistical inference. They focus on renewal and latent inhibition, 2 conditioning paradigms in which contextual manipulations have been studied extensively, and show that online Bayesian inference within a model that assumes an unbounded number of latent causes can characterize a diverse set of behavioral results from such manipulations, some of which pose problems for the model of Redish et al. Moreover, in both paradigms, context dependence is absent in younger animals, or if hippocampal lesions are made prior to training. The authors suggest an explanation in terms of a restricted capacity to infer new causes.",0 +,JAGS: A program for analysis of Bayesian graphical models using Gibbs sampling,"JAGS is a program for Bayesian Graphical modelling which aims for compatibility with Classic BUGS. The program could eventually be developed as an R package. This article explains the motivations for this program, briefly describes the architecture and then discusses some ideas for a vectorized form of the BUGS language.",0 +https://doi.org/10.1007/s001800000041,Implementation and performance issues in the Bayesian and likelihood fitting of multilevel models,"Computational Statistics, September 2000, Volume 15, Issue 3, pp 391-420",1 +https://doi.org/10.1080/00949650212842,Marginal Likelihood for a Class of Bayesian Generalized Linear Models,"The Bayes factor has become an important tool for model selection. The marginal likelihoods are also important because they can be used to rank the models. In fact, the Bayes factor is the ratio of the marginal likelihoods for two models with proper prior densities. We discuss the marginal likelihood for a class of generalized linear models used in small area estimation for mortality data analysis. Computation in these models is intensive and requires the implementation of Markov chain Monte Carlo (MCMC) methods. A sophisticated method for computing the marginal likelihoods for generalized linear models using reduced Metropolis-Hastings (M-H) samplers has recently been introduced. Also, a much simpler method that uses the Laplace approximation has been proposed. Our method lies between these two in simplicity, and it uses importance sampling via a simple output analysis from a MCMC sampler. We also show that the new method can be approximated without using the MCMC sampler. We illustrate our methods for t...",0 +https://doi.org/10.1016/s0304-3959(01)00354-2,A new model of sciatic inflammatory neuritis (SIN): induction of unilateral and bilateral mechanical allodynia following acute unilateral peri-sciatic immune activation in rats,"Immune activation near healthy peripheral nerves may have a greater role in creating pathological pain than previously recognized. We have developed a new model of sciatic inflammatory neuritis to assess how such immune activation may influence somatosensory processing. The present series of experiments reveal that zymosan (yeast cell walls) acutely injected around the sciatic nerve of awake unrestrained rats rapidly (within 3h) produces low threshold mechanical allodynia in the absence of thermal hyperalgesia. Low (4 microg) doses of zymosan produce both territorial and extra-territorial allodynia restricted to the ipsilateral hindpaw. Higher (40-400 microg) doses of zymosan again produce both territorial and extra-territorial allodynia. However, allodynia is now expressed both in the ipsilateral as well as contralateral hindpaws. Several lines of evidence are provided that the appearance of this contralateral ('mirror') allodynia reflects local actions of zymosan on the sciatic nerve rather than spread of this immune activator to the general circulation. Since many clinical neuropathies result from inflammation/infection of peripheral nerves rather than frank physical trauma, understanding how immune activation alters pain processing may suggest novel approaches to pain control.",0 +https://doi.org/10.1093/scan/nsq099,One’s motor performance predictably modulates the understanding of others’ actions through adaptation of premotor visuo-motor neurons,"Neurons firing both during self and other's motor behavior (mirror neurons) have been described in the brain of vertebrates including humans. The activation of somatic motor programs driven by perceived behavior has been taken as evidence for mirror neurons' contribution to cognition. The inverse relation, that is the influence of motor behavior on perception, is needed for demonstrating the long-hypothesized causal role of mirror neurons in action understanding. We provide here conclusive behavioral and neurophysiological evidence for that causal role by means of cross-modal adaptation coupled with a novel transcranial magnetic stimulation (TMS)-adaptation paradigm. Blindfolded repeated motor performance of an object-directed action (push or pull) induced in healthy participants a strong visual after-effect when categorizing others' actions, as a result of motor-to-visual adaptation of visuo-motor neurons. TMS over the ventral premotor cortex, but not over the primary motor cortex, suppressed the after-effect, thus localizing the population of adapted visuo-motor neurons in the premotor cortex. These data are exquisitely consistent in humans with the existence of premotor mirror neurons that have access to the action meaning. We also show that controlled manipulation of the firing properties of this neural population produces strong predictable changes in the way we categorize others' actions.",0 +https://doi.org/10.1016/j.jclinepi.2010.10.016,Mixed treatment comparison meta-analysis of altered fractionated radiotherapy and chemotherapy in head and neck cancer,"

Abstract

Objective

Different treatments have been investigated in head and neck cancers (HNCs) but not all of them have been appraised using pairwise comparison. This has resulted in failure to directly identify the best treatment with standard methods. Mixed treatment comparison (MTC) meta-analysis allows one to perform simultaneous inference regarding all treatments and select the best among them.

Study Design and Setting

We applied MTC models to the Meta-Analyses of Chemotherapy and Radiotherapy in HNC, which pooled individual patient data concerning more than 24,000 patients involved in 102 trials. Fixed- and random-effects models, models with or without consistency factors, possibly adapted to multiarm trials are discussed.

Results

Altered fractionated concomitant chemoradiotherapy (AF-CRT) leads to the highest probability of survival in nonmetastatic HNC. The probability that AF-CRT is the best treatment is 94% with random-effects models. There was no relevant inconsistency. When only the most recent trials were selected, AF-CRT and concomitant chemoradiotherapy (CRT) were the two best treatments. AF-CRT remains better than CRT but with a lower posterior probability.

Conclusion

MTC is a powerful method for investigating networks of randomized trials. Homogeneity, similarity of trial designs, populations, and the consistency of the network should be thoroughly checked.",0 +https://doi.org/10.1198/jasa.2009.0237,Bayesian Mixture Labeling by Highest Posterior Density,"A fundamental problem for Bayesian mixture model analysis is label switching, which occurs as a result of the nonidentifiability of the mixture components under symmetric priors. We propose two labeling methods to solve this problem. The first method, denoted by PM(ALG), is based on the posterior modes and an ascending algorithm generically denoted ALG. We use each Markov chain Monte Carlo sample as the starting point in an ascending algorithm, and label the sample based on the mode of the posterior to which it converges. Our natural assumption here is that the samples converged to the same mode should have the same labels. The PM(ALG) labeling method has some computational advantages over other popular labeling methods. Additionally, it automatically matches the “ideal” labels in the highest posterior density credible regions. The second method does labeling by maximizing the normal likelihood of the labeled Gibbs samples. Using a Monte Carlo simulation study and a real dataset, we demonstrate the succes...",0 +https://doi.org/10.1111/1467-9248.12183,Equal Partners in Dialogue? Participation Equality in a Transnational Deliberative Poll (Europolis),"By gathering a representative sample of citizens from all 27 EU Member States, the deliberative poll Europolis created the opportunity for the inclusion of a wide variety of European voices. Taking up claims of difference democrats who argue that informal hurdles to participation can endure even after individuals gain formal access to the floor, this article argues for an extended approach to evaluate equality in deliberative minipublics. Specifically, it assesses whether participants contributed in roughly equal measures to the discussion and whether their discussion partners considered their contributions on equal merits. In doing so, the article adds to the small but growing literature on deliberation that expresses reservations about taking the willingness to engage with others' claims for granted. In order to account for the intrinsically relational aspect of interpersonal communication, measures of social network analysis are introduced as possible tools to evaluate participation equality in deliberative encounters.",0 +https://doi.org/10.1145/358315.358390,Generating gamma variates by a modified rejection technique,"A suitable square root transformation of a gamma random variable with mean a ≥ 1 yields a probability density close to the standard normal density. A modification of the rejection technique then begins by sampling from the normal distribution, being able to accept and transform the initial normal observation quickly at least 85 percent of the time (95 percent if a ≥ 4). When used with efficient subroutines for sampling from the normal and exponential distributions, the resulting accurate method is significantly faster than competing algorithms.",0 +,R: A language and environment for statistical computing.,,0 +https://doi.org/10.1111/j.1745-3984.2003.tb01149.x,A Method for Maintaining Scale Stability in the Presence of Test Speededness,"Administering tests under time constraints may result in poorly estimated item parameters, particularly for items at the end of the test (Douglas, Kim, Habing, & Gao, 1998; Oshima, 1994). Bolt, Cohen, and Wollack (2002) developed an item response theory mixture model to identify a latent group of examinees for whom a test is overly speeded, and found that item parameter estimates for end-of-test items in the nonspeeded group were similar to estimates for those same items when administered earlier in the test. In this study, we used the Bolt et al. (2002) method to study the effect of removing speeded examinees on the stability of a score scale over an II-year period. Results indicated that using only the nonspeeded examinees for equating and estimating item parameters provided a more unidimensional scale, smaller effects of item parameter drift (including fewer drifting items), and less scale drift (i.e., bias) and variability (i.e., root mean squared errors) when compared to the total group of examinees.",0 +https://doi.org/10.1111/j.0006-341x.2004.00211.x,Maximum Likelihood Analysis of a General Latent Variable Model with Hierarchically Mixed Data,"A general two-level latent variable model is developed to provide a comprehensive framework for model comparison of various submodels. Nonlinear relationships among the latent variables in the structural equations at both levels, as well as the effects of fixed covariates in the measurement and structural equations at both levels, can be analyzed within the framework. Moreover, the methodology can be applied to hierarchically mixed continuous, dichotomous, and polytomous data. A Monte Carlo EM algorithm is implemented to produce the maximum likelihood estimate. The E-step is completed by approximating the conditional expectations through observations that are simulated by Markov chain Monte Carlo methods, while the M-step is completed by conditional maximization. A procedure is proposed for computing the complicated observed-data log likelihood and the BIC for model comparison. The methods are illustrated by using a real data set.",0 +,Nonlinear structural equation models: The Kenny-Judd model with Interaction effects,,0 +https://doi.org/10.1002/sim.5494,A fully Bayesian application of the Copas selection model for publication bias extended to network meta-analysis,"The Copas parametric model is aimed at exploring the potential impact of publication bias via sensitivity analysis, by making assumptions regarding the probability of publication of individual studies related to the standard error of their effect sizes. Reviewers often have prior assumptions about the extent of selection in the set of studies included in a meta-analysis. However, a Bayesian implementation of the Copas model has not been studied yet. We aim to present a Bayesian selection model for publication bias and to extend it to the case of network meta-analysis where each treatment is compared either with placebo or with a reference treatment creating a star-shaped network. We take advantage of the greater flexibility offered in the Bayesian context to incorporate in the model prior information on the extent and strength of selection. To derive prior distributions, we use both external data and an elicitation process of expert opinion.",0 +https://doi.org/10.1016/j.jspi.2008.05.036,Propriety of posteriors in structured additive regression models: Theory and empirical evidence,"Abstract Structured additive regression comprises many semiparametric regression models such as generalized additive (mixed) models, geoadditive models, and hazard regression models within a unified framework. In a Bayesian formulation, non-parametric functions, spatial effects and further model components are specified in terms of multivariate Gaussian priors for high-dimensional vectors of regression coefficients. For several model terms, such as penalized splines or Markov random fields, these Gaussian prior distributions involve rank-deficient precision matrices, yielding partially improper priors. Moreover, hyperpriors for the variances (corresponding to inverse smoothing parameters) may also be specified as improper, e.g. corresponding to Jeffreys prior or a flat prior for the standard deviation. Hence, propriety of the joint posterior is a crucial issue for full Bayesian inference in particular if based on Markov chain Monte Carlo simulations. We establish theoretical results providing sufficient (and sometimes necessary) conditions for propriety and provide empirical evidence through several accompanying simulation studies.",0 +https://doi.org/10.1207/s15366359mea0204_1,"A Manifesto on Psychology as Idiographic Science: Bringing the Person Back Into Scientific Psychology, This Time Forever","Psychology is focused on variation between cases (interindividual variation). Results thus obtained are considered to be generalizable to the understanding and explanation of variation within single cases (intraindividual variation). It is indicated, however, that the direct consequences of the classical ergodic theorems for psychology and psychometrics invalidate this conjectured generalizability: only under very strict conditions-which are hardly obtained in real psychological processes-can a generalization be made from a structure of interindividual variation to the analogous structure of intraindividual variation. Illustrations of the lack of this generalizability are given in the contexts of psychometrics, developmental psychology, and personality theory.",0 +https://doi.org/10.1080/10705510802339106,A SAS Interface for Bayesian Analysis With WinBUGS,"Bayesian methods are becoming very popular despite some practical difficulties in implementation. To assist in the practical application of Bayesian methods, we show how to implement Bayesian analysis with WinBUGS as part of a standard set of SAS routines. This implementation procedure is first illustrated by fitting a multiple regression model and then a linear growth curve model. A third example is also provided to demonstrate how to iteratively run WinBUGS inside SAS for Monte Carlo simulation studies. The SAS codes used in this study are easily extended to accommodate many other models with only slight modification. This interface can be of practical benefit in many aspects of Bayesian methods because it allows the SAS users to benefit from the implementation of Bayesian estimation and it also allows the WinBUGS user to benefit from the data processing routines available in SAS.",0 +https://doi.org/10.1016/j.amjmed.2009.05.021,Bayesian Meta-analysis of Hormone Therapy and Mortality in Younger Postmenopausal Women,"There is uncertainty over the risks and benefits of hormone therapy. We performed a Bayesian meta-analysis to evaluate the effect of hormone therapy on total mortality in younger postmenopausal women. This analysis synthesizes evidence from different sources, taking into account varying views on the issue.A comprehensive search from 1966 through January 2008 identified randomized controlled trials of at least 6 month's duration that evaluated hormone therapy in women with mean age <60 years and reported at least one death, and prospective observational cohort studies that evaluated the relative risk of mortality associated with hormone therapy after adjustment for confounding variables.The results were synthesized using a hierarchical random-effects Bayesian meta-analysis. The pooled results from 19 randomized trials, with 16,000 women (mean age 55 years) followed for 83,000 patient-years, showed a mortality relative risk of 0.73 (95% credible interval 0.52-0.96). When data from 8 observational studies were added to the analysis, the resultant relative risk was 0.72 (credible interval 0.62-0.82). The posterior probability that hormone therapy reduces total mortality in younger women is almost 1.The synthesis of data using Bayesian meta-analysis indicates a reduction in mortality in younger postmenopausal women taking hormone therapy compared with no treatment. This finding should be interpreted taking into account the potential benefits and harms of hormone therapy.",0 +https://doi.org/10.1163/156856809788746309,Fixed vs. variable noise in 2AFC contrast discrimination: lessons from psychometric functions,"Recent discussion regarding whether the noise that limits 2AFC discrimination performance is fixed or variable has focused either on describing experimental methods that presumably dissociate the effects of response mean and variance or on reanalyzing a published data set with the aim of determining how to solve the question through goodness-of-fit statistics. This paper illustrates that the question cannot be solved by fitting models to data and assessing goodness-of-fit because data on detection and discrimination performance can be indistinguishably fitted by models that assume either type of noise when each is coupled with a convenient form for the transducer function. Thus, success or failure at fitting a transducer model merely illustrates the capability (or lack thereof) of some particular combination of transducer function and variance function to account for the data, but it cannot disclose the nature of the noise. We also comment on some of the issues that have been raised in recent exchange on the topic, namely, the existence of additional constraints for the models, the presence of asymmetric asymptotes, the likelihood of history-dependent noise, and the potential of certain experimental methods to dissociate the effects of response mean and variance.",0 +https://doi.org/10.1016/j.jeconom.2006.07.014,Modeling and calculating the effect of treatment at baseline from panel outcomes,"We propose and examine a panel data model for isolating the effect of a treatment, taken once at baseline, from outcomes observed over subsequent time periods. In the model, the treatment intake and outcomes are assumed to be correlated, due to unobserved or unmeasured confounders. Intake is partly determined by a set of instrumental variables and the confounding on unobservables is modeled in a flexible way, varying both by time and treatment state. Covariate effects are assumed to be subject-specific and potentially correlated with other covariates. Estimation and inference is by Bayesian methods that are implemented by tuned Markov chain Monte Carlo methods. Because our analysis is based on the framework developed by Chib [2004. Analysis of treatment response data without the joint distribution of counterfactuals. Journal of Econometrics, in press], the modeling and estimation does not involve either the unknowable joint distribution of the potential outcomes or the missing counterfactuals. The problem of model choice through marginal likelihoods and Bayes factors is also considered. The methods are illustrated in simulation experiments and in an application dealing with the effect of participation in high school athletics on future labor market earnings.",0 +https://doi.org/10.1177/0272431614537117,Teaching Through Interactions in Secondary School Classrooms,"Valid measurement of how students’ experiences in secondary school classrooms lead to gains in learning requires a developmental approach to conceptualizing classroom processes. This article presents a potentially useful theoretical model, the Teaching Through Interactions framework, which posits teacher-student interactions as a central driver for student learning and that teacher-student interactions can be organized into three major domains. Results from 1,482 classrooms provide evidence for distinct emotional, organizational, and instructional domains of teacher-student interaction. It also appears that a three-factor structure is a better fit to observational data than alternative one- and two-domain models of teacher-student classroom interactions, and that the three-domain structure is generalizable from 6th through 12th grade. Implications for practitioners, stakeholders, and researchers are discussed.",0 +https://doi.org/10.1207/s15327906mbr3604_07,Hypothesis Testing and Model Comparison in Two-level Structural Equation Models,"One basic and important problem in two-level structural equation modeling is to find a good model for the observed sample data. This article demonstrates the use of the well-known Bayes factor in the Bayesian literature for hypothesis testing and model comparison in general two-level structural equation models. It is shown that the proposed methodology is flexible, and can be applied to situations with a wide variety of nonnested models. Moreover, some problems encountered in using existing methods for goodness-of-fit assessment of the proposed model can be alleviated. An illustrative example with some real data from an AIDS care study is presented.",0 +https://doi.org/10.1002/sim.2672,Bayesian statistics in medicine: a 25 year review,"This review examines the state of Bayesian thinking as Statistics in Medicine was launched in 1982, reflecting particularly on its applicability and uses in medical research. It then looks at each subsequent five-year epoch, with a focus on papers appearing in Statistics in Medicine, putting these in the context of major developments in Bayesian thinking and computation with reference to important books, landmark meetings and seminal papers. It charts the growth of Bayesian statistics as it is applied to medicine and makes predictions for the future. From sparse beginnings, where Bayesian statistics was barely mentioned, Bayesian statistics has now permeated all the major areas of medical statistics, including clinical trials, epidemiology, meta-analyses and evidence synthesis, spatial modelling, longitudinal modelling, survival modelling, molecular genetics and decision-making in respect of new technologies.",0 +https://doi.org/10.1002/sim.6131,Hierarchical network meta-analysis models to address sparsity of events and differing treatment classifications with regard to adverse outcomes,"Meta-analysis for adverse events resulting from medical interventions has many challenges, in part due to small numbers of such events within primary studies. Furthermore, variability in drug dose, potential differences between drugs within the same pharmaceutical class and multiple indications for a specific treatment can all add to the complexity of the evidence base.This paper explores the use of synthesis methods, incorporating mixed treatment comparisons, to estimate the risk of adverse events for a medical intervention, while acknowledging and modelling the complexity of the structure of the evidence base.The motivating example was the effect on malignancy of three anti-tumour necrosis factor (anti-TNF) drugs (etanercept, adalimumab and infliximab) indicated to treat rheumatoid arthritis. Using data derived from 13 primary studies, a series of meta-analysis models of increasing complexity were applied. Models ranged from a straightforward comparison of anti-TNF against non-anti-TNF controls, to more complex models in which a treatment was defined by individual drug and its dose. Hierarchical models to allow ‘borrowing strength’ across treatment classes and dose levels, and models involving constraints on the impact of dose level, are described.These models provide a flexible approach to estimating sparse, often adverse, outcomes associated with interventions. Each model makes its own set of assumptions, and approaches to assessing goodness of fit of the various models will usually be extremely limited in their effectiveness, due to the sparse nature of the data. Both methodological and clinical considerations are required to fit realistically complex models in this area and to evaluate their appropriateness. Copyright © 2014 John Wiley & Sons, Ltd.",0 +https://doi.org/10.3102/1076998607302632,Effects on Scale Linking of Different Definitions of Criterion Functions for the IRT Characteristic Curve Methods,"Under item response theory, the characteristic curve methods (Haebara and Stocking-Lord methods) are used to link two ability scales from separate calibrations. The linking methods use their respective criterion functions that can be defined differently according to the symmetry- and distribution-related schemes. The symmetry-related scheme relates to which scale, targeted or transformed, should be used for the definition. The distribution-related scheme refers to a way of incorporating underlying ability distributions into the definition. Through simulations, this study examined if a certain optimal combination of the two schemes exists regardless of differences in proficiency distribution between samples involved in scale linking. Concurrent calibration was considered for comparative purposes and, across all nine combinations of proficiency distributions to be linked, its performance was better in linking accuracy than the linking methods. There was no optimal combination of the symmetry- and distribution-related schemes that led to minimal linking error across the nine combinations.",0 +https://doi.org/10.1093/ije/29.1.158,Principles of multilevel modelling,"Multilevel modelling, also known as hierarchical regression, generalizes ordinary regression modelling to distinguish multiple levels of information in a model. Use of multiple levels gives rise to an enormous range of statistical benefits. To aid in understanding these benefits, this article provides an elementary introduction to the conceptual basis for multilevel modelling, beginning with classical frequentist, Bayes, and empirical-Bayes techniques as special cases. The article focuses on the role of multilevel averaging ('shrinkage') in the reduction of estimation error, and the role of prior information in finding good averages.",0 +https://doi.org/10.1002/sim.3380,A random change point model for assessing variability in repeated measures of cognitive function,"Some cognitive functions undergo transitions in old age, which motivates the use of a change point model for the individual trajectory. The age when the change occurs varies between individuals and is treated as random. We illustrate the properties of a random change point model and use it for data from a Swedish study of change in cognitive function in old age. Variance estimates are obtained from Markov chain Monte Carlo simulation using Gibbs sampling. The random change point model is compared with models within the family of linear random effects models. The focus is on the ability to capture variability in measures of cognitive function. The models make different assumptions about the variance over the age span, and we demonstrate that the random change point model has the most reasonable structure. Copyright © 2008 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1111/j.1467-6494.1993.tb01031.x,Analyzing Individual Status and Change with Hierarchical Linear Models:Illustration with Depression in College Students,"A recently developed class of multilevel or hierarchical linear models (HLM) provides an intuitive and efficient way to estimate individual growth or change curves. The approach also models the between-subjects variation of the individual change curves with treatment factors and individual attributes. Unlike other repeated measures analysis methods common in the behavioral sciences, HLM allows the fit of data with unequal numbers of repeated observations for each subject, variable timing of observations, and missing data, features which are often characteristic of data from field studies. The application of HLM for the analysis of repeated psychological measures is discussed and illustrated here with depression data for college students. Strengths and limitations of the approach are discussed.",0 +https://doi.org/10.3102/1076998606298044,Conditional Item-Exposure Control in Adaptive Testing Using Item-Ineligibility Probabilities,"Two conditional versions of the exposure-control method with item-ineligibility constraints for adaptive testing in van der Linden and Veldkamp (2004 ) are presented. The first version is for unconstrained item selection, the second for item selection with content constraints imposed by the shadow-test approach. In both versions, the exposure rates of the items are controlled using probabilities of item ineligibility given θ that adapt the exposure rates automatically to a goal value for the items in the pool. In an extensive empirical study with an adaptive version of the Law School Admission Test, the authors show how the method can be used to drive conditional exposure rates below goal values as low as 0.025. Obviously, the price to be paid for minimal exposure rates is a decrease in the accuracy of the ability estimates. This trend is illustrated with empirical data.",0 +https://doi.org/10.1027/1614-2241.3.3.100,Challenges in Nonlinear Structural Equation Modeling,"Abstract. Challenges in evaluating nonlinear effects in multiple regression analyses include reliability, validity, multicollinearity, and dichotomization of continuous variables. While reliability and validity issues are solved by employing nonlinear structural equation modeling, multicollinearity remains a problem which may even be aggravated when using latent variable approaches. Further challenges of nonlinear latent analyses comprise the distribution of latent product terms, a problem especially relevant for approaches using maximum likelihood estimation methods based on multivariate normally distributed variables, and unbiased estimates of nonlinear effects under multicollinearity. The only methods that explicitly take the nonnormality of nonlinear latent models into account are latent moderated structural equations (LMS) and quasi-maximum likelihood (QML). In a small simulation study both methods yielded unbiased parameter estimates and correct estimates of standard errors for inferential statistics. The advantages and limitations of nonlinear structural equation modeling are discussed.",0 +https://doi.org/10.1007/s11336-009-9141-0,Hierarchical Multinomial Processing Tree Models: A Latent-Trait Approach,"Multinomial processing tree models are widely used in many areas of psychology. A hierarchical extension of the model class is proposed, using a multivariate normal distribution of person-level parameters with the mean and covariance matrix to be estimated from the data. The hierarchical model allows one to take variability between persons into account and to assess parameter correlations. The model is estimated using Bayesian methods with weakly informative hyperprior distribution and a Gibbs sampler based on two steps of data augmentation. Estimation, model checks, and hypotheses tests are discussed. The new method is illustrated using a real data set, and its performance is evaluated in a simulation study. © 2009 The Psychometric Society.",0 +https://doi.org/10.1037/a0016132,An effectiveness trial of a dissonance-based eating disorder prevention program for high-risk adolescent girls.,"Efficacy trials indicate that an eating disorder prevention program involving dissonance-inducing activities that decrease thin-ideal internalization reduces risk for current and future eating pathology, yet it is unclear whether this program produces effects under real-world conditions. The present effectiveness trial tested whether this program produced effects when school staff recruit participants and deliver the intervention. Adolescent girls with body image concerns (N = 306; M age = 15.7, SD = 1.1) randomized to the dissonance intervention showed significantly greater decreases in thin-ideal internalization, body dissatisfaction, dieting attempts, and eating disorder symptoms from pretest to posttest than did those assigned to a psychoeducational brochure control condition, with the effects for body dissatisfaction, dieting, and eating disorder symptoms persisting through 1-year follow-up. Effects were slightly smaller than those observed in a prior efficacy trial, suggesting that this program is effective under real-world conditions, but that facilitator selection, training, and supervision could be improved.",0 +https://doi.org/10.1080/01621459.2014.983229,An Analysis of an Incomplete Marked Point Pattern of Heat-Related 911 Calls,"We analyze an incomplete marked point pattern of heat-related 911 calls between the years 2006–2010 in Houston, TX, to primarily investigate conditions that are associated with increased vulnerability to heat-related morbidity and, secondarily, build a statistical model that can be used as a public health tool to predict the volume of 911 calls given a time frame and heat exposure. We model the calls as arising from a nonhomogenous Cox process with unknown intensity measure. By using the kernel convolution construction of a Gaussian process, the intensity surface is modeled using a low-dimensional representation and properly adheres to circular domain constraints. We account for the incomplete observations by marginalizing the joint intensity measure over the domain of the missing marks and also demonstrate model based imputation. We find that spatial regions of high risk for heat-related 911 calls are temporally dynamic with the highest risk occurring in urban areas during the day. We also find that elde...",0 +https://doi.org/10.1177/1465116514532556,"The Europeanization of interest groups: Group type, resources and policy area","Large variation exists in the extent to which national interest groups focus on European Union (EU) legislation and carry out their political activities in Brussels and Strasbourg. What explains this variation? We propose a series of hypotheses that suggest that business groups, and groups active in policy areas with high EU competence, are more Europeanized than other groups. The effect of group type, moreover, is conditional on the material resources a group possesses: we expect the difference between business and non-business groups to be largest for actors that are well endowed with material resources. Using novel data on 880 national associations, gained from a survey of interest groups in five European countries, we find support for these hypotheses. The article has implications for the literatures on lobbying, Europeanization, and theories of European integration.",0 +https://doi.org/10.1177/014662168801200105,The Application of an Unfolding Model of the PIRT Type to the Measurement of Attitude,"Unfolding data for unidimensional variables con structed from direct responses (e.g., agreement or dis agreement) are characterized by single peaked func tions involving the locations of each person and each stimulus. A continuous discrirninal process, of the form postulated by Thurstone when he proposed his Law of Comparative Judgment, is suggested. This process is transformed to a qualitative dichotomous re sponse in which the probability of endorsement is governed by the square of the distance between the lo cations of the person and the stimulus. Maximum like lihood estimates of the parameters are derived, and it is shown that the information associated with any re sponse is a bimodal function of the difference between the person and stimulus locations. The feasibility of parameter estimation is demonstrated with a limited simulation study. The model is applied to a set of statements designed to measure attitudes toward capi tal punishment and scaled by the methods of Thur stone. The responses conformed to the unfolding mechanism, and the scale values of the statements are statistically equivalent to those obtained by Thur stone's methods. Index terms: Attitude measure ment, Developmental data, Discriminal process, Item response theory, Person response theory, Thurstone scaling, Unfolding data, Unidimensional scaling.",0 +https://doi.org/10.1016/j.neuroscience.2014.09.020,"Activation of adult rat CNS endothelial cells by opioid-induced toll-like receptor 4 (TLR4) signaling induces proinflammatory, biochemical, morphological, and behavioral sequelae","CNS immune signaling contributes to deleterious opioid effects including hyperalgesia, tolerance, reward, and dependence/withdrawal. Such effects are mediated by opioid signaling at toll-like receptor 4 (TLR4), presumptively of glial origin. Whether CNS endothelial cells express TLR4 is controversial. If so, they would be well positioned for activation by blood-borne opioids, contributing to opioid-induced pro-inflammatory responses. These studies examined adult primary rat CNS endothelial cell responses to (-)-morphine or its mu opioid receptor (MOR)-inactive metabolite morphine-3-glucuronide (M3G), both known TLR4 agonists. We demonstrate that adult rat CNS endothelial cells express functional TLR4. M3G activated nuclear factor kappaB (NF-κB), increased tumor necrosis factor-α (TNFα) and cyclooxygenase-2 (COX2) mRNAs, and released prostaglandin E2 (PGE2) from these cells. (-)-Morphine-induced upregulation of TNFα mRNA and PGE2 release were unmasked by pre-treatment with nalmefene, a MOR antagonist without TLR4 activity (unlike CTAP, shown to have both MOR- and TLR4-activity), suggestive of an interplay between MOR and TLR4 co-activation by (-)-morphine. In support, MOR-dependent Protein Kinase A (PKA) opposed TLR4 signaling, as PKA inhibition (H-89) also unmasked (-)-morphine-induced TNFα and COX2 mRNA upregulation. Intrathecal injection of CNS endothelial cells, stimulated in vitro with M3G, produced TLR4-dependent tactile allodynia. Further, cortical suffusion with M3G in vivo induced TLR4-dependent vasodilation. Finally, endothelial cell TLR4 activation by lipopolysaccharide and/or M3G was blocked by the glial inhibitors AV1013 and propentofylline, demonstrating endothelial cells as a new target of such drugs. These data indicate that (-)-morphine and M3G can activate CNS endothelial cells via TLR4, inducing proinflammatory, biochemical, morphological, and behavioral sequelae. CNS endothelial cells may have previously unanticipated roles in opioid-induced effects, in phenomena blocked by presumptive glial inhibitors, as well as TLR4-mediated phenomena more broadly.",0 +https://doi.org/10.1111/j.1745-3984.2005.00013.x,Increasing the Homogeneity of CAT's Item-Exposure Rates by Minimizing or Maximizing Varied Target Functions While Assembling Shadow Tests,"A computerized adaptive testing (CAT) algorithm that has the potential to increase the homogeneity of CAT's item-exposure rates without significantly sacrificing the precision of ability estimates was proposed and assessed in the shadow-test (van der Linden & Reese, 1998) CAT context. This CAT algorithm was formed by a combination of maximizing or minimizing varied target functions while assembling shadow tests. There were four target functions to be separately used in the first, second, third, and fourth quarter test of CAT. The elements to be used in the four functions were associated with (a) a random number assigned to each item, (b) the absolute difference between an examinee's current ability estimate and an item difficulty, (c) the absolute difference between an examinee's current ability estimate and an optimum item difficulty, and (d) item information. The results indicated that this combined CAT fully utilized all the items in the pool, reduced the maximum exposure rates, and achieved more homogeneous exposure rates. Moreover, its precision in recovering ability estimates was similar to that of the maximum item-information method. The combined CAT method resulted in the best overall results compared with the other individual CAT item-selection methods. The findings from the combined CAT are encouraging. Future uses are discussed.",0 +https://doi.org/10.1111/j.2044-8309.1995.tb01058.x,The theory of planned behaviour: The effects of perceived behavioural control and self-efficacy,"The present study was undertaken to assess the utility of the theory of planned behaviour, using separate measures of the two variables that are considered to comprise the notion of perceived behavioural control, namely, beliefs concerning the controllability of the behaviour and efficacy expectancies. The study was concerned with the prediction of intentions to engage in regular exercise (for at least 20 minutes, three times a week for a fortnight) and actual exercise behaviour. A sample of 146 undergraduate subjects participated in the study. It was prospective in design; measures of attitudes, norms, intentions, perceived control and self-efficacy were obtained at the first wave of data collection, while actual behaviour was assessed two weeks later. The results of the study revealed support for the view that separate measures of self-efficacy and perceived behavioural control should be employed in the theory of planned behaviour. In the first instance, confirmatory factor analysis revealed that the two variables could be empirically distinguished. Second, the effects of perceived behavioural control and self-efficacy on behavioural intentions and actual behaviour differed. As predicted, efficacy expectancies influenced behavioural intentions, but not actual behaviour. In contrast, levels of perceived behavioural control had no effect on behavioural intentions, but emerged as a significant (positive) predictor of actual behaviour (there was also evidence that the effects of intentions on behaviour were moderated by the level of perceived behavioural control).",0 +https://doi.org/10.1080/0022250x.1997.9990193,Consensus analysis of three‐way social network data,"Three‐way social network data occurs when every actor in a social network generates a digraph of the entire network. This paper presents a statistical model based on cultural consensus analysis for aggregating these separate digraphs into a single consensus digraph. In addition, the model allows estimation of separate hit and false alarm rates for each actor that can vary within each actor in different regions of the digraph. Several standard signal detection models are used to interpret the hit and false alarm parameters in terms of knowledge and response bias. A published three‐way data set by Kumbasar, Romney, and Batchelder (American Journal of Sociology, 1994) is analyzed, and the model reveals that both response bias and knowledge decrease with distance from ego.",0 +https://doi.org/10.1207/s15328007sem0904_8,How to Use a Monte Carlo Study to Decide on Sample Size and Determine Power,"A common question asked by researchers is, What sample size do I need for my study? Over the years, several rules of thumb have been proposed. In reality there is no rule of thumb that applies to all situations. The sample size needed for a study depends on many factors, including the size of the model, distribution of the variables, amount of missing data, reliability of the variables, and strength of the relations among the variables. The purpose of this article is to demonstrate how substantive researchers can use a Monte Carlo study to decide on sample size and determine power. Two models are used as examples, a confirmatory factor analysis (CFA) model and a growth model. The analyses are carried out using the Mplus program (Muthen& Muthen 1998).",0 +https://doi.org/10.1007/bf02294170,"The effect of sampling error on convergence, improper solutions, and goodness-of-fit indices for maximum likelihood confirmatory factor analysis","A Monte Carlo study assessed the effect of sampling error and model characteristics on the occurrence of nonconvergent solutions, improper solutions and the distribution of goodness-of-fit indices in maximum likelihood confirmatory factor analysis. Nonconvergent and improper solutions occurred more frequently for smaller sample sizes and for models with fewer indicators of each factor. Effects of practical significance due to sample size, the number of indicators per factor and the number of factors were found for GFI, AGFI, and RMR, whereas no practical effects were found for the probability values associated with the chi-square likelihood ratio test. © 1984 The Psychometric Society.",0 +https://doi.org/10.1016/j.cct.2012.05.004,Comparison of methods for estimating the intraclass correlation coefficient for binary responses in cancer prevention cluster randomized trials,"The intraclass correlation coefficient (ICC) is a fundamental parameter of interest in cluster randomized trials as it can greatly affect statistical power. We compare common methods of estimating the ICC in cluster randomized trials with binary outcomes, with a specific focus on their application to community-based cancer prevention trials with primary outcome of self-reported cancer screening. Using three real data sets from cancer screening intervention trials with different numbers and types of clusters and cluster sizes, we obtained point estimates and 95% confidence intervals for the ICC using five methods: the analysis of variance estimator, the Fleiss-Cuzick estimator, the Pearson estimator, an estimator based on generalized estimating equations and an estimator from a random intercept logistic regression model. We compared estimates of the ICC for the overall sample and by study condition. Our results show that ICC estimates from different methods can be quite different, although confidence intervals generally overlap. The ICC varied substantially by study condition in two studies, suggesting that the common practice of assuming a common ICC across all clusters in the trial is questionable. A simulation study confirmed pitfalls of erroneously assuming a common ICC. Investigators should consider using sample size and analysis methods that allow the ICC to vary by study condition.",0 +https://doi.org/10.1007/s00221-012-3354-7,Signal detection theory and vestibular perception: III. Estimating unbiased fit parameters for psychometric functions,"Psychophysics generally relies on estimating a subject's ability to perform a specific task as a function of an observed stimulus. For threshold studies, the fitted functions are called psychometric functions. While fitting psychometric functions to data acquired using adaptive sampling procedures (e.g., ""staircase"" procedures), investigators have encountered a bias in the spread (""slope"" or ""threshold"") parameter that has been attributed to the serial dependency of the adaptive data. Using simulations, we confirm this bias for cumulative Gaussian parametric maximum likelihood fits on data collected via adaptive sampling procedures, and then present a bias-reduced maximum likelihood fit that substantially reduces the bias without reducing the precision of the spread parameter estimate and without reducing the accuracy or precision of the other fit parameters. As a separate topic, we explain how to implement this bias reduction technique using generalized linear model fits as well as other numeric maximum likelihood techniques such as the Nelder-Mead simplex. We then provide a comparison of the iterative bootstrap and observed information matrix techniques for estimating parameter fit variance from adaptive sampling procedure data sets. The iterative bootstrap technique is shown to be slightly more accurate; however, the observed information technique executes in a small fraction (0.005 %) of the time required by the iterative bootstrap technique, which is an advantage when a real-time estimate of parameter fit variance is required.",0 +https://doi.org/10.1002/acp.3143,The Presence of a Weapon Shrinks the Functional Field of View,"Summary This study examined whether the functional field of view shrinks by the presence of a weapon or the increase of emotional arousal. In Experiment 1, participants viewed two types of pictures depicting scenes involving weapons or control objects and were asked to identify digits presented at the periphery when the pictures disappeared. The results showed that the presence of a weapon impaired identification of the peripheral digits, even when the pictures were equal with respect to emotional arousal level. In Experiment 2, participants viewed emotionally arousing pictures or neutral pictures, neither of which included weapons, and they were asked to identify digits presented at the periphery when the pictures disappeared. The results revealed that the increased emotional arousal did not impair identification of the peripheral digits. These results indicate that the functional field of view shrinks because of the presence of a weapon but not because of increased emotional arousal.Copyright © 2015 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1177/014662169802200406,A Method for Obtaining Standard Errors and Confidence Intervals of Composite Reliability for Congeneric Items,"A method for obtaining standard errors and confidence intervals of composite reliability co-efficients based on the bootstrap method is proposed. Using a structural equation modeling framework for estimating composite reliability of congeneric measures (Raykov, 1997), the approach takes repeated samples from a given sample and then estimates reliability. This approach extends earlier research on the distribution of scale reliability that is primarily concerned with Cronbach's coefficient alpha, and represents a general method based on fewer assumptions. It also permits testing hypotheses about composite reliability. Its use is demonstrated on simulated data.",0 +https://doi.org/10.1214/08-ba318rej,Rejoinder,"In the main article I presented a series of objections to Bayesian inference, written in the voice of a hypothetical anti-Bayesian statistician. Here I respond to these objections along with some other comments made by four discussants. © 2008 International Society for Bayesian Analysis.",0 +https://doi.org/10.1007/978-3-319-07503-7_21,Model Selection Criteria for Latent Growth Models Using Bayesian Methods,"Research in applied areas, such as statistical, psychological, behavioral, and educational areas, often involves the selection of the best available model from among a large set of candidate models. Considering that there is no well-defined model selection criterion in a Bayesian context and that latent growth mixture models are becoming popular in many areas, the goal of this study is to investigate the performance of a series of model selection criteria in the framework of latent growth mixture models with missing data and outliers in a Bayesian context. This study conducted five simulation studies to cover different cases, including latent growth curve models with missing data, latent growth curve models with missing data and outliers, growth mixture models with missing data and outliers, extended growth mixture models with missing data and outliers, and latent growth models with different classes. Simulation results show that almost all the proposed criteria can effectively identify the true models. This study also illustrated the application of these model selection criteria in real data analysis. The results will help inform the selection of growth models by researchers seeking to provide states with accurate estimates of the growth of their students. © Springer International Publishing Switzerland 2015.",0 +https://doi.org/10.1123/japa.14.1.74,The Effect of Aging and Tennis Playing on Coincidence-Timing Accuracy,"This study examined the effect of tennis playing on the coincidence timing (CT) of older adults. Young, younger-old and older-old (20–30, 60–69, and 70–79 years old, respectively) tennis players and nonplayers were asked to synchronize a simple response (pressing a button) with the arrival of a moving stimulus at a target. Results showed that the older tennis players responded with a slight bias similar to that of the young players. Two experiments were conducted to determine whether the elimination of age effects through tennis playing was a result of maintaining basic perceptuomotor and perceptual processes or of some possible compensation strategy. The results revealed that the age-related increase in the visuomotor delay was significantly correlated with CT performance in older nonplayers but not in older tennis players. These results suggest that playing tennis is beneficial to older adults, insofar as they remained as accurate as younger ones despite less efficient perceptuomotor processes. This supports the compensation hypothesis.",0 +https://doi.org/10.1348/096317909x476333,Job resources and flow at work: Modelling the relationship via latent growth curve and mixture model methodology,"The aim of the present three-wave follow-up study (n = 335) among employees of an employment agency was to investigate the association between job resources and work-related flow utilizing both variable- and person-oriented approaches. In addition, emotional exhaustion was studied as a moderator of the job resources–flow relationship, and as a predictor of the development of job resources and flow. The variable-oriented approach, based on latent growth curve analyses, revealed that the levels of job resources and flow at work, as well as changes in these variables, were positively associated with each other. The person-oriented inspection with the growth mixture modelling identified four trajectories based on the mean levels of job resources and flow and on the changes of these mean levels over time: (a) moderate work-related resources (n = 166), (b) declining work-related resources (n = 87), (c) high work-related resources (n = 46), and (d) low work-related resources (n = 36). Exhaustion was found to be an important predictor of job resources and flow, but it did not moderate their mutual association. Specifically, a low level of exhaustion was found to predict high levels of job resources and flow. Overall, these results suggest the importance of a person-oriented view of motivational processes at work. In addition, in order to fully understand positive motivational processes it seems important to investigate the role of negative well-being states as well.",0 +https://doi.org/10.3102/1076998615606109,A Multilevel CFA-MTMM Model for Nested Structurally Different Methods,"The numerous advantages of structural equation modeling (SEM) for the analysis of multitrait–multimethod (MTMM) data are well known. MTMM-SEMs allow researchers to explicitly model the measurement error, to examine the true convergent and discriminant validity of the given measures, and to relate external variables to the latent trait as well as the latent method factors in the model. According to Eid et al. (2008) different MTMM measurement designs require different types of MTMM-SEMs. Eid et al. (2008) proposed three different MTMM-SEMs for measurement designs with (a) structurally different methods, (b) interchangeable methods, and (c) a combination of both types of methods. In the present work, we extend this taxonomy to a multilevel correlated traits–correlated methods minus one [CTC(M − 1)] model for nested structurally different methods. The new model enables researchers to study method effects on both measurement levels (i.e., within and between clusters, classes, schools, etc.) and evaluate the convergent and discriminant validity of the measures. The statistical performance of the model is examined by a simulation study, and recommendations for the application of the model are given.",0 +https://doi.org/10.1186/1297-9686-44-10,Genetic evaluation of mastitis liability and recovery through longitudinal analysis of transition probabilities,"Many methods for the genetic analysis of mastitis use a cross-sectional approach, which omits information on, e.g., repeated mastitis cases during lactation, somatic cell count fluctuations, and recovery process. Acknowledging the dynamic behavior of mastitis during lactation and taking into account that there is more than one binary response variable to consider, can enhance the genetic evaluation of mastitis.Genetic evaluation of mastitis was carried out by modeling the dynamic nature of somatic cell count (SCC) within the lactation. The SCC patterns were captured by modeling transition probabilities between assumed states of mastitis and non-mastitis. A widely dispersed SCC pattern generates high transition probabilities between states and vice versa. This method can model transitions to and from states of infection simultaneously, i.e. both the mastitis liability and the recovery process are considered. A multilevel discrete time survival model was applied to estimate breeding values on simulated data with different dataset sizes, mastitis frequencies, and genetic correlations.Correlations between estimated and simulated breeding values showed that the estimated accuracies for mastitis liability were similar to those from previously tested methods that used data of confirmed mastitis cases, while our results were based on SCC as an indicator of mastitis. In addition, unlike the other methods, our method also generates breeding values for the recovery process.The developed method provides an effective tool for the genetic evaluation of mastitis when considering the whole disease course and will contribute to improving the genetic evaluation of udder health.",0 +https://doi.org/10.1007/s11336-013-9358-9,Nonlinear Random-Effects Mixture Models for Repeated Measures,"A mixture model for repeated measures based on nonlinear functions with random effects is reviewed. The model can include individual schedules of measurement, data missing at random, nonlinear functions of the random effects, of covariates and of residuals. Individual group membership probabilities and individual random effects are obtained as empirical Bayes predictions. Although this is a complicated model that combines a mixture of populations, nonlinear regression, and hierarchical models, it is straightforward to estimate by maximum likelihood using SAS PROC NLMIXED. Many different models can be studied with this procedure. The model is more general than those that can be estimated with most special purpose computer programs currently available because the response function is essentially any form of nonlinear regression. Examples and sample code are included to illustrate the method. © 2013 The Psychometric Society.",0 +https://doi.org/10.1080/00273171.2017.1306432,Bayesian SEM for Specification Search Problems in Testing Factorial Invariance,"Specification search problems refer to two important but under-addressed issues in testing for factorial invariance: how to select proper reference indicators and how to locate specific non-invariant parameters. In this study, we propose a two-step procedure to solve these issues. Step 1 is to identify a proper reference indicator using the Bayesian structural equation modeling approach. An item is selected if it is associated with the highest likelihood to be invariant across groups. Step 2 is to locate specific non-invariant parameters, given that a proper reference indicator has already been selected in Step 1. A series of simulation analyses show that the proposed method performs well under a variety of data conditions, and optimal performance is observed under conditions of large magnitude of non-invariance, low proportion of non-invariance, and large sample sizes. We also provide an empirical example to demonstrate the specific procedures to implement the proposed method in applied research. The importance and influences are discussed regarding the choices of informative priors with zero mean and small variances. Extensions and limitations are also pointed out.",0 +https://doi.org/10.1111/j.1744-6570.2001.tb00223.x,ESTIMATION OF SAMPLING VARIANCE OF CORRELATIONS IN META-ANALYSIS,"Monte Carlo simulations were conducted to compare the performance of the traditional (Fisher, 1954) and mean (Hunter & Schmidt, 1990) estimators of the sampling variance of correlations in meta-analysis. The mean estimator differs from the traditional estimator in that it uses the mean observed correlation, averaged across studies, in the sampling variance formula. The simulations investigated the homogeneous (i.e., no true correlation variance across studies) and heterogeneous case (i.e., true correlation variance across studies). Results reveal that, compared to the traditional estimator, the mean estimator provides less negatively biased estimates of sampling variance in the homogeneous and heterogeneous cases and more positively biased estimates in the heterogenous case. Thus, results support the use of the mean estimator unless strong, theory-based hypotheses regarding moderating effects exist.",0 +https://doi.org/10.1037//0022-3514.83.1.126,The statistical analysis of data from small groups.,"The authors elaborate the complications and the opportunities inherent in the statistical analysis of small-group data. They begin by discussing nonindependence of group members' scores and then consider standard methods for the analysis of small-group data and determine that these methods do not take into account this nonindependence. A new method is proposed that uses multilevel modeling and allows for negative nonindependence and mutual influence. Finally, the complications of interactions, different group sizes, and differential effects are considered. The authors strongly urge that the analysis model of data from small-group studies should mirror the psychological processes that generate those data.",0 +https://doi.org/10.1037//1082-989x.7.1.41,Multiphase mixed-effects models for repeated measures data.,"Behavior that develops in phases may exhibit distinctively different rates of change in one time period than in others. In this article, a mixed-effects model for a response that displays identifiable regimes is reviewed. An interesting component of the model is the change point. In substantive terms, the change point is the time when development switches from one phase to another. In a mixed-effects model, the change point can be a random coefficient. This possibility allows individuals to make the transition from one phase to another at different ages or after different lengths of time in treatment. Two examples are reviewed in detail, both of which can be estimated with software that is widely available.",0 +,Robust inference using weighted least squares and quadratic estimating equations in latent variable modeling with categorical and continuous outcomes,,0 +https://doi.org/10.1080/10705510903438872,Structural Equation Models of Latent Interactions: An Appropriate Standardized Solution and Its Scale-Free Properties,"Standardized parameter estimates are routinely used to summarize the results of multiple regression models of manifest variables and structural equation models of latent variables, because they facilitate interpretation. Although the typical standardization of interaction terms is not appropriate for multiple regression models, straightforward alternatives are well known (Aiken & West, 1991; Friedrich, 1982). Whereas the analogous problem exists for the estimation of latent interactions in structural equation modeling (SEM), the problem is more complex and apparently has not been resolved. Here we demonstrate that the appropriate “standardized” parameter estimates are easily formulated from parameter estimates routinely available from existing SEM software packages. Some properties of the appropriate “standardized” solution are mathematically derived, including the demonstration that the main and interaction effects are scale-free, as are the factor loadings. These desirable properties of the standardized...",0 +https://doi.org/10.1111/rssa.12022,Fitting multilevel multivariate models with missing data in responses and covariates that may include interactions and non-linear terms,"Summary The paper extends existing models for multilevel multivariate data with mixed response types to handle quite general types and patterns of missing data values in a wide range of multilevel generalized linear models. It proposes an efficient Bayesian modelling approach that allows missing values in covariates, including models where there are interactions or other functions of covariates such as polynomials. The procedure can also be used to produce multiply imputed complete data sets. A simulation study is presented as well as the analysis of a longitudinal data set. The paper also shows how existing multiprocess models for handling endogeneity can be extended by the framework proposed.",0 +https://doi.org/10.1097/ijg.0b013e31820bd1fd,Improved Prediction of Rates of Visual Field Loss in Glaucoma Using Empirical Bayes Estimates of Slopes of Change,"To describe and test a new methodology for estimation of rates of progressive visual field loss in glaucoma.This observational cohort study enrolled 643 eyes of 368 patients recruited from the Diagnostic Innovations in Glaucoma Study, followed for an average of 6.5±2.0 years. The visual field index was used to evaluate degree of visual field loss in standard automated perimetry. Growth mixture models were used to evaluate visual field index changes over time. Empirical Bayes estimates of best linear unbiased predictions (BLUPs) were used to obtain slopes of change based on the first 5 visual fields for each eye. These slopes were then used to predict future observations. The same procedure was done for ordinary least squares (OLS) estimates. The mean square error of the predictions was used to compare the predictive performance of the different methods.The growth mixture model successfully identified subpopulations of nonprogressors, slow, moderate, and fast progressors. The mean square error was significantly higher for OLS compared with the BLUP method (32.3 vs 13.9, respectively; P<0.001), indicating a better performance of the BLUP method to predict future observations. The benefit of BLUP predictions was especially evident in eyes with moderate and fast rates of change.Empirical Bayes estimates of rates of change performed significantly better than the commonly used technique of OLS regression in predicting future observations. Use of BLUP estimates should be considered when evaluating rates of functional change in glaucoma and predicting future impairment from the disease.",0 +https://doi.org/10.1093/biomet/76.3.622,Restricted unbiased iterative generalized least-squares estimation,SUMMARY It is shown that the iterative least-squares procedure for estimating the parameters in a general multilevel random coefficients linear model can be modified to produce unbiased estimates of the random parameters. In the multivariate normal case these are equivalent to restricted maximum likelihood estimates.,0 +https://doi.org/10.1007/bf02294110,Bayesian estimation in the two-parameter logistic model,"A Bayesian procedure is developed for the estimation of parameters in the two-parameter logistic item response model. Joint modal estimates of the parameters are obtained and procedures for the specification of prior information are described. Through simulation studies it is shown that Bayesian estimates of the parameters are superior to maximum likelihood estimates in the sense that they are (a) more meaningful since they do not drift out of range, and (b) more accurate in that they result in smaller mean squared differences between estimates and true values. © 1985 The Psychometric Society.",0 +https://doi.org/10.1080/15332660802508364,Does “Made in …” Also Apply to Services? An Empirical Assessment of the Country-of-Origin Effect in Service Settings,"ABSTRACT The country-of-origin (COO) effect is one of the most prominent phenomena in the field of international marketing. Its influence on consumer quality perception, as well as on purchase decision, is strongly supported by a notable amount of empirical work. However, despite the obvious managerial relevance, most COO studies have been conducted with respect to products, whereas the impact of COO in service settings is a woefully underresearched area. This article fills that void by using limit conjoint analysis to empirically test the role of COO effect for services in two experimental settings. Specifically, the study investigates how much the relative importance of COO changes if additional quality cues are available for the consumer. Results lend support for the relevance of COO effects for services and provide useful implications for ways to utilize COO effects in international services marketing.",0 +https://doi.org/10.1093/biomet/58.3.545,Recovery of inter-block information when block sizes are unequal,"SUMMARY A method is proposed for estimating intra-block and inter-block weights in the analysis of incomplete block designs with block sizes not necessarily equal. The method consists of maximizing the likelihood, not of all the data, but of a set of selected error contrasts. When block sizes are equal results are identical with those obtained by the method of Nelder (1968) for generally balanced designs. Although mainly concerned with incomplete block designs the paper also gives in outline an extension of the modified maximum likelihood procedure to designs with a more complicated block structure. In this paper we consider the estimation of weights to be used in the recovery of interblock information in incomplete block designs with possibly unequal block sizes. The problem can also be thought of as one of estimating constants and components of variance from data arranged in a general two-way classification when the effects of one classification are regarded as fixed and the effects of the second classification are regarded as random. Nelder (1968) described the efficient estimation of weights in generally balanced designs, in which the blocks are usually, although not always, of equal size. Lack of balance resulting from unequal block sizes is, however, common in some experimental work, for example in animal breeding experiments. The maximum likelihood procedure described by Hartley & Rao (1967) can be used but does not give the same estimates as Nelder's method in the balanced case. As will be shown, the two methods in effect use the same weighted sums of squares of residuals but assign different expectations. In the maximum likelihood approach, expectations are taken over a conditional distribution with the treatment effects fixed at their estimated values. In contrast Nelder uses unconditional expectations. The difference between the two methods is analogous to the well-known difference between two methods of estimating the variance o2 of a normal distribution, given a random sample of n values. Both methods use the same total sum of squares of deviations. But",0 +,Discovering statistics using SPSS for Windows.,"The book Discovering Statistics Using SPSS for Windows is exactly that! Since it calculates amazingly fast, in the recent years, the computer has become the most useful and helpful tool for the researchers in almost every field of knowledge be it open and distance education, psychology, sociology, management or else. Quality research not only depends on fair data collection techniques but also on the respectable treatment of that data. Once the data have been collected, what is most important is the storage of data, their fast and 'as it is' retrieval when required, and their proper processing and analyses. Computers are of immense help in all these operations. However, it is interesting to note that computer is just a tool and what it will vomit (or produce) depends entirely upon the fingers and mind of its operator (or the researcher in the research settings). The computer has no mind (up to now!). So, it is the researcher who should be held responsible for the unfair treatment of the data. Proper treatment of the research data not only requires research attitude but also research aptitude, and proficiency and a solid background in statistical treatment of the data. For this purpose, some good textbooks are available that explain statistical theory and techniques. And some other good textbooks are also there on the role of computers and statistical software (e.g. SPSS) in the practical application of these statistical procedures employed on the data through computers. Here, the present book by Andy Field is a rare and excellent combination of both statistical theory as well as statistical treatment of the data using SPSS under one umbrella.",0 +https://doi.org/10.1080/00273171.2012.673924,Estimating the Reliability of Aggregated and Within-Person Centered Scores in Ecological Momentary Assessment,"A procedure for estimating the reliability of test scores in the context of ecological momentary assessment (EMA) was proposed to take into account the characteristics of EMA measures. Two commonly used test scores in EMA were considered: the aggregated score (AGGS) and the within-person centered score (WPCS). Conceptually, AGGS and WPCS represent the interindividual differences and the intraindividual differences, respectively. The reliability coefficients for AGGS and WPCS were derived using a multilevel factor model with a serial correlation structure framework. Point estimates and confidence intervals of these coefficients were obtained using Mx ( Neale, Boker, Xie, & Maes, 2004 ). A simulation study showed that the proposed procedure performed well empirically. Diary data from Huang (2009) , which recorded daily joy level of 110 undergraduate students for 8 days, was used to illustrate the applicability of the proposed method.",0 +https://doi.org/10.1214/aos/1176345010,Empirical Bayes Estimation of the Multivariate Normal Covariance Matrix,"Let $\mathbf{S}_{p \times p}$ have a Wishart distribution with scale matrix $\Sigma$ and $k$ degrees of freedom. Estimators of $\Sigma$ are given for each of the loss functions $L_1(\hat{\Sigma}, \Sigma) = \operatorname{tr} (\hat{\Sigma}\Sigma^{-1}) - \log \det (\hat{\Sigma}\Sigma^{-1}) - p$ and $L_2(\hat{\Sigma}, \Sigma) = \operatorname{tr} (\hat{\Sigma}\Sigma^{-1} - I)^2$. The obvious estimators of $\Sigma$ are the scalar multiples of $\mathbf{S}$, i.e., $a\mathbf{S}$ where $0 < a \leqslant 1/k$. (Recall that $(1/k)\mathbf{S}$ is unbiased.) For each problem $(\Sigma, \hat{\Sigma}, L_i), i = 1, 2$, we provide empirical Bayes estimators which dominate $a\mathbf{S}$ by a substantial amount. It is seen that the uniform reduction in the risk function determined by $L_2$ is at least $100(p + 1)/(k + p + 1){\tt\%}$. Dominance results for $L_1$ and $L_2$ were first given by James and Stein.",0 +https://doi.org/10.1177/01466216970212004,Implementation of Marginal Bayesian Estimation with Four-Parameter Beta Prior Distributions,"Item parameter estimation for the threeparameter logistic model (3PLM) is sometimes problematic. The estimation algorithm of the 3PLM maximum likelihood estimation procedure often fails, which results in invalid parameter estimates. A procedure based on the marginal Bayesian estimation method introduced by Bock & Aitkin (1981), Swaminathan & Gifford (1985, 1986), and Mislevy & Bock (1990) is proposed here to improve the item parameter estimates for the 3PLM. Four-parameter beta distributions are used as prior distributions for estimating item parameters. A computer simulation study suggested that implementing the marginal Bayesian estimation algorithm with four-parameter beta prior distributions and then updating the priors with empirical means of the updated intermediate estimates can improve item parameter estimation when accurate prior information about the unknown parameters is not available.",0 +,Applications of ideal point approaches to scale construction and scoring in personality measurement: The development of a six-faceted measure of conscientiousness.,,0 +https://doi.org/10.1177/0013164414527448,Maximum Likelihood Item Easiness Models for Test Theory Without an Answer Key,Cultural consensus theory (CCT) is a data aggregation technique with many applications in the social and behavioral sciences. We describe the intuition and theory behind a set of CCT models for continuous type data using maximum likelihood inference methodology. We describe how bias parameters can be incorporated into these models. We introduce two extensions to the basic model in order to account for item rating easiness/difficulty. The first extension is a multiplicative model and the second is an additive model. We show how the multiplicative model is related to the Rasch model. We describe several maximum-likelihood estimation procedures for the models and discuss issues of model fit and identifiability. We describe how the CCT models could be used to give alternative consensus-based measures of reliability. We demonstrate the utility of both the basic and extended models on a set of essay rating data and give ideas for future research.,0 +https://doi.org/10.1016/j.csda.2005.02.008,MCMC algorithms for constrained variance matrices,The problem of finding a generic algorithm for applying Markov chain Monte Carlo (MCMC) estimation procedures to statistical models that include variance matrices with additional parameter constraints is considered. Such problems can be split between additional constraints across variance matrices and within variance matrices. The case of additional constraints across variance matrices is considered here for the first time and a review of existing work on the case of additional parameter constraints within a variance matrix is given. Two simple single-site updating random walk Metropolis algorithms are described which have the advantage of generality in that they can be applied to virtually all scenarios. Four applications where these methods can be used in practice are given. Some situations when such single-site algorithms break down are described and multiple-site alternatives are briefly discussed.,0 +https://doi.org/10.1007/978-0-387-35768-3,Finite Mixture and Markov Switching Models,"WINNER OF THE 2007 DEGROOT PRIZE! The prominence of finite mixture modelling is greater than ever. Many important statistical topics like clustering data, outlier treatment, or dealing with unobserved heterogeneity involve finite mixture models in some way or other. The area of potential applications goes beyond simple data analysis and extends to regression analysis and to non-linear time series analysis using Markov switching models. For more than the hundred years since Karl Pearson showed in 1894 how to estimate the five parameters of a mixture of two normal distributions using the method of moments, statistical inference for finite mixture models has been a challenge to everybody who deals with them. In the past ten years, very powerful computational tools emerged for dealing with these models which combine a Bayesian approach with recent Monte simulation techniques based on Markov chains. This book reviews these techniques and covers the most recent advances in the field, among them bridge sampling techniques and reversible jump Markov chain Monte Carlo methods. It is the first time that the Bayesian perspective of finite mixture modelling is systematically presented in book form. It is argued that the Bayesian approach provides much insight in this context and is easily implemented in practice. Although the main focus is on Bayesian inference, the author reviews several frequentist techniques, especially selecting the number of components of a finite mixture model, and discusses some of their shortcomings compared to the Bayesian approach. The aim of this book is to impart the finite mixture and Markov switching approach to statistical modelling to a wide-ranging community. This includes not only statisticians, but also biologists, economists, engineers, financial agents, market researcher, medical researchers or any other frequent user of statistical models. This book should help newcomers to the field to understand how finite mixture and Markov switching models are formulated, what structures they imply on the data, what they could be used for, and how they are estimated. Researchers familiar with the subject also will profit from reading this book. The presentation is rather informal without abandoning mathematical correctness. Previous notions of Bayesian inference and Monte Carlo simulation are useful but not needed.",0 +https://doi.org/10.1037/met0000065,Improving transparency and replication in Bayesian statistics: The WAMBS-Checklist.,"Bayesian statistical methods are slowly creeping into all fields of science and are becoming ever more popular in applied research. Although it is very attractive to use Bayesian statistics, our personal experience has led us to believe that naively applying Bayesian methods can be dangerous for at least 3 main reasons: the potential influence of priors, misinterpretation of Bayesian features and results, and improper reporting of Bayesian results. To deal with these 3 points of potential danger, we have developed a succinct checklist: the WAMBS-checklist (When to worry and how to Avoid the Misuse of Bayesian Statistics). The purpose of the questionnaire is to describe 10 main points that should be thoroughly checked when applying Bayesian analysis. We provide an account of ""when to worry"" for each of these issues related to: (a) issues to check before estimating the model, (b) issues to check after estimating the model but before interpreting results, (c) understanding the influence of priors, and (d) actions to take after interpreting results. To accompany these key points of concern, we will present diagnostic tools that can be used in conjunction with the development and assessment of a Bayesian model. We also include examples of how to interpret results when ""problems"" in estimation arise, as well as syntax and instructions for implementation. Our aim is to stress the importance of openness and transparency of all aspects of Bayesian estimation, and it is our hope that the WAMBS questionnaire can aid in this process. (PsycINFO Database Record",0 +,Combining estimates of effect size.,,0 +https://doi.org/10.1111/j.1540-5907.2008.00352.x,Economic Inequality and Intolerance: Attitudes toward Homosexuality in 35 Democracies,"Using hierarchical linear models fitted to data from the World Values Survey and national statistics for 35 countries, this article builds on the postmaterialist thesis by assessing the impact of economic inequality across and within nations on attitudes toward homosexuality. It provides evidence that tolerance tends to decline as national income inequality rises. For professionals and managers, the results also support the postmaterialist argument that economic development leads to more tolerant attitudes. On the other hand, attitudes of the working class are generally less tolerant, and contrary to expectations of the postmaterialist thesis, are seemingly unaffected by economic development. In other words, economic development influences attitudes only for those who benefit most. These findings have political implications, suggesting that state policies that have the goal of economic growth but fail to consider economic inequality may contribute to intolerant social and political values, an attribute widely considered detrimental for the health of democracy. I nglehart’s (1987, 1990, 1997) postmaterialist thesis suggests that liberal values result from democracy, economic development, and modernization. Important to this argument is the idea that the prosperity of modern societies allows people to shift their attentionfrommaterialconcernstoso-called“postmaterialist” concerns, such as social issues and self-expression. This shift to postmaterialist values allegedly results in greater social tolerance. Moreover, by focusing on average value differences across country and time, the postmaterialist thesis implies that economic prosperity affects the attitudes of citizens in all economic positions within a given nationinmuchthesameway.Althoughinequalitywithin nationsisnotentirelydiscounted,thetheoryassumesthat once economic development reaches a particularly high level, inequality lessens to the point that it no longer influences values (Inglehart 1987). The present research takes issue with the assumption that national economic prosperity affects all members within a nation in a similar manner. Given the vast differences in economic conditions and life chances according to income group, social class, and occupation, even within rich democracies, it is not controversial to argue",0 +https://doi.org/10.1111/j.1467-985x.2008.00593.x,Multivariate meta-analysis: the effect of ignoring within-study correlation,"Summary. Multivariate meta-analysis allows the joint synthesis of summary estimates from multiple end points and accounts for their within-study and between-study correlation. Yet practitioners usually meta-analyse each end point independently. I examine the role of within-study correlation in multivariate meta-analysis, to elicit the consequences of ignoring it. Using analytic reasoning and a simulation study, the within-study correlation is shown to influence the ‘borrowing of strength’ across end points, and wrongly ignoring it gives meta-analysis results with generally inferior statistical properties; for example, on average it increases the mean-square error and standard error of pooled estimates, and for non-ignorable missing data it increases their bias. The influence of within-study correlation is only negligible when the within-study variation is small relative to the between-study variation, or when very small differences exist across studies in the within-study covariance matrices. The findings are demonstrated by applied examples within medicine, dentistry and education. Meta-analysts are thus encouraged to account for the correlation between end points. To facilitate this, I conclude by reviewing options for multivariate meta-analysis when within-study correlations are unknown; these include obtaining individual patient data, using external information, performing sensitivity analyses and using alternatively parameterized models.",0 +https://doi.org/10.1007/bf02294318,Bayesian estimation and testing of structural equation models,"The Gibbs sampler can be used to obtain samples of arbitrary size from the posterior distribution over the parameters of a structural equation model (SEM) given covariance data and a prior distribution over the parameters. Point estimates, standard deviations and interval estimates for the parameters can be computed from these samples. If the prior distribution over the parameters is uninformative, the posterior is proportional to the likelihood, and asymptotically the inferences based on the Gibbs sample are the same as those based on the maximum likelihood solution, for example, output from LISREL or EQS. In small samples, however, the likelihood surface is not Gaussian and in some cases contains local maxima. Nevertheless, the Gibbs sample comes from the correct posterior distribution over the parameters regardless of the sample size and the shape of the likelihood surface. With an informative prior distribution over the parameters, the posterior can be used to make inferences about the parameters of underidentified models, as we illustrate on a simple errors-in-variables model.",0 +https://doi.org/10.1111/bmsp.12058,Latent growth curve analysis with dichotomous items: Comparing four approaches,"A Monte Carlo study was used to compare four approaches to growth curve analysis of subjects assessed repeatedly with the same set of dichotomous items: A two-step procedure first estimating latent trait measures using MULTILOG and then using a hierarchical linear model to examine the changing trajectories with the estimated abilities as the outcome variable; a structural equation model using modified weighted least squares (WLSMV) estimation; and two approaches in the framework of multilevel item response models, including a hierarchical generalized linear model using Laplace estimation, and Bayesian analysis using Markov chain Monte Carlo (MCMC). These four methods have similar power in detecting the average linear slope across time. MCMC and Laplace estimates perform relatively better on the bias of the average linear slope and corresponding standard error, as well as the item location parameters. For the variance of the random intercept, and the covariance between the random intercept and slope, all estimates are biased in most conditions. For the random slope variance, only Laplace estimates are unbiased when there are eight time points.",0 +https://doi.org/10.1007/s00221-013-3738-3,The role of spatiotemporal and spectral cues in segregating short sound events: evidence from auditory Ternus display,"Previous studies using auditory sequences with rapid repetition of tones revealed that spatiotemporal cues and spectral cues are important cues used to fuse or segregate sound streams. However, the perceptual grouping was partially driven by the cognitive processing of the periodicity cues of the long sequence. Here, we investigate whether perceptual groupings (spatiotemporal grouping vs. frequency grouping) could also be applicable to short auditory sequences, where auditory perceptual organization is mainly subserved by lower levels of perceptual processing. To find the answer to that question, we conducted two experiments using an auditory Ternus display. The display was composed of three speakers (A, B and C), with each speaker consecutively emitting one sound consisting of two frames (AB and BC). Experiment 1 manipulated both spatial and temporal factors. We implemented three 'within-frame intervals' (WFIs, or intervals between A and B, and between B and C), seven 'inter-frame intervals' (IFIs, or intervals between AB and BC) and two different speaker layouts (inter-distance of speakers: near or far). Experiment 2 manipulated the differentiations of frequencies between two auditory frames, in addition to the spatiotemporal cues as in Experiment 1. Listeners were required to make two alternative forced choices (2AFC) to report the perception of a given Ternus display: element motion (auditory apparent motion from sound A to B to C) or group motion (auditory apparent motion from sound 'AB' to 'BC'). The results indicate that the perceptual grouping of short auditory sequences (materialized by the perceptual decisions of the auditory Ternus display) was modulated by temporal and spectral cues, with the latter contributing more to segregating auditory events. Spatial layout plays a less role in perceptual organization. These results could be accounted for by the 'peripheral channeling' theory. © 2013 Springer-Verlag Berlin Heidelberg.",0 +https://doi.org/10.1080/00220970109599492,Using Multilevel Modeling in Large-Scale Planned Variation Educational Experiments: Improving Understanding of Intervention Effects,"The author shows how one can combine a large-scale planned variation experimental design and multilevel analysis to address research questions that go beyond the issue of overall treatment effectiveness. In particular, the design and analysis approach presented here can address the following research questions: how an educational intervention produces its results, for whom the intervention works, and whether the intervention works well across different contexts. The author used data based on a large-scale educational field experiment to describe multilevel models that one can use to address this set of research questions. Important design and analysis considerations are highlighted, especially with regard to assessing the impact of school-level characteristics.",0 +https://doi.org/10.1121/1.406696,A maximum‐likelihood method for estimating thresholds in a yes–no task,"A maximum-likelihood procedure for estimating threshold values in a yes-no task is presented. In computer simulations of this procedure, it is demonstrated that the variability of the threshold estimates is little affected by the density of the hypotheses tested for a fixed range, or by serious misestimates of the slope of the psychometric functions. The threshold value is also largely independent of the starting value of the signal. The standard deviation of the threshold estimates appears to decrease with the square root of the number of trials, with a 2- to 3-dB standard deviation possible if only 12 trials are used in the threshold estimates. Data are presented using human listeners tested on 5 days. Two threshold estimates, based on 12 trials, were made at each of the six audiometric frequencies on each day. The mean data appear sensible, and the standard deviation of the measured thresholds is about 3 dB. Using this procedure, it takes less than 3 min to measure the audiogram for a single ear.",0 +https://doi.org/10.1002/sim.5745,Bayesian multivariate meta-analysis with multiple outcomes,"There has been a recent growth in developments of multivariate meta-analysis. We extend the methodology of Bayesian multivariate meta-analysis to the situation when there are more than two outcomes of interest, which is underexplored in the current literature. Our objective is to meta-analyse summary data from multiple outcomes simultaneously, accounting for potential dependencies among the data. One common issue is that studies do not all report all of the outcomes of interests, and we take an approach relying on marginal modelling of only the reported data. We employ a separation prior for the between-study variance-covariance matrix, which offers an improvement on the conventional inverse-Wishart prior, showing robustness in estimation and flexibility in incorporating prior information. Particular challenges arise when the number of outcomes is large relative to the number of studies because the number of parameters in the variance-covariance matrix can become substantial and there can be very little information with which to estimate between-study correlation coefficients. We explore assumptions that reduce the number of parameters in this matrix, including assumptions of homogenous variances, homogenous correlations for certain outcomes and positive correlation coefficients. We illustrate the methods with an example data set from the Cochrane Database of Systematic Reviews.",0 +https://doi.org/10.1080/00273170902949719,The Effects of Educational Diversity in a National Sample of Law Students: Fitting Multilevel Latent Variable Models in Data With Categorical Indicators,"Controversy surrounding the use of race-conscious admissions can be partially resolved with improved empirical knowledge of the effects of racial diversity in educational settings. We use a national sample of law students nested in 64 law schools to test the complex and largely untested theory regarding the effects of educational diversity on student outcomes. Social scientists who study these outcomes frequently encounter both latent variables and nested data within a single analysis. Yet, until recently, an appropriate modeling technique has been computationally infeasible, and consequently few applied researchers have estimated appropriate models to test their theories, sometimes limiting the scope of their research question. Our results, based on disaggregated multilevel structural equation models, show that racial diversity is related to a reduction in prejudiced attitudes and increased perceived exposure to diverse ideas and that these effects are mediated by more frequent interpersonal contact with diverse peers. These findings provide support for the idea that administrative manipulation of educational diversity may lead to improved student outcomes. Admitting a racially/ethnically diverse student body provides an educational experience that encourages increased exposure to diverse ideas and belief systems.",0 +https://doi.org/10.1037/a0020511,Rational approximations to rational models: Alternative algorithms for category learning.,"Rational models of cognition typically consider the abstract computational problems posed by the environment, assuming that people are capable of optimally solving those problems. This differs from more traditional formal models of cognition, which focus on the psychological processes responsible for behavior. A basic challenge for rational models is thus explaining how optimal solutions can be approximated by psychological processes. We outline a general strategy for answering this question, namely to explore the psychological plausibility of approximation algorithms developed in computer science and statistics. In particular, we argue that Monte Carlo methods provide a source of rational process models that connect optimal solutions to psychological processes. We support this argument through a detailed example, applying this approach to Anderson's (1990, 1991) rational model of categorization (RMC), which involves a particularly challenging computational problem. Drawing on a connection between the RMC and ideas from nonparametric Bayesian statistics, we propose 2 alternative algorithms for approximate inference in this model. The algorithms we consider include Gibbs sampling, a procedure appropriate when all stimuli are presented simultaneously, and particle filters, which sequentially approximate the posterior distribution with a small number of samples that are updated as new data become available. Applying these algorithms to several existing datasets shows that a particle filter with a single particle provides a good description of human inferences.",0 +,"The Common Structure of Statistical Models of Truncation, Sample Selection and Limited Dependent Variables and a Simple Estimator for Such Models",,0 +https://doi.org/10.1016/j.prevetmed.2013.10.009,"Temporal associations between low body condition, lameness and milk yield in a UK dairy herd","Previous work has hypothesised that cows in low body condition become lame. We tested this in a prospective longitudinal study. Body condition score (BCS), causes of lameness and milk yield were collected from a 600-cow herd over 44-months. Mixed effect binomial models and a continuous outcome model were used to investigate the associations between lameness, BCS and milk yield. In total, 14,320 risk periods were obtained from 1137 cows. There were 1510 lameness treatments: the most common causes of lameness were sole ulcer (SU) (39%), sole haemorrhage (SH) (13%), digital dermatitis (DD) (10%) and white line disease (WLD) (8%). These varied by year and year quarter. Body condition was scored at 60-day intervals. BCS ranged from 1 to 5 with a mean of 2.5, scores were higher in very early lactation but varied widely throughout lactation; approximately 45% of scores were <2.5. The key finding was that BCS<2.5 was associated with an increased risk of treatment for lameness in the following 0-2 months and >2-4 months for all causes of lameness and also specifically for SU/WLD lameness. BCS<2.5 was associated with an increased risk of treatment for SH in the following 0-2 months but not >2-4 months. There was no such association with DD. All lameness, SU/WLD, SH and DD were significantly more likely to occur in cows that had been lame previously, but the effect of BCS was present even when all repeat cases of lameness were excluded from the analysis. Milk yield was significantly higher and fell in the month before treatment in cows lame with SU/WLD but it was not significantly higher for cows that were treated for DD compared with non-lame cows. These findings support the hypothesis that low BCS contributes to the development of horn related claw lameness but not infectious claw diseases in dairy cows. One link between low BCS and lameness is a thin digital cushion which has been proposed as a trigger for claw horn disease. Cows with BCS 2 produced more milk than cows with BCS 2.5, however, this was only approximately 100 kg difference in yield over a 305-day lactation. Given the increased risk of lameness in cows with BCS 2, the direct costs of lameness and the small variability in milk yield by BCS, preventing cows from falling to BCS<2.5 would improve cow welfare and be economically beneficial.",0 +https://doi.org/10.1037/0033-2909.96.1.201,Estimating the nonlinear and interactive effects of latent variables.,"Describes a procedure that enables researchers to estimate nonlinear and interactive effects of latent variables in structural equation models. Given that the latent variables are normally distributed, the parameters of such models can be estimated. To do this, products of the measured variables are used as indicators of latent product variables. Estimation must be done using a procedure that allows nonlinear constraints on parameters. The procedure is demonstrated in 3 examples. The 1st 2 examples use artificial data with known parameter values. These parameters are successfully recovered by the procedure. The final complex example uses national election survey data. (14 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1984 American Psychological Association.",0 +https://doi.org/10.1185/03007995.2015.1135110,Network meta-analysis of treatments for type 2 diabetes mellitus following failure with metformin plus sulfonylurea,"Aims The efficacy and safety of sodium-glucose linked transporters (SGLT2s) plus metformin and a sulfonylurea (MET + SU) for the treatment of type 2 diabetes mellitus (T2DM) in patients who fail to achieve glycemic control with MET + SU, relative to other triple therapies licensed in the EU, were estimated. Methods A systematic literature review and network meta-analysis (NMA) of randomized controlled trials (RCTs) involving anti-diabetes treatments added to MET + SU were conducted.Of 2236 abstracts identified through a systematic literature review, 30 RCTs published between 2003 and 2013 were included. RCTs ranged from 12 to 52 weeks in duration, included 28 to 1274 patients, were of parallel design, and most were open-label. Comparators included placebo (reference treatment), SGLT2 inhibitors, dipeptidyl peptidase-4 (DPP-4) inhibitors, thiazolidinediones (TZDs), alpha-glucosidase inhibitors (AGIs), meglitinides, glucagon-like peptide 1 (GLP-1) analogues, and basal, bolus, and biphasic insulin, all added on to MET + SU, as well as basal and biphasic insulin added to MET and monotherapy. The mean change (%) in HbA1c levels compared to placebo was -0.86 for SGLT2 inhibitors, -0.68 for DPP-4 inhibitors, -0.93 for TZDs, and -1.07 for GLP-1 analogues, respectively. Only SGLT2 inhibitors and GLP-1 analogues led to a weight loss (-1.71 kg and -1.14 kg, respectively) and decrease in systolic blood pressure (SBP; -3.73 mmHg and -2.90 mmHg, respectively), while all other treatments showed either an increase or no changes in weight or SBP. Conclusion SGLT2 inhibitors are at least as effective as other classes of antidiabetic agents at controlling HbA1c levels, while providing the additional benefits of weight loss and reducing SBP. Additionally, since the risk of hypoglycemia is similar or reduced with SGLT2 inhibitors, patients do not have to trade off efficacy for tolerability. Similar findings were observed for GLP-1 analogues.",0 +https://doi.org/10.1080/02664763.2012.710896,A generalized Q–Q plot for longitudinal data,"Most biomedical research is carried out using longitudinal studies. The method of generalized estimating equations (GEEs) introduced by Liang and Zeger [Longitudinal data analysis using generalized linear models, Biometrika 73 (1986), pp. 13-22] and Zeger and Liang [Longitudinal data analysis for discrete and continuous outcomes, Biometrics 42 (1986), pp. 121-130] has become a standard method for analyzing non-normal longitudinal data. Since then, a large variety of GEEs have been proposed. However, the model diagnostic problem has not been explored intensively. Oh et al. [Modeldiagnostic plots for repeated measures data using the generalized estimating equations approach, Comput. Statist. Data Anal. 53 (2008), pp. 222-232] proposed residual plots based on the quantile-quantile (Q-Q) plots of the chi(2)-distribution for repeated-measures data using the GEE methodology. They considered the Pearson, Anscombe and deviance residuals. In this work, we propose to extend this graphical diagnostic using a generalized residual. A simulation study is presented as well as two examples illustrating the proposed generalized Q-Q plots.",0 +https://doi.org/10.1590/1678-7153.201528302,Intrinsic Motivation Inventory: Psychometric Properties in the Context of First Language and Mathematics Learning,"Intrinsic Motivation Inventory (IMI) is a multidimensional measurement grounded on the Self-Determination Theory (SDT) used in assessing the subjective experiences of participants when developing an activity. The aim of this study is to analyze the characteristics of IMI among Portuguese students, testing four organizational models (unidimensional, multidimensional, hierarchical and bi-factor). A total of 3685 students from the 5th to the 12th grades (50.4% boys) participated in the study (M = 13.67, SD = 2.26). Two versions of IMI were used (First Language and Mathematics) with twenty-one items distributed over five subscales: Enjoyment, Perceived Competence, Pressure/Tension, Perceived Choice and Value/Utility. The confirmatory factor analysis corroborated the multidimensionality of intrinsic motivation, and that the bi-factor model presented the best fit indexes. This model showed the existence of one general factor, resulting from the contribution of all individual dimensions and the particularities of most of them. Furthermore, results also highlighted satisfactory reliability scores both through Cronbach's alpha scores and Composite reliability scores. These results indicate that this scale is appropriate to evaluate the underlying constructs of the theoretical model of SDT and allows for the calculation of a global measure of intrinsic motivation, as well as specific measures for their predictors.",0 +https://doi.org/10.1002/sim.2112,How vague is vague? A simulation study of the impact of the use of vague prior distributions in MCMC using WinBUGS,"There has been a recent growth in the use of Bayesian methods in medical research. The main reasons for this are the development of computer intensive simulation based methods such as Markov chain Monte Carlo (MCMC), increases in computing power and the introduction of powerful software such as WinBUGS. This has enabled increasingly complex models to be fitted. The ability to fit these complex models has led to MCMC methods being used as a convenient tool by frequentists, who may have no desire to be fully Bayesian. Often researchers want 'the data to dominate' when there is no prior information and thus attempt to use vague prior distributions. However, with small amounts of data the use of vague priors can be problematic. The results are potentially sensitive to the choice of prior distribution. In general there are fewer problems with location parameters. The main problem is with scale parameters. With scale parameters, not only does one have to decide the distributional form of the prior distribution, but also whether to put the prior distribution on the variance, standard deviation or precision. We have conducted a simulation study comparing the effects of 13 different prior distributions for the scale parameter on simulated random effects meta-analysis data. We varied the number of studies (5, 10 and 30) and compared three different between-study variances to give nine different simulation scenarios. One thousand data sets were generated for each scenario and each data set was analysed using the 13 different prior distributions. The frequentist properties of bias and coverage were investigated for the between-study variance and the effect size. The choice of prior distribution was crucial when there were just five studies. There was a large variation in the estimates of the between-study variance for the 13 different prior distributions. With a large number of studies the choice of prior distribution was less important. The effect size estimated was not biased, but the precision with which it was estimated varied with the choice of prior distribution leading to varying coverage intervals and, potentially, to different statistical inferences. Again there was less of a problem with a larger number of studies. There is a particular problem if the between-study variance is close to the boundary at zero, as MCMC results tend to produce upwardly biased estimates of the between-study variance, particularly if inferences are based on the posterior mean. The choice of 'vague' prior distribution can lead to a marked variation in results, particularly in small studies. Sensitivity to the choice of prior distribution should always be assessed.",0 +https://doi.org/10.1037/0033-2909.119.1.166,Latent variable interaction and quadratic effect estimation: A two-step technique using structural equation analysis.,"The author proposes an alternative estimation technique for latent variable interactions and quadraties. Available techniques for specifying these variables in structural equation models require adding variables or constraint equations that can produce specification tedium and errors or estimation difficulties. The proposed technique avoids these difficulties and may be useful for EQS, LISREL 7, and LISREL 8 users. First, measurement parameters for indicator Ioadings and errors of linear latent variables are estimated in a measurement model that excludes the interaction and quadratic variables. Next, these estimates are used to calculate values for the indicator loadings and error variances ofthe interaction and quadratic latent variables. Then, these calculated values are specified as constants in the structural model containing the interaction and quadratic variables. Interaction and quadratic effects are routinely reported for categorical independent variables (i.e., in analysis of variance) frequently to aid in the interpretation of significant main effects. However, interaction and quadratic effects are less frequently reported for continuous independent variables.",0 +https://doi.org/10.1037/a0026728,"The effect of exposure duration on visual character identification in single, whole, and partial report.","The psychometric function of single-letter identification is typically described as a function of stimulus intensity. However, the effect of stimulus exposure duration on letter identification remains poorly described. This is surprising because the effect of exposure duration has played a central role in modeling performance in whole and partial report (Shibuya & Bundesen, 1988). Therefore, we experimentally investigated visual letter identification as a function of exposure duration. We compared the exponential, the gamma, and the Weibull psychometric functions, all with a temporal offset included, as well as the ex-Gaussian, the log-logistic, and finally the squared-logistic, which is a psychometric function that to our knowledge has not been described before. The log-logistic and the squared-logistic psychometric function fit well to experimental data. Also, we conducted an experiment to test the ability of the psychometric functions to fit single-letter identification data, at different stimulus contrast levels; also here the same psychometric functions prevailed. Finally, after insertion into Bundesen's Theory of Visual Attention (Bundesen, 1990), the same psychometric functions enable closer fits to data from a previous whole and partial report experiment.",0 +https://doi.org/10.1080/13506285.2013.844963,Environment sensitivity in hierarchical representations,,0 +https://doi.org/10.1093/ije/dys041,"Predicting the extent of heterogeneity in meta-analysis, using empirical data from the Cochrane Database of Systematic Reviews","Many meta-analyses contain only a small number of studies, which makes it difficult to estimate the extent of between-study heterogeneity. Bayesian meta-analysis allows incorporation of external evidence on heterogeneity, and offers advantages over conventional random-effects meta-analysis. To assist in this, we provide empirical evidence on the likely extent of heterogeneity in particular areas of health care.Our analyses included 14 886 meta-analyses from the Cochrane Database of Systematic Reviews. We classified each meta-analysis according to the type of outcome, type of intervention comparison and medical specialty. By modelling the study data from all meta-analyses simultaneously, using the log odds ratio scale, we investigated the impact of meta-analysis characteristics on the underlying between-study heterogeneity variance. Predictive distributions were obtained for the heterogeneity expected in future meta-analyses.Between-study heterogeneity variances for meta-analyses in which the outcome was all-cause mortality were found to be on average 17% (95% CI 10-26) of variances for other outcomes. In meta-analyses comparing two active pharmacological interventions, heterogeneity was on average 75% (95% CI 58-95) of variances for non-pharmacological interventions. Meta-analysis size was found to have only a small effect on heterogeneity. Predictive distributions are presented for nine different settings, defined by type of outcome and type of intervention comparison. For example, for a planned meta-analysis comparing a pharmacological intervention against placebo or control with a subjectively measured outcome, the predictive distribution for heterogeneity is a log-normal (-2.13, 1.58(2)) distribution, which has a median value of 0.12. In an example of meta-analysis of six studies, incorporating external evidence led to a smaller heterogeneity estimate and a narrower confidence interval for the combined intervention effect.Meta-analysis characteristics were strongly associated with the degree of between-study heterogeneity, and predictive distributions for heterogeneity differed substantially across settings. The informative priors provided will be very beneficial in future meta-analyses including few studies.",0 +https://doi.org/10.1177/0149206314551964,Improving the Meta-Analytic Assessment of Effect Size Variance With an Informed Bayesian Prior,"Meta-analytic estimation of effect size variance is critical for determining the degree to which a relationship or finding generalizes across contexts. In most meta-analyses, population effect size variability is estimated by subtracting expected sampling error variance from observed variance, using only information from a limited set of available studies. We propose an improved Bayesian variance estimation technique that incorporates findings from previous meta-analytic research through an informed prior distribution of likely levels of effect size variance. The logic of exchangeability as a conceptual foundation for using an informed prior is explicated. On the basis of Monte Carlo simulations, we find the traditional method of meta-analytic variance estimation the most biased and least accurate technique across all sizes of meta-analyses considered. The Bayesian methodology incorporating an informed prior proved to be the most accurate and overall least biased of all estimation methods. Conceptual advantages and limitations that must be taken into account when incorporating an informed prior to estimate variability of effect sizes in a meta-analysis are also discussed.",0 +https://doi.org/10.1186/1471-2288-14-103,Methods for calculating confidence and credible intervals for the residual between-study variance in random effects meta-regression models,"Meta-regression is becoming increasingly used to model study level covariate effects. However this type of statistical analysis presents many difficulties and challenges. Here two methods for calculating confidence intervals for the magnitude of the residual between-study variance in random effects meta-regression models are developed. A further suggestion for calculating credible intervals using informative prior distributions for the residual between-study variance is presented.Two recently proposed and, under the assumptions of the random effects model, exact methods for constructing confidence intervals for the between-study variance in random effects meta-analyses are extended to the meta-regression setting. The use of Generalised Cochran heterogeneity statistics is extended to the meta-regression setting and a Newton-Raphson procedure is developed to implement the Q profile method for meta-analysis and meta-regression. WinBUGS is used to implement informative priors for the residual between-study variance in the context of Bayesian meta-regressions.Results are obtained for two contrasting examples, where the first example involves a binary covariate and the second involves a continuous covariate. Intervals for the residual between-study variance are wide for both examples.Statistical methods, and R computer software, are available to compute exact confidence intervals for the residual between-study variance under the random effects model for meta-regression. These frequentist methods are almost as easily implemented as their established counterparts for meta-analysis. Bayesian meta-regressions are also easily performed by analysts who are comfortable using WinBUGS. Estimates of the residual between-study variance in random effects meta-regressions should be routinely reported and accompanied by some measure of their uncertainty. Confidence and/or credible intervals are well-suited to this purpose.",0 +https://doi.org/10.1093/ije/dyi312,Bayesian perspectives for epidemiological research: I. Foundations and basic methods,"One misconception (of many) about Bayesian analyses is that prior distributions introduce assumptions that are more questionable than assumptions made by frequentist methods; yet the assumptions in priors can be more reasonable than the assumptions implicit in standard frequentist models. Another misconception is that Bayesian methods are computationally difficult and require special software. But perfectly adequate Bayesian analyses can be carried out with common software for frequentist analysis. Under a wide range of priors, the accuracy of these approximations is just as good as the frequentist accuracy of the software--and more than adequate for the inaccurate observational studies found in health and social sciences. An easy way to do Bayesian analyses is via inverse-variance (information) weighted averaging of the prior with the frequentist estimate. A more general method expresses the prior distributions in the form of prior data or 'data equivalents', which are then entered in the analysis as a new data stratum. That form reveals the strength of the prior judgements being introduced and may lead to tempering of those judgements. It is argued that a criterion for scientific acceptability of a prior distribution is that it be expressible as prior data, so that the strength of prior assumptions can be gauged by how much data they represent.",0 +https://doi.org/10.3102/1076998610375835,On the Importance of Reliable Covariate Measurement in Selection Bias Adjustments Using Propensity Scores,"The effect of unreliability of measurement on propensity score (PS) adjusted treatment effects has not been previously studied. The authors report on a study simulating different degrees of unreliability in the multiple covariates that were used to estimate the PS. The simulation uses the same data as two prior studies. Shadish, Clark, and Steiner showed that a PS formed from many covariates demonstrably reduced selection bias, while Steiner, Cook, Shadish, and Clark identified the subsets of covariates from the larger set that were most effective for bias reduction. Adding different degrees of random error to these covariates in a simulation, the authors demonstrate that unreliability of measurement can degrade the ability of PSs to reduce bias. Specifically, increases in reliability only promote bias reduction, if the covariates are effective in reducing bias to begin with. Increasing or decreasing the reliability of covariates that do not effectively reduce selection bias makes no difference at all.",0 +https://doi.org/10.1037/a0035234,Factorial comparison of working memory models.,"Three questions have been prominent in the study of visual working memory limitations: (a) What is the nature of mnemonic precision (e.g., quantized or continuous)? (b) How many items are remembered? (c) To what extent do spatial binding errors account for working memory failures? Modeling studies have typically focused on comparing possible answers to a single one of these questions, even though the result of such a comparison might depend on the assumed answers to both others. Here, we consider every possible combination of previously proposed answers to the individual questions. Each model is then a point in a 3-factor model space containing a total of 32 models, of which only 6 have been tested previously. We compare all models on data from 10 delayed-estimation experiments from 6 laboratories (for a total of 164 subjects and 131,452 trials). Consistently across experiments, we find that (a) mnemonic precision is not quantized but continuous and not equal but variable across items and trials; (b) the number of remembered items is likely to be variable across trials, with a mean of 6.4 in the best model (median across subjects); (c) spatial binding errors occur but explain only a small fraction of responses (16.5% at set size 8 in the best model). We find strong evidence against all 6 documented models. Our results demonstrate the value of factorial model comparison in working memory.",0 +https://doi.org/10.1037/1082-989x.13.2.150,Constrained versus unconstrained estimation in structural equation modeling.,"Recently, R. D. Stoel, F. G. Garre, C. Dolan, and G. van den Wittenboer (2006) reviewed approaches for obtaining reference mixture distributions for difference tests when a parameter is on the boundary. The authors of the present study argue that this methodology is incomplete without a discussion of when the mixtures are needed and show that they only become relevant when constrained difference tests are conducted. Because constrained difference tests can hide important model misspecification, a reliable way to assess global model fit under constrained estimation would be needed. Examination of the options for assessing model fit under constrained estimation reveals that no perfect solutions exist, although the conditional approach of releasing a degree of freedom for each active constraint appears to be the most methodologically sound one. The authors discuss pros and cons of constrained and unconstrained estimation and their implementation in 5 popular structural equation modeling packages and argue that unconstrained estimation is a simpler method that is also more informative about sources of misfit. In practice, researchers will have trouble conducting constrained difference tests appropriately, as this requires a commitment to ignore Heywood cases. Consequently, mixture distributions for difference tests are rarely appropriate.",0 +https://doi.org/10.1002/sim.2423,Meta-analysis of heterogeneously reported trials assessing change from baseline,"This paper considers the quantitative synthesis of published comparative study results when the outcome measures used in the individual studies and the way in which they are reported varies between studies. Whilst the former difficulty may be overcome, at least to a limited extent, by the use of standardized effects, the latter is often more problematic. Two potential solutions to this problem are; sensitivity analyses and a fully Bayesian approach, in which pertinent external information is included. Both approaches are illustrated using the results of two systematic reviews and meta-analyses which consider the difference in mean change in systolic blood pressure and the difference in physical functioning between an intervention and control group. The two examples illustrate that by adopting a fully Bayesian approach, as opposed to undertaking sensitivity analyses assuming fixed values for unknown parameters, the overall intervention effect can be estimated with greater uncertainty, but that assessing the sensitivity of results to choice of prior distributions in such analyses is crucial.",0 +https://doi.org/10.2501/ijmr-2013-058,Reviews of Market Drivers of New Product Performance: Effects and Relationships,"This study adopts a meta-analytic approach to review the performance effects of the market predictors of new product performance and their structural relationships. Based on empirical findings from the relevant studies published before 2011, this study has a number of interesting findings. First, market orientation, competitor orientation, product advantage and launch proficiency are the dominant drivers of new product performance. Second, market orientation, marketing synergy, product advantage and competitive intensity have significant effects on new product performance. Third, product advantage serves as an important intermediary between the market predictors and new product performance. Fourth, product innovativeness per se does not affect new product performance. Finally, launch proficiency translates the effect of market orientation into new product performance. These findings not only identify the dominant market drivers of new product performance, but also profile the routes leading to better new product performance. Some important implications for market research and practice are also provided.",0 +https://doi.org/10.1080/00273171.2010.483387,Using a Multivariate Multilevel Polytomous Item Response Theory Model to Study Parallel Processes of Change: The Dynamic Association Between Adolescents' Social Isolation and Engagement With Delinquent Peers in the National Youth Survey,"The application of multidimensional item response theory models to repeated observations has demonstrated great promise in developmental research. It allows researchers to take into consideration both the characteristics of item response and measurement error in longitudinal trajectory analysis, which improves the reliability and validity of the latent growth curve (LGC) model. The purpose of this study is to demonstrate the potential of Bayesian methods and the utility of a comprehensive modeling framework, the one combining a measurement model (e.g., a multidimensional graded response model, MGRM) with a structural model (e.g., an associative latent growth curve analysis, ALGC). All analyses are implemented in WinBUGS 1.4.3 ( Spiegelhalter, Thomas, Best, & Lunn, 2003 ), which allows researchers to use Markov chain Monte Carlo simulation methods to fit complex statistical models and circumvent intractable analytic or numerical integrations. The utility of this MGRM-ALGC modeling framework was investigated with both simulated and empirical data, and promising results were obtained. As the results indicate, being a flexible multivariate multilevel model, this MGRM-ALGC model not only produces item parameter estimates that are readily estimable and interpretable but also estimates the corresponding covariation in the developmental dimensions. In terms of substantive interpretation, as adolescents perceived themselves more socially isolated, the chance that they are engaged with delinquent peers becomes profoundly larger. Generally, boys have a higher initial exposure extent than girls. However, there is no gender difference associated with other latent growth parameters.",0 +https://doi.org/10.1207/s15327906mb340203,Structural Equation Modeling with Small Samples: Test Statistics,"Structural equation modeling is a well-known technique for studying relationships among multivariate data. In practice, high dimensional nonnormal data with small to medium sample sizes are very common, and large sample theory, on which almost all modeling statistics are based, cannot be invoked for model evaluation with test statistics. The most natural method for nonnormal data, the asymptotically distribution free procedure, is not defined when the sample size is less than the number of nonduplicated elements in the sample covariance. Since normal theory maximum likelihood estimation remains defined for intermediate to small sample size, it may be invoked but with the probable consequence of distorted performance in model evaluation. This article studies the small sample behavior of several test statistics that are based on maximum likelihood estimator, but are designed to perform better with nonnormal data. We aim to identify statistics that work reasonably well for a range of small sample sizes and distribution conditions. Monte Carlo results indicate that Yuan and Bentler's recently proposed F-statistic performs satisfactorily.",0 +https://doi.org/10.1080/10705519809540105,Interactions of latent variables in structural equation models,"Interactions of variables occur in a variety of statistical analyses. The best known procedures for models with interactions of latent variables are technically demanding. Not only does the potential user need to be familiar with structural equation modeling (SEM), but the researcher must be familiar with programming nonlinear and linear constraints and must be comfortable with fairly large and complicated models. This article provides a largely nontechnical description of an alternative two‐stage least squares (2SLS) technique to include interactions of latent variables in SEM. The method requires the selection of instrumental variables and we give rules for their selection in the most common cases. We compare the 2SLS method to the alternatives. Some of the important advantages of the 2SLS are that it can handle nonnormal observed variables, is readily available in major statistical software packages, and has a known asymptotic distribution. In providing the comparisons, we reanalyze all the interaction...",0 +https://doi.org/10.1111/1467-985x.00283,A Bayesian approach to Markov modelling in cost-effectiveness analyses: application to taxane use in advanced breast cancer,"Summary. The paper demonstrates how cost-effectiveness decision analysis may be implemented from a Bayesian perspective, using Markov chain Monte Carlo simulation methods for both the synthesis of relevant evidence input into the model and the evaluation of the model itself. The desirable aspects of a Bayesian approach for this type of analysis include the incorporation of full parameter uncertainty, the ability to perform all the analysis, including each meta-analysis, in a single coherent model and the incorporation of expert opinion either directly or regarding the relative credibility of different data sources. The method is described, and its ease of implementation demonstrated, through a practical example to evaluate the cost-effectiveness of using taxanes for the second-line treatment of advanced breast cancer compared with conventional treatment. For completeness, the results from the Markov chain Monte Carlo simulation model are compared and contrasted with those from a classical Monte Carlo simulation model.",0 +https://doi.org/10.1214/ss/1032209662,R. A. Fisher and multivariate analysis,This paper reviews R. A. Fisher's many fundamental contri- butions to multivariate statistical analysis-from the derivation of the distribution of the sample correlation coefficient to discriminant analysis. The emphasis here is on the conceptual and mathematical development. All of his papers on multivariate analysis will be included in this survey.,0 +https://doi.org/10.1016/s0169-7161(05)25034-4,Bayesian Aspects of Small Area Estimation,"This chapter deals with the Bayesian aspects of small area estimation. It discusses only some aspects of small area estimation, particularly the model based EB and HB approach. Models play a major role in modern small area estimation. There are several advantages of model based inference over the traditional indirect estimators. EB produce approximate estimates whereas HB provides accurate estimates. For HB analysis, the standard Bayesian model diagnostics tools are applied so far. The chapter addresses the basic models, and mentions some extensions of those models. This chapter focuses mainly on empirical Bayes and hierarchical Bayes estimators related to small area models. The Bayes estimators are usually obtained under squared error loss. This chapter concludes that Empirical Bayes estimators are obtained as estimated posterior mean, while for hierarchical Bayes usually subjective prior distributions are assumed for the model parameters.",0 +https://doi.org/10.1167/12.6.25,The psychometric function: The lapse rate revisited,"In their influential paper, Wichmann and Hill (2001) have shown that the threshold and slope estimates of a psychometric function may be severely biased when it is assumed that the lapse rate equals zero but lapses do, in fact, occur. Based on a large number of simulated experiments, Wichmann and Hill claim that threshold and slope estimates are essentially unbiased when one allows the lapse rate to vary within a rectangular prior during the fitting procedure. Here, I replicate Wichmann and Hill's finding that significant bias in parameter estimates results when one assumes that the lapse rate equals zero but lapses do occur, but fail to replicate their finding that freeing the lapse rate eliminates this bias. Instead, I show that significant and systematic bias remains in both threshold and slope estimates even when one frees the lapse rate according to Wichmann and Hill's suggestion. I explain the mechanisms behind the bias and propose an alternative strategy to incorporate the lapse rate into psychometric function models, which does result in essentially unbiased parameter estimates.",0 +https://doi.org/10.3102/1076998607302626,Using Response Times for Item Selection in Adaptive Testing,"Response times on items can be used to improve item selection in adaptive testing provided that a probabilistic model for their distribution is available. In this research, the author used a hierarchical modeling framework with separate first-level models for the responses and response times and a second-level model for the distribution of the ability and speed parameters in the population of test takers. The framework allows the author to retrofit an empirical prior distribution for the ability parameter on each occurrence of a new response time. In an example with an adaptive version of the Law School Admission Test (LSAT), the author shows how this additional update of the posterior distribution of the ability leads to a substantial improvement of the ability estimator. Two ways of applying the procedure in real-world adaptive testing are discussed.",0 +https://doi.org/10.1007/bf02294554,Finite mixtures in confirmatory factor-analysis models,"In this paper, various types of finite mixtures of confirmatory factor-analysis models are proposed for handling data heterogeneity. Under the proposed mixture approach, observations are assumed to be drawn from mixtures of distinct confirmatory factor-analysis models. But each observation does not need to be identified to a particular model prior to model fitting. Several classes of mixture models are proposed. These models differ by their unique representations of data heterogeneity. Three different sampling schemes for these mixture models are distinguished. A mixed type of the these three sampling schemes is considered throughout this article. The proposed mixture approach reduces to regular multiple-group confirmatory factor-analysis under a restrictive sampling scheme, in which the structural equation model for each observation is assumed to be known. By assuming a mixture of multivariate normals for the data, maximum likelihood estimation using the EM (Expectation-Maximization) algorithm and the AS (Approximate-Scoring) method are developed, respectively. Some mixture models were fitted to a real data set for illustrating the application of the theory. Although the EM algorithm and the AS method gave similar sets of parameter estimates, the AS method was found computationally more efficient than the EM algorithm. Some comments on applying the mixture approach to structural equation modeling are made.",0 +https://doi.org/10.1080/14783360903492694,Rethinking perceived service quality: An alternative to hierarchical and multidimensional models,"Measuring perceived service quality continues to be a controversial topic in management literature. Brady and Cronin's (2001) hierarchical and multidimensional model overcame several limitations of previously proposed models. Nevertheless, Brady and Cronin's conceptualisation has been the object of substantial criticism. This research describes the most important limitations of the Brady and Cronin's (2001) model, pointing out some newly identified drawbacks to this kind of conceptualisation and to using the methodology for analysing service quality models. To overcome these shortcomings, a new procedure is proposed, based on the proper identification of service quality attributes and on the study of unobserved heterogeneity in customer perceptions. An application of this procedure to the insurance industry shows the possible advantages of using this method for studying perceived quality in services. The results of the empirical study confirm the presence of several latent classes formed by customers with...",0 +https://doi.org/10.1198/tast.2009.08140,Comparison of Software Algorithms for Calculating REML Wald Type Confidence Limits for the Between-Group Variance Component in a Small Sample One-Way Random Effects Model Example,"Confidence limits for variance components in mixed effects models can be readily estimated by procedures such as PROC MIXED (SAS®), MIXED (SPSS®), LME (S-PLUS®), and XTMIXED (Stata®). For a small sample unbalanced one-way random effects model case study, the REML Wald type confidence limits for the between-group variance obtained from PROC MIXED differ substantially from those from MIXED, LME, and XTMIXED. Simulations indicate that the Satterthwaite approximation used by PROC MIXED results in highly inflated confidence interval lengths, while the interval lengths from the other procedures are usually similar but also biased upward. The coverage rates of the confidence limits from all four procedures appear above the nominal value. Extreme upper limits and problems with computing the confidence limits are also possible, especially with PROC MIXED. In general, one should avoid the naive use of statistical software packages when estimating REML confidence limits for variance components with small datasets, a...",0 +https://doi.org/10.1007/bf02295737,A Bayesian analysis of finite mixtures in the LISREL model,"In this paper, we propose a Bayesian framework for estimating finite mixtures of the LISREL model. The basic idea in our analysis is to augment the observed data of the manifest variables with the latent variables and the allocation variables. The Gibbs sampler is implemented to obtain the Bayesian solution. Other associated statistical inferences, such as the direct estimation of the latent variables, establishment of a goodness-of-fit assessment for a posited model, Bayesian classification, residual and outlier analyses, are discussed. The methodology is illustrated with a simulation study and a real example.",0 +https://doi.org/10.1207/s15327906mbr3001_3,A Simulation Study of Mediated Effect Measures,"Analytical solutions for point and variance estimators of the mediated effect, the ratio of the mediated to the direct effect, and the proportion of the total effect that is mediated were studied with statistical simulations. We compared several approximate solutions based on the multivariate delta method and second order Taylor series expansions to the empirical standard deviation of each estimator and theoretical standard error when available. The simulations consisted of 500 replications of three normally distributed variables for eight sample sizes (N = 10, 25, 50, 100, 500, 1000, and 5000) and 64 parameter value combinations. The different solutions for the standard error of the indirect effect were very similar for sample sizes of at least 50, except when the independent variable was dichotomized. A sample size of at least 500 was needed for accurate point and variance estimates of the proportion mediated. The point and variance estimates of the ratio of the mediated to nonmediated effect did not stabilize until the sample size was 2,000 for the all continuous variable case. Implications for the estimation of mediated effects in experimental and nonexperimental studies are discussed.",0 +https://doi.org/10.1037/apl0000026,An item analysis of the Conditional Reasoning Test of Aggression.,"This manuscript uses item response theory (IRT) to estimate item characteristics of the Conditional Reasoning Test of Aggression (CRT-A). Using a sample size of 5,511 respondents, the present analysis provides an accurate assessment of the capability of the CRT-A to measure latent aggression. The one-parameter logistic (1PL) model, two-parameter logistic (2PL) model, and three-parameter logistic (3PL) model are compared before the item analysis. Results suggest that the 2PL model is the most appropriate dichotomous IRT model for describing the item characteristics of the CRT-A. Potential multdimensionality in the CRT-A is also examined. Results suggest that CRT-A items work as theoretically intended, with the probability of selecting an aggressive response increasing with latent trait levels. Information curves indicate that the CRT-A is best suited for use with individuals who are high on latent aggression. Exploratory analyses include an examination of polytomous IRT models and DIF comparing student and employee respondents. The results have implications for future research using the CRT-A as well as the identification of populations appropriate for measurement using this assessment tool.",0 +https://doi.org/10.1002/eat.10109,Healthy weight control and dissonance-based eating disorder prevention programs: Results from a controlled trial,"Because universal psychoeducational eating disorder prevention programs have had little success, we developed and evaluated two interventions for high-risk populations: a healthy weight control intervention and a dissonance-based intervention.Adolescent girls (N = 148) with body image concerns were randomized to one of these interventions or to a waitlist control group. Participants completed baseline, termination, and 1, 3, and 6-month follow-up surveys.Participants in both interventions reported decreased thin-ideal internalization, negative affect, and bulimic symptoms at termination and follow-up relative to controls. However, no effects were observed for body dissatisfaction or dieting and effects diminished over time.Results provide evidence that both interventions effectively reduce bulimic pathology and risk factors for eating disturbances.",0 +https://doi.org/10.3102/10769986030001059,Using Propensity Score Subclassification for Multiple Treatment Doses to Evaluate a National Antidrug Media Campaign,"In 1998, the U.S. Office of National Drug Control Policy launched a national media campaign in an effort to reduce and prevent drug use among young Americans. Because the campaign was implemented nationwide, there is no control group available for use in evaluating the effects of the campaign. Nevertheless, it is possible to use propensity score methods to evaluate the effects of the campaign. However, because teens receive varying degrees of exposure to the media campaign, it is necessary to apply propensity score methods that accommodate multiple treatment doses. This work extends that of previous authors to subclassification on the propensity score for observational studies with multiple treatment doses, rather than matching on the propensity score, and proposes modifications to accommodate complex survey data. This methodology is illustrated using data from a pilot study for the media campaign evaluation.",0 +https://doi.org/10.17705/1cais.03476,Bayesian Structural Equation Models for Cumulative Theory Building in Information Systems―A Brief Tutorial Using BUGS and R,"Structural equation models (SEM) are frequently used in information systems (IS) to analyze and test theoretical propositions. As IS researchers frequently reuse measurement instruments and adapt or extend theories, they frequently re-estimate regression relationships in their SEM that have been examined in previous studies. We advocate the use of Bayesian estimation of structural equation models as an aid to cumulative theory building; Bayesian statistics offer a statistically sound way to incorporate prior knowledge into SEM estimation, allowing researchers to keep a “running tally” of the best estimates of model parameters. This tutorial on the application of Bayesian principles to SEM estimation discusses when and why the use of Bayesian estimation should be considered by IS researchers, presents an illustrative example using best practices, and makes recommendations to guide IS researchers in the application of Bayesian SEM.",0 +https://doi.org/10.1016/j.jspi.2004.10.012,Discussion on the paper by Pardoe and Weidner,,0 +https://doi.org/10.1371/journal.pone.0091710,Joint Bayesian Inference Reveals Model Properties Shared between Multiple Experimental Conditions,"Statistical modeling produces compressed and often more easily interpretable descriptions of experimental data in form of model parameters. When experimental manipulations target selected parameters, it is necessary for their interpretation that other model components remain constant. For example, psychophysicists use dose rate models to describe how behavior changes as a function of a single stimulus variable. The main interest is on shifts of this function induced by experimental manipulation, assuming invariance in other aspects of the function. Combining several experimental conditions in a joint analysis that takes such invariance constraints into account can result in a complex model for which no robust standard procedures are available. We formulate a solution for the joint analysis through repeated applications of standard procedures by allowing an additional assumption. This way, experimental conditions can be analyzed separately such that all conditions are implicitly taken into account. We investigate the validity of the supplementary assumption through simulations. Furthermore, we present a natural way to check whether a joint treatment is appropriate. We illustrate the method for the specific case of the psychometric function; however the procedure applies to other models that encompass multiple experimental conditions.",0 +https://doi.org/10.7326/m13-2886,Random-Effects Meta-analysis of Inconsistent Effects: A Time for Change,"A primary goal of meta-analysis is to improve the estimation of treatment effects by pooling results of similar studies. This article explains how the most widely used method for pooling heterogeneous studies--the Der Simonian-Laird (DL) estimator--can produce biased estimates with falsely high precision. A classic example is presented to show that use of the DL estimator can lead to erroneous conclusions. Particular problems with the DL estimator are discussed, and several alternative methods for summarizing heterogeneous evidence are presented. The authors support replacing universal use of the DL estimator with analyses based on a critical synthesis that recognizes the uncertainty in the evidence,focuses on describing and explaining the probable sources of variation in the evidence, and uses random-effects estimates that provide more accurate confidence limits than the DL estimator.",0 +https://doi.org/10.7916/d8rj4sgp,Estimating High Dimensional Covariance Matrices and Its Applications,"Estimating covariance matrices is an important part of portfolio selection, risk management, and asset pricing. This paper reviews the recent development in estimating high dimensional covariance matrices, where the number of variables can be greater than the number of observations. The limitations of the sample covariance matrix are discussed. Several new approaches are presented, including the shrinkage method, the observable and latent factor method, the Bayesian approach, and the random matrix theory approach. For each method, the construction of covariance matrices is given. The relationships among these methods are discussed.",0 +https://doi.org/10.1515/jbnst-2008-0407,The Hausman Test Statistic can be Negative even Asymptotically,"Summary We show that under the alternative hypothesis the Hausman chi-square test statistic can be negative not only in small samples but even asymptotically. Therefore in large samples such a result is only compatible with the alternative and should be interpreted accordingly. Applying a known insight from finite samples, this can only occur if the different estimation precisions (often the residual variance estimates) under the null and the alternative both enter the test statistic. In finite samples, using the absolute value of the test statistic is a remedy that does not alter the null distribution and is thus admissible. Even for positive test statistics the relevant covariance matrix difference should be routinely checked for positive semi-definiteness, because we also show that otherwise test results may be misleading. Of course the preferable solution still is to impose the same nuisance parameter (i.e., residual variance) estimate under the null and alternative hypotheses, if the model context permits that with relative ease. We complement the likelihood-based exposition by a formal proof in an omitted-variable context, we present simulation evidence for the test of panel random effects, and we illustrate the problems with a panel homogeneity test.",0 +https://doi.org/10.1080/10618600.2016.1164709,Combining Functional Data Registration and Factor Analysis,"ABSTRACTWe extend the definition of functional data registration to encompass a larger class of registration models. In contrast to traditional registration models, we allow for registered functions that have more than one primary direction of variation. The proposed Bayesian hierarchical model simultaneously registers the observed functions and estimates the two primary factors that characterize variation in the registered functions. Each registered function is assumed to be predominantly composed of a linear combination of these two primary factors, and the function-specific weights for each observation are estimated within the registration model. We show how these estimated weights can easily be used to classify functions after registration using both simulated data and a juggling dataset. Supplementary materials for this article are available online.",0 +https://doi.org/10.1080/02699931.2012.667392,Getting stuck in depression: The roles of rumination and emotional inertia,"Like many other mental disorders, depression is characterised by psychological inflexibility. Two instances of such inflexibility are rumination: repetitive cognitions focusing on the causes and consequences of depressive symptoms; and emotional inertia: the tendency for affective states to be resistant to change. In two studies, we tested the predictions that: (1) rumination and emotional inertia are related; and (2) both independently contribute to depressive symptoms. We examined emotional inertia of subjective affective experiences in daily life among a sample of non-clinical undergraduates (Study 1), and of affective behaviours during a family interaction task in a sample of clinically depressed and non-depressed adolescents (Study 2), and related it to self-reported rumination and depression severity. In both studies, rumination (particularly the brooding facet) and emotional inertia (particularly of sad/dysphoric affect) were positively associated, and both independently predicted depression severity. These findings demonstrate the importance of studying both cognitive and affective inflexibility in depression.",0 +https://doi.org/10.1177/0165025407077764,Bayesian analysis of longitudinal data using growth curve models,"Bayesian methods for analyzing longitudinal data in social and behavioral research are recommended for their ability to incorporate prior information in estimating simple and complex models. We first summarize the basics of Bayesian methods before presenting an empirical example in which we fit a latent basis growth curve model to achievement data from the National Longitudinal Survey of Youth. This step-by-step example illustrates how to analyze data using both noninformative and informative priors. The results show that in addition to being an alternative to the maximum likelihood estimation (MLE) method, Bayesian methods also have unique strengths, such as the systematic incorporation of prior information from previous studies. These methods are more plausible ways to analyze small sample data compared with the MLE method.",0 +https://doi.org/10.1177/0146167298242002,"Emotional Reactivity to Everyday Problems, Affective Inertia, and Neuroticism","A naturalistic diary recording study was conducted to assess affective responses to everyday stress. Community-residing male participants made diary recordings regarding problem occurrence and mood several times a day for 8 days. In addition to reporting more frequent daily problems, persons scoring high in neuroticism were more reactive to stressors and were more distressed by recurrent problems than were persons scoring low in neuroticism. New problems affected everyone comparably. There was also evidence of affective inertia, such that bad mood was more likely to carry over to the next assessment. This lag effect tended to be stronger among more neurotic individuals.",0 +https://doi.org/10.1002/(sici)1097-0258(19960615)15:11<1069::aid-sim220>3.0.co;2-q,ON DESIGN CONSIDERATIONS AND RANDOMIZATION-BASED INFERENCE FOR COMMUNITY INTERVENTION TRIALS,"This paper discusses design considerations and the role of randomization-based inference in randomized community intervention trials. We stress that longitudinal follow-up of cohorts within communities often yields useful information on the effects of intervention on individuals, whereas cross-sectional surveys can usefully assess the impact of intervention on group indices of health. We also discuss briefly special design considerations, such as sampling cohorts from targeted subpopulations (for example, heavy smokers), matching the communities, calculating sample size, and other practical issues. We present randomization tests for matched and unmatched cohort designs. As is well known, these tests necessarily have proper size under the strong null hypothesis that treatment has no effect on any community response. It is less well known, however, that the size of randomization tests can exceed nominal levels under the 'weak' null hypothesis that intervention does not affect the average community response. Because this weak null hypothesis is of interest in community intervention trials, we study the size of randomization tests by simulation under conditions in which the weak null hypothesis holds but the strong null hypothesis does not. In unmatched studies, size may exceed nominal levels under the weak null hypothesis if there are more intervention than control communities and if the variance among community responses is larger among control communities than among intervention communities; size may also exceed nominal levels if there are more control than intervention communities and if the variance among community responses is larger among intervention communities. Otherwise, size is likely near nominal levels. To avoid such problems, we recommend use of the same numbers of control and intervention communities in unmatched designs. Pair-matched designs usually have size near nominal levels, even under the weak null hypothesis. We have identified some extreme cases, unlikely to arise in practice, in which even the size of pair-matched studies can exceed nominal levels. These simulations, however, tend to confirm the robustness of randomization tests for matched and unmatched community intervention trials, particularly if the latter designs have equal numbers of intervention and control communities. We also describe adaptations of randomization tests to allow for covariate adjustment, missing data, and application to cross-sectional surveys. We show that covariate adjustment can increase power, but such power gains diminish as the random component of variation among communities increases, which corresponds to increasing intraclass correlation of responses within communities. We briefly relate our results to model-based methods of inference for community intervention trials that include hierarchical models such as an analysis of variance model with random community effects and fixed intervention effects. Although we have tailored this paper to the design of community intervention trials, many of the ideas apply to other experiments in which one allocates groups or clusters of subjects at random to intervention or control treatments.",0 +,Bayesian Structural Equation Models for Cumulative Theory Building in Information Systems.,"Theories are sets of causal relationships between constructs and their proxy indicator variables. Theories are tested and their numerical parameters are estimated using statistical models of latent and observed variables. A considerable amount of theoretical development in Information Systems occurs by theory extension or adaptation. Moreover, researchers are encouraged to reuse existing measurement instruments when possible. As a consequence, there are many cases when a relationship between two variables (latent and/or observed) is re-estimated in a new study with a new sample or in a new context. To aid in cumulative theory building, a re-estimation of parameters should take into account our prior knowledge about their likely values. In this paper, we show how Bayesian statistical models can provide a statistically sound way of incorporating prior knowledge into parameter estimation, allowing researchers to keep a “running tally” of the best estimates of model parameters.",0 +https://doi.org/10.1111/j.1745-3984.2004.tb01112.x,Effects of Practical Constraints on Item Selection Rules at the Early Stages of Computerized Adaptive Testing,"The purpose of this study was to compare the effects of four item selection rules—(1) Fisher information (F), (2) Fisher information with a posterior distribution (FP), (3) Kullback-Leibler information with a posterior distribution (KP), and (4) completely randomized item selection (RN)—with respect to the precision of trait estimation and the extent of item usage at the early stages of computerized adaptive testing. The comparison of the four item selection rules was carried out under three conditions: (1) using only the item information function as the item selection criterion; (2) using both the item information function and content balancing; and (3) using the item information function, content balancing, and item exposure control. When test length was less than 10 items, FP and KP tended to outperform F at extreme trait levels in Condition 1. However, in more realistic settings, it could not be concluded that FP and KP outperformed F, especially when item exposure control was imposed. When test length was greater than 10 items, the three nonrandom item selection procedures performed similarly no matter what the condition was, while F had slightly higher item usage.",0 +https://doi.org/10.1177/0013164403258402,The Effect of Multicollinearity on Multilevel Modeling Parameter Estimates and Standard Errors,"This study investigates the quality of multilevel model parameter estimates and standard errors as a function of varying magnitudes of correlation among Level 1 predictors and model characteristics. The results of the study showthat with multicollinearity presented at Level 1 of a two-level mixed-effects linear model, the fixed-effect parameter estimates produce relatively unbiased values; however, the variance and covariance component estimates produce downwardly biased values except for Level 1 variance (< 5%). The standard errors associated with the parameter estimates are also biased under varied magnitudes of Level 1 predictor correlation.",0 +https://doi.org/10.1080/10503300701796992,Statistical analysis of group-administered intervention data: Reanalysis of two randomized trials,"Group-administered interventions often create statistical dependencies, which, if ignored, increase the rate of Type I errors. The authors analyzed data from two randomized trials involving group interventions to document the impact of statistical dependency on tests of intervention effects and to provide estimates of statistical dependency. Intraclass correlations ranged from .02 to .12. Adjusting for dependencies increased p values for the tests of intervention effects. The increase in the p values depended on the magnitude of the statistical dependence and available degrees of freedom. Results suggest that the literature may overstate the efficacy of group interventions and imply that it will be important to study why groups create dependencies. The authors discuss how dependencies impact statistical power and how researchers can address this concern.",0 +https://doi.org/10.3758/s13428-013-0395-1,Statistical power of latent growth curve models to detect quadratic growth,"Latent curve models (LCMs) have been used extensively to analyze longitudinal data. However, little is known about the power of LCMs to detect nonlinear trends when they are present in the data. For this study, we utilized simulated data to investigate the power of LCMs to detect the mean of the quadratic slope, Type I error rates, and rates of nonconvergence during the estimation of quadratic LCMs. Five factors were examined: the number of time points, growth magnitude, interindividual variability, sample size, and the R 2s of the measured variables. The results showed that the empirical Type I error rates were close to the nominal value of 5 %. The empirical power to detect the mean of the quadratic slope was affected by the simulation factors. Finally, a substantial proportion of samples failed to converge under conditions of no to small variation in the quadratic factor, small sample sizes, and small R 2 of the repeated measures. In general, we recommended that quadratic LCMs be based on samples of (a) at least 250 but ideally 400, when four measurement points are available; (b) at least 100 but ideally 150, when six measurement points are available; (c) at least 50 but ideally 100, when ten measurement points are available. © 2013 Psychonomic Society, Inc.",0 +https://doi.org/10.1016/j.pain.2004.02.018,HIV-1 gp120 Stimulates proinflammatory cytokine-mediated pain facilitation via activation of nitric oxide synthase-I (nNOS),"It has become clear that spinal cord glia (microglia and astrocytes) importantly contribute to the creation of exaggerated pain responses. One model used to study this is peri-spinal (intrathecal, i.t.) administration of gp120, an envelope protein of HIV-1 known to activate glia. Previous studies demonstrated that i.t. gp120 produces pain facilitation via the release of glial proinflammatory cytokines. The present series of studies tested whether spinal nitric oxide (NO) contributes to i.t. gp120-induced mechanical allodynia and, if so, what effect NO has on spinal proinflammatory cytokines. gp120 stimulation of acutely isolated lumbar dorsal spinal cords released NO as well as proinflammatory cytokines (tumor necrosis factor-alpha, interleukin-1beta (IL1), interleukin-6 (IL6)), thus identifying NO as a candidate mediator of gp120-induced behavioral effects. Behaviorally, identical effects were observed when gp120-induced mechanical allodynia was challenged by i.t. pre-treatment with either a broad-spectrum nitric oxide synthase (NOS) inhibitor (L-NAME) or 7-NINA, a selective inhibitor of NOS type-I (nNOS). Both abolished gp120-induced mechanical allodynia. While the literature pre-dominantly documents that proinflammatory cytokines stimulate the production of NO rather than the reverse, here we show that gp120-induced NO increases proinflammatory cytokine mRNA levels (RT-PCR) and both protein expression and protein release (serial ELISA). Furthermore, gp120 increases mRNA for IL1 converting enzyme and matrix metalloproteinase-9, enzymes responsible for activation and release of proinflammatory cytokines.",0 +https://doi.org/10.1016/j.ijresmar.2009.06.003,A meta-analysis of the determinants of organic sales growth,"Abstract We present the results of a meta-analysis on drivers of organic sales growth conducted using a Hierarchical Bayes estimation technique. Based on a comprehensive review of a diverse set of literatures on organic sales growth, we identify eleven drivers of organic sales growth performance of firms: (i) innovation, (ii) marketing orientation (iii) advertising (iv) interorganizational networks, (v) entrepreneurial orientation, (vi) management capacity, (vii) firm age, (viii) firm size, (ix) competition, (x) munificence, and (xi) dynamism. Among the variables under a manager's control, innovation, advertising, market orientation, interorganizational networks, entrepreneurial orientation and managerial capacity serve as positive drivers of organic growth. Older firms and firms operating in dynamic and competitive environments face constraints in terms of organic growth. We find that the omission of marketing variables in empirical models biases the elasticities of eight of the drivers of organic growth. Three study design characteristics impact the magnitude of elasticity of organic growth drivers: using cross-sectional data instead of panel data, using growth rates instead of absolute change as operationalization of growth and using market share instead of sales as a measure of revenues.",0 +https://doi.org/10.1016/j.jspi.2012.01.005,Reference priors for linear models with general covariance structures,"Abstract We develop a new class of reference priors for linear models with general covariance structures. A general Markov chain Monte Carlo algorithm is also proposed for implementing the computation. We present several examples to demonstrate the results: Bayesian penalized spline smoothing, a Bayesian approach to bivariate smoothing for a spatial model, and prior specification for structural equation models.",0 +https://doi.org/10.1111/j.1467-985x.2007.00487.x,A hierarchical modelling framework for identifying unusual performance in health care providers,"Summary. A wide variety of statistical methods have been proposed for detecting unusual performance in cross-sectional data on health care providers. We attempt to create a unified framework for comparing these methods, focusing on a clear distinction between estimation and hypothesis testing approaches, with the corresponding distinction between detecting ‘extreme’ and ‘divergent’ performance. When assuming a random-effects model the random-effects distribution forms the null hypothesis, and there appears little point in testing whether individual effects are greater or less than average. The hypothesis testing approach uses p-values as summaries and brings with it the standard problems of multiple testing, whether Bayesian or classical inference is adopted. A null random-effects formulation allows us to answer appropriate questions of the type: ‘is a particular provider worse than we would expect the true worst provider (but still part of the null distribution) to be'? We outline a broad three-stage strategy of exploratory detection of unusual providers, detailed modelling robust to potential outliers and confirmation of unusual performance, illustrated by using two detailed examples. The concepts are most easily handled within a Bayesian analytic framework using Markov chain Monte Carlo methods, but the basic ideas should be generally applicable.",0 +https://doi.org/10.1080/19312458.2012.679848,Advantages of Monte Carlo Confidence Intervals for Indirect Effects,"Monte Carlo simulation is a useful but underutilized method of constructing confidence intervals for indirect effects in mediation analysis. The Monte Carlo confidence interval method has several distinct advantages over rival methods. Its performance is comparable to other widely accepted methods of interval construction, it can be used when only summary data are available, it can be used in situations where rival methods (e.g., bootstrapping and distribution of the product methods) are difficult or impossible, and it is not as computer-intensive as some other methods. In this study we discuss Monte Carlo confidence intervals for indirect effects, report the results of a simulation study comparing their performance to that of competing methods, demonstrate the method in applied examples, and discuss several software options for implementation in applied settings.",0 +https://doi.org/10.1080/0094965031000147713,Implementation of a robust bayesian method,"In this work we study robustness in Bayesian models through a generalization of the Normal distribution. We show new appropriate techniques in order to deal with this distribution in Bayesian inference. Then we propose two approaches to decide, in some applications, if we should replace the usual Normal model by this generalization. First, we pose this dilemma as a model rejection problem, using diagnostic measures. In the second approach we evaluate the model's predictive efficiency. We illustrate those perspectives with a simulation study, a non linear model and a longitudinal data model.",0 +https://doi.org/10.1037/0021-9010.88.1.100,Using theory to evaluate personality and job-performance relations: A socioanalytic perspective.,"The authors used socioanalytic theory to understand individual differences in people's performance at work. Specifically, if predictors and criteria are aligned by using theory, then the meta-analytic validity of personality measures exceeds that of atheoretical approaches. As performance assessment moved from general to specific job criteria, all Big Five personality dimensions more precisely predicted relevant criterion variables, with estimated true validities of .43 (Emotional Stability), .35 (Extraversion-Ambition), .34 (Agreeableness), .36 (Conscientiousness), and .34 (Intellect-Openness to Experience).",0 +https://doi.org/10.1002/bimj.201300288,Evidence synthesis for count distributions based on heterogeneous and incomplete aggregated data,"The analysis of count data is commonly done using Poisson models. Negative binomial models are a straightforward and readily motivated generalization for the case of overdispersed data, that is, when the observed variance is greater than expected under a Poissonian model. Rate and overdispersion parameters then need to be considered jointly, which in general is not trivial. Here, we are concerned with evidence synthesis in the case where the reporting of data is rather heterogeneous, that is, events are reported either in terms of mean event counts, the proportion of event-free patients, or rate estimates and standard errors. Either figure carries some information about the relevant parameters, and it is the joint modeling that allows for coherent inference on the parameters of interest. The methods are motivated and illustrated by a systematic review in chronic obstructive pulmonary disease.",0 +https://doi.org/10.1016/j.jspi.2006.08.008,Empirical Bayes estimation in finite population sampling under functional measurement error models,"Abstract The paper considers simultaneous estimation of finite population means for several strata. A model-based approach is taken, where the covariates in the super-population model are subject to measurement errors. Empirical Bayes (EB) estimators of the strata means are developed and an asymptotic expression for the MSE of the EB estimators is provided. It is shown that the proposed EB estimators are “first order optimal” in the sense of Robbins [1956. An empirical Bayes approach to statistics. In: Proceedings of the Third Berkeley Symposium on Mathematical Statistics and Probability, vol. 1, University of California Press, Berkeley, pp. 157–164], while the regular EB estimators which ignore the measurement error are not.",0 +https://doi.org/10.1007/0-306-47531-6_13,Testlet Response Theory: An Analog for the 3PL Model Useful in Testlet-Based Adaptive Testing,"The invention of short multiple choice test items provided an enormous technical and practical advantage for test developers; certainly the items could be scored easily, but that was just one of the reasons for their popular adoption in the early part of the 20th century. A more important reason was the increase in validity offered because of the speed with which such items could be answered. This meant that a broad range of content specifications could be addressed, and hence an examinee need no longer be penalized because of an unfortunate choice of constructed response (e.g., essay) question. These advantages, as well as many others (see Anastasi, 1976, 415-417) led the multiple choice format to become, by far, the dominant form used in large-scale standardized mental testing throughout this century. Nevertheless, this breakthrough in test construction, dominant at least since the days of Army is currently being reconsidered. Critics of tests that are made up of large numbers of short questions suggest that decontextualized items yield a task that is abstracted too far from the domain of inference for many potential uses. For several reasons, only one of them as a response to this criticism, variations in test theory were considered that would allow the retention of the shortanswer format while at the same time eliminating the shortcomings expressed by those critics. One of these variations was the development of item response theory (IRT), an analytic breakthrough in test scoring. A key feature of IRT is that examinee responses are conceived of as reflecting evidence of a particular location on a single underlying latent",0 +https://doi.org/10.1037/0022-3514.51.6.1173,"The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations.","In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators. © 1986 American Psychological Association.",0 +https://doi.org/10.1007/bf02294365,On structural equation modeling with data that are not missing completely at random,"A general latent variable model is given which includes the specification of a missing data mechanism. This framework allows for an elucidating discussion of existing general multivariate theory bearing on maximum likelihood estimation with missing data. Here, missing completely at random is not a prerequisite for unbiased estimation in large samples, as when using the traditional listwise or pairwise present data approaches. The theory is connected with old and new results in the area of selection and factorial invariance. It is pointed out that in many applications, maximum likelihood estimation with missing data may be carried out by existing structural equation modeling software, such as LISREL and LISCOMP. Several sets of artifical data are generated within the general model framework. The proposed estimator is compared to the two traditional ones and found superior.",0 +https://doi.org/10.1016/0893-6080(95)00014-3,Convergence results for the EM approach to mixtures of experts architectures,"The Expectation-Maximization (EM) algorithm is an iterative approach to maximum likelihood parameter estimation. Jordan and Jacobs (1993) recently proposed an EM algorithm for the mixture of experts architecture of Jacobs, Jordan, Nowlan and Hinton (1991) and the hierarchical mixture of experts architecture of Jordan and Jacobs (1992). They showed empirically that the EM algorithm for these architectures yields significantly faster convergence than gradient ascent. In the current paper we provide a theoretical analysis of this algorithm. We show that the algorithm can be regarded as a variable metric algorithm with its searching direction having a positive projection on the gradient of the log likelihood. We also analyze the convergence of the algorithm and provide an explicit expression for the convergence rate. In addition, we describe an acceleration technique that yields a significant speedup in simulation experiments.",0 +https://doi.org/10.1002/sim.3124,A Bayesian approach for sample size determination in method comparison studies,"Studies involving two methods for measuring a continuous response are regularly conducted in health sciences to evaluate agreement of a method with itself and agreement between methods. Notwithstanding their wide usage, the design of such studies, in particular, the sample size determination, has not been addressed in the literature when the goal is the simultaneous evaluation of intra- and inter-method agreement. We fill this need by developing a simulation-based Bayesian methodology for determining sample sizes in a hierarchical model framework. Unlike a frequentist approach, it takes into account uncertainty in parameter estimates. This methodology can be used with any scalar measure of agreement available in the literature. We demonstrate this for four currently used measures. The proposed method is applied to an ongoing proteomics project, where we use pilot data to determine the number of individuals and the number of replications needed to evaluate the agreement between two methods for measuring protein ratios. We also apply our method to determine the sample size for an experiment involving measurement of blood pressure. Copyright © 2007 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1207/s15328007sem0803_1,The Consequences of Ignoring Multilevel Data Structures in Nonhierarchical Covariance Modeling,"This study examined the effects of ignoring multilevel data structures in nonhierarchical covariance modeling using a Monte Carlo simulation. Multilevel sample data were generated with respect to 3 design factors: (a) intraclass correlation, (b) group and member configuration, and (c) the models that underlie the between-group and within-group variance components associated with multilevel data. Covariance models that ignored the multilevel structure were then fit to the data. Results indicated that when variables exhibit minimal levels of intraclass correlation, the chi-square model/data fit statistic, the parameter estimators, and the standard error estimators are relatively unbiased. However, as the level of intraclass correlation increases, the chi-square statistic, the parameters, and their standard errors all exhibit estimation problems. The specific group/member configurations as well as the underlying between-group and within-group model structures further exacerbate the estimation problems encoun...",0 +https://doi.org/10.1109/icemt.2010.5657604,Notice of Retraction: A study of equating of Computer-Based College English Placement Test,"This paper was to investigate the application of item response theory to specify an appropriate item response model for the equating of the mixed-format of multiple-choice items and open-ended items, since equating is the precondition of the development of an item bank for the Computer-Based College English Placement Test. It was shown that the equating approach based on common-item nonequivalent groups design and the two-parameter logistic model is ideal to be used to calibrate item and ability parameters in two alternate test forms since this model fits data of all listening and reading sections in both forms.",0 +https://doi.org/10.1177/1094428104263672,Using Generalized Estimating Equations for Longitudinal Data Analysis,"The generalized estimating equation (GEE) approach of Zeger and Liang facilitates analysis of data collected in longitudinal, nested, or repeated measures designs. GEEs use the generalized linear model to estimate more efficient and unbiased regression parameters relative to ordinary least squares regression in part because they permit specification of a working correlation matrix that accounts for the form of within-subject correlation of responses on dependent variables of many different distributions, including normal, binomial, and Poisson. The author briefly explains the theory behind GEEs and their beneficial statistical properties and limitations and compares GEEs to suboptimal approaches for analyzing longitudinal data through use of two examples. The first demonstration applies GEEs to the analysis of data from a longitudinal lab study with a counted response variable; the second demonstration applies GEEs to analysis of data with a normally distributed response variable from subjects nested within branch offices ofan organization.",0 +https://doi.org/10.1111/j.0006-341x.2003.00097.x,Modeling Longitudinal Data with Nonignorable Dropouts Using a Latent Dropout Class Model,"In longitudinal studies with dropout, pattern-mixture models form an attractive modeling framework to account for nonignorable missing data. However, pattern-mixture models assume that the components of the mixture distribution are entirely determined by the dropout times. That is, two subjects with the same dropout time have the same distribution for their response with probability one. As that is unlikely to be the case, this assumption made lead to classification error. In addition, if there are certain dropout patterns with very few subjects, which often occurs when the number of observation times is relatively large, pattern-specific parameters may be weakly identified or require identifying restrictions. We propose an alternative approach, which is a latent-class model. The dropout time is assumed to be related to the unobserved (latent) class membership, where the number of classes is less than the number of observed patterns; a regression model for the response is specified conditional on the latent variable. This is a type of shared-parameter model, where the shared ""parameter"" is discrete. Parameter estimates are obtained using the method of maximum likelihood. Averaging the estimates of the conditional parameters over the distribution of the latent variable yields estimates of the marginal regression parameters. The methodology is illustrated using longitudinal data on depression from a study of HIV in women.",0 +https://doi.org/10.1080/10705510701758265,A Simulation Study Comparison of Bayesian Estimation With Conventional Methods for Estimating Unknown Change Points,"The main purpose of this research is to evaluate the performance of a Bayesian approach for estimating unknown change points using Monte Carlo simulations. The univariate and bivariate unknown change point mixed models were presented and the basic idea of the Bayesian approach for estimating the models was discussed. The performance of Bayesian estimation was evaluated using simulation studies of longitudinal data with different sample sizes, varying change point values, different levels of Level-1 variances, and univariate versus bivariate outcomes. The numerical results compared the performance of the Bayesian methods with the first-order Taylor expansion method and the adaptive Gaussian quadrature method implemented in SAS PROC NLMIXED. These simulation results showed that the first-order Taylor expansion method and the adaptive Gaussian quadrature method were sensitive to the initial values, making the results somewhat unreliable. In contrast, these simulation results showed that Bayesian estimation w...",0 +https://doi.org/10.1198/016214504000001187,Causal Inference With General Treatment Regimes,"In this article we develop the theoretical properties of the propensity function, which is a generalization of the propensity score of Rosenbaum and Rubin. Methods based on the propensity score have long been used for causal inference in observational studies; they are easy to use and can effectively reduce the bias caused by nonrandom treatment assignment. Although treatment regimes need not be binary in practice, the propensity score methods are generally confined to binary treatment scenarios. Two possible exceptions have been suggested for ordinal and categorical treatments. In this article we develop theory and methods that encompass all of these techniques and widen their applicability by allowing for arbitrary treatment regimes. We illustrate our propensity function methods by applying them to two datasets; we estimate the effect of smoking on medical expenditure and the effect of schooling on wages. We also conduct simulation studies to investigate the performance of our methods.",0 +https://doi.org/10.1167/iovs.13-12032,"Perimetric Evaluation of Saccadic Latency, Saccadic Accuracy, and Visual Threshold for Peripheral Visual Stimuli in Young Compared With Older Adults","Using a novel automated perimetry technique, we tested the hypothesis that older adults will have increased latency and decreased accuracy of saccades, as well as higher visual thresholds, to peripheral visual stimuli when compared with younger adults.We tested 20 healthy subjects aged 18 to 30 years (""young"") and 21 healthy subjects at least 60 years old (""older"") for detection of briefly flashed peripheral stimuli of differing sizes in eight locations along the horizontal meridian (±4°, ±12°, ±20°, and ±28°). With the left eye occluded, subjects were instructed to look quickly toward any seen stimuli. Right eye movements were recorded with an EyeLink 1000 infrared camera system. Limiting our analysis to the four stimulus positions in the nasal hemifield (-4°, -12°, -20°, and -28°), we evaluated for group-level differences in saccadic latency, accuracy, and visual threshold at each stimulus location.Saccadic latency increased as stimulus size decreased in both groups. Older subjects had significantly increased saccadic latencies (at all locations; P < 0.05), decreased accuracies (at all locations; P < 0.05), and higher visual thresholds (at the -12°, -20°, and -28° locations; P < 0.05). Additionally, there were significant relationships between visual threshold and latency, visual threshold and accuracy, and latency and accuracy (P < 0.0001).Older adults have increased latency and decreased accuracy of saccades, as well as higher visual thresholds, to peripheral visual stimuli when compared with younger adults. Saccadic latency and accuracy are related to visual threshold, suggesting that saccadic latency and accuracy could be useful as perimetric outcome measures.",0 +https://doi.org/10.1525/aa.1986.88.2.02a00020,Culture as Consensus: A Theory of Culture and Informant Accuracy,"This paper presents and tests a formal mathematical model for the analysis of informant responses to systematic interview questions. We assume a situation in which the ethnographer does not know how much each informant knows about the cultural domain under consideration nor the answers to the questions. The model simultaneously provides an estimate of the cultural competence or knowledge of each informant and an estimate of the correct answer to each question asked of the informant. The model currently handles true-false, multiple-choice, andfill-in-the-blank type question formats. In familiar cultural domains the model produces good results from as few as four informants. The paper includes a table showing the number of informants needed to provide stated levels of confidence given the mean level of knowledge among the informants. Implications are discussed.",0 +https://doi.org/10.3389/fnbeh.2014.00040,Sex differences in mechanical allodynia: how can it be preclinically quantified and analyzed?,"Translating promising preclinical drug discoveries to successful clinical trials remains a significant hurdle in pain research. Although animal models have significantly contributed to understanding chronic pain pathophysiology, the majority of research has focused on male rodents using testing procedures that produce sex difference data that do not align well with comparable clinical experiences. Additionally, the use of animal pain models presents ongoing ethical challenges demanding continuing refinement of preclinical methods. To this end, this study sought to test a quantitative allodynia assessment technique and associated statistical analysis in a modified graded nerve injury pain model with the aim to further examine sex differences in allodynia. Graded allodynia was established in male and female Sprague Dawley rats by altering the number of sutures placed around the sciatic nerve and quantified by the von Frey test. Linear mixed effects modeling regressed response on each fixed effect (sex, oestrus cycle, pain treatment). On comparison with other common von Frey assessment techniques, utilizing lower threshold filaments than those ordinarily tested, at 1 s intervals, appropriately and successfully investigated female mechanical allodynia, revealing significant sex and oestrus cycle difference across the graded allodynia that other common behavioral methods were unable to detect. Utilizing this different von Frey approach and graded allodynia model, a single suture inflicting less allodynia was sufficient to demonstrate exaggerated female mechanical allodynia throughout the phases of dioestrus and pro-oestrus. Refining the von Frey testing method, statistical analysis technique and the use of a graded model of chronic pain, allowed for examination of the influences on female mechanical nociception that other von Frey methods cannot provide.",0 +https://doi.org/10.1007/s10742-015-0139-z,Multilevel Poisson sample selection models and alternative methods for estimating hospital effects on long-term outcomes,"Hospital care focuses on improving patients’ long-term quality of life, yet hospital quality metrics typically focus on short-term processes. Attempting to understand a patient’s long-term process introduces sample selection bias since patients must survive the hospitalization in order to observe post-hospitalization outcomes. As a result, proper analysis of long-term outcomes should account for clustering, due to the hierarchical structure of hospital data, as well as sample selection bias. The objective of this paper was to evaluate random effect parameter estimation and higher-level ranking of long-term count outcomes and short-term selection processes in the presence of cluster and selection bias by comparing multilevel Poisson models, multilevel zero-inflated Poisson models, and multilevel Poisson sample selection models (MPSSMs) in a series of simulations. We simulated an outcome resembling a post-discharge Poisson count with a pre-specified selection process determining a patient’s hospitalization survival with each hospital having a unique effect on both processes. In order to clarify the methodology, we also analyzed a real-world hospital dataset involving a count outcome conditioned on the selection process of hospital survival. Across all simulations, the random effect parameter estimates were directly compared and the empirical Bayes estimates were extracted, ranked, and compared using the Spearman rank correlation. Results show that the MPSSM produces more accurate random effect parameter estimates and higher-level empirical Bayes ranks. When modeling multilevel effects on long-term count outcomes observed after a short-term selection process, higher-level effects are more reliably measured using MPSSMs. © 2015, Springer Science+Business Media New York (outside the USA).",0 +https://doi.org/10.1007/s40273-013-0067-0,A Choice That Matters?,"Decision-analytic cost-effectiveness (CE) models combine many different parameters like transition probabilities, event probabilities, utilities and costs, which are often obtained after meta-analysis. The method of meta-analysis may affect the CE estimate.Our aim was to perform a simulation study that compares the performance of different methods of meta-analysis, especially with respect to model-based health economic (HE) outcomes.A reference patient population of 50,000 was simulated from which sets of samples were drawn. Each sample drawn represented a clinical trial comparing two fictitious interventions. In several scenarios, the heterogeneity between these trials was varied, by drawing one or more of the trials from predefined subpopulations. Parameter estimates from these trials were combined using frequentist fixed (FFE) and random effects (FRE), and Bayesian fixed (BFE) and random effects (BRE) meta-analysis. The pooled parameter estimates were entered into a probabilistic cost-effectiveness Markov model. The four methods of meta-analysis resulted in different parameter estimates and HE outcomes, which were compared with the true values in the reference population. Performance statistics were: (1) the percentage of repetitions that the confidence interval of the probabilistic sensitivity analysis covers the true value (coverage), (2) the difference between the estimated and true value (bias), (3) the mean absolute value of the bias (MAD) and (4) the percentage of repetitions that result in a statistically significant difference between the two interventions (statistical power). As the differences between methods could be due to chance, we repeated every step of the analysis 1,000 times to study whether differences were systematic.FFE, FRE and BFE lead to different parameter estimates, but, when entered into the model, they do not lead to large differences in the point estimates of the HE outcomes, even in scenarios where we built in heterogeneity. Random effects methods do not necessarily reduce bias when heterogeneity is added to the trials, and may even increase bias in certain situations. BRE tends to overestimate uncertainty reflected in the CE acceptability curve.FFE, FRE and BFE lead to comparable HE outcomes. BRE tends to overestimate uncertainty. Based on this study, we recommend FRE as the preferred method of meta-analysis.",0 +https://doi.org/10.1037/a0019390,Perceiver effects as projective tests: What your perceptions of others say about you.,"In 3 studies, we document various properties of perceiver effects--or how an individual generally tends to describe other people in a population. First, we document that perceiver effects have consistent relationships with dispositional characteristics of the perceiver, ranging from self-reported personality traits and academic performance to well-being and measures of personality disorders, to how liked the person is by peers. Second, we document that the covariation in perceiver effects among trait dimensions can be adequately captured by a single factor consisting of how positively others are seen across a wide range of traits (e.g., how nice, interesting, trustworthy, happy, and stable others are generally seen). Third, we estimate the 1-year stability of perceiver effects and show that individual differences in the typical perception of others have a level of stability comparable to that of personality traits. The results provide compelling evidence that how individuals generally perceive others is a stable individual difference that reveals much about the perceiver's own personality.",0 +https://doi.org/10.3389/fpsyg.2016.00289,The Importance of Isomorphism for Conclusions about Homology: A Bayesian Multilevel Structural Equation Modeling Approach with Ordinal Indicators,"We describe a Monte Carlo study examining the impact of assuming item isomorphism (i.e., equivalent construct meaning across levels of analysis) on conclusions about homology (i.e., equivalent structural relations across levels of analysis) under varying degrees of non-isomorphism in the context of ordinal indicator multilevel structural equation models (MSEMs). We focus on the condition where one or more loadings are higher on the between level than on the within level to show that while much past research on homology has ignored the issue of psychometric isomorphism, psychometric isomorphism is in fact critical to valid conclusions about homology. More specifically, when a measurement model with non-isomorphic items occupies an exogenous position in a multilevel structural model and the non-isomorphism of these items is not modeled, the within level exogenous latent variance is under-estimated leading to over-estimation of the within level structural coefficient, while the between level exogenous latent variance is overestimated leading to underestimation of the between structural coefficient. When a measurement model with non-isomorphic items occupies an endogenous position in a multilevel structural model and the non-isomorphism of these items is not modeled, the endogenous within level latent variance is under-estimated leading to under-estimation of the within level structural coefficient while the endogenous between level latent variance is over-estimated leading to over-estimation of the between level structural coefficient. The innovative aspect of this article is demonstrating that even minor violations of psychometric isomorphism render claims of homology untenable. We also show that posterior predictive p-values for ordinal indicator Bayesian MSEMs are insensitive to violations of isomorphism even when they lead to severely biased within and between level structural parameters. We highlight conditions where poor estimation of even correctly specified models rules out empirical examination of isomorphism and homology without taking precautions, for instance, larger Level-2 sample sizes, or using informative priors.",0 +https://doi.org/10.1167/15.14.6,Independence of the completion effect from the noncompletion effect in illusory contour perception,"Spatially separated object information can be effortlessly completed in the visual system, as demonstrated by the well-known Kanizsa-type illusory contours. The perception of illusory contours is closely associated with the spatial configuration of contour fragments, leading to the long-lasting difficulty in distinguishing the effect of the completion process that interpolates the contour fragments from the effect of the noncompletion process that analyzes the contour fragments. However, a close relationship does not necessarily imply nonindependence, e.g., two people may show similar behaviors in one situation but may not in another situation. Inspired by this simple common sense, we conducted a contour discrimination task (i.e., discriminating between the interpolated contours) and a fragment discrimination task (i.e., discriminating between the physically-specified contour fragments) for Kanizsa squares and Kanizsa circles. The performance difference between the contour and fragment discrimination tasks was much larger for Kanizsa circles than for Kanizsa squares. This independence of the completion effect--as indicated by the performance in the contour task--from the noncompletion effect--as indicated by the performance in the fragment task--provides new insights into the understanding of the mechanism of visual completion.",0 +https://doi.org/10.1214/12-ba730,On the Half-Cauchy Prior for a Global Scale Parameter,"This paper argues that the half-Cauchy distribution should replace the inverseGamma distribution as a default prior for a top-level scale parameter in Bayesian hierarchical models, at least for cases where a proper prior is necessary. Our arguments involve a blend of Bayesian and frequentist reasoning, and are intended to complement the original case made by Gelman (2006) in support of the folded-t family of priors. First, we generalize the half-Cauchy prior to the wider class of hypergeometric inverted-beta priors. We derive expressions for posterior moments and marginal densities when these priors are used for a top-level normal variance in a Bayesian hierarchical model. We go on to prove a proposition that, together with the results for moments and marginals, allows us to characterize the frequentist risk of the Bayes estimators under all global-shrinkage priors in the class. These theoretical results, in turn, allow us to study the frequentist properties of the half-Cauchy prior versus a wide class of alternatives. The half-Cauchy occupies a sensible “middle ground” within this class: it performs very well near the origin, but does not lead to drastic compromises in other parts of the parameter space. This provides an alternative, classical justification for the repeated, routine use of this prior. We also consider situations where the underlying mean vector is sparse, where we argue that the usual conjugate choice of an inverse-gamma prior is particularly inappropriate, and can lead to highly distorted posterior inferences. Finally, we briefly summarize some open issues in the specification of default priors for scale terms in hierarchical models.",0 +https://doi.org/10.1080/10705510709336744,Detecting Mixtures From Structural Model Differences Using Latent Variable Mixture Modeling: A Comparison of Relative Model Fit Statistics,"The accuracy of structural model parameter estimates in latent variable mixture modeling was explored with a 3 (sample size) × 3 (exogenous latent mean difference) × 3 (endogenous latent mean difference) × 3 (correlation between factors) × 3 (mixture proportions) factorial design. In addition, the efficacy of several likelihood-based statistics (Akaike's Information Criterion [AIC], Bayesian Information Ctriterion [BIC], the sample-size adjusted BIC [ssBIC], the consistent AIC [CAIC], the Vuong-Lo-Mendell-Rubin adjusted likelihood ratio test [aVLMR]), classification-based statistics (CLC [classification likelihood information criterion], ICL-BIC [integrated classification likelihood], normalized entropy criterion [NEC], entropy), and distributional statistics (multivariate skew and kurtosis test) were examined to determine which statistics best recover the correct number of components. Results indicate that the structural parameters were recovered, but the model fit statistics were not exceedingly accurat...",0 +https://doi.org/10.1111/biom.12411,Nonparametric Bayes modeling for case control studies with many predictors,"It is common in biomedical research to run case-control studies involving high-dimensional predictors, with the main goal being detection of the sparse subset of predictors having a significant association with disease. Usual analyses rely on independent screening, considering each predictor one at a time, or in some cases on logistic regression assuming no interactions. We propose a fundamentally different approach based on a nonparametric Bayesian low rank tensor factorization model for the retrospective likelihood. Our model allows a very flexible structure in characterizing the distribution of multivariate variables as unknown and without any linear assumptions as in logistic regression. Predictors are excluded only if they have no impact on disease risk, either directly or through interactions with other predictors. Hence, we obtain an omnibus approach for screening for important predictors. Computation relies on an efficient Gibbs sampler. The methods are shown to have high power and low false discovery rates in simulation studies, and we consider an application to an epidemiology study of birth defects.",0 +https://doi.org/10.1207/s15328007sem1304_1,On the Merits of Orthogonalizing Powered and Product Terms: Implications for Modeling Interactions Among Latent Variables,"The goals of this article are twofold: (a) briefly highlight the merits of residual centering for representing interaction and powered terms in standard regression contexts (e.g., Lance, 1988), and (b) extend the residual centering procedure to represent latent variable interactions. The proposed method for representing latent variable interactions has potential advantages over extant procedures. First, the latent variable interaction is derived from the observed covariation pattern among all possible indicators of the interaction. Second, no constraints on particular estimated parameters need to be placed. Third, no recalculations of parameters are required. Fourth, model estimates are stable and interpretable. In our view, the orthogonalizing approach is technically and conceptually straightforward, can be estimated using any structural equation modeling software package, and has direct practical interpretation of parameter estimates. Its behavior in terms of model fit and estimated standard errors is v...",0 +https://doi.org/10.1177/0013164403260196,The Analysis of Repeated Measurements with Mixed-Model Adjusted F Tests,"One approach to the analysis of repeated measures data allows researchers to model the covariance structure of their data rather than presume a certain structure, as is the case with conventional univariate and multivariate test statistics. This mixed-model approach, available through SAS PROC MIXED, was compared to a Welch-James type statistic. The Welch-James approach is known to provide generally robust tests of treatment effects in a repeated measures between-by within-subjects design under assumption violations given certain sample size requirements. The mixed-model F tests were based on Kenward-Roger’s adjusted degrees of freedom solution, an approach specifically proposed for small sample settings. The authors investigated Type I error control for repeated measures main and interaction effects in unbalanced designs when normality and covariance homogeneity assumptions did not hold. The mixed-model Kenward-Roger’s adjusted F tests showed superior Type I error control in small sample size conditions in which the Welch-James type statistic was nonrobust; power rates, however, did not favor one approach over the other.",0 +https://doi.org/10.1068/i0411,Surprise Leads to Noisier Perceptual Decisions,"Surprising events in the environment can impair task performance. This might be due to complete distraction, leading to lapses during which performance is reduced to guessing. Alternatively, unpredictability might cause a graded withdrawal of perceptual resources from the task at hand and thereby reduce sensitivity. Here we attempt to distinguish between these two mechanisms. Listeners performed a novel auditory pitch—duration discrimination, where stimulus loudness changed occasionally and incidentally to the task. Responses were slower and less accurate in the surprising condition, where loudness changed unpredictably, than in the predictable condition, where the loudness was held constant. By explicitly modelling both lapses and changes in sensitivity, we found that unpredictable changes diminished sensitivity but did not increase the rate of lapses. These findings suggest that background environmental uncertainty can disrupt goal-directed behaviour. This graded processing strategy might be adaptive in potentially threatening contexts, and reflect a flexible system for automatic allocation of perceptual resources.",0 +https://doi.org/10.1023/a:1020281327116,,"This purpose of this introductory paper is threefold. First, it introduces the Monte Carlo method with emphasis on probabilistic machine learning. Second, it reviews the main building blocks of modern Markov chain Monte Carlo simulation, thereby providing and introduction to the remaining papers of this special issue. Lastly, it discusses new interesting research horizons.",0 +https://doi.org/10.1177/0272431613511331,Single-Level and Multilevel Mediation Analysis,"Mediation analysis is a statistical approach used to examine how the effect of an independent variable on an outcome is transmitted through an intervening variable (mediator). In this article, we provide a gentle introduction to single-level and multilevel mediation analyses. Using single-level data, we demonstrate an application of structural equation modeling (SEM) in estimating mediation models with multiple mediators and multiple outcomes. We also describe the estimation and interpretation of a 2→1→1 multilevel mediation model in which the first, second, and third numbers correspond to the measurement levels of the independent, mediator, and outcome variables, respectively. We present two numerical examples that use simulated data based on published studies in adolescence research to demonstrate how to specify, estimate, and interpret the results of single-level and multilevel mediation analyses to answer key research questions. We briefly discuss underlying assumptions required to make a valid causal interpretation of a mediation analysis.",0 +https://doi.org/10.1016/j.psychsport.2015.11.004,Using self-determination theory to understand motivation for walking: Instrument development and model testing using Bayesian structural equation modelling,"Abstract Objective The motivational processes underpinning walking behaviour are not well understood. This study aimed to develop walking-specific motivation measures drawn from self-determination theory (SDT), assess the psychometric properties of the measures, incorporating Baysesian structural equation modelling (BSEM), and examine how these variables relate to walking behaviour. Method Participants (n = 298; mean age = 41.69; S.D. = 11.06; male = 57) completed the Behavioural Regulations in Walking Questionnaire (BRWQ), Psychological Needs Satisfaction for Walking Scale (PNSWS) and the IPAQ-long form, from which measures of workplace, transport and leisure walking were extracted. BSEM was used to test the hypothesized factor structures of the BRWQ and PNSWS. Internal reliabilities were assessed using the composite reliability coefficient. Convergent and discriminant validity were assessed by examining the relationships between the variables in relation to established theory. Results BSEM showed excellent fit for the BRWQ and PNSWS measurement models. The scales demonstrated good internal consistency. The associations within and between the BRWQ and PNSWS subscales were generally as expected. The relationship between the BRWQ subscales and walking for transport and leisure were also generally as expected, but there were no significant relationships for walking at work. Two PNSWS subscales were significantly related to walking for leisure, but no significant relationships were evident for walking for transport and at work. Conclusions There is preliminary evidence for the acceptable psychometric properties of instruments to measure SDT constructs in walking, and the findings highlight the advantages of BSEM. The findings also suggest that the motivational processes underpinning walking may vary by type of walking.",0 +https://doi.org/10.1080/01621459.1987.10478410,Better Bootstrap Confidence Intervals,"Abstract We consider the problem of setting approximate confidence intervals for a single parameter θ in a multiparameter family. The standard approximate intervals based on maximum likelihood theory, , can be quite misleading. In practice, tricks based on transformations, bias corrections, and so forth, are often used to improve their accuracy. The bootstrap confidence intervals discussed in this article automatically incorporate such tricks without requiring the statistician to think them through for each new application, at the price of a considerable increase in computational effort. The new intervals incorporate an improvement over previously suggested methods, which results in second-order correctness in a wide variety of problems. In addition to parametric families, bootstrap intervals are also developed for nonparametric situations.",0 +https://doi.org/10.1037/1082-989x.9.2.147,"The Persistence of Underpowered Studies in Psychological Research: Causes, Consequences, and Remedies.","Underpowered studies persist in the psychological literature. This article examines reasons for their persistence and the effects on efforts to create a cumulative science. The ""curse of multiplicities"" plays a central role in the presentation. Most psychologists realize that testing multiple hypotheses in a single study affects the Type I error rate, but corresponding implications for power have largely been ignored. The presence of multiple hypothesis tests leads to 3 different conceptualizations of power. Implications of these 3 conceptualizations are discussed from the perspective of the individual researcher and from the perspective of developing a coherent literature. Supplementing significance tests with effect size measures and confidence intervals is shown to address some but not necessarily all problems associated with multiple testing.",0 +https://doi.org/10.1016/j.jsp.2010.06.003,First graders' literacy and self-regulation gains: The effect of individualizing student instruction,"We examined the effect of individualizing student instruction (ISI; N=445 students, 46 classrooms) on first graders' self-regulation gains compared to a business-as-usual control group. Self-regulation, conceptualized as a constellation of executive skills, was positively associated with academic development. We hypothesized that the ISI intervention's emphasis on teacher planning and organization, classroom management, and the opportunity for students to work independently and in small groups would promote students' self-regulation. We found no main effect of ISI on self-regulation gains. However, for students with weaker initial self-regulation, ISI was associated with greater self-regulation gains compared to peers in control classrooms. The ISI effect on self-regulation was greater when the intervention was more fully implemented.",0 +https://doi.org/10.1177/0013164410387594,The Influence of Dimensionality on Parameter Estimation Accuracy in the Generalized Graded Unfolding Model,"The generalized graded unfolding model (GGUM) is an ideal point model of responding that is consistent with the Thurstonian theory of respondent behavior. Ideal point models have recently generated interest in the realms of attitude and personality assessment. One unclear aspect of applying ideal point models is the influence of multidimensionality on GGUM item and person parameters estimation accuracy. Using simulated data, the authors tested the influence of the balance, or ratio, of items loading onto two dimensions, the degree of bidimensionality and sample size on parameter estimation accuracy. The results suggest that bidimensionality and the proportion of items loading onto a second trait increases estimation error. The second trait was chosen in estimation when a large number of the items in the survey reflected a highly irrelevant second trait. Estimation error was greater for persons and items at the extreme ends of the continuum; positive estimates were biased upward and positive parameters downward. The results suggest that although the GGUM chooses another trait in estimation, in most cases conventional fit analyses and checks for item parameter extremity are likely to be successful in identifying items measuring another trait. Furthermore, the conditions in which the trait being estimated may not be clear should be rare in practice. The implications of these results for researchers who wish to apply these models to real-life data are discussed.",0 +https://doi.org/10.1007/bf02294403,The area between two item characteristic curves,"Formulas for computing the exact signed and unsigned areas between two item characteristic curves (ICCs) are presented. It is further shown that when the c parameters are unequal, the area between two ICCs is infinite. The significance of the exact area measures for item bias research is discussed. © 1988 The Psychometric Society.",0 +https://doi.org/10.1111/bmsp.12054,A mixture hierarchical model for response times and response accuracy,"In real testing, examinees may manifest different types of test-taking behaviours. In this paper we focus on two types that appear to be among the more frequently occurring behaviours – solution behaviour and rapid guessing behaviour. Rapid guessing usually happens in high-stakes tests when there is insufficient time, and in low-stakes tests when there is lack of effort. These two qualitatively different test-taking behaviours, if ignored, will lead to violation of the local independence assumption and, as a result, yield biased item/person parameter estimation. We propose a mixture hierarchical model to account for differences among item responses and response time patterns arising from these two behaviours. The model is also able to identify the specific behaviour an examinee engages in when answering an item. A Monte Carlo expectation maximization algorithm is proposed for model calibration. A simulation study shows that the new model yields more accurate item and person parameter estimates than a non-mixture model when the data indeed come from two types of behaviour. The model also fits real, high-stakes test data better than a non-mixture model, and therefore the new model can better identify the underlying test-taking behaviour an examinee engages in on a certain item.",0 +https://doi.org/10.1111/1467-985x.00206,Improved estimation procedures for multilevel models with binary response: a case‐study,"During recent years, analysts have been relying on approximate methods of inference to estimate multilevel models for binary or count data. In an earlier study of random-intercept models for binary outcomes we used simulated data to demonstrate that one such approximation, known as marginal quasi-likelihood, leads to a substantial attenuation bias in the estimates of both fixed and random effects whenever the random effects are non-trivial. In this paper, we fit three-level random-intercept models to actual data for two binary outcomes, to assess whether refined approximation procedures, namely penalized quasi-likelihood and second-order improvements to marginal and penalized quasi-likelihood, also underestimate the underlying parameters. The extent of the bias is assessed by two standards of comparison: exact maximum likelihood estimates, based on a Gauss–Hermite numerical quadrature procedure, and a set of Bayesian estimates, obtained from Gibbs sampling with diffuse priors. We also examine the effectiveness of a parametric bootstrap procedure for reducing the bias. The results indicate that second-order penalized quasi-likelihood estimates provide a considerable improvement over the other approximations, but all the methods of approximate inference result in a substantial underestimation of the fixed and random effects when the random effects are sizable. We also find that the parametric bootstrap method can eliminate the bias but is computationally very intensive.",0 +https://doi.org/10.1191/096228001678227794,Bayesian methods in meta-analysis and evidence synthesis,"This paper reviews the use of Bayesian methods in meta-analysis. Whilst there has been an explosion in the use of meta-analysis over the last few years, driven mainly by the move towards evidence-based healthcare, so too Bayesian methods are being used increasingly within medical statistics. Whilst in many meta-analysis settings the Bayesian models used mirror those previously adopted in a frequentist formulation, there are a number of specific advantages conferred by the Bayesian approach. These include: full allowance for all parameter uncertainty in the model, the ability to include other pertinent information that would otherwise be excluded, and the ability to extend the models to accommodate more complex, but frequently occurring, scenarios. The Bayesian methods discussed are illustrated by means of a meta-analysis examining the evidence relating to electronic fetal heart rate monitoring and perinatal mortality in which evidence is available from a variety of sources.",0 +https://doi.org/10.1161/strokeaha.108.515460,Longitudinal Analysis of Quality of Life for Stroke Survivors Using Latent Curve Models,"For the survivors, activities of daily living, handicap, and depression have a significant impact on health-related quality of life (HRQOL). How the dynamic changes of these variables relate to HRQOL over time in the subacute phase of stroke recovery has not been investigated. The objective of this study was to study longitudinal behaviors of HRQOL of the stroke survivors in relation to the changes in activities of daily living, handicap, and depression after stroke.This was a prospective cohort study of first disabling patients with stroke. Subjects were interviewed at 3, 6, and 12 months after stroke for modified Barthel Index, London Handicap Scale, Geriatric Depression Scale, and the World Health Organization Quality of Life questionnaire (abbreviated Hong Kong version). A latent curve model was developed to analyze how the dynamic changes in activities of daily living, handicap, and depressive mood related to the changes in HRQOL.Two hundred forty-seven of 303 patients (82%) followed up at 3 months after stroke could complete the quality-of-life questionnaire. Their mean age was 68.8 years. The latent curve model analysis revealed that initial physical health HRQOL was independently associated with activities of daily living, handicap, and depression. The other 3 HRQOL domain scores were primarily associated with depression only. The rates of change in all 4 domains of HRQOL were significantly and inversely associated with rate of change in the Geriatric Depression Scale only.Change in mood in the postacute phase of stroke recovery is the most significant determinant of change in HRQOL. More attention should be paid to the detection and management of poststroke depression.",0 +https://doi.org/10.1207/s15327906mbr3602_06,Multilevel Modeling of Individual and Group Level Mediated Effects,"This article combines procedures for single-level mediational analysis with multilevel modeling techniques in order to appropriately test mediational effects in clustered data. A simulation study compared the performance of these multilevel mediational models with that of single-level mediational models in clustered data with individual- or group-level initial independent variables, individual- or group-level mediators, and individual level outcomes. The standard errors of mediated effects from the multilevel solution were generally accurate, while those from the single-level procedure were downwardly biased, often by 20% or more. The multilevel advantage was greatest in those situations involving group-level variables, larger group sizes, and higher intraclass correlations in mediator and outcome variables. Multilevel mediational modeling methods were also applied to data from a preventive intervention designed to reduce intentions to use steroids among players on high school football teams. This example illustrates differences between single-level and multilevel mediational modeling in real-world clustered data and shows how the multilevel technique may lead to more accurate results.",0 +https://doi.org/10.1080/10705511.2011.557338,Estimation of MIMIC Model Parameters with Multilevel Data,"The purpose of this simulation study was to assess the performance of latent variable models that take into account the complex sampling mechanism that often underlies data used in educational, psychological, and other social science research. Analyses were conducted using the multiple indicator multiple cause (MIMIC) model, which is a flexible and effective tool for relating observed and latent variables. The data were simulated in a hierarchical framework (e.g., individuals nested in schools) so that a multilevel modeling approach would be appropriate. Analyses were conducted accounting for and not accounting for the nested data to determine the impact of ignoring such multilevel data structures in full structural equation models. Results highlight the differences in modeling results when the analytic strategy is congruent with the data structure and what occurs when this congruency is absent. Type I error rates and power for the standard and multilevel methods were similar for within-cluster variables ...",0 +https://doi.org/10.1177/0003122415573049,Paradoxes of Social Policy,"Korpi and Palme’s (1998) classic “The Paradox of Redistribution and Strategies of Equality” claims that universal social policy better reduces poverty than social policies targeted at the poor. This article revisits Korpi and Palme’s classic, and in the process, explores and informs a set of enduring questions about social policy, politics, and social equality. Specifically, we investigate the relationships between three dimensions of welfare transfers—transfer share (the average share of household income from welfare transfers), low-income targeting, and universalism—and poverty and preferences for redistribution. We analyze rich democracies like Korpi and Palme, but we also generalize to a broader sample of developed and developing countries. Consistent with Korpi and Palme, we show (1) poverty is negatively associated with transfer share and universalism; (2) redistribution preferences are negatively associated with low-income targeting; and (3) universalism is positively associated with transfer share. Contrary to Korpi and Palme, redistribution preferences are not related to transfer share or universalism; and low-income targeting is neither positively associated with poverty nor negatively associated with transfer share. Therefore, instead of the “paradox of redistribution” we propose two new paradoxes of social policy: non-complementarity and undermining. The non-complementarity paradox entails a mismatch between the dimensions that matter to poverty and the dimension that matters to redistribution preferences. The undermining paradox emphasizes that the dimension (transfer share) that most reduces poverty tends to increase with the one dimension (low-income targeting) that reduces support for redistribution.",0 +https://doi.org/10.1111/j.1467-842x.2012.00647.x,COMBINING INDIVIDUAL PARTICIPANT DATA AND SUMMARY STATISTICS FROM BOTH CONTINUOUSLY VALUED AND BINARY VARIABLES TO ESTIMATE REGRESSION PARAMETERS,"Summary Recent research has extended standard methods for meta-analysis to more general forms of evidence synthesis, where the aim is to combine different data types or data summaries that contain information about functions of multiple parameters to make inferences about the parameters of interest. We consider one such scenario in which the goal is to make inferences about the association between a primary binary exposure and continuously valued outcome in the context of several confounding exposures, and where the data are available in various different forms: individual participant data (IPD) with repeated measures, sample means that have been aggregated over strata, and binary data generated by thresholding the underlying continuously valued outcome measure. We show that an estimator of the population mean of a continuously valued outcome can be constructed using binary threshold data provided that a separate estimate of the outcome standard deviation is available. The results of a simulation study show that this estimator has negligible bias but is less efficient than the sample mean – the minimum variance ratio is based on a Taylor series expansion. Combining this estimator with sample means and IPD from different sources (such as a series of published studies) using both linear and probit regression does, however, improve the precision of estimation considerably by incorporating data that would otherwise have been excluded for being in the wrong format. We apply these methods to investigate the association between the G277S mutation in the transferrin gene and serum ferritin (iron) levels separately in pre- and post-menopausal women based on data from three published studies.",0 +https://doi.org/10.1007/978-3-319-01264-3_9,Bayesian Methods for Conjoint Analysis-Based Predictions: Do We Still Need Latent Classes?,"AbstractRecently, more and more Bayesian methods have been proposed for modeling heterogeneous preference structures of consumers (see, e.g., Allenby et al., J Mark Res 32:152–162, 1995, 35:384–389, 1998; Baier and Polasek, Stud Classif Data Anal Knowl Organ 22:413–421, 2003; Otter et al., Int J Res Mark 21(3):285–297, 2004). Comparisons have shown that these new methods compete well with the traditional ones where latent classes are used for this purpose (see Ramaswamy and Cohen (2007) Latent class models for conjoint analysis. In: Gustafsson A, Herrmann A, Huber (eds) Conjoint measurement – methods and applications, 4th edn. Springer, Berlin, pp 295–320) for an overview on these traditional methods). This applies especially when the prediction of choices among products is the main objective (e.g. Moore et al., Mark Lett 9(2):195–207, 1998; Andrews et al., J Mark Res 39:479–487, 2002a; 39:87–98, 2002b; Moore, Int J Res Mark 21:299–312, 2004; Karniouchina et al., Eur J Oper Res 19(1):340–348, 2009, with comparative results). However, the question is still open whether this superiority still holds when the latent class approach is combined with the Bayesian one. This paper responds to this question. Bayesian methods with and without latent classes are used for modeling heterogeneous preference structures of consumers and for predicting choices among competing products. The results show a clear superiority of the combined approach over the purely Bayesian one. It seems that we still need latent classes for conjoint analysis-based predictions.KeywordsRoot Mean Square ErrorPosterior DistributionLatent ClassPredictive ValidityMarket SegmentThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.",0 +https://doi.org/10.22329/amr.v13i1.2835,Analyzing Structural Relations in Multivariate Dyadic Binary Data,"In social network studies, most often only a single relation (or link) between the actors is investigated. When more than one link has been recorded, the two-way sociomatrix becomes a three-way array with the set of links being the third way. In this paper, we present a model which simultaneously accounts for the three ways in the data. Random effects are used to model the between-actor variability, both on senders and receivers side. In addition, structural relations between the linking variables are investigated. The model is applied to a study of popularity and strength in a class of students. It is shown that popularity can be seen as a linear function of strength on the receivers’ side, but not on the senders’ side.",0 +,Windowed Sine Bursts: In Search of Optimal Test Signals for Detecting the Threshold of Audibility of Temporal Decays,"A slow decay in an audio signal is perceived as ringing and is commonly caused by room modes. This affects the perception of intelligibility, clarity, definition, and spatial rendering. A method has previously been devised to find the threshold of audibility of the decay in low-frequency narrow-band signals. One of the test signals in the largescale listening test will be a low-frequency sine burst, but spectral spreading at the start and end of the test signal acts as an additional non-modal cue. This effect is removed by windowing, for example a half Hann. The aim of this paper is to determine the window length required (threshold) to render the end of the test signal free from audible spectral spreading. The Parameter Estimation by Sequential Testing (PEST) method and calibrated headphones (to remove factors associated with the listening environment) are used in subjective listening tests. The window length threshold is found to be constant above 200 Hz but rises exponentially towards low frequencies, and is replay level dependent. Threshold may be related to the absolute threshold of hearing, masking curves and/or auditory filter bandwidth.",0 +https://doi.org/10.1371/journal.pone.0096002,A Bayesian Geostatistical Moran Curve Model for Estimating Net Changes of Tsetse Populations in Zambia,"For the first time a Bayesian geostatistical version of the Moran Curve, a logarithmic form of the Ricker stock recruitment curve, is proposed that is able to give an estimate of net change in population demographic rates considering components such as fertility and density dependent and density independent mortalities. The method is applied to spatio-temporally referenced count data of tsetse flies obtained from fly-rounds. The model is a linear regression with three components: population rate of change estimated from the Moran curve, an explicit spatio-temporal covariance, and the observation error optimised within a Bayesian framework. The model was applied to the three main climate seasons of Zambia (rainy--January to April, cold-dry--May to August, and hot-dry--September to December) taking into account land surface temperature and (seasonally changing) cattle distribution. The model shows a maximum positive net change during the hot-dry season and a minimum between the rainy and cold-dry seasons. Density independent losses are correlated positively with day-time land surface temperature and negatively with night-time land surface temperature and cattle distribution. The inclusion of density dependent mortality increases considerably the goodness of fit of the model. Cross validation with an independent dataset taken from the same area resulted in a very accurate estimate of tsetse catches. In general, the overall framework provides an important tool for vector control and eradication by identifying vector population concentrations and local vector demographic rates. It can also be applied to the case of sustainable harvesting of natural populations.",0 +https://doi.org/10.1093/biomet/71.1.1,On the existence of maximum likelihood estimates in logistic regression models,"SUMMARY The problems of existence, uniqueness and location of maximum likelihood estimates in log linear models have received special attention in the literature (Haberman, 1974, Chapter 2; Wedderburn, 1976; Silvapulle, 1981). For multinomial logistic regression models, we prove existence theorems by considering the possible patterns of data points, which fall into three mutually exclusive and exhaustive categories: complete separation, quasicomplete separation and overlap. Our results suggest general rules for identifying infinite parameter estimates in log linear models for frequency tables.",0 +https://doi.org/10.1038/384356a0,Genetic and environmental contributions to the acquisition of a motor skill,"Practice, with feedback, is a fundamental variable that influences the aquisition of motor skills: with it, everyone improves, but some improve more than others. This simple fact has led to frequent debate over the relative importance of genetic and environmental influences on motor learning. In principle these factors could influence subjects' initial level of proficiency, their rate of improvement or their final level of attainment. The problem has been investigated using the rotary pursuit (RP) task, in which subjects learn to track a rotating target with a stylus; this is a factorially pure task which is relatively unaffected by cognitive or verbal factors. Earlier studies of twins reared together indicated that heredity was the primary factor responsible for individual differences in motor skill. Here we have studied learning in a sample of monozygotic (MZA) and dizygotic (DZA) twins who had been reared apart. Heritability of performance was high even in the initial phase, and increased with practice. The rate of learning was also significantly heritable. We propose that the effect of practice is to decrease the effect of environmental variation (previous learning) and increase the relative strength of genetic influences on motor performance.",0 +https://doi.org/10.1080/10705511.2014.937849,A Bayesian Approach to Multilevel Structural Equation Modeling With Continuous and Dichotomous Outcomes,"Multilevel Structural equation models are most often estimated from a frequentist framework via maximum likelihood. However, as shown in this article, frequentist results are not always accurate. Alternatively, one can apply a Bayesian approach using Markov chain Monte Carlo estimation methods. This simulation study compared estimation quality using Bayesian and frequentist approaches in the context of a multilevel latent covariate model. Continuous and dichotomous variables were examined because it is not yet known how different types of outcomes—most notably categorical—affect parameter recovery in this modeling context. Within the Bayesian estimation framework, the impact of diffuse, weakly informative, and informative prior distributions were compared. Findings indicated that Bayesian estimation may be used to overcome convergence problems and improve parameter estimate bias. Results highlight the differences in estimation quality between dichotomous and continuous variable models and the importance o...",1 +https://doi.org/10.3102/10769986029002201,Asymptotic Effect of Misspecification in the Random Part of the Multilevel Model,"The authors examine the asymptotic effect of omitting a random coefficient in the multilevel model and derive expressions for the change in (a) the variance components estimator and (b) the estimated variance of the fixed effects estimator. They apply the method of moments, which yields a closed form expression for the omission effect. In practice, the model parameters are estimated by maximum likelihood; however, since the moment estimator and the maximum likelihood estimator are both consistent, the presented expression for the change in the variance components estimator asymptotically holds for the maximum likelihood estimator as well. The results are illustrated with an analysis of mathematics performance data.",0 +https://doi.org/10.1097/jom.0b013e3180329a8d,The PHLAME (Promoting Healthy Lifestyles: Alternative Models??? Effects) Firefighter Study: Outcomes of Two Models of Behavior Change,"PHLAME's (Promoting Healthy Lifestyles: Alternative Models' Effects) objective was to assess and compare two means to promote healthy lifestyles.Prospective trial among 599 firefighters randomized by station to 1) team-centered curriculum, 2) one-on-one motivational interviewing (MI), and 3) controls. Assessment included dietary behavior, physical activity, weight, and general well-being at baseline and 12 months. Program effects were determined using an analysis of covariance (ANCOVA) based approach, and models for relationships were evaluated with path analysis.Both interventions were acceptable and delivered with high fidelity. The team and MI programs increased fruit and vegetable consumption (P < 0.01 and 0.05, respectively) and general well-being (P < 0.01). Significantly less weight gain occurred in both (P < 0.05). A cross-sectional model was consistent with mediation differing between interventions.Both a team-centered and individual-oriented intervention promoted healthy behaviors. The scripted team curriculum is innovative, exportable, and may enlist influences not accessed with individual formats.",0 +https://doi.org/10.3102/1076998607307359,Extended Generalized Linear Latent and Mixed Model,"The generalized linear latent and mixed modeling (GLLAMM framework) includes many models such as hierarchical and structural equation models. However, GLLAMM cannot currently accommodate some models because it does not allow some parameters to be random. GLLAMM is extended to overcome the limitation by adding a submodel that specifies a distribution of the additional random effects (Extended-GLLAMM). The extension is extremely simple to implement through the Bayesian framework with the WinBUGS software. Our approach is illustrated through the analysis of data from a youth tobacco cessation study.",0 +https://doi.org/10.1016/j.visres.2006.04.022,Bayesian adaptive estimation of threshold versus contrast external noise functions: The quick TvC method,"External noise paradigms, measuring contrast threshold as a function of external noise contrast (the “ TvC ” function), provide a valuable tool for studying perceptual mechanisms. However, measuring TvC functions at the multiple performance criteria needed to constrain observer models has previously involved demanding data collection (often > 2000 trials). To ease this task, we developed a novel Bayesian adaptive procedure, the “quick TvC ” or “ qTvC ” method, to rapidly estimate multiple TvC functions, by adapting a strategy originally developed to estimate psychometric threshold and slope [Cobo-Lewis, A. B. (1996). An adaptive method for estimating multiple parameters of a psychometric function. Journal of Mathematical Psychology , 40 , 353–354; Kontsevich, L. L., & Tyler, C. W. (1999). Bayesian adaptive estimation of psychometric slope and threshold. Vision Research , 39 (16), 2729–2737]. Exploiting the regularities observed in empirical TvC functions, the qTvC method estimates three parameters: the optimal threshold c 0 , the critical noise level N c , and the common slope, η , of log-parallel psychometric functions across external noise conditions. Before each trial, the qTvC uses a one-step-ahead search to select the stimulus (jointly defined by signal and noise contrast) that minimizes the expected entropy of the three-dimensional posterior probability distribution, p ( N c , c 0 , η ). The method’s accuracy and precision, for estimating TvC functions at three performance criteria (65%, 79%, and 92% correct), were evaluated using Monte-Carlo simulations and a psychophysical task. Simulations showed that less than 300 trials were needed to estimate TvC functions at three widely separated criteria with good accuracy (bias < 5%) and precision (mean root mean square error <1.5 dB). Using an orientation identification task, we found excellent agreement (weighted r 2 > .95) between TvC estimates obtained with the qTvC and the method of constant stimuli, although the qTvC used only 12% of the data collection (240 vs 1920 trials). The qTvC may hold considerable practical value for applying the external noise method to study mechanisms of observer state changes and special populations. We suggest that the same adaptive strategy can be applied to directly estimate other classical functions, such as the contrast sensitivity function, elliptical equi-discrimination contours, and sensory memory decay functions.",0 +https://doi.org/10.1080/00273171.2013.796280,Response Time Modeling Based on the Proportional Hazards Model,"Response time data are regularly analyzed in psychology. When several response times are assessed per participant, it is common practice to use latent trait models in order to account for the dependency of the response times from the same participant. One such model is the proportional hazards model with random effects. Despite its popularity in survival analysis, this model is rarely used in psychology because of the difficulty of model estimation when latent variables are present. In this article, a new estimation method is proposed. This method is based on the rank correlation matrix containing Kendall's Tau coefficients and unweighted least squares estimation ( Kendall, 1938 ). Compared with marginal maximum likelihood estimation, the new estimation approach is simple, not computationally intensive, and almost as efficient. Additionally, the approach allows the implementation of a test for model fit. Feasibility of the estimation method and validity of the fit test is demonstrated with a simulation study. An application of the model to a real data set is provided.",0 +https://doi.org/10.1007/s10928-008-9108-2,Comparing models for perfluorooctanoic acid pharmacokinetics using Bayesian analysis,"Selecting the appropriate pharmacokinetic (PK) model given the available data is investigated for perfluorooctanoic acid (PFOA), which has been widely analyzed with an empirical, one-compartment model. This research examined the results of experiments [Kemper R. A., DuPont Haskell Laboratories, USEPA Administrative Record AR-226.1499 (2003)] that administered single oral or iv doses of PFOA to adult male and female rats. PFOA concentration was observed over time; in plasma for some animals and in fecal and urinary excretion for others. There were four rats per dose group, for a total of 36 males and 36 females. Assuming that the PK parameters for each individual within a gender were drawn from the same, biologically varying population, plasma and excretion data were jointly analyzed using a hierarchical framework to separate uncertainty due to measurement error from actual biological variability. Bayesian analysis using Markov Chain Monte Carlo (MCMC) provides tools to perform such an analysis as well as quantitative diagnostics to evaluate and discriminate between models. Starting from a one-compartment PK model with separate clearances to urine and feces, the model was incrementally expanded using Bayesian measures to assess if the expansion was supported by the data. PFOA excretion is sexually dimorphic in rats; male rats have bi-phasic elimination that is roughly 40 times slower than that of the females, which appear to have a single elimination phase. The male and female data were analyzed separately, keeping only the parameters describing the measurement process in common. For male rats, including excretion data initially decreased certainty in the one-compartment parameter estimates compared to an analysis using plasma data only. Allowing a third, unspecified clearance improved agreement and increased certainty when all the data was used, however a significant amount of eliminated PFOA was estimated to be missing from the excretion data. Adding an additional PK compartment reduced the unaccounted-for elimination to amounts comparable to the cage wash. For both sexes, an MCMC estimate of the appropriateness of a model for a given data type, the Deviance Information Criterion, indicated that this two-compartment model was better suited to describing PFOA PK. The median estimate was 142.1 ± 37.6 ml/kg for the volume of the primary compartment and 1.24 ± 1.1 ml/kg/h for the clearances of male rats and 166.4 ± 46.8 ml/kg and 30.3 ± 13.2 ml/kg/h, respectively for female rats. The estimates for the second compartment differed greatly with gender-volume 311.8 ± 453.9 ml/kg with clearance 3.2 ± 6.2 for males and 1400 ± 2507.5 ml/kg and 4.3 ± 2.2 ml/kg/h for females. The median estimated clearance was 12 ± 6% to feces and 85 ± 7% to urine for male rats and 8 ± 6% and 77 ± 9% for female rats. We conclude that the available data may support more models for PFOA PK beyond two-compartments and that the methods employed here will be generally useful for more complicated, including PBPK, models. © 2008 Springer Science+Business Media, LLC.",0 +https://doi.org/10.1214/aos/1176325750,Markov Chains for Exploring Posterior Distributions,"Several Markov chain methods are available for sampling from a posterior distribution. Two important examples are the Gibbs sampler and the Metropolis algorithm. In addition, several strategies are available for constructing hybrid algorithms. This paper outlines some of the basic methods and strategies and discusses some related theoretical and practical issues. On the theoretical side, results from the theory of general state space Markov chains can be used to obtain convergence rates, laws of large numbers and central limit theorems for estimates obtained from Markov chain methods. These theoretical results can be used to guide the construction of more efficient algorithms. For the practical use of Markov chain methods, standard simulation methodology provides several variance reduction techniques and also give guidance on the choice of sample size and allocation.",0 +https://doi.org/10.1016/s0169-7161(06)26010-3,10 Structural Equation Modeling,"Structural equation modeling (SEM), by segregating measurement errors from the true scores of attributes, provides a methodology to model the latent variables, such as attitudes, IQ, personality traits, political liberalism or conservatism, and socio-economic status, directly. The methodology of SEM has enjoyed tremendous developments since 1970, and is now widely applied. The idea of multiple indicators for a latent variable is from factor analysis. SEM is often regarded as an extension of factor analysis in the psychometric literature. This methodology also covers several widely used statistical models in various disciplines. This chapter presents several specific models before introducing the general mean and covariance structures. It is noted that unlike the exploratory factor analysis (EFA) model, the zero loadings in a general confirmatory factor analysis (CFA) model are specified a priori based on subject-matter knowledge, and their number and placement guarantee that the model is identified without any rotational constraints.",0 +https://doi.org/10.1002/tea.20313,How and when does complex reasoning occur? Empirically driven development of a learning progression focused on complex reasoning about biodiversity,"In order to compete in a global economy, students are going to need resources and curricula focusing on critical thinking and reasoning in science. Despite awareness for the need for complex reasoning, American students perform poorly relative to peers on international standardized tests measuring complex thinking in science. Research focusing on learning progressions is one effort to provide more coherent science curricular sequences and assessments that can be focused on complex thinking about focal science topics. This article describes an empirically driven, five-step process to develop a 3-year learning progression focusing on complex thinking about biodiversity. Our efforts resulted in empirical results and work products including: (1) a revised definition of learning progressions, (2) empirically driven, 3-year progressions for complex thinking about biodiversity, (3) an application of statistical approaches for the analysis of learning progression products, (4) Hierarchical Linear Modeling results demonstrating significant student achievement on complex thinking about biodiversity, and (5) Growth Model results demonstrating strengths and weaknesses of the first version of our curricular units. The empirical studies present information to inform both curriculum and assessment development. For curriculum development, the role of learning progressions as templates for the development of organized sequences of curricular units focused on complex science is discussed. For assessment development, learning progression-guided assessments provide a greater range and amount of information that can more reliably discriminate between students of differing abilities than a contrasting standardized assessment measure that was also focused on biodiversity content. © 2009 Wiley Periodicals, Inc. J Res Sci Teach 46: 610–631, 2009",0 +https://doi.org/10.1111/rssc.12107,Objective Bayesian estimation of the probability of default,"Summary Reliable estimation of the probability of default (PD) of a customer is one of the most important tasks in credit risk modelling for banks applying the internal ratings-based approach under the Basel II–III framework. Motivated by the desire to analyse reliably a low default portfolio of non-profit housing companies, we consider PD estimation within a Bayesian framework and develop objective priors for the parameter θ representing the PD in the Gaussian and the Student t single-factor models. A marginal reference prior and limiting versions of it are presented and their posterior propriety is studied. The priors are shown to be direct generalizations of the Jeffreys prior in the binomial model. We use Markov chain Monte Carlo strategies to sample efficiently from the posterior distributions and compare the developed priors on the grounds of the frequentist properties of the resulting Bayesian inferences with subjective priors previously proposed in the literature. Finally, the analysis of the non-profit housing companies portfolio highlights the ultility of the methodological developments.",0 +https://doi.org/10.1002/env.850,Evaluation of Bayesian models for focused clustering in health data,"This paper examines the ability of Bayesian hierarchical models to recover evidence of disease risk excess around a fixed location. This location can be a putative source of health hazard, such as an incinerator, mobile phone mast or dump site. While Bayesian models are convenient to use for modeling, it is useful to consider how well these models perform in the true risk scenarios. In what follows, we evaluate the ability of these models to recover the true risk under simulation. It is surprising that the resulting posterior parameters estimates are heavily biased. Using the credible intervals for distance decline parameter to assess ‘coverage or power’ of detecting distance effect, the ‘power’ decreases with increasing correlation in the background population effect. The inclusion of correlated heterogeneity in models does affect the ability of the models to detect the stronger distance decline scenarios. The uncorrelated heterogeneity seems little affect this ability however. Copyright © 2007 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1136/bmjopen-2015-009013,Antiplatelet regimens in the long-term secondary prevention of transient ischaemic attack and ischaemic stroke: an updated network meta-analysis,"To examine the comparative efficacy and safety of different antiplatelet regimens in patients with prior non-cardioembolic ischaemic stroke or transient ischaemic attack.Systematic review and network meta-analysis.As on 31 March 2015, all randomised controlled trials that investigated the effects of antiplatelet agents in the long-term (≥ 3 months) secondary prevention of non-cardioembolic transient ischaemic attack or ischaemic stroke were searched and identified.The primary outcome measure of efficacy was serious vascular events (non-fatal stroke, non-fatal myocardial infarction and vascular death). The outcome measure of safety was any bleeding.A total of 36 randomised controlled trials (82,144 patients) were included. Network meta-analysis showed that cilostazol was significantly more effective than clopidogrel (OR 0.77, 95% credible interval 0.60-0.98) and low-dose (75-162 mg daily) aspirin (0.69, 0.55-0.86) in the prevention of serious vascular events. Aspirin (50 mg daily) plus dipyridamole (400 mg daily) and clopidogrel reduced the risk of serious vascular events compared with low-dose aspirin; however, the difference was not statistically significant. Furthermore, low-dose aspirin was as effective as higher daily doses. Cilostazol was associated with a significantly lower bleeding risk than most of the other regimens. Moreover, aspirin plus clopidogrel was associated with significantly more haemorrhagic events than other regimens. Direct comparisons showed similar results as the network meta-analysis.Cilostazol was significantly more effective than aspirin and clopidogrel alone in the long-term prevention of serious vascular events in patients with prior non-cardioembolic ischaemic stroke or transient ischaemic attack. Cilostazol was associated with a significantly lower bleeding risk than low-dose aspirin (75-162 mg daily) and aspirin (50 mg daily) plus dipyridamole (400 mg daily). Low-dose aspirin was as effective as higher daily doses. However, further large, randomised, controlled, head-to-head trials are needed, especially in non-Asian ethnic groups.",0 +https://doi.org/10.1016/j.spl.2015.02.022,Further results on estimation of covariance matrix,"Abstract This paper considers the problem of estimating a covariance matrix under Stein’s loss. Sufficient conditions for the modified Efron–Morris estimator to be minimax under weighted quadratic loss are shown, which provide a general method for improving the estimator of the covariance matrix.",0 +https://doi.org/10.1007/bf02295278,A unifying expression for the maximal reliability of a linear composite,"A formally simple expression for the maximal reliability of a linear composite is provided, its theoretical implications and its relation to existing results for reliability are discussed.",0 +https://doi.org/10.1177/0164027599212006,A Multilevel Model of Early Retirement Decisions among Autoworkers in Plants with Different Futures,"During the period of their 1986-1989 General Motors (GM)-United Auto Workers (UAW) contract, about 17% of all GM autoworkers who were eligible to elect early retirement did so. Those who did were distinctive in theoretically expected ways, with expectations defined by individual characteristics such as age, physical health, and pension wealth. But some of the workers were employed in plants that GM had decided to abandon. Did that difference in organizational context make a difference in individual workers’ decisions about early retirement? Would workers who chose to take early retirement and who were employed in plants scheduled to close have made the same decision had their plants not been selected for closure? If the rate of early retirement was higher in plants scheduled to close, and it was, how did that difference relate to the process by which individual workers reached their decisions? These are some of the questions asked and answered through multilevel analyses of data from a probability sample of GM’s autoworkers. These analyses generate findings not detected in single-level analyses of the same data.",0 +https://doi.org/10.1111/jora.12066,Processes Linking Father Absence to Educational Attainment Among African American Females,"Previous researchers have assessed how father absence influences both socioeconomic and reproductive development, but have not analyzed these relationships jointly or used theoretical support for explaining why father absence affects socioeconomic and reproductive development, especially for African American girls. Guided by the family economic stress model and psychosocial acceleration theory, this study investigates how and why these relationships exist for 532 African American females. Structural equation modeling revealed that longer duration of father absence predicted lowered educational attainment in early adulthood via lower income, increased economic pressure, accelerated reproductive development, and lowered educational expectations. We include recommendations for the use of these perspectives to better understand the interplay between family socioeconomic processes and reproductive maturation in African American females.",0 +https://doi.org/10.1017/cbo9781139022422,Design and Analysis of Long-term Ecological Monitoring Studies,"To provide useful and meaningful information, long-term ecological programs need to implement solid and efficient statistical approaches for collecting and analyzing data. This volume provides rigorous guidance on quantitative issues in monitoring, with contributions from world experts in the field. These experts have extensive experience in teaching fundamental and advanced ideas and methods to natural resource managers, scientists and students. The chapters present a range of tools and approaches, including detailed coverage of variance component estimation and quantitative selection among alternative designs; spatially balanced sampling; sampling strategies integrating design- and model-based approaches; and advanced analytical approaches such as hierarchical and structural equation modelling. Making these tools more accessible to ecologists and other monitoring practitioners across numerous disciplines, this is a valuable resource for any professional whose work deals with ecological monitoring. Supplementary example software code is available online at www.cambridge.org/9780521191548.",0 +https://doi.org/10.1300/j426v02n04_05,The Persistent Sciatic Inflammatory Neuropathy (SIN) Rat Model of Neuropathic Pain Does Not Involve Small-Fiber Axon Damage,"ABSTRACTMost neuropathic pain conditions are caused by damage to peripheral nociceptive neurons known as “small-fibers.” Examination of punch skin biopsies immunolabeled with pan-axonal markers has identified degeneration of distal nociceptive axons as a pathological hallmark of most neuralgias including numerous polyneuropathies, postherpetic neuralgia, and complex regional pain syndrome. Similar axonopathy is present in several rodent models of neuralgia (chronic constriction injury and spared nerve injury). Here we have measured the density of distal cutaneous small-fiber axons in rats with persistent mechanical allodynia caused by the sciatic inflammatory neuropathy (SIN), a model of painful neuritis. We have evaluated whether perineural immune activation sufficient to cause evoked-pain behaviors is also associated with loss of distal epidermal innervation.SIN was created in adult male Sprague-Dawley rats by perineural zymosan administration using established methods. Unoperated rats provided controls...",0 +https://doi.org/10.1080/00273171.2015.1090899,A Bayesian Approach to More Stable Estimates of Group-Level Effects in Contextual Studies,"Multilevel analyses are often used to estimate the effects of group-level constructs. However, when using aggregated individual data (e.g., student ratings) to assess a group-level construct (e.g., classroom climate), the observed group mean might not provide a reliable measure of the unobserved latent group mean. In the present article, we propose a Bayesian approach that can be used to estimate a multilevel latent covariate model, which corrects for the unreliable assessment of the latent group mean when estimating the group-level effect. A simulation study was conducted to evaluate the choice of different priors for the group-level variance of the predictor variable and to compare the Bayesian approach with the maximum likelihood approach implemented in the software Mplus. Results showed that, under problematic conditions (i.e., small number of groups, predictor variable with a small ICC), the Bayesian approach produced more accurate estimates of the group-level effect than the maximum likelihood approach did.",0 +https://doi.org/10.1167/13.7.3,"The psi-marginal adaptive method: How to give nuisance parameters the attention they deserve (no more, no less)","Adaptive testing methods serve to maximize the information gained regarding the values of the parameters of a psychometric function (PF). Such methods typically target only one or two (""threshold"" and ""slope"") of the PF's four parameters while assuming fixed values for the ""nuisance"" parameters (""guess rate"" and ""lapse rate""). Here I propose the ""psi-marginal"" adaptive method, which can target nuisance parameters but only when this is the most optimal manner in which to reduce uncertainty in the value of the parameters of primary interest. The method is based on Kontsevich and Tyler's (1999) psi-method. However, in the proposed method a posterior distribution defined across all parameters of unknown value is maintained. Each of the parameters is specified either as a parameter of primary interest whose estimation should be optimized or as a nuisance parameter whose estimation should be subservient to the estimation of the parameters of primary interest. Critically, selection of stimulus intensities is based on the expected information gain in the marginal posterior distribution defined across the parameters of interest only. The appeal of this method is that it will target nuisance parameters adaptively and only when doing so maximizes the expected information gain regarding the values of the parameters of interest. Simulations indicate that treating the lapse rate as a nuisance parameter in the psi-marginal method results in smaller bias and higher precision in threshold and slope estimates compared to the original psi method. The method is highly flexible and various other uses are discussed.",0 +https://doi.org/10.1111/jtsa.12182,A Bayesian Non-Parametric Dynamic AR Model for Multiple Time Series Analysis,"In this article, we propose a Bayesian non-parametric model for the analysis of multiple time series. We consider an autoregressive structure of order p for each of the series and borrow strength across the series by considering a common error population that is also evolving in time. The error populations (distributions) are assumed non-parametric whose law is based on a series of dependent Polya trees with zero median. This dependence is of order q and is achieved via a dependent beta process that links the branching probabilities of the trees. We study the prior properties and show how to obtain posterior inference. The model is tested under a simulation study and is illustrated with the analysis of the economic activity index of the 32 states of Mexico.",0 +https://doi.org/10.1111/j.2517-6161.1970.tb00842.x,Asymptotic Properties of Conditional Maximum-Likelihood Estimators,The problem of obtaining consistent estimates for structural parameters in the presence of infinitely many incidental parameters was discussed first by Neyman and Scott (1948). In this paper a maximum-likelihood method based on the conditional distribution given minimal sufficient statistics for the incidental parameters is suggested. It is proved that conditional maximumlikelihood estimates in the regular case are consistent and asymptotically normally distributed with a simple asymptotic variance. The efficiency problem of this new estimator is discussed in particular with respect to some situations with ancillary information.,0 +https://doi.org/10.1016/j.drugalcdep.2014.12.029,Effects of marijuana use on impulsivity and hostility in daily life,"Marijuana use is increasingly prevalent among young adults. While research has found adverse effects associated with marijuana use within experimentally controlled laboratory settings, it is unclear how recreational marijuana use affects day-to-day experiences in users. The present study sought to examine the effects of marijuana use on within-person changes in impulsivity and interpersonal hostility in daily life using smartphone administered assessments.Forty-three participants with no substance dependence reported on their alcohol consumption, tobacco use, recreational marijuana use, impulsivity, and interpersonal hostility over the course of 14 days. Responses were analyzed using multilevel modeling.Marijuana use was associated with increased impulsivity on the same day and the following day relative to days when marijuana was not used, independent of alcohol use. Marijuana was also associated with increased hostile behaviors and perceptions of hostility in others on the same day when compared to days when marijuana was not used. These effects were independent of frequency of marijuana use or alcohol use. There were no significant effects of alcohol consumption on impulsivity or interpersonal hostility.Marijuana use is associated with changes in impulse control and hostility in daily life. This may be one route by which deleterious effects of marijuana are observed for mental health and psychosocial functioning. Given the increasing prevalence of recreational marijuana use and the potential legalization in some states, further research on the potential consequences of marijuana use in young adults' day-to-day life is warranted.",0 +https://doi.org/10.1207/s15328007sem0802_1,The Accuracy of Multilevel Structural Equation Modeling With Pseudobalanced Groups and Small Samples,"Hierarchical structured data cause problems in analysis, because the usual assumptions of independently and identically distributed variables are violated. Muthen (1989) described an estimation method for multilevel factor and path analysis with hierarchical data. This article assesses the robustness of the method with unequal groups, small sample sizes at both the individual and the group level, in the presence of a low or a high intraclass correlation (ICC). The within-groups part of the model poses no problems. The most important problem in the between-groups part of the model is the occurrence of inadmissible estimates, especially when group level sample size is small (50) while the intracluster correlation is low. This is partly compensated by using large group sizes. When an admissible solution is reached, the factor loadings are generally accurate. However, the residual variances are underestimated, and the standard errors are generally too small. Having more or larger groups or a higher ICC does n...",0 +https://doi.org/10.1037/a0039540,Bayesian hierarchical grouping: Perceptual grouping as mixture estimation.,"We propose a novel framework for perceptual grouping based on the idea of mixture models, called Bayesian hierarchical grouping (BHG). In BHG, we assume that the configuration of image elements is generated by a mixture of distinct objects, each of which generates image elements according to some generative assumptions. Grouping, in this framework, means estimating the number and the parameters of the mixture components that generated the image, including estimating which image elements are ""owned"" by which objects. We present a tractable implementation of the framework, based on the hierarchical clustering approach of Heller and Ghahramani (2005). We illustrate it with examples drawn from a number of classical perceptual grouping problems, including dot clustering, contour integration, and part decomposition. Our approach yields an intuitive hierarchical representation of image elements, giving an explicit decomposition of the image into mixture components, along with estimates of the probability of various candidate decompositions. We show that BHG accounts well for a diverse range of empirical data drawn from the literature. Because BHG provides a principled quantification of the plausibility of grouping interpretations over a wide range of grouping problems, we argue that it provides an appealing unifying account of the elusive Gestalt notion of Prägnanz.",0 +https://doi.org/10.1007/bf02294195,Test theory without an answer key,"A general model is presented for homogeneous, dichotomous items when the answer key is not known a priori. The model is structurally related to the two-class latent structure model with the roles of respondents and items interchanged. For very small sets of respondents, iterative maximum likelihood estimates of the parameters can be obtained by existing methods. For other situations, new estimation methods are developed and assessed with Monte Carlo data. The answer key can be accurately reconstructed with relatively small sets of respondents. The model is useful when a researcher wants to study objectively the knowledge possessed by members of a culturally coherent group that the researcher is not a member of. © 1987 The Psychometric Society.",0 +https://doi.org/10.1080/00949650701519635,Parameter expansion for sampling a correlation matrix: an efficient GPX-RPMH algorithm,"Sampling the correlation matrix (R) plays an important role in statistical inference for correlated models. There are two main constraints on a correlation matrix: positive definiteness and fixed diagonal elements. These constraints make sampling R difficult. In this paper, an efficient generalized parameter expanded re-parametrization and Metropolis-Hastings (GPX-RPMH) algorithm for sampling a correlation matrix is proposed. Drawing all components of R simultaneously from its full conditional distribution is realized by first drawing a covariance matrix from the derived parameter expanded candidate density (PXCD), and then translating it back to a correlation matrix and accepting it according to a Metropolis-Hastings (M-H) acceptance rate. The mixing rate in the M-H step can be adjusted through a class of tuning parameters embedded in the generalized candidate prior (GCP), which is chosen for R to derive the PXCD. This algorithm is illustrated using multivariate regression (MVR) models and a simulation s...",0 +https://doi.org/10.1007/bf00122574,Advances in prospect theory: Cumulative representation of uncertainty,"We develop a new version of prospect theory that employs cumulative rather than separable decision weights and extends the theory in several respects. This version, called cumulative prospect theory, applies to uncertain as well as to risky prospects with any number of outcomes, and it allows different weighting functions for gains and for losses. Two principles, diminishing sensitivity and loss aversion, are invoked to explain the characteristic curvature of the value function and the weighting functions. A review of the experimental evidence and the results of a new experiment confirm a distinctive fourfold pattern of risk attitudes: risk aversion for gains and risk seeking for losses of high probability; risk seeking for gains and risk aversion for losses of low probability. This article has benefited from discussions with Colin Camerer, Chew Soo-Hong, David Freedman, and David H. Krantz. We are especially grateful to Peter P. Wakker for his invaluable input and contribution to the axiomatic analysis. We are indebted to Richard Gonzalez and Amy Hayes for running the experiment and analyzing the data. This work was supported by Grants 89-0064 and 88-0206 from the Air Force Office of Scientific Research, by Grant SES-9109535 from the National Science Foundation, and by the Sloan Foundation. © 1992 Kluwer Academic Publishers.",0 +https://doi.org/10.3102/0162373707299706,Intraclass Correlation Values for Planning Group-Randomized Trials in Education,"Experiments that assign intact groups to treatment conditions are increasingly common in social research. In educational research, the groups assigned are often schools. The design of group-randomized experiments requires knowledge of the intraclass correlation structure to compute statistical power and sample sizes required to achieve adequate power. This article provides a compilation of intraclass correlation values of academic achievement and related covariate effects that could be used for planning group-randomized experiments in education. It also provides variance component information that is useful in planning experiments involving covariates. The use of these values to compute the statistical power of group-randomized experiments is illustrated.",0 +https://doi.org/10.1080/00273170802034844,The Performance of Methods to Test Upper-Level Mediation in the Presence of Nonnormal Data,"A Monte Carlo study compared the statistical performance of standard and robust multilevel mediation analysis methods to test indirect effects for a cluster randomized experimental design under various departures from normality. The performance of these methods was examined for an upper-level mediation process, where the indirect effect is a fixed effect and a group-implemented treatment is hypothesized to impact a person-level outcome via a person-level mediator. Two methods-the bias-corrected parametric percentile bootstrap and the empirical-M test-had the best overall performance. Methods designed for nonnormal score distributions exhibited elevated Type I error rates and poorer confidence interval coverage under some conditions. Although preliminary, the findings suggest that new mediation analysis methods may provide for robust tests of indirect effects.",0 +https://doi.org/10.1016/j.neuroscience.2014.05.036,The place of human psychophysics in modern neuroscience,"Human psychophysics is the quantitative measurement of our own perceptions. In essence, it is simply a more sophisticated version of what humans have done since time immemorial: noticed and reflected upon what we can see, hear, and feel. In the 21st century, when hugely powerful techniques are available that enable us to probe the innermost structure and function of nervous systems, is human psychophysics still relevant? I argue that it is, and that in combination with other techniques, it will continue to be a key part of neuroscience for the foreseeable future. I discuss these points in detail using the example of binocular stereopsis, where human psychophysics in combination with physiology and computational vision, has made a substantial contribution.",0 +https://doi.org/10.1007/bf02288892,A basis for analyzing test-retest reliability,"Three sources of variation in experimental results for a test are distinguished: trials, persons, and items. Unreliability is defined only in terms of variation over trials. This definition leads to a more complete analysis than does the conventional one; Spearman's contention is verified that the conventional approach-which was formulated by Yule-introduces unnecessary hypotheses. It is emphasized that at least two trials are necessary to estimate the reliability coefficient. This paper is devoted largely to developing lower bounds to the reliability coefficient that can be computed from but a single trial; these avoid the experimental difficulties of making two independent trials. Six different lower bounds are established, appropriate for different situations. Some of the bounds are easier to compute than are conventional formulas, and all the bounds assume less than do conventional formulas. The terminology used is that of psychological and sociological testing, but the discussion actually provides a general analysis of the reliability of the sum of n variables. © 1945 Psychometric Society.",0 +https://doi.org/10.1207/s15328007sem0702_1,"Point Estimation, Hypothesis Testing, and Interval Estimation Using the RMSEA: Some Comments and a Reply to Hayduk and Glaser","Hayduk and Glaser (2000) asserted that the most commonly used point estimate of the Root Mean Square Error of Approximation index of fit (Steiger & Lind, 1980) has two significant problems: (a) The frequently cited target value of. 05 is not a stable target, but a sample size adjustment; and (b) the truncated point estimate Rt = max(R, 0) effectively throws away a substantial part of the sampling distribution of the test statistic with proper models, rendering it useless a substantial portion of the time. In this article, I demonstrate that both issues discussed by Hayduk and Glaser are actually not problems at all. The first derives from a false premise by Hayduk and Glaser that Steiger (1995) specifically warned about in an earlier publication. The second so-called problem results from the point estimate satisfying a fundamental property of a good estimator and can be shown to have virtually no negative implications for statistical practice.",0 +https://doi.org/10.2165/00019053-200624010-00001,Bayesian Methods for Evidence Synthesis in Cost-Effectiveness Analysis,"Recently, health systems internationally have begun to use cost-effectiveness research as formal inputs into decisions about which interventions and programmes should be funded from collective resources. This process has raised some important methodological questions for this area of research. This paper considers one set of issues related to the synthesis of effectiveness evidence for use in decision-analytic cost-effectiveness (CE) models, namely the need for the synthesis of all sources of available evidence, although these may not 'fit neatly' into a CE model. Commonly encountered problems include the absence of head-to-head trial evidence comparing all options under comparison, the presence of multiple endpoints from trials and different follow-up periods. Full evidence synthesis for CE analysis also needs to consider treatment effects between patient subpopulations and the use of nonrandomised evidence. Bayesian statistical methods represent a valuable set of analytical tools to utilise indirect evidence and can make a powerful contribution to the decision-analytic approach to CE analysis. This paper provides a worked example and a general overview of these methods with particular emphasis on their use in economic evaluation. © 2006 Adis Data Information BV. All rights reserved.",0 +https://doi.org/10.1093/biostatistics/kxp053,Bayesian inference for generalized linear mixed models,"Generalized linear mixed models (GLMMs) continue to grow in popularity due to their ability to directly acknowledge multiple levels of dependency and model different data types. For small sample sizes especially, likelihood-based inference can be unreliable with variance components being particularly difficult to estimate. A Bayesian approach is appealing but has been hampered by the lack of a fast implementation, and the difficulty in specifying prior distributions with variance components again being particularly problematic. Here, we briefly review previous approaches to computation in Bayesian implementations of GLMMs and illustrate in detail, the use of integrated nested Laplace approximations in this context. We consider a number of examples, carefully specifying prior distributions on meaningful quantities in each case. The examples cover a wide range of data types including those requiring smoothing over time and a relatively complicated spline model for which we examine our prior specification in terms of the implied degrees of freedom. We conclude that Bayesian inference is now practically feasible for GLMMs and provides an attractive alternative to likelihood-based approaches such as penalized quasi-likelihood. As with likelihood-based approaches, great care is required in the analysis of clustered binary data since approximation strategies may be less accurate for such data.",0 +https://doi.org/10.1186/s13075-015-0864-2,Determinants of patient preferences for total knee replacement: African-Americans and whites,"Patient preferences contribute to marked racial disparities in the utilization of total knee replacement (TKR). The objectives of this study were to identify the determinants of knee osteoarthritis (OA) patients' preferences regarding TKR by race and to identify the variables that may mediate racial differences in willingness to undergo TKR.Five hundred fourteen White (WH) and 285 African-American (AA) patients with chronic knee pain and radiographic evidence of OA participated in the study. Participants were recruited from the community, an academic medical center, and a Veterans Affairs hospital. Structured interviews were conducted to collect socio-demographics, disease severity, socio-cultural determinants, and treatment preferences. Logistic regression was performed, stratified by race, to identify determinants of preferences. Clinical and socio-cultural factors were entered simultaneously into the models. Stepwise selection identified factors for inclusion in the final models (p < 0.20).Compared to WHs, AAs were less willing to undergo TKR (80 % vs. 62 %, respectively). Better expectations regarding TKR surgery outcomes determined willingness to undergo surgery in both AAs (odds ratio (OR) 2.08, 95 % confidence interval (CI) 0.91-4.79 for 4(th) vs. 1(st) quartile) and WHs (OR 5.11, 95 % CI 2.31-11.30 for 4(th) vs. 1(st) quartile). Among AAs, better understanding of the procedure (OR 1.80, 95 % CI 0.97-3.35), perceiving a short hospital course (OR 0.81, 95 % CI 0.58-1.13), and believing in less post-surgical pain (OR 0.73, 95 % CI 0.39-1.35) and walking difficulties (OR 0.66, 95 % CI 0.37-1.16) also determined willingness. Among WHs, having surgical discussion with a physician (OR 1.96, 95 % CI 1.05-3.68), not ever receiving surgical referral (OR 0.56, 95 % CI 0.32-0.99), and higher trust in the healthcare system (OR 1.58, 95 % CI 0.75-3.31 for 4(th) vs. 1(st) quartile) additionally determined willingness. Among the variables considered, only knowledge-related matters pertaining to TKR attenuated the racial difference in knee OA patients' treatment preference.Expectations of surgical outcomes influence preference for TKR in all patients, but clinical and socio-cultural factors exist that shape marked racial differences in preferences for TKR. Interventions to reduce or eliminate racial disparities in the utilization of TKR should consider and target these factors.",0 +,Estimation and Optimization of Functions,,0 +https://doi.org/10.1006/jmps.1999.1268,Selective Influence and Response Time Cumulative Distribution Functions in Serial-Parallel Task Networks,"We analyze sets of mental processes, some of which are concurrent and some of which are sequential, under the assumption that the processes are partially ordered, that is, arranged in a directed acyclic network. Information about the process arrangement can be discovered by examining the effects on response time of selectively influencing process durations. Previous work has mainly focused on analyses of mean response times. Here we consider analyses based on cumulative distribution functions, for one of the major classes of directed acyclic networks, serial-parallel networks. When two processes are selectively influenced, patterns in the cumulative distribution functions can be used to test whether the processes are sequential or concurrent and whether the task network has AND gates or OR gates. Cumulative distribution functions are potentially more informative than means, and some previous results for means are shown to follow from our results for cumulative distribution functions. Copyright 2000 Academic Press.",0 +https://doi.org/10.1006/jmps.1995.1033,"Spatio-temporal Properties of Elementary Perception: An Investigation of Parallel, Serial, and Coactive Theories","A mathematical theory and related experimental methodology are developed that permit strong, converging tests of parallel versus serial versus channel summation processing and of exhaustive versus self-terminating processing. An experimental design is used for two studies, in which the presence or absence of a target in each of two positions, is factorially combined with two levels of brightness (a version of the double factorial paradigm). When both targets are present (redundant target condition) the two levels of brightness permit factorial technology to determine mental architecture and stopping rules. Comparison of the single versus double target conditions allows capacity analyses that strongly reinforce the double target factorial phase of the investigation. The results provide decisive support for parallel channels with either a self-terminating stopping rule or a coactive summation of information. General serial models and any variety of exhaustive processing were conclusively falsified.",0 +https://doi.org/10.1016/j.actpsy.2014.03.001,Properties of the size–weight illusion as shown by lines of subjective equality,"We studied the size-weight illusion through comparative judgments. The experiment had two direct aims: to verify whether the relative contribution of size to apparent heaviness can differ for different stimulus sets, and to verify whether that contribution can differ for different methods of comparing two objects (consecutive vs. simultaneous weighing). Thirty university students participated. Results show that the relative contribution of size depends on stimulus set, but is independent of the method used for comparing objects. The first finding implies that a linear model cannot describe the integration of size and weight information in the illusion; the second finding is evidence for the low-level character of the integration process.",0 +https://doi.org/10.1007/bf00152012,New developments in LISREL: analysis of ordinal variables using polychoric correlations and weighted least squares,New developments in LISREL: : Analysis of ordinal variables using polychoric correlations and weighted least squares,0 +https://doi.org/10.1037/met0000034,Fitting a linear–linear piecewise growth mixture model with unknown knots: A comparison of two common approaches to inference.,"A linear-linear piecewise growth mixture model (PGMM) is appropriate for analyzing segmented (disjointed) change in individual behavior over time, where the data come from a mixture of 2 or more latent classes, and the underlying growth trajectories in the different segments of the developmental process within each latent class are linear. A PGMM allows the knot (change point), the time of transition from 1 phase (segment) to another, to be estimated (when it is not known a priori) along with the other model parameters. To assist researchers in deciding which estimation method is most advantageous for analyzing this kind of mixture data, the current research compares 2 popular approaches to inference for PGMMs: maximum likelihood (ML) via an expectation-maximization (EM) algorithm, and Markov chain Monte Carlo (MCMC) for Bayesian inference. Monte Carlo simulations were carried out to investigate and compare the ability of the 2 approaches to recover the true parameters in linear-linear PGMMs with unknown knots. The results show that MCMC for Bayesian inference outperformed ML via EM in nearly every simulation scenario. Real data examples are also presented, and the corresponding computer codes for model fitting are provided in the Appendix to aid practitioners who wish to apply this class of models.",0 +https://doi.org/10.1002/sim.1980,A three-level model for binary time-series data: the effects of air pollution on school absences in the Southern California Children's Health Study,"A three-level model is proposed to simultaneously examine the effects of daily exposure to air pollution and individual risk factors on health outcomes without aggregating over subjects or time. We used a logistic transition model with random effects to take into account heterogeneity and overdispersion of the observations. A distributed lag structure for pollution has been included, assuming that the event on day t for a subject depends on the levels of air pollution for several preceding days. We illustrate this proposed model via detailed analysis of the effect of air pollution on school absenteeism based on data from the Southern California Children's Health Study.",0 +https://doi.org/10.1080/10705511.2014.936082,Diagnosing Global Case Influence on MAR Versus MNAR Model Comparisons,"When missingness is suspected to be not at random (MNAR) in longitudinal studies, researchers sometimes compare the fit of a target model that assumes missingness at random (here termed a MAR model) and a model that accommodates a hypothesized MNAR missingness mechanism (here termed a MNAR model). It is well known that such comparisons are only interpretable conditional on the validity of the chosen MNAR model’s assumptions about the missingness mechanism. For that reason, researchers often perform a sensitivity analysis comparing the MAR model to not one, but several, plausible alternative MNAR models. In the social sciences, it is not widely known that such model comparisons can be particularly sensitive to case influence, such that conclusions drawn could depend on a single case. This article describes two convenient diagnostics suited for detecting case influence on MAR–MNAR model comparisons. Both diagnostics require much less computational burden than global influence diagnostics that have been used...",0 +https://doi.org/10.1177/1745691611406925,Bayesian Assessment of Null Values Via Parameter Estimation and Model Comparison,"Psychologists have been trained to do data analysis by asking whether null values can be rejected. Is the difference between groups nonzero? Is choice accuracy not at chance level? These questions have been traditionally addressed by null hypothesis significance testing (NHST). NHST has deep problems that are solved by Bayesian data analysis. As psychologists transition to Bayesian data analysis, it is natural to ask how Bayesian analysis assesses null values. The article explains and evaluates two different Bayesian approaches. One method involves Bayesian model comparison (and uses Bayes factors). The second method involves Bayesian parameter estimation and assesses whether the null value falls among the most credible values. Which method to use depends on the specific question that the analyst wants to answer, but typically the estimation approach (not using Bayes factors) provides richer information than the model comparison approach.",0 +https://doi.org/10.1016/j.jlp.2011.11.014,Prediction of occupational accident statistics and work time loss distributions using Bayesian analysis,"This paper uses Bayesian analysis tools for the stochastic evaluation of work time losses due to occupational accidents in a workplace. Models are developed for accident frequencies, duration of recovery from an accident, and the worker unavailability. The unavailability statistics are hereby derived considering a two state stochastic model, to provide estimates for the expected work time losses over a base period of workplace operation. The above models are applied on real multiyear accident data collected from the Greek Petrochemical Industry.",0 +https://doi.org/10.1037/1082-989x.12.2.121,Centering predictor variables in cross-sectional multilevel models: A new look at an old issue.,"Appropriately centering Level 1 predictors is vital to the interpretation of intercept and slope parameters in multilevel models (MLMs). The issue of centering has been discussed in the literature, but it is still widely misunderstood. The purpose of this article is to provide a detailed overview of grand mean centering and group mean centering in the context of 2-level MLMs. The authors begin with a basic overview of centering and explore the differences between grand and group mean centering in the context of some prototypical research questions. Empirical analyses of artificial data sets are used to illustrate key points throughout. The article provides a number of practical recommendations designed to facilitate centering decisions in MLM applications.",0 +,Fixed effects models.,,0 +https://doi.org/10.1007/s13253-013-0140-3,Modeling Complex Spatial Dependencies: Low-Rank Spatially Varying Cross-Covariances With Application to Soil Nutrient Data,"Advances in geo-spatial technologies have created data-rich environments which provide extraordinary opportunities to understand the complexity of large and spatially indexed data in ecology and the natural sciences. Our current application concerns analysis of soil nutrients data collected at La Selva Biological Station, Costa Rica, where inferential interest lies in capturing the spatially varying relationships among the nutrients. The objective here is to interpolate not just the nutrients across space, but also associations among the nutrients that are posited to vary spatially. This requires spatially varying cross-covariance models. Fully process-based specifications using matrix-variate processes are theoretically attractive but computationally prohibitive. Here we develop fully process-based low-rank but non-degenerate spatially varying cross-covariance processes that can effectively yield interpolate cross-covariances at arbitrary locations. We show how a particular low-rank process, the predictive process, which has been widely used to model large geostatistical datasets, can be effectively deployed to model non-degenerate cross-covariance processes. We produce substantive inferential tools such as maps of nonstationary cross-covariances that constitute the premise of further mechanistic modeling and have hitherto not been easily available for environmental scientists and ecologists. © 2013 International Biometric Society.",0 +https://doi.org/10.4992/jjpsy.85.13077,Unfolding item response model using best-worst scaling,"In attitude measurement and sensory tests, the unfolding model is typically used. In this model, response probability is formulated by the distance between the person and the stimulus. In this study, we proposed an unfolding item response model using best-worst scaling (BWU model), in which a person chooses the best and worst stimulus among repeatedly presented subsets of stimuli. We also formulated an unfolding model using best scaling (BU model), and compared the accuracy of estimates between the BU and BWU models. A simulation experiment showed that the BWU modell performed much better than the BU model in terms of bias and root mean square errors of estimates. With reference to Usami (2011), the proposed models were apllied to actual data to measure attitudes toward tardiness. Results indicated high similarity between stimuli estimates generated with the proposed models and those of Usami (2011).",0 +https://doi.org/10.2307/1267913,Restricted Maximum Likelihood (REML) Estimation of Variance Components in the Mixed Model,"The maximum likelihood (ML) procedure of Hartley aud Rao [2] is modified by adapting a transformation from Pattersou and Thompson [7] which partitions the likelihood render normality into two parts, one being free of the fixed effects. Maximizing this part yields what are called restricted maximum likelihood (REML) estimators. As well as retaining the property of invariance under translation that ML estimators have, the REML estimators have the additional property of reducing to the analysis variance (ANOVA) estimators for many, if not all, cases of balanced data (equal subclass numbers). A computing algorithm is developed, adapting a transformation from Hemmerle and Hartley [6], which reduces computing requirements to dealing with matrices having order equal to the dimension of the parameter space rather than that of the sample space. These same matrices also occur in the asymptotic sampling variances of the estimators.",0 +https://doi.org/10.1002/hec.1496,"Bayesian methods in cost-effectiveness studies: objectivity, computation and other relevant aspects","In a probabilistic sensitivity analysis (PSA) of a cost–effectiveness (CE) study, the unknown parameters are considered as random variables. A crucial question is what probabilistic distribution is suitable for synthesizing the available information (mainly data from clinical trials) about these parameters. In this context, the important role of Bayesian methodology has been recognized, where the parameters are of a random nature. We explore, in the context of CE analyses, how formal objective Bayesian methods can be implemented. We fully illustrate the methodology using two CE problems that frequently appear in the CE literature. The results are compared with those obtained with other popular approaches to PSA. We find that the discrepancies can be quite marked, specially when the number of patients enrolled in the simulated cohort under study is large. Finally, we describe in detail the numerical methods that need to be used to obtain the results. Copyright © 2009 John Wiley & Sons, Ltd.",0 +https://doi.org/10.4324/978131589416-11,Multilevel models of burnout: separating group level and individual level effects in burnout research,"For nearly two decades, there has been a growing trend toward a multilevel perspective of individual behavior in organizations (Klein et al., 1994; Kozlowski & Klein, 2000). More recently, there has been an increasing emphasis on multilevel explanations within the stress literature, both from psychological and public health researchers (Bliese & Jex, 2002). Burnout research has followed a similar pattern to many organizational behavior constructs. Throughout the years, burnout has fairly consistently been defined as an individual phenomenon (Halbesleben & Buckley, 2004; Maslach et al., 2001). However, throughout that same time, there have been suggestions that burnout has a collective or shared element to it (Edelwich & Brodsky, 1980; Gonzalez-Morales et al., 2012). For example, Gonzalez-Morales et al. (2012) defined collective burnout in terms of the shared experience of burnout among coworkers in the same work environment. They argued that the contextual antecedents and experiences of burnout (e.g., Bakker & Schaufeli, 2000; Bakker et al., 2009) suggest that burnout can be conceptualized as an individual phenomenon or a socially constructed experience.",0 +https://doi.org/10.1146/annurev-statistics-022513-115701,"Breaking Bad: Two Decades of Life-Course Data Analysis in Criminology, Developmental Psychology, and Beyond","Studies of human development require longitudinal data analysis methods that describe within- and between-individual variation in developmental and behavioral trajectories. This article reviews life-course data analysis methods for modeling these trajectories, as well as their application in studies of antisocial behavior and of crime in childhood, in adolescence, and throughout life. We set the stage by introducing growth curve (hierarchical linear) models. We focus our review on finite mixture models for life-course data, known as group-based trajectory and growth mixture models. We then discuss how these models are applied within criminology and developmental psychology, recent controversies over their substantive use and interpretation, and important issues of statistical practice and the challenges they raise. Building on the critical literature, we offer several recommendations for the applied users of the models. Finally, we present the most recent method of examining behavioral trajectories in criminology, the unimodal curve registration (UCR) approach. We briefly contrast the UCR model with growth curve and finite mixture models for life-course data analysis.",0 +https://doi.org/10.1097/01.aud.0000440715.85844.b8,Listening Effort and Perceived Clarity for Normal-Hearing Children With the Use of Digital Noise Reduction,"Objectives The goal of this study was to evaluate how digital noise reduction (DNR) impacts listening effort and judgment of sound clarity in children with normal hearing. It was hypothesized that when two DNR algorithms differing in signal-to-noise ratio (SNR) output are compared, the algorithm that provides the greatest improvement in overall output SNR will reduce listening effort and receive a better clarity rating from child listeners. A secondary goal was to evaluate the relation between the inversion method measurements and listening effort with DNR processing. Design Twenty-four children with normal hearing (ages 7 to 12 years) participated in a speech recognition task in which consonant-vowel-consonant nonwords were presented in broadband background noise. Test stimuli were recorded through two hearing aids with DNR off and DNR on at 0 dB and +5 dB input SNR. Stimuli were presented to listeners and verbal response time (VRT) and phoneme recognition scores were measured. The underlying assumption was that an increase in VRT reflects an increase in listening effort. Children rated the sound clarity for each condition. The two commercially available HAs were chosen based on: (1) an inversion technique, which was used to quantify the magnitude of change in SNR with the activation of DNR, and (2) a measure of magnitude-squared coherence, which was used to ensure that DNR in both devices preserved the spectrum. Results One device provided a greater improvement in overall output SNR than the other. Both DNR algorithms resulted in minimal spectral distortion as measured using coherence. For both devices, VRT decreased for the DNR-on condition, suggesting that listening effort decreased with DNR in both devices. Clarity ratings were also better in the DNR-on condition for both devices. The device showing the greatest improvement in output SNR with DNR engaged improved phoneme recognition scores. The magnitude of this improved phoneme recognition was not accurately predicted with measurements of output SNR. Measured output SNR varied in the ability to predict other outcomes. Conclusions Overall, results suggest that DNR effectively reduces listening effort and improves subjective clarity ratings in children with normal hearing but that these improvements are not necessarily related to the output SNR improvements or preserved speech spectra provided by the DNR.",0 +https://doi.org/10.1002/sim.4780142408,Bayesian approaches to random-effects meta-analysis: A comparative study,"Current methods for meta-analysis still leave a number of unresolved issues, such as the choice between fixed- and random-effects models, the choice of population distribution in a random-effects analysis, the treatment of small studies and extreme results, and incorporation of study-specific covariates. We describe how a full Bayesian analysis can deal with these and other issues in a natural way, illustrated by a recent published example that displays a number of problems. Such analyses are now generally available using the BUGS implementation of Markov chain Monte Carlo numerical integration techniques. Appropriate proper prior distributions are derived, and sensitivity analysis to a variety of prior assumptions carried out. Current methods are briefly summarized and compared to the full Bayes analysis.",0 +,Estimation of the standard error and confidence interval of the indirect effect in multiple mediator models,,0 +,Model Likelihoods and Bayes Factors for Switching and Mixture Models,"In the present paper we discuss the problem of estimating model likelihoods from the MCMC output for a general mixture and switching model. Estimation is based on the method of bridge sampling (Meng and Wong, 1996), where the MCMC sample is combined with an iid sample from an importance density. The importance density is constructed in an unsupervised manner from the MCMC output using a mixture of complete data posteriors. Whereas the importance sampling estimator as well as the reciprocal importance sampling estimator are sensitive to the tail behaviour of the importance density, we demonstrate that the bridge sampling estimator is far more robust in this concern. Our case studies range from computing marginal likelihoods for a mixture of multivariate normal distributions, testing for the inhomogeneity of a discrete time Poisson process, to testing for the presence of Markov switching and order selection in the MSAR model. (author's abstract)",0 +https://doi.org/10.1037/0278-7393.10.4.598,Analysis of response time distributions in the study of cognitive processes.,"Examined the convolution analysis of RT distributions in 3 experiments employing 4 cognitive tasks with 14 college students. In Exp I (n = 6), a visual search task was contrasted with a short-term memory search task. In Exp II (n = 4) and Exp III (n = 4), a relative judgment of recency task was contrasted with a 2-alternative, forced-choice recognition task. Taken together, the experiments demonstrate that the convolution analysis provides a good description of RT distributions in a variety of tasks and that the parameters of the convolution analysis can behave differentially in different tasks. It is argued that the parameters of the convolution analysis can play an important role in discriminating between models and in critically evaluating models that may be otherwise acceptable. (26 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1984 American Psychological Association.",0 +https://doi.org/10.1037/met0000094,Maximum likelihood versus multiple imputation for missing data in small longitudinal samples with nonnormality.,"The study examined the performance of maximum likelihood (ML) and multiple imputation (MI) procedures for missing data in longitudinal research when fitting latent growth models. A Monte Carlo simulation study was conducted with conditions of small sample size, intermittent missing data, and nonnormality. The results indicated that ML tended to display slightly smaller degrees of bias than MI across missing completely at random (MCAR) and missing at random (MAR) conditions. Although specification of prior information in the MI imputation-posterior (I-P) phase influenced the performance of MI, especially with nonnormal small samples and missing not at random (MNAR), the impact of this tight specification was not dramatic. Several corrected ML test statistics showed proper rejections rates across research designs, whereas posterior predictive p values for MI methods were more likely to be influenced by distribution shape and yielded higher rejection rates in MCAR and MAR than in MNAR. In conclusion, ML appears to be preferable to MI in research conditions with small missing samples and multivariate nonnormality whether or not strong prior information for the I-P phase of MI analysis is available. (PsycINFO Database Record",0 +https://doi.org/10.1111/j.1468-2389.2006.00331.x,"From the Work One Knows the Worker: A Systematic Review of the Challenges, Solutions, and Steps to Creating Synthetic Validity","Synthetic validity has been promised as the future for selection, providing an inexpensive, fast, high-quality, legally defensible, and easily administered process. Despite 50 years of development, this promise has yet to be realized. However, recent advances in areas such as validity generalization indicate that synthetic validity is technically feasible and practically achievable. Consolidating new and previous work carried out on two synthetic validity strategies, the job-requirement matrix and job component validity, we review the methodological steps required to build them and provide working examples. Although the resources required for full realization of synthetic validity are large, similar, although larger, projects have been undertaken in the past and in the present, and there is increasing infrastructure to facilitate them in the future.",0 +https://doi.org/10.3389/fpsyg.2013.00918,Release the BEESTS: Bayesian Estimation of Ex-Gaussian STop-Signal reaction time distributions,"The stop-signal paradigm is frequently used to study response inhibition. In this paradigm, participants perform a two-choice response time (RT) task where the primary task is occasionally interrupted by a stop-signal that prompts participants to withhold their response. The primary goal is to estimate the latency of the unobservable stop response (stop signal reaction time or SSRT). Recently, Matzke et al. (2013) have developed a Bayesian parametric approach (BPA) that allows for the estimation of the entire distribution of SSRTs. The BPA assumes that SSRTs are ex-Gaussian distributed and uses Markov chain Monte Carlo sampling to estimate the parameters of the SSRT distribution. Here we present an efficient and user-friendly software implementation of the BPA-BEESTS-that can be applied to individual as well as hierarchical stop-signal data. BEESTS comes with an easy-to-use graphical user interface and provides users with summary statistics of the posterior distribution of the parameters as well various diagnostic tools to assess the quality of the parameter estimates. The software is open source and runs on Windows and OS X operating systems. In sum, BEESTS allows experimental and clinical psychologists to estimate entire distributions of SSRTs and hence facilitates the more rigorous analysis of stop-signal data.",0 +https://doi.org/10.1207/s15327906mbr3904_4,Evaluation of the Bayesian and Maximum Likelihood Approaches in Analyzing Structural Equation Models with Small Sample Sizes,"The main objective of this article is to investigate the empirical performances of the Bayesian approach in analyzing structural equation models with small sample sizes. The traditional maximum likelihood (ML) is also included for comparison. In the context of a confirmatory factor analysis model and a structural equation model, simulation studies are conducted with the different magnitudes of parameters and sample sizes n = da, where d = 2, 3, 4 and 5, and a is the number of unknown parameters. The performances are evaluated in terms of the goodness-of-fit statistics, and various measures on the accuracy of the estimates. The conclusion is: for data that are normally distributed, the Bayesian approach can be used with small sample sizes, whilst ML cannot.",1 +https://doi.org/10.1080/01621459.1995.10476572,Bayes Factors,"In a 1935 paper and in his book Theory of Probability, Jeffreys developed a methodology for quantifying the evidence in favor of a scientific theory. The centerpiece was a number, now called the Bayes factor, which is the posterior odds of the null hypothesis when the prior probability on the null is one-half. Although there has been much discussion of Bayesian hypothesis testing in the context of criticism of P-values, less attention has been given to the Bayes factor as a practical tool of applied statistics. In this article we review and discuss the uses of Bayes factors in the context of five scientific applications in genetics, sports, ecology, sociology, and psychology. We emphasize the following points: • From Jeffreys’ Bayesian viewpoint, the purpose of hypothesis testing is to evaluate the evidence in favor of a scientific theory. • Bayes factors offer a way of evaluating evidence in favor of a null hypothesis. • Bayes factors provide a way of incorporating external information into the evaluation of evidence about a hypothesis. • Bayes factors are very general and do not require alternative models to be nested. • Several techniques are available for computing Bayes factors, including asymptotic approximations that are easy to compute using the output from standard packages that maximize likelihoods. • In “nonstandard†statistical models that do not satisfy common regularity conditions, it can be technically simpler to calculate Bayes factors than to derive non-Bayesian significance tests. • The Schwarz criterion (or BIC) gives a rough approximation to the logarithm of the Bayes factor, which is easy to use and does not require evaluation of prior distributions. • When one is interested in estimation or prediction, Bayes factors may be converted to weights to be attached to various models so that a composite estimate or prediction may be obtained that takes account of structural or model uncertainty. • Algorithms have been proposed that allow model uncertainty to be taken into account when the class of models initially considered is very large. • Bayes factors are useful for guiding an evolutionary model-building process. • It is important, and feasible, to assess the sensitivity of conclusions to the prior distributions used. © 1995 Taylor & Francis Group, LLC.",0 +https://doi.org/10.1177/0146167215573212,The Girls Set the Tone,"In a four-wave longitudinal study with N = 1,321 adolescents in Germany, we examined the impact of class-level normative beliefs about aggression on aggressive norms and behavior at the individual level over the course of 3 years. At each data wave, participants indicated their normative acceptance of aggressive behavior and provided self-reports of physical and relational aggression. Multilevel analyses revealed significant cross-level interactions between class-level and individual-level normative beliefs at T1 on individual differences in physical aggression at T2, and the indirect interactive effects were significant up to T4. Normative approval of aggression at the class level, especially girls’ normative beliefs, defined the boundary conditions for the expression of individual differences in aggressive norms and their impact on physically and relationally aggressive behavior for both girls and boys. The findings demonstrate the moderating effect of social norms on the pathways from individual normative beliefs to aggressive behavior in adolescence.",0 +https://doi.org/10.3982/ecta6474,On the Failure of the Bootstrap for Matching Estimators,"Matching estimators are widely used in empirical economics for the evaluation of programs or treatments. Researchers using matching methods often apply the bootstrap to calculate the standard errors. However, no formal justification has been provided for the use of the bootstrap in this setting. In this article, we show that the standard bootstrap is, in general, not valid for matching estimators, even in the simple case with a single continuous covariate where the estimator is root-N consistent and asymptotically normally distributed with zero asymptotic bias. Valid inferential methods in this setting are the analytic asymptotic variance estimator of Abadie and Imbens (2006a) as well as certain modifications of the standard bootstrap, like the subsampling methods in Politis and Romano (1994).",0 +https://doi.org/10.1111/j.1469-7998.2010.00770.x,Starting size and tadpole performance in the frog Rana latastei,"Egg provisioning is a major maternal effect in amphibians. We evaluated the relationship between starting body size (a proxy of egg provisioning) and multiple measures of larval performance in the Italian agile frog Rana latastei; we analysed within-clutch variation, to remove co-variation between provisioning and genetic maternal effect. We reared tadpoles from multiple clutches in a common environment under two food treatments (high- and low-protein content), and measured the mortality, tadpole size during development and development rate. We used a Bayesian framework (Markov chain Monte Carlo generalized linear mixed models) for the multivariate analysis of performance measures. Tadpoles with a large starting size remained the largest ones through the entire larval development, and attained metamorphosis earlier. Food with a high-protein content reduced mortality and increased the growth and development rate; the choice of food may be important in captive-breeding/headstarting programmes. We did not detect effects of the interaction between provisioning and type of food on tadpole performance. Our study confirms the importance of egg provisioning in amphibians, showing that it can affect multiple traits, and that their effects can last through the entire larval development.",0 +https://doi.org/10.1037/0021-9010.66.3.274,Testing the constancy of validity with computer-generated sampling distributions of the multiplicative model variance estimate: Results for petroleum industry validation research.,"A comparison of computer-generated sampling distributions showed that increases in total N resulting from greater sample size/validity study reduced the sampling variation of multiplicative model estimates of true validity variance more than did increases in total N resulting from a larger number of studies. Validity coefficients, range restriction, and criterion reliability data for 5 tests predicting job performance and training performance were obtained from studies conducted at petroleum industry plants. Those tests included the Richardson-Bellows-Henry Ability, Arithmetic Reasoning, and Chemical Comprehension Tests; the Bennett Mechanical Comprehension Tests; and the Mathematics scale of the California Achievement Tests. Studies for 3 job categories (operation, maintenance, and laboratory) were combined for analysis to maximize sensitivity to job and plant differences. Sampling distributions of true validity variance estimates were generated for each test-criterion type combination. A comparison of actual variance estimates with critical values indicated that 3 of the 5 tests did not vary significantly in true validities for job performance or for training criteria. Results for 2 arithmetic reasoning tests support the existence of variation in true validities for job performance and for training criteria. (19 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1981 American Psychological Association.",0 +https://doi.org/10.1186/2046-4053-3-110,A Microsoft-Excel-based tool for running and critically appraising network meta-analyses—an overview and application of NetMetaXL,"The use of network meta-analysis has increased dramatically in recent years. WinBUGS, a freely available Bayesian software package, has been the most widely used software package to conduct network meta-analyses. However, the learning curve for WinBUGS can be daunting, especially for new users. Furthermore, critical appraisal of network meta-analyses conducted in WinBUGS can be challenging given its limited data manipulation capabilities and the fact that generation of graphical output from network meta-analyses often relies on different software packages than the analyses themselves.We developed a freely available Microsoft-Excel-based tool called NetMetaXL, programmed in Visual Basic for Applications, which provides an interface for conducting a Bayesian network meta-analysis using WinBUGS from within Microsoft Excel. . This tool allows the user to easily prepare and enter data, set model assumptions, and run the network meta-analysis, with results being automatically displayed in an Excel spreadsheet. It also contains macros that use NetMetaXL's interface to generate evidence network diagrams, forest plots, league tables of pairwise comparisons, probability plots (rankograms), and inconsistency plots within Microsoft Excel. All figures generated are publication quality, thereby increasing the efficiency of knowledge transfer and manuscript preparation.We demonstrate the application of NetMetaXL using data from a network meta-analysis published previously which compares combined resynchronization and implantable defibrillator therapy in left ventricular dysfunction. We replicate results from the previous publication while demonstrating result summaries generated by the software.Use of the freely available NetMetaXL successfully demonstrated its ability to make running network meta-analyses more accessible to novice WinBUGS users by allowing analyses to be conducted entirely within Microsoft Excel. NetMetaXL also allows for more efficient and transparent critical appraisal of network meta-analyses, enhanced standardization of reporting, and integration with health economic evaluations which are frequently Excel-based.",0 +https://doi.org/10.1111/jcom.12115,"Deliberative Performance of Television News in Three Types of Democracy: Insights from the United States, Germany, and Russia","We show that television news is considerably more deliberative in established (United States, Germany) than in defective democracies (Russia) and slightly more deliberative in a power-sharing political system (Germany) than in a power-concentrating system (United States). We further demonstrate that public-service channels, nonpartisan programs, and in-depth news shows make stronger overall contributions toward deliberativeness than their respective counterparts. While national news cultures produce distinct national styles of mediated deliberation, individual channels in the United States (Fox, CNN) and Russia (REN) cut across these national patterns. The significance of deliberative media content for citizens and political elites is discussed.",0 +https://doi.org/10.1016/b978-044452044-9/50011-2,Bayesian Structural Equation Modeling,"Abstract Structural equation models (SEMs) with latent variables are routinely used in social science research, and are of increasing importance in biomedical applications. Standard practice in implementing SEMs relies on frequentist methods. A simple and concise description of an alternative Bayesian approach is developed. Furthermore, a brief overview of the literature, a description of Bayesian specification of SEMs, and an outline of a Gibbs sampling strategy for model fitting is provided. Bayesian inferences are illustrated through an industrialization and democratization case study from the literature. The Bayesian approach has some distinct advantages, due to the availability of samples from the joint posterior distribution of the model parameters and latent variables, that are highlighted. These posterior samples provide important information not contained in the measurement and structural parameters. As is illustrated using the case study, this information can often provide valuable insight into structural relationships.",0 +https://doi.org/10.3945/jn.113.184317,"Dietary Carotenoids Are Associated with Cardiovascular Disease Risk Biomarkers Mediated by Serum Carotenoid Concentrations ,","Hyperlipidemia and elevated circulating C-reactive protein (CRP) and total homocysteine (tHcy) concentrations are cardiovascular disease (CVD) risk factors. Previous studies indicated that higher serum carotenoid concentrations were inversely associated with some of these biomarkers. However, whether dietary carotenoid intake is inversely associated with these CVD risk biomarkers is not well known. We assessed the associations between individual dietary carotenoid intake and CVD risk biomarkers and tested whether the serum carotenoid concentrations explain (mediate) or influence the strength of (moderate) the associations, if any association exists. Dietary data collected from 2 24-h dietary recalls and serum measurements in adult men (n = 1312) and women (n = 1544) from the NHANES 2003-2006 were used. Regression models designed for survey analysis were used to examine the associations between individual dietary carotenoids and log-transformed blood cholesterol, CRP, and tHcy. The corresponding individual serum carotenoid concentration was considered as mediator (and moderator if applicable). After adjustment for covariates, significant inverse associations with LDL cholesterol were observed for dietary β-carotene (P < 0.05) and lutein + zeaxanthin (P < 0.001), and with tHcy for dietary β-carotene (P < 0.05), lycopene (P < 0.05), and total carotenoids (P < 0.05). Dietary lutein + zeaxanthin intake was also positively associated with HDL cholesterol concentrations (P < 0.01). Most of these associations were null after additional adjustment for corresponding serum carotenoid concentrations, indicating the complete mediation effects of serum carotenoids. Serum β-carotene significantly moderated the associations between dietary β-carotene and CRP (P-interaction < 0.05), and quartile 4 of dietary β-carotene was associated with lower CRP concentrations only among participants with serum β-carotene > 0.43 μmol/L. In this population-based cross-sectional study, serum carotenoids were mediators of dietary carotenoids and CVD risk biomarker associations. Serum β-carotene was also a moderator of the dietary β-carotene and CRP association. These findings may help in the design of future intervention studies on dietary carotenoids in the prevention of CVD.",0 +https://doi.org/10.1080/00273171.2012.715560,A Bayesian Model For The Estimation Of Latent Interaction And Quadratic Effects When Latent Variables Are Non-Normally Distributed,"Structural equation models with interaction and quadratic effects have become a standard tool for testing nonlinear hypotheses in the social sciences. Most of the current approaches assume normally distributed latent predictor variables. In this article, we present a Bayesian model for the estimation of latent nonlinear effects when the latent predictor variables are nonnormally distributed. The nonnormal predictor distribution is approximated by a finite mixture distribution. We conduct a simulation study that demonstrates the advantages of the proposed Bayesian model over contemporary approaches (Latent Moderated Structural Equations [LMS], Quasi-Maximum-Likelihood [QML], and the extended unconstrained approach) when the latent predictor variables follow a nonnormal distribution. The conventional approaches show biased estimates of the nonlinear effects; the proposed Bayesian model provides unbiased estimates. We present an empirical example from work and stress research and provide syntax for substantive researchers. Advantages and limitations of the new model are discussed.",0 +https://doi.org/10.1016/j.socnet.2009.02.004,Introduction to stochastic actor-based models for network dynamics,"Abstract Stochastic actor-based models are models for network dynamics that can represent a wide variety of influences on network change, and allow to estimate parameters expressing such influences, and test corresponding hypotheses. The nodes in the network represent social actors, and the collection of ties represents a social relation. The assumptions posit that the network evolves as a stochastic process ‘driven by the actors’, i.e., the model lends itself especially for representing theories about how actors change their outgoing ties. The probabilities of tie changes are in part endogenously determined, i.e., as a function of the current network structure itself, and in part exogenously, as a function of characteristics of the nodes (‘actor covariates’) and of characteristics of pairs of nodes (‘dyadic covariates’). In an extended form, stochastic actor-based models can be used to analyze longitudinal data on social networks jointly with changing attributes of the actors: dynamics of networks and behavior. This paper gives an introduction to stochastic actor-based models for dynamics of directed networks, using only a minimum of mathematics. The focus is on understanding the basic principles of the model, understanding the results, and on sensible rules for model selection.",0 +https://doi.org/10.1177/01466210022031705,A Comparison of Item Selection Rules at the Early Stages of Computerized Adaptive Testing,"The effects of five item selection rules—Fisher information (FI), Fisher interval information (FII), Fisher information with a posterior distribution (FIP), Kullback-Leibler information (KL), and Kullback-Leibler information with a posterior distribution (KLP)—were compared with respect to the efficiency and precision of trait (Θ) estimation at the early stages of computerized adaptive testing (CAT). FII, FIP, KL, and KLP performed marginally better than FI at the early stages of CAT for Θ= -3 and -2. For tests longer than 10 items,there appeared to be no precision advantage for any of the selection rules.",0 +https://doi.org/10.1198/016214501750333063,Markov chain Monte Carlo Estimation of Classical and Dynamic Switching and Mixture Models,"Bayesian estimation of a very general model class, where the distribution of the observations depends on a latent process taking values in a discrete state space, is discussed in this article. This model class covers finite mixture modeling, Markov switching autoregressive modeling, and dynamic linear models with switching. The consequences the unidentifiability of this type of model has on Markov chain Monte Carlo (MCMC) estimation are explicitly dealt with. Joint Bayesian estimation of all latent variables, model parameters, and parameters that determine the probability law of the latent process is carried out by a new MCMC method called permutation sampling. The permutation sampler first samples from the unconstrained posterior–which often can be done in a convenient multimove manner–and then applies a permutation of the current labeling of the states of the latent process. In a first run, the random permutation sampler used selected the permutation randomly. The MCMC output of the random permutation s...",0 +https://doi.org/10.1016/s0001-4575(01)00086-0,The use of multilevel models for the prediction of road accident outcomes,"An important problem in road traffic accident research is the resolution of the magnitude by which individual accident characteristics affect the risk of fatality for each person involved. This article introduces the potential of a recently developed form of regression models, known as multilevel models, for quantifying the various influences on casualty outcomes. The application of multilevel models is illustrated by the analysis of the predictors of outcome amongst over 16,000 fatally and seriously injured casualties involved in accidents between 1985 and 1996 in Norway. Risk of fatality was found to be associated with casualty age and sex, as well as the type of vehicles involved, the characteristics of the impact, the attributes of the road section on which it took place, the time of day, and whether alcohol was suspected. After accounting for these factors, the multilevel analysis showed that 16% of unexplained variation in casualty outcomes was between accidents, whilst approximately 1% was associated with the area of Norway in which each incident occurred. The benefits of using multilevel models to analyse accident data are discussed along with the limitations of traditional regression modelling approaches.",0 +https://doi.org/10.1007/bf01404679,Derivative free analogues of the Levenberg-Marquardt and Gauss algorithms for nonlinear least squares approximation,"In this paper we give two derivative-free computational algorithms for nonlinear least squares approximation. The algorithms are finite difference analogues of the Levenberg-Marquardt and Gauss methods. Local convergence theorems for the algorithms are proven. In the special case when the residuals are zero at the minimum, we show that certain computationally simple choices of the parameters lead to quadratic convergence. Numerical examples are included. © 1971 Springer-Verlag.",0 +https://doi.org/10.2307/2532086,Some Covariance Models for Longitudinal Count Data with Overdispersion,"A family of covariance models for longitudinal counts with predictive covariates is presented. These models account for overdispersion, heteroscedasticity, and dependence among repeated observations. The approach is a quasi-likelihood regression similar to the formulation given by Liang and Zeger (1986, Biometrika 73, 13-22). Generalized estimating equations for both the covariate parameters and the variance-covariance parameters are presented. Large-sample properties of the parameter estimates are derived. The proposed methods are illustrated by an analysis of epileptic seizure count data arising from a study of progabide as an adjuvant therapy for partial seizures.",0 +https://doi.org/10.1016/s0149-2063(03)00084-9,Recent Advances in Causal Modeling Methods for Organizational and Management Research,"The purpose of this article is to review recent advanced applications of causal modeling methods in organizational and management research. Developments over the past 10 years involving research on measurement and structural components of causal models will be discussed. Specific topics to be addressed include reflective vs. formative measurement, multidimensional construct assessment, method variance, measurement invariance, latent growth modeling (LGM), moderated structural relationships, and analysis of latent variable means. For each of the areas mentioned above an overview of developments will be presented, and examples from organizational and management research will be provided.",0 +https://doi.org/10.2427/8981,"Building reliable evidence from real-world data: methods, cautiousness and recommendations","Routinely stored information on healthcare utilisation in everyday clinical practice has proliferated over the past several decades. There is, however, some reluctance on the part of many health professionals to use observational data to support healthcare decisions, especially when data are derived from large databases. Challenges in conducting observational studies based on electronic databases include concern about the adequacy of study design and methods to minimise the effect of both misclassifications (in the absence of direct assessments of exposure and outcome validity) and confounding (in the absence of randomisation). This paper points out issues that may compromise the validity of such studies, and approaches to managing analytic challenges. First, strategies of sampling within a large cohort, as an alternative to analysing the full cohort, will be presented. Second, methods for controlling outcome and exposure misclassifications will be described. Third, several techniques that take into account both measured and unmeasured confounders will also be presented. Fourth, some considerations regarding random uncertainty in the framework of observational studies using healthcare utilisation data will be discussed. Finally, some recommendations for good research practice are listed in this paper. The aim is to provide researchers with a methodological framework, while commenting on the value of new techniques for more advanced users.",0 +https://doi.org/10.1080/01621459.1994.10476768,"Missing Data, Imputation, and the Bootstrap","Missing data refers to a class of problems made difficult by the absence of some portions of a familiar data structure. For example, a regression problem might have some missing values in the predi...",0 +https://doi.org/10.1136/bmjopen-2013-004475,Built environment and physical activity in New Zealand adolescents: a protocol for a cross-sectional study: Table 1,"Built-environment interventions have the potential to provide population-wide effects and the means for a sustained effect on behaviour change. Population-wide effects for adult physical activity have been shown with selected built environment attributes; however, the association between the built environment and adolescent health behaviours is less clear. This New Zealand study is part of an international project across 10 countries (International Physical Activity and the Environment Network-adolescents) that aims to characterise the links between built environment and adolescent health outcomes.An observational, cross-sectional study of the associations between measures of the built environment with physical activity, sedentary behaviour, body size and social connectedness in 1600 New Zealand adolescents aged 12-18 years will be conducted in 2013-2014. Walkability and neighbourhood destination accessibility indices will be objectively measured using Geographic Information Systems (GIS). Physical activity and sedentary behaviours will be objectively measured using accelerometers over seven consecutive days. Body mass index will be calculated as weight divided by squared height. Demographics, socioeconomic status, active commuting behaviours and perceived neighbourhood walkability will be assessed using the Neighbourhood Environment Walkability Scale for Youth and psychosocial indicators. A web-based computer-assisted personal interview tool Visualisation and Evaluation of Route Itineraries, Travel Destinations, and Activity Spaces (VERITAS) and Global Positioning System (GPS) receivers will be used in a subsample of 300 participants. A qualitative research component will explore barriers and facilitators for physical activity in adolescents with respect to the built and social environment in a subsample of 80 participants.The study received ethical approval from the Auckland University of Technology Ethics Committee (12/161). Data will be entered and stored into a secure (password protected) database. Only the named researchers will have access to the data. Data will be stored for 10 years and permanently destroyed thereafter. The results papers will be submitted for publication in peer-reviewed journals.",0 +https://doi.org/10.1111/j.1541-0420.2012.01781.x,Bayesian Inference for the Causal Effect of Mediation,Summary We propose a nonparametric Bayesian approach to estimate the natural direct and indirect effects through a mediator in the setting of a continuous mediator and a binary response. Several conditional independence assumptions are introduced (with corresponding sensitivity parameters) to make these effects identifiable from the observed data. We suggest strategies for eliciting sensitivity parameters and conduct simulations to assess violations to the assumptions. This approach is used to assess mediation in a recent weight management clinical trial.,0 +https://doi.org/10.1016/j.jvb.2015.12.004,State work engagement and state affect: Similar yet distinct concepts,"Abstract State work engagement (SWE), a multidimensional construct of work-related well-being, was originally conceptualized as a trait, but diary studies have revealed substantial within-person fluctuations. Given that SWE is conceptualized as a work-related affective-motivational construct, the question arises as to whether SWE can be differentiated from other affective constructs. Thus, the goal of the present study was to compare SWE and state affect with respect to their degree of within-person variability and to examine their distinct relationships with health and performance variables (i.e., sleep quality and job performance). Fifty-two employees (44% female) participated in the study, which included 3 assessments per day over the course of 2 weeks. Our results revealed that energetic arousal and tense arousal fluctuated more strongly within days than vigor and absorption. Multilevel analyses demonstrated that high sleep quality predicted higher state affect but not higher SWE. In addition, vigor exhibited an inverted U-shaped relation with performance. In sum, SWE as a time-varying construct showed some overlap with state affect but also demonstrated discriminant validity.",0 +https://doi.org/10.1080/01621459.1969.10500979,Missing Observations in Multivariate Statistics III: Large Sample Analysis of Simple Linear Regression,"Abstract We derive the asymptotic distribution of several estimators for the parameters of the linear regression of y on x when some observations on y and on x are missing. Then, we compare estimators using a mean square error criterion. We find for example that a simple estimator of the linear regression function has asymptotic efficiency no worse than 0.95 compared with the maximum likelihood estimator (assuming bivariate normality) provided that no more than 30 per cent of the y's and 30 per cent of the x's are missing. This simple estimator is defined without assuming bivariate normality in Section 8.1.",0 +https://doi.org/10.1177/014662168500900409,The Difficulty of Test Items That Measure More Than One Ability,Many test items require more than one ability to obtain a correct response. This article proposes a mul tidimensional index of item difficulty that can be used with items of this type. The proposed index describes multidimensional item difficulty as the direction in the multidimensional space in which the item provides the most information and the distance in that direction to the most informative point. The multidimensional dif ficulty is derived for a particular item response theory model and an example of its application is given using the ACT Mathematics Usage Test.,0 +https://doi.org/10.1080/00220970903224685,Three-Level Models for Indirect Effects in School- and Class-Randomized Experiments in Education,"Due to the clustered nature of field data, multi-level modeling has become commonly used to analyze data arising from educational field experiments. While recent methodological literature has focused on multi-level mediation analysis, relatively little attention has been devoted to mediation analysis when three levels (e.g., student, class, school) are present in a study setting. This article presents analysis models that can be used to test indirect effects in experimental designs having three levels where random assignment is at the third (school) or second (class) level and where the indirect effect may be random. In the presentation, simulated datasets are used to illustrate model specification and results interpretation for hypothetical three-level educational experiments involving mediation and moderation of treatment effects.",0 +https://doi.org/10.1007/bf03372669,Nutzenermittlung in wahlbasierter Conjoint-Analyse: Ein Vergleich von Latent-Class- und hierarchischem Bayes-Verfahren,"Two different concepts of disentangling noise from systematic deviations in Choice-Based Conjoint evaluations are compared: The Latent Class Technique and the Hierarchical Bayes procedure. In addition, a probabilistic interpretation of LC estimates is presented as an interims model. Conceptual differences between these models are discussed and hypotheses on resulting differences in estimates are derived. These are tested in a large-scale empirical study. The relative performance is evaluated in two distinct application areas: segment/level and individual/level estimates. The expected patterns are confirmed only partly by empirical evidence. It is shown that the structure of the underlying heterogeneity concept influences the achievable outcomes. Contrary to expectations it is shown that the segment-level estimates are highly stable across methods. While individual Hierarchical Bayes estimates are often of questionable quality, they are to be preferred against the Latent Class estimates, because they detect outliers reasonably well and provide more flexibility in the data evaluation.",0 +https://doi.org/10.1016/j.neuroimage.2014.12.025,Comparison of variants of canonical correlation analysis and partial least squares for combined analysis of MRI and genetic data,"The standard analysis approach in neuroimaging genetics studies is the mass-univariate linear modeling (MULM) approach. From a statistical view, however, this approach is disadvantageous, as it is computationally intensive, cannot account for complex multivariate relationships, and has to be corrected for multiple testing. In contrast, multivariate methods offer the opportunity to include combined information from multiple variants to discover meaningful associations between genetic and brain imaging data. We assessed three multivariate techniques, partial least squares correlation (PLSC), sparse canonical correlation analysis (sparse CCA) and Bayesian inter-battery factor analysis (Bayesian IBFA), with respect to their ability to detect multivariate genotype-phenotype associations. Our goal was to systematically compare these three approaches with respect to their performance and to assess their suitability for high-dimensional and multi-collinearly dependent data as is the case in neuroimaging genetics studies. In a series of simulations using both linearly independent and multi-collinear data, we show that sparse CCA and PLSC are suitable even for very high-dimensional collinear imaging data sets. Among those two, the predictive power was higher for sparse CCA when voxel numbers were below 400 times sample size and candidate SNPs were considered. Accordingly, we recommend Sparse CCA for candidate phenotype, candidate SNP studies. When voxel numbers exceeded 500 times sample size, the predictive power was the highest for PLSC. Therefore, PLSC can be considered a promising technique for multivariate modeling of high-dimensional brain-SNP-associations. In contrast, Bayesian IBFA cannot be recommended, since additional post-processing steps were necessary to detect causal relations. To verify the applicability of sparse CCA and PLSC, we applied them to an experimental imaging genetics data set provided for us. Most importantly, application of both methods replicated the findings of this data set.",0 +https://doi.org/10.1207/s15328007sem1401_2,"Performance of Factor Mixture Models as a Function of Model Size, Covariate Effects, and Class-Specific Parameters","Abstract Factor mixture models are designed for the analysis of multivariate data obtained from a population consisting of distinct latent classes. A common factor model is assumed to hold within each of the latent classes. Factor mixture modeling involves obtaining estimates of the model parameters, and may also be used to assign subjects to their most likely latent class. This simulation study investigates aspects of model performance such as parameter coverage and correct class membership assignment and focuses on covariate effects, model size, and class-specific versus class-invariant parameters. When fitting true models, parameter coverage is good for most parameters even for the smallest class separation investigated in this study (0.5 SD between 2 classes). The same holds for convergence rates. Correct class assignment is unsatisfactory for the small class separation without covariates, but improves dramatically with increasing separation, covariate effects, or both. Model performance is not influe...",0 +https://doi.org/10.1016/0304-4076(83)90093-3,Latent variable structural equation modeling with categorical data,"Structural equation modeling with latent variables is overviewed for situations involving a mixture of dichotomous, ordered polytomous, and continuous indicators of latent variables. Special emphasis is placed on categorical variables. Models in psychometrics, econometrics and biometrics are interrelated via a general model due to Muthén. Limited information least squares estimators and full information estimation are discussed. An example is estimated with a model for a four-wave longitudinal data set, where dichotomous responses are related to each other and a set of independent variables via latent variables with a variance component structure.",0 +https://doi.org/10.1177/0146621609349800,IRT Parameter Estimation With Response Times as Collateral Information,"Hierarchical modeling of responses and response times on test items facilitates the use of response times as collateral information in the estimation of the response parameters. In addition to the regular information in the response data, two sources of collateral information are identified: (a) the joint information in the responses and the response times summarized in the estimates of the second-level parameters and (b) the information in the posterior distribution of the response parameters given the response times. The latter is shown to be a natural empirical prior distribution for the estimation of the response parameters. Unlike traditional hierarchical item response theory (IRT) modeling, where the gain in estimation accuracy is typically paid for by an increase in bias, use of this posterior predictive distribution improves both the accuracy and the bias of IRT parameter estimates. In an empirical study, the improvements are demonstrated for the estimation of the person and item parameters in a three-parameter response model.",0 +https://doi.org/10.1111/add.12278,Availability of convenience stores and adolescent alcohol use in Taiwan: a multi-level analysis of national surveys,"Aim To examine the association between alcohol in school environments and adolescent alcohol use over the previous 6 months. Design A multi-level logistic regression analysis was performed of cross-sectional surveys conducted in 2004, 2005 and 2006. Participants and setting A total of 52 214 students aged 11–19 years from 387 middle or high schools were selected from a nationally representative, multi-stage, stratified probability sampling across Taiwan. Measurements Information on socio-demographic features and substance use experiences was collected using self-administered questionnaires. The alcohol in the environment was measured using the availability of convenience stores surrounding the schools. Using geographical information systems, the weighted numbers of convenience stores within 1 km, a 12–15-minute walk, of a school were calculated. The schools were later categorized into three subgroups via the tertile of nearby convenience stores. Findings Considering the compositional characteristics, the availability of convenience stores was found to account for 1.5% of the school-level variance of youthful drinking. The odds ratios (95% confidence interval) of alcohol use over the previous 6 months among youth attending schools with medium and high availability were 1.04 (0.96–1.13) and 1.08 (1.00–1.17), respectively, with a P-value of 0.04 in the trend test. Conclusion The greater availability of convenience stores near a school is associated with an increased risk of alcohol use among adolescents over the previous 6 months.",0 +https://doi.org/10.1191/1740774505cn072oa,"Prior distributions for the intracluster correlation coefficient, based on multiple previous estimates, and their application in cluster randomized trials","Numerous estimates for the intracluster correlation coefficient (ICC) are available in research databases and publications. When planning a cluster randomized trial, an anticipated value for the ICC is required; currently, researchers base their choice informally on the magnitude of previous ICC estimates. In this paper, we make use of the wealth of ICC information by formally constructing informative prior distributions, while acknowledging the varying relevance and precision of the estimates available. Typically, for a planned trial in a given clinical setting, multiple relevant ICC estimates are available from each of several completed studies. Our preferred model allows for the imprecision in each ICC estimate around its underlying true value and, separately, allows for the similarity of ICC values from the same study. The relevance of each previous estimate to the planned clinical setting is considered, and estimates corresponding to less relevant outcomes or population types are given less influence. We find that such downweighting can increase the precision of the anticipated ICC. In trial design, the prior distribution constructed allows uncertainty about the ICC to be acknowledged, and we describe how to choose a design that provides adequate power across the range of likely ICC values. Prior information on the ICC can also be incorporated in analysis of the trial data, when taking a Bayesian approach. The methods proposed enable available ICC information to be summarised appropriately by an informative prior distribution, which is of direct practical use in cluster randomized trials.",0 +https://doi.org/10.1080/00273170802490673,Distinguishing Between Latent Classes and Continuous Factors with Categorical Outcomes: Class Invariance of Parameters of Factor Mixture Models,"Factor mixture models (FMM's) are latent variable models with categorical and continuous latent variables which can be used as a model-based approach to clustering. A previous paper covered the results of a simulation study showing that in the absence of model violations, it is usually possible to choose the correct model when fitting a series of models with different numbers of classes and factors within class. The response format in the first study was limited to normally distributed outcomes. The current paper has two main goals, firstly, to replicate parts of the first study with 5-point Likert scale and binary outcomes, and secondly, to address the issue of testing class invariance of thresholds and loadings. Testing for class invariance of parameters is important in the context of measurement invariance and when using mixture models to approximate non-normal distributions. Results show that it is possible to discriminate between latent class models and factor models even if responses are categorical. Comparing models with and without class-specific parameters can lead to incorrectly accepting parameter invariance if the compared models differ substantially with respect to the number of estimated parameters. The simulation study is complemented with an illustration of a factor mixture analysis of ten binary depression items obtained from a female subsample of the Virginia Twin Registry.",0 +https://doi.org/10.1007/978-94-007-3024-3_5,Multilevel Modelling,"Data often form a complex hierarchy, where multiple observations are made from within the same cluster. This natural clustering or nesting of observations results in data that possesses a lack of independence, which violates an important assumption of conventional single-level analyses and poses an issue in its correct implementation. In contrast, multilevel modelling (MLM) exploits this lack of independence to its advantage. Through outlining the notation used to specify MLM formulation, the theory of MLM is introduced. The pitfalls of ignoring the hierarchy in data are outlined. The assumptions and limitations of MLM are outlined and contrasted with those of the single-level model. The initial MLM considers the variance components model, which is further developed to illustrate random intercepts, slopes, and complex variation at both levels 1 and 2. Markov Chain Monte Carlo (MCMC) methods appropriate for estimating MLMs are introduced. Finally, complex hierarchies, such as cross-classified and multiple-membership structures are considered. These concepts are illustrated using various clinical examples. © Springer Science+Business Media Dordrecht 2012.",0 +https://doi.org/10.1177/1094428107300342,The Relative Validity of Inferences About Mediation as a Function of Research Design Characteristics,"Tests of assumed mediation models are common in the organizational sciences. However, the validity of inferences about mediation is a function of experimental design and the setting of a study. Regrettably, most tests of mediation have relied on the application of so-called ``causal modeling'' techniques to data from nonexperimental studies. As we demonstrate, inferences about the validity of assumed mediation models are highly suspect when they are based on the findings of nonexperimental research. One of the many reasons for this is the failure of the model being tested to be consistent with reality. Valid research-based inferences about mediation are possible. However, inferences from such tests are most likely to be valid when they are based on research that uses randomized experimental designs. Strategies for conducting research using these and other designs are described. Finally, we offer a set of conclusions and recommendations that stem from our analysis.",0 +https://doi.org/10.1007/bf02296651,Model comparison of nonlinear structural equation models with fixed covariates,"Recently, it has been recognized that the commonly used linear structural equation model is inadequate to deal with some complicated substantive theory. A new nonlinear structural equation model with fixed covariates is proposed in this article. A procedure, which utilizes the powerful path sampling for computing the Bayes factor, is developed for model comparison. In the implementation, the required random observations are simulated via a hybrid algorithm that combines the Gibbs sampler and the Metropolis-Hastings algorithm. It is shown that the proposed procedure is efficient and flexible; and it produces Bayesian estimates of the parameters, latent variables, and their highest posterior density intervals as by-products. Empirical performances of the proposed procedure such as sensitivity to prior inputs are illustrated by a simulation study and a real example.",0 +https://doi.org/10.2165/11594990-000000000-00000,Cost Utility of Tumour Necrosis Factor-α Inhibitors for Rheumatoid Arthritis,"Rheumatoid arthritis (RA) is a chronic autoimmune disease that affects approximately 1.5 million people in the US. Tumour necrosis factor (TNF)α; inhibitors have been shown to effectively treat and maintain remission in patients with moderately to severely active RA compared with conventional agents. The high acquisition cost of TNFα; inhibitors prohibits access, which mandates economic investigations into their affordability. The lack of head-to-head comparisons between these agents makes it difficult to determine which agent is the most cost effective. Objective: This study aimed to determine which TNFα; inhibitor was the most cost-effective agent for the treatment of moderately to severely active RA from the US healthcare payer's perspective. Methods: A Markov model was constructed to analyse the cost utility of five TNFα; inhibitors (in combination with methotrexate [+MTX]) versus MTX monotherapy using Bayesian methods for evidence synthesis. The model had a cycle length of 3 months and an overall time horizon of 5 years. Transition probabilities and utility scores were based on published studies. Total direct costs were adjusted to year 2009 US using the medical component of the Consumer Price Index. All costs and QALYs were discounted at a rate of 3% per year. Patient response to the different strategies was determined by the American College of Rheumatology (ACR)50 criteria. One-way and probabilistic sensitivity analyses (PSAs) were performed to test the robustness of the base-case scenario. The base-case scenario was changed to ACR20 criteria (scenario 1) and ACR70 criteria (scenario 2) to determine the model's robustness. Cost-effectiveness acceptability curves and cost-effectiveness frontiers were used to estimate the cost-effectiveness probability of each treatment strategy. A willingness-to-pay (WTP) threshold was defined as three times the US GDP per capita (US139 143 per additional QALY gained). Primary results were presented as incremental cost-effective ratios (ICERs).Results: Etanercept+MTX was the most cost-effective treatment strategy in the base-case scenario up to a WTP threshold of US546 449 per QALY gained. At a WTP threshold of greater than US546 499 per QALY gained, certolizumab+MTX was the most cost-effective treatment strategy. One-way analyses showed that the base-case scenario was sensitive to the probability of achieving ACR50 criteria for MTX and each TNFα; inhibitor, and changes in the utility score for patients who achieved the ACR50 criteria. With the exception of infliximab, all of the TNFα; inhibitors were sensitive to drug cost per cycle. In the scenario analyses, certolizumab+MTX was a dominant treatment strategy using ACR20 criteria, but etanercept+MTX was a dominant treatment strategy using ACR70 criteria. Conclusions: Etanercept+MTX was a cost-effective treatment strategy in the base-case scenario; however, the model was sensitive to parameter uncertainties and ACR response criteria. Although Bayesian methods were used to determine transition probabilities, future studies will need to focus on head-tohead comparisons of multiple TNFα; inhibitors to provide valid comparisons. Adis © 2012 Springer International Publishing AG.",0 +https://doi.org/10.1198/106186007x208768,Spatially Adaptive Bayesian Penalized Splines With Heteroscedastic Errors,"Penalized splines have become an increasingly popular tool for nonparametric smoothing because of their use of low-rank spline bases, which makes computations tractable while maintaining accuracy as good as smoothing splines. This article extends penalized spline methodology by both modeling the variance function nonparametrically and using a spatially adaptive smoothing parameter. This combination is needed for satisfactory inference and can be implemented effectively by Bayesian MCMC. The variance process controlling the spatially adaptive shrinkage of the mean and the variance of the heteroscedastic error process are modeled as log-penalized splines. We discuss the choice of priors and extensions of the methodology, in particular, to multivariate smoothing. A fully Bayesian approach provides the joint posterior distribution of all parameters, in particular, of the error standard deviation and penalty functions. MATLAB, C, and FORTRAN programs implementing our methodology are publicly available.",0 +https://doi.org/10.1186/1471-2288-3-5,Estimation of the correlation coefficient using the Bayesian Approach and its applications for epidemiologic research,"BackgroundThe Bayesian approach is one alternative for estimating correlation coefficients in which knowledge from previous studies is incorporated to improve estimation. The purpose of this paper is to illustrate the utility of the Bayesian approach for estimating correlations using prior knowledge.MethodsThe use of the hyperbolic tangent transformation (ρ = tanh ξ and r = tanh z) enables the investigator to take advantage of the conjugate properties of the normal distribution, which are expressed by combining correlation coefficients from different studies.ConclusionsOne of the strengths of the proposed method is that the calculations are simple but the accuracy is maintained. Like meta-analysis, it can be seen as a method to combine different correlations from different studies.",0 +https://doi.org/10.1017/s1049096504004585,Does identity or economic rationality drive public opinion on European integration,How do citizens respond to the reallocation of authority across levels of government? This article investigates the relative importance of economic versus identity bases of citizen support for the most far-reaching example of authority migration—European integration.,0 +https://doi.org/10.1017/s0033291713002134,Randomized controlled trial and uncontrolled 9-month follow-up of an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder,"Background Despite the clinical importance of deliberate self-harm (DSH; also referred to as non-suicidal self-injury) within borderline personality disorder (BPD), empirically supported treatments for this behavior among individuals with BPD are difficult to implement in many clinical settings. To address this limitation, a 14-week, adjunctive emotion regulation group therapy (ERGT) for DSH among women with BPD was developed. The current study examined the efficacy of this ERGT in a randomized controlled trial (RCT) and the durability of treatment gains over a 9-month uncontrolled follow-up period. Method Female out-patients with BPD and recent recurrent DSH were randomly assigned to receive this ERGT in addition to their ongoing out-patient therapy immediately ( n = 31) or after 14 weeks ( n = 30). Measures of DSH and other self-destructive behaviors, psychiatric symptoms, adaptive functioning and the proposed mechanisms of change (emotion dysregulation/avoidance) were administered pre- and post-treatment or -waitlist (to assess treatment efficacy), and 3 and 9 months post-treatment (to assess durability of treatment gains). Results Intent-to-treat (ITT) analyses ( n = 61) revealed significant effects of this ERGT on DSH and other self-destructive behaviors, emotion dysregulation, BPD symptoms, depression and stress symptoms, and quality of life. Analyses of all participants who began ERGT (across treatment and waitlist conditions; n = 51) revealed significant improvements from pre- to post-treatment on all outcomes, additional significant improvements from post-treatment to 9-month follow-up for DSH, emotion dysregulation/avoidance, BPD symptoms and quality of life, and no significant changes from post-treatment to 9-month follow-up on the other measures. Conclusions The results support the efficacy of this ERGT and the durability of treatment gains.",0 +https://doi.org/10.1016/j.displa.2015.02.002,Measurement of minimum angle of resolution (MAR) for the spatial grating consisting of lines of two colors,"Abstract Minimum angle of resolution (MAR) was measured for the grating which consisted of lines of two colors selected from Red, Green, Blue, White and Black. Method of two alternative forced choice (2AFC) was used where the participants were asked to answer the direction of the color grating of the horizontal or vertical directions. From the measured psychometric function of the ratio of the correct answers, MAR which corresponded to the threshold of 75% correct answer ratio was determined. MAR of the grating patches with more than one primary color was measured to be affected by the combination of colors and to be 10–30% larger than that of the grating patch of White–Black. While the resolving power for Blue pattern had been known to be worse than those for Green and Red patterns, MAR of the grating including Blue was not always the worst.",0 +https://doi.org/10.1097/ede.0b013e3181ba41cc,Mediating Various Direct-effect Approaches,,0 +https://doi.org/10.1093/biostatistics/kxg040,Hierarchical bivariate time series models: a combined analysis of the effects of particulate matter on morbidity and mortality,"In this paper we develop a hierarchical bivariate time series model to characterize the relationship between particulate matter less than 10 microns in aerodynamic diameter (PM10) and both mortality and hospital admissions for cardiovascular diseases. The model is applied to time series data on mortality and morbidity for 10 metropolitan areas in the United States from 1986 to 1993. We postulate that these time series should be related through a shared relationship with PM10. At the first stage of the hierarchy, we fit two seemingly unrelated Poisson regression models to produce city-specific estimates of the log relative rates of mortality and morbidity associated with exposure to PM10 within each location. The sample covariance matrix of the estimated log relative rates is obtained using a novel generalized estimating equation approach that takes into account the correlation between the mortality and morbidity time series. At the second stage, we combine information across locations to estimate overall log relative rates of mortality and morbidity and variation of the rates across cities. Using the combined information across the 10 locations we find that a 10 microg/m3 increase in average PM10 at the current day and previous day is associated with a 0.26% increase in mortality (95% posterior interval -0.37, 0.65), and a 0.71% increase in hospital admissions (95% posterior interval 0.35, 0.99). The log relative rates of mortality and morbidity have a similar degree of heterogeneity across cities: the posterior means of the between-city standard deviations of the mortality and morbidity air pollution effects are 0.42 (95% interval 0.05, 1.18), and 0.31 (95% interval 0.10, 0.89), respectively. The city-specific log relative rates of mortality and morbidity are estimated to have very low correlation, but the uncertainty in the correlation is very substantial (posterior mean = 0.20, 95% interval -0.89, 0.98). With the parameter estimates from the model, we can predict the hospitalization log relative rate for a new city for which hospitalization data are unavailable, using that city's estimated mortality relative rate. We illustrate this prediction using New York as an example.",0 +https://doi.org/10.1207/s15328007sem1202_5,Embedding IRT in Structural Equation Models: A Comparison With Regression Based on IRT Scores,"This article reviews the problems associated with using item response theory (IRT)-based latent variable scores for analytical modeling, discusses the connection between IRT and structural equation modeling (SEM)-based latent regression modeling for discrete data, and compares regression parameter estimates obtained using predicted IRT scores and standardized number-right scores in Ordinary Least Squares (OLS) regression with regression estimates obtained using the combined IRT-SEM approach. The Monte Carlo results show the expected a posteriori (EA approach is insensitive to sample size as expected but leads to appreciable attenuation in regression parameter estimates. Standardized number-right estimates and EAP regression estimates were found to be highly comparable. On the other hand, the IRT-SEM method produced smaller finite sample bias, and as expected, generated consistent regression estimates for suitably large sample sizes.",0 +https://doi.org/10.1002/sim.4475,Using R and WinBUGS to fit a generalized partial credit model for developing and evaluating patient-reported outcomes assessments,"The US Food and Drug Administration recently announced the final guidelines on the development and validation of patient-reported outcomes (PROs) assessments in drug labeling and clinical trials. This guidance paper may boost the demand for new PRO survey questionnaires. Henceforth, biostatisticians may encounter psychometric methods more frequently, particularly item response theory (IRT) models to guide the shortening of a PRO assessment instrument. This article aims to provide an introduction on the theory and practical analytic skills in fitting a generalized partial credit model (GPCM) in IRT. GPCM theory is explained first, with special attention to a clearer exposition of the formal mathematics than what is typically available in the psychometric literature. Then, a worked example is presented, using self-reported responses taken from the international personality item pool. The worked example contains step-by-step guides on using the statistical languages r and WinBUGS in fitting the GPCM. Finally, the Fisher information function of the GPCM model is derived and used to evaluate, as an illustrative example, the usefulness of assessment items by their information contents. This article aims to encourage biostatisticians to apply IRT models in the re-analysis of existing data and in future research.",0 +https://doi.org/10.1177/0013164411431838,Balancing Flexible Constraints and Measurement Precision in Computerized Adaptive Testing,"Managing test specifications—both multiple nonstatistical constraints and flexibly defined constraints—has become an important part of designing item selection procedures for computerized adaptive tests (CATs) in achievement testing. This study compared the effectiveness of three procedures: constrained CAT, flexible modified constrained CAT, and the weighted penalty model in balancing multiple flexible constraints and maximizing measurement precision in a fixed-length CAT. The study also addressed the effect of two different test lengths—25 items and 50 items—and of including or excluding the randomesque item exposure control procedure with the three methods, all of which were found effective in selecting items that met flexible test constraints when used in the item selection process for longer tests. When the randomesque method was included to control for item exposure, the weighted penalty model and the flexible modified constrained CAT models performed better than did the constrained CAT procedure in maintaining measurement precision. When no item exposure control method was used in the item selection process, no practical difference was found in the measurement precision of each balancing method.",0 +https://doi.org/10.1175/2010jcli3503.1,Climate Sensitivity Distributions Dependence on the Possibility that Models Share Biases,"Abstract Uncertainty about biases common across models and about unknown and unmodeled feedbacks is important for the tails of temperature change distributions and thus for climate risk assessments. This paper develops a hierarchical Bayes framework that explicitly represents these and other sources of uncertainty. It then uses models’ estimates of albedo, carbon cycle, cloud, and water vapor–lapse rate feedbacks to generate posterior probability distributions for feedback strength and equilibrium temperature change. The posterior distributions are especially sensitive to prior beliefs about models’ shared structural biases: nonzero probability of shared bias moves some probability mass toward lower values for climate sensitivity even as it thickens the distribution’s positive tail. Obtaining additional models of these feedbacks would not constrain the posterior distributions as much as narrowing prior beliefs about shared biases or, potentially, obtaining feedback estimates having biases uncorrelated with those impacting climate models. Carbon dioxide concentrations may need to fall below current levels to maintain only a 10% chance of exceeding official 2°C limits on global average temperature change.",0 +https://doi.org/10.1186/s12913-015-0686-6,"The effect of patient, provider and financing regulations on the intensity of ambulatory physical therapy episodes: a multilevel analysis based on routinely available data","BackgroundMany studies have found considerable variations in the resource intensity of physical therapy episodes. Although they have identified several patient- and provider-related factors, few studies have examined their relative explanatory power. We sought to quantify the contribution of patients and providers to these differences and examine how effective Swiss regulations are (nine-session ceiling per prescription and bonus for first treatments).MethodsOur sample consisted of 87,866 first physical therapy episodes performed by 3,365 physiotherapists based on referrals by 6,131 physicians. We modeled the number of visits per episode using a multilevel log linear regression with crossed random effects for physiotherapists and physicians and with fixed effects for cantons. The three-level explanatory variables were patient, physiotherapist and physician characteristics.ResultsThe median number of sessions was nine (interquartile range 6–13). Physical therapy use increased with age, women, higher health care costs, lower deductibles, surgery and specific conditions. Use rose with the share of nine-session episodes among physiotherapists or physicians, but fell with the share of new treatments. Geographical area had no influence. Most of the variance was explained at the patient level, but the available factors explained only 4% thereof. Physiotherapists and physicians explained only 6% and 5% respectively of the variance, although the available factors explained most of this variance. Regulations were the most powerful factors.ConclusionAgainst the backdrop of abundant physical therapy supply, Swiss financial regulations did not restrict utilization. Given that patient-related factors explained most of the variance, this group should be subject to closer scrutiny. Moreover, further research is needed on the determinants of patient demand.",0 +https://doi.org/10.1111/cdev.12169,A Gentle Introduction to Bayesian Analysis: Applications to Developmental Research,"Bayesian statistical methods are becoming ever more popular in applied and fundamental research. In this study a gentle introduction to Bayesian analysis is provided. It is shown under what circumstances it is attractive to use Bayesian estimation, and how to interpret properly the results. First, the ingredients underlying Bayesian methods are introduced using a simplified example. Thereafter, the advantages and pitfalls of the specification of prior knowledge are discussed. To illustrate Bayesian methods explained in this study, in a second example a series of studies that examine the theoretical framework of dynamic interactionism are considered. In the Discussion the advantages and disadvantages of using Bayesian statistics are reviewed, and guidelines on how to report on Bayesian statistics are provided.",0 +https://doi.org/10.3102/0013189x031003025,What Future Quantitative Social Science Research Could Look Like: Confidence Intervals for Effect Sizes,"An improved quantitative science would emphasize the use of confidence intervals (CIs), and especially CIs for effect sizes. This article reviews some definitions and issues related to developing these intervals. Confidence intervals for effect sizes are especially valuable because they facilitate meta-analytic thinking and the interpretation of intervals via comparison with the effect intervals from related prior studies. Several recommendations for the thoughtful use of such CIs are presented.",0 +https://doi.org/10.1214/06-ba117a,Prior distributions for variance parameters in hierarchical models (comment on article by Browne and Draper),"Various prior distributions have been suggested for scale parameters in hierarchical models. We construct a new folded-noncentral-$t$ family of conditionally conjugate priors for hierarchical standard deviation parameters, and then consider and weakly informative priors in this family. We use an example to illustrate serious problems with the inverse-gamma family of noninformative prior distributions. We suggest instead to use a uniform prior on the hierarchical standard deviation, using the half-$t$ family when the number of groups is small and in other settings where a weakly informative prior is desired. We also illustrate the use of the half-$t$ family for hierarchical modeling of multiple variance parameters such as arise in the analysis of variance.",0 +https://doi.org/10.3102/10769986028003195,Using Data Augmentation and Markov Chain Monte Carlo for the Estimation of Unfolding Response Models,"Unfolding response models, a class of item response theory (IRT) models that assume a unimodal item response function (IRF), are often used for the measurement of attitudes. Verhelst and Verstralen (1993) and Andrich and Luo (1993) independently developed unfolding response models by relating the observed responses to a more common monotone IRT model using a latent response model (LRM; Maris, 1995 ). This article generalizes their approach, and suggests a data augmentation scheme for the estimation of any unfolding response model. The article introduces two Markov chain Monte Carlo (MCMC) estimation procedures for the Bayesian estimation of unfolding model parameters; one is a direct implementation of MCMC, and the second utilizes the data augmentation method. We use the estimation procedure to analyze three data sets, one simulated, and two from real attitudinal surveys.",0 +https://doi.org/10.1007/bf02293983,Bayesian estimation of item response curves,"Item response curves for a set of binary responses are studied from a Bayesian viewpoint of estimating the item parameters. For the two-parameter logistic model with normally distributed ability, restricted bivariate beta priors are used to illustrate the computation of the posterior mode via the EM algorithm. The procedure is illustrated by data from a mathematics test. © 1986 The Psychometric Society.",0 +https://doi.org/10.1207/s15328007sem0904_4,A Bayesian Approach for Multigroup Nonlinear Factor Analysis,"The main purpose of this article is to develop a Bayesian approach for a general multigroup nonlinear factor analysis model. Joint Bayesian estimates of the factor scores and the structural parameters subjected to some constraints across different groups are obtained simultaneously. A hybrid algorithm that combines the Metropolis-Hastings algorithm and the Gibbs sampler is implemented to produce these joint Bayesian estimates. It is shown that this algorithm is computationally efficient. The Bayes factor approach is introduced for comparing models under various degrees of invariance across groups. The Schwarz criterion (BIC), a simple and useful approximation of the Bayes factor, is calculated on the basis of simulated observations from the Gibbs sampler. Efficiency and flexibility of the proposed Bayesian procedure are illustrated by some simulation results and a real-life example.",0 +https://doi.org/10.1080/10705511.2014.936096,Detecting Individual Differences in Change: Methods and Comparisons,"This study examined and compared various statistical methods for detecting individual differences in change. Considering 3 issues including test forms (specific vs. generalized), estimation procedures (constrained vs. unconstrained), and nonnormality, we evaluated 4 variance tests including the specific Wald variance test, the generalized Wald variance test, the specific likelihood ratio (LR) variance test, and the generalized LR variance test under both constrained and unconstrained estimation for both normal and nonnormal data. For the constrained estimation procedure, both the mixture distribution approach and the alpha correction approach were evaluated for their performance in dealing with the boundary problem. To deal with the nonnormality issue, we used the sandwich standard error (SE) estimator for the Wald tests and the Satorra–Bentler scaling correction for the LR tests. Simulation results revealed that testing a variance parameter and the associated covariances (generalized) had higher power th...",0 +https://doi.org/10.1093/jjfinec/nbs009,Efficient Estimation of Covariance Matrices using Posterior Mode Multiple Shrinkage,"We propose an approach to the regularization of covariance matrices that can be applied to any model for which the likelihood is available in closed form. The approach is based on using mixtures of double exponential or normal distributions as priors for correlation parameters, and on maximizing the resulting log-posterior (or penalized likelihood) using a stochastic optimization algorithm. The mixture priors are capable of clustering the correlations in several groups, each with separate mean and variance, and can therefore capture a large variety of structures besides sparsity. We apply this approach to the normal linear multivariate regression model as well as several other models that are popular in the literature but have not been previously studied for the purpose of regularization, including multivariate t, normal and t copulas, and mixture of normal distributions. Simulation experiments show the potential for large efficiency gains in estimating the density of the observations in all these models. Sizable gains are also obtained in four real applications. Copyright The Author, 2012. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org, Oxford University Press.",0 +https://doi.org/10.1177/0013164410391575,Computerized Classification Testing Under the Generalized Graded Unfolding Model,"The generalized graded unfolding model (GGUM) has been recently developed to describe item responses to Likert items (agree—disagree) in attitude measurement. In this study, the authors (a) developed two item selection methods in computerized classification testing under the GGUM, the current estimate/ability confidence interval method and the cut score/sequential probability ratio test method and (b) evaluated their accuracy and efficiency in classification through simulations. The results indicated that both methods were very accurate and efficient. The more points each item had and the fewer the classification categories, the more accurate and efficient the classification would be. However, the latter method may yield a very low accuracy in dichotomous items with a short maximum test length. Thus, if it is to be used to classify examinees with dichotomous items, the maximum text length should be increased.",0 +https://doi.org/10.1167/4.12.11,A detection theory account of change detection,"Previous studies have suggested that visual short-term memory (VSTM) has a storage limit of approximately four items. However, the type of high-threshold (HT) model used to derive this estimate is based on a number of assumptions that have been criticized in other experimental paradigms (e.g., visual search). Here we report findings from nine experiments in which VSTM for color, spatial frequency, and orientation was modeled using a signal detection theory (SDT) approach. In Experiments 1-6, two arrays composed of multiple stimulus elements were presented for 100 ms with a 1500 ms ISI. Observers were asked to report in a yes/no fashion whether there was any difference between the first and second arrays, and to rate their confidence in their response on a 1-4 scale. In Experiments 1-3, only one stimulus element difference could occur (T = 1) while set size was varied. In Experiments 4-6, set size was fixed while the number of stimuli that might change was varied (T = 1, 2, 3, and 4). Three general models were tested against the receiver operating characteristics generated by the six experiments. In addition to the HT model, two SDT models were tried: one assuming summation of signals prior to a decision, the other using a max rule. In Experiments 7-9, observers were asked to directly report the relevant feature attribute of a stimulus presented 1500 ms previously, from an array of varying set size. Overall, the results suggest that observers encode stimuli independently and in parallel, and that performance is limited by internal noise, which is a function of set size.",0 +https://doi.org/10.1080/01621459.1982.10477876,Round Robin Analysis of Variance via Maximum Likelihood,"Abstract A class of two-way random-effects models is presented for analyzing data that arise in a large variety of round robin designs. Examples of such designs can be found in numerous games, tournaments, and social interactions. The proposed models provide information not only about individual differences but also about the mutual contingency of the behaviors of interaction dyads. The statistical inference of the linear effects is discussed and a converging algorithm based on the EM algorithm is proposed for obtaining the maximum likelihood estimates of the covariance components. A balanced data set is analyzed using the methodology developed.",0 +https://doi.org/10.1111/ajps.12212,The Externalities of Inequality: Fear of Crime and Preferences for Redistribution in Western Europe,"Why is the difference in redistribution preferences between the rich and the poor high in some countries and low in others? In this article, we argue that it has a lot to do with the rich and very little to do with the poor. We contend that while there is a general relative income effect on redistribution preferences, the preferences of the rich are highly dependent on the macrolevel of inequality. The reason for this effect is not related to immediate tax and transfer considerations but to a negative externality of inequality: crime. We will show that the rich in more unequal regions in Western Europe are more supportive of redistribution than the rich in more equal regions because of their concern with crime. In making these distinctions between the poor and the rich, the arguments in this article challenge some influential approaches to the politics of inequality.",0 +https://doi.org/10.1111/j.1467-842x.2004.00363.x,INFERENCE IN DIRICHLET PROCESS MIXED GENERALIZED LINEAR MODELS BY USING MONTE CARLO EM,"Summary Generalized linear mixed models are widely used for describing overdispersed and correlated data. Such data arise frequently in studies involving clustered and hierarchical designs. A more flexible class of models has been developed here through the Dirichlet process mixture. An additional advantage of using such mixture models is that the observations can be grouped together on the basis of the overdispersion present in the data. This paper proposes a partial empirical Bayes method for estimating all the model parameters by adopting a version of the EM algorithm. An augmented model that helps to implement an efficient Gibbs sampling scheme, under the non-conjugate Dirichlet process generalized linear model, generates observations from the conditional predictive distribution of unobserved random effects and provides an estimate of the average number of mixing components in the Dirichlet process mixture. A simulation study has been carried out to demonstrate the consistency of the proposed method. The approach is also applied to a study on outdoor bacteria concentration in the air and to data from 14 retrospective lung-cancer studies.",0 +https://doi.org/10.1016/j.ecolmodel.2011.01.007,Estimation methods for nonlinear state-space models in ecology,"The use of nonlinear state-space models for analyzing ecological systems is increasing. A wide range of estimation methods for such models are available to ecologists, however it is not always clear, which is the appropriate method to choose. To this end, three approaches to estimation in the theta logistic model for population dynamics were benchmarked by Wang (2007). Similarly, we examine and compare the estimation performance of three alternative methods using simulated data. The first approach is to partition the state-space into a finite number of states and formulate the problem as a hidden Markov model (HMM). The second method uses the mixed effects modeling and fast numerical integration framework of the AD Model Builder (ADMB) open-source software. The third alternative is to use the popular Bayesian framework of BUGS. The study showed that state and parameter estimation performance for all three methods was largely identical, however with BUGS providing overall wider credible intervals for parameters than HMM and ADMB confidence intervals. © 2011 Elsevier B.V. All rights reserved.",0 +https://doi.org/10.1016/j.scitotenv.2009.07.039,Temperature-dependent bioaccumulation of copper in an estuarine oyster,"Bioaccumulation models are an important and widely-used tool for assessing ecosystem health with regards to heavy metal contamination. However, these models do not usually account for the potentially significant effect of temperature-dependency in metal uptake. In this study, we explored the role of temperature-dependency in heavy metal bioaccumulation by developing and comparing two kinetic-based copper bioaccumulation models for a common estuarine oyster (Saccostrea glomerata): (i) a standard first-order model that ignores temperature effects; and (ii) a modified first-order model that uses a standard temperature function to account for the temperature-dependency of the uptake rate constant. The models were calibrated within a Bayesian framework so that parameters could be treated as random variables and any uncertainty propagated through to the model output. A 12-month biomonitoring study was carried out within Moreton Bay, Queensland, Australia to provide time-series data for the modelling. Results of the modelling showed that the two bioaccumulation models provided comparable fits of the biomonitoring field data. However, dependent on the time of year and monitoring period selected, the copper uptake rate would vary dramatically due to temperature effects, which could result in an overestimation or underestimation of the copper uptake rate. Finally by calibrating the bioaccumulation models within a Bayesian framework, these models were able to utilize prior knowledge of the model parameters as part of the calibration process and also account for the uncertainty and variability in the bioaccumulation predictions. The ability to account for uncertainty and variability is an important consideration when undertaking environmental risk assessments especially in coastal waterways where there are strong seasonal variations.",0 +https://doi.org/10.1016/j.csda.2006.05.021,Robustness of the linear mixed model to misspecified error distribution,"A simulation study is performed to investigate the robustness of the maximum likelihood estimator of fixed effects from a linear mixed model when the error distribution is misspecified. Inference for the fixed effects under the assumption of independent normally distributed errors with constant variance is shown to be robust when the errors are either non-gaussian or heteroscedastic, except when the error variance depends on a covariate included in the model with interaction with time. Inference is impaired when the errors are correlated. In the latter case, the model including a random slope in addition to the random intercept is more robust than the random intercept model. The use of Cholesky residuals and conditional residuals to evaluate the fit of a linear mixed model is also discussed.",0 +https://doi.org/10.2307/2533160,Matching Using Estimated Propensity Scores: Relating Theory to Practice,"Matched sampling is a standard technique in the evaluation of treatments in observational studies. Matching on estimated propensity scores comprises an important class of procedures when there are numerous matching variables. Recent theoretical work (Rubin, D. B. and Thomas, N., 1992, The Annals of Statistics 20, 1079-1093) on affinely invariant matching methods with ellipsoidal distributions provides a general framework for evaluating the operating characteristics of such methods. Moreover, Rubin and Thomas (1992, Biometrika 79, 797-809) uses this framework to derive several analytic approximations under normality for the distribution of the first two moments of the matching variables in samples obtained by matching on estimated linear propensity scores. Here we provide a bridge between these theoretical approximations and actual practice. First, we complete and refine the normal- based analytic approximations, thereby making it possible to apply these results to practice. Second, we perform Monte Carlo evaluations of the analytic results under normal and nonnormal ellipsoidal distributions, which confirm the accuracy of the analytic approximations, and demonstrate the predictable ways in which the approximations deviate from simulation results when normal assumptions are violated within the ellipsoidal family. Third, we apply the analytic approximations to real data with clearly nonellipsoidal distributions, and show that the theoretical expressions, although derived under artificial distributional conditions, produce useful guidance for practice. Our results delineate the wide range of settings in which matching on estimated linear propensity scores performs well, thereby providing useful information for the design of matching studies. When matching with a particular data set, our theoretical approximations provide benchmarks for expected performance under favorable conditions, thereby identifying matching variables requiring special treatment. After matching is complete and data analysis is at hand, our results provide the variances required to compute valid standard errors for common estimators.",0 +https://doi.org/10.1111/1468-2389.00149,Impact of Assessments of Validity Generalization and Situational Specificity on the Science and Practice of Personnel Selection,"The application of meta-analysis, in particular validity generalization (VG) analysis, to the cumulative literature on the validity of selection tests has fundamentally changed the science and practice of personnel selection. VG analyses suggest that the validities of standardized tests and other structured assessments are both higher and more consistent across jobs and organizations than was previously believed. As a result, selection researchers and practitioners can draw on the research literature to make reasonably accurate forecasts about the validity and usefulness of different tests in particular applications. Distinctions between tests of validity generalization and tests of situational specificity are described, and difficulties in demonstrating that validity is constant across the different settings where tests are used are outlined.",0 +https://doi.org/10.1002/j.1662-6370.2007.tb00091.x,Mixing Habermas with Bayes: Methodological and Theoretical Advances in the Study of Deliberation,"Two challenges stand out in the study of deliberation: the development of appropriate methodological tools and the development of more unified analytical frameworks. On the one hand, analysing deliberative processes is demanding and time-consuming; hence we tend to have only few and non-randomly selected cases at the group or context level. In addition, the real world of deliberation presents us with a complex matrix of nested, cross-classified, and repeated speakers. This article shows that Bayesian multi-level modelling provides an elegant way to tackle these methodological problems. On the other hand, we attempt to enrich comparative institutionalism with individual characteristics and psychologically relevant variables (such as group composition). Focusing on Swiss and German parliamentary debates we show that institutional factors - in particular, consensus systems -, the gender composition of committees and plenary sessions, and age matter for the quality of deliberation. Furthermore, we also show that partisan affiliation - government or opposition status of MPs - affects deliberative quality and can refine institutional arguments. We conclude that a multi-level approach to deliberation focusing on contextual and actor-related characteristics and using Bayesian hierarchical modelling paves the way toward a more advanced understanding - and methodological handling - of deliberative processes.",0 +https://doi.org/10.1177/1548051815614321,An Assessment of the Magnitude of Effect Sizes,"This study compiles information from more than 250 meta-analyses conducted over the past 30 years to assess the magnitude of reported effect sizes in the organizational behavior (OB)/human resources (HR) literatures. Our analysis revealed an average uncorrected effect of r = .227 and an average corrected effect of ρ = .278 ( SDρ = .140). Based on the distribution of effect sizes we report, Cohen’s effect size benchmarks are not appropriate for use in OB/HR research as they overestimate the actual breakpoints between small, medium, and large effects. We also assessed the average statistical power reported in meta-analytic conclusions and found substantial evidence that the majority of primary studies in the management literature are statistically underpowered. Finally, we investigated the impact of the file drawer problem in meta-analyses and our findings indicate that the file drawer problem is not a significant concern for meta-analysts. We conclude by discussing various implications of this study for OB/HR researchers.",0 +https://doi.org/10.1080/10705511.2010.489003,Confirmatory Factor Analysis of Ordinal Variables With Misspecified Models,Ordinal variables are common in many empirical investigations in the social and behavioral sciences. Researchers often apply the maximum likelihood method to fit structural equation models to ordin ...,0 +https://doi.org/10.1177/0146621604265938,Implementation and Measurement Efficiency of Multidimensional Computerized Adaptive Testing,"Multidimensional adaptive testing (MAT) procedures are proposed for the measurement of several latent traits by a single examination. Bayesian latent trait estimation and adaptive item selection are derived. Simulations were conducted to compare the measurement efficiency of MAT with those of unidimensional adaptive testing and random administration. The results showed that the higher the correlation between latent traits, the more latent traits there were, and the more scoring levels there were in the items, the more efficient MAT was than the other two procedures. For tests containing multidimensional items, only MAT is applicable, whereas unidimensional adaptive testing is not. Issues in implementing MAT are discussed.",0 +https://doi.org/10.1080/10705510701758166,Resampling and Distribution of the Product Methods for Testing Indirect Effects in Complex Models,"Recent advances in testing mediation have found that certain resampling methods and tests based on the mathematical distribution of 2 normal random variables substantially outperform the traditional z test. However, these studies have primarily focused only on models with a single mediator and 2 component paths. To address this limitation, a simulation was conducted to evaluate these alternative methods in a more complex path model with multiple mediators and indirect paths with 2 and 3 paths. Methods for testing contrasts of 2 effects were evaluated also. The simulation included 1 exogenous independent variable, 3 mediators and 2 outcomes and varied sample size, number of paths in the mediated effects, test used to evaluate effects, effect sizes for each path, and the value of the contrast. Confidence intervals were used to evaluate the power and Type I error rate of each method, and were examined for coverage and bias. The bias-corrected bootstrap had the least biased confidence intervals, greatest power to detect nonzero effects and contrasts, and the most accurate overall Type I error. All tests had less power to detect 3-path effects and more inaccurate Type I error compared to 2-path effects. Confidence intervals were biased for mediated effects, as found in previous studies. Results for contrasts did not vary greatly by test, although resampling approaches had somewhat greater power and might be preferable because of ease of use and flexibility.",0 +https://doi.org/10.1073/pnas.17.12.684,The Distribution of Chi-Square,,0 +https://doi.org/10.1111/pere.12065,A tutorial on analyzing data from speed-dating studies with heterosexual dyads,"Speed-dating studies provide a useful venue for studying attraction and other relationship initiation processes. They provide researchers with a unique opportunity to assess how much a dyadic behavior (e.g., attraction) is due to some relationship-specific adjustment or the dispositional tendencies of the two people interacting. Researchers can also investigate the impact of individual difference variables on relationship initiation outcomes. This article shows researchers how to address such interesting questions by providing an extended treatment of how to apply the social relations model (D. A. Kenny & L. La Voie, 1984) to data from a typical speed-dating study with heterosexual dyads. The statistical program SPSS is used given its widespread use and accessibility.",0 +,"A multilevel approach to theory and research in organizations: Contextual, temporal, and emergent processes.",,0 +https://doi.org/10.3102/10769986029004461,Experiences With Markov Chain Monte Carlo Convergence Assessment in Two Psychometric Examples,"There is an increasing use of Markov chain Monte Carlo (MCMC) algorithms for fitting statistical models in psychometrics, especially in situations where the traditional estimation techniques are very difficult to apply. One of the disadvantages of using an MCMC algorithm is that it is not straightforward to determine the convergence of the algorithm. Using the output of an MCMC algorithm that has not converged may lead to incorrect inferences on the problem at hand. The convergence is not one to a point, but that of the distribution of a sequence of generated values to another distribution, and hence is not easy to assess; there is no guaranteed diagnostic tool to determine convergence of an MCMC algorithm in general. This article examines the convergence of MCMC algorithms using a number of convergence diagnostics for two real data examples from psychometrics. Findings from this research have the potential to be useful to researchers using the algorithms. For both the examples, the number of iterations required (suggested by the diagnostics) to be reasonably confident that the MCMC algorithm has converged may be larger than what many practitioners consider to be safe.",0 +https://doi.org/10.1002/sim.4031,Linear mixed models for skew-normal/independent bivariate responses with an application to periodontal disease,"Bivariate clustered (correlated) data often encountered in epidemiological and clinical research are routinely analyzed under a linear mixed model (LMM) framework with underlying normality assumptions of the random effects and within-subject errors. However, such normality assumptions might be questionable if the data set particularly exhibits skewness and heavy tails. Using a Bayesian paradigm, we use the skew-normal/independent (SNI) distribution as a tool for modeling clustered data with bivariate non-normal responses in an LMM framework. The SNI distribution is an attractive class of asymmetric thick-tailed parametric structure which includes the skew-normal distribution as a special case. We assume that the random effects follow multivariate SNI distributions and the random errors follow SNI distributions which provides substantial robustness over the symmetric normal process in an LMM framework. Specific distributions obtained as special cases, viz. the skew-t, the skew-slash and the skew-contaminated normal distributions are compared, along with the default skew-normal density. The methodology is illustrated through an application to a real data which records the periodontal health status of an interesting population using periodontal pocket depth (PPD) and clinical attachment level (CAL).",0 +https://doi.org/10.1007/bf02295598,Bayesian estimation in the three-parameter logistic model,"A joint Bayesian estimation procedure for the estimation of parameters in the three-parameter logistic model is developed in this paper. Procedures for specifying prior beliefs for the parameters are given. It is shown through simulation studies that the Bayesian procedure (i) ensures that the estimates stay in the parameter space, and (ii) produces better estimates than the joint maximum likelihood procedure as judged by such criteria as mean squared differences between estimates and true values. © 1986 The Psychometric Society.",0 +https://doi.org/10.1007/s00221-004-1991-1,Transcranial magnetic stimulation in the visual system. I. The psychophysics of visual suppression,"When applied over the occipital pole, transcranial magnetic stimulation (TMS) disrupts visual perception and induces phosphenes. Both the underlying mechanisms and the brain structures involved are still unclear. The first part of the study characterizes the suppressive effect of TMS by psychophysical methods. Luminance increment thresholds for orientation discrimination were determined in four subjects using an adaptive staircase procedure. Coil position was controlled with a stereotactic positioning device. Threshold values were modulated by TMS, reaching a maximum effect at a stimulus onset asynchrony (SOA) of approx. 100 ms after visual target presentation. Stronger TMS pulses increased the maximum threshold while decreasing the SOA producing the maximum effect. Slopes of the psychometric function were flattened with TMS masking by a factor of 2, compared to control experiments in the absence of TMS. No change in steepness was observed in experiments using a light flash as the mask instead of TMS. Together with the finding that at higher TMS intensities, threshold elevation occurs even with shorter SOAs, this suggests lasting inhibitory processes as masking mechanisms, contradicting the assumption that the phosphene as excitatory equivalent causes masking. In the companion contribution to this one we present perimetric measurements and phosphene forms as a function of the stimulation site in the brain and discuss the putative generator structures. © Springer-Verlag 2004.",0 +https://doi.org/10.1016/j.ecolmodel.2014.01.011,Modeling environmental factors affecting assimilation of bomb-produced Δ14C in the North Pacific Ocean: Implications for age validation studies,"Abstract The bomb-produced radiocarbon (14C) chronometer has become the gold standard for assessing the accuracy of otolith growth ring based fish age estimates. In the northeast Pacific Ocean, nearly a dozen age validation studies have been conducted, ranging from California to Alaska, most of which have relied on a single reference chronology from the Gulf of Alaska. We developed a Bayesian hierarchical model using data sets of bomb-produced radiocarbon in the northeast Pacific Ocean and investigated whether latitude and upwelling exerts an influence on the parameters that describe the rapid Δ14C increase in marine calcium carbonates. Models incorporating both latitude and upwelling as linear covariates of a 4-parameter logistic model were favored based on ΔDIC statistics. There was substantial evidence to support that the timing of the Δ14C pulse was advanced and that total Δ14C uptake increased with increasing latitude. In contrast, increased oceanographic upwelling resulted in lower total radiocarbon input as well as a delay in the timing of the pulse curve, as was demonstrated in the upwelling dominated California Current System. Within the observed latitudinal and upwelling range of the data sets examined in this study the predicted timing of the bomb pulse curve varied by as much as 3 years, which could be misinterpreted as aging error. Our results suggest that new reference chronologies may be needed for regions of the North Pacific Ocean differing in latitude, seasonal upwelling strength and other mixing factors that can potentially change the functional form of the Δ14C curve.",0 +https://doi.org/10.1108/s1475-9144(2009)0000008008,A componential analysis of leadership using the social relations model,"The social relations model (SRM; Kenny, 1994) explicitly proposes that leadership simultaneously operates at three levels of analysis: group, dyad, and individual (perceiver and target). With this model, researchers can empirically determine the amount of variance at each level as well as those factors that explain variance at these different levels. This chapter shows how the SRM can be used to address many theoretically important questions in the study of leadership and can be used to advance both the theory of and research in leadership. First, based on analysis of leadership ratings from seven studies, we find that there is substantial agreement (i.e., target variance) about who in the group is the leader and little or no reciprocity in the perceptions of leadership. We then consider correlations of leadership perceptions. In one analysis, we examine the correlations between task-oriented and socioemotional leadership. In another analysis, we examine the effect of gender and gender composition on the perception of leadership. We also explore how self-ratings of leadership differ from member perceptions of leadership. Finally, we discuss how the model can be estimated using conventional software.",0 +https://doi.org/10.1080/00949655.2014.935377,Bayesian estimation with integrated nested Laplace approximation for binary logit mixed models,"In multilevel models for binary responses, estimation is computationally challenging due to the need to evaluate intractable integrals. In this paper, we investigate the performance of integrated nested Laplace approximation (INLA), a fast deterministic method for Bayesian inference. In particular, we conduct an extensive simulation study to compare the results obtained with INLA to the results obtained with a traditional stochastic method for Bayesian inference (MCMC Gibbs sampling), and with maximum likelihood through adaptive quadrature. Particular attention is devoted to the case of small number of clusters. The specification of the prior distribution for the cluster variance plays a crucial role and it turns out to be more relevant than the choice of the estimation method. The simulations show that INLA has an excellent performance as it achieves good accuracy (similar to MCMC) with reduced computational times (similar to adaptive quadrature).",0 +https://doi.org/10.1214/aos/1176344611,Conjugate Priors for Exponential Families,Let $X$ be a random vector distributed according to an exponential family with natural parameter $\theta \in \Theta$. We characterize conjugate prior measures on $\Theta$ through the property of linear posterior expectation of the mean parameter of $X : E\{E(X|\theta)|X = x\} = ax + b$. We also delineate which hyperparameters permit such conjugate priors to be proper.,0 +https://doi.org/10.1016/j.lindif.2015.06.003,Examining factor structures on the Test of Early Mathematics Ability — 3: A longitudinal approach,"Assessment of early mathematics skills in young children is important both psychometrically and practically. The TEMA-3 (Ginsburg & Baroody, 2003) yields a total score (Math Ability Score) and provides useful information on children's overall mathematics performance, but not about performance in specific skill areas that are targeted by state early learning guidelines and by the National Council of Teachers of Mathematics (NCTM) and Common Core State Standards for Mathematics as important content for Understanding Number in early childhood. This study examined the factor structure of the TEMA-3 to examine whether items reflect the conceptual categories in the TEMA-3 Examiner's Manual (Ginsburg & Baroody, 2003) or a priori categories reflecting Understanding Number. Longitudinal data from 389 children (182 males), mean age 54.46 months at first assessment, were obtained in fall and spring of pre-kindergarten, spring of kindergarten, and spring of 1st grade. Changes in factor structure are examined across measurement points. The a priori factor structure was found by confirmatory factor analysis to better fit the data. The numbers of factors identified increased across time. Subscale scores reflecting children's knowledge of specific mathematics concepts related to number concepts could enable teachers and parents to select activities to strengthen children's mathematical knowledge in those skill areas.",0 +https://doi.org/10.1016/j.indmarman.2015.02.042,Which types of multi-stage marketing increase direct customers' willingness-to-pay? Evidence from a scenario-based experiment in a B2B setting,"The present study investigates empirically which types of multi-stage marketing by a business-to-business supplier affect its direct customers' willingness-to-pay. We conceptually develop comprehensive and selective multi-stage marketing as well as multi-stage awareness as distinct types of this concept. Their properties lead to differentiated hypotheses concerning their effects on direct customers' relationship value perceptions and perceived price importance which in turn influence willingness-to-pay. The paper also demonstrates how the direct customers' power position toward their own customers affects the effectiveness of a supplier's multi-stage marketing endeavors. We conduct a scenario-based, experimental study among 103 knowledgeable purchasing managers in customer companies to the adhesives industry, measuring willingness-to-pay, perceived relationship value, and price importance with a limit conjoint analysis. Multi-level modeling is used to test our hypotheses. The results show that comprehensive multi-stage marketing significantly increases purchasing agents' willingness-to-pay, mostly through their relationship value perception, and especially when the customer company is in a less powerful position toward its own customers. For managers, our study highlights the benefits of comprehensive multi-stage marketing over the other multi-stage marketing types.",0 +https://doi.org/10.1073/pnas.0407247101,A versatile statistical analysis algorithm to detect genome copy number variation,"We have developed a versatile statistical analysis algorithm for the detection of genomic aberrations in human cancer cell lines. The algorithm analyzes genomic data obtained from a variety of array technologies, such as oligonucleotide array, bacterial artificial chromosome array, or array-based comparative genomic hybridization, that operate by hybridizing with genomic material obtained from cancer and normal cells and allow detection of regions of the genome with altered copy number. The number of probes (i.e., resolution), the amount of uncharacterized noise per probe, and the severity of chromosomal aberrations per chromosomal region may vary with the underlying technology, biological sample, and sample preparation. Constrained by these uncertainties, our algorithm aims at robustness by using a priorless maximum a posteriori estimator and at efficiency by a dynamic programming implementation. We illustrate these characteristics of our algorithm by applying it to data obtained from representational oligonucleotide microarray analysis and array-based comparative genomic hybridization technology as well as to synthetic data obtained from an artificial model whose properties can be varied computationally. The algorithm can combine data from multiple sources and thus facilitate the discovery of genes and markers important in cancer, as well as the discovery of loci important in inherited genetic disease.",0 +https://doi.org/10.1214/11-sts352,Is Bayes Posterior just Quick and Dirty Confidence?,"Bayes [Philos. Trans. R. Soc. Lond. 53 (1763) 370--418; 54 296--325] introduced the observed likelihood function to statistical inference and provided a weight function to calibrate the parameter; he also introduced a confidence distribution on the parameter space but did not provide present justifications. Of course the names likelihood and confidence did not appear until much later: Fisher [Philos. Trans. R. Soc. Lond. Ser. A Math. Phys. Eng. Sci. 222 (1922) 309--368] for likelihood and Neyman [Philos. Trans. R. Soc. Lond. Ser. A Math. Phys. Eng. Sci. 237 (1937) 333--380] for confidence. Lindley [J. Roy. Statist. Soc. Ser. B 20 (1958) 102--107] showed that the Bayes and the confidence results were different when the model was not location. This paper examines the occurrence of true statements from the Bayes approach and from the confidence approach, and shows that the proportion of true statements in the Bayes case depends critically on the presence of linearity in the model; and with departure from this linearity the Bayes approach can be a poor approximation and be seriously misleading. Bayesian integration of weighted likelihood thus provides a first-order linear approximation to confidence, but without linearity can give substantially incorrect results.",0 +https://doi.org/10.1037/a0024376,A 2 × 2 taxonomy of multilevel latent contextual models: Accuracy–bias trade-offs in full and partial error correction models.,"In multilevel modeling, group-level variables (L2) for assessing contextual effects are frequently generated by aggregating variables from a lower level (L1). A major problem of contextual analyses in the social sciences is that there is no error-free measurement of constructs. In the present article, 2 types of error occurring in multilevel data when estimating contextual effects are distinguished: unreliability that is due to measurement error and unreliability that is due to sampling error. The fact that studies may or may not correct for these 2 types of error can be translated into a 2 × 2 taxonomy of multilevel latent contextual models comprising 4 approaches: an uncorrected approach, partial correction approaches correcting for either measurement or sampling error (but not both), and a full correction approach that adjusts for both sources of error. It is shown mathematically and with simulated data that the uncorrected and partial correction approaches can result in substantially biased estimates of contextual effects, depending on the number of L1 individuals per group, the number of groups, the intraclass correlation, the number of indicators, and the size of the factor loadings. However, the simulation study also shows that partial correction approaches can outperform full correction approaches when the data provide only limited information in terms of the L2 construct (i.e., small number of groups, low intraclass correlation). A real-data application from educational psychology is used to illustrate the different approaches.",0 +https://doi.org/10.1111/j.1745-3984.2009.00080.x,Conceptual Issues in Response-Time Modeling,"Two different traditions of response-time (RT) modeling are reviewed: the tradition of distinct models for RTs and responses, and the tradition of model integration in which RTs are incorporated in response models or the other way around. Several conceptual issues underlying both traditions are made explicit and analyzed for their consequences. We then propose a hierarchical modeling framework consistent with the first tradition but with the integration of their parameter structures as a second level of modeling. Two examples of the framework are presented. Also, a fundamental equation is derived which relates the RTs on test items to the speed of the test taker and the time intensity of the items. The equation serves as the core of the RT model in the framework. Finally, empirical applications of the framework demonstrating its practical value are reviewed. Test theorists have always been intrigued by the relationship between responses to test items and the time used by a test taker to produce them. Both seem indicative of the same behavior on test items. Nevertheless, their relationship appears to be difficult to conceptualize, let alone represent coherently in a statistical model. Although the computerization of educational tests has been a major impetus to the current interest in response-time (RT) modeling, it would be wrong to ignore its historical origins. One early development that has left traces in our current thinking about RTs was Woodbury’s (1951, 1963) treatment of test scores as the result of a time-dependent stochastic response process. His theory, which is summarized in Lord and Novick (1968, chap. 5), has linear axioms and theorems that are entirely parallel to those of regular classical test theory. But, more important to the scope of this article, it also lent statistical sophistication to the intuitive idea that total time and numbers of items completed are equivalent measures of the test taker’s performance (see the example in Lord & Novick, pp. 104‐105). The same idea was present in Gulliksen’s (1950, chap. 17) treatment of speed and power tests. He defined a pure speed test as a test with an unlimited number of items that are easy enough to be answered correctly. Such tests can be scored in two different ways, as (a) the total time used to complete a fixed number of items, and (b) the number of items completed in a fixed time interval. On the other hand, a pure power test was defined by him as a test with unlimited time but a fixed number of items of varying difficulty. Such tests can be scored only by counting the number of correct responses. A fundamental problem exists with respect to the asymmetry between Gulliksen’s scoring rules for speed and power tests. At a practical level, the problem becomes manifest when a test taker produces an incorrect answer on a speed test, which is not very likely for high-ability test takers and easy items but certainly possible. How should we treat such responses? And would it be fair to treat their RTs as equivalent",0 +https://doi.org/10.1037/1082-989x.4.2.139,"Analyzing developmental trajectories: A semiparametric, group-based approach.","Carnegie Mellon UniversityA developmental trajectory describes the course of a behavior over age or time. Agroup-based method for identifying distinctive groups of individual trajectorieswithin the population and for profiling the characteristics of group members isdemonstrated. Such clusters might include groups of increasers. decreasers,and no changers. Suitably defined probability distributions are used to handle 3data types—count, binary, and psychometric scale data. Four capabilities are dem-onstrated: (a) the capability to identify rather than assume distinctive groups oftrajectories, (b) the capability to estimate the proportion of the population followingeach such trajectory group, (c) the capability to relate group membership probabil-ity to individual characteristics and circumstances, and (d) the capability to use thegroup membership probabilities for various other purposes such as creating profilesof group members.",0 +https://doi.org/10.1007/s11222-010-9210-3,Reversible jump methods for generalised linear models and generalised linear mixed models,"A reversible jump algorithm for Bayesian model determination among generalised linear models, under relatively diffuse prior distributions for the model parameters, is proposed. Orthogonal projections of the current linear predictor are used so that knowledge from the current model parameters is used to make effective proposals. This idea is generalised to moves of a reversible jump algorithm for model determination among generalised linear mixed models. Therefore, this algorithm exploits the full flexibility available in the reversible jump method. The algorithm is demonstrated via two examples and compared to existing methods. © 2010 Springer Science+Business Media, LLC.",0 +https://doi.org/10.1007/978-1-4419-0056-2_5,Cultural Consensus Theory: Aggregating Expert Judgments about Ties in a Social Network,"This paper describes an approach to information aggregation called Cultural Consensus Theory (CCT). CCT is a statistical modeling approach to pooling information from informants (experts, automated sources) who share a common culture or knowledge base. Each informant responds to the same set of questions, and the goal is to estimate the consensus knowledge of the informants. CCT has become a leading methodology for determining consensus beliefs of groups in the social sciences, especially cultural and medical anthropology. The paper illustrates CCT by providing a model for aggregating expert judgments about ties in a social network. Expert sources each provide a digraph on the same set of nodes, and the CCT model is used to estimate the most likely digraph to represent their shared knowledge. © Springer Science + Business Media, LLC 2009.",0 +https://doi.org/10.1214/aos/1034276631,Bayesian inference for causal effects in randomized experiments with noncompliance,"For most of this century, randomization has been a cornerstone of scientific experimentation, especially when dealing with humans as experimental units. In practice, however, noncompliance is relatively common with human subjects, complicating traditional theories of inference that require adherence to the random treatment assignment. In this paper we present Bayesian inferential methods for causal estimands in the presence of noncompliance, when the binary treatment assignment is random and hence ignorable, but the binary treatment received is not ignorable. We assume that both the treatment assigned and the treatment received are observed. We describe posterior estimation using EM and data augmentation algorithms. Also, we investigate the role of two assumptions often made in econometric instrumental variables analyses, the exclusion restriction and the monotonicity assumption, without which the likelihood functions generally have substantial regions of maxima. We apply our procedures to real and artificial data, thereby demonstrating the technology and showing that our new methods can yield valid inferences that differ in practically important ways from those based on previous methods for analysis in the presence of noncompliance, including intention-to-treat analyses and analyses based on econometric instrumental variables techniques. Finally, we perform a simulation to investigate the operating characteristics of the competing procedures in a simple setting, which indicates relatively dramatic improvements in frequency operating characteristics attainable using our Bayesian procedures.",0 +https://doi.org/10.1080/10705510903439003,A Comparison of Approaches for the Analysis of Interaction Effects Between Latent Variables Using Partial Least Squares Path Modeling,"In social and business sciences, the importance of the analysis of interaction effects between manifest as well as latent variables steadily increases. Researchers using partial least squares (PLS) to analyze interaction effects between latent variables need an overview of the available approaches as well as their suitability. This article presents 4 PLS-based approaches: a product indicator approach (Chin, Marcolin, & Newsted, 2003), a 2-stage approach (Chin et al., 2003; Henseler & Fassott, in press), a hybrid approach (Wold, 1982), and an orthogonalizing approach (Little, Bovaird, & Widaman, 2006), and contrasts them using data related to a technology acceptance model. By means of a more extensive Monte Carlo experiment, the different approaches are compared in terms of their point estimate accuracy, their statistical power, and their prediction accuracy. Based on the results of the experiment, the use of the orthogonalizing approach is recommendable under most circumstances. Only if the orthogonalizing approach does not find a significant interaction effect, the 2-stage approach should be additionally used for significance test, because it has a higher statistical power. For prediction accuracy, the orthogonalizing and the product indicator approach provide a significantly and substantially more accurate prediction than the other two approaches. Among these two, the orthogonalizing approach should be used in case of small sample size and few indicators per construct. If the sample size or the number of indicators per construct is medium to large, the product indicator approach should be used.",0 +https://doi.org/10.4324/9780203403020,Contemporary Issues in Exploratory Data Mining in the Behavioral Sciences,,0 +https://doi.org/10.1214/ss/1177011137,Practical Markov Chain Monte Carlo,"Markov chain Monte Carlo using the Metropolis-Hastings algorithm is a general method for the simulation of stochastic processes having probability densities known up to a constant of proportionality. Despite recent advances in its theory, the practice has remained controversial. This article makes the case for basing all inference on one long run of the Markov chain and estimating the Monte Carlo error by standard nonparametric methods well-known in the time-series and operations research literature. In passing it touches on the Kipnis-Varadhan central limit theorem for reversible Markov chains, on some new variance estimators, on judging the relative efficiency of competing Monte Carlo schemes, on methods for constructing more rapidly mixing Markov chains and on diagnostics for Markov chain Monte Carlo.",0 +https://doi.org/10.1093/acprof:oso/9780195339888.001.0001,Confirmatory Factor Analysis,"Measures that are reliable, valid, and can be used across diverse populations are vital to social work research, but the development of new measures is an expensive and time-consuming process. An array of existing measures can provide a cost-effective alternative, but in order to take this expedient step with confidence, researchers must ensure that the existing measure is appropriate for the new study. Confirmatory factor analysis (CFA) is one of the ways to do so. CFA has four primary functions-psychometric evaluation of measures, construct validation, testing method effects, and testing measurement invariance. This book provides an overview of the method, step-by-step guides to creating a CFA model and assessing its fit, and explanations of the requirements for using CFA, as well the book underscores the issues that are necessary to consider when using multiple groups or equivalent and multilevel models. Real-world examples, screenshots from the Amos software program that can be used to conduct CFA, and reading suggestions for each chapter form part of the book. © Oxford University Press, 2013.",0 +https://doi.org/10.1111/biom.12269,On Bayesian estimation of marginal structural models,"The purpose of inverse probability of treatment (IPT) weighting in estimation of marginal treatment effects is to construct a pseudo-population without imbalances in measured covariates, thus removing the effects of confounding and informative censoring when performing inference. In this article, we formalize the notion of such a pseudo-population as a data generating mechanism with particular characteristics, and show that this leads to a natural Bayesian interpretation of IPT weighted estimation. Using this interpretation, we are able to propose the first fully Bayesian procedure for estimating parameters of marginal structural models using an IPT weighting. Our approach suggests that the weights should be derived from the posterior predictive treatment assignment and censoring probabilities, answering the question of whether and how the uncertainty in the estimation of the weights should be incorporated in Bayesian inference of marginal treatment effects. The proposed approach is compared to existing methods in simulated data, and applied to an analysis of the Canadian Co-infection Cohort.",0 +https://doi.org/10.1093/biomet/87.2.425,Maximum likelihood estimation of generalised linear models for multivariate normal covariance matrix,"The positive-definiteness constraint is the most awkward stumbling block in modelling the covariance matrix. Pourahmadi's (1999) unconstrained parameterisation models covariance using covariates in a similar manner to mean modelling in generalised linear models. The new covariance parameters have statistical interpretation as the regression coefficients and logarithms of prediction error variances corresponding to regressing a response on its predecessors. In this paper, the maximum likelihood estimators of the parameters of a generalised linear model for the covariance matrix, their consistency and their asymptotic normality are studied when the observations are normally distributed. These results along with the likelihood ratio test and penalised likelihood criteria such as BIC for model and variable selection are illustrated using a real dataset.",0 +https://doi.org/10.1111/j.1745-3984.2010.00127.x,A Strategy for Developing a Common Metric in Item Response Theory When Parameter Posterior Distributions Are Known,"Growing interest in fully Bayesian item response models begs the question: To what extent can model parameter posterior draws enhance existing practices? One practice that has traditionally relied on model parameter point estimates but may be improved by using posterior draws is the development of a common metric for two independently calibrated test forms. Before parameter estimates from independently calibrated forms can be compared, at least one form's estimates must be adjusted such that both forms share a common metric. Because this adjustment is estimated, there is a propagation of error effect when it is applied. This effect is typically ignored, which leads to overconfidence in the adjusted estimates; yet, when model parameter posterior draws are available, it may be accounted for with a simple sampling strategy. In this paper, it is shown using simulated data that the proposed sampling strategy results in adjusted posteriors with superior coverage properties than those obtained using traditional point-estimate-based methods.",0 +https://doi.org/10.1007/s12187-014-9285-z,"Family, School, and Community Correlates of Children’s Subjective Well-being: An International Comparative Study","The primary purposes of this study are twofold: to examine how family, school, and community factors are related to children’s subjective well-being; and to examine the patterns of the relationships between family, school, and community variables and children’s subjective well-being across nations. We use the data from the pilot study of the International Survey of Children’s Well-Being for our analysis. We use multiple regression and multilevel methods in the study. We find that family, school, and community lives all significantly affect the levels of children’s subjective well-being. We also find that family, school, and community lives of children are important predictors of subjective well-being even after controlling for the country-specific cultural and contextual factors. We find that the economic variables of GDP and inequality are not significant factors predicting children’s subjective well-being. Rather it is the nature of children’s relationships with immediate surrounding environments, such as frequency of family activities, frequency of peer activities, and neighborhood safety, are most consistently related to the levels of children’s subjective well-being across the nations. © 2014, Springer Science+Business Media Dordrecht.",0 +https://doi.org/10.1207/s15328007sem0801_3,A Note on Estimating the Jöreskog-Yang Model for Latent Variable Interaction Using LISREL 8.3,"Kenny and Judd (1984) developed a latent variable interaction model for observed variables centered around their population means. They estimated the model by using a covariance matrix calculated from sample-mean-centered variables and products of these variables. Subsequently,Joreskog and Yang (1996) identified the need to include intercepts for the measurement and structural equations and estimated the model by using a covariance matrix calculated from noncentered observed variables and products of these variables, and means of the observed variables and the products of noncentered variables. Evidence is presented that the Joreskog-Yang procedure for estimating the Kenny-Judd interaction model is subject to severe convergence problems when implemented in LISREL8.3 and means for the indicators of the latent exogenous variables are nonzero. An alternative procedure is presented that solves the convergence problem and provides consistent estimators of the parameters.",0 +https://doi.org/10.4324/9781410606747-8,Analysis of Reading Skills Development from Kindergarten through First Grade: An Application of Growth Mixture Modeling to Sequential Processes,Methods for investigating the influence of an early developmental process on a later process are discussed. Conventional growth modeling is found inadequate but a general growth mixture model is sufficiently flexible. The growth mixture model allows prediction of the later process using different trajectory classes for the early process. The growth mixture model is applied to the study of progress in reading skills among first-grade students.,0 +https://doi.org/10.1093/biomet/asn048,Small area estimation when auxiliary information is measured with error,"SUMMARY Small area estimation methods typically combine direct estimates from a survey with pre dictions from a model in order to obtain estimates of population quantities with reduced mean squared error. When the auxiliary information used in the model is measured with error, using a small area estimator such as the Fay-Herriot estimator while ignoring measurement error may be worse than simply using the direct estimator. We propose a new small area estimator that accounts for sampling variability in the auxiliary information, and derive its properties, in particular show ing that it is approximately unbiased. The estimator is applied to predict quantities measured in the U.S. National Health and Nutrition Examination Survey, with auxiliary information from the U.S. National Health Interview Survey.",0 +https://doi.org/10.1186/1471-2288-10-64,The importance of adjusting for potential confounders in Bayesian hierarchical models synthesising evidence from randomised and non-randomised studies: an application comparing treatments for abdominal aortic aneurysms,"Informing health care decision making may necessitate the synthesis of evidence from different study designs (e.g., randomised controlled trials, non-randomised/observational studies). Methods for synthesising different types of studies have been proposed, but their routine use requires development of approaches to adjust for potential biases, especially among non-randomised studies. The objective of this study was to extend a published Bayesian hierarchical model to adjust for bias due to confounding in synthesising evidence from studies with different designs.In this new methodological approach, study estimates were adjusted for potential confounders using differences in patient characteristics (e.g., age) between study arms. The new model was applied to synthesise evidence from randomised and non-randomised studies from a published review comparing treatments for abdominal aortic aneurysms. We compared the results of the Bayesian hierarchical model adjusted for differences in study arms with: 1) unadjusted results, 2) results adjusted using aggregate study values and 3) two methods for downweighting the potentially biased non-randomised studies. Sensitivity of the results to alternative prior distributions and the inclusion of additional covariates were also assessed.In the base case analysis, the estimated odds ratio was 0.32 (0.13,0.76) for the randomised studies alone and 0.57 (0.41,0.82) for the non-randomised studies alone. The unadjusted result for the two types combined was 0.49 (0.21,0.98). Adjusted for differences between study arms, the estimated odds ratio was 0.37 (0.17,0.77), representing a shift towards the estimate for the randomised studies alone. Adjustment for aggregate values resulted in an estimate of 0.60 (0.28,1.20). The two methods used for downweighting gave odd ratios of 0.43 (0.18,0.89) and 0.35 (0.16,0.76), respectively. Point estimates were robust but credible intervals were wider when using vaguer priors.Covariate adjustment using aggregate study values does not account for covariate imbalances between treatment arms and downweighting may not eliminate bias. Adjustment using differences in patient characteristics between arms provides a systematic way of adjusting for bias due to confounding. Within the context of a Bayesian hierarchical model, such an approach could facilitate the use of all available evidence to inform health policy decisions.",0 +https://doi.org/10.1002/wics.1308,Estimation of variances and covariances for high‐dimensional data: a selective review,"Estimation of variances and covariances is required for many statistical methods such as t-test, principal component analysis and linear discriminant analysis. High-dimensional data such as gene expression microarray data and financial data pose challenges to traditional statistical and computational methods. In this paper, we review some recent developments in the estimation of variances, covariance matrix, and precision matrix, with emphasis on the applications to microarray data analysis. WIREs Comput Stat 2014, 6:255–264. doi: 10.1002/wics.1308 For further resources related to this article, please visit the WIREs website. Conflict of interest: The authors have declared no conflicts of interest for this article.",0 +https://doi.org/10.1198/108571105x58199,A simulation study on tests of hypotheses and confidence intervals for fixed effects in mixed models for blocked experiments with missing data,"This article considers the analysis of experiments with missing data from various experimental designs frequently used in agricultural research (randomized complete blocks, split plots, strip plots). We investigate the small sample properties of REML-based Wald-type F tests using linear mixed models. Several methods for approximating the denominator degrees of freedom are employed, all of which are available with the MIXED procedure of the SAS System (8.02). The simulation results show that the Kenward-Roger method provides the best control of the Type I error rate and is not inferior to other methods in terms of power. © 2005 American Statistical Association and the International Biometric Society.",0 +https://doi.org/10.1037/pas0000004,A test of the International Personality Item Pool representation of the Revised NEO Personality Inventory and development of a 120-item IPIP-based measure of the five-factor model.,"There has been a substantial increase in the use of personality assessment measures constructed using items from the International Personality Item Pool (IPIP) such as the 300-item IPIP-NEO (Goldberg, 1999), a representation of the Revised NEO Personality Inventory (NEO PI-R; Costa & McCrae, 1992). The IPIP-NEO is free to use and can be modified to accommodate its users' needs. Despite the substantial interest in this measure, there is still a dearth of data demonstrating its convergence with the NEO PI-R. The present study represents an investigation of the reliability and validity of scores on the IPIP-NEO. Additionally, we used item response theory (IRT) methodology to create a 120-item version of the IPIP-NEO. Using an undergraduate sample (n = 359), we examined the reliability, as well as the convergent and criterion validity, of scores from the 300-item IPIP-NEO, a previously constructed 120-item version of the IPIP-NEO (Johnson, 2011), and the newly created IRT-based IPIP-120 in comparison to the NEO PI-R across a range of outcomes. Scores from all 3 IPIP measures demonstrated strong reliability and convergence with the NEO PI-R and a high degree of similarity with regard to their correlational profiles across the criterion variables (rICC = .983, .972, and .976, respectively). The replicability of these findings was then tested in a community sample (n = 757), and the results closely mirrored the findings from Sample 1. These results provide support for the use of the IPIP-NEO and both 120-item IPIP-NEO measures as assessment tools for measurement of the five-factor model.",0 +https://doi.org/10.1016/0749-5978(87)90045-8,A meta-analytic study of the effects of goal setting on task performance: 1966–1984,"A meta-analytic study was conducted involving primarily published research from 1966 to 1984 and focusing on the relationship between goal-setting variables and task performance. Two major sets of studies were analyzed, those contrasting hard goals (goal difficulty) versus easy goals, and those comparing specific hard goals (goal specificity/difficulty) versus general goals, “do best” instructions, or no goal. As expected, strong support was obtained for the goal difficulty and goal specificity/difficulty components of E. A. Locke's (1968a , Organizational Behavior and Human Performance , 3 , 157–189) theory. A two-stage approach was employed to identify potential moderators of the goal difficulty and goal specificity/difficulty—performance relationships. Setting (laboratory versus field) was identified as a moderator of the relationship between goal specificity/difficulty and task performance. Two supplemental meta-analyses yielded support for the efficacy of combining specific hard goals with feedback versus specific hard goals without feedback and for participatively set goals versus assigned goal setting (when goal level is held constant), although this latter finding was interpreted as inconclusive based on the limited studies available. Implications for future research are addressed.",0 +https://doi.org/10.1016/j.bbi.2006.10.010,Interleukin-6 mediates low-threshold mechanical allodynia induced by intrathecal HIV-1 envelope glycoprotein gp120,"Spinal cord glia (microglia and astrocytes) contribute to enhanced pain states. One model that has been used to study this phenomenon is intrathecal (i.t.) administration of gp120, an envelope glycoprotein of HIV-1 known to activate spinal cord glia and thereby induce low-threshold mechanical allodynia, a pain symptom where normally innocuous (non-painful) stimuli are perceived as painful. Previous studies have shown that i.t. gp120-induced allodynia is mediated via the release of the glial pro-inflammatory cytokines, tumor necrosis factor-alpha (TNF), and interleukin-1beta (IL-1). As we have recently reported that i.t. gp120 induces the release of interleukin-6 (IL-6), in addition to IL-1 and TNF, the present study tested whether this IL-6 release in spinal cord contributes to gp120-induced mechanical allodynia and/or to gp120-induced increases in TNF and IL-1. An i.t. anti-rat IL-6 neutralizing antibody was used to block IL-6 actions upon its release by i.t. gp120. This IL-6 blockade abolished gp120-induced mechanical allodynia. While the literature predominantly documents the cascade of pro-inflammatory cytokines as beginning with TNF, followed by the stimulation of IL-1, and finally TNF plus IL-1 stimulating the release of IL-6, the present findings indicate that a blockade of IL-6 inhibits the gp120-induced elevations of TNF, IL-1, and IL-6 mRNA in dorsal spinal cord, elevation of IL-1 protein in lumbar dorsal spinal cord, and TNF and IL-1 protein release into the surrounding lumbosacral cerebrospinal fluid. These results would suggest that IL-6 induces pain facilitation, and may do so in part by stimulating the production and release of other pro-inflammatory cytokines.",0 +https://doi.org/10.1016/s0042-6989(97)00340-4,Forced-choice staircases with fixed step sizes: asymptotic and small-sample properties,"Visual detection and discrimination thresholds are often measured using adaptive staircases, and most studies use transformed (or weighted) up/down methods with fixed step sizes—in the spirit of Wetherill and Levitt (Br J Mathemat Statist Psychol 1965;18:1–10) or Kaernbach (Percept Psychophys 1991;49:227–229)—instead of changing step size at each trial in accordance with best-placement rules—in the spirit of Watson and Pelli (Percept Psychophys 1983;47:87–91). It is generally assumed that a fixed-step-size (FSS) staircase converges on the stimulus level at which a correct response occurs with the probabilities derived by Wetherill and Levitt or Kaernbach, but this has never been proved rigorously. This work used simulation techniques to determine the asymptotic and small-sample convergence of FSS staircases as a function of such parameters as the up/down rule, the size of the steps up or down, the starting stimulus level, or the spread of the psychometric function. The results showed that the asymptotic convergence of FSS staircases depends much more on the sizes of the steps than it does on the up/down rule. Yet, if the size Δ + of a step up differs from the size Δ − of a step down in a way that the ratio Δ − /Δ + is constant at a specific value that changes with up/down rule, then convergence percent-correct is unaffected by the absolute sizes of the steps. For use with the popular one-, two-, three- and four-down/one-up rules, these ratios must respectively be set at 0.2845, 0.5488, 0.7393 and 0.8415, rendering staircases that converge on the 77.85%-, 80.35%-, 83.15%- and 85.84%-correct points. Wetherill and Levitt's transformed up/down rules—which require Δ − /Δ + =1—and the general version of Kaernbach's weighted up/down rule—which allows any Δ − /Δ + ratio—fail to reach their presumed targets. The small-sample study showed that, even with the optimal settings, short FSS staircases (up to 20 reversals in length) are subject to some bias, and their precision is less than reasonable, but their characteristics improve when the size Δ + of a step up is larger than half the spread of the psychometric function. Practical recommendations are given for the design of efficient and trustworthy FSS staircases.",0 +https://doi.org/10.1016/s0047-259x(03)00096-4,A well-conditioned estimator for large-dimensional covariance matrices,"Many applied problems require a covariance matrix estimator that is not only invertible, but also well-conditioned (that is, inverting it does not amplify estimation error). For large-dimensional covariance matrices, the usual estimator—the sample covariance matrix—is typically not well-conditioned and may not even be invertible. This paper introduces an estimator that is both well-conditioned and more accurate than the sample covariance matrix asymptotically. This estimator is distribution-free and has a simple explicit formula that is easy to compute and interpret. It is the asymptotically optimal convex linear combination of the sample covariance matrix with the identity matrix. Optimality is meant with respect to a quadratic loss function, asymptotically as the number of observations and the number of variables go to infinity together. Extensive Monte Carlo confirm that the asymptotic results tend to hold well in finite sample.",0 +https://doi.org/10.1007/s10651-012-0209-0,Space-time stick-breaking processes for small area disease cluster estimation,"We propose a space-time stick-breaking process for the disease cluster estimation. The dependencies for spatial and temporal effects are introduced by using space-time covariate dependent kernel stick-breaking processes. We compared this model with the space-time standard random effect model by checking each model’s ability in terms of cluster detection of various shapes and sizes. This comparison was made for simulated data where the true risks were known. For the simulated data, we have observed that space-time stick-breaking process performs better in detecting medium- and high-risk clusters. For the real data, county specific low birth weight incidences for the state of South Carolina for the years 1997–2007, we have illustrated how the proposed model can be used to find grouping of counties of higher incidence rate.",0 +https://doi.org/10.1037/1082-989x.11.2.142,Conceptualizing and testing random indirect effects and moderated mediation in multilevel models: New procedures and recommendations.,"The authors propose new procedures for evaluating direct, indirect, and total effects in multilevel models when all relevant variables are measured at Level 1 and all effects are random. Formulas are provided for the mean and variance of the indirect and total effects and for the sampling variances of the average indirect and total effects. Simulations show that the estimates are unbiased under most conditions. Confidence intervals based on a normal approximation or a simulated sampling distribution perform well when the random effects are normally distributed but less so when they are nonnormally distributed. These methods are further developed to address hypotheses of moderated mediation in the multilevel context. An example demonstrates the feasibility and usefulness of the proposed methods.",0 +https://doi.org/10.1007/978-1-4614-1800-9_17,Bayesian Statistics,"Article Outline: Glossary Definition of the Subject and Introduction The Bayesian Statistical Paradigm Three Examples Comparison with the Frequentist Statistical Paradigm Future Directions Bibliography © 2012 Springer Science+Business Media, LLC. All rights reserved.",0 +https://doi.org/10.1198/1085711032697,Nonlinear models for repeated measurement data: An overview and update,"Nonlinear mixed effects models for data in the form of continuous, repeated measurements on each of a number of individuals, also known as hierarchical nonlinear models, are a popular platform for analysis when interest focuses on individual-specific characteristics. This framework first enjoyed widespread attention within the statistical research community in the late 1980s, and the 1990s saw vigorous development of new methodological and computational techniques for these models, the emergence of general-purpose software, and broad application of the models in numerous substantive fields. This article presents an overview of the formulation, interpretation, and implementation of nonlinear mixed effects models and surveys recent advances and applications. © 2003 American Statistical Association and the International Biometric Society.",0 +https://doi.org/10.1111/j.1475-6811.2010.01274.x,The measurement of reliability of social relations components from round-robin designs,"The social relations model (SRM) is a useful tool for measuring relationship effects, defined as the unique perceptions or behaviors of 2 people. The sources of variance in SRM studies are persons (actors and partners), groups, and items; the relationship effect is defined as the actor–partner interaction. By removing variance because of persons and groups, a measure of a “pure” relationship effect is obtained. In this article, generalizability theory (G Theory) is applied to estimate the reliability of SRM components from round-robin data structures. Using G Theory, reliability formulas for actor, partner, group, and relationship are developed and interpretations for the reliability estimates are provided. The authors also discuss how these formulas can be used in both planning and interpreting results from relationship research.",0 +https://doi.org/10.2202/1558-3708.1609,Discovering Hidden Structures Using Mixture Models: Application to Nonlinear Time Series Processes,"This paper discuses the application of mixture models for analyzing data with hidden structure. More specifically, we are interested in situations where the structure is due to some unobserved factors. Detecting the latent structures in data is not trivial. On the other hand, since such structures could obscure the effect of the observed variables, ignoring them (e.g., using simple linear models) could result in wrong inference. To address this issue, we propose to use Dirichlet process mixtures. In this approach, the mixture identifier (i.e., the latent variable that assigns each component to a data point) acts as a surrogate for possible missing factors and provides insight into possible hidden structure in the data. An illustrative example is provided to show the usefulness of this approach. We also discuss the application of our method for analyzing time series processes that are subject to regime changes where there is no specific economic theory about the structure of the model.",0 +https://doi.org/10.1080/00273170701710205,Quasi-Maximum Likelihood Estimation of Structural Equation Models With Multiple Interaction and Quadratic Effects,"In this article, a nonlinear structural equation model is introduced and a quasi-maximum likelihood method for simultaneous estimation and testing of multiple nonlinear effects is developed. The fo...",0 +https://doi.org/10.1016/j.nicl.2018.01.027,An fMRI investigation of empathic processing in boys with conduct problems and varying levels of callous-unemotional traits,"The ability to empathise relies in part on using one's own affective experience to simulate the affective experience of others. This process is supported by a number of brain areas including the anterior insula (AI), anterior cingulate cortex (ACC), medial prefrontal cortex (mPFC), and the amygdala. Children with conduct problems (CP), and in particular those with high levels of callous-unemotional traits (CP/HCU) present with less empathy than their peers. They also show reduced neural response in areas supporting empathic processing when viewing other people in distress. The current study focused on identifying brain areas co-activated during affective introspection of: i) One's own emotions ('Own emotion'); ii) Others' emotions ('Other emotion'); and iii) One's feelings about others' emotions ('Feel for other') during fearful vs neutral scenarios in typically developing boys (TD; n = 31), boys with CP/HCU (n = 31), and boys with CP and low levels of CU (CP/LCU; n = 33). The conjunction analysis across conditions within the TD group revealed significant clusters of activation in the AI, ACC/mPFC, and occipital cortex. Conjunction analyses across conditions in the CP/HCU and CP/LCU groups did not identify these areas as significantly activated. However, follow-up analyses were not able to confirm statistically significant differences between groups across the whole network, and Bayes-factor analyses did not provide substantial support for either the null or alternate hypotheses. Post-hoc comparisons indicated that the lack of conjunction effects in the CP/HCU group may reflect reduced affective introspection in the 'Other emotion' and 'Feel for other' conditions, and by reduced affective introspection in the 'Own emotion' condition in the CP/LCU group. These findings provide limited and ultimately equivocal evidence for altered affective introspection regarding others in CP/HCU, and altered affective introspection for own emotions in CP/LCU, and highlight the need for further research to systematically investigate the precise nature of empathy deficits in children with CP.",0 +https://doi.org/10.1002/sim.2671,Random changepoint modelling of HIV immunologic responses,"We propose a changepoint model for the analysis of longitudinal CD4 T-cell counts for HIV infected subjects following highly active antiretroviral treatment. The profile of CD4 counts for each subject follows a simple, 'broken stick' changepoint model, with random subject-specific parameters, including the changepoint. The model accounts for baseline covariates. The longitudinal CD4 records are censored at the time of the subject going off-study-treatment. This is a potentially informative drop-out mechanism, which we address by modelling it jointly with the CD4 count outcome. The drop-out model incorporates terms from the CD4 model, including the changepoint. The estimation is done in a Bayesian framework, with implementation via Markov chain Monte Carlo methods in the WinBUGS software. Model selection using DIC indicates that the data support the complex random changepoint and informative censoring model.",0 +,SIMULATING RATIOS OF NORMALIZING CONSTANTS VIA A SIMPLE IDENTITY: A THEORETICAL EXPLORATION,"Let pi(w) ,i =1 , 2, be two densities with common support where each density is known up to a normalizing constant: pi(w )= qi(w)/ci .W e have draws from each density (e.g., via Markov chain Monte Carlo), and we want to use these draws to simulate the ratio of the normalizing constants, c1/c2. Such a compu- tational problem is often encountered in likelihood and Bayesian inference, and arises in fields such as physics and genetics. Many methods proposed in statistical and other literature (e.g., computational physics) for dealing with this problem are based on various special cases of the following simple identity: c1 c2 = E2(q1(w)α(w)) E1(q2(w)α(w)) . Here Ei denotes the expectation with respect to pi (i =1 , 2), and α is an arbitrary function such that the denominator is non-zero. A main purpose of this paper is to provide a theoretical study of the usefulness of this identity, with focus on (asymptotically) optimal and practical choices of α. Using a simple but informa- tive example, we demonstrate that with sensible (not necessarily optimal) choices of α, we can reduce the simulation error by orders of magnitude when compared to the conventional importance sampling method, which corresponds to α =1 /q2. We also introduce several generalizations of this identity for handling more compli- cated settings (e.g., estimating several ratios simultaneously) and pose several open problems that appear to have practical as well as theoretical value. Furthermore, we discuss related theoretical and empirical work.",0 +https://doi.org/10.1093/pan/mpi030,Applying a Two-Step Strategy to the Analysis of Cross-National Public Opinion Data,"In recent years, large sets of national surveys with shared content have increasingly been used for cross-national opinion research. But scholars have not yet settled on the most flexible and efficient models for utilizing such data. We present a two-step strategy for such analysis that takes advantage of the fact that in such datasets each “cluster” (i.e., country sample) is large enough to sustain separate analysis of its internal variances and covariances. We illustrate the method by examining a puzzle of comparative electoral behavior—why does turnout decline rather than increase with the number of parties competing in an election (Blais and Dobryzynska 1998, for example)? This discussion demonstrates the ease with which a two-step strategy incorporates confounding variables operating at different levels of analysis. Technical appendices demonstrate that the two-step strategy does not lose efficiency of estimation as compared with a pooling strategy.",0 +https://doi.org/10.1080/10705511.2010.489006,Residual Structures in Latent Growth Curve Modeling,"Several alternatives are available for specifying the residual structure in latent growth curve modeling. Two specifications involve uncorrelated residuals and represent the most commonly used residual structures. The first, building on repeated measures analysis of variance and common specifications in multilevel models, forces residual variances to be invariant across measurement occasions. The second, generally arising from structural equation modeling perspectives, allows residual variances to be freely estimated across occasions. Usually an afterthought, alternate specifications of the residual structure can have sizable effects on variance and covariance estimates for the intercept and slope factors (Ferron, Dailey, & Yi, 2002; Kwok, West, & Green, 2007; Sivo, Fan, & Witta, 2005), the fit of the model, and model convergence. We propose additional residual structures in latent growth modeling arising from ideas regarding growth curve reliability. These structures allow residual variances to change ac...",0 +https://doi.org/10.1007/s10461-013-0620-z,Assessing Appearance-Related Disturbances in HIV-Infected Men Who have Sex with Men (MSM): Psychometrics of the Body Change and Distress Questionnaire—Short Form (ABCD-SF),"Appearance-related disturbances are common among HIV-infected MSM; however, to date, there have been limited options in the valid assessment of this construct. The aim of the current study was to assess the structural, internal, and convergent validity of the assessment of body change distress questionnaire (ABCD) and its short version. Exploratory and confirmatory factor analyses indicated that both versions fit the data well. Four subfactors were revealed measuring the following body disturbance constructs: (1) negative affect about appearance, (2) HIV health-related outcomes and stigma, (3) eating and exercise confusion, and (4) ART non-adherence. The subfactors and total scores revealed bivariate associations with salient health outcomes, including depressive symptoms, HIV sexual transmission risk behaviors, and ART non-adherence. The ABCD and its short form, offer valid means to assess varied aspects of body image disturbance among HIV-infected MSM, and require modest participant burden.",0 +https://doi.org/10.1207/s15324818ame1603_4,The Use of Multilevel Item Response Theory Modeling in Applied Research: An Illustration,"Embedding item response theory (IRT) models within a multilevel modeling framework has been shown by many authors to allow better estimation of the relationships between predictor variables and IRT latent traits (Adams, Wilson, & Wu,1997). A multilevel IRT model recently proposed by Kamata (1998, 2001) yields the additional benefit of being able to accommodate data that are collected in hierarchical settings. This expansion of multilevel IRT models to three levels allows not only the dependency typically found in hierarchical data to be accommodated, but also the estimation of (a) latent traits at different levels and (b) the relationships between predictor variables and latent traits at different levels. The purpose of this article is to provide both a description and application of Kamata's 3-level IRT model. The advantages and disadvantages of using multilevel IRT models in applied research are discussed and directions for future research are given.",0 +https://doi.org/10.1080/1369183x.2014.996534,Political Competition and Attitudes towards Immigration in Africa,"This paper examines the political conditions under which individuals are more likely to oppose immigration. We focus on immigration attitudes in Africa, which has been overlooked in existing literature and where there is wide variation on political factors. Drawing on existing case study literature that links exclusionary politics in that region to on-going processes of political liberalisation, we hypothesise that political competition heightens opposition to immigration by raising the salience of the issue and legitimising hostile attitudes. Using multilevel mixed-effect ordered logistic regression analysis with survey data from African countries, we find that opposition to immigration is significantly higher among individuals in countries that are more democratic, that have dominant party systems, and when the survey is conducted shortly before or after a national election. Our analysis also shows that opposition to immigration is more likely in African countries with higher levels of ethnic diversity ...",0 +https://doi.org/10.1080/00949659308811554,Generalized linear mixed models a pseudo-likelihood approach,"A useful extension of the generalized linear model involves the addition of random effects andlor correlated errors. A pseudo-likelihood estimation procedure is developed to fit this class of mixed models based on an approximate marginal model for the mean response. The procedure is implemented via iterated fitting of a weighted Gaussian linear mixed model to a modified dependent variable. The approach allows for flexible specification of covariance structures for both the random effects and the correlated errors. An estimate of an additional dispersion parameter for underlying exponential family distributions is optionally automatic. The method allows for subject-specific and population-averaged inference, and the Salamander data example from McCullagh and Nelder (1989) is used to illustrate both.",0 +https://doi.org/10.1086/209506,Consumer Preference for a No‐Choice Option,"The traditional focus in the decision-making literature has been on understanding how consumers choose among a given set of alternatives. The notion that preference uncertainty may lead to choice deferral when no single alternative has a decisive advantage is tested in seven studies. Building on recent research, the article shows that the decision to defer choice is influenced by the absolute difference in attractiveness among the alternatives provided and is not consistent with trade-off difficulty or the theory of search. These findings are then extended to show that choice deferral can also be modified for the same alternatives by manipulations that make them appear more similar in attractiveness, or that decrease the need to differentiate among them. The results are consistent with the notion that preference uncertainty results in a hesitation to commit to any single action since small differences in attractiveness among the alternatives are potentially reversible. Consistent with this premise, the effect of attractiveness difference on choice deferral decreased significantly when subjects were first allowed to practice making monetary trade-offs among the available alternatives.",0 +https://doi.org/10.1037/1082-989x.13.1.1,Cluster randomized trials with treatment noncompliance.,"Cluster randomized trials (CRTs) have been widely used in field experiments treating a cluster of individuals as the unit of randomization. This study focused particularly on situations where CRTs are accompanied by a common complication, namely, treatment noncompliance or, more generally, intervention nonadherence. In CRTs, compliance may be related not only to individual characteristics but also to the environment of clusters individuals belong to. Therefore, analyses ignoring the connection between compliance and clustering may not provide valid results. Although randomized field experiments often suffer from both noncompliance and clustering of the data, these features have been studied as separate rather than concurrent problems. On the basis of Monte Carlo simulations, this study demonstrated how clustering and noncompliance may affect statistical inferences and how these two complications can be accounted for simultaneously. In particular, the effect of the intervention on individuals who not only were assigned to active intervention but also abided by this intervention assignment (complier average causal effect) was the focus. For estimation of intervention effects considering noncompliance and data clustering, an ML-EM estimation method was employed.",0 +https://doi.org/10.1016/j.obhdp.2005.09.002,"Relationships between leader reward and punishment behavior and subordinate attitudes, perceptions, and behaviors: A meta-analytic review of existing and new research","Despite decades of research on the relationships between leader reward and punishment behaviors and employee attitudes, perceptions, and performance, no comprehensive examination of these relationships has been reported in the literature. This paper reports the results of two studies that address this issue. In the Wrst study, data from 20 new samples were gathered on the relationships between leader reward and punishment behaviors and some criterion variables that have not been examined extensively in previous research. In the second study, a meta-analytic review was conducted incorporating both the new and existing research in order to provide estimates of the bivariate relationships between these leader behaviors and a variety of employee criterion variables across 78 studies containing 118 independent samples. Results of regression analyses designed to control for the eVects of the other leader behaviors showed that: (a) the relationships between leader reward and punishment behaviors and employee attitudes, perceptions, and behaviors were more functional when the rewards or punishments were administered contingently than when they were administered non-contingently, and (b) these leader reward and punishment behaviors were strongly related to two variables (employees’ perceptions of justice and role ambiguity) that were expected to be key mediators of the relationships between these leader behaviors and the employee criterion variables. In addition, meta-analytic evidence from longitudinal studies suggested that the same leader behavior can be a cause of some employee criterion variables, and a consequence of others. Implications of these Wndings for future research in the area are discussed.",0 +https://doi.org/10.3389/fpsyg.2014.00078,"Analyzing indirect effects in cluster randomized trials. The effect of estimation method, number of groups and group sizes on accuracy and power","Cluster randomized trials assess the effect of an intervention that is carried out at the group or cluster level. Ajzen's theory of planned behavior is often used to model the effect of the intervention as an indirect effect mediated in turn by attitude, norms and behavioral intention. Structural equation modeling (SEM) is the technique of choice to estimate indirect effects and their significance. However, this is a large sample technique, and its application in a cluster randomized trial assumes a relatively large number of clusters. In practice, the number of clusters in these studies tends to be relatively small, e.g., much less than fifty. This study uses simulation methods to find the lowest number of clusters needed when multilevel SEM is used to estimate the indirect effect. Maximum likelihood estimation is compared to Bayesian analysis, with the central quality criteria being accuracy of the point estimate and the confidence interval. We also investigate the power of the test for the indirect effect. We conclude that Bayes estimation works well with much smaller cluster level sample sizes such as 20 cases than maximum likelihood estimation; although the bias is larger the coverage is much better. When only 5-10 clusters are available per treatment condition even with Bayesian estimation problems occur.",1 +https://doi.org/10.3758/s13428-014-0469-8,Validity and reliability of an online visual–spatial working memory task for self-reliant administration in school-aged children,"Working memory is an important predictor of academic performance, and of math performance in particular. Most working memory tasks depend on one-to-one administration by a testing assistant, which makes the use of such tasks in large-scale studies time-consuming and costly. Therefore, an online, self-reliant visual-spatial working memory task (the Lion game) was developed for primary school children (6-12 years of age). In two studies, the validity and reliability of the Lion game were investigated. The results from Study 1 (n = 442) indicated satisfactory six-week test-retest reliability, excellent internal consistency, and good concurrent and predictive validity. The results from Study 2 (n = 5,059) confirmed the results on the internal consistency and predictive validity of the Lion game. In addition, multilevel analysis revealed that classroom membership influenced Lion game scores. We concluded that the Lion game is a valid and reliable instrument for the online computerized and self-reliant measurement of visual-spatial working memory (i.e., updating).",0 +https://doi.org/10.1016/j.rssm.2015.09.005,"What makes education positional? Institutions, overeducation and the competition for jobs","We compare three theoretical models for the relationship between schooling and labor market outcomes. On the one hand, the job competition model, which views education as a positional good with relative value on the labor market; on the other hand, the human capital and the social closure models, which view the value of education as absolute but differ in their expectations about returns to years of education above what required for the job. We analyze European countries using data from the European Social Survey (2010), and investigate the incidence of overeducation and the returns to years of overeducation in order to distinguish between the three theoretical models. We then relate these theoretical perspectives to institutions of the education system and of labor market coordination. Our empirical results indicate that education is more likely to function as a positional good in countries with weakly developed vocational education systems, where individuals have an incentive to acquire higher levels of education in order to stay ahead of the labor queue. However, no convincing support was found for the relationship we hypothesized between wage coordination and returns to years of overeducation.",0 +https://doi.org/10.3758/bf03200763,Analyzing the dynamics of free recall: An integrative review of the empirical literature,"Relatively few experiments have measured the time course of free recall from episodic or semantic memory. Of those that have, most report that cumulative recall is a negatively accelerated exponential (or hyperbolic) function that is characterized by two properties: asymptotic recall and rate of approach to asymptote. The most common measure of free recall performance (viz., the number of items recalled) provides a reasonably good estimate of asymptotic recall if a relatively long recall period is used (which is rare), but the effect of experimental manipulations on the rate of approach to asymptote cannot be determined without timing when recall responses occur. The research reviewed herein suggests that the rate of approach to asymptote may offer an estimate of the breadth of search through long-term memory. The search in question, unlike most of those investigated in the memory literature, is unique in that it requires minutes rather than milliseconds to complete.",0 +https://doi.org/10.2980/20-3-3599,Topographic influences on the distribution of white pine blister rust inPinus albicaulistreeline communities,"The exotic disease white pine blister rust (caused by Cronartium ribicola) damages and kills whitebark pine (Pinus albicaulis), even in the extreme environments of alpine treeline communities. We surveyed P. albicaulis trees and tree islands for blister rust in 2 distinct alpine treeline communities in Montana, USA, and examined meso- and microtopographic factors potentially related to the climatic requirements for blister rust infection. For each of 60 sampling plots, we created high-resolution digital elevation models, derived microtopography variables, and compared these and distance to water feature variables with blister rust occurrence and intensity (number of cankers per infected tree) for every sampled P. albicaulis tree. Infection rates were 19% (of 328 sampled trees) and 24% (of 585 sampled trees) at the 2 sites. Tree island P. albicaulis had higher infection percentages than solitary trees. Using Bayesian analysis and a zero-inflated Poisson regression model, we determined that solar radiation and moisture-related variables correlated with both presence and number of blister rust cankers on P. albicaulis. Site factors that influence moisture, such as local topography, hydrology, and climate, differed between the 2 treeline study areas, which may account for the model variability.",0 +https://doi.org/10.1037/0021-9010.91.1.25,Examining assumptions about item responding in personality assessment: Should ideal point methods be considered for scale development and scoring?,"The present study investigated whether the assumptions of an ideal point response process, similar in spirit to Thurstone's work in the context of attitude measurement, can provide viable alternatives to the traditionally used dominance assumptions for personality item calibration and scoring. Item response theory methods were used to compare the fit of 2 ideal point and 2 dominance models with data from the 5th edition of the Sixteen Personality Factor Questionnaire (S. Conn & M. L. Rieke, 1994). The authors' results indicate that ideal point models can provide as good or better fit to personality items than do dominance models because they can fit monotonically increasing item response functions but do not require this property. Several implications of these findings for personality measurement and personnel selection are described.",0 +https://doi.org/10.1146/annurev.fluid.010908.165248,Uncertainty Quantification and Polynomial Chaos Techniques in Computational Fluid Dynamics,"The quantification of uncertainty in computational fluid dynamics (CFD) predictions is both a significant challenge and an important goal. Probabilistic uncertainty quantification (UQ) methods have been used to propagate uncertainty from model inputs to outputs when input uncertainties are large and have been characterized probabilistically. Polynomial chaos (PC) methods have found increased use in probabilistic UQ over the past decade. This review describes the use of PC expansions for the representation of random variables/fields and discusses their utility for the propagation of uncertainty in computational models, focusing on CFD models. Many CFD applications are considered, including flow in porous media, incompressible and compressible flows, and thermofluid and reacting flows. The review examines each application area, focusing on the demonstrated use of PC UQ and the associated challenges. Cross-cutting challenges with time unsteadiness and long time horizons are also discussed.",0 +,Measuring the Threshold of Audibility of Temporal Decays,"A listening test system designed to measure the threshold of audibility of the decay time of low frequency resonances is described. The system employs the Parameter Estimation by Sequential Testing (PEST) technique and the listening test is conducted on calibrated headphones to remove factors associated with the listening environment. Program signal, replay level, and resonance frequency are believed to influence decay time threshold. A trial listening test shows that the system reveals realistic results but the temporal resonance modeling filter requires some adjustment to remove audible non-modal cues. Transducer limitations still affect the test at low frequencies and high replay levels. Factors for future large-scale listening tests are refined. Early indications are that temporal decay thresholds rise with reduced frequency and SPL.",0 +https://doi.org/10.1007/s00180-007-0100-x,Computation of reference Bayesian inference for variance components in longitudinal studies,"Generalized linear mixed models (GLMMs) have been applied widely in the analysis of longitudinal data. This model confers two important advantages, namely, the flexibility to include random effects and the ability to make inference about complex covariances. In practice, however, the inference of variance components can be a difficult task due to the complexity of the model itself and the dimensionality of the covariance matrix of random effects. Here we first discuss for GLMMs the relation between Bayesian posterior estimates and penalized quasi-likelihood (PQL) estimates, based on the generalization of Harville's result for general linear models. Next, we perform fully Bayesian analyses for the random covariance matrix using three different reference priors, two with Jeffreys' priors derived from approximate likelihoods and one with the approximate uniform shrinkage prior. Computations are carried out via the combination of asymptotic approximations and Markov chain Monte Carlo methods. Under the criterion of the squared Euclidean norm, we compare the performances of Bayesian estimates of variance components with that of PQL estimates when the responses are non-normal, and with that of the restricted maximum likelihood (REML) estimates when data are assumed normal. Three applications and simulations of binary, normal, and count responses with multiple random effects and of small sample sizes are illustrated. The analyses examine the differences in estimation performance when the covariance structure is complex, and demonstrate the equivalence between PQL and the posterior modes when the former can be derived. The results also show that the Bayesian approach, particularly under the approximate Jeffreys' priors, outperforms other procedures. © 2008 Springer-Verlag.",1 +https://doi.org/10.1037/a0024756,Changing emotion dynamics: Individual differences in the effect of anticipatory social stress on emotional inertia.,"Emotional inertia-the degree to which people's feelings carry over from one moment to the next-is an important property of the temporal dynamics of emotions. Thus far, emotional inertia has only been examined as a stable, trait-like characteristic. However, internal or external events (e.g., stress) may trigger changes in people's emotion dynamics, particularly among individuals with heightened sensitivity to such events. The current study investigated how emotional inertia is influenced by the anticipation of social stress, and how this effect is moderated by individual differences in depression, self-esteem, and fear of negative evaluation. We measured participants' (n = 71) emotional inertia in daily life using experience sampling before and after experimentally manipulating anticipatory social stress. Consistent with previous research, psychological maladjustment was associated with higher emotional inertia during ""normal"" daily life. However, when anticipating a socially stressful event, levels of emotional inertia dropped, particularly among participants scoring high on depression and fear of negative evaluation and low on self-esteem. These results demonstrate that emotion dynamics can vary as a function of contextual factors and identify moderators of such variation.",0 +https://doi.org/10.1177/014662169101500307,A Comparison of Two Area Measures for Detecting Differential Item Functioning,"The area between two item response functions is often used as a measure of differential item functioning under item response theory. This area can be measured over either an open interval (i.e., exact) or closed interval. Formulas are presented for com puting the closed-interval signed and unsigned areas. Exact and closed-interval measures were estimated on data from a test with embedded items intentionally constructed to favor one group over another. No real differences in detection of these items were found between exact and closed-interval methods.",0 +https://doi.org/10.1016/j.intmar.2010.04.003,Context-general and Context-specific Determinants of Online Satisfaction and Loyalty for Commerce and Content Sites,"We use the context-general and context-specific factor approach to examine the generalizability of satisfaction and loyalty models across two disparate online contexts—online retailing and content site browsing. Our conceptual models include the moderating effects of user-characteristic Web expertise, besides main effects of Web site factors and Web expertise. Results indicate that satisfaction and loyalty judgments are sensitive to both context-general and context-specific determinants, as well as to some interactions between them. Among context-general determinants, ease of use and customer service are positively related to satisfaction, Web community to loyalty, and Web expertise to both satisfaction and loyalty. Flow, a context-specific determinant, has a significant positive effect on satisfaction alone; security affects loyalty alone; and fulfillment/reliability and information quality are significant predictors of both satisfaction and loyalty. The results show that Web expertise moderates the effect of ease of use on satisfaction. The study contributes to marketing theory and practice by identifying satisfaction and loyalty mechanisms that are potentially generalizable across the two online contexts and providing a guiding framework for simultaneous consideration of context-specific and context-general factors in future research.",0 +https://doi.org/10.1016/j.drugalcdep.2014.07.032,Familiality of addiction and its developmental mechanisms in girls,"Drug use disorders (DUD) have been theorized to share sources of risk variation with other consummatory behaviors. We hypothesized that common mechanisms exist for familial risk for DUD, physiological maturation and nutritional status in girls. Whereas body fat content must exceed a threshold to enable adrenarche and gonadarche, nutritional status may also be a behavior risk indicator. Impaired psychological self-regulation associated with DUD risk may manifest in early overeating, which could in turn accelerate reproductive maturation, resulting in a greater likelihood of affiliation with deviant/older peers and drug use.The sample consisted of families ascertained through the father who either had (N=95) or did not have (N=130) a DUD, and who had a 10-12 year old daughter and her mother available for study. Correlation, survival and path analyses of three consecutive assessments evaluated the relationships between parental DUD (number of affected parents, NAP), nutritional status (NS, subscapular skinfold measurements and body mass index), sexual maturation (Tanner stage), peer delinquency, and the daughter's lifetime DUD diagnosis.NAP was positively related to the girls' nutritional status. Longitudinal path analysis indicated mediation of the relationship between NAP and peer delinquency by sexual maturation. The relationship between NAP and sexual maturation is mediated by NS. The effect of sexual maturation at age ∼11 on the girls' DUD risk is mediated by peer delinquency.The data are consistent with mediation of intergenerational transmission of DUD risk in females by elevated nutrition, leading to accelerated maturation, and affiliation with deviant peers.",0 +,"Interpreting Biomedical Science: Experiment, Evidence, and Belief","Interpreting Biomedical Science: Experiment, Evidence, and Belief discusses what can go wrong in biological science, providing an unbiased view and cohesive understanding of scientific methods, statistics, data interpretation, and scientific ethics that are illustrated with practical examples and real-life applications. Casting a wide net, the reader is exposed to scientific problems and solutions through informed perspectives from history, philosophy, sociology, and the social psychology of science. The book shows the differences and similarities between disciplines and different eras and illustrates the concept that while sound methodology is necessary for the progress of science, we cannot succeed without a right culture of doing things.Features theoretical concepts accompanied by examples from biological literatureContains an introduction to various methods, with an emphasis on statistical hypothesis testingPresents a clear argument that ties the motivations and ethics of individual scientists to the success of their scienceProvides recommendations on how to safeguard against scientific misconduct, fraud, and retractionsArms young scientists with practical knowledge that they can use every day",0 +https://doi.org/10.1037/a0033820,Robust mediation analysis based on median regression.,"Mediation analysis has many applications in psychology and the social sciences. The most prevalent methods typically assume that the error distribution is normal and homoscedastic. However, this assumption may rarely be met in practice, which can affect the validity of the mediation analysis. To address this problem, we propose robust mediation analysis based on median regression. Our approach is robust to various departures from the assumption of homoscedasticity and normality, including heavy-tailed, skewed, contaminated, and heteroscedastic distributions. Simulation studies show that under these circumstances, the proposed method is more efficient and powerful than standard mediation analysis. We further extend the proposed robust method to multilevel mediation analysis, and demonstrate through simulation studies that the new approach outperforms the standard multilevel mediation analysis. We illustrate the proposed method using data from a program designed to increase reemployment and enhance mental health of job seekers.",0 +https://doi.org/10.1080/00273171.2014.950719,Handling Missing Covariates in Conditional Mixture Models Under Missing at Random Assumptions,"Mixture modeling is a popular method that accounts for unobserved population heterogeneity using multiple latent classes that differ in response patterns. Psychologists use conditional mixture models to incorporate covariates into between-class and/or within-class regressions. Although psychologists often have missing covariate data, conditional mixtures are currently fit with a conditional likelihood, treating covariates as fixed and fully observed. Under this exogenous-x approach, missing covariates are handled primarily via listwise deletion. This sacrifices efficiency and does not allow missingness to depend on observed outcomes. Here we describe a modified joint likelihood approach that (a) allows inference about parameters of the exogenous-x conditional mixture even with nonnormal covariates, unlike a conventional multivariate mixture; (b) retains all cases under missing at random assumptions; (c) yields lower bias and higher efficiency than the exogenous-x approach under a variety of conditions with missing covariates; and (d) is straightforward to implement in available commercial software. The proposed approach is illustrated with an empirical analysis predicting membership in latent classes of conduct problems. Recommendations for practice are discussed.",0 +https://doi.org/10.1080/10705511.2014.936340,"Growth Mixture Models Outperform Simpler Clustering Algorithms When Detecting Longitudinal Heterogeneity, Even With Small Sample Sizes","Identifying subpopulations based on longitudinal trajectories can provide new avenues to answer theoretically interesting research questions. Although many techniques to accomplish this task exist, a common method used in psychology is the growth mixture model. Recent simulations have found that this analytic method shows a decline in performance for smaller sample sizes commonly found in psychological research (Kim, 2012; Peugh & Fan, 2012). This raises this question: Are there better methods available for smaller sample sizes? Monte Carlo simulations were used to explicitly compare growth mixture models with other clustering methods, ranging on a spectrum from not informed to very informed, across different simulation conditions. To compare results both between and within analytic method, Kullback–Leibler divergence is introduced as a measure of cluster solution misfit. Results show that despite this decreased performance for smaller sample sizes, growth mixture models still outperform simpler, more gen...",0 +https://doi.org/10.1016/j.jmva.2005.06.001,Bayesian modeling of several covariance matrices and some results on propriety of the posterior for linear regression with correlated and/or heterogeneous errors,"We explore simultaneous modeling of several covariance matrices across groups using the spectral (eigenvalue) decomposition and modified Cholesky decomposition. We introduce several models for covariance matrices under different assumptions about the mean structure. We consider ‘dependence’ matrices, which tend to have many parameters, as constant across groups and/or parsimoniously modeled via a regression formulation. For ‘variances’, we consider both unrestricted across groups and more parsimoniously modeled via log-linear models. In all these models, we explore the propriety of the posterior when improper priors are used on the mean and ‘variance’ parameters (and in some cases, on components of the ‘dependence’ matrices). The models examined include several common Bayesian regression models, whose propriety has not been previously explored, as special cases. We propose a simple approach to weaken the assumption of constant dependence matrices in an automated fashion and describe how to compute Bayes factors to test the hypothesis of constant ‘dependence’ across groups. The models are applied to data from two longitudinal clinical studies.",0 +https://doi.org/10.1007/bf00170144,Multilevel analysis of the changing relationship between class and party in Britain 1964?1992,"Previous analyses of the changing relationship between class and vote in Britain have assumed that the British Election Surveys constitute simple random samples. In fact, they are all clustered samples, and the number of sampling points has varied substantially over time. The paper uses the statistical technique of multi-level modelling to investigate the effects of this clustering and compares the results with those obtained with single-level logistic models. In general, the multilevel and single-level models lead to similar conclusions about the changing relation between class and vote; they both show evidence of a change in the class/vote relationship over time. However, the multilevel models also show that, while the clustering does not affect conclusions about the class dealignment debate, there are other important substantive findings which emerge from the multilevel approach. First, there is clear evidence of substantial constituency differences in the intercepts; that is, individuals had very different propensities to vote Conservative in different constituencies. Second, there were also significant constituency differences in class voting, that is, constituencies seemed to vary in their level of class polarization.",0 +https://doi.org/10.1002/(sici)1097-0258(20000415)19:7<975::aid-sim381>3.0.co;2-9,A robust mixed linear model analysis for longitudinal data,"This paper describes robust procedures for estimating parameters of a mixed effects linear model as applied to longitudinal data. In addition to fixed regression parameters, the model incorporates random subject effects to accommodate between-subjects variability and autocorrelation for within-subject variability. Robust empirical Bayesian estimation of subject effects is briefly discussed. As an illustration, the procedures are applied to data from a multiple sclerosis clinical trial.",0 +,Bayesian Analysis for Penalized Spline Regression Using Win BUGS,"Penalized splines can be viewed as BLUPs in a mixed model framework, which allows the use of mixed model software for smoothing. Thus, software originally developed for Bayesian analysis of mixed models can be used for penalized spline regression. Bayesian inference for nonparametric models enjoys the flexibility of nonparametric models and the exact inference provided by the Bayesian inferential machinery. This paper provides a simple, yet comprehensive, set of programs for the implementation of nonparametric Bayesian analysis in WinBUGS.",0 +https://doi.org/10.1080/0013791x.2013.859336,Empirical Tests of Stochastic Dominance in Capital Investment Planning: A Spreadsheet Framework,"The empirical inadequacy of direct application of stochastic dominance rules and their variants has led to the development of statistical tests for making dominance inferences. Yet very little is known about their application in capital investment planning, and the algorithms for their implementation are not readily available to the analyst who uses spreadsheets for capital investment planning. Therefore, this article develops a spreadsheet framework for conducting empirical tests of stochastic dominance when comparing alternative capital investment plans under uncertainty. It uses bootstrap and simulation methodology to compute the p-values required for making first- and second-order dominance inferences. Results from numerical examples show that empirical tests yield robust inferences when the structure of risk profiles and their integrals is such that dominance inferences by visual inspection are difficult. Therefore, analysts should model and empirically test for these relationships if they want to ma...",0 +https://doi.org/10.1159/000313852,Localizing Putative Markers in Genetic Association Studies by Incorporating Linkage Disequilibrium into Bayesian Hierarchical Models,"Numerous methods have been proposed to model the association between multiple single nucleotide polymorphisms (SNPs) and a phenotype. Often these methods do not explicitly model the information regarding the linkage disequilibrium (LD) between SNPs. Furthermore, many methods shrink the SNP effects towards zero, rather than to an unknown latent gene-level effect.We outline the use of bayesian hierarchical models for gene-level analysis that incorporates LD information. Four different bayesian models, with either the inclusion or exclusion of LD information and 'shrinkage' of SNP effects to a latent gene-level effect or zero, were applied to a pharmacogenomic study and simulation STUDY.We observed that the inclusion of LD information resulted in increased precision in the SNP parameter estimates. The simulation study also demonstrated that the bayesian models were able to determine the simulated 'causative' variant more often with less false-positive associations as compared to commonly used multi-SNP analysis methods.Incorporating LD information in the analysis of multiple SNPs results in more precise estimates of SNP effects. In addition, the bayesian models are able to isolate the simulated 'causative' variant more often than commonly used regression modeling methods.",0 +,Racial differences in treatment preferences among lupus patients: a two-site study.,"To identify the demographic, clinical and psychosocial characteristics associated with racial differences in willingness to receive cyclophosphamide (CYC) or participate in a research clinical trial (RCT) among patients with systemic lupus erythematosus (SLE).Data from 163 African-American (AA) and 180 white (WH) SLE patients were evaluated. Structured interviews and chart reviews were conducted to determine treatment preferences in hypothetical situations and identify variables that may affect preferences. Logistic regression models were performed to evaluate the relationship between patient preferences and race, adjusted for patient characteristics.Among patients who had never received CYC (n=293), 62.9% AAs compared to 87.6% WHs were willing to receive the medication (p<0.001). This difference persisted (OR 0.37 [95% CI, 0.16-0.87]) after adjusting for socio-demographics, clinical characteristics, and perceptions about CYC and physicians. Income and higher perception of CYC effectiveness were other determinants of willingness to receive CYC. Among patients who had never participated in an RCT (n=326), 64.9% AAs compared to 84.3% WHs were willing to do so (p<0.001). This difference persisted (OR 0.41 [95% CI, 0.20-0.83]) after adjusting for socio-demographics, clinical context and patients' perceptions of physicians. SLE damage score, number of immunosuppressive medications and higher trust in physicians were also independently associated with willingness to participate in an RCT.Race remains an independent determinant of treatment preferences after adjustment for income, medications, medication efficacy expectations and trust in physicians. While some factors related to racial differences in preferences are relatively fixed, others that may alleviate these differences also exist, including medication beliefs and provider trust.",0 +https://doi.org/10.1111/j.1460-9568.2005.04379.x,Involvement of spinal cord nuclear factor κB activation in rat models of proinflammatory cytokine-mediated pain facilitation,"Proinflammatory cytokines, such as interleukin-1beta and tumour necrosis factor-alpha, are released by activated glial cells in the spinal cord and play a major role in pain facilitation. These cytokines exert their actions, at least partially, through the activation of the transcription factor, nuclear factor kappaB (NF-kappaB). In turn, NF-kappaB regulates the transcription of many inflammatory mediators, including cytokines. We have previously shown that intrathecal injection of the human immunodeficiency virus-1 (HIV-1) envelope glycoprotein, gp120, induces mechanical allodynia via the release of proinflammatory cytokines. Here, we investigated whether NF-kappaB is involved in gp120-induced pain behaviour in Sprague-Dawley rats. Intrathecal administration of NF-kappaB inhibitors, pyrrolidinedithiocarbamate (PDTC) and SN50, prior to gp120 partially attenuated gp120-induced allodynia. In addition, PDTC delayed and reversed allodynia in a model of neuropathic pain induced by sciatic nerve inflammation. These observations suggest that intrathecal gp120 may lead to activation of NF-kappaB within the spinal cord. To reveal NF-kappaB activation, we assessed inhibitory factor kappaBalpha (IkappaBalpha) mRNA expression by in situ hybridization, as NF-kappaB activation up-regulates IkappaBalpha gene expression as part of an autoregulatory feedback loop. No or low levels of IkappaBalpha mRNA were detected in the lumbar spinal cord of vehicle-injected rats, whereas IkappaBalpha mRNA expression was markedly induced in the spinal cord following intrathecal gp120 in predominantly astrocytes and endothelial cells. Moreover, IkappaBalpha mRNA expression positively correlated with proinflammatory cytokine protein levels in lumbosacral cerebrospinal fluid. Together, these results demonstrate that spinal cord NF-kappaB activation is involved, at least in part, in exaggerated pain states.",0 +https://doi.org/10.1002/sim.2328,A comparison of propensity score methods: a case-study estimating the effectiveness of post-AMI statin use,"There is an increasing interest in the use of propensity score methods to estimate causal effects in observational studies. However, recent systematic reviews have demonstrated that propensity score methods are inconsistently used and frequently poorly applied in the medical literature. In this study, we compared the following propensity score methods for estimating the reduction in all-cause mortality due to statin therapy for patients hospitalized with acute myocardial infarction: propensity-score matching, stratification using the propensity score, covariate adjustment using the propensity score, and weighting using the propensity score. We used propensity score methods to estimate both adjusted treated effects and the absolute and relative risk reduction in all-cause mortality. We also examined the use of statistical hypothesis testing, standardized differences, box plots, non-parametric density estimates, and quantile-quantile plots to assess residual confounding that remained after stratification or matching on the propensity score. Estimates of the absolute reduction in 3-year mortality ranged from 2.1 to 4.5 per cent, while estimates of the relative risk reduction ranged from 13.3 to 17.0 per cent. Adjusted estimates of the reduction in the odds of 3-year death varied from 15 to 24 per cent across the different propensity score methods.",0 +https://doi.org/10.1177/0272989x07302132,Cost-Effectiveness Analysis Using Data from Multinational Trials: The Use of Bivariate Hierarchical Modeling,"Health care cost-effectiveness analysis (CEA) often uses individual patient data (IPD) from multinational randomized controlled trials. Although designed to account for between-patient sampling variability in the clinical and economic data, standard analytical approaches to CEA ignore the presence of between-location variability in the study results. This is a restrictive limitation given that countries often differ in factors that could affect the results of CEAs, such as the availability of health care resources, their unit costs, clinical practice, and patient case mix. The authors advocate the use of Bayesian bivariate hierarchical modeling to analyze multinational cost-effectiveness data. This analytical framework explicitly recognizes that patient-level costs and outcomes are nested within countries. Using real-life data, the authors illustrate how the proposed methods can be applied to obtain (a) more appropriate estimates of overall cost-effectiveness and associated measure of sampling uncertainty compared to standard CEA and (b) country-specific cost-effectiveness estimates that can be used to assess the between-location variability of the study results while controlling for differences in country-specific and patientspecific characteristics. It is demonstrated that results from standard CEA using IPD from multinational trials display a large degree of variability across the 17 countries included in the analysis, producing potentially misleading results. In contrast, ``shrinkage estimates'' obtained from the modeling approach proposed here facilitate the appropriate quantification of country-specific cost-effectiveness estimates while weighting the results based on the level of information available within each country. The authors suggest that the methods presented here represent a general framework for the analysis of economic data collected from different locations.",0 +https://doi.org/10.1177/147078530704900306,Predicting Purchase Decisions with Different Conjoint Analysis Methods: A Monte Carlo Simulation,"To forecast purchase decisions, different conjoint-based approaches have been discussed. Nevertheless, there is no clear evidence on which variant performs best. This study uses a Monte Carlo simulation to systematically compare different choice-based models and different models of a modified traditional conjoint variant, namely limit conjoint analysis (LCA), which allows for integrating choice decisions. All models compared, except the aggregate logit model, are rather robust. However, the hierarchical Bayes approaches perform best with both choice-based and limit data. The limit models are more efficient than those based on choice data. Thus, to predict purchase decision in practice, the limit hierarchical Bayes model should be considered first. © 2007 The Market Research Society. https://www.mrs.org.uk/ijmr_article/article/85657",0 +https://doi.org/10.4054/demres.2014.30.11,Another 'futile quest'? A simulation study of Yang and Land's Hierarchical Age-Period-Cohort model,"Background: Whilst some argue that a solution to the age-period-cohort (APC) 'identification problem' is impossible, numerous methodological solutions have been proposed, including Yang and Land's Hierarchical-APC (HAPC) model: a multilevel model considering periods and cohorts as cross-classified contexts in which individuals exist. Objective: To assess the assumptions made by the HAPC model, and the situations in which it does and does not work. Methods: Simulation study. Simulation scenarios assess the effect of (a) cohort trends in the Data Generating Process (DGP) (compared to only random variation), and (b) grouping cohorts (in both DGP and fitted model). Results: The model only works if either (a) we can assume that there are no linear (or non-linear) trends in periods or cohorts, (b) we control any cohort trend in the model's fixed part and assume there is no period trend, or (c) we group cohorts in such a way that they exactly match the groupings in the (unknown) DGP. Otherwise, the model can arbitrarily reapportion APC effects, radically impacting interpretation. Conclusions: Since the purpose of APC analysis is often to ascertain the presence of period and/or cohort trends, and since we rarely have solid (if any) theory regarding cohort groupings, there are few circumstances in which this model achieves what Yang and Land claim it can. The results bring into question findings of several published studies using the HAPC model. However, the structure of the model remains a conceptual advance that is useful when we can assume the DGP has no period trends.",0 +https://doi.org/10.1002/sim.2704,Evidence-based sample size calculations based upon updated meta-analysis,"Meta-analyses of randomized controlled trials (RCTs) provide the highest level of evidence regarding the effectiveness of interventions and as such underpin much of evidence-based medicine. Despite this, meta-analyses are usually produced as observational by-products of the existing literature, with no formal consideration of future meta-analyses when individual trials are being designed. Basing the sample size of a new trial on the results of an updated meta-analysis which will include it, may sometimes make more sense than powering the trial in isolation. A framework for sample size calculation for a future RCT based on the results of a meta-analysis of the existing evidence is presented. Both fixed and random effect approaches are explored through an example. Bayesian Markov Chain Monte Carlo simulation modelling is used for the random effects model since it has computational advantages over the classical approach. Several criteria on which to base inference and hence power are considered. The prior expectation of the power is averaged over the prior distribution for the unknown true treatment effect. An extension to the framework allowing for consideration of the design for a series of new trials is also presented. Results suggest that power can be highly dependent on the statistical model used to meta-analyse the data and even very large studies may have little impact on a meta-analysis when there is considerable between study heterogeneity. This raises issues regarding the appropriateness of the use of random effect models when designing and drawing inferences across a series of studies.",0 +https://doi.org/10.1207/s15327906mbr3701_04,Analytic Estimation of Standard Error and Confidence Interval for Scale Reliability,"An analytic approach to standard error and confidence interval estimation of scale reliability with fixed congeneric measures is proposed that is based on a generally applicable estimator stability evaluation procedure, the delta method (e.g., Ogasawara, 1999). The approach complements wide-spread point estimation of composite reliability in behavioral scale construction and development, and can be used to evaluate precision of estimates and plausible ranges for reliability of multiple-component instruments in studied populations. The method is illustrated by means of a numerical example.",0 +https://doi.org/10.5705/ss.2009.319,Bayesian designs for hierarchical linear models,"Two Bayesian optimal design criteria for hierarchical linear models are discussed – the ?? criterion for the estimation of individual-level parameters ?, and the ?? criterion for the estimation of hyperparameters ?. We focus on a specific case in which all subjects receive the same set of treatments and in which the covariates are independent of treatments. We obtain the explicit structure of ??- and ??- optimal continuous (approximate) designs for the case of independent random effects, and for some special cases of correlated random effects. Through examples and simulations, we compare ??- and ??-optimal designs under more gen- eral scenarios of correlated random effects. While orthogonal designs are often ??-optimal even when the random effects are correlated, ??-optimal designs tend to be nonorthogonal and unbalanced. In our study of the robustness of ??- and ??-optimal designs, both types of designs are found to be insensitive to various specifications of the response errors and the vari- ances of the random effects, but sensitive to the specifications of the signs of the correlations of the random effects.",0 +https://doi.org/10.1002/9780470575789,Surveying Cultures,"Surveying Cultures uniquely employs techniques rooted in survey methodology to discover cultural patterns in social science research. Examining both classical and emerging methods that are used to survey and assess differing norms among populations, the book successfully breaks new ground in the field, introducing a theory of measurement for ethnographic studies that employs the consensus-as-culture model. The book begins with a basic overview of cross-cultural measurement of sentiments and presents innovative and sophisticated analyses of measurement issues and of homogeneity among respondents. Subsequent chapters explore topics that are at the core of successful data collection and analysis in culture studies, including: The role of bipolar scales and Internet data collection in measuring sentiments. Key methodological variables that determine the quality of quantitative data, including measurement errors, validity, and reliability. New approaches to reliability and several new methods of assessing a respondent's degree of inculcation into group culture. Sampling, coverage, nonresponse, and measurement errors, with an in-depth discussion of their occurrence in culture surveys, their impact assessments, and how current measurement techniques are constructed to help prevent these kinds of errors. Common problems often encountered in the acquisition and communication of data, including identifying error variances, interpreting gender differences in responses, and defining the difference between cultures and subcultures. Throughout the book, each topic is accompanied by a review of related methodological literature. For many of the presented concepts, the author includes a formal analysis of the related issues in measuring cultural norms and reports on analyses. Each chapter concludes with an organized list of major findings as well as an insightful outline of specific recommendations regarding practical problems in culture studies. Surveying Cultures serves as a valuable supplemental book to courses on survey and research methods at the upper-undergraduate and graduate levels. It is also an excellent reference for researchers in the fields of sociology, anthropology, psychology, and political science. © 2010 John Wiley & Sons, Inc.",0 +https://doi.org/10.1080/00273171.2017.1292893,"Bayesian Modal Estimation of the Four-Parameter Item Response Model in Real, Realistic, and Idealized Data Sets","In this study, we explored item and person parameter recovery of the four-parameter model (4PM) in over 24,000 real, realistic, and idealized data sets. In the first analyses, we fit the 4PM and three alternative models to data from three Minnesota Multiphasic Personality Inventory-Adolescent form factor scales using Bayesian modal estimation (BME). Our results indicated that the 4PM fits these scales better than simpler item Response Theory (IRT) models. Next, using the parameter estimates from these real data analyses, we estimated 4PM item parameters in 6,000 realistic data sets to establish minimum sample size requirements for accurate item and person parameter recovery. Using a factorial design that crossed discrete levels of item parameters, sample size, and test length, we also fit the 4PM to an additional 18,000 idealized data sets to extend our parameter recovery findings. Our combined results demonstrated that 4PM item parameters and parameter functions (e.g., item response functions) can be accurately estimated using BME in moderate to large samples (N ⩾ 5, 000) and person parameters can be accurately estimated in smaller samples (N ⩾ 1, 000). In the supplemental files, we report annotated [Formula: see text] code that shows how to estimate 4PM item and person parameters in [Formula: see text] (Chalmers, 2012 ).",0 +https://doi.org/10.1186/s12868-015-0228-5,Multilevel analysis quantifies variation in the experimental effect while optimizing power and preventing false positives,"In neuroscience, experimental designs in which multiple measurements are collected in the same research object or treatment facility are common. Such designs result in clustered or nested data. When clusters include measurements from different experimental conditions, both the mean of the dependent variable and the effect of the experimental manipulation may vary over clusters. In practice, this type of cluster-related variation is often overlooked. Not accommodating cluster-related variation can result in inferential errors concerning the overall experimental effect.The exact effect of ignoring the clustered nature of the data depends on the effect of clustering. Using simulation studies we show that cluster-related variation in the experimental effect, if ignored, results in a false positive rate (i.e., Type I error rate) that is appreciably higher (up to ~20-~50 %) than the chosen [Formula: see text]-level (e.g., [Formula: see text] = 0.05). If the effect of clustering is limited to the intercept, the failure to accommodate clustering can result in a loss of statistical power to detect the overall experimental effect. This effect is most pronounced when both the magnitude of the experimental effect and the sample size are small (e.g., ~25 % less power given an experimental effect with effect size d of 0.20, and a sample size of 10 clusters and 5 observations per experimental condition per cluster).When data is collected from a research design in which observations from the same cluster are obtained in different experimental conditions, multilevel analysis should be used to analyze the data. The use of multilevel analysis not only ensures correct statistical interpretation of the overall experimental effect, but also provides a valuable test of the generalizability of the experimental effect over (intrinsically) varying settings, and a means to reveal the cause of cluster-related variation in experimental effect.",0 +https://doi.org/10.1002/env.613,Semiparametric spatio-temporal frailty modeling,"Recent developments in GIS have encouraged health science databases to incorporate geographical information about the subjects under study. Such databases have in turn generated interest among statisticians to develop and analyze models that account for spatial clustering and variation. In this article we develop a semiparametric (Cox) hierarchical Bayesian frailty model for capturing spatio-temporal heterogeneity in the survival patterns of women diagnosed with breast cancer in Iowa. In the absence of appropriate surrogates for standards of treatments and health care for cancer patients in the different counties, epidemiologists and health-care professionals are interested in discerning spatial patterns in survival from breast cancer that might be present among the counties. In addition, it is naturally of interest to see if the counties show discernible temporal trends over the years. The SEER (Surveillance Epidemiology and End Results) database from the National Cancer Institute (NCI) provides data on a cohort of breast cancer patients observed progressively through time, spanning 26 years. We implement our hierarchical spatio-temporal models on data extracted from the database for the 99 counties of Iowa. Our results suggest log-relative hazards that are generally flat initially, but steadily decrease for more recent years. Copyright © 2003 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1080/01621459.1991.10475080,"Some Bayesian and Non-Bayesian Procedures for the Analysis of Comparative Experiments and for Small-Area Estimation: Computational Aspects, Frequentist Properties, and Relationships","Abstract The estimation of a treatment contrast from experimental data and the estimation of a small-area mean are special cases of the prediction of the realization of a linear combination of fixed and random effects in a possibly unbalanced two-part mixed linear model. In this article a Bayesian approach to point and interval prediction is presented and its computational requirements are examined. Differences between the Bayesian approach and the traditional (classical) approach are discussed in general terms and, in addition, in terms of two examples taken from the literature: (1) the comparison of drug formulations in a bioavailability trial (Westlake) and (2) the estimation of corn-crop areas using satellite data (Battese, Harter, and Fuller). Some deficiencies in the classical approach are pointed out, and the Bayesian approach is considered from a frequentist perspective. It is shown, via a Monte Carlo study, that, for certain (noninformative) choices of the prior distribution, the frequentist prop...",0 +https://doi.org/10.5465/amj.2006.0241,Trust in Typical and High-Reliability Contexts: Building and Reacting to Trust among Firefighters,We develop theory that distinguishes trust among employees in typical task contexts (marked by low levels of situational unpredictability and danger) from trust in “high-reliability” task contexts ...,0 +https://doi.org/10.1348/000711004849295,Estimation of maximal reliability: A note on a covariance structure modelling approach,"A one-step covariance structure analysis procedure for estimation of maximal reliability of linear composites with congeneric measures is outlined. The approach is readily employed within a single modelling session using popular covariance structure analysis software, and permits simultaneous estimation of the optimal measure weights with standard errors. The method is illustrated by a numerical example.",0 +https://doi.org/10.1080/17437199.2017.1343676,An introduction to Bayesian statistics in health psychology,"The aim of the current article is to provide a brief introduction to Bayesian statistics within the field of health psychology. Bayesian methods are increasing in prevalence in applied fields, and they have been shown in simulation research to improve the estimation accuracy of structural equation models, latent growth curve (and mixture) models, and hierarchical linear models. Likewise, Bayesian methods can be used with small sample sizes since they do not rely on large sample theory. In this article, we discuss several important components of Bayesian statistics as they relate to health-based inquiries. We discuss the incorporation and impact of prior knowledge into the estimation process and the different components of the analysis that should be reported in an article. We present an example implementing Bayesian estimation in the context of blood pressure changes after participants experienced an acute stressor. We conclude with final thoughts on the implementation of Bayesian statistics in health psychology, including suggestions for reviewing Bayesian manuscripts and grant proposals. We have also included an extensive amount of online supplementary material to complement the content presented here, including Bayesian examples using many different software programmes and an extensive sensitivity analysis examining the impact of priors.",0 +https://doi.org/10.1037/0033-2909.86.3.446,Group reaction time distributions and an analysis of distribution statistics.,"A method of obtaining an average reaction time distribution for a group of subjects is described. The method is particularly useful for cases in which data from many subjects are available but there are only 10-20 reaction time observations per subject cell. Essentially, reaction times for each subject are organized in ascending order, and quantiles are calculated. The quantiles are then averaged over subjects to give group quantiles (cf. Vincent learning curves). From the group quantiles, a group reaction time distribution can be constructed. It is shown that this method of averaging is exact for certain distributions (i.e., the resulting distribution belongs to the same family as the individual distributions). Furthermore, Monte Carlo studies and application of the method to the combined data from three large experiments provide evidence that properties derived from the group reaction time distribution are much the same as average properties derived from the data of individual subjects. This article also examines how to quantitatively describe the shape of reaction time distributions. The use of moments and cumulants as sources of information about distribution shape is evaluated and rejected because of extreme dependence on long, outlier reaction times. As an alternative, the use of explicit distribution functions as approximations to reaction time distributions is considered.",0 +https://doi.org/10.1016/j.jbtep.2011.12.002,An experimental investigation of the role of negative mood in worry: The role of appraisals that facilitate systematic information processing,"Negative mood is associated with increased worry levels, and also with deployment of a systematic information processing style. An experimental study assessed the potential role of systematic information processing in mediating the facilitative effect of negative mood on worry (e.g. Johnston & Davey, 1997).Participants underwent appropriate vignette-based mood inductions (negative, neutral, and cognitive priming). Participants completed visual analogue scales measuring variables that reflect a raised processing sufficiency threshold and are known to increase systematic processing (responsibility, accountability, desire for control, and need for cognition), a measure of 'as many as can' worry stop rule deployment, and two measures of worry (the catastrophising interview and the Penn State Worry Questionnaire, PSWQ, Meyer, Miller, Metzger, & Borkovec, 1990).Experimentally-induced negative mood facilitated the endorsement of cognitive appraisals known to increase systematic as opposed to heuristic information processing. In addition, a meditational analysis showed that the systematic processing facilitators measure together with a measure of 'as many as can' worry stop rule deployment fully mediated the relationship between negative mood and a measure of worry frequency (PSWQ).Future studies should develop and validate direct measures of systematic processing.Similarities and differences between systematic processing and chronic worrying as effortful forms of information processing are discussed, and a role for systematic processing as an information processing style relevant to understanding worrisome thought is described.",0 +https://doi.org/10.1093/esr/jcq071,Education Policy and Educational Inequality--Evidence from the Swiss Laboratory,"This article examines how the different education policies in the subnational units of Switzerland - the cantons - affect educational inequality. The article builds on previous research arguing that in order to properly evaluate education policy and its outcomes in decentralized countries, regional disparities must been taken into account. Switzerland has one of the most decentralized education systems in the world and is thus an exemplary case for a subnational analysis. Applying multilevel models the article illustrates that small class size, public investments in education as well as the mobility between ability groups are related to a lower degree of educational inequality. In contrast, longer schooldays strengthen inequality in education, implying that school instruction in the Swiss cantons does not provide equal opportunities to pupils irrespective of social class. © 2011 The Author. Published by Oxford University Press. All rights reserved.",0 +https://doi.org/10.1007/bf02296397,Latent variable modeling in heterogeneous populations,"Common applications of latent variable analysis fail to recognize that data may be obtained from several populations with different sets of parameter values. This article describes the problem and gives an overview of methodology that can address heterogeneity. Artificial examples of mixtures are given, where if the mixture is not recognized, strongly distorted results occur. MIMIC structural modeling is shown to be a useful method for detecting and describing heterogeneity that cannot be handled in regular multiple-group analysis. Other useful methods instead take a random effects approach, describing heterogeneity in terms of random parameter variation across groups. These random effects models connect with emerging methodology for multilevel structural equation modeling of hierarchical data. Examples are drawn from educational achievement testing, psychopathology, and sociology of education. Estimation is carried out by the LISCOMP program.",0 +https://doi.org/10.1577/t06-108.1,"Modeling Annual Growth Variation using a Hierarchical Bayesian Approach and the von Bertalanffy Growth Function, with Application to Lake Trout in Southern Lake Huron","We compared two models for time-varying growth using a hierarchical Bayesian approach to inference. Both models were derived from the same time-invariant von Bertalanffy growth function (VBGF), and our model comparisons were based on the deviance information criterion. We fit models to length and age data for 15,675 individual lake trout Salvelinus namaycush collected during annual spring gill-net surveys in southern Lake Huron from 1976 to 2004. We found that a model structured with both year and cohort effects outperformed a model that only used the same year-specific VBGF parameters for all age-groups. For the better model, the full version that allowed all VBGF parameters to vary over time also outperformed alternatives for which some parameters were constant. Length at age changed greatly over the 1976-2004 period, and in some years different ages changed in different directions. These complex patterns, which were due to the combination of cohort-specific growth and year-specific changes in growth environment, were well captured by our model. When we modeled growth as varying over time, inferences about VBGF parameters differed between the two models, and correlations among VBGF parameters also differed from the usually reported relations based on time-invariant models.",0 +https://doi.org/10.1037/0022-0167.52.3.310,"Group Climate, Cohesion, Alliance, and Empathy in Group Psychotherapy: Multilevel Structural Equation Models.","This study examined the definitional and statistical overlap among 4 key group therapeutic relationship constructs—group climate, cohesion, alliance, and empathy—across member–member, member–group, and member–leader relationships. Three multilevel structural equation models were tested using selfreport measures completed by 662 participants from 111 counseling center and personal growth groups. As hypothesized, almost all measures of therapeutic relationship were significantly correlated. Hypothesized 1-factor, 2-factor (Working and Bonding factors), and 3-factor (Member, Leader, and Group factors) models did not fit the data adequately. An exploratory model with Bonding, Working, and Negative factors provided the best fit to the data. Group members distinguished among relationships primarily according to relationship quality rather than the status or role of others (i.e., leader, member, or whole group).",0 +https://doi.org/10.1002/hec.1531,Improving costing methods in multicentre economic evaluation: the use of multiple imputation for unit costs,"Economic evaluations must use appropriate costing methods. However, in multicentre cost-effectiveness analyses (CEA) a fundamental issue of how best to measure and analyse unit costs has been neglected. Multicentre CEA commonly take the mean unit cost from a national database, such as NHS reference costs. This approach does not recognise that unit costs vary across centres and are unavailable in some centres. This paper proposes the use of multiple imputation (MI) to predict those centre-specific unit costs that are not available, while recognising the statistical uncertainty surrounding this imputation.We illustrate MI with a CEA of a multicentre randomised trial (1014 patients, 60 centres), implemented using multilevel modelling. We use MI to derive centre-specific unit costs, based on centre characteristics including average casemix, and compare this to using mean NHS reference costs. In this case study, using MI unit costs rather than mean reference costs led to less heterogeneity across centres, more precise estimates of incremental cost, but similar estimates of incremental cost-effectiveness.We conclude that using MI to predict unit costs can preserve correlations, maximise the use of available data, and, when combined with multilevel modelling is an appropriate method for recognising the statistical uncertainty in multicentre CEA.",0 +https://doi.org/10.1016/j.jval.2010.12.006,"Cost-Effectiveness Analysis of Linezolid, Daptomycin, and Vancomycin in Methicillin-Resistant Staphylococcus aureus: Complicated Skin and Skin Structure Infection Using Bayesian Methods for Evidence Synthesis","Methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and skin structure infection (cSSSI) is a prominent infection encountered in hospital and outpatient settings that is associated with high resource use for the health-care system.A decision analytic (DA) model was developed to evaluate the cost-effectiveness analysis (CEA) of linezolid, daptomycin, and vancomycin in MRSA cSSSI.Bayesian methods for evidence synthesis were used to generate efficacy and safety parameters for a DA model using published clinical trials. CEA was done from the US health-care perspective. Efficacy was defined as a successfully treated patient at the test of cure without any adverse reaction. Primary outcome was the incremental cost-effectiveness ratio between linezolid and vancomycin, daptomycin and vancomycin, and linezolid and daptomycin in MRSA cSSSI. Univariate and probabilistic sensitivity analyses were performed to test the robustness of the model.The total direct costs of linezolid, daptomycin, and vancomycin were $18,057, $20,698, and $23,671, respectively. The cost-effectiveness ratios for linezolid, daptomycin, and vancomycin were $37,604, $44,086, and $52,663 per successfully treated patient, respectively. Linezolid and daptomycin were dominant strategies compared to vancomycin. However, linezolid was dominant when compared to daptomycin. The model was sensitive to the duration of daptomycin and linezolid treatment.Linezolid and daptomycin are potentially cost-effective based on the assumptions of the DA model; however, linezolid appears to be more cost-effective compared to daptomycin and vancomycin for MRSA cSSSIs.",0 +https://doi.org/10.1007/bf02294775,Bayesian item selection criteria for adaptive testing,Owen (1975) proposed an approximate empirical Bayes procedure for item selection in computerized adaptive testing (CAT). The procedure replaces the true posterior by a normal approximation with closed-form expressions for its first two moments. This approximation was necessary to minimize the computational complexity involved in a fully Bayesian approach but is no longer necessary given the computational power currently available for adaptive testing. This paper suggests several item selection criteria for adaptive testing which are all based on the use of the true posterior. Some of the statistical properties of the ability estimator produced by these criteria are discussed and empirically characterized.,0 +https://doi.org/10.1046/j.0039-0402.2003.00252.x,Robustness issues in multilevel regression analysis,"A multilevel problem concerns a population with a hierarchical structure. A sample from such a population can be described as a multistage sample. First, a sample of higher level units is drawn (e.g. schools or organizations), and next a sample of the sub-units from the available units (e.g. pupils in schools or employees in organizations). In such samples, the individual observations are in general not completely independent. Multilevel analysis software accounts for this dependence and in recent years these programs have been widely accepted. Two problems that occur in the practice of multilevel modeling will be discussed. The first problem is the choice of the sample sizes at the different levels. What are sufficient sample sizes for accurate estimation? The second problem is the normality assumption of the level-2 error distribution. When one wants to conduct tests of significance, the errors need to be normally distributed. What happens when this is not the case? In this paper, simulation studies are used to answer both questions. With respect to the first question, the results show that a small sample size at level two (meaning a sample of 50 or less) leads to biased estimates of the second-level standard errors. The answer to the second question is that only the standard errors for the random effects at the second level are highly inaccurate if the distributional assumptions concerning the level-2 errors are not fulfilled. Robust standard errors turn out to be more reliable than the asymptotic standard errors based on maximum likelihood.",0 +https://doi.org/10.1111/j.1745-3984.1998.tb00530.x,Properties of Ability Estimation Methods in Computerized Adaptive Testing,"Simulations of computerized adaptive tests (CATs) were used to evaluate results yielded by four commonly used ability estimation methods: maximum likelihood estimation (MLE) and three Bayesian approaches—Owen's method, expected a posteriori (EAP), and maximum a posteriori. In line with the theoretical nature of the ability estimates and previous empirical research, the results showed clear distinctions between MLE and the Bayesian methods, with MLE yielding lower bias, higher standard errors, higher root mean square errors, lower fidelity, and lower administrative efficiency. Standard errors for MLE based on test information underestimated actual standard errors, whereas standard errors for the Bayesian methods based on posterior distribution standard deviations accurately estimated actual standard errors. Among the Bayesian methods, Owen's provided the worst overall results, and EAP provided the best. Using a variable starting rule in which examinees were initially classified into three broad/ability groups greatly reduced the bias for the Bayesian methods, but had little effect on the results for MLE. On the basis of these results, guidelines are offered for selecting appropriate CAT ability estimation methods in different decision contexts.",0 +https://doi.org/10.1214/088342306000000015,General Design Bayesian Generalized Linear Mixed Models,"Linear mixed models are able to handle an extraordinary range of complications in regression-type analyses. Their most common use is to account for within-subject correlation in longitudinal data analysis. They are also the standard vehicle for smoothing spatial count data. However, when treated in full generality, mixed models can also handle spline-type smoothing and closely approximate kriging. This allows for nonparametric regression models (e.g., additive models and varying coefficient models) to be handled within the mixed model framework. The key is to allow the random effects design matrix to have general structure; hence our label general design. For continuous response data, particularly when Gaussianity of the response is reasonably assumed, computation is now quite mature and supported by the R, SAS and S-PLUS packages. Such is not the case for binary and count responses, where generalized linear mixed models (GLMMs) are required, but are hindered by the presence of intractable multivariate integrals. Software known to us supports special cases of the GLMM (e.g., PROC NLMIXED in SAS or glmmML in R) or relies on the sometimes crude Laplace-type approximation of integrals (e.g., the SAS macro glimmix or glmmPQL in R). This paper describes the fitting of general design generalized linear mixed models. A Bayesian approach is taken and Markov chain Monte Carlo (MCMC) is used for estimation and inference. In this generalized setting, MCMC requires sampling from nonstandard distributions. In this article, we demonstrate that the MCMC package WinBUGS facilitates sound fitting of general design Bayesian generalized linear mixed models in practice.",0 +https://doi.org/10.1002/2014wr016553,A regional estimate of postfire streamflow change in California,"The effect of fire on annual streamflow has been examined in numerous watershed studies, with some studies observing postfire increases in streamflow while other have observed no conclusive change. Despite this inherent variability in streamflow response, the management of water resources for flood protection, water supply, water quality, and the environment necessitates an understanding of postfire effects on streamflow at regional scales. In this study, the regional effect of wildfire on annual streamflow was investigated using 12 paired watersheds in central and southern California. A mixed model was used to pool and statistically examine the combined paired-watershed data, with emphasis on the effects of percentage area burned, postfire recovery of vegetation, and postfire wetness conditions on postfire streamflow change. At a regional scale, postfire annual streamflow increased 134% (82%–200%) during the first postfire year assuming 100% area burned and average annual wetness conditions. Postfire response decreased with lower percentages of percentage area burned and during subsequent years as vegetation recovered following fire. Annual streamflow response to fire was found to be sensitive to annual wetness conditions, with postfire response being smallest during dry years, greatest during wet years, and slowly decreasing during very wet years. These findings provide watershed managers with a first-order estimate for predicting postfire streamflow response in both gauged and ungauged watersheds.",0 +https://doi.org/10.1111/spsr.12125,What Type of Resources? Household Effects and Female Electoral Participation,"This paper investigates the relationship between socioeconomic resources and women's political participation, more precisely whether the distinction between individual and household resources helps to identify different mechanisms behind a possible “resource effect”. Based on a Bayesian multilevel analysis using the Swiss Election Study 2011, we show that both individual and household resources matter for explaining female electoral participation. However, resource effects must not necessarily be positive: While higher education of women and their partners tend to increase female participation, a demanding job of either the woman and/or her partner rather decreases her propensity to vote. Moreover, the mechanisms behind partner effects are contingent on women's individual resource endowment. While low and medium educated women most strongly profit from higher educational partner resources, i.e. from a compensatory mechanism, the resource “time” seems to particularly confine political involvement of women with both high professional status or no employment.",0 +https://doi.org/10.1214/aoms/1177693250,Formal Bayes Estimation with Application to a Random Effects Model,,0 +https://doi.org/10.1002/sim.3460,Bayesian propensity score analysis for observational data,"In the analysis of observational data, stratifying patients on the estimated propensity scores reduces confounding from measured variables. Confidence intervals for the treatment effect are typically calculated without acknowledging uncertainty in the estimated propensity scores, and intuitively this may yield inferences, which are falsely precise. In this paper, we describe a Bayesian method that models the propensity score as a latent variable. We consider observational studies with a dichotomous treatment, dichotomous outcome, and measured confounders where the log odds ratio is the measure of effect. Markov chain Monte Carlo is used for posterior simulation. We study the impact of modelling uncertainty in the propensity scores in a case study investigating the effect of statin therapy on mortality in Ontario patients discharged from hospital following acute myocardial infarction. Our analysis reveals that the Bayesian credible interval for the treatment effect is 10 per cent wider compared with a conventional propensity score analysis. Using simulations, we show that when the association between treatment and confounders is weak, then this increases uncertainty in the estimated propensity scores. Bayesian interval estimates for the treatment effect are longer on average, though there is little improvement in coverage probability. A novel feature of the proposed method is that it fits models for the treatment and outcome simultaneously rather than one at a time. The method uses the outcome variable to inform the fit of the propensity model. We explore the performance of the estimated propensity scores using cross-validation. Copyright © 2008 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1088/0004-637x/811/2/78,ELEMENTAL DEPLETIONS IN THE MAGELLANIC CLOUDS AND THE EVOLUTION OF DEPLETIONS WITH METALLICITY,"We present a study of the composition of gas and dust in the Large and Small Magellanic Clouds (LMC and SMC, together -- the MCs) as measured by UV absorption spectroscopy. We have measured P II and Fe II along 85 sightlines toward the MCs using archival FUSE observations. For 16 of those sightlines, we have measured Si II, Cr II, and Zn II from new HST COS observations. We have combined these measurements with H I and H$_2$ column densities and reference stellar abundances from the literature to derive gas-phase abundances, depletions, and gas-to-dust ratios (GDRs). 80 of our 84 P measurements and 13 of our 16 Zn measurements are depleted by more than 0.1 decades, suggesting that P and Zn abundances are not accurate metallicity indicators at and above the metallicity of the SMC. The maximum P and Zn depletions are the same in the MW, LMC, and SMC. Si, Cr, and Fe are systematically less depleted in the SMC than in the MW or LMC. The minimum Si depletion in the SMC is consistent with zero. Our depletion-derived GDRs broadly agree with GDRs from the literature. The GDR varies from location to location within a galaxy by a factor of up to 2 in the LMC and up to 5 in the SMC. This variation is evidence of dust destruction and/or growth in the diffuse neutral phase of the interstellar medium.",0 +https://doi.org/10.3758/bf03202110,Microcomputer-based estimation of psychophysical thresholds: The Best PEST,"A new, maximally efficient technique for measuring psychophysical thresholds (Pentland, 1980) has been implemented on the microcomputer. This PEST (parameter estimation by sequential testing) technique is the most efficient sequential parameter estimation technique possible, given that the form of the psychometric function is known. The technique is similar to but faster and more accurate than other staircase procedures and may be applied whenever staircase techniques are applicable. The “Best PEST” is easily implemented on the micro-computer; a BASIC program for the Apple II which does so is presented. The Best PEST is compared with other staircase procedures, including one recently implemented on a micro-computer (Corwin, Kintz, & Beaty, 1979).",0 +https://doi.org/10.1214/aoms/1177704731,The Problem of Negative Estimates of Variance Components,"The usefulness of variance component techniques is frequently limited by the occurrence of negative estimates of essentially positive parameters. This paper uses a restricted maximum likelihood principle to remove this objectionable characteristic for certain experimental models. Section 2 discusses certain necessary results from the theory of non-linear programming. Section 3 derives specific formulae for estimating the variance components of the random one-way and two-way classification models. The problem of determining the precision of instruments in the two instrument case is dealt with in section 4, and a surprising though not unreasonable answer is obtained. The remaining sections provide an algorithm for solving the problem of negative estimates of variance components for all random effects models whose expected mean square column may be thought of as forming a mathematical tree in a certain sense. The algorithm is as follows: Consider the minimum mean square in the entire array; if this mean square is the root of the tree then equate it to its expectation. If the minimum mean square is not the root then pool it with its predecessor. In either case the problem is reduced to an identical one having one less variable, and hence in a finite number of steps the process will yield estimates of the variance components. These estimates are non-negative and have a maximum likelihood property.",0 +https://doi.org/10.18187/pjsor.v12i1.952,Bayesian Analysis of Linear and Nonlinear Latent Variable Models with Fixed Covariate and Ordered Categorical Data,"In this paper, ordered categorical variables are used to compare between linear and nonlinear interactions of fixed covariate and latent variables Bayesian structural equation models. Gibbs sampling method is applied for estimation and model comparison. Hidden continuous normal distribution (censored normal distribution) is used to handle the problem of ordered categorical data. Statistical inferences, which involve estimation of parameters and their standard deviations, and residuals analyses for testing the selected model, are discussed. The proposed procedure is illustrated by a simulation data obtained from R program. Analysis are done by using OpenBUGS program.",0 +https://doi.org/10.1177/0962280206075309,Bayesian methods for latent trait modelling of longitudinal data,"Latent trait models have long been used in the social science literature for studying variables that can only be measured indirectly through multiple items. However, such models are also very useful in accounting for correlation in multivariate and longitudinal data, particularly when outcomes have mixed measurement scales. Bayesian methods implemented with Markov chain Monte Carlo provide a flexible framework for routine fitting of a broad class of latent variable (LV) models, including very general structural equation models. However, in considering LV models, a number of challenging issues arise, including identifiability, confounding between the mean and variance, uncertainty in different aspects of the model, and difficulty in computation. Motivated by the problem of modelling multidimensional longitudinal data, this article reviews the recent literature, provides some recommendations and highlights areas in need of additional research, focusing on methods for model uncertainty.",0 +,The Beast of Aggregating Cognitive Load Measures in Technology-Based Learning.,"An increasing part of cognitive load research in technology-based learning includes a component of repeated measurements, that is: participants are measured two or more times on the same performance, mental effort or other variable of interest. In many cases, researchers aggregate scores obtained from repeated measurements to one single sum or average score per participant and use these aggregated scores in subsequent analysis. This paper demonstrates some dangers of this commonly encountered aggregation approach and presents two comprehensive alternatives: Split-plot analysis of variance (ANOVA) and more flexible two-level regression analysis. The core message of this paper is that the application of the aggregation approach can seriously distort our view of effects and relations of interest and should therefore not be used in cognitive load research. Multilevel analysis of repeated measurements data can account for various features of the data and constitutes a best practice.",0 +https://doi.org/10.1080/10705511.2014.882688,An Empirical Evaluation of Mediation Effect Analysis With Manifest and Latent Variables Using Markov Chain Monte Carlo and Alternative Estimation Methods,"Recently, the Markov chain Monte Carlo (MCMC) estimation method has become explosively popular in a variety of quantitative research methods. In mediation effect analysis (MEA), the MCMC estimation methods can be a promising tool and an important alternative as compared with traditional methods (e.g., the z test using the delta method and the bias-corrected bootstrapping method) in addressing issues such as nonconvergence and complex modeling. In this article, a subject-level MCMC approach for the single MEA is empirically evaluated and compared with traditional methods through Monte Carlo simulation. The evaluation covers point and interval estimates of both manifest and latent variables across conditions including sample size, effect size, and magnitude of factor loadings. BUGS codes for MEA with both manifest and latent variables are provided that can be easily adapted to fit various MEA models in practice.",1 +,A MULTIVARIATE PROBIT LATENT VARIABLE MODEL FOR ANALYZING DICHOTOMOUS RESPONSES,"We propose a multivariate probit model that is dened by a conrmatory factor analysis model with covariates for analyzing dichotomous data in medical re- search. Our proposal is a generalization of several useful multivariate probit models, and provides a exible framework for practical applications. We implement a Monte Carlo EM algorithm for maximum likelihood estimation of the model, and develop a path sampling procedure to compute the observed-data log-likelihood for evalu- ating the Bayesian Information Criterion for model comparison. Our methodology is illustrated by analyzing two data sets in medical research.",0 +https://doi.org/10.1111/j.0269-283x.2004.00511.x,Exposure of sheep to mosquito bites: possible consequences for the transmission risk of Rift Valley Fever in Senegal,"Abstract. Rift Valley Fever (RVF) is a growing health problem in West Africa. In northern Senegal, the candidate vectors of this arbovirosis are Aedes (Aedimorphus) vexans Meigen and Culex (Culex) poicilipes Theobald (Diptera: Culicidae). Domestic ruminants are the reservoirs of the virus. A study was undertaken during the 2002 rainy season to assess spatial and temporal variations in exposure to mosquito bites in sheep herds, and to evaluate the possible consequences on the risk of RVF transmission to sheep. Mosquitoes were collected with sheep-baited traps. The number of Ae. vexans females (the predominant species during the 2002 rainy season) trapped per trap-night was the dependent variable in statistical analyses. The trapping periods were divided into six series of two to five consecutive days, from July to November 2002. Three temporary ponds were selected according to their ecological features: depth, bank slope, size and vegetation cover. Traps were laid on the pond bank and in the nearest available compound, close to the sheep night pen. Data were analysed using mixed-effects Poisson models. The explanatory variables were the trapping period, the pond, and the capture site. The exposure to mosquito bites varied according to the pond type, suggesting that the risk of transmission was spatially heterogeneous. However, there was no obvious trend in transmission risk due to the effect of the distance from the compound to the pond. The period with the highest exposure was in October, i.e. when transhumant herds left the Ferlo to relocate to their dry-season settlement. It is thus hypothesized that transhumance, the seasonal movements of herds, plays a significant role in the dissemination of RVF virus in the region.",0 +https://doi.org/10.1198/016214503000071,Principal Stratification Approach to Broken Randomized Experiments,"The precarious state of the educational system in the inner cities of the United States, as well as its potential causes and solutions, have been popular topics of debate in recent years. Part of the difficulty in resolving this debate is the lack of solid empirical evidence regarding the true impact of educational initiatives. The efficacy of so-called “school choice” programs has been a particularly contentious issue. A current multimillion dollar program, the School Choice Scholarship Foundation Program in New York, randomized the distribution of vouchers in an attempt to shed some light on this issue. This is an important time for school choice, because on June 27, 2002 the U.S. Supreme Court upheld the constitutionality of a voucher program in Cleveland that provides scholarships both to secular and religious private schools. Although this study benefits immensely from a randomized design, it suffers from complications common to such research with human subjects: noncompliance with assigned “treatmen...",0 +https://doi.org/10.1177/0049124194022003006,Multilevel Covariance Structure Analysis,"This article gives an introduction to some new techniques for multilevel covariance structure modeling with latent variables. Although these techniques only incorporate a subset of models that are relevant to multilevel data, the techniques do provide a large set of new analysis possibilities and have the advantage that they only require conventional structural equation modeling software. The presentation draws on methodology presented in earlier works by the author.",0 +https://doi.org/10.1093/aje/kwq328,Invited Commentary: Pushing the Mediation Envelope,"The very insightful and clear paper by VanderWeele and Vansteelandt in this issue of the Journal (Am J Epidemiol. 2010;172(12):1339-1348) bridges the gap between biostatistics methodologists focusing on causal methods for mediation analyses and the practitioners of mediational analyses to the benefit of both groups. In an effort to continue the bridging of this gap, this invited commentary relates the important issue of ""natural direct effects"" to the well-known epidemiologic method of direct standardization. Additionally, attention is paid to the importance of temporal sequencing to help substantiate the mediation relations among the exposure, mediation, and outcome. A crucial mathematical distortion under the logistics model, called ""absence of collapsibility,"" is noted in motivating VanderWeele and Vansteelandt's use of the log-linear model for comparing the effect of exposure adjusted for the mediator with the effect of exposure unadjusted for the mediator. It is also noted that this issue applies to one approach to assessing confounding. Finally, some issues are raised for consideration when testing the interaction between the exposure and mediator before assessing mediation.",0 +https://doi.org/10.1080/01621459.1972.10481215,Limiting the Risk of Bayes and Empirical Bayes Estimators—Part II: The Empirical Bayes Case,Abstract We discuss compromises between Stein's estimator and the MLE which limit the risk to individual components of the estimation problem while sacrificing only a small fraction of the savings in total squared error loss given by Stein's rule. The compromise estimators “limit translation” away from the MLE. The calculations are pursued in an empirical Bayesian manner by considering their performance against an entire family of prior distributions on the unknown parameters.,0 +https://doi.org/10.3758/bf03212980,A comparison of two response time models applied to perceptual matching,"Two models, a Poisson race model and a diffusion model, are fit to data from a perceptual matching task. In each model, information about the similarity or the difference between two stimuli accumulates toward thresholds for either response. Stimulus variables are assumed to influence the rate at which information accumulates, and response variables are assumed to influence the level of the response thresholds. Three experiments were conducted to assess the performance of each model. In Experiment 1, observers performed under different response deadlines; in Experiment 2, response bias was manipulated by changing the relative frequency of same and different stimuli. In Experiment 3, stimulus pairs were presented at three eccentricities: foveal, parafoveal, and peripheral. We examined whether the race and diffusion models could fit the response time and accuracy data through changes only in response parameters (for Experiments 1 and 2) or stimulus parameters (for Experiment 3). Comparisons between the two models suggest that the race model, which has not been studied extensively, can account for perceptual matching data at least as well as the diffusion model. Furthermore, without the constraints on the parameters provided by the experimental conditions, the diffusion and the race models are indistinguishable. This finding emphasizes the importance of fitting models across several conditions and imposing logical psychological constraints on the parameters of models.",0 +https://doi.org/10.1007/s11336-011-9211-y,A Joint Modeling Approach for Reaction Time and Accuracy in Psycholinguistic Experiments,"In the psycholinguistic literature, reaction times and accuracy can be analyzed separately using mixed (logistic) effects models with crossed random effects for item and subject. Given the potential correlation between these two outcomes, a joint model for the reaction time and accuracy may provide further insight. In this paper, a Bayesian hierarchical framework is proposed that allows estimation of the correlation between time intensity and difficulty at the item level, and between speed and ability at the subject level. The framework is shown to be flexible in that reaction times can follow a (log-) normal or (shifted) Weibull distribution. A simulation study reveals the reduction in bias gains possible when using joint models, and an analysis of an example from a Dutch–English word recognition study illustrates the proposed method.",0 +https://doi.org/10.1007/s11336-009-9136-x,High-dimensional Exploratory Item Factor Analysis by A Metropolis–Hastings Robbins–Monro Algorithm,"A Metropolis–Hastings Robbins–Monro (MH-RM) algorithm for high-dimensional maximum marginal likelihood exploratory item factor analysis is proposed. The sequence of estimates from the MH-RM algorithm converges with probability one to the maximum likelihood solution. Details on the computer implementation of this algorithm are provided. The accuracy of the proposed algorithm is demonstrated with simulations. As an illustration, the proposed algorithm is applied to explore the factor structure underlying a new quality of life scale for children. It is shown that when the dimensionality is high, MH-RM has advantages over existing methods such as numerical quadrature based EM algorithm. Extensions of the algorithm to other modeling frameworks are discussed.",0 +https://doi.org/10.1080/00220973.2014.919569,Standardized Effect Size Measures for Mediation Analysis in Cluster-Randomized Trials,"This article presents 3 standardized effect size measures to use when sharing results of an analysis of mediation of treatment effects for cluster-randomized trials. The authors discuss 3 examples of mediation analysis (upper-level mediation, cross-level mediation, and cross-level mediation with a contextual effect) with demonstration of the calculation and interpretation of the effect size measures using a simulated dataset and an empirical dataset from a cluster-randomized trial of peer tutoring. SAS syntax is provided for parametric percentile bootstrapped confidence intervals of the effect sizes. The use of any of the 3 standardized effect size measures depends on the nature of the inference the researcher wishes to make within a single site, across the broad population, or at the site level.",0 +https://doi.org/10.1111/1467-9868.00220,Latent variable models with mixed continuous and polytomous data,"Owing to the nature of the problems and the design of questionnaires, discrete polytomous data are very common in behavioural, medical and social research. Analysing the relationships between the manifest and the latent variables based on mixed polytomous and continuous data has proven to be difficult. A general structural equation model is investigated for these mixed outcomes. Maximum likelihood (ML) estimates of the unknown thresholds and the structural parameters in the covariance structure are obtained. A Monte Carlo-EM algorithm is implemented to produce the ML estimates. It is shown that closed form solutions can be obtained for the M-step, and estimates of the latent variables are produced as a by-product of the analysis. The method is illustrated with a real example.",0 +https://doi.org/10.1093/ije/dyi069,Covariance components models for longitudinal family data,"A longitudinal family study is an epidemiological design that involves repeated measurements over time in a sample that includes families. Such studies, that may also include relative pairs and unrelated individuals, allow closer investigation of not only the factors that cause a disease to arise, but also the genetic and environmental determinants that modulate the subsequent progression of that disease. Knowledge of such determinants may pay high dividends in terms of prognostic assessment and in the development of new treatments that may be tailored to the prognostic profile of individual patients. Unfortunately longitudinal family studies are difficult to analyse. They conflate the complex within-family correlation structure of a cross-sectional family study with the correlation over time that is intrinsic to longitudinal repeated measures. Here we describe an approach to analysis that is relatively straightforward to implement, yet is flexible in its application. It represents a natural extension of a Gibbs-sampling-based approach to the analysis of cross-sectional family studies that we have described previously. The approach can be applied to pedigrees of arbitrary complexity. It is applicable to continuous traits, repeated binary disease states, and repeated counts or rates with a Poisson distribution. It not only supports the analysis of observed determinants, including measured genotypes, but also allows decomposition of the correlation structure, thereby permitting conclusions to be drawn about the effect of unobserved genes and environment on key features of disease progression, and hence to estimate the heritability of these features. We demonstrate the efficacy of our methods using a range of simulated data analyses, and illustrate its practical application to longitudinal blood pressure data measured in families from the Framingham Heart Study.",0 +https://doi.org/10.1002/sim.782,A closer look at combining data among a small number of binomial experiments,"In a regulatory environment, the regulators and the regulated may not be able to agree on the use of subjective prior information for a clinical trial. The use of a data-based prior offers a greater possibility for agreement, however, the degree of importance given to the prior data may still be contentious. The use of a hierarchical model to link the prior data and the current trial is shown to provide a relatively objective method for assigning weight to the prior data. Using a series of examples combining two binomial experiments, the effect of a hierarchical model on estimating rates, on the degree to which data is combined and on hypothesis testing is illustrated. In addition, the phenomenon in which combining data reduces the precision is explained. Simpler models based on finite mixtures of beta distributions are shown to work as well as the more computationally intensive, continuous mixtures. Lastly, an example combining three concurrent studies is illustrated. Published in 2001 by John Wiley & Sons, Ltd.",0 +https://doi.org/10.1016/j.jkss.2015.01.002,A test for the increasing convex order based on the cumulative residual entropy,"The complete cumulative residual entropy can be generalized to the incomplete cumulative residual entropy (ICRE). In this paper, we introduce a partial ordering in terms of ICRE. The relationship between this ordering and some important orderings of lifetime distributions are investigated. We use this order to establish a test statistic for testing the stochastic equality against increasing convex order alternative. The performance of the test statistic is evaluated using a simulation study. Finally, a numerical example illustrating the theory is also given. © 2015 The Korean Statistical Society.",0 +https://doi.org/10.1007/bf02293813,Contributions to factor analysis of dichotomous variables,"A new method is proposed for the factor analysis of dichotomous variables. Similar to the method of Christoffersson this uses information from the first and second order proportions to fit a multiple factor model. Through a transformation into a new set of sample characteristics, the estimation is considerably simplified. A generalized least-squares estimator is proposed, which asymptotically is as efficient as the corresponding estimator of Christoffersson, but which demands less computing time. © 1978 Psychometric Society.",0 +https://doi.org/10.2202/1544-6115.1175,A Shrinkage Approach to Large-Scale Covariance Matrix Estimation and Implications for Functional Genomics,"Inferring large-scale covariance matrices from sparse genomic data is an ubiquitous problem in bioinformatics. Clearly, the widely used standard covariance and correlation estimators are ill-suited for this purpose. As statistically efficient and computationally fast alternative we propose a novel shrinkage covariance estimator that exploits the Ledoit-Wolf (2003) lemma for analytic calculation of the optimal shrinkage intensity.Subsequently, we apply this improved covariance estimator (which has guaranteed minimum mean squared error, is well-conditioned, and is always positive definite even for small sample sizes) to the problem of inferring large-scale gene association networks. We show that it performs very favorably compared to competing approaches both in simulations as well as in application to real expression data.",0 +https://doi.org/10.1080/10705511.2014.882686,The Impact of Inaccurate “Informative” Priors for Growth Parameters in Bayesian Growth Mixture Modeling,"Within Bayesian estimation, prior distributions are placed on model parameters and these distributions can take on many different levels of informativeness. Although much of the research conducted within this estimation framework uses what are called diffuse (or noninformative) priors, there are certain models and modeling circumstances where it is more optimal to use what are referred to as informative priors. This study focuses on the latter situation and examines the effects of inaccurate informative priors on the growth parameters within the context of growth mixture modeling. Overall, results indicated that growth mixture modeling is relatively robust to the use of inaccurate mean hyperparameters for the growth parameters, as long as the variance hyperparameters are somewhat large.",0 +https://doi.org/10.1177/0956797610372634,Emotional Inertia and Psychological Maladjustment,"In this article, we examine the concept of emotional inertia as a fundamental property of the emotion dynamics that characterize psychological maladjustment. Emotional inertia refers to the degree to which emotional states are resistant to change. Because psychological maladjustment has been associated with both emotional underreactivity and ineffective emotion-regulation skills, we hypothesized that its overall emotion dynamics would be characterized by high levels of inertia. We provide evidence from two naturalistic studies that, using different methods, showed that the emotional fluctuations of individuals who exhibited low self-esteem (Study 1) and depression (Study 2) were characterized by higher levels of inertia in both positive and negative emotions than the emotional fluctuations of people who did not exhibit low self-esteem and depression. We also discuss the usefulness of the concept of emotional inertia as a hallmark of maladaptive emotion dynamics.",0 +https://doi.org/10.1017/s0003055408080398,The Impartiality of International Judges: Evidence from the European Court of Human Rights,"Can international judges be relied upon to resolve disputes impartially? If not, what are the sources of their biases? Answers to these questions are critically important for the functioning of an emerging international judiciary, yet we know remarkably little about international judicial behavior. An analysis of a new dataset of dissents in the European Court of Human Rights (ECtHR) yields a mixed set of answers. On the bright side, there is no evidence that judges systematically employ cultural or geopolitical biases in their rulings. There is some evidence that career insecurities make judges more likely to favor their national government when it is a party to a dispute. Most strongly, the evidence suggests that international judges are policy seekers. Judges vary in their inclination to defer to member states in the implementation of human rights. Moreover, judges from former socialist countries are more likely to find violations against their own government and against other former socialist governments, suggesting that they are motivated by rectifying a particular set of injustices. I conclude that the overall picture is mostly positive for the possibility of impartial review of government behavior by judges on an international court. Like judges on domestic review courts, ECtHR judges are politically motivated actors in the sense that they have policy preferences on how to best apply abstract human rights in concrete cases, not in the sense that they are using their judicial power to settle geopolitical scores.",0 +https://doi.org/10.1207/s15327906mbr3804_5,Have Multilevel Models Been Structural Equation Models All Along?,"A core assumption of the standard multiple regression model is independence of residuals, the violation of which results in biased standard errors and test statistics. The structural equation model (SEM) generalizes the regression model in several key ways, but the SEM also assumes independence of residuals. The multilevel model (MLM) was developed to extend the regression model to dependent data structures. Attempts have been made to extend the SEM in similar ways, but several complications currently limit the general application of these techniques in practice. Interestingly, it is well known that under a broad set of conditions SEM and MLM longitudinal ""growth curve"" models are analytically and empirically identical. This is intriguing given the clear violation of independence in growth modeling that does not detrimentally affect the standard SEM. Better understanding the source and potential implications of this isomorphism is my focus here. I begin by exploring why SEM and MLM are analytically equivalent methods in the presence of nesting due to repeated observations over time. I then capitalize on this equivalency to allow for the extension of SEMs to a general class of nested data structures. I conclude with a description of potential opportunities for multilevel SEMs and directions for future developments.",0 +https://doi.org/10.1002/sim.6573,A Bayesian approach to estimating causal vaccine effects on binary post-infection outcomes,"To estimate causal effects of vaccine on post-infection outcomes, Hudgens and Halloran (2006) defined a post-infection causal vaccine efficacy estimand VEI based on the principal stratification framework. They also derived closed forms for the maximum likelihood estimators of the causal estimand under some assumptions. Extending their research, we propose a Bayesian approach to estimating the causal vaccine effects on binary post-infection outcomes. The identifiability of the causal vaccine effect VEI is discussed under different assumptions on selection bias. The performance of the proposed Bayesian method is compared with the maximum likelihood method through simulation studies and two case studies - a clinical trial of a rotavirus vaccine candidate and a field study of pertussis vaccination. For both case studies, the Bayesian approach provided similar inference as the frequentist analysis. However, simulation studies with small sample sizes suggest that the Bayesian approach provides smaller bias and shorter confidence interval length.",0 +https://doi.org/10.1198/000313001300339950,Calibration ofρValues for Testing Precise Null Hypotheses,"P values are the most commonly used tool to measure evidence against a hypothesis or hypothesized model. Unfortunately, they are often incorrectly viewed as an error probability for rejection of the hypothesis or, even worse, as the posterior probability that the hypothesis is true. The fact that these interpretations can be completely misleading when testing precise hypotheses is first reviewed, through consideration of two revealing simulations. Then two calibrations of a ρ value are developed, the first being interpretable as odds and the second as either a (conditional) frequentist error probability or as the posterior probability of the hypothesis.",0 +https://doi.org/10.3758/bf03201182,Similarity comparisons with remembered and perceived magnitudes: Memory psychophysics and fundamental measurement,"At the outset, subjects learned to associate a label with each element in a set of perceptual magnitudes (visual extents), using traditional paired-associate learning methods. Subsequently, on some trials, subjects indicated which pair of two pairs of labels corresponded to the more similar perceptual referents, and, on other trials, they selected the more dissimilar pair. It is shown that these similarity comparisons satisfy the axioms (transitivity and intradimensional subtractivity) necessary to conclude that they are based on computation of the difference of the differences of analogue-based interval scale representations. The findings also permitted refutation of the idea that memory for elementary percepts arises from their reperception. Notably, the memory exponent was 0.697, but the perception exponent was 0.546, and the reperception idea requires that the memory exponent be the square of the perception exponent (0.546(2) = 0.298). Symbolic distance effects and enhanced response time-based semantic congruity effects, typically found with binary comparisons, extend the range of commonalties found between perceptual and memory psychophysics.",0 +https://doi.org/10.4135/9781446247600.n4,Bayesian Multilevel Models,,0 +https://doi.org/10.21236/ada640705,How Many Iterations in the Gibbs Sampler?,"Abstract : When the Gibbs sampler is used to estimate posterior distributions (Gelfand and Smith, 1990) the question of how many iterations are required is central to its implementation. When interest focuses on quantiles of functionals of the posterior distribution, we describe an easily-implemented method for determining the total number of iterations required, and also the number of initial iterations that should be discarded to allow for burn-in. The method uses only the Gibbs iterates themselves, and does not, for example, require external specification of characteristics of the posterior density. Here the method is described for the situation where one long run is generated, but it can also be easily applied if there are several runs from different starting points. It also applies more generally to Markov chain Monte Carlo schemes other than the quantities of interest are probabilities rather than full posterior distributions, and when the draws from the posterior distribution are required to be approximately independent. The method is applied to several different posterior distributions. These include a multivariate normal posterior distribution with independent parameters, a bimodal distribution, a cigar-shaped multivariate normal distribution in ten dimensions, and a highly complex 190-dimensional posterior distribution arising in spatial statistics. In each case the method appears to give satisfactory results.",0 +https://doi.org/10.1007/bf02294828,A general model for two-level data with responses missing at random,"A general model for two-level multivariate data, with responses possibly missing at random, is described. The model combines regressions on fixed explanatory variables with structured residual covariance matrices. The likelihood function is reduced to a form enabling computational methods for estimating the model to be devised. © 1993 The Psychometric Society.",0 +https://doi.org/10.1080/10543406.2013.863780,A Comparison of Confidence Interval Methods for the Concordance Correlation Coefficient and Intraclass Correlation Coefficient with Small Number of Raters,"The intraclass correlation coefficient (ICC) with fixed raters or, equivalently, the concordance correlation coefficient (CCC) for continuous outcomes is a widely accepted aggregate index of agreement in settings with small number of raters. Quantifying the precision of the CCC by constructing its confidence interval (CI) is important in early drug development applications, in particular in qualification of biomarker platforms. In recent years, there have been several new methods proposed for construction of CIs for the CCC, but their comprehensive comparison has not been attempted. The methods consisted of the delta method and jackknifing with and without Fisher's Z-transformation, respectively, and Bayesian methods with vague priors. In this study, we carried out a simulation study, with data simulated from multivariate normal as well as heavier tailed distribution (t-distribution with 5 degrees of freedom), to compare the state-of-the-art methods for assigning CI to the CCC. When the data are normally distributed, the jackknifing with Fisher's Z-transformation (JZ) tended to provide superior coverage and the difference between it and the closest competitor, the Bayesian method with the Jeffreys prior was in general minimal. For the nonnormal data, the jackknife methods, especially the JZ method, provided the coverage probabilities closest to the nominal in contrast to the others which yielded overly liberal coverage. Approaches based upon the delta method and Bayesian method with conjugate prior generally provided slightly narrower intervals and larger lower bounds than others, though this was offset by their poor coverage. Finally, we illustrated the utility of the CIs for the CCC in an example of a wake after sleep onset (WASO) biomarker, which is frequently used in clinical sleep studies of drugs for treatment of insomnia.",0 +https://doi.org/10.1016/s0065-2660(07)00413-0,Meta‐Analysis Methods,"Meta-analysis is the quantitative synthesis of information from several studies. It is applicable to a variety of study designs in genetics, from family-based linkage studies and population-based association studies to genome-wide scans and genome-wide association studies. By combining relevant evidence from many studies, statistical power is increased and more precise estimates may be obtained. Most importantly, meta-analysis provides a framework for the appreciation and assessment of between-study heterogeneity, that is, the methodological, epidemiological, clinical, and biological dissimilarity across the various studies. Being a retrospective research design in most cases, meta-analysis is subject to a variety of selection biases that may undermine its validity. A major challenge is to differentiate genuine between-study heterogeneity from systematic errors and biases.",0 +https://doi.org/10.1080/01621459.1994.10476828,Toward a Reconciliation of the Bayesian and Frequentist Approaches to Point Estimation,"Abstract The Bayesian and frequentist approaches to point estimation are reviewed. The status of the debate regarding the use of one approach over the other is discussed, and its inconclusive character is noted. A criterion for comparing Bayesian and frequentist estimators within a given experimental framework is proposed. The competition between a Bayesian and a frequentist is viewed as a contest with the following components: a random observable, a true prior distribution unknown to both statisticians, an operational prior used by the Bayesian, a fixed frequentist rule used by the frequentist, and a fixed loss criterion. This competition is studied in the context of exponential families, conjugate priors, and squared error loss. The class of operational priors that yield Bayes estimators superior to the “best” frequentist estimator is characterized. The implications of the existence of a threshold separating the space of operational priors into good and bad priors are explored, and their relevance in ar...",0 +https://doi.org/10.1002/9780470024737,Structural Equation Modeling,"Structural equation modeling , Structural equation modeling , کتابخانه دیجیتال جندی شاپور اهواز",0 +https://doi.org/10.1016/j.tranpol.2015.07.001,Gender differences in activity and travel behavior in the Arab world,"Abstract The purpose of this study is to extend the research on gendered differences in travel patterns in the Arab world by an in-depth study of the interrelationship of travel-related activities and various socio-economic and demographic characteristics. This study is based on a unique data set that includes activity and travel diaries collected from three Arab communities in the Galilee region of Israel. Through descriptive statistics and nonlinear structural equations modeling, we found that gender plays an important role in both activity participation and travel behavior in these communities. Women tend to travel less than men in terms of both number of tours, defined as chain of trip segments that start and end at home, trips, and total time spent traveling. Women tend to work more within their communities and to conduct more of their activities by walking; they are also the ones who make more child-serving stops, which affect their travel patterns. Women tend to travel by car more as passengers, whereas men tend to be drivers. Those who made more tours also tended to make more complex tours, with more stops per tour, although, in general, complex tours are not substituted for making additional tours. People who work outside the community and make complex tours are more likely to drive, as the car is needed for these types of trips, which men make more than women. From a policy perspective, these findings suggest that public transportation services are needed to help overcome gender differences in travel behavior. Improving transit service for school trips and improving urban design through a friendlier environment, especially for children, will beneficially affect the complexity of women’s daily activity patterns and their quality of life.",0 +https://doi.org/10.1287/opre.31.6.1109,Simulation Run Length Control in the Presence of an Initial Transient,"This paper studies the estimation of the steady state mean of an output sequence from a discrete event simulation. It considers the problem of the automatic generation of a confidence interval of prespecified width when there is an initial transient present. It explores a procedure based on Schruben's Brownian bridge model for the detection of nonstationarity and a spectral method for estimating the variance of the sample mean. The procedure is evaluated empirically for a variety of output sequences. The performance measures considered are bias, confidence interval coverage, mean confidence interval width, mean run length, and mean amount of deleted data. If the output sequence contains a strong transient, then inclusion of a test for stationarity in the run length control procedure results in point estimates with lower bias, narrower confidence intervals, and shorter run lengths than when no check for stationarity is performed. If the output sequence contains no initial transient, then the performance measures of the procedure with a stationarity test are only slightly degraded from those of the procedure without such a test. If the run length is short relative to the extent of the initial transient, the stationarity tests may not be powerful enough to detect the transient, resulting in a procedure with unreliable point and interval estimates.",0 +https://doi.org/10.1080/00273171.2015.1093459,Moving in Parallel Toward a Modern Modeling Epistemology: Bayes Factors and Frequentist Modeling Methods,"The Bayesian-frequentist debate typically portrays these statistical perspectives as opposing views. However, both Bayesian and frequentist statisticians have expanded their epistemological basis away from a singular focus on the null hypothesis, to a broader perspective involving the development and comparison of competing statistical/mathematical models. For frequentists, statistical developments such as structural equation modeling and multilevel modeling have facilitated this transition. For Bayesians, the Bayes factor has facilitated this transition. The Bayes factor is treated in articles within this issue of Multivariate Behavioral Research. The current presentation provides brief commentary on those articles and more extended discussion of the transition toward a modern modeling epistemology. In certain respects, Bayesians and frequentists share common goals.",0 +https://doi.org/10.1016/j.sste.2011.07.001,Space-time confounding adjusted determinants of child HIV/TB mortality for large zero-inflated data in rural South Africa,"South Africa is experiencing a major burden of HIV/TB. We used longitudinal data from the Agincourt sub-district in rural northeast South Africa over the years 2000 to 2005. A total of 187 HIV/TB deaths were observed among 16,844 children aged 1-5 years coming from 8,863 households. In this paper we used Bayesian models to assess risk factors for child HIV/TB mortality taking into account the presence of spatial correlation. Bayesian zero inflated spatiotemporal models were able to detect hidden patterns within the data. Our main finding was that maternal orphans experienced a threefold greater risk of HIV/TB death compared to those with living mothers (AHR=2.93, 95% CI[1.29;6.93]). Risk factor analyses which adjust for person, place and time provide evidence for policy makers that includes a spatial distribution of risk. Child survival is dependent on the mother's survival; hence programs that promote maternal survival are critical.",0 +https://doi.org/10.1177/1043463114523715,Reciprocity and volunteering,"This paper evaluates whether volunteering is imbued with altruistic or strategic reciprocity. Although scholars have intensively studied the motivations and social norms to volunteer, to date there is no agreement why human beings perform activities in which time is freely given up in order to benefit another person, group or organization. We argue that attitudes towards reciprocity and volunteering are related, but that this relationship becomes only visible if we refine the conceptual framework for both concepts. Using data from the Swiss Volunteering Survey 2009, the empirical results of our Bayesian multilevel models show the following: firstly, individuals exhibiting high levels of altruistic reciprocity are more likely to engage in informal volunteering; secondly, we find a negative relationship between altruist reciprocity and the individual likeliness to do voluntary work within non-solidary associations; thirdly, once individuals opted to engage in formal volunteering, we find that strategic reciprocity is clearly related to voluntary engagement in non-solidary associations. Overall, our conceptual foundation provides a more appropriate model to explain the formation of volunteering.",0 +,Estimating population kinetics.,"This paper will review the methods that have been advanced for the estimation of parameters of models quantifying the population characteristics of the kinetic behavior of endogenous and exogenous substances in individuals of the population. Such methods are used frequently, for example, in pharmacokinetic studies. In certain populations, especially biological ones, considerable kinetic variability between population members is present. The models with which we are concerned describe this variability. Some interindividual kinetic variability may be explainable on the basis of measureable concomitant variables, but much of it may remain unexplainable on such a basis. We give this matter particular attention. The assumptions underlying the models are critically discussed.",0 +https://doi.org/10.1002/bimj.200900130,A Hierarchical Model to Estimate Fish Abundance in Alpine Streams by using Removal Sampling Data from Multiple Locations,"The author compares 12 hierarchical models in the aim of estimating the abundance of fish in alpine streams by using removal sampling data collected at multiple locations. The most expanded model accounts for (i) variability of the abundance among locations, (ii) variability of the catchability among locations, and (iii) residual variability of the catchability among fish. Eleven model reductions are considered depending which variability is included in the model. The more restrictive model considers none of the aforementioned variabilities. Computations of the latter model can be achieved by using the algorithm presented by Carle and Strub (Biometrics 1978, 34, 621–630). Maximum a posteriori and interval estimates of the parameters as well as the Akaike and the Bayesian information criterions of model fit are computed by using samples simulated by a Markov chain Monte Carlo method. The models are compared by using a trout (Salmo trutta fario) parr (0+) removal sampling data set collected at three locations in the Pyrénées mountain range (Haute-Garonne, France) in July 2006. Results suggest that, in this case study, variability of the catchability is not significant, either among fish or locations. Variability of the abundance among locations is significant. 95% interval estimates of the abundances at the three locations are [0.15, 0.24], [0.26, 0.36], and [0.45, 0.58] parrs per m2. Such differences are likely the consequence of habitat variability.",0 +https://doi.org/10.3758/brm.42.3.884,Bayesian inference using WBDev: A tutorial for social scientists,"Over the last decade, the popularity of Bayesian data analysis in the empirical sciences has greatly increased. This is partly due to the availability of WinBUGS, a free and flexible statistical software package that comes with an array of predefined functions and distributions, allowing users to build complex models with ease. For many applications in the psychological sciences, however, it is highly desirable to be able to define one's own distributions and functions. This functionality is available through the WinBUGS Development Interface (WBDev). This tutorial illustrates the use of WBDev by means of concrete examples, featuring the expectancy-valence model for risky behavior in decision making, and the shifted Wald distribution of response times in speeded choice.",0 +https://doi.org/10.2307/2531734,Models for Longitudinal Data: A Generalized Estimating Equation Approach,"This article discusses extensions of generalized linear models for the analysis of longitudinal data. Two approaches are considered: subject-specific (SS) models in which heterogeneity in regression parameters is explicitly modelled; and population-averaged (PA) models in which the aggregate response for the population is the focus. We use a generalized estimating equation approach to fit both classes of models for discrete and continuous outcomes. When the subject-specific parameters are assumed to follow a Gaussian distribution, simple relationships between the PA and SS parameters are available. The methods are illustrated with an analysis of data on mother's smoking and children's respiratory disease.",0 +https://doi.org/10.1177/00131649921969811,Validity Issues in the Likert and Thurstone Approaches to Attitude Measurement,"This article highlights the theoretical differences between the Likert and Thurstone approaches to attitude measurement and demonstrates how such differences can lead to discrepant attitude estimates for individuals with the most extreme opinions. Both simulated data and real data on attitude toward abortion are used to demonstrate this discrepancy. The results suggest that attitude researchers should, at the very least, devote more attention to the empirical response characteristics of items on a Likert attitude questionnaire. At most, these results suggest that other methods, such as the Thurstone technique or one of its recently developed item response theory counterparts, should be used to derive attitude estimates from disagree-agree responses.",0 +https://doi.org/10.1007/s00221-015-4501-8,"Determining thresholds using adaptive procedures and psychometric fits: evaluating efficiency using theory, simulations, and human experiments","When measuring thresholds, careful selection of stimulus amplitude can increase efficiency by increasing the precision of psychometric fit parameters (e.g., decreasing the fit parameter error bars). To find efficient adaptive algorithms for psychometric threshold (""sigma"") estimation, we combined analytic approaches, Monte Carlo simulations, and human experiments for a one-interval, binary forced-choice, direction-recognition task. To our knowledge, this is the first time analytic results have been combined and compared with either simulation or human results. Human performance was consistent with theory and not significantly different from simulation predictions. Our analytic approach provides a bound on efficiency, which we compared against the efficiency of standard staircase algorithms, a modified staircase algorithm with asymmetric step sizes, and a maximum likelihood estimation (MLE) procedure. Simulation results suggest that optimal efficiency at determining threshold is provided by the MLE procedure targeting a fraction correct level of 0.92, an asymmetric 4-down, 1-up staircase targeting between 0.86 and 0.92 or a standard 6-down, 1-up staircase. Psychometric test efficiency, computed by comparing simulation and analytic results, was between 41 and 58% for 50 trials for these three algorithms, reaching up to 84% for 200 trials. These approaches were 13-21% more efficient than the commonly used 3-down, 1-up symmetric staircase. We also applied recent advances to reduce accuracy errors using a bias-reduced fitting approach. Taken together, the results lend confidence that the assumptions underlying each approach are reasonable and that human threshold forced-choice decision making is modeled well by detection theory models and mimics simulations based on detection theory models.",0 +https://doi.org/10.1016/j.jempfin.2014.09.006,An empirical Bayesian approach to stein-optimal covariance matrix estimation,"This paper proposes a conjugate Bayesian regression model to estimate the covariance matrix of a large number of securities. Characterizing the return generating process with an unrestricted factor model, prior beliefs impose structure while preserving estimator consistency. This framework accommodates economically-motivated prior beliefs and nests shrinkage covariance matrix estimators, providing a common model for their interpretation. Minimizing posterior finite-sample square error delivers a fully-automated covariance matrix estimator with beliefs that become diffuse as the sample grows relative to the dimension of the problem. In application, this Stein-optimal posterior covariance matrix performs well in a large set of simulation experiments.",0 +https://doi.org/10.1109/jbhi.2016.2532354,Driver Fatigue Classification With Independent Component by Entropy Rate Bound Minimization Analysis in an EEG-Based System,"This paper presents a two-class electroencephal-ography-based classification for classifying of driver fatigue (fatigue state versus alert state) from 43 healthy participants. The system uses independent component by entropy rate bound minimization analysis (ERBM-ICA) for the source separation, autoregressive (AR) modeling for the features extraction, and Bayesian neural network for the classification algorithm. The classification results demonstrate a sensitivity of 89.7%, a specificity of 86.8%, and an accuracy of 88.2%. The combination of ERBM-ICA (source separator), AR (feature extractor), and Bayesian neural network (classifier) provides the best outcome with a p-value < 0.05 with the highest value of area under the receiver operating curve (AUC-ROC = 0.93) against other methods such as power spectral density as feature extractor (AUC-ROC = 0.81). The results of this study suggest the method could be utilized effectively for a countermeasure device for driver fatigue identification and other adverse event applications.",0 +https://doi.org/10.1080/01621459.1975.10479864,Data Analysis Using Stein's Estimator and its Generalizations,"Abstract In 1961, James and Stein exhibited an estimator of the mean of a multivariate normal distribution having uniformly lower mean squared error than the sample mean. This estimator is reviewed briefly in an empirical Bayes context. Stein's rule and its generalizations are then applied to predict baseball averages, to estimate toxomosis prevalence rates, and to estimate the exact size of Pearson's chi-square test with results from a computer simulation. In each of these examples, the mean square error of these rules is less than half that of the sample mean.",0 +https://doi.org/10.1093/esr/jcs059,Positive or Negative Policy Feedbacks? Explaining Popular Attitudes Towards Pragmatic Pension Policy Reforms,"Recent decades have seen increased interest in public attitudes towards public pension policies. Most previous research, however, relies heavily on dependent variables that fail to reflect the effective alternatives being discussed in most affluent democracies. This article seeks to improve our understanding of public attitudes towards pragmatic welfare policy options by examining cross-national differences in attitudes towards (i) cuts in old-age pension benefits, (ii) increases in social security contributions, and (iii) increases in the statutory retirement age. We test predictions of the dominant positive policy feedback theory and the alternative negative policy feedback theory. These approaches argue that policies induce consequences and attitudes that reinforce (positive feedback) or undermine (negative feedback) past policymaking trajectories. Empirical results obtained by multilevel analyses from a sample of 27 European countries are consistent mainly with the negative feedback approach. In countries with higher statutory retirement ages, citizens are more likely to support a postponement of retirement. However, in countries with higher elderly poverty, citizens are less likely to support cuts in pension benefits. In countries with higher social security contributions, citizens are less likely to support further increases in these contributions. © The Author 2012.",0 +https://doi.org/10.1186/1471-2458-13-300,Weight gain prevention in young adults: design of the study of novel approaches to weight gain prevention (SNAP) randomized controlled trial,"Weight gain during young adulthood is common and is associated with increased cardiovascular risk. Preventing this weight gain from occurring may be critical to improving long-term health. Few studies have focused on weight gain prevention, and these studies have had limited success. SNAP (Study of Novel Approaches to Weight Gain Prevention) is an NIH-funded randomized clinical trial examining the efficacy of two novel self-regulation approaches to weight gain prevention in young adults compared to a minimal treatment control. The interventions focus on either small, consistent changes in eating and exercise behaviors, or larger, periodic changes to buffer against expected weight gains.SNAP targets recruitment of six hundred young adults (18-35 years) with a body mass index between 21.0-30.0 kg/m2, who will be randomly assigned with equal probability to: (1) minimal intervention control; (2) self-regulation with Small Changes; or (3) self-regulation with Large Changes. Both interventions receive 8 weekly face-to-face group sessions, followed by 2 monthly sessions, with two 4-week refresher courses in each of subsequent years. Participants are instructed to report weight via web at least monthly thereafter, and receive monthly email feedback. Participants in Small Changes are taught to make small daily changes (~100 calorie changes) in how much or what they eat and to accumulate 2000 additional steps per day. Participants in Large Changes are taught to create a weight loss buffer of 5-10 pounds once per year to protect against anticipated weight gains. Both groups are encouraged to self-weigh daily and taught a self-regulation color zone system that specifies action depending on weight gain prevention success. Individualized treatment contact is offered to participants who report weight gains. Participants are assessed at baseline, 4 months, and then annually. The primary outcome is weight gain over an average of 3 years of follow-up; secondary outcomes include diet and physical activity behaviors, psychosocial measures, and cardiovascular disease risk factors.SNAP is unique in its focus on weight gain prevention in young adulthood. The trial will provide important information about whether either or both of these novel interventions are effective in preventing weight gain.ClinicalTrials.gov, NCT01183689.",0 +https://doi.org/10.1177/0272989x08324036,Integration of Meta-analysis and Economic Decision Modeling for Evaluating Diagnostic Tests,"Meta-analysis of diagnostic test accuracy data is more difficult than of effectiveness data because of 1) statistical challenges of dealing with multiple measures of accuracy (e.g., sensitivity and specificity) simultaneously and 2) incorporating threshold effects. A number of meta-analysis models are in use, ranging from naïve synthesis of independent sensitivity and specificity to optimization of a hierarchical summary receiver operating characteristic (SROC) curve. Little work has been done on how such analyses should inform decision models. This article aims to present a unified framework for the synthesis of primary data and economic evaluation of alternative diagnostic testing strategies using Bayesian Markov Chain Monte Carlo simulation methods. The authors extend this previous work by using systematic review to derive model parameters, fully allowing for uncertainty in their estimation, and formally incorporating variability between study results into the decision analysis. Using a simple decision model comparing alternative testing strategies for suspected deep vein thrombosis as an example, the authors consider how to use outputs of different alternative meta-analysis models in decision models. They also explore the limitations of diagnostic test studies, particularly when there is no obvious threshold value. To correct some of the limitations of diagnostic test studies, they propose that tests with implicit and explicit thresholds should be studied using distinctly different frameworks. Specifically, when a threshold exists, quantitative threshold information should be included in meta-analysis models to aid interpretation of SROCs. Setting policy to relate to a specific point may be much more difficult for studies with implicit thresholds.",0 +https://doi.org/10.1080/10543406.2011.607736,The Bootstrap and Markov-Chain Monte Carlo,"This note concerns the use of parametric bootstrap sampling to carry out Bayesian inference calculations. This is only possible in a subset of those problems amenable to Markov-Chain Monte Carlo (MCMC) analysis, but when feasible the bootstrap approach offers both computational and theoretical advantages. The discussion here is in terms of a simple example, with no attempt at a general analysis.",0 +https://doi.org/10.1080/10705511.2012.634703,Using SEM to Analyze Complex Survey Data: A Comparison between Design-Based Single-Level and Model-Based Multilevel Approaches,"Both ad-hoc robust sandwich standard error estimators (design-based approach) and multilevel analysis (model-based approach) are commonly used for analyzing complex survey data with nonindependent observations. Although these 2 approaches perform equally well on analyzing complex survey data with equal between- and within-level model structures (B. O. Muthen & Satorra, 1995), the performances of these 2 approaches for analyzing multilevel data with unequal between- and within-level structures have not yet been systematically examined. In this study, we extended B. O. Muthen and Satorra's (1995) study by comparing these 2 approaches and an additional model-based maximum model for analyzing multilevel data considering number of clusters, cluster size, intraclass correlation, and the equality of different level structures. The simulation results showed the model-based maximum model generally performed well across conditions. This model is also recommended as an alternative for analyzing nonindependent survey...",0 +https://doi.org/10.1080/00273171.2012.640596,Explanation of Two Anomalous Results in Statistical Mediation Analysis,"Previous studies of different methods of testing mediation models have consistently found two anomalous results. The first result is elevated Type I error rates for the bias-corrected and accelerated bias-corrected bootstrap tests not found in nonresampling tests or in resampling tests that did not include a bias correction. This is of special concern as the bias-corrected bootstrap is often recommended and used due to its higher statistical power compared with other tests. The second result is statistical power reaching an asymptote far below 1.0 and in some conditions even declining slightly as the size of the relationship between X and M, a, increased. Two computer simulations were conducted to examine these findings in greater detail. Results from the first simulation found that the increased Type I error rates for the bias-corrected and accelerated bias-corrected bootstrap are a function of an interaction between the size of the individual paths making up the mediated effect and the sample size, such that elevated Type I error rates occur when the sample size is small and the effect size of the nonzero path is medium or larger. Results from the second simulation found that stagnation and decreases in statistical power as a function of the effect size of the a path occurred primarily when the path between M and Y, b, was small. Two empirical mediation examples are provided using data from a steroid prevention and health promotion program aimed at high school football players (Athletes Training and Learning to Avoid Steroids; Goldberg et al., 1996), one to illustrate a possible Type I error for the bias-corrected bootstrap test and a second to illustrate a loss in power related to the size of a. Implications of these findings are discussed.",0 +https://doi.org/10.1177/014662169301700307,A Hyperbolic Cosine Latent Trait Model For Unfolding Dichotomous Single-Stimulus Responses,"Social-psychological variables are typically measured using either cumulative or unfolding response processes. In the former, the greater the location of a person relative to the location of a stimulus on the continuum, the greater the proba bility of a positive response; in the latter, the closer the location of the person to the location of the statement, irrespective of direction, the greater the probability of a positive response. Formal probability models for these processes are, respec tively, monotonically increasing and single-peaked as a function of the location of the person relative to the location of the statement. In general, these models have been considered to be independent of each other. However, if statements constructed on the basis of a cumulative model have three ordered response categories, the response function within the statement for the middle category is in fact single-peaked. Using this observation, a unidimen sional model for responses to statements that have an unfolding structure was constructed from the cumulative Rasch model for ordered response categories. A location and unit of measurement parameter exist for each statement. A joint maxi mum likelihood estimation procedure was inves tigated. Analysis of a small simulation study and a small real dataset showed that the model is readily applicable.",0 +https://doi.org/10.3758/bf03192841,Analyzing individual differences in sentence processing performance using multilevel models,"The use of multilevel models is increasingly common in the behavioral sciences for analyzing hierarchically structured data, including repeated measures data. These models are flexible and easily implemented via a variety of commercially available statistical software programs. We consider their application in the context of an eye-movement experiment testing readers' responses to a semantic plausibility manipulation in temporarily ambiguous sentences. Multilevel models were used to study the relationship between working memory capacity and the extent to which readers were disrupted by syntactic misanalysis. This represented a cross-level interaction between an individual difference measure and a sentence-level characteristic. We compare a multilevel modeling approach to a standard approach based on ANOVA.",0 +https://doi.org/10.1348/000711005x38951,Multilevel IRT using dichotomous and polytomous response data,"A structural multilevel model is presented where some of the variables cannot be observed directly but are measured using tests or questionnaires. Observed dichotomous or ordinal polytomous response data serve to measure the latent variables using an item response theory model. The latent variables can be defined at any level of the multilevel model. A Bayesian procedure Markov chain Monte Carlo (MCMC), to estimate all parameters simultaneously is presented. It is shown that certain model checks and model comparisons can be done using the MCMC output. The techniques are illustrated using a simulation study and an application involving students' achievements on a mathematics test and test results regarding management characteristics of teachers and principles.",0 +https://doi.org/10.1177/1094428108327450,Testing Multilevel Mediation Using Hierarchical Linear Models,"Testing multilevel mediation using hierarchical linear modeling (HLM) has gained tremendous popularity in recent years. However, potential confounding in multilevel mediation effect estimates can arise in these models when within-group effects differ from between-group effects. This study summarizes three types of HLM-based multilevel mediation models, and then explains that in two types of these models confounding can be produced and erroneous conclusions may be derived when using popularly recommended procedures. A Monte Carlo simulation study illustrates that these procedures can underestimate or overestimate true mediation effects. Recommendations are provided for appropriately testing multilevel mediation and for differentiating within-group versus between-group effects in multilevel settings.",0 +https://doi.org/10.1111/rssc.12096,A Bayesian approach for the analysis of triadic data in cognitive social structures,Summary The paper proposes a fully Bayesian approach for the analysis of triadic data in social networks. Inference is based on Markov chain Monte Carlo methods as implemented in the software package WinBUGS. We apply the methodology to two data sets to highlight the ease with which cognitive social structures can be analysed.,0 +https://doi.org/10.1016/j.neurobiolaging.2008.04.004,Establishing short-term prognosis in Frontotemporal Lobar Degeneration spectrum: Role of genetic background and clinical phenotype,"Establishing the short-term prognosis in Frontotemporal Lobar Degeneration (FTLD) is a clinical challenge for defining disease outcomes and monitoring therapeutic interventions. No reliable neuropsychological assessment balancing all FTLD aspects is available yet, thus no clear-cut follow-up study has been performed.To evaluate the rate of progression and the predictors of worsening in FTLD patients.One-hundred twenty-seven FTLD patients entered the study and were re-evaluated at 1-year follow-up. A statistical driven approach on wide neuropsychological, behavioral, and functional data was applied to identify homogeneous groups both at baseline and at follow-up within FTLD. Three set of predictors on disease progression were considered: (i) the demographic characteristics, (ii) the genetic background, i.e. Apolipoprotein E (APOE) genotype, Tau haplotype, and functional polymorphisms affecting serotonin and dopamine pathways, and (iii) the clinical phenotype.Among FTLD, two groups of patients were recognized on the basis of the overall assessment, thus termed for different disease severity as ""good performers"" and ""bad performers"". At 1-year follow-up, almost 30% of FTLD patients progressed from ""good"" to ""bad"" performances, whilst 70% maintained stable ""good"" performances. APOE varepsilon4 allele, Tau H2 haplotype and behavioral variant FTD phenotype were associated with worse prognosis over time.This preliminary study proposed genetic and clinical predictors in FTLD progression. The identification of disease-modifying predictors of prognosis opens a new avenue in studying FTLD, and may contribute to define outcomes and to monitor pharmacological targets.",0 +https://doi.org/10.1177/0146621603027004004,Further Investigation of the Performance of S - X2: An Item Fit Index for Use With Dichotomous Item Response Theory Models,"This study presents new findings on the utility of S - X 2 as an item fit index for dichotomous item response theory models. Results are based on a simulation study in which item responses were generated and calibrated for 100 tests under each of 27 conditions. The item fit indices S - X 2 and Q 1 - X 2 were calculated for each item. ROC curves were constructed based on the hit and false alarm rates of the two indices. Examination of these curves indicated that in general, the performance of S - X 2 improved with test length and sample size. The performance of S - X 2 was superior to that of Q 1 - X 2 under most but not all conditions. Results from this study imply that S - X 2 may be a useful tool in detecting the misfit of one item contained in an otherwise well-fitted test, lending additional support to the utility of the index for use with dichotomous item response theory models. Index Terms: item response theory, S - X 2 , Q 1 - X, model = data fit, item fit index.",0 +https://doi.org/10.1016/j.adolescence.2015.08.009,Does body satisfaction influence self‐esteem in adolescents' daily lives? An experience sampling study,"This study examined, within the context of the Contingencies of Self-Worth model, state-based associations between self-esteem and body satisfaction using the experience sampling method. One hundred and forty-four adolescent girls (mean age = 14.28 years) completed up to 6 assessments per day for one week using Palm Digital Assistants, in addition to baseline measures of trait body satisfaction and self-esteem. Results showed considerable variation in both state-based constructs within days, and evidence of effects of body satisfaction on self-esteem, but not vice versa. Although these state-based associations were small in size and weakened as the time lag between assessments increased for the sample as a whole, individual differences in the magnitude of these effects were observed and predicted by trait self-esteem and body satisfaction. Collectively, these findings offer support for key tenets of the Contingencies of Self-Worth model.",0 +https://doi.org/10.1093/europace/euq450,"Mixed treatment comparison of dronedarone, amiodarone, sotalol, flecainide, and propafenone, for the management of atrial fibrillation","Mixed treatment comparisons (MTC) were performed to assess the relative efficacy and tolerability of the main anti-arrhythmic drugs used for the treatment of atrial fibrillation (AF)/flutter.Electronic databases were systematically searched to identify randomized controlled trials (RCTs) examining amiodarone, dronedarone, flecainide, propafenone, sotalol, or placebo for the treatment of AF. Thirty-nine RCTs met inclusion criteria and were combined using MTC models to provide direct and indirect comparisons in a single analysis. Results are presented vs. placebo. Amiodarone had the largest effect in reducing AF recurrence (OR 0.22, 95% CI 0.16-0.29). Amiodarone was associated with the highest rate of patients experiencing at least one serious adverse event (OR 2.41, 95% CI 0.96-6.06) and treatment withdrawals due to adverse events (OR 2.91, 95% CI 1.66-5.11). Dronedarone was associated with the lowest rate of proarrhythmic events including bradycardia (OR 1.45, 95% CI 1.02-2.08). Dronedarone significantly reduced the risk of stroke (OR 0.69, 95% CI 0.57-0.84). Trends towards increased mortality for sotalol (OR 3.44, 95% CI 1.02-11.59) and amiodarone (OR 2.17, 95% CI 0.63-7.51) were found, which were stronger when small studies randomizing <100 subjects per group were excluded.Amiodarone has been demonstrated to be the most effective drug in maintaining sinus rhythm. Differences in outcomes between the anti-antiarrhythmic drugs were reported, with sotalol and possibly amiodarone increasing mortality and dronedarone possibly decreasing the incidence of serious adverse events and proarrhythmia.",0 +https://doi.org/10.1198/000313005x20727,Randomization of Clusters Versus Randomization of Persons Within Clusters,"Many experiments aim at populations with persons nested within clusters. Randomization to treatment conditions can be done at the cluster level or at the person level within each cluster. The latter may result in control group contamination, and cluster randomization is therefore often preferred in practice. This article models the control group contamination, calculates the required sample sizes for both levels of randomization, and gives the degree of contamination for which cluster randomization is preferable above randomization of persons within clusters. Moreover, it provides examples of situations where one has to make a choice between both levels of randomization.",0 +https://doi.org/10.1016/s0042-6989(02)00118-9,Recognizing spatial patterns: a noisy exemplar approach,"Models of categorization typically rely on the use of stimuli composed of well-defined dimensions (e.g., Ashby & Maddox (1998) in Choice , decision , and measurement: Essays in honor of R. Duncan Luce , p. 251–301, Mahwah, NJ: Erlbaum). We apply a similar approach to the analysis of recognition memory. Using a version of short-term recognition paradigm (Sternberg, Science 153 (1966) 652), we asked whether NEMO Sternberg's, a noisy exemplar summed-similarity model, could account for variation in mean performance on individual trials. NEMO provided a very good overall fit to recognition data from three experiments. However, its failure to fit data for certain lists of stimuli suggested a revision of the summed-similarity assumption. Our model-based analysis showed that subjects used interitem similarity, in addition to probe-item similarity, as the basis for their decisions. This represents a major departure from existing recognition models that assume subjects' judgments depend exclusively on the summed similarity of the probe to the study items.",0 +https://doi.org/10.1214/ss/1009212673,Power prior distributions for regression models,"We propose a general class of prior distributions for arbitrary regression models. We discuss parametric and semiparametric models. The prior specification for the regression coefficients focuses on observ- able quantities in that the elicitation is based on the availability of his- torical data Do and a scalar quantity ao quantifying the uncertainty in Do. Then Do and ao are used to specify a prior for the regression coeffi- cients in a semiautomatic fashion. The most natural specification of Do arises when the raw data from a similar previous study are available. The availability of historical data is quite common in clinical trials, car- cinogenicity studies, and environmental studies, where large data bases are available from similar previous studies. Although the methodology we present here is quite general, we will focus only on using historical data from similar previous studies to construct the prior distributions. The prior distributions are based on the idea of raising the likelihood function of the historical data to the power ao, where 0 < ao < 1. We call such prior distributions power prior distributions. We examine the power prior for four commonly used classes of regression models. These include generalized linear models, generalized linear mixed models, semipara- metric proportional hazards models, and cure rate models for survival data. For these classes of models, we discuss the construction of the power prior, prior elicitation issues, propriety conditions, model selec- tion, and several other properties. For each class of models, we present real data sets to demonstrate the proposed methodology.",0 +https://doi.org/10.1037/1082-989x.12.3.317,Mixed-effects logistic regression for estimating transitional probabilities in sequentially coded observational data.,"This article demonstrates the use of mixed-effects logistic regression (MLR) for conducting sequential analyses of binary observational data. MLR is a special case of the mixed-effects logit modeling framework, which may be applied to multicategorical observational data. The MLR approach is motivated in part by G. A. Dagne, G. W. Howe, C. H. Brown, & B. O. Muthén (2002) advances in general linear mixed models for sequential analyses of observational data in the form of contingency table frequency counts. The advantage of the MLR approach is that it circumvents obstacles in the estimation of random sampling error encountered using Dagne and colleagues' approach. This article demonstrates the MLR model in an analysis of observed sequences of communication in a sample of young adult same-sex peer dyads. The results obtained using MLR are compared with those of a parallel analysis using Dagne and colleagues' linear mixed model for binary observational data in the form of log odds ratios. Similarities and differences between the results of the 2 approaches are discussed. Implications for the use of linear mixed models versus mixed-effects logit models for sequential analyses are considered.",0 +https://doi.org/10.1007/bf02296272,A rasch model for partial credit scoring,"A unidimensional latent trait model for responses scored in two or more ordered categories is developed. This ""Partial Credit"" model is a member of the family of latent trait models which share the property of parameter separability and so permit ""specifically objective"" comparisons of persons and items. The model can be viewed as an extension of Andrich's Rating Scale model to situations in which ordered response alternatives are free to vary in number and structure from item to item. The difference between the parameters in this model and the ""category boundaries"" in Samejima's Graded Response model is demonstrated. An unconditional maximum likelihood procedure for estimating the model parameters is developed. © 1982 The Psychometric Society.",0 +https://doi.org/10.3402/ejpt.v4i0.21892,Longitudinal course of physical and psychological symptoms after a natural disaster,"After disaster, physical symptoms are common although seldom recognized due to lack of knowledge of the course of symptoms and relation to more studied psychological symptoms.This study aimed to investigate the change in the reporting of different physical symptoms after a disaster, including possible factors for change, and whether psychological symptoms predict physical symptoms reporting at a later point in time.A longitudinal study of citizens of Stockholm who survived the 2004 Indian Ocean tsunami. A total of 1,101 participants completed questionnaires on somatic symptoms, general distress, posttraumatic stress, exposure, and demographic details 14 months and 3 years after the disaster. Physical symptoms occurring daily or weekly during the last year were investigated in four symptom indices: neurological, cardiorespiratory, gastrointestinal, and musculoskeletal. We used generalized estimating equations (GEE) analysis to determine odds ratios for a change in symptoms, and pathway analysis to predict the influence of psychological symptoms on physical symptoms.There was a general decrease of reporting in all physical symptom indices except the musculoskeletal symptom index. The change in the neurological symptom index showed the strongest association with exposure, and for women. General distress and posttraumatic stress at 14 months postdisaster predicted physical symptoms at 3 years.Physical symptoms were predicted by psychological symptoms at an earlier time point, but in a considerable proportion of respondents, physical symptoms existed independently from psychological symptoms. Physicians should be observant on the possible connection of particular pseudoneurological symptoms with prior adversities.",0 +https://doi.org/10.1186/1476-072x-13-36,Comparing multilevel and Bayesian spatial random effects survival models to assess geographical inequalities in colorectal cancer survival: a case study,"Multilevel and spatial models are being increasingly used to obtain substantive information on area-level inequalities in cancer survival. Multilevel models assume independent geographical areas, whereas spatial models explicitly incorporate geographical correlation, often via a conditional autoregressive prior. However the relative merits of these methods for large population-based studies have not been explored. Using a case-study approach, we report on the implications of using multilevel and spatial survival models to study geographical inequalities in all-cause survival.Multilevel discrete-time and Bayesian spatial survival models were used to study geographical inequalities in all-cause survival for a population-based colorectal cancer cohort of 22,727 cases aged 20-84 years diagnosed during 1997-2007 from Queensland, Australia.Both approaches were viable on this large dataset, and produced similar estimates of the fixed effects. After adding area-level covariates, the between-area variability in survival using multilevel discrete-time models was no longer significant. Spatial inequalities in survival were also markedly reduced after adjusting for aggregated area-level covariates. Only the multilevel approach however, provided an estimation of the contribution of geographical variation to the total variation in survival between individual patients.With little difference observed between the two approaches in the estimation of fixed effects, multilevel models should be favored if there is a clear hierarchical data structure and measuring the independent impact of individual- and area-level effects on survival differences is of primary interest. Bayesian spatial analyses may be preferred if spatial correlation between areas is important and if the priority is to assess small-area variations in survival and map spatial patterns. Both approaches can be readily fitted to geographically enabled survival data from international settings.",0 +https://doi.org/10.1002/sim.6631,The choice of prior distribution for a covariance matrix in multivariate meta-analysis: a simulation study,"Bayesian meta-analysis is an increasingly important component of clinical research, with multivariate meta-analysis a promising tool for studies with multiple endpoints. Model assumptions, including the choice of priors, are crucial aspects of multivariate Bayesian meta-analysis (MBMA) models. In a given model, two different prior distributions can lead to different inferences about a particular parameter. A simulation study was performed in which the impact of families of prior distributions for the covariance matrix of a multivariate normal random effects MBMA model was analyzed. Inferences about effect sizes were not particularly sensitive to prior choice, but the related covariance estimates were. A few families of prior distributions with small relative biases, tight mean squared errors, and close to nominal coverage for the effect size estimates were identified. Our results demonstrate the need for sensitivity analysis and suggest some guidelines for choosing prior distributions in this class of problems. The MBMA models proposed here are illustrated in a small meta-analysis example from the periodontal field and a medium meta-analysis from the study of stroke. Copyright © 2015 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1080/03055698.2015.955750,The relationship between ethnic diversity and classroom disruption in the context of migration policies,"This paper studies the relationship between ethnic school composition and classroom disruption in secondary education in the context of migration policies. We measured classroom disruption using students’ reports from 3533 schools in 20 countries provided by cross-national PISA (Programme for International Student Assessment) 2009 data. We employ the migrant share and the ethnic diversity net of the native share as indicators of the ethnic composition of a school. The MIPEX (Immigrant Integration Policy indEX) is used as an indicator of migration policies. Our results show a positive association between ethnic school diversity net of the migrant share and classroom disruption. Furthermore, we show a negative interaction term of the migration policy and ethnic diversity. Consequently, our results indicate that students in countries with a more inclusive migration policy are at least less harmed by influence of ethnic school diversity regarding classroom disruption. Findings partly support the “contact hypo...",0 +https://doi.org/10.1207/s15324818ame0204_6,Procedures for Selecting Items for Computerized Adaptive Tests,"Many procedures have been developed for selecting the best items for a computerized adaptive test. There is a trend toward the use of adaptive testing in applied settings such as licensure tests, program entrance tests, and educational tests. It is useful to consider procedures for item selection and the special needs of applied testing settings to facilitate test design. The current study reviews several classical approaches and alternative approaches to item selection and discusses their relative merit. This study also describes procedures for constrained computerized adaptive testing (C-CAT) that may be added to classical item selection approaches to allow them to be used for applied testing, while maintaining the high measurement precision and short test length that made adaptive testing attractive to practitioners initially.",0 +https://doi.org/10.1016/j.humov.2007.07.005,A new methodology providing evidence of two distinct processes in the production of hand/foot simultaneous responses,"To get simultaneous responses of the hand and the foot, it is mandatory to compensate for the longer peripheral motor conduction delay of the foot. According to the reactive-projective model [Paillard, J. (1948). Quelques données psychophysiologiques relatives au déclenchement de la commande motrice (Some psychophysiological data in relation to the releasing of the motor commands). Année Psychologique, 28-47; Paillard, J. (1990). Réactif et prédictif: deux modes de gestion du geste de la motricité. In V. Nougier, & J. Blanchi (Eds.), Pratiques sportives et modélisation du geste (Sport activity and gesture modeling) (pp. 13-56). Grenoble: Université Joseph-Fourier.] no compensation occurs in a reaction time situation; the hand responds before the foot, which indicates a single motor command released for both effectors. However, in a self-initiated condition, the foot tends to precede the hand suggesting that two distinct motor commands are issued, with the foot command first. Fully self-initiated movements are not usual. It is more usual to prepare a response in anticipation of the time occurrence of a stimulus (e.g., a musician following a conductor, synchronized swimmers emerging together with the music). Therefore, we developed a methodology to test whether the model holds in an anticipation coincidence task. In Experiment 1, the participants were asked to initiate a synchronized hand/foot response when the continuous visual stimulus (constant speed) reaches a target. The results fitted the model. In Experiment 2, anticipation coincidence tasks were performed in three conditions: using the foot (1) or the hand (2) alone, and using the hand and the foot simultaneously (3). Following a constant stimulus protocol, short tones were randomly produced, prior the stimulus, to indicate the participants to inhibit their response. As expected, the frequencies of correct inhibition in each preset period followed a sigmoid curve. The command release is assumed to occur at the biserial point (50% of inhibition). The results confirmed that the motor command of the foot is released sooner than the command of the hand. The hand/foot delay is lower in the simultaneous condition, because the command of the hand is released 40 ms earlier; while the foot command is 10 ms earlier. These data confirm and extend the projective-reactive model to a new category of coordination behavior.",0 +https://doi.org/10.1198/jasa.2009.tm08564,Generalized Multilevel Functional Regression,"We introduce Generalized Multilevel Functional Linear Models (GMFLMs), a novel statistical framework for regression models where exposure has a multilevel functional structure. We show that GMFLMs are, in fact, generalized multilevel mixed models (GLMMs). Thus, GMFLMs can be analyzed using the mixed effects inferential machinery and can be generalized within a well researched statistical framework. We propose and compare two methods for inference: 1) a two-stage frequentist approach; and 2) a joint Bayesian analysis. Our methods are motivated by and applied to the Sleep Heart Health Study (SHHS), the largest community cohort study of sleep. However, our methods are general and easy to apply to a wide spectrum of emerging biological and medical data sets. Supplemental materials for this article are available online.",0 +https://doi.org/10.1002/9781119961154.ch19,Multilevel Models for Ordinal Data,"This chapter is concerned with regression models for ordinal responses, with special emphasis on random effects models for multilevel or clustered data. After a brief discussion on ordinal variables, it reviews the most common regression models for ordinal responses, focusing on cumulative models, namely models based on cumulative probabilities. The chapter then deals with random effects cumulative models for multilevel data, discussing several issues peculiar to the random effects extension such as the distinction between marginal and conditional effects, the measures of unobserved cluster-level heterogeneity, the consequences of adding covariates, and the main types of predicted probabilities. It also deals with estimation, inference and prediction, with a brief look on available software. Finally, it presents an application of random effects cumulative models to the analysis of student ratings of university courses. © 2012 John Wiley & Sons, Ltd. All rights reserved.",0 +https://doi.org/10.15446/rce.v37n2spe.47940,Hierarchical Graphical Bayesian Models in Psychology,The improvement of graphical methods in psychological research can promote their use and a better comprehension of their expressive power. The application of hierarchical Bayesian graphical models has recently become more frequent in psychological research. The aim of this contribution is to introduce suggestions for the improvement of hierarchical Bayesian graphical models in psychology. This novel set of suggestions stems from the description and comparison between two main approaches concerned with the use of plate notation and distribution pictograms. It is concluded that the combination of relevant aspects of both models might improve the use of powerful hierarchical Bayesian graphical models in psychology.,0 +https://doi.org/10.1214/aoms/1177693528,Proper Bayes Minimax Estimators of the Multivariate Normal Mean,,0 +https://doi.org/10.1037/a0028087,"Testing the significance of a correlation with nonnormal data: Comparison of Pearson, Spearman, transformation, and resampling approaches.","It is well known that when data are nonnormally distributed, a test of the significance of Pearson's r may inflate Type I error rates and reduce power. Statistics textbooks and the simulation literature provide several alternatives to Pearson's correlation. However, the relative performance of these alternatives has been unclear. Two simulation studies were conducted to compare 12 methods, including Pearson, Spearman's rank-order, transformation, and resampling approaches. With most sample sizes (n ≥ 20), Type I and Type II error rates were minimized by transforming the data to a normal shape prior to assessing the Pearson correlation. Among transformation approaches, a general purpose rank-based inverse normal transformation (i.e., transformation to rankit scores) was most beneficial. However, when samples were both small (n ≤ 10) and extremely nonnormal, the permutation test often outperformed other alternatives, including various bootstrap tests.",0 +https://doi.org/10.1177/01421602026002002,Multidimensional Constrained Test Assembly,"Two mathematical programming approaches are presented for the assembly of ability tests from item pools calibrated under a multidimensional item response theory model. Item selection is based on Fisher information matrix. Several criteria can be used to optimize this matrix. In this article, the A-criterion and the D-criterion are applied. Empirical examples for a two-dimensional mathematics item pool illustrate the methods. Both criteria provided good results. Recommendations are provided about when to apply either approach.",0 +https://doi.org/10.1037/a0014268,Average causal effects from nonrandomized studies: A practical guide and simulated example.,"In a well-designed experiment, random assignment of participants to treatments makes causal inference straightforward. However, if participants are not randomized (as in observational study, quasi-experiment, or nonequivalent control-group designs), group comparisons may be biased by confounders that influence both the outcome and the alleged cause. Traditional analysis of covariance, which includes confounders as predictors in a regression model, often fails to eliminate this bias. In this article, the authors review Rubin's definition of an average causal effect (ACE) as the average difference between potential outcomes under different treatments. The authors distinguish an ACE and a regression coefficient. The authors review 9 strategies for estimating ACEs on the basis of regression, propensity scores, and doubly robust methods, providing formulas for standard errors not given elsewhere. To illustrate the methods, the authors simulate an observational study to assess the effects of dieting on emotional distress. Drawing repeated samples from a simulated population of adolescent girls, the authors assess each method in terms of bias, efficiency, and interval coverage. Throughout the article, the authors offer insights and practical guidance for researchers who attempt causal inference with observational data.",0 +https://doi.org/10.1002/9781119030638.ch12,RMPW extensions to alternative designs and measurement,,0 +https://doi.org/10.1177/0962280211432219,A practical introduction to multivariate meta-analysis,"Multivariate meta-analysis is becoming increasingly popular and official routines or self-programmed functions have been included in many statistical software. In this article, we review the statistical methods and the related software for multivariate meta-analysis. Emphasis is placed on Bayesian methods using Markov chain Monte Carlo, and codes in WinBUGS are provided. The various model-fitting options are illustrated in two examples and specific guidance is provided on how to run a multivariate meta-analysis using various software packages.",0 +https://doi.org/10.1016/s0885-2006(03)00027-9,Evaluating academic outcomes of Head Start: an application of general growth mixture modeling,"Abstract This study intends to illustrate the utility of general growth mixture modeling (GGMM) for evaluation of early childhood education programs, using a sample of children with Head Start experience. In the first analysis of this study growth mixture modeling (GMM) found that children with Head Start experience had two distinct growth patterns. In the second analysis of this study general growth mixture modeling found that children with two or more years of program participation did not have faster achievement growth, on average, than children with only one year of program participation. This study also found that a gender gap in mathematics and an income gap in reading and mathematics were exclusively exhibited by the children with no preschool experience. Therefore, it was concluded that the Head Start program may be reducing both a gender gap in mathematics and an income gap in reading and mathematics.",0 +https://doi.org/10.1111/1467-9868.00070,"Updating Schemes, Correlation Structure, Blocking and Parameterization for the Gibbs Sampler",In this paper many convergence issues concerning the implementation of the Gibbs sampler are investigated. Exact computable rates of convergence for Gaussian target distributions are obtained. Different random and non-random updating strategies and blocking combinations are compared using the rates. The effect of dimensionality and correlation structure on the convergence rates are studied. Some examples are considered to demonstrate the results. For a Gaussian image analysis problem several updating strategies are described and compared. For problems in Bayesian linear models several possible parameterizations are analysed in terms of their convergence rates characterizing the optimal choice.,0 +https://doi.org/10.1371/journal.pone.0148171,Use of Wishart Prior and Simple Extensions for Sparse Precision Matrix Estimation,"A conjugate Wishart prior is used to present a simple and rapid procedure for computing the analytic posterior (mode and uncertainty) of the precision matrix elements of a Gaussian distribution. An interpretation of covariance estimates in terms of eigenvalues is presented, along with a simple decision-rule step to improve the performance of the estimation of sparse precision matrices and associated graphs. In this, elements of the estimated precision matrix that are zero or near zero can be detected and shrunk to zero. Simulated data sets are used to compare posterior estimation with decision-rule with two other Wishart-based approaches and with graphical lasso. Furthermore, an empirical Bayes procedure is used to select prior hyperparameters in high dimensional cases with extension to sparsity.",0 +https://doi.org/10.1111/j.1467-985x.2010.00639.x,Estimation and adjustment of bias in randomized evidence by using mixed treatment comparison meta-analysis,"Summary.  There is good empirical evidence that specific flaws in the conduct of randomized controlled trials are associated with exaggeration of treatment effect estimates. Mixed treatment comparison meta-analysis, which combines data from trials on several treatments that form a network of comparisons, has the potential both to estimate bias parameters within the synthesis and to produce bias-adjusted estimates of treatment effects. We present a hierarchical model for bias with common mean across treatment comparisons of active treatment versus control. It is often unclear, from the information that is reported, whether a study is at risk of bias or not. We extend our model to estimate the probability that a particular study is biased, where the probabilities for the ‘unclear’ studies are drawn from a common beta distribution. We illustrate these methods with a synthesis of 130 trials on four fluoride treatments and two control interventions for the prevention of dental caries in children. Whether there is adequate allocation concealment and/or blinding are considered as indicators of whether a study is at risk of bias. Bias adjustment reduces the estimated relative efficacy of the treatments and the extent of between-trial heterogeneity.",0 +https://doi.org/10.1111/j.2044-8317.1970.tb00432.x,"THE THEORETICAL FOUNDATIONS OF PRINCIPAL FACTOR ANALYSIS, CANONICAL FACTOR ANALYSIS, AND ALPHA FACTOR ANALYSIS","It is shown that PFA, CFA and AFA are particular cases of a scale-invariant factoring procedure based on variance ratios of certain weighted combinations of variables. Standard derivations in the literature are shown, in contrast, to have unsatisfactory features. It is suggested that the choice between PFA, CFA and AFA involves relatively independent choices of features of each, and that in most cases CFA is to be preferred.",0 +https://doi.org/10.1155/2015/592626,Assessing Traffic Accident Occurrence of Road Segments through an Optimized Decision Rule,"Statistical models for estimating the safety status of transportation facilities have received great attention in the last two decades. These models also perform an important role in transportation safety planning as well as diagnoses of locations with high accident risks. However, the current methods largely rely on regression analyses and therefore they could ignore the multicollinearity characteristics of factors, which may provide additional information for enhancing the performance of forecasting models. This study seeks to develop more precise models for forecasting safety status as well as addressing the issue of multicollinearity of dataset. The proposed mathematical approach is indeed a discriminant analysis with respect to the goal of minimizing Bayes risks given multivariate distributions of factors. Based on this model, numerical analyses also perform with the application of a simulated dataset and an empirically observed dataset of traffic accidents in road segments. These examples essentially illustrate the process of Bayes risk minimization on predicating the safety status of road segments toward the objective of smallest misclassification rate. The paper finally concludes with a discussion of this methodology and several important avenues for future studies are also provided.",0 +https://doi.org/10.1016/j.ijresmar.2007.10.001,"Estimating the SCAN⁎PRO model of store sales: HB, FM or just OLS?","In this paper we investigate whether consideration of store-level heterogeneity in marketing mix effects improves the accuracy of the marketing mix elasticities, fit, and forecasting accuracy of the widely-applied SCAN*PRO model of store sales. Models with continuous and discrete representations of heterogeneity, estimated using hierarchical Bayes (HB) and finite mixture (FM) techniques, respectively, are empirically compared to the original model, which does not account for store-level heterogeneity in marketing mix effects, and is estimated using ordinary least squares (OLS). The empirical comparisons are conducted in two contexts: Dutch store-level scanner data for the shampoo product category, and an extensive simulation experiment. The simulation investigates how between- and within-segment variance in marketing mix effects, error variance, the number of weeks of data, and the number of stores impact the accuracy of marketing mix elasticities, model fit, and forecasting accuracy. Contrary to expectations, accommodating store-level heterogeneity does not improve the accuracy of marketing mix elasticities relative to the homogeneous SCAN*PRO model, suggesting that little may be lost by employing the original homogeneous SCAN*PRO model estimated using ordinary least squares. Improvements in fit and forecasting accuracy are also fairly modest. We pursue an explanation for this result since research in other contexts has shown clear advantages from assuming some type of heterogeneity in market response models. In an Afterthought section, we comment on the controversial nature of our result, distinguishing factors inherent to household-level data and associated models vs. general store-level data and associated models vs. the unique SCAN*PRO model specification.",0 +https://doi.org/10.1037/pspp0000043,Consequences of interpersonal spin on couple-relevant goal progress and relationship satisfaction in romantic relationships.,"Large fluctuations in a person's interpersonal behavior across situations and over time are thought to be associated with poor personal and interpersonal outcomes. This study examined 2 outcomes, relationship satisfaction and goal progress, that could be associated with individual differences in dispersion of interpersonal behavior (interpersonal spin) in romantic relationships. Need satisfaction and perceived autonomy support for goal pursuit from the partner were examined as mediator variables. Spin was measured using an event-contingent recording (ECR) methodology with a sample of 93 cohabiting couples who reported their interpersonal behavior in interactions with each other during a 20-day period. Relationship satisfaction and goal completion were measured at the end of the ECR procedure (T2) and approximately 7 months after the ECR (T3). Need satisfaction and perceived autonomy support were measured at T2. In both genders, higher spin was associated with lower T2 relationship satisfaction. There was also a decline in relationship satisfaction from T2 to T3 among men with high spin partners. In both genders, higher spin was associated with lower need satisfaction, and lower need satisfaction was associated with a decline in relationship satisfaction from T2 to T3. In both genders, higher spin was associated with lower perceived autonomy support, and lower support was associated with decreased progress in goal completion from T2 to T3. The effects of spin were independent of the effects of mean levels of behavior. These findings extend the understanding of the detrimental consequences of dispersion in interpersonal behavior to the disruption of the person's romantic relationships.",0 +https://doi.org/10.4324/9780203843147-9,Modeling age-based turning points in longitudinal life-span growth curves of cognition,,0 +https://doi.org/10.1111/1467-985x.0asp2,Some Practical Issues in the Evaluation of Heterogeneous Labour Market Programmes by Matching Methods,"Summary Recently several studies have analysed active labour market policies by using a recently proposed matching estimator for multiple programmes. Since there is only very limited practical experience with this estimator, this paper checks its sensitivity with respect to issues that are of practical importance in this kind of evaluation study. The estimator turns out to be fairly robust to several features that concern its implementation. Furthermore, the paper demonstrates that the matching approach per se is no panacea for solving all the problems of evaluation studies, but that its success depends critically on the information that is available in the data. Finally, a comparison with a bootstrap distribution provides some justification for using a simplified approximation of the distribution of the estimator that ignores its sequential nature.",0 +https://doi.org/10.2307/2986186,Algorithm AS 287: Adaptive Rejection Sampling from Log-Concave Density Functions,,0 +https://doi.org/10.1111/j.1468-5884.2011.00476.x,Generalized graded unfolding model with structural equation for subject parameters,"The generalized graded unfolding model (GGUM) is capable of analyzing polytomous scored, unfolding data such as agree-disagree responses to attitude statements. In the present study, we proposed a GGUM with structural equation for subject parameters, which enabled us to evaluate the relation between subject parameters and covariates and/or latent variables simultaneously, in order to avoid the influence of attenuation. Additionally, an algorithm for parameter estimation is newly implemented via the Markov Chain Monte Carlo (MCMC) method, based on Bayesian statistics. In the simulation, we compared the accuracy of estimates of regression coefficients between the proposed model and a conventional method using a GGUM (where regression coefficients are estimated using estimates of θ). As a result, the proposed model performed much better than the conventional method in terms of bias and root mean squared errors of estimates of regression coefficients. The study concluded by verifying the efficacy of the proposed model, using an actual data example of attitude measurement.",0 +https://doi.org/10.1198/016214504000001015,Bilinear Mixed-Effects Models for Dyadic Data,"This article discusses the use of a symmetric multiplicative interaction effect to capture certain types of third-order dependence patterns often present in social networks and other dyadic datasets. Such an effect, along with standard linear fixed and random effects, is incorporated into a generalized linear model, and a Markov chain Monte Carlo algorithm is provided for Bayesian estimation and inference. In an example analysis of international relations data, accounting for such patterns improves model fit and predictive performance.",0 +https://doi.org/10.1037/0022-3514.77.6.1200,Intergroup perception in naturally occurring groups of differential status: A social relations perspective.,"This study investigated intergroup perception in well-acquainted groups. Also of interest were the effects of a naturally occurring status differential on these perceptions. The study is framed within the social relations model, which provides a measure of in-group bias as well as 3 innovative measures of out-group homogeneity. Results indicated that low-status groups consistently displayed out-group favoritism. High-status groups displayed in-group bias, but only on ratings of leadership ability. The results also provided consistent evidence of out-group homogeneity. In instances when group status moderated out-group homogeneity effects, members of the high-status groups perceived their in-group as more variable than the out-group, whereas members of the low-status groups tended to see the in-group and out-group as equally variable.",0 +https://doi.org/10.1186/s12886-015-0085-0,Outcome measure for the treatment of cone photoreceptor diseases: orientation to a scene with cone-only contrast,"Inherited retinal degenerations (IRDs) preferentially affecting cone photoreceptor function are being considered for treatment trials aiming to improve day vision. The purpose of the current work was to develop cone-specific visual orientation outcomes that can differentiate day vision improvement in the presence of retained night vision.A lighted wall (1.4 m wide, 2 m high) resembling a beaded curtain was formed with 900 individually addressable red, blue and green LED triplets placed in 15 vertical strips hanging 0.1 m apart. Under computer control, different combination of colors and intensities were used to produce the appearance of a door on the wall. Scotopically-matched trials were designed to be perceptible to the cone-, but not rod-, photoreceptor based visual systems. Unmatched control trials were interleaved at each luminance level to determine the existence of any vision available for orientation. Testing started with dark-adapted eyes and a scene luminance attenuated 8 log units from the maximum attainable, and continued with progressively increasing levels of luminance. Testing was performed with a three-alternative forced choice method in healthy subjects and patients with Leber congenital amaurosis (LCA) caused by mutations in GUCY2D, the gene that encodes retinal guanylate cyclase-1.Normal subjects could perform the orientation task using cone vision at 5 log attenuation and brighter luminance levels. Most GUCY2D-LCA patients failed to perform the orientation task with scotopically-matched test trials at any luminance level even though they were able to perform correctly with unmatched control trials. These results were consistent with a lack of cone system vision and use of the rod system under ambient conditions normally associated with cone system activity. Two GUCY2D-LCA patients demonstrated remnant cone vision but at a luminance level 2 log brighter than normal.The newly developed device can probe the existence or emergence of cone-based vision in patients for an orientation task involving the identification of a door on the wall under free-viewing conditions. This key advance represents progress toward developing an appropriate outcome measure for a clinical trial to treat currently incurable eye diseases severely affecting cone vision despite retained rod vision.",0 +https://doi.org/10.1207/s15328007sem1303_1,A Maximum Likelihood Approach for Multisample Nonlinear Structural Equation Models With Missing Continuous and Dichotomous Data,"Structural equation models are widely appreciated in social-psychological research and other behavioral research to model relations between latent constructs and manifest variables and to control for measurement error. Most applications of SEMs are based on fully observed continuous normal data and models with a linear structural equation. However, discrete nonnormal data and missing data are rather common, and sometimes it is necessary to incorporate nonlinear structural equations for assessing the impact of nonlinear terms of the exogenous latent variables to the endogenous latent variables. Moreover, to study the behaviors of different populations, it is necessary to extend from a single sample model to a multisample model. In this article, a maximum likelihood (ML) approach is developed for analyzing a multisample nonlinear structural equation model, in the context of mixed continuous and dichotomous data that involve data that are missing at random. The article demonstrates the newly developed method...",0 +https://doi.org/10.1007/978-3-642-83943-6_15,New Results in Test Theory Without an Answer Key,"This paper discusses some recent developments in a new methodology for the social sciences being developed jointly by the authors. The methodology is called cultural consensus analysis, and it is designed to aggregate informant responses to test items about their common culture. The object is to determine correct knowledge about the nature of that culture. Our methods estimate informant competency parameters and “correct” answers to each item from the informant response data. The methodology is designed for anthropological field studies and related research designs. This paper studies the consequences of relaxing the axioms of our model for dichotomous items, and it presents new models for other testing formats.",0 +https://doi.org/10.1016/j.pain.2003.12.023,"Snake venom phospholipase A2s (Asp49 and Lys49) induce mechanical allodynia upon peri-sciatic administration: involvement of spinal cord glia, proinflammatory cytokines and nitric oxide","Snakebites constitute a serious public health problem in Central and South America, where species of the lancehead pit vipers (genus Bothrops) cause the majority of accidents. Bothrops envenomations are very painful, and this effect is not neutralized by antivenom treatment. Two variants of secretory phospholipases A2 (sPLA2), corresponding to Asp49 and Lys49 PLA2s, have been isolated from Bothrops asper venom. These sPLA2s induce hyperalgesia in rats following subcutaneous injection. However, venom in natural Bothrops bites is frequently delivered intramuscularly, thereby potentially reaching peripheral nerve bundles. Thus, the present series of experiments tested whether these sPLA2s could exert pain-enhancing effects following administration around healthy sciatic nerve. Both were found to produce mechanical allodynia ipsilateral to the injection site; no thermal hyperalgesia was observed. As no prior study has examined potential spinal mechanisms underlying sPLA2 actions, a series of anatomical and pharmacological studies were performed. These demonstrated that both sPLA2s produce activation of dorsal horn astrocytes and microglia that is more prominent ipsilateral to the site of injection. As proinflammatory cytokines and nitric oxide have each been previously implicated in spinally mediated pain facilitation, the effect of pharmacological blockade of these substances was tested. The results demonstrate that mechanical allodynia induced by both sPLA2s is blocked by interleukin-1 receptor antagonist, anti-rat interleukin-6 neutralizing antibody, the anti-inflammatory cytokine interleukin-10, and a nitric oxide synthesis inhibitor (L-NAME). As a variety of immune cells also produce and release sPLA2s during inflammatory states, the data may have general implications for the understanding of inflammatory pain.",0 +https://doi.org/10.1080/00273171.2014.931798,Structural Equation Models in a Redundancy Analysis Framework With Covariates,"A recent method to specify and fit structural equation modeling in the Redundancy Analysis framework based on so-called Extended Redundancy Analysis (ERA) has been proposed in the literature. In this approach, the relationships between the observed exogenous variables and the observed endogenous variables are moderated by the presence of unobservable composites, estimated as linear combinations of exogenous variables. However, in the presence of direct effects linking exogenous and endogenous variables, or concomitant indicators, the composite scores are estimated by ignoring the presence of the specified direct effects. To fit structural equation models, we propose a new specification and estimation method, called Generalized Redundancy Analysis (GRA), allowing us to specify and fit a variety of relationships among composites, endogenous variables, and external covariates. The proposed methodology extends the ERA method, using a more suitable specification and estimation algorithm, by allowing for covariates that affect endogenous indicators indirectly through the composites and/or directly. To illustrate the advantages of GRA over ERA we propose a simulation study of small samples. Moreover, we propose an application aimed at estimating the impact of formal human capital on the initial earnings of graduates of an Italian university, utilizing a structural model consistent with well-established economic theory.",0 +https://doi.org/10.1198/106186008x287337,Using Redundant Parameterizations to Fit Hierarchical Models,"Hierarchical linear and generalized linear models can be fit using Gibbs samplers and Metropolis algorithms; these models, however, often have many parameters, and convergence of the seemingly most natural Gibbs and Metropolis algorithms can sometimes be slow. We examine solutions that involve reparameterization and over-parameterization. We begin with parameter expansion using working parameters, a strategy developed for the EM algorithm. This strategy can lead to algorithms that are much less susceptible to becoming stuck near zero values of the variance parameters than are more standard algorithms. Second, we consider a simple rotation of the regression coefficients based on an estimate of their posterior covariance matrix. This leads to a Gibbs algorithm based on updating the transformed parameters one at a time or a Metropolis algorithm with vector jumps; either of these algorithms can perform much better (in terms of total CPU time) than the two standard algorithms: one-at-a-time updating of untrans...",0 +https://doi.org/10.1007/bf02294494,Kernel smoothing approaches to nonparametric item characteristic curve estimation,"The option characteristic curve, the relation between ability and probability of choosing a particular option for a test item, can be estimated by nonparametric smoothing techniques. What is smoothed is the relation between some function of estimated examinee ability rankings and the binary variable indicating whether or not the option was chosen. This paper explores the use of kernel smoothing, which is particularly well suited to this application. Examples show that, with some help from the fast Fourier transform, estimates can be computed about 500 times as rapidly as when using commonly used parametric approaches such as maximum marginal likelihood estimation using the three-parameter logistic distribution. Simulations suggest that there is no loss of efficiency even when the population curves are three-parameter logistic. The approach lends itself to several interesting extensions. © 1991 The Psychometric Society.",0 +,The Infinite Gaussian Mixture Model,In a Bayesian mixture model it is not necessary a priori to limit the number of components to be finite. In this paper an infinite Gaussian mixture model is presented which neatly sidesteps the difficult problem of finding the right number of mixture components. Inference in the model is done using an efficient parameter-free Markov Chain that relies entirely on Gibbs sampling.,0 +https://doi.org/10.1002/1098-2272(200009)19:2<127::aid-gepi2>3.0.co;2-s,Variance components analysis for pedigree-based censored survival data using generalized linear mixed models (GLMMs) and Gibbs sampling in BUGS,"Complex human diseases are an increasingly important focus of genetic research. Many of the determinants of these diseases are unknown and there is often a strong residual covariance between relatives even when all known genetic and environmental factors have been taken into account. This must be modeled correctly whether scientific interest is focused on fixed effects, as in an association analysis, or on the covariance structure itself. Analysis is straightforward for multivariate normally distributed traits, but difficulties arise with other types of trait. Generalized linear mixed models (GLMMs) offer a potentially unifying approach to analysis for many classes of phenotype including right censored survival times. This includes age-at-onset and age-at-death data and a variety of other censored traits. Markov chain Monte Carlo (MCMC) methods, including Gibbs sampling, provide a convenient framework within which such GLMMs may be fitted. In this paper, we use BUGS (“Bayesian inference using Gibbs sampling”: a readily available, generic Gibbs sampler) to fit GLMMs for right-censored survival times in nuclear and extended families. We discuss parameter interpretation and statistical inference, and show how to circumvent a number of important theoretical and practical problems. Using simulated data, we show that model parameters are consistent. We further illustrate our methods using data from an ongoing cohort study. Finally, we propose that the random effects associated with a genetic component of variance (e.g., σ2A) in a GLMM may be regarded as an adjusted “phenotype” and used as input to a conventional model-based or model-free linkage analysis. This provides a simple way to conduct a linkage analysis for a trait reflected in a right-censored survival time while comprehensively adjusting for observed confounders at the level of the individual and latent environmental effects shared across families. Genet. Epidemiol. 19:127–148, 2000. © 2000 Wiley-Liss, Inc.",0 +https://doi.org/10.1577/t07-012.1,Modeling Variation in Mass-Length Relations and Condition Indices of Lake Trout and Chinook Salmon in Lake Huron: A Hierarchical Bayesian Approach,"Abstract Commonly used approaches to studying mass-length relations and condition indices often do not adequately address covariance between mass-length parameters, usually ignore heterogeneity in individual variance for body mass at a given length, and assume that length distributions of fish samples are similar across regions and years. We used body mass at selected lengths as condition indices based on statistical modeling and a hierarchical Bayesian approach to inferences, and our approach allowed us to avoid using restrictive assumptions. We estimated spatial and annual variation in mass-length relations, where the process errors in parameters are drawn from a multivariate distribution. We also estimated region-, year-, and size-group-specific variance for individual variation in mass at given lengths. We applied our approach to study mass-length relations of lake trout Salvelinus namaycush (1977-2005) and Chinook salmon Oncorhynchus tshawytscha (1983-2004) in U.S. waters of Lake Huron. We found that...",0 +https://doi.org/10.1016/j.jbi.2007.01.003,Estimation of epistasis among finite polygenic loci for complex traits with a mixed model using Gibbs sampling,"Epistasis among loci is important factor behind the expression of many complex traits, but many analyses have ruled out its possibility. A method to estimate epistasis was introduced with a mixed model using Gibbs sampling (MMGS). The posterior mean estimate for every possible genotype combined from multiple loci was calculated as the mean of the conditional expected values of the parameters in post warming-up rounds from Gibbs sampling. A simulation study was performed to compare MMGS with restricted partition method (RPM). Mean square prediction error (MSPE) using MMGS was smaller than that using RPM ( P < 0.05), which might be due to information loss introduced by grouping of genotypes in RPM. This was also supported by the result that MSPE increased as the number of merged groups decreased. The simulation study implied that MMGS was more plausible in estimating epistatic effects than the RPM.",0 +https://doi.org/10.1080/00273171.2014.928492,Bayesian Model Averaging for Propensity Score Analysis,"This article considers Bayesian model averaging as a means of addressing uncertainty in the selection of variables in the propensity score equation. We investigate an approximate Bayesian model averaging approach based on the model-averaged propensity score estimates produced by the R package BMA but that ignores uncertainty in the propensity score. We also provide a fully Bayesian model averaging approach via Markov chain Monte Carlo sampling (MCMC) to account for uncertainty in both parameters and models. A detailed study of our approach examines the differences in the causal estimate when incorporating noninformative versus informative priors in the model averaging stage. We examine these approaches under common methods of propensity score implementation. In addition, we evaluate the impact of changing the size of Occam's window used to narrow down the range of possible models. We also assess the predictive performance of both Bayesian model averaging propensity score approaches and compare it with the case without Bayesian model averaging. Overall, results show that both Bayesian model averaging propensity score approaches recover the treatment effect estimates well and generally provide larger uncertainty estimates, as expected. Both Bayesian model averaging approaches offer slightly better prediction of the propensity score compared with the Bayesian approach with a single propensity score equation. Covariate balance checks for the case study show that both Bayesian model averaging approaches offer good balance. The fully Bayesian model averaging approach also provides posterior probability intervals of the balance indices.",0 +https://doi.org/10.1037/1082-989x.6.4.371,"Evaluating statistical difference, equivalence, and indeterminacy using inferential confidence intervals: An integrated alternative method of conducting null hypothesis statistical tests.","Null hypothesis statistical testing (NHST) has been debated extensively but always successfully defended. The technical merits of NHST are not disputed in this article. The widespread misuse of NHST has created a human factors problem that this article intends to ameliorate. This article describes an integrated, alternative inferential confidence interval approach to testing for statistical difference, equivalence, and indeterminacy that is algebraically equivalent to standard NHST procedures and therefore exacts the same evidential standard. The combined numeric and graphic tests of statistical difference, equivalence, and indeterminacy are designed to avoid common interpretive problems associated with NHST procedures. Multiple comparisons, power, sample size, test reliability, effect size, and cause-effect ratio are discussed. A section on the proper interpretation of confidence intervals is followed by a decision rule summary and caveats.",0 +https://doi.org/10.1016/j.peptides.2008.05.023,Antinociceptive effect of the C-terminus of murine S100A9 protein on experimental neuropathic pain,"The synthetic peptide identical to the C-terminus of murine S100A9 protein (mS100A9p) has antinociceptive effect on different acute inflammatory pain models. In this study, the effect of mS100A9p was investigated on neuropathic pain induced by chronic constriction injury (CCI) of the sciatic nerve in rats. Hyperalgesia, allodynia, and spontaneous pain were assessed to evaluate nociception. These three signs were detected as early as 2 days after sciatic nerve constriction and lasted for over 14 days after CCI. Rats were treated with different doses of mS100A9p by intraplantar, oral, or intrathecal routes on day 14 after CCI, and nociception was evaluated 1h later. These three routes of administration blocked hyperalgesia, allodynia and spontaneous pain. The duration of the effect of mS100A9p depends on the route used and phenomenon analyzed. Moreover, intraplantar injection of mS100A9p in the contralateral paw inhibited the hyperalgesia on day 14 days after CCI. The results obtained herein demonstrate the antinociceptive effect of the C-terminus of murine S100A9 protein on experimental neuropathic pain, suggesting a potential therapeutic use for it in persistent pain syndromes, assuming that tolerance does not develop to mS100A9p.",0 +https://doi.org/10.1007/s11306-017-1164-4,Multilevel pharmacokinetics-driven modeling of metabolomics data,"Multilevel modeling is a quantitative statistical method to investigate variability and relationships between variables of interest, taking into account population structure and dependencies. It can be used for prediction, data reduction and causal inference from experiments and observational studies allowing for more efficient elucidation of knowledge.In this study we introduced the concept of multilevel pharmacokinetics (PK)-driven modelling for large-sample, unbalanced and unadjusted metabolomics data comprising nucleoside and creatinine concentration measurements in urine of healthy and cancer patients.A Bayesian multilevel model was proposed to describe the nucleoside and creatinine concentration ratio considering age, sex and health status as covariates. The predictive performance of the proposed model was summarized via area under the ROC, sensitivity and specificity using external validation.Cancer was associated with an increase in methylthioadenosine/creatinine excretion rate by a factor of 1.42 (1.09-2.03) which constituted the highest increase among all nucleosides. Age influenced nucleosides/creatinine excretion rates for all nucleosides in the same direction which was likely caused by a decrease in creatinine clearance with age. There was a small evidence of sex-related differences for methylthioadenosine. The individual a posteriori prediction of patient classification as area under the ROC with 5th and 95th percentile was 0.57(0.5-0.67) with sensitivity and specificity of 0.59(0.42-0.76) and 0.57(0.45-0.7), respectively suggesting limited usefulness of 13 nucleosides/creatinine urine concentration measurements in predicting disease in this population.Bayesian multilevel pharmacokinetics-driven modeling in metabolomics may be useful in understanding the data and may constitute a new tool for searching towards potential candidates of disease indicators.",0 +https://doi.org/10.1002/sim.4780100604,Using empirical bayes methods in biopharmaceutical research,"A compound sampling model, where a unit-specific parameter is sampled from a prior distribution and then observed are generated by a sampling distribution depending on the parameter, underlies a wide variety of biopharmaceutical data. For example, in a multi-centre clinical trial the true treatment effect varies from centre to centre. Observed treatment effects deviate from these true effects through sampling variation. Knowledge of the prior distribution allows use of Bayesian analysis to compute the posterior distribution of clinic-specific treatment effects (frequently summarized by the posterior mean and variance). More commonly, with the prior not completely specified, observed data can be used to estimate the prior and use it to produce the posterior distribution: an empirical Bayes (or variance component) analysis. In the empirical Bayes model the estimated prior mean gives the typical treatment effect and the estimated prior standard deviation indicates the heterogeneity of treatment effects. In both the Bayes and empirical Bayes approaches, estimated clinic effects are shrunken towards a common value from estimates based on single clinics. This shrinkage produces more efficient estimates. In addition, the compound model helps structure approaches to ranking and selection, provides adjustments for multiplicity, allows estimation of the histogram of clinic-specific effects, and structures incorporation of external information. This paper outlines the empirical Bayes approach. Coverage will include development and comparison of approaches based on parametric priors (for example, a Gaussian prior with unknown mean and variance) and non-parametric priors, discussion of the importance of accounting for uncertainty in the estimated prior, comparison of the output and interpretation of fixed and random effects approaches to estimating population values, estimating histograms, and identification of key considerations in the use and interpretation of empirical Bayes methods.",0 +https://doi.org/10.1111/1467-9248.12162,When the Going Gets Tough: The Differential Impact of National Unemployment on the Perceived Threats of Immigration,"Economic competition theory predicts that anti-immigration sentiments will increase in periods with high unem-ployment, in particular among low-skilled workers. Using five rounds of cross-sectional data from the European Social Survey and utilising the rise in unemployment in many European countries due to the financial crisis, this article provides a more effective empirical test of interest-based theories than previous studies. It employs hierarchical, two-stage regression techniques to estimate the relationship between aggregate unemployment rates and immigration opinion, and explores whether the relationship differs according to respondent’s level of education. It is found that high unemployment rates are associated with a high level of economic concern over immigration – particularly if the size of the foreign-born population is large. The relationship is stronger among the low skilled, implying a tendency for polarisation of opinions about immigration in economic recessions. Finally, it is discovered that the general level of cultural concern over immigration is unrelated to variation in unemployment.",0 +https://doi.org/10.3102/1076998609332756,Sample Size Estimation in Cluster Randomized Educational Trials: An Empirical Bayes Approach,"The educational field has now accumulated an extensive literature reporting on values of the intraclass correlation coefficient, a parameter essential to determining the required size of a planned cluster randomized trial. We propose here a simple simulation-based approach including all relevant information that can facilitate this task. An example and corresponding computer code is attached.",0 +https://doi.org/10.1177/0013164409332222,A Model Fit Statistic for Generalized Partial Credit Model,"Investigating the fit of a parametric model is an important part of the measurement process when implementing item response theory (IRT), but research examining it is limited. A general nonparametric approach for detecting model misfit, introduced by J. Douglas and A. S. Cohen (2001), has exhibited promising results for the two-parameter logistic model and Samejima s graded response model. This study extends this approach to test the fit of generalized partial credit model (GPCM). The empirical Type I error rate and power of the proposed method are assessed for various test lengths, sample sizes, and type of assessment. Overall, the proposed fit statistic performed well under the studied conditions in that the Type I error rate was not inflated and the power was acceptable, especially for moderate to large sample sizes. A further advantage of the nonparametric approach is that it provides a convenient graphical display of possible misfit.",0 +,USAGE OF DIFFERENT PRIOR DISTRIBUTIONS IN BAYESIAN VECTOR AUTOREGRESSIVE MODELS,"In Bayesian vector autoregressive models, the Litterman or Minnesota Prior is widely used. However, in some cases, the Minnesota prior is not the best prior distribution that can be used. Thus, other prior dis- tributions can also be applied. In this paper, as well as the Minnesota prior, four other prior distributions have been studied. Based on these prior distributions, five different Bayesian vector autoregressive models have been built to forecast the Turkish unemployment rate and the in- dustrial production index for the two periods of the year 2008. Finally, the five priors have been compared with each other according to the forecasting performances of the models that they are used in.",0 +https://doi.org/10.1080/10705511.2010.488997,An Alternative Approach for Nonlinear Latent Variable Models,"In the last decades there has been an increasing interest in nonlinear latent variable models. Since the seminal paper of Kenny and Judd, several methods have been proposed for dealing with these kinds of models. This article introduces an alternative approach. The methodology involves fitting some third-order moments in addition to the means and covariances. This article discusses how the model equations can be formulated and how several standard tests, like the model fit and Lagrange multiplier tests, can be performed. The new method compares favorably with the maximum likelihood method in several studies and can provide evidence of interaction that earlier approaches might ignore.",0 +https://doi.org/10.1016/j.jmp.2009.06.006,Systems Factorial Technology provides new insights on global–local information processing in autism spectrum disorders,"Previous studies of global-local processing in autism spectrum disorders (ASDs) have indicated mixed findings, with some evidence of a local processing bias, or preference for detail-level information, and other results suggesting typical global advantage, or preference for the whole or gestalt. Findings resulting from this paradigm have been used to argue for or against a detail focused processing bias in ASDs, and thus have important theoretical implications. We applied Systems Factorial Technology, and the associated Double Factorial Paradigm (both defined in the text), to examine information processing characteristics during a divided attention global-local task in high-functioning individuals with an ASD and typically developing controls. Group data revealed global advantage for both groups, contrary to some current theories of ASDs. Information processing models applied to each participant revealed that task performance, although showing no differences at the group level, was supported by different cognitive mechanisms in ASD participants compared to controls. All control participants demonstrated inhibitory parallel processing and the majority demonstrated a minimum-time stopping rule. In contrast, ASD participants showed exhaustive parallel processing with mild facilitatory interactions between global and local information. Thus our results indicate fundamental differences in the stopping rules and channel dependencies in individuals with an ASD.",0 +https://doi.org/10.1523/jneurosci.4097-14.2015,Neural Population Coding of Multiple Stimuli,"In natural scenes, objects generally appear together with other objects. Yet, theoretical studies of neural population coding typically focus on the encoding of single objects in isolation. Experimental studies suggest that neural responses to multiple objects are well described by linear or nonlinear combinations of the responses to constituent objects, a phenomenon we call stimulus mixing. Here, we present a theoretical analysis of the consequences of common forms of stimulus mixing observed in cortical responses. We show that some of these mixing rules can severely compromise the brain's ability to decode the individual objects. This cost is usually greater than the cost incurred by even large reductions in the gain or large increases in neural variability, explaining why the benefits of attention can be understood primarily in terms of a stimulus selection, or demixing, mechanism rather than purely as a gain increase or noise reduction mechanism. The cost of stimulus mixing becomes even higher when the number of encoded objects increases, suggesting a novel mechanism that might contribute to set size effects observed in myriad psychophysical tasks. We further show that a specific form of neural correlation and heterogeneity in stimulus mixing among the neurons can partially alleviate the harmful effects of stimulus mixing. Finally, we derive simple conditions that must be satisfied for unharmful mixing of stimuli.",0 +https://doi.org/10.1080/07474938.2012.690650,Introduction to Robustness in Multidimensional Wellbeing Analysis,"The multidimensional nature of wellbeing is now the widely accepted approach in frontier research on poverty, inequality and policy analysis. However, significant challenges and disagreement remain...",0 +https://doi.org/10.1177/0143624414566245,Is CO2 a good proxy for indoor air quality in classrooms? Part 2: Health outcomes and perceived indoor air quality in relation to classroom exposure and building characteristics,"The aim of this paper is to investigate whether keeping indoor thermal conditions and carbon dioxide (CO 2 ) levels within the current guideline values can provide a healthy and comfortable school environment. The study was organised as a longitudinal investigation over an academic year using a cohort of 376 students aged 9 to 11 (response rate: 87%) attending 15 classrooms in five London primary schools. The prevalence of asthmatic symptoms and asthma attacks was significantly higher among children attending urban schools (10.2%) than suburban schools (1.5%), and was significantly related to exposure to higher nitrogen dioxide (NO 2 ) concentrations (odds ratio: 1.11, 95% confidence interval: 1.00–1.19). Self-reported dermal, mucosal, respiratory and general symptoms were 18.5%, 60.7%, 28.2% and 43.6% respectively in the heating season, and decreased in the non-heating season. Infiltration rates were negatively associated with prevalence and incidence of all sick building syndrome symptoms. Exposure to traffic-related pollutants, such NO 2 , ozone (O 3 ) and tetrachloroethylene (T4CE), associated with mucosal symptoms, also increased dissatisfaction with indoor air quality (IAQ) and, therefore, perceived IAQ might be a first indication of exposure. Among targeted microbial counts, only Trichoderma viride remained significant predictors of satisfaction with IAQ even at low concentrations. The study provides evidence that simultaneous provision for limiting indoor CO 2 levels and thermal conditions below current guidelines (e.g. below 1000 ppm and 26℃ or 22℃ depending on season) may improve perceived IAQ. This paper stresses the need to go beyond current regulations to investigate concentrations of specific pollutants to ensure a healthy school environment, and closes with a section on the practical implications on the UK policy and the building design industry. Practical application: The findings highlight the role and responsibility of stakeholders, from regulators to designers and school authorities, to account for the external environment and take the steps needed to ensure that schools provide a healthy indoor environment for their students. The recommendations focus on the need to decrease outdoor pollution levels in the school vicinity, thus improving health of the students and reducing the prevalence of respiratory illness. Building designers and engineers shall adopt an integrated approach for the simultaneous provision of adequate thermal conditions and IAQ in classrooms.",0 +https://doi.org/10.1016/j.jclinepi.2010.08.010,Conducting quantitative synthesis when comparing medical interventions: AHRQ and the Effective Health Care Program,"

Abstract

Objective

This article is to establish recommendations for conducting quantitative synthesis, or meta-analysis, using study-level data in comparative effectiveness reviews (CERs) for the Evidence-based Practice Center (EPC) program of the Agency for Healthcare Research and Quality.

Study Design and Setting

We focused on recurrent issues in the EPC program and the recommendations were developed using group discussion and consensus based on current knowledge in the literature.

Results

We first discussed considerations for deciding whether to combine studies, followed by discussions on indirect comparison and incorporation of indirect evidence. Then, we described our recommendations on choosing effect measures and statistical models, giving special attention to combining studies with rare events; and on testing and exploring heterogeneity. Finally, we briefly presented recommendations on combining studies of mixed design and on sensitivity analysis.

Conclusion

Quantitative synthesis should be conducted in a transparent and consistent way. Inclusion of multiple alternative interventions in CERs increases the complexity of quantitative synthesis, whereas the basic issues in quantitative synthesis remain crucial considerations in quantitative synthesis for a CER. We will cover more issues in future versions and update and improve recommendations with the accumulation of new research to advance the goal for transparency and consistency.",0 +https://doi.org/10.1177/1742715014543579,Thought self-leadership and effectiveness in self-management teams,"This study empirically examines the multilevel nature of thought self-leadership at work. Furthermore, this study tests the relationship between team level thought self-leadership and team effectiveness (i.e. performance and viability) through collective efficacy. A total of 103 self-management teams (453 individuals), enrolled in a five-week management competition participated in the study. The results from multilevel confirmatory factor analysis suggest that thought self-leadership is functionally equivalent across levels of analysis (i.e. individuals and teams). In addition, we found an indirect effect of team level thought self-leadership on team effectiveness criteria, through collective efficacy. These findings extend previous work on thought self-leadership and team effectiveness, and open new roads for research in self-managing work teams. Finally, this study also provides guidelines for organizations in case they wish to foster team performance and viability in their work force.",0 +https://doi.org/10.1080/01621459.1995.10476487,Estimating Unknown Transition Times Using a Piecewise Nonlinear Mixed-Effects Model in Men with Prostate Cancer,Abstract It may be clinically useful to know when prostate-specific antigen (PSA) levels first begin to rise rapidly and to determine if the natural history of PSA progression is different in men with locally confined prostate cancers compared to men with metastatic tumors. This article uses a nonlinear mixed-effects model to describe longitudinal changes in PSA in men before their prostate cancers were detected clinically. Repeated measurements of PSA are available for 18 subjects with a diagnosis of prostate cancer based on prostate biopsy. PSA measurements were determined on repeated frozen serum samples collected from subjects with at least 10.0 years and up to 25.6 years of observation before the cancer was detected. A piecewise model is used to describe this data. The model is linear long before the cancer was detected and exponential nearer the time the cancer was detected. The time at which the PSA levels change from linear to exponential PSA progression is unknown but can be estimated by includin...,0 +https://doi.org/10.1007/bf02294856,A Bayesian approach to nonlinear latent variable models using the Gibbs sampler and the metropolis-hastings algorithm,"Nonlinear latent variable models are specified that include quadratic forms and interactions of latent regressor variables as special cases. To estimate the parameters, the models are put in a Bayesian framework with conjugate priors for the parameters. The posterior distributions of the parameters and the latent variables are estimated using Markov chain Monte Carlo methods such as the Gibbs sampler and the Metropolis-Hastings algorithm. The proposed estimation methods are illustrated by two simulation studies and by the estimation of a non-linear model for the dependence of performance on task complexity and goal specificity using empirical data.",0 +https://doi.org/10.1007/bf02293811,A method for simulating non-normal distributions,"A method of introducing a controlled degree of skew and kurtosis for Monte Carlo studies was derived. The form of such a transformation on normal deviates [X ≈N(0, 1)] is Y =a +bX +cX2 +dX3. Analytic and empirical validation of the method is demonstrated. © 1978 Psychometric Society.",0 +https://doi.org/10.1177/1094428114555993,Developing Ideal Intermediate Personality Items for the Ideal Point Model,"The importance of intermediate items has been overlooked since the emergence of dominance-based Likert-type scales. The current study aims to advance our understanding of the psychometric properties of intermediate items by showing that they can be successfully calibrated by an ideal point model. A student sample and an MTurk sample were selected to answer personality scales with intermediate items included. Results showed that personality scales with intermediate items demonstrated satisfactory model fits to the ideal point model, but not to the dominance model. When analyzed with the ideal point model, intermediate items provided more information than extreme items for respondents with high latent trait levels. Among four proposed domains of intermediate items (Frequency, Average, Condition, and Transition, “FACT”), the Average domain was consistently found to exhibit the best properties. The proportion of intermediate items in the scale also affected the model fit and the validity of the scale.",0 +https://doi.org/10.1027/1614-2241.4.3.97,Nonlinear Change Models in Populations with Unobserved Heterogeneity,"When unobserved heterogeneity exists in populations where the phenomenon of interest is governed by a functional form of change linear in its parameters, the growth mixture model (GMM) is useful for modeling change conditional on latent class. However, when the functional form of interest is nonlinear in its parameters, the GMM is not very useful because it is based on a system of equations linear in its parameters. The nonlinear change mixture model (NCMM) is proposed, which explicitly addresses unobserved heterogeneity in situations where change follows a nonlinear functional form. Due to the integration of nonlinear multilevel models and finite mixture models, neither of which generally have closed form solutions, analytic solutions do not generally exist for the NCMM. Five methods of parameter estimation are developed and evaluated with a comprehensive Monte Carlo simulation study. The simulation showed that the parameters of the NCMM can be accurately estimated with several of the proposed methods, and that the method of choice depends on the precise question of interest.",0 +https://doi.org/10.1037/xlm0000075,No evidence for a fixed object limit in working memory: Spatial ensemble representations inflate estimates of working memory capacity for complex objects.,"A central question for models of visual working memory is whether the number of objects people can remember depends on object complexity. Some influential ""slot"" models of working memory capacity suggest that people always represent 3-4 objects and that only the fidelity with which these objects are represented is affected by object complexity. The primary evidence supporting this claim is the finding that people can detect large changes to complex objects (consistent with remembering at least 4 individual objects), but that small changes cannot be detected (consistent with low-resolution representations). Here we show that change detection with large changes greatly overestimates individual item capacity when people can use global representations of the display to detect such changes. When the ability to use such global ensemble or texture representations is reduced, people remember individual information about only 1-2 complex objects. This finding challenges models that propose people always remember a fixed number of objects, regardless of complexity, and supports a more flexible model with an important role for spatial ensemble representations.",0 +https://doi.org/10.1002/sim.5795,Propensity scores used for analysis of cluster randomized trials with selection bias: a simulation study,"Cluster randomized trials (CRTs) are often prone to selection bias despite randomization. Using a simulation study, we investigated the use of propensity score (PS) based methods in estimating treatment effects in CRTs with selection bias when the outcome is quantitative. Of four PS-based methods (adjustment on PS, inverse weighting, stratification, and optimal full matching method), three successfully corrected the bias, as did an approach using classical multivariable regression. However, they showed poorer statistical efficiency than classical methods, with higher standard error for the treatment effect, and type I error much smaller than the 5% nominal level.",0 +https://doi.org/10.1080/10705511.2011.534695,Addressing the Problem of Switched Class Labels in Latent Variable Mixture Model Simulation Studies,"The discrimination between alternative models and the detection of latent classes in the context of latent variable mixture modeling depends on sample size, class separation, and other aspects that are related to power. Prior to a mixture analysis it is useful to investigate model performance in a simulation study that reflects the research settings. Multiple data sets are generated under 1 or more models, and alternative models are fitted to the data. The aggregation of results over multiple data sets is complicated by the fact that mixture models are only identified up to a permutation of the class labels. Estimated class labels are arbitrary, with the effect that the estimated parameters for Class 1 could be incorrectly labeled as Class 2, Class 3, and so forth, relative to their data generating labels. In a simulation study, the detection of switched labels needs to be automated. Switched class labels are not necessarily simple to detect. This article describes different possible scenarios of switched...",0 +https://doi.org/10.1080/10705511.2014.882660,A Simulation Study Comparing Recent Approaches for the Estimation of Nonlinear Effects in SEM Under the Condition of Nonnormality,"In the past decade new approaches for the estimation of latent nonlinear interaction and quadratic effects in structural equation modeling have been proposed (Kelava & Brandt, 2009; Klein & Moosbrugger, 2000; Klein & Muthen, 2007; Marsh, Wen, & Hau, 2004; Mooijaart & Bentler, 2010; Wall & Amemiya, 2003). Most approaches have been developed for the analysis of normally distributed latent predictor variables. In this article, we investigate the performance of five recent approaches under the condition of nonnormally distributed data: the extended unconstrained approach (Kelava & Brandt, 2009), LMS (Klein & Moosbrugger, 2000), QML (Klein & Muthen, 2007), the 2SMM approach (Wall & Amemiya, 2003), and the method of moments approach by Mooijaart and Bentler (2010). Advantages and limitations of the approaches are discussed.",0 +https://doi.org/10.1207/s15327906mbr3704_04,A Version of Quadratic Regression with Interpretable Parameters,"The quadratic regression model is popular and effective in describing a wide variety of data, but it is based on a function whose parameters are not easy to interpret. We suggest an alternative form of the quadratic model that has the same expectation function, but also has the useful feature that its parameters are interpretable. Examples are provided of a simple regression problem and also of a nonlinear mixed-effects model. The models can be estimated with available software.",0 +https://doi.org/10.1037/0021-9010.69.2.307,"Mediators, moderators, and tests for mediation.","Abstract : The following points are developed. First, mediation relations are generally thought of in causal terms. Influences of an antecedent are transmitted to a consequence through an intervening mediator. Second, mediation relations may assume a number of functional forms, including nonadditive, nonlinear, and nonrecursive forms. Special attention is given to nonadditive forms, or moderated mediation, where it is shown that while mediation and moderation are distinguishable processes, a particular variable may be both a mediator and a moderator within a single set of functional relations. Third, current procedures for testing mediation relations in industrial and organizational psychology need to be updated because these procedures often involve a dubious interplay between exploratory (correlational) statistical tests and causal inference. It is suggested that no middle ground exists between exploratory and confirmatory (causal) analysis, and that attempts to explain how mediation processes occur require well-specified causal models. Given such models, confirmatory analytic techniques furnish the more informative tests of mediation. (Author)",0 +https://doi.org/10.1111/ddi.12062,The value of a datum - how little data do we need for a quantitative risk analysis?,"Aim Conservation managers are typically faced with limited resources, time and information. The philosophy underlying risk assessment should be robust to these limitations. While there is a broad support for the concept of risk assessments, there is a tendency to rely on expert opinion and exclude formal data analysis, possibly because available information is often scarce. When data analyses are conducted, often much simplified models are advocated, even though this means excluding processes believed by experts to be important. In this manuscript, we ask: should statistical analyses be conducted and decisions modified based on a single datum? How many data points are needed before predictions are meaningful? Given limited data, how complex should models be? Location World-wide. Methods We use simulation approaches with known ‘true’ values to assess which inferences are possible, given different amounts of information. We use two metrics of performance: the magnitude of uncertainty (using posterior mean squared error) and bias (using P–P plots). We assess six models of relevance to conservation ecologists. Results We show that the greatest reduction in uncertainty occurred at the smallest sample sizes for models examined, and much of parameter space could be excluded. Thus, analyses based on even a single datum potentially can be useful. Further, with only a few observations, the predicted distribution of outcomes matched the probabilities of actual occurrences, even for relatively complex state-space models with multiple sources of stochasticity. Main conclusions We highlight the utility of quantitative analyses even with severely limited data, given existing practices and arguments in the conservation literature. The purpose of our manuscript is in part a philosophical discourse, as modifications are needed to how conservation ecologists are often trained to think about problems and data, and in part a demonstration via simulation analysis.",0 +https://doi.org/10.1080/1359432x.2014.983085,From state neuroticism to momentary task performance: A person × situation approach,"The goal of this article was to investigate the mechanisms through which personality relates to task performance. We argue that perceptions of work pressure and task complexity trigger momentary levels of neuroticism (i.e., state neuroticism) and that these momentary levels of neuroticism predict momentary task performance. Moreover, we hypothesized that the relationship between momentary job demands and state neuroticism is moderated by trait neuroticism. To test this model, we conducted an event reconstruction study and a day reconstruction study. The results revealed that trait neuroticism indeed moderated the momentary job demands–state neuroticism relationship, and in three out of four cases state neuroticism was found to mediate the relationship between momentary job demands and momentary task performance. From a practical point-of-view our results suggest that employees’ task performance can be improved by enhancing the way in which individuals perceive job demands. This strategy would be particula...",0 +https://doi.org/10.18148/srm/2009.v3i1.666,A Monte Carlo sample size study: How many countries are needed for accurate multilevel SEM?,"Recently, there has been growing scientific interest for cross-national survey research. Various scholars have used multilevel techniques to link individual characteristics to aspects of the national context. At first sight, multilevel SEM seems to be a promising tool for this purpose, as it integrates multilevel modeling within a latent variable framework. However, due to the fact that the number of countries in most international surveys does not exceed 30, the application of multilevel SEM in cross-national research is problematic. Taking European Social Survey (ESS) data as a point of departure, this paper uses Monte Carlo studies to assess the estimation accuracy of multilevel SEM with small group sample sizes. The results indicate that a group sample size of 20 ‐ a situation common in cross-national research ‐ does not guarantee accurate estimation at all. Unacceptable amounts of parameter and standard error bias are present for the between-level estimates. Unless the standardized e ect is very large (0.75), statistical power for detecting a significant between-level structural e ect is seriously lacking. Required group sample sizes depend strongly on the specific interests of the researcher, the expected e ect sizes and the complexity of the model. If the between-level model is relatively simple and one is merely interested in the between-level factor structure, a group sample size of 40 could be su cient. To detect large (>0.50) structural e ects at the between level, at least 60 groups are required. To have an acceptable probability of detecting smaller e ects, more than 100 groups are needed. These guidelines are shown to be quite robust for varying cluster sizes and intra-class correlations (ICCs).",0 +https://doi.org/10.1007/bf02294839,Bayesian estimation of a multilevel IRT model using gibbs sampling,"In this article, a two-level regression model is imposed on the ability parameters in an item response theory (IRT) model. The advantage of using latent rather than observed scores as dependent variables of a multilevel model is that it offers the possibility of separating the influence of item difficulty and ability level and modeling response variation and measurement error. Another advantage is that, contrary to observed scores, latent scores are test-independent, which offers the possibility of using results from different tests in one analysis where the parameters of the IRT model and the multilevel model can be concurrently estimated. The two-parameter normal ogive model is used for the IRT measurement model. It will be shown that the parameters of the two-parameter normal ogive model and the multilevel model can be estimated in a Bayesian framework using Gibbs sampling. Examples using simulated and real data are given.",0 +https://doi.org/10.1086/288135,Theory-Testing in Psychology and Physics: A Methodological Paradox,"Because physical theories typically predict numerical values, an improvement in experimental precision reduces the tolerance range and hence increases corroborability. In most psychological research, improved power of a statistical design leads to a prior probability approaching ½ of finding a significant difference in the theoretically predicted direction. Hence the corroboration yielded by “success” is very weak, and becomes weaker with increased precision. “Statistical significance” plays a logical role in psychology precisely the reverse of its role in physics. This problem is worsened by certain unhealthy tendencies prevalent among psychologists, such as a premium placed on experimental “cuteness” and a free reliance upon ad hoc explanations to avoid refutation.",0 +https://doi.org/10.1080/00220973.2014.907229,Examining the Rule of Thumb of Not Using Multilevel Modeling: The “Design Effect Smaller Than Two” Rule,"Educational researchers commonly use the rule of thumb of “design effect smaller than 2” as the justification of not accounting for the multilevel or clustered structure in their data. The rule, however, has not yet been systematically studied in previous research. In the present study, we generated data from three different models (which differ in the location of the clustering effect). With a 3 (design effect) × 5 (cluster size) × 4 (number of clusters) Monte Carlo simulation study we found that the rule should not be applied when researchers: (a) are interested in the effects of higher-level predictors, or (b) have a cluster size less than 10. Implications of the findings and limitations of the study are discussed.",0 +https://doi.org/10.1016/j.jspi.2012.09.006,Estimation of covariance matrices based on hierarchical inverse-Wishart priors,"Abstract This paper focuses on Bayesian shrinkage methods for covariance matrix estimation. We examine posterior properties and frequentist risks of Bayesian estimators based on new hierarchical inverse-Wishart priors. More precisely, we give the conditions for the existence of the posterior distributions. Advantages in terms of numerical simulations of posteriors are shown. A simulation study illustrates the performance of the estimation procedures under three loss functions for relevant sample sizes and various covariance structures.",0 +https://doi.org/10.1037/met0000112,An alternative to post hoc model modification in confirmatory factor analysis: The Bayesian lasso.,"As a commonly used tool for operationalizing measurement models, confirmatory factor analysis (CFA) requires strong assumptions that can lead to a poor fit of the model to real data. The post hoc modification model approach attempts to improve CFA fit through the use of modification indexes for identifying significant correlated residual error terms. We analyzed a 28-item emotion measure collected for n = 175 participants. The post hoc modification approach indicated that 90 item-pair errors were significantly correlated, which demonstrated the challenge in using a modification index, as the error terms must be individually modified as a sequence. Additionally, the post hoc modification approach cannot guarantee a positive definite covariance matrix for the error terms. We propose a method that enables the entire inverse residual covariance matrix to be modeled as a sparse positive definite matrix that contains only a few off-diagonal elements bounded away from zero. This method circumvents the problem of having to handle correlated residual terms sequentially. By assigning a Lasso prior to the inverse covariance matrix, this Bayesian method achieves model parsimony as well as an identifiable model. Both simulated and real data sets were analyzed to evaluate the validity, robustness, and practical usefulness of the proposed procedure. (PsycINFO Database Record",0 +https://doi.org/10.1002/sim.6185,Propensity score methods for estimating relative risks in cluster randomized trials with low-incidence binary outcomes and selection bias,"Despite randomization, selection bias may occur in cluster randomized trials. Classical multivariable regression usually allows for adjusting treatment effect estimates with unbalanced covariates. However, for binary outcomes with low incidence, such a method may fail because of separation problems. This simulation study focused on the performance of propensity score (PS)-based methods to estimate relative risks from cluster randomized trials with binary outcomes with low incidence. The results suggested that among the different approaches used (multivariable regression, direct adjustment on PS, inverse weighting on PS, and stratification on PS), only direct adjustment on the PS fully corrected the bias and moreover had the best statistical properties.",0 +https://doi.org/10.1177/1465116515618252,Going public against institutional constraints? Analyzing the online presence intensity of 2014 European Parliament election candidates,"Political parties and candidates have not been immune to the changes that the Internet and social media have introduced in electoral campaigns. Yet, as the use of digital media by political elites is becoming a norm in the United States, in Europe, the decision to develop an online presence depends on the cross-national differences regarding candidates’ constraints and incentives. European Parliament elections present an exceptional comparative opportunity to measure this potential diversity. Using an original database on the online presence of more than 5000 candidates competing under the label of incumbent parties in 2014, we demonstrate that there are two relevant groups of nonadopters, and that candidates’ online campaign intensity varies significantly depending on incumbency and the ballot structure in their countries.",0 +https://doi.org/10.2165/00019053-200624050-00005,Comprehensive Decision-Analytic Model and Bayesian Value-of-Information Analysis,"Objective: To conduct a Bayesian value-of-information analysis of the cost effectiveness of pentoxifylline (vs placebo) as an adjunct to compression for venous leg ulcers. Methods: A probabilistic Markov model was developed to estimate mean clinical benefits and costs associated with oral pentoxifylline (400mg three times daily) and placebo. Clinical data were obtained from a systematic review and synthesised using Bayesian methods. The decision uncertainty associated with the adoption of pentoxifylline as well as the maximum value associated with further research were estimated before and after the completion of the largest 'definitive' treatment trial. Resource use was obtained from a UK national audit and unit costs applied (£, 2004 values). Results: The prior and posterior analyses suggest that pentoxifylline is a dominant therapy versus placebo. In the prior analysis, patients in the pentoxifylline group healed an average of 8.28 weeks quicker than patients in the placebo group (95% credibility interval [CI] 1.89, 14.56), had a 0.02 gain in QALYs (95% CI -0.12, 0.17) and an average reduction in cost of £153.4 (95% CI -53.11, 354.9). Estimates of the uncertainty surrounding the cost effectiveness of pentoxifylline and the value of perfect information in both analyses did not suggest further research was justified. In the prior analysis, for willingness-to-pay values of £0, £100 and £500 per QALY gained, the estimated values of perfect information were £128 200, £127 100 and £126 700, respectively. Incorporation of the information from the largest randomised controlled trial on pentoxifylline did improve the estimate of the clinical effect associated with this drug; however, the variation was not large enough to reverse either the decision regarding the dominance of pentoxifylline or the maximum value associated with further research. Conclusion: Bayesian value-of-information analysis represents a valuable tool for healthcare decision making. Had the results from this analysis been available before the largest trial was funded, a more efficient allocation of research and development resources could have been made. © 2006 Adis Data Information BV. All rights reserved.",0 +https://doi.org/10.1016/j.cyto.2003.08.001,Further characterization of high mobility group box 1 (HMGB1) as a proinflammatory cytokine: central nervous system effects,"High mobility group box 1 (HMGB1), an abundant, highly conserved cellular protein, is widely known as a nuclear DNA-binding protein. HMGB1 has been recently implicated as a proinflammatory cytokine because of its role as a late mediator of endotoxin lethality and ability to stimulate release of proinflammatory cytokines from monocytes. Production of central cytokines is a critical step in the pathway by which endotoxin and peripheral proinflammatory cytokines, including interleukin-1beta (IL-1) and tumor necrosis factor-alpha (TNF), produce sickness behaviors and fever. Intracerebroventricular (ICV) administration of HMGB1 has been shown to increase TNF expression in mouse brain and induce aphagia and taste aversion. Here we show that ICV injections of HMGB1 induce fever and hypothalamic IL-1 in rats. Furthermore, we show that intrathecal administration of HMGB1 produces mechanical allodynia (lowering of the response threshold to calibrated stimuli). Finally, while endotoxin (lipopolysaccharide, LPS) administration elevates IL-1 and TNF mRNA in various brain regions, HMGB1 mRNA is unchanged. It remains possible that HMGB1 protein is released in brain in response to LPS. Nonetheless, these data suggest that HMGB1 may play a role as an endogenous pyrogen and support the concept that HMGB1 has proinflammatory characteristics within the central nervous system.",0 +https://doi.org/10.1037/a0020761,A general approach to causal mediation analysis.,"Traditionally in the social sciences, causal mediation analysis has been formulated, understood, and implemented within the framework of linear structural equation models. We argue and demonstrate that this is problematic for 3 reasons: the lack of a general definition of causal mediation effects independent of a particular statistical model, the inability to specify the key identification assumption, and the difficulty of extending the framework to nonlinear models. In this article, we propose an alternative approach that overcomes these limitations. Our approach is general because it offers the definition, identification, estimation, and sensitivity analysis of causal mediation effects without reference to any specific statistical model. Further, our approach explicitly links these 4 elements closely together within a single framework. As a result, the proposed framework can accommodate linear and nonlinear relationships, parametric and nonparametric models, continuous and discrete mediators, and various types of outcome variables. The general definition and identification result also allow us to develop sensitivity analysis in the context of commonly used models, which enables applied researchers to formally assess the robustness of their empirical conclusions to violations of the key assumption. We illustrate our approach by applying it to the Job Search Intervention Study. We also offer easy-to-use software that implements all our proposed methods.",0 +https://doi.org/10.1007/s13595-015-0530-5,Improved models of harvest-induced bark damage,"We provided a precise quantitative analysis of the factors at the origin of bark damage during harvesting operations and developed a model able to predict them accurately. The major factors were the distance of trees to skid trails, the intensity of removals, the harvesting system as well as the interactions between the distance of trees to skid trails with harvesting systems, the average skidding distance, the tree species and tree height. During timber harvesting, trees in the remaining stand may suffer bark damage resulting from tree-felling or log manipulation. Although a multitude of case studies and empirical observations provide qualitative and quantitative information with respect to the potential causal factors, the basic quantitative relationship between major factors of influence and the resulting degree of bark damage remains largely unclear. The objective was to provide a precise quantitative analysis of impact factors explaining the occurrence of bark damage during harvesting operations. Three different modelling approaches were tested: boosted regression tree (BRT), a generalised linear mixed effects model (GLMM) and Bayesian Markov chain Monte Carlo generalised linear mixed models (MCMCglmm). The major factors with a significant impact on the occurrence of bark damage were the distance of trees to skid trails, the intensity of removals, the harvesting system and the interaction term between the distance of trees to skid trails with harvesting systems, average skidding distance, tree species and tree height. The final model includes the relevant major factors impacting on the infliction of bark damage during practical harvesting operations. Furthermore, it discriminates well with respect to the occurrence of bark damage, and it provides managers with a rational and conclusive tool for optimising harvesting operations.",0 +https://doi.org/10.1016/s0022-5371(80)90266-2,"Norms of 300 general-information questions: Accuracy of recall, latency of recall, and feeling-of-knowing ratings","Normative data were collected on 300 general-information questions from a wide variety of topics, including history, sports, art, geography, literature, and entertainment. Male and female undergraduates at two different universities made a one-word response to each question either in a response booklet or at a computer console. The reported data include the following for each question: (a) probability of recall for all 270 undergraduates, for males versus females, and for University of Washington subjects versus University of California, Irvine, subjects, (b) latency of correct recall, (c) latency of errors, and (d) feeling-of-knowing ratings for nonrecalled items. Correlations among these dependent variables, along with measures of reliability, are also reported.",0 +https://doi.org/10.1046/j.0039-0402.2003.00256.x,Performance of empirical Bayes estimators of random coefficients in multilevel analysis: Some results for the random intercept-only model,"For a multilevel model with two levels and only a random intercept, the quality of different estimators of the random intercept is examined. Analytical results are given for the marginal model interpretation where negative estimates of the variance components are allowed for. Except for four or five level-2 units, the Empirical Bayes Estimator (EBE) has a lower average Bayes risk than the Ordinary Least Squares Estimator (OLSE). The EBEs based on restricted maximum likelihood (REML) estimators of the variance components have a lower Bayes risk than the EBEs based on maximum likelihood (ML) estimators. For the hierarchical model interpretation, where estimates of the variance components are restricted being positive, Monte Carlo simulations were done. In this case the EBE has a lower average Bayes risk than the OLSE, also for four or five level-2 units. For large numbers of level-1 (30) or level-2 units (100), the performances of REML-based and ML-based EBEs are comparable. For small numbers of level-1 (10) and level-2 units (25), the REML-based EBEs have a lower Bayes risk than ML-based EBEs only for high intraclass correlations (0.5).",0 +https://doi.org/10.1177/0013164413498256,Mutual Information Item Selection Method in Cognitive Diagnostic Computerized Adaptive Testing With Short Test Length,"Cognitive diagnostic computerized adaptive testing (CD-CAT) purports to combine the strengths of both CAT and cognitive diagnosis. Cognitive diagnosis models aim at classifying examinees into the correct mastery profile group so as to pinpoint the strengths and weakness of each examinee whereas CAT algorithms choose items to determine those strengths and weakness as efficiently as possible. Most of the existing CD-CAT item selection algorithms are evaluated when test length is relatively long whereas several applications of CD-CAT, such as in interim assessment, require an item selection algorithm that is able to accurately recover examinees’ mastery profile with short test length. In this article, we introduce the mutual information item selection method in the context of CD-CAT and then provide a computationally easier formula to make the method more amenable in real time. Mutual information is then evaluated against common item selection methods, such as Kullback–Leibler information, posterior weighted Kullback–Leibler information, and Shannon entropy. Based on our simulations, mutual information consistently results in nearly the highest attribute and pattern recovery rate in more than half of the conditions. We conclude by discussing how the number of attributes, Q-matrix structure, correlations among the attributes, and item quality affect estimation accuracy.",0 +https://doi.org/10.1016/j.fishres.2014.11.016,"Relative magnitude of cohort, age, and year effects on size at age of exploited marine fishes","Abstract Variation in individual growth rates contributes to changes over time in compensatory population growth and surplus production for marine fishes. However, there is little evidence regarding the prevalence and magnitude of time-varying growth for exploited marine fishes in general, whether it is best approximated using changes in length-at-age or weight-at-length parameters, or how it can be represented parsimoniously. We therefore use a database of average weight in each year and age for 91 marine fish stocks from 25 species, and fit models with random variation in length and weight parameters by year, age, or cohort (birth-year). Results show that year effects are more parsimonious than age or cohort effects and that variation in length and weight parameters provide roughly similar fit to average weight-at-age data, although length parameters show a greater magnitude of variability than weight parameters. Finally, the saturated model can explain nearly 2/3 of total variability, while a single time-varying factor can explain nearly 1/2 of variability in weight-at-age data. We conclude that time-varying growth can often be estimated parsimoniously using a single time-varying factor, either internally or prior to including ‘empirical’ weight at age in population dynamics models.",0 +https://doi.org/10.1016/j.jsp.2013.05.005,Examining classroom influences on student perceptions of school climate: The role of classroom management and exclusionary discipline strategies,"There is growing emphasis on the use of positive behavior supports rather than exclusionary discipline strategies to promote a positive classroom environment. Yet, there has been limited research examining the association between these two different approaches to classroom management and students' perceptions of school climate. Data from 1902 students within 93 classrooms that were nested within 37 elementary schools were examined using multilevel structural equation modeling procedures to investigate the association between two different classroom management strategies (i.e., exclusionary discipline strategies and the use of positive behavior supports) and student ratings of school climate (i.e., fairness, order and discipline, student-teacher relationship, and academic motivation). The analyses indicated that greater use of exclusionary discipline strategies was associated with lower order and discipline scores, whereas greater use of classroom-based positive behavior supports was associated with higher scores on order and discipline, fairness, and student-teacher relationship. These findings suggest that pre-service training and professional development activities should promote teachers' use of positive behavior support strategies and encourage reduced reliance on exclusionary discipline strategies in order to enhance the school climate and conditions for learning.",0 +https://doi.org/10.4324/9780203848852.ch9,Bootstrapping in Multilevel Models,"We note, however, that even as the number of bootstrap replications tends to infinity, the estimate of the population density function that is used to generate the bootstrap samples is the empirical “plug in” one derived from the actual sampled observations by placing mass points (e.g., equal probabilities) at each one. In other words the sample is assumed to be a reasonable representation of the population. Thus, with nonparametric bootstrapping, we do not have exact inference. This does not carry over to the parametric case that we describe below, where the model-based (assumed) population distribution is used for sampling: we shall return to this case later. In fact, in some situations the nonparametric bootstrap can perform very badly, for example, in small or moderate samples where the statistic of interest is the smallest or largest value, say of a set of higher level residuals in a multilevel model.",0 +https://doi.org/10.1111/j.1745-9125.2008.00123.x,THE EFFECTS OF RESIDENTIAL TURNOVER ON HOUSEHOLD VICTIMIZATION*,"Americans move frequently, and moving alters their risks of victimization. This study uses unique longitudinal, multilevel data from the 1980–1985 National Crime Survey to examine the effects of residential turnover on household victimization. The two major findings of the study are as follows: First, housing turnover is a transition that independently increases the risk that a dwelling will experience a crime. This finding is true even controlling for persistent differences in crime vulnerability between dwellings. Second, changes in the composition and routine activities of households also alter the risks of victimization. These findings provide support for social disorganization and crime opportunity theories.",0 +https://doi.org/10.1038/36846,The capacity of visual working memory for features and conjunctions,"Short-term memory storage can be divided into separate subsystems for verbal information and visual information, and recent studies have begun to delineate the neural substrates of these working-memory systems. Although the verbal storage system has been well characterized, the storage capacity of visual working memory has not yet been established for simple, suprathreshold features or for conjunctions of features. Here we demonstrate that it is possible to retain information about only four colours or orientations in visual working memory at one time. However, it is also possible to retain both the colour and the orientation of four objects, indicating that visual working memory stores integrated objects rather than individual features. Indeed, objects defined by a conjunction of four features can be retained in working memory just as well as single-feature objects, allowing sixteen individual features to be retained when distributed across four objects. Thus, the capacity of visual working memory must be understood in terms of integrated objects rather than individual features, which places significant constraints on cognitive and neurobiological models of the temporary storage of visual information.",0 +https://doi.org/10.1026/0932-4089/a000165,Metaanalyse–praktische Schritte und Entscheidungen im Umsetzungsprozess,"In diesem Beitrag wird der Durchführungsprozess metaanalytischer Techniken nach Hunter und Schmidt (2004) Schritt für Schritt beschrieben. In Form eines Tutoriums geben wir evidenzbasierte Empfehlungen, verweisen auf relevante Quellen und Hilfsmittel und bewerten alternative Vorgehensweisen in Bezug auf ihre Güte und Akzeptanz. Wir wenden uns an Forschende, die eine Metaanalyse mit der Besonderheit der Artefaktkorrekturen nach Hunter und Schmidt durchführen wollen und geben Anregungen für die Verbreitung metaanalytischer Ergebnisse sowohl im Wissenschaftskontext als auch im Austausch mit Praktikern.",0 +https://doi.org/10.1177/0146621613497532,A General Approach for Assessing Person Fit and Person Reliability in Typical-Response Measurement,"In constant-θ IRT models, person unreliability is regarded as a source of person misfit. In Variable-θ IRT models, on the other hand, it is regarded as a relevant individual characteristic, which is modeled as an additional person parameter. As in any IRT application, person fit must be assessed when a variable-θ model is fitted to real data. This assessment aims to detect inconsistent response patterns once person unreliability has been taken into account. The present paper makes a general proposal for assessing person fit based on variable-θ models that are intended to be used with personality and attitude measures. For the three types of variable-θ IRT models developed to date—binary, graded, and (approximately) continuous response models—(a) graphical procedures, (b) global person-fit indices, and (c) residual indices at the item level are proposed and discussed. A multistage approach for using the indices and procedures is also proposed and illustrated using an empirical example.",0 +https://doi.org/10.1016/b978-012372560-8/50040-1,Multivariate autoregressive models,"Functional neuroimaging has been used to corroborate functional specialization as a principle of organization in the human brain. However, disparate regions of the brain do not operate in isolation and, more recently, neuroimaging has been used to characterize the network properties of the brain under speci.c cognitive states Buchel and Friston, 1997a  and  Buchel and Friston, 2000 . These studies address a complementary principle of organization, functional integration.",0 +https://doi.org/10.3102/10769986028002111,Maximum Likelihood Estimation of Nonlinear Structural Equation Models with Ignorable Missing Data,"The existing maximum likelihood theory and its computer software in structural equation modeling are established on the basis of linear relationships among latent variables with fully observed data. However, in social and behavioral sciences, nonlinear relationships among the latent variables are important for establishing more meaningful models and it is very common to encounter missing data. In this article, an EM type algorithm is developed for maximum likelihood estimation of a general nonlinear structural equation model with ignorable missing data, which are missing at random with an ignorable mechanism. To avoid computation of the complicated multiple integrals involved in the conditional expectations, the E-step is completed by a hybrid algorithm that combines the Gibbs sampler and the Metropolis-Hastings algorithm; while the M-step is completed efficiently by conditional maximization. Standard errors of the maximum likelihood estimates are obtained via Louis’s formula. The methodology is illustrated with results obtained from a simulation study and a real data set with rather complicated missing patterns and a large number of missing entries.",0 +https://doi.org/10.1016/s0167-9473(01)00058-5,Bayesian and likelihood methods for fitting multilevel models with complex level-1 variation,"In multilevel modelling it is common practice to assume constant variance at level 1 across individuals. In this paper we consider situations where the level-1 variance depends on predictor variables. We examine two cases using a dataset from educational research; in the first case the variance at level 1 of a test depends on a continuous intake score predictor, and in the second case the variance is assumed to differ according to gender. We contrast two maximum-likelihood methods based on iterative generalised least squares with two Markov chain Monte Carlo (MCMC) methods based on adaptive hybrid versions of the Metropolis-Hastings (MH) algorithm, and we use two simulation experiments to compare these four methods. We find that all four approaches have good repeated-sampling behaviour in the classes of models we simulate. We conclude by contrasting raw- and log-scale formulations of the level-1 variance function, and we find that adaptive MH sampling is considerably more efficient than adaptive rejection sampling when the heteroscedasticity is modelled polynomially on the log scale.",0 +https://doi.org/10.1016/j.worlddev.2011.07.013,Small Farmers and Big Retail: Trade-offs of Supplying Supermarkets in Nicaragua,"Summary In Nicaragua and elsewhere in Central America, small-scale farmers are weighing the risks of entering into contracts with supermarket chains. We use unique data from cooperatives supplying supermarkets to study the effect of supply agreements on producers’ mean output prices and price stability. We find that prices paid by the domestic retail chain approximate the traditional market in mean and variance while mean prices paid by Walmart are significantly lower than the traditional market. However, the Walmart contract is found to systematically reduce price volatility. We find some evidence, however, that farmers may be paying too much for this contractual insurance against price variation.",0 +,Data analysis in social psychology.,,0 +https://doi.org/10.1016/j.neuropsychologia.2010.12.023,Storage and binding of object features in visual working memory,"An influential conception of visual working memory is of a small number of discrete memory ""slots"", each storing an integrated representation of a single visual object, including all its component features. When a scene contains more objects than there are slots, visual attention controls which objects gain access to memory. A key prediction of such a model is that the absolute error in recalling multiple features of the same object will be correlated, because features belonging to an attended object are all stored, bound together. Here, we tested participants' ability to reproduce from memory both the color and orientation of an object indicated by a location cue. We observed strong independence of errors between feature dimensions even for large memory arrays (6 items), inconsistent with an upper limit on the number of objects held in memory. Examining the pattern of responses in each dimension revealed a gaussian distribution of error centered on the target value that increased in width under higher memory loads. For large arrays, a subset of responses were not centered on the target but instead predominantly corresponded to mistakenly reproducing one of the other features held in memory. These misreporting responses again occurred independently in each feature dimension, consistent with 'misbinding' due to errors in maintaining the binding information that assigns features to objects. The results support a shared-resource model of working memory, in which increasing memory load incrementally degrades storage of visual information, reducing the fidelity with which both object features and feature bindings are maintained.",0 +https://doi.org/10.1207/s15327906mbr4001_5,Fit Indices Versus Test Statistics,"Model evaluation is one of the most important aspects of structural equation modeling (SEM). Many model fit indices have been developed. It is not an exaggeration to say that nearly every publication using the SEM methodology has reported at least one fit index. Most fit indices are defined through test statistics. Studies and interpretation of fit indices commonly assume that the test statistics follow either a central chi-square distribution or a noncentral chi-square distribution. Because few statistics in practice follow a chi-square distribution, we study properties of the commonly used fit indices when dropping the chi-square distribution assumptions. The study identifies two sensible statistics for evaluating fit indices involving degrees of freedom. We also propose linearly approximating the distribution of a fit index/statistic by a known distribution or the distribution of the same fit index/statistic under a set of different conditions. The conditions include the sample size, the distribution of the data as well as the base-statistic. Results indicate that, for commonly used fit indices evaluated at sensible statistics, both the slope and the intercept in the linear relationship change substantially when conditions change. A fit index that changes the least might be due to an artificial factor. Thus, the value of a fit index is not just a measure of model fit but also of other uncontrollable factors. A discussion with conclusions is given on how to properly use fit indices.",0 +https://doi.org/10.1002/sim.2666,Flexible random-effects models using Bayesian semi-parametric models: applications to institutional comparisons,"Random effects models are used in many applications in medical statistics, including meta-analysis, cluster randomized trials and comparisons of health care providers. This paper provides a tutorial on the practical implementation of a flexible random effects model based on methodology developed in Bayesian non-parametrics literature, and implemented in freely available software. The approach is applied to the problem of hospital comparisons using routine performance data, and among other benefits provides a diagnostic to detect clusters of providers with unusual results, thus avoiding problems caused by masking in traditional parametric approaches. By providing code for Winbugs we hope that the model can be used by applied statisticians working in a wide variety of applications.",0 +https://doi.org/10.1002/0470023724.ch1b(ii),Hierarchical Modelling: Multilevel Modelling of Medical Data,"This tutorial presents an overview of multilevel or hierarchical data modelling and its applications in medicine. A description of the basic model for nested data is given and it is shown how this can be extended to fit flexible models for repeated measures data and more complex structures involving cross-classi cations and multiple membership patterns within the software package MLwiN. A variety of response types are covered and both frequentist and Bayesian estimation methods are described. © 2004 John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester. All Rights Reserved.",0 +https://doi.org/10.1016/s0169-2607(00)00096-1,A system for the assessment and training of temporal-order discrimination,"Two programs were developed for psychophysical assessment and training of temporal-order thresholds in the visual and auditory modalities. Order threshold is defined as the minimum onset interval between two sensory events (stimulus onset asynchrony, SOA) that must exist before an observer is able to indicate the correct order of the events. Brain-injured patients with aphasia and children with language-learning impairments, i.e. those who have been diagnosed as performing poorly on temporal-order tasks and in discriminating stop-consonant vowel syllables, can effectively be trained by a feedback training procedure in which the SOA is manipulated. The performance in the temporal-order task and the ability to discriminate phonemes improves with this procedure. In the diagnostic program, the SOA is changed by an adaptive procedure that generates a sequence of SOAs converging to the threshold and is driven by the responses of the subject. The feedback-training program begins with the presentation of SOAs, which are slightly above the individual order threshold; they are subsequently varied according to the responses of the subject.",0 +https://doi.org/10.1063/1.1666011,Generalization of Euler Angles to N‐Dimensional Orthogonal Matrices,"An algorithm is presented whereby an N‐dimensional orthogonal matrix can be represented in terms of ½N(N − 1) independent parameters θk(ν)[ν=2,3,…,N;k=1,2,…,(ν−1)]. The parameters have the character of angles, whose compact domains are defined in a manner such that there exists a one‐to‐one correspondence between the points in the parameter space and the group of orthogonal matrices. Explicit formulas are given which express all matrix elements in terms of the angles, and formulas are given which express the angles in terms of the matrix elements. Special choices of angles give block‐diagonal matrices. For three‐dimensional matrices, the parametrization is equivalent to that of Euler.",0 +https://doi.org/10.1016/j.pain.2004.06.001,Snake venom components enhance pain upon subcutaneous injection: an initial examination of spinal cord mediators,"Snakebites are a relevant public health problem in Central and South America. Snake bite envenomations cause intense pain, not relieved by anti-venom. The fangs of many species are short, causing subcutaneous injection. Fangs of larger species inflict subcutaneous or intramuscular envenomation. To understand pain induced by subcutaneous venom, this study examined spinal mechanisms involved in pain-enhancing effects of subcutaneous Lys49 and Asp49 secretory phospholipase-A(2) (sPLA2), two components of Bothrops asper snake venom showing highly different enzymatic activities. Unilateral intraplantar sPLA2-Lys49 (catalytically inactive) or sPLA2-Asp49 (catalytically active) into rat hindpaws each induced mechanical hyperalgesia (Randall-Selitto test), whereas only catalytically active sPLA2-Asp49 caused mechanical allodynia (von Frey test). Effects induced by both sPLA2s were inhibited by intrathecal fluorocitrate, a reversible glial metabolic inhibitor. In support, immunohistochemical analysis revealed activation of dorsal horn astrocytes and microglia after intraplantar injection of either sPLA2. Spinal proinflammatory cytokines, nitric oxide, and prostanoids each appear to be involved in the pain-enhancing effects of these sPLA2s. Blockade of interleukin-1 (IL1) inhibited hyperalgesia induced by both sPLA2s, while leaving allodynia unaffected. Blockade of tumor necrosis factor reduced responses to sPLA2-Asp49. An inhibitor of neuronal nitric oxide synthase, 7-nitroindazole (7-NI), inhibited hyperalgesia induced by both sPLA2s, without interfering with allodynia induced by sPLA2-Asp49. On the other hand, L-N(6)-(1-iminoethyl)lysine (L-NI), an inhibitor of the inducible nitric oxide synthase, did not alter any sPLA2-induced effect. Lastly, celecoxib, an inhibitor of cyclooxygenase-2, attenuated sPLA2 actions. These data provide the first evidence of spinal mediators involved in pain facilitation induced by subcutaneous venoms.",0 +https://doi.org/10.1136/bmjopen-2014-005644,"Evidence for a persistent, major excess in all cause admissions to hospital in children with type-1 diabetes: results from a large Welsh national matched community cohort study","

Objectives

To estimate the excess in admissions associated with type1 diabetes in childhood.

Design

Matched-cohort study using anonymously linked hospital admission data.

Setting

Brecon Group Register of new cases of childhood diabetes in Wales linked to hospital admissions data within the Secure Anonymised Information Linkage Databank.

Population

1577 Welsh children (aged between 0 and 15 years) from the Brecon Group Register with newly-diagnosed type-1 diabetes between 1999–2009 and 7800 population controls matched on age, sex, county, and deprivation, randomly selected from the local population.

Main outcome measures

Difference in all-cause hospital admission rates, 30-days post-diagnosis until 31 May 2012, between participants and controls.

Results

Children with type-1 diabetes were followed up for a total of 12 102 person years and were at 480% (incidence rate ratios, IRR 5.789, (95% CI 5.34 to 6.723), p<0.0001) increased risk of hospital admission in comparison to matched controls. The highest absolute excess of admission was in the age group of 0–5 years, with a 15.4% (IRR 0.846, (95% CI 0.744 to 0.965), p=0.0061) reduction in hospital admissions for every 5-year increase in age at diagnosis. A trend of increasing admission rates in lower socioeconomic status groups was also observed, but there was no evidence of a differential rate of admissions between men and women when adjusted for background risk. Those receiving outpatient care at large centres had a 16.1% (IRR 0.839, (95% CI 0.709 to 0.990), p=0.0189) reduction in hospital admissions compared with those treated at small centres.

Conclusions

There is a large excess of hospital admissions in paediatric patients with type-1 diabetes. Rates are highest in the youngest children with low socioeconomic status. Factors influencing higher admission rates in smaller centres (eg, “out of hours resources”) need to be explored with the aim of targeting modifiable influences on admission rates.",0 +https://doi.org/10.1016/j.jmva.2006.08.003,Estimation of high-dimensional prior and posterior covariance matrices in Kalman filter variants,"This work studies the effects of sampling variability in Monte Carlo-based methods to estimate very high-dimensional systems. Recent focus in the geosciences has been on representing the atmospheric state using a probability density function, and, for extremely high-dimensional systems, various sample-based Kalman filter techniques have been developed to address the problem of real-time assimilation of system information and observations. As the employed sample sizes are typically several orders of magnitude smaller than the system dimension, such sampling techniques inevitably induce considerable variability into the state estimate, primarily through prior and posterior sample covariance matrices. In this article, we quantify this variability with mean squared error measures for two Monte Carlo-based Kalman filter variants: the ensemble Kalman filter and the ensemble square-root Kalman filter. Expressions of the error measures are derived under weak assumptions and show that sample sizes need to grow proportionally to the square of the system dimension for bounded error growth. To reduce necessary ensemble size requirements and to address rank-deficient sample covariances, covariance-shrinking (tapering) based on the Schur product of the prior sample covariance and a positive definite function is demonstrated to be a simple, computationally feasible, and very effective technique. Rules for obtaining optimal taper functions for both stationary as well as non-stationary covariances are given, and optimal taper lengths are given in terms of the ensemble size and practical range of the forecast covariance. Results are also presented for optimal covariance inflation. The theory is verified and illustrated with extensive simulations.",0 +https://doi.org/10.1198/016214502388618942,Parsimonious Covariance Matrix Estimation for Longitudinal Data,"This article proposes a data-driven method to identify parsimony in the covariance matrix of longitudinal data and to exploit any such parsimony to produce a statistically efficient estimator of the covariance matrix. The approach parameterizes the covariance matrix through the Cholesky decomposition of its inverse. For longitudinal data, this is a one-step-ahead predictive representation, and the Cholesky factor is likely to have off-diagonal elements that are zero or close to zero. A hierarchical Bayesian model is used to identify any such zeros in the Cholesky factor, similar to approaches that have been successful in Bayesian variable selection. The model is estimated using a Markov chain Monte Carlo sampling scheme that is computationally efficient and can be applied to covariance matrices of high dimension. It is demonstrated through simulations that the proposed method compares favorably in terms of statistical efficiency with a highly regarded competing approach. The estimator is applied to three ...",0 +https://doi.org/10.1037/a0020141,A general multilevel SEM framework for assessing multilevel mediation.,"Several methods for testing mediation hypotheses with 2-level nested data have been proposed by researchers using a multilevel modeling (MLM) paradigm. However, these MLM approaches do not accommodate mediation pathways with Level-2 outcomes and may produce conflated estimates of between- and within-level components of indirect effects. Moreover, these methods have each appeared in isolation, so a unified framework that integrates the existing methods, as well as new multilevel mediation models, is lacking. Here we show that a multilevel structural equation modeling (MSEM) paradigm can overcome these 2 limitations of mediation analysis with MLM. We present an integrative 2-level MSEM mathematical framework that subsumes new and existing multilevel mediation approaches as special cases. We use several applied examples and accompanying software code to illustrate the flexibility of this framework and to show that different substantive conclusions can be drawn using MSEM versus MLM.",0 +https://doi.org/10.1037/a0016972,Bayesian mediation analysis.,"In this article, we propose Bayesian analysis of mediation effects. Compared with conventional frequentist mediation analysis, the Bayesian approach has several advantages. First, it allows researchers to incorporate prior information into the mediation analysis, thus potentially improving the efficiency of estimates. Second, under the Bayesian mediation analysis, inference is straightforward and exact, which makes it appealing for studies with small samples. Third, the Bayesian approach is conceptually simpler for multilevel mediation analysis. Simulation studies and analysis of 2 data sets are used to illustrate the proposed methods. (PsycINFO Database Record (c) 2009 APA, all rights reserved).",1 +https://doi.org/10.1080/10705511.2010.510052,Evaluation of Reliability Coefficients for Two-Level Models via Latent Variable Analysis,"A latent variable analysis procedure for evaluation of reliability coefficients for 2-level models is outlined. The method provides point and interval estimates of group means' reliability, overall reliability of means, and conditional reliability. In addition, the approach can be used to test simple hypotheses about these parameters. The procedure is applicable with unconditional models as well as with conditional models including higher level explanatory variables. The proposed method is illustrated with an empirical example.",0 +https://doi.org/10.1016/s0304-3959(99)00302-4,An evaluation of homogeneity tests in meta-analyses in pain using simulations of individual patient data,"In this paper we consider the validity and power of some commonly used statistics for assessing the degree of homogeneity between trials in a meta-analysis. We show, using simulated individual patient data typical of that occurring in randomized controlled trials in pain, that the most commonly used statistics do not give the expected levels of statistical significance (i.e. the proportion of trials giving a significant result is not equal to the proportion expected due to random chance) when used with truly homogeneous data. In addition, all such statistics are shown to have extremely low power to detect true heterogeneity even when that heterogeneity is very large. Since, in most practical situations, failure to detect heterogeneity does not allow us to say with any helpful degree of certainty that the data is truly homogeneous, we advocate the quantitative combination of results only where the trials contained in a meta-analysis can be shown to be clinically homogeneous. We propose as a definition of clinical homogeneity that all trials have (i) fixed and clearly defined inclusion criteria and (ii) fixed and clearly defined outcomes or outcome measures. In pain relief, for example, the first of these would be satisfied by all patients having moderate or severe pain, whilst the second would be satisfied by using at least 50% pain relief as the successful outcome measure.",0 +https://doi.org/10.1007/978-1-4939-2236-9_10,Constraining Cognitive Abstractions Through Bayesian Modeling,"There are many ways to combine neural and behavioral measures to study cognition. Someways are theoretical, and otherways are statistical. The predominant statistical approach treats both sources of data as independent and the relationship between the two measures is inferred by way of a (post hoc) regression analysis. Inthis chapter, we review an alternative approach that allows for flexible modeling of both measures simultaneously.We then explore and elaborate on several of the most important benefits of this modeling approach, and close with a model comparison of the Linear Ballistic Accumulator model and a drift diffusion model on neural and behavioral data. © Springer Science+Business Media, LLC 2015.",0 +https://doi.org/10.1016/b978-0-12-724960-5.50010-x,Patterns of Change within Latent Variable Structural Equation Models,"This chapter demonstrates how selected hypotheses about patterns of change can be investigated using concepts derived from linear structural equation modeling. In Section 5.1 we discuss the concept of structuring correlations by structural equation methods. In Section 5.2 we describe some longitudinal data and illustrate technical aspects of various structural models for these summary statistics. Here we describe the relations between the algebraic and graphic representation of linear models and the nonlinear expectations they imply. In Section 5.3 four different models of change are presented and fitted to these longitudinal data using structural equation model algorithms. These models include an autoregressive change model, a difference components change model, a growth curve change model, and a factor analysis change model. In Section 5.4 some of these ideas are considered together in a multivariate framework. These examples demonstrate the merger of contemporary issues in developmental psychology and structural equation analysis.",0 +https://doi.org/10.1598/rrq.40.2.3,Reinterpreting the development of reading skills,"Theories about reading have neglected basic differences in the developmental trajectories of skills related to reading. This essay proposes that some reading skills, such as learning the letters of the alphabet, are constrained to small sets of knowledge that are mastered in relatively brief periods of development. In contrast, other skills, such as vocabulary, are unconstrained by the knowledge to be acquired or the duration of learning. The conceptual, developmental, and methodological constraints on different reading skills are described in this essay that identifies various types of constraints on reading constructs and measures. Examples of reading research and assessment are discussed to illustrate (a) how the constraints can help to explain transitory correlational patterns among reading data, (b) how proxy effects surrounding constrained skills influence interpretations of reading development, (c) how prescriptions to teach constrained skills are causal misinterpretations of longitudinal correlations, and (d) why interventions on constrained skills usually lead only to temporary gains on skills aligned with the constrained skill. Because constrained skills are not normally distributed conceptually or empirically, except on special occasions, analyses based on parametric statistics are inappropriate. This essay describes implications for theories of reading development, research methods, and educational policies; the “extra” commentary linked to the online version of the article expands on this latter theme. Las teorias acerca de la lectura han descuidado diferencias basicas en el camino evolutivo de las habilidades relacionadas con la lectura. Este ensayo propone que ciertas habilidades de lectura, como el aprendizaje de las letras del alfabeto, estan restringidas a pequenos conjuntos de conocimientos cuyo dominio se concreta en periodos relativamente breves. En contraste, otras habilidades tales como el vocabulario, no estan restringidas por el conocimiento que se adquirira ni por la duracion del aprendizaje. En este ensayo se describen las restricciones conceptuales, evolutivas y metodologicas en diferentes habilidades de lectura; el mismo identifica varios tipos de restricciones en las conceptualizaciones sobre la lectura y en las medidas de lectura. Se discuten ejemplos de investigacion y evaluacion en lectura para ilustrar: a) de que modo las restricciones pueden ayudar a explicar patrones correlacionales transitorios entre los datos de lectura, b) como efectos secundarios proximos a las habilidades restringidas influencian las interpretaciones del desarrollo en lectura, c) como ciertas propuestas para ensenar habilidades restringidas son malas interpretaciones causales de correlaciones longitudinales y d) por que las intervenciones sobre las habilidades restringidas generalmente conducen solo a logros temporarios en habilidades afines a la habilidad restringida. Debido a que las habilidades restringidas, excepto en ocasiones especiales, no estan normalmente distribuidas conceptual o empiricamente, son inapropiados los analisis basados en la estadistica parametrica. El ensayo describe implicancias para las teorias del desarrollo lector, los metodos de investigacion y las politicas educativas. Theorien ubers Lesen haben die grundsatzlichen Unterschiede in den aufs Lesen bezogenen sich entwickelnden Leistungsbahnen vernachlassigt. Dieser Aufsatz vertritt die Ansicht, das einige Leseleistungen, wie beispielsweise das Erlernen der Buchstaben des Alphabets, auf eng begrenzte Erkenntniswerte beschrankt sind, die in relativ kurzen Entwicklungsperioden beherrscht werden. Im Gegensatz dazu sind andere Kenntnisse, wie das Vokabular, unbegrenzt im zu erlernenden Wissen oder in der Dauer beim Lernen. Die konzeptualen, entwicklungsbedingten und methodologischen Beschrankungen auf unterschiedliche Leseleistungen werden in diesem Aufsatz beschrieben, welcher verschiedene Typen von Einschrankungen im Lesen von Wortfugungen und Abschatzungen identifiziert. Beispiele aus der Leseforschung und Bewertung werden diskutiert, um zu illustrieren, (a) wie die Einschrankungen dazu verhelfen konnen, transitorische Korrelationsmuster zwischen den Lesedaten zu erklaren, (b) wie Vertretungsfunktionen umgebende Auswertungen von Leistungseinwirkungen der Leseentwicklung beeinflust, (c) wie Verordnungen zum Unterrichten eingegrenzter Kenntnisse kausale Fehlinterpretationen der Langenkorrelationen sind, und (d) warum Interventionen bei eingegrenzten Kenntnissen meistens nur zu zeitweisen Fortschritten der angeglichenen Leistungen eingeschrankter Fahigkeiten fuhren. Da eingeschrankte Befahigungen normalerweise nicht konzeptionell oder empirisch eingeteilt sind, auser bei speziellen Anlassen, sind die auf parametrische Statistiken basierte Analysen ungeeignet. Dieser Aufsatz beschreibt Implikationen fur Theorien zur Leseentwicklung, Forschungsmethoden und Unterrichtsverfahren. Les theories de la lecture ont neglige des differences de base dans les trajectoires du developpement des competences relatives a la lecture. Cet essai enonce que certaines competences de lecture telles que les lettres de l'alphabet se reduisent a de petits ensembles de connaissances qui sont maitrisees au cours de periodes de developpement relativement breves. Par contre, d'autres competences telles que le vocabulaire ne sont pas limitees par les connaissances a acquerir ou par la duree de l'apprentissage. On decrit dans cet essai, qui identifie differents types de contraintes sur les constructs et les evaluations de la lecture, les contraintes conceptuelles, developpementales, et methodologiques de differentes competences de lecture. On discute des exemples de recherche et d'evaluation de la lecture afin de montrer a) comment les contraintes peuvent aider a expliquer certains patrons provisoires de correlations entre resultats de lecture, b) comment des effets voisins qui se trouvent autour des competences reduites jouent un role sur les interpretations du developpement de la lecture, c) comment les prescriptions d'enseignement de competences reduites sont responsables d'erreurs d'interpretation des correlations longitudinales, et d) pourquoi des interventions sur des competences reduites ne conduisent en general qu'a des gains temporaires sur des competences liees a celles-ci. Du fait que, sauf en de rares occasions, les competences reduites ne sont pas distribuees normalement, tant conceptuellement qu'empiriquement, les analyses reposant sur des statistiques parametriques sont inappropriees. Cet essai enonce enfin des implications sur les theories du developpement de la lecture, les methodes de recherche, et les politiques educatives.",0 +https://doi.org/10.1037/a0023002,The PHLAME (Promoting Healthy Lifestyles: Alternative Models' Effects) firefighter study: Testing mediating mechanisms.,"This paper examines the mechanisms by which PHLAME (Promoting Healthy Lifestyles: Alternative Models' Effects), a health promotion intervention, improved healthy eating and exercise behavior among firefighters, a population at high risk for health problems due to occupational hazards. In a randomized trial, 397 firefighters participated in either the PHLAME team intervention with their work shift or a control condition. Intervention sessions taught benefits of a healthy diet and regular exercise, and sought to improve social norms and social support from coworkers for healthy behavior. At posttest, team intervention participants had increased their fruit and vegetable consumption as compared to control participants. An increase in knowledge of fruit and vegetable benefits and improved dietary coworker norms partially mediated these effects. Exercise habits and VO2 max were related to targeted mediators but were not significantly changed by the team intervention. Partial support was found for both the action and conceptual theories underlying the intervention. Our findings illustrate how an effective program's process can be deconstructed to understand the underpinnings of behavior change and refine interventions. Further, fire stations may improve the health of firefighters by emphasizing the benefits of healthy diet and exercise behaviors while also encouraging behavior change by coworkers as a whole.",0 +https://doi.org/10.1007/s11222-006-7072-5,Variance component models for longitudinal count data with baseline information: epilepsy data revisited,"Random effect models have often been used in longitudinal data analysis since they allow for association among repeated measurements due to unobserved heterogeneity. Various approaches have been proposed to extend mixed models for repeated count data to include dependence on baseline counts. Dependence between baseline counts and individual-specific random effects result in a complex form of the (conditional) likelihood. An approximate solution can be achieved ignoring this dependence, but this approach could result in biased parameter estimates and in wrong inferences. We propose a computationally feasible approach to overcome this problem, leaving the random effect distribution unspecified. In this context, we show how the EM algorithm for nonparametric maximum likelihood (NPML) can be extended to deal with dependence of repeated measures on baseline counts. © Springer Science + Business Media, LLC 2006.",0 +https://doi.org/10.1023/a:1020206907668,,"Markov chain Monte Carlo (MCMC) techniques have revolutionized the field of Bayesian statistics by enabling posterior inference for arbitrarily complex models. The now widely used WinBUGS software has, over the years, made the methodology accessible to a great many applied scientists, in all fields of research. Despite this, serious application of MCMC methods within the field of population PK/PD has been comparatively limited. We appreciate that for many applied pharmacokineticists the prospect of conducting a Bayesian analysis will require numerous alien concepts to be taken on board and it may be difficult to justify investing the time and effort required in order to understand them (especially since the approach is so computer-intensive). For this reason we provide here a thorough (but often informal) discussion of all aspects of Bayesian inference as they apply specifically to population PK/PD. We also acknowledge that while the WinBUGS software is general purpose, model specification for some types of problem, population PK/PD being a prime example, can be very difficult, to the extent that a specialized interface for describing the problem at hand is often a practical necessity. In the latter part of this paper we describe such an interface, namely PKBugs. A principal aim of the paper is to offer sufficient technical background, in an easy to follow format, that the reader may develop both the confidence and know-how to make appropriate use of the PKBugs/WinBUGS framework (or similar software) for their own data analysis needs, should they choose to adopt a Bayesian approach.",0 +https://doi.org/10.1177/0013164406288164,Mutual Information Item Selection in Adaptive Classification Testing,"A general approach for item selection in adaptive multiple-category classification tests is provided. The approach uses mutual information (MI), a special case of the Kullback-Leibler distance, or relative entropy. MI works efficiently with the sequential probability ratio test and alleviates the difficulties encountered with using other local- and global-information measures in the multiple-category classification setting. Results from simulation studies using three item selection methods, Fisher information (FI), posterior-weighted FI (FIP), and MI, are provided for an adaptive four-category classification test. Both across and within the four classification categories, it is shown that in general, MI item selection classifies the highest proportion of examinees correctly and yields the shortest test lengths. The next best performance is observed for FIP item selection, followed by FI.",0 +https://doi.org/10.1007/bf02296207,Maximum likelihood estimation of the polychoric correlation coefficient,"The polychoric correlation is discussed as a generalization of the tetrachoric correlation coefficient to more than two classes. Two estimation methods are discussed: Maximum likelihood estimation, and what may be called ""two-step maximum likelihood"" estimation. For the latter method, the thresholds are estimated in the first step. For both methods, asymptotic covariance matrices for estimates are derived, and the methods are illustrated and compared with artificial and real data. © 1979 The Psychometric Society.",0 +https://doi.org/10.1348/135910700168892,The Theory of Planned Behaviour and exercise: Evidence for the moderating role of past behaviour,"Objectives. This study reports an application of the Theory of Planned Behaviour (TPB) to the prediction of exercise intentions and behaviour over a 6-month period. The study also considers the moderating effect of past behaviour on the intention-behaviour and perceived behavioural control-behaviour relationships. Design and methods. A sample of 87 patients attending health promotions clinics in a primary care setting completed questionnaires on the TPB and exercise behaviour after their clinic appointment and were followed-up at 6 months. Results. The TPB was found to be predictive of initial exercise intentions and future exercise behaviour at 6-month follow-up, with the perceived behavioural control construct emerging as the sole independent predictor in both cases. Past behaviour was found to have a direct effect on future exercise behaviour over and above the influence of the TPB. In addition, past behaviour moderated the perceived behavioural control-behaviour relationship which was found to be significant when the frequency of past behaviour was moderate or high, but non-significant when the frequency of past behaviour was low. Conclusion. The results highlight (1) the importance of the perceived behavioural control construct of the TPB in the prediction of exercise intentions and behaviour, and (2) the need to consider the moderating effect of past behaviour on TPB-behaviour relations.",0 +https://doi.org/10.1037/0022-006x.74.2.263,Dissonance and healthy weight eating disorder prevention programs: A randomized efficacy trial.,"In this trial, adolescent girls with body dissatisfaction (N = 481, M age = 17 years) were randomized to an eating disorder prevention program involving dissonance-inducing activities that reduce thin-ideal internalization, a prevention program promoting healthy weight management, an expressive writing control condition, or an assessment-only control condition. Dissonance participants showed significantly greater reductions in eating disorder risk factors and bulimic symptoms than healthy weight, expressive writing, and assessment-only participants, and healthy weight participants showed significantly greater reductions in risk factors and symptoms than expressive writing and assessment-only participants from pretest to posttest. Although these effects faded over 6-month and 12-month follow-ups, dissonance and healthy weight participants showed significantly lower binge eating and obesity onset and reduced service utilization through 12-month follow-up, suggesting that both interventions have public health potential.",0 +https://doi.org/10.1080/00273171.2013.802978,Accuracy and Precision of an Effect Size and Its Variance From a Multilevel Model for Cluster Randomized Trials: A Simulation Study,"This article investigates an effect size (MLM ES) and its variance for cluster randomized trials based on parameter estimates from multilevel modeling analysis. Accuracy and precision of MLM ES were evaluated using Monte Carlo simulation methods and compared with the performance of an effect size, computed from summary statistics, proposed by Hedges (2007; Hedges' dB ). Simulation results indicated that MLM ES had acceptable accuracy in all conditions, also demonstrating efficiency and consistency. With small sample sizes, MLM ES did not suffer from the same negative bias as Hedges' dB due to overestimation of between-cluster variance. With large sample sizes, MLM ES and Hedges' dB were comparable for accuracy and efficiency. Both MLM ES and Hedges' dB showed considerable bias in some conditions when cluster sizes were unequal. An illustrative example using real data was provided.",0 +https://doi.org/10.1016/s0065-2601(08)60144-6,The Social Relations Model,"Publisher Summary The Social Relations Model represents one method of studying two-person relationships. It attempts to separate the effects of persons and dyad. The Social Relations Model has three potential contributions to the study of dyads. First, it provides a purely methodological-statistical solution to the analysis of dyadic data. The Social Relations Model represents a new approach to the analysis of dyadic data structures. Second, the model can provide social psychology with better procedures to resolve the theoretical issues of the discipline. Third, the model is useful because it looks at social behavior as simultaneously operating at multiple levels. Very different principles operate at these different levels and only by simultaneously examining social behavior at different levels, the complexity and simplicity of social life can be fully appreciated.",0 +https://doi.org/10.1037/0021-9010.88.4.694,Ethnic group differences in measures of job performance: A new meta-analysis.,"The authors conducted a new meta-analysis of ethnic group differences in job performance. Given a substantially increased set of data as compared with earlier analyses, the authors were able to conduct analyses of Black-White differences within more homogeneous categories of job performance and to reexamine findings on objective versus subjective measurement. Contrary to one perspective sometimes adopted in the field, objective measures are associated with very similar, if not somewhat larger, standardized ethnic group differences (ds) than subjective measures across a variety of indicators. This trend was consistent across quality, quantity, and absenteeism measures. Further, work samples and job knowledge tests are associated with larger ds than performance ratings or measures of absenteeism. Analysis of Hispanic-White standardized differences shows that they are generally lower than Black-White differences in several categories.",0 +https://doi.org/10.1016/j.ssresearch.2015.12.006,Using geocoded survey data to improve the accuracy of multilevel small area synthetic estimates,"This paper examines the secondary data requirements for multilevel small area synthetic estimation (ML-SASE). This research method uses secondary survey data sets as source data for statistical models. The parameters of these models are used to generate data for small areas. The paper assesses the impact of knowing the geographical location of survey respondents on the accuracy of estimates, moving beyond debating the generic merits of geocoded social survey datasets to examine quantitatively the hypothesis that knowing the approximate location of respondents can improve the accuracy of the resultant estimates. Four sets of synthetic estimates are generated to predict expected levels of limiting long term illnesses using different levels of knowledge about respondent location. The estimates were compared to comprehensive census data on limiting long term illness (LLTI). Estimates based on fully geocoded data were more accurate than estimates based on data that did not include geocodes.",0 +https://doi.org/10.1097/jnr.0000000000000042,Factors Affecting Perceptions of Family Function in Caregivers of Children With Attention Deficit Hyperactivity Disorders,"Attention deficit and hyperactivity disorder (ADHD) is the most common neurobehavioral disorder of childhood. ADHD has been shown to persist into adulthood in 30%-70% of cases. The long-term and escalating nature of ADHD creates an increasing burden on families because of the influence of hyperactivity and impulsivity on academic achievement and social interaction. There is a lack of information on factors influencing function in the families of children with ADHD.The purpose of this study was to test theoretically derived relationships among family demographic characteristics; family factors such as support, hardiness, and caregiver health; and family-functioning outcomes.This study used a cross-sectional study and structural equation modeling approach. A self-report questionnaire collected information from 122 caregivers on demographics, income, employment, and marital status data as well as on personal health, family support, family hardiness, and family function statuses as determined, respectively, using the Duke Health Profile, Family APGAR score, Family Hardiness Index, and Family Assessment Device.Structural equation modeling provided a reasonable fit to the data using AMOS (χ = .249, df = 1, p = .613, minimum discrepancy C = .249), goodness-of-fit index (.999), adjusted goodness of fit index (.990), normed fit index (.999), comparative fit index (1.0), and root mean square error of approximation (.000). Results indicated a 55.6% probability of becoming the construct model, with family hardiness and family support directly affecting family function and caregiver health. Family support functioned as a mediator in the relationship between family hardiness and family function.The findings of this study help nurses improve professional assessments and interventions for families of children with ADHD by highlighting the importance of increased family support, promoting family hardiness, and promoting caregivers' health to improved family function.",0 +https://doi.org/10.3102/10769986030001026,Maximum Likelihood Analysis of a Two-Level Nonlinear Structural Equation Model With Fixed Covariates,"In this article, a maximum likelihood (ML) approach for analyzing a rather general two-level structural equation model is developed for hierarchically structured data that are very common in educational and/or behavioral research. The proposed two-level model can accommodate nonlinear causal relations among latent variables as well as effects of fixed covariate in its various components. Methods for computing the ML estimates, and the Bayesian information criterion (BIC) for model comparison are established on the basis of powerful tools in statistical computing such as the Monte Carlo EM algorithm, Gibbs sampler, Metropolis–Hastings algorithm, conditional maximization, bridge sampling, and path sampling. The newly developed procedures are illustrated by results obtained from a simulation study and analysis of a real data set in education.",0 +https://doi.org/10.1177/0146621612446806,"Evaluating EIV, OLS, and SEM Estimators of Group Slope Differences in the Presence of Measurement Error","Measurement error significantly biases interaction effects and distorts researchers’ inferences regarding interactive hypotheses. This article focuses on the single-indicator case and shows how to accurately estimate group slope differences by disattenuating interaction effects with errors-in-variables (EIV) regression. New analytic findings were presented along with simulation results to compare the relative bias, power, and Type I error rates of EIV, ordinary least squares (OLS), and sparse (i.e., single indicator) multigroup structural equation model (SEM) estimators of interaction effects in the presence of measurement error. The results suggest that EIV was less biased than were OLS and sparse SEM. Furthermore, OLS and sparse SEM were unable to control the Type I error rate for tests of slope differences in circumstances where groups differ in predictor reliability. Additional derivations examined the impact of using Cronbach’s alpha, which is typically a lower bound for reliability, with EIV. The results provided evidence that using alpha does result in overcorrected EIV estimates and the bias in EIV estimates associated with using Cronbach’s alpha increases with variability in item loadings and bias decreases as either test length or the average loading increases. The bias in EIV estimates when using alpha is not larger than the bias produced by using OLS or sparse SEM. In summary, the results provide compelling evidence that researchers should use EIV instead of OLS and sparse SEM to estimate group slope differences in the presence of measurement error.",0 +https://doi.org/10.1016/0022-2496(80)90003-6,On appropriate procedures for combining probability distributions within the same family,"Abstract This article considers procedures for combining individual probability distributions that belong to some “family” into a “group” probability distribution that belongs to the same family. The procedures considered are Vincentizing, in which quantiles are averaged across distributions; generalized Vincentizing, in which the quantiles are transformed before averaging; and pooling based on the distribution function or the probability density function. Some of these results are applied to models of reaction time in psychological experiments.",0 +https://doi.org/10.1201/b14835-13,Inference and monitoring convergence,,0 +https://doi.org/10.1002/sim.1020,Sample size considerations in observational health care quality studies,"A common objective in health care quality studies involves measuring and comparing the quality of care delivered to cohorts of patients by different health care providers. The data used for inference involve observations on units grouped within clusters, such as patients treated within hospitals. Unlike cluster randomization trials where often clusters are randomized to interventions to learn about individuals, the target of inference in health quality studies is the cluster. Furthermore, randomization is often not performed and the resulting biases may invalidate standard tests. In this paper, we discuss approaches to sample size determination in the design of observational health quality studies when the outcome is binary. Methods for calculating sample size using marginal models are briefly reviewed, but the focus is on hierarchical binomial models. Sample size in unbalanced clusters and stratified designs are characterized. We draw upon the experiences that have arisen from a study funded by the Agency for Healthcare Research and Quality involving assessment of quality of care for patients with cardiovascular disease. If researchers are interested in comparing clusters, hierarchical models are preferred. Copyright © 2002 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1016/j.addbeh.2012.03.031,Personality mediators of psychopathy and substance dependence in male offenders,"Psychopathy and substance dependence (SUD) is highly prevalent in incarcerated populations and tends to co-occur in the same individuals. The factors underlying this relationship are not clearly understood. The primary purpose of this study was to investigate whether two personality models mediate the relationship between psychopathy and substance misuse in male offenders. Ninety-two inmates in provincial correctional centers in New Brunswick completed questionnaires, including the Sensitivity to Reward Sensitivity to Punishment Questionnaire to measure behavioral activation and behavioral inhibition, the Substance Use Risk Profile Scale to measure anxiety sensitivity, introversion/hopelessness, sensation seeking and impulsivity, and the Psychopathic Personality Inventory—Revised to assess psychopathy levels. Results revealed that high impulsivity indirectly mediated the relationship between psychopathy and stimulant dependence. In addition, low anxiety sensitivity indirectly mediated the relationship between psychopathy and opioid dependence. Finally, impulsivity indirectly and inconsistently mediated the relationship between psychopathy and alcohol dependence. These results suggest that individuals with psychopathic traits are at increased risk of misusing certain drugs due to underlying personality-based differences. ► Psychopathy traits/substance misuse are highly prevalent and comorbid in offenders. ► We recruited inmates and measured psychopathy, personality, and substance dependence. ► High impulsivity was an indirect mediator of psychopathy and stimulant/alcohol SUD. ► Low anxiety sensitivity was an indirect mediator of psychopathy and opioid SUD. ► Psychopathic traits are distinctly related with SUDS due to personality differences.",0 +https://doi.org/10.1007/s11336-007-9008-1,Multilevel Modeling with Correlated Effects,"When there exist omitted effects, measurement error, and/or simultaneity in multilevel models, explanatory variables may be correlated with random components, and standard estimation methods do not provide consistent estimates of model parameters. This paper introduces estimators that are consistent under such conditions. By employing generalized method of moments (GMM) estimation techniques in multilevel modeling, the authors present a series of estimators along a robust to efficient continuum. This continuum depends on the assumptions that the analyst makes regarding the extent of the correlated effects. It is shown that the GMM approach provides an overarching framework that encompasses well-known estimators such as fixed and random effects estimators and also provides more options. These GMM estimators can be expressed as instrumental variable (IV) estimators which enhances their interpretability. Moreover, by exploiting the hierarchical structure of the data, the current technique does not require additional variables unlike traditional IV methods. Further, statistical tests are developed to compare the different estimators. A simulation study examines the finite sample properties of the estimators and tests and confirms the theoretical order of the estimators with respect to their robustness and efficiency. It further shows that not only are regression coefficients biased, but variance components may be severely underestimated in the presence of correlated effects. Empirical standard errors are employed as they are less sensitive to correlated effects when compared to model-based standard errors. An example using student achievement data shows that GMM estimators can be effectively used in a search for the most efficient among unbiased estimators. © 2007 The Psychometric Society.",0 +https://doi.org/10.1016/j.csda.2006.10.005,Comparison of PQL and Laplace 6 estimates of hierarchical linear models when comparing groups of small incident rates in cluster randomised trials,"The variances of the random components in hierarchical generalised linear models (HGLMs) with binary outcomes have been reported to have a considerable downward bias when estimated with the commonly used penalised quasilikelihood (PQL) technique. The more recently proposed Laplace 6 approximation promises to reduce this bias. This study compares the performance of these two techniques when estimating the parameters of a particular HGLM. This comparison is performed via Monte Carlo simulations in which the difference between two groups of proportions, modelled after those appearing in many epidemiological cluster randomised interventions, are tested using this model. The Laplace 6 approximation does reduce the bias mentioned above, but at the price of a higher mean square error. The results of this study suggest that the optimal solution involves using a combination of these two techniques. This combination is illustrated by analysing a data set from a real cluster randomised intervention.",0 +https://doi.org/10.3102/1076998609332750,A Nonlinear Mixed Effects Model for Latent Variables,"The nonlinear mixed effects model for continuous repeated measures data has become an increasingly popular and versatile tool for investigating nonlinear longitudinal change in observed variables. In practice, for each individual subject, multiple measurements are obtained on a single response variable over time or condition. This structure can be adapted to examine the change in latent variables rather than modeling change in manifest variables. This article considers a nonlinear mixed effects model for describing nonlinear change of a latent construct over time, where the latent construct of interest is measured by multiple indicators gathered at each measurement occasion. To accomplish this, the nonlinear mixed effects model is modified to include a measurement model that explicitly expresses the relationship of the observed variables to the latent constructs. A method for marginal maximum likelihood estimation of this model is presented and discussed. An example using education data is provided to illustrate the utility of the model.",0 +,Double pulse resolution in the visual field: the influence of temporal stimulus characteristics,"I. It has been suggested that measuring double-pulse resolution in the visual field is more useful than performing flicker perimetry. Yet it is difficult to assess the diagnostic potentials of this technique unless a number of methodological difficulties are overcome. 2. We succeeded to show that double-pulse resolution can be measured efficiently and reliably by varying pulse durations over a wide temporal range, by employing a nine-alternative forced-choice paradigm with nine locations in the visual field, and by employing a maximum likelihood estimate of the threshold parameter. Our results, which have been obtained at the central fovea and at eight locations on the principal meridians with 3.4° eccentricity, reveal three main properties of visual performance. 3. Temporal resolution is worst (i.e. 50-70 ms) at a duration of the leading pulse of 20 ms. It monotonically improves to assume an asymptotic value of about 20 ms beyond pulse durations of say 150 ms. Resolution may also improve if the pulse duration is as brief as 10 ms. 4. The prolongation of the trailing pulse has virtually no effect on double-pulse resolution. 5. Double-pulse resolution in the central fovea is, almost independently of the pulse duration, 10-20 ms better than in the peripheral visual field.",0 +https://doi.org/10.1177/0963721414529144,The Adaptive Nature of Visual Working Memory,"A growing body of scientific evidence suggests that visual working memory and statistical learning are intrinsically linked. Although visual working memory is severely resource limited, in many cases, it makes efficient use of its available resources by adapting to statistical regularities in the visual environment. However, experimental evidence also suggests that there are clear limits and biases in statistical learning. This raises the intriguing possibility that performance limitations observed in visual working memory tasks can to some degree be explained in terms of limits and biases in statistical-learning ability, rather than limits in memory capacity.",0 +https://doi.org/10.1002/sim.1903,Stratification and weighting via the propensity score in estimation of causal treatment effects: a comparative study,"Estimation of treatment effects with causal interpretation from observational data is complicated because exposure to treatment may be confounded with subject characteristics. The propensity score, the probability of treatment exposure conditional on covariates, is the basis for two approaches to adjusting for confounding: methods based on stratification of observations by quantiles of estimated propensity scores and methods based on weighting observations by the inverse of estimated propensity scores. We review popular versions of these approaches and related methods offering improved precision, describe theoretical properties and highlight their implications for practice, and present extensive comparisons of performance that provide guidance for practical use. Copyright © 2004 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1177/01466216970212006,Estimation of Composite Reliability for Congeneric Measures,"A structural equation model is described that permits estimation of the reliability index and coefficient of a composite test for congeneric measures. The method is also helpful in exploring the factorial structure of an item set, and its use in scale reliability estimation and development is illustrated. The modeling. estimator of composite reliability it yields does not possess the general underestimation property of Cronbach's coefficient a.",0 +https://doi.org/10.1016/j.bbi.2008.05.004,Proinflammatory cytokines oppose opioid-induced acute and chronic analgesia,"Spinal proinflammatory cytokines are powerful pain-enhancing signals that contribute to pain following peripheral nerve injury (neuropathic pain). Recently, one proinflammatory cytokine, interleukin-1, was also implicated in the loss of analgesia upon repeated morphine exposure (tolerance). In contrast to prior literature, we demonstrate that the action of several spinal proinflammatory cytokines oppose systemic and intrathecal opioid analgesia, causing reduced pain suppression. In vitro morphine exposure of lumbar dorsal spinal cord caused significant increases in proinflammatory cytokine and chemokine release. Opposition of analgesia by proinflammatory cytokines is rapid, occurring < or =5 min after intrathecal (perispinal) opioid administration. We document that opposition of analgesia by proinflammatory cytokines cannot be accounted for by an alteration in spinal morphine concentrations. The acute anti-analgesic effects of proinflammatory cytokines occur in a p38 mitogen-activated protein kinase and nitric oxide dependent fashion. Chronic intrathecal morphine or methadone significantly increased spinal glial activation (toll-like receptor 4 mRNA and protein) and the expression of multiple chemokines and cytokines, combined with development of analgesic tolerance and pain enhancement (hyperalgesia, allodynia). Statistical analysis demonstrated that a cluster of cytokines and chemokines was linked with pain-related behavioral changes. Moreover, blockade of spinal proinflammatory cytokines during a stringent morphine regimen previously associated with altered neuronal function also attenuated enhanced pain, supportive that proinflammatory cytokines are importantly involved in tolerance induced by such regimens. These data implicate multiple opioid-induced spinal proinflammatory cytokines in opposing both acute and chronic opioid analgesia, and provide a novel mechanism for the opposition of acute opioid analgesia.",0 +https://doi.org/10.1046/j.1529-8027.2001.006001111.x,Sciatic inflammatory neuritis (SIN): Behavioral allodynia is paralleled by peri‐sciatic proinflammatory cytokine and superoxide production,"We have recently developed a model of sciatic inflammatory neuritis (SIN) to assess how immune activation near peripheral nerves influences somatosensory processing. Administration of zymosan (yeast cell walls) around a single sciatic nerve produces dose-dependent low-threshold mechanical allodynia without thermal hyperalgesia. Low (4 microg) doses produce both territorial and extraterritorial allodynia restricted to the injected hindleg. In contrast, higher (40 microg) doses produce territorial and extraterritorial allodynias of both hindlegs, an effect not accounted for by systemic spread of the zymosan. The aim of these experiments was to determine whether these behavioral allodynias were correlated with immunological and/or anatomical changes in or around the sciatic nerve. These experiments reveal that zymosan-induced bilateral allodynia was associated with the following: (a) increased release of both interleukin-1beta and tumor necrosis factor-alpha from peri-sciatic immune cells; (b) increased release of reactive oxygen species from perisciatic immune cells; (c) no change in circulating levels of proinflammatory cytokine; (d) no apparent zymosan-induced influx of immune cells into the sciatic nerve from the endoneurial blood vessels; (e) mild edema of the sciatic, which was predominantly restricted to superficial regions closest to the peri-sciatic immune cells; and (f) no anatomic evidence of changes in either the ipsilateral saphenous nerve or contralateral sciatic nerve that could account for the appearance of extraterritorial or contralateral (""mirror"") allodynia, respectively. No reliable differences were found when the low-dose zymosan was compared with vehicle controls. Taken together, these data suggest that substances released by peri-sciatic immune cells may induce changes in the sciatic nerve, leading to the appearance of bilateral allodynia.",0 +https://doi.org/10.1111/j.1559-1816.1998.tb01685.x,Extending the Theory of Planned Behavior: A Review and Avenues for Further Research,"This paper describes and reviews the theory of planned behavior (TPB). The focus is on evidence supporting the further extension of the TPB in various ways. Empirical and theoretical evidence to support the addition of 6 variables to the TPB is reviewed: belief salience measures, past behaviodhabit, perceived behavioral control (PBC) vs. selfefficacy, moral norms, self-identity, and affective beliefs. In each case there appears to be growing empirical evidence to support their addition to the TPB and some understanding of the processes by which they may be related to other TPB variables, intentions, and behavior. Two avenues for expansion of the TPB are presented. First, the possibility of incorporating the TPB into a dual-process model of attitude-behavior relationships is reviewed. Second, the expansion of the TPB to include consideration of the volitional processes determining how goal intentions may lead to goal achievement is discussed.",0 +https://doi.org/10.1093/mnras/stv2501,Hierarchical cosmic shear power spectrum inference,"We develop a Bayesian hierarchical modelling approach for cosmic shear power spectrum inference, jointly sampling from the posterior distribution of the cosmic shear field and its (tomographic) power spectra. Inference of the shear power spectrum is a powerful intermediate product for a cosmic shear analysis, since it requires very few model assumptions and can be used to perform inference on a wide range of cosmological models \emph{a posteriori} without loss of information. We show that joint posterior for the shear map and power spectrum can be sampled effectively by Gibbs sampling, iteratively drawing samples from the map and power spectrum, each conditional on the other. This approach neatly circumvents difficulties associated with complicated survey geometry and masks that plague frequentist power spectrum estimators, since the power spectrum inference provides prior information about the field in masked regions at every sampling step. We demonstrate this approach for inference of tomographic shear $E$-mode, $B$-mode and $EB$-cross power spectra from a simulated galaxy shear catalogue with a number of important features; galaxies distributed on the sky and in redshift with photometric redshift uncertainties, realistic random ellipticity noise for every galaxy and a complicated survey mask. The obtained posterior distributions for the tomographic power spectrum coefficients recover the underlying simulated power spectra for both $E$- and $B$-modes.",0 +https://doi.org/10.3758/pbr.17.1.59,Homogeneity computation: How interitem similarity in visual short-term memory alters recognition,"Visual short-term recognition memory for multiple stimuli is strongly influenced by the study items’ similarity to one another—that is, by their homogeneity. However, the mechanism responsible for this homogeneity effect has remained unclear. We evaluated competing explanations of this effect, using controlled sets of Gabor patches as study items and probe stimuli. Our results, based on recognition memory for spatial frequency, rule out the possibility that the homogeneity effect arises because similar study items are encoded and/or maintained with higher fidelity in memory than dissimilar study items are. Instead, our results support the hypothesis that the homogeneity effect reflects trial-by-trial comparisons of study items, which generate a homogeneity signal. This homogeneity signal modulates recognition performance through an adjustment of the subject’s decision criterion. Additionally, it seems the homogeneity signal is computed prior to the presentation of the probe stimulus, by evaluating the familiarity of each new stimulus with respect to the items already in memory. This suggests that recognition-like processes operate not only on the probe stimulus, but on study items as well.",0 +https://doi.org/10.1007/s12561-014-9124-2,Bayesian Two-Stage Biomarker-Based Adaptive Design for Targeted Therapy Development,"We propose a Bayesian two-stage biomarker-based adaptive randomization (AR) design for the development of targeted agents. The design has three main goals: (1) to test the treatment efficacy, (2) to identify prognostic and predictive markers for the targeted agents, and (3) to provide better treatment for patients enrolled in the trial. To treat patients better, both stages are guided by the Bayesian AR based on the individual patient's biomarker profiles. The AR in the first stage is based on a known marker. A Go/No-Go decision can be made in the first stage by testing the overall treatment effects. If a Go decision is made at the end of the first stage, a two-step Bayesian lasso strategy will be implemented to select additional prognostic or predictive biomarkers to refine the AR in the second stage. We use simulations to demonstrate the good operating characteristics of the design, including the control of per-comparison type I and type II errors, high probability in selecting important markers, and treating more patients with more effective treatments. Bayesian adaptive designs allow for continuous learning. The designs are particularly suitable for the development of multiple targeted agents in the quest of personalized medicine. By estimating treatment effects and identifying relevant biomarkers, the information acquired from the interim data can be used to guide the choice of treatment for each individual patient enrolled in the trial in real time to achieve a better outcome. The design is being implemented in the BATTLE-2 trial in lung cancer at the MD Anderson Cancer Center.",0 +https://doi.org/10.1215/03616878-3523946,Path Dependency and the Politics of Socialized Health Care,"Abstract Rich democracies exhibit vast cross-national and historical variation in the socialization of health care. Yet, cross-national analyses remain relatively rare in the health policy literature, and health care remains relatively neglected in the welfare state literature. We analyze pooled time series models of the public share of total health spending for eighteen rich democracies from 1960 to 2010. Building on path dependency theory, we present a strategy for modeling the relationship between the initial 1960 public share and the current public share. We also examine two contrasting accounts for how the 1960 public share interacts with conventional welfare state predictors: the self-reinforcing hypothesis expecting positive feedbacks and the counteracting hypothesis expecting negative feedbacks. We demonstrate that most of the variation from 1960 to 2010 in the public share can be explained by a country's initial value in 1960. This 1960 value has a large significant effect in models of 1961–2010, and including the 1960 value alters the coefficients of conventional welfare state predictors. To investigate the mechanism whereby prior social policy influences public opinion about current social policy, we use the 2006 International Social Survey Programme (ISSP). This analysis confirms that the 1960 values predict individual preferences for government spending on health. Returning to the pooled time series, we demonstrate that the 1960 values interact significantly with several conventional welfare state predictors. Some interactions support the self-reinforcing hypothesis, while others support the counteracting hypothesis. Ultimately, this study illustrates how historical legacies of social policy exert substantial influence on the subsequent politics of social policy.",0 +https://doi.org/10.1111/j.1467-9469.2006.00492.x,Empirical and Hierarchical Bayesian Estimation in Finite Population Sampling under Structural Measurement Error Models,".  This paper considers simultaneous estimation of means from several strata. A model-based approach is taken, where the covariates in the superpopulation model are subject to measurement errors. Empirical Bayes (EB) and Hierarchical Bayes estimators of the strata means are developed and asymptotic optimality of EB estimators is proved. Their performances are examined and compared with that of the sample mean in a simulation study as well as in data analysis.",0 +https://doi.org/10.1080/00273171.2015.1022639,A Heterogeneous Growth Curve Model for Nonnormal Data,"The heterogeneous growth curve model (HGM; Klein & Muthén, 2006 ) is a method for modeling heterogeneity of growth rates with a heteroscedastic residual structure for the slope factor. It has been developed as an extension of a conventional growth curve model and a complementary tool to growth curve mixture models. In this article, a robust version of the heterogeneous growth curve model (HGM-R) is presented that extends the original HGM with a mixture model to allow for an unbiased parameter estimation under the condition of nonnormal data. In two simulation studies, the performance of the method is examined under the condition of nonnormality and a misspecified heteroscedastic residual structure. The results of the simulation studies suggest an unbiased estimation of the heterogeneity by the HGM-R when sample size was large enough and a good approximation of the heteroscedastic residual structure even when the functional form of the heteroscedasticity was misspecified. The practical application of the approach is demonstrated for a data set from HIV-infected patients.",0 +https://doi.org/10.1080/00220973.2013.813360,Tests of Mediation: Paradoxical Decline in Statistical Power as a Function of Mediator Collinearity,"Increasing the correlation between the independent variable and the mediator (a coefficient) increases the effect size (ab) for mediation analysis; however, increasing a by definition increases collinearity in mediation models. As a result, the standard error of product tests increase. The variance inflation due to increases in a at some point outweighs the increase of the effect size (ab) and results in a loss of statistical power. This phenomenon also occurs with nonparametric bootstrapping approaches because the variance of the bootstrap distribution of ab approximates the variance expected from normal theory. Both variances increase dramatically when a exceeds the b coefficient, thus explaining the power decline with increases in a. Implications for statistical analysis and applied researchers are discussed.",0 +https://doi.org/10.1037/a0023464,Evaluating models for partially clustered designs.,"Partially clustered designs, where clustering occurs in some conditions and not others, are common in psychology, particularly in prevention and intervention trials. This article reports results from a simulation comparing 5 approaches to analyzing partially clustered data, including Type I errors, parameter bias, efficiency, and power. Results indicate that multilevel models adapted for partially clustered data are relatively unbiased and efficient and consistently maintain the nominal Type I error rate when using appropriate degrees of freedom. To attain sufficient power in partially clustered designs, researchers should attend primarily to the number of clusters in the study. An illustration using data from a partially clustered eating disorder prevention trial is provided.",0 +https://doi.org/10.1111/j.2517-6161.1963.tb00481.x,Sequential Estimation of Quantal Response Curves,,0 +https://doi.org/10.1093/acprof:oso/9780195173444.001.0001,Models for Intensive Longitudinal Data,A new class of longitudinal data has emerged with the use of technological devices for scientific data collection. This class of data is called intensive longitudinal data (ILD). This volume features state-of-the-art applied statistical modelling strategies developed by leading statisticians and methodologists working in conjunction with behavioural scientists.,0 +https://doi.org/10.1111/1467-9884.00117,Markov chain Monte Carlo method and its application,"The Markov chain Monte Carlo (MCMC) method, as a computer-intensive statistical tool, has enjoyed an enormous upsurge in interest over the last few years. This paper provides a simple, comprehensive and tutorial review of some of the most common areas of research in this field. We begin by discussing how MCMC algorithms can be constructed from standard building-blocks to produce Markov chains with the desired stationary distribution. We also motivate and discuss more complex ideas that have been proposed in the literature, such as continuous time and dimension jumping methods. We discuss some implementational issues associated with MCMC methods. We take a look at the arguments for and against multiple replications, consider how long chains should be run for and how to determine suitable starting points. We also take a look at graphical models and how graphical approaches can be used to simplify MCMC implementation. Finally, we present a couple of examples, which we use as case-studies to highlight some of the points made earlier in the text. In particular, we use a simple changepoint model to illustrate how to tackle a typical Bayesian modelling problem via the MCMC method, before using mixture model problems to provide illustrations of good sampler output and of the implementation of a reversible jump MCMC algorithm",0 +https://doi.org/10.1287/mnsc.38.4.555,Stochastic Dominance and Expected Utility: Survey and Analysis,"While Stochastic Dominance has been employed in various forms as early as 1932, it has only been since 1969–1970 that the notion has been developed and extensively employed in the area of economics, finance, agriculture, statistics, marketing and operations research. In this survey, the first-, second- and third-order stochastic dominance rules are discussed with an emphasis on the development in the area since the 1980s.",0 +https://doi.org/10.1111/j.1470-6431.2011.01067.x,Consumer willingness to pay for food safety in Tanzania: an incentive-aligned conjoint analysis,"In this paper, we present results from a consumer experiment in Tanzania focusing on food safety. We elicit consumers' willingness to pay (WTP) a premium for tomatoes that have been inspected by health officials to meet the standards set by the Tanzania Bureau of Standards. We also elicit consumers' WTP for tomato attributes that can be associated with different food safety standards: conventional vs. organically produced and various origins. Two hundred sixty-nine urban consumers from Morogoro, Tanzania took part in the experiment where they evaluated tomatoes using the Becker–deGroot–Marschak mechanism. The results show that on average, consumers in Tanzania are willing to pay a premium for inspected and organically produced tomatoes. Consumers have a strong preference for tomatoes produced in Tanzania and do not discount tomatoes produced in areas associated with poor agricultural practices. However, consumers do significantly discount tomatoes imported from South Africa.",0 +https://doi.org/10.3310/hta16350,Influence of reported study design characteristics on intervention effect estimates from randomised controlled trials: combined analysis of meta-epidemiological studies.,"Background The design of randomised controlled trials (RCTs) should incorporate characteristics (such as concealment of randomised allocation and blinding of participants and personnel) that avoid biases resulting from lack of comparability of the intervention and control groups. Empirical evidence suggests that the absence of such characteristics leads to biased intervention effect estimates, but the findings of different studies are not consistent. Objectives To examine the influence of unclear or inadequate random sequence generation and allocation concealment, and unclear or absent double blinding, on intervention effect estimates and between-trial heterogeneity, and whether or not these influences vary with type of clinical area, intervention, comparison and outcome measure. Data sources and methods Data were combined from seven contributing meta-epidemiological studies (collections of meta-analyses in which trial characteristics are assessed and results recorded). The resulting database was used to identify and remove overlapping meta-analyses. Outcomes were coded such that odds ratios < 1 correspond to beneficial intervention effects. Outcome measures were classified as mortality, other objective or subjective. We examined agreement between assessments of trial characteristics in trials assessed in more than one contributing study. We used hierarchical Bayesian bias models to estimate the effect of trial characteristics on average bias [quantified as ratios of odds ratios (RORs) with 95% credible intervals (CrIs) comparing trials with and without a characteristic] and in increasing between-trial heterogeneity. Results The analysis data set contained 1973 trials included in 234 meta-analyses. Median kappa statistics for agreement between assessments of trial characteristics were: sequence generation 0.60, allocation concealment 0.58 and blinding 0.87. Intervention effect estimates were exaggerated by an average 11% in trials with inadequate or unclear (compared with adequate) sequence generation (ROR 0.89, 95% CrI 0.82 to 0.96); between-trial heterogeneity was higher among such trials. Bias associated with inadequate or unclear sequence generation was greatest for subjective outcomes (ROR 0.83, 95% CrI 0.74 to 0.94) and the increase in heterogeneity was greatest for such outcomes [standard deviation (SD) 0.20, 95% CrI 0.03 to 0.32]. The effect of inadequate or unclear (compared with adequate) allocation concealment was greatest among meta-analyses with a subjectively assessed outcome intervention effect (ROR 0.85, 95% CrI 0.75 to 0.95), and the increase in between-trial heterogeneity was also greatest for such outcomes (SD 0.20, 95% CrI 0.02 to 0.33). Lack of, or unclear, double blinding (compared with double blinding) was associated with an average 13% exaggeration of intervention effects (ROR 0.87, 95% CrI 0.79 to 0.96), and between-trial heterogeneity was increased for such studies (SD 0.14, 95% CrI 0.02 to 0.30). Average bias (ROR 0.78, 95% CrI 0.65 to 0.92) and between-trial heterogeneity (SD 0.37, 95% CrI 0.19 to 0.53) were greatest for meta-analyses assessing subjective outcomes. Among meta-analyses with subjectively assessed outcomes, the effect of lack of blinding appeared greater than the effect of inadequate or unclear sequence generation or allocation concealment. Conclusions Bias associated with specific reported study design characteristics leads to exaggeration of beneficial intervention effect estimates and increases in between-trial heterogeneity. For each of the three characteristics assessed, these effects were greatest for subjectively assessed outcomes. Assessments of the risk of bias in RCTs should account for these findings. Further research is needed to understand the effects of attrition bias, as well as the relative importance of blinding of patients, care-givers and outcome assessors, and thus separate the effects of performance and detection bias. Funding National Institute for Health Research Health Technology Assessment programme.",0 +https://doi.org/10.1023/b:hsor.0000031402.52155.62,Hierarchical Generalised Linear Models with Time-Dependent Clustering: Assessing the Effect of Health Sector Reform on Patient Outcomes in New Zealand,"New Zealand has one of the most reformed health systems in the world. This paper is primarily concerned with modelling the impact on hospital outcomes of the reforms of the early 1990s, when as part of a major, health sector wide reform process, the administration of public hospitals passed from elected Area Health Boards (AHBs) to Crown Health Enterprises (CHEs) operating under a competitive model of health care provision dominated by the funder/purchaser/provider split. The impact of reform processes on public hospitals is of particular interest since they consume 40%-50% of public expenditure on health, and have been repeatedly restructured in an attempt to contain the ever-expanding cost of health care. There is concern among both health professionals and the general public that these restructurings are reducing the quality of hospital services, and therefore negatively effecting patient outcomes. Using data from a study of 34 New Zealand public hospitals, we discuss the application of Bayesian hierarchical generalised linear models to the analysis of trends in patient outcomes over the period 1988-2001. The time-varying nature of the grouping of hospitals within larger health authorities complicates the application of HGLMs because the cluster structure of the data changes over the study period. An approach to dealing with such ""time-dependent clustering"" by introducing period-specific authority level effects is developed. The analysis does not support the proposition that higher level authorities had an effect on outcome trends, or that the administrative changeover from AHBs to CHEs impacted on 60-day post-admission mortality. © 2004 Kluwer Academic Publishers.",0 +https://doi.org/10.1080/1369183x.2013.830496,Do Integration Policies Affect Immigrants' Voluntary Engagement? An Exploration at Switzerland's Subnational Level,"This paper investigates whether integration policies influence immigrants' propensity to volunteer, the latter being an important element of immigrants' integration into the host society. By distinguishing different categories of integration policies at Switzerland's subnational level and applying a Bayesian multilevel approach, our results suggest varying policy effects: while policies fostering socio-structural rights enhance immigrants' propensity to volunteer, we observe a negative curvilinear relationship between cultural rights and obligations and immigrants' volunteerism implying that a combination of cultural entitlements and obligations is most conducive to immigrants' civic engagement.",0 +https://doi.org/10.1177/0146621612459552,Computerized Adaptive Testing Using a Class of High-Order Item Response Theory Models,"In the human sciences, a common assumption is that latent traits have a hierarchical structure. Higher order item response theory models have been developed to account for this hierarchy. In this study, computerized adaptive testing (CAT) algorithms based on these kinds of models were implemented, and their performance under a variety of situations was examined using simulations. The results showed that the CAT algorithms were very effective. The progressive method for item selection, the Sympson and Hetter method with online and freeze procedure for item exposure control, and the multinomial model for content balancing can simultaneously maintain good measurement precision, item exposure control, content balance, test security, and pool usage.",0 +,Multivariate and Propensity Score Matching Software with Automated Balance Optimization: The Matching Package for R,"Matching is an R package which provides functions for multivariate and propensity score matching and for finding optimal covariate balance based on a genetic search algorithm. A variety of univariate and multivariate metrics to determine if balance actually has been obtained are provided. The underlying matching algorithm is written in C++, makes extensive use of system BLAS and scales efficiently with dataset size. The genetic algorithm which finds optimal balance is parallelized and can make use of multiple CPUs or a cluster of computers. A large number of options are provided which control exactly how the matching is conducted and how balance is evaluated.",0 +https://doi.org/10.1177/0013164405278558,Using the SPSS Mixed Procedure to Fit Cross-Sectional and Longitudinal Multilevel Models,"Beginning with Version 11, SPSS implemented the MIXED procedure, which is capable of performing many common hierarchical linear model analyses. The purpose of this article was to provide a tutorial for performing cross-sectional and longitudinal analyses using this popular software platform. In doing so, the authors borrowed heavily from Singer’s overview of SAS PROC MIXED, duplicating her analyses using the SPSS MIXED procedure.",0 +https://doi.org/10.1111/j.0006-341x.2004.00224.x,Bayesian Multivariate Logistic Regression,"Bayesian analyses of multivariate binary or categorical outcomes typically rely on probit or mixed effects logistic regression models that do not have a marginal logistic structure for the individual outcomes. In addition, difficulties arise when simple noninformative priors are chosen for the covariance parameters. Motivated by these problems, we propose a new type of multivariate logistic distribution that can be used to construct a likelihood for multivariate logistic regression analysis of binary and categorical data. The model for individual outcomes has a marginal logistic structure, simplifying interpretation. We follow a Bayesian approach to estimation and inference, developing an efficient data augmentation algorithm for posterior computation. The method is illustrated with application to a neurotoxicology study.",0 +https://doi.org/10.1504/ijids.2013.058286,Consumer-oriented new product development: a review of recent developments,"Firms need to continuously develop new products or redesign their existing ones, due to the intense competition they are facing, as well as the rapidly changing economical and sociopolitical environment. In this context, consumer behaviour modelling has become an important and inextricable part of successful new product development during the last decades. This paper constitutes a survey of the literature in consumer-oriented new product development. We review a total of 60 research propositions in consumer behaviour modelling as a part of the product development procedure. The findings indicate a trend for integrative methodologies that approach the new product development process from both a marketing and an engineering perspective. The incorporation of dynamic consumer behaviour models into the product development methodologies seems to be the most promising area for future research.",0 +https://doi.org/10.1037//1082-989x.7.4.422,Mediation in experimental and nonexperimental studies: New procedures and recommendations.,"Mediation is said to occur when a causal effect of some variable X on an outcome Y is explained by some intervening variable M. The authors recommend that with small to moderate samples, bootstrap methods (B. Efron & R. Tibshirani. 1993) be used to assess mediation. Bootstrap tests are powerful because they detect that the sampling distribution of the mediated effect is skewed away from 0. They argue that R. M. Baron and D. A. Kenny's (1986) recommendation of first testing the X → Y association for statistical significance should not be a requirement when there is a priori belief that the effect size is small or suppression is a possibility. Empirical examples and computer setups for bootstrap analyses are provided.",0 +https://doi.org/10.1016/j.ssresearch.2015.08.003,"The mental health consequences of the economic crisis in Europe among the employed, the unemployed, and the non-employed","Applying a multi-level framework to the data from the European Social Survey's Round 3 (2006) and Round 6 (2012), we assessed the crisis by increases in rates of unemployment, while also controlling for countries' pre-crisis economic conditions. We found a positive relationship between depression and an increase in national unemployment rates. This relationship can be only partly ascribed to an increase in the number of unemployed and those employed in nonstandard job conditions-with the exception of the self-employed and women working part-time. The crisis effect is more pronounced among men and those between 35 and 49years of age. Moreover, in strongly effected countries, the crisis has changed the relationship between part-time work and depression, between depression and certain subcategories of the unemployed (looking for a job or not looking), and between depression and the non-employed.",0 +https://doi.org/10.1007/bf02291552,Bayesian estimation in unrestricted factor analysis: A treatment for heywood cases,"A Bayesian procedure is given for estimation in unrestricted common factor analysis. A choice of the form of the prior distribution is justified. It is shown empirically that the procedure achieves its objective of avoiding inadmissible estimates of unique variances, and is reasonably insensitive to certain variations in the shape of the prior distribution. © 1975 Psychometric Society.",0 +https://doi.org/10.1080/00273171.2014.962683,An Index and Test of Linear Moderated Mediation,"I describe a test of linear moderated mediation in path analysis based on an interval estimate of the parameter of a function linking the indirect effect to values of a moderator-a parameter that I call the index of moderated mediation. This test can be used for models that integrate moderation and mediation in which the relationship between the indirect effect and the moderator is estimated as linear, including many of the models described by Edwards and Lambert ( 2007 ) and Preacher, Rucker, and Hayes ( 2007 ) as well as extensions of these models to processes involving multiple mediators operating in parallel or in serial. Generalization of the method to latent variable models is straightforward. Three empirical examples describe the computation of the index and the test, and its implementation is illustrated using Mplus and the PROCESS macro for SPSS and SAS.",0 +https://doi.org/10.3758/pbr.15.1.1,Three case studies in the Bayesian analysis of cognitive models,"Bayesian statistical inference offers a principled and comprehensive approach for relating psychological models to data. This article presents Bayesian analyses of three influential psychological models: multidimensional scaling models of stimulus representation, the generalized context model of category learning, and a signal detection theory model of decision making. In each case, the model is recast as a probabilistic graphical model and is evaluated in relation to a previously considered data set. In each case, it is shown that Bayesian inference is able to provide answers to important theoretical and empirical questions easily and coherently. The generality of the Bayesian approach and its potential for the understanding of models and data in psychology are discussed.",0 +https://doi.org/10.1037/a0035628,Analyzing multiple outcomes in clinical research using multivariate multilevel models.,"Multilevel models have become a standard data analysis approach in intervention research. Although the vast majority of intervention studies involve multiple outcome measures, few studies use multivariate analysis methods. The authors discuss multivariate extensions to the multilevel model that can be used by psychotherapy researchers.Using simulated longitudinal treatment data, the authors show how multivariate models extend common univariate growth models and how the multivariate model can be used to examine multivariate hypotheses involving fixed effects (e.g., does the size of the treatment effect differ across outcomes?) and random effects (e.g., is change in one outcome related to change in the other?). An online supplemental appendix provides annotated computer code and simulated example data for implementing a multivariate model.Multivariate multilevel models are flexible, powerful models that can enhance clinical research.",0 +https://doi.org/10.1371/journal.pone.0060650,Individual Participant Data Meta-Analysis for a Binary Outcome: One-Stage or Two-Stage?,"A fundamental aspect of epidemiological studies concerns the estimation of factor-outcome associations to identify risk factors, prognostic factors and potential causal factors. Because reliable estimates for these associations are important, there is a growing interest in methods for combining the results from multiple studies in individual participant data meta-analyses (IPD-MA). When there is substantial heterogeneity across studies, various random-effects meta-analysis models are possible that employ a one-stage or two-stage method. These are generally thought to produce similar results, but empirical comparisons are few.We describe and compare several one- and two-stage random-effects IPD-MA methods for estimating factor-outcome associations from multiple risk-factor or predictor finding studies with a binary outcome. One-stage methods use the IPD of each study and meta-analyse using the exact binomial distribution, whereas two-stage methods reduce evidence to the aggregated level (e.g. odds ratios) and then meta-analyse assuming approximate normality. We compare the methods in an empirical dataset for unadjusted and adjusted risk-factor estimates.Though often similar, on occasion the one-stage and two-stage methods provide different parameter estimates and different conclusions. For example, the effect of erythema and its statistical significance was different for a one-stage (OR = 1.35, [Formula: see text]) and univariate two-stage (OR = 1.55, [Formula: see text]). Estimation issues can also arise: two-stage models suffer unstable estimates when zero cell counts occur and one-stage models do not always converge.When planning an IPD-MA, the choice and implementation (e.g. univariate or multivariate) of a one-stage or two-stage method should be prespecified in the protocol as occasionally they lead to different conclusions about which factors are associated with outcome. Though both approaches can suffer from estimation challenges, we recommend employing the one-stage method, as it uses a more exact statistical approach and accounts for parameter correlation.",0 +https://doi.org/10.1177/0149206314546750,Institutionalizing Bayesianism Within the Organizational Sciences,"Bayesian estimation and inference remain infrequently used in organizational science research. Despite innumerable warnings regarding the entrenched frequentist paradigm, our field has yet to embrace the Bayesian “revolution” that seems to be sweeping through so many other disciplines. With this context as a backdrop, we address a simple yet difficult question: What is the likelihood that Bayesian methodologies eventually will supplement or even supplant traditional frequentist methodologies in the organizational science community? We draw on institutional theory to address this question, highlighting the cultural-cognitive, normative, and regulative forces that play important roles. As novel contributions to the discussion, we go beyond our own ideas and previously published opinions on the subject to report the opinions of 26 institutional elites (current and former officers of academic associations, editors, and editorial board members). These leading scholars help us shed light not only on the likelihood that Bayesianism will take root in the field but also on practical steps that could be taken to assist in this process. In some ways, we build Bayesian priors about Bayesian analysis, where those priors will be qualified on the basis of future events and outcomes.",0 +https://doi.org/10.3758/bf03196470,Perceptual organization influences visual working memory,"Previous studies have demonstrated that top-down factors can bias the storage of information in visual working memory. However, relatively little is known about the role that bottom-up stimulus characteristics play in visual working memory storage. In the present study, subjects performed a change detection task in which the to-be-remembered objects were organized in accordance with Gestalt grouping principles. When an attention-capturing cue was presented at the location of one object, other objects that were perceptually grouped with the cued object were more likely to be stored in working memory than were objects that were not grouped with the cued object. Thus, objects that are grouped together tend to be stored together, indicating that bottom-up perceptual organization influences the storage of information in visual working memory.",0 +https://doi.org/10.1109/jstsp.2015.2407855,Bayesian Fusion of Multi-Band Images,"In this paper, a Bayesian fusion technique for remotely sensed multi-band images is presented. The observed images are related to the high spectral and high spatial resolution image to be recovered through physical degradations, e.g., spatial and spectral blurring and/or subsampling defined by the sensor characteristics. The fusion problem is formulated within a Bayesian estimation framework. An appropriate prior distribution exploiting geometrical consideration is introduced. To compute the Bayesian estimator of the scene of interest from its posterior distribution, a Markov chain Monte Carlo algorithm is designed to generate samples asymptotically distributed according to the target distribution. To efficiently sample from this high-dimension distribution, a Hamiltonian Monte Carlo step is introduced in the Gibbs sampling strategy. The efficiency of the proposed fusion method is evaluated with respect to several state-of-the-art fusion techniques. In particular, low spatial resolution hyperspectral and multispectral images are fused to produce a high spatial resolution hyperspectral image.",0 +https://doi.org/10.1016/c2009-0-30639-x,Introduction to WinBUGS for Ecologists,"Bayesian statistics has exploded into biology and its sub-disciplines such as ecology over the past decade. The free software program WinBUGS and its open-source sister OpenBugs is currently the only flexible and general-purpose program available with which the average ecologist can conduct their own standard and non-standard Bayesian statistics. Introduction to WINBUGS for Ecologists goes right to the heart of the matter by providing ecologists with a comprehensive, yet concise, guide to applying WinBUGS to the types of models that they use most often: linear (LM), generalized linear (GLM), linear mixed (LMM) and generalized linear mixed models (GLMM).Introduction to WinBUGS for Ecologists combines the use of simulated data sets ""paired"" analyses using WinBUGS (in a Bayesian framework for analysis) and in R (in a frequentist mode of inference) and uses a very detailed step-by-step tutorial presentation style that really lets the reader repeat every step of the application of a given mode in their own research.- Introduction to the essential theories of key models used by ecologists- Complete juxtaposition of classical analyses in R and Bayesian Analysis of the same models in WinBUGS- Provides every detail of R and WinBUGS code required to conduct all analyses- Written with ecological language and ecological examples- Companion Web Appendix that contains all code contained in the book, additional material (including more code and solutions to exercises)- Tutorial approach shows ecologists how to implement Bayesian analysis in practical problems that they face. © 2010 Elsevier Inc. All rights reserved.",0 +https://doi.org/10.1186/1471-2288-12-34,Individual patient data meta-analysis of survival data using Poisson regression models,"Abstract Background An Individual Patient Data (IPD) meta-analysis is often considered the gold-standard for synthesising survival data from clinical trials. An IPD meta-analysis can be achieved by either a two-stage or a one-stage approach, depending on whether the trials are analysed separately or simultaneously. A range of one-stage hierarchical Cox models have been previously proposed, but these are known to be computationally intensive and are not currently available in all standard statistical software. We describe an alternative approach using Poisson based Generalised Linear Models (GLMs). Methods We illustrate, through application and simulation, the Poisson approach both classically and in a Bayesian framework, in two-stage and one-stage approaches. We outline the benefits of our one-stage approach through extension to modelling treatment-covariate interactions and non-proportional hazards. Ten trials of hypertension treatment, with all-cause death the outcome of interest, are used to apply and assess the approach. Results We show that the Poisson approach obtains almost identical estimates to the Cox model, is additionally computationally efficient and directly estimates the baseline hazard. Some downward bias is observed in classical estimates of the heterogeneity in the treatment effect, with improved performance from the Bayesian approach. Conclusion Our approach provides a highly flexible and computationally efficient framework, available in all standard statistical software, to the investigation of not only heterogeneity, but the presence of non-proportional hazards and treatment effect modifiers.",0 +https://doi.org/10.1093/pan/mpl013,Matching as Nonparametric Preprocessing for Reducing Model Dependence in Parametric Causal Inference,"Although published works rarely include causal estimates from more than a few model specifications, authors usually choose the presented estimates from numerous trial runs readers never see. Given the often large variation in estimates across choices of control variables, functional forms, and other modeling assumptions, how can researchers ensure that the few estimates presented are accurate or representative? How do readers know that publications are not merely demonstrations that it is possible to find a specification that fits the author's favorite hypothesis? And how do we evaluate or even define statistical properties like unbiasedness or mean squared error when no unique model or estimator even exists? Matching methods, which offer the promise of causal inference with fewer assumptions, constitute one possible way forward, but crucial results in this fast-growing methodological literature are often grossly misinterpreted. We explain how to avoid these misinterpretations and propose a unified approach that makes it possible for researchers to preprocess data with matching (such as with the easy-to-use software we offer) and then to apply the best parametric techniques they would have used anyway. This procedure makes parametric models produce more accurate and considerably less model-dependent causal inferences.",0 +https://doi.org/10.1080/00273171.2010.519276,Multilevel Factor Analysis and Structural Equation Modeling of Daily Diary Coping Data: Modeling Trait and State Variation,"The current study used multilevel modeling of daily diary data to model within-person (state) and between-person (trait) components of coping variables. This application included the introduction of multilevel factor analysis (MFA) and a comparison of the predictive ability of these trait/state factors. Daily diary data was collected on a large (n = 366) multiethnic sample over the course of five days. Intraclass correlation coefficient for the derived factors suggested approximately equal amounts of variability in coping usage at the state and trait levels. MFAs showed that Problem-Focused Coping and Social Support emerged as stable factors at both the within-person and between-person levels. Other factors (Minimization, Emotional Rumination, Avoidance, Distraction) were specific to the within-person or between-person levels, but not both. Multilevel structural equation modeling (MSEM) showed that the prediction of daily positive and negative affect differed as a function of outcome and level of coping factor. The Discussion section focuses primarily on a conceptual and methodological understanding of modeling state and trait coping using daily diary data with MFA and MSEM to examine covariation among coping variables and predicting outcomes of interest.",0 +https://doi.org/10.1214/06-ba117rej,Rejoinder,,0 +https://doi.org/10.1037/a0029317,Investigating inter-individual differences in short-term intra-individual variability.,"Intra-individual variability over a short period of time may contain important information about how individuals differ from each other. In this article we begin by discussing diverse indicators for quantifying intra-individual variability and indicate their advantages and disadvantages. Then we propose an alternative method that models inter-individual differences in intra-individual variability by separately considering both the amplitude of fluctuations and temporal dependency in the data. In the proposed model, temporal dependency and amplitude of fluctuations are both included as random effects. Parameter estimation is done with a multiple-step approach using maximum likelihood, or with a recommended 1-step approach using a Bayesian method. The similarities and differences between the proposed method and some existing methods are discussed and investigated using diary study data from older adults. The results from empirical data analysis revealed that temporal dependency and amplitude of fluctuations have different predictability of health outcomes and thus should be modeled and considered separately.",0 +https://doi.org/10.1006/jmps.1993.1033,Response Time Distributions in Memory Scanning,"Abstract This article reports the results of a memory scanning experiment (S. Sternberg. 1966, Science, 153 , 652-654) in which each of four subjects participated in about 1500 experimental trials per memory set size. These large samples made it possible to test a number of important nonparametric (i.e., model-free) properties of the response time (RT) distributions. These properties place severe constraints on the various memory scanning models and they provide a deeper description of the data than summary statistics or goodness-of-fit values. Five conclusions stood out. First, increasing the size of the memory set induced the strongest possible form of stochastic dominance on both target present and target absent trials. Second, the RT hazard functions were nonmonotonic, thereby falsifying a large class of serial searell models, Third, strong evidence was obtained against art exhaustive search. Fourth, some evidence was found that adding an item to the memory set inserts a stage with exponentially distributed duration into the processing claim, at least on largest absent trials. Fifth, the data supported the hypothesis that three of the subjects stored the representations of the memory set items in a visual short-term memory system and the fourth subject used all acoustic short-term system. To our knowledge, the only extant model of memory scanning that is consistent with all these results assumes that search is parallel, self-terminating, and of very limited capacity.",0 +https://doi.org/10.1007/s00477-007-0139-9,Quantifying geographic variations in associations between alcohol distribution and violence: a comparison of geographically weighted regression and spatially varying coefficient models,"Past studies consistently indicate measurable local associations between alcohol distribution and the incidence of violence. These results, coupled with measurements of spatial correlation, reveal the importance of spatial analysis in the study of the interaction of alcohol and violence. While studies increasingly incorporate spatial correlation among model residuals to improve precision and reduce bias, to date, most analyses assume associations that are constant and independent of location, an assumption coming under increasing scrutiny in the quantitative geography literature. In this paper, we review and contrast two approaches for the estimation of and inference for spatially heterogeneous effects (i.e., associative factors whose impacts on the outcome of interest vary throughout geographic space). Specifically, we provide an in-depth comparison of 'geographically weighted regression' models (allowing covariate effects to vary in space but only allowing relatively ad hoc inference) with 'variable coefficient' models (allowing varying effects via spatial random fields and providing model-based estimation and inference, but requiring more advanced computational techniques). We compare the approaches with respect to underlying conceptual structures, computational implementation, and inferential output. We apply both approaches to violent crime, illegal drug arrest, and alcohol distribution data from Houston, Texas and compare results in light of the differing methodological structures of the two approaches. © Springer-Verlag 2007.",0 +https://doi.org/10.1037/1082-989x.10.3.259,People are variables too: Multilevel structural equations modeling.,"The article uses confirmatory factor analysis (CFA) as a template to explain didactically multilevel structural equation models (ML-SEM) and to demonstrate the equivalence of general mixed-effects models and ML-SEM. An intuitively appealing graphical representation of complex ML-SEMs is introduced that succinctly describes the underlying model and its assumptions. The use of definition variables (i.e., observed variables used to fix model parameters to individual specific data values) is extended to the case of ML-SEMs for clustered data with random slopes. Empirical examples of multilevel CFA and ML-SEM with random slopes are provided along with scripts for fitting such models in SAS Proc Mixed, Mplus, and Mx. Methodological issues regarding estimation of complex ML-SEMs and the evaluation of model fit are discussed. Further potential applications of ML-SEMs are explored.",0 +https://doi.org/10.1111/rssa.12016,Handling missing values in cost effectiveness analyses that use data from cluster randomized trials,"Public policy makers use cost effectiveness analyses (CEAs) to decide which health and social care interventions to provide. Missing data are common in CEAs, but most studies use complete-case analysis. Appropriate methods have not been developed for handling missing data in complex settings, exemplified by CEAs that use data from cluster randomized trials. We present a multilevel multiple-imputation approach that recognizes the hierarchical structure of the data and is compatible with the bivariate multilevel models that are used to report cost effectiveness. We contrast this approach with single-level multiple imputation and complete-case analysis, in a CEA alongside a cluster randomized trial. The paper highlights the importance of adopting a principled approach to handling missing values in settings with complex data structures.",0 +https://doi.org/10.1111/j.2044-8317.1993.tb01016.x,Confirmatory factor analysis of ordered categorical variables with large models,"This simulation study examined the utility of a categorical variable methodology developed by Muthen (1984) for confirmatory factor analysis of ordinal variables. Multivariate normal data were generated according to four different factor models (4, 9, 15 and 22 parameters) for samples of 500 and 1000. Indicators were classified into Five categories so that manifest variables displayed negative, zero, positive or highly positive kurtosis. Each of the 32 design cells was replicated 100 times. Parameter estimates exhibited little or no bias under any condition. Standard errors were underestimated with respect to the standard deviation of the parameter estimates. This negative bias worsened as model size grew or as positive kurtosis increased; it was more severe for factor correlations than indicator loadings. Chi-square fit statistics rejected the true model more often than expected for nine-parameter and larger models. Although variables with high positive kurtosis led to the greatest misfit in large models, fit was poor even with variables of zero kurtosis. As expected, larger samples always yielded more accurate results.",0 +https://doi.org/10.1080/10705519809540106,Analyzing measurement models of latent variables through multilevel confirmatory factor analysis and hierarchical linear modeling approaches,"Confirmatory factor analysis (CFA) is often used in the social sciences to estimate a measurement model in which multiple measurement items are hypothesized to assess a particular latent construct. This article presents the utility of multilevel CFA (MCFA; Muthen, 1991, 1994) and hierarchical linear modeling (HLM; Raudenbush, Rowan, & Kang, 1991) methods in testing measurement models in which the underlying attribute may vary as a function of various levels of observation. An illustrative example using a real dataset is provided in which an unconditional model specification and parameter estimates from the MCFA and HLM are shown. The article demonstrates the comparability of the two methods in estimating measurement parameters of interest (i.e., true variance at levels the measures are used and measurement errors).",0 +https://doi.org/10.1037/a0038100,Psychometric analysis of the Ten-Item Perceived Stress Scale.,"Although the 10-item Perceived Stress Scale (PSS-10) is a popular measure, a review of the literature reveals 3 significant gaps: (a) There is some debate as to whether a 1- or a 2-factor model best describes the relationships among the PSS-10 items, (b) little information is available on the performance of the items on the scale, and (c) it is unclear whether PSS-10 scores are subject to gender bias. These gaps were addressed in this study using a sample of 1,236 adults from the National Survey of Midlife Development in the United States II. Based on self-identification, participants were 56.31% female, 77% White, 17.31% Black and/or African American, and the average age was 54.48 years (SD = 11.69). Findings from an ordinal confirmatory factor analysis suggested the relationships among the items are best described by an oblique 2-factor model. Item analysis using the graded response model provided no evidence of item misfit and indicated both subscales have a wide estimation range. Although t tests revealed a significant difference between the means of males and females on the Perceived Helplessness Subscale (t = 4.001, df = 1234, p < .001), measurement invariance tests suggest that PSS-10 scores may not be substantially affected by gender bias. Overall, the findings suggest that inferences made using PSS-10 scores are valid. However, this study calls into question inferences where the multidimensionality of the PSS-10 is ignored.",0 +https://doi.org/10.1037/h0023577,Some implications of psychotherapy research for therapeutic practice.,"Implications for practice and research are drawn from a survey of psychotherapy research findings, condensed into 6 broad conclusions: (1) psychotherapy causes clients to become better or worse adjusted than controls; (2) control Ss improve with time as a result of informal therapeutic encounters; (3) therapeutic progress varies with therapist warmth, empathy, adjustment, and experience; (4) client-centered therapy is the only interview-oriented method that has been validated by research; (5) traditional therapies are seriously limited in effectiveness and are relevant for a small minority of disturbances; and (6) behavior therapies have considerable promise for enhancing therapeutic effectiveness and should be utilized or experimented with more widely. (2 p. ref.) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1966 American Psychological Association.",0 +https://doi.org/10.1037/0003-066x.60.2.170,Inference by Eye: Confidence Intervals and How to Read Pictures of Data.,"Wider use in psychology of confidence intervals (CIs), especially as error bars in figures, is a desirable development. However, psychologists seldom use CIs and may not understand them well. The authors discuss the interpretation of figures with error bars and analyze the relationship between CIs and statistical significance testing. They propose 7 rules of eye to guide the inferential use of figures with error bars. These include general principles: Seek bars that relate directly to effects of interest, be sensitive to experimental design, and interpret the intervals. They also include guidelines for inferential interpretation of the overlap of CIs on independent group means. Wider use of interval estimation in psychology has the potential to improve research communication substantially.",0 +https://doi.org/10.1214/ss/1177011926,That BLUP is a Good Thing: The Estimation of Random Effects,"In animal breeding, Best Linear Unbiased Prediction, or BLUP, is a technique for estimating genetic merits. In general, it is a method of estimating random effects. It can be used to derive the Kalman filter, the method of Kriging used for ore reserve estimation, credibility theory used to work out insurance premiums, and Hoadley's quality measurement plan used to estimate a quality index. It can be used for removing noise from images and for small-area estimation. This paper presents the theory of BLUP, some examples of its application and its relevance to the foundations of statistics. Understanding of procedures for estimating random effects should help people to understand some complicated and controversial issues about fixed and random effects models and also help to bridge the apparent gulf between the Bayesian and Classical schools of thought.",0 +https://doi.org/10.1037/a0030676,Further insights on the French WISC–IV factor structure through Bayesian structural equation modeling.,"The interpretation of the Wechsler Intelligence Scale for Children--Fourth Edition (WISC-IV) is based on a 4-factor model, which is only partially compatible with the mainstream Cattell-Horn-Carroll (CHC) model of intelligence measurement. The structure of cognitive batteries is frequently analyzed via exploratory factor analysis and/or confirmatory factor analysis. With classical confirmatory factor analysis, almost all cross-loadings between latent variables and measures are fixed to zero in order to allow the model to be identified. However, inappropriate zero cross-loadings can contribute to poor model fit, distorted factors, and biased factor correlations; most important, they do not necessarily faithfully reflect theory. To deal with these methodological and theoretical limitations, we used a new statistical approach, Bayesian structural equation modeling (BSEM), among a sample of 249 French-speaking Swiss children (8-12 years). With BSEM, zero-fixed cross-loadings between latent variables and measures are replaced by approximate zeros, based on informative, small-variance priors. Results indicated that a direct hierarchical CHC-based model with 5 factors plus a general intelligence factor better represented the structure of the WISC-IV than did the 4-factor structure and the higher order models. Because a direct hierarchical CHC model was more adequate, it was concluded that the general factor should be considered as a breadth rather than a superordinate factor. Because it was possible for us to estimate the influence of each of the latent variables on the 15 subtest scores, BSEM allowed improvement of the understanding of the structure of intelligence tests and the clinical interpretation of the subtest scores.",0 +https://doi.org/10.1037/0022-0663.96.3.518,"Why Multicollinearity Matters: A Reexamination of Relations Between Self-Efficacy, Self-Concept, and Achievement.","Multicollinearity is a well-known general problem, but it also seriously threatens valid interpretations in structural equation models. Illustrating this problem, J. Pietsch, R. Walker, and E. Chapman (2003) found paths leading to achievement were apparently much larger for self-efficacy (.55) than self-concept (-.05), suggesting - erroneously, as the authors' reanalysis shows - that self-efficacy was a better predictor of achievement. However, because standard errors for these two paths were so huge (.25) thanks to the extremely high correlation between self-concept and self-efficacy (r = .93), interpretations were problematic. In a model comparison approach to this multicollinearity problem, constraining these two paths to be equal provided a better, more parsimonious fit to the data and also substantially reduced the standard errors (from .25 to .03).",0 +https://doi.org/10.1016/j.cose.2014.11.002,Comparing intention to avoid malware across contexts in a BYOD-enabled Australian university: A Protection Motivation Theory approach,"Malware have been regarded as a persistent threat to both individuals and organisations due to its wide spread via various means of infection. With the increasing use of personal mobile devices and the trending adoption of Bring Your Own Device (BYOD) practices, this threat has become even more versatile and dreadful as it could hide behind the users' typical and daily Internet activities. The importance of investigating whether the user's intention to perform malware avoidance behaviours would change across multiple contexts is emphasised. Consequently, this study determines the contributing factors and compares their impacts on such intention by extending Protection Motivation Theory in two different contexts. A total of 252 Australian higher education students were surveyed when using mobile devices such as smartphone, laptop and tablet at home and at a BYOD-enabled university. Paired t- test, Bayesian structural equation modelling, and revised z -test were employed for data analysis. The empirical findings reveal that intention to perform malware avoidance behaviours differed across the contexts. Furthermore, the researchers found perceptions of self-efficacy and vulnerability to have different impacts on such intention and other variables in the model. As a result, such findings suggested developing community of practice and repeated trainings to maintain the users' confidence in their own abilities to cope with malware threats. Message that focuses on the threats' consequences was suggested to improve home users' intention to avoid malware, along with a number of factors that could be critical to designing information security education programs. Moreover, these implications particularly address information security management at educational institutions that adopt BYOD policy. Finally, theoretical contributions include an extended model based on Protection Motivation Theory that reflects the users' intention to avoid malware threats in BYOD context, from which directions for future research were also provided.",0 +https://doi.org/10.4172/2155-6180.1000189,General Multiple Mediation Analysis With an Application to Explore Racial Disparities in Breast Cancer Survival,"Mediation refers to the effect transmitted by mediators that intervenes in the relationship between an exposure and a response variable. Mediation analysis has been broadly studied in many fields. However, it remains a challenge for researchers to differentiate individual effect from multiple mediators. This paper proposes general definitions of mediation effects that are consistent for all different types (categorical or continuous) of response, exposure, or mediation variables. With these definitions, multiple mediators can be considered simultaneously, and the indirect effects carried by individual mediators can be separated from the total effect. Moreover, the derived mediation analysis can be performed with general predictive models. For linear predictive models with continuous mediators, we show that the proposed method is equivalent to the conventional coefficients product method. We also establish the relationship between the proposed definitions of direct or indirect effect and the natural direct or indirect effect for binary exposure variables. The proposed method is demonstrated by both simulations and a real example examining racial disparities in three-year survival rates for female breast cancer patients in Louisiana.",0 +https://doi.org/10.1111/j.1541-0420.2005.00499.x,Bayesian Covariance Selection in Generalized Linear Mixed Models,"The generalized linear mixed model (GLMM), which extends the generalized linear model (GLM) to incorporate random effects characterizing heterogeneity among subjects, is widely used in analyzing correlated and longitudinal data. Although there is often interest in identifying the subset of predictors that have random effects, random effects selection can be challenging, particularly when outcome distributions are nonnormal. This article proposes a fully Bayesian approach to the problem of simultaneous selection of fixed and random effects in GLMMs. Integrating out the random effects induces a covariance structure on the multivariate outcome data, and an important problem that we also consider is that of covariance selection. Our approach relies on variable selection-type mixture priors for the components in a special Cholesky decomposition of the random effects covariance. A stochastic search MCMC algorithm is developed, which relies on Gibbs sampling, with Taylor series expansions used to approximate intractable integrals. Simulated data examples are presented for different exponential family distributions, and the approach is applied to discrete survival data from a time-to-pregnancy study.",0 +https://doi.org/10.1016/j.prevetmed.2009.10.004,A simulation study to assess statistical methods for binary repeated measures data,"Binary repeated measures data are commonly encountered in both experimental and observational veterinary studies. Among the wide range of statistical methods and software applicable to such data one major distinction is between marginal and random effects procedures. The objective of the study was to review and assess the performance of marginal and random effects estimation procedures for the analysis of binary repeated measures data. Two simulation studies were carried out, using relatively small, balanced, two-level (time within subjects) datasets. The first study was based on data generated from a marginal model with first order autocorrelation, the second on a random effects model with autocorrelated random effects within subjects. Three versions of the models were considered in which a dichotomous treatment was modelled additively, either between or within subjects, or modelled by a time interaction. Among the studied statistical procedures were: generalized estimating equations (GEE), Marginal Quasi Likelihood, likelihood based on numerical integration, penalized quasi-likelihood, restricted pseudo likelihood and Bayesian Markov Chain Monte Carlo. Results for data generated by the marginal model showed autoregressive GEE to be highly efficient when treatment was within subjects, even with strongly correlated responses. For treatment between subjects, random effects procedures also performed well in some situations; however, a relatively small number of subjects with a short time series proved a challenge for both marginal and random effects procedures. Results for data generated by the random effects model showed bias in estimates from random effects procedures when autocorrelation was present in the data, while the marginal procedures generally gave estimates close to the marginal parameters.",0 +https://doi.org/10.3102/1076998609337138,Modeling Heterogeneity in Relationships Between Initial Status and Rates of Change: Treating Latent Variable Regression Coefficients as Random Coefficients in a Three-Level Hierarchical Model,"In studies of change in education and numerous other fields, interest often centers on how differences in the status of individuals at the start of a period of substantive interest relate to differences in subsequent change. In this article, the authors present a fully Bayesian approach to estimating three-level Hierarchical Models in which latent variable regression (LVR) coefficients capturing the relationship between initial status and rates of change within each of J schools (Bw j , j = 1, …, J) are treated as varying across schools. Specifically, the authors treat within-group LVR coefficients as random coefficients in three-level models. Through analyses of data from the Longitudinal Study of American Youth, the authors show how modeling differences in Bw j as a function of school characteristics can broaden the kinds of questions they can address in school effects research. They also illustrate the possibility of conducting sensitivity analyses using t distributional assumptions at each level of such models (termed latent variable regression in a three-level hierarchical model [LVR-HM3s]), and present results from a small-scale simulation study that help provide some guidance concerning the specification of priors for variance components in LVR-HM3s. They outline extensions of LVR-HM3s to settings in which growth is nonlinear, and discuss the use of LVR-HM3s in other types of research including multisite evaluation studies in which time-series data are collected during a preintervention period, and cross-sectional studies in which within-cluster LVR slopes are treated as varying across clusters.",0 +https://doi.org/10.1111/j.1467-842x.2011.00623.x,SMALL AREA ESTIMATION USING SURVEY WEIGHTS WITH FUNCTIONAL MEASUREMENT ERROR IN THE COVARIATE,"Summary Nested error linear regression models using survey weights have been studied in small area estimation to obtain efficient model-based and design-consistent estimators of small area means. The covariates in these nested error linear regression models are not subject to measurement errors. In practical applications, however, there are many situations in which the covariates are subject to measurement errors. In this paper, we develop a nested error linear regression model with an area-level covariate subject to functional measurement error. In particular, we propose a pseudo-empirical Bayes (PEB) predictor to estimate small area means. This predictor borrows strength across areas through the model and makes use of the survey weights to preserve the design consistency as the area sample size increases. We also employ a jackknife method to estimate the mean squared prediction error (MSPE) of the PEB predictor. Finally, we report the results of a simulation study on the performance of our PEB predictor and associated jackknife MSPE estimator.",0 +https://doi.org/10.1080/00273171.2011.589261,Bayesian Inference for Growth Mixture Models with Latent Class Dependent Missing Data,"Growth mixture models (GMMs) with nonignorable missing data have drawn increasing attention in research communities but have not been fully studied. The goal of this article is to propose and to evaluate a Bayesian method to estimate the GMMs with latent class dependent missing data. An extended GMM is first presented in which class probabilities depend on some observed explanatory variables and data missingness depends on both the explanatory variables and a latent class variable. A full Bayesian method is then proposed to estimate the model. Through the data augmentation method, conditional posterior distributions for all model parameters and missing data are obtained. A Gibbs sampling procedure is then used to generate Markov chains of model parameters for statistical inference. The application of the model and the method is first demonstrated through the analysis of mathematical ability growth data from the National Longitudinal Survey of Youth 1997 (Bureau of Labor Statistics, U.S. Department of Labor, 1997). A simulation study considering 3 main factors (the sample size, the class probability, and the missing data mechanism) is then conducted and the results show that the proposed Bayesian estimation approach performs very well under the studied conditions. Finally, some implications of this study, including the misspecified missingness mechanism, the sample size, the sensitivity of the model, the number of latent classes, the model comparison, and the future directions of the approach, are discussed.",0 +,On Bayesian Analysis of Mixtures with an Unknown Number of Components,"SUMMARY New methodology for fully Bayesian mixture analysis is developed, making use of reversible jump Markov chain Monte Carlo methods that are capable of jumping between the parameter subspaces corresponding to different numbers of components in the mixture. A sample from the full joint distribution of all unknown variables is thereby generated, and this can be used as a basis for a thorough presentation of many aspects of the posterior distribution. The methodology is applied here to the analysis of univariate normal mixtures, using a hierarchical prior model that offers an approach to dealing with weak prior information while avoiding the mathematical pitfalls of using improper priors in the mixture context.",0 +https://doi.org/10.1186/2046-4053-3-11,HHV-8 seroprevalence: a global view,"Human herpes virus 8 (HHV-8) is the underlying infectious cause of Kaposi sarcoma (KS) and other proliferative diseases; that is, primary effusion lymphoma and multicentric Castleman disease. In regions with high HHV-8 seroprevalence in the general population, KS accounts for a major burden of disease. Outside these endemic regions, HHV-8 prevalence is high in men who have sex with men (MSM) and in migrants from endemic regions. We aim to conduct a systematic literature review and meta-analysis in order 1) to define the global distribution of HHV-8 seroprevalence (primary objective) and 2) to identify risk factors for HHV-8 infection, with a focus on HIV status (secondary objective).We will include observational studies reporting data on seroprevalence of HHV-8 in children and/or adults from any region in the world. Case reports and case series as well as any studies with fewer than 50 participants will be excluded. We will search MEDLINE, EMBASE, and relevant conference proceedings without language restriction. Two reviewers will independently screen the identified studies and extract data on study characteristics and quality, study population, risk factors, and reported outcomes, using a standardized form. For the primary objective we will pool the data using a fully bayesian approach for meta-analysis, with random effects at the study level. For the secondary objective (association of HIV and HHV-8) we aim to pool odds ratios for the association of HIV and HHV-8 using a fully bayesian approach for meta-analysis, with random effects at the study level. Sub-group analyses and meta-regression analyses will be used to explore sources of heterogeneity, including factors such as geographical region, calendar years of recruitment, age, gender, ethnicity, socioeconomic status, different risk groups for sexually and parenterally transmitted infections (MSM, sex workers, hemophiliacs, intravenous drug users), comorbidities such as organ transplantation and malaria, test(s) used to measure HHV-8 infection, study design, and study quality.Using the proposed systematic review and meta-analysis, we aim to better define the global seroprevalence of HHV-8 and its associated risk factors. This will improve the current understanding of HHV-8 epidemiology, and could suggest measures to prevent HHV-8 infection and to reduce its associated cancer burden.",0 +https://doi.org/10.1177/0146621614533987,Computerized Adaptive Testing for the Random Weights Linear Logistic Test Model,"This article discusses four-item selection rules to design efficient individualized tests for the random weights linear logistic test model (RWLLTM): minimum posterior-weighted [Formula: see text]-error [Formula: see text]minimum expected posterior-weighted [Formula: see text]-error [Formula: see text]maximum expected Kullback–Leibler divergence between subsequent posteriors ( KLP), and maximum mutual information ( MUI). The RWLLTM decomposes test items into a set of subtasks or cognitive features and assumes individual-specific effects of the features on the difficulty of the items. The model extends and improves the well-known linear logistic test model in which feature effects are only estimated at the aggregate level. Simulations show that the efficiencies of the designs obtained with the different criteria appear to be equivalent. However, KLP and MUI are given preference over [Formula: see text] and [Formula: see text] due to their lesser complexity, which significantly reduces the computational burden.",0 +https://doi.org/10.1016/j.foodqual.2012.02.006,Determining odour detection thresholds: Incorporating a method-independent definition into the implementation of ASTM E679,"Abstract ASTM international standard practice E679 prescribes the use of a 3-alternative forced-choice (3AFC) method with an ascending concentration series for measuring odour detection thresholds. It recommends obtaining an individual’s threshold by geometrically averaging the concentrations at which the judge’s detection response reverses from incorrect to correct. The legitimate reversal point is defined by a stopping rule. Previous researchers have identified some methodological flaws with this calculation approach, relating to the use of stopping rules and the method’s unconventional definition of thresholds. The current study aims to empirically investigate these issues in more depth. Thresholds for three odorants were obtained for 100 judges. 1,8-Cineole, isobutyraldehyde and β-damascenone were tested in accordance with the data collection procedure of ASTM E679. Initially, thresholds were estimated by the ASTM-based method with four different stopping rules. These estimates were subsequently compared against thresholds estimated by an alternative method; that of fitting psychometric functions. The theoretical grounds on which the latter method is based, and the clear connection between performance and stimulus concentration that it demonstrates, provide a thorough comparison of both conventionally-defined thresholds and method-independent thresholds against the ASTM-based method. Comparisons between the thresholds resulting from the various estimation methods demonstrated (1) the choice of stopping rule had a significant effect on threshold estimates (P",0 +https://doi.org/10.1093/ije/31.1.96,Being sceptical about meta-analyses: a Bayesian perspective on magnesium trials in myocardial infarction,"There has been extensive discussion of the apparent conflict between meta-analyses and a mega-trial investigating the benefits of intravenous magnesium following myocardial infarction, in which the early trial results have been said to be 'too good to be true'.We apply Bayesian methods of meta-analysis to the trials available before and after the publication of the ISIS-4 results. We show how scepticism can be formally incorporated into an analysis as a Bayesian prior distribution, and how Bayesian meta-analysis models allow appropriate exploration of hypotheses that the treatment effect depends on the size of the trial or the risk in the control group.Adoption of a sceptical prior would have led early enthusiasm for magnesium to be suitably tempered, but only if combined with a random effects meta-analysis, rather than the fixed effect analysis that was actually conducted.We argue that neither a fixed effect nor a random effects analysis is appropriate when the mega-trial is included. The Bayesian framework provides many possibilities for flexible exploration of clinical hypotheses, but there can be considerable sensitivity to apparently innocuous assumptions.",0 +https://doi.org/10.1016/s0047-259x(02)00076-3,Empirical Bayesian estimation of normal variances and covariances,"This paper derives and evaluates an algorithm for estimating normal covariances. A particular concern is the performance of the estimator when the dimension of the space exceeds the number of observations. The algorithm is simple, tolerably well founded, and seems to be more accurate for its purpose than the alternatives. Other topics discussed are the joint estimation of variances in one and many dimensions; the loss function appropriate to a variance estimator; and its connection with a certain Bayesian prescription.",0 +https://doi.org/10.1201/9780203909935.ch6,Computer-modeling and Graphical Strategies for Meta-analysis,,0 +https://doi.org/10.1177/01466210122032046,Nonparametric Item Response Function Estimation for Assessing Parametric Model Fit,"Methods are developed that investigate the fit of parametric item response models by comparing them to models fitted under nonparametric assumptions. The approach is primarily graphical, but is made inferential through resampling from an estimated parametric model. The identifiability and estimation consistency of item response theory models are discussed and shown to be vital to the interpretation of differences between two fitted item response theory models. Simulation studies and real-data examples illustrate these techniques.",0 +https://doi.org/10.1111/j.1745-3984.1991.tb00350.x,A Comparison of Two Procedures for Computing IRT Equating Coefficients,"In order to equate tests under Item Response Theory (IRT), one must obtain the slope and intercept coefficients of the appropriate linear transformation. This article compares two methods for computing such equating coefficients–Loyd and Hoover (1980) and Stocking and Lord (1983). The former is based upon summary statistics of the test calibrations; the latter is based upon matching test characteristic curves by minimizing a quadratic loss function. Three types of equating situations: horizontal, vertical, and that inherent in IRT parameter recovery studies–were investigated. The results showed that the two computing procedures generally yielded similar equating coefficients in all three situations. In addition, two sets of SAT data were equated via the two procedures, and little difference in the obtained results was observed. Overall, the results suggest that the Loyd and Hoover procedure usually yields acceptable equating coefficients. The Stocking and Lord procedure improves upon the Loyd and Hoover values and appears to be less sensitive to atypical test characteristics. When the user has reason to suspect that the test calibrations may be associated with data sets that are typically troublesome to calibrate, the Stocking and Lord procedure is to be preferred.",0 +https://doi.org/10.1007/s00359-006-0189-3,Psychometric function for nectar volume perception of a flower-visiting bat,"For foraging pollinators one aspect of floral quality is the volume of nectar available. Thus, nectar-feeding animals should be able to estimate volumes of received nectar. In this study, we determined the psychometric function for nectar volume discrimination of a Neotropical flower-visiting bat Glossophaga soricina. For this, we examined the ability of bats to discriminate between two nectar volumes in a two-alternative forced-choice paradigm. We used a Bayesian inference approach to determine psychometric functions. From the derived psychometric function we assessed the discrimination threshold at a value of 0.69. G. soricina could clearly distinguish between two volumes, when the difference between the two nectar volumes divided by their average exceeded this value. This indicates that bats possess a sense for the perception and discrimination of volumes of nectar that is better developed than in honeybees. © 2006 Springer-Verlag.",0 +https://doi.org/10.1016/j.jglr.2014.07.006,Comparing Bayesian and frequentist methods of fisheries models: Hierarchical catch curves,"Bayesian inference is an emerging statistical paradigm and is becoming an increasingly used alternative to frequentist inference. Unfortunately, little is known about the efficacy of Bayesian inference and how it relates to the historical methodology of evaluating fisheries related models. Mortality information is routinely used in fisheries management to describe fish population abundance over time and has been historically estimated using catch curves and frequentist inference (i.e., maximum likelihood estimation). The objective of this study was to compare frequentist and Bayesian inference approaches to estimate instantaneous mortality (Z) from a hierarchical catch curve model. The data used in the comparison were from a long term monitoring program of yellow perch Perca flavescens from southern Lake Michigan in addition to a simulated dataset where parameter estimates were compared to known values. Point estimates of Z were similar among both methods. Similarly, Bayesian inference 95% credible intervals were concordant with frequentist 95% confidence intervals. However, the root mean squared error of frequentist inference increased at a higher rate than Bayesian inference with increasing variability in the simulated dataset. Our study builds on the literature that seeks to compare results between these two paradigms to assist managers to make the best decision possible when deciding what statistical paradigm to employ.",0 +https://doi.org/10.3758/bf03193596,Lure similarity affects visual episodic recognition: Detailed tests of a noisy exemplar model,"Summed-similarity models of visual episodic recognition memory successfully predict the variation in false alarm rates across different test items. With data averaged across subjects, Kahana and Sekuler demonstrated that subjects' performance appears to change along with the mean similarity among study items; with high interstimulus similarity, subjects were less likely to commit false alarms to similar lures. We examined this effect in detail by systematically varying the coordinates of study and test items along a critical stimulus dimension and measuring memory performance at each point. To reduce uncontrolled variance associated with individual differences in vision, the coordinates of study and test items were scaled according to each subject's discrimination threshold. Fitting each of four summed-similarity models to the individual subjects' data demonstrated a clear superiority for models that take account of interitem similarity on a trialwise basis.",0 +https://doi.org/10.3758/app.71.6.1414,Model-free estimation of the psychometric function,"A subject's response to the strength of a stimulus is described by the psychometric function, from which summary measures, such as a threshold or a slope, may be derived. Traditionally, this function is estimated by fitting a parametric model to the experimental data, usually the proportion of successful trials at each stimulus level. Common models include the Gaussian and Weibull cumulative distribution functions. This approach works well if the model is correct, but it can mislead if not. In practice, the correct model is rarely known. Here, a nonparametric approach based on local linear fitting is advocated. No assumption is made about the true model underlying the data, except that the function is smooth. The critical role of the bandwidth is identified, and its optimum value is estimated by a cross-validation procedure. As a demonstration, seven vision and hearing data sets were fitted by the local linear method and by several parametric models. The local linear method frequently performed better and never worse than the parametric ones. Supplemental materials for this article can be downloaded from app.psychonomic-journals.org/content/supplemental.",0 +https://doi.org/10.1177/0146621615605307,Three-Element Item Selection Procedures for Multiple Forms Assembly,"In educational measurement, building multiple alternate test forms is usually highly desirable in practice. Test assembly problems are classified as NP-hard (Non-deterministic Polynomial-time hard) problems, and their computation time increases exponentially as the problem size grows. The purpose of this study was to construct parallel forms item-by-item based on a seed test, using two proposed item selection heuristic methods (random item sequence assigned to maximum distance form with content balance [R-MD-B] and random item sequence assigned to random form with content balancing [R-R-B]) incorporating a flexible content balancing method. The results were compared with two modified versions of the Armstrong, Jones, and Wu heuristics (random item sequence assigned to maximum distance form with Armstrong’s replacement [R-MD-R] and random item sequence assigned to random form with Armstrong’s replacement [R-R-R]) and two models incorporating mixed integer programming (MIP) methods. The results showed that the R-MD-B and R-R-B methods yielded results comparable with the two MIP methods with less computation time in terms of the item information functions, test characteristic curves, and content coverage. The results also showed that R-MD-B and R-R-B can be extended to handle test assembly constraints in practical settings.",0 +https://doi.org/10.1007/s11336-013-9396-3,The Lognormal Race: A Cognitive-Process Model of Choice and Latency with Desirable Psychometric Properties,"We present a cognitive process model of response choice and response time performance data that has excellent psychometric properties and may be used in a wide variety of contexts. In the model there is an accumulator associated with each response option. These accumulators have bounds, and the first accumulator to reach its bound determines the response time and response choice. The times at which accumulator reaches its bound is assumed to be lognormally distributed, hence the model is race or minima process among lognormal variables. A key property of the model is that it is relatively straightforward to place a wide variety of models on the logarithm of these finishing times including linear models, structural equation models, autoregressive models, growth-curve models, etc. Consequently, the model has excellent statistical and psychometric properties and can be used in a wide range of contexts, from laboratory experiments to high-stakes testing, to assess performance. We provide a Bayesian hierarchical analysis of the model, and illustrate its flexibility with an application in testing and one in lexical decision making, a reading skill. © 2014, The Psychometric Society.",0 +https://doi.org/10.3389/fpsyg.2015.01599,Comparing interval estimates for small sample ordinal CFA models,"Robust maximum likelihood (RML) and asymptotically generalized least squares (AGLS) methods have been recommended for fitting ordinal structural equation models. Studies show that some of these methods underestimate standard errors. However, these studies have not investigated the coverage and bias of interval estimates. An estimate with a reasonable standard error could still be severely biased. This can only be known by systematically investigating the interval estimates. The present study compares Bayesian, RML, and AGLS interval estimates of factor correlations in ordinal confirmatory factor analysis models (CFA) for small sample data. Six sample sizes, 3 factor correlations, and 2 factor score distributions (multivariate normal and multivariate mildly skewed) were studied. Two Bayesian prior specifications, informative and relatively less informative were studied. Undercoverage of confidence intervals and underestimation of standard errors was common in non-Bayesian methods. Underestimated standard errors may lead to inflated Type-I error rates. Non-Bayesian intervals were more positive biased than negatively biased, that is, most intervals that did not contain the true value were greater than the true value. Some non-Bayesian methods had non-converging and inadmissible solutions for small samples and non-normal data. Bayesian empirical standard error estimates for informative and relatively less informative priors were closer to the average standard errors of the estimates. The coverage of Bayesian credibility intervals was closer to what was expected with overcoverage in a few cases. Although some Bayesian credibility intervals were wider, they reflected the nature of statistical uncertainty that comes with the data (e.g., small sample). Bayesian point estimates were also more accurate than non-Bayesian estimates. The results illustrate the importance of analyzing coverage and bias of interval estimates, and how ignoring interval estimates can be misleading. Therefore, editors and policymakers should continue to emphasize the inclusion of interval estimates in research.",1 +https://doi.org/10.1002/sim.1189,Bayesian random effects meta-analysis of trials with binary outcomes: methods for the absolute risk difference and relative risk scales,"When conducting a meta-analysis of clinical trials with binary outcomes, a normal approximation for the summary treatment effect measure in each trial is inappropriate in the common situation where some of the trials in the meta-analysis are small, or the observed risks are close to 0 or 1. This problem can be avoided by making direct use of the binomial distribution within trials. A fully Bayesian method has already been developed for random effects meta-analysis on the log-odds scale using the BUGS implementation of Gibbs sampling. In this paper we demonstrate how this method can be extended to perform analyses on both the absolute and relative risk scales. Within each approach we exemplify how trial-level covariates, including underlying risk, can be considered. Data from 46 trials of the effect of single-dose ibuprofen on post-operative pain are analysed and the results contrasted with those derived from classical and Bayesian summary statistic methods. The clinical interpretation of the odds ratio scale is not straightforward. The advantages and flexibility of a fully Bayesian approach to meta-analysis of binary outcome data, considered on an absolute risk or relative risk scale, are now available.",0 +https://doi.org/10.3389/fpsyg.2015.00036,"Math achievement is important, but task values are critical, too: examining the intellectual and motivational factors leading to gender disparities in STEM careers","Although young women now obtain higher course grades in math than boys and are just as likely to be enrolled in advanced math courses in high school, females continue to be underrepresented in some Science, Technology, Engineering, and Mathematics (STEM) occupations. This study drew on expectancy-value theory to assess (1) which intellectual and motivational factors in high school predict gender differences in career choices and (2) whether students' motivational beliefs mediated the pathway of gender on STEM career via math achievement by using a national longitudinal sample in the United States. We found that math achievement in 12th grade mediated the association between gender and attainment of a STEM career by the early to mid-thirties. However, math achievement was not the only factor distinguishing gender differences in STEM occupations. Even though math achievement explained career differences between men and women, math task value partially explained the gender differences in STEM career attainment that were attributed to math achievement. The identification of potential factors of women's underrepresentation in STEM will enhance our ability to design intervention programs that are optimally tailored to female needs to impact STEM achievement and occupational choices.",0 +https://doi.org/10.1037/a0020858,Leader–member exchange and affective organizational commitment: The contribution of supervisor's organizational embodiment.,"In order to account for wide variation in the relationship between leader-member exchange and employees' affective organizational commitment, we propose a concept termed supervisor's organizational embodiment (SOE), which involves the extent to which employees identify their supervisor with the organization. With samples of 251 social service employees in the United States (Study 1) and 346 employees in multiple Portuguese organizations (Study 2), we found that as SOE increased, the association between leader-member exchange and affective organizational commitment became greater. This interaction carried through to in-role and extra-role performance. With regard to antecedents, we found in Study 1 that supervisor's self-reported identification with the organization increased supervisor's expression of positive statements about the organization, which in turn increased subordinates' SOE.",0 +https://doi.org/10.1111/j.0006-341x.2000.00768.x,Nonconjugate Bayesian Analysis of Variance Component Models,"Summary. We consider the usual normal linear mixed model for variance components from a Bayesian viewpoint. With conjugate priors and balanced data, Gibbs sampling is easy to implement; however, simulating from full conditionals can become difficult for the analysis of unbalanced data with possibly nonconjugate priors, thus leading one to consider alternative Markov chain Monte Carlo schemes. We propose and investigate a method for posterior simulation based on an independence chain. The method is customized to exploit the structure of the variance component model, and it works with arbitrary prior distributions. As a default reference prior, we use a version of Jeffreys' prior based on the integrated (restricted) likelihood. We demonstrate the ease of application and flexibility of this approach in familiar settings involving both balanced and unbalanced data.",0 +https://doi.org/10.1007/s13253-010-0043-5,Statistical Modelling of Neighbor Treatment Effects in Aquaculture Clinical Trials,"In the design of clinical trials involving fish observed over time in tanks, there may be advantages in housing several treatment groups within the same tank. In particular, such ""within-tank"" designs will be more efficient than designs with treatment groups in separate tanks when substantial between-tank variability is expected. One potential problem with within-tank designs is that it may not be possible to include all treatments in one tank; in statistical terms this means that the blocks (tanks) are incomplete. In incomplete block designs, there may be a concern that the treatments present in the same tank (denoted here as ""neighbors"") affect each other in their performance; thus the need for an assessment of neighbor effects. In this paper, we propose two statistical approaches to assess and account for neighbor effects. The first approach is based on a non-linear mixed model and the second involves cross-classified and multiple membership models. Both approaches are illustrated on simulated data as well as data from a clinical ISAV (Infectious Salmon Anaemia Virus) trial; corresponding computer code is available online. The simulation studies demonstrated that both models show promise in capturing neighbor treatment effects of the type assumed for the models, whenever such neighbor effects are of at least moderate magnitude. In the absence of or with low magnitudes of neighbor effects, the non-linear mixed model faced numerical challenges and produced noisy results. One version of the cross-classified and multiple membership model was shown to depend strongly on prior information about variance-covariance parameters for datasets similar to the ISAV data. Analyses of the ISAV trial data by both models did not provide any evidence of substantial neighbor effects. © 2010 International Biometric Society.",0 +https://doi.org/10.1111/j.0963-7214.2005.00354.x,Mood and Emotion in Major Depression,"Nothing is more familiar to people than their moods and emotions. Oddly, however, it is not clear how these two kinds of affective processes are related. Intuitively, it makes sense that emotional reactions are stronger when they are congruent with a preexisting mood, an idea reinforced by contemporary emotion theory. Yet empirically, it is uncertain whether moods actually facilitate emotional reactivity to mood-congruent stimuli. One approach to the question of how moods affect emotions is to study mood-disturbed individuals. This review describes recent experimental studies of emotional reactivity conducted with individuals suffering from major depression. Counter to intuitions, major depression is associated with reduced emotional reactivity to sad contexts. A novel account of emotions in depression is advanced to assimilate these findings. Implications for the study of depression and normal mood variation are considered.",0 +https://doi.org/10.1177/000312240607100606,Scar Effects of Unemployment: An Assessment of Institutional Complementarities,"This article uses panel data from the Survey of Income and Program Participation (SIPP) and the European Community Household Panel (ECHP) for a comparative analysis of workers' post-unemployment earnings trajectories in the United States and 12 Western European countries. Across the study sample of industrialized countries, results of difference-in-difference propensity score matching show post-unemployment earnings losses to be largely permanent and particularly significant for high-wage and older workers as well as for women. The analyses also show that negative effects of unemployment on workers' subsequent earnings are mitigated through either generous unemployment benefit systems or strict labor market regulation. These effects stem partly from favorable behavioral responses that prevent downward occupational and industrial mobility and partly from changes in the overall structure of labor markets favoring the transferability of worker skills between jobs. These positive effects materialize despite the fact that labor market policies tend to successfully protect the core work force from experiencing a job loss in the first place.",0 +,Prior distributions for variance parameters in hierarchical models,"Various prior distributions have been suggested for scale parameters in hierarchical models. We construct a new folded-noncentral-t family of conditionally conjugate priors for hierarchical standard deviation pa- rameters, and then consider and weakly informative priors in this family. We use an example to illustrate serious problems with the inverse-gamma family of noninformative prior distributions. We suggest instead to use a uni- form prior on the hierarchical standard deviation, using the half-t family when the number of groups is small and in other settings where a weakly informative prior is desired. We also illustrate the use of the half-t family for hierarchical modeling of multiple variance parameters such as arise in the analysis of variance.",0 +https://doi.org/10.1007/s11336-008-9060-5,A Robust Bayesian Approach for Structural Equation Models with Missing Data,"In this paper, normal/independent distributions, including but not limited to the multivariate t distribution, the multivariate contaminated distribution, and the multivariate slash distribution, are used to develop a robust Bayesian approach for analyzing structural equation models with complete or missing data. In the context of a nonlinear structural equation model with fixed covariates, robust Bayesian methods are developed for estimation and model comparison. Results from simulation studies are reported to reveal the characteristics of estimation. The methods are illustrated by using a real data set obtained from diabetes patients. © 2008 The Psychometric Society.",0 +https://doi.org/10.1177/1471082x0700700301,Using cross-classified multivariate mixed response models with application to life history traits in great tits (Parus major),"Longitudinal observations on known individuals are an important source of data with which to test evolutionary theory within natural populations, in particular, the evolution and maintenance of life-history traits. In this paper, we concentrate on the reproductive behaviour and survival of a small passerine bird, the great tit ( Parus major). The dataset we consider is taken from the long-term study of great tits in Wytham Woods in Oxfordshire. The models we consider are designed to relate variation in several phenotypic response variables that are linked to evolutionary fitness, alongside the correlations between them, to both general environmental and individual-specific factors. We fit multivariate cross-classified random effects models using a Markov chain Monte Carlo (MCMC) estimation algorithm described in the paper. Our results show for which traits variability is influenced by environmental factors and for which traits individual bird factors are more important. The partitioning of correlations is particularly illuminating, producing some pairs of ‘antagonistic’ correlations which are biologically meaningful.",0 +https://doi.org/10.1111/j.1541-0420.2012.01807.x,Modeling Seroadaptation and Sexual Behavior Among HIV+Study Participants with a Simultaneously Multilevel and Multivariate Longitudinal Count Model,"Longitudinal behavioral intervention trials to reduce HIV transmission risk collect complex multilevel and multivariate data longitudinally for each subject with important correlation structures across time, level, and variables. Accurately assessing the effects of these trials are critical for determining which interventions are effective. Both numbers of partners and numbers of sex acts with each partner are reported at each time point. Sex acts with each partner are further differentiated into protected and unprotected acts with correspondingly differing risks of HIV/STD transmission. These trials generally also have eligibility criteria limiting enrollment to participants with some minimal level of risky sexual behavior tied directly to the outcome of interest. The combination of these factors makes it difficult to quantify sexual behaviors and the effects of intervention. We propose a multivariate multilevel count model that simultaneously models the number of partners, acts within partners, and accounts for recruitment eligibility. Our methods are useful in the evaluation of intervention trials and provide a more accurate and complete model for sexual behavior. We illustrate the contributions of our model by examining seroadaptive behavior defined as risk reducing behavior that depends on the serostatus of the partner. Several forms of seroadaptive risk reducing behavior are quantified and distinguished from nonseroadaptive risk reducing behavior.",0 +https://doi.org/10.1348/000711004849204,Bayesian model comparison of nonlinear structural equation models with missing continuous and ordinal categorical data,"Missing data are very common in behavioural and psychological research. In this paper, we develop a Bayesian approach in the context of a general nonlinear structural equation model with missing continuous and ordinal categorical data. In the development, the missing data are treated as latent quantities, and provision for the incompleteness of the data is made by a hybrid algorithm that combines the Gibbs sampler and the Metropolis-Hastings algorithm. We show by means of a simulation study that the Bayesian estimates are accurate. A Bayesian model comparison procedure based on the Bayes factor and path sampling is proposed. The required observations from the posterior distribution for computing the Bayes factor are simulated by the hybrid algorithm in Bayesian estimation. Our simulation results indicate that the correct model is selected more frequently when the incomplete records are used in the analysis than when they are ignored. The methodology is further illustrated with a real data set from a study concerned with an AIDS preventative intervention for Filipina sex workers.",0 +https://doi.org/10.1198/10618600152418584,The Art of Data Augmentation,"The term data augmentation refers to methods for constructing iterative optimization or sampling algorithms via the introduction of unobserved data or latent variables. For deterministic algorithms, the method was popularized in the general statistical community by the seminal article by Dempster, Laird, and Rubin on the EM algorithm for maximizing a likelihood function or, more generally, a posterior density. For stochastic algorithms, the method was popularized in the statistical literature by Tanner and Wong's Data Augmentation algorithm for posterior sampling and in the physics literature by Swendsen and Wang's algorithm for sampling from the Ising and Potts models and their generalizations; in the physics literature, the method of data augmentation is referred to as the method of auxiliary variables. Data augmentation schemes were used by Tanner and Wong to make simulation feasible and simple, while auxiliary variables were adopted by Swendsen and Wang to improve the speed of iterative simulation. In...",0 +https://doi.org/10.1007/978-3-642-19656-0_34,A Psychological Model for Aggregating Judgments of Magnitude,"In this paper, we develop and illustrate a psychologically-motivated model for aggregating judgments of magnitude across experts. The model assumes that experts’ judgments are perturbed from the truth by both systematic biases and random error, and it provides aggregated estimates that are implicitly based on the application of nonlinear weights to individual judgments. The model is also easily extended to situations where experts report multiple quantile judgments. We apply the model to expert judgments concerning flange leaks in a chemical plant, illustrating its use and comparing it to baseline measures.",0 +https://doi.org/10.1026/0049-8637/a000051,Multivariate Veränderungsmodelle für Schulnoten und Schülerleistungen in Deutsch und Mathematik,"Zusammenfassung. Schülerleistungen in standardisierten Leistungstests weisen einen mittleren Zusammenhang zu Schulnoten im gleichen Fach auf. Über die Fächergrenzen hinweg sind die Zusammenhänge geringer aber positiv. Über längsschnittliche Zusammenhänge zwischen Schulnoten und Schülerleistungen ist wenig bekannt. In dieser Studie untersuchen wir längsschnittliche Zusammenhänge zwischen Schülerleistungen und Schulnoten in Deutsch und Mathematik. Die vorliegenden Analysen wurden an Prä- und Postmessungen einer Gymnasialstichprobe (N=168) vorgenommen, die zu Studien- und Kontrollgruppen einer intensiv-längsschnittlichen Studie gehörte. Multigruppenanalysen weisen auf vollständige Messinvarianz zwischen beiden Gruppen hin, Testungseffekte zeigen sich nicht. Die längsschnittlichen Zusammenhänge wurden mit dem Change-Score-Modell analysiert. Die Veränderungen in Schülerleistungen in beiden Schulfächern korrelieren nicht signifikant, die Veränderungen in Schulnoten beider Schulfächer korrelieren positiv. In beiden Schulfächern zeigen Veränderungen der Schülerleistungen und der Schulnoten einen positiven Zusammenhang. Die Korrelation ist nur moderat, da Schulnoten aus Gründen wie Referenzrahmeneffekte auch querschnittlich nur moderat mit Schülerleistungen korrelieren. Der Leistungszuwachs lässt sich am effektivsten mit normreferenzierten Skalen quantifizieren.",0 +https://doi.org/10.1002/sim.7374,A Dirichlet process mixture model for clustering longitudinal gene expression data,"Subgroup identification (clustering) is an important problem in biomedical research. Gene expression profiles are commonly utilized to define subgroups. Longitudinal gene expression profiles might provide additional information on disease progression than what is captured by baseline profiles alone. Therefore, subgroup identification could be more accurate and effective with the aid of longitudinal gene expression data. However, existing statistical methods are unable to fully utilize these data for patient clustering. In this article, we introduce a novel clustering method in the Bayesian setting based on longitudinal gene expression profiles. This method, called BClustLonG, adopts a linear mixed-effects framework to model the trajectory of genes over time, while clustering is jointly conducted based on the regression coefficients obtained from all genes. In order to account for the correlations among genes and alleviate the high dimensionality challenges, we adopt a factor analysis model for the regression coefficients. The Dirichlet process prior distribution is utilized for the means of the regression coefficients to induce clustering. Through extensive simulation studies, we show that BClustLonG has improved performance over other clustering methods. When applied to a dataset of severely injured (burn or trauma) patients, our model is able to identify interesting subgroups. Copyright © 2017 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1002/sim.3915,A Bayesian analysis of mixture structural equation models with non-ignorable missing responses and covariates,"In behavioral, biomedical, and social-psychological sciences, it is common to encounter latent variables and heterogeneous data. Mixture structural equation models (SEMs) are very useful methods to analyze these kinds of data. Moreover, the presence of missing data, including both missing responses and missing covariates, is an important issue in practical research. However, limited work has been done on the analysis of mixture SEMs with non-ignorable missing responses and covariates. The main objective of this paper is to develop a Bayesian approach for analyzing mixture SEMs with an unknown number of components, in which a multinomial logit model is introduced to assess the influence of some covariates on the component probability. Results of our simulation study show that the Bayesian estimates obtained by the proposed method are accurate, and the model selection procedure via a modified DIC is useful in identifying the correct number of components and in selecting an appropriate missing mechanism in the proposed mixture SEMs. A real data set related to a longitudinal study of polydrug use is employed to illustrate the methodology.",0 +https://doi.org/10.2307/2331838,Frequency Distribution of the Values of the Correlation Coefficient in Samples from an Indefinitely Large Population,,0 +https://doi.org/10.5705/ss.2009.180,Center-adjusted inference for a nonparametric Bayesian random effect distribution,"Dirichlet process (DP) priors are a popular choice for semiparametric Bayesian random effect models. The fact that the DP prior implies a non-zero mean for the random effect distribution creates an identifiability problem that complicates the interpretation of, and inference for, the fixed effects that are paired with the random effects. Similarly, the interpretation of, and inference for, the variance components of the random effects also becomes a challenge. We propose an adjustment of conventional inference using a post-processing technique based on an analytic evaluation of the moments of the random moments of the DP. The adjustment for the moments of the DP can be conveniently incorporated into Markov chain Monte Carlo simulations at essentially no additional computational cost. We conduct simulation studies to evaluate the performance of the proposed inference procedure in both a linear mixed model and a logistic linear mixed effect model. We illustrate the method by applying it to a prostate specific antigen dataset. We provide an R function that allows one to implement the proposed adjustment in a post-processing step of posterior simulation output, without any change to the posterior simulation itself.",0 +,Making BUGS open,,0 +https://doi.org/10.1007/s11336-012-9301-5,Methods for Mediation Analysis with Missing Data,"Despite wide applications of both mediation models and missing data techniques, formal discussion of mediation analysis with missing data is still rare. We introduce and compare four approaches to dealing with missing data in mediation analysis including listwise deletion, pairwise deletion, multiple imputation (MI), and a two-stage maximum likelihood (TS-ML) method. An R package bmem is developed to implement the four methods for mediation analysis with missing data in the structural equation modeling framework, and two real examples are used to illustrate the application of the four methods. The four methods are evaluated and compared under MCAR, MAR, and MNAR missing data mechanisms through simulation studies. Both MI and TS-ML perform well for MCAR and MAR data regardless of the inclusion of auxiliary variables and for AV-MNAR data with auxiliary variables. Although listwise deletion and pairwise deletion have low power and large parameter estimation bias in many studied conditions, they may provide useful information for exploring missing mechanisms. © 2012 The Psychometric Society.",0 +https://doi.org/10.1007/s11336-004-1215-4,"The applicability of deadline models: Comment on Glickman, Gray, and Morales (2005)","Glickman, Gray, and Morales (this issue) propose a statistical model for measuring the unobserved latency of stimulus-controlled processes. The model accounts for both speed and accuracy and does so by assuming that participants set an internal deadline. If a stimulus-controlled response is not produced by the deadline, the participant then guesses. The applicability of the model is discussed in this Comment. The deadline model yields specific predictions for the case in which stimulus difficulty is manipulated in a within-block manner. In this case, it is reasonable to assume that stimulus difficulty does not affect the deadline. It is shown that in common perceptual and cognitive domains, extant data do not fully meet these predictions. Hence, practitioners need be aware of the possibility and consequences of model misspecification. © 2005 The Psychometric Society.",0 +https://doi.org/10.1016/0022-2496(80)90001-2,Decomposing the reaction time distribution: Pure insertion and selective influence revisited,"Abstract This paper investigates the consequences of extending the assumptions of pure insertion and selective influence (popular in RT theorizing) to the level of the distribution. In the case of pure insertion and under the additional assumption that the additive random variable is exponentially distributed, a solution is obtained which not only allows estimation of the exponential-rate parameter but also provides a test of the assumptions. The result is shown to be applicable not only when processing is serial but also for certain parallel models. In addition, discrimination between self-terminating and exhaustive search strategies is provided, and in the case of either, both parameter estimation and tests of the model are possible. Extensions to nonexponential models are investigated and a general method of moments solution is outlined. In the case of selective influence a general nonparametric alternative to Sternberg's additive factor method is developed. The problem of empirical estimation and application is then considered. Simulations which place bounds on the type I and II error are reported. Finally the first theorem is provided an illustrative application with data from a memory scanning experiment. The results provide some support for the double assumption of pure insertion and that the additive random variable is distributed exponentially.",0 +https://doi.org/10.1177/0049124199027003004,Evaluating and Using Statistical Methods in the Social Sciences,,0 +,AN ANALYSIS OF SURVEY DATA ON SMOKING USING PROPENSITY SCORES,"SUMMARY. Responses to questions on perceived health risks from smoking, amount of exercise, overall health, and desire to quit smoking vary across smoking groups. The smoking groups also have very different distributions of covariates. Categorizing respondents based on estimated propensities to smoke, as in blocking, creates groups with less measurable imbalance in distributions of covariates. Adjustment of results using propensity score classes lessens some effect estimates while increasing others and changes results of some significance tests. However, even after adjusting for covariates through the use of propensity scores, smokers report a higher risk of disease than do nonsmokers.",0 +https://doi.org/10.1080/00031305.1995.10476177,Understanding the Metropolis-Hastings Algorithm,"Abstract We provide a detailed, introductory exposition of the Metropolis-Hastings algorithm, a powerful Markov chain method to simulate multivariate distributions. A simple, intuitive derivation of this method is given along with guidance on implementation. Also discussed are two applications of the algorithm, one for implementing acceptance-rejection sampling when a blanketing function is not available and the other for implementing the algorithm with block-at-a-time scans. In the latter situation, many different algorithms, including the Gibbs sampler, are shown to be special cases of the Metropolis-Hastings algorithm. The methods are illustrated with examples.",0 +https://doi.org/10.1037/a0027558,"Changing the pond, not the fish: Following high-ability students across different educational environments.","Big-fish-little-pond effect (BFLPE) research (e.g., Marsh & Parker, 1984) has found that perceptions of academic ability are generally positively related to individual ability and negatively related to classroom and school average ability. However, BFLPE research typically relies on environmental differences as a between-subjects factor. Unlike most previous BFLPE research, the current study used group average ability as a within-subject variable by measuring student self-concept before and after high-ability students left their regular school environment to participate in a supplemental academic summer program. Results revealed that academic self-concept (ASC) and educational aspirations did not undergo significant declines when students were in the relatively higher ability environment. Even with ceiling effects limiting potential increases in ASC, participants were more than 2 times as likely to increase or maintain their ASC as they were to report declines in ASC. Further, several boosts were found in nonacademic self-concepts. Such findings indicate that BFLPEs are not necessarily associated with supplemental educational environments.",0 +https://doi.org/10.1007/bf02295939,Generalized multilevel structural equation modeling,"A unifying framework for generalized multilevel structural equation modeling is introduced. The models in the framework, called generalized linear latent and mixed models (GLLAMM), combine features of generalized linear mixed models (GLMM) and structural equation models (SEM) and consist of a response model and a structural model for the latent variables. The response model generalizes GLMMs to incorporate factor structures in addition to random intercepts and coefficients. As in GLMMs, the data can have an arbitrary number of levels and can be highly unbalanced with different numbers of lower-level units in the higher-level units and missing data. A wide range of response processes can be modeled including ordered and unordered categorical responses, counts, and responses of mixed types. The structural model is similar to the structural part of a SEM except that it may include latent and observed variables varying at different levels. For example, unit-level latent variables (factors or random coefficients) can be regressed on cluster-level latent variables. Special cases of this framework are explored and data from the British Social Attitudes Survey are used for illustration. Maximum likelihood estimation and empirical Bayes latent score prediction within the GLLAMM framework can be performed using adaptive quadrature in gllamm, a freely available program running in Stata.",0 +https://doi.org/10.1007/978-0-387-73186-5_2,Bayesian Multilevel Analysis and MCMC,"Multilevel models have gained wide acceptance over the past 20 years in many fields, including education and medicine [e.g., 26, 43, 45], as an important methodology for dealing appropriately with nested or clustered data. The idea of conducting an experiment in such a way that the levels of one factor are nested inside those of another goes back all the way to the initial development, in the 1920s, of the analysis of variance (ANOVA; [34]), so there?s nothing new in working with nested data; the novelty in recent decades is in the methods for fitting multilevel models, the ability to work with data possessing many levels of nesting and multiple predictor variables at any or all levels, and an increased flexibility in distributional assumptions. The earliest designs featured one-way ANOVA models such as1 yij = μ + αTj + aSij , j = 1, . . . , J, i = 1, . . . , nj , ∑j=1J nj = N, ∑Jj=1 αTj = 0, aSij∼iid N(0, σ2S), in which the subject factor S (indexed by i), treated as random, is nested within the treatment factor T (indexed by j), treated as fixed. Under the normality assumption in (2.1) such models required little for the (frequentist) estimation of the parameters μ, σ2S , and the αTj beyond minor extensions of the least squares methods known since the time of Legendre [51] and Gauss [36]. Regarding the treatment factor as random, however, by changing the αTj to aTj ∼iid N(0, α2T ) (with the a Tj and aS ij mutually independent), created substantial new difficulties in model fitting-indeed, as late as the 1950s, one of the leading estimation methods [e.g., 65] was based on unbiased estimates of the variance components α2T and α2 s , the former of which can easily, and embarrassingly, go negative when α2T is small. Fisher [33] had much earlier pioneered the use of maximum likelihood estimation, but before the widespread use of fast computers this approach was impractical in random-effects and mixed models such as yij = β0 + β1(xij ? xÌ„) + aTj + aSij , j = 1, . . . , J, i = 1, . . . , nj , XJj=1 nj = N, aTj∼iid N(0, σ;a2 T), aSij∼iid N(0, σ2S) (where the xij are fixed known values of a predictor variable and ?x is the sample mean of this variable), because the likelihood equations in such models can only be solved iteratively. Multilevel modeling entered a new phase in the 1980s, with the development of computer programs such as ML3, VARCL, and HLM using likelihood-based estimation approaches based on iterative generalized least squares [42], Fisher scoring [52], and the EM algorithm [e.g., 15], respectively. In particular, the latest versions of MLwiN (the successor to ML3; [60]) and HLM [66] have worldwide user bases in the social and biomedical sciences numbering in the thousands, and likelihood-based fitting of at least some multilevel models is also now obtainable in more general-purpose statistical packages such as SAS [64] and Stata [71]. However, the use of the likelihood function alone in multilevel modeling can lead to the following technical problems: Maximum-likelihood estimates (MLEs) and their (estimated asymptotic) standard errors (SEs) can readily be found by iterative means for the parameters in Gaussian multilevel models such as (2.2), but interval stimates of those parameters can be problematic when J, the number of level-2 units, is small. For example, simple ?95%? intervals of the form α̂2T ± 1.96 b se(α̂2T ) (based on the large-sample Gaussian repeated-sampling distribution of α̂2T ) can go negative and can have actual coverage levels substantially below 95%, and other methods based only on α̂2T and b se(α̂2T ) (which are the default outputs of packages such as MLwiN and HLM) are not guaranteed to do much better, in part because (with small sample sizes) the MLE of α2T can be 0 even when the true value of α2T is well away from 0 [e.g., 12]. The situation becomes even more difficult when the outcome variable y in the multilevel model is dichotomous rather than Gaussian, as in randomeffects logistic regression (RELR) models such as (yij | p ij) ∼indep Bernoulli(pij), where logit(pij) = β0 + β1(xij ? xÌ„) + uj , uj ∼iid N(0, α2u). Here the likelihood methods that work with Gaussian outcomes fail; the likelihood function itself cannot even be evaluated without integrating out the random effects uj from (2.3). Available software such as MLwiN fits RELR models via quasi-likelihood methods [7]; this approach to fitting nonlinear models such as (2.3) proceeds by linearizing the second line of the model via Taylor series expansion, yielding marginal and penalized quasi-likelihood (MQL and PQL) estimates according to the form of the expansion used. These are not full likelihood methods and would be better termed likelihood-based techniques. Browne and Draper [12] have shown that the actual coverage of nominal 95% interval estimates with this approach in RELR models can be far less than 95% when the intervals are based only on MQL and PQL point estimates and their (estimated asymptotic) SEs; see Section 2.3.3 below. Calibration results of this kind for other methods which attempt to more accurately approximate the actual likelihood function [e.g., 1, 50, 53, 57, 61] are sparse and do not yet fully cover the spectrum of models in routine use, and user-friendly software for many of these methods is still hard to come by. This chapter concerns the Bayesian approach to fitting multilevel models, which (a) attempts to remedy the above problems (though not without introducing some new challenges of its own) and (b) additionally provides a mechanism for the formal incorporation of any prior information which may be available about the parameters of the multilevel model of interest external to the current data set. A computing revolution based on Markov chain Monte Carlo (MCMC) methods, and the availability of much faster (personal) computers, have together made the Bayesian fitting of multilevel models increasingly easier since the early 1990s. In this chapter I (1) describe the basic outline of a Bayesian analysis (multilevel or not), in the context of a case study, (2) motivate the need for simulation-based computing methods, (3) describe MCMC methods in general and their particular application to multilevel modeling, (4) discuss MCMC diagnostic methods (to ensure accuracy of the computations), and (5) present an MCMC solution to the multilevel modeling case study. © 2008 Springer Science+Business Media, LLC.",0 +https://doi.org/10.1027/1614-2241.2.3.124,Does Money Matter? A Theory-Driven Growth Mixture Model to Explain Travel-Mode Choice with Experimental Data,"In the present article we apply a growth mixture model using Mplus via STREAMS to delineate the mechanism underlying travel-mode choice. Three waves of an experimental field study conducted in Frankfurt Main, Germany, are applied for the statistical analysis. Five major questions are addressed: (1) whether the choice of public transport rather than the car changes over time; (2) whether a soft policy intervention to change travel mode choice has any effect on the travel-mode chosen; (3) whether one can identify different groups of people regarding the importance allocated to monetary and time considerations for the decision of which travel mode to use; (4) whether the different subgroups of people have different initial states and rates of change in their travel-model choices; (5) whether sociodemographic variables have an additional effect on the latent class variables and on the changes in travel-mode choice over time. We also found that choice of public transportation in our study is stable over time. Moreover, the intervention has an effect only on one of the classes. We identify four classes of individuals. One class allocates a low importance to both monetary and time considerations, the second allocates high importance to money and low importance to time, the third allocates high importance to both, and the fourth allocates a low importance to money and a high importance to time. We found no difference in the patterns of travel-mode changes over time in the four classes. We also found some additional effects of sociodemographic characteristics on the latent class variables and on behavior in the different classes. The model specification and the empirical findings are discussed in light of the theory of the allocation of time of Gary Becker.",0 +https://doi.org/10.1080/00031305.1989.10475663,Errors-in-Variables Regression Using Stein Estimates,"Abstract A method is proposed for estimating regression parameters from data containing covariate measurement errors by using Stein estimates of the unobserved true covariates. The method produces consistent estimates for the slope parameter in the classical linear errors-in-variables model and applies to a broad range of nonlinear regression problems, provided the measurement error is Gaussian with known variance. Simulations are used to examine the performance of the estimates in a nonlinear regression problem and to compare them with the usual naive ones obtained by ignoring error and with other estimates proposed recently in the literature.",0 +https://doi.org/10.1214/aoms/1177704568,Classification into two Multivariate Normal Distributions with Different Covariance Matrices,"Linear procedures for classifying an observation as coming from one of two multivariate normal distributions are studied in the case that the two distributions differ both in mean vectors and covariance matrices. We find the class of admissible linear procedures, which is the minimal complete class of linear procedures. It is shown how to construct the linear procedure which minimizes one probability of misclassification given the other and how to obtain the minimax linear procedure; Bayes linear procedures are also discussed.",0 +https://doi.org/10.1007/bf02294709,Heterogeneous factor analysis models: A bayesian approach,"Multilevel factor analysis models are widely used in the social sciences to account for heterogeneity in mean structures. In this paper we extend previous work on multilevel models to account for general forms of heterogeneity in confirmatory factor analysis models. We specify various models of mean and covariance heterogeneity in confirmatory factor analysis and develop Markov Chain Monte Carlo (MCMC) procedures to perform Bayesian inference, model checking, and model comparison. We test our methodology using synthetic data and data from a consumption emotion study. The results from synthetic data show that our Bayesian model perform well in recovering the true parameters and selecting the appropriate model. More importantly, the results clearly illustrate the consequences of ignoring heterogeneity. Specifically, we find that ignoring heterogeneity can lead to sign reversals of the factor covariances, inflation of factor variances and underappreciation of uncertainty in parameter estimates, The results from the emotion study show that subjects vary both in means and covariances, Thus traditional psychometric methods cannot fully capture the heterogeneity in our data.",0 +https://doi.org/10.1016/j.pain.2005.02.009,Minocycline attenuates mechanical allodynia and proinflammatory cytokine expression in rat models of pain facilitation,"Activated glial cells (microglia and astroglia) in the spinal cord play a major role in mediating enhanced pain states by releasing proinflammatory cytokines and other substances thought to facilitate pain transmission. In the present study, we report that intrathecal administration of minocycline, a selective inhibitor of microglial cell activation, inhibits low threshold mechanical allodynia, as measured by the von Frey test, in two models of pain facilitation. In a rat model of neuropathic pain induced by sciatic nerve inflammation (sciatic inflammatory neuropathy, SIN), minocycline delayed the induction of allodynia in both acute and persistent paradigms. Moreover, minocycline was able to attenuate established SIN-induced allodynia 1 day, but not 1 week later, suggesting a limited role of microglial activation in more perseverative pain states. Our data are consistent with a crucial role for microglial cells in initiating, rather than maintaining, enhanced pain responses. In a model of spinal immune activation by intrathecal HIV-1 gp120, we show that the anti-allodynic effects of minocycline are associated with decreased microglial activation, attenuated mRNA expression of interleukin-1beta (IL-1beta), tumor necrosis factor-alpha (TNF-alpha), IL-1beta-converting enzyme, TNF-alpha-converting enzyme, IL-1 receptor antagonist and IL-10 in lumbar dorsal spinal cord, and reduced IL-1beta and TNF-alpha levels in the CSF. In contrast, no significant effects of minocycline were observed on gp120-induced IL-6 and cyclooxygenase-2 expression in spinal cord or CSF IL-6 levels. Taken together these data highlight the importance of microglial activation in the development of exaggerated pain states.",0 +https://doi.org/10.1007/s10869-014-9351-z,"RWA Web: A Free, Comprehensive, Web-Based, and User-Friendly Tool for Relative Weight Analyses","Over the last 15 years, a number of methodological developments have enabled researchers to draw more accurate inferences concerning the relative contribution (i.e., relative importance) among multiple (often correlated) predictor variables in a regression analysis. One such development has been relative weight analysis (RWA). Researchers can use a RWA to decompose the total variance predicted in a regression model (R2) into weights that accurately reflect the proportional contribution of the various predictor variables. Prior to RWA, researchers were forced to rely on traditional statistics (e.g., correlations; standardized regression weights), which are known to yield faulty or misleading information concerning variable importance (especially when predictor variables are correlated with one another, which is often the case in organizational research). Although there has been a surge of interest in RWA over the last 10 years, integration of this statistical tool into organizational research has been hampered by the lack of a user-friendly statistical package for implementing RWA. Indeed, most popular statistical packages (e.g., SPSS, SAS) have yet to include RWA protocols into their regression modules. The purpose of this paper is to present a new, free, comprehensive, web-based, user-friendly resource, RWA-Web, which may be used by anyone having simple access to the internet. Our paper is structured as a tutorial on using RWA-Web to examine relative importance in the classic multiple regression model, the multivariate multiple regression model, and the logistic regression model. We also illustrate how RWA-Web may be used to conduct null hypothesis significance tests using advanced bootstrapping procedures.",0 +https://doi.org/10.2522/ptj.20130302,"Association Between Physical Activity and Sleep in Adults With Chronic Pain: A Momentary, Within-Person Perspective","Background Individuals with chronic pain consider improved sleep to be one of the most important outcomes of treatment. Physical activity has been shown to have beneficial effects on sleep in the general population. Despite these findings, the physical activity–sleep relationship has not been directly examined in a sample of people with chronic pain. Objective This study aimed to examine the association between objective daytime physical activity and subsequent objective sleep for individuals with chronic pain while controlling for pain and psychosocial variables. Design An observational, prospective, within-person study design was used. Methods A clinical sample of 50 adults with chronic pain was recruited. Participation involved completing a demographic questionnaire followed by 5 days of data collection. Over this period, participants wore a triaxial accelerometer to monitor their daytime activity and sleep. Participants also carried a handheld computer that administered a questionnaire measuring pain, mood, catastrophizing, and stress 6 times throughout the day. Results The results demonstrated that higher fluctuations in daytime activity significantly predicted shorter sleep duration. Furthermore, higher mean daytime activity levels and a greater number of pain sites contributed significantly to the prediction of longer periods of wakefulness at night. Limitations The small sample size used in this study limits the generalizability of the findings. Missing data may have led to overestimations or underestimations of effect sizes, and additional factors that may be associated with sleep (eg, medication usage, environmental factors) were not measured. Conclusions The results of this study suggest that engagement in high-intensity activity and high fluctuations in activity are associated with poorer sleep at night; hence, activity modulation may be a key treatment strategy to address sleep complaints in individuals with chronic pain.",0 +https://doi.org/10.1027/1614-2241.4.2.51,Multicollinearity and Missing Constraints,"Multicollinearity complicates the simultaneous estimation of interaction and quadratic effects in structural equation modeling (SEM). So far, approaches developed within the Kenny-Judd (1984 ) tradition have failed to specify additional and necessary constraints on the measurement error covariances of the nonlinear indicators. Given that the constraints comprise, in part, latent linear predictor correlations, multicollinearity poses a problem for such approaches. Klein and Moosbrugger’s (2000 ) latent moderated structural equations approach (LMS) approach does not utilize nonlinear indicators and should therefore not be affected by this problem. In the context of a simulation study, we varied predictor correlation and the number of nonlinear effects in order to compare the performance of three approaches developed for the estimation of simultaneous nonlinear effects: Ping’s (1996 ) two-step approach, a correctly extended Jöreskog-Yang (1996 ) approach, and LMS. Results show that in contrast to the Jöreskog-Yang approach and LMS, the two-step approach produces biased parameter estimates and false inferences under heightened multicollinearity. Ping’s approach resulted in overestimated interaction effects and underestimated quadratic effects.",0 +https://doi.org/10.1080/00273171003680336,The Multigroup Multilevel Categorical Latent Growth Curve Models,"Longitudinal data describe developmental patterns and enable predictions of individual changes beyond sampled time points. Major methodological issues in longitudinal data include modeling random effects, subject effects, growth curve parameters, and autoregressive residuals. This study embedded the longitudinal model within a multigroup multilevel framework and allowed for autoregressive residuals. The parameter in the new model can be estimated using the computer program WinBUGS, which adopts Markov Chain Monte Carlo algorithms. Two simulation studies were conducted. An empirical example was raised and established based on models generated by the results of empirical data, which have been fitted and compared.",0 +https://doi.org/10.1186/1471-2288-9-10,Overstating the evidence – double counting in meta-analysis and related problems,"The problem of missing studies in meta-analysis has received much attention. Less attention has been paid to the more serious problem of double counting of evidence.Various problems in overstating the precision of results from meta-analyses are described and illustrated with examples, including papers from leading medical journals. These problems include, but are not limited to, simple double counting of the same studies, double counting of some aspects of the studies, inappropriate imputation of results, and assigning spurious precision to individual studies.Some suggestions are made as to how the quality and reliability of meta-analysis can be improved. It is proposed that the key to quality in meta-analysis lies in the results being transparent and checkable.Existing quality check lists for meta-analysis do little to encourage an appropriate attitude to combining evidence and to statistical analysis. Journals and other relevant organisations should encourage authors to make data available and make methods explicit. They should also act promptly to withdraw meta-analyses when mistakes are found.",0 +https://doi.org/10.3102/0034654317727727,Challenging Conventional Wisdom for Multivariate Statistical Models With Small Samples,"In education research, small samples are common because of financial limitations, logistical challenges, or exploratory studies. With small samples, statistical principles on which researchers rely...",0 +https://doi.org/10.1177/0149206314549252,Rendezvous Overdue,"Bayesian estimation and inference have been core features of scientific knowledge generation since the work of Sir Thomas Bayes was built upon by Pierre-Simone Laplace from the late 1700s through the early 1800s. Although present-day statistical analysis in organizational research is “frequentist” in nature (due to the influence of scholars such as Sir Ronald Fisher and Jerzey Neyman), the past 20 years has seen a veritable explosion of Bayesian applications across the social and physical sciences. This special issue highlights these applications and the many opportunities they carry, including precise and flexible methods for testing hypotheses and very intuitive ways of describing results. For this special issue, three editorial commentaries were solicited from world-renowned experts in statistics, probability, and their historical and current applications. These papers offer a view from outside management, giving fresh insight into topics that are rarely covered in management research, including critical perspectives on existing paradigms in our field and recommendations for improvements in statistical methods and research design. The topics covered relate to (a) the apparent desire for universal or default methods of inquiry and inference—whether Bayesian or frequentist—which narrows researchers’ focus and reduces their ability to develop and deploy a larger “toolbox” of methods and approaches; (b) the many limitations of existing frequentist tools, which tend to be underestimated or ignored because of their institutionalized and habitual nature; and (c) the existence and importance of",0 +https://doi.org/10.1111/j.1467-8624.2007.01091.x,"Living Arrangements and Children’s Development in Low-Income White, Black, and Latino Families","This article uses longitudinal data from approximately 2,000 low-income families participating in the national evaluation of the Comprehensive Child Development Program to examine the associations between preschool children's living arrangements and their cognitive achievement and emotional adjustment. The analysis distinguishes families in which children live only with their mothers from children who live in biological father, blended, and multigenerational households. Linkages are examined separately for White, Black, and Latino children. Fixed effects regression techniques reveal few significant associations between living arrangements and child development. These findings suggest that substantial diversity exists in the developmental contexts among children living in the same family structure. Policies seeking to change the living arrangements of low-income children may do little to improve child well-being.",0 +https://doi.org/10.1002/sim.5866,An assessment of estimation methods for generalized linear mixed models with binary outcomes,"Two main classes of methodology have been developed for addressing the analytical intractability of generalized linear mixed models: likelihood-based methods and Bayesian methods. Likelihood-based methods such as the penalized quasi-likelihood approach have been shown to produce biased estimates especially for binary clustered data with small clusters sizes. More recent methods using adaptive Gaussian quadrature perform well but can be overwhelmed by problems with large numbers of random effects, and efficient algorithms to better handle these situations have not yet been integrated in standard statistical packages. Bayesian methods, although they have good frequentist properties when the model is correct, are known to be computationally intensive and also require specialized code, limiting their use in practice. In this article, we introduce a modification of the hybrid approach of Capanu and Begg, 2011, Biometrics 67, 371-380, as a bridge between the likelihood-based and Bayesian approaches by employing Bayesian estimation for the variance components followed by Laplacian estimation for the regression coefficients. We investigate its performance as well as that of several likelihood-based methods in the setting of generalized linear mixed models with binary outcomes. We apply the methods to three datasets and conduct simulations to illustrate their properties. Simulation results indicate that for moderate to large numbers of observations per random effect, adaptive Gaussian quadrature and the Laplacian approximation are very accurate, with adaptive Gaussian quadrature preferable as the number of observations per random effect increases. The hybrid approach is overall similar to the Laplace method, and it can be superior for data with very sparse random effects.",0 +https://doi.org/10.1023/b:ejep.0000036572.00663.f2,Longitudinal Data Analysis. A Comparison Between Generalized Estimating Equations and Random Coefficient Analysis,"The analysis of data from longitudinal studies requires special techniques, which take into account the fact that the repeated measurements within one individual are correlated. In this paper, the two most commonly used techniques to analyze longitudinal data are compared: generalized estimating equations (GEE) and random coefficient analysis. Both techniques were used to analyze a longitudinal dataset with six measurements on 147 subjects. The purpose of the example was to analyze the relationship between serum cholesterol and four predictor variables, i.e., physical fitness at baseline, body fatness (measured by sum of the thickness of four skinfolds), smoking and gender. The results showed that for a continuous outcome variable, GEE and random coefficient analysis gave comparable results, i.e., GEE-analysis with an exchangeable correlation structure and random coefficient analysis with only a random intercept were the same. There was also no difference between both techniques in the analysis of a dataset with missing data, even when the missing data was highly selective on earlier observed data. For a dichotomous outcome variable, the magnitude of the regression coefficients and standard errors was higher when calculated with random coefficient analysis then when calculated with GEE-analysis. Analysis of a dataset with missing data with a dichotomous outcome variable showed unpredictable results for both GEE and random coefficient analysis. It can be concluded that for a continuous outcome variable, GEE and random coefficient analysis are comparable. Longitudinal data-analysis with dichotomous outcome variables should, however, be interpreted with caution, especially when there are missing data. © 2004 Kluwer Academic Publishers.",0 +https://doi.org/10.1037/h0031322,Belief in the law of small numbers.,"Reports that people have erroneous intuitions about the laws of chance. In particular, they regard a sample randomly drawn from a population as highly representative, I.e., similar to the population in all essential characteristics. The prevalence of the belief and its unfortunate consequences for psychological research are illustrated by the responses of 84 professional psychologists to a questionnaire concerning research decisions. (PsycINFO Database Record (c) 2012 APA, all rights reserved) Language: en",0 +https://doi.org/10.1037/0033-295x.111.1.94,Reconceptualizing Individual Differences in Self-Enhancement Bias: An Interpersonal Approach.,"Self-enhancement bias has been studied from 2 perspectives: L. Festinger's (1954) social comparison theory (self-enhancers perceive themselves more positively than they perceive others) and G. W. Allport's (1937) self-insight theory (self-enhancers perceive themselves more positively than they are perceived by others). These 2 perspectives are theoretically and empirically distinct, and the failure to recognize their differences has led to a protracted debate. A new interpersonal approach to self-enhancement decomposes self-perception into 3 components: perceiver effect, target effect, and unique self-perception. Both theoretical derivations and an illustrative study suggest that this resulting measure of self-enhancement is less confounded by unwanted components of interpersonal perception than previous social comparison and self-insight measures. Findings help reconcile conflicting views about whether self-enhancement is adaptive or maladaptive.",0 +https://doi.org/10.1097/01.ede.0000256320.30737.c0,Bayesian Methods for Highly Correlated Exposure Data,"Studies that include individuals with multiple highly correlated exposures are common in epidemiology. Because standard maximum likelihood techniques often fail to converge in such instances, hierarchical regression methods have seen increasing use. Bayesian hierarchical regression places prior distributions on exposure-specific regression coefficients to stabilize estimation and incorporate prior knowledge, if available. A common parametric approach in epidemiology is to treat the prior mean and variance as fixed constants. An alternative parametric approach is to place distributions on the prior mean and variance to allow the data to help inform their values. As a more flexible semiparametric option, one can place an unknown distribution on the coefficients that simultaneously clusters exposures into groups using a Dirichlet process prior. We also present a semiparametric model with a variable-selection prior to allow clustering of coefficients at 0. We compare these 4 hierarchical regression methods and demonstrate their application in an example estimating the association of herbicides with retinal degeneration among wives of pesticide applicators.",0 +https://doi.org/10.1214/ss/1030037958,Publication bias in meta-analysis: a Bayesian data-augmentation approach to account for issues exemplified in the passive smoking debate,"Publication bias is a relatively new statistical phenomenon that only arises when one attempts through a meta-analysis to review all studies, significant or insignificant, in order to provide a total perspective on a particular issue. This has recently received some notoriety as an issue in the evaluation of the relative risk of lung cancer associated with passive smoking, following legal challenges to a 1992 Environmental Protection Agency analysis which concluded that such exposure is associated with significant excess risk of lung cancer. We introduce a Bayesian approach which estimates and adjusts for publication bias. Estimation is based on a data-augmentation principle within a hierarchical model, and the number and outcomes of unobserved studies are simulated using Gibbs sampling methods. This technique yields a quantitative adjustment for the passive smoking meta-analysis. We estimate that there may be both negative and positive but insignificant studies omitted, and that failing to allow for these would mean that the estimated excess risk may be overstated by around 30%, both in U.S. studies and in the global collection of studies.",0 +https://doi.org/10.7551/mitpress/7503.003.0106,A Bayesian Approach to Diffusion Models of Decision-Making and Response Time,"We present a computational Bayesian approach for Wiener diffusion models, which are prominent accounts of response time distributions in decision-making. We first develop a general closed-form analytic approximation to the response time distributions for one-dimensional diffusion processes, and derive the required Wiener diffusion as a special case. We use this result to undertake Bayesian modeling of benchmark data, using posterior sampling to draw inferences about the interesting psychological parameters. With the aid of the benchmark data, we show the Bayesian account has several advantages, including dealing naturally with the parameter variation needed to account for some key features of the data, and providing quantitative measures to guide decisions about model construction.",0 +https://doi.org/10.1080/00273170701341316,"Addressing Moderated Mediation Hypotheses: Theory, Methods, and Prescriptions","This article provides researchers with a guide to properly construe and conduct analyses of conditional indirect effects, commonly known as moderated mediation effects. We disentangle conflicting definitions of moderated mediation and describe approaches for estimating and testing a variety of hypotheses involving conditional indirect effects. We introduce standard errors for hypothesis testing and construction of confidence intervals in large samples but advocate that researchers use bootstrapping whenever possible. We also describe methods for probing significant conditional indirect effects by employing direct extensions of the simple slopes method and Johnson-Neyman technique for probing significant interactions. Finally, we provide an SPSS macro to facilitate the implementation of the recommended asymptotic and bootstrapping methods. We illustrate the application of these methods with an example drawn from the Michigan Study of Adolescent Life Transitions, showing that the indirect effect of intrinsic student interest on mathematics performance through teacher perceptions of talent is moderated by student math self-concept.",0 +https://doi.org/10.1016/j.electstud.2015.03.002,Reassessing the trade-off hypothesis: How misery drives the corruption effect on presidential approval,"Do economic conditions drive voters to punish politicians that tolerate corruption? Previous scholarly work contends that citizens in young democracies support corrupt governments that are capable of promoting good economic outcomes, the so-called trade-off hypothesis. We test this hypothesis based on mass surveys in eighteen Latin American countries throughout 2004–2012. We find that citizens that report bribe attempts from bureaucrats are always more likely to report presidential disapproval than citizens that report no such attempts, that is, Latin American victims of corruption are not duped by good economic performance. However, we find some evidence for a weaker form of the trade-off hypothesis: presidential disapproval among corruption victims might be more pronounced in contexts of high inflation and high unemployment.",0 +https://doi.org/10.1136/bmj.h5392,Treatment strategies for coronary in-stent restenosis: systematic review and hierarchical Bayesian network meta-analysis of 24 randomised trials and 4880 patients,"What is the most safe and effective interventional treatment for coronary in-stent restenosis?In a hierarchical Bayesian network meta-analysis, PubMed, Embase, Scopus, Cochrane Library, Web of Science, ScienceDirect, and major scientific websites were screened up to 10 August 2015. Randomised controlled trials of patients with any type of coronary in-stent restenosis (either of bare metal stents or drug eluting stents; and either first or recurrent instances) were included. Trials including multiple treatments at the same time in the same group or comparing variants of the same intervention were excluded. Primary endpoints were target lesion revascularisation and late lumen loss, both at six to 12 months. The main analysis was complemented by network subanalyses, standard pairwise comparisons, and subgroup and sensitivity analyses.Twenty four trials (4880 patients), including seven interventional treatments, were identified. Compared with plain balloons, bare metal stents, brachytherapy, rotational atherectomy, and cutting balloons, drug coated balloons and drug eluting stents were associated with a reduced risk of target lesion revascularisation and major adverse cardiac events, and with reduced late lumen loss. Treatment ranking indicated that drug eluting stents had the highest probability (61.4%) of being the most effective for target lesion vascularisation; drug coated balloons were similarly indicated as the most effective treatment for late lumen loss (probability 70.3%). The comparative efficacy of drug coated balloons and drug eluting stents was similar for target lesion revascularisation (summary odds ratio 1.10, 95% credible interval 0.59 to 2.01) and late lumen loss reduction (mean difference in minimum lumen diameter 0.04 mm, 95% credible interval -0.20 to 0.10). Risks of death, myocardial infarction, and stent thrombosis were comparable across all treatments, but these analyses were limited by a low number of events. Trials had heterogeneity regarding investigation periods, baseline characteristics, and endpoint reporting, with a lack of information at long term follow-up. Direct and indirect evidence was also inconsistent for the comparison between drug eluting stents and drug coated balloons.Compared with other currently available interventional treatments for coronary in-stent restenosis, drug coated balloons and drug eluting stents are associated with superior clinical and angiographic outcomes, with a similar comparative efficacy.This study received no external funding. The authors declare no competing interests. No additional data available.",0 +https://doi.org/10.1002/ir.155,Weighting and adjusting for design effects in secondary data analyses,Institutional researchers frequently use national datasets such as those provided by the National Center for Education Statistics (NCES). The authors of this chapter explore the adjustments required when analyzing NCES data collected using complex sample designs.,0 +https://doi.org/10.3758/s13428-011-0150-4,TripleR: An R package for social relations analyses based on round-robin designs,"In this article, we present TripleR, an R package for the calculation of social relations analyses (Kenny, 1994) based on round-robin designs. The scope of existing software solutions is ported to R and enhanced with previously unimplemented methods of significance testing in single groups (Lashley & Bond, 1997) and handling of missing values. The package requires only minimal knowledge of R, and results can be exported for subsequent analyses to other software packages. We demonstrate the use of TripleR with several didactic examples.",0 +https://doi.org/10.1177/1094428105285144,A Tale of Two Methods,"The structural equation modeling approach to testing for mediation is compared to the Baron and Kenny approach. The approaches are essentially the same when the hypothesis being tested predicts partial mediation. The approaches differ, however, in how each tests for complete mediation. Disparities in both theory and statistical estimators are identified and discussed. A strategy for future tests of mediation is recommended.",0 +https://doi.org/10.1080/00031305.1994.10476079,The Shape of Correlation Matrices,"Abstract A correlation matrix between three variables has to satisfy certain conditions. Such a matrix essentially contains three numbers and thus can be represented by a point in three dimensions. The set of all possible correlation matrices yields a convex solid body with an uncommon shape. All its cross sections perpendicular to the axes are ellipses. At the same time, its surface contains the vertices and edges of a regular tetrahedron. Another unusual shape is obtained for banded correlation matrices between four variables.",0 +https://doi.org/10.1007/bf01639850,Ueber die Maassbestimmungen des Ortssinnes der Haut mittels der Methode der richtigen und falschen Fälle,,0 +https://doi.org/10.1007/978-3-658-07327-5,Trust and Rationality,"Combining economic, social-psychological and sociological approaches to trust, this book provides a general theoretical framework to causally explain conditional and unconditional trust; it also presents an experimental test of the corresponding integrative model and its predictions. Broadly, it aims at advancing a cognitive turn in trust research by highlighting the importance of (1) an actor’s context-dependent definition of the situation and (2) the flexible and dynamic degree of rationality involved. In essence, trust is as ""multi-faceted"" as there are cognitive routes that take us to the choice of a trusting act. Therefore, variable rationality has to be incorporated as an orthogonal dimension to the typological space of trust. The theory presents an analytically tractable model; the empirical test combines trust games, high- and low-incentive conditions, framing manipulations, and psychometric measurements, and is complemented by decision-time analyses. © Springer Fachmedien Wiesbaden 2015.",0 +https://doi.org/10.1177/1536867x0400400307,Implementing Matching Estimators for Average Treatment Effects in Stata,This paper presents an implementation of matching estimators for average treatment effects in Stata. The nnmatch command allows you to estimate the average effect for all units or only for the treated or control units; to choose the number of matches; to specify the distance metric; to select a bias adjustment; and to use heteroskedastic-robust variance estimators.,0 +https://doi.org/10.1007/bf02301417,Isotonic ordinal probabilistic models (ISOP),"The concept of an ordinal instrumental probabilistic comparison is introduced. It relies on an ordinal scale given a priori and on the concept of stochastic dominance. It is used to define a weakly independently ordered system, or isotonic ordinal probabilistic (ISOP) model, which allows the construction of separate ""sample-free"" ordinal scales on a set of ""subjects"" and a set of ""items"". The ISOP-model is a common nonparametric theoretical structure for unidimensional models for quantitative, ordinal and dichotomous variables. Fundamental theorems on dichotomous and polytomous weakly independently ordered systems are derived. It is shown that the raw score system has the same formal properties as the latent system, and therefore the latter can be tested at the observed empirical level. © 1995 The Psychometric Society.",0 +https://doi.org/10.1080/01621459.1973.10481353,Fitting Segmented Polynomial Regression Models Whose Join Points Have to Be Estimated,Abstract The study considers the problem of finding the least squares estimates for the unknown parameters of a regression model which consists of grafted polynomial submodels. The abscissae of the join points are a subset of the unknown parameters. Examples are given to illustrate how continuity and differentiability conditions on the model can be used to reparameterize the model so as to allow Modified Gauss-Newton fitting. A slightly generalized version of Hartley's theorem is stated to extend the Modified Gauss-Newton method to this problem.,0 +https://doi.org/10.1016/j.neuroscience.2010.06.014,Spinal upregulation of glutamate transporter GLT-1 by ceftriaxone: therapeutic efficacy in a range of experimental nervous system disorders,"Glutamate neurotransmission is highly regulated, largely by glutamate transporters. In the spinal cord, the glutamate transporter GLT-1 is primarily responsible for glutamate clearance. Downregulation of GLT-1 can occur in activated astrocytes, and is associated with increased extracellular glutamate and neuroexcitation. Among other conditions, astrocyte activation occurs following repeated opioids and in models of chronic pain. If GLT-1 downregulation occurs in these states, GLT-1 could be a pharmacological target for improving opioid efficacy and controlling chronic pain. The present studies explored whether daily intrathecal treatment of rats with ceftriaxone, a beta-lactam antibiotic that upregulates GLT-1 expression, could prevent development of hyperalgesia and allodynia following repeated morphine, reverse pain arising from central or peripheral neuropathy, and reduce glial activation in these models. Ceftriaxone pre-treatment attenuated the development of hyperalgesia and allodynia in response to repeated morphine, and prevented associated astrocyte activation. In a model of multiple sclerosis (experimental autoimmune encephalomyelitis; EAE), ceftriaxone reversed tactile allodynia and halted the progression of motor weakness and paralysis. Similarly, ceftriaxone reversed tactile allodynia induced by chronic constriction nerve injury (CCI). EAE and CCI each significantly reduced the expression of membrane-bound, dimerized GLT-1 protein in lumbar spinal cord, an effect normalized by ceftriaxone. Lastly, ceftriaxone normalized CCI- and EAE-induced astrocyte activation in lumbar spinal cord. Together, these data indicate that increasing spinal GLT-1 expression attenuates opioid-induced paradoxical pain, alleviates neuropathic pain, and suppresses associated glial activation. GLT-1 therefore may be a therapeutic target that could improve available treatment options for patients with chronic pain.",0 +https://doi.org/10.1590/s0104-40362013005000001,Bayesian computerized adaptive testing,"Computerized adaptive testing (CAT) comes with many advantages. Unfortunately, it still is quite expensive to develop and maintain an operational CAT. In this paper, various steps involved in developing an operational CAT are described and literature on these topics is reviewed. Bayesian CAT is introduced as an alternative, and the use of empirical priors is proposed for estimating item and person parameters to reduce the costs of CAT. Methods to elicit empirical priors are presented and a two small examples are presented that illustrate the advantages of Bayesian CAT. Implications of the use of empirical priors are discussed, limitations are mentioned and some suggestions for further research are formulated.",0 +https://doi.org/10.1002/1097-0258(20010215)20:3<453::aid-sim803>3.0.co;2-l,Bayesian methods of analysis for cluster randomized trials with binary outcome data,"We explore the potential of Bayesian hierarchical modelling for the analysis of cluster randomized trials with binary outcome data, and apply the methods to a trial randomized by general practice. An approximate relationship is derived between the intracluster correlation coefficient (ICC) and the between-cluster variance used in a hierarchical logistic regression model. By constructing an informative prior for the ICC on the basis of available information, we are thus able implicitly to specify an informative prior for the between-cluster variance. The approach also provides us with a credible interval for the ICC for binary outcome data. Several approaches to constructing informative priors from empirical ICC values are described. We investigate the sensitivity of results to the prior specified and find that the estimate of intervention effect changes very little in this data set, while its interval estimate is more sensitive. The Bayesian approach allows us to assume distributions other than normality for the random effects used to model the clustering. This enables us to gain insight into the robustness of our parameter estimates to the classical normality assumption. In a model with a more complex variance structure, Bayesian methods can provide credible intervals for a difference between two variance components, in order for example to investigate whether the effect of intervention varies across clusters. We compare our results with those obtained from classical estimation, discuss the relative merits of the Bayesian framework, and conclude that the flexibility of the Bayesian approach offers some substantial advantages, although selection of prior distributions is not straightforward.",0 +https://doi.org/10.1198/016214507000000428,Application of Multidimensional Selective Item Response Regression Model for Studying Multiple Gene Methylation in SV40 Oncogenic Pathways,"Alteration of gene methylation patterns has been reported to be involved in the early onsets of many human malignancies. Many exogenous risk factors, such as cigarette smoke, dietary additives, chemical exposures, radiation, and biologic agents including viral infection, are involved in the methylation pathways of cancers. We propose a multidimensional selective item response regression model to describe and test how a risk factor may alter molecular pathways involving aberrant methylation of multiple genes in oncogenesis. Our modeling framework is built on an item response model for multivariate dichotomous responses of high dimension, such as aberrant methylation of multiple tumor-suppressor genes, but we allow risk factors such as SV40 viral infection to alter the distribution of the latent factors that subsequently affect the outcome of cancer. We postulate empirical identification conditions under our model formulation. Moreover, we do not prespecify the links between the multiple dichotomous methylation responses and the latent factors, but rather conduct specification searches with a genetic algorithm to discover the links. Parameter estimation through maximum likelihood and specification searches in models with multidimensional latent factors for multivariate binary responses have become practical only recently, due to modern statistical computing development. We illustrate our proposal with the biological finding that simultaneous methylation of multiple tumor-suppressor genes is associated with the presence of SV40 viral sequences and with the cancer status of lymphoma/leukemia.We are able to test whether the data are consistent with the causal hypothesis that SV40 induces aberrant methylation of multiple genes in its oncogenic pathways. At the same time, we are able to evaluate the role of SV40 in the methylation pathway and to determine whether the methylation pathway is responsible for the development of leukemia/lymphoma.",0 +https://doi.org/10.1348/096317905x52869,The team-level model of climate for innovation: A two-level confirmatory factor analysis,"The level structure of West's (1990) four-factor model of team climate for innovation was assessed by means of multi-level confirmatory factor analysis (MCFA). The sample consisted of 1,487 individuals (195 teams) from a wide range of professions. Results showed that a considerable portion of the variance in the data was explained on the team level with intra-class correlations ranging from .30 to .39. Furthermore, the results demonstrated that the overall measurement model fitted the data well at both the team and individual levels, while the factor loadings were slightly different across the levels with item loadings showing partial invariance. Results from confirmatory factor analyses conducted on separate levels, however, showed that the four-factor model displayed the best fit to the data for both individual and team levels. A second-order one-factor model also fitted the data well on both levels. The results indicate that the team climate for innovation model can be used as a team-level consensus model of team climate for innovation.",0 +https://doi.org/10.1155/2013/493019,"New aQTL SNPs for the CYP2D6 Identified by a Novel Mediation Analysis of Genome-Wide SNP Arrays, Gene Expression Arrays, and CYP2D6 Activity","Background . The genome-wide association studies (GWAS) have been successful during the last few years. A key challenge is that the interpretation of the results is not straightforward, especially for transacting SNPs. Integration of transcriptome data into GWAS may provide clues elucidating the mechanisms by which a genetic variant leads to a disease. Methods . Here, we developed a novel mediation analysis approach to identify new expression quantitative trait loci (eQTL) driving CYP2D6 activity by combining genotype, gene expression, and enzyme activity data. Results . 389,573 and 1,214,416 SNP-transcript-CYP2D6 activity trios are found strongly associated (P<10-5,FDR=16.6% and 11.7%) for two different genotype platforms, namely, Affymetrix and Illumina, respectively. The majority of eQTLs are trans-SNPs. A single polymorphism leads to widespread downstream changes in the expression of distant genes by affecting major regulators or transcription factors (TFs), which would be visible as an eQTL hotspot and can lead to large and consistent biological effects. Overlapped eQTL hotspots with the mediators lead to the discovery of 64 TFs. Conclusions . Our mediation analysis is a powerful approach in identifying the trans-QTL-phenotype associations. It improves our understanding of the functional genetic variations for the liver metabolism mechanisms.",0 +https://doi.org/10.1080/10705511.2014.859510,Relative Performance of Categorical Diagonally Weighted Least Squares and Robust Maximum Likelihood Estimation,"Robust maximum likelihood (ML) and categorical diagonally weighted least squares (cat-DWLS) estimation have both been proposed for use with categorized and nonnormally distributed data. This study compares results from the 2 methods in terms of parameter estimate and standard error bias, power, and Type I error control, with unadjusted ML and WLS estimation methods included for purposes of comparison. Conditions manipulated include model misspecification, level of asymmetry, level and categorization, sample size, and type and size of the model. Results indicate that cat-DWLS estimation method results in the least parameter estimate and standard error bias under the majority of conditions studied. Cat-DWLS parameter estimates and standard errors were generally the least affected by model misspecification of the estimation methods studied. Robust ML also performed well, yielding relatively unbiased parameter estimates and standard errors. However, both cat-DWLS and robust ML resulted in low power under cond...",0 +https://doi.org/10.1198/016214501753382309,A Note on the Efficiency of Sandwich Covariance Matrix Estimation,"The sandwich estimator, also known as robust covariance matrix estimator, heteroscedasticity-consistent covariance matrix estimate, or empirical covariance matrix estimator, has achieved increasing use in the econometric literature as well as with the growing popularity of generalized estimating equations. Its virtue is that it provides consistent estimates of the covariance matrix for parameter estimates even when the fitted parametric model fails to hold or is not even specified. Surprisingly though, there has been little discussion of properties of the sandwich method other than consistency. We investigate the sandwich estimator in quasi-likelihood models asymptotically, and in the linear case analytically. We show that under certain circumstances when the quasi-likelihood model is correct, the sandwich estimate is often far more variable than the usual parametric variance estimate. The increased variance is a fixed feature of the method and the price that one pays to obtain consistency even when the p...",0 +https://doi.org/10.1177/0958928714542732,The capacity of social policies to combat poverty among new social risk groups,"This article considers groups who are most likely to be vulnerable to new social risks and tests the effects of social policies on their poverty levels. Specifically, the article conducts multi-level regression analyses across 18 OECD countries around the year 2004, analysing the effects of social policies on the likelihood of being poor for low-skilled young women and men, and for those at risk of possessing obsolete skills, namely low-educated men aged 55–64 years. The central question asks which policies – active labour market policies (ALMP), passive labour market policies (PLMP), employment protection legislation (EPL), family policies, and government daycare spending – are effective at combating new social risks. In addition to analysing social policies, the article also considers union density and representation of women in national parliaments as two measures that depict agents who are most intent on combating old and new social risks, respectively. The findings show that ALMP are the most important predictor of a decrease in poverty levels among the low skilled. The negative effect of PLMP on poverty is only significant for the older male group. Family policies are related to a reduction in poverty for both low-skilled young women and men. Gross public social spending as a measure of overall welfare generosity is found to be associated with a reduction in poverty only of the older male group, but not that of the younger groups. The article’s analyses suggest that some social policies remain geared towards older segments of society, leaving the younger population at greater financial and therefore social risk.",0 +https://doi.org/10.1016/j.brat.2012.08.003,Investigating the effect of intolerance of uncertainty on catastrophic worrying and mood,"Intolerance of uncertainty (IU) is a construct known to influence catastrophic worry and is often observed in Generalized Anxiety Disorder (GAD). Research into the psychological manifestations of GAD suggests IU is associated with worry, but has not confirmed a causal link. The current study investigated the relationship between catastrophic worry and IU in a non-clinical undergraduate and postgraduate population (n = 46), with a mean age of 26.8 (SD = 5.52 years), where 71.74% were women. Participants received either a high or low IU manipulation, mood was measured throughout the study on 100 point visual analogue scales (VAS), and worry was measured using the catastrophising interview (CI). The high IU group generated significantly more catastrophising steps than the low IU group. Increased levels of sadness and anxiety were observed in the high as compared to the low IU group post IU manipulation, and this difference was maintained throughout the CI interview. A mediation analysis revealed that sadness and anxiety did not significantly mediate the relationship between IU and number of CI steps. These findings have implications for GAD treatment, as they suggest that manipulating IU affects measures of worry and its associated emotional and behavioural symptoms.",0 +https://doi.org/10.1103/physrevlett.115.211103,"Search for GeVγ-Ray Pair Halos Around Low Redshift Blazars","We report on the results of a search for $\gamma$-ray pair halos with a stacking analysis of low-redshift blazars using data from the Fermi Large Area Telescope. For this analysis we used a number of a-priori selection criteria, including the spatial and spectral properties of the Fermi sources. The angular distribution of $\sim$ 1GeV photons around 24 stacked isolated high-synchrotron-peaked BL Lacs with redshift $z<0.5$ shows an excess over that of point-like sources. A statistical analysis yields a Bayes factor of $\mathrm{log}_{10}B_{10}>2$, providing evidence in favor of extended emission against the point-source hypothesis, consistent with expectations for pair halos produced in the IGMF with strength $B_{\mathrm{IGMF}}\sim 10^{-17}-10^{-15}\mathrm{G}$.",0 +https://doi.org/10.1017/s0140525x01003922,The magical number 4 in short-term memory: A reconsideration of mental storage capacity,"Miller (1956) summarized evidence that people can remember about seven chunks in short-term memory (STM) tasks. However, that number was meant more as a rough estimate and a rhetorical device than as a real capacity limit. Others have since suggested that there is a more precise capacity limit, but that it is only three to five chunks. The present target article brings together a wide variety of data on capacity limits suggesting that the smaller capacity limit is real. Capacity limits will be useful in analyses of information processing only if the boundary conditions for observing them can be carefully described. Four basic conditions in which chunks can be identified and capacity limits can accordingly be observed are: (1) when information overload limits chunks to individual stimulus items, (2) when other steps are taken specifically to block the recording of stimulus items into larger chunks, (3) in performance discontinuities caused by the capacity limit, and (4) in various indirect effects of the capacity limit. Under these conditions, rehearsal and long-term memory cannot be used to combine stimulus items into chunks of an unknown size; nor can storage mechanisms that are not capacity-limited, such as sensory memory, allow the capacity-limited storage mechanism to be refilled during recall. A single, central capacity limit averaging about four chunks is implicated along with other, noncapacity-limited sources. The pure STM capacity limit expressed in chunks is distinguished from compound STM limits obtained when the number of separately held chunks is unclear. Reasons why pure capacity estimates fall within a narrow range are discussed and a capacity limit for the focus of attention is proposed.",0 +https://doi.org/10.1016/b978-0-444-53737-9.50010-4,Structural Equation Modeling,,0 +https://doi.org/10.1515/1557-4679.1360,A Reproducing Kernel-Based Spatial Model in Poisson Regressions,"A semi-parametric spatial model for spatial dependence is proposed in Poisson regressions to study the effects of risk factors on incidence outcomes. The spatial model is constructed through an application of reproducing kernels. A Bayesian framework is proposed to infer the unknown parameters. Simulations are performed to compare the reproducing kernel-based method with several commonly used approaches in spatial modeling, including independent Gaussian and CAR models. Compared with these models, the reproducing kernel-based method is easy to implement and more flexible in terms of the ability to model various spatial dependence patterns. To further demonstrate the proposed method, two real data applications are discussed: Scottish lip cancer data and Florida smoke-related cancer data.",0 +https://doi.org/10.1093/biomet/80.4.791,Laplace's approximation for nonlinear mixed models,"SUMMARY An approximation to Laplace's method for integrals is applied to marginal distributions of data arising from models in which both fixed and random effects enter nonlinearly. The approach provides alternative derivations of some recent algorithms for fitting such models, and it has direct ties with Gaussian restricted maximum likelihood and the accompanying mixed model equations.",0 +https://doi.org/10.1027/1614-2241.3.1.14,Methods for Restricting Maximum Exposure Rate in Computerized Adaptative Testing,"Abstract. The Sympson-Hetter (1985) method provides a means of controlling maximum exposure rate of items in Computerized Adaptive Testing. Through a series of simulations, control parameters are set that mark the probability of administration of an item on being selected. This method presents two main problems: it requires a long computation time for calculating the parameters and the maximum exposure rate is slightly above the fixed limit. Van der Linden (2003) presented two alternatives which appear to solve both of the problems. The impact of these methods in the measurement accuracy has not been tested yet. We show how these methods over-restrict the exposure of some highly discriminating items and, thus, the accuracy is decreased. It also shown that, when the desired maximum exposure rate is near the minimum possible value, these methods offer an empirical maximum exposure rate clearly above the goal. A new method, based on the initial estimation of the probability of administration and the probability of selection of the items with the restricted method ( Revuelta & Ponsoda, 1998 ), is presented in this paper. It can be used with the Sympson-Hetter method and with the two van der Linden's methods. This option, when used with Sympson-Hetter, speeds the convergence of the control parameters without decreasing the accuracy.",0 +https://doi.org/10.1111/1467-9876.00237,On the Effect of the Number of Quadrature Points in a Logistic Random Effects Model: An Example,"SUMMARY Although generalized linear mixed models are recognized to be of major practical importance, it is also known that they can be computationally demanding. The problem is the evaluation of the integral in calculating the marginalized likelihood. The straightforward method is based on the Gauss–Hermite technique, based on Gaussian quadrature points. Another approach is provided by the class of penalized quasi-likelihood methods. It is commonly believed that the Gauss–Hermite method works relatively well in simple situations but fails in more complicated structures. However, we present here a strikingly simple example of a logistic random-intercepts model in the context of a longitudinal clinical trial where the method gives valid results only for a high number of quadrature points (Q). As a consequence, this result warns the practitioner to examine routinely the dependence of the results on Q. The adaptive Gaussian quadrature, as implemented in the new SAS procedure NLMIXED, offered the solution to our problem. However, even the adaptive version of Gaussian quadrature needs careful handling to ensure convergence.",0 +https://doi.org/10.1016/j.jval.2014.10.006,Network Meta-Analysis: Development of a Three-Level Hierarchical Modeling Approach Incorporating Dose-Related Constraints,"Network meta-analysis (NMA) is commonly used in evidence synthesis; however, in situations in which there are a large number of treatment options, which may be subdivided into classes, and relatively few trials, NMAs produce considerable uncertainty in the estimated treatment effects, and consequently, identification of the most beneficial intervention remains inconclusive.To develop and demonstrate the use of evidence synthesis methods to evaluate extensive treatment networks with a limited number of trials, making use of classes.Using Bayesian Markov chain Monte Carlo methods, we build on the existing work of a random effects NMA to develop a three-level hierarchical NMA model that accounts for the exchangeability between treatments within the same class as well as for the residual between-study heterogeneity. We demonstrate the application of these methods to a continuous and binary outcome, using a motivating example of overactive bladder. We illustrate methods for incorporating ordering constraints in increasing doses, model selection, and assessing inconsistency between the direct and indirect evidence.The methods were applied to a data set obtained from a systematic literature review of trials for overactive bladder, evaluating the mean reduction in incontinence episodes from baseline and the number of patients reporting one or more adverse events. The data set involved 72 trials comparing 34 interventions that were categorized into nine classes of interventions, including placebo.Bayesian three-level hierarchical NMAs have the potential to increase the precision in the effect estimates while maintaining the interpretability of the individual interventions for decision making.",0 +https://doi.org/10.1111/1467-9868.00265,Dealing with label switching in mixture models,"Summary. In a Bayesian analysis of finite mixture models, parameter estimation and clustering are sometimes less straightforward than might be expected. In particular, the common practice of estimating parameters by their posterior mean, and summarizing joint posterior distributions by marginal distributions, often leads to nonsensical answers. This is due to the so-called 'label switching' problem, which is caused by symmetry in the likelihood of the model parameters. A frequent response to this problem is to remove the symmetry by using artificial identifiability constraints. We demonstrate that this fails in general to solve the problem, and we describe an alternative class of approaches, relabelling algorithms, which arise from attempting to minimize the posterior expected loss under a class of loss functions. We describe in detail one particularly simple and general relabelling algorithm and illustrate its success in dealing with the label switching problem on two examples.",0 +https://doi.org/10.2307/2347027,Some Comments on Multicollinearity in Regression,"In contrast to the views put forward in a recent paper, the following points are made concerning multicollinearity in regression models: firstly, multicollinearity is almost invariably a problem of degree rather than kind; and, secondly, the search for an appropriate functional form for a regression equation should not be confused with the treatment of multicollinearity. Finally, some comments are made on the role of prior detrending in both linear and nonlinear models.",0 +https://doi.org/10.1016/j.jmva.2011.01.001,Constructing priors based on model size for nondecomposable Gaussian graphical models: A simulation based approach,"A method for constructing priors is proposed that allows the off-diagonal elements of the concentration matrix of Gaussian data to be zero. The priors have the property that the marginal prior distribution of the number of nonzero off-diagonal elements of the concentration matrix (referred to below as model size) can be specified flexibly. The priors have normalizing constants for each model size, rather than for each model, giving a tractable number of normalizing constants that need to be estimated. The article shows how to estimate the normalizing constants using Markov chain Monte Carlo simulation and supersedes the method of Wong et al. (2003) [24] because it is more accurate and more general. The method is applied to two examples. The first is a mixture of constrained Wisharts. The second is from Wong et al. (2003) [24] and decomposes the concentration matrix into a function of partial correlations and conditional variances using a mixture distribution on the matrix of partial correlations. The approach detects structural zeros in the concentration matrix and estimates the covariance matrix parsimoniously if the concentration matrix is sparse.",0 +https://doi.org/10.1111/j.1467-9574.2009.00445.x,The effect of estimation method and sample size in multilevel structural equation modeling,"Multilevel structural equation modeling (multilevel SEM) has become an established method to analyze multilevel multivariate data. The first useful estimation method was the pseudobalanced method. This method is approximate because it assumes that all groups have the same size, and ignores unbalance when it exists. In addition, full information maximum likelihood (ML) estimation is now available, which is often combined with robust chi-squares and standard errors to accommodate unmodeled heterogeneity (MLR). In addition, diagonally weighted least squares (DWLS) methods have become available as estimation methods. This article compares the pseudobalanced estimation method, ML(R), and two DWLS methods by simulating a multilevel factor model with unbalanced data. The simulations included different sample sizes at the individual and group levels and different intraclass correlation (ICC). The within-group part of the model posed no problems. In the between part of the model, the different ICC sizes had no effect. There is a clear interaction effect between number of groups and estimation method. ML reaches unbiasedness fastest, then the two DWLS methods, then MLR, and then the pseudobalanced method (which needs more than 200 groups). We conclude that both ML(R) and DWLS are genuine improvements on the pseudobalanced approximation. With small sample sizes, the robust methods are not recommended.",0 +https://doi.org/10.1207/s15516709cog0000_69,A Hierarchical Bayesian Model of Human Decision-Making on an Optimal Stopping Problem,"We consider human performance on an optimal stopping problem where people are presented with a list of numbers independently chosen from a uniform distribution. People are told how many numbers are in the list, and how they were chosen. People are then shown the numbers one at a time, and are instructed to choose the maximum, subject to the constraint that they must choose a number at the time it is presented, and any choice below the maximum is incorrect. We present empirical evidence that suggests people use threshold-based models to make decisions, choosing the first currently maximal number that exceeds a fixed threshold for that position in the list. We then develop a hierarchical generative account of this model family, and use Bayesian methods to learn about the parameters of the generative process, making inferences about the threshold decision models people use. We discuss the interesting aspects of human performance on the task, including the lack of learning, and the presence of large individual differences, and consider the possibility of extending the modeling framework to account for individual differences. We also use the modeling results to discuss the merits of hierarchical, generative and Bayesian models of cognitive processes more generally.",0 +https://doi.org/10.1057/ap.2013.32,Individual socialization or polito-cultural context? The cultural roots of volunteering in Switzerland,"Volunteering rates in Switzerland vary substantially across language regions. In this article, we investigate the cultural roots of this variation by presenting and empirically testing two different conceptualizations of how linguistic culture is related to individual volunteering. Whereas the first perspective perceives the individual as belonging to a particular language community and its norms and values as crucial for individual volunteering, the other sees the linguistic culture mainly as an important context in which an individual lives and which therefore influences individual volunteering. Empirically, we base our analysis on new survey data from 60 Swiss communes and apply a Bayesian multi-level analysis in order to disentangle the linguistic group from contextual effects. Our analysis supports the view that cultural patterns of civic self-organization can indeed explain regional volunteering behaviour in Switzerland. Whereas the propensity to volunteer is generally highest in German-speaking Switzerland, our findings reveal that it is the group of French speakers that exhibits the highest propensity to volunteer when controlling for language region. © 2015 Macmillan Publishers Limited.",0 +https://doi.org/10.1177/0962280206074463,Multiple imputation of discrete and continuous data by fully conditional specification,"The goal of multiple imputation is to provide valid inferences for statistical estimates from incomplete data. To achieve that goal, imputed values should preserve the structure in the data, as well as the uncertainty about this structure, and include any knowledge about the process that generated the missing data. Two approaches for imputing multivariate data exist: joint modeling (JM) and fully conditional specification (FCS). JM is based on parametric statistical theory, and leads to imputation procedures whose statistical properties are known. JM is theoretically sound, but the joint model may lack flexibility needed to represent typical data features, potentially leading to bias. FCS is a semi-parametric and flexible alternative that specifies the multivariate model by a series of conditional models, one for each incomplete variable. FCS provides tremendous flexibility and is easy to apply, but its statistical properties are difficult to establish. Simulation work shows that FCS behaves very well in the cases studied. The present paper reviews and compares the approaches. JM and FCS were applied to pubertal development data of 3801 Dutch girls that had missing data on menarche (two categories), breast development (five categories) and pubic hair development (six stages). Imputations for these data were created under two models: a multivariate normal model with rounding and a conditionally specified discrete model. The JM approach introduced biases in the reference curves, whereas FCS did not. The paper concludes that FCS is a useful and easily applied flexible alternative to JM when no convenient and realistic joint distribution can be specified.",0 +https://doi.org/10.3758/bf03193505,Short-term recognition memory for serial order and timing,"Recent evidence suggests that a common temporal representation underlies memory for serial order of items in a sequence, and the timing of items in a sequence. This stands in contrast to other data suggesting a reliance on only ordinal information in short-term memory tasks. An experiment is reported here in which participants were post cued to perform a comparison between a probe and study list of items irregularly spaced in time, on the basis of order or temporal information.Participants' performance on theserial recognition task was notaffected by the temporal proximity of items, although participants were able to use temporal information to perform a temporal recognition task. Application of a temporal matching model of serial and temporal recognition suggests that although participants were able to remember the timing of items, this memory for timing was unlikely to determine serial recognition performance. The results suggest a dissociation between ordinal and temporal information in short-term memory.",0 +https://doi.org/10.3758/brm.40.3.879,Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models,"Hypotheses involving mediation are common in the behavioral sciences. Mediation exists when a predictor affects a dependent variable indirectly through at least one intervening variable, or mediator. Methods to assess mediation involving multiple simultaneous mediators have received little attention in the methodological literature despite a clear need. We provide an overview of simple and multiple mediation and explore three approaches that can be used to investigate indirect processes, as well as methods for contrasting two or more mediators within a single model. We present an illustrative example, assessing and contrasting potential mediators of the relationship between the helpfulness of socialization agents and job satisfaction. We also provide SAS and SPSS macros, as well as Mplus and LISREL syntax, to facilitate the use of these methods in applications.",0 +https://doi.org/10.1111/j.1467-985x.2005.00389.x,A Bayesian hierarchical model for categorical longitudinal data from a social survey of immigrants,"The paper investigates a Bayesian hierarchical model for the analysis of categorical longitudinal data from a large social survey of immigrants to Australia. Data for each subject are observed on three separate occasions, or waves, of the survey. One of the features of the data set is that observations for some variables are missing for at least one wave. A model for the employment status of immigrants is developed by introducing, at the first stage of a hierarchical model, a multinomial model for the response and then subsequent terms are introduced to explain wave and subject effects. To estimate the model, we use the Gibbs sampler, which allows missing data for both the response and the explanatory variables to be imputed at each iteration of the algorithm, given some appropriate prior distributions. After accounting for significant covariate effects in the model, results show that the relative probability of remaining unemployed diminished with time following arrival in Australia.",0 +https://doi.org/10.1002/env.877,A comparison of the hierarchical likelihood and Bayesian approaches to spatial epidemiological modelling,"Recently Bayesian methods have been widely used in disease mapping. Hierarchical (h-) likelihood methods allow reliable likelihood inference in random-effect models and it is therefore interesting to compare h-likelihood and Bayesian methods. For comparison we consider three examples: low birth weight and cancer mortality data in South Carolina and lip cancer data in Scotland. Mean estimates from both h-likelihood and Bayesian approaches are almost identical, while variance-component estimates can be somewhat different, depending upon choice of priors. Copyright © 2007 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1080/02664763.2013.807331,A multiple group item response theory model with centered skew-normal latent trait distributions under a Bayesian framework,"Very often, in psychometric research, as in educational assessment, it is necessary to analyze item response from clustered respondents. The multiple group item response theory (IRT) model proposed by Bock and Zimowski [12] provides a useful framework for analyzing such type of data. In this model, the selected groups of respondents are of specific interest such that group-specific population distributions need to be defined. The usual assumption for parameter estimation in this model, which is that the latent traits are random variables following different symmetric normal distributions, has been questioned in many works found in the IRT literature. Furthermore, when this assumption does not hold, misleading inference can result. In this paper, we consider that the latent traits for each group follow different skew-normal distributions, under the centered parameterization. We named it skew multiple group IRT model. This modeling extends the works of Azevedo et al. [4], Bazan et al. [11] and Bock and Zimo...",0 +https://doi.org/10.1136/bmjopen-2015-010160,Safety and effectiveness of long-acting versus intermediate-acting insulin for patients with type 1 diabetes: protocol for a systematic review and individual patient data network meta-analysis,"The choice of a basal insulin regimen to manage type 1 diabetes mellitus (T1DM) may have different risks of adverse events and effectiveness, due to the difference in the effectiveness of these agents across patient characteristics (eg, baseline glycosylated haemoglobin; A1C). Currently, there is a lack of high quality evidence to support the tailoring of insulin regimens according to an individual's needs. The aim of this study is to update our previous systematic review and perform an individual patient data network meta-analysis (IPD-NMA) to evaluate the comparative safety and effectiveness of long-acting versus intermediate-acting insulin in different subgroups of patients with T1DM.We will update our previous literature search from January 2013 onwards searching relevant electronic databases (eg, MEDLINE), as well as perform grey literature search through relevant society/association websites, and conference abstracts, and scan reference lists of the eligible studies. We will include randomised clinical trials of any duration examining long-acting versus intermediate-acting insulin preparations for adult patients with T1DM. We will focus on A1C and severe hypoglycaemia outcomes. For each pairwise treatment comparison, we will combine all IPD from all studies in a single multilevel model, where each study is a different cluster. For a connected network of trials, we will perform an IPD-NMA to identify potential effect modifiers, and estimate the most effective and safe treatments for patients with different characteristics. If we are not successful in obtaining IPD for at least one study, we will include aggregated data (AD) abstracted from the included RCTs in our analysis, combining IPD and AD into a single model. We will report our results using the PRISMA-IPD statement.The results of this systematic review and IPD-NMA will be of interest to stakeholders and will help in improving existing guideline recommendations.CRD42015023511.",0 +https://doi.org/10.1016/0270-0255(86)90088-6,A new approach to causal inference in mortality studies with a sustained exposure period—application to control of the healthy worker survivor effect,"In observational cohort mortality studies with prolonged periods of exposure to the agent under study, it is not uncommon for risk factors for death to be determinants of subsequent exposure. For instance, in occupational mortality studies date of termination of employment is both a determinant of future exposure (since terminated individuals receive no further exposure) and an independent risk factor for death (since disabled individuals tend to leave employment). When current risk factor status determines subsequent exposure and is determined by previous exposure, standard analyses that estimate age-specific mortality rates as a function of cumulative exposure may underestimate the true effect of exposure on mortality whether or not one adjusts for the risk factor in the analysis. This observation raises the question, which if any population parameters can be given a causal interpretation in observational mortality studies? In answer, we offer a graphical approach to the identification and computation of causal parameters in mortality studies with sustained exposure periods. This approach is shown to be equivalent to an approach in which the observational study is identified with a hypothetical double-blind randomized trial in which data on each subject's assigned treatment protocol has been erased from the data file. Causal inferences can then be made by comparing mortality as a function of treatment protocol, since, in a double-blind randomized trial missing data on treatment protocol, the association of mortality with treatment protocol can still be estimated. We reanalyze the mortality experience of a cohort of arsenic-exposed copper smelter workers with our method and compare our results with those obtained using standard methods. We find an adverse effect of arsenic exposure on all-cause and lung cancer mortality which standard methods fail to detect.",0 +https://doi.org/10.1037/0096-3445.108.3.356,Automatic and effortful processes in memory.,"Proposes a framework for the conceptualization of a broad range of memory phenomena that integrates research on memory performance in young children, the elderly, and individuals under stress with research on memory performance in normal college students. One basic assumption is that encoding operations vary in their attentional requirements. Operations that drain minimal energy from limited-capacity attentional mechanisms are called automatic. Automatic operations function at a constant level under all circumstances, occur without intention, and do not benefit from practice. Effortful operations, such as rehearsal and elaborative mnemonic activities, require considerable capacity, interfere with other cognitive activities also requiring capacity, are initiated intentionally, and show benefits from practice. A 2nd assumption is that attentional capacity varies both within and among individuals. Depression, high arousal levels, and old age are variables thought to reduce attentional capacity. The conjunction of the 2 assumptions of the framework yields the prediction that the aged and individuals under stress will show a decrease in performance only on tasks requiring effortful processing. Evidence from the literature on development, aging, depression, arousal, and normal memory is presented in support of the framework, and 4 experiments with 301 5-40 yr old Ss are described. (51/2 p ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1979 American Psychological Association.",0 +https://doi.org/10.1198/016214506000000104,A Hierarchical Multivariate Two-Part Model for Profiling Providers' Effects on Health Care Charges,"Procedures for analyzing and comparing health care providers' effects on health services delivery and outcomes have been referred to as provider profiling. In a typical profiling procedure, patient-level responses are measured for clusters of patients treated by providers that in turn can be considered statistically exchangeable. Thus a hierarchical model naturally represents the structure of the data. When provider effects on multiple responses are profiled, a multivariate model rather than a series of univariate models can capture associations among responses at both the provider and patient levels. When responses are in the form of charges for health care services and sampled patients include nonusers of services, charge variables are a mix of 0's and highly skewed positive values that present a modeling challenge. For analysis of covariate effects on charges for a single service, a frequently used approach is a two-part model that combines logistic or probit regression on any use of the service and li...",0 +https://doi.org/10.2307/3088424,Modeling Multilevel Data Structures,"data are becoming quite common in political science and provide numerous opportunities for theory testing and development. Unfortunately this type of data typically generates a number of statistical problems, of which clustering is particularly impor? tant. To exploit the opportunities of? fered by multilevel data, and to solve the statistical problems inherent in them, special statistical techniques are required. In this article, we focus on a technique that has become popular in educational statistics and sociology?multilevel analysis. In multilevel analysis, researchers build models that capture the layered structure of multilevel data, and determine how layers interact and impact a dependent variable of interest. Our objective in this article is to introduce the logic and statistical theory behind multilevel models, to illustrate how such models can be applied fruitfully in political science, and to call atten? tion to some of the pitfalls in multilevel analysis.",0 +,Correlation and causality,,0 +https://doi.org/10.1016/j.prevetmed.2015.12.010,Investigating preventive-medicine consultations in first-opinion small-animal practice in the United Kingdom using direct observation,"Preventive-medicine consultations account for a large proportion of the veterinary caseload and previous research has suggested these consultations are fundamentally different from those in which the animal is presented for a specific health problem. There has been recent controversy around some aspects of preventive medicine for cats and dogs, and the full health benefits of the preventive-medicine consultation remain unclear. The aim of this study was to compare characteristics of the consultation and the problems discussed during the consultation between preventive-medicine consultations and other types of consultations. Data were gathered during direct observation of small-animal consultations in seven first-opinion practices in the United Kingdom. Data collected included type of clinical examination performed, patient signalment, and details of all problems discussed (including whether the problem was presenting or non-presenting, new or pre-existing, who had raised the problem, body system affected and whether an action was taken). A two-level multivariable logistic-regression model was developed, with canine and feline patients at Level 1 nested within consulting veterinary surgeons at Level 2, and a binary outcome variable of preventive-medicine consultation versus specific health-problem consultation. A total of 1807 patients were presented, of which 690 (38.2%) presented for a preventive-medicine consultation. Dogs were the most frequently presented species (n=1168; 64.6%) followed by cats (n=510; 28.2%), rabbits (n=86; 4.8%) and patients of other species (n=43; 2.4%). The five variables remaining in the multi-level model were whether multiple patients were presented, patient age, clinical examination type, weighing and number of problems discussed. Species, breed, sex, neutering status and practice did not remain in the final model. Many non-presenting problems, including both preventive-medicine problems and specific-health problems, were discussed and acted upon during all types of consultations. Dental and behavioural non-presenting problems were discussed more frequently during preventive-medicine consultations compared with specific health-problem consultations. Preventive-medicine consultations represent an opportunity for veterinary surgeons to discuss other aspects of preventive medicine, and to detect and manage new and ongoing health problems. A greater evidence base is needed to understand whether detecting and managing underlying disease during the preventive-medicine consultation has a positive impact on lifelong patient health and welfare.",0 +https://doi.org/10.1037/1082-989x.10.1.40,Meta-analytic structural equation modeling: A two-stage approach.,"To synthesize studies that use structural equation modeling (SEM), researchers usually use Pearson correlations (univariate r), Fisher z scores (univariate z), or generalized least squares (GLS) to combine the correlation matrices. The pooled correlation matrix is then analyzed by the use of SEM. Questionable inferences may occur for these ad hoc procedures. A 2-stage structural equation modeling (TSSEM) method is proposed to incorporate meta-analytic techniques and SEM into a unified framework. Simulation results reveal that the univariate-r, univariate-z, and TSSEM methods perform well in testing the homogeneity of correlation matrices and estimating the pooled correlation matrix. When fitting SEM, only TSSEM works well. The GLS method performed poorly in small to medium samples.",0 +https://doi.org/10.1080/01621459.1975.10479871,A Bayesian Sequential Procedure for Quantal Response in the Context of Adaptive Mental Testing,Abstract This article is concerned with a generalization of the problem of estimation of median effective dose in bioassay with a normal quantal response curve. A new kind of Bayesian motivated procedure is introduced which leads to a strongly consistent estimator. The convergence is robust in that it holds for a bundle of sequences of design vectors—an important feature in a mental testing context where a specified design vector cannot be produced on demand.,0 +https://doi.org/10.1027/1614-2241.3.4.149,Are There Test Administrator Effects in Large-Scale Educational Assessments?,"Abstract. In large-scale educational assessments such as the Third International Mathematics and Sciences Study (TIMSS) or the Program for International Student Assessment (PISA), sizeable numbers of test administrators (TAs) are needed to conduct the assessment sessions in the participating schools. TA training sessions are run and administration manuals are compiled with the aim of ensuring standardized, comparable, assessment situations in all student groups. To date, however, there has been no empirical investigation of the effectiveness of these standardizing efforts. In the present article, we probe for systematic TA effects on mathematics achievement and sample attrition in a student achievement study. Multilevel analyses for cross-classified data using Markov Chain Monte Carlo (MCMC) procedures were performed to separate the variance that can be attributed to differences between schools from the variance associated with TAs. After controlling for school effects, only a very small, nonsignificant proportion of the variance in mathematics scores and response behavior was attributable to the TAs (< 1%). We discuss practical implications of these findings for the deployment of TAs in educational assessments.",0 +https://doi.org/10.1111/j.1540-5907.2009.00369.x,"Contextual Factors and the Extreme Right Vote in Western Europe, 1980-2002","Research on the voters of the extreme right in Western Europe has become a minor industry, but relatively little attention has been paid to the twin question of why support for these parties is often unstable, and why the extreme right is so weak in many countries. Moreover, the findings from different studies often contradict each other. This article aims at providing a more comprehensive and satisfactory answer to this research problem by employing a broader database and a more adequate modeling strategy. The main finding is that while immigration and unemployment rates are important, their interaction with other political factors is much more complex than suggested by previous research. Moreover, persistent country effects prevail even if a whole host of individual and contextual variables is controlled for.",0 +https://doi.org/10.1111/j.1468-0262.2006.00655.x,Large Sample Properties of Matching Estimators for Average Treatment Effects,"Matching estimators for average treatment effects are widely used in evaluation research despite the fact that their large sample properties have not been established in many cases. The absence of formal results in this area may be partly due to the fact that standard asymptotic expansions do not apply to matching estimators with a fixed number of matches because such estimators are highly nonsmooth functionals of the data. In this article we develop new methods for analyzing the large sample properties of matching estimators and establish a number of new results. We focus on matching with replacement with a fixed number of matches. First, we show that matching estimators are not N 1/2 -consistent in general and describe conditions under which matching estimators do attain N 1/2 -consistency. Second, we show that even in settings where matching estimators are N 1/2 -consistent, simple matching estimators with a fixed number of matches do not attain the semiparametric efficiency bound. Third, we provide a consistent estimator for the large sample variance that does not require consistent nonparametric estimation of unknown functions. Software for implementing these methods is available in Matlab, Stata, and R.",0 +https://doi.org/10.1146/annurev-psych-010814-015258,Advances in Mediation Analysis: A Survey and Synthesis of New Developments,"Mediation processes are fundamental to many classic and emerging theoretical paradigms within psychology. Innovative methods continue to be developed to address the diverse needs of researchers studying such indirect effects. This review provides a survey and synthesis of four areas of active methodological research: (a) mediation analysis for longitudinal data, (b) causal inference for indirect effects, (c) mediation analysis for discrete and nonnormal variables, and (d) mediation assessment in multilevel designs. The aim of this review is to aid in the dissemination of developments in these four areas and suggest directions for future research.",0 +https://doi.org/10.1198/073500103288619331,Bayesian Analysis of the Heterogeneity Model,"We consider Bayesian estimation of a finite mixture of models with random effects, which is also known as the heterogeneity model. First, we discuss the properties of various Markov chain Monte Carlo samplers that are obtained from full conditional Gibbs sampling by grouping and collapsing. Whereas full conditional Gibbs sampling turns out to be sensitive to the parameterization chosen for the mean structure of the model, the alternative sampler is robust in this respect. However, the logical extension of the approach to the sampling of the group variances does not further increase the efficiency of the sampler. Second, we deal with the identifiability problem due to the arbitrary labeling within the model. Finally, a case study involving metric conjoint analysis serves as a practical illustration.",0 +https://doi.org/10.1007/s13524-015-0430-1,"Ethnic Residential Segregation: A Multilevel, Multigroup, Multiscale Approach Exemplified by London in 2011","Abstract We develop and apply a multilevel modeling approach that is simultaneously capable of assessing multigroup and multiscale segregation in the presence of substantial stochastic variation that accompanies ethnicity rates based on small absolute counts. Bayesian MCMC estimation of a log-normal Poisson model allows the calculation of the variance estimates of the degree of segregation in a single overall model, and credible intervals are obtained to provide a measure of uncertainty around those estimates. The procedure partitions the variance at different levels and implicitly models the dependency (or autocorrelation) at each spatial scale below the topmost one. Substantively, we apply the model to 2011 census data for London, one of the world’s most ethnically diverse cities. We find that the degree of segregation depends both on scale and group.",0 +https://doi.org/10.1111/spsr.12184,How Exclusive is Assembly Democracy? Citizens' Assembly and Ballot Participation Compared,"This paper analyses the difference between two specific forms of citizens’ involvements, namely whether a vote is cast by ballot or in a citizens’ assembly in which people gather in town halls to decide legislative questions in a deliberative manner. We show both theoretically and empirically how citizens’ assemblies and decisions at the ballot box substantially differ not only in terms of their underlying model of democracy, but also in their structural conditions and, thus, with respect to the social inequality of participation. We test our hypotheses in a Bayesian multilevel framework using real participation data collected from 15 political decisions made in a Swiss commune. Our results show that citizens’ assemblies are not only characterised by lower participation rates, but also by a particular composition of the electorate. While citizens’ assemblies are more equal regarding income groups, ballots favour a more equitable participation in terms of gender and age.",0 +https://doi.org/10.1080/00220973.2014.952397,Alternatives to Multilevel Modeling for the Analysis of Clustered Data,"Multilevel modeling has grown in use over the years as a way to deal with the nonindependent nature of observations found in clustered data. However, other alternatives to multilevel modeling are available that can account for observations nested within clusters, including the use of Taylor series linearization for variance estimation, the design effect adjusted standard errors approach, and fixed effects modeling. Using 1,000 replications of 12 conditions with varied Level 1 and Level 2 sample sizes, the author compared parameter estimates, standard errors, and statistical significance using various alternative procedures. Results indicate that several acceptable procedures can be used in lieu of or together with multilevel modeling, depending on the type of research question asked and the number of clusters under investigation. Guidelines for applied researchers are discussed.",0 +https://doi.org/10.1007/978-1-4684-6994-3_16,Statistical Problems of Fitting Individual Growth Curves,"A thorough-going longitudinal study of a child’s growth can produce upward of forty observations spaced over the years from birth to maturity. Such a data record is too long and inevitably too noisy (because of measurement error and short-run growth variation) to be interpreted without some sort of condensation and smoothing. The length of the record forces attention to certain critical regions or features of the curve, but the noisiness of the data makes it risky to characterize these regions or features by a few isolated measurements. The only safe approach to interpretation of individual growth data is via a statistical method capable of revealing the essential trend and concisely describing its main features.",0 +,YAAP: yet another adaptive procedure.,"YAAP is an implementation of an adaptive psychophysical method, based on Bayesian statistics, for estimating the threshold of a psychometric function. On the basis of Bayesian probability intervals, a dynamic termination criterion allows for threshold estimation within pre-specified confidence limits.",0 +https://doi.org/10.1037//0021-9010.87.2.377,Comparison of two random-effects methods of meta-analysis.,"Two studies compared the Schmidt-Hunter method of meta-analysis (J. E. Hunter & F. L. Schmidt, 1990) with the method described by L. V. Hedges and J. L. Vevea (1998). Study 1 evaluated estimates of à �Ì„, à ƒà �, and resulting credibility intervals for both models through Monte Carlo methods. Results showed slight differences between the 2 methods. In Study 2, a reanalysis of published meta-analyses using both methods with several artifact distributions showed that although both choice of technique and type of correction could matter, the technique of meta-analysis used is less influential on the study outcome than is the choice of artifact correction.",0 +https://doi.org/10.2307/2346572,Multicollinearity caused by Specification Errors,The advantages of using linear least squares regressions induce us to adopt functions which are linear in parameters. Often this imposes unrealistically rigid constraints which may create multicollinearity. Using more realistic non‐linear forms and non‐linear least squares regressions is likely to overcome this problem as shown in a study of a production function.,0 +https://doi.org/10.3758/bf03201438,Efficient estimation of sensory thresholds,"Laboratory computers permit detection and discrimination thresholds to be measured rapidly, efficiently, and accurately. In this paper, the general natures of psychometric functions and of thresholds are reviewed, and various methods for estimating sensory thresholds are summarized. The most efficient method, in principle, using maximum-likelihood threshold estimations, is examined in detail. Four techniques are discussed that minimize the reported problems found with the maximum-likelihood method. A package of FORTRAN subroutines, ML-TEST, which implements the maximum-likelihood method, is described. These subroutines are available on request from the author.",0 +https://doi.org/10.1007/s00221-014-3877-1,Fast transfer of crossmodal time interval training,"Sub-second time perception is essential for many important sensory and perceptual tasks including speech perception, motion perception, motor coordination, and crossmodal interaction. This study investigates to what extent the ability to discriminate sub-second time intervals acquired in one sensory modality can be transferred to another modality. To this end, we used perceptual classification of visual Ternus display (Ternus in Psychol Forsch 7:81-136, 1926) to implicitly measure participants' interval perception in pre- and posttests and implemented an intra- or crossmodal sub-second interval discrimination training protocol in between the tests. The Ternus display elicited either an ""element motion"" or a ""group motion"" percept, depending on the inter-stimulus interval between the two visual frames. The training protocol required participants to explicitly compare the interval length between a pair of visual, auditory, or tactile stimuli with a standard interval or to implicitly perceive the length of visual, auditory, or tactile intervals by completing a non-temporal task (discrimination of auditory pitch or tactile intensity). Results showed that after fast explicit training of interval discrimination (about 15 min), participants improved their ability to categorize the visual apparent motion in Ternus displays, although the training benefits were mild for visual timing training. However, the benefits were absent for implicit interval training protocols. This finding suggests that the timing ability in one modality can be rapidly acquired and used to improve timing-related performance in another modality and that there may exist a central clock for sub-second temporal processing, although modality-specific perceptual properties may constrain the functioning of this clock. © 2014 Springer-Verlag.",0 +https://doi.org/10.1111/j.1475-6811.1999.tb00204.x,The social relations model for family data: A multilevel approach,"Multilevel models are proposed to study relational or dyadic data from multiple persons in families or other groups. The variable under study is assumed to refer to a dyadic relation between individuals in the groups. The proposed models are elaborations of the Social Relations Model. The different roles of father, mother, and child are emphasized in these models. Multilevel models provide researchers with a method to estimate the variances and correlations of the Social Relations Model and to incorporate the effects of covariates and test specialized models, even with missing observations.",0 +https://doi.org/10.1037/0893-3200.19.2.314,The Interpersonal Process Model of Intimacy in Marriage: A Daily-Diary and Multilevel Modeling Approach.,"This study used daily reports of interactions in marriage to examine predictions from the conceptualization of intimacy as the outcome of an interpersonal process. Both partners of 96 married couples completed daily diaries assessing self-disclosure, partner disclosure, perceived partner responsiveness, and intimacy on each of 42 consecutive days. Multivariate multilevel modeling revealed that self-disclosure and partner disclosure both significantly and uniquely contributed to the contemporaneous prediction of intimacy. Perceived partner responsiveness partially mediated the effects of self-disclosure and partner disclosure on intimacy. Global marital satisfaction, relationship intimacy, and demand-withdraw communication were related to daily levels of intimacy. Implications for the importance of perceived partner responsiveness in the intimacy process for married partners are discussed.",0 +https://doi.org/10.3758/bf03211951,Fitting the psychometric function,"A constrained generalized maximum likelihood routine for fitting psychometric functions is proposed, which determines optimum values for the complete parameter set—that is, threshold and slopeas well as for guessing and lapsing probability. The constraints are realized by Bayesian prior distributions for each of these parameters. The fit itself results from maximizing the posterior distribution of the parameter values by a multidimensional simplex method. We present results from extensive Monte Carlo simulations by which we can approximate bias and variability of the estimated parameters of simulated psychometric functions. Furthermore, we have tested the routine with data gathered in real sessions of psychophysical experimenting.",0 +https://doi.org/10.1086/588741,What Can We Learn about Neighborhood Effects from the Moving to Opportunity Experiment?,Experimental estimates from Moving to Opportunity (MTO) show no significant impacts of moves to lower‐poverty neighborhoods on adult economic self‐sufficiency four to seven years after random assignment. The authors disagree with Clampet‐Lundquist and Massey's claim that MTO was a weak intervention and therefore uninformative about neighborhood effects. MTO produced large changes in neighborhood environments that improved adult mental health and many outcomes for young females. Clampet‐Lundquist and Massey's claim that MTO experimental estimates are plagued by selection bias is erroneous. Their new nonexperimental estimates are uninformative because they add back the selection problems that MTO's experimental design was intended to overcome.,0 +https://doi.org/10.1177/1354068813520271,Allure or alternative? Direct democracy and party identification,"This article presents the first investigation of whether and how party identification is influenced by direct democratic institutions. The concept of party identification is of central interest to political science. Despite declining partisan attachment and increasing dealignment among voters, little systematic evidence exists as to which factors influence individual party identification. Our article contributes to improving on this lacuna by considering the educative effects of direct democratic institutions. Theoretically, two competing hypotheses are plausible. On the one hand, direct democracy might strengthen political parties and promote the need for cues so that voters succumb to the allure of partisan attachment. On the other hand, direct democracy might provide an alternative to the representational function of political parties thus rendering party identification less essential. Drawing on recent data from the Swiss cantons, we estimate multi-level models. Our analyses, though giving support to the alternative hypothesis, yield some surprising findings.",0 +https://doi.org/10.1111/j.2044-8317.1984.tb00789.x,Asymptotically distribution-free methods for the analysis of covariance structures,Methods for obtaining tests of fit of structural models for covariance matrices and estimator standard errors which are asymptotically distribution free are derived. Modifications to standard normal theory tests and standard errors which make them applicable to the wider class of elliptical distributions are provided. A random sampling experiment to investigate some of the proposed methods is described.,0 +https://doi.org/10.1093/swr/18.4.247,The M word: Multicollinearity in multiple regression,,0 +https://doi.org/10.1214/088342304000000116,The Interplay of Bayesian and Frequentist Analysis,"Statistics has struggled for nearly a century over the issue of whether the Bayesian or frequentist paradigm is superior. This debate is far from over and, indeed, should continue, since there are fundamental philosophical and pedagogical issues at stake. At the methodological level, however, the debate has become considerably muted, with the recognition that each approach has a great deal to contribute to statistical practice and each is actually essential for full development of the other approach. In this article, we embark upon a rather idiosyncratic walk through some of these issues.",0 +https://doi.org/10.1006/jmps.1996.0030,Premature Sampling in Random Walks,"Abstract Premature sampling is a plausible modification of the random walk that is regarded as sufficient in allowing the sequential probability ratio test (SPRT) model of choice response time to account for the frequent observation that mean error response latency is smaller than that for correct responses. This paper establishes a mathematical framework for random walks with premature sampling. Four important points are made. First, Wald's Identity and the small steps assumption fail to make the problem tractable in its fullest generality. Second, Laming's (1968) derivation of the important result that premature sampling leads to smaller mean latencies for error responses than correct responses in the SPRT model may be flawed by a tenuous approximation. Third, expressions for response probabilities and mean latencies are derived for the general model on the assumption that premature sampling is not sufficient, by itself, to trigger a response, although it does influence the process. Fourth, the SPRT model with premature sampling does not necessarily imply that when conditioned on a response, mean response time for error responses is smaller than that for correct responses—and counterexamples to this claim are provided.",0 +https://doi.org/10.1037/0096-3445.136.3.414,Individual differences in components of reaction time distributions and their relations to working memory and intelligence.,"The authors bring together approaches from cognitive and individual differences psychology to model characteristics of reaction time distributions beyond measures of central tendency. Ex-Gaussian distributions and a diffusion model approach are used to describe individuals' reaction time data. The authors identified common latent factors for each of the 3 ex-Gaussian parameters and for 3 parameters central to the diffusion model using structural equation modeling for a battery of choice reaction tasks. These factors had differential relations to criterion constructs. Parameters reflecting the tail of the distribution (i.e., tau in the ex-Gaussian and drift rate in the diffusion model) were the strongest unique predictors of working memory, reasoning, and psychometric speed. Theories of controlled attention and binding are discussed as potential theoretical explanations.",0 +https://doi.org/10.1348/026151008x329517,An investigation of the impact of young children's self-knowledge of trustworthiness on school adjustment: A test of the realistic self-knowledge and positive illusion models,"The study aimed to examine the relationship between self-knowledge of trustworthiness and young children's school adjustment. One hundred and seventy-three (84 male and 89 female) children from school years 1 and 2 in the United Kingdom (mean age 6 years 2 months) were tested twice over 1-year. Children's trustworthiness was assessed using: (a) self-report at Time 1 and Time 2; (b) peers' reports at Time 1 and Time 2; and (c) teacher-reports at Time 2. School adjustment was assessed by child-rated school-liking and the Short-Form Teacher Rating Scale of School Adjustment (Short-Form TRSSA). Longitudinal quadratic relationships were found between school adjustment and children's self-knowledge, using peer-reported trustworthiness as a reference: more accurate self-knowledge of trustworthiness predicted increases in school adjustment. Comparable concurrent quadratic relationships were found between teacher-rated school adjustment and children's self-knowledge, using teacher-reported trustworthiness as a reference, at Time 2. The findings support the conclusion that young children's psychosocial adjustment is best accounted for by the realistic self-knowledge model (Colvin & Block, 1994).",0 +https://doi.org/10.1080/10503300802326038,Beyond the individual: Group effects in mindfulness-based stress reduction,"The authors explored the group as a source of change in mindfulness-based stress reduction (MBSR). Participants consisted of 606 adults in 59 groups who completed an 8-week MBSR program. The authors examined change in the General Symptom Index (GSI) of the Symptom Checklist-90-Revised and the Medical Symptom Checklist (MSC) from pre- to postintervention. Multilevel models were used to examine the extent to which groups differed in the amount of change reported by the participants. After controlling for pretreatment severity, group accounted for 7% of the variability in the GSI and 0% in the MSC. The authors discuss the implications of these findings for the practice of MBSR as well as for research investigating the effects of MBSR and other programs or psychotherapies.",0 +https://doi.org/10.1037/h0045764,Intelligence at adulthood: A twenty-five year follow-up.,"This paper reports findings from 111 Ss tested with the Stanford-Binet (S-B) at preschool and adolescence who were administered the S-B and WAIS at adulthood. Correlations of preschool IQs with adult S-B and full WAIS IQs are .59 and .64; of adolescent IQs with adult IQs, .85 and .80. Mean S-B IQ increase from adolescence to adulthood is 11 points, indicating that mental growth continues beyond 16 years. Males show more IQ gain after adolescence than do females (p<.01). Girls with high IQs increase least. Analysis of increases in percent passing S-B items shows more growth after adolescence in abstract reasoning and vocabulary than in rote memory and practical reasoning. Preschool verbal and memory items are better predictors than nonverbal items of both verbal and performance adult IQs. Pattern of individual differences in relative amounts of these abilities shows some stability over 25 years. (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1962 American Psychological Association.",0 +https://doi.org/10.1207/s15327906mbr4104_4,Distinguishing Between Latent Classes and Continuous Factors: Resolution by Maximum Likelihood?,"Latent variable models exist with continuous, categorical, or both types of latent variables. The role of latent variables is to account for systematic patterns in the observed responses. This article has two goals: (a) to establish whether, based on observed responses, it can be decided that an underlying latent variable is continuous or categorical, and (b) to quantify the effect of sample size and class proportions on making this distinction. Latent variable models with categorical, continuous, or both types of latent variables are fitted to simulated data generated under different types of latent variable models. If an analysis is restricted to fitting continuous latent variable models assuming a homogeneous population and data stem from a heterogeneous population, overextraction of factors may occur. Similarly, if an analysis is restricted to fitting latent class models, overextraction of classes may occur if covariation between observed variables is due to continuous factors. For the data-generating models used in this study, comparing the fit of different exploratory factor mixture models usually allows one to distinguish correctly between categorical and/or continuous latent variables. Correct model choice depends on class separation and within-class sample size.",0 +https://doi.org/10.1177/1094428108318065,Scale Coarseness as a Methodological Artifact,"Scale coarseness is a pervasive yet ignored methodological artifact that attenuates observed correlation coefficients in relation to population coefficients. The authors describe how to disattenuate correlations that are biased by scale coarseness in primary-level as well as meta-analytic studies and derive the sampling error variance for the corrected correlation. Results of two Monte Carlo simulations reveal that the correction procedure is accurate and show the extent to which coarseness biases the correlation coefficient under various conditions (i.e., value of the population correlation, number of item scale points, and number of scale items). The authors also offer a Web-based computer program that disattenuates correlations at the primary-study level and computes the sampling error variance as well as confidence intervals for the corrected correlation. Using this program, which implements the correction in primary-level studies, and incorporating the suggested correction in meta-analytic reviews will lead to more accurate estimates of construct-level correlation coefficients.",0 +https://doi.org/10.1016/0042-6989(94)90039-6,"Efficient and unbiased modifications of the QUEST threshold method: Theory, simulations, experimental evaluation and practical implementation","QUEST [Watson and Pelli, Perception and Psychophysics, 13, 113-120 (1983)] is an efficient method of measuring thresholds which is based on three steps: (1) Specification of prior knowledge and assumptions, including an initial probability density function (p.d.f.) of threshold (i.e. relative probability of different thresholds in the population). (2) A method for choosing the stimulus intensity of any trial. (3) A method for choosing the final threshold estimate. QUEST introduced a Bayesian framework for combining prior knowledge with the results of previous trials to calculate a current p.d.f.; this is then used to implement Steps 2 and 3. While maintaining this Bayesian approach, this paper evaluates whether modifications of the QUEST method (particularly Step 2, but also Steps 1 and 3) can lead to greater precision and reduced bias. Four variations of the QUEST method (differing in Step 2) were evaluated by computer simulations. In addition to the standard method of setting the stimulus intensity to the mode of the current p.d.f. of threshold, the alternatives of using the mean and the median were evaluated. In the fourth variation--the Minimum Variance Method--the next stimulus intensity is chosen to minimize the expected variance at the end of the next trial. An exact enumeration technique with up to 20 trials was used for both yes-no and two-alternative forced-choice (2AFC) experiments. In all cases, using the mean (here called ZEST) provided better precision than using the median which in turn was better than using the mode. The Minimum Variance Method provided slightly better precision than ZEST. The usual threshold criterion--based on the ""ideal sweat factor""--may not provide optimum precision; efficiency can generally be improved by optimizing the threshold criterion. We therefore recommend either using ZEST with the optimum threshold criterion or the more complex Minimum Variance Method. A distinction is made between ""measurement bias"", which is derived from the mean of repeated threshold estimates for a single real threshold, and ""interpretation bias"", which is derived from the mean of real thresholds yielding a single threshold estimate. If their assumptions are correct, the current methods have no interpretation bias, but they do have measurement bias. Interpretation bias caused by errors in the assumptions used by ZEST is evaluated. The precisions and merits of yes-no and 2AFC techniques are compared.(ABSTRACT TRUNCATED AT 400 WORDS)",0 +https://doi.org/10.2200/s00371ed1v01y201107aim013,Human Computation,"Human computation is a new and evolving research area that centers around harnessing human intelligence to solve computational problems that are beyond the scope of existing Artificial Intelligence (AI) algorithms. With the growth of the Web, human computation systems can now leverage the abilities of an unprecedented number of people via the Web to perform complex computation. There are various genres of human computation applications that exist today. Games with a purpose (e.g., the ESP Game) specifically target online gamers who generate useful data (e.g., image tags) while playing an enjoyable game. Crowdsourcing marketplaces (e.g., Amazon Mechanical Turk) are human computation systems that coordinate workers to perform tasks in exchange for monetary rewards. In identity verification tasks, users perform computation in order to gain access to some online content; an example is reCAPTCHA, which leverages millions of users who solve CAPTCHAs every day to correct words in books that optical character recognition (OCR) programs fail to recognize with certainty. This book is aimed at achieving four goals: (1) defining human computation as a research area; (2) providing a comprehensive review of existing work; (3) drawing connections to a wide variety of disciplines, including AI, Machine Learning, HCI, Mechanism/Market Design and Psychology, and capturing their unique perspectives on the core research questions in human computation; and (4) suggesting promising research directions for the future. © 2011 by Morgan & Claypool.",0 +https://doi.org/10.1111/j.1744-6570.2000.tb02426.x,"SO MANY JOBS, SO LITTLE ""N"": APPLYING EXPANDED VALIDATION MODELS TO SUPPORT GENERALIZATION OF COGNITIVE TEST VALIDITY","This paper describes a case study in which practitioners were faced with the challenge of validating cognitive ability tests in a setting where additional criterion-related validation research was not technically feasible. Research conducted within this organization had reached the point of diminishing returns because most of the “large incumbent” jobs had already been the subject of validation research, and the remaining jobs had relatively few incumbents. Landy (1986), and more recently, Binning and Barrett (1989), characterized validation as the process of accumulating a variety of forms of judgmental and empirical evidence to support inferences regarding psychological constructs and operational measures of those constructs. The converging lines of evidence brought together in this study by the synthesisof data from externally conducted VG research, internal validation studies, test transportability, job component validity, and analysis of attributes requirements support inferences regarding the validity of cognitive ability tests for predicting training and job performance for company nonmanagement jobs. This study demonstrates the soundness and practicality of the advice that Landy and Binning and Barrett provided regarding validity models. Although this study does not fit neatly into any one of the three “boxes” (Landy, 1986) the Guidelines allow in supporting validation efforts, it is likely more defensible than if we had followed Guidefines prescriptions by rote. The interlinking systems of job families and test batteries described here and in Hoffman (1999) are also responsive to company needs regarding cost containment and quick implementation of staffing systems.",0 +https://doi.org/10.1080/01621459.2013.779832,Mediation and Spillover Effects in Group-Randomized Trials: A Case Study of the 4Rs Educational Intervention,"Peer influence and social interactions can give rise to spillover effects in which the exposure of one individual may affect outcomes of other individuals. Even if the intervention under study occurs at the group or cluster level as in group-randomized trials, spillover effects can occur when the mediator of interest is measured at a lower level than the treatment. Evaluators who choose groups rather than individuals as experimental units in a randomized trial often anticipate that the desirable changes in targeted social behaviors will be reinforced through interference among individuals in a group exposed to the same treatment. In an empirical evaluation of the effect of a school-wide intervention on reducing individual students' depressive symptoms, schools in matched pairs were randomly assigned to the 4Rs intervention or the control condition. Class quality was hypothesized as an important mediator assessed at the classroom level. We reason that the quality of one classroom may affect outcomes of children in another classroom because children interact not simply with their classmates but also with those from other classes in the hallways or on the playground. In investigating the role of class quality as a mediator, failure to account for such spillover effects of one classroom on the outcomes of children in other classrooms can potentially result in bias and problems with interpretation. Using a counterfactual conceptualization of direct, indirect and spillover effects, we provide a framework that can accommodate issues of mediation and spillover effects in group randomized trials. We show that the total effect can be decomposed into a natural direct effect, a within-classroom mediated effect and a spillover mediated effect. We give identification conditions for each of the causal effects of interest and provide results on the consequences of ignoring ""interference"" or ""spillover effects"" when they are in fact present. Our modeling approach disentangles these effects. The analysis examines whether the 4Rs intervention has an effect on children's depressive symptoms through changing the quality of other classes as well as through changing the quality of a child's own class.",0 +https://doi.org/10.1191/1740774505cn082oa,The use of random effects models to allow for clustering in individually randomized trials,"Background We describe different forms of clustering that may occur in individually randomized trials, where the observed outcomes for different individuals cannot be regarded as independent. We propose random effects models to allow for such clustering, across a range of contexts and trial designs, and investigate their effect on estimation and interpretation of the treatment effect. Methods We apply our proposed models to two individually randomized trials with potential for clustering, a trial of teleconsultation in hospital referral (the main outcome being offer of a further hospital appointment) and a trial of exercise therapy delivered by physiotherapists for low back pain (the outcome being a back pain score). Extensions to the methods include the possibility of explaining heterogeneity between clusters using cluster level characteristics and the potential dilution of cluster effects due to noncompliance. Results In the teleconsultation trial, the odds ratio was significant (1.52, 95% CI 1.27 to 1.82) when clustering was ignored, but smaller and nonsignificant (1.36, 95% CI 0.85 to 2.13) when clustering by hospital consultant was taken into account. The 95% range of estimated treatment effects across consultants was from 0.21 to 8.76. This variability was only partially explained by the specialty of the consultant. In the back pain trial, although there was an overall benefit of exercise (change of 20.51 points on the back pain score) and little evidence of clustering, the estimated treatment effects for different physiotherapists ranged from 21.26 to +0.26 points. Conclusions Clustering is an important issue in many individually randomized trials. Ignoring it can lead to underestimates of the uncertainty and too extreme P-values. Even when there is little apparent heterogeneity across clusters, it can still have a large impact on the estimation and interpretation of the treatment effect.",0 +https://doi.org/10.1098/rspl.1897.0091,Mathematical contributions to the theory of evolution. IV. On the probable errors of frequency constants and on the influence of random selection on variation and correlation,"This memoir starts with a general theorem, by which the probable errors made in calculating the constants of any frequency distribution may be determined. It is shown that these probable errors form a correlated system approximately following the normal law of frequency, whatever be the nature of the original frequency distribution, i. e .,whether it be skew or normal. The importance of this result for the theory of evolution is then drawn attention to.",0 +https://doi.org/10.1080/01402382.2014.929341,Social Inequality in Political Participation: The Dark Sides of Individualisation,"Has the participatory gap between social groups widened over the past decades? And if so, how can it be explained? Based on a re-analysis of 94 electoral surveys in eight Western European countries between 1956 and 2009, this article shows that the difference in national election turnout between the half of the population with the lowest level of education and the half with the highest has increased. It shows that individualisation – the decline of social integration and social control – is a major cause of this trend. In their electoral choices, citizens with fewer resources – in terms of education – rely more heavily on cues and social control of the social groups to which they belong. Once the ties to these groups loosen, these cues and mobilising norms are no longer as strong as they once were, resulting in an increasing abstention of the lower classes on Election Day. In contrast, citizens with abundant resources rely much less on cues and social control, and the process of individualisation impacts ...",0 +https://doi.org/10.1002/sim.7612,A Bayesian confirmatory factor model for multivariate observations in the form of two-way tables of data,"Researchers collected multiple measurements on patients with schizophrenia and their relatives, as well as control subjects and their relatives, to study vulnerability factors for schizophrenics and their near relatives. Observations across individuals from the same family are correlated, and also the multiple outcome measures on the same individuals are correlated. Traditional data analyses model outcomes separately and thus do not provide information about the interrelationships among outcomes. We propose a novel Bayesian family factor model (BFFM), which extends the classical confirmatory factor analysis model to explain the correlations among observed variables using a combination of family-member and outcome factors. Traditional methods for fitting confirmatory factor analysis models, such as full-information maximum likelihood (FIML) estimation using quasi-Newton optimization (QNO), can have convergence problems and Heywood cases (lack of convergence) caused by empirical underidentification. In contrast, modern Bayesian Markov chain Monte Carlo handles these inference problems easily. Simulations compare the BFFM to FIML-QNO in settings where the true covariance matrix is identified, close to not identified, and not identified. For these settings, FIML-QNO fails to fit the data in 13%, 57%, and 85% of the cases, respectively, while MCMC provides stable estimates. When both methods successfully fit the data, estimates from the BFFM have smaller variances and comparable mean-squared errors. We illustrate the BFFM by analyzing data on data from schizophrenics and their family members.",0 +https://doi.org/10.1007/bf02294778,Joint consistency of nonparametric item characteristic curve and ability estimation,The simultaneous and nonparametric estimation of latent abilities and item characteristic curves is considered. The asymptotic properties of ordinal ability estimation and kernel smoothed nonparametric item characteristic curve estimation are investigated under very general assumptions on the underlying item response theory model as both the test length and the sample size increase. A large deviation probability inequality is stated for ordinal ability estimation. The mean squared error of kernel smoothed item characteristic curve estimates is studied and a strong consistency result is obtained showing that the worst case error in the item characteristic curve estimates over all items and ability levels converges to zero with probability equal to one.,0 +https://doi.org/10.1371/journal.pone.0096431,A Cognitive Model for Aggregating People's Rankings,"We develop a cognitive modeling approach, motivated by classic theories of knowledge representation and judgment from psychology, for combining people's rankings of items. The model makes simple assumptions about how individual differences in knowledge lead to observed ranking data in behavioral tasks. We implement the cognitive model as a Bayesian graphical model, and use computational sampling to infer an aggregate ranking and measures of the individual expertise. Applications of the model to 23 data sets, dealing with general knowledge and prediction tasks, show that the model performs well in producing an aggregate ranking that is often close to the ground truth and, as in the ""wisdom of the crowd"" effect, usually performs better than most of individuals. We also present some evidence that the model outperforms the traditional statistical Borda count method, and that the model is able to infer people's relative expertise surprisingly well without knowing the ground truth. We discuss the advantages of the cognitive modeling approach to combining ranking data, and in wisdom of the crowd research generally, as well as highlighting a number of potential directions for future model development.",0 +https://doi.org/10.1002/j.2162-6057.2008.tb01298.x,A Longitudinal Analysis of Student Creativity Scripts,"In the present study we used bayesian latent growth modeling to asses the impact of a one-semester creativity course on the development of engineering students' creativity scripts. We compared a treatment (N = 52) and a control (N = 42) group with respect to individual differences in initial status and in rate of change. Results revealed that the development of creativity scripts followed a linear change over time, with the rate of change being higher for the treatment compared to the control group. Furthermore, substantial individual variability in the rate of creativity scripts gain across students was detected, where students with richer creativity scripts had a weaker rate of increase. The present exploratory effort lays the groundwork for further theoretical and empirical research on the effects of intervention programs for fostering creativity.",0 +https://doi.org/10.1214/11-ba631,Mean Field Variational Bayes for Elaborate Distributions,"We develop strategies for mean eld variational Bayes approximate inference for Bayesian hierarchical models containing elaborate distributions. We loosely dene elaborate distributions to be those having more complicated forms compared with common distributions such as those in the Normal and Gamma families. Examples are Asymmetric Laplace, Skew Normal and Generalized Ex- treme Value distributions. Such models suer from the diculty that the param- eter updates do not admit closed form solutions. We circumvent this problem through a combination of (a) specially tailored auxiliary variables, (b) univariate quadrature schemes and (c) nite mixture approximations of troublesome den-",0 +https://doi.org/10.1016/j.ress.2007.03.038,Spatial generalized linear mixed models of electric power outages due to hurricanes and ice storms,"Abstract This paper presents new statistical models that predict the number of hurricane- and ice storm-related electric power outages likely to occur in each 3 km×3 km grid cell in a region. The models are based on a large database of recent outages experienced by three major East Coast power companies in six hurricanes and eight ice storms. A spatial generalized linear mixed modeling (GLMM) approach was used in which spatial correlation is incorporated through random effects. Models were fitted using a composite likelihood approach and the covariance matrix was estimated empirically. A simulation study was conducted to test the model estimation procedure, and model training, validation, and testing were done to select the best models and assess their predictive power. The final hurricane model includes number of protective devices, maximum gust wind speed, hurricane indicator, and company indicator covariates. The final ice storm model includes number of protective devices, ice thickness, and ice storm indicator covariates. The models should be useful for power companies as they plan for future storms. The statistical modeling approach offers a new way to assess the reliability of electric power and other infrastructure systems in extreme events.",0 +https://doi.org/10.5964/ejop.v7i4.163,Doing Bayesian Data Analysis: A Tutorial with R and BUGS,"Bayesian reasoning is a blessed relief to those who have always struggled with the idea that the probability of heads coming up in a supposedly fair coin flip is always 50%, even after a long series of coin flips has come up tails each time. According to Bayes, if a coin keeps coming up tails we should adjust our prior belief that the probability is 50% in the light of the posterior belief that the coin appears to be biased towards tails. John Kruschke’s book is a 600 page development of this Bayesian theme. The 23 chapters cover the basics of parameters, probability, Baye’s rule, the R and BUGS statistical programmes, the fundamentals applied to inferring a binomial proportion, and how all of this is applied to the generalized linear model. Kruschke has the rare ability amongst statistical textbook authors of writing very engagingly about knotty topics. For those who want to do what the title of the book suggests – learning to do Bayesian data analysis by learning programs languages R and BUGS – this book must be ideal.",0 +https://doi.org/10.1016/0304-4076(94)90064-7,An exact likelihood analysis of the multinomial probit model,"Abstract We develop new methods for conducting a finite sample, likelihood-based analysis of the multinomial probit model. Using a variant of the Gibbs sampler, an algorithm is developed to draw from the exact posterior of the multinomial probit model with correlated errors. This approach avoids direct evaluation of the likelihood and, thus, avoids the problems associated with calculating choice probabilities which affect both the standard likelihood and method of simulated moments approaches. Both simulated and actual consumer panel data are used to fit six-dimensional choice models. We also develop methods for analyzing random coefficient and multiperiod probit models.",0 +https://doi.org/10.1509/jmkr.39.1.87.18936,"Hierarchical Bayes versus Finite Mixture Conjoint Analysis Models: A Comparison of Fit, Prediction, and Partworth Recovery","A study conducted by Vriens, Wedel, and Wilms (1996) and published in Journal of Marketing Research found that finite mixture (FM) conjoint models had the best overall performance of nine conjoint segmentation methods in terms of fit, prediction, and parameter recovery. Since that study, hierarchical Bayes (HB) conjoint analysis methods have been proposed to estimate individual-level partworths and have received much attention in the marketing research literature. However, no study has compared the relative effectiveness of FM and HB conjoint analysis models in terms of fit, prediction, and parameter recovery. To conduct such a comparison, the authors employ the simulation methodology proposed by Vriens, Wedel, and Wilms with some modification. The authors estimate traditional individual-level conjoint models as well. The authors show that FM and HB models are equally effective in recovering individual-level parameters and predicting ratings of holdout profiles. Two surprising findings are that (1) HB performs well even when partworths come from a mixture of distributions and (2) FM produces good parameter estimates, even at the individual level. The authors show that both models are quite robust to violations of underlying assumptions and that traditional individual-level models overfit the data.",0 +https://doi.org/10.1111/j.1745-3984.2001.tb01117.x,Item Analysis by the Hierarchical Generalized Linear Model,"The hierarchical generalized linear model (HGLM) is presented as an explicit, two-level formulation of a multilevel item response model. In this paper, it is shown that the HGLM is equivalent to the Rasch model and that, characteristic of the HGLM, person ability can be expressed in the form of random effects rather than parameters. The two-level item analysis model is presented as a latent regression model with person-characteristic variables. Furthermore, it is shown that the two-level HGLM model can be extended to a three-level latent regression model that permits investigation of the variation of students' performance across groups, such as is found in classrooms and schools, and of the interactive effect of person-and group-characteristic variables.",0 +https://doi.org/10.1016/0169-2607(96)01723-3,MIXREG: a computer program for mixed-effects regression analysis with autocorrelated errors,"MIXREG is a program that provides estimates for a mixed-effects regression model (MRM) for normally-distributed response data including autocorrelated errors. This model can be used for analysis of unbalanced longitudinal data, where individuals may be measured at a different number of timepoints, or even at different timepoints. Autocorrelated errors of a general form or following an AR(1), MA(1), or ARMA(1,1) form are allowable. This model can also be used for analysis of clustered data, where the mixed-effects model assumes data within clusters are dependent. The degree of dependency is estimated jointly with estimates of the usual model parameters, thus adjusting for clustering. MIXREG uses maximum marginal likelihood estimation, utilizing both the EM algorithm and a Fisher-scoring solution. For the scoring solution, the covariance matrix of the random effects is expressed in its Gaussian decomposition, and the diagonal matrix reparameterized using the exponential transformation. Estimation of the individual random effects is accomplished using an empirical Bayes approach. Examples illustrating usage and features of MIXREG are provided.",0 +https://doi.org/10.1002/1099-0992(200007/08)30:4<533::aid-ejsp6>3.0.co;2-f,Self-schemas and the theory of planned behaviour,"This paper argues that empirical, conceptual, and statistical difficulties characterise previous demonstrations that self-schemas moderate the relationship between intentions and behaviour. A longitudinal study (n=163) was designed to overcome limitations of previous research. Theory of planned behaviour variables, past behaviour, and self-schemas were assessed in relation to exercise. Behaviour was followed up two weeks later. Findings showed that self-schemas moderated the intention–behaviour relation such that schematics were more likely to enact their intentions to exercise compared to unschematics. Evidence suggested that the importance dimension of self-schema measures was responsible for the moderator effect. Self-schemas were also associated with improved prediction of behavioural intentions after controlling for the other predictors. Copyright © 2000 John Wiley & Sons, Ltd.",0 +https://doi.org/10.2307/2971733,Matching As An Econometric Evaluation Estimator: Evidence from Evaluating a Job Training Programme,"This paper considers whether it is possible to devise a nonexperimental procedure for evaluating a prototypical job training programme. Using rich nonexperimental data, we examine the performance of a two-stage evaluation methodology that (a) estimates the probability that a person participates in a programme and (b) uses the estimated probability in extensions of the classical method of matching. We decompose the conventional measure of programme evaluation bias into several components and find that bias due to selection on unobservables, commonly called selection bias in econometrics, is empirically less important than other components, although it is still a sizeable fraction of the estimated programme impact. Matching methods applied to comparison groups located in the same labour markets as participants and administered the same questionnaire eliminate much of the bias as conventionally measured, but the remaining bias is a considerable fraction of experimentally-determined programme impact estimates. We test and reject the identifying assumptions that justify the classical method of matching. We present a nonparametric conditional difference-in-differences extension of the method of matching that is consistent with the classical index-sufficient sample selection model and is not rejected by our tests of identifying assumptions. This estimator is effective in eliminating bias, especially when it is due to temporally-invariant omitted variables.",0 +https://doi.org/10.1002/jrsm.1103,Bayesian network meta-analysis for unordered categorical outcomes with incomplete data,"We develop a Bayesian multinomial network meta-analysis model for unordered (nominal) categorical outcomes that allows for partially observed data in which exact event counts may not be known for each category. This model properly accounts for correlations of counts in mutually exclusive categories and enables proper comparison and ranking of treatment effects across multiple treatments and multiple outcome categories. We apply the model to analyze 17 trials, each of which compares two of three treatments (high and low dose statins and standard care/control) for three outcomes for which data are complete: cardiovascular death, non-cardiovascular death and no death. We also analyze the cardiovascular death category divided into the three subcategories (coronary heart disease, stroke and other cardiovascular diseases) that are not completely observed. The multinomial and network representations show that high dose statins are effective in reducing the risk of cardiovascular disease.",0 +https://doi.org/10.1177/0146621610370152,A Method for the Comparison of Item Selection Rules in Computerized Adaptive Testing,"In a typical study comparing the relative efficiency of two item selection rules in computerized adaptive testing, the common result is that they simultaneously differ in accuracy and security, making it difficult to reach a conclusion on which is the more appropriate rule. This study proposes a strategy to conduct a global comparison of two or more selection rules. A plot showing the performance of each selection rule for several maximum exposure rates is obtained and the whole plot is compared with other rule plots. The strategy was applied in a simulation study with fixed-length CATs for the comparison of six item selection rules: the point Fisher information, Fisher information weighted by likelihood, Kullback-Leibler weighted by likelihood, maximum information stratification with blocking, progressive and proportional methods. Our results show that there is no optimal rule for any overlap value or root mean square error (RMSE). The fact that a rule, for a given level of overlap, has lower RMSE than another does not imply that this pattern holds for another overlap rate. A fair comparison of the rules requires extensive manipulation of the maximum exposure rates. The best methods were the Kullback-Leibler weighted by likelihood, the proportional method, and the maximum information stratification method with blocking.",0 +https://doi.org/10.1186/s12874-015-0007-0,Network meta-analysis combining individual patient and aggregate data from a mixture of study designs with an application to pulmonary arterial hypertension,"BackgroundNetwork meta-analysis (NMA) is a methodology for indirectly comparing, and strengthening direct comparisons of two or more treatments for the management of disease by combining evidence from multiple studies. It is sometimes not possible to perform treatment comparisons as evidence networks restricted to randomized controlled trials (RCTs) may be disconnected. We propose a Bayesian NMA model that allows to include single-arm, before-and-after, observational studies to complete these disconnected networks. We illustrate the method with an indirect comparison of treatments for pulmonary arterial hypertension (PAH).MethodsOur method uses a random effects model for placebo improvements to include single-arm observational studies into a general NMA. Building on recent research for binary outcomes, we develop a covariate-adjusted continuous-outcome NMA model that combines individual patient data (IPD) and aggregate data from two-arm RCTs with the single-arm observational studies. We apply this model to a complex comparison of therapies for PAH combining IPD from a phase-III RCT of imatinib as add-on therapy for PAH and aggregate data from RCTs and single-arm observational studies, both identified by a systematic review.ResultsThrough the inclusion of observational studies, our method allowed the comparison of imatinib as add-on therapy for PAH with other treatments. This comparison had not been previously possible due to the limited RCT evidence available. However, the credible intervals of our posterior estimates were wide so the overall results were inconclusive. The comparison should be treated as exploratory and should not be used to guide clinical practice.ConclusionsOur method for the inclusion of single-arm observational studies allows the performance of indirect comparisons that had previously not been possible due to incomplete networks composed solely of available RCTs. We also built on many recent innovations to enable researchers to use both aggregate data and IPD. This method could be used in similar situations where treatment comparisons have not been possible due to restrictions to RCT evidence and where a mixture of aggregate data and IPD are available.",0 +https://doi.org/10.3758/bf03194552,"Measuring, estimating, and understanding the psychometric function: A commentary","The psychometric function, relating the subject's response to the physical stimulus, is fundamental to psychophysics. This paper examines various psychometric function topics, many inspired by this special symposium issue of Perception & Psychophysics: What are the relative merits of objective yes/no versus forced choice tasks (including threshold variance)? What are the relative merits of adaptive versus constant stimuli methods? What are the relative merits of likelihood versus up-down staircase adaptive methods? Is 2AFC free of substantial bias? Is there no efficient adaptive method for objective yes/no tasks? Should adaptive methods aim for 90% correct? Can adding more responses to forced choice and objective yes/no tasks reduce the threshold variance? What is the best way to deal with lapses? How is the Weibull function intimately related to the d' function? What causes bias in the likelihood goodness-of-fit? What causes bias in slope estimates from adaptive methods? How good are nonparametric methods for estimating psychometric function parameters? Of what value is the psychometric function slope? How are various psychometric functions related to each other? The resolution of many of these issues is surprising.",0 +,An analysis of the costs of treating schizophrenia in Spain: a hierarchical Bayesian approach.,"Health care decisions should incorporate cost of illness and treatment data, particularly for disorders such as schizophrenia with a high morbidity rate and a disproportionately low allocation of resources. Previous cost of illness analyses may have disregarded geographical aspects relevant for resource consumption and unit cost calculation.To compare the utilisation of resources and the care costs of schizophrenic patients in four mental-health districts in Spain (in Madrid, Catalonia, Navarra and Andalusia), and to analyse factors that determine the costs and the differences between areas.A treated prevalence bottom-up three year follow-up design was used for obtaining data concerning socio-demography, clinical evolution and the utilisation of services. 1997 reference prices were updated for years 1998-2000 in euros. We propose two different scenarios, varying in the prices applied. In the first (Scenario 0) the reference prices are those obtained for a single geographic area, and so the cost variations are only due to differences in the use of resources. In the second situation (Scenario 1), we analyse the variations in resource utilisation at different levels, using the prices applicable to each healthcare area. Bayesian hierarchical models are used to discuss the factors that determine such costs and the differences between geographic areas.In scenario 0, the estimated mean cost was 4918.948 euros for the first year. In scenario 1 the highest cost was in Gava (Catalonia) and the lowest in Loja (Andalusia). Mean costs were respectively 4547.24 and 2473.98 euros. With respect to the evolution of costs over time, we observed an increase during the second year and a reduction during the third year. Geographical differences appeared in follow-up costs. The variables related to lower treatment costs were: residence in the family household, higher patient age and being in work. On the contrary, the number of relapses is directly related to higher treatment costs. No differences were observed between health areas concerning resource utilisation.Calculating the costs of a given disease involves two principal factors: the resource utilisation and the prices. In most studies, emphasis is placed on the analysis of resource utilisation. Other evaluations, however, have recognized the implications of incorporating different prices into the final results. In this study we show both scenarios. The factors that determine the cost of schizophrenia for the Spanish case are similar to the factors encountered in studies carried out in other countries.Treatment costs may be reduced by the prevention of psychotic symptoms and relapse.The use of the same price data in multicentre studies may not be realistic. More effort should be made to obtain price data from all the centres or countries participating in a study. In the present study, only direct healthcare and social costs have been included. Future research should consider informal and indirect costs.",0 +https://doi.org/10.1093/aje/kwm167,Joint Effects of the N-Acetyltransferase 1 and 2 (NAT1 and NAT2) Genes and Smoking on Bladder Carcinogenesis: A Literature-based Systematic HuGE Review and Evidence Synthesis,"Bladder cancer is an increasingly important international public health problem, with over 330,000 new cases being diagnosed each year worldwide. In a systematic review and evidence synthesis, the authors investigated the joint effects of the N-acetyltransferase genes NAT1 and NAT2 and cigarette smoking on bladder carcinogenesis. Studies were identified through an exhaustive search of multiple electronic databases and reference lists and through direct contact with study authors and experts. Random-effects meta-analysis was used within a Bayesian framework to investigate individual effects of NAT1 and NAT2 acetylation status on bladder cancer risk, while a novel approach was used to investigate joint effects of these two genes with cigarette smoking. An increased risk of bladder cancer was found in NAT2 slow acetylators (odds ratio = 1.46, 95% credible interval (CI): 1.26, 1.68) but not in NAT1 fast acetylators (odds ratio = 1.01, 95% CI: 0.86, 1.22). The joint effects in the highest risk category (NAT2 slow acetylator, NAT1 fast acetylator, and current or ever cigarette smoking) as compared with the reference category (NAT2 fast acetylator, NAT1 slow acetylator, and never smoking) were associated with an odds ratio of 2.73 (95% CI: 1.70, 4.31). The importance of considering joint effects between genetic and environmental factors in the etiology of common complex diseases is underlined.",0 +https://doi.org/10.4324/9780203864746,Statistical Methods for Modeling Human Dynamics,,0 +https://doi.org/10.1080/09540129850124460,"The effects of establishment practices, knowledge and attitudes on condom use among Filipina sex workers","The findings for a baseline assessment for a community-based HIV/STD prevention intervention for commercial sex workers (CSWs) and managers of the establishments that employ them in the Philippines is presented in this study. CSW knowledge, attitudes, behaviours and establishment policies concerning HIV prevention were assessed. Baseline assessments are part of an iterative process that will be used to modify the planned intervention. The preliminary findings point to the importance of an intervention that stresses changes in establishment policies and expectations as a means of reducing risk behaviours associated with HIV/STD transmission.As of May 1996, 1025 HIV-infected individuals had been identified in the Philippines, 260 of whom had AIDS. However, in the Philippines' total population of 65 million, approximately 18,000 adults are estimated to carry HIV. Unprotected sex and multiple partners place prostitutes at risk of contracting and transmitting HIV and other STDs. There are 65,000 registered prostitutes and 200,000 or more freelance sex workers in the Philippines. 1394 registered prostitutes, of whom 98.6% were female, were recruited from commercial sex work establishments in 4 sites about 400 miles from Manila for participation in a study assessing prostitutes' knowledge, attitudes, behaviors, and establishment policies concerning HIV prevention. The participants were aged 15-54 of mean age 23.5 years. Establishment policies and practices appear to be more important than prostitutes' knowledge of HIV transmission or their attitudes toward condoms. Any intervention to prevent HIV/STD among prostitutes in the Philippines should therefore consider and possibly target sex work establishments' policies.",0 +https://doi.org/10.1111/j.1541-0420.2007.00806.x,Penalized Item Response Theory Models: Application to Epigenetic Alterations in Bladder Cancer,"Increasingly used in health-related applications, latent variable models provide an appealing framework for handling high-dimensional exposure and response data. Item response theory (IRT) models, which have gained widespread popularity, were originally developed for use in the context of educational testing, where extremely large sample sizes permitted the estimation of a moderate-to-large number of parameters. In the context of public health applications, smaller sample sizes preclude large parameter spaces. Therefore, we propose a penalized likelihood approach to reduce mean square error and improve numerical stability. We present a continuous family of models, indexed by a tuning parameter, that range between the Rasch model and the IRT model. The tuning parameter is selected by cross validation or approximations such as Akaike Information Criterion. While our approach can be placed easily in a Bayesian context, we find that our frequentist approach is more computationally efficient. We demonstrate our methodology on a study of methylation silencing of gene expression in bladder tumors. We obtain similar results using both frequentist and Bayesian approaches, although the frequentist approach is less computationally demanding. In particular, we find high correlation of methylation silencing among 16 loci in bladder tumors, that methylation is associated with smoking and also with patient survival.",0 +https://doi.org/10.1080/19345747.2011.618213,Why We (Usually) Don't Have to Worry About Multiple Comparisons,"Abstract Applied researchers often find themselves making statistical inferences in settings that would seem to require multiple comparisons adjustments. We challenge the Type I error paradigm that underlies these corrections. Moreover we posit that the problem of multiple comparisons can disappear entirely when viewed from a hierarchical Bayesian perspective. We propose building multilevel models in the settings where multiple comparisons arise. Multilevel models perform partial pooling (shifting estimates toward each other), whereas classical procedures typically keep the centers of intervals stationary, adjusting for multiple comparisons by making the intervals wider (or, equivalently, adjusting the p values corresponding to intervals of fixed width). Thus, multilevel models address the multiple comparisons problem and also yield more efficient estimates, especially in settings with low group-level variation, which is where multiple comparisons are a particular concern.",0 +https://doi.org/10.1145/2422105.2422109,Sound sample detection and numerosity estimation using auditory display,"This article investigates the effect of various design parameters of auditory information display on user performance in two basic information retrieval tasks. We conducted a user test with 22 participants in which sets of sound samples were presented. In the first task, the test participants were asked to detect a given sample among a set of samples. In the second task, the test participants were asked to estimate the relative number of instances of a given sample in two sets of samples. We found that the stimulus onset asynchrony (SOA) of the sound samples had a significant effect on user performance in both tasks. For the sample detection task, the average error rate was about 10% with an SOA of 100 ms. For the numerosity estimation task, an SOA of at least 200 ms was necessary to yield average error rates lower than 30%. Other parameters, including the samples' sound type (synthesized speech or earcons) and spatial quality (multichannel loudspeaker or diotic headphone playback), had no substantial effect on user performance. These results suggest that diotic, or indeed monophonic, playback with appropriately chosen SOA may be sufficient in practical applications for users to perform the given information retrieval tasks, if information about the sample location is not relevant. If location information was provided through spatial playback of the samples, test subjects were able to simultaneously detect and localize a sample with reasonable accuracy.",0 +https://doi.org/10.1177/0146621606290248,A Comparison of Methods for Nonparametric Estimation of Item Characteristic Curves for Binary Items,"This study compares the performance of three nonparametric item characteristic curve (ICC) estimation procedures: isotonic regression, smoothed isotonic regression, and kernel smoothing. Smoothed isotonic regression, employed along with an appropriate kernel function, provides better estimates and also satisfies the assumption of strict monotonicity. As the number of items and the sample size increase, the kernel smoothing and smoothed isotonic regression ICC estimation procedures yield similar results across all conditions.",0 +https://doi.org/10.1093/biomet/91.1.1,Bayesian correlation estimation,"We propose prior probability models for variance-covariance matrices in order to address two important issues. First, the models allow a researcher to represent substantive prior information about the strength of correlations among a set of variables. Secondly, even in the absence of such information, the increased flexibility of the models mitigates dependence on strict parametric assumptions in standard prior models. For example, the model allows a posteriori different levels of uncertainty about correlations among different subsets of variables. We achieve this by including a clustering mechanism in the prior probability model. Clustering is with respect to variables and pairs of variables. Our approach leads to shrinkage towards a mixture structure implied by the clustering. We discuss appropriate posterior simulation schemes to implement posterior inference in the proposed models, including the evaluation of normalising constants that are functions of parameters of interest. The normalising constants result from the restriction that the correlation matrix be positive definite. We discuss examples based on simulated data, a stock return dataset and a population genetics dataset.",0 +https://doi.org/10.1109/health.2011.6026776,Semantic models for ranking medical images using Dirichlet non-parametric mixture models,"With recent advances in diagnostic medical imaging, huge quantities of medical images are produced and stored in digital image repositories. While these repositories are difficult to be analyzed manually by medical experts, they can be evaluated using computer-based methods to enrich the process of decision making. For example, query by image methods can be used by medical experts for differential diagnosis by displaying previously evaluated cases that contain similar visual patterns. Also, less experienced practitioners can benefit from query-by-semantic methods in training processes especially for difficult-to-interpret cases with multiple pathologies. In this article we develop a methodology for ranking medical images based on Dirichlet process nonparametric distributions. Our approach uses natural groupings of images in a generated feature space to evaluate associative semantic mappings. Relevant semantic mappings are then used to generate additive computer models of semantic understanding of visual patterns found in images. We evaluate the performance of our method using mean average precision and precision-recall charts.",0 +https://doi.org/10.1167/11.12.1,Perceptual compression of visual space during eye-head gaze shifts,"In primates, inspection of a visual scene is typically interrupted by frequent gaze shifts, occurring at an average rate of three to five times per second. Perceptually, these gaze shifts are accompanied by a compression of visual space toward the saccade target, which may be attributed to an oculomotor signal that transiently influences visual processing. While previous studies of compression have focused exclusively on saccadic eye movements made with the head artificially immobilized, many brain structures involved in saccade generation also encode combined eye-head gaze shifts. Thus, in order to understand the interaction between gaze motor and visual signals, we studied perception during eye-head gaze shifts and found a powerful compression of visual space that was spatially directed toward the intended gaze (and not the eye movement) target location. This perceptual compression was nearly constant in duration across gaze shift amplitudes, suggesting that the signal that triggers compression is largely independent of the size and kinematics of the gaze shift. The spatial pattern of results could be captured by a model that involves interactions, on a logarithmic map of visual space, between two loci of neural activity that encode the gaze shift vector and visual stimulus position relative to the fovea.",0 +https://doi.org/10.1093/pan/mpi027,Introduction to the Special Issue,"The use of multilevel models—models in which lower-level (“micro”) units are nested within higher-level (“macro”) units—has blossomed recently in political science. Possible relationships in such models include macro variables influencing macro variables; micro variables influencing micro variables; macro variables influencing micro variables, and vice versa; and often most interestingly, micro-micro relationships varying interactively with macro variables. Most work in political science has drawn on the useful introductions of Raudenbush and Bryk (2002), Western (1998), and Steenbergen and Jones (2002). We refer readers to good general introductions/reviews of multi-level modeling in the articles in this issue by Bowers and Drake and by Franzese.",0 +https://doi.org/10.1177/0013164417709314,Evaluating Model Fit in Bayesian Confirmatory Factor Analysis With Large Samples: Simulation Study Introducing the BRMSEA,"Bayesian confirmatory factor analysis (CFA) offers an alternative to frequentist CFA based on, for example, maximum likelihood estimation for the assessment of reliability and validity of educational and psychological measures. For increasing sample sizes, however, the applicability of current fit statistics evaluating model fit within Bayesian CFA is limited. We propose, therefore, a Bayesian variant of the root mean square error of approximation (RMSEA), the BRMSEA. A simulation study was performed with variations in model misspecification, factor loading magnitude, number of indicators, number of factors, and sample size. This showed that the 90% posterior probability interval of the BRMSEA is valid for evaluating model fit in large samples ( N≥ 1,000), using cutoff values for the lower (<.05) and upper limit (<.08) as guideline. An empirical illustration further shows the advantage of the BRMSEA in large sample Bayesian CFA models. In conclusion, it can be stated that the BRMSEA is well suited to evaluate model fit in large sample Bayesian CFA models by taking sample size and model complexity into account.",0 +https://doi.org/10.1080/13636820.2012.727849,Value added as an indicator of educational effectiveness in Dutch senior secondary vocational education,"This study investigates the possibilities of estimating value added as a performance indicator in senior secondary vocational education. Value added is interesting in this context because it is considered as a reliable tool for comparing the effectiveness of educational institutions. Although value added indicators have been developed since the 1980s for both primary and secondary educations, the research on school effectiveness has largely neglected vocational education because of its complexity. For estimating value added in this study, data concerning almost 90,000 students in Dutch senior secondary vocational education are used. Factors such as ethnicity, living in problematic neighbourhoods and students’ prior educational attainment appear to be significant predictors of student outcomes. The results indicate considerable differences in the effectiveness among clusters of training programmes, whereas there are hardly any differences between the educational institutions. Of the total variance among th...",0 +https://doi.org/10.1016/j.jad.2009.11.010,Unveiling patterns of affective responses in daily life may improve outcome prediction in depression: A momentary assessment study,"Daily life affective responses are closely linked to vulnerability and resilience in depression. Prediction of future clinical course may be improved if information on daily life emotional response patterns is taken into account.Female subjects with a history of major depression (n=83), recruited from a population twin register, participated in a longitudinal study using momentary assessment technology with 4 follow-up measurements. The effect of baseline daily life emotional response patterns (affect variability, stress-sensitivity and reward experience) on follow-up depressive symptomatology was examined.Both reward experience (B=-0.30, p=0.001) and negative affect variability (B=0.46, p=0.001) predicted future negative affective symptoms independent of all other dynamic emotional patterns and conventional predictors.Daily life information on dynamic emotional patterns adds to the prediction of future clinical course, independent of severity of symptoms and neuroticism score. Better prediction of course may improve decision-making regarding quantitative and qualitative aspects of treatment.",0 +https://doi.org/10.3726/978-3-653-04521-5,Sociologies of Formality and Informality,status: publishe,0 +https://doi.org/10.1177/1471082x0800900301,Multilevel models with multivariate mixed response types,"We build upon the existing literature to formulate a class of models for multivariate mixtures of Gaussian, ordered or unordered categorical responses and continuous distributions that are not Gaussian, each of which can be defined at any level of a multilevel data hierarchy. We describe a Markov chain Monte Carlo algorithm for fitting such models. We show how this unifies a number of disparate problems, including partially observed data and missing data in generalized linear modelling. The two-level model is considered in detail with worked examples of applications to a prediction problem and to multiple imputation for missing data. We conclude with a discussion outlining possible extensions and connections in the literature. Software for estimating the models is freely available.",0 +https://doi.org/10.1007/s10928-012-9263-3,Combining patient-level and summary-level data for Alzheimer’s disease modeling and simulation: a beta regression meta-analysis,"Our objective was to develop a beta regression (BR) model to describe the longitudinal progression of the 11 item Alzheimer's disease (AD) assessment scale cognitive subscale (ADAS-cog) in AD patients in both natural history and randomized clinical trial settings, utilizing both individual patient and summary level literature data. Patient data from the coalition against major diseases database (3,223 patients), the Alzheimer's disease neruroimaging initiative study database (186 patients), and summary data from 73 literature references (representing 17,235 patients) were fit to a BR drug-disease-trial model. Treatment effects for currently available acetyl cholinesterase inhibitors, longitudinal changes in disease severity, dropout rate, placebo effect, and factors influencing these parameters were estimated in the model. Based on predictive checks and external validation, an adequate BR meta-analysis model for ADAS-cog using both summary-level and patient-level data was developed. Baseline ADAS-cog was estimated from baseline MMSE score. Disease progression was dependent on time, ApoE4 status, age, and gender. Study drop out was a function of time, baseline age, and baseline MMSE. The use of the BR constrained simulations to the 0-70 range of the ADAS-cog, even when residuals were incorporated. The model allows for simultaneous fitting of summary and patient level data, allowing for integration of all information available. A further advantage of the BR model is that i t constrains values to the range of the original instrument for simulation purposes, in contrast to methodologies that provide appropriate constraints only for conditional expectations. © Springer Science+Business Media, LLC 2012.",0 +https://doi.org/10.2307/2531248,Longitudinal Data Analysis for Discrete and Continuous Outcomes,"Longitudinal data sets are comprised of repeated observations of an outcome and a set of covariates for each of many subjects. One objective of statistical analysis is to describe the marginal expectation of the outcome variable as a function of the covariates while accounting for the correlation among the repeated observations for a given subject. This paper proposes a unifying approach to such analysis for a variety of discrete and continuous outcomes. A class of generalized estimating equations (GEEs) for the regression parameters is proposed. The equations are extensions of those used in quasi-likelihood (Wedderburn, 1974, Biometrika 61, 439-447) methods. The GEEs have solutions which are consistent and asymptotically Gaussian even when the time dependence is misspecified as we often expect. A consistent variance estimate is presented. We illustrate the use of the GEE approach with longitudinal data from a study of the effect of mothers' stress on children's morbidity.",0 +https://doi.org/10.1007/bf02294400,A general model for the analysis of multilevel data,"A general model is developed for the analysis of multivariate multilevel data structures. Special cases of the model include repeated measures designs, multiple matrix samples, multilevel latent variable models, multiple time series, and variance and covariance component models.",0 +https://doi.org/10.1093/carcin/bgq063,"Wheel running, skeletal muscle aerobic capacity and 1-methyl-1-nitrosourea induced mammary carcinogenesis in the rat","Emerging evidence indicates that intrinsic differences and induced changes in aerobic capacity are probably to play a critical role in the development of chronic diseases like cancer. This study was initiated: (i) to determine how citrate synthase activity, which is routinely used as a marker of aerobic capacity and mitochondrial density in skeletal muscle, was affected by voluntary running on either a motorized activity wheel or a non-motorized free wheel and (ii) to investigate the association between aerobic capacity and the carcinogenic response induced in the mammary gland by intraperitoneal injection of 1-methyl-1-nitrosurea. Overall, wheel running reduced cancer incidence (96 versus 72%, P = 0.0006) and the number of cancers per animal (2.84 versus 1.78, P < 0.0001) and induced citrate synthase activity (276 versus 353 U/mg, P < 0.0001, sedentary control versus wheel running,respectively). Both motorized and free wheel running increased citrate synthase activity (373 +/- 24, 329 +/- 11 and 276 +/- 9 U/mg protein, P < 0.0001) and reduced the average number of cancers per rat (2.84, 1.96 and 1.63, P < 0.01), sedentary control, free wheel and motorized wheel, respectively. However, regression analyses failed to provide evidence of a significant association between citrate synthase activity and either cancer incidence or cancer multiplicity. Citrate synthase activity is a single measure in a complex pathway that determines aerobic capacity. The multifaceted nature of intrinsic and inducible aerobic capacity limits the usefulness of citrate synthase activity alone in elucidating the relationship between aerobic capacity and the carcinogenic response.",0 +https://doi.org/10.1037/0021-9010.75.3.227,Operationalization of goal difficulty as a moderator of the goal difficulty-performance relationship.,"Examined the research studies cumulated in recent quantitative reviews of the relationship between goal difficulty and performance to determine how goal difficulty has been operationalized. 4 categories (assigned goal level, self-set goal level, performance improvement, and difficulty perceptions) of operationalization were discovered, and the operationalization of goal difficulty was tested as a moderator of the relationship between goal difficulty and performance",0 +https://doi.org/10.1186/1471-2288-12-64,Systematic review of methods used in meta-analyses where a primary outcome is an adverse or unintended event,"Abstract Background Adverse consequences of medical interventions are a source of concern, but clinical trials may lack power to detect elevated rates of such events, while observational studies have inherent limitations. Meta-analysis allows the combination of individual studies, which can increase power and provide stronger evidence relating to adverse events. However, meta-analysis of adverse events has associated methodological challenges. The aim of this study was to systematically identify and review the methodology used in meta-analyses where a primary outcome is an adverse or unintended event, following a therapeutic intervention. Methods Using a collection of reviews identified previously, 166 references including a meta-analysis were selected for review. At least one of the primary outcomes in each review was an adverse or unintended event. The nature of the intervention, source of funding, number of individual meta-analyses performed, number of primary studies included in the review, and use of meta-analytic methods were all recorded. Specific areas of interest relating to the methods used included the choice of outcome metric, methods of dealing with sparse events, heterogeneity, publication bias and use of individual patient data. Results The 166 included reviews were published between 1994 and 2006. Interventions included drugs and surgery among other interventions. Many of the references being reviewed included multiple meta-analyses with 44.6% (74/166) including more than ten. Randomised trials only were included in 42.2% of meta-analyses (70/166), observational studies only in 33.7% (56/166) and a mix of observational studies and trials in 15.7% (26/166). Sparse data, in the form of zero events in one or both arms where the outcome was a count of events, was found in 64 reviews of two-arm studies, of which 41 (64.1%) had zero events in both arms. Conclusions Meta-analyses of adverse events data are common and useful in terms of increasing the power to detect an association with an intervention, especially when the events are infrequent. However, with regard to existing meta-analyses, a wide variety of different methods have been employed, often with no evident rationale for using a particular approach. More specifically, the approach to dealing with zero events varies, and guidelines on this issue would be desirable.",0 +https://doi.org/10.1177/0020852314563899,"Extrinsic motivation, PSM and labour market characteristics: a multilevel model of public sector employment preference in 26 countries","Research findings have been contradictory with respect to the determinants of why people choose a public sector job. In this article we use an internationally comparative design with data from 26 countries to explain public sector employment preference. The study shows that on the individual level, public service motivation and extrinsic motivation are both important drivers for this preference. Intrinsic motivation, in turn, is negatively related to people’s inclination to work for the public sector. Moreover, having a lower income and lower education is associated with a greater preference for public sector employment. This suggests that working for the public sector is seen as a good and safe career option. Our results furthermore show that variation in this preference can only partly be explained by country differences. Nevertheless, in countries with a career- rather than position-based system of public employment, people are more likely to prefer public employment. Points for practitioners Attracting the best and brightest to work for the public sector requires an insight into why people prefer public over private sector employment. This article looks at what makes people prefer public sector employment in 26 countries. Findings reveal that public service motivation (helping other people, being useful to society) and extrinsic motives (job security, a high income, opportunities for advancement) play an important role in this preference. Still, there are considerable differences between countries. In countries with a career-based system of public employment, working in the public sector is seen as more attractive.",0 +https://doi.org/10.1002/sim.1091,Approaches to heterogeneity in meta-analysis,"This paper reviews publications from January 1999 to March 2001 on reproductive health topics that were self-identified as meta-analysis or were indexed as meta-analysis in MEDLINE. It sought to assess whether tests of statistical heterogeneity were done, whether the results were reported, and how a finding of significance for a test of statistical heterogeneity was handled and the results interpreted. The review identified some concerns. Tests of statistical heterogeneity were not done universally even though virtually all writers on the topic emphasize their importance. Even when done, results of these tests were not universally reported. Although the consensus appears to be that heterogeneity tests are conservative for meta-analysis of studies and a probability value of 0.10 is preferred, many meta-analyses used the conventional value of 0.05 without providing a reason. The rationale for the choice of a random or fixed effects model was not generally evident. The review also provided some positive models and some recommendations for assessing, reporting and exploring heterogeneity are made considering these models and the published recommendations of experts.",0 +https://doi.org/10.1002/9781119942986,Evidence Synthesis for Decision Making in Healthcare,"In the evaluation of healthcare, rigorous methods of quantitative assessment are necessary to establish interventions that are both effective and cost-effective. Usually a single study will not fully address these issues and it is desirable to synthesize evidence from multiple sources. This book aims to provide a practical guide to evidence synthesis for the purpose of decision making, starting with a simple single parameter model, where all studies estimate the same quantity (pairwise meta-analysis) and progressing to more complex multi-parameter structures (including meta-regression, mixed treatment comparisons, Markov models of disease progression, and epidemiology models). A comprehensive, coherent framework is adopted and estimated using Bayesian methods. Key features: A coherent approach to evidence synthesis from multiple sources. Focus is given to Bayesian methods for evidence synthesis that can be integrated within cost-effectiveness analyses in a probabilistic framework using Markov Chain Monte Carlo simulation. Provides methods to statistically combine evidence from a range of evidence structures. Emphasizes the importance of model critique and checking for evidence consistency. Presents numerous worked examples, exercises and solutions drawn from a variety of medical disciplines throughout the book. WinBUGS code is provided for all examples. Evidence Synthesis for Decision Making in Healthcare is intended for health economists, decision modelers, statisticians and others involved in evidence synthesis, health technology assessment, and economic evaluation of health technologies. © 2012 John Wiley & Sons, Ltd. All rights reserved.",0 +https://doi.org/10.1177/0735633115620432,Preservice Teachers and Self-Assessing Digital Competence,"This study compares matched surveys of subjective self-assessment and objective assessment on seven domains of digital competence for preservice teachers at a large Southwest public university. The results, consistent with earlier studies, confirm that the participating preservice teachers inaccurately self-assessed their digital competence. The study concluded that subjective self-assessment lacks appropriate validity and is not an accurate stand-alone predictor of digital competence among preservice teachers. However, if considered in conjunction with other means, self-assessment may prove to be useful for preservice teachers to aid in their reflection of their competence, skills, and knowledge and to aid them in adjusting their perceptions and attitudes regarding technology throughout their professional practice. In addition, self-assessment in conjunction with other means may assist teacher educators in providing opportunities to improve the competence in teacher training programs.",0 +https://doi.org/10.2307/2531694,Estimation and comparison of Changes in the Presence of Informative Right Censoring: Conditional Linear Model,"A general linear regression model for the usual least squares estimated rate of change (slope) on censoring time is described as an approximation to account for informative right censoring in estimating and comparing changes of a continuous variable in two groups. Two noniterative estimators for the group slope means, the linear minimum variance unbiased (LMVUB) estimator and the linear minimum mean squared error (LMMSE) estimator, are proposed under this conditional model. In realistic situations, we illustrate that the LMVUB and LMMSE estimators, derived under a simple linear regression model, are quite competitive compared to the pseudo maximum likelihood estimator (PMLE) derived by modeling the censoring probabilities. Generalizations to polynomial response curves and general linear models are also described.",0 +https://doi.org/10.1177/0011392115589599,"Recent development of propensity score methods in observational studies: Multi-categorical treatment, causal mediation, and heterogeneity","This article reviews and comments on three major expansions of propensity score methods in recent decades. First, how to use generalized propensity scores to tackle multi-categorical or continuous treatment variables is shown in procedures of propensity score regression adjustment and propensity score weighting. Second, the counterfactual framework of causal inference in the analysis of mediation mechanisms is reviewed and the decomposition of the causal relationship between variables into causal direct effects and causal indirect effects is illustrated. Third, the heterogeneous treatment effect across the distribution of propensity score values is discussed in the framework of the stratification-multilevel model. For each methodological breakthrough, this article comments on potential issues which deserve serious attention in the practical application of these methods.",0 +https://doi.org/10.1086/209277,State versus Action Orientation and the Theory of Reasoned Action: An Application to Coupon Usage,"This article investigates how the individual difference variable of state versus action orientation moderates the pattern of relationships among constructs in the theory of reasoned action. State orientation refers to a low capacity for the enactment of action-related mental structures, whereas action orientation refers to a high capacity for this type of enactment. A field study was conducted in the context of consumers' self-reported usage of coupons for grocery shopping. The results showed that state versus action orientation moderates the relative importance of determinants of intentions; specifically, subjective norms become more important as people become state oriented, whereas the relative importance of attitudes increases as people become action oriented. In addition, the study showed that past behavior is a determinant of intentions to use coupons.",0 +https://doi.org/10.1007/s11109-011-9164-y,Does Satisfaction with Democracy Really Increase Happiness? Direct Democracy and Individual Satisfaction in Switzerland,"This paper takes the influential “direct democracy makes people happy”-research as a starting point and asks whether direct democracy impacts individual satisfaction. Unlike former studies we distinguish two aspects of individual satisfaction, namely satisfaction with life (“happiness”) and with how democracy works. Based on multilevel analysis of the 26 Swiss cantons we show that the theoretical assumption on which the happiness hypothesis is based has to be questioned, as there is very little evidence for a robust relationship between satisfaction with democracy and life satisfaction. Furthermore, we do not find a substantive positive effect of direct democracy on happiness. However, with respect to satisfaction with democracy, our analysis shows some evidence for a procedural effect of direct democracy, i.e. positive effects related to using direct democratic rights, rather than these rights per se.",0 +https://doi.org/10.1177/0170840603024003910,Corporate Social and Financial Performance: A Meta-Analysis,"Most theorizing on the relationship between corporate social/environmental performance (CSP) and corporate financial performance (CFP) assumes that the current evidence is too fractured or too variable to draw any generalizable conclusions. With this integrative, quantitative study, we intend to show that the mainstream claim that we have little generalizable knowledge about CSP and CFP is built on shaky grounds. Providing a methodologically more rigorous review than previous efforts, we conduct a meta-analysis of 52 studies (which represent the population of prior quantitative inquiry) yielding a total sample size of 33,878 observations. The meta-analytic findings suggest that corporate virtue in the form of social responsibility and, to a lesser extent, environmental responsibility is likely to pay off, although the operationalizations of CSP and CFP also moderate the positive association. For example, CSP appears to be more highly correlated with accounting-based measures of CFP than with market-based indicators, and CSP reputation indices are more highly correlated with CFP than are other indicators of CSP. This meta-analysis establishes a greater degree of certainty with respect to the CSP-CFP relationship than is currently assumed to exist by many business scholars.",0 +https://doi.org/10.1016/j.pain.2014.04.017,Relationship satisfaction moderates the associations between male partner responses and depression in women with vulvodynia: A dyadic daily experience study,"Abstract Vulvodynia is a prevalent vulvovaginal pain condition that interferes with women’s psychological health. Given the central role of sexuality and relationships in vulvodynia, relationship satisfaction may be an important moderator of daily partner responses to this pain and associated negative sequelae, such as depression. Sixty-nine women (M age = 28.12 years, SD = 6.68) with vulvodynia and their cohabiting partners (M age = 29.67 years, SD = 8.10) reported their daily relationship satisfaction, and male partner responses on sexual intercourse days (M = 3.74, SD = 2.47) over 8 weeks. Women also reported their depressive symptoms. Relationship satisfaction on the preceding day moderated the associations between partner responses and women’s depressive symptoms in several significant ways: (1) On days after women reported higher relationship satisfaction than usual, their perception of greater facilitative male partner responses was associated with their decreased depression; (2) on days after women reported lower relationship satisfaction than usual, their perception of greater negative male partner responses was associated with their increased depression; (3) on days after men reported higher relationship satisfaction than usual, their self-reported higher negative responses were associated with decreased women’s depression, and higher solicitous responses were associated with increased women’s depression, whereas (4) on days after men reported lower relationship satisfaction than usual, their self-reported higher negative responses were related to increased women’s depression, and higher solicitous responses were associated with decreased women’s depression. Targeting partner responses and relationship satisfaction may enhance the quality of interventions aimed at reducing depression in women with vulvodynia.",0 +https://doi.org/10.1111/1475-6765.12096,"Authoritarianism, socioethnic diversity and political participation across countries","It is argued in this article that threatening stimuli affect political participation levels among non-authoritarians more than among authoritarians. Focusing on socioethnic diversity, which is known to be particularly threatening to authoritarians and to relate negatively to political participation in the general public, analyses of individual- and macro-level data from 53 countries is presented which supports this thesis. Participation levels among authoritarians are largely static, regardless of a country's level of socioethnic heterogeneity, while non-authoritarians participate considerably less in countries with relatively high levels of socioethnic heterogeneity. This suggests that authoritarians participate to a proportionately greater degree in the most diverse countries.",0 +https://doi.org/10.1111/j.1745-3984.1990.tb00738.x,Parameter Recovery in the Graded Response Model Using MULTILOG,"The graded response model can be used to describe test-taking behavior when item responses are classified into ordered categories. In this study, parameter recovery in the graded response model was investigated using the MULTILOG computer program under default conditions. Based on items having five response categories, 36 simulated data sets were generated that varied on true θ distribution, true item discrimination distribution, and calibration sample size. The findings suggest, first, the correlations between the true and estimated parameters were consistently greater than 0.85 with sample sizes of at least 500. Second, the root mean square error differences between true and estimated parameters were comparable with results from binary data parameter recovery studies. Of special note was the finding that the calibration sample size had little influence on the recovery of the true ability parameter but did influence item-parameter recovery. Therefore, it appeared that item-parameter estimation error, due to small calibration samples, did not result in poor person-parameter estimation. It was concluded that at least 500 examinees are needed to achieve an adequate calibration under the graded model.",0 +https://doi.org/10.1093/biomet/88.4.987,"Hierarchical generalised linear models: A synthesis of generalised linear models, random-effect models and structured dispersions","SUMMARY Hierarchical generalised linear models are developed as a synthesis of generalised linear models, mixed linear models and structured dispersions. We generalise the restricted maximum likelihood method for the estimation of dispersion to the wider class and show how the joint fitting of models for mean and dispersion can be expressed by two interconnected generalised linear models. The method allows models with (i) any combination of a generalised linear model distribution for the response with any conjugate distribution for the random effects, (ii) structured dispersion components, (iii) different link and variance functions for the fixed and random effects, and (iv) the use of quasilikelihoods in place of likelihoods for either or both of the mean and dispersion models. Inferences can be made by applying standard procedures, in particular those for model checking, to components of either generalised linear model. We also show by numerical studies that the new method gives an efficient estimation procedure for substantial class of models of practical importance. Likelihood-type inference is extended to this wide class of models in a unified way.",0 +https://doi.org/10.1186/1471-2288-14-92,Network meta-analysis of multiple outcome measures accounting for borrowing of information across outcomes,"BackgroundNetwork meta-analysis (NMA) enables simultaneous comparison of multiple treatments while preserving randomisation. When summarising evidence to inform an economic evaluation, it is important that the analysis accurately reflects the dependency structure within the data, as correlations between outcomes may have implication for estimating the net benefit associated with treatment. A multivariate NMA offers a framework for evaluating multiple treatments across multiple outcome measures while accounting for the correlation structure between outcomes.MethodsThe standard NMA model is extended to multiple outcome settings in two stages. In the first stage, information is borrowed across outcomes as well across studies through modelling the within-study and between-study correlation structure. In the second stage, we make use of the additional assumption that intervention effects are exchangeable between outcomes to predict effect estimates for all outcomes, including effect estimates on outcomes where evidence is either sparse or the treatment had not been considered by any one of the studies included in the analysis. We apply the methods to binary outcome data from a systematic review evaluating the effectiveness of nine home safety interventions on uptake of three poisoning prevention practices (safe storage of medicines, safe storage of other household products, and possession of poison centre control telephone number) in households with children. Analyses are conducted in WinBUGS using Markov Chain Monte Carlo (MCMC) simulations.ResultsUnivariate and the first stage multivariate models produced broadly similar point estimates of intervention effects but the uncertainty around the multivariate estimates varied depending on the prior distribution specified for the between-study covariance structure. The second stage multivariate analyses produced more precise effect estimates while enabling intervention effects to be predicted for all outcomes, including intervention effects on outcomes not directly considered by the studies included in the analysis.ConclusionsAccounting for the dependency between outcomes in a multivariate meta-analysis may or may not improve the precision of effect estimates from a network meta-analysis compared to analysing each outcome separately.",0 +https://doi.org/10.1080/00273171.2014.973990,Iteration of Partially Specified Target Matrices: Applications in Exploratory and Bayesian Confirmatory Factor Analysis,"We describe and evaluate a factor rotation algorithm, iterated target rotation (ITR). Whereas target rotation (Browne, 2001) requires a user to specify a target matrix a priori based on theory or prior research, ITR begins with a standard analytic factor rotation (i.e., an empirically informed target) followed by an iterative search procedure to update the target matrix. In Study 1, Monte Carlo simulations were conducted to evaluate the performance of ITR relative to analytic rotations from the Crawford-Ferguson family with population factor structures varying in complexity. Simulation results: (a) suggested that ITR analyses will be particularly useful when evaluating data with complex structures (i.e., multiple cross-loadings) and (b) showed that the rotation method used to define an initial target matrix did not materially affect the accuracy of the various ITRs. In Study 2, we: (a) demonstrated the application of ITR as a way to determine empirically informed priors in a Bayesian confirmatory factor analysis (BCFA; Muthén & Asparouhov, 2012) of a rater-report alexithymia measure (Haviland, Warren, & Riggs, 2000) and (b) highlighted some of the challenges when specifying empirically based priors and assessing item and overall model fit.",0 +https://doi.org/10.1016/s0167-9473(03)00149-x,Piecewise growth curve modeling approach for longitudinal prevention study,"Abstract Conventional growth curve modeling typically involves a single growth profile to represent changes in an outcome variable across time. This study applies an alternative growth curve model with multiple profiles to incorporate multiple developmental stages from which longitudinal data have been obtained. Identifying and modeling the multiple transitional stages involved in repeated measures are both theoretically and empirically important in longitudinal study. A longitudinal data set obtained from a substance use prevention study was used as an example to illustrate this application. The data contained a total of 50 junior high schools (23 control and 27 program schools) observed for seven waves crossing junior high school and high school stages, with the prevalence rate of monthly cigarette use as the outcome measure. Comparisons showed that the piecewise growth curve models incorporating multiple stages demonstrated significant improvement on model fitting compared to the single-piece growth curve model. Results showed marginal prevention effects in the junior high school stage but not in the high school stage. Piecewise growth curve models offer more both substantively and analytically appropriate model specification and flexibility in incorporating transitional periods in studying changes across time.",0 +https://doi.org/10.1177/0146167215610520,The Double-Edged Sword of Genetic Accounts of Criminality,"Much debate exists surrounding the applicability of genetic information in the courtroom, making the psychological processes underlying how people consider this information important to explore. This article addresses how people think about different kinds of causal explanations in legal decision-making contexts. Three studies involving a total of 600 Mechanical Turk and university participants found that genetic, versus environmental, explanations of criminal behavior lead people to view the applicability of various defense claims differently, perceive the perpetrator's mental state differently, and draw different causal attributions. Moreover, mediation and path analyses highlight the double-edged nature of genetic attributions-they simultaneously reduce people's perception of the perpetrator's sense of control while increasing people's tendencies to attribute the cause to internal factors and to expect the perpetrator to reoffend. These countervailing relations, in turn, predict sentencing in opposite directions, although no overall differences in sentencing or ultimate verdicts were found.",0 +https://doi.org/10.1080/00223891.2015.1044604,Conceptualizing and Measuring Self-Criticism as Both a Personality Trait and a Personality State,"Blatt's ( 2004 , 2008 ) conceptualization of self-criticism is consistent with a state-trait model that postulates meaningful variation in self-criticism both between persons (traits) and within person (states). We tested the state-trait model in a 7-day diary study with 99 college student participants. Each evening they completed a 6-item measure of self-criticism, as well as measures of perceived social support, positive and negative affect, compassionate and self-image goals during interactions with others, and interpersonal behavior, including overt self-criticism and given social support. As predicted, self-criticism displayed both trait-like variance between persons and daily fluctuations around individuals' mean scores for the week; slightly more than half of the total variance was between persons (ICC = .56). Numerous associations at both the between-persons and within-person levels were found between self-criticism and the other variables, indicating that individuals' mean levels of self-criticism over the week, and level of self-criticism on a given day relative to their personal mean, were related to their cognitions, affect, interpersonal goals, and behavior. The results supported the construct validity of the daily self-criticism measure. Moreover, the findings were consistent with the state-trait model and with Blatt's theoretical analysis of self-critical personality.",0 +https://doi.org/10.1111/j.1467-8624.2011.01630.x,Nonlinear Growth Curves in Developmental Research,"Developmentalists are often interested in understanding change processes, and growth models are the most common analytic tool for examining such processes. Nonlinear growth curves are especially valuable to developmentalists because the defining characteristics of the growth process such as initial levels, rates of change during growth spurts, and asymptotic levels can be estimated. A variety of growth models are described beginning with the linear growth model and moving to nonlinear models of varying complexity. A detailed discussion of nonlinear models is provided, highlighting the added insights into complex developmental processes associated with their use. A collection of growth models are fit to repeated measures of height from participants of the Berkeley Growth and Guidance Studies from early childhood through adulthood.",0 +https://doi.org/10.1002/sim.3196,The use of hierarchical models for estimating relative risks of individual genetic variants: An application to a study of melanoma,"For major genes known to influence the risk of cancer, an important task is to determine the risks conferred by individual variants, so that one can appropriately counsel carriers of these mutations. This is a challenging task, since new mutations are continually being identified, and there is typically relatively little empirical evidence available about each individual mutation. Hierarchical modeling offers a natural strategy to leverage the collective evidence from these rare variants with sparse data. This can be accomplished when there are available higher-level covariates that characterize the variants in terms of attributes that could distinguish their association with disease. In this article, we explore the use of hierarchical modeling for this purpose using data from a large population-based study of the risks of melanoma conferred by variants in the CDKN2A gene. We employ both a pseudo-likelihood approach and a Bayesian approach using Gibbs sampling. The results indicate that relative risk estimates tend to be primarily influenced by the individual case-control frequencies when several cases and/or controls are observed with the variant under study, but that relative risk estimates for variants with very sparse data are more influenced by the higher-level covariate values, as one would expect. The analysis offers encouragement that we can draw strength from the aggregating power of hierarchical models to provide guidance to medical geneticists when they offer counseling to patients with rare or even hitherto unobserved variants. However, further research is needed to validate the application of asymptotic methods to such sparse data.",0 +https://doi.org/10.1027/1015-5759/a000062,Consequences of Test Anxiety on Adaptive Versus Fixed Item Testing,"We investigated the effects of test anxiety on test performance using computerized adaptive testing (CAT) versus conventional fixed item testing (FIT). We hypothesized that tests containing mainly items with medium probabilities of being solved would have negative effects on test performance for testtakers high in test anxiety. A total of 110 students (aged 16 to 20) from a German secondary modern school filled out a short form of the Test Anxiety Inventory (TAI-G; Wacker, Jaunzeme, & Jaksztat, 2008 ) and then were presented with items from the Adaptive Matrices Test (AMT; Hornke, Etzel, & Rettig, 1999 ) on the computer, either in CAT form or in a fixed item test form with a selection of items arranged in order of increasing item difficulty. Additionally, half of the students were given a short summary of information about the mode of item selection in adaptive testing before working on the CAT. In a moderated regression approach, a significant interaction of test anxiety and test mode was revealed. The effect of test mode on the AMT score was stronger for students with higher scores on test anxiety than for students with lower test anxiety. Furthermore, getting information about CAT led to significantly better results than receiving standard test instructions. Results are discussed with reference to test fairness.",0 +https://doi.org/10.1177/0146621603027003004,"MetaAnalysisCorr: An SAS/IML Program to Synthesize Correlation Matrices with Hunter and Schmidt, Hedges and Olkin, and Generalized Least Squares Approaches","Meta-analysis, the analysis of analyses, is a standard statistical procedure for summarizing research findings in behavioral sciences. The Hunter-Schmidt approach (Hunter & Schmidt, 1990) and the Hedges-Olkin (Hedges & Olkin, 1985) approach are the two most frequently used procedures. When dealing with multivariate cases, for instance, correlation matrices, these procedures are applied to individual correlation coefficients of the correlation matrix separately. A better approach, however, is to use the generalized least squares approach, which was proposed for multivariate effect sizes (e.g., Becker, 1992, 1995; Hedges & Olkin, 1985).",0 +https://doi.org/10.1525/auk.2008.07134,SOURCES OF VARIATION IN DETECTION OF WADING BIRDS FROM AERIAL SURVEYS IN THE FLORIDA EVERGLADES,"Abstract We conducted dual-observer trials to estimate detection probabilities (probability that a group that is present and available is detected) for fixed-wing aerial surveys of wading birds in the Everglades system, Florida. Detection probability ranged from <0.2 to ~0.75 and varied according to species, group size, observer, and the observer's position in the aircraft (front or rear seat). Aerial-survey simulations indicated that incomplete detection can have a substantial effect on assessment of population trends, particularly over relatively short intervals (≤3 years) and small annual changes in population size (≤3%). We conclude that detection bias is an important consideration for interpreting observations from aerial surveys of wading birds, potentially limiting the use of these data for comparative purposes and trend analyses. We recommend that workers conducting aerial surveys for wading birds endeavor to reduce observer and other controllable sources of detection bias and account for uncontro...",0 +https://doi.org/10.1037/10099-004,Models for learning data.,,0 +https://doi.org/10.1016/0304-4076(94)90003-5,Journal of econometrics,,0 +https://doi.org/10.1086/209170,The Theory of Reasoned Action: A Meta-Analysis of Past Research with Recommendations for Modifications and Future Research,"Two meta-analyses were conducted to Investigate the effectiveness of the Fishbein and Ajzen model in research to date. Strong overall evidence for the predictive utility of the model was found. Although numerous instances were identified in which researchers overstepped the boundary conditions initially proposed for the model, the predictive utility remained strong across conditions. However, three variables were proposed and found to moderate the effectiveness of the model. Suggested extensions to the model are discussed and general directions for future research are given.",0 +https://doi.org/10.1037/0033-295x.112.4.744,The Cultural Mind: Environmental Decision Making and Cultural Modeling Within and Across Populations.,"This article describes cross-cultural research on the relation between how people conceptualize nature and how they act in it. Mental models of nature differ dramatically among populations living in the same area and engaged in similar activities. This has novel implications for environmental decision making and management, including common problems. The research offers a distinct perspective on cultural modeling and a unified approach to studies of culture and cognition. The authors argue that cultural transmission and formation consist primarily not in shared rules or norms but in complex distributions of causally connected representations across minds interacting with the environment. The cultural stability and diversity of these representations often derive from rich, biologically prepared mental mechanisms that limit variation to readily transmissible psychological forms. This framework addresses several methodological issues, such as limitations on conceiving culture to be a well-defined system, bounded entity, independent variable, or an internalized component of minds.",0 +https://doi.org/10.1111/jopy.12136,"Explaining Differences in Subjective Well-Being Across 33 Nations Using Multilevel Models: Universal Personality, Cultural Relativity, and National Income","This multinational study simultaneously tested three prominent hypotheses--universal disposition, cultural relativity, and livability--that explained differences in subjective well-being across nations. We performed multilevel structural equation modeling to examine the hypothesized relationships at both individual and cultural levels in 33 nations. Participants were 6,753 university students (2,215 men; 4,403 women; 135 did not specify), and the average age of the entire sample was 20.97 years (SD = 2.39). Both individual- and cultural-level analyses supported the universal disposition and cultural relativity hypotheses by revealing significant associations of subjective well-being with Extraversion, Neuroticism, and independent self-construal. In addition, interdependent self-construal was positively related to life satisfaction at the individual level only, whereas aggregated negative affect was positively linked with aggregate levels of Extraversion and interdependent self-construal at the cultural level only. Consistent with the livability hypothesis, gross national income (GNI) was related to aggregate levels of negative affect and life satisfaction. There was also a quadratic relationship between GNI and aggregated positive affect. Our findings reveal that universal disposition, cultural self-construal, and national income can elucidate differences in subjective well-being, but the multilevel analyses advance the literature by yielding new findings that cannot be identified in studies using individual-level analyses alone.",0 +https://doi.org/10.1037/a0022658,Effect size measures for mediation models: Quantitative strategies for communicating indirect effects.,"The statistical analysis of mediation effects has become an indispensable tool for helping scientists investigate processes thought to be causal. Yet, in spite of many recent advances in the estimation and testing of mediation effects, little attention has been given to methods for communicating effect size and the practical importance of those effect sizes. Our goals in this article are to (a) outline some general desiderata for effect size measures, (b) describe current methods of expressing effect size and practical importance for mediation, (c) use the desiderata to evaluate these methods, and (d) develop new methods to communicate effect size in the context of mediation analysis. The first new effect size index we describe is a residual-based index that quantifies the amount of variance explained in both the mediator and the outcome. The second new effect size index quantifies the indirect effect as the proportion of the maximum possible indirect effect that could have been obtained, given the scales of the variables involved. We supplement our discussion by offering easy-to-use R tools for the numerical and visual communication of effect size for mediation effects.",0 +https://doi.org/10.1177/0146621606292933,Two-Phase Item Selection Procedure for Flexible Content Balancing in CAT,"Content balancing is an important issue in the design and implementation of computerized adaptive testing (CAT). Content-balancing techniques that have been applied in fixed content balancing, where the number of items from each content area is fixed, include constrained CAT (CCAT), the modified multinomial model (MMM), modified constrained CAT (MCCAT), and others. In this article, four methods are proposed to address the flexible content-balancing issue with the a-stratification design, named STR_C. The four methods are MMM+, an extension of MMM; MCCAT+, an extension of MCCAT; the TPM method, a two-phase content-balancing method using MMM in both phases; and the TPF method, a two-phase content-balancing method using MMM in the first phase and MCCAT in the second. Simulation results show that all of the methods work well in content balancing, and TPF performs the best in item exposure control and item pool utilization while maintaining measurement precision.",0 +https://doi.org/10.1093/biomet/76.1.1,On the use of nonparametric regression for model checking,"SUMMARY The use of nonparametric regression is explored to check the fit of a parametric regression model. The principal aim is to check the validity of the regression curve rather than necessarily to detect outliers. A pseudo likelihood ratio test is developed to provide a global assessment of fit and simulation bands are used to indicate the nature of departures from the model. The types of data considered include discrete response variables, where standard diagnostic techniques are often not appropriate, and first-order autoregressive series. Several numerical examples are given. Nonparametric regression can be used in an informal graphical way to assess the relationship between a response and an explanatory variable. In this paper we aim to develop more formal methods of assessing the assumptions of a parametric model, in particular when regression diagnostics of the type developed for normal linear models are not readily available. The principal aim is to check the validity of the systematic part of the model by comparing a nonparametric estimate of the regression curve with a parametric one. Such a comparison may also identify outliers, although the distinction between outliers and model inadequacy is not always easy. Two techniques are used to assess the fit of a parametric model. In ? 2, confidence bands are constructed around the fitted regression curve by simulation. A comparison of these with the nonparametric curve gives an indication of the nature of any departures from the model. In ? 3, a pseudo likelihood ratio test is developed. This provides a quantitative global assessment of fit. In applying these ideas, special emphasis is given to discrete data, and notably logistic regression, because of the difficulty in applying standard residual-based model checking techniques to this type of response variable. A Poisson regression example is discussed in ? 4. However, the underlying ideas have wider applications. Autoregressive time series of order 1 are discussed in ? 6. Sections 5 and 7 discuss general issues. We first discuss the context of binary regression with a single covariate and the difficulties caused by the discreteness of the response variable. The observed data are assumed to be of the form (xi, yi, ni), where xi is a covariate value, and yi has a binomial",0 +https://doi.org/10.1111/jomf.12112,Grasping the Diversity of Cohabitation: Fertility Intentions Among Cohabiters Across Europe,"The authors examined the association between different meanings of cohabitation and fertility intentions. Using data from the Generations and Gender Surveys on 5,565 cohabiters from 9 European countries (Austria, Bulgaria, France, Germany, Hungary, Lithuania, Norway, Romania, and Russia), they proposed a cohabitation typology based on attitudes toward marriage, intentions to marry, and perceived economic deprivation. Despite substantial variation in the prevalence and types of cohabiting relationships across Europe, cohabitation has become a living arrangement within which childbearing intentions are commonly formed and at times carried out. The authors found that the meaning that cohabiters attached to their union influenced significantly their short-term fertility intentions, net of other covariates. Cohabiters who viewed their unions as a prelude to marriage were the most likely to plan to have a child in the near future, both in Western and Eastern European societies. The association between fertility intentions and marriage intentions was particularly strong among cohabiters who do not as yet have children in common, but it was also present in a more muted form among cohabitating parents. The findings suggest that, although marriage and childbearing are becoming less closely linked life events, they are not disconnected decisions for a large majority of cohabiters across Europe. Keywords: cohabitation; cohabitation typology; Europe; fertility intentions; Generations and Gender Surveys",0 +https://doi.org/10.1017/cbo9780511601118.010,The robustness of maximum likelihood estimation in structural equation models,"Introduction General methods for the analysis of covariance structures were introduced by Joreskog (1970, 1973). Within the general theoretical framework it is possible to estimate parameters and their corresponding standard errors and to test the goodness-of-fit of a linear structural equation system by means of maximum likelihood methods . Although other methods of estimating such models (least squares procedures, instrumental variable methods) are available, we do not discuss them here. For an introduction to the general model the reader is referred to Chapter 2 and for more detailed statistical discussions to Joreskog (1978, 1982a, b). The LISREL model considers a data matrix Z ( N × k ) of N observations on k random vaŕiables. It is assumed that the rows of Z are independently distributed, each having a multivariate normal distribution with the same mean vector μ and the same covariance matrix ∑; that is, each case in the data is independently sampled from the same population. In a specified model there are s independent model parameters co, to be estimated. For large samples the sampling distribution of the estimated parameters ŵ i and the sampling distribution of the likelihood ratio estimate for goodness-of-fit are approximately known, provided that the preceding assumptions hold. Under the same conditions the standard errors of the estimated parameters se ŵ i are also known asymptotically. In the following, standardized parameter estimates are defined by ŵ* i = (ŵ i − ω i )/ se ŵ i . For large samples the sampling distribution of ŵ* i is approximately standard normal, and the goodness-of-fit estimate has an approximate chi-square distribution with k ( k + 1)/2 – s degrees of freedom.",0 +https://doi.org/10.1080/0141192970230405,Differential Secondary School Effectiveness: comparing the performance of different pupil groups,"Abstract This article reports the results of an Economic and Social Research Council (ESRC) funded study which focuses on the differential academic achievement of different groups of pupils. The paper describes the findings on the size and extent of school effects across 3 years (1990, 1991, 1992) for different groups of pupils (classified by gender, eligibility for free school means [FSM], ethnic group and by prior attainment). Pupils’ overall General Certificate of Secondary Education performance and their performance in selected subjects (English, English literature, French, history, mathematics and science) have been analysed using multilevel modelling, employing a total sample of 94 inner London secondary schools. A ‘value added’ approach is adopted, controlling for selected student background measures of prior attainment (at secondary transfer), gender, age, ethnicity and low income to provide statistical controls for differences between schools in the characteristics of their intakes. Differential ...",0 +https://doi.org/10.1016/j.pain.2004.04.008,"Peri-sciatic proinflammatory cytokines, reactive oxygen species, and complement induce mirror-image neuropathic pain in rats","In inflammatory neuropathy, immune activation near intact peripheral nerves induces mechanical allodynia. The identity of the peripheral immune product(s) that lead to these changes in pain behavior is unknown. The present series of studies utilized the sciatic inflammatory neuropathy (SIN) model to examine this question. Here, inflammatory neuropathy is created by injecting an immune activator (zymosan) around one sciatic nerve via an indwelling catheter. Our prior studies demonstrated that peri-sciatic zymosan activated macrophages and neutrophils to release proinflammatory cytokines and reactive oxygen species (ROS). In addition, zymosan is a classical activator of the complement cascade. Thus the present series of experiments examined whether any of these inflammatory mediators are involved in the initial induction of SIN-induced ipsilateral or bilateral allodynias. Peri-sciatic injection of selective inhibitors/antagonists revealed that a number of immune products are early mediators of the resultant allodynias, including proinflammatory cytokines (tumor necrosis factor, interleukin-1, and interleukin-6), ROS, and complement. Thus these immune-derived substances can markedly alter sensory nerve function at mid-axon.",0 +https://doi.org/10.1037/0096-1523.10.3.340,Are lexical decisions a good measure of lexical access? The role of word frequency in the neglected decision stage.,"Three experiments with 80 undergraduates investigated the impact of 5 lexical variables (instance dominance, category dominance, word frequency, word length in letters, and word length in syllables) on performance in 3 tasks involving word recognition: category verification, lexical decision, and pronunciation. Although the same set of words was used in each task, the relationship of the lexical variables to RT varied significantly with the task within which the words were embedded. The effect of word frequency was minimal in the category verification task, whereas it was significantly larger in the pronunciation task and significantly larger yet in the lexical decision task. It is argued that decision processes having little to do with lexical access accentuate the word-frequency effect in the lexical decision task and that results from this task have questionable value in testing the assumption that word frequency orders the lexicon, thereby affecting time to access the mental lexicon. A simple 2-stage model is outlined to account for the role of word frequency and other variables in lexical decision. The model is applied to the results of the reported experiments and some of the findings in other studies of lexical decision and pronunciation. (49 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1984 American Psychological Association.",0 +https://doi.org/10.1093/biomet/89.3.553,Bayesian analysis of covariance matrices and dynamic models for longitudinal data,"Parsimonious modelling of the within‐subject covariance structure while heeding its positive‐definiteness is of great importance in the analysis of longitudinal data. Using the Cholesky decomposition and the ensuing unconstrained and statistically meaningful reparameterisation, we provide a convenient and intuitive framework for developing conditionally conjugate prior distributions for covariance matrices and show their connections with generalised inverse Wishart priors. Our priors offer many advantages with regard to elicitation, positive definiteness, computations using Gibbs sampling, shrinking covariances toward a particular structure with considerable flexibility, and modelling covariances using covariates. Bayesian estimation methods are developed and the results are compared using two simulation studies. These simulations suggest simpler and more suitable priors for the covariance structure of longitudinal data.",0 +https://doi.org/10.1007/0-306-47531-6_14,MML and EAP Estimation in Testlet-based Adaptive Testing,"In the previous chapter, Wainer, Bradlow and Du (this volume) presented a generalization of the three-parameter item response model in which the dependencies generated by a testlet structure are explicitly taken into account. That chapter is an extension of their prior work that developed the generalization for the two-parameter model (Bradlow, Wainer, & Wang, 1999). Their approach is to use a fully Bayesian formulation of the problem, coupled with a Markov Chain Monte Carlo (MCMC) procedure to estimate the posterior distribution of the model parameters. They then use the estimated posterior distribution to compute interval and point estimates. In this chapter, we derive estimates for the parameters of the Wainer, Bradlow, and Du testlet model using more traditional estimation methodology; maximum marginal likelihood (MML) and expected a posteriori (EAP) estimates. We also show how the model might be used within a CAT environment. After deriving the estimation equations, we compare the results of MCMC and MML estimation procedures and we examine the extent to which ignoring the testlet structure affects the precision of item calibration and the estimation of ability within a CAT procedure.",0 +https://doi.org/10.1016/j.jmp.2014.06.004,A cognitive latent variable model for the simultaneous analysis of behavioral and personality data,"I describe a cognitive latent variable model , a combination of a cognitive model and a latent variable model that can be used to aggregate information regarding cognitive parameters across participants and tasks. The model is ideally suited for uncovering relationships between latent task abilities as they are expressed in experimental paradigms, but can also be used as data fusion tools to connect latent abilities with external covariates from entirely different data sources. An example application deals with the structure of cognitive abilities underlying an executive functioning task and its relation to personality traits. • Cognitive models and latent variable models are combined into a single framework. • The framework can be applied in a Bayesian inferential context. • An application uses data from an RT experiment and questionnaires in a single model.",0 +https://doi.org/10.1177/014662169301700305,Equating Tests Under The Nominal Response Model,"Under item response theory, test equating involves finding the coefficients of a linear trans formation of the metric of one test to that of another. A procedure for finding these equating coefficients when the items in the two tests are nominally scored was developed. A quadratic loss function based on the differences between response category probabilities in the two tests is employed. The gradients of this loss function needed by the iterative multivariate search procedure used to obtain the equating coefficients were derived for the nominal response case. Examples of both hori zontal and vertical equating are provided. The empirical results indicated that tests scored under a nominal response model can be placed on a com mon metric in both horizontal and vertical equatings.",0 +https://doi.org/10.1002/jrsm.1164,Methods to estimate the between‐study variance and its uncertainty in meta‐analysis,"Meta-analyses are typically used to estimate the overall/mean of an outcome of interest. However, inference about between-study variability, which is typically modelled using a between-study variance parameter, is usually an additional aim. The DerSimonian and Laird method, currently widely used by default to estimate the between-study variance, has been long challenged. Our aim is to identify known methods for estimation of the between-study variance and its corresponding uncertainty, and to summarise the simulation and empirical evidence that compares them. We identified 16 estimators for the between-study variance, seven methods to calculate confidence intervals, and several comparative studies. Simulation studies suggest that for both dichotomous and continuous data the estimator proposed by Paule and Mandel and for continuous data the restricted maximum likelihood estimator are better alternatives to estimate the between-study variance. Based on the scenarios and results presented in the published studies, we recommend the Q-profile method and the alternative approach based on a 'generalised Cochran between-study variance statistic' to compute corresponding confidence intervals around the resulting estimates. Our recommendations are based on a qualitative evaluation of the existing literature and expert consensus. Evidence-based recommendations require an extensive simulation study where all methods would be compared under the same scenarios.",0 +https://doi.org/10.1017/cbo9781107323667.008,Putting Broca’s region into context: fMRI evidence for a role in predictive language processing,"Broca’s region is known to play a key role in speech production as well as in the processing of language input. Still, the exact function (or functions) of Broca’s region remains highly disputed. Within the generativist framework it has been argued that part of Broca’s region is dedicated to syntactical analysis. Others, however, have related Broca’s region activity to more domain-general processes, e.g. working memory load and argument hierarchy demands. We here present results that show how contextual cues completely alter the effects of syntax in behaviour and in Broca’s region, and suggest that activation in this area reflects general linguistic processing costs or prediction error. We review the fMRI literature in the light of this theory. Introduction: the controversy over Broca's region In 1861 Paul Broca presented the brain of one of his patients to the anthropological society in Paris. Before his death, this patient had displayed a severe speech deficit, being unable to say more than a single word, Tan', while apparently maintaining many of his other mental faculties (Broca, 1861). Broca found that the patient had a large lesion in the brain's left inferior frontal gyrus (LIFG). Since then, this area, now often referred to as Broca's region, has been considered a key speech/language brain region. With the advent of cell-staining techniques, Korbinian Brodmann (Brodmann, 1909) found that the LIFG, based on the cytoarchitecture, could be subdivided into distinct regions: Brodmann areas 44, 45 and 47 (BA 44/45/47). The subregions are depicted in Plate 8.1 (see colour plate section). Agrammatical speech was already early considered to be a specific symptom in aphasiology (e.g. Kussmaul, 1877), and it has subsequently been argued that Broca's region plays a significant role in the processing of syntax, both in comprehension and production of language (Friedmann, 2006; Grodzinsky & Santi, 2008). © Cambridge University Press 2015.",0 +https://doi.org/10.1080/10705510903203466,Level-Specific Evaluation of Model Fit in Multilevel Structural Equation Modeling,"In multilevel structural equation modeling, the “standard” approach to evaluating the goodness of model fit has a potential limitation in detecting the lack of fit at the higher level. Level-specific model fit evaluation can address this limitation and is more informative in locating the source of lack of model fit. We proposed level-specific test statistics for the test of overall model fit, comparative fit index, and root mean squared error of approximation using partially saturated models, and we also considered another level-specific approach proposed by Yuan and Bentler (2007) Yuan, K.-H. and Bentler, P. M. 2007. Multilevel covariance structure analysis by fitting multiple single-level models.. Sociological Methodology, 37: 53–82. [Crossref], [Web of Science ®] , [Google Scholar]. A simulation study showed that the standard approach failed to detect the lack of fit at the group level. The fit indexes produced by the level-specific approaches both successfully detected the lack of model fit at each level. There were only minor differences in the performance of the 2 level-specific approaches.",0 +https://doi.org/10.1201/b10905-7,Inference from Simulations and Monitoring Convergence,"Markov chainMonteCarlo (MCMC)methodshavebeenaround for almost as longasMonte Carlo techniques, even though their impact on statistics was not truly felt until the very early 1990s, except in the specialized fields of spatial statistics and image analysis, where those methods appeared earlier. The emergence of Markov based techniques in physics is a story that remains untold within this survey (see Landau and Binder, 2005). Also, we will not enter into a description of MCMC techniques, unless they have some historical link, as the remainder of this volume covers the technical aspects.Acomprehensive treatment with further references can also be found in Robert and Casella (2004). We will distinguish between the introduction of Metropolis-Hastings based algorithmsand those related to Gibbs sampling, since they each stem from radically different origins, even though their mathematical justification via Markov chain theory is the same. Tracing the development of Monte Carlo methods, we will also briefly mention what we might call the “second-generation MCMC revolution.” Starting in the mid to late 1990s, this includes the development of particle filters, reversible jump and perfect sampling, and concludes with more current work on population or sequential Monte Carlo and regeneration and the computing of “honest” standard errors. As mentioned above, the realization that Markov chains could be used in a wide varietyof situations only came (tomainstream statisticians)withGelfand and Smith (1990), despite earlier publications in the statistical literature such as Hastings (1970), Geman and Geman (1984), and Tanner and Wong (1987). Several reasons can be advanced: lack of computing machinery (think of the computers of 1970!), or background onMarkov chains, or hesitation to trust in the practicality of themethod. It thus required visionary researchers like Gelfand and Smith to convince the community, supported by papers that demonstrated, through a series of applications, that the method was easy to understand, easy to implement and practical (Gelfand et al., 1990, 1992; Smith and Gelfand, 1992; Wakefield et al., 1994). The rapid emergence of the dedicated BUGS (Bayesian inference using Gibbs sampling) software as early as 1991, when a paper on BUGS was presented at the Valencia meeting, was another compelling argument for adopting, at large, MCMC algorithms.∗Monte Carlo methods were born in Los Alamos, New Mexico, during World War II, eventually resulting in theMetropolis algorithm in the early 1950s. WhileMonte Carlo methods were in use by that time, MCMC was brought closer to statistical practicality by the work of Hastings in the 1970s. What can be reasonably seen as the first MCMC algorithm is what we now call theMetropolis algorithm, published by Metropolis et al. (1953). It emanates from the same group of scientists who produced the Monte Carlo method, namely the research scientists of Los Alamos, mostly physicists working on mathematical physics and the atomic bomb. MCMC algorithms therefore date back to the same time as the development of regular(MC only) Monte Carlo methods, which are usually traced to Ulam and von Neumann in the late 1940s. StanislawUlam associates the original ideawith an intractable combinatorial computation he attempted in 1946 (calculating the probability of winning at the solitaire card game). This ideawas enthusiastically adopted by John vonNeumann for implementationwith direct applications to neutron diffusion, the name “Monte Carlo” being suggested by Nicholas Metropolis. Eckhardt (1987) describes these early Monte Carlo developments, and Hitchcock (2003) gives a brief history of the Metropolis algorithm. These occurrences very closely coincide with the appearance of the very first general-purpose digital computer, the ENIAC,which came to life in February 1946, after three years of construction. The Monte Carlo method was set up by von Neumann, who was using it on thermonuclear and fission problems as early as 1947. That same year, Ulam and vonNeumann invented inversion andaccept-reject techniques (also recounted inEckhardt, 1987) to simulate from nonuniform distributions. Without computers, a rudimentary version invented by Fermi in the 1930s went unrecognized (Metropolis, 1987). Note also that, as early as 1949, a symposiumonMonteCarlowas supported byRand, theNational Bureau of Standards, and theOakRidge laboratory and thatMetropolis andUlam (1949) published the very first paper about the Monte Carlo method.",0 +https://doi.org/10.1016/0022-2496(92)90038-9,The structure of simple reaction time to step-function signals,"Simple reaction time to a step-function signal of amplitude A can be additively decomposed into a signal-dependent component, T ( A ) (converging to zero as A increases), and a signal-independent component, R . The two components, however, are not mutually independent, they both are increasing deterministic functions of a single random variable; T ( A ) = T ( A , C ) and R = R ( C ). C is interpreted as a “criterion” or “inhibition factor” controlling simultaneously “readiness to detect” and “readiness to respond”. The model is not based on a priori distributional assumptions. RT percentiles of a given rank P computed across RT distributions for different values of A , have a deterministic structure, RT P ( A ) = T ( A , C P ) + R ( C P ), where C P is the P th percentile of C . Subtracting RT P (A ∗ ) for a very large A ∗ from RT P ( A ), one gets an estimate of T ( A , C P ), the P th percentile of T ( A ). Applying this to different values of P , one can a posteriori reconstruct the joint distribution of the two RT components. The asymptotic consequences of this model (for sufficiently large A ) are corroborated by data on the RT to instantaneous displacements of a visual target.",0 +https://doi.org/10.1006/jmps.2000.1319,Testing Evidence Accrual Models by Manipulating Stimulus Onset,"Many models of response time assume that subjects accrue stimulus ""evidence"" samples in time (e.g., random walk models, counter models). In this paper, the concept of one stimulus dominating another is used to construct a test of the whole class of evidence accrual models. For an example of dominance, consider stimuli that are presented either virtually instantaneously (stepped) or in a gradually increasing manner (ramped). Ramped stimuli are presented such that the ramped portion precedes the stepped onset of stepped stimuli. In this case ramped stimuli dominate stepped stimuli. In this paper the class of evidence accrual models is formalized. It is shown that under appropriate assumptions evidence accrual models do predict more accurate responses to dominating stimuli. However, this result does not hold for response latencies. There are anomalous cases where an evidence accrual model (the accumulator model of Vickers (1970, Ergonomics 13, 37-58)) predicts slower mean correct response latencies to dominating stimuli. It is shown through extensive computer simulation that these anomalous cases occur only when response criteria are so asymmetric that there are exceedingly extreme response biases. For experiments where response biases are not exceedingly extreme, random walk and accumulator models predict more accurate and quicker correct responses to dominating stimuli. In sum, manipulating the time course of stimuli in accordance with the concept of dominance can provide empirical tests of the class of evidence accrual models. Copyright 2001 Academic Press.",0 +https://doi.org/10.3389/fpsyg.2013.00770,"Facing off with Scylla and Charybdis: a comparison of scalar, partial, and the novel possibility of approximate measurement invariance","Measurement invariance (MI) is a pre-requisite for comparing latent variable scores across groups. The current paper introduces the concept of approximate MI building on the work of Muthén and Asparouhov and their application of Bayesian Structural Equation Modeling (BSEM) in the software Mplus. They showed that with BSEM exact zeros constraints can be replaced with approximate zeros to allow for minimal steps away from strict MI, still yielding a well-fitting model. This new opportunity enables researchers to make explicit trade-offs between the degree of MI on the one hand, and the degree of model fit on the other. Throughout the paper we discuss the topic of approximate MI, followed by an empirical illustration where the test for MI fails, but where allowing for approximate MI results in a well-fitting model. Using simulated data, we investigate in which situations approximate MI can be applied and when it leads to unbiased results. Both our empirical illustration and the simulation study show approximate MI outperforms full or partial MI In detecting/recovering the true latent mean difference when there are (many) small differences in the intercepts and factor loadings across groups. In the discussion we provide a step-by-step guide in which situation what type of MI is preferred. Our paper provides a first step in the new research area of (partial) approximate MI and shows that it can be a good alternative when strict MI leads to a badly fitting model and when partial MI cannot be applied.",0 +https://doi.org/10.1037/0278-6133.27.2(suppl.).s101,How and why criteria defining moderators and mediators differ between the Baron & Kenny and MacArthur approaches.,"In recognition of the increasingly important role of moderators and mediators in clinical research, clear definitions are sought of the two terms to avoid inconsistent, ambiguous, and possibly misleading results across clinical research studies.The criteria used to define moderators and mediators proposed by the Baron & Kenny approach, which have been long used in social/behavioral research, are directly compared to the criteria proposed by the recent MacArthur approach, which modified the Baron & Kenny criteria.After clarifying the differences in criteria between approaches, the rationale for the modifications is clarified and the implications for the design and interpretation of future studies considered.Researchers may find modifications introduced in the MacArthur approach more appropriate to their research objectives, particularly if their research might have a direct influence on decision making.",0 +https://doi.org/10.1214/aos/1176348244,The Variational Form of Certain Bayes Estimators,"A general representation is obtained for formal Bayes of a parameter matrix. We assume that prior distribution is symmetric in some sense, but it is not specified otherwise. The formal Bayes risk is minimized subject to order constraints by a variational technique; hence our representation is called the variational form of Bayes estimator (VFBE). The VFBE is used to obtain estimators that have good frequency properties relative to usual estimators. Such estimators are obtained for mean vector and covariance matrix of a multivariate normal distribution. Also, for possibly nonnormal data, we give VFBE of several Pearson means. A certain emphasis is placed on problem of estimating covariance matrix. For that problem, our constrained optimization provides an with very good properties: Its eigenvalues are in proper order, and they are not as distorted as those in sample covariance matrix. The VFBE for covariance matrix is related to an of Stein. Of two, VFBE deals with order relations in a more natural way; that is, it is more criterion dependent. In addition, it is easier to compute than Stein's estimator, and a brief Monte Carlo simulation indicates that it has better risk properties as well.",0 +https://doi.org/10.1007/978-3-642-14064-8_30,The Influence of Different Haptic Environments on Time Delay Discrimination in Force Feedback,"Time delay in haptic telepresence arising from compression or communication alters the phase characteristics of the environment impedance. This paper describes how well a human operator can discriminate these changes in haptic environments. Three different environments are rendered on a haptic interface and manually excited by a human operator using sinusoidal movements. We find that time delay in haptic feedback can be discriminated starting from 15 ms in a pure damper environment, 36 ms in a spring system, and 72 ms when moving a damped inertia. We conclude that the discrimination thresholds increase with the absolute phase between velocity and force signals resulting from the remote environment characteristics. These results may benefit the human-centered design of high-fidelity haptic communication protocols and haptic filters.",0 +https://doi.org/10.1037/a0024338,"Effect size estimates: Current use, calculations, and interpretation.","The Publication Manual of the American Psychological Association (American Psychological Association, 2001, American Psychological Association, 2010) calls for the reporting of effect sizes and their confidence intervals. Estimates of effect size are useful for determining the practical or theoretical importance of an effect, the relative contributions of factors, and the power of an analysis. We surveyed articles published in 2009 and 2010 in the Journal of Experimental Psychology: General, noting the statistical analyses reported and the associated reporting of effect size estimates. Effect sizes were reported for fewer than half of the analyses; no article reported a confidence interval for an effect size. The most often reported analysis was analysis of variance, and almost half of these reports were not accompanied by effect sizes. Partial η2 was the most commonly reported effect size estimate for analysis of variance. For t tests, 2/3 of the articles did not report an associated effect size estimate; Cohen's d was the most often reported. We provide a straightforward guide to understanding, selecting, calculating, and interpreting effect sizes for many types of data and to methods for calculating effect size confidence intervals and power analysis.",0 +https://doi.org/10.1214/ss/1028905934,Simulating normalizing constants: from importance sampling to bridge sampling to path sampling,"Computing (ratios of) normalizing constants of probability models is a fundamental computational problem for many statistical and scientific studies. Monte Carlo simulation is an effective technique, especially with complex and high-dimensional models. This paper aims to bring to the attention of general statistical audiences of some effective methods originating from theoretical physics and at the same time to explore these methods from a more statistical perspective, through establishing theoretical connections and illustrating their uses with statistical problems. We show that the acceptance ratio method and thermodynamic integration are natural generalizations of importance sampling, which is most familiar to statistical audiences. The former generalizes importance sampling through the use of a single ""bridge"" density and is thus a case of bridge sampling in the sense of Meng and Wong. Thermodynamic integration, which is also known in the numerical analysis literature as Ogata's method for high-dimensional integration, corresponds to the use of infinitely many and continuously connected bridges (and thus a ""path""). Our path sampling formulation offers more flexibility and thus potential efficiency to thermodynamic integration, and the search of optimal paths turns out to have close connections with the Jeffreys prior density and the Rao and Hellinger distances between two densities. We provide an informative theoretical example as well as two empirical examples (involving 17- to 70-dimensional integrations) to illustrate the potential and implementation of path sampling. We also discuss some open problems.",0 +https://doi.org/10.1198/016214502753479419,Bootstrap Tests for Distributional Treatment Effects in Instrumental Variable Models,"This article considers the problem of assessing the distributional consequences of a treatment on some outcome variable of interest when treatment intake is (possibly) nonrandomized, but there is a binaryinstrument available for the researcher. Such a scenario is common in observational studies and in randomized experiments with imperfect compliance. One possible approach to this problem is to compare the counterfactual cumulative distribution functions of the outcome with and without the treatment. This article shows how to estimate these distributions using instrumental variable methods and a simple bootstrap procedure is proposed to test distributional hypotheses, such as equality of distributions, first-order and second-order stochastic dominance. These tests and estimators are applied to the study of the effects of veteran status on the distribution of civilian earnings. The results show a negative effect of military service during the Vietnam era that appears to be concentrated on the lower tail of ...",0 +https://doi.org/10.1093/biomet/90.4.809,Efficient estimation of covariance selection models,"SUMMARY A Bayesian method is proposed for estimating an inverse covariance matrix from Gaussian data. The method is based on a prior that allows the off-diagonal elements of the inverse covariance matrix to be zero, and in many applications results in a parsimonious parameterisation of the covariance matrix. No assumption is made about the structure of the corresponding graphical model, so the method applies to both nondecomposable and decomposable graphs. All the parameters are estimated by model averaging using an efficient Metropolis-Hastings sampling scheme. A simulation study demonstrates that the method produces statistically efficient estimators of the covariance matrix, when the inverse covariance matrix is sparse. The methodology is illustrated by applying it to three examples that are high-dimensional relative to the sample size.",0 +https://doi.org/10.18637/jss.v061.i07,WebBUGS: Conducting Bayesian Statistical Analysis Online,"A web interface, named WebBUGS, is developed to conduct Bayesian analysis online over the Internet through OpenBUGS and R. WebBUGS can be used with the minimum requirement of a web browser both remotely and locally. WebBUGS has many collaborative features such as email notification and sharing. WebBUGS also eases the use of OpenBUGS by providing built-in model templates, data management module, and other useful modules. In this paper, the use of WebBUGS is illustrated and discussed.",0 +,Graphical models for visual object recognition and tracking,"We develop statistical methods which allow effective visual detection, categorization, and tracking of objects in complex scenes. Such computer vision systems must be robust to wide variations in object appearance; the often small size of training databases, and ambiguities induced by articulated or partially occluded objects. Graphical models provide a powerful framework for encoding the statistical structure of visual scenes, and developing corresponding learning and inference algorithms. In this thesis, we describe several models which integrate graphical representations with nonparametric statistical methods. This approach leads to inference algorithms which tractably recover high-dimensional, continuous object pose variations, and learning procedures which transfer knowledge among related recognition tasks. Motivated by visual tracking problems, we first develop a nonparametric extension of the belief propagation (BP) algorithm. Using Monte Carlo methods, we provide general procedures for recursively updating particle-based approximations of continuous sufficient statistics. Efficient multiscale sampling methods then allow this nonparametric BP algorithm to be flexibly adapted to many different applications. As a particular example, we consider a graphical model describing the hand's three-dimensional (3D) structure, kinematics, and dynamics. This graph encodes global hand pose via the 3D position and orientation of several rigid components, and thus exposes local structure in a high-dimensional articulated model. Applying nonparametric BP, we recover a hand tracking algorithm which is robust to outliers and local visual ambiguities. Via a set of latent occupancy masks, we also extend our approach to consistently infer occlusion events in a distributed fashion. In the second half of this thesis, we develop methods for learning hierarchical models of objects, the parts composing them, and the scenes surrounding them. Our approach couples topic models originally developed for text analysis with spatial transformations, and thus consistently accounts for geometric constraints. By building integrated scene models, we may discover contextual relationships, and better exploit partially labeled training images. We first consider images of isolated objects, and show that sharing parts among object categories improves accuracy when learning from few examples. Turning to multiple object scenes, we propose nonparametric models which use Dirichlet processes to automatically learn the number of parts underlying each object category, and objects composing each scene. Adapting these transformed Dirichlet processes to images taken with a binocular stereo camera, we learn integrated, 3D models of object geometry and appearance. This leads to a Monte Carlo algorithm which automatically infers 3D scene structure from the predictable geometry of known object categories. (Copies available exclusively from MIT Libraries, Rm. 14-0551, Cambridge, MA 02139-4307. Ph. 617-253-5668; Fax 617-253-1690.)",0 +https://doi.org/10.1016/j.socscimed.2015.09.040,Educational expansion and the education gradient in health: A hierarchical age-period-cohort analysis,"Researchers have recently been investigating the temporal variation in the educational gradient in health. While there is abundant literature concerning age trajectories, theoretical knowledge about cohort differences is relatively limited. Therefore, in analogy with the life course perspective, we introduce two contrasting cohort-specific hypotheses. The diminishing health returns hypothesis predicts a decrease in educational disparities in health across cohorts. By contrast, the cohort accretion hypothesis suggests that the education-health gap will be more pronounced among younger cohorts. To shed light on this, we perform a hierarchical age-period-cohort analysis (HAPC), using data from a subsample of individuals between 25 and 85 years of age (N = 232,573) from 32 countries in the European Social Survey (six waves: 2002-2012). The analysis leads to three important conclusions. First, we observe a widening health gap between different educational levels over the life course. Second, we find that these educational differences in the age trajectories of health seem to strengthen with each successive birth cohort. However, the two age-related effects disappear when we control for employment status, household income, and family characteristics. Last, when adjusting for these mediators, we reveal evidence to support the diminishing health returns hypothesis, implying that it is primarily the direct association between education and health that decreases across cohorts. This finding raises concerns about potential barriers to education being a vehicle for empowerment and the promotion of health.",0 +https://doi.org/10.1093/chemse/bjj001,Evaluation of the Validity of a Maximum Likelihood Adaptive Staircase Procedure for Measurement of Olfactory Detection Threshold in Mice,"Threshold is defined as the stimulus intensity necessary for a subject to reach a specified percent correct on a detection test. MLPEST (maximum likelihood parameter estimation by sequential testing) is a method that is able to determine threshold accurately and more rapidly than many other methods. Originally developed for human auditory and visual tasks, it has been adapted for human olfactory and gustatory tests. In order to utilize this technique for olfactory testing in mice, we have adapted MLPEST methodology for use with computerized olfactometry as a tool to estimate odor detection thresholds. Here we present Monte Carlo simulations and operant conditioning data that demonstrate the potential utility of this technique in mice, we explore the ramifications of altering MLPEST test parameters on performance, and we discuss the advantages and disadvantages of using MLPEST compared to other methods for the estimation of thresholds in rodents. Using MLPEST, we find that olfactory detection thresholds in mice deficient for the cyclic nucleotide-gated channel subunit A2 are similar to those of wild-type animals for odorants the knockout animals are able to detect.",0 +https://doi.org/10.1080/01621459.1991.10475006,Generalized Linear Models with Random Effects; a Gibbs Sampling Approach,"Abstract Generalized linear models have unified the approach to regression for a wide variety of discrete, continuous, and censored response variables that can be assumed to be independent across experimental units. In applications such as longitudinal studies, genetic studies of families, and survey sampling, observations may be obtained in clusters. Responses from the same cluster cannot be assumed to be independent. With linear models, correlation has been effectively modeled by assuming there are cluster-specific random effects that derive from an underlying mixing distribution. Extensions of generalized linear models to include random effects has, thus far, been hampered by the need for numerical integration to evaluate likelihoods. In this article, we cast the generalized linear random effects model in a Bayesian framework and use a Monte Carlo method, the Gibbs sampler, to overcome the current computational limitations. The resulting algorithm is flexible to easily accommodate changes in the number...",0 +https://doi.org/10.3758/bf03193007,Distribution of the product confidence limits for the indirect effect: Program PRODCLIN,"This article describes a program, PRODCLIN (distribution of the PRODuct Confidence Limits for INdirect effects), written for SAS, SPSS, and R, that computes confidence limits for the product of two normal random variables. The program is important because it can be used to obtain more accurate confidence limits for the indirect effect, as demonstrated in several recent articles (MacKinnon, Lockwood, & Williams, 2004; Pituch, Whittaker, & Stapleton, 2005). Tests of the significance of and confidence limits for indirect effects based on the distribution of the product method have more accurate Type I error rates and more power than other, more commonly used tests. Values for the two paths involved in the indirect effect and their standard errors are entered in the PRODCLIN program, and distribution of the product confidence limits are computed. Several examples are used to illustrate the PRODCLIN program. The PRODCLIN programs in rich text format may be downloaded from www.psychonomic.org/archive.",0 +https://doi.org/10.1037/0033-2909.93.3.549,Analysis of multiplicative combination rules when the causal variables are measured with error.,"Evaluates the validity of the observational method used to test multiplicative combination rules with respect to 2 measurement issues: measurement level (i.e., the effects produced by allowing monotonic transformations of the measures) and measurement error (i.e., the effects produced by using unreliable measures of the causal variables). The evaluation is based on a theoretical distinction between the structural model (the set of equations relating theoretical constructs to each other) and the measurement model (the set of equations relating the theoretical constructs to the observed measures). It is concluded that hierarchical regression analysis is inadequate for determining whether the structural model is additive or multiplicative for 2 reasons: First, an additive structural model may produce multiplicative effects through a nonlinear measurement model. Second, a multiplicative structural model may produce nondetectable multiplicative effects because of multiplicative measurement error. Some alternatives to hierarchical regression analysis are described. (35 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1983 American Psychological Association.",0 +https://doi.org/10.1198/016214501750332758,Gibbs Sampling Methods for Stick-Breaking Priors,"A rich and flexible class of random probability measures, which we call stick-breaking priors, can be constructed using a sequence of independent beta random variables. Examples of random measures that have this characterization include the Dirichlet process, its two-parameter extension, the two-parameter Poisson–Dirichlet process, finite dimensional Dirichlet priors, and beta two-parameter processes. The rich nature of stick-breaking priors offers Bayesians a useful class of priors for nonparametric problems, while the similar construction used in each prior can be exploited to develop a general computational procedure for fitting them. In this article we present two general types of Gibbs samplers that can be used to fit posteriors of Bayesian hierarchical models based on stick-breaking priors. The first type of Gibbs sampler, referred to as a Polya urn Gibbs sampler, is a generalized version of a widely used Gibbs sampling method currently employed for Dirichlet process computing. This method applies t...",0 +https://doi.org/10.1371/journal.pbio.0050056,Auditory Short-Term Memory Behaves Like Visual Short-Term Memory,"Are the information processing steps that support short-term sensory memory common to all the senses? Systematic, psychophysical comparison requires identical experimental paradigms and comparable stimuli, which can be challenging to obtain across modalities. Participants performed a recognition memory task with auditory and visual stimuli that were comparable in complexity and in their neural representations at early stages of cortical processing. The visual stimuli were static and moving Gaussian-windowed, oriented, sinusoidal gratings (Gabor patches); the auditory stimuli were broadband sounds whose frequency content varied sinusoidally over time (moving ripples). Parallel effects on recognition memory were seen for number of items to be remembered, retention interval, and serial position. Further, regardless of modality, predicting an item's recognizability requires taking account of (1) the probe's similarity to the remembered list items (summed similarity), and (2) the similarity between the items in memory (inter-item homogeneity). A model incorporating both these factors gives a good fit to recognition memory data for auditory as well as visual stimuli. In addition, we present the first demonstration of the orthogonality of summed similarity and inter-item homogeneity effects. These data imply that auditory and visual representations undergo very similar transformations while they are encoded and retrieved from memory.",0 +https://doi.org/10.1016/j.csda.2010.03.016,An encompassing prior generalization of the Savage–Dickey density ratio,"An encompassing prior (EP) approach to facilitate Bayesian model selection for nested models with inequality constraints has been previously proposed. In this approach, samples are drawn from the prior and posterior distributions of an encompassing model that contains an inequality restricted version as a special case. The Bayes factor in favor of the inequality restriction then simplifies to the ratio of the proportions of posterior and prior samples consistent with the inequality restriction. This formalism has been applied almost exclusively to models with inequality or ''about equality'' constraints. It is shown that the EP approach naturally extends to exact equality constraints by considering the ratio of the heights for the posterior and prior distributions at the point that is subject to test (i.e., the Savage-Dickey density ratio). The EP approach generalizes the Savage-Dickey ratio method, and can accommodate both inequality and exact equality constraints. The general EP approach is found to be a computationally efficient procedure to calculate Bayes factors for nested models. However, the EP approach to exact equality constraints is vulnerable to the Borel-Kolmogorov paradox, the consequences of which warrant careful consideration.",0 +https://doi.org/10.1016/j.jmp.2010.06.005,Distribution-free tests of stochastic dominance for small samples,"One variable is said to “stochastically dominate” another if the probability of observations smaller than x is greater for one variable than the other, for all x. Inferring stochastic dominance from data samples is important for many applications of econometrics and experimental psychology, but little is known about the performance of existing inferential methods. Through simulation, we show that three of the most widely used inferential methods are inadequate for use in small samples of the size commonly encountered in many applications (up to 400 observations from each distribution). We develop two new inferential methods that perform very well in a limited, but practically important, case where the two variables are guaranteed not to be equal in distribution. We also show that extensions of these new methods, and an improved version of an existing method, perform quite well in the original, unlimited case.",0 +https://doi.org/10.4324/9780203882924,Cross-Cultural Analysis,"Intended to bridge the gap between the latest methodological developments and cross-cultural research, this interdisciplinary resource presents the latest strategies for analyzing cross-cultural data. Techniques are demonstrated through the use of applications that employ cross national data sets such as the latest European Social Survey. With an emphasis on the generalized latent variable approach, internationally-prominent researchers from a variety of fields explain how the methods work, how to apply them, and how they relate to other methods presented in the book. Syntax and graphical and verbal explanations of the techniques are included. A website features some of the data sets and syntax commands used in the book. Applications from the behavioral and social sciences that use real data-sets demonstrate: * The use of samples from 17 countries to validate the resistance to change scale across these nations * How to test the cross-national invariance properties of social trust * The interplay between social structure, religiosity, values, and social attitudes * A comparison of anti-immigrant attitudes and patterns of religious orientations across European countries. The book is divided into techniques for analyzing cross-cultural data within the generalized-latent-variable approach: multiple-group confirmatory factor analysis and multiple-group structural equation modeling; multi-level analysis; latent class analysis; and item-response theory. Since researchers from various disciplines often use different methodological approaches, a consistent framework for describing and applying each method is used so as to cross 'methodological borders' between disciplines. Some chapters describe the basic strategy and how it relates to other techniques presented in the book, others apply the techniques and address specific research questions, and a few combine the two. A table in the preface highlights for each chapter: a brief description of the contents, the statistical methods used, the goal(s) of the analysis, and the data set employed. This book is intended for researchers, practitioners, and advanced students interested in cross-cultural research. Because the applications span a variety of disciplines, the book will appeal to cross-cultural researchers and students in: psychology, political science, sociology, education, marketing and economics, geography, criminology, psychometrics, epidemiology, and public health, as well as those interested in social-science and behavioral methodology. It is also appropriate for an advanced methods course in cross-cultural analysis.",0 +https://doi.org/10.1016/b978-0-12-742780-5.50009-3,Estimation of Parameters in the Three-Parameter Latent Trait Model,"This chapter discusses a study to investigate the efficiency of the Urry procedure and the maximum likelihood procedure to estimate parameters in the three-parameter model, to study the properties of the estimators, and to provide some guidelines regarding the conditions under which they should be employed. In particular, the issues investigated were (1) the accuracy of the two estimation procedures; (2) the relations among the number of items, examinees, and the accuracy of estimation; (3) the effect of the distribution of ability on the estimates of item and ability parameters; and (4) the statistical properties, such as bias and consistency, of the estimators. To investigate the issues mentioned above, artificial data were generated according to the three-parameter logistic model using the DATGEN program of Hambleton and Rovinelli. Data were generated to simulate various testing situations by varying the test length, the number of examinees, and the ability distribution of the examinees. In the Urry estimation procedure, the relationships that exist for item discrimination and item difficulty between the latent trait theory parameters and the classical item parameters are exploited. These relationships are derived under the assumption that ability is normally distributed and that the item characteristic curve is the normal ogive. To study how the departures from the assumption of normally distributed abilities affect the Urry procedure, three ability distributions were considered: normal, uniform, and negatively skewed.",0 +https://doi.org/10.2307/2530095,The Product of Two Normally Distributed Random Variables,,0 +https://doi.org/10.1037//0021-9010.86.3.468,Implications of empirical Bayes meta-analysis for test validation.,"Empirical Bayes meta-analysis provides a useful framework for examining test validation. The fixedeffects case in which Ï� has a single value corresponds to the inference that the situational specificity hypothesis can be rejected in a validity generalization study. A Bayesian analysis of such a case provides a simple and powerful test of Ï� = 0; such a test has practical implications for significance testing in test validation. The random-effects case in which σ2Ï� > 0 provides an explicit method with which to assess the relative importance of local validity studies and previous meta-analyses. Simulated data are used to illustrate both cases. Results of published meta-analyses are used to show that local validation becomes increasingly important as σ2Ï� increases. The meaning of the term validity generalization is explored, and the problem of what can be inferred about test transportability in the random-effects case is described.",0 +https://doi.org/10.1523/jneurosci.0362-10.2010,A Study of Clustered Data and Approaches to Its Analysis,"Statistical analysis is critical in the interpretation of experimental data across the life sciences, including neuroscience. The nature of the data collected has a critical role in determining the best statistical approach to take. One particularly prevalent type of data is referred to as ""clustered data."" Clustered data are characterized as data that can be classified into a number of distinct groups or ""clusters"" within a particular study. Clustered data arise most commonly in neuroscience when data are compiled across multiple experiments, for example in electrophysiological or optical recordings taken from synaptic terminals, with each experiment providing a distinct cluster of data. However, there are many other types of experimental design that can yield clustered data. Here, we provide a statistical model for intracluster correlation and systematically investigate a range of methods for analyzing clustered data. Our analysis reveals that it is critical to take data clustering into account and suggests appropriate statistical approaches that can be used to account for data clustering.",0 +,DEALING WITH SPATIAL NORMALIZATION ERRORS IN fMRI GROUP INFERENCE USING HIERARCHICAL MODELING,"An important challenge in neuroimaging multi-subject studies is to take into account that different brains cannot be aligned perfectly. To this end, we extend the classical mass univariate model for group analysis to incorporate uncer- tainty on localization by introducing, for each subject, a spatial jitter variable to be marginalized out. We derive a Bayes factor to test for the mean popula- tion effect's sign in each voxel of a search volume, and discuss a Gibbs sampler to compute it. This Bayes factor, which generalizes the classical t-statistic, may be combined with a permutation test in order to control the frequentist false positive rate. Results on both simulated and experimental data suggest that this test may outperform conventional mass univariate tests in terms of detection power, while limiting the problem of overestimating the size of activity clusters.",0 +https://doi.org/10.1080/00949659608811729,The posterior distribution of the fixed and random effects in a mixed-effects linear model,"The subject of this paper is Bayesian inference about the fixed and random effects of a mixed-effects linear statistical model with two variance components. It is assumed that a priori the fixed effects have a noninformative distribution and that the reciprocals of the variance components are distributed independently (of each other and of the fixed effects) as gamma random variables. It is shown that techniques similar to those employed in a ridge analysis of a response surface can be used to construct a one-dimensional curve that contains all of the stationary points of the posterior density of the random effects. The “ridge analysis” (of the posterior density) can be useful (from a computational standpoint) in finding the number and the locations of the stationary points and can be very informative about various features of the posterior density. Depending on what is revealed by the ridge analysis, a multivariate normal or multivariate-t distribution that is centered at a posterior mode may provide a s...",0 +https://doi.org/10.1198/016214508000000724,Domain-Level Covariance Analysis for Multilevel Survey Data With Structured Nonresponse,"Health care quality surveys in the United States are administered to individual respondents (i.e., hospital patients, health plan members) to evaluate the performance of health care organizations (i.e., hospitals, health plans), which thus constitute estimation domains. For better understanding and more parsimonious reporting of dimensions of quality, we analyze relationships among quality measures at the domain level. Rather than specifying a full parametric model for the observed responses and the nonresponse patterns at the lower (patient) level, we first fit generalized variance–covariance functions that take into account nonresponse patterns in the survey responses, then specify a likelihood function for the domain mean responses using these generalized variance–covariance functions. This allows us to model directly the relationships among domain means for different items. Because the response scales are bounded, we assume that these means follow a truncated multivariate normal distribution. We calcu...",0 +https://doi.org/10.2307/2533455,Variance Components Testing in the Longitudinal Mixed Effects Model,"This article discusses the asymptotic behavior of likelihood ratio tests for nonzero variance components in the longitudinal mixed effects linear model described by Laird and Ware (1982, Biometrics 38, 963-974). Our discussion of the large-sample behavior of likelihood ratio tests for nonzero variance components is based on the results for nonstandard testing situations by Self and Liang (1987, Journal of the American Statistical Association 82, 605-610).",0 +https://doi.org/10.1016/s0169-7161(07)27013-0,13 Structural Equation Modeling,"Structural equation modeling (SEM) is a multivariate statistical technique for testing hypotheses about the influences of sets of variables on other variables. Hypotheses can involve correlational and regression-like relations among observed variables as well as latent variables. The adequacy of such hypotheses is evaluated by modeling the mean and covariance structures of the observed variables. After an introduction, we present the statistical model. Then we discuss estimation methods and hypothesis tests with an emphasis on the maximum likelihood method based on the assumption of multivariate normal data, including the issues of model (parameter) identification and regularity conditions. We also discuss estimation and testing with non-normal data and with misspecified models, as well as power analysis. To supplement model testing, fit indices have been developed to measure the degree of fit for a SEM model. We describe the major ones. When an initial model does not fit well, Lagrange Multiplier (score) and Wald tests can be used to identify how an initial model might be modified. In addition to these standard topics, we discuss extensions of the model to multiple groups, to repeated observations (growth curve SEM), to data with a hierarchical structure (multi-level SEM), and to nonlinear relationships between latent variables. We also discuss more practical topics such as treatment of missing data, categorical dependent variables, and software information.",0 +https://doi.org/10.1037/fam0000098,"Dyadic conflict, drinking to cope, and alcohol-related problems: A psychometric study and longitudinal actor–partner interdependence model.","The motivational model of alcohol use posits that individuals may consume alcohol to cope with negative affect. Conflict with others is a strong predictor of coping motives, which in turn predict alcohol-related problems. Two studies examined links between conflict, coping motives, and alcohol-related problems in emerging adult romantic dyads. It was hypothesized that the association between conflict and alcohol-related problems would be mediated by coping-depression and coping-anxiety motives. It was also hypothesized that this would be true for actor (i.e., how individual factors influence individual behaviors) and partner effects (i.e., how partner factors influence individual behaviors) and at the between- (i.e., does not vary over the study period) and within-subjects (i.e., varies over the study period) levels. Both studies examined participants currently in a romantic relationship who consumed ≥12 alcoholic drinks in the past year. Study 1 was cross-sectional using university students (N = 130 students; 86.9% female; M = 21.02 years old, SD = 3.43). Study 2 used a 4-wave, 4-week longitudinal design with romantic dyads (N = 100 dyads; 89% heterosexual; M = 22.13 years old, SD = 5.67). In Study 2, coping-depression motives emerged as the strongest mediator of the conflict-alcohol-related problems association, and findings held for actor effects but not partner effects. Supplemental analyses revealed that this mediational pathway only held among women. Within any given week, alcohol-related problems changed systematically in the same direction between romantic partners. Interventions may wish to target coping-depression drinking motives within couples in response to conflict to reduce alcohol-related problems.",0 +https://doi.org/10.1027/1614-2241.5.1.7,Item Selection Rules in Computerized Adaptive Testing,"The item selection rule (ISR) most commonly used in computerized adaptive testing (CAT) is to select the item with maximum Fisher information for the current trait estimation (PFI). Several alternative ISRs have been proposed. Among them, Fisher information considered in an interval (FI*I), Fisher information weighted with the likelihood function (FI*L), Kullback-Leibler information considered in an interval (KL*I) and Kullback-Leibler weighted with the likelihood function (KL*L) have shown a greater precision of trait estimation at the early stages of CAT. A new ISR is proposed, Fisher information by interval with geometric mean (FI*IG), which tries to rectify some detected problems in FI*I. We evaluate accuracy and item bank security for these six ISRs. FI*IG is the only ISR which simultaneously outperforms PFI in both variables. For the other ISRs, there seems to be a trade-off between accuracy and security, PFI being the one with worse accuracy and greater security, and the ISRs using the likelihood function the reverse.",0 +https://doi.org/10.2307/3235360,"Economics and Public Support for the European Union: An Analysis at the National, Regional, and Individual Levels","The intention of this paper is to explore the sources of public attitudes toward the European Union over the last two decades, using cumulative data available from the Eurobarometer series of publi...",0 +https://doi.org/10.5705/ss.2010.106,Default Bayesian analysis for multivariate generalized CAR models,"In recent years, multivariate spatial models have been proven to be an effective tool for analyzing spatially related multidimensional data arising from a common underlying spatial process. Currently, the Bayesian analysis is perhaps the only solution available in this framework where prior selection plays an important role in the inference. The present article contributes towards the development of Bayesian inferential methodology for multivariate generalized linear mixed models, in particular, multivariate conditional autoregressive (CAR) models. The two main contributions of this article are the development of a shrinkage-type default prior for the covariance matrices and innovative computational techniques for the Gibbs sampling implementation. The default prior elicitation is non-informative but results in a proper posterior on the related parameter spaces. This elicitation not only provides robust inference (with respect to prior choice), but also provides improved estimation. In the computational step, we have developed a transformation of the parameters that avoids sampling from restricted domains, thus providing more stability and efficiency in the Gibbs implementation. The methodology has been extended to the case of missing responses in the multi-dimensional setup. Both simulations and real examples are provided to validate and illustrate the proposed methodology.",0 +https://doi.org/10.1207/s15328007sem0802_7,Monte Carlo Experiments: Design and Implementation,"The use of Monte Carlo simulations for the empirical assessment of statistical estimators is becoming more common in structural equation modeling research. Yet, there is little guidance for the researcher interested in using the technique. In this article we illustrate both the design and implementation of Monte Carlo simulations. We present 9 steps in planning and performing a Monte Carlo analysis: (1) developing a theoretically derived research question of interest, (2) creating a valid model, (3) designing specific experimental conditions, (4) choosing values of population parameters, (5) choosing an appropriate software package, (6) executing the simulations, (7) file storage, (8) troubleshooting and verification, and (9) summarizing results. Throughout the article, we use as a running example a Monte Carlo simulation that we performed to illustrate many of the relevant points with concrete information and detail.",0 +https://doi.org/10.1177/0146621605282774,A Feedback Control Strategy for Enhancing Item Selection Efficiency in Computerized Adaptive Testing,"A computerized adaptive test (CAT) may be modeled as a closed-loop system, where item selection is influenced by trait level (θ) estimation and vice versa. When discrepancies exist between an examinee's estimated and true θ levels, nonoptimal item selection is a likely result. Nevertheless, examinee response behavior consistent with optimal item selection can be predicted using item response theory (IRT), without knowledge of an examinee's true θ level, yielding a specific reference point for applying an internal correcting or feedback control mechanism. Incorporating such a mechanism in a CAT is shown to be an effective strategy for increasing item selection efficiency. Results from simulation studies using maximum likelihood (ML) and modal a posteriori (MAP) trait-level estimation and Fisher information (FI) and Fisher interval information (FII) item selection are provided.",0 +https://doi.org/10.1080/1359432x.2015.1063486,"The effect of state core self-evaluations on task performance, organizational citizenship behaviour, and counterproductive work behaviour","Although the personality–performance relationship has been studied extensively, most studies focused on the relationship between between-person differences in the Big Five personality dimensions and between-person differences in job performance. The current paper extends this research in two ways. First, we build on core self-evaluations (CSEs): an alternative, broad personality dimension that has proven to be a good predictor of job performance. Second, we tested concurrent and lagged within-person relationships between CSEs and task performance, organizational citizenship behaviour (OCB), and counterproductive work behaviour (CWB). To this end, we conducted two experience sampling studies; the first one assessing the relationship between state CSEs and levels of momentary task performance and OCB, and a second study in which employees reported on their level of state CSEs and momentary CWB. Results showed that there is substantial within-person variability in CSEs and that these within-person fluctuatio...",0 +https://doi.org/10.1007/s11031-015-9494-x,Attuned to the positive? Awareness and responsiveness to others’ positive emotion experience and display,"Positive emotions are implicated in affiliation and cooperation processes that are central to human social life. For this reason, we hypothesized that people should be highly aware of and responsive to the positive emotions of others. Study 1 examined awareness by testing the accuracy with which perceivers tracked others’ positive emotions. Study 2 examined responsiveness by testing whether positive emotions were predictive of perceivers responding to new relationship opportunity. In Study 1, multilevel analyses of dating couples’ estimates of their partner’s emotions across four semi-structured interactions revealed that both women and men tracked partner positive emotions with considerable accuracy. Additional analyses indicated that tracking accuracy was most pronounced for positive emotions whose display is known to include the Duchenne smile. In Study 2, multilevel analyses of dyads who watched a set of positive and negative emotion-eliciting film clips with a stranger indicated that only positive emotion display predicted subsequent closeness. Together, these findings show that people are highly attuned to the positive emotions of others and can be more attuned to others’ positive emotions than negative emotions. © 2015, Springer Science+Business Media New York.",0 +https://doi.org/10.1111/j.1541-0420.2009.01227.x,Bayesian Inference in Semiparametric Mixed Models for Longitudinal Data,"We consider Bayesian inference in semiparametric mixed models (SPMMs) for longitudinal data. SPMMs are a class of models that use a nonparametric function to model a time effect, a parametric function to model other covariate effects, and parametric or nonparametric random effects to account for the within-subject correlation. We model the nonparametric function using a Bayesian formulation of a cubic smoothing spline, and the random effect distribution using a normal distribution and alternatively a nonparametric Dirichlet process (DP) prior. When the random effect distribution is assumed to be normal, we propose a uniform shrinkage prior (USP) for the variance components and the smoothing parameter. When the random effect distribution is modeled nonparametrically, we use a DP prior with a normal base measure and propose a USP for the hyperparameters of the DP base measure. We argue that the commonly assumed DP prior implies a nonzero mean of the random effect distribution, even when a base measure with mean zero is specified. This implies weak identifiability for the fixed effects, and can therefore lead to biased estimators and poor inference for the regression coefficients and the spline estimator of the nonparametric function. We propose an adjustment using a postprocessing technique. We show that under mild conditions the posterior is proper under the proposed USP, a flat prior for the fixed effect parameters, and an improper prior for the residual variance. We illustrate the proposed approach using a longitudinal hormone dataset, and carry out extensive simulation studies to compare its finite sample performance with existing methods.",0 +https://doi.org/10.1080/00031305.1992.10475842,A Note on the Delta Method,Abstract The delta method is an intuitive technique for approximating the moments of functions of random variables. This note reviews the delta method and conditions under which delta-method approximate moments are accurate.,0 +https://doi.org/10.1080/07399330802523824,Violence and Women's Psychological Distress After Birth: An Exploratory Study in Italy,"Our aim in conducting this study was to analyze the relationships between violence and maternal psychological distress 8 months after a birth, taking into account other important psychosocial factors, known to be associated both with violence and with new mothers’ mental health. A total of 352 women responded to a questionnaire after the birth at a maternity hospital in northern Italy, and 292 also participated in a telephone interview 8 months later. We evaluated psychological distress with the General Health Questionnaire (GHQ), and partner and family violence with a 28-item scale. Eight months postpartum, 5% of women showed high psychological distress; 10% were currently experiencing violence from the partner or another family member. After adjustment for covariates, the odds ratio for depressive symptoms was 13.74 for women experiencing violence. We believe that these results provide support for the important role of violence in postpartum maternal psychological distress.",0 +https://doi.org/10.1002/9780470181218.ch7,Spatial Epidemiology,,0 +https://doi.org/10.1080/10705511.2013.797827,Multivariate Meta-Analysis as Structural Equation Models,"Multivariate meta-analysis has become increasingly popular in the educational, social, and medical sciences. It is because the outcome measures in a meta-analysis can involve more than one effect size. This article proposes 2 mathematically equivalent models to implement multivariate meta-analysis in structural equation modeling (SEM). Specifically, this article shows how multivariate fixed-, random- and mixed-effects meta-analyses can be formulated as structural equation models. metaSEM (a free R package based on OpenMx) and Mplus are used to implement the proposed procedures. A real data set is used to illustrate the procedures. Formulating multivariate meta-analysis as structural equation models provides many new research opportunities for methodological development in both meta-analysis and SEM. Issues related to and extensions on the SEM-based meta-analysis are discussed.",0 +https://doi.org/10.1073/pnas.0711295105,An assessment of fixed-capacity models of visual working memory,"Visual working memory is often modeled as having a fixed number of slots. We test this model by assessing the receiver operating characteristics (ROC) of participants in a visual-working-memory change-detection task. ROC plots yielded straight lines with a slope of 1.0, a tell-tale characteristic of all-or-none mnemonic representations. Formal model assessment yielded evidence highly consistent with a discrete fixed-capacity model of working memory for this task.",0 +https://doi.org/10.1080/0305498930190401,A Multilevel Analysis of School Examination Results,"Data on examination results from inner London schools are analysed in relation to intake achievement, pupil gender and school type. The examination achieve- ment, averaged over subjects, is studied as is achievement in the separate subjects of mathematics and English. Multilevel models are fitted, so that the variation between schools can be studied. It is shown that confidence intervals for school 'residuals' or 'effects' are wide, so that few schools can be separated reliably. In particular, no fine rank ordering of schools legitimately can be produced. A bivariate model for mathematics and English examination achievement scores is fitted. The student level variance for both subjects is shown to increase from the lowest to the highest intake achievement group, with moderately high correlation between the subjects. The paper discusses the implications of these findings for the publication of 'league tables' of school examination and test scores.",0 +https://doi.org/10.1111/1467-9868.00082,The EM Algorithm-an Old Folk-song Sung to a Fast New Tune,"Celebrating the 20th anniversary of the presentation of the paper by Dempster, Laird and Rubin which popularized the EM algorithm, we investigate, after a brief historical account, strategies that aim to make the EM algorithm converge faster while maintaining its simplicity and stability (e.g. automatic monotone convergence in likelihood). First we introduce the idea of a ‘working parameter’ to facilitate the search for efficient data augmentation schemes and thus fast EM implementations. Second, summarizing various recent extensions of the EM algorithm, we formulate a general alternating expectation–conditional maximization algorithm AECM that couples flexible data augmentation schemes with model reduction schemes to achieve efficient computations. We illustrate these methods using multivariate t-models with known or unknown degrees of freedom and Poisson models for image reconstruction. We show, through both empirical and theoretical evidence, the potential for a dramatic reduction in computational time with little increase in human effort. We also discuss the intrinsic connection between EM-type algorithms and the Gibbs sampler, and the possibility of using the techniques presented here to speed up the latter. The main conclusion of the paper is that, with the help of statistical considerations, it is possible to construct algorithms that are simple, stable and fast.",0 +https://doi.org/10.1016/j.jmva.2014.11.007,"A Bayesian method for analyzing combinations of continuous, ordinal, and nominal categorical data with missing values","From a Bayesian perspective, we propose a general method for analyzing a combination of continuous, ordinal (including binary), and categorical/nominal multivariate measures with missing values. We assume multivariate normal linear regression models for multivariate continuous measures, multivariate probit models for correlated ordinal measures, and multivariate multinomial probit models for multivariate categorical/nominal measures. Then we assume a multivariate normal linear model on the continuous vector comprised of continuous variables and those underlying normal variables for ordinal variables from multivariate probit models and for categorical variables from multinomial probit models. We develop a Markov chain Monte Carlo (MCMC) algorithm to estimate unknown parameters including regression parameters, cut-points for ordinal data from the multivariate probit models, and the covariance matrix encompassing both continuous variables and the underlying normal latent variables. Combining the continuous variables and the normal latent variables allows us to model combinations of continuous, ordinal, and categorical multivariate data simultaneously. The framework incorporates flexible priors for the covariance matrix, provides a foundation for inference about the underlying covariance structure, and imputes missing data where needed. The method is illustrated through simulated examples and two real data applications.",0 +https://doi.org/10.1016/j.jpain.2010.01.271,Pain Intensity and Duration Can Be Enhanced by Prior Challenge: Initial Evidence Suggestive of a Role of Microglial Priming,"

Abstract

Activation of spinal microglia and consequent release of proinflammatory mediators facilitate pain. Under certain conditions, responses of activated microglia can become enhanced. Enhanced microglial production of proinflammatory products may result from priming (sensitization), similar to macrophage priming. We hypothesized that if spinal microglia were primed by an initial inflammatory challenge, subsequent challenges may create enhanced pain. Here, we used a ""two-hit"" paradigm using 2 successive challenges, which affect overlapping populations of spinal microglia, presented 2 weeks apart. Mechanical allodynia and/or activation of spinal glia were assessed. Initially, laparotomy preceded systemic lipopolysaccharide (LPS). Prior laparotomy caused prolonged microglial (not astrocyte) activation plus enhanced LPS-induced allodynia. In this ""two-hit"" paradigm, minocycline, a microglial activation inhibitor, significantly reduced later exaggerated pain induced by prior surgery when minocycline was administered intrathecally for 5 days starting either at the time of surgery or 5 days before LPS administration. To test generality of the priming effect, subcutaneous formalin preceded intrathecal HIV-1 gp120, which activates spinal microglia and causes robust allodynia. Prior formalin enhanced intrathecal gp120-induced allodynia, suggesting that microglial priming is not limited to laparotomy and again supporting a spinal site of action. Therefore, spinal microglial priming may increase vulnerability to pain enhancement.

Perspective

Spinal microglia may become ""primed"" (sensitized) following their activation by disparate forms of peripheral trauma/inflammation. As a result, such primed microglia may overrespond to subsequent challenges, thereby enhancing pain intensity and duration.",0 +https://doi.org/10.1007/978-3-319-11424-8_6,Flexibly-Bounded Rationality in Interstate Conflict,"This chapter applies the theory of flexibly bounded rationality to interstate conflict. Flexibly bounded rationality is a theory that states that the bounds prescribed by Herbert Simon in his theory of bounded rationality are flexible. On contextualizing the theory of flexibly bounded rationality, inference, the theory of rational expectation, the theory of rational choice and the theory of rational conterfactuals are described. The theory of flexibly bounded rationality is applied for decision making process. This is done by using a multi-layer perceptron network and particle swarm optimization.",0 +https://doi.org/10.1111/j.1541-0420.2008.01107.x,Testing Random Effects in the Linear Mixed Model Using Approximate Bayes Factors,"Deciding which predictor effects may vary across subjects is a difficult issue. Standard model selection criteria and test procedures are often inappropriate for comparing models with different numbers of random effects due to constraints on the parameter space of the variance components. Testing on the boundary of the parameter space changes the asymptotic distribution of some classical test statistics and causes problems in approximating Bayes factors. We propose a simple approach for testing random effects in the linear mixed model using Bayes factors. We scale each random effect to the residual variance and introduce a parameter that controls the relative contribution of each random effect free of the scale of the data. We integrate out the random effects and the variance components using closed-form solutions. The resulting integrals needed to calculate the Bayes factor are low-dimensional integrals lacking variance components and can be efficiently approximated with Laplace's method. We propose a default prior distribution on the parameter controlling the contribution of each random effect and conduct simulations to show that our method has good properties for model selection problems. Finally, we illustrate our methods on data from a clinical trial of patients with bipolar disorder and on data from an environmental study of water disinfection by-products and male reproductive outcomes.",0 +https://doi.org/10.1348/000711007x270843,Nearly unbiased estimators for the three-parameter Weibull distribution with greater efficiency than the iterative likelihood method,"The maximum likelihood estimation (MLE) method is the most commonly used method to estimate the parameters of the three-parameter Weibull distribution. However, it returns biased estimates. In this paper, we show how to calculate weights which cancel the biases contained in the MLE equations. The exact weights can be computed when the population parameters are known and the expected weights when they are not. Two of the three weights' expected values are dependent only on the sample size, whereas the third also depends on the population shape parameters. Monte Carlo simulations demonstrate the practicability of the weighted MLE method. When compared with the iterative MLE technique, the bias is reduced by a factor of 7 (irrespective of the sample size) and the variability of the parameter estimates is also reduced by a factor of 7 for very small sample sizes, but this gain disappears for large sample sizes.",0 +https://doi.org/10.1093/esr/jcv059,Multilevel Modelling of Country Effects: A Cautionary Tale,"Country effects on outcomes for individuals are often analysed using multilevel (hierarchical) models applied to harmonized multi-country data sets such as ESS, EU-SILC, EVS, ISSP, and SHARE. We point out problems with the assessment of country effects that appear not to be widely appreciated, and develop our arguments using Monte Carlo simulation analysis of multilevel linear and logit models. With large sample sizes of individuals within each country but only a small number of countries, analysts can reliably estimate individual-level effects but estimates of parameters summarizing country effects are likely to be unreliable. Multilevel modelling methods are no panacea.",0 +https://doi.org/10.2307/2998560,On the Role of the Propensity Score in Efficient Semiparametric Estimation of Average Treatment Effects,"In this paper, the role of the propensity score in the efficient estimation of average treatment effects is examined. Under the assumption that the treatment is ignorable given some observed characteristics, it is shown that the propensity score is ancillary for estimation of the average treatment effects. The propensity score is not ancillary for estimation of average treatment effects on the treated. It is suggested that the marginal value of the propensity score lies entirely in the dimension reduction. Efficient semiparametric estimators of average treatment effects and average treatment effects on the treated are shown to take the form of relevant sample averages of the data completed by the nonparametric imputation method. It is shown that the projection on the propensity score is not necessary for efficient semiparametric estimation of average treatment effects on the treated even if the propensity score is known. An application to the experimental data reveals that conditioning on the propensity score may even result in a loss of efficiency.",0 +https://doi.org/10.3758/pbr.15.6.1209,Bayesian and maximum likelihood estimation of hierarchical response time models,"Hierarchical (or multilevel) statistical models have become increasingly popular in psychology in the last few years. In this article, we consider the application of multilevel modeling to the ex-Gaussian, a popular model of response times. We compare single-level and hierarchical methods for estimation of the parameters of ex-Gaussian distributions. In addition, for each approach, we compare maximum likelihood estimation with Bayesian estimation. A set of simulations and analyses of parameter recovery show that although all methods perform adequately well, hierarchical methods are better able to recover the parameters of the ex-Gaussian, by reducing variability in the recovered parameters. At each level, little overall difference was observed between the maximum likelihood and Bayesian methods.",1 +https://doi.org/10.1214/12-ba722,Commensurate Priors for Incorporating Historical Information in Clinical Trials Using General and Generalized Linear Models,"Assessing between-study variability in the context of conventional random-effects meta-analysis is notoriously difficult when incorporating data from only a small number of historical studies. In order to borrow strength, historical and current data are often assumed to be fully homogeneous, but this can have drastic consequences for power and Type I error if the historical information is biased. In this paper, we propose empirical and fully Bayesian modifications of the commensurate prior model (Hobbs et al. 2011) extending Pocock (1976), and evaluate their frequentist and Bayesian properties for incorporating patient-level historical data using general and generalized linear mixed regression models. Our proposed commensurate prior models lead to preposterior admissible estimators that facilitate alternative bias-variance trade-offs than those offered by pre-existing methodologies for incorporating historical data from a small number of historical studies. We also provide a sample analysis of a colon cancer trial comparing time-to-disease progression using a Weibull regression model.",0 +,The College Board computerized placement tests: an application of computerized adaptive testing,,0 +https://doi.org/10.1002/sim.1847,Statistical assessment of mediational effects for logistic mediational models,"The concept of mediation has broad applications in medical health studies. Although the statistical assessment of a mediational effect under the normal assumption has been well established in linear structural equation models (SEM), it has not been extended to the general case where normality is not a usual assumption. In this paper, we propose to extend the definition of mediational effects through causal inference. The new definition is consistent with that in linear SEM and does not rely on the assumption of normality. Here, we focus our attention on the logistic mediation model, where all variables involved are binary. Three approaches to the estimation of mediational effects-Delta method, bootstrap, and Bayesian modelling via Monte Carlo simulation are investigated. Simulation studies are used to examine the behaviour of the three approaches. Measured by 95 per cent confidence interval (CI) coverage rate and root mean square error (RMSE) criteria, it was found that the Bayesian method using a non-informative prior outperformed both bootstrap and the Delta methods, particularly for small sample sizes. Case studies are presented to demonstrate the application of the proposed method to public health research using a nationally representative database. Extending the proposed method to other types of mediational model and to multiple mediators are also discussed.",0 +https://doi.org/10.1111/j.1745-3984.2000.tb01076.x,Monte Carlo Based Null Distribution for an Alternative Goodness-of-Fit Test Statistic in IRT Models,"Assessing the correspondence between model predictions and observed data is a recommended procedure for justifying the application of an IRT model. However, with shorter tests, current goodness-of-fit procedures that assume precise point estimates of ability, are inappropriate. The present paper describes a goodness-of-fit statistic that considers the imprecision with which ability is estimated and involves constructing item fit tables based on each examinee's posterior distribution of ability, given the likelihood of their response pattern and an assumed marginal ability distribution. However, the posterior expectations that are computed are dependent and the distribution of the goodness-of-fit statistic is unknown. The present paper also describes a Monte Carlo resampling procedure that can be used to assess the significance of the fit statistic and compares this method with a previously used method. The results indicate that the method described herein is an effective and reasonably simple procedure for assessing the validity of applying IRT models when ability estimates are imprecise.",0 +https://doi.org/10.1007/bf02294210,"A general structural equation model with dichotomous, ordered categorical, and continuous latent variable indicators","A structural equation model is proposed with a generalized measurement part, allowing for dichotomous and ordered categorical variables (indicators) in addition to continuous ones. A computationally feasible three-stage estimator is proposed for any combination of observed variable types. This approach provides large-sample chi-square tests of fit and standard errors of estimates for situations not previously covered. Two multiple-indicator modeling examples are given. One is a simultaneous analysis of two groups with a structural equation model underlying skewed Likert variables. The second is a longitudinal model with a structural model for multivariate probit regressions.",0 +https://doi.org/10.1111/j.0006-341x.1999.00463.x,Finite Mixture Modeling with Mixture Outcomes Using the EM Algorithm,"This paper discusses the analysis of an extended finite mixture model where the latent classes corresponding to the mixture components for one set of observed variables influence a second set of observed variables. The research is motivated by a repeated measurement study using a random coefficient model to assess the influence of latent growth trajectory class membership on the probability of a binary disease outcome. More generally, this model can be seen as a combination of latent class modeling and conventional mixture modeling. The EM algorithm is used for estimation. As an illustration, a random-coefficient growth model for the prediction of alcohol dependence from three latent classes of heavy alcohol use trajectories among young adults is analyzed.",0 +https://doi.org/10.1016/j.jspi.2010.03.046,Pseudo-empirical Bayes estimation of small area means under a nested error linear regression model with functional measurement errors,"Abstract Small area estimation is studied under a nested error linear regression model with area level covariate subject to measurement error. Ghosh and Sinha (2007) obtained a pseudo-Bayes (PB) predictor of a small area mean and a corresponding pseudo-empirical Bayes (PEB) predictor, using the sample means of the observed covariate values to estimate the true covariate values. In this paper, we first derive an efficient PB predictor by using all the available data to estimate true covariate values. We then obtain a corresponding PEB predictor and show that it is asymptotically “optimal”. In addition, we employ a jackknife method to estimate the mean squared prediction error (MSPE) of the PEB predictor. Finally, we report the results of a simulation study on the performance of our PEB predictor and associated jackknife MSPE estimator. Our results show that the proposed PEB predictor can lead to significant gain in efficiency over the previously proposed PEB predictor. Area level models are also studied.",0 +https://doi.org/10.1207/s15327906mbr3604_06,Sample Size in Factor Analysis: The Role of Model Error,"This article examines effects of sample size and other design features on correspondence between factors obtained from analysis of sample data and those present in the population from which the samples were drawn. We extend earlier work on this question by examining these phenomena in the situation in which the common factor model does not hold exactly in the population. We present a theoretical framework for representing such lack of fit and examine its implications in the population and sample. Based on this approach we hypothesize that lack of fit of the model in the population will not, on the average, influence recovery of population factors in analysis of sample data, regardless of degree of model error and regardless of sample size. Rather, such recovery will be affected only by phenomena related to sampling error which have been studied previously. These hypotheses are investigated and verified in two sampling studies, one using artificial data and one using empirical data.",0 +https://doi.org/10.1348/000711005x81403,Bayesian analysis of structural equation models with mixed exponential family and ordered categorical data,"Structural equation models are very popular for studying relationships among observed and latent variables. However, the existing theory and computer packages are developed mainly under the assumption of normality, and hence cannot be satisfactorily applied to non-normal and ordered categorical data that are common in behavioural, social and psychological research. In this paper, we develop a Bayesian approach to the analysis of structural equation models in which the manifest variables are ordered categorical and/or from an exponential family. In this framework, models with a mixture of binomial, ordered categorical and normal variables can be analysed. Bayesian estimates of the unknown parameters are obtained by a computational procedure that combines the Gibbs sampler and the Metropolis-Hastings algorithm. Some goodness-of-fit statistics are proposed to evaluate the fit of the posited model. The methodology is illustrated by results obtained from a simulation study and analysis of a real data set about non-adherence of hypertension patients in a medical treatment scheme.",0 +https://doi.org/10.1126/science.153.3736.652,High-Speed Scanning in Human Memory,"When subjects judge whether a test symbol is contained in a short memorized sequence of symbols, their mean reaction-time increases linearly with the length of the sequence. The linearity and slope of the function imply the existence of an internal serial-comparison process whose average rate is between 25 and 30 symbols per second.",0 +https://doi.org/10.3758/s13428-014-0526-3,Estimation of the latent mediated effect with ordinal data using the limited-information and Bayesian full-information approaches,"It is common to encounter latent variables with ordinal data in social or behavioral research. Although a mediated effect of latent variables (latent mediated effect, or LME) with ordinal data may appear to be a straightforward combination of LME with continuous data and latent variables with ordinal data, the methodological challenges to combine the two are not trivial. This research covers model structures as complex as LME and formulates both point and interval estimates of LME for ordinal data using the Bayesian full-information approach. We also combine weighted least squares (WLS) estimation with the bias-corrected bootstrapping (BCB; Efron Journal of the American Statistical Association, 82, 171–185, 1987) method or the traditional delta method as the limited-information approach. We evaluated the viability of these different approaches across various conditions through simulation studies, and provide an empirical example to illustrate the approaches. We found that the Bayesian approach with reasonably informative priors is preferred when both point and interval estimates are of interest and the sample size is 200 or above. © 2014, Psychonomic Society, Inc.",1 +https://doi.org/10.1037/a0027131,Hopes and cautions in implementing Bayesian structural equation modeling.,"Muthén and Asparouhov (2012) have proposed and demonstrated an approach to model specification and estimation in structural equation modeling (SEM) using Bayesian methods. Their contribution builds on previous work in this area by (a) focusing on the translation of conventional SEM models into a Bayesian framework wherein parameters fixed at zero in a conventional model can be respecified using small-variance priors and (b) implementing their approach in software that is widely accessible. We recognize potential benefits for applied researchers as discussed by Muthén and Asparouhov, and we also see a tradeoff in that effective use of the proposed approach introduces increased demands in terms of expertise of users to navigate new complexities in model specification, parameter estimation, and evaluation of results. We also raise cautions regarding the issues of model modification and model fit. Although we see significant potential value in the use of Bayesian SEM, we also believe that effective use will require an awareness of these complexities.",0 +https://doi.org/10.2307/3002019,An Approximate Distribution of Estimates of Variance Components,,0 +https://doi.org/10.1080/00273171.2013.784861,A Multidimensional and Multilevel Extension of a Random-Effect Approach to Subjective Judgment in Rating Scales,"In responding to rating scale items, respondents may hold different perspectives on the given categories. The random-effect rating scale model (RERSM), developed to account for variations in the category thresholds across respondents, is unidimensional and unilevel. It becomes statistically inefficient when multiple unidimensional tests have to be analyzed and inapplicable when data have a multilevel structure (e.g., respondents nested within organizations, students nested within schools). To resolve these problems, this study develops a multidimensional and multilevel version of the RERSM. The parameters can be estimated with existing computer software. Thus, there is no need to develop estimation procedures or corresponding computer programs. Simulation studies were conducted to evaluate the parameter recovery of the multidimensional RERSM, the multilevel RERSM, and the multidimensional and multilevel RERSM using WinBUGS. The results showed that the parameter recovery was generally satisfactory. An empirical example of the application of the multidimensional and multilevel RERSM to 2006 Program for International Student Assessment inventories about attitudes toward learning sciences is provided.",0 +https://doi.org/10.2307/3316114,Multiple roots of estimating functions,en,0 +https://doi.org/10.3109/09286586.2013.867508,Structural Equation Modeling: A Framework for Ocular and Other Medical Sciences Research,"Structural equation modeling (SEM) is a modeling framework that encompasses many types of statistical models and can accommodate a variety of estimation and testing methods. SEM has been used primarily in social sciences but is increasingly used in epidemiology, public health, and the medical sciences. SEM provides many advantages for the analysis of survey and clinical data, including the ability to model latent constructs that may not be directly observable. Another major feature is simultaneous estimation of parameters in systems of equations that may include mediated relationships, correlated dependent variables, and in some instances feedback relationships. SEM allows for the specification of theoretically holistic models because multiple and varied relationships may be estimated together in the same model. SEM has recently expanded by adding generalized linear modeling capabilities that include the simultaneous estimation of parameters of different functional form for outcomes with different distributions in the same model. Therefore, mortality modeling and other relevant health outcomes may be evaluated. Random effects estimation using latent variables has been advanced in the SEM literature and software. In addition, SEM software has increased estimation options. Therefore, modern SEM is quite general and includes model types frequently used by health researchers, including generalized linear modeling, mixed effects linear modeling, and population average modeling. This article does not present any new information. It is meant as an introduction to SEM and its uses in ocular and other health research.",0 +https://doi.org/10.1111/hepr.12467,Relative efficacy and safety of simeprevir and telaprevir in treatment-naïve hepatitis C-infected patients in a Japanese population: A Bayesian network meta-analysis,"Simeprevir (SMV) is an oral, once-daily protease inhibitor for the treatment of chronic hepatitis C virus (HCV) genotype 1 infection. In phase II/III randomized controlled trials (RCT) conducted in Japan, SMV, in combination with peginterferon-α and ribavirin (PEG IFN/RBV), demonstrated potent efficacy in HCV genotype 1-infected patients relative to PEG IFN/RBV and was generally well tolerated. Telaprevir (TVR) in combination with PEG IFN/RBV is licensed for the treatment of HCV in Japan. In the absence of head-to-head comparisons of TVR and SMV in a Japanese population, we undertook a network meta-analysis (NMA) to examine the relative efficacy and safety of SMV and TVR in combination with PEG IFN/RBV.A systematic review identified SMV and TVR RCT in Japanese treatment-naïve patients. Bayesian NMA was performed assuming fixed study effects.Three studies met our inclusion criteria: two SMV and one TVR. SMV showed a higher mean odds ratio (OR) of achieving SVR versus TVR (OR, 1.68 (95% credible interval 0.66-4.26)). SMV showed a lower mean OR of discontinuation: overall, 0.35 (0.12-1.00); and due to AE, 0.87 (0.23-3.34) versus TVR. SMV showed a lower mean OR of experiencing anemia 0.20 (0.07-0.56) and rash 0.41 (0.17-0.99) but a higher mean OR of experiencing pruritus 1.26 (0.46-3.47) versus TVR.In this indirect treatment comparison, SMV, in combination with PEG IFN/RBV, showed a favorable risk-benefit profile compared with TVR with PEG IFN/RBV in Japanese treatment-naïve HCV patients.",0 +https://doi.org/10.1111/j.0081-1750.2006.00163.x,Editor's Introduction,,0 +https://doi.org/10.2307/3172669,A Monte Carlo Comparison of Estimators for the Multinomial Logit Model,,0 +https://doi.org/10.1177/0013164410387336,Item Selection Criteria With Practical Constraints for Computerized Classification Testing,"This study compares four item selection criteria for a two-category computerized classification testing: (1) Fisher information (FI), (2) Kullback—Leibler information (KLI), (3) weighted log-odds ratio (WLOR), and (4) mutual information (MI), with respect to the efficiency and accuracy of classification decision using the sequential probability ratio test as well as the extent of item usage. The comparability of the four item selection criteria are examined primarily under three types of item selection conditions: (1) using only the four item selection algorithms, (2) using the four item selection algorithms and content balancing control, and (3) using the four item selection algorithms, content balancing control, and item exposure control. The comparability of the four item selection criteria is also evaluated in two types of proficiency distribution and three levels of indifference region width. The results show that the differences of the four item selection criteria are washed out as more realistic constraints are imposed. Moreover, within two-category classification testing, the use of MI does not necessarily generate greater efficiency than FI, WLOR, and KLI, although MI might seem attractive for its general form of formula in item selection.",0 +https://doi.org/10.1080/10705510701301511,"Bayesian Methods for Analyzing Structural Equation Models With Covariates, Interaction, and Quadratic Latent Variables","The analysis of interaction among latent variables has received much attention. This article introduces a Bayesian approach to analyze a general structural equation model that accommodates the general nonlinear terms of latent variables and covariates. This approach produces a Bayesian estimate that has the same statistical optimal properties as a maximum likelihood estimate. Other advantages over the traditional approaches are discussed. More important, we demonstrate through examples how to use the freely available software WinBUGS to obtain Bayesian results for estimation and model comparison. Simulation studies are conducted to assess the empirical performances of the approach for situations with various sample sizes and prior inputs.",0 +https://doi.org/10.1111/1467-9884.00242,On Estimating Standard Errors in Multilevel Analysis,"Standard errors of maximum likelihood estimators are commonly estimated from the inverse of the information matrix. When the information matrix is a function of parameters, some of which are estimated with little precision, the standard error may be estimated very poorly. This problem is discussed in the context of two-level (random-coefficient) models, and some remedies are proposed.",0 +https://doi.org/10.1214/08-sts257,Markov Chain Monte Carlo: Can We Trust the Third Significant Figure?,"Current reporting of results based on Markov chain Monte Carlo computations could be improved. In particular, a measure of the accuracy of the resulting estimates is rarely reported. Thus we have little ability to objectively assess the quality of the reported estimates. We address this issue in that we discuss why Monte Carlo standard errors are important, how they can be easily calculated in Markov chain Monte Carlo and how they can be used to decide when to stop the simulation. We compare their use to a popular alternative in the context of two examples.",0 +https://doi.org/10.1016/s0277-9536(02)00370-2,"The health impact of health care on families: a matched cohort study of hospice use by decedents and mortality outcomes in surviving, widowed spouses","Alternative ways of caring for seriously ill patients might have implications not only for patients' own outcomes, but also, indirectly, for the health outcomes of their family members. Clinical observation suggests that patients who die ""good deaths"" may impose less stress on their spouses. Consequently, we sought to assess whether hospice use by a decedent is associated with decreased risk of death in surviving, bereaved spouses. We conducted a matched retrospective cohort study involving a population-based sample of 195,553 elderly couples in the USA. A total of 30,838 couples where the decedent used hospice care were matched using the propensity score method to 30,838 couples where the decedent did not use hospice care. Our principal outcome of interest was the duration of survival of bereaved widow/ers. After adjustment for other measured variables, 5.4% of bereaved wives died by 18 months after the death of their husband when their deceased husband did not use hospice and 4.9% died when their deceased husband did use hospice, yielding an odds ratio (OR) of 0.92 (95% CI: 0.84-0.99) in favor of hospice use. Similarly, whereas 13.7% of bereaved husbands died by 18 months when their deceased wife did not use hospice, 13.2% died when their deceased wife did use hospice, yielding an OR of 0.95 (95% CI: 0.84-1.06) in favor of hospice use. Our findings suggest a possible beneficial impact of hospice--as a particularly supportive type of end-of-life care--on the spouses of patients who succumb to their disease. Hospice care might attenuate the ordinarily increased mortality associated with becoming widowed. This effect is present in both men and women, but it is statistically significant and possibly larger in bereaved wives. The size of this effect is comparable to the reductions in the risk of death seen in a variety of other modifiable risk factors in women. Health care may have positive, group-level health ""externalities"": it may affect the health not only of patients but also of patients' family members.",0 +https://doi.org/10.3102/0002831207308230,Classroom Effects on Children’s Achievement Trajectories in Elementary School,"This nonexperimental, longitudinal field study examines the extent to which variation in observed classroom supports (quality of emotional and instructional interactions and amount of exposure to literacy and math activities) predicts trajectories of achievement in reading and math from 54 months to fifth grade. Growth mixture modeling detected two latent classes of readers: fast readers whose skills developed rapidly and leveled off, and a typical group for which reading growth was somewhat less rapid. Only one latent class was identified for math achievement. For reading, there were small positive associations between observed emotional quality of teacher-child interactions and growth. Growth in math achievement showed small positive relations with observed emotional interactions and exposure to math activities. There was a significant interaction between quality and quantity of instruction for reading such that at higher levels of emotional quality there was less of a negative association between amount of literacy exposure and reading growth.",0 +https://doi.org/10.1080/00949655.2012.692368,An item response model for Likert-type data that incorporates response time in personality measurements,"This study defines a measurement index for the differences in response probabilities to an item. Based on the difference index, a probability–difficulty (PD) hypothesis is proposed. A general framework for modelling responses and response times (RTs) on Likert-type personality items is presented, in which the submodel describing the item responses can be a graded item response theory model, and the submodel describing RTs is developed based on the PD hypothesis. This framework is exemplified by employing the generalized partial credit model for responses and a log-normal model for RTs. Furthermore, Bayesian methods for estimating model parameters and for assessing the model–data fit are described. A simulation study shows that the new approach improves the accuracy of estimating the individual trait levels with the ancillary information contained in RTs. Finally, the applicability of our approach is illustrated by an empirical example in personality measurements.",0 +,"The Rasch model, additive conjoint measurement, and new models of probabilistic measurement theory.","This research describes some of the similarities and differences between additive conjoint measurement (a type of fundamental measurement) and the Rasch model. It seems that there are many similarities between the two frameworks, however, their differences are nontrivial. For instance, while conjoint measurement specifies measurement scales using a data-free, non-numerical axiomatic frame of reference, the Rasch model specifies measurement scales using a numerical frame of reference that is, by definition, data dependent. In order to circumvent difficulties that can be realistically imposed by this data dependence, this research formalizes new non-parametric item response models. These models are probabilistic measurement theory models in the sense that they explicitly integrate the axiomatic ideas of measurement theory with the statistical ideas of order-restricted inference and Markov Chain Monte Carlo. The specifications of these models are rather flexible, as they can represent any one of several models used in psychometrics, such as Mokken's (1971) monotone homogeneity model, Scheiblechner's (1995) isotonic ordinal probabilistic model, or the Rasch (1960) model. The proposed non-parametric item response models are applied to analyze both real and simulated data sets.",0 +https://doi.org/10.1037/met0000029,Monotonicity of effect sizes: Questioning kappa-squared as mediation effect size measure.,"Mediation analysis is important for research in psychology and other social and behavioral sciences. Great progress has been made in testing mediation effects and in constructing their confidence intervals. Mediation effect sizes have also been considered. Preacher and Kelley (2011) proposed and recommended κ² as an effect size measure for a mediation effect. In this article, we argue that κ² is not an appropriate effect size measure for mediation models, because of its lack of the property of rank preservation (e.g., the magnitude of κ² may decrease when the mediation effect that κ² represents increases). Furthermore, κ² can lead to paradoxical results in multiple mediation models. We show that the problem of κ² is due to (a) the improper calculation of the maximum possible value of the indirect effect, and (b) mathematically, the maximum possible indirect effect is infinity, implying that the definition of κ² is mathematically incorrect. At this time, it appears that the traditional mediation effect size measure PM (the ratio of the indirect effect to the total effect), together with some other statistical information, should be preferred for basic mediation models. But for inconsistent mediation models where the indirect effect and the direct effect have opposite signs, the situation is less clear. Other considerations and suggestions for future research are also discussed.",0 +https://doi.org/10.11575/prism/28116,The Effects of School Work Pressure on Depression and Substance Use: A Cross-National Study of School-Aged Children in Canada and Finland,,0 +https://doi.org/10.1016/j.ssresearch.2010.09.012,The typification of Hispanics as criminals and support for punitive crime control policies,"The Hispanic population is now the largest and fastest growing minority in the United States, so it is not surprising that ethnic threat linked to Hispanics has been associated with harsher crime control. While minority threat research has found that individuals who associate blacks with crime are more likely to support harsh criminal policies, the possibility that this relationship exists for those who typify Hispanics as criminal has yet to be examined. Using a national random sample, this study is the first to use HLM to find that perceptions of Hispanics as criminals do increase support for punitive crime control measures, controlling for various individual and state influences. Moderated and contextual analyses indicate this relationship is most applicable for individuals who are less apt to typify criminals as black, less prejudiced, less fearful of victimization, politically liberal or moderate, not parents, and living in states with relatively fewer Latin American immigrants.",0 +https://doi.org/10.1016/j.csda.2007.03.024,A Bayesian propensity score adjustment for latent variable modeling and MCMC algorithm,"The estimation of the differences among groups in observational studies is frequently inaccurate owing to a bias caused by differences in the distributions of covariates. In order to estimate the average treatment effects when the treatment variable is binary, Rosenbaum and Rubin [1983. The central role of the propensity score in observational studies for causal effects. Biometrika 70, 41-55] proposed an adjustment method for pre-treatment variables using propensity scores. Imbens [2000. The role of the propensity score in estimating dose-response functions. Biometrika 87, 706-710] extended the propensity score methodology for estimation of average treatment effects with multivalued treatments. However, these studies focused only on estimating the marginal mean structure. In many substantive sciences such as the biological and social sciences, a general estimation method is required to deal with more complex analyses other than regression, such as testing group differences on latent variables. For latent variable models, the EM algorithm or the traditional Monte Carlo methods are necessary. However, in propensity score adjustment, these methods cannot be used because the full distribution is not specified. In this paper, we propose a quasi-Bayesian estimation method for general parametric models that integrate out the distributions of covariates using propensity scores. Although the proposed Bayes estimates are shown to be consistent, they can be calculated by existing Markov chain Monte Carlo methods such as Gibbs sampler. The proposed method is useful to estimate parameters in latent variable models, while the previous methods were unable to provide valid estimates for complex models such as latent variable models. We also illustrated the procedure using the data obtained from the US National Longitudinal Survey of Children and Youth (NLSY1979-2002) for estimating the effect of maternal smoking during pregnancy on the development of the child's cognitive functioning.",0 +https://doi.org/10.1177/026540758800500207,Interpersonal Perception: A Social Relations Analysis,"Seven basic research questions in interpersonal perception are posed concerning issues of consensus, assimilation, reciprocity, accuracy, congruence, assumed similarity and self—other agreement. All questions can be addressed at the individual level, and three at the dyadic level. It is shown how the Social Relations Model can be used to answer the questions.",0 +https://doi.org/10.1080/00273170903333665,Doubly-Latent Models of School Contextual Effects: Integrating Multilevel and Structural Equation Approaches to Control Measurement and Sampling Error,"This article is a methodological-substantive synergy. Methodologically, we demonstrate latent-variable contextual models that integrate structural equation models (with multiple indicators) and multilevel models. These models simultaneously control for and unconfound measurement error due to sampling of items at the individual (L1) and group (L2) levels and sampling error due the sampling of persons in the aggregation of L1 characteristics to form L2 constructs. We consider a set of models that are latent or manifest in relation to sampling items (measurement error) and sampling of persons (sampling error) and discuss when different models might be most useful. We demonstrate the flexibility of these 4 core models by extending them to include random slopes, latent (single-level or cross-level) interactions, and latent quadratic effects. Substantively we use these models to test the big-fish-little-pond effect (BFLPE), showing that individual student levels of academic self-concept (L1-ASC) are positively associated with individual level achievement (L1-ACH) and negatively associated with school-average achievement (L2-ACH)-a finding with important policy implications for the way schools are structured. Extending tests of the BFLPE in new directions, we show that the nonlinear effects of the L1-ACH (a latent quadratic effect) and the interaction between gender and L1-ACH (an L1 × L1 latent interaction) are not significant. Although random-slope models show no significant school-to-school variation in relations between L1-ACH and L1-ASC, the negative effects of L2-ACH (the BFLPE) do vary somewhat with individual L1-ACH. We conclude with implications for diverse applications of the set of latent contextual models, including recommendations about their implementation, effect size estimates (and confidence intervals) appropriate to multilevel models, and directions for further research in contextual effect analysis.",0 +https://doi.org/10.1016/j.ophtha.2013.04.010,A Systematic Review of Endophthalmitis after Microincisional versus 20-Gauge Vitrectomy,"Endophthalmitis is a rare but severe complication of vitrectomy.Post-surgical endophthalmitis is suspected to be more frequent after microincisional (23- and 25-gauge) compared with standard (20-gauge) vitrectomy.We conducted a systematic review of studies that compared microincisional and standard vitrectomy by searching MEDLINE and EMBASE up to November 2012. We used the Bayesian meta-analysis method to compute the odds ratio (OR) of endophthalmitis. We conducted subgroup analyses to compare the effect of different incision types and use of perioperative antibiotics.We identified 3 small randomized and 18 nonrandomized studies that reported 68 cases of endophthalmitis in 148 643 participants. The overall OR of endophthalmitis for microincisional versus standard vitrectomy was 2.3 (95% credible interval [CrI], 0.8-5.8). We found an increased risk of endophthalmitis using a microincisional straight approach compared with standard vitrectomy (OR, 15.1; 95% CrI, 2.01-179), but not for a beveled approach (OR, 0.82; 95% CrI, 0.23-2.28). The OR of studies that reported on mixed microincision was between these 2 values (OR, 4.4; 95% CrI, 1.32-14.3). We estimated that the overall rate of endophthalmitis with 20-gauge vitrectomy was 3 cases in 10 000 procedures, and the probability that a beveled microincision increases the rate of endophthalmitis to more than 6 or 9 events was small (no more than 5% or 1%, respectively).We did not find an increased risk of endophthalmitis for microincisional vitrectomy compared with standard vitrectomy. The beveled approach seems to be safer than a straight approach, supporting the current recommendation of its adoption in microincisional vitrectomy. However, these findings must be interpreted cautiously because of the small number of endophthalmitis events reported from included studies.",0 +https://doi.org/10.1371/journal.pcbi.1004003,A Probabilistic Palimpsest Model of Visual Short-term Memory,"Working memory plays a key role in cognition, and yet its mechanisms remain much debated. Human performance on memory tasks is severely limited; however, the two major classes of theory explaining the limits leave open questions about key issues such as how multiple simultaneously-represented items can be distinguished. We propose a palimpsest model, with the occurrent activity of a single population of neurons coding for several multi-featured items. Using a probabilistic approach to storage and recall, we show how this model can account for many qualitative aspects of existing experimental data. In our account, the underlying nature of a memory item depends entirely on the characteristics of the population representation, and we provide analytical and numerical insights into critical issues such as multiplicity and binding. We consider representations in which information about individual feature values is partially separate from the information about binding that creates single items out of multiple features. An appropriate balance between these two types of information is required to capture fully the different types of error seen in human experimental data. Our model provides the first principled account of misbinding errors. We also suggest a specific set of stimuli designed to elucidate the representations that subjects actually employ.",0 +https://doi.org/10.2307/2986138,Adaptive Rejection Metropolis Sampling within Gibbs Sampling,"Gibbs sampling is a powerful technique for statistical inference. It involves little more than sampling from full conditional distributions, which can be both complex and computationally expensive to evaluate. Gilks and Wild have shown that in practice full conditionals are often log‐concave, and they proposed a method of adaptive rejection sampling for efficiently sampling from univariate log‐concave distributions. In this paper, to deal with non‐log‐concave full conditional distributions, we generalize adaptive rejection sampling to include a Hastings‐Metropolis algorithm step. One important field of application in which statistical models may lead to non‐log‐concave full conditionals is population pharmacokinetics. Here, the relationship between drug dose and blood or plasma concentration in a group of patients typically is modelled by using nonlinear mixed effects models. Often, the data used for analysis are routinely collected hospital measurements, which tend to be noisy and irregular. Consequently, a robust (t‐distributed) error structure is appropriate to account for outlying observations and/or patients. We propose a robust nonlinear full probability model for population pharmacokinetic data. We demonstrate that our method enables Bayesian inference for this model, through an analysis of antibiotic administration in new‐born babies.",0 +https://doi.org/10.1207/s15328007sem1203_1,Sensitivity of Fit Indexes to Misspecified Structural or Measurement Model Components: Rationale of Two-Index Strategy Revisited,"In previous research (Hu & Bentler, 1998, 1999), 2 conclusions were drawn: standardized root mean squared residual (SRMR) was the most sensitive to misspecified factor covariances, and a group of other fit indexes were most sensitive to misspecified factor loadings. Based on these findings, a 2-index strategy-that is, SRMR coupled with another index-was proposed in model fit assessment to detect potential misspecification in both the structural and measurement model parameters. Based on our reasoning and empirical work presented in this article, we conclude that SRMR is not necessarily most sensitive to misspecified factor covariances (structural model misspecification), the group of indexes (TLI, BL89, RNI, CFI, Gamma hat, Mc, or RMSEA) are not necessarily more sensitive to misspecified factor loadings (measurement model misspecification), and the rationale for the 2-index presentation strategy appears to have questionable validity.",0 +https://doi.org/10.1108/ijphm-05-2014-0028,Healthcare service quality: what really matters to the female patient?,Purpose – This paper aims to develop a model that encompasses the constructs and sub-constructs consumers use in evaluating healthcare service quality (HSQ) in Egypt. Design/methodology/approach – Factor analysis was performed on 40 variables to identify the constructs. Ordinal logistic regression was also used to identify the sub-constructs and examine the effect of each sub-construct on patients’ overall perception of service quality. Findings – Factor analysis confirmed an eight-construct framework: hospital premises and employees; doctor medical service; nursing medical service; diagnostic medical service; admission; discharge; rooms and housekeeping; and meals. Ordinal logistic regression established 17 sub-constructs – physician reliability; physician assurance; physician interaction; physician’s competence; nursing tangibles; nursing reliability; nursing assurance; nursing interaction; nursing responsiveness; diagnostic service competence; diagnostic service reliability; hospital premises and employees tangibles; admission responsiveness; admission knowledge and courtesy; meals tangibles; rooms tangibles and housekeeping courtesy; and discharge knowledge and courtesy – that have significant effect on HSQ. Some sub-constructs had a significantly greater impact on overall perception of service quality than others. Practical implications – Healthcare providers will be able to pinpoint areas of service quality shortfall and better satisfy their patients. This will ultimately lead to repeat patronage and positive recommendation behavior. Originality/value – The model is the first comprehensive model in the Middle East that takes into account all constructs and sub-constructs patients use for evaluation of HSQ.,0 +https://doi.org/10.1007/s00180-010-0215-3,Prediction interval for disease mapping using hierarchical likelihood,"In disease mapping, the Bayesian approach is widely used for forming the prediction interval of relative risks. In this paper we propose a hierarchical-likelihood interval for disease mapping, which accounts for the inflation of standard error estimates caused by uncertainty in the estimation of the fixed parameters. Comparison is made with the Bayesian prediction intervals derived from penalized quasi-likelihood and fully Bayesian methods. Through simulation studies, we show that prediction intervals for random effects using hierarchical likelihood maintains the required level. © 2010 Springer-Verlag.",0 +https://doi.org/10.1007/bf02295614,A hierarchical bayesian statistical framework for response time distributions,"This paper provides a statistical framework for estimating higher-order characteristics of the response time distribution, such as the scale (variability) and shape. Consideration of these higher order characteristics often provides for more rigorous theory development in cognitive and perceptual psychology (e.g., Luce, 1986). RT distribution for a single participant depends on certain participant characteristics, which in turn can be thought of as arising from a distribution of latent variables. The present work focuses on the three-parameter Weibull distribution, with parameters for shape, scale, and shift (initial value). Bayesian estimation in a hierarchical framework is conceptually straightforward. Parameter estimates, both for participant quantities and population parameters, are obtained through Markov Chain Monte Carlo methods. The methods are illustrated with an application to response time data in an absolute identification task. The behavior of the Bayes estimates are compared to maximum likelihood (ML) estimates through Monte Carlo simulations. For small sample size, there is an occasional tendency for the ML estimates to be unreasonably extreme. In contrast, by borrowing strength across participants, Bayes estimation “shrinks” extreme estimates. The results are that the Bayes estimators are more accurate than the corresponding ML estimators.",0 +https://doi.org/10.1007/s00127-015-1168-1,The Great Smoky Mountains Study: developmental epidemiology in the southeastern United States,"To describe the Great Smoky Mountains Study (GSMS).GSMS is a longitudinal study of child psychiatric disorders that began in 1992 to look at need for mental health services in a rural area of the USA. Over 20 years it has expanded its range to include developmental epidemiology more generally, not only the development of psychiatric and substance abuse problems but also their correlates and predictors: family and environmental risk, physical development including puberty, stress and stress-related hormones, trauma, the impact of poverty, genetic markers, and epigenetics. Now that participants are in their 30s the focus has shifted to adult outcomes of childhood psychopathology and risk, and early physical, cognitive, and psychological markers of aging.This paper describes the results from over 11,000 interviews, examples of the study's contributions to science and policy, and plans for the future.Longitudinal studies can provide insights that aid in policy planning.",0 +https://doi.org/10.1177/0010414008325286,Ethnic Diversity and Generalized Trust in Europe,"While most current research documents a negative relation between ethnic diversity and generalized trust, it has to be acknowledged that these results often originate from one-country analyses in North America. In this article, attitudinal measurements from the European Social Survey are combined with Organization for Economic Co-Operation and Development data on migration patterns, thus examining the relationship between diversity and trust in a comparative manner across 20 European countries. More fine-grained measurements of diversity (including type and rise of diversity over time and legal status of immigrants) are included in a multilevel model. At the individual level, most of the familiar relations were confirmed. At the country level, hardly any indicators for migration or diversity proved to be strongly and consistently related to generalized trust. Results suggest that the pessimistic conclusions about the negative effects of ethnic diversity on generalized trust cannot be confirmed at the aggregate level across European countries.",0 +https://doi.org/10.1093/ije/dyn088,Morbidity and mortality in Brazilian municipalities: a multilevel study of the association between socioeconomic and healthcare indicators,"Socioeconomic and healthcare indicators are major determinants of health outcomes. The impact of social and healthcare inequalities on Brazilian morbidity and mortality indicators is of concern but it is not well studied.A multilevel ecological study was performed in order to investigate the association between a set of socioeconomic and healthcare indicators and five morbidity and mortality outcomes. Datasets were presented at three hierarchical levels: local (lower level), regional (intermediate level) and state (higher level). A Poisson regression model was estimated for each outcome with random intercept and fixed regression coefficients for independent variables at the three levels. The magnitude of outcome variability at intermediate and higher levels was assessed for all models.All outcomes were associated with both socioeconomic and healthcare variables, with predominance of associations at the local level. General and high-complexity healthcare infrastructures were directly associated with indicators related to later stages of the demographic and epidemiological transition process. A mild effect on morbidity and mortality related to political voting patterns was found at the local level.Healthcare conditions and socioeconomic indicators are associated with health outcomes in a complex way at the local level in Brazil, but part of the variability of health outcomes is related to factors operating at higher levels. Some possible interaction effects and cross-sectional design limitations of this study must be considered.",0 +https://doi.org/10.1177/1534735408322849,Biological Mediators of Effect of Diet and Stress Reduction on Prostate Cancer,"Background. A 6-month pilot intervention trial was conducted to determine whether adoption of a plant-based diet, reinforced by stress reduction, could reduce the rate of prostate-specific antigen (PSA) increase, a marker of disease progression, in asymptomatic, hormonally untreated patients experiencing consistently increasing PSA levels after surgery or radiation. Methods. A pre—post design was used to examine (1) the effect of intervention on potential mediators of disease progression, including body composition and weight-related biomarkers (sex steroid hormones and cytokines), and (2) whether changes in these variables were associated with change in rate of PSA increase. The baseline rate of PSA increase (from the time of posttreatment recurrence to the start of intervention) was ascertained from medical records. Body composition and biomarkers were assessed at baseline (prior to intervention), during the intervention (3 months), and at the end of the intervention (6 months). Changes in body composition and biomarkers were determined and compared with rates of PSA increase over the corresponding time intervals. Results. There was a significant reduction in waist-to-hip ratio ( P = .03) and increase in circulating sex hormone binding globulin ( P = .04). The rate of PSA increase decreased from the preintervention period (PSA slope = 0.059) to the period from 0 to 3 months (PSA slope = 0.002, P < .01) and increased slightly, although not significantly, from 0 to 3 months to the period from 3 to 6 months (0.029, P = .43). Conclusions. Adoption of a plant-based diet and stress reduction may reduce central adiposity and improve the hormonal milieu in patients with recurrent PC. Changes in the rate of increase in PSA were in the same direction as changes in waist-to-hip ratio and opposite those of sex hormone binding globulin, raising the possibility that the effect of the intervention may have been mediated, in part, by these variables.",0 +https://doi.org/10.1002/sim.1187,How should meta-regression analyses be undertaken and interpreted?,"Appropriate methods for meta-regression applied to a set of clinical trials, and the limitations and pitfalls in interpretation, are insufficiently recognized. Here we summarize recent research focusing on these issues, and consider three published examples of meta-regression in the light of this work. One principal methodological issue is that meta-regression should be weighted to take account of both within-trial variances of treatment effects and the residual between-trial heterogeneity (that is, heterogeneity not explained by the covariates in the regression). This corresponds to random effects meta-regression. The associations derived from meta-regressions are observational, and have a weaker interpretation than the causal relationships derived from randomized comparisons. This applies particularly when averages of patient characteristics in each trial are used as covariates in the regression. Data dredging is the main pitfall in reaching reliable conclusions from meta-regression. It can only be avoided by prespecification of covariates that will be investigated as potential sources of heterogeneity. However, in practice this is not always easy to achieve. The examples considered in this paper show the tension between the scientific rationale for using meta-regression and the difficult interpretative problems to which such analyses are prone.",0 +https://doi.org/10.1201/b14835-24,MCMC for nonlinear hierarchical models,,0 +https://doi.org/10.1111/j.1744-6570.1991.tb00688.x,THE BIG FIVE PERSONALITY DIMENSIONS AND JOB PERFORMANCE: A META-ANALYSIS,"This study investigated the relation of the “Big Five” personality dimensions (Extraversion, Emotional Stability, Agreeableness, Conscientiousness, and Openness to Experience) to three job performance criteria (job proficiency, training proficiency, and personnel data) for five occupational groups (professionals, police, managers, sales, and skilled/semi-skilled). Results indicated that one dimension of personality, Conscientiousness, showed consistent relations with all job performance criteria for all occupational groups. For the remaining personality dimensions, the estimated true score correlations varied by occupational group and criterion type. Extraversion was a valid predictor for two occupations involving social interaction, managers and sales (across criterion types). Also, both Openness to Experience and Extraversion were valid predictors of the training proficiency criterion (across occupations). Other personality dimensions were also found to be valid predictors for some occupations and some criterion types, but the magnitude of the estimated true score correlations was small (ρ < .10). Overall, the results illustrate the benefits of using the 5-factor model of personality to accumulate and communicate empirical findings. The findings have numerous implications for research and practice in personnel psychology, especially in the subfields of personnel selection, training and development, and performance appraisal.",0 +https://doi.org/10.1111/j.1460-9568.2004.03709.x,Evidence that exogenous and endogenous fractalkine can induce spinal nociceptive facilitation in rats,"Recent evidence suggests that spinal cord glia can contribute to enhanced nociceptive responses. However, the signals that cause glial activation are unknown. Fractalkine (CX3C ligand-1; CX3CL1) is a unique chemokine expressed on the extracellular surface of spinal neurons and spinal sensory afferents. In the dorsal spinal cord, fractalkine receptors are primarily expressed by microglia. As fractalkine can be released from neurons upon strong activation, it has previously been suggested to be a neuron-to-glial signal that induces glial activation. The present series of experiments provide an initial investigation of the spinal pain modulatory effects of fractalkine. Intrathecal fractalkine produced dose-dependent mechanical allodynia and thermal hyperalgesia. In addition, a single injection of fractalkine receptor antagonist (neutralizing antibody against rat CX3C receptor-1; CX3CR1) delayed the development of mechanical allodynia and/or thermal hyperalgesia in two neuropathic pain models: chronic constriction injury (CCI) and sciatic inflammatory neuropathy. Intriguingly, anti-CX3CR1 reduced nociceptive responses when administered 5–7 days after CCI, suggesting that prolonged release of fractalkine may contribute to the maintenance of neuropathic pain. Taken together, these initial investigations of spinal fractalkine effects suggest that exogenous and endogenous fractalkine are involved in spinal sensitization, including that induced by peripheral neuropathy.",0 +https://doi.org/10.1177/0146621605285517,Posterior Predictive Assessment of Item Response Theory Models,"Model checking in item response theory (IRT) is an underdeveloped area. There is no universally accepted tool for checking IRT models. The posterior predictive model-checking method is a popular Bayesian model-checking tool because it has intuitive appeal, is simple to apply, has a strong theoretical basis, and can provide graphical or numerical evidence about model misfit. An important issue with the application of the posterior predictive model-checking method is the choice of a discrepancy measure (which plays a role like that of a test statistic in traditional hypothesis tests). This article examines the performance of a number of discrepancy measures for assessing different aspects of fit of the common IRT models and makes specific recommendations about what measures are most useful in assessing model fit. Graphical summaries of model-checking results are demonstrated to provide useful insights about model fit.",0 +https://doi.org/10.1093/acprof:oso/9780195152968.001.0001,Applied Longitudinal Data Analysis,"Abstract Change is constant in everyday life. Infants crawl and then walk, children learn to read and write, teenagers mature in myriad ways, and the elderly become frail and forgetful. Beyond these natural processes and events, external forces and interventions instigate and disrupt change: test scores may rise after a coaching course, drug abusers may remain abstinent after residential treatment. By charting changes over time and investigating whether and when events occur, researchers reveal the temporal rhythms of our lives. This book is concerned with behavioral, social, and biomedical sciences. It offers a presentation of two of today's most popular statistical methods: multilevel models for individual change and hazard/survival models for event occurrence (in both discrete- and continuous-time). Using data sets from published studies, the book takes you step by step through complete analyses, from simple exploratory displays that reveal underlying patterns through sophisticated specifications of complex statistical models.",0 +https://doi.org/10.1111/j.1468-0491.2011.01521.x,Dimensions of Family Policy and Female Labor Market Participation: Analyzing Group-Specific Policy Effects,"This article investigates whether and how family policy influences the probability and intensity of mothers' labor market participation. Unlike previous studies, this contribution focuses on group-specific policy effects, thereby accounting for the fact that, theoretically, women with different resources and preferences should respond differently to given policy measures. The analyses show that varying individual characteristics indeed influence the impact family policy measures have on women's individual behavior. First and foremost, family policies most strongly influence mothers with medium levels of education, for whom labor market participation tends to be “optional.” Moreover, high direct and indirect cash benefits to families, which primarily stem from traditional conservative family policy, reduce the probability of employment for women with low to medium levels of education.",0 +https://doi.org/10.1167/5.3.8,Relational information in visual short-term memory: The structural gist,"Over the past 20 years, storage of visual items in visual short-term memory has been extensively studied by many research groups. In addition to questions concerning the format of object storage is a more global question that focuses on the organization of information in visual short-term memory. In a series of experiments we investigated how relations across visual items determined the accessibility of individual item information. This relational information seems to be very strong within the store devoted to each feature dimension. We also investigated the role of selective attention on the storage of relational information. The experiments suggest a broadening of the parallel store model of visual short-term memory proposed by M. E. Wheeler and A. M. Treisman (2002) to include the notion of what we call ""structural gist.""",0 +,"Modeling covariance matrices in terms of standard deviations and correlations, with application to shrinkage","The covariance matrix plays an important role in statistical inference, yet modeling a covariance matrix is often a difficult task in practice due to its dimensionality and the non-negative definite constraint. In order to model a co- variance matrix effectively, it is typically broken down into components based on modeling considerations or mathematical convenience. Decompositions that have received recent research attention include variance components, spectral decompo- sition, Cholesky decomposition, and matrix logarithm. In this paper we study a statistically motivated decomposition which appears to be relatively unexplored for the purpose of modeling. We model a covariance matrix in terms of its correspond- ing standard deviations and correlation matrix. We discuss two general modeling situations where this approach is useful: shrinkage estimation of regression co- efficients, and a general location-scale model for both categorical and continuous variables. We present some simple choices for priors in terms of standard deviations and the correlation matrix, and describe a straightforward computational strategy for obtaining the posterior of the covariance matrix. We apply our method to real and simulated data sets in the context of shrinkage estimation.",0 +https://doi.org/10.1096/fj.12-222992,Rifampin inhibits Toll‐like receptor 4 signaling by targeting myeloid differentiation protein 2 and attenuates neuropathic pain,"Rifampin has been used for the treatment of bacterial infections for many years. Clinically, rifampin has been found to possess immunomodulatory effects. However, the molecular target responsible for the immunosuppressive effects of rifampin is not known. Herein, we show that rifampin binds to myeloid differentiation protein 2 (MD-2), the key coreceptor for innate immune TLR4. Rifampin blocked TLR4 signaling induced by LPS, including NF-κB activation and the overproduction of proinflammatory mediators nitric oxide, interleukin 1β, and tumor necrosis factor α in mouse microglia BV-2 cells and macrophage RAW 264.7 cells. Rifampin's inhibition of TLR4 signaling was also observed in immunocompetent rat primary macrophage, microglia, and astrocytes. Further, we show that rifampin (75 or 100 mg/kg b.i.d. for 3 d, intraperitoneal) suppressed allodynia induced by chronic constriction injury of the sciatic nerve and suppressed nerve injury-induced activation of microglia. Our findings indicate that MD-2 is a important target of rifampin in its inhibition of innate immune function and contributes to its clinically observed immune-suppressive effect. The results also suggest that rifampin may be repositioned as an agent for the treatment of neuropathic pain.",0 +https://doi.org/10.1167/13.10.9,Modeling visual working memory with the MemToolbox,"The MemToolbox is a collection of MATLAB functions for modeling visual working memory. In support of its goal to provide a full suite of data analysis tools, the toolbox includes implementations of popular models of visual working memory, real and simulated data sets, Bayesian and maximum likelihood estimation procedures for fitting models to data, visualizations of data and fit, validation routines, model comparison metrics, and experiment scripts. The MemToolbox is released under the permissive BSD license and is available at http://memtoolbox.org.",0 +https://doi.org/10.1111/j.1467-842x.2005.00405.x,HIERARCHICAL BAYESIAN MODELLING OF SOCIAL VARIATION IN THE AGE DEPENDENCE OF DISABILITY PREVALENCE,"Summary Motivated by a study of social variation in the relationship of functional limitation prevalence to age, this paper examines methods for modelling social variation in health outcomes. It is argued that, from a Bayesian perspective, modelling the dependence of functional limitation prevalence on age separately for each social group, corresponds to an implausible prior model, in addition to leading to imprecise estimates for some groups. The alternative strategy of fitting a single model, perhaps including some age-by-group interactions but omitting higher-order interactions, requires a strong prior commitment to the absence of such effects. Hierarchical Bayesian modelling is proposed as a compromise between these two analytical approaches. Under all hierarchical Bayes analyses there is strong evidence for an ethnic group difference in limitation prevalence in early- to mid-adulthood among tertiary-qualified males. In contrast, the single-model approach largely misses this effect, while the group-specific analyses exhibit an unrealistically large degree of heterogeneity in gender-education-specific ethnicity effects. The sensitivity of posterior inferences to prior specifications is studied.",0 +https://doi.org/10.1080/09644016.2011.589577,Citizens as veto players: climate change policy and the constraints of direct democracy,"The search for and implementation of effective climate change policies is one of the crucial challenges of policy-makers. One strand of literature argues that domestic factors and in particular institutional prerequisites or veto points strongly influence the quality and pace of a country's policy innovation and adaptation. Focusing on a particular institutional veto point – direct democracy – how does direct democracy influence a country's adaptive capacity in the areas of climate change and, more precisely, what kind of climate change policies have the best chances to be accepted in citizen's direct decision-making? The analyses demonstrate that direct democracy makes it difficult to implement far-reaching, but probably most effective climate change policies, while its direct and indirect impact on the policy-making process rather produces politics of small steps that are supported by a broad political elite.",0 +https://doi.org/10.1002/9780470686621,Bayesian Analysis for the Social Sciences,"List of Figures. List of Tables. Preface. Acknowledgments. Introduction. Part I: Introducing Bayesian Analysis. 1. The foundations of Bayesian inference. 1.1 What is probability? 1.2 Subjective probability in Bayesian statistics. 1.3 Bayes theorem, discrete case. 1.4 Bayes theorem, continuous parameter. 1.5 Parameters as random variables, beliefs as distributions. 1.6 Communicating the results of a Bayesian analysis. 1.7 Asymptotic properties of posterior distributions. 1.8 Bayesian hypothesis testing. 1.9 From subjective beliefs to parameters and models. 1.10 Historical note. 2. Getting started: Bayesian analysis for simple models. 2.1 Learning about probabilities, rates and proportions. 2.2 Associations between binary variables. 2.3 Learning from counts. 2.4 Learning about a normal mean and variance. 2.5 Regression models. 2.6 Further reading. Part II: Simulation Based Bayesian Analysis. 3. Monte Carlo methods. 3.1 Simulation consistency. 3.2 Inference for functions of parameters. 3.3 Marginalization via Monte Carlo integration. 3.4 Sampling algorithms. 3.5 Further reading. 4. Markov chains. 4.1 Notation and definitions. 4.2 Properties of Markov chains. 4.3 Convergence of Markov chains. 4.4 Limit theorems for Markov chains. 4.5 Further reading. 5. Markov chain Monte Carlo. 5.1 Metropolis-Hastings algorithm. 5.2 Gibbs sampling. 6. Implementing Markov chain Monte Carlo. 6.1 Software for Markov chain Monte Carlo. 6.2 Assessing convergence and run-length. 6.3 Working with BUGS/JAGS from R. 6.4 Tricks of the trade. 6.5 Other examples. 6.6 Further reading. Part III: Advanced Applications in the Social Sciences. 7. Hierarchical Statistical Models. 7.1 Data and parameters that vary by groups: the case for hierarchical modeling. 7.2 ANOVA as a hierarchical model. 7.3 Hierarchical models for longitudinal data. 7.4 Hierarchical models for non-normal data. 7.5 Multi-level models. 8. Bayesian analysis of choice making. 8.1 Regression models for binary responses. 8.2 Ordered outcomes. 8.3 Multinomial outcomes. 8.4 Multinomial probit. 9. Bayesian approaches to measurement. 9.1 Bayesian inference for latent states. 9.2 Factor analysis. 9.3 Item-response models. 9.4 Dynamic measurement models. Part IV: Appendices. Appendix A: Working with vectors and matrices. Appendix B: Probability review. B.1 Foundations of probability. B.2 Probability densities and mass functions. B.3 Convergence of sequences of random variabales. Appendix C: Proofs of selected propositions. C.1 Products of normal densities. C.2 Conjugate analysis of normal data. C.3 Asymptotic normality of the posterior density. References. Topic index. Author index.",0 +https://doi.org/10.1080/10705511.2014.935749,Modeling Nonlinear Structural Equation Models: A Comparison of the Two-Stage Generalized Additive Models and the Finite Mixture Structural Equation Model,"Researchers have devoted some time and effort to developing methods for fitting nonlinear relationships among latent variables. In particular, most of these have focused on correctly modeling interactions between 2 exogenous latent variables, and quadratic relationships between exogenous and endogenous variables. All of these approaches require prespecification of the nonlinearity by the researcher, and are limited to fairly simple nonlinear relationships. Other work has been done using mixture structural equation models (SEMM) in an attempt to fit more complex nonlinear relationships. This study expands on this earlier work by introducing the 2-stage generalized additive model (2SGAM) approach for fitting regression splines in the context of structural equation models. The model is first described and then investigated through the use of simulated data, in which it was compared with the SEMM approach. Results demonstrate that the 2SGAM is an effective tool for fitting a variety of nonlinear relationships...",0 +https://doi.org/10.1214/08-aos619,Flexible covariance estimation in graphical Gaussian models,"In this paper, we propose a class of Bayes estimators for the covariance matrix of graphical Gaussian models Markov with respect to a decomposable graph G. Working with the WPG family defined by Letac and Massam [Ann. Statist. 35 (2007) 1278–1323] we derive closed-form expressions for Bayes estimators under the entropy and squared-error losses. The WPG family includes the classical inverse of the hyper inverse Wishart but has many more shape parameters, thus allowing for flexibility in differentially shrinking various parts of the covariance matrix. Moreover, using this family avoids recourse to MCMC, often infeasible in high-dimensional problems. We illustrate the performance of our estimators through a collection of numerical examples where we explore frequentist risk properties and the efficacy of graphs in the estimation of high-dimensional covariance structures.",0 +https://doi.org/10.1016/s0167-9473(02)00234-7,Computing the distribution of the product of two continuous random variables,"We present an algorithm for computing the probability density function of the product of two independent random variables, along with an implementation of the algorithm in a computer algebra system. We combine this algorithm with the earlier work on transformations of random variables to create an automated algorithm for convolutions of random variables. Some examples demonstrate the algorithm's application.",0 +https://doi.org/10.2307/3001666,The Combination of Estimates from Different Experiments,"When we are trying to make the best estimate of some quantity A that is available from the research conducted to date, the problem of combining results from different experiments is encountered. The problem is often troublesome, particularly if the individual estimates were made by different workers using different procedures. This paper discusses one of the simpler aspects of the problem, in which there is sufficient uniformity of experimental methods so that the ith experiment provides an estimate xi of u, and an estimate si of the standard error of xi . The experiments may be, for example, determinations of a physical or astronomical constant by different scientists, or bioassays carried out in different laboratories, or agricultural field experiments laid out in different parts of a region. The quantity xi may be a simple mean of the observations, as in a physical determination, or the difference between the means of two treatments, as in a comparative experiment, or a median lethal dose, or a regression coefficient. The problem of making a combined estimate has been discussed previously by Cochran (1937) and Yates and Cochran (1938) for agricultural experiments, and by Bliss (1952) for bioassays in different laboratories. The last two papers give recommendations for the practical worker. My purposes in treating the subject again are to discuss it in more general terms, to take account of some recent theoretical research, and, I hope, to bring the practical recommendations to the attention of some biologists who are not acquainted with the previous papers. The basic issue with which this paper deals is as follows. The simplest method of combining estimates made in a number of different experiments is to take the arithmetic mean of the estimates. If, however, the experiments vary in size, or appear to be of different precision, the investigator may wonder whether some kind of weighted meani would be more precise. This paper gives recommendations about the kinds of weighted mean that are appropriate, the situations in which they",0 +https://doi.org/10.4310/sii.2013.v6.n1.a4,A Bayesian analysis of generalized latent curve mixture models,"Latent curve models for longitudinal data have received increasing attention in medical, educational, psychological, and behavioral sciences. In these applied areas of research, heterogeneous longitudinal data are common. This paper proposes the use of generalized latent curve models for analyzing heterogenous longitudinal data. The basic model features a mixture of trajectories. It also employs a multinomial logit model for assessing the influence of fixed covariates and explanatory latent variables on the class membership probability within the mixture model. This broad class of models also handles non-normal data from the exponential family distributions. A Bayesian approach is implemented for data analysis. We report a simulation study that proves the satisfactory performance of the proposed approach. Furthermore, we analyzed a real data set extracted from the National Longitudinal Survey of Youth to illustrate the practical value of the proposed model and methodology.",0 +https://doi.org/10.1037/a0013024,Central relationship themes in group psychotherapy: A social relations model analysis of transference.,"Group members (N = 55) in 11 therapy groups reported central relationship themes (CRTs) (wishes, responses of others, and responses of self) with other group members and with a romantic partner. Social relations model analyses were used to partition the variance in group member CRT ratings with other members into perceiver, target, and relationship plus error variance components. Significant perceiver variance in member CRT ratings was proposed to serve as a proxy for transference. Overall, significant perceiver variance and mostly insignificant target variance was found, and the perceiver effect accounted for substantially more variance than the target effect. As an exploratory question, the authors wondered to what extent relationship variance accounted for the total variance in member ratings of their CRT? Unfortunately, relationship variance could not be separated from error in this study. Relationship plus error variance accounted for, on average, 42% of the variance in scores. In addition, as a test of the social microcosm of the group theory, it was hypothesized that group member CRTs within the group would relate to member CRTs with a romantic partner outside of the group. Contrary to expectation, this hypothesis was not supported. © 2008 American Psychological Association.",0 +https://doi.org/10.1037/a0032574,Multilevel confirmatory ordinal factor analysis of the Life Skills Profile–16.,"The aim of this study was to assess the factor structure of the Life skills profile-16 (LSP-16; Buckingham, Burgess, Solomon, Pirkis, & Eagar, 1998a, 1998b) with a view to meeting the assumption of statistical independence that is at significant risk of violation due to the dependency introduced to the data by pooling numerous ratings made by the same observers across independent patients. The sample consisted of 20,181 outpatients rated by 2,071 clinicians employed within 54 mental health organizations within the New South Wales public adult mental health service. To estimate the extent to which the item scores were contaminated with rater-level intraclass correlations (ICC), I fit 16 3-level multinominal ordered proportional odds intercept only models that revealed large ICCs associated with Level 2 (the rater of the LSP-16) demonstrating that a multilevel analysis was required. A multilevel confirmatory factor analysis (M-CFA) using robust weighted least squares (B. O. Muthén, du Toit, & Spisic, 1997) with polychoric correlation was used to test the fit of 2 measurement models that were hypothesized a priori. The 2 models failed to provide an acceptable fit to the sample data and within- and between-level CFAs were used to inform revisions to the 4-factor model. A 15-item version of the LSP was developed, which provided an improved approximate fit in an M-CFA. Limitations of these findings are discussed.",0 +https://doi.org/10.1093/biomet/79.4.797,Characterizing the effect of matching using linear propensity score methods with normal distributions,"SUMMARY Matched sampling is a standard technique for controlling bias in observational studies due to specific covariates. Since Rosenbaum & Rubin (1983), multivariate matching methods based on estimated propensity scores have been used with increasing frequency in medical, educational, and sociological applications. We obtain analytic expressions for the effect of matching using linear propensity score methods with normal distributions. These expressions cover cases where the propensity score is either known, or estimated using either discriminant analysis or logistic regression, as is typically done in current practice. The results show that matching using estimated propensity scores not only reduces bias along the population propensity score, but also controls variation of components orthogonal to it. Matching on estimated rather than population propensity scores can therefore lead to relatively large variance reduction, as much as a factor of two in common matching settings where close matches are possible. Approximations are given for the magnitude of this variance reduction, which can be computed using estimates obtained from the matching pools. Related expressions for bias reduction are also presented which suggest that, in difficult matching situations, the use of population scores leads to greater bias reduction than the use of estimated scores.",0 +https://doi.org/10.1080/10705511.2016.1186549,On Using Bayesian Methods to Address Small Sample Problems,"As Bayesian methods continue to grow in accessibility and popularity, more empirical studies are turning to Bayesian methods to model small sample data. Bayesian methods do not rely on asympotics, a property that can be a hindrance when employing frequentist methods in small sample contexts. Although Bayesian methods are better equipped to model data with small sample sizes, estimates are highly sensitive to the specification of the prior distribution. If this aspect is not heeded, Bayesian estimates can actually be worse than frequentist methods, especially if frequentist small sample corrections are utilized. We show with illustrative simulations and applied examples that relying on software defaults or diffuse priors with small samples can yield more biased estimates than frequentist methods. We discuss conditions that need to be met if researchers want to responsibly harness the advantages that Bayesian methods offer for small sample problems as well as leading small sample frequentist methods.",1 +https://doi.org/10.18148/srm/2012.v6i2.5033,How few countries will do? Comparative survey analysis from a Bayesian perspective,"Meuleman and Billiet (2009) have carried out a simulation study aimed at the question how many countries are needed for accurate multilevel SEM estimation in comparative studies. The authors concluded that a sample of 50 to 100 countries is needed for accurate estimation. Recently, Bayesian estimation methods have been introduced in structural equation modeling which should work well with much lower sample sizes. The current study reanalyzes the simulation of Meuleman and Billiet using Bayesian estimation to find the lowest number of countries needed when conducting multilevel SEM. The main result of our simulations is that a sample of about 20 countries is sufficient for accurate Bayesian estimation, which makes multilevel SEM practicable for the number of countries commonly available in large scale comparative surveys.",1 +https://doi.org/10.1111/j.1365-2753.2008.01010.x,Meta-analysis of repeated measures study designs,"Repeated measures studies are found in many areas of research, particularly in areas of healthcare. There is currently little information available to inform the method of meta-analysis of repeated measures studies so that the structural dependence of the data is appropriately accommodated and the findings are meaningful.Using a published meta-analysis on the impact of diet advice on weight reduction of obese or overweight individuals, we demonstrate possible approaches for repeated measures meta-analysis. These approaches differ in terms of the type of result obtained (e.g. effect at a particular time-point, trend over time, change between time-points) and the data needed for the analysis (e.g. means, regression slope estimates). Some approaches involve violating assumptions of independence in the data structure and so to investigate the impact of this violation a simulation study is carried out.The different approaches described for the meta-analyses of repeated measures studies can all provide useful effect estimates depending on the question to be addressed by the meta-analysis. However, violation of the independence assumption in some approaches can lead to biased estimates.In practice, the methods available to carry out meta-analyses of repeated measures studies will not only depend upon the question of interest, but also on the data available from the primary studies.",0 +https://doi.org/10.1177/1536867x0200200101,Reliable Estimation of Generalized Linear Mixed Models using Adaptive Quadrature,"Generalized linear mixed models or multilevel regression models have become increasingly popular. Several methods have been proposed for estimating such models. However, to date there is no single method that can be assumed to work well in all circumstances in terms of both parameter recovery and computational efficiency. Stata's xt commands for two-level generalized linear mixed models (e.g., xtlogit) employ Gauss–Hermite quadrature to evaluate and maximize the marginal log likelihood. The method generally works very well, and often better than common contenders such as MQL and PQL, but there are cases where quadrature performs poorly. Adaptive quadrature has been suggested to overcome these problems in the two-level case. We have recently implemented a multilevel versionofthismethodin gllamm, a program that fits a large class of multilevel latent variable models including multilevel generalized linear mixed models. As far as we know, this is the first time that adaptive quadrature has been proposed for multilevel models. We show that adaptive quadrature works well in problems where ordinary quadrature fails. Furthermore, even when ordinary quadrature works, adaptive quadrature is often computationally more efficient since it requires fewer quadrature points to achieve the same precision.",0 +https://doi.org/10.1111/j.1751-9004.2010.00303.x,The Social Relations Model: How to Understand Dyadic Processes,The social relations model (SRM) is an intriguing tool both to conceptualize and to analyze dyadic processes. We begin with explaining why interpersonal phenomena in everyday life are more complex than often considered. We then show how the SRM accounts for these complexities by decomposing interpersonal perceptions and behaviors into three independent components and describe the designs required to investigate these components. We then provide a step-by-step,0 +https://doi.org/10.1111/j.1745-3984.1998.tb00537.x,Some Practical Examples of Computer-Adaptive Sequential Testing,"Computerized testing has created new challenges for the production and administration of test forms. Many testing organizations engaged in or considering computerized testing may find themselves changing from well-established procedures for handcrafting a small number of paper-and-pencil test forms to procedures for mass producing many computerized test forms. This paper describes an integrated approach to test development and administration called computer-adaptive sequential testing, or CAST. CAST is a structured approach to test construction which incorporates both adaptive testing methods with automated test assembly to allow test developers to maintain a greater degree of control over the production, quality assurance, and administration of different types of computerized tests. CAST retains much of the efficiency of traditional computer adaptive testing (CAT) and can be modified for computer mastery testing (CMT) applications. The CAST framework is described in detail and several applications are demonstrated using a medical licensure example.",0 +https://doi.org/10.1111/j.1467-9248.2010.00835.x,When Deliberative Theory Meets Empirical Political Science: Theoretical and Methodological Challenges in Political Deliberation,"Re-linking deliberative theory with empirical political science has become a major theme in the discipline. But when philosophical concepts are to be integrated into positive political science, researchers confront both theoretical and methodological challenges. Focusing on deliberative democracy, a major theoretical challenge is the practical implementation of deliberative ideals. Comparative scholars have explored institutional contexts that favour deliberation, but they have largely neglected actor-centric and cultural variables that might affect deliberative quality as well. Focusing on legislatures in Switzerland and Germany, we show that political institutions as well as partisan strategies and status strongly affect deliberative action, while the effects of culture are less clear. Methodologically, one (frequently neglected) challenge concerns the appropriate statistical tools with which to study deliberation. On the one hand, analysing deliberative processes is demanding and time consuming; hence we tend to have only few and non-randomly selected cases at the group or context level. In addition, the real world of deliberation presents us with a complex matrix of cross-classified speakers. We demonstrate that Bayesian multi-level modelling provides an elegant way to tackle these methodological problems.",0 +https://doi.org/10.1016/j.jmva.2009.04.013,Bayesian analysis of non-linear structural equation models with non-ignorable missing outcomes from reproductive dispersion models,"Non-linear structural equation models are widely used to analyze the relationships among outcomes and latent variables in modern educational, medical, social and psychological studies. However, the existing theories and methods for analyzing non-linear structural equation models focus on the assumptions of outcomes from an exponential family, and hence can’t be used to analyze non-exponential family outcomes. In this paper, a Bayesian method is developed to analyze non-linear structural equation models in which the manifest variables are from a reproductive dispersion model (RDM) and/or may be missing with non-ignorable missingness mechanism. The non-ignorable missingness mechanism is specified by a logistic regression model. A hybrid algorithm combining the Gibbs sampler and the Metropolis–Hastings algorithm is used to obtain the joint Bayesian estimates of structural parameters, latent variables and parameters in the logistic regression model, and a procedure calculating the Bayes factor for model comparison is given via path sampling. A goodness-of-fit statistic is proposed to assess the plausibility of the posited model. A simulation study and a real example are presented to illustrate the newly developed Bayesian methodologies.",0 +https://doi.org/10.1016/j.lisr.2012.11.006,International students' everyday life information seeking: The informational value of social networking sites,"Abstract Sojourns to other countries, such as for studying abroad, are increasingly common. However, adjusting to life in a different country can be stressful and require significant effort. Sojourners need to not only maintain and expand their social networks, but they also continuously seek information about their new environment. While international students are a sizable group, their daily information behavior is not well understood. This study posits that social networking sites (SNS), such as Facebook, may play an important role in international students' everyday life information seeking (ELIS). Using descriptive statistics, ANOVA, and structural equation modeling (SEM), the study analyzed international students' everyday life information needs, their usage of SNS for ELIS, and the relationships among demographics, personality traits, SNS usage, and perceived usefulness of the acquired everyday life information. Findings indicate that a majority of the respondents frequently used SNS for ELIS. Younger students, undergraduates, and extroverts were more likely to use SNS for ELIS, while no gender difference was found. Notably, among the nine user characteristics and behavior factors, SNS usage emerged as the only positive predictor of perceived usefulness of acquired information in meeting daily needs. This indicates that SNS serve as a valuable channel for purposeful everyday life information seeking. Beyond its social support value, the ELIS value of SNS is a fruitful area for future research.",0 +https://doi.org/10.1207/s15328007sem0703_2,Performance of Modified Test Statistics in Covariance and Correlation Structure Analysis Under Conditions of Multivariate Nonnormality,"Questions of whether hypothesized structure models are appropriate representations of the pattern of association among a group of variables can be addressed using a wide variety of statistical procedures. These procedures include covariance structure analysis techniques and correlation structure analysis techniques, in which covariance structure procedures are based on distribution theory for covariances, and correlation structure procedures are based on distribution theory for correlations. The present article provides an overview of standard and modified normal theory and asymptotically distribution-free covariance and correlation structure analysis techniques and also details Monte Carlo simulation results on the Type I and Type II error control as a function of structure model type, number of variables in the model, sample size, and distributional nonnormality. The present Monte Carlo simulation demonstrates clearly that the robustness and nonrobustness of structure analysis techniques vary as a funct...",0 +https://doi.org/10.1167/11.5.1,Surface color perception and equivalent illumination models,"Vision provides information about the properties and identity of objects. The ease with which we perceive object properties belies the difficulty of the underlying information-processing task. In the case of object color, retinal information about object reflectance is confounded with information about the illumination as well as about the object's shape and pose. There is no obvious rule that allows transformation of the retinal image to a color representation that depends primarily on object surface reflectance. Under many circumstances, however, object color appearance is remarkably stable across scenes in which the object is viewed. Here, we review a line of experiments and theory that aim to understand how the visual system stabilizes object color appearance. Our emphasis is on models derived from explicit analysis of the computational problem of estimating the physical properties of illuminants and surfaces from the retinal image, and experiments that test these models. We argue that this approach has considerable promise for allowing generalization from simplified laboratory experiments to richer scenes that more closely approximate natural viewing. We discuss the relation between the work we review and other theoretical approaches available in the literature.",0 +https://doi.org/10.1007/bf02294343,Multidimensional adaptive testing,"Maximum likelihood and Bayesian procedures for item selection and scoring of multidimensional adaptive tests are presented. A demonstration using simulated response data illustrates that multidimensional adaptive testing (MAT) can provide equal or higher reliabilities with about one-third fewer items than are required by one-dimensional adaptive testing (OAT). Furthermore, holding test-length constant across the MAT and OAT approaches, substantial improvements in reliability can be obtained from multidimensional assessment. A number of issues relating to the operational use of multidimensional adaptive testing are discussed.",0 +https://doi.org/10.1177/0146621613508306,Detecting DIF With Ideal Point Models,"Ideal point models have become increasingly popular in research and practice, but little is known about how traditional methods for linking and detecting differential item functioning (DIF) perform with data satisfying ideal point assumptions. Very few studies have been conducted on this topic, and the results of some well-known area and parameter difference DIF detection methods have been inconsistent with previous research involving dominance models. Consequently, the authors conducted a Monte Carlo study to help identify sources of these discrepancies. Specifically, they compared the effectiveness of the Lord’s chi-square parameter difference method and the differential functioning of items and tests (DFIT) area method for detecting DIF with the Generalized Graded Unfolding Model (GGUM). The results clearly indicated that when DIF was simulated via parameter shifts that produced constant magnitudes of effect for all designated items, Lord’s chi-square and DFIT performed similarly well. In addition, the authors found that iterative item characteristic curve (ICC) linking outperformed iterative test characteristic curve (TCC) linking in most experimental conditions. The implications of these findings for DIF detection research and practice with ideal point models are discussed.",0 +https://doi.org/10.2466/pr0.106.2.519-533,Classical and Bayesian Estimation in the Logistic Regression Model Applied to Diagnosis of Child Attention Deficit Hyperactivity Disorder,"The limitations inherent to classical estimation of the logistic regression models are known. The Bayesian approach in statistical analysis is an alternative to be considered, given that it makes it possible to introduce prior information about the phenomenon under study. The aim of the present work is to analyze binary and multinomial logistic regression simple models estimated by means of a Bayesian approach in comparison to classical estimation. To that effect, Child Attention Deficit Hyperactivity Disorder (ADHD) clinical data were analyzed. The sample included 286 participants of 6-12 years (78% boys, 22% girls) with ADHD positive diagnosis in 86.7% of the cases. The results show a reduction of standard errors associated to the coefficients obtained from the Bayesian analysis, thus bringing a greater stability to the coefficients. Complex models where parameter estimation may be easily compromised could benefit from this advantage.",0 +https://doi.org/10.1038/ncomms10985,Unpredictable environments lead to the evolution of parental neglect in birds,"A nest of begging chicks invites an intuitive explanation: needy chicks want to be fed and parents want to feed them. Surprisingly, however, in a quarter of species studied, parents ignore begging chicks. Furthermore, parents in some species even neglect smaller chicks that beg more, and preferentially feed the biggest chicks that beg less. This extreme variation across species, which contradicts predictions from theory, represents a major outstanding problem for the study of animal signalling. We analyse parent-offspring communication across 143 bird species, and show that this variation correlates with ecological differences. In predictable and good environments, chicks in worse condition beg more, and parents preferentially feed those chicks. In unpredictable and poor environments, parents pay less attention to begging, and instead rely on size cues or structural signals of quality. Overall, these results show how ecological variation can lead to different signalling systems being evolutionarily stable in different species.",0 +https://doi.org/10.1111/j.2044-8317.1998.tb00682.x,Normal theory based test statistics in structural equation modelling,"Even though data sets in psychology are seldom normal, the statistics used to evaluate covariance structure models are typically based on the assumption of multivariate normality. Consequently, many conclusions based on normal theory methods are suspect. In this paper, we develop test statistics that can be correctly applied to the normal theory maximum likelihood estimator. We propose three new asymptotically distribution-free (ADF) test statistics that technically must yield improved behaviour in samples of realistic size, and use Monte Carlo methods to study their actual finite sample behaviour. Results indicate that there exists an ADF test statistic that also performs quite well in finite sample situations. Our analysis shows that various forms of ADF test statistics are sensitive to model degrees of freedom rather than to model complexity. A new index is proposed for evaluating whether a rescaled statistic will be robust. Recommendations are given regarding the application of each test statistic.",0 +https://doi.org/10.1007/s10162-006-0042-y,Comparison of Absolute Thresholds Derived from an Adaptive Forced-Choice Procedure and from Reaction Probabilities and Reaction Times in a Simple Reaction Time Paradigm,"An understanding of the auditory system's operation requires knowledge of the mechanisms underlying thresholds. In this work we compare detection thresholds obtained with a three-interval-three-alternative forced-choice paradigm with reaction thresholds extracted from both reaction probabilities (RP) and reaction times (RT) in a simple RT paradigm from the same listeners under otherwise nearly identical experimental conditions. Detection thresholds, RP, and RT to auditory stimuli exhibited substantial variation from session to session. Most of the intersession variation in RP and RT could be accounted for by intersession variation in a listener's absolute sensitivity. The reaction thresholds extracted from RP were very similar, if not identical, to those extracted from RT. On the other hand, reaction thresholds were always higher than detection thresholds. The difference between the two thresholds can be considered as the additional amount of evidence required by each listener to react to a stimulus in an unforced design on top of that necessary for detection in the forced-choice design. This difference is inversely related to the listener's probability of producing false alarms. We found that RT, once corrected for some irreducible minimum RT, reflects the time at which a given stimulus reaches the listener's reaction threshold. This suggests that the relationships between simple RT and loudness (reported in the literature) are probably caused by a tight relationship between temporal summation at threshold and temporal summation of loudness.",0 +,Reliability analysis of supply chain in strategy synergetic networks based on hierarchical Bayesian method,"The reliability computing formula of supply chain is achieved based on the analysis and judgment of supply chain reliability within the strategy synergetic networks.Accounting to the statistical characteristic of supply chain reliability of the strategy synergetic networks,there are three estimation methods,two Bayesian estimation methods and one hierarchical Bayesian estimation method,used for the evaluation of supply chain specimen's reliability.The test of the estimation of supply chain reliability shows that the hierarchical Bayesian estimation method is more effective than others.",0 +https://doi.org/10.1007/bf02291477,Factor analysis of dichotomized variables,An approach for multiple factor analysis of dichotomized variables is presented. It is based on the distribution of the first and second order joint probabilities of the binary scored items. The estimator is based on the generalized least squares principle. Standard errors and a test of the fit of the model is given. © 1975 Psychometric Society.,0 +https://doi.org/10.1080/10618600.1995.10474663,Approximations to the Log-Likelihood Function in the Nonlinear Mixed-Effects Model,"Abstract Nonlinear mixed-effects models have received a great deal of attention in the statistical literature in recent years because of the flexibility they offer in handling the unbalanced repeated-measures data that arise in different areas of investigation, such as pharmacokinetics and economics. Several different methods for estimating the parameters in nonlinear mixed-effects model have been proposed. We concentrate here on two of them—maximum likelihood and restricted maximum likelihood. A rather complex numerical issue for (restricted) maximum likelihood estimation in nonlinear mixed-effects models is the evaluation of the log-likelihood function of the data, because it involves the evaluation of a multiple integral that, in most cases, does not have a closed-form expression. We consider here four different approximations to the log-likelihood, comparing their computational and statistical properties. We conclude that the linear mixed-effects (LME) approximation suggested by Lindstrom and Bates, t...",0 +https://doi.org/10.1201/b14835-6,Introducing Markov chain Monte Carlo,,0 +https://doi.org/10.1177/000312240907400502,Low-Income Students and the Socioeconomic Composition of Public High Schools,"Increasing constraints placed on race-based school diversification have shifted attention to socioeconomic desegregation. Although past research suggests that socioeconomic desegregation can produce heightened achievement, the “frog pond” perspective points to potential problems with socioeconomic desegregation in nonachievement domains. Such problems are important in their own right, and they may also chip away at the magnitude of potential achievement benefits. In this article, I report conducted propensity score analyses and robustness calculations on a sample of public high schools in the National Longitudinal Study of Adolescent Health. As the proportion of the student body with middle- or high-income parents increased, low-income students progressed less far in math and science. Moreover, as the proportion of the student body with middle- or high-income or college-educated parents increased, low-income students experienced more psychosocial problems. Such patterns were often more pronounced among African American and Latino students. These findings suggest curricular and social psychological mechanisms of oft-noted frog pond effects in schools and extend the frog pond framework beyond achievement itself to demographic statuses (e.g., race/ethnicity and SES) perceptually linked to achievement. In terms of policy, these findings indicate that socioeconomic desegregation plans should also attend to equity in course enrollments and the social integration of students more generally.",0 +https://doi.org/10.3168/jds.2011-4629,Associations between udder health and reproductive performance in United Kingdom dairy cows,"The objective of this research was to evaluate the relationship between udder health and reproductive performance in UK dairy cows. Data from 80 herds were restructured such that each unit of data represented a 2-d period during lactation where a cow was at risk of becoming pregnant. Multilevel discrete-time survival models were then used within a Bayesian framework to explore associations between reproductive outcomes and a variety of potential explanatory variables. Separate models were constructed using 2 different univariate binary outcomes: a cow becoming pregnant during a risk period and a cow becoming pregnant as a result of a given service. Potential explanatory variables included occurrence of clinical mastitis and a categorical representation of individual cow somatic cell count (SCC), both at a variety of timings relative to the risk period. Posterior predictions were used to assess model fit and to check model building assumptions. These demonstrated that the model represented the data well. Within-sample Monte Carlo simulation (i.e., use of the model to predict outcomes for cases within the data set, repeated over a large number of iterations) was used to illustrate results as posterior predicted relative risks. A negative association was found between reproductive performance and cases of clinical mastitis over a wide time frame relative to the risk period (from 28 d before to 70 d after the risk period). A similar negative association with the probability of a service leading to a pregnancy (pregnancy rate) was observed over the same time frame. Higher SCC recordings (i.e., those more likely to be associated with an intramammary infection) were also associated with decreased reproductive performance, especially where an individual cow SCC of greater than 399,000/mL was recorded in the 30 d following a risk period or service. This research demonstrates that both clinical and subclinical mastitis are associated with a reduction in reproductive performance, and that this influence varies in magnitude but can be exerted over a prolonged period.",0 +https://doi.org/10.1024/1010-0652/a000059,Dynamic Task Selection in Learning Arithmetic: The Role of Learner Control and Adaptation Based on a Hierarchy of Skills 1Dieser Beitrag wurde unter der geschäftsführenden Herausgeberschaft von Jens Möller angenommen,"Abstract.The effects of locus of instructional control in computer-assisted practice of arithmetic skills and word problem solving were investigated in a field experiment with 13 third grade classes. In a program-controlled condition (n = 95), the selection of practice problems was based on a hypothetical hierarchy of skills. This was expected to regulate cognitive load to a moderate level. In a condition with shared control (n = 89), subjects could select problems from a subset provided by the program. Results show that program-controlled selection of problems based on the hierarchy of skills was more successful in supporting skill development than the students’ selection. In the shared control condition, students tended to select too easy problems, regardless of their level of expertise. Both conditions with computer assisted instruction caused more progress than traditional instruction (n = 94). Ways of improving the regulation of cognitive load within a shared control approach are discussed.",0 +https://doi.org/10.1186/s12955-015-0395-1,Detecting short-term change and variation in health-related quality of life: within- and between-person factor structure of the SF-36 health survey,"A major goal of much aging-related research and geriatric medicine is to identify early changes in health and functioning before serious limitations develop. To this end, regular collection of patient-reported outcome measure (PROMs) in a clinical setting may be useful to identify and monitor these changes. However, existing PROMs were not designed for repeated administration and are more commonly used as one-time screening tools; as such, their ability to detect variation and measurement properties when administered repeatedly remain unknown. In this study we evaluated the potential of the RAND SF-36 Health Survey as a repeated-use PROM by examining its measurement properties when modified for administration over multiple occasions.To distinguish between-person (i.e., average) from within-person (i.e., occasion) levels, the SF-36 Health Survey was completed by a sample of older adults (N = 122, M age = 66.28 years) daily for seven consecutive days. Multilevel confirmatory factor analysis (CFA) was employed to investigate the factor structure at both levels for two- and eight-factor solutions.Multilevel CFA models revealed that the correlated eight-factor solution provided better model fit than the two-factor solution at both the between-person and within-person levels. Overall model fit for the SF-36 Health Survey administered daily was not substantially different from standard survey administration, though both were below optimal levels as reported in the literature. However, individual subscales did demonstrate good reliability.Many of the subscales of the modified SF-36 for repeated daily assessment were found to be sufficiently reliable for use in repeated measurement designs incorporating PROMs, though the overall scale may not be optimal. We encourage future work to investigate the utility of the subscales in specific contexts, as well as the measurement properties of other existing PROMs when administered in a repeated measures design. The development and integration of new measures for this purpose may ultimately be necessary.",0 +https://doi.org/10.1371/journal.pone.0039059,When One Size Does Not Fit All: A Simple Statistical Method to Deal with Across-Individual Variations of Effects,"In science, it is a common experience to discover that although the investigated effect is very clear in some individuals, statistical tests are not significant because the effect is null or even opposite in other individuals. Indeed, t-tests, Anovas and linear regressions compare the average effect with respect to its inter-individual variability, so that they can fail to evidence a factor that has a high effect in many individuals (with respect to the intra-individual variability). In such paradoxical situations, statistical tools are at odds with the researcher's aim to uncover any factor that affects individual behavior, and not only those with stereotypical effects. In order to go beyond the reductive and sometimes illusory description of the average behavior, we propose a simple statistical method: applying a Kolmogorov-Smirnov test to assess whether the distribution of p-values provided by individual tests is significantly biased towards zero. Using Monte-Carlo studies, we assess the power of this two-step procedure with respect to RM Anova and multilevel mixed-effect analyses, and probe its robustness when individual data violate the assumption of normality and homoscedasticity. We find that the method is powerful and robust even with small sample sizes for which multilevel methods reach their limits. In contrast to existing methods for combining p-values, the Kolmogorov-Smirnov test has unique resistance to outlier individuals: it cannot yield significance based on a high effect in one or two exceptional individuals, which allows drawing valid population inferences. The simplicity and ease of use of our method facilitates the identification of factors that would otherwise be overlooked because they affect individual behavior in significant but variable ways, and its power and reliability with small sample sizes (<30-50 individuals) suggest it as a tool of choice in exploratory studies.",0 +https://doi.org/10.1007/bf02294461,EM and beyond,"The basic theme of the EM algorithm, to repeatedly use complete-data methods to solve incomplete data problems, is also a theme of several more recent statistical techniques. These techniques-multiple imputation, data augmentation, stochastic relaxation, and sampling importance resampling-combine simulation techniques with complete-data methods to attack problems that are difficult or impossible for EM. © 1991 The Psychometric Society.",0 +https://doi.org/10.1111/j.1541-0420.2007.00764.x,A Comparison of Two Bias-Corrected Covariance Estimators for Generalized Estimating Equations,"Mancl and DeRouen (2001, Biometrics57, 126-134) and Kauermann and Carroll (2001, JASA96, 1387-1398) proposed alternative bias-corrected covariance estimators for generalized estimating equations parameter estimates of regression models for marginal means. The finite sample properties of these estimators are compared to those of the uncorrected sandwich estimator that underestimates variances in small samples. Although the formula of Mancl and DeRouen generally overestimates variances, it often leads to coverage of 95% confidence intervals near the nominal level even in some situations with as few as 10 clusters. An explanation for these seemingly contradictory results is that the tendency to undercoverage resulting from the substantial variability of sandwich estimators counteracts the impact of overcorrecting the bias. However, these positive results do not generally hold; for small cluster sizes (e.g., <10) their estimator often results in overcoverage, and the bias-corrected covariance estimator of Kauermann and Carroll may be preferred. The methods are illustrated using data from a nested cross-sectional cluster intervention trial on reducing underage drinking.",0 +https://doi.org/10.1080/10705511.2014.915205,Interaction Effects in Latent Growth Models: Evaluation of Alternative Estimation Approaches,"The purpose of this investigation is to compare and evaluate 2 approaches for estimating interaction effects in latent growth models (LGMs): the unconstrained approach and the latent moderated structural equations (LMS) approach. To reduce the complexity of modeling interactions in LGMs, we created difference-product indicators to replace the traditional product indicators used in the unconstrained approach because these differences in original indicators represent changes over time. Our focus was to verify the performance of this simplified interaction model of LGMs with difference-product indicators by using the unconstrained approach and comparing it with the LMS approach. Our simulation study showed that the LMS approach generally resulted in smaller biases in the estimated parameters and was consistently more precise than the unconstrained approach under normal conditions, particularly when the sample size was small. When normality assumptions were violated, however, the unconstrained approach was sh...",0 +https://doi.org/10.1037/met0000073,Bayesian dynamic mediation analysis.,"Most existing methods for mediation analysis assume that mediation is a stationary, time-invariant process, which overlooks the inherently dynamic nature of many human psychological processes and behavioral activities. In this article, we consider mediation as a dynamic process that continuously changes over time. We propose Bayesian multilevel time-varying coefficient models to describe and estimate such dynamic mediation effects. By taking the nonparametric penalized spline approach, the proposed method is flexible and able to accommodate any shape of the relationship between time and mediation effects. Simulation studies show that the proposed method works well and faithfully reflects the true nature of the mediation process. By modeling mediation effect nonparametrically as a continuous function of time, our method provides a valuable tool to help researchers obtain a more complete understanding of the dynamic nature of the mediation process underlying psychological and behavioral phenomena. We also briefly discuss an alternative approach of using dynamic autoregressive mediation model to estimate the dynamic mediation effect. The computer code is provided to implement the proposed Bayesian dynamic mediation analysis. (PsycINFO Database Record",0 +https://doi.org/10.1080/19345747.2014.911396,Covariate Balance in Bayesian Propensity Score Approaches for Observational Studies,"AbstractBayesian alternatives to frequentist propensity score approaches have recently been proposed. However, few studies have investigated their covariate balancing properties. This article compares a recently developed two-step Bayesian propensity score approach to the frequentist approach with respect to covariate balance. The effects of different priors on covariate balance are evaluated and the differences between frequentist and Bayesian covariate balance are discussed. Results of the case study reveal that both the Bayesian and frequentist propensity score approaches achieve good covariate balance. The frequentist propensity score approach performs slightly better on covariate balance for stratification and weighting methods, whereas the two-step Bayesian approach offers slightly better covariate balance in the optimal full matching method. Results of a comprehensive simulation study reveal that accuracy and precision of prior information on propensity score model parameters do not greatly influen...",0 +https://doi.org/10.1007/bf02289028,An application of confidence intervals and of maximum likelihood to the estimation of an examinee's ability,"A mathematical definition of the theoretical relation between the examinee's actual responses to the test items and his ""true ability"" is selected. A maximum-likelihood solution is obtained for estimating the examinee's ""true ability"" from his responses to the items. The standard error of the maximum-likelihood estimate is obtained, its relation to the discriminating power of the test is pointed out, and some generalizations are drawn as to the optimum level of item difficulty. The Neyman-Pearson power function is applied to determine which of two psychological tests is the most powerful for the selection of ""successful"" examinees. © 1953 Psychometric Society.",0 +https://doi.org/10.1016/j.healthplace.2013.07.001,A multilevel analysis of the role of the family and the state in self-rated health of elderly Chinese,"This study examines the geographical variations of self-rated health of the elderly based on the 2008 Chinese Longitudinal Healthy Longevity Survey. Multilevel logistic models are employed to estimate how individual, family, and institutional factors affect the health of the elderly at both individual and province levels. Results show that while individual characteristics help to explain self-rated health, the family remains an important determinant. Those with nobody to care for them, those in poverty and those who have to rely on medical insurance report the worst health. The role of the state is relatively limited in contributing to the health of the elderly. There are substantial between province differences.",0 +https://doi.org/10.3102/10769986026001001,Generalized Appended Product Indicator Procedure for Nonlinear Structural Equation Analysis,Interest in considering nonlinear structural equation models is well documented in the behavioral and social sciences as well as in the education and marketing literature. This article considers estimation of polynomial structural models. An existing method is shown to have a limitation that the produced estimator is inconsistent for most practical situations. A new procedure is introduced and defined for a general model using products of observed indicators. The resulting estimator is consistent without assuming any distributional form for the underlying factors or errors. Identification assessment and standard error estimation are discussed. A simulation study addresses statistical issues including comparisons of discrepancy functions and the choice of appended product indicators. Application of the new procedure in a substance abuse prevention study is also reported.,0 +https://doi.org/10.3758/s13414-010-0083-5,Visual apparent motion can be modulated by task-irrelevant lexical information,"Previous studies have repeatedly demonstrated the impact of Gestalt structural grouping principles upon the parsing of motion correspondence in ambiguous apparent motion. Here, by embedding Chinese characters in a visual Ternus display that comprised two stimulus frames, we showed that the perception of visual apparent motion can be modulated by activation of task-irrelevant lexical representations. Each frame had two disks, with the second disk of the first frame and the first disk of the second frame being presented at the same location. Observers could perceive either ""element motion,"" in which the endmost disk is seen as moving back and forth while the middle disk at the central position remains stationary, or ""group motion,"" in which both disks appear to move laterally as a whole. More reports of group motion, as opposed to element motion, were obtained when the embedded characters formed two-character compound words than when they formed nonwords, although this lexicality effect appeared to be attenuated by the use of the same characters at the overlapping position across the two frames. Thus, grouping of visual elements in a changing world can be guided by both structural principles and prior world knowledge, including lexical information.",0 +https://doi.org/10.1016/j.jmp.2012.06.004,Approximate Bayesian computation with differential evolution,"a b s t r a c t Approximate Bayesian computation (ABC) is a simulation-based method for estimating the posterior distribution of the parameters of a model. The ABC approach is instrumental when a likelihood function for a model cannot be mathematically specified, or has a complicated form. Although difficulty in calculating a model's likelihood is extremely common, current ABC methods suffer from two problems that have largely prevented their mainstream adoption: long computation time and an inability to scale beyond a few parameters. We introduce differential evolution as a computationally efficient genetic algorithm for proposal generation in our ABC sampler. We show how using this method allows our new ABC algorithm, called ABCDE, to obtain accurate posterior estimates in fewer iterations than kernel-based ABC algorithms and to scale to high-dimensional parameter spaces that have proven difficult for current ABC methods.",0 +https://doi.org/10.1126/science.277.5328.918,Neighborhoods and Violent Crime: A Multilevel Study of Collective Efficacy,"It is hypothesized that collective efficacy, defined as social cohesion among neighbors combined with their willingness to intervene on behalf of the common good, is linked to reduced violence. This hypothesis was tested on a 1995 survey of 8782 residents of 343 neighborhoods in Chicago, Illinois. Multilevel analyses showed that a measure of collective efficacy yields a high between-neighborhood reliability and is negatively associated with variations in violence, when individual-level characteristics, measurement error, and prior violence are controlled. Associations of concentrated disadvantage and residential instability with violence are largely mediated by collective efficacy.",0 +https://doi.org/10.1007/bf02289400,Coefficient alpha and the reliability of composite measurements,"Following a general approach due to Guttman, coefficient α is rederived as a lower bound on the reliability of a test. A necessary and sufficient condition under which equality is attained in this inequality and hence that α is equal to the reliability of the test is derived and shown to be closely related to the recent redefinition of the concept of parallel measurements due to Novick. This condition is then also shown to be closely related to the unit rank assumption originally adopted by Kuder and Richardson in the derivation of their formula 20. The assumption later adopted by Jackson and Ferguson and the one adopted by Gulliksen are shown to be related to the necessary and sufficient condition derived here. It is then pointed out that the statement that ""coefficient α is equal to the mean of the split-half reliabilities"" is true only under the restricted condition assumed by Cronbach in the body of his derivation of this result. Finally some limitations on the uses of any function of α as a measure of internal consistency are noted. © 1967 Psychometric Society.",0 +https://doi.org/10.1111/j.1467-985x.2008.00576.x,"Multilevel multivariate modelling of childhood growth, numbers of growth measurements and adult characteristics",Summary. A general latent normal model for multilevel data with mixtures of response types is extended in the case of ordered responses to deal with variates having a large number of categories and including count data. An example is analysed by using repeated measures data on child growth and adult measures of body mass index and glucose. Applications are described that are concerned with the flexible prediction of adult measurements from collections of growth measurements and for studying the relationship between the number of measurement occasions and growth trajectories.,0 +https://doi.org/10.1177/0272431613498646,Conducting Three-Level Cross-Sectional Analyses,"Applied early adolescent researchers often sample students (Level 1) from within classrooms (Level 2) that are nested within schools (Level 3), resulting in data that requires multilevel modeling analysis to avoid Type 1 errors. Although several articles have been published to assist researchers with analyzing sample data nested at two levels, few articles are available to researchers seeking assistance with three-level data analyses. The purpose of this article is to extend the presentational logic and pedagogical flow employed in previous two-level pedagogical publications to illustrate the relevant issues researchers face, the decisions to be made, and the proper procedures needed, when analyzing cross-sectional three-level data. These procedures are demonstrated with a generated three-level data example based on the Early Childhood Longitudinal Study (ECLS-K) public use dataset. The generated data used in this article, as well as the SPSS, SAS, and Mplus model specification syntax files needed to reproduce all analyses in this article, and additional illustrative examples, are available as supplemental online materials at http://jea.sagepub.com/content/early/recent .",0 +https://doi.org/10.1016/j.jmp.2010.04.001,A general latent assignment approach for modeling psychological contaminants,"Abstract Data from psychological experiments are rife with ‘contaminants’, which can generally be defined as data generated by psychological processes different from those intended as the object of study. Contaminant data can interfere with the testing of substantive psychological models and their parameters, so it is important to have methods for their identification and removal. After noting that current practices in cognitive modeling for dealing with contaminants are not completely satisfactory, we argue for a general latent mixture approach to the problem. We demonstrate the tractability and effectiveness of the approach concretely, through a series of four applications. These applications involve a simple choice problem, a diffusion model of a response time and accuracy in decision-making, a hierarchical signal detection model of recognition memory, and a reinforcement learning model of decision-making on bandit problems. We conclude that developing models of contaminant processes requires the same sort of creative effort that is needed to model substantive psychological processes, but that it is a necessary endeavour that can be coherently and usefully pursued within the latent mixture modeling approach.",0 +https://doi.org/10.1093/biomet/82.3.479,Efficient parametrisations for normal linear mixed models,"SUMMARY The generality and easy programmability of modern sampling-based methods for maximisation of likelihoods and summarisation of posterior distributions have led to a tremendous increase in the complexity and dimensionality of the statistical models used in practice. However, these methods can often be extremely slow to converge, due to high correlations between, or weak identifiability of, certain model parameters. We present simple hierarchical centring reparametrisations that often give improved convergence for a broad class of normal linear mixed models. In particular, we study the two-stage hierarchical normal linear model, the Laird-Ware model for longitudinal data, and a general structure for hierarchically nested linear models. Using analytical arguments, simulation studies, and an example involving clinical markers of acquired immune deficiency syndrome (AIDS), we indicate when reparametrisation is likely to provide substantial gains in efficiency.",0 +https://doi.org/10.1177/1094428107300343,Testing Mediation and Suppression Effects of Latent Variables,"Because of the importance of mediation studies, researchers have been continuously searching for the best statistical test for mediation effect. The approaches that have been most commonly employed include those that use zero-order and partial correlation, hierarchical regression models, and structural equation modeling (SEM). This study extends MacKinnon and colleagues (MacKinnon, Lockwood, Hoffmann, West, & Sheets, 2002; MacKinnon, Lockwood, & Williams, 2004, MacKinnon, Warsi, & Dwyer, 1995) works by conducting a simulation that examines the distribution of mediation and suppression effects of latent variables with SEM, and the properties of confidence intervals developed from eight different methods. Results show that SEM provides unbiased estimates of mediation and suppression effects, and that the bias-corrected bootstrap confidence intervals perform best in testing for mediation and suppression effects. Steps to implement the recommended procedures with Amos are presented.",0 +https://doi.org/10.3389/fpsyg.2014.00748,A general non-linear multilevel structural equation mixture model,"In the past 2 decades latent variable modeling has become a standard tool in the social sciences. In the same time period, traditional linear structural equation models have been extended to include non-linear interaction and quadratic effects (e.g., Klein and Moosbrugger, 2000), and multilevel modeling (Rabe-Hesketh et al., 2004). We present a general non-linear multilevel structural equation mixture model (GNM-SEMM) that combines recent semiparametric non-linear structural equation models (Kelava and Nagengast, 2012; Kelava et al., 2014) with multilevel structural equation mixture models (Muthén and Asparouhov, 2009) for clustered and non-normally distributed data. The proposed approach allows for semiparametric relationships at the within and at the between levels. We present examples from the educational science to illustrate different submodels from the general framework.",0 +https://doi.org/10.1037/0022-3514.94.6.1062,Conceptualizing and assessing self-enhancement bias: A componential approach.,"Four studies implemented a componential approach to assessing self-enhancement and contrasted this approach with 2 earlier ones: social comparison (comparing self-ratings with ratings of others) and self-insight (comparing self-ratings with ratings by others). In Study 1, the authors varied the traits being rated to identify conditions that lead to more or less similarity between approaches. In Study 2, the authors examined the effects of acquaintance on the conditions identified in Study 1. In Study 3, the authors showed that using rankings renders the self-insight approach equivalent to the component-based approach but also has limitations in assessing self-enhancement. In Study 4, the authors compared the social-comparison and the component-based approaches in terms of their psychological implications; the relation between self-enhancement and adjustment depended on the self-enhancement approach used, and the positive-adjustment correlates of the social-comparison approach disappeared when the confounding influence of the target effect was controlled.",0 +https://doi.org/10.1198/000313006x117837,Calibrated Bayes,"The lack of an agreed inferential basis for statistics makes life interesting for academic statisticians, but at the price of negative implications for the status of statistics in industry, science, and government. The practice of our discipline will mature only when we can come to a basic agreement about how to apply statistics to real problems. Simple and more general illustrations are given of the negative consequences of the existing schism between frequentists and Bayesians. An assessment of strengths and weaknesses of the frequentist and Bayes systems of inference suggests that calibrated Bayes-a compromise based on the works of Box, Rubin, and others-captures the strengths of both approaches and provides a roadmap for future advances. The approach asserts that inferences under a particular model should be Bayesian, but model assessment can and should involve frequentist ideas. This article also discusses some implications of this proposed compromise for the teaching and practice of statistics.",0 +https://doi.org/10.1007/s10463-007-0127-3,Bayesian hierarchical linear mixed models for additive smoothing splines,"Bayesian hierarchical models have been used for smoothing splines, thin-plate splines, and L-splines. In analyzing high dimensional data sets, additive models and backfitting methods are often used. A full Bayesian analysis for such models may include a large number of random effects, many of which are not intuitive, so researchers typically use noninformative improper or nearly improper priors. We investigate propriety of the posterior for these cases. Our findings extend known results for normal linear mixed models to certain cases with Bayesian additive smoothing spline models. © 2007 The Institute of Statistical Mathematics.",0 +https://doi.org/10.1109/tdei.2009.4784578,Fitting the three-parameter weibull distribution: review and evaluation of existing and new methods,"The three-parameter Weibull distribution is a commonly-used distribution for the study of reliability and breakage data. However, given a data set, it is difficult to estimate the parameters of the distribution and that, for many reasons: (1) the equations of the maximum likelihood estimators are not all available in closed form. These equations can be estimated using iterative methods. However, (2) they return biased estimators and the exact amount of bias is not known. (3) The Weibull distribution does not meet the regularity conditions so that in addition to being biased, the maximum likelihood estimators may also be highly variable from one sample to another (weak efficiency). The methods to estimate parameters of a distribution can be divided into three classes: a) the maximizing approaches, such as the maximum likelihood method, possibly followed by a bias-correction operation; b) the methods of moments; and c) a mixture of the previous two classes of methods. We found using Monte Carlo simulations that a mixed method was the most accurate to estimate the parameters of the Weibull distribution across many shapes and sample sizes, followed by the weighted maximum likelihood estimation method. If the shape parameter is known to be larger than 1, the maximum product of spacing method is the most accurate whereas in the opposite case, the mixed method is to be preferred. A test that can detect if the shape parameter is smaller than 1 is discussed and evaluated. Overall, the maximum likelihood estimation method was the worst, with errors of estimation almost twice as large as those of the best methods.",0 +https://doi.org/10.1111/obr.12373,Neighbourhood social capital: measurement issues and associations with health outcomes,"We compared ecometric neighbourhood scores of social capital (contextual variation) to mean neighbourhood scores (individual and contextual variation), using several health-related outcomes (i.e. self-rated health, weight status and obesity-related behaviours). Data were analysed from 5,900 participants in the European SPOTLIGHT survey. Factor analysis of the 13-item social capital scale revealed two social capital constructs: social networks and social cohesion. The associations of ecometric and mean neighbourhood-level scores of these constructs with self-rated health, weight status and obesity-related behaviours were analysed using multilevel regression analyses, adjusted for key covariates. Analyses using ecometric and mean neighbourhood scores, but not mean neighbourhood scores adjusted for individual scores, yielded similar regression coefficients. Higher levels of social network and social cohesion were not only associated with better self-rated health, lower odds of obesity and higher fruit consumption, but also with prolonged sitting and less transport-related physical activity. Only associations with transport-related physical activity and sedentary behaviours were associated with mean neighbourhood scores adjusted for individual scores. As analyses using ecometric scores generated the same results as using mean neighbourhood scores, but different results when using mean neighbourhood scores adjusted for individual scores, this suggests that the theoretical advantage of the ecometric approach (i.e. teasing out individual and contextual variation) may not be achieved in practice. The different operationalisations of social network and social cohesion were associated with several health outcomes, but the constructs that appeared to represent the contextual variation best were only associated with two of the outcomes.",0 +https://doi.org/10.1080/01621459.1952.10483446,A Generalization of Sampling Without Replacement from a Finite Universe,"This paper presents a general technique for the treatment of samples drawn without replacement from finite universes when unequal selection probabilities are used. Two sampling schemes are discussed in connection with the problem of determining optimum selection probabilities according to the information available in a supplementary variable. Admittedly, these two schemes have limited application. They should prove useful, however, for the first stage of sampling with multi-stage designs, since both permit unbiased estimation of the sampling variance without resorting to additional assumptions.Journal Paper No. J2139 of the Iowa Agricultural Experiment Station, Ames, Iowa, Project 1005. Presented to the Institute of Mathematical Statistics, March 17, 1951. © Taylor & Francis Group, LLC.",0 +https://doi.org/10.1177/0193945914548229,Model-Driven Meta-Analyses for Informing Health Care,"A relatively novel type of meta-analysis, a model-driven meta-analysis, involves the quantitative synthesis of descriptive, correlational data and is useful for identifying key predictors of health outcomes and informing clinical guidelines. Few such meta-analyses have been conducted and thus, large bodies of research remain unsynthesized and uninterpreted for application in health care. We describe the unique challenges of conducting a model-driven meta-analysis, focusing primarily on issues related to locating a sample of published and unpublished primary studies, extracting and verifying descriptive and correlational data, and conducting analyses. A current meta-analysis of the research on predictors of key health outcomes in diabetes is used to illustrate our main points.",0 +https://doi.org/10.1002/(sici)1097-0258(19990915/30)18:17/18<2343::aid-sim260>3.0.co;2-3,Meta-analysis by random effect modelling in generalized linear models,"The meta-analysis of multi-centre trials can be based on either fixed or random effect models. This paper argues for the general use of random effect models, and illustrates the value of non-parametric maximum likelihood (NPML) analysis of such trials. The same general approach unifies administrative 'league table' analyses in epidemiological and other studies. Several examples of the NPML analysis are given, including a 70-centre trial.",0 +https://doi.org/10.1080/10705511.2013.742404,Implementing Restricted Maximum Likelihood Estimation in Structural Equation Models,"Structural equation modeling (SEM) is now a generic modeling framework for many multivariate techniques applied in the social and behavioral sciences. Many statistical models can be considered either as special cases of SEM or as part of the latent variable modeling framework. One popular extension is the use of SEM to conduct linear mixed-effects modeling (LMM) such as cross-sectional multilevel modeling and latent growth modeling. It is well known that LMM can be formulated as structural equation models. However, one main difference between the implementations in SEM and LMM is that maximum likelihood (ML) estimation is usually used in SEM, whereas restricted (or residual) maximum likelihood (REML) estimation is the default method in most LMM packages. This article shows how REML estimation can be implemented in SEM. Two empirical examples on latent growth model and meta-analysis are used to illustrate the procedures implemented in OpenMx. Issues related to implementing REML in SEM are discussed.",0 +https://doi.org/10.1214/15-ba962,Posterior Propriety for Hierarchical Models with Log-Likelihoods That Have Norm Bounds,"Statisticians often use improper priors to express ignorance or to provide good frequency properties, requiring that posterior propriety be verified. This paper addresses generalized linear mixed models, GLMMs, when Level I parameters have Normal distributions, with many commonly-used hyperpriors. It provides easy-to-verify sufficient posterior propriety conditions based on dimensions, matrix ranks, and exponentiated norm bounds, ENBs, for the Level I likelihood. Since many familiar likelihoods have ENBs, which is often verifiable via log-concavity and MLE finiteness, our novel use of ENBs permits unification of posterior propriety results and posterior MGF/moment results for many useful Level I distributions, including those commonly used with multilevel generalized linear models, e.g., GLMMs and hierarchical generalized linear models, HGLMs. Those who need to verify existence of posterior distributions or of posterior MGFs/moments for a multilevel generalized linear model given a proper or improper multivariate F prior as in Section 1 should find the required results in Sections 1 and 2 and Theorem 3 (GLMMs), Theorem 4 (HGLMs), or Theorem 5 (posterior MGFs/moments).",0 +https://doi.org/10.1037/1082-989x.10.1.21,Investigating population heterogeneity with factor mixture models.,"Sources of population heterogeneity may or may not be observed. If the sources of heterogeneity are observed (e.g., gender), the sample can be split into groups and the data analyzed with methods for multiple groups. If the sources of population heterogeneity are unobserved, the data can be analyzed with latent class models. Factor mixture models are a combination of latent class and common factor models and can be used to explore unobserved population heterogeneity. Observed sources of heterogeneity can be included as covariates. The different ways to incorporate covariates correspond to different conceptual interpretations. These are discussed in detail. Characteristics of factor mixture modeling are described in comparison to other methods designed for data stemming from heterogeneous populations. A step-by-step analysis of a subset of data from the Longitudinal Survey of American Youth illustrates how factor mixture models can be applied in an exploratory fashion to data collected at a single time point.",0 +https://doi.org/10.1016/j.jmva.2014.06.001,Estimating high dimensional covariance matrices: A new look at the Gaussian conjugate framework,"In this paper, we describe and study a class of linear shrinkage estimators of the covariance matrix that is well-suited for high dimensional matrices, has a rather wide domain of applicability, and is rooted into the Gaussian conjugate framework of Chen (1979). We propose here a new look at this framework. The linear shrinkage estimator is thereby obtained as the posterior mean of the covariance, using a Bayesian Gaussian model with conjugate inverse Wishart prior, and deriving the shrinkage intensity and target matrix by marginal likelihood maximization. We introduce some extensions to the seminal approach by deriving a closed-form expression of the marginal likelihood as well as computationally light schemes for its maximization. Further, these developments are implemented in a variety of situations and include a simulation-based performance comparison with a recent, widely used class of linear shrinkage estimators. The Gaussian conjugate estimators are found to outperform these estimators in every tested situation where the latter are available and to be more widely and directly applicable. • We (re)introduce a class of linear shrinkage estimators of the covariance matrix. • We follow an empirical Bayesian approach to obtain shrinkage intensity and target. • The method is generally applicable to any class of target matrices. • Estimators are found to outperform those of the state-of-the-art Ledoit–Wolf class. • The implementation is computationally light.",0 +https://doi.org/10.1177/1471082x1001100305,Robust statistical modelling using the multivariate skew t distribution with complete and incomplete data,"Missing data is inevitable in many situations that could hamper data analysis for scientific investigations. We establish flexible analytical tools for multivariate skew t models when fat-tailed, asymmetric and missing observations simultaneously occur in the input data. For the ease of computation and theoretical developments, two auxiliary indicator matrices are incorporated into the model for the determination of observed and missing components of each observation that can effectively reduce the computational complexity. Under the missing at random assumption, we present a Monte Carlo version of the expectation conditional maximization algorithm, which is performed to estimate the parameters and retrieve each missing observation with a single value. Additionally, a Metropolis–Hastings within Gibbs sampler with data augmentation is developed to account for the uncertainty of parameters as well as missing outcomes. The methodology is illustrated through two real data sets.",0 +https://doi.org/10.2307/2986304,Straight Lines with a Change-Point: A Bayesian Analysis of Some Renal Transplant Data,"Y1=(X2+f2xi+ei, i=zT+l,..., (1) where the ei are independently, normally distributed, N(O, a2), 1 < T < T (al f,) $ (a2, ,B2) and all the parameters a,, f1 a25 ,B25 a2, T are unknown. The two straight lines in (1) intersect at a point with x coordinate v = (a1 a2)/(12 fl1). If we further assume that X1 < X2 <... < XT (in many applications, x will denote time), it is useful to distinguish two versions of (1) according to whether v satisfies x, < v < x+ 1 or not. When this constraint is assumed, we shall refer to the constrained case of switching straight lines. It has been found see, for example, Knapp et al. (1977)-that the constrained version provides a satisfactory statistical model for monitoring the function of renal transplants. Following a transplant, daily measurements are made of serum-creatinine, a substance which indicates the level of functioning of the patient's kidney and a plot of the reciprocal of bodyweight corrected serum-creatinine (y) is then made against time (x). Fig. 1 shows part of two typical plots obtained from patients undergoing treatment at the City Hospital, Nottingham. An increasing straight line indicates successful functioning of the transplanted kidney. A sudden switch to a decreasing straight line indicates that rejection has occurred. It might be argued that rejection is not an instantaneous process, so that the sharp intersection of the two lines is a fiction, and an approach assuming a less sharp transition, such as that of Bacon and Watts (1971), might be more reasonable. On present evidence, however, any transition period would appear to be usually very short compared with the interval between measurements, and so the switching straight line model provides a reasonable approximation. With this assumption, in the renal transplant application the intersection point, y, corresponds to the time at which a rejection occurs. This parameter is of very great interest, both in the treatment of individual patients and because inferences about v for each of a number of patients permit inferences about daily and hourly variations in the rates of rejection. This, in turn, has implications for treatment and monitoring procedures in the hospital (see Knapp et al., 1979).",0 +https://doi.org/10.1037/a0014686,A randomized trial of individual and couple behavioral alcohol treatment for women.,"Although alcohol use disorders (AUDs) adversely affect women, research on efficacious treatments for women is limited. In this randomized efficacy trial of 102 heterosexual women with AUDs, the authors compared alcohol behavioral couple therapy (ABCT) and alcohol behavioral individual therapy (ABIT) on percentage of days abstinent (PDA) and percentage of days of heavy drinking (PDH) over 6 months of treatment and 12 months of posttreatment follow-up. Baseline relationship functioning and comorbid disorders were tested as moderators of outcome. Piecewise linear growth models were used to model outcomes. During treatment, women increased their PDA and decreased their PDH, with significantly greater improvements in ABCT than in ABIT (d = 0.59 for PDA; d = 0.79 for PDH). Differences favoring ABCT were maintained during follow-up. Women with poorer baseline relationship functioning improved more on PDA during treatment with ABCT than with ABIT. For PDH, results during treatment and follow-up favored ABCT for women with better baseline relationship functioning. ABCT resulted in better outcomes than ABIT for women with Axis I disorders at the end of follow-up (PDA), and for women with Axis II disorders at the end of treatment (PDA) and at the end of follow-up (PDH).",0 +https://doi.org/10.3758/s13428-011-0138-0,CAML—Maximum likelihood consensus analysis,"Consensus analysis enables estimation of individual differences in competencies and response tendencies when answer keys to dichotomous forced-choice questions are unknown. CAML, a set of functions written in R, implements maximum likelihood estimation for the general Condorcet model that underlies consensus analysis. CAML avoids problems of alternative approaches that have often rendered consensus analysis impractical or unfeasible in the past. It provides (1) measures of model fit, (2) a measure of consensus, (3) point and interval estimates of competencies and response tendencies, and (4) an estimate of the unknown answer key. The present article describes the general Condorcet model, the CAML algorithms, and the handling of the software. In addition, the validity of CAML results is tested in a recognition memory study using selective experimental manipulations of the parameters. The results show that CAML works very well in practice and provides valid estimates of competencies, response tendencies, and answer keys.",0 +https://doi.org/10.1023/a:1022930918859,,"Event history models typically assume that the entire population is at risk of experiencing the event of interest throughout the observation period. However, there will often be individuals, referred to as long-term survivors, who may be considered a priori to have a zero hazard throughout the study period. In this paper, a discrete-time mixture model is proposed in which the probability of long-term survivorship and the timing of event occurrence are modelled jointly. Another feature of event history data that often needs to be considered is that they may come from a population with a hierarchical structure. For example, individuals may be nested within geographical regions and individuals in the same region may have similar risks of experiencing the event of interest due to unobserved regional characteristics. Thus, the discrete-time mixture model is extended to allow for clustering in the likelihood and timing of an event within regions. The model is further extended to allow for unobserved individual heterogeneity in the hazard of event occurrence. The proposed model is applied in an analysis of contraceptive sterilization in Bangladesh. The results show that a woman's religion and education level affect her probability of choosing sterilization, but not when she gets sterilized. There is also evidence of community-level variation in sterilization timing, but not in the probability of sterilization.",0 +https://doi.org/10.1207/s15328007sem1103_8,Modeling Latent Growth Curves With Incomplete Data Using Different Types of Structural Equation Modeling and Multilevel Software,"This article offers different examples of how to fit latent growth curve (LGC) models to longitudinal data using a variety of different software programs (i.e., LISREL, Mx, Mplus, AMOS, SAS). The article shows how the same model can be fitted using both structural equation modeling and multilevel software, with nearly identical results, even in the case of models of latent growth fitted to incomplete data. The general purpose of this article is to provide a demonstration that integrates programming features from different software. The most immediate goal is to help researchers implement these LGC models as a useful way to test hypotheses of growth.",0 +https://doi.org/10.3102/1076998610375834,Bayesian Estimation of the Logistic Positive Exponent IRT Model,"A Bayesian inference approach using Markov Chain Monte Carlo (MCMC) is developed for the logistic positive exponent (LPE) model proposed by Samejima and for a new skewed Logistic Item Response Theory (IRT) model, named Reflection LPE model. Both models lead to asymmetric item characteristic curves (ICC) and can be appropriate because a symmetric ICC treats both correct and incorrect answers symmetrically, which results in a logical contradiction in ordering examinees on the ability scale. A data set corresponding to a mathematical test applied in Peruvian public schools is analyzed, where comparisons with other parametric IRT models also are conducted. Several model comparison criteria are discussed and implemented. The main conclusion is that the LPE and RLPE IRT models are easy to implement and seem to provide the best fit to the data set considered.",0 +https://doi.org/10.1080/02664760903093625,Extended Bayesian model averaging for heritability in twin studies,"Family studies are often conducted to examine the existence of familial aggregation. Particularly, twin studies can model separately the genetic and environmental contribution. Here we estimate the heritability of quantitative traits via variance components of random-effects in linear mixed models (LMMs). The motivating example was a myopia twin study containing complex nesting data structures: twins and siblings in the same family and observations on both eyes for each individual. Three models are considered for this nesting structure. Our proposal takes into account the model uncertainty in both covariates and model structures via an extended Bayesian model averaging (EBMA) procedure. We estimate the heritability using EBMA under three suggested model structures. When compared with the results under the model with the highest posterior model probability, the EBMA estimate has smaller variation and is slightly conservative. Simulation studies are conducted to evaluate the performance of variance-componen...",0 +https://doi.org/10.1111/j.1745-3984.2003.tb01150.x,Assessing Goodness of Fit of Item Response Theory Models: A Comparison of Traditional and Alternative Procedures,"Testing the goodness of fit of item response theory (IRT) models is relevant to validating IRT models, and new procedures have been proposed. These alternatives compare observed and expected response frequencies conditional on observed total scores, and use posterior probabilities for responses across 0 levels rather than cross-classifying examinees using point estimates of 0 and score responses. This research compared these alternatives with regard to their methods, properties (Type I error rates and empirical power), available research, and practical issues (computational demands, treatment of missing data, effects of sample size and sparse data, and available computer programs). Different advantages and disadvantages related to these characteristics are discussed. A simulation study provided additional information about empirical power and Type I error rates. Item response theory (IRT) involves a class of mathematical models that are used to predict examinee performance using item and person characteristics. The properties of these models offer many well-known advantages in testing applications. However, the extent to which these properties are attained is dependent on the degree to which the IRT model itself is appropriate. To validate the use of an IRT model, goodness of fit for a model, or correspondence between model predictions and observed data, is often examined (see Hambleton & Swaminathan, 1985, for a discussion of other useful validation studies). When a model is not appropriate or does not fit the data, use of estimated parameters may be compromised. Several alternative approaches to assessing IRT model-data-fit have emerged in response to using traditional methods in different testing applications. Orlando and Thissen (2000) described a fit statistic that does not use ability estimates but provides a comparison of observed and expected frequencies for score responses across total score levels. Stone, Mislevy, and Mazzeo (1994) argued that uncertainty in ability estimation was responsible for deviations in the approximation of the goodness-of-fit statistics to the null distribution, and discussed a fit statistic based on posterior expectations that addressed the issue. A scaling correction for the chi-squared fit statistic based on resampling methods was subsequently described (Stone, 2000a). Donoghue and Hombo (1999, 2001a) also used the fit statistic based on posterior probabilities to evaluate goodness of fit for National Assessment of Educational Progress (NAEP) items, but derived a distribution for the fit statistic (labeled QDH) that could be used for hypothesis testing.",0 +,Lisrel 8: Structural Equation Modeling With the Simplis Command Language,"This text introduces the SIMPLIS command language for structural equation modelling. It is written for students and researchers with limited mathematical and statistical training who need to use structural equation models to analyze their data, and for those who have tried but failed to learn the LISREL command language. It is not a textbook on factor analysis, structural equations or latent variable models, although there are many examples of such in the book. Rather, it is assumed that the reader is already familiar with the basic ideas and principles of these types of analyses and techniques. The main objective is to demonstrate that structural equation modelling can be done easily without the technical jargon with which it has been associated. The SIMPLIS language shifts the focus away from the technical question How to do it, so that researchers can concentrate on the question, What does it all mean? Although the SIMPLIS language makes it easier to specify models and to carry out the analysis, the substantive specification and interpretation remain the same as with the LISREL command language.",0 +https://doi.org/10.1016/j.ijresmar.2009.09.004,A simple mechanism to incentive-align conjoint experiments,"Recent literature has established the importance of incentive-aligning research participants in conjoint analysis. Pertinent studies have also proposed and validated a fairly general incentive-aligning mechanism (willingness-to-pay, or WTP) that achieves incentive alignment by using respondents' data to determine their value for a reward product (Ding, 2007). This mechanism, however, requires an estimation of the value of money and is relatively difficult for the average respondent to understand. We propose an alternative mechanism based on inferred rank order for situations where conjoint practitioners have more than one version of real products. In an empirical test of choice-based conjoint, we show that the RankOrder mechanism leads to substantial improvement in predictive performance when compared to non-aligned hypothetical choices. A second test shows that both incentive-aligned mechanisms – RankOrder and WTP – produce very similar predictive performances. RankOrder, however, dominates the WTP mechanism in user preference, an outcome shown both by perceived understanding and by the incentive-aligned money that respondents are willing to pay to switch from one mechanism to the other.",0 +https://doi.org/10.1186/1745-6215-15-346,Meta-analysis of randomized phase II trials to inform subsequent phase III decisions,"If multiple Phase II randomized trials exist then meta-analysis is favorable to increase statistical power and summarize the existing evidence about an intervention's effect in order to help inform Phase III decisions. We consider some statistical issues for meta-analysis of Phase II trials for this purpose, as motivated by a real example involving nine Phase II trials of bolus thrombolytic therapy in acute myocardial infarction with binary outcomes.We propose that a Bayesian random effects logistic regression model is most suitable as it models the binomial distribution of the data, helps avoid continuity corrections, accounts for between-trial heterogeneity, and incorporates parameter uncertainty when making inferences. The model also allows predictions that inform Phase III decisions, and we show how to derive: (i) the probability that the intervention will be truly beneficial in a new trial, and (ii) the probability that, in a new trial with a given sample size, the 95% credible interval for the odds ratio will be entirely in favor of the intervention. As Phase II trials are potentially optimistic due to bias in design and reporting, we also discuss how skeptical prior distributions can reduce this optimism to make more realistic predictions.In the example, the model identifies heterogeneity in intervention effect missed by an I-squared of 0%. Prediction intervals accounting for this heterogeneity are shown to support subsequent Phase III trials. The probability of success in Phase III trials increases as the sample size increases, up to 0.82 for intracranial hemorrhage and 0.79 for reinfarction outcomes.The choice of meta-analysis methods can influence the decision about whether a trial should proceed to Phase III and thus need to be clearly documented and investigated whenever a Phase II meta-analysis is performed.",0 +https://doi.org/10.1080/07481756.1988.12022886,Using Generalizability Theory in Counseling and Development,"(1988). Using Generalizability Theory in Counseling and Development. Measurement and Evaluation in Counseling and Development: Vol. 21, No. 2, pp. 81-90.",0 +https://doi.org/10.1080/00273171.2015.1114911,Incorporating Mobility in Growth Modeling for Multilevel and Longitudinal Item Response Data,"Multilevel data often cannot be represented by the strict form of hierarchy typically assumed in multilevel modeling. A common example is the case in which subjects change their group membership in longitudinal studies (e.g., students transfer schools; employees transition between different departments). In this study, cross-classified and multiple membership models for multilevel and longitudinal item response data (CCMM-MLIRD) are developed to incorporate such mobility, focusing on students' school change in large-scale longitudinal studies. Furthermore, we investigate the effect of incorrectly modeling school membership in the analysis of multilevel and longitudinal item response data. Two types of school mobility are described, and corresponding models are specified. Results of the simulation studies suggested that appropriate modeling of the two types of school mobility using the CCMM-MLIRD yielded good recovery of the parameters and improvement over models that did not incorporate mobility properly. In addition, the consequences of incorrectly modeling the school effects on the variance estimates of the random effects and the standard errors of the fixed effects depended upon mobility patterns and model specifications. Two sets of large-scale longitudinal data are analyzed to illustrate applications of the CCMM-MLIRD for each type of school mobility.",0 +https://doi.org/10.1080/01621459.1992.10475235,Bayesian Analysis of Constrained Parameter and Truncated Data Problems Using Gibbs Sampling,"Abstract Constrained parameter problems arise in a wide variety of applications, including bioassay, actuarial graduation, ordinal categorical data, response surfaces, reliability development testing, and variance component models. Truncated data problems arise naturally in survival and failure time studies, ordinal data models, and categorical data studies aimed at uncovering underlying continuous distributions. In many applications both parameter constraints and data truncation are present. The statistical literature on such problems is very extensive, reflecting both the problems’ widespread occurrence in applications and the methodological challenges that they pose. However, it is striking that so little of this applied and theoretical literature involves a parametric Bayesian perspective. From a technical viewpoint, this perhaps is not difficult to understand. The fundamental tool for Bayesian calculations in typical realistic models is (multidimensional) numerical integration, which often is problem...",0 +https://doi.org/10.1044/2014_jslhr-h-13-0166,Simulating the Effects of Common and Specific Abilities on Test Performance: An Evaluation of Factor Analysis,"Purpose Factor analysis is a useful technique to aid in organizing multivariate data characterizing speech, language, and auditory abilities. However, knowledge of the limitations of factor analysis is essential for proper interpretation of results. The present study used simulated test scores to illustrate some characteristics of factor analysis. Method Linear models were used to simulate test scores that were determined by multiple latent variables. These simulated test scores were evaluated with principal components analysis and, in certain cases, structural equation modeling. In addition, a subset of simulated individuals characterized by poor test performance was examined. Results The number of factors recovered and their identity do not necessarily correspond to the structure of the latent variables that generated the test scores. The first principal component may represent variance from multiple uncorrelated sources. Practices such as correction or control for general cognitive ability may produce misleading results. Conclusions Inferences from the results of factor analysis should be primarily about the structure of test batteries rather than the structure of human mental abilities. Researchers and clinicians should consider multiple sources of evidence to evaluate hypotheses about the processes generating test results.",0 +https://doi.org/10.1186/1471-2288-7-34,A simulation study of sample size for multilevel logistic regression models,"BackgroundMany studies conducted in health and social sciences collect individual level data as outcome measures. Usually, such data have a hierarchical structure, with patients clustered within physicians, and physicians clustered within practices. Large survey data, including national surveys, have a hierarchical or clustered structure; respondents are naturally clustered in geographical units (e.g., health regions) and may be grouped into smaller units. Outcomes of interest in many fields not only reflect continuous measures, but also binary outcomes such as depression, presence or absence of a disease, and self-reported general health. In the framework of multilevel studies an important problem is calculating an adequate sample size that generates unbiased and accurate estimates.MethodsIn this paper simulation studies are used to assess the effect of varying sample size at both the individual and group level on the accuracy of the estimates of the parameters and variance components of multilevel logistic regression models. In addition, the influence of prevalence of the outcome and the intra-class correlation coefficient (ICC) is examined.ResultsThe results show that the estimates of the fixed effect parameters are unbiased for 100 groups with group size of 50 or higher. The estimates of the variance covariance components are slightly biased even with 100 groups and group size of 50. The biases for both fixed and random effects are severe for group size of 5. The standard errors for fixed effect parameters are unbiased while for variance covariance components are underestimated. Results suggest that low prevalent events require larger sample sizes with at least a minimum of 100 groups and 50 individuals per group.ConclusionWe recommend using a minimum group size of 50 with at least 50 groups to produce valid estimates for multi-level logistic regression models. Group size should be adjusted under conditions where the prevalence of events is low such that the expected number of events in each group should be greater than one.",0 +https://doi.org/10.1111/j.1467-985x.2009.00586.x,The use of simple reparameterizations to improve the efficiency of Markov chain Monte Carlo estimation for multilevel models with applications to discrete time survival models,"We consider the application of Markov chain Monte Carlo (MCMC) estimation methods to random-effects models and in particular the family of discrete time survival models. Survival models can be used in many situations in the medical and social sciences and we illustrate their use through two examples that differ in terms of both substantive area and data structure. A multilevel discrete time survival analysis involves expanding the data set so that the model can be cast as a standard multilevel binary response model. For such models it has been shown that MCMC methods have advantages in terms of reducing estimate bias. However, the data expansion results in very large data sets for which MCMC estimation is often slow and can produce chains that exhibit poor mixing. Any way of improving the mixing will result in both speeding up the methods and more confidence in the estimates that are produced. The MCMC methodological literature is full of alternative algorithms designed to improve mixing of chains and we describe three reparameterization techniques that are easy to implement in available software. We consider two examples of multilevel survival analysis: incidence of mastitis in dairy cattle and contraceptive use dynamics in Indonesia. For each application we show where the reparameterization techniques can be used and assess their performance.",0 +https://doi.org/10.1177/0958928714538214,Subjective insecurity and the role of institutions,"The issue of social insecurity is high on the public and scientific agenda. Most research, however, looks at objective forms of insecurity like growing labour market volatilities or atypical employment. Less has been done with regard to the way people perceive these changes and the role of institutions therein. While recent studies have highlighted the relatively weak role of institutions in explaining different levels of subjective insecurity, they were limited in their understanding in the institutions–security interplay. This special issue aims to understand how institutions generate and moderate the outcomes of subjective insecurity, as well as to overcome some of the methodological limitations of previous studies. The introduction provides a state-of-the-art literature review and unfolds the research question addressed in the special issue. It concludes with some thoughts for future research in the field of social insecurity and institutions.",0 +https://doi.org/10.1348/000711007x213963,Generalized latent variable models with non-linear effects,"Until recently, item response models such as the factor analysis model for metric responses, the two-parameter logistic model for binary responses and the multinomial model for nominal responses considered only the main effects of latent variables without allowing for interaction or polynomial latent variable effects. However, non-linear relationships among the latent variables might be necessary in real applications. Methods for fitting models with non-linear latent terms have been developed mainly under the structural equation modelling approach. In this paper, we consider a latent variable model framework for mixed responses (metric and categorical) that allows inclusion of both non-linear latent and covariate effects. The model parameters are estimated using full maximum likelihood based on a hybrid integration-maximization algorithm. Finally, a method for obtaining factor scores based on multiple imputation is proposed here for the non-linear model.",0 +https://doi.org/10.1080/0924345950060201,A Multi-Level Analysis of School Improvement: Changes in Schools' Performance over Time,"ABSTRACT The improvement of schools takes place over extended periods of time. Consequently longitudinal studies which track successive cohorts of pupils through their schooling are required if estimates of the extent of improvement are to be established. To date, hardly any studies have collected the necessary data. Those studies which have had appropriate data have tended to emphasise the extent of stability of schools' effectiveness over time rather than the extent of any changes. A shift in conceptual framework is called for if improvements in schools' effectiveness are to be the central focus of concern. The study is based on three successive cohorts of pupils passing through some 30 English secondary schools. It uses examination results as the outcome measure and includes a prior attainment measure amongst the variables used to control for differences between schools' intakes. A multi‐level strategy for conceptualising and modelling data on schools' changes in performance over time is offered. In co...",0 +https://doi.org/10.1123/jsep.2013-0261,Goal Striving and Well-Being in Sport: The Role of Contextual and Personal Motivation,"This investigation sought to clarify mixed results in the literature exploring coach behaviors, basic psychological needs, goal motivation, and well- and ill-being. Regional-level team sport athletes ( N = 241) completed questionnaires on the aforementioned variables at the beginning of the season. A subsample ( n = 70) provided saliva samples to assess physical ill-being. At the end of the season, athletes ( n = 98) reported their goal motivation and attainment. Structural equation modeling demonstrated that coach behaviors were related to needs satisfaction and thwarting, which were related to autonomous and controlled goal motives respectively. Autonomous motives were related to well- and ill-being; controlled motives were only related to ill-being. Over time, only end-of-season autonomous goal motives were related to goal attainment. The findings provide an insight into how coaches can facilitate optimum goal striving and well-being in their athletes.",0 +https://doi.org/10.1214/12-ba729,Bayesian Graphical Lasso Models and Efficient Posterior Computation,"Recently, the graphical lasso procedure has become popular in estimating Gaussian graphical models. In this paper, we introduce a fully Bayesian treatment of graphical lasso models. We first investigate the graphical lasso prior that has been relatively unexplored. Using data augmentation, we develop a simple but highly efficient block Gibbs sampler for simulating covariance matrices. We then generalize the Bayesian graphical lasso to the Bayesian adaptive graphical lasso. Finally, we illustrate and compare the results from our approach to those obtained using the standard graphical lasso procedures for real and simulated data. In terms of both covariance matrix estimation and graphical structure learning, the Bayesian adaptive graphical lasso appears to be the top overall performer among a range of frequentist and Bayesian methods.",0 +https://doi.org/10.1038/npp.2008.66,Reduced Stress-Sensitivity or Increased Reward Experience: The Psychological Mechanism of Response to Antidepressant Medication,"Depression has often been associated with increased negative affect reactivity to stress (Stress-Sensitivity) and reduced capacity to experience pleasure or positive affect (Reward Experience). To date, no studies have prospectively examined changes in Stress-Sensitivity and Reward Experience following antidepressant treatment. The sample included 83 depressed patients and 22 healthy controls. A randomized controlled trial was carried out with patients receiving either imipramine or placebo for 6 weeks. At baseline and 6 weeks, patients and controls participated in an Experience Sampling procedure, prospectively measuring ecologically valid daily life appraisals of activities and mood states. The course of depression was assessed with the Hamilton Depression Rating Scale (HDRS). Multilevel linear regression analyses showed that patients had higher negative and lower positive appraisals of activities than controls. In addition, patients showed increased Stress-Sensitivity (negative affect reactivity to negatively appraised activities). Treatment with imipramine decreased Stress-Sensitivity and increased Reward Experience (positive affect reactivity to positively appraised activities). Changes in Stress-Sensitivity and Reward Experience were in part reducible to changes in the process of activity appraisal itself. However, increase in Reward Experience, but not decrease in Stress-Sensitivity, discriminated between patients who responded and those who did not, independent of changes in the process of activity appraisal itself. Response to treatment in depression may be conditional on restoration of hedonic capacity, the cerebral substrate of which requires further study in relation to antidepressant response. A search for (synergistic) antidepressant therapies specifically targeting ability to experience reward may be warranted.",0 +https://doi.org/10.2307/271070,Complex Sample Data in Structural Equation Modeling,"Large-scale surveys using complex sample designs are frequently carried out by government agencies. The statistical analysis technology available for such data is, however, limited in scope. This study investigates and further develops statistical methods that could be used in software for the analysis of data collected under complex sample designs. First, it identifies several recent methodological lines of inquiry which taken together provide a powerful and general statistical basis for a complex sample, structural equation modeling analysis. Second, it extends some of this research to new situations of interest. A Monte Carlo study that empirically evaluates these techniques on simulated data comparable to those in largescale complex surveys demonstrates that they work well in practice. Due to the generality of the approaches, the methods cover not only continuous normal variables but also continuous nonnormal variables and dichotomous variables. Two methods designed to take into account the complex sample structure were",0 +https://doi.org/10.1037/a0035420,Spatial working memory in children with high-functioning autism: Intact configural processing but impaired capacity.,"Visual attention and visual working memory exert severe capacity limitations on cognitive processing. Impairments in both functions may exacerbate the social and communication deficits seen in children with an autism spectrum disorder (ASD). This study characterizes spatial working memory and visual attention in school-age children with high-functioning autism. Children with ASD, and age, gender, and IQ-matched typically developing (TD) children performed 2 tasks: a spatial working memory task and an attentive tracking task. Compared with TD children, children with ASD showed a more pronounced deficit in the spatial working memory task than the attentive tracking task, even though the latter placed significant demands on sustained attention, location updating, and distractor inhibition. Because both groups of children were sensitive to configuration mismatches between the sample and test arrays, the spatial working memory deficit was not because of atypical organization of spatial working memory. These findings show that attention and working memory are dissociable, and that children with ASD show a specific deficit in buffering visual information across temporal discontinuity.",0 +https://doi.org/10.1001/jama.2014.10780,Benefits and Risks Associated With Thrombolysis for Pulmonary Embolism,,0 +https://doi.org/10.1080/10705511003659318,Evaluation of Structural Equation Mixture Models: Parameter Estimates and Correct Class Assignment,"Structural Equation Mixture Models(SEMMs) are latent class models that permit the estimation of a structural equation model within each class. Fitting SEMMs is illustrated using data from one wave of the Notre Dame Longitudinal Study of Aging. Based on the model used in the illustration, SEMM parameter estimation and correct class assignment are investigated in a large scale simulation study. Design factors of the simulation study are (im)balanced class proportions, (im)balanced factor variances, sample size, and class separation. We compare the fit of models with correct and misspecified within-class structural relations. In addition, we investigate the potential to fit SEMMs with binary indicators. The structure of within-class distributions can be recovered under a wide variety of conditions, indicating the general potential and flexibility of SEMMs to test complex within-class models. Correct class assignment is limited.",0 +https://doi.org/10.3758/s13428-012-0207-z,Estimating discrimination performance in two-alternative forced choice tasks: Routines for MATLAB and R,"Ulrich and Vorberg (Attention, Perception, & Psychophysics 71: 1219-1227, 2009) introduced a novel approach for estimating discrimination performance in two-alternative forced choice (2AFC) tasks. This approach avoids pitfalls that are inherent when the order of the standard and the comparison is neglected in estimating the difference limen (DL), as in traditional approaches. The present article provides MATLAB and R routines that implement this novel procedure for estimating DLs. These routines also allow to account for processing failures such as lapses or finger errors and can be applied to experimental designs in which the standard and comparison differ only along the task-relevant dimension, as well as to designs in which the stimuli differ in more than one dimension. In addition, Monte Carlo simulations were conducted to check the quality of our routines. © 2012 Psychonomic Society, Inc.",0 +https://doi.org/10.1186/1744-8069-1-9,"Controlling Neuropathic Pain by Adeno-Associated Virus Driven Production of the Anti-Inflammatory Cytokine, Interleukin-10","Despite many decades of drug development, effective therapies for neuropathic pain remain elusive. The recent recognition of spinal cord glia and glial pro-inflammatory cytokines as important contributors to neuropathic pain suggests an alternative therapeutic strategy; that is, targeting glial activation or its downstream consequences. While several glial-selective drugs have been successful in controlling neuropathic pain in animal models, none are optimal for human use. Thus the aim of the present studies was to explore a novel approach for controlling neuropathic pain. Here, an adeno-associated viral (serotype II; AAV2) vector was created that encodes the anti-inflammatory cytokine, interleukin-10 (IL-10). This anti-inflammatory cytokine is known to suppress the production of pro-inflammatory cytokines. Upon intrathecal administration, this novel AAV2-IL-10 vector was successful in transiently preventing and reversing neuropathic pain. Intrathecal administration of an AAV2 vector encoding beta-galactosidase revealed that AAV2 preferentially infects meningeal cells surrounding the CSF space. Taken together, these data provide initial support that intrathecal gene therapy to drive the production of IL-10 may prove to be an efficacious treatment for neuropathic pain.",0 +https://doi.org/10.3389/fpsyg.2014.01531,Logical-rules and the classification of integral dimensions: individual differences in the processing of arbitrary dimensions,"A variety of converging operations demonstrate key differences between separable dimensions, which can be analyzed independently, and integral dimensions, which are processed in a non-analytic fashion. A recent investigation of response time distributions, applying a set of logical rule-based models, demonstrated that integral dimensions are pooled into a single coactive processing channel, in contrast to separable dimensions, which are processed in multiple, independent processing channels. This paper examines the claim that arbitrary dimensions created by factorially morphing four faces are processed in an integral manner. In two experiments, 16 participants completed a categorization task in which either upright or inverted morph stimuli were classified in a speeded fashion. Analyses focused on contrasting different assumptions about the psychological representation of the stimuli, perceptual and decisional separability, and the processing architecture. We report consistent individual differences which demonstrate a mixture of some observers who demonstrate coactive processing with other observers who process the dimensions in a parallel self-terminating manner.",0 +https://doi.org/10.1002/sim.5904,"Regression calibration for models with two predictor variables measured with error and their interaction, using instrumental variables and longitudinal data","Regression calibration provides a way to obtain unbiased estimators of fixed effects in regression models when one or more predictors are measured with error. Recent development of measurement error methods has focused on models that include interaction terms between measured-with-error predictors, and separately, methods for estimation in models that account for correlated data. In this work, we derive explicit and novel forms of regression calibration estimators and associated asymptotic variances for longitudinal models that include interaction terms, when data from instrumental and unbiased surrogate variables are available but not the actual predictors of interest. The longitudinal data are fit using linear mixed models that contain random intercepts and account for serial correlation and unequally spaced observations. The motivating application involves a longitudinal study of exposure to two pollutants (predictors) - outdoor fine particulate matter and cigarette smoke - and their association in interactive form with levels of a biomarker of inflammation, leukotriene E4 (LTE 4 , outcome) in asthmatic children. Because the exposure concentrations could not be directly observed, we used measurements from a fixed outdoor monitor and urinary cotinine concentrations as instrumental variables, and we used concentrations of fine ambient particulate matter and cigarette smoke measured with error by personal monitors as unbiased surrogate variables. We applied the derived regression calibration methods to estimate coefficients of the unobserved predictors and their interaction, allowing for direct comparison of toxicity of the different pollutants. We used simulations to verify accuracy of inferential methods based on asymptotic theory.",0 +https://doi.org/10.1093/biomet/73.1.13,Longitudinal data analysis using generalized linear models,"SUMMARY This paper proposes an extension of generalized linear models to the analysis of longitudinal data. We introduce a class of estimating equations that give consistent estimates of the regression parameters and of their variance under mild assumptions about the time dependence. The estimating equations are derived without specifying the joint distribution of a subject's observations yet they reduce to the score equations for multivariate Gaussian outcomes. Asymptotic theory is presented for the general class of estimators. Specific cases in which we assume independence, m-dependence and exchangeable correlation structures from each subject are discussed. Efficiency of the proposed estimators in two simple situations is considered. The approach is closely related to quasi-likelih ood. Some key ironh: Estimating equation; Generalized linear model; Longitudinal data; Quasi-likelihood; Repeated measures.",0 +https://doi.org/10.1093/biomet/73.1.43,Multilevel mixed linear model analysis using iterative generalized least squares,"SUMMARY Models for the analysis of hierarchically structured data are discussed. An iterative generalized least squares estimation procedure is given and shown to be equivalent to maximum likelihood in the normal case. There is a discussion of applications to complex surveys, longitudinal data, and estimation in multivariate models with missing responses. An example is given using educational data.",0 +https://doi.org/10.1111/risa.12157,"Risk Perception, Experience, and Objective Risk: A Cross-National Study with European Emergency Survivors","Understanding public risk perceptions and their underlying processes is important in order to learn more about the way people interpret and respond to hazardous emergency events. Direct experience with an involuntary hazard has been found to heighten the perceived risk of experiencing the same hazard and its consequences in the future, but it remains unclear if cross-over effects are possible (i.e., experience with one hazard influencing perceived risk for other hazards also). Furthermore, the impact of objective risk and country of residence on perceived risk is not well understood. As part of the BeSeCu (Behavior, Security, and Culture) Project, a sample of 1,045 survivors of emergencies from seven European countries (i.e., Germany, the Czech Republic, Poland, Sweden, Spain, Turkey, and Italy) was drawn. Results revealed heightened perceived risk for emergency events (i.e., domestic and public fires, earthquakes, floods, and terrorist attacks) when the event had been experienced previously plus some evidence of cross-over effects, although these effects were not so strong. The largest country differences in perceived risk were observed for earthquakes, but this effect was significantly reduced by taking into account the objective earthquake risk. For fires, floods, terrorist attacks, and traffic accidents, only small country differences in perceived risk were found. Further studies including a larger number of countries are welcomed.",0 +https://doi.org/10.1016/j.ecoenv.2015.01.022,Hierarchical modelling of species sensitivity distribution: Development and application to the case of diatoms exposed to several herbicides,"The species sensitivity distribution (SSD) is a key tool to assess the ecotoxicological threat of contaminants to biodiversity. For a contaminant, it predicts which concentration is safe for a community of species. Widely used, this approach suffers from several drawbacks: (i) summarizing the sensitivity of each species by a single value entails a loss of valuable information about the other parameters characterizing the concentration-effect curves; (ii) it does not propagate the uncertainty on estimated sensitivities into the SSD; (iii) the hazardous concentration estimated with SSD only indicates the threat to biodiversity, without any insight about a global response of the community related to the measured endpoint. To remedy these drawbacks, we built a global hierarchical model including the concentration-effect model together with the distribution law of the SSD. We revisited the current SSD approach to account for more sources of variability and uncertainty into the prediction than the traditional analysis and to assess a global response for the community. Working within a Bayesian framework, we were able to compute an SSD taking into account the uncertainty from the original raw data. We also developed a quantitative indicator of a global response of the community to the contaminant. We applied this methodology to study the toxicity and the risk of six herbicides to benthic diatoms from Lake Geneva, based on the biomass endpoint. Our approach highlighted a wide variability within the set of diatom species for all the parameters of the concentration-effect model and a potential correlation between them. Remarkably, variability of the shape parameter of the model and correlation had not been considered before. Comparison between the SSD and the global response of the community revealed that protecting 95% of the species might preserve only 80-86% of the global response. Finally, propagating the uncertainty on the estimated sensitivity showed that building an SSD on a low level of effect, such as EC10, might be unreasonable as it induces a large uncertainty on the result.",0 +https://doi.org/10.1016/j.socscimed.2011.11.023,"Psychological pathways linking social support to health outcomes: A visit with the “ghosts” of research past, present, and future","Contemporary models postulate the importance of psychological mechanisms linking perceived and received social support to physical health outcomes. In this review, we examine studies that directly tested the potential psychological mechanisms responsible for links between social support and health-relevant physiological processes (1980s-2010). Inconsistent with existing theoretical models, no evidence was found that psychological mechanisms such as depression, perceived stress, and other affective processes are directly responsible for links between support and health. We discuss the importance of considering statistical/design issues, emerging conceptual perspectives, and limitations of our existing models for future research aimed at elucidating the psychological mechanisms responsible for links between social support and physical health outcomes.",0 +https://doi.org/10.1016/s0166-4115(08)62094-4,A New Derivation of the Rasch Model,"Abstract The Rasch model is usually derived from statistical requirements of estimation of its parameters. The principle of 'specific objectivity' or, equivalently, 'sample independence' requires that subject parameters can be estimated independent from the item parameters and vice versa. This in turn requires that sufficient statistics exist for the parameters, from which the Rasch model follows. Rather than using a statistical argument, the present paper presents a derivation of the Rasch model based on the requirement that the probability of inferential ordering of subjects (or items, resp.) is sample independent. The derivation parallels Ducamp & Falmagne's axiomatization of the Guttman scale (composite measurement); it is first given for the ordering of two items or subjects, and subsequently generalized to the probability of a multiple ordering. The core equation in the derivation is, of course, not different from the core equation in the statistical derivation.",0 +https://doi.org/10.1037/0033-2909.103.1.111,Modeling multivariate effect sizes.,"In this article, we present a flexible approach to the modeling of multiple effect sizes in meta-analysis. The method uses generalized least squares regression to account for interdependence among multiple outcomes within studies and to allow for different numbers of effect sizes across studies. Furthermore, the approach allows great flexibility in modeling linear equations for multivariate outcomes by means of the inclusion of different sets of predictors for each outcome. We use data from studies of the effectiveness of coaching on performance on the Scholastic Aptitude Test to illustrate application of the method.",0 +https://doi.org/10.1214/08-aoas191,A weakly informative default prior distribution for logistic and other regression models,"We propose a new prior distribution for classical (nonhierarchical) logistic regression models, constructed by first scaling all nonbinary variables to have mean 0 and standard deviation 0.5, and then placing independent Student-$t$ prior distributions on the coefficients. As a default choice, we recommend the Cauchy distribution with center 0 and scale 2.5, which in the simplest setting is a longer-tailed version of the distribution attained by assuming one-half additional success and one-half additional failure in a logistic regression. Cross-validation on a corpus of datasets shows the Cauchy class of prior distributions to outperform existing implementations of Gaussian and Laplace priors. We recommend this prior distribution as a default choice for routine applied use. It has the advantage of always giving answers, even when there is complete separation in logistic regression (a common problem, even when the sample size is large and the number of predictors is small), and also automatically applying more shrinkage to higher-order interactions. This can be useful in routine data analysis as well as in automated procedures such as chained equations for missing-data imputation. We implement a procedure to fit generalized linear models in R with the Student-$t$ prior distribution by incorporating an approximate EM algorithm into the usual iteratively weighted least squares. We illustrate with several applications, including a series of logistic regressions predicting voting preferences, a small bioassay experiment, and an imputation model for a public health data set.",0 +https://doi.org/10.1093/oxfordjournals.aje.a008945,"Intraclass Correlation Estimates in a School-based Smoking Prevention Study: Outcome and Mediating Variables, by Sex and Ethnicity","Most school-based smoking prevention studies employ designs in which schools or classrooms are assigned to different treatment conditions while observations are made on individual students. This design requires that the treatment effect be assessed against the between-school variance. However, the between-school variance is usually larger than the variance that would be obtained if students were individually randomized to different conditions. Consequently, the power of the test for a treatment effect is reduced, and it becomes difficult to detect important treatment effects. To assess the potential loss of power or to calculate appropriate sample sizes, investigators need good estimates of the intraclass correlations for the variables of interest. The authors calculated intraclass correlations for some common outcome variables in a school-based smoking prevention study, using a three-level model-i.e., students nested within classrooms and classrooms nested within schools. The authors present the intraclass correlation estimates for the entire data set, as well as separately by sex and ethnicity. They also illustrate the use of these estimates in the planning of future studies.",0 +https://doi.org/10.1002/jrsm.1112,A multivariate model for the meta‐analysis of study level survival data at multiple times,"Motivated by our meta-analytic dataset involving survival rates after treatment for critical leg ischemia, we develop and apply a new multivariate model for the meta-analysis of study level survival data at multiple times. Our data set involves 50 studies that provide mortality rates at up to seven time points, which we model simultaneously, and we compare the results to those obtained from standard methodologies. Our method uses exact binomial within-study distributions and enforces the constraints that both the study specific and the overall mortality rates must not decrease over time. We directly model the probabilities of mortality at each time point, which are the quantities of primary clinical interest. We also present I2 statistics that quantify the impact of the between-study heterogeneity, which is very considerable in our data set. © 2014 The Authors. Research Synthesis Methods published by John Wiley & Sons, Ltd.",0 +https://doi.org/10.1016/j.lindif.2011.09.006,"Prediction of self-reported knowledge with over-claiming, fluid and crystallized intelligence and typical intellectual engagement","abstract Article history:Received 19 April 2011Received in revised form 7 September 2011Accepted 9 September 2011Keywords:Over-Claiming Technique (OCT)Over-Claiming Questionnaire (OCQ)Self-reported knowledgeFluid and crystallized intelligenceIntellectual engagement We investigated the usefulness of the Over-Claiming Questionnaire (OCQ) as a measure of cognitive abilities. InOCQs respondents are asked to rate their familiarity with items of academic or everyday knowledge (Paulhus,Harms, Bruce, & Lysy, 2003). Some items exist in reality (reals), and others do not (foils). We developed fourOCQs, each consisting of 40 reals and 8 foils from the domains of Science, Humanities and Civics. The OCQswere administered in a longitudinal rotation design to 112 participants who attended the 9th school grade atthe beginning ofthestudy. Inlatent variableregression analyses53% ofvariation inthe reals couldbeexplainedbyfluidandcrystallizedintelligenceandover-claimingasindicatedbyresponsestofoils.Furthervariationinre-sponses to reals and foils was explained by intellectual engagement. Our results show that self-reported knowl-edge, although positively related to measures of ability, to a large extent reflects over-claiming.© 2011 Elsevier Inc. All rights reserved.",0 +,Statistically based tests for the number of common factors,,0 +https://doi.org/10.1016/j.jmva.2015.12.004,Approximate uniform shrinkage prior for a multivariate generalized linear mixed model,Multivariate generalized linear mixed models (MGLMM) are used for jointly modeling the clustered mixed outcomes obtained when there are two or more responses repeatedly measured on each individual in scientific studies. Bayesian methods are widely used techniques for analyzing MGLMM. The need for noninformative priors arises when there is insufficient prior information on the model parameters. The main aim of the present study is to propose an approximate uniform shrinkage prior for the random effect variance components in the Bayesian analysis for the MGLMM. This prior is an extension of the approximate uniform shrinkage prior proposed by Natarajan and Kass (2000). This prior is easy to apply and is shown to possess several nice properties. The use of the approximate uniform shrinkage prior is illustrated in terms of both a simulation study and osteoarthritis data.,0 +https://doi.org/10.1111/j.2044-8295.1940.tb00968.x,WEIGHTING FOR BATTERY RELIABILITY AND PREDICTION,,0 +https://doi.org/10.1177/0146621609359284,Modeling DIF Effects Using Distractor-Level Invariance Effects: Implications for Understanding the Causes of DIF,"In 2008, Penfield showed that measurement invariance across all response options of a multiple-choice item (correct option and the J distractors) can be modeled using a nominal response model that included a differential distractor functioning (DDF) effect for each of the J distractors. This article extends this concept to consider how the differential item functioning (DIF) effect (i.e., the conditional between-group differences in the probability of correct response) is determined by the J DDF effects. In particular, this article shows how the DIF effect can be modeled as a function of the J DDF effects and thus reveals the conditions that must hold for uniform DIF, nonuniform DIF, and crossing DIF to exist. The results provide insight into the potential item-level properties that lead to uniform, nonuniform, and crossing DIF. The findings may shed light on the etiology of different forms of DIF, which may help analysts target the particular causes of the DIF effect.",0 +https://doi.org/10.1037/a0037244,"Testing the four-factor model of personality vulnerability to alcohol misuse: A three-wave, one-year longitudinal study.","The 4-factor model of personality vulnerability identifies 4 personality risk factors for alcohol misuse: hopelessness, anxiety sensitivity, impulsivity, and sensation seeking. These personality traits are associated with distinct mechanisms and motivations for alcohol misuse. Individuals high in hopelessness drink to regulate dysphoric affect, while those high in anxiety sensitivity drink to reduce anxiety and to conform to peer expectations. Individuals high in sensation seeking are highly sensitive to the rewarding properties of alcohol, and misuse alcohol to maximize enjoyment. Impulsivity is a broad risk factor contributing to all drinking motives. We hypothesized that personality vulnerabilities would indirectly predict alcohol quantity and problems through specific drinking motives theorized by the 4-factor model. The present study tested hypotheses using a 3-wave, 1-year longitudinal study of undergraduate drinkers (N = 302). Data were analyzed using multilevel path analysis. Hopelessness and impulsivity were positively related to drinking motives in the expected fashion. Anxiety sensitivity was related to coping-anxiety and conformity motives only in the between-subjects model (partially supporting hypotheses), while sensation seeking was generally unrelated to all drinking motives and alcohol outcomes (failing to support hypotheses). Enhancement motives predicted alcohol quantity and problems at both levels, coping-depression motives predicted alcohol problems at the between-subjects level only, and coping-anxiety, conformity, and social motives failed to predict alcohol outcomes beyond other motives. Overall, this study partially supports the 4-factor model, with the strongest support emerging for impulsivity and hopelessness. This study suggests that personality traits such as impulsivity and hopelessness may be important targets in prevention and treatment with undergraduate drinkers.",0 +https://doi.org/10.1177/0272989x12453504,The Choice of a Noninformative Prior on Between-Study Variance Strongly Affects Predictions of Future Treatment Effect,"Purpose. Bayesian random-effects meta-analyses require the analyst to specify the prior distribution for between-study variance of the treatment effect. We assessed the sensitivity of prediction and other outputs of the meta-analysis to the choice of this prior. Methods. We reanalyzed 7 published meta-analyses (5–14 trials) with rare (event rates <5%), moderate (15%–50%), and frequent binary outcomes (>50%). We examined 10 noninformative priors: inverse gamma on between-study variance ( τ 2 ), 2 uniforms on each of the between-study standard deviation ( τ) and τ 2 , uniform shrinkage on τ 2 , DuMouchel shrinkage on τ, half-normal on τ 2 , and half-normal priors on τ with large and small variances. For each analysis, we calculated the posterior distributions for τ, the population treatment effect in current studies, and the predicted treatment effect in a future study. We assessed goodness of fit using total residual deviance, the deviance information criterion, and predictive deviance (by cross-validations). Results. According to total residual deviance, the best-fitting priors were uniform on τ 2 . According to predictive deviance, half-normal on τ 2 and the shrinkage priors were optimal. Across analyses with the 10 priors, there were no important differences in the posteriors for the population treatment effect, but there were substantial differences in the posteriors for τ and predictions. The priors that fitted best according to predictive deviance resulted in less uncertainty around predictions of future treatment effect. Conclusions. In this sample of Bayesian meta-analyses with binary outcomes, the choice of noninformative prior for between-study variance affected model fit and the predictions of future treatment effect. When the predictive distribution is of interest, we highly recommend examination of multiple prior distributions for between-study variance, especially the half-normal on τ 2 and the shrinkage priors.",0 +https://doi.org/10.1177/0958928713507468,Public opinion and the reform of the pension systems in Europe: the influence of solidarity principles,"The demographic changes that have occurred in European countries in recent decades have made the policies of the public pension system one of the most debated issues of the welfare state. In this paper, I focus on preferences for three pension policy reforms with different distributive consequences: raising contributions, raising the age of retirement, and allowing free choice between public and private pension plans. I use multilevel models to analyse how individual attachment to different solidarity principles (universalistic, conservative, liberal and familistic) affects attitudes toward pension system reforms while controlling for institutional factors. The empirical results strongly support the hypothesis that solidarity principles have a significant influence on individual preferences. I find that individuals who adhere to universalistic or conservative principles are more in favour of increasing contributions in order to maintain the level of pensions, whereas they oppose a postponement of retirement age. In contrast, those who adhere to liberal or familistic principles are against increasing contributions and prefer extending retirement age. The findings at least partially support the ‘regime hypothesis’, as a more generous pension system appears to increase support for raising contributions while decreasing support for a raise in the age of retirement.",0 +https://doi.org/10.3758/bf03206555,Fitting distributions using maximum likelihood: Methods and packages,"The most powerful tests of response time (RT) models often involve the whole shape of the RT distribution, thus avoiding mimicking that can occur at the level of RT means and variances. Nonparametric distribution estimation is, in principle, the most appropriate approach, but such estimators are sometimes difficult to obtain. On the other hand, distribution fitting, given an algebraic function, is both easy and compact. We review the general approach to performing distribution fitting with maximum likelihood (ML) and a method based on quantiles (quantile maximum probability, QMP). We show that QMP has both small bias and good efficiency when used with common distribution functions (the ex-Gaussian, Gumbel, lognormal, Wald, and Weibull distributions). In addition, we review some software packages performing ML (PASTIS, QMPE, DISFIT, and MATHEMATICA) and compare their results. In general, the differences between packages have little influence on the optimal solution found, but the form of the distribution function has: Both the lognormal and the Wald distributions have non-linear dependencies between the parameter estimates that tend to increase the overall bias in parameter recovery and to decrease efficiency. We conclude by laying out a few pointers on how to relate descriptive models of RT to cognitive models of RT. A program that generated the random deviates used in our studies may be downloaded from www.psychonomic.org/archive/.",0 +https://doi.org/10.1198/016214504000000647,Full Matching in an Observational Study of Coaching for the SAT,"Among matching techniques for observational studies, full matching is in principle the best, in the sense that its alignment of comparable treated and control subjects is as good as that of any alternate method, and potentially much better. This article evaluates the practical performance of full matching for the first time, modifying it in order to minimize variance as well as bias and then using it to compare coached and uncoached takers of the SAT. In this new version, with restrictions on the ratio of treated subjects to controls within matched sets, full matching makes use of many more observations than does pair matching, but achieves far closer matches than does matching with k≥ 2 controls. Prior to matching, the coached and uncoached groups are separated on the propensity score by 1.1 SDs. Full matching reduces this separation to 1% or 2% of an SD. In older literature comparing matching and regression, Cochran expressed doubts that any method of adjustment could substantially reduce observed bias ...",0 +https://doi.org/10.1214/06-ba115,The case for objective Bayesian analysis,"Bayesian statistical practice makes extensive use of versions of objective Bayesian analysis. We discuss why this is so, and address some of the criticisms that have been raised concerning objective Bayesian analysis. The dangers of treating the issue too casually are also considered. In particular, we suggest that the statistical community should accept formal objective Bayesian techniques with confidence, but should be more cautious about casual objective Bayesian techniques.",0 +https://doi.org/10.1108/jmhtep-02-2015-0005,Developing a scale measuring perceived knowledge and skills dimensions for mental health promotion: a pilot test using a convenience sample,"Purpose – Against the background of rising mental health (MH) problems many practitioners and health programmers require tools to plan and implement mental health promotion (MHP). A Likert scale to measure Perceived Knowledge of Skills needed for MHP (PKSMHP) was developed and pilot tested. The paper aims to discuss these issues. Design/methodology/approach – A convenience sample of leading personnel ( n =106) in three settings (43 schools, 24 workplaces, 39 care facilities) was drawn in five European countries. A descriptive item analysis, an exploratory and confirmatory factor analysis, and a scales’ performance analysis was adopted. Findings – The validated PKSMHP scale included nine high-quality items measuring the knowledge level of three skills dimensions: MHP management/planning, MHP tools/methods/services and recognition/detection of MH problems. Taken together these can be seen to represent the overall type of skills needed for implementing MHP. Originality/value – The short scale showed very good scale performance values in this pilot study. After further testing the scale might be used as a baseline assessment of MHP needs, as a building block for MHP training and organisational capacity building.",0 +https://doi.org/10.1037/0033-295x.102.2.396,A measurement-theoretic analysis of the fuzzy logic model of perception.,"The fuzzy logic model of perception (FLMP) is analyzed from a measurement-theoretic perspective. FLMP has an impressive history of fitting factorial data, suggesting that its probabilistic form is valid. The authors raise questions about the underlying processing assumptions of FLMP. Although FLMP parameters are interpreted as fuzzy logic truth values, the authors demonstrate that for several factorial designs widely used in choice experiments, most desirable fuzzy truth value properties fail to hold under permissible rescalings, suggesting that the fuzzy logic interpretation may be unwarranted. The authors show that FLMP's choice rule is equivalent to a version of G. Rasch's (1960) item response theory model, and the nature of FLMP measurement scales is transparent when stated in this form. Statistical inference theory exists for the Rasch model and its equivalent forms. In fact, FLMP can be reparameterized as a simple 2-category logit model, thereby facilitating interpretation of its measurement scales and allowing access to commercially available software for performing statistical inference.",0 +https://doi.org/10.1214/07-ba221,Re-considering the variance parameterization in multiple precision models,"Recent developments in Bayesian computing allow accurate estimation of integrals, making advanced Bayesian analysis feasible. However, some problems remain difficult, such as estimating posterior distributions for variance parameters. For models with three or more variances, this paper proposes a simplex parameterization for the variance structure, which has appealing properties and eases the related burden of specifying a reference prior. This parameterization can be profitably used in several multiple-precision models, including crossed random-effect models, many linear mixed models, smoothed ANOVA, and the conditionally autoregressive (CAR) model with two classes of neighbor relations, often useful for spatial data. The simplex parameterization has at least two attractive features. First, it typically leads to simple MCMC algorithms with good mixing properties regardless of the parameterization used to specify the model's reference prior. Thus, a Bayesian analysis can take computational advantage of the simplex parameterization even if its prior was specified using another parameterization. Second, the simplex parameterization suggests a natural reference prior that is proper, invariant under multiplication of the data by a constant, and which appears to reduce the posterior correlation of smoothing parameters with the error precision. We use simulations to compare the simplex parameterization, with its reference prior, to other parameterizations with their reference priors, according to bias and mean-squared error of point estimates and coverage of posterior 95% credible intervals. The results suggest advantages for the simplex approach, particularly when the error precision is small. We offer results in the context of two real data sets from the fields of periodontics and prosthodontics.",0 +https://doi.org/10.1080/13594320244000184,Comprehensive meta-analysis of the construct validity of the employment interview,"This article presents a series of meta-analyses carried out, exploring the construct validity of personnel selection interviews. Accordingly, the interviews were divided into two different groups: conventional interviews and behavior interviews. Conventional interviews are typically composed of questions directed at checking credentials, description of experience, and self-evaluative information. Behavior interviews mainly include questions concerning job knowledge, job experience, and behavior descriptions. The results showed that conventional interviews assessed general mental ability, job experience, the Big Five personality dimensions, and social skills, whereas behavior interviews mainly assessed job knowledge, job experience, situational judgment, and social skills. According to these findings, conventional and behavior interviews seem to be different interviews.",0 +https://doi.org/10.1002/j.2162-6057.2010.tb01328.x,Unfolding the Measurement of the Creative Personality,"ABSTRACT Gough’s Creative Personality Scale (CPS) is a self-report personality inventoryfor creativity assessment. We investigated the undimensionality and the responseprocess on the CPS from an ideal point (unfolding) perspective. The Graded Unfold-ing Model (GUM) was used to model binary responses and participants were228 engineering students who completed a Greek version of the CPS. Resultssupport the undimensionality of the CPS construct and suggest that unfoldingmeasurement models may provide new insights to the assessment of creativity. Keywords: Creativity measurement, ideal point models, GUM, Greece INTRODUCTION Creativity assessments seek to identify the creative individual and this is one ofthe most exciting adventures in creativity research (Runco, 2007). Psychometrictests (i.e. tests of divergent thinking, attitude and interest inventories, personalityinventories, and biographical inventories) are one general approach used in thestudy of creativity (Hocevar and Bachelor, 1989). Researchers have devoted sub-stantial efforts to demonstrating the psychometric quality of creativity tests; andthe importance of understanding the psychometric properties of creativity mea-sures has been recognized (Plucker and Renzulli, 1999). Yet, the techniques usedin these efforts have not kept pace with the advances in psychometric theory andmethods. In the field of creativity, the application of modern test theory — notablyItem Response Theory (IRT) and its variants, such as unfolding models is rare.This is regrettable given that modern test theory may bring more psychometricrigor to the problem of measuring creativity, over and above traditional psycho-metric techniques.",0 +https://doi.org/10.1890/07-0744.1,Accounting for uncertainty in ecological analysis: the strengths and limitations of hierarchical statistical modeling,"Analyses of ecological data should account for the uncertainty in the process(es) that generated the data. However, accounting for these uncertainties is a difficult task, since ecology is known for its complexity. Measurement and/or process errors are often the only sources of uncertainty modeled when addressing complex ecological problems, yet analyses should also account for uncertainty in sampling design, in model specification, in parameters governing the specified model, and in initial and boundary conditions. Only then can we be confident in the scientific inferences and forecasts made from an analysis. Probability and statistics provide a framework that accounts for multiple sources of uncertainty. Given the complexities of ecological studies, the hierarchical statistical model is an invaluable tool. This approach is not new in ecology, and there are many examples (both Bayesian and non-Bayesian) in the literature illustrating the benefits of this approach. In this article, we provide a baseline for concepts, notation, and methods, from which discussion on hierarchical statistical modeling in ecology can proceed. We have also planted some seeds for discussion and tried to show where the practical difficulties lie. Our thesis is that hierarchical statistical modeling is a powerful way of approaching ecological analysis in the presence of inevitable but quantifiable uncertainties, even if practical issues sometimes require pragmatic compromises.",0 +https://doi.org/10.1037/a0039251,Signal detection and threshold modeling of confidence-rating ROCs: A critical test with minimal assumptions.,"An ongoing discussion in the recognition-memory literature concerns the question of whether recognition judgments reflect a direct mapping of graded memory representations (a notion that is instantiated by signal detection theory) or whether they are mediated by a discrete-state representation with the possibility of complete information loss (a notion that is instantiated by threshold models). These 2 accounts are usually evaluated by comparing their (penalized) fits to receiver operating characteristic data, a procedure that is predicated on substantial auxiliary assumptions, which if violated can invalidate results. We show that the 2 accounts can be compared on the basis of critical tests that invoke only minimal assumptions. Using previously published receiver operating characteristic data, we show that confidence-rating judgments are consistent with a discrete-state account. (PsycINFO Database Record",0 +https://doi.org/10.1186/1744-859x-12-26,No role for initial severity on the efficacy of antidepressants: results of a multi-meta-analysis,"During the last decade, a number of meta-analyses questioned the clinically relevant efficacy of antidepressants. Part of the debate concerned the method used in each of these meta-analyses as well as the quality of the data set.The Kirsch data set was analysed with a number of different methods, and eight key questions were tackled. We fit random effects models in both Bayesian and frequentist statistical frameworks using raw mean difference and standardised mean difference scales. We also compare between-study heterogeneity estimates and produce treatment rank probabilities for all antidepressants. The role of the initial severity is further examined using meta-regression methods.The results suggest that antidepressants have a standardised effect size equal to 0.34 which is lower but comparable to the effect of antipsychotics in schizophrenia and acute mania. The raw HDRS difference from placebo is 2.82 with the value of 3 included in the confidence interval (2.21-3.44). No role of initial severity was found after partially controlling for the effect of structural (mathematical) coupling. Although data are not definite, even after controlling for baseline severity, there is a strong possibility that venlafaxine is superior to fluoxetine, with the other two agents positioned in the middle. The decrease in the difference between the agent and placebo in more recent studies in comparison to older ones is attributed to baseline severity alone.The results reported here conclude the debate on the efficacy of antidepressants and suggest that antidepressants are clearly superior to placebo. They also suggest that baseline severity cannot be utilized to dictate whether the treatment should include medication or not. Suggestions like this, proposed by guidelines or institutions (e.g. the NICE), should be considered mistaken.",0 +https://doi.org/10.1111/bmsp.12081,Bayesian analysis of longitudinal multitrait-multimethod data with ordinal response variables,"A new multilevel latent state graded response model for longitudinal multitrait-multimethod (MTMM) measurement designs combining structurally different and interchangeable methods is proposed. The model allows researchers to examine construct validity over time and to study the change and stability of constructs and method effects based on ordinal response variables. We show how Bayesian estimation techniques can address a number of important issues that typically arise in longitudinal multilevel MTMM studies and facilitates the estimation of the model presented. Estimation accuracy and the impact of between- and within-level sample sizes as well as different prior specifications on parameter recovery were investigated in a Monte Carlo simulation study. Findings indicate that the parameters of the model presented can be accurately estimated with Bayesian estimation methods in the case of low convergent validity with as few as 250 clusters and more than two observations within each cluster. The model was applied to well-being data from a longitudinal MTMM study, assessing the change and stability of life satisfaction and subjective happiness in young adults after high-school graduation. Guidelines for empirical applications are provided and advantages and limitations of a Bayesian approach to estimating longitudinal multilevel MTMM models are discussed.",0 +https://doi.org/10.1111/j.1471-4159.2012.07833.x,Harnessing pain heterogeneity and RNA transcriptome to identify blood-based pain biomarkers: a novel correlational study design and bioinformatics approach in a graded chronic constriction injury model,"A quantitative, peripherally accessible biomarker for neuropathic pain has great potential to improve clinical outcomes. Based on the premise that peripheral and central immunity contribute to neuropathic pain mechanisms, we hypothesized that biomarkers could be identified from the whole blood of adult male rats, by integrating graded chronic constriction injury (CCI), ipsilateral lumbar dorsal quadrant (iLDQ) and whole blood transcriptomes, and pathway analysis with pain behavior. Correlational bioinformatics identified a range of putative biomarker genes for allodynia intensity, many encoding for proteins with a recognized role in immune/nociceptive mechanisms. A selection of these genes was validated in a separate replication study. Pathway analysis of the iLDQ transcriptome identified Fcγ and Fcε signaling pathways, among others. This study is the first to employ the whole blood transcriptome to identify pain biomarker panels. The novel correlational bioinformatics, developed here, selected such putative biomarkers based on a correlation with pain behavior and formation of signaling pathways with iLDQ genes. Future studies may demonstrate the predictive ability of these biomarker genes across other models and additional variables.",0 +https://doi.org/10.1007/bf03395630,Effective Analysis of Reaction Time Data,"Most analyses of reaction time (RT) data are conducted by using the statistical techniques with which psychologists are most familiar, such as analysis of variance on the sample mean. Unfortunately, these methods are usually inappropriate for RT data, because they have little power to detect genuine differences in RT between conditions. In addition, some statistical approaches can, under certain circumstances, result in findings that are artifacts of the analysis method itself. A corpus of research has shown more effective analytical methods, such as analyzing the whole RT distribution, although this research has had limited influence. The present article will summarize these advances in methods for analyzing RT data.",0 +https://doi.org/10.3310/hta14400,Systematic review and economic modelling of the effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence,"To assess the clinical effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence (SUI) through systematic review and economic modelling.The Cochrane Incontinence Group Specialised Register, electronic databases and the websites of relevant professional organisations and manufacturers, and the following databases: CINAHL, EMBASE, BIOSIS, Science Citation Index and Social Science Citation Index, Current Controlled Trials, ClinicalTrials.gov and the UKCRN Portfolio Database.The study comprised three distinct elements. (1) A survey of 188 women with SUI to identify outcomes of importance to them (activities of daily living; sex, hygiene and lifestyle issues; emotional health; and the availability of services). (2) A systematic review and meta-analysis of non-surgical treatments for SUI to find out which are most effective by comparing results of trials (direct pairwise comparisons) and by modelling results (mixed-treatment comparisons - MTCs). A total of 88 randomised controlled trials (RCTs) and quasi-RCTs reporting data from 9721 women were identified, considering five generic interventions [pelvic floor muscle training (PFMT), electrical stimulation (ES), vaginal cones (VCs), bladder training (BT) and serotonin-noradrenaline reuptake inhibitor (SNRI) medications], in many variations and combinations. Data were available for 37 interventions and 68 treatment comparisons by direct pairwise assessment. Mixed-treatment comparison models compared 14 interventions, using data from 55 trials (6608 women). (3) Economic modelling, using a Markov model, to find out which combinations of treatments (treatment pathways) are most cost-effective for SUI.Titles and abstracts identified were assessed by one reviewer and full-text copies of all potentially relevant reports independently assessed by two reviewers. Any disagreements were resolved by consensus or arbitration by a third person.Direct pairwise comparison and MTC analysis showed that the treatments were more effective than no treatment. Delivering PFMT in a more intense fashion, either through extra sessions or with biofeedback (BF), appeared to be the most effective treatment [PFMT extra sessions vs no treatment (NT) odds ratio (OR) 10.7, 95% credible interval (CrI) 5.03 to 26.2; PFMT + BF vs NT OR 12.3, 95% CrI 5.35 to 32.7]. Only when success was measured in terms of improvement was there evidence that basic PFMT was better than no treatment (PFMT basic vs NT OR 4.47, 95% CrI 2.03 to 11.9). Analysis of cost-effectiveness showed that for cure rates, the strategy using lifestyle changes and PFMT with extra sessions followed by tension-free vaginal tape (TVT) (lifestyle advice-PFMT extra sessions-TVT) had a probability of greater than 70% of being considered cost-effective for all threshold values for willingness to pay for a QALY up to 50,000 pounds. For improvement rates, lifestyle advice-PFMT extra sessions-TVT had a probability of greater than 50% of being considered cost-effective when society's willingness to pay for an additional QALY was more than 10,000 pounds. The results were most sensitive to changes in the long-term performance of PFMT and also in the relative effectiveness of basic PFMT and PFMT with extra sessions.Although a large number of studies were identified, few data were available for most comparisons and long-term data were sparse. Challenges for evidence synthesis were the lack of consensus on the most appropriate method for assessing incontinence and intervention protocols that were complex and varied considerably across studies.More intensive forms of PFMT appear worthwhile, but further research is required to define an optimal form of more intensive therapy that is feasible and efficient for the NHS to provide, along with further definitive evidence from large, well-designed studies.",0 +https://doi.org/10.1207/s15327906mbr4002_1,Maximum Likelihood Analysis of Nonlinear Structural Equation Models With Dichotomous Variables,"In this article, a maximum likelihood approach is developed to analyze structural equation models with dichotomous variables that are common in behavioral, psychological and social research. To assess nonlinear causal effects among the latent variables, the structural equation in the model is defined by a nonlinear function. The basic idea of the development is to augment the observed dichotomous data with the hypothetical missing data that involve the latent underlying continuous measurements and the latent variables in the model. An EM algorithm is implemented. The conditional expectation in the E-step is approximated via observations simulated from the appropriate conditional distributions by a Metropolis-Hastings algorithm within the Gibbs sampler, whilst the M-step is completed by conditional maximization. Convergence is monitored by bridge sampling. Standard errors are also obtained. Results from a simulation study and a real example are presented to illustrate the methodology.",0 +https://doi.org/10.1177/0049124106289112,A Multilevel Factor Model for Mixed Binary and Ordinal Indicators of Women's Status,"The authors present a factor model for the analysis of categorical responses with a two-level hierarchical structure. The model allows for multiple, potentially correlated factors at each level as well as covariate effects on the responses. Estimation using Markov chain Monte Carlo (MCMC) methods is described. The methodology is applied in an analysis of women's status in Bangladesh. Two dimensions of women's status are considered—social independence and decision-making power—and the factor structure of the responses at the woman and district levels is explored.",0 +https://doi.org/10.4324/9781315092614-1,A Comparative Review of Interaction and Nonlinear Modeling,,0 +https://doi.org/10.1080/00031305.1987.10475509,How Do We Judge Confidence-Interval Adequacy?,"Abstract Simulation studies of confidence-interval procedures often only report coverage rates. This is not sufficient to judge whether the intervals are “unbiased,” that is, whether they are equally likely to be above as below the true value if they do not cover the true value. Most procedures suggest that they are forming such intervals.",0 +https://doi.org/10.1016/0042-6989(95)00016-x,Adaptive psychophysical procedures,"Improvements in measuring thresholds, or points on a psychometric function, have advanced the field of psychophysics in the last 30 years. The arrival of laboratory computers allowed the introduction of adaptive procedures, where the presentation of the next stimulus depends on previous responses of the subject. Unfortunately, these procedures present themselves in a bewildering variety, though some of them differ only slightly. Even someone familiar with several methods cannot easily name the differences, or decide which method would be best suited for a particular application. This review tries to illuminate the historical background of adaptive procedures, explain their differences and similarities, and provide criteria for choosing among the various techniques.",0 +https://doi.org/10.1007/s11121-014-0519-6,Engagement in Training as a Mechanism to Understanding Fidelity of Implementation of the Responsive Classroom Approach,"Fidelity of implementation of classroom interventions varies greatly, a reality that is concerning because higher fidelity of implementation relates to greater effectiveness of the intervention. We analyzed 126 fourth and fifth grade teachers from the treatment group of a randomized controlled trial of the Responsive Classroom® (RC) approach. Prior to training in the intervention, we assessed factors that had the potential to represent a teacher’s readiness to implement with fidelity. These included teachers’ observed emotional support, teacher-rated use of intervention practices, teacher-rated self-efficacy, teacher-rated collective responsibility, education level, and years of experience, and they were not directly related to observed fidelity of implementation 2 years later. Further analyses indicated, however, that RC trainers’ ratings of teachers’ engagement in the initial weeklong RC training mediated the relation between initial observed emotional support and later observed fidelity of implementation. We discuss these findings as a way to advance understanding of teachers’ readiness to implement new interventions with fidelity. © 2014, Society for Prevention Research.",0 +,Cross-domain collaborative filtering via bilinear multilevel analysis,"Cross-domain collaborative filtering (CDCF), which aims to leverage data from multiple domains to relieve the data sparsity issue, is becoming an emerging research topic in recent years. However, current CDCF methods that mainly consider user and item factors but largely neglect the heterogeneity of domains may lead to improper knowledge transfer issues. To address this problem, we propose a novel CDCF model, the Bilinear Multilevel Analysis (BLMA), which seamlessly introduces multilevel analysis theory to the most successful collaborative filtering method, matrix factorization (MF). Specifically, we employ BLMA to more efficiently address the determinants of ratings from a hierarchical view by jointly considering domain, community, and user effects so as to overcome the issues caused by traditional MF approaches. Moreover, a parallel Gibbs sampler is provided to learn these effects. Finally, experiments conducted on a realworld dataset demonstrate the superiority of the BLMA over other state-of-the-art methods.",0 +https://doi.org/10.1080/10705510802561279,Small-Sample Robust Estimators of Noncentrality-Based and Incremental Model Fit,"Traditional estimators of fit measures based on the noncentral chi–square distribution (root mean square error of approximation [RMSEA], Steiger's γ, etc.) tend to overreject acceptable models when the sample size is small. To handle this problem, it is proposed to employ Bartlett's (1950) Bartlett, M. S. 1950. Tests of significance in factor analysis. British Journal of Psychology (Statistical Section), 3: 77–85. [Crossref], [Web of Science ®] , [Google Scholar], Yuan's (2005) Yuan, K.-H. 2005. Fit indices versus test statistics. Multivariate Behavioral Research, 40: 115–148. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar], or Swain's (1975) Swain, A. J. 1975. Analysis of parametric structures for variance matrices., Australia: Department of Statistics, University of Adelaide. Unpublished doctoral dissertation [Google Scholar] correction of the maximum likelihood chi–square statistic for the estimation of noncentrality–based fit measures. In a Monte Carlo study, it is shown that Swain's correction especially produces reliable estimates and confidence intervals for different degrees of model misspecification (RMSEA range: 0.000–0.096) and sample sizes (50, 75, 100, 150, 200). In the second part of the article, the study is extended to incremental fit indexes (Tucker–Lewis Index, Comparative Fit Index, etc.). For their small–sample robust estimation, use of Swain's correction is recommended only for the target model, not for the independence model. The Swain–corrected estimators only require a ratio of sample size to estimated parameters of about 2:1 (sometimes even less) and are thus strongly recommended for applied research. R software is provided for convenient use.",0 +https://doi.org/10.1076/edre.4.1.13.13014,A Multilevel Perspective on the Design and Analysis of Intervention Studies,"The level (pupil, classroom or school) at which an educational intervention is assigned affects both the kinds of questions which can be answered in evaluation research, and the statistical methods used to answer them. This paper sets out ways of analysing different kinds of designs using multilevel models. It also considers practical issues such as the method used to allocate interventions, leakage, integrity of delivery, and cost, and how these interact with the more technical issues of model specification. These practical issues are illustrated by two recent British intervention studies. Resume Le niveau - eleve, classe ou ecole - auquel s'adresse une intervention educative affecte tout a la fois le genre de questions qui peuvent trouver reponse dans la recherche evaluative et les methodes statistiques pour y repondre. Cet article presente des voies pour analyser differents types de design qui utilisent des modeles a plusieurs niveaux. Il traite aussi de certains aspects pratiques tels que la methode...",0 +https://doi.org/10.1080/00031305.1992.10475878,Explaining the Gibbs Sampler,"Abstract Computer-intensive algorithms, such as the Gibbs sampler, have become increasingly popular statistical tools, both in applied and theoretical work. The properties of such algorithms, however, may sometimes not be obvious. Here we give a simple explanation of how and why the Gibbs sampler works. We analytically establish its properties in a simple case and provide insight for more complicated cases. There are also a number of examples.",0 +https://doi.org/10.1016/j.csda.2013.07.036,"Robust growth mixture models with non-ignorable missingness: Models, estimation, selection, and application","Challenges in the analyses of growth mixture models include missing data, outliers, estimation, and model selection. Four non-ignorable missingness models to recover the information due to missing data, and three robust models to reduce the effect of non-normality are proposed. A full Bayesian method is implemented by means of data augmentation algorithm and Gibbs sampling procedure. Model selection criteria are also proposed in the Bayesian context. Simulation studies are then conducted to evaluate the performances of the models, the Bayesian estimation method, and selection criteria under different situations. The application of the models is demonstrated through the analysis of education data on children's mathematical ability development. The models can be widely applied to longitudinal analyses in medical, psychological, educational, and social research. Four non-ignorable missingness models are proposed.Three robust models to deal with outliers are proposed.A full Bayesian method is implemented.Model selection criteria are proposed in a Bayesian context.Three simulation studies and one real data case study are conducted.",0 +https://doi.org/10.1108/tpm-03-2015-0014,Measuring adaptive performance in individuals and teams,"Purpose – While scales were developed to measure individual adaptive performance (IAP), fewer contributions have been done to assess the construct at the team level of analysis. This issue is addressed through two related studies: Study 1 builds on Pulakos et al. (2000) to develop a measure of IAP. Study 2 follows from the results in Study 1 and tests a measure of team adaptive performance (Chan, 1998). Design/methodology/approach – Scale development was done adopting a single level (Study 1) and multi-level (Study 2) structural equations modeling approach. Findings – Results suggest that both measures of individual and team adaptive performance are reliable and show evidence supporting the adequacy of adopting referent-shift methodologies to the measurement and aggregation of team members’ rating of team adaptive performance. Originality/value – The study offers a reliable, parsimonious and easy to apply measure of individual and team adaptive performance in organizational work environments.",0 +https://doi.org/10.1080/10888438.2011.618153,Fluency Has a Role in the Simple View of Reading,"The Simple View of Reading (SVR) suggests that the components of reading comprehension are decoding and linguistic comprehension. Given research that suggests that fluency is a separate construct from decoding and linguistic comprehension in fourth grade, the aim of this study was to examine the role of fluency in the SVR model. Analyses of data from 248 fourth-grade children explored whether the influence of fluency on reading comprehension is direct or whether fluency plays an indirect role on reading comprehension as a mediator or moderator of decoding. Structural equation modeling and latent regression analyses revealed that reading fluency plays a mediating role in explaining the relation between decoding and reading comprehension. This novel finding is placed in the context of studies that reported either a direct effect or no effect of reading fluency in SVR.",0 +https://doi.org/10.1214/06-ba128,A skew item response model,"We introduce a new skew-probit link for item response theory (IRT) by considering an accumulated skew-normal distribution. The model extends the symmetric probit-normal IRT model by considering a new item (or skewness) parameter for the item characteristic curve. A special interpretation is given for this parameter, and a latent linear structure is indicated for the model when an augmented likelihood is considered. Bayesian MCMC inference approach is developed and an efficiency study in the estimation of the model parameters is undertaken for a data set from (Tanner 1996, pg. 190) by using the notion of effective sample size (ESS) as defined in Kass et al. (1999) and the sample size per second (ESS/s) as considered in Sahu (2002). The methodology is illustrated using a data set corresponding to a Mathematical Test applied in Peruvian schools for which a sensitivity analysis of the chosen priors is conducted and also a comparison with seven parametric IRT models is conducted. The main conclusion is that the skew-probit item response model seems to provide the best fit.",0 +https://doi.org/10.3758/s13428-018-1054-3,On the importance of avoiding shortcuts in applying cognitive models to hierarchical data,"Psychological experiments often yield data that are hierarchically structured. A number of popular shortcut strategies in cognitive modeling do not properly accommodate this structure and can result in biased conclusions. To gauge the severity of these biases, we conducted a simulation study for a two-group experiment. We first considered a modeling strategy that ignores the hierarchical data structure. In line with theoretical results, our simulations showed that Bayesian and frequentist methods that rely on this strategy are biased towards the null hypothesis. Secondly, we considered a modeling strategy that takes a two-step approach by first obtaining participant-level estimates from a hierarchical cognitive model and subsequently using these estimates in a follow-up statistical test. Methods that rely on this strategy are biased towards the alternative hypothesis. Only hierarchical models of the multilevel data lead to correct conclusions. Our results are particularly relevant for the use of hierarchical Bayesian parameter estimates in cognitive modeling.",0 +https://doi.org/10.1037/0022-3514.86.1.148,"Academic Performance, Career Potential, Creativity, and Job Performance: Can One Construct Predict Them All?","This meta-analysis addresses the question of whether 1 general cognitive ability measure developed for predicting academic performance is valid for predicting performance in both educational and work domains. The validity of the Miller Analogies Test (MAT; W. S. Miller, 1960) for predicting 18 academic and work-related criteria was examined. MAT correlations with other cognitive tests (e.g., Raven's Matrices [J. C. Raven, 1965]; Graduate Record Examinations) also were meta-analyzed. The results indicate that the abilities measured by the MAT are shared with other cognitive ability instruments and that these abilities are generalizably valid predictors of academic and vocational criteria, as well as evaluations of career potential and creativity. These findings contradict the notion that intelligence at work is wholly different from intelligence at school, extending the voluminous literature that supports the broad importance of general cognitive ability (g).",0 +https://doi.org/10.1007/s11336-008-9088-6,Identifying Variables Responsible for Data not Missing at Random,"When data are not missing at random (NMAR), maximum likelihood (ML) procedure will not generate consistent parameter estimates unless the missing data mechanism is correctly modeled. Understanding NMAR mechanism in a data set would allow one to better use the ML methodology. A survey or questionnaire may contain many items; certain items may be responsible for NMAR values in other items. The paper develops statistical procedures to identify the responsible items. By comparing ML estimates (MLE), statistics are developed to test whether the MLEs are changed when excluding items. The items that cause a significant change of the MLEs are responsible for the NMAR mechanism. Normal distribution is used for obtaining the MLEs; a sandwich-type covariance matrix is used to account for distribution violations. The class of nonnormal distributions within which the procedure is valid is provided. Both saturated and structural models are considered. Effect sizes are also defined and studied. The results indicate that more missing data in a sample does not necessarily imply more significant test statistics due to smaller effect sizes. Knowing the true population means and covariances or the parameter values in structural equation models may not make things easier either. © 2008 The Psychometric Society.",0 +https://doi.org/10.1177/1094428107308906,Estimating Statistical Power and Required Sample Sizes for Organizational Research Using Multilevel Modeling,"The use of multilevel modeling to investigate organizational phenomena is rapidly increasing. Unfortunately, little advice is readily available for organizational researchers attempting to determine statistical power when using multilevel models or when determining sample sizes for each level that will maximize statistical power. This article presents an introduction to statistical power in multilevel models. The unique factors influencing power in multilevel models and calculations for estimating power for simple fixed effects, variance components, and cross-level interactions are presented. The results of simulation studies and the existing general rules of thumb are discussed, and the available power analysis software is reviewed.",0 +https://doi.org/10.1186/1471-2288-13-2,Modelling heterogeneity variances in multiple treatment comparison meta-analysis – Are informative priors the better solution?,"BackgroundMultiple treatment comparison (MTC) meta-analyses are commonly modeled in a Bayesian framework, and weakly informative priors are typically preferred to mirror familiar data driven frequentist approaches. Random-effects MTCs have commonly modeled heterogeneity under the assumption that the between-trial variance for all involved treatment comparisons are equal (i.e., the ‘common variance’ assumption). This approach ‘borrows strength’ for heterogeneity estimation across treatment comparisons, and thus, ads valuable precision when data is sparse. The homogeneous variance assumption, however, is unrealistic and can severely bias variance estimates. Consequently 95% credible intervals may not retain nominal coverage, and treatment rank probabilities may become distorted. Relaxing the homogeneous variance assumption may be equally problematic due to reduced precision. To regain good precision, moderately informative variance priors or additional mathematical assumptions may be necessary.MethodsIn this paper we describe four novel approaches to modeling heterogeneity variance - two novel model structures, and two approaches for use of moderately informative variance priors. We examine the relative performance of all approaches in two illustrative MTC data sets. We particularly compare between-study heterogeneity estimates and model fits, treatment effect estimates and 95% credible intervals, and treatment rank probabilities.ResultsIn both data sets, use of moderately informative variance priors constructed from the pair wise meta-analysis data yielded the best model fit and narrower credible intervals. Imposing consistency equations on variance estimates, assuming variances to be exchangeable, or using empirically informed variance priors also yielded good model fits and narrow credible intervals. The homogeneous variance model yielded high precision at all times, but overall inadequate estimates of between-trial variances. Lastly, treatment rankings were similar among the novel approaches, but considerably different when compared with the homogenous variance approach.ConclusionsMTC models using a homogenous variance structure appear to perform sub-optimally when between-trial variances vary between comparisons. Using informative variance priors, assuming exchangeability or imposing consistency between heterogeneity variances can all ensure sufficiently reliable and realistic heterogeneity estimation, and thus more reliable MTC inferences. All four approaches should be viable candidates for replacing or supplementing the conventional homogeneous variance MTC model, which is currently the most widely used in practice.",0 +https://doi.org/10.1177/0013164407301544,Estimating the Standard Error of the Maximum Likelihood Ability Estimator in Adaptive Testing Using the Posterior-Weighted Test Information Function,"The standard error of the maximum likelihood ability estimator is commonly estimated by evaluating the test information function at an examinee's current maximum likelihood estimate (a point estimate) of ability. Because the test information function evaluated at the point estimate may differ from the test information function evaluated at an examinee's true ability value, the estimated standard error may be biased under certain conditions. This is of particular concern in adaptive testing because the height of the test information function is expected to be higher at the current estimate of ability than at the actual value of ability. This article proposes using the posterior-weighted test information function in computing the standard error of the maximum likelihood ability estimator for adaptive test sessions. A simulation study showed that the proposed approach provides standard error estimates that are less biased and more efficient than those provided by the traditional point estimate approach.",0 +https://doi.org/10.1037/0022-006x.72.2.288,"Structural Ecosystems Therapy for HIV-Seropositive African American Women: Effects on Psychological Distress, Family Hassles, and Family Support.","This study tests the efficacy of Structural Ecosystems Therapy (SET), a family-ecological intervention, in improving psychosocial functioning when compared with an attention-comparison person-centered condition and a community control condition. A sample of 209 HIV-seropositive, urban, low-income, African American women was randomized into 1 of the 3 conditions. Results of growth curve analyses over 5 time points revealed that SET was more efficacious than either of the control conditions in reducing psychological distress and family-related hassles. However, contrary to hypotheses, SET was not more efficacious in increasing family support. Latent growth mixture modeling analyses indicated that SET was most efficacious for women who, on average, were at or near the clinical threshold for psychological distress and for women with high levels of family hassles. Implications for further intervention development are discussed.",0 +https://doi.org/10.1002/(sici)1098-2272(1999)17:2<118::aid-gepi3>3.0.co;2-v,Genetic variance components analysis for binary phenotypes using generalized linear mixed models (GLMMs) and Gibbs sampling,"The common complex diseases such as asthma are an important focus of genetic research, and studies based on large numbers of simple pedigrees ascertained from population-based sampling frames are becoming commonplace. Many of the genetic and environmental factors causing these diseases are unknown and there is often a strong residual covariance between relatives even after all known determinants are taken into account. This must be modelled correctly whether scientific interest is focused on fixed effects, as in an association analysis, or on the covariances themselves. Analysis is straightforward for multivariate Normal phenotypes, but difficulties arise with other types of trait. Generalized linear mixed models (GLMMs) offer a potentially unifying approach to analysis for many classes of phenotype including multivariate Normal traits, binary traits, and censored survival times. Markov Chain Monte Carlo methods, including Gibbs sampling, provide a convenient framework within which such models may be fitted. In this paper, Bayesian inference Using Gibbs Sampling (a generic Gibbs sampler; BUGS) is used to fit GLMMs for multivariate Normal and binary phenotypes in nuclear families. BUGS is easy to use and readily available. We motivate a suitable model structure for Normal phenotypes and show how the model extends to binary traits. We discuss parameter interpretation and statistical inference and show how to circumvent a number of important theoretical and practical problems that we encountered. Using simulated data we show that model parameters seem consistent and appear unbiased in smaller data sets. We illustrate our methods using data from an ongoing cohort study.",0 +https://doi.org/10.1056/nejm198010303031804,Influence of Adherence to Treatment and Response of Cholesterol on Mortality in the Coronary Drug Project,"The Coronary Drug Project was carried out to evaluate the efficacy and safety of several lipid-influencing drugs in the long-term treatment of coronary heart disease. The five-year mortality in 1103 men treated with clofibrate was 20.0 per cent, as compared with 20.9 per cent in 2789 men given placebo (P = 0.55). Good adherers to clofibrate, i.e., patients who took 80 per cent of more of the protocol prescription during the five-year follow-up period, had a substantially lower five-year mortality than did poor adherers to clofibrate (15.0 vs. 24.6 per cent; P = 0.00011). However, similar findings were noted in the placebo group, i.e., 15.1 per cent mortality for good adherers and 28.3 per cent for poor adherers (P = 4.7x10-16). These findings and various other analyses of mortality in the clofibrate and placebo groups of the project show the serious difficulty, if not impossibility, of evaluating treatment efficacy in subgroups determined by patient responses (e.g., adherence or cholesterol change) to the treatment protocol after randomization.",0 +https://doi.org/10.1093/annonc/mdv238,Statistical controversies in clinical research: scientific and ethical problems with adaptive randomization in comparative clinical trials,"In recent years, various outcome adaptive randomization (AR) methods have been used to conduct comparative clinical trials. Rather than randomizing patients equally between treatments, outcome AR uses the accumulating data to unbalance the randomization probabilities in favor of the treatment arm that currently is superior empirically. This is motivated by the idea that, on average, more patients in the trial will be given the treatment that is truly superior, so AR is ethically more desirable than equal randomization. AR remains controversial, however, and some of its properties are not well understood by the clinical trials community.Computer simulation was used to evaluate properties of a 200-patient clinical trial conducted using one of four Bayesian AR methods and compare them to an equally randomized group sequential design.Outcome AR has several undesirable properties. These include a high probability of a sample size imbalance in the wrong direction, which might be surprising to nonstatisticians, wherein many more patients are assigned to the inferior treatment arm, the opposite of the intended effect. Compared with an equally randomized design, outcome AR produces less reliable final inferences, including a greatly overestimated actual treatment effect difference and smaller power to detect a treatment difference. This estimation bias becomes much larger if the prognosis of the accrued patients either improves or worsens systematically during the trial.AR produces inferential problems that decrease potential benefit to future patients, and may decrease benefit to patients enrolled in the trial. These problems should be weighed against its putative ethical benefit. For randomized comparative trials to obtain confirmatory comparisons, designs with fixed randomization probabilities and group sequential decision rules appear to be preferable to AR, scientifically, and ethically.",0 +https://doi.org/10.1080/03610920701826427,On Mean Squared Prediction Error Estimation in Small Area Estimation Problems,"For a general linear mixed normal model, a new linearized weighted jackknife method is proposed to estimate the mean squared prediction error (MSPE) of an empirical best linear unbiased predictor (EBLUP) of a general mixed effect. Different MSPE estimators are compared using a Monte Carlo simulation study.",0 +https://doi.org/10.1080/01621459.1981.10477731,Bayes Empirical Bayes,"Abstract A Bayesian approach is given for various kinds of empirical Bayes problems. In particular it is shown that empirical Bayes procedures are really non-Bayesian, asymptotically optimal, classical procedures for mixtures. In some situations these procedures are Bayes with respect to some prior and in other situations, there is no prior for which they are Bayes. Several examples of these concepts are given as well as a general theory showing the difference between an empirical Bayes model and a Bayes empirical Bayes model.",0 +https://doi.org/10.1080/10705511.2014.935256,Moderated Mediation Analysis Using Bayesian Methods,"Conventionally, moderated mediation analysis is conducted through adding relevant interaction terms into a mediation model of interest. In this study, we illustrate how to conduct moderated mediation analysis by directly modeling the relation between the indirect effect components including a and b and the moderators, to permit easier specification and interpretation of moderated mediation. With this idea, we introduce a general moderated mediation model that can be used to model many different moderated mediation scenarios including the scenarios described in Preacher, Rucker, and Hayes (2007). Then we discuss how to estimate and test the conditional indirect effects and to test whether a mediation effect is moderated using Bayesian approaches. How to implement the estimation in both BUGS and Mplus is also discussed. Performance of Bayesian methods is evaluated and compared to that of frequentist methods including maximum likelihood (ML) with 1st-order and 2nd-order delta method standard errors and mL with bootstrap (percentile or bias-corrected confidence intervals) via a simulation study. The results show that Bayesian methods with diffuse (vague) priors implemented in both BUGS and Mplus yielded unbiased estimates, higher power than the ML methods with delta method standard errors, and the ML method with bootstrap percentile confidence intervals, and comparable power to the ML method with bootstrap bias-corrected confidence intervals. We also illustrate the application of these methods with the real data example used in Preacher et al. (2007). Advantages and limitations of applying Bayesian methods to moderated mediation analysis are also discussed.",0 +https://doi.org/10.3758/bf03214307,Simple adaptive testing with the weighted up-down method,"This paper proposes a method for adaptive testing that is less complicated than the commonly used transformed up-down methods (1 up 2 down, 1 up 3 down, etc.). In addition, the weighted up-down method can converge to any desired point of the psychometric function. The rule is very simple: Each correct response leads to a decrease in signal level, each incorrect response to an increase. The only difference from the simple up-down method (1 up 1 down) is that the steps upward and the steps downward are of a different size. The straightforward construction of the novel procedure pays off in efficiency and stability: A Monte Carlo simulation reveals a definite advantage, though small, of the weighted up-down method over the 1-up-2-down rule.",0 +https://doi.org/10.1002/sim.3478,"Fixed effects, random effects and GEE: What are the differences?","For analyses of longitudinal repeated-measures data, statistical methods include the random effects model, fixed effects model and the method of generalized estimating equations. We examine the assumptions that underlie these approaches to assessing covariate effects on the mean of a continuous, dichotomous or count outcome. Access to statistical software to implement these models has led to widespread application in numerous disciplines. However, careful consideration should be paid to their critical assumptions to ascertain which model might be appropriate in a given setting. To illustrate similarities and differences that might exist in empirical results, we use a study that assessed depressive symptoms in low-income pregnant women using a structured instrument with up to five assessments that spanned the pre-natal and post-natal periods. Understanding the conceptual differences between the methods is important in their proper application even though empirically they might not differ substantively. The choice of model in specific applications would depend on the relevant questions being addressed, which in turn informs the type of design and data collection that would be relevant. Copyright © 2008 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1207/s15328007sem0902_3,Reliability of Scales With General Structure: Point and Interval Estimation Using a Structural Equation Modeling Approach,"A method for obtaining point and interval estimates of reliability for composites of measures with a general structure is discussed. The approach is based on fitting a correspondingly constrained structural equation model and generalizes earlier covariance structure analysis methods for scale reliability estimation with congeneric tests. The procedure can be used with weighted or unweighted composites, in which the weights need not be known in advance but may be estimated simultaneously. The approach allows one also to obtain an approximate standard error and confidence interval for scale reliability using the bootstrap methodology.",0 +https://doi.org/10.1016/j.jrp.2010.03.003,The General Factor of Personality: A meta-analysis of Big Five intercorrelations and a criterion-related validity study,"Recently, it has been proposed that a General Factor of Personality (GFP) occupies the top of the hierarchical personality structure. We present a meta-analysis (K = 212, total N = 144,117) on the intercorrelations among the Big Five personality factors (Openness, Conscientiousness, Extraversion, Agreeableness, and Neuroticism) to test for the existence of a GFP. In addition, we report a multi-method validity study testing the relationship between the GFP and supervisor-rated job performance. The meta-analysis provided supporting evidence for the two meta-factors Stability and Plasticity (ora and b, respectively) and a GFP at the highest hierarchal level. The validity study indicated that the GFP has a substantive component as it is related to supervisor-rated job performance.",0 +https://doi.org/10.1177/1740774511430714,An approach to combining parallel and cross-over trials with and without run-in periods using individual patient data,"Background In active run-in trials, where patients may be excluded after a run-in period based on their response to the treatment, it is implicitly assumed that patients have individual treatment effects. If individual patient data are available, active run-in trials can be modelled using patient-specific random effects. With more than one trial on the same medication available, one can obtain a more precise overall treatment effect estimate. Methods We present a model for joint analysis of a two-sequence, four-period cross-over trial (AABB/BBAA) and a three-sequence, two-period active run-in trial (AB/AA/A), where the aim is to investigate the effect of a new treatment for patients with pain due to osteoarthritis. Results Our approach enables us to separately estimate the direct treatment effect for all patients, for the patients excluded after the active run-in trial prior to randomisation, and for the patients who completed the active run-in trial. A similar model approach can be used to analyse other types of run-in trials, but this depends on the data and type of other trials available. Limitations We assume equality of the various carry-over effects over time. Conclusions The proposed approach is flexible and can be modified to handle other designs. Our results should be encouraging for those responsible for planning cost-efficient clinical development programmes.",0 +https://doi.org/10.1080/01621459.1949.10483310,The Monte Carlo Method,"Abstract We shall present here the motivation and a general description of a method dealing with a class of problems in mathematical physics. The method is, essentially, a statistical approach to the study of differential equations, or more generally, of integro-differential equations that occur in various branches of the natural sciences.",0 +https://doi.org/10.1037/a0015857,Modeling life-span growth curves of cognition using longitudinal data with multiple samples and changing scales of measurement.,"The authors use multiple-sample longitudinal data from different test batteries to examine propositions about changes in constructs over the life span. The data come from 3 classic studies on intellectual abilities in which, in combination, 441 persons were repeatedly measured as many as 16 times over 70 years. They measured cognitive constructs of vocabulary and memory using 8 age-appropriate intelligence test batteries and explore possible linkage of these scales using item response theory (IRT). They simultaneously estimated the parameters of both IRT and latent curve models based on a joint model likelihood approach (i.e., NLMIXED and WINBUGS). They included group differences in the model to examine potential interindividual differences in levels and change. The resulting longitudinal invariant Rasch test analyses lead to a few new methodological suggestions for dealing with repeated constructs based on changing measurements in developmental studies.",0 +https://doi.org/10.3389/fnint.2012.00024,Modulation of tactile duration judgments by emotional pictures,"Judging the duration of emotional stimuli is known to be influenced by their valence and arousal values. However, whether and how perceiving emotion in one modality affects time perception in another modality is still unclear. To investigate this, we compared the influence of different types of emotional pictures-a picture of threat, disgust, or a neutral picture presented at the start of a trial-on temporal bisection judgments of the duration of a subsequently presented vibrotactile stimulus. We found an overestimation of tactile duration following exposure to pictures of threat, but not pictures of disgust (even though these scored equally high on arousal), in a short-range temporal bisection task (range 300/900 ms). Follow-up experiments revealed that this duration lengthening effect was abolished when the range to be bisected was increased (1000/1900 ms). However, duration overestimation was maintained in the short-range bisection task regardless of whether the interval between the visual and tactile events was short or long. This pattern is inconsistent with a general arousal interpretation of duration distortion and suggests that crossmodal linkages in the processing of emotions and emotional regulation are two main factors underlying the manifestation of crossmodal duration modulation.",0 +https://doi.org/10.1016/j.socscimed.2012.09.028,"An exploratory multilevel analysis of income, income inequality and self-rated health of the elderly in China","In the last three decades, China has experienced rapid economic development and growing economic inequality, such that economic disparities between rural and urban areas, as well as coastal and interior areas have deepened. Since the late 1990s China has also experienced an ageing population which has attracted attention to the wellbeing of the rapidly growing number of elderly. This research aims to characterise province differences in health and to explore the effects of individual income and economic disparity in the form of income inequality on health outcomes of the elderly. The study is based on the Chinese Longitudinal Healthy Longevity Survey data collected in 2008 for 23 provinces. Multilevel logistic models are employed to investigate the relationship between income, income inequality and self-rated health for the elderly using both individual and province-level variables. Results are presented as relative odds ratios, and for province differentials as Median Odds Ratios. The analysis is deliberately exploratory so as to find evidence of income effects if they exist and particular attention is placed on how province-level inequality (contemporaneous and lagged) may moderate individual relationships. The results show that the health of the elderly is not only affected by individual income (the odds of poor health are 3 times greater for the elderly with the lowest income compared to those at the upper quartile) but also by a small main effect for province-level income inequality (odds ratio of 1.019). There are significant cross-level interactions such that where inequality is high there are greater differences between those with and without formal education, and between men and women with the latter experiencing poorer health.",0 +https://doi.org/10.1002/sim.6188,A design‐by‐treatment interaction model for network meta‐analysis with random inconsistency effects,"Network meta-analysis is becoming more popular as a way to analyse multiple treatments simultaneously and, in the right circumstances, rank treatments. A difficulty in practice is the possibility of ‘inconsistency’ or ‘incoherence’, where direct evidence and indirect evidence are not in agreement. Here, we develop a random-effects implementation of the recently proposed design-by-treatment interaction model, using these random effects to model inconsistency and estimate the parameters of primary interest. Our proposal is a generalisation of the model proposed by Lumley and allows trials with three or more arms to be included in the analysis. Our methods also facilitate the ranking of treatments under inconsistency. We derive R and I2 statistics to quantify the impact of the between-study heterogeneity and the inconsistency. We apply our model to two examples. © 2014 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd.",0 +https://doi.org/10.3758/bf03206553,SPSS and SAS procedures for estimating indirect effects in simple mediation models,"Researchers often conduct mediation analysis in order to indirectly assess the effect of a proposed cause on some outcome through a proposed mediator. The utility of mediation analysis stems from its ability to go beyond the merely descriptive to a more functional understanding of the relationships among variables. A necessary component of mediation is a statistically and practically significant indirect effect. Although mediation hypotheses are frequently explored in psychological research, formal significance tests of indirect effects are rarely conducted. After a brief overview of mediation, we argue the importance of directly testing the significance of indirect effects and provide SPSS and SAS macros that facilitate estimation of the indirect effect with a normal theory approach and a bootstrap approach to obtaining confidence intervals, as well as the traditional approach advocated by Baron and Kenny (1986). We hope that this discussion and the macros will enhance the frequency of formal mediation tests in the psychology literature. Electronic copies of these macros may be downloaded from the Psychonomic Society’s Web archive atwww.psychonomic.org/archive/.",0 +https://doi.org/10.1007/s10654-007-9145-y,A Bayesian multinomial model to analyse spatial patterns of childhood co-morbidity in Malawi,"Children in less developed countries die from relatively small number of infectious disease, some of which epidemiologically overlap. Using self-reported illness data from the 2000 Malawi Demographic and Health Survey, we applied a random effects multinomial model to assess risk factors of childhood co-morbidity of fever, diarrhoea and pneumonia, and quantify area-specific spatial effects. The spatial structure was modelled using the conditional autoregressive prior. Various models were fitted and compared using deviance information criterion. Inference was Bayesian and was based on Markov Chain Monte Carlo simulation techniques. We found spatial variation in childhood co-morbidity and determinants of each outcome category differed. Specifically, risk factors associated with child co-morbidity included age of the child, place of residence, undernutrition, bednet use and Vitamin A. Higher residual risk levels were identified in the central and southern-eastern regions, particularly for fever, diarrhoea and pneumonia; fever and pneumonia; and fever and diarrhoea combinations. This linkage between childhood health and geographical location warrants further research to assess local causes of these clusters. More generally, although each disease has its own mechanism, overlapping risk factors suggest that integrated disease control approach may be cost-effective and should be employed. © 2007 Springer Science+Business Media B.V.",0 +https://doi.org/10.1068/p6134,A Contextual Effect of 2nd-Order Configural Processing of Non-Face Objects by Non-Experts,"We investigated here the detection of 2nd-order configural relations both in faces and in non-face objects. In experiment 1 it was shown that observers were more sensitive to feature displacements in upright faces and houses than in inverted faces and houses. The presence of an inversion effect in the house stimuli suggested that 2nd-order relational processing was applied to the non-face stimuli. In experiment 2, the inversion effect for houses was absent when only houses were presented. In experiment 3, face and house stimuli were once again presented in the same task and inversion effects were again seen for both types of stimuli. Together, these results suggest that 2nd-order relational processing can be flexibly applied to non-face objects when they are presented in the context of faces.",0 +https://doi.org/10.1167/11.10.1,The horizontal tuning of face perception relies on the processing of intermediate and high spatial frequencies,"It was recently shown that expert face perception relies on the extraction of horizontally oriented visual cues. Picture-plane inversion was found to eliminate horizontal, suggesting that this tuning contributes to the specificity of face processing. The present experiments sought to determine the spatial frequency (SF) scales supporting the horizontal tuning of face perception. Participants were instructed to match upright and inverted faces that were filtered both in the frequency and orientation domains. Faces in a pair contained horizontal or vertical ranges of information in low, middle, or high SF (LSF, MSF, or HSF). Our findings confirm that upright (but not inverted) face perception is tuned to horizontal orientation. Horizontal tuning was the most robust in the MSF range, next in the HSF range, and absent in the LSF range. Moreover, face inversion selectively disrupted the ability to process horizontal information in MSF and HSF ranges. This finding was replicated even when task difficulty was equated across orientation and SF at upright orientation. Our findings suggest that upright face perception is tuned to horizontally oriented face information carried by intermediate and high SF bands. They further indicate that inversion alters the sampling of face information both in the orientation and SF domains.",0 +https://doi.org/10.3758/s13428-011-0181-x,Four applications of permutation methods to testing a single-mediator model,"Four applications of permutation tests to the single-mediator model are described and evaluated in this study. Permutation tests work by rearranging data in many possible ways in order to estimate the sampling distribution for the test statistic. The four applications to mediation evaluated here are the permutation test of ab, the permutation joint significance test, and the noniterative and iterative permutation confidence intervals for ab. A Monte Carlo simulation study was used to compare these four tests with the four best available tests for mediation found in previous research: the joint significance test, the distribution of the product test, and the percentile and bias-corrected bootstrap tests. We compared the different methods on Type I error, power, and confidence interval coverage. The noniterative permutation confidence interval for ab was the best performer among the new methods. It successfully controlled Type I error, had power nearly as good as the most powerful existing methods, and had better coverage than any existing method. The iterative permutation confidence interval for ab had lower power than do some existing methods, but it performed better than any other method in terms of coverage. The permutation confidence interval methods are recommended when estimating a confidence interval is a primary concern. SPSS and SAS macros that estimate these confidence intervals are provided.",0 +https://doi.org/10.1080/104852502310001652629,Nonparametric Bayesian analysis of a proportion for a small area under nonignorable nonresponse,"In small area estimation, it is a standard practice to assume that the area effects are exchangeable. This is obtained by assuming that the area effects have a common parametric distribution, and a Bayesian approach is attractive. The Dirichlet process prior (DPP) has been used to provide a nonparametric version of this approach. The DPP is useful because it makes the procedure more robust, and the Bayesian approach helps to reduce the effect of nonidentifiability prominent in nonignorable nonresponse models. Using the DPP, we develop a Bayesian methodology for the analysis of nonignorable nonresponse binary data from many small areas, and for each area, we estimate the proportion of individuals with a particular characteristic. Our DPP model is centered on a baseline model, a standard parametric model. We use Markov chain Monte Carlo methods to fit the DPP model and the baseline model, and our methodology is illustrated using data on victimization in ten domains from the National Crime Survey. Our compar...",0 +https://doi.org/10.1146/annurev.clinpsy.1.102803.144239,"Structural Equation Modeling: Strengths, Limitations, and Misconceptions","Because structural equation modeling (SEM) has become a very popular data-analytic technique, it is important for clinical scientists to have a balanced perception of its strengths and limitations. We review several strengths of SEM, with a particular focus on recent innovations (e.g., latent growth modeling, multilevel SEM models, and approaches for dealing with missing data and with violations of normality assumptions) that underscore how SEM has become a broad data-analytic framework with flexible and unique capabilities. We also consider several limitations of SEM and some misconceptions that it tends to elicit. Major themes emphasized are the problem of omitted variables, the importance of lower-order model components, potential limitations of models judged to be well fitting, the inaccuracy of some commonly used rules of thumb, and the importance of study design. Throughout, we offer recommendations for the conduct of SEM analyses and the reporting of results.",0 +https://doi.org/10.1016/j.csda.2008.03.030,Structural equation modeling with near singular covariance matrices,"Conventional structural equation modeling involves fitting a structural model to the sample covariance matrix S. Due to collinearity or small samples with practical data, nonconvergences often occur in the estimation process. For a small constant a, this paper proposes to fit the structural model to the covariance matrix Sa=S+aI. When treating Sa as the sample covariance matrix in the maximum likelihood (ML) procedure, consistent parameter estimates are still obtained. The asymptotic distributions of the parameter estimates and the corresponding likelihood ratio statistic are studied and compared to those by the conventional ML. Two rescaled statistics for the overall model evaluation with modeling Sa are constructed. Empirical results imply that the estimates from modeling Sa are more efficient than those of fitting the structural model to S even when data are normally distributed. Simulations and real data examples indicate that modeling Sa allows us to evaluate the overall model structure even when S is literally singular. Implications of modeling Sa in a broader context are discussed.",0 +https://doi.org/10.1177/0146167206287721,A Procedure for Evaluating Sensitivity to Within-Person Change: Can Mood Measures in Diary Studies Detect Change Reliably?,"The recent growth in diary and experience sampling research has increased research attention on how people change over time in natural settings. Often however, the measures in these studies were originally developed for studying between-person differences, and their sensitivity to within-person changes is usually unknown. Using a Generalizability Theory framework, the authors illustrate a procedure for developing reliable measures of change using a version of the Profile of Mood States (POMS; McNair, Lorr, & Droppleman, 1992) shortened for diary studies. Analyzing two data sets, one composed of 35 daily reports from 68 persons experiencing a stressful examination and another composed of daily reports from 164 persons over a typical 28-day period, we demonstrate that three-item measures of anxious mood, depressed mood, anger, fatigue, and vigor have appropriate reliability to detect within-person change processes.",0 +https://doi.org/10.1080/1743727x.2014.885012,A methodological review of statistical methods for handling multilevel non-nested longitudinal data in educational research,"As applications of multilevel modelling in educational research increase, researchers realize that multilevel data collected in many educational settings are often not purely nested. The most common multilevel non-nested data structure is one that involves student mobility in longitudinal studies. This article provides a methodological review of three statistical methods for handling student mobility in longitudinal studies: a multilevel approach, a cross-classified approach, and a cross-classified multiple membership approach. The strengths and weaknesses of each approach and the essential differences between the three approaches are discussed. The Early Childhood Longitudinal Study Kindergarten Cohort data are analysed to demonstrate the differences in parameter estimates and statistical inference between the three approaches. Potential applications of the three approaches in educational research and beyond and directions for further methodological investigations are discussed.",0 +https://doi.org/10.3102/1076998611422912,Utilizing Response Time Distributions for Item Selection in CAT,"Traditional methods for item selection in computerized adaptive testing only focus on item information without taking into consideration the time required to answer an item. As a result, some examinees may receive a set of items that take a very long time to finish, and information is not accrued as efficiently as possible. The authors propose two item-selection criteria that utilize information from a lognormal model for response times. The first modifies the maximum information criterion to maximize information per time unit. The second is an inverse time-weighted version of a-stratification that takes advantage of the response time model, but achieves more balanced item exposure than the information-based techniques. Simulations are conducted to compare these procedures against their counterparts that ignore response times, and efficiency of estimation, time-required, and item exposure rates are assessed.",0 +https://doi.org/10.1093/biostatistics/kxv036,Modeling agreement on categorical scales in the presence of random scorers,"Kappa coefficients are often used to assess agreement between two fixed scorers on categorical scales. Cohen's version is popular for nominal scales and the weighted version for ordinal scales. In the present paper, similar agreement coefficients are defined for random scorers. A partial-Bayesian methodology is then developed to directly relate these agreement coefficients to predictors through a multilevel model. Statistical properties of the proposed approach are studied using simulations. Finally, the approach is applied to gynecological and medical imaging data.",0 +https://doi.org/10.1111/j.1467-9868.2004.00438.x,Likelihood ratio tests in linear mixed models with one variance component,Summary. We consider the problem of testing null hypotheses that include restrictions on the variance component in a linear mixed model with one variance component and we derive the finite sample and asymptotic distribution of the likelihood ratio test and the restricted likelihood ratio test. The spectral representations of the likelihood ratio test and the restricted likelihood ratio test statistics are used as the basis of efficient simulation algorithms of their null distributions. The large sample χ2 mixture approximations using the usual asymptotic theory for a null hypothesis on the boundary of the parameter space have been shown to be poor in simulation studies. Our asymptotic calculations explain these empirical results. The theory of Self and Liang applies only to linear mixed models for which the data vector can be partitioned into a large number of independent and identically distributed subvectors. One-way analysis of variance and penalized splines models illustrate the results.,0 +https://doi.org/10.1214/06-ba117c,Comment on article by Browne and Draper,http://projecteuclid.org/euclid.ba/1340371050#ui-tabs-1,0 +https://doi.org/10.1007/s11336-005-1297-7,Are unshifted distributional models appropriate for response time?,"Van Breukelen (this issue) provides an approach to using both response time (RT) and accuracy for (1) measuring latent abilities of participants even when they may trade speed for accuracy, and for (2) providing insight into the psychological processes underlying task performance. In this commentary, I focus on the second of these aims and assess how useful this approach is for exploring cognition. The approach is based on formulating statistical rather than substantive models on accuracy and RT. I focus here on the appropriateness of the RT component model. This RT model joins a family of recent statistical approaches to RT including those of Glickman, Gray, and Morales (in press); Peruggia, Van Zandt, and Chen (2002); Rouder, Lu, Speckman, Sun, and Jiang (in press); Schnipke and Scrams (1997); and Wenger and Gibson (2004). The advantage of these statistical rather than substantive models is robust estimation and sound inference when data are collected across disparate individuals and items. It is not hard to see how these statistical developments will lead to better substantive theory testing and development in cognitive psychology. Van Breukelen’s model for the ith participant’s RT to the j th item is given by:",0 +https://doi.org/10.1167/15.15.6,Contextual effects in visual working memory reveal hierarchically structured memory representations,"Influential slot and resource models of visual working memory make the assumption that items are stored in memory as independent units, and that there are no interactions between them. Consequently, these models predict that the number of items to be remembered (the set size) is the primary determinant of working memory performance, and therefore these models quantify memory capacity in terms of the number and quality of individual items that can be stored. Here we demonstrate that there is substantial variance in display difficulty within a single set size, suggesting that limits based on the number of individual items alone cannot explain working memory storage. We asked hundreds of participants to remember the same sets of displays, and discovered that participants were highly consistent in terms of which items and displays were hardest or easiest to remember. Although a simple grouping or chunking strategy could not explain this individual-display variability, a model with multiple, interacting levels of representation could explain some of the display-by-display differences. Specifically, a model that includes a hierarchical representation of items plus the mean and variance of sets of the colors on the display successfully accounts for some of the variability across displays. We conclude that working memory representations are composed only in part of individual, independent object representations, and that a major factor in how many items are remembered on a particular display is interitem representations such as perceptual grouping, ensemble, and texture representations.",0 +https://doi.org/10.1016/j.cogpsych.2009.07.001,Uncovering mental representations with Markov chain Monte Carlo,"A key challenge for cognitive psychology is the investigation of mental representations, such as object categories, subjective probabilities, choice utilities, and memory traces. In many cases, these representations can be expressed as a non-negative function defined over a set of objects. We present a behavioral method for estimating these functions. Our approach uses people as components of a Markov chain Monte Carlo (MCMC) algorithm, a sophisticated sampling method originally developed in statistical physics. Experiments 1 and 2 verified the MCMC method by training participants on various category structures and then recovering those structures. Experiment 3 demonstrated that the MCMC method can be used estimate the structures of the real-world animal shape categories of giraffes, horses, dogs, and cats. Experiment 4 combined the MCMC method with multidimensional scaling to demonstrate how different accounts of the structure of categories, such as prototype and exemplar models, can be tested, producing samples from the categories of apples, oranges, and grapes.",0 +https://doi.org/10.1016/j.neuroscience.2010.02.011,Possible involvement of toll-like receptor 4/myeloid differentiation factor-2 activity of opioid inactive isomers causes spinal proinflammation and related behavioral consequences,"Opioid-induced glial activation and its proinflammatory consequences have been associated with both reduced acute opioid analgesia and the enhanced development of tolerance, hyperalgesia and allodynia following chronic opioid administration. Intriguingly, recent evidence demonstrates that these effects can result independently from the activation of classical, stereoselective opioid receptors. Here, a structurally disparate range of opioids cause activation of signaling by the innate immune receptor toll like receptor 4 (TLR4), resulting in proinflammatory glial activation. In the present series of studies, we demonstrate that the (+)-isomers of methadone and morphine, which bind with negligible affinity to classical opioid receptors, induced upregulation of proinflammatory cytokine and chemokine production in rat isolated dorsal spinal cord. Chronic intrathecal (+)-methadone produced hyperalgesia and allodynia, which were associated with significantly increased spinal glial activation (TLR4 mRNA and protein) and the expression of multiple chemokines and cytokines. Statistical analysis suggests that a cluster of cytokines and chemokines may contribute to these nociceptive behavioral changes. Acute intrathecal (+)-methadone and (+)-morphine were also found to induce microglial, interleukin-1 and TLR4/myeloid differentiation factor-2 (MD-2) dependent enhancement of pain responsivity. In silico docking analysis demonstrated (+)-naloxone sensitive docking of (+)-methadone and (+)-morphine to human MD-2. Collectively, these data provide the first evidence of the pro-nociceptive consequences of small molecule xenobiotic activation of spinal TLR4 signaling independent of classical opioid receptor involvement.",0 +https://doi.org/10.2307/2533558,Small Sample Inference for Fixed Effects from Restricted Maximum Likelihood,"Restricted maximum likelihood (REML) is now well established as a method for estimating the parameters of the general Gaussian linear model with a structured covariance matrix, in particular for mixed linear models. Conventionally, estimates of precision and inference for fixed effects are based on their asymptotic distribution, which is known to be inadequate for some small-sample problems. In this paper, we present a scaled Wald statistic, together with an F approximation to its sampling distribution, that is shown to perform well in a range of small sample settings. The statistic uses an adjusted estimator of the covariance matrix that has reduced small sample bias. This approach has the advantage that it reproduces both the statistics and F distributions in those settings where the latter is exact, namely for Hotelling T2 type statistics and for analysis of variance F-ratios. The performance of the modified statistics is assessed through simulation studies of four different REML analyses and the methods are illustrated using three examples.",0 +https://doi.org/10.1177/0049124103260187,Estimating Causal Effects With Matching Methods in the Presence and Absence of Bias Cancellation,"This article explores the implications of bias cancellation on the estimate of average treatment effects using ordinary least squares (OLS) and Rubin-style matching methods. Bias cancellation (offsetting biases at high and low propensities for treatment in estimates of treatment effects that are uncorrected for nonrandom selection) has been observed when job training is the treatment variable and earnings is the outcome variable. Contrary to published assertions in the literature, bias cancellation is not explainable in terms of the standard selection model, which assumes a symmetric distribution for the errors in the structural and assignment equations. A substantive rationale for bias cancellation is offered, which conceptualizes bias cancellation as the result of a mixture process based on two distinct individual-level decision-making models. While the general properties are unknown, the existence of bias cancellation appears to reduce the average bias in both OLS and matching methods relative to the symmetric distribution case.",0 +https://doi.org/10.1051/vetres/2009013,Use of posterior predictive assessments to evaluate model fit in multilevel logistic regression,"Assessing the fit of a model is an important final step in any statistical analysis, but this is not straightforward when complex discrete response models are used. Cross validation and posterior predictions have been suggested as methods to aid model criticism. In this paper a comparison is made between four methods of model predictive assessment in the context of a three level logistic regression model for clinical mastitis in dairy cattle; cross validation, a prediction using the full posterior predictive distribution and two “mixed” predictive methods that incorporate higher level random effects simulated from the underlying model distribution. Cross validation is considered a gold standard method but is computationally intensive and thus a comparison is made between posterior predictive assessments and cross validation. The analyses revealed that mixed prediction methods produced results close to cross validation whilst the full posterior predictive assessment gave predictions that were over-optimistic (closer to the observed disease rates) compared with cross validation. A mixed prediction method that simulated random effects from both higher levels was best at identifying the outlying level two (farm-year) units of interest. It is concluded that this mixed prediction method, simulating random effects from both higher levels, is straightforward and may be of value in model criticism of multilevel logistic regression, a technique commonly used for animal health data with a hierarchical structure.",0 +https://doi.org/10.1348/000711010x497442,Ridge structural equation modelling with correlation matrices for ordinal and continuous data,"This paper develops a ridge procedure for structural equation modelling (SEM) with ordinal and continuous data by modelling the polychoric/polyserial/product-moment correlation matrix R. Rather than directly fitting R, the procedure fits a structural model to R(a) =R+aI by minimizing the normal distribution-based discrepancy function, where a > 0. Statistical properties of the parameter estimates are obtained. Four statistics for overall model evaluation are proposed. Empirical results indicate that the ridge procedure for SEM with ordinal data has better convergence rate, smaller bias, smaller mean square error, and better overall model evaluation than the widely used maximum likelihood procedure.",0 +https://doi.org/10.1080/03610920903145154,A Hybrid Approximation Bayesian Test of Variance Components for Longitudinal Data,"The test of variance components of possibly correlated random effects in generalized linear mixed models (GLMMs) can be used to examine if there exists heterogeneous effects. The Bayesian test with Bayes factors offers a flexible method. In this article, we focus on the performance of Bayesian tests under three reference priors and a conjugate prior: an approximate uniform shrinkage prior, modified approximate Jeffreys' prior, half-normal unit information prior and Wishart prior. To compute Bayes factors, we propose a hybrid approximation approach combining a simulated version of Laplace's method and importance sampling techniques to test the variance components in GLMMs.",0 +https://doi.org/10.1016/s0165-0270(00)00173-4,Assessing spatial vision — automated measurement of the contrast-sensitivity function in the hooded rat,"The contrast-sensitivity function (CSF) provides a concise and thorough description of an organism’s spatial vision; it is widely used to describe vision in animals and humans, to track developmental changes in vision, and to compare vision among different species. Despite the predominance of rats in neuroscience research, their vision is not thoroughly studied due to the complexity of psychophysical measurement and a generally held notion that rat vision is poor. We therefore designed an economical and rapid method to assess the hooded rat’s CSF, using a computer monitor to display stimuli and an infrared touch screen to record responses. A six-alternative forced-choice task presented trials in which a sine-wave grating (S+), varying in spatial frequency and contrast, was displayed at different locations along with five gray stimuli (S−). Nose pokes to the S+ but not the S− produced water reinforcers. Contrasts were tested at each spatial frequency with a simple adaptive procedure until stimulus detection fell below chance. Psychometric functions were obtained by maximum-likelihood fitting of a logistic function to the raw data, obtaining the threshold as the function’s point of inflection. As in previous studies with rats, CSFs showed an inverse-U shape with peak sensitivity at 0.12 cyc/deg and acuity just under 1 cyc/deg. The results indicate the present computer-controlled behavioral testing device is a precise and efficient instrument to assess spatial visual function in rats.",0 +https://doi.org/10.1037/fam0000058,Getting the most out of family data with the R package fSRM.,"Family research aims to explore family processes, but is often limited to the examination of unidirectional processes. As the behavior of 1 person has consequences that go beyond that individual, family functioning should be investigated in its full complexity. The social relations model (SRM; Kenny & La Voie, 1984) is a conceptual and analytical model that can disentangle family data from a round-robin design at 3 different levels: the individual level (actor and partner effects), the dyadic level (relationship effects), and the family level (family effect). Its statistical complexity may however be a hurdle for family researchers. The user-friendly R package fSRM performs almost automatically those rather complex SRM analyses and introduces new possibilities for assessing differences between SRM means and between SRM variances, both within and between groups of families. Using family data on negative processes, different type of research questions are formulated and corresponding analyses with fSRM are presented.",0 +https://doi.org/10.1038/nn.3655,Changing concepts of working memory,"Working memory is widely considered to be limited in capacity, holding a fixed, small number of items, such as Miller's 'magical number' seven or Cowan's four. It has recently been proposed that working memory might better be conceptualized as a limited resource that is distributed flexibly among all items to be maintained in memory. According to this view, the quality rather than the quantity of working memory representations determines performance. Here we consider behavioral and emerging neural evidence for this proposal.",0 +https://doi.org/10.1037/0022-006x.73.5.924,Empirically supported treatments or type I errors? Problems with the analysis of data from group-administered treatments.,"When treatments are administered in groups, clients interact in ways that lead to violations of a key assumption of most statistical analyses-the assumption of independence of observations. The resulting dependencies, when not properly accounted for, can increase Type I errors dramatically. Of the 33 studies of group-administered treatment on the empirically supported treatments list, none appropriately analyzed their data. The current authors provide corrections that can be applied to improper analyses. After the corrections, only 12.4% to 68.2% of tests that were originally reported as significant remained significant, depending on what assumptions were made about how large the dependencies among observations really are. Of the 33 studies, 6-19 studies no longer had any significant results after correction. The authors end by providing recommendations for researchers planning group-administered treatment research.",0 +https://doi.org/10.1093/biomet/81.4.633,The ECME algorithm: A simple extension of EM and ECM with faster monotone convergence,"A generalisation of the ECM algorithm (Meng & Rubin, 1993), which is itselfan extension of the EM algorithm (Dempster, Laird & Rubin, 1977), can be obtained by replacing some CM-steps of ECM, which maximise the constrained expected complete-data loglikelihood function, with steps that maximise the correspondingly constrained actual likelihood function. This algorithm, which we call ECME algorithm, for Expectation /Conditional Maximisation Either, shares with both EM and ECM their stable monotone convergence and basic simplicity of implementation relative to competing faster converging methods. Moreover, ECME can have a substantially faster convergence rate than either EM or ECM, measured using either the number of iterations or actual computer time",0 +https://doi.org/10.3102/1076998609359788,MCMC Sampling for a Multilevel Model With Nonindependent Residuals Within and Between Cluster Units,"In this article, we discuss the effect of removing the independence assumptions between the residuals in two-level random effect models. We first consider removing the independence between the Level 2 residuals and instead assume that the vector of all residuals at the cluster level follows a general multivariate normal distribution. We demonstrate how this assumption can allow us to fit higher levels of clustering and school competition effects via an example from education. We then consider removing the assumption of independence between Level 1 residuals within clusters. We show how this extension can allow time series type models. Both normal and binary responses are considered.",0 +https://doi.org/10.1023/a:1017529427433,Joint Bayesian Analysis of Factor Scores and Structural Parameters in the Factor Analysis Model,"A Bayesian approach is developed to assess the factor analysis model. Joint Bayesian estimates of the factor scores and the structural parameters in the covariance structure are obtained simultaneously. The basic idea is to treat the latent factor scores as missing data and augment them with the observed data in generating a sequence of random observations from the posterior distributions by the Gibbs sampler. Then, the Bayesian estimates are taken as the sample means of these random observations. Expressions for implementing the algorithm are derived and some statistical properties of the estimates are presented. Some aspects of the algorithm are illustrated by a real example and the performance of the Bayesian procedure is studied using simulation.",0 +https://doi.org/10.1007/978-3-319-19977-1_17,A General SEM Framework for Integrating Moderation and Mediation: The Constrained Approach,"Modeling the combination of latent moderating and mediating effects is a significant issue in the social and behavioral sciences. Chen and Cheng (Structural Equation Modeling: A Multidisciplinary Journal 21: 94-101, 2014) generalized Jöreskog and Yang’s (Advanced structural equation modeling: Issues and techniques (pp. 57-88). Mahwah, NJ: Lawrence Erlbaum, 1996) constrained approach to allow for the concurrent modeling of moderation and mediation within the context of SEM. Unfortunately, due to restrictions related to Chen and Cheng’s partitioning scheme, their framework cannot completely conceptualize and interpret moderation of indirect effects in a mediated model. In the current study, the Chen and Cheng (abbreviated below as C & C) framework is extended to accommodate situations in which any two pathways that constitute a particular indirect effect in a mediated model can be differentially or collectively moderated by the moderator variable(s). By preserving the inherent advantage of the C & C framework, i.e., the matrix partitioning technique, while at the same time further generalizing its applicability, it is expected that the current framework enhances the potential usefulness of the constrained approach as well as the entire class of the product indicator approaches. © Springer International Publishing Switzerland 2015.",0 +https://doi.org/10.1037/h0021740,Inferred components of reaction times as functions of foreperiod duration.,"A distribution function representing simple reaction-time distributions was derived, assuming RT is the sum of 2 component variables with exponential and normal distributions. 4 Ss each gave 100 RTs to an auditory stimulus following each of 4 foreperiods, under each of 2 conditions: (a) foreperiod constant within sessions but varied over sessions, and (b) foreperiods appearing in a random sequence. The derived distribution function provided completely satisfactory representations of all 32 RT distributions, and the relations of the fitted parameters of this function to foreperiod suggest that the variation of RT as a function of foreperiod is due to variation in the normally distributed component. (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1965 American Psychological Association.",0 +https://doi.org/10.1177/1740774509339977,"Effects of sources of variability on sample sizes required for RCTs, applied to trials of lipid-altering therapies on carotid artery intima-media thickness","Objective Studies measuring progression of carotid artery intima-media thickness (cIMT) have been used to estimate the effect of lipid-modifying therapies cardiovascular event risk. The likelihood that future cIMT clinical trials will detect a true treatment effect is estimated by leveraging results from prior studies. The present analyses assess the impact of between- and within-study variability based on currently published data from prior clinical studies on the likelihood that ongoing or future cIMT trials will detect the true treatment effect of lipid-modifying therapies. Methods Published data from six contemporary cIMT studies (ASAP, ARBITER 2, RADIANCE 1, RADIANCE 2, ENHANCE, and METEOR) including data from a total of 3563 patients were examined. Bayesian and frequentist methods were used to assess the impact of between study variability on the likelihood of detecting true treatment effects on 1-year cIMT progression/regression and to provide a sample size estimate that would specifically compensate for the effect of between-study variability. Results In addition to the well-described within-study variability, there is considerable between-study variability associated with the measurement of annualized change in cIMT. Accounting for the additional between-study variability decreases the power for existing study designs. In order to account for the added between-study variability, it is likely that future cIMT studies would require a large increase in sample size in order to provide substantial probability (≥90%) to have 90% power of detecting a true treatment effect. Limitation Analyses are based on study level data. Future meta-analyses incorporating patient-level data would be useful for confirmation. Conclusion Due to substantial within- and between-study variability in the measure of 1-year change of cIMT, as well as uncertainty about progression rates in contemporary populations, future study designs evaluating the effect of new lipid-modifying therapies on atherosclerotic disease progression are likely to be challenged by large sample sizes in order to demonstrate a true treatment effect.",0 +https://doi.org/10.1037/a0030642,Bayesian methods for the analysis of small sample multilevel data with a complex variance structure.,"Inferences from multilevel models can be complicated in small samples or complex data structures. When using (restricted) maximum likelihood methods to estimate multilevel models, standard errors and degrees of freedom often need to be adjusted to ensure that inferences for fixed effects are correct. These adjustments do not address problems in estimating variance/covariance components. An alternative to the adjusted likelihood method is to use Bayesian methods, which can produce accurate inferences about fixed effects and variance/covariance parameters. In this article, the authors contrast the benefits and limitations of likelihood and Bayesian methods in the estimation of multilevel models. The issues are discussed in the context of a partially clustered intervention study, a common intervention design that has been shown to require an adjusted likelihood analysis. The authors report a Monte Carlo study that compares the performance of an adjusted restricted maximum likelihood (REML) analysis to a Bayesian analysis. The results suggest that for fixed effects, the models perform equally well with respect to bias, efficiency, and coverage of interval estimates. Bayesian models with a carefully selected gamma prior for the variance components were more biased but also more efficient with respect to estimation of the variance components than the REML model. However, the results also show that the inferences about the variance components in partially clustered studies are sensitive to the prior distribution when sample sizes are small. Finally, the authors compare the results of a Bayesian and adjusted likelihood model using data from a partially clustered intervention trial.",1 +https://doi.org/10.1016/j.jmp.2012.02.005,A tutorial on approximate Bayesian computation,"Abstract This tutorial explains the foundation of approximate Bayesian computation (ABC), an approach to Bayesian inference that does not require the specification of a likelihood function, and hence that can be used to estimate posterior distributions of parameters for simulation-based models. We discuss briefly the philosophy of Bayesian inference and then present several algorithms for ABC. We then apply these algorithms in a number of examples. For most of these examples, the posterior distributions are known, and so we can compare the estimated posteriors derived from ABC to the true posteriors and verify that the algorithms recover the true posteriors accurately. We also consider a popular simulation-based model of recognition memory (REM) for which the true posteriors are unknown. We conclude with a number of recommendations for applying ABC methods to solve real-world problems.",0 +https://doi.org/10.1177/0146621613513494,General Test Overlap Control,"This article proposed a new online test overlap control algorithm that is an improvement of Chen’s algorithm in controlling general test overlap rate for item pooling among a group of examinees. Chen’s algorithm is not very efficient in that not only item pooling between current examinee and prior examinees is controlled for but also item pooling between previous examinees, which would have been controlled for when they were current examinees. The proposed improvement increases efficiency by only considering item pooling between current and previous examinees, and its improved performance over Chen is demonstrated in a simulated computerized adaptive testing (CAT) environment. Moreover, the proposed algorithm is adapted for computerized classification testing (CCT) using the sequential probability ratio test procedure and is evaluated against some existing exposure control procedures. The proposed algorithm appears to work best in controlling general test overlap rate among the exposure control procedures examined without sacrificing much classification precision, though longer tests might be required for more stringent control of item pooling among larger groups. Given the capability of the proposed algorithm in controlling item pooling among a group of examinees of any size and its ease of implementation, it appears to be a good test overlap control method.",0 +https://doi.org/10.1037/a0031609,Mixture class recovery in GMM under varying degrees of class separation: Frequentist versus Bayesian estimation.,"Growth mixture modeling (GMM) represents a technique that is designed to capture change over time for unobserved subgroups (or latent classes) that exhibit qualitatively different patterns of growth. The aim of the current article was to explore the impact of latent class separation (i.e., how similar growth trajectories are across latent classes) on GMM performance. Several estimation conditions were compared: maximum likelihood via the expectation maximization (EM) algorithm and the Bayesian framework implementing diffuse priors, ""accurate"" informative priors, weakly informative priors, data-driven informative priors, priors reflecting partial-knowledge of parameters, and ""inaccurate"" (but informative) priors. The main goal was to provide insight about the optimal estimation condition under different degrees of latent class separation for GMM. Results indicated that optimal parameter recovery was obtained though the Bayesian approach using ""accurate"" informative priors, and partial-knowledge priors showed promise for the recovery of the growth trajectory parameters. Maximum likelihood and the remaining Bayesian estimation conditions yielded poor parameter recovery for the latent class proportions and the growth trajectories.",1 +https://doi.org/10.1080/01621459.1969.10501064,Mean Square Efficiency of Estimators of Variance Components,Abstract Various estimators of components of variance for the balanced one way layout are compared using mean squared error as a measure of performance. Several modifications of the maximum likelihood estimator and several formal Bayes estimators are compared and mean square error relationships are given. Inadmissibility is established for a large class of translation and scale invariant estimators. Numerical results are tabled and graphed to exhibit the relative efficiency of the estimators considered.,0 +https://doi.org/10.1080/00273171.2011.625310,Conceptualizing and Estimating Process Speed in Studies Employing Ecological Momentary Assessment Designs: A Multilevel Variance Decomposition Approach,"Researchers have been making use of ecological momentary assessment (EMA) and other study designs that sample feelings and behaviors in real time and in naturalistic settings to study temporal dynamics and contextual factors of a wide variety of psychological, physiological, and behavioral processes. As EMA designs become more widespread, questions are arising about the frequency of data sampling, with direct implications for participants' burden and researchers' ability to capture and study dynamic processes. Traditionally, spectral analytic techniques are used for time series data to identify process speed. However, the nature of EMA data, often collected with fewer than 100 measurements per person, sampled at randomly spaced intervals, and replete with planned and unplanned missingness, precludes application of traditional spectral analytic techniques. Building on principles of variance partitioning used in the generalizability theory of measurement and spectral analysis, we illustrate the utility of multilevel variance decompositions for isolating process speed in EMA-type data. Simulation and empirical data from a smoking-cessation study are used to demonstrate the method and to evaluate the process speed of smoking urges and quitting self-efficacy. Results of the multilevel variance decomposition approach can inform process-oriented theory and future EMA study designs.",0 +https://doi.org/10.1037/a0035147,Linear and nonlinear growth models: Describing a Bayesian perspective.,"Conventional estimation of longitudinal growth models can produce inaccurate parameter estimates under certain research scenarios (e.g., smaller sample sizes and nonlinear growth patterns) and thus lead to potentially misleading interpretations of results (i.e., interpreting growth patterns that do not reflect the population patterns). The current article used patterns of change in cigarette and alcohol abuse prevalence and depression levels to demonstrate an alternative method for estimating growth models more accurately under these conditions, namely, via the Bayesian estimation framework. This article acts as an introduction and tutorial for implementing Bayesian methods when examining growth or change over time, particularly nonlinear growth.The National Longitudinal Survey of Youth 1997 database was used to highlight different linear and nonlinear (quadratic and logistic) growth models via growth curve modeling (GCM) and growth mixture modeling (GMM). The specific focus was on changes in cigarette/alcohol consumption and depression throughout adolescence and young adulthood. Specifically, a nationally representative group of individuals between the ages of 12 and 16 years were assessed at 4 time-points for levels of cigarette consumption, alcohol use, and depression.The results for each example illustrated different patterns of linear and nonlinear growth via GCM and GMM through the versatile Bayesian estimation framework.Growth models may benefit from the Bayesian perspective by incorporating prior information or knowledge into the model, especially when sample sizes are small or growth is nonlinear. A step-by-step tutorial for assessing various growth models via the Bayesian perspective is provided as online supplemental material.",0 +https://doi.org/10.1080/01621459.1987.10478458,The Calculation of Posterior Distributions by Data Augmentation,"Abstract The idea of data augmentation arises naturally in missing value problems, as exemplified by the standard ways of filling in missing cells in balanced two-way tables. Thus data augmentation refers to a scheme of augmenting the observed data so as to make it more easy to analyze. This device is used to great advantage by the EM algorithm (Dempster, Laird, and Rubin 1977) in solving maximum likelihood problems. In situations when the likelihood cannot be approximated closely by the normal likelihood, maximum likelihood estimates and the associated standard errors cannot be relied upon to make valid inferential statements. From the Bayesian point of view, one must now calculate the posterior distribution of parameters of interest. If data augmentation can be used in the calculation of the maximum likelihood estimate, then in the same cases one ought to be able to use it in the computation of the posterior distribution. It is the purpose of this article to explain how this can be done. The basic idea ...",0 +https://doi.org/10.1111/j.2044-8317.1994.tb01039.x,"Factor analysis of variables with 2, 3, 5 and 7 response categories: A comparison of categorical variable estimators using simulated data","Two estimators in the factor analysis of categorical items are studied, the weighted least squares function implemented in the tandem PRELIS-LISREL 7 and a generalized least squares function implemented in LISCOMP. Of main interest is the performance of these estimators in relatively small samples (200 to 400) and the comparison of their performance with the normal theory maximum likelihood estimator given an increasing number of response categories. The evaluation of the performance of these estimators concerns the variability of the parameter estimates, the bias of the parameter estimates, the distribution of the parameter estimates and the χ2 goodness-of-fit statistics. The model used in the simulation is an 8-indicator single common factor model. The effect of model size (12- and 16-indicator models) on the categorical item estimator of LISREL 7 is investigated briefly. The results indicate that in the ideal circumstances of the simulation study, 200 is too small a sample size to justify the use of large sample statistics associated with these estimators.",0 +https://doi.org/10.1080/1359432x.2015.1028378,The perceived value of team players: a longitudinal study of how group identification affects status in work groups,"Theory and research on status attainment in work groups primarily focuses on members’ abilities and characteristics that make them appear competent as predictors of their status in the group. We complement the abilities perspective with a social identity perspective by arguing that another important determinant of a member’s status is based on the extent to which the member serves the group’s interests. Specifically, we assert that a member’s identification with the group affects performance on behalf of the group, which in turn affects other members’ assessment of the member’s status. We test this social identity perspective on status attainment by studying the influence of members’ group identification on their performance and status in the group, while controlling for the members’ abilities and status characteristics. In a three-wave longitudinal field study following 33 work groups during a six-month group project, we find that members’ identification enhances their performance on behalf of the group,...",0 +https://doi.org/10.1080/10705511.2015.1057284,Monte Carlo Confidence Intervals for Complex Functions of Indirect Effects,"One challenge in mediation analysis is to generate a confidence interval (CI) with high coverage and power that maintains a nominal significance level for any well-defined function of indirect and direct effects in the general context of structural equation modeling (SEM). This study discusses a proposed Monte Carlo extension that finds the CIs for any well-defined function of the coefficients of SEM such as the product of k coefficients and the ratio of the contrasts of indirect effects, using the Monte Carlo method. Finally, we conduct a small-scale simulation study to compare CIs produced by the Monte Carlo, nonparametric bootstrap, and asymptotic-delta methods. Based on our simulation study, we recommend researchers use the Monte Carlo method to test a complex function of indirect effects.",0 +https://doi.org/10.1109/soli.2008.4682982,Judge neural networks for multi-channel retailing competition,"With the development of online commerce, its becoming more and more important to deal with multi-channel problem, especially when there is an e-channel. In this paper, we establish neural networks to describe customers' decision process. Based on the neural networks, a new price setting game is proposed, which can simulate the competition in multichannel. Since the networks can reflect the real situation well, in simulation experiments, the game and neural networks have shown their ability of describing the multi-channel competition. This provides a powerful tool for retail companies' decision making.",0 +https://doi.org/10.1111/biom.12278,Generalized multilevel function-on-scalar regression and principal component analysis,"This manuscript considers regression models for generalized, multilevel functional responses: functions are generalized in that they follow an exponential family distribution and multilevel in that they are clustered within groups or subjects. This data structure is increasingly common across scientific domains and is exemplified by our motivating example, in which binary curves indicating physical activity or inactivity are observed for nearly 600 subjects over 5 days. We use a generalized linear model to incorporate scalar covariates into the mean structure, and decompose subject-specific and subject-day-specific deviations using multilevel functional principal components analysis. Thus, functional fixed effects are estimated while accounting for within-function and within-subject correlations, and major directions of variability within and between subjects are identified. Fixed effect coefficient functions and principal component basis functions are estimated using penalized splines; model parameters are estimated in a Bayesian framework using Stan, a programming language that implements a Hamiltonian Monte Carlo sampler. Simulations designed to mimic the application have good estimation and inferential properties with reasonable computation times for moderate datasets, in both cross-sectional and multilevel scenarios; code is publicly available. In the application we identify effects of age and BMI on the time-specific change in probability of being active over a 24-hour period; in addition, the principal components analysis identifies the patterns of activity that distinguish subjects and days within subjects.",0 +https://doi.org/10.1080/00949658408810713,On maximum likelihood and restricted maximum likelihood approaches to estimation of variance components,"Two variations of the dispersion-mean correspondence model for varince components lead to the ML and REML equations. This formulation provides for addition of a nonnegativity constraint to the computational method of T. W. Anderson (1971, 1973), an iterative procedure for obtaining ML and REML estimates, which not only assures that estimates will be within the parameter space, but contributes to the stability of the algorithm as well. Estimates of the variance components obtained in this way (which includes MINQUE) are simulated for four balanced and two unbalanced random effects designs. The effect of the nonnegativity constraint on mean squared error is compared to the alternative of replacing negative values of unconstrained estimates to zero, for both the REML and ML approaches. For the two unbalanced designs, the effect of initial starting values and the significance of iterating are also assessed. The simulation results are an extension of those reported by Rich and Brown (1979) for the REML approac...",0 +https://doi.org/10.1001/archgenpsychiatry.2011.132,Trajectories of Depression Severity in Clinical Trials of Duloxetine,"The high percentage of failed clinical trials in depression may be due to high placebo response rates and the failure of standard statistical approaches to capture heterogeneity in treatment response.To assess whether growth mixture modeling can provide insights into antidepressant and placebo responses in clinical trials of patients with major depression.We reanalyzed clinical trials of duloxetine to identify distinct trajectories of Hamilton Scale for Depression (HAM-D) scores during treatment. We analyzed the trajectories in the entire sample and then separately in all active arms and in all placebo arms. Effects of duloxetine hydrochloride, selective serotonin reuptake inhibitor (SSRI), and covariates on the probability of following a particular trajectory were assessed. Outcomes in different trajectories were compared using mixed-effects models.Seven randomized double-blind clinical trials of duloxetine vs placebo and comparator SSRI. Patients A total of 2515 patients with major depression.Duloxetine and comparator SSRI. Main Outcome Measure Total score on the HAM-D.In the entire sample and in the antidepressant-treated subsample, we identified trajectories of responders (76.3% of the sample) and nonresponders (23.7% of the sample). However, placebo-treated patients were characterized by a single response trajectory. Duloxetine and SSRI did not differ in efficacy, and compared with placebo they significantly decreased the odds of following the nonresponder trajectory. Antidepressant responders had significantly better HAM-D scores over time than placebo-treated patients, but antidepressant nonresponders had significantly worse HAM-D scores over time than the placebo-treated patients.Most patients treated with serotonergic antidepressants showed a clinical trajectory over time that is superior to that of placebo-treated patients. However, some patients receiving these medications did more poorly than patients receiving placebo. These data highlight the importance of ongoing monitoring of medication risks and benefits during serotonergic antidepressant treatment. They should further stimulate the search for biomarkers or other predictors of responder status in guiding antidepressant treatment.",0 +https://doi.org/10.1093/ijpor/edv039,Informal Political Conversation in Old and New Democracies in a Comparative Perspective,,0 +https://doi.org/10.1093/jssam/smu003,Design Effects for a Regression Slope in a Cluster Sample,,0 +https://doi.org/10.1002/sim.3858,Bayesian bivariate meta-analysis of diagnostic test studies using integrated nested Laplace approximations,"For bivariate meta-analysis of diagnostic studies, likelihood approaches are very popular. However, they often run into numerical problems with possible non-convergence. In addition, the construction of confidence intervals is controversial. Bayesian methods based on Markov chain Monte Carlo (MCMC) sampling could be used, but are often difficult to implement, and require long running times and diagnostic convergence checks. Recently, a new Bayesian deterministic inference approach for latent Gaussian models using integrated nested Laplace approximations (INLA) has been proposed. With this approach MCMC sampling becomes redundant as the posterior marginal distributions are directly and accurately approximated. By means of a real data set we investigate the influence of the prior information provided and compare the results obtained by INLA, MCMC, and the maximum likelihood procedure SAS PROC NLMIXED. Using a simulation study we further extend the comparison of INLA and SAS PROC NLMIXED by assessing their performance in terms of bias, mean-squared error, coverage probability, and convergence rate. The results indicate that INLA is more stable and gives generally better coverage probabilities for the pooled estimates and less biased estimates of variance parameters. The user-friendliness of INLA is demonstrated by documented R-code.",0 +https://doi.org/10.1002/sim.6471,Summarising and validating test accuracy results across multiple studies for use in clinical practice,"Following a meta-analysis of test accuracy studies, the translation of summary results into clinical practice is potentially problematic. The sensitivity, specificity and positive (PPV) and negative (NPV) predictive values of a test may differ substantially from the average meta-analysis findings, because of heterogeneity. Clinicians thus need more guidance: given the meta-analysis, is a test likely to be useful in new populations, and if so, how should test results inform the probability of existing disease (for a diagnostic test) or future adverse outcome (for a prognostic test)? We propose ways to address this. Firstly, following a meta-analysis, we suggest deriving prediction intervals and probability statements about the potential accuracy of a test in a new population. Secondly, we suggest strategies on how clinicians should derive post-test probabilities (PPV and NPV) in a new population based on existing meta-analysis results and propose a cross-validation approach for examining and comparing their calibration performance. Application is made to two clinical examples. In the first example, the joint probability that both sensitivity and specificity will be >80% in a new population is just 0.19, because of a low sensitivity. However, the summary PPV of 0.97 is high and calibrates well in new populations, with a probability of 0.78 that the true PPV will be at least 0.95. In the second example, post-test probabilities calibrate better when tailored to the prevalence in the new population, with cross-validation revealing a probability of 0.97 that the observed NPV will be within 10% of the predicted NPV.",0 +https://doi.org/10.1002/(sici)1097-0258(19981130)17:22<2537::aid-sim953>3.0.co;2-c,Meta-analysis of multiple outcomes by regression with random effects,"Earlier work showed how to perform fixed-effects meta-analysis of studies or trials when each provides results on more than one outcome per patient and these multiple outcomes are correlated. That fixed-effects generalized-least-squares approach analyzes the multiple outcomes jointly within a single model, and it can include covariates, such as duration of therapy or quality of trial, that may explain observed heterogeneity of results among the trials. Sometimes the covariates explain all the heterogeneity, and the fixed-effects regression model is appropriate. However, unexplained heterogeneity may often remain, even after taking into account known or suspected covariates. Because fixed-effects models do not make allowance for this remaining unexplained heterogeneity, the potential exists for bias in estimated coefficients, standard errors and p-values. We propose two random-effects approaches for the regression meta-analysis of multiple correlated outcomes. We compare their use with fixed-effects models and with separate-outcomes models in a meta-analysis of periodontal clinical trials. A simulation study shows the advantages of the random-effects approach. These methods also facilitate meta-analysis of trials that compare more than two treatments.",0 +https://doi.org/10.1177/1073191113509004,Cross-Validation Study Using Item Response Theory,"The Health-Related Quality of Life for Eating Disorder–Short questionnaire is one of the most suitable existing instruments for measuring quality of life in patients with eating disorders. The objective of the study was to evaluate its reliability, validity, and responsiveness in a cohort of 377 patients. A comprehensive validation process was performed, including confirmatory factor analysis and a graded response model, and assessments of reliability and responsiveness at 1 year of follow-up. The confirmatory factor analysis confirmed the two second-order latent traits, social maladjustment, and mental health and functionality. The graded response model results showed that all items were good for discriminating their respective latent traits. Cronbach’s alpha coefficients were high, and responsiveness parameters showed moderate changes. In conclusion, this short questionnaire has good psychometric properties. Its simplicity and ease of application further enhance its acceptability and usefulness in clinical research and trials, as well as in routine practice.",0 +https://doi.org/10.1016/j.jmp.2012.02.001,A tutorial on the Bayesian approach for analyzing structural equation models,"Abstract In this paper, we provide a tutorial exposition on the Bayesian approach in analyzing structural equation models (SEMs). SEMs, which can be regarded as regression models with observed and latent variables, have been widely applied to substantive research. However, the classical methods and most commercial software in this area are based on the covariance structure approach, which would encounter serious difficulties when dealing with complicated models and/or data structures. In contrast, the Bayesian approach has much more flexibility in handling complex situations. We give a brief introduction to SEMs and a detailed description of how to apply the Bayesian approach to this kind of model. Advantages of the Bayesian approach are discussed, and results obtained from a simulation study are provided for illustration. The intended audience is statisticians/methodologists who either know about SEMs or simple Bayesian statistics, and Ph.D. students in statistics, psychometrics, or mathematical psychology.",0 +https://doi.org/10.1111/1467-937x.00044,Matching As An Econometric Evaluation Estimator,"This paper develops the method of matching as an econometric evaluation estimator. A rigorous distribution theory for kernel-based matching is presented. The method of matching is extended to more general conditions than the ones assumed in the statistical literature on the topic. We focus on the method of propensity score matching and show that it is not necessarily better, in the sense of reducing the variance of the resulting estimator, to use the propensity score method even if propensity score is known. We extend the statistical literature on the propensity score by considering the case when it is estimated both parametrically and nonparametrically. We examine the benefits of separability and exclusion restrictions in improving the efficiency of the estimator. Our methods also apply to the econometric selection bias estimator. Matching is a widely-used method of evaluation. It is based on the intuitively attractive idea of contrasting the outcomes of programme participants (denoted Y1) with the outcomes of comparable nonparticipants (denoted Y0). Differences in the outcomes between the two groups are attributed to the programme. Let 1 and 11 denote the set of indices for nonparticipants and participants, respectively. The following framework describes conventional matching methods as well as the smoothed versions of these methods analysed in this paper. To estimate a treatment effect for each treated person iecI, outcome Yli is compared to an average of the outcomes Yoj for matched persons je10 in the untreated sample. Matches are constructed on the basis of observed characteristics X in Rd. Typically, when the observed characteristics of an untreated person are closer to those of the treated person ieI1, using a specific distance measure, the untreated person gets a higher weight in constructing the match. The estimated gain for each person i in the treated sample is",0 +https://doi.org/10.1080/10705511003659375,Small Sample Statistics for Incomplete Nonnormal Data: Extensions of Complete Data Formulae and a Monte Carlo Comparison,"Incomplete nonnormal data are common occurrences in applied research. Although these 2 problems are often dealt with separately by methodologists, they often cooccur. Very little has been written about statistics appropriate for evaluating models with such data. This article extends several existing statistics for complete nonnormal data to incomplete data and evaluates their performance via a Monte Carlo study. The focus is on statistics that also perform well in small samples. The following statistics are defined and studied: corrected residual-based statistic, residual-based F statistic, scaled chi-square, adjusted chi-square, Bartlett-corrected scaled chi-square, and Swain-corrected scaled chi-square. Both Type I error rates and power are studied with missing completely at random nonnnormally distributed data and varying degrees of nonnormality. Sample size, model size, and number of variables containing missingness are also varied. For power comparisons, both minor and major model misspecifications a...",0 +https://doi.org/10.1111/bmsp.12020,Semi-parametric proportional hazards models with crossed random effects for psychometric response times,"The semi-parametric proportional hazards model with crossed random effects has two important characteristics: it avoids explicit specification of the response time distribution by using semi-parametric models, and it captures heterogeneity that is due to subjects and items. The proposed model has a proportionality parameter for the speed of each test taker, for the time intensity of each item, and for subject or item characteristics of interest. It is shown how all these parameters can be estimated by Markov chain Monte Carlo methods (Gibbs sampling). The performance of the estimation procedure is assessed with simulations and the model is further illustrated with the analysis of response times from a visual recognition task.",0 +https://doi.org/10.2307/3316112,A prior for the variance in hierarchical models,"The choice of prior distributions for the variances can be important and quite difficult in Bayesian hierarchical and variance component models. For situations where little prior information is available, a ‘nonin-formative’ type prior is usually chosen. ‘Noninformative’ priors have been discussed by many authors and used in many contexts. However, care must be taken using these prior distributions as many are improper and thus, can lead to improper posterior distributions. Additionally, in small samples, these priors can be ‘informative’. In this paper, we investigate a proper ‘vague’ prior, the uniform shrinkage prior (Strawder-man 1971; Christiansen & Morris 1997). We discuss its properties and show how posterior distributions for common hierarchical models using this prior lead to proper posterior distributions. We also illustrate the attractive frequentist properties of this prior for a normal hierarchical model including testing and estimation. To conclude, we generalize this prior to the multivariate situation of a covariance matrix. Le choix d'une loi a priori pour les variances peut s'averer a la fois difficile et important dans le cadre d'une analyse bayesienne hierarchique ou d'un modele des composantes de la variance. En l'absence totale ou quasi-totale d'information a priori, l'emploi d'une loi ‘non informative’ est de mise. Plusieurs lois de ce type ont ete proposees dans differents contextes, mais leur utilisation est delicate, puisque certaines d'entre elles sont impropres et peuvent conduire a des lois a posteriori non integrables. Dans de petits echantillons, ces lois peuvent aussi se reveler ‘informatives’. Cet article est consacre a l'etude d'une loi a priori a la fois vague et integrable, la loi a priori a retrecissement uniforme (Strawderman 1971; Christiansen & Morris, 1997). Certaines de ses proprietes sont evoquees, notamment le fait que les lois a posteriori auxquelles elle conduit dans certains modeles hierarchiques classiques sont bel et bien integrables. Ses proprietes frequentistes sont egalement mises en valeur dans des situations d'estimation et de test au sein du modele hierarchique gaussien. On montre en outre comment elle peut ětre generalisee au cas multivarie d'une matrice de covariance.",0 +,Florida State University Libraries,,0 +https://doi.org/10.7275/qkqa-9k50,Comparing Propensity Score Methods in Balancing Covariates and Recovering Impact in Small Sample Educational Program Evaluations.,"Propensity score applications are often used to evaluate educational program impact. However, various options are available to estimate both propensity scores and construct comparison groups. This study used a student achievement dataset with commonly available covariates to compare different propensity scoring estimation methods (logistic regression, boosted regression, and Bayesian logistic regression) in combination with different methods for constructing comparison groups (nearest-neighbor matching, optimal matching, weighting) relative to balancing pre-existing differences and recovering a simulated treatment effect in small samples. Results indicated that applied researchers evaluating program impact should first consider use of standard logistic regression methods with nearest-neighbor or optimal matching or boosted regression in combination with propensity score weighting. Advantages and disadvantages of the methods are discussed.",0 +https://doi.org/10.1007/bf02291262,Fitting a response model forn dichotomously scored items,"A method of estimating the parameters of the normal ogive model for dichotomously scored item-responses by maximum likelihood is demonstrated. Although the procedure requires numerical integration in order to evaluate the likelihood equations, a computer implemented Newton-Raphson solution is shown to be straightforward in other respects. Empirical tests of the procedure show that the resulting estimates are very similar to those based on a conventional analysis of item ""difficulties"" and first factor loadings obtained from the matrix of tetrachoric correlation coefficients. Problems of testing the fit of the model, and of obtaining invariant parameters are discussed. © 1970 Psychometric Society.",0 +https://doi.org/10.1080/13803611.2012.702991,Educational choice in secondary school in Flanders: the relative impact of occupational interests on option choice,"The present study aims at unravelling the myriad of student-level (i.e., gender, socioeconomic status [SES], academic self-concept, achievement, ability, and occupational interests) and school-level (i.e., gender composition, maths composition, and SES composition) determinants of option choice in the academic track of secondary school in Flanders. We focused on 2 decisional thresholds in Flemish secondary education, namely, the transition from Grade 8 to Grade 9 (N = 2518) and from Grade 10 to Grade 11 (N = 2871). Data were analyzed through multinomial multilevel analysis. Our results strongly confirm Lent's (2005) jigsaw puzzle metaphor in that different factors go into a complex and dynamic interplay. Especially in the first grades, prior achievement is a major predictor of option choice in secondary education, whereas in the last years occupational interests become increasingly important. From a gender perspective, boys rather choose math/sciences-oriented options than girls. Option choice is mainly d...",0 +https://doi.org/10.3402/ejpt.v6.27882,Mobile mental health: a challenging research agenda,"The field of mobile health (""m-Health"") is evolving rapidly and there is an explosive growth of psychological tools on the market. Exciting high-tech developments may identify symptoms, help individuals manage their own mental health, encourage help seeking, and provide both preventive and therapeutic interventions. This development has the potential to be an efficient cost-effective approach reducing waiting lists and serving a considerable portion of people globally (""g-Health""). However, few of the mobile applications (apps) have been rigorously evaluated. There is little information on how valid screening and assessment tools are, which of the mobile intervention apps are effective, or how well mobile apps compare to face-to-face treatments. But how feasible is rigorous scientific evaluation with the rising demands from policy makers, business partners, and users for their quick release? In this paper, developments in m-Health tools-targeting screening, assessment, prevention, and treatment-are reviewed with examples from the field of trauma and posttraumatic stress disorder. The academic challenges in developing and evaluating m-Health tools are being addressed. Evidence-based guidance is needed on appropriate research designs that may overcome some of the public and ethical challenges (e.g., equity, availability) and the market-driven wish to have mobile apps in the ""App Store"" yesterday rather than tomorrow.",0 +,Large sample estimation and hypothesis testing,"Asymptotic distribution theory is the primary method used to examine the properties of econometric estimators and tests. We present conditions for obtaining cosistency and asymptotic normality of a very general class of estimators (extremum estimators). Consistent asymptotic variance estimators are given to enable approximation of the asymptotic distribution. Asymptotic efficiency is another desirable property then considered. Throughout the chapter, the general results are also specialized to common econometric estimators (e.g. MLE and GMM), and in specific examples we work through the conditions for the various results in detail. The results are also extended to two-step estimators (with finite-dimensional parameter estimation in the first step), estimators derived from nonsmooth objective functions, and semiparametric two-step estimators (with nonparametric estimation of an infinite-dimensional parameter in the first step). Finally, the trinity of test statistics is considered within the quite general setting of GMM estimation, and numerous examples are given.",0 +https://doi.org/10.1080/01621459.1988.10478561,An Error-Components Model for Prediction of County Crop Areas Using Survey and Satellite Data,"Abstract Knowledge of the area under different crops is important to the U.S. Department of Agriculture. Sample surveys have been designed to estimate crop areas for large regions, such as crop-reporting districts, individual states, and the United States as a whole. Predicting crop areas for small areas such as counties has generally not been attempted, due to a lack of available data from farm surveys for these areas. The use of satellite data in association with farm-level survey observations has been the subject of considerable research in recent years. This article considers (a) data for 12 Iowa counties, obtained from the 1978 June Enumerative Survey of the U.S. Department of Agriculture and (b) data obtained from land observatory satellites (LANDSAT) during the 1978 growing season. Emphasis is given to predicting the area under corn and soybeans in these counties. A linear regression model is specified for the relationship between the reported hectares of corn and soybeans within sample segments in...",0 +,Key advances in the history of structural equation modeling.,,0 +https://doi.org/10.1214/aos/1176344845,Estimation of the Inverse Covariance Matrix: Random Mixtures of the Inverse Wishart Matrix and the Identity,"Let $S_{p \times p}$ have a nonsingular Wishart distribution with unknown matrix $\Sigma$ and $k$ degrees of freedom. For two different loss functions, estimators of $\Sigma^{-1}$ are given which dominate the obvious estimators $aS^{-1}, 0 < a \leqslant k - p - 1$. Our class of estimators $\mathscr{C}$ includes random mixtures of $S^{-1}$ and $I$. A subclass $\mathscr{C}_0 \subset \mathscr{C}$ was given by Haff. Here, we show that any member of $\mathscr{C}_0$ is dominated in $\mathscr{C}$. Some troublesome aspects of the estimation problem are discussed, and the theory is supplemented by simulation results.",0 +https://doi.org/10.1016/b978-0-12-742780-5.50022-6,Reliability and Validity of Adaptive Ability Tests in a Military Setting,"Publisher Summary This chapter presents a research to discuss the reliability and validity of adaptive ability tests in a military setting. It discusses a research with the purpose to report the results of the first in a series of live-testing studies investigating the psychometric characteristics of computer-administered adaptive testing in comparison with a conventional test. A pilot study based on a small sample of Marine recruits was followed by a larger study based on the same research design. The two studies were designed in part to address two psychometric research questions: (1) whether a computer-administered adaptive test is more reliable than a conventional test, holding test length constant and (2) whether a computer-administered test is more valid than a comparable conventional test with test length constant. These questions were motivated by the results of previous research. The question of the advantages of adaptive tests over conventional ones in terms of reliability has a clear and positive theoretical answer: Holding test length and all else constant, a good adaptive test is superior, provided that highly discriminating test items are available. The general method used in both studies was that of equivalent tests administered to independent examinee groups. One group took two equivalent computer-administered adaptive tests. The other group took two equivalent conventional tests, also administered by computer. To control for item quality, both test types were made up of items from the same source—a common pool of 150 verbal ability items, which had previously been calibrated using item response theory methods in large samples of Marine recruits.",0 +,An empirical comparison of methods to measure willingness to pay by examining the hypothetical bias,"In the literature, several methods to measure willingness to pay (WTP) have been proposed. However, there is still little knowledge about their reliability. We empirically test the appropriateness of two methods - open-ended contingent valuation (CV) and limit conjoint analysis (LCA) - for measuring willingness to pay, by examining their hypothetical bias. Significant differences of the WTP values were found between the two methods. Comparing the respective hypothetical biases, LCA performs better than CV, yielding non-significant differences in different purchase situations. Nevertheless, our results may depend on the product category analysed. As a consequence, further studies are needed to determine which factors influence the appropriateness of methods for measuring WTP. © 2005 The Market Research Society.",0 +https://doi.org/10.2307/2983404,An Assessment of Estimation Procedures for Multilevel Models with Binary Responses,"We evaluate two software packages that are available for fitting multilevel models to binary response data, namely VARCL and ML3, by using a Monte Carlo study designed to represent quite closely the actual structure of a data set used in an analysis of health care utilization in Guatemala. We find that the estimates of fixed effects and variance components produced by the software packages are subject to very substantial downward bias when the random effects are sufficiently large to be interesting. In fact, the fixed effect estimates are no better than the estimates obtained by using standard logit models that ignore the hierarchical structure of the data. The estimates of standard errors appear to be reasonably accurate and superior to those obtained by ignoring clustering, although one might question their utility in the presence of large biases. We conclude that alternative estimation procedures need to be developed and implemented for the binary response case",0 +https://doi.org/10.3102/1076998606298039,Bayesian Methods for Scalable Multivariate Value-Added Assessment,There is increased interest in value-added models relying on longitudinal student-level test score data to isolate teachers’ contributions to student achievement. The complex linkage of students to...,0 +https://doi.org/10.1002/wics.1218,A Bayesian model for inference on population proportions,"In recent times and even up to now, traffic congestion and parking difficulties, especially during morning and evening rush hours, have become a major concern to members of the University of Lagos (UNILAG) community and visitors alike. UNILAG has witnessed unprecedented growth in student enrollment during the past 10 years or so culminating in the current total enrollment of more than 35,000 students, of which about 25,000 are undergraduates. In order to study the worrisome traffic situation at UNILAG in the wake of these large numbers, independent, although similar, sample surveys of undergraduate students of the eight faculties on the main campus of UNILAG were conducted in 2007. The purpose of the surveys was to collect data on undergraduate students who owned or used motor vehicles on campus. Furthermore, to investigate possible temporal trends, the surveys were repeated in 2009. The types of data obtained from the surveys provided veritable impetus for the application of empirical Bayes (EB) analysis to estimate the proportions of students of individual faculties who used motor vehicles on campus roads during the periods under reference. The EB technique, being a Bayesian method, combines prior information and sample information in a manner that ‘shrinks’ an EB estimator toward the sample estimator if a vague prior (proper prior with a large variance) is used. The main result is that in 2007 about one in four students used motor vehicles, and this result held almost across the eight faculties. Although results of the 2009 surveys were generally similar there were faculties that recorded some reduction in the estimated proportions of students who used motor vehicles. WIREs Comput Stat 2012 doi: 10.1002/wics.1218",0 +https://doi.org/10.1007/s11336-003-1108-y,Multilevel Model Prediction,"Multilevel models are proven tools in social research for modeling complex, hierarchical systems. In multilevel modeling, statistical inference is based largely on quantification of random variables. This paper distinguishes among three types of random variables in multilevel modeling - model disturbances, random coefficients, and future response outcomes - and provides a unified procedure for predicting them. These predictors are best linear unbiased and are commonly known via the acronym BLUP; they are optimal in the sense of minimizing mean square error and are Bayesian under a diffuse prior. For parameter estimation purposes, a multilevel model can be written as a linear mixed-effects model. In this way, parameters of the many equations can be estimated simultaneously and hence efficiently. For prediction purposes, we show that it is more convenient to retain the multiple equation feature of multilevel models. In this way, the efficient BLUPs are easy to compute and retain their intuitively appealing recursive form. We also derive explicit equations for standard errors of these different types of predictors. Prediction in multilevel modeling is important in a wide range of applications. To demonstrate the applicability of our results, this paper discusses prediction in the context of a study of school effectiveness. © 2006 The Psychometric Society.",0 +https://doi.org/10.1007/bf02294492,A generalized rasch model for manifest predictors,"A logistic regression model is suggested for estimating the relation between a set of manifest predictors and a latent trait assumed to be measured by a set of k dichotomous items. Usually the estimated subject parameters of latent trait models are biased, especially for short tests. Therefore, the relation between a latent trait and a set of predictors should not be estimated with a regression model in which the estimated subject parameters are used as a dependent variable. Direct estimation of the relation between the latent trait and one or more independent variables is suggested instead. Estimation methods and test statistics for the Rasch model are discussed and the model is illustrated with simulated and empirical data. © 1991 The Psychometric Society.",0 +https://doi.org/10.1016/j.ejphar.2008.07.053,Crotalphine induces potent antinociception in neuropathic pain by acting at peripheral opioid receptors,"Neuropathic pain is an important clinical problem and it is usually resistant to the current therapy. We have recently characterized a novel analgesic peptide, crotalphine, from the venom of the South American rattlesnake Crotalus durissus terrificus. In the present work, the antinociceptive effect of crotalphine was evaluated in an experimental model of neuropathic pain induced in rats by chronic constriction of sciatic nerve. The effect of the peptide was compared to that induced by the crude venom, which confirmed that crotalphine is responsible for the antinociceptive effect of the crotalid venom on neuropathic pain. For characterization of neuropathic pain, the presence of hyperalgesia, allodynia and spontaneous pain was assessed at different times after nerve constriction. These phenomena were detected 24 h after surgery and persisted at least for 14 days. The pharmacological treatments were performed on day 14 after surgery. Crotalphine (0.2-5 microg/kg) and the crude venom (400-1600 microg/kg) administered p.o. inhibited hyperalgesia, allodynia and spontaneous pain induced by nerve constriction. The antinociceptive effect of the peptide and crude venom was long lasting, since it was detected up to 3 days after treatment. Intraplantar injection of naloxone (1 microg/paw) blocked the antinociceptive effect, indicating the involvement of opioid receptors in this phenomenon. Gabapentin (200 mg/kg, p.o.), and morphine (5 mg/kg, s.c.), used as positive controls, blocked hyperalgesia and partially inhibited allodynia induced by nerve constriction. These data indicate that crotalphine induces a potent and long lasting opioid antinociceptive effect in neuropathic pain that surpasses that observed with standard analgesic drugs.",0 +https://doi.org/10.1586/14737167.2015.1011131,A Bayesian sensitivity study of risk difference in the meta-analysis of binary outcomes from sparse data,"In most cases, including those of discrete random variables, statistical meta-analysis is carried out using the normal random effect model. The authors argue that normal approximation does not always properly reflect the underlying uncertainty of the original discrete data. Furthermore, in the presence of rare events the results from this approximation can be very poor. This review proposes a Bayesian meta-analysis to address binary outcomes from sparse data and also introduces a simple way to examine the sensitivity of the quantities of interest in the meta-analysis with respect to the structure dependence selected. The findings suggest that for binary outcomes data it is possible to develop a Bayesian procedure, which can be directly applied to sparse data without ad hoc corrections. By choosing a suitable class of linking distributions, the authors found that a Bayesian robustness study can be easily implemented. For illustrative purposes, an example with real data is analyzed using the proposed Bayesian meta-analysis for binomial sparse data.",0 +https://doi.org/10.1093/biomet/70.1.41,The central role of the propensity score in observational studies for causal effects,"Abstract : The results of observational studies are often disputed because of nonrandom treatment assignment. For example, patients at greater risk may be overrepresented in some treatment group. This paper discusses the central role of propensity scores and balancing scores in the analysis of observational studies. The propensity score is the (estimated) conditional probability of assignment to a particular treatment given a vector of observed covariates. Both large and small sample theory show that adjustment for the scalar propensity score is sufficient to remove bias due to all observed covariates. Applications include: matched sampling on the univariate propensity score which is equal percent bias reducing under more general conditions than required for discriminant matching, multivariate adjustment by subclassification on balancing scores where the same subclasses are used to estimate treatment effects for all outcome variables and in all subpopulations, and visual representation of multivariate adjustment by a two-dimensional plot. (Author)",0 +https://doi.org/10.1177/096228029600500202,An introduction to finite mixture distributions,"Finite mixture densities can be used to model data from populations known or suspected to contain a number of separate subpopulations. Most commonly used are mixture densities with Gaussian (univariate or multivariate) components, but mixtures with other types of component are also increas ingly used to model, for example, survival times. This paper gives a general introduction to the topic which should help when considering the other more specialized papers in this issue.",0 +https://doi.org/10.1111/jopy.12146,Extraversion and Agreeableness: Divergent Routes to Daily Satisfaction With Social Relationships,"We examined the unique effects of extraversion and agreeableness (and honesty-humility) on everyday satisfaction with family, friends, romantic life, and acquaintances, and explored potential mediators of these effects. Three diary studies (Ns = 206, 139, 185) were conducted on Singaporean university students. In Studies 1 and 2, participants rated their satisfaction with different relationship categories. In Study 3, participants rated their satisfaction and social interactions with 10 target individuals each day for a 1-week period. Both extraversion and agreeableness predicted relationship satisfaction. However, the effect of extraversion was mediated by greater levels of trust in others, whereas the effect of agreeableness was mediated by less frequent negative exchanges (e.g., criticism, perceived anger, and perceived neglect). The effect of honesty-humility on negative exchanges was similar to agreeableness. When both were entered as predictors, only the effect of honesty-humility was significant. We discuss how the processes by which personality affect relationship satisfaction vary depending on the trait as well as the particular measure that is used (IPIP NEO PI-R, California Q-Set, and IPIP-HEXACO).",0 +https://doi.org/10.1207/s15327906mbr3101_6,Latent Variable Regression: A Technique for Estimating Interaction and Quadratic Coefficients,"The article proposes a technique to estimate regression coefficients for interaction and quadratic latent variables that combines regression analysis with the measurement model portion of structural equation analysis (e.g., analysis involving CALLS, EQS or LISREL). The measurement model provides parameter estimates that can be combined to correct the variance-covariance matrix used in regression, as Heise (1986) and others recommend. The proposed technique will provide coefficient estimates for regression models involving existing measures, or new measures for which a priori error estimates are not available.",0 +https://doi.org/10.1198/jbes.2010.07136,Robust Inference With Multiway Clustering,"In this article we propose a variance estimator for the OLS estimator as well as for nonlinear estimators such as logit, probit, and GMM. This variance estimator enables cluster-robust inference when there is two-way or multiway clustering that is nonnested. The variance estimator extends the standard cluster-robust variance estimator or sandwich estimator for one-way clustering (e.g., Liang and Zeger 1986; Arellano 1987) and relies on similar relatively weak distributional assumptions. Our method is easily implemented in statistical packages, such as Stata and SAS, that already offer cluster-robust standard errors when there is one-way clustering. The method is demonstrated by a Monte Carlo analysis for a two-way random effects model; a Monte Carlo analysis of a placebo law that extends the state–year effects example of Bertrand, Duflo, and Mullainathan (2004) to two dimensions; and by application to studies in the empirical literature where two-way clustering is present.",0 +https://doi.org/10.1002/dev.20262,On the implications of the classical ergodic theorems: Analysis of developmental processes has to focus on intra-individual variation,"It is argued that general mathematical-statistical theorems imply that standard statistical analysis techniques of inter-individual variation are invalid to investigate developmental processes. Developmental processes have to be analyzed at the level of individual subjects, using time series data characterizing the patterns of intra-individual variation. It is shown that standard statistical techniques based on the analysis of inter-individual variation appear to be insensitive to the presence of arbitrary large degrees of inter-individual heterogeneity in the population. An important class of nonlinear epigenetic models of neural growth is described which can explain the occurrence of such heterogeneity in brain structures and behavior. Links with models of developmental instability are discussed. A simulation study based on a chaotic growth model illustrates the invalidity of standard analysis of inter-individual variation, whereas time series analysis of intra-individual variation is able to recover the true state of affairs.",0 +https://doi.org/10.1509/jmkr.40.2.235.19225,A Comparison of Segment Retention Criteria for Finite Mixture Logit Models,"Despite the widespread application of finite mixture models in marketing research, the decision of how many segments to retain in the models is an important unresolved issue. Almost all applications of the models in marketing rely on segment retention criteria such as Akaike's information criterion, Bayesian information criterion, consistent Akaike's information criterion, and information complexity to determine the number of latent segments to retain. Because these applications employ real-world data in which the true number of segments is unknown, it is not clear whether these criteria are effective. Retaining the true number of segments is crucial because many product design and marketing decisions depend on it. The purpose of this extensive simulation study is to determine how well commonly used segment retention criteria perform in the context of simulated multinomial choice data, as obtained from supermarket scanner panels, in which the true number of segments is known. The authors find that an Akaike's information criterion with a penalty factor of three rather than the traditional value of two has the highest segment retention success rate across nearly all experimental conditions. Currently, this criterion is rarely, if ever, applied in the marketing literature. Experimental factors of particular interest in marketing contexts, such as the number of choices per household, the number of choice alternatives, the error variance of the choices, and the minimum segment size, have not been considered in the statistics literature. The authors show that they, among other factors, affect the performance of segment retention criteria.",0 +https://doi.org/10.1037/0033-2909.108.3.551,Truth and consequences of ordinal differences in statistical distributions: Toward a theory of hierarchical inference.,"A theory is presented that establishes a dominance hierarchy of potential distinctions (order relations) between two distributions. It is proposed that it is worthwhile for researchers to ascertain the strongest possible distinction, because all weaker distinctions are logically implied. Implications of the theory for hypothesis testing, theory construction, and scales of measurement are considered. Open problems for future research are outlined.",0 +https://doi.org/10.1177/01466216980223001,Optimal Assembly of Psychological and Educational Tests,"The advent of computers in psychological and educational measurement has led to the need for algorithms for optimal assembly of tests from item banks. This paper reviews optimal test assembly literature and introduces the contributions to this Special Issue. Four approaches to computerized test assembly are discussed: heuristic-based test assembly, 0-1 linear programming, network-flow programming, and an optimal design approach. Ap-plications of these methods to a variety of problems are examined, including IRT-based test assembly, classical test assembly, assembling multiple test forms, item matching, observed-score equating, constrained adaptive testing, assembling tests with item sets, item bank design, and assembling tests with multiple traits. A bibliography on optimal test assembly is provided.",0 +https://doi.org/10.1207/s15327906mbr3901_2,Comparison of Approaches in Estimating Interaction and Quadratic Effects of Latent Variables,"Various approaches using the maximum likelihood (ML) option of the LISREL program and products of indicators have been proposed to analyze structural equation models with non-linear latent effects on the basis of Kenny and Judd's formulation. Recently, some methods based on the Bayesian approach and the exact ML approaches have been developed. This article reviews, elaborates and compares several approaches for analyzing nonlinear models with interaction and/or quadratic effects. A total of four approaches are examined, including the product indicator ML approaches proposed by Jaccard and Wan (1995) and Joreskog and Yang (1996), a Bayesian approach and an exact ML approach. The empirical performances of these approaches are assessed using simulation studies in terms of their capabilities in producing reliable parameter and standard error estimates. It is found that whilst the Bayesian and the exact ML approaches produce satisfactory results in all the settings under consideration, and are in general very reliable; the product indicator ML approaches can only produce reasonable results in simple models with large sample sizes.",0 +https://doi.org/10.1073/pnas.1117465109,Variability in encoding precision accounts for visual short-term memory limitations,"It is commonly believed that visual short-term memory (VSTM) consists of a fixed number of ""slots"" in which items can be stored. An alternative theory in which memory resource is a continuous quantity distributed over all items seems to be refuted by the appearance of guessing in human responses. Here, we introduce a model in which resource is not only continuous but also variable across items and trials, causing random fluctuations in encoding precision. We tested this model against previous models using two VSTM paradigms and two feature dimensions. Our model accurately accounts for all aspects of the data, including apparent guessing, and outperforms slot models in formal model comparison. At the neural level, variability in precision might correspond to variability in neural population gain and doubly stochastic stimulus representation. Our results suggest that VSTM resource is continuous and variable rather than discrete and fixed and might explain why subjective experience of VSTM is not all or none.",0 +https://doi.org/10.1037/a0032222,A method for efficiently sampling from distributions with correlated dimensions.,"Bayesian estimation has played a pivotal role in the understanding of individual differences. However, for many models in psychology, Bayesian estimation of model parameters can be difficult. One reason for this difficulty is that conventional sampling algorithms, such as Markov chain Monte Carlo (MCMC), can be inefficient and impractical when little is known about the target distribution--particularly the target distribution's covariance structure. In this article, we highlight some reasons for this inefficiency and advocate the use of a population MCMC algorithm, called differential evolution Markov chain Monte Carlo (DE-MCMC), as a means of efficient proposal generation. We demonstrate in a simulation study that the performance of the DE-MCMC algorithm is unaffected by the correlation of the target distribution, whereas conventional MCMC performs substantially worse as the correlation increases. We then show that the DE-MCMC algorithm can be used to efficiently fit a hierarchical version of the linear ballistic accumulator model to response time data, which has proven to be a difficult task when conventional MCMC is used.",0 +https://doi.org/10.1034/j.1600-0420.2001.790304.x,An intervention trial on efficacy of atropine and multi-focal glasses in controlling myopic progression,"This randomized clinical trial assessed the treatment effects of atropine and/or multi-focal lenses in decreasing the progression rate of myopia in children.Two hundred and twenty-seven schoolchildren with myopia, aged from 6 to 13 years, who were stratified based on gender, age and the initial amount of myopia were randomly assigned to three treatment groups: 0.5% atropine with multi-focal glasses, multi-focal glasses, and single vision spectacles. Each subject was followed for at least eighteen months. These results report on the 188 patients available for the follow-up.The mean progression of myopia in atropine with multi-focal glasses group (0.41 D) was significantly less than the multi-focal (1.19 D) and single vision group (1.40 D) (p < 0.0001). But no significant difference was noted between the last two groups (p = 0.44). The progression of myopia was significantly correlated with the increases of axial length (r = 0.65, p = 0.0001), but not with the changes of corneal power (r=-0.09), anterior chamber depth (r = -0.023), lens thickness (r = -0.08), or intra-ocular pressure (r = -0.008).The 0.5% atropine with multi-focal lenses can slow down the progression rate of myopia. However, multi-focal lenses alone showed no difference in effect compared to control.",0 +https://doi.org/10.1080/00273171.2011.589274,Formulation and Application of the Hierarchical Generalized Random-Situation Random-Weight MIRID,"The process-component approach has become quite popular for examining many psychological concepts. A typical example is the model with internal restrictions on item difficulty (MIRID) described by Butter (1994) and Butter, De Boeck, and Verhelst (1998). This study proposes a hierarchical generalized random-situation random-weight MIRID. The proposed model is more flexible for formulating endogenous latent variables within a multilevel framework, allowing the analysis of polytomous data with complex models (e.g., including item discriminations, random situations, random weights, and heteroskedasticity). The parameters in the proposed model can be estimated using the computer program WinBUGS, which adopts Markov Chain Monte Carlo algorithms. To illustrate the application of the proposed model, a real data set about guilt is analyzed and a comparison of MIRIDs for various conditions is conducted.",0 +https://doi.org/10.1109/tac.1974.1100705,A new look at the statistical model identification,The history of the development of statistical hypothesis testing in time series analysis is reviewed briefly and it is pointed out that the hypothesis testing procedure is not adequately defined as the procedure for statistical model identification. The classical maximum likelihood estimation procedure is reviewed and a new estimate minimum information theoretical criterion (AIC) estimate (MAICE) which is designed for the purpose of statistical identification is introduced. When there are several competing models the MAICE is defined by the model and the maximum likelihood estimates of the parameters which give the minimum of AIC defined by AIC = (-2)log-(maximum likelihood) + 2(number of independently adjusted parameters within the model). MAICE provides a versatile procedure for statistical model identification which is free from the ambiguities inherent in the application of conventional hypothesis testing procedure. The practical utility of MAICE in time series analysis is demonstrated with some numerical examples.,0 +https://doi.org/10.1111/j.1745-3984.2011.00132.x,Assessing Fit of Unidimensional Graded Response Models Using Bayesian Methods,"The posterior predictive model checking method is a flexible Bayesian model-checking tool and has recently been used to assess fit of dichotomous IRT models. This paper extended previous research to polytomous IRT models. A simulation study was conducted to explore the performance of posterior predictive model checking in evaluating different aspects of fit for unidimensional graded response models. A variety of discrepancy measures (test-level, item-level, and pair-wise measures) that reflected different threats to applications of graded IRT models to performance assessments were considered. Results showed that posterior predictive model checking exhibited adequate power in detecting different aspects of misfit for graded IRT models when appropriate discrepancy measures were used. Pair-wise measures were found more powerful in detecting violations of the unidimensionality and local independence assumptions.",0 +https://doi.org/10.1016/j.jmp.2005.11.006,Modeling individual differences using Dirichlet processes,"Abstract We introduce a Bayesian framework for modeling individual differences, in which subjects are assumed to belong to one of a potentially infinite number of groups. In this model, the groups observed in any particular data set are not viewed as a fixed set that fully explains the variation between individuals, but rather as representatives of a latent, arbitrarily rich structure. As more people are seen, and more details about the individual differences are revealed, the number of inferred groups is allowed to grow. We use the Dirichlet process—a distribution widely used in nonparametric Bayesian statistics—to define a prior for the model, allowing us to learn flexible parameter distributions without overfitting the data, or requiring the complex computations typically required for determining the dimensionality of a model. As an initial demonstration of the approach, we present three applications that analyze the individual differences in category learning, choice of publication outlets, and web-browsing behavior.",0 +https://doi.org/10.4324/9780203879313,The Routledge Companion to Philosophy of Psychology,21 page(s,0 +https://doi.org/10.1214/13-aoas702,Small area estimation of general parameters with application to poverty indicators: A hierarchical Bayes approach,"Poverty maps are used to aid important political decisions such as allocation of development funds by governments and international organizations. Those decisions should be based on the most accurate poverty figures. However, often reliable poverty figures are not available at fine geographical levels or for particular risk population subgroups due to the sample size limitation of current national surveys. These surveys cannot cover adequately all the desired areas or population subgroups and, therefore, models relating the different areas are needed to 'borrow strength"" from area to area. In particular, the Spanish Survey on Income and Living Conditions (SILC) produces national poverty estimates but cannot provide poverty estimates by Spanish provinces due to the poor precision of direct estimates, which use only the province specific data. It also raises the ethical question of whether poverty is more severe for women than for men in a given province. We develop a hierarchical Bayes (HB) approach for poverty mapping in Spanish provinces by gender that overcomes the small province sample size problem of the SILC. The proposed approach has a wide scope of application because it can be used to estimate general nonlinear parameters. We use a Bayesian version of the nested error regression model in which Markov chain Monte Carlo procedures and the convergence monitoring therein are avoided. A simulation study reveals good frequentist properties of the HB approach. The resulting poverty maps indicate that poverty, both in frequency and intensity, is localized mostly in the southern and western provinces and it is more acute for women than for men in most of the provinces.",0 +https://doi.org/10.1027/1015-5759/a000232,How Test Takers See Test Examiners,Abstract. We addressed potential test takers’ preferences for women or men as examiners as well as how examiners were perceived depending on their gender. We employed an online design with 375 students who provided preferences for and ratings of examiners based on short video clips. The clips showed four out of 15 psychologists who differed in age (young vs. middle-aged) and gender giving an introduction to a fictional intelligence test session. Employing multivariate multilevel analyses we found female examiners to be perceived as more social competent and middle-aged examiners being perceived as more competent. Data analyses revealed a significant preference for choosing women as examiners. Results were discussed with reference to test performance and fairness.,0 +https://doi.org/10.1177/1525822x07303502,Cultural Consensus Theory: Applications and Frequently Asked Questions,"In the ethnographic context, where answers to questions are unknown, consensus theory estimates the culturally appropriate or correct answers to the questions and individual differences in cultural knowledge. The cultural consensus model is a formal model of the process for asking and answering questions and is limited to categorical response data. An informal version of the model is available as a set of analytic procedures and obtains similar information with fewer assumptions. This article describes the assumptions, appropriate interview materials, and analytic procedures for carrying out a consensus analysis. Finally, issues that sometimes arise during the application of a consensus analysis are discussed.",0 +https://doi.org/10.1016/j.jpain.2006.04.001,Spinal Cord Glia and Interleukin-1 Do Not Appear to Mediate Persistent Allodynia Induced by Intramuscular Acidic Saline in Rats,"Spinal glial activation and consequent interleukin-1 (IL-1) release are implicated in pain facilitation induced by inflammation/damage to skin and peripheral nerves. It is unclear whether pain facilitation induced at deep tissue sites also depends on these. We investigated whether spinal IL-1 and/or glial activation mediates bilateral allodynia induced by repeated unilateral intramuscular injections of acidic saline to rats. Given the prominent role of spinal IL-1 in various bilateral pain models, we predicted that intrathecal IL-1 receptor antagonist (IL-1ra) would suppress bilateral allodynia in this model as well. Surprisingly, neither single nor repeated intrathecal injections of IL-1ra affected allodynia, measured by the von Frey test, induced by prior intramuscular acidic saline compared with vehicle-injected controls. In addition, we tested the effect of 2 additional intrathecal manipulations that are broadly efficacious in suppressing glially mediated pain facilitation: (1) a glial metabolic inhibitor (fluorocitrate) and (2) the anti-inflammatory cytokine, interleukin-10 (IL-10). Like IL-1ra, fluorocitrate and IL-10 each failed to reverse allodynia. Finally, we observed no significant activation of glial cells, as assessed by immunohistochemistry of glial activation markers, in the lumbar spinal cord in response to intramuscular acidic saline. Taken together, the present data suggest that acidic saline-induced bilateral allodynia is created independently of glial activation.From converging lines of evidence, the current studies suggest that persistent bilateral allodynia induced by repeated intramuscular acidic saline is not mediated by spinal IL-1 and/or spinal glial activation. As such, this might represent the first evidence for pain facilitation occurring in the absence of glial involvement.",0 +https://doi.org/10.2307/3316080,Statistical analyses for round robin interaction data,"This paper considers the analysis of round robin interaction data whereby individuals from a group of subjects interact with one another, producing a pair of outcomes, one for each individual. The authors provide an overview of the various analyses applied to these types of data and extend the work in several directions. In particular, they provide a fully Bayesian analysis for such data and use a real data example for illustration purposes.",0 +https://doi.org/10.1002/sim.4072,The analysis of very small samples of repeated measurements II: A modified Box correction,"There is a need for appropriate methods for the analysis of very small samples of continuous repeated measurements. A key feature of such analyses is the role played by the covariance matrix of the repeated observations. When subjects are few it can be difficult to assess the fit of parsimonious structures for this matrix, while the use of an unstructured form may lead to a serious lack of power. The Kenward-Roger adjustment is now widely adopted as a means of providing an appropriate inferences in small samples, but does not perform adequately in very small samples. Adjusted tests based on the empirical sandwich estimator can be constructed that have good nominal properties, but are seriously underpowered. Further, when such data are incomplete, or unbalanced, or non-saturated mean models are used, exact distributional results do not exist that justify analyses with any sample size. In this paper, a modification of Box's correction applied to a linear model-based F-statistic is developed for such small sample settings and is shown to have both the required nominal properties and acceptable power across a range of settings for repeated measurements.",0 +https://doi.org/10.1123/jsep.19.1.36,Application of the Theories of Reasoned Action and Planned Behavior to Exercise Behavior: A Meta-Analysis,"The primary purpose of this study was to use meta-analysis to statistically examine the utility of the theory of reasoned action (TRA) and the theory of planned behavior (TPB) for the explanation and prediction of exercise behavior. The results showed that the effect size for the relationships (a) between intention and exercise behavior, attitude and intention, attitude and exercise behavior, perceived behavioral control and intention, and perceived behavioral control and exercise behavior was large; (b) between subjective norm and intention was moderate; and (c) between subjective norm and exercise behavior was zero-order. The results also supported the conclusions that (a) TPB is superior to TRA in accounting for exercise behavior, (b) there is no differences in the ability to predict exercise behavior from proximal and distal measures of intention, and (c) expectation is a better predictor of exercise behavior than intention.",0 +https://doi.org/10.1111/spsr.12179,A Decline in the Quality of Debate? The Evolution of Cognitive Complexity in Swiss Parliamentary Debates on Immigration (1968-2014),"This article explores the evolution of debate quality in the Swiss parliament. Focusing on immigration debates, we employ a psychological construct—cognitive complexity (CC)—which captures both epistemic and accommodative dimensions of political argumentation. We find a decrease in CC in parliamentary immigration debates over time, but this decrease was driven by the rise of the SVP (Swiss People's Party). However, there was almost no “spillover” of this new communication style to other parties. Moreover, we also find a constant difference between the Standerat and the Nationalrat, with the former scoring higher on CC and thus asserting its role as a “chambre de reflexion” in immigration debates. Our diachronic focus on the quality of political debate takes a novel perspective on the dynamics of consensus democracy as well as on elite political culture. While our results indicate that the rise of the SVP has transformed the traditional consensual and deliberative pattern of Swiss policy-making style into one which is geared towards less accommodation and a higher simplicity of political talk, there is still remarkable resilience against this new style of political interaction.",0 +https://doi.org/10.1111/j.1540-5907.2006.00166.x,The Political Economy of Gender: Explaining Cross-National Variation in the Gender Division of Labor and the Gender Voting Gap,"Mainstream political economy has tended to treat the family as a unit when examining the distributional consequences of labor market institutions and of public policy. In a world with high divorce rates, we argue that this simplification is more likely to obscure than to instruct. We find that labor market opportunities for women, which vary systematically with the position of countries in the international division of labor and with the structure of the welfare state, affect women's bargaining power within the family and as a result, can explain much of the cross country variation in the gender division of labor as well as the gender gap in political preferences.",0 +https://doi.org/10.1136/bmj.i1777,Methotrexate monotherapy and methotrexate combination therapy with traditional and biologic disease modifying antirheumatic drugs for rheumatoid arthritis: abridged Cochrane systematic review and network meta-analysis,"To compare methotrexate based disease modifying antirheumatic drug (DMARD) treatments for rheumatoid arthritis in patients naive to or with an inadequate response to methotrexate.Systematic review and Bayesian random effects network meta-analysis of trials assessing methotrexate used alone or in combination with other conventional synthetic DMARDs, biologic drugs, or tofacitinib in adult patients with rheumatoid arthritis.Trials were identified from Medline, Embase, and Central databases from inception to 19 January 2016; abstracts from two major rheumatology meetings from 2009 to 2015; two trial registers; and hand searches of Cochrane reviews.Randomized or quasi-randomized trials that compared methotrexate with any other DMARD or combination of DMARDs and contributed to the network of evidence between the treatments of interest.American College of Rheumatology (ACR) 50 response (major clinical improvement), radiographic progression, and withdrawals due to adverse events. A comparison between two treatments was considered statistically significant if its credible interval excluded the null effect, indicating >97.5% probability that one treatment was superior.158 trials were included, with between 10 and 53 trials available for each outcome. In methotrexate naive patients, several treatments were statistically superior to oral methotrexate for ACR50 response: sulfasalazine and hydroxychloroquine (""triple therapy""), several biologics (abatacept, adalimumab, etanercept, infliximab, rituximab, tocilizumab), and tofacitinib. The estimated probability of ACR50 response was similar between these treatments (range 56-67%), compared with 41% with methotrexate. Methotrexate combined with adalimumab, etanercept, certolizumab, or infliximab was statistically superior to oral methotrexate for inhibiting radiographic progression, but the estimated mean change over one year with all treatments was less than the minimal clinically important difference of 5 units on the Sharp-van der Heijde scale. Triple therapy had statistically fewer withdrawals due to adverse events than methotrexate plus infliximab. After an inadequate response to methotrexate, several treatments were statistically superior to oral methotrexate for ACR50 response: triple therapy, methotrexate plus hydroxychloroquine, methotrexate plus leflunomide, methotrexate plus intramuscular gold, methotrexate plus most biologics, and methotrexate plus tofacitinib. The probability of response was 61% with triple therapy and ranged widely (27-70%) with other treatments. No treatment was statistically superior to oral methotrexate for inhibiting radiographic progression. Methotrexate plus abatacept had a statistically lower rate of withdrawals due to adverse events than several treatments.Triple therapy (methotrexate plus sulfasalazine plus hydroxychloroquine) and most regimens combining biologic DMARDs with methotrexate were effective in controlling disease activity, and all were generally well tolerated in both methotrexate naive and methotrexate exposed patients.",0 +https://doi.org/10.1038/sj.jea.7500182,Improved non-negative estimation of variance components for exposure assessment,"Hygiene surveys of pollutants exposure data can be analyzed by analysis of variance (ANOVA) model with a random worker effect. Typically, workers are classified into homogeneous exposure groups, so it is very common to obtain a zero or negative ANOVA estimate of the between-worker variance (à ƒB2). Negative estimates are not sensible and also pose problems for estimating the probability (ÃŽËœ) that in a job group, a randomly selected worker's mean exposure exceeds the occupational exposure standard. Therefore, it was suggested by Rappaport et al. to replace a non-positive estimate with an approximate one-sided 60% upper confidence bound. This article develops an alternative estimator, based on the upper tolerance interval suggested by Wang and Iyer. We compared the performance of the two methods using real data and simulations with respect to estimating both the between-worker variance and the probability of overexposure in balanced designs. We found that the method of Rappaport et al. has three main disadvantages: (i) the estimated à ƒB2 remains negative for some data sets; (ii) the estimator performs poorly in estimating à ƒB2 and ÃŽËœ with two repeated measures per worker and when true à ƒB2 is quite small, which are quite common situations when studying exposure; (iii) the estimator can be extremely sensitive to small changes in the data. Our alternative estimator offers a solution to these problems.",0 +https://doi.org/10.1185/03007995.2012.734798,Efficacy of telaprevir and boceprevir in treatment-naïve and treatment-experienced genotype 1 chronic hepatitis C patients: an indirect comparison using Bayesian network meta-analysis,"To indirectly compare the efficacy of telaprevir (TVR) and boceprevir (BOC) combined with peginterferon/ribavirin α-2a/2b (PR) in achieving sustained viral response (SVR) in treatment-naïve and treatment-experienced patients with genotype 1 chronic hepatitis C virus (HCV) infection.A systematic literature review was conducted to identify randomized controlled trials reporting the efficacy of PR-based treatment in genotype 1 chronic HCV patients. A Bayesian network meta-analysis was performed on the endpoint of SVR, assuming fixed study effects. For treatment-experienced patients, only previous relapsers and partial responders were included, as no results in prior null responders were available for boceprevir.Eleven publications were included. In treatment-naïve patients, the odds ratios (OR) (posterior median [95% credible interval]) for telaprevir (12 weeks + response guided treatment [RGT] 24/48 weeks PR) and boceprevir (24 weeks + RGT 28/48 weeks PR) versus PR were respectively 3.80 (2.78-5.22) and 2.99 (2.23-4.01). The OR for telaprevir versus boceprevir was 1.42 (0.89-2.25), with a probability for telaprevir being more effective (P[OR > 1]) of 0.93. In treatment-experienced patients, the OR of telaprevir (12 weeks + 48 weeks PR) and boceprevir (32 weeks + RGT 36/48 weeks PR) versus PR were respectively 13.11 (7.30-24.43) and 5.36 (2.90-10.30). The OR for telaprevir versus boceprevir was 2.45 (1.02-5.80), with telaprevir having a probability of 0.98 of being more effective.The main limitation of this study is the low number of trials included in the analysis, especially for the treatment-experienced patient population, which only allowed random-effect models to be explored. We tried to identify potential biases due to study heterogeneity.In the absence of direct comparative head-to-head studies between telaprevir and boceprevir for the treatment of chronic HCV genotype 1 patients, an indirect comparison based on Bayesian network meta-analysis suggests better efficacy for telaprevir than boceprevir in both treatment-naïve and treatment-experienced patients.",0 +https://doi.org/10.1037/1082-989x.9.4.466,An Empirical Evaluation of Alternative Methods of Estimation for Confirmatory Factor Analysis With Ordinal Data.,"Confirmatory factor analysis (CFA) is widely used for examining hypothesized relations among ordinal variables (e.g., Likert-type items). A theoretically appropriate method fits the CFA model to polychoric correlations using either weighted least squares (WLS) or robust WLS. Importantly, this approach assumes that a continuous, normal latent process determines each observed variable. The extent to which violations of this assumption undermine CFA estimation is not well-known. In this article, the authors empirically study this issue using a computer simulation study. The results suggest that estimation of polychoric correlations is robust to modest violations of underlying normality. Further, WLS performed adequately only at the largest sample size but led to substantial estimation difficulties with smaller samples. Finally, robust WLS performed well across all conditions.",0 +https://doi.org/10.1111/j.1541-0420.2010.01463.x,Fixed and Random Effects Selection in Mixed Effects Models,"We consider selecting both fixed and random effects in a general class of mixed effects models using maximum penalized likelihood (MPL) estimation along with the smoothly clipped absolute deviation (SCAD) and adaptive least absolute shrinkage and selection operator (ALASSO) penalty functions. The MPL estimates are shown to possess consistency and sparsity properties and asymptotic normality. A model selection criterion, called the IC(Q) statistic, is proposed for selecting the penalty parameters (Ibrahim, Zhu, and Tang, 2008, Journal of the American Statistical Association 103, 1648-1658). The variable selection procedure based on IC(Q) is shown to consistently select important fixed and random effects. The methodology is very general and can be applied to numerous situations involving random effects, including generalized linear mixed models. Simulation studies and a real data set from a Yale infant growth study are used to illustrate the proposed methodology.",0 +https://doi.org/10.1214/aos/1176349736,Calibration-Based Empirical Probability,"Probability forecasts for a sequence of uncertain events may be compared with the outcomes of those events by means of a natural criterion of empirical validity, calibration. It is shown that any two sequences of forecasts which both meet this criterion must be in asymptotic agreement. These agreed values can then be considered as correct objective probability forecasts for the particular sequence of outcome results obtained. However, the objective forecasts vary with the extent of the information taken into account when they are formulated. We thus obtain a general theory of empirical probability, relative to an information base. This theory does not require that such probabilities be interpreted in terms of repeated trials of the same event. Some implications of this theory are discussed.",0 +https://doi.org/10.1002/(sici)1097-0258(19980430)17:8<841::aid-sim781>3.0.co;2-d,Detecting and describing heterogeneity in meta-analysis,"The investigation of heterogeneity is a crucial part of any meta-analysis. While it has been stated that the test for heterogeneity has low power, this has not been well quantified. Moreover the assumptions of normality implicit in the standard methods of meta-analysis are often not scrutinized in practice. Here we simulate how the power of the test for heterogeneity depends on the number of studies included, the total information (that is total weight or inverse variance) available and the distribution of weights among the different studies. We show that the power increases with the total information available rather than simply the number of studies, and that it is substantially lowered if, as is quite common in practice, one study comprises a large proportion of the total information. We also describe normal plots that are useful in assessing whether the data conform to a fixed effect or random effects model, together with appropriate tests, and give an application to the analysis of a multi-centre trial of blood pressure reduction. We conclude that the test of heterogeneity should not be the sole determinant of model choice in meta-analysis, and inspection of relevant normal plots, as well as clinical insight, may be more relevant to both the investigation and modelling of heterogeneity.",0 +https://doi.org/10.1007/978-3-642-15387-7_32,A Computer Adaptive Testing Method for Intelligent Tutoring Systems,"AbstractThe growth of popularity of computers increases interest of adaptive testing in tutoring systems. Computer adaptive testing is a form of educational measurement that is adaptable to examine proficiency. In a procedure of adaptive testing it is required to determine a selection of the first item, a method of estimation of student’s proficiency, a method of selection of the next item and a termination criterion. In this paper the original algorithm of adaptive testing with all basic steps is proposed. The level of difficulty of the first item is set using user’s profile. Such solution allows to start a test, where the first item is suitable for student’s preferences. In our method 2-parameter IRT model is applied to choose the next item.KeywordsTest ItemItem Response TheoryItem Response Theory ModelIntelligent Tutor SystemProficiency LevelThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.",0 +https://doi.org/10.3758/brm.41.4.1083,Statistical power analysis for growth curve models using SAS,"Power analysis is critical in research designs. This study discusses a simulation-based approach utilizing the likelihood ratio test to estimate the power of growth curve analysis. The power estimation is implemented through a set of SAS macros. The application of the SAS macros is demonstrated through several examples, including missing data and nonlinear growth trajectory situations. The results of the examples indicate that the power of growth curve analysis increases with the increase of sample sizes, effect sizes, and numbers of measurement occasions. In addition, missing data can reduce power. The SAS macros can be modified to accommodate more complex power analysis for both linear and nonlinear growth curve models.",0 +https://doi.org/10.1016/0042-6989(81)90115-2,On the psychometric function for contrast detection,"Abstract The frequent current use in probability summation calculations of equations of the form. P = 1 − (1−γ)exp[−(I/α)β] to represent the psychometric function for contrast detection is based on two assumptions: (1) γ can be changed without affecting α and β (the high-threshold assumption) and (2) β is the same for all pattern-detecting mechnisms (the homogeneity assumption). Results of yes-no, rating-scale, and forced-choice experiments contradict the high-threshold assumption: estimates of α and β covary with γ. Contrary to the homogeneity assumption, bipartite fields yield lower values of β than do 12 c/deg gratings. Some consequences of these findings for probability summation calculations are discussed.",0 +https://doi.org/10.1121/1.3598448,Psychometric functions for pure-tone frequency discrimination,"The form of the psychometric function (PF) for auditory frequency discrimination is of theoretical interest and practical importance. In this study, PFs for pure-tone frequency discrimination were measured for several standard frequencies (200-8000 Hz) and levels [35-85 dB sound pressure level (SPL)] in normal-hearing listeners. The proportion-correct data were fitted using a cumulative-Gaussian function of the sensitivity index, d', computed as a power transformation of the frequency difference, Δf. The exponent of the power function corresponded to the slope of the PF on log(d')-log(Δf) coordinates. The influence of attentional lapses on PF-slope estimates was investigated. When attentional lapses were not taken into account, the estimated PF slopes on log(d')-log(Δf) coordinates were found to be significantly lower than 1, suggesting a nonlinear relationship between d' and Δf. However, when lapse rate was included as a free parameter in the fits, PF slopes were found not to differ significantly from 1, consistent with a linear relationship between d' and Δf. This was the case across the wide ranges of frequencies and levels tested in this study. Therefore, spectral and temporal models of frequency discrimination must account for a linear relationship between d' and Δf across a wide range of frequencies and levels.",0 +https://doi.org/10.2307/2988546,Analysis of Clinical Data Using Imprecise Prior Probabilities,"This paper describes a new method based on the theory of imprecise probabilities, for analysing clinical data in the form of a contingency table. The method is applied to a well-known set of statistical data from randomized clinical trials of two treatments for severe cardiorespiratory failure in newborn babies. Two problems are distinguished. The inference problem is to draw conclusions about which treatment is more effective. The decision problem is to determine whether one treatment should be preferred to another for the next patient, or whether it is ethical to select the treatment by randomization. The two problems are analysed using three possible models for prior ignorance about the statistical parameters, and one of the models is modified to take account of earlier clinical data. In this example the four models produce essentially the same conclusions.",0 +https://doi.org/10.1111/ajps.12200,"IMF Conditionality, Government Partisanship, and the Progress of Economic Reforms","The International Monetary Fund (IMF) often seeks to influence countries' domestic public policy via varying levels of conditionality—linking financial support to borrowing governments' commitment to policy reforms. When does extensive conditionality encourage domestic economic reforms and when does it impede them? We argue that, rather than universally benefiting or harming reforms, the effects of stricter IMF conditionality depend on domestic partisan politics. More IMF conditions can pressure left-wing governments into undertaking more ambitious reforms with little resistance from partisan rivals on the right; under right governments, however, more conditions hinder reform implementation by heightening resistance from the left while simultaneously reducing leaders' ability to win their support through concessions or compromise. Using data on post-communist IMF programs for the period 1994–2010, we find robust evidence supporting these claims, even after addressing the endogeneity of IMF programs via instrumental variables analysis.",0 +https://doi.org/10.3102/10769986029002177,Evaluation of the CATSIB DIF Procedure in a Pretest Setting,"A new procedure, CATSIB, for assessing differential item functioning (DIF) on computerized adaptive tests (CATs) is proposed. CATSIB, a modified SIBTEST procedure, matches test takers on estimated ability and controls for impact-induced Type 1 error inflation by employing a CAT version of the SIBTEST “regression correction.” The performance of CATSIB in terms of detection of DIF in pretest items was evaluated in a simulation study. Simulated test takers were adaptively administered 25 operational items from a pool of 1,000 and were linearly administered 16 pretest items that were evaluated for DIF. Sample size varied from 250 to 500 in each group. Simulated impact levels ranged from a 0- to 1-standard-deviation difference in mean ability levels. The results showed that CATSIB with the regression correction displayed good control over Type 1 error, whereas CATSIB without the regression correction displayed impact-induced Type 1 error inflation. With 500 test takers in each group, power rates were exceptionally high (84% to 99%) for values of DIF at the boundary between moderate and large DIF. For smaller samples of 250 test takers in each group, the corresponding power rates ranged from 47% to 95%. In addition, in all cases, CATSIB was very accurate in estimating the true values of DIF, displaying at most only minor estimation bias.",0 +https://doi.org/10.3758/s13428-013-0351-0,An alternative approach to analysis of mental states in experimental social cognition research,"Establishing the mental states that affect human behavior is a primary goal of experiments on social cognitive processes. Such mental states can be manipulated only indirectly; therefore, after delivering a manipulation, researchers attempt to verify that the mental state of interest, the representation of a mental state, was in fact changed by the manipulation and that this change caused the observed effect. The usual procedure is to examine mean differences in a measure of the mental state of interest (a manipulation check) among experimental conditions and to infer whether the manipulation was effective. We describe a procedure that strengthens the construct validity of manipulations and, hence, causal inferences in experiments that focus on mental states using analyses familiar to most researchers. This procedure employs a traditional manipulation check that assesses the relationship between manipulations and mental states but, additionally, tests the relationship between the manipulation check and dependent measure. © 2013 Psychonomic Society, Inc.",0 +https://doi.org/10.1016/s0148-2963(00)00127-2,The ability of ratings and choice conjoint to predict market shares: a Monte Carlo simulation,"We use a Monte Carlo simulation with many synthetic data sets to compare ratings and choice conjoint analysis in their ability to correctly predict market shares under varying market conditions. Our results provide guidance to researchers seeking to use conjoint analysis for managerial decisions. Our recommendations are quite different from the recommendations of prior researchers who compared conjoint methods using single empirical data sets. Our results indicate that one must, at least roughly, assess the degree of consumers' heterogeneity in preferences, product similarity in the marketplace, typical consumers' choice-rule (probabilistic or deterministic), and magnitude of error in measurement of utilities in order to make a prudent choice between ratings and choice conjoint analysis.",0 +https://doi.org/10.1038/srep19203,Evaluating and excluding swap errors in analogue tests of working memory,"Abstract When observers retrieve simple visual features from working memory, two kinds of error are typically confounded in their recall. First, responses reflect noise or variability within the feature dimension they were asked to report. Second, responses are corrupted by “swap errors”, in which a different item from the memory set is reported in place of the one that was probed. Independent evaluation of these error sources is vital for understanding the structure of internal representations and their binding. However, previous methods for disentangling these errors have been critically dependent on assumptions about the noise distribution, which is a priori unknown. Here I address this question with novel non-parametric (NP) methods, which estimate swap frequency and feature variability with fewer prior assumptions and without a fitting procedure. The results suggest that swap errors are considerably more prevalent than previously appreciated (accounting for more than a third of responses at set size 8). These methods also identify which items are swapped in for targets: when the target item is cued by location, the items in closest spatial proximity are most likely to be incorrectly reported, thus implicating noise in the probe feature dimension as a source of swap errors.",0 +https://doi.org/10.1111/j.1745-3992.1998.tb00632.x,Protecting the Integrity of Computerized Testing Item Pools,What are the issues and techniques involved in protecting the integrity of item pools in computerized testing? How can item exposure be limited? How do security issues differ in computerized testing and paper-and-pencil testing?,0 +https://doi.org/10.1214/10-sts321,"Identification, Inference and Sensitivity Analysis for Causal Mediation Effects","Causal mediation analysis is routinely conducted by applied researchers in a variety of disciplines. The goal of such an analysis is to investigate alternative causal mechanisms by examining the roles of intermediate variables that lie in the causal paths between the treatment and outcome variables. In this paper we first prove that under a particular version of sequential ignorability assumption, the average causal mediation effect (ACME) is nonparametrically identified. We compare our identification assumption with those proposed in the literature. Some practical implications of our identification result are also discussed. In particular, the popular estimator based on the linear structural equation model (LSEM) can be interpreted as an ACME estimator once additional parametric assumptions are made. We show that these assumptions can easily be relaxed within and outside of the LSEM framework and propose simple nonparametric estimation strategies. Second, and perhaps most importantly, we propose a new sensitivity analysis that can be easily implemented by applied researchers within the LSEM framework. Like the existing identifying assumptions, the proposed sequential ignorability assumption may be too strong in many applied settings. Thus, sensitivity analysis is essential in order to examine the robustness of empirical findings to the possible existence of an unmeasured confounder. Finally, we apply the proposed methods to a randomized experiment from political psychology. We also make easy-to-use software available to implement the proposed methods.",0 +https://doi.org/10.1198/jasa.2011.tm09680,Bayesian Inference for the Spatial Random Effects Model,"Spatial statistical analysis of massive amounts of spatial data can be challenging because computation of optimal procedures can break down. The Spatial Random Effects (SRE) model uses a fixed number of known but not necessarily orthogonal (multiresolutional) spatial basis functions, which gives a flexible family of nonstationary covariance functions, results in dimension reduction, and yields optimal spatial predictors whose computations are scalable. By modeling spatial data in a hierarchical manner with a process model that includes the SRE model, the choice is whether to estimate the SRE model’s parameters or to take a Bayesian approach and put a prior distribution on them. In this article, we develop Bayesian inference for the SRE model when the spatial basis functions are multiresolutional. Then the covariance matrix of the random effects decomposes naturally in terms of Givens angles and eigenvalues, for which a new class of prior distributions is developed. This approach to prior specification of ...",0 +https://doi.org/10.1214/10-sts318,"Calibrated Bayes, for Statistics in General, and Missing Data in Particular","It is argued that the Calibrated Bayesian (CB) approach to statistical inference capitalizes on the strength of Bayesian and frequentist approaches to statistical inference. In the CB approach, inferences under a particular model are Bayesian, but frequentist methods are useful for model development and model checking. In this article the CB approach is outlined. Bayesian methods for missing data are then reviewed from a CB perspective. The basic theory of the Bayesian approach, and the closely related technique of multiple imputation, is described. Then applications of the Bayesian approach to normal models are described, both for monotone and nonmonotone missing data patterns. Sequential Regression Multivariate Imputation and Penalized Spline of Propensity Models are presented as two useful approaches for relaxing distributional assumptions.",0 +https://doi.org/10.1186/2046-4053-1-44,Drugs commonly associated with weight change: umbrella systematic review and meta-analysis (Protocol),"Abstract Background Many drugs and treatments given to patients for various reasons affect their weight. This side effect is of great importance to patients and is also a concern for the treating physician because weight change may lead to the emergence or worsening of other health conditions. Objective The aim of this study is to summarize the evidence about commonly prescribed drugs and their association with weight change. Methods/Design Umbrella systematic review and meta-analysis of randomized controlled trials. We will use an umbrella approach to identify eligible randomized controlled trials (RCTs). We will search for systematic reviews of RCTs that compare any of the drugs that have been associated with weight gain (obesogenic) or weight loss (leptogenic); these have been summarized by our experts’ panel in a predefined list. Two reviewers will independently determine RCT eligibility. Disagreement will be solved by consensus and arbitrated by a third reviewer. We will extract descriptive, methodological, and efficacy data in duplicate. Our primary continuous outcomes will be weight loss or gain expressed as a mean difference (MD) for weight (kg) or BMI (kg/m 2 ). We will calculate the MD considering the mean difference in weight or BMI between baseline and the last available follow-up in both study arms (drugs and placebo). Our primary dichotomous outcome, presented as a relative risk, will compare the ratio of the incidence of weight change in each trial arm. When possible, results will be pooled using classic random-effects meta-analyses and a summary estimate with 95% confidence interval will provided. We will use the I 2 statistic and Cochran’s Q test to assess heterogeneity. The risk of bias will be assessed using the Cochrane risk of bias tool. Publication bias, if appropriate, will be evaluated, as well as overall strength of the evidence. Discussion This systematic review will offer the opportunity to generate a ranking of commonly prescribed drugs in terms of their effect on weight, allowing guideline developers and patient-physician dyad to choose between available therapies.",0 +https://doi.org/10.2307/3151320,Alternative Estimation Methods for Conjoint Analysis: A Monte Carlo Study,,0 +https://doi.org/10.4324/9781410606747-5,Nonlinear Multilevel Models for Repeated Measures Data,,0 +https://doi.org/10.1177/0146621608327801,Comparison of CAT Item Selection Criteria for Polytomous Items,"Item selection is a core component in computerized adaptive testing (CAT). Several studies have evaluated new and classical selection methods; however, the few that have applied such methods to the use of polytomous items have reported conflicting results. To clarify these discrepancies and further investigate selection method properties, six different selection methods are compared systematically. The results showed no clear benefit from more sophisticated selection criteria and showed one method previously believed to be superior—the maximum expected posterior weighted information (MEPWI)—to be mathematically equivalent to a simpler method, the maximum posterior weighted information (MPWI).",0 +https://doi.org/10.3168/jds.2015-10264,Use of early lactation milk recording data to predict the calving to conception interval in dairy herds,"Economic success in dairy herds is heavily reliant on obtaining pregnancies at an early stage of lactation. Our objective in this study was to attempt to predict the likelihood of conception occurring by d 100 and 150 of lactation (days in milk, DIM) by Markov chain Monte Carlo analysis using test day milk recording data and reproductive records gathered retrospectively from 8,750 cows from 33 dairy herds located in the United Kingdom. Overall, 65% of cows recalved with 30, 46, and 65% of cows conceiving by 100 DIM, 150 DIM, and beyond 150 DIM, respectively. Overall conception rate (total cows pregnant/total number of inseminations) was 27.47%. Median and mean calving to conception intervals were 123 and 105 d, respectively. The probability of conception by both 100 DIM and 150 DIM was positively associated with the average daily milk weight produced during the fourth week of lactation (W4MK) and protein percentage for test day samples collected between 0 to 30 and 31 to 60 DIM. Butterfat percentage at 0 to 30 DIM was negatively associated with the probability of conception by 100 DIM but not at 150 DIM. High somatic cell count (SCC) at both 0 to 30 and 31 to 60 DIM was negatively associated with the probability of conception by 100 DIM, whereas high SCC at 31 to 60 DIM was associated with a reduced probability of conception by 150 DIM. Increasing parity was associated with a reduced odds of pregnancy. Posterior predictions of the likelihood of conception for cows categorized as having ""good"" (W4MK >30kg and protein percentage at 0 to 30 and 31 to 60 DIM >3.2%) or ""poor"" (W4MK <25kg and protein percentage at 0 to 30 and 31 to 60 DIM <3.0%) early lactation attributes with actual observed values indicated model fit was good. The predicted likelihood of a ""good"" cow conceiving by 100 and 150 DIM was 0.39 and 0.57, respectively (actual observed values 0.40 and 0.59). The corresponding values for a ""poor"" cow were 0.28 and 0.42 (actual observed values 0.26 and 0.37). Predictions of the future reproductive success of cows may be possible using a limited number of early lactation attributes.",0 +https://doi.org/10.1037/xge0000038,The effect of horizontal eye movements on free recall: A preregistered adversarial collaboration.,"A growing body of research has suggested that horizontal saccadic eye movements facilitate the retrieval of episodic memories in free recall and recognition memory tasks. Nevertheless, a minority of studies have failed to replicate this effect. This article attempts to resolve the inconsistent results by introducing a novel variant of proponent-skeptic collaboration. The proposed approach combines the features of adversarial collaboration and purely confirmatory preregistered research. Prior to data collection, the adversaries reached consensus on an optimal research design, formulated their expectations, and agreed to submit the findings to an academic journal regardless of the outcome. To increase transparency and secure the purely confirmatory nature of the investigation, the 2 parties set up a publicly available adversarial collaboration agreement that detailed the proposed design and all foreseeable aspects of the data analysis. As anticipated by the skeptics, a series of Bayesian hypothesis tests indicated that horizontal eye movements did not improve free recall performance. The skeptics suggested that the nonreplication may partly reflect the use of suboptimal and questionable research practices in earlier eye movement studies. The proponents countered this suggestion and used a p curve analysis to argue that the effect of horizontal eye movements on explicit memory did not merely reflect selective reporting.",0 +https://doi.org/10.1037/1082-989x.10.2.227,Meta-Analytic Methods of Pooling Correlation Matrices for Structural Equation Modeling Under Different Patterns of Missing Data.,"Three methods of synthesizing correlations for meta-analytic structural equation modeling (SEM) under different degrees and mechanisms of missingness were compared for the estimation of correlation and SEM parameters and goodness-of-fit indices by using Monte Carlo simulation techniques. A revised generalized least squares (GLS) method for synthesizing correlations, weighted-covariance GLS (W-COV GLS), was compared with univariate weighting with untransformed correlations (univariate r) and univariate weighting with Fisher's z-transformed correlations (univariate z). These 3 methods were crossed with listwise and pairwise deletion. Univariate z and W-COV GLS performed similarly, with W-COV GLS providing slightly better estimation of parameters and more correct model rejection rates. Missing not at random data produced high levels of relative bias in correlation and model parameter estimates and higher incorrect SEM model rejection rates. Pairwise deletion resulted in inflated standard errors for all synthesis methods and higher incorrect rejection rates for the SEM model with univariate weighting procedures.",0 +https://doi.org/10.1214/14-ba933,Objective Bayesian Inference for a Generalized Marginal Random Effects Model,"An objective Bayesian inference is proposed for the generalized marginal random effects model p(x|μ,σλ)=f((x−μ1)T(V+σλ2I)−1(x−μ1))/det(V+σλ2I). The matrix V is assumed to be known, and the goal is to infer μ given the observations x=(x1,…,xn)T, while σλ is a nuisance parameter. In metrology this model has been applied for the adjustment of inconsistent data x1,…,xn, where the matrix V contains the uncertainties quoted for x1,…,xn. We show that the reference prior for grouping {μ,σλ} is given by π(μ,σλ)∝F22, where F22 denotes the lower right element of the Fisher information matrix F. We give an explicit expression for the reference prior, and we also prove propriety of the resulting posterior as well as the existence of mean and variance of the marginal posterior for μ. Under the additional assumption of normality, we relate the resulting reference analysis to that known for the conventional balanced random effects model in the asymptotic case when the number of repeated within-class observations for that model tends to infinity. We investigate the frequentist properties of the proposed inference for the generalized marginal random effects model through simulations, and we also study its robustness when the underlying distributional assumptions are violated. Finally, we apply the model to the adjustment of current measurements of the Planck constant.",0 +https://doi.org/10.1080/14616696.2015.1072226,Credential and Skill Mismatches Among Tertiary Graduates: The effect of labour market institutions on the differences between fields of study in 18 countries,"ABSTRACTThis study provides new empirical evidence about tertiary graduates’ overeducation, by analysing the influence of labour market institutions on the incidence and distribution of the phenomenon across fields of study. In particular, the analyses focus on the level of employment protection, the regulation of access to the so-called liberal professions, and the propensity of welfare states to hire skilled workers. Data from two comparative surveys – REFLEX and HEGESCO – are used, and a wide set of information is employed to split overeducation in two forms of suboptimal allocation of individuals in the labour market: credential and skill mismatches. The first term refers to the mismatch between formal educational credentials and job requirements, whereas the second term refers to the mismatch between the skills acquired through education and those needed to perform a job. Results suggest that field of study differentials vary by country and that welfare and labour market institutions illuminate these...",0 +https://doi.org/10.1214/13-sts418,Variational Inference for Generalized Linear Mixed Models Using Partially Noncentered Parametrizations,"The effects of different parametrizations on the convergence of Bayesian computational algorithms for hierarchical models are well explored. Techniques such as centering, noncentering and partial noncentering can be used to accelerate convergence in MCMC and EM algorithms but are still not well studied for variational Bayes (VB) methods. As a fast deterministic approach to posterior approximation, VB is attracting increasing interest due to its suitability for large high-dimensional data. Use of different parametrizations for VB has not only computational but also statistical implications, as different parametrizations are associated with different factorized posterior approximations. We examine the use of partially noncentered parametrizations in VB for generalized linear mixed models (GLMMs). Our paper makes four contributions. First, we show how to implement an algorithm called nonconjugate variational message passing for GLMMs. Second, we show that the partially noncentered parametrization can adapt to the quantity of information in the data and determine a parametrization close to optimal. Third, we show that partial noncentering can accelerate convergence and produce more accurate posterior approximations than centering or noncentering. Finally, we demonstrate how the variational lower bound, produced as part of the computation, can be useful for model selection.",0 +https://doi.org/10.1007/s10457-013-9622-0,Fertilizer type and species composition affect leachate nutrient concentrations in coffee agroecosystems,"Intensification of coffee (Coffea arabica) production is associated with increases in inorganic fertilizer application and decreases in species diversity. Both the use of organic fertilizers and the incorporation of trees on farms can, in theory, reduce nutrient loss in comparison with intensified practices. To test this, we measured nutrient concentrations in leachate at 15 and 100 cm depths on working farms. We examined (1) organically managed coffee agroforests (38 kg N ha -1 - year -1 ; n = 4), (2) conventionally managed coffee agroforests (96 kg N ha -1 year -1 ; n = 4), and (3) one conventionally managed monoculture coffee farm in Costa Rica (300 kg N ha -1 year -1 ). Concentrations of nitrate (NO3 - -N) and phosphate (PO4 3- -P) were higher in the monoculture compared to agroforests at both depths. Nitrate concentrations were higher in conven- tional than organic agroforests at 15 cm only. Soil solutions collected under nitrogen (N)-fixing Erythrina poeppigiana had elevated NO3 - -N concentrations at 15 cm compared to Musa acuminata (banana) or Coffea. Total soil N and carbon (C) were also higher under Erythrina. This research shows that both fertilizer type and species affect concentrations of N and P in leachate in coffee agroecosystems.",0 +https://doi.org/10.1016/j.ijforecast.2010.08.002,Forecasting television ratings,"Abstract Despite the state of flux in media today, television remains the dominant player globally for advertising spending. Since television advertising time is purchased on the basis of projected future ratings, and ad costs have skyrocketed, there is increasingly pressure to forecast television ratings accurately. The forecasting methods that have been used in the past are not generally very reliable, and many have not been validated; also, even more distressingly, none have been tested in today’s multichannel environment. In this study we compare eight different forecasting models, ranging from a naive empirical method to a state-of-the-art Bayesian model-averaging method. Our data come from a recent time period, namely 2004–2008, in a market with over 70 channels, making the data more typical of today’s viewing environment. The simple models that are commonly used in industry do not forecast as well as any econometric models. Furthermore, time series methods are not applicable, as many programs are broadcast only once. However, we find that a relatively straightforward random effects regression model often performs as well as more sophisticated Bayesian models in out-of-sample forecasting. Finally, we demonstrate that making improvements in ratings forecasts could save the television industry between $250 and $586 million per year.",0 +https://doi.org/10.1002/sim.6062,A multivariate multilevel Gaussian model with a mixed effects structure in the mean and covariance part,"A traditional Gaussian hierarchical model assumes a nested multilevel structure for the mean and a constant variance at each level. We propose a Bayesian multivariate multilevel factor model that assumes a multilevel structure for both the mean and the covariance matrix. That is, in addition to a multilevel structure for the mean we also assume that the covariance matrix depends on covariates and random effects. This allows to explore whether the covariance structure depends on the values of the higher levels and as such models heterogeneity in the variances and correlation structure of the multivariate outcome across the higher level values. The approach is applied to the three-dimensional vector of burnout measurements collected on nurses in a large European study to answer the research question whether the covariance matrix of the outcomes depends on recorded system-level features in the organization of nursing care, but also on not-recorded factors that vary with countries, hospitals, and nursing units. Simulations illustrate the performance of our modeling approach.",0 +https://doi.org/10.3758/s13428-013-0368-4,Tracking of nociceptive thresholds using adaptive psychophysical methods,"Psychophysical thresholds reflect the state of the underlying nociceptive mechanisms. For example, noxious events can activate endogenous analgesic mechanisms that increase the nociceptive threshold. Therefore, tracking thresholds over time facilitates the investigation of the dynamics of these underlying mechanisms. Threshold tracking techniques should use efficient methods for stimulus selection and threshold estimation. This study compares, in simulation and in human psychophysical experiments, the performance of different combinations of adaptive stimulus selection procedures and threshold estimation methods. Monte Carlo simulations were first performed to compare the bias and precision of threshold estimates produced by three different stimulus selection procedures (simple staircase, random staircase, and minimum entropy procedure) and two estimation methods (logistic regression and Bayesian estimation). Logistic regression and Bayesian estimations resulted in similar precision only when the prior probability distributions (PDs) were chosen appropriately. The minimum entropy and simple staircase procedures achieved the highest precision, while the random staircase procedure was the least sensitive to different procedure-specific settings. Next, the simple staircase and random staircase procedures, in combination with logistic regression, were compared in a human subject study (n = 30). Electrocutaneous stimulation was used to track the nociceptive perception threshold before, during, and after a cold pressor task, which served as the conditioning stimulus. With both procedures, habituation was detected, as well as changes induced by the conditioning stimulus. However, the random staircase procedure achieved a higher precision. We recommend using the random staircase over the simple staircase procedure, in combination with logistic regression, for nonstationary threshold tracking experiments. © 2013 Psychonomic Society, Inc.",0 +https://doi.org/10.1002/sim.4040,Random effects meta-analysis of event outcome in the framework of the generalized linear mixed model with applications in sparse data,"We consider random effects meta-analysis where the outcome variable is the occurrence of some event of interest. The data structures handled are where one has one or more groups in each study, and in each group either the number of subjects with and without the event, or the number of events and the total duration of follow-up is available. Traditionally, the meta-analysis follows the summary measures approach based on the estimates of the outcome measure(s) and the corresponding standard error(s). This approach assumes an approximate normal within-study likelihood and treats the standard errors as known. This approach has several potential disadvantages, such as not accounting for the standard errors being estimated, not accounting for correlation between the estimate and the standard error, the use of an (arbitrary) continuity correction in case of zero events, and the normal approximation being bad in studies with few events. We show that these problems can be overcome in most cases occurring in practice by replacing the approximate normal within-study likelihood by the appropriate exact likelihood. This leads to a generalized linear mixed model that can be fitted in standard statistical software. For instance, in the case of odds ratio meta-analysis, one can use the non-central hypergeometric distribution likelihood leading to mixed-effects conditional logistic regression. For incidence rate ratio meta-analysis, it leads to random effects logistic regression with an offset variable. We also present bivariate and multivariate extensions. We present a number of examples, especially with rare events, among which an example of network meta-analysis.",0 +https://doi.org/10.1037/met0000078,On the unnecessary ubiquity of hierarchical linear modeling.,"In psychology and the behavioral sciences generally, the use of the hierarchical linear model (HLM) and its extensions for discrete outcomes are popular methods for modeling clustered data. HLM and its discrete outcome extensions, however, are certainly not the only methods available to model clustered data. Although other methods exist and are widely implemented in other disciplines, it seems that psychologists have yet to consider these methods in substantive studies. This article compares and contrasts HLM with alternative methods including generalized estimating equations and cluster-robust standard errors. These alternative methods do not model random effects and thus make a smaller number of assumptions and are interpreted identically to single-level methods with the benefit that estimates are adjusted to reflect clustering of observations. Situations where these alternative methods may be advantageous are discussed including research questions where random effects are and are not required, when random effects can change the interpretation of regression coefficients, challenges of modeling with random effects with discrete outcomes, and examples of published psychology articles that use HLM that may have benefitted from using alternative methods. Illustrative examples are provided and discussed to demonstrate the advantages of the alternative methods and also when HLM would be the preferred method. (PsycINFO Database Record",0 +https://doi.org/10.1177/0146621606292213,IRT Model Selection Methods for Dichotomous Items,"Fit of the model to the data is important if the benefits of item response theory (IRT) are to be obtained. In this study, the authors compared model selection results using the likelihood ratio test, two information-based criteria, and two Bayesian methods. An example illustrated the potential for inconsistency in model selection depending on which of the indices was used. Results from a simulation study indicated that the inconsistencies among the indices were common but that model selection was relatively accurate for longer tests administered to larger sample of examinees. The cross-validation log-likelihood (CVLL) appeared to work the best of the five models for the conditions simulated in this study.",0 +https://doi.org/10.1037/a0037011,A dynamic Thurstonian item response theory of motive expression in the picture story exercise: Solving the internal consistency paradox of the PSE.,"The measurement of implicit or unconscious motives using the picture story exercise (PSE) has long been a target of debate in the psychological literature. Most debates have centered on the apparent paradox that PSE measures of implicit motives typically show low internal consistency reliability on common indices like Cronbach's alpha but nevertheless predict behavioral outcomes. I describe a dynamic Thurstonian item response theory (IRT) model that builds on dynamic system theories of motivation, theorizing on the PSE response process, and recent advancements in Thurstonian IRT modeling of choice data. To assess the models' capability to explain the internal consistency paradox, I first fitted the model to archival data (Gurin, Veroff, & Feld, 1957) and then simulated data based on bias-corrected model estimates from the real data. Simulation results revealed that the average squared correlation reliability for the motives in the Thurstonian IRT model was .74 and that Cronbach's alpha values were similar to the real data (<.35). These findings suggest that PSE motive measures have long been reliable and increase the scientific value of extant evidence from motivational research using PSE motive measures.",0 +https://doi.org/10.1207/s15327906mbr3901_4,Confidence Limits for the Indirect Effect: Distribution of the Product and Resampling Methods,"The most commonly used method to test an indirect effect is to divide the estimate of the indirect effect by its standard error and compare the resulting z statistic with a critical value from the standard normal distribution. Confidence limits for the indirect effect are also typically based on critical values from the standard normal distribution. This article uses a simulation study to demonstrate that confidence limits are imbalanced because the distribution of the indirect effect is normal only in special cases. Two alternatives for improving the performance of confidence limits for the indirect effect are evaluated: (a) a method based on the distribution of the product of two normal random variables, and (b) resampling methods. In Study 1, confidence limits based on the distribution of the product are more accurate than methods based on an assumed normal distribution but confidence limits are still imbalanced. Study 2 demonstrates that more accurate confidence limits are obtained using resampling methods, with the bias-corrected bootstrap the best method overall.",0 +https://doi.org/10.3758/bf03195458,A framework for ML estimation of parameters of (mixtures of) common reaction time distributions given optional truncation or censoring,"We present a framework for distributional reaction time (RT) analysis, based on maximum likelihood (ML) estimation. Given certain information relating to chosen distribution functions, one can estimate the parameters of these distributions and of finite mixtures of these distributions. In addition, left and/or right censoring or truncation may be imposed. Censoring and truncation are useful methods by which to accommodate outlying observations, which are a pervasive problem in RT research. We consider five RT distributions: the Weibull, the ex-Gaussian, the gamma, the log-normal, and the Wald. We employ quasi-Newton optimization to obtain ML estimates. Multicase distributional analyses can be carried out, which enable one to conduct detailed (across or within subjects) comparisons of RT data by means of loglikelihood difference tests. Parameters may be freely estimated, estimated subject to boundary constraints, constrained to be equal (within or over cases), or fixed. To demonstrate the feasibility of ML estimation and to illustrate some of the possibilities offered by the present approach, we present three small simulation studies. In addition, we present three illustrative analyses of real data.",0 +,Assessment of auditory temporal-order thresholds - a comparison of different measurement procedures and the influences of age and gender.,"The relationship between auditory temporal-order perception and phoneme discrimination has been discussed for several years, based on findings, showing that patients with cerebral damage in the left hemisphere and aphasia, as well as children with specific language impairments, show deficits in temporal-processing and phoneme discrimination. Over the last years several temporal-order measurement procedures and training batteries have been developed. However, there exists no standard diagnostic tool for adults that could be applied to patients with aphasia. Therefore, our study aimed at identifying a feasible, reliable and efficient measurement procedure to test for auditory-temporal processing in healthy young and elderly adults, which in a further step can be applied to patients with aphasia.The tasks varied according to adaptive procedures (staircase vs. maximum-likelihood), stimuli (tones vs. clicks) and stimulation modes (binaural- vs. alternating monaural) respectively. A phoneme-discrimination task was also employed to assess the relationship between temporal and language processing.The results show that auditory temporal-order thresholds are stimulus dependent, age related, and influenced by gender. Furthermore, the cited relationship between temporal-order threshold and phoneme discrimination can only be confirmed for measurements with pairs of tones.Our results indicate, that different norms have to be established for different gender and age groups. Furthermore, temporal-order measurements with tones seem to be more suitable for clinical intervention studies than measurements with clicks, as they show higher re-test reliabilities, and only for measurements with tones an association with phoneme-discrimination abilities was found.",0 +https://doi.org/10.1037/0021-9010.92.2.297,Updating meta-analytic research findings: Bayesian approaches versus the medical model.,"The authors examine 3 methods of combining new studies into existing meta-analyses: (a) adding the new study or studies to the database and recalculating the meta-analysis (the medical model); (b) using the Bayesian procedure advocated by F. L. Schmidt and J. E. Hunter (1977) and F. L. Schmidt, J. E. Hunter, K. Pearlman, and G. S. Shane (1979) to update the meta-analysis; and (c) using the Bayesian methods advocated by these authors and M. T. Brannick (2001) and M. T. Brannick, S. M. Hall, and Y. Liu (2002) to estimate study-specific parameters. Method b was found to severely overweight new studies relative to the previous studies contained in the meta-analysis, and Method c was found to do the same while also requiring an assumption with a low prior probability of being correct, causing the method to violate Bayesian principles. The authors present an alternative Bayesian procedure that does not suffer from these drawbacks and yields meta-analytic results very similar to those obtained with the medical model. They recommend use of the medical model or this alternative Bayesian procedure.",0 +https://doi.org/10.1177/1094428107303155,Psychometric Accuracy and (the Continuing Need for) Quality Thinking in Meta-Analysis,"The four feature-topic articles advance the accuracy of meta-analytic techniques. As might be expected, most articles focus on more precise ways to aggregate all available relationships in a given topic domain. Such aggregation results in overall estimates of relationships and estimates conditional on particular moderators. However, scholars and practitioners can expect more than empirical aggregation from meta-analysis. Careful attention to underlying theory, application, and important methodological issues will result in clearer understanding and explanation. Using the situational judgment testing literature as an example, the current analysis suggests the need for much more upfront, reflective thinking about each meta-analytic study's purpose and how this thinking relates to the inclusion or choice of primary studies, analytic method, coding, and so on. For example, when the focus is on prediction, frequent use of concurrent designs may bias aggregated parameter estimates. Also, it is noted that methods and constructs continue to be confounded in the research literatures.",0 +,Giving up Linearity : Absorptive Capacity and Performance,"INTRODUCTION Absorptive capacity (ACAP) is defined as one of the firm's key learning processes with regard to identifying, assimilating, and exploiting knowledge from the environment (Cohen and Levinthal, 1989; Lane et al., 2006; Lane and Lubatkin, 1998). This process arises from the seminal work of Cohen and Levinthal (1989, 1990, and 1994) and enables firms to profit from external knowledge. ACAP has received broad attention in research as innovative capabilities have become more and more important in sustaining a competitive advantage (Bower and Christensen, 1995; Eisenhardt and Martin, 2000; Helfat, 2000; Li and Atuahene-Gima, 2001) and, particularly, as innovation from external sources is on the rise (Jansen et al., 2005; Zollo et al., 2002). Even though the construct of ACAP has been studied widely during the past two decades (Easterby-Smith et al., 2008; Lane et al., 2006), there have not been any findings yet on curvilinear relationships between ACAP and performance. The existing literature has provided considerable empirical work on ACAP and its relationship to innovation (Tsai, 2001), interorganizational learning (Lane and Lubatkin, 1998; Lane et al., 2001; Lichtenthaler, 2009), intra-organizational transfer of knowledge (Gupta et al., 2006; Szulanski, 1996), and firm performance (Lane et al., 2001; Lichtenthaler, 2009; Tsai, 2001). However, in its analysis of the relationship between ACAP and a second variable, current research has relied primarily on the assumption of linearity and has not taken into account the extent to which the variables are developed. Nevertheless, non-linear relationships could exist in many cases, e.g., when a dependent variable develops positively to a certain optimum with respect to an independent variable and then decreases after having reached this optimal point (Ahuja and Lampert, 2001; Tang et al., 2008). Curvilinear relationships between ACAP and a certain dependent variable could, for example, reflect decreasing or even negative marginal growth. Thus, by assuming a linear relationship, recent research may have neglected U-shaped or inverted U-shaped relationships and, therefore, may have led practitioners to nonoptimal resource allocations--maybe even to the point of decreasing marginal growth (Herold et al., 2006). To put it more concretely, as the development of ACAP requires resources, it would be entirely possible that the positive effects of ACAP do not outweigh their respective investments at a certain level of development. Although some scholars engaged in ACAP research have pointed out the possibility of meaningful curvilinear relationships (Lane et al., 2006; Lichtenthaler, 2009), no empirical studies of ACAP and performance have examined this phenomenon explicitly. This deficiency in the field of ACAP research is rooted in two causes. First, recent research on ACAP has usually built upon linear structural equation models (e.g., Flatten et al., 2009, 2011; Lichtenthaler, 2009; Jansen et al., 2005). However, even though these second-generation methods (e.g., Lisrel and PLS) offer a wide range of advantages (e.g., depiction of complex models, evaluation of models, capture of measurement errors) compared to the first generation (Fornell and Bookstein, 1982), curvilinear effects can be pictured in a limited way only (Lee et al., 2004). In the past, most researchers captured ACAP via research and development (RD Szulanski, 1996; Therin, 2007). Now that validated operationalizations of ACAP (Flatten et al., 2009; Lichtenthaler, 2009) have been published, a basis for further understanding ACAP and its effect on performance has been established. The purpose of this paper is to address the described research gap and to contribute to existing literature in the following way. …",0 +https://doi.org/10.3102/1076998611432173,Modeling Differential Item Functioning Using a Generalization of the Multiple-Group Bifactor Model,"The authors present a generalization of the multiple-group bifactor model that extends the classical bifactor model for categorical outcomes by relaxing the typical assumption of independence of the specific dimensions. In addition to the means and variances of all dimensions, the correlations among the specific dimensions are allowed to differ between groups. By including group-specific difficulty parameters, the model can be used to assess differential item functioning (DIF) for testlet-based tests. The model encompasses various item response models for polytomous data by allowing for different link functions, and it includes testlet and second-order models as special cases. Importantly, by assuming that the testlet dimensions are conditionally independent given the general dimension, the authors show, using a graphical model framework, that the integration over all latent variables can be carried out through a sequence of computations in two-dimensional subspaces, making full-information maximum likelihood estimation feasible for high-dimensional problems and large datasets. The importance of relaxing the orthogonality assumption and allowing for a different covariance structure of the dimensions for each group is demonstrated in the context of the assessment of DIF. Through a simulation study, it is shown that ignoring between-group differences in the structure of the multivariate latent space can result in substantially biased estimates of DIF.",0 +https://doi.org/10.1002/0470857005.ch1,Optimal Design in Educational Testing,,0 +https://doi.org/10.1037/1082-989x.12.3.298,Hierarchical modeling of sequential behavioral data: Examining complex association patterns in mediation models.,"This article presents new methods for modeling the strength of association between multiple behaviors in a behavioral sequence, particularly those involving substantively important interaction patterns. Modeling and identifying such interaction patterns becomes more complex when behaviors are assigned to more than two categories, as is the case for most observational research. The authors propose multilevel empirical Bayes methods to overcome the challenges inherent in such data. Furthermore, these methods allow the study of how variation in interaction patterns can mediate the effects of antecedents or intervention on distal outcomes. New procedures are developed to compare alternative mediation models and pinpoint which random effects operate as mediators. These models are then applied to observational data taken from a study of the behavioral interactions of 254 couples.",0 +https://doi.org/10.1016/j.ecolmodel.2012.08.024,Bayesian hierarchical modeling of Pacific geoduck growth increment data and climate indices,"Growth increment widths from hard structures of marine and freshwater fish and bivalve species are increasingly used to model growth and elucidate relationships with environmental variability. Fully characterizing the intrinsic age-related growth variation among individuals within and between populations, while estimating the extrinsic environmental effects simultaneously, can be challenging. Using the long-lived bivalve Pacific geoduck (Panopea generosa), we develop an integrated approach to analyze the relationship between growth increment data and climate indices using Bayesian hierarchical methods. Fitting models to growth increment data from multiple individuals over two sites, we examined different covariance structures related to random individual effects, long- and short-term environmental effects and unexplained errors. The best fitting hierarchical model accounted for a site-specific mean growth response, individual growth variability through random parameter effects, and site-specific error variances. Extrinsic environmental effects on growth were also significant and included a random year effect and the Pacific Decadal Oscillation (PDO) as a predictor of mean growth across both individuals and sites. Once intrinsic age-related growth was accounted for, PDO accounted for 18% to total variability in growth increment data; geoduck shell size was predicted to increase as a function of larger PDO anomalies. However, the greatest variability in growth increment data was explained by random year effects (∼60–70%), and while largely unexplained, sea surface temperature (SST) is a likely determinant on geoduck growth rates showing a positive growth–SST response.",0 +https://doi.org/10.1016/j.jecp.2014.02.001,Explaining numeracy development in weak performing kindergartners,"• 990 Children were screened for weak early numeracy at the start of kindergarten. • Early numeracy development was monitored at four points throughout kindergarten. • Growth was predicted by several predictors together in one multilevel model. • Math language is underestimated as important factor in numeracy development. Gaining better insight into precursors of early numeracy in young children is important, especially in those with inadequate numeracy skills. Therefore, in the current study, visual and verbal working memory, non-symbolic and symbolic comparison skills, and specific math-related language were used to explain early numeracy performance and development of weak performing children throughout kindergarten. The early numeracy ability of both weak performers and typical performers was measured at four time points during 2 years of kindergarten to compare growth rates. Results show a significant faster development of early numeracy in the weak performers. The development of weak performers’ numeracy was influenced by verbal working memory, symbolic comparison skills, and math language, whereas only math language was positively related to the slope of typical performers’ numeracy. In the weak performers, visual working memory, non-symbolic comparison skills, and math language showed an effect on the initial early numeracy level of these children. The intercept of the typical performers was predicted by five covariates, all except non-symbolic comparison.",0 +https://doi.org/10.1177/0022022113492892,Cultural Variation in the Minimal Group Effect,"The minimal group effect (MGE) is one of the most robust psychological findings in studies of intergroup conflict, yet there is little evidence comparing its magnitude across cultures. Recent evidence suggests that the MGE is due in part to a projection of one’s own perceived characteristics onto the novel in-group. Because of cultural variability in self-enhancement motivations, we thus expected that those from East Asian cultures would exhibit a diminished MGE relative to Westerners. A large and diverse sample of Japanese and American participants completed a traditional minimal group study. American participants were more likely to show an in-group bias in group identification, perceived group intelligence, perceived group personality traits, and resource allocation. Furthermore, these cultural differences were partially mediated by self-esteem. We discuss the implication of these findings for theories of intergroup conflict and suggest multiple directions for future cross-cultural research on the MGE.",0 +https://doi.org/10.1016/j.artmed.2012.12.007,Multilevel Bayesian networks for the analysis of hierarchical health care data,"Large health care datasets normally have a hierarchical structure, in terms of levels, as the data have been obtained from different practices, hospitals, or regions. Multilevel regression is the technique commonly used to deal with such multilevel data. However, for the statistical analysis of interactions between entities from a domain, multilevel regression yields little to no insight. While Bayesian networks have proved to be useful for analysis of interactions, they do not have the capability to deal with hierarchical data. In this paper, we describe a new formalism, which we call multilevel Bayesian networks; its effectiveness for the analysis of hierarchically structured health care data is studied from the perspective of multimorbidity.Multilevel Bayesian networks are formally defined and applied to analyze clinical data from family practices in The Netherlands with the aim to predict interactions between heart failure and diabetes mellitus. We compare the results obtained with multilevel regression.The results obtained by multilevel Bayesian networks closely resembled those obtained by multilevel regression. For both diseases, the area under the curve of the prediction model improved, and the net reclassification improvements were significantly positive. In addition, the models offered considerable more insight, through its internal structure, into the interactions between the diseases.Multilevel Bayesian networks offer a suitable alternative to multilevel regression when analyzing hierarchical health care data. They provide more insight into the interactions between multiple diseases. Moreover, a multilevel Bayesian network model can be used for the prediction of the occurrence of multiple diseases, even when some of the predictors are unknown, which is typically the case in medicine.",0 +https://doi.org/10.1093/arclin/acv033,The Mediating Role of Visuospatial Planning Skills on Adaptive Function Among Young–Adult Survivors of Childhood Brain Tumor,"The Boston Qualitative Scoring System (BQSS) was used as a method to examine executive skills on the Rey-Osterrieth complex figure (ROCF). Young-adult survivors of childhood brain tumor (N = 31) and a demographically-matched comparison group (N = 33) completed the ROCF copy version and Grooved Pegboard, and informants were administered the Scales of Independent Behavior-Revised (SIB-R) and Behavior Rating Inventory of Executive Function (BRIEF). Survivors had significantly lower BQSS planning and SIB-R community living skills and greater perseveration. Mediation analyses found that BQSS planning skills mediate the relationship between group and community living skills. Convergent findings of the BRIEF Planning, and discriminant findings with the BQSS Fragmentation, BRIEF Emotional Control, and Grooved Pegboard support the planning construct as the specific mediator in this model. Together, these findings highlight the role of planning skills in adaptive functions of young-adult survivors of childhood brain tumor.",0 +https://doi.org/10.17485/ijst/2015/v8i15/70774,An Empirical Study to Develop a Decision Support System (DSS) for Measuring the Impact of Quality Measurements over Agile Software Development (ASD),"Background/Objectives: Primarily, this quantitative research aims to study the impact of integrating quality measurements with ASD, quantify it, and develop a DSS for predicting its outcome. Methods/Statistical Analysis: Included within a survey, the population sample is represented by project managers, who were divided into two independent groups: The first one adopts an explicit quality measurement framework while the second group does not apply quality measurements. After that, the researcher tested both groups in an independent samples t-test, and analysed results statistically. After experimenting different machine learning models, the researcher developed a DSS based on Linear Regression. Findings: Only 150 responded out of 200 respondents. The research dataset passed the “independent t-test” validity test with the fulfilment of the six assumptions. After conducting the independent t-test design, the researcher found that the value of Sig. (2-tailed) is less than .05, which means that the differences between the experimented groups are statistically significant. After that, the researcher utilized WEKA experimenter with 10-folds cross validation to test the dataset fitness with four different machine learning algorithms, which are Linear Regression (base), Multilayer Perceptron, KStar, and Decision Stump. The results showed that Linear Regression (base) provides better fitness with the dataset. Moreover, The R Square for it is .836. Based on Linear Regression, the researcher developed web and windows version of the DSS using VB.NET. In summary, research results shows that there is empirical evidence to support the proposition that quality measurements integration with ASD presents a strategic value to organizations. The contribution of these findings is materialized in its empirical nature and the scariness of research in this domain. Application/Improvements: Henceforward, the researcher are planning to expand the population sample, publishing the developed DSS online with integrated feedback, and developing other DSSs for supporting integrating quality measurements with ASD.",0 +https://doi.org/10.1080/16506073.2010.520731,Intraclass Correlation Associated with Therapists: Estimates and Applications in Planning Psychotherapy Research,"It is essential that outcome research permit clear conclusions to be drawn about the efficacy of interventions. The common practice of nesting therapists within conditions can pose important methodological challenges that affect interpretation, particularly if the study is not powered to account for the nested design. An obstacle to the optimal design of these studies is the lack of data about the intraclass correlation coefficient (ICC), which measures the statistical dependencies introduced by nesting. To begin the development of a public database of ICC estimates, the authors investigated ICCs for a variety outcomes reported in 20 psychotherapy outcome studies. The magnitude of the 495 ICC estimates varied widely across measures and studies. The authors provide recommendations regarding how to select and aggregate ICC estimates for power calculations and show how researchers can use ICC estimates to choose the number of patients and therapists that will optimize power. Attention to these recommendations will strengthen the validity of inferences drawn from psychotherapy studies that nest therapists within conditions.",0 +https://doi.org/10.1016/j.jval.2011.01.011,Conducting Indirect-Treatment-Comparison and Network-Meta-Analysis Studies: Report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices: Part 2,"Evidence-based health care decision making requires comparison of all relevant competing interventions. In the absence of randomized controlled trials involving a direct comparison of all treatments of interest, indirect treatment comparisons and network meta-analysis provide useful evidence for judiciously selecting the best treatment(s). Mixed treatment comparisons, a special case of network meta-analysis, combine direct evidence and indirect evidence for particular pairwise comparisons, thereby synthesizing a greater share of the available evidence than traditional meta-analysis. This report from the International Society for Pharmacoeconomics and Outcomes Research Indirect Treatment Comparisons Good Research Practices Task Force provides guidance on technical aspects of conducting network meta-analyses (our use of this term includes most methods that involve meta-analysis in the context of a network of evidence). We start with a discussion of strategies for developing networks of evidence. Next we briefly review assumptions of network meta-analysis. Then we focus on the statistical analysis of the data: objectives, models (fixed-effects and random-effects), frequentist versus Bayesian approaches, and model validation. A checklist highlights key components of network meta-analysis, and substantial examples illustrate indirect treatment comparisons (both frequentist and Bayesian approaches) and network meta-analysis. A further section discusses eight key areas for future research.",0 +https://doi.org/10.1207/s15328007sem0802_2,Piecewise Growth Mixture Modeling of Adolescent Alcohol Use Data,"This article addresses issues of heterogeneity in multiple-stage development as it corresponds to qualitatively different development in alcohol use during adolescence. Using a piecewise growth mixture modeling methodology proposed by Muthen (in press), a 2-piece linear growth model capturing growth trajectories in adolescent alcohol use during the transition from middle school (ages 11 to 13) to high school (ages 14 to 17; N = 81) was examined. It was hypothesized that 2 stages of alcohol use development with varying trajectories would exist in these data, the 1st corresponding to development during middle school (Growth Rate 1), followed by a 2nd stage of continuing growth during high school (Growth Rate 2). Results suggested the tenability of the 2-piece linear development in alcohol use and the emergence of 2 latent classes with individually varying transition points. Class 1 showed linear increases only during high school, whereas Class 2 showed a continued, linear growth throughout the middle and hi...",0 +https://doi.org/10.1007/bf02295640,Higher-order latent trait models for cognitive diagnosis,"Higher-order latent traits are proposed for specifying the joint distribution of binary attributes in models for cognitive diagnosis. This approach results in a parsimonious model for the joint distribution of a high-dimensional attribute vector that is natural in many situations when specific cognitive information is sought but a less informative item response model would be a reasonable alternative. This approach stems from viewing the attributes as the specific knowledge required for examination performance, and modeling these attributes as arising from a broadly-defined latent trait resembling theϑ of item response models. In this way a relatively simple model for the joint distribution of the attributes results, which is based on a plausible model for the relationship between general aptitude and specific knowledge. Markov chain Monte Carlo algorithms for parameter estimation are given for selected response distributions, and simulation results are presented to examine the performance of the algorithm as well as the sensitivity of classification to model misspecification. An analysis of fraction subtraction data is provided as an example.",0 +https://doi.org/10.2307/1421337,The Measurement and Prediction of Judgment and Choice,,0 +https://doi.org/10.1037/tra0000096,Applying Bayesian statistics to the study of psychological trauma: A suggestion for future research.,"Several contemporary researchers have noted the virtues of Bayesian methods of data analysis. Although debates continue about whether conventional or Bayesian statistics is the ""better"" approach for researchers in general, there are reasons why Bayesian methods may be well suited to the study of psychological trauma in particular. This article describes how Bayesian statistics offers practical solutions to the problems of data non-normality, small sample size, and missing data common in research on psychological trauma.After a discussion of these problems and the effects they have on trauma research, this article explains the basic philosophical and statistical foundations of Bayesian statistics and how it provides solutions to these problems using an applied example.Results of the literature review and the accompanying example indicates the utility of Bayesian statistics in addressing problems common in trauma research.Bayesian statistics provides a set of methodological tools and a broader philosophical framework that is useful for trauma researchers. Methodological resources are also provided so that interested readers can learn more.",0 +https://doi.org/10.1214/ss/1177011136,Inference from Iterative Simulation Using Multiple Sequences,"The Gibbs sampler, the algorithm of Metropolis and similar iterative simulation methods are potentially very helpful for summarizing multivariate distributions. Used naively, however, iterative simulation can give misleading answers. Our methods are simple and generally applicable to the output of any iterative simulation; they are designed for researchers primarily interested in the science underlying the data and models they are analyzing, rather than for researchers interested in the probability theory underlying the iterative simulations themselves. Our recommended strategy is to use several independent sequences, with starting points sampled from an overdispersed distribution. At each step of the iterative simulation, we obtain, for each univariate estimand of interest, a distributional estimate and an estimate of how much sharper the distributional estimate might become if the simulations were continued indefinitely. Because our focus is on applied inference for Bayesian posterior distributions in real problems, which often tend toward normality after transformations and marginalization, we derive our results as normal-theory approximations to exact Bayesian inference, conditional on the observed simulations. The methods are illustrated on a random-effects mixture model applied to experimental measurements of reaction times of normal and schizophrenic patients.",0 +https://doi.org/10.1016/j.cognition.2015.10.005,Organization principles in visual working memory: Evidence from sequential stimulus display,"Although the mechanisms of visual working memory (VWM) have been studied extensively in recent years, the active property of VWM has received less attention. In the current study, we examined how VWM integrates sequentially presented stimuli by focusing on the role of Gestalt principles, which are important organizing principles in perceptual integration. We manipulated the level of Gestalt cues among three or four sequentially presented objects that were memorized. The Gestalt principle could not emerge unless all the objects appeared together. We distinguished two hypotheses: a perception-alike hypothesis and an encoding-specificity hypothesis. The former predicts that the Gestalt cue will play a role in information integration within VWM; the latter predicts that the Gestalt cue will not operate within VWM. In four experiments, we demonstrated that collinearity (Experiment 1) and closure (Experiment 2) cues significantly improved VWM performance, and this facilitation was not affected by the testing manner (Experiment 3) or by adding extra colors to the memorized objects (Experiment 4). Finally, we re-established the Gestalt cue benefit with similarity cues (Experiment 5). These findings together suggest that VWM realizes and uses potential Gestalt principles within the stored representations, supporting a perception-alike hypothesis.",0 +https://doi.org/10.1163/156856897x00159,Efficient estimation of sensory thresholds with ML-PEST,"A set of C and C+2 routines are described that allow the efficient estimation of sensory thresholds in psychophysical experiments using a maximum-likelihood staircase procedure. They have been used effectively in visual, auditory, gustatory, and olfactory psychophysics.",0 +https://doi.org/10.1287/mksc.1040.0088,Dynamic Models Incorporating Individual Heterogeneity: Utility Evolution in Conjoint Analysis,"It has been shown in the behavioral decision making, marketing research, and psychometric literature that the structure underlying preferences can change during the administration of repeated measurements (e.g., conjoint analysis) and data collection because of effects from learning, fatigue, boredom, and so on. In this research note, we propose a new class of hierarchical dynamic Bayesian models for capturing such dynamic effects in conjoint applications, which extend the standard hierarchical Bayesian random effects and existing dynamic Bayesian models by allowing for individual-level heterogeneity around an aggregate dynamic trend. Using simulated conjoint data, we explore the performance of these new dynamic models, incorporating individual-level heterogeneity across a number of possible types of dynamic effects, and demonstrate the derived benefits versus static models. In addition, we introduce the idea of an unbiased dynamic estimate, and demonstrate that using a counterbalanced design is important from an estimation perspective when parameter dynamics are present.",0 +https://doi.org/10.1198/jasa.2010.tm09757,Estimability and Likelihood Inference for Generalized Linear Mixed Models Using Data Cloning,"Maximum likelihood estimation for Generalized Linear Mixed Models (GLMM), an important class of statistical models with substantial applications in epidemiology, medical statistics, and many other fields, poses significant computational difficulties. In this article, we use data cloning, a simple computational method that exploits advances in Bayesian computation, in particular the Markov Chain Monte Carlo method, to obtain maximum likelihood estimators of the parameters in these models. This method also leads to a simple estimator of the asymptotic variance of the maximum likelihood estimators. Determining estimability of the parameters in a mixed model is, in general, a very difficult problem. Data cloning provides a simple graphical test to not only check if the full set of parameters is estimable but also, and perhaps more importantly, if a specified function of the parameters is estimable. One of the goals of mixed models is to predict random effects. We suggest a frequentist method to obtain predict...",0 +,R2WinBUGS: A Package for Running WinBUGS from R,"The R2WinBUGS package provides convenient functions to call WinBUGS from R. It automatically writes the data and scripts in a format readable by WinBUGS for processing in batch mode, which is possible since version 1.4. After the WinBUGS process has finished, it is possible either to read the resulting data into R by the package itself-which gives a compact graphical summary of inference and convergence diagnostics-or to use the facilities of the coda package for further analyses of the output. Examples are given to demonstrate the usage of this package.",0 +https://doi.org/10.1348/000711008x292343,Non-linear structural equation models with correlated continuous and discrete data,"Structural equation models (SEMs) have been widely applied to examine interrelationships among latent and observed variables in social and psychological research. Motivated by the fact that correlated discrete variables are frequently encountered in practical applications, a non-linear SEM that accommodates covariates, and mixed continuous, ordered, and unordered categorical variables is proposed. Maximum likelihood methods for estimation and model comparison are discussed. One real-life data set about cardiovascular disease is used to illustrate the methodologies.",0 +https://doi.org/10.1016/j.stamet.2012.08.003,Bayesian predictive inference of a finite population proportion under selection bias,"Abstract We show how to infer about a finite population proportion using data from a possibly biased sample. In the absence of any selection bias or survey weights, a simple ignorable selection model, which assumes that the binary responses are independent and identically distributed Bernoulli random variables, is not unreasonable. However, this ignorable selection model is inappropriate when there is a selection bias in the sample. We assume that the survey weights (or their reciprocals which we call ‘selection’ probabilities) are available, but there is no simple relation between the binary responses and the selection probabilities. To capture the selection bias, we assume that there is some correlation between the binary responses and the selection probabilities (e.g., there may be a somewhat higher/lower proportion of positive responses among the sampled units than among the nonsampled units). We use a Bayesian nonignorable selection model to accommodate the selection mechanism. We use Markov chain Monte Carlo methods to fit the nonignorable selection model. We illustrate our method using numerical examples obtained from NHIS 1995 data.",0 +https://doi.org/10.1002/cjs.5550340302,Conservative prior distributions for variance parameters in hierarchical models,"Bayesian hierarchical models typically involve specifying prior distributions for one or more variance components. This is rather removed from the observed data, so specification based on expert knowledge can be difficult. While there are suggestions for default priors in the literature, often a condi tionally conjugate inverse-gamma specification is used, despite documented drawbacks of this choice. The authors suggest conservative prior distributions for variance components, which deliberately give more weight to smaller values. These are appropriate for investigators who are skeptical about the presence of variability in the second-stage parameters (random effects) and want to particularly guard against inferring more structure than is really present. The suggested priors readily adapt to various hierarchical modelling settings, such as fitting smooth curves, modelling spatial variation and combining data from multiple sites. Lois a priori pour les parametres de variance de modeles hierarchiques Rgsum6: Les modeles bay6siens hierarchiques comportent g6n6ralement une ou des composantes de va riance que l'on doit doter de lois a priori. Le choix de ces lois est delicat car la variation est un aspect des donn6es difficile a cemer. De toutes les lois a priori par defaut, une loi conjuguee inverse-gamma con ditionnelle est la plus souvent employ6e, malgr6 ses inconvenients. Les auteurs proposent des lois a priori conservatrices pour les composantes de la variance qui privilegient les petites valeurs. Elles conviennent bien aux situations oiu le chercheur s'interroge sur la presence r6elle de variabilit6 dans les parametres de deuxieme degre (effets aleatoires) et qu'il veut eviter d'imposer une structure artificielle. Les lois a priori sugg6rdes s'adaptent A diverses situations propices a la mod6lisation hierarchique, notamment l'ajustement de courbes lisses et la modelisation de variation spatiale ou de donn6es issues de nombreux sites.",0 +https://doi.org/10.1007/s10071-012-0582-y,The psychophysics of sugar concentration discrimination and contrast evaluation in bumblebees,"The capacity to discriminate between choice options is crucial for a decision-maker to avoid unprofitable options. The physical properties of rewards are presumed to be represented on context-dependent, nonlinear cognitive scales that may systematically influence reward expectation and thus choice behavior. In this study, we investigated the discrimination performance of free-flying bumblebee workers (Bombus impatiens) in a choice between sucrose solutions with different concentrations. We conducted two-alternative free choice experiments on two B. impatiens colonies containing some electronically tagged bumblebees foraging at an array of computer-automated artificial flowers that recorded individual choices. We mimicked natural foraging conditions by allowing uncertainty in the probability of reward delivery while maintaining certainty in reward concentration. We used a Bayesian approach to fit psychometric functions, relating the strength of preference for the higher concentration option to the relative intensity of the presented stimuli. Psychometric analysis was performed on visitation data from individually marked bumblebees and pooled data from unmarked individuals. Bumblebees preferred the more concentrated sugar solutions at high stimulus intensities and showed no preference at low stimulus intensities. The obtained psychometric function is consistent with reward evaluation based on perceived concentration contrast between choices. We found no evidence that bumblebees reduce reward expectations upon experiencing non-rewarded visits. We compare psychometric function parameters between the bumblebee B. impatiens and the flower bat Glossophaga commissarisi and discuss the relevance of psychophysics for pollinator-exerted selection pressures on plants.",0 +https://doi.org/10.1111/1467-9892.00222,A Hierarchical Approach to Covariance Function Estimation for Time Series,"The covariance function in time series models is typically modelled via a parametric family. This ensures straightforward best linear prediction while maintaining positive-definiteness of the covariance function. We suggest an alternative approach, which will result in data-determined shrinkage towards this parametric model. Positive-definiteness is maintained by carrying out the shrinkage in the spectral domain. We offer both a fully Bayesian hierarchical approach and an approximate hierarchical approach that will be much simpler computationally. These are implemented on the frequently analysed Canadian lynx data and compared to other models that have been fitted to these data.",0 +https://doi.org/10.1016/j.cognition.2011.11.014,Temporal expectation and information processing: A model-based analysis,"People are able to use temporal cues to anticipate the timing of an event, enabling them to process that event more efficiently. We conducted two experiments, using the fixed-foreperiod paradigm (Experiment 1) and the temporal-cueing paradigm (Experiment 2), to assess which components of information processing are speeded when subjects use such temporal cues to predict the onset of a target stimulus. We analyzed the observed temporal expectation effects on task performance using sequential-sampling models of decision making: the Ratcliff diffusion model and the shifted-Wald model. The results from the two experiments were consistent: temporal expectation affected the duration of nondecision processes (target encoding and/or response preparation) but had little effect on the two main components of the decision process: response-threshold setting and the rate of evidence accumulation. Our findings provide novel evidence about the psychological processes underlying temporal-expectation effects on reaction time.",0 +https://doi.org/10.1007/bf01065485,Latent variable growth within behavior genetic models,"The purpose of this paper is to introduce one kind of latent-variable structural-equation model for multivariate longitudinal data which includes behavioral genetic components. A generic structural-equation model termed RAM (McArdle, J. J. and McDonald, R. P. (1984). Br. J. Math. Stat. Psychol., 37:239-251.) is used to define the univariate twin design, including both covariances and means. This model is extended to multivariate form using a latent-variable growth-curve model recently presented by W. Meredith and J. Tisak [(1984). ""Tuckerizing"" curves. Psychometric Society Annual Meetings]. The model presented herein further permits hypothesis testing of various biometric models of the sources of these individual differences in latent growth. Aspects of this model are illustrated using the LISREL algorithm [Jöreskog, K. G. and Sörbom, D. (1979). Advances in Factor Analysis and Structural Equation Models, Abt Books, Cambridge, Mass.] and longitudinal twin data on early childhood abilities [Wilson, R. S. (1983). Child Dev.54:298-316]. © 1986 Plenum Publishing Corporation.",0 +https://doi.org/10.1007/s11135-007-9133-z,Evaluating estimation methods for ordinal data in structural equation modeling,"This study examined the performance of two alternative estimation approaches in structural equation modeling for ordinal data under different levels of model misspecification, score skewness, sample size, and model size. Both approaches involve analyzing a polychoric correlation matrix as well as adjusting standard error estimates and model chi-squared, but one estimates model parameters with maximum likelihood and the other with robust weighted least-squared. Relative bias in parameter estimates and standard error estimates, Type I error rate, and empirical power of the model test, where appropriate, were evaluated through Monte Carlo simulations. These alternative approaches generally provided unbiased parameter estimates when the model was correctly specified. They also provided unbiased standard error estimates and adequate Type I error control in general unless sample size was small and the measured variables were moderately skewed. Differences between the methods in convergence problems and the evaluation criteria, especially under small sample and skewed variable conditions, were discussed. © 2007 Springer Science + Business Media B.V.",0 +https://doi.org/10.1111/j.1745-3984.2008.00063.x,An Odds Ratio Approach for Assessing Differential Distractor Functioning Effects under the Nominal Response Model,"Investigations of differential distractor functioning (DDF) can provide valuable information concerning the location and possible causes of measurement invariance within a multiple-choice item. In this article, I propose an odds ratio estimator of the DDF effect as modeled under the nominal response model. In addition, I propose a simultaneous distractor-level (SDL) test of invariance based on the results of the distractor-level tests of DDF. The results of a simulation study indicated that the DDF effect estimator maintained good statistical properties under a variety of conditions, and the SDL test displayed substantially higher power than the traditional Mantel-Haenszel test of no DIF when the DDF effect varied in magnitude and/or size across the distractors.",0 +https://doi.org/10.1016/j.fishres.2014.02.036,Accounting for vessel effects when standardizing catch rates from cooperative surveys,"Interpretation of fishery-dependent and independent-survey data requires accounting for changes in the proportion of local individuals that are caught by fishing gear (“catchability”). Catchability may be influenced by measured characteristics of fishing gear, and even standardized fishing techniques may experience changing catchability over time due to changes in fishing vessel characteristics and personnel. The importance of vessel power has long been recognized in the analysis of fishery dependent catch per unit effort data, but less-studied in the analysis of fishery independent data collected by research vessel surveys. Here we demonstrate how differences in catchability among vessels (“vessel effects”), as well as random variation in vessel-specific catchability over time (“vessel-year effects”) can be incorporated into generalized linear mixed models through their treatment as random effects. We apply these methods to data for 28 groundfish species caught in a standardized survey using contracted fishery vessels and personnel in the Northeast Pacific. Model selection shows that vessel, vessel-year, and both effects simultaneously are supported by available data for at least a few species. However, vessel-year effects generally have a larger effect on catch rates than vessel-effects and hence abundance indices estimated using both vessel- and vessel-year effects are generally similar to estimates when using just vessel-year effects. Additionally, models indicate little support for the hypothesis that characteristics such as length and displacement of the contracted vessels used in this survey have a substantial impact on catch rates. Finally, inclusion of vessel- or vessel-year effects generally results in wider estimates of credible intervals for resulting indices of abundance. This increased credible interval width is consistent with statistical theory, because vessel effects will result in non-independence of different sampling occasions, thus decreasing effective sample sizes. For this reason, we advocate that future analyses include vessel- and/or vessel-year effects when standardizing survey data from cooperative research programs.",0 +https://doi.org/10.1177/0146621610367788,A Procedure for Controlling General Test Overlap in Computerized Adaptive Testing,"To date, exposure control procedures that are designed to control test overlap in computerized adaptive tests (CATs) are based on the assumption of item sharing between pairs of examinees. However, in practice, examinees may obtain test information from more than one previous test taker. This larger scope of information sharing needs to be considered in conducting test overlap control. The purpose of this study is to propose a test overlap control method such that the proportion of overlapping items encountered by an examinee with a group of previous examinees (described as general test overlap rate) can be controlled. Results indicated that item exposure rate and general test overlap rate could be simultaneously controlled by implementing the procedure. In addition, these two indices were controlled on the fly without any iterative simulations conducted prior to operational CATs. Thus, the proposed procedure would be an efficient method for controlling both the item exposure and general test overlap in CATs.",0 +https://doi.org/10.1002/9780470998137,Semiparametric Regression for the Social Sciences,List of Tables. List of Figures. Preface. 1 Introduction: Global versus Local Statistics. 1.1 The Consequences of Ignoring Nonlinearity. 1.2 Power Transformations. 1.3 Nonparametric and Semiparametric Techniques. 1.4 Outline of the Text. 2 Smoothing and Local Regression. 2.1 Simple Smoothing. 2.1.1 Local Averaging. 2.1.2 Kernel Smoothing. 2.2 Local Polynomial Regression. 2.3 Nonparametric Modeling Choices. 2.3.1 The Span. 2.3.2 Polynomial Degree and Weight Function. 2.3.3 A Note on Interpretation. 2.4 Statistical Inference for Local Polynomial Regression. 2.5 Multiple Nonparametric Regression. 2.6 Conclusion. 2.7 Exercises. 3 Splines. 3.1 Simple Regression Splines. 3.1.1 Basis Functions. 3.2 Other Spline Models and Bases. 3.2.1 Quadratic and Cubic Spline Bases. 3.2.2 Natural Splines. 3.2.3 B-splines. 3.2.4 Knot Placement and Numbers. 3.2.5 Comparing Spline Models. 3.3 Splines and Overfitting. 3.3.1 Smoothing Splines. 3.3.2 Splines as Mixed Models. 3.3.3 Final Notes on Smoothing Splines. 3.3.4 Thin Plate Splines. 3.4 Inference for Splines. 3.5 Comparisons and Conclusions. 3.6 Exercises. 4 Automated Smoothing Techniques. 4.1 Span by Cross-Validation. 4.2 Splines and Automated Smoothing. 4.2.1 Estimating Smoothing Through the Likelihood. 4.2.2 Smoothing Splines and Cross-Validation. 4.3 Automated Smoothing in Practice. 4.4 Automated Smoothing Caveats. 4.5 Exercises. 5 Additive and Semiparametric Regression Models. 5.1 Additive Models. 5.2 Semiparametric Regression Models. 5.3 Estimation. 5.3.1 Backfitting. 5.4 Inference. 5.5 Examples. 5.5.1 Congressional Elections. 5.5.2 Feminist Attitudes. 5.6 Discussion. 5.7 Exercises. 6 Generalized Additive Models. 6.1 Generalized Linear Models. 6.2 Estimation of GAMS. 6.3 Statistical Inference. 6.4 Examples. 6.4.1 Logistic Regression: The Liberal Peace. 6.4.2 Ordered Logit: Domestic Violence. 6.4.3 Count Models: Supreme Court Overrides. 6.4.4 Survival Models: Race Riots. 6.5 Discussion. 6.6 Exercises. 7 Extensions of the Semiparametric Regression Model. 7.1 Mixed Models. 7.2 Bayesian Smoothing. 7.3 Propensity Score Matching. 7.4 Conclusion. 8 Bootstrapping. 8.1 Classical Inference. 8.2 Bootstrapping - An Overview. 8.2.1 Bootstrapping. 8.2.2 An Example: Bootstrapping the Mean. 8.2.3 Bootstrapping Regression Models. 8.2.4 An Example: Presidential Elections. 8.3 Bootstrapping Nonparametric and Semiparametric Regression Models. 8.3.1 Bootstrapping Nonparametric Fits. 8.3.2 Bootstrapping Nonlinearity Tests. 8.4 Conclusion. 8.5 Exercises. 9 Epilogue. Appendix: Software. Bibliography. Author Index. Subject Index.,0 +,R functions for quantifying nonindependence in standard dyadic and SRM designs,"Interdependence is the main feature of dyadic relationships and, in recent years, various statistical procedures have been proposed for quantifying and testing this social attribute in different dyadic designs. The purpose of this paper is to develop several functions for this kind of statistical tests in an R package, known as nonindependence, for use by applied social researchers. A Graphical User Interface (GUI) is also developed to facilitate the use of the functions included in this package. Examples drawn from psychological research and simulated data are used to illustrate how the software works.",0 +https://doi.org/10.1111/j.2517-6161.1996.tb02105.x,Hierarchical Generalized Linear Models,"We consider hierarchical generalized linear models which allow extra error components in the linear predictors of generalized linear models. The distribution of these components is not restricted to be normal; this allows a broader class of models, which includes generalized linear mixed models. We use a generalization of Henderson's joint likelihood, called a hierarchical or h-likelihood, for inferences from hierarchical generalized linear models. This avoids the integration that is necessary when marginal likelihood is used. Under appropriate conditions maximizing the h-likelihood gives fixed effect estimators that are asymptotically equivalent to those obtained from the use of marginal likelihood; at the same time we obtain the random effect estimates that are asymptotically best unbiased predictors. An adjusted profile h-likelihood is shown to give the required generalization of restricted maximum likelihood for the estimation of dispersion components. A scaled deviance test for the goodness of fit, a model selection criterion for choosing between various dispersion models and a graphical method for checking the distributional assumption of random effects are proposed. The ideas of quasi-likelihood and extended quasi-likelihood are generalized to the new class. We give examples of the Poisson-gamma, binomial-beta and gamma-inverse gamma hierarchical generalized linear models. A resolution is proposed for the apparent difference between population-averaged and subject-specific models. A unified framework is provided for viewing and extending many existing methods.",0 +https://doi.org/10.4324/9781410601858-10,Bayesian Structural Equation Models for Multilevel Data,,0 +https://doi.org/10.1177/0143624414566244,"Is CO2 a good proxy for indoor air quality in classrooms? Part 1: The interrelationships between thermal conditions, CO2 levels, ventilation rates and selected indoor pollutants","Current indoor air quality (IAQ) guidelines in school buildings are framed around thermal conditions, carbon dioxide (CO 2 ) levels and corresponding ventilation rates without considering specific indoor pollution levels. Drawing on detailed monitoring data from a sample of 18 classrooms from six London schools, the aim of this paper is to highlight behavioural and environmental factors that affect pollution levels in classrooms, and evaluate the adequacy of CO 2 as an overall predictor for IAQ using multilevel modelling. Together with elimination of indoor emission sources, keeping the temperatures below 26℃, and preferably below 22℃ depending on season, may limit total volatile organic compounds below thresholds associated with sensory irritations. The models suggested that after removing dust reservoirs from the classrooms, lowering average indoor CO 2 levels below 1000 ppm by increasing ventilation rates can limit indoor airborne particulate matter concentrations below recommended annual WHO 2010 guidelines. Uncontrolled infiltration rates may increase indoor NO 2 levels and microbial counts of fungal and bacterial groups, whose presence is associated with wet and moist materials. Overall, indoor CO 2 levels were a useful proxy for indoor investigations as they can prevent overheating, dilute pollutants with indoor sources and purge concentrations of airborne particles; however, they were a poor predictor of traffic related pollutants. Practical implications of the findings on the UK policy and building design industry are discussed. Practical application: Driven by the growing population, and many years of intensive use, the UK building stock is in need of rapid expanding, extensive refurbishment and maintenance. However, local authorities lack the money for comprehensive and specialist renovations. The recommendations presented in this paper take into account specific needs and possibilities, and target building designers, engineers and occupants involved with daily operation and management of school buildings. Timely control of ventilation and heating systems, informed selection of construction materials, interior finishing and elimination of indoor sources may improve IAQ of school classrooms.",0 +https://doi.org/10.1214/009053605000000075,Posterior propriety and admissibility of hyperpriors in normal hierarchical models,"Hierarchical modeling is wonderful and here to stay, but hyperparameter priors are often chosen in a casual fashion. Unfortunately, as the number of hyperparameters grows, the effects of casual choices can multiply, leading to considerably inferior performance. As an extreme, but not uncommon, example use of the wrong hyperparameter priors can even lead to impropriety of the posterior. For exchangeable hierarchical multivariate normal models, we first determine when a standard class of hierarchical priors results in proper or improper posteriors. We next determine which elements of this class lead to admissible estimators of the mean under quadratic loss; such considerations provide one useful guideline for choice among hierarchical priors. Finally, computational issues with the resulting posterior distributions are addressed.",0 +https://doi.org/10.1017/s0003055409090248,Who Wants To Revise Privatization? The Complementarity of Market Skills and Institutions,"Using survey data from 28 transition countries, we test for the complementarity and substitutability of market-relevant skills and institutions. We show that democracy and good governance complement market skills in transition economies. Under autocracy and weak governance institutions, there is no significant difference in support for revising privatization between high- and low-skilled respondents. As the level of democracy and the quality of governance increases, the difference in the level of support for revising privatization between the high and low skilled grows dramatically. This finding contributes to our understanding of microfoundations of the politics of economic reform.",0 +https://doi.org/10.1504/ijstm.2007.013922,Random effect modelling using Bayesian methods,"Bayesian methods are increasingly used in a variety of academic disciplines, and important applications in ecology, medicine, management science, operations research and finance. The continued use of these methods depends on understanding the strengths and weaknesses of current Bayesian modelling practice. In this paper, we examine important implementation issues within the context of data analysis with statistical models which contain random effects or unmeasured heterogeneity. Random effect models provide an effective way to incorporate sources of variation not able to be modelled by covariate information, and these models lead naturally to Bayesian formulations using prior distributions for the variance components. We examine implications for specifying scale parameters in hierarchical models.",0 +https://doi.org/10.1093/biomet/82.4.711,Reversible jump Markov chain Monte Carlo computation and Bayesian model determination,"Markov chain Monte Carlo methods for Bayesian computation have until recently been restricted to problems where the joint distribution of all variables has a density with respect to some fixed standard underlying measure. They have therefore not been available for application to Bayesian model determination, where the dimensionality of the parameter vector is typically not fixed. This paper proposes a new framework for the construction of reversible Markov chain samplers that jump between parameter subspaces of differing dimensionality, which is flexible and entirely constructive. It should therefore have wide applicability in model determination problems. The methodology is illustrated with applications to multiple change-point analysis in one and two dimensions, and to a Bayesian comparison of binomial experiments.",0 +https://doi.org/10.1167/5.5.8,Bayesian inference for psychometric functions,"In psychophysical studies, the psychometric function is used to model the relation between physical stimulus intensity and the observer's ability to detect or discriminate between stimuli of different intensities. In this study, we propose the use of Bayesian inference to extract the information contained in experimental data to estimate the parameters of psychometric functions. Because Bayesian inference cannot be performed analytically, we describe how a Markov chain Monte Carlo method can be used to generate samples from the posterior distribution over parameters. These samples are used to estimate Bayesian confidence intervals and other characteristics of the posterior distribution. In addition, we discuss the parameterization of psychometric functions and the role of prior distributions in the analysis. The proposed approach is exemplified using artificially generated data and in a case study for real experimental data. Furthermore, we compare our approach with traditional methods based on maximum likelihood parameter estimation combined with bootstrap techniques for confidence interval estimation and find the Bayesian approach to be superior.",0 +https://doi.org/10.1007/s11336-006-1478-z,A Hierarchical Framework for Modeling Speed and Accuracy on Test Items,"Current modeling of response times on test items has been strongly influenced by the paradigm of experimental reaction-time research in psychology. For instance, some of the models have a parameter structure that was chosen to represent a speed-accuracy tradeoff, while others equate speed directly with response time. Also, several response-time models seem to be unclear as to the level of parametrization they represent. A hierarchical framework for modeling speed and accuracy on test items is presented as an alternative to these models. The framework allows a plug-and-play approach with alternative choices of models for the response and response-time distributions as well as the distributions of their parameters. Bayesian treatment of the framework with Markov chain Monte Carlo (MCMC) computation facilitates the approach. Use of the framework is illustrated for the choice of a normal-ogive response model, a lognormal model for the response times, and multivariate normal models for their parameters with Gibbs sampling from the joint posterior distribution.",0 +https://doi.org/10.1177/0962280210372453,A spatial beta-binomial model for clustered count data on dental caries,"One of the most important indicators of dental caries prevalence is the total count of decayed, missing or filled surfaces in a tooth. These count data are often clustered in nature (several count responses clustered within a subject), over-dispersed as well as spatially referenced (a diseased tooth might be positively influencing the decay process of a set of neighbouring teeth). In this article, we develop a multivariate spatial betabinomial (BB) model for these data that accommodates both over-dispersion as well as latent spatial associations. Using a Bayesian paradigm, the re-parameterised marginal mean (as well as variance) under the BB framework are modelled using a regression on subject/tooth-specific co-variables and a conditionally autoregressive prior that models the latent spatial process. The necessity of exploiting spatial associations to model count data arising in dental caries research is demonstrated using a small simulation study. Real data confirms that our spatial BB model provides a superior estimation and model fit as compared to other sub-models that do not consider modelling spatial associations.",0 +https://doi.org/10.1007/bf00143942,Simulation of truncated normal variables,We provide simulation algorithms for one-sided and two-sided truncated normal distributions. These algorithms are then used to simulate multivariate normal variables with convex restricted parameter space for any covariance structure.,0 +https://doi.org/10.1016/j.jsr.2013.03.003,Bayesian road safety analysis: Incorporation of past evidence and effect of hyper-prior choice,"This paper aims to address two related issues when applying hierarchical Bayesian models for road safety analysis, namely: (a) how to incorporate available information from previous studies or past experiences in the (hyper) prior distributions for model parameters and (b) what are the potential benefits of incorporating past evidence on the results of a road safety analysis when working with scarce accident data (i.e., when calibrating models with crash datasets characterized by a very low average number of accidents and a small number of sites).A simulation framework was developed to evaluate the performance of alternative hyper-priors including informative and non-informative Gamma, Pareto, as well as Uniform distributions. Based on this simulation framework, different data scenarios (i.e., number of observations and years of data) were defined and tested using crash data collected at 3-legged rural intersections in California and crash data collected for rural 4-lane highway segments in Texas.This study shows how the accuracy of model parameter estimates (inverse dispersion parameter) is considerably improved when incorporating past evidence, in particular when working with the small number of observations and crash data with low mean. The results also illustrates that when the sample size (more than 100 sites) and the number of years of crash data is relatively large, neither the incorporation of past experience nor the choice of the hyper-prior distribution may affect the final results of a traffic safety analysis.As a potential solution to the problem of low sample mean and small sample size, this paper suggests some practical guidance on how to incorporate past evidence into informative hyper-priors. By combining evidence from past studies and data available, the model parameter estimates can significantly be improved. The effect of prior choice seems to be less important on the hotspot identification.The results show the benefits of incorporating prior information when working with limited crash data in road safety studies.",0 +https://doi.org/10.1007/0-306-47531-6_9,Methods of Controlling the Exposure of Items in CAT,,0 +https://doi.org/10.1080/01621459.1984.10477102,Approximations for Standard Errors of Estimators of Fixed and Random Effects in Mixed Linear Models,"Abstract Best linear unbiased estimators of the fixed and random effects of mixed linear models are available when the true values of the variance ratios are known. If the true values are replaced by estimated values, the mean squared errors of the estimators of the fixed and random effects increase in size. The magnitude of this increase is investigated, and a general approximation is proposed. The performance of this approximation is investigated in the context of (a) the estimation of the effects of the balanced one-way random model and (b) the estimation of treatment contrasts for balanced incomplete block designs.",0 +https://doi.org/10.1214/aoms/1177730442,The Probability Function of the Product of Two Normally Distributed Variables,"Let $x$ and $y$ follow a normal bivariate probability function with means $\bar X, \bar Y$, standard deviations $\sigma_1, \sigma_2$, respectively, $r$ the coefficient of correlation, and $\rho_1 = \bar X/\sigma_1, \rho_2 = \bar Y/\sigma_2$. Professor C. C. Craig [1] has found the probability function of $z = xy/\sigma_1\sigma_2$ in closed form as the difference of two integrals. For purposes of numerical computation he has expanded this result in an infinite series involving powers of $z, \rho_1, \rho_2$, and Bessel functions of a certain type; in addition, he has determined the moments, semin-variants, and the moment generating function of $z$. However, for $\rho_1$ and $\rho_2$ large, as Craig points out, the series expansion converges very slowly. Even for $\rho_1$ and $\rho_2$ as small as 2, the expansion is unwieldy. We shall show that as $\rho_1$ and $\rho_2 \rightarrow \infty$, the probability function of $z$ approaches a normal curve and in case $r = 0$ the Type III function and the Gram-Charlier Type A series are excellent approximations to the $z$ distribution in the proper region. Numerical integration provides a substitute for the infinite series wherever the exact values of the probability function of $z$ are needed. Some extensions of the main theorem are given in section 5 and a practical problem involving the probability function of $z$ is solved.",0 +https://doi.org/10.4135/9781446247600.n22,Robust Methods for Multilevel Analysis,,0 +https://doi.org/10.4061/2011/759170,"Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine","We review evidence for links between personality traits and longevity. We provide an overview of personality for health scientists, using the primary organizing framework used in the study of personality and longevity. We then review data on various aspects of personality linked to longevity. In general, there is good evidence that higher level of conscientiousness and lower levels of hostility and Type D or “distressed” personality are associated with greater longevity. Limited evidence suggests that extraversion, openness, perceived control, and low levels of emotional suppression may be associated with longer lifespan. Findings regarding neuroticism are mixed, supporting the notion that many component(s) of neuroticism detract from life expectancy, but some components at some levels may be healthy or protective. Overall, evidence suggests various personality traits are significant predictors of longevity and points to several promising directions for further study. We conclude by discussing the implications of these links for epidemiologic research and personalized medicine and lay out a translational research agenda for integrating the psychology of individual differences into public health and medicine.",0 +,New Algorithms for Item Selection and Exposure Control with Computerized Adaptive Testing.,"Computerized adaptive testing (CAT) offers the prospect of both reducing testing time and increasing measurement precision when compared to conventional pencil-and-paper tests. Although adaptive tests acquire their efficiency by successively selecting items that provide optimal` *. measurement at each examinee's estimated level of ability, operational testing programs will typically consider additional factors in item selection. In practice, items are generally selected with regard to at least three, often conflicting goals: 1) to maximize test efficiency by measuring examinees as quickly and as accurately as possible, 2) to protect the security of the item pool by controlling the rates at which popular items can be administered, and 3) to assure that the test measures the same composite of multiple traits for each examinee by balancing the rates at which items with different content properties are administered. This paper focuses on the goals of maximizing test efficiency and controlling item exposure rates, avoiding discussion of content balance. While a number of algorithms for accomplishing these goals have been developed, all are problematic to some extent. We briefly sketch the nature of these problems, and then present alternative algorithms that offer at least a partial solution. U.S. DEPARTMENT OF EDUCATION Office of Educational Research and Improvement EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC) Crfhis document has been reproduced as received from the person or organization originating it. Minor changes have heen made to improve reproduction quality. Points of view or opinions stated in this CO document do not necessarily represent official OERI position or policy. Co tN 2 PERMISSION TO REPRODUCE AND DISSEMINATE THIS MATERIAL HAS BEEN GRANTED BY iclhAc511A.IL TO THE EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC) 1 Paper presented at the annual meeting of the American Educational Research Association, April 18-22, 1995, San Francisco New Algorithms for CAT 2 New Algorithms for Item Selection and Exposure Control with Computerized Adaptive Testing",0 +https://doi.org/10.1016/j.csda.2010.05.003,Bayesian inference for a skew-normal IRT model under the centred parameterization,"Item response theory (IRT) comprises a set of statistical models which are useful in many fields, especially when there is interest in studying latent variables. These latent variables are directly considered in the Item Response Models (IRM) and they are usually called latent traits. A usual assumption for parameter estimation of the IRM, considering one group of examinees, is to assume that the latent traits are random variables which follow a standard normal distribution. However, many works suggest that this assumption does not apply in many cases. Furthermore, when this assumption does not hold, the parameter estimates tend to be biased and misleading inference can be obtained. Therefore, it is important to model the distribution of the latent traits properly. In this paper we present an alternative latent traits modeling based on the so-called skew-normal distribution; see Genton (2004) . We used the centred parameterization, which was proposed by Azzalini (1985) . This approach ensures the model identifiability as pointed out by Azevedo et al. (2009b) . Also, a Metropolis–Hastings within Gibbs sampling (MHWGS) algorithm was built for parameter estimation by using an augmented data approach. A simulation study was performed in order to assess the parameter recovery in the proposed model and the estimation method, and the effect of the asymmetry level of the latent traits distribution on the parameter estimation. Also, a comparison of our approach with other estimation methods (which consider the assumption of symmetric normality for the latent traits distribution) was considered. The results indicated that our proposed algorithm recovers properly all parameters. Specifically, the greater the asymmetry level, the better the performance of our approach compared with other approaches, mainly in the presence of small sample sizes (number of examinees). Furthermore, we analyzed a real data set which presents indication of asymmetry concerning the latent traits distribution. The results obtained by using our approach confirmed the presence of strong negative asymmetry of the latent traits distribution.",0 +https://doi.org/10.1121/1.1970490,Maximum‐Likelihood Sequential Procedure for Estimation of Psychometric Functions,"This paper describes a computer‐oriented sequential procedure for the estimation of parameters of a psychometric function. In common with other sequential procedures (BUDTIF, PEST, UDTR), the goal is to concentrate observations in the region of interest. The experimenter assumes a parametric form of the psychometric function (cumulative normal from 0 to 1, for example, but any other desired form could be used). After each response, values of the parameters are computed that maximize the probability of the set of responses that have been obtained, given the set of stimuli that have been presented. These values are then used to determine the placement of the next stimulus. A compromise between fidelity of tracking a time‐varying threshold and accuracy can be effected by appropriate choice of the weighting function for previous observations. The procedure has been simulated on a GE‐645 computer and applied in the laboratory with a DDP‐516 computer.",0 +https://doi.org/10.1177/0146621608320760,The Multiple-Choice Model,"This article deals with some of the problems that have hindered the application of Samejima's and Thissen and Steinberg's multiple-choice models: (a) parameter estimation difficulties owing to the large number of parameters involved, (b) parameter identifiability problems in the Thissen and Steinberg model, and (c) their treatment of omitted responses. The authors propose a new multiple-choice model (Restricted Samejima Multiple-Choice Model) that is more explicit about the assumed omitting mechanisms and takes advantage of this knowledge to improve the estimation of parameters. The three above-mentioned models and the Nominal Response Model were fitted to a 3,224-subject sample that took a Written English Test. Fit plots, X 2 statistics, and information-based fit indexes were obtained to assess the goodness of fit. Results show that the new model proposed fits as well as the other two multiple-choice models and better than the Nominal model. A parameter recovery simulation study was also carried out to confirm that its estimation features are indeed improved. Parameters are better recovered in the new model than in the other two multiple-choice models.",0 +https://doi.org/10.1007/bf02291411,Estimating item parameters and latent ability when responses are scored in two or more nominal categories,"A multivariate logistic latent trait model for items scored in two or more nominal categories is proposed. Statistical methods based on the model provide 1) estimation of two item parameters for each response alternative of each multiple choice item and 2) recovery of information from “wrong” responses when estimating latent ability. An application to a large sample of data for twenty vocabulary items shows excellent fit of the model according to a chi-square criterion. Item and test information curves are compared for estimation of ability assuming multiple category and dichotomous scoring of these items. Multiple scoring proves substantially more precise for subjects of less than median ability, and about equally precise for subjects above the median.",0 +https://doi.org/10.1214/aos/1176343345,Multivariate Empirical Bayes and Estimation of Covariance Matrices,"The problem of estimating several normal mean vectors in an empirical Bayes situation is considered. In this case, it reduces to the problem of estimating the inverse of a covariance matrix in the standard multivariate normal situation using a particular loss function. Estimators which dominate any constant multiple of the inverse sample covariance matrix are presented. These estimators work by shrinking the sample eigenvalues toward a central value, in much the same way as the James-Stein estimator for a mean vector shrinks the maximum likelihood estimators toward a common value. These covariance estimators then lead to a class of multivariate estimators of the mean, each of which dominates the maximum likelihood estimator.",0 +https://doi.org/10.1037/a0025813,Fitting multilevel models with ordinal outcomes: Performance of alternative specifications and methods of estimation.,"Previous research has compared methods of estimation for fitting multilevel models to binary data, but there are reasons to believe that the results will not always generalize to the ordinal case. This article thus evaluates (a) whether and when fitting multilevel linear models to ordinal outcome data is justified and (b) which estimator to employ when instead fitting multilevel cumulative logit models to ordinal data, maximum likelihood (ML), or penalized quasi-likelihood (PQL). ML and PQL are compared across variations in sample size, magnitude of variance components, number of outcome categories, and distribution shape. Fitting a multilevel linear model to ordinal outcomes is shown to be inferior in virtually all circumstances. PQL performance improves markedly with the number of ordinal categories, regardless of distribution shape. In contrast to binary data, PQL often performs as well as ML when used with ordinal data. Further, the performance of PQL is typically superior to ML when the data include a small to moderate number of clusters (i.e., ≤ 50 clusters).",0 +https://doi.org/10.3758/s13428-017-0870-1,Statistical properties of four effect-size measures for mediation models,"This project examined the performance of classical and Bayesian estimators of four effect size measures for the indirect effect in a single-mediator model and a two-mediator model. Compared to the proportion and ratio mediation effect sizes, standardized mediation effect-size measures were relatively unbiased and efficient in the single-mediator model and the two-mediator model. Percentile and bias-corrected bootstrap interval estimates of ab/s Y , and ab(s X )/s Y in the single-mediator model outperformed interval estimates of the proportion and ratio effect sizes in terms of power, Type I error rate, coverage, imbalance, and interval width. For the two-mediator model, standardized effect-size measures were superior to the proportion and ratio effect-size measures. Furthermore, it was found that Bayesian point and interval summaries of posterior distributions of standardized effect-size measures reduced excessive relative bias for certain parameter combinations. The standardized effect-size measures are the best effect-size measures for quantifying mediated effects.",1 +https://doi.org/10.1177/1354068814549339,Corruption as an obstacle to women’s political representation,"This article presents evidence from 18 European countries showing that where levels of corruption are high, the proportion of women elected is low. We hypothesize that corruption indicates the presence of ‘shadowy arrangements’ that benefit the already privileged and pose a direct obstacle to women when male-dominated networks influence political parties’ candidate selection. There is also an indirect signal effect derived from citizen’s experiences with a broad range of government authorities. The article uses data that are more fine-grained than usual in this literature. We conduct an empirical test on a new dataset on locally elected councilors in 167 regions in Europe. Using a novel measure of regional quality of government and corruption we perform a multi-level analysis with several regional- and national-level controls. This study provides a unique picture of the proportion of women in locally elected assemblies throughout Europe and a new way of understanding the variations found.",0 +https://doi.org/10.1080/02664763.2013.785491,Bayesian structural equation modeling for the health index,"There are many factors which could influence the level of health of an individual. These factors are interactive and their overall effects on health are usually measured by an index which is called as health index. The health index could also be used as an indicator to describe the health level of a community. Since the health index is important, many research have been done to study its determinant. The main purpose of this study is to model the health index of an individual based on classical structural equation modeling (SEM) and Bayesian SEM. For estimation of the parameters in the measurement and structural equation models, the classical SEM applies the robust-weighted least-square approach, while the Bayesian SEM implements the Gibbs sampler algorithm. The Bayesian SEM approach allows the user to use the prior information for updating the current information on the parameter. Both methods are applied to the data gathered from a survey conducted in Hulu Langat, a district in Malaysia. Based on the cl...",0 +https://doi.org/10.1080/01621459.1986.10478292,Judging Inference Adequacy in Logistic Regression,"Abstract Inference for logistic regression based on the information matrix may be poor. This is noted in two examples in which confidence regions are examined. A measure to detect such inadequacies is presented; it judges the quadratic approximation to the likelihood surface, which justifies the usual procedure.",0 +https://doi.org/10.1111/j.0006-341x.1999.00044.x,Flexible Parametric Measurement Error Models,"Inferences in measurement error models can be sensitive to modeling assumptions. Specifically, if the model is incorrect, the estimates can be inconsistent. To reduce sensitivity to modeling assumptions and yet still retain the efficiency of parametric inference, we propose using flexible parametric models that can accommodate departures from standard parametric models. We use mixtures of normals for this purpose. We study two cases in detail: a linear errors-in-variables model and a change-point Berkson model.",0 +https://doi.org/10.1093/rfs/hhn053,Estimating Standard Errors in Finance Panel Data Sets: Comparing Approaches,"In both corporate finance and asset pricing empirical work, researchers are often confronted with panel data. In these data sets, the residuals may be correlated across firms and across time, and OLS standard errors can be biased. Historically, the two literatures have used different solutions to this problem. Corporate finance has relied on clustered standard errors, while asset pricing has used the Fama-MacBeth procedure to estimate standard errors. This paper examines the different methods used in the literature and explains when the different methods yield the same (and correct) standard errors and when they diverge. The intent is to provide intuition as to why the different approaches sometimes give different answers and give researchers guidance for their use.",0 +https://doi.org/10.1111/j.1744-6570.1985.tb00565.x,FORTY QUESTIONS ABOUT VALIDITY GENERALIZATION AND META-ANALYSIS.,,0 +https://doi.org/10.1177/0013164413517503,A Comparison of Four Item-Selection Methods for Severely Constrained CATs,"This study compared four item-selection procedures developed for use with severely constrained computerized adaptive tests (CATs). Severely constrained CATs refer to those adaptive tests that seek to meet a complex set of constraints that are often not conclusive to each other (i.e., an item may contribute to the satisfaction of several constraints at the same time). The procedures examined in the study included the weighted deviation model (WDM), the weighted penalty model (WPM), the maximum priority index (MPI), and the shadow test approach (STA). In addition, two modified versions of the MPI procedure were introduced to deal with an edge case condition that results in the item selection procedure becoming dysfunctional during a test. The results suggest that the STA worked best among all candidate methods in terms of measurement accuracy and constraint management. For the other three heuristic approaches, they did not differ significantly in measurement accuracy and constraint management at the lower bound level. However, the WPM method appears to perform considerably better in overall constraint management than either the WDM or MPI method. Limitations and future research directions were also discussed.",0 +https://doi.org/10.1016/s0304-4076(00)00034-8,A Bayesian analysis of the multinomial probit model with fully identified parameters,"We present a new prior and corresponding algorithm for Bayesian analysis of the multinomial probit model. Our new approach places a prior directly on the identified parameter space. The key is the specification of a prior on the covariance matrix so that the (1,1) element if fixed at 1 and it is possible to draw from the posterior using standard distributions. Analytical results are derived which can be used to aid in assessment of the prior.",0 +https://doi.org/10.1080/00273170701540537,The Impact of Misspecifying the Within-Subject Covariance Structure in Multiwave Longitudinal Multilevel Models: A Monte Carlo Study,"This Monte Carlo study examined the impact of misspecifying the Σ matrix in longitudinal data analysis under both the multilevel model and mixed model frameworks. Under the multilevel model approach, under-specification and general-misspecification of the Σ matrix usually resulted in overestimation of the variances of the random effects (e.g., τ00, ττ11 ) and standard errors of the corresponding growth parameter estimates (e.g., SEβ 0, SEβ 1). Overestimates of the standard errors led to lower statistical power in tests of the growth parameters. An unstructured Σ matrix under the mixed model framework generally led to underestimates of standard errors of the growth parameter estimates. Underestimates of the standard errors led to inflation of the type I error rate in tests of the growth parameters. Implications of the compensatory relationship between the random effects of the growth parameters and the longitudinal error structure for model specification were discussed.",0 +https://doi.org/10.1016/b978-0-08-044894-7.01370-1,Structural Equation Models,"In this article, we introduce structural equation models which are powerful multivariate tools in analyzing interrelationships among observed and latent variables. Useful models, including the standard linear model and its generalizations such as the nonlinear models, multilevel models, and models with ordered categorical data are discussed. In addition, the maximum likelihood approach, a Bayesian approach for estimation and model comparison, as well as the freely available software WinBUGS for obtaining the Bayesian results are described.",0 +https://doi.org/10.1002/wics.1311,Bayesian structural equation model,"Latent variables that should be measured by multiple observed variable are common in substantive research. Structural equation models SEMs, which can be regarded as regression models with observed and latent variables, are useful models to assess interrelationships among these variables and have been widely applied to many fields. When applied with data augmentation and recent techniques in statistical computing, the Bayesian approach has been found to be a powerful tool for analysing many important extensions of the basic SEMs. Here, we introduce the basic SEM, present a brief discussion on the Bayesian approach and illustrate it with a simulation study, and review some recent extension, such as two-level SEMs, transformation SEMs, and nonparametric SEMs. WIREs Comput Stat 2014, 6:276-287. doi: 10.1002/wics.1311",0 +https://doi.org/10.1016/j.ijresmar.2010.08.001,Enhancing marketing with engineering: Optimal product line design for heterogeneous markets,"article i nfo Successful product line design and development often require a balance of technical and market tradeoffs. Quantitative methods for optimizing product attribute levels using preference elicitation (e.g., conjoint) data are useful for many product types. However, products with substantial engineering content involve critical tradeoffs in the ability to achieve those desired attribute levels. Technical tradeoffs in product design must be made with an eye toward market consequences, particularly when heterogeneous market preferences make differentiation and strategic positioning critical to capturing a range of market segments and avoiding cannibalization. We present a unified methodology for product line optimization that coordinates positioning and design models to achieve realizable firm-level optima. The approach overcomes several shortcomings of prior product line optimization models by incorporating a general Bayesian account of consumer preference heterogeneity, managing attributes over a continuous domain to alleviate issues of combinatorial complexity, and avoiding solutions that are impossible to realize. The method is demonstrated for a line of dial-readout scales, using physical models and conjoint-based consumer choice data. The results show that the optimal number of products in the line is not necessarily equal to the number of market segments, that an optimal single product for a heterogeneous market differs from that for a homogeneous one, and that the representational form for consumer heterogeneity has a substantial impact on the design and profitability of the resulting optimal product line — even for the design of a single product. The method is managerially valuable because it yields product line solutions efficiently, accounting for marketing-based preference heterogeneity as well as engineering-based constraints with which product attributes can be realized.",0 +https://doi.org/10.1214/aos/1065705116,Enriched conjugate and reference priors for the Wishart family on symmetric cones,"A general Wishart family on a symmetric cone is a natural exponential family (NEF) having a homogeneous quadratic variance function. Using results in the abstract theory of Euclidean Jordan algebras, the structure of conditional reducibility is shown to hold for such a family, and we identify the associated parameterization $\phi$ and analyze its properties. The enriched standard conjugate family for $\phi$ and the mean parameter $\mu$ are defined and discussed. This family is considerably more flexible than the standard conjugate one. The reference priors for $\phi$ and $\mu$ are obtained and shown to belong to the enriched standard conjugate family; in particular, this allows us to verify that reference posteriors are always proper. The above results extend those available for NEFs having a simple quadratic variance function. Specifications of the theory to the cone of real symmetric and positive-definite matrices are discussed in detail and allow us to perform Bayesian inference on the covariance matrix $\Sigma$ of a multivariate normal model under the enriched standard conjugate family. In particular, commonly employed Bayes estimates, such as the posterior expectation of $\Sigma$ and $\Sigma^{-1}$, are provided in closed form.",0 +https://doi.org/10.1198/016214506000000753,Spatial Analyses of Periodontal Data Using Conditionally Autoregressive Priors Having Two Classes of Neighbor Relations,"Attachment loss, the extent of a tooth's root (in millimeters) that is no longer attached to surrounding bone by periodontal ligament, is often used to measure the current state of a patient's periodontal disease and monitor disease progression. Attachment loss data can be analyzed using a conditionally autoregressive (CAR) prior distribution that smooths fitted values toward neighboring values. However, it may be desirable to have more than one class of neighbor relation in the spatial structure, so the different classes of neighbor relations can induce different degrees of smoothing. For example, we may wish to allow smoothing of neighbor pairs bridging the gap between teeth to differ from smoothing of pairs that do not bridge such gaps. Adequately modeling the spatial structure may improve the monitoring of periodontal disease progression. This article develops a two-neighbor-relation CAR model to handle this situation and presents associated theory to help explain the sometimes unusual posterior distr...",0 +https://doi.org/10.1007/bf02294773,An estimating equations approach for the LISCOMP model,"Maximum likelihood estimation is computationally infeasible for latent variable models involving multivariate categorical responses, in particular for the LISCOMP model. A three-stage generalized least squares approach introduced by Muthén (1983, 1984) can experience problems of instability, bias, non-convergence, and non-positive definiteness of weight matrices in situations of low prevalence, small sample size and large numbers of observed indicator variables. We propose a quadratic estimating equations approach that only requires specification of the first two moments. By performing simultaneous estimation of parameters, this method does not encounter the problems mentioned above and experiences gains in efficiency. Methods are compared through a numerical study and an application to a study of life-events and neurotic illness.",0 +https://doi.org/10.3758/s13428-016-0739-8,Default “Gunel and Dickey” Bayes factors for contingency tables,"The analysis of R×C contingency tables usually features a test for independence between row and column counts. Throughout the social sciences, the adequacy of the independence hypothesis is generally evaluated by the outcome of a classical p-value null-hypothesis significance test. Unfortunately, however, the classical p-value comes with a number of well-documented drawbacks. Here we outline an alternative, Bayes factor method to quantify the evidence for and against the hypothesis of independence in R×C contingency tables. First we describe different sampling models for contingency tables and provide the corresponding default Bayes factors as originally developed by Gunel and Dickey (Biometrika, 61(3):545-557 (1974)). We then illustrate the properties and advantages of a Bayes factor analysis of contingency tables through simulations and practical examples. Computer code is available online and has been incorporated in the ""BayesFactor"" R package and the JASP program ( jasp-stats.org ).",0 +https://doi.org/10.1037/1082-989x.9.2.250,The Role of Parametric Assumptions in Adaptive Bayesian Estimation.,"Variants of adaptive Bayesian procedures for estimating the 5% point on a psychometric function were studied by simulation. Bias and standard error were the criteria to evaluate performance. The results indicated a superiority of (a) uniform priors, (b) model likelihood functions that are odd symmetric about threshold and that have parameter values larger than their counterparts in the psychometric function, (c) stimulus placement at the prior mean, and (d) estimates defined as the posterior mean. Unbiasedness arises in only 10 trials, and 20 trials ensure constant standard errors. The standard error of the estimates equals 0.617 times the inverse of the square root of the number of trials. Other variants yielded bias and larger standard errors.",0 +https://doi.org/10.1093/her/17.5.586,Promoting Healthy Lifestyles: Alternative Models' Effects (PHLAME),"The Promoting Healthy Lifestyles: Alternative Models' Effects (PHLAME) study evaluates the efficacy of two intervention strategies for improving nutrition and physical activity practices in fire fighters: a team-centered program and a one-on-one format targeting the individual. PHLAME compares these two behavior change models (the team-based versus the one-on-one approaches) against a usual-care control group. As a group, fire fighters have a concentration of the same harmful behaviors and health risks commonly afflicting the US population. Fire fighters have a unique work structure which is ideal for a team-centered model of behavior change. This strategy, based on Social Learning Theory, focuses on a team of fire fighters who work together on the same shift. If this team-centered model proves successful, it could provide a cost-effective method to impact behavior, and be disseminated among fire bureaus and in other team settings. The one-on-one intervention incorporates the Transtheoretical Model of behavior change, uses Motivational Interviewing for its counseling strategy and could be used in the more typical provider-client clinic setting. Findings from PHLAME will provide information about the process and outcomes of these models' ability to achieve health behavior change.",0 +https://doi.org/10.1007/978-0-387-73186-5_9,Multilevel Generalized Linear Models,"Two of the most influential papers in applied statistics published in the last few decades are Nelder and Wedderburn [65], introducing generalized linear models (GLMs), and Cox [20], the seminal paper introducing life tables with regression, better known as proportional hazard models. As we will see, these two developments are closely related. Nelder and Wedderburn?s unique contribution was to provide a unified conceptual framework for studying a large range of statistical models, including not only classical linear models, but also logit and probit models for binary data, log-linear Poisson models for count data, and others. The unification was not only conceptual, but also led to common estimation procedures in the form of an iteratively re-weighted least squares (IRLS) algorithm. The first implementation of these procedures appeared in the highly successful program GLIM [3], which for many statisticians became synonymous with GLMs. In this chapter we follow Wong and Mason [94], Longford [54, 56], Goldstein [30], Breslow and Clayton [11], and others in exploring extensions of GLMs to include random effects in a multilevel setting. Chapter 1 in this handbook has described multilevel models for continuous outcomes, while Chapter 6 has focused on multilevel models for categorical outcomes. Here we adopt a unified approach that views the general linear mixed model and many of the random-effects models for categorical data discussed in earlier chapters as special cases of the Multilevel Generalized Linear Model (MGLM). This approach has conceptual merit in emphasizing the similarities among these models, and provides a common framework to study and evaluate estimation methods. Alas, we do not have a single estimation procedure that can be applied to all MGLMs with the same measure of success that IRLS achieved for GLMs. Instead, we must choose between quick but sometimes biased approximations, and more accurate but often compute-intensive maximum likelihood and Bayesian approaches. Part of our task in this chapter is to describe and illustrate the alternatives. Section 9.2 develops the modeling framework. We introduce generalized linear models (GLMs) as an extension of linear models, and proceed to an analogous derivation of multilevel generalized linear models (MGLMs) as an extension of multilevel linear models. The ideas discussed apply more generally to generalized linear mixed models (GLMMs) and our notation reflects this broader applicability, but we tend to focus the narrative on the multilevel case. We review survival models, note their close connection with GLMs, and describe a natural extension to the multilevel case. We draw an important distinction between conditional and marginal models that is significant in the generalized linear case. Finally, we introduce non-linear mixed models and contrast them with MGLMs. Section 9.3 is devoted to a discussion of estimation procedures. It turns out that calculation of the likelihood function for MGLMs involves intractable integrals. We discuss several alternatives and assess their performance in realistic situations, referring to some of our earlier work using simulated data and a case study [81, 82] and introducing new results.We review a range of approximate estimation procedures that, unfortunately, can be severely biased when random effects are substantial. We describe maximum likelihood estimation using Gauss-Hermite quadrature, a method that appears to work remarkably well, but is limited to relatively low-dimensional models. We also discuss Bayesian estimation procedures focusing on the Gibbs sampler, a Markov Chain Monte Carlo (MCMC) method that can be pplied to more complex models involving high-dimensional integrals, albeit not without difficulty. We close this section with a brief discussion of other approaches to estimation, an active area of current research. Section 9.4 is devoted to an application of MGLMs to the study of infant and child mortality in Kenya, using data from a national survey conducted in 1998. We use a three-level piece-wise exponential survival model that allows for clustering of infant and child deaths at both the family and community levels, and fit it to data using the equivalent MGLM with Poisson errors and log link. We compare estimates that ignore clustering, and estimates obtained by approximate quasi-likelihood and by full maximum likelihood. The discussion emphasizes interpretation of the results, particularly the family and community random parameters. Finally, we show how the model can be used to estimate measures of intra-family and intra-community correlation in infant and child deaths. Section 9.5 is a brief discussion and summary of our conclusions. © 2008 Springer Science+Business Media, LLC.",0 +https://doi.org/10.3168/jds.2008-1497,Factors affecting cure when treating bovine clinical mastitis with cephalosporin-based intramammary preparations,"Data were collated for an independent scientific analysis from 2 international, multicenter studies that had compared the efficacy of 3 different cephalosporin-containing intramammary preparations in the treatment of clinical mastitis in dairy cattle [cefalexin (first generation) in combination with kanamycin; cefquinome (fourth generation); and cefoperazone (third generation)]. Quarters were assessed using standard bacteriological techniques before treatment and at 16 and 25 d posttreatment. Additional data were also available on individual cows and study farms, including parity, breed, and cow somatic cell count histories, herd bulk milk somatic cell counts, and farm management regimens. Sufficient data for analysis were available from a total of 491 cases on 192 farms in 3 countries (United Kingdom, France, and Germany) with up to 16 cases being recruited from any one farm. Clinical cases were of diverse etiology, representing both contagious and environmental pathogens. Univariable analysis demonstrated that quarters in the cefalexin + kanamycin and cefquinome treatment groups were not significantly different from each other, but were both significantly more likely to be pathogen free posttreatment than quarters in the cefoperazone group. Multivariable analysis was undertaken using conventional random effects models. Two models were built, with the first incorporating only information available to the practitioner at the time of treatment and the second including all information collected during the study. These models indicated that country, pretreatment rectal temperature (above-normal temperature associated with an increased chance of being pathogen free posttreatment), individual cow somatic cell count (increased somatic cell count associated with a decreased chance of being pathogen free posttreatment), and pathogen (Staphylococcus aureus isolation associated with a decreased chance of being pathogen free posttreatment) were useful predictors of pathogen free status; parity, yield, bulk milk somatic cell counts, and other farm management factors were not. The importance of country in the analysis demonstrates the need to generate local data when assessing treatment regimens. In addition, these results suggest that the factors important in predicting the outcome of treatment of clinical mastitis cases may be dissimilar to those reported to affect the likelihood of cure when treating subclinical intramammary infections.",0 +https://doi.org/10.2307/2094445,The Decomposition of Effects in Path Analysis,"This paper is about the logic of interpreting recursive causal theories in sociology. We review the distinction between associations and effects and discuss the decomposition of effects into direct and indirect components. We then describe a general method for decomposing effects into their components by the systematic application of ordinary least squares regression. The method involves successive computation of reduced-form equations, beginning with an equation containing only exogenous variables, then computing equations which add intervening variables in sequence from cause to effect. This generates all the information required to decompose effects into their various direct and indirect parts. This method is a substitute for the often more cumbersome computation of indirect effects from the structural coefficients (direct effects) of the causal model Finally, we present a way of summarizing this information in tabular form and illustrate the procedures using an empirical example.",0 +https://doi.org/10.1177/0049124199028002001,Assessing Direct and Indirect Effects in Multilevel Designs with Latent Variables,"Researchers commonly ask whether relationships between exogenous predictors, X, and outcomes, Y, are mediated by a third set of variables, Z. Simultaneous equations decompose the relationship between X and Y into an indirect component, operating through Z, and a direct component, the relationship between X and Y given Z. Often, X, Y, and/or Z are measured with error. Structural equation modeling is widely used in this scenario. However, sociological data commonly have a nested structure (students within schools, residents within local areas). Hierarchical linear models represent such multilevel data well and can handle errors of measurement, but have not incorporated simultaneous equations for direct and indirect effects. This article incorporates the study of such mediated effects into the hierarchical linear model, naturally extending the analysis to include unbalanced, multilevel designs and missing data. The authors illustrate the approach by examining the extent to which neighborhood social control mediates the relationship between neighborhood social composition and violence in Chicago.",0 +https://doi.org/10.1037/1082-989x.11.2.127,Structural equation modeling with interchangeable dyads.,"Structural equation modeling (SEM) can be adapted in a relatively straightforward fashion to analyze data from interchangeable dyads (i.e., dyads in which the 2 members cannot be differentiated). The authors describe a general strategy for SEM model estimation, comparison, and fit assessment that can be used with either dyad-level or pairwise (double-entered) dyadic data. They present applications illustrating this approach with the actor-partner interdependence model, confirmatory factor analysis, and latent growth curve analysis.",0 +https://doi.org/10.1002/sim.5677,Level-adjusted funnel plots based on predicted marginal expectations: an application to prophylactic antibiotics in gallstone surgery,"Funnel plots are widely used to visualize grouped data, for example, in institutional comparison. This paper extends the concept to a multi-level setting, displaying one level at a time, adjusted for the other levels, as well as for covariates at all levels. These level-adjusted funnel plots are based on a Markov chain Monte Carlo fit of a random effects model, translating the estimated model parameters to predicted marginal expectations. Working within the estimation framework, we accommodate outlying institutions using heavy-tailed random effects distributions. We also develop computer-efficient methods to compute predicted probabilities in the case of dichotomous outcome data and various random effect distributions. We apply the method to a data set on prophylactic antibiotics in gallstone surgery.",0 +https://doi.org/10.1007/s11336-013-9360-2,Additive Multilevel Item Structure Models with Random Residuals: Item Modeling for Explanation and Item Generation,"An additive multilevel item structure (AMIS) model with random residuals is proposed. The model includes multilevel latent regressions of item discrimination and item difficulty parameters on covariates at both item and item category levels with random residuals at both levels. The AMIS model is useful for explanation purposes and also for prediction purposes as in an item generation context. The parameters can be estimated with an alternating imputation posterior algorithm that makes use of adaptive quadrature, and the performance of this algorithm is evaluated in a simulation study. © 2013 The Psychometric Society.",0 +https://doi.org/10.1177/0146621612446170,Recovery of Graded Response Model Parameters,"Markov chain Monte Carlo (MCMC) methods enable a fully Bayesian approach to parameter estimation of item response models. In this simulation study, the authors compared the recovery of graded response model parameters using marginal maximum likelihood (MML) and Gibbs sampling (MCMC) under various latent trait distributions, test lengths, and sample sizes. Sample size and test length explained the largest amount of variance in item and person parameter estimates, respectively. There was little difference in item parameter recovery between MML and MCMC in samples with 300 or more respondents. MCMC recovered some item threshold parameters better in samples with 75 or 150 respondents. Bias in threshold parameter estimates depended on the generating value and the type of threshold. Person parameters were comparable between MCMC and MML/expected a posteriori for all test lengths.",0 +https://doi.org/10.1177/0958928713511280,What explains ‘generosity’ in the public financing of high-tech drugs? An empirical investigation of 25 OECD countries and 11 controversial drugs,"In times of increasing cost pressures, public healthcare systems in Organisation for Economic Co-operation and Development (OECD) countries face the question of whether and to which extent new high-tech drugs are to be financed within their public healthcare systems. Systematic empirical research that explains across-country variation in these decisions is, however, almost non-existent. We analyse an original dataset that contains coverage decisions for 11 controversial drugs in 25 OECD countries using multilevel modelling. Our results indicate that the ‘generosity’ with which controversial new drugs are publicly financed is unrelated to a country’s wealth and general expenditure levels for healthcare. However, healthcare systems financed through social insurance contributions tend to be more generous than tax-financed ones. Moreover, we uncover evidence suggesting that the institutional characteristics of the decision-making process matter systematically for decisions on whether to finance controversial drugs.",0 +https://doi.org/10.1016/j.socnet.2014.02.002,Food sharing networks in lowland Nicaragua: An application of the social relations model to count data,"Abstract Previous research on food sharing in small-scale societies provides support for multiple evolutionary hypotheses, but evolutionary anthropologists have devoted relatively little attention to the broader relational context of inter-household transfers of food. The present research observes transfers of meat over a yearlong period among 25 households of indigenous Mayangna and Miskito horticulturalists in Nicaragua. To analyze these data, we extend the multilevel formulation of the social relations model to count data, namely the number of portions of meat exchanged between households. Along with other covariates, we examine the effect of an “association index,” which reflects the amount of time that households interact with one another. The association index exhibits a positive effect on sharing, and our overall results indicate that food sharing networks largely correspond to kin-based networks of social interaction, suggesting that food sharing is embedded in broader social relationships between households. We discuss possible extensions of our methodological approach, as appropriate for research on food sharing and social network analysis more broadly.",0 +https://doi.org/10.1177/0146621608324023,I've Fallen and I Can't Get Up: Can High-Ability Students Recover From Early Mistakes in CAT?,"A difficult result to interpret in Computerized Adaptive Tests (CATs) occurs when an ability estimate initially drops and then ascends continuously until the test ends, suggesting that the true ability may be higher than implied by the final estimate. This study explains why this asymmetry occurs and shows that early mistakes by high-ability students can lead to considerable underestimation, even in tests with 45 items. The opposite response pattern, where low-ability students start with lucky guesses, leads to much less bias. The authors show that using Barton and Lord's four-parameter model (4PM) and a less informative prior can lower bias and root mean square error (RMSE) for high-ability students with a poor start, as the CAT algorithm ascends more quickly after initial underperformance. Results also show that the 4PM slightly outperforms a CAT in which less discriminating items are initially used. The practical implications and relevance for psychological measurement more generally are discussed.",0 +https://doi.org/10.1007/bf00144234,"The problem of multicollinearity in a multistage causal alienation model: A comparison of ordinary least squares, maximum-likelihood and ridge estimators",,0 +https://doi.org/10.1080/01966324.2007.10737689,Bayesian Analysis of Dyadic Data,"SYNOPTIC ABSTRACTThis paper considers the Bayesian analysis of dyadic data with particular emphasis on applications in social psychology. Various existing models are extended and unified under a class of models where a single value is elicited to complete the prior specification. Certain situations which have sometimes been problematic (e.g. incomplete data, non-standard covariates, missing data, unbalanced data) are easily handled under the proposed class of Bayesian models. Inference is straightforward using software that is based on Markov chain Monte Carlo methods. Examples are provided which highlight the variety of data sets that can be entertained and the ease in which they can now be analyzed.",0 +https://doi.org/10.1093/pan/mpi033,Two-Step Hierarchical Estimation: Beyond Regression Analysis,"Two-step estimators for hierarchical models can be constructed even when neither stage is a conventional linear regression model. For example, the first stage might consist of probit models, or duration models, or event count models. The second stage might be a nonlinear regression specification. This note sketches some of the considerations that arise in ensuring that two-step estimators are consistent in such cases.",0 +https://doi.org/10.1080/00273171.2014.977429,Detecting Misspecified Multilevel Structural Equation Models with Common Fit Indices: A Monte Carlo Study,"This study investigated the sensitivity of common fit indices (i.e., RMSEA, CFI, TLI, SRMR-W, and SRMR-B) for detecting misspecified multilevel SEMs. The design factors for the Monte Carlo study were numbers of groups in between-group models (100, 150, and 300), group size (10, 20, 30, and 60), intra-class correlation (low, medium, and high), and the types of model misspecification (Simple and Complex). The simulation results showed that CFI, TLI, and RMSEA could only identify the misspecification in the within-group model. Additionally, CFI, TLI, and RMSEA were more sensitive to misspecification in pattern coefficients while SRMR-W was more sensitive to misspecification in factor covariance. Moreover, TLI outperformed both CFI and RMSEA in terms of the hit rates of detecting the within-group misspecification in factor covariance. On the other hand, SRMR-B was the only fit index sensitive to misspecification in the between-group model and more sensitive to misspecification in factor covariance than misspecification in pattern coefficients. Finally, we found that the influence of ICC on the performance of targeted fit indices was trivial.",0 +https://doi.org/10.1007/bf02296338,Maximum likelihood estimation of latent interaction effects with the LMS method,"In the context of structural equation modeling, a general interaction model with multiple latent interaction effects is introduced. A stochastic analysis represents the nonnormal distribution of the joint indicator vector as a finite mixture of normal distributions. The Latent Moderated Structural Equations (LMS) approach is a new method developed for the analysis of the general interaction model that utilizes the mixture distribution and provides a ML estimation of model parameters by adapting the EM algorithm. The finite sample properties and the robustness of LMS are discussed. Finally, the applicability of the new method is illustrated by an empirical example.",0 +https://doi.org/10.1037/a0036635,Small sample mediation testing: Misplaced confidence in bootstrapped confidence intervals.,"Bootstrapping is an analytical tool commonly used in psychology to test the statistical significance of the indirect effect in mediation models. Bootstrapping proponents have particularly advocated for its use for samples of 20-80 cases. This advocacy has been heeded, especially in the Journal of Applied Psychology, as researchers are increasingly utilizing bootstrapping to test mediation with samples in this range. We discuss reasons to be concerned with this escalation, and in a simulation study focused specifically on this range of sample sizes, we demonstrate not only that bootstrapping has insufficient statistical power to provide a rigorous hypothesis test in most conditions but also that bootstrapping has a tendency to exhibit an inflated Type I error rate. We then extend our simulations to investigate an alternative empirical resampling method as well as a Bayesian approach and demonstrate that they exhibit comparable statistical power to bootstrapping in small samples without the associated inflated Type I error. Implications for researchers testing mediation hypotheses in small samples are presented. For researchers wishing to use these methods in their own research, we have provided R syntax in the online supplemental materials.",1 +https://doi.org/10.1111/j.1540-5907.2010.00452.x,Who Learns from What in Policy Diffusion Processes?,"The idea that policy makers in different states or countries may learn from one another has fascinated scholars for a long time, but little systematic evidence has been produced so far. This article improves our understanding of this elusive argument by distinguishing between the policy and political consequences of reforms and by emphasizing the conditional nature of learning processes. Using a directed dyadic approach and multilevel methods, the analysis of unemployment benefits retrenchment in OECD countries demonstrates that policy makers learn selectively from the experience of others. Right governments tend to be more sensitive to information on the electoral consequences of reforms, while left governments are more likely to be influenced by their policy effects.",0 +https://doi.org/10.1016/s0376-8716(02)00216-8,Mediation designs for tobacco prevention research,"This paper describes research designs and statistical analyses to investigate how tobacco prevention programs achieve their effects on tobacco use. A theoretical approach to program development and evaluation useful for any prevention program guides the analysis. The theoretical approach focuses on action theory for how the program affects mediating variables and on conceptual theory for how mediating variables are related to tobacco use. Information on the mediating mechanisms by which tobacco prevention programs achieve effects is useful for the development of efficient programs and provides a test of the theoretical basis of prevention efforts. Examples of these potential mediating mechanisms are described including mediated effects through attitudes, social norms, beliefs about positive consequences, and accessibility to tobacco. Prior research provides evidence that changes in social norms are a critical mediating mechanism for successful tobacco prevention. Analysis of mediating variables in single group designs with multiple mediators are described as well as multiple group randomized designs which are the most likely to accurately uncover important mediating mechanisms. More complicated dismantling and constructive designs are described and illustrated based on current findings from tobacco research. Mediation analysis for categorical outcomes and more complicated statistical methods are outlined.",0 +https://doi.org/10.1080/00273171.2016.1167008,Modeling Clustered Data with Very Few Clusters,"Small-sample inference with clustered data has received increased attention recently in the methodological literature, with several simulation studies being presented on the small-sample behavior of many methods. However, nearly all previous studies focus on a single class of methods (e.g., only multilevel models, only corrections to sandwich estimators), and the differential performance of various methods that can be implemented to accommodate clustered data with very few clusters is largely unknown, potentially due to the rigid disciplinary preferences. Furthermore, a majority of these studies focus on scenarios with 15 or more clusters and feature unrealistically simple data-generation models with very few predictors. This article, motivated by an applied educational psychology cluster randomized trial, presents a simulation study that simultaneously addresses the extreme small sample and differential performance (estimation bias, Type I error rates, and relative power) of 12 methods to account for clustered data with a model that features a more realistic number of predictors. The motivating data are then modeled with each method, and results are compared. Results show that generalized estimating equations perform poorly; the choice of Bayesian prior distributions affects performance; and fixed effect models perform quite well. Limitations and implications for applications are also discussed.",1 +https://doi.org/10.1177/01466219922031130,Item Parameter Recovery for the Nominal Response Model,"Establishing guidelines for reasonable item parameter estimation is fundamental to use of the nominal response model. Factors studied were the sample size ratio (SSR), latent trait distribution (LD), and amount of item information. Results showed that the LD accounted for 42.5% of the variability in the accuracy of estimating the slope parameter; the SSR and the maximum item information factors accounted for 29.5% and 3.5% of the accuracy, respectively. In general, as the LD departed from a normal distribution, a larger number of examinees was required to accurately estimate the slope and intercept parameters. Results indicated that an SSR of 10:1 can produce reasonably accurate item parameter estimates when the LD is normal.",0 +https://doi.org/10.1348/000711007x227067,Controlling item exposure and test overlap on the fly in computerized adaptive testing,"This paper proposes an on-line version of the Sympson and Hetter procedure with test overlap control (SHT) that can provide item exposure control at both the item and test levels on the fly without iterative simulations. The on-line procedure is similar to the SHT procedure in that exposure parameters are used for simultaneous control of item exposure rates and test overlap rate. The exposure parameters for the on-line procedure, however, are updated sequentially on the fly, rather than through iterative simulations conducted prior to operational computerized adaptive tests (CATs). Unlike the SHT procedure, the on-line version can control item exposure rate and test overlap rate without time-consuming iterative simulations even when item pools or examinee populations have been changed. Moreover, the on-line procedure was found to perform better than the SHT procedure in controlling item exposure and test overlap for examinees who take tests earlier. Compared with two other on-line alternatives, this proposed on-line method provided the best all-around test security control. Thus, it would be an efficient procedure for controlling item exposure and test overlap in CATs.",0 +https://doi.org/10.1017/s0003055409990050,Gay Rights in the States: Public Opinion and Policy Responsiveness,"We study the effects of policy-specific public opinion on state adoption of policies affecting gays and lesbians, and the factors that condition this relationship. Using national surveys and advances in opinion estimation, we create new estimates of state-level support for eight policies, including civil unions and nondiscrimination laws. We differentiate between responsiveness to opinion and congruence with opinion majorities. We find a high degree of responsiveness, controlling for interest group pressure and the ideology of voters and elected officials. Policy salience strongly increases the influence of policy-specific opinion (directly and relative to general voter ideology). There is, however, a surprising amount of noncongruence—for some policies, even clear supermajority support seems insufficient for adoption. When noncongruent, policy tends to be more conservative than desired by voters; that is, there is little progay policy bias. We find little to no evidence that state political institutions affect policy responsiveness or congruence.",0 +https://doi.org/10.1002/(sici)1097-0258(19990715)18:13<1707::aid-sim138>3.0.co;2-h,Longitudinal data analysis (repeated measures) in clinical trials,"Longitudinal data is often collected in clinical trials to examine the effect of treatment on the disease process over time. This paper reviews and summarizes much of the methodological research on longitudinal data analysis from the perspective of clinical trials. We discuss methodology for analysing Gaussian and discrete longitudinal data and show how these methods can be applied to clinical trials data. We illustrate these methods with five examples of clinical trials with longitudinal outcomes. We also discuss issues of particular concern in clinical trials including sequential monitoring and adjustments for missing data. A review of current software for analysing longitudinal data is also provided. Published in 1999 by John Wiley & Sons, Ltd. This article is a US Government work and is the public domain in the United States.",0 +https://doi.org/10.1152/jn.00206.2011,Attention to baseline: does orienting visuospatial attention really facilitate target detection?,"Standard protocols testing the orientation of visuospatial attention usually present spatial cues before targets and compare valid-cue trials with invalid-cue trials. The valid/invalid contrast results in a relative behavioral or physiological difference that is generally interpreted as a benefit of attention orientation. However, growing evidence suggests that inhibitory control of response is closely involved in this kind of protocol that requires the subjects to withhold automatic responses to cues, probably biasing behavioral and physiological baselines. Here, we used two experiments to disentangle the inhibitory control of automatic responses from orienting of visuospatial attention in a saccadic reaction time task in humans, a variant of the classical cue-target detection task and a sustained visuospatial attentional task. Surprisingly, when referring to a simple target detection task in which there is no need to refrain from reacting to avoid inappropriate responses, we found no consistent evidence of facilitation of target detection at the attended location. Instead, we observed a cost at the unattended location. Departing from the classical view, our results suggest that reaction time measures of visuospatial attention probably relie on the attenuation of elementary processes involved in visual target detection and saccade initiation away from the attended location rather than on facilitation at the attended location. This highlights the need to use proper control conditions in experimental designs to disambiguate relative from absolute cueing benefits on target detection reaction times, both in psychophysical and neurophysiological studies.",0 +https://doi.org/10.2307/2648877,Econometric Issues in the Analysis of Regressions with Generated Regressors,,0 +https://doi.org/10.1177/0049124106289164,Matching Estimators of Causal Effects,"As the counterfactual model of causality has increased in popularity, sociologists have returned to matching as a research methodology. In this article, advances over the past two decades in matching estimators are explained, and the practical limitations of matching techniques are emphasized. The authors introduce matching methods by focusing first on ideal scenarios in which stratification and weighting procedures warrant causal inference. Then, they discuss how matching is often undertaken in practice, offering an overview of the most prominent data analysis routines. With four hypothetical examples, they demonstrate how the assumptions behind matching estimators often break down in practice. Even so, the authors argue that matching techniques can be used effectively to strengthen the prosecution of causal questions in sociology.",0 +https://doi.org/10.1093/ijpor/edp021,An Application of the Estimated Dependent Variable Approach: Trade Union Members' Support for Active Labor Market Policies and Insider-Outsider Politics,,0 +https://doi.org/10.1007/bf02294842,Maximum likelihood estimation of nonlinear structural equation models,"The existing maximum likelihood theory and its computer software in structural equation modeling are established based on linear relationships among manifest variables and latent variables. However, models with nonlinear relationships are often encountered in social and behavioral sciences. In this article. an EM type algorithm is developed for maximum likelihood estimation of a general nonlinear structural equation model. To avoid computation of the complicated multiple integrals involved, the E-step is completed by a Metropolis-Hastings algorithm. It is shown that the M-step can be completed efficiently by simple conditional maximization. Standard errors of the maximum likelihood estimates are obtained via Louis's formula. The methodology is illustrated with results from a simulation study and two real examples.",0 +https://doi.org/10.1016/j.yrtph.2009.01.011,Interspecies extrapolation in environmental exposure standard setting: A Bayesian synthesis approach,"Currently the extrapolation of evidence from studies of non-human species to the setting of environmental exposure standards for humans includes the imposition of a variety of uncertainty factors reflecting unknown aspects of the procedure, including the relevance of evidence from one species to impacts in another. This paper develops and explores more flexible modelling of aspects of this extrapolation, using models proposed by DuMouchel [DuMouchel, W.H., Harris, J.E., 1983. Bayes methods for combining the results of cancer studies in humans and other species (with comment). J. Am. Statist. Assoc. 78, 293–308.] The approaches are based on Bayesian meta-analysis methods involving explicit modelling of relevance in the prior distributions, estimated using Markov chain Monte Carlo (MCMC) methods. The methods are applied to evidence relating chlorinated by-products exposure to adverse reproductive health effects. The relative merits of various approaches are discussed, and developments and next steps are outlined.",0 +https://doi.org/10.1002/9781119970583,Latent Variable Models and Factor Analysis,"Latent Variable Models and Factor Analysis provides a comprehensive and unified approach to factor analysis and latent variable modeling from a statistical perspective. This book presents a general framework to enable the derivation of the commonly used models, along with updated numerical examples. Nature and interpretation of a latent variable is also introduced along with related techniques for investigating dependency. This book: Provides a unified approach showing how such apparently diverse methods as Latent Class Analysis and Factor Analysis are actually members of the same family. Presents new material on ordered manifest variables, MCMC methods, non-linear models as well as a new chapter on related techniques for investigating dependency. Includes new sections on structural equation models (SEM) and Markov Chain Monte Carlo methods for parameter estimation, along with new illustrative examples. Looks at recent developments on goodness-of-fit test statistics and on non-linear models and models with mixed latent variables, both categorical and continuous. No prior acquaintance with latent variable modelling is pre-supposed but a broad understanding of statistical theory will make it easier to see the approach in its proper perspective. Applied statisticians, psychometricians, medical statisticians, biostatisticians, economists and social science researchers will benefit from this book. © 2011 John Wiley & Sons, Ltd. All rights reserved.",0 +https://doi.org/10.1016/j.jmva.2014.12.013,Joint prior distributions for variance parameters in Bayesian analysis of normal hierarchical models,"In random effect models, error variance (stage 1 variance) and scalar random effect variance components (stage 2 variances) are a priori modeled independently. Considering the intrinsic link between the stages 1 and 2 variance components and their interactive effect on the parameter draws in Gibbs sampling, we propose modeling the variances of the two stages a priori jointly in a multivariate fashion. We use random effects linear growth model for illustration and consider multivariate distributions to model the variance components jointly including the recently developed generalized multivariate log gamma (G-MVLG) distribution. We discuss these variance priors as well as the independent variance priors exercised in the literature in different aspects including noninformativeness and propriety of the associated posterior density. We show through an extensive simulation experiment that modeling the variance components of different stages multivariately results in better estimation properties for the response and random effect model parameters compared to independent modeling. We scrutinize the sensitivity of response model coefficient estimates to the parameters of considered noninformative variance priors and find that their full conditional expectations are insensitive to noninformative G-MVLG prior parameters. We apply independent and joint models for analysis of a real dataset and find that multivariate priors for variance components lead to better fitted hierarchical model than the univariate variance priors.",0 +https://doi.org/10.1037/1082-989x.10.4.477,Inequality Constrained Analysis of Variance: A Bayesian Approach.,"Researchers often have one or more theories or expectations with respect to the outcome of their empirical research. When researchers talk about the expected relations between variables if a certain theory is correct, their statements are often in terms of one or more parameters expected to be larger or smaller than one or more other parameters. Stated otherwise, their statements are often formulated using inequality constraints. In this article, a Bayesian approach to evaluate analysis of variance or analysis of covariance models with inequality constraints on the (adjusted) means is presented. This evaluation contains two issues: estimation of the parameters given the restrictions using the Gibbs sampler and model selection using Bayes factors in the case of competing theories. The article concludes with two illustrations: a one-way analysis of covariance and an analysis of a three-way table of ordered means.",0 +https://doi.org/10.1016/j.csda.2003.10.005,Small sample inference for the fixed effects in the mixed linear model,"The small sample performance of several procedures for testing a given fixed effect in a mixed linear model is investigated. Using simulations, constructed on the basis of a study of growth of children with Gaucher's disease, standard normal-theory Wald tests for both ML and REML estimates, the likelihood ratio test (LRT), a modified LRT based on Bartlett correction, and a number of adjusted tests based on t and F distributions are evaluated. Methods used for determining the denominator degrees of freedom in the t and F tests include the residual degrees of freedom method, the between and within degrees of freedom, the containment method, the naive method and the Satterthwaite method. A test based on a sandwich-type estimator of the variance of the parameter estimate is evaluated as well and the effect of mis-specifying the random-effects distribution is considered. Results show that Type I error rates for the Wald-type test with chi-square approximation are substantially inflated, though less so with REML estimates than with ML estimates. The LRT based on ML estimates yielded Type I error rates similar to those observed for the Wald-type chi-square test with REML estimates. A substantial improvement in Type I error rates for testing on both the intercept and slope is provided by each of the three following modifications: the Satterthwaite and naive methods with REML-based estimates and the Bartlett-corrected LRT.",0 +https://doi.org/10.1207/s15328007sem0703_3,Bayesian Analysis of Structural Equation Model With Fixed Covariates,"This article extends the LISREL model to incorporate fixed covariates at both the measurement and the structural equations of the model. A Bayesian procedure with conjugate type prior distributions is established. The joint Bayesian estimates of the latent variables and the structural parameters that involve the regression coefficients of the covariates, the variances, covariances and causations among the manifest and latent variables are obtained via the Gibbs sampler algorithm. It is shown that the conditional distributions required in the Gibbs sampler are familiar distributions, hence the algorithm is very efficient. A goodness of fit statistic for assessing the proposed model is presented. An illustrative example with some real data is presented.",0 +https://doi.org/10.1002/jrsm.1129,Multivariate meta‐analysis using individual participant data,"When combining results across related studies, a multivariate meta-analysis allows the joint synthesis of correlated effect estimates from multiple outcomes. Joint synthesis can improve efficiency over separate univariate syntheses, may reduce selective outcome reporting biases, and enables joint inferences across the outcomes. A common issue is that within-study correlations needed to fit the multivariate model are unknown from published reports. However, provision of individual participant data (IPD) allows them to be calculated directly. Here, we illustrate how to use IPD to estimate within-study correlations, using a joint linear regression for multiple continuous outcomes and bootstrapping methods for binary, survival and mixed outcomes. In a meta-analysis of 10 hypertension trials, we then show how these methods enable multivariate meta-analysis to address novel clinical questions about continuous, survival and binary outcomes; treatment–covariate interactions; adjusted risk/prognostic factor effects; longitudinal data; prognostic and multiparameter models; and multiple treatment comparisons. Both frequentist and Bayesian approaches are applied, with example software code provided to derive within-study correlations and to fit the models. © 2014 The Authors. Research Synthesis Methods published by John Wiley & Sons, Ltd.",0 +https://doi.org/10.1177/0049124107301947,Latent Variable Models Under Misspecification: Two-Stage Least Squares (2SLS) and Maximum Likelihood (ML) Estimators,"This article compares maximum likelihood (ML) estimation to three variants of two-stage least squares (2SLS) estimation in structural equation models. The authors use models that are both correctly and incorrectly specified. Simulated data are used to assess bias, efficiency, and accuracy of hypothesis tests. Generally, 2SLS with reduced sets of instrumental variables performs similarly to ML when models are correctly specified. Under correct specification, both estimators have little bias except at the smallest sample sizes and are approximately equally efficient. As predicted, when models are incorrectly specified, 2SLS generally performs better, with less bias and more accurate hypothesis tests. Unless a researcher has tremendous confidence in the correctness of his or her model, these results suggest that a 2SLS estimator should be considered.",0 +https://doi.org/10.1037/a0012320,"Where similarity beats redundancy: The importance of context, higher order similarity, and response assignment.","People are especially efficient in processing certain visual stimuli such as human faces or good configurations. It has been suggested that topology and geometry play important roles in configural perception. Visual search is one area in which configurality seems to matter. When either of 2 target features leads to a correct response and the sequence includes trials in which either or both targets are present, the result is a redundant-target paradigm. It is common for such experiments to find faster performance with the double target than with either alone, something that is difficult to explain with ordinary serial models. This redundant-targets study uses figures that can be dissimilar in their topology and geometry and manipulates the stimulus set and the stimulus?response assignments. The authors found that the combination of higher order similarity (e.g., topological) among the features in the stimulus set and response assignment can effectively overpower or facilitate the redundant-target effect, depending on the exact nature of the former characteristics. Several reasonable models of redundant-targets performance are falsified. Parallel models with the potential for channel interactions are supported by the data.",0 +https://doi.org/10.1093/bioinformatics/btt633,Testing multiple biological mediators simultaneously,"Abstract Motivation: Modern biomedical and epidemiological studies often measure hundreds or thousands of biomarkers, such as gene expression or metabolite levels. Although there is an extensive statistical literature on adjusting for ‘multiple comparisons’ when testing whether these biomarkers are directly associated with a disease, testing whether they are biological mediators between a known risk factor and a disease requires a more complex null hypothesis, thus offering additional methodological challenges. Results: We propose a permutation approach that tests multiple putative mediators and controls the family wise error rate. We demonstrate that, unlike when testing direct associations, replacing the Bonferroni correction with a permutation approach that focuses on the maximum of the test statistics can significantly improve the power to detect mediators even when all biomarkers are independent. Through simulations, we show the power of our method is 2–5× larger than the power achieved by Bonferroni correction. Finally, we apply our permutation test to a case-control study of dietary risk factors and colorectal adenoma to show that, of 149 test metabolites, docosahexaenoate is a possible mediator between fish consumption and decreased colorectal adenoma risk. Availability and implementation: R-package included in online Supplementary Material. Contact: joshua.sampson@nih.gov Supplementary information: Supplementary materials are available at Bioinformatics online.",0 +https://doi.org/10.1037/0022-0663.90.1.153,Individual differences in dyadic cooperative learning.,"The impact of individual differences on the performance of 2 roles-learner and learning facilitator-was assessed during dyadic cooperative learning. Eighty university students, 40 men and 40 women, participated in same-sex groups of 4. Each student cooperatively learned a text passage with 1 partner and then learned a 2nd passage with another partner. It a later session, the students recalled the information contained within both text passages and completed several personality measures. A social relations analysis (D. A. Kenny & L. LaVoie, 1984) was used to partition the variability in recall for the passages into various sources. Variability in recall depended strongly on individual differences in learning ability and (to a lesser extent) on individual differences in the ability to facilitate others' learning. Differences in the ability to learn text passages were independent of individual differences in the ability to facilitate others' learning. Effective learners were high in verbal ability, whereas effective learning facilitators were low in public self-consciousness and in self-monitoring. The influence of cognitive and rapport factors on the performance of the learner role and the learning facilitator role is discussed.",0 +https://doi.org/10.1016/j.neuroimage.2015.05.041,Dynamic causal modelling of brain–behaviour relationships,"In this work, we expose a mathematical treatment of brain-behaviour relationships, which we coin behavioural Dynamic Causal Modelling or bDCM. This approach aims at decomposing the brain's transformation of stimuli into behavioural outcomes, in terms of the relative contribution of brain regions and their connections. In brief, bDCM places the brain at the interplay between stimulus and behaviour: behavioural outcomes arise from coordinated activity in (hidden) neural networks, whose dynamics are driven by experimental inputs. Estimating neural parameters that control network connectivity and plasticity effectively performs a neurobiologically-constrained approximation to the brain's input-outcome transform. In other words, neuroimaging data essentially serves to enforce the realism of bDCM's decomposition of input-output relationships. In addition, post-hoc artificial lesions analyses allow us to predict induced behavioural deficits and quantify the importance of network features for funnelling input-output relationships. This is important, because this enables one to bridge the gap with neuropsychological studies of brain-damaged patients. We demonstrate the face validity of the approach using Monte-Carlo simulations, and its predictive validity using empirical fMRI/behavioural data from an inhibitory control task. Lastly, we discuss promising applications of this work, including the assessment of functional degeneracy (in the healthy brain) and the prediction of functional recovery after lesions (in neurological patients).",0 +https://doi.org/10.1080/00273170701710338,Observations on the Use of Growth Mixture Models in Psychological Research,"Psychologists are applying growth mixture models at an increasing rate. This article argues that most of these applications are unlikely to reproduce the underlying taxonic structure of the population. At a more fundamental level, in many cases there is probably no taxonic structure to be found. Latent growth classes then categorically approximate the true continuum of individual differences in change. This approximation, although in some cases potentially useful, can also be problematic. The utility of growth mixture models for psychological science thus remains in doubt. Some ways in which these models might be more profitably used are suggested.",0 +https://doi.org/10.1080/03610929508831616,Eliciting prior information to enhance the predictive performance of bayesian graphical models,"Both knowledge-based systems and statistical models are typically concerned with making predictions about future observables. Here we focus on assessment of predictive performance and provide two techniques for improving the predictive performance of Bayesian graphical models. First, we present Bayesian model averaging, a technique for accounting for model uncertainty. Second, we describe a technique for eliciting a prior distribution for competing models from domain experts. We explore the predictive performance of both techniques in the context of a urological diagnostic problem.",0 +https://doi.org/10.1080/01621459.1987.10478441,Model-Based Direct Adjustment,"Abstract Direct adjustment or standardization applies population weights to subclass means in an effort to estimate population quantities from a sample that is not representative of the population. Direct adjustment has several attractive features, but when there are many subclasses it can attach large weights to small quantities of data, often in a fairly erratic manner. In the extreme, direct adjustment can attach infinite weight to nonexistent data, a noticeable inconvenience in practice. This article proposes a method of model-based direct adjustment that preserves the attractive features of conventional direct adjustment while stabilizing the weights attached to small subclasses. The sample mean and conventional direct adjustment are both special cases of model-based direct adjustment under two different extreme models for the subclass-specific selection probabilities. The discussion of this method provides some insights into the behavior of true and estimated propensity scores: the estimated scores ...",0 +https://doi.org/10.1111/j.1368-423x.2007.00212.x,Propensity score matching without conditional independence assumption—with an application to the gender wage gap in the United Kingdom,"revised version of Discussion paper 2002-08#### Propensity score matching is frequently used for estimating average treatment effects. Its applicability, however, is not confined to treatment evaluation. In this paper it is shown that propensity score matching does not hinge on a selection on observables assumption and can be used to estimate not only adjusted means but also their distributions, even with non-iid sampling. Propensity score matching is used to analyze the gender wage gap among graduates in the UK. It is found that subject of degree contributes substantially to explaining the gender wage gap, particularly at higher quantiles of the wage distribution. Download Discussion Paper: (pdf, 910 kb)",0 +https://doi.org/10.1016/s0169-7161(07)27002-6,"2 Statistical Inference for Causal Effects, With Emphasis on Applications in Epidemiology and Medical Statistics","Abstract A central problem in epidemiology and medical statistics is how to draw inferences about the causal effects of treatments (i.e., interventions) from randomized and nonrandomized data. For example, does the new drug really reduce heart disease, or does exposure to that chemical in drinking water increase cancer rates relative to drinking water without that chemical? This chapter provides an overview of the approach to the estimation of such causal effects based on the concept of potential outcomes. We discuss randomization-based approaches and the Bayesian posterior predictive approach.",0 +https://doi.org/10.3758/s13414-014-0825-x,Modeling visual search using three-parameter probability functions in a hierarchical Bayesian framework,"In this study, we applied Bayesian-based distributional analyses to examine the shapes of response time (RT) distributions in three visual search paradigms, which varied in task difficulty. In further analyses we investigated two common observations in visual search-the effects of display size and of variations in search efficiency across different task conditions-following a design that had been used in previous studies (Palmer, Horowitz, Torralba, & Wolfe, Journal of Experimental Psychology: Human Perception and Performance, 37, 58-71, 2011; Wolfe, Palmer, & Horowitz, Vision Research, 50, 1304-1311, 2010) in which parameters of the response distributions were measured. Our study showed that the distributional parameters in an experimental condition can be reliably estimated by moderate sample sizes when Monte Carlo simulation techniques are applied. More importantly, by analyzing trial RTs, we were able to extract paradigm-dependent shape changes in the RT distributions that could be accounted for by using the EZ2 diffusion model. The study showed that Bayesian-based RT distribution analyses can provide an important means to investigate the underlying cognitive processes in search, including stimulus grouping and the bottom-up guidance of attention.",0 +https://doi.org/10.1080/00273171.2016.1208074,"A Comparison of ML, WLSMV, and Bayesian Methods for Multilevel Structural Equation Models in Small Samples: A Simulation Study","Multilevel structural equation models are increasingly applied in psychological research. With increasing model complexity, estimation becomes computationally demanding, and small sample sizes pose further challenges on estimation methods relying on asymptotic theory. Recent developments of Bayesian estimation techniques may help to overcome the shortcomings of classical estimation techniques. The use of potentially inaccurate prior information may, however, have detrimental effects, especially in small samples. The present Monte Carlo simulation study compares the statistical performance of classical estimation techniques with Bayesian estimation using different prior specifications for a two-level SEM with either continuous or ordinal indicators. Using two software programs (Mplus and Stan), differential effects of between- and within-level sample sizes on estimation accuracy were investigated. Moreover, it was tested to which extent inaccurate priors may have detrimental effects on parameter estimates in categorical indicator models. For continuous indicators, Bayesian estimation did not show performance advantages over ML. For categorical indicators, Bayesian estimation outperformed WLSMV solely in case of strongly informative accurate priors. Weakly informative inaccurate priors did not deteriorate performance of the Bayesian approach, while strong informative inaccurate priors led to severely biased estimates even with large sample sizes. With diffuse priors, Stan yielded better results than Mplus in terms of parameter estimates.",1 +https://doi.org/10.1111/1467-9280.00067,Modeling Response Times for Two-Choice Decisions,"The diffusion model for two-choice real-time decisions is applied to four psychophysical tasks. The model reveals how stimulus information guides decisions and shows how the information is processed through time to yield sometimes correct and sometimes incorrect decisions. Rapid two-choice decisions yield multiple empirical measures: response times for correct and error responses, the probabilities of correct and error responses, and a variety of interactions between accuracy and response time that depend on instructions and task difficulty. The diffusion model can explain all these aspects of the data for the four experiments we present. The model correctly accounts for error response times, something previous models have failed to do. Variability within the decision process explains how errors are made, and variability across trials correctly predicts when errors are faster than correct responses and when they are slower.",0 +https://doi.org/10.1177/0146621615574694,Marginalized Maximum Likelihood Estimation for the 1PL-AG IRT Model,Marginal maximum likelihood estimation based on the expectation–maximization algorithm (MML/EM) is developed for the one-parameter logistic model with ability-based guessing (1PL-AG) item response theory (IRT) model. The use of the MML/EM estimator is cross-validated with estimates from NLMIXED procedure (PROC NLMIXED) in Statistical Analysis System. Numerical data are provided for comparisons of results from MML/EM and PROC NLMIXED.,0 +https://doi.org/10.1093/biostatistics/kxq016,Surface shape analysis with an application to brain surface asymmetry in schizophrenia,"Some methods for the statistical analysis of surface shapes and asymmetry are introduced. We focus on a case study where magnetic resonance images of the brain are available from groups of 30 schizophrenia patients and 38 controls, and we investigate large-scale brain surface shape differences. Key aspects of shape analysis are to remove nuisance transformations by registration and to identify which parts of one object correspond with the parts of another object. We introduce maximum likelihood and Bayesian methods for registering brain images and providing large-scale correspondences of the brain surfaces. Brain surface size-and-shape analysis is considered using random field theory, and also dimension reduction is carried out using principal and independent components analysis. Some small but significant differences are observed between the the patient and control groups. We then investigate a particular type of asymmetry called torque. Differences in asymmetry are observed between the control and patient groups, which add strength to other observations in the literature. Further investigations of the midline plane location in the 2 groups and the fitting of nonplanar curved midlines are also considered.",0 +https://doi.org/10.3102/10769986027003223,A New Maximum Likelihood Estimator for the Population Squared Multiple Correlation,"Using maximum likelihood estimation as described by R. A. Fisher (1912) , a new estimator for the population squared multiple correlation was developed. This estimator ( ρcirc; 2 (ML) ) was derived by examining all possible values of the population squared multiple correlation for a given sample size and number of predictors, and finding the one for which the observed sample value had the highest probability of occurring. The new estimator is shown to have greater accuracy than other estimators and to generate values that always fall within the parameter space. The utility of ρcirc; 2 (ML) in terms of providing the basis for the development of small sample significance tests is demonstrated. A Microsoft Excel workbook for computing ρcirc; 2 (ML) and its regions of nonsignificance and for computing a normal transformation for R 2 is offered.",0 +https://doi.org/10.1177/0146621609349804,A Comparison of Item Selection Techniques for Testlets,"This study examined the performance of the maximum Fisher’s information, the maximum posterior weighted information, and the minimum expected posterior variance methods for selecting items in a computerized adaptive testing system when the items were grouped in testlets. A simulation study compared the efficiency of ability estimation among the item selection techniques under varying conditions of local-item dependency when the response model was either the three-parameter-logistic item response theory or the three-parameter-logistic testlet response theory. The item selection techniques performed similarly within any particular condition, the practical implications of which are discussed within the article.",0 +https://doi.org/10.2147/btt.s37606,Anti-tumor necrosis factor (TNF) drugs for the treatment of psoriatic arthritis: an indirect comparison meta-analysis,"To evaluate the comparative effectiveness of available tumor necrosis factor-α inhibitors (anti-TNFs) for the management of psoriatic arthritis (PsA) in patients with an inadequate response to disease-modifying antirheumatic drugs (DMARDs).We used an exhaustive search strategy covering randomized clinical trials, systematic reviews and health technology assessments (HTA) published on anti-TNFs for PsA. We performed indirect comparisons of the available anti-TNFs (adalimumab, etanercept, golimumab, and infliximab) measuring relative risks (RR) for the psoriatic arthritis response criteria (PsARC), mean differences (MDs) for improvements from baseline for the Health Assessment Questionnaire (HAQ) by PsARC responders and non-responders, and MD for the improvements from baseline for the psoriasis area and severity index (PASI). When the reporting of data on intervention group response rates and improvements were incomplete, we used straightforward conversions based on the available data.We retrieved data from 20 publications representing seven trials, as well as two HTAs. All anti-TNFs were significantly better than control, but the indirect comparison did not reveal any statistically significant difference between the anti-TNFs. For PsARC response, golimumab yielded the highest RR and etanercept the second highest; adalimumab and infliximab both yielded notably smaller RRs. For HAQ improvement, etanercept and infliximab yielded the largest MD among PsARC responders. For PsARC nonresponders, etanercept, infliximab, and golimumab yielded similar MDs, and adalimumab a notably lower MD. For PASI improvement, infliximab yielded the largest MD and golimumab the second largest, while etanercept yielded the smallest MD. In some instances, the estimated magnitudes of effect were notably different from the estimates of previous HTA indirect comparisons.There is insufficient statistical evidence to demonstrate differences in effectiveness between available anti-TNFs for PsA. Effect estimates seem sensitive to the analytic approach, and this uncertainty should be taken into account in future economic evaluations.",0 +https://doi.org/10.1080/10705511.2014.915379,A Nonlinear Structural Equation Mixture Modeling Approach for Nonnormally Distributed Latent Predictor Variables,"Structural equation models with interaction and quadratic effects have become a standard tool for testing nonlinear hypotheses in the social sciences. Most of the current approaches assume normally distributed latent predictor variables. In this article, we describe a nonlinear structural equation mixture approach that integrates the strength of parametric approaches (specification of the nonlinear functional relationship) and the flexibility of semiparametric structural equation mixture approaches for approximating the nonnormality of latent predictor variables. In a comparative simulation study, the advantages of the proposed mixture procedure over contemporary approaches [Latent Moderated Structural Equations approach (LMS) and the extended unconstrained approach] are shown for varying degrees of skewness of the latent predictor variables. Whereas the conventional approaches show either biased parameter estimates or standard errors of the nonlinear effects, the proposed mixture approach provides unbias...",0 +https://doi.org/10.1177/0899764010362114,Making Civil Society Work: Models of Democracy and Their Impact on Civic Engagement,"This article evaluates the influence of different models of democracy on individual volunteering in associations and organizations. More precisely, we investigate the extent to which the degree of liberal and participatory conceptions of democracy respectively shapes the conditions under which voluntary engagement thrives. We apply multilevel analysis—a method that corresponds well to the central hypothesis of institutional approaches and is most suitable for modeling the relationship between the democratic context and individual volunteering. We show that both a representative conception of democracy, as well as strong direct democracy, leads to advantageous conditions for civic engagement. In contrast, if the two models of democracy are combined, the two different logics of the democratic process disturb one another, resulting in less voluntary engagement.",0 +https://doi.org/10.1207/s15328007sem1003_1,Effect of the Number of Variables on Measures of Fit in Structural Equation Modeling,"There has been relatively little systematic investigation of the effect of the number of variables on measures of model fit in structural equation modeling. There is conflicting evidence as to whether measures of fit tend to improve or decline as more variables are added to the model. We consider 3 different types of specification error: minor factors, 2-factor models, and method errors. Using a formal method based on the noncentrality parameter (NCP), we find that root mean squared error of approximation (RMSEA) tends to improve regardless of the type of specification error and that the comparative fit index (CFI) and Tucker-Lewis Index (TLI), generally, though not always, tend to worsen as the number of variables in the model increases. The formal method that we develop can be used to investigate other measures of fit and other types of misspecification.",0 +https://doi.org/10.1111/bmsp.12040,A threshold theory account of psychometric functions with response confidence under the balance condition,"The study of thresholds for discriminability has been of long-standing interest in psychophysics. While threshold theories embrace the concept of discrete-state thresholds, signal detection theory discounts such a concept. In this paper we concern ourselves with the concept of thresholds from the discrete-state modelling viewpoint. In doing so, we find it necessary to clarify some fundamental issues germane to the psychometric function (PF), which is customarily constructed using psychophysical methods with a binary-response format. We challenge this response format and argue that response confidence also plays an important role in the construction of PFs, and thus should have some impact on threshold estimation. We motivate the discussion by adopting a three-state threshold theory for response confidence proposed by Krantz (1969, Psychol. Rev., 76, 308–324), which is a modification of Luce's (1963, Psychol. Rev., 70, 61–79) low-threshold theory. In particular, we discuss the case in which the practice of averaging over order (or position) is enforced in data collection. Finally, we illustrate the fit of the Luce–Krantz model to data from a line-discrimination task with response confidence.",0 +https://doi.org/10.1890/12-0156.1,Temporal shifts in top-down vs. bottom-up control of epiphytic algae in a seagrass ecosystem,"In coastal marine food webs, small invertebrate herbivores (mesograzers) have long been hypothesized to occupy an important position facilitating dominance of habitat-forming macrophytes by grazing competitively superior epiphytic algae. Because of the difficulty of manipulating mesograzers in the field, however, their impacts on community organization have rarely been rigorously documented. Understanding mesograzer impacts has taken on increased urgency in seagrass systems due to declines in seagrasses globally, caused in part by widespread eutrophication favoring seagrass overgrowth by faster-growing algae. Using cage-free field experiments in two seasons (fall and summer), we present experimental confirmation that mesograzer reduction and nutrients can promote blooms of epiphytic algae growing on eelgrass (Zostera marina). In this study, nutrient additions increased epiphytes only in the fall following natural decline of mesograzers. In the summer, experimental mesograzer reduction stimulated a 447% increase in epiphytes, appearing to exacerbate seasonal dieback of eelgrass. Using structural equation modeling, we illuminate the temporal dynamics of complex interactions between macrophytes, mesograzers, and epiphytes in the summer experiment. An unexpected result emerged from investigating the interaction network: drift macroalgae indirectly reduced epiphytes by providing structure for mesograzers, suggesting that the net effect of macroalgae on seagrass depends on macroalgal density. Our results show that mesograzers can control proliferation of epiphytic algae, that top-down and bottom-up forcing are temporally variable, and that the presence of macroalgae can strengthen top-down control of epiphytic algae, potentially contributing to eelgrass persistence.",0 +https://doi.org/10.1080/17405629.2015.1040757,The Achievement Emotions Questionnaire: Validation for Pre-Adolescent Students,"The Achievement Emotions Questionnaire (AEQ) is a self-report instrument developed to measure the emotions of students in academic situations. The main purpose of this research was to adapt and validate this questionnaire to assess pre-adolescents' class- and test-related emotions towards mathematics. The participants were 1515 Portuguese students from grades 5 and 7 (age range 10–13 years). Confirmatory factor analyses and descriptive statistics confirm the reliability and internal validity of the AEQ for Pre-Adolescents (AEQ-PA), providing evidence that the AEQ-PA is an effective instrument to assess pre-adolescent achievement emotions towards mathematics classes and tests.",0 +https://doi.org/10.1080/01621459.1992.10475289,Facilitating the Gibbs Sampler: The Gibbs Stopper and the Griddy-Gibbs Sampler,"Abstract The article briefly reviews the history, literature, and form of the Gibbs sampler. An importance sampling device is proposed for converting the output of the Gibbs sampler to a sample from the exact posterior. This Gibbs stopper technique is also useful for assessing convergence of the Gibbs sampler for moderate sized problems. Also presented is an approach for implementing the Gibbs sampler in nonconjugate situations. The basic idea is to approximate the true cdf of each conditional distribution by a piecewise linear function and then sample from the approximation. Questions relating to the number of nodes in the approximation, gap size between successive nodes, and the treatment of unbounded intervals for a given conditional are discussed. The methodology is illustrated using a genetic linkage model, a nonlinear regression model, and the Cox model.",0 +https://doi.org/10.1016/j.obhdp.2011.09.004,The pursuit of missing information in negotiation,A large body of research has focused on how people exchange and use information during the negotiation process. This work tends to treat information as if it all were readily available upon request. The current research investigated how delays in the pursuit of missing information can influence people's ex-ante priorities and the final settlements they reach. Study 1 found that negotiators achieved more value on an issue after seeking missing information about that issue compared to when the same information was readily accessible. Study 2 found that the effect of searching for information on outcomes was mediated by changes in how important negotiators perceived the issue to be. Theoretical and practical implications are discussed.,0 +https://doi.org/10.1037//0021-9010.86.5.837,Job search and employment: A personality-motivational analysis and meta-analytic review.,"A motivational, self-regulatory conceptualization of job search was used to organize and investigate the relationships between personality, expectancies, self, social, motive, and biographical variables and individual differences in job search behavior and employment outcomes. Meta-analytic results indicated that all antecedent variables, except optimism, were significantly related to job search behavior, with estimated population correlations ranging from -.15 to .46. As expected, job search behavior was significantly and positively related to finding employment. Several antecedents of job search were also significantly related to employment success, although the size of these relationships was consistently smaller than those obtained for job search. Moderator analyses showed significant differences in the size of variable relationships for type of job search measure (effort vs. intensity) and sample type (job loser vs. employed job seeker vs. new entrant).",0 +https://doi.org/10.1002/sim.6163,Objective Bayesian meta-analysis for sparse discrete data,"This paper presents a Bayesian model for meta-analysis of sparse discrete binomial data, which are out of the scope of the usual hierarchical normal random-effect models. Treatment effectiveness data are often of this type. The crucial linking distribution between the effectiveness conditional on the healthcare center and the unconditional effectiveness is constructed from specific bivariate classes of distributions with given marginals. This assures coherency between the marginal and conditional prior distributions utilized in the analysis. Further, we impose a bivariate class of priors that is able to accommodate a wide range of heterogeneity degrees between the multicenter clinical trials involved. Applications to real multicenter data are given and compared with previous meta-analysis. Copyright © 2014 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1037/a0015730,Complex span versus updating tasks of working memory: The gap is not that deep.,"How to best measure working memory capacity is an issue of ongoing debate. Besides established complex span tasks, which combine short-term memory demands with generally unrelated secondary tasks, there exists a set of paradigms characterized by continuous and simultaneous updating of several items in working memory, such as the n-back, memory updating, or alpha span tasks. With a latent variable analysis (N = 96) based on content-heterogeneous operationalizations of both task families, the authors found a latent correlation between a complex span factor and an updating factor that was not statistically different from unity (r = .96). Moreover, both factors predicted fluid intelligence (reasoning) equally well. The authors conclude that updating tasks measure working memory equally well as complex span tasks. Processes involved in building, maintaining, and updating arbitrary bindings may constitute the common working memory ability underlying performance on reasoning, complex span, and updating tasks.",0 +https://doi.org/10.1037//0021-9010.86.1.145,Risk propensity differences between entrepreneurs and managers: A meta-analytic review.,"Research examining the relative risk-taking propensities of entrepreneurs and managers has produced conflicting findings and no consensus, posing an impediment to theory development. To overcome the limitations of narrative reviews, the authors used psychometric meta-analysis to mathematically cumulate the literature concerning risk propensity differences between entrepreneurs and managers. Results indicate that the risk propensity of entrepreneurs is greater than that of managers. Moreover, there are larger differences between entrepreneurs whose primary goal is venture growth versus those whose focus is on producing family income. Results also underscore the importance of precise construct definitions and rigorous measurement.",0 +https://doi.org/10.1002/sim.2211,Inference of nested variance components in a longitudinal myopia intervention trial,"This paper was motivated by a double-blind randomized clinical trial of myopia intervention. In addition to the primary goal of comparing treatment effects, we are concerned with the modelling of correlation that may come from two possible sources, one among the longitudinal observations and the other between measurements taken from both eyes per subject. The data are nested repeated measurements. We suggest three models for analysis. Each one expresses the correlation differently in various covariance structures. We articulate their differences and describe the implementations in estimation using commercial statistical software. The computer output can be further utilized to perform model selection with Schwarz criterion. Simulation studies are conducted to evaluate the performance under each model. Data of the myopia intervention trial are reanalysed with these models for illustration. The results indicate that atropine is more effective in reducing the progression rate, the rates are homogeneous across subjects, and, among the suggested models, the one with independent random effects of two eyes fits best. We conclude that model selection is a crucial step before making inference with estimates; otherwise the correlation may be attributed incorrectly to a different mechanism. The same conclusion applies to other variance components as well.",0 +https://doi.org/10.1007/bf02289856,Local influence analysis of nonlinear structural equation models,"By regarding the latent random vectors as hypothetical missing data and based on the conditional expectation of the complete-data log-likelihood function in the EM algorithm, we investigate assessment of local influence of various perturbation schemes in a nonlinear structural equation model. The basic building blocks of local influence analysis are computed via observations of the latent variables generated by the Metropolis-Hastings algorithm, while the diagnostic measures are obtained via the conformal normal curvature. Seven perturbation schemes, including some perturbation schemes on latent vectors, are investigated. The proposed procedure is illustrated by a simulation study and a real example. © 2004 The Psychometric Society.",0 +https://doi.org/10.1080/10705510701758281,The Impact of Misspecifying Class-Specific Residual Variances in Growth Mixture Models,"The purpose of this study was to examine the impact of misspecifying a growth mixture model (GMM) by assuming that Level-1 residual variances are constant across classes, when they do, in fact, vary in each subpopulation. Misspecification produced bias in the within-class growth trajectories and variance components, and estimates were substantially less precise than those obtained from a correctly specified GMM. Bias and precision became worse as the ratio of the largest to smallest Level-1 residual variances increased, class proportions became more disparate, and the number of class-specific residual variances in the population increased. Although the Level-1 residuals are typically of little substantive interest, these results suggest that researchers should carefully estimate and report these parameters in published GMM applications.",0 +https://doi.org/10.1016/j.jval.2013.09.006,An Integrated Approach to Evaluating Alternative Risk Prediction Strategies: A Case Study Comparing Alternative Approaches for Preventing Invasive Fungal Disease,"This article proposes an integrated approach to the development, validation, and evaluation of new risk prediction models illustrated with the Fungal Infection Risk Evaluation study, which developed risk models to identify non-neutropenic, critically ill adult patients at high risk of invasive fungal disease (IFD).Our decision-analytical model compared alternative strategies for preventing IFD at up to three clinical decision time points (critical care admission, after 24 hours, and end of day 3), followed with antifungal prophylaxis for those judged ""high"" risk versus ""no formal risk assessment."" We developed prognostic models to predict the risk of IFD before critical care unit discharge, with data from 35,455 admissions to 70 UK adult, critical care units, and validated the models externally. The decision model was populated with positive predictive values and negative predictive values from the best-fitting risk models. We projected lifetime cost-effectiveness and expected value of partial perfect information for groups of parameters.The risk prediction models performed well in internal and external validation. Risk assessment and prophylaxis at the end of day 3 was the most cost-effective strategy at the 2% and 1% risk threshold. Risk assessment at each time point was the most cost-effective strategy at a 0.5% risk threshold. Expected values of partial perfect information were high for positive predictive values or negative predictive values (£11 million-£13 million) and quality-adjusted life-years (£11 million).It is cost-effective to formally assess the risk of IFD for non-neutropenic, critically ill adult patients. This integrated approach to developing and evaluating risk models is useful for informing clinical practice and future research investment.",0 +https://doi.org/10.1007/bf02296195,MCMC estimation and some model-fit analysis of multidimensional IRT models,A Bayesian procedure to estimate the three-parameter normal ogive model and a generalization of the procedure to a model with multidimensional ability parameters are presented. The procedure is a generalization of a procedure by Albert (1992) for estimating the two-parameter normal ogive model. The procedure supports analyzing data from multiple populations and incomplete designs. It is shown that restrictions can be imposed on the factor matrix for testing specific hypotheses about the ability structure. The technique is illustrated using simulated and real data.,0 +https://doi.org/10.1002/sim.1142,Small-sample adjustments in using the sandwich variance estimator in generalized estimating equations,"The generalized estimating equation (GEE) approach is widely used in regression analyses with correlated response data. Under mild conditions, the resulting regression coefficient estimator is consistent and asymptotically normal with its variance being consistently estimated by the so-called sandwich estimator. Statistical inference is thus accomplished by using the asymptotic Wald chi-squared test. However, it has been noted in the literature that for small samples the sandwich estimator may not perform well and may lead to much inflated type I errors for the Wald chi-squared test. Here we propose using an approximate t- or F-test that takes account of the variability of the sandwich estimator. The level of type I error of the proposed t- or F-test is guaranteed to be no larger than that of the Wald chi-squared test. The satisfactory performance of the proposed new tests is confirmed in a simulation study. Our proposal also has some advantages when compared with other new approaches based on direct modifications of the sandwich estimator, including the one that corrects the downward bias of the sandwich estimator. In addition to hypothesis testing, our result has a clear implication on constructing Wald-type confidence intervals or regions.",0 +https://doi.org/10.1037/0021-9010.71.2.302,On seeking moderator variables in the meta-analysis of correlational data: A Monte Carlo investigation of statistical power and resistance to Type I error.,"A series of Monte Carlo computer simulations was conducted to investigate (a) the likelihood that meta-analysis will detect true differences in effect sizes rather than attributing differences to methodological artifact and (b) the likelihood that meta-analysis will suggest the presence of moderator variables when in fact differences in effect sizes are due to methodological artifact. The simulations varied the magnitude of the true population differences between correlations, the number of studies included in the meta-analysis, and the average sample size. Simulations were run both correcting for and not correcting for measurement error. The power of three indexes-the Schmidt-Hunter ratio of expected to observed variance, the Callender-Osburn procedure, and a chi-square test-to detect true differences was investigated. Small true differences will not be detected regardless of sample size and number of studies, and moderate true differences will not be detected with small numbers of studies or small sample sizes. Hence there is a need for caution in attributing observed variation across studies to artifact. © 1986 American Psychological Association.",0 +https://doi.org/10.1007/s11121-009-0125-1,Evaluating Mediation in Longitudinal Multivariate Data: Mediation Effects for the Aban Aya Youth Project Drug Prevention Program,"This study illustrates a method to evaluate mediational mechanisms in a longitudinal prevention trial, the Aban Aya Youth Project (AAYP). In previous studies, interventions of AAYP were found to be effective in reducing the growth of violence, substance use and unsafe sex among African American adolescents. In this article, we hypothesized that the effects of the interventions in reducing the growth of substance use behavior were achieved through their effects in changing intermediate processes such as behavioral intentions, attitudes toward the behavior, estimates of peers' behaviors, best friends' behaviors, and peer group pressure. In evaluating these mediational mechanisms, difficulties arise because the growth trajectories of the substance use outcome variable and some of the mediating variables were curvilinear. In addition, all of the multivariate mediational measures had planned missing data so that a score from the multiple items for a mediator could not be formed easily. In this article, we introduce a latent growth modeling (LGM) approach; namely, a two-domain LGM mediation model, in which the growth curves of the outcome and the mediator are simultaneously modeled and the mediation effects are evaluated. Results showed that the AAYP intervention effects on adolescent drug use were mediated by normative beliefs of prevalence estimates, friends' drug use behavior, perceived friends' encouragement to use, and attitudes toward the behavior. © 2009 Society for Prevention Research.",0 +https://doi.org/10.1177/0146621605279761,Longitudinal Rasch Modeling in the Context of Psychotherapy Outcomes Assessment,"The present study illustrates an extension of Kamata's (2001) restricted form of the hierarchical generalized linear model that provides a multilevel longitudinal Rasch measurement model appropriate for use with polytomous responses. This extension can be used to assess average and interindividual change in the latent trait of interest, concurrently with an assessment of the invariance of item locations over time. Responses of 1,353 college students to three subscales (namely, measures of depression/ anxiety, stress, and well-being) of the Outcome Questionnaire were used for demonstration purposes. Interpretation of the results is provided, and the benefits of using a multilevel item response theory model with longitudinal data are discussed.",0 +https://doi.org/10.1080/10705511.2013.769391,Sample Size Limits for Estimating Upper Level Mediation Models Using Multilevel SEM,"This simulation study investigated use of the multilevel structural equation model (MLSEM) for handling measurement error in both mediator and outcome variables (M and Y) in an upper level multilevel mediation model. Mediation and outcome variable indicators were generated with measurement error. Parameter and standard error bias, confidence interval coverage, and power to detect the ab mediated effect using Empirical-M confidence interval estimates were assessed for the correct MLSEM versus a conventional multilevel model (MM) that used composite scores for M and Y. The following conditions were manipulated: level 1 and 2 sample sizes, intraclass correlation, degree of measurement error in M, and the true value of ab. The MLSEM more accurately recovered the ab effect's value, but serious convergence issues were encountered with MLSEM estimates based on fewer than 80 clusters. More power for detecting a nonzero ab was found for MM than for MLSEM estimates.",0 +https://doi.org/10.1016/s0160-2896(02)00115-0,The multiple faces of working memory,"Investigated the distinctiveness of working memory functions and their components against the background of a multi-facet model. 133 university students (mean age 26 years) performed a series of specially constructed working memory tasks. Each task represented an operationalization of specific cells of the proposed taxonomy of working memory functional and content-related facets. Dependent variables included recall performance and reaction time. Structural equation modeling yielded 3 distinct working memory functions: (1) simultaneous storage of information in the context of processing, (2) supervision, and (3) coordination of elements into structures. Further analyses allowed for a more detailed subdivision of each function into specific components. Only a minimal portion of the variance associated with working memory functions is specific to the verbal or the spatial domain. Overall, the findings demonstrate that working memory is best characterized as a highly interrelated collection of cognitive functions.",0 +https://doi.org/10.1371/journal.pone.0106528,The Influence of Compositional and Contextual Factors on Non-Receipt of Basic Vaccines among Children of 12-23-Month Old in India: A Multilevel Analysis,"Children unreached by vaccination are at higher risk of poor health outcomes and India accounts for nearly a quarter of unvaccinated children worldwide. The objective of this study was to investigate compositional and contextual determinants of non-receipt of childhood vaccines in India using multilevel modelling.We studied characteristics of unvaccinated children using the District Level Health and Facility Survey 3, a nationally representative probability sample containing 65 617 children aged 12-23 months from 34 Indian states and territories. We developed four-level Bayesian binomial regression models to examine the determinants of non-vaccination. The analysis considered two outcomes: completely unvaccinated (CUV) children who had not received any of the eight vaccine doses recommended by India's Universal Immunization Programme, and children who had not received any dose from routine immunisation services (no RI). The no RI category includes CUV children and those who received only polio doses administered via mass campaigns. Overall, 4.83% (95% CI: 4.62-5.06) of children were CUV while 12.01% (11.68-12.35) had received no RI. Individual compositional factors strongly associated with CUV were: non-receipt of tetanus immunisation for mothers during pregnancy (OR = 3.65 [95% CrI: 3.30-4.02]), poorest household wealth index (OR = 2.44 [1.81-3.22] no maternal schooling (OR = 2.43 [1.41-4.05]) and no paternal schooling (OR = 1.83 [1.30-2.48]). In rural settings, the influence of maternal illiteracy disappeared whereas the role of household wealth index was reinforced. Factors associated with no RI were similar to those for CUV, but effect sizes for individual compositional factors were generally larger. Low maternal education was the strongest risk factor associated with no RI in all models. All multilevel models found significant variability at community, district, and state levels net of compositional factors.Non-vaccination in India is strongly related to compositional characteristics and is geographically distinct. Tailored strategies are required to overcome current barriers to immunisation.",0 +https://doi.org/10.1086/208721,Conjoint Analysis in Consumer Research: Issues and Outlook,Since 1971 conjoint analysis has been applied to a wide variety of problems in consumer research. This paper discusses various issues involved in implementing conjoint analysis and describes some new technical developments and application areas for the methodology.,0 +https://doi.org/10.1207/s15328007sem0901_3,Latent Variable Interaction Modeling,Latent variable interaction modeling with continuous observed variables is presented using 2 different approaches. The 1st approach analyzes data using a LISREL 8.30 program where the latent interaction variable is defined by multiplying pairs of observed variables. The 2nd approach analyzes data using PRELIS2 and SIMPLIS programs where the latent interaction variable is defined by multiplying the latent variable scores of the exogeneous latent independent variables. The programs used to create the multivariate normal observed variables and conduct the analyses for the 2 different approaches are given in the appendixes. The product indicant and latent variable score approach produced similar gamma coefficients in their hypothesized models but differed in their standard errors for the gamma coefficients. The latent variable score approach holds the promise of being easier to implement and can be applied to more complex latent variable interaction models.,0 +https://doi.org/10.3758/bf03194550,Slope bias of psychometric functions derived from adaptive data,"Several investigators have fit psychometric functions to data from adaptive procedures for threshold estimation. Although the threshold estimates are in general quite correct, one encounters a slope bias that has not been explained up to now. The present paper demonstrates slope bias for parametric and nonparametric maximum-likelihood fits and for Spearman-Kärber analysis of adaptive data. The examples include staircase and stochastic approximation procedures. The paper then presents an explanation of slope bias based on serial data dependency in adaptive procedures. Data dependency is first illustrated with simple two-trial examples and then extended to realistic adaptive procedures. Finally, the paper presents an adaptive staircase procedure designed to measure threshold and slope directly. In contrast to classical adaptive threshold-only procedures, this procedure varies both a threshold and a spread parameter in response to double trials.",0 +https://doi.org/10.3200/jexe.73.3.221-248,A Primer for Using and Understanding Weights With National Datasets,"Using data from the National Study of Postsecondary Faculty and the Early Childhood Longitudinal Study—Kindergarten Class of 1998-99, the author provides guidelines for incorporating weights and design effects in single-level analysis using Windows-based SPSS and AM software. Examples of analyses that do and do not employ weights and design effects are also provided to illuminate the differential results of key parameter estimates and standard errors using varying degrees of using or not using the weighting and design effect continuum. The author gives recommendations on the most appropriate weighting options, with specific reference to employing a strategy to accommodate both oversampled groups and cluster sampling (i.e., using weights and design effects) that leads to the most accurate parameter estimates and the decreased potential of committing a Type I error. However, using a design effect adjusted weight in SPSS may produce underestimated standard errors when compared with accurate estimates produce...",0 +https://doi.org/10.1002/9780470712993.ch4,"Psychometric Models, Test Designs and Item Types for the Next Generation of Educational and Psychological Tests",,0 +https://doi.org/10.1177/0049124194022003007,The Bilevel Reticular Action Model for Path Analysis with Latent Variables,"A two-level (hierarchical) model for path analysis with latent variables is described, together with some properties of a computer program written to implement the model. A simple illustrative example is given.",0 +https://doi.org/10.1207/s15328007sem1204_1,A Semiparametric Approach to Modeling Nonlinear Relations Among Latent Variables,"To date, finite mixtures of structural equation models (SEMMs) have been developed and applied almost exclusively for the purpose of providing model-based cluster analyses. This type of analysis constitutes a direct application of the model wherein the estimated component distributions of the latent classes are thought to represent the characteristics of distinct unobserved subgroups of the population. This article instead considers an indirect application of the SEMM in which the latent classes are estimated only in the service of more flexibly modeling the characteristics of the aggregate population as a whole. More specifically, the SEMM is used to semiparametrically model nonlinear latent variable regression functions. This approach is first developed analytically and then demonstrated empirically through analyses of simulated and real data.",0 +https://doi.org/10.1080/16184742.2013.837942,The influence of professional athlete philanthropy on donation intentions,"Athlete-supported charities and foundations have become increasingly popular forms of philanthropy in the professional sport landscape. However, a paucity of research has examined whether the high-profile status of a professional athlete can influence third-party donations to the charitable cause the athlete supports. Based on theory and prior literature, the image of, and identification with, a professional National Basketball Association athlete were hypothesized to influence donation intentions from potential donors in the Orlando, Florida area. In addition, the intervening effects of personal involvement with the athlete's cause and trust toward the athlete were examined. The results suggest that athlete identification, image of the athlete, trust toward the athlete, and cause involvement significantly influenced donation intentions. The results also indicate that athlete trust mediated the relationship between identification, image, and donation intentions. Finally, cause involvement moderated the re...",0 +https://doi.org/10.1080/10705511.2011.557329,Alternative Methods for Assessing Mediation in Multilevel Data: The Advantages of Multilevel SEM,"Multilevel modeling (MLM) is a popular way of assessing mediation effects with clustered data. Two important limitations of this approach have been identified in prior research and a theoretical rationale has been provided for why multilevel structural equation modeling (MSEM) should be preferred. However, to date, no empirical evidence of MSEM's advantages relative to MLM approaches for multilevel mediation analysis has been provided. Nor has it been demonstrated that MSEM performs adequately for mediation analysis in an absolute sense. This study addresses these gaps and finds that the MSEM method outperforms 2 MLM-based techniques in 2-level models in terms of bias and confidence interval coverage while displaying adequate efficiency, convergence rates, and power under a variety of conditions. Simulation results support prior theoretical work regarding the advantages of MSEM over MLM for mediation in clustered data.",0 +https://doi.org/10.1093/acprof:oso/9780199216093.003.0014,Categorization as nonparametric Bayesian density estimation,"Abstract The authors apply the state of the art techniques from machine learning and statistics to reconceptualize the problem of unsupervised category learning, and to relate it to previous psychologically motivated models, especially Anderson's rational analysis of categorization. The resulting analysis provides a deeper understanding of the motivations underlying the classic models of category representation, based on prototypes or exemplars, as well as shedding new light on the empirical data. Exemplar models assume that a category is represented by a set of stored exemplars, and categorizing new stimuli involves comparing these stimuli to the set of exemplars in each category. Prototype models assume that a category is associated with a single prototype and categorization involves comparing new stimuli to these prototypes. These approaches to category learning correspond to different strategies for density estimation used in statistics, being nonparametric and parametric density estimation respectively.",0 +https://doi.org/10.1146/annurev.psych.58.110405.085520,Analysis of Nonlinear Patterns of Change with Random Coefficient Models,"Abstract Nonlinear patterns of change arise frequently in the analysis of repeated measures from longitudinal studies in psychology. The main feature of nonlinear development is that change is more rapid in some periods than in others. There generally also are strong individual differences, so although there is a general similarity of patterns for different persons over time, individuals exhibit substantial heterogeneity in their particular response. To describe data of this kind, researchers have extended the random coefficient model to accommodate nonlinear trajectories of change. It can often produce a statistically satisfying account of subject-specific development. In this review we describe and illustrate the main ideas of the nonlinear random coefficient model with concrete examples.",0 +https://doi.org/10.1080/01621459.1990.10475312,Approaches for Empirical Bayes Confidence Intervals,"Abstract Parametric empirical Bayes (EB) methods of point estimation date to the landmark paper by James and Stein (1961). Interval estimation through parametric empirical Bayes techniques has a somewhat shorter history, which was summarized by Laird and Louis (1987). In the exchangeable case, one obtains a “naive” EB confidence interval by simply taking appropriate percentiles of the estimated posterior distribution of the parameter, where the estimation of the prior parameters (“hyperparameters”) is accomplished through the marginal distribution of the data. Unfortunately, these “naive” intervals tend to be too short, since they fail to account for the variability in the estimation of the hyperparameters. That is, they do not attain the desired coverage probability in the EB sense defined by Morris (1983a, b). They also provide no statement of conditional calibration (Rubin 1984). In this article we propose a conditional bias correction method for developing EM intervals that corrects these deficiencies...",0 +https://doi.org/10.1214/009053605000000039,Testing for monotone increasing hazard rate,"A test of the null hypothesis that a hazard rate is monotone nondecreasing, versus the alternative that it is not, is proposed. Both the test statistic and the means of calibrating it are new. Unlike previous approaches, neither is based on the assumption that the null distribution is exponential. Instead, empirical information is used to effectively identify and eliminate from further consideration parts of the line where the hazard rate is clearly increasing; and to confine subsequent attention only to those parts that remain. This produces a test with greater apparent power, without the excessive conservatism of exponential-based tests. Our approach to calibration borrows from ideas used in certain tests for unimodality of a density, in that a bandwidth is increased until a distribution with the desired properties is obtained. However, the test statistic does not involve any smoothing, and is, in fact, based directly on an assessment of convexity of the distribution function, using the conventional empirical distribution. The test is shown to have optimal power properties in difficult cases, where it is called upon to detect a small departure, in the form of a bump, from monotonicity. More general theoretical properties of the test and its numerical performance are explored.",0 +https://doi.org/10.1093/biomet/80.2.267,Maximum likelihood estimation via the ECM algorithm: A general framework,"Two major reasons for the popularity of the EM algorithm are that its maximum step involves only complete-data maximum likelihood estimation, which is often computationally simple, and that its convergence is stable, with each iteration increasing the likelihood. When the associated complete-data maximum likelihood estimation itself is complicated, EM is less attractive because the M-step is computationally unattractive. In many cases, however, complete-data maximum likelihood estimation is relatively simple when conditional on some function of the parameters being estimated",0 +https://doi.org/10.1207/s15327906mbr3903_3,Evaluating Small Sample Approaches for Model Test Statistics in Structural Equation Modeling,"Through Monte Carlo simulation, small sample methods for evaluating overall data-model fit in structural equation modeling were explored. Type I error behavior and power were examined using maximum likelihood (ML), Satorra-Bentler scaled and adjusted (SB; Satorra & Bentler, 1988, 1994), residual-based (Browne, 1984), and asymptotically distribution free (ADF; Browne, 1982, 1984) test statistics. To accommodate small sample sizes the ML and SB statistics were adjusted using a k-factor correction (Bartlett, 1950); the residual-based and ADF statistics were corrected using modified x2 and F statistics (Yuan & Bentler, 1998, 1999). Design characteristics include model type and complexity, ratio of sample size to number of estimated parameters, and distributional form. The k-factor-corrected SB scaled test statistic was especially stable at small sample sizes with both normal and nonnormal data. Methodologists are encouraged to investigate its behavior under a wider variety of models and distributional forms.",0 +https://doi.org/10.1007/s11266-012-9347-0,Eliciting Donor Preferences,"Most charity organizations depend on contributions from the general public, but little research is conducted on donor preferences. Do donors have geographical, recipient, or thematic preferences? We designed a conjoint analysis experiment in which people rated development aid projects by donating money in dictator games. We find that our sample show strong age, gender, regional, and thematic preferences. Furthermore, we find significant differences between segments. The differences in donations are consistent with differences in donors’ attitudes toward development aid and their beliefs about differences in poverty and vulnerability of the recipients. The method here used for development projects can easily be adapted to elicit preferences for other kinds of projects that rely on gifts from private donors.",0 +https://doi.org/10.1111/bmsp.12028,Statistical mediation analysis with a multicategorical independent variable,"Virtually all discussions and applications of statistical mediation analysis have been based on the condition that the independent variable is dichotomous or continuous, even though investigators frequently are interested in testing mediation hypotheses involving a multicategorical independent variable (such as two or more experimental conditions relative to a control group). We provide a tutorial illustrating an approach to estimation of and inference about direct, indirect, and total effects in statistical mediation analysis with a multicategorical independent variable. The approach is mathematically equivalent to analysis of (co)variance and reproduces the observed and adjusted group means while also generating effects having simple interpretations. Supplementary material available online includes extensions to this approach and Mplus, SPSS, and SAS code that implements it.",0 +https://doi.org/10.1161/circoutcomes.111.960724,Bayesian Hierarchical Modeling and the Integration of Heterogeneous Information on the Effectiveness of Cardiovascular Therapies,"When making therapeutic decisions for an individual patient or formulating treatment guidelines on a population level, it is often necessary to utilize information arising from different study designs, settings, or treatments. In clinical practice, heterogeneous information is frequently synthesized qualitatively, whereas in comparative effectiveness research and guideline development, it is imperative that heterogeneous data are integrated quantitatively and in a manner that accurately captures the true uncertainty in the results. Bayesian hierarchical modeling is a technique that utilizes all available information from multiple sources and naturally yields a revised estimate of the treatment effect associated with each source. A hierarchical model consists of multiple levels (ie, a hierarchy) of probability distributions that represent relationships between information arising within single populations or trials, as well as relationships between information arising from different populations or trials. We describe the structure of Bayesian hierarchical models and discuss their advantages over simpler models when multiple information sources are relevant. Two examples are presented that illustrate this technique: a meta-analysis of immunosuppressive therapy in idiopathic dilated cardiomyopathy and a subgroup analysis of the National Institute of Neurological Disorders and Stroke Intravenous Tissue Plasminogen Activator Stroke Trial.",0 +https://doi.org/10.1007/978-0-387-73186-5_8,Non-Hierarchical Multilevel Models,"In the models discussed in this book so far we have assumed that the structures of the populations from which the data have been drawn are hierarchical. This assumption is sometimes not justified. In this chapter two main types of non-hierarchical model are considered. Firstly, cross-classified models. The notion of cross-classification is probably reasonably familiar to most readers. Secondly, we consider multiple membership models, where lower level units are influenced by more than one higher-level unit from the same classification. For example, some pupils may attend more than one school. We also consider situations that contain a mixture of hierarchical, crossed and multiple membership relationships. © 2008 Springer Science+Business Media, LLC.",0 +https://doi.org/10.1177/0146621612469720,The Random-Threshold Generalized Unfolding Model and Its Application of Computerized Adaptive Testing,"The random-threshold generalized unfolding model (RTGUM) was developed by treating the thresholds in the generalized unfolding model as random effects rather than fixed effects to account for the subjective nature of the selection of categories in Likert items. The parameters of the new model can be estimated with the JAGS (Just Another Gibbs Sampler) freeware, which adopts a Bayesian approach for estimation. A series of simulations was conducted to evaluate the parameter recovery of the new model and the consequences of ignoring the randomness in thresholds. The results showed that the parameters of RTGUM were recovered fairly well and that ignoring the randomness in thresholds led to biased estimates. Computerized adaptive testing was also implemented on RTGUM, where the Fisher information criterion was used for item selection and the maximum a posteriori method was used for ability estimation. The simulation study showed that the longer the test length, the smaller the randomness in thresholds, and the more categories in an item, the more precise the ability estimates would be.",0 +https://doi.org/10.1007/s11222-012-9343-7,Likelihood-based and Bayesian methods for Tweedie compound Poisson linear mixed models,"The Tweedie compound Poisson distribution is a subclass of the exponential dispersion family with a power variance function, in which the value of the power index lies in the interval (1,2). It is well known that the Tweedie compound Poisson density function is not analytically tractable, and numerical procedures that allow the density to be accurately and fast evaluated did not appear until fairly recently. Unsurprisingly, there has been little statistical literature devoted to full maximum likelihood inference for Tweedie compound Poisson mixed models. To date, the focus has been on estimation methods in the quasi-likelihood framework. Further, Tweedie compound Poisson mixed models involve an unknown variance function, which has a significant impact on hypothesis tests and predictive uncertainty measures. The estimation of the unknown variance function is thus of independent interest in many applications. However, quasi-likelihood-based methods are not well suited to this task. This paper presents several likelihood-based inferential methods for the Tweedie compound Poisson mixed model that enable estimation of the variance function from the data. These algorithms include the likelihood approximation method, in which both the integral over the random effects and the compound Poisson density function are evaluated numerically; and the latent variable approach, in which maximum likelihood estimation is carried out via the Monte Carlo EM algorithm, without the need for approximating the density function. In addition, we derive the corresponding Markov Chain Monte Carlo algorithm for a Bayesian formulation of the mixed model. We demonstrate the use of the various methods through a numerical example, and conduct an array of simulation studies to evaluate the statistical properties of the proposed estimators. © 2012 Springer Science+Business Media, LLC.",0 +https://doi.org/10.1002/sim.6776,Bayesian meta-analytical methods to incorporate multiple surrogate endpoints in drug development process,"A number of meta-analytical methods have been proposed that aim to evaluate surrogate endpoints. Bivariate meta-analytical methods can be used to predict the treatment effect for the final outcome from the treatment effect estimate measured on the surrogate endpoint while taking into account the uncertainty around the effect estimate for the surrogate endpoint. In this paper, extensions to multivariate models are developed aiming to include multiple surrogate endpoints with the potential benefit of reducing the uncertainty when making predictions. In this Bayesian multivariate meta-analytic framework, the between-study variability is modelled in a formulation of a product of normal univariate distributions. This formulation is particularly convenient for including multiple surrogate endpoints and flexible for modelling the outcomes which can be surrogate endpoints to the final outcome and potentially to one another. Two models are proposed, first, using an unstructured between-study covariance matrix by assuming the treatment effects on all outcomes are correlated and second, using a structured between-study covariance matrix by assuming treatment effects on some of the outcomes are conditionally independent. While the two models are developed for the summary data on a study level, the individual-level association is taken into account by the use of the Prentice's criteria (obtained from individual patient data) to inform the within study correlations in the models. The modelling techniques are investigated using an example in relapsing remitting multiple sclerosis where the disability worsening is the final outcome, while relapse rate and MRI lesions are potential surrogates to the disability progression.",0 +https://doi.org/10.1016/j.addbeh.2005.04.006,The development of alcohol use and outcome expectancies among American Indian young adults: A growth mixture model,"Adolescence is an important developmental period for understanding alcohol use. American Indian youth are a group for whom various preventive interventions focusing on alcohol use have been implemented but have not necessarily been widely successful, highlighting the need to further refine our approaches. In the work reported here, we followed 464 14- to 18-year-old American Indian youth annually for seven years. We examined the development of alcohol use and positive alcohol outcome expectancies in parallel, using growth mixture modeling to identify classes with different trajectories of alcohol use and expectancies. We found five classes; the largest (n = 198) was made up of youth who experienced increases in both alcohol use and positive outcome expectancies. Initial levels of outcome expectancies were related to subsequent changes in alcohol use, while the reverse was not true, suggesting that interventions focusing on outcome expectancies are appropriate for a substantial number of youth. However, class heterogeneity in the relationships between the two processes pointed out that changes in expectancies may not always precede changes in alcohol use. Thus, intervention design implications are discussed for the class structures.",0 +https://doi.org/10.1016/j.csda.2008.12.013,An improved approximation to the precision of fixed effects from restricted maximum likelihood,"An approximate small sample variance estimator for fixed effects from the multivariate normal linear model, together with appropriate inference tools based on a scaled F pivot, is now well established in practice and there is a growing literature on its properties in a variety of settings. Although effective under linear covariance structures, there are examples of nonlinear structures for which it does not perform as well. The cause of this problem is shown to be a missing term in the underlying Taylor series expansion which accommodates the bias in the estimators of the parameters of the covariance structure. The form of this missing term is derived, and then used to adjust the small sample variance estimator. The behaviour of the resulting estimator is explored in terms of invariance under transformation of the covariance parameters and also using a simulation study. It is seen to perform successfully in the way predicted from its derivation.",0 +https://doi.org/10.1515/9783110267709,Multilevel Models,"This book covers a broad range of topics about multilevel modeling. The goal is to help readersto understand the basic concepts, theoretical frameworks, and application methods of multilevel modeling. Itis at a level also accessible to non-mathematicians, focusing on the methods and applications of various multilevel models and using the widely used statistical software SAS.Examples are drawn from analysis of real-world research data. © 2012 Higher Education Press and Walter de Gruyter GmbH & Co. KG, Berlin/Boston.",0 +https://doi.org/10.1177/0049124112460380,Distinguishing Between Cross- and Cluster-Level Mediation Processes in the Cluster Randomized Trial,"For the cluster randomized trial, the treatment, implemented at the cluster level, may be hypothesized to impact a final outcome of interest via a mediating variable, with the mediator and outcome being measured typically at the participant level. Two opposing views—one that allows the mediation process to flow through a participant-level mediator and one that does not—have been presented in the literature. We integrate these perspectives and argue that it is the theoretical model and the nature of the mediating variable that determines whether the treatment effect may be mediated by a participant-level or only a cluster-level mediator in this design. An accompanying simulation study shows that when the mediation process is unnecessarily restricted to the cluster level, the power to detect the presence of mediation is substantially reduced.",0 +https://doi.org/10.3389/fnbot.2014.00014,Time changes with feeling of speed: an embodied perspective,"The speed of moving stimuli can bias duration perception. Here, we investigated whether words describing different speeds influence subjective duration estimation in a temporal bisection task. Duration estimations of two different types of speed words (fast- vs. slow-speed words) were compared. We found that the time bisection point was significantly lower for fast-speed words than for slow-speed words, suggesting that the durations of fast-speed words were overestimated compared to the slow-speed words. In contrast, fast- and slow-speed words did not significantly differ in just noticeable differences and Weber fractions, indicating that the types of speed words did not influence the sensitivity of duration estimation. These results provide new evidence to support the theory of embodied cognition in the context of implicit meaning of a speed word.",0 +https://doi.org/10.1037/a0025688,A time-lagged momentary assessment study on daily life physical activity and affect.,"Novel study designs using within-subject methodology and frequent and prospective measurements are required to unravel direction of causality and dynamic processes of behavior over time. The current study examined the effects of physical activity on affective state. A primary and within-study replication sample was derived from twin pairs.Female twins (n = 504) participated in an experience sampling method study at baseline. Positive and negative affective changes were examined before and following daily life increases in physical activity. Neuroticism was measured at baseline and depressive symptoms were assessed at baseline and at each of four follow-up assessments. Diagnoses, derived by Structured Clinical Interview for Diagnostic and Statistical Manual for Mental Health-IV axis I disorders, (A. P. A., 1994) were obtained at baseline.A significant increase in positive affect (PA) following the moment of increase in physical activity was replicated across both samples up to 180 min after physical activity. There was no effect of physical activity on negative affect (NA). Across the two samples, a history of fulfilling diagnostic criteria for depression at least once moderated the effect of physical activity on PA, in that the effect was lost more rapidly.The study supports a causal effect of physical activity on PA. However, people with past experience of clinical depression may benefit less from the PA-inducing effect of physical activity. These findings have implications for the use of physical exercise in clinical practice.",0 +https://doi.org/10.2307/1403259,A Review of Inference Procedures for the Intraclass Correlation Coefficient in the One-Way Random Effects Model,"Summary Recent theory and methodology for inferences concerning the intraclass correlation coefficient are reviewed, under the assumption of an underlying random effects model. Topics discussed include point and interval estimation, significance-testing for nonzero values of the intraclass correlation, and inference procedures in multiple samples.",0 +https://doi.org/10.1080/10618600.2013.785732,On a Class of Shrinkage Priors for Covariance Matrix Estimation,"We propose a flexible class of models based on scale mixture of uniform distributions to construct shrinkage priors for covariance matrix estimation. This new class of priors enjoys a number of advantages over the traditional scale mixture of normal priors, including its simplicity and flexibility in characterizing the prior density. We also exhibit a simple, easy to implement Gibbs sampler for posterior simulation which leads to efficient estimation in high dimensional problems. We first discuss the theory and computational details of this new approach and then extend the basic model to a new class of multivariate conditional autoregressive models for analyzing multivariate areal data. The proposed spatial model flexibly characterizes both the spatial and the outcome correlation structures at an appealing computational cost. Examples consisting of both synthetic and real-world data show the utility of this new framework in terms of robust estimation as well as improved predictive performance.",0 +https://doi.org/10.12738/estp.2015.6.0102,Effects of Calibration Sample Size and Item Bank Size on Ability Estimation in Computerized Adaptive Testing,"This study aimed to investigate the effects of calibration sample size and item bank size on examinee ability estimation in computerized adaptive testing (CAT). For this purpose, a 500-item bank pre-calibrated using the three-parameter logistic model with 10,000 examinees was simulated. Calibration samples of varying sizes (150, 250, 350, 500, 750, 1,000, 2,000, 3,000, and 5,000) were selected from the parent sample, and item banks that represented small (100) and medium size (200 and 300) banks were drawn from the 500-item bank. Items in these banks were recalibrated using the drawn samples, and their estimated parameters were used in post-hoc simulations to re-estimate ability parameters for the simulated 10,000 examinees. The findings showed that ability estimates in CAT are robust against fluctuations in item parameter estimation and that accurate ability parameter estimates can be obtained with a calibration sample of 150 examinees. Moreover, a 200-item bank pre-calibrated with as few as 150 examinees can be used for some purposes in CAT as long as it has sufficient information at targeted ability levels.",0 +https://doi.org/10.1126/science.1158023,Dynamic Shifts of Limited Working Memory Resources in Human Vision,"Our ability to remember what we have seen is very limited. Most current views characterize this limit as a fixed number of items—only four objects—that can be held in visual working memory. We show that visual memory capacity is not fixed by the number of objects, but rather is a limited resource that is shared out dynamically between all items in the visual scene. This resource can be shifted flexibly between objects, with allocation biased by selective attention and toward targets of upcoming eye movements. The proportion of resources allocated to each item determines the precision with which it is remembered, a relation that we show is governed by a simple power law, allowing quantitative estimates of resource distribution in a scene.",0 +https://doi.org/10.2753/mtp1069-6679160402,Structural Equation Modeling in Marketing: Some Practical Reminders,"The authors review issues related to the application of structural equation modeling (SEM) in marketing. The discussion begins by considering issues related to the process of applying SEM in empirical research, including model specification, identification, estimation, evaluation, and respecification, and reporting of results. In addition to these process issues, a number of other issues, such as formulation of multiple theoretical models, model error versus sampling error, and relating study objectives to the capabilities of SEM, are considered, and suggestions offered regarding ways that SEM applications might be improved.",0 +https://doi.org/10.1167/11.6.1,Differential attentional modulation of cortical responses to S-cone and luminance stimuli,"Neural signals driven by short-wave-sensitive (S) cones are, to a large degree, anatomically and functionally separate from the achromatic luminance pathway until at least one synapse into V1. Attentional mechanisms that act at an anatomically early stage in V1 may, therefore, affect S-cone and luminance signals differently. Here, we used a steady-state visually evoked potential (SSVEP) paradigm combined with electrical source imaging to study the effects of contrast and attention on neural responses to both chromatic S-cone isolating and achromatic stimuli in five human visual areas including V1. The responses to these gratings were affected very differently by changes in contrast and attention. Increasing cone contrast increased the response amplitude for both types of stimulus. For the S-cone-defined stimuli, we also observed a systematic decrease in the response phase of the first harmonic with increasing stimulus contrast, but there was no corresponding change in phase for the first harmonic of the luminance probes. Attending to the contrast of the grating increased the amplitude and phase of luminance-driven responses but had no effect on S-cone-driven responses. We conclude that while attentional modulation can be observed in achromatic pathways as early as V1, attention may not affect SSVEP signals generated by S-cone stimuli.",0 +https://doi.org/10.1177/0013161x11400185,How to Improve Teaching Practices,"Purpose: Although it is expected that building schoolwide capacity for teacher learning will improve teaching practices, there is little systematic evidence to support this claim. This study aimed to examine the relative impact of transformational leadership practices, school organizational conditions, teacher motivational factors, and teacher learning on teaching practices. Research Design: Data were collected from a survey of 502 teachers from 32 elementary schools in the Netherlands. A structural model was tested on the within-school covariance matrix and a chi-square test taking into account nonindependence of observations. Findings: Results suggest that teachers’ engagement in professional learning activities, in particular experimenting and reflection, is a powerful predictor for teaching practices. Teachers’ sense of self-efficacy appeared to be the most important motivational factor for explaining teacher learning and teaching practices. Motivational factors also mediate the effects of school organizational conditions and leadership practices on teacher learning and teaching practices. Finally, transformational leadership practices stimulate teachers’ professional learning and motivation and improve school organizational conditions. Conclusions: For school leaders, to foster teacher learning and improve teaching practices a combination of transformational leadership behaviors is required. Further research is needed to examine the relative effects of transformational leadership dimensions on school organizational conditions, teacher motivation, and professional learning in schools. Finally, conditions for school improvement were examined at one point in time. Longitudinal studies to school improvement are required to model changes in schools’ capacities and growth and their subsequent effects on teaching practices.",0 +,POSTERIOR PREDICTIVE ASSESSMENT OF MODEL FITNESS VIA REALIZED DISCREPANCIES,"This paper considers Bayesian counterparts of the classical tests for good- ness of fit and their use in judging the fit of a single Bayesian model to the observed data. We focus on posterior predictive assessment, in a framework that also includes conditioning on auxiliary statistics. The Bayesian formulation facilitates the con- struction and calculation of a meaningful reference distribution not only for any (classical) statistic, but also for any parameter-dependent statistic or discrep- ancy. The latter allows us to propose the realized discrepancy assessment of model fitness, which directly measures the true discrepancy between data and the posited model, for any aspect of the model which we want to explore. The computation required for the realized discrepancy assessment is a straightforward byproduct of the posterior simulation used for the original Bayesian analysis. We illustrate with three applied examples. The first example, which serves mainly to motivate the work, illustrates the difficulty of classical tests in assessing the fitness of a Poisson model to a positron emission tomography image that is constrained to be nonnegative. The second and third examples illustrate the details of the posterior predictive approach in two problems: estimation in a model with inequality constraints on the parameters, and estimation in a mixture model. In all three examples, standard test statistics (either a χ 2 or a likelihood ratio) are not pivotal: the difficulty is not just how to compute the reference distribution for the test, but that in the classical framework no such distribution exists, independent of the unknown model parameters.",0 +https://doi.org/10.1002/jts.22039,Temporal Associations Among Chronic PTSD Symptoms in U.S. Combat Veterans,"The present study examined fluctuation over time in symptoms of posttraumatic stress disorder (PTSD) among 34 combat veterans (28 with diagnosed PTSD, 6 with subclinical symptoms) assessed every 2 weeks for up to 2 years (range of assessments = 13-52). Temporal relationships were examined among four PTSD symptom clusters (reexperiencing, avoidance, emotional numbing, and hyperarousal) with particular attention to the influence of hyperarousal. Multilevel cross-lagged random coefficients autoregression for intensive time series data analyses were used to model symptom fluctuation decades after combat experiences. As anticipated, hyperarousal predicted subsequent fluctuations in the 3 other PTSD symptom clusters (reexperiencing, avoidance, emotional numbing) at subsequent 2-week intervals (rs = .45, .36, and .40, respectively). Additionally, emotional numbing influenced later reexperiencing and avoidance, and reexperiencing influenced later hyperarousal (rs = .44, .40, and .34, respectively). These findings underscore the important influence of hyperarousal. Furthermore, results indicate a bidirectional relationship between hyperarousal and reexperiencing as well as a possible chaining of symptoms (hyperarousal → emotional numbing → reexperiencing → hyperarousal) and establish potential internal, intrapersonal mechanisms for the maintenance of persistent PTSD symptoms. Results suggested that clinical interventions targeting hyperarousal and emotional numbing symptoms may hold promise for PTSD of long duration.",0 +https://doi.org/10.1177/01466216980223006,A Model for Optimal Constrained Adaptive Testing,"A model for constrained computerized adaptive testing is proposed in which the information in the test at the trait level (0) estimate is maximized subject to a number of possible constraints on the content of the test. At each item-selection step, a full test is assembled to have maximum information at the current 0 estimate, fixing the items already administered. Then the item with maximum in-formation is selected. All test assembly is optimal because a linear programming (LP) model is used that automatically updates to allow for the attributes of the items already administered and the new value of the 0 estimator. The LP model also guarantees that each adaptive test always meets the entire set of constraints. A simulation study using a bank of 753 items from the Law School Admission Test showed that the 0 estimator for adaptive tests of realistic lengths did not suffer any loss of efficiency from the presence of 433 constraints on the item selection process.",0 +https://doi.org/10.1002/sim.1524,Separation of individual-level and cluster-level covariate effects in regression analysis of correlated data,"The focus of this paper is regression analysis of clustered data. Although the presence of intracluster correlation (the tendency for items within a cluster to respond alike) is typically viewed as an obstacle to good inference, the complex structure of clustered data offers significant analytic advantages over independent data. One key advantage is the ability to separate effects at the individual (or item-specific) level and the group (or cluster-specific) level. We review different approaches for the separation of individual-level and cluster-level effects on response, their appropriate interpretation and give recommendations for model fitting based on the intent of the data analyst. Unlike many earlier papers on this topic, we place particular emphasis on the interpretation of the cluster-level covariate effect. The main ideas of the paper are highlighted in an analysis of the relationship between birth weight and IQ using sibling data from a large birth cohort study.",0 +https://doi.org/10.1017/s0266466600008884,Testing for Second-Order Stochastic Dominance of Two Distributions,"A distribution function F is said to stochastically dominate another distribution function G in the second-order sense if , for all x . Second-order stochastic dominance plays an important role in economics, finance, and accounting. Here a statistical test has been constructed to test , for some x ∈ [ a , b ], against the hypothesis , for all x ∈ [ a , b ], where a and b are any two real numbers. The test has been shown to be consistent and has an upper bound α on the asymptotic size. The test is expected to have usefulness for comparison of random prospects for risk averters.",0 +https://doi.org/10.1002/sim.3067,Authors' Reply,,0 +https://doi.org/10.1002/(sici)1099-0720(199808)12:4<339::aid-acp571>3.0.co;2-d,Modelling clustered data in autobiographical memory research: the multilevel approach,"Much memory research involves recording several autobiographical memories for each of several people. These memories are not independent of each other, an assumption of the statistical procedures used in many cognitive psychology papers. In recent years there have been both statistical and computational advances for modelling these hierarchical data structures. This is often called multilevel modelling. Using data from recent memory research (Burt et al., 1995), I describe this approach and show how it compares favourably with traditional approaches. © 1998 John Wiley & Sons, Ltd.",0 +https://doi.org/10.5194/aab-58-277-2015,Comparison of inference methods of genetic parameters with an application to body weight in broilers,"Abstract. REML (restricted maximum likelihood) has become the standard method of variance component estimation in animal breeding. Inference in Bayesian animal models is typically based upon Markov chain Monte Carlo (MCMC) methods, which are generally flexible but time-consuming. Recently, a new Bayesian computational method, integrated nested Laplace approximation (INLA), has been introduced for making fast non-sampling-based Bayesian inference for hierarchical latent Gaussian models. This paper is concerned with the comparison of estimates provided by three representative programs (ASReml, WinBUGS and the R package AnimalINLA) of the corresponding methods (REML, MCMC and INLA), with a view to their applicability for the typical animal breeder. Gaussian and binary as well as simulated data were used to assess the relative efficiency of the methods. Analysis of 2319 records of body weight at 35 days of age from a broiler line suggested a purely additive animal model, in which the heritability estimates ranged from 0.31 to 0.34 for the Gaussian trait and from 0.19 to 0.36 for the binary trait, depending on the estimation method. Although in need of further development, AnimalINLA seems a fast program for Bayesian modeling, particularly suitable for the inference of Gaussian traits, while WinBUGS appeared to successfully accommodate a complicated structure between the random effects. However, ASReml remains the best practical choice for the serious animal breeder.",0 +https://doi.org/10.3758/bf03196750,An introduction to Bayesian hierarchical models with an application in the theory of signal detection,"Although many nonlinear models of cognition have been proposed in the past 50 years, there has been little consideration of corresponding statistical techniques for their analysis. In analyses with nonlinear models, unmodeled variability from the selection of items or participants may lead to asymptotically biased estimation. This asymptotic bias, in turn, renders inference problematic. We show, for example, that a signal detection analysis of recognition memory data leads to asymptotic underestimation of sensitivity. To eliminate asymptotic bias, we advocate hierarchical models in which participant variability, item variability, and measurement error are modeled simultaneously. By accounting for multiple sources of variability, hierarchical models yield consistent and accurate estimates of participant and item effects in recognition memory. This article is written in tutorial format; we provide an introduction to Bayesian statistics, hierarchical modeling, and Markov chain Monte Carlo computational techniques.",0 +https://doi.org/10.1016/b978-044452044-9/50005-7,Advances in Analysis of Mean and Covariance Structure when Data are Incomplete,"Missing data arise in many areas of empirical research. One such area is in the context of structural equation models (SEM). A review is presented of the methodological advances in fitting data to SEM and, more generally, to mean and covariance structure models when there is missing data. This encompasses common missing data mechanisms and some widely used methods for handling missing data. The methods fall under the classifications of ad-hoc, likelihood-based, and simulation-based. Also included are the results of some of the published simulation studies. In order to encourage further research, a method is proposed for performing sensitivity analysis, which up to now has been seemingly lacking. A simulation study was done to demonstrate the method using a three-factor factor analysis model, focusing on MCAR and MNAR data. Parameter estimates from samples of all available data, in the form of box plots, are compared with parameter estimates from only the complete data. The results indicate a possible distinction for determining missing data mechanisms.",0 +https://doi.org/10.1002/per.1988,"Felt Security in Daily Interactions as a Mediator of the Effect of Attachment on Relationship Satisfaction†Some of the Results Reported in this Article Were Previously Presented at the Annual Meeting of the Society for Interpersonal Theory and Research in Montreal, Canada (May 2012).","This study examined how felt security in interpersonal situations with one's romantic partner mediated the effect of global (dispositional) attachment on relationship satisfaction. Felt security was measured using an event–contingent recording (ECR) methodology with a sample of 93 cohabiting couples who reported their social interactions with each other during a 20–day period. Global attachment was measured at the beginning of the ECR procedure. Relationship satisfaction was measured at the end of the ECR procedure (T1) and approximately 7 months after the ECR procedure (T2). Results confirmed the established links between attachment and relationship satisfaction such that higher attachment avoidance and attachment anxiety were associated with decline in satisfaction over time. Results also indicated that attachment avoidance but not attachment anxiety was negatively related to felt security, both within–partner and across–partners. As expected, lower felt security exerted a negative effect on relationship satisfaction at T1 and T2, and partly mediated the effect of attachment avoidance on relationship satisfaction at T1 and T2, both within–partner and across–partners. Partners’ gender emerged as a moderator of these results. Findings suggest higher attachment avoidance leads to less felt security in daily social interactions, which leads to less satisfaction with the romantic relationship. Copyright © 2015 European Association of Personality Psychology",0 +https://doi.org/10.1080/10705510701575511,Lower Level Mediation Effect Analysis in Two-Level Studies: A Note on a Multilevel Structural Equation Modeling Approach,"This article presents a didactic discussion of a multilevel covariance structure modeling approach to estimation of lowest level mediation effect indexes in two-level studies. The procedure is useful when addressing questions about relations among total and indirect effects between variables of interest while accounting for the hierarchical structure of analyzed data. The discussed method also permits interval estimation and hypothesis tests with respect to related quantities of relevance when evaluating mediated effects with clustered data, and is illustrated on a two-level data set.",0 +https://doi.org/10.1093/biomet/82.1.81,Bias correction in generalised linear mixed models with a single component of dispersion,"SUMMARY General expressions are derived for the asymptotic biases in three approximate estimators of regression coefficients and variance component, for small values of the variance component, in generalised linear mixed models with canonical link function and a single source of extraneous variation. The estimators involve first and second order Laplace expansions of the integrated likelihood and a related procedure known as penalised quasilikelihood. Numerical studies of a series of matched pairs of binary outcomes show that the first order estimators of the variance component are seriously biased. Easily computed correction factors produce satisfactory estimators of small variance components, comparable to those obtained with a second order Laplace expansion, and markedly improve the asymptotic performance for larger values. For a series of matched pairs of binomial observations, the variance correction factors rapidly approach one as the binomial denominators increase. These results greatly extend the range of parameter values for which the approximate estimation procedures have satisfactory asymptotic properties.",0 +https://doi.org/10.1016/j.aap.2015.06.002,Estimating the safety effects of lane widths on urban streets in Nebraska using the propensity scores-potential outcomes framework,"A sufficient understanding of the safety impact of lane widths in urban areas is necessary to produce geometric designs that optimize safety performance for all users. The overarching trend found in the research literature is that as lane widths narrow, crash frequency increases. However, this trend is inconsistent and is the result of multiple cross-sectional studies that have issues related to lack of control for potential confounding variables, unobserved heterogeneity or omitted variable bias, or endogeneity among independent variables, among others. Using ten years of mid-block crash data on urban arterials and collectors from four cities in Nebraska, crash modification factors (CMFs) were estimated for various lane widths and crash types. These CMFs were developed using the propensity scores-potential outcomes methodology. This method reduces many of the issues associated with cross-sectional regression models when estimating the safety effects of infrastructure-related design features. Generalized boosting, a non-parametric modeling technique, was used to estimate the propensity scores. Matching was performed using both Nearest Neighbor and Mahalanobis matching techniques. CMF estimation was done using mixed-effects negative binomial or Poisson regression with the matched data. Lane widths included in the analysis included 9ft, 10ft, 11ft, and 12ft. Some of the estimated CMFs were point estimates while others were functions of traffic volume (i.e., the CMF changed depending on the traffic volume). Roadways with 10ft travel lanes were found to experience the highest crash frequency relative to other lane widths. Meanwhile, roads with 9ft travel lanes were found to experience the lowest relative crash frequency. While this may be due to increased driver caution when traveling on narrow lanes, it is possible that unobserved factors influenced this result. CMFs for target crash types (sideswipe same-direction and sideswipe opposite-direction) were consistent with the values currently used in the Highway Safety Manual (HSM).",0 +https://doi.org/10.1080/00401706.1979.10489726,Tables of the Studentized Maximum Modulus Distribution and an Application to Multiple Comparisons Among Means,"Tables of the upper α-points m α; k*, v of the studentized maximum modulus distribution with parameter k* and v degrees of freedom are given for α = .01, .05, 10, and .20, twelve values 01 V, and k* = k(k − 1)/2 for k = 3(1)20. The tables are of use in applying Hochberg's GT2-Method [6] of multiple comparison and extend the use of this method to cases with k ≤ 20 means. As conjectured in [15]. the GT2-Method is in almost all cases the strongest of several competitors of Spodtvoll and Stoline's T′-Method [11] for carrying out the set of k* pairwise comparisons between the means of k groups with arbitrary sample sizes. The auxiliary tables of [15], in which the T′-Method and other procedures are compared, are extended here. These tables should aid the user in choosing between the T′ and GT2-Methods. The results of the comparisons continue to support the fact that the T-Method is preferred if the unbalance of the sample sizes is slight and that T becomes a stronger competitor as α increases.",0 +https://doi.org/10.1054/jpai.2001.26174,"Systemic administration of CNI-1493, a p38 mitogen-activated protein kinase inhibitor, blocks intrathecal human immunodeficiency virus-1 gp120-induced enhanced pain states in rats","Intrathecal administration of the human immunodeficiency virus-1 envelope glycoprotein, gp120, activates astrocytes and microglia to release products that induce thermal hyperalgesia and mechanical allodynia. Both pain states are disrupted by intrathecal CNI-1493, a p38 mitogen-activated protein (MAP) kinase inhibitor. Whether CNI-1493, or any other p38 MAP kinase inhibitor, can cross the blood-brain barrier to affect spinal cord function is unknown. Given that several such drugs are in clinical trials, it is of interest to determine whether they may be potentially useful in treating centrally mediated pain. The aim of the present studies was to determine whether systemic CNI-1493 could block intrathecal gp120-induced thermal hyperalgesia and/or mechanical allodynia. Because p38 MAP kinase inhibition would be expected to prevent proinflammatory cytokine release and/or signal transduction, we sought to determine from the same animals the likely mechanism by which CNI-1493 blocks gp120-induced pain states. These studies show that systemic CNI-1493 blocks intrathecal gp120-induced thermal hyperalgesia and mechanical allodynia. Because CNI-1493 did not block proinflammatory cytokine release, this may suggest disruption at the level of signal transduction. These studies provide the first evidence that systemic p38 MAP kinase inhibitors can prevent centrally mediated exaggerated pain states. Thus, CNI-1493 may provide a novel therapeutic approach for the treatment of pain.",0 +https://doi.org/10.1111/j.2044-8317.1989.tb00911.x,Balanced versus unbalanced designs for linear structural relations in two-level data,"A general two-level model for multivariate data is described and illustrated by specializations to a common factor model and a path model with latent variables. The problem of estimation is treated, and in the special case of a balanced sampling design, a likelihood-based discrepancy function and a test of goodness of fit are obtained in terms of some simple sufficient statistics.",0 +https://doi.org/10.1007/s11266-014-9496-4,Environmental Philanthropy and Environmental Behavior in Five Countries: Is There Convergence Among Youth?,"This paper compares and contrasts environmental philanthropy, environmental behavior, and their determinants among university students in five countries: Canada, Germany, Israel, South Korea, and the United States. The paper’s unique contribution to the nonprofit literature is its focus on environmental philanthropy as an unexplored form of philanthropic behavior, and the ability to test environmental philanthropy in an international setting and in comparison to other modes of environmental behavior. By environmental philanthropy, we mean giving to, and volunteering in, various environmental non-governmental organizations, and by environmental behavior, we refer to daily behaviors in the private sphere with ecological implications. We hypothesize that although the five countries vary on several characteristics, the student populations who are young, educated, and exposed to global ideas and norms will be relatively similar to each other in their environmental and philanthropic behavior and in the determinants of such behavior. To test this hypothesis, a standardized questionnaire was administered to 8,477 students on five campuses. Results show significant differences between students in their environmental philanthropic behavior, as well as in the demographic and attitudinal determinants of such behaviors. © 2014, International Society for Third-Sector Research and The Johns Hopkins University.",0 +https://doi.org/10.1109/iccv.2005.77,Discovering objects and their location in images,"We seek to discover the object categories depicted in a set of unlabelled images. We achieve this using a model developed in the statistical text literature: probabilistic latent semantic analysis (pLSA). In text analysis, this is used to discover topics in a corpus using the bag-of-words document representation. Here we treat object categories as topics, so that an image containing instances of several categories is modeled as a mixture of topics. The model is applied to images by using a visual analogue of a word, formed by vector quantizing SIFT-like region descriptors. The topic discovery approach successfully translates to the visual domain: for a small set of objects, we show that both the object categories and their approximate spatial layout are found without supervision. Performance of this unsupervised method is compared to the supervised approach of Fergus et al. (2003) on a set of unseen images containing only one object per image. We also extend the bag-of-words vocabulary to include 'doublets' which encode spatially local co-occurring regions. It is demonstrated that this extended vocabulary gives a cleaner image segmentation. Finally, the classification and segmentation methods are applied to a set of images containing multiple objects per image. These results demonstrate that we can successfully build object class models from an unsupervised analysis of images.",0 +https://doi.org/10.3758/app.72.4.1179,DLs in reminder and 2AFC tasks: Data and models,"García-Pérez and Alcalá-Quintana (2010) dispute the conclusion of Lapid, Ulrich, and Rammsayer (2008) that the two-alternative forced choice (2AFC) task yields meaningfully larger estimates of the difference limen (DL) than does the reminder task. García-Pérez and Alcalá-Quintana overlook, however, fundamental properties of 2AFC psychometric functions and Type B order errors in their reanalysis. In addition, their favored theory (i.e., the difference model with guessing) does not provide a plausible account for why the 2AFC task tends to yield larger DLs (by about 50%) than does the reminder task. In trying to clarify these issues, I hope to advance the proper assessment of discrimination performance in 2AFC tasks.",0 +https://doi.org/10.1007/978-94-010-1436-6_6,Confidence Intervals vs Bayesian Intervals,"For many years, statistics textbooks have followed this ‘canonical’ procedure: (1) the reader is warned not to use the discredited methods of Bayes and Laplace, (2) an orthodox method is extolled as superior and applied to a few simple problems, (3) the corresponding Bayesian solutions are not worked out or described in any way. The net result is that no evidence whatsoever is offered to substantiate the claim of superiority of the orthodox method.",0 +https://doi.org/10.1093/biostatistics/kxh022,Using a Bayesian latent growth curve model to identify trajectories of positive affect and negative events following myocardial infarction,"Positive and negative affect data are often collected over time in psychiatric care settings, yet no generally accepted means are available to relate these data to useful diagnoses or treatments. Latent class analysis attempts data reduction by classifying subjects into one of K unobserved classes based on observed data. Latent class models have recently been extended to accommodate longitudinally observed data. We extend these approaches in a Bayesian framework to accommodate trajectories of both continuous and discrete data. We consider whether latent class models might be used to distinguish patients on the basis of trajectories of observed affect scores, reported events, and presence or absence of clinical depression.",0 +https://doi.org/10.1002/9781119170174.epcn506,Cultural Consensus Theory,,0 +https://doi.org/10.1207/s15327906mbr4002_2,Comparison of Two Procedures for Analyzing Small Sets of Repeated Measures Data,"This article compares two methods for analyzing small sets of repeated measures data under normal and non-normal heteroscedastic conditions: a mixed model approach with the Kenward-Roger correction and a multivariate extension of the modified Brown-Forsythe (BF) test. These procedures differ in their assumptions about the covariance structure of the data and in the method of estimation of the parameters defining the mean structure. Simulation results show that the BF test outperformed its competitor, in terms of Type I errors, particularly when the total sample size was small, and the data were normally distributed. Under non-normal distributions the BF test tended to err on the side of conservatism. Results also indicate that neither method was uniformly more powerful. With very few exceptions, the power differences between these two methods depended on the population covariance structure, the nature of the pairing of covariance matrices and group sizes, and the relationship between mean vectors and dispersion matrices.",0 +https://doi.org/10.2307/2532317,Generalized Linear Models with Random Effects; Salamander Mating Revisited,"In recent years much effort has been devoted to extending regression methodology to non-Gaussian data, where responses are not independent. These methods for dependent responses are suitable for data from longitudinal studies or nested designs. However, use of these methods for crossed designs seems to have serious limitations due to the intensive computations involved because of the intractable nature of the joint distribution. In this paper, we cast the problem in a Bayesian framework and use a Monte Carlo method, the Gibbs sampler, to avoid current computational limitations. The flexibility of this approach is illustrated by analyzing the interesting salamander mating data reported by McCullagh and Nelder (1989, Generalized Linear Models, 2nd edition, London: Chapman and Hall).",0 +https://doi.org/10.1016/j.cognition.2009.03.008,A Bayesian framework for word segmentation: Exploring the effects of context,"Since the experiments of Saffran et al. [Saffran, J., Aslin, R., & Newport, E. (1996). Statistical learning in 8-month-old infants. Science, 274, 1926-1928], there has been a great deal of interest in the question of how statistical regularities in the speech stream might be used by infants to begin to identify individual words. In this work, we use computational modeling to explore the effects of different assumptions the learner might make regarding the nature of words--in particular, how these assumptions affect the kinds of words that are segmented from a corpus of transcribed child-directed speech. We develop several models within a Bayesian ideal observer framework, and use them to examine the consequences of assuming either that words are independent units, or units that help to predict other units. We show through empirical and theoretical results that the assumption of independence causes the learner to undersegment the corpus, with many two- and three-word sequences (e.g. what's that, do you, in the house) misidentified as individual words. In contrast, when the learner assumes that words are predictive, the resulting segmentation is far more accurate. These results indicate that taking context into account is important for a statistical word segmentation strategy to be successful, and raise the possibility that even young infants may be able to exploit more subtle statistical patterns than have usually been considered.",0 +https://doi.org/10.1017/s1740925x0700035x,The glial modulatory drug AV411 attenuates mechanical allodynia in rat models of neuropathic pain,"Abstract Controlling neuropathic pain is an unmet medical need and we set out to identify new therapeutic candidates. AV411 (ibudilast) is a relatively nonselective phosphodiesterase inhibitor that also suppresses glial-cell activation and can partition into the CNS. Recent data strongly implicate activated glial cells in the spinal cord in the development and maintenance of neuropathic pain. We hypothesized that AV411 might be effective in the treatment of neuropathic pain and, hence, tested whether it attenuates the mechanical allodynia induced in rats by chronic constriction injury (CCI) of the sciatic nerve, spinal nerve ligation (SNL) and the chemotherapeutic paclitaxel (Taxol ¯ ). Twice-daily systemic administration of AV411 for multiple days resulted in a sustained attenuation of CCI-induced allodynia. Reversal of allodynia was of similar magnitude to that observed with gabapentin and enhanced efficacy was observed in combination. We further show that multi-day AV411 reduces SNL-induced allodynia, and reverses and prevents paclitaxel-induced allodynia. Also, AV411 cotreatment attenuates tolerance to morphine in nerve-injured rats. Safety pharmacology, pharmacokinetic and initial mechanistic analyses were also performed. Overall, the results indicate that AV411 is effective in diverse models of neuropathic pain and support further exploration of its potential as a therapeutic agent for the treatment of neuropathic pain.",0 +https://doi.org/10.1080/00031305.1985.10479400,An Introduction to Empirical Bayes Data Analysis,"Abstract Empirical Bayes methods have been shown to be powerful data-analysis tools in recent years. The empirical Bayes model is much richer than either the classical or the ordinary Bayes model and often provides superior estimates of parameters. An introduction to some empirical Bayes methods is given, and these methods are illustrated with two examples.",0 +https://doi.org/10.1016/s0927-5398(03)00007-0,Improved estimation of the covariance matrix of stock returns with an application to portfolio selection,"This paper proposes to estimate the covariance matrix of stock returns by an optimally weighted average of two existing estimators: the sample covariance matrix and single-index covariance matrix. This method is generally known as shrinkage, and it is standard in decision theory and in empirical Bayesian statistics. Our shrinkage estimator can be seen as a way to account for extra-market covariance without having to specify an arbitrary multi-factor structure. For NYSE and AMEX stock returns from 1972 to 1995, it can be used to select portfolios with significantly lower out-of-sample variance than a set of existing estimators, including multi-factor models.",0 +https://doi.org/10.1177/0146621603260678,Order-Constrained Bayes Inference for Dichotomous Models of Unidimensional Nonparametric IRT,"This study introduces an order-constrained Bayes inference framework useful for analyzing data containing dichotomous-scored item responses, under the assumptions of either the monotone homogeneity model or the double monotonicity model of nonparametric item response theory (NIRT). The framework involves the implementation of Gibbs sampling to estimate order-constrained parameters, followed by inference with the posterior-predictive distribution to test the monotonicity, invariant item ordering, and local independence assumptions of NIRT. The Bayes framework is demonstrated through the analysis of real test data, and possible extensions of it are discussed.",0 +https://doi.org/10.1016/0010-0285(80)90005-5,A feature-integration theory of attention,"A new hypothesis about the role of focused attention is proposed. The feature-integration theory of attention suggests that attention must be directed serially to each stimulus in a display whenever conjunctions of more than one separable feature are needed to characterize or distinguish the possible objects presented. A number of predictions were tested in a variety of paradigms including visual search, texture segregation, identification and localization, and using both separable dimensions (shape and color) and local elements or parts of figures (lines, curves, etc. in letters) as the features to be integrated into complex wholes. The results were in general consistent with the hypothesis. They offer a new set of criteria for distinguishing separable from integral features and a new rationale for predicting which tasks will show attention limits and which will not.",0 +https://doi.org/10.1371/journal.pgen.1005650,"A Flexible, Efficient Binomial Mixed Model for Identifying Differential DNA Methylation in Bisulfite Sequencing Data","Identifying sources of variation in DNA methylation levels is important for understanding gene regulation. Recently, bisulfite sequencing has become a popular tool for investigating DNA methylation levels. However, modeling bisulfite sequencing data is complicated by dramatic variation in coverage across sites and individual samples, and because of the computational challenges of controlling for genetic covariance in count data. To address these challenges, we present a binomial mixed model and an efficient, sampling-based algorithm (MACAU: Mixed model association for count data via data augmentation) for approximate parameter estimation and p-value computation. This framework allows us to simultaneously account for both the over-dispersed, count-based nature of bisulfite sequencing data, as well as genetic relatedness among individuals. Using simulations and two real data sets (whole genome bisulfite sequencing (WGBS) data from Arabidopsis thaliana and reduced representation bisulfite sequencing (RRBS) data from baboons), we show that our method provides well-calibrated test statistics in the presence of population structure. Further, it improves power to detect differentially methylated sites: in the RRBS data set, MACAU detected 1.6-fold more age-associated CpG sites than a beta-binomial model (the next best approach). Changes in these sites are consistent with known age-related shifts in DNA methylation levels, and are enriched near genes that are differentially expressed with age in the same population. Taken together, our results indicate that MACAU is an efficient, effective tool for analyzing bisulfite sequencing data, with particular salience to analyses of structured populations. MACAU is freely available at www.xzlab.org/software.html.",0 +https://doi.org/10.1016/j.jmva.2009.05.002,Shrinkage estimators for large covariance matrices in multivariate real and complex normal distributions under an invariant quadratic loss,"The problem of estimating large covariance matrices of multivariate real normal and complex normal distributions is considered when the dimension of the variables is larger than the number of samples. The Stein–Haff identities and calculus on eigenstructure for singular Wishart matrices are developed for real and complex cases, respectively. By using these techniques, the unbiased risk estimates for certain classes of estimators for the population covariance matrices under invariant quadratic loss functions are obtained for real and complex cases, respectively. Based on the unbiased risk estimates, shrinkage estimators which are counterparts of the estimators due to Haff [L.R. Haff, Empirical Bayes estimation of the multivariate normal covariance matrix, Ann. Statist. 8 (1980) 586–697] are shown to improve upon the best scalar multiple of the empirical covariance matrix under the invariant quadratic loss functions for both real and complex multivariate normal distributions in the situation where the dimension of the variables is larger than the number of samples.",0 +https://doi.org/10.1007/bf02294246,A dynamic factor model for the analysis of multivariate time series,"As a method to ascertain the structure of intra-individual variation, P-technique has met difficulties in the handling of a lagged covariance structure. A new statistical technique, coined dynamic factor analysis, is proposed, which accounts for the entire lagged covariance function of an arbitrary second order stationary time series. Moreover, dynamic factor analysis is shown to be applicable to a relatively short stretch of observations and therefore is considered worthwhile for psychological research. At several places the argumentation is clarified through the use of examples. © 1985 The Psychometric Society.",0 +https://doi.org/10.2307/2532834,High-Dimensional Multivariate Probit Analysis,"A computationally practical form of probit analysis for multiple response variables based on an assumed common factor model for the latent tolerances is proposed. Numerical integration over the factor space provides maximum likelihood estimation of the probit regression parameters and of the probabilities of response combinations under the model. The procedure is applied to five variables from the Pneumoconiosis Field Trial, two variables of which were previously analyzed by Ashford and Sowden (1970, Biometrics 26, 535-546).",0 +https://doi.org/10.1080/01621459.1990.10474968,Illustration of Bayesian Inference in Normal Data Models Using Gibbs Sampling,"Abstract The use of the Gibbs sampler as a method for calculating Bayesian marginal posterior and predictive densities is reviewed and illustrated with a range of normal data models, including variance components, unordered and ordered means, hierarchical growth curves, and missing data in a crossover trial. In all cases the approach is straightforward to specify distributionally and to implement computationally, with output readily adapted for required inference summaries.",0 +https://doi.org/10.1198/108571102726,Adequacy of approximations to distributions of test statistics in complex mixed linear models,"A recent study of lady beetle antennae was a small sample repeated measures design involving a complex covariance structure. Distributions of test statistics based on mixed models fitted to such data are unknown, but two recently developed methods for approximating the distributions of test statistics in mixed linear models have been included as options in the latest release of the MIXED procedure of SAS®. One method (FC, from Fai and Cornelius) computes degrees of freedom of an approximating F distribution for the test statistic using spectral decomposition of the hypothesis matrix together with repeated application of a method for single-degree-of-freedom tests. The other method (KR, from Kenward and Roger) adjusts the estimated covariance matrix of the parameter estimates, computes a scale adjustment to the test statistic, and computes the degrees of freedom of an approximating F distribution. Using the two methods, p values for a hypothesis of interest in the lady beetle study were quite different. Simulation studies on the Proc MIXED implementation of these methods showed that Type I error rates of both methods are affected by covariance structure complexity, sample size, and imbalance. Nonetheless, the KR method performs well in situations with fairly complicated covariance structures when sample sizes are moderate to small and the design is reasonably balanced. The KR method should be used in preference to the FC method, although it had inflated Type I error rates for complex covariance structures combined with small sample sizes. © 2002 American Statistical Association and the International Biometric Society.",0 +https://doi.org/10.1007/s00439-007-0445-9,Methods for meta-analysis in genetic association studies: a review of their potential and pitfalls,"Meta-analysis offers the opportunity to combine evidence from retrospectively accumulated or prospectively generated data. Meta-analyses may provide summary estimates and can help in detecting and addressing potential inconsistency between the combined datasets. Application of meta-analysis in genetic associations presents considerable potential and several pitfalls. In this review, we present basic principles of meta-analytic methods, adapted for human genome epidemiology. We describe issues that arise in the retrospective or the prospective collection of relevant data through various sources, common traps to consider in the appraisal of evidence and potential biases that may interfere. We describe the relative merits and caveats for common methods used to trace inconsistency across studies along with possible reasons for non-replication of proposed associations. Different statistical models may be employed to combine data and some common misconceptions may arise in the process. Several meta-analysis diagnostics are often applied or misapplied in the literature, and we comment on their use and limitations. An alternative to overcome limitations arising from retrospective combination of data from published studies is to create networks of research teams working in the same field and perform collaborative meta-analyses of individual participant data, ideally on a prospective basis. We discuss the advantages and the challenges inherent in such collaborative approaches. Meta-analysis can be a useful tool in dissecting the genetics of complex diseases and traits, provided its methods are properly applied and interpreted. © Springer-Verlag 2007.",0 +https://doi.org/10.1016/s0304-4076(98)00055-4,Marketing models of consumer heterogeneity,"The distribution of consumer preferences plays a central role in many marketing activities. Pricing and product design decisions, for example, are based on an understanding of the differences among consumers in price sensitivity and valuation of product attributes. In addition, marketing activities which target specific households require household level parameter estimates. Thus, the modeling of consumer heterogeneity is the central focus of many statistical marketing applications. In contrast, heterogeneity is often regarded as an ancillary nuisance problem in much of the applied econometrics literature which must be dealt with but is not the focus of the investigation. The focus is instead on estimating average effects of policy variables. In this paper, we discuss various approaches to modeling consumer heterogeneity and evaluate the utility of these approaches for marketing applications.",0 +https://doi.org/10.2307/2669749,P Values for Composite Null Models,,0 +https://doi.org/10.1007/s13253-013-0137-y,Objective Bayesian Analysis of Geometrically Anisotropic Spatial Data,"Anisotropic models are often used in spatial statistics to analyze spatially referenced data. Within a Bayesian framework we develop default priors for the anisotropic Gaussian random field model with and without including a nugget parameter accounting for the effects of microscale variations and measurement errors. We present Jeffreys priors and a reference prior and study their posterior propriety. Moreover, we obtain that the predictive distributions at ungauged locations have finite variance. We also show that the seemingly uninformative uniform prior for the anisotropy parameters, ratio and angle, yields an improper posterior. Finally, we find that the proposed priors have good frequentist properties and we illustrate our approach by analyzing two data sets for which we discuss model choice as well as predictions and uncertainty estimates. © 2013 International Biometric Society.",0 +https://doi.org/10.1016/j.ijresmar.2004.01.002,A cross-validity comparison of rating-based and choice-based conjoint analysis models,"Abstract This paper compares OLS, hierarchical Bayes (HB), and latent segment, rating-based conjoint models to HB and latent segment choice-based conjoint models. The biggest systematic difference between rating- and choice-based parameters is consistent with a compatibility effect. This leads to a stronger prominence effect for rating-based models. The HB rating-based model has the highest hit rate and choice share validations and the OLS model has the second highest. Within both rating- and choice-based models, hierarchical Bayes models have higher hit rate and choice share validations than latent segment models. Using a choice simulator, the profiles predicted to be optimal with an HB choice-based model are similar to those predicted to be optimal with an HB rating-based model.",0 +,Markov Chain Monte Carlo Maximum Likelihood,"http://conservancy.umn.edu/handle/11299/58440 Markov chain Monte Carlo (e. g., the Metropolis algorithm and Gibbs sampler) is a general tool for simulation of complex stochastic processes useful in many types of statistical inference. The basics of Markov chain Monte Carlo are reviewed, including choice of algorithms and variance estimation, and some new methods are introduced. The use of Markov chain Monte Carlo for maximum likelihood estimation is explained, and its performance is compared with maximum pseudo likelihood estimation.",0 +https://doi.org/10.1002/(sici)1097-0258(19971030)16:20<2349::aid-sim667>3.0.co;2-e,Using the general linear mixed model to analyse unbalanced repeated measures and longitudinal data,"The general linear mixed model provides a useful approach for analysing a wide variety of data structures which practising statisticians often encounter. Two such data structures which can be problematic to analyse are unbalanced repeated measures data and longitudinal data. Owing to recent advances in methods and software, the mixed model analysis is now readily available to data analysts. The model is similar in many respects to ordinary multiple regression, but because it allows correlation between the observations, it requires additional work to specify models and to assess goodness-of-fit. The extra complexity involved is compensated for by the additional flexibility it provides in model fitting. The purpose of this tutorial is to provide readers with a sufficient introduction to the theory to understand the method and a more extensive discussion of model fitting and checking in order to provide guidelines for its use. We provide two detailed case studies, one a clinical trial with repeated measures and dropouts, and one an epidemiological survey with longitudinal follow-up.",0 +https://doi.org/10.1186/s13643-016-0186-8,The effectiveness and safety of treatments used for acute diarrhea and acute gastroenteritis in children: protocol for a systematic review and network meta-analysis,"Acute diarrhea and acute gastroenteritis (AD/AGE) are common among children in low- and middle-income countries (LMIC) and high-income countries (HIC). Supportive therapy including maintaining feeding, prevention of dehydration, and use of oral rehydration solution (ORS), is the mainstay of treatment in all children. Several additional treatments aiming to reduce the episode duration have been compared to placebo, but the differences in effectiveness among them are unknown.We will conduct a systematic review of all randomized controlled trials evaluating the use of zinc, vitamin A, probiotics, prebiotics, synbiotics, racecadotril, smectite, and fermented and lactose-free milk/formula for AD/AGE treatment in children. The primary outcomes are diarrhea duration and mortality. Secondary outcomes are diarrhea lasting 3 or 7 days, stool frequency, treatment failure, hospitalizations, and adverse events. We will search MEDLINE, Ovid EMBASE, CINAHL, the Cochrane Central Register of Controlled Trials (CENTRAL), and LILACS through Ovid, as well as grey literature resources. Two reviewers will independently screen titles and abstracts, review full texts, extract information, and assess the risk of bias (ROB) and the confidence in the estimate (with the grading of recommendations, assessment, development, and evaluation [GRADE] approach). Results will be summarized narratively and statistically. Subgroup analysis according to HIC vs. LMIC, age, nutrition status, and ROB is planned. We will perform a Bayesian network meta-analysis to combine the pooled direct and indirect treatment effect estimates for each outcome, if adequate data is available.This is the first systematic review and network meta-analysis that aims to determine the relative effectiveness of pharmacological and nutritional treatments for reducing the duration of AD/AGE in children. The results will help to reduce the uncertainty of the effectiveness of the interventions, find knowledge gaps, and/or encourage further research for other therapeutic options.PROSPERO registration number: CRD42015023778.",0 +https://doi.org/10.1093/biomet/73.3.755,A note on A. Albert and J. A. Anderson's conditions for the existence of maximum likelihood estimates in logistic regression models,"SUMMARY This note expands the paper by Albert & Anderson (1984) on the existence and uniqueness of maximum likelihood estimates in logistic regression models. Their three possible mutually exclusive data pattems: (i) overlap, (ii) complete separation, and (iii) quasiseparation are considered. The maximum likelihood estimate exists only in (i). Modifications of the statement and proofs of Albert & Anderson's results are given for (ii) and (iii). The identifiability for a more general model arising in the study of (iii) is discussed together with the maximization of the corresponding likelihood. A linear program is presented which determines whether data is of type (i), (ii) or (iii), and in the case of (iii) identifies Albert & Anderson's minimal set Qm.",0 +https://doi.org/10.1177/014662167700100209,A Use of the Information Function in Tailored Testing,"Several important and useful implications in latent trait theory, with direct implications for individualized adaptive or tailored testing, are pointed out. A way of using the information function in tailored testing in connection with the standard error of estimation of the ability level using maximum likelihood estimation is suggested. It is emphasized that the standard error of estimation should be considered as the major index of dependability, as opposed to the reliability of a test. The concept of weak parallel forms is expanded to testing procedures in which different sets of items are presented to different examinees. Examples are given. Researchers have tended to use latent trait theory rather than classical test theory in research on individualized adaptive or tailored testing. This is quite natural, since latent trait theory has definite merits over classical test theory in many crucial matters. Because of the lack of opportunities to really learn the theory, however, these researchers tend to overlook some important implications in latent trait theory. As a result, its full use has not yet materialized. Not only are information functions seldom used to maximum advantage, but also those who have tried to use latent trait theory still use some popular concepts in classical test theory, such as reliability. expanded to testing procedures in which different sets of items are presented to different examinees. Examples are given. In this paper, the author points out some important implications in latent trait theory which are not fully understood and appreciated among researchers, and gives some practical suggestions for its use",0 +https://doi.org/10.1177/0038040715588603,Secondary Education Systems and the General Skills of Less- and Intermediate-educated Adults,"We investigate the impact of external differentiation and vocational orientation of (lower and upper) secondary education on country variation in the mean numeracy skills of, and skills gaps between, adults with low and intermediate formal qualifications. We use data on 30- to 44-year-olds in 18 countries from the 2011–12 round of the Program for the International Assessment of Adult Competencies. We find that higher levels of external differentiation (tracking) amplify skills gaps between less- and intermediate-educated adults. This is mainly due to lower mean skills achievement of less-educated adults. By contrast, greater emphasis on vocational skills in upper-secondary education is positively related to numeracy skills for both less- and intermediate-educated adults. Gains are larger for the less educated, so the gap in numeracy skills tends to fall with the degree of vocational orientation. We discuss implications of our findings for research on educational and labor market inequalities.",0 +https://doi.org/10.1002/sim.2639,Trying to be precise about vagueness,"A previous investigation by Lambert et al., which used computer simulation to examine the influence of choice of prior distribution on inferences from Bayesian random effects meta-analysis, is critically examined from a number of viewpoints. The practical example used is shown to be problematic. The various prior distributions are shown to be unreasonable in terms of what they imply about the joint distribution of the overall treatment effect and the random effects variance. An alternative form of prior distribution is tentatively proposed. Finally, some practical recommendations are made that stress the value both of fixed effect analyses and of frequentist approaches as well as various diagnostic investigations.",0 +https://doi.org/10.1016/j.jmp.2008.03.002,Bayes factors: Prior sensitivity and model generalizability,"Model selection is a central issue in mathematical psychology. One useful criterion for model selection is generalizability; that is, the chosen model should yield the best predictions for future data. Some researchers in psychology have proposed that the Bayes factor can be used for assessing model generalizability. An alternative method, known as the generalization criterion, has also been proposed for the same purpose. We argue that these two methods address different levels of model generalizability (local and global), and will often produce divergent conclusions. We illustrate this divergence by applying the Bayes factor and the generalization criterion to a comparison of retention functions. The application of alternative model selection criteria will also be demonstrated within the framework of model generalizability.",0 +https://doi.org/10.1201/b10905-8,Implementing MCMC,"The reversible jump Markov chain Monte Carlo (MCMC) sampler (Green, 1995) provides a general framework for Markov chain Monte Carlo simulation in which the dimension of the parameter space can vary between iterates of the Markov chain. The reversible jump sampler can be viewed as an extension of the Metropolis-Hastings algorithm onto more general state spaces. To understand this in a Bayesian modeling context, suppose that for observed data x wehavea countable collectionof candidatemodelsM = {M1,M2, . . .} indexedbyaparameter k ∈ K. The index k can be considered as an auxiliarymodel indicator variable, such thatMk′ denotes themodel where k = k′. EachmodelMk has an nk-dimensional vector of unknown parameters, θk ∈ Rnk , where nk can take different values for different models k ∈ K. The joint posterior distribution of (k, θk) given observed data, x, is obtained as the product of the likelihood, L(x | k, θk), and the joint prior, p(k, θk) = p(θk | k)p(k), constructed from the prior distribution of θk under model Mk , and the prior for the model indicator k (i.e. the prior for model Mk). Hence, the joint posterior isπ(k, θk | x) = L(x | k, θk)p(θk | k)p(k)∑ k′∈K∫ R nk′ L(x | k′, θ′k′)p(θ′k′ | k′)p(k′)dθ′k′. (3.1)The reversible jump algorithm uses the joint posterior distribution in Equation 3.1 as the target of an MCMC sampler over the state space Θ = ⋃k∈K({k} × Rnk ), where the states of the Markov chain are of the form (k, θk), the dimension of which can vary over the state space. Accordingly, from the output of a single Markov chain sampler, the user is able to obtain a full probabilistic description of the posterior probabilities of each model having observed the data, x, in addition to the posterior distributions of the individual models. This chapter aims to provide an overview of the reversible jump sampler. Wewill outlinethe sampler’s theoretical underpinnings, present the latest and most popular techniques for enhancing algorithmperformance, and discuss the analysis of sampler output. Through the use of numerous worked examples it is hoped that the reader will gain a broad appreciation of the issues involved in multi-model simulation, and the confidence to implement reversible jump samplers in the course of their own studies.",0 +https://doi.org/10.1287/mksc.1040.0100,Generalized Robust Conjoint Estimation,"We introduce methods from statistical learning theory to the field of conjoint analysis for preference modeling. We present a method for estimating preference models that can be highly nonlinear and robust to noise. Like recently developed polyhedral methods for conjoint analysis, our method is based on computationally efficient optimization techniques. We compare our method with standard logistic regression, hierarchical Bayes, and the polyhedral methods using standard, widely used simulation data. The experiments show that the proposed method handles noise significantly better than both logistic regression and the recent polyhedral methods and is never worse than the best method among the three mentioned above. It can also be used for estimating nonlinearities in preference models faster and better than all other methods. Finally, a simple extension for handling heterogeneity shows promising results relative to hierarchical Bayes. The proposed method can therefore be useful, for example, for analyzing large amounts of data that are noisy or for estimating interactions among product features.",0 +https://doi.org/10.2307/2112482,A Hierarchical Model for Studying School Effects,"When researchers investigate how school policies, practices, or climates affect student outcomes, they use multilevel, hierarchical data. Though methodologists have consistently warned of the formidable inferential problems such data pose for traditional statistical methods, no comprehensive alternative analytic strategy has been available. This paper presents a general statistical methodology for such hierarchically structured data and illustrates its use by reexamining the High School and Beyond data and the controversy over the effectiveness of public and Catholic schools. The model enables the researcher to utilize mean achievement and certain structural parameters that characterize the equity in the social distribution of achievement as multivariate outcomes for each school. Variation in these school-level outcomes is then explained as a function of school characteristics.",0 +https://doi.org/10.3102/10769986028002169,Performance of Empirical Bayes Estimators of Level-2 Random Parameters in Multilevel Analysis: A Monte Carlo Study for Longitudinal Designs,"Multilevel analysis is a useful technique for analyzing longitudinal data. To describe a person’s development across time, the quality of the estimates of the random coefficients, which relate time to individual changes in a relevant dependent variable, is of importance. The present study compares three estimators of the random coefficients: the Bayes estimator (BE), the empirical Bayes estimator (EBE), and the ordinary least squares estimator (OLSE). Using MLwiN, Monte Carlo simulations are carried out to study the performance of the estimators, while systematically varying the size of the sample as well as the number of measurement occasions. First, we examine for normally distributed random coefficients to what extent the EBE performs better than the OLSE and to what extent the EBE preserves the good properties of the BE. Second, we examine the robustness of the EBE which is based on a normal distribution of the random parameters, by comparing its performance to the OLSE for data being generated from two distributions other than the normal distribution: a modified t-distribution and a modified exponential distribution. As performance criteria we examine the Bayes risk as well as a criterion based on the frequentist notion of mean squared error.",0 +https://doi.org/10.1080/10705511.2015.1014041,A Poor Person’s Posterior Predictive Checking of Structural Equation Models,"Posterior predictive model checking (PPMC) is a Bayesian model checking method that compares the observed data to (plausible) future observations from the posterior predictive distribution. We propose an alternative to PPMC in the context of structural equation modeling, which we term the poor person’s PPMC (PP-PPMC), for the situation wherein one cannot afford (or is unwilling) to draw samples from the full posterior. Using only by-products of likelihood-based estimation (maximum likelihood estimate and information matrix), the PP-PPMC offers a natural method to handle parameter uncertainty in model fit assessment. In particular, a coupling relationship between the classical p values from the model fit chi-square test and the predictive p values from the PP-PPMC method is carefully examined, suggesting that PP-PPMC might offer an alternative, principled approach for model fit assessment. We also illustrate the flexibility of the PP-PPMC approach by applying it to case-influence diagnostics.",0 +https://doi.org/10.1038/jes.2015.44,Retrospective benzene exposure assessment for a multi-center case-cohort study of benzene-exposed workers in China,"Quality of exposure assessment has been shown to be related to the ability to detect risk of lymphohematopoietic disorders in epidemiological investigations of benzene, especially at low levels of exposure. We set out to build a statistical model for reconstructing exposure levels for 2898 subjects from 501 factories that were part of a nested case-cohort study within the NCI-CAPM cohort of more than 110,000 workers. We used a hierarchical model to allow for clustering of measurements by factory, workshop, job, and date. To calibrate the model we used historical routine monitoring data. Measurements below the limit of detection were accommodated by constructing a censored data likelihood. Potential non-linear and industry-specific time-trends and predictor effects were incorporated using regression splines and random effects. A partial validation of predicted exposures in 2004/2005 was performed through comparison with full-shift measurements from an exposure survey in facilities that were still open. Median cumulative exposure to benzene at age 50 for subjects that ever held an exposed job (n=1175) was 509 mg/m 3 years. Direct comparison of model estimates with measured full-shift personal exposure in the 2004/2005 survey showed moderate correlation and a potential downward bias at low (<1 mg/m 3) exposure estimates. The modeling framework enabled us to deal with the data complexities generally found in studies using historical exposure data in a comprehensive way and we therefore expect to be able to investigate effects at relatively low exposure levels. © 2016 Nature America, Inc.",0 +https://doi.org/10.1167/10.2.11,Rod and cone contrast gains derived from reaction time distribution modeling,"Contrast gain reflects the rapidity of response amplitude increase with increase in stimulus contrast. In physiology, contrast gain can be measured directly as the initial slope of cell contrast response function. In psychophysics, contrast gain estimation is not straightforward. Further, rod and cone contrast gains have not been measured psychophysically at mesopic light levels where both rods and cones are active, due to the difficulty in producing stimuli that excite rods and cones separately at the same adaptation level. Here, we estimated rod and contrast gains by fitting reaction time distributions measured at a light level in which rods alone (scotopic), rods and cones (mesopic), or cones alone (photopic) mediate vision. The reaction time distributions were modeled by two different strategies, a simplified diffusion model that assumes a stochastic accumulation process and a model we developed that begins with sensory input based on early visual processing impulse response functions and assumes the reaction time variability originates in the response criterion. Estimates of contrast gain from both models were comparable and consistent with primate physiology measurements.",0 +https://doi.org/10.1016/s0895-4356(03)00007-6,A comparison between traditional methods and multilevel regression for the analysis of multicenter intervention studies,"This article reviews three traditional methods for the analysis of multicenter trials with persons nested within clusters, i.e., centers, namely naïve regression (persons as units of analysis), fixed effects regression, and the use of summary measures (clusters as units of analysis), and compares these methods with multilevel regression. The comparison is made for continuous (quantitative) outcomes, and is based on the estimator of the treatment effect and its standard error, because these usually are of main interest in intervention studies. When the results of the experiment have to be valid for some larger population of centers, the centers in the intervention study have to present a random sample from this population and multilevel regression may be used. It is shown that the treatment effect and especially its standard error, are generally incorrectly estimated by the traditional methods, which should, therefore, not in general be used as an alternative to multilevel regression.",0 +https://doi.org/10.1111/j.1530-0277.2007.00596.x,"Where, With Whom, and How Much Alcohol Is Consumed on Drinking Events Involving Aggression? Event-Level Associations in a Canadian National Survey of University Students","Epidemiological research using event-level data can provide a better understanding of the association between alcohol consumption, characteristics of drinking contexts, and the likelihood of aggressive behavior. The present research assessed whether alcohol intake and characteristics of the drinking context were associated with the likelihood of aggression within individuals across 3 drinking events based on a national sample of university students, taking into account individual characteristics and university level variables. Additionally, we determined whether individual characteristics, particularly drinking pattern, were associated with alcohol-related aggression controlling for drinking event characteristics, and whether relations of aggression to alcohol and drinking contexts differed by gender.Secondary analyses of the 2004 Canadian Campus Survey (CCS), a national survey of 6,282 university students (41% response rate) at 40 Canadian universities, were conducted. Respondents were asked about their three most recent drinking events, including whether they were in an argument or fight with someone, number of drinks consumed, and characteristics of the drinking context as well as their usual drinking frequency and heavy episodic drinking. We used multi-level analyses to account for the nested structure of the data (i.e., drinking events nested within individuals who were nested within universities).The number of drinks consumed was positively associated with aggression. Drinking contexts found to be positively associated with aggression included being at a party, at a fraternity/sorority and/or residence, at three or more drinking places (versus 1 or 2), and having a partner present whereas having a meal reduced the likelihood of aggression. A significant interaction was found between gender and being at a party, with a significant effect found for women but not for men.These results support experimental evidence indicating a direct role of alcohol in aggression and point to characteristics of the drinking context that might be targeted in future prevention initiatives.",0 +https://doi.org/10.1037/a0012869,"The multilevel latent covariate model: A new, more reliable approach to group-level effects in contextual studies.","In multilevel modeling (MLM), group-level (L2) characteristics are often measured by aggregating individual-level (L1) characteristics within each group so as to assess contextual effects (e.g., group-average effects of socioeconomic status, achievement, climate). Most previous applications have used a multilevel manifest covariate (MMC) approach, in which the observed (manifest) group mean is assumed to be perfectly reliable. This article demonstrates mathematically and with simulation results that this MMC approach can result in substantially biased estimates of contextual effects and can substantially underestimate the associated standard errors, depending on the number of L1 individuals per group, the number of groups, the intraclass correlation, the sampling ratio (the percentage of cases within each group sampled), and the nature of the data. To address this pervasive problem, the authors introduce a new multilevel latent covariate (MLC) approach that corrects for unreliability at L2 and results in unbiased estimates of L2 constructs under appropriate conditions. However, under some circumstances when the sampling ratio approaches 100%, the MMC approach provides more accurate estimates. Based on 3 simulations and 2 real-data applications, the authors evaluate the MMC and MLC approaches and suggest when researchers should most appropriately use one, the other, or a combination of both approaches.",0 +https://doi.org/10.1093/oxfordhb/9780199286546.003.0026,Multilevel Models,"Abstract This article addresses multilevel models in which units are nested within one another. The focus is primarily two-level models. It also describes cross-unit heterogeneity. Moreover, it assesses the fixed and random effects from the multilevel model. It generally tries to convey the scope of multilevel models but in a very compact way. Multilevel models provide great promise for exploiting information in hierarchical data structures. There are a range of alternatives for such data and it bears repeating that sometimes, simpler-to-apply correctives are best.",0 +https://doi.org/10.1002/sim.6791,A tutorial on Bayesian bivariate meta-analysis of mixed binary-continuous outcomes with missing treatment effects,"Bivariate random-effects meta-analysis (BVMA) is a method of data synthesis that accounts for treatment effects measured on two outcomes. BVMA gives more precise estimates of the population mean and predicted values than two univariate random-effects meta-analyses (UVMAs). BVMA also addresses bias from incomplete reporting of outcomes. A few tutorials have covered technical details of BVMA of categorical or continuous outcomes. Limited guidance is available on how to analyze datasets that include trials with mixed continuous-binary outcomes where treatment effects on one outcome or the other are not reported. Given the advantages of Bayesian BVMA for handling missing outcomes, we present a tutorial for Bayesian BVMA of incompletely reported treatment effects on mixed bivariate outcomes. This step-by-step approach can serve as a model for our intended audience, the methodologist familiar with Bayesian meta-analysis, looking for practical advice on fitting bivariate models. To facilitate application of the proposed methods, we include our WinBUGS code. As an example, we use aggregate-level data from published trials to demonstrate the estimation of the effects of vitamin K and bisphosphonates on two correlated bone outcomes, fracture, and bone mineral density. We present datasets where reporting of the pairs of treatment effects on both outcomes was 'partially' complete (i.e., pairs completely reported in some trials), and we outline steps for modeling the incompletely reported data. To assess what is gained from the additional work required by BVMA, we compare the resulting estimates to those from separate UVMAs. We discuss methodological findings and make four recommendations. Copyright © 2015 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1080/10439463.2013.878344,"Policy spillover and the policing of protest in New York City, 1960–2006","Scholars have suggested that the policing of protest have become more permissive in Western democracies since the 1960s. While widely accepted, studies affirming a softening of police conduct have focused on national trends despite awareness that police tactics have unevenly diffused across the USA. This study examines the temporal trends in protest policing in New York City to evaluate how and why the dominant strategies of protest control have changed over time. Drawing on the widespread privatisation of public space in New York during the 1980s coupled with the adoption of Broken Windows crime control strategies, I develop an alternative explanation of the temporal dynamics of protest policing that is based on policy spillover, or the unintentional spillover effects that policy decisions unrelated to protest policing may nonetheless have on police conduct. Using a sample of 6147 protest events occurring in New York between 1960 and 2006, I confirm that the prevalence of arrests and other forms of polic...",0 +https://doi.org/10.1037/0033-295x.112.3.662,Bayesian statistical inference in psychology: Comment on Trafimow (2003).,"D. Trafimow (2003) presented an analysis of null hypothesis significance testing (NHST) using Bayes's theorem. Among other points, he concluded that NHST is logically invalid, but that logically valid Bayesian analyses are often not possible. The latter conclusion reflects a fundamental misunderstanding of the nature of Bayesian inference. This view needs correction, because Bayesian methods have an important role to play in many psychological problems where standard techniques are inadequate. This comment, with the help of a simple example, explains the usefulness of Bayesian inference for psychology.",0 +https://doi.org/10.1002/sim.3680,"The BUGS project: Evolution, critique and future directions","BUGS is a software package for Bayesian inference using Gibbs sampling. The software has been instrumental in raising awareness of Bayesian modelling among both academic and commercial communities internationally, and has enjoyed considerable success over its 20-year life span. Despite this, the software has a number of shortcomings and a principal aim of this paper is to provide a balanced critical appraisal, in particular highlighting how various ideas have led to unprecedented flexibility while at the same time producing negative side effects. We also present a historical overview of the BUGS project and some future perspectives.",0 +https://doi.org/10.1007/s11336-005-1350-6,Signal Detection Models with Random Participant and Item Effects,"The theory of signal detection is convenient for measuring mnemonic ability in recognition memory paradigms. In these paradigms, randomly selected participants are asked to study randomly selected items. In practice, researchers aggregate data across items or participants or both. The signal detection model is nonlinear; consequently, analysis with aggregated data is not consistent. In fact, mnemonic ability is underestimated, even in the large-sample limit. We present two hierarchical Bayesian models that simultaneously account for participant and item variability. We show how these models provide for accurate estimation of participants' mnemonic ability as well as the memorability of items. The model is benchmarked with a simulation study and applied to a novel data set. © 2007 The Psychometric Society.",0 +https://doi.org/10.1109/icssbe.2012.6396604,Guessing-testlet response model,"The psychometric standard of fairness can be violated if the guessing effect is improperly handled. The two most common ways of handling guessing effect are through item design and guessing effect modeling. Items with lower priori guessing probability helps to reduce guessing effect. This paper proposes a two-parameter logistic guessing-testlet response model to model such items. The proposed model is an extended testlet response model where items of the same guessing priori guessing probability are grouped in the same testlet. To reduce the priori guessing probabilities, the items are designed to have multiple-correct responses and the number of correct responses is varying across items. Simulation result shows that the proposed model outperforms the two-parameter logistic item response model in model fit. The proposed guessing-testlet merits ability with no guessing but penalizes ability with guessing.",0 +https://doi.org/10.1080/10705510903203573,Factor Analysis with Ordinal Indicators: A Monte Carlo Study Comparing DWLS and ULS Estimation,"Factor analysis models with ordinal indicators are often estimated using a 3-stage procedure where the last stage involves obtaining parameter estimates by least squares from the sample polychoric correlations. A simulation study involving 324 conditions (1,000 replications per condition) was performed to compare the performance of diagonally weighted least squares (DWLS) and unweighted least squares (ULS) in the procedure's third stage. Overall, both methods provided accurate and similar results. However, ULS was found to provide more accurate and less variable parameter estimates, as well as more precise standard errors and better coverage rates. Nevertheless, convergence rates for DWLS are higher. Our recommendation is therefore to use ULS, and, in the case of nonconvergence, to use DWLS, as this method might converge when ULS does not.",0 +https://doi.org/10.1007/978-3-642-69746-3_2,From Intentions to Actions: A Theory of Planned Behavior,"There appears to be general agreement among social psychologists that most human behavior is goal-directed (e. g., Heider, 1958 ; Lewin, 1951). Being neither capricious nor frivolous, human social behavior can best be described as following along lines of more or less well-formulated plans. Before attending a concert, for example, a person may extend an invitation to a date, purchase tickets, change into proper attire, call a cab, collect the date, and proceed to the concert hall. Most, if not all, of these activities will have been designed in advance; their execution occurs as the plan unfolds. To be sure, a certain sequence of actions can become so habitual or routine that it is performed almost automatically, as in the case of driving from home to work or playing the piano. Highly developed skills of this kind typically no longer require conscious formulation of a behavioral plan. Nevertheless, at least in general outline, we are normally well aware of the actions required to attain a certain goal. Consider such a relatively routine behavior as typing a letter. When setting this activity as a goal, we anticipate the need to locate a typewriter, insert a sheet of paper, adjust the margins, formulate words and sentences, strike the appropriate keys, and so forth. Some parts of the plan are more routine, and require less conscious thought than others, but without an explicit or implicit plan to guide the required sequence of acts, no letter would get typed.",0 +https://doi.org/10.2307/2530695,Unbalanced Repeated-Measures Models with Structured Covariance Matrices,"The question of how to analyze unbalanced or incomplete repeated-measures data is a common problem facing analysts. We address this problem through maximum likelihood analysis using a general linear model for expected responses and arbitrary structural models for the within-subject covariances. Models that can be fit include standard univariate and multivariate models with incomplete data, random-effects models, and models with time-series and factor-analytic error structures. We describe Newton-Raphson and Fisher scoring algorithms for computing maximum likelihood estimates, and generalized EM algorithms for computing restricted and unrestricted maximum likelihood estimates. An example fitting several models to a set of growth data is included.",0 +https://doi.org/10.1214/07-aoas138,In-season prediction of batting averages: A field test of empirical Bayes and Bayes methodologies,"Batting average is one of the principle performance measures for an individual baseball player. It is natural to statistically model this as a binomial-variable proportion, with a given (observed) number of qualifying attempts (called “at-bats”), an observed number of successes (“hits”) distributed according to the binomial distribution, and with a true (but unknown) value of pi that represents the player’s latent ability. This is a common data structure in many statistical applications; and so the methodological study here has implications for such a range of applications. We look at batting records for each Major League player over the course of a single season (2005). The primary focus is on using only the batting records from an earlier part of the season (e.g., the first 3 months) in order to estimate the batter’s latent ability, pi, and consequently, also to predict their batting-average performance for the remainder of the season. Since we are using a season that has already concluded, we can then validate our estimation performance by comparing the estimated values to the actual values for the remainder of the season. The prediction methods to be investigated are motivated from empirical Bayes and hierarchical Bayes interpretations. A newly proposed nonparametric empirical Bayes procedure performs particularly well in the basic analysis of the full data set, though less well with analyses involving more homogeneous subsets of the data. In those more homogeneous situations better performance is obtained from appropriate versions of more familiar methods. In all situations the poorest performing choice is the naïve predictor which directly uses the current average to predict the future average. One feature of all the statistical methodologies here is the preliminary use of a new form of variance stabilizing transformation in order to transform the binomial data problem into a somewhat more familiar structure involving (approximately) Normal random variables with known variances. This transformation technique is also used in the construction of a new empirical validation test of the binomial model assumption that is the conceptual basis for all our analyses.",0 +https://doi.org/10.1177/0146621605282772,Markov Chain Monte Carlo Estimation of Item Parameters for the Generalized Graded Unfolding Model,"The authors present a Markov Chain Monte Carlo (MCMC) parameter estimation procedure for the generalized graded unfolding model (GGUM) and compare it to the marginal maximum likelihood (MML) approach implemented in the GGUM2000 computer program, using simulated and real personality data. In the simulation study, test length, number of response options, and sample size were manipulated. Results indicate that the two methods are comparable in terms of item parameter estimation accuracy. Although the MML estimates exhibit slightly smaller bias than MCMC estimates, they also show greater variability, which results in larger root mean squared errors. Of the two methods, only MCMC provides reasonable standard error estimates for all items.",0 +https://doi.org/10.1093/aje/kwq472,Implementation of G-Computation on a Simulated Data Set: Demonstration of a Causal Inference Technique,The growing body of work in the epidemiology literature focused on G-computation includes theoretical explanations of the method but very few simulations or examples of application. The small number of G-computation analyses in the epidemiology literature relative to other causal inference approaches may be partially due to a lack of didactic explanations of the method targeted toward an epidemiology audience. The authors provide a step-by-step demonstration of G-computation that is intended to familiarize the reader with this procedure. The authors simulate a data set and then demonstrate both G-computation and traditional regression to draw connections and illustrate contrasts between their implementation and interpretation relative to the truth of the simulation protocol. A marginal structural model is used for effect estimation in the G-computation example. The authors conclude by answering a series of questions to emphasize the key characteristics of causal inference techniques and the G-computation procedure in particular.,0 +https://doi.org/10.1080/02664760802191397,Bayesian assessment of times to diagnosis in breast cancer screening,"Breast cancer is one of the diseases with the most profound impact on health in developed countries and mammography is the most popular method for detecting breast cancer at a very early stage. This paper focuses on the waiting period from a positive mammogram until a confirmatory diagnosis is carried out in hospital. Generalized linear mixed models are used to perform the statistical analysis, always within the Bayesian reasoning. Markov chain Monte Carlo algorithms are applied for estimation by simulating the posterior distribution of the parameters and hyperparameters of the model through the free software WinBUGS.",0 +https://doi.org/10.1348/000711001159546,Bayesian estimation and test for factor analysis model with continuous and polytomous data in several populations,"The main purpose of this paper is to develop a Bayesian approach for the multisample factor analysis model with continuous and polytomous variables. Joint Bayesian estimates of the thresholds, the factor scores and the structural parameters subjected to some simple constraints across groups are obtained simultaneously. The Gibbs sampler is used to produce the joint Bayesian estimates. It is shown that the conditional distributions involved in the implementation are the familiar uniform, gamma, normal, univariate truncated normal and Wishart distributions. The Bayes factor is introduced to test hypotheses involving constraints among the structural parameters of the factor analysis models across groups. Two procedures for computing the test statistics are developed, one based on the Schwarz criterion (or Bayesian information criterion), while the other computes the posterior densities and likelihood ratios by means of draws from the appropriate conditional distributions via the Gibbs sampler. The empirical performance of the proposed Bayesian procedure and its sensitivity to prior distributions are illustrated by some simulation results and two real-life examples.",0 +https://doi.org/10.2501/s1470785309200402,The Truth is out there! how External Validity can Lead to Better Marketing Decisions,"Marketing managers typically have to use and integrate many pieces of data and marketing intelligence when taking decisions such as whether to launch a product and, if so, at what price. Conjoint experiments and analysis remain popular marketing research tools with business practitioners to test and measure how the market will react to different actions. There is a growing body of work that focuses on, first, how to construct the experiments so that they better represent real market conditions and, second, the use of sophisticated model specifications that provide information on consumers' responses. The market researcher typically uses internal validation for model validity - a comparison of model prediction and within-sample holdout data. We contend in this paper that customers and users of market research information need to adopt a different and wider meaning of validity, referred to as external validity, to facilitate improved decision making. In this research, a case study is used as an example to demonstrate how marketing managers can use the information from a choice-based conjoint derived choice model differently depending on the manner in which the model validation is carried out. © 2009 The Market Research Society.",0 +https://doi.org/10.1371/journal.pone.0071608,Recalibration of the Multisensory Temporal Window of Integration Results from Changing Task Demands,"The notion of the temporal window of integration, when applied in a multisensory context, refers to the breadth of the interval across which the brain perceives two stimuli from different sensory modalities as synchronous. It maintains a unitary perception of multisensory events despite physical and biophysical timing differences between the senses. The boundaries of the window can be influenced by attention and past sensory experience. Here we examined whether task demands could also influence the multisensory temporal window of integration. We varied the stimulus onset asynchrony between simple, short-lasting auditory and visual stimuli while participants performed two tasks in separate blocks: a temporal order judgment task that required the discrimination of subtle auditory-visual asynchronies, and a reaction time task to the first incoming stimulus irrespective of its sensory modality. We defined the temporal window of integration as the range of stimulus onset asynchronies where performance was below 75% in the temporal order judgment task, as well as the range of stimulus onset asynchronies where responses showed multisensory facilitation (race model violation) in the reaction time task. In 5 of 11 participants, we observed audio-visual stimulus onset asynchronies where reaction time was significantly accelerated (indicating successful integration in this task) while performance was accurate in the temporal order judgment task (indicating successful segregation in that task). This dissociation suggests that in some participants, the boundaries of the temporal window of integration can adaptively recalibrate in order to optimize performance according to specific task demands.",0 +https://doi.org/10.1111/j.1745-3984.1991.tb00363.x,Multilevel Factor Analysis of Class and Student Achievement Components,"Multilevel Factor Analysis of Class and Student Achievement Components Author(s): Bengt O. Muthen Source: Journal of Educational Measurement, Vol. 28, No. 4 (Winter, 1991), pp. 338-354 Published by: National Council on Measurement in Education Stable URL: http://www.jstor.org/stable/1434897 . Accessed: 18/05/2011 18:39 Your use of the JSTOR archive indicates your acceptance of JSTOR's Terms and Conditions of Use, available at . http://www.jstor.org/page/info/about/policies/terms.jsp. JSTOR's Terms and Conditions of Use provides, in part, that unless you have obtained prior permission, you may not download an entire issue of a journal or multiple copies of articles, and you may use content in the JSTOR archive only for your personal, non-commercial use. Please contact the publisher regarding any further use of this work. Publisher contact information may be obtained at . http://www.jstor.org/action/showPublisher?publisherCode=ncme. . Each copy of any part of a JSTOR transmission must contain the same copyright notice that appears on the screen or printed page of such transmission. JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org. National Council on Measurement in Education is collaborating with JSTOR to digitize, preserve and extend access to Journal of Educational Measurement. http://www.jstor.org",0 +https://doi.org/10.1007/bf02288391,The theory of the estimation of test reliability,"The theoretically best estimate of the reliability coefficient is stated in terms of a precise definition of the equivalence of two forms of a test. Various approximations to this theoretical formula are derived, with reference to several degrees of completeness of information about the test and to special assumptions. The familiar Spearman-Brown Formula is shown to be a special case of the general formulation of the problem of reliability. Reliability coefficients computed in various ways are presented for comparative purposes. © 1937 Psychometric Society.",0 +https://doi.org/10.3102/1076998615621299,Using Data-Dependent Priors to Mitigate Small Sample Bias in Latent Growth Models,"Mixed-effects models (MEMs) and latent growth models (LGMs) are often considered interchangeable save the discipline-specific nomenclature. Software implementations of these models, however, are not interchangeable, particularly with small sample sizes. Restricted maximum likelihood estimation that mitigates small sample bias in MEMs has not been widely developed for LGMs, and fully Bayesian methods, while not dependent on asymptotics, can encounter issues because the choice for the factor covariance matrix prior distribution has substantial influence with small samples. This tutorial discusses differences between LGMs and MEMs and demonstrates how data-dependent priors, an established class of methods that blend frequentist and Bayesian paradigms, can be implemented within M plus 7.1 to abate the small sample bias that is prevalent with LGM software while keeping additional programming to the bare minimum.",1 +https://doi.org/10.1111/j.1541-0420.2011.01617.x,Split-Plot Designs for Robotic Serial Dilution Assays,"This article explores effective implementation of split-plot designs in serial dilution bioassay using robots. We show that the shortest path for a robot to fill plate wells for a split-plot design is equivalent to the shortest common supersequence problem in combinatorics. We develop an algorithm for finding the shortest common supersequence, provide an R implementation, and explore the distribution of the number of steps required to implement split-plot designs for bioassay through simulation. We also show how to construct collections of split plots that can be filled in a minimal number of steps, thereby demonstrating that split-plot designs can be implemented with nearly the same effort as strip-plot designs. Finally, we provide guidelines for modeling data that result from these designs.",0 +https://doi.org/10.1080/02664763.2015.1010491,Comparison of three-level cluster randomized trials using quantile dispersion graphs,"The purpose of this article is to evaluate and compare several three-level cluster randomized designs on the basis of their power functions. The power function of cluster designs depends on the intracluster correlations (ICCs), which are generally unknown at the planning stage. Thus, to compare these designs a prior knowledge of the ICCs is required. Three interval estimation methods are proposed for assigning joint confidence intervals to the two ICCs (corresponding to each cluster level). A detailed simulation study comparing the confidence intervals attained by the different techniques is given. The technique of quantile dispersion graphs is used for comparing the three-level cluster designs. For a given design, quantiles of the power function, are obtained for various effect sizes. These quantiles are functions of the unknown ICC coefficients. To address the dependence of the quantiles on the correlations, a 100(1−α)% confidence region is computed, and used as a parameter space. A three-level nested d...",0 +,A digitally delivered and fully automated internet- and mobile-based smoking cessation programme : a randomized controlled trial,,0 +https://doi.org/10.1177/2158244015625445,Two Cross-Platform Programs for Inferences and Interval Estimation About Indirect Effects in Mediational Models,"In this article, we describe two new programs that compute both p-values and confidence intervals (CI) for the indirect effect in mediational models, including (a) a p-value based on the partial posterior method, which we refer to as p 3 computed across the posterior distribution of the regression coefficients; (b) a variant of p 3 that uses a normal approximation for the posterior distributions, p 3N ; (c) Hierarchical Bayesian CIs (CI HB ) based on the posterior distributions of the regression coefficients; and (d) CIs based on the Monte Carlo method (CI MC ). These programs do not require access to raw data as do resampling methods. Similar to Sobel’s test, p 3 and p 3N constitute a single p-value for the indirect effect while performing substantially better in terms of Type I and II error rates. Furthermore, we include a memory efficient computational algorithm for CI HB and CI MC that allows for precision beyond that in existing alternative implementations. The underlying programs can utilize multicore processors, and their performance is tested through a simulation study. Finally, the use of these programs is illustrated with an empirical example.",0 +https://doi.org/10.1002/sim.7347,Multidimensional latent trait linear mixed model: an application in clinical studies with multivariate longitudinal outcomes,"Multilevel item response theory (MLIRT) models have been widely used to analyze the multivariate longitudinal data of mixed types (e.g., categorical and continuous) in clinical studies. The MLIRT models often have unidimensional assumption, that is, the multiple outcomes are clinical manifestations of a univariate latent variable. However, the unidimensional assumption may be unrealistic because some diseases may be heterogeneous and characterized by multiple impaired domains with variable clinical symptoms and disease progressions. We relax this assumption and propose a multidimensional latent trait linear mixed model (MLTLMM) to allow multiple latent variables and within-item multidimensionality (one outcome can be a manifestation of more than one latent variable). We conduct extensive simulation studies to assess the unidimensional MLIRT model and the proposed MLTLMM model. The simulation studies suggest that the MLTLMM model outperforms unidimensional model when the multivariate longitudinal outcomes are manifested by multiple latent variables. The proposed model is applied to two motivating studies of amyotrophic lateral sclerosis: a clinical trial of ceftriaxone and the Pooled Resource Open-Access ALS Clinical Trials database. Copyright © 2017 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1007/s11121-014-0505-z,Preventing Weight Gain and Obesity: Indirect Effects of the Family Check-Up in Early Childhood,"The early signs of obesity are observable in early childhood. Although the most promising prevention approaches are family-centered, few relevant early prevention programs exist. This study evaluated the effects of an evidence-based, home-visiting intervention, the Family Check-Up (FCU), on the trajectory of children's weight gain. The FCU was designed to prevent the development of behavior problems by improving family management practices; children's weight has not been an explicit target. On the basis of previous research and conceptual models, we hypothesized that intervention effects on parenting practices, specifically caregivers' use of positive behavior support (PBS) strategies in toddlerhood, would mediate improvements in children's weight trajectories. A total of 731 indigent caregiver-child dyads from a multisite randomized intervention trial were examined. Observational assessment of parenting and mealtime behaviors occurred from age 2-5 years. The child's body mass index (BMI) was assessed yearly from age 5-9.5 years. Path analysis with a latent growth model revealed a significant indirect effect of the FCU on the trajectory of BMI in later childhood. Improvements in caregivers' PBS in toddlerhood, which was related to the nutritional quality of the meals caregivers served to the child during the mealtime task, served as the intervening process. Furthermore, findings indicate that the FCU prevents progression to overweight and obese status amongst at-risk children. These study results add to existing evidence that has demonstrated that family-based interventions aimed at improving general family management skills are effective at preventing weight gain. Future directions are discussed.",0 +https://doi.org/10.1007/s11336-012-9257-5,Application of a Multidimensional Nested Logit Model to Multiple-Choice Test Items,"Nested logit models have been presented as an alternative to multinomial logistic models for multiple-choice test items (Suh and Bolt in Psychometrika 75:454-473, 2010) and possess a mathematical structure that naturally lends itself to evaluating the incremental information provided by attending to distractor selection in scoring. One potential concern in attending to distractors is the possibility that distractor selection reflects a different trait/ability than that underlying the correct response. This paper illustrates a multidimensional extension of a nested logit item response model that can be used to evaluate such distinctions and also defines a new framework for incorporating collateral information from distractor selection when differences exist. The approach is demonstrated in application to questions faced by a university testing center over whether to incorporate distractor selection into the scoring of its multiple-choice tests. Several empirical examples are presented. © 2012 The Psychometric Society.",0 +https://doi.org/10.1177/0272989x09341752,Bayesian Hierarchical Models for Cost-Effectiveness Analyses that Use Data from Cluster Randomized Trials,"Cost-effectiveness analyses (CEA) may be undertaken alongside cluster randomized trials (CRTs) where randomization is at the level of the cluster (for example, the hospital or primary care provider) rather than the individual. Costs (and outcomes) within clusters may be correlated so that the assumption made by standard bivariate regression models, that observations are independent, is incorrect. This study develops a flexible modeling framework to acknowledge the clustering in CEA that use CRTs. The authors extend previous Bayesian bivariate models for CEA of multicenter trials to recognize the specific form of clustering in CRTs. They develop new Bayesian hierarchical models (BHMs) that allow mean costs and outcomes, and also variances, to differ across clusters. They illustrate how each model can be applied using data from a large (1732 cases, 70 primary care providers) CRT evaluating alternative interventions for reducing postnatal depression. The analyses compare cost-effectiveness estimates from BHMs with standard bivariate regression models that ignore the data hierarchy. The BHMs show high levels of cost heterogeneity across clusters (intracluster correlation coefficient, 0.17). Compared with standard regression models, the BHMs yield substantially increased uncertainty surrounding the cost-effectiveness estimates, and altered point estimates. The authors conclude that ignoring clustering can lead to incorrect inferences. The BHMs that they present offer a flexible modeling framework that can be applied more generally to CEA that use CRTs.",0 +https://doi.org/10.1080/01650250444000414,Gender effects in peer nominations for aggression and social status,"Little prior research has examined children’s interpersonal perceptions of peers from a social relations model framework. This study examines the degree of actor and partner variances, as well as generalised and dyadic reciprocities, in a sample of 351 sixth graders’ peer nominations of different forms and functions of aggression and aspects of social status. Gender differences in these nominations are also explored. Results indicate significant actor and partner variances for all measures, and generalised reciprocity in social status perceptions. Clear gender differences were noted in rates of nominations, such that more same-sex than cross-sex nominations were generally given for both positive and negative aspects; however, we found mixed evidence of gender differences in the variance partitioning and reciprocity correlation estimates.",0 +https://doi.org/10.1191/1471082x06st119oa,A Bayesian approach to inequality constrained linear mixed models: estimation and model selection,Constrained parameter problems arise in a wide variety of applications. This article deals with estimation and model selection in linear mixed models with inequality constraints on the parameters. It is shown that different theories can be translated into statistical models by putting constraints on the model parameters yielding a set of competing models. A new approach based on the principle of encompassing priors is proposed and used to compute Bayes factors and subsequently posterior model probabilities. Model selection is based on posterior model probabilities. The approach is illustrated using a longitudinal data set.,0 +https://doi.org/10.1002/sim.3848,Meta-regression with partial information on summary trial or patient characteristics,"We present a model for meta-regression in the presence of missing information on some of the study level covariates, obtaining inferences using Bayesian methods. In practice, when confronted with missing covariate data in a meta-regression, it is common to carry out a complete case or available case analysis. We propose to use the full observed data, modelling the joint density as a factorization of a meta-regression model and a conditional factorization of the density for the covariates. With the inclusion of several covariates, inter-relations between these covariates are modelled. Under this joint likelihood-based approach, it is shown that the lesser assumption of the covariates being Missing At Random is imposed, instead of the more usual Missing Completely At Random (MCAR) assumption. The model is easily programmable in WinBUGS, and we examine, through the analysis of two real data sets, sensitivity and robustness of results to the MCAR assumption.",0 +https://doi.org/10.1016/j.bbr.2011.08.048,Post-conditioning experience with acute or chronic inflammatory pain reduces contextual fear conditioning in the rat,"There is evidence that pain can impact cognitive function in people. The present study evaluated whether Pavlovian fear conditioning in rats would be reduced if conditioning were followed by persistent inflammatory pain induced by a subcutaneous injection of dilute formalin or complete Freund's adjuvant (CFA) on the dorsal lumbar surface of the back. Formalin-induced pain specifically impaired contextual fear conditioning but not auditory cue conditioning (Experiment 1A). Moreover, formalin pain only impaired contextual fear conditioning if it was initiated within 1h of conditioning and did not have a significant effect if initiated 2, 8 or 32 h after (Experiments 1A and 1B). Experiment 2 showed that formalin pain initiated after a session of context pre-exposure reduced the ability of that pre-exposure to facilitate contextual fear when the rat was limited to a brief exposure to the context during conditioning. Similar impairments in context- but not CS-fear conditioning were also observed if the rats received an immediate post-conditioning injection with CFA (Experiment 3). Finally, we confirmed that formalin and CFA injected s.c. on the back induced pain-indicative behaviours, hyperalgesia and allodynia with a similar timecourse to intraplantar injections (Experiment 4). These results suggest that persistent pain impairs learning in a hippocampus-dependent task, and may disrupt processes that encode experiences into long-term memory.",0 +https://doi.org/10.2165/11539870-000000000-00000,Comparing Methods of Data Synthesis,"Background: Cost-effectiveness models should always be amendable to updating once new data on important model parameters become available. However, several methods of synthesizing data exist and the choice of method may affect the cost-effectiveness estimates. Objectives: To investigate the impact of the different methods of metaanalysis on final estimates of cost effectiveness from a probabilistic Markov model for chronic obstructive pulmonary disease (COPD). Methods: We compared four different methods to synthesize data for the parameters of a cost-effectiveness model for COPD: frequentist and Bayesian fixed-effects (FE) and random-effects (RE) meta-analyses. These methods were applied to obtain new transition probabilities between stable disease states and new event probabilities. Results: The four methods resulted in different estimates of probabilities and their standard errors (SE). The effects of using different synthesis techniques were most prominent in the estimation of the SEs. We found up to 9-fold differences in SEs of the exacerbation probabilities and up to almost 3-fold differences in SEs of the transition probabilities. We found that the frequentist FE model produced the lowest SEs, whereas the Bayesian RE model produced the highest for all parameters. The estimates of differences between treatments in total costs, QALYs and cost-effectiveness acceptability curves (CEAC) also varied depending on the synthesis method. The CEAC was 15% lower with a Bayesian RE model than with any of the other models. Conclusions: Health economic modellers should be aware that the choice of synthesis technique can affect resulting model parameters considerably, which can in turn affect estimates of cost effectiveness and the uncertainty around them. © 2011 Adis Data Information BV. All rights reserved.",0 +https://doi.org/10.1037/10099-006,Interindividual differences in intraindividual change.,,0 +https://doi.org/10.1016/j.pain.2012.02.015,"Intrathecal cannabilactone CB2R agonist, AM1710, controls pathological pain and restores basal cytokine levels","Spinal glial and proinflammatory cytokine actions are strongly implicated in pathological pain. Spinal administration of the anti-inflammatory cytokine interleukin (IL)-10 abolishes pathological pain and suppresses proinflammatory IL-1β and tumor necrosis factor alpha (TNF-α). Drugs that bind the cannabinoid type-2 receptor (CB(2)R) expressed on spinal glia reduce mechanical hypersensitivity. To better understand the CB(2)R-related anti-inflammatory profile of key anatomical nociceptive regions, we assessed mechanical hypersensitivity and protein profiles following intrathecal application of the cannabilactone CB(2)R agonist, AM1710, in 2 animal models; unilateral sciatic nerve chronic constriction injury (CCI), and spinal application of human immunodeficiency virus-1 glycoprotein 120 (gp120), a model of peri-spinal immune activation. In CCI animals, lumbar dorsal spinal cord and corresponding dorsal root ganglia (DRG) were evaluated by immunohistochemistry for expression of IL-10, IL-1β, phosphorylated p38-mitogen-activated-kinase (p-p38MAPK), a pathway associated with proinflammatory cytokine production, glial cell markers, and degradative endocannabinoid enzymes, including monoacylglycerol lipase (MAGL). AM1710 reversed bilateral mechanical hypersensitivity. CCI revealed decreased IL-10 expression in dorsal spinal cord and DRG, while AM1710 resulted in increased IL-10, comparable to controls. Adjacent DRG and spinal sections revealed increased IL-1β, p-p38MAPK, glial markers, and/or MAGL expression, while AM1710 suppressed all but spinal p-p38MAPK and microglial activation. In spinal gp120 animals, AM1710 prevented bilateral mechanical hypersensitivity. For comparison to immunohistochemistry, IL-1β and TNF-α protein quantification from lumbar spinal and DRG homogenates was determined, and revealed increased DRG IL-1β protein levels from gp120, that was robustly prevented by AM1710 pretreatment. Cannabilactone CB(2)R agonists are emerging as anti-inflammatory agents with pain therapeutic implications.",0 +https://doi.org/10.1198/106186006x137047,Optimal Full Matching and Related Designs via Network Flows,"In the matched analysis of an observational study, confounding on covariates X is addressed by comparing members of a distinguished group (Z = 1) to controls (Z = 0) only when they belong to the same matched set. The better matchings, therefore, are those whose matched sets exhibit both dispersion in Z and uniformity in X. For dispersion in Z, pair matching is best, creating matched sets that are equally balanced between the groups; but actual data place limits, often severe limits, on matched pairs' uniformity in X. At the other extreme is full matching, the matched sets of which are as uniform in X as can be, while often so poorly dispersed in Z as to sacrifice efficiency.This article presents an algorithm for exploring the intermediate territory. Given requirements on matched sets' uniformity in X and dispersion in Z, the algorithm first decides the requirements' feasibility. In feasible cases, it furnishes a match that is optimal for X-uniformity among matches with Z-dispersion as stipulated. To illus...",0 +https://doi.org/10.1093/oxfordhb/9780195394399.013.0012,Social Support and Immunity,"Abstract Social support has been reliably related to lower rates of morbidity and mortality across a number of diseases. However, little is known about the more specific pathways and mechanisms responsible for such links. In this chapter, we argue that part of the link between social support and health is explained by immune-system alternations that, in turn, influence broad-based disease outcomes. Recent studies suggest that social support is related to lower IL-6 and better immune function in biologically relevant contexts (e.g., vaccinations, cancer patients). The implications of these findings are discussed in light of a broad model hypothesizing that social support may influence health outcomes via behavioral (e.g., health behaviors), psychological (e.g., stress appraisals), and neuroendocrine-immune mechanisms. Important future research areas are also emphasized, especially the need to uncover the psychological pathways by which social support may be health-promoting.",0 +https://doi.org/10.1002/sim.2393,Bayesian implementation of a genetic model-free approach to the meta-analysis of genetic association studies,"A genetic model-free method for the meta-analysis of genetic association studies is described that estimates the mode of inheritance from the data rather than assuming that it is known. For a bi-allelic polymorphism, with G as risk allele and g as wild-type, the genetic model depends on the ratio of the two log odds ratios, lambda = log OR(Gg)/log OR(GG), where OR(GG) compares GG with gg and OR(Gg) compares Gg with gg. Modelling log OR(GG) as a random effect creates a hierarchical model that can be implemented within a Bayesian framework. In Bayesian modelling, vague prior distributions have to be specified for all unknown parameters when no external information is available. When the data are sparse even supposedly vague prior distributions may have an influence on the posterior estimates. We investigate the impact of different vague prior distributions for the between-study standard deviation of log OR(GG) and for lambda, by considering three published meta-analyses and associated simulations. Our results show that depending on the characteristics of the meta-analysis the results may indeed be sensitive to the choice of vague prior distribution for either parameter. Genetic association studies usually use a case-control design that should be analysed by the corresponding retrospective likelihood. However, under some circumstances the prospective likelihood has been shown to produce identical results and it is usually preferred for its simplicity. In our meta-analyses the two likelihoods give very similar results.",0 +https://doi.org/10.1111/j.1600-0706.2013.00946.x,"Plant damage and herbivore performance change with latitude for two old-field plant species, but rarely as predicted","A long standing hypothesis in biogeography is that latitudinal gradients in plant defenses (LGPD) should arise because selection for plant defenses is greater in the tropics compared to temperate areas. Previous studies have focused on plant traits thought to confer resistance, yet many traits may not actually confer resistance (putative resistance) or interact to influence herbivore performance. In this study, I used a multi-trophic approach to examine relationships between latitude, herbivore pressure, and plant resistance (measured as the growth rates of herbivores) of two old-field plant species (Solanum carolinense and Solidago altissima) using a field survey across a 12 degree gradient in the eastern US combined with laboratory bioassays measuring the performance of generalist and specialist herbivores. I used structural equation modeling to examine the direct and indirect pathways by which latitude influences herbivore pressure and plant resistance. A latitudinal gradient in plant damage was observed in the expected direction for S. caroliense (damage decreased with latitude), but the opposite relationship was observed for S. altissima. Damage to both plant species was mediated by herbivore abundances, which was in turn influenced by predator abundances. Resistance to herbivores also varied with latitude but the form of the relationship was dependent on herbivore and plant species. There were direct, non-linear relationships between latitude and resistance (for Spodoptera exigua and Schistocerca americana feeding on S. altissima; S. exigua and Manduca sexta feeding on S. carolinense). Herbivore growth rates were also mediated by the density of S. carolinense for Leptinotarsa juncta and S. americana feeding on S. carolinense. There was no relationship between plant resistance and herbivore pressure and no indication of feedbacks. Results from this study indicate that latitudinal variation in plant resistance is complex, possibly constrained by resource availability and tradeoffs in plant defenses.",0 +https://doi.org/10.1007/s11135-014-0058-z,Simulation studies of structural equation models with covariates in a redundancy analysis framework,"A recent approach to structural equation modelling based on so-called extended redundancy analysis (ERA) has been proposed in the literature, enhanced with the added characteristic of generalizing redundancy analysis (GRA) models for more than two blocks. In this approach, the relationships between the observed exogenous variables and the observed endogenous variables are moderated by the presence of unobservable composites, estimated as linear combinations of exogenous variables. However, in presence of direct effects linking exogenous and endogenous variables, the composite scores are estimated by ignoring the presence of the specified direct effects. In this paper, we generalize the ERA, extending this new class of models to allow for external covariate effects. In particular, covariates are allowed to affect endogenous indicators indirectly through the composites and/or directly. The method proposed herein is called GRA, which allows us to specify and fit a variety of relationships among composites and endogenous variables. In the paper we propose two simulation studies aimed to illustrate the advantages of GRA over ERA in terms of recovery of the original underlying structure of the data in small samples. Moreover, other than the proposal of this new methodology, a second aspect of originality of this paper is that, to our knowledge, no existing empirical research addresses the behaviour of ERA with external covariate effect in simulation studies. © 2014, Springer Science+Business Media Dordrecht.",0 +https://doi.org/10.1080/00949659208811388,On some small sample properties of generalized estimating equationEstimates for multivariate dichotomous outcomes,"(1992). On some small sample properties of generalized estimating equationEstimates for multivariate dichotomous outcomes. Journal of Statistical Computation and Simulation: Vol. 41, No. 1-2, pp. 19-29.",0 +,Imposing structure on an unstructured environment : Ontogenetic changes in the ability to form rules of behavior under conditions of low environmental predictability,,0 +https://doi.org/10.1177/1094428107300344,Tests of the Three-Path Mediated Effect,"In a three-path mediational model, two mediators intervene in a series between an independent and a dependent variable. Methods of testing for mediation in such a model are generalized from the more often used single-mediator model. Six such methods are introduced and compared in a Monte Carlo study in terms of their Type I error, power, and coverage. Based on its results, the joint significance test is preferred when only a hypothesis test is of interest. The percentile bootstrap and bias-corrected bootstrap are preferred when a confidence interval on the mediated effect is desired, with the latter having more power but also slightly inflated Type I error in some conditions.",0 +https://doi.org/10.1080/00273171.2017.1342203,Bayesian Estimation for Item Factor Analysis Models with Sparse Categorical Indicators,"Psychometric models for item-level data are broadly useful in psychology. A recurring issue for estimating item factor analysis (IFA) models is low-item endorsement (item sparseness), due to limited sample sizes or extreme items such as rare symptoms or behaviors. In this paper, I demonstrate that under conditions characterized by sparseness, currently available estimation methods, including maximum likelihood (ML), are likely to fail to converge or lead to extreme estimates and low empirical power. Bayesian estimation incorporating prior information is a promising alternative to ML estimation for IFA models with item sparseness. In this article, I use a simulation study to demonstrate that Bayesian estimation incorporating general prior information improves parameter estimate stability, overall variability in estimates, and power for IFA models with sparse, categorical indicators. Importantly, the priors proposed here can be generally applied to many research contexts in psychology, and they do not impact results compared to ML when indicators are not sparse. I then apply this method to examine the relationship between suicide ideation and insomnia in a sample of first-year college students. This provides an important alternative for researchers who may need to model items with sparse endorsement.",0 +https://doi.org/10.1037/a0026802,Bayesian structural equation modeling: A more flexible representation of substantive theory.,"This article proposes a new approach to factor analysis and structural equation modeling using Bayesian analysis. The new approach replaces parameter specifications of exact zeros with approximate zeros based on informative, small-variance priors. It is argued that this produces an analysis that better reflects substantive theories. The proposed Bayesian approach is particularly beneficial in applications where parameters are added to a conventional model such that a nonidentified model is obtained if maximum-likelihood estimation is applied. This approach is useful for measurement aspects of latent variable modeling, such as with confirmatory factor analysis, and the measurement part of structural equation modeling. Two application areas are studied, cross-loadings and residual correlations in confirmatory factor analysis. An example using a full structural equation model is also presented, showing an efficient way to find model misspecification. The approach encompasses 3 elements: model testing using posterior predictive checking, model estimation, and model modification. Monte Carlo simulations and real data are analyzed using Mplus. The real-data analyses use data from Holzinger and Swineford's (1939) classic mental abilities study, Big Five personality factor data from a British survey, and science achievement data from the National Educational Longitudinal Study of 1988.",0 +https://doi.org/10.1037/a0014877,Evaluating cognitive theory: A joint modeling approach using responses and response times.,"In current psychological research, the analysis of data from computer-based assessments or experiments is often confined to accuracy scores. Response times, although being an important source of additional information, are either neglected or analyzed separately. In this article, a new model is developed that allows the simultaneous analysis of accuracy scores and response times of cognitive tests with a rule-based design. The model is capable of simultaneously estimating ability and speed on the person side as well as difficulty and time intensity on the task side, thus dissociating information that is often confounded in current analysis procedures. Further, by integrating design matrices on the task side, it becomes possible to assess the effects of design parameters (e.g., cognitive processes) on both task difficulty and time intensity, offering deeper insights into the task structure. A Bayesian approach, using Markov Chain Monte Carlo methods, has been developed to estimate the model. An application of the model in the context of educational assessment is illustrated using a large-scale investigation of figural reasoning ability.",0 +https://doi.org/10.1037/a0013269,A double-structure structural equation model for three-mode data.,"Structural equation models are commonly used to analyze 2-mode data sets, in which a set of objects is measured on a set of variables. The underlying structure within the object mode is evaluated using latent variables, which are measured by indicators coming from the variable mode. Additionally, when the objects are measured under different conditions, 3-mode data arise, and with this, the simultaneous study of the correlational structure of 2 modes may be of interest. In this article the authors present a model with a simultaneous latent structure for 2 of the 3 modes of such a data set. They present an empirical illustration of the method using a 3-mode data set (person by situation by response) exploring the structure of anger and irritation across different interpersonal situations as well as across persons.",0 +https://doi.org/10.1111/j.2044-8317.1998.tb00679.x,Bayesian sampling-based approach for factor analysis models with continuous and polytomous data,"Factor analysis is an important technique in behavioural science research in explaining the interdependence and assessing causations and correlations of the observed variables and the latent factors. Recently, generalization of the model to handle polytomous variables has received a lot of attention. In this paper, a Bayesian approach to analysing the model with continuous and polytomous variables is developed. In the posterior analysis, the observed continuous and polytomous data are augmented with the latent factor scores and the unobserved measurements underlying the polytomous variables. Random observations from the posterior distributions are simulated via the Gibbs sampler algorithm. It is shown that the conditional distributions involved in the implementation of the algorithm are the familiar distributions, hence the simulation is rather straightforward. Joint Bayesian estimates of the unknown thresholds, structural parameters and the factor scores are produced simultaneously. The efficiency and accuracy of our approach are demonstrated by a real-life example and a simulation study.",0 +https://doi.org/10.1207/s15326985ep3903_2,Beyond Individual Differences: Exploring School Effects on SAT Scores,"This article explores the complex, hierarchical relation among school characteristics, individual differences in academic achievement, extracurricular activities, and socioeconomic background on performance on the verbal and mathematics Scholastic Aptitude Test (SAT). Using multilevel structural equation models (SEMs) with latent means, we analyzed data from a national sample of college-bound high school students. A nested series of SEMs were fit simultaneously to eight subgroups (disaggregated by both gender and ethnicity) of high school students. Our analyses suggest that (a) multilevel SEMs provide a reasonably good fit to the data, (b) family background influences SAT scores directly and indirectly, learning opportunities in and outside the school curriculum are related to SAT performance, and (c) the characteristics of the schools matter when it comes to performance on the SAT. We argue that context matters and that researchers ought to move beyond analyses of individual differences when attempting t...",0 +https://doi.org/10.1016/j.electstud.2010.04.009,Stumbling block or stepping stone? The influence of direct democracy on individual participation in parliamentary elections,"This paper evaluates whether direct democracy supplements or undermines traditional representative democracy. While a first approach assumes that a culture of active direct democracy stimulates citizens’ political interest and ultimately bolsters participation in parliamentary elections, a competing hypothesis proposes a negative relationship between the frequency of ballot measures and electoral participation due to voter fatigue and decreased significance of elections. Our multilevel analysis of the 26 Swiss cantons challenges recent studies conducted for the U.S. states: In the Swiss context, where direct democracy is more important in the political process than the less salient parliamentary elections, greater use of direct democratic procedures is associated with a lower individual probability to participate in elections. Furthermore, by distinguishing between short and long-term effects of direct democracy, we show that the relationship observed is of a long-term nature and can therefore be seen as a result of adaptive learning processes rather than of instantaneous voter fatigue.",0 +https://doi.org/10.1177/0049124187016001006,Direct and Indirect Effects in Linear Structural Equation Models,"This article discusses total indirect effects in linear structural equation models. First, I define these effects. Second, I show how the delta method may be used to obtain the standard errors of the sample estimates of these effects and test hypotheses about the magnitudes of the indirect effects. To keep matters simple, I focus throughout on a particularly simple linear structural equation system; for a treatment of the general case, see Sobel (1986). To illustrate the ideas and results, a detailed example is presented.",0 +,Statistical Inference in Factor Analysis,"In this paper we discuss some methods of factor analysis. The entire discussion is centered around one general probability model. We consider some mathematical problems of the model, such as whether certain kinds of observed data determine the model uniquely. We treat the statistical problems of estimation and tests of certain hypotheses. For these purposes the asymptotic distribution theory of some statistics is treated. The primary aim of this paper is to give a unified exposition of this part of factor analysis from the viewpoint of the mathematical statistician. The literature on factor analysis is scattered; moreover, the many papers and books have been written from many different points of view. By confining ourselves to one model and by emphasizing statistical inferences for this model we hope to present a clear picture to the statistician. The development given here is expected to point up features of model-building and statistical inference that occur in other areas where statistical theories are being developed. For example, nearly all of the problems met in factor analysis are met in latent structure analysis. There are also some new results given in this paper. The proofs of these are mainly given in a technical Part II of the paper. In confining.ourselves to the mathematical and statistical aspects of one model, we are leaving out of consideration many important and interesting topics. We shall not consider how useful this model may be nor in what substantive areas one may expect to find data (and problems) that fit the model. We also do not consider methods based on other models. In doing this, we do not mean to imply that the model considered here is the most useful or important. It seems that this model has some usefulness and importance, it has been studied considerably, and one can give a fairly unified exposition of it. Extensive discussion of the purposes and applications (as well as other developments) of factor analysis is given in books by psychologists (for example, Holzinger and Harmon [10], Thomson [23], Thurstone [24]). Some general discussion of statistical inference has been given in papers by Bartlett [9] and Kendall [12].",0 +https://doi.org/10.1177/0146621613517165,Expediting Clinical and Translational Research via Bayesian Instrument Development,"Developing valid and reliable instruments is crucial, but costly and time-consuming in health care research and evaluation. The Food and Drug Administration (FDA) and the National Institutes of Health (NIH) have set up guidelines for developing patient-reported outcome (PRO) instruments. However, the guidelines are not applicable to cases of small sample sizes. Instead of using an exact estimation procedure to examine psychometric properties, the Bayesian Instrument Development (BID) method integrates expert data and participant data into a single seamless analysis. Using a novel set of priors, simulated data were used to compare BID to classical instrument development procedures and test the stability of BID. To display BID to non-statisticians, a graphical user interface (GUI) based on R and WINBUGS is developed and demonstrated with data on a small sample of heart failure patients. Costs were saved by eliminating the need for unnecessary continuation of data collection for larger samples as required by the classical instrument development approach.",0 +https://doi.org/10.1207/s15324818ame1904_3,Simultaneous Use of Multiple Answer Copying Indexes to Improve Detection Rates,"Many of the currently available statistical indexes to detect answer copying lack sufficient power at small α levels or when the amount of copying is relatively small. Furthermore, there is no one index that is uniformly best. Depending on the type or amount of copying, certain indexes are better than others. The purpose of this article was to explore the utility of simultaneously using multiple copying indexes to detect different types and amounts of answer copying. This study compared eight copying indexes: S1 and S2 (Sotaridona & Meijer, 2003), K¯ 2 (Sotaridona & Meijer, 2002), ω (Wollack, 1997),B and H (Angoff, 1974), and new indexes Runs and MaxStrings, plus all possible pairs and triplets of the 8 indexes using multiple comparison procedures (Dunn, 1961) to adjust the critical α level for each index in a pair or triplet. Empirical Type-I error rates and power of all indexes, pairs, and triplets were examined in a real data simulation (i.e., where actual examinee responses to items [rather than gener...",0 +https://doi.org/10.1111/insr.12067,On Some Principles of Statistical Inference,"Summary Statistical theory aims to provide a foundation for studying the collection and interpretation of data, a foundation that does not depend on the particular details of the substantive field in which the data are being considered. This gives a systematic way to approach new problems, and a common language for summarising results; ideally, the foundations and common language ensure that statistical aspects of one study, or of several studies on closely related phenomena, can be broadly accessible. We discuss some principles of statistical inference, to outline how these are, or could be, used to inform the interpretation of results, and to provide a greater degree of coherence for the foundations of statistics.",0 +https://doi.org/10.1198/jasa.2011.ap09653,A Hierarchical Model for Quantifying Forest Variables Over Large Heterogeneous Landscapes With Uncertain Forest Areas,"We are interested in predicting one or more continuous forest variables (e.g., biomass, volume, age) at a fine resolution (e.g., pixel level) across a specified domain. Given a definition of forest/nonforest, this prediction is typically a two-step process. The first step predicts which locations are forested. The second step predicts the value of the variable for only those forested locations. Rarely is the forest/nonforest status predicted without error. However, the uncertainty in this prediction is typically not propagated through to the subsequent prediction of the forest variable of interest. Failure to acknowledge this error can result in biased estimates of forest variable totals within a domain. In response to this problem, we offer a modeling framework that will allow propagation of this uncertainty. Here we envision two latent processes generating the data. The first is a continuous spatial process while the second is a binary spatial process. The continuous spatial process controls the spatial association structure of the forest variable of interest, while the binary process indicates presence of a possible nonzero value for the forest variable at a given location. The proposed models are applied to georeferenced National Forest Inventory (NFI) data and spatially coinciding remotely sensed predictor variables. Due to the large number of observed locations in this dataset we seek dimension reduction not just in the likelihood, but also for unobserved stochastic processes. We demonstrate how a low-rank predictive process can be adapted to our setting and reduce the dimensionality of the data and ease the computational burden.",0 +https://doi.org/10.1177/0146621608329891,Addressing Score Bias and Differential Item Functioning Due to Individual Differences in Response Style,"A multidimensional item response theory model that accounts for response style factors is presented. The model, a multidimensional extension of Bock's nominal response model, is shown to allow for the study and control of response style effects in ordered rating scale data so as to reduce bias in measurement of the intended trait. In the current application, the model is also used to investigate response style as an underlying cause of differential item functioning. The approach is illustrated using the item responses of cigarette smokers to the Wisconsin Inventory of Smoking Dependence Motives, a self-report measure of tobacco dependence.",0 +https://doi.org/10.3102/1076998609346967,A Model for Teacher Effects From Longitudinal Data Without Assuming Vertical Scaling,"There is an increasing interest in using longitudinal measures of student achievement to estimate individual teacher effects. Current multivariate models assume each teacher has a single effect on student outcomes that persists undiminished to all future test administrations (complete persistence [CP]) or can diminish with time but remains perfectly correlated (variable persistence [VP]). However, when state assessments do not use a vertical scale or the evolution of the mix of topics present across a sequence of vertically aligned assessments changes as students advance in school, these assumptions of persistence may not be consistent with the achievement data. We develop the “generalized persistence” (GP) model, a Bayesian multivariate model for estimating teacher effects that accommodates longitudinal data that are not vertically scaled by allowing less than perfect correlation of a teacher’s effects across test administrations. We illustrate the model using mathematics assessment data.",0 +https://doi.org/10.1111/j.2517-6161.1979.tb01078.x,Bayesian Inference for a Normal Dispersion Matrix and its Application to Stochastic Multiple Regression Analysis,"SUMMARY This paper discusses Bayesian inference procedures for a normal dispersion matrix. Structural information for the prior mean of the dispersion matrix is incorporated into the analysis through a Normal-Wishart prior distribution. Many of the resulting Bayes estimates are invariant, consistent and asymptotically efficient. Using this procedure, a coherent Bayesian argument for stochastic multiple regression analysis is developed, where dependent and independent variables are jointly random, without experimental control. It is shown that ordinary least squares, a general form of ridge regression, and factor analysis regression methods can be represented as special cases within this general framework. The preliminary report of a simulation study indicates that the Bayesian regression techniques demonstrate substantial improvements over least squares, even using frequentist criteria. Finally, the related problem of joint estimation of the normal population mean and dispersion matrix is briefly discussed in Section 5. The resulting Bayes estimate for the population mean is shown to be closely related to Stein estimates.",0 +https://doi.org/10.1111/1467-8624.00571,A Longitudinal Study of Mathematical Competencies in Children With Specific Mathematics Difficulties Versus Children With Comorbid Mathematics and Reading Difficulties,"Mathematical competencies of 180 children were examined at 4 points between 2nd and 3rd grades (age range between 7 and 9 years). Children were initially classified into one of 4 groups: math difficulties but normal reading (MD only), math and reading difficulties (MD-RD), reading difficulties but normal math (RD only), and normal achievement in math and reading (NA). The groups did not differ significantly in rate of development. However, at the end of 3rd grade the MD only group performed better than the MD-RD group in problem solving but not in calculation. The NA and RD only groups performed better than the MD-RD group in most areas. Deficiencies in fact mastery and calculation fluency, in particular, are defining features of MD, with or without RD.",0 +https://doi.org/10.1002/gepi.21960,Bayesian Variable Selection in Multilevel Item Response Theory Models with Application in Genomics,"The goal of this paper is to present an implementation of stochastic search variable selection (SSVS) to multilevel model from item response theory (IRT). As experimental settings get more complex and models are required to integrate multiple (and sometimes massive) sources of information, a model that can jointly summarize and select the most relevant characteristics can provide better interpretation and a deeper insight into the problem. A multilevel IRT model recently proposed in the literature for modeling multifactorial diseases is extended to perform variable selection in the presence of thousands of covariates using SSVS. We derive conditional distributions required for such a task as well as an acceptance-rejection step that allows for the SSVS in high dimensional settings using a Markov Chain Monte Carlo algorithm. We validate the variable selection procedure through simulation studies, and illustrate its application on a study with genetic markers associated with the metabolic syndrome.",0 +https://doi.org/10.1177/0146621602026001007,A General Bayesian Model for Testlets: Theory and Applications,"The need for more realistic and richer forms of assessment in educational tests has led to the inclusion (in many tests) of polytomously scored items, multiple items based on a single stimulus (a “testlet”), and the increased use of a generalized mixture of binary and polytomous item formats. In this paper, the authors extend earlier work on the modeling of testlet-based response data to include the situation in which a test is composed, partially or completely, of polytomously scored items and/or testlets. The model they propose, a modified version of commonly employed item response models, is embedded within a fully Bayesian framework, and inferences under the model are obtained using Markov chain Monte Carlo techniques. The authors demonstrate its use within a designed series of simulations and by analyzing operational data from the North Carolina Test of Computer Skills and the Educational Testing Service’s Test of Spoken English. Their empirical findings suggest that the North Carolina Test of Computer Skills exhibits significant testlet effects, indicating significant dependence of item scores obtained from common stimuli, whereas the Test of Spoken English does not.",0 +https://doi.org/10.1198/000313006x90305,A Spatial Analysis of Basketball Shot Chart Data,"Basketball coaches at all levels use shot charts to study shot locations and outcomes for their own teams as well as upcoming opponents. Shot charts are simple plots of the location and result of each shot taken during a game. Although shot chart data are rapidly increasing in richness and availability, most coaches still use them purely as descriptive summaries. However, a team's ability to defend a certain player could potentially be improved by using shot data to make inferences about the player's tendencies and abilities. This article develops hierarchical spatial models for shot-chart data, which allow for spatially varying effects of covariates. Our spatial models permit differential smoothing of the fitted surface in two spatial directions, which naturally correspond to polar coordinates: distance to the basket and angle from the line connecting the two baskets. We illustrate our approach using the 2003–2004 shot chart data for Minnesota Timberwolves guard Sam Cassell.",0 +https://doi.org/10.1198/106186006x160681,A New Algorithm for Simulating a Correlation Matrix Based on Parameter Expansion and Reparameterization,"The correlation matrix (denoted by R) plays an important role in many statistical models. Unfortunately, sampling the correlation matrix in Markov chain Monte Carlo (MCMC) algorithms can be problematic. In addition to the positive definite constraint of covariance matrices, correlation matrices have diagonal elements fixed at one. In this article, we propose an efficient two-stage parameter expanded reparameterization and Metropolis-Hastings (PX-RPMH) algorithm for simulating R. Using this algorithm, we draw all elements of R simultaneously by first drawing a covariance matrix from an inverse Wishart distribution, and then translating it back to a correlation matrix through a reduction function and accepting it based on a Metropolis-Hastings acceptance probability. This algorithm is illustrated using multivariate probit (MVP) models and multivariate regression (MVR) models with a common correlation matrix across groups. Via both a simulation study and a real data example, the performance of the PX-RPMH al...",0 +https://doi.org/10.1037/h0037350,Estimating causal effects of treatments in randomized and nonrandomized studies.,"A discussion of matching, randomization, random sampling, and other methods of controlling extraneous variation is presented. The objective is to specify the benefits of randomization in estimating causal effects of treatments. The basic conclusion is that randomization should be employed whenever possible but that the use of carefully controlled nonrandomized data to estimate causal effects is a reasonable and necessary procedure in many cases. Recent psychological and educational literature has included extensive criticism of the use of nonrandomized studies to estimate causal effects of treatments (e.g., Campbell & Erlebacher, 1970). The implication in much of this literature is that only properly randomized experiments can lead to useful estimates of causal effects. If taken as applying to all fields of study, this position is untenable. Since the extensive use of randomized experiments is limited to the last half century,8 and in fact is not used in much scientific investigation today,4 one is led to the conclusion that most scientific truths have been established without using randomized experiments. In addition, most of us successfully determine the causal effects of many of our everyday actions, even interpersonal behaviors, without the benefit of randomization. Even if the position that causal effects of treatments can only be well established from randomized experiments is taken as applying only to the social sciences in which",0 +https://doi.org/10.1007/s00221-010-2286-3,Auditory temporal modulation of the visual Ternus effect: the influence of time interval,"Research on multisensory interactions has shown that the perceived timing of a visual event can be captured by a temporally proximal sound. This effect has been termed 'temporal ventriloquism effect.' Using the Ternus display, we systematically investigated how auditory configurations modulate the visual apparent-motion percepts. The Ternus display involves a multielement stimulus that can induce either of two different percepts of apparent motion: 'element motion' or 'group motion'. We found that two sounds presented in temporal proximity to, or synchronously with, the two visual frames, respectively, can shift the transitional threshold for visual apparent motion (Experiments 1 and 3). However, such effects were not evident with single-sound configurations (Experiment 2). A further experiment (Experiment 4) provided evidence that time interval information is an important factor for crossmodal interaction of audiovisual Ternus effect. The auditory interval was perceived as longer than the same physical visual interval in the sub-second range. Furthermore, the perceived audiovisual interval could be predicted by optimal integration of the visual and auditory intervals. © 2010 Springer-Verlag.",0 +https://doi.org/10.1016/j.bbi.2006.10.012,Intrathecal interleukin-10 gene therapy attenuates paclitaxel-induced mechanical allodynia and proinflammatory cytokine expression in dorsal root ganglia in rats,"Paclitaxel is a commonly used cancer chemotherapy drug that frequently causes painful peripheral neuropathies. The mechanisms underlying this dose-limiting side effect are poorly understood. Growing evidence supports that proinflammatory cytokines, such as interleukin-1 (IL-1) and tumor necrosis factor (TNF), released by activated spinal glial cells and within the dorsal root ganglia (DRG) are critical in enhancing pain in various animal models of neuropathic pain. Whether these cytokines are involved in paclitaxel-induced neuropathy is unknown. Here, using a rat neuropathic pain model induced by repeated systemic paclitaxel injections, we examined whether paclitaxel upregulates proinflammatory cytokine gene expression, and whether these changes and paclitaxel-induced mechanical allodynia can be attenuated by intrathecal IL-1 receptor antagonist (IL-1ra) or intrathecal delivery of plasmid DNA encoding the anti-inflammatory cytokine, interleukin-10 (IL-10). The data show that paclitaxel treatment induces mRNA expression of IL-1, TNF, and immune cell markers in lumbar DRG. Intrathecal IL-1ra reversed paclitaxel-induced allodynia and intrathecal IL-10 gene therapy both prevented, and progressively reversed, this allodynic state. Moreover, IL-10 gene therapy resulted in increased IL-10 mRNA levels in lumbar DRG and meninges, measured 2 weeks after initiation of therapy, whereas paclitaxel-induced expression of IL-1, TNF, and CD11b mRNA in lumbar DRG was markedly decreased. Taken together, these data support that paclitaxel-induced neuropathic pain is mediated by proinflammatory cytokines, possibly released by activated immune cells in the DRG. We propose that targeting the production of proinflammatory cytokines by intrathecal IL-10 gene therapy may be a promising therapeutic strategy for the relief of paclitaxel-induced neuropathic pain.",0 +https://doi.org/10.1016/j.jmva.2009.05.001,Normal distribution based pseudo ML for missing data: With applications to mean and covariance structure analysis,"When missing data are either missing completely at random (MCAR) or missing at random (MAR), the maximum likelihood (ML) estimation procedure preserves many of its properties. However, in any statistical modeling, the distribution specification for the likelihood function is at best only an approximation to the real world. In particular, since the normal-distribution-based ML is typically applied to data with heterogeneous marginal skewness and kurtosis, it is necessary to know whether such a practice still generates consistent parameter estimates. When the manifest variables are linear combinations of independent random components and missing data are MAR, this paper shows that the normal-distribution-based MLE is consistent regardless of the distribution of the sample. Examples also show that the consistency of the MLE is not guaranteed for all nonnormally distributed samples. When the population follows a confirmatory factor model, and data are missing due to the magnitude of the factors, the MLE may not be consistent even when data are normally distributed. When data are missing due to the magnitude of measurement errors/uniqueness, MLEs for many of the covariance parameters related to the missing variables are still consistent. This paper also identifies and discusses the factors that affect the asymptotic biases of the MLE when data are not missing at random. In addition, the paper also shows that, under certain data models and MAR mechanism, the MLE is asymptotically normally distributed and the asymptotic covariance matrix is consistently estimated by the commonly used sandwich-type covariance matrix. The results indicate that certain formulas and/or conclusions in the existing literature may not be entirely correct.",0 +https://doi.org/10.1093/biomet/57.1.97,Monte Carlo sampling methods using Markov chains and their applications,"SUMMARY A generalization of the sampling method introduced by Metropolis et al. (1953) is presented along with an exposition of the relevant theory, techniques of application and methods and difficulties of assessing the error in Monte Carlo estimates. Examples of the methods, including the generation of random orthogonal matrices and potential applications of the methods to numerical problems arising in statistics, are discussed. For numerical problems in a large number of dimensions, Monte Carlo methods are often more efficient than conventional numerical methods. However, implementation of the Monte Carlo methods requires sampling from high dimensional probability distributions and this may be very difficult and expensive in analysis and computer time. General methods for sampling from, or estimating expectations with respect to, such distributions are as follows. (i) If possible, factorize the distribution into the product of one-dimensional conditional distributions from which samples may be obtained. (ii) Use importance sampling, which may also be used for variance reduction. That is, in order to evaluate the integral J = X) p(x)dx = Ev(f), where p(x) is a probability density function, instead of obtaining independent samples XI, ..., Xv from p(x) and using the estimate J, = Zf(xi)/N, we instead obtain the sample from a distribution with density q(x) and use the estimate J2 = Y{f(xj)p(x1)}/{q(xj)N}. This may be advantageous if it is easier to sample from q(x) thanp(x), but it is a difficult method to use in a large number of dimensions, since the values of the weights w(xi) = p(x1)/q(xj) for reasonable values of N may all be extremely small, or a few may be extremely large. In estimating the probability of an event A, however, these difficulties may not be as serious since the only values of w(x) which are important are those for which x -A. Since the methods proposed by Trotter & Tukey (1956) for the estimation of conditional expectations require the use of importance sampling, the same difficulties may be encountered in their use. (iii) Use a simulation technique; that is, if it is difficult to sample directly from p(x) or if p(x) is unknown, sample from some distribution q(y) and obtain the sample x values as some function of the corresponding y values. If we want samples from the conditional dis",0 +https://doi.org/10.1177/014662169201600111,Equating Tests Under the Graded Response Model,"The Stocking and Lord (1983) procedure for computing equating coefficients for tests having dichotomously scored items is extended to the case of graded response items. A system of equations for obtaining the equating coefficients under Samejima's (1969, 1972) graded response model is derived. These equations are used to compute equating coefficients in two related situations. Under the first, the equating coefficients are obtained by matching, on an examinee by examinee basis, the true scores on two tests. In the second case, the equating coefficients are obtained by matching the test characteristic curves (TCCS) of the two tests. Several examples of computing equating coefficients in these two situations are provided. The TCC matching ap proach was much less demanding computationally and yielded equating coefficients that differed little from those obtained through the true score distribution matching approach.",0 +https://doi.org/10.2307/2348941,A Language and Program for Complex Bayesian Modelling,"Gibbs sampling has enormous potential for analysing complex data sets. However, routine use of Gibbs sampling has been hampered by the lack of general purpose software for its implementation. Until now all applications have involved writing one-off computer code in low or intermediate level languages such as C or Fortran. We describe some general purpose software that we are currently developing for implementing Gibbs sampling: BUGS (Bayesian inference using Gibbs sampling). The BUGS system comprises three components: first, a natural language for specifying complex models; second, an 'expert system' for deciding appropriate methods for obtaining samples required by the Gibbs sampler; third, a sampling module containing numerical routines to perform the sampling. S objects are used for data input and output. BUGS is written in Modula-2 and runs under both DOS and UNIX.",0 +https://doi.org/10.1136/bmjopen-2015-010251,Comparative safety and effectiveness of cognitive enhancers for Alzheimer's dementia: protocol for a systematic review and individual patient data network meta-analysis,"Alzheimer's dementia (AD) is the most common cause of dementia, and several organisations, such as the National Institute for Health and Care Excellence, suggest that management of patients with AD should be tailored to their needs. To date, little research has been conducted on the treatment effect in different subgroups of patients with AD. The aim of this study is to examine the comparative effectiveness and safety of cognitive enhancers for different patient characteristics.We will update our previous literature search from January 2015 forward, using the same terms and electronic databases (eg, MEDLINE) from our previous review. We will additionally search grey literature and scan the reference lists of the included studies. Randomised clinical trials of any duration conducted at any time comparing cognitive enhancers alone or in any combination against other cognitive enhancers, or placebo in adults with AD will be eligible. The outcomes of interest are cognition according to the Mini-Mental State Examination, and overall serious adverse events. For each outcome and treatment comparison, we will perform a Bayesian hierarchical random-effects meta-analysis combining the individual patient data (IPD) from each eligible study. If the identified treatment comparisons form a connected network diagram, we will perform an IPD network meta-analysis (NMA) to estimate subgroup effects for patients with different characteristics, such as AD severity and sex. We will combine aggregated data from studies that we will not be able to obtain IPD, with the IPD provided by the original authors, in a single model. We will use the PRISMA-IPD and PRISMA-NMA statements to report our findings.The findings of this study will be of interest to stakeholders, including decision makers, guideline developers, clinicians, methodologists and patients, and they will help to improve guidelines for the management of patients with AD.CRD42015023507.",0 +https://doi.org/10.1007/s11336-010-9174-4,Bayesian Semiparametric Structural Equation Models with Latent Variables,"Structural equation models (SEMs) with latent variables are widely useful for sparse covariance structure modeling and for inferring relationships among latent variables. Bayesian SEMs are appealing in allowing for the incorporation of prior information and in providing exact posterior distributions of unknowns, including the latent variables. In this article, we propose a broad class of semiparametric Bayesian SEMs, which allow mixed categorical and continuous manifest variables while also allowing the latent variables to have unknown distributions. In order to include typical identifiability restrictions on the latent variable distributions, we rely on centered Dirichlet process (CDP) and CDP mixture (CDPM) models. The CDP will induce a latent class model with an unknown number of classes, while the CDPM will induce a latent trait model with unknown densities for the latent traits. A simple and efficient Markov chain Monte Carlo algorithm is developed for posterior computation, and the methods are illustrated using simulated examples, and several applications. © 2010 The Psychometric Society.",0 +https://doi.org/10.1159/000360485,Multilevel Modeling in the Context of Growth Modeling,"Multilevel modeling is a flexible approach for the analysis of nested data structures, such as those encountered in longitudinal studies with repeated measures of an outcome of interest taken across time and nested within subjects. The baseline score on the outcome and rate of change vary across subjects, and subject level predictor variables may be used to explain part of the between-subject variability. This contribution shows how to formulate linear and logistic models for continuous and binary outcomes. A study of the effect of growth hormone in adolescents with short stature is used as an illustrative example to demonstrate the use of these models and to aid in the interpretation of model parameter estimates. Attention is also paid to sufficient sample sizes, and two methods to explore the relation between sample size and power of statistical tests are discussed.",0 +https://doi.org/10.1016/0010-0285(72)90016-3,Subjective probability: A judgment of representativeness,"This paper explores a heuristic — representativeness — according to which the subjective probability of an event, or a sample, is determined by the degree to which it: (i) is similar in essential characteristics to its parent population; and (ii) reflects the salient features of the process by which it is generated. This heuristic is explicated in a series of empirical examples demonstrating predictable and systematic errors in the evaluation of uncertain events. In particular, since sample size does not represent any property of the population, it is expected to have little or no effect on judgment of likelihood. This prediction is confirmed in studies showing that subjective sampling distributions and posterior probability judgments are determined by the most salient characteristic of the sample (e.g., proportion, mean) without regard to the size of the sample. The present heuristic approach is contrasted with the normative (Bayesian) approach to the analysis of the judgment of uncertainty.",0 +https://doi.org/10.1037/0021-9010.66.2.166,Task differences as moderators of aptitude test validity in selection: A red herring.,"This article describes results of two studies, based on a total sample size of nearly 400,000, examining the traditional belief that between-job task differences cause aptitude tests to be valid for some jobs but not for others. Results indicate that aptitude tests are valid across jobs. The moderating effect of tasks is negligible even when jobs differ grossly in task makeup and is probably nonexistent when task differences are less extreme. These results have important implications for validity generalization, for the use of task-oriented job analysis in selection research, for criterion construction, for moderator research, and for proper interpretation of the Uniform Guidelines on Employee Selection Procedures. The philosophy of science and methodological assumptions historically underlying belief in the hypothesis that tasks are important moderators of test validities are examined and critiqued. It is concluded that the belief in this hypothesis can be traced to behaviorist assumptions introduced into personnel psychology in the early 1960s and that, in retrospect, these assumptions can be seen to be false.",0 +https://doi.org/10.1111/jasp.12298,On feeling good at work: the role of regulatory mode and passion in psychological adjustment,"Abstract The major postulate of this work is that regulatory modes influence the type ofpassion people experience with regard to an activity,which in turn influences theirpsychological adjustment. Integrating regulatory mode theory and the dualisticmodelof passion,wehypothesizedthatlocomotion—associatedwithintrinsicandautonomousmotivations—wouldpositivelypredictharmoniouspassion,whichinturn would enhance workers’ psychological adjustment. In contrast, we hypoth-esized that assessment—associated with extrinsic and non-autonomousmotivations—would positively predict obsessive passion, which in turn wouldreduce workers’ psychological adjustment. Two field studies supported thesehypotheseswithpsychologicaladjustmentmeasuresofstress(Study1)andburnout(Study2)indifferentworkcontexts.SusanandClaireworkforthesamefinancialdepartmentofahardware supply company.At work,they assist their manag-ers in making strategic decisions and ensure that the comp-any’s operations run smoothly. Susan is a“doer,”she bustlesabout all day and works relentlessly to get the job done,whereasClaireismoredetail-orientedandalwaysensuresheisdoing“therightthing.”Despite,havingsimilarresponsibil-ities and being equally committed to their work, Susan andClaire’s work experience is much different. Susan is con-stantly full of energy and copes very well with stress.After aday’s work, she can easily let go of her responsibilities andenjoy other activities in her life. Claire, on the other hand,feels emotionally drained and constantly preoccupied withherwork,evenoutsideworkinghours.Howcanthisbe?Inthelastdecades,muchresearchhasfocusedonworker’spsychological adjustment: a billion dollar problem drainingorganizational profit by increasing turnover rates (Gupta B Schaufeli & Salanova,2007). For instance, extensive work has been conductedon topics such as supervisor–subordinate relationships(Landeweerd & Boumans, 1994; Tepper, 2000) and socialsupport at work (for a review, see Viswesvaran, Sanchez, &Fisher, 1999).However,as the preceding example illustrates,one important question that remains is how can peopleexperience diametrically opposed psychological adjustmentdespite working in similar environment? The presentresearch addresses this theoretical question by investigatingthe interface between regulatory mode theory (Kruglanskiet al., 2000) and the dualistic model of passion (Vallerandet al.,2003).Inthepresentarticle,weproposethatonepivotalfactorforpsychologicaladjustmentcanbefoundinworkers’attitudetowardtheirwork.Specifically,wesuggestthatbasicself-regulatory processes such as locomotion (i.e., being a“doer”) and assessment (i.e., “doing the right thing”) canimpact individuals’ psychological adjustment by influencingthe type of passion individuals entertain for an importantactivity(e.g.,work).Inturn,thetypeofpassion(harmoniousvs.obsessive)onedevelopsforanactivitycaneitherfacilitateorpreventtheoccurrenceof stressandburnoutatwork.",0 +https://doi.org/10.1037/0022-3514.42.6.1051,Perception of out-group homogeneity and levels of social categorization: Memory for the subordinate attributes of in-group and out-group members.,"Four experiments were conducted to explore the hypothesis that in-group members perceive their own group as more variegated and complex than do out-group members (the out-group homogeneity principle). The first three experiments were designed to demonstrate this effect in a symmetric manner for both parties of the in-group-out-group dichotomy, and the fourth experiment tested one particular theoretical account of this phenomenon. In Experiments 1 and 2, men and women subjects estimated the proportion of men or women who would endorse a variety of personality/attitude items. The items were constructed to vary on the dimensions of stereotypic meaning (masculinity-femininity) and social desirability (favorable-unfavorable). It was predicted and found that outgroup members viewed a group as endorsing more stereotypic and fewer counterstereotypic items than, did in-group members. These findings were interpreted as support for the out-group homogeneity principle, and it was argued that since this effect was general across items varying in social desirability, the phenomenon was independent of traditional ethnocentrism effects. Experiment 3 asked members of three campus sororities to directly judge the degree of intragroup similarity for their own group and two other groups. Again, each group judged its own members to be more dissimilar to one another than did out-group judges. In Experiment 4 a theory was proposed suggesting that different levels of social categorization are used to encode in-group and out-group members' behavior and that this process could account for the perception of out-group homogeneity. It was predicted and found that men and women were more likely to remember the subordinate attributes of an in-group member than of an out-group member, which provides some evidence for the theoretical model.",0 +https://doi.org/10.1016/j.ejpoleco.2005.10.005,The determinants of individual attitudes towards immigration,"The paper formulates hypotheses and reports on individual attitudes towards immigration based on data for 24 countries on socioeconomic position, sociodemographic characteristics and political attitudes. The results are consistent with the predictions of factor proportions trade theory, but also suggest that a range of other economic and cultural factors influence attitudes towards immigration.",0 +https://doi.org/10.1016/j.ecolmodel.2011.11.001,Performance of a Bayesian state-space model of semelparous species for stock-recruitment data subject to measurement error,"Abstract Measurement errors in spawner abundance create problems for fish stock assessment scientists. To deal with measurement error, we develop a Bayesian state-space model for stock-recruitment data that contain measurement error in spawner abundance, process error in recruitment, and time series bias. Through extensive simulations across numerous scenarios, we compare the statistical performance of the Bayesian state-space model with that of standard regression for a traditional stock-recruitment model that only considers process error. Performance varies depending on the information content in data, as determined by stock productivity, types of harvest situations, and amount of measurement error. Overall, in terms of estimating optimal spawner abundance S MSY , the Ricker density-dependence parameter β , and optimal harvest rate h MSY , the Bayesian state-space model works best for informative data from low and variable harvest rate situations for high-productivity salmon stocks. The traditional stock-recruitment model (TSR) may be used for estimating α and h MSY for low-productivity stocks from variable and high harvest rate situations. However, TSR can severely overestimate S MSY when spawner abundance is measured with large error in low and variable harvest rate situations. We also found that there is substantial merit in using h MSY (or benchmarks derived from it) instead of S MSY as a management target.",0 +https://doi.org/10.1016/j.jpain.2004.06.006,Spinal gap junctions: Potential involvement in pain facilitation,"Glia are now recognized as important contributors in pathological pain creation and maintenance. Spinal cord glia exhibit extensive gap junctional connectivity, raising the possibility that glia are involved in the contralateral spread of excitation resulting in mirror image pain. In the present experiments, the gap junction decoupler carbenoxolone was administered intrathecally after induction of neuropathic pain in response to sciatic nerve inflammation (sciatic inflammatory neuropathy) or partial nerve injury (chronic constriction injury). In both neuropathic pain models, a low dose of carbenoxolone reversed mirror image mechanical allodynia, while leaving ipsilateral mechanical allodynia unaffected. Ipsilateral thermal hyperalgesia was briefly attenuated. Critically, blockade of mechanical allodynia and thermal hyperalgesia was not observed in response to intrathecal glycyrrhizic acid, a compound similar to carbenoxolone in all respects but it does not decouple gap junctions. Thus, blockade of mechanical allodynia and thermal hyperalgesia by carbenoxolone does appear to reflect an effect on gap junctions. Examination of carbenoxolone's effects on intrathecal human immunodeficiency virus type 1 gp120 showed that blockade of pain facilitation might result, at least in part, via suppression of interleukin-1 and, in turn, interleukin-6. These data provide the first suggestion that spread of excitation via gap junctions might contribute importantly to inflammatory and traumatic neuropathic pain.The current studies provide evidence for involvement of gap junctions in spinal cord pain facilitation. Intrathecal carbenoxolone, a gap junction decoupler, reversed neuropathy-induced mirror image pain and intrathecal gp120-induced allodynia. In addition, it decreased gp120-induced proinflammatory cytokines. This suggests gap junction activation might lead to proinflammatory cytokine release by distantly activated glia.",0 +https://doi.org/10.1080/14697680903369500,Bayesian analysis of multi-group nonlinear structural equation models with application to behavioral finance,"Structural equation models (SEMs) have been widely used to determine the relationships among certain observed and latent variables in behavioral finance. The purpose of this paper is to develop a Bayesian approach for analysing multi-group nonlinear SEMs. Using recently developed tools in statistical computing, such as the Gibbs sampler, we propose an efficient method to estimate parameters and select an appropriate model. The proposed method is used to investigate the relationships among all identified influential factors that have an impact on the motivation for insider trading within the framework of behavioral finance.",0 +https://doi.org/10.1287/mksc.1030.0032,"A Choice Model with Conjunctive, Disjunctive, and Compensatory Screening Rules","Many theories of consumer behavior involve thresholds and discontinuities. In this paper, we investigate consumers' use of screening rules as part of a discrete-choice model. Alternatives that pass the screen are evaluated in a manner consistent with random utility theory; alternatives that do not pass the screen have a zero probability of being chosen. The proposed model accommodates conjunctive, disjunctive, and compensatory screening rules. We estimate a model that reflects a discontinuous decision process by employing the Bayesian technique of data augmentation and using Markov-chain Monte Carlo methods to integrate over the parameter space. The approach has minimal information requirements and can handle a large number of choice alternatives. The method is illustrated using a conjoint study of cameras. The results indicate that 92% of respondents screen alternatives on one or more attributes.",0 +https://doi.org/10.1080/00273171.2016.1168279,Bayesian Factor Analysis as a Variable-Selection Problem: Alternative Priors and Consequences,"Factor analysis is a popular statistical technique for multivariate data analysis. Developments in the structural equation modeling framework have enabled the use of hybrid confirmatory/exploratory approaches in which factor-loading structures can be explored relatively flexibly within a confirmatory factor analysis (CFA) framework. Recently, Muthén & Asparouhov proposed a Bayesian structural equation modeling (BSEM) approach to explore the presence of cross loadings in CFA models. We show that the issue of determining factor-loading patterns may be formulated as a Bayesian variable selection problem in which Muthén and Asparouhov's approach can be regarded as a BSEM approach with ridge regression prior (BSEM-RP). We propose another Bayesian approach, denoted herein as the Bayesian structural equation modeling with spike-and-slab prior (BSEM-SSP), which serves as a one-stage alternative to the BSEM-RP. We review the theoretical advantages and disadvantages of both approaches and compare their empirical performance relative to two modification indices-based approaches and exploratory factor analysis with target rotation. A teacher stress scale data set is used to demonstrate our approach.",0 +https://doi.org/10.3141/2392-04,Does Prior Specification Matter in Hotspot Identification and Before–After Road Safety Studies?,"This study investigated the effects of prior assumptions in applications of full Bayes methods in road safety analysis. The effect of prior choice was evaluated in the accuracy of model parameters, hotspot identification, goodness of fit, and a treatment effectiveness index in before–after studies. Particular attention was devoted to conditions with a lack of data, which were referenced as the low-mean and small-sample problem. In this research, informative, semi-informative, and noninformative priors were determined on the basis of past published studies. A simulation framework was used to evaluate various scenarios of sample size and crash occurrence mean. Quasi-simulated data were generated on the basis of two empirical databases of divided and undivided rural highway segments in New York and Texas. Various sample mean values were obtained on the basis of time period (number of years) and classifying accidents in fatal–injury and total accidents. The outcomes under low-mean and small-sample conditions were found to be significantly biased. However, the introduction of informative priors can make observational before–after studies feasible when a few observations from treatment or comparison sites are used. Informative priors can help provide more accurate estimates of the effectiveness of the treatment. Finally, in accordance with previous works, the inverse dispersion parameter was significantly affected by prior specifications; nevertheless, regression parameters, goodness of fit, and hotspot identification were less sensitive to prior choices.",0 +https://doi.org/10.1080/00401706.1984.10487921,"Monte Carlo Comparison of ANOVA, MIVQUE, REML, and ML Estimators of Variance Components","For the one-way classification random model with unbalanced data, we compare five estimators of σ2 a and σ2 e , the among- and within-treatments variance components: analysis of variance (ANOVA), maximum likelihood (ML), restricted maximum likelihood (REML), and two minimum variance quadratic unbiased (MIVQUE) estimators. MIVQUE(0) is MIVQUE with a priori values = 0 and = 1; MIVQUE(A) is MIVQUE with the ANOVA estimates used as a priori's, We enforce nonnegativity for all estimators, setting any negative estimate to zero in accord with usual practice. The estimators are compared through their biases and MSE's, estimated by Monte Carlo simulation. Our results indicate that the ANOVA estimators perform well, except with seriously unbalanced data when σ2 a /σ2 e > 1; ML is excellent when σ2 a /σ2 e < 0.5, and MIVQUE(A) is adequate; further iteration to the REML estimates is unnecessary. When σ2 a /σ2 e ≥ 1, MIVQUE(0) (the default for SASS PROCEDURE VARCOMP) is poor for estimating σ2 a and very poor for σ2 e ,...",0 +https://doi.org/10.1111/j.1467-985x.2008.00552.x,A re-evaluation of random-effects meta-analysis,"Meta-analysis in the presence of unexplained heterogeneity is frequently undertaken by using a random-effects model, in which the effects underlying different studies are assumed to be drawn from a normal distribution. Here we discuss the justification and interpretation of such models, by addressing in turn the aims of estimation, prediction and hypothesis testing. A particular issue that we consider is the distinction between inference on the mean of the random-effects distribution and inference on the whole distribution. We suggest that random-effects meta-analyses as currently conducted often fail to provide the key results, and we investigate the extent to which distribution-free, classical and Bayesian approaches can provide satisfactory methods. We conclude that the Bayesian approach has the advantage of naturally allowing for full uncertainty, especially for prediction. However, it is not without problems, including computational intensity and sensitivity to a priori judgements. We propose a simple prediction interval for classical meta-analysis and offer extensions to standard practice of Bayesian meta-analysis, making use of an example of studies of 'set shifting' ability in people with eating disorders.",0 +https://doi.org/10.1111/j.2044-8317.2011.02023.x,The impact of ignoring multiple membership data structures in multilevel models,"This study compared the use of the conventional multilevel model (MM) with that of the multiple membership multilevel model (MMMM) for handling multiple membership data structures. Multiple membership data structures are commonly encountered in longitudinal educational data sets in which, for example, mobile students are members of more than one higher-level unit (e.g., school). While the conventional MM requires the user either to delete mobile students' data or to ignore prior schools attended, MMMM permits inclusion of mobile students' data and models the effect of all schools attended on student outcomes. The simulation study identified underestimation of the school-level predictor coefficient, as well as underestimation of the level-two variance component with corresponding overestimation of the level-one variance when multiple membership data structures were ignored. Results are discussed along with limitations and ideas for future MMMM methodological research as well as implications for applied researchers.",0 +,"Understanding the New Statistics: Effect Sizes, Confidence Intervals, and Meta-Analysis","Preface. About this Book 1. Introduction to The New Statistics 2. From Null Hypothesis Significance Testing to Effect Sizes 3. Confidence Intervals 4. Confidence Intervals, Error Bars, and p Values 5. Replication 6. Two Simple Designs 7. Meta-Analysis 1: Introduction and Forest Plots 8. Meta-Analysis 2: Models 9. Meta-Analysis 3: Large-Scale Analyses 10. The Noncentral t Distribution 11. Cohen's d 12. Power 13. Precision for Planning 14. Correlations, Proportions, and Further Effect Size Measures 15. More Complex Designs and The New Statistics in Practice. Glossary. Appendixes A. Loading and Using ESCI. B. ESCI for the Normal and t Distributions, and Values of z and t. C. Guide to the ESCI Modules and Pages",0 +https://doi.org/10.1509/jmr.10.0395,Model-Based Segmentation Featuring Simultaneous Segment-Level Variable Selection,"The authors propose a new Bayesian latent structure regression model with variable selection to solve various commonly encountered marketing problems related to market segmentation and heterogeneity. The proposed procedure simultaneously performs segmentation and regression analysis within the derived segments, in addition to determining the optimal subset of independent variables per derived segment. The authors present comparative analyses contrasting the performance of the proposed methodology against standard latent class regression and traditional Bayesian finite mixture regression. They demonstrate that their proposed Bayesian model compares favorably with these traditional benchmark models. They then present an actual commercial customer satisfaction study performed for an electric utility company in the southeastern United States, in which they examine the heterogeneous drivers of perceived quality. Finally, they discuss limitations of the research and provide several directions for further research.",0 +https://doi.org/10.1007/bf02294341,Round-robin analysis of social interaction: Exact and estimated standard errors,Kenny has proposed a variance-components model for dyadic social interaction. His Social Relations model estimates variances and covariances from a round-robin of two-person interactions. The current paper presents a matrix formulation of the Social Relations model. It uses the formulation to derive exact and estimated standard errors for round-robin estimates of Social Relations parameters.,0 +https://doi.org/10.1080/01621459.1989.10478825,Approximate Bayesian Inference in Conditionally Independent Hierarchical Models (Parametric Empirical Bayes Models),"Abstract We consider two-stage models of the kind used in parametric empirical Bayes (PEB) methodology, calling them conditionally independent hierarchical models. We suppose that there are k “units,” which may be experimental subjects, cities, study centers, etcetera. At the first stage, the observation vectors Yi for units i = 1, …, k are independently distributed with densities p(yi | θi ), or more generally, p(yi | θi, λ). At the second stage, the unit-specific parameter vectors θi are iid with densities p(θi | λ). The PEB approach proceeds by regarding the second-stage distribution as a prior and noting that, if λ were known, inference about θ could be based on its posterior. Since λ is not known, the simplest PEB methods estimate the parameter λ by maximum likelihood or some variant, and then treat λ as if it were known to be equal to this estimate. Although this procedure is sometimes satisfactory, a well-known defect is that it neglects the uncertainty due to the estimation of λ. In this article w...",0 +https://doi.org/10.1002/(sici)1097-0258(19970415)16:7<753::aid-sim494>3.0.co;2-g,INCORPORATING VARIABILITY IN ESTIMATES OF HETEROGENEITY IN THE RANDOM EFFECTS MODEL IN META-ANALYSIS,"When combining results from separate investigations in a meta-analysis, random effects methods enable the modelling of differences between studies by incorporating a heterogeneity parameter τ2 that accounts explicitly for across-study variation. We develop a simple form for the variance of Cochran's homogeneity statistic Q, leading to interval estimation of τ2 utilizing an approximating distribution for Q; this enables us to extend the point estimation of DerSimonian and Laird. We also develop asymptotic likelihood methods and compared them with this method. We then use these approximating distributions to give a new method of calculating the weight given to the individual studies’ results when estimating the overall mean which takes into account variation in these point estimates of τ2. Two examples illustrate the methods presented, where we show that the new weighting scheme is between the standard fixed and random effects models in down-weighting the results of large studies and up-weighting those of small studies. © 1997 by John Wiley & Sons, Ltd.",0 +https://doi.org/10.1037/1082-989x.12.1.58,Item factor analysis: Current approaches and future directions.,"The rationale underlying factor analysis applies to continuous and categorical variables alike; however, the models and estimation methods for continuous (i.e., interval or ratio scale) data are not appropriate for item-level data that are categorical in nature. The authors provide a targeted review and synthesis of the item factor analysis (IFA) estimation literature for ordered-categorical data (e.g., Likert-type response scales) with specific attention paid to the problems of estimating models with many items and many factors. Popular IFA models and estimation methods found in the structural equation modeling and item response theory literatures are presented. Following this presentation, recent developments in the estimation of IFA parameters (e.g., Markov chain Monte Carlo) are discussed. The authors conclude with considerations for future research on IFA, simulated examples, and advice for applied researchers.",0 +https://doi.org/10.1177/0272989x02239653,Use of Bayesian Markov Chain Monte Carlo Methods to Model Cost-of-Illness Data,"It is well known that the modeling of cost data is often problematic due to the distribution of such data. Commonly observed problems include 1) a strongly right-skewed data distribution and 2) a significant percentage of zero-cost observations. This article demonstrates how a hurdle model can be implemented from a Bayesian perspective by means of Markov Chain Monte Carlo simulation methods using the freely available software WinBUGS. Assessment of model fit is addressed through the implementation of two cross-validation methods. The relative merits of this Bayesian approach compared to the classical equivalent are discussed in detail. To illustrate the methods described, patient-specific non-health-care resource-use data from a prospective longitudinal study and the Norfolk Arthritis Register (NOAR) are utilized for 218 individuals with early inflammatory polyarthritis (IP). The NOAR database also includes information on various patient-level covariates.",0 +https://doi.org/10.1080/00949659608811724,Reparameterizing the generalized linear model to accelerate gibbs sampler convergence,"Albert and Chib introduced a complete Bayesian method to analyze data arising from the generalized linear model in which they used the Gibbs sampling algorithm facilitated by latent variables. Recently, Cowles proposed an alternative algorithm to accelerate the convergence of the Albert-Chib algorithm. The novelty in this latter algorithm is achieved by using a Hastings algorithm to generate latent variables and bin boundary parameters jointly instead of individually from their respective full conditionals. In the same spirit, we reparameterize the cumulative-link generalized linear model to accelerate the convergence of Cowles’ algorithm even further. One important advantage of our method is that for the three-bin problem it does not require the Hastings algorithm. In addition, for problems with more than three bins, while the Hastings algorithm is required, we provide a proposal density based on the Dirichlet distribution which is more natural than the truncated normal density used in the competing algo...",0 +https://doi.org/10.3758/s13428-012-0244-7,Assessing the evidence for response time mixture distributions,"I describe a technique for comparing two simple accounts of a distribution of response times: A mixture model and a generalized-shift model. In the mixture model, a target distribution is assumed to be a mixture of response times from two other (reference) distributions. In the generalized-shift model, the target distribution is assumed to be a quantile average of the reference distributions. In order to distinguish these two possibilities, quantiles for the target distribution are estimated from the quantiles of the reference distributions assuming either a shift or a mixture, and the predicted quantiles are used to calculate the multinomial likelihood of the obtained data. Monte Carlo simulations reported here demonstrate that the index is relatively unbiased, is effective with moderate sample sizes and modest spreads between the reference distributions, is relatively unaffected by changes in the number of bins or by data trimming, can be used with data aggregated across subjects, and is relatively insensitive to a range of subject variations in distribution shape and in mixture or shift proportion. As an illustration, the index is applied to the interpretation of three effects from distinct paradigms: residual switch costs in the task-switching paradigm, the psychological refractory period effect, and sequential effects in the Simon task. I conclude that the multinomial likelihood index provides a useful and easily applied tool for the interpretation of effects on response time distributions.",0 +https://doi.org/10.1111/j.1745-3992.2007.00107.x,Estimating Item Response Theory Models Using Markov Chain Monte Carlo Methods,"The purpose of this ITEMS module is to provide an introduction to Markov chain Monte Carlo (MCMC) estimation for item response models. A brief description of Bayesian inference is followed by an overview of the various facets of MCMC algorithms, including discussion of prior specification, sampling procedures, and methods for evaluating chain convergence. Model comparison and fit issues in the context of MCMC are also considered. Finally, an illustration is provided in which a two-parameter logistic (2PL) model is fit to item response data from a university mathematics placement test through MCMC using the WINBUGS 1.4 software. While MCMC procedures are often complex and can be easily misused, it is suggested that they offer an attractive methodology for experimentation with new and potentially complex IRT models, as are frequently needed in real-world applications in educational measurement.",0 +https://doi.org/10.1111/j.1745-3984.2010.00109.x,Stratified and Maximum Information Item Selection Procedures in Computer Adaptive Testing,"In this study we evaluated and compared three item selection procedures: the maximum Fisher information procedure (F), the a-stratified multistage computer adaptive testing (CAT) (STR), and a refined stratification procedure that allows more items to be selected from the high a strata and fewer items from the low a strata (USTR), along with completely random item selection (RAN). The comparisons were with respect to error variances, reliability of ability estimates and item usage through CATs simulated under nine test conditions of various practical constraints and item selection space. The results showed that F had an apparent precision advantage over STR and USTR under unconstrained item selection, but with very poor item usage. USTR reduced error variances for STR under various conditions, with small compromises in item usage. Compared to F, USTR enhanced item usage while achieving comparable precision in ability estimates; it achieved a precision level similar to F with improved item usage when items were selected under exposure control and with limited item selection space. The results provide implications for choosing an appropriate item selection procedure in applied settings.",0 +https://doi.org/10.1111/j.1467-9868.2008.00663.x,Gaussian predictive process models for large spatial data sets,"With scientific data available at geocoded locations, investigators are increasingly turning to spatial process models for carrying out statistical inference. Over the last decade, hierarchical models implemented through Markov chain Monte Carlo methods have become especially popular for spatial modelling, given their flexibility and power to fit models that would be infeasible with classical methods as well as their avoidance of possibly inappropriate asymptotics. However, fitting hierarchical spatial models often involves expensive matrix decompositions whose computational complexity increases in cubic order with the number of spatial locations, rendering such models infeasible for large spatial data sets. This computational burden is exacerbated in multivariate settings with several spatially dependent response variables. It is also aggravated when data are collected at frequent time points and spatiotemporal process models are used. With regard to this challenge, our contribution is to work with what we call predictive process models for spatial and spatiotemporal data. Every spatial (or spatiotemporal) process induces a predictive process model (in fact, arbitrarily many of them). The latter models project process realizations of the former to a lower dimensional subspace, thereby reducing the computational burden. Hence, we achieve the flexibility to accommodate non-stationary, non-Gaussian, possibly multivariate, possibly spatiotemporal processes in the context of large data sets. We discuss attractive theoretical properties of these predictive processes. We also provide a computational template encompassing these diverse settings. Finally, we illustrate the approach with simulated and real data sets.",0 +https://doi.org/10.1177/1094428109342899,Identifying and Analyzing Extremes: Illustrated by CEOs’ Pay and Performance,"This article presents statistical methods for identifying outcomes in a given sample that can be inferred as plausible extreme and whether the extremes on two variables are associated. Applications to CEO pay and performance of 50 top-paid CEOs illustrate these methodologies. Thresholds between extremes and nonextremes are found using high probability intervals under the probability distributions that govern sampling variations of the sample extremes. A Bayesian approach is used to compute odds on the association between the extremes of the two variables. The extreme pay—performance analysis of 50 top-paid CEOs reveals astonishing odds in favor of a company being extreme high only on one of the two versus on both variables. The result is considered decisive evidence for a negative association between extreme on CEO pay and extreme on performance among such top-paid CEOs. By contrast, analysis of the nonextreme CEOs yielded no evidence of any association between CEO pay and performance.",0 +https://doi.org/10.1016/j.ecolmodel.2009.06.035,"Assessing and testing prediction uncertainty for single tree-based models: A case study applied to northern hardwood stands in southern Québec, Canada","Abstract Estimating prediction uncertainty for a single tree-based model is hindered by the complex structure of these models. In this paper, we addressed this issue with a case study applied to northern hardwood stands in Quebec, Canada. SaMARE is a stochastic single tree-based model that was designed for these types of stands. Using a Monte Carlo approach, the model can provide a mean predicted value and its confidence limits for some plot-level attributes. The mean predicted values were compared to observed values in terms of bias and accuracy. In addition to these common statistics, we compared nominal coverage of Monte Carlo-simulated confidence intervals with real (observed) coverage to verify the adequacy of the simulated uncertainty. A comparison was made using several plot-level attributes, which exhibited an increasing discriminative complexity. This complexity ranges from coarse attributes, such as all-species basal area, up to more complex ones, such as basal area for stems of a particular species and with sawlog potential. The results showed that in terms of absolute value, biases were small, but could be relatively high with respect to the average observed value when the discriminative complexity of the attribute increased. The comparison between nominal and real coverage of confidence intervals gave satisfactory results for all-species plot-level attributes. However, for some species-specific attributes, the Monte Carlo-simulated confidence intervals overestimated the real coverage.",0 +https://doi.org/10.1177/0146621603260916,Kernel-Smoothing Estimation of Item Characteristic Functions for Continuous Personality Items: An Empirical Comparison with the Linear and the Continuous-Response Models,"This study used kernel-smoothing procedures to estimate the item characteristic functions (ICFs) of a set of continuous personality items. The nonparametric ICFs were compared with the ICFs estimated (a) by the linear model and (b) by Samejima’s continuous-response model. The study was based on a conditioned approach and used an error-in-variables kernel model. The assumptions of the model were approximately correct in the present conditions. The results obtained with the kernel procedure suggested that (a) the ICFs of these items were essentially sigmoid curves, as is usually assumed in parametric item response theory, and (b) for most of the items, these curves were well approximated by both the linear and the continuous-response model.",0 +https://doi.org/10.1007/s11336-006-1177-1,Bayesian Analysis of Nonlinear Structural Equation Models with Nonignorable Missing Data,"A Bayesian approach is developed for analyzing nonlinear structural equation models with nonignorable missing data. The nonignorable missingness mechanism is specified by a logistic regression model. A hybrid algorithm that combines the Gibbs sampler and the Metropolis - Hastings algorithm is used to produce the joint Bayesian estimates of structural parameters, latent variables, parameters in the nonignorable missing model, as well as their standard errors estimates. A goodness-of-fit statistic for assessing the plausibility of the posited nonlinear structural equation model is introduced, and a procedure for computing the Bayes factor for model comparison is developed via path sampling. Results obtained with respect to different missing data models, and different prior inputs are compared via simulation studies. In particular, it is shown that in the presence of nonignorable missing data, results obtained by the proposed method with a nonignorable missing data model are significantly better than those that are obtained under the missing at random assumption. A real example is presented to illustrate the newly developed Bayesian methodologies. © 2006 The Psychometric Society.",0 +https://doi.org/10.1371/journal.pone.0120025,Exploratory Movement Generates Higher-Order Information That Is Sufficient for Accurate Perception of Scaled Egocentric Distance,"Body movement influences the structure of multiple forms of ambient energy, including optics and gravito-inertial force. Some researchers have argued that egocentric distance is derived from inferential integration of visual and non-visual stimulation. We suggest that accurate information about egocentric distance exists in perceptual stimulation as higher-order patterns that extend across optics and inertia. We formalize a pattern that specifies the egocentric distance of a stationary object across higher-order relations between optics and inertia. This higher-order parameter is created by self-generated movement of the perceiver in inertial space relative to the illuminated environment. For this reason, we placed minimal restrictions on the exploratory movements of our participants. We asked whether humans can detect and use the information available in this higher-order pattern. Participants judged whether a virtual object was within reach. We manipulated relations between body movement and the ambient structure of optics and inertia. Judgments were precise and accurate when the higher-order optical-inertial parameter was available. When only optic flow was available, judgments were poor. Our results reveal that participants perceived egocentric distance from the higher-order, optical-inertial consequences of their own exploratory activity. Analysis of participants' movement trajectories revealed that self-selected movements were complex, and tended to optimize availability of the optical-inertial pattern that specifies egocentric distance. We argue that accurate information about egocentric distance exists in higher-order patterns of ambient energy, that self-generated movement can generate these higher-order patterns, and that these patterns can be detected and used to support perception of egocentric distance that is precise and accurate.",0 +,A UNIFIED THEORY OF STATISTICAL ANALYSIS AND INFERENCE FOR VARIANCE COMPONENT MODELS FOR DYADIC DATA,"Using the covariance structure induced by the exchangeability of sampling units, a unified approach to the analysis of dyadic data is proposed. Dyadic data, encountered in diallel designs in genetics and other substantive scientific fields, arise when pairs of sampling units are studied. The problem has been addressed independently in a number of different areas of study. This paper argues that dyadic data structures involve the same statistical elements as those of ordinary analysis of variance and multivariate analysis. In addition to a synthesis of the available literature, the article provides a closed form expression of the Gaussian likelihood, the sufficient statistics and their joint distributions, and outlines for EM and ECM algorithms for handling missing data and other complications. The approach is illustrated with an applied example. The objective is to show that the analysis of dyadic data can be developed as a standard statistical method not unlike the analysis of variance, albeit with a multivariate twist. Dyadic data structures can be treated similarly to ordinary factorial structures and have the potential to be more widely used.",0 +https://doi.org/10.1002/(sici)1097-0258(19971215)16:23<2741::aid-sim703>3.0.co;2-0,Investigating underlying risk as a source of heterogeneity in meta-analysis,"In a meta-analysis of clinical trials, an important issue is whether the treatment benefit varies according to the underlying risk of the patients in the different trials. The usual naive analyses employed to investigate this question use either the observed risk of events in the control groups, or the average risk in the control and treatment groups, as a measure of underlying risk. These analyses are flawed and can produce seriously misleading results. We show how their biases depend on three components of variability, the within-trial and between-trial variances of the control group risks, and the between-trial variance of the treatment effects. We propose a Bayesian solution to the problem which can be carried out using the BUGS implementation of Gibbs sampling. The analysis is illustrated for a meta-analysis of bleeding and mortality data in trials of sclerotherapy for patients with cirrhosis, and the results contrasted with those from the naive approaches. Comparisons with other methods recently proposed for this problem are also made. We conclude that the Bayesian solution presented in this paper is not only more appropriate than other proposed methods, but is also sufficiently easy to implement that it can be used by applied researchers undertaking meta-analyses.",0 +https://doi.org/10.1037/a0035889,"Empirical Bayes MCMC estimation for modeling treatment processes, mechanisms of change, and clinical outcomes in small samples.","The current analysis demonstrates the use of empirical Bayes (EB) estimation methods with data-derived prior parameters for studying clinically intricate process-mechanism-outcome linkages using structural equation modeling (SEM) with small samples.The data were obtained from a small subsample of 23 families receiving Functional Family Therapy (FFT) for adolescent substance abuse during a completed randomized clinical trial. Two or 3 video-recorded FFT sessions were randomly selected for each family. The middle 20-min portion of each session was observed and coded. An SEM examining the influence of a select set of observed therapist behaviors on pre- to posttreatment change in mother reports of family functioning and, in turn, pre- to posttreatment change in adolescent reports of adolescent marijuana use and delinquent behavior was specified. The SEM was implemented using EB estimation with data-derived maximum likelihood (ML) prior parameters and Markov Chain Monte Carlo (MCMC) estimation of the joint posterior distribution.The EB SEM results indicated that a relatively high proportion of individually focused general interventions (i.e., seek information, acknowledge) as well as relationally focused meaning change interventions by therapists during sessions of FFT were predictive of pre- to posttreatment increases in levels of family functioning as reported by mothers in families of substance-abusing adolescents. In turn, increases in mother-reported family functioning were predictive of reductions in levels of adolescent-reported delinquent behavior.EB MCMC methods produced more stable results than did ML, especially regarding the variances on the change factors in the SEM. EB MCMC estimation is a viable alternative to ML estimation of SEMs in clinical research with prohibitively small samples.",0 +https://doi.org/10.1287/mksc.17.2.91,Similarities in Choice Behavior Across Product Categories,"Differences between consumers in sensitivity to marketing mix variables have been extensively documented in the scanner panel data. All studies of consumer heterogeneity focus on a specific category of products and ignore the fact that the purchase behavior of panel households is often observed simultaneously in multiple categories. If sensitivity to marketing mix variables is a common consumer trait, then one should expect to see similarities in sensitivity across multiple categories. The goal in this paper is to measure the covariance of both observed (linked to measured characteristics of households) and unobserved heterogeneity in marketing mix sensitivity across multiple categories. Measurement of correlation in sensitivities across categories will serve to guide the interpretation of the literature on household heterogeneity. If there is a large correlation, one can be more confident that sensitivity to marketing variables is a fundamental household property and not simply a category-specific anomaly. Detection of correlation in sensitivities across categories requires an appropriate methodology that can handle the high dimensional covariance structures and properly account for uncertainty in estimation. For example, a simple approach might be to fit a brand choice model to each of the available categories in turn, ignoring the data in the other categories. For each category, household parameter estimates could be obtained for the parameters corresponding to price, display, and feature sensitivity. These parameter estimates could be viewed as data and the correlations across categories could be computed. Such a procedure could induce a downward bias in the estimation of correlation due to the independent sampling errors, which are present in each parameter estimate. We develop a hierarchical model structure that introduces an explicit correlation structure across categories and utilizes the data in multiple categories at the same time. To reduce the size of the covariance matrix, we use a variance components approach. We introduce household-specific demographic variables to decompose the correlation across categories into that which can be ascribed to observable and unobservable sources. Shopping behavior variables such as shopping frequency and market basket size as well as intensity of shopping in a category are also included in the model. Using data on five categories, we find substantial and statistically important correlations ranging from .32 for price sensitivities to .58 for feature sensitivity. These correlations are much larger than the correlations obtained with the state-of-the-art techniques available prior to our work. We attribute our ability to detect substantial correlations to our method, which involves the joint use of multiple category data in a parsimonious and efficient manner. Unlike previous studies with panel data, household demographic variables are found to be strongly related to price sensitivity. Higher income households are less price sensitive and large families are more price sensitive. Shopping behavior variables are also important in explaining price sensitivity. Households that visit the store often are more price sensitive. Households with larger market baskets are less price sensitive, confirming the view of Bell and Lattin (1998). Heavy user households tend to be both less price sensitive and less display sensitive. The evidence presented here of substantial correlations validates, in part, the notion that sensitivity to marketing mix variables is a consumer trait and is not unique to specific product categories. It also opens the possibility of using information across categories in making inferences about consumer brand preference and marketing mix sensitivity, providing a richer source of information for target marketing.",0 +https://doi.org/10.1093/chemse/bjt073,Fitting Psychometric Functions Using a Fixed-Slope Parameter: An Advanced Alternative for Estimating Odor Thresholds With Data Generated by ASTM E679,"Psychometric functions are predominately used for estimating detection thresholds in vision and audition. However, the requirement of large data quantities for fitting psychometric functions (>30 replications) reduces their suitability in olfactory studies because olfactory response data are often limited (<4 replications) due to the susceptibility of human olfactory receptors to fatigue and adaptation. This article introduces a new method for fitting individual-judge psychometric functions to olfactory data obtained using the current standard protocol-American Society for Testing and Materials (ASTM) E679. The slope parameter of the individual-judge psychometric function is fixed to be the same as that of the group function; the same-shaped symmetrical sigmoid function is fitted only using the intercept. This study evaluated the proposed method by comparing it with 2 available methods. Comparison to conventional psychometric functions (fitted slope and intercept) indicated that the assumption of a fixed slope did not compromise precision of the threshold estimates. No systematic difference was obtained between the proposed method and the ASTM method in terms of group threshold estimates or threshold distributions, but there were changes in the rank, by threshold, of judges in the group. Overall, the fixed-slope psychometric function is recommended for obtaining relatively reliable individual threshold estimates when the quantity of data is limited.",0 +https://doi.org/10.1080/00031305.1985.10479383,Constructing a Control Group Using Multivariate Matched Sampling Methods That Incorporate the Propensity Score,"Matched sampling is a method for selecting units from a large reservoir of potential controls to produce a control group of modest size that is similar to a treated group with respect to the distribution of observed covariates. We illustrate the use of multivariate matching methods in an observational study of the effects of prenatal exposure to barbiturates on subsequent psychological development. A key idea is the use of the propensity score as a distinct matching variable. © 1985 Taylor & Francis Group, LLC.",0 +https://doi.org/10.1007/bf02294565,Constrained maximum likelihood estimation of two-level covariance structure model via EM type algorithms,"In this paper, the constrained maximum likelihood estimation of a two-level covariance structure model with unbalanced designs is considered. The two-level model is reformulated as a single-level model by treating the group level latent random vectors as hypothetical missing-data. Then, the popular EM algorithm is extended to obtain the constrained maximum likelihood estimates. For general nonlinear constraints, the multiplier method is used at the M-step to find the constrained minimum of the conditional expectation. An accelerated EM gradient procedure is derived to handle linear constraints. The empirical performance of the proposed EM type algorithms is illustrated by some artifical and real examples.",0 +https://doi.org/10.1177/0013164414537491,A Note on the Specification of Error Structures in Latent Interaction Models,"Latent interaction models have motivated a great deal of methodological research, mainly in the area of estimating such models. Product-indicator methods have been shown to be competitive with other methods of estimation in terms of parameter bias and standard error accuracy, and their continued popularity in empirical studies is due, in part, to their straightforward implementation and relative ease of estimation in mainstream structural equation modeling software. In recent years, the impact of different specifications of the mean structure of the structural model has been the focus of a fair amount of investigation in this area. Yet the effects of misspecification of the error structure of the observed variables implied by the model have not been investigated. In this study, the authors demonstrate algebraically the ramifications of misspecifying these error structures for the unconstrained product-indicator approach. Recommendations to practitioners based on these results are discussed.",0 +https://doi.org/10.1523/jneurosci.21-08-02808.2001,Intrathecal HIV-1 Envelope Glycoprotein gp120 Induces Enhanced Pain States Mediated by Spinal Cord Proinflammatory Cytokines,"Perispinal (intrathecal) injection of the human immunodeficiency virus-1 (HIV-1) envelope glycoprotein gp120 creates exaggerated pain states. Decreases in response thresholds to both heat stimuli (thermal hyperalgesia) and light tactile stimuli (mechanical allodynia) are rapidly induced after gp120 administration. gp120 is the portion of HIV-1 that binds to and activates microglia and astrocytes. These glial cells have been proposed to be key mediators of gp120-induced hyperalgesia and allodynia because these pain changes are blocked by drugs thought to affect glial function preferentially. The aim of the present series of studies was to determine whether gp120-induced pain changes involve proinflammatory cytokines [interleukin-1β (IL-1) and tumor necrosis factor-α (TNF-α)], substances released from activated glia. IL-1 and TNF antagonists each prevented gp120-induced pain changes. Intrathecal gp120 produced time-dependent, site-specific increases in TNF and IL-1 protein release into lumbosacral CSF; parallel cytokine increases in lumbar dorsal spinal cord were also observed. Intrathecal administration of fluorocitrate (a glial metabolic inhibitor), TNF antagonist, and IL-1 antagonist each blocked gp120-induced increases in spinal IL-1 protein. These results support the concept that activated glia in dorsal spinal cord can create exaggerated pain states via the release of proinflammatory cytokines.",0 +https://doi.org/10.1007/bf02293108,"Computer methods for sampling from gamma, beta, poisson and bionomial distributions","Accurate computer methods are evaluated which transform uniformly distributed random numbers into quantities that follow gamma, beta, Poisson, binomial and negative-binomial distributions. All algorithms are designed for variable parameters. The known convenient methods are slow when the parameters are large. Therefore new procedures are introduced which can cope efficiently with parameters of all sizes. Some algorithms require sampling from the normal distribution as an intermediate step. In the reported computer experiments the normal deviates were obtained from a recent method which is also described. © 1974 Springer-Verlag.",0 +https://doi.org/10.1016/j.indmarman.2015.04.014,The influence of leadership on product and process innovations in China: The contingent role of knowledge acquisition capability,"Abstract Building upon upper echelon theory and a dynamic capability perspective, this study investigates the relative effectiveness of two types of leadership on product and process innovations in emerging economies. The authors found that in China transformational-charismatic (TC) leadership has a stronger effect on product innovation, while transactional leadership has a stronger effect on process innovation. The authors further study the boundary conditions of leadership and empirically examine the contingent effects of organizational level capability on the relationships between leadership and innovation. The moderating effects are intriguing: knowledge acquisition capability strengthens the effect of TC leadership on process innovation and that of transactional leadership on product innovation. However, knowledge acquisition capability attenuates the positive relationship between TC leadership and product innovation as well as the positive relationship between transactional leadership and process innovation.",0 +https://doi.org/10.1080/10543406.2015.1008516,Inference for Surrogate Endpoint Validation in the Binary Case,"Surrogate endpoint validation for a binary surrogate endpoint and a binary true endpoint is investigated using the criteria of proportion explained (PE) and the relative effect (RE). The concepts of generalized confidence intervals and fiducial intervals are used for computing confidence intervals for PE and RE. The numerical results indicate that the proposed confidence intervals are satisfactory in terms of coverage probability, whereas the intervals based on Fieller's theorem and the delta method fall short in this regard. Our methodology can also be applied to interval estimation problems in a causal inference-based approach to surrogate endpoint validation.",0 +https://doi.org/10.1371/journal.pone.0147040,Autism and Overcoming Job Barriers: Comparing Job-Related Barriers and Possible Solutions in and outside of Autism-Specific Employment,"The aim of this study was to discover how individuals with autism succeed in entering the job market. We therefore sought to identify expected and occurred barriers, keeping them from taking up and staying in employment as well as to identify the solutions used to overcome these barriers. Sixty-six employed individuals with autism--17 of them with autism-specific employment--participated in an online survey. Results showed a variety of possible barriers. Individuals in autism-specific employment named formality problems--problems with organizational and practical process-related aspects of the job entry--most frequently while individuals in non-autism-specific employment mentioned social problems--obstacles concerning communication and human interaction--most. In terms of solutions, both groups used their own resources as much as external help, but differed in their specific strategies. In addition, correlations of an autism-specific employment with general and occupational self-efficacy as well as life and job satisfaction were examined. Possible implications of the results are discussed with regard to problem solving behavior and the use of strengths.",0 +https://doi.org/10.1080/10705511.2011.607723,Bayesian Data-Model Fit Assessment for Structural Equation Modeling,"Bayesian approaches to modeling are receiving an increasing amount of attention in the areas of model construction and estimation in factor analysis, structural equation modeling (SEM), and related...",0 +https://doi.org/10.4324/9780203813409,Current Topics in the Theory and Application of Latent Variable Models,"M. C. Edwards, R. C. MacCallum, Introduction: Complexity and Meaning in Latent Variable Modeling. Part I. Complexities in Latent Variable Modeling. R. Cudeck, J. R. Harring, Estimating the Correlation between Two Variables when Individuals are Measured Repeatedly. R. Gonzalez, D. Griffin, Deriving Estimators and Their Standard Errors in Dyadic Data Analysis: Examples Using a Symbolic Computation Program. P. F. Craigmile, M. Peruggia, T. Van Zandt, A Bayesian Hierarchical Model for Response Time Data Providing Evidence for Criteria Changes Over Time. I. Moustaki, A Review of Estimation Methods for Latent Variable Models. G. Zhang, C.T. Lee, Standard Errors for Ordinary Least Squares Estimates of Parameters in Structural Equation Modeling. L. Cai, Three Cheers for the Asymptotically Distribution Free Theory of Estimation and Inference: Some Recent Applications in Linear and Nonlinear Latent Variable Modeling. K. A. Duncan, S. N. MacEachern, Nonparametric Bayesian Modeling of Item Response Curves with a Three Parameter Logistic Prior Mean. W. A. Nicewander, Exact Solutions for IRT Latent Regression Slopes and Latent Variable Intercorrelations. S. du Toit, Analysis of Structural Equation Models Based on a Mixture of Continuous and Ordinal Random Variables in the Case of Complex Survey Data. Part II. Drawing Meaning from Latent Variable Models. R. E. Millsap, A Simulation Paradigm for Evaluating Approximate Fit. R. C. MacCallum, T. Lee, M. W. Browne, Fungible Parameter Values in Latent Curve Models. A. Shapiro, Statistical Inference of Moment/Covariance Structures. J. L. Rodgers, W. H. Beasley, Fisher, Gosset, and Alternative Hypothesis Significance Testing (AHST): Using the Bootstrap to Test Scientific Hypotheses about the Multiple Correlation. S. M. Boker, M. Martin, On The Equilibrium Dynamics of Meaning. K. Tateneni, M. Schiller, Applying Components Analysis to Attitudinal Segmentation.",0 +https://doi.org/10.1057/cep.2013.16,Cantonal variations of integration policy and their impact on immigrant educational inequality,"Migration policy regimes are mainly analysed from an international comparative perspective, whereas subnational policy variations, although they are particularly pronounced in federal states, remain largely neglected. By transferring an international concept of integration policy to Switzerland’s cantonal level, we show that cantonal variations of integration policy are not only considerable but even occasionally exceed international variance. Subsequent outcome analyses further undermine the relevance of cantonal integration polices, suggesting that liberal and culturally pluralist policies moderate immigrant educational inequality in schools. As the results of our Bayesian multilevel analyses show, a combination of different policy aspects representing inclusive cantonal integration policies has the greatest potential to ameliorate immigrants’ equal opportunities in school. Accounting for immigrants’ heterogeneity in terms of linguistic and social background moreover reveals that integration policy differently affects various groups of immigrants.",0 +https://doi.org/10.1111/j.1745-3984.1998.tb00533.x,Simultaneous Assembly of Multiple Test Forms,"An algorithm for the assembly of multiple test forms is proposed in which the multiple-form problem is reduced to a series of computationally less intensive two-form problems. At each step, one form is assembled to its true specifications; the other form is a dummy assembled only to maintain a balance between the quality of the current form and the remaining forms. It is shown how the method can be implemented using the technique of O-1 linear programming. Two empirical examples using a former item pool from the LSAT are given - one in which a set of parallel forms is assembled and another in which the targets for the information functions of the forms are shifted systematically.",0 +https://doi.org/10.1167/15.3.2,The cost of misremembering: Inferring the loss function in visual working memory,"Visual working memory (VWM) is a highly limited storage system. A basic consequence of this fact is that visual memories cannot perfectly encode or represent the veridical structure of the world. However, in natural tasks, some memory errors might be more costly than others. This raises the intriguing possibility that the nature of memory error reflects the costs of committing different kinds of errors. Many existing theories assume that visual memories are noise-corrupted versions of afferent perceptual signals. However, this additive noise assumption oversimplifies the problem. Implicit in the behavioral phenomena of visual working memory is the concept of a loss function: a mathematical entity that describes the relative cost to the organism of making different types of memory errors. An optimally efficient memory system is one that minimizes the expected loss according to a particular loss function, while subject to a constraint on memory capacity. This paper describes a novel theoretical framework for characterizing visual working memory in terms of its implicit loss function. Using inverse decision theory, the empirical loss function is estimated from the results of a standard delayed recall visual memory experiment. These results are compared to the predicted behavior of a visual working memory system that is optimally efficient for a previously identified natural task, gaze correction following saccadic error. Finally, the approach is compared to alternative models of visual working memory, and shown to offer a superior account of the empirical data across a range of experimental datasets.",0 +https://doi.org/10.1111/rssa.12012,Multilevel factor analytic models for assessing the relationship between nurse-reported adverse events and patient safety,"Summary We explore health outcomes and nurse staffing data that are multivariate multilevel structured. These data can be used to relate latent constructs such as patient safety to hospital, nursing unit, nurse and patient characteristics by using factor analytic models. It is important that the multilevel nature of the data is taken into account; otherwise it can lead to invalid inferences. We explore the relationship between patient safety and nurse-reported adverse events from the Belgian chapter of the Europe Nurse Forecasting Survey. The data were split into a learning and a validation data set. Since no a priori factor structure has been proposed in the literature, we establish the factor structure by using a frequentist exploratory factor analysis on the learning data set and validate the factor structure proposed by using a Bayesian confirmatory factor analysis on the validation data set. Multivariate analysis-of-variance discrepancy measures were used to assess the need for multilevel factor analysis. We establish that there was substantial between-nursing-unit, but not between-hospital, variability to warrant the use of multilevel factor analyses. The final model was a two-level (nurse level and nursing unit level) factor analytic model with two factors at both levels. The Bayesian approach offers more flexibility in fitting the multilevel confirmatory factor analysis. To avoid double usage of the data the validation and learning data sets were used to fit and assess the goodness of fit of the multilevel confirmatory factor analysis respectively.",0 +https://doi.org/10.1007/s11336-013-9328-2,A Nondegenerate Penalized Likelihood Estimator for Variance Parameters in Multilevel Models,"Group-level variance estimates of zero often arise when fitting multilevel or hierarchical linear models, especially when the number of groups is small. For situations where zero variances are implausible a priori, we propose a maximum penalized likelihood approach to avoid such boundary estimates. This approach is equivalent to estimating variance parameters by their posterior mode, given a weakly informative prior distribution. By choosing the penalty from the log-gamma family with shape parameter greater than 1, we ensure that the estimated variance will be positive. We suggest a default log-gamma(2,λ) penalty with λ → 0, which ensures that the maximum penalized likelihood estimate is approximately one standard error from zero when the maximum likelihood estimate is zero, thus remaining consistent with the data while being nondegenerate. We also show that the maximum penalized likelihood estimator with this default penalty is a good approximation to the posterior median obtained under a noninformative prior.Our default method provides better estimates of model parameters and standard errors than the maximum likelihood or the restricted maximum likelihood estimators. The log-gamma family can also be used to convey substantive prior information. In either case-pure penalization or prior information-our recommended procedure gives nondegenerate estimates and in the limit coincides with maximum likelihood as the number of groups increases.",0 +https://doi.org/10.1016/j.jag.2012.04.007,"Hierarchical Bayesian spatial models for predicting multiple forest variables using waveform LiDAR, hyperspectral imagery, and large inventory datasets","a b s t r a c t In this paper we detail a multivariate spatial regression model that couples LiDAR, hyperspectral and for- est inventory data to predict forest outcome variables at a high spatial resolution. The proposed model is used to analyze forest inventory data collected on the US Forest Service Penobscot Experimental Forest (PEF), ME, USA. In addition to helping meet the regression model's assumptions, results from the PEF analysis suggest that the addition of multivariate spatial random effects improves model fit and pre- dictive ability, compared with two commonly applied modeling approaches. This improvement results from explicitly modeling the covariation among forest outcome variables and spatial dependence among observations through the random effects. Direct application of such multivariate models to even moder- ately large datasets is often computationally infeasible because of cubic order matrix algorithms involved in estimation. We apply a spatial dimension reduction technique to help overcome this computational hurdle without sacrificing richness in modeling.",0 +https://doi.org/10.1002/per.1997,"The Social Consequences and Mechanisms of Personality: How to Analyse Longitudinal Data from Individual, Dyadic, Round–Robin and Network Designs","There is a growing interest among personality psychologists in the processes underlying the social consequences of personality. To adequately tackle this issue, complex designs and sophisticated mathematical models must be employed. In this article, we describe established and novel statistical approaches to examine social consequences of personality for individual, dyadic and group (round–robin and network) data. Our overview includes response surface analysis (RSA), autoregressive path models and latent growth curve models for individual data; actor–partner interdependence models and dyadic RSAs for dyadic data; and social relations and social network analysis for round–robin and network data. Altogether, our goal is to provide an overview of various analytical approaches, the situations in which each can be employed and a first impression about how to interpret their results. Three demo data sets and scripts show how to implement the approaches in R. Copyright © 2015 European Association of Personality Psychology",0 +https://doi.org/10.1007/978-3-319-20585-4_10,Can Psychometric Measurement Models Inform Behavior Genetic Models? A Bayesian Model Comparison Approach,"As methodologists have increasingly noted, the role of psychometrics in operationalizing a construct is often overlooked when evaluating research claims (Borsboom, 2006). In a related vein, others have noted that psychological research appears to move away from assessment and interpretation of a single a priori statistical model to a more nuanced comparison of models which assess the trade-off between a model’s parsimony and complexity in explaining behavior (e.g., Rodgers, 2010). The genetic factor model is one such statistical model often used to estimate the relative contributions of genetic and environmental components of observed behavior in genetically informative designs (Heath, Neale, Hewitt, Eaves, & Fulker, 1989; Martin, Eaves et al., 1977; Neale & Cardon, 1992). Mathematically, the genetic factor model decomposes observed phenotypic variability into additive genetic (A), common (C), and unique (E) environmental components and is, for that reason, often referred to as the ACE model.",0 +https://doi.org/10.4324/9781315091655-7,Dynamic Structural Equation Modeling in Longitudinal Experimental Studies,,0 +https://doi.org/10.3310/hta17590,"The Percutaneous shunting in Lower Urinary Tract Obstruction (PLUTO) study and randomised controlled trial: evaluation of the effectiveness, cost-effectiveness and acceptability of percutaneous vesicoamniotic shunting for lower urinary tract obstruction","Congenital lower urinary tract obstruction (LUTO) is a disease associated with high perinatal mortality and childhood morbidity. Fetal vesicoamniotic shunting (VAS) bypasses the obstruction with the potential to improve outcome.To determine the effectiveness, cost-effectiveness and patient acceptability of VAS for fetal LUTO.A multicentre, randomised controlled trial incorporating a prospective registry, decision-analytic health economic model and preplanned Bayesian analysis using elicited opinions. Patient acceptability was evaluated by interview in a qualitative study.Fetal medicine departments in the UK, Ireland and the Netherlands.Pregnant women with a male singleton fetus with LUTO.In utero percutaneous VAS compared with conservative care.The primary outcome was survival to 28 days. Secondary outcome measures were survival and renal function at 1 year of age, cost of care and cost per additional life-year and per disability-free survival at the end of 1 year.The trial stopped early with 31 women randomised because of difficulties in recruitment. Of those randomised to VAS and conservative management, 3/16 (19%) and 2/15 (13%), respectively, did not receive their allocated intervention. Based on intention-to-treat analysis, survival at 28 days was higher if allocated VAS (50%) than conservative management (27%) [relative risk (RR) 1.88, 95% confidence interval (CI) 0.71 to 4.96, p = 0.27]. At 12 months survival was 44% in the VAS arm and 20% in the conservative arm (RR 2.19, 95% CI 0.69 to 6.94, p = 0.25). Neither difference was statistically significant. Of survivors at 1 year, two in the VAS arm had no evidence of renal impairment and four in the VAS arm and two in the conservative arm required medical management. One baby in the conservative arm had end-stage renal failure at 1 year. VAS was more expensive because of additional surgery and intensive care. VAS cost £15,500 per survivor at 1 year and £43,900 per disability-free year. Elicited expert opinions showed uncertainty in the effect of VAS at 28 days. In a Bayesian analysis combining elicited opinion with the results, uncertainty of the benefit of VAS remained (RR 1.31, 95% credible interval 0.84 to 2.18). The acceptability study identified visualisation of the fetus during ultrasound scanning, perceiving a personal benefit, and altruism as positive influences on recruitment. Fear of the VAS procedure and the perceived severity of LUTO influenced non-participation. The need for more detailed information about the condition and its implications during pregnancy and following delivery was a further important finding of this research. Recruitment was hampered by logistical and regulatory difficulties, a lower incidence of LUTO and lower antenatal diagnosis rate [estimated to be 3.34 (95% CI 2.95 to 3.72) per 10,000 total births and 47%, respectively, in an associated epidemiological study] and high termination of pregnancy rates. In the registry women also demonstrated a clear preference for conservative management.Survival to 28 days and 1 year appears to be higher with VAS than with conservative management, but it is not possible to prove benefit beyond reasonable doubt. Notably, prognosis in both arms for survival and renal function is poor. VAS was substantially more costly and unlikely to be regarded as cost-effective based on the 1-year data. Parents should be counselled about the risks of pregnancy loss with or without VAS insertion. The National Institute for Health and Care Excellence interventional procedures guidance (IPG 202) should be updated to reflect this new evidence. Babies in the PLUTO trial should be followed up long term for the different outcomes.ISRCTN53328556.This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol. 17, No. 59. See the NIHR Journals Library website for further project information.",0 +https://doi.org/10.2307/2983637,Statistical Problems in Agricultural Experimentation,,0 +https://doi.org/10.1177/1368430215603457,Emergence of internal and external motivations to respond without prejudice in White children,"This research examined White U.S. children’s internal and external motivations to respond without prejudice (IMS and EMS). Study 1 examined the psychometric properties of IMS and EMS scales adapted from Plant and Devine (1998) in a predominately White sample of children ( N = 123, ages 7–12, M age = 9.50, SD = 1.66). Among children aged 8 and older, both scales were reliable and correlated with theoretically relevant constructs. Study 2 examined whether IMS and EMS mediate the inverse relation between age and explicit prejudice in a sample of White children ( N = 145, ages 8–10, M age = 8.98, SD = 0.82). When ethnic labeling was present, EMS mediated the inverse relation between age and explicit ethnic bias. When ethnic labeling was absent, IMS mediated the inverse relation between age and explicit ethnic bias. Results indicate IMS and EMS emerge in childhood and bear implications for theories of ethnic attitude development.",0 +https://doi.org/10.1037/a0029252,A general and flexible approach to estimating the social relations model using Bayesian methods.,"The social relations model (SRM) is a conceptual, methodological, and analytical approach that is widely used to examine dyadic behaviors and interpersonal perception within groups. This article introduces a general and flexible approach to estimating the parameters of the SRM that is based on Bayesian methods using Markov chain Monte Carlo techniques. The Bayesian approach overcomes several statistical problems that have plagued SRM researchers. First, it provides a single unified approach to estimating SRM parameters that can be easily extended to more specialized models (e.g., measurement models, moderator variables, categorical outcome variables). Second, sampling-based Bayesian methods allow statistically reliable inferences to be made about variance components and correlations, even with small sample sizes. Third, the Bayesian approach is able to handle designs with missing data. In a simulation study, the statistical properties (bias, root-mean-square error, coverage rate) of the parameter estimates produced by the Bayesian approach are compared with those of the method of moment estimates that have been used in previous research. A data example is presented to illustrate how discrete person moderators can be included in SRM analyses using the Bayesian approach. Finally, further extensions of the SRM are discussed, and suggestions for applied research are made.",0 +https://doi.org/10.2202/1544-6115.1414,Orthology-Based Multilevel Modeling of Differentially Expressed Mouse and Human Gene Pairs,"There is great interest in finding human genes expressed through pharmaceutical intervention, thus opening a genomic window into benefit and side-effect profiles of a drug. Human insight gained from FDA-required animal experiments has historically been limited, but in the case of gene expression measurements, proposed biological orthologies between mouse and human genes provide a foothold for animal-to-human extrapolation. We have investigated a five-component, multilevel, bivariate normal mixture model that incorporates mouse, as well as human, gene expression data. The goal is two-fold: to increase human differential gene-finding power; and to find a subclass of gene pairs for which there is a direct exploitable relationship between animal and human genes. In simulation studies, the dual-species model boasted impressive gains in differential gene-finding power over a related marginal model using only human data. Bias in parameter estimation was problematic, however, and occasionally led to failures in control of the false discovery rate. Though it was considerably more difficult to find species-extrapolative gene-pairs (than differentially expressed human genes), simulation experiments deemed it to be possible, especially when traditional FDR controls are relaxed and under hypothetical parameter configurations.",0 +https://doi.org/10.1002/sim.1544,Bayesian analysis of structural equation models with dichotomous variables,"Structural equation modelling has been used extensively in the behavioural and social sciences for studying interrelationships among manifest and latent variables. Recently, its uses have been well recognized in medical research. This paper introduces a Bayesian approach to analysing general structural equation models with dichotomous variables. In the posterior analysis, the observed dichotomous data are augmented with the hypothetical missing values, which involve the latent variables in the model and the unobserved continuous measurements underlying the dichotomous data. An algorithm based on the Gibbs sampler is developed for drawing the parameters values and the hypothetical missing values from the joint posterior distributions. Useful statistics, such as the Bayesian estimates and their standard error estimates, and the highest posterior density intervals, can be obtained from the simulated observations. A posterior predictive p-value is used to test the goodness-of-fit of the posited model. The methodology is applied to a study of hypertensive patient non-adherence to medication.",0 +https://doi.org/10.1523/jneurosci.1850-04.2004,"A Role for Proinflammatory Cytokines and Fractalkine in Analgesia, Tolerance, and Subsequent Pain Facilitation Induced by Chronic Intrathecal Morphine","The present experiments examined the role of spinal proinflammatory cytokines [interleukin-1β (IL-1)] and chemokines (fractalkine) in acute analgesia and in the development of analgesic tolerance, thermal hyperalgesia, and tactile allodynia in response to chronic intrathecal morphine. Chronic (5 d), but not acute (1 d), intrathecal morphine was associated with a rapid increase in proinflammatory cytokine protein and/or mRNA in dorsal spinal cord and lumbosacral CSF. To determine whether IL-1 release modulates the effects of morphine, intrathecal morphine was coadministered with intrathecal IL-1 receptor antagonist (IL-1ra). This regimen potentiated acute morphine analgesia and inhibited the development of hyperalgesia, allodynia, and analgesic tolerance. Similarly, intrathecal IL-1ra administered after the establishment of morphine tolerance reversed hyperalgesia and prevented the additional development of tolerance and allodynia. Fractalkine also appears to modulate the effects of intrathecal morphine because coadministration of morphine with intrathecal neutralizing antibody against the fractalkine receptor (CX3CR1) potentiated acute morphine analgesia and attenuated the development of tolerance, hyperalgesia, and allodynia. Fractalkine may be exerting these effects via IL-1 because fractalkine (CX3CL1) induced the release of IL-1 from acutely isolated dorsal spinal cord in vitro . Finally, gene therapy with an adenoviral vector encoding for the release of the anti-inflammatory cytokine IL-10 also potentiated acute morphine analgesia and attenuated the development of tolerance, hyperalgesia, and allodynia. Taken together, these results suggest that IL-1 and fractalkine are endogenous regulators of morphine analgesia and are involved in the increases in pain sensitivity that occur after chronic opiates.",0 +https://doi.org/10.1207/s15328007sem1203_5,Application of Structural Equation Models to Quality of Life,"Quality of life (QOL) has become an important concept for health care. As QOL is a multidimensional concept that is best evaluated by a number of latent constructs, it is well recognized that latent variable models, such as exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) are useful tools for analyzing QOL data. Recently, QOL researchers have realized the potential of structural equation modeling (SEM), which is a generalization of EFA and CFA in formulating a regression type equation in the model for studying the effects of the latent constructs to the QOL or health-related QOL. However, as the items in a QOL questionnaire are usually measured on an ordinal categorical scale, standard methods in SEM that are based on the normal distribution may produce misleading results. In this article, we propose an approach that uses a threshold specification to handle the ordinal categorical variables. Then, on the basis of observed ordinal categorical data, a maximum likelihood (ML) approach...",0 +https://doi.org/10.1177/1065912914534534,"Happy Medium, Happy Citizens","Institutional and behavioral theories of democracy abound but rarely intersect. Do executive lawmaking power and prowess condition democratic regime support in presidential democracies? We develop theoretical expectations linking the lawmaking powers of the president and mass regime support and test them by analyzing survey data from eighteen Latin American countries over ten years. As hypothesized, results indicate that preference for, and satisfaction with, democracy is highest where presidents have moderate legislative powers and success and lowest where presidents either dominate policymaking or face gridlock. Hence, a “happy medium” of presidential power promotes the attitudinal foundations of democracy.",0 +https://doi.org/10.1177/0165025409343765,Methods and Measures: Growth mixture modeling: A method for identifying differences in longitudinal change among unobserved groups,"Growth mixture modeling (GMM) is a method for identifying multiple unobserved sub-populations, describing longitudinal change within each unobserved sub-population, and examining differences in change among unobserved sub-populations. We provide a practical primer that may be useful for researchers beginning to incorporate GMM analysis into their research. We briefly review basic elements of the standard latent basis growth curve model, introduce GMM as an extension of multiple-group growth modeling, and describe a four-step approach to conducting a GMM analysis. Example data from a cortisol stress-response paradigm are used to illustrate the suggested procedures.",0 +https://doi.org/10.1016/j.jsp.2013.12.002,An effect size measure and Bayesian analysis of single-case designs,"This article describes a linear modeling approach for the analysis of single-case designs (SCDs). Effect size measures in SCDs have been defined and studied for the situation where there is a level change without a time trend. However, when there are level and trend changes, effect size measures are either defined in terms of changes in R(2) or defined separately for changes in slopes and intercept coefficients. We propose an alternate effect size measure that takes into account changes in slopes and intercepts in the presence of serial dependence and provides an integrated procedure for the analysis of SCDs through estimation and inference based directly on the effect size measure. A Bayesian procedure is described to analyze the data and draw inferences in SCDs. A multilevel model that is appropriate when several subjects are available is integrated into the Bayesian procedure to provide a standardized effect size measure comparable to effect size measures in a between-subjects design. The applicability of the Bayesian approach for the analysis of SCDs is demonstrated through an example.",0 +https://doi.org/10.1016/0749-596x(91)90025-f,A process dissociation framework: Separating automatic from intentional uses of memory,"Abstract This paper begins by considering problems that have plagued investigations of automatic or unconscious influences of perception and memory. A process dissociation procedure that provides an escape from those problems is introduced. The process dissociation procedure separates the contributions of different types of processes to performance of a task, rather than equating processes with tasks. Using that procedure, I provide new evidence in favor of a two-factor theory of recognition memory; one factor relies on automatic processes and the other relies on intentional processes. Recollection (an intentional use of memory) is hampered when attention is divided, rather than full, at the time of test. In contrast, the use of familiarity as a basis for recognition memory judgments (an automatic use of memory) is shown to be invariant across full versus divided attention, manipulated at test. Process dissociation procedures provide a general framework for separating automatic from intentional forms of processing in a variety of domains; including perception, memory, and thought.",0 +https://doi.org/10.3389/fpsyg.2015.01680,The curvilinear relationship between work pressure and momentary task performance: the role of state and trait core self-evaluations,"Whereas several studies have demonstrated that core self-evaluations (CSE)-or one's appraisals about one's own self-worth, capabilities, and competences-relate to job outcomes, less is known about the mechanisms underlying these relationships. In the present study, we address this issue by examining the role of within- and between-person variation in CSE in the relationship between work pressure and task performance. We hypothesized that (a) work pressure relates to task performance in a curvilinear way, (b) state CSE mediates the curvilinear relationship between work pressure and task performance, and (c) the relationship between work pressure and state CSE is moderated by trait CSE. Our hypotheses were tested via a 10-day daily diary study with 55 employees in which trait CSE was measured at baseline, while work pressure, task performance, and state CSE were assessed on a daily basis. Bayesian multilevel path analysis showed that work pressure affects task performance via state CSE, with state CSE increasing as long as the employee feels that (s)he is able to handle the work pressure, while it decreases when the level of work pressure exceeds the employees' coping abilities. Moreover, we found that for people low on trait CSE, the depleting effect of work pressure via state CSE happens for low levels of work pressure, while for people high in trait CSE the depleting effect is located at high levels of work pressure. Together, our findings suggest that the impact of work pressure on task performance is driven by a complex interplay of between- and within-person differences in CSE.",0 +https://doi.org/10.1198/sbr.2009.0070,Evaluating the Proportion of Treatment Effect Explained by a Continuous Surrogate Marker in Logistic or Probit Regression Models,"Using surrogate endpoints in clinical trials is desirable for drug development because the trials can be shortened and therefore more cost-effective. Validating a surrogate for the clinical endpoint is critical in this context. One of the key steps in statistical validation of a surrogate for a single trial is to estimate the proportion of treatment effect explained (PTE or PE) by a surrogate. Often the measure for PTE is estimated from the difference in coefficients of treatment from two models with or without adjusting for the surrogate for clinical endpoint. Inherent problems with the method are: the two models may not be valid simultaneously; and the estimate can often lie outside the interval [0, 1]. In this article, we provide alternative measures for evaluating the proportion of treatment effect explained by a surrogate in logistic or probit regression models. Our measures can be estimated easily with any statistical programs capable of binary linear regression modeling, and the interpretation of the measures can be illustrated using Ordinal Dominance (OD) curves. The concept can be visually understood by any practical user. Simulation shows our alternative measures yield more accurate estimates which are less biased, less variable, and with narrower confidence intervals. A clinical trial example is provided.",0 +https://doi.org/10.22237/jmasm/1241137860,A Comparison of Maximum Likelihood and Expected A Posteriori Estimation for Polychoric Correlation Using Monte Carlo Simulation,"This study aims to compare the maximum likelihood (ML) and expected a posterior (EAP) estimation for polychoric correlation (PCC) under diverse conditions, especially when considering a sample size. As the ML is the classical solution to estimate PCC, the EAP is a new method based on Bayes’ theorem. Different types of prior distributions are also adapted to investigate the sensitivity of prior distribution onto the PCC estimate for the EAP case. The Monte Carlo simulation is used for this comparison by a specialized program code in MATLAB.",0 +https://doi.org/10.3758/bf03194023,An EZ-diffusion model for response time and accuracy,"The EZ-diffusion model for two-choice response time tasks takes mean response time, the variance of response time, and response accuracy as inputs. The model transforms these data via three simple equations to produce unique values for the quality of information, response conservativeness, and nondecision time. This transformation of observed data in terms of unobserved variables addresses the speed-accuracy trade-off and allows an unambiguous quantification of performance differences in two-choice response time tasks. The EZ-diffusion model can be applied to data-sparse situations to facilitate individual subject analysis. We studied the performance of the EZ-diffusion model in terms of parameter recovery and robustness against misspecification by using Monte Carlo simulations. The EZ model was also applied to a real-world data set.",0 +https://doi.org/10.1093/biostatistics/2.4.485,Empirical Bayes Gibbs sampling,"The wide applicability of Gibbs sampling has increased the use of more complex and multi-level hierarchical models. To use these models entails dealing with hyperparameters in the deeper levels of a hierarchy. There are three typical methods for dealing with these hyperparameters: specify them, estimate them, or use a 'flat' prior. Each of these strategies has its own associated problems. In this paper, using an empirical Bayes approach, we show how the hyperparameters can be estimated in a way that is both computationally feasible and statistically valid.",0 +https://doi.org/10.1037/0022-3514.92.6.990,Misunderstanding the affective consequences of everyday social interactions: the hidden benefits of putting one's best face forward.,"Positive self-presentation may have beneficial consequences for mood that are typically overlooked. Across a series of studies, participants underestimated how good they would feel in situations that required them to put their best face forward. In Studies 1 and 2A, participants underestimated the emotional benefits of interacting with an opposite sex stranger versus the benefits of interacting with a romantic partner. In Study 2B, participants who were instructed to engage in self-presentation felt happier after interacting with their romantic partner than participants who were not given this instruction, although other participants serving as forecasters did not anticipate such benefits. Increasing the generalizability of this self-presentation effect across contexts, the authors demonstrated that participants also underestimated how good they would feel before and after being evaluated by another person (Studies 3 and 4). This failure to recognize the affective benefits of putting one's best face forward may underlie forecasting errors regarding the emotional consequences of the most common forms of social interactions.",0 +https://doi.org/10.1287/mksc.2014.0859,Partner Selection in Brand Alliances: An Empirical Investigation of the Drivers of Brand Fit,"We investigate whether partners in a brand alliance should be similar or dissimilar in brand image to foster favorable perceptions of brand fit. Using a Bayesian nonlinear structural equation model and evaluations of 1,200 brand alliances, we find that the conceptual coherence in brand personality profiles predicts attitudes towards a brand alliance. More specifically, we find that similarity in Sophistication and Ruggedness and moderate dissimilarity in Sincerity and Competence result in more favorable brand alliance evaluations. Overall, we find that similarity effects are more pronounced than dissimilarity effects. Implications for brand alliance strategies and marketing managers are discussed.",0 +https://doi.org/10.1348/000711009x430906,Investigating the relationship between item exposure and test overlap: Item sharing and item pooling,"To date, exposure control procedures that are designed to control item exposure and test overlap simultaneously are based on the assumption of item sharing between pairs of examinees. However, examinees may obtain test information from more than one examinee in practice. This larger scope of information sharing needs to be taken into account in refining exposure control procedures. To control item exposure and test overlap among a group of examinees larger than two, the relationship between the two indices needs to be identified first. The purpose of this paper is to analytically derive the relationships between item exposure rate and each of the two forms of test overlap, item sharing and item pooling, for fixed-length computerized adaptive tests. Item sharing is defined as the number of common items shared by all examinees in a group, while item pooling is the number of overlapping items that an examinee has with a group of examinees. The accuracy of the derived relationships was verified using numerical examples. The relationships derived will lay the foundation for future development of procedures to simultaneously control item exposure and item sharing or item pooling among a group of examinees larger than two.",0 +https://doi.org/10.5849/forsci.11-146,Volume and Error Variance Estimation Using Integrated Stem Taper Models,"In this study, we propose two volume and error variance estimators based on an integrated nonlinear mixed-effects stem taper model. The estimators rely either on a first- or a second-order Taylor series expansion. They were first tested through Monte Carlo simulations. The accuracy of the volume and error variance estimates was then tested against more than 1,000 observations. Empirical and nominal coverage of the confidence intervals were also compared under the assumption of a Gaussian distribution. For the volume estimators, results showed that the first-order estimator tends to slightly underestimate the volume, mainly because the stem taper model had random effects specified in a nonlinear manner. The second-order estimator was more accurate with neither under- nor overestimations of volume. For both the first- and the second-order variance estimators, the confidence intervals had empirical coverage that closely matches nominal coverage for probability levels >0.9. Although the proposed estimators require the stem taper model to predict the squared diameter of the cross section, they have the benefit of providing a tractable estimate of the variance. The covariances between different stem sections are quickly estimated because there is no need for repeated numerical integrations. © 2013 by the Society of American Foresters.",0 +https://doi.org/10.1348/000711099159080,Statistical analysis of nonlinear factor analysis models,"This paper presents a Bayesian analysis of a general nonlinear factor analysis model. Both the non-informative and conjugate prior distributions are considered. A hybrid algorithm that combines the Metropolis-Hastings algorithm and the Gibbs sampler is implemented to produce direct estimates of the latent factor scores and the structural parameters. Standard errors estimates as well as a goodness-of-fit statistic for assessing the posited model are presented. To illustrate the methodology, results from a simulation study and a real example are reported.",0 +https://doi.org/10.1111/j.2044-8317.1992.tb00977.x,Prior distribution for item response curves,"The paper examines the use of the ordered Dirichlet prior for binary logistic item response models. This prior is based on the investigator's prior information about the probabilities of correct response to items from examinees at several ability levels. The effect of the prior is examined in terms of the posterior mode of the item parameters computed via the EM algorithm. An illustration is used to explore the application of a 1981 ACT math test to form a prior that is then used on a similar 1987 test. A novel feature of the paper is the emphasis placed on the entire item response curves, rather than the item parameters per se. Detailed computational expressions for the three-parameter logistic model are summarized in an Appendix.",0 +https://doi.org/10.1111/j.0006-341x.2001.01198.x,Small-Sample Adjustments for Wald-Type Tests Using Sandwich Estimators,"The sandwich estimator of variance may be used to create robust Wald-type tests from estimating equations that are sums of K independent or approximately independent terms. For example, for repeated measures data on K individuals, each term relates to a different individual. These tests applied to a parameter may have greater than nominal size if K is small, or more generally if the parameter to be tested is essentially estimated from a small number of terms in the estimating equation. We offer some practical modifications to these robust Wald-type tests, which asymptotically approach the usual robust Wald-type tests. We show that one of these modifications provides exact coverage for a simple case and examine by simulation the modifications applied to the generalized estimating equations of Liang and Zeger (1986), conditional logistic regression, and the Cox proportional hazard model.",0 +https://doi.org/10.1080/1369183x.2014.915192,Over-education among Immigrants in Europe: The Value of Civic Involvement,"The present study investigates the effect of social connectedness through associational involvement on over-education among immigrants in 19 European societies, addressing the often-claimed importance of weak ties. Based on the idea that the effectiveness of social networks in distributing relevant information may depend on the degree to which such networks are linked to other networks, it thereby specifically distinguishes between associations that are connected to the wider community and those that are rather isolated. Using pooled individual-level data from the European Social Survey, empirical analyses indeed reveal active participation in associations to be related to lower risk of experiencing over-education. Moreover, the effect appears type specific, indicating access to multiple associations which are widely connected to different parts of society to be of particular benefit, especially in case of more recent migration.",0 +https://doi.org/10.1111/j.2044-8317.1995.tb01067.x,A two-stage estimation of structural equation models with continuous and polytomous variables,"This paper develops a computationally efficient procedure for analysis of structural equation models with continuous and polytomous variables. A partition maximum likelihood approach is used to obtain the first stage estimates of the thresholds and the polyserial and polychoric correlations in the underlying correlation matrix. Then, based on the joint asymptotic distribution of the first stage estimator and an appropriate weight matrix, a generalized least squares approach is employed to estimate the structural parameters in the correlation structure. Asymptotic properties of the estimators are derived. Some simulation studies are conducted to study the empirical behaviours and robustness of the procedure, and compare it with some existing methods.",0 +https://doi.org/10.1016/j.csda.2003.08.006,The influence of violations of assumptions on multilevel parameter estimates and their standard errors,"A crucial problem in the statistical analysis of hierarchically structured data is the dependence of the observations at the lower levels. Multilevel modeling programs account for this dependence and in recent years these programs have been widely accepted. One of the major assumptions of the tests of significance used in the multilevel programs is normality of the error distributions involved. Simulations were used to assess how important this assumption is for the accuracy of multilevel parameter estimates and their standard errors. Simulations varied the number of groups, the group size, and the intraclass correlation, with the second level residual errors following one of three non-normal distributions. In addition asymptotic maximum likelihood standard errors are compared to robust (Huber/White) standard errors. The results show that non-normal residuals at the second level of the model have little or no effect on the parameter estimates. For the fixed parameters, both the maximum likelihood-based standard errors and the robust standard errors are accurate. For the parameters in the random part of the model, the maximum likelihood-based standard errors at the lowest level are accurate, while the robust standard errors are often overcorrected. The standard errors of the variances of the level-two random effects are highly inaccurate, although the robust errors do perform better than the maximum likelihood errors. For good accuracy, robust standard errors need at least 100 groups. Thus, using robust standard errors as a diagnostic tool seems to be preferable to simply relying on them to solve the problem.",0 +https://doi.org/10.3102/1076998606298042,Multilevel Structural Equation Models for the Analysis of Comparative Data on Educational Performance,The Programme for International Student Assessment comparative study of reading performance among 15-year-olds is reanalyzed using statistical procedures that allow the full complexity of the data ...,0 +https://doi.org/10.1023/a:1020371312283,,"We consider methods for estimating causal effects of treatments when treatment assignment is unconfounded with outcomes conditional on a possibly large set of covariates. Robins and Rotnitzky (1995) suggested combining regression adjustment with weighting based on the propensity score (Rosenbaum and Rubin, 1983). We adopt this approach, allowing for a flexible specification of both the propensity score and the regression function. We apply these methods to data on the effects of right heart catheterization (RHC) studied in Connors et al (1996), and we find that our estimator gives stable estimates over a wide range of values for the two parameters governing the selection of variables.",0 +https://doi.org/10.1037/0022-006x.65.4.599,"Toward terminological, conceptual, and statistical clarity in the study of mediators and moderators: Examples from the child-clinical and pediatric psychology literatures.","Numerous recent attempts to identify mediated and moderated effects in child-clinical and pediatric research on child adjustment have been characterized by terminological, conceptual, and statistical inconsistencies. To promote greater clarity, the terms mediating and moderating are defined and differentiated. Recommended statistical strategies that can be used to test for these effects are reviewed (i.e., multiple regression and structural equation modeling techniques). The distinction between mediated and indirect effects is also discussed. Examples of troublesome and appropriate uses of these terms in the child-clinical and pediatric psychology literatures are highlighted.",0 +https://doi.org/10.1191/096228001682157616,"Multilevel models for meta-analysis, and their application to absolute risk differences","Meta-analysis can be considered a multilevel statistical problem, since information within studies is combined in the presence of potential heterogeneity between studies. Here a general multilevel model framework is developed for meta-analysis to combine either summary data or individual patient outcome data from each study, and to include either study or individual level covariates that might explain heterogeneity. Classical and Bayesian approaches to estimation are contrasted. These methods are applied to a meta-analysis of trials of thrombolytic therapy after myocardial infarction. Subgroups within the trials were available, categorized by the time delay until treatment, so that a three-level random effects model that includes time delay as a covariate is proposed. In addition it was desired to represent the treatment effect as an absolute risk reduction, rather than the conventional odds ratio. We show how this can be achieved within a Bayesian analysis, while still recognizing the binary nature of the original outcome data.",0 +https://doi.org/10.4324/9780203852279,Multilevel Analysis,"This practical introduction helps readers apply multilevel techniques to their research. Noted as an accessible introduction, the book also includes advanced extensions, making it useful as both an introduction and as a reference to students, researchers, and methodologists. Basic models and examples are discussed in non-technical terms with an emphasis on understanding the methodological and statistical issues involved in using these models. The estimation and interpretation of multilevel models is demonstrated using realistic examples from various disciplines. For example, readers will find data sets on stress in hospitals, GPA scores, survey responses, street safety, epilepsy, divorce, and sociometric scores, to name a few. The data sets are available on the website in SPSS, HLM, MLwiN, LISREL and/or Mplus files. Readers are introduced to both the multilevel regression model and multilevel structural models. Highlights of the second edition include: Two new chapters—one on multilevel models for ordinal and count data (Ch. 7) and another on multilevel survival analysis (Ch. 8). Thoroughly updated chapters on multilevel structural equation modeling that reflect the enormous technical progress of the last few years. The addition of some simpler examples to help the novice, whilst the more complex examples that combine more than one problem have been retained. A new section on multivariate meta-analysis (Ch. 11). Expanded discussions of covariance structures across time and analyzing longitudinal data where no trend is expected. Expanded chapter on the logistic model for dichotomous data and proportions with new estimation methods. An updated website at http://www.joophox.net/ with data sets for all the text examples and up-to-date screen shots and PowerPoint slides for instructors. Ideal for introductory courses on multilevel modeling and/or ones that introduce this topic in some detail taught in a variety of disciplines including: psychology, education, sociology, the health sciences, and business. The advanced extensions also make this a favorite resource for researchers and methodologists in these disciplines. A basic understanding of ANOVA and multiple regression is assumed. The section on multilevel structural equation models assumes a basic understanding of SEM.",0 +https://doi.org/10.1093/biomet/86.2.365,Addressing complications of intention-to-treat analysis in the combined presence of all-or-none treatment-noncompliance and subsequent missing outcomes,"SUMMARY We study the combined impact that all-or-none compliance and subsequent missing outcomes can have on the estimation of the intention-to-treat effect of assignment in randomised studies. In this setting, a standard analysis, which drops subjects with missing outcomes and ignores compliance information, can be biased for the intention-to-treat effect. To address all-or-none compliance that is followed by missing outcomes, we construct a new estimation procedure for the intention-to-treat effect that maintains good randomisation-based properties under more plausible, nonignorable noncompliance and nonignorable missing-outcome conditions: the 'compound exclusion restriction' on the effect of assignment and the 'latent ignorability' of the missing data mechanism. We present both theoretical results and a simulation study. Moreover, we show how the two key concepts of compound exclusion and latent ignorability are relevant in more complicated settings, such as right censoring of a time-to-event outcome.",0 +https://doi.org/10.1177/0146621614540514,MCMC GGUM,Link_to_subscribed_fulltex,0 +https://doi.org/10.1111/j.1460-9568.2012.08264.x,Proactive inhibitory control varies with task context,"The goal of executive control is to adjust our behaviour to the environment. It involves not only the continuous planning and adaptation of actions but also the inhibition of inappropriate movements. Recently, a proactive form of inhibitory control has been shown, demonstrating that actions can be withheld, in an uncertain environment, thanks to the proactive locking of the mechanism by which motor commands are triggered (e.g. while waiting at traffic lights in a dense pedestrian zone, one will refrain in anticipation of a brisk acceleration when the green light comes on). However, little is known about this executive function and it remains unclear whether the overall amount of inhibitory control can be modulated as a function of the context. Here, we show that the level of this control varies parametrically as a function of the exogenous and endogenous factors setting the task context. We also show that the level of implemented proactive inhibitory control is dynamically readjusted to match the implicit temporal structure of the environment. These observations are discussed in relation to possible underlying functional substrates and related neurological and psychiatric pathologies.",0 +,xtmixed and Denominator Degrees of Freedom: Myth or Magic,A review of issues and controversy surrounding F-ratio denominator degrees of freedom (DDF) in linear mixed models. The presentation will look at the history of denominator degrees of freedom as well survey their use in various statistical packages.,0 +https://doi.org/10.1016/j.jamcollsurg.2013.07.386,Antibiotic Prophylaxis for the Prevention of Surgical Site Infection after Tension-Free Hernia Repair: A Bayesian and Frequentist Meta-Analysis,"Efficacy of antibiotic prophylaxis for the prevention of surgical site infection (SSI) after open tension-free hernia repair remains controversial. In light of additional data, the aim of this study was to determine whether antibiotic prophylaxis reduces SSI after hernia repair.We conducted a systematic review and meta-analysis to identify randomized controlled trials comparing antibiotic prophylaxis and the subsequent incidence of SSI after inguinal or femoral hernia repair. The primary outcomes measure was the incidence of SSI. Subgroup analysis was evaluated by stratifying the categories of SSI. The meta-analysis was performed using Bayesian and frequentist methods.Twelve studies were included in this meta-analysis; 1,902 patients received antibiotic prophylaxis and the other 1,936 patients were allocated to the control group. Incidence of SSI was 47 (pooled rate 3.0%) in the antibiotic group and 91 (6.0%) in the control group. The number needed to treat to prevent 1 episode of SSI is 41. The Bayesian meta-analysis yielded a significant reduction of SSI in the antibiotic group (odds ratio = 0.49; 95% credible interval 0.25-0.81). Subgroup analysis showed that an antibiotic prophylaxis was beneficial for the prevention of superficial SSI (odds ratio = 0.40; 95% credible interval 0.12-0.98), but not beneficial for prevention of deep SSI (odds ratio = 0.59; 95% credible interval 0.11-3.20). Also, the results were similar to those with frequentist methods.This meta-analysis suggests that antibiotic prophylaxis is efficacious for the prevention of SSI after open mesh hernia repair.",0 +https://doi.org/10.3102/1076998607313593,Marginal Maximum Likelihood Estimation of a Latent Variable Model With Interaction,"There has been considerable interest in nonlinear latent variable models specifying interaction between latent variables. Although it seems to be only slightly more complex than linear regression without the interaction, the model that includes a product of latent variables cannot be estimated by maximum likelihood assuming normality. Consequently, many approximate methods have been proposed. Recently, a maximum likelihood method of estimation based on the expectation–maximization algorithm has been suggested that is optimum if the distribution assumptions are true. In this article, the authors outline an alternative marginal maximum likelihood estimator using numerical quadrature. A key feature of the approach is that in the marginal distribution of the manifest variables the complicated integration can be reduced, often to a single dimension. This allows a direct approach to maximizing the log-likelihood and makes the method relatively straightforward to use.",0 +https://doi.org/10.1002/brb3.44,"Immunofluorescent spectral analysis reveals the intrathecal cannabinoid agonist, AM1241, produces spinal anti‐inflammatory cytokine responses in neuropathic rats exhibiting relief from allodynia","During pathological pain, the actions of the endocannabinoid system, including the cannabinoid 2 receptor (CB(2)R), leads to effective anti-allodynia and modifies a variety of spinal microglial and astrocyte responses. Here, following spinal administration of the CB(2)R compound, AM1241, we examined immunoreactive alterations in markers for activated p38 mitogen-activated protein kinase, interleukin-1β (IL-1β), the anti-inflammatory cytokine, interleukin-10 (IL-10) as well as degradative endocannabinoid enzymes, and markers for altered glial responses in neuropathic rats. In these studies, the dorsal horn of the spinal cord and dorsal root ganglia were examined. AM1241 produced profound anti-allodynia with corresponding immunoreactive levels of p38 mitogen-activated kinase, IL-1β, IL-10, the endocannabinoid enzyme monoacylglycerol lipase, and astrocyte activation markers that were similar to nonneuropathic controls. In contrast, spinal AM1241 did not suppress the increased microglial responses observed in neuropathic rats. The differences in fluorescent markers were determined within discrete anatomical regions by applying spectral analysis methods, which virtually eliminated nonspecific signal during the quantification of specific immunofluorescent intensity. These data reveal expression profiles that support the actions of intrathecal AM1241 control pathological pain through anti-inflammatory mechanisms by modulating critical glial factors, and additionally decrease expression levels of endocannabinoid degradative enzymes.",0 +https://doi.org/10.1002/sim.7572,A Bayesian semiparametric latent variable approach to causal mediation,"In assessing causal mediation effects in randomized studies, a challenge is that the direct and indirect effects can vary across participants due to different measured and unmeasured characteristics. In that case, the population effect estimated from standard approaches implicitly averages over and does not estimate the heterogeneous direct and indirect effects. We propose a Bayesian semiparametric method to estimate heterogeneous direct and indirect effects via clusters, where the clusters are formed by both individual covariate profiles and individual effects due to unmeasured characteristics. These cluster-specific direct and indirect effects can be estimated through a set of regression models where specific coefficients are clustered by a stick-breaking prior. To let clustering be appropriately informed by individual direct and indirect effects, we specify a data-dependent prior. We conduct simulation studies to assess performance of the proposed method compared to other methods. We use this approach to estimate heterogeneous causal direct and indirect effects of an expressive writing intervention for patients with renal cell carcinoma.",0 +https://doi.org/10.1037//0022-006x.70.4.976,A finite mixture model of growth trajectories of adolescent alcohol use: Predictors and consequences.,"The current study sought to identify classes of growth trajectories of adolescent alcohol use and to examine the predictors and outcomes associated with the classes. Alcohol use was assessed from Grades 7 to 12 in a school-based sample. Latent growth mixture modeling was used, and results indicated 5 discrete longitudinal drinking patterns. The 2 most common drinking patterns included occasional very light drinking from Grades 7 to 12 and moderate escalation in both quantity and frequency of alcohol use. One group drank infrequently but at high levels throughout the study period. Another group exhibited rapid escalation in both quantity and frequency. The final group started at high levels of frequency and quantity in Grade 7 and showed rapid de-escalation in frequency. Emotional distress and risk taking distinguished the classes, and all classes, particularly rapid escalators, showed elevated levels of alcohol-related problems relative to occasional very light drinkers.",0 +https://doi.org/10.1177/0146167215626706,Motivational Affordance and Risk-Taking Across Decision Domains,"We propose a motivational affordance account to explain both stability and variability in risk-taking propensity in major decision domains. We draw on regulatory focus theory to differentiate two types of motivation (prevention, promotion) that play a key role in predicting risk-taking. Study 1 demonstrated that prevention motivation is negatively associated with risk-taking across six key decision domains, including health/safety, ethics, recreation, gambling, investment, and social. In contrast, promotion motivation is positively associated with risk-taking in the social and investment domains. Study 2 replicated the same pattern and provided direct evidence that promotion motivation is a strong predictor of risk-taking only in domains where there is true potential for gains. Study 3 manipulated promotion (vs. prevention) motivation experimentally to demonstrate that motivational affordance is a critical mechanism for understanding risk-taking behaviors.",0 +https://doi.org/10.1146/annurev.psych.58.110405.085542,Mediation Analysis,"Abstract Mediating variables are prominent in psychological theory and research. A mediating variable transmits the effect of an independent variable on a dependent variable. Differences between mediating variables and confounders, moderators, and covariates are outlined. Statistical methods to assess mediation and modern comprehensive approaches are described. Future directions for mediation analysis are discussed.",0 +https://doi.org/10.3168/jds.2007-0621,"Cow, Farm, and Herd Management Factors in the Dry Period Associated with Raised Somatic Cell Counts in Early Lactation","This study investigated cow characteristics, farm facilities, and herd management strategies during the dry period to examine their joint influence on somatic cell counts (SCC) in early lactation. Data from 52 commercial dairy farms throughout England and Wales were collected over a 2-yr period. For the purpose of analysis, cows were separated into those housed for the dry period (6,419 cow-dry periods) and those at pasture (7,425 cow-dry periods). Bayesian multilevel models were specified with 2 response variables: ln SCC (continuous) and SCC >199,000 cells/mL (binary), both within 30 d of calving. Cow factors associated with an increased SCC after calving were parity, an SCC >199,000 cells/mL in the 60 d before drying off, increasing milk yield 0 to 30 d before drying off, and reduced DIM after calving at the time of SCC estimation. Herd management factors associated with an increased SCC after calving included procedures at drying off, aspects of bedding management, stocking density, and method of pasture grazing. Posterior predictions were used for model assessment, and these indicated that model fit was generally good. The research demonstrated that specific dry-period management strategies have an important influence on SCC in early lactation.",0 +https://doi.org/10.1037/0021-843x.89.2.203,Social competence and depression: The role of illusory self-perceptions.,"Attempted to evaluate the role in clinical depression of 2 personal variables: social competencies (as perceived by others) and their encoding or self-perception by the individual. Both self-ratings and ratings from observers were obtained for 71 depressed, 59 psychiatric control, and 73 normal control individuals following a group interaction at different times in the course of treatment. As expected, the depressed Ss initially rated themselves and were rated by others as less socially competent than the 2 control groups, and their self-perceptions improved with treatment. Surprisingly, the depressed were more realistic in their self-perceptions than the controls. Specifically, the controls perceived themselves more positively than others saw them, whereas the depressed saw themselves as they were seen. This realism of the depressed tended to decrease in the course of treatment. The theoretical implications of a possibly illusory flow for appropriate affect and self-regulation are discussed. (20 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1980 American Psychological Association.",0 +https://doi.org/10.1111/j.1559-1816.2002.tb01434.x,The Influence of Affective and Instrumental Beliefs on Exercise Intentions and Behavior: A Longitudinal Analysis,"Programs encouraging exercise might reduce coronary illness. Ajzen's theory of planned behavior is a useful model for understanding exercise motivation. The current study investigated the contribution of the instrumental and affective components of attitude. As part of a community-based study of exercise behavior, 424 men and 572 women completed questionnaires, with 365 participants providing 6-month follow-up data. Regressions highlighted the affective component as a much more powerful predictor of intention compared to the instrumental component. After controlling for prior exercise, intention was not predictive of later exercise, although the affective component was. The implications for exercise promotion are discussed.",0 +https://doi.org/10.1214/aos/1043351257,A unified jackknife theory for empirical best prediction with M-estimation,"The paper presents a unified jackknife theory for a fairly general class of mixed models which includes some of the widely used mixed linear models and generalized linear mixed models as special cases. The paper develops jackknife theory for the important, but so far neglected, prediction problem for the general mixed model. For estimation of fixed parameters, a jackknife method is considered for a general class of M-estimators which includes the maximum likelihood, residual maximum likelihood and ANOVA estimators for mixed linear models and the recently developed method of simulated moments estimators for generalized linear mixed models. For both the prediction and estimation problems, a jackknife method is used to obtain estimators of the mean squared errors (MSE). Asymptotic unbiasedness of the MSE estimators is shown to hold essentially under certain moment conditions. Simulation studies undertaken support our theoretical results.",0 +https://doi.org/10.1080/00031305.2015.1111260,The Central Role of Bayes’ Theorem for Joint Estimation of Causal Effects and Propensity Scores,"Although propensity scores have been central to the estimation of causal effects for over 30 years, only recently has the statistical literature begun to consider in detail methods for Bayesian estimation of propensity scores and causal effects. Underlying this recent body of literature on Bayesian propensity score estimation is an implicit discordance between the goal of the propensity score and the use of Bayes theorem. The propensity score condenses multivariate covariate information into a scalar to allow estimation of causal effects without specifying a model for how each covariate relates to the outcome. Avoiding specification of a detailed model for the outcome response surface is valuable for robust estimation of causal effects, but this strategy is at odds with the use of Bayes theorem, which presupposes a full probability model for the observed data that adheres to the likelihood principle. The goal of this paper is to explicate this fundamental feature of Bayesian estimation of causal effects with propensity scores in order to provide context for the existing literature and for future work on this important topic.",0 +https://doi.org/10.1111/j.1600-0447.2006.00914.x,A framework for evidence-based mental health care and policy,"Care planning integrates a growing number of disciplines, research fields and analysis techniques. A framework of the main areas of interest with regard to evidence-based health care in mental health is provided here.The framework is based on the experience of working with data analysts and health and social decision makers at the PSICOST/RIRAG network, a Spanish research association which includes psychiatrists, health economists and health policy experts, as well as on a review of the literature.Three main areas have been identified and described here: outcomes management, knowledge discovery from data, and decision support systems. Their use in mental health care is reviewed.It is important to promote bridging strategies among these new fields in order to enhance communication and information transfer between the different parts involved in mental health decision making: i) clinicians and epidemiologists, ii) data analysts, iii) care policy makers and other end-users.",0 +https://doi.org/10.1002/ejsp.2420250405,"The theory of planned behaviour and exercise: An investigation into the role of prior behaviour, behavioural intentions and attitude variability","This paper reports a prospective study which applied the Theory of Planned Behaviour (TPB) to the prediction of exercise behaviour over a six-month period. The study addressed a number of issues which have been identified in the literature on the TPB; these being the role of prior behaviour in the TPB, the distinction between desires and self-predictions, and the question of attitude variability. The findings showed prior behaviour to be the strongest predictor of exercise behaviour at six months. Contrary to expectations, the self-prediction measure was not found to be a better predictor of behaviour than the desire measure. Attitude variability was found to be related to perceptions of control. However, attitude variability was not found to moderate relationships between components of the TPB. The implications of the results for the development of the TPB are discussed.",0 +https://doi.org/10.1198/000313008x331530,A Note Concerning a Selection “Paradox” of Dawid's,"This article briefly reviews a selection “paradox” of Dawid's, whereby Bayesian inference appears to be unchanged whether or not treatments have been selected for inspection on the basis of extreme values. The problem is recast in terms of a hierarchical model. This offers an alternative explanation of the paradox but also reveals a disturbing dependence of inference on prior specification. The example may also be used to deepen students' understanding of the implications of using conjugate nonhierarchical priors in Bayesian analysis. To illustrate, some simulations are presented.",0 +https://doi.org/10.1136/ip.2006.014571,"Maternal depression, child behavior, and injury","

Summary

Background and objectives

Recent interest has focused on wait listing patients without pretreating coronary artery disease to expedite transplantation. Our practice is to offer coronary revascularization before transplantation if indicated.

Design, setting, participants, & measurements

Between 2006 and 2009, 657 patients (427 men, 230 women; ages, 56.5 ± 9.94 years) underwent pretransplant assessment with coronary angiography. 573 of 657 (87.2%) patients were wait listed; 247 of 573 (43.1%) patients were transplanted during the follow-up period, 30.09 ± 11.67 months.

Results

Patient survival for those not wait listed was poor, 83.2% and 45.7% at 1 and 3 years, respectively. In wait-listed patients, survival was 98.9% and 95.3% at 1 and 3 years, respectively. 184 of 657 (28.0%) patients were offered revascularization. Survival in patients (n = 16) declining revascularization was poor: 75% survived 1 year and 37.1% survived 3 years. Patients undergoing revascularization followed by transplantation (n = 51) had a 98.0% and 88.4% cardiac event–free survival at 1 and 3 years, respectively. Cardiac event–free survival for patients revascularized and awaiting deceased donor transplantation was similar: 94.0% and 90.0% at 1 and 3 years, respectively.

Conclusions

Our data suggest pre-emptive coronary revascularization is not only associated with excellent survival rates in patients subsequently transplanted, but also in those patients waiting on dialysis for a deceased donor transplant.",0 +,Principles and selected applications of item response theory.,,0 +https://doi.org/10.1007/bf02294248,"Nonconvergence, improper solutions, and starting values in lisrel maximum likelihood estimation","In the framework of a robustness study on maximum likelihood estimation with LISREL three types of problems are dealt with: nonconvergence, improper solutions, and choice of starting values. The purpose of the paper is to illustrate why and to what extent these problems are of importance for users of LISREL. The ways in which these issues may affect the design and conclusions of robustness research is also discussed.",0 +https://doi.org/10.1080/00461520.2012.670488,Classroom Climate and Contextual Effects: Conceptual and Methodological Issues in the Evaluation of Group-Level Effects,"Classroom context and climate are inherently classroom-level (L2) constructs, but applied researchers sometimes—inappropriately—represent them by student-level (L1) responses in single-level models rather than more appropriate multilevel models. Here we focus on important conceptual issues (distinctions between climate and contextual variables; use of classroom L2 rather than student-level L1 measures) and more appropriate multilevel models. To illustrate these issues, we consider the effects of two L2 classroom climate variables and one L2 classroom contextual variable on two L1 student-level outcomes for 2261 students in 128 classes. Through this example, we illustrate how to apply evolving doubly latent multilevel models to (a) evaluate the factor structure of L1 and L2 constructs based on multiple indicators of classroom climate and context measures, (b) control measurement error at L1 and L2, (c) control sampling error in the aggregation of L1 responses to form L2 constructs (the average of student-l...",0 +https://doi.org/10.1007/bf02293801,Marginal maximum likelihood estimation of item parameters: Application of an EM algorithm,"Maximum likelihood estimation of item parameters in the marginal distribution, integrating over the distribution of ability, becomes practical when computing procedures based on an EM algorithm are used. By characterizing the ability distribution empirically, arbitrary assumptions about its form are avoided. The Em procedure is shown to apply to general item-response models lacking simple sufficient statistics for ability. This includes models with more than one latent dimension. © 1981 The Psychometric Society.",0 +https://doi.org/10.1006/jmps.1993.1032,Information Processing Models Generating Lognormally Distributed Reaction Times,"Abstract The lognormal distribution has been fitted successfully to empirical reaction times (RTs), yet mechanisms that might generate lognormally distributed (RTs are unknown. Thus, the lognormal has the status of an ad-hoc distribution in RT research. In this paper we describe mechanisms that could generate the lognormal distribution and show how specific RT models can be constructed within the framework of general mathematical properties of the lognormal. It is demonstrated that various conceptually different mechanisms could produce lognormally distributed RTs.",0 +https://doi.org/10.1177/1094428103257358,"Apples and Oranges (and Pears, Oh My!): The Search for Moderators in Meta-Analysis","The purpose of this article is to review current practices with respect to detection and estimation of moderators in meta-analysis and to develop recommendations that are driven by the results of this review and previous research. The first purpose was accomplished through a review of the meta-analyses published in Journal of Applied Psychology from 1978 to 1997. Results show, first, that practices with respect to both the execution of and the reporting of results from searches for moderators are highly variable and, second, that findings relevant for detection of moderators (e.g., percentage variance attributable to artifacts, SDρ, etc.) are often highly inconsistent with what has been suggested in the past. These practices held regardless of time of publication, specificity of the question addressed in the paper, and content area. Detailed suggestions for modifications of current practices are offered.",0 +https://doi.org/10.1037/a0013971,Mediators of change for multisystemic therapy with juvenile sexual offenders.,"The mediators of favorable multisystemic therapy (MST) outcomes achieved at 12 months postrecruitment were examined within the context of a randomized effectiveness trial with 127 juvenile sexual offenders and their caregivers. Outcome measures assessed youth delinquency, substance use, externalizing symptoms, and deviant sexual interest/risk behaviors; hypothesized mediators included measures of parenting and peer relations. Data were collected at pretreatment, 6 months postrecruitment, and 12 months postrecruitment. Consistent with the MST theory of change and the small extant literature in this area of research, analyses showed that favorable MST effects on youth antisocial behavior and deviant sexual interest/risk behaviors were mediated by increased caregiver follow-through on discipline practices as well as decreased caregiver disapproval of and concern about the youth's bad friends during the follow-up. These findings have important implications for the community-based treatment of juvenile sexual offenders.",0 +https://doi.org/10.1111/j.1460-9568.2005.04057.x,"Controlling pathological pain by adenovirally driven spinal production of the anti-inflammatory cytokine, interleukin-10","Gene therapy for the control of pain has, to date, targeted neurons. However, recent evidence supports that spinal cord glia are critical to the creation and maintenance of pain facilitation through the release of proinflammatory cytokines. Because of the ability of interleukin-10 (IL-10) to suppress proinflammatory cytokines, we tested whether an adenoviral vector encoding human IL-10 (AD-h-IL10) would block and reverse pain facilitation. Three pain models were examined, all of which are mediated by spinal pro-inflammatory cytokines. Acute intrathecal administration of rat IL-10 protein itself briefly reversed chronic constriction injury-induced mechanical allodynia and thermal hyperalgesia. The transient reversal caused by IL-10 protein paralleled the half-life of human IL-10 protein in the intrathecal space (t1/2 ∼ 2 h). IL-10 gene therapy both prevented and reversed thermal hyperalgesia and mechanical allodynia, without affecting basal responses to thermal or mechanical stimuli. Extra-territorial, as well as territorial, pain changes were reversed by this treatment. Intrathecal AD-h-IL10 injected over lumbosacral spinal cord led to elevated lumbosacral cerebrospinal fluid (CSF) levels of human IL-10, with far less human IL-10 observed in cervical CSF. In keeping with IL-10's known anti-inflammatory actions, AD-h-IL10 lowered CSF levels of IL-1, relative to control AD. These studies support that this gene therapy approach provides an alternative to neuronally focused drug and gene therapies for clinical pain control.",0 +https://doi.org/10.3389/fpsyg.2015.01963,Psychometric Evaluation of the Overexcitability Questionnaire-Two Applying Bayesian Structural Equation Modeling (BSEM) and Multiple-Group BSEM-Based Alignment with Approximate Measurement Invariance,"The Overexcitability Questionnaire-Two (OEQ-II) measures the degree and nature of overexcitability, which assists in determining the developmental potential of an individual according to Dabrowski's Theory of Positive Disintegration. Previous validation studies using frequentist confirmatory factor analysis, which postulates exact parameter constraints, led to model rejection and a long series of model modifications. Bayesian structural equation modeling (BSEM) allows the application of zero-mean, small-variance priors for cross-loadings, residual covariances, and differences in measurement parameters across groups, better reflecting substantive theory and leading to better model fit and less overestimation of factor correlations. Our BSEM analysis with a sample of 516 students in higher education yields positive results regarding the factorial validity of the OEQ-II. Likewise, applying BSEM-based alignment with approximate measurement invariance, the absence of non-invariant factor loadings and intercepts across gender is supportive of the psychometric quality of the OEQ-II. Compared to males, females scored significantly higher on emotional and sensual overexcitability, and significantly lower on psychomotor overexcitability.",0 +https://doi.org/10.1080/08957347.2012.714686,Item Selection and Ability Estimation Procedures for a Mixed-Format Adaptive Test,"In this study we compared five item selection procedures using three ability estimation methods in the context of a mixed-format adaptive test based on the generalized partial credit model. The item selection procedures used were maximum posterior weighted information, maximum expected information, maximum posterior weighted Kullback-Leibler information, and maximum expected posterior weighted Kullback-Leibler information procedures. The ability estimation methods investigated were maximum likelihood estimation (MLE), weighted likelihood estimation (WLE), and expected a posteriori (EAP). Results suggested that all item selection procedures, regardless of the information functions on which they were based, performed equally well across ability estimation methods. The principal conclusions drawn about the ability estimation methods are that MLE is a practical choice and WLE should be considered when there is a mismatch between pool information and the population ability distribution. EAP can serve as a viab...",0 +https://doi.org/10.1080/07474938.2012.690653,Stochastic Dominance with Ordinal Variables: Conditions and a Test,"A re-emerging literature on robustness in multidimensional welfare and poverty comparisons has revived interest in multidimensional stochastic dominance. Considering the widespread use of ordinal variables in wellbeing measurement, and particularly in composite indices, I derive multivariate stochastic dominance conditions for ordinal variables. These are the analogues of the conditions for continuous variables (e.g., Bawa, 1975, and Atkinson and Bourguignon, 1982). The article also derives mixed-order-of-dominance conditions for any type of variable. Then I propose an extension of Anderson's nonparametric test in order to test these conditions for ordinal variables. In addition, I propose the use of vectors and matrices of positions in order to handle multivariate, multinomial distributions. An empirical application to multidimensional wellbeing in Peru illustrates these tests.",0 +https://doi.org/10.1371/journal.pone.0058369,Bayesian Inference for Generalized Linear Mixed Model Based on the Multivariate t Distribution in Population Pharmacokinetic Study,"This article provides a fully bayesian approach for modeling of single-dose and complete pharmacokinetic data in a population pharmacokinetic (PK) model. To overcome the impact of outliers and the difficulty of computation, a generalized linear model is chosen with the hypothesis that the errors follow a multivariate Student t distribution which is a heavy-tailed distribution. The aim of this study is to investigate and implement the performance of the multivariate t distribution to analyze population pharmacokinetic data. Bayesian predictive inferences and the Metropolis-Hastings algorithm schemes are used to process the intractable posterior integration. The precision and accuracy of the proposed model are illustrated by the simulating data and a real example of theophylline data.",0 +https://doi.org/10.3758/bf03257252,A hierarchical model for estimating response time distributions,"We present a statistical model for inference with response time (RT) distributions. The model has the following features. First, it provides a means of estimating the shape, scale, and location (shift) of RT distributions. Second, it is hierarchical and models between-subjects and within-subjects variability simultaneously. Third, inference with the model is Bayesian and provides a principled and efficient means of pooling information across disparate data from different individuals. Because the model efficiently pools information across individuals, it is particularly well suited for those common cases in which the researcher collects a limited number of observations from several participants. Monte Carlo simulations reveal that the hierarchical Bayesian model provides more accurate estimates than several popular competitors do. We illustrate the model by providing an analysis of the symbolic distance effect in which participants can more quickly ascertain the relationship between nonadjacent digits than that between adjacent digits.",0 diff --git a/examples/prior_example/data/van_de_Schoot_2018.csv b/examples/prior_example/data/van_de_Schoot_2018.csv new file mode 100644 index 0000000..27e5ce4 --- /dev/null +++ b/examples/prior_example/data/van_de_Schoot_2018.csv @@ -0,0 +1,4545 @@ +doi,title,abstract,label_included +https://doi.org/10.1111/jcpp.12053,Annual Research Review: Resilience and mental health in children and adolescents living in areas of armed conflict - a systematic review of findings in low- and middle-income countries,"Researchers focused on mental health of conflict-affected children are increasingly interested in the concept of resilience. Knowledge on resilience may assist in developing interventions aimed at improving positive outcomes or reducing negative outcomes, termed promotive or protective interventions.We performed a systematic review of peer-reviewed qualitative and quantitative studies focused on resilience and mental health in children and adolescents affected by armed conflict in low- and middle-income countries.Altogether 53 studies were identified: 15 qualitative and mixed methods studies and 38 quantitative, mostly cross-sectional studies focused on school-aged children and adolescents. Qualitative studies identified variation across socio-cultural settings of relevant resilience outcomes, and report contextually unique processes contributing to such outcomes. Quantitative studies focused on promotive and protective factors at different socio-ecological levels (individual, family-, peer-, school-, and community-levels). Generally, promotive and protective factors showed gender-, symptom-, and phase of conflict-specific effects on mental health outcomes.Although limited by its predominantly cross-sectional nature and focus on protective outcomes, this body of knowledge supports a perspective of resilience as a complex dynamic process driven by time- and context-dependent variables, rather than the balance between risk- and protective factors with known impacts on mental health. Given the complexity of findings in this population, we conclude that resilience-focused interventions will need to be highly tailored to specific contexts, rather than the application of a universal model that may be expected to have similar effects on mental health across contexts.",0 +https://doi.org/10.1097/00005053-200007000-00004,Profiling the Trauma Related Symptoms of Bosnian Refugees Who Have not Sought Mental Health Services,"The objective of this study was to profile trauma related psychiatric symptoms in a group of refugees not seeking mental health services and to consider the services implications. The study involved research assessments of two groups of Bosnian refugees: those who have not presented for mental health services and those who have. A total of 28 of 41 nonpresenters (70%) met symptom criteria for posttraumatic stress disorder (PTSD) diagnosis. All service presenters (N = 29) met symptom criteria for PTSD diagnosis. The group that did not present for services reported substantial but lower trauma exposure, PTSD symptom severity, and depression symptom severity. They had significant differences on all subscales of the MOS SF-36, indicating better health status. We concluded that those who do not seek services have substantial symptom levels, but their self-concept appears to be less oriented toward illness and help seeking. Innovative access, engagement, and preventive interventions are needed to address those who have symptoms but do not readily seek help for trauma mental health services.",0 +https://doi.org/10.1016/j.jpsychires.2011.01.009,"Acute panicogenic, anxiogenic and dissociative effects of carbon dioxide inhalation in patients with post-traumatic stress disorder (PTSD)","Increased anxiety and panic to inhalation of carbon dioxide (CO(2)) has been described in patients with anxiety disorders, especially panic disorder, compared to healthy subjects. Post-traumatic stress disorder (PTSD) has been hypothesised to resemble panic disorder and is currently classified as an anxiety disorder in DSM-IV. However, there are only very few data available about the sensitivity of patients with PTSD to CO(2).In 10 patients with PTSD, 10 sex- and age-matched healthy subjects and 8 patients with panic disorder we assessed anxiety, panic, dissociative and PTSD symptoms before and after a single vital capacity inhalation of 35% CO(2).Patients with PTSD showed an increased anxiety, panic and dissociative reaction to the inhalation of 35% CO(2) compared to healthy participants. PTSD subjects' responses were indistinguishable from those of panic patients. Additionally, PTSD-typical symptoms like post-traumatic flashbacks were provoked in patients with PTSD after the inhalation of CO(2).In our sample, PTSD was associated with an increased CO(2) reactivity, pointing to an increased susceptibility of PTSD patients to CO(2) challenge.",0 +https://doi.org/10.4088/jcp.v69n1002,A Pooled Analysis of Gender and Trauma-Type Effects on Responsiveness to Treatment of PTSD With Venlafaxine Extended Release or Placebo,"To examine effects of gender and trauma type on response to treatment with venlafaxine extended release (ER) or placebo in patients with posttraumatic stress disorder (PTSD).Data were pooled from 2 flexible-dose, parallel-group, randomized, double-blind, placebo-controlled trials: a 12-week trial conducted in the United States (March 2001 to December 2002) and a 24-week trial conducted in 12 countries outside the United States (October 2001 to December 2003). Six hundred eighty-seven outpatients with DSM-IV-diagnosed PTSD and a 17-item Clinician-Administered PTSD Scale abbreviated 1-week Symptom Status version (CAPS-SX-17) score > or = 60 were randomly assigned to treatment with venlafaxine ER (37.5 mg/day-300 mg/day, N = 340) or placebo (N = 347). The primary efficacy end point was the CAPS-SX-17 total score at week 12. Secondary end points included CAPS-SX-17 cluster scores for reexperiencing, avoidance/numbing, and hyperarousal and scores on the Connor-Davidson Resilience Scale (CD-RISC), Clinical Global Impressions-Severity of Illness scale, Sheehan Disability Scale (SDS), and 17-item Hamilton Rating Scale for Depression (HAM-D-17). Analysis-of-covariance models were used to test for differences by gender and trauma type (accidental injury, combat, nonsexual abuse, adult sexual abuse, childhood sexual abuse, unexpected death, and other), treatment (venlafaxine ER vs. placebo), and the treatment-by-trauma-type interaction.Using last-observation-carried-forward analysis, significant effects of treatment with venlafaxine ER were found on the CAPS-SX-17 total score and on all CAPS-SX-17 cluster scores and most other secondary measures. No significant treatment-by-gender interactions were observed. Trauma type significantly affected treatment responsiveness on symptom-related disability (SDS, p = .0057) and resilience (CD-RISC, p = .0012), with a nearly significant effect on depression (HAM-D-17, p = .0625).Overall, there does not appear to be a significant effect of gender on the efficacy of venlafaxine ER in the treatment of PTSD. Trauma type may affect treatment outcome but seems to affect domains such as disability and resilience more than core PTSD symptoms.",0 +https://doi.org/10.1001/archpsyc.62.6.629,Twelve-Month Use of Mental Health Services in the United States,"Dramatic changes have occurred in mental health treatments during the past decade. Data on recent treatment patterns are needed to estimate the unmet need for services.To provide data on patterns and predictors of 12-month mental health treatment in the United States from the recently completed National Comorbidity Survey Replication.Nationally representative face-to-face household survey using a fully structured diagnostic interview, the World Health Organization's World Mental Health Survey Initiative version of the Composite International Diagnostic Interview, carried out between February 5, 2001, and April 7, 2003.A total of 9282 English-speaking respondents 18 years and older.Proportions of respondents with 12-month DSM-IV anxiety, mood, impulse control, and substance disorders who received treatment in the 12 months before the interview in any of 4 service sectors (specialty mental health, general medical, human services, and complementary and alternative medicine). Number of visits and proportion of patients who received minimally adequate treatment were also assessed.Of 12-month cases, 41.1% received some treatment in the past 12 months, including 12.3% treated by a psychiatrist, 16.0% treated by a non-psychiatrist mental health specialist, 22.8% treated by a general medical provider, 8.1% treated by a human services provider, and 6.8% treated by a complementary and alternative medical provider (treatment could be received by >1 source). Overall, cases treated in the mental health specialty sector received more visits (median, 7.4) than those treated in the general medical sector (median, 1.7). More patients in specialty than general medical treatment also received treatment that exceeded a minimal threshold of adequacy (48.3% vs 12.7%). Unmet need for treatment is greatest in traditionally underserved groups, including elderly persons, racial-ethnic minorities, those with low incomes, those without insurance, and residents of rural areas.Most people with mental disorders in the United States remain either untreated or poorly treated. Interventions are needed to enhance treatment initiation and quality.",0 +https://doi.org/10.1016/j.physbeh.2008.01.023,Rats exposed to traumatic stress bury unfamiliar objects — A novel measure of hyper-vigilance in PTSD models?,"Electric shocks lead to lasting behavioral deficits in rodents, and as such are often used to model post-traumatic stress disorder (PTSD) in the laboratory. Here we show that a single exposure of rats to 3 mA-strong shocks results in a marked social avoidance that lasts at least 28 days; moreover, the response intensifies over time. In an attempt to study the impact of cue reminders on the behavior of shocked rats, we administered shocks in the presence of a highly conspicuous, 10 cm-large object. This object was introduced into the home cage of rats 28 days after shock exposure. Shocked rats manipulated the object considerably less than controls. More importantly, however, the object was buried by shocked rats. This behavior was virtually absent in controls. The response strongly depended on the intensity of shocks, and was robust. Rats shocked with 3 mA currents spent 40% of time burying the object, which was often hardly visible at the end of the 5 min test. Subsequent experiments demonstrated that the response was not cue-specific as unfamiliar objects were also buried. Rats are well known to bury dangerous objects; the shock-prod burying test of anxiety is based on this response. Behavioral similarities with this test and the differences from the marble-burying behavior of mice suggest that traumatized rats bury unfamiliar objects in defense, and the response can be interpreted as a sign of hyper-vigilance. We further suggest that object burying can be used as a sign of hyper-vigilance in models of PTSD.",0 +https://doi.org/10.1111/ner.12399,Trigeminal Nerve Stimulation for Comorbid Posttraumatic Stress Disorder and Major Depressive Disorder,"External stimulation of the trigeminal nerve (eTNS) is an emerging neuromodulation therapy for epilepsy and depression. Preliminary studies suggest it has an excellent safety profile and is associated with significant improvements in seizures and mood. Neuroanatomical projections of the trigeminal system suggest eTNS may alter activity in structures regulating mood, anxiety, and sleep. In this proof-of-concept trial, the effects of eTNS were evaluated in adults with posttraumatic stress disorder (PTSD) and comorbid unipolar major depressive disorder (MDD) as an adjunct to pharmacotherapy for these commonly co-occurring conditions.Twelve adults with PTSD and MDD were studied in an eight-week open outpatient trial (age 52.8 [13.7 sd], 8F:4M). Stimulation was applied to the supraorbital and supratrochlear nerves for eight hours each night as an adjunct to pharmacotherapy. Changes in symptoms were monitored using the PTSD Patient Checklist (PCL), Hamilton Depression Rating Scale (HDRS-17), Quick Inventory of Depressive Symptomatology (QIDS-C), and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q).Over the eight weeks, eTNS treatment was associated with significant decreases in PCL (p = 0.003; median decrease of 15 points; effect size d 1.5), HDRS-17 (p < 0.001; 42% response rate, 25% remission; d 2.1), and QIDS-C scores (p < 0.001; d 1.8), as well as an improvement in quality of life (Q-LES-Q, p < 0.01). eTNS was well tolerated with few treatment emergent adverse events.Significant improvements in PTSD and depression severity were achieved in the eight weeks of acute eTNS treatment. This novel approach to wearable brain stimulation may have use as an adjunct to pharmacotherapy in these disorders if efficacy and tolerability are confirmed with additional studies.",0 +https://doi.org/10.1111/nuf.12007,Military Resilience: A Concept Analysis,"Since the events surrounding September 11, 2011, and natural disasters, research on resilience has shifted from children to adult resilience. The military began to embrace the concept in 2008 in an effort to decrease the number of military service member (SM) suicides.The purpose of this article is to explain resilience as it relates to military SMs using the process for concept analysis outlined by Walker and Avant (2005).Adaptive coping, personal control, hardiness, and social support are the attributes that characterize psychological resilience in SMs. Antecedents for resilience are life events such as serious accidents, prior deployments where death is witnessed, and combat involvement. Consequences of high resilience include decreased mental health symptoms and career and personal success, while consequences of low resilience include increased mental health symptoms and participating in high-risk behaviors.Understanding resilience as it relates to SMs is critical. Nurses must be able to assess SMs and be equipped to refer them or their family members to the most appropriate care. As more is learned about resilience in the military community, there may be broader implications to the civilian community. Improved understanding of psychological resilience may lead to improved interventions appropriate for both civilians and military SMs.",0 +,Looking like the enemy: An interpretative phenomenological analysis of how race-related stressors in the military contribute to post traumatic stress disorder in Asian American and Pacific Islander Vietnam veterans,"Although significant evidence exists in the current literature about both the impact of race-related stressors on racial minority groups as well as the psychological impact of military-related stressors, there is very little research demonstrating the complexities of what a soldier may experience when a war is fought in a country where she/he resembles the enemy. This study explores how race-related stressors experienced in the military by Vietnam War veterans of Asian American and Pacific Islander (AAPI) ancestry contributed to the severity of post-traumatic stress disorder (PTSD) and other trauma-related psychiatric disorders. This topic has been explored by researchers out of the VA Pacific Islands Health Care System, National Center for PTSD in 1994 and their findings suggest that race-related stressors is a significant predictor of PTSD symptoms for Vietnam veterans of AAPI ancestry. Almost two decades since that study was conducted, this dissertation will examine, through the use of focus groups, if certain phenomenological themes have remained constant over time and also if new ones emerge. The generated hypothesis is that there will be phenomenological themes that abide over time related to the extended biopsychosocial effects of race-related stressors, particularly in the context of war. The second hypothesis posits that new themes will also surface as a result of the different political, social, and cultural climate these veterans currently reside in nearly two decades later. Clinical implications and suggestions for future research are also explored. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0 +https://doi.org/10.1007/978-1-4615-2820-3_39,The North Sea Oil Rig Disaster,"Located halfway between the United Kingdom and Norway, the Ekofisk is the most highly developed of the oil fields of the North Sea. Approximately two dozen permanent and a few floating rigs are in operation there; some of them are interconnected by bridges. From the Ekofisk pipelines, crude oil is channeled to Teesside in England and gas to Emden in western Germany. The basic function of the Ekofisk fields is the supply of energy, made possible by the gigantic achievements of modern technology. Considerable attention has been given to safety issues, yet accidents and disasters have occurred.",0 +https://doi.org/10.1037/0021-843x.112.4.526,The Use of Latent Trajectory Models in Psychopathology Research.,"Despite the recent surge in the development of powerful modeling strategies to test questions about individual differences in stability and change over time, these methods are not currently widely used in psychopathology research. In an attempt to further the dissemination of these new methods, the authors present a pedagogical introduction to the structural equation modeling based latent trajectory model, or LTM. They review several different types of LTMs, discuss matching an optimal LTM to a given question of interest, and highlight several issues that might be particularly salient for research in psychopathology. The authors augment each section with a review of published applications of these methods in psychopathology-related research to demonstrate the implementation and interpretation of LTMs in practice.",0 +https://doi.org/10.1016/j.janxdis.2015.06.002,Anxiety sensitivity and post-traumatic stress reactions: Evidence for intrusions and physiological arousal as mediating and moderating mechanisms,"A growing body of research has implicated anxiety sensitivity (AS) and its dimensions in the development of post-traumatic stress disorder (PTSD). However, the mechanism(s) that may account for the association between AS and PTSD remains unclear. Using the ""trauma film paradigm,"" which provides a prospective experimental tool for investigating analog intrusion development, the present study examines the extent to which intrusions mediate the association between AS and the development of posttraumatic stress reactions. After completing a measure of AS and state mood, unselected participants (n = 45) viewed a 10 min film of graphic scenes of fatal traffic accidents and then completed a second assessment of state mood. Participants then kept a daily diary to record intrusions about the film for a one-week period. Post-traumatic stress reactions about the film were then assessed after the one-week period. The results showed that general AS and physical and cognitive concerns AS predicted greater post-traumatic stress reactions about the film a week later. Furthermore, the number of intrusions the day after viewing the traumatic film, but not fear and disgust in response to the trauma film, mediated the association between general AS (and AS specifically for physical and cognitive concerns) and post-traumatic stress reactions a week later. Subsequent analysis also showed that physiological arousal during initial exposure to the traumatic film moderated the association between general AS and the number of intrusions reported the day after viewing the film. The implications of these analog findings for conceptualizing the mechanism(s) that may interact to explain the role of AS in the development of PTSD and its effective treatment are discussed.",0 +https://doi.org/10.1177/0093854814556882,Trajectories of Exposure to Community Violence and Mental Health Symptoms Among Serious Adolescent Offenders,"The present study uses longitudinal data to investigate whether differences in exposure to community violence discriminate among serious juvenile offenders in terms of mental health symptomatology for depression, anxiety, posttraumatic stress, and hostility. Group-based modeling and moderation analyses are used to assess the influence of exposure to violence on mental health outcomes. The results demonstrate a moderating effect of psychosocial maturity and social support between exposure to community violence and adverse mental health consequences for youth on the stable low exposure trajectory. In addition, youth who experience stable high exposure to violence consistently suffer worse outcomes. The study contributes to the development of empirically derived profiles of serious youth offenders. While all of the youth in this study may face the stigma of being labeled as dangerous, some (particularly those on the chronic exposure trajectory) might find themselves in a situation where their psychological status exacerbates an already tenuous situation: reentry. Therefore, reentry services should better target the specific needs of this returning subgroup of serious youth offenders.",0 +https://doi.org/10.1186/s40621-014-0016-1,A spatial analysis of functional outcomes and quality of life outcomes after pediatric injury,"BackgroundChanges in health-related quality of life (HRQoL) are more regularly being monitored during the first year after injury. Monitoring changes in HRQoL using spatial cluster analysis can potentially identify concentrations of geographic areas with injury survivors with similar outcomes, thereby improving how interventions are delivered or in how outcomes are evaluated.MethodsWe used a spatial scan statistic designed for oridinal data to test two different spatial cluster analysis of very low, low, high, and very high HRQoL scores. Our study was based on HRQoL scores returned by children treated for injury at British Columbia Children’s Hospital and discharged to the Vancouver Metropolitan Area. Spatial clusters were assessed at 4 time periods – baseline (based on pre-injury health as reported prior to discharge from hospital), and one, four, and twelve months after discharge. Outcome data were measured used the PedsQL™ outcome scale. Outcome values of very low, low, high, and very high HRQoL scores were defined by classifying PedsQL™ scores into quartiles. In the first test, all scores were assessed for clustering without specifying whether the response score was from a baseline or follow-up response. In the second analysis, we built a space-time model to identify whether HRQoL responses could be identified at specific time points.ResultsAmong all participants, geographic clustering of response scores were observed globally and at specific time periods. In the purely spatial analysis, five significant clusters of ‘very low’ PedsQL physical and psychosocial health outcomes were identified within geographic zones ranging in size from 1 to 21 km. A space-time analysis of outcomes identified significant clusters of both ‘very low’ and ‘low’ outcomes between survey months within zones ranging in size from 3 to 5 km.ConclusionMonitoring patient health outcomes following injury is important for planning and targeting interventions. A common theme in the literature is that future prevention efforts may benefit from identifying those most a risk of developing ongoing problems after injury in effort to target resources to those most in need. Spatial scan statistics are tools that could be applied for identifying concentrations of poor recovery outcomes. By classifying outcomes as a categorical variable, clusters of ‘potentially low’ outcomes can also be mapped, thereby identifying populations whose recovery status may decrease.",0 +https://doi.org/10.1093/occmed/kqn062,Post-Traumatic Stress Diagnostic Scale (PDS),,0 +https://doi.org/10.1016/s0140-6736(74)91639-0,ASSESSMENT OF COMA AND IMPAIRED CONSCIOUSNESS,"

Abstract

A clinical scale has been evolved for assessing the depth and duration of impaired consciousness and coma. Three aspects of behaviour are independently measured—motor responsiveness, verbal performance, and eye opening. These can be evaluated consistently by doctors and nurses and recorded on a simple chart which has proved practical both in a neurosurgical unit and in a general hospital. The scale facilitates consultations between general and special units in cases of recent brain damage, and is useful also in defining the duration of prolonged coma.",0 +https://doi.org/10.1016/j.jns.2013.02.001,Frequency and predictors of post-traumatic stress disorder after stroke: A pilot study,"

Abstract

Objective

Few data exist about post-stroke symptoms of post-traumatic stress disorder (sPTSD) and none on DSM-IV formally diagnosed PTSD (fdPTSD). We investigated the frequency and predictors of sPTSD and fdPTSD 1–6months after a nondisabling ischemic stroke (IS) or transient ischemic attack (TIA).

Methods

Consecutive patients were assessed for sPTSD (Impact of Events Scale-Revised, IES-R, significant if >30) and fdPTSD (PTSD-Interview). We recorded sociodemographic factors, stroke features (including severity of the initial deficit, persistent disability, localization), associated mood changes, peritraumatic reactions during the stroke (Peritraumatic Distress Inventory (PDI) for fear and distress, Peritraumatic Dissociative Experience Questionnaire for cognitive appraisal), and psychiatric history. Patients with sPTSD and fdPTSD were compared to patients with IES-R<30.

Results

Among the 40 patients (65% male, mean age 52years) studied post-IS (n=30; mean initial NIHSS 4) or TIA, 25% had sPTSD, including 10% with fdPTSD. sPTSD was more frequent in women (p=0.02), patients with intense peritraumatic reactions especially on PDI (p=0.001) or identified prior depression and anxiety (p=0.007). No other demographic factors or stroke characteristics were associated with sPTSD. Forty percent of sPTSD patients were depressed versus none of the controls (p<0.002). All fdPTSD patients had ≥3 prior psychiatric co-morbidities.

Conclusions

After nondisabling IS or TIA, sPTSD is frequent, with fdPTSD for 10%. Patients with intense peritraumatic reactions, women, and those with prior psychiatric morbidity, require particular attention to detect sPTSD.",0 +https://doi.org/10.1503/cmaj.131792,Child abuse and mental disorders in Canada,"Nationally representative Canadian data on the prevalence of child abuse and its relation with mental disorders are lacking. We used contemporary, nationally representative data to examine the prevalence of 3 types of child abuse (physical abuse, sexual abuse and exposure to intimate partner violence) and their association with 14 mental conditions, including suicidal ideation and suicide attempts.We obtained data from the 2012 Canadian Community Health Survey: Mental Health, collected from the 10 provinces. Respondents aged 18 years and older were asked about child abuse and were selected for the study sample (n = 23,395). The survey had a multistage stratified cluster design (household response rate 79.8%).The prevalence of any child abuse was 32% (individual types ranged from 8% to 26%). All types of child abuse were associated with all mental conditions, including suicidal ideation and suicide attempts, after adjustment for sociodemographic variables (adjusted odds ratios ranged from 1.4 to 7.9). We found a dose-response relation, with increasing number of abuse types experienced corresponding with greater odds of mental conditions. Associations between child abuse and attention deficit disorder, suicidal ideation and suicide attempts showed stronger effects for women than men.We found robust associations between child abuse and mental conditions. Health care providers, especially those assessing patients with mental health problems, need to be aware of the relation between specific types of child abuse and certain mental conditions. Success in preventing child abuse could lead to reductions in the prevalence of mental disorders, suicidal ideation and suicide attempts.",0 +https://doi.org/10.1097/htr.0b013e318250e9dd,"Traumatic Brain Injury, Shell Shock, and Posttraumatic Stress Disorder in the Military—Past, Present, and Future","With preferential use of high explosives in modern warfare, traumatic brain injury (TBI) has become a common injury for troops. Most TBIs are classified as ""mild,"" although military personnel with these injuries can have persistent symptoms such as headache, memory impairment, and behavioral changes. During World War I, soldiers in the trenches, undergoing unrelenting artillery bombardment, suffered from similar symptoms, designated at the time as ""shell shock."" Dr Frederick Mott proposed studying the brains of deceased soldiers to elucidate the neuropathology of this clinical entity. Subsequent to a British government enquiry after World War I, the term ""shell shock"" was banned and further investigation into a possible organic cause for these symptoms was discontinued. Nevertheless, similar clinical entities, such as combat or battle fatigue and posttraumatic stress disorder, continue to be encountered by combatants in subsequent military conflicts. To this day, there exists a paucity of neuropathology studies investigating the effects of high explosives on the human brain. By analogy, studies have recently revealed that athletes with repeated head trauma can develop a neurodegenerative disease, chronic traumatic encephalopathy, who present with similar clinical features. Given current circumstance, we propose completing the work envisioned by Dr Mott almost 100 years ago.",0 +https://doi.org/10.1191/1740774506cn133oa,Consumer involvement in consent document development: a multicenter cluster randomized trial to assess study participants' understanding,"Despite widespread agreement on the importance of informed consent in clinical research, uncertainty remains about the adequacy of current consent procedures and documentation.The objective of the study was to compare an informed consent document developed by a consumer group of potential study participants to one developed by the study investigators. The study was a cluster randomized, controlled study embedded in a 'parent' randomized controlled trial of 1092 participants with Gulf War veterans' illnesses recruited in 1999-2000 at 20 US medical centers. Centers were randomized to the investigator-developed or participant-developed consent document. The primary outcome measure was an Informed Consent Questionnaire-4 (ICQ-4), a validated four-item scale measuring self-reported participant understanding scored from 0 to 1. Secondary outcomes included the Client Satisfaction Questionnaire-8 and measures of study refusal and adherence to the parent trial protocol.There were no significant differences between consent documents on the ICQ-4 score overall or at any of the time points. Mean (95% CI) treatment differences ranged from +0.020 (-0.015, 0.055) (better understanding) at entry to -0.021 (-0.054, 0.012) (worse understanding) at three-months for the participant versus the investigator document group. There were also no significant differences in satisfaction, adherence to the protocol, or in the proportion of patients who refused to participate in the trial.The consumer group may not have been representative of the study participants and they did not suggest dramatic changes to the consent document. The outcome assessment questionnaire was not validated prior to the trial's initiation.Consumer modification of the consent document did not lead to either benefit or harm in understanding, satisfaction, or study refusal and adherence rates. This study did demonstrate, however, that embedding consent studies in a clinical trial is feasible and can address important questions about informed consent without disrupting the primary study.",0 +https://doi.org/10.1007/s00127-004-0868-8,"Epidemiology of multiple childhood traumatic events: child abuse, parental psychopathology, and other family-level stressors","Background: Multiple family-level childhood stressors are common and are correlated. It is unknown if clusters of commonly co-occurring stressors are identifiable. The study was designed to explore family-level stressor clustering in the general population, to estimate the prevalence of exposure classes, and to examine the correlation of sociodemographic characteristics with class prevalence. Method: Data were collected from an epidemiological sample and analyzed using latent class regression. Results: A six-class solution was identified. Classes were characterized by low risk (prevalence = 23%), universal high risk (7 %), family conflict (11 %), household substance problems (22 %), non-nuclear family structure (24 %), parent's mental illness (13 %). Conclusions: Class prevalence varied with race and welfare status, not gender. Interventions for childhood stressors are person-focused; the analytic approach may uniquely inform resource allocation. © Steinkopff Verlag 2004.",0 +,Optimization and characterization of an antagonist for vasopressin 1a (V1a) receptor,"Evidence from preclinical and human studies demonstrate that arginine vasopressin and vasopressin receptor 1a (V1a-R) play a crucial role in the pathophysiology of psychiatric disorders such as anxiety, depression and post-traumatic stress disorder (PTSD). The lack of selective, brain-penetrant and orally active V1a receptor antagonists has hampered the progress in our understanding of the precise/complete pharmacological role of V1a-R in central nervous system disorders and the development of novel treatments for these disorders. The optimization of promising V1a-R antagonist lead compounds and testing in known and relevant in vivo animal models will be a significant step forward in our understanding of the role of V1a-R in CNS disorders and in the development of novel treatments of anxiety, depression and PTSD. The lack of published data regarding brain-penetration and off-target selectivity, along with intellectual property barriers of the known V1a-R antagonists precludes their potential usefulness as CNS agents. As a result, there is a substantial need to discover centrally active V1a-R antagonists that are useful as in vivo tools to better understand the pharmacological role of V1a-R in CNS disorders with the potential as clinically therapeutic agents. The Scripps Research Institute Molecular Screening Center (SRIMSC), part of the Molecular Libraries Probe Production Centers Network (MLPCN), reports ML389 as a highly potent V1a-R antagonist with an IC50 of 40 nM, and high selectivity (selectivities vs. vasopressin 1b receptor, vasopressin 2 receptor, and the oxytocin receptor of >1250 fold). ML389 was identified by medicinal chemistry optimization of lead compounds. A set of pharmacokinetic analyses show that ML389 has good brain penetration, no significant activity at four human cytochrome P450 subtypes, high binding for human and rodent plasma protein, and an encouraging in vivo pharmacokinetic profile in mice. Broad selectivity screening data against a panel of receptors, transporters, and ion channels suggest that ML389 is generally inactive against a broad array of off targets and does not likely exert unwanted effects. ML389 serves as a novel V1a-R antagonist that can be developed as a therapeutic for the treatment of psychiatric disorders such as anxiety, depression and PTSD.",0 +https://doi.org/10.1177/003335491112600211,Evaluating Risk Factors and Possible Mediation Effects in Posttraumatic Depression and Posttraumatic Stress Disorder Comorbidity,"Objectives. On September 11, 2001 (9/11), attacks on the World Trade Center (WTC) killed 341 Fire Department of the City of New York (FDNY) firefighters and injured hundreds more. Previous WTC-related studies reported high rates of comorbid depression and posttraumatic stress disorder (PTSD), identifying disability retirement, alcohol use, and early arrival at the WTC site as correlates. However, those studies did not evaluate risk factors that could have mediated the observed comorbidity. We identified unique risk factors for each condition in an effort to better understand comorbidity. Methods. We screened retired WTC-exposed firefighters using self-administered questionnaires including the Center for Epidemiologic Studies Depression Scale, the Post Traumatic Stress Disorder Checklist, and the Alcohol Use Disorders Identification Test. We performed regression analyses to compare independent predictors of elevated depression and PTSD risk, and also tested a mediation hypothesis. Results. From December 2005 to July 2007, 23% and 22% of 1,915 retirees screened positive for elevated depression and PTSD risk, respectively, with comorbidity >70%. Controlling for comorbidity, we identified unique risk factors for (7) depression: problem alcohol use and (2) PTSD: early arrival at the WTC site. Conclusions. Our data support the premise that PTSD and depression are different responses to trauma with unique risk factors. The data also suggest a hypothesis that PTSD mediates the relationship between early WTC arrival and depression, while depression mediates the relationship between alcohol use and PTSD, a more complex relationship than shown in previous studies. Clinicians should consider these factors when evaluating patients for depression and PTSD.",0 +https://doi.org/10.1017/s135246581500003x,Treating Multiple Incident Post-Traumatic Stress Disorder (PTSD) in an Inner City London Prison: The Need for an Evidence Base,"Background: Mental health problems have been found to be more prevalent in prison populations, and higher rates of post-traumatic stress disorder (PTSD) have been found in sentenced populations compared to the general population. Evidence-based treatment in the general population however has not been transferred and empirically supported into the prison system. Aims: The aim of this manuscript is to illustrate how trauma focused work can be applied in a prison setting. Method: This report describes a two-phased approach to treating PTSD, starting with stabilization, followed by an integration of culturally appropriate ideas from narrative exposure therapy (NET), given that the traumas were during war and conflict, and trauma-focused cognitive behavioural therapy (TF-CBT). Results : PTSD and scores on paranoia scales improved between start and end of treatment; these improvements were maintained at a 6-month follow-up. Conclusion : This case report 1 illustrates successful treatment of multiple incident PTSD in a prison setting using adaptations to TF-CBT during a window of opportunity when individuals are more likely to be free from substances and live in relative stability. Current service provision and evidence-based practice for PTSD is urgently required in UK prisons to allow individuals to engage in opportunities to reduce re-offending, free from mental health symptoms.",0 +https://doi.org/10.1097/wnr.0000000000000232,Stress-induced enhancement of fear conditioning activates the amygdalar cholecystokinin system in a rat model of post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD), a debilitating psychiatric disease characterized by invasive and persistent fear memories-induced stressful experience, is associated with numerous changes in neuroendocrine function. Here, we investigated whether PTSD-like symptoms are associated with changes in the cholecystokinin (CCK) system in the basolateral amygdala. We developed an animal model of PTSD using multiple foot shocks at 1.1 mA. The resulting conditioned fear response was severe (>80% freezing) and maintained for at least 28 days. The stress-associated neurotransmitters norepinephrine, dopamine, and corticotrophin-releasing hormone were elevated at 1 day after foot shock. CCK immunoreactivity and extracellular concentration as well as the expression of CCK receptors (CCK1R, CCK2R) increased progressively for 28 days following foot shock. Taken together, these results suggest that stress-induced activation of the CCK system in the BLA, which may contribute toward the development of PTSD-like symptoms.",0 +https://doi.org/10.1891/088667007782312186,"Female Domestic Violence Offenders: Their Attachment Security, Trauma Symptoms, and Personality Organization","Unlike male domestic violence offenders, female domestic violence offenders have traditionally been overlooked in research and theory, despite the fact that females also have high rates of domestic violence perpetration. Towards the aim of extending extant research on male and female pepetrators of domestic violence, we examined attachment style, trauma symptoms, and personality organization in 33 female offenders receiving mandated treatment for domestic violence. These offenders were compared to 32 nonoffending women receiving psychological treatment. The Experiences in Close Relationships Revised (ECR-Revised) was used to examine adult attachment, the Trauma Symptom Inventory (TSI) was used to examine trauma symptomology, and finally, the Millon Clinical Multiaxial Inventory III (MCMI-III) was used to examine cluster B personality traits. Analyses indicated that female domestic violence offenders reported less attachment security, more trauma-related symptoms, and more personality psychopathology (Antisocial, Borderline, and Dependent Subscales) than did nonoffender clinical comparison women. © 2007 Springer Publishing Company.",0 +https://doi.org/10.1016/j.jad.2010.09.026,Identification of post traumatic stress disorder and risk factors in military first responders 6months after Wen Chuan earthquake in China,"Military personnel commonly serve as first responders to natural disasters. Our aim is to identify Post-Traumatic Stress Disorder (PTSD) and determine risk in military responders to the Wen Chuan earthquake.Analyses were carried out on 1056 of the 1125 soldiers enrolled. In addition to social demographic characteristics, the Davidson Trauma Scale (DTS) and an Earthquake exposure screening scale were administered.PTSD prevalence was 6.53% (69 cases). Logistic regression indicated that intensity of traumatic exposure (odds ratio 6.46, 95% CI 4.47-9.32, p<0.001), not having received psychological counseling (odds ratio 3.28, 95% CI 1.31-8.20, p<0.02) and regular drinking (odds ratio 2.42, 95% CI 1.04-5.62, p<0.05) were significant predictors of PTSD. Being a single-child, not being raised by both parents and regular smoking also independently predicted PTSD if intensity of earthquake traumatic exposure was not included in the model.The self-rated DTS was used to classify PTSD in this study and psychiatric co-morbidity outside of PTSD was not assessed in this sample.PTSD is a concern for Military disaster responders; to identify those with high risk of developing PTSD would be important and beneficial.",0 +https://doi.org/10.3390/ijms150915924,Therapeutic Effects of Melatonin Receptor Agonists on Sleep and Comorbid Disorders,"Several melatonin receptors agonists (ramelteon, prolonged-release melatonin, agomelatine and tasimelteon) have recently become available for the treatment of insomnia, depression and circadian rhythms sleep-wake disorders. The efficacy and safety profiles of these compounds in the treatment of the indicated disorders are reviewed. Accumulating evidence indicates that sleep-wake disorders and co-existing medical conditions are mutually exacerbating. This understanding has now been incorporated into the new Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Therefore, when evaluating the risk/benefit ratio of sleep drugs, it is pertinent to also evaluate their effects on wake and comorbid condition. Beneficial effects of melatonin receptor agonists on comorbid neurological, psychiatric, cardiovascular and metabolic symptomatology beyond sleep regulation are also described. The review underlines the beneficial value of enhancing physiological sleep in comorbid conditions.",0 +https://doi.org/10.1097/01.pcc.0000144705.81825.ee,Short-term psychiatric adjustment of children and their parents following meningococcal disease,"To assess short-term changes in child and parent psychiatric status following meningococcal disease.Prospective cohort study; 3-month follow-up using parent, teacher, and child questionnaires.Hospital admissions to three pediatric intensive care units and 19 general pediatric wards.Sixty children aged 3-6 yrs, 60 mothers, and 45 fathers.We administered measures of illness severity (Glasgow Meningococcal Septicaemia Prognostic Score, days in hospital) and psychiatric morbidity (Strengths and Difficulties Questionnaires, parent and teacher versions; Impact of Event scales; General Health Questionnaire-28).In children admitted to pediatric intensive care units, parental reports at 3-month follow-up showed a significant increase in emotional and hyperactivity symptoms and in related impairment; symptoms of posttraumatic stress disorder were present in four of 26 (15%) children >8 yrs old. Regarding the parents, 26 of 60 (43%) mothers in the total sample had questionnaire scores indicative of high risk for psychiatric disorder and 22 of 58 (48%) for posttraumatic stress disorder. In fathers there was high risk for psychiatric disorder in 11 of 45 (24%) and for posttraumatic stress disorder in 8 of 43 (19%). Severity of the child's physical condition on admission was significantly associated with hyperactivity and conduct symptoms at follow-up. Length of hospital admission was associated with psychiatric symptoms in the child and posttraumatic stress disorder symptoms in parents. There were also significant associations between psychiatric symptoms in children and parents.Admission of children to pediatric intensive care units for meningococcal disease is associated with an increase in and high levels of psychiatric and posttraumatic stress disorder symptoms in children and parents. Length of admission is associated with psychiatric symptoms in children and posttraumatic stress disorder symptoms in parents. Pediatric follow-up should explore psychiatric as well as physical sequelae in children and parents.",0 +https://doi.org/10.1016/b978-0-444-52002-9.00018-8,Biological and clinical framework for posttraumatic stress disorder,"Three decades of posttraumatic stress disorder (PTSD) research have placed it well on the map. PTSD is a young disorder that started being properly understood only from 1980 with incorporation in DSM-III, in which it was acknowledged that exposure to traumatic events can lead to long-term psychopathology. This chapter reviews the history and nosology of the disorder, epidemiology, and etiology, as well as the clinical features. It lists the diagnostic assessments and provides an overview of the biological framework of the disorder by addressing brain, neurohormonal, and transmitter alterations. Exposure to traumatic events is commonplace. The majority of exposed subjects are resilient, as this is still the rule rather than the exception. The reported prevalence of PTSD is twice as common in females compared to males. The A criterion in PTSD expressed the traumatic event, after which the symptom clusters are based on intrusions, avoidance, and irritability. Gene–environmental studies are needed, with a focus on specific, distinct endophenotypes and influences from environmental factors (e.g., traumatic early-life experiences, with abuse or neglect, as well as exposure to disasters or combat). PTSD is often accompanied by comorbid disorders, such as depression and other anxiety disorders, as well as drug and alcohol abuse and dependence. The disorder is heterogeneous, sometimes with complex features that focus on emotional dysregulation, attachment, and dissociation. Several validated trauma assessments are available that allow quantification of trauma symptomatology. The biological framework is based on the concepts of stress sensitization and fear conditioning as well as failure of inhibition. After the decade of the hippocampus we have seen a shift to the decade of the amygdala in the new millennium. Given the specific role of the prefrontal cortex in (neuro)psychological functions in patients with PTSD (i.e., attention and cognitive interference), interest in the role of the prefrontal cortex will increase significantly. Increased multidisciplinary involvement, with inclusion of genetics, endocrinology, immunology, (neuro)psychology, and psychopathology, is essential to find consistency between biological, emotional, and cognitive dysfunction in PTSD. A variety of effective psychological and pharmacological interventions can be used to treat PTSD. The mechanisms of exposure therapy and cognitive therapy in influencing neurobiological markers need to be further investigated. The same goes for emerging therapies such as eye movement desensitization and reprocessing, virtual reality exposure, internet therapy, and neurofeedback. There are no specific drugs for PTSD, except for the treatment of irritability and depressive features with selective serotonin reuptake inhibitors. Other options, such as specific serotonergic agents, e.g., 5-HT1A antagonists, norepinephrine blockers, corticotropin-releasing factor antagonists, glucocorticoid receptor antagonists, prazosin and α1-adrenergic blocker with nightmares, and use of beta-blockers early after trauma exposure, are investigated. New treatment options such as d-cycloserine and cortisol seem to offer opportunities to influence memory consolidation of traumatic experiences in timed relation to exposure. For health economy it is important to be aware that there is an economic burden associated with PTSD, and treatments require the use of scarce resources. They will ultimately provide tools to ascertain the relative efficiency of different treatment options and plan the availability of these for the affected population. This can be seen as the biggest challenge for the future evolution of the disorder.",0 +https://doi.org/10.1111/fare.12103,"Child and Family Resilience: A Call for Integrated Science, Practice, and Professional Training","Science and practice focused on child resilience and family resilience have deep and intertwined roots, yet there have been surprisingly few efforts to systematically integrate the theory, findings, and implications of these two traditions of work. In this article, the authors discuss parallels in concepts and processes that link the sciences of child and family resilience and the potential of relational developmental systems theory to provide an integrative framework for understanding and promoting resilience in children and families. The authors describe components of an integrated approach to child and family resilience, highlighting examples from recent research, and discuss implications for research, practice, and professional training.",0 +https://doi.org/10.2307/2676301,Resolution of Stressful Experiences as an Indicator of Coping Effectiveness in Young Adults: An Event History Analysis,"Coping research has been limited by an almost exclusivefocus on emotional distress as an indicator of coping effectiveness. The present study considers the role of stressful event duration as an indicator of coping effectiveness. The effects of specific coping strategies on the duration and resolution of different types of stressful experiences was examined in a cross-sectional, retrospective study of a large young adult sample (N = 829; age range = 21 to 26; 60% female; 94% Caucasian). Results revealed that use of coping strategies varied among different types of stressors, which included interpersonal problems, role strains, illnesses, and transitional experiences. Event history analyses indicated that avoidance and active cognitive coping were linked with longer duration, while active behavioral coping was linked with shorter duration. These coping differences did not account for the differences in duration across stressor domain. Finally, the impact of coping on duration varied as events progressed.",0 +https://doi.org/10.1176/ajp.155.5.630,Prospective Study of Posttraumatic Stress Disorder and Depression Following Trauma,"OBJECTIVE: The purpose of this study was to prospectively evaluate the onset, overlap, and course of posttraumatic stress disorder (PTSD) and major depression following traumatic events. METHOD: The occurrence of PTSD and major depression and the intensity of related symptoms were assessed in 211 trauma survivors recruited from a general hospital's emergency room. Psychometrics and structured clinical interview (the Structured Clinical Interview for DSM-III-R and the Clinician-Administered PTSD Scale) were administered 1 week, 1 month, and 4 months after the traumatic event. Heart rate was assessed upon arrival at the emergency room for subjects with minor physical injury. Twenty-three subjects with PTSD and 35 matched comparison subjects were followed for 1 year. RESULTS: Major depression and PTSD occurred early on after trauma; patients with these diagnoses had similar recovery rates: 63 survivors (29.9%) met criteria for PTSD at 1 month, and 37 (17.5%) had PTSD at 4 months. Forty subjects (19.0%) met criteria for major depression at 1 month, and 30 (14.2%) had major depression at 4 months. Comorbid depression occurred in 44.5% of PTSD patients at 1 month and in 43.2% at 4 months. Comorbidity was associated with greater symptom severity and lower levels of functioning. Survivors with PTSD had higher heart rate levels at the emergency room and reported more intrusive symptoms, exaggerated startle, and peritraumatic dissociation than those with major depression. Prior depression was associated with a higher prevalence of major depression and with more reported symptoms. CONCLUSIONS: Major depression and PTSD are independent sequelae of traumatic events, have similar prognoses, and interact to increase distress and dysfunction. Both should be targeted by early treatment interventions and by neurobiological research.",0 +https://doi.org/10.4324/9781410601858-6,Latent Variable Mixture Modeling,"This chapter discusses models with latent variables that are continuous and/ or categorical. It also gives an overview of modeling issues related to crosssectional analysis using latent class models, modeling of longitudinal data using latent class models, and modeling of longitudinal data using a combination of continuous and categorical latent variables (growth mixture models). A series of examples are presented. The analyses are carried out within a general latent variable modeling f\work shown in the appendix using the Mplus program (Muthen & Muthen, 1998). Mplus input specifications for these analyses can be obtained from www.statmodel.com. To introduce the analyses, a brief overview of modeling ideas is presented in Figs. 1.1 to 1.3.",0 +https://doi.org/10.1017/s0033291707001456,"Olfactory identification dysfunction, aggression and impulsivity in war veterans with post-traumatic stress disorder","Background Due to neuropsychological conceptualizations of orbitoprefrontal cortex (OFC) dysfunction underpinning impulsive aggression and the incidence of such behaviour in post-traumatic stress disorder (PTSD), this study aimed to explore olfactory identification (OI) ability in war veterans with PTSD as a probe of putative OFC dysfunction; and to explore the utility of OI ability in predicting aggressive and impulsive behavior in this clinical population. Method Participants comprised 31 out-patient male war veterans with PTSD (mean=58.23 years, s.d .=2.56) recruited from a Melbourne Veterans Psychiatry Unit, and 31 healthy age- and gender-matched controls (mean=56.84 years, s.d .=7.24). All participants were assessed on clinical measures of PTSD, depression, anxiety, and alcohol misuse; olfactory identification; neurocognitive measures of dorsolateral prefrontal, lateral prefrontal and mesial temporal functioning; and self-report measures of aggression and impulsivity. Results War veterans with PTSD exhibited significant OI deficits (OIDs) compared to controls, despite uncompromised performance on cognitive measures. OIDs remained after covaring for IQ, anxiety, depression and alcohol misuse, and were significant predictors of aggression and impulsivity. Conclusions This research contributes to emerging evidence of orbitoprefrontal dysfunction in the pathophysiology underlying PTSD. This is the first study to report OIDs as a predictor of aggression and impulsivity in this clinical population. It prompts further exploration of the potential diagnostic utility of OIDs in the assessment of PTSD. Such measures may help delineate the clinical complexity of PTSD, and support more targeted interventions for individuals with a greater susceptibility to aggressive and impulsive behaviors.",0 +https://doi.org/10.4088/jcp.08m04347,The longitudinal course of posttraumatic stress disorder symptom clusters among war veterans.,"The aim of this study was to examine the long-term trajectories and interrelationships of posttraumatic stress disorder (PTSD) symptom clusters (intrusion, avoidance, and hyperarousal) in clinical and nonclinical groups of war veterans.Six hundred seventy-five Israeli veterans from the 1982 Lebanon War were assessed. The clinical group consisted of 369 who had combat stress reaction (CSR) during the war, and the nonclinical group consisted of 306 veterans with no antecedent CSR. The 2 groups were matched in age, education, military rank, and assignment. They were prospectively evaluated 1, 2, and 20 years after the war.The clinical group endorsed a higher number of symptoms than the nonclinical group, both cross-sectionally and across time. In both the clinical and nonclinical groups, the clusters of intrusion, avoidance, and hyperarousal were interrelated at any given point in time and across 20 years. In both groups, avoidance was found to be a particularly stable symptom cluster over time. Finally, hyperarousal levels 1 year after the war were found to play an important role in both groups, as they predicted future avoidance and intrusion symptoms.The findings of this study suggest that PTSD is not a monolithic disorder, as symptom clusters differ in several important aspects. Also, the course and severity of symptoms differ between clinical and nonclinical groups. Finally, practitioners are encouraged to focus on the identification and treatment of early hyperarousal due to its prominent role in the development of other PTSD symptoms.",0 +https://doi.org/10.1016/j.drugpo.2010.09.002,The expansion of the field of research on ayahuasca: Some reflections about the ayahuasca track at the 2010 MAPS “Psychedelic Science in the 21st Century” conference,"A recent conference sponsored by the Multidisciplinary Assoiation for Psychedelic Studies (MAPS) in collaboration with the effter Research Institute, the Beckley Foundation and the Council n Spiritual Practices held fromApril 15th to 18th 2010, in San Jose, SA (MAPS, 2010) united 90 presenters and 1100 participantswith he goal of giving visibility to studies on the therapeutic potentials f psychedelics (psilocybin,MDMA, ibogaine, ayahuasca, etc.) in the reatment of often intractable ailments such as anxiety in terminal ancer patients, cluster headaches, obsessive–compulsive disorers, drug addiction, and post-traumatic stress disorders, as well s the role of these substances in human enhancement and welleing in general. MAPS was chartered in 1986, with the mission to evelop cannabis and psychedelics into prescription medicines to reat illnesses, tobuildanetworkof clinicswhere theseprescription edicines can be administered, and to provide public education n the harm and benefits of using psychedelics and cannabis. The nstitution has managed to get the permission of the DEA and FDA o conduct a number of clinical trials with psychedelics over the ears. Straddling the fence between establishment and counterculure, MAPS has generally been criticized by mainstream medicine or promoting the use of “dangerous drugs,” while other members f the psychedelic community have complained thatMAPS is either oo medically focused or too incendiary in its tactics with the US overnment. Ultimately,MAPS continues to enjoy the popular suport of many and occupy a leading position on the field, such as the evelopment, with the support of other important institutions, of he Psychedelic Science in the 21st Century conference The gathering was held in Silicon Valley, where psychedelics ave often, though quietly, been credited with helping to inspire",0 +https://doi.org/10.1016/s0145-2134(96)00176-7,Refugee children in Sweden: Post-Traumatic Stress Disorder in Iranian preschool children exposed to organized violence,"Fifty preschool children from 47 Iranian families living as refugees in Sweden were assessed individually, simultaneously with parental interviews focusing on exposure to organized violence and post-traumatic stress symptomatology in the children. Information given by the children increased the prevalence of a Post-Traumatic Stress Disorder (PTSD) diagnosis (DSM-III-R) from 2% to 21% in the 42 children with traumatic exposure through war and political persecution. The amount of traumatic exposure was strongly related to the prevalence of PTSD. The stability of prevalence was high in a follow-up 2 and 1/2 years later; 23% of the children with traumatic exposure still met the full criteria of PTSD according to DSM-III-R.",0 +https://doi.org/10.1016/j.neubiorev.2010.12.016,Epigenetic mechanisms mediating vulnerability and resilience to psychiatric disorders,"The impact that stressful encounters have upon long-lasting behavioural phenotypes is varied. Whereas a significant proportion of the population will develop ""stress-related"" conditions such as post-traumatic stress disorder or depression in later life, the majority are considered ""resilient"" and are able to cope with stress and avoid such psychopathologies. The reason for this heterogeneity is undoubtedly multi-factorial, involving a complex interplay between genetic and environmental factors. Both genes and environment are of critical importance when it comes to developmental processes, and it appears that subtle differences in either of these may be responsible for altering developmental trajectories that confer vulnerability or resilience. At the molecular level, developmental processes are regulated by epigenetic mechanisms, with recent clinical and pre-clinical data obtained by ourselves and others suggesting that epigenetic differences in various regions of the brain are associated with a range of psychiatric disorders, including many that are stress-related. Here we provide an overview of how these epigenetic differences, and hence susceptibility to psychiatric disorders, might arise through exposure to stress-related factors during critical periods of development.",0 +https://doi.org/10.1093/brain/awv139,"Military blast exposure, ageing and white matter integrity","Mild traumatic brain injury, or concussion, is associated with a range of neural changes including altered white matter structure. There is emerging evidence that blast exposure-one of the most pervasive causes of casualties in the recent overseas conflicts in Iraq and Afghanistan-is accompanied by a range of neurobiological events that may result in pathological changes to brain structure and function that occur independently of overt concussion symptoms. The potential effects of brain injury due to blast exposure are of great concern as a history of mild traumatic brain injury has been identified as a risk factor for age-associated neurodegenerative disease. The present study used diffusion tensor imaging to investigate whether military-associated blast exposure influences the association between age and white matter tissue structure integrity in a large sample of veterans of the recent conflicts (n = 190 blast-exposed; 59 without exposure) between the ages of 19 and 62 years. Tract-based spatial statistics revealed a significant blast exposure × age interaction on diffusion parameters with blast-exposed individuals exhibiting a more rapid cross-sectional age trajectory towards reduced tissue integrity. Both distinct and overlapping voxel clusters demonstrating the interaction were observed among the examined diffusion contrast measures (e.g. fractional anisotropy and radial diffusivity). The regions showing the effect on fractional anisotropy included voxels both within and beyond the boundaries of the regions exhibiting a significant negative association between fractional anisotropy and age in the entire cohort. The regional effect was sensitive to the degree of blast exposure, suggesting a 'dose-response' relationship between the number of blast exposures and white matter integrity. Additionally, there was an age-independent negative association between fractional anisotropy and years since most severe blast exposure in a subset of the blast-exposed group, suggesting a specific influence of time since exposure on tissue structure, and this effect was also independent of post-traumatic stress symptoms. Overall, these data suggest that blast exposure may negatively affect brain-ageing trajectories at the microstructural tissue level. Additional work examining longitudinal changes in brain tissue integrity in individuals exposed to military blast forces will be an important future direction to the initial findings presented here.",0 +https://doi.org/10.1523/jneurosci.5080-14.2015,Predator Stress-Induced CRF Release Causes Enduring Sensitization of Basolateral Amygdala Norepinephrine Systems that Promote PTSD-Like Startle Abnormalities,"The neurobiology of post-traumatic stress disorder (PTSD) remains unclear. Intense stress promotes PTSD, which has been associated with exaggerated startle and deficient sensorimotor gating. Here, we examined the long-term sequelae of a rodent model of traumatic stress (repeated predator exposure) on amygdala systems that modulate startle and prepulse inhibition (PPI), an operational measure of sensorimotor gating. We show in rodents that repeated psychogenic stress (predator) induces long-lasting sensitization of basolateral amygdala (BLA) noradrenergic (NE) receptors (α1) via a corticotropin-releasing factor receptor 1 (CRF-R1)-dependent mechanism, and that these CRF1 and NE α1 receptors are highly colocalized on presumptive excitatory output projection neurons of the BLA. A profile identical to that seen with predator exposure was produced in nonstressed rats by intra-BLA infusions of CRF (200 ng/0.5 μl), but not by repeated NE infusions (20 μg/0.5 μl). Infusions into the adjacent central nucleus of amygdala had no effect. Importantly, the predator stress- or CRF-induced sensitization of BLA manifested as heightened startle and PPI deficits in response to subsequent subthreshold NE system challenges (with intra-BLA infusions of 0.3 μg/0.5 μl NE), up to 1 month after stress. This profile of effects closely resembles aspects of PTSD. Hence, we reveal a discrete neural pathway mediating the enhancement of NE system function seen in PTSD, and we offer a model for characterizing potential new treatments that may work by modulating this BLA circuitry.The present findings reveal a novel and discrete neural substrate that could underlie certain core deficits (startle and prepulse inhibition) that are observed in post-traumatic stress disorder (PTSD). It is shown here that repeated exposure to a rodent model of traumatic stress (predator exposure) produces a long-lasting sensitization of basolateral amygdala noradrenergic substrates [via a corticotropin-releasing factor (CRF)-dependent mechanism] that regulate startle, which is exaggerated in PTSD. Moreover, it is demonstrated that the sensitized noradrenergic receptors colocalize with CRF1 receptors on output projection neurons of the basolateral amygdala. Hence, this stress-induced sensitization of noradrenergic receptors on basolateral nucleus efferents has wide-ranging implications for the numerous deleterious sequelae of trauma exposure that are seen in multiple psychiatric illnesses, including PTSD.",0 +https://doi.org/10.1002/jclp.20283,Resilience in the face of potential trauma: Clinical practices and illustrations,"Many persons exposed to loss or potentially traumatic events manage the stresses of these experiences with minimal to no impact on their daily functioning. The prevalence of this resilient capacity has surprised researchers and clinicians alike and refocused clinical practice. We review three key points about resilience: resilience is different from the process of recovery; resilience in the face of loss or potential trauma is common; and there are multiple and sometimes unexpected pathways to resilience. We then present six clinical practices informed by the study of resilience, illustrating key points with clinical vignettes. © 2006 Wiley Periodicals, Inc. J Clin Psychol: In Session 62: 971–985, 2006.",0 +https://doi.org/10.1016/j.physbeh.2010.08.017,Novelty-evoked activity in open field predicts susceptibility to helpless behavior,"Learned helplessness in animals has been used to model disorders such as depression and post-traumatic stress disorder (PTSD), but there is a lack of knowledge concerning which individual behavioral characteristics at baseline can predict helpless behavior after exposure to inescapable stress. The first aim of this study was to determine behavioral predictors of helplessness using the novel and familiar open-field tests, sucrose consumption, and passive harm-avoidance tasks before learned helplessness training and testing. Individual differences in physiologic responses to restraint stress were also assessed. A cluster analysis of escape latencies from helplessness testing supported the division of the sample population of Holtzman rats into approximately 50% helpless and 50% non-helpless. Linear regression analyses further revealed that increased reactivity to the novel environment, but not general activity or habituation, predicted susceptibility to learned helplessness. During restraint stress there were no mean differences in heart rate, heart rate variability, and plasma corticosterone between helpless and non-helpless rats; however, a lower heart rate during stress was associated with higher activity levels during exploration. Our most important finding was that by using an innocuous screening tool such as the novel and familiar open-field tests, it was possible to identify subjects that were susceptible to learned helplessness.",0 +https://doi.org/10.1055/s-0034-1383507,"Use of a Frequency-Modulated System for Veterans with Blast Exposure, Perceived Hearing Problems, and Normal Hearing Sensitivity","Traumatic brain injury can impact the central auditory system leading to poor auditory recall and increased difficulties hearing in poor acoustic environments. In recent years, audiologists have increasingly encountered blast-exposed veterans who report speech understanding problems that are disproportionate to their essentially normal hearing sensitivity, and thus are thought to have an auditory processing disorder. In light of studies showing frequency-modulated (FM) systems to be effective rehabilitation for auditory processing difficulties, we examined the use of an FM system intervention for blast-exposed veterans with functional hearing problems in the presence of normal hearing sensitivity. The outcomes for three veterans who were provided with an FM system as part of a multisite randomized clinical trial are described. Data indicate that FM systems are beneficial for some patients reporting hearing problems in the presence of normal hearing sensitivity but factors other than audiometric profile and reported complaints influence outcome. These include understanding of speech in noise, patient communication demands, auditory lifestyle, and the presence of posttraumatic stress disorder or other mental health factors. Furthermore, education (and reeducation if necessary) of the patient and their spouse or family is critical to successful outcome.",0 +https://doi.org/10.1111/j.1467-9450.2005.00475.x,Post-traumatic stress disorder in a Danish population of elderly bereaved,"The objectives of this study were to examine psychological sequalae of loss of a spouse in late life especially the occurrence of post-traumatic stress disorder (PTSD) and possible predictors of PTSD and symptom development. Fifty-four bereaved Danes (mean age 75 years) from five geographically different areas were studied by the Harvard Trauma Questionnaire (HTQ), the Trauma Symptom Checklist (TSC), and the Crisis Support Scale (CSS). One month after the loss, 27% of the subjects had PTSD. Six months after the loss, this number decreased to 17%; if the A2 criterion was dismissed, the number increased to 24%. Lack of expressive ability, numbing, fear of death or illness, and helplessness in relation to the loss predicted 73% of the variance of the HTQ-total scores. The study concluded that for a considerable number of elderly, losing a spouse in late life appeared to be a traumatic experience. Pre- and peritraumatic factors together with numbing were important predictors of traumatization. Research implications are discussed.",0 +https://doi.org/10.1080/15434610600683742,"The Effects of Disaster Exposure and Post-Disaster Critical Incidents on Intrusions, Avoidance Reactions and Health Problems Among Firefighters: A Comparative Study","Firefighters are at risk to be confronted with critical incidents and disasters. This study focused on the predictive value of these variables and their interaction effect for intrusions, avoidance reactions, and health problems among firefighters 18 months post-disaster (N = 639). Furthermore, the course of intrusions, avoidance reactions, and health problems in the period 2–3 weeks to 18 months post-disaster was assessed. Health problems were compared with those of non-affected firefighters (N = 132). Results showed that only disaster exposure and critical incidents accounted for a significant but small proportion of the variance (R 2 < .07) of intrusions, avoidance reactions and health problems among the affected firefighters. Health problems among affected firefighters did not decline in the period 2–3 weeks–18 months post-disaster, in contrast to intrusions and avoidance reactions. Health problems of both groups were comparable at T2. Results suggest that resilience in firefighters is rather high.",0 +https://doi.org/10.1016/j.ejpain.2010.03.004,Quantitative somatosensory testing of subjects with chronic post-traumatic headache: Implications on its mechanisms,"Chronic headache is one of the most prominent symptoms among subjects with traumatic head injury (THI). Despite the relatively high prevalence of chronic post-traumatic headache (CPTHA) and its enormous effect on the already poor quality of life of subjects with THI, its mechanisms has not been studied in depth.To conducted quantitative somatosensory testing in THI subjects with and without chronic post-traumatic headache (CPTHA) in order to shed light on the yet, unknown pathophysiology of CPTHA.THI subjects with and without CPTHA and healthy controls underwent thermal and mechanical threshold measurements in painful and pain-free regions in the head and in their hands (a remote pain-free region) and filled out and the post-traumatic stress disorder (PTSD) inventory. In addition, the THI and CPTHA filled out the Mc'Gill pain questionnaire (MPQ).THI subjects with CPTHA had significantly higher thermal thresholds in both the head and hand indicating central damage to the pain and temperature system and in addition, a significantly lower pressure-pain threshold in the head as well as more severe PTSD symptomatology than the pain-free THI subjects and healthy controls.The sensory profile of subjects with CPTHA suggests that CPTHA may be a form of central pain. The cranial mechanical hyperalgesia may originate from peripheral tissue damage accompanying the THI. Psychological factors may contribute to the development, and maintenance of CPTHA in susceptible individuals.",0 +https://doi.org/10.1038/mp.2011.118,No association between ADCYAP1R1 and post-traumatic stress disorder in two independent samples,"Presents a study which aims to replicate genetic association between single nucleotide polymorphisms rs2267735 and post-traumatic stress disorder (PTSD) in two independent samples. The first sample consisted of women from the Nurses' Health Study II (NHSII) and second sample contained 6074 individuals recruited for genetic studies of substance dependence at five US sites. The authors were unable to replicate the association between rs2267735 and PTSD in these two large independent samples. The findings do not, however, exclude the possibility that the pituitary adenylate cyclase-activating peptide-ligand type 1 receptor (PACAP-PACl1) receptor pathway has a role in the production of PTSD. Further research is needed to understand how selection factors, demographic characteristics and social context influence the role of the PACAP-PACl receptor pathway in PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1682/jrrd.2011.10.0194,Review of VA/DOD Clinical Practice Guideline on management of acute stress and interventions to prevent posttraumatic stress disorder,"This article summarizes the recommendations of the Department of Veterans Affairs (VA)/Department of Defense (DOD) VA/DOD Clinical Practice Guideline for Management of Post-Traumatic Stress that pertain to acute stress and the prevention of posttraumatic stress disorder, including screening and early interventions for acute stress states in various settings. Recommended interventions during the first 4 days after a potentially traumatic event include attending to safety and basic needs and providing access to physical, emotional, and social resources. Psychological first aid is recommended for management of acute stress, while psychological debriefing is discouraged. Further medical and psychiatric assessment and provision of brief, trauma-focused cognitive-behavioral therapy are warranted if clinically significant distress or functional impairment persists or worsens after 2 days or if the criteria for a diagnosis of acute stress disorder are met. Follow-up monitoring and rescreening are endorsed for at least 6 months for everyone who experiences significant acute posttraumatic stress. Four interventions that illustrate early intervention principles contained in the VA/DOD Clinical Practice Guideline are described.",0 +https://doi.org/10.7205/milmed-d-13-00234,Recruitment and Attrition Issues in Military Clinical Trials and Health Research Studies,"conducting long-term multidisciplinary research projects across a range of military health issues. The plethora of individually funded studies, program grants, and multisite military health research consortia speak to the considerable national investment in the well-being of the U.S. service member. In the context of the current economic situation, maximizing efficiency through optimal human subject participation is of paramount importance to research. A range of factors, however, can contribute to less-than-ideal levels of study participation. 5 Poor recruitment and high dropout rates are not only frustrating and costly, but they also pose a threat to the interpretation, integrity, and validity of research findings. A number of articles have reported obstacles to civilian study participation and have outlined strategies for overcoming those obstacles. 5‐11 However, to the best of our knowledge, none have been devoted to the unique challenges inherent to research with military service members. In this commentary, we review the civilian literature for recruitment and retention factors that potentially may also have relevance to military populations. We then examine research study recruitment and attrition in the U.S. military, highlighting militaryspecific issues that may impact study participation. Finally, we suggest strategies for improving research participation by service members.",0 +https://doi.org/10.2340/16501977-1156,"Depressive symptoms and psychological distress during the first five years after traumatic brain injury: Relationship with psychosocial stressors, fatigue and pain","To determine the prevalence of depressive symptoms among individuals with traumatic brain injury (TBI) and to identify predictors of depressive symptoms and psychological distress.A longitudinal study with assessments at 3 months, 1 year and 5 years after injury.A total of 118 individuals (29% females; mean age 32.5; range 16-55 years) with mild-to-severe TBI who were hospitalized in the Trauma Referral Centre from 2005 to 2007.Self-report assessments using the Hospital Anxiety- and Depression Scale, the Symptom Checklist 90-Revised and the Fatigue Severity Scale. Injury severity, trauma scores, pain, fatigue, substance abuse and demographic characteristics were also recorded.The prevalence of depressive symptoms was 18% at 3 months, 13% at 1 year and 18% at 5 years after injury. Only 4% had persistent depressive symptoms at all time-points. At 1 year post-injury, anxiety, age, ongoing stressors and employment status predicted depressive symptoms (R2 = 0.43, p < 0.001), and ongoing stressors, employment status, fatigue and pain predicted psychological distress (R2 = 0.45, p < 0.001).Psychosocial stressors and employment status contributed to depressive symptoms and psychological distress, whereas injury severity did not have any predictive value. The prevalence of depressive symptoms remained stable over time, emphasizing the importance of recognizing and treating depression early after the injury.",0 +https://doi.org/10.1002/jts.22055,Mental Health Over Time in a Military Sample: The Impact of Alcohol Use Disorder on Trajectories of Psychopathology After Deployment,"To identify trajectories of depression and posttraumatic stress (PTS) symptom groups after deployment and determine the effect of alcohol use disorder on these trajectories, depression symptoms were modeled using the 9-item Patient Health Questionnaire in 727 Ohio National Guard members, and PTS symptoms were modeled using the PTSD Checklist in 472 Ohio National Guard members. There were 55.8% who were resistant to depression symptoms across the 4 years of study, and 41.5% who were resistant to PTS symptoms. There were 18.7% and 42.2% of participants who showed resilience (experiencing slightly elevated symptoms followed by a decline, according to Bonanno et al., 2002) to depression and PTS symptoms, respectively. Mild and chronic dysfunction constituted the smallest trajectory groups across disorders. Marital status, deployment to an area of conflict, and number of lifetime stressors were associated with membership into different latent groups for depression (unstandardized β estimates range = 0.69 to 1.37). Deployment to an area of conflict, number of lifetime traumatic events and education predicted membership into different latent groups for PTS (significant unstandardized β estimate range = 0.83 to 3.17). AUD was associated with an increase in both symptom outcomes (significant unstandardized β estimate range = 0.20 to 9.45). These results suggested that alcohol use disorder may have contributed substantially to trajectories of psychopathology in this population.",1 +https://doi.org/10.1097/ta.0b013e3182199072,Health-related quality of life after burns,"Health-related quality of life (HRQOL) is an important parameter after medical treatments. Knowledge of (predictors of) diminished quality of life can help improve medical outcome. The aim of this study was to quantify health loss in patients with burns and to assess the contribution of injury extent, age, gender, and psychologic factors to HRQOL and speed of recovery. A multicenter prospective cohort design was used to address these aims.Data were obtained from 260 adults with burns. Patients completed the EQ-5D at 3 weeks, 3, 6, 9, and 18 months after burn and psychologic questionnaires during hospitalization. Patients' scores were compared with an age- and gender-weighted normpopulation.Patients suffered from substantial health losses at short term, but after 18 months the majority reached a HRQOL comparable with the norm population with the exception of patients requiring two or more surgeries. The best predictor of long-term HRQOL and the speed of recovery was the number of surgeries, followed by psychologic problems. Both predicted baseline and trajectories of improvement. Symptoms of traumatic stress were most debilitating over time.Both injury severity and psychologic problems play a pivotal role in reduced HRQOL and the speed of recovery. The number of surgeries seems to give a practically useful indication of the expected recovery speed that could aid in decision making and provides adequate information for patients in the aftermath of their initial surgical treatment. Screening for traumatic stress is recommended.",0 +https://doi.org/10.1016/j.eurpsy.2005.03.007,"A comparative study of fluoxetine, moclobemide, and tianeptine in the treatment of posttraumatic stress disorder following an earthquake","Abstract. Purpose Although antidepressant drugs have been proven as an effective treatment for posttraumatic stress disorder (PTSD), there are few comparative studies of antidepressants that are acting on different neurotransmitters. The main aim of this study is to compare the efficacy of different class of antidepressant drugs on the PTSD. Subjects/materials and methods. – In this open label study, the patients who met DSM-IV criteria for PTSD were randomly assigned to flexible doses of fluoxetine, moclobemide, or tianeptine. After the first assessment, consecutive assessments were performed at the end of weeks 2, 4, 8, and 12 using clinician administered PTSD scale (CAPS) and Clinical Global Impression of Severity (CGI-S). Changes in the total score of CAPS and sub-scale scores of symptom clusters (re-experience, avoidance, and hyperarousal) were the main output of efficacy. All statistics were based on intention-to-treat and last-observation-carried-forward (LOCF) principles. Results. Thirty-eight patients were assigned to fluoxetine, 35 patients were assigned to moclobemide, and 30 patients were assigned to tianeptine group. Gender distributions and mean ages of the treatment groups were not significantly different. Drop-out rates due to an adverse events or unknown reasons were not significantly different among fluoxetine (18.4%), moclobemide (14.3%), and tianeptine (20.0%) groups. All three treatments has led to a significant improvement in PTSD severity assessed with CAPS total score (ANOVA P < 0.001). Similarly, total scores of re-experiencing, avoidance, and hyperarousal clusters that are subscales of CAPS were significantly reduced by all three treatments (with ANOVA all P values < 0.001). There was not significant difference in terms of treatment effect between three groups. Discussion. – Treatment groups showed very similar improvement on all ratings scales. The findings support that fluoxetine, moclobemide, and tianeptine are all effective in the treatment of PTSD. Different mechanisms of action for these antidepressant drugs might result in the same common neurochemical end point. However, further studies using different classes of antidepressant drugs are needed.",0 +https://doi.org/10.1080/13811118.2013.845123,Suicide Ideation and Deliberate Self-Harm among Ex-Prisoners of War,"The current study aims to assess the relations among war captivity, PTSD, suicidal ideation (SI), and deliberate self-harm (DSH) among former prisoners of war (ex-POWs). Israeli ex-POWs (N = 176) and a matched control group of combat veterans (controls; N = 118) were assessed using self-report measures. Ex-POWs with PTSD reported higher levels of both SI and DSH compared to ex-POWs and comparable veterans without PTSD. Furthermore, captivity-related variables as well as PTSD symptom clusters were positively related to both SI and DSH. However, only loss of emotional control in captivity and posttraumatic intrusion and emotional numbing symptoms, predicted SI. Ex-POWs with PTSD endorse high levels of SI and DSH. Among ex-POWs, both SI and DSH share similar captivity-related and posttraumatic symptoms correlates but only posttraumatic intrusion and emotional numbing symptoms predict SI.",0 +https://doi.org/10.1037/ort0000001,"Examining cumulative victimization, community violence exposure, and stigma as contributors to PTSD symptoms among high-risk young women.","This study examines patterns of lifetime victimization within the family, community violence exposure, and stigma as contributors to posttraumatic stress disorder (PTSD) symptoms within a sample of 198 high-risk young women who are pregnant or parenting. We used cluster analysis to identify 5 profiles of cumulative victimization, based on participants' levels of witnessing intimate partner violence (IPV), physical abuse by an adult caregiver, and sexual victimization, all beginning by age 12. Hierarchical regression was used to examine these 5 clusters (ranging from a High All Victimization cluster characterized by high levels of all 3 forms of violence, to a Low All Victimization cluster characterized by low levels of all 3 forms), along with community violence exposure and stigma, as predictors of PTSD symptoms. We found that 3 of the cumulative victimization clusters, in comparison with Low All Victimization, were significant predictors of PTSD symptoms, as was stigma, while community violence exposure was not a significant predictor.",0 +,Post traumatic stress disorder: Insights from cat hair and catfish,"Post traumatic stress disorder (PTSD) is an anxiety disorder that develops in some, but not all, individuals following a traumatic experience. Established PTSD is difficult to treat, therefore prevention and early intervention is important to reduce prevalence. Identifying individuals susceptible to developing PTSD before trauma exposure and investigating neurophysiological processes that contribute to the disease will help develop better treatment and preventive methods. Limitations to such investigations in humans make animal models a necessary tool. Like humans, only some rats develop PTSD-like behavior after trauma but pre-trauma identification of these rats was not possible until now. We were able to reliably predict before trauma exposure which rats are susceptible (Susceptible) or resistant (Resistant) to developing two PTSD-like symptoms: impaired fear extinction and lasting elevation in acoustic startle responses. We hypothesized that Susceptible rats will have pre-existing alterations in plasticity-related responses in the hippocampus, a brain region whose altered size and function is associated with PTSD diagnosis. We also hypothesized that Susceptible rats will differ from Resistant rats in the acquisition of a traumatic event and tested this using Arc/H1a catFISH, a cellular imaging technique that detects neurons expressing plasticity-related immediate early genes (IEGs) during behavior. We found that, in Resistant rats a large proportion of the same dorsal CA1 (dCA1) neurons expressed IEGs during two identical explorations of the experimental box. This suggests that dCA1 responds to identical events with high fidelity. In Susceptible rats, however, different neuronal ensembles expressed IEGs during identical explorations suggesting a lack of fidelity in hippocampal response to identical events. In addition fewer ventral CA3 neurons expressed IEGs during the second exploration in Susceptible as compared to Resistant rats. We also examined the basolateral nucleus of the amygdala, but found no difference in IEG expression. Contrary to hypothesis, differences between Susceptible and Resistant rats during a foot shock paired exploration (traumatic event) were not pronounced. These findings show that rats susceptible to developing PTSD-like symptoms can be behaviorally identified and have altered hippocampal plasticity-related responses prior to the trauma. This study provides a frame-work for the investigation and remediation of susceptibilities. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0 +https://doi.org/10.1089/cap.2009.0115,"Sertraline Treatment of Children and Adolescents With Posttraumatic Stress Disorder: A Double-Blind, Placebo-Controlled Trial","The aim of this study was to evaluate the safety and efficacy of sertraline in children and adolescents who met Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for posttraumatic stress disorder (PTSD).Children and adolescents (6-17 years old) meeting DSM-IV criteria for PTSD were randomized to 10 weeks of double-blind treatment with sertraline (50-200 mg/day) or placebo. The primary efficacy measure was the University of California, Los Angeles Post-Traumatic Stress Disorder Index for DSM-IV (UCLA PTSD-I).A total of 131 patients met entry criteria and were randomized to sertraline (n = 67; female, 59.7%; mean age, 10.8; mean UCLA PTSD-I score, 43.8 ± 8.5) or placebo (n = 62; female, 61.3%; mean age, 11.2; mean UCLA PTSD-I score, 42.1 ± 8.8). There was no difference between sertraline and placebo in least squares (LS) mean change in the UCLA PTSD-I score, either on a completer analysis (-20.4 ± 2.1 vs. -22.8 ± 2.1; p = 0.373) or on an last observation carried forward (LOCF) end point analysis (-17.7 ± 1.9 vs. -20.8 ± 2.1; p = 0.201). Attrition was higher on sertraline (29.9%) compared to placebo (17.7%). Discontinuation due to adverse events occurred in a 7.5% treated with sertraline and 3.2% treated with placebo.Sertraline was a generally safe treatment in children and adolescents with PTSD, but did not demonstrate efficacy when compared to placebo during 10 weeks of treatment. ClinicalTrials.gov Identifier: NCT00150306.",0 +https://doi.org/10.1016/j.psychres.2014.03.001,Distinctiveness of prolonged grief disorder symptoms among survivors of the Great East Japan Earthquake and Tsunami,"Prolonged Grief Disorder (PGD) has been proposed for diagnostic classification as an independent psychiatric disorder. Previous research has investigated it in relation to other axis I disorders in order to determine whether it could be considered an independent nosological entity. The distinctiveness of this condition was apparent in cases of ordinary bereavement and in those following human-made disasters. However, this disorder may be expanded to include bereavement resulting from natural disasters. The present study aims to explore the differences between this disorder and posttraumatic stress disorder or major depressive disorder as experienced after the Great East Japan Earthquake and Tsunami. The subjects were 82 hospital workers. Each type of disorder was assessed by means of the Inventory of Complicated Grief, the Impact of Event Scale-Revised, and the Center for Epidemiological Studies Depression Scale. Exploratory factor analysis showed 3 dimensions, with PGD items independently clustering in the same dimension. Our findings support the uniqueness of PGD even in a post-natural disaster situation in a non-Western culture and warrant grief intervention for high-risk bereaved survivors.",0 +https://doi.org/10.1177/0886260510362894,Employment Status and Posttraumatic Stress Disorder Following Compensation Seeking in Victims of Violence,"The current study was developed to explore the associations between posttraumatic stress disorder (PTSD), level of compensation for pain and suffering, and employment status in a sample of victims of violence ( n = 226) who had held a full-time job at time of victimization and had filed a claim with the Dutch Victim Compensation Fund (DVCF) thereafter. Based on previous research, it was expected that PTSD would be associated with current unemployment. If a relationship between the two were to be found, the study would explore whether this should be ascribed to the presence of a sense of foreshortened future. Results confirmed this hypothesis and indicated that participants with PTSD were more prone to be currently unemployed than non-PTSDs. Additional analyses revealed that PTSD symptom severity and symptom cluster scores were also positively associated to higher unemployment rates. The observed relationships were not merely due to a high level of compensation for pain and suffering and failed to remain significant after adjusting for sense of foreshortened future. Implications for policy practice as well as strengths and limitations of the study were discussed.",0 +https://doi.org/10.1001/dmp.2011.50,"Trauma Exposure and Posttraumatic Stress Disorder Among Employees of New York City Companies Affected by the September 11, 2001 Attacks on the World Trade Center","Several studies have provided prevalence estimates of posttraumatic stress disorder (PTSD) related to the September 11, 2001 (9/11) attacks in broadly affected populations, although without sufficiently addressing qualifying exposures required for assessing PTSD and estimating its prevalence. A premise that people throughout the New York City area were exposed to the attacks on the World Trade Center (WTC) towers and are thus at risk for developing PTSD has important implications for both prevalence estimates and service provision. This premise has not, however, been tested with respect to DSM-IV-TR criteria for PTSD. This study examined associations between geographic distance from the 9/11 attacks on the WTC and reported 9/11 trauma exposures, and the role of specific trauma exposures in the development of PTSD.Approximately 3 years after the attacks, 379 surviving employees (102 with direct exposures, including 65 in the towers, and 277 with varied exposures) recruited from 8 affected organizations were interviewed using the Diagnostic Interview Schedule/Disaster Supplement and reassessed at 6 years. The estimated closest geographic distance from the WTC towers during the attacks and specific disaster exposures were compared with the development of 9/11-related PTSD as defined by the Diagnostic and Statistical Manual, Fourth Edition, Text Revision.The direct exposure zone was largely concentrated within a radius of 0.1 mi and completely contained within 0.75 mi of the towers. PTSD symptom criteria at any time after the disaster were met by 35% of people directly exposed to danger, 20% of those exposed only through witnessed experiences, and 35% of those exposed only through a close associate's direct exposure. Outside these exposure groups, few possible sources of exposure were evident among the few who were symptomatic, most of whom had preexisting psychiatric illness.Exposures deserve careful consideration among widely affected populations after large terrorist attacks when conducting clinical assessments, estimating the magnitude of population PTSD burdens, and projecting needs for specific mental health interventions.",0 +https://doi.org/10.1177/1363459314539774,The effect of strategies of personal resilience on depression recovery in an Australian cohort: A mixed methods study,"Strategies of personal resilience enable successful adaptation in adversity. Among patients experiencing depression symptoms, we explored which personal resilience strategies they find most helpful and tested the hypothesis that use of these strategies improves depression recovery. We used interview and survey data from the Diagnosis, Management and Outcomes of Depression in Primary Care 2005 cohort of patients experiencing depression symptoms in Victoria, Australia. A total of 564 participants answered a computer-assisted telephone interview question at 12 months follow-up, about what they found most helpful for their depression, stress or worries. Depressive disorder and severity were measured at annual follow-up using the Composite International Diagnostic Interview and the Patient Health Questionnaire self-rating questionnaire. Using interview responses, we categorised participants as users or not of strategies of personal resilience, specifically, drawing primarily on expanding their own inner resources or pre-existing relationships: 316 (56%) were categorised as primarily users of personal resilience strategies. Of these, 193 (61%) reported expanding inner resources, 79 (25%) drawing on relationships and 44 (14%) reported both. There was no association between drawing on relationships and depression outcome. There was evidence supporting an association between expanding inner resources and depression outcome: 25 per cent of users having major depressive disorder 1 year later compared to 38 per cent of non-users (adjusted odds ratio: 0.59, confidence interval: 0.36–0.97). This is the first study to show improved outcome for depression for those who identify as most helpful the use of personal resilience strategies. The difference in outcome is important as expanding inner resources includes a range of low intensity, yet commonly available strategies.",0 +https://doi.org/10.3109/00048670903489916,Vulnerability Factors for Disaster-Induced Child Post-Traumatic Stress Disorder: The Case for Low Family Resilience and Previous Mental Illness,"Objective: The aim of the present study was to investigate whether parent report of family resilience predicted children's disaster-induced post-traumatic stress disorder (PTSD) and general emotional symptoms, independent of a broad range of variables including event-related factors, previous child mental illness and social connectedness. Methods: A total of 568 children (mean age = 10.2 years, SD = 1.3) who attended public primary schools, were screened 3 months after Cyclone Larry devastated the Innisfail region of North Queensland. Measures included parent report on the Family Resilience Measure and Strengths and Difficulties Questionnaire (SDQ)–emotional subscale and child report on the PTSD Reaction Index, measures of event exposure and social connectedness. Results: Sixty-four students (11.3%) were in the severe–very severe PTSD category and 53 families (28.6%) scored in the poor family resilience range. A lower family resilience score was associated with child emotional problems on the SDQ and longer duration of previous child mental health difficulties, but not disaster-induced child PTSD or child threat perception on either bivariate analysis, or as a main or moderator variable on multivariate analysis (main effect: adjusted odds ratio (OR adj ) = 0.57, 95% confidence interval (CI) = 0.13–2.44). Similarly, previous mental illness was not a significant predictor of child PTSD in the multivariate model (OR adj = 0.75, 95%CI = 0.16–3.61). Conclusion: In this post-disaster sample children with existing mental health problems and those of low-resilience families were not at elevated risk of PTSD. The possibility that the aetiological model of disaster-induced child PTSD may differ from usual child and adolescent conceptualizations is discussed.",0 +https://doi.org/10.1037/tra0000003,PTSD personality subtypes in women exposed to intimate-partner violence.,"There is considerable research implicating posttraumatic stress disorder (PTSD) as a common reaction to intimate-partner violence (IPV; Golding, 1999). PTSD is categorized as a single disorder; however, there is significant heterogeneity in its symptom-presentation patterns (Dickstein, Suvak, Litz, & Adler, 2010). Researchers have posited underlying personality characteristics as potentiating different expressions of PTSD (Miller, Greif, & Smith, 2003). Specifically, a model with 3 personality subtypes (i.e., externalizing, internalizing, and simple) has been proposed to explain PTSD symptom-pattern heterogeneity (Miller, 2003; Miller & Resick, 2007). The current study tested the PTSD personality-subtype model in a sample of 129 women exposed to a range of IPV experiences. Temperament patterns of women reporting clinically significant PTSD symptoms replicated the 3 personality-subtype patterns found in previous investigations (i.e., an externalizing subtype group characterized by high negative emotionality and low disinhibition, an internalizing subtype group characterized by high negative emotionality and low positive emotionality, and a simple subtype group characterized by midrange scores across the temperament variables; Miller et al., 2003; Miller, Kaloupek, Dillon, & Keane, 2004; Miller & Resick, 2007). Differences between personality-subtype groups and women without clinically significant PTSD symptoms were found (p < .05), with women reporting personality patterns consistent with the internalizing and externalizing subtype groups exhibiting higher comorbid personality pathology and psychological difficulties. Implications are discussed for personality as a risk or resiliency factor in PTSD and as contributing to explaining PTSD symptom heterogeneity.",0 +https://doi.org/10.1016/j.nlm.2013.12.002,"Substance abuse, memory, and post-traumatic stress disorder","• We discuss effects of nicotine, cocaine, and alcohol on memory. • We describe comorbidities for abuse of nicotine, cocaine, and alcohol with PTSD. • CPP We discuss how nicotine, cocaine, and alcohol may alter the course and treatment of PTSD. A large body of literature demonstrates the effects of abused substances on memory. These effects differ depending on the drug, the pattern of delivery (acute or chronic), and the drug state at the time of learning or assessment. Substance use disorders involving these drugs are often comorbid with anxiety disorders, such as post-traumatic stress disorder (PTSD). When the cognitive effects of these drugs are considered in the context of the treatment of these disorders, it becomes clear that these drugs may play a deleterious role in the development, maintenance, and treatment of PTSD. In this review, we examine the literature evaluating the cognitive effects of three commonly abused drugs: nicotine, cocaine, and alcohol. These three drugs operate through both common and distinct neurobiological mechanisms and alter learning and memory in multiple ways. We consider how the cognitive and affective effects of these drugs interact with the acquisition, consolidation, and extinction of learned fear, and we discuss the potential impediments that substance abuse creates for the treatment of PTSD.",0 +https://doi.org/10.1007/s11205-009-9441-x,"Emergency Workers’ Quality of Life: The Protective Role of Sense of Community, Efficacy Beliefs and Coping Strategies","This study, involving a sample of 764 emergency workers, investigates dimensions of quality of life at work (Compassion fatigue, Burnout and Compassion satisfaction), and their relationships with Coping strategies and some psychosocial variables (Sense of Community, Collective Efficacy and Self-efficacy). Results indicate the usefulness of distinguishing between positive and negative indicators of emergency workers’ quality of life. Compassion satisfaction is positively correlated with efficacy beliefs, Sense of Community and the use of Active coping strategies. Burnout and Compassion fatigue are especially correlated with the use of dysfunctional coping strategies like distraction and self-criticism. Volunteer emergency workers enjoy a higher well being than full-time professional workers. Results and their implications for interventions aimed at increasing rescue workers’ quality of life by enhancing psychosocial competences are discussed.",0 +https://doi.org/10.1038/npp.2013.336,Forebrain-Specific CRF Overproduction During Development is Sufficient to Induce Enduring Anxiety and Startle Abnormalities in Adult Mice,"Corticotropin releasing factor (CRF) regulates physiological and behavioral responses to stress. Trauma in early life or adulthood is associated with increased CRF in the cerebrospinal fluid and heightened anxiety. Genetic variance in CRF receptors is linked to altered risk for stress disorders. Thus, both heritable differences and environmentally induced changes in CRF neurotransmission across the lifespan may modulate anxiety traits. To test the hypothesis that CRF hypersignaling is sufficient to modify anxiety-related phenotypes (avoidance, startle, and conditioned fear), we induced transient forebrain-specific overexpression of CRF (CRFOE) in mice (1) during development to model early-life stress, (2) in adulthood to model adult-onset stress, or (3) across the entire postnatal lifespan to model heritable increases in CRF signaling. The consequences of these manipulations on CRF peptide levels and behavioral responses were examined in adulthood. We found that transient CRFOE during development decreased startle habituation and prepulse inhibition, and increased avoidance (particularly in females) recapitulating the behavioral effects of lifetime CRFOE despite lower CRF peptide levels at testing. In contrast, CRFOE limited to adulthood reduced contextual fear learning in females and increased startle reactivity in males but did not change avoidance or startle plasticity. These findings suggest that forebrain CRFOE limited to development is sufficient to induce enduring alterations in startle plasticity and anxiety, while forebrain CRFOE during adulthood results in a different phenotype profile. These findings suggest that startle circuits are particularly sensitive to forebrain CRFOE, and that the impact of CRFOE may be dependent on the time of exposure.",0 +https://doi.org/10.1097/dbp.0000000000000174,"Depression, Anxiety, and Perinatal-Specific Posttraumatic Distress in Mothers of Very Low Birth Weight Infants in the Neonatal Intensive Care Unit","To compare the trajectories and determine the predictors of maternal distress defined as a continuous spectrum of symptomatology and elevated symptomatology, of depression, anxiety, and perinatal-specific posttraumatic stress (PPTS), in mothers of very low birth weight (VLBW) infants throughout the neonatal intensive care unit (NICU) hospitalization.Sixty-nine mothers completed psychological questionnaires within the first month of their infant's NICU hospitalization and again 2 weeks before NICU discharge. Multiple regression models determined maternal psychological, reproductive, sociodemographic, and infant medical predictors of maternal distress.Perinatal-specific posttraumatic stress remained stable throughout the NICU hospitalization, whereas other aspects of distress declined. Previous psychological history and infant medical variables predicted higher PPTS but no other aspects of distress. Reproductive variables predicted anxiety and PPTS; history of fetal loss initially predicted lower PPTS but throughout hospitalization primipara status emerged as a predictor of higher anxiety and PPTS. Sociodemographic variables predicated initial, but not later, depressive distress.Psychological screening is important in the NICU. The PPTS profile suggests it may require distinct treatment. Primiparas should be targeted for intervention.",0 +https://doi.org/10.1016/j.jad.2013.01.026,Co-occurring posttraumatic stress and depression symptoms after sexual assault: A latent profile analysis,"Symptoms of posttraumatic stress disorder (PTSD) and depression frequently co-occur, but their distinctiveness following trauma remains unclear. We examined patterns of PTSD and depression symptoms after sexual assault to evaluate the extent to which assault survivors primarily reported symptoms of both disorders or whether there were meaningfully distinct subgroups with discordant PTSD and depression symptoms.Latent profile analysis was used to examine self-reported PTSD and depression symptoms among 119 female sexual assault survivors at 1-, 2-, 3-, and 4-months post-assault.At all time points, a 4-class solution fit the data best, revealing four subgroups with low, low-moderate, high-moderate, and severe levels of both PTSD and depression symptoms. Within each subgroup, PTSD symptom severity co-occurred with comparable depression symptom severity. At no time point were there reliable subgroups with discordant PTSD and depression symptom severities. Emotional numbing, hyperarousal, and overall PTSD symptom severity reliably distinguished each class from the others. Class membership at 1-month post-assault predicted subsequent class membership and functional impairment.Additional research is needed to evaluate predictors of class membership, temporal stability of classes, and generalizability to other trauma populations.Co-occurring and comparably severe PTSD and depression symptoms are pervasive among female sexual assault survivors. The absence of a distinct subset of individuals with only PTSD or depression symptoms suggests that PTSD and depression may be manifestations of a general posttraumatic stress response rather than distinct disorders after trauma. Integrated treatments targeting both PTSD and depression symptoms may therefore prove more efficient and effective.",0 +,"Prior trauma and PTSD among homeless mothers: Effects on subsequent stress appraisals, coping, posttraumatic growth, and health outcomes","There is much evidence that the experience of trauma is related to poorer subsequent outcomes, including mental health symptoms, poor physical health, and substance abuse. A high number of previous lifetime traumas and/or the experience of PTSD symptoms may contribute to difficulties adjusting to future life stress. However, some factors may protect individuals from the effects of posttraumatic stress and mediate the relationship between trauma exposure and adjustment outcomes. For instance, stress appraisals and coping behaviors may affect how an individual responds to stressful experiences. Furthermore, there is a growing interest in the potential for positive change following stressful life events (i.e., ""posttraumatic growth"" (PTG)). This longitudinal study investigated the effect of prior trauma history and PTSD symptoms on subsequent mental health, physical health, substance use, and posttraumatic growth in a sample of 70 homeless mothers. Participants' appraisals and coping behaviors with regard to a future life stressor and the contribution of these factors on adjustment outcomes were examined. The potential moderating effect of social support on appraisals, coping, and subsequent outcomes was also tested. A series of hierarchical regression analyses were conducted to test the effect of the proposed predictors on each adjustment outcome separately. Results indicated that the sample reported moderate to high levels of posttraumatic growth as a result of a recent life stressor. This is the first study to demonstrate that this phenomenon is observed in homeless mothers. Higher levels of PTSD symptomatology (but not number of prior traumas) and use of avoidant coping predicted greater subsequent mental health symptoms. Appraisals of a stressor as threatening and use of active coping contributed to posttraumatic growth. The examined variables did not significantly predict physical health or substance use outcomes in this sample. No significant moderating effect of social support on any of the outcomes was found. Implications for future research and for the development of interventions aimed at reducing the negative effects of trauma and facilitating posttraumatic growth in homeless women are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1002/da.22044,WHITE MATTER INTEGRITY AND ITS RELATIONSHIP TO PTSD AND CHILDHOOD TRAUMA-A SYSTEMATIC REVIEW AND META-ANALYSIS,"Recent reviews and meta-analyses reported structural gray matter changes in patients suffering from adult-onset posttraumatic stress disorder (PTSD) and in subjects with and without PTSD who experienced childhood trauma. However, it remains unclear if such structural changes are also affecting the white matter. The aim of this systematic review is to provide a comprehensive overview of all empirical investigations measuring white matter integrity in populations affected by PTSD and/or childhood trauma. To this end, results from different methodological approaches were included. Twenty-five articles are reviewed of which 10 pertained to pediatric PTSD and the effects of childhood trauma measured during childhood, seven to the effects of childhood trauma measured during adulthood, and eight to adult-onset PTSD. Overall, reductions in white matter volume were reported more often than increases in these populations. However, the heterogeneity of the exact locations indicates only a weak overlap across published studies. In addition, a meta-analysis was carried out on seven whole-brain diffusion tensor imaging (DTI) studies in adults. Significant clusters of both increases and decreases were identified in various structures, most notably the cingulum and the superior longitudinal fasciculus. Future research directions are discussed.",0 +https://doi.org/10.1038/nrd3702,Neuropeptide receptor ligands as drugs for psychiatric diseases: the end of the beginning?,"The search for novel drugs for treating psychiatric disorders is driven by the growing medical need to improve on the effectiveness and side-effect profile of currently available therapies. Given the wealth of preclinical data supporting the role of neuropeptides in modulating behaviour, pharmaceutical companies have been attempting to target neuropeptide receptors for over two decades. However, clinical studies with synthetic neuropeptide ligands have been unable to confirm the promise predicted by studies in animal models. Here, we analyse preclinical and clinical results for neuropeptide receptor ligands that have been studied in clinical trials for psychiatric diseases, including agents that target the receptors for tachykinins, corticotropin-releasing factor, vasopressin and neurotensin, and suggest new ways to exploit the full potential of these candidate drugs.",0 +https://doi.org/10.1017/s1092852900008877,Contemporary Longitudinal Methods for the Study of Trauma and Posttraumatic Stress Disorder,"Traditional methods for analyzing trends in longitudinal data have typically emphasized average group change over time. In this article, we propose multilevel, regression-based methods for examining inter-individual differences in intra-individual change and apply these methods to research in trauma and posttraumatic stress disorder (PTSD). The outcome or dependent variable of interest is reconceptualized as an index of dynamic change reflecting the trend or trajectory of an individual's PTSD symptom severity scores across time. A basic statistical model is presented, and analyses and findings are demonstrated with an existing database used in previously published studies. The methods offer promise for future study of the natural course of PTSD chronicity or recovery, risk and resilience factors that influence individual growth or decline, and critical timepoints for intervention.",0 +https://doi.org/10.1002/jts.20031,"Traumatic brain injury, dissociation, and posttraumatic stress disorder in road traffic accident survivors","This study investigated the symptom profiles of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) in participants who did and did not sustain traumatic brain injury (TBI), following a road traffic accident. The participants were assessed at three time points: as soon as possible posttrauma as well as at 6 weeks and 3 months posttrauma. At the first assessment, fewer participants from the TBI group recalled feeling fear and helplessness at the time of the trauma, fewer TBI participants reported recurrent intrusive thoughts and images, and more TBI participants reported dissociation since the trauma, relative to the non-TBI group. At the second assessment, fewer participants from the TBI group recalled feeling intense helplessness at the time of the trauma. Fewer TBI participants also reported reliving and physiological reactions on trauma reminders relative to the non-TBI group. At 3 months posttrauma, there was no difference in PTSD symptom profile between non-TBI and TBI groups. Our findings indicate that the presence of TBI is likely to influence the distribution of certain symptoms, but need not be a significant barrier to diagnosing ASD and PTSD.",0 +https://doi.org/10.1016/j.paid.2015.12.032,Relations among emotion regulation and DSM-5 symptom clusters of PTSD,"Abstract Emotion regulation has been implicated as a risk and maintaining factor for posttraumatic stress disorder (PTSD). Three aspects of emotion regulation have demonstrated the strongest relations with PTSD symptoms: experiential avoidance, rumination, and thought suppression. Given that emotion regulation has demonstrated differential relations with DSM-IV PTSD symptom clusters, the current study sought to examine these relations with the DSM-5 symptom clusters of PTSD. Participants were recruited via Amazon's Mechanical Turk (N = 403). All participants endorsed trauma exposure. Measures included the PTSD Checklist for DSM-5 (PCL-5), the Acceptance and Action Questionnaire-II (AAQ-II), the negative affect scale of the Positive and Negative Affect Schedule (PANAS-NA; included as a control variable), the Ruminative Responses Scale (RRS), and the White Bear Suppression Inventory (WBSI). A path analysis model in Mplus indicated that the AAQ-II demonstrated large effects with all four PTSD symptom clusters. Of those relations, the largest was observed for the AAQ-II and the Negative Alterations in Cognition and Mood cluster of PTSD. Results suggest that individual variation in PTSD symptoms may have implications for the salience of particular emotion regulation strategies.",0 +,Risk factors of posttraumatic stress disorder within emergency medical service personnel,"The current study examined the relationship between risk factors for posttraumatic stress disorder (PTSD) in Emergency Medical Service (EMS) personnel. It was hypothesized that EMS workers who were female; older; single; had less social support; reported more life stressors, depression, peritraumatic dissociation, history of trauma, negative cognitions; and experienced more life-threatening critical incidents would report a greater number of PTSD symptoms. The participants completed the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), the Center for Epidemiologic Studies Depression Scale (CES-D), the Posttraumatic Cognitions Inventory (PTCI), the Peritraumatic Dissociative Experiences Questionnaire (PDEQ), the Traumatic Events Questionnaire (TEQ), the Multidimensional Scale of Perceived Social Support (MSPSS), the Life Experiences Survey (LES), and a researcher-created EMS Demographic Questionnaire. To access predictor variables related to PTSD, all eight predictor variables were entered into a multiple regression in their continuous form. The criterion variable was the participants' score on the PCL-C. Preliminary Pearson product-moment correlations revealed that six of the eight predictor variables yielded statistically significant correlations with the PCL-C total score. Overall, these eight predictor variables were able to account for 64% of the variability in PTSD (adjusted R2 = .64, p < .001). Upon further examination, depression, traumatic events, negative cognitions, and sex all significantly contributed to the regression equation. The results of this study indicate that this combination of predictor variables is related to PTSD. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0 +https://doi.org/10.1093/ntr/ntp123,Influence of PTSD symptom clusters on smoking status among help-seeking Iraq and Afghanistan veterans,"Despite the strong association between smoking and posttraumatic stress disorder (PTSD), mechanisms influencing smoking in this population remain unclear. Previous smoking research has largely examined PTSD as a homogenous syndrome despite the fact that PTSD is composed of four distinct symptom clusters (i.e., reexperiencing, effortful avoidance, emotional numbing, and hyperarousal). Examination of the relationship between smoking and PTSD symptom clusters may increase understanding of mechanisms influencing comorbidity between smoking and PTSD. The goals of the present study were to (a) examine the influence of overall PTSD symptom severity on likelihood of smoking and smoking heaviness and (b) examine the influence of each PTSD symptom cluster on smoking.Participants (N = 439) were Operation Iraqi Freedom/Operation Enduring Freedom combat veterans referred to VA mental health services.Multinomial logistic regression was chosen to accommodate a three-level outcome, in which the likelihood of being a nonsmoker was compared with (a) light smoking (1-9 cigarettes/day), (b) moderate smoking (10-19 cigarettes/day), and (c) heavy smoking (> or =20 cigarettes/day). Results showed that veterans with higher levels of overall PTSD symptomatology were more likely to endorse heavy smoking (Wald = 4.56, p = .03, odds ratio [OR] = 1.65). Veterans endorsing high levels of emotional numbing were also more likely to endorse heavy smoking (Wald = 6.49, p = .01, OR = 1.81); all other PTSD symptom clusters were unrelated to smoking.The association between emotional numbing and heavy daily smoking suggests that veterans with PTSD may smoke to overcome emotional blunting following trauma exposure.",0 +https://doi.org/10.1053/comp.2001.21219,Gender differences in risk factors for trauma exposure and post-traumatic stress disorder among inner-city drug abusers in and out of treatment,"Over the past two decades there has been a growing awareness of the comorbidity between post-traumatic stress disorder (PTSD) and substance use disorders in the general population. The purpose of these analyses was to examine, in a population of drug users, the role of gender in (1) predicting the nature of the traumatic event and PTSD symptoms, (2) patterns of substance use disorders in relation to trauma exposure and PTSD symptoms, (3) comorbidity of other psychiatric disorders with trauma exposure and PTSD, and (4) the temporal association of substance use disorder, exposure to trauma, and PTSD. Drug abusers (n = 464) were interviewed using the Diagnostic Interview Schedule for DSM-III-R (DIS) and the Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM). Although more women than men met criteria for DSM-III-R PTSD, there were no gender differences on endorsement for a traumatic event. Adult antisocial behavior, affective disorder, schizophrenia, other anxiety disorder and polysubstance use predicted exposure to an event, whereas, only schizophrenia and other anxiety disorder predicted PTSD. In men, drug use preceded the exposure to an event, while in women, the onset age for both drug use and exposure to an event were nearly identical. This work suggests implications for gender-based education and prevention interventions.",0 +https://doi.org/10.1016/j.addbeh.2015.03.013,Emotion dysregulation facets as mediators of the relationship between PTSD and alcohol misuse,"Posttraumatic stress disorder (PTSD) and alcohol misuse, which frequently co-occur among combat veterans, have been linked to emotion dysregulation. Emotion dysregulation may explain the link between PTSD and alcohol misuse, and this investigation tested emotion dysregulation as a mediator of that relationship.Correlations between PTSD symptoms and cluster symptoms, emotion dysregulation full and subscales, and alcohol misuse were examined in a sample of 139 combat Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans (45% African American; 89% men). Emotion dysregulation full scale and subscales were examined as mediators of the relationship between PTSD symptoms and alcohol misuse for the full sample and men only.PTSD symptoms and symptom clusters, emotion dysregulation, and alcohol misuse showed positive correlations for the full sample and men only. Neither the full scale of emotion dysregulation nor the facets of emotion dysregulation mediated the relationship between PTSD symptoms and alcohol misuse for the full sample; among men, the Impulse Control Difficulties when Upset and Lack of Emotional Clarity subscales were mediators of that relationship.Impulse control difficulties and lack of emotional clarity may play an important role in the link between PTSD and alcohol misuse for male veterans and should be an important target in treatment for individuals with both disorders. Addressing impulse control difficulties and lack of emotional clarity in those with PTSD and alcohol misuse may improve outcomes by helping individuals identify and describe upsetting emotions and develop healthy coping alternatives to alcohol misuse.",0 +https://doi.org/10.1002/jts.20141,Comparison of two widely used PTSD-screening instruments: Implications for public mental health planning,"Epidemiological research serves a critical role in public mental health planning in the aftermath of disasters, particularly via estimation of the mental health burden and potential needs of affected communities. However, different measures are used across studies to assess mental health response, making cross-study comparison difficult. The National Women's Study Posttraumatic Stress Disorder module (NWS-PTSD) and PTSD Checklist (PCL) have been among the most widely used measures of PTSD in postdisaster research. Here, the authors used a sample of 233 New York City-area residents who were administered both the NWS-PTSD and PCL 4 months after the September 11, 2001 terrorist attacks. The PCL yielded higher prevalence estimates at the symptom, cluster, and diagnostic levels. Implications for the interpretation of epidemiological data are discussed.",0 +https://doi.org/10.1097/00004850-200015040-00006,Symptom-specific effects of fluoxetine in post-traumatic stress disorder,"The selective serotonin reuptake inhibitors have become a first line treatment for post-traumatic stress disorder (PTSD). In a recent double-blind study in civilians, fluoxetine produced clinically and statistically significant effects on all general measures of PTSD. We examined the specific effects of fluoxetine versus placebo in the above mentioned study of PTSD clusters and individual symptoms. Individuals were included if they met criteria for PTSD according to the Structured Clinical Interview for DSM-III-R (SCID). Symptoms were assessed at sequential time points by the Structured Interview for PTSD (SIP), a clinician interview based assessment, and a self-report scale, the Davidson Trauma Scale (DTS). A total of 53 patients were included in the analysis. On the SIP and DTS, fluoxetine was found to produce statistically significant changes on all clusters. Significant effects for fluoxetine were noted on 10 items of the DTS, and 8 items of the SIP. The SIP and DTS had 6 items in common that were significant. Fluoxetine exerts a broad spectrum effect in reducing all the symptom clusters of PTSD in this sample. The symptoms of being physically upset at reminders of the trauma, avoiding thoughts of the trauma, having difficulty enjoying things, feeling distant/estranged, having a sense of foreshortened future, and impaired concentration, were the symptoms most responsive to the effects of treatment with fluoxetine on both scales.",0 +https://doi.org/10.1016/j.jad.2014.04.061,Latent classes of PTSD symptoms in Iraq and Afghanistan female veterans,"Recent studies have used latent class analysis (LCA) to identify subgroups of individuals who share similar patterns of PTSD symptom endorsement; however, further study is needed among female veterans, whose PTSD symptom expression may vary from that of their male counterparts. The current study examined latent PTSD symptom classes in female veterans who returned from recent military service in Iraq and Afghanistan, and explored military and demographic variables associated with distinct PTSD symptom presentations. A retrospective analysis was conducted using existing medical records from female Iraq and Afghanistan veterans who were new users of VA mental health outpatient (MHO) care, had received a PTSD diagnosis anytime during the post-deployment period, and completed the PTSD checklist within 30 days of their first MHO visit ( N =2425). The LCA results identified four latent classes of PTSD symptom profiles in the sample: High Symptom, Intermediate Symptom, Intermediate Symptom with High Emotional Numbing (EN), and Low Symptom. Race/ethnicity, age, time since last deployment, and distance from a VA facility emerged as predictors of PTSD symptom presentation. The current study was cross-sectional and utilized administrative data. The results may not be generalizable to female veterans from other service eras. Longer times between end of last deployment and initiation of MHO services were associated with more symptomatic classes. Exploration of PTSD symptom presentation may enhance our understanding of the service needs of female veterans with PTSD, and suggests potential benefits to engaging veterans in MHO soon after last deployment.",0 +https://doi.org/10.1007/s10896-008-9184-5,Symptom Patterns among Youth Exposed to Intimate Partner Violence,"Children and adolescents exposed to intimate partner violence display a broad range of symptoms. We sought to differentiate symptom patterns and predictors of these patterns using a person-oriented approach. Previous cluster analysis research of exposed youth was extended to include youth PTSD symptoms and trauma history. Participants were 74 mothers who had received a police call for domestic violence, and who had a child between 2 and 17 years old. Cluster analysis was used to identify four symptom patterns among exposed youth: Typical, Asymptomatic, General Distress, and Acute PTSD. These patterns were replicated in separate cluster analyses with younger and older participants. Symptom patterns were differentiated by maternal distress, maternal aggression, and youth trauma history, but not by male partner aggression. Implications for assessment and treatment of youth exposed to intimate partner violence, and suggestions for further research, are discussed. © 2008 Springer Science+Business Media, LLC.",0 +https://doi.org/10.1001/archpedi.1996.02170330048008,The Psychological and Medical Sequelae of War in Central American Refugee Mothers and Children,"To investigate the physical and mainly psychological sequelae of exposure to war in Central American children and their mothers who immigrated to the United States on average 4 years before the study began.Interview study.Twenty-two immigrant Central American women caretakers and 1 of their children aged 5 to 13 years.Standardized and new measures were administered to assess children's physical and mental health symptoms and exposure to political violence.Eighteen of the 22 children had chronic health problems. Fifteen children and all of the adults had observed traumatic events, including bombings and homicides. Thirteen of the children showed mental health symptom profiles above established norms, although only 2 met the criteria for posttraumatic stress disorder according to their own reports. Many of the caretakers were unaware of their child's psychological distress. Four of the mothers exhibited posttraumatic stress disorder, and their symptoms predicted their child's mental health.Pediatricians are sometimes the first and only contacts these families have with health care providers. Caretakers' reports of children's mental health are often incomplete. It is therefore important for physicians to probe for ""hidden"" symptoms in refugee children. These family members may need referrals to social and psychological services, and pediatricians can open the gates to existing community networks of support. Because we found that maternal mental health influences the child's, the child's interests are well served when pediatricians also encourage the mother to contact services for herself if she confides that she is experiencing some of the severe psychological sequelae reported by the women in this study.",0 +https://doi.org/10.1016/s0006-3223(99)00307-8,Hormone profiles in humans experiencing military survival training,"Clinical models of the human response to intense, acute stress have been limited to laboratory settings or cross sectional characterizations. As a result, data about the sensitivity of the human neuroendocrine activation to realistic stressors of varying magnitudes are limited. The U.S. Army survival course offers a unique opportunity to examine, in a controlled manner, the human response to acute, realistic, military stress.Salivary data were collected in 109 subjects at baseline during four stress exposure time points and at recovery. Serum data was collected at baseline and recovery in 72 subjects and at baseline and during stress exposure in a subgroup of subjects (n = 21).Cortisol significantly increased during the captivity experience and was greatest after subjects' exposure to interrogations. Cortisol remained significantly elevated at recovery. Testosterone was significantly reduced within 12 hours of captivity. Reductions of both total and free T4 and of total and free T3 were observed, as were increases in thyrotropin.The stress of military survival training produced dramatic alterations in cortisol, percent free cortisol, testosterone, and thyroid indices. Different types of stressors had varying effects on the neuroendocrine indices. The degree of neuroendocrine changes observed may have significant implications for subsequent responses to stress.",0 +https://doi.org/10.1002/cpp.1946,Interpersonal Subtypes and Therapy Response in Patients Treated for Posttraumatic Stress Disorder,"Interpersonal traits may influence psychotherapy success. One way of conceptualizing such traits is the interpersonal circumplex model. In this study, we analyse interpersonal circumplex data, assessed with the Inventory of Interpersonal Problems (Horowitz, Strauß, & Kordy, 1994) from a randomized study with 138 patients suffering from posttraumatic stress disorder after trauma in adulthood. The study compared cognitive processing therapy and dialogical exposure therapy, a Gestalt-based intervention. We divided the interpersonally heterogeneous sample according to the quadrants of the interpersonal circumplex. The division into quadrants yielded subgroups that did not differ in their general psychological distress, but the cold-submissive quadrant tended to exhibit higher posttraumatic stress disorder symptom severity and interpersonal distress than the other three. There was also a trend for patients in different quadrants to be affected differently by the treatments. Correlation analyses supported these results: in cognitive processing therapy, more dominant patients had more successful therapies, while in dialogical exposure therapy, success was not correlated with interpersonal style. Results indicate that especially patients with cold interpersonal styles profited differentially from the two treatments offered. Dividing samples according to the interpersonal circumplex quadrants seems promising. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message: Interpersonal traits may contribute to psychotherapy outcome. Dividing the sample according to the quadrants of the interpersonal circumplex, as opposed to cluster analysis, yielded promising results. Patients higher in dominance fared better with cognitive processing therapy, while interpersonal style had no correlations with therapy success in dialogical exposure therapy.",0 +https://doi.org/10.1016/j.jmwh.2008.04.013,"Mental Health, Demographic, and Risk Behavior Profiles of Pregnant Survivors of Childhood and Adult Abuse","Our objective was to address the gap in knowledge about the extent to which perinatal mental health and risk behaviors are associated with childhood and adult experiences of abuse that arises because of barriers to screening and disclosure about past and current abuse. Survey data from an ongoing study of the effects of posttraumatic stress on childbearing were used to describe four groups of nulliparous women: those with no abuse history, adult abuse only, childhood abuse only, and abuse that occurred during both periods. The rates of abuse history disclosure were higher in the research context than in the clinical settings. Mental health morbidity and risk behaviors occurred in a dose-response pattern with cumulative abuse exposure. Rates of current posttraumatic stress disorder ranged from 4.1% among those never abused to 11.4% (adult only), 16.0% (childhood only), and 39.2% (both periods). Women abused during both periods also were more likely to be using tobacco (21.5%) and drugs (16.5%) during pregnancy. We conclude that mental health and behavioral risk sequelae affect a significant portion of both childhood and adult abuse survivors in prenatal care. The integration into the maternity setting of existing evidence-based interventions for the mental health and behavioral sequelae of abuse is needed.",0 +https://doi.org/10.1023/a:1024765001122,"Combat, dissociation, and posttraumatic stress disorder in Australian Vietnam veterans","The specificity of various wartime stressors for different posttraumatic stress disorder (PTSD) symptoms is inconsistently reported in the literature. Combat, wounding, and peritraumatic dissociation have not been assessed together in their effects on each of the various PTSD symptom clusters. This cohort study of a random sample of male Australian Army Vietnam veterans yielded psychiatric assessments of 641 subjects. PTSD measures comprised symptom criteria for reexperiencing, numbing and avoidance, hyperarousal, and PTSD diagnosis both lifetime and current within the past month. Logistic regression is used to examine the effects of combat, wounding, and peritraumatic dissociation together on PTSD. Combat experiences comprised four components derived from a principal components analysis of combat experiences: direct combat exposure, exposure to death and injury, exposure to civilian death and injury, and exposure to mutilation. Each was differentially related to reexperiencing, avoidance, hyperarousal, and PTSD diagnosis. Being wounded was not related to lifetime or current PTSD and peritraumatic dissociation was related to all diagnostic components of PTSD in the presence of other variables.",0 +https://doi.org/10.1037/a0022503,Attachment insecurities and the processing of threat-related information: Studying the schemas involved in insecure people's coping strategies.,"In 6 studies we examined procedural, scriptlike knowledge associated with 2 different kinds of attachment insecurity: anxiety and avoidance. The studies examined associations between attachment insecurities, the cognitive accessibility of sentinel and rapid fight-flight schemas, and the extent to which these schemas guide the processing of threat-related information and actual behavior during an experimentally induced threatening event. Anxious attachment was associated with (a) greater accessibility of the sentinel schema in narratives of threatening events; (b) faster, deeper, and more schema-biased processing of information about components of the sentinel schema; and (c) quicker detection of a threat. Avoidant attachment was associated with greater accessibility of the rapid fight-flight schema in narratives of threatening events and faster, deeper, and more schema-biased processing of information about components of the schema. We discuss implications of the findings for understanding the cognitive aspects of insecure people's coping strategies in threatening situations, as well as the potential benefits of these strategies to the people who enact them and to the groups to which they belong.",0 +https://doi.org/10.1159/000284632,A Typology of Psychiatric Reactions to Motor Vehicle Accidents,"Perhaps owing to their commonness, nonserious motor vehicle accidents, i.e. those not resulting in death or major bodily injury, have received scant systematic study in the psychiatric literature. However, patients presenting with lingering psychiatric distress following such accidents are seen commonly in practice. The authors reviewed the patterns of presentation and background circumstances in a series of 55 such cases, presenting at varying periods of time after the incident. They found such patients to cluster into four distinct groups. The most common presentation was that of a depressive syndrome, outnumbering those with features of posttraumatic stress disorder by 3:1.",0 +https://doi.org/10.1016/s0084-3970(08)70737-0,Natural Course of Posttraumatic Stress Disorder: A 20-Month Prospective Study of Turkish Earthquake Survivors,"Objective: A 20-month prospective follow-up of survivors of the severe earthquake in Turkey in 1999 examined the natural course of posttraumatic stress disorder (PTSD) and the contribution of different symptom clusters to the emergence of PTSD. Method: Subjects were randomly sampled in a suburb of Istanbul that was severely affected by the earthquake. A total of 464 adults were assessed with a self-report instrument for PTSD symptoms on 3 consecutive surveys that were administered 1 to 3, 6 to 10, and 18 to 20 months following the earthquake. Results: The prevalence of PTSD was 30.2% on the first survey and decreased to 26.9% and 10.6% on the second and third surveys, respectively. Female subjects showed initially higher (34.8%) PTSD rates compared with male subjects (19.1%). However, gender differences disappeared by the time of the third survey due to high spontaneous remission rates in female subjects. Low levels of chronic and delayed-onset PTSD were observed. A major contribution of the avoidance symptoms to PTSD diagnosis was identified by statistical analysis. Conclusions: Initial PTSD following an earthquake may be as prevalent as in other natural disasters, but high rates of spontaneous remission lead to low prevalence 1.5 years following the earthquake. Initial avoidance characteristics play a major role in the emergence of PTSD.",0 +https://doi.org/10.1080/17450120802282876,"The relationship between sense of hope, family support and post-traumatic stress disorder among children: The case of young victims of rocket attacks in Israel","Post-traumatic stress disorder (PTSD) is diagnosed commonly in Israeli children following violent episodes of the ongoing Arab–Israeli conflict. Research has suggested that as many as 70% of war-affected children present symptoms of PTSD. This study examined two factors that may contribute to resiliency: perceived social support and sense of hope. The research participants (n = 311) were children who experienced the rocket attacks during Israel's Second Lebanon War and a control group of Israeli children from a town that was not affected directly by the 2006 war. It was hypothesized that a complex relationship would be demonstrated between presentation of symptoms of PTSD and perceived social support. It was hypothesized further that an inverse relationship would be measured between sense of hope and presentation of symptoms of PTSD in the children who experienced the rocket attacks and that those in the control group would show less symptoms of PTSD than those in the experimental group. Finally, females ...",0 +https://doi.org/10.1016/j.injury.2011.11.025,Do compensation processes impair mental health? A meta-analysis,"Victims who are involved in a compensation processes generally have more health complaints compared to victims who are not involved in a compensation process. Previous research regarding the effect of compensation processes has concentrated on the effect on physical health. This meta-analysis focuses on the effect of compensation processes on mental health.Prospective cohort studies addressing compensation and mental health after traffic accidents, occupational accidents or medical errors were identified using PubMed, EMBASE, PsycInfo, CINAHL, and the Cochrane Library. Relevant studies published between January 1966 and 10 June 2011 were selected for inclusion.Ten studies were included. The first finding was that the compensation group already had higher mental health complaints at baseline compared to the non-compensation group (standardised mean difference (SMD)=-0.38; 95% confidence interval (CI) -0.66 to -0.10; p=.01). The second finding was that mental health between baseline and post measurement improved less in the compensation group compared to the non-compensation group (SMD=-0.35; 95% CI -0.70 to -0.01; p=.05). However, the quality of evidence was limited, mainly because of low quality study design and heterogeneity.Being involved in a compensation process is associated with higher mental health complaints but three-quarters of the difference appeared to be already present at baseline. The findings of this study should be interpreted with caution because of the limited quality of evidence. The difference at baseline may be explained by a selection bias or more anger and blame about the accident in the compensation group. The difference between baseline and follow-up may be explained by secondary gain and secondary victimisation. Future research should involve assessment of exposure to compensation processes, should analyse and correct for baseline differences, and could examine the effect of time, compensation scheme design, and claim settlement on (mental) health.",0 +https://doi.org/10.1371/journal.pone.0120270,A Meta-Analysis of Risk Factors for Combat-Related PTSD among Military Personnel and Veterans,"Post-traumatic stress disorder (PTSD), a complex and chronic disorder caused by exposure to a traumatic event, is a common psychological result of current military operations. It causes substantial distress and interferes with personal and social functioning. Consequently, identifying the risk factors that make military personnel and veterans more likely to experience PTSD is of academic, clinical, and social importance. Four electronic databases (PubMed, Embase, Web of Science, and PsycINFO) were used to search for observational studies (cross-sectional, retrospective, and cohort studies) about PTSD after deployment to combat areas. The literature search, study selection, and data extraction were conducted by two of the authors independently. Thirty-two articles were included in this study. Summary estimates were obtained using random-effects models. Subgroup analyses, sensitivity analyses, and publication bias tests were performed. The prevalence of combat-related PTSD ranged from 1.09% to 34.84%. A total of 18 significant predictors of PTSD among military personnel and veterans were found. Risk factors stemming from before the trauma include female gender, ethnic minority status, low education, non-officer ranks, army service, combat specialization, high numbers of deployments, longer cumulative length of deployments, more adverse life events, prior trauma exposure, and prior psychological problems. Various aspects of the trauma period also constituted risk factors. These include increased combat exposure, discharging a weapon, witnessing someone being wounded or killed, severe trauma, and deployment-related stressors. Lastly, lack of post-deployment support during the post-trauma period also increased the risk of PTSD. The current analysis provides evidence of risk factors for combat-related PTSD in military personnel and veterans. More research is needed to determine how these variables interact and how to best protect against susceptibility to PTSD.",0 +https://doi.org/10.1037/ort0000126,"Associations of adult separation anxiety disorder with conflict-related trauma, ongoing adversity, and the psychosocial disruptions of mass conflict among West Papuan refugees.","Refugees commonly experience traumatic events that threaten the self and close others, suggesting the possibility that they may experience overlapping symptoms of posttraumatic stress disorder (PTSD) and separation anxiety disorder (SAD). We examine this possibility among West Papua refugees (n = 230) displaced to Port Moresby, Papua New Guinea. We also examine associations between the combined PTSD-SAD construct and indices of past trauma exposure, ongoing adversity, and the psychosocial disruptions caused by mass conflict and displacement. We applied culturally adapted interview modules to assess symptoms of PTSD, SAD, traumatic events (TEs), ongoing adversity, and 5 psychosocial dimensions. Latent class analysis identified a PTSD class (23%), a posttraumatic (PT) SAD class (22%), and a low-symptom class (55%). Compared with the low-symptom class, both the PTSD and PT-SAD classes endorsed higher levels of exposure to all domains of TEs (conflict-related trauma, witnessing murder, childhood related adversities, traumatic losses, and health stress) and ongoing adversity (access to health care, displacement/separation, safety in the community, and access to basic needs), but the 2 comorbid groups did not differ on these indices. The PT-SAD class alone scored higher than the low-symptom reference class in relation to disruptions to the psychosocial domains (safety/security, bonds/network, access to justice, roles/identities, existential meaning) and higher than the PTSD class on safety/security, justice and roles/identities. Our findings suggest that the PT-SAD pattern may represent a response to the most severe forms of psychosocial disruptions of mass conflict among refugees. A focus on separation anxiety may enhance psychotherapies designed to treat PTSD in refugees. (PsycINFO Database Record",0 +https://doi.org/10.1073/pnas.1217750110,Childhood maltreatment is associated with distinct genomic and epigenetic profiles in posttraumatic stress disorder,"Childhood maltreatment is likely to influence fundamental biological processes and engrave long-lasting epigenetic marks, leading to adverse health outcomes in adulthood. We aimed to elucidate the impact of different early environment on disease-related genome-wide gene expression and DNA methylation in peripheral blood cells in patients with posttraumatic stress disorder (PTSD). Compared with the same trauma-exposed controls ( n = 108), gene-expression profiles of PTSD patients with similar clinical symptoms and matched adult trauma exposure but different childhood adverse events ( n = 32 and 29) were almost completely nonoverlapping (98%). These differences on the level of individual transcripts were paralleled by the enrichment of several distinct biological networks between the groups. Moreover, these gene-expression changes were accompanied and likely mediated by changes in DNA methylation in the same loci to a much larger proportion in the childhood abuse (69%) vs. the non-child abuse-only group (34%). This study is unique in providing genome-wide evidence of distinct biological modifications in PTSD in the presence or absence of exposure to childhood abuse. The findings that nonoverlapping biological pathways seem to be affected in the two PTSD groups and that changes in DNA methylation appear to have a much greater impact in the childhood-abuse group might reflect differences in the pathophysiology of PTSD, in dependence of exposure to childhood maltreatment. These results contribute to a better understanding of the extent of influence of differences in trauma exposure on pathophysiological processes in stress-related psychiatric disorders and may have implications for personalized medicine.",0 +https://doi.org/10.1093/epirev/mxi003,The Epidemiology of Post-Traumatic Stress Disorder after Disasters,"Traumatic experiences are relatively common. More than two thirds of persons in the general population may experience a significant traumatic event at some point in their lives, and up to one fifth of people in the United States may experience such an event in any given year (1–5). Although comparable international data are limited, large proportions of populations in many countries have been exposed to terrorism, forced relocation, and violence, which suggests that the overall prevalence of exposure to traumatic events worldwide may be even higher than that in the United States (6, 7). Disasters (e.g., floods, transportation accidents) are traumatic events that are experienced by many people and may result in a wide range of mental and physical health consequences (8). In one survey of US residents, 13 percent of the sample reported a lifetime exposure to natural or human-generated disaster (9). In the National Comorbidity Survey, 18.9 percent of men and 15.2 percent of women reported a lifetime experience of a natural disaster (4). Post-traumatic stress disorder (PTSD) is the most commonly studied and probably the most frequent and debilitating psychological disorder that occurs after traumatic events and disasters (8, 10). The growing threat of terrorism worldwide has heightened our awareness of disasters as a potentially important determinant of population health and suggests a pressing need both to identify key areas of consensus in postdisaster research and to highlight areas that require additional study (11). It is our purpose in this review to contribute to this overall goal by comprehensively and systematically assessing the epidemiologic evidence about PTSD after disasters.",0 +https://doi.org/10.1080/15374416.2015.1094739,The Role of Anxiety Control and Treatment Implications of Informant Agreement on Child PTSD Symptoms,"The goal of this study is to examine parent and child agreement of child posttraumatic stress disorder (PTSD) symptoms pre- and posttreatment, as well as potential moderators of agreement including treatment responder status, child anxiety control, and parent self-reported PTSD symptoms. We examined child self-reported and parent-reported child PTSD symptoms from the Diagnostic Interview Schedule for Children. Of the 141 parent-child pairs, the mean age of children was 12.72 (SD = 3.40), 53% were female, and 54% were Black. A subsample of participants (n = 47) was assessed after completion of a cognitive behavioral therapy treatment for PTSD. Moderate levels of agreement were found at baseline, though Criterion D (increased arousal) symptoms had lower levels of agreement than the other symptom clusters. Symptom agreement was lower at posttreatment. Treatment responders had higher levels of baseline informant agreement than treatment nonresponders. Child perceived anxiety control significantly moderated informant agreement, such that pairs with children who had high levels of perceived control of their anxiety had lower PTSD symptom agreement where children reported lower symptoms relative to their parents. Contrary to expectations, parent self-reported PTSD did not moderate parent-child symptom agreement. Factors associated with higher parent-child agreement of child PTSD symptoms were being a PTSD treatment responder and children with lower perceived anxiety control. These findings have potential implications for determining those who may benefit from greater symptom monitoring over the course of intervention and potential alternative intervention approaches.",0 +https://doi.org/10.2190/17du-21aa-5huk-7ufg,Physiological Reactivity to Cognitive Stressors: Variations by Age and Socioeconomic Status,"The present study focused on age and SES differences in stress reactivity in response to cognitively challenging tasks. Specifically, we assessed within-person trajectories of cortisol, a steroid hormone released by the adrenal gland in response to stressors, before, during, and after exposure to cognitively challenging tasks. We extend the current literature by simultaneously examining age and SES differences in physiological reactivity. Findings suggest that age and SES both play an important role in reactivity, such that it was the older adults with higher SES who were the most physiologically reactive to cognitive stressors. Implications of these findings for cognitive aging research are discussed.",0 +https://doi.org/10.1007/s12193-014-0160-5,Multimodal PTSD characterization via the StartleMart game,"Computer games have recently shown promise as a diagnostic and treatment tool for psychiatric rehabilitation. This paper examines the potential of combining multiple modalities for detecting affective responses of patients interacting with a simulation built on game technology, aimed at the treatment of mental diagnoses such as post traumatic stress disorder (PTSD). For that purpose, we couple game design and game technology to create a game-based tool for exposure therapy and stress inoculation training that utilizes stress detection for the automatic profiling and potential personalization of PTSD treatments. The PTSD treatment game we designed forces the player to go through various stressful experiences while a stress detection mechanism profiles the severity and type of PTSD by analyzing the physiological responses to those in-game stress elicitors in two separate modalities: skin conductance (SC) and blood volume pulse (BVP). SC is often used to monitor stress as it is connected to the activation of the sympathetic nervous system (SNS). By including BVP into the model we introduce information about para-sympathetic activation, which offers a more complete view of the psycho-physiological experience of the player; in addition, as BVP is also modulated by SNS, a multimodal model should be more robust to changes in each modality due to particular drugs or day-to-day bodily changes. Overall, the study and analysis of 14 PTSD-diagnosed veteran soldiers presented in this paper reveals correspondence between diagnostic standard measures of PTSD severity and SC and BVP responsiveness and feature combinations thereof. The study also reveals that these features are significantly correlated with subjective evaluations of the stressfulness of experiences, represented as pairwise preferences. More importantly, the results presented here demonstrate that using the modalities of SC and BVP captures a more nuanced representation of player stress responses than using SC alone. We conclude that the results support the use of the simulation as a relevant treatment tool for stress inoculation training, and suggest the feasibility of using such a tool to profile PTSD patients. The use of multiple modalities appears to be key for an accurate profiling, although further research and analysis are required to identify the most relevant physiological features for capturing user stress.",0 +https://doi.org/10.1080/02699050500394090,Errors in self-report of post-traumatic stress disorder after severe traumatic brain injury,"Assessing PTSD by questionnaire can lead to false positive diagnosis after severe traumatic brain injury. Sumpter and McMillan, reported quantitative data on 34 people with severe TBI; 59% were PTSD 'cases' by questionnaire assessment, but only 3% using a structured interview. The present paper describes ways in which these individuals made errors on questionnaires. Some did not follow questionnaire instructions because of inattention and concrete thinking or instead reported effects of brain injury. Symptom overlap between TBI and PTSD, including insomnia, irritability and impaired concentration can cause errors. Brain injury can also provoke curiosity about loss of memory (during coma, retrograde and post-traumatic amnesia), decreased participation, social withdrawal and difficulty adjusting to injury that may be mistaken for fear-associated PTSD symptoms. Assessment of PTSD by questionnaire can lead to erroneous conclusions and factors related to brain injury must be carefully considered when investigating PTSD.",0 +https://doi.org/10.1371/journal.pone.0094075,Dysregulation in microRNA Expression Is Associated with Alterations in Immune Functions in Combat Veterans with Post-Traumatic Stress Disorder,"While the immunological dysfunction in combat Veterans with post-traumatic stress disorder (PTSD) has been well documented, the precise mechanisms remain unclear. The current study evaluated the role of microRNA (miR) in immunological dysfunction associated with PTSD. The presence of peripheral blood mononuclear cells (PBMC) and various lymphocyte subsets in blood collected from PTSD patients were analyzed. Our studies demonstrated that the numbers of both PBMC and various lymphocyte subsets increased significantly in PTSD patients. When T cells were further analyzed, the percentage of Th1 cells and Th17 cells increased, regulatory T cells(Tregs) decreased, while Th2 cells remained unaltered in PTSD patients. These data correlated with increased plasma levels of IFN-γ and IL-17 while IL-4 showed no significant change. The increase in PBMC counts, Th1 and Th17 cells seen in PTSD patients correlated with the clinical scores. High-throughput analysis of PBMCs for 1163 miRs showed that the expression of a significant number of miRs was altered in PTSD patients. Pathway analysis of dysregulated miRs seen in PTSD patients revealed relationship between selected miRNAs and genes that showed direct/indirect role in immunological signaling pathways consistent with the immunological changes seen in these patients. Of interest was the down-regulation of miR-125a in PTSD, which specifically targeted IFN-γ production. Together, the current study demonstrates for the first time that PTSD was associated with significant alterations in miRNAs, which may promote pro-inflammatory cytokine profile. Such epigenetic events may provide useful tools to identify potential biomarkers for diagnosis, and facilitate therapy of PTSD.",0 +https://doi.org/10.1016/0006-3223(95)00519-6,Dopamine D2 receptor (DRD2) gene and susceptibility to posttraumatic stress disorder: A study and replication,"Subjects on an addiction treatment unit who had been exposed to severe combat conditions in Vietnam were screened for posttraumatic stress disorder (PTSD). Of 24 with PTSD, 58.3% carried the D2A1 allele. Of the remaining eight who did not meet PTSD criteria, 12.5% carried the D2A1 allele (p = 0.04). In a replication study of 13 with PTSD, 61.5% carried the D2A1 allele. Of the remaining 11 who did not meet criteria for PTSD, 0% carried the D2A1 allele (p = 0.002). For the combined group 59.5% of those with PTSD carried the D2A1 allele versus 5.3% of those who did not have PTSD (p = 0.0001). These results suggest that a DRD2 variant in linkage disequilibrium with the D2A1 allele confers an increased risk to PTSD, and the absence of the variant confers a relative resistance to PTSD.",0 +https://doi.org/10.1016/j.psychres.2015.07.071,"Incidence, clinical correlates and treatment effect of rage in anxious children","Episodic rage represents an important and underappreciated clinical feature in pediatric anxiety. This study examined the incidence and clinical correlates of rage in children with anxiety disorders. Change in rage during treatment for anxiety was also examined. Participants consisted of 107 children diagnosed with an anxiety disorder and their parents. Participants completed structured clinical interviews and questionnaire measures to assess rage, anxiety, functional impairment, family accommodation and caregiver strain, as well as the quality of the child's relationship with family and peers. Rage was a common feature amongst children with anxiety disorders. Rage was associated with a more severe clinical profile, including increased anxiety severity, functional impairment, family accommodation and caregiver strain, as well as poorer relationships with parents, siblings, extended family and peers. Rage was more common in children with separation anxiety, comorbid anxiety, attention deficit/hyperactivity disorder and behavioral disorders, but not depressive symptoms. Rage predicted higher levels of functional impairment, beyond the effect of anxiety severity. Rage severity reduced over treatment in line with changes in anxiety symptoms. Findings suggest that rage is a marker of greater psychopathology in anxious youth. Standard cognitive behavioral treatment for anxiety appears to reduce rage without adjunctive treatment.",0 +https://doi.org/10.1037/1040-3590.9.3.233,Shortening the CES–D to improve its ability to detect cases of depression.,"Psychometric analyses evaluated how primary care patients with and without major depressive disorder endorsed individual response options on the Center for Epidemiologic Studies-Depression Scale (CES-D; L. S. Radloff, 1977). The analyses were then used to identify a subset of items that when appropriately weighted improved the efficiency with which depressed individuals were identified. Efficiency of the revised measure was evaluated relative to standard cutpoints used with the full scale. Results showed that some improvement in most indices of efficiency could be achieved with half as many items and a simplified scoring scheme, but great improvement in one measure was usually achieved only at the expense of other measures of efficiency. The efficiency of the CES-D can be improved with appropriate analytic techniques, but its limitations as a self-report screening measure persist.",0 +https://doi.org/10.1080/17542863.2012.681670,Trauma amid ‘culture of avoidance’: Symptom profile of PTSD in Bedouin members of the Israel Defense Forces,"The appropriateness and cultural relevance of the construct of posttraumatic stress disorder (PTSD) has been questioned by previous studies of non-Western populations. The current study examined the symptom profile of PTSD in an ethnic minority group of Bedouin members of the Israel Defense Forces (N=317). Comparing individuals with PTSD to traumatized individuals without PTSD, we identified a pattern of symptoms that differed between the groups: while symptoms from the re-experiencing cluster were those most frequently reported by the PTSD group, avoidance symptoms were the most frequently reported by the traumatized group without PTSD. Our findings highlight the role of sociocultural considerations in the development of trauma-related problems and the special meaning of avoidant strategies for traumatized individuals from non-Western backgrounds.",0 +https://doi.org/10.1002/da.20091,Anxiety sensitivity taxon and trauma: discriminant associations for posttraumatic stress and panic symptomatology among young adults,"The present investigation examined whether the anxiety sensitivity (AS) taxon interacts with theoretically relevant traumatic types of aversive life events to show discriminant (concurrent) associations with posttraumatic stress symptoms, but not panic attacks or bodily vigilance among young adults. The interaction between the AS Taxon Scale and trauma exposure accounted for significant variance above and beyond negative affectivity and each of the main effects in terms of a posttraumatic stress disorder (PTSD) symptom-severity criterion variable, but not for posttraumatic-related thoughts and beliefs or either panic-relevant criterion variable. Thus, results suggest that although the AS taxon may function as a common cognitive diathesis for PTSD and panic outcomes, the AS taxon coupled with traumatic life events may confer emotional vulnerability that is specific to PTSD symptoms. These findings are discussed in terms of theoretical and clinical implications for PTSD and panic vulnerability.",0 +https://doi.org/10.1177/1073191114550816,A Brief Retrospective Method for Identifying Longitudinal Trajectories of Adjustment Following Acute Stress,"Research increasingly indicates that prototypical trajectories of resilience, recovery, delayed, and chronic distress characterize reactions to acute adversity. However, trajectory research has been limited by the practical and methodological difficulties of obtaining pre-event and longitudinal data. In two studies, we employed a novel method in which trained interviewers provided a graphical depiction of prototypical stress trajectories to participants and asked them to select the one that best described their experience. In Study 1, self-identified trajectories from 21 high-exposure survivors of the September 11th World Trade Center attacks distinguished variation in posttraumatic stress disorder and depression symptoms at 7 and 18 months, and were consistent with trajectories based on longitudinal outcomes and friend/relative ratings. In Study 2, we examined self-identified trajectories from 115 bereaved spouses at 1.5 to 3 years. Persons who identified a resilient trajectory, compared with recovery and chronic distress trajectories, had fewer interviewer-rated symptoms of grief, depression, and posttraumatic stress disorder were rated as functioning more effectively by friends, reported higher life satisfaction, and had fewer somatic complaints. The present results provide initial evidence for the construct validity of a cross-sectional and less demanding method for identifying acute stress trajectories.",0 +https://doi.org/10.1037/a0032486,Nonpathological response to ongoing traumatic stress.,"For individuals faced with ongoing traumatic stress, a range of adverse reactions are possible. Carrying over models from acute trauma, developed for soldiers suffering months and years after returning from combat, and for victims of rape and other community violence, most psychological literature emphasizes psychopathological syndromes, especially posttraumatic stress disorder (PTSD). The implicit assumption is that reactions that entail significant suffering must be explained by a diagnosable disorder. Ironically, this locates the mechanisms that explain ongoing suffering within the mind of the victim rather than in the stressful context in which s/he is forced to live. We present a description and venture theoretical consideration of an alternative phenomenon, which we refer to as ongoing traumatic stress response (OTSR). OTSR is not a diagnosis nor label, but an alternative framework through which to make sense of intense psychological suffering in the increasingly common situation of ongoing traumatic stress. In this article, we consider conceptual boundaries that distinguish pathologic reactions such as PTSD from nonpathologic reactions better captured by OTSR. We draw a distinction between PTSD, which is conceptualized as a disorder because it is driven primarily by internal psychological effects of a past trauma, and OTSR, which is determined by real and external environmental factors in the present. To illustrate these boundaries, we provide examples of how experiences and behaviors that may appear to reflect symptoms of PTSD or other disorders are actually adaptive and normative under extreme conditions, despite their causing clinical levels of distress. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1586/ern.10.114,Neurobiology of suicidal behavior in post-traumatic stress disorder,"Posttraumatic stress disorder (PTSD) is a frequent and severe disorder that can develop after exposure to a traumatic event. People with PTSD suffer from a range of symptoms that interfere with their capacities to enjoy normal life. Post-traumatic stress disorder is frequently comorbid with other psychiatric disorders. Multiple lines of evidence suggest an important relationship between PTSD and suicidal behavior. This association has been observed both in clinical and in general population samples, and is irrespective of the type of trauma that led to PTSD. High rates of suicidal behavior have been found among PTSD patients exposed to combat trauma, physical or sexual abuse, intimate partner violence and natural disasters. Neurobiological changes observed in PTSD include alterations in the hypothalamic–pituitary–adrenal axis, increased noradrenergic activity, and changes in the serotonergic and other neurotransmitter systems. Further studies of the role of the endocannabinoid system in the pathophysiology of PTSD may help to develop new modalities to treat PTSD and suicidal behavior in persons with PTSD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)",0 +https://doi.org/10.2307/1519784,Race Differences in Depressive Symptoms: A Dynamic Perspective on Stress Exposure and Vulnerability,"The existence, nature, and strength of race differences in mental health remain unclear after several decades of research. In this research, we examine black-white differences in the relationship between acute stressors and depressive symptoms. We reframe the stress exposure and differential vulnerability hypotheses in the context of long-term trajectories of stress and depression, and we hypothesize that trajectories of stress growth will be associated with trajectories of depressive symptom growth. Using latent growth curve analysis of a sample of 1,972 older persons interviewed three times at three-year intervals, we test the hypotheses that (1) growth in exposure to loss-related events will predict growth in depressive symptoms, and (2) African Americans will experience greater stress growth than whites. Results support the hypotheses. Stress growth exhibited a linear increase for blacks but not for whites, and predicted depression growth for both races, but explained more variance for blacks than for whites.",0 +https://doi.org/10.1016/j.socscimed.2009.07.020,Use of khat and posttraumatic stress disorder as risk factors for psychotic symptoms: A study of Somali combatants,"The chewing of the khat leaves, which contain the amphetamine-like cathinone, is a traditional habit in Somalia. Our objective was to explore the effects of khat use and Posttraumatic Stress Disorder (PTSD) on paranoid symptoms and to test a potential causal chain. We report on a cross-sectional study in Somalia that was conducted in 2003. Trained local staff interviewed 8723 personnel of armed groups in seven regional convenience samples. Of them, 8124 were included in the analysis. We assessed current khat use, PTSD symptoms, functional drug use and paranoid ideation using items from the Composite International Diagnostic Interview (CIDI) and the Somali version of the Posttraumatic Stress Diagnostic Scale (PDS). Applying the causal steps approach, in a series of logistic regression models, we used PTSD as independent and paranoia as outcome variable; the quantity of khat use was defined as mediator variable and functional drug use as moderator. The results showed that respondents with PTSD used khat more frequently. Khat chewers with PTSD reported a higher intake compared to khat chewers without PTSD. Among excessive khat chewers with PTSD, paranoia was most frequent. The greatest amount of khat use was among respondents with PTSD who indicated that they found drugs help them to forget war experiences. The proposed mediated moderation model was supported by the data, i.e. besides the direct effects of PTSD and functional drug use on paranoia, the amount of khat use appeared to be a mechanism, by which paranoia is caused. We conclude that in our data we have uncovered a relationship between khat, PTSD and paranoia. Khat is functionally used by respondents with PTSD. Findings support a dose effect: the more khat consumption and when a respondent has PTSD, the higher the odds for paranoid ideation. However, the proposed causal chain needs to be confirmed in longitudinal studies. Demobilization and reintegration programs in Somalia need to be prepared to deal with complex psychological problems.",0 +https://doi.org/10.3389/fneur.2014.00164,Mitochondrial Gene Expression Profiles and Metabolic Pathways in the Amygdala Associated with Exaggerated Fear in an Animal Model of PTSD,"The metabolic mechanisms underlying the development of exaggerated fear in post-traumatic stress disorder (PTSD) are not well defined. In the present study, alteration in the expression of genes associated with mitochondrial function in the amygdala of an animal model of PTSD was determined. Amygdala tissue samples were excised from 10 non-stressed control rats and 10 stressed rats, 14 days post-stress treatment. Total RNA was isolated, cDNA was synthesized, and gene expression levels were determined using a cDNA microarray. During the development of the exaggerated fear associated with PTSD, 48 genes were found to be significantly upregulated and 37 were significantly downregulated in the amygdala complex based on stringent criteria (p < 0.01). Ingenuity pathway analysis revealed up- or downregulation in the amygdala complex of four signaling networks - one associated with inflammatory and apoptotic pathways, one with immune mediators and metabolism, one with transcriptional factors, and one with chromatin remodeling. Thus, informatics of a neuronal gene array allowed us to determine the expression profile of mitochondrial genes in the amygdala complex of an animal model of PTSD. The result is a further understanding of the metabolic and neuronal signaling mechanisms associated with delayed and exaggerated fear.",0 +https://doi.org/10.1023/a:1024404729251,Posttraumatic stress disorder in veterans with spinal cord injury: Trauma-related risk factors,"Trauma-related risk factors for posttraumatic stress disorder (PTSD) were examined in a sample of 125 veterans with spinal cord injury. Category of injury was found to be the most consistent predictor of PTSD diagnosis and symptom severity with paraplegia predicting more PTSD symptoms than quadriplegia. The occurrence of a head injury at the time of the trauma was found to predict PTSD symptom severity measures, but not PTSD diagnosis. Trauma recency consistently predicted Impact of Event score (IES) and was found to be related to current PTSD severity and lifetime PTSD diagnosis in multiple but not simple regression models. Trauma severity was found to be significantly related to self-reported PTSD symptoms and lifetime PTSD diagnosis in simple but not in multiple regression analyses. Type of trauma, alcohol or other drug (AOD) use during the trauma and loss of consciousness (LOC) during the trauma were not consistently associated with PTSD symptom severity or diagnosis.",0 +,Epidemiological risk factors for trauma and PTSD.,,0 +https://doi.org/10.1016/j.jad.2014.10.025,Elucidating the transdiagnostic dimensional structure of trauma-related psychopathology: Findings from VA cooperative study 504 – risperidone treatment for military service related chronic post traumatic stress disorder,"Three of the most common trauma-related mental disorders—posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD)—are highly comorbid and share common transdiagnostic symptom dimensions of threat (i.e., fear) and loss (i.e., dysphoria) symptomatology. However, empirical evaluation of the dimensional structure of component aspects of these disorders is lacking. Using structured clinical interview data from U.S. military veterans with chronic military-related PTSD, we evaluated the transdiagnostic dimensional structure of PTSD, MDD, and GAD symptoms. We then examined the relationship between the best-fitting transdiagnostic model of these symptoms, and measures of physical and mental functioning, and life satisfaction and well-being. Exploratory factor analysis revealed that a 3-factor transdiagnostic model comprised of loss (i.e., dysphoria), threat (i.e., anxious arousal, re-experiencing, and avoidance symptoms), and somatic anxiety (i.e., physiological manifestations of anxiety) symptoms provided the best representation of trauma-related PTSD, MDD, and GAD symptoms. Somatic anxiety symptoms were independently associated with physical functioning, while loss symptoms were independently associated with mental functioning and life satisfaction and well-being. Evaluation of study aims in a relatively homogeneous sample of veterans with chronic, military-related PTSD. Results of this study suggest that a 3-factor transdiagnostic model best characterizes the dimensional structure of PTSD, MDD, and GAD symptoms in military veterans with chronic military-related PTSD. This model evidenced external validity in demonstrating differential associations with measures of physical and mental functioning, and life satisfaction and well-being. Results provide support for emerging contemporary models of psychopathology, which emphasize transdiagnostic and dimensional conceptualizations of mental disorders. Such models may have utility in understanding the functional status of trauma survivors.",0 +https://doi.org/10.1037/a0018601,Psychopathology and resilience following traumatic injury: A latent growth mixture model analysis.,"To investigate trajectories of PTSD and depression following traumatic injury using latent class growth curve modeling.A longitudinal study of 330 injured trauma survivors was conducted and participants were assessed during hospitalization, and at 1, 3, and 6 months follow-up. Acute Stress Disorder (ASD) was assessed during hospitalization using the Acute Stress Disorder Interview (ASD-I), PTSD was measured at all follow-up with the Post-Traumatic Stress Diagnostic Scale (PDS) and depression was measured at hospitalization with the (BSI) and at follow-up with the Center for Epidemiologic Studies Depression Scale (CESDS). Covariates were explored, including coping self-efficacy, anger, education level, and mechanism of injury.Four latent classes were identified for PTSD and Depression symptoms: chronic distress, delayed distress, recovered, and resilience. When compared to the resilient group, individuals with chronic distress were more likely to have been assaulted, had higher levels of anger, and had less coping self-efficacy. The delayed distress group had lower education levels, higher levels of coping self-efficacy, and higher levels of anger. Individuals in the recovered group had fewer years of education, and higher levels of anger.The majority of the injured trauma sample demonstrated resiliency, with those exhibiting distress doing so as a delayed, chronic, or recovered trajectory. Coping self efficacy, education, assaultive trauma type, and anger were important covariates of depression and PTSD trajectories. These results are similar to studies of individuals who experienced a major health threat and with survivors from the World Trade Center attacks in the U.S.",1 +https://doi.org/10.1016/s0006-3223(03)00086-6,"Severity, timing, and duration of reactions to trauma in the population: an example from Mexico","Normative data describing acute reactions to trauma are few. Of 2509 Mexican adults interviewed with the Composite International Diagnostic Interview, 1241 met trauma exposure criteria for index events occurring more than 1 year previously. The modal response, describing 45%, was a reaction to trauma that was mild (present but below levels of posttraumatic stress disorder symptom criteria), immediate (within the first month), and transient (over within a year). Nonetheless, 29% experienced immediate and serious reactions. Of these, 44% had chronic posttraumatic stress disorder symptoms. Those whose reactions were serious and chronic differed in many ways from those whose reactions were serious but transient. They had more traumatic events during their lives, and their index events were more likely to have occurred in childhood and to have involved violence. They had more symptoms and functional impairment after the trauma and higher levels of depressive and somatic symptoms when data were collected. Psychiatrically significant reactions to trauma persist often enough to justify their detection and treatment. Persons in need of acute intervention can be identified on the basis of the nature and severity of the initial response as well as characteristics of the stressor.",0 +https://doi.org/10.1016/0006-3223(95)00314-2,Positive symptoms of psychosis in posttraumatic stress disorder,"The possible presence of hallucinations and delusional thoughts in posttraumatic stress disorder (PTSD) was investigated. Other symptom clusters were also assessed in order to further clarify the nature of PTSD. Twenty combat veterans with PTSD were compared to 18 combat veterans without PTSD on symptom rating scales. The subjects with PTSD exhibited a greater degree of depression, anxiety, agitation, anhedonia, and positive symptoms of psychosis than the comparison group. Specifically, the PTSD group manifested increased hallucinations, delusions, and bizarre behavior. Some of these positive symptoms did not appear to be due to reexperiencing of the trauma. The groups were not significantly different on indices of mania, thought disorder, or inertia. The clinical and diagnostic implications of the results are discussed. A diagnosis of PTSD should be considered with patients who have positive symptoms in the absence of thought disorder.",0 +https://doi.org/10.1177/1534765612459892,The dynamics of cumulative trauma and trauma types in adults patients with psychiatric disorders: Two cross-cultural studies.,There is an intricate divide between three major valid paradigms in studying traumatic processes: The psychiatric paradigm that focused mostly on the survival types of traumas and on posttraumatic ...,0 +https://doi.org/10.1002/jts.2490100310,Individual differences in posttraumatic stress disorder symptom profiles in Holocaust survivors in concentration camps or in hiding,"Symptom patterns were compared between Holocaust survivors in concentration camp (n = 70) and those who were in 'hiding' (n = 30) during the war. The impact of age at the time of the trauma, gender, and cumulative lifetime stress, and the effect of each of these variables controlling for the others, on posttraumatic stress disorder (PTSD) symptoms were also evaluated. A significant negative relationship between age at the time of the trauma and symptoms of psychogenic amnesia, hypervigilence and emotional detachment, and a positive correlation between age and intrusive thoughts, were observed. Cumulative lifetime stress was positively associated with symptoms of avoidance. The study provides the first empirical data regarding the factors that potentially explain individual differences in PTSD symptom patterns in Holocaust survivors.",0 +https://doi.org/10.1192/bjp.bp.114.148551,Pharmacotherapy for post-traumatic stress disorder: Systematic review and meta-analysis,"Pharmacological treatment is widely used for post-traumatic stress disorder (PTSD) despite questions over its efficacy.To determine the efficacy of all types of pharmacotherapy, as monotherapy, in reducing symptoms of PTSD, and to assess acceptability.A systematic review and meta-analysis of randomised controlled trials was undertaken; 51 studies were included.Selective serotonin reuptake inhibitors were found to be statistically superior to placebo in reduction of PTSD symptoms but the effect size was small (standardised mean difference -0.23, 95% CI -0.33 to -0.12). For individual pharmacological agents compared with placebo in two or more trials, we found small statistically significant evidence of efficacy for fluoxetine, paroxetine and venlafaxine.Some drugs have a small positive impact on PTSD symptoms and are acceptable. Fluoxetine, paroxetine and venlafaxine may be considered as potential treatments for the disorder. For most drugs there is inadequate evidence regarding efficacy for PTSD, pointing to the need for more research in this area.",0 +,Resilience in highly stressed urban children: concepts and findings.,"The Rochester Child Resilience Project is a coordinated set of studies of the correlates and antecedents of outcomes relating to resilience among profoundly stressed urban children. The studies have been conducted over the course of the past decade. Based on child test data, parent, teacher, and self ratings of child adjustment, and in-depth individual interviews with parents and children, a cohesive picture has developed of child and family milieu variables that consistently differentiate children with resilient versus stress-affected outcomes within this highly stressed sample. Resilient children are characterized by an easy temperament and higher IQ; sound parent/child relationships; a parent's sense of efficacy; the parent's own wellness, especially mental health; and the child's perceived competence, realistic control, empathy, and social problem-solving.",0 +https://doi.org/10.1016/j.intimp.2015.05.020,A novel use for testosterone to treat central sensitization of chronic pain in fibromyalgia patients,"Fibromyalgia is a diffuse chronic pain condition that occurs predominantly in women and may be under-reported in men. Symptoms include a loss of feeling of well-being and generalized widespread flu-like muscle aches and pain that fail to resolve due to central sensitization of nociceptive neurons. It has commonalities with a myriad of other chronic pain conditions which include PTSD, ""Gulf War Syndrome"", and various stress-induced conditions caused, for example, by viral infection, emotional or physical stress, trauma, combat, accident or surgery. It is not understood why some individuals are susceptible to this condition and others are not. White et al., elsewhere in this issue, present a clinical feasibility study designed to test the hypothesis that 1) low or deficient testosterone serum levels are linked to a high risk for an inflamed nociceptive nervous system and resultant chronic pain states, and 2) a testosterone transdermal gel applied once a day by fibromyalgia patients can be an effective therapeutic against chronic pain. Here, a short profile of fibromyalgia is provided along with a brief summary of best practices currently recommended by clinical specialists. The link between testosterone and pain is then discussed, with an overview of scientific studies that lay the foundation for testosterone as a possible important additional therapeutic that has the potential to be safely administered and effective but also avoid the adverse effects of other therapeutics. Finally, novel mechanisms by which testosterone therapy is likely to down-modulate pain signaling are proposed.",0 +https://doi.org/10.1007/s00127-014-0970-5,A focus group study of the impact of trauma exposure in the 9/11 terrorist attacks,"Much of the mental health research that has emerged from the September 11 (9/11) attacks has been focused on posttraumatic stress disorder and its symptoms. To better understand the broader experience of individuals following a disaster, focus groups were conducted with individuals from affected companies both at Ground Zero and elsewhere in New York City.Twenty-one focus groups with a total of 140 participants were conducted in the second post-9/11 year. Areas of identified concern were coded into the following themes: Disaster Experience, Emotional Responses, Workplace Issues, Coping, and Issues of Public Concern.Discussions of focus groups included material represented in all five themes in companies both at Ground Zero and elsewhere. The emphasis and the content within these themes varied between the Ground Zero and other companies. Content suggesting symptoms of PTSD represented only a minority of the material, especially in the company groups not at Ground Zero.This study's findings revealed an array of psychosocial concerns following the 9/11 attacks among employees of companies in New York City that extended far beyond PTSD. This study's results provide further evidence that trauma exposure is central to individuals' post-disaster experience and focus, and to individuals' adjustment and experience after disaster.",0 +https://doi.org/10.1016/j.biopsych.2005.04.002,Unsupervised Fuzzy Clustering Analysis Supports Behavioral Cutoff Criteria in an Animal Model of Posttraumatic Stress Disorder,"Unsupervised fuzzy clustering (UFC) analysis is a mathematical technique that groups together objects in the multidimensional feature space according to a specified similarity measurement, thereby yielding clusters of similar data points that can be represented by a set of prototypes or centroids.Since clinical studies of mental disorders distinguish between affected and unaffected individuals, we designed an inclusion/exclusion criteria (cutoff behavioral criteria [CBC]) approach for animal behavioral studies. The effect of classifying the study population into clearly affected versus clearly unaffected individuals according to behaviors on two behavioral paradigms was statistically significant.Here the raw data from previous studies were subjected to UFC algorithms as a means of objectively testing the validity of the concept of the CBC for our experimental model. The first UFC algorithm yielded two clearly discrete clusters, found to consist almost exclusively of the exposed animals in the one and unexposed animals in the other. The second algorithm yielded three clusters corresponding to animals designated as clearly affected, partially affected, and clearly unaffected. The algorithm for physiological data in addition to behavioral data failed to elicit discrete clusters.The UFC analysis yielded data that support the conceptual contention of the CBC and lends additional validity to our previous behavioral studies.",0 +https://doi.org/10.1002/jts.21855,The 5-HTTLPR Polymorphism and Posttraumatic Stress Disorder: A Meta-Analysis,en,0 +https://doi.org/10.1037/a0019894,Prospective predictors of posttraumatic stress disorder symptoms: Direct and mediated relations.,"This study assessed the relations between pretrauma risk (neuroticism, negative affect, prior distress) and protective (self-esteem, optimism) factors and posttraumatic stress disorder (PTSD) symptoms and potential mediators (subjective event-related distress, unsupportive social interactions, perceived control) of those relations. Students (N = 1,528) at four U.S. universities completed online surveys assessing pretrauma risk and protective factors at Time 1 (T1); 84% (N = 1,281) completed a survey 2 months later (T2). PTSD symptoms and the three potential mediators were assessed among those who experienced potentially traumatic events between T1 and T2 (n = 264). PTSD symptoms related to prior traumas were controlled in all analyses. In structural equation modeling (SEM) analyses, the relation between risk factors and PTSD symptoms was mediated by unsupportive social interactions. Protective factors did not independently predict PTSD symptoms when risk factors also were included in the SEM models. Implications for research and practice are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1037/a0036787,Implicit and explicit memory in survivors of chronic interpersonal violence.,"We investigated the relationship of implicit and explicit memory to a range of symptoms in a sample of 27 women with exposure to chronic interpersonal violence (IPV). Participants viewed the first 3 letters (""stems"") of trauma-related, general threat, and neutral words; valenced words were matched with neutral words with the same stem. Free recall and a word-stem completion task were used to test explicit and implicit memory, respectively. Participants exhibited increased implicit memory for trauma-related words as compared with both general threat words and neutral ""match"" words. They also showed increased explicit memory for both general threat and trauma-related words. Finally, although neither implicit nor explicit memory was correlated with PTSD symptoms, implicit memory for trauma-related words was significantly correlated with symptoms associated with ongoing IPV. Interpersonal sensitivity, hostility, and alexithymia were significantly correlated with implicit, but not explicit, memory for trauma words. Somatization, dissociation, and alexithymia were negatively correlated with explicit, but not implicit, memory for general-threat words. These findings suggest that memory processes in survivors of IPV are closely related to the symptom profile associated with complex trauma. Exploring memory processes in survivors of IPV may lend unique insight into the development and maintenance of the symptom profile associated with IPV.",0 +https://doi.org/10.2105/ajph.2009.166165,Gender Differences in Mental Health Diagnoses Among Iraq and Afghanistan Veterans Enrolled in Veterans Affairs Health Care,"Objectives. We examined gender differences in sociodemographic, military service, and mental health characteristics among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans. We evaluated associations between these sociodemographic and service characteristics and depression and posttraumatic stress disorder (PTSD) diagnoses. Methods. In a retrospective, cross-sectional study, we used univariate descriptive statistics and log binominal regression analyses of Department of Veterans Affairs (VA) administrative data on 329 049 OEF and OIF veterans seeking VA health care from April 1, 2002, through March 31, 2008. Results. Female veterans were younger and more likely to be Black and to receive depression diagnoses than were male veterans, who were more frequently diagnosed with PTSD and alcohol use disorders. Older age was associated with a higher prevalence of PTSD and depression diagnoses among women but not among men. Conclusions. Consideration of gender differences among OEF and OIF veterans seeking health care at the VA will facilitate more targeted prevention and treatment services for these newly returning veterans.",0 +https://doi.org/10.1177/0020764004043125,Household Survey of Psychiatric Morbidity in Cambodia,"Aims: To estimate the prevalence of psychiatric symptoms in the Kampong Cham province and to determine the association between these symptoms and an impaired social functioning. Methods: Cross-sectional cluster sample survey conducted among adults randomly selected within 50 clusters distributed over the province. Results: Of the respondents, 42.4% reported symptoms that met the Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria for depression, 53% displayed high anxiety symptoms and 7.3% met posttraumatic stress disorder (PTSD) criteria. Posttraumatic symptoms of intrusion and avoidance were present in 47.8% and 45.4% respectively. When reviewing comorbidities, 29.2% had depression and anxiety symptoms, 16.5% anxiety symptoms, 6.1% depression and 7.1% had triple comorbidity (PTSD, depression and anxiety). Regarding social functioning, 25.3% reported being socially impaired. Respondents with comorbid symptoms for depression, anxiety and PTSD were associated with an increased risk for social impairment compared with others. Being over 65 years and having experienced violent events were other factors associated with social impairment. Conclusion: Five years after the return of a more stable context in Cambodia, the prevalence of psychiatric symptoms in the community remains high. In addition, these symptoms are strongly associated with social impairment. This suggests that beyond psychosocial programs, the implementation of adapted clinical psychiatric care should be considered as a priority.",0 +https://doi.org/10.1016/j.burns.2009.06.121,Psychosocial screening and outcome measurement in paediatric burns services in the UK,Rationale: The British Burn Association Psychosocial Special Interest Group convened a small working party to review available psychosocial screening tools and outcome measures that could be piloted in paediatric burn services across the UK. Psychosocial screening tools can be administered around the time of a child's admission to identify any pre-morbid psychosocial factors known to impact on treatment and/or recovery after a burn. Psychosocial outcome measures can be used to measure the key psychosocial domains shown to be important after a burn injury. Methods: The Working Party therefore made the following recommendations (subsequently endorsed by the wider BBA Psychosocial Special Interest Group membership): 1. Psychosocial screening tool: A wider pilot of a tool developed and piloted in Manchester be carried out. It is designed to be administered by nursing staff as part of the burns integrated care pathway and then reviewed by the psychology service on a weekly basis (or more often if required). It has proven useful in highlighting psychosocial need that support/intervention can then be directed towards. 2. Psychosocial outcome measures: A nullpacknull ofmeasures to be completed at particular time-points during inpatient and outpatient phases was identified. These cover the domains of: child well-being (PTSD; emotional and behavioural well-being and quality of life; pain; appearance concerns) and parental/family well-being. A number of burns services treating children across the UK agreed to pilot these tools and report back. Results: This paper presents the output of the Working Party and preliminary findings from this pilot. It explores: (i) progress around the practicalities of implementing these recommendations; (ii) the information gathered on the profile of the families of children that are being admitted to UK burn services; (iii) whether the screening tool is facilitating greater psychosocial care for families; and (iv) preliminary outcome data for this patient cohort. Conclusion: The paper concludes with lessons learned and recommendations for future directions.,0 +https://doi.org/10.7860/jcdr/2014/7885.4282,"Recent Trends in the Sociodemographic, Clinical Profile and Psychiatric Comorbidity Associated with Posttraumatic Stress Disorder: A Study from Kashmir, India","To estimate the Prevalence of post-traumatic stress disorders (PTSD) among adults in field practise areas of Government Medical College, Srinagar, India.The present study was cross-sectional in nature and was conducted in field practice areas of Government Medical College Srinagar. Three blocks of field practise areas of Government Medical College, Srinagar comprising of various villages were selected. Further 10 per cent of these villages were selected by the method of randomization sampling and then 10 per cent of household were taken again by systemic random sampling. In the selected household all adult population (18 years and above) were selected and screened by using General health questionnaires(GHQ). The patients who screened positive for PTSD (post-traumatic stress Disorders) were assessed and diagnosed. From the line listing the positive cases, the prevalence rates were calculated.Of the total 3400 subjects (age≥18 years), the prevalence of posttraumatic stress disorders among general population was found to be 3.76%. Prevalence was found to be more in females (Chi-square test=2.086, p>0.05 (Insignificant). Most of cases were found to be in the age group 0-40 years. Most of the cases were unmarried, illiterate and belong to lower socioeconomic class. Death of near one comprised the major traumatic event. Acute onset Posttraumatic stress disorder was the commonest type, previous history of psychiatric illness was found in 12 % of patients and drug abuse was present in 22.6%.Our findings clearly indicates that posttraumatic stress disorders (PTSD) is a prevalent disorder in the developing world, especially in disaster prone regions and in areas of political unrest. Resilience to various traumatic events in Kashmir has developed over the years and this might explains the lower prevalence of Post-traumatic disorder (PTSD) in our study.",0 +https://doi.org/10.1037/a0020808,Family and individual factors associated with substance involvement and PTS symptoms among adolescents in greater New Orleans after Hurricane Katrina.,"This study examined the influence of hurricane impact as well as family and individual risk factors on posttraumatic stress (PTS) symptoms and substance involvement among clinically referred adolescents affected by Hurricane Katrina.A total of 80 adolescents (87% male; 13-17 years old; mean age = 15.6 years; 38% minorities) and their parents were interviewed at the adolescent's intake into substance abuse treatment, 16 to 46 months postdisaster. Independent measures included hurricane impact variables (initial loss/disruption and perceived life threat); demographic and predisaster variables (family income, gender, predisaster adolescent substance use, predisaster trauma exposure, and parental substance abuse); postdisaster family factors (parental psychopathology, family cohesion, and parental monitoring); and postdisaster adolescent delinquency.Hierarchical multivariate regression analyses showed that adolescent substance involvement was associated with higher family income, lower parental monitoring (adolescent report), and more adolescent delinquency. Adolescent-reported PTS symptoms were associated with greater hurricane-related initial loss/disruption, lower family cohesion (adolescent report), and more adolescent delinquency, whereas parent-reported adolescent PTS symptoms were associated with greater parental psychopathology, lower parental monitoring (adolescent report), and lower family cohesion (parent report).The results suggest that hurricane impact was related only to adolescent-reported PTS. However, certain postdisaster family and individual risk factors (low family cohesion and parental monitoring, more adolescent delinquency) were associated both with adolescent substance involvement and with PTS symptoms. Identification of these factors suggests directions for future research as well as potential target areas for screening and intervention with substance-abusing adolescents after disasters.",0 +https://doi.org/10.1007/s11126-006-9035-6,"Psychometric Properties of Darryl, a Cartoon Based Measure to Assess Community Violence-Related PTSD in Children","OBJECTIVE: To examine the reliability and validity of Darryl, a cartoon-based measure of PTSD symptoms and a screening tool for identifying children and adolescents with a PTSD diagnosis. METHOD: Exposure to community violence, PTSD symptoms and diagnostic status were assessed in a sample of 49 children and adolescents at an urban outpatient psychiatry clinic. RESULTS: Darryl has good internal consistency for the full scale and adequate reliability for each DSM-IV PTSD symptom cluster. Darryl correlates significantly (r = 0.64, P < 0.001) with the most frequently used measure for assessing PTSD in children (CPTSD-RI). As a screening tool, Darryl has excellent sensitivity and specificity in relationship to the KID-SCID. CONCLUSIONS: In comparison to other child PTSD measures, Darryl has comparable or better psychometric properties and assesses PTSD symptoms in a more developmentally appropriate manner, especially in the domain of community violence. The value of Darryl as a screening tool remains preliminary given the limited number of diagnosed cases of PTSD in the study sample. Full scale efforts at replication are warranted.",0 +https://doi.org/10.1093/oxfordhb/9780195307030.013.0006,Phenomenology of Posttraumatic Stress Disorder and Acute Stress Disorder,"This chapter reviews how fear-conditioning models of posttraumatic stress disorder (PTSD) have been bolstered by our growing understanding of neurocircuitry involving the amygdala, hippocampus, and prefrontal cortex. It describes the reexperiencing, avoidant/numbing, and hyperarousal symptom clusters as well as other PTSD diagnostic criteria with specific reference to DSM-IV's changes in the A (A1 and A2) stressor criterion. Associated symptoms (e.g., danger to self or others, intolerance of ongoing stressors, capacity to acquire social support, and risk of reactivation and relapse) are briefly discussed. Longitudinal course, comorbidity, epidemiology, risk factors, and cross-cultural issues are also addressed. Other posttraumatic syndromes described include acute stress disorder, partial/subsyndromal PTSD, and complex PTSD. Finally, clinical issues in assessment are considered. © 2009 by Oxford University Press. All rights reserved.",0 +https://doi.org/10.1002/(sici)1099-0720(199802)12:1<81::aid-acp507>3.0.co;2-8,Traumatic memories and pseudomemories in posttraumatic stress disorder,"Intrusive imagery was investigated in survivors of motor vehicle accidents with (a) posttraumatic stress disorder (PTSD) and accurate recall of the trauma, (b) PTSD and amnesia of the trauma, (c) no PTSD, or (d) control participants who simulated PTSD. Imagery was precipitated by presentation of an audiotape of a motor vehicle accident. Whereas the traumatic imagery of participants who had accurate recall of their trauma was consistent with third party accounts of the trauma, the imagery of amnesic participants was inconsistent with these accounts. Participants were then interviewed about cognitive and emotional aspects of their responses. All participants with PTSD and simulators reported similar levels of imagery detail, involuntariness, re-experiencing, and emotional response, and reported higher levels than participants with no PTSD. Findings are discussed in terms of cognitive and contextual factors that can mediate accurate and inaccurate traumatic imagery. © 1998 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1056/nejm200004203421606,Effect of Eliminating Compensation for Pain and Suffering on the Outcome of Insurance Claims for Whiplash Injury,"The incidence and prognosis of whiplash injury from motor vehicle collisions may be related to eligibility for compensation for pain and suffering. On January 1, 1995, the tort-compensation system for traffic injuries, which included payments for pain and suffering, in Saskatchewan, Canada, was changed to a no-fault system, which did not include such payments. To determine whether this change was associated with a decrease in claims and improved recovery after whiplash injury, we studied a population-based cohort of persons who filed insurance claims for traffic injuries between July 1, 1994, and December 31, 1995.Of 9006 potentially eligible claimants, 7462 (83 percent) met our criteria for whiplash injury. The six-month cumulative incidence of claims was 417 per 100,000 persons in the last six months of the tort system, as compared with 302 and 296 per 100,000, respectively, in the first and second six-month periods of the no-fault system. The incidence of claims was higher for women than for men in each period; the incidence decreased by 43 percent for men and by 15 percent for women between the tort period and the two no-fault periods combined. The median time from the date of injury to the closure of a claim decreased from 433 days (95 percent confidence interval, 409 to 457) to 194 days (95 percent confidence interval, 182 to 206) and 203 days (95 percent confidence interval, 193 to 213), respectively. The intensity of neck pain, the level of physical functioning, and the presence or absence of depressive symptoms were strongly associated with the time to claim closure in both systems.The elimination of compensation for pain and suffering is associated with a decreased incidence and improved prognosis of whiplash injury.",0 +https://doi.org/10.1007/s00421-013-2591-1,Physiological Employment Standards III: physiological challenges and consequences encountered during international military deployments,"Modern international military deployments in austere environments (i.e., Iraq and Afghanistan) place considerable physiological demands on soldiers. Significant physiological challenges exist: maintenance of physical fitness and body composition, rigors of external load carriage, environmental extremes (heat, cold, and altitude), medical illnesses, musculoskeletal injuries, traumatic brain injuries, post-traumatic stress disorder, and environmental exposure hazards (i.e., burn pits, vehicle exhaust, etc.). To date there is very little published research and no comprehensive reviews on the physiological effects of deployments. The purpose of this paper is to overview what is currently known from the literature related mainly to current military conflicts with regard to the challenges and consequences from deployments. Summary findings include: (1) aerobic capacity declines while muscle strength, power and muscular endurance appear to be maintained, (2) load carriage continues to tax the physical capacities of the Soldier, (3) musculoskeletal injuries comprise the highest proportion of all injury categories, (4) environmental insults occur from both terrestrial extremes and pollutant exposure, and (5) post-deployment concerns linger for traumatic brain injury and post-traumatic stress disorder. A full understanding of these responses will assist in identifying the most effective risk mitigation strategies to ensure deployment readiness and to assist in establishment of military employment standards. © 2013 Springer-Verlag Berlin Heidelberg (outside the USA).",0 +https://doi.org/10.1007/s00213-015-4194-5,Escitalopram reversed the traumatic stress-induced depressed and anxiety-like symptoms but not the deficits of fear memory,"Rationale: Posttraumatic stress disorder (PTSD) is a trauma-induced mental disorder characterised by fear extinction dysfunction in which fear circuit monoamines are possibly associated. PTSD often coexists with depressive/anxiety symptoms, and selective serotonin reuptake inhibitors (SSRIs) are recommended to treat PTSD. However, therapeutic mechanisms of SSRIs underlying the PTSD fear symptoms remain unclear. Objectives: Using a rodent PTSD model, we examined the effects of early SSRI intervention in mood and fear dysfunctions with associated changes of monoamines within the fear circuit areas. Methods: A 14-day escitalopram (ESC) regimen (5 mg/kg/day) was undertaken in two separate experiments in rats which previously received a protocol of single prolonged stress (SPS). In experiment 1, sucrose preference and elevated T-maze were used to index anhedonia depression and avoidance/escape anxiety profiles. In experiment 2, the percentage of freezing time was measured in a 3-day fear conditioning paradigm. At the end of our study, tissue levels of serotonin (5-HT) in the medial prefrontal cortex, amygdala, hippocampus, and striatum were measured in experiment 1, and the efflux levels of infralimbic (IL) monoamines were measured in experiment 2. Results: In experiment 1, ESC corrected both behavioural (depression/anxiety) and neurochemical (reduced 5-HT tissue levels in amygdala/hippocampus) abnormalities. In experiment 2, ESC was unable to correct the SPS-impaired retrieval of fear extinction. In IL, ESC increased the efflux level of 5-HT but failed to reverse SPS-reduced dopamine (DA) and noradrenaline (NA). Conclusions: PTSD-induced mood dysfunction is psychopathologically different from PTSD-induced fear disruption in terms of disequilibrium of monoamines within the fear circuit areas. © 2016 Springer-Verlag Berlin Heidelberg",0 +https://doi.org/10.1016/j.jpain.2012.12.016,Does Opiate Use in Traumatically Injured Individuals Worsen Pain and Psychological Outcomes?,"Opiate use for chronic pain is becoming increasingly controversial. There has been a shift away from supporting the use of opiates for treatment of chronic pain. In addition to lack of effectiveness, concerns for adverse clinical outcomes, addiction, and death have provided the impetus for this change. The purpose of this study was to investigate the percent of trauma patients still using opiates, their pain levels, and psychological outcomes 4 months posttrauma. This was a study to evaluate chronic pain at 4 months posttrauma in 101 participants from a single level 1 trauma center. Eighty of the 101 participants developed chronic pain 4 months after their initial traumatic injury (79%). Of those who developed chronic pain, 27 (26%) were still using opiates. Those using narcotics at 4 months posttrauma had significantly more pain, life interference, depression, and anxiety. Posttraumatic stress disorder (PTSD) was not significantly influenced by narcotic use in this analysis. However, the mean associated with those using narcotics was higher and diagnostic for PTSD. Those taking opiates did not have significantly better relief from their pain using treatments or medications than those not using opiates (F = 8, P = .08). These findings bring into question the appropriate use of opiates for chronic pain and the possible exacerbating effects on pain and psychopathology in traumatically injured patients.This article identifies data that provide evidence that narcotic pain medication needs to be used carefully in traumatically injured patients with chronic pain, especially in those individuals with comorbid psychological pathology.",0 +https://doi.org/10.1023/a:1020125006371,Male war-zone veterans' perceived relationships with their children: The importance of emotional numbing,"Despite growing recognition of substantial interpersonal impairment among many war-zone veterans with posttraumatic stress disorder (PTSD), little is known about the association between PTSD symptomatology and veterans' relationships with their children. This study examined the differential pattern of associations between the symptom clusters of PTSD and the perceived father-child relationships of 66 male Vietnam veterans. Analyses revealed that only the emotional numbing cluster was significantly related to perceived quality of all relationship domains. The association between emotional numbing and perceived relationship quality remained significant in regression analyses even after controlling for fathers' family-of-origin stressors, combat exposure, depression, and substance abuse. Findings suggest that emotional numbing may be the component of PTSD most closely linked to interpersonal impairment in war-zone veterans.",0 +https://doi.org/10.1159/000080952,Noradrenergic Mechanisms in the Pathophysiology of Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) is a serious psychiatric illness that may develop in individuals after exposure to a traumatic event. Recent data suggest that trauma and/or long-term stressors can cause alterations in the functioning of neuroanatomical structures and neural networks throughout the central nervous system. Specifically, dysregulation in central and perhaps, peripheral noradrenergic neural networks has been implicated as the cause of specific symptom clusters in the pathophysiology of PTSD. In this review, both clinical and preclinical data are presented to highlight types of noradrenergic dysfunction observed in individuals with PTSD. Additionally, the role of noradrenaline dysregulation in the acquisition/initiation, and maintenance of hyperarousal and reexperiencing symptom clusters in PTSD will be addressed.",0 +https://doi.org/10.1002/da.21926,STATISTICAL SUPPORT FOR SUBTYPES IN POSTTRAUMATIC STRESS DISORDER: THE HOW AND WHY OF SUBTYPE ANALYSIS,"A number of researchers have argued for the existence of different subtypes of posttraumatic stress disorder (PTSD). In the current paper we present criteria by which to assess these putative subtypes, clarify potential pitfalls of the statistical methods employed to determine them, and propose alternative methods for such determinations. Specifically, three PTSD subtypes are examined: (1) complex PTSD, (2) externalizing/internalizing PTSD, and (3) dissociative/nondissociative PTSD. In addition, three criteria are proposed for subtype evaluation, these are the need for (1) reliability and clarity of definition, (2) distinctions between subtypes either structurally or by mechanism, and (3) clinical meaningfulness. Common statistical evidence for subtyping, such as statistical mean difference and cluster analysis, are presented and evaluated. Finally, more robust statistical methods are suggested for future research on PTSD subtyping.",0 +https://doi.org/10.1080/00223891.1990.9674112,The Rorschach and Traumatic Loss: Can the Presence of Traumatic Loss Be Detected From the Rorschach?,"Loss, an expected part of everyone's life, can be a catalyst promoting significant growth. But all losses are not the same or affect everyone in like manner. Some losses are of such magnitude and intensity that individuals cannot cope, and, therefore, they keep reliving them (posttraumatic stress syndrome) as if through repeated attempts (Freud, 1923-1922/1961) they might master what had been initially so overwhelming. This study, using an inpatient hospital sample, examines the Rorschach protocols of individuals who had experienced traumatic loss in childhood or early adolescence and compares them with a control group of individuals who appear to have no such history. Our hypotheses that victims of early trauma have a distinguishing Rorschach profile was validated in the exploratory study. Further study is needed to clarify whether factors other than traumatic loss may be contributing to this profile.",0 +,Should psychiatrists use atypical antipsychotics to treat nonpsychotic anxiety?,"There is neurobiologically based, theoretical support for the use of antipsychotic medications in the treatment of anxiety, and two first-generation neuroleptics are approved by the United States Food and Drug Administration for the treatment of nonpsychotic anxiety. However, neuroleptics are associated with a large side effect burden, which has limited their utility in the treatment of nonpsychotic disorders. Because of their somewhat improved safety profile, atypical antipsychotics are increasingly used for the treatment of nonpsychotic anxiety. The published literature describing the efficacy of atypical antipsychotics in randomized, controlled trials involving patients with anxiety disorders is briefly reviewed, and the safety of atypical antipsychotics in nonpsychotic disorders is discussed. There is moderately strong controlled evidence supporting the use of some atypical antipsychotics, either as adjunctive treatment or monotherapy, in the treatment of nonpsychotic anxiety; however, the side effect burden of some atypical antipsychotics probably outweighs their benefits for most patients with anxiety disorders. The evidence to date does not warrant the use of atypical antipsychotics as first-line monotherapy or as first- or second-line adjunctive therapy in the treatment of anxiety disorders. Rigorous, independently funded, long-term studies are needed to support the off-label use of atypical antipsychotics in the treatment of anxiety disorders. Nevertheless, some patients with highly refractory anxiety disorders may benefit from the judicious and carefully monitored use of adjunctive atypical antipsychotics. A careful risk-benefit assessment must be undertaken by the physician, on a case-by-case basis, with appropriate informed consent.",0 +https://doi.org/10.1016/j.addbeh.2009.06.008,"Alcohol use motives among traumatic event-exposed, treatment-seeking adolescents: Associations with posttraumatic stress","The current study evaluated the linkage between posttraumatic stress symptoms and alcohol use motives among 49 traumatic event-exposed adolescents (M(age)=16.39 years). It was hypothesized that posttraumatic stress symptom levels would be positively associated with coping-related drinking motives specifically (cf., social, enhancement, or conformity motives) and that coping-related drinking motives would evidence associations with the hyperarousal and reexperiencing posttraumatic stress symptom types. Findings were consistent with hypotheses, suggesting traumatic event-exposed adolescents may be using alcohol to manage posttraumatic stress symptoms.",0 +https://doi.org/10.1097/01.ta.0000136289.15303.44,Life-Altering Outcomes after Lower Extremity Injury Sustained in Motor Vehicle Crashes,"Lower extremity injuries (LEIs) sustained in vehicular crashes result in physical problems and unexpected psychosocial consequences. Their significance is diminished by low Abbreviated Injury Scale scores.Drivers who sustained LEIs were identified as part of the Crash Injury Research and Engineering Network (CIREN) and interviewed during hospitalization, at 6 months, and at 1 year. All were occupants of newer vehicles with seatbelts and airbags.Sixty-five patients were followed for 1 year. Injuries included mild brain injury (43%), ankle/foot fractures (55%), and bilateral injuries (37%). One year post-injury, 46% reported limitations in walking and 22% with ankle/foot fractures were unable to return to work. Depression (39%), cognitive problems (32%), and post-traumatic stress disorder (18%) were significant in the mild brain injury group.Long-lasting physical and psychological burdens may impede recovery and alter the lifestyle of patients with LEI. These issues need to be addressed by trauma center personnel.",0 +https://doi.org/10.1007/978-1-60327-329-9_15,The Amygdala in Post-Traumatic Stress Disorder,"Over the past decade, neuroimaging studies have yielded important insights into the function of the amygdala in post-traumatic stress disorder (PTSD). The results of these studies are presented here. Because neurocircuitry models of PTSD also emphasize the role of the medial prefrontal cortex, findings regarding that brain region are discussed as well. The reviewed studies suggest that (1) the amygdala is hyperresponsive to both trauma-related and unrelated stimuli in PTSD, (2) amygdala activation is positively correlated with PTSD symptom severity and, in some studies, inversely correlated with medial prefrontal cortex function, (3) symptom reduction after treatment is associated with decreased amygdala activation and increased medial prefrontal cortex activation, and (4) medial prefrontal cortex is hyporesponsive in PTSD, perhaps reflecting diminished inhibitory control over the amygdala. All of this information suggests that the amygdala and medial prefrontal cortex play important roles in the pathogenesis or maintenance of this disorder. Limitations and future directions of this research are discussed.",0 +https://doi.org/10.1111/j.1540-4560.1993.tb01179.x,Reassessing War Stress: Exposure and the Persian Gulf War,"Research has shown a clear association between war-zone exposure and psychological readjustment in soldiers. Newer findings suggest that certain event and person characteristics are especially influential in this process. The present article has the following goals: (a) to review existing parameters in the traditional measurement of war-zone exposure, (b) to consider conceptual and methodological limitations in these approaches, (c) to present empirical data from a cohort of Persian Gulf War veterans that support the utility of a broader conceptualization of war trauma, and (d) to examine how gender may be differentially associated with some dimensions of war-zone stress and psychological outcome following deployment. Data suggest that identifying diverse dimensions of war-zone stress may enhance efforts to understand veterans' initial and long-range wartime recovery.",0 +https://doi.org/10.1002/jts.20521,Bushfire impact on youth,"The authors examined the association between disaster-related traumatic experiences and posttraumatic stress disorder (PTSD) symptoms in 155 youth, aged 8–18 years, from the Lower Eyre Peninsula of South Australia who were affected by January 2005 bushfires. Youth completed measures of PTSD symptoms and disaster experiences 11–5 months postdisaster. Many youth (27%) reported moderate to severe levels of PTSD symptoms; younger children reported greater PTSD symptom severity than older youth. Perceived personal life threat and ongoing loss/disruption were related to greater PTSD symptomatology. Following disasters, it may be helpful to identify young children and youth who perceived that their life was threatened and experienced more ongoing life disruption, as these youth may be at higher risk for persistent PTSD symptoms.",0 +https://doi.org/10.1177/1077559511406109,Identifying and Determining the Symptom Severity Associated With Polyvictimization Among Psychiatrically Impaired Children in the Outpatient Setting,"Polyvictimization involves experiencing multiple forms of maltreatment or other interpersonal victimization, and places children at risk for severe psychosocial impairment. Children with psychiatric problems are at risk for polyvictimization, and polyvictimized child psychiatric inpatients have been found to have particularly severe psychiatric symptoms. Cluster analysis was used to identify a polyvictimized subgroup (N = 22, 8%) among 295 outpatient admissions in 2007-2009 to a child psychiatry outpatient clinic, based on chart review of documented maltreatment, parental impairment (history of arrest, psychiatric illness, and substance use), and multiple out-of-home placements. Polyvictimization was associated with severe parent-reported externalizing problems and clinician-rated psychosocial impairment, independent of demographics and psychiatric diagnoses. Posttraumatic stress disorder (PTSD) was the only psychiatric diagnosis associated with polyvictimization. Polyvictimization merits further clinical and research assessment with child psychiatry outpatients. Evidence-based PTSD assessment and treatment for polyvictimized children with adaptations to address their severe impairment and externalizing problems also warrants empirical evaluation.",0 +https://doi.org/10.1017/cbo9781139333610.005,Family relationshipsembedded in United Statesmilitary culture,"United States military personnel and their families have made substantial sacrifices to protect and defend their country in the service of the post-9/11 global war on terrorism (MacDermid Wadsworth, 2010; Willerton, MacDermid Wadsworth, and Riggs, 2011). Service members, their romantic partners, and their children have handled the increased operational tempo of deployments resulting from both Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) with impressive resilience (Bonanno et al., 2012; Cozza, Chun, and Polo, 2005; Lester et al., 2010), although the challenges of war can take a substantial toll on people’s physical health (Badr, Barker, and Milbury, 2011; Gorman, Eide, and Hilse-Gorman, 2010), mental health (Mansfield et al., 2010; Milliken, Auchterlonie, and Hoge, 2007; Pfefferbaum et al., 2011), and relationship health (Adams, Durand, and Castro, 2006; Allen et al., 2010; Nelson Goff et al., 2007). One foundation of this resilience is undoubtedly the strong military identity that many families embrace. US military culture espouses the ideals of courage, fortitude, strength, fairness, discipline, loyalty, respect for authority, determination, and valor (Coll, Weiss, and Yarvis, 2011; Greene et al., 2010b; Ulmer, Collins, and Jacobs, 2000), and these qualities are the signature values of many active duty and reserve component military families (Hall, 2008). To be a US military family is to be proud, to be strong, and to be brave (Hall 2011a; 2011b; Park, 2011). Although military culture provides a pervasive backdrop for how service members and their families navigate domestic life (Hall 2008; 2011a; Sherman and Bowling, 2011), scholarship on the interpersonal functioning of military couples and families has not always been sensitive to the unique parameters at play. With some notable exceptions (Palmer, 2008; Pincus et al., 2001; Riggs and Riggs, 2011), scholars have tended to apply established theories of relationship functioning to the military context without fully taking into account the social circumstances that envelop military personnel, their romantic partners, and their children. The result is a body of work (including some of our own research) that underemphasizes the distinctive trademarks of military life. As Wiens and Boss (2006) noted, ""To understand how best to support today’s military families, it is essential to understand their contexts. What are the contextual sources of their stress and resiliency?"" (p. 25). This chapter takes up that question. © Cambridge University Press 2014.",0 +https://doi.org/10.1007/s10880-011-9239-2,Complicating Factors Associated with Mild Traumatic Brain Injury: Impact on Pain and Posttraumatic Stress Disorder Treatment,"The nature of combat in Iraq and Afghanistan has resulted in high rates of comorbidity among chronic pain, posttraumatic stress disorder (PTSD), and mild traumatic brain injury (mTBI) in Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF). Although separate evidence-based psychological treatments have been developed for chronic pain and PTSD, far less is known about how to approach treatment when these conditions co-occur, and especially when they co-occur with mTBI. To provide the best care possible for OEF/OIF Veterans, clinicians need to have a clearer understanding of how to identify these conditions, ways in which these conditions may interact with one another, and ways in which existing evidence-based treatments can be modified to meet the needs of individuals with mTBI. The purpose of the present paper is to review the comorbidity of pain, PTSD, and mTBI in OEF/OIF Veterans, and provide recommendations to clinicians who provide care to Veterans with these conditions. First, we will begin with an overview of the presentation, symptomatology, and treatment of chronic pain and PTSD. The challenges associated with mTBI in OEF/OIF Veterans will be reported and data will be presented on the comorbidity among all three of these conditions in OEF/OIF Veterans. Second, we will present recommendations for providing psychological treatment for chronic pain and PTSD when comorbid with mTBI. Finally, the paper concludes with a discussion of the need for a multidisciplinary treatment approach, as well as a call for continued research to further refine existing treatments for these conditions. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1080/02640414.2014.901551,Psychological resilience in sport performers: a review of stressors and protective factors,"Psychological resilience is important in sport because athletes must utilise and optimise a range of mental qualities to withstand the pressures that they experience. In this article, we discuss psychological resilience in sport performers via a review of the stressors athletes encounter and the protective factors that help them withstand these demands. It is hoped that synthesising what is known in these areas will help researchers gain a deeper profundity of resilience in sport, and also provide a rigorous and robust foundation for the development of a sport-specific measure of resilience. With these points in mind, we divided the narrative into two main sections. In the first section, we review the different types of stressors encountered by sport performers under three main categories: competitive, organisational and personal. Based on our recent research examining psychological resilience in Olympics champions, in the second section we discuss the five main families of psychological factors (viz. positive personality, motivation, confidence, focus, perceived social support) that protect the best athletes from the potential negative effect of stressors. It is anticipated that this review will help sport psychology researchers examine the interplay between stressors and protective factors, which will, in turn, focus the analytical lens on the processes underlying psychological resilience in athletes.",0 +https://doi.org/10.1016/j.jad.2009.04.015,"Psychosocial buffers of traumatic stress, depressive symptoms, and psychosocial difficulties in veterans of Operations Enduring Freedom and Iraqi Freedom: The role of resilience, unit support, and postdeployment social support","Little research has examined the role of protective factors such as psychological resilience, unit support, and postdeployment social support in buffering against PTSD and depressive symptoms, and psychosocial difficulties in veterans of Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF).A total of 272 OEF/OIF veterans completed a survey containing PTSD and depression screening measures, and questionnaires assessing resilience, social support, and psychosocial functioning.Lower unit support and postdeployment social support were associated with increased PTSD and depressive symptoms, and decreased resilience and psychosocial functioning. Path analyses suggested that resilience fully mediated the association between unit support and PTSD and depressive symptoms, and that postdeployment social support partially mediated the association between PTSD and depressive symptoms and psychosocial functioning.Generalizability of results is limited by the relatively low response rate and predominantly older and reserve/National Guard sample.These results suggest that interventions designed to bolster unit support, resilience, and postdeployment support may help protect against traumatic stress and depressive symptoms, and improve psychosocial functioning in veterans.",0 +https://doi.org/10.1097/nmd.0b013e3181775f05,The Relationship Between PTSD Arousal Symptoms and Depression Among Mothers Exposed to the World Trade Center Attacks,"Posttraumatic stress disorder (PTSD) is associated with greater risk of developing comorbid depression. However, little is known about the relationship between specific PTSD symptom clusters and comorbid depression. Approximately 4 years after the World Trade Center (WTC) attacks, we examined the association between PTSD symptom clusters and depression severity among 64 mothers directly exposed to the WTC attacks. Severity scores were computed for each PTSD symptom cluster by summing symptom frequency. Partial correlations with depression severity were calculated separately for PTSD symptom clusters, controlling for demographic variables, time elapsed since the attacks, WTC attack exposure, meeting PTSD criterion A, and the other cluster scores. Higher arousal symptom cluster scores were significantly correlated with persistent depression, but the re-experiencing and avoidance symptom clusters were not. Subsequent analyses isolating shared symptoms of PTSD and depression from those unique to PTSD suggest a complex interrelationship among symptoms of arousal, numbing, and depression.",0 +https://doi.org/10.1017/s0033291703001703,"Trauma, time and mental health: a study of temporal reintegration and Depressive Disorder among Southeast Asian refugees","Background. Prior research suggested that time splitting – suppressing the past and dissociating it from present and future – protected refugee mental health in the aftermath of catastrophe. The current study investigates temporal reintegration, defined as cognitive recapture of the past and reconnecting it with present and future, the mental health effects of temporal reintegration, and factors moderating the associated risk for Depressive Disorder. Method. A community sample of 608 Southeast Asian refugees, resettled in Vancouver British Columbia between 1979 and 1981, were interviewed on three separate occasions over a 10-year period. Participants performed a temporal orientation task and responded to questions about employment, social relations and mental health. Depressive Disorder, measured by a typology derived from Grade of Membership analysis of symptoms, constituted the dependent variable. Latent Growth Curve Analysis was used to examine both levels and rates of change in the probability of Depressive Disorder as predicted by changes in temporal reintegration, as well as the contribution of putative social and psychological moderators to explaining variations in growth parameters. Results. Time relatedness increased over the duration of the study. Temporal reintegration jeopardized mental health. Employment and relational stability each moderated the mental health effects of temporal reintegration. Conclusions. Although time splitting may be effective in coping with adversity over the short-term, eventual temporal reintegration is probably ineluctable. Stability in love and work are protective factors, mitigating the mental health vicissitudes of temporal reintegration. Implications for optimal timing of clinical interventions are discussed.",0 +https://doi.org/10.1192/bjp.bp.113.136077,Early responding to traumatic events,"Summary How to respond optimally following traumatic events remains a Holy Grail. A number of early interventions lack evidence of effect. Practical, pragmatic support provided in an empathic manner is likely to be an appropriate initial response and complement the high levels of resilience shown by individuals exposed to traumatic events.",0 +https://doi.org/10.1891/vivi.17.4.403.33684,Sexual and Nonsexual Dating Violence Perpetration: Testing an Integrated Perpetrator Typology,"The present study tested the validity of an integrated sexual and nonsexual violence perpetrator typology outlined by Monson and Langhinrichsen-Rohling (1998) in a sample of 670 dating individuals. Two-hundred-and-sixty-five of the participants (87 men, 178 women) reported some act of sexual and/or physical dating violence perpetration in their lifetime. The data supported at least three perpetrator types, namely, the Relationship-only, Generally Violent/Antisocial, and Histrionic/Preoccupied types. Overall, these findings indicate that different factors may cause or maintain the intimate violence perpetrated within this heterogeneous population. There were important gender differences in perpetrator type membership, highlighting the differences in men's and women's use of violence. The implications of these findings are discussed with regard to the development of typologies, their application to men and women perpetrators, as well as their utility for the assessment and treatment of perpetrators.",0 +https://doi.org/10.1177/00957984960224005,Adverse Health Effects in African American Residents Living Adjacent to Chemical Industries,"The objective of the present study was to compare the physical and psychological health of three groups of African Americans (N = 310): acute sulfuric acid exposed, nonacute exposed, and unexposed controls. Instruments included a health questionnaire, a Toxic Symptom Checklist, the Profile of Mood States (POMS), the Post-Traumatic Stress and the Neurotoxic Anxiety scales of the MMPI-2, the Impact of Event Scale, the Symptom Check List 90-Revised (SCL 90-R), and several brief mood and personality scales. Blood pressure and pulse rates were also taken. Matching produced 51 three-way pairs. MANOVA results indicate significant effects for exposure. Significant univariate Fs (p < .05) were foundfor all the scales across the exposed groups exceptfor the Toxic Symptom category of memory/concentration, POMS depression, and 5 of the 9 SCL 90-R subscales. The t-test results using adjusted a = .0167 indicate both exposed groups had more mood and health symptoms than the controls. The acute were the most symptomatic, and both exposed groups had more respiratory problems, skin rashes, and allergies; results that are consistent with chemical exposure. Results also indicate all three groups had higher than average blood pressure, and the SCL 90-R scores for all three groups were higher than reported in the manual.",0 +https://doi.org/10.1016/j.eurpsy.2011.03.002,Association between flashbacks and structural brain abnormalities in posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) is reliably associated with reduced brain volume relative to healthy controls, in areas similar to those found in depression. We investigated whether in a PTSD sample brain volumes in these areas were related to reporting specific symptoms of PTSD or to overall symptom severity.Structural MRI scans were obtained from 28 participants diagnosed with PTSD according to DSM-IV-TR. Participants reported the extent of individual PTSD symptoms using the Posttraumatic Diagnostic Scale. Voxel-based morphometry applying the Dartel algorithm implemented within SPM5 was used to identify volumetric changes, related to PTSD total, symptom cluster, and individual symptom scores.Brain volume was unrelated to overall PTSD severity, but greater reexperiencing scores predicted reduced volumes in the middle temporal and inferior occipital cortices. Increased reports of flashbacks predicted reduced volume in the insula/parietal operculum and in the inferior temporal gyrus.The data illustrate the value of analyses at the symptom level within a patient population to supplement group comparisons of patients and healthy controls. Areas identified were consistent with a neurobiological account of flashbacks implicating specific abnormalities in the ventral visual stream.",0 +https://doi.org/10.1080/00273170802490673,Distinguishing Between Latent Classes and Continuous Factors with Categorical Outcomes: Class Invariance of Parameters of Factor Mixture Models,"Factor mixture models (FMM's) are latent variable models with categorical and continuous latent variables which can be used as a model-based approach to clustering. A previous paper covered the results of a simulation study showing that in the absence of model violations, it is usually possible to choose the correct model when fitting a series of models with different numbers of classes and factors within class. The response format in the first study was limited to normally distributed outcomes. The current paper has two main goals, firstly, to replicate parts of the first study with 5-point Likert scale and binary outcomes, and secondly, to address the issue of testing class invariance of thresholds and loadings. Testing for class invariance of parameters is important in the context of measurement invariance and when using mixture models to approximate non-normal distributions. Results show that it is possible to discriminate between latent class models and factor models even if responses are categorical. Comparing models with and without class-specific parameters can lead to incorrectly accepting parameter invariance if the compared models differ substantially with respect to the number of estimated parameters. The simulation study is complemented with an illustration of a factor mixture analysis of ten binary depression items obtained from a female subsample of the Virginia Twin Registry.",0 +https://doi.org/10.1002/jts.20440,Posttraumatic stress symptom trajectories in children living in families reported for family violence,"The present study examined latent class trajectories of posttraumatic stress disorder (PTSD) and associations between demographics, prior trauma, and reason for referral on class membership. Children ages 7-18 (n=201) were recruited for participation in the Navy Family Study following reports to the U.S. Navy's Family Advocacy Program (FAP). Initial interviews were conducted 2-6 weeks following FAP referral, with follow-ups conducted at 9-12, 18-24, and 36-40 months. Growth mixture modeling revealed two latent class trajectories: a resilient class and a persistent symptom class. Relative to youth in the resilient class, participants in the persistent symptom class were more likely to be older and to report exposure to a greater number of trauma experiences at Time 1.",0 +https://doi.org/10.1016/j.ijlp.2011.08.003,"PTSD symptom clusters, feelings of revenge, and perceptions of perpetrator punishment severity in victims of interpersonal violence","Feelings of revenge have often been found to correlate with symptoms of posttraumatic stress disorder (PTSD). Which PTSD symptom cluster prevails in this association is, however, unknown. Furthermore, previous studies suggest that revenge may be satisfied by perceptions of perpetrator punishment severity, but did not control for concurrent symptoms of PTSD. Therefore, this study explored associations between PTSD symptom clusters, feelings of revenge, and perceived perpetrator punishment severity in a sample of victims of interpersonal violence. Results indicated that the re-experiencing/intrusion symptom cluster was the only index of PTSD which was related to victims' feelings of revenge (n=207). Revenge correlated negatively with perceptions of punishment severity in victim who knew that the perpetrator had been sentenced, but not after adjustment for PTSD symptoms (n=96).",0 +https://doi.org/10.1517/17425255.2013.759209,Understanding the pharmacokinetics of anxiolytic drugs,"Anxiety disorders are considered the most common mental disorders and they can increase the risk for comorbid mood and substance use disorders, significantly contributing to the global burden of disease. For this reason, anxiolytics are the most prescribed psychoactive drugs, particularly in the Western world.This review aims to analyze pharmacokinetic profile, plasma level variations so as the metabolism, interactions and possible relation to clinical effect of several drugs which are used primarily as anxiolytics. The drugs analyzed include benzodiazepines, anticonvulsants (pregabalin, gabapentin), buspirone, β-blockers and antihistamines (hydroxyzine). Regarding the most frequently used anxiolytic benzodiazepines, data on alprazolam, bromazepam, chlordesmethyldiazepam, chlordiazepoxide, clotiazepam, diazepam, etizolam, lorazepam, oxazepam, prazepam and clonazepam have been detailed.There is a need for a more balanced assessment of the benefits and risks associated with benzodiazepine use, particularly considering pharmacokinetic profile of the drugs to ensure that patients, who would truly benefit from these agents, are not denied appropriate treatment. An optimal pharmacological approach involving an integrative pharmacokinetic and pharmacodynamic optimization strategy would ensure better treatment and personalization of anxiety disorders. So it would be desirable for the development of new anxiolytic drug(s) that are more selective, fast acting and free from the unwanted effects associated with the traditional benzodiazepines as tolerance or dependence.",0 +https://doi.org/10.1007/978-3-642-39454-6_67,Quantifying Resilience to Enhance Individualized Training,"Resilience is the human ability to adapt in the face of tragedy, trauma, adversity, hardship, and ongoing life stressors. To date, experimental reports on this subject have focused on long-term trajectories (weeks to months) of resilience, with little or no focus on whether significant changes to resilience could be achieved by short-term interventions. Currently, an individual’s resilience is defined either by self-report or by behavioral changes such as the development of depression, post-traumatic stress disorder, or suicide. We propose that the quantification of an individual’s physiological and behavioral response to stress under controlled conditions is an indication of the individual’s level of resilience. To address such real-time resilience, we propose the first in a series of studies to evaluate real-time human resilience by exposing participants to controlled stressors while assessing the stress response. Activation of the hypothalamus-pituitary-adrenal cortex axis and sympathetic branch of the autonomic nervous system via monitoring of the pupil constriction, heart and respiration rate, muscle tonicity, salivary cortisol, and electrodermal activity will be assessed. Stress exposure will consist of virtual stressors presented using Virtual Battlespace 2 software-based scenarios, such as noise exposure, time pressure, and emotion-induction tasks, as well as external stressors such as socio-evaluative stress via the Trier social stress task, while evaluating decision-making and performance. The relationship between performance and the physiological stress response will be quantified, including the creation of a series of stress-performance trajectories based upon individual differences. Such an analysis is similar to probing for resilience in material testing, in which a load is applied to a candidate material, and the resulting forces and observable changes in dimension are quantified and reported via stress-strain curves. Ongoing studies will examine how this resilience measure may be integrated into a closed-loop training system to provide appropriate coping strategies to optimize resilience training. Such training programs, which take into account individual perceptions of stressors and physiological responses, are expected to be effective in helping trainees develop resiliency during high-stress operations.",0 +,Premorbid combat related ptsd in Huntington's disease - Case report.,"Huntington's disease (HD) is a neurodegenerative, autosomal dominant disease that manifests with a triad of symptom clusters including movement disorder, cognitive impairment and psychiatric symptoms. We present a patient with HD who, prior to developing neurological signs and symptoms, had been exposed to war trauma and had developed posttraumatic stress disorder. Fifteen years later he manifested with dysarthria, difficulties with swallowing and involuntary movement. What brought him to psychiatrist was a heteroanamnestically noticed change in personality with irritable mood, impulsivity, aggressive outbursts in behavior and delusional ideation. Therapy was stared with haloperidol, but patient developed severe extrapiramidal side effects. Subsequent treatment with olanzapine, diazepam and omega 3 fatty acids lead to mood stabilization and better impulse control with even some improvement in motoric symptoms. To our knowledge, this is the first case report on combat related PTSD as psychiatric disorder manifested prior to HD. We discuss a possible influence of psychological stress disorder on severity of psychiatric symptoms in the HD. The importance of personalized approach in both psychopharmacological and psychotherapeutical treatment of patients with HD is emphasized. If the influence of environmental stress on the psychiatric phenotype of the disease should be confirmed by clinical trials and further studies, both screening methods and interventions aimed to reduce psychological stress in carriers of Huntington gene could be considered.",0 +,[Sleep electroencephalography in depression and mental disorders with depressive comorbidity].,"Traditional scoring of sleep EEG in depressed patients shows abnormalities in sleep maintenance, sleep architecture, REM sleep, the distribution of slow wave and REM sleep during the night. Computerized analysis that comprises the period-amplitude analysis procedure and spectral analysis discloses changes in delta activity and distribution of delta activity. However, these methods of analysing EEG sleep are not able to distinguish the various concepts of depression: endogenous and non-endogenous depression, unipolar and bipolar depression, psychotic and non-psychotic depression. Polysomnographical data in patients with recurrent depression show alteration during remission suggesting trait-like abnormalities of sleep in depression illness. Shortened REM latency is not specific in depression. This sleep parameter is defined in many different ways explaining the heterogeneousness of study results and the failure of constituting a biological marker. Many sleep parameters are affected by several factors such as age, gender and severity. Several physiopathological hypotheses have been proposed to explain EEG sleep alterations. They refer either to circadian rhythms such as the two process model of Borbély, the phase advance hypothesis and the circadian amplitude hypothesis, or to neurotransmitter abnormalities such as the cholinergic hypothesis. None of them takes sufficient account of all the sleep abnormalities. Sleep abnormalities have also been described in other psychiatric disorders such as mania, panic and obsessional-compulsive disorders, generalized anxiety, phobias, post-traumatic stress disorder, eating disorders, borderline personality, schizophrenia and dementia. None of them have a particular sleep EEG profile which allows to differentiate between them. A concomitant episode of major depression cannot be uncovered by sleep recordings.",0 +https://doi.org/10.1093/oxfordhb/9780195399066.013.0008,Traumatic Stress Disorders in Children and Adolescents,"Abstract Many children and adolescents who experience potentially traumatic events, such as natural disasters, acts of violence, physical injuries, child abuse, and life-threatening medical illnesses, display significant stress symptoms. In fact, these potentially traumatic events can lead to the development of acute stress disorder (ASD) and/or posttraumatic stress disorder (PTSD) and cause significant psychological impairment. In this chapter, we discuss the types of potentially traumatic events that lead to ASD or PTSD in youth, as well as various aspects of trauma exposure. We next review available evidence on the definition, prevalence, and course of ASD and PTSD in youth, and the risk factors associated with their development. To date, relatively few studies have examined ASD and existing evidence calls into question the validity of dissociative symptoms as part of the existing ASD diagnostic criteria for youth. In contrast, many studies have evaluated PTSD and its symptoms in youth exposed to trauma, although PTSD prevalence rates vary substantially depending on a host of factors, including the type of traumatic event experienced, the degree of exposure to the event, and the informant for PTSD symptoms, among other factors. We also discuss developmental considerations for the ASD and PTSD diagnoses and directions for future research. The chapter closes with a brief summary of proposed changes to the diagnostic criteria for ASD and PTSD in youth that are being considered for the DSM-5.",0 +https://doi.org/10.3389/fpsyt.2015.00059,Improved Sleep in Military Personnel is Associated with Changes in the Expression of Inflammatory Genes and Improvement in Depression Symptoms,"Sleep disturbances are common in military personnel and are associated with increased risk for psychiatric morbidity, including posttraumatic stress disorder (PTSD) and depression, as well as inflammation. Improved sleep quality is linked to reductions in inflammatory bio-markers; however, the underlying mechanisms remain elusive.In this study, we examine whole genome expression changes related to improved sleep in 68 military personnel diagnosed with insomnia. Subjects were classified into the following groups and then compared: improved sleep (n = 46), or non-improved sleep (n = 22) following three months of standard of care treatment for insomnia. Within subject differential expression was determined from microarray data using the Partek Genomics Suite analysis program and the ingenuity pathway analysis (IPA) was used to determine key regulators of observed expression changes. Changes in symptoms of depression and PTSD were also compared.At baseline, both groups were similar in demographics, clinical characteristics, and gene-expression profiles. The microarray data revealed that 217 coding genes were differentially expressed at the follow-up-period compared to baseline in the participants with improved sleep. Expression of inflammatory cytokines were reduced including IL-1β, IL-6, IL-8, and IL-13, with fold changes ranging from -3.19 to -2.1, and there were increases in the expression of inflammatory regulatory genes including toll-like receptors 1, 4, 7, and 8 in the improved sleep group. IPA revealed six gene networks, including ubiquitin, which was a major regulator in these gene-expression changes. The improved sleep group also had a significant reduction in the severity of depressive symptoms.Interventions that restore sleep likely reduce the expression of inflammatory genes, which relate to ubiquitin genes and relate to reductions in depressive symptoms.",0 +https://doi.org/10.1378/chest.12-3091,Surviving the ICU Does Not Mean That the War Is Over,,0 +https://doi.org/10.1521/psyc.64.3.202.18462,Television Exposure in Children after a Terrorist Incident,"This study examined the influence of bomb-related television viewing in the context of physical and emotional exposure on posttraumatic stress symptoms--intrusion, avoidance, and arousal--in middle school students following the 1995 Oklahoma City bombing. Over 2,000 middle school students in Oklahoma City were surveyed 7 weeks after the incident. The primary outcome measures were the total posttraumatic stress symptom score and symptom cluster scores at the time of assessment. Bomb-related television viewing in the aftermath of the disaster was extensive. Both emotional and television exposure were associated with posttraumatic stress at 7 weeks. Among children with no physical or emotional exposure, the degree of television exposure was directly related to posttraumatic stress symptomatology. These findings suggest that television viewing in the aftermath of a disaster may make a small contribution to subsequent posttraumatic stress symptomatology in children or that increased television viewing may be a sign of current distress and that it should be monitored. Future research should examine further whether early symptoms predict increased television viewing and/or whether television viewing predicts subsequent symptoms.",0 +,ESTIMATING UNKNOWN KNOTS IN PIECEWISE LINEAR-LINEAR LATENT GROWTH MIXTURE MODELS,"A piecewise linear-linear latent growth mixture model (LGMM) combines features of a piecewise linear-linear latent growth curve (LGC) model with the ideas of latent class methods all within a structural equation modeling (SEM) context. A piecewise linear-linear LGMM is an appropriate framework for analyzing longitudinal data that come from a mixture of two or more subpopulations (i.e., latent classes) where each latent class incorporates a separate growth trajectory corresponding to multiple growth phases from which repeated measurements arise. The benefit of the model is that it allows the specification of each growth phase to conform to a particular form of overall change process within each latent class thereby making these models flexible and useful for substantive researchers. There are two main objectives of this current study. The first objective is to demonstrate how the parameters of a piecewise linear-linear LGMM, including the unknown knot, can be estimated using standard SEM software. A series of Monte Carlo simulations empirically investigated the ability of piecewise linear-linear LGMMs to recover true (known) growth parameters of distinct populations. Specifically, the current research compared the performance of the piecewise linear-linear LGMM under different manipulated conditions of (1) sample size, (2) class mixing proportions, (3) class separation of location of knot, (4) the mean of the slope growth factor of the second phase, (5) the variance of the slope growth factor of the second phase, and (6) residual variance of the observed variables. The second objective is to address the issue of model mis-specification. It is important to analyze this issue because applied researchers have to make model selection decisions. Therefore, the current research examined the possibility of extracting spurious latent classes. To achieve this objective 1-, 2-, and 3-class piecewise linear-linear LGMMs were fit to data sets generated under different manipulated conditions using a 2-class piecewise linear-linear LGMM as a population model. The number of times the correct model (i.e., 2-class piecewise linear-linear LGMM) was preferred over incorrect models (i.e., 1- and 3-class piecewise linear-linear LGMMs) using the Bayesian Information Criterion (BIC) was examined. Results suggested that the recovery of model parameters, specifically, the variances of growth factors were generally poor. In addition, none of the manipulated conditions were systematically related to the outcome measures, parameter bias and variability index of parameter bias. Furthermore, among all the manipulated conditions, the residual variance of observed variable had the strongest statistically significant effect on both the model convergence rate and the model selection rate. Other manipulated conditions that had an impact on the model convergence rate and/or the model selection rate were the growth factor mean of slope of the second phase, the growth factor variance of slope of the second phase, and the class mixing proportion. The manipulated conditions whose levels had no influence on either the model convergence rate or the model selection rate were sample size and the class separation of location of knot. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1016/j.neuroscience.2012.11.004,d-Cycloserine administered directly to infralimbic medial prefrontal cortex enhances extinction memory in sucrose-seeking animals,"d-Cycloserine (DCS), a co-agonist at the N-methyl-D-aspartate (NMDA) receptor, has proven to be an effective adjunct to cognitive behavioral therapies that utilize extinction. This pharmacological-based enhancement of extinction memory has been primarily demonstrated in neuropsychiatric disorders characterized by pathological fear (e.g. posttraumatic stress disorder and various phobias). More recently, there has been an interest in applying such a strategy in the disorders of appetitive learning (e.g. substance abuse and other addictions), but these studies have generated mixed results. Here we first examined whether extinction memory encoding in a sucrose self-administration model is dependent on NMDA receptors. The NMDA antagonist (±)-3-(2-carboxypiperazin-4-yl)propyl-1-phosphonic acid (5mg/kg, i.p.) administered 2h prior to the first extinction training session effectively inhibited extinction memory recall 24h later, without affecting the expression of the conditioned sucrose-seeking response while the drug was on board. This profile of effects suggests a specific effect on extinction memory consolidation. Next, we sought to enhance extinction memory using the co-agonist DCS (10 μg/side) by infusion directly into infralimbic medial prefrontal cortex, a brain site implicated in extinction memory recall in conditioned fear models. Indeed, infusion of DCS immediately after the first extinction training session effectively enhanced extinction memory recall 24h later. Collectively, these data suggest that the neurobiological mechanisms and the neurocircuitry mediating extinction memory are similar regardless of the valence (aversive or appetitive) of the conditioned behavior, and that similar pharmacological strategies for treatment may be applied to neuropsychiatric disorders characterized by a failure to inhibit pathological emotional memories.",0 +https://doi.org/10.1016/j.jpsychires.2011.07.003,Incubation of conditioning-specific reflex modification: Implications for post traumatic stress disorder,"Incubation of fear has been used to account for the delayed manifestation of symptoms of fear and anxiety including the delayed onset of Post Traumatic Stress Disorder (PTSD). We have shown the utility of classical conditioning-specific modification of the rabbit nictitating membrane response (NMR) as a model of PTSD. This modification includes an exaggeration in the size and a change in the timing of the unconditioned NMR after several days of classical conditioning. To assess the effects of incubation on conditioning-specific modification, we measured changes in responding as a function of the time between classical conditioning and NMR testing. After just one day of classical conditioning resulting in modest levels of learning, increases in response size were an inverted-U shaped function of days of incubation with little if any change occurring one and ten days after training but significant change occurring after six days. The incubation effect persisted for a week. An unpaired control group showed no change in the size of the response confirming the incubation effect was associative. The results bear a striking resemblance to symptoms of PTSD that do not always occur immediately after trauma and become exacerbated over time and then persist. They point to a window when incubation can exacerbate symptoms and speak to the vulnerability of re-experiencing trauma too soon. This could be a serious problem for military or emergency personnel recalled to combat or a disaster site without sufficient time to deal with the effects of their initial experiences.",0 +https://doi.org/10.1016/j.neuropsychologia.2013.10.008,Increased response variability as a marker of executive dysfunction in veterans with post-traumatic stress disorder,"The stability of cognitive control processes over time can be indexed by trial-to-trial variability in reaction time (RT). Greater RT variability has been interpreted as an indicator of executive dysfunction, inhibitory inefficiency, and excessive mental noise. Previous studies have demonstrated that combat veterans with post-traumatic stress disorder (PTSD) show substantial impairments in inhibitory control, but no studies have examined response variability in this population. In the current experiment, RT variability in the Go/NoGo response inhibition task was assessed for 45 veterans with PTSD and 34 control veterans using the intra-individual coefficient of variation (ICV) and ex-Gaussian analysis of RT distributions. Despite having mean RTs that were indistinguishable from controls, the PTSD patients had significantly greater RT variability as measured by ICV. More variable RTs were in turn associated with a greater number of false alarm errors in the patients, suggesting that less consistent performers were less successful at inhibiting inappropriate responses. RT variability was also highly correlated with self-reported symptoms of PTSD, depression, and attentional impulsiveness. Furthermore, response variability predicted diagnosis even when controlling for PTSD symptom severity. In turn, PTSD severity was correlated with self-rated attentional impulsiveness. Deficits in the top-down cognitive control processes that cause greater response variability might contribute to the maintenance of PTSD symptomology. Thus, the distractibility issues that cause more variable reaction times might also result in greater distress related to the trauma.",0 +https://doi.org/10.1017/cbo9780511570148.005,Theoretical perspectives of traumatic stress and debriefings,"The purpose of this article was to attempt to identify and examine the core set of elements or factors which are germane to understanding the process and effects of traumatic stress and psychological debriefings. Before these factors are addressed, relevant questions regarding the nature, level of care, and implementation of debriefings are raised. A person-environment interactional model is used to explain the typologies of traumatic events and stressor dimensions. Factors considered fundamental to crisis response, goals common to debriefings, and the need to recognize the diversity of traumatic events are then reviewed.",0 +https://doi.org/10.1017/s0033291707000943,A nationwide US study of post-traumatic stress after hospitalization for physical injury,"ABSTRACT Background Injured survivors of individual and mass trauma are at risk for developing post-traumatic stress disorder (PTSD). Few investigations have assessed PTSD after injury in large samples across diverse acute care hospital settings. Method A total of 2931 injured trauma survivors aged 18–84 who were representative of 9983 in-patients were recruited from 69 hospitals across the USA. In-patient medical records were abstracted, and hospitalized patients were interviewed at 3 and 12 months after injury. Symptoms consistent with a DSM-IV diagnosis of PTSD were assessed with the PTSD Checklist (PCL) 12 months after injury. Results Approximately 23% of injury survivors had symptoms consistent with a diagnosis of PTSD 12 months after their hospitalization. Greater levels of early post-injury emotional distress and physical pain were associated with an increased risk of symptoms consistent with a PTSD diagnosis. Pre-injury, intensive care unit (ICU) admission [relative risk (RR) 1·17, 95% confidence interval (CI) 1·02–1·34], pre-injury depression (RR 1·33, 95% CI 1·15–1·54), benzodiazepine prescription (RR 1·46, 95% CI 1·17–1·84) and intentional injury (RR 1·32, 95% CI 1·04–1·67) were independently associated with an increased risk of symptoms consistent with a PTSD diagnosis. White injury survivors without insurance demonstrated approximately twice the rate of symptoms consistent with a diagnosis of PTSD when compared to white individuals with private insurance. By contrast, for Hispanic injury survivors PTSD rates were approximately equal between uninsured and privately insured individuals. Conclusions Nationwide in the USA, more than 20% of injured trauma survivors have symptoms consistent with a diagnosis of PTSD 12 months after acute care in-patient hospitalization. Coordinated investigative and policy efforts could target mandates for high-quality PTSD screening and intervention in acute care medical settings.",0 +https://doi.org/10.1007/s10608-012-9512-1,The Interactive Effect of Worry and Intolerance of Uncertainty on Posttraumatic Stress Symptoms,"In this study, relations among worry, intolerance of uncertainty (IU), and posttraumatic stress symptoms (PTSS) were examined in N = 89 participants with a trauma history. Both worry and IU shared significant zero-order correlations with each of the three DSM-IV posttraumatic stress symptom clusters. Partial correlations, controlling for the overlap among the symptom clusters, suggested that both worry and IU shared unique associations only with hyperarousal. Finally, and consistent with predictions, IU moderated the relation between worry and PTSS. When examining each PTSS cluster separately, evidence of the moderating role of IU was found only in relation to hyperarousal. More specifically, simple effects revealed that worry had a significant positive association with PTSS and hyperarousal only at high levels of IU. These findings suggest a specific risk profile of high worry in conjunction with high IU for the development and maintenance of PTSS, with particular relevance to hyperarousal symptoms. Conceptual and practical implications of these findings regarding common PTSD treatment approaches are discussed. © 2012 Springer Science+Business Media New York.",0 +https://doi.org/10.1007/s10608-013-9531-6,Intolerance of Uncertainty and PTSD Symptoms: Exploring the Construct Relationship in a Community Sample with a Heterogeneous Trauma History,"Intolerance of uncertainty has received substantial empirical attention in recent years. The contribution of intolerance of uncertainty to the development and maintenance of anxiety disorders has become increasingly recognized by researchers; however, relationships between intolerance of uncertainty and symptoms of posttraumatic stress disorder remain largely unexplored. As part of a larger study, North American community members (n = 122, 81 % women) with a heterogeneous trauma history completed self-report measures assessing intolerance of uncertainty and its dimensions (inhibitory and prospective intolerance of uncertainty) and posttraumatic stress disorder symptoms (re-experiencing, avoidance, numbing, hyperarousal). Intolerance of uncertainty total scores accounted for statistically significant variance in each posttraumatic stress disorder symptom score except re-experiencing. Inhibitory intolerance of uncertainty scores accounted for statistically significant variance in each posttraumatic stress disorder symptom score except re-experiencing. Prospective intolerance of uncertainty scores did not account for statistically significant variance in any of the posttraumatic stress disorder symptom scores. Results suggest that intolerance of uncertainty relates differentially to posttraumatic stress disorder symptom clusters and inhibitory intolerance of uncertainty appears to be the main component of the relationship. © 2013 Springer Science+Business Media New York.",0 +https://doi.org/10.1037/0021-843x.116.1.65,"Diagnostic, demographic, memory quality, and cognitive variables associated with acute stress disorder in children and adolescents.","To date, no studies have investigated factors associated with acute stress disorder (ASD) in children and adolescents. Relationships between ASD and a number of demographic, trauma, cognitive, and trauma memory variables were therefore investigated in a sample (N=93) of children and adolescents involved in assaults and motor vehicle accidents. Several cognitive variables and the quality of trauma memories, but not demographic or trauma variables, were correlated with ASD and also mediated the relationship between peritraumatic threat and ASD. Finally, nosological analyses comparing ASD with indexes of posttraumatic stress disorder in the month posttrauma revealed little support for the dissociation mandate that uniquely characterizes ASD. The results are discussed with respect to assessment and treatment for the acute traumatic stress responses of children and young people.",0 +https://doi.org/10.1007/s10608-005-9630-0,The Structure of Maladaptive Schemas: A Confirmatory Factor Analysis and a Psychometric Evaluation of Factor-Derived Scales,"One thousand and thirty-seven psychiatric patients and non-patients from six different sites completed the 205-item Young Schema Questionnaire or its shortended form, the 75-item Young Schema Questionnaire-S. Among 888 of the subjects, who all were patients, a confirmatory factor analysis (CFA) of the 75 items included in both forms of the questionnaire clearly yielded the 15 Early Maladaptive Schema (EMS) factors rationally developed by J. E. Young (1990). Confirmatory factor analyses, testing three models of the higher-order structure of the 15 EMSs, indicated that a four-factor model was the best alternative. The results slightly favored a correlated four second-order factor model over one also including a third-order global factor. The four factors or schema domains were Disconnection, Impaired Autonomy, Exaggerated Standards, and Impaired Limits. Scales derived from the four higher-order factors had good internal and test-retest reliabilities and were related to DSM-IV Cluster C personality traits, agoraphobic avoidance behavior, and depressive symptoms. (",0 +,[Less severe sexual child abuse and its sequelae: are there different psychic and psychosomatic symptoms in relation to various forms of sexual interaction?].,"A typology of less severe sexual encounters was used to analyze short and long term sequelae of sexual abuse via intimate skin contact. Well known theoretical approaches on the harmful effects of sexual abuse were tested. Do we find different peri- and posttraumatic reactions dependent upon varied forms of sexual interactions with children? A cluster analysis was calculated with symptom variables that were described in 141 child statements taken out of written expert opinions. Afterwards variance analyses of these symptom clusters were conducted in reference to six different abuse constellations. Different symptom profiles were found for these six abuse constellations. Panic symptoms, shame related feelings, avoidant behavior and physical reactions showed significant results. The sequelae to different forms of less severe sexual child abuse differ and depend more upon the situational dynamic than upon the kind of relationship between adult and child.",0 +https://doi.org/10.1111/j.1469-7610.2004.00378.x,Pre-attack symptomatology and temperament as predictors of children's responses to the September 11 terrorist attacks,"The aims of this study were to assess the psychological response of children following the September 11, 2001 terrorist attacks in New York and Washington, DC and to examine prospective predictors of children's post-attack responses.Children's responses were assessed in a community sample of children in Seattle, Washington, participating in an ongoing study. Symptomatology and temperament assessed prior to the attacks were examined as prospective predictors of post-attack post-traumatic stress (PTS), anxiety, depression and externalizing problems.Children demonstrated PTS symptoms and worries at levels comparable to those in children directly experiencing disasters, with 77% of children reporting being worried, 68% being upset by reminders, and 39% having upsetting thoughts. The most common PTS symptom cluster was re-experiencing, and 8% of children met criteria consistent with PTSD. African-American children reported more avoidant PTS symptoms and being more upset by the attacks than European-American children. Girls reported being more upset than boys. Prior internalizing, externalizing, social competence and self-esteem were related to post-attack PTS; and child inhibitory control, assessed prior to the 9/11 attacks, demonstrated a trend towards an association with post-attack PTS symptoms controlling for prior levels of symptomatology. PTS predicted child-report anxiety and conduct problem symptoms at follow-up, approximately 6 months after 9/11.Children experiencing a major disaster at a distance or indirectly through media exposure demonstrated worries and PTS symptoms suggesting that communities need to attend to children's mental health needs in response to national or regional disasters. Pre-disaster symptomatology or low self-regulation may render children more vulnerable in response to a disaster, and immediate post-disaster responses predict subsequent symptomatology. These variables might be used in the identification of children in need of intervention.",0 +https://doi.org/10.1007/bf02688856,Pavlovian eyeblink conditioning in combat veterans with and without post-traumatic stress disorder,"Several recent studies have investigated relationships between post-traumatic stress disorder (PTSD) and learning and memory problems. These reports have found in general that not only does PTSD affect trauma-related memories, but when patients with PTSD are compared with similar trauma patients without PTSD, general memory impairments have been found. The present paper reports a study in which associative learning, using Pavlovian eyeblink conditioning, was investigated in combat veterans with and without chronic PTSD, using interstimulus intervals of 500 and 1000 msec in two separate experiments. Although several recent reports suggest that larger-magnitude autonomic conditioned responses occur in patients with PTSD during Pavlovian conditioning, the present study found evidence of impaired Pavlovian eyeblink conditioning in combat veterans with and without PTSD, compared to non-combat veterans. Although these data suggest that combat leads to an impaired associative learning process regardless of whether PTSD is apparent, a group of community-dwelling combat veterans not under medical treatment showed normal conditioning, suggesting that variables other than prior combat must also be involved.",0 +https://doi.org/10.1016/j.drugalcdep.2010.04.011,The role of alcohol misuse in PTSD outcomes for women in community treatment: a secondary analysis of NIDA's Women and Trauma Study.,"Individuals with comorbid substance use and posttraumatic stress disorder may differentially benefit from integrated trauma-focused interventions based on specific presenting characteristics such as substance use type and PTSD severity. The current study is a secondary analysis of a NIDA Clinical Trials Network study exploring the effectiveness of two interventions for women with comorbid PTSD and substance use disorders.Generalized estimating equations were used to examine the association of baseline alcohol misuse with PTSD outcome measures over time for all randomized participants.Women entering treatment with baseline alcohol misuse had higher Post Traumatic Stress Disorder Symptom Scale (PSS-SR) total scores (t=2.43, p<.05), cluster C (avoidance/numbing) scores (t=2.63, p<.01), and cluster D (hyper-arousal) scores (t=2.31, p<.05). For women with alcohol misuse, after treatment week 1, PSS-SR scores were significantly lower in the Seeking Safety intervention during treatment (chi(2)(1)=4.00, p<.05) and follow-up (chi(2)(1)=4.87, p<.05) compared to those in the health education intervention. Alcohol misusers in the Seeking Safety group who had higher baseline hyper-arousal severity improved more quickly than those with lower baseline hyper-arousal severity during treatment (chi(2)(1)=4.06, p<.05).These findings suggest that the type of substance abuse at treatment entry may inform treatment selection, predict treatment response among those with co-occurring PTSD and substance use disorders, and indicate a more severe clinical picture.",0 +https://doi.org/10.1016/j.jpsychires.2013.10.020,"The dimensional structure of posttraumatic stress symptomatology in 323,903 U.S. veterans","There is ongoing debate regarding the optimal dimensional structure of posttraumatic stress disorder symptomatology. A better understanding of this structure has significant implications, as it can provide more refined phenotypic measures for use in studies of the etiology and neurobiology of PTSD, as well as for use as endpoints in treatment studies of this disorder. In this study we analyzed the dimensional structure of PTSD symptomatology, as assessed using the PTSD Symptom Checklist-Military Version in 323,903 Veterans. Confirmatory factor analyses were used to compare two 4-factor models and a newly proposed 5-factor model to the 3-factor DSM-IV model of PTSD symptom dimensionality. To evaluate the external validity of the best-fitting model, we then conducted a structural equation model examining how the symptom dimensions of this model related to diagnoses of depression, anxiety, and substance use disorder. Results indicated that a newly proposed 5-factor ‘dysphoric arousal’ model comprised of separate re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal symptom clusters provided a significantly better fit to the data compared to the DSM-IV and the two alternative four-factor models. External validity analyses revealed that numbing symptoms were most strongly related to diagnoses of depression and substance use disorder, and that dysphoric arousal symptoms were most strongly related to a diagnosis of anxiety disorder. Thus the dimensional structure of PTSD may be best represented by five symptom dimensions. The clinical implications of these results and implications for further refinement of extant PTSD assessment instruments are discussed.",0 +https://doi.org/10.1371/journal.pone.0065584,Increased Prefrontal Cortical Thickness Is Associated with Enhanced Abilities to Regulate Emotions in PTSD-Free Women with Borderline Personality Disorder,"Previous studies suggest that amygdala, insula and prefrontal cortex (PFC) disintegrity play a crucial role in the failure to adequately regulate emotions in Borderline Personality Disorder (BPD). However, prior results are confounded by the high rate of comorbidity with Posttraumatic Stress Disorder (PTSD), which itself has been associated with changes in frontolimbic circuitry. We thus scrutinized the link between PFC, amygdala, insula, and the ability to regulate emotions, contrasting 17 women with BPD without comorbid PTSD to 27 non-clinical control women and in addition to those with BPD and PTSD (n = 14). BPD women without PTSD, but not those with comorbid PTSD, had increased cortical thickness in the dorsolateral PFC (DLPFC) in comparison to control women. Furthermore, cortical thickness in the DLPFC of BPD women without PTSD positively correlated with emotion regulation scores and furthermore was positively associated with amygdala volume, as well as cortical thickness of the insula. Our findings highlight the importance of disentangling the impact of BPD and PTSD on the brain and suggest possible compensatory mechanisms for the impaired emotion regulation in BPD women without PTSD.",0 +https://doi.org/10.1111/j.2044-8260.1992.tb00965.x,Aftermaths of combat stress reactions: A three-year study,"The current study provides an overview of a study assessing the psychological and somatic health adjustment of Lebanon War veterans one, two and three years after the war, comparing combat stress reactions (CSR) casualties with controls. Findings indicated that combat-related psychopathology was overwhelmingly more prevalent among CSR casualties than among their matched controls one, two and three years after war. In addition, the passage of time had no effect on the relative psychiatric symptomatology, social functioning, self-efficacy, and somatic complaints in either of the two study groups. This stable mental health status of the CSR casualty over the three years of the study contrasts with the observed decline in trauma-related distress in the third year. Results are discussed in terms of the emotional sequelae of war trauma.",0 +https://doi.org/10.1002/jts.20077,"Posttraumatic stress disorder symptoms among low-income, African American women with a history of intimate partner violence and suicidal behaviors: Self-esteem, social support, and religious coping","There is a dearth of research on risk/protective factors for posttraumatic stress disorder (PTSD) among low-income African American women with a history of intimate partner violence (IPV), presenting for suicidal behavior or routine medical care in a large, urban hospital. We examined self-esteem, social support, and religious coping as mediators between experiences of child maltreatment (CM) and IPV and symptoms of PTSD in a sample (N = 134) of low-income African American women. Instruments used included the Index of Spouse Abuse, the Childhood Trauma Questionnaire, the Taylor Self-Esteem Inventory, the Multidimensional Profile of Social Support, the Brief Religious Coping Activities Scale, and the Davidson Trauma Scale. Both CM and IPV related positively to PTSD symptoms. Risk and resilience individual difference factors accounted for 18% of the variance in PTSD symptoms over and above IPV and CM, with self-esteem and negative religious coping making unique contributions. Both variables mediated the abuse-PTSD symptom link. In addition, we tested an alternate model in which PTSD symptoms mediated the relationship between abuse and both self-esteem and negative religious coping.",0 +https://doi.org/10.1136/bmjopen-2012-001720,Police officers: a high-risk group for the development of mental health disturbances? A cohort study,"Policing is generally considered a high-risk profession for the development of mental health problems, but this assumption lacks empirical evidence. Research question of the present study is to what extent mental health disturbances, such as (very) severe symptoms of anxiety, depression and hostility are more prevalent among police officers than among other occupational groups.Multicomparative cross-sectional study using the data of several cross-sectional and longitudinal studies in the Netherlands.Two samples of police officers (N=144 and 503), employees of banks (N=1113) and employees of banks who were robbed (N=144); employees of supermarkets (N=335), and a psychiatric hospital (N=219), employees of a governmental social welfare organisation (N=76), employees who followed a training based on rational-motive therapy to strengthen their assertiveness (N=710), soldiers before deployment (N=278) and before redeployment (N=236) and firefighters (N=123). The numbers refer to respondents with complete data.Prevalence of severe (subclinical level) and very severe symptoms (clinical level) were computed using the Dutch norm tables (80th percentile and 95th percentile, respectively) of the Symptom Check List Revised (SCL-90-R). All comparisons were controlled for age, gender and education.Multivariate logistic regression and analyses showed that the prevalence of clinical and subclinical levels of symptoms of anxiety, depression and hostility among police officers were not significantly higher than among comparison groups. The same pattern was found for the other SCL-90-R subscales.We found no indications that self-reported mental health disturbances were more prevalent among police officers than among groups of employees that are not considered high-risk groups, such as employees of banks, supermarkets, psychiatric hospital and soldiers before deployment.",0 +,A Study of Symptoms of the Post-traumatic Stress Disorder and Its Related Factors in Adolescents after the Wenchuan Earthquake,"Objective:To investigate the related factors of post-traumatic stress disorder(PTSD) among adolescents in different areas after the Wenchuan Earthquake.Methods:With Revised Impact of Events Scale for Children(CRIES-13) and self made survey,1267 students in the extremely severe disaster areas in Mianzhu,Sichuan province and the severe disaster areas in Baoji,Shaanxi were tested.Results:The extent of disaster exposure in Mianzhu was significantly higher than that in Baoji.However,there was no difference in the extent of PTSD symptoms between the two areas(t=0.181,df=1265,P=0.857),but only significant difference in the incidence rate(χ2=8.766,df=1,P=0.003),and the incidence rate of PTSD in Mianzhu areas was significantly higher than that of Baoji areas.Conclusion:5·12 Wenchuan earthquake has caused severe post-traumatic response in adolescents both in the extremely severe disaster areas and the severe disaster areas,but the former is higher in the incidence rate of PTSD,and age,sex,getting trapped in the earthquake,having relatives and friends injured in the earthquake,witnessing death in the earthquake were all significant predictors for PTSD severity.",0 +https://doi.org/10.1186/s12888-014-0260-5,Differential roles of childhood adversities and stressful war experiences in the development of mental health symptoms in post-war adolescents in northern Uganda,"BackgroundPrevious studies have shown a relationship between stressful war experiences and mental health symptoms in children and adolescents. To date, no comprehensive studies on the role of childhood adversities have been conducted with war-exposed adolescents living in post-war, low-resource settings in Sub-Saharan Africa.MethodsA cross-sectional study of 551 school-going adolescents aged 13-21 years old was undertaken four years post-war in northern Uganda. Participants completed self-administered questionnaires assessing demographics, stressful war experiences, childhood adversities, posttraumatic stress disorder (PTSD), depression, and anxiety symptoms.ResultsOur analyses revealed a main effect of gender on all mental health outcomes except avoidance symptoms, with girls reporting higher scores than boys. Stressful war experiences were associated with all mental health symptoms, after adjusting for potential confounders. Childhood adversity was independently associated with depression symptoms but not PTSD, anxiety, and PTSD cluster symptoms. However, in situations of high childhood adversity, our analyses showed that stressful war experiences were less associated with vulnerability to avoidance symptoms than in situations of low childhood adversity.ConclusionsBoth stressful war experiences and childhood adversities are risk factors for mental health symptoms among war-affected adolescents. Adolescents with histories of high childhood adversities may be less likely to develop avoidance symptoms in situations of high stressful war experiences. Further exploration of the differential roles of childhood adversities and stressful war experiences is needed.",0 +https://doi.org/10.1016/j.jmwh.2008.07.004,Physical Health and Posttraumatic Stress Disorder Symptoms in Women Experiencing Intimate Partner Violence,"This correlational-predictive study addresses the associations between intimate partner violence (IPV) and physical health and posttraumatic stress disorder (PTSD) symptoms, including: 1) detailed physical health symptoms reported and health care sought by women in intimate abusive relationships, 2) relationships between physical health symptoms, IPV, and PTSD, and 3) unique predictors of physical health symptoms. An ethnically diverse sample of 157 abused women was recruited from crisis shelters and the community. The women averaged almost 34 years of age and had been in the abusive relationship for slightly more than 5 years. The women experienced physical health symptoms falling into 4 groups: neuromuscular, stress, sleep, and gynecologic symptoms. Women experiencing more severe IPV reported more physical health and PTSD symptomatology. PTSD avoidance and threats of violence or risk of homicide uniquely predicted physical health. More than 75% of the women had sought treatment from a health care professional in the previous 9 months. Implications for practice are discussed.",0 +,An Expressive Arts Therapy Model with Groups for Post-Traumatic Stress Disorder.,"(from the chapter) This chapter sets forth a model of group treatment for children who have been impacted by abuse and neglect. This model of group therapy was developed for a population of children aged between 9 and 12. An overview of group therapy theory precedes a brief review of my integration of recent trauma research with direct clinical practice in the field. This research has served as a foundation for the treatment model as well as a rationale for the use of expressive arts and play therapy with children who have developed post-traumatic stress disorder symptoms (PTSD). A case example will be presented to demonstrate how theory and practice can be integrated. The remainder of the chapter focuses on the specifics of this particular treatment model. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1016/j.trf.2012.05.008,"Psychological consequences of trauma in MVA perpetrators – Relationship between post-traumatic growth, PTSD symptoms and individual characteristics","The study explores two problems rarely discussed in literature. Firstly, it presents the psychological consequences of traumatic stress in perpetrators of motor vehicle accidents (MVAs). The attention of both clinicians and researchers is very seldom focused on this group of MVA participants, as in the natural way, people have a tendency to empathise with victims and distancing from those who make harm to others. MVA perpetrators usually feel no right to complain about experienced symptoms of poor well-being, and guilt prevent them against searching for any help. Such a situation may lead to further problems related to traffic safety, as persistent and untreated symptoms of PTSD or other anxiety disorders may negatively affect driving behaviour. Secondly, apart from post-traumatic psychopathology, the symptoms of post-traumatic growth (PTG) in MVA perpetrators together with factors related to them are analysed in the study. The examination results from the comprehensive sample of MVA perpetrators (n = 236) referred to Occupational Medicine Centres in the catchment area of Mazowieckie Voivodship, Poland, indicate that both PTSD and PTG symptoms are experienced by MVA perpetrators. The key predictors of PTG are neuroticism, conscientiousness, agreeableness and intensity of PTSD symptoms. Moreover, sex and perpetrators’ injuries during the accident seem to play a vital role in the process of post-traumatic growth. Those of subjects who were women or were injured generally declared more positive changes in their life as a consequences of the accident they caused.",0 +https://doi.org/10.1002/pits.20285,Validity of the osu post-traumatic stress disorder scale and the behavior assessment system for children self-report of personality with child tornado survivors,"Tornadoes and other natural disasters can lead to anxiety and posttraumatic stress disorder (PTSD) in children. This study provides further validity for the Oklahoma State University Post-Traumatic Stress Disorder Scale–Child Form (OSU PTSDS-CF) by comparing it to the Behavior Assessment System for Children Self-Report of Personality (BASC-SRP). Correlations were significant at 0.01 between BASC-SRP scales of Anxiety, Atypicality, and Clinical Maladjustment, and at least 0.05 between OSU PTSDS-CF scales for Social Stress, Depression, Inadequacy, and Emotional Symptoms Index (ESI). Analyses of variance (ANOVAs) yielded significant differences at 0.01 between children with and without PTSD, based on OSU PTSDS-CF cut-off scores, for BASC-SRP Anxiety, Atypicality, and Clinical Maladjustment. ANOVAs were significant at 0.05 for Social Stress, Locus of Control, Relationship with Parents, and ESI. Results yielded moderate effect sizes, and BASC-SRP means were within normal limits for all groups. Practitioners are encouraged to supplement the BASC-SRP with PTSD measures in children who have experienced trauma. © 2008 Wiley Periodicals, Inc.",0 +https://doi.org/10.1017/cbo9780511790515,Systems Biology,"Genome sequences are now available that enable us to determine the biological components that make up a cell or an organism. The discipline of systems biology examines how these components interact and form networks, and how the networks generate whole cell functions corresponding to observable phenotypes. This 2006 textbook devoted to systems biology describes how to model networks, how to determine their properties, and how to relate these to phenotypic functions. The prerequisites are some knowledge of linear algebra and biochemistry. Though the links between the mathematical ideas and biological processes are made clear, the book reflects the irreversible trend of increasing mathematical content in biology education. Therefore to assist both teacher and student, in an associated web site Palsson provides problem sets, projects and Powerpoint slides, and keeps the presentation in the book concrete with illustrative material and experimental results.",0 +https://doi.org/10.1002/jts.22047,Randomized Controlled Trial of Online Expressive Writing to Address Readjustment Difficulties Among U.S. Afghanistan and Iraq War Veterans,"We examined the efficacy of a brief, accessible, nonstigmatizing online intervention-writing expressively about transitioning to civilian life. U.S. Afghanistan and Iraq war veterans with self-reported reintegration difficulty (N = 1,292, 39.3% female, M = 36.87, SD = 9.78 years) were randomly assigned to expressive writing (n = 508), factual control writing (n = 507), or no writing (n = 277). Using intention to treat, generalized linear mixed models demonstrated that 6-months postintervention, veterans who wrote expressively experienced greater reductions in physical complaints, anger, and distress compared with veterans who wrote factually (ds = 0.13 to 0.20; ps < .05) and greater reductions in PTSD symptoms, distress, anger, physical complaints, and reintegration difficulty compared with veterans who did not write at all (ds = 0.22 to 0.35; ps ≤ .001). Veterans who wrote expressively also experienced greater improvement in social support compared to those who did not write (d = 0.17). Relative to both control conditions, expressive writing did not lead to improved life satisfaction. Secondary analyses also found beneficial effects of expressive writing on clinically significant distress, PTSD screening, and employment status. Online expressive writing holds promise for improving health and functioning among veterans experiencing reintegration difficulty, albeit with small effect sizes.",0 +https://doi.org/10.2146/ajhp070124,Prazosin for treatment of nightmares related to posttraumatic stress disorder,"The efficacy of prazosin for the treatment of posttraumatic stress disorder (PTSD)-related nightmares is reviewed.PTSD is an anxiety disorder that can occur after experiencing or witnessing a life-threatening event, such as military combat, natural disasters, terrorist attacks, serious accidents, or violent personal assaults. The event that induced PTSD is often relived through nightmares or flashbacks. Sleep disturbances affect approximately 70% of patients with PTSD. Several medications have been evaluated for reducing PTSD-related nightmares, with limited success. Prazosin is a centrally and peripherally acting alpha(1)-adrenergic antagonist whose mechanism of action, favorable adverse-effect profile, and low cost make it a promising agent for the treatment of PTSD. To date, two case reports, two chart reviews, three open-label trials, and two placebo-controlled trials have been published documenting the efficacy and safety of prazosin in the treatment of PTSD-related nightmares. Therapy with prazosin resulted in a reduction in nightmares in patients with both combat- and noncombat-related trauma. A therapeutic benefit occurred with prazosin dosages as low as 1 mg daily, and suppression of nightmare symptoms occurred within one week of prazosin initiation. The most frequently reported adverse event was orthostatic hypotension. The variability in the populations studied (e.g., combat, noncombat, recent traumatic experiences) leaves additional unanswered questions that must be addressed in large, randomized, controlled trials.Prazosin appears to be a promising and well-tolerated agent for the management of PTSD-related nightmares. Further well-designed trials are warranted to establish its place in the treatment of PTSD.",0 +https://doi.org/10.1017/s0954579498001904,Neuroendocrine activity and memory-related impairments in posttraumatic stress disorder,"This article reviews memory-related impairments in trauma survivors with posttraumatic stress disorder and their possible association to neuroendocrine alterations seen in this disorder. The neuroendocrine profile in PTSD first described in chronically ill combat veterans is characterized by lower basal cortisol levels, higher glucocorticoid receptor number, enhanced sensitivity to exogenous steroids, and increased variation in basal cortisol levels over the diurnal cycle. The generalizability and time course of these neuroendocrine alterations are explored in longitudinal studies and studies in other traumatized populations. These studies suggest that at least some aspects of this neuroendocrine profile can also be seen in other populations, including women, children, and victims of childhood trauma. Additionally, the alterations may be present early in the course of illness, perhaps even in the immediate aftermath of trauma, and may continue to be manifest in elderly trauma survivors. The mechanisms by which these neuroendocrine alterations may influence the formation and processing of traumatic memories are discussed.",0 +https://doi.org/10.1034/j.1600-0447.2002.01099.x,Identifying crime victims who are at high risk for post traumatic stress disorder: developing a practical referral instrument,"Objective To construct a practical instrument for the identification and referral of crime victims who are at high risk for post traumatic stress disorder (PTSD). Method: Crime victims filing a complaint at a police station were asked to fill out a questionnaire probing risk factors for PTSD (n=126). One and 3 months later, these victims filled out a self-report version of the PTSD Symptom Scale (PSS-SR). Results: The combination of four items predicted persistent PTSD with a sensitivity of 1.00 and a specificity of 0.62. The items were: being victims of a violent crime, knowing the perpetrator, experiencing the results of the crime as worse than was expected, and blaming oneself for the event. Only 25% of PTSD cases received emotional support from a victim assistance organization. Conclusion: This study demonstrates that early detection of high-risk victims and their referral to treatment is both necessary and possible.",0 +https://doi.org/10.1017/s0954579400006192,"Violent communities, family choices, and children's chances: An algorithm for improving the odds","Abstract Data are presented concerning the early predictors of adaptational success and failure among 72 children attending their 1st years of elementary school in a violent Washington, D.C., neighborhood. Adaptational failures were defined as those children who were doing poorly or failing in school and rated by their parents as suffering clinically significant levels of behavior problems. Adaptational successes were defined as children whose performance as students was rated in the average to excellent range and whose parent-rated levels of behavior problems were within the normal range. Despite the fact that these children were being raised in violent neighborhoods, had been exposed to relatively high levels of violence in the community, and were experiencing associated distress symptoms, community violence exposure levels were not predictive of adaptational failure or success. Instead, adaptational status was systematically related to characteristics of the children's homes. More specifically, the children's chances of adaptational failure rose dramatically as a function of living in unstable and/or unsafe homes. Moreover, it was not the mere accumulation of environmental adversities that gave rise to adaptational failure in these children. Rather, it was only when such adversities contaminated or eroded the stability and/or safety levels of the children's homes that the odds of their adaptational failure increased. We argue that this erosion of the quality of the child's microsystem (i.e., family) by adversities and pressures in the exosystem (i.e., community) is not an inevitable process. Although not yet well understood, it is a process over which families have and must exercise control. The implications of these data for improving children's chances of physical, psychological, and academic survival in violent neighborhoods are considered.",0 +https://doi.org/10.1002/jclp.22224,"Predictors of Prolonged Grief, Resilience, and Recovery Among Bereaved Spouses","Most reactions to loss can be characterized by three prototypical trajectories of resilience, gradual recovery, and chronic distress (Bonanno, ). However, research on the factors that uniquely predict these trajectories of response has been limited. We examined theoretically relevant predictors of each of the trajectory patterns.We assessed 115 bereaved spouses at 1.5 to 3 years postloss and 74 married controls. To identify grief trajectory, we provided bereaved participants with a graphical depiction of the trajectories and asked them to select the one that best described their experience.Group comparisons revealed substantial differences between resilient and prolonged grievers, and almost no differences between resilient and married controls. Multivariate analyses indicated that prolonged grief, when compared to resilience, was uniquely associated with maladaptive dependency traits, difficulty accessing positive memories of the deceased, and higher recalled marital adjustment.The present results extend our understanding of factors associated with distinct trajectories of adjustment after loss.",0 +https://doi.org/10.1016/0034-5288(95)90026-8,Creatine kinase isoenzyme profiles in the plasma of the domestic fowl (Gallus domesticus): effects of acute heat stress,"Creatine kinase isoenzyme activities in extracts of plasma, skeletal muscle, heart and brain tissue of domestic fowls were separated by anion exchange chromatography and tissue specific distributions of the isoenzyme designated MM-CK, BB-CK1 and BB-CK2 were demonstrated. The muscle isoenzyme (MM-CK) was the predominant form in plasma (99 per cent) and its activity increased in response to an episode of acute heat stress.",0 +https://doi.org/10.1111/bjc.12089,Psychometric properties of the Posttraumatic Cognition Inventory within a Northern Ireland adolescent sample,"This study sought to investigate the psychometric properties of the Posttraumatic Cognitions Inventory (PTCI; Foa et al., 1999, Psychol. Assess., 11, 303) among a cohort of older adolescents and to determine the relationship between post-traumatic cognitions and a variety of psychological outcomes including depression, anxiety, stress, and loneliness.The PTCI was investigated among a large sample (N = 785) of Northern Irish adolescents. Confirmatory factor analysis and composite reliability analysis were conducted to assess the psychometric properties of the scale.The familiar three-factor solution of negative cognitions of self, negative cognitions of the world and others, and self-blame was supported; however, it was necessary to remove eight items from the original 33-item scale. The three-factor structure was subsequently demonstrated to be factorially invariant across gender and to possess satisfactory internal reliability. The three PTCI factors were found to correlate with depression, anxiety, stress, and three dimensions of loneliness.These results provide the first piece of evidence that older adolescents cognitively respond to trauma in a similar manner to adults, that the PTCI is factorially invariant between genders, and that trauma cognitions are correlated with feelings of loneliness. The contextual dependent nature of the structure of the PTCI factors is discussed in relation to future research efforts.The PTCI is a valid and reliable measure of trauma-related cognitions among adolescents and works equally well for male adolescents and female adolescents. Trauma cognitions are associated with a range of mental health problems beyond post-traumatic stress disorder including depression, anxiety, stress, and various aspects of loneliness. Reductions in trauma cognitions in survivors of trauma will have wide-scale clinical benefits to patient well-being. The exact structure and make-up of items in the PTCI may well be dependent on culture, context, and the nature of the trauma. The study is limited due to the fact that the authors could not assess the severity of the trauma experienced by the adolescent sample.",0 +https://doi.org/10.1016/j.pscychresns.2003.05.002,Dimensional complexity of the EEG in patients with posttraumatic stress disorder,"Recent electrophysiological studies have reported evidence of information processing abnormalities in patients with posttraumatic stress disorder (PTSD). The aim of this study is to examine dynamical complexity of the EEG in PTSD patients, which is thought to reflect information processing of the brain. Resting EEG recordings (32,800 data points acquired continuously from 82 s of an EEG record) were obtained in 16 channels of 27 patients with PTSD from a mixed civilian trauma population and 14 healthy subjects. The correlation dimension (D2) of the EEG was used to quantify the complexity of the cortical dynamics underlying the EEG signal. The PTSD patients were found to have lower D2 values than those of the healthy subjects in most channels (Fp1, F8, C4, P4, T3, T4, T5, T6, and O1), indicating that PTSD patients have globally reduced complexity in their EEG waveforms. This study supports the hypotheses that PTSD patients exhibit disturbed cortical information processing, and that non-linear dynamical analysis of the EEG can be a tool for detecting changes in neurodynamics of the brain in PTSD.",0 +,[Features of a short stay service facility for the severely motor and intellectually disabled persons in relation to the Niigata Chuetsu Prefecture earthquake in 2004].,"Twenty-four handicapped victims of the Niigata-Chuetsu earthquake have used our ""short-stay-service"" . We have summarized the characteristics of this utilization. Two prominent patterns were noted:1) The mean duration of the stays was clearly longer when compared to ordinary service, and correlated with the proximity of the victims to the focus of the earthquake, and 2) victims living near the epicenter took longer to start utilizing the short-stay service. The Niigata-Chuetsu earthquake has destroyed roads and highways at over 200 locations, preventing transportation, isolating the seismic center, and resulting in delayed rescue of the handicapped victims and their admittance to the institution. More of the 24 victims were from the severest region (on 7 of the Japanese seismic intensity scale) than from the violent region (scale 6). Unfortunately, the social and administrative network for supporting and protecting severely motor and intellectually disabled persons is still at an embryonic stages. Based of this experience, we propose the building and organization of a functional network for the disabled.",0 +https://doi.org/10.1080/00273170701710338,Observations on the Use of Growth Mixture Models in Psychological Research,"Psychologists are applying growth mixture models at an increasing rate. This article argues that most of these applications are unlikely to reproduce the underlying taxonic structure of the population. At a more fundamental level, in many cases there is probably no taxonic structure to be found. Latent growth classes then categorically approximate the true continuum of individual differences in change. This approximation, although in some cases potentially useful, can also be problematic. The utility of growth mixture models for psychological science thus remains in doubt. Some ways in which these models might be more profitably used are suggested.",0 +https://doi.org/10.1016/j.jsmc.2010.01.003,Frequency and Content of Dreams Associated with Trauma,"Sleep disturbances and dream-related disorders play a prominent role in trauma victims' clinical profile. Although some progress has been made in understanding the impact of sleep mechanisms and nightmares in the development, maintenance, and treatment of posttraumatic stress disorder (PTSD), little is known about the actual content of trauma-related dreams beyond the more strictly defined PTSD nightmares. This article presents key methodological issues, reviews findings on dream recall frequency following trauma exposure, examines the incidence of dream-related disorders as a function of trauma characteristics and personality variables, and reviews findings on the relationship between dream content and specific types of traumas. It is concluded that greater clinical and research efforts should be directed at understanding the natural course and impact of dream-related disorders as well as normal dream processes in trauma victims.",0 +https://doi.org/10.1016/j.comppsych.2013.09.004,Comorbid depressive symptoms in treatment-seeking PTSD outpatients affect multiple domains of quality of life,"No study has examined the impact of the comorbid Axis I conditions on the quality of life (QoL) of patients with a primary diagnosis of PTSD. Our goal was to investigate the influence of comorbid disorders on the QoL of treatment-seeking outpatients with PTSD.The diagnoses of PTSD and of the comorbid disorders were established using the SCID-I. The 54 volunteers also completed the Posttraumatic Stress Disorder Checklist - Civilian Version, the BDI, the BAI, the Trauma History Questionnaire, and a socio-demographic questionnaire. Quality of life was assessed by means of the WHOQOL-BREF, a 26-item self-administered scale that measures four domains of QoL: psychological, physical, social, and environmental. Multiple linear regression models were fitted to investigate the relationship between the severity of post-traumatic, mood, and anxiety symptoms; the presence of specific current comorbid disorders and of psychotic symptoms, the number of current comorbid conditions, and a history of child abuse for each of the four domains of QoL, after adjusting for the effect of socio-demographic characteristics.The severity of PTSD symptoms impacted negatively on the psychological and physical domains. The severity of depressive symptoms correlated negatively with QoL in all domains, independently of sex, age, occupation, and marital status. The psychotic symptoms impacted negatively on the environmental domain. A history of child abuse was negatively associated with the psychological and the social domains.The severity of comorbid depressive symptoms is one of the most important factors in the determination of the QoL in patients with PTSD.",0 +https://doi.org/10.1080/17439760.2014.994223,Stressful life events and predictors of post-traumatic growth among high-risk early emerging adults,"Stressful life events (SLEs) may elicit positive psychosocial change among youth, referred to as Post-traumatic Growth (PTG). We assessed types of SLEs experienced, degree to which participants reported PTG, and variables predicting PTG across 24 months among a sample of high risk, ethnically diverse early emerging adults. Participants were recruited from alternative high schools (n = 564; mean age=16.8; 65% Hispanic). Multi-level regression models were constructed to examine the impact of environmental (SLE quantity, severity) and personal factors (hedonic ability, perceived stress, developmental stage, future time orientation) on a composite score of PTG. The majority of participants reported positive changes resulted from their most life-altering SLE of the past two years. Predictors of PTG included fewer SLEs, less general stress, having a future time perspective, and greater identification with the developmental stage of Emerging Adulthood. Findings suggest intervention targets to foster positive adaptation among early emerging adults who experience frequent SLEs.",0 +https://doi.org/10.1146/annurev.clinpsy.121208.131413,Group-Based Trajectory Modeling in Clinical Research,"Group-based trajectory models are increasingly being applied in clinical research to map the developmental course of symptoms and assess heterogeneity in response to clinical interventions. In this review, we provide a nontechnical overview of group-based trajectory and growth mixture modeling alongside a sampling of how these models have been applied in clinical research. We discuss the challenges associated with the application of both types of group-based models and propose a set of preliminary guidelines for applied researchers to follow when reporting model results. Future directions in group-based modeling applications are discussed, including the use of trajectory models to facilitate causal inference when random assignment to treatment condition is not possible.",0 +https://doi.org/10.1016/s0272-7358(01)00086-1,Posttraumatic stress disorder in children: The influence of developmental factors,"Despite the prevalence of childhood trauma, there are currently no developmentally oriented cognitive theories of posttraumatic stress disorder (PTSD). This paper outlines the definitional issues of PTSD in children, reviews the incidence of PTSD in children, and compares PTSD profiles in children and adults. We propose that a cognitive theory of childhood PTSD needs to accommodate developmental factors, including knowledge, language development, memory, emotion regulation, and social cognition, in addition to contextual factors such as family interactions. Implications of these developmental factors for assessment and treatment of traumatized children are discussed.",0 +https://doi.org/10.1016/j.cpr.2012.02.002,"Relations among posttraumatic stress disorder, comorbid major depression, and HPA function: A systematic review and meta-analysis","Exposure to traumatic stress is associated with increased risk for posttraumatic stress disorder (PTSD) and alterations of hypothalamic-pituitary-adrenocortical (HPA) function. Research linking traumatic stress with HPA function in PTSD has been inconsistent, however, in part due to (a) the inclusion of trauma-exposed individuals without PTSD (TE) in control groups and (b) a failure to consider comorbid major depressive disorder (MDD) and moderating variables. This meta-analysis of 47 studies (123 effect sizes, N=6008 individuals) revealed that daily cortisol output was lower for PTSD (d=-.36, SE=.15, p=.008) and PTSD+MDD (d=-.65, SE=.25, p=.008) groups relative to no trauma controls (NTC); TE and NTC groups did not differ significantly from each other. Afternoon/evening cortisol was lower in TE (d=-.25, SE=.09, p=.007) and PTSD (d=-.27, SE=.12, p=.021) groups and higher in PTSD+MDD groups (d=.49, SE=.24, p=.041) relative to NTC. Post-DST cortisol levels were lower in PTSD (d=-.40, SE=.12, p<.001), PTSD+MDD (d=-.65, SE=.14, p<.001), and TE groups (d=-.53, SE=.14, p<.001) relative to NTC. HPA effect sizes were moderated by age, sex, time since index event, and developmental timing of trauma exposure. These findings suggest that enhanced HPA feedback function may be a marker of trauma-exposure rather than a specific mechanism of vulnerability for PTSD, whereas lower daily cortisol output may be associated with PTSD in particular.",0 +https://doi.org/10.1097/nmd.0b013e3181a206f7,Impact of Exposure to Trauma on Posttraumatic Stress Disorder Symptomatology in Swedish Tourist Tsunami Survivors,"The aim was to examine long-term mental health and posttraumatic stress symptomatology in a Swedish tourist population after exposure to the 2004 Southeast Asian tsunami. Data from 4822 returned questionnaires 14 months after the disaster were analyzed. Respondents were categorized into 3 subgroups: (1) danger-to-life exposure group (having been caught or chased by the waves), (2) nondanger-to-life exposure group (exposed to other disaster-related stressors), and (3) low exposure group. Main outcome measures were General Health Questionnaire-12 and Impact of Event Scale-22-Revised. Danger-to-life exposure was an important factor in causing more severe posttraumatic stress symptoms and in affecting mental health. Female gender, single status, and former trauma experiences were associated with greater distress. Other factors related to more severe symptoms were loss of relatives, physical injuries, viewing many dead bodies, experiencing life threat, and showing signs of cognitive confusion. Disaster exposure has a substantial impact on survivors, which stresses the need for long-lasting support.",0 +https://doi.org/10.3109/02699052.2010.542429,Post-traumatic stress symptoms in relatives in the first weeks after severe traumatic brain injury,"Severe traumatic brain injury (STBI) can cause psychological stress in proxies in the long-term. This study assessed post-traumatic stress (PTS) symptoms in proxies of survivors of STBI in the short-term and investigated stress-associated factors.Prospective cross-sectional study, conducted at three Swiss trauma centres over 1 year. Patient and proxy demographics, trauma data including Glasgow Coma Scale (GCS) and management data were collected. The proxies' PTS symptoms were assessed by applying the Impact of Event Scale-Revised (IES-R), once in the first month after the accident (median: 11 days).Sixty-nine proxies were included; 52 proxies were female (77.8%). Mean IES-R sum score for intrusions was 13.38 (SD=7.26), for avoidance 8.91 (SD=5.94), and for hyperarousal 9.07 (SD=6.75). Clinically significant PTS symptoms were observed in 36 proxies (52.2%); mean IES-R sum scores were significantly higher in women. IES-R sub-scale values were inversely related with GCS at the scene of the accident and on hospital admission.More than half of proxies had clinically significant PTS symptoms shortly after their relative's accident. More severe PTS symptoms were found in women and in proxies of patients with poorer initial GCS scores. Further research into risk groups in the short- and long-term and the long-term impact on patients of PTS syndrome in proxies is warranted.",0 +https://doi.org/10.4324/9781315755922,"Trauma, Survival and Resilience in War Zones","This book, based upon a series of psychological research studies, examines Sierra Leone as a case study of a constructivist and narrative perspective on psychological responses to warfare, telling the stories of a range of survivors of the civil war. The authors explore previous research on psychological responses to warfare while providing background information on the Sierra Leone civil war and its context. Chapters consider particular groups of survivors, including former child soldiers, as well as amputee footballers, mental health service users and providers, and refugees. Implications of the themes emerging from this research are considered with respect to how new understandings can inform current models of trauma and work with its survivors. Amongst the issues concerned will be post-traumatic stress and post-traumatic growth; resilience; mental health service provision; perpetration of atrocities; and forgiveness. The book also provides a critical consideration of the appropriateness of the use of Western concepts and methods in an African context. Drawing upon psychological theory and rich narrative research, Trauma, Survival and Resilience in War Zones will appeal to researchers and academics in the field of clinical psychology, as well as those studying post-war conflict zones. © 2016 David A. Winter, Rachel Brown, Stephanie Goins and Clare Mason.",0 +https://doi.org/10.1176/appi.ajp.162.1.181,A Pilot Study of Interpersonal Psychotherapy for Posttraumatic Stress Disorder,"This article describes pilot testing of interpersonal psychotherapy adapted for posttraumatic stress disorder (PTSD). Unlike most psychotherapies for PTSD, interpersonal psychotherapy is not exposure-based, focusing instead on interpersonal sequelae of trauma.Fourteen consecutively enrolled subjects with chronic PTSD (DSM-IV) from various traumas received an open, 14-week interpersonal psychotherapy trial.Treatment was well tolerated: 13 subjects (93%) completed therapy. After 14 weeks, 12 of 14 subjects no longer met diagnostic criteria for PTSD, 69% responded (50% Clinician Administered PTSD Scale score decrement), and 36% remitted (score < or =20). Thirteen subjects reported declines in PTSD symptoms across all three symptom clusters. Depressive symptoms, anger reactions, and interpersonal functioning also improved.Treating interpersonal sequelae of PTSD appears to improve other symptom clusters. Interpersonal psychotherapy may be an efficacious alternative for patients who refuse repeated exposure to past trauma. This represents an exciting extension of interpersonal psychotherapy to an anxiety disorder.",0 +https://doi.org/10.1192/bjp.bp.113.134627,Violent behaviour and post-traumatic stress disorder in US Iraq and Afghanistan veterans,"Background Violence towards others in the community has been identified as a significant problem for a subset of Iraq and Afghanistan veterans. Aims To investigate the extent to which post-traumatic stress disorder (PTSD) and other risk factors predict future violent behaviour in military veterans. Method A national, multiwave survey enrolling a random sample of all US veterans who served in the military after 11 September 2001 was conducted. A total of 1090 veterans from 50 US states and all military branches completed two survey waves mailed 1 year apart (retention rate = 79%). Results Overall, 9% endorsed engaging in severe violence and 26% in other physical aggression in the previous year, as measured at Wave 2. Younger age, financial instability, history of violence before military service, higher combat exposure, PTSD, and alcohol misuse at Wave 1 were significantly associated with higher severe violence and other physical aggression in the past year at Wave 2. When combinations of these risk factors were present, predicted probability of violence in veterans rose sharply. Veterans with both PTSD and alcohol misuse had a substantially higher rate of subsequent severe violence (35.9%) compared with veterans with alcohol misuse without PTSD (10.6%), PTSD without alcohol misuse (10.0%) or neither PTSD nor alcohol misuse (5.3%). Using multiple regression, we found that veterans with PTSD and without alcohol misuse were not at significantly higher risk of severe violence than veterans with neither PTSD nor alcohol misuse. There was a trend for other physical aggression to be higher in veterans with PTSD without alcohol misuse. Conclusions Co-occurring PTSD and alcohol misuse was associated with a marked increase in violence and aggression in veterans. Compared with veterans with neither PTSD nor alcohol misuse, veterans with PTSD and no alcohol misuse were not significantly more likely to be severely violent and were only marginally more likely to engage in other physical aggression. Attention to cumulative effects of multiple risk factors beyond diagnosis – including demographics, violence history, combat exposure, and veterans' having money to cover basic needs like food, shelter, transportation, and medical care – is crucial for optimising violence risk management.",0 +https://doi.org/10.1300/j070v14n03_06,Stockholm Syndrome and Child Sexual Abuse,"This article, based on an analysis of unstructured interviews, identifies that the emotional bond between survivors of child sexual abuse and the people who perpetrated the abuse against them is similar to that of the powerful bi-directional relationship central to Stockholm Syndrome as described by Graham (1994). Aspects of Stockholm Syndrome could be identified in the responses of adult survivors of child sexual abuse, which appeared to impact on their ability to criminally report offenders. An emotional bond, which has enabled the sexual abuse of children, has served to protect the offender long after the abuse has ceased. The implications of Stockholm Syndrome could offer valuable insights to those working in the field of child sexual abuse.",0 +https://doi.org/10.1176/ajp.156.3.353,Posttraumatic Stress Disorder and Identification in Disaster Workers,"OBJECTIVE: Disaster workers who work with deceased victims are at increased risk of posttraumatic stress disorder (PTSD). Identification with the deceased has been proposed as one of the mechanisms in this stress-illness relationship. To examine this hypothesis, this study investigated three types of identification with the dead in a group of disaster workers: identification with the deceased as oneself, identification with the deceased as a friend, and identification with the deceased as a family member. METHOD: Fifty-four volunteer disaster workers who worked with the dead following an explosion on the USS Iowa naval ship were assessed 1, 4, and 13 months after the disaster. PTSD symptoms (measured with the DSMPTSD-IV scale), intrusive and avoidant disaster-related symptoms (measured with the Impact of Event Scale), somatization and general distress (measured with the SCL-90-R), and health care utilization were assessed. RESULTS: Disaster workers who reported identification with the deceased as a friend were more likely than those who did not to have PTSD, more intrusive and avoidant symptoms, and greater levels of other posttraumatic symptoms including somatization. Disaster workers who reported identification with the deceased as a family member had greater intrusive symptoms 1 month after the disaster than those who did not. There were no differences between those who did and did not identify with the deceased as self. Health care utilization was not associated with identification. CONCLUSIONS: Identification with the deceased is a risk factor for PTSD and posttraumatic symptoms in disaster workers exposed to the dead. Identification with the dead as a friend is specifically associated with higher risk for these workers.",0 +https://doi.org/10.1016/j.psychres.2011.03.016,"Posttraumatic stress disorder, poor physical health and substance use behaviors in a national trauma-exposed sample","Both experiencing a traumatic event and PTSD are related to physical health problems (e.g., Schnurr and Jankowski, 1999) and health-risk behavior (e.g., Stewart, 1996). Using structural equation modeling analyses, we examined the interrelationships among number of distinct traumatic event exposures, PTSD diagnosis, physical health, and substance use behavior using epidemiological data from the National Comorbidity Survey Replication (NCS-R; Kessler et al., 2004). Results provide some evidence that PTSD mediates the relationship between: (a) number of distinct traumatic event exposures and poor physical health defined by clusters of difficulties with gastrointestinal, musculoskeletal, and/or cardiovascular health, and (b) number of distinct traumatic event exposures and substance use behaviors. However, substance use behaviors did not significantly mediate the relationship between PTSD and poor physical health.",0 +https://doi.org/10.1016/j.jad.2014.06.055,PTSD prevalence and symptom structure of DSM-5 criteria in adolescents and young adults surviving the 2011 shooting in Norway,"Diagnostic criteria for Posttraumatic Stress Disorder (PTSD) have been revised for DSM-5. Two key changes include alteration of the clustering of PTSD symptoms and new PTSD symptom criteria related to negative alterations in cognition and mood. In this study, we empirically investigated these changes.We interviewed 325 adolescents and young adults who survived the 2011 youth camp shooting at Utøya Island, Norway. The UCLA PTSD Reaction Index for DSM-IV was used to assess symptoms of PTSD. In addition, 11 questions were added to assess the four new symptom criteria within the new DSM-5 symptom categories.PTSD prevalence did not differ significantly whether DSM-IV (11.1%) or DSM-5 (11.7%) criteria were used and the Cohen׳s Kappa for consistency between the diagnoses was 0.061. Confirmatory factor analyses showed that the four-factor structure of the DSM-5 fit the data adequately according to the conceptual model outlined.The homogeneity of this sample of highly exposed subjects may preclude generalization to less severely exposed groups. Also, we did not assess criterion G in regard to symptoms causing clinically significant distress and functional impairment.The prevalence of PTSD was quite similar regardless of diagnostic system. The relatively low concordance between the diagnoses has implications for eligibility for a diagnosis of PTSD.",0 +https://doi.org/10.1097/01.chi.0000164590.48318.9c,"Trauma Exposure, Posttraumatic Stress, and Psychiatric Comorbidity in Female Juvenile Offenders","To document the rate of posttraumatic stress disorder (PTSD) in female juvenile offenders and its relationship to trauma history, comorbid diagnoses, attributional style, and family functioning.The psychological profiles and trauma histories of 100 incarcerated female juvenile offenders (ages 13.5-19 years) were assessed using a semistructured interview. Two self-report measures were used to assess family functioning and attributional style.High rates of PTSD were reported by offenders (37%), with sexual abuse the precipitant in 70% of cases. Offenders with PTSD had significantly more comorbid diagnoses than those without (PTSD = 5.4, no PTSD = 3.1, p < .001). The majority (73%) of comorbid diagnoses appeared concurrently with or after PTSD onset. The presence of four or more psychiatric diagnoses (OR = 14.48, p < .001) and a history of sexual abuse (OR = 7.91, p < .001) were independently associated with a diagnosis of PTSD among female juvenile offenders.These results suggest a link among trauma, PTSD, and the development of further psychopathology in female juvenile offenders. This link highlights the importance of comprehensive diagnosis and treatment of this and other comorbid disorders to ensure the effectiveness of interventions designed to treat antisocial behavior.",0 +https://doi.org/10.1016/s0079-6123(07)67003-4,Amygdala modulation of memory-related processes in the hippocampus: potential relevance to PTSD,"A key assumption in the study of stress-induced cognitive and neurobiological modifications is that alterations in hippocampal functioning after stress are due to an excessive activity exerted by the amygdala on the hippocampus. Research so far focused on stress-induced impairment of hippocampal plasticity and memory but an exposure to stress may simultaneously also result in strong emotional memories. In fact, under normal conditions emotionally charged events are better remembered compared with neutral ones. Results indicate that under these conditions there is an increase in activity within the amygdala that may lead to memory of a different quality. Studying the way emotionality activates the amygdala and the functional impact of this activation we found that the amygdala modulates memory-related processes in other brain areas, such as the hippocampus. However, this modulation is complex, involving both enhancing and suppressing effects, depending on the way the amygdala is activated and the hippocampal subregion examined. The current review summarizes our findings and attempts to put them in context with the impact of an exposure to a traumatic experience, in which there is a mixture of a strong memory of some aspects of the experience but impaired memory of other aspects of that experience. Toward that end, we have recently developed an animal model for the induction of predisposition to stress-related disorders, focusing on the consequences of exposure to stressors during juvenility on the ability to cope with stress in adulthood. Exposing juvenile-stressed rats to an additional stressful challenge in adulthood revealed their impairment to cope with stress and resulted in significant elevation of the amygdala. Interestingly, and similar to our electrophysiological findings, differential effects were observed between the impact of the emotional challenge on CA1 and dentate gyrus subregions of the hippocampus. Taken together, the results indicate that long-term alterations within the amygdala contribute to stress-related mnemonic symptoms and suggest that elucidating further these intra-amygdala alterations and their effects on modulating other brain regions is likely to be beneficial for the development of novel approaches to treat stress-related disorders.",0 +https://doi.org/10.1007/s10571-010-9550-8,Single-Prolonged Stress Induces Apoptosis by Activating Cytochrome C/Caspase-9 Pathway in a Rat Model of Post-traumatic Stress Disorder,"The purpose of this study was to provide a novel insight into the mechanism of how amygdala might participate in PTSD by investigating the changes of cytochrome c oxidase (COX), caspase-9, and caspase-3 in the amygdala of single-prolonged stress (SPS) rats. A total of 80 healthy, male Wistar rats were selected for this study. The models of post-traumatic stress disorder (PTSD) were created by SPS, which is an established animal model for PTSD. The change of COX was detected by light microscope and transmission electron microscopy (TEM). The expression of caspase-9 and caspase-3 in the basolateral amygdala was examined by immunofluorescence and reverse transcription-polymerase chain reaction (RT-PCR). SPS exposure resulted in a significant change of COX in the SPS model groups compared with the normal control group. Evaluation by enzymohistochemistry indicated translocation of COX from mitochondria to cytoplasm. The expression of both caspase-9 and caspase-3 significantly increased 1 day after SPS stimulation, then gradually increased and peaked at SPS 7d. This findings suggest changes of COX, caspase-9, and caspase-3 in the amygdala of SPS rats, which may play important roles in the pathogenesis of PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1007/s10802-009-9352-y,"Post Traumatic Stress, Context, and the Lingering Effects of the Hurricane Katrina Disaster among Ethnic Minority Youth","This study examined the stability of post traumatic stress disorder (PTSD) symptoms in a predominantly ethnic minority sample of youth exposed to Hurricane Katrina. Youth (n∈=∈191 grades 4th thru 8th) were screened for exposure to traumatic experiences and PTSD symptoms at 24 months (Time 1) and then again at 30 months (Time 2) post-disaster. PTSD symptoms did not significantly decline over time and were higher than rates reported at earlier time points for more ethnically diverse samples. Younger age, female sex, and continued disrepair to the child's home predicted stable elevated PTSD symptoms. Findings are consistent with predictions from contextual theories of disaster exposure and with epidemiological data from adult samples suggesting that the incidence of PTSD post Katrina is showing an atypical pattern of remittance. Theoretical, applied, and policy implications are discussed. © 2009 Springer Science+Business Media, LLC.",0 +https://doi.org/10.1016/j.comppsych.2010.04.003,Psychosocial adjustment of directly exposed survivors 7 years after the Oklahoma City bombing,"Abstract Objective The aim of this study was to prospectively examine the long-term course of psychiatric disorders, symptoms, and functioning among 113 directly exposed survivors of the Oklahoma City bombing systematically assessed at 6 months and again nearly 7 years postbombing. Methods The Diagnostic Interview Schedule/Disaster Supplement was used to assess predisaster and postdisaster psychiatric disorders and symptoms and other variables of relevance to disaster exposure and outcomes. Results Total prevalence of posttraumatic stress disorder (PTSD) was 41%. Seven years postbombing, 26% of the sample still had active PTSD. Delayed-onset PTSD and new postdisaster alcohol use disorders were not observed. PTSD nonremission was predicted by the occurrence of negative life events after the bombing. Posttraumatic symptoms among survivors without PTSD decayed more rapidly than for those with PTSD, and symptoms remained at 7 years even for many who did not develop PTSD. Those with PTSD reported more functioning problems at index than those without PTSD, but functioning improved dramatically over 7 years, regardless of PTSD or remission from PTSD. No survivors had long-term employment disability based on psychiatric problems alone. Conclusions These findings have potentially important implications for anticipation of long-term emotional and functional recovery from disaster trauma.",0 +https://doi.org/10.1002/icd.481,Growth mixture modelling in developmental psychology: overview and demonstration of heterogeneity in developmental trajectories of adolescent antisocial behaviour,"Recent advances in statistical techniques for longitudinal data analysis have provided increased capabilities for elucidating individual differences in trajectories of change in child behaviours and abilities. However, most techniques still assume that there is a single underlying distribution with respect to changes over time, about which children are normally distributed. If there are multiple subgroups of youth following distinct developmental trajectories with unique predictors, however, the results of these statistical techniques may provide an incomplete analysis of the data. A newer class of statistical techniques, latent growth mixture modelling, provides a robust framework for examining heterogeneity in patterns of development. This paper illustrates the use of latent growth mixture modelling for examining heterogeneity in developmental trajectories of adolescent antisocial behaviour. Copyright © 2006 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1371/journal.pone.0077535,Dysfunction and Post-Traumatic Stress Disorder in Fracture Victims 50 Months after the Sichuan Earthquake,"This study aimed to evaluate the effectiveness of a rehabilitation intervention on physical dysfunction (PDF) and post-traumatic stress disorder (PTSD) in fracture victims 50 months after the Sichuan earthquake of 2008 and to identify risk factors for PTSD.This is a retrospective cohort study. Four hundred and fifty-nine earthquake-related fracture victims from Mianzhu city, Sichuan Province who did not qualify for disability pension participated. Two hundred and forty-five subjects received regular rehabilitation and 214 did not. Muscle strength, joint range of motion (ROM),sensory function, and sit-to-stand balance capacity were evaluated to assess PDF. The PTSD Checklist-Civilian Version (PCL-C) was administered to screen for PTSD. An ordinary least square regression was used to predict PTSD, and a logistic regression was used to predict PDF. In addition a Least Angle Regression (LARS) was carried out for PTSD to study the effects of rehabilitation and PDF at the same time.Unadjusted and adjusted group differences in physical dysfunction (p<0.01) and PTSD prevalence (p<0.05) were significant in favor of the rehabilitation group. In addition, being female, average or above family income, having witnessed death and fearfulness were found risk factors for PTSD symptoms 50 months after the earthquake. Both PDF and rehabilitation were selected predictors by LARS demonstrating opposite effects.PDF and PTSD were significantly reduced by the rehabilitation intervention. Future medical intervention strategies should consider rehabilitation in order to assist survivors in dealing with both physical and psychological effects of natural disaster.",0 +https://doi.org/10.1207/s15327752jpa7902_10,Differentiating Overreporting and Extreme Distress: MMPI-2 Use With Compensation-Seeking Veterans With PTSD,"This purpose of this study was to examine overreporting on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) in compensation-seeking veterans with posttraumatic stress disorder (PTSD). A sample of veterans tested during a V.A. hospital compensation and pension exam were given the MMPI-2 and measures of PTSD, depression, and combat exposure. Veteran's MMPI-2s were only included in the analyses if their profile was extremely exaggerated, as measured by an F scale T score above 80, did not elevate the MMPI-2 VRIN and TRIN scales, and had a primary diagnosis of PTSD (n = 127). Using the Infrequency-Psychopathology, F(p), scale to distinguish overreporting from distress, it was found that 98 veterans elevated profiles due to distress, whereas 29 elevated due to overreporting, F(p) below and above 7, respectively. Differences between groups on MMPI-2 clinical scales and the other measures were assessed. Implications of these findings for assessing veteran response style and using the MMPI-2 with a PTSD population are discussed.",0 +https://doi.org/10.1002/(sici)1099-0879(200005)7:2<155::aid-cpp237>3.0.co;2-z,Feigning post-traumatic stress disorder on the PAI,"Multiscale personality inventories have been used to detect dissimulation of PTSD. The Personality Assessment Inventory (PAI) is a self-report inventory which has validity indicators that may be used to detect dishonest or biased self-report. The accuracy of these validity indicators was tested by comparing non-traumatized individuals instructed to fake PTSD with patients diagnosed as having PTSD and normal controls. Twenty-five individuals completed the PAI with the instruction to feign PTSD. The PAI results of these participants were compared to a cohort of 19 patients diagnosed as suffering from PTSD and 21 controls. Eleven of the 25 individuals instructed to fake PTSD on the PAI produced a profile consistent with this diagnosis. However, more than half of the faked profiles were correctly identified as feigned by the validity indicators. Specificity of the validity indicators was very high. The results of this study indicate that the PAI can be one useful source of information for the clinician when assessing for the possible distortion of PTSD symptoms. Copyright © 2000 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1093/jpepsy/jsh053,Patterns of Maternal Distress Among Children With Cancer and Their Association With Child Emotional and Somatic Distress,"To identify patterns of distress among mothers of children with cancer over the initial 6 months of treatment and to examine these patterns as predictors of child somatic and emotional distress.Data were gathered regarding maternal perceived stress and affective distress from mothers of children (N = 65, mean age = 8.3 years) with cancer at 2 to 5 weeks postdiagnosis, then at 12 to 14 weeks and 22 to 24 weeks. Mothers and nurses provided indexes of child somatic and emotional distress at these assessments.Hierarchical and k-means cluster analyses revealed four distinct patterns of maternal distress: high, moderate, declining, and low. The high maternal distress group reported higher child emotional distress at all three points but higher child somatic distress only at the final assessment. Maternal distress group was unrelated to nurse-reported child distress.The identification of four empirically derived patterns of maternal distress may explain some of the variance in the literature regarding parental distress vis-à-vis pediatric cancer treatment and may have relevance to intervention efforts. Differences in the relations between maternal distress groups and mother- and nurse-reported child distress underscore the importance of collecting child distress data from multiple sources.",0 +https://doi.org/10.1016/j.biopsycho.2012.01.001,Early-life trauma is associated with rapid eye movement sleep fragmentation among military veterans,"The role of sleep in the relations between early-life trauma and the development of adverse psychological trajectories is relatively unknown and was the primary aim of the present study. Military veterans were evaluated for posttraumatic stress disorder, combat exposure, trauma history, sleep quality, disruptive nocturnal behaviors, and a subsample completed overnight polysomnography that yielded objectively measured sleep parameters. When relevant variables were controlled, increased earlier-life traumatic event exposure was associated with increased rapid-eye-movement sleep (REMs) fragmentation, and increased REMs fragmentation was associated with increased later-life disruptive nocturnal behaviors. REMs fragmentation carried an indirect relation between earlier-life trauma and later-life disruptive nocturnal behaviors. Objectively measured sleep parameters were used to describe REMs fragmentation physiology. The current findings elucidate the important role that earlier-life trauma exposure may have in the development of REM sleep physiology, and how this altered sleep physiology may have dynamic influences on subsequent posttraumatic stress symptoms in adulthood.",0 +https://doi.org/10.1016/j.envint.2012.05.001,Comparing exposure metrics for classifying ‘dangerous heat’ in heat wave and health warning systems,"Heat waves have been linked to excess mortality and morbidity, and are projected to increase in frequency and intensity with a warming climate. This study compares exposure metrics to trigger heat wave and health warning systems (HHWS), and introduces a novel multi-level hybrid clustering method to identify potential dangerously hot days. Two-level and three-level hybrid clustering analysis as well as common indices used to trigger HHWS, including spatial synoptic classification (SSC), and the 90th, 95th, and 99th percentiles of minimum and relative minimum temperature (using a 10 day reference period), were calculated using a summertime weather dataset in Detroit from 1976 to 2006. The days classified as 'hot' with hybrid clustering analysis, SSC, minimum and relative minimum temperature methods differed by method type. SSC tended to include the days with, on average, 2.5 °C lower daily minimum temperature and 5.3 °C lower dew point than days identified by other methods. These metrics were evaluated by comparing their performance in predicting excess daily mortality. The 99th percentile of minimum temperature was generally the most predictive, followed by the three-level hybrid clustering method, the 95th percentile of minimum temperature, SSC and others. Our proposed clustering framework has more flexibility and requires less substantial meteorological prior information than the synoptic classification methods. Comparison of these metrics in predicting excess daily mortality suggests that metrics thought to better characterize physiological heat stress by considering several weather conditions simultaneously may not be the same metrics that are better at predicting heat-related mortality, which has significant implications in HHWSs.",0 +https://doi.org/10.4088/jcp.v69n1104,A Multisite Study of Initial Respiration Rate and Heart Rate as Predictors of Posttraumatic Stress Disorder,"Fear-conditioning models posit that increased arousal at the time of trauma predicts subsequent posttraumatic stress disorder (PTSD). This multisite study evaluated the extent to which acute heart rate and respiration rate predict subsequent chronic PTSD.Traumatically injured patients admitted to 4 hospitals across Australia between April 2004 and February 2006 were initially assessed during hospital admission (N = 1105) and were reassessed 3 months later for PTSD by using the Clinician-Administered PTSD Scale-IV and for major depressive disorder (MDD) by using the Mini-International Neuropsychiatric Interview (English version 5.0.0) (N = 955). Heart rate, respiration rate, and blood pressure were assessed on the initial day of traumatic injury.Ninety patients (10%) met criteria for PTSD and 159 patients (17%) met criteria for MDD at the 3-month assessment. Patients with PTSD compared to those without PTSD had higher heart rate (90.16 +/- 18.66 vs. 84.84 +/-17.41, t = 2.74, p < .01) and respiration rate (20.24 +/- 5.16 vs. 18.58 +/- 4.29, t = 3.43, p < .001) immediately after injury. There were no heart rate or respiration rate differences between patients who did and did not develop MDD. Patients were more likely to develop PTSD at 3 months if they had a heart rate of at least 96 beats per minute (15% vs. 8%, OR = 2.12, 95% CI = 1.34 to 3.33) or respiration rate of at least 22 breaths per minute (18% vs. 8%, OR = 2.42, 95% CI = 1.48 to 3.94).Elevated heart rate and respiration rate are predictors of subsequent PTSD. These data underscore the need for future research into secondary prevention strategies that reduce acute arousal immediately after trauma and may limit PTSD development in some individuals.",0 +https://doi.org/10.32469/10355/8885,"Attachment to therapist, the working alliance and emotional processing of traumatic material in session among veterans diagnosed with posttraumatic stress disorder","Title from PDF of title page (University of Missouri--Columbia, viewed on August 25, 2010).",0 +https://doi.org/10.1001/jamapsychiatry.2013.399,Association of Posttraumatic Stress Disorder With Reduced In Vivo Norepinephrine Transporter Availability in the Locus Coeruleus,"Animal data suggest that chronic stress is associated with a reduction in norepinephrine transporter (NET) availability in the locus coeruleus. However, it is unclear whether such models are relevant to posttraumatic stress disorder (PTSD), which has been linked to noradrenergic dysfunction in humans.To use positron emission tomography and the radioligand [11C]methylreboxetine to examine in vivo NET availability in the locus coeruleus in the following 3 groups of individuals: healthy adults (HC group), adults exposed to trauma who did not develop PTSD (TC group), and adults exposed to trauma who developed PTSD (PTSD group) and to evaluate the relationship between NET availability in the locus coeruleus and a contemporary phenotypic model of PTSD symptoms.Cross-sectional positron emission tomography study under resting conditions at academic and Veterans Affairs medical centers among 56 individuals in the following 3 study groups: HC (n = 18), TC (n = 16), and PTSD (n = 22).The [11C]methylreboxetine-binding potential of NET availability in the locus coeruleus and the severity of PTSD symptoms assessed using the Clinician-Administered PTSD Scale.The PTSD group had significantly lower NET availability than the HC group (41% lower, Cohen d = 1.07). NET availability did not differ significantly between the TC and HC groups (31% difference, Cohen d = 0.79) or between the TC and PTSD groups (15% difference, Cohen d = 0.28). In the PTSD group, NET availability in the locus coeruleus was independently positively associated with the severity of anxious arousal (ie, hypervigilance) symptoms (r = 0.52) but not with any of the other PTSD symptom clusters.These results suggest that PTSD is associated with significantly reduced NET availability in the locus coeruleus and that greater NET availability in this brain region is associated with increased severity of anxious arousal symptoms in individuals with PTSD.",0 +https://doi.org/10.1080/14681811.2012.745808,Trauma-informed sexuality education: recognising the rights and resilience of youth,"Experiences of maltreatment during childhood and the emergence of sexuality during adolescence are both critical developmental issues that intersect in meaningful ways, yet the two are often isolated from each other in practice. Despite the prevalence of childhood maltreatment, sexuality education does not accommodate young people with trauma histories. This results in curricula and content that ignore the particular needs and experiences of a proportion of students in sexuality education classrooms. Trauma interventions commit a similar oversight by neglecting the prospects for positive, growth-promoting sexual experiences and relationships among young people who have been abused. The failure to account for young people's resilience in the sexual domain results in treatment approaches that emphasise sexual risks (e.g. revictimisation) and problem behaviours to the exclusion of guidance in cultivating positive sexualities. Consequently, many forms of sexuality education and maltreatment interventions may ...",0 +https://doi.org/10.1016/j.chiabu.2009.01.002,Factors discriminating among profiles of resilience and psychopathology in children exposed to intimate partner violence (IPV),"To evaluate the social and emotional adjustment of 219 children in families with varying levels of intimate partner violence (IPV) using a model of risk and protection. To explore factors that differentiate children with poor adjustment from those with resilience.Mothers who experienced IPV in the past year and their children ages 6-12 were interviewed. Standardized measures assessed family violence, parenting, family functioning, maternal mental health, and children's adjustment and beliefs.Using cluster analysis, all cases with valid data on the Child Behavior Checklist, Child Depression Inventory, General Self-Worth and Social Self-Competence measures were described by four profiles of children's adjustment: Severe Adjustment Problems (24%); children who were Struggling (45%); those with Depression Only (11%); and Resilient (20%) with high competence and low adjustment problems. Multinomial logistic regression analyses showed children in the Severe Problems cluster witnessed more family violence and had mothers higher in depression and trauma symptoms than other children. Resilient and Struggling children had mothers with better parenting, more family strengths and no past violent partner. Parents of children with Severe Problems were lacking these attributes. The Depressed profile children witnessed less violence but had greater fears and worries about mother's safety.Factors related to the child, to the mother and to the family distinguish different profiles of adjustment for children exposed to IPV who are living in the community. Resilient children have less violence exposure, fewer fears and worries, and mothers with better mental health and parenting skills, suggesting avenues for intervention with this population.Findings suggest that child adjustment is largely influenced by parent functioning. Thus, services should be targeted at both the child and the parent. Clinical interventions shaped to the unique needs of the child might also be tested with this population.",0 +https://doi.org/10.1186/1471-244x-5-11,"The Bosnian version of the international self-report measure of posttraumatic stress disorder, the Posttraumatic Stress Diagnostic Scale, is reliable and valid in a variety of different adult samples affected by war","The aim of the present study was to assess the internal consistency and discriminant and convergent validity of the Bosnian version of a self-report measure of posttraumatic stress disorder (PTSD), the Posttraumatic Stress Diagnostic Scale (PTDS). The PTDS yields both a PTSD diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) and a measure of symptom severity.812 people living in Sarajevo or in Banja Luka in Bosnia-Herzegovina, of whom the majority had experienced a high number of traumatic war events, were administered the PTDS and other measures of trauma-related psychopathology. The psychometric properties of the instrument were assessed using Cronbach's alpha and principal components analysis, and its construct validity was assessed via Spearman correlation coefficients with the other instruments.The PTDS and its subscales demonstrated high internal consistency. The principal components revealed by an exploratory analysis are broadly consistent with the DSM-IV subscales except that they reproduce some previously reported difficulties with the ""numbing"" items from the avoidance subscale. The construct validity of the PTDS was supported by appropriate correlations with other relevant measures of trauma related psychopathology.The Bosnian version of the PTDS thus appears to be a time-economic and psychometrically sound measure for screening and assessing current PTSD. This self-report measure awaits further validation by interview methods.",0 +https://doi.org/10.1016/j.schres.2016.01.027,"Resilience, internalized stigma, self-esteem, and hopelessness among people with schizophrenia: Cultural comparison in Austria and Japan","Resilience is becoming an important topic in people with schizophrenia since there is evidence that it increases the probability for long-term recovery. The current study investigated transcultural differences in resilience across schizophrenia patients from two different geographical regions, Austria and Japan. Another objective was to examine transcultural differences in internalized stigma, self-esteem, and hopelessness, which can be expected to be relevant in this context, as well as the interrelations between these subjective elements of recovery and symptom severity. To this end, patients from outpatient mental health services in Innsbruck, Austria (N=52) and Tokyo, Japan (N=60) as well as 137 healthy comparison subjects from both countries were included into this cross-sectional study. Notably, we detected a significant country effect with markedly lower resilience (F=74.4, p<0.001) and self-esteem scores (F=226.0, p<0.001) as well as higher hopelessness scores (F=37.4, p<0.001) among Japanese subjects in general. In addition, both Austrian and Japanese patients indicated significantly lower degrees of resilience (F=57.5, p<0.001), self-esteem (F=51.8, p<0.001), and hope (F=29.5, p<0.001) compared to healthy control subjects. The inter-correlations between subjective elements of recovery were comparable in size in the two patient samples, but the inter-correlations between these issues and residual symptoms of schizophrenia as objective domains of recovery were markedly higher in Austrian subjects. This suggests that schizophrenia patients from Western European and Japanese cultures may have different needs to achieve recovery. In conclusion, it will be critical to develop culture-specific psychosocial programs and to examine their feasibility and effectiveness among these patients.",0 +https://doi.org/10.1002/jts.20337,Pilot study on prolonged exposure of Japanese patients with posttraumatic stress disorder due to mixed traumatic events,"This pilot study investigated the feasibility of Prolonged Exposure (PE) treatment for Japanese patients with posttraumatic stress disorder (PTSD) due to mixed traumatic events. Among 12 participants in this study, 9 women and 1 man completed between 9 and 15 weekly individual PE sessions; 2 female participants dropped out in early sessions. Among completers, the authors identified a significant reduction of symptom severity scores from pretreatment to posttreatment in terms of PTSD and depression on therapist-rated and self-rated measurements. Symptom levels remained low in 3- and 6-month follow-up assessments. Our findings suggest that PE is feasible and can be accepted for PTSD patients not only in Western countries, but also for those in Japan.",0 +https://doi.org/10.1016/j.comppsych.2012.12.007,Hierarchical organization of axis I psychiatric disorder comorbidity through age 30,"Hierarchical models of psychopathology based on substantial numbers of lifetime diagnostic categories have not been sufficiently evaluated, even though such models have relevance for theories of disorder etiology, course, or prognosis. In this research, a hierarchical component model of 16 Axis I disorders is derived, and model elements are evaluated in terms of their ability to demonstrate distinct associations with several clinically-relevant variables. Participants were 816 randomly selected adolescents from the community who were repeatedly assessed for psychiatric disorders and associated risk and protective factors over a 14-year period. First-degree relatives were also interviewed to establish their lifetime psychiatric history. Patterns of lifetime comorbidity among 16 psychiatric disorders were described at five levels of organization. In addition to the broadest level that accounted for the most variance in disorder covariation, evidence was obtained at successive levels in the hierarchy for internalizing and externalizing broad-band domains that could be subdivided into more refined clusters. The validity and potential utility of the resultant hierarchical model were further supported by distinct associations that components at each level had with exposure to childhood adversities, psychiatric disorders among first-degree relatives, and psychosocial functioning at ~age 30. A large number of DSM Axis I disorders can be described within broad-band internalizing and externalizing domains, and further differentiation within these domains is possible and likely useful for some purposes. Implications of this research for conceptualizing relations among psychiatric disorders are discussed.",0 +,A Guide to Psychological Debriefing: Managing Emotional Decompression and Post-Traumatic Stress Disorder,"(from the cover) Traumatic events strike unexpectedly and can turn everyday life upside down. Frequently, people suffering trauma cannot get past the experience and develop Post-Traumatic Stress Disorder (PTSD). Psychological debriefing (PD) is a process commonly used to prevent an individual from developing PTSD, allowing them to re-examine the event in a safe and controlled environment. This book offers a practical introduction to PTSD and psychological debriefing, and outlines an enhanced model of PD: 'Emotional Decompression'. Structured like a deep-sea dive, it incorporates carefully planned safety stops for discussion and explanation on the way back to the 'surface' to avoid getting 'the bends'. The book presents a range of recovery models, from the 'simple' models developed by Williams and Horowitz to the more complex 'Snakes and Ladders' model developed by the author. This book is essential for health practitioners, counselors, psychologists and professionals working with clients suffering from PTSD, as well as students. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1037/a0037848,The role of ex-POWs’ PTSD symptoms and trajectories in wives’ secondary traumatization.,"Secondary traumatization describes the phenomenon whereby those in proximity to trauma survivors develop psychological symptoms similar to those experienced by the direct survivor. The current study examined secondary trauma (ST) and generalized distress symptoms (general psychiatric symptomatology, functional disability, and self-rated health) in wives of former prisoners of war (ex-POWs). The study compared wives of Israeli ex-POWs from the 1973 Yom Kippur War with wives of a matched control group of non-POW Yom Kippur War combat veterans (CVs). The wives also were divided into groups based on their husbands' current posttraumatic stress disorder (PTSD) status and PTSD trajectory (i.e., chronic, delayed), and their outcomes were compared with resilient CVs. We found that wives of ex-POWs with PTSD reported higher ST and generalized distress than wives of ex-POWs and non-POW CVs without PTSD. Wives of ex-POWs with chronic PTSD reported the highest levels of functional disability. We also found that the relationships between husbands' prior captivity, and wives' ST and general psychiatric symptomatology were fully mediated by the husbands' PTSD symptoms. These findings indicate that it is exposure to a partner with PTSD that leads to overall ST and other distress symptoms, and not simply to a trauma survivor. Furthermore, the more severe their husbands' PTSD, the more wives are at risk for ST and general psychiatric symptomatology. Wives of partners with PTSD should therefore be considered high-risk groups for ST and distress that may require targeted interventions.",0 +https://doi.org/10.1111/j.1939-0025.2010.01017.x,"Community-building before, during, and after times of trauma: The application of the LINC model of community resilience in Kosovo.","A family's heritage and values have profound bearing on the stressors they encounter and how they cope. Socioeconomic change, natural and man-made disasters, and international migration are major influences on the integrity of society. In these times of global financial crisis, communities around the world are in danger of losing their intrinsic structure and protective factors. Connectedness or attachment to family and culture of origin correlate with reduced risk-taking behaviors and a reduction in family and societal violence, posttraumatic stress, addiction, depression, suicidality, sexual risk taking, and other chronic and/or life-threatening health problems and illnesses. Facilitating these families' cultural and community ties and enhancing their access to extended-family and community resources can thus be protective against trauma. These relationships foster resilience and reduce the short- and long-term effects of stress on families and communities. Targets of interventions may be individuals, families, or communities. Assessment of vulnerabilities, protective factors, goals, and resources encourages and facilitates collaboration across natural and artificial support systems. Such collaboration is important in building resilience rather than perpetuating vulnerability and long-term problems for individuals, their families, and the communities in which they live. The recent Kosovar experience in implementing the LINC Model of Community Resilience illustrates these principles, as applied in the context of substance abuse services and community rebuilding in the period soon after armed conflict.",0 +https://doi.org/10.1002/14651858.cd002795.pub2,Pharmacotherapy for post traumatic stress disorder (PTSD),"Post traumatic stress disorder (PTSD) is a prevalent and disabling disorder. Evidence that PTSD is characterised by specific psychobiological dysfunctions has contributed to a growing interest in the use of medication in its treatment.To assess the effects of medication for post traumatic stress disorder.We searched the Cochrane Depression, Anxiety and Neurosis Group specialised register (CCDANCTR-Studies) on 18 August 2005, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library issue 4, 2004), MEDLINE (January 1966 to December 2004), PsycINFO (1966 to 2004), and the National PTSD Center Pilots database. Reference lists of retrieved articles were searched for additional studies.All randomised controlled trials (RCTs) of pharmacotherapy for PTSD.Two raters independently assessed RCTs for inclusion in the review, collated trial data, and assessed trial quality. Investigators were contacted to obtain missing data. Summary statistics were stratified by medication class, and by medication agent for the selective serotonin reuptake inhibitors (SSRIs). Dichotomous and continuous measures were calculated using a random effects model, heterogeneity was assessed, and subgroup/sensitivity analyses were undertaken.35 short-term (14 weeks or less) RCTs were included in the analysis (4597 participants). Symptom severity for 17 trials was significantly reduced in the medication groups, relative to placebo (weighted mean difference -5.76, 95% confidence intervals (CI) -8.16 to -3.36, number of participants (N) = 2507). Similarly, summary statistics for responder status from 13 trials demonstrated overall superiority of a variety of medication agents to placebo (relative risk 1.49, 95% CI 1.28 to 1.73, number needed to treat = 4.85, 95% CI 3.85 to 6.25, N = 1272). Medication and placebo response occurred in 59.1% (N = 644) and 38.5% (628) of patients, respectively. Of the medication classes, evidence of treatment efficacy was most convincing for the SSRIs. Medication was superior to placebo in reducing the severity of PTSD symptom clusters, comorbid depression and disability. Medication was also less well tolerated than placebo. A narrative review of 3 maintenance trials suggested that long term medication may be required in treating PTSD.Medication treatments can be effective in treating PTSD, acting to reduce its core symptoms, as well as associated depression and disability. The findings of this review support the status of SSRIs as first line agents in the pharmacotherapy of PTSD, as well as their value in long-term treatment. However, there remain important gaps in the evidence base, and a continued need for more effective agents in the management of PTSD.",0 +https://doi.org/10.1037/0278-6133.27.5.659,Psychological resilience and dysfunction among hospitalized survivors of the SARS epidemic in Hong Kong: A latent class approach.,"To examine trajectories of psychological functioning using latent class analysis on a sample of hospitalized survivors of the 2003 severe acute respiratory syndrome (SARS) epidemic in Hong Kong.A longitudinal study of 997 survivors, recruited from among 1,331 individuals hospitalized for SARS, were interviewed at 6, 12, and 18 months after hospitalization.Psychological and physical functioning at each time point was measured using the 12-item Medical Outcome Study Short-Form Health Survey (SF-12).Four latent classes were identified--chronic dysfunction, delayed dysfunction, recovery, and resilience. All groups had better physical health than the chronic group. Resilient and recovered individuals had greater social support and less SARS-related worry, and resilient individuals were more likely to be male. The resilient group also had greater social support than the delayed group and better physical functioning than the recovered group.This study demonstrated that longitudinal outcome trajectories following a major health-threat event in an Asian sample bear close resemblance to prototypical trajectories observed in trauma studies using Western samples. Unique predictors of the trajectories included factors observed in previous studies, such as social support, as well as factors of particular relevance to a major disease outbreak, such as SARS-related worry.",0 +https://doi.org/10.1038/mp.2014.111,"Traumatic stress, oxidative stress and post-traumatic stress disorder: neurodegeneration and the accelerated-aging hypothesis","Post-traumatic stress disorder (PTSD) is associated with elevated risk for a variety of age-related diseases and neurodegeneration. In this paper, we review evidence relevant to the hypothesis that chronic PTSD constitutes a form of persistent life stress that potentiates oxidative stress (OXS) and accelerates cellular aging. We provide an overview of empirical studies that have examined the effects of psychological stress on OXS, discuss the stress-perpetuating characteristics of PTSD, and then identify mechanisms by which PTSD might promote OXS and accelerated aging. We review studies on OXS-related genes and the role that they may have in moderating the effects of PTSD on neural integrity and conclude with a discussion of directions for future research on antioxidant treatments and biomarkers of accelerated aging in PTSD.",0 +https://doi.org/10.3109/10253890.2015.1094689,Post-traumatic stress avoidance is attenuated by corticosterone and associated with brain levels of steroid receptor co-activator-1 in rats,"Individuals with post-traumatic stress disorder (PTSD) avoid trauma-related stimuli and exhibit blunted hypothalamic-pituitary-adrenal (HPA) axis activation at the time of stress. Our rodent model of stress mimics the avoidance symptom cluster of PTSD. Rats are classified as ""Avoiders"" or ""Non-Avoiders"" post-stress based on the avoidance of a predator-odor paired context. Previously, we found Avoiders exhibit an attenuated HPA stress response to predator odor. We hypothesized that corticosterone administration before stress would reduce the magnitude and incidence of stress-paired context avoidance. Furthermore, we also predicted that Avoiders would exhibit altered expression of glucocorticoid receptor (GR) signaling machinery elements, including steroid receptor co-activator (SRC)-1. Male Wistar rats (n = 16) were pretreated with corticosterone (25 mg/kg) or saline and exposed to predator-odor stress paired with a context and tested for avoidance 24 h later. A second group of corticosterone-naïve rats (n = 24) were stressed (or not), indexed for avoidance 24 h later, and killed 48 h post-odor exposure to measure phosphorylated GR, FKBP51 and SRC-1 levels in the paraventricular nucleus (PVN), central amygdala (CeA) and ventral hippocampus (VH), all brain sites that highly express GRs and regulate HPA function. Corticosterone pretreatment reduced the magnitude and incidence of avoidance. In Avoiders, predator-odor exposure led to lower SRC-1 expression in the PVN and CeA, and higher SRC-1 expression in the VH. SRC-1 expression in PVN, CeA and VH was predicted by prior avoidance behavior. Hence, a blunted HPA stress response may contribute to stress-induced neuroadaptations in central SRC-1 levels and behavioral dysfunction in Avoider rats.",0 +https://doi.org/10.1016/j.psc.2005.10.014,Psychological Assessment of Patients with Dissociative Identity Disorder,"This article discusses how psychologic assessment can assist in the diagnosis of dissociative identity disorder (DID) and in planning treatment for patients who are dissociative. A battery of tests that can assess the extent of dissociation is outlined, the research on dissociation on various psychologic tests is reviewed, and new Rorschach data on severely dissociative patients that can be useful in planning treatment is presented. Diagnosing DID is a complex process and requires assessors to have knowledge of the assessment and treatment literature on posttraumatic stress disorder (PTSD), dissociative disorders, and personality disorders. The literature provides excellent reviews of assessment of posttraumatic states [1–4]. In addition to the complexity of assessing PTSD itself, assessment of DID requires the patient to reveal what is often a private, hidden world to a powerful stranger [5]. These challenges may be further compounded because many of the measures, particularly the projective tests, can open up emotional wounds and stir potentially painful memories, triggering dissociation and switching among dissociated states during the testing itself [5,6]. Clinicians must develop a collaborative relationship with patients who have DID before beginning the assessment to make the experience therapeutic rather than retraumatizing. A collaborative relationship will also help yield meaningful, rather than defended, test results.",0 +https://doi.org/10.1002/cncr.29490,Are lifestyle behavioral factors associated with health-related quality of life in long-term survivors of non-Hodgkin lymphoma?,"The objective of the current study was to determine whether survivors of non-Hodgkin lymphoma are meeting select American Cancer Society (ACS) health-related guidelines for cancer survivors, as well as to examine relationships between these lifestyle factors and health-related quality of life (HRQoL) and posttraumatic stress (PTS).A cross-sectional sample of 566 survivors of NHL was identified from the tumor registries of 2 large academic medical centers. Respondents were surveyed regarding physical activity, fruit and vegetable intake, body weight, tobacco use, HRQoL using the Medical Outcomes Study Short Form-36, and PTS using the Posttraumatic Stress Disorder CheckList-Civilian form. Lifestyle cluster scores were generated based on whether individuals met health guidelines and multiple linear regression analysis was used to evaluate relationships between lifestyle behaviors and HRQoL scores and PTS scores.Approximately 11% of participants met all 4 ACS health recommendations. Meeting all 4 healthy recommendations was related to better physical and mental QoL (standardized regression coefficient [β], .57 [P<.0001] and β, .47 [P = .002]) and to lower PTS scores (β, -0.41; P = .01).Survivors of NHL who met more ACS health-related guidelines appeared to have better HRQoL and less PTS. Unfortunately, many survivors are not meeting these guidelines, which could impact their overall well-being and longevity.",0 +https://doi.org/10.1016/j.jchromb.2010.01.046,Heat stress deteriorates mitochondrial β-oxidation of long-chain fatty acids in cultured fibroblasts with fatty acid β-oxidation disorders,"Mitochondrial fatty acids beta-oxidation disorder (FAOD) has become popular with development of tandem mass spectrometry (MS/MS) and enzymatic evaluation techniques. FAOD occasionally causes acute encephalopathy or even sudden death in children. On the other hand, hyperpyrexia may also trigger severe seizures or encephalopathy, which might be caused by the defects of fatty acid beta-oxidation (FAO). We investigated the effect of heat stress on FAO to determine the relationship between serious febrile episodes and defect in beta-oxidation of fatty acid in children. Fibroblasts from healthy control and children with various FAODs, were cultured in the medium loaded with unlabelled palmitic acid for 96 h at 37 degrees C or 41 degrees C. Acylcarnitine (AC) profiles in the medium were determined by MS/MS, and specific ratios of ACs were calculated. Under heat stress (at 41 degrees C), long-chain ACs (C12, C14, or C16) were increased, while medium-chain ACs (C6, C8, or C10) were decreased in cells with carnitine palmitoyl transferase II deficiency, very-long-chain acyl-CoA dehydrogenase deficiency and mitochondrial trifunctional protein deficiency, whereas AC species from short-chain (C4) to long-chain (C16) were barely affected in medium-chain acyl-CoA dehydrogenase and control. While long-chain ACs (C12-C16) were significantly elevated, short to medium-chain ACs (C4-C10) were reduced in multiple acyl-CoA dehydrogenase deficiency. These data suggest that patients with long-chain FAODs may be more susceptible to heat stress compared to medium-chain FAOD or healthy control and that serious febrile episodes may deteriorate long-chain FAO in patients with long-chain FAODs.",0 +https://doi.org/10.1007/s00127-015-1121-3,Determinants of resource needs and utilization among refugees over time,"This study examined refugees' resource needs and utilization over time, investigated the relationships between pre-displacement/socio-demographic variables and resource needs and utilization, and explored the role of resource needs and utilization on psychiatric symptom trajectories.Iraqi refugees to the United States (N = 298) were assessed upon arrival and at 1-year intervals for 2 years for socio-demographic variables and pre-displacement trauma experiences, their need for and utilization of 14 different resources, and PTSD and depressive symptoms.Although refugees reported reduction of some needs over time (e.g., need for cash assistance declined from 99 to 71 %), other needs remained high (e.g., 99 % of refugees reported a need for health care at the 2-year interview). Generally, the lowest needs were reported after 2 years, and the highest utilization occurred during the first year post-arrival. Pre-displacement trauma exposure predicted high health care needs but not high health care utilization. Both high need for and use of health care predicted increasing PTSD and depressive symptoms. Specifically, increased use of psychological care across the three measurement waves predicted more PTSD and depression symptoms at the 2-year interview.Differences emerged between need for and actual use of resources, especially for highly trauma-exposed refugees. Resettlement agencies and assistance programs should consider the complex relationships between resource needs, resource utilization, and mental health during the early resettlement period.",0 +https://doi.org/10.1080/15374416.2015.1072822,Profiles of Adaptation Among Child Victims of Suspected Maltreatment,"This research seeks to identify profiles of adaptation among child victims of suspected maltreatment using a social-ecological framework. Data were drawn from the LONGSCAN multisite longitudinal study. Participants were 597 12-year-old children of diverse backgrounds (57% girls) with at least one Child Protective Services report of suspected maltreatment (M = 3.4 reports). Self-, caregiver-, and teacher-reports were collected to assess child competence, psychological and behavioral problems, and family and neighborhood characteristics. Latent Profile Analysis was used to classify individuals into empirically derived groups. The best-fitting model yielded five distinct profiles: consistent resilience; consistent maladaptation; posttraumatic stress problems; school maladaptation, family protection; and low socialization skills. Findings underscore the heterogeneity of child adaptation and reveal unique profiles of adaptation and contextual protection. Within-person variation in functioning suggests the need for comprehensive assessment across domains and contexts to address the clinical needs of maltreated youth.",0 +https://doi.org/10.4088/jcp.13m08910,Postdeployment Suicidal Ideations and Trajectories of Posttraumatic Stress Disorder in Danish Soldiers,"Article AbstractObjective: Suicidal ideation in veterans is of great concern. The objective of this study is to examine how heterogeneous posttraumatic stress disorder (PTSD) trajectories are associated with postdeployment suicidal ideation in veterans 2.5 years postdeployment to a combat zone in Afghanistan. If PTSD trajectories are associated with postdeployment suicidal ideations, then the accumulative knowledge on what characterizes veterans falling into different PTSD trajectories may provide better opportunities for early identification of suicidal high-risk veterans.Method: In this prospective study of 743 Danish soldiers deployed to Afghanistan from February to August in 2009, we collected data at 6 time points from 6 weeks before deployment to 2.5 years after homecoming (total for this study: 456). At all assessments, the soldiers responded to a comprehensive questionnaire including measures of PTSD (measured by the PTSD Checklist, Civilian Version) and other mental and physical health variables, demographics, and social and combat-related factors. Suicidal ideation was measured by an item from the European Parasuicide Study Interview Schedule II. In a previous study based on soldiers from this cohort, we identified 6 PTSD trajectories using latent growth mixture modeling, which we have extracted and applied as independent variables in this study. Adjusted multivariable logistic regression analyses were applied to examine whether deployed soldiers with certain PTSD symptom trajectories were more likely to report suicidal ideation 2.5 years after homecoming.Results: Two PTSD trajectories with high PTSD symptom level 2.5 years after return were significantly associated with suicidal ideation 2.5 years after homecoming. Thus, a relieved-worsening class, described by initial decreasing PTSD symptom levels followed by a steep increase in symptoms had higher risk of suicidal ideation (OR = 7.84; 95% CI, 1.68-36.6), which was also the case for a late-onset class (OR 5.2; 95% CI, 2.21-12.24) when compared to a low-stable class.Conclusions: Heterogeneous PTSD trajectories are associated with suicidal ideation in veterans 2.5 years after homecoming.",0 +https://doi.org/10.1007/s00127-007-0200-5,The descriptive epidemiology of internalizing and externalizing psychiatric dimensions,"Background: There is a growing recognition that comorbidity among individual mental disorders is best explained by the broad, psychiatric dimensions of internalization (sub-divided into distress and fear) and externalization. The aims of the current study were to examine the descriptive epidemiology of these psychiatric dimensions. Methods: Continuous measures of distress, fear and externalization dimensions were obtained from principal components analysis of 11 common ICD-10 mental disorders in a large (N = 10,641) community sample. The relationships between these three dimensions and sociodemographic, physical illness and personality disorder characteristics were determined using multivariate linear regression analyses. Results: The results suggest that the distress dimension is more strongly related to disadvantageous sociodemographic characteristics and physical health conditions than either the fear or externalizing dimensions. The results also demonstrate some specificity in profiles particularly with regard to the personality disorders. Conclusions: Greater emphasis should be placed on continuous psychiatric dimensions that are thought to underlie the expression of putatively independent mental disorders. \ \text",0 +https://doi.org/10.1017/s0033291707001353,Post-traumatic stress disorder following disasters: a systematic review,"Background Disasters are traumatic events that may result in a wide range of mental and physical health consequences. Post-traumatic stress disorder (PTSD) is probably the most commonly studied post-disaster psychiatric disorder. This review aimed to systematically assess the evidence about PTSD following exposure to disasters. Method A systematic search was performed. Eligible studies for this review included reports based on the DSM criteria of PTSD symptoms. The time-frame for inclusion of reports in this review is from 1980 (when PTSD was first introduced in DSM-III) and February 2007 when the literature search for this examination was terminated. Results We identified 284 reports of PTSD following disasters published in peer-reviewed journals since 1980. We categorized them according to the following classification: (1) human-made disasters ( n =90), (2) technological disasters ( n =65), and (3) natural disasters ( n =116). Since some studies reported on findings from mixed samples (e.g. survivors of flooding and chemical contamination) we grouped these studies together ( n =13). Conclusions The body of research conducted after disasters in the past three decades suggests that the burden of PTSD among persons exposed to disasters is substantial. Post-disaster PTSD is associated with a range of correlates including sociodemographic and background factors, event exposure characteristics, social support factors and personality traits. Relatively few studies have employed longitudinal assessments enabling documentation of the course of PTSD. Methodological limitations and future directions for research in this field are discussed.",0 +https://doi.org/10.1080/15299732.2011.551508,Posttraumatic Stress Symptomatology as a Mediator of the Association Between Military Sexual Trauma and Post-Deployment Physical Health in Women,"This study examined posttraumatic stress symptomatology (PSS) as a mediator of the association between military sexual trauma and post-deployment physical health. Relationships were examined in a sample of 83 female veterans of the first Gulf War (1990-1991) approximately 10 years post-deployment. Participants reported on the frequency of sexual harassment and sexual assault experienced during deployment. Physical health was measured using participants' self-reports of pre-deployment and post-deployment symptoms within 7 body systems. Sexual harassment exposure was not found to be associated with PSS-mediated associations with physical health symptoms. However, sexual assault during deployment was found to be associated with PSS and 4 of the 7 health symptom clusters assessed: gastrointestinal, genitourinary, musculoskeletal, and neurological symptoms. Furthermore, PSS was found to be a significant mediator of the sexual assault-physical health relationship in each of these domains, with the indirect path accounting for 74% to 100% of the relationship. The findings from the current study indicate that sexual assault has detrimental associations with physical health and that PSS plays a primary role in that relationship.",0 +https://doi.org/10.1521/psyc.2010.73.3.219,Exposure to Prolonged Socio-Political Conflict and the Risk of PTSD and Depression among Palestinians,"Little is known about the impact of traumatic experiences and stressful life conditions on people in low-income countries who live in conditions of ongoing political violence. In order to determine the prevalence and predictors of post-traumatic stress disorder (PTSD) and major depression (MD) among Palestinians subjected to chronic political violence and upheaval, we used a stratified multi-stage cluster random sampling strategy to interview a representative sample of 1,200 Palestinian adults living in Gaza, the West Bank, and East Jerusalem. Prevalence of PTSD/MD for men living in the West Bank, Gaza, and East Jerusalem was 25.4%/29.9%, 22.6%/27.6%, and 16.1%/16.1%, respectively. For women, the prevalence of PTSD/MD was 23.8%/29.0%, 23.9%/28.9%, and 19.7%/27.6%. Among men, PTSD was significantly positively associated with age group, two or more incidences of political violence (compared to none), greater intrapersonal resource loss, and loss of faith in government. MD was positively associated with experiencing exposure to one, or two or more, incidences of political violence (compared to none), and greater interpersonal and intrapersonal resource loss. Among women, PTSD was positively associated with greater interpersonal and intrapersonal resource loss, and MD was positively associated with death of a loved one, two or more socio-political stressors (compared to none) previous to the past year, one or more socio-political stressors (compared to none) in the past year, and greater interpersonal and intrapersonal resource loss. Interpersonal and intrapersonal resource losses were consistently associated with PTSD and MD, suggesting potential targets for intervention and prevention efforts and thus provide important keys to treatment in areas of ongoing conflict.",0 +https://doi.org/10.1097/00005373-199804000-00013,Psychosocial Factors Limit Outcomes after Trauma,"Psychological morbidity compromises return to work after trauma. We demonstrate this relationship and present methods to identify risks for significant psychological morbidity.Thirty-five adults were evaluated prospectively for return to functional employment after injury using demographic data, validated psychological and health measures, and the Michigan Critical Events Perception Scale. Evaluation was conducted at admission and at 1 and 5 months after injury.Poor return to work at 5 months was attributable to physical disability (p < 0.05) and psychological disturbance (p < 0.05) in a regression model that controlled for preinjury employment and psychopathologic factors as well as injury severity. A high score on the Impact of Events Scale administered during acute admission predicted development of acute stress disorder at 1 month (p < 0.01, odds ratio (OR) = 9.4) and posttraumatic stress disorder at 5 months (p < 0.05, OR = 6.7). Peritraumatic dissociation on the Michigan Critical Events Perception Scale was predictive for development of acute stress disorder (p < 0.05, OR = 5.8) at 1 month and posttraumatic stress disorder (p < 0.05, OR = 7.5) at 5 months.Psychological morbidity after injury compromises return to work independent of preinjury employment and psychopathologic condition, Injury Severity Score, or ambulation. A high Impact of Events Scale score or peritraumatic dissociation at admission predicts this morbidity.",0 +,The Equivalence of Traditional and Diagnostic Classification Model Approaches in Analyzing Empirical and Simulated Posttraumatic Stress Disorder Data,"The purpose of this study was to evaluate the performance of a log-linear cognitive diagnosis model (LCDM) as compared to three traditional scoring methods for the diagnosis of posttraumatic stress disorder (PTSD) as measured by the Posttraumatic Stress Disorder Checklist (PCL) civilian and military versions. Both civilian (empirical) and military (simulated) data were used in this study. Changes in the measurement and structure of PTSD have occurred over the years, especially as it related to military Veterans. Just recently in 2013, the diagnostic criteria for PTSD was changed to a four-dimensional diagnosis, although this study used the pre-2013 three-dimensional diagnosis due to the time period and instruments used to collect the empirical sample and the original samples used as parameters for the simulated data. Model parameters, respondent estimates, respondent classifications, and rates of agreement between the diagnostic methods were explored for both empirical and simulated data and further for sample size differences with the simulated data. The LCDM structural model was found to be comparable to the CFA model and the average item intercept -.539, showing that roughly 37% of respondents who were not positive for any PTSD clusters endorsed the item as being a problem they experienced. The average main effect parameter was 2.318, the size of which is relative to the size of the intercept where the lower intercepts and higher main effects showed more discrimination between those respondents who were ill or not ill with PTSD. Since posttraumatic stress disorder is both a compensatory and non-compensatory diagnosis the LCDM was evaluated on how well it was able to reflect these dimensions in the respondent estimates and classifications. Overall, the LCDM performed poorly compared to the traditional scoring, with the LCDM performing better at the symptom cluster level than at the diagnostic level. The potential utility of this feedback to a practicing clinician was found to be not yet suitable to clinical practice, but this study shows an opportunity to refine the PCL instrument to perform better in the LCDM framework, or to develop an instrument that is more discriminating and may be useful in differential diagnosis. (PsycINFO Database Record (c) 2015 APA, all rights reserved)",0 +https://doi.org/10.1016/j.mehy.2014.07.013,“Clinical brain profiling”: A neuroscientific diagnostic approach for mental disorders,"Clinical brain profiling is an attempt to map a descriptive nosology in psychiatry to underlying constructs in neurobiology and brain dynamics. This paper briefly reviews the motivation behind clinical brain profiling (CBP) and presents some provisional validation using clinical assessments and meta-analyses of neuroscientific publications. The paper has four sections. In the first, we review the nature and motivation for clinical brain profiling. This involves a description of the key aspects of functional anatomy that can lead to psychopathology. These features constitute the dimensions or categories for a profile of brain disorders based upon pathophysiology. The second section describes a mapping or translation matrix that maps from symptoms and signs, of a descriptive sort, to the CBP dimensions that provide a more mechanistic explanation. We will describe how this mapping engenders archetypal diagnoses, referring readers to tables and figures. The third section addresses the construct validity of clinical brain profiling by establishing correlations between profiles based on clinical ratings of symptoms and signs under classical diagnostic categories with the corresponding profiles generated automatically using archetypal diagnoses. We then provide further validation by performing a cluster analysis on the symptoms and signs and showing how they correspond to the equivalent brain profiles based upon clinical and automatic diagnosis. In the fourth section, we address the construct validity of clinical brain profiling by looking for associations between pathophysiological mechanisms (such as connectivity and plasticity) and nosological diagnoses (such as schizophrenia and depression). Based upon the mechanistic perspective offered in the first section, we test some particular hypotheses about double dissociations using a meta-analysis of PubMed searches. The final section concludes with perspectives for the future and outstanding validation issues for clinical brain profiling.",0 +https://doi.org/10.1017/s1352465803004089,PREVENTING PTSD: THE VALUE OF INNER RESOURCEFULNESS AND A SENSE OF PERSONAL CONTROL OF A SITUATION. IS IT A MATTER OF PROBLEM-SOLVING OR ANXIETY MANAGEMENT?,"The accounts of five subjects who survived life threatening experiences without the development of PTSD were examined, focusing on the coping strategies and cognitions described in these situations. The study aimed to determine whether there was a common pattern of response amongst subjects in these situations similar to the cognitive patterns described by the senior author of the previous case study (Ness & Macaskill, 2000) who survived a near drowning experience without the development of PTSD. In the search for common coping strategies all five respondents in the study completed the Locus of Control Scale (Rotter, 1966) and the Self-Control Schedule (Fisher & Reason, 1988). All five respondents demonstrated the use of problem solving as their main cognitive strategy, utilizing specific information from their previous experience relevant to their life-threatening situation. Respondents did not appear to rely on coping strategies aimed at the management of acute anxiety symptomatology. There was no common pattern among respondents in profiles on the Self-Control Schedule or the Locus of Control Scale. The possible implications of this case series study are discussed in relation to opportunities for the prevention of PTSD, the use of debriefing and the treatment of post-traumatic stress.",0 +https://doi.org/10.1300/j229v07n02_06,The Multidimensional Inventory of Dissociation (MID): A Comprehensive Measure of Pathological Dissociation,"This article describes the development and validation of the Multidimensional Inventory of Dissociation (MID). The MID is a 218-item, self-administered, multiscale instrument that comprehensively assesses the phenomenological domain of pathological dissociation and diagnoses the dissociative disorders. The MID measures 14 major facets of pathological dissociation; it has 23 dissociation diagnostic scales that simultaneously operationalize (1) the subjective/ phenomenological domain of pathological dissociation and (2) the hypothesized dissociative symptoms of dissociative identity disorder (Dell, 2001a). The MID was designed for clinical research and for diagnostic assessment of patients who present with a mixture of dissociative, posttraumatic, and borderline symptoms. The MID demonstrated internal reliability, temporal stability, convergent validity, discriminant validity, and construct validity. The MID also exhibited incremental validity over the Dissociative Experiences Scale (DES) by predicting an additional 18% of the variance in weighted abuse scores on the Traumatic Experiences Questionnaire (TEQ). Confirmatory factor analysis (CFA) did not support a one-factor model of the MID's clinical scales (i.e., the 14 facets and the 23 diagnostic symptoms). In contrast, however, CFA of the MID's factor scales (Dell & Lawson, 2005) has strongly supported a one-factor model. It was concluded that both the MID's 168 dissociation items and the construct of pathological dissociation have a second-order, unifactorial structure.",0 +https://doi.org/10.1177/1359104505051212,Cognitive Model of the Maintenance and Treatment of Post-traumatic Stress Disorder Applied to Children and Adolescents,"The diagnosis of post-traumatic stress disorder (PTSD) has recently been established as a useful construct in children and adolescents, and is also now held to be a helpful framework when describing symptoms in refugees or survivors of war. This article reviews existing models of PTSD and existing evidence for treatment efficacy in both adults and children, and leads on to discuss the application of the Ehlers and Clark (2000) cognitive model to work with children and adolescents. The difference between techniques such as exposure and cognitive restructuring is examined. Two vignettes illustrate the practical details of working with young refugees with PTSD, including both exposure and cognitive restructuring in different phases of therapy, the importance of a collaborative formulation, and the importance of parental support during treatment as well as cultural and language factors specific to refugees.",0 +https://doi.org/10.3390/ph2030082,Obsessive-Compulsive and Post Traumatic Avoidance Symptoms Influence the Response to Antihypertensive Therapy: Relevance in Uncontrolled Hypertension,"Aim: To investigate the association of uncontrolled hypertension with psychological factors associated with high cardiovascular morbidity and mortality (type D personality, depression, posttraumatic stress-related symptoms). Methods: 205 consecutive outpatient hypertensives completed three questionnaires evaluating Type D personality (DS 16), post traumatic symptoms (revised Impact of Events Scale), symptoms of anxiety, hostility, depression and obsessive-compulsive traits (subscales of the Symptom Checklist). Uncontrolled hypertension was diagnosed when clinic sitting blood pressure was above 140/90 mmHg (130/80 in the presence of diabetes or nephropathy), despite reported adherence to treatment with at least three antihypertensive medications, including a diuretic. Results: Uncontrolled hypertension (39%), was predicted by lower scores at Symptom Checklist obsessive-compulsive subscale and higher number of post traumatic avoidance symptoms, older age, diabetes, higher systolic pressure at first visit and longstanding hypertension. Type D personality correlated with depression, hostility, anxiety, compulsiveness, history of malignancy, and older age, but not with uncontrolled hypertension. Conclusions: Uncontrolled hypertension is associated with low obsessionality and avoidance symptoms, which reduce compliance to treatment. On the contrary, type D personality is not correlated with uncontrolled hypertension, as it includes compulsiveness, which improves compliance. A multidisciplinary approach to the hypertensive patient is mandatory to establish if the psychological profile affects compliance.",0 +https://doi.org/10.1186/1471-2458-10-437,Do adverse childhood experiences increase the risk of postdeployment posttraumatic stress disorder in US Marines?,"BackgroundPosttraumatic stress disorder (PTSD) has been associated with combat intensity, lack of social support, and adverse childhood factors among military personnel in previous studies. It has not been well established if adverse childhood experiences reported predeployment are independently associated with postdeployment PTSD.MethodsData were evaluated from 8,391 male responders of the Recruit Assessment Program survey at Marine Corps Recruit Depot in San Diego who were deployed in support of military conflicts between September 2001 and June 2004. Using patient medical records to determine PTSD diagnoses, Cox proportional hazard modeling was performed to examine if adverse childhood experiences were independently associated with postdeployment PTSD.ResultsAfter adjustment, those who reported adverse childhood experiences in more than one category were significantly more likely to be diagnosed with postdeployment PTSD. Specifically, childhood physical neglect was mostly strongly associated with postdeployment PTSD.ConclusionsFindings suggest that Marines who experience multiple types of adverse childhood experiences may be at increased risk for postdeployment PTSD. It is possible, however, that these results indicate that men willing to report childhood adverse experiences are also more willing to seek care for PTSD.",0 +https://doi.org/10.3389/fnsys.2014.00179,Heterogeneity in signaled active avoidance learning: substantive and methodological relevance of diversity in instrumental defensive responses to threat cues,"Individuals exposed to traumatic stressors follow divergent patterns including resilience and chronic stress. However, researchers utilizing animal models that examine learned or instrumental threat responses thought to have translational relevance for Posttraumatic Stress Disorder (PTSD) and resilience typically use central tendency statistics that assume population homogeneity. This approach potentially overlooks fundamental differences that can explain human diversity in response to traumatic stressors. The current study tests this assumption by identifying and replicating common heterogeneous patterns of response to signaled active avoidance (AA) training. In this paradigm, rats are trained to prevent an aversive outcome (shock) by performing a learned instrumental behavior (shuttling between chambers) during the presentation of a conditioned threat cue (tone). We test the hypothesis that heterogeneous trajectories of threat avoidance provide more accurate model fit compared to a single mean trajectory in two separate studies. Study 1 conducted 3 days of signaled AA training (n = 81 animals) and study 2 conducted 5 days of training (n = 186 animals). We found that four trajectories in both samples provided the strongest model fit. Identified populations included animals that acquired and retained avoidance behavior on the first day (Rapid Avoiders: 22 and 25%); those who never successfully acquired avoidance (Non-Avoiders; 20 and 16%); a modal class who acquired avoidance over 3 days (Modal Avoiders; 37 and 50%); and a population who demonstrated a slow pattern of avoidance, failed to fully acquire avoidance in study 1 and did acquire avoidance on days 4 and 5 in study 2 (Slow Avoiders; 22.0 and 9%). With the exception of the Slow Avoiders in Study 1, populations that acquired demonstrated rapid step-like increases leading to asymptotic levels of avoidance. These findings indicate that avoidance responses are heterogeneous in a way that may be informative for understanding both resilience and PTSD as well as the nature of instrumental behavior acquisition. Characterizing heterogeneous populations based on their response to threat cues would increase the accuracy and translatability of such models and potentially lead to new discoveries that explain diversity in instrumental defensive responses.",0 +https://doi.org/10.1177/0020764011423468,Lessons from the 2004 Asian tsunami: Epidemiological and nosological debates in the diagnosis of post-traumatic stress disorder in non-Western post-disaster communities,"Background: The nosological validity of post-traumatic stress disorder (PTSD) remains controversial in non-Western communities. After natural disasters, epidemiological studies often overlook these conceptual debates and assess post-traumatic stress symptoms (PTSS) by short screening instruments. Such PTSS estimates are reported as inflated prevalence rates of PTSD in post-disaster settings. Aims: To discuss the prevalence and determinants of PTSS within the context of pertinent epidemiological and nosological debates. Methods: We assessed PTSS and grief symptoms of 643 survivors from five Indian villages struck by the Asian tsunami using the Impact of Events Scale – Revised and Complicated Grief Assessment Scale. We adopted a case control design and employed complex sample multiple logistic regression statistics to study the determinants of PTSS. Results: The prevalence of PTSS was 15.1% (95% CI 12.3%–17.9%). PTSS was significantly associated with traumatic grief, female gender, physical injury, death of children and financial losses, but not with functional disability ( p = .91). Conclusions: Although PTSS were common in this population, elevating them to a psychiatric construct of PTSD is questionable, when functional impairment and avoidance behaviours were absent. Grief reactions, socio-economic burden, and poor support systems contribute towards PTSS. We highlight the important issues regarding the nosological validity and epidemiology of PTSD in non-Western communities.",0 +https://doi.org/10.1016/s1077-7229(00)80015-2,Treatment of concurrent PTSD and OCD: A commentary on the case of Howard,"The complexity inherent in treating patients diagnosed with multiple disorders often leaves clinicians feeling unsure of how best to encourage change, or even where to begin. The present commentary discusses the interplay between the symptoms of posttraumatic stress disorder and obsessive-compulsive disorder ( Kimble, 2000 ). Focusing on the need to assess the interplay of the two symptom clusters, the paper presents a model for understanding the etiological and functional relations that could link the symptoms of posttraumatic stress disorder and obsessive-compulsive disorder. Further, the paper discusses ways in which a clinician might approach such complex cases in order to address all of the client's needs in an effective and efficient manner.",0 +https://doi.org/10.1016/j.janxdis.2004.11.004,Exploratory factor analysis of two measures of posttraumatic stress disorder (PTSD) symptoms in a non-clinical sample of college students,"This study investigated the psychometric structure of two widely utilized measures of posttraumatic symptoms in a primarily Caucasian non-clinical sample. Given the prevalence of trauma exposure in non-referred samples, measurement of resulting symptoms is a critical issue. Exploratory factor analysis was utilized to assess and compare the factor structure of the Impact of Event Scale [IES; Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: a measure of subjective stress. Psychosomatic Medicine, 41, 209-218] and the Mississippi Scale for Posttraumatic Stress Disorder, Civilian version [MIS-Civ; Vreven, D. L., Gudanowski, D. M., King, L. A., & King, D. W. (1995). The Civilian Version of the Mississippi PTSD Scale-a psychometric evaluation. Journal of Traumatic Stress, 8, 91-109] in a sample of college students reporting exposure to potentially traumatic events. The psychometric structure of the IES was largely consistent with the two-factor structure widely reported in the literature, while the structure of the MIS-Civ varied considerably in this sample. Notably, non-clinical samples tended to report fewer social and occupational dysfunction than clinical samples predominantly utilized in PTSD research. Implications for use of these instruments in screening samples are discussed.",0 +https://doi.org/10.1186/1471-244x-13-182,Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study,"South Africa's unique history, characterised by apartheid, a form of constitutional racial segregation and exploitation, and a long period of political violence and state-sponsored oppression ending only in 1994, suggests a high level of trauma exposure in the general population. The aim of this study was to document the epidemiology of trauma and posttraumatic stress disorder (PTSD) in the South African general population.The South African Stress and Health Study is a nationally representative survey of South African adults using the WHO's Composite International Diagnostic Interview (CIDI) to assess exposure to trauma and presence of DSM-IV mental disorders.The most common traumatic events were the unexpected death of a loved one and witnessing trauma occurring to others. Lifetime and 12-month prevalence rates of PTSD were 2.3% and 0.7% respectively, while the conditional prevalence of PTSD after trauma exposure was 3.5%. PTSD conditional risk after trauma exposure and probability of chronicity after PTSD onset were both highest for witnessing trauma. Socio-demographic factors such as sex, age and education were largely unrelated to PTSD risk.The occurrence of trauma and PTSD in South Africa is not distributed according to the socio-demographic factors or trauma types observed in other countries. The dominant role of witnessing in contributing to PTSD may reflect the public settings of trauma exposure in South Africa and highlight the importance of political and social context in shaping the epidemiology of PTSD.",0 +https://doi.org/10.5935/1678-4669.20150009,Resposta ao estresse: II. Resiliência e vulnerabilidade,"A crescente exposicao a estressores na vida cotidiana aumentou significativamente a investigacao da resposta ao estresse nas duas ultimas decadas. Embora associada a consequencias negativas, pois muitas patologias fisicas e mentais sao desencadeadas por exposicao cronica a estressores, esta resposta e indispensavel para sobrevivencia do individuo e e extremamente adaptativa quando ativada de forma aguda. Na parte I desta revisao foram abordados os conceitos de homestase e alostase e os sistemas fisiologicos ativados durante a resposta ao estresse. Na parte II serao discutidos fatores que modulam a resposta ao estresse tais como sexo, temperamento, periodos criticos do desenvolvimento e a presenca ou ausencia de suporte social. A interacao entre os fatores geneticos e ambientais gera os perfis da resposta psicofisiologica que caracterizam os fenotipos de susceptibilidade e resiliencia frente aos estressores e sua relacao com uma patologia mental cada vez mais presente na sociedade moderna, o transtorno de estresse pos-traumatico.",0 +https://doi.org/10.1055/s-2004-830026,Psychogene Störungen bei deutschen Soldaten des Ersten und Zweiten Weltkrieges,"In the First and Second World War German soldiers frequently suffered from psychogenic disorders. By comparison a change in the prevalences can be noted: in the First World War dissociative disorders dominated the clinical impression (""shell shock""), in the Second World War they could rarely be seen but were replaced by somatoform and psychosomatic diseases. The discussion about numerous reasons for this development has not been completed yet and is still not free from political attitudes. To achieve a more scientific point of view, the perspective of psychotraumatology might be helpful. According to psychotraumatic research, dissociative and somatoform disorders can emerge in a close relation to a Posttraumatic Stress Disorder. The choice of symptoms depends on personality traits of the victim, but also on specific factors that characterise the situation in which the trauma appears. The mixture of pathogenetic and protective influences includes e. g. the possibility of flight- or fight reactions, feelings of trauma-associated guilt and group cohesion in the military unit. These factors can be useful to help explain the change of symptoms between both wars. In addition the analysis of situational conditions in former wars can give hints to actual planning and prophylaxis strategies in modern military psychiatry, that has to adjust to very different military operation fields.",0 +https://doi.org/10.1038/ajg.2011.300,Gastroesophageal Reflux Symptoms and Comorbid Asthma and Posttraumatic Stress Disorder Following the 9/11 Terrorist Attacks on World Trade Center in New York City,"Excess gastroesophageal reflux disease (GERD) was reported in several populations exposed to the September 11 2001 (9/11) terrorist attacks on the World Trade Center (WTC). We examined new onset gastroesophageal reflux symptoms (GERS) since 9/11 and persisting up to 5-6 years in relation to 9/11-related exposures among the WTC Health Registry enrollees, and potential associations with comorbid asthma and posttraumatic stress disorder (PTSD).This is a retrospective analysis of 37,118 adult enrollees (i.e., rescue/recovery workers, local residents, area workers, and passersby in lower Manhattan on 9/11) who reported no pre-9/11 GERS and who participated in two Registry surveys 2-3 and 5-6 years after 9/11. Post-9/11 GERS (new onset since 9/11) reported at first survey, and persistent GERS (post-9/11 GERS reported at both surveys) were analyzed using log-binomial regression.Cumulative incidence was 20% for post-9/11 GERS and 13% for persistent GERS. Persistent GERS occurred more often among those with comorbid PTSD (24%), asthma (13%), or both (36%) compared with neither of the comorbid conditions (8%). Among enrollees with neither asthma nor PTSD, the adjusted risk ratio (aRR) for persistent GERS was elevated among: workers arriving at the WTC pile on 9/11 (aRR=1.6; 95% confidence interval (CI) 1.3-2.1) or working at the WTC site > 90 days (aRR=1.6; 1.4-2.0); residents exposed to the intense dust cloud on 9/11 (aRR=1.5; 1.0-2.3), or who did not evacuate their homes (aRR=1.7; 1.2-2.3); and area workers exposed to the intense dust cloud (aRR=1.5; 1.2-1.8).Disaster-related environmental exposures may contribute to the development of GERS. GERS may be accentuated in the presence of asthma or PTSD.",0 +https://doi.org/10.1080/08870446.2012.676644,Pathways for psychological adjustment in breast cancer: A longitudinal study on coping strategies and posttraumatic growth,"This longitudinal study examined the role of coping strategies and posttraumatic growth (PTG) on the psychological adjustment to breast cancer trajectory. The participants were 50 women assessed at the time of surgery (T1), during adjuvant treatment (T2) and six months after the end of treatment (T3). Women completed questionnaires assessing coping strategies, PTG and psychological adjustment (psychological quality of life, anxiety and depression). Results showed that the greatest impact of breast cancer on women's adjustment occurred at T1, when patients were significantly more anxious than in the other phases of the disease. The type of surgery and adjuvant treatment did not account for the course of PTG and adjustment. Coping through seeking social support and using cognitive strategies at T1 were linked to psychological quality of life and depression at T3 via PTG dimension of personal resources and skills at T2. Findings emphasise the value of promoting adaptive coping strategies and PTG in order to improve psychological adjustment in breast cancer patients.",0 +https://doi.org/10.1037/a0020577,A preliminary study of the association between traditional masculine behavioral norms and PTSD symptoms in Iraq and Afghanistan veterans.,"Studies identifying a high prevalence of posttraumatic stress disorder (PTSD) and low treatment utilization among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) Veterans reinforce the need for a greater understanding of the disorder in this population. Although traditional masculine norms have been found to relate to both help seeking and PTSD among civilians, little is known about their impact on war Veterans. The current study examined relationships between masculine behaviors, using the Masculine Behavior Scale (MBS), and PTSD symptoms in OEF/OIF Veterans, drawing on archival clinical data from 69 patients at an outpatient PTSD clinic. Despite a positive trend, total MBS scores were not correlated with overall PTSD severity. However, the MBS subscale Exaggerated Self-Reliance and Control positively predicted hyperarousal symptoms in a hierarchical regression model. Unexpectedly, the MBS subscale Success Dedication negatively predicted avoidance, suggesting that this masculine norm may serve a protective function against avoidance symptoms. Results suggest that elements of masculinity are related to specific PTSD symptom clusters in ways that may be both adaptive and maladaptive. Implications for PTSD treatment are discussed. © 2011 American Psychological Association.",0 +https://doi.org/10.1016/j.jsat.2011.10.023,Examination of the latent factor structure of the Alcohol Use Disorders Identification Test in two independent trauma patient groups using confirmatory factor analysis,"Recent research on the factor structure of the Alcohol Use Disorders Identification Test (AUDIT) provides support for two underlying factors: consumption and consequences. The current study sought to extend these findings to two independent and diverse trauma populations: traumatic injury patients and military veterans treated for posttraumatic stress disorder. The 2- and 3-factor solutions provided the best fit to the data, but there was a very high correlation between the second and third factors of the 3-factor solution. Parsimony suggests that the 2-factor solution is the preferred model. The 2-factor model has implications for alcohol screening using the AUDIT and supports the goal of screening to identify those with hazardous drinking and alcohol use disorders. An algorithm is proposed to inform alcohol screening protocols in a range of health settings for trauma-exposed patient groups.",0 +https://doi.org/10.1080/00332747.2015.1082337,Examination of the Content Specificity of Posttraumatic Cognitions in Combat Veterans With Posttraumatic Stress Disorder,"Cognitive theories have proposed the idea of content specificity, which holds that emotional disorders are associated with unique sets of negative cognitions. The existent research exploring the content specificity related to posttraumatic stress disorder (PTSD) and depression is sparse, and research is especially needed in veteran samples. The purpose of this study was to examine the associations of PTSD symptom clusters and comorbid depressive symptoms with posttraumatic cognitions.This study was cross-sectional in design, and the sample consisted of data from 150 male combat veterans with PTSD drawn from the baseline assessments of a large clinical trial. Analyses involved a series of separate and simultaneous linear regressions to examine the unique associations of comorbid depressive symptoms and PTSD symptom clusters with posttraumatic cognitions, as well as post hoc analyses to examine the mediational role of comorbid depressive symptoms.Findings demonstrated that posttraumatic negative cognitions about the self and self-blame were most strongly associated with comorbid depressive symptoms and the depression-related PTSD numbing cluster. Comorbid depressive symptoms also partially mediated nearly all the relationships between posttraumatic cognitions and PTSD symptom clusters.The findings of this study suggest that posttraumatic cognitions about the self and self-blame are not specific to PTSD but rather are more strongly related to symptoms of depression and negative affect. The results also suggest a potential pathway from posttraumatic cognitions to PTSD through the partially mediating influence of comorbid depression, and highlight the need to assess and treat comorbid depression in veterans with PTSD.",0 +https://doi.org/10.2466/pr0.1993.73.2.363,F Scale Elevation and PTSD MMPI Profiles,MMPI profiles for 87 PTSD veteran inpatients were classified and studied according to MMPI F Scale elevation. Mean MMPI profiles and frequency of high two-point code types were studied for different levels of F Scale elevation. Similar mean profile configurations were found for subgroups with F ≥ 70 with Scales 2 and 8 appearing as the two highest clinical scales. For F < 70 the configuration was different in that Scale 8 was not one of the two highest scales. The 2-8/8-2 high two-point code was the modal high two-point code for the total sample but the relative frequency of high two-point codes did vary somewhat within and across levels of F Scale elevation.,0 +https://doi.org/10.1097/00008483-200505000-00008,Relationship of Quality of Life and Perceived Control With Posttraumatic Stress Disorder Symptoms 3 to 6 Months After Myocardial Infarction,"This study examined whether psychological variables were associated with posttraumatic stress disorder (PTSD) symptoms 3 to 6 months after myocardial infarction.The sample included 52 patients with myocardial infarction. A structured interview was used to obtain information about PTSD symptoms, quality of life, and ratings of perceived control, danger, and predictability, as well as information about stressful events that occurred during hospitalization.Four patients (7.7%) met criteria for the diagnosis of PTSD. Elevated PTSD scores were associated with poorer quality of life (r = -0.32 to -0.79). Lower perceived control was associated with higher PTSD symptom scores (r = -0.30 to -0.52). Finally, PTSD scores were significantly correlated with the number of times patients were readmitted to the hospital (r = 0.35-0.57).Approximately 8% of patients experienced PTSD 3 to 6 months following MI. Increasing levels of PTSD symptoms were correlated with poorer quality of life. Perceived lack of control during the MI and multiple hospitalizations may be related to the severity of PTSD symptoms.",0 +https://doi.org/10.4324/9781315223742-89,"Journalists, War, and Post Traumatic Stress Disorder *","(from the chapter) In this study of how war journalists deal with the stresses and physical dangers of their work, approximately one in five journalists was found to have ""probable"" Post Traumatic Stress Disorder (PTSD) while one in three showed evidence of psychological distress. Some of the large news organizations have belatedly discovered that war journalists are at risk for disorders such as PTSD. While confidential psychiatric help is now offered to war journalists within these organizations, the same does not apply to freelance journalists. The latter also lack the logistical back-up provided by the large organizations to their journalists in the field. Thus, the freelancer is potentially at greater risk for developing more frequent and enduring psychological difficulties. PTSD is potentially a chronic disorder. It also impacts on the quality of life and is known to affect the lives of family members too. For all these reasons, it behoves the news organizations to provide speedy access to therapy for their staff and any freelance journalists whom they may employ on a contract basis. It is equally important that no stigma be attached to those journalists requiring therapy. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1146/annurev-clinpsy-032210-104526,Resilience to Loss and Potential Trauma,"Initial research on loss and potentially traumatic events (PTEs) has been dominated by either a psychopathological approach emphasizing individual dysfunction or an event approach emphasizing average differences between exposed and nonexposed groups. We consider the limitations of these approaches and review more recent research that has focused on the heterogeneity of outcomes following aversive events. Using both traditional analytic tools and sophisticated latent trajectory modeling, this research has identified a set of prototypical outcome patterns. Typically, the most common outcome following PTEs is a stable trajectory of healthy functioning or resilience. We review research showing that resilience is not the result of a few dominant factors, but rather that there are multiple independent predictors of resilient outcomes. Finally, we critically evaluate the question of whether resilience-building interventions can actually make people more resilient, and we close with suggestions for future research on resilience.",0 +https://doi.org/10.1590/0004-282x20140098,Mental health of children and adolescents with epilepsy: analysis of clinical and neuropsichological aspects,"Epilepsy compromises the development of cognitive and social skills and represents a risk of psychiatric comorbidity. Objective: To compare psychopathological symptoms in children with epilepsy and in a healthy group, and to correlate the results with neuropsychological and clinical variables. Method: Forty five children with idiopathic epilepsy and sixty five healthy controls underwent neuropsychological evaluation and their caregivers replied to a psychopathology questionnaire (Child Behavior Checklist – CBCL). Results: There were significant differences in CBCL, with poorer results showed mainly by patients with epilepsy. There was no significant association between any psychopathological symptom and disease duration or amount of antiepileptic drugs used. There was positive correlation between intelligence quocient and CBCL on items such as sluggish cognitive tempo, aggressive behavior, attention problems and activities and a negative relation between academic achievement, conduct and rule-breaking behavior. Conclusion: Children with epilepsy had the worse results in the psychopathology evaluation. Certain psychopathological variables are related to the cognitive profile, with no relation to clinical variables.",0 +https://doi.org/10.1348/135910706x120627,Childbirth-related post-traumatic stress disorder in couples: A qualitative study,"Previous research has established that women can develop childbirth-related post-traumatic stress disorder (PTSD), but the effect of this on a couple's relationship has not been examined. This study aimed to look at the experience and impact of childbirth-related PTSD in women and their partners.This was a qualitative interview study of six couples, where at least one partner had clinically significant symptoms of childbirth-related PTSD.Semi-structured interviews were conducted separately with each partner and interview transcripts subjected to thematic analysis.Analysis identified four themes with 18 subthemes as follows: (1) birth factors (pain, negative emotions in labour, perceived lack of control, lack of choice or lack of involvement in decision-making, restricted movement or physical restraint, and expectations not being met); (2) quality of care (information provision, staff factors, continuity of care and environment); (3) effects on relationship with partner (impact on physical relationship, communication within the relationship, negative emotions within the relationship, receiving or giving support from partner, coping together as a couple and overall effect on the relationship); and (4) effects on relationship with child (perceptions of the child and parent-baby bond).This study suggests that PTSD may have a negative impact on the couple's relationship and the parent-baby bond.",0 +https://doi.org/10.1097/bcr.0b013e3182374452,Epidemiology and Impact of Scarring After Burn Injury,"The purpose of this study was to perform a systematic review of the existing literature on the incidence of hypertrophic scarring and the psychosocial impact of burn scars. In a comprehensive literature review, the authors identified 48 articles published since 1965 and written in English which reported the incidence and risk factors for hypertrophic scarring or assessed outcomes related to scarring. Most studies had important methodological limitations limiting the generalizability of the findings. In particular, the absence of standardized valid measures of scarring and other outcome variables was a major barrier to drawing strong conclusions. Among studies on hypertrophic scarring, the prevalence rate varied between 32 and 72%. Identified risk factors included dark skin, female gender, young age, burn site on neck and upper limb, multiple surgical procedures, meshed skin graph, time to healing, and burn severity. With regard to psychosocial outcomes, two studies compared pediatric burn survivors with a nonburn comparison group on a body image measure; neither study found differences between groups. Across studies, burn severity and location had a modest relationship with psychosocial outcome variables. Psychosocial variables such as social comfort and perceived stigmatization were more highly associated with body image than burn characteristics. To advance our knowledge of the epidemiology of scars and the burden of scars, future studies need to implement more rigorous methodologies. In particular, standardized valid measures of scarring and other outcomes should be developed. This process could be facilitated by an international collaboration among burn centers.",0 +https://doi.org/10.1016/s0193-953x(18)30111-4,The Phenomenology of Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) has been recognized for centuries, but has been named and formally characterized only recently. Criteria of PTSD in DSM-IV are a mixture of the new and old; some of the changes have far-reaching consequences. Acute stress disorder represents a new category that is long overdue. Even when well characterized, PTSD is an unusually broad condition with an uncertain epidemiology, a variable course, and a confused mixture of risk factors and vulnerabilities.",0 +https://doi.org/10.1177/1077559506287866,A Typological Analysis of Behavioral Profiles of Sexually Abused Children,"A cluster analysis is used to explore differential outcomes in 123 French Canadian children reporting sexual abuse contrasted with 123 control children. Mothers' reports of behavioral problems on the Child Behavior Checklist, abuse-related variables, personal factors, and family characteristics are used as potential variables discriminating clusters. Results reveal four clusters: (a) anxiety constellation group refers to children displaying behavior problems on a subset of scales, (b) the severe distress group refers to children showing a broader array of behavior problems, (c) victims of less severe sexual abuse (SA) group consists of children disclosing mostly extrafamilial SA, and (d) resilient children refers to children who, while disclosing severe abuse, rely less on avoidance coping. Findings underscore the need to go beyond abuse-related variables to orient treatment for children disclosing sexual abuse and for tailoring interventions to distinct subgroups.",0 +https://doi.org/10.1007/s10578-015-0552-0,Psychometric Properties of the German Version of the Child Post-Traumatic Cognitions Inventory (CPTCI-GER),"Dysfunctional trauma-related cognitions are associated with posttraumatic stress disorder (PTSD). The psychometric properties of the German version of the Child Post-Traumatic Cognitions Inventory (CPTCI-GER) were assessed in a sample of 223 children and adolescents (7-16 years) with a history of different traumatic events. Confirmatory factor analyses supported the original two-factor structure--permanent and disturbing change (CPTCI-PC) and fragile person in a scary world (CPTCI-SW). The total scale and both subscales showed good internal consistency. Participants with PTSD had significantly more dysfunctional trauma-related cognitions than those without PTSD. Dysfunctional posttraumatic cognitions correlated significantly with posttraumatic stress symptoms (PTSS; r = .62), depression (r = .71), and anxiety (r = .67). The CPTCI-GER has good psychometric properties and may facilitate evaluation of treatments and further research on the function of trauma-related cognitions in children and adolescents. (Partial) correlations provide empirical support for the combined DSM-5 symptom cluster negative alterations in cognitions and mood.",0 +https://doi.org/10.1080/09515079308254126,The role of offender profiling in classifying rapists: Implications for counselling,"Abstract The offender profiling process is an investigative technique used to identify the major personality and behavioural characteristics of the offender based upon an analysis of the crime(s) he or she has committed (Douglas & Burgess, 1986). Attempts have been made in both England and America to classify rapists into various subgroups. Instead of definitive groups of offenders a suggestion is made as to the formation of a dimensional typology of rapists. This would allow for the difficulties in defining boundaries for subgroups and accounting for individual differences and heterogeneity of both the rapist and the assault. The various criteria that attempt to distinguish the different types of offender are discussed including behavioural and motivational characteristics of the offender, lay theories of rape and the victim-offender relationship. The implications of the dimensional typology are outlined. There are indications that some factors may contribute to a longer and more complicated recovery pro...",0 +https://doi.org/10.1159/000331393,Post-Weaning to Pre-Pubertal (‘Juvenile’) Stress: A Model of Induced Predisposition to Stress-Related Disorders,"Human studies suggest that childhood trauma predisposes individuals to develop stress-related disorders such as depression and post-traumatic stress disorder (PTSD). Recent years have witnessed growing interest in effectively modeling in animals the long-term effects of childhood emotional trauma on stress responses in adulthood. Most studies concerned with the impact of early-life stress on subsequent stress responses in adulthood in rodents have focused on the post-natal pre-weaning period. However, psychiatric studies often refer to human childhood rather than infancy when investigating the patients’ traumatic history of stress-related psychopathologies. In accordance with that, we have examined the consequences of stress exposure at a later early-life period, the post-weaning, pre-puberty (juvenile) period, which holds greater resemblance to human childhood. This review summarizes a series of studies examining the impact of exposure of rats to stressors during ‘juvenility’ (‘juvenile stress’) on the ability of these animals to cope with stress later in life. Exposure to relatively brief but significant stress experience during juvenility was found to impair the ability of animals to cope with stressful challenges in adulthood. These behavioral manifestations were associated with lasting alterations in limbic system brain regions of neuromodulatory pathways, such as alterations in the expression of cell adhesion molecules, GABAergic system functioning and alterations in levels of circulating corticosterone. Importantly, these studies have also demonstrated considerable individual and sex differences, which call for the development of adequate analysis approaches. The juvenile stress model combined with characterization of individual profiles is presented as a useful model to study in rodents different facets of stress-related disorders and neural mechanisms of vulnerability and resilience to stress.",0 +https://doi.org/10.1016/j.janxdis.2011.12.001,Towards a post-traumatic subtype of obsessive–compulsive disorder,"We evaluated whether traumatic events are associated with a distinctive pattern of socio-demographic and clinical features of obsessive-compulsive disorder (OCD). We compared socio-demographic and clinical features of 106 patients developing OCD after post-traumatic stress disorder (PTSD; termed post-traumatic OCD), 41 patients developing OCD before PTSD (pre-traumatic OCD), and 810 OCD patients without any history of PTSD (non-traumatic OCD) using multinomial logistic regression analysis. A later age at onset of OCD, self-mutilation disorder, history of suicide plans, panic disorder with agoraphobia, and compulsive buying disorder were independently related to post-traumatic OCD. In contrast, earlier age at OCD onset, alcohol-related disorders, contamination-washing symptoms, and self-mutilation disorder were all independently associated with pre-traumatic OCD. In addition, patients with post-traumatic OCD without a previous history of obsessive-compulsive symptoms (OCS) showed lower educational levels, greater rates of contamination-washing symptoms, and more severe miscellaneous symptoms as compared to post-traumatic OCD patients with a history of OCS.",0 +,Prototypes of Student Veterans with Post Traumatic Stress Disorder and Traumatic Brain Injury among Faculty in Illinois Public Four-Year Universities.,"One of the primary reasons many college students with disabilities, and more specifically college student veterans with disabilities, do not seek support services is due to the stigma associated with disability, especially cognitive and mental health disabilities. The purpose of the present study was to explore how public university faculty in the state of Illinois perceive a college student veteran with the concurrent disabilities of post traumatic stress disorder (PTSD) and traumatic brain injury (TBI). This information was gleaned by means of a mixed-method, online survey. Through iterative, comparative, qualitative analysis, characteristics used to describe college student veterans with the PTSD and TBI were classified into six emergent prototypes. These prototypes included (1) the mature independent student; (2) the American hero; (3) the special needs student; (4) the isolated student; (5) the volatile student; and (6) the wounded warrior. Secondary analyses quantitatively examined the relationship between contact with a student veteran and the proportion of positive responses given for each participant as well as the relationship between contact with a student veteran and the proportion of negative responses given for each participant. Pearson correlation analysis indicated no significant relationship between prior contact factor scores and the proportion of positive responses given by faculty r(269) = .032, p = .597 nor was there a significant relationship detected between prior contact factor scores and the proportion of negative responses given by faculty r(269) = -.020, p= .745. Tertiary analysis examined the proportion of positive to negative perceptions by faculty. Overall, faculty responses were more negative than positive. Implications for best practices at the administration level as well as for faculty and students were discussed. Limitations to the study were also discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0 +https://doi.org/10.1080/00223890903230899,Investigating the MMPI–2 Trauma Profile in Treatment-Seeking Peacekeepers,"Most available research on MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) scores in combat veterans suffering from posttraumatic stress disorder (PTSD) has focused on Vietnam veterans. No data are available from peacekeepers suffering from PTSD. The aim of this study was to investigate the relationship between PTSD and the MMPI-2 in a sample of 120 treatment seeking peacekeeping veterans. Results show that relative to a non-PTSD reference group, veterans who screened positive for PTSD scored higher on Scales F, 2 (D), 4 (Pd), 6 (Pa), 7 (Pt), 8 (Sc), and 0 (Si) of the MMPI-2. Scales 2 (D), 7 (Pt), and 8 (Sc) were highest in the mean PTSD profile but no 2- or 3-point code type could be defined. Moderate correlations were found between a self-report measure for PTSD symptoms and scores on MMPI-2 clinical scales 1 (Hs), 2 (D), 6 (Pa), 7 (Pt), and 8 (Sc). The MMPI-2 proved to be useful in assessing the broad range of symptoms typically present in trauma populations as well as the severity of posttraumatic morbidity.",0 +https://doi.org/10.5042/amhid.2010.0544,Trauma and post‐traumatic stress disorder (PTSD) in a high secure forensic learning disability population: future directions for practice,"Literature on trauma and post‐traumatic stress disorder (PTSD) has neglected the needs of people with intellectual disability, particularly those in forensic settings. The National Centre for High Secure Learning Disability Services at Rampton Hospital conducted a service evaluation on aspects of trauma experience and post‐trauma symptoms in the current population. File information and self‐reports indicated that most individuals had experienced a great deal of lifetime trauma, typically multiple types of abuse. A high rate of potentially trauma‐related symptoms was noted in files. However, file records of potentially traumatic events, including abuse, were often lacking in detail. There was limited information about the events themselves, and there was no information to suggest that any trauma‐specific assessments had been used to measure trauma exposure or symptoms. PTSD as a diagnosis was rarely considered, and there was little consideration of trauma‐specific interventions. While some individuals said that their experiences had resulted in a lot of distress, others could not talk about the past at all. This paper discusses the problem of assessing past trauma and response in a forensic intellectual disability population, and future directions for practice in forensic services. The service under study plans to address the needs of patients who have experienced trauma and abuse by conducting routine structured assessments, offering adapted evidence‐based psychological interventions where appropriate, and providing trauma‐specific education for staff to promote a compassionate approach.",0 +https://doi.org/10.15288/jsad.2011.72.480,Evaluation of Two Web-Based Alcohol Interventions in the U.S. Military,"The U.S. military has traditionally had high rates of alcohol misuse and alcohol-related problems, necessitating effective treatment programs that minimize participant burden. Web-based interventions have shown promise as efficient treatment options for college students and adults but have not been widely evaluated in the military. This study evaluated the efficacy of two web-based alcohol interventions originally created for civilians and then adapted for U.S. military personnel.Two web-based alcohol interventions, Alcohol Savvy and Drinker's Check-Up, were adapted for use among military populations. The interventions were evaluated using a convenience sample of 3,070 active-duty military personnel at eight installations. Following a baseline survey, participants were assigned to one of three treatment conditions: (a) Alcohol Savvy, (b) Drinker's Check-Up, or (c) control (no program participation). Follow-up surveys were completed by 1,072 participants 1 month following baseline and by 532 participants 6 months following baseline.At 1-month follow-up, participants who completed the Drinker's Check-Up intervention had significant reductions in multiple measures of alcohol use relative to controls. Positive outcomes were found for average number of drinks consumed per occasion, frequent heavy episodic drinker status, and estimated peak blood alcohol concentration. These reductions in alcohol use at the 1-month follow-up were maintained at the 6-month follow-up. There were no statistically significant changes in alcohol use for participants who completed Alcohol Savvy.This study expands the literature on the effectiveness of web-based treatment for alcohol misuse. Findings indicate that web-based programs (Drinker's Check-Up in particular) can significantly decrease several indicators of alcohol use in U.S. military personnel.",0 +https://doi.org/10.1016/j.psychres.2014.02.025,The impact of social support on psychological distress for U.S. Afghanistan/Iraq era veterans with PTSD and other psychiatric diagnoses,"This study aimed to examine the degree to which posttraumatic stress disorder (PTSD) affects the relationship between social support and psychological distress for U.S. Afghanistan/Iraq era veterans with and without co-occurring psychiatric disorders. Veterans (N=1825) were administered self-report questionnaires and a structured diagnostic interview as part of a multi-site study of post-deployment mental health through the Department of Veterans Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC). Main and interaction effects models assessed the association between psychological distress and social support for three comparisons conditions (Controls vs. PTSD-only, non-PTSD, and PTSD plus co-morbid diagnoses). Having PTSD was a critical factor in attenuating the strength of this association, more so than other diagnoses. Furthermore, those with PTSD plus co-morbid diagnoses did not demonstrate significantly larger attenuation in that association compared to the PTSD-only group, indicating that psychiatric comorbidity may be less important in considering the role of social support in PTSD. By understanding this relationship, new avenues for engaging and enhancing treatment outcomes related to social support for veterans of this cohort may be identified. Additional longitudinal research could help evaluate the effect of PTSD symptom clusters, social support type, and trauma exposure type on these relationships.",0 +https://doi.org/10.3233/dma-2011-0761,Corticotrophin-releasing hormone type 1 receptor gene (CRHR1) variants predict posttraumatic stress disorder onset and course in pediatric injury patients.,"Posttraumatic stress disorder (PTSD) is a common and disabling anxiety disorder that may occur in the aftermath of exposure to potentially traumatic life events. PTSD is moderately heritable, but few specific molecular variants accounting for this heritability have been identified. Genes regulating the hypothalamic-pituitary-adrenal (HPA) axis, such as corticotrophin-releasing hormone type 1 receptor gene (CRHR1), have been implicated in traumatic-stress related phenotypes but have yet to be studied in relation to PTSD. The present study sought to examine the relation between 9 single nucleotide polymorphisms (SNPs) in the CRHR1 gene and posttraumatic stress symptoms in a prospective study of pediatric injury patients (n=103) who were first assessed in the acute aftermath of their injury at the hospital. Results indicated that multiple SNPs were associated with acute symptoms at a univariate level, and after correction for multiple testing, rs12944712 was significantly related to acute PTSD symptoms. Longitudinal latent growth curve analyses suggest that rs12944712 is also related to both acute symptom level and trajectory of symptoms over time. The present study adds support for the role of CRHR1 in the stress response following potentially traumatic event exposure in youth. It should be noted that the sample size in this study was small, and therefore statistical power was low; following, results from this study should be considered preliminary. Although results are not definitive, the findings from this study warrant future replication studies on how variation in this gene relates to response to traumatic event exposure in youth.",0 +https://doi.org/10.1016/j.jpsychires.2011.07.010,An examination of the relation between combat experiences and combat-related posttraumatic stress disorder in a sample of Connecticut OEF–OIF Veterans,"Combat exposure is an important risk factor for posttraumatic stress disorder (PTSD). However, little research has examined specific combat experiences associated with PTSD and confirmatory factor analytically (CFA)-derived re-experiencing, avoidance, dysphoria, and hyperarousal symptom clusters.A total of 285 predominantly older National Guard/Reservist OEF-OIF Veterans completed an anonymous mail survey that assessed demographics and deployment history, a broad range of combat experiences, PTSD, and unit and postdeployment social support.Personally witnessing someone from one's unit or an ally unit being seriously wounded or killed (β = 0.22), and being exposed to ""friendly"" fire (β = 0.14) and land mines/traps (β = 0.13) were the only three combat experiences associated with severity of combat-related PTSD symptoms, after adjustment for age, relationship status, unit support, postdeployment social support, and other combat experiences. Differential patterns of associations were observed for specific combat experiences in relation to CFA-derived symptom clusters (e.g., experiencing ""friendly"" fire was associated with re-experiencing and dysphoria symptoms, but not avoidance and hyperarousal symptoms). Personally witnessing someone from one's unit or an ally unit being seriously wounded or killed (odds ratio [OR] = 4.34; 95% confidence interval [CI] = 1.62-11.61) and being exposed to ""friendly"" fire (OR = 2.94; 95%CI = 1.16-7.47) emerged as independent predictors of a positive screen for probable PTSD.Results of this study suggest that witnessing someone in one's unit or ally unit being seriously wounded or killed while in a combat zone and being exposed to ""friendly"" fire are most strongly associated with combat-related PTSD in this sample of OEF/OIF Veterans. Examination of the relation between specific combat experiences and combat-related PTSD in OEF/OIF Veterans may help inform etiologic models of PTSD, and guide prevention and treatment approaches in this population.",0 +https://doi.org/10.1111/ajop.12019,"Trajectories of psychological distress among low‐income, female survivors of Hurricane Katrina.","The purpose of this study was to investigate trajectories of psychological distress among low-income, primarily unmarried and African American women who survived Hurricane Katrina (N = 386). Data were collected in the year prior to the hurricane as well as approximately 1 and 3 years thereafter. Using Latent Class Growth Analysis (LCGA), we detected 6 distinct trajectory groups. Over half of the participants fit into a trajectory consistent with resilience; that is, they maintained low levels of psychological distress over the course of the study, but experienced an elevation in symptoms at the first predisaster time point followed by a return to predisaster levels. The other trajectories reflected a range of psychological responses to disasters and indicated that predisaster functioning had a major influence on postdisaster psychological outcomes. Degree of exposure to hurricane-related stressors, experiences of human and pet bereavement, perceived social support, and socioeconomic status were significant predictors of trajectory group membership. Implications for research and policy are discussed.",0 +https://doi.org/10.1002/jts.22053,Borderline Personality Disorder and Posttraumatic Stress Disorder at Psychiatric Discharge Predict General Hospital Admission for Self-Harm,"We investigated whether posttraumatic stress disorder (PTSD) was predictor of suicidal behavior even when adjusting for comorbid borderline personality disorder (BPD) and other salient risk factors. To study this, we randomly selected 308 patients admitted to a psychiatric hospital because of suicide risk. Baseline interviews were performed within the first days of the stay. Information concerning the number of self-harm admissions to general hospitals over the subsequent 6 months was retrieved through linkage with the regional hospital registers. A censored regression analysis of hospital admissions for self-harm indicated significant associations with both PTSD (β = .21, p < .001) and BPD (β = .27, p < .001). A structural model comprising two latent BPD factors, dysregulation and relationship problems, as well as PTSD and several other variables, demonstrated that PTSD was an important predictor of the number of self-harm admissions to general hospitals(B = 1.52, p < .01). Dysregulation predicted self-harm directly (B = 0.28, p < .05), and also through PTSD [corrected]. These results suggested that PTSD and related dysregulation problems could be important treatment targets for a reduction in the risk of severe self-harm in high-risk psychiatric patients.",0 +https://doi.org/10.1097/ta.0b013e3181e16e2a,Posttraumatic Stress Disorder: A Primer for Trauma Surgeons,"In 1980, posttraumatic stress disorder (PTSD) officially became classified as an anxiety disorder in the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition. Since then, there has been increasing recognition that PTSD is a prevalent disorder that may have significant impact on the quality of life for survivors of traumatic events. More recently, methodologically sound research has begun to provide important insight into this disorder. The following review serves to provide the trauma surgeons information on PTSD in terms of its diagnosis, prevalence, risk factors, treatment strategies, and outcomes, with the goal of minimizing the sequelae of PTSD and maximizing postinjury quality of life.",0 +https://doi.org/10.1017/s003329171000125x,Psycho-educational interventions designed to prevent deployment-related psychological ill-health in Armed Forces personnel: a review,"Background Employers such as the Armed Forces (AF) and emergency services, who predictably expose their staff to potentially traumatic events (PTEs), often provide psycho-educational briefings in an attempt to mitigate possible adverse psychological sequelae. Within the military, psycho-educational briefings are widely used, particularly following exposure to PTEs on operations. The aim of this review was to evaluate the efficacy of these interventions and make appropriate recommendations. Method A search of Medline, PsycINFO and EMBASE was conducted, bibliographies of retrieved articles were searched and experts in the field were consulted. Results Two surveys and seven intervention studies were identified for inclusion in the review. Only three studies were randomized controlled trials (RCTs). Overall, the review found some evidence of benefit of psycho-educational interventions but it was not consistent across studies or outcomes and effects were small. However, there was also little evidence to suggest that they caused harm. There was some evidence that the beneficial effects may be greater for those who have been exposed to a higher number of PTEs. Conclusions Given the high operational tempo currently faced by coalition forces personnel, there remains a pressing need to identify the most effective way of minimizing the impact of exposure to potentially traumatic deployment incidents. To date, few psycho-educational interventions designed to prevent deployment-related psychological ill-health have been evaluated systematically in methodologically robust studies. The review recommends that future interventions are theoretically based and evaluated in cluster RCTs that examine both process and outcome variables.",0 +https://doi.org/10.1097/00000433-200112000-00008,Environmental Hyperthermic Infant and Early Childhood Death,"Infant and early childhood death caused by environmental hyperthermia (fatal heat stroke) is a rare event, typically occurring in vehicles or beds. The aims of this study were to describe the demographics, circumstances, pathology, and manner of death in infants and young children who died of environmental hyperthermia and to compare these cases with those reported in the literature. Scene investigation, autopsy reports, and the microscopic slides of cases from three jurisdictions were reviewed. The subjects in 10 identified cases ranged in age from 53 days to 9 years. Eight were discovered in vehicles and 2 in beds. When the authors' cases were grouped with reported cases, the profile of those in vehicles differed from those in beds. The former were older, were exposed to rapidly reached higher temperatures, and often had more severe skin damage. The latter were mostly infants and were exposed to lower environmental temperatures. Hepatocellular necrosis and disseminated intravascular coagulation were reported in victims who survived at least 6 hours after the hyperthermic exposure. The consistent postmortem finding among nearly all victims was intrathoracic petechiae, suggesting terminal gasping in an attempt at autoresuscitation before death. The manner of death was either accident or homicide. Recommendations for the scene investigation are made.",0 +https://doi.org/10.1080/10803548.2010.11076836,Optimizing the Protection Against the Physiological Burden of CBRN Clothing,"Soldiers can wear chemical, biological, radiological and nuclear (CBRN) protective clothing to be protected against warfare agents. The disadvantage of that clothing is that higher protection introduces higher physiological burden. Therefore an optimum between comfort and protection must be found. Models of all relevant processes were created to find this optimum. The airflow profile around a cylinder with clothing-representing a dressed human body part-was modelled. This flow profile was used for calculating the agent vapour breakthrough through the clothing and for calculating the deposition of agents onto the skin (as indicators for protection). The flow profile was also used for calculating the temperature profile around the body part and the relative humidity underneath and in the clothing (as representative for physiological burden). As a result a tool was created, which can be used to identify the optimum properties of CBRN protective clothing, depending on the intended mission of the soldiers.",0 +,"[Post-traumatic stress, post-traumatic depression and major depressive episode: literature].","Although they are likely to add their effects, physical and psychic traumata (or traumas) can provoke in different ways the appearance of depressive symptoms sometimes common. Post-traumatic depression, reactional depression, major depressive disorder and post-traumatic stress disorder represent different clinical and nosographic disorders in despite of their occasionally common symptomatic core. Historically, it is interesting to note during the XXth century the true semantic change of the terms of trauma from the somatic field to the psychic sphere. Physical traumatism is often represented by a material shock for the subject and by its organic consequences. It is defined as an event that leaves its mark which itself inflicts and handicaps the vital trajectory of the subject. It primarily comprises brain and rachis injuries, whose evolution is frequently characterized by the occurrence/appearance of a depressive disorder, whose genesis rests on psychological but also neurobiologic and physical arguments. Thus major depressive disorders are often present in the course of various physical traumatisms mainly related to nervous system. In accordance with several studies, the prevalence of major depressive disorders ranges from 25% to 50%. These mood disorders occur in the year which follows the accidental event. Their average time of revelation is estimated at four months and their average duration lies between three and six months. Lastly, although these depressive illnesses present clinical symptoms comparable with those observed in other contexts, some nuances can be raised. Nonetheless, they confine sometimes with true clinical forms depending on the intensity, the form, the circumstances or the consequences of the trauma. Psychic traumatism doesn't have the same profile and rests for much dedicated with the reexperiencing. Thus for some authors, depression illness represents a disorder that occurs after a traumatic event whereas others see a differential diagnosis which exludes or which represents a comorbidity with post-traumatic stress disorder. The review of the literature allows us to emphasize the complexity of the links as well as the clinical and epidemiologic differences between stress disorder and major depressive disorder. From the clinical point of view, the major features of PTSD are articulated around a triad of symptoms. They include the reexperiencing symptoms of the traumatic event such as intrusive memories and recurrent nightmares, the protective reactions such as avoidance of the stimuli associated with the trauma and emotional numbing, and the arousal symptoms such as the startled response and hypervigilance. The complexity of this syndrom is due to the frequent combination of these symptoms with other nonspecific ones. As far as the mood is concerned (the mood symptoms are concerned), the regrouping of some of these symptoms allows the clinician to sometimes releave a depressive symptomatology without being able to assess the DSM diagnosis of major depressive disorder. Epidemiologic studies dealing with the risk of installation of a PTSD after a traumatic event reveal differences in the prevalence depending on the nature of the traumatic events: ranging from 1% in general population to 80% following some situations of extreme and durable psychic suffering. Between both poles, one finds a prevalence ranging between 20 and 50% following other events such as serious accidents, natural disasters or criminal assaults. The clinical features of depressive episodes comorbid or associated with PTSD have some characteristics making it possible to individualize various clinical forms as a function of traumatic event type: asthenic, characterial or with somatic symptoms. According to the majority of authors, the co-occurrence of post-traumatic stress disorder and major depressive disorder is high although differential diagnosis is sometimes difficult. However, conceptual differences remain and two conceptions are distinguished. For some authors, like Bleich and Shalev, there would not be true chronological evolution from PTSD to MDD. Moreover the presence of symptoms considered as pertaining to the mood register within the criteria of PTSD would be clearly predictive of the occurrence and the severity of the diagnosis but not of the chronicity. For others, there would be a continuity between post-traumatic stress disorder and major depressive disorder. It is the case in many studies of veterans but also for civilian traumatic events. It is also the case for the American national study of comorbidity in which Kessler concludes that for 78% of the subjects who present a comorbidity PTSD/MDD (comorbidity raised for 48% of the 5,877 subjects included), the mood disorder is secondary to PTSD. (ABSTRACT TRUNCATED)",0 +https://doi.org/10.7205/milmed-d-13-00298,Randomized Controlled Trial of Accelerated Resolution Therapy (ART) for Symptoms of Combat-Related Post-Traumatic Stress Disorder (PTSD),"Therapies for post-traumatic stress disorder (PTSD) endorsed by the Department of Defense and Veterans Administration are relatively lengthy, costly, and yield variable success. We evaluated Accelerated Resolution Therapy (ART) for the treatment of combat-related psychological trauma.A randomized controlled trial of ART versus an Attention Control (AC) regimen was conducted among 57 U.S. service members/veterans. After random assignment, those assigned to AC were offered crossover to ART, with 3-month follow-up on all participants. Self-report symptoms of PTSD and comorbidities were analyzed among study completers and by the intention-to-treat principle.Mean age was 41 ± 13 years with 19% female, 54% Army, and 68% with prior PTSD treatment. The ART was delivered in 3.7 ± 1.1 sessions with a 94% completion rate. Mean reductions in symptoms of PTSD, depression, anxiety, and trauma-related guilt were significantly greater (p < 0.001) with ART compared to AC. Favorable results for those treated with ART persisted at 3 months, including reduction in aggression (p < 0.0001). Adverse treatment-related events were rare and not serious.ART appears to be a safe and effective treatment for symptoms of combat-related PTSD, including refractory PTSD, and is delivered in significantly less time than therapies endorsed by the Department of Defense and Veterans Administration.",0 +https://doi.org/10.1002/jcop.20522,THE PERSONAL POLITICS OF DISASTER: NARRATIVES OF SURVIVORS OF A SOUTH AFRICAN SHANTY TOWN FIRE,"Despite the fact that natural disasters occur more commonly in low and middle income countries than in wealthier countries, we know relatively little about how these disasters are experienced in such contexts. South Africa presents an especially telling example in which it is clear that natural events are affected profoundly by sociopolitical factors, including the spatial design of the apartheid city. We report here on interviews with twenty survivors of the biggest shanty town fire in the history of Cape Town, South Africa. The narratives of participants demonstrate that in order to understand the human cost of such disasters it is as important to understand the politics of the precursors of the disaster as well as what occurred subsequent to the disaster. The South African case, like that of Hurricane Katrina, underscores the fact that disaster, far from being an acute event which happens to individuals, is better understood as part of a far longer sociopolitical process affecting individuals, groups, and, indeed, societies.",0 +https://doi.org/10.1016/j.jad.2011.04.053,"Longitudinal study of PTSD, depression, and quality of life among adolescents after the Parnitha earthquake","To investigate the course of PTSD, depression, and current quality of life among adolescents 32-months after the 1999 Parnitha earthquake in Greece.The follow-up was conducted among 511 adolescents originally evaluated at 3-months post-earthquake using the UCLA PTSD Reaction Index (PTSD-RI), Depression Self-Rating Scale (DSRS), and Quality of Life Questionnaire (QOLQ).Mean PTSD scores for the whole sample had subsided to mild levels; however, 8.8% were still experiencing moderate to severe levels of symptoms, and 13.6% met criteria for clinical depression. Frequency of experiencing reminders of the earthquake in the past month best explained the variance (15%) in PTSD severity, followed by depression at 3-months (8%). The QOLQ domain scores were negatively correlated with PTSD and depression. Depression at 3-months was the best predictor of QOLQ at 32-months, explaining 16% of the variance.Self-report instruments were used; hence the responses may have been over- or under-estimated; also, the findings may not be generalizable to other ethnic groups.Ongoing screening is recommended after disaster to identify adolescents who continue to experience moderate to severe levels of PTSD and depressive symptoms. Specific interventions to reduce reactivity to earthquake-related reminders should be a component of post-disaster recovery programs. A quality of life measure can provide important information in addition to traditional scales for monitoring the course of recovery among adolescents after disasters.",0 +,"[Repeated amenorrhea in an adolescent girl in the course of flood disaster in Kłodzko Region, July 1997].","A natural disaster has been defined as a disruption of human ecology that exceeds the capacity of the community to function normally.After the flood disaster in Kłodzko Region, July 1997, the major problem in female adolescents was observed: secondary amenorrhea.17 female adolescents, aged 13-18, which injured from the flood disaster with secondary amenorrhea were investigated. A control random group consists of 17 girls diagnosed before oral contraception. Diagnostic work-up includes history, physical and psychological examinations, hormonal profiles, transvaginal ultrasonography, color Doppler analysis of utero-ovarian arterial blood flow.FSH, LH, E2 plasma levels and LH/FSH ratio were significantly lower in the amenorrheic group compared to normal girls. Prolactin serum levels after metoclopramid administration were significantly higher in the amenorrheic group. Lower impedance to blood flow in the intraovarian arteries have been shown. Psychosomatic disorders related to hypothalamic amenorrhoea were diagnosed.Psychosocial stress observed during the flood disaster caused hypogonadotropic hypogonadism amenorrhoea in the female adolescents.",0 +https://doi.org/10.1037/a0030001,Structural equation model trees.,"In the behavioral and social sciences, structural equation models (SEMs) have become widely accepted as a modeling tool for the relation between latent and observed variables. SEMs can be seen as a unification of several multivariate analysis techniques. SEM Trees combine the strengths of SEMs and the decision tree paradigm by building tree structures that separate a data set recursively into subsets with significantly different parameter estimates in a SEM. SEM Trees provide means for finding covariates and covariate interactions that predict differences in structural parameters in observed as well as in latent space and facilitate theory-guided exploration of empirical data. We describe the methodology, discuss theoretical and practical implications, and demonstrate applications to a factor model and a linear growth curve model.",0 +https://doi.org/10.1007/s00127-014-0949-2,Posttraumatic growth in the aftermath of a disaster: looking for the role of gender,"In the past 10 years, the literature on disasters and mental health has shifted from a focus on psychopathology, to an interest in documenting manifestations of resilience in the face of mass trauma. The Jin et al. study, published in this issue of the Journal, examines gender differences in the relationship between posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) in the aftermath of the Wenchuan Earthquake in China. The study suggests that the coping response to PTSD may differ between males and females, and raises interesting questions about the types of factors that contribute to the manifestation of high versus low PTG given high levels of PTSD. At the same time, this type of study highlights the need to investigate the long-term impact and meaning of PTG, and to examine whether it reflects an adaptive process with long-term benefits in the face of traumatic exposures, or an illusory type of posttraumatic response.",0 +https://doi.org/10.1176/ajp.155.7.934,Posttraumatic Stress Disorder Following an Air Disaster: A Prospective Study,"OBJECTIVE: The purpose of this study was to determine predictors of posttraumatic stress disorder (PTSD) in health care workers exposed to a disaster, in order to facilitate early case identification and prevention of subsequent morbidity. METHOD: Following an air disaster, 355 military medical health care workers were studied over an 18-month follow-up period. Measures included assessment of peritraumatic reactions associated with the disaster, the frequency of other stressful events after the disaster, and standard PTSD rating scales at 6, 12, and 18 months. RESULTS: Multivariate logistic regression of data on health care workers who cared for victims of the air disaster showed that PTSD was more likely to develop in those who had not completed college, those who had worked with burn victims, those who had experienced more stressful life events in a period of approximately 6 months following the disaster, and those who experienced emotional numbness immediately after the disaster. CONCLUSIONS: Results suggest that lower levels of education, exposure to grotesque burn injuries, stressful life events following exposure, and feelings of numbness following exposure are useful predictors of subsequent development of PTSD. (Am J Psychiatry 1998; 155:934–938)",0 +https://doi.org/10.1371/journal.pone.0144315,The Relationship between Cortisol Activity during Cognitive Task and Posttraumatic Stress Symptom Clusters,"The latest development in the dimensional structure of posttraumatic stress disorder (PTSD) is a novel 6-factor model, which builds on the newly released DSM-5. One notable gap in the literature is that little is known about how distinct symptom clusters of PTSD are related to hypothalamic-pituitary-adrenal (HPA) axis activity when people perform a relatively less stressful cognitive task. The purpose of this study was to investigate the relationship between cortisol activity when individuals perform cognitive tasks in the laboratory and a contemporary phenotypic model of posttraumatic stress symptomatology in earthquake survivors.Salivary cortisol while performing cognitive tasks was collected and analyzed in 89 adult earthquake survivors. The PTSD Checklist for the DSM-5 (PCL-5) was used to assess the severity of total PTSD as well as six distinct symptom clusters. Regression analyses were conducted to examine the associations between the six distinct PTSD symptom clusters and cortisol profiles.The results showed that the score of the negative affect symptom cluster, but not anhedonia or other clusters, was positively associated with cortisol levels before and during the cognitive tasks.The results showed that higher cortisol levels before and during cognitive tasks might be specifically linked to a distinct symptom cluster of PTSD-negative affect symptomatology. This suggests that a distinction should be made between negative affect and anhedonia symptom clusters, as the 6-factor model proposed.",0 +https://doi.org/10.1177/0022002709360322,The Trauma of Truth Telling: Effects of Witnessing in the Rwandan Gacaca Courts on Psychological Health,"Truth telling has come to play a pivotal role in postconflict reconciliation processes around the world. A common claim is that truth telling is healing and will lead to reconciliation. The present study applies recent psychological research to this issue by examining whether witnessing in the gacaca, the Rwandan village tribunals for truth and reconciliation after the 1994 genocide, was beneficial for psychological health. The results from the multistage, stratified cluster random survey of 1,200 Rwandans demonstrate that gacaca witnesses suffer from higher levels of depression and PTSD than do nonwitnesses, also when controlling for important predictors of psychological ill health. Furthermore, longer exposure to truth telling has not lowered the levels of psychological ill health, nor has the prevalence of depression and PTSD decreased over time. This study strongly challenges the claim that truth telling is healing and presents a novel understanding of the complexity of truth-telling processes in postconflict peace building.",0 +https://doi.org/10.1111/j.1467-6494.1994.tb00308.x,Expressive and Defensive Behavior during Discourse on Unresolved Topics: A Single Case Study of Pathological Grief,"Both psychodynamic and social-cognitive theoretical domains have control process models of behavior but with different ideas about the purpose and loci of control. This study examines expressive and defensive behaviors associated with different topics of discourse in the time-limited psychotherapy of a woman treated for pathological grief. Conceptually the study is based on a model of defensive control processes that integrates states of mind and person schemas. Theoretically derived measures of discourse topics, verbal and nonverbal defensive behaviors, emotional disclosure, and states of mind were applied to transcripts and videotapes of the entire therapy. Evidence from combined cluster and factor analyses supported the existence of recurring emotionally significant states. Two of these are particularly interesting from a clinical perspective: One, a ""shimmering"" state of intense emotional expression with concurrent signs of avoidance, was associated with topics identified clinically as stressful, unresolved, and conflictual. The other, a state of more uniformly stifled emotionality, was characteristic of discourse thought of clinically as resistance.",0 +https://doi.org/10.1177/0145445502026002003,Psychological Impact of Fire Disaster on Children and Their Parents,"Six weeks following a major wildfire, children's psychosocial functioning was examined. Employing a multimethod assessment approach, the short-term mental health consequences of the fire were evaluated. Individual adjustment was compared between families who reported high levels of loss as a result of the fire (high-loss group) and families who reported relatively low levels of loss resulting from the fire (low-loss group). Standardized assessment procedures were employed for children and adolescents as well as their parents. In general, high-loss participants reported slightly higher levels of post-traumatic stress disorder (PTSD) symptoms and significantly higher scores on the Impact of Events Scale. PTSD symptoms reported by parents were generally significantly correlated with (but not concordant with) PTSD symptoms reported by their children. The high-loss group scored significantly higher on the Resource Loss Index than did the low-loss group. Preexisting and comorbid disorders and previous stressors are described. A methodological framework for future studies in this area is discussed.",0 +,"Socio-demographic and Clinical Profile of Substance Abusers Attending a Regional Drug De-addiction Centre in Chronic Conflict Area: Kashmir, India.","The menace of substance abuse is not only a socially unacceptable reality, but in its entirety is a disease and emerging as a major public health challenge.To study the socio-demographic and clinical profile of patients attending the drug de-addiction centre.A descriptive study was undertaken in a drug de-addiction centre at the Police Hospital in Srinagar, and all patients (198) who were admitted during this period were interviewed.The mean (SD) age of patients was 26.8 years (SD 7.37), and over half (56%) belonged to the lower-middle social class. Poly-substance abuse was seen in 91.9%; medicinal opioids and cannabis were the most common substances abused. Most common age of initiation was 11-20 years (76.8%), with peer pressure and relief from a negative mood state being the most common reasons given for starting the drug(s). Prevalence of a co-morbid psychiatric disorder was high, on the order of 49.5%. A high rate of volatile substance use was observed among adolescents (54.5%).A pattern of poly-substance abuse was found to be quite common in patients, and use of volatile substances at a very young age emerged as a new trend. The dreadful repercussions of substance abuse justify the urgency to evolve a comprehensive strategy.",0 +,Faking PTSD From a Motor Vehicle Accident on the MMPI-2,"The MMPI-2 is often used to assess posttraumatic stress disorder (PTSD) in individuals who claim psychological injury as a result of a motor vehicle accident. There is concern that attorneys can coach plaintiffs to fake PTSD. The purpose of this study was to determine whether prior symptom knowledge increased one's ability to fake PTSD on the MMPI-2. Eighty-four female undergraduate students completed the MMPI-2 under either of two conditions, informed (given DSM-IV diagnostic criteria for PTSD prior to testing) or uninformed (no diagnostic criteria provided). It was hypothesized that the informed subjects would more accurately fake PTSD than the uninformed subjects. Results indicated that knowledge about the specific symptoms of PTSD did not create a more accurate profile, but rather was likely to produce more invalid (F>T89) profiles, detecting them as malingerers.",0 +https://doi.org/10.1023/a:1024804312978,,"Dissociative responses to trauma have been hypothesized to be associated with long-term increases in psychopathology. The purpose of this study was to examine dissociative responses to premilitary, combat-related and postmilitary traumatic events and long-term psychopathology in Vietnam combat veterans with (n = 34) and without (n = 28) posttraumatic stress disorder (PTSD). PTSD patients reported higher levels of dissociative states at the time of combat-related traumatic events than non-PTSD patients. Higher levels of dissociative states persisted in PTSD patients in the form of higher levels of dissociative states in-response to postmilitary traumatic events. In addition, dissociative responses to combat trauma were associated with higher long-term general dissociative symptomatology as measured by scores on the Dissociative Experience Scale, as well as increases in the number of flashbacks since the time of the war. These findings are consistent with previous formulations that dissociation in the face of trauma is a marker of long-term psychopathology.",0 +https://doi.org/10.1002/jts.20156,"PTSD as a mediator of sexual revictimization: The role of reexperiencing, avoidance, and arousal symptoms","Theory and research suggest that posttraumatic stress disorder (PTSD) may mediate the relationship between child sexual abuse and adult sexual assault. However, little empirical research has examined the mediational role of PTSD. In the present study, the authors use structural equation modeling to examine the degree to which the three symptom clusters that define PTSD (reexperiencing, avoidance, and hyperarousal) contribute to sexual revictimization. To assess PTSD symptomatology, undergraduate women completed questionnaires (N = 1,449), which detailed the history and severity of childhood and adult sexual assault experiences. Results indicated that PTSD mediated sexual revictimization. When PTSD symptom clusters were examined individually, only the hyperarousal cluster was a significant mediator. Results are discussed in terms of information-processing mechanisms that may underlie sexual revictimization.",0 +https://doi.org/10.1002/cpp.534,Post-traumatic stress disorder in a person with a diagnosis of schizophrenia: Examining the efficacy of psychological intervention using single N methodology,"Psychological intervention for post-traumatic stress disorder (PTSD) in a person with a diagnosis of schizophrenia is presented using single N methodology. Psychological formulation and intervention were informed by psychological models of PTSD symptom persistence that focus on dual maintaining factors of (a) disturbance in the form of trauma autobiographical memory and (b) problematic trauma-related appraisals. Baseline assessment of difficulties related to intrusive memories, problematic trauma-related appraisals (e.g., responsibility appraisals) and associated negative emotions (e.g., anger) was followed by two phases of intervention: (1) written elaboration of the trauma memory and (2) cognitive restructuring of problematic trauma-related appraisals. Treatment produced reduction in ratings of distress in all domains and there were clinically significant reductions in PTSD symptomatology and co-morbid depression on standardized self-report measures. There were, however, differential effects of treatment components as evidenced during the sequential introduction of treatment components. These are discussed and directions for future research in the treatment of PTSD in persons with severe mental health problems are highlighted. Copyright © 2007 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1146/annurev.psych.51.1.445,The Effects of Family and Community Violence on Children,"This review examines theoretical and empirical literature on children's reactions to three types of violence--child maltreatment, community violence, and interparental violence. In addition to describing internalizing and externalizing problems associated with exposure to violence, this review identifies ways that violence can disrupt typical developmental trajectories through psychobiological effects, post-traumatic stress disorder (PTSD), cognitive consequences, and peer problems. Methodological challenges in this literature include high rates of co-occurrence among types of violence exposure, co-occurrence of violence with other serious life adversities, heterogeneity in the frequency, severity, age of onset, and chronicity of exposure, and difficulties in making causal inferences. A developmental psychopathology perspective focuses attention on how violence may have different effects at different ages and may compromise children's abilities to face normal developmental challenges. Emphasis is placed on the variability of children's reactions to violence, on outcomes that go beyond diagnosable disorders, and on variables that mediate and moderate children's reactions to violence.",0 +https://doi.org/10.1007/s11920-013-0393-0,Psychopharmacology in Psycho-oncology,"Psychopharmacological intervention is a major clinical and research area in oncology and palliative care. Over the last 35 years, psychotropic drugs have been shown to have a number of important indications for the treatment of the most common psychiatric disorders, such as depression, anxiety, stress-related syndromes, severe adjustment disorders, sleep disorders and delirium, which combined affect at least 30-40% of patients with cancer and even a higher percentage of patients in an advanced phase of illness. The availability of new drugs, with less side-effects and safer pharmacological profiles, has been a major advance in clinical psycho-oncology. Interestingly, several drugs have also been found to be helpful for the adjuvant treatment of cancer-related symptoms, such as pain, hot flashes, pruritus, nausea and vomiting, fatigue, and cognitive impairment, making psychopharmacology an important tool for the improvement of cancer patients' quality of life. The aim of this paper is to summarize recent relevant data concerning the use of psychotropic drugs, namely antidepressants, anxiolytics, antipsychotics, anticonvulsants and psychostimulants in patients with cancer. © 2013 Springer Science+Business Media New York.",0 +https://doi.org/10.1080/01926189208250889,Mapping family stress: The application of family adaptation theory to post-traumatic stress disorder,Abstract This articel examines the role of interpersonal factors in the maintenance of Post-Traumatic Stress Disorder (PTSD) and suggests a need for clinicans to conceptualize PTSD within a family systems context. A case study illustrates the use of Family Adaptation Theory as a model for assessment and intervention.,0 +https://doi.org/10.2174/1568007023339049,"Non-Peptidic CRF1 Receptor Antagonists for the Treatment of Anxiety, Depression and Stress Disorders","Anxiety and depression are psychiatric disorders that constitute a major health concern worldwide, and new pharmacological approaches with the potential for improved efficacy and decreased side effect profiles relative to currently marketed drugs are desired. Since the identification of corticotropin releasing factor (CRF) by Vale and colleagues in 1981, an extensive research effort has solidified the importance of this 41 amino acid peptide in mediating the body's behavioral, endocrine, and autonomic responses to stress. The further identification of CRF receptor subtypes has provided compelling targets for novel pharmaceutical agents. The present review focuses on the potential of non-peptidic antagonists of the CRF(1) receptor subtype as a novel therapeutic approach for the treatment of anxiety and depression. The first section reviews preclinical and clinical evidence implicating CRF, in general, and CRF(1) receptors, in particular, in anxiety and depression. Clinical studies have demonstrated a dysfunctional hypothalamic-pituitary-adrenal (HPA) axis and/or elevated CRF levels in depression and in some anxiety disorders. Preclinical data utlilizing correlational methods, genetic models, and exogenous CRF administration techniques in rodents and non-human primates supports a link between hyperactive CRF pathways and anxiogenic and depressive-like symptoms. Studies employing the use of receptor knockouts and selective, non-peptidic antagonists of the CRF(1) receptor have demonstrated anxiolytic and antidepressant effects under certain types of laboratory conditions. A Phase II, open-label, clinical trial in major depressive disorder has reported that a CRF(1) receptor antagonist was safe and effective in reducing symptoms of anxiety and depression. In the second section, a topological approach is used to describe the design strategies employed to produce potent, non-peptidic CRF(1) receptor antagonists. Two main topologies, featuring a center core, a top side-chain, and a pending aromatic ring, can be used to characterize the vast majority of currently known CRF(1) receptor antagonists. By exploiting some of these structural elements, pharmacological, physicochemical, and pharmacokinetic properties can be modulated and optimized. However, as a result of a relatively conservative iteration process during the structural optimization, the chemical space presently defined by the existing CRF(1) receptor antagonists still remains fairly narrow. Expanding these structural and topological boundaries, while optimizing the ""drug-like"" properties of the CRF(1) receptor antagonists, seems to be a common objective across pharmaceutical companies to maximize the chances for a clinical success in the near future.",0 +https://doi.org/10.1371/journal.pone.0107241,Age-Associated Epigenetic Upregulation of the FKBP5 Gene Selectively Impairs Stress Resiliency,"Single nucleotide polymorphisms (SNPs) in the FK506 binding protein 5 (FKBP5) gene combine with traumatic events to increase risk for post-traumatic stress and major depressive disorders (PTSD and MDD). These SNPs increase FKBP51 protein expression through a mechanism involving demethylation of the gene and altered glucocorticoid signaling. Aged animals also display elevated FKBP51 levels, which contribute to impaired resiliency to depressive-like behaviors through impaired glucocorticoid signaling, a phenotype that is abrogated in FKBP5-/- mice. But the age of onset and progressive stability of these phenotypes remain unknown. Moreover, it is unclear how FKBP5 deletion affects other glucocorticoid-dependent processes or if age-associated increases in FKBP51 expression are mediated through a similar epigenetic process caused by SNPs in the FKBP5 gene. Here, we show that FKBP51-mediated impairment in stress resiliency and glucocorticoid signaling occurs by 10 months of age and this increased over their lifespan. Surprisingly, despite these progressive changes in glucocorticoid responsiveness, FKBP5-/- mice displayed normal longevity, glucose tolerance, blood composition and cytokine profiles across lifespan, phenotypes normally associated with glucocorticoid signaling. We also found that methylation of Fkbp5 decreased with age in mice, a process that likely explains the age-associated increases in FKBP51 levels. Thus, epigenetic upregulation of FKBP51 with age can selectively impair psychological stress-resiliency, but does not affect other glucocorticoid-mediated physiological processes. This makes FKBP51 a unique and attractive therapeutic target to treat PTSD and MDD. In addition, aged wild-type mice may be a useful model for investigating the mechanisms of FKBP5 SNPs associated with these disorders.",0 +https://doi.org/10.1017/s1049023x00000200,Frail Elderly as Disaster Victims: Emergency Management Strategies,"To identify the vulnerabilities of elderly to disasters, and to develop strategies to address these vulnerabilities.A relevant literature search of journal articles, government training materials, news reports, and materials from senior organizations was conducted.The vulnerability of the elderly to disasters is related to their impaired physical mobility, diminished sensory awareness, chronic health conditions, and social and economic limitations that prevent adequate preparation for disasters, and hinder their adaptability during disasters. Frail elderly, those with serious physical, cognitive, economic, and psycho-social problems, are at especially high risk.This segment of the population is growing rapidly. Therefore, it is important that emergency management recognize the frail elderly as a special needs population, and develop targeted strategies that meet their needs. Several management strategies are presented and recommendations for further action are proposed.",0 +https://doi.org/10.1586/ecp.10.138,Trazodone: properties and utility in multiple disorders,"Trazodone is an established antidepressant that is prescribed frequently as an off-label hypnotic with wide acceptance among psychiatrists. Owing to its atypical mixed serotonergic and adrenolytic pharmacology, trazodone has been investigated in a number of disorders besides depression and insomnia, including anxiety disorders, chronic pain, frontal cognitive dysfunctions, erectile dysfunction and others. Clinical studies using subjective and objective measures generally tend to support its efficacy as a hypnotic in depressed subjects. Various other attributes of trazodone, including interaction with adrenergic receptors, formation of an active metabolite with potent serotonergic activity, low abuse potential and putative utility in various disorders, warrant further exploration. The adverse effects of trazodone generally mirror its serotonergic activity and include sedation, headache, sweating, weight changes and gastrointestinal effects such as nausea and vomiting. Clinicians and patients should be cognizant of the risk for potential, but rare, cardiovascular adverse effects of trazodone. The safety and toxicology of trazodone should be examined under current standards of drug development before exposure to new patient populations. This article provides an overview of trazodone with a focus on its clinical pharmacology and opportunities, gaps and scientific strategies in developing it for new indications such as insomnia, anxiety disorders, chronic pain and frontal cognitive dysfunction. Modified release formulations, alternate forms of drug delivery and combination products are discussed as strategies to optimize the efficacy of trazodone and improve its safety profile.",0 +https://doi.org/10.1002/da.22048,PATTERNS OF LIFETIME PTSD COMORBIDITY: A LATENT CLASS ANALYSIS,"Posttraumatic stress disorder (PTSD) is associated with high rates of psychiatric comorbidity, most notably substance use disorders, major depression, and other anxiety disorders. However, little is known about how these disorders cluster together among people with PTSD, if disorder clusters have distinct etiologies in terms of trauma type, and if they confer greater burden over and above PTSD alone.Utilizing Latent Class Analysis, we tested for discrete patterns of lifetime comorbidity with PTSD following trauma exposure (n = 409). Diagnoses were based on the Structured Clinical Interview for DSM-IV (SCID). Next, we examined if gender, trauma type, symptom frequency, severity, and interference with everyday life were associated with the latent classes.Three patterns of lifetime comorbidity with PTSD emerged: a class characterized by predominantly comorbid mood and anxiety disorders; a class characterized by predominantly comorbid mood, anxiety, and substance dependence; and a relatively pure low-comorbidity PTSD class. Individuals in both high comorbid classes had nearly two and a half times the rates of suicidal ideation, endorsed more PTSD symptom severity, and demonstrated a greater likelihood of intimate partner abuse compared to the low comorbidity class. Men were most likely to fall into the substance dependent class.PTSD comorbidity clusters into a small number of common patterns. These patterns may represent an important area of study, as they confer distinct differences in risk and possibly etiology. Implications for research and treatment are discussed.",0 +https://doi.org/10.1017/s1461145713001090,Genetic approaches to understanding post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) is increasingly recognized as both a disorder of enormous mental health and societal burden, but also as an anxiety disorder that may be particularly understandable from a scientific perspective. Specifically, PTSD can be conceptualized as a disorder of fear and stress dysregulation, and the neural circuitry underlying these pathways in both animals and humans are becoming increasingly well understood. Furthermore, PTSD is the only disorder in psychiatry in which the initiating factor, the trauma exposure, can be identified. Thus, the pathophysiology of the fear and stress response underlying PTSD can be examined and potentially interrupted. Twin studies have shown that the development of PTSD following a trauma is heritable, and that genetic risk factors may account for up to 30-40% of this heritability. A current goal is to understand the gene pathways that are associated with PTSD, and how those genes act on the fear/stress circuitry to mediate risk vs. resilience for PTSD. This review will examine gene pathways that have recently been analysed, primarily through candidate gene studies (including neuroimaging studies of candidate genes), in addition to genome-wide associations and the epigenetic regulation of PTSD. Future and on-going studies are utilizing larger and collaborative cohorts to identify novel gene candidates through genome-wide association and other powerful genomic approaches. Identification of PTSD biological pathways strengthens the hope of progress in the mechanistic understanding of a model psychiatric disorder and allows for the development of targeted treatments and interventions.",0 +https://doi.org/10.1111/j.1465-3362.2011.00401.x,Exposure to dysfunctional parenting and trauma events and posttraumatic stress profiles among a treatment sample with coexisting depression and alcohol use problems,"Trauma exposure (including experiencing dysfunctional parenting when a child) and posttraumatic stress disorder (PTSD) frequently coexist with major depressive disorder (MDD) and alcohol use disorders (AUD), with the impact of this comorbidity usually studied as a dual disorder (i.e. PTSD-MDD or PTSD-AUD). This study explores trauma exposure (including to dysfunctional parenting), PTSD symptom severity and PTSD in people seeking treatment for coexisting depressive symptoms and alcohol use problems.Participants (n = 221) with current depression and alcohol use problems were recruited. Trauma exposure, PTSD symptoms and PTSD were assessed using the Posttraumatic Stress Diagnostic Scale. The Measure of Parenting Style assessed dysfunctional parenting (neglect/over-control/abuse) experienced as a child.Most participants experienced trauma (71.6%, n = 159), with more than one-third reaching DSM-IV criteria for current PTSD (38.0%, n = 84). Unique to this study was that there were no gender differences in rates of trauma exposure, number of traumatic events and PTSD. More severe PTSD symptoms and PTSD were associated with: childhood neglect; earlier depression onset; more severe depression and alcohol problems; and lower general functioning. More severe problems with alcohol were related to Intrusion and Avoidance symptoms, while severe alcohol dependence symptoms were related to hyperarousal.PTSD symptoms and PTSD are highly prevalent in those with coexisting depression and alcohol use problems and are associated with a history of childhood neglect and higher levels of comorbidity. Trauma, PTSD symptoms and PTSD should be assessed and addressed among people seeking treatment for coexisting depression and alcohol problems.",0 +https://doi.org/10.1080/08039480410006278,Does acute stress disorder predict post-traumatic stress disorder in traffic accident victims? Analysis of a self-report inventory,"The objective of this study was to account for acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) morbidity in a self-report survey of traffic accident victims and to evaluate the relationship between ASD and PTSD in this sample, and furthermore, to find both a model of independent variables accounting for variance in ASD and PTSD symptom level. Ninety patients, treated at an emergency ward after traffic accidents, participated in this longitudinal self-report survey. ASD was assessed using the Acute Stress Disorder Scale (ASDS) and PTSD was assessed at 6-8 months follow-up using the Posttraumatic Diagnostic Scale (PDS). Twenty-five patients (28%) met the cutoff scores for ASDS. Fifteen patients (17%) fulfilled criteria for PTSD according to the PDS. ASD was only able to predict 50% of patients who later developed high levels of PTSD symptomatology. A model of three variables explained 35% of the variance in ASD symptom level. Two variables explained 40% of the variance in PTSD symptom level. In both regression models, dissatisfaction with social support was associated with a higher symptom level. The results from this study reflect already voiced problems with the ASD diagnosis. The lack of precision in predicting who will develop PTSD is pronounced in this study. The acute traumatic symptom level explains a large part of the variance in PTSD symptom level. However, other variables also seem to play an important role. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1080/00273170903103308,Sequential Temporal Dependencies in Associations Between Symptoms of Depression and Posttraumatic Stress Disorder: An Application of Bivariate Latent Difference Score Structural Equation Modeling,"Depression and posttraumatic stress disorder (PTSD) are highly comorbid conditions that may arise following exposure to psychological trauma. This study examined their temporal sequencing and mutual influence using bivariate latent difference score structural equation modeling. Longitudinal data from 182 emergency room patients revealed level of depression symptom severity to be positively associated with changes in PTSD intrusion, avoidance, and hyperarousal over 3 time intervals, beginning shortly after the traumatic event. Higher scores on depression anticipated increases (or worsening) in PTSD symptom severity. The pattern of influence from PTSD symptom severity to change in depression symptom severity simply followed the general trend toward health and well-being. Results are discussed in terms of the dynamic interplay and associated mechanisms of posttrauma depression and PTSD symptom severity.",0 +https://doi.org/10.1016/j.ijdrr.2016.01.013,Social determinants of mid- to long-term disaster impacts on health: A systematic review,"Disasters cause a wide range of health impacts. Although there remains a need to understand and improve acute disaster management, a stronger understanding of how health is affected in the medium and longer term is also required to inform the design and delivery of measures to manage post-disaster health risks, and to guide actions taken before and during events which will also lead to reduction in health impact. Social determinants exert a powerful influence on different elements of risk, principally vulnerability, exposure and capacity, and thus, on people's health. As disaster health data and research has tended to focus on the short-term health impacts, no systematic assessment of the social determinants of the mid- to long-term health impacts of disasters has been identified. We assessed the chronic health impacts of disasters and explored the potential socioeconomic determinants of health impact through a systematic review. Our findings, based on 28 studies, highlighted that regardless of health outcomes and event types, the influence of disasters on chronic heath persists beyond the initial disaster period, affecting people's health for months to years. Using the World Health Organization's conceptual framework for the social determinants of health, we identified a total of 35 themes across the three conceptual domains (determinants related to the socioeconomic and political context, structural determinants, and intermediate determinants) as potentially influencing disaster impact. Investment to tackle modifiable underlying determinants could aid disaster risk management, improve medium and long-term health outcomes from disasters, and build community resilience.",0 +https://doi.org/10.1002/oby.21025,Post-traumatic stress disorder predicts future weight change in the Millennium Cohort Study,"Objective To prospectively examine the association between post-traumatic stress disorder (PTSD) and weight change. Methods Longitudinal analysis techniques were used to examine data (2001–2008) from Millennium Cohort Study participants, consisting of U.S. service members and veterans. Using the PTSD Checklist–Civilian Version, PTSD was assessed as none, resolved, new onset, or persistent. Subsequent weight change was assessed as stable (≤3% loss or gain), >3% weight loss, >3% but <10% weight gain, and ≥10% weight gain. Results Of the 38,352 participants, 2391 (6.2%) had PTSD (838 resolved, 1024 new onset, and 529 persistent), and 11% of participants subsequently had ≥10% weight gain. In multivariable models, PTSD was associated with higher odds of ≥10% weight gain (new onset OR: 1.44 [95% CI: 1.20–1.73]; persistent OR: 1.51 [CI: 1.17–1.96]; resolved OR: 1.30 [CI: 1.05–1.60]) compared with those without PTSD. New-onset and persistent PTSD were also associated with higher odds of >3% weight loss (OR: 1.41 [CI: 1.17–1.71]; OR: 1.42 [CI: 1.09–1.86], respectively). Conclusions PTSD is independently associated with a higher risk of weight gain and loss, the former of which leads to a higher prevalence of overweight and obesity and a higher risk of comorbidities associated with excessive body adiposity.",0 +https://doi.org/10.1001/jama.297.8.820,Cognitive Behavioral Therapy for Posttraumatic Stress Disorder in Women,"

Context

The prevalence of posttraumatic stress disorder (PTSD) is elevated among women who have served in the military, but no prior study has evaluated treatment for PTSD in this population. Prior research suggests that cognitive behavioral therapy is a particularly effective treatment for PTSD.

Objective

To compare prolonged exposure, a type of cognitive behavioral therapy, with present-centered therapy, a supportive intervention, for the treatment of PTSD.

Design, Setting, and Participants

A randomized controlled trial of female veterans (n=277) and active-duty personnel (n=7) with PTSD recruited from 9 VA medical centers, 2 VA readjustment counseling centers, and 1 military hospital from August 2002 through October 2005.

Intervention

Participants were randomly assigned to receive prolonged exposure (n = 141) or present-centered therapy (n = 143), delivered according to standard protocols in 10 weekly 90-minute sessions.

Main Outcome Measures

Posttraumatic stress disorder symptom severity was the primary outcome. Comorbid symptoms, functioning, and quality of life were secondary outcomes. Blinded assessors collected data before and after treatment and at 3- and 6-month follow-up.

Results

Women who received prolonged exposure experienced greater reduction of PTSD symptoms relative to women who received present-centered therapy (effect size, 0.27;P = .03). The prolonged exposure group was more likely than the present-centered therapy group to no longer meet PTSD diagnostic criteria (41.0% vs 27.8%; odds ratio, 1.80; 95% confidence interval, 1.10-2.96;P = .01) and achieve total remission (15.2% vs 6.9%; odds ratio, 2.43; 95% confidence interval, 1.10-5.37;P = .01). Effects were consistent over time in longitudinal analyses, although in cross-sectional analyses most differences occurred immediately after treatment.

Conclusions

Prolonged exposure is an effective treatment for PTSD in female veterans and active-duty military personnel. It is feasible to implement prolonged exposure across a range of clinical settings.

Trial Registration

clinicaltrials.gov Identifier:NCT00032617",0 +https://doi.org/10.3168/jds.s0022-0302(02)74228-8,Studies on Genetics of Heat Tolerance in Dairy Cattle with Reduced Weather Information via Cluster Analysis,"The objective of this study was to explore the possibility of reducing the number of weather stations for studies on genetics of heat tolerance in dairy cattle. The similarity of information from 21 Georgia weather stations was analyzed by cluster analysis. Two major clusters have been found, separating Georgia along the NE and SW line. One weather station was selected for each of the clusters based on the minimal distance to all the remaining weather stations and on completeness of the weather information. The production dataset consisted of 114,751 first-parity test-day records for milk on 14,297 Holsteins from 120 herds in Georgia. Analyses using a model for daily milk yield with temperature-humidity index classes and several other fixed effects showed no increase in error sum of squares when using only two weather stations. The threshold of heat stress was different for each of the two regions but the rate of decline after the threshold was similar. After accounting for different thresholds, the genetic component of heat tolerance for milk was higher with the two-station model. Genetic studies on or evaluation for heat tolerance based on information from a few carefully selected weather stations can be as accurate as those based on information from numerous such stations.",0 +https://doi.org/10.1093/jpepsy/jst085,An Introduction to Latent Variable Mixture Modeling (Part 2): Longitudinal Latent Class Growth Analysis and Growth Mixture Models,"Pediatric psychologists are often interested in finding patterns in heterogeneous longitudinal data. Latent variable mixture modeling is an emerging statistical approach that models such heterogeneity by classifying individuals into unobserved groupings (latent classes) with similar (more homogenous) patterns. The purpose of the second of a 2-article set is to offer a nontechnical introduction to longitudinal latent variable mixture modeling.3 latent variable approaches to modeling longitudinal data are reviewed and distinguished.Step-by-step pediatric psychology examples of latent growth curve modeling, latent class growth analysis, and growth mixture modeling are provided using the Early Childhood Longitudinal Study-Kindergarten Class of 1998-1999 data file.Latent variable mixture modeling is a technique that is useful to pediatric psychologists who wish to find groupings of individuals who share similar longitudinal data patterns to determine the extent to which these patterns may relate to variables of interest.",0 +https://doi.org/10.1080/15325024.2013.815055,Loneliness Trajectories: The Role of Posttraumatic Symptoms and Social Support,"This study prospectively examines the longitudinal course of loneliness, social support, and posttraumatic symptoms (PTS) among Israeli war veterans. Two groups of veterans with and without antecedent combat stress reaction (CSR) were assessed at three points of time during a 20-year period. Veterans with CSR reported higher levels of loneliness compared with veterans without CSR. Loneliness remained stable among veterans with CSR but decreased among veterans without CSR. Baseline level of social support predicted the trajectory of change in loneliness. Finally, higher levels of PTS and lower levels of social support were associated with more loneliness among veterans with CSR.",0 +https://doi.org/10.1176/appi.ajp.2007.06091491,Delayed-Onset Posttraumatic Stress Disorder: A Systematic Review of the Evidence,"Objective: Since the diagnosis of delayed-onset posttraumatic stress disorder (PTSD) was introduced in DSM-III, there has been controversy over its prevalence and even its existence. The authors sought to resolve discrepant findings concerning the prevalence of delayed-onset PTSD by conducting a systematic review of the evidence. Method: A literature search was conducted for case reports and group studies with adequate measurement of delayed-onset PTSD according to DSM criteria. Studies that met inclusion criteria were examined for the defined length of delay for delayed-onset PTSD, presence of symptoms before full diagnostic criteria were met, length of follow-up, prevalence estimates, and other variables. Studies were also examined for differences between immediate-onset PTSD, delayed-onset PTSD, and no-PTSD cases. Results: Ten case studies and 19 group studies met criteria for inclusion in the review. Studies consistently showed that delayed-onset PTSD in the absence of any prior symptoms was rare, whereas delayed onsets that represented exacerbations or reactivations of prior symptoms accounted on average for 38.2% and 15.3%, respectively, of military and civilian cases of PTSD. Conclusions: The discrepant findings in the literature concerning prevalence can be largely, but not completely, explained as being due to definitional issues. Little is known about what distinguishes the delayed-onset and immediate-onset forms of the disorder. Continuing scientific study of delayed-onset PTSD would benefit if future editions of DSM were to adopt a definition that explicitly accepts the likelihood of at least some prior symptoms.",0 +https://doi.org/10.1038/bjc.2012.284,Vinorelbine and gemcitabine vs vinorelbine and carboplatin as first-line treatment of advanced NSCLC. A phase III randomised controlled trial by the Norwegian Lung Cancer Study Group,"Platinum-based doublet chemotherapy is the standard first-line treatment for advanced non-small cell lung cancer (NSCLC), but earlier studies have suggested that non-platinum combinations are equally effective and better tolerated. We conducted a national, randomised study to compare a non-platinum with a platinum combination.Eligible patients had stage IIIB/IV NSCLC and performance status (PS) 0-2. Patients received up to three cycles of vinorelbine 60 mg m(-2) p.o.+gemcitabine 1000 mg m(-2) i.v. day 1 and 8 (VG) or vinorelbine 60 mg m(-2) p.o. day 1 and 8+carboplatin area under the curve=5 (Calvert's formula) i.v. day 1 (VC). Patients ≥75 years received 75% of the dose. Endpoints were overall survival, health-related quality of life (HRQoL), toxicity, and the use of radiotherapy.We randomised 444 patients from September 2007 to April 2009. The median age was 65 years, 58% were men and 25% had PS 2. Median survival was VG: 6.3 months; VC: 7.0 months, P=0.802. Vinorelbine plus carboplatin patients had more grade III/IV nausea/vomiting (VG: 4%, VC: 12%, P=0.008) and grade IV neutropenia (VG: 7%, VC: 19%, P<0.001). Infections, HRQoL and the use of radiotherapy did not differ significantly between the treatment groups.The two regimens yielded similar overall survival. The VG combination had only a slightly better toxicity profile.",0 +https://doi.org/10.1016/j.biopsych.2010.07.033,Sustained Elevation of Serum Interleukin-6 and Relative Insensitivity to Hydrocortisone Differentiates Posttraumatic Stress Disorder with and Without Depression,"

Background

Elevated levels of proinflammatory cytokines, especially interleukin-6 (IL-6), can mediate the greater risk for cardiovascular disease in individuals with posttraumatic stress disorder (PTSD), particularly in those with comorbid major depressive disorder (MDD). However, IL-6 levels are not consistently elevated in either PTSD or MDD. Although PTSD is associated with supersensitivity to glucocorticoids; prior studies have not evaluated the effect of comorbid MDD.

Methods

Serum IL-6 levels were measured hourly between 7:00 pm and 7:00 am in individuals with PTSD with comorbid MDD (PTSD + MDD) (n = 9) and compared with those with PTSD without MDD (PTSD − MDD) (n = 9) and nontraumatized healthy control subjects (n = 14). Group differences in serum IL-6, plasma adrenocorticotropic hormone (ACTH), and plasma cortisol response to 30 mg of intravenous hydrocortisone were evaluated using linear mixed models.

Results

Only subjects with PTSD + MDD exhibited higher, overnight serum IL-6 levels compared with individuals with PTSD − MDD (p < .01) and healthy control subjects (p < .001). Peak overnight IL-6 levels positively correlated with severity of PTSD (r = .56, p < .01) and depressive symptoms (r = .54, p < .01). Hydrocortisone administration significantly reduced IL-6 levels in both PTSD groups; however, IL-6 levels in PTSD + MDD were higher than both PTSD − MDD (p < .05) and healthy control subjects (p < .01). Following hydrocortisone administration, there was a greater reduction in levels of ACTH in PTSD − MDD compared with control subjects (p < .01).

Conclusions

Sustained elevations of overnight IL-6 levels and relatively decreased sensitivity to hydrocortisone distinguish PTSD + MDD from PTSD − MDD. Novel strategies that decrease IL-6 levels offer a new direction in the prevention and treatment of PTSD and associated comorbid medical illnesses.",0 +https://doi.org/10.1111/j.1440-1819.2010.02087.x,A three-year follow-up study of the psychosocial predictors of delayed and unresolved post-traumatic stress disorder in Taiwan Chi-Chi earthquake survivors,"To predict the longitudinal course of post-traumatic stress disorder (PTSD) in survivors three years following a catastrophic earthquake using multivariate data presented six months after the earthquake.Trained assistants and psychiatrists used the Disaster-related Psychological Screening Test (DRPST) to interview earthquake survivors 16 years and older and to assess current and incidental psychopathology. A total of 1756 respondents were surveyed over the three-year follow-up period.A total of 38 (9.1%) of the original 418 PTSD subjects and 40 of the original 1338 (3.0%) non-PTSD subjects were identified as having PTSD at the 3-year post-earthquake follow up. Younger age, significant financial loss, and memory/attention impairment were predictive factors of unresolved PTSD and delayed PTSD.The longitudinal course of PTSD three years after the earthquake could be predicted as early as six months after the earthquake on the basis of demographic data, PTSD-related factors, and putative factors for PTSD.",0 +https://doi.org/10.1177/070674371305801204,Distinctive Trajectory Groups of Mental Health Functioning among Assertive Community Treatment Clients: An Application of Growth Mixture Modelling Analysis,"Objective: Assertive community treatment (ACT) studies that have used conventional, statistical growth modelling methods have not examined different trajectories of outcomes or covariates that could influence different trajectories, even though heterogeneity in outcomes has been established in other research on severe mental illness. The purpose of our study was to examine the general trend in mental health functioning of ACT clients over a 2-year follow-up time period, to discover groups of ACT clients with distinctive longitudinal trajectories of mental health functioning, and to examine if some of the key sociodemographic and illness-related factors influence group membership. Method: A 2-year, prospective, within-subjects study of 216 ACT clients within southern Ontario, collected functional outcome data at baseline and 12 and 24 months using the Colorado Client Assessment Record. Baseline covariates included sex, primary diagnosis, number of comorbidities, hospitalization history, and duration of illness. Growth mixture modelling (GMM) was used to examine trajectories. Results: Clinical staff assessments of ACT clients showed a statistically significant improvement in functioning and 84% achieved successful community tenure. GMM analysis identified 2 classes of ACT clients: class 1 (79.63% of clients) experienced lower and stable overall functioning, and class 2 (20.37%) showed a better baseline functioning score and improvement in the overall functioning over time. Class membership was predicted by the number of comorbidities and diagnosis. Conclusions: Our study suggests general stability in overall functioning for the sampled ACT clients over 2 years, but significant heterogeneity in trajectories of functioning.",0 +,Heterogeneity of posttraumatic stress disorder symptoms in Croatian war veterans: retrospective study.,"To determine the relationship between the intensity of combat-related posttraumatic stress disorder (PTSD) and the intensity of predominating symptoms.The study included 151 veterans from 1992-1995 war in Croatia (aged 38.3+/-7.3 years) with PTSD. The veterans were psychologically tested with the Mississippi Scale for Combat-related PTSD (M-PTSD), Questionnaire on Traumatic Combat and War Experiences (USTBI-M), and Minnesota Multiphasic Personality Inventory-version 201 (MMPI-201).The discriminative analysis of the data revealed that the group with lower PTSD intensity had the highest scores on MMPI scales D (depression, T-score 98.3+/-5.6), Hs (hypochondriasis, 90.1+/-5.1), and Hy (hysteria, 89.5+/-4.9), whereas the group with higher PTSD intensity, besides these three scales (D=95.7+/-5.3; Hs=87.6+/-4.3; Hy=85.6+/-4.7), also had clinically significantly elevated Pt (psychastenia, 80.6+/-5.6), Sc (schizophrenia, 79.6+/-4.8), and Pa (paranoia, 85.6+/-5.4) scales, with the highest Pa scale.It was possible to differentiate study participants with different PTSD intensity on the basis of their MMPI profile. More intense PTSD was associated with externalized symptoms, such as aggression, acting-out, hostility, and mistrust, whereas less intensive PTSD was associated with mostly depressive symptoms. Our study showed that different intensity of PTSD has different symptom patterns.",0 +https://doi.org/10.1016/s0140-6736(14)61260-5,Battle for the mind: World War 1 and the birth of military psychiatry,"

Summary

The 100th anniversary of the outbreak of World War 1 could be viewed as a tempting opportunity to acknowledge the origins of military psychiatry and the start of a journey from psychological ignorance to enlightenment. However, the psychiatric legacy of the war is ambiguous. During World War 1, a new disorder (shellshock) and a new treatment (forward psychiatry) were introduced, but the former should not be thought of as the first recognition of what is now called post-traumatic stress disorder and the latter did not offer the solution to the management of psychiatric casualties, as was subsequently claimed. For this Series paper, we researched contemporary publications, classified military reports, and casualty returns to reassess the conventional narrative about the effect of shellshock on psychiatric practice. We conclude that the expression of distress by soldiers was culturally mediated and that patients with postcombat syndromes presented with symptom clusters and causal interpretations that engaged the attention of doctors but also resonated with popular health concerns. Likewise, claims for the efficacy of forward psychiatry were inflated. The vigorous debates that arose in response to controversy about the nature of psychiatric disorders and the discussions about how these disorders should be managed remain relevant to the trauma experienced by military personnel who have served in Iraq and Afghanistan. The psychiatric history of World War 1 should be thought of as an opportunity for commemoration and in terms of its contemporary relevance—not as an opportunity for self-congratulation.",0 +https://doi.org/10.1186/1471-2474-14-361,The clinical course over the first year of Whiplash Associated Disorders (WAD): pain-related disability predicts outcome in a mildly affected sample,"Different recovery patterns are reported for those befallen a whip-lash injury, but little is known about the variability within subgroups. The aims were (1) to compare a self-selected mildly affected sample (MILD) with a self-selected moderately to severely affected sample (MOD/SEV) with regard to background characteristics and pain-related disability, pain intensity, functional self-efficacy, fear of movement/(re)injury, pain catastrophising, post-traumatic stress symptoms in the acute stage (at baseline), (2) to study the development over the first year after the accident for the above listed clinical variables in the MILD sample, and (3) to study the validity of a prediction model including baseline levels of clinical variables on pain-related disability one year after baseline assessments.The study had a prospective and correlative design. Ninety-eight participants were consecutively selected. Inclusion criteria; age 18 to 65 years, WAD grade I-II, Swedish language skills, and subjective report of not being in need of treatment due to mild symptoms. A multivariate linear regression model was applied for the prediction analysis.The MILD sample was less affected in all study variables compared to the MOD/SEV sample. Pain-related disability, pain catastrophising, and post-traumatic stress symptoms decreased over the first year after the accident, whereas functional self-efficacy and fear of movement/(re)injury increased. Pain intensity was stable. Pain-related disability at baseline emerged as the only statistically significant predictor of pain-related disability one year after the accident (Adj r² = 0.67).A good prognosis over the first year is expected for the majority of individuals with WAD grade I or II who decline treatment due to mild symptoms. The prediction model was not valid in the MILD sample except for the contribution of pain-related disability. An implication is that early observations of individuals with elevated levels of pain-related disability are warranted, although they may decline treatment.",0 +https://doi.org/10.1016/0010-440x(92)90052-r,Schneiderian symptoms and childhood trauma in the general population,"The Dissociative Disorders Interview Schedule (DDIS) was administered to a sample of 502 adults in the city of Winnipeg, Manitoba, Canada. Findings indicate that Schneiderian symptoms are highly related to childhood trauma and other dissociative symptoms clusters in the general population, as they are in clinical populations. Implications of the findings are discussed.",0 +https://doi.org/10.1002/ajim.20894,Longitudinal study of probable post-traumatic stress disorder in firefighters exposed to the World Trade Center disaster,"Symptoms of post-traumatic stress disorder (PTSD) have been reported even years after the terrorist attacks of September 11, 2001 (9/11).We used screening tools to assess the prevalence of probable PTSD in 9/11-exposed firefighters at two time points, within 6 months of 9/11 (baseline) and 3-4 years post-disaster (follow-up).Five thousand six hundred fifty-six individuals completed assessments at both times. 15.5% reported probable PTSD post-9/11, 8.6% at baseline and 11.1% at follow-up, on average 2.9 (SD 0.5) years later. Analyses revealed that nearly half of all probable PTSD occurred as delayed onset (absent baseline, present follow-up). Compared with the resilient group (no probable PTSD at either time), probable PTSD at baseline, and delayed onset at follow-up were each associated with concomitant functional impairment (OR 19.5 and 18.9), respectively.Similar percentages of firefighters met criteria for baseline and delayed onset probable PTSD at follow-up, years later. Both were associated with substantial functional impairment. Early risk identification could provide opportunities for mental health interventions before symptoms compromise work and social relationships.",0 +https://doi.org/10.1016/j.jclinepi.2012.05.012,Research on injury compensation and health outcomes: ignoring the problem of reverse causality led to a biased conclusion,"This study highlights the serious consequences of ignoring reverse causality bias in studies on compensation-related factors and health outcomes and demonstrates a technique for resolving this problem of observational data.Data from an English longitudinal study on factors, including claims for compensation, associated with recovery from neck pain (whiplash) after rear-end collisions are used to demonstrate the potential for reverse causality bias. Although it is commonly believed that claiming compensation leads to worse recovery, it is also possible that poor recovery may lead to compensation claims--a point that is seldom considered and never addressed empirically. This pedagogical study compares the association between compensation claiming and recovery when reverse causality bias is ignored and when it is addressed, controlling for the same observable factors.When reverse causality is ignored, claimants appear to have a worse recovery than nonclaimants; however, when reverse causality bias is addressed, claiming compensation appears to have a beneficial effect on recovery, ceteris paribus.To avert biased policy and judicial decisions that might inadvertently disadvantage people with compensable injuries, there is an urgent need for researchers to address reverse causality bias in studies on compensation-related factors and health.",0 +https://doi.org/10.1177/0886260515576967,"Victimization Profiles, Non-Suicidal Self-Injury, Suicide Attempt, and Post-Traumatic Stress Disorder Symptomology","Few studies have incorporated multiple dimensions of victimization or examined whether victimization profiles differ by gender. Consequently, the present study sought to extend prior research by using latent class analysis (LCA) to identify naturally occurring subgroups of individuals who have experienced victimization, and to test for sex differences. Data from 4,016 females and 3,032 males in the Adult Psychiatric Morbidity Survey (APMS) were analyzed. Evidence of the existence of similar victimization subtypes for both males and females emerged, with a three-class solution providing the best fit to the data for both sexes. Furthermore, the classes were labeled “low victimization” (the baseline class; Class 3), the “high victimization class” (Class 1), and “the bullying and domestic violence class” (Class 2) for both males and females. Multinomial logistic regression was used to interpret the nature of the latent classes, or groups, by estimating the associations with post-traumatic stress disorder (PTSD) dimensions, suicide attempt, and non-suicidal self-injury. Although different constellations of victimization experiences did not emerge through the gender-specific analyses, the nature of the associations between class membership and external variables differed between males and females. Findings highlight the heterogeneity of victimization experiences and their relations to functioning, and have implications for policy and practice implications.",0 +https://doi.org/10.17761/1531-2054-25.1.89,Efficacy of a Satyananda Yoga Intervention for Reintegrating Adults Diagnosed with Posttraumatic Stress Disorder,"The prevalence of posttraumatic stress disorder (PTSD) in ex-combatants from illegal armed groups in Colombia has been estimated at 37.4%. This high prevalence indicates a need to explore alternative and adjunctive therapies in the treatment of PTSD. A randomized controlled trial was undertaken to evaluate the efficacy and safety of a protocol based on Satyananda Yoga® in PTSD-diagnosed reintegrating adults in Colombia. One hundred reintegrating adults (n = 50 for each of the yoga and control arms) from Bogota and Medellin participated in this study. Yoga participants engaged in a Satyananda Yoga intervention for 16 weeks while the control group continued the regular demobilization program. The Posttraumatic Stress Disorder Checklist - Civilian Version (PCL-C) was used to evaluate the effects of the applied therapy. Outcomes were assessed before entry and after the treatment. T-tests revealed a treatment effect of d = 1.15 for the yoga group and a between-groups effect size of d = .73. The difference in improvement in PCL-C scores between both groups was 18.91% (p < 0.05). The highest percentage of improvement was observed in the re-experiencing symptom cluster (23.71%; p < 0.05), with a treatment effect of d = 1.40 for the yoga group and a between-groups effect size of d = 1.15. The data suggest that Satyananda Yoga methodology is an effective therapy for reintegrating adults diagnosed with PTSD. Further research is needed in order to evaluate prolonged effects of this alternative therapy.",0 +https://doi.org/10.1177/0886260507305569,Structural Validity of the Posttraumatic Stress Disorder Checklist Among College Students With a Trauma History,"The authors conducted confirmatory factor analyses to test three-factor and four-factor models of posttraumatic stress disorder (PTSD) using the PTSD Checklist with college students reporting a traumatic event history. The authors found support for the three-factor DSM-IV-based PTSD diagnostic model including reexperiencing, avoidance/numbing, and hyperarousal symptom factors, with slightly better support for a four-factor model separating the avoidance and numbing factors. Results further attest to the PTSD Checklist's construct validity, and to research finding that PTSD avoidance and numbing constructs are distinct.",0 +https://doi.org/10.1016/j.drugalcdep.2012.11.009,Mental disorders and smoking trajectories: A 10-year prospective study among adolescents and young adults in the community,"Numerous studies have documented an association between mental disorders and onset of cigarette smoking. Yet, there is little understanding of the potential impact of mental disorders on trajectories of smoking over time. The objective of this study was to investigate this relationship among adolescents over a 10-year span. Data were drawn from the Early Developmental Stages of Psychopathology Study, a 10-year prospective investigation of youth in Germany. Growth mixture modeling was used to identify smoking trajectories and logistic regression analyses were used to examine relationships between mental disorders and subsequent trajectories. Four trajectories were identified: non-users; increasing use; decreasing use; persistent use. Alcohol/drug use disorders, stress disorders, anxiety disorders, somatoform disorder and nicotine dependence were associated with nicotine use (as compared to the non-smoker class). However, comparisons between trajectories of nicotine use showed that any stress disorder predicted only decreasing use compared to the other two trajectories; nicotine dependence, alcohol/illicit drug use disorders as well as panic disorder and somatoform disorders were inversely associated with increasing use; nicotine dependence and alcohol/drug use disorders were associated with persistent use. Several mental disorders appear to be non-specific markers of the range of smoking trajectories while others predict specific trajectories. Numerous disorders (e.g., alcohol/drug use disorders) do not appear to occur only prior to and predict increased smoking trajectory as had been previously suggested, but rather they also occur concurrently, with high levels of smoking and in some cases smoking persists at a steady level over time.",0 +https://doi.org/10.1097/00008480-199908000-00008,Posttraumatic stress disorders in children and adolescents,"Millions of children are exposed to traumatic experiences each year. Over 30% of these children develop a clinical syndrome with emotional, behavioral, cognitive, social, and physical symptoms called posttraumatic stress disorder. The symptoms of posttraumatic stress disorder fall into three clusters: reenactment of the traumatic event: avoidance of cues associated with the event or general withdrawal; and physiological hyperreactivity. Significant physical and medical problems in childhood, adolescence, and adulthood appear to be related to childhood trauma. Current treatment approaches include postacute psychoeducation, individual psychotherapy, pharmacotherapy, and cognitive-behavioral therapy. Despite increasing attention over the past 10 years, childhood posttraumatic stress disorder remains an understudied public health problem.",0 +https://doi.org/10.1289/ehp.9592,The World Trade Center Disaster and the Health of Workers: Five-Year Assessment of a Unique Medical Screening Program,"Approximately 40,000 rescue and recovery workers were exposed to caustic dust and toxic pollutants following the 11 September 2001 attacks on the World Trade Center (WTC). These workers included traditional first responders, such as firefighters and police, and a diverse population of construction, utility, and public sector workers.To characterize WTCrelated health effects, the WTC Worker and Volunteer Medical Screening Program was established. This multicenter clinical program provides free standardized examinations to responders. Examinations include medical, mental health, and exposure assessment questionnaires; physical examinations; spirometry; and chest X rays.Of 9,442 responders examined between July 2002 and April 2004, 69% reported new or worsened respiratory symptoms while performing WTC work. Symptoms persisted to the time of examination in 59% of these workers. Among those who had been asymptomatic before September 11, 61% developed respiratory symptoms while performing WTC work. Twenty-eight percent had abnormal spirometry; forced vital capacity (FVC) was low in 21%; and obstruction was present in 5%. Among nonsmokers, 27% had abnormal spirometry compared with 13% in the general U.S. population. Prevalence of low FVC among nonsmokers was 5-fold greater than in the U.S. population (20% vs. 4%). Respiratory symptoms and spirometry abnormalities were significantly associated with early arrival at the site.WTC responders had exposure-related increases in respiratory symptoms and pulmonary function test abnormalities that persisted up to 2.5 years after the attacks. Longterm medical monitoring is required to track persistence of these abnormalities and identify late effects, including possible malignancies. Lessons learned should guide future responses to civil disasters.",0 +https://doi.org/10.1186/1747-5341-3-20,Ethical challenges with the left ventricular assist device as a destination therapy,"The left ventricular assist device was originally designed to be surgically implanted as a bridge to transplantation for patients with chronic end-stage heart failure. On the basis of the REMATCH trial, the US Food and Drug Administration and the US Centers for Medicare & Medicaid Services approved permanent implantation of the left ventricular assist device as a destination therapy in Medicare beneficiaries who are not candidates for heart transplantation. The use of the left ventricular assist device as a destination therapy raises certain ethical challenges. Left ventricular assist devices can prolong the survival of average recipients compared with optimal medical management of chronic end-stage heart failure. However, the overall quality of life can be adversely affected in some recipients because of serious infections, neurologic complications, and device malfunction. Left ventricular assist devices alter end-of-life trajectories. The caregivers of recipients may experience significant burden (e.g., poor physical health, depression, anxiety, and posttraumatic stress disorder) from destination therapy with left ventricular assist devices. There are also social and financial ramifications for recipients and their families. We advocate early utilization of a palliative care approach and outline prerequisite conditions so that consenting for the use of a left ventricular assist device as a destination therapy is a well informed process. These conditions include: (1) direct participation of a multidisciplinary care team, including palliative care specialists, (2) a concise plan of care for anticipated device-related complications, (3) careful surveillance and counseling for caregiver burden, (4) advance-care planning for anticipated end-of-life trajectories and timing of device deactivation, and (5) a plan to address the long-term financial burden on patients, families, and caregivers.Short-term mechanical circulatory devices (e.g. percutaneous cardiopulmonary bypass, percutaneous ventricular assist devices, etc.) can be initiated in emergency situations as a bridge to permanent implantation of ventricular assist devices in chronic end-stage heart failure. In the absence of first-person (patient) consent, presumed consent or surrogate consent should be used cautiously for the initiation of short-term mechanical circulatory devices in emergency situations as a bridge to permanent implantation of left ventricular assist devices. Future clinical studies of destination therapy with left ventricular assist devices should include measures of recipients' quality of end-of-life care and caregivers' burden.",0 +https://doi.org/10.1176/jnp.10.3.308,Findings of Mild Traumatic Brain Injury in Combat Veterans With PTSD and a History of Blast Concussion,"Veterans with chronic posttraumatic stress disorder were evaluated for a history of blast concussion, controlling for confounding conditions. Electroencephalograms were analyzed by discriminant function for traumatic brain injury. A difference was found in discriminant scores between veterans with and without blast concussion. More members of the blast group had attentional symptoms and attentional dysfunction. Combat veterans with a remote history of blast injury have persistent electroencephalographic features of traumatic brain injury as well as attentional problems. The authors hypothesize that these constitute a type of chronic postconcussive syndrome that has cognitive and mood symptoms overlapping those of posttraumatic stress disorder.",0 +https://doi.org/10.1016/j.bbr.2004.01.004,Aged neuropeptide Y transgenic rats are resistant to acute stress but maintain spatial and non-spatial learning,"The behavioral phenotype of five-month-old rats overexpressing neuropeptide Y (NPY) has previously been described [Proc Natl Acad Sci USA 97 (2000) 12852]. In this transgenic rat model, there is central overexpression of prepro-NPY mRNA and NPY peptide in the hippocampus and hypothalamus and decreased Y1 binding sites within the hippocampus. These molecular and neurochemical events led to altered anxiety profile and learning abilities in NPY-overexpressing rats. In the present study, anxiety and learning/memory related behaviors were examined in one-year-old NPY-transgenic rats in order to assess any behavioral changes that may have occurred during the aging process. As observed in 5-month-old overexpressing rats, aged NPY-transgenic animals are resistant to acute physical restraint stress measured by the elevated-plus maze and demonstrate anxiolytic-like activity in the open field. However, in contrast to data in young rats, there was no significant difference between aged wildtype and NPY-transgenic animals in relation to spatial and non-spatial memory as indicated by the (allo- and ego-centric) Morris water maze and object recognition test. It would thus appear that the anxiolytic-like profile observed in young NPY-overexpressing rats is maintained in older animals providing further evidence for a role for NPY in anxious behaviors. However, the cognitive deficits observed in young rats do not appear to occur in older animals suggesting the existence of compensatory mechanisms leading to a reversal of the learning deficits noted in younger animals. These results also provide additional evidence for the mechanistic dissociation between anxiety and cognition-related behaviors modulated by NPY.",0 +https://doi.org/10.1375/brim.2005.6.3.169,A Randomised Controlled Trial of a Cognitive-Behavioural Therapy Program for Managing Social Anxiety After Acquired Brain Injury,"Abstract Despite the prevalence of psychiatric illness in people with acquired brain injury (ABI), there are very few empirically validated studies examining the efficacy of treatments targeting commonly occurring disorders such as depression and anxiety. Using a randomised controlled trial, this study evaluated the efficacy of a cognitive behavioural intervention specifically designed for managing social anxiety following ABI. Twelve brain-injured participants were screened, randomly allocated to either treatment group (TG) or a wait list group (WLG), and proceeded through to the final stages of therapy. The TG received between 9 and 14 hourly, individual sessions of cognitive behavioural therapy. Repeated measures analyses revealed significant improvements in general anxiety, depression and a transient mood measure, tension-anxiety, for the TG when compared to the WLG at posttreatment. These treatment gains were maintained at one-month follow-up. Although in the predicted direction, postintervention improvements in social anxiety and self-esteem for the TG were not significant in comparison with the WLG. This study lends support to the small body of literature highlighting the potential of cognitive behavioural interventions for managing the psychological problems that serve as a barrier to rehabilitation following ABI.",0 +https://doi.org/10.1016/j.janxdis.2007.02.007,The Impact of Event Scale-Revised: Psychometric properties in a sample of motor vehicle accident survivors,"This study examined the factor structure, internal consistency, concurrent validity, and discriminative validity of the Impact of Event Scale-Revised (IES-R, [Weiss, D. S. & Marmar, C. R. (1997). The Impact of Event Scale-Revised. In: J. P. Wilson & T. M. Keane (Eds.). Assessing psychological trauma and PTSD (pp. 399-411). New York: Guilford Press]) in a sample of 182 individuals who had experienced a serious motor vehicle accident. Results supported the three-factor structure of the IES-R, Intrusion, Avoidance, and Hyperarousal, with adequate internal consistency noted for each subscale. Support was obtained for the concurrent and discriminative validity, as well as the absence of social desirability effects. Although some differences were noted between the IES-R Avoidance subscale and diagnostically based measures of this cluster of symptoms, these differences do not necessarily signify measurement problems with the IES-R. The IES-R seems to be a solid measure of post-trauma phenomena that can augment related assessment approaches in clinical and research settings.",0 +https://doi.org/10.1080/10538712.2013.741666,Identification of sexually abused female adolescents at risk for suicidal ideations: a classification and regression tree analysis.,"This study explored the clinical profiles of 77 female teenager survivors of sexual abuse and examined the association of abuse-related and personal variables with suicidal ideations. Analyses revealed that 64% of participants experienced suicidal ideations. Findings from classification and regression tree analysis indicated that depression, posttraumatic stress symptoms, and hopelessness discriminated profiles of suicidal and nonsuicidal survivors. The elevated prevalence of suicidal ideations among adolescent survivors of sexual abuse underscores the importance of investigating the presence of suicidal ideations in sexual abuse survivors. However, suicidal ideation is not the sole variable that needs to be investigated; depression, hopelessness and posttraumatic stress symptoms are also related to suicidal ideations in survivors and could therefore guide interventions.",0 +https://doi.org/10.1093/jpepsy/jsh022,Posttraumatic Stress Disorder (PTSD) and Posttraumatic Stress Symptoms (PTSS) in Families of Adolescent Childhood Cancer Survivors,"To describe rates and concordance of posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSS) in adolescent childhood cancer survivors and their mothers and fathers.Participants were 150 adolescent survivors of childhood cancer, 146 mothers, and 103 fathers who completed the Impact of Events Scale-Revised, the Posttraumatic Stress Disorder Reaction Index, and the PTSD module of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition.PTSS are common in families of childhood cancer survivors. Parents reported more symptomatology than former patients. Mothers and fathers had relatively equal rates of current PTSD and levels of PTSS. Nearly 30% of mothers met diagnostic criteria since their child's diagnosis, with 13.7% currently experiencing PTSD. Nearly 20% of families had at least one parent with current PTSD. Ninety-nine percent of the sample had at least one family member reexperiencing symptoms.Both PTSD and PTSS help in understanding the experience of adolescent cancer survivors and their families. Within families of childhood cancer survivors, it is likely that some member may be experiencing treatable bothersome memories, arousal, or avoidance specific to the cancer experience.",0 +https://doi.org/10.1002/pon.3334,Trajectories of caregiver depressive symptoms while providing end-of-life care,"The course of caregivers' depressive symptoms may not be homogenous. This study identified trajectories of depressive symptoms among caregivers providing end-of-life care to cancer patients and profiled the unique characteristics of caregivers within each trajectory.Trajectories of depressive symptoms were explored in 447 caregivers who completed the Center for Epidemiological Studies Depression Scale over four periods close to the patient's death (1-30, 31-90, 91-180, and >180 days). Distinct trajectories were identified by latent class analysis.Four trajectories were identified as endurance, resilience, moderately symptomatic, and chronically distressed and contained 32.0%, 11.4%, 36.9%, and 19.7% of the sample, respectively. Caregivers in the endurance trajectory were relatively well-adjusted individuals with less education, adequate financial support, and ample psychological resources but provided care to older patients with greater symptom distress. They perceived less subjective caregiving burden than caregivers with moderate or chronic depressive symptoms. Caregivers in the resilience trajectory were in a more vulnerable position than those in other trajectories when they first transitioned into the caregiving role because they were more likely to be the patient's spouse, have greater educational attainment and insufficient finances, provide higher intensity assistance to a younger relative, and have weaker psychological resources. However, they were older, reported greater confidence in caregiving, and perceived less caregiving burden than caregivers in other trajectories. The moderately symptomatic and chronically distressed trajectories were differentiated only by the strength of psychological resources.Caregivers of terminally ill cancer patients follow distinct depressive-symptom trajectories while providing end-of-life care.",0 +https://doi.org/10.1186/1741-7015-4-14,"Superior efficacy of St John's wort extract WS®5570 compared to placebo in patients with major depression: a randomized, double-blind, placebo-controlled, multi-center trial [ISRCTN77277298]","The aim of the current study was to assess the antidepressant efficacy and safety of Hypericum perforatum (St. John's wort) extract WS 5570 at doses of 600 mg/day in a single dose and 1200 mg/day in two doses.The participants in this double-blind, randomized, placebo-controlled, multi-center clinical trial were male and female adult out-patients with an episode of mild or moderate major depressive episode (single or recurrent episode, DSM-IV criteria). As specified by the relevant guideline, the study was preceded by a medication-free run-in phase. For the 6-week treatment, 332 patients were randomized: 123 to WS 5570 600 mg/day, 127 to WS 5570 1200 mg/day, and 82 to placebo. The primary outcome measure was the change in total score on the Hamilton Rating Scale for Depression (HAM-D, 17-item version) between baseline and endpoint. Additional measures included the number of responders, the number of patients in remission, and several other standard rating scales. Efficacy and safety were assessed after 2 and 6 weeks. The design included an interim analysis performed after randomization with the option of early termination.After 6 weeks of treatment, mean +/- standard deviation decreases in HAM-D total scores of 11.6 +/- 6.4, 10.8 +/- 7.3, and 6.0 +/- 8.1 points were observed for the WS 5570 600 mg/day, 1200 mg/day and placebo groups, respectively (endpoint analysis). Secondary measures of treatment efficacy also showed that both WS 5570 groups were statistically superior to placebo. Significantly more patients in the WS 5570 treatment groups than in the placebo group showed treatment response and remission. WS 5570 was consistently more effective than placebo in patients with either less severe or more severe baseline impairment. The number of patients who experienced remission was higher in the WS 5570 1200 mg/day group than the WS 5570 600 mg/day group. The incidence of adverse events was low in all groups. The adverse event profile was consistent with the known profile for Hypericum extract preparations.Hypericum perforatum extract WS 5570 at doses of 600 mg/day (once daily) and 1200 mg/day (600 mg twice daily) were found to be safe and more effective than placebo, with comparable efficacy of the WS 5570 groups for the treatment of mild to moderate major depression.",0 +https://doi.org/10.1001/jama.286.5.555,Lifetime Events and Posttraumatic Stress Disorder in 4 Postconflict Settings,"Little is known about the impact of trauma in postconflict, low-income countries where people have survived multiple traumatic experiences.To establish the prevalence rates of and risk factors for posttraumatic stress disorder (PTSD) in 4 postconflict, low-income countries.Epidemiological survey conducted between 1997 and 1999 among survivors of war or mass violence (aged >/=16 years) who were randomly selected from community populations in Algeria (n = 653), Cambodia (n = 610), Ethiopia (n = 1200), and Gaza (n = 585).Prevalence rates of PTSD, assessed using the PTSD module of the Composite International Diagnostic Interview version 2.1 and evaluated in relation to traumatic events, assessed using an adapted version of the Life Events and Social History Questionnaire.The prevalence rate of assessed PTSD was 37.4% in Algeria, 28.4% in Cambodia, 15.8% in Ethiopia, and 17.8% in Gaza. Conflict-related trauma after age 12 years was the only risk factor for PTSD that was present in all 4 samples. Torture was a risk factor in all samples except Cambodia. Psychiatric history and current illness were risk factors in Cambodia (adjusted odds ratio [OR], 3.6; 95% confidence interval [CI], 2.3-5.4 and adjusted OR,1.6; 95% CI, 1.0-2.7, respectively) and Ethiopia (adjusted OR, 3.9; 95% CI, 2.0-7.4 and adjusted OR, 1.8; 95% CI, 1.1-2.7, respectively). Poor quality of camp was associated with PTSD in Algeria (adjusted OR, 1.8; 95% CI, 1.3-2.5) and in Gaza (adjusted OR, 1.7; 95% CI, 1.1-2.8). Daily hassles were associated with PTSD in Algeria (adjusted OR, 1.6; 95% CI, 1.1-2.4). Youth domestic stress, death or separation in the family, and alcohol abuse in parents were associated with PTSD in Cambodia (adjusted OR, 1.7; 95% CI, 1.1-2.6; adjusted OR, 1.7; 95% CI, 1.0-2.8; and adjusted OR, 2.2; 95% CI, 1.1-4.4, respectively).Using the same assessment methods, a wide range of rates of symptoms of PTSD were found among 4 low-income populations who have experienced war, conflict, or mass violence. We identified specific patterns of risk factors per country. Our findings indicate the importance of contextual differences in the study of traumatic stress and human rights violations.",0 +https://doi.org/10.1093/jpepsy/jsq113,The Impact of Caregiver Distress on the Longitudinal Development of Child Acute Post-traumatic Stress Disorder Symptoms in Pediatric Injury Victims,The present study prospectively examined the development of child PTSD symptoms (PTSS) and the impact of caregiver PTSS on child PTSS following injury.One hundred and eighteen ED patients and their caregivers were interviewed in-hospital and 2- and 6-weeks posttrauma. Structural equation modeling and hierarchical linear regressions examined the development of PTSS.A model combining child and caregiver 2-week PTSS into one latent family PTSS variable provided the best fit to the data. Child in-hospital avoidance symptoms predicted higher levels of 2-week family PTSS. Two-week family PTSS predicted child 6-week PTSS. Post hoc analyses revealed an interaction between in-hospital caregiver avoidance symptoms and child reexperiencing symptoms in predicting 6-week child PTSS.Results highlight the dynamic development of child PTSS. Different symptom clusters may be related to higher PTSS at differing times posttrauma and may inform the development of time-sensitive methods of assessment and intervention for injury victims.,0 +https://doi.org/10.1002/jts.20592,Course of posttraumatic stress symptoms over the 5 years following an industrial disaster: A structural equation modeling study,"The present study examined individual latent changes in posttraumatic stress disorder (PTSD) symptoms over a 60-month period after an industrial disaster. Participants were recruited from survivors of a factory explosion. Participants were assessed retrospectively for peritraumatic reactions and acute stress symptoms. Posttraumatic stress disorder symptoms were then assessed at 6, 15, and 60 months. Using structural equation modeling, the authors tested 3 hypotheses of individual latent change: stability of PTSD symptoms between 6, 15, and 60 months; change between 6 and 15 months; and change between 15 and 60 months. Only one model provided a good fit suggesting that PTSD symptoms evolved between 6 and 15 months after trauma exposure and remained stable at the individual level thereafter.",0 +https://doi.org/10.1002/jnr.23641,Examining the relationship between blast-induced mild traumatic brain injury and posttraumatic stress-related traits,"Emerging evidence suggests that mild traumatic brain injury (mTBI) resulting from blast exposure may contribute to the occurrence of posttraumatic stress disorder (PTSD) and related affective sequelae, such as anxiety and depression. Many studies have used survey techniques to describe blast exposure leading to comorbid mTBI and related persistent postconcussive symptoms (PPCS) with PTSD in military populations. Despite this, there is a lack of literature that examines possible biological mechanisms by which blast exposure contributes to the development of PTSD sequelae. This Mini-Review addresses the current literature on potential neurophysiological changes that may contribute to PTSD-like traits as a result of a single or multiple exposures to blast events. Evidence from clinical blast-induced mTBI populations and animal models of blast-induced mTBI was evaluated with an emphasis on behavioral and physiological symptoms similar to those seen in PTSD populations and models. From the analysis, we propose potential mechanisms that merit further investigation for better understanding of how blast exposures may produce a higher rate of comorbid PPCS, PTSD, and affective phenomena. An improved understanding of PTSD-like outcomes resulting from blast exposure will ultimately help facilitate the development of future treatments and contribute to a better understanding of PTSD sequelae that develop from physical trauma.",0 +https://doi.org/10.15288/jsad.2015.76.406,"Use of Prescription Pain Medications Among Medical Cannabis Patients: Comparisons of Pain Levels, Functioning, and Patterns of Alcohol and Other Drug Use","Management of chronic pain is one of the most common reasons given by individuals seeking medical cannabis. However, very little information exists about the concurrent use of cannabis and prescription pain medication (PPM). This study fills this gap in knowledge by systematically comparing medical cannabis users who use or do not use PPM, with an emphasis on understanding whether concurrent use of cannabis and PPM is associated with more serious forms of alcohol and other drug involvement.Data from this study were collected from a medical cannabis clinic in southwestern Michigan (N = 273). Systematic comparisons were made on measures of sociodemographics, reasons for substance use, pain, functioning, and perceptions of PPM and medical cannabis efficacy.PPM users tended to be older and reported higher levels of pain and lower levels of functioning. The overall sample exhibited higher lifetime and past-3-month rates of alcohol and other noncannabis drug use than did the general population. Approximately 40% of subjects reported combining cannabis with alcohol, but no significant difference was observed between PPM users and nonusers. PPM users and nonusers did not exhibit any difference in either lifetime or past-3-month use of other drugs, including cocaine, sedatives, street opioids, and amphetamines. PPM users rated the efficacy of cannabis higher than PPM for pain management and indicated a strong desire to reduce PPM usage.Use of PPM among medical cannabis users was not identified as a correlate for more serious forms of alcohol and other drug involvement. However, longitudinal study designs are needed to better understand the trajectories of alcohol and other drug involvement over time among medical cannabis users.",0 +https://doi.org/10.1007/978-1-4899-1034-9_3,An Integrative Two-Factor Model of Post-Traumatic Stress,"(from the book) provides [a] macroanalytic integrative construction of post-traumatic stress wherein posttraumatic stress disorder (PTSD) is viewed as an epiphenomenon / [builds] an integrative 2-factor model wherein biological factors are inextricably intertwined with psychological factors to explain the posttraumatic stress phenomenon, (from the chapter) [suggests] that PTSD is an epiphenomenon undergirded by a core 2-factor phenomenology consisting of (1) subcortical neurological hypersensitivity and (2) psychological hypersensitivity / the neurobiology of PTSD was posited to be a combination of amygdalar-hippocampus neural networks with numerous and varied efferent projections (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1080/02699931.2014.926861,Low emotional response to traumatic footage is associated with an absence of analogue flashbacks: An individual participant data meta-analysis of 16 trauma film paradigm experiments,"Most people will experience or witness a traumatic event. A common occurrence after trauma is the experience of involuntary emotional memories of the traumatic event, herewith ""flashbacks"". Some individuals, however, report no flashbacks. Prospective work investigating psychological factors associated with an absence of flashbacks is lacking. We performed an individual participant data meta-analysis on 16 experiments (n = 458) using the trauma film paradigm to investigate the association of emotional response to traumatic film footage and commonly collected baseline characteristics (trait anxiety, current depression, trauma history) with an absence of analogue flashbacks. An absence of analogue flashbacks was associated with low emotional response to the traumatic film footage and, to a lesser extent, low trait anxiety and low current depression levels. Trauma history and recognition memory for the film were not significantly associated with an absence of analogue flashbacks. Understanding why some individuals report an absence of flashbacks may aid preventative treatments against flashback development.",0 +https://doi.org/10.1002/jts.20128,Fear and avoidance of internal experiences among patients with substance use disorders and PTSD: The centrality of anxiety sensitivity*,"This study evaluated anxiety sensitivity, cognitive avoidance, and alexithymia and their relationship to posttraumatic stress disorder (PTSD) and alcohol use indices concurrently and prospectively in an outpatient substance abuse treatment sample that screened positive for PTSD (N=58). Anxiety sensitivity accounted for substantial variance in the PTSD clusters, reexperiencing, avoidance, and hyperarousal, both concurrently and prospectively. Cognitive avoidance accounted for additional variance with concurrent PTSD avoidance symptoms. Anxiety sensitivity and cognitive avoidance were largely not associated with alcohol use indices. Alexithymia was largely redundant with cognitive avoidance and was, therefore, not included in the regression analyses. Theoretical and treatment implications of these findings are discussed in the context of individuals with dually diagnosed PTSD and substance abuse disorders.",0 +,Directions in Disaster Resilience Policy,"Currently, a range of common terms are being used differently within government and the emergency management community. This paper provides a foundation for an understanding of the term 'resilience' so that constructive discussion can emerge amongst those involved in disaster management policy and practice. In doing so, we provide a short review of how the term can be used differently within policy, as well as how it has come to be influential in emergency management policy.",0 +https://doi.org/10.1096/fasebj.27.1_supplement.569.1,Correlation between Genotypes and Behavioral Phenotypes in a Mouse Model simulating aspects of Human Post‐traumatic Stress Disorder (PTSD),"Biologically meaningful correlations between behavioral phenotypes and genotypes are evaluated in a modified ‘residentintruder’- type stress on mice. This model was established by housing male C57BL/6 naïve subject mice with an SJL aggressor (Agg) mouse without direct contact for 6 h/d for 10 d or 5 d, and then briefly pairing the C57BL/6 mice with the Agg mice for 3x/d. Controls (C), also housed without food/liquid during the 6hr session, did not experience direct physical contact with Agg. At time points of 24 hours or 6 wks after the last exposure, behaviors of C and aggressor-exposed (Agg-E) mice were studied using the partition test, which allows mutual exposure of only sensory cues without physical contact. Behavioral patterns (partition avoidance, freezing) of Agg-E mice suggested fear and social withdrawal, the reported traits of PTSD. Global gene expression profiling of three major stress-relevant brain regions, namely Hippocampus (HC), Amygdala (AY), and Medial Pre-Frontal Cortex (mPFC) shows a clear genotype distribution between the C and Agg-E in AY and not in HC which is a positive correlation with PTSD symptom severity. The cluster pattern of MPFC reflects similarity between the genotype profile and behavioral phenotype. Further comprehensive analysis can potentially lead to identifying diagnostic and therapeutic biomarkers that serve as internal indicators of the complex psycho-pathogenesis.",0 +https://doi.org/10.1037/a0033252,Posttraumatic stress and posttraumatic growth among low-income mothers who survived Hurricane Katrina.,"The purpose of the study was to explore the relationship between posttraumatic stress (PTS) and posttraumatic growth (PTG) after Hurricane Katrina, and the role of demographics, predisaster psychological distress, hurricane-related stressors, and psychological resources (optimism and purpose) in predicting each.Participants were 334 low-income mothers (82.0% non-Hispanic Black) living in the New Orleans area prior to Hurricane Katrina, who completed surveys in the year prior to the hurricane (T1 [Time 1]) and 1 and 3 years thereafter (T2 and T3).Higher T2 and T3 PTS full-scale and symptom cluster subscales (Intrusion, Avoidance, and Hyperarousal) were significantly associated with higher T3 PTG, and participants who surpassed the clinical cutoff for probable posttraumatic stress disorder at both T2 and T3 had significantly higher PTG than those who never surpassed the clinical cutoff. Older and non-Hispanic Black participants, as well as those who experienced a greater number of hurricane-related stressors and bereavement, reported significantly greater T3 PTS and PTG. Participants with lower T2 optimism reported significantly greater T3 intrusive symptoms, whereas those with higher T1 and T2 purpose reported significantly greater T3 PTG.Based on the results, we suggest practices and policies with which to identify disaster survivors at greater risk for PTS, as well as longitudinal investigations of reciprocal and mediational relationships between psychological resources, PTS, and PTG.",0 +https://doi.org/10.1176/ps.43.8.816,Clinical Presentation of PTSD in World War II Combat Veterans,"Clinicians have increasingly recognized posttraumatic stress disorder (PTSD) among Vietnam veterans, but the disorder may be easily overlooked among World War II combat veterans. The authors review recent studies of PTSD in older veterans and describe five cases that illustrate the diverse clinical presentations of PTSD in this population. Symptoms included anxiety, cognitive and somatic complaints, depression, alcohol dependence, and amnestic periods. Despite the varied presentations, a fairly consistent patient profile emerged. Patients avoided reminders of war, showed an exaggerated startle response, and experienced restless sleep and chronic anxiety. Factors associated with exacerbations of symptoms were retirement and reminders of war experiences. Although past studies have emphasized resuppression of the trauma, the authors encourage a flexible approach to treatment, including exploratory techniques.",0 +https://doi.org/10.1017/s0033291710002072,Common genetic and environmental contributions to post-traumatic stress disorder and alcohol dependence in young women,"The few genetically informative studies to examine post-traumatic stress disorder (PTSD) and alcohol dependence (AD), all of which are based on a male veteran sample, suggest that the co-morbidity between PTSD and AD may be attributable in part to overlapping genetic influences, but this issue has yet to be addressed in females.MethodData were derived from an all-female twin sample (n=3768) ranging in age from 18 to 29 years. A trivariate genetic model that included trauma exposure as a separate phenotype was fitted to estimate genetic and environmental contributions to PTSD and the degree to which they overlap with those that contribute to AD, after accounting for potential confounding effects of heritable influences on trauma exposure.Additive genetic influences (A) accounted for 72% of the variance in PTSD; individual-specific environmental (E) factors accounted for the remainder. An AE model also provided the best fit for AD, for which heritability was estimated to be 71%. The genetic correlation between PTSD and AD was 0.54.The heritability estimate for PTSD in our sample is higher than estimates reported in earlier studies based almost exclusively on an all-male sample in which combat exposure was the precipitating traumatic event. However, our findings are consistent with the absence of evidence for shared environmental influences on PTSD and, most importantly, the substantial overlap in genetic influences on PTSD and AD reported in these investigations. Additional research addressing potential distinctions by gender in the relative contributions of genetic and environmental influences on PTSD is merited.",0 +https://doi.org/10.1192/bjp.bp.106.034884,Deployment-related stress and trauma in Dutch soldiers returning from Iraq,"Some questionnaire studies have shown increased mental health problems, including probable post-traumatic stress disorder (PTSD), in soldiers deployed to Iraq.To test prospectively whether such problems change over time and whether questionnaires provide accurate estimates of deployment-related PTSD compared with a clinical interview.Dutch infantry troops from three cohorts completed questionnaires before deployment to Iraq (n=479), and about 5 months (n=382, 80%) and 15 months (n=331, 69%) thereafter. Post-traumatic stress disorder was evaluated by questionnaire and clinical interview.There were no group changes for general distress symptoms. The rates of PTSD for each cohort were 21, 4 and 6% based on questionnaires at 5 months. The deployment-related rates of PTSD based on the clinical interview were 4, 3 and 3%.There was a specific effect of deployment on mental health for a small minority. Questionnaires eliciting stress symptoms gave substantial overestimations of the rate of PTSD.",0 +https://doi.org/10.1111/j.1749-6632.1997.tb51756.x,Heat Acclimation and Heat Stress Have Different Effects on Cholinergic Muscarinic Receptors,"In this brief report we have proved that membranal changes take place upon short-term heat acclimation. These changes may switch on a cascade of transient acclimatory compensatory responses as well as long-term processes. The changes observed in the MR profile are heat acclimation specific, and differ from those observed upon heat stress. These bring about functional changes in the signal transduction pathway for water secretion in the submaxillary salivary gland. A recovery period from heat stress, similar to STHA, leads to MR upregulation and decreased binding affinity. This response, however, is more pronounced than that observed upon STHA. The functional importance of the phenomenon is unclear. However, it could designate a novel component of the heat shock response.",0 +https://doi.org/10.1080/03630242.2012.679337,Posttraumatic Stress Disorder and Posttraumatic Growth in Breast Cancer Patients: A Systematic Review,"Breast cancer, potentially a traumatic stressor, may be accompanied by negative outcomes, such as posttraumatic stress disorder or positive changes, such as posttraumatic growth. The authors reviewed 24 studies published from 1990 to 2010 that measured posttraumatic stress disorder and posttraumatic growth in women with breast cancer, in terms of frequency rates, factors associated with posttraumatic stress disorder and posttraumatic growth, and their interrelationships. A relatively small percentage of women experienced posttraumatic stress disorder, while the majority of them reported posttraumatic growth. Age, education, economic status, subjective appraisal of the threat of the disease, treatment, support from significant others, and positive coping strategies were among the most frequently reported factors associated with these phenomena. Moreover, posttraumatic stress disorder and posttraumatic growth were not related. Future research should shed more light on posttraumatic growth and posttraumatic stress disorder among women with breast cancer, the parameters that influence them, and their possible relationship.",0 +https://doi.org/10.1023/a:1011169019614,Development of a depersonalization severity scale,"Our aim was to develop a clinician-rated scale assessing depersonalization severity for use in clinical trials of Depersonalization Disorder and trauma-related disorders in general. The 6-item Depersonalization Severity Scale (DSS) was administered to 63 participants with DSM-IV Depersonalization Disorder as diagnosed by the SCID-D, and its psychometric properties were examined. The sensitivity of the DSS and of the Dissociative Experiences Scale (DES) to treatment change was assessed in blinded, controlled settings. Individual items were widely distributed across the severity range. Interrater reliability was excellent and internal consistency was moderate. The DSS had high convergent and discriminant validity and was sensitive to treatment change. The DES was also sensitive to treatment change. We recommend piloting the DSS in future treatment trials of trauma-spectrum disorders.",0 +,Post-traumatic stress disorder in victims of traumatic events.,"The present study obtained data on frequency of Post-traumatic Stress Disorder (PTSD) symptoms, victims' gender and age, type of trauma and diagnostic comorbidity in a sample of 274 subjects (77 male and 197 female), victims of a severe traumatic event. The Checklist of Stressful and Traumatic Events, Trauma Assessment for Adults (TAA) Revised, Structured Interview for PTSD (SIP), Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) were used. Results indicated that 28% of the subjects met the criteria for Posttraumatic Stress Disorder, and that females were more likely than males to receive the PTSD classification. Significant differences were found in the PTSD diagnoses related to type of traumatic event and depression and anxiety symptoms.",0 +https://doi.org/10.1007/s00127-013-0759-y,Posttraumatic stress disorder and symptoms among American Indians and Alaska Natives: a review of the literature,"American Indians and Alaska Natives (AI/ANs) experience high rates of trauma and posttraumatic stress disorder (PTSD). We reviewed existing literature to address three interrelated questions: (1) What is the prevalence of PTSD and PTSD symptoms among AI/ANs? (2) What are the inciting events, risk factors, and co-morbidities in AI/ANs, and do they differ from those in the general U.S. population? (3) Are studies available to inform clinicians about the course and treatment of PTSD in this population?We searched the PubMed and Web of Science databases and a database on AI/AN health, capturing an initial sample of 77 original English-language articles published 1992–2010. After applying exclusion criteria, we retained 37 articles on prevalence of PTSD and related symptoms among AI/AN adults. We abstracted key information and organized it in tabular format.AI/ANs experience a substantially greater burden of PTSD and related symptoms than U.S. Whites. Combat experience and interpersonal violence were consistently cited as leading causes of PTSD and related symptoms. PTSD was associated with bodily pain, lung disorders, general health problems, substance abuse, and pathological gambling. In general, inciting events, risk factors, and co-morbidities appear similar to those in the general U.S. population.Substantial research indicates a strikingly high incidence of PTSD in AI/AN populations. However, inciting events, risk factors, and co-morbidities in AI/ANs, and how they may differ from those in the general population, are poorly understood. Very few studies are available on the clinical course and treatment of PTSD in this vulnerable population.",0 +https://doi.org/10.1152/ajpregu.90683.2008,"Expression of intracellular cytokines, HSP72, and apoptosis in monocyte subsets during exertional heat stress in trained and untrained individuals","This study examined intracellular cytokine, heat shock protein (HSP) 72, and cellular apoptosis in classic and inflammatory CD14 + monocyte subsets during exertional heat stress (EHS). Subjects were divided into endurance-trained [TR; n = 12, peak aerobic power (V̇o 2peak ) = 70 ± 2 ml·kg lean body mass (LBM) −1 ·min −1 ] and sedentary-untrained (UT; n = 11, V̇o 2peak = 50 ± 1 ml·kg LBM −1 ·min −1 ) groups before walking at 4.5 km/h with 2% elevation in a climatic chamber (40°C, 30% relative humidity) wearing protective clothing until exhaustion (Exh). Venous blood samples at baseline and 0.5°C rectal temperature increments (38.0, 38.5, 39.0, 39.5, and 40.0°C/Exh) were analyzed for cytokines (TNF-α, IL-1β, IL-6, IL-1ra, and IL-10) in CD14 ++ CD16 − /CD14 + CD16 + and HSP72/apoptosis in CD14 Bri /CD14 Dim subsets. In addition, serum levels of extracellular (e)HSP72 were also examined. Baseline and Exh samples were separately stimulated with LPS (1 μg/ml) or heat shocked (42°C) and cultured in vitro for 2 h. A greater temperature-dependent increase in CD14 + CD16 + cells was observed in TR compared with UT subjects as well as a greater LPS tolerance following in vitro LPS stimulation. TNF-α and IL-1β cytokine expression was elevated in CD14 + CD16 + but not in CD14 ++ CD16 − cells. A greater induction of intracellular HSP72 and eHSP72 was observed in TR compared with UT subjects, which coincided with reduced apoptosis at Exh and following in vitro heat shock. Induced HSP in vitro was not uniform across CD14 + subsets. Findings suggest that circulating CD14 + CD16 + , but not CD14 ++ CD16 − monocytes, contribute to the proinflammatory cytokine profiles observed during EHS. In addition, the enhanced HSP72 response in endurance-trained individuals may confer improved heat tolerance through both anti-inflammatory and anti-apoptotic mechanisms.",0 +https://doi.org/10.1002/jts.21873,Relationship of Trauma Symptoms to Amygdala-Based Functional Brain Changes in Adolescents,en,0 +https://doi.org/10.1007/s12207-011-9097-0,The Detection of Feigned Psychiatric Disorders Using the MMPI-2-RF Overreporting Validity Scales: An Analog Investigation,"Individuals who are motivated to feign psychological problems to achieve a desired outcome (e.g., insanity defense) may overreport symptoms of psychopathology, with type of pathology being dependent on the setting. In the current investigation, we examined the utility of the overreporting validity scales (infrequent responses [F-r], infrequent psychopathology responses [F P-r], infrequent somatic responses [Fs], and symptom validity [FBS-r]) on the Minnesota Multiphasic Personality Inventory-2-Restructured Form (Ben-Porath and Tellegen 2008) to detect research participants instructed to simulate one of three mental disorders: major depressive disorder (MDD), schizophrenia (SCH), or post-traumatic stress disorder (PTSD). The restructured clinical (RC) and overreporting validity scale scores of bona fide psychiatric patients with a primary diagnosis of either MDD, SCH, or PTSD were compared to two groups of simulators-naïve (i.e., undergraduate students with no training in mental disorders) and sophisticated (i.e., individuals with advanced training in psychopathology or personal experience with the disorder asked to overreport symptoms). Examination of the RC Scale profiles revealed that the sophisticated simulators produced symptom profiles more similar to the profiles of the psychiatric patients than did the naïve simulators. For the overreporting validity scales, the sophisticated simulators were less likely to be detected as feigning compared to the naïve simulators; overall, the validity scales were able to distinguish patients from simulators and accurately classify most of the simulators regardless of their level of ""symptom"" sophistication. Examination and comparison of the validity scales revealed that across disorders and level of research participant symptom sophistication, the F P-r scale best differentiated simulators from patients. © 2011 Springer Science+Business Media, LLC.",0 +https://doi.org/10.1037/a0024571,The buffering effect of resilience on depression among individuals with spinal cord injury: A structural equation model.,"To translate the theoretical constructs from a model of resilience into a structural equation model and evaluate relationships among the model's theoretical constructs associated with resilience and the occurrence of depressive symptoms.Quantitative descriptive research design using structural equation modeling (SEM).Two-hundred and fifty-five individuals with SCI recruited from the Canadian Paraplegic Association (CPA).Outcome was measured by the Center for Epidemiologic Studies-Depression Scale.The resilience model fit the data relatively well: χ² (200, N = 255) = 451.57, p < .001; χ²/df = 2.26; CFI = .92, RMSEA = 0.070 (90% CI: 0.062-0.079), explaining 77% of the variance in depressive symptomatology. Severity of SCI-related stressors significantly influenced perceived stress (β = .60) and perceived stress, in turn, affected depressive symptoms (β = .66), characteristics of resilience (β = -.43), and social support (β = -.26). The resilience characteristics had an inverse relationship with depressive symptoms (β = -.29). No direct relationship was found between severity of SCI-related stressors and depressive symptoms.Findings provide support for the resilience model and suggests characteristics of resilience ""buffer"" the perceptions of stress on depressive symptoms. The resilience model may be useful to guide clinical interventions designed to improve the mental health of individuals with SCI.",0 +https://doi.org/10.1111/j.1399-5618.2007.00396.x,Post-traumatic stress disorder among adolescents with bipolar disorder and its relationship to suicidality,"The aims of this cross-sectional pilot study were to ascertain the rates of post-traumatic stress disorder (PTSD) among adolescents with bipolar disorder (BPD) and major depressive disorder (MDD) relative to a comparison group comprised of non-affectively ill patients, and to determine whether PTSD is related to suicidal ideation and attempts. The impetus for the study was born of clinical impressions derived in the course of routine clinical practice.Patients were screened by a single interviewer for BPD, MDD and PTSD, panic disorder, obsessive-compulsive disorder (OCD) and social phobia using the apposite modules from the Structured Clinical Interview for DSM-IV (SCID) and histories of suicidal ideation and attempts. The data were subjected to analysis using a logistic regression model.The database included 34 patients with BPD, 79 with MDD and 26 with a non-affective disorder. The risk for PTSD for a patient with BPD significantly exceeded that for a patient with MDD [odds ratio (OR) = 4.9, 95% confidence interval (CI) = 1.9-12.2, p = 0.001]. Patients with PTSD had an insignificantly increased risk for suicidal ideation (OR = 2.8, 95% CI = 0.9-8.9, p = 0.069), and a 4.5-fold significantly increased risk of having had a suicide attempt (OR = 4.5, 95% CI = 1.7-11.7, p = 0.002). The relationship between PTSD and suicide attempts remained significant even after controlling for the confounding effects of concurrent panic disorder, OCD and social phobia (OR = 3.4, 95% CI = 1.1-10.0, p = 0.023).Patients with BPD have a greater risk for PTSD than those with MDD. Post-traumatic stress disorder is significantly related to history of suicide attempts.",0 +https://doi.org/10.1177/1073191114555523,Factor Structure and Psychometric Properties of the Posttraumatic Stress Disorder (PTSD) Checklist and DSM-5 PTSD Symptom Set in a Long-Term Postearthquake Cohort in Armenia,"Psychometric properties of the Armenian-language posttraumatic stress disorder (PTSD) Checklist–Civilian version (PCL-C) and the DSM-5 PTSD symptom set were examined in a long-term cohort of earthquake survivors. In 2012, 725 survivors completed the instruments. Item-/scale-level analysis and confirmatory factor analysis (CFA) were performed for both scales. In addition, exploratory factor analysis (EFA) was conducted for DSM-5 symptoms. Also, the differential internal versus external specificity of PTSD symptom clusters taken from the most supported PTSD structural models was examined. Both scales had Cronbach’s alpha greater than .9. CFA of PCL-C structure demonstrated an excellent fit by a four-factor (reexperiencing, avoidance, numbing, and hyperarousal) model known as numbing model; however, a superior fit was achieved by a five-factor model (Elhai et al.). EFA yielded a five-factor structure for DSM-5 symptoms with the aforementioned four domains plus a negative state domain. This model achieved an acceptable fit during CFA, whereas the DSM-5 criteria-based model did not. The Armenian-language PCL-C was recommended as a valid PTSD screening tool. The study findings provided support to the proposed new classification of common mental disorders, where PTSD, depression, and generalized anxiety are grouped together as a subclass of distress disorders. Recommendations were made to further improve the PTSD diagnostic criteria.",0 +https://doi.org/10.1177/0004867413500349,Correlates of persisting posttraumatic symptoms in children and adolescents 18 months after a cyclone disaster,"Objective: To describe PTSD symptom persistence and resolution, including the potential phenomenon of late-onset PTSD, in children and adolescents 18 months after a cyclone disaster; and to investigate factors that predict longer-term symptom outcome. Method: 71 children and 191 adolescents who were screened three months after a Category 5 Cyclone were re-screened 18 months post-disaster. Child-report measures included the PTSD Reaction Index, measures of event exposure and social connectedness. Results: Approximately 1-in-5 children and 1-in-12 adolescents endorsed cyclone-related PTSD symptoms at the moderate to severe level 18 months post-disaster. Of these approximately one-half (44.8%) of children were in the ‘high-persister’ group at 18-month follow-up. Persistence of low symptoms was very common (97.6%) and late-onset PTSD was a rare phenomenon. This pattern was similar in adolescents: 25.0% were in the ‘high-persister’ group and few students experienced late-onset PTSD. In multivariate analysis, only initial severe to very severe PTSD category made a significant independent contribution to explaining persisting moderate to severe PTSD symptoms in primary school students (ORadj=8.33, 95% CI=1.45-47.84). There was a trend for a similar result in secondary students. Conclusion: A child or adolescent with few PTSD symptoms three months post-disaster is likely to remain so unless a further traumatic event occurs. However, if symptomatic at three months, there is approximately a 30-45% chance that the child or adolescent will still be symptomatic 18 months after the disaster. Given the high rate of students in the ‘resolver’ group, initial posttraumatic symptoms are a necessary but not sufficient condition for predicting chronic symptomatology. Other targets for predictive modelling include initial threat perception and high and low social connectedness.",0 +,Outcomes after ARDS: a distinct group in the spectrum of disability after complex and protracted critical illness.,"ARDS represents an important public health problem for patients, family caregivers and society. The last decade has seen a burgeoning literature focussed on the outcomes of this patient group and has informed important new knowledge about the devastating and often irreversible morbidity related to nerve, muscle and brain injury More recent studies have reinforced these robust themes of physical and neuropsychological morbidity in other patient groups and have shown that outcomes after ARDS are one segment of a spectrum of disability and may not be widely generalizable across older patients with multiple comorbidities and protracted length of stay in the critical care unit. Our literature has reached theme saturation in terms of morbidity and needs to identify and begin to address the research agenda for the next decade. Several of these themes will be addressed here and include the following: 1) to generate large diverse datasets to understand different outcome trajectories over time to facilitate risk stratification and inform development of rehabilitation programs; 2) to embrace mixed methodology as a new longitudinal study standard to facilitate detailed qualitative observations to augment insights from quantitative data; 3) to educate patients, families, colleagues and decision-makers about outcomes after critical illness to inform policy and decision-making; 4) to embrace family caregivers and provide intervention when needed and ongoing support across transitions of care; 5) prioritize functional outcome measures over those targeted at health-related quality of life for construction of more focussed rehabilitation interventions; 6) embrace translational research programs to elucidate the relationship between functional outcome and molecular mechanism to gain further insight into the pathophysiology of critical illness, muscle and brain injury and potential insights into novel therapeutic strategies.",0 +https://doi.org/10.1207/s15374424jccp2703_3,Diagnostic efficacy of posttraumatic symptoms in children exposed to disaster,"Examined 5 conditional probability indices to determine the diagnostic efficacy of 48 symptoms associated with posttraumatic stress disorder (PTSD) in 5,687 children exposed to Hurricane Hugo, of whom 5.5% had a diagnosis of posttraumatic stress syndrome (PTSS). Moderate levels of sensitivity and high levels of specificity were obtained for most symptoms. Odds ratios more precisely demonstrated that some Diagnostic and Statistical Manual of Mental Disorders (DSM) symptoms of PTSD, especially when combined, were useful for identifying children with PTSS but that anxiety symptoms and some DSM symptoms of PTSD had poor diagnostic utility. Satisfying criteria for the DSM-III-R numbing/avoidance cluster and symptoms from the numbing/avoidance cluster had the highest diagnostic efficacy, suggesting that avoidance may be the hallmark of severe posttraumatic reactions. These results suggest which symptoms should be conceptualized as central versus peripheral to the disorder and which symptoms and symptom combinations clinicians should attend to most when diagnosing or screening PTSD in children.",0 +https://doi.org/10.1017/s0954579400005812,Resilience and development: Contributions from the study of children who overcome adversity,"Abstract This article reviews the research on resilience in order to delineate its significance and potential for understanding normal development. Resilience refers to the process of, capacity for, or outcome of successful adaptation despite challenging or threatening circumstances. Three resilience phenomena are reviewed: (a) good outcomes in high-risk children, (b) sustained competence in children under stress, and (c) recovery from trauma. It is concluded that human psychological development is highly buffered and that long-lasting consequences of adversity usually are associated with either organic damage or severe interference in the normative protective processes embedded in the caregiving system. Children who experience chronic adversity fare better or recover more successfully when they have a positive relationship with a competent adult, they are good learners and problem-solvers, they are engaging to other people, and they have areas of competence and perceived efficacy valued by self or society. Future studies of resilience will need to focus on processes that facilitate adaptation. Such studies have the potential to illuminate the range and self-righting properties of, constraints on, and linkages among different aspects of cognitive, emotional, and social development.",0 +https://doi.org/10.1186/1471-244x-13-232,Posttraumatic stress and symptom improvement in Norwegian tourists exposed to the 2004 tsunami – a longitudinal study,"Mental health consequences of disasters are frequently studied. However, few studies have investigated symptom improvement in victims after natural disasters. This study aimed to identify predictors of 6 months post-disaster stress symptoms and to study 6 months and 24 months course of symptoms among Norwegian tourists who experienced the 2004 tsunami.Norwegian tourists (≥ 18 years) who experienced the 2004 tsunami (n = 2468) were invited to return a postal questionnaire at two points of time. The first data set was collected at 6 months (T1, n = 899) and the second data set at 24 months post-disaster (T2, n = 1180). The population studied consisted of those who responded at both assessments (n = 674). Impact of Event Scale Revised (IES-R) was used to measure posttraumatic stress symptoms. IES-R score ≥ 33 (caseness) was used to identify various symptom trajectories from T1 to T2. Multiple linear regression was used to determine predictors of posttraumatic stress at T1 and to identify variables associated with symptom improvement from T1 to T2.The majority was identified as non-case at both assessments (57.7%), while 20.8% of the respondents were identified as case at both assessments. Symptoms at T1 were positively related to female gender, older age, unemployment, being chased or caught by the waves, witnessing death or suffering, loss of loved ones, experiencing intense fear during the disaster, low conscientiousness, neuroticism and low levels of social support. The IES-R sum score declined from 24.6 (SD = 18.5) at T1 to 22.9 (SD = 18.3) at T2, p < 0.001. Emotional stability and high IES-R scores at T1 were positively related to symptom improvement, while received social support was not. Being referred to a mental health specialist was negatively related to symptom improvement.A significant minority (20-30%) among Norwegian tourists developed enduring posttraumatic stress symptoms in the aftermath of the 2004 tsunami. Tsunami exposure, peritraumatic fear, neuroticism and low levels of social support were the strongest predictors of posttraumatic stress at 6 months post-disaster. Decrease in posttraumatic stress was related to emotional stability and higher symptom levels at T1. Being referred to a mental health specialist did not facilitate symptom improvement.",0 +https://doi.org/10.1017/s0033291714002815,The structure and short-term stability of the emotional disorders: a dimensional approach,"Background Factor-analytic studies have found that depressive, bipolar, post-traumatic, obsessive–compulsive, and anxiety disorders – jointly referred to as the emotional disorders – form an internalizing spectrum that includes distress and fear subfactors. However, placement of some disorders is uncertain. Also, prior research analysed dichotomous interview-based diagnoses or dimensional self-report measures. We investigated this structure using a third-generation measure – the Interview for Mood and Anxiety Symptoms (IMAS) – that combines strengths of a clinical interview with dimensional assessment. Method The interview was administered to 385 students and 288 psychiatric out-patients. Participants were reinterviewed 2 months later. Results Exploratory and confirmatory factor analyses identified three factors: distress (depression, generalized anxiety, post-traumatic stress, irritability, and panic syndrome); fear (social anxiety, agoraphobia, specific phobia, and obsessive–compulsive); and bipolar (mania and obsessive–compulsive). The structure was consistent over time and across samples, except that panic and agoraphobia had higher factor loadings in patients. Longitudinal analyses revealed high temporal stability of the factors (test–retest r = 0.72 to 0.87), but also substantial disorder-specific stability. Conclusions This investigation – which bridges diagnostic and self-report studies – found three subfactors of internalizing psychopathology. It provided support for a new subfactor, clarified the placement of obsessive–compulsive and bipolar disorders, and demonstrated that this model generalizes across populations. The accumulating research suggests the need to recognize formally the close links among the emotional disorders, as well as empirical clusters within this spectrum. The IMAS demonstrated strong psychometric properties and can be useful for various research and clinical applications by providing dimensional, interview-based assessment of the emotional disorders.",0 +https://doi.org/10.1177/0886260514564069,"Longitudinal Relationships of Social Reactions, PTSD, and Revictimization in Sexual Assault Survivors","Sexual assault survivors receive various positive and negative social reactions to assault disclosures, yet little is known about the directionality of associations of social reactions to posttraumatic stress disorder (PTSD) symptoms over time. Data from a large, diverse sample of women who had experienced adult sexual assault was analyzed with hierarchical linear modeling (HLM) to examine how negative and positive reactions relate to PTSD symptoms over 3 years and to test the hypothesis that the relationship between negative social reactions and PTSD symptoms is reciprocal. We found that, as predicted, social reactions predicted subsequent PTSD symptoms, and in turn PTSD symptoms predicted subsequent social reactions. We also investigated the role of sexual revictimization by comparing women who suffered (vs. not) additional sexual victimization during the course of our study. Revictimized women had greater PTSD symptoms and more negative social reactions, but associations of social reactions with PTSD symptoms did not vary according to revictimization status. Implications for practice and suggestions for future research are discussed.",0 +https://doi.org/10.1177/1010539513481800,The Psychological Impact of Exposure to the 2008 Snowstorms on Migrant Workers in China,"This study aimed to estimate the prevalence of posttraumatic stress disorder (PTSD) and to identify associated risk factors among migrant workers 4 years after the 2008 snowstorm in China. A cross-sectional survey of 528 respondents was conducted to collect data in Changsha, the capital of Hunan Province. A multistage cluster sampling method was applied in selecting subjects from migrant workers’ gathering areas. Association between the independent variables and PTSD was analyzed using logistic regression analysis. The prevalence of PTSD was 17.42% among migrant workers in Changsha. Being male, being older than 35 years, being an electrician, having dependent children, suffering property damage, being without medical insurance, and having low social support were risk factors significantly related to the development of PTSD. Effective and sustainable mental health services should be directed particularly to the migrant workers, who are among the groups most vulnerable to the direct impact of snowstorms.",0 +https://doi.org/10.1111/j.1528-1157.2000.tb00187.x,A Comparative Study of Trauma and Posttraumatic Stress Disorder Prevalence in Epilepsy Patients and Psychogenic Nonepileptic Seizure Patients,"This study tests the hypothesis that trauma histories, including histories of physical and sexual abuse, and posttraumatic stress disorder (PTSD) are more prevalent in psychogenic non-epileptic seizure (NES) patients than in epilepsy patients.Thirty-five inpatients with intractable seizures were evaluated for trauma history and PTSD. After these assessments, patients were diagnosed as having either epileptic or nonepileptic seizures through EEG monitoring.NES diagnosis correlated with PTSD and total number of lifetime traumas, adult traumas, and abuse traumas. Contrary to previous hypotheses, reported childhood sexual abuse (CSA) did not correlate significantly with NES diagnosis. However, CSA predicted PTSD in a discriminant analysis.We found evidence for the hypothesized relations between trauma, abuse, PTSD, and NES diagnosis. However, elevated levels in both seizure-disorder groups suggest that routine assessment for abuse, trauma, and PTSD might facilitate medical care and treatment for all intractable seizure patients.",0 +,Longitudinal modeling of population heterogeneity: Methodological challenges to the analysis of empirically derived criminal trajectory profiles,,0 +https://doi.org/10.1016/s0006-3223(00)00933-1,A second look at comorbidity in victims of trauma: the posttraumatic stress disorder–major depression connection,"We examine whether traumatic events increase the risk for major depression independent of their effects on posttraumatic stress disorder (PTSD).Data come from the Epidemiologic Study of Young Adults in southeast Michigan (N = 1007). Retrospective and prospective data were used to estimate the risk of major depression in persons with PTSD and persons exposed to trauma with no PTSD, compared with persons who did not experience a trauma. National Comorbidity Survey data were used to evaluate the influence of trauma type.In the retrospective lifetime data, hazard ratios were, for first-onset major depression in exposed persons with PTSD, 2.8 and, in exposed persons with no PTSD, 1.3 (not significant), as compared with persons who were not exposed. Corresponding estimates from the prospective data were 11.7 and 1.4 (not significant). The difference in the risk for depression associated with PTSD versus exposure without PTSD is unlikely to be due to differences in trauma type.The findings of a markedly increased risk for major depression in persons with PTSD, but not in exposed persons without PTSD, do not support the hypothesis that PTSD and major depression in trauma victims are influenced by separate vulnerabilities.",0 +https://doi.org/10.1016/s0005-7967(99)00061-3,Dimensionality of posttraumatic stress symptoms: a confirmatory factor analysis of DSM-IV symptom clusters and other symptom models,"Recent exploratory [Taylor, S., Kuch, K., Koch, W. J., Crockett, D. J., & Passey, G. (1998). The structure of posttraumatic stress symptoms. Journal of Abnormal Psychology, 107, 154-160.] and confirmatory [Buckley, T. C., Blanchard, E. B., & Hickling, E. J. (1998). A confirmatory factor analysis of posttraumatic stress symptoms. Behaviour Research and Therapy, 36, 1091-1099; King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998). Confirmatory factor analysis of the clinician-administered PTSD scale: evidence for the dimensionality of posttraumatic stress disorder. Psychological Assessment, 10, 90-96.] factor analytic investigations suggest that the three symptom clusters of posttraumatic stress disorder (PTSD) as defined in the Diagnostic and Statistical Manual [4th ed.; DSM-IV; American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.] may not provide the best conceptualization of symptom dimensionality. However, the alternative models have not been in agreement, nor have they been compared against each other or models based on the DSM-IV. The purpose of the present investigation was to test a series of dimensional models suggested by these recent factor analytic investigations and the DSM-IV. Using data collected with the PTSD Checklist--Civilian Version [Weathers, F. W., Litz, B. T., Huska, J. A., & Keane, T. M. (1994). PCL-C for DSM-IV. Boston: National Center for PTSD--Behavioral Science Division.] from 349 referrals to a primary care medical clinic, we used confirmatory factor analysis to evaluate a: (1) hierarchical four-factor model, (2) four-factor intercorrelated model, (3) hierarchical three-factor model, (4) three-factor intercorrelated model, and (5) hierarchical two-factor model. The hierarchical four-factor model (comprising four first-order factors corresponding to reexperiencing, avoidance, numbing, and hyperarousal all subsumed by a higher-order general factor) provided the best overall fit to the data; although, all models met some standards specified for good model fit. More research is needed to establish the dimensional nature of PTSD symptoms and to assess whether identified dimensions differ as a function of the trauma experience. Implications for assessment, diagnosis, and treatment are also discussed.",0 +https://doi.org/10.3928/00485713-20090514-02,Sleep Disturbances in Posttraumatic Stress Disorder,"Sleep disturbances are common complaints among patients with posttraumatic stress disorder (PTSD), as well as intrusive recollection, avoidance of disturbing stimuli, difficulty in concentration, and depressive symptoms. Patients with PTSD frequently report difficulty falling or staying asleep and recurrent nightmares related to the traumatic events. These sleep disturbances are part of the diagnostic criteria for PTSD and are included in both the re-experiencing (Criterion B) and increased arousal (Criterion D) symptom cluster in the DSM-IV-TR. Despite these sleep complaints, polysomnographic studies have not provided consistent evidence of sleep disturbances, especially regarding non-rapid eye movement (REM) sleep. However, the characteristic sleep disturbances, in particular the repetitive, stereotypical nightmares may be relatively specific to PTSD. The presence of nightmares in PTSD has been hypothesized as a dysfunction of REM sleep mechanisms and investigators have reported various types of REM sleep abnormalities. Treatment studies also have shown that antidepressants, such as nefazodone, trazodone, fluvoxamine, and image rehearsal therapy are beneficial in the treatment of PTSD-related sleep disturbances as well as core symptoms of this anxiety disorder; however, these sleep disturbances may persist and impair the quality of life in PTSD patients for several decades. It is important, therefore, to understand the characteristics of sleep disturbances in PTSD and these treatments. In this review, we discuss the clinical features and objective findings of sleep disturbances in PTSD and these treatments based on the published literature, including our findings. © 2010 Nova Science Publishers, Inc. All rights reserved.",0 +https://doi.org/10.1016/j.cpr.2011.12.001,A meta-analysis of risk factors for post-traumatic stress disorder in children and adolescents,"Post-traumatic stress disorder (PTSD) is a complex and chronic disorder that causes substantial distress and interferes with social and educational functioning. Consequently, identifying the risk factors that make a child more likely to experience traumatic distress is of academic, clinical and social importance. This meta-analysis estimated the population effect sizes of 25 potential risk factors for PTSD in children and adolescents aged 6-18 years across 64 studies (N=32,238). Medium to large effect sizes were shown for many factors relating to subjective experience of the event and post-trauma variables (low social support, peri-trauma fear, perceived life threat, social withdrawal, comorbid psychological problem, poor family functioning, distraction, PTSD at time 1, and thought suppression); whereas pre-trauma variables and more objective measures of the assumed severity of the event generated small to medium effect sizes. This indicates that subjective peri-trauma factors and post-event factors are likely to have a major role in determining whether a child develops PTSD following exposure to a traumatic event. Such factors could potentially be assessed following a potentially traumatic event in order to screen for those most vulnerable to developing PTSD and target treatment efforts accordingly. The findings support the cognitive model of PTSD as a way of understanding its development and guiding interventions to reduce symptoms.",0 +https://doi.org/10.1176/ajp.145.3.301,Dissociation and hypnotizability in posttraumatic stress disorder,"The authors compared the hypnotizability of 65 Vietnam veteran patients with posttraumatic stress disorder (PTSD) to that of a normal control group and four patient samples using the Hypnotic Induction Profile. The patients with PTSD had significantly higher hypnotizability scores than patients with diagnoses of schizophrenia (N = 23); major depression, bipolar disorder--depressed, and dysthymic disorder (N = 56); and generalized anxiety disorder (N = 18) and the control sample (N = 83). This finding supports the hypothesis that dissociative phenomena are mobilized as defenses both during and after traumatic experiences. The literature suggests that spontaneous dissociation, imagery, and hypnotizability are important components of PTSD symptoms.",0 +https://doi.org/10.1002/da.20838,Differences in the determinants of posttraumatic stress disorder and depression after a mass traumatic event,"Background: Hurricane Ike struck the Galveston Bay area of Texas on September 13, 2008, leaving substantial destruction and a number of deaths in its wake. We assessed differences in the determinants of posttraumatic stress disorder (PTSD) and depression after this event, including the particular hurricane experiences, including postevent nontraumatic stressors, that were associated with these pathologies. Methods: 658 adults who had been living in Galveston and Chambers counties, TX in the month before Hurricane Ike were interviewed 2–5 months after the hurricane. We collected information on experiences during and after Hurricane Ike, PTSD and depressive symptoms in the month before the interview, and socio-demographic characteristics. Results: The prevalence of past month hurricane-related PTSD and depression was 6.1 and 4.9%, respectively. Hurricane experiences, but not socio-demographic characteristics, were associated with Ike-related PTSD. By contrast, lower education and household income, and more lifetime stressors were associated with depression, as were hurricane exposures and hurricane-related stressors. When looking at specific hurricane-related stressors, loss or damage of sentimental possessions was associated with both PTSD and depression; however, health problems related to Ike were associated only with PTSD, whereas financial loss as a result of the hurricane was associated only with depression. Conclusions: PTSD is indeed a disorder of event exposure, whereas risk of depression is more clearly driven by personal vulnerability and exposure to stressors. The role of nontraumatic stressors in shaping risk of both pathologies suggests that alleviating stressors after disasters has clear potential to mitigate the psychological sequelae of these events. Depression and Anxiety, 2011. © 2011 Wiley-Liss, Inc.",0 +https://doi.org/10.1176/ajp.155.4.562,PTSD Symptoms in Bosnian Refugees 1 Year After Resettlement in the United States,"The authors' goal was to describe the characteristics of posttraumatic stress disorder (PTSD) symptoms on resettlement in the United States and at 1-year follow-up among Bosnian refugees as well as possible factors affecting the PTSD symptom profile among these refugees.They used standardized instruments to assess 34 Bosnian refugees for PTSD at resettlement in the United States and 1 year later.Fifteen of the refugees were diagnosed with PTSD at 1-year follow-up, compared with 25 at initial assessment. The average PTSD severity score at follow-up was 12.5, compared with 20.6 at initial assessment. At 1-year follow-up, 25 of the refugees experienced a decrease in severity of PTSD symptoms, one remained the same, and eight experienced an increase in severity. Older refugees were significantly more likely to have PTSD than younger refugees, and older refugees had more severe symptoms.The level of PTSD diagnosis and symptoms in Bosnian refugees remained substantial 1 year after their resettlement in the United States, although there were notable overall decreases. Older refugees appeared to be at greater risk.",0 +https://doi.org/10.1002/jts.2490100104,Anger regulation deficits in combat-related posttraumatic stress disorder,"We describe a typology of regulatory deficits associated with anger in combat-related posttraumatic stress disorder (PTSD). Cognitive, arousal, and behavioral domain deficits in anger regulation were observed clinically in PTSD patients with high levels of anger who were participating in a multi-year trial of a structured anger treatment. We also describe a category of patients whose anger type we have termed 'ball of rage'. These patients exhibit regulatory deficits in all three domains of anger regulation. We offer a conceptual framework to advance the understanding of anger associated with PTSD and to guide its effective treatment.",0 +https://doi.org/10.1016/s0306-4522(02)00801-1,Role of postsynaptic density protein-95 in the maintenance of peripheral nerve injury-induced neuropathic pain in rats,"Our previous work has demonstrated that postsynaptic density protein-95, a molecular scaffolding protein that binds and clusters N-methyl-D-aspartate receptors at neuronal synapses, plays an important role in the development of peripheral nerve injury-induced neuropathic pain. The current study further investigated the possible involvement of postsynaptic density protein-95 in the maintenance of neuropathic pain. Mechanical and thermal hyperalgesia were induced within 3 days and maintained for 15 days or longer after unilateral injury to the fifth lumbar spinal nerve. The rats injected intrathecally with postsynaptic density protein-95 antisense oligodeoxynucleotide every 24 h for 4 days from day 7 to day 10 post-surgery exhibited not only a marked decrease in spinal cord postsynaptic density protein-95 protein expression but also a significant reduction in mechanical and thermal hyperalgesia on day 11 post-surgery. The rats injected with sense oligodeoxynucleotide did not display these changes. However, in the rats without nerve injury, postsynaptic density protein-95 antisense oligodeoxynucleotide given intrathecally every 24 h for 4 days did not affect responses to mechanical and thermal stimulation. In addition, postsynaptic density protein-95 antisense oligodeoxynucleotide did not change locomotor activity of experimental animals. Our results indicate that the deficiency of postsynaptic density protein-95 protein in the spinal cord significantly attenuates nerve injury-induced mechanical and thermal hyperalgesia during both the development and maintenance of chronic neuropathic pain. These results suggest that postsynaptic density protein-95 might be involved in the central mechanisms of chronic neuropathic pain and provide a novel target for development of new pain therapies.",0 +https://doi.org/10.1023/a:1007781909213,Comparison of the PTSD symptom scale-interview version and the clinician-administered PTSD scale,"The Clinician-Administered PTSD Scale (CAPS) is one of the most frequently used measures of posttraumatic stress disorder (PTSD). It has been shown to be a reliable and valid measure, although its psychometric properties in nonveteran populations are not well known. One problem with the CAPS is its long assessment time. The PTSD Symptom Scale--Interview Version (PSS-I) is an alternative measure of PTSD severity, requiring less assessment time than the CAPS. Preliminary studies indicate that the PSS-I is reliable and valid in civilian trauma survivors. In the present study we compared the psychometric properties of the CAPS and the PSS-I in a sample of 64 civilian trauma survivors with and without PTSD. Participants were administered the CAPS, the PSS-I, and the Structured Clinical Interview for DSM-IV (SCID) by separate interviewers, and their responses were videotaped and rated by independent clinicians. Results indicated that the CAPS and the PSS-I showed high internal consistency, with no differences between the two measures. Interrater reliability was also high for both measures, with the PSS-I yielding a slightly higher coefficient. The CAPS and the PSS-I correlated strongly with each other and with the SCID. Although the CAPS had slightly higher specificity and the PSS-I had slightly higher sensitivity to PTSD, overall the CAPS and the PSS-I performed about equally well. These results suggest that the PSS-I can be used instead of the CAPS in the assessment of PTSD, thus decreasing assessment time without sacrificing reliability or validity.",0 +https://doi.org/10.1089/acm.2014.0014,The Effect of a Yoga Intervention on Alcohol and Drug Abuse Risk in Veteran and Civilian Women with Posttraumatic Stress Disorder,"Individuals with posttraumatic stress disorder (PTSD) often exhibit high-risk substance use behaviors. Complementary and alternative therapies are increasingly used for mental health disorders, although evidence is sparse.Investigate the effect of a yoga intervention on alcohol and drug abuse behaviors in women with PTSD. Secondary outcomes include changes in PTSD symptom perception and management and initiation of evidence-based therapies.The current investigation analyzed data from a pilot randomized controlled trial comparing a 12-session yoga intervention with an assessment control for women age 18 to 65 years with PTSD. The Alcohol Use Disorder Identification Test (AUDIT) and Drug Use Disorder Identification Test (DUDIT) were administered at baseline, after the intervention, and a 1-month follow-up. Linear mixed models were used to test the significance of the change in AUDIT and DUDIT scores over time. Treatment-seeking questions were compared by using Fisher exact tests.The mean AUDIT and DUDIT scores decreased in the yoga group; in the control group, mean AUDIT score increased while mean DUDIT score remained stable. In the linear mixed models, the change in AUDIT and DUDIT scores over time did not differ significantly by group. Most yoga group participants reported a reduction in symptoms and improved symptom management. All participants expressed interest in psychotherapy for PTSD, although only two participants, both in the yoga group, initiated therapy.Results from this pilot study suggest that a specialized yoga therapy may play a role in attenuating the symptoms of PTSD, reducing risk of alcohol and drug use, and promoting interest in evidence-based psychotherapy. Further research is needed to confirm and evaluate the strength of these effects.",0 +https://doi.org/10.1002/jts.20318,PTSD symptom clusters are differentially related to substance use among community women exposed to intimate partner violence,"Women who experience intimate partner violence (IPV) have higher rates of posttraumatic stress disorder (PTSD) and substance abuse compared to women who do not experience IPV. However, the extent to which IPV-related PTSD symptoms are related to women's substance use involvement largely has been unexplored. The current study investigated PTSD symptomatology and substance use in a community sample of 212 IPV-exposed women. Drug-using women reported higher PTSD severity scores compared to women who reported no substance use or alcohol use only. Moreover, the reexperiencing, avoidance and numbing, and arousal clusters demonstrated unique associations with substance use involvement. Findings not only elucidate the associations among IPV-related PTSD symptoms and substance use, but they also can inform community-based preventive interventions.",0 +https://doi.org/10.3109/08039488.2011.621975,Impact of physical injury on mental health after the 2004 Southeast Asia tsunami,"The risk of developing enduring post-traumatic stress reactions and mental health problems in the aftermath of disasters is substantial. However, there are inconsistencies regarding the contribution of physical injury as an independent risk factor for developing psychiatric morbidity after disasters.The aim was to assess whether physical injury was associated with post-traumatic stress reactions and general mental health after adjusting for perceived life-threat in the aftermath of the 2004 tsunami.A sample of 1501 highly exposed survivors from the 2004 Southeast Asia tsunami was selected from a cohort of Swedish survivors surveyed 14 and 36 months after the event. The impact of physical injury on post-traumatic stress and general mental health was assessed by regression models accounting for subjective life-threat.Physical injury was associated with higher levels of post-traumatic stress reactions and poorer general mental health. These associations were observed at both 14 and 36 months after the disaster.Physical injury has a specific contribution to the association between traumatic experience and both post-traumatic stress reactions and general mental health in victims of the 2004 tsunami. The effect is stable over several years.",0 +https://doi.org/10.1007/s10072-013-1427-4,Pain and neurological sequelae of cluster munitions on children and adolescents in South Lebanon,"This paper aims at evaluating the neurological repercussions arising from injuries sustained due to cluster munitions in children up to 18 years in South Lebanon following the 2006 conflict. Data on neurological and pain symptoms suffered during and after treatment because of sub-munitions in South Lebanon from August 2006 till late 2011 were prospectively recorded. Patients were divided into subcategories; children aged 12 and under and adolescents aged between 13 and 18. During the study period, there were 407 casualties, 122 (30 %) of which were aged 18 years or younger. There were 116 (95 %) males and six (5 %) females. Average age was 14 years. 10 (8.2 %), all males, died as a result of their injuries. 42 (34.4 %) were children and 80 (65.6 %) were adolescents. 112 had surgical treatments for their injuries. 83 out of 112 patients (74 %) with non-lethal injuries had amputations, 67 % children and 78 % adolescents. Among those who had amputations, 31 (37.4 %) suffered from phantom limb pain and 71 % suffered from stump/residual limb pain. 88 % of patients were diagnosed with post-traumatic stress disorder (44 % children and 77 % adolescents) and 41 % were diagnosed with post-concussion syndrome. Four patients (3.6 %) suffered from traumatic brain injuries, both penetrating and closed. Pain syndromes were found in all patients who had amputation. The injury related comorbidities together with many post-concussion syndrome cases, and fewer traumatic brain injuries lead into a high level of physical, psychosocial and economic burdens on the community. © 2013 Springer-Verlag Italia.",0 +https://doi.org/10.7205/milmed-d-12-00186,Group Exposure Therapy Treatment for Post-Traumatic Stress Disorder in Female Veterans,"The purpose of this study was to examine the application of a group exposure therapy model, the content of which consisted solely of repeated imaginal exposure during sessions, in a clinical sample of female veterans with post-traumatic stress disorder (PTSD). Establishing group delivery of exposure therapy will expand options, increase efficiency, and introduce group curative factors.Eighty-eight female veterans with PTSD completed a six-session exposure group, three participants per group, as a component of a larger treatment program. The PTSD symptom checklist (PCL) was used as the outcome measure and administered in each session.Pre/post-paired t-tests showed significant improvement in PTSD on the PCL, with 40% of completers showing at least a 10-point drop in the PCL scores. In addition, a repeated measures analysis of variance showed a significant main effect and a significant quadratic equation, with expected initial increases in the PCL followed by a decrease below baseline at session 6.The group exposure treatment protocol showed positive outcomes on PTSD symptoms in a real-world clinical sample of female veterans. The implications include an expansion of exposure treatment choices for veterans with PTSD and increased options for therapists.",0 +https://doi.org/10.1002/da.1071,Predictors of post-traumatic stress disorder following severe injury,"The chronicity and morbidity of established post-traumatic stress disorder (PTSD) has stimulated interest in recognizing and understanding the early development of the disorder. Acute stress disorder, a new diagnosis intended to facilitate early case detection, rests on the occurrence of dissociative reactions. It remains uncertain whether dissociation is a universal or unique early predictor of subsequent PTSD. Traumatic injury is an important and relatively understudied antecedent of PTSD. The objective of this study was to preliminarily identify which previously implicated early reactions and risk factors would apply to the prediction of PTSD following severe traumatic injury. Patients admitted to a regional Level I trauma center following life threatening events who had recall of the incident and did not have signs of traumatic brain injury or recent psychopathology were enrolled. Comprehensive assessments were conducted during hospitalization and after discharge approximately 2 months after the traumatic event. At follow-up, 24% of the available 50 subjects met full criteria for PTSD and an additional 22% met criteria for two of three symptom clusters. Early symptoms of heightened arousal and coping with disengagement were independent predictors of PTSD severity at follow-up. Relationships to initial dissociative reactions and a diagnosis of ASD were not significant. These early predictors found in a setting of severe injury only partially overlap findings from previous PTSD studies.",0 +https://doi.org/10.1097/01.nmd.0000228503.95503.e9,Predictors of PTSD and Delayed PTSD After Disaster,"In the present study we sought to identify factors associated with posttraumatic stress disorder (PTSD) following the World Trade Center Disaster (WTCD) and examine changes in PTSD status over time. Our data come from a two-wave, prospective cohort study of New York City adults who were living in the city on September 11, 2001. We conducted a baseline survey 1 year after the attacks (year 1), followed by a survey 1 year later (year 2). Overall, 2368 individuals completed the year 1 survey, and 1681 were interviewed at year 2. Analyses for year 1 indicated that being younger, being female, experiencing more WTCD events, reporting more traumatic events other than the WTCD, experiencing more negative life events, having low social support, and having low self-esteem increased the likelihood of PTSD. For year 2, being middle-aged, being Latino, experiencing more negative life events and traumas since the WTCD, and having low self-esteem increased the likelihood of PTSD. Exposure to WTCD events was not related to year 2 PTSD once other factors were controlled. Following previous research, we divided study respondents into four categories: resilient cases (no PTSD years 1 or 2), remitted cases (PTSD year 1 but not year 2), delayed cases (no PTSD year 1 but PTSD year 2), and acute cases (PTSD both years 1 and 2). Factors predicting changes in PTSD between year 1 and year 2 suggested that delayed PTSD cases were more likely to have been Latino, to have experienced more negative life events, and to have had a decline in self-esteem. In contrast, remitted cases experienced fewer negative life events and had an increase in self-esteem. We discuss these findings in light of the psychosocial context associated with community disasters and traumatic stress exposures.",0 +https://doi.org/10.1111/inm.12007,Treatment of post-traumatic stress disorder in patients with severe mental illness: A review,"Although the prevalence of post-traumatic stress disorder (PTSD) is high among those with severe mental illness, little is known about the use of interventions to lessen the burden of PTSD in this population. Currently, there are limited data about safe and effective interventions to treat these individuals. This systematic published work review presents the scientific published work reporting studies of psychological treatment approaches for individuals with comorbid PTSD and severe mental illness. A secondary aim of this study was to identify the specific models implemented and tested, and their impact upon patient outcomes. A review of the published work from January 2001 through January 2012 of English-language publications retrieved from the Cumulative Index of Nursing and Allied Health Literature (CINAHL), MEDLINE, and the American Psychological Association generated abstracts (PsycINFO) databases was conducted. Six studies met the inclusion criteria for the review. The treatment programs described were cognitive-behavioural therapy, psychoeducation, exposure-based cognitive-behavioural therapy, and eye movement desensitization and reprocessing. Evidence of the effectiveness of these programs is examined. Data to support the use of these interventions are limited, indicating the need for further research and efficacy trials. Future areas of research and implications for nursing are discussed.",0 +https://doi.org/10.1002/jts.21752,Attachment and Mental Health Symptoms Among U.S. Afghanistan and Iraq Veterans Seeking Health Care Services,"Attachment theory has become a primary framework for understanding adjustment to traumas. In a convenience sample of 157 U.S. service members from the Afghanistan and Iraq wars seeking health care services at a Veterans Administration (VA) hospital, this study examined (a) the impact of attachment characteristics on several key mental health symptoms in this new generation of veterans, (b) the relative frequencies of prominent attachment styles in the sample, and (c) how these higher order orientations related to study outcomes. First, with demographic and military background factors in the model, attachment-related anxiety and avoidance were each uniquely associated with posttraumatic stress symptoms (PTSS), psychiatric distress, and alcohol misuse, βs = .25 to .60. Second, latent class analysis highlighted the underrepresentation of avoidant veterans of a dismissive type in the sample. Third, of the different possible types of attachment insecurities, veterans with a fearful disorganized orientation were also shown to be particularly vulnerable to PTSS and other problems, even when compared to preoccupied-dependent persons. These findings yield further support for the protective benefit of attachment security, while also suggesting the importance of both attachment anxiety and avoidance in the context of postdeployment adjustment.",0 +https://doi.org/10.1080/00029157.2002.10403493,The Role of Hypnosis in the Detection of Psychogenic Seizures,"In this preliminary clinical investigation, hypnosis was used in the differential diagnosis of epileptic versus psychogenic seizures (PS). Eight patients with a clinical profile suggesting the presence of PS were given a hypnotic suggestion in which they had to go back in time to the exact moment of their last seizure. They were then asked to concentrate their attention on any unusual feeling or bodily sensation. All 8 patients presented a PS during the age regression protocol. In 6 cases, independent testimony from family members corroborated the morphological similarity of the induced attack and the ones presented in their natural environment. Also, the seizures ended abruptly after a command was given to stop them. A control group of 5 epileptic subjects did not present any signs of discomfort or seizure behavior during the hypnotic protocol. It is argued that a simple procedure as the one described in this investigation can be useful as a diagnostic tool in the differentiation of epileptic from PS attacks.",0 +https://doi.org/10.1080/15325024.2014.897573,"The Impact of Previous Suicide Ideations, Traumatic Stress, and Gender on Future Suicide Ideation Trajectories Among Black American Adolescents: A Longitudinal Investigation","It has long been asserted that previous suicide behaviors (gestures and attempts) are a significant predictor of future suicide behaviors. Less is known about the extent to which this axiom applies to suicide ideations. The current investigation explored suicide ideations in a longitudinal sample of Black American adolescents (N = 977) aged 11 to 18. Logistic growth models were conducted with future suicide ideations as the dependent variable and the number of previous suicide ideations, traumatic stress, and gender as independent variables. Results show, first, that previous suicide ideations and traumatic stress are potent predictors of future suicide ideations. Second, the probability of future suicide ideations is higher when both the number of previous suicide ideations and traumatic stress levels increase, and this probability remains higher as the adolescent ages. These results demonstrate that the long-held proposition that previous suicide behaviors are predictive of future suicide behavior traje...",0 +https://doi.org/10.1016/j.neuropharm.2011.11.008,Glycine reuptake inhibitor RG1678: A pharmacologic characterization of an investigational agent for the treatment of schizophrenia,"Dysfunctional N-methyl-d-aspartate (NMDA) receptor neurotransmission has been implicated in the pathophysiology of schizophrenia. It is thought that this abnormal functioning can be corrected by increasing availability of the NMDA co-agonist glycine through inhibition of glycine transporter type 1 (GlyT1). Herein is described the pharmacologic profile of RG1678, a potent and noncompetitive glycine reuptake inhibitor. In vitro, RG1678 noncompetitively inhibited glycine uptake at human GlyT1 with a concentration exhibiting half-maximal inhibition (IC(50)) of 25 nM and competitively blocked [(3)H]ORG24598 binding sites at human GlyT1b in membranes from Chinese hamster ovary cells. In hippocampal CA1 pyramidal cells, RG1678 enhanced NMDA-dependent long-term potentiation at 100 nM but not at 300 nM. In vivo, RG1678 dose-dependently increased cerebrospinal fluid and striatal levels of glycine measured by microdialysis in rats. Additionally RG1678 attenuated hyperlocomotion induced by the psychostimulant d-amphetamine or the NMDA receptor glycine site antagonist L-687,414 in mice. RG1678 also prevented the hyper-response to d-amphetamine challenge in rats treated chronically with phencyclidine, an NMDA receptor open-channel blocker. In the latter experiment, a decrease in ex vivo striatal [(3)H]raclopride binding was also measured. These data demonstrate that RG1678 is a potent, noncompetitive glycine reuptake inhibitor that can modulate both glutamatergic and dopaminergic neurotransmission in animal experiments that model aspects of schizophrenia. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0 +https://doi.org/10.1007/s00127-013-0762-3,"Determinants of the development of post-traumatic stress disorder, in the general population","To assess (1) the lifetime prevalence of exposure both to trauma and post-traumatic stress disorder (PTSD); (2) the risk of PTSD by type of trauma; and (3) the determinants of the development of PTSD in the community.The Diagnostic Interview for Genetic Studies was administered to a random sample of an urban area (N = 3,691).(1) The lifetime prevalence estimates of exposure to trauma and PTSD were 21.0 and 5.0%; respectively, with a twice as high prevalence of PTSD in women compared to men despite a similar likelihood of exposure in the two sexes; (2) Sexual abuse was the trauma involving the highest risk of PTSD; (3) The risk of PTSD was most strongly associated with sexual abuse followed by preexisting bipolar disorder, alcohol dependence, antisocial personality, childhood separation anxiety disorder, being victim of crime, witnessing violence, Neuroticism and Problem-focused coping strategies. After adjustment for these characteristics, female sex was no longer found to be significantly associated with the risk of PTSD.The risk for the development of PTSD after exposure to traumatic events is associated with several factors including the type of exposure, preexisting psychopathology, personality features and coping strategies which independently contribute to the vulnerability to PTSD.",0 +https://doi.org/10.1002/brb3.392,"Brain‐derived neurotropic factor polymorphisms, traumatic stress, mild traumatic brain injury, and combat exposure contribute to postdeployment traumatic stress","BACKGROUND: In addition to experiencing traumatic events while deployed in a combat environment, there are other factors that contribute to the development of posttraumatic stress disorder (PTSD) in military service members. This study explored the contribution of genetics, childhood environment, prior trauma, psychological, cognitive, and deployment factors to the development of traumatic stress following deployment. METHODS: Both pre- and postdeployment data on 231 of 458 soldiers were analyzed. Postdeployment assessments occurred within 30 days from returning stateside and included a battery of psychological health, medical history, and demographic questionnaires; neurocognitive tests; and blood serum for the D2 dopamine receptor (DRD2), apolipoprotein E (APOE), and brain-derived neurotropic factor (BDNF) genes. RESULTS: Soldiers who screened positive for traumatic stress at postdeployment had significantly higher scores in depression (d = 1.91), anxiety (d = 1.61), poor sleep quality (d = 0.92), postconcussion symptoms (d = 2.21), alcohol use (d = 0.63), traumatic life events (d = 0.42), and combat exposure (d = 0.91). BDNF Val66 Met genotype was significantly associated with risk for sustaining a mild traumatic brain injury (mTBI) and screening positive for traumatic stress. Predeployment traumatic stress, greater combat exposure and sustaining an mTBI while deployed, and the BDNF Met/Met genotype accounted for 22% of the variance of postdeployment PTSD scores (R (2) = 0.22, P CONCLUSION: These findings suggest predeployment traumatic stress, genetic, and environmental factors have unique contributions to the development of combat-related traumatic stress in military service members. Language: en",0 +https://doi.org/10.1111/jcpp.12213,Double disadvantage: the influence of childhood maltreatment and community violence exposure on adolescent mental health,"Childhood maltreatment is a key risk factor for maladjustment and psychopathology. Although maltreated youth are more likely to experience community violence, both forms of adversity are generally examined separately. Consequently, little is known about the unique and interactive effects that characterize maltreatment and community violence exposure (CVE) on mental health.Latent Profile Analysis (LPA) was applied to data from a community sample of high-risk adolescents and young adults (n = 204, M = 18.85) to categorize groups of participants with similar patterns of childhood (i.e. past) maltreatment exposure. Associations between childhood maltreatment, CVE and mental health outcomes were then explored using multivariate regression and moderation analyses.Latent Profile Analysis identified three groups of individuals with low, moderate and severe levels of childhood maltreatment. Maltreatment was associated with more internalizing, externalizing, and trauma-related symptoms. By contrast, CVE showed independent associations with only externalizing and trauma-related symptoms. Typically, childhood maltreatment and CVE exerted additive effects; however, these forms of adversity interacted to predict levels of anger.Exposure to maltreatment and community violence is associated with increased levels of clinical symptoms. However, while maltreatment is associated with increased symptoms across a broad range of mental health domains, the impact of community violence is more constrained, suggesting that these environmental risk factors differentially impact mental health functioning.",0 +https://doi.org/10.1002/jts.20234,"PTSD symptoms, life events, and unit cohesion in U.S. soldiers: Baseline findings from the neurocognition deployment health study","Relationships among a modifiable situational factor (unit cohesion), prior stressful life events, and posttraumatic stress disorder (PTSD) symptoms were assessed in 1,579 U.S. Army soldiers with no history of contemporary war zone deployment. It was predicted that unit cohesion would attenuate the dose-response relationship between past stressor exposures and PTSD symptoms at relatively moderate levels of exposure. Consistent with this hypothesis, regression analysis revealed that life experiences and unit cohesion strongly and independently predicted PTSD symptoms, and that unit cohesion attenuated the impact of life experiences on PTSD. Some military personnel reported significant predeployment, stress-related symptoms. These symptoms may serve as vulnerabilities that could potentially be activated by subsequent war-zone deployment. Higher predeployment unit cohesion levels appear to ameliorate such symptoms, potentially lessening future vulnerability.",0 +https://doi.org/10.1016/j.biopsych.2009.01.031,Serotonin and Sensitivity to Trauma-Related Exposure in Selective Serotonin Reuptake Inhibitors-Recovered Posttraumatic Stress Disorder,"

Background

Selective serotonin reuptake inhibitors (SSRIs) are first-line treatments for posttraumatic stress disorder (PTSD). Serotonergic (5HT) attenuation of stress sensitivity is postulated from SSRIs' effects in other anxiety disorders, and we studied this in PTSD.

Methods

Ten patients with PTSD fully recovered on SSRIs (Clinical Global Impression Scale—I 1 and 2) were enrolled in the study. Patients were tested on two occasions 1 week apart; in each session, they received a drink containing large neutral amino acids (LNAAs) either with (sham tryptophan depletion [STD], control) or without (acute tryptophan depletion [ATD]) tryptophan. At 5.5 hours after the drink, subjects were exposed to a trauma-related exposure challenge. Self-reports of PTSD (visual analogue scales [VAS] and the Davidson Trauma Scale [DTS]), anxiety (Spielberger State Inventory [STAI] Form Y-1), and mood (Profile of Mood States [POMS]) were obtained. Heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure were also measured.

Results

The trauma-related exposure challenge induced anxiety on both days, with more marked responses on the ATD day according to VAS, DTS, POMS, and DBP (p < .05). A trend of significance (.1 > p > .05) was observed for STAI Form Y-1, HR, and SBP.

Conclusions

These data demonstrate that ATD accentuates responses to trauma-related stimuli in SSRI-recovered PTSD. They also suggest that SSRI-induced increases in serotonin function restrain PTSD symptoms, especially under provocation, supporting a role for serotonin in mediating stress resilience.",0 +https://doi.org/10.1186/1745-6215-15-240,Evaluation of a corticotropin releasing hormone type 1 receptor antagonist in women with posttraumatic stress disorder: study protocol for a randomized controlled trial,"Pharmacologic treatment options for posttraumatic stress disorder (PTSD) are limited in number and effectiveness. Medications currently in use to treat PTSD were originally approved based on their efficacy in other disorders, such as major depression. Substantial research in PTSD suggests that increased activity of corticotropin releasing hormone (CRH)-containing circuits are involved in the pathophysiology of the disease. This Phase II trial aims to evaluate the efficacy of a CRH type 1 receptor (CRHR1) antagonist in the treatment of PTSD.Currently untreated adult women, ages 18 to 65 years, with a primary psychiatric diagnosis of PTSD of at least 3 months' duration, are being enrolled in a parallel-group, double-blind, placebo-controlled, randomized clinical trial evaluating the efficacy and safety of GSK561679, a novel CRHR1 receptor antagonist. GSK561679 (or matching placebo) is prescribed at a fixed dose of 350 mg nightly for six weeks. The primary trial hypothesis is that GSK561679 will reduce symptoms of PTSD, as measured by the Clinician-Administered PTSD Scale (CAPS), significantly more than placebo after six weeks of treatment. Putative biological markers of PTSD which may influence treatment response are measured prior to randomization and after five weeks' exposure to the study medication, including: fear conditioning and extinction using psychophysiological measures; variants of stress-related genes and gene expression profiles; and indices of HPA axis reactivity. In addition, the impact of PTSD and treatment on neuropsychological performance and functional capacity are assessed at baseline and after the fifth week of study medication. After completion of the six-week double blind treatment period, subjects enter a one-month follow-up period to monitor for sustained response and resolution of any adverse effects.Considerable preclinical and human research supports the hypothesis that alterations in central nervous system CRH neuronal activity are a potential mediator of PTSD symptoms. This study is the first to assess the efficacy of a specific antagonist of a CRH receptor in the treatment of PTSD. Furthermore, the biological and neuropsychological measures included in this trial will substantially inform our understanding of the mechanisms of PTSD.Clinicaltrials.gov Identifier: NCT01018992.Registered 6 November 2009. First patient randomized 14 January 2010.",0 +https://doi.org/10.1177/1745691613504115,"636,120 Ways to Have Posttraumatic Stress Disorder","In an attempt to capture the variety of symptoms that emerge following traumatic stress, the revision of posttraumatic stress disorder (PTSD) criteria in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has expanded to include additional symptom presentations. One consequence of this expansion is that it increases the amorphous nature of the classification. Using a binomial equation to elucidate possible symptom combinations, we demonstrate that the DSM-IV criteria listed for PTSD have a high level of symptom profile heterogeneity (79,794 combinations); the changes result in an eightfold expansion in the DSM-5, to 636,120 combinations. In this article, we use the example of PTSD to discuss the limitations of DSM-based diagnostic entities for classification in research by elucidating inherent flaws that are either specific artifacts from the history of the DSM or intrinsic to the underlying logic of the DSM's method of classification. We discuss new directions in research that can provide better information regarding both clinical and nonclinical behavioral heterogeneity in response to potentially traumatic and common stressful life events. These empirical alternatives to an a priori classification system hold promise for answering questions about why diversity occurs in response to stressors.",0 +https://doi.org/10.1016/j.jad.2011.12.018,"Posttraumatic stress disorder, depression, and perceived needs for psychological care in older persons affected by Hurricane Ike","To examine the prevalence and correlates of disaster-related posttraumatic stress disorder (PTSD), depression, and needs for psychological care in older persons affected by Hurricane Ike.A total of 193 adults aged 60 or older who resided in the Galveston Bay area were interviewed 2-5 months following Hurricane Ike. Pre-, peri-, and post-disaster variables hypothesized to be related to PTSD and depressive symptoms, and perceived needs for psychological care were assessed.Weighted prevalences of past-month Ike-related PTSD and depression were 7.6% and 8.6%, respectively. Risk factors for Ike-related PTSD symptoms were predominantly peri-disaster in nature, with greater hurricane exposure, and peri-event dissociative and autonomic activation symptoms associated positively with these symptoms. Risk factors for depressive symptoms were predominantly pre-disaster in nature, with being married/living with partner associated negatively, and prior disaster exposure and pre-disaster PTSD or depression associated positively with these symptoms. 27.2% of the sample endorsed at least one of the perceived needs for psychological care assessed. A history of PTSD or depression, greater peri-event autonomic activation, and Ike-related PTSD and depressive symptoms were associated with greater need for psychological care.This study is limited by its cross-sectional design and employment of psychiatric screening instruments.A substantial proportion of older adults may have PTSD and depression, as well as perceived needs for psychological care, after a disaster. Assessment of disaster exposures, and peri-event dissociative and autonomic symptoms may help identify older adults at risk for disaster-related psychopathology. Older adults with a history of PTSD or depression, and greater peri-event autonomic activation and PTSD symptoms may be more likely to have needs for psychological care.",0 +https://doi.org/10.1080/09515070.2013.816840,Emotional Processing Therapy for post traumatic stress disorder,"While prolonged exposure is considered one of the “gold standard” and recommended treatments for post traumatic stress disorder (PTSD), it has been poorly utilised in clinical practice. Individuals with PTSD often find it too distressing to confront memories, and therapists may be uncomfortable using the therapy. A new Emotional Processing Therapy is described in which an emotional approach to prolonged exposure provides individuals with a new insight into how trauma is processed. A conceptual analysis of exposure suggests that it is exposure to distressing emotional experiences which is a key element. Viewing it as an emotion-based therapy, allows the creative addition of new emotional elements. Through exploring the individual’s emotional processing style, previously learned and unhelpful patterns can be addressed, and the addition of an “emotional preparation” phase helps them understand why it is important to face emotionally distressing memories before exposure sessions begin. Emotional Processing Th...",0 +https://doi.org/10.1016/j.pain.2007.05.005,The relation between multiple pains and mental disorders: Results from the World Mental Health Surveys,"It is unclear whether differences exist in the prevalence of mood, anxiety and alcohol use disorders among persons with multiple pain conditions compared with those with single pain problems. We conducted population surveys in 17 countries in Europe, the Americas, the Middle East, Africa, Asia, and the South Pacific. Participants were community-dwelling adults (N=85,088). Mental disorders were assessed with the Composite International Diagnostic Interview. Pain was assessed by self-report. Both multiple and single site pain problems were associated with mood and anxiety disorders, but not with alcohol abuse or dependence. In general, the prevalence of specific mood and anxiety disorders followed a linear pattern with the lowest rates found among persons with no pain, intermediate rates among those with one pain, and highest rates among those with multi-site pain problems. Relative to persons not reporting pain, the pooled estimates of the age-sex adjusted odds ratios were 1.8 (1.7-2.0) for mood disorders and 1.9 (1.8-2.1) for anxiety disorders for persons with single site pain; 3.7 (3.3-4.1) for mood disorders and 3.6 (3.3-4.0) for anxiety disorders among those with multi-site pain. Our results indicate that the presence of multiple pain conditions was strongly and comparably associated with mood and anxiety disorders in diverse cultures. This consistent pattern of associations suggests that diffuse pain and psychiatric disorders are generally associated, rather than diffuse pain representing an idiom for expressing distress that is specific to particular cultural settings or diffuse pain solely representing a form of masked depression.",0 +https://doi.org/10.1037/h0099857,"Hierarchical convergence of PTSD symptom clusters: A comparison of the numbing, dysphoria, and dysphoric arousal models of PTSD.","Previous research has found support for 3 intercorrelated models of posttraumatic stress disorder (PTSD): the Numbing model (King, Leskin, King, & Weathers, 1998), the Dysphoria model (Simms, Watson, & Doebbelling, 2002), and the Dysphoric Arousal model (Elhai et al., 2011). Researchers have not yet examined whether the symptom clusters represented by these 3 models would converge together in the same manner at the second-order level. The aim of the present study was to compare the efficiency of 1- and 2-factor hierarchical structures for each of the 3 PTSD models. Two large samples (total N = 3,178) of college students who reported a traumatic event completed a measure of PTSD. Confirmatory factor analysis showed that Elhai et al.'s (2011) Dysphoric Arousal model fit the data best at the first-order, intercorrelated level. Examination of the fit of the hierarchical structures showed important differences among the models: the Numbing model fit a 2-factor second-order structure more efficiently than it fit a single-factor hierarchical structure, whereas the Dysphoria model was better explained at the second-order level by a single-factor, General PTSD structure. The Dysphoric Arousal model showed poor fit statistics with both the 1- and 2-factor hierarchical structures, suggesting that Elhai et al.'s (2011) model does not fit either the General PTSD representation or a 2-factor hierarchical conception of PTSD. The differences in fit of the 3 models at the hierarchical level have implications for the measurement, theoretical understanding, and treatment of PTSD. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0 +,Interpersonal Processes in the Anxiety Disorders,"We examine the role of interpersonal processes in the anxiety disorders, a group of conditions characterized by excessive and incapacitating anxiety. The chapter begins with an empirical review that summarizes what is known about the interpersonal factors associated with social anxiety disorder, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. We then examine similarities and differences among the disorders as a first step toward establishing their unique interpersonal profiles. Despite limitations in extant studies, the literature as a whole supports the notion that interpersonal processes play a key role in these conditions. We end with suggestions for the way in which interpersonal theory might provide leads for future research. © 2011 John Wiley & Sons, Inc. All rights reserved.",0 +https://doi.org/10.1016/j.janxdis.2007.04.007,Memory impairments in posttraumatic stress disorder are related to depression,"The present study focuses on verbal learning and memory alterations in refugees with posttraumatic stress disorder, and whether the alterations are related to attention, acquisition, storage, or retrieval. Twenty-one refugees exposed to war and political violence with chronic PTSD, were compared to an exposed control sample of 21 refugees without PTSD. No differences were found in attention span, but tests of verbal memory showed less efficient learning in the PTSD sample. Group differences in delayed recall could be explained by learning efficiency. No differences were seen in recognition memory. These results indicate that memory alterations in PTSD are related to impaired acquisition and less effective encoding of the memory material and not to impaired attention span and/or impaired retrieval. Controlling for specific PTSD symptom clusters and self-reported depression showed that the intrusion subscale and depressive reactions are the most important symptoms in understanding the memory alterations in PTSD.",0 +https://doi.org/10.1177/1073191106298876,Validation of a Tibetan Translation of the Hopkins Symptom Checklist–25 and the Harvard Trauma Questionnaire,"This study sought to translate and validate the Hopkins Symptom Checklist–25 (HSCL) and the Harvard Trauma Questionnaire (HTQ) in a Tibetan population. Translated questionnaires were administered to 57 Tibetan survivors of torture/human rights abuses living in the United States and receiving services in a torture treatment program. Participants were evaluated to determine if they met criteria for major depressive episode, generalized anxiety disorder, or posttraumatic stress disorder (PTSD). Coefficient alpha for the HSCL Anxiety subscale (.89), Depression subscale (.92), and the HTQ (.89) were high. Diagnostic accuracy using receiver operating characteristic curve analysis generated good classification accuracy for anxiety (.89), depression (.92), and PTSD (.83). However, although sensitivity and specificity for HSCL subscales were quite high, the HTQ generated low sensitivity (.33), partly because of a low rate of PTSD. Results support the reliability and validity of the HSCL but suggest further study of the HTQ with this population is required.",0 +https://doi.org/10.1002/gps.2826,Post-traumatic stress disorder symptoms in emotionally distressed individuals referred for a depression prevention intervention: relationship to problem-solving skills,"Objectives This study examined the rates of syndromal and subthreshold post-traumatic stress disorder (PTSD) and PTSD symptom scores in participants with symptoms of emotional distress, subsyndromal depression, and a history of traumatic exposure. Participants had been referred to a study of an indicated depression prevention intervention using problem-solving therapy in primary care. We hypothesized that higher severity of PTSD symptom scores would predict poorer problem-solving skills. In addition, some reports have suggested that there are higher rates of PTSD in minority populations relative to Caucasians; thus we hypothesized that race would also predict problem-solving skills in these individuals. Methods We examined the rates of traumatic exposure, syndromal, and subthreshold PTSD. In those exposed to trauma, we performed a multiple linear regression to examine the effects of PTSD symptoms, depression symptoms, race, age, and gender on social problem-solving skills. Results Of the 244 participants, 64 (26.2%) reported a traumatic event; 6/234 (2.6%) had syndromal PTSD, and 14/234 (6.0%) had subthreshold PTSD. By way of regression analysis, higher PTSD symptom scores predicted poorer problem-solving skills. In addition, racial status (Caucasian vs. African American) predicted problem-solving skills; Caucasians exhibited lower levels of problem-solving skills. Conclusions Individuals presenting with subsyndromal depressive symptoms may also have a history of traumatic exposure, subthreshold and syndromal PTSD. Thus, screening these individuals for PTSD symptoms is important and may inform clinical management decisions because problem-solving skills are lower in those with more severe PTSD symptoms (even after adjusting for race, age, gender, and depressive symptoms). Copyright © 2011 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1080/13623690802568913,"Prevalence of mental disorders among children exposed to war: a systematic review of 7,920 children","Worldwide, millions of children are affected by armed conflict. However, data on the prevalence of mental disorders among these children is sparse. We aimed to determine the prevalence of mental disorders among children affected by war using a systematic review and meta-regression analysis. We systematically reviewed existing literature to identify studies on prevalence of post-traumatic stress disorder (PTSD), anxiety, depression and psychosis among children exposed to armed conflict. We searched electronic databases and references listed in studies to obtain eligible studies. We pooled studies using the random-effects method and explored heterogeneity using meta-regression analysis. Seventeen studies met our inclusion criteria. Studies included 7,920 children. Sample sizes ranged from 22 to 2,976. Four studies were conducted during a conflict and others during post-conflict. All the studies reported PTSD as the primary outcome ranging from 4.5 to 89.3%, with an overall pooled estimate of 47% (9% CI: 35-60%, I2 = 98%). Meta-analysis heterogeneity was attributable to study location (OR 1.33, 95% CI: 1.27-1.41), method of measurement (OR 1.36, 95% CI: 1.29-1.44) and duration since exposure to war (coefficient 0.17, 95% CI: 0.94-0.25). In addition, four studies reported elevated depression that allowed pooling (43%, 95% CI: 31-55%) and three studies reported elevated anxiety disorders allowing pooling (27%, 95% CI: 21-33%). Our systematic review suggests a higher prevalence rate of mental disorders among children exposed to conflict than among the general population. Given the number of current conflicts, there is a paucity of information regarding mental disorders among children affected by war.",0 +https://doi.org/10.1016/j.dcn.2013.02.004,"Mental imagery, emotion and psychopathology across child and adolescent development","Mental imagery-based interventions are receiving increasing interest for the treatment of psychological disorders in adults. This is based on evidence that mental imagery potently influences the experience of emotion in non-clinical samples, and that a number of psychological disorders are marked by syndrome-specific, distressing abnormalities in mental imagery. During childhood and adolescence, neurocognitive development impacting mental imagery processes may moderate its relationship with clinically-relevant emotional symptoms at a number of potential loci. Crucially, these changes could impact vulnerability to distressing mental imagery and the efficacy of mental imagery-based clinical interventions. This review synthesises evidence pertaining to developmental changes in the role and content of mental imagery, and in the cognitive sub-processes required to generate and sustain mental images. Subsequently, we discuss implications for understanding the developmental relationship between mental imagery, emotion and psychopathology. Translational cognitive neuroscience research investigating the content, emotional impact and neurocognitive substrates of mental imagery across development may reveal insights into trajectories of vulnerability to symptoms of a number of psychological disorders. If proper consideration is given to developmental factors, techniques based on mental imagery may be valuable as part of a treatment armoury for child and adolescent clinical populations and those at risk of emotional disorders.",0 +https://doi.org/10.1007/s00068-010-0020-2,Functional outcome and quality of life in victims of terrorist explosions as compared to conventional trauma,"Background: Following trauma, the number of preventable deaths is low. Outcome should also be measured in terms of quality of life (QoL). Studies analyzing QoL in trauma patients have been published, but little is known about the long term QoL of victims of terrorist attacks. Methods: This is a case-control study of casualties of the March 11, 2004 attacks in Madrid. Patients treated for other trauma with similar age and Injury Severity Score (ISS), served as controls. Patients were assessed using the POLO-Chart (VAS, SF-36 and TOP). Results: Fifty-eight patients were included, 32 casualties admitted following the March 11, 2004 attacks and 26 controls. Both groups were comparable in age (average = 37), ISS (average = 23) and time from trauma (average = 1,770 days). Subjects demonstrated lower scores for the VAS, and the SF-36 clusters social functioning, role emotional and mental health. There was a tendency towards higher prevalence of symptoms associated to posttraumatic stress disorder (PTSD) in subjects (p = 0.056). Subjects suffered from higher residual pain in the head region (p = 0.032). Strong association was found between the presence of symptoms associated to depression, anxiety and PTSD and worse QoL (p < 0.001). Conclusion: Subjects present more emotional distortions, residual pain in the head region and a tendency towards a worsened perception of their own health and wellness. They also present symptoms associated to PTSD more frequently. The presence of symptoms associated to PTSD, depression or anxiety was an independent variable related to lower QoL in both groups. © 2010 Urban & Vogel.",0 +https://doi.org/10.1016/j.jad.2013.09.018,Interaction between genetic variants and exposure to Hurricane Katrina on post-traumatic stress and post-traumatic growth: A prospective analysis of low income adults,"There is considerable variation in psychological reactions to natural disasters, with responses ranging from relatively mild and transitory symptoms to severe and persistent posttraumatic stress (PTS). Some survivors also report post-traumatic growth (PTG), or positive psychological changes due to the experience and processing of the disaster and its aftermath. Gene-environment interaction (GxE) studies could offer new insight into the factors underlying variability in post-disaster psychological responses. However, few studies have explored GxE in a disaster context.We examined whether ten common variants in seven genes (BDNF, CACNA1C, CRHR1, FKBP5, OXTR, RGS2, SLC6A4) modified associations between Hurricane Katrina exposure and PTS and PTG. Data were from a prospective study of 205 low-income non-Hispanic Black parents residing in New Orleans prior to and following Hurricane Katrina.We found a significant association (after correction) between RGS2 (rs4606; p=0.0044) and PTG, which was mainly driven by a cross-over GxE (p=0.006), rather than a main genetic effect (p=0.071). The G (minor allele) was associated with lower PTG scores for low levels of Hurricane exposure and higher PTG scores for moderate and high levels of exposure. We also found a nominally significant association between variation in FKBP5 (rs1306780, p=0.0113) and PTG, though this result did not survive correction for multiple testing.Although the inclusion of low-income non-Hispanic Black parents allowed us to examine GxE among a highly vulnerable group, our findings may not generalize to other populations or groups experiencing other natural disasters. Moreover, not all participants invited to participate in the genetic study provided saliva.To our knowledge, this is the first study to identify GxE in the context of post-traumatic growth. Future studies are needed to clarify the role of GxE in PTS and PTG and post-disaster psychological responses, especially among vulnerable populations.",0 +https://doi.org/10.1080/15325024.2012.679129,The Dynamics of Posttraumatic Growth Across Different Trauma Types in a Palestinian Sample,"A Palestinian sample was used to explore the dynamics of posttraumatic growth (PTG) across different trauma types. Cumulative trauma, posttraumatic stress disorder, depression, anxiety, PTG, and stress-related growth (SRG) measures were administered. As predicted, only type I traumas were associated with PTG. Type II traumas were not associated with PTG, while type III collective identity traumas were negatively associated with PTG. Results indicated that PTG was not a significant predictor of any mental health symptoms and that PTG is different from SRG, which seems to describe growth in non-traumatic situations. The results suggest that it is important to analyze trauma profiles rather than single trauma.",0 +https://doi.org/10.1016/s0006-3223(03)00547-x,Near-infrared spectroscopy analysis of frontal lobe dysfunction in schizophrenia,"Previous studies have shown that near-infrared spectroscopy (NIRS) has high temporal resolution, requires little restraint, and is suitable for examining the effect of psychological tasks on brain circulation. In the present study, frontal function in schizophrenic patients was analyzed by NIRS during random number generation (RNG), ruler-catching (RC), and sequential finger-to-thumb (SFT) tasks.Two sets of NIRS probes were attached to the foreheads of 13 schizophrenic patients and 10 control subjects approximately at Fp1-F7 and Fp2-F8. Near-infrared spectroscopy was conducted at a sampling rate of 1 Hz, with the pathlength being determined by time-resolved spectroscopy with differential pathlength factor measurements. The absolute changes in oxygenated (oxy-Hb) and deoxygenated (deoxy-Hb) hemoglobin concentrations in response to each task were measured, and total hemoglobin (total-Hb) concentration was calculated as the sum of the two.During RNG task, total- and oxy-Hb concentrations increased, and deoxy-Hb decreased, but the responses were significantly smaller in schizophrenic patients. During RC task, oxy-Hb in schizophrenic patients tended to decrease, in contrast to the mostly increasing response in control subjects. No group difference was observed during SFT task.Task-dependent profile of functional abnormalities was observed in schizophrenic frontal brain metabolism. These results support the usefulness of NIRS data in investigating frontal lobe dysfunction and evaluating psychopathologic condition in schizophrenic patients.",0 +https://doi.org/10.7196/samj.3888,Reported rapes at a hospital rape centre: Demographic and clinical profiles,"2South Africa has one of the highest incidences of rape in the world and the most violent types of rape in the world, with gang rape and severe physical injury to rape victims commonly occurring. 3,4 Moreover, the consequences of rape potentially include many medical and psychological difficulties, such as unwanted pregnancy, risk of sexually transmitted infections (STIs), genital and physical injury, and psychological disturbance e.g. post-traumatic stress disorder, major depression, increased risk of suicidal ideation, and alcohol and drug abuse problems. 5,6 Rape survivors have specific health needs, ideally met by providing integrated and holistic post-rape services, including the provision of pregnancy testing and prevention, termination of pregnancy, testing and treatment of STIs and injuries, and psychosocial counselling. 7 Rape survivors strongly value the availability of HIV prophylaxis, an understanding health care provider, access to and receiving counselling, and thorough physical examination, emphasising the need for a holistic approach to post-rape care. 8,9 The Act aims to provide certain services to survivors of sexual assault to minimise or prevent further traumatisation, yet the only medical service conditionally provided to rape survivors is the provision of post-exposure prophylaxis (PEP). 2",0 +https://doi.org/10.1002/cpp.1805,A Socio-interpersonal Perspective on PTSD: The Case for Environments and Interpersonal Processes,"Post-traumatic stress disorder (PTSD) is a common reaction to traumatic experiences. We propose a socio-interpersonal model of PTSD that complements existing models of post-traumatic memory processes or neurobiological changes. The model adds an interpersonal perspective to explain responses to traumatic stress. The framework draws from lifespan psychology, cultural psychology and research into close relationships and groups. Additionally, clinical knowledge about PTSD is incorporated. This involves knowledge about shame, guilt, estrangement feelings and protective factors, such as social support and forgiveness. Three levels are proposed at which relevant interpersonal processes can be situated and should be adequately researched. First, the individual level comprises social affective states, such as shame, guilt, anger and feelings of revenge. Second, at the close relationship level, social support, negative exchange (ostracism and blaming the victim), disclosure and empathy are proposed as dyadic processes relevant to PTSD research and treatment. Third, the distant social level represents culture and society, in which the collectivistic nature of trauma, perceived injustice, and social acknowledgement are concepts that predict the response trajectories to traumatic stress. Research by the current authors and others is cited in an effort to promote future investigation based on the current model. Methodological implications, such as multi-level data analyses, and clinical implications, such as the need for couple, community or larger-level societal interventions, are both outlined.The socio-interpersonal model proposes an interpersonal view of the processes that occur in the aftermath of a traumatic experience. At the individual level, the model integrates the social affective phenomena that clinical research identifies in PTSD patients, including shame, guilt, anger, revenge and the urges or reluctance to disclose. At the level of close relationships, there is an emphasis on the role of the individuals' partner, family or social support in the development or maintenance of PTSD and its recovery. At the distant social level, societal and cultural factors, e.g., individualistic versus collectivistic or other human value orientations, are acknowledged as contributing to the severity and course of PTSD. Increasing attention should be given to new approaches of PTSD treatment that refer to an interpersonal view of PTSD, e.g., communication training, PTSD-specific couples' therapy or community programs.",0 +https://doi.org/10.1111/bjc.12049,Parent and child distress after war exposure,"The purpose of this study was to examine multiple distress symptoms (i.e., post-traumatic stress [PTS], anxiety, depression) among parents and children exposed to the Gulf Crisis in 1990-1991. Profiles of parent distress were identified, and the relationship between parent distress and specific child distress symptoms was examined.Parents and children were assessed at one time point.Participants included 151 children (Mage = 10.62 years; 51% female) and 140 parents (Mage = 40 years; 81% female).Utilizing latent profile analysis, three parallel profiles of parent distress were identified: low distress, moderate distress, and high distress. Parent distress was a risk factor for child depression, but it was not a risk factor for child PTS or anxiety.Findings support the importance of broadening the scope of research conducted after exposure to traumatic events to include the assessment of anxiety and depression, as well as PTS, among both parents and children. Additional implications for research and clinical work are discussed.Findings support the importance of screening for multiple distress symptoms among both children and parents after war exposure. Based on our findings, clinicians may want to consider including parents in therapy for children reporting psychological distress, especially depression symptoms, after exposure to traumatic events. This study was cross-sectional. Thus, we are not able to infer direction or causality. The generalizability of our study should be interpreted with caution, as findings will need to be replicated across other populations and other cultures.",0 +https://doi.org/10.2165/00023210-199401010-00006,Fluvoxamine,"Synopsis Fluvoxamine is a selective serotonin reuptake inhibitor which was initially developed as an antidepressant. Additional clinical research has identified several other disorders of the central nervous system in whichfluvoxamine has potential benefits, and which are the focus of this review. At present, the largest volume of data concerns the use of fluvoxamine in obsessive-compulsive disorder. Oral fluvoxamine at dosages of up to 300 mg/day is effective in alleviating, although not preventing, the symptoms of obsessivecompulsive disorder in 40 to 50% of patients, and limited data indicate that it is as effective as clomipramine. Encouraging initial data are also available regarding the efficacy of fluvoxamine in panic disorder. Further data are required to fully establish the efficacy of fluvoxamine in preventing panic attacks, and to investigate possible beneficial effects in the treatment of anxiety symptoms, bulimia nervosa, alcohol (ethanol )-induced amnesia, schizophrenia and several other psychiatric disorders, and pain states. Comparative and long term data in all disorders in which fluvoxamine shows potential are also required. Fluvoxamine is well tolerated by the majority of patients. Nausea is the most frequent adverse effect and can lead to withdrawal from treatment. However, nausea and most other adverse effects are generally mild to moderate in nature. Fluvoxamine induces less anticholinergic and sedative effects than tricyclic antidepressants, and does not appear to have cardiotoxic effects. In addition, as with many other antidepressants there is no evidence thatfluvoxamine induces suicidal behaviour. Compared with tricyclic antidepressants,fluvoxamine is relatively safe in overdose. Thus, studies available to date have demonstrated the efficacy offluvoxamine in obsessive-compulsive disorder. Efficacy in other central nervous system disorders has been indicated but further confirmatory data are required, as are comparative data in all disorders. The improved tolerability profile of fluvoxamine compared with many other agents used in these conditions will help to establish the agent as a useful alternative in obsessive-compulsive disorder, and in other conditions if preliminary efficacy findings are confirmed. Pharmacological Properties Fluvoxamine is a potent and selective inhibitor of serotonin reuptake. In addition to its lack of effects on other monoamine reuptake mechanisms, fluvoxamine has little or no effect on the neuronal function of other monoamines and has a low affinity for the receptors of a variety of neurotransmitters. While acute inhibition of serotonin reuptake by fluvoxamine is well documented, clinical response is slower and therefore is not readily explained by this acute effect. Studies in animals and humans have shown that fluvoxamine, unlike the tricyclic antidepressants, has relatively few cardiovascular or anticholinergic effects. In addition, fluvoxamine does not appear to have pro-convulsive or sedative effects, and does not impair cognition. Fluvoxamine has anxiolytic and anti-nociceptive activity in some animal models, and reduces alcohol (ethanol) intake in alcohol-preferring rats. Pain thresholds in healthy volunteers are increased by fluvoxamine. The pharmacokinetic properties of fluvoxamine are well established. The drug is almost completely absorbed following oral administration and the extent of absorption is not affected by the presence of food in the gastrointestinal tract. Maximum plasma concentrations are reached within 2 to 8 hours of administration and steady-state concentrations are achieved after 10 days. There is no drug accumulation after repeated administration. Fluvoxamine is extensively metabolised in the liver, with 11 pharmacologically inactive metabolites identified. Most of a dose offluvoxamineis excreted in the urine, with only about 3% as unchanged parent compound. Mean elimination half-life is 14 to 22 hours. Limited data suggest that the pharmacokinetic parameters of fluvoxamine are not affected by increased age, renal impairment or geneti polymorphism. However, elimination half-life is increased in patients with hepatic disease. Therapeutic Potential Fluvoxamine at oral dosages of 50 to 300 mg/day has been investigated in a number of non-depressive disorders. Positive results in 6 placebo-controlled trials support the efficacy of fluvoxamine in obsessive-compulsive disorder. At present, comparative data are limited but promising, with 2 trials showing that fluvoxamine is as effective as clomipramine. As with clomipramine, fluvoxamine reduces but does not eliminate obsessions and compulsions, is effective in only 40 to 50% of patients and has a delay in onset of action of approximately 4 weeks. Limited data indicate that fluvoxamine may also be effective in preventing panic attacks, although further placebo-controlled comparisons with standard agents are required. Encouraging preliminary results suggest that fluvoxamine may have potential in the treatment of anxiety symptoms, bulimia nervosa, alcohol- induced amnesia, schizophrenia and several other psychiatric disorders, and pain syndromes. Fluvoxamine does not appear to be effective in patients with dementia, post-traumatic stress disorder or menstrually related disorders, or in reducing body weight in obese patients. Tolerability Fluvoxamine is well tolerated in patients with depression or other central nervous system disorders at oral dosages of up to 300 mg/day for up to 12 weeks. Long term tolerability has not been fully established. A least 43% of patients experience at least 1 adverse effect, with the highest incidence of adverse effects being associated with the gastrointestinal tract (nausea, vomiting, abdominal pain) and central nervous system (somnolence, headache, insomnia). Asthenia is also a common adverse effect. The most common adverse effect is nausea, which can result in discontinuation of therapy. Most adverse effects are transient and of mild to moderate severity. No fluvoxamine-associated clinically significant changes in vital signs or laboratory parameters have been reported. Fluvoxamine produces fewer anticholinergic effects than tricyclic antidepressants, and is thought to have less epileptogenic potential than these agents. In addition, fluvoxamine does not appear to have any cardiotoxic effects. The adverse effects profile of fluvoxamine appears to be similar to that of other selective serotonin reuptake inhibitors. Fluvoxamine treatment has not been associated with an increase in suicidal behaviour, and the agent is considered less harmful than tricyclic antidepressants in overdose. Dosage and Administration For the treatment of non-depressive disorders, fluvoxamine has been administered at oral dosages of 50 to 300 mg/day. Dosages over 100 mg/day were most commonly used. Titration of the dosage in 50mg increments is recommended for the treatment of depression and a similar procedure should probably be used for other disorders. A starting dosage of 50 mg/day may reduce nausea. Dosage should not exceed 100 mg/day in patients with hepatic or renal impairment. While it does not seem necessary to reduce the dosage in elderly patients, slow titration of the dosage should be employed in these patients. Caution is recommended when administering fluvoxamine with agents with which it is known to interact, such as lithium, theophylline, tricyclic antidepressants or warfarin. In addition, cautious use is recommended when fluvoxamine is administered to patients with epilepsy or a medical condition that may be exacerbated by vomiting. Fluvoxamine should not be administered with or within 2 weeks of withdrawing a monoamine oxidase inhibitor, and a monoamine oxidase inhibitor should not be started within 1 week of stopping fluvoxamine. © 1994, Adis International Limited. All rights reserved.",0 +https://doi.org/10.1037/a0035240,Posttraumatic stress reactions among Rwandan youth in the second year after the genocide: Rising trajectory among girls.,"This study examines levels of traumatic stress reactions among youth attending school in the second year after the 1994 Rwandan genocide. From August to December 1995, the survey team visited 22 schools throughout Rwanda. The survey (n 942; youth aged 8 to 19 years) assessed exposure to wartime violence and symptoms of posttraumatic stress disorder (PTSD), as outlined in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM–IV; American Psychiatric Association, 2000). Mean symptom levels and the proportion of respondents meeting DSM–IV PTSD symptom criteria (“probable PTSD”) were examined for evidence of systematic decline over time. Multivariate analyses controlled for major confounders and the complex survey design. Overall, traumatic stress reactions increased among youth interviewed at successively later time points. For example, in the first third of the survey period, the “probable PTSD” rate was 48%; in the second, 54%; and in the third, 58%. The rise was confined to females. Among females, the adjusted odds of having “probable PTSD” in the last third of the study period was 2.71 (95% CI [1.66, 4.43]) fold higher than in the first. These results suggest that in planning health services in postconflict settings, humanitarian agencies should be alert to the possibility that traumatic stress reactions among youth may not decline with passage of time. Despite limitations in design, to date, this report represents the only formal structured evaluation of the mental health of youth living in the community, in the very early aftermath of catastrophic violence.",0 +https://doi.org/10.1017/s0033291712002632,Neuroticism and post-traumatic stress disorder: a prospective investigation,"Background Neuroticism has been consistently correlated with the post-traumatic stress disorder (PTSD) response to traumatic events. Interpretation of these findings is limited by the retrospective nature of these findings: neuroticism was measured after the trauma had occurred. The prospective association of neuroticism with PTSD has not been examined (the relationship of neuroticism with PTSD symptoms was examined in a few prospective studies). We evaluate prospectively the relationship of neuroticism, measured at baseline, with the cumulative occurrence of PTSD during the subsequent 10 years, using data from a longitudinal epidemiological study of young adults. Method A sample of 1007 young adults randomly selected from the membership of a large health maintenance organization in southeast Michigan was assessed at baseline and followed up at 3, 5 and 10 years later. We conducted a series of multinomial logistic regressions to estimate the relative risk (RR) of exposure to trauma and PTSD by neuroticism at baseline, adjusting for history of major depression ( n = 990). Results During the 10-year follow-up, 50.2% of the sample experienced traumatic events and 5.2% developed PTSD. Neuroticism score at baseline increased significantly the RR of PTSD response to trauma. Additional analysis revealed that, among persons with history of major depression at baseline, RR for PTSD associated with neuroticism was equal to the null value of 1, but was increased significantly among those with no history of major depression. Conclusions The results confirm the role of neuroticism as diathesis in the PTSD response to traumatic experiences.",0 +https://doi.org/10.1016/j.pain.2013.07.001,Derivation of a clinical prediction rule to identify both chronic moderate/severe disability and full recovery following whiplash injury,"Recovery following a whiplash injury is varied: approximately 50% of individuals fully recover, 25% develop persistent moderate/severe pain and disability, and 25% experience milder levels of disability. Identification of individuals likely to develop moderate/severe disability or to fully recover may help direct therapeutic resources and optimise treatment. A clinical prediction rule (CPR) is a research-generated tool used to predict outcomes such as likelihood of developing moderate/severe disability or experiencing full recovery from whiplash injury. The purpose of this study was to assess the plausibility of developing a CPR. Participants from 2 prospective, longitudinal studies that examined prognostic factors for poor functional recovery following whiplash injury were used to derive this tool. Eight factors, previously identified as predictor variables of poor recovery, were included in the analyses: initial neck disability index (NDI), initial neck pain (visual analogue scale), cold pain threshold, range of neck movement, age, gender, presence of headache, and posttraumatic stress symptoms (Posttraumatic Diagnostic Scale [PDS]). An increased probability of developing chronic moderate/severe disability was predicted in the presence of older age and initially higher levels of NDI and hyperarousal symptoms (PDS) (positive predictive value [PPV]=71%). The probability of full recovery was increased in younger individuals with initially lower levels of neck disability (PPV=71%). This study provides initial evidence for a CPR to predict both chronic moderate/severe disability and full recovery following a whiplash injury. Further research is needed to validate the tool, determine the acceptability of the proposed CPR by practitioners, and assess the impact of inclusion in practice.",0 +https://doi.org/10.3109/0167482x.2010.486453,Exploring posttraumatic stress disorder symptom profile among pregnant women,"Posttraumatic stress disorder (PTSD) is more prevalent in perinatal than general samples of women (6-8% vs. 4-5%). To explore potential causes, we examined the symptom profiles of women belonging to two separate samples: a perinatal clinic sample (n = 1581) and a subsample of women in a similar age range from the U. S. National Women's Study (NWS) (n = 2000). Within the perinatal sample, risk ratios were higher for all 17 PTSD symptoms among women with current PTSD compared with unaffected women, suggesting that higher rates are not likely due to measurement error. The younger age and greater social disadvantage in the perinatal clinic sample contributed only a small proportion of variance in symptom levels compared with extent of trauma exposure and pre-existing PTSD. Compared with the national study sample's symptom profile, the perinatal sample had higher rates of occurrence of five symptoms: detachment, loss of interest, anger and irritability, trouble sleeping, and nightmares. This analysis confirms that PTSD rates are higher in perinatal samples, which is likely due to exacerbation of pre-existing PTSD among women of a younger age and greater social disadvantage. Further elucidation is warranted, including identifying triggers and determining if there are needs for pregnancy-specific interventions.",0 +https://doi.org/10.1037/a0025989,Post-traumatic stress disorder is associated with poor health behaviors: Findings from the Heart and Soul Study.,"Posttraumatic stress disorder (PTSD) results in substantial disability, including increased risk of cardiovascular disease (CVD). Poor health behaviors are major risk factors for initial and recurrent CVD events. Therefore, this study investigated whether PTSD is associated with poor health behaviors in patients with CVD.Cross-sectional study of 1,022 men and women with CVD. PTSD was assessed with the Computerized Diagnostic Interview Schedule for DSM-IV. Physical activity, medication adherence and smoking history were determined by self-report questionnaires. Multivariate logistic and linear regression models were used to evaluate the association of PTSD with health behaviors.Of the 1,022 participants, 95 (9%) had PTSD. PTSD was associated with significantly higher rates of physical inactivity in terms of overall exercise (OR 1.6, 95% CI [1.0-2.6]; p = .049), light exercise (OR 1.7, 95% CI [1.0-2.9]; p = .045), and self-rated level of exercise compared to others of their age and sex (OR 1.8, 95% CI [1.0-3.0]; p = .047). Participants with PTSD were more likely to report medication nonadherence, including forgetting medications (OR 1.8, 95% CI [1.0-3.3]; p = .04) or skipping medications (OR 1.7, 95% CI [1.1-2.9]; p = .03). Participants with PTSD also reported a greater smoking history (β 6.4 pack years, 95% CI [1.8-10.9]; p = .006), which remained significant after adjustment for depression and income.Among patients with heart disease, those with PTSD were more likely to report physical inactivity, medication nonadherence and smoking. The majority of these associations were explained by adjustment for comorbid depression and lower income.",0 +https://doi.org/10.1016/j.psym.2012.07.010,Incidence and Prediction of Post-Traumatic Stress Disorder at 6 Months After Motor Vehicle Accidents in Japan,"Incidence proportion of post-traumatic stress disorder (PTSD) after motor vehicle accidents (MVA) vary considerably across countries, and whether heart rate (HR) and respiratory rate (RR) immediately after MVA predict subsequent PTSD remains controversial. This study examined the incidence proportion of PTSD at 6 months after MVA in Japan, and the predictors of PTSD in MVA survivors.Patients with MVA-related injuries consecutively admitted to the intensive care unit of a teaching hospital in Tokyo were recruited. Six months after MVA, PTSD was diagnosed using the Clinician Administered Post-traumatic Stress Disorder Scale (CAPS).Of the 300 participants, 106 completed the assessments at 6 months after MVA and PTSD was diagnosed in 7.5% of the patients. Eight of the 300 participants (2.7%) were regarded as having PTSD after imputing their CAPS score at follow-up assessment for participants who dropped out. In multivariate regression analysis, no variables were shown to be independent predictors for PTSD. HR and RR did not predict PTSD in the analysis.The results suggested that the incidence proportion of PTSD following MVA in Japan was lower than that in most developed countries, and HR and RR might not be accurate screening tools despite their importance in a fear-conditioning model of the genesis of PTSD.",0 +https://doi.org/10.1037/a0015051,Trajectories of life satisfaction in the first 5 years following traumatic brain injury.,"The trajectories of life satisfaction for 609 individuals who sustained a traumatic brain injury (TBI) were studied. Hierarchical linear modeling analysis examined individual level growth trends over the first 5 years following TBI using gender, functional independence, age, and time to estimate life satisfaction trajectories.Participants completed the Functional Independence Measure and the Life Satisfaction Inventory at years 1, 2, 4, and 5 after sustaining TBI.Participants who reported higher functional independence at year 1 also had higher life satisfaction at year 1. Participants with lower functional independence across the 5-year period had life satisfaction trajectories that decreased at significantly greater rates than the individuals with more functional independence. The life satisfaction trajectory declined for the sample, but participants reporting lower cognitive and motor functional independence had significantly greater declines in life satisfaction trajectories. Age and gender were not significant factors in predicting life satisfaction trajectories following TBI.Individuals with greater cognitive and motor impairments following TBI are likely to experience significant declines in life satisfaction within 5 years of living with TBI.",0 +https://doi.org/10.1017/s0021963001007065,War Exposure and Maternal Reactions in the Psychological Adjustment of Children from Bosnia-Hercegovina,,0 +https://doi.org/10.1007/7854_2014_307,Neurobehavioral Mechanisms of Traumatic Stress in Post-traumatic Stress Disorder.,"Post-traumatic stress disorder (PTSD) is a debilitating psychiatric disorder that develops following trauma exposure. It is characterized by four symptom clusters: intrusion, avoidance, negative alteration in cognitions and mood, and alterations in arousal and reactivity. Several risk factors have been associated with PTSD, including trauma type and severity, gender and sexual orientation, race and ethnicity, cognitive reserve, pretrauma psychopathology, familial psychiatric history, and genetics. Great strides have been made in understanding the neurobiology of PTSD through animal models and human imaging studies. Most of the animal models have face validity, but they have limitations in the generalization to the human model of PTSD. Newer animal models, such as the ""CBC"" model, have better validity for PTSD, which takes into account the different components of its diagnostic criteria. To date, fear conditioning and fear extinction animal models have provided support for the hypothesis that PTSD is a dysregulation of the processes related to fear regulation and, especially, fear extinction. More research is needed to further understand these processes as they relate not only to PTSD but also to resilience. Further, this research could be instrumental in the development of novel effective treatments for PTSD.",0 +https://doi.org/10.1207/s15327752jpa7503_06,Cross-Validation of the MMPI-2 in Detecting Malingered Posttraumatic Stress Disorder,"We attempted to cross-validate findings from a previous study (Elhai, Gold, Sellers, & Dorfman, in press) using a clinical sample of combat-related war veterans to distinguish genuine from malingered posttraumatic stress disorder (PTSD) on the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). The MMPI-2 scores of 124 male combat war veterans at the PTSD outpatient treatment program of a Veterans Affairs Medical Center were compared with those of 84 adult college students instructed and trained to malinger PTSD. MMPI-2 overreporting variables examined were F, F-Fb, F-K, F(p), Ds2, O-S, OT, and FBS. A stepwise discriminant analysis identified F. F-Fb, F-K, Ds2, O-S, and OT as the best malingering predictors. A predictive discriminant analysis yielded good hit rates for the model with impressive cross-validation results. We assessed cutting scores for the predictors of the model. We discuss clinical implications for using the MMPI-2 to distinguish malingered PTSD from combat-related PTSD.",0 +https://doi.org/10.3109/02699052.2014.934285,Identifying longitudinal trajectories of emotional distress symptoms 5 years after traumatic brain injury,"To evaluate longitudinal trajectories of emotional distress symptoms after traumatic brain injury (TBI).Longitudinal study.Patients with mild-to-severe TBI, 118 patients participated at 3 months, 109 attended at 1-year and 89 attended the 5-year follow-up. Emotional distress was measured with the Impact of Event Scale-Revised. Patients were also assessed for coping style, anxiety, depression, substance abuse and trauma severity.Based on growth mixture modelling, four trajectories of emotional distress symptoms were identified: 73.5% of patients were characterized by a pattern of resilience, 6.8% by a pattern of delayed distress, 14.6% by recovery and 5.1% by chronic distress. Relative to the resilience trajectory, avoidant-coping style and psychiatric problems were related to recovery and chronic trajectories. The delayed trajectory was similar to the resilience trajectory, except for elevated depressive and anxiety symptoms at 1- and 5-years. Demographics and injury-related variables were not significantly associated with emotional distress trajectories.Resilience was the most common trajectory following TBI. Patients characterized by recovery and chronic trajectories required attention and long-term clinical monitoring of their symptoms. Future research would benefit from longitudinal studies to analyse emotional distress symptoms and the strength of resilience over time.",1 +https://doi.org/10.1002/jts.21699,A critical evaluation of the complex PTSD literature: Implications for DSM-5,"Complex posttraumatic stress disorder (CPTSD) has been proposed as a diagnosis for capturing the diverse clusters of symptoms observed in survivors of prolonged trauma that are outside the current definition of PTSD. Introducing a new diagnosis requires a high standard of evidence, including a clear definition of the disorder, reliable and valid assessment measures, support for convergent and discriminant validity, and incremental validity with respect to implications for treatment planning and outcome. In this article, the extant literature on CPTSD is reviewed within the framework of construct validity to evaluate the proposed diagnosis on these criteria. Although the efforts in support of CPTSD have brought much needed attention to limitations in the trauma literature, we conclude that available evidence does not support a new diagnostic category at this time. Some directions for future research are suggested.",0 +https://doi.org/10.1007/s10862-005-5380-2,Use of the Personality Assessment Inventory in Assessment of Posttraumatic Stress Disorder in Women,"This study investigated the utility of the Personality Assessment Inventory (PAI) for the assessment of posttraumatic stress disorder (PTSD). Participants were 55 community-residing adult women who were administered a comprehensive battery that included the PAI and the Clinician-Administered PTSD Scale (CAPS). Participants were classified as either PTSD or non-PTSD based on the CAPS, and PAI profiles were compared between the two groups. Significant group differences were found for seven PAI clinical scales (Anxiety, Depression, Anxiety-Related Disorders, Somatic Complaints, Paranoia, Borderline Features, and Schizophrenia), one validity scale (Negative Impression), and two treatment scales (Nonsupport and Treatment Rejection). When all PAI scales and component subscales are considered, the largest group differences were found for the physiological subscale of the Depression scale (DEP-P) and the Traumatic Stress subscale of the Anxiety-Related Disorders scale (ARD-T). ARD-T and DEP-P also demonstrated excellent diagnostic utility. Finally, correlations between PAI scales and four CAPS symptom clusters provided additional validity evidence, in particular supporting a distinction between effortful avoidance and numbing. Taken together, these results support the use of the PAI in the assessment of PTSD. © 2005 Springer Science+Business Media, Inc.",0 +https://doi.org/10.3389/fnhum.2013.00367,"A comprehensive review of auditory verbal hallucinations: lifetime prevalence, correlates and mechanisms in healthy and clinical individuals","Over the years, the prevalence of auditory verbal hallucinations (AVHs) have been documented across the lifespan in varied contexts, and with a range of potential long-term outcomes. Initially the emphasis focused on whether AVHs conferred risk for psychosis. However, recent research has identified significant differences in the presentation and outcomes of AVH in patients compared to those in non-clinical populations. For this reason, it has been suggested that auditory hallucinations are an entity by themselves and not necessarily indicative of transition along the psychosis continuum. This review will examine the presentation of auditory hallucinations across the life span, as well as in various clinical groups. The stages described include childhood, adolescence, adult non-clinical populations, hypnagogic/hypnopompic experiences, high schizotypal traits, schizophrenia, substance induced AVH, AVH in epilepsy, and AVH in the elderly. In children, need for care depends upon whether the child associates the voice with negative beliefs, appraisals and other symptoms of psychosis. This theme appears to carry right through to healthy voice hearers in adulthood, in which a negative impact of the voice usually only exists if the individual has negative experiences as a result of their voice(s). This includes features of the voices such as the negative content, frequency, and emotional valence as well as anxiety and depression, independently or caused by voices presence. It seems possible that the mechanisms which maintain AVH in non-clinical populations are different from those which are behind AVH presentations in psychotic illness. For example, the existence of maladaptive coping strategies in patient populations is one significant difference between clinical and non-clinical groups which is associated with a need for care. Whether or not these mechanisms start out the same and have differential trajectories is not yet evidenced. Future research needs to focus on the comparison of underlying factors and mechanisms that lead to the onset of AVH in both patient and non-clinical populations.",0 +https://doi.org/10.1371/journal.pone.0104470,Longitudinal Relationships between Posttraumatic Stress Symptoms and Sleep Problems in Adolescent Survivors following the Wenchuan Earthquake in China,"To examine the longitudinal relationships between Posttraumatic Stress Disorder (PTSD) and sleep problems among adolescent survivors in the Wenchuan earthquake, China.350 adolescent survivors were randomly selected from several primary and secondary schools in the counties of Wenchuan and Maoxian, the two areas most severely affected by the Wenchuan earthquake. Participants completed Revised Child PTSD Symptom Scale and Sleep Problems Subscale of Self-generated Child Behavior Problems Questionnaire at one year (T1), one-and-a-half years (T2), two years (T3) after the earthquake, respectively.There was a bidirectional relationship between intrusive symptom clusters of PTSD and sleep problems from T1 to T2, and this relationship became non-significant from T2 to T3. There was a one-way predictive relationship of avoidance symptom clusters of PTSD onto sleep problems from T1 to T3. The hyperarousal symptom clusters of PTSD had effects on sleep problems from T1 to T2 but not from T2 to T3, while sleep problems have no significant effect on hyperarousal symptom clusters of PTSD from T1 to T3. In addition, the relationships between three symptom clusters of PTSD and sleep problems weakened with time change.From 1 year to 1.5 years after the earthquake, all the three symptom clusters of PTSD could be important predictive factors for the development and maintenance of sleep problems, while sleep problems could only be risk factors for the intrusive symptom clusters of PTSD. From 1.5 years to 2 years, only the avoidance symptom clusters of PTSD were risk factors for sleep problems, and sleep problems had no significant effects on any symptom clusters of PTSD. Overall, the relationship between PTSD and sleep problems weakened with time change.",0 +https://doi.org/10.1002/9781119943242.ch20,Training Resilience for High-risk Environments: Towards a Strength-based Approach within the Military,"In this chapter, we introduced the concept of resilience as especially relevant for soldiers as they nowadays operate in cumulative stressful environments. Resilience is different from traditional approaches to building, maintaining and restoring soldiers’ adaptation capabilities, because it focuses on positive adjustment besides the absence of pathology after a potentially traumatic event. We introduced the definition of military resilience the ability to maintain optimal performance during acute situations, positively recover afterwards, and sustain combat motivation under chronic stressful circumstances. Whether a soldier is resilient depends on the available internal and external resources. Several internal and external resources have been identified. However, not many studies have investigated the interplay between internal and external resources. More knowledge on the combined effects of these resources could provide valuable insights in how to best enhance military resilience. We discussed existing resilience interventions for personnel in high-risk occupations. Most interventions focused on individual resources and were based on cognitive principles that aim to enhance awareness and knowledge that will enable a soldier to better cope with stressful situations. Although these interventions addressed the positive adaptation perspective of resilience, the full range of resources has yet to be capitalized upon. In addition, only a few interventions explicitly aim to enhance resilience through external resources. Future interventions should include the positive adaptation perspective and address external resources to enhance effectiveness of resilience interventions.",0 +https://doi.org/10.1073/pnas.0910794107,Epigenetic and immune function profiles associated with posttraumatic stress disorder,"The biologic underpinnings of posttraumatic stress disorder (PTSD) have not been fully elucidated. Previous work suggests that alterations in the immune system are characteristic of the disorder. Identifying the biologic mechanisms by which such alterations occur could provide fundamental insights into the etiology and treatment of PTSD. Here we identify specific epigenetic profiles underlying immune system changes associated with PTSD. Using blood samples (n = 100) obtained from an ongoing, prospective epidemiologic study in Detroit, the Detroit Neighborhood Health Study, we applied methylation microarrays to assay CpG sites from more than 14,000 genes among 23 PTSD-affected and 77 PTSD-unaffected individuals. We show that immune system functions are significantly overrepresented among the annotations associated with genes uniquely unmethylated among those with PTSD. We further demonstrate that genes whose methylation levels are significantly and negatively correlated with traumatic burden show a similar strong signal of immune function among the PTSD affected. The observed epigenetic variability in immune function by PTSD is corroborated using an independent biologic marker of immune response to infection, CMV-a typically latent herpesvirus whose activity was significantly higher among those with PTSD. This report of peripheral epigenomic and CMV profiles associated with mental illness suggests a biologic model of PTSD etiology in which an externally experienced traumatic event induces downstream alterations in immune function by reducing methylation levels of immune-related genes.",0 +https://doi.org/10.1007/s00213-002-1097-z,Relief of serotonin selective reuptake inhibitor induced sexual dysfunction with low-dose mianserin in patients with traumatic brain injury,"Rationale: Serotonin selective reuptake inhibitors (SSRI) are commonly used in the treatment of many psychiatric disorders. Although possessing a relatively mild side effect profile, these drugs can cause a number of difficulties, including sexual dysfunction. A variety of strategies have been reported in the management of SSRI-induced sexual dysfunction, including dose reduction, drug holidays, substitution of another antidepressant drug, and various augmentation strategies, including use of sildenafil citrate (Viagra), buspirone, and others. Objectives: We aimed to examine the effect of adding another medication, mianserin, a mainly postsynaptic serotonin 2A agonist, to ongoing SSRI treatment in order to alleviate sexual side effects caused by SSRIs. Methods: The patients included in this study suffered from traumatic brain injury and from psychiatric complications that necessitated the use of SSRIs. Seventeen patients were included in this study, all were being treated with SSRIs, and all complained of sexual dysfunction. Mianserin was added to on-going treatment at low doses, 7.5-15 mg/day. Patients were followed for at least 3 months. Results: Fifteen of the 17 patients (88%) included in this study reported improvement in sexual dysfunction following this intervention. Ten (59%) reported that sexual function achieved pretreatment level. Five (29%) reported ""significant improvement,"" and two (12%) did not respond to this intervention and were given sildenafil citrate, with good results. Side effects were minimal and included dry mouth, drowsiness, headaches, and agitation. Conclusions: The use of low-dose mianserin as an add-on treatment to SSRIs appears to be an effective and well tolerated intervention for sexual dysfunction caused by SSRIs.",0 +https://doi.org/10.1176/ajp.156.3.483,Assessing Long-Term Effects of Trauma: Diagnosing Symptoms of Avoidance and Numbing,"OBJECTIVE: This study compared the discovery of posttraumatic stress disorder (PTSD) symptoms by means of the Structured Clinical Interview for DSM-III-R (SCID) with a semistructured, psychodynamic clinical interview in a long-term follow-up of the survivors of the Buffalo Creek (W.Va.) flood. METHOD: Videotaped semistructured, psychodynamic clinical interviews of a small group of survivors (N=6) were compared with the results obtained in a prior group-level SCID investigation. RESULTS: Seventy-two percent of the total PTSD symptoms for the subjects studied were elicited exclusively by the psychodynamic clinical interview. PTSD cluster C symptoms of avoidance and numbing of general responsiveness were especially sensitive to discovery by this method. CONCLUSIONS: The psychodynamic clinical interview should be included in the design of studies that seek to investigate long-term effects of trauma, which are especially likely to be manifest in negative symptoms and subtle character change. (Am J Psychiatry 1999; 156:483–485)",0 +https://doi.org/10.1016/j.amp.2014.07.014,La honte d’être soi. De l’intérêt de la psychothérapie à médiation artistique pour la réhabilitation des personnes en situation d’exclusion sociale,"Resume Dans le cadre d’un projet de recherche multi-annuel portant sur les relations entre les evenements biographiques traumatogenes, vecus depuis l’enfance, et le fonctionnement structurel de la personnalite a l’âge adulte, nous presentons les resultats d’une etude longitudinale. L’etude concerne l’evaluation d’ateliers d’art-therapie proposes a des personnes en situation de marginalisation et d’exclusion (n = 34). L’exploration du processus therapeutique est basee sur l’application de grilles d’analyse de contenu originales permettant d’utiliser la production artistique a titre de recherche. Des vignettes cliniques illustrent l’etre-au-monde singulier et l’angoisse existentielle des sujets qui se sentent discrimines et deracines et dont l’estime de soi est fortement ebranlee. La discussion porte sur la pertinence des resultats de l’etude, dans le cadre de la litterature actuelle concernant le psycho-traumatisme, la discrimination et la grande precarite, ainsi que sur la possibilite de degager de l’analyse de la production artistique quelques indices montrant une reprise du processus de subjectivation.",0 +https://doi.org/10.1016/j.jad.2014.02.043,Associations between the SS variant of 5-HTTLPR and PTSD among adults with histories of childhood emotional abuse: Results from two African American independent samples,"Prior studies have found that the 5-HTTLPR polymorphism in the promoter region of the serotonin transporter gene (SLC6A4) interacts with stressful life events to increase general risk for PTSD, but this association has not extended to African American samples. Further, little is known about the effects of this interaction on specific PTSD symptom clusters, despite indications that clusters may have different biological substrates. The current study examined the interaction between exposure to childhood emotional abuse and 5-HTTLPR genotype on risk for PTSD symptom severity and severity of specific PTSD symptom clusters in two African American samples.Participants were 136 African American household residents from Detroit, MI and 546 African American patients recruited from waiting rooms in primary care clinics in Atlanta, GA. Participants reported emotional abuse exposure and PTSD symptom severity, and provided DNA for triallelic 5-HTTLPR genotyping. Analysis of covariance (ANCOVA) was used to examine main effects and interactions.In both African American samples, 5-HTTLPR genotype modified the effect of emotional abuse on PTSD symptom severity. Participants with the low-expression SS genotype who were exposed to emotional abuse had significantly lower reexperiencing and arousal symptom severity scores.The DNHS genetic sample size was small, and abuse data were assessed retrospectively.The SS variant of 5-HTTLPR appears to buffer against developing the reexperiencing and arousal symptoms of PTSD in two independent African American samples exposed to childhood emotional abuse. Findings also highlight the importance of considering emotional abuse experiences in patients with suspected PTSD.",0 +https://doi.org/10.1097/00005373-200108000-00010,Perceived Threat to Life Predicts Posttraumatic Stress Disorder after Major Trauma: Risk Factors and Functional Outcome,"The importance of psychological morbidity after major trauma, such as posttraumatic stress disorder (PTSD), is continuing to gain attention in trauma outcomes research. The Trauma Recovery Project is a large prospective epidemiologic study designed to examine multiple outcomes after major trauma, including quality of life (QoL) and PTSD. The specific objectives of the present report are to examine risk factors for PTSD and to assess the impact on QoL at the 6-, 12-, and 18-month follow-up time points in the Trauma Recovery Project population.Between December 1, 1993, and September 1, 1996, 1,048 eligible trauma patients triaged to four participating trauma center hospitals in the San Diego Regionalized Trauma System were enrolled in the study. The enrollment criteria for the study included age 18 years and older, admission Glasgow Coma Scale score of 12 or greater, and length of stay > 24 hours. QoL was measured after injury using the Quality of Well-being scale, a sensitive index to the well end of the functioning continuum (range, 0 = death to 1.000 = optimum functioning). Early symptoms of acute stress reaction (SASR) at discharge were assessed using the Impact of Events Scale (score > 30 = SASR). PTSD at 6-month follow-up was diagnosed using standardized Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, criteria. Patient outcomes were assessed at discharge and at 6, 12, and 18 months after discharge.PTSD was diagnosed in 32% (261 of 824) patients at 6-month follow-up. Perceived threat to life predicted PTSD onset (odds ratio [OR], 1.6; p < 0.01) and early SASR (OR, 2.2; p < 0.001). PTSD was more frequent in women (39%) than in men (29%) and in younger low-income patients. Other major risk factors were penetrating trauma (OR, 2.3; p < 0.001) and assaults (OR, 1.5; p < 0.05). PTSD had a major impact on QoL at 6-, 12-, and 18-month follow-up (Quality of Well-being scale score: 6 months, 0.576 vs. 0.658; 12 months, 0.620 vs. 0.691; 18 months, 0.620 vs. 0.700; p < 0.0001).These results provide new and provocative evidence that perceived threat to life and mechanism predict PTSD after major traumatic injury. PTSD had a prolonged and profound impact on short- and long-term outcome and QoL.",0 +https://doi.org/10.7205/milmed-d-09-00215,Characterizing Aggression and Its Association to Anger and Hostility Among Male Veterans With Post-Traumatic Stress Disorder,"The basis for the associations among anger, hostility, aggressive behavior, and post-traumatic stress disorder (PTSD) remains unclear. We suggest classifying aggressive behavior may elucidate the associations among these factors. On the basis of diagnostic and neurobiological similarities between impulsive aggression (IA) and PTSD, we proposed that IA was the predominant form of aggression in PTSD and that anger and hostility would not significantly predict PTSD when IA was also included as a predictor.We used cross-sectional self-report data obtained from two samples of male veterans (N = 136).Over 70% of veterans with PTSD reported IA compared to 29% of those without PTSD. IA, not anger, hostility, or premeditated aggression significantly predicted a diagnosis of PTSD.Associations between anger and PTSD may be unique to individuals with IA, and considering impulsive and premeditated aggressors separately may account for the heterogeneity found within samples of aggressive veterans with PTSD.",0 +https://doi.org/10.1136/jnnp.2004.049189,Whiplash following rear end collisions: a prospective cohort study,"The purpose of this study was to investigate the factors which predict neck pain initially and at 1 year following a rear end collision.All people who reported a rear end collision to the Devon and Cornwall Constabulary were identified and formed the basis of the cohort. People were excluded if they were under 18 years of age or had suffered a head injury. The main outcome measures were neck pain lasting for more than a week after the accident and neck pain at least 1 day a week at 1 year. Logistic regression was used to investigate associations between demographic and accident related variables and outcomes.A total of 1147 people reported rear end collisions to the police during the study period and 503 (44%) agreed to take part in the study. Of the respondents, 78% had neck pain lasting for more than a week and 52% still had pain at 1 year. Age (odds ratio, 95% confidence interval: 0.957, 0.942-0.972) and prior history of neck pain (8.32, 2.89-23.89) were the most important predictors of early neck pain. The most important predictors of pain at 1 year were the initial neck visual analogue scale (VAS) score (1.03, 1.01-1.05) and the presence of a compensation claim (4.09, 1.62-10.32). There was only weak evidence that measures of the severity of the impact were associated with outcomes.Demographic variables and the presence of a compensation suit show the strongest correlation with acute and chronic neck pain following rear end collisions.",0 +https://doi.org/10.1097/htr.0000000000000089,Development and Initial Validation of Military Deployment-Related TBI Quality-of-Life Item Banks,"To investigate unique factors that affect health-related quality of life (QOL) in individuals with military deployment-related traumatic brain injury (MDR-TBI) and to develop appropriate assessment tools, consistent with the TBI-QOL/PROMIS/Neuro-QOL systems.Three focus groups from each of the 4 Veterans Administration (VA) Polytrauma Rehabilitation Centers, consisting of 20 veterans with mild to severe MDR-TBI, and 36 VA providers were involved in early stage of new item banks development. The item banks were field tested in a sample (N = 485) of veterans enrolled in VA and diagnosed with an MDR-TBI.Focus groups and survey.Developed item banks and short forms for Guilt, Posttraumatic Stress Disorder/Trauma, and Military-Related Loss.Three new item banks representing unique domains of MDR-TBI health outcomes were created: 15 new Posttraumatic Stress Disorder items plus 16 SCI-QOL legacy Trauma items, 37 new Military-Related Loss items plus 18 TBI-QOL legacy Grief/Loss items, and 33 new Guilt items. Exploratory and confirmatory factor analyses plus bifactor analysis of the items supported sufficient unidimensionality of the new item pools. Convergent and discriminant analyses results, as well as known group comparisons, provided initial support for the validity and clinical utility of the new item response theory-calibrated item banks and their short forms.This work provides a unique opportunity to identify issues specific to individuals with MDR-TBI and ensure that they are captured in QOL assessment, thus extending the existing TBI-QOL measurement system.",0 +https://doi.org/10.1097/00004850-200607000-00001,Pharmacotherapy for disordered sleep in post-traumatic stress disorder: a systematic review,"Sleep disorders, such as insomnia and nightmares, are common problems in post-traumatic stress disorder (PTSD), exert a strong negative influence on the quality of life and are a great challenge for clinical psychiatry. Several studies have reported on the efficacy of drugs for the treatment of PTSD-related sleep disorders. These studies have not been systematically reviewed. This is the first review on the effectiveness of sleep medication in PTSD. We performed a Medline, EMBASE and Cochrane Library Indexed search, using the keywords: PTSD, pharmacotherapy, therapy, sleep, nightmares, insomnia and review. From this database, English-language, human subject, data driven papers published after 1980 were selected. Forty eight articles are discussed. Open-label and case studies suggest efficacy for some antidepressants, anticonvulsants and atypical antipsychotics. Only a few placebo-controlled studies have been published. They show promising results for the atypical antipsychotic olanzapine, and the alpha1-adrenoceptor antagonist prazosin. In comparison to the incidence and impact of sleep complaints in PTSD, the pharmacotherapeutic armamentarium for PTSD-related sleep complaints remains poorly investigated. Some recent studies show promising results, especially for alpha1-adrenoceptor and 5-HT2 receptor antagonists. However, randomized controlled trials with larger populations need to be conducted.",0 +https://doi.org/10.1080/00048670902721061,Post-Traumatic Stress Disorder and Health Problems Among Medically Ill Canadian Peacekeeping Veterans,"Objective: The aim of the present study was to examine the relationship between post-traumatic stress disorder (PTSD) symptom severity and four significant health conditions (gastrointestinal disorders, musculoskeletal problems, headaches, and cardiovascular problems). Method: Participants included 707 Canadian peacekeeping veterans with service-related disabilities, from a random, national Canadian survey, who had been deployed overseas. Results: PTSD severity was significantly related to gastrointestinal disorders, musculoskeletal problems, and headaches, but not to cardiovascular problems. Controlling for demographic factors did not affect PTSD's relationships with the three significant health conditions. Conclusions: The present study supports previous work in finding consistent relations between PTSD severity and specific types of medical problems.",0 +https://doi.org/10.1007/s10862-010-9209-2,An Evaluation of the Relation Between Distress Tolerance and Posttraumatic Stress within a Trauma-Exposed Sample,"The present investigation examined the incremental associations between distress tolerance, or the perceived capacity to tolerate emotional distress, and global posttraumatic stress symptom severity as well as symptom cluster severity, beyond the variance accounted for by number of trauma exposure types and negative affectivity. The sample consisted of 140 adults (72 women; M(age)=25.9, SD=11.1) who endorsed exposure to traumatic life events, as defined by posttraumatic stress disorder diagnostic criterion A (American Psychiatric Association 2000). Participants did not meet diagnostic criteria for current axis I psychopathology. Distress tolerance demonstrated significant incremental associations with global posttraumatic stress symptom severity (p<.01) as well as re-experiencing (p<.05), avoidance (p=.05), and hyperarousal (p<.001) symptom cluster severity. Given the cross-sectional study design, causation cannot be inferred. Theoretical implications and future directions for better understanding associations between distress tolerance and posttraumatic stress are discussed.",0 +https://doi.org/10.1080/1025389031000136242,Neural Correlates of Traumatic Recall in Posttraumatic Stress Disorder,"Functional activation studies of posttraumatic stress disorder (PTSD) using symptom provocation paradigms have implicated dysfunction in limbic and paralimbic brain regions. Increased or altered cerebral blood flow has been observed in amygdala and insula. Decreased or absent activity has been seen in medial prefrontal and anterior cingulate cortex (ACC). These brain regions comprise a neural circuit that has been demonstrated as important for emotional processing and emotional regulation. We studied combat veterans with PTSD (n=16), combat veterans without PTSD (combat controls, n=15), and age-matched healthy control subjects (n=15) with [O-15] H2O PET under a script-driven imagery paradigm of personalized traumatic/stressful and emotionally neutral events. Preliminary findings show that PTSD patients and combat controls had differential blood flow patterns during emotional recall in amygdala, insula and medial prefrontal cortex. Consistent with and extending prior findings, these preliminary results replicate differential patterns of activation in limbic and paralimbic regions of PTSD patients and trauma exposed controls suggesting that these neural substrates may be involved in the deficits in emotional processing in PTSD on one hand, and in resilience to trauma on the other.",0 +https://doi.org/10.1002/jts.22025,A Web-Based Early Intervention Can Prevent Long-Term PTS Reactions in Children With High Initial Distress Following Accidental Injury,"The present study explored the targeting of a preventative information provision intervention delivered to children following accidental injury by assessing the impact of initial traumatic distress on response to treatment. Analyses were based on baseline and 6-month outcome of child traumatic stress in a control (n = 28) and an intervention group (n = 31). Moderation of treatment outcome by initial levels of child traumatic stress was assessed through multiple hierarchical regression analyses. Results indicated the interaction between treatment provision and initial level of posttraumatic stress significantly predicted 6-month outcome (β = -.42, p = .019). When initial distress was high, children in the control group demonstrated an increase in trauma symptoms, and had significantly higher trauma symptoms at follow-up than those in the treatment group (d = 0.94, p = .008). When initial distress was not elevated, no significant differences were noted between the groups. These results indicate that a preventative early intervention may be best targeted at children presenting with the specific risk factor of high initial distress.",0 +https://doi.org/10.1207/s15327752jpa7103_7,Susceptibility of the Trauma Symptom Inventory to Malingering,"This study examined the sensitivity and specificity of the Trauma Symptom Inventory (TSI; Briere, 1995), a self-report measure of psychological sequelae of potentially traumatic events, to malingering. An optimal cutting score for a validity scale--Atypical Responding (ATR)--designed to identify exaggeration or other unusual response sets was developed in an analogue sample of 155 college students and subsequently applied to TSI profiles from several samples of patients with various psychiatric disorders. Use of a cross-validated T-score cutoff of 61 and below on the ATR scale produced good sensitivity (81%) and specificity (92%) rates in the analogue sample. Participants in the analogue sample who reported a history of traumatic experiences were no more able to successfully malinger trauma symptoms than were participants without such histories. Furthermore, false-positive rates in the clinical samples were generally low, suggesting that relatively few genuinely symptomatic individuals would be misclassified as malingering.",0 +https://doi.org/10.1016/j.jpsychores.2011.07.003,Heterogeneity in the response to rheumatoid arthritis (RA): The challenge of accounting for individual variability in the face of chronic disease,,0 +,Cluster analysis of obsessive-compulsive symptomatology: identifying obsessive-compulsive disorder subtypes.,"There is increasing evidence that obsessive-compulsive disorder (OCD) is a heterogeneous disorder. Different clinical subtypes may be characterized by differing pathophysiological mechanisms and treatment outcomes.A cluster analysis was performed on 45 items of the Yale-Brown Obsessive-Compulsive Symptoms Checklist (YBOCS-CL) for 261 patients with OCD. Cluster solutions emerging at different linkage distance levels, and the associations of identified clusters with demographic, clinical and relevant genetic variables, were investigated.A 6-cluster solution emerged at a linkage distance level of 1.5, and a 3-cluster solution emerged at a linkage distance level of 2.1. The 3 clusters in the latter solution were labeled I) Contamination / washing, II) Hoarding / symmetry / ordering, and III) Obsessional / checking. Increased Cluster III scores were associated with earlier age of OCD onset and the Met/Met (L/L) genotype of the COMT Val158Met polymorphism.The data here are consistent with previous work delineating the different symptom subtypes of OCD, also with previous work suggesting that the Met/Met (L/L) genotype of the COMT Val158Met polymorphism may be associated with anxiety symptoms, as well as with previous work suggesting that dopaminergic genes may be particularly important in early-onset OCD.",0 +https://doi.org/10.1097/nmd.0000000000000390,"Exploratory Factor Analysis of Diagnostic and Statistical Manual, 5th Edition, Criteria for Posttraumatic Stress Disorder","One change to the posttraumatic stress disorder (PTSD) nomenclature highlighted in the Diagnostic and Statistical Manual, 5th Edition (DSM-5; American Psychiatric Association, 2013) is the conceptualization of PTSD as a diagnostic category with four distinct symptom clusters. This article presents exploratory factor analysis to test the structural validity of the DSM-5 conceptualization of PTSD via an online survey that included the PTSD Checklist-5. The study utilized a sample of 113 college students from a large Midwestern university and 177 Amazon Mechanical Turk users. Participants were primarily female, Caucasian, single, and heterosexual with an average age of 32 years. Approximately 30% to 35% of participants met diagnostic criteria for PTSD based on two different scoring criteria. Results of the exploratory factor analysis revealed five distinct symptom clusters. The implications for the classification of PTSD are discussed.",0 +https://doi.org/10.1093/oxfordhb/9780199733989.013.0003,Psychological Models in Rehabilitation Psychology,"Abstract Rehabilitation psychology depends upon a broad theoretical base incorporating frameworks, theories, models, and methodologies from many different areas of psychology, as well as from other professions invested in the health and rehabilitation of persons living with disabilities and chronic health conditions. This chapter considers some illustrative models that have been influential in rehabilitation psychology—both historically and in the present—including the biopsychosocial model, and psychological models derived from learning theory and behavior modification, psychoanalytic theory, social psychology, neuropsychology, and cognitive-behavioral theory. The current status of these models, their impact on current clinical practice, and future directions—including the role of dynamic models sensitive to differential trajectories of growth, adjustment, and development over time—will be discussed.",0 +https://doi.org/10.1080/08870440701864520,Post-traumatic growth in women after childbirth,"Childbirth is a complex event that leads to a variety of psychological outcomes. This cross-sectional study examined post-traumatic growth in women following childbirth (N = 219) using an online questionnaire, and explored associations between growth, support and control during birth, coping after birth and symptoms of post-traumatic stress disorder (PTSD). At least moderate degrees of growth were reported by 50.2% of women and average levels of growth were similar to those reported following accidents and assaults. Growth was positively related to approach coping and the avoidant strategy of seeking alternative rewards, but was unrelated to support and control during birth, other avoidant coping strategies after birth, and PTSD symptoms. It is concluded that growth does occur following childbirth. Further research is needed to clarify factors associated with growth in women following childbirth and to determine if growth is associated with psychological benefits in this population.",0 +https://doi.org/10.1111/1556-4029.12178,Posttraumatic Stress Disorder: Protective and Risk Factors in 18 Survivors of a Plane Crash,"The aim of this study is to identify protective and risk factors related to the development of posttraumatic stress disorder (PTSD) on a sample of survivors from a single plane crash. Eighteen survivors were examined 6 months following the event. The subjects all underwent psychiatric interviews, Clinician-Administered PTSD Scale structured interviews, personality and cognitive tests. Only 38.9% of them presented with all of the symptoms of PTSD; 22.2% showed no symptoms for PTSD; remaining survivors exhibited emotional/affective symptoms related to the event. In addition to the severity of the traumatic event itself, other risk factors identified were the loss of a relative, the manifestation of depressive symptoms, and the severity of physical injuries sustained. Low levels of hostility and high levels of self-efficacy represented protective factors against developing PTSD.",0 +https://doi.org/10.1007/s11920-007-0033-7,Glutamate and anxiety disorders,"Anxiety disorders are among the most prevalent psychiatric disorders, but they represent a particular challenge for treatment. The standard first-line treatments, including antidepressants, benzodiazepines, and buspirone, result in significant response rates for a majority of patients; however, unfavorable side effect profiles or risk for dependency for particular agents might limit their use by anxious patients, who often have low thresholds for medication discontinuation. Novel pharmacologic agents that modulate particular receptors, ion channels, or transporters relevant to glutamatergic neurotransmission may represent a new approach to the treatment of anxiety disorders, with generally more favorable side effect profiles. Although the role of glutamate in the pathophysiology of anxiety disorders is listill being elucidated, the use of these agents in treatment of anxiety disorders and commonly comorbid conditions such as substance abuse and mood disorders will continue to increase.",0 +https://doi.org/10.1016/j.jpsychires.2014.11.010,"Post-disaster stressful life events and WTC-related posttraumatic stress, depressive symptoms, and overall functioning among responders to the World Trade Center disaster","The current study examined contributions of post-disaster stressful life events in relation to the maintenance of WTC-related posttraumatic stress, depressive symptoms, and overall functioning among rescue, recovery, and clean-up workers who responded to the September 11, 2001 World Trade Center (WTC) terrorist attacks.Participants were 18,896 WTC responders, including 8466 police officers and 10,430 non-traditional responders (85.8% male; 86.4% Caucasian; M(age) = 39.5, SD = 8.8) participating in the WTC Health Program who completed an initial examination between July, 2002 and April, 2010 and who were reassessed, on average, 2.5 years later.Path analyses were conducted to evaluate contributions of life events to the maintenance of WTC-related posttraumatic stress, depressive symptoms, and overall functioning. These analyses were stratified by police and non-traditional responder groups and adjusted for age, sex, time from 9/11 to initial visit, WTC exposures (three WTC contextual exposures: co-worker, friend, or a relative died in the disaster; co-worker, friend, or a relative injured in the disaster; and responder was exposed to the dust cloud on 9/11), and interval from initial to first follow-up visit. In both groups, WTC-related posttraumatic stress, depressive symptoms, and overall functioning were stable over the follow-up period. WTC exposures were related to these three outcomes at the initial assessment. WTC-related posttraumatic stress, depressive symptoms, and overall functioning, at the initial assessment each predicted the occurrence of post-disaster stressful life events, as measured by Disaster Supplement of the Diagnostic Interview Schedule. Post-disaster stressful life events, in turn, were associated with subsequent mental health, indicating partial mediation of the stability of observed mental health.The present findings suggest a dynamic interplay between exposure, post-disaster stressful life events, and WTC-related posttraumatic stress, depressive symptoms, and overall functioning among WTC disaster responders.",0 +https://doi.org/10.1016/j.cpr.2005.07.002,Posttraumatic stress following childbirth: A review,"To assess the empirical basis of prevalence and risk factors of childbirth-related posttraumatic stress symptoms and PTSD in mothers, the relevant literature was critically reviewed. A MEDLINE and PSYCHLIT search using the key words ""posttraumatic stress"", ""PTSD"", ""childbirth"" and ""traumatic delivery"" was performed. The generated list of articles was supplemented by a review of their bibliographies. A total of 31 articles was selected. The primary inclusion criterion was report of posttraumatic stress symptoms or PTSD specifically related to childbirth. Case studies and quantitative studies on regular childbirth and childbirth by emergency cesarean section were identified. Consistency among studies was found with regard to development of posttraumatic stress symptoms as a consequence of traumatic delivery. Methodological issues concerning prevalence and risk factors were discussed. Case studies and quantitative studies confirm that childbirth may be experienced as so emotionally intense that it can lead to the development of posttraumatic stress symptoms or even a PTSD-profile. Among the identified risk factors were a history of psychological problems, trait anxiety, obstetric procedures, negative aspects in staff-mother contact, feelings of loss of control over the situation, and lack of partner support. The conclusion of the current review is twofold. First, traumatic reactions to childbirth are an important public health issue. Secondly, studying childbirth offers opportunity to prospectively study the development of posttraumatic stress reactions.",0 +https://doi.org/10.1111/jam.12606,Oral administration of Bacillus subtilis strain BSB3 can prevent heat stress-related adverse effects in rats,"To determine the efficacy of Bacillus subtilis strain in prevention of heat stress-related complications in rats.Male Sprague-Dawley rats weighing 250-300 g were treated by oral gavage with B. subtilis BSB3 strain or PBS twice a day for 2 days. Half of the rats of each group were exposed to heat stress (45°C, relative humidity 55% for 25 min), while the remaining rats were placed at identical conditions but at 25°C. Bacterial translocation, histological changes in the intestine, cytokines profile, serum lipopolysaccharide level (LPS), as well as vesiculation of erythrocytes were analysed and compared between groups. Adverse effects of heat stress (morphological changes in intestine, bacterial translocation, elevated levels of LPS and IL-10, increased vesiculation of erythrocytes) were observed only in rats not protected with B. subtilis strain and exposed to heat. All registered parameters in rats pretreated with bacilli and exposed to heat were similar to control groups.Bacillus subtilis BS3B strain was effective in the prevention of complications related to heat stress in rats.This work will contribute towards better understanding of probiotics' mechanisms of action and will bring new approaches to characterize and use of beneficial bacteria.",0 +https://doi.org/10.1001/jama.292.15.1811,"Physical Health Status of World Trade Center Rescue and Recovery Workers and Volunteers—New York City, July 2002–August 2004",,0 +https://doi.org/10.1007/s10484-015-9270-4,Stress and Cortisol in Disaster Evacuees: An Exploratory Study on Associations with Social Protective Factors,"Though cumulative emotional and physical effects of disasters may diminish evacuees’ short and long-term mental and physical health, social factors may buffer such consequences. We approached survivors of the October 2007 San Diego, California firestorms. We gathered data during the evacuation and 3 months afterward. Questionnaires measured social support as well as PTSD, depression, and anxiety symptoms. Saliva samples were used to assess the stress hormone, cortisol. Analyses, adjusting for age, gender, and socioeconomic status, showed PTSD symptoms were associated with flattening of the diurnal cortisol rhythm during evacuation. Secondary analyses showed those reporting a family emphasis on moral and religious values had lower psychological distress. Though anxiety symptoms had significantly decreased in the overall sample at follow-up, blunted cortisol rhythms persisted among those individuals with continued high anxiety. Results highlight a possible psychological, and perhaps a physiological, benefit of social and existential factors in disaster situations. Future work should explore the role of psychosocial factors and stress physiology in the development of long-term health concerns among individuals exposed to disaster. © 2015, Springer Science+Business Media New York.",0 +https://doi.org/10.1002/jts.20136,Role of distinct PTSD symptoms in intimate partner reabuse: A prospective study,"This prospective study examines the impact of four posttraumatic stress disorder (PTSD) symptom clusters (hyperarousal, reexperiencing, numbing, and avoidance) on reabuse over 1 year among women exposed to intimate partner violence (IPV). The covariates include severity of IPV, a history of childhood violence, and characteristics of the abusive relationship. Although both hyperarousal and numbing symptoms were higher at baseline among women subsequently reabused, only numbing symptoms increased the odds of reabuse after controlling for the covariates. Greater IPV severity and shorter relationship duration also increased the risk of reabuse. Results indicate that specific symptoms of PTSD, especially numbing, need to be addressed to increase the safety of women seeking services for IPV.",0 +https://doi.org/10.1023/a:1024710803042,"MMPI, MMPI-2 and PTSD: Overview of scores, scales, and profiles","A number of issues should be considered when applying profile interpretations and subscales derived from the original MMPI. These issues and the overall utility of the MMPI-2 for posttraumatic stress disorder (PTSD) evaluations are summarized. The Keane PTSD scale is found to be an effective tool for differential diagnosis when a cut-off score of 28 is used. The Schlenger PTSD scale warrants additional study. Various MMPI-2 validity scales are useful in detecting malingering, but concurrence regarding cut-off scores is lacking. The 2-8/8-2 MMPI PTSD profile does not emerge as consistently on the MMPI-2 as it did on the MMPI, due to the frequent elevation of scale 7 on the MMPI-2.",0 +https://doi.org/10.1007/s00127-003-0612-9,Coping strategies in civilians during air attacks,"Coping strategies may influence the psychological outcome after a stressful event, both as coping at the time of the event and as strategies of dealing with its consequences after the event. The aim of the study was to investigate coping strategies used by civilians during the air attacks in Yugoslavia in 1999, and their association with the level of exposure, gender and psychological symptoms 1 year later.The sample is a non-selective group of 139 medical students from the University of Belgrade, Yugoslavia. Open questions and content analysis were used to assess coping strategies. Symptoms of intrusion and avoidance were assessed, as well as general psychological symptoms.Content analysis of answers to open questions revealed nine categories of coping strategies (sport and walks, leisure activities, talking and gathering, humor, avoidance, philosophical approach, getting information, work, and substance abuse). A cluster analysis identified three groups of students with different styles of coping. Students that used dominantly 'talking and gathering' had the highest, and the ones that mostly used 'leisure activities' the lowest scores on intrusion. There were significant gender differences in how coping strategies were associated with intrusive symptoms.The type of coping strategies used during the air attacks may contribute to the level of intrusive symptoms 1 year after the event. Different coping strategies might be effective in men and women to reduce intrusive symptoms. Longitudinal and prospective studies are needed to draw definite conclusions on causal relationships between coping strategies and levels of posttraumatic stress.",0 +https://doi.org/10.1097/01.mlr.0000114909.33878.ca,The Parent Report Form of the CHIP–Child Edition,"Valid, comprehensive instruments to describe, monitor, and evaluate health from childhood through adolescence are almost nonexistent, but are critical for health resource planning, evaluation of policy, preventive, and clinical interventions, and understanding trajectories of health during this important period of life.The objectives of this study were to describe the development, testing, and final versions of the Parent Report Form of the Child Health and Illness Profile-Child Edition (CHIP-CE/PRF), designed to measure the health of children 6 to 11 years old from the caregiver perspective.Parents (N=1049) completed a version of the CHIP-CE/PRF in 4 locations in the United States, either in clinic waiting rooms or their homes. They differed in race/ethnicity, socioeconomic level, and native language.The Parent CHIP-CE is feasible; parents with a 5th-grade reading level complete the 76-item PRF in 20 minutes. Its domains (Satisfaction, Comfort, Risk Avoidance, Resilience, and Achievement) measure structurally distinct, interrelated aspects of health. Domain reliability is high: internal consistency=0.79-0.88; retest reliability (ICC)=0.71-0.85. Validity is supported. The scale scores are sensitive to predicted age, gender, and socioeconomic status differences in health.The CHIP-Child Edition/Parent Report Form is a psychometrically sound, conceptually based measure of child health that works well in diverse populations. It produces scores that parallel those of children on the CHIP-CE/CRF and adolescents on the CHIP-AE and allows health to be consistently assessed from childhood through adolescence. It should meet many needs for describing, monitoring, and understanding child health and evaluating outcomes of interventions.",0 +https://doi.org/10.1016/j.jpp.2015.10.003,Du pré-partum au post-partum : étude des profils et des symptomatologies maternelles,"Resume Objectifs Si les recherches sur les troubles psychiatriques en pre-partum sont nombreuses, il n’existe, a notre connaissance, aucune etude se focalisant sur les profils psychopathologiques des femmes en pre-partum. Le but de cette etude longitudinale est d’examiner les typologies de femmes en pre-partum et d’examiner si ces typologies se differencient au niveau des symptomes de troubles en post-partum immediat et a long terme. Participants, materiel et methode Quarante-six femmes ont rempli, entre le 8e et le 9e mois de grossesse (T1), des questionnaires mesurant la peur de l’accouchement et les symptomes de stress pretraumatique. Trois jours post-accouchement (T2), elles ont complete des mesures concernant l’experience et la douleur de l’accouchement et la detresse perinatale. A 6 semaines du post-partum (T3), des echelles mesurant les symptomes de depression postnatale et de stress post-traumatique ont egalement ete remplies. La symptomatologie anxio-depressive a egalement ete mesuree aux 3 temps de l’etude. Resultats Quatre typologies ont ete identifiees en pre-partum : le « groupe resilient » presentant une faible symptomatologie ; le « groupe peur » avec des symptomes averes de peur de l’accouchement ; le « groupe anxieux » rapportant une anxiete suspectee ; le « groupe stress pretraumatique-peur-anxiete-depression » avec des symptomes multiples. Nos resultats montrent egalement un impact des troubles en pre-partum sur les symptomatologies presentes en post-partum. Conclusion Les recherches sur les troubles en pre-partum et leurs etiologies sont a encourager afin de prevenir la formation de troubles secondaires.",0 +https://doi.org/10.1111/j.1651-2227.2008.00873.x,Posttraumatic stress among children in Kurdistan,"To identify a posttraumatic stress disorder profile for the Child Behaviour Checklist.Checklist item scores for 806 school-aged children in Iraqi Kurdistan (201 randomly selected from the general population, 241 orphans, 199 primary medical care visitors and 165 hospital in-patients) were analysed against the Posttraumatic Stress Symptom Scale for Children (PTSS-C) scores, estimating not only stress diagnoses, but also nonstress-related, child-specific posttraumatic symptoms.Twenty checklist items, which revealed significant correlations with the stress diagnoses, formed the checklist-stress profile with acceptable reliability and validity, and significant correlation to the PTSS-C estimates.A child-specific stress profile for the checklist is recommended for use as a screening instrument.",0 +https://doi.org/10.1007/s10597-012-9511-4,"Negative Affect Predicts Adults’ Ratings of the Current, but Not Childhood, Impact of Adverse Childhood Events","Adverse childhood events (ACE's) have been empirically related to a wide range of negative health and mental health outcomes. However, not all individuals who experience ACE's follow a trajectory of poor outcomes, and not all individuals perceive the impact of ACE's as necessarily negative. The purpose of this study was to investigate positive and negative affect as predictors of adults' ratings of both the childhood and adult impact of their childhood adversity. Self-report data on ACE experiences, including number, severity, and 'impact' were collected from 158 community members recruited on the basis of having adverse childhood experiences. Results indicated that, regardless of event severity and number of different types of adverse events experienced, high levels of negative affect were the strongest predictor of whether the adult impact of the adverse childhood events was rated as negative. All individuals rated the childhood impact of events the same. Implications are discussed. © 2012 Springer Science+Business Media, LLC.",0 +https://doi.org/10.1111/j.1749-6632.2010.05720.x,Effects of psychological and biomechanical trauma on brain and behavior,"The current conflicts in Iraq and Afghanistan have resulted in a large cohort of military personnel exposed to combat-related psychological trauma as well as biomechanical trauma, including proximity to blast events. Historically, the long-term effects of both types of trauma have been viewed as having different neural substrates, with some controversy over the proper attribution of such symptoms evident after each of the major conflicts of the last century. Recently, great effort has been directed toward distinguishing which neuropsychiatric sequelae are due to which type of trauma. Of interest, however, is that the chronic effects of exposure to either process are associated with a significant overlap in clinical symptoms. Furthermore, similar brain regions are vulnerable to the effects of either psychological or biomechanical trauma, raising the possibility that shared mechanisms may underlie the clinically observed overlap in symptom profile. This paper reviews the literature on the neural substrate of biomechanical and psychological injury and discusses the implications for evaluation and treatment of the neuropsychiatric sequelae of these processes.",0 +https://doi.org/10.2989/17280583.2010.528580,Bullying boys: the traumatic effects of bullying in male adolescent learners,"This study investigated the nature and extent of the relationship between bullying and trauma among male adolescent learners. Trauma was operationalised through the multiple constructs of post-traumatic stress, anxiety, depression, dissociation and anger.In this quantitative study, two objective measures were administered (viz. the Olweus Bullying/ Victimisation Scale and the Trauma Symptom Checklist for children) to a sample of male adolescent learners between the ages of 12 and 17, from a South African male-only high school (n = 486).Statistical analysis (correlational analysis and MANOVA) produced evidence to suggest that there was a statistically significant relationship between bullying and trauma, and this was strongest for the victim role. The relationship between bullying and trauma was dependent on the frequency of bullying; as the frequency of being bullied increased so too did the mean scores of all the five trauma subscales. In general, the findings indicated that learners presented with elevated levels of internalising trauma outcomes. Depression demonstrated the highest correlation with the victim role, followed by Posttraumatic stress. In addition, 22.4% of learners could be clinically and sub-clinically diagnosed with post-traumatic stress and 21.0% with dissociation. Overall, the findings corroborate the argument that repetitive stressful events (such as bullying) are related to symptom-clusters of ongoing trauma.",0 +,"Circulating lymphocyte subsets, natural killer cell cytotoxicity, and components of hypothalamic-pituitary-adrenal axis in Croatian war veterans with posttraumatic stress disorder: cross-sectional study.","To determine peripheral blood lymphocyte subsets--T cells, helper T cells, cytotoxic T cells, B cells, and natural killer cells, natural killer cell cytotoxicity, serum cortisol concentration, and lymphocyte glucocorticoid receptor expression in Croatian combat veterans diagnosed with chronic posttraumatic stress disorder (PTSD); and to examine the relationship between the assessed parameters and the time passed since the traumatic experience.Well-characterized group of 38 PTSD patients was compared to a group of 24 healthy civilians. Simultaneous determination of lymphocyte subsets and the expression of intracellular glucocorticoid receptor was performed using three-color flow cytometry. Natural killer cell cytotoxicity was measured by (51)Cr-release assay and the serum cortisol concentration was determined by radioimmunoassay.We found higher lymphocyte counts in PTSD patients than in healthy controls (2294.7+/-678.0/microL vs 1817.2+/-637.0/microL, P=0.007) and a positive correlation between lymphocyte glucocorticoid receptor expression and the number of years that passed from the traumatic experience (r(s)=0.43, P=0.008). Lymphocyte glucocorticoid receptor expression positively correlated with serum cortisol concentration both in PTSD patients (r=0.46, P=0.006) and healthy controls (r=0.46, P=0.035).This study confirmed that the immune system was affected in the course of chronic PTSD. Our findings also indicated that the hypothalamic-pituitary-adrenal axis profile in PTSD was associated with the duration of the disorder. Due to the lack of power, greater sample sizes are needed to confirm the results of this study.",0 +https://doi.org/10.1300/j229v08n02_03,Levels of Trauma Among Women Inmates with HIV Risk and Alcohol Use Disorders: Behavioral and Emotional Impacts,"An increasing number of women are involved in the criminal justice system. Women in corrections are often of low socioeconomic status, medically underserved and exposed to a variety of traumatic events. Programs and services provided in correctional settings should be informed by the unique profiles and needs of these women. This study sought to identify distinct sub-groups (classes) of incarcerated women based on differences in their qualitative (types of trauma) and quantitative (number of) trauma experiences. Demographics, psychosocial and behavioral characteristics were measured in 149 women entering jail, who reported recent hazardous drinking and HIV sexual risk behavior. Two classes based on trauma exposure of women were identified through latent class analysis. The classes did not differ with respect to qualitative differences in trauma exposure (both classes reported all forms of trauma), but did differ with respect to quantitative differences (Class 2 reported more exposure to trauma in all categories than Class 1). The classes also differed significantly on current psychological functioning, alcohol treatment, problems, and consequences, drug histories, sexual risk, medical conditions, and social group characteristics. In all areas, members of Class 2 were significantly more likely to report higher levels of measured variables. Nearly all women in our sample reported levels of trauma exposure, suggesting a need for intervention and attention. Through identifying these separate classes, limited resources for trauma survivors in the correctional setting could be most appropriately allocated.",0 +https://doi.org/10.1007/s00127-015-1026-1,Borderline personality disorder and Axis I psychiatric and substance use disorders among women experiencing homelessness in three US cities,"In this study, we report prevalence rates of borderline personality disorder (BPD) and Axis I psychiatric and substance use disorders among randomly selected women who were experiencing episodes of homelessness in three US cities.The sample consists of 156 women, 79 from Omaha, NE, 39 from Pittsburgh, PA, and 38 from Portland, OR. It included 140 women from shelters and 16 women from meal locations. Latent class analysis was used to evaluate BPD symptoms.A large majority of the women (84.6 %) met criteria for at least one lifetime psychiatric disorder, about three-fourths (73.1 %) met criteria for a psychiatric disorder in the past year, and 39.7 % met past month criteria for a psychiatric disorder. Approximately three-fourths of the sample (73.7 %) met lifetime criteria for at least two disorders, about half (53.9 %) met criteria for at least three lifetime disorders, and approximately one-third (39.1 %) met criteria for four or more disorders. Latent class analyses indicated that 16.7 % of the women could be categorized as low self-harm BPD and 19.9 % high self-harm BPD.In shelters and in treatment settings, these women will present with complex histories of multiple serious psychiatric disorders. They are highly likely to manifest symptoms of BPD, post-traumatic stress disorder, and substance abuse disorders in addition to other psychiatric symptoms which will add to clinical complications.",0 +https://doi.org/10.1017/s0033291709991310,Support for the mutual maintenance of pain and post-traumatic stress disorder symptoms,"Background Pain and post-traumatic stress disorder (PTSD) are frequently co-morbid in the aftermath of a traumatic event. Although several models attempt to explain the relationship between these two disorders, the mechanisms underlying the relationship remain unclear. The aim of this study was to investigate the relationship between each PTSD symptom cluster and pain over the course of post-traumatic adjustment. Method In a longitudinal study, injury patients ( n =824) were assessed within 1 week post-injury, and then at 3 and 12 months. Pain was measured using a 100-mm Visual Analogue Scale (VAS). PTSD symptoms were assessed using the Clinician-Administered PTSD Scale (CAPS). Structural equation modelling (SEM) was used to identify causal relationships between pain and PTSD. Results In a saturated model we found that the relationship between acute pain and 12-month pain was mediated by arousal symptoms at 3 months. We also found that the relationship between baseline arousal and re-experiencing symptoms, and later 12-month arousal and re-experiencing symptoms, was mediated by 3-month pain levels. The final model showed a good fit [χ 2 =16.97, df=12, p >0.05, Comparative Fit Index (CFI)=0.999, root mean square error of approximation (RMSEA)=0.022]. Conclusions These findings provide evidence of mutual maintenance between pain and PTSD.",0 +https://doi.org/10.1192/bjp.bp.106.025684,"Anxiety, post-traumatic stress disorder and depression in Korean War veterans 50 years after the war","Background There has been no comprehensive investigation of psychological health in Australia's Korean War veteran population, and few researchers are investigating the health of coalition Korean War veterans into old age. Aims To investigate the association between war service, anxiety, post-traumatic stress disorder (PTSD) and depression in Australia's 7525 surviving male Korean War veterans and a community comparison group. Method A survey was conducted using a self-report postal questionnaire which included the PTSD Checklist, the Hospital Anxiety and Depression scale and the Combat Exposure Scale. Results Post-traumatic stress disorder (OR 6.63, P <0.001), anxiety (OR 5.74, P <0.001) and depression (OR 5.45, P <0.001) were more prevalent in veterans than in the comparison group. These disorders were strongly associated with heavy combat and low rank. Conclusions Effective intervention is necessary to reduce the considerable psychological morbidity experienced by Korean War veterans. Attention to risk factors and early intervention will be necessary to prevent similar long-term psychological morbidity in veterans of more recent conflicts.",0 +https://doi.org/10.1007/s00213-005-2146-1,Lamotrigine has an anxiolytic-like profile in the rat conditioned emotional response test of anxiety: a potential role for sodium channels?,"Rationale: Many anticonvulsants are used in disorders other than epilepsy. For example, lamotrigine is reported to be effective in post-traumatic stress disorder and mania. Objective: We assessed the effects of the anticonvulsants lamotrigine, valproate and carbamazepine in an animal model of anxiety. We assessed a wide range of pharmacological tools to delineate the mechanism of lamotrigine's anxiolytic effect. Methods: We assessed these compounds in the rat conditioned emotional response (CER) test of anxiety. Results: Lamotrigine (30-80 mg/kg) dose-dependently and reproducibly engendered an anxiolytic response in this test, with similar efficacy to benzodiazepines. Carbamazepine (20-40 mg/kg) and riluzole (10 mg/kg), which block Na+ channels by a similar mechanism as lamotrigine, were also anxiolytic. By contrast, valproate (100-600 mg/kg) was inactive and appears to differ in its interaction with Na+ channels. The SSRI paroxetine, the GABAA receptor positive modulator propofol, the NMDA antagonists memantine and (+)MK-801, and the Ca2+ channel antagonist nifedipine were all inactive in the CER test, suggesting these mechanisms may not mediate the anxiolytic effect of lamotrigine. More directly, we showed that the anxiolytic effect of lamotrigine could be blocked by co-administering rats with the Na+ channel activator veratrine (0.1 mg/kg). By contrast, neither the Ca2+ channel agonist BAYK8644 (0.5 mg/kg) nor the 5-HT1A or 5-HT 1/2 antagonists WAY100635 (0.3 mg/kg) and metergoline (3 mg/kg), respectively, were able to block the effect. Conclusion: Lamotrigine's anxiolytic effect in the CER test may be mediated via block of Na+ channels, and this may represent a target for the development of novel anxiolytics. (",0 +https://doi.org/10.1016/s0191-8869(03)00003-5,Posttraumatic symptoms and suicide risk,"Abstract The relationship between traumatic events and suicide risk is well known. Most researches agree that Posttraumatic Stress Disorder (PTSD) plays a major role in this link. However, less is known about the specific posttraumatic symptom constellation that predicts suicide risk. In the current study we examined the posttraumatic symptom's profile which is associated with suicide risk, in a community sample of men with no known psychopathology. The research population included 103 men aged 25–45. They were administered the ‘Traumatic Event Questionnaire’, ‘PTSD Scale’, ‘Suicide Risk Scale’ (SRS) and the SCL-90. Results indicated that suicide risk was predicted by high levels of depression and hostility. High levels of arousal symptom and low levels of avoidance added a significant contribution to that prediction, suggesting that avoidance may serve as a buffer against suicide risk, while high levels of arousal may increase suicide risk. These findings may serve mental health professionals to identify high-risk persons also in a non-clinical population.",0 +https://doi.org/10.1017/s0790966700013884,“War neurosis” and associated physical conditions: an exploratory statistical analysis,Abstract Records of the war service disability claims for Australian Vietnam veterans in Tasmania (n = 751) were analysed to establish patterns of interrelationships between categories of disability. The predicted relationship between psychiatric disability and stress related skin disabilities was strongly supported and relationships between psychiatric and other medical disabilities were found. An exploratory principal components analysis produced three independent components which accounted for 21.2 percent of total variance. Component 1 was interpreted as a general military service component and components 2 and 3 were labelled as stress components. The most likely interpretation of the two stress components was that they reflect differences in profiles of records for disability claims depending on the time when the disability presented. The relevance of the findings is discussed.,0 +https://doi.org/10.1176/ajp.155.9.1172,Efficacy of Psychoeducational Group Therapy in Reducing Symptoms of Posttraumatic Stress Disorder Among Multiply Traumatized Women,"Objective: The role of group therapy in treatment of posttraumatic stress disorder (PTSD) has been traditionally restricted to issues of self-esteem and interpersonal relationships, rather than primary symptoms of the disorder. In this study, the authors examined the effectiveness of a 16-week trauma-focused, cognitive-behavioral group therapy, named Interactive Psychoeducational Group Therapy, in reducing primary symptoms of PTSD in five groups (N=29) of multiply traumatized women diagnosed with chronic PTSD. Method: The authors made assessments at baseline, at 1-month intervals during treatment, at termination, and at 6-month follow-up by using self-report and structured interview measures of PTSD and psychiatric symptoms. The absence of a control group limits the conclusions drawn from the study.Results: At termination, subjects showed significant reductions in all three clusters of PTSD symptoms (i.e., reexperiencing, avoidance, and hyperarousal) and in depressive symptoms; they showed near-significant reductions in general psychiatric and dissociative symptoms, at termination. These improvements were sustained at 6-month follow-up.Conclusions: The role of group therapy in PTSD treatment should not be prematurely restricted to addressing self-esteem and interpersonal dimensions only. The use of structured, cognitive-behavioral elements within the group format may allow for more targeted treatment of core symptoms of the disorder. Am J Psychiatry 1998; 155: 1172-1177",0 +https://doi.org/10.1186/1752-4458-5-24,Validation of the UCLA Child Post traumatic stress disorder-reaction index in Zambia,"Sexual violence against children is a major global health and human rights problem. In order to address this issue there needs to be a better understanding of the issue and the consequences. One major challenge in accomplishing this goal has been a lack of validated child mental health assessments in low-resource countries where the prevalence of sexual violence is high. This paper presents results from a validation study of a trauma-focused mental health assessment tool - the UCLA Post-traumatic Stress Disorder - Reaction Index (PTSD-RI) in Zambia.The PTSD-RI was adapted through the addition of locally relevant items and validated using local responses to three cross-cultural criterion validity questions. Reliability of the symptoms scale was assessed using Cronbach alpha analyses. Discriminant validity was assessed comparing mean scale scores of cases and non-cases. Concurrent validity was assessed comparing mean scale scores to a traumatic experience index. Sensitivity and specificity analyses were run using receiver operating curves.Analysis of data from 352 youth attending a clinic specializing in sexual abuse showed that this adapted PTSD-RI demonstrated good reliability, with Cronbach alpha scores greater than .90 on all the evaluated scales. The symptom scales were able to statistically significantly discriminate between locally identified cases and non-cases, and higher symptom scale scores were associated with increased numbers of trauma exposures which is an indication of concurrent validity. Sensitivity and specificity analyses resulted in an adequate area under the curve, indicating that this tool was appropriate for case definition.This study has shown that validating mental health assessment tools in a low-resource country is feasible, and that by taking the time to adapt a measure to the local context, a useful and valid Zambian version of the PTSD-RI was developed to detect traumatic stress among youth. This valid tool can now be used to appropriately measure treatment effectiveness, and more effectively and efficiently triage youth to appropriate services.",0 +https://doi.org/10.1097/mlr.0000000000000007,"Prevalence, Risk, and Correlates of Posttraumatic Stress Disorder Across Ethnic and Racial Minority Groups in the United States","We assess whether posttraumatic stress disorder (PTSD) varies in prevalence, diagnostic criteria endorsement, and type and frequency of potentially traumatic events (PTEs) among a nationally representative US sample of 5071 non-Latino whites, 3264 Latinos, 2178 Asians, 4249 African Americans, and 1476 Afro-Caribbeans.PTSD and other psychiatric disorders were evaluated using the World Mental Health-Composite International Diagnostic Interview (WMH-CIDI) in a national household sample that oversampled ethnic/racial minorities (n=16,238) but was weighted to produce results representative of the general population.Asians have lower prevalence rates of probable lifetime PTSD, whereas African Americans have higher rates as compared with non-Latino whites, even after adjusting for type and number of exposures to traumatic events, and for sociodemographic, clinical, and social support factors. Afro-Caribbeans and Latinos seem to demonstrate similar risk to non-Latino whites, adjusting for these same covariates. Higher rates of probable PTSD exhibited by African Americans and lower rates for Asians, as compared with non-Latino whites, do not appear related to differential symptom endorsement, differences in risk or protective factors, or differences in types and frequencies of PTEs across groups.There appears to be marked differences in conditional risk of probable PTSD across ethnic/racial groups. Questions remain about what explains risk of probable PTSD. Several factors that might account for these differences are discussed, as well as the clinical implications of our findings. Uncertainty of the PTSD diagnostic assessment for Latinos and Asians requires further evaluation.",0 +https://doi.org/10.1016/j.neuropharm.2011.07.007,Stress modulation of drug self-administration: Implications for addiction comorbidity with post-traumatic stress disorder,"Drug abuse and dependence present significant health burdens for our society, affecting roughly 10% of the population. Stress likely contributes to the development and persistence of drug use; for example, rates of substance dependence are elevated among individuals diagnosed with post-traumatic stress disorder (PTSD). Thus, understanding the interaction between stress and drug use, and associated neuroadaptations, is key for developing therapies to combat substance use disorders. For this purpose, many rodent models of the effects of stress exposure on substance use have been developed; the models can be classified according to three categories of stress exposure: developmental, adult nonsocial, and adult social. The present review addresses preclinical findings on the effect of each type of trauma on responses to and self-administration of drugs of abuse by focusing on a key exemplar for each category. In addition, the potential efficacy of targeting neuropeptide systems that have been implicated in stress responses and stress system neuroadaptation in order to treat comorbid PTSD and substance abuse will be discussed. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0 +https://doi.org/10.3389/fnbeh.2014.00265,GAD65 haplodeficiency conveys resilience in animal models of stress-induced psychopathology,"GABAergic mechanisms are critically involved in the control of fear and anxiety, but their role in the development of stress-induced psychopathologies, including post-traumatic stress disorder (PTSD) and mood disorders is not sufficiently understood. We studied these functions in two established mouse models of risk factors for stress-induced psychopathologies employing variable juvenile stress and/or social isolation. A battery of emotional tests in adulthood revealed the induction of contextually generalized fear, anxiety, hyperarousal and depression-like symptoms in these paradigms. These reflect the multitude and complexity of stress effects in human PTSD patients. With factor analysis we were able to identify parameters that reflect these different behavioral domains in stressed animals and thus provide a basis for an integrated scoring of affectedness more closely resembling the clinical situation than isolated parameters. To test the applicability of these models to genetic approaches we further tested the role of GABA using heterozygous mice with targeted mutation of the GABA synthesizing enzyme GAD65 [GAD65(+/-) mice], which show a delayed postnatal increase in tissue GABA content in limbic and cortical brain areas. Unexpectedly, GAD65(+/-) mice did not show changes in exploratory activity regardless of the stressor type and were after the variable juvenile stress procedure protected from the development of contextual generalization in an auditory fear conditioning experiment. Our data demonstrate the complex nature of behavioral alterations in rodent models of stress-related psychopathologies and suggest that GAD65 haplodeficiency, likely through its effect on the postnatal maturation of GABAergic transmission, conveys resilience to some of these stress-induced effects.",0 +https://doi.org/10.1016/j.brat.2013.08.005,Prevention of chronic PTSD with early cognitive behavioral therapy. A meta-analysis using mixed-effects modeling,"Post-traumatic stress disorder (PTSD) is of great interest to public health, due to the high burden it places on both the individual and society. We meta-analyzed randomized-controlled trials to examine the effectiveness of early trauma-focused cognitive-behavioral treatment (TFCBT) for preventing chronic PTSD. Systematic bibliographic research was undertaken to find relevant literature from on-line databases (Pubmed, PsycINFO, Psyndex, Medline). Using a mixed-effect approach, we calculated effect sizes (ES) for the PTSD diagnoses (main outcome) as well as PTSD and depressive symptoms (secondary outcomes), respectively. Calculations of ES from pre-intervention to first follow-up assessment were based on 10 studies. A moderate effect (ES = 0.54) was found for the main outcome, whereas ES for secondary outcomes were predominantly small (ES = 0.27-0.45). The ES for the main outcome decreased to small (ES = 0.34) from first follow-up to long-term follow-up assessment. The mean dropout rate was 16.7% pre- to post-treatment. There was evidence for the impact of moderators on different outcomes (e.g., the number of sessions on PTSD symptoms). Future studies should include survivors of other trauma types (e.g., burn injuries) rather than predominantly survivors of accidents and physical assault, and should compare early TFCBT with other interventions that previously demonstrated effectiveness.",0 +https://doi.org/10.1037/1082-989x.8.3.369,Statistical and Substantive Checking in Growth Mixture Modeling: Comment on Bauer and Curran (2003).,This commentary discusses the D. J. Bauer and P. J. Curran (2003) investigation of growth mixture modeling. Single-class modeling of nonnormal outcomes is compared with modeling with multiple latent trajectory classes. New statistical tests of multiple-class models are discussed. Principles for substantive investigation of growth mixture model results are presented and illustrated by an example of high school dropout predicted by low mathematics achievement development in Grades 7-10.,0 +https://doi.org/10.1111/j.1440-1819.2008.01906.x,Neurostructural imaging findings in children with post-traumatic stress disorder: Brief review,"Child maltreatment has been associated with different psychiatric disorders. Studies on both animals and humans have suggested that some brain areas would be directly affected by severe psychological trauma. The pathophsysiology of post-traumatic stress disorder (PTSD) appears to be related to a complex interaction involving genetic and environmental factors. Advanced neuroimaging techniques have been used to investigate neurofunctional and neurostructural abnormalities in children, adolescents, and adults with PTSD. This review examined structural brain imaging studies that were performed in abused and traumatized children, and discusses the possible biological mechanisms involved in the pathophysiology of PTSD, the implications and future directions for magnetic resonance imaging (MRI) studies. Published reports in refereed journals were reviewed by searching Medline and examining references of the articles related to structural neuroimaging of PTSD. Structural MRI studies have been performed in adults and children to evaluate the volumetric brain alterations in the PTSD population. In contrast with studies involving adults, in which hippocampus volumetric reduction was the most consistent finding, studies involving children and adolescents with PTSD have demonstrated smaller medial and posterior portions of the corpus callosum.",0 +https://doi.org/10.1002/da.21946,THE DISSOCIATIVE SUBTYPE OF PTSD: A REPLICATION AND EXTENSION,The nature of the relationship between dissociation and posttraumatic stress disorder (PTSD) has clinical and nosological importance. The aim of this study was to evaluate the evidence for a dissociative subtype of PTSD in two independent samples and to examine the pattern of personality disorder (PD) comorbidity associated with the dissociative subtype of PTSD.Latent profile analyses were conducted on PTSD and dissociation items reflecting derealization and depersonalization in two samples of archived data: Study 1 included 360 male Vietnam War Veterans with combat-related PTSD; Study 2 included 284 female Veterans and active duty service personnel with PTSD and a high base rate of exposure to sexual trauma.The latent profile analysis yielded evidence for a three-class solution in both samples: the model was defined by moderate and high PTSD classes and a class marked by high PTSD severity coupled with high levels of dissociation. Approximately 15% of the male sample and 30% of the female sample were classified into the dissociative class. Women (but not men) in the dissociative group exhibited higher levels of comorbid avoidant and borderline PD diagnoses.Results provide support for a dissociative subtype of PTSD and also suggest that dissociation may play a role in the frequent co-occurrence of PTSD and borderline PD among women. These results are pertinent to the on-going revisions to the DSM and suggest that consideration should be given to incorporating a dissociative subtype into the revised PTSD criteria.,0 +https://doi.org/10.1111/jan.12139,A qualitative review of migrant women's perceptions of their needs and experiences related to pregnancy and childbirth,"A synthesis of the evidence of migrant women's perceptions of their needs and experiences in relation to pregnancy and childbirth.Despite the fact that all European Union member states have ratified human rights-based resolutions aimed at non-discrimination, there is a relationship between social inequality and access to pre-, intra-, and postpartum care.A qualitative systematic review of studies from European countries.A search was made for relevant articles published between January 1996-June 2010.Data were analysed by means of thematic synthesis.Sixteen articles were selected, analysed, and synthesized. One overall theme; 'Preserving one's integrity in the new country' revealed two key aspects; 'Struggling to find meaning' and 'Caring relationships'. 'Struggling to find meaning' comprised four sub-themes; 'Communication and connection', 'Striving to cope and manage', 'Struggling to achieve a safe pregnancy and childbirth', and 'Maintaining bodily integrity'. 'Caring relationships' was based on the following three sub-themes: 'Sources of strength', 'Organizational barriers to maternity care', and 'The nature and quality of caring relationships'.The results of this review demonstrate that migrant women are in a vulnerable situation when pregnant and giving birth and that their access to health services must be improved to better meet their needs. Research is required to develop continuity of care and improve integrated maternal care.",0 +https://doi.org/10.1007/bf02105408,The development of a Clinician-Administered PTSD Scale,"Several interviews are available for assessing PTSD. These interviews vary in merit when compared on stringent psychometric and utility standards. Of all the interviews, the Clinician-Administered PTSD Scale (CAPS-1) appears to satisfy these standards most uniformly. The CAPS-1 is a structured interview for assessing core and associated symptoms of PTSD. It assesses the frequency and intensity of each symptom using standard prompt questions and explicit, behaviorally-anchored rating scales. The CAPS-1 yields both continuous and dichotomous scores for current and lifetime PTSD symptoms. Intended for use by experienced clinicians, it also can be administered by appropriately trained paraprofessionals. Data from a large scale psychometric study of the CAPS-1 have provided impressive evidence of its reliability and validity as a PTSD interview.",0 +https://doi.org/10.1016/j.socscimed.2011.10.004,Five years later: Recovery from post traumatic stress and psychological distress among low-income mothers affected by Hurricane Katrina,"Hurricane Katrina, which struck the Gulf Coast of the United States in August 2005, exposed area residents to trauma and extensive property loss. However, little is known about the long-run effects of the hurricane on the mental health of those who were exposed. This study documents long-run changes in mental health among a particularly vulnerable group-low income mothers-from before to after the hurricane, and identifies factors that are associated with different recovery trajectories. Longitudinal surveys of 532 low-income mothers from New Orleans were conducted approximately one year before, 7-19 months after, and 43-54 months after Hurricane Katrina. The surveys collected information on mental health, social support, earnings and hurricane experiences. We document changes in post-traumatic stress symptoms (PTSS), as measured by the Impact of Event Scale-Revised, and symptoms of psychological distress (PD), as measured by the K6 scale. We find that although PTSS has declined over time after the hurricane, it remained high 43-54 months later. PD also declined, but did not return to pre-hurricane levels. At both time periods, psychological distress before the hurricane, hurricane-related home damage, and exposure to traumatic events were associated with PTSS that co-occurred with PD. Hurricane-related home damage and traumatic events were associated with PTSS without PD. Home damage was an especially important predictor of chronic PTSS, with and without PD. Most hurricane stressors did not have strong associations with PD alone over the short or long run. Over the long run, higher earnings were protective against PD, and greater social support was protective against PTSS. These results indicate that mental health problems, particularly PTSS alone or in co-occurrence with PD, among Hurricane Katrina survivors remain a concern, especially for those who experienced hurricane-related trauma and had poor mental health or low socioeconomic status before the hurricane.",0 +https://doi.org/10.3389/fpsyg.2014.01304,The experience of traumatic events disrupts the measurement invariance of a posttraumatic stress scale,"Studies that include multiple assessments of a particular instrument within the same population are based on the presumption that this instrument measures the same construct over time. But what if the meaning of the construct changes over time due to one's experiences? For example, the experience of a traumatic event can influence one's view of the world, others, and self, and may disrupt the stability of a questionnaire measuring posttraumatic stress symptoms (i.e., it may affect the interpretation of items). Nevertheless, assessments before and after such a traumatic event are crucial to study longitudinal development of posttraumatic stress symptoms. In this study, we examined measurement invariance of posttraumatic stress symptoms in a sample of Dutch soldiers before and after they went on deployment to Afghanistan (N = 249). Results showed that the underlying measurement model before deployment was different from the measurement model after deployment due to invariant item thresholds. These results were replicated in a sample of soldiers deployed to Iraq (N = 305). Since the lack of measurement invariance was due to instability of the majority of the items, it seems reasonable to conclude that the underlying construct of PSS is unstable over time if war-zone related traumatic events occur in between measurements. From a statistical point of view, the scores over time cannot be compared when there is a lack of measurement invariance. The main message of this paper is that researchers working with posttraumatic stress questionnaires in longitudinal studies should not take measurement invariance for granted, but should use pre- and post-symptom scores as different constructs for each time point in the analysis.",0 +https://doi.org/10.1002/da.20202,A comparison of the SPRINT and CAPS assessment scales for posttraumatic stress disorder,"The Clinician-Administered PTSD Scale for DSM-IV (CAPS) is a widely used assessment tool for (posttraumatic stress disorder) (PTSD). However, a shorter assessment tool may be beneficial for clinical work. Here, we compare such a tool, the Short PTSD Rating Interview (SPRINT) to the CAPS. We found that the SPRINT rating scale performs similarly to the CAPS rating scale in the assessment of PTSD symptom clusters and total scores, and that the SPRINT takes significantly less time to administer than the CAPS.",0 +https://doi.org/10.3109/10253890.2015.1053450,Increased generalization of learned associations is related to re-experiencing symptoms in veterans with symptoms of post-traumatic stress,"One interpretation of re-experiencing symptoms in post-traumatic stress disorder (PTSD) is that memories related to emotional information are stored strongly, but with insufficient specificity, so that stimuli which are minimally related to the traumatic event are sufficient to trigger recall. If so, re-experiencing symptoms may reflect a general bias against encoding background information during a learning experience, and this tendency might not be limited to learning about traumatic or even autobiographical events. To test this possibility, we administered a discrimination-and-transfer task to 60 Veterans (11.2% female, mean age 54.0 years) self-assessed for PTSD symptoms in order to examine whether re-experiencing symptoms were associated with increased generalization following associative learning. The discrimination task involved learning to choose the rewarded object from each of six object pairs; each pair differed in color or shape but not both. In the transfer phase, the irrelevant feature in each pair was altered. Regression analysis revealed no relationships between re-experiencing symptoms and initial discrimination learning. However, re-experiencing symptom scores contributed to the prediction of transfer performance. Other PTSD symptom clusters (avoidance/numbing, hyperarousal) did not account for significant additional variance. The results are consistent with an emerging interpretation of re-experiencing symptoms as reflecting a learning bias that favors generalization at the expense of specificity. Future studies will be needed to determine whether this learning bias may pre-date and confer risk for, re-experiencing symptoms in individuals subsequently exposed to trauma, or emerges only in the wake of trauma exposure and PTSD symptom development.",0 +https://doi.org/10.1002/jts.20160,Is mixed-handedness a marker of treatment response in posttraumatic stress disorder?: A pilot study,"Recent studies suggest that mixed-handedness is a risk factor for posttraumatic stress disorder (PTSD). This study examined whether mixed-handed veterans with combat-related PTSD respond more poorly to psychosocial treatment. Consistency of hand preference was assessed in 150 Vietnam combat veterans with PTSD using the Edinburgh Handedness Inventory (R. C. Oldfield, 1971). Growth modeling analyses using Mplus (L. K. Muthén & B. Muthén, 2002) identified that PTSD veterans with mixed-handedness reported significantly less treatment improvement on the PTSD Checklist (F. W. Weathers, B. T. Litz, D. S. Herman, J. A. Huska, & T. M. Keane, 1993) than did veterans with consistent handedness. These data suggest that mixed-handedness is associated with poorer PTSD treatment response. Several possible explanations for this finding are discussed.",0 +https://doi.org/10.1016/j.psyneuen.2014.12.005,Cell type-specific modifications of corticotropin-releasing factor (CRF) and its type 1 receptor (CRF1) on startle behavior and sensorimotor gating,"The corticotropin-releasing factor (CRF) family of peptides and receptors coordinates the mammalian endocrine, autonomic, and behavioral responses to stress. Excessive CRF production has been implicated in the etiology of stress-sensitive psychiatric disorders such as posttraumatic stress disorder (PTSD), which is associated with alterations in startle plasticity. The CRF family of peptides and receptors mediate acute startle response changes during stress, and chronic CRF activation can induce startle abnormalities. To determine what neural circuits modulate startle in response to chronic CRF activation, transgenic mice overexpressing CRF throughout the central nervous system (CNS; CRF-COE(CNS)) or restricted to inhibitory GABAergic neurons (CRF-COE(GABA)) were compared across multiple domains of startle plasticity. CRF overexpression throughout the CNS increased startle magnitude and reduced ability to inhibit startle (decreased habituation and decreased prepulse inhibition (PPI)), similar to previous reports of exogenous effects of CRF. Conversely, CRF overexpression confined to inhibitory neurons decreased startle magnitude but had no effect on inhibitory measures. Acute CRF receptor 1 (CRF1) antagonist treatment attenuated only the effects on startle induced by CNS-specific CRF overexpression. Specific deletion of CRF1 receptors from forebrain principal neurons failed to alter the effects of exogenous CRF or stress on startle, suggesting that these CRF1 expressing neurons are not required for CRF-induced changes in startle behaviors. These data indicate that the effects of CRF activation on startle behavior utilize an extensive neural circuit that includes both forebrain and non-forebrain regions. Furthermore, these findings suggest that the neural source of increased CRF release determines the startle phenotype elicited. It is conceivable that this may explain why disorders characterized by increased CRF in cerebrospinal fluid (e.g. PTSD and major depressive disorder) have distinct symptom profiles in terms of startle reactivity.",0 +https://doi.org/10.1016/j.jad.2007.08.013,Abnormal serum lipid profile in Brazilian police officers with post-traumatic stress disorder,"To measure the serum lipid composition of a sample of Brazilian police officers with and without PTSD regularly exposed to potentially traumatic situations.A cross-sectional survey was conducted with 118 active duty male police officers. Serum concentrations for total cholesterol, LDL-C, HDL-C, and triglycerides were enzymatically determined. Body mass index (BMI) was obtained for each participant.Officers with PTSD exhibited significantly higher serum total cholesterol, LDL-C and triglycerides levels than those without PTSD. Total cholesterol and triglycerides, but not LDL-C, remained associated with PTSD diagnosis after controlling for confounding influences (i.e. socio-demographics, BMI, and tobacco, alcohol and medication use).The sample size was small. A nutritional interview was employed instead of established scales to assess alimentary habits, tobacco or alcohol consumption. A self-report screening tool was used to assess the prevalence of PTSD.The association between PTSD and abnormal serum lipid profile and a tendency to exhibit higher BMI suggests that individuals with PTSD may be at increased risk for developing metabolic syndrome, a condition that by itself could account for many of the most serious PTSD-related physical health problems.",0 +,Etiological factors in the development of posttraumatic stress disorder.,"(from the chapter) focuses on epidemiologic and descriptive studies in an effort to delineate specific factors that contribute to the development of posttraumatic stress disorder (PTSD) [primarily in veteran populations] / [review] noncombat-related trauma . . . as it relates to the generalizability of findings related to trauma / findings from studies at the West Haven Veterans Administration Medical Center (VAMC) on the role of dissociation in the etiology of PTSD are presented and discussed (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1002/jts.20397,Anxiety sensitivity and aspects of alexithymia are independently and uniquely associated with posttraumatic distress,"Using a sample of adult survivors of physical trauma requiring hospitalization (N = 677), we examined the relationship of aspects of alexithymia and anxiety sensitivity to symptoms of posttraumatic distress (PTD). At the bivariate level, both aspects of alexithymia and anxiety sensitivity were positively associated with acute PTD symptomatology, but anxiety sensitivity was more strongly related to PTD symptoms. At the multivariate level, both anxiety sensitivity and aspects of alexithymia made unique and independent contributions to both total PTD symptoms and the majority of PTD symptom clusters. At the facet level, anxiety sensitivity-physical concerns and anxiety sensitivity-psychological concerns, and the alexithymic dimension of difficulty identifying feelings, were uniquely associated with acute PTD symptoms. Findings are discussed in terms of potential clinical implications.",0 +https://doi.org/10.1007/bf00789038,Psychiatric morbidity following a natural disaster: An Australian bushfire,"This study investigated the prevalence of mental health problems after a major bushfire in Australia and examined the validity of the General Health Questionnaire (GHQ) (Goldberg 1978) against the Anxiety, Affective and Post-Traumatic Stress Disorder modules of the Diagnostic Interview Schedule (DIS; Robins et al. 1981). Study 1 was carried out 12 months after the Ash Wednesday bushfires and sought to include all the victims of the fires. Study 2 was conducted 20 months after the fires and included a sample of victims who had experienced major losses in the fires. Twelve months after the fires, 42% (n = 1,526) of the victims were defined as a potential psychiatric case using the GHQ. This rate indicated a significantly greater level of morbidity than found in communities that have not experienced a natural disaster. Twenty months after the fires, 23% (n = 43) were defined as ""cases"". The 28-item GHQ was found to be a valid instrument for defining the presence of psychiatric disorder in a disaster-effected community. The findings demonstrated that lasting psychiatric morbidity is associated with natural disasters.",0 +https://doi.org/10.1371/journal.pone.0096131,Leg Extension Power Is a Pre-Disaster Modifiable Risk Factor for Post-Traumatic Stress Disorder among Survivors of the Great East Japan Earthquake: A Retrospective Cohort Study,"Post-traumatic stress disorder (PTSD) is a common psychological problem following natural disasters. Although pre-disaster risk factors are important for early detection and proactive support, the examination of such has been limited to sociodemographic factors, which were largely unaffected by the disasters. We examined the association between pre-disaster physical functioning and lifestyle and PTSD symptoms five months after the earthquake in the Great East Japan Earthquake survivors who were participating in a pre-existing cohort study.We designed a retrospective cohort study of a cooperative association in Sendai from August 2010 to August 2011. In 2010, lifestyle, physical condition, and sociodemographic factors were examined by self-reported questionnaires completed by 522 employees of this organization. We also measured the leg extension power of all the participants. PTSD symptoms were evaluated by the Japanese version of the Impact of Event Scale-Revised (IES-R-J) following the earthquake of 2011.In multivariate linear regression analysis, leg extension power (β = -0.128, P = 0.025), daily drinking (β = 0.203, P = 0.006), and depressive symptoms (β = 0.139, P = 0.008) were associated with total score of the IES-R-J among men. Moreover, for the IES-R-J subscale, leg extension power was also negatively associated with Intrusion (β = -0.114, P = 0.045) and Hyperarousal (β = -0.163, P = 0.004) after adjusting for all other significant variables. For women, hypertension (β = 0.226, P = 0.032) and depressive symptoms (β = 0.205, P = 0.046) were associated with the total score of the IES-R-J.Leg extension power is a potentially modifiable pre-disaster risk factor among men for attenuating the severity of PTSD symptoms associated with great disasters such as the Great East Japan Earthquake among men.",0 +https://doi.org/10.1111/jan.12726,Post-traumatic stress disorder symptoms in first-time myocardial infarction patients: roles of attachment and alexithymia,"To explore the roles of attachment and alexithymia in the severity of post-traumatic stress disorder symptoms and to specify the relationship between sub-dimensions of attachment, alexithymia and posttraumatic stress disorder symptoms in patients with first-time myocardial infarction in mainland China.Patients experiencing myocardial infarction have a risk of developing post-traumatic stress disorder symptoms. However, there have been few studies on the roles of attachment and alexithymia.A cross-sectional survey design.Ninety-seven patients participated in the assessment of post-traumatic stress disorder symptoms, attachment and alexithymia from June-December in 2012. To assess post-traumatic stress disorder symptoms and their correlates, we administered the Post-traumatic Stress Disorder Checklist-Civilian Version, the 20-item Toronto Alexithymia Scale and the Experiences in Close Relationships Scale 5-17 days after the remission of first myocardial infarction attack.Twenty-five (25·77%) patients met the criteria of posttraumatic stress disorder symptoms. Greater attachment anxiety and avoidance were associated with more severe posttraumatic stress disorder symptoms. Except for externally oriented thinking, all dimensions of alexithymia were significantly correlated with post-traumatic stress symptoms. In the regression model, attachment anxiety and difficulties identifying feelings were found to be predictive and the total regression equation explained 24·2% variance of posttraumatic stress disorder symptoms among myocardial infarction patients.First-time myocardial infarction patients were at risk of developing posttraumatic stress disorder symptoms. Attachment anxiety and difficulties identifying feelings were positively associated with posttraumatic stress disorder symptoms in the early stage of myocardial infarction rehabilitation. It is essential to evaluate the causal relationship between attachment, alexithymia and posttraumatic stress disorder symptoms in longitudinal studies.",0 +https://doi.org/10.1186/1745-0179-4-5,Post-traumatic stress disorder among people exposed to the Ventotene street disaster in Rome,"To test five hypotheses on Post-traumatic stress disorder (PTSD): 1) Is PTSD the most prevalent disorder after trauma? 2) Is the proximity to the disaster related to the risk of PTSD? 3) Is PTSD associated with child mourning or separation, previous stress, or familiarity for psychiatric disorders? 4) Does the exposition to trauma increase substance abuse or somatization? 5) Can episodic trauma cause long-lasting psychiatric morbidity?Clinical assessment of subjects exposed to an explosion in a building caused by a gas-leak. Best estimate clinical diagnoses were made according to DSM-IV-TR criteria. The Zung Depression Rating Scale, the Zung Anxiety Rating Scale, and the Clinician Administered Post Traumatic Stress Disorder Scale were used in the clinical assessment. Statistical analysis was performed by means of t-test with Bonferroni's correction on continuous variables and chi2 or Fisher test on categorical variables.PTSD was the most prevalent disorder after trauma, diagnosed in 32 (36.8%) subjects. The subjects who had not seen dead or injured people were more likely to receive no psychiatric diagnosis. Civil status, parenthood, death of relatives in the disaster, personal injuries, history of child mourning or separation, of previous stress, as well as familiarity for any psychiatric disorder or substance use disorder were not related with the rate of ascertained psychiatric diagnoses. Nearly two years after trauma, most of patients who had suffered PTSD still met PTSD criteria.The 1st and the 5th hypotheses were corroborated, the 3rd and the 4th hypotheses were not confirmed. The 2nd hypothesis was partially confirmed.",0 +https://doi.org/10.1186/1741-7015-4-21,Mental health and resiliency following 44 months of terrorism: a survey of an Israeli national representative sample,"Israeli citizens have been exposed to intense and ongoing terrorism since September 2000. We previously studied the mental health impact of terrorism on the Israeli population (Bleich et al., 2002), however the long-term impact of ongoing terrorism has not yet been examined. The present study evaluated the psychological sequelae of 44 months of terrorism in Israel, and sought to identify factors that may contribute to vulnerability and resilience.This was a telephone survey using strata sampling of 828 households, which reached a representative sample of 702 adult Israeli residents (84.8% contact rate). In total, 501 people (60.5%) agreed to participate. The methodology was similar to that of our previous study. Exposure to terrorism and other traumatic events, number of traumatic stress-related symptoms (TSRS), percentage of respondents with symptom criteria for post-traumatic stress disorder (PTSD), traumatic stress (TS) resiliency and feelings of depression, anxiety, optimism, sense of safety, and help-seeking were the main outcome measures.In total, 56 participants (11.2%) were directly exposed to a terrorist incident, and 101 (20.2%) had family members or friends exposed. Respondents reported a mean +/- SD of 5.0 +/- 4.5 TSRS; 45 (9%) met symptom criteria for PTSD; and 72 (14.4%) were TS-resilient. There were 147 participants (29.5%) who felt depressed, 50 (10.4%) felt anxious, and almost half (235; 47%) felt life-threatening danger; 48 (9.7%) felt the need for professional help. Women and people of Arab ethnicity had more TSRS, more PTSD, and less TS resiliency. Injury following a life-threatening experience, a major stressful life event, and a major loss of income were associated with PTSD. Immigrant status, lower education, low sense of safety, low sense of social support, high societal distress, and injury following life-threatening experiences were associated with TSRS. TSRS did not increase with exposure severity. This study revealed less depression and functional impairment, similar rates of PTSD, increased help-seeking and poorer TSRS and TS resiliency than our initial study, 2 years previously.The response of people in Israel to 4 years of terrorism is heterogeneous. Vulnerability factors change over time; Arab ethnicity, immigrant status and less education, not found to be risk factors in our previous study, were found in the present study to contribute to trauma-related distress. Prior experience of highly stressful events increases vulnerability to adverse psychological effects of terror.",0 +https://doi.org/10.1097/00004583-200202000-00010,Toward an Empirical Definition of Pediatric PTSD: The Phenomenology of PTSD Symptoms in Youth,"To examine the frequency and intensity of posttraumatic stress disorder (PTSD) symptoms and their relation to clinical impairment, to examine the requirement of meeting all DSM-IV symptom cluster criteria (i.e., criteria B, C, D), and to examine the aggregation of PTSD symptom clusters across developmental stages.Fifty-nine children between the ages of 7 and 14 years with a history of trauma and PTSD symptoms were assessed with the Clinician-Administered PTSD Scale for Children and Adolescents.Data support the utility of distinguishing between the frequency and the intensity of symptoms in the investigation of the phenomenology of pediatric PTSD. Children fulfilling requirements for two symptom clusters did not differ significantly from children meeting all three cluster criteria with regard to impairment and distress. Reexperience (cluster B) showed increased aggregation with avoidance and numbing (cluster C) and hyperarousal (cluster D) in the later stages of puberty.Frequency and intensity of symptoms may both contribute to the phenomenology of pediatric PTSD. Children with subthreshold criteria for PTSD demonstrate substantial functional impairment and distress.",0 +https://doi.org/10.1111/j.1521-0391.2013.12068.x,"Associations between Post-Traumatic Stress Symptoms, Stimulant Use, and Treatment Outcomes: A Secondary Analysis of NIDA's Women and Trauma Study","Background and Objectives To examine the associations between post-traumatic stress disorder (PTSD) symptoms, stimulant use, and treatment outcomes among dually diagnosed women. Methods Participants were 141 women who participated in a multisite clinical trial of group treatments for PTSD and addictions. Results Generalized linear models indicated Seeking Safety (SS; a cognitive-behavioral intervention) was significantly more effective than Women's Health Education (WHE; a control group intervention) in reducing stimulant use at follow-up among women who were heavy stimulant users at pre-treatment and who showed improvements in PTSD symptoms. There were no significant differences between the interventions among women who were light stimulant users at treatment entry. Conclusions and Scientific Significance These findings suggest that integrated treatment of co-occurring PTSD and addictions may be more effective than general health education approaches for heavy stimulant users. Assessment of frequency of stimulant use among individuals with PTSD symptoms may inform treatment selection for this population. (Am J Addict 2014;23:90–95)",0 +https://doi.org/10.1007/s00127-014-0819-y,The co-occurrence of PTSD and dissociation: differentiating severe PTSD from dissociative-PTSD,"A dissociative-posttraumatic stress disorder (PTSD) subtype has been included in the DSM-5. However, it is not yet clear whether certain socio-demographic characteristics or psychological/clinical constructs such as comorbid psychopathology differentiate between severe PTSD and dissociative-PTSD. The current study investigated the existence of a dissociative-PTSD subtype and explored whether a number of trauma and clinical covariates could differentiate between severe PTSD alone and dissociative-PTSD.The current study utilized a sample of 432 treatment seeking Canadian military veterans. Participants were assessed with the Clinician Administered PTSD Scale (CAPS) and self-report measures of traumatic life events, depression, and anxiety. CAPS severity scores were created reflecting the sum of the frequency and intensity items from each of the 17 PTSD and 3 dissociation items. The CAPS severity scores were used as indicators in a latent profile analysis (LPA) to investigate the existence of a dissociative-PTSD subtype. Subsequently, several covariates were added to the model to explore differences between severe PTSD alone and dissociative-PTSD.The LPA identified five classes: one of which constituted a severe PTSD group (30.5 %), and one of which constituted a dissociative-PTSD group (13.7 %). None of the included, demographic, trauma, or clinical covariates were significantly predictive of membership in the dissociative-PTSD group compared to the severe PTSD group.In conclusion, a significant proportion of individuals report high levels of dissociation alongside their PTSD, which constitutes a dissociative-PTSD subtype. Further investigation is needed to identify which factors may increase or decrease the likelihood of membership in a dissociative-PTSD subtype group compared to a severe PTSD only group.",0 +https://doi.org/10.1017/s003329171300038x,Paranoia and post-traumatic stress disorder in the months after a physical assault: a longitudinal study examining shared and differential predictors,"Background Being physically assaulted is known to increase the risk of the occurrence of post-traumatic stress disorder (PTSD) symptoms but it may also skew judgements about the intentions of other people. The objectives of the study were to assess paranoia and PTSD after an assault and to test whether theory-derived cognitive factors predicted the persistence of these problems. Method At 4 weeks after hospital attendance due to an assault, 106 people were assessed on multiple symptom measures (including virtual reality) and cognitive factors from models of paranoia and PTSD. The symptom measures were repeated 3 and 6 months later. Results Factor analysis indicated that paranoia and PTSD were distinct experiences, though positively correlated. At 4 weeks, 33% of participants met diagnostic criteria for PTSD, falling to 16% at follow-up. Of the group at the first assessment, 80% reported that since the assault they were excessively fearful of other people, which over time fell to 66%. Almost all the cognitive factors (including information-processing style during the trauma, mental defeat, qualities of unwanted memories, self-blame, negative thoughts about self, worry, safety behaviours, anomalous internal experiences and cognitive inflexibility) predicted later paranoia and PTSD, but there was little evidence of differential prediction. Conclusions Paranoia after an assault may be common and distinguishable from PTSD but predicted by a strikingly similar range of factors.",0 +https://doi.org/10.1111/j.0963-7214.2005.00347.x,Resilience in the Face of Potential Trauma,"Until recently, resilience among adults exposed to potentially traumatic events was thought to occur rarely and in either pathological or exceptionally healthy individuals. Recent research indicates, however, that the most common reaction among adults exposed to such events is a relatively stable pattern of healthy functioning coupled with the enduring capacity for positive emotion and generative experiences. A surprising finding is that there is no single resilient type. Rather, there appear to be multiple and sometimes unexpected ways to be resilient, and sometimes resilience is achieved by means that are not fully adaptive under normal circumstances. For example, people who characteristically use self-enhancing biases often incur social liabilities but show resilient outcomes when confronted with extreme adversity. Directions for further research are considered.",0 +https://doi.org/10.1016/j.injury.2014.07.012,Comparison of long-term outcomes following traumatic injury: What is the unique experience for those with brain injury compared with orthopaedic injury?,"

Abstract

Objective

Whilst it has been well-demonstrated that traumatic brain injury (TBI) results in long-term cognitive, behavioural and emotional difficulties, less is understood about how these outcomes differ from those following traumatic orthopaedic injury (TOI). The aim of this study was to compare self-reported outcomes at 5–10 years post-injury for those with TBI, TOI, and uninjured controls. It was hypothesised that participants with TBI would have greater cognitive difficulties; participants with TOI and TBI would have similar functional and physical outcomes, both being poorer than controls; and participants with TBI would have poorer psychosocial outcomes than those with TOI.

Participants and methods

Eighty-eight individuals with complicated mild to severe TBI and 96 with TOI recruited during inpatient rehabilitation were followed up 5–10 years post-injury, together with 48 controls followed over a similar period. Self-report measures of global functioning (GOS-E), quality of life (SF-36), psychological wellbeing (SCL-90-R, HADS, PCL-S), psychosocial difficulties (SIP), cognitive difficulties (SF-36 COG), pain (BPI), and fatigue (FSS) were administered.

Results

Outcomes for individuals with TBI and TOI differed significantly from controls, with poorer global functioning, and greater psychological distress and interference from pain. Only participants with TBI reported greater cognitive difficulties and anxiety than controls, and were less likely to be employed or in a relationship. Participants with TBI reported greater anxiety, PTSD, psychological distress and psychosocial difficulties than those with TOI.

Conclusions

Both TOI and TBI cause long-term disability, interference from pain, and psychological distress. However, cognitive impairments, unemployment, lack of long-term relationships, anxiety and PTSD are more substantial long-term problems following TBI. Findings from this study have implications for managing risks associated with these injury groups and tailoring rehabilitation to improve long-term outcomes.",0 +https://doi.org/10.1185/135525704x20385,Subthreshold post traumatic stress disorder in the survivors of Marmara earthquake,"This study was conducted in order to determine the symptom profile and risk factors associated with subthreshold post traumatic stress disorder (PTSD). It was conducted in 1316 subjects who had experienced the Marmara Earthquake. The data collected included socio-demographic features, experiences during the earthquake and risk factors associated with trauma. The subjects who have at least one symptom in each of the B, C or D clusters in DSM-IV PTSD diagnostic criteria were accepted as ""subthreshold PTSD"". It was found that the prevalence of full PTSD and subthreshold PTSD was 13.8% and 28.0%, respectively. Female gender, excessive horror during the earthquake, damage to the home, being trapped under the rubble, loss of loved ones, and preexisting alcohol abuse were found to be the risk factors both for full PTSD and subthreshold PTSD. People with subthreshold PTSD seem to have similarities with full PTSD patients, as regards socio-demographic features, risk factors and functional impairment. It is concluded that the need for treatment of subthreshold PTSD patients should be considered. (",0 +https://doi.org/10.3402/ejpt.v1i0.5558,The younger sibling of PTSD: similarities and differences between complicated grief and posttraumatic stress disorder,"Just as traumatic experiences may lead to posttraumatic stress disorder (PTSD) in some individuals, grief may also be a serious health concern for individuals who have experienced bereavement. At present, neither the DSM-IV nor the ICD-10 recognizes any form of grief as a mental disorder. The aim of this review is to summarize recent advances in definition, assessment, prevention, and treatment of complicated grief disorder (CGD) and to compare CGD with PTSD. Four areas are identified to be of importance to clinicians and researchers: (a) the recently proposed consensus criteria of CGD for DSM-V and ICD-11, (b) available assessment instruments, (c) recent prevention and treatment techniques and related effectiveness studies, and (d) emerging disorder models and research on risks and protective factors. This review focuses on the similarities and differences between CGD and PTSD and highlights how a PTSD-related understanding aids the investigation and clinical management of CGD.",0 +https://doi.org/10.1111/pme.12321,Increased Polysedative Use in Veterans with Posttraumatic Stress Disorder,"Posttraumatic stress disorder (PTSD) treatment is often complicated in veterans by co-occurring conditions including pain, insomnia, brain injury, and other mental disorders. Pharmacologic approaches to these conditions can produce an accumulation of sedating medications with potential for safety concerns.The objective of this study was to characterize polysedative prescribing among veterans with PTSD over an 8-year period.National Department of Veterans Affairs (VA) data were used to identify veterans with PTSD using International Classification of Diseases, Ninth Revision codes among regular medication users. Prescribing of benzodiazepines, hypnotics, atypical antipsychotics, opioids, and muscle relaxants was determined annually. Prevalence and incidence rates were determined for each medication class from 2004 through 2011. Polysedative use was determined from longitudinal refill patterns that indicated concurrent use across sedative classes.In 2004, 9.8% of veterans with PTSD concurrently received medications from three or more sedative classes. By 2011, the prevalence of concurrent use involving three or more classes increased to 12.1%. Polysedative use varied across demographic subgroups, with higher rates observed among women, rural residents, younger adults, Native Americans and Whites. The most common combination was an opioid plus a benzodiazepine, taken concurrently by 15.9% of veterans with PTSD.Important trends in polysedative use among veterans with PTSD illustrate the complexity of treating an intersecting cluster of symptoms managed by sedative medications. As the VA seeks to improve care by focusing on non-pharmacologic options, our findings emphasize the need for a comprehensive approach that encompasses overlapping conditions of relevance to veterans with PTSD.",0 +https://doi.org/10.1345/aph.1l155,Antipsychotic Medication Utilization Trends Among Texas Veterans: 1997–2002,"Background An antipsychotic utilization pattern has evolved substantially over the past 20 years or so due to the introduction of the second-generation antipsychotics (SGAs) and the increasing understanding of their adverse effect profile. Objective To understand antipsychotic utilization trends (including monotherapy, antipsychotic switching, and combination therapy) and to investigate factors associated with antipsychotic index medication selection (SGAs vs first-generation antipsychotics [FGAs]) among Texas veterans. Methods Data were taken from the Veterans Administration North Texas Health Care System (VANTHCS) and South Texas Veterans Health Care System (STVHCS) from January 1996 to December 2003. Adults with continuous enrollment (1 y before and after the Index date) who had newly initiated antipsychotic therapy were included. Prescriptions were followed for up to 12 months. Descriptive analyses examined utilization trends; logistic regression evaluated factors associated with antipsychotic index medication selection. Results: A total of 8096 patients were included in the study (VANTHCS n = 4477; STVHCS n = 3619), with the majority being male (93.6%) and white (62.6%) and nearly naif aged 55 years or older (44.1%). Between 1997 and 2002, antipsychotic prescriptions changed from primarily FGAs (1997:71.7%; 1999; 25.2%; 2002: 5.7%) to SGAs. Over the 6-year time frame, risperidone (31.0%) and olanzapine (30.7%) were most commonly prescribed. The overall combination therapy slightly increased over time (4.3%), switching to another antipsychotic remained stable (14.2%), and antipsychotic monotherapy remained dominant (81.5%). Hispanic and black patients were less likely than white patients to be initiated on SGAs. Patients who were older, had hypertension, and were in STVHCS were less likely to start on SGAs. Patients with dyslipidemia, bipolar disorder, and treatment in recent years were more likely to start on SGAs Conclusions: SGAs have replaced FGAs as first-line medications for patients with mental disorders. Race, age, physical comorbidities (ie, dyslipidemia, hypertension), and treatment initiation year were important factors in index medication selection.",0 +https://doi.org/10.3402/ejpt.v4i0.20706,Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis,"The WHO International Classification of Diseases, 11th version (ICD-11), has proposed two related diagnoses, posttraumatic stress disorder (PTSD) and complex PTSD within the spectrum of trauma and stress-related disorders.To use latent profile analysis (LPA) to determine whether there are classes of individuals that are distinguishable according to the PTSD and complex PTSD symptom profiles and to identify potential differences in the type of stressor and severity of impairment associated with each profile.An LPA and related analyses were conducted on 302 individuals who had sought treatment for interpersonal traumas ranging from chronic trauma (e.g., childhood abuse) to single-incident events (e.g., exposure to 9/11 attacks).THE LPA REVEALED THREE CLASSES OF INDIVIDUALS: (1) a complex PTSD class defined by elevated PTSD symptoms as well as disturbances in three domains of self-organization: affective dysregulation, negative self-concept, and interpersonal problems; (2) a PTSD class defined by elevated PTSD symptoms but low scores on the three self-organization symptom domains; and (3) a low symptom class defined by low scores on all symptoms and problems. Chronic trauma was more strongly predictive of complex PTSD than PTSD and, conversely, single-event trauma was more strongly predictive of PTSD. In addition, complex PTSD was associated with greater impairment than PTSD. The LPA analysis was completed both with and without individuals with borderline personality disorder (BPD) yielding identical results, suggesting the stability of these classes regardless of BPD comorbidity.Preliminary data support the proposed ICD-11 distinction between PTSD and complex PTSD and support the value of testing the clinical utility of this distinction in field trials. Replication of results is necessary.",0 +https://doi.org/10.1017/s1041610212000853,Diagnostic utility and factor structure of the PTSD Checklist in older adults,"ABSTRACT Background: Little research has examined the diagnostic utility and factor structure of commonly used posttraumatic stress disorder (PTSD) assessment instruments in older persons. Methods: A total of 206 adults aged 60 or older (mean age = 69 years; range = 60–92), who resided in the Galveston Bay area when Hurricane Ike struck in September 2008, completed a computer-assisted telephone interview two–five months after this disaster. Using the PTSD Checklist (PCL), PTSD symptoms were assessed related both to this disaster and to participants’ worst lifetime traumatic event. Total PCL scores were compared to PCL-based, Diagnostic and Statistical Manual of Mental Disorders , 4th edition (DSM-IV)-derived probable diagnoses of PTSD to determine optimal cut scores. Confirmatory factor analyses (CFAs) were conducted to evaluate PTSD symptom structure. Results: Receiver operating characteristic analyses indicated that a PCL score of 39 achieved optimal sensitivity and specificity in assessing a PCL-based, algorithm-derived DSM-IV diagnosis of worst event-related PTSD; and that a score of 37 optimally assessed probable Ike-related PTSD. CFAs revealed that a recently proposed five-factor model – comprised of re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal factors – provided a better fitting representation of both worst event- and disaster-related PTSD symptoms than alternative models. Current Ike-related anxious arousal symptoms demonstrated a significantly stronger association with current generalized anxiety than depressive symptoms, thereby supporting the construct validity of this five-factor model of PTSD symptomatology. Conclusions: A PCL score of 37 to 39 may help identify probable PTSD in older persons. The expression of PTSD symptoms in older adults may be best characterized by a recently proposed five-factor model with distinct dysphoric arousal and anxious arousal clusters.",0 +https://doi.org/10.1016/j.janxdis.2004.01.003,The looming maladaptive style predicts shared variance in anxiety disorder symptoms: further support for a cognitive model of vulnerability to anxiety,"Looming vulnerability pertains to a distinct cognitive phenomenology characterized by mental representations of dynamically intensifying danger and rapidly rising risk as one projects the self into an anticipated future [J. Pers. Soc. Psychol. 79 (2000) 837]. While looming appraisals can be experienced as state elicitation, some individuals are hypothesized to develop an enduring cognitive pattern of cross-situational looming appraisals, the looming maladaptive style (LMS), which functions as a cognitive vulnerability to anxiety. In the present study, we examined the extent to which the LMS predicts common variance in numerous anxiety disorder symptoms, independent of the potentially confounding effects of current depressive symptoms. Specifically, we hypothesized that controlling for depressive symptoms, LMS would predict shared variance in a latent factor comprised of indicators of five anxiety disorder symptoms: obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, social phobia, and specific phobic fears. Measures of these anxiety disorder symptoms, depressive symptoms, and looming vulnerability were administered to unselected college student population. Structural equations modeling analyses provided support for our hypothesis that LMS predicts shared variance in anxiety disorder symptoms and suggest that this cognitive style may be an overarching dimension of vulnerability to anxiety.",0 +https://doi.org/10.3233/nre-2007-22309,Post concussion syndrome ebb and flow: Longitudinal effects and management,"This research identified persistent post concussion symptoms (PCS) in a group of 20 adult subjects. PCS generally lasted for two years with a mean of 3.35 years. Typical symptoms included physical and cognitive fatigue, depressive behaviors, sensitivity to noise, social withdrawal, irritability, concentration and problem solving difficulties, loss of libido and much difficulty making decisions at even the simplest strategic level. They represented a hard core group for whom the original symptoms persisted well beyond the 6~month period. Participants identified their PCS according to sensory, somatic affective and cognitive items immediately following their trauma (01) and two years later (02). Counseling and psychotherapy intervention took place between 01 and 02. Items on the PCS schedules and the Beck Depression Inventory (II) demonstrated significant decline in the presence of overall symptoms most noticeably in reduction of agitation, irritability and suicidal wishes. However, subjects throughout generally experienced the feeling that they were being punished which equated with behaviors comparable with learned helplessness. The PCS group considered themselves to be different people after trauma. They had different goals, changing lifestyle, relationships and employment and were more often in a dependent state. Comparability with other conditions such as PTSD and chronic fatigue syndrome (CFS) was demonstrated by individuals who experienced persistent and invasive post concussion symptoms.",0 +https://doi.org/10.1017/s1121189x00003821,Trauma and victims: epidemiology of post-traumatic stress disorder,"Riassunto Scopo - Presentare una esaustiva review degli studi riguardanti l'epidemiologia del DPTS condotti nella popolazione generale, tra i soggetti a rischio, e, infine, tra gruppi clinicamente selezionati. Disegno - Attraverso Excepta Medica Psychiatry CD-ROM 1980-1993 (ottobre), utilizzando come parola chiave «Post-Traumatic Stress Disorder», sono stati identificati 1.057 articoli pubblicati nel periodo considerate Sono stati anche consultati altri data base della letteratura medica (MEDLINE CD-ROM 1988-1993); è stata quindi operata una ricerca manuale su tutti i numeri del Journal of Traumatic Stress. Risultati - In totale, 135 lavori che hanno soddisfatto i criteri di inclusione prescelti sono stati inclusi nella review. I due terzi (n = 86, 64%) di queste ricerche sono state condotte negli USA. Solo 8 (6%) sono le indagini effettivamente realizzate nei paesi del Terzo Mondo. L'ampiezza del campione varia da un minimo di 11 soggetti, numero riscontrato in due studi, sino ad un massimo di 22.436, per un campione medio di 500 e mediano di 108. Per quanto attiene ai metodi di valutazione, in un terzo degli studi (n = 45, 33%), i ricercatori hanno impiegato un questionario (auto- o etero- somministrato). In un altro terzo delle ricerche elencate (n = 44, 33%) e stata somministrata un'intervista strutturata (la DIS, la SCID, o la SADS), mentre nei rimanenti studi la valutazione diagnostica si è basata o su una procedura clinica non strutturata, o sulla somministrazione di altri strumenti specifici dai quali è possibile inferire una diagnosi di DPTS (M-PTSD, IES, SCL-90-R,o pochi altri). In 77 studi (57%) i ricercatori hanno basato la loro valutazione sui criteri diagnostici propri del DSM-III, mentre in altri 55 (41%) su quelli del DSM-III-R. La prevalenza del DPTS e analizzata quindi separatamente per le diverse popolazioni studiate. Conclusioni - Nell'arco di soli 13 anni, a partire cioe dalla definizione di criteri diagnostici operazionali ben definiti per il DPTS, sono stati condotti numerosi studi volti ad indagare la prevalenza, i fattori di rischio, la storia naturale, il decorso e l' esito di questo disturbo tra campioni diversi di popolazioni a rischio; inoltre, anche il livello qualitativo di queste ricerche, per quanto attiene alia sofisticazione metodologica, si è accresciuto sensibilmente in un tempo tutto sommato breve. Molte aree, pero', restano tuttora inesplorate, ed inoltre appare imperativo avviare ricerche estensive tra le popolazioni dei paesi in via di sviluppo, maggiormente esposte a disastri naturali o provocati dall'uomo.",0 +https://doi.org/10.1016/j.psychres.2014.06.043,Treatment of post traumatic stress disorder symptoms in emotionally distressed individuals,"Older individuals with emotional distress and a history of psychologic trauma are at risk for post traumatic stress disorder (PTSD) and major depression. This study was an exploratory, secondary analysis of data from the study ""Prevention of Depression in Older African Americans"". It examined whether Problem Solving Therapy-Primary Care (PST-PC) would lead to improvement in PTSD symptoms in patients with subsyndromal depression and a history of psychologic trauma. The control condition was dietary education (DIET). Participants (n=60) were age 50 or older with scores on the Center for Epidemiologic Studies-Depression scale of 11 or greater and history of psychologic trauma. Exclusions stipulated no major depression and substance dependence within a year. Participants were randomized to 6-8 sessions of either PST-PC or DIET and followed 2 years with booster sessions every 6 months; 29 participants were in the PST-PC group and 31 were in the DIET group. Mixed effects models showed that improvement of PTSD Check List scores was significantly greater in the DIET group over two years than in the PST-PC group (based on a group time interaction). We observed no intervention⁎time interactions in Beck Depression Inventory or Brief Symptom Inventory-Anxiety subscale scores.",0 +https://doi.org/10.1177/107319110100800107,Subtypes of Clinical Presentations in Malingerers of Posttraumatic Stress Disorder: An MMPI-2 Cluster Analysis,"This paper investigated subtypes of individuals trained and instructed to malinger Posttraumatic Stress Disorder (PTSD) through a cluster analysis of their Minnesota Multiphasic Personality Inventory-2 (MMPI-2) clinical and validity scales. Participants were 84 men and women college students at a community college in the southeastern United States. Two well fitting MMPI-2 cluster solutions were evaluated with discriminant analyses and multivariate analyses of variance (MANOVAs); a 2-cluster solution was deemed optimal. Significant between-cluster differences emerged in follow-up analyses on most of the content scales of the MMPI-2. Most demographic variables did not account for differences in cluster membership. Clusters differed in their reported clarity of the materials used to educate them about PTSD. Discriminant analyses yielded better correct classification rates than those from previous studies, when the more severely symptomatic cluster was compared with a sample of clinical combat-related PTSD veterans. Implications are considered in conducting future malingered PTSD investigations.",0 +https://doi.org/10.1097/00005053-199708000-00004,Risk Factors for Posttraumatic Stress Symptomatology in Police Officers: A Prospective Analysis,"This study examines internal and external risk factors for posttraumatic stress symptoms in 262 traumatized police officers. Results show that 7% of the entire sample had PTSD, as established by means of a structured interview; 34% had posttraumatic stress symptoms or subthreshold PTSD. Trauma severity was the only predictor of posttraumatic stress symptoms identified at both 3 and 12 months posttrauma. At 3 months posttrauma, symptomatology was further predicted by introversion, difficulty in expressing feelings, emotional exhaustion at time of trauma, insufficient time allowed by employer for coming to terms with the trauma, dissatisfaction with organizational support, and insecure job future. At 12 months posttrauma, posttraumatic stress symptoms were further predicted by lack of hobbies, acute hyperarousal, subsequent traumatic events, job dissatisfaction, brooding over work, and lack of social interaction support in the private sphere. Implications of the findings regarding organizational risk factors are discussed in the light of possible occupational health interventions.",0 +https://doi.org/10.3109/00048678909062620,Post-Traumatic Stress Disorder: Some Diagnostic and Clinical Issues,"The development of post-traumatic stress disorder (PTSD) in a group of 42 individuals exposed to a multiple homicide was examined. A comparison of DSM-III and DSM-III-R indicated that 74% qualified for a diagnosis of PTSD using DSM-III, but only 33% met the criteria outlined in DSM-III-R. The most commonly reported symptoms were found to be intrusive recollections of the event and exaggerated startle response. In general, those symptoms that are new additions in the revised version were the least frequently reported, whilst guilt, which has been excluded from DSM-III-R, was experienced by 38% of the sample. It is suggested that the new criteria may not cluster with the core syndrome of PTSD.",0 +https://doi.org/10.1097/01.jgp.0000221327.97904.b0,Risk and Protective Factors for Psychopathology Among Older versus Younger Adults After the 2004 Florida Hurricanes,"Previous research demonstrates increased resiliency to psychopathology after disasters among older adults. However, little is known about differences in age-based risk and protective factors for postdisaster mental illness.The authors used random-digit dialing methodology to survey 1,130 older adults (60+ years) and 413 younger adults residing in Florida counties directly affected by the 2004 hurricanes. Assessed risk and protective factors included demographics, social support, displacement, incurred dollar losses, perceived positive outcomes, and self-rated health status. Outcome variables included symptom counts of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-defined posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD).Older adults reported fewer symptoms of PTSD, MDD, and GAD. Explanatory risk variables accounted for large proportions of variance, but differed in meaningful ways across age groups.Although older adults are less symptomatic, their psychologic reactions appear more closely connected to economic consequences of disasters.",0 +https://doi.org/10.1007/978-94-017-8999-8_8,The Consequences of Violence on the Mental Health of the Elderly,"This chapter reviews the prevalence and risk factors associated with violence during the life course of the elderly, including its short and long-term consequences. As violence is highly prevalent in many societies individuals who have been exposed to violence have also grown old. There is limited knowledge about the long-term implications of early exposure into late life. Elder abuse has become a major issue in public health; however, the elderly are also victims to crime, war, atrocities in society, and trauma from disasters. The mental health implications of exposure to violence are reviewed, in particular post-traumatic stress disorder. Controlled studies on treatment of older individuals exposed to violence are rare. The findings suggest that exposure to violence in childhood, as a young adult or as an elder all have adverse effects on mental health in old age. The trajectory of these mental health outcomes suggests that the elderly may have a path of resilience. © Springer Science+Business Media Dordrecht 2015",0 +https://doi.org/10.1111/ajad.12170,"Post-traumatic stress disorder symptoms, underlying affective vulnerabilities, and smoking for affect regulation","Post-traumatic stress disorder (PTSD) is overrepresented among cigarette smokers. It has been hypothesized that those with PTSD smoke to alleviate negative affect and counteract deficient positive affect commonly associated with the disorder; however, limited research has examined associations between PTSD symptoms, smoking motives, and affective vulnerability factors. In the current study, we examined (1) whether PTSD symptoms were associated with positive reinforcement and negative reinforcement smoking motives; and (2) whether two affective vulnerability factors implicated in PTSD-anxiety sensitivity and anhedonia-mediated relationships between PTSD symptoms and smoking motives.Data were drawn from a community sample of non-treatment-seeking smokers recruited without regard for trauma history (N = 342; 10+ cig/day). We used the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) to assess overall PTSD symptom severity as well as individual PTSD subfactors.Overall, PTSD symptom severity was significantly associated with negative reinforcement, but not positive reinforcement, smoking motives. Variation in anxiety sensitivity significantly mediated the relation between PTSD symptom severity and negative reinforcement smoking motives, whereas anhedonia did not. Regarding PTSD subfactors, emotional numbing was the only PTSD subfactor associated with smoking rate, while re-experiencing symptoms were uniquely associated with both positive reinforcement and negative reinforcement smoking motives.Findings suggest that anxiety sensitivity may be an important feature associated with PTSD that enhances motivation to smoke for negative reinforcement purposes. Smoking cessation interventions that alleviate anxiety sensitivity and enhance coping with negative affect may be useful for smokers with elevated PTSD symptoms.",0 +https://doi.org/10.1517/14656566.2.5.883,Review of sertraline and its clinical applications in psychiatric disorders,"Sertraline (Zoloft, Pfizer) has been shown in numerous controlled studies to have similar efficacy to other selective serotonin (5-HT) re-uptake inhibitors (SSRIs) in the treatment of depression and anxiety disorders. Further research is indicating that the efficacy of sertraline extends even beyond the treatment of depression and anxiety to include utility in eating disorders, premenstrual dysphoric disorder (PMDD) and possibly substance abuse treatment. Along with other SSRIs, sertraline offers several advantages over older antidepressants, including improved patient tolerability, low risk of lethality in overdose and no dependence potential. In head-to-head comparisons, sertraline appears to be at least as well-tolerated as other SSRIs and may even have a more favourable side effect profile. Low potential for pharmacokinetic drug interactions is another advantage of sertraline. Unlike fluoxetine, fluvoxamine and paroxetine, sertraline is not a potent inhibitor of any of the cytochrome P450 isoenzyme systems. As a result of its proven efficacy, good tolerability and lack of pharmacokinetic interactions, sertraline should be considered first-line in the treatment of anxiety and depressive disorders.",0 +https://doi.org/10.1037/mil0000089,Pain Descriptors Used by Military Personnel Deployed to Iraq and Afghanistan Following Combat-Related Blast Experience,"Pain complaints are highly prevalent among military personnel of the combat operations in Iraq and Afghanistan, due, in part, to blast-related injuries. Further, pain often co-occurs with condition...",0 +https://doi.org/10.1016/j.brat.2005.11.013,"Contribution of cognitive factors to the prediction of post-traumatic stress disorder, phobia and depression after motor vehicle accidents","Past research into the psychological consequences of traumatic events has largely focused on post-traumatic stress disorder (PTSD), although other anxiety disorders and depression are also common in the aftermath of trauma. Little is known about differential predictors of these conditions. The present study investigated the extent to which theoretically derived cognitive variables predict PTSD, phobias and depression after motor vehicle accidents. The cognitive predictors were compared to a set of established, mainly non-cognitive predictors. In addition, we tested how disorder-specific the cognitive predictors are. Participants (n=101) were interviewed within a year after having been injured in a motor vehicle accident. Diagnoses of PTSD, travel phobias and depression, symptom severities and predictor variables were assessed with self-report questionnaires and structured interviews. In multiple regression analyses, the sets of cognitive variables derived from disorder-specific models explained significantly greater proportions of the variance of the symptom severities than the established predictors (PTSD 76% vs. 45%, depression 72% vs. 46% and phobia 66% vs. 40%), and than cognitive variables derived from the models of the other disorders. In addition, the majority of individual cognitive variables showed the expected pattern of differences between diagnostic groups. The results support the hypothesis that disorder-specific sets of cognitive factors contribute to the development and maintenance of PTSD, phobias and depression following traumatic events.",0 +https://doi.org/10.1097/00004630-199403000-00008,Posttraumatic Stress Disorder in Patients With Burns,"Among 39 patients with burns evaluated a mean of 12 months after hospital discharge, 38% met DSM-III-R criteria for post-traumatic stress disorder (PTSD) for at least 1 month. With proposed DSM-IV criteria, 43% met criteria for past or current PTSD. Analysis of specific symptom clusters of PTSD revealed that 74% of patients had been affected by a reexperience symptom for at least 1 month, but only 30% were currently experiencing flashbacks. No correlation was found between several clinical correlates (TBSA, length of hospitalization, and age) and development of PTSD. There was no correlation between presence of a DSM-III-R psychiatric diagnosis at the time of hospitalization and later development of PTSD and no correlation between whether or not a psychiatric diagnosis emerged during hospitalization and later development of PTSD. Finally, patients who had injuries that they could not prevent were no more likely to experience PTSD.",0 +https://doi.org/10.12740/pp/36754,Trauma Related Guilt Inventory – psychometric properties of the Polish adaptation (TRGI-PL),"AIM : Although various aspects of guilt are frequent problems of patients suffering from PTSD, they have been included into the diagnostic criteria for PTSD just in the present version DSM-5. Kubany proposed a cognitive conceptualization of guilt in PTSD followed by development of the Trauma Related Guilt Inventory (TRGI). The aim of the paper is to present psychometric properties of the Polish version of the inventory - the TRGI-PL.A Polish adaptation of the Trauma-Related Guilt Inventory was applied to a sample of 280 motor vehicle (MVA) participants (147 females, 133 males of age from 18 to 80 (M=34,93, SD=13,71) within 1-24 months after a MVA (M=10,18, SD=6,23). Validation of the Polish version was done by analyzing the internal structure of the instrument and comparing the emotional and cognitive aspects of guilt assessed by the TRGI with PTSD symptoms, post-traumatic cognitions and responsibility for MVA and subjective agreement with the judgment.The model with four latent factors: Distress, Hindsight-Bias/Responsibility, Wrongdoing and Insufficient Justification scales showed acceptable fit (Satorra-Bentler chi2=518,62, df=203, p<0,01, RMSEA=0,079, CFI=0,96, GFI=0,97), what confirms the four-factor structure of guilt, obtained in the studies on original TRGI version. Reliability coefficients are similar to original version. Correlations with other PTSD measures showed satisfactory convergent and discriminative validity.The Polish adaptation of the Trauma-Related Guilt Inventory is a reliable and valid tool for assessing guilt as a multidimensional phenomenon, comprising emotional and several cognitive characteristics, in trauma survivors.",0 +https://doi.org/10.3109/10398569609080498,Post-Traumatic Stress Disorder: A Comment on the Value of ‘Mixed Trauma’ Treatment Groups,"(1996). Post-Traumatic Stress Disorder: A Comment on the Value of ‘Mixed Trauma’ Treatment Groups. Australasian Psychiatry: Vol. 4, No. 5, pp. 258-259.",0 +https://doi.org/10.1111/j.1600-0412.2011.01304.x,The effects of preterm birth on mother-infant interaction and attachment during the infant's first two years,"Abstract Objective. Early mother–infant relationships in preterm populations were evaluated in the context of a systematic review of the literature. Design and setting. A systematic search of three electronic databases (PsychINFO, PubMed and Cochrane Library) was undertaken. Three studies of maternal attachment, 18 studies of mother–preterm infant interaction and eight studies of infant attachment were included. Studies of preterm infant attachment were also evaluated using a meta-analysis. Results. Studies of mother–preterm infant interactions showed that the differences in maternal interaction behavior between mothers of preterm infants and mothers of full-term infants seem to be most evident during the first six months of life. Differences in the preterm infant's interaction behavior seem also to continue for six months after birth. However, five of 18 studies showed an equal or even higher quality of mother–infant interaction in groups of preterm compared to groups of full-term infants. Studies of maternal and infant attachment indicated that preterm infants and their mothers are not at higher risk of insecure attachment than full-term infants and their mothers. Conclusions. The mother–preterm infant relationship is complex, and some relational patterns forecast greater psychological risk than others. It is important to decrease maternal stress and early separation in every possible way during hospitalization as well as after discharge.",0 +https://doi.org/10.1007/s11682-015-9391-7,Personality Assessment Inventory profiles of veterans: Differential effects of mild traumatic brain injury and psychopathology,"Objective: Neuropsychiatric complaints often accompany mild traumatic brain injury (mTBI), a common condition in post-deployed Veterans. Self-report, multi-scale personality inventories may elucidate the pattern of psychiatric distress in this cohort. This study investigated valid Personality Assessment Inventory (PAI) profiles in post-deployed Veterans. Method: Measures of psychopathology and mTBI were examined in a sample of 144 post-deployed Veterans divided into groups: healthy controls (n = 40), mTBI only (n = 31), any mental health diagnosis only (MH; n = 25), comorbid mTBI and Posttraumatic Stress Disorder (mTBI/PTSD; n = 23), and comorbid mTBI, PTSD, and other psychological diagnoses (mTBI/PTSD/MDD+; n = 25). Results: There were no significant differences between the mTBI and the control group on mean PAI subscale elevation, or number of subscale elevations above 60T or 70T. The other three groups had significantly higher overall mean scores, and more elevations above 60 and 70T compared to both controls and mTBI only. The mTBI/PTSD/MDD+ group showed the highest and most elevations. After entering demographics, PTSD, and number of other psychological diagnoses into hierarchical regressions using the entire sample, mTBI history did not predict mean PAI subscale score or number of elevations above 60T or 70T. PTSD was the only significant predictor. There were no interaction effects between mTBI and presence of PTSD, or between mTBI and total number of diagnoses. Conclusions: This study suggests that mTBI alone is not uniquely related to psychiatric distress in Veterans, but that PTSD accounts for self-reported symptom distress. © 2015, Springer Science+Business Media New York (outside the USA).",0 +https://doi.org/10.1016/j.addbeh.2008.03.004,Relationship between PTSD symptomatology and nicotine dependence severity in crime victims,"Smoking rates are higher and cessation rates are lower among individuals with posttraumatic stress disorder (PTSD) compared to the general population, thus understanding the relationship between PTSD and nicotine dependence is important. In a sample of 213 participants with a crime-related trauma (109 with PTSD), the relationship between PTSD status, smoking status (smoker vs. non-smoker), substance abuse diagnosis (SUD), PTSD symptoms, and sex was assessed. SUD diagnosis was significantly related to smoking status, but PTSD symptomatology and sex were not. Among smokers (n=117), increased nicotine dependence severity was associated with being male and with increased level of PTSD avoidance symptoms. Correlations indicated that PTSD avoidance and hyperarousal symptom clusters and total PTSD symptom scores were significantly related to nicotine dependence severity in males, while PTSD symptomatology in general did not correlate with dependence severity for females. The results suggest that level of PTSD symptomatology, particularly avoidance symptoms, may be important targets for smoking cessation treatment among male smokers who have experienced a traumatic event.",0 +https://doi.org/10.1002/jts.21676,PTSD symptoms as risk factors for intimate partner violence revictimization and the mediating role of victims' violent behavior,"Apart from being a consequence of intimate partner violence (IPV), posttraumatic stress disorder (PTSD) can also be a risk factor for IPV revictimization. The current study examined how each of 4 PTSD symptom clusters (reexperiencing, arousal, avoidance, and numbing) related to revictimization in a sample of 156 female help-seeking victims of IPV, recruited from various victim support services in the Netherlands. In addition, we hypothesized that victim-perpetrated IPV would mediate the relation between PTSD symptomatology and IPV revictimization. Our results show that victims' PTSD reexperiencing symptoms predict revictimization of partner violence (d = .45 for physical IPV revictimization; d = .35 for psychological IPV revictimization); the other 3 PTSD symptom clusters were not related to IPV revictimization. Furthermore, victim-perpetrated psychological IPV was found to partially mediate the relation between victims' PTSD reexperiencing symptoms and IPV revictimization (Z = 2.339, SE = 0.044, p = .019 for physical IPV revictimization, and Z = 2.197, SE = 0.038, p = .028 for psychological IPV revictimization). Findings indicate that IPV victims with higher levels of PTSD reexperiencing symptoms may be more likely to perpetrate psychological IPV themselves, which may put them at greater risk for receiving IPV in return. Based on these results, a focus on individual PTSD symptom clusters and victim behaviors seems relevant for practice and may contribute to a decrease in victims' risk for future IPV.",0 +https://doi.org/10.1080/1047840x.2015.1002377,Expanding the Science of Resilience: Conserving Resources in the Aid of Adaptation,In considering resilience to stress there are several key organizing principles that will aid both research and understanding. Understanding resilience is critical to illumination of the stress pro...,0 +https://doi.org/10.1037/0022-006x.75.5.671,"What predicts psychological resilience after disaster? The role of demographics, resources, and life stress.","A growing body of evidence suggests that most adults exposed to potentially traumatic events are resilient. However, research on the factors that may promote or deter adult resilience has been limited. This study examined patterns of association between resilience and various sociocontextual factors. The authors used data from a random-digit-dial phone survey (N = 2,752) conducted in the New York City area after the September 11, 2001, terrorist attack. Resilience was defined as having 1 or 0 posttraumatic stress disorder symptoms and as being associated with low levels of depression and substance use. Multivariate analyses indicated that the prevalence of resilience was uniquely predicted by participant gender, age, race/ethnicity, education, level of trauma exposure, income change, social support, frequency of chronic disease, and recent and past life stressors. Implications for future research and intervention are discussed.",0 +https://doi.org/10.1016/j.janxdis.2008.06.006,"Post-traumatic stress disorder, social anxiety disorder, and depression in survivors of the Kosovo War: Experiential avoidance as a contributor to distress and quality of life","Few studies have been conducted on psychological disorders other than post-traumatic stress disorder (PTSD) in war survivors. The aim of this study was to examine PTSD, social anxiety disorder (SAD), and major depressive disorder (MDD) and their associations with distress and quality of life in 174 Albanian civilian survivors of the Kosovo War. This included testing of conceptual models suggesting that experiential avoidance might influence associations between anxiety and mood disorders with psychological functioning. Each of the three psychiatric disorders was associated with greater experiential avoidance and psychological distress, and lower quality of life. Being a refugee was associated with a higher likelihood of having SAD and MDD. We found evidence for experiential avoidance as a partial mediator of the respective effects of SAD and PTSD on quality of life; experiential avoidance did not mediate the effects of disorders on global distress. We also found support for a moderation model showing that only war survivors without SAD and low experiential avoidance reported elevated quality of life; people with either SAD or excessive reliance on experiential avoidance reported compromised, low quality of life. This is the third independent study, each using a different methodology, to find empirical support for this moderation model [Kashdan, T. B., & Breen, W. E. (2008). Social anxiety and positive emotions: a prospective examination of a self-regulatory model with tendencies to suppress or express emotions as a moderating variable. Behavior Therapy, 39, 1-12; Kashdan, T. B., & Steger, M. F. (2006). Expanding the topography of social anxiety: an experience sampling assessment of positive emotions and events, and emotion suppression. Psychological Science, 17, 120-128]. Overall, we provided initial evidence for the importance of addressing PTSD, SAD, MDD, and experiential avoidance in primarily civilian war survivors.",0 +https://doi.org/10.1196/annals.1364.036,Differential Effects of Subtypes of Trauma Symptoms on Couples' Hypothalamus-Pituitary-Adrenal (HPA) Axis Reactivity and Recovery in Response to Interpersonal Stress,"Abstract: This article examined the relation of five subtypes of trauma symptoms to hypothalamus-pituitary-adrenal (HPA) functioning as assessed with salivary cortisol before, during, and after an experimentally induced interpersonal conflict task in 194 heterosexual young adult couples. Trauma history and symptoms were assessed through structured clinical interviews and standardized self-report measures. Hierarchical linear modeling was used to analyze the effects of trauma symptoms on trajectories of cortisol reactivity to and recovery from the interpersonal stress. Trauma-related anxiety, depression, sleep disturbances, and dissociation significantly predicted cortisol reactivity and recovery. Trauma-related anxiety, sleep disturbances, and sexual problems significantly predicted partners' cortisol reactivity to interpersonal stress.",0 +https://doi.org/10.1097/01.nmd.0000061143.66146.a8,"Trauma and Posttraumatic Stress Disorder in an Urban Xhosa Primary Care Population: Prevalence, Comorbidity, and Service Use Patterns","Despite increased awareness of the prevalence and morbidity of psychiatric illnesses, relatively few studies have been undertaken in primary care settings in the African context. The authors determined the prevalence of trauma exposure and posttraumatic stress disorder (PTSD) in a South African township primary health care clinic and assessed associated demographic factors, comorbidity, service use, service satisfaction, and quality of life. Subjects were directly interviewed using translated, standardized instruments to assess variables described. Retrospective chart analysis assessed clinician case identification and psychotropic drug-prescribing habits. Of the 201 participants, 94% reported exposure to traumatic events (mean, 3.8). Trauma was associated with single status (p =.01), and PTSD was associated with poverty and single status (p =.04). Both sexes were equally likely to develop PTSD. PTSD (current; 19.9%), depression (37%), and somatization disorder (18.4%) were the most common diagnoses. Comorbidity with PTSD was high and included depression (75%, p <.01), somatization (35%, p <.01), and panic disorder (25%, p <.01). Levels of functional impairment were higher for subjects with PTSD, depression, and somatization than for those without (p <.05). PTSD comorbid with depression compounded impairment (p =.04). Levels of trauma, PTSD, and depression did not increase service use or dissatisfaction with services. Clinicians did not identify trauma (0%) or psychopathology (0%), and psychotropic medication was prescribed for only 1% of participants. In this population, trauma and PTSD were highly prevalent and associated with significant unidentified morbidity and comorbidity. Patients remain untreated for years in the current system of primary care consultations.",0 +https://doi.org/10.1016/j.psychres.2015.09.009,The impact of ecological momentary assessment on posttraumatic stress symptom trajectory,"Ecological momentary assessment includes continuous, real-time gathering of self-report data in a participant's natural environment. The current study evaluated the possible impact of this assessment strategy on severity of posttraumatic stress (PTS) in a sample of participants who reported experiencing a past traumatic event. Participants with clinically elevated PTS symptoms reported symptom severity at three time-points: during an initial screening, following an unmonitored period, and following two weeks of monitoring. During the monitoring period, participants carried an Android device which prompted them to report PTS symptoms and negative emotions six times daily. PTS severity scores were then compared across these three time-points. Results indicated that participating in the ecological momentary assessment protocol was associated with a significant reduction in PTS severity, whereas significant changes were not noted over the unmonitored control condition. The authors conclude that ecological momentary assessment may have therapeutic value even when not combined with formal intervention, and it may be a useful tool for improving the efficiency of a stepped-care approach to treating PTS symptoms.",0 +https://doi.org/10.1371/journal.pone.0103340,Long-Term Positive and Negative Psychological Late Effects for Parents of Childhood Cancer Survivors: A Systematic Review,"Increasing survival rates in childhood cancer have yielded a growing population of parents of childhood cancer survivors (CCSs). This systematic review compiles the literature on positive and negative long-term psychological late effects for parents of CCSs, reported at least five years after the child's diagnosis and/or two years after the end of the child's treatment. Systematic searches were made in the databases CINAHL, EMBASE, PsycINFO, and PubMed. Fifteen studies, published between 1988 and 2010, from 12 projects were included. Thirteen studies used quantitative methodology, one quantitative and qualitative methodology, and one qualitative methodology. A total of 1045 parents participated in the reviewed studies. Mean scores were within normal ranges for general psychological distress, coping, and family functioning. However, a substantial subgroup reported a clinical level of general psychological distress, and 21-44% reported a severe level of posttraumatic stress symptoms. Worry, disease-related thoughts and feelings, marital strains, as well as posttraumatic growth was reported. Several factors were associated with the long-term late effects, such as parents' maladaptive coping during earlier stages of the childs disease trajectory and children's current poor adjustment. Quality assessments of reviewed studies and clinical implications of findings are discussed and recommendations for future research are presented.",0 +https://doi.org/10.1177/2167702613483112,Measuring the Severity of Negative and Traumatic Events,"We devised three measures of the general severity of events, which raters applied to participants' narrative descriptions: 1) placing events on a standard normed scale of stressful events, 2) placing events into five bins based on their severity relative to all other events in the sample, and 3) an average of ratings of the events' effects on six distinct areas of the participants' lives. Protocols of negative events were obtained from two non-diagnosed undergraduate samples (n = 688 and 328), a clinically diagnosed undergraduate sample all of whom had traumas and half of whom met PTSD criteria (n = 30), and a clinically diagnosed community sample who met PTSD criteria (n = 75). The three measures of severity correlated highly in all four samples but failed to correlate with PTSD symptom severity in any sample. Theoretical implications for the role of trauma severity in PTSD are discussed.",0 +https://doi.org/10.1097/nmd.0000000000000365,Treatment Outcome in Depressed Latinos Predicted by Concomitant Psychosislike Symptoms,"We compared treatment response (≥50 decrease in Nine-Item Patient Health Questionnaire total score) among 24 Latinos with major depressive disorder, presenting with and without specific psychosislike symptoms: A, hearing noises or house sounds, B, hearing voices calling one's name, C, seeing fleeting visions such as shadows, and D, symptoms more likely to be truly psychotic (e.g., poorly defined and short-lasting voices [other than B], fleeting paranoid ideation, or fleeting ideas of reference). 18 subjects (75%) endorsed symptoms of cluster A, 12 (50%) of cluster B, 10 (31%) of cluster C, and 12 (50%) of cluster D. Only subjects who reported symptoms from the D cluster exhibited significantly unfavorable depressive outcomes (compared to those with absence of D symptoms). The authors propose a phenomenological differentiation between benign psychosislike symptoms (clusters A-C) and the expression of the psychotic continuum (cluster D) in depressed Latinos.",0 +https://doi.org/10.1016/j.psyneuen.2014.10.012,Translational evidence for a role of endocannabinoids in the etiology and treatment of posttraumatic stress disorder,"• Endocannabinoids are involved in the etiology of PTSD . • They are linked to anxious arousal symptoms. • Enhancing endocannabinois function may specifically treat this symptom complex of PTSD. Posttraumatic stress disorder (PTSD) is a prevalent, chronic, and disabling anxiety disorder that may develop following exposure to a traumatic event. Despite the public health significance of PTSD, relatively little is known about the etiology or pathophysiology of this disorder, and pharmacotherapy development to date has been largely opportunistic instead of mechanism-based. Recently, an accumulating body of evidence has implicated the endocannabinoid system in the etiology of PTSD, and targets within this system are believed to be suitable for treatment development. Herein, we describe evidence from translational studies arguing for the relevance of the endocannabinoid system in the etiology of PTSD. We also show mechanisms relevant for treatment development. There is convincing evidence from multiple studies for reduced endocannabinoid availability in PTSD. Brain imaging studies show molecular adaptations with elevated cannabinoid type 1 (CB 1 ) receptor availability in PTSD which is linked to abnormal threat processing and anxious arousal symptoms. Of particular relevance is evidence showing reduced levels of the endocannabinoid anandamide and compensatory increase of CB 1 receptor availability in PTSD, and an association between increased CB 1 receptor availability in the amygdala and abnormal threat processing, as well as increased severity of hyperarousal, but not dysphoric symptomatology, in trauma survivors. Given that hyperarousal symptoms are the key drivers of more disabling aspects of PTSD such as emotional numbing or suicidality, novel, mechanism-based pharmacotherapies that target this particular symptom cluster in patients with PTSD may have utility in mitigating the chronicity and morbidity of the disorder.",0 +https://doi.org/10.1007/s12160-011-9286-9,Obesogenic Family Types Identified through Latent Profile Analysis,"Obesity may cluster in families due to shared physical and social environments.This study aims to identify family typologies of obesity risk based on family environments.Using 2007-2008 data from 706 parent/youth dyads in Minnesota, we applied latent profile analysis and general linear models to evaluate associations between family typologies and body mass index (BMI) of youth and parents.Three typologies described most families with 18.8% ""Unenriched/Obesogenic,"" 16.9% ""Risky Consumer,"" and 64.3% ""Healthy Consumer/Salutogenic."" After adjustment for demographic and socioeconomic factors, parent BMI and youth BMI Z-scores were higher in unenriched/obesogenic families (BMI difference = 2.7, p < 0.01 and BMI Z-score difference = 0.51, p < 0.01, respectively) relative to the healthy consumer/salutogenic typology. In contrast, parent BMI and youth BMI Z-scores were similar in the risky consumer families relative to those in healthy consumer/salutogenic type.We can identify family types differing in obesity risks with implications for public health interventions.",0 +https://doi.org/10.1016/s0165-0327(00)00173-7,Risk and preventive factors of post-traumatic stress disorder (PTSD): alcohol consumption and intoxication prior to a traumatic event diminishes the relative risk to develop PTSD in response to that trauma,"Previous reports examined the effects of selected pre- (e.g. female gender, previous trauma), peri- (e.g. the horror of the trauma, threatened death) or post-exposure (e.g. the physical injury caused by the trauma) risk factors on the development of post-traumatic stress disorder (PTSD), an anxiety disorder associated with a traumatic event outside the range of usual human experience. We hypothesized that alcohol consumption prior to traumatic events may reduce the incidence rate of PTSD. The aim of this study was to examine the effects of the above risk factors and preventive factors, such as alcohol consumption, on the development of PTSD.An epidemiological cohort study was carried out on 127 victims trapped in a ballroom fire. Data were collected, 7-9 months after the traumatic event, by means of the Composite International Diagnostic Interview (CIDI) and structured interviews, aimed to assess the above pre-, peri- and post-exposure factors. Logistic regression analysis was used to examine the association of PTSD with the etiologic factors and to delineate those risk factors which contribute most to the development of PTSD.Female gender, the number of previous trauma, a past history of simple phobia, threatened death, trauma exposure, hospitalization for trauma-induced injuries and the presence of burns increased the odds of PTSD, whereas a sense of control during the trauma, and alcohol consumption and intoxication decreased the odds of PTSD. Six factors made independent contributions to the prediction of PTSD, i.e. the number of previous trauma, a past history of simple phobia, loss of control (increase the odds), a sense of control, alcohol consumption and alcohol intoxication (decrease the odds).The results of this study show that the development of PTSD is determined by the effects of pre-, peri- and post-exposure risk factors and may be prevented by the effects of peri-traumatic factors, such as sense of control, alcohol consumption and intoxication.",0 +https://doi.org/10.1186/s12888-014-0232-9,"The relationship between glucocorticoid receptor polymorphisms, stressful life events, social support, and post-traumatic stress disorder","It is debatable whether or not glucocorticoid receptor (GR) polymorphisms moderate susceptibility to PTSD. Our objective was to examine the effects of stressful life events, social support, GR genotypes, and gene-environment interactions on the etiology of PTSD.Three tag single nucleotide polymorphisms, trauma events, stressful life events, and social support were assessed in 460 patients with PTSD and 1158 control subjects from a Chinese Han population. Gene-environment interactions were analyzed by generalized multifactor dimensionality reduction (GMDR).Variation in GR at rs41423247 and rs258747, stressful life events, social support, and the number of traumatic events were each separately associated with the risk for PTSD. A gene-environment interaction among the polymorphisms, rs41423247 and rs258747, the number of traumatic events, stressful life events, and social support resulted in an increased risk for PTSD. High-risk individuals (a large number of traumatic events, G allele of rs258747 and rs41423247, high level stressful life events, and low social support) had a 3.26-fold increased risk of developing PTSD compared to low-risk individuals. The association was statistically significant in the sub-groups with and without childhood trauma.Our data support the notion that stressful life events, the number of trauma events, and social support may play a contributing role in the risk for PTSD by interacting with GR gene polymorphisms.",0 +https://doi.org/10.1016/0146-6402(91)90002-r,Children's reactions to a natural disaster: symptom severity and degree of exposure,"Abstract Self-report data for 5,687 children ranging in age from 9 to 19 years were collected approximately three months after Hurricane Hugo devastated the rural community where the children lived. Information about the children's perceptions of hurricane severity, degree of home damage suffered as a result of the hurricane, and hurricane-related parental job loss was used to categorize children into four levels of hurricane exposure. Reports of anxiety were obtained via the Revised Children's Manifest Anxiety Scale (RCMAS) and reports of posttraumatic stress disorder (PTSD) symptoms were obtained via the Reaction Index (RI). Significantly higher anxiety scores and significantly more PTSD symptomatology was found for children experiencing more or more severe exposure to the hurricane. Girls reported more anxiety and PTSD symptoms than boys, and black children were more likely than the white children to report PTSD symptomatology. Additionally, girls were more severely affected by increasing levels of hurricane exposure as indicated by their RI scores. These results indicate that, similar to adult and child victims of crime and adult victims of disaster, the development of PTSD symptoms in children exposed to a natural disaster is a function of the degree of exposure to the traumatic event. The results also suggest that children's trait negative affectivity may moderate the effects of exposure on the development of PTSD symptoms.",0 +https://doi.org/10.1016/j.psychres.2010.07.031,The structure of post-traumatic stress symptoms in young survivors of war,"Research on the dimensionality of post-traumatic stress disorder (PTSD) has generally failed to provide support for the three clusters of PTSD suggested in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). However, much research has been restricted to samples in North America and Western European countries. The aim of the current study was to test four alternative factor models among a relatively understudied population-young civilian survivors of war who had experienced war-related events as adolescents-in order to establish whether the factor structure of PTSD is consistent among various traumatized populations and age groups. Using the Posttraumatic Stress Diagnostic Scale, the results indicated that the four-factor model including intrusion, avoidance, hyperarousal, and numbing factors provided a better fit than the three-factor model suggested by the DSM-IV. The current study offers additional support from another population for a four-factor model of PTSD that implies a separation of avoidance and numbing items. Case conceptualization and treatment implications are discussed.",0 +https://doi.org/10.1016/j.yebeh.2012.11.039,Post-traumatic stress disorder in partners of people with epilepsy,"The objectives of the present study were to examine whether living with an individual who suffered from epilepsy was a potentially traumatizing event and to identify predictive risk factors in developing post-traumatic stress disorder (PTSD).Six hundred fourteen respondents completed the Harvard Trauma Questionnaire, the Crisis Support Scale, the Hopkins Symptom Checklist-25, and the Dyadic Adjustment Scale. In addition, demographic variables were included in order to identify factors that might predict PTSD.The percentage of the participants that fulfilled the symptom criteria of PTSD was 7.7%, and an additional 43.9% reported a subclinical level of PTSD. Clinical and subclinical anxiety was unveiled in 9.3% of the respondents.Partners were at risk of PTSD when living with a patient with epilepsy. Identified variables that explained PTSD were frequency and types of seizures medication, side effects, and objective and subjective epilepsy severity, anxiety, and depression. High level of social support decreased the level of traumatic stress.",0 +https://doi.org/10.1093/occmed/kqt125,Post-traumatic stress and coping factors among search and recovery divers,"Irish search and recovery divers dive on a voluntary basis to recover missing persons. During these procedures, they encounter situations not typically part of ordinary human experience and might be expected to experience psychological effects as a result.To investigate the association of post-traumatic stress disorder (PTSD) symptoms with previous experience of missing person recovery among divers, and to investigate the coping mechanisms used.Self-administered questionnaires were distributed to all 206 active search divers in Ireland. A validated questionnaire, the Impact of Event Scale revised (IES-R), was used together with a coping questionnaire to compare the level of symptoms in divers with and without recovery experience, and to describe the main coping factors.One hundred and fifty-five questionnaires were returned, a response rate of 75%. Divers with prior missing person recovery experience scored lower on all three PTSD dimensions (avoidance, intrusion and hyper-arousal) with a significant difference for intrusion (P < 0.001). Coping mechanisms listed by the divers were search and recovery training, support from peers and search unit and sense of duty.The results do not support the hypothesis of an accumulation of traumatic experience in experienced divers but may indicate a survivor bias of the most resilient individuals, or a wearing off of vulnerability to traumatic events with experience.",0 +https://doi.org/10.1080/03069880410001727567,Bullying: a source of chronic post traumatic stress?,"This study surveyed 165 care professionals on their experience of workplace bullying. The results showed that in a 2-year period 40% had been bullied and 68% had observed bullying taking place. Of the 67 care professionals that had been bullied 44% were experiencing high levels of PTSD symptoms based on the general factor of the IES-E. However, when these results were examined further it was found that the symptoms clustered rather differently to those of victims of other forms of trauma. In victims of bullying, the symptoms of arousal and re-experience formed a single cluster of symptoms with avoidance remaining as a separate cluster. These results are challenging in both the classification of Post Traumatic Stress Disorder and for the treatment of victims of bullying.",0 +https://doi.org/10.1177/1367493512473856,Parenting an infant with a congenital anomaly,"The present study examined psychological adjustment in parents of infants with congenital anomalies (CAs), focusing on the interval from the disclosure of the diagnosis to six months after the infant’s birth and considering the effects of the parent’s gender and the timing of diagnosis (pre- vs postnatal). Within-group diversity was also examined by identifying distinct patterns of individual adjustment over time. Parents of 43 infants (43 mothers and 36 fathers) with a pre- or postnatal diagnosis of a CA answered questionnaires assessing psychological distress and quality of life one month after the disclosure of the diagnosis and six months after the infant’s birth. Results showed a significant reduction in psychological distress and a significant increase in physical quality of life over time, for both parents, regardless of the timing of diagnosis. In all, 57% of parents presented a pattern of recovery from diagnosis to six months post birth and 26.6% presented a pattern of resilience. However, 15.2% of parents showed chronic adjustment difficulties. Findings suggest that most parents tend to adjust to their infant’s CA, although some experienced difficulties and should be targeted for specialised counselling. Both members of the couple should be acknowledged, as both experience similar patterns of adjustment.",0 +https://doi.org/10.1002/jts.21688,The role of shame in distinguishing perpetrators of intimate partner violence in U.S. veterans,"Increasing attention is being paid to the fact that exposure to traumatic stressors in military combat may lead to perpetration of intimate partner violence (IPV). Because shame has been identified as a factor in posttraumatic stress disorder (PTSD), the current cross-sectional study examined the relationship in U.S. veterans between IPV and PTSD, depression, guilt, and shame. We hypothesized that shame would be the strongest correlate of perpetration of IPV and that shame would mediate the relationship between PTSD and IPV. Participants were 264 primarily male and Caucasian mixed-era veterans presenting for psychological treatment at a Veterans Affairs hospital. They completed standard measures of depression, PTSD symptoms, shame, and guilt and a local checklist was used to dichotomize the sample regarding IPV. Discriminant analysis indicated that shame contributed most (standardized canonical discriminant function coefficient = .44) to distinguishing perpetrators of IPV. In addition, the results were consistent with shame as a mediator of the relationship between PTSD and IPV. These results are in line with studies indicating that shame is linked to IPV perpetration in nonveteran samples (Harmon, 2002; Rand, 2004; Schibik, 2002) and suggests that shame may be an important aspect of the relationship between PTSD and IPV.",0 +https://doi.org/10.1097/01.nmd.0000188977.44657.1d,Postmigration Living Problems and Common Psychiatric Disorders in Iraqi Asylum Seekers in the Netherlands,"In a previous community-based, national study among Iraqi asylum seekers, a long asylum procedure was found to have a higher risk for common psychiatric disorders than adverse life events in Iraq. In the present article, the postmigration period is considered in more detail and evaluated in relationship with psychiatric disorders. Respondents were interviewed with fully structured, culturally validated, translated questionnaires. With the use of a Post- migration Living Problems questionnaire, worries about all kinds of problems were gathered. Psychiatric (DSM-IV) disorders were measured with the Composite International Diagnostic Interview 2.1. Factor analysis was done on the postmigration living problems, and in univariate and multivariate analyses, associations with psychopathology were calculated. Results show that clusters of postmigration living problems could be identified: family issues, discrimination, asylum procedure, socioeconomic living conditions, socioreligious aspects, and work-related issues. There was a significant relationship between all clustered postmigration living problems and psychopathology, except for socioreligious aspects. Multivariate logistic regression showed that lack of work, family issues, and asylum procedure stress had the highest odds ratios for psychopathology. The findings appeal to governments to shorten the asylum procedures, allow asylum seekers to work, and give preference to family reunion. Mental health workers should recognize the impact of postmigration living problems and consider focusing their treatment on coping with these problems instead of traumas from the past.",0 +https://doi.org/10.1111/j.1440-1819.2007.01774.x,Psychometric properties of the Korean version of the Short Post-Traumatic Stress Disorder Rating Interview (K-SPRINT),"Aims: The Short Post-traumatic Stress Disorder (PTSD) Rating Interview (SPRINT) is a validated, eight-item, brief global assessment scale for PTSD. This report investigated the psychometric properties of the Korean version of the SPRINT (K-SPRINT). Methods: Eighty-seven PTSD patients, 47 other psychiatric patients, and 63 healthy control subjects were enrolled in the study. All subjects completed a psychometric assessment package that included the K-SPRINT and the Korean versions of the Clinician-Administered PTSD Scale (CAPS), the Beck Depression Inventory (BDI), and the State Trait Anxiety Inventory (STAI). Results: The K-SPRINT showed good internal consistency (Cronbach's α = 0.86) and test–retest reliability (r = 0.82). K-SPRINT showed moderatecorrelations with CAPS (r = 0.71). An exploratory factor analysis produced one K-SPRINT factor. The optimal diagnostic efficiency (91.9%) of the K-SPRINT was found at a total score of 15, at which point the sensitivity and specificity were 90.8% and 92.7%, respectively. Conclusions: The present findings demonstrate that the K-SPRINT had good psychometric properties and can be used as a reliable and valid instrument for the assessment of PTSD.",0 +https://doi.org/10.1177/1359104507088348,"Active Multimodal Psychotherapy in Children and Adolescents with Suicidality: Description, Evaluation and Clinical Profile","The aim of this study was to describe and evaluate the clinical pattern of 14 youths with presenting suicidality, to describe an integrative treatment approach, and to estimate therapy effectiveness. Fourteen patients aged 10 to 18 years from a child and adolescent outpatient clinic in Stockholm were followed in a case series. The patients were treated with active multimodal psychotherapy. This consisted of mood charting by mood-maps, psycho-education, wellbeing practice and trauma resolution. Active techniques were psychodrama and body—mind focused techniques including eye movement desensitization and reprocessing. The patients were assessed before treatment, immediately after treatment and at 22 months post treatment with the Global Assessment of Functioning Scale. The clinical pattern of the group was observed. After treatment there was a significant change towards normality in the Global Assessment of Functioning scale both immediately post-treatment and at 22 months. A clinical pattern, post trauma suicidal reaction, was observed with a combination of suicidality, insomnia, bodily symptoms and disturbed mood regulation. We conclude that in the post trauma reaction suicidality might be a presenting symptom in young people. Despite the shortcomings of a case series the results of this study suggest that a mood-map-based multimodal treatment approach with active techniques might be of value in the treatment of children and youth with suicidality.",0 +https://doi.org/10.1023/a:1024719104351,Validation of the PTSD checklist-civilian version in survivors of bone marrow transplantation,"Life-threatening illness now qualifies as a precipitating stessor for posttraumatic stress disorder (PTSD). We examined the validity of the PTSD Checklist-Civilian Version (PCL-C; Weathers, Litz, Herman, Juska, & Keane, 1993), a brief 17-item inventory of PTSD-like symptoms, in a sample of 111 adults who had undergone bone marrow transplantation an average of 4.04 years previously. Exploratory factor analysis of the PCL-C identified four distinct patterns of symptom responses: Numbing-Hyperarousal, Dreams-Memories of the Cancer Treatment, General Hyperarousal, Responses to Cancer-Related Reminders and Avoidance-Numbing. Respondents meeting PTSD symptom criteria on the PCL-C had significantly lower physical, role, and social functioning, greater distress and anxiety, and significantly more intrusive and avoidant responses than individuals who did not meet PTSD symptom criteria.",0 +https://doi.org/10.2989/17280583.2014.898643,South African adolescents with cystic fibrosis: a qualitative exploration of their bio-psychosocial fields,"This qualitative case study explored risk factors and protective factors in the bio-psychosocial fields of adolescents living with cystic fibrosis (CF).Semi-structured interviews were conducted with adolescents in the middle and late adolescent years (15-22 years) who had the defining characteristics of CF and were living in Gauteng province.Themes emerged from individual interviews. The fundamental human need to be understood and to understand was negatively affected as the illness affected socialisation and learning. Participants experienced an array of emotions including loss and bereavement linked to their illness and when friends with CF died. Constructive internal dialogue and positive thinking emerged as protective variables. Participants generally showed awareness of how they regulated their contact with the illness and how they self-regulate. Despite the severity of their symptoms and the taxing demands of managing CF, participants expressed hope for the future and could find some meaning in the illness.Adolescents with CF who participated in this study indicated that they felt different from their peers. Apart from the general developmental tasks typical to adolescence they faced the challenge of managing a severe chronic and potentially terminal illness.",0 +https://doi.org/10.1016/s0027-9684(15)31405-x,Structural Model Analysis of HIV Risk Behaviors among Sexually Active Minority Adolescents,"Contents of this article are solely the responsibility of the authors and do not necessarily reflect the opinions, official policy or position of the U.S. Department of Health and Human Services, the Substance Abuse and Mental Health Services Administration or Centers for Mental Health Services and Substance Abuse Prevention.To evaluate an HIV risk profile in sexually active black and Hispanic adolescents using a structural equation model (SEM).Grantees from 15 states and Washington, DC, were selected to participate in the study. Black and Hispanic adolescents (N = 2,371) who completed the baseline instrument were required to have experienced vaginal, oral or anal sex in order to be included in this study. Total minority youths who self-reported as black but not Hispanic were n = 1,455 and for Hispanic n = 916.The hypothesized model fit moderately well (CFI = 0.940, TLI = 0.928, RMSEA = 0.039). The key significant direct effect was found (P < 0.05) for higher alcohol, tobacco and other drug use related to nonuse of condoms, more sex partners and use of substances before sex.Current findings underscore the need to incorporate culturally sensitive strategies in developing programs for minority youth. However, given that minority group members often report greater experiences of discrimination than whites, future research in this area should also include an examination of the role of other stressors such as racial disparities and their potential cumulative impact on minority youth and their risks for alcohol, tobacco and other drug use and HIV.",0 +https://doi.org/10.2174/156802612799078748,Recent Developments in Potential Anxiolytic Agents Targeting GABAA/BzR Complex or the Translocator Protein (18kDa) (TSPO),"Anxiety disorders are frequent and disabling disorders. For short-term treatment, benzodiazepines are useful due to their rapid onset of anxiolytic action. However, these compounds have sedative properties and may induce tolerance, abuse liability and withdrawal symptoms. First-line choices for the long-term treatment are selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors. The major disadvantage of these compounds is their delayed onset of action. It is obvious that there is a need for novel pharmacological approaches that combine a rapid anxiolytic efficacy with the lack of tolerance induction, abuse liability and withdrawal symptoms. A very important target for the development of such compounds is the -amino-butyric-acid (GABA)A receptor. Subtype specific benzodiazepines are being developed, but also phytotherapeutic agents experience a renaissance as GABAA receptor modulators. On the other hand, GABA related compounds, e.g. tiagabine, did not show pronounced anxiolytic efficacy. Neuroactive steroids such as allopregnanolone and tetrahydrodeoxycorticosterone (THDOC) are potent modulators of GABAA receptors. To date synthetic neuroactive steroids could not be established in the treatment of anxiety disorders. Regarding endogenous neurosteroidogenesis, recently the translocator protein (18kDa) (TSPO) has been identified as a potential novel target. TSPO is supposed to play an important role for the synthesis of neuroactive steroids. TSPO ligands may promote the synthesis of neuroactive steroids via induction of cholesterol translocation to the inner mitochondrial membrane. First clinical studies revealed promising results. In this review, we discuss putative compounds affecting the GABAergic system which may provide the basis for fast acting anxiolytics with a favorable side effect profile.",0 +https://doi.org/10.1016/j.psyneuen.2014.07.011,Longitudinal changes of telomere length and epigenetic age related to traumatic stress and post-traumatic stress disorder,"Several studies have reported an association between traumatic stress and telomere length suggesting that traumatic stress has an impact on ageing at the cellular level. A newly derived tool provides an additional means to investigate cellular ageing by estimating epigenetic age based on DNA methylation profiles. We therefore hypothesise that in a longitudinal study of traumatic stress both indicators of cellular ageing will show increased ageing. We expect that particularly in individuals that developed symptoms of post-traumatic stress disorder (PTSD) increases in these ageing parameters would stand out. From an existing longitudinal cohort study, ninety-six male soldiers were selected based on trauma exposure and the presence of symptoms of PTSD. All military personnel were deployed in a combat zone in Afghanistan and assessed before and 6 months after deployment. The Self-Rating Inventory for PTSD was used to measure the presence of PTSD symptoms, while exposure to combat trauma during deployment was measured with a 19-item deployment experiences checklist. These groups did not differ for age, gender, alcohol consumption, cigarette smoking, military rank, length, weight, or medication use. In DNA from whole blood telomere length was measured and DNA methylation levels were assessed using the Illumina 450K DNA methylation arrays. Epigenetic ageing was estimated using the DNAm age estimator procedure. The association of trauma with telomere length was in the expected direction but not significant (B=-10.2, p=0.52). However, contrary to our expectations, development of PTSD symptoms was associated with the reverse process, telomere lengthening (B=1.91, p=0.018). In concordance, trauma significantly accelerated epigenetic ageing (B=1.97, p=0.032) and similar to the findings in telomeres, development of PTSD symptoms was inversely associated with epigenetic ageing (B=-0.10, p=0.044). Blood cell count, medication and premorbid early life trauma exposure did not confound the results. Overall, in this longitudinal study of military personnel deployed to Afghanistan we show an acceleration of ageing by trauma. However, development of PTSD symptoms was associated with telomere lengthening and reversed epigenetic ageing. These findings warrant further study of a perhaps dysfunctional compensatory cellular ageing reversal in PTSD.",0 +,Outcomes of posttraumatic stress disorder.,"The typical reaction to a life-threatening experience is one of distress, anxiety, and fear. This is characteristic of the basic survival instinct; these emotions enhance the individual's memory of the traumatic experience and thus serve to help in the recognition and avoidance of similarly dangerous situations in the future. In a significant minority of individuals, however, the natural reaction to trauma becomes uncontrollably and disastrously intensified, resulting in the symptoms of posttraumatic stress disorder (PTSD). PTSD varies in severity and duration between individuals, often relating to personal characteristics and the nature of the trauma to which a person is subjected. However, several factors, namely, chronicity, impairment, comorbidity, and somatization, are significantly related to and can influence the course of PTSD and subsequent outcome. This article briefly reviews each of these factors.",0 +https://doi.org/10.1001/archpsyc.55.7.626,Trauma and Posttraumatic Stress Disorder in the Community,"The study estimates the relative importance of specific types of traumas experienced in the community in terms of their prevalence and risk of leading to posttraumatic stress disorder (PTSD).A representative sample of 2181 persons in the Detroit area aged 18 to 45 years were interviewed by telephone to assess the lifetime history of traumatic events and PTSD, according to DSM-IV. Posttraumatic stress disorder was assessed with respect to a randomly selected trauma from the list of traumas reported by each respondent, using a modified version of the Diagnostic Interview Schedule, Version IV, and the World Health Organization Composite International Diagnostic Interview.The conditional risk of PTSD following exposure to trauma was 9.2%. The highest risk of PTSD was associated with assaultive violence (20.9%). The trauma most often reported as the precipitating event among persons with PTSD (31% of all PTSD cases) was sudden unexpected death of a loved one, an event experienced by 60% of the sample, and with a moderate risk of PTSD (14.3%). Women were at higher risk of PTSD than men, controlling for type of trauma.The risk of PTSD associated with a representative sample of traumas is less than previously estimated. Previous studies have overestimated the conditional risk of PTSD by focusing on the worst events the respondents had ever experienced. Although recent research has focused on combat, rape, and other assaultive violence as causes of PTSD, sudden unexpected death of a loved one is a far more important cause of PTSD in the community, accounting for nearly one third of PTSD cases.",0 +https://doi.org/10.1016/j.jbtep.2009.07.005,Attributional style and anxiety sensitivity as maintenance factors of posttraumatic stress symptoms: A prospective examination of a diathesis–stress model,"Diathesis-stress models of posttraumatic stress disorder (PTSD) assert that traumatic events function as stressors that interact with vulnerabilities to influence the development of PTSD. The present study prospectively examined negative attributional style (NAS) and anxiety sensitivity (AS) as maintenance factors for PTSD in female adult sexual assault victims. A diathesis-stress model was tested by examining interactions between the vulnerabilities and negative life events. The present study included both the traditional three-factor model of PTSD (re-experiencing, avoidance and emotional numbing, and arousal) and the dysphoria four-factor model of PTSD (re-experiencing, avoidance, arousal, and dysphoria). Robust regression analyses revealed that negative life events at Time 2 significantly predicted increases in all clusters of the three-factor model (i.e., re-experiencing, avoidance and numbing, and arousal) and the re-experiencing, arousal, and dysphoria clusters of the four-factor model (but not avoidance). Neither NAS nor AS significantly independently predicted any of the symptom clusters for either model. Both NAS and AS interacted with negative life events to predict increases in the avoidance and numbing symptoms. However, examination of the dysphoria four-factor model of PTSD revealed that the NAS and AS interactions with negative life events only predicted dysphoria symptoms.",0 +https://doi.org/10.1002/cpp.341,A controlled comparison of eye movement desensitization and reprocessing versus exposure plus cognitive restructuring versus waiting list in the treatment of post-traumatic stress disorder,"A total of 105 patients with post-traumatic stress disorder (PTSD) were randomly allocated to eye-movement desensitization and reprocessing (EMDR) (n = 39) versus exposure plus cognitive restructuring (E + CR) (n = 37) versus waiting list (WL) (n = 29) in a primary care setting. EMDR and E + CR patients received a maximum of 10 treatment sessions over a 10-week period. All patients were assessed by blind raters prior to randomization and at end of the 10-week treatment or waiting list period. EMDR and E + CR patients were also assessed by therapists at the mid-point of the 10-week treatment period and on average at 15 months follow-up. Patients were assessed on a variety of assessor-rated and self-report measures of PTSD symptomatology including the Clinician Administered PTSD Scale (CAPS), the Impact of Events Scale (IOE) and a self-report version of the SI-PTSD Checklist. Measures of anxiety and depression included the Montgomery Asberg Depression Rating Scale (MADRS), the Hamilton Anxiety Scale (HAM-A) and the Hospital Anxiety and Depression Scale (HADS). A measure of social function, the Sheehan Disability Scale was also used. Drop-out rates between the three groups were 12 EMDR, 16 E + CR and five WL. Treatment end-point analyses were conducted on the remaining 72 patients. Repeated measures analysis of variance of treatment outcome at 10 weeks revealed significant time, interaction and group effects for all the above measures. In general there were significant and substantial pre–post reductions for EMDR and E + CR groups but no change for the WL patients. Both treatments were effective over WL. The only indication of superiority of either active treatment, in relation to measures of clinically significant change, was a greater reduction in patient self-reported depression ratings and improved social functioning for EMDR in comparison to E + CR at the end of the treatment period and for fewer number of treatment sessions for EMDR (mean 4.2) than E + CR (mean 6.4) patients. At 15 months follow-up treatment gains were generally well-maintained with the only difference, in favour of EMDR over E + CR, occurring in relation to assessor-rated levels of clinically significant change in depression. However, exclusion of patients who had subsequent treatment during the follow-up period diminished the proportion of patients achieving long-term clinically significant change. In summary, at end of treatment and at follow-up, both EMDR and E + CR are effective in the treatment of PTSD with only a slight advantage in favour of EMDR. Copyright © 2002 John Wiley & Sons, Ltd.",0 +,Plasma neurotransmitters and cortisol in chronic illness: role of stress.,"We routinely measured plasma neurotransmitters and hormone levels in order to investigate the role of stress on many types of diseases. In this study, we present results obtained from patients with severe chronic diseases. The study sample consisted of 88 patients (asthmatics, ulcerative colitis, Crohn's disease, chronic active hepatitis, chronic relapsing hepatitis, multiple sclerosis, trigeminal neuralgia, systemic lupus erithematous, and rheumatoid arthritis), and their respective controls. Noradrenaline (NA), adrenaline (Ad), dopamine (DA), platelet-serotonin (pS), free-serotonin (fS), growth hormone (GH) and cortisol (CRT) were determined during both exacerbation and improvement periods. A profile compatible with uncoping stress disorder (raised NA-Ad-DA + fS + CRT as well as low pS and NA/Ad ratio) was found during exacerbation periods when compared with improvement, as seen in controls. However, during improvement periods the neurochemical profile remained significantly different from that of normal controls. The neurochemical plus hormonal plasma profiles registered in chronic illness, both during exacerbation and improvement periods, strongly suggest that an uncoping stress mechanism underlies diseases of these patients.",0 +https://doi.org/10.1097/00004583-199401000-00012,Children Exposed to Disaster: I. Epidemiology of Post-Traumatic Symptoms and Symptom Profiles,"To determine the range and severity of post-traumatic stress disorder (PTSD) symptoms exhibited by children after exposure to a natural disaster.Three months after Hurricane Hugo struck Berkeley County, South Carolina, 5,687 school-aged children were surveyed about their experiences and reactions related to the storm. Self-reports of PTSD symptoms were obtained by use of a PTSD Reaction Index.Significant variation in the prevalence of PTSD symptoms was found across race, gender, and age groups. Self-reported symptoms were used to derive a post-traumatic stress syndrome classification according to DSM-III-R guidelines for the diagnosis of PTSD. More than 5% of the sample reported sufficient symptoms to be classified as exhibiting this post-traumatic stress syndrome. Females and younger children were more likely to receive this classification. At the symptom level, females reported more symptoms associated with emotional processing and emotional reaction to the trauma. Males were more likely to report symptoms related to cognitive and behavioral factors. Younger children were more likely to report symptoms overall.Children exposed to a high magnitude natural disaster report sufficient symptoms to establish a DSM-III-R derived classification of a PTSD syndrome. Differences between gender, age, and race groups appear to be related to differential risk of exposure, reporting biases, as well as a differential risk for developing post-traumatic symptoms.",0 +https://doi.org/10.1038/npp.2015.118,The Psychiatric Genomics Consortium Posttraumatic Stress Disorder Workgroup: Posttraumatic Stress Disorder Enters the Age of Large-Scale Genomic Collaboration,"The development of posttraumatic stress disorder (PTSD) is influenced by genetic factors. Although there have been some replicated candidates, the identification of risk variants for PTSD has lagged behind genetic research of other psychiatric disorders such as schizophrenia, autism, and bipolar disorder. Psychiatric genetics has moved beyond examination of specific candidate genes in favor of the genome-wide association study (GWAS) strategy of very large numbers of samples, which allows for the discovery of previously unsuspected genes and molecular pathways. The successes of genetic studies of schizophrenia and bipolar disorder have been aided by the formation of a large-scale GWAS consortium: the Psychiatric Genomics Consortium (PGC). In contrast, only a handful of GWAS of PTSD have appeared in the literature to date. Here we describe the formation of a group dedicated to large-scale study of PTSD genetics: the PGC-PTSD. The PGC-PTSD faces challenges related to the contingency on trauma exposure and the large degree of ancestral genetic diversity within and across participating studies. Using the PGC analysis pipeline supplemented by analyses tailored to address these challenges, we anticipate that our first large-scale GWAS of PTSD will comprise over 10 000 cases and 30 000 trauma-exposed controls. Following in the footsteps of our PGC forerunners, this collaboration-of a scope that is unprecedented in the field of traumatic stress-will lead the search for replicable genetic associations and new insights into the biological underpinnings of PTSD.",0 +,Risk factors for posttraumatic stress disorder,Introduction. Strategies to study risk for the development of PTSD. Epidemiological risk factors for trauma and PTSD. Genetic risk factors for PTSD: a twin study. Family studies of PTSD: a review. Parental PTSD as a risk factor for PTSD. Neurocognitive risk factors for PTSD. Psychophysiological expression of risk factors for PTSD. Risk factors for the acute biological and psychological response to trauma. Personality as a risk factor for PTSD. Risk factors for PTSD reflections and recommendations. Index.,0 +https://doi.org/10.1007/s11013-010-9175-x,Idioms of Distress Among Trauma Survivors: Subtypes and Clinical Utility,"In this introduction to the Special Issue on Trauma and Idioms of Distress, we provide an overview of the concept and typology of ""idioms of distress,"" focusing particularly on their clinical utility. This includes the role of idioms as indicators of trauma exposure, of various types of psychopathology and of levels of distress, risk and functioning. It likewise includes the fact that idioms of distress may profoundly influence the personal meaning of having a trauma-related disorder, may shape the interpersonal course of the disorder and may pattern help-seeking and self-treatment. Finally, it illustrates the fact that idioms may also help clinicians understand sufferers' views of the causes of their distress, constitute key therapeutic targets and help increase therapeutic empathy and treatment adherence. This special issue focuses on the role played by idioms of distress in the local trauma ontology, the associations between the idioms and psychiatric disorders occurring in the context of trauma and the mechanisms by which the idioms profoundly influence the personal and interpersonal course of trauma-related disorders.",0 +https://doi.org/10.1111/j.2042-7166.2011.01138_17.x,Clinical efficacy of a Phaseolus vulgaris and Cynara scolymus mixture on satiety,"Rondanelli M, Giacosa A, Orsini F, Opizzi A, Villani S. Appetite control and glycaemia reduction in overweight subjects treated with a combination of two highly standardized extracts from Phaseolus vulgaris and Cynara scolymus. Phytother Res 2011; 25: 1275–82.",0 +,Posttraumatic stress disorder in school-age children exposed to domestic violence: An examination of emotion regulation and cognitive inhibition as predictors of PTSD symptomatology,"Exposure to the physical abuse of a parent can be a traumatic event for a child, leaving the child fearful, helpless, and horrified. Research results have documented that children exposed to domestic violence are at increased risk for developing trauma symptoms characteristic of Posttraumatic Stress Disorder (PTSD). This study examined how childhood developmental factors, specifically emotion regulation and inhibition, predict PTSD symptomatology in school-age children exposed to domestic violence. Based on Horowitz's (1986) Stress Response Theory of PTSD, this study was formulated on the premise that effective coping of trauma material requires a balance of mental processes. Child participants between the ages of 8 and 12 and their mothers were asked to complete a battery of assessment measures that included the following areas: posttraumatic stress symptoms, avoidance, emotion regulation, and inhibition. The current study extends the research literature regarding PTSD symptoms in children and the influence of developmental factors. Based on results from the current study, emotion regulation seems to function as a protective factor in children, and was predictive of lower levels of avoidance symptoms Children reported to have high emotion regulation skills varied on PTSD avoidance symptoms as a function of inhibitory control. Specifically, inhibitory control was a significant predictor of symptoms for children with high emotion regulation skills Inhibition was predictive of higher rates of PTSD symptoms (child reported) when using a child-report measure of thought suppression (WBSI). Maternal report of inhibitory control and maternal report of PTSD Total symptoms were negatively correlated, thus, as inhibitory control increases, PTSD avoidance symptoms decrease Finally, avoidance symptoms were found to be an important mediator of inhibition and the development of PTSD arousal and reexperiencing symptoms in children. Post Hoc analyses also revealed emotion regulation as a mediator of maternal report of inhibitory control skills on PTSD Total symptoms. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1016/j.comppsych.2014.01.009,Factors associated with comorbidity patterns in full and partial PTSD: Findings from the PsyCoLaus study,"Subtypes of comorbid conditions and their associated trauma and clinical characteristics in full and partial PTSD were examined. Data from 289 subjects from the general population that met criteria for full or partial PTSD were analyzed. Latent class analyses (LCA) were performed to derive homogeneous patterns of DSM-IV Axis-I disorders and anti-social personality comorbid to PTSD. Logistic regression models were conducted to characterize these classes by trauma-related and clinical features. The LCA revealed three classes: (1) low comorbidity; (2) high comorbidity with primarily substance-related disorders and a higher proportion of males; and (3) more severe PTSD-symptomatology and higher comorbid anxiety disorders and depression, almost entirely represented by females. Exposure to sexual abuse was more likely in the substance-dependent class and contributed strongly to the distinction between classes. Affective disorders tended to precede the onset of PTSD in the substance-dependent class, whereas phobias were more likely to follow PTSD in the depressed-anxious class. Posttrauma onset of alcohol use disorders in the substance dependent class confirmed the self-medication hypothesis. The three classes of comorbidity and their sequence of onset with PTSD suggest different mechanisms involved in their development. Our findings suggest that PTSD-related comorbidity subtypes also apply to individuals with partial PTSD.",0 +https://doi.org/10.1016/j.janxdis.2011.06.006,"PTSD symptoms, potentially traumatic event exposure, and binge drinking: A prospective study with a national sample of adolescents","Research demonstrates substantial comorbidity between PTSD and alcohol use disorders. Evidence for functional relationships between PTSD and problematic alcohol use has not always been consistent, and there have been few investigations with adolescent samples. Further, research has not consistently controlled for cumulative potentially traumatic event (PTE) exposure when examining prospective relationships between PTSD and problematic alcohol use (i.e., binge drinking). This study examines the prospective relationships between PTSD symptoms, problematic alcohol use, and cumulative PTE exposure measured at three time points over approximately three years among a nationally representative sample of adolescents exposed to at least one PTE (n=2399 and age range=12-17 at Wave 1). Results from parallel process latent growth curve models demonstrated that increases in cumulative PTE exposure over time positively predicted increases in both PTSD symptoms and binge drinking, whereas increases in PTSD symptoms and increases in binge drinking were not related when controlling for the effect of cumulative PTE exposure. Further analyses suggested that these relationships are specific to assaultive PTEs and are not found with non-assaultive PTEs. Theoretical implications are discussed.",0 +https://doi.org/10.1176/appi.ajp.2008.07081282,The Posttraumatic Stress Disorder Diagnosis in Preschool- and Elementary School-Age Children Exposed to Motor Vehicle Accidents,"Increasingly, children are being diagnosed with psychiatric disorders, including preschool-age children. These diagnoses in young children raise questions pertaining to 1) how diagnostic algorithms for individual disorders should be modified for young age groups, 2) how psychopathology is best detected at an early stage, and 3) how to make use of multiple informants. The authors examined these issues in a prospective longitudinal assessment of preschool- and elementary school-age children who were exposed to a traumatic event.Participants were 114 children (age range: 2-10 years) who had experienced a motor vehicle accident. Parents and older children (age range: 7-10 years) completed structured interviews 2-4 weeks (initial assessment) and 6 months (6-month follow-up) after the traumatic event. A recently proposed alternative symptom algorithm for diagnosing posttraumatic stress disorder (PTSD) was utilized and compared with the standard DSM-IV algorithms for diagnosing PTSD and acute stress disorder.At the 2- to 4-week assessment, 11.5% of the children met conditions for a diagnosis of PTSD based on the alternative algorithm criteria per parent report, and 13.9% met criteria for this diagnosis at the 6-month follow-up. These percentages were much higher than those for DSM-IV diagnoses of acute stress disorder and PTSD. Among 7- to 10-year-old subjects, the use of combined parent- and child-reported symptoms to derive a diagnosis resulted in an increased number of children in this age group who were identified with psychiatric illness relative to the use of parent report alone. Agreement between parent and child on symptoms for 1) a diagnosis of PTSD based on the alternative algorithm criteria and 2) diagnoses of DSM-IV acute stress disorder and PTSD in this age group was poor. Among 2- to 6-year-old subjects, the alternative algorithm PTSD diagnosis per parent report was a more sensitive predictor of later onset psychopathology relative to a diagnosis of DSM-IV acute stress disorder or PTSD per parent report. However, among 7- to 10-year-old subjects, a combined symptom report (from both parent and child) was optimal in predicting posttraumatic psychopathology.These findings support the use of the proposed alternative algorithm for assessing PTSD in young children and suggest that the diagnosis of PTSD based on the alternative algorithm criteria is stable from the acute phase onward. When both parent- and child-reported symptoms are utilized for the assessment of PTSD among 7- to 10-year-old children, the alternative algorithm and DSM-IV criteria have broad comparable validity. However, in the absence of child-reported symptoms, the alternative algorithm criteria per parent report appears to be an optimal diagnostic measure of PTSD among children in this age group, relative to the standard DSM-IV algorithm for diagnosing the disorder.",0 +https://doi.org/10.1016/j.jpsychires.2011.05.012,Trajectory and predictors of depression in a 12-month prospective study after the Madrid March 11 terrorist attacks,"Few longitudinal studies have examined the trajectory of and the risk factors for depression in a representative sample of the population exposed to terrorism. A 12 month prospective study was conducted among a sample of Madrid city residents after the March 11, 2004 terrorist attacks. We aimed to document the trajectories of depressive symptoms and determine the risk factors associated with these trajectories.We conducted telephone surveys among a representative sample of Madrid citizens (N = 1589) to recruit baseline respondents approximately 1 month after the March 11 terrorist attacks. Participants were re-contacted at 6 and 12 months after baseline for further telephone interviews.Findings reveal heterogeneity in the longitudinal trajectories of depression ranging from the absence of depressive symptoms over time, to transient or chronic depression. Life and recent stressors, experiencing direct exposure to the attacks, personality traits, poor physical health and other psychological disorders were principally associated with a worse trajectory of depression after this event.Consistent with a stress diathesis model, ongoing stressors and intense event exposure are key drivers of a chronic depression trajectory after a mass traumatic event.",0 +https://doi.org/10.1016/j.psychres.2007.10.019,Treatment of post-traumatic stress disorder with eye movement desensitization and reprocessing: Outcome is stable in 35-month follow-up,"Post-traumatic stress disorder (PTSD) is an anxiety disorder that may follow major psychological trauma. The disorder is longstanding, even chronic, and there is a need for effective treatment. The most effective short-term treatments are cognitive behavioural therapy and eye movement desensitization and reprocessing (EMDR). Twenty subjects with chronic PTSD following occupational health hazards from “person under train” accidents or assault at work were treated with five sessions of EMDR. They were assessed with psychometric scales and diagnostic interviews before treatment, directly after treatment, at 8 months, and at 35 months after the end of Therapy. The primary outcome variable was full diagnosis of PTSD according to the DSM-IV diagnostic criteria. Results from interview-based and self-evaluation psychometric scales were used as secondary outcome variables. Immediately following treatment, the patients were divided up into two groups, initial remitters (12 of 20) and non-remitters (8 of 20). There were no drop-outs during therapy, but three patients withdrew during follow-up. The initial result was maintained at the 35-month follow-up. The secondary outcome variables also showed a significant immediate change towards normality that was stable during the long-term follow-up. After 3 years of follow-up, 83% of the initial remitters had full working capacity.",0 +https://doi.org/10.1177/1039856213492350,Therapy implications of child abuse in multi-risk families,"Objectives: Our aim is to critique Australian child maltreatment policy, outline abuse trends and provide data on family risk factors. Method: We identified policy gaps and reviewed family profiles within selective child maltreatment databases. Data sources included international and Australian literature, Queensland Department of Child Safety reports and a research clinical database. Results: Data reviewed suggest that a pattern of co-occurring complex multiple system family problems characterize substantiated abuse cases. Conclusions: The presence of multiple family problems suggests the need for a new treatment paradigm. Multisystemic Therapy for child physical abuse and neglect is an evidence-based intervention that matches the therapeutic needs of such families.",0 +https://doi.org/10.1023/b:jots.0000022614.21794.f4,Risk factors for the development versus maintenance of posttraumatic stress disorder,"This study examined risk factors for posttraumatic stress disorder (PTSD) in Vietnam veterans: 68 women and 414 men of whom 88 were White, 63 Black, 80 Hispanic, 90 Native Hawaiian, and 93 Japanese American. Continuation ratio logistic regression was used to compare the predictive power of risk factors for the development versus maintenance of full or partial PTSD. The development of PTSD was related to premilitary, military, and postmilitary factors. The maintenance of PTSD was related primarily to military and postmilitary factors. Multivariate analyses identified different models for development and maintenance. We conclude that development of PTSD is related to factors that occur before, during, and after a traumatic event, whereas failure to recover is related primarily to factors that occur during and after the event.",0 +https://doi.org/10.1002/da.22104,A PILOT STUDY OF GROUP MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) FOR COMBAT VETERANS WITH POSTTRAUMATIC STRESS DISORDER (PTSD),"""Mindfulness-based"" interventions show promise for stress reduction in general medical conditions, and initial evidence suggests that they are accepted in trauma-exposed individuals. Mindfulness-based cognitive therapy (MBCT) shows substantial efficacy for prevention of depression relapse, but it has been less studied in anxiety disorders. This study investigated the feasibility, acceptability, and clinical outcomes of an MBCT group intervention adapted for combat posttraumatic stress disorder (PTSD).Consecutive patients seeking treatment for chronic PTSD at a VA outpatient clinic were enrolled in 8-week MBCT groups, modified for PTSD (four groups, n = 20) or brief treatment-as-usual (TAU) comparison group interventions (three groups, n = 17). Pre and posttherapy psychological assessments with clinician administered PTSD scale (CAPS) were performed with all patients, and self-report measures (PTSD diagnostic scale, PDS, and posttraumatic cognitions inventory, PTCI) were administered in the MBCT group.Intent to treat analyses showed significant improvement in PTSD (CAPS (t(19) = 4.8, P < .001)) in the MBCT condition but not the TAU conditions, and a significant Condition × Time interaction (F[1,35] = 16.4, P < .005). MBCT completers (n = 15, 75%) showed good compliance with assigned homework exercises, and significant and clinically meaningful improvement in PTSD symptom severity on posttreatment assessment in CAPS and PDS (particularly in avoidance/numbing symptoms), and reduced PTSD-relevant cognitions in PTCI (self blame).These data suggest group MBCT as an acceptable brief intervention/adjunctive therapy for combat PTSD, with potential for reducing avoidance symptom cluster and PTSD cognitions. Further studies are needed to examine efficacy in a randomized controlled design and to identify factors influencing acceptability and efficacy.",0 +https://doi.org/10.1097/00004850-199903000-00001,Nefazodone in post-traumatic stress disorder: results from six open-label trials,"Nefazodone, an antidepressant which blocks serotonin (5-HT)2 receptors and 5-HT reuptake, was evaluated in the treatment of post-traumatic stress disorder (PTSD) in six open-label studies involving both civilians and combat veterans. Our objective was to report this available pooled data to characterize the response of this drug in PTSD. Specifically, we looked at response rates using three different criteria, the effect of nefazodone on each PTSD cluster and individual symptoms and, lastly, variables that might predict response. One hundred and five outpatients with chronic PTSD were treated with nefazodone titrated up to 600 mg/day, 92 of whom were entered in an intent to treat analysis. We used the percentage drop in score between baseline and endpoint on main scale as a common measure to evaluate outcome. The response criterion of a drop in score of at least 30%, 40% and 50% revealed response rates of 46, 36 and 26%, respectively. Nefazodone showed a broad spectrum of action on PTSD symptoms. This profile might make nefazodone a useful drug to treat PTSD. Predictors of response include age, sex and trauma type. Double-blind, placebo-controlled clinical trials in PTSD are in progress to assess the utility of nefazodone as a treatment in this disorder.",0 +https://doi.org/10.1007/s11205-005-5552-1,Interpreting the WHOQOL-Brèf: Preliminary Population Norms and Effect Sizes,"Since publication use of the WHOQOL-Bref has rapidly risen. However, as yet no population norms have been published as a reference point against which researchers can interpret their findings. This study provides preliminary population norms for this purpose. Randomly sampled community residents from two studies were pooled and used to examine the properties of the WHOQOL-Bref by age group, gender and health status. The results showed that general norms for the WHOQOL-Bref domains were 73.5 (SD=18.1) for the Physical health domain, 70.6 (14.0) for Psychological wellbeing, 71.5 (18.2) for Social relationships and 75.1 (13.0) for the Environment domain. In general scores declined slightly by age group. For females scores were stable across the lifespan with an accelerated decline after the age of 60 years. Males exhibited a more consistent and even decline across the lifespan. There were significant differences in WHOQOL-Bref scores when reported by health status, with those in poor health obtaining scores that were up to 50% lower than those in excellent health. Effect sizes between different health status levels are reported. These preliminary norms and effect sizes may be used as reference points for interpreting WHOQOL-Bref scores. They provide additional information to the numerous national studies already reporting on the validity of the WHOQOL-Bref.",0 +https://doi.org/10.1037/tra0000020,"""Sexual assault-characteristis effects of PTSD and psychosocial mediators: A cluster-analysis approach to sexual assault types"": Correction to Peter-Hagene and Ullman (2014).","Reports an error in ""Sexual Assault-Characteristics Effects on PTSD and Psychosocial Mediators: A Cluster-Analysis Approach to Sexual Assault Types"" by Liana C. Peter-Hagene and Sarah E. Ullman (Psychological Trauma: Theory, Research, Practice, and Policy, Advanced Online Publication, Aug 18, 2014, np). In the article, there was an error in the abstract. The second to last sentence should have read, ""The effect of assault-characteristics clusters on Time 2 PTSD was mediated by Time 1 self-blame and turning against social reactions."" (The following abstract of the original article appeared in record 2014-33772-001.) Using cluster analysis, we investigated the effects of assault characteristics (i.e., level of violence, subjective distress, alcohol consumption, perpetrator identity) on PTSD symptoms, and whether these effects are mediated by postassault social and psychological reactions. A large community sample of women sexual assault survivors completed 2 mail surveys at a 1-year interval. In line with prior research, cluster analyses revealed the existence of 3 general categories of sexual assault, which we described as ""high violence,"" ""alcohol-related,"" and ""moderate sexual severity."" Alcohol-related assaults resulted in fewer PTSD symptoms than high-violence assaults at Time 1, but not at Time 2. Alcohol-related and violent assaults resulted in more PTSD symptoms than moderate-severity assaults at both times. The effect of assault-characteristics clusters on Time 2 PTSD was mediated by Time 1 self-blame and turning against social reactions. The importance of considering effects of violence and alcohol consumption during the assault to better understand postassault PTSD, including implications for theory and practice, are discussed. (PsycINFO Database Record",0 +https://doi.org/10.1097/00006842-197103000-00003,Magnitude of Life Events and Seriousness of Illness,"A study investigating the relationship between the quantity of life change that patients have undergone during the 2 years before the onset of their illness, and the seriousness of that illness, is described in this report. The sample represented 42 disease items and 232 patients. Thirty-six percent",0 +https://doi.org/10.1016/s0272-7358(03)00036-9,Posttraumatic disorders following injury: an empirical and methodological review,"Although there has been a marked increase in research on psychological disorders following physical injury in recent years, there are many discrepancies between the reported findings. This paper reviews the prevalence outcomes of recent studies of the mental health sequelae of physical injury with a focus on posttraumatic stress disorder (PTSD), acute stress disorder (ASD), and depression. The review critically outlines some of the methodological factors that may have contributed to these discrepancies. The phenomenological overlap between organic and psychogenic symptoms, the use of narcotic analgesia, the role of brain injury, the timing and content of assessments, and litigation are discussed in terms of their potential to confound findings with this population. Recommendations are proposed to clarify methodological approaches in this area. It is suggested that a clearer understanding of the psychological effects of physical injury will require the widespread adoption of more rigorous, standardized and transparent methodological procedures.",0 +https://doi.org/10.1016/s0735-1097(13)61347-9,POST-TRAUMATIC STRESS DISORDER IS ASSOCIATED WITH INCREASED INCIDENCE OF INSULIN RESISTANCE AND METABOLIC SYNDROME,"Insulin resistance (IR) increases atherogenesis and atherosclerotic plaque instability and further increases risk of myocardial infarction, but its potential association with Post-traumatic stress disorder(PTSD) has not been evaluated. This study assessed the association of PTSD with incidence of IR",0 +https://doi.org/10.1080/15299732.2010.496141,Women at War: Implications for Mental Health,"Few studies have investigated the impact of deployment stressors on the mental health outcomes of women deployed to Iraq in support of Operation Iraqi Freedom. This pilot study examined exposure to combat experiences and military sexual harassment in a sample of 54 active duty women and assessed the impact of these stressors on post-deployment posttraumatic stress disorder (PTSD) symptoms and depressive symptoms. Within 3 months of returning from deployment to Iraq, participants completed (a) the Combat Experiences Scale and the Sexual Harassment Scale of the Deployment Risk and Resilience Inventory, (b) the Primary Care PTSD Screen, and (c) an abbreviated version of the Center for Epidemiological Studies-Depression scale. Approximately three quarters of the sample endorsed exposure to combat experiences, and more than half of the sample reported experiencing deployment-related sexual harassment, with nearly half of the sample endorsing both stressors. Approximately one third of the sample endorsed clinical or subclinical levels of PTSD symptoms, with 11% screening positive for PTSD and 9% to 14% of the sample endorsing depressive symptoms. Regression analyses revealed that combat experiences and sexual harassment jointly accounted for significant variance in post-deployment PTSD symptoms, whereas military sexual harassment was identified as the only unique significant predictor of these symptoms. Findings from the present study lend support to research demonstrating that military sexual trauma may be more highly associated with post-deployment PTSD symptoms than combat exposure among female service members and veterans.",0 +https://doi.org/10.3389/fnbeh.2011.00046,Analysis of Kinase Gene Expression in the Frontal Cortex of Suicide Victims: Implications of Fear and Stress†,"Suicide is a serious public health issue that results from an interaction between multiple risk factors including individual vulnerabilities to complex feelings of hopelessness, fear, and stress. Although kinase genes have been implicated in fear and stress, including the consolidation and extinction of fearful memories, expression profiles of those genes in the brain of suicide victims are less clear. Using gene expression microarray data from the Online Stanley Genomics Database and a quantitative PCR, we investigated the expression profiles of multiple kinase genes including the calcium calmodulin-dependent kinase (CAMK), the cyclin-dependent kinase, the mitogen-activated protein kinase (MAPK), and the protein kinase C (PKC) in the prefrontal cortex (PFC) of mood disorder patients died with suicide (N = 45) and without suicide (N = 38). We also investigated the expression pattern of the same genes in the PFC of developing humans ranging in age from birth to 49 year (N = 46). The expression levels of CAMK2B, CDK5, MAPK9, and PRKCI were increased in the PFC of suicide victims as compared to non-suicide controls (false discovery rate, FDR-adjusted p < 0.05, fold change >1.1). Those genes also showed changes in expression pattern during the postnatal development (FDR-adjusted p < 0.05). These results suggest that multiple kinase genes undergo age-dependent changes in normal brains as well as pathological changes in suicide brains. These findings may provide an important link to protein kinases known to be important for the development of fear memory, stress associated neural plasticity, and up-regulation in the PFC of suicide victims. More research is needed to better understand the functional role of these kinase genes that may be associated with the pathophysiology of suicide.",0 +https://doi.org/10.1002/cpp.733,"Basic emotion profiles in healthy, chronic pain, depressed and PTSD individuals","To compare self-reports of five basic emotions across four samples: healthy, chronic pain, depressed and post-traumatic stress disorder (PTSD), and to investigate the extent to which basic emotion reports discriminate between individuals in healthy or clinical groups.In total, 439 participants took part in this study: healthy (n = 131), chronic pain (n = 220), depressed (n = 24) and PTSD (n = 64). The participants completed the trait version of the Basic Emotion Scale. Basic emotion profiles were compared both within each group and between the healthy group and each of the three other groups. Discriminant analysis was used to assess the extent to which basic emotions can be used to classify the participants as belonging to the healthy group or one of the clinical groups.In the healthy group, happiness was experienced more than any other basic emotion. This was not found in the clinical groups. In comparison to the healthy participants, the chronic pain group experienced more fear, anger and sadness, the depressed group reported more sadness and the PTSD group experienced all of the negative emotions more frequently. Discriminant analysis revealed that happiness was the most important variable in determining whether an individual belonged to the healthy group or one of the clinical groups. Anger was found to further discriminate between depressed and chronic pain individuals.The findings demonstrate that basic emotion profile analysis can provide a useful foundation for the exploration of emotional experience both within and between healthy and clinical groups.",0 +https://doi.org/10.1037/10008-000,The major symptoms of hysteria.,,0 +https://doi.org/10.5694/j.1326-5377.2010.tb03692.x,Beacon: a web portal to high‐quality mental health websites for use by health professionals and the public,"Objective To describe the Beacon web portal, which lists and rates quality health websites, collects user characteristics and publishes user feedback; and to report summary data on Beacon's highest-rated (best evidence-based) sites for mental health. Data sources A systematic search was undertaken in February 2009 for potentially relevant websites through a review of research papers and a recently published book, an internet search of Open Directory Project medical categories, a review of material on a high-profile mental health portal, and a survey of international researchers. Selection criteria All sites were ranked on a 7-point scale from -1 to 5, with negative scores indicating evidence of no effect and scores of 2 or more indicating evidence of efficacy based on reports in the scientific literature. Results By March 2010, 183 sites had been identified, of which 122 focused on physical health or wellbeing, 40 targeted anxiety, and 23 targeted depression. Of the eight generalised anxiety disorder sites identified, four achieved ratings of 2 or above. Two social anxiety disorder sites achieved scores higher than 2. Ten panic disorder sites were identified, with three achieving ratings of 2 or above; and five post-traumatic stress disorder sites were identified, with two achieving ratings of 2 or above. Of the 23 identified depression sites, four achieved a rating of 2 or above. Conclusions There are a number of high-quality mental health websites on the internet, and Beacon provides a portal to enable the wide dissemination of these resources.",0 +https://doi.org/10.1093/geronb/gbs081,"Social Support, Stressors, and Frailty Among Older Mexican American Adults","There is little research on the effects of stressors and social support on frailty. Older Mexican Americans, in particular, are at higher risk of medical conditions, such as diabetes, that could contribute to frailty. Given that the Mexican American population is rapidly growing in the United States, it is important to determine whether there are modifiable social factors related to frailty in this older group.To address the influence of social support and stressors on frailty among older Mexican Americans, we utilized five waves of the Hispanic Established Populations for the Epidemiologic Study of the Elderly (Hispanic EPESE) to examine the impact of stressors and social support on frailty over a 12-year period. Using a modified version of the Fried and Walston Frailty Index, we estimated the effects of social support and stressors on frailty over time using trajectory modeling (SAS 9.2, PROC TRAJ).We first grouped respondents according to one of three trajectories: low, progressive moderate, and progressive high frailty. Second, we found that the effects of stressors and social support on frailty varied by trajectory and by type of stressor. Health-related stressors and financial strain were related to increases in frailty over time, whereas social support was related to less-steep increases in frailty.Frailty has been hypothesized to reflect age-related physiological vulnerability to stressors, and the analyses presented indicate partial support for this hypothesis in an older sample of Mexican Americans. Future research needs to incorporate measures of stressors and social support in examining those who become frail, especially in minority populations.",0 +https://doi.org/10.1080/10615806.2014.956097,Latent classes of posttraumatic stress and growth,"Potentially traumatic events may lead to different patterns of posttraumatic stress symptoms and posttraumatic growth. The objective of the present study was to identify subgroups with different patterns of posttraumatic reactions, and to determine whether these subgroups differed in terms of personal and social resources and indicators of adjustment.This study used survey data collected 10 months after the 2011 Oslo bombing attack to investigate patterns of reactions among ministerial employees (N=1970).We applied latent class analyses with covariates to extract subgroups of individuals.Three classes of individual reactions were extracted, and these were similar among those who were and those who were not physically proximate to the bombing attack: ""High stress/high growth"" (27% and 11%, respectively), ""Low stress/high growth"" (74% and 42%, respectively), and ""Low stress/low growth"" (only among the not physically proximate: 47%). The classes differed in terms of gender, neuroticism, and social support as well as life satisfaction and daily functioning.Heterogeneous patterns of posttraumatic reactions were found. Physical proximity is not necessary to experience posttraumatic stress or growth after political violence. Among individuals with low stress, posttraumatic growth may not encompass higher life satisfaction or functioning.",0 +https://doi.org/10.1016/s0306-4603(98)00070-7,"Functional associations among trauma, ptsd, and substance-related disorders","This review article presents several potential functional pathways which may explain the frequent co-occurrence of PTSD and substance abuse disorders in traumatized individuals. Emerging empirical studies which have examined these potential pathways are reviewed, including studies on relative order of onset, PTSD patients' perceptions of various drug effects, comparisons of PTSD patients with and without comorbid substance use disorders, and correlational studies examining the relations between severity of specific PTSD symptom clusters and substance disorder symptoms. Research on the acute and chronic effects of alcohol and other drugs on cognitive and physiological variables relevant to PTSD intrusion and arousal symptoms is reviewed to highlight ways in which these two sets of PTSD symptoms might be functionally interrelated with substance abuse. Finally, based on these findings, recommendations are made for the treatment of individuals with comorbid PTSD-substance use disorders.",0 +https://doi.org/10.1007/s10802-010-9457-3,Longitudinal Pathways Between Political Violence and Child Adjustment: The Role of Emotional Security about the Community in Northern Ireland,"Links between political violence and children’s adjustment problems are well-documented. However, the mechanisms by which political tension and sectarian violence relate to children’s well-being and development are little understood. This study longitudinally examined children’s emotional security about community violence as a possible regulatory process in relations between community discord and children’s adjustment problems. Families were selected from 18 working class neighborhoods in Belfast, Northern Ireland. Participants (695 mothers and children, M = 12.17, SD = 1.82) were interviewed in their homes over three consecutive years. Findings supported the notion that politically-motivated community violence has distinctive effects on children’s externalizing and internalizing problems through the mechanism of increasing children’s emotional insecurity about community. Implications are considered for understanding relations between political violence and child adjustment from a social ecological perspective.",0 +https://doi.org/10.1097/jnn.0b013e31819a7133,A Review of Health-Related Quality of Life in Adult Traumatic Brain Injury Survivors in the Context of Combat Veterans,"Health-related quality of life (HRQOL) research in traumatic brain injury (TBI) populations is beginning to emerge in the literature. Because rehabilitation and reintegration issues are complex with TBI, especially with new combat veterans, it is critical that future HRQOL research be designed to consider these issues. Utilizing explicit definitions and a conceptual model of HRQOL can provide researchers with a holistic base on which to build interventions for successful patient outcomes. The conceptual model of HRQOL of C.E. Ferrans, J.J. Zerwic, J.E. Wilbur, and J.L. Larson (2005) is an exemplar model that presents clear definitions and encompasses domains of HRQOL relevant to TBI survivors and their families. This review was organized utilizing the model of HRQOL of Ferrans et al. The objective of this review was to identify gaps in current knowledge of HRQOL and TBI. These findings were then used to develop recommendations for future research with combat veterans who have sustained a TBI.",0 +https://doi.org/10.1097/01.jom.0000158722.57980.4a,Rethinking First Response: Effects of the Clean Up and Recovery Effort on Workers at the World Trade Center Disaster Site,"We sought to describe the physical and mental health effects of the cleanup and recovery effort on workers at the World Trade Center disaster site.A mailed survey was sent to truck drivers, heavy equipment operators, laborers, and carpenters. It assessed work-related exposures and somatic and mental health symptoms. In one open-ended question, respondents shared any aspect of their experiences they wished; these 332 narrative responses were analyzed using qualitative techniques.Respondents reported suffering debilitating consequences of their work, including depression, drug use, and posttraumatic stress disorder. They felt poorly prepared to work in a disaster, lacked protective equipment and training, and felt overwhelmed by the devastation they faced.These workers' experiences were qualitatively similar to the experiences of the first responders. To protect workers in the future, the focus on preparing ""first"" responders should be reconsidered more broadly.",0 +https://doi.org/10.1016/j.janxdis.2008.03.009,The symptom structure of posttraumatic stress disorder in the National Comorbidity Replication Survey,"Previous research has provided mixed findings for the validity of various three- and four-factor models of posttraumatic stress disorder (PTSD) symptomatology. However, much of this research has been restricted to clinical samples rather than nationally representative community-based samples. The current study employed confirmatory factor analysis to evaluate the validity of three competing models of PTSD symptom structure using the DSM-IV-based National Comorbidity Replication Survey (part II of the NCS-R: N=5692). Individuals with a lifetime diagnosis of PTSD (N=588) were selected and symptom assessment was based on the World Health Organization Composite International Diagnostic Interview. Strong support was found for both the DSM-IV three-factor model and a four-factor model of PTSD symptoms by King et al. [King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998). Confirmatory factor analysis of the clinician-administered PTSD scale: evidence for the dimensionality of posttraumatic stress disorder. Psychological Assessment,10, 90-96], a variation of the DSM-IV model in which avoidance and numbing are viewed as separate factors. There was some evidence, however, that the King et al. [King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998). Confirmatory factor analysis of the clinician-administered PTSD scale: evidence for the dimensionality of posttraumatic stress disorder. Psychological Assessment,10, 90-96] model demonstrated a significantly superior fit over the DSM-IV three-factor model. Because this study provided support for both the DSM-IV three-factor model and the King et al., four-factor model of PTSD symptoms, further research is still necessary to provide more definitive conclusions in this area.",0 +https://doi.org/10.1111/j.1545-5300.2007.00216.x,Enhancing Resilience: Families and Communities as Agents for Change,"In this article, the Linking Human Systems (LINC) Community Resilience model, a theoretical framework for initiating and sustaining change in communities that have undergone rapid and untimely transition or loss, is presented. The model assumes that individuals, families, and communities are inherently competent and resilient, and that with appropriate support and encouragement, they can access individual and collective strengths that will allow them to transcend their loss. This competence can be nurtured by helping people regain a sense of connectedness with one another; with those who came before them; with their daily patterns, rituals, and stories that impart spiritual meaning; and with tangible resources within their community. Rather than imposing artificial support infrastructures, LINC interventions engage respected community members to act as natural agents for change. These ""community links"" provide a bridge between outside professionals, families, and communities, particularly in circumstances in which outside intervention may not be welcomed. The article illustrates how LINC interventions successfully have been used in communities around the world.",0 +https://doi.org/10.1002/j.1532-2149.2012.00265.x,Laypersons' expectations of recovery and beliefs about whiplash injury: A cross-cultural comparison between Australians and Singaporeans,"Background Beliefs and expectations are thought to influence outcome following whiplash injury. Studies have proposed a link between rates of chronic whiplash and laypersons' expectations about outcome following a motor vehicle accident. The prevalence of chronic whiplash is relatively high in Australia and apparently low in Singapore. This study's objectives were to compare laypersons' beliefs and expectations of recovery of whiplash injury in Brisbane and Singapore and to assess the effect of demographic factors on whiplash beliefs. Methods A cross-sectional study using online surveys was conducted on adult Internet users in Brisbane (Australia) and Singapore. The 14-item whiplash beliefs questionnaire (WBQ) was used to evaluate whiplash beliefs. Two additional items assessed expectations of recovery. Individual items of WBQ, WBQ score and expectations of recovery were analysed. Stratified analysis was performed to adjust for sampling bias due to quota sampling. Results A total of 402 participants from Singapore and 411 participants from Brisbane, Australia, completed the survey. While participants from Singapore demonstrated slightly more negative whiplash beliefs than participants from Brisbane [t(811) = −5.72; p < 0.0001], participants from both samples were similar in their expectations of quick recovery and return to normal activities following whiplash injury. Only gender had a significant effect on whiplash beliefs [estimated marginal means of WBQ score for men = 21.5; standard error (SE) = 0.20; women = 22.5; SE = 0.20; F(1,810) = 11.2; p = 0.001]. Conclusions Laypersons' expectations of recovery and beliefs about whiplash injury in Brisbane and Singapore were generally similar and mostly positive. Our results demonstrate that cultural differences reflected by laypersons' beliefs may not reflect the differences in prevalence of chronic whiplash between countries.",0 +https://doi.org/10.1016/s0005-7967(03)00141-4,The relationship between acute stress disorder and posttraumatic stress disorder in severely injured trauma survivors,"This prospective longitudinal study was designed to investigate the relationship between acute stress disorder (ASD) and the subsequent development of posttraumatic stress disorder (PTSD) in a population of severely injured hospitalised trauma survivors. Symptoms of ASD were assessed just prior to discharge in 307 consecutive admissions to a Level 1 Trauma Centre, with PTSD assessments completed at 3 and 12 months post-injury. A well-established structured clinical interview was adopted for both assessments. Only 1% of the sample met criteria for an ASD diagnosis (at a mean of 8 days post-injury), while the incidence of PTSD was 9% at 3 months and 10% at 12 months. Although all ASD symptom clusters contributed to the prediction of subsequent PTSD severity, logistic regression indicated that only re-experiencing and arousal predicted a categorical PTSD diagnosis. The dissociative symptoms that form the core of ASD were rarely endorsed and showed high specificity but low sensitivity, resulting in a high proportion of false negative diagnoses. Reducing the number of dissociative symptoms required for a diagnosis ameliorated, but did not resolve, the problem. In this particular population, the low sensitivity of the ASD diagnosis renders it a poor screening test for use in identifying high risk individuals for early intervention and prevention strategies.",0 +https://doi.org/10.1016/j.biopsych.2015.04.003,"Epigenetics of Posttraumatic Stress Disorder: Current Evidence, Challenges, and Future Directions","Posttraumatic stress disorder (PTSD) is a stress-related psychiatric disorder that is thought to emerge from complex interactions among traumatic events and multiple genetic factors. Epigenetic regulation lies at the heart of these interactions and mediates the lasting effects of the environment on gene regulation. An increasing body of evidence in human subjects with PTSD supports a role for epigenetic regulation of distinct genes and pathways in the pathogenesis of PTSD. The role of epigenetic regulation is further supported by studies examining fear conditioning in rodent models. Although this line of research offers an exciting outlook for future epigenetic research in PTSD, important limitations include the tissue specificity of epigenetic modifications, the phenomenologic definition of the disorder, and the challenge of translating molecular evidence across species. These limitations call for studies that combine data from postmortem human brain tissue and animal models, assess longitudinal epigenetic changes in living subjects, and examine dimensional phenotypes in addition to diagnoses. Moreover, examining the environmental, genetic, and epigenetic factors that promote resilience to trauma may lead to important advances in the field.",0 +https://doi.org/10.1016/j.chiabu.2011.08.001,Variations in emotional abuse experiences among multiply maltreated young adolescents and relations with developmental outcomes,"Based on the data obtained through Child Protective Services (CPS) case records abstraction, this study aimed to explore patterns of overlapping types of child maltreatment in a sample of urban, ethnically diverse male and female youth (n= 303) identified as maltreated by a large public child welfare agency.A cluster analysis was conducted on data for 303 maltreated youth. The overall categorization of four types of abuse (i.e., physical, sexual, emotional abuse and neglect) was used to provide a starting point for clustering of the 303 cases and then the subtypes of emotional abuse were broken down in the clusters. The different clusters of child maltreatment were compared on the multiple outcomes such as mental health, behavior problems, self-perception, and cognitive development.In this study, we identified four clusters of child maltreatment experiences. Three patterns involved emotional abuse. One cluster of children experienced all four types. Different clusters were differentially associated with multiple outcome measures. In general, multiply-maltreated youth fared worst, especially when the cluster involved sexual abuse. Also, sex differences were found in these associations. Boys who experienced multiple types of maltreatment showed more difficulties than girls.These results reiterate the importance of creating more complex models of child maltreatment. Children who have experienced various types of maltreatment are especially in need of more attention from professionals and resources should be allocated accordingly.",0 +https://doi.org/10.1023/a:1024405716529,"The relationship among cognitive schemas, job-related traumatic exposure, and posttraumatic stress disorder in journalists","American newspaper journalists (N = 906) participated in a study examining a cognitive mediational model for explaining the relationship between exposure to work-related traumatic events and work-related posttraumatic stress disorder (PTSD). Results indicated (a) greater exposure to work-related traumatic events was associated with work-related PTSD symptoms, as well as negative cognitive schemas; (b) cognitive beliefs partially accounted for PTSD symptoms, but the full cognitive mediational model was not supported. Implications include targeting interventions for journalists who experience traumatic stress and modifying theories about PTSD symptoms in journalists.",0 +https://doi.org/10.1176/appi.ajp.2008.08040590,Systematic Review and Meta-Analysis of Multiple-Session Early Interventions Following Traumatic Events,"The authors sought to determine the efficacy of multiple-session psychological interventions to prevent and treat traumatic stress symptoms beginning within 3 months of a traumatic event.Nine computerized databases were searched, and manual searches were conducted of reference lists of selected articles as well as two journals. In addition, key researchers in the field were contacted to determine whether they were aware of other relevant studies. The reviewers identified randomized controlled trials of multiple-session psychological treatments aimed at preventing or reducing traumatic stress symptoms in individuals within 3 months of exposure to a traumatic event. Details of the studies were independently extracted by two reviewers, and outcome data were entered into the Review Manager software package. Quality assessment was also conducted by two researchers independently.Twenty-five studies examining a range of interventions were identified. For treatment of individuals exposed to a trauma irrespective of their symptoms, there was no significant difference between any intervention and usual care. For treatment of traumatic stress symptoms irrespective of diagnosis, trauma-focused cognitive-behavioral therapy (CBT) was more effective than waiting list or supportive counseling conditions. The difference was greatest for treatment of acute stress disorder and acute posttraumatic stress disorder.Trauma-focused CBT within 3 months of a traumatic event appears to be effective for individuals with traumatic stress symptoms, especially those who meet the threshold for a clinical diagnosis.",0 +,"Displacement, Gender, and the Challenges of Parenting after Hurricane Katrina","In emergency situations and in the aftermath of disaster, parents are essential in caring for children. Yet very little has been written explicitly about the experiences of mothers and fathers - either as individuals or partners - in postdisaster contexts. With the understanding that parenting is a gendered endeavor that occurs in a society stratified by race and class, this article focuses on the responses of mothers and fathers to Hurricane Katrina. This article draws on data gathered in Louisiana through observations, focus groups, and in-depth interviews with parents and other adults responsible for the care of children. Through a qualitative analysis, this research examines the strategies that mothers and fathers used to deal with the challenges of parenting in the aftermath of Katrina, the role of advocates who worked on behalf of families, the importance of kin networks, and the uniqueness of New Orleans and what the city means for families struggling to recover after the storm.",0 +https://doi.org/10.1093/milmed/167.6.483,"The Millennium Cohort Study: A 21-Year Prospective Cohort Study of 140,000 Military Personnel","Does military service, in particular operational deployment, result in a higher risk of chronic illness among military personnel and veterans? The Millennium Cohort Study, the largest Department of Defense prospective cohort study ever conducted, will attempt to answer this question. The probability-based sample of 140,000 military personnel will be surveyed every 3 years during a 21-year period. The first questionnaire, scheduled for release in summer 2001, will be sent to 30,000 veterans who have been deployed to southwest Asia, Bosnia, or Kosovo since August 1997 and 70,000 veterans who have not been deployed to these conflict areas. Twenty thousand new participants will be added to the group in each of the years 2004 and 2007 to complete the study population of 140,000. The participants will have the option of completing the study questionnaire either on the paper copy received in the mail or through the World Wide Web-based version, which is available at www.MillenniumCohort.org. This will be one of the first prospective studies ever to offer such an option. The initial survey instrument will collect data regarding demographic characteristics, self-reported medical conditions and symptoms, and health-related behaviors. Validated instruments will be incorporated to capture self-assessed physical and mental functional status (Short Form for Veterans), psychosocial assessment (Patient Health Questionnaire), and post-traumatic stress disorder (Patient Checklist-17). Information obtained from the survey responses will be linked with other military databases, including data on deployment, occupation, vaccinations, health care utilization, and disability. In addition to revealing changes in veterans' health status over time, the Millennium Cohort Study will serve as a data repository, providing a solid foundation upon which additional epidemiological studies may be constructed.",0 +https://doi.org/10.1093/milmed/164.4.275,Stress and Health during Medical Humanitarian Assistance Missions,"The present research examined stress and health among service members deployed on a medical humanitarian assistance mission to Kazakstan. Team members were surveyed before and during their deployment. Team members underestimated how much stress they would experience in terms of isolation and inability to help the local population. Team members also used less adaptive coping mechanisms than anticipated and showed elevations in alcohol and cigarette consumption. Despite these negative experiences, reports of depression and physical symptoms did not increase during the deployment. This may have been a function of team members being personally involved in important and relevant work during the humanitarian operation.",0 +https://doi.org/10.1016/s0165-1781(02)00135-x,Internal validity of an anxiety disorder screening instrument across five ethnic groups,"We tested the factor structure of the National Anxiety Disorder Screening Day instrument (n=14860) within five ethnic groups (White, Black, Hispanic, Asian, Native American). Conducted yearly across the US, the screening is meant to detect five common anxiety syndromes. Factor analyses often fail to confirm the validity of assessment tools' structures, and this is especially likely for minority ethnic groups. If symptoms cluster differently across ethnic groups, criteria for conventional DSM-IV disorders are less likely to be met, leaving significant distress unlabeled and under-detected in minority groups. Exploratory and confirmatory factor analyses established that the items clustered into the six expected factors (one for each disorder plus agoraphobia). This six-factor model fit the data very well for Whites and not significantly worse for each other group. However, small areas of the model did not appear to fit as well for some groups. After taking these areas into account, the data still clearly suggest more prevalent PTSD symptoms in the Black, Hispanic and Native American groups in our sample. Additional studies are warranted to examine the model's external validity, generalizability to more culturally distinct groups, and overlap with other culture-specific syndromes.",0 +https://doi.org/10.1111/j.1467-6494.1995.tb00806.x,Life after Trauma: Personality and Daily Life Experiences of Traumatized People,"In this study, we explored differences in personality and daily life experiences of traumatized (n = 26) versus nontraumatized (n = 30) college students. Study participants completed a variety of personality measures as well as a 28-day experience sampling study assessing daily activities, emotions, and physical health. Although not differing on general demographics, traumatized individuals reported more trait anxiety and lower self-esteem than nontraumatized individuals. They scored higher on Neuroticism, were more introverted, and were less emotionally stable than nontraumatized participants. Traumatized individuals also reported more cognitive disturbances, emotional blunting, and interpersonal withdrawal. They did not report being more depressed, but did endorse cognitive styles associated with heightened risk for depression. Earlier age of trauma was associated with more pathological outcomes: lower self-esteem and psychological well-being, more anxiety, more pessimism, and emotional constriction of positive mood. We compare this symptom profile to that of posttraumatic stress disorder.",0 +https://doi.org/10.46743/2160-3715/2015.1420,Exploring the Lived-Experience of Limerence: A Journey toward Authenticity,"Limerence is an acute onset, unexpected, obsessive attachment to one person, the Limerent Object, which is rarely reported in scientific literature. Presented here is an interpretative phenomenological analysis to explore the livedexperience of six international Limerent respondents. The condition's unique and common journey is conceptualised in a Limerence Trajectory, which is characterized by generally sequential yet overlapping super-ordinate themes. The themes primarily regard experiences of ruminative thinking, free floating anxiety and depression temporarily fixated and the disintegration of the self. These themes are further linked to an inclination to reintegrate unresolved past life(s) experiences and to progress to a state of greater authenticity (i.e., being truer to one's inner self). A paradigm shift is identified in the realization that both a real and idealized Limerent Object are involved which may relate to attachment anxieties. Symptomology relating to Obsessive Compulsive Disorder, addiction, separation anxiety and depression, Post Traumatic Stress Disorder, disassociated states and maladaptive fantasy are discussed. The study authors and respondents collective aim is to promote awareness, research and resources for Limerent Experiencers and those who seek to support them.",0 +https://doi.org/10.1037/a0033917,Religious meaning-making at the community level: The forced relocation from the Gaza Strip.,"The purpose of the current study was to describe the process of religious coping in a religious community that underwent a forced relocation. Whereas previous work on meaning-making processes has looked at individuals, we sought to understand what happens to the process of religious coping when an entire community experiences a shared stressful event. Using Park’s (2005) model of religion as a meaningmaking framework, we analyzed open-ended narratives of 230 former residents of Gush Katif who wrote about the ways in which they coped with their relocation, 8 to 10 months after it took place. The primary finding was that participants referred to the impact of the relocation on their religious beliefs and referred to it not only as individuals but also, and perhaps mostly, as members of a community. Analyzing the content of these answers revealed four pathways of religious coping: resilient (no change in religious belief), strengthening of belief, weakening of belief, and open crisis. The findings suggest that in collective events, and especially in communities, meaning-making processes take place at both individual and collective levels. We discuss the findings in light of existing theories of religious coping.",0 +https://doi.org/10.1037/hea0000145,Treatment type and demographic characteristics as predictors for cancer adjustment: Prospective trajectories of depressive symptoms in a population sample.,"Prospectively identifying individuals at heightened risk for depression can alleviate the disease burden of distal physical and mental health consequences after cancer onset. Our objective was to identify heterogeneous trajectories of adjustment in cancer patients, using treatment-type as a predictor.Participants were followed for 6 years within the Health and Retirement Study (HRS), a prospective population-based cohort study. The sample consisted of 1,294 middle-aged participants who were assessed once before and 3 time points after their report of an initial cancer diagnosis. In addition to self-reported depressive symptoms, subjects indicated receipt of surgical, radiological, or chemical interventions as part of their usual oncological care.Four symptom trajectories were identified with Latent Growth Mixture Modeling: an increasing depression (10.5%), chronic depression (8.0%), depressed-improved (7.8%), and stable-low depression (73.7%). A conditional model using participants with available predictor data (n = 545) showed individuals in the emerging depression class were significantly more likely to have received chemo/medication therapy when compared with the remitting depression, stable-low, and chronic depression classes. Participants in the chronic and depressed-improved classes generally had worse baseline health, and the depressed-improved were also younger in age.Patients who exhibited increasing depressive symptoms had a greater probability of receiving chemo/medication therapy than any other adjustment trajectory group, although the majority of chemotherapy patients did not exhibit depressive symptom changes. These data underscore the diversity of ways that patients adjust to cancer, and suggest cancer treatment, baseline health, and age may influence long-term patterns of psychological adjustment.",0 +https://doi.org/10.1017/s0954579412000156,"Children and war: Risk, resilience, and recovery","This article reviews and reflects on studies that have explored the effects of war on children around the world. Most are cross-sectional and based on self-reports. They describe a range of mental health problems, related to dose effects and to the negative impact of being a victim or witness of violent acts, threats to and loss of loved ones, prolonged parental absence, and forced displacement. The more recent the exposure to war, and the older the child, the higher was the likelihood of reported posttraumatic stress disorder symptoms. Especially vulnerable to long-term emotional distress were child soldiers, children who were raped, and children who had been forcibly displaced. In adulthood, war-traumatized children displayed significantly increased risks for a wide range of medical conditions, especially cardiovascular diseases. Among protective factors that moderated the impact of war-related adversities in children were a strong bond between the primary caregiver and the child, the social support of teachers and peers, and a shared sense of values. Among the few documented intervention studies for children of war, school-based interventions, implemented by teachers or locally trained paraprofessionals, proved to be a feasible and low-cost alternative to individual or group therapy. More longitudinal research with multiple informants is needed to document the trajectories of risk and resilience in war-affected children, to assess their long-term development and mental health, and to identify effective treatment approaches.",0 +https://doi.org/10.1523/jneurosci.3113-13.2014,Additive Gene-Environment Effects on Hippocampal Structure in Healthy Humans,"Hippocampal volume loss has been related to chronic stress as well as genetic factors. Although genetic and environmental variables affecting hippocampal volume have extensively been studied and related to mental illness, limited evidence is available with respect to G × E interactions on hippocampal volume. The present MRI study investigated interaction effects on hippocampal volume between three well-studied functional genetic variants (COMT Val158Met, BDNF Val66Met, 5-HTTLPR) associated with hippocampal volume and a measure of environmental adversity (life events questionnaire) in a large sample of healthy humans (n = 153). All three variants showed significant interactions with environmental adversity with respect to hippocampal volume. Observed effects were additive by nature and driven by both recent as well as early life events. A consecutive analysis of hippocampal subfields revealed a spatially distinct profile for each genetic variant suggesting a specific role of 5-HTTLPR for the subiculum, BDNF Val66Met for CA4/dentate gyrus, and COMT Val158Met for CA2/3 volume changes. The present study underscores the importance of G × E interactions as determinants of hippocampal volume, which is crucial for the neurobiological understanding of stress-related conditions, such as mood disorders or post-traumatic stress disorder (PTSD).",0 +https://doi.org/10.1017/s0033291711002844,Prevalence of post-traumatic stress disorder among adolescents after the Wenchuan earthquake in China,"Background The Wenchuan earthquake was a catastrophic earthquake in China. The aim of this study is to explore longitudinally the rates of post-traumatic stress disorder (PTSD) and depression in adolescents after the Wenchuan earthquake, and to identify independent predictors of PTSD. Method PTSD and depression symptoms among adolescents at 6, 12 and 18 months after the Wenchuan earthquake were investigated using the PTSD Checklist Civilian Version and the Beck Depression Inventory (BDI). Subjects in this study included 548 high school student survivors in a local boarding high school. Results The rates of PTSD symptoms were 9.7%, 1.3% and 1.6% at the 6-, 12- and 18-month follow-ups, respectively. BDI scores were found to be the best predictor of severity of PTSD at 6, 12 and 18 months. Gender was another variable contributing significantly to PTSD at 6 and 12 months after the earthquake. In the 12-month follow-up, home damage was found to be a predictor of severity of PTSD symptoms. Being a child with siblings was found to be a predictor of severity of PTSD symptoms at 12 and 18 months after the earthquake. Conclusions PTSD symptoms changed gradually at various stages after the earthquake. Depression symptoms were predictive of PTSD symptoms in the 18-month follow-up study. Other predictors of PTSD symptoms included female gender and being a child with siblings. The results of this study may be helpful for further mental health interventions for adolescents after earthquakes.",0 +,"Finding One's Way to ""a Place Where I Am Respected"": the Experiences of First-Generation Vietnamese Americans with Depression and/or Post-traumatic Stress Disorder","Despite the high prevalence of depression and post-traumatic stress disorder among first-generation Vietnamese Americans, their underutilization of mental health services continues to persist. The question of how culturally sensitive mental health services can be delivered to engage this population effectively in treatment has been a key issue for disparities research for the past several decades. Ample literature has identified individual, sociocultural and structural factors that influence mental health service use among this population, but very few studies have explored the perceptions of the clients themselves about mental illness or their pathways to care. Twenty-one individual, inductive, and qualitative one-on-one interviews were conducted to address three aims: 1) to explore the conceptualizations of health among first-generation Vietnamese Americans living with depression and/or PTSD, 2) to illustrate the pathways through which this population obtained outpatient mental health services, and 3) to describe their expectations and perceptions of outpatient mental health treatment. Constructivist grounded theory (GT) guided all aspects of this study. The participants were mostly female and ranged in age from 42 to 74 years. Two major themes, bounded within these four walls and finding one's way to a place where I am respected, emerged as overarching processes through which the participants described their experiences. Their rich stories portrayed journeys through losing, finding and reclaiming their self worth -- journeys marked with losses, sacrifices, disruptions, stigma, resilience, coming to terms with their conditions, and managing their illnesses. These men and women remained optimistic on the road to reclaiming their sense of self worth, despite being crippled by their legacies of war, trauma, and migration to the United States. Their stories offer a culturally nuanced understanding of how participants explained their emotional discomforts, how they found their various ways to agencies that could help ease these discomforts, and the unexpected resources and relationships they gained from outpatient mental health care. This study's findings provide strong implications for social work research, practice, and policy that can help empower these individuals to find purpose and hope in their lives.",0 +https://doi.org/10.1007/7854_2014_346,Psychophysiology in the Study of Psychological Trauma: Where Are We Now and Where Do We Need to Be?,"Posttraumatic stress disorder (PTSD) is a major public health concern, which has been seeing increased recent attention partly due to the wars in Iraq and Afghanistan. Historically, research attempting to understand the etiology and treatment of PTSD has made frequent use of psychophysiological measures of arousal as they provide a number of advantages in providing objective, non-self-report outcomes that are closely related to proposed neurobiological mechanisms and provide opportunity for cross-species translation. Further, the ongoing shift in classification of psychiatric illness based on symptom clusters to specific biological, physiological, and behavioral constructs, as outlined in the US National Institute of Mental Health (NIMH) Research Domain Criteria project (RDoC), promises that psychophysiological research will continue to play a prominent role in research on trauma-related illnesses. This review focuses on the current state of the knowledge regarding psychophysiological measures and PTSD with a focus on physiological markers associated with current PTSD symptoms, as well as markers of constructs thought to be relevant to PTSD symptomatology (safety signal learning, fear extinction), and psychophysiological markers of risk for developing PTSD following trauma. Future directions and issues for the psychophysiological study of trauma including traumatic brain injury (TBI), treatment outcome studies, and new wearable physiological monitoring technologies are also discussed.",0 +https://doi.org/10.1037/pas0000259,Psychometric properties of the Posttraumatic Stress Disorder Symptom Scale Interview for DSM–5 (PSSI–5).,"Changes to the diagnostic criteria for posttraumatic stress disorder (PTSD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) create a need for valid and reliable updated assessment tools. This study examined key psychometric properties (e.g., internal consistency, test-retest reliability, interrater reliability, and convergent and discriminant validity) of the PTSD Symptom Scale Interview for DSM-5 (PSSI-5), a modified version of the PSS-I (PTSD Symptom Scale)-Interview Version for the DSM-IV. Participants were 242 urban community residents, veterans, and college undergraduates, recruited from 3 study sites, who had experienced a DSM-5 Criterion A traumatic event. The PSSI-5 demonstrated good internal consistency (α = .89) and test-retest reliability (r = .87), as well as excellent interrater reliability for the total severity score (intraclass correlation = .98) and interrater agreement for PTSD diagnosis (κ = .84). The PSSI-5 also demonstrated convergent validity with 3 measures of PTSD (i.e., Clinician-Administered PTSD Scale for DSM-5, Posttraumatic Diagnostic Scale for DSM-5, and PTSD Checklist-Specific Version; all rs > .72) and discriminant validity with the Beck Depression Inventory-II and the State-Trait Anxiety Inventory-Trait scale. Receiver operating characteristic analysis yielded a cutoff score of 23 for identifying a probable PTSD diagnosis. Together, these findings indicate that the PSSI-5 is a valid and reliable instrument for assessing PTSD diagnosis and severity. (PsycINFO Database Record",0 +https://doi.org/10.4324/9780203112816,Social Work Practice for Promoting Health and Wellbeing,,0 +https://doi.org/10.1093/jpepsy/jsp050,The Course of Posttraumatic Stress in Children: Examination of Recovery Trajectories Following Traumatic Injury,"Group-based trajectory modeling was used to identify patterns of posttraumatic stress symptom (PTSS) in children 6-16 years following accidental injury. The aims were to: (a) identify probable groups of children following distinct trajectories, and (b) identify risk factors affecting the probability of group membership.Children's Impact of Events Scale (n = 190) was used to assess PTSS up to 2 years post injury. Age, gender, type of injury, and preinjury behavior were assessed as risk factors.Three distinct trajectory groups were identified: resilient (57%), elevated stress symptoms which recovered quickly (33%), and chronic (10%). Younger children were more likely to be in the recovery group. Those with serious injuries were more likely to be in the chronic group. Preinjury child behavior problems were predictive of recovery and high chronic symptoms.Identification of distinct PTSS trajectory groups has implications for understanding the course and treatment of PTSS in children.",0 +https://doi.org/10.1016/j.trf.2015.05.006,Models for pedestrian gap acceptance behaviour analysis at unprotected mid-block crosswalks under mixed traffic conditions,"Pedestrian safety is an important aspect while crossing the road and it can be explained by pedestrian gap acceptance behaviour. The statistical models such as multiple linear regression (MLR) is often used to model linear relationships between dependent variable (viz., pedestrian gap acceptance behaviour) and independent variables, due to their ability to quantitatively predict the effect of various factors on the dependent variable. However such linear models cannot consider the effect of several variables on the output variable, due to primary assumptions of normality, linear, homoscedasticity and multicollinearity. In this regard, the non-linear models based on the artificial neural network (ANN), which are free from assumptions of linear models, can be easily employed for obtaining the effect of several input variables on the pedestrian accepted gap size. However, researchers have rarely applied ANN modelling technique for predicting the pedestrian gap acceptance behaviour, as the pedestrian gap acceptance behaviour depends on several pedestrian, traffic and vehicular characteristics. The ANN based models would be quite useful in establishing relationship between these factors on the pedestrian gap acceptance behaviour at midblock crosswalks under mixed traffic conditions. In this direction, the present study adopts both MLR as well as ANN with different pedestrian, traffic and vehicular characteristics to assess the significant contributing factors for pedestrians’ gap acceptance behaviour at unprotected mid-block crosswalks under mixed traffic conditions. For this purpose, a video graphic survey was conducted at a six lane divided road at unprotected mid-block crossing in Mumbai, India. The data such as pedestrian (gender and age), vehicular, traffic and pedestrian behavioural characteristics were extracted to model pedestrian accepted gaps. The model results show that pedestrian rolling behaviour has a significant effect on pedestrian accepted gap size. The model results concluded that ANN has a better prediction with possibility to consider the effect of more number of variables on the pedestrian gap acceptance behaviour as compared to the MLR model under mixed traffic conditions. However, the quantification of significant contributing variables on pedestrian accepted gap size is easy by MLR model as compared to the ANN technique. So, both models have their own significant role in pedestrian gap acceptance analysis. The developed models may be useful to enhance the existing mid-block crosswalk facilities or planning new facilities by more accurate prediction of the pedestrian gap acceptance behaviour considering the influence of various factors under mixed traffic conditions.",0 +https://doi.org/10.3233/jad-141515,Cognitive Debt and Alzheimer's Disease,"We propose the concept of Cognitive Debt to characterize thoughts and behaviors that increase vulnerability to symptomatic Alzheimer's disease (AD). Evidence indicates that depression, anxiety, sleep disorder, neuroticism, life stress, and post-traumatic stress disorder increase risk for AD, and we suggest they do so by increasing Cognitive Debt. Repetitive negative thinking (RNT), a behaviorally measurable process common to these factors, may drive Cognitive Debt acquisition. RNT transcends disorder-specific definition, encompasses rumination and worry, and is defined by perseverative, negative thought tendencies. Evidence of dysregulated stress responses supports the concept of Cognitive Debt, of RNT as its causal mechanism, and of an interaction with the APOE-ε4 genotype to increase vulnerability to clinical AD, independent from traditional AD pathology. Defining a more specific behavioral profile of risk would enable interventions to be targeted earlier and more precisely at individuals most vulnerable to developing AD. Additionally, modulating RNT could potentially reduce risk of clinical AD. Interventions to reduce RNT are discussed, as are suggestions for future research. For these reasons we submit that the Cognitive Debt model may aid understanding of the psychological mechanisms that potentially increase predisposition to AD.",0 +https://doi.org/10.1017/s2045796011000758,The importance of secondary trauma exposure for post-disaster mental disorder,"Background. Interventions to treat mental disorders after natural disasters are important both for humanitarian reasons and also for successful post-disaster physical reconstruction that depends on the psychological functioning of the affected population. A major difficulty in developing such interventions, however, is that large between-disaster variation exists in the prevalence of post-disaster mental disorders, making it difficult to estimate need for services in designing interventions without carrying out a post-disaster mental health needs assessment survey. One of the daunting methodological challenges in implementing such surveys is that secondary stressors unique to the disaster often need to be discovered to understand the magnitude, type, and population segments most affected by post-disaster mental disorders. Methods. This problem is examined in the current commentary by analyzing data from the WHO World Mental Health (WMH) Surveys. We analyze the extent to which people exposed to natural disasters throughout the world also experienced secondary stressors and the extent to which the mental disorders associated with disasters were more proximally due to these secondary stressors than to the disasters themselves. Results. Lifetime exposure to natural disasters was found to be high across countries (4.4–7.5%). 10.7–11.4% of those exposed to natural disasters reported the occurrence of other related stressors (e.g. death of a loved one and destruction of property). A monotonic relationship was found between the number of additional stressors and the subsequent onset of mental disorders Conclusions. These results document the importance of secondary stressors in accounting for the effects of natural disasters on mental disorders. Implications for intervention planning are discussed.",0 +https://doi.org/10.1007/s10566-013-9212-3,Introduction to a Special Issue on Research with Youth Exposed to Disasters and Violence,,0 +https://doi.org/10.1037//1082-989x.7.2.147,Missing data: Our view of the state of the art.,"Statistical procedures for missing data have vastly improved, yet misconception and unsound practice still abound. The authors frame the missing-data problem, review methods offer advice, and raise issues that remain unresolved. They clear up common misunderstandings regarding the missing at random (MAR) concept. They summarize the evidence against older procedures and, with few exceptions, discourage their use. They present, in both technical and practical language, 2 general approaches that come highly recommended: maximum likelihood (ML) and Bayesian multiple imputation (MI). Newer developments are discussed, including some for dealing with missing data that are not MAR. Although not yet in the mainstream, these procedures may eventually extend the ML and MI methods that currently represent the state of the art.",0 +https://doi.org/10.1097/00004583-199509000-00013,Posttraumatic Stress Disorder across Two Generations of Cambodian Refugees,"To examine the expression of war-related trauma as manifested by DSM-III-R rates of posttraumatic stress disorder (PTSD) and major depressive disorder in two generations of Cambodian refugees living in the western United States.A probability sample of 209 Khmer adolescents and one of their parents were interviewed using portions of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version and the PTSD section of the Diagnostic Interview for Children and Adolescents. Interviews were conducted in English by a master's-level clinician with a Khmer interpreter.PTSD was found to be significantly related across parent-child generations. A nonsignificant generational trend was also found for depressive disorders. A number of environmental variables measured in the study (amount of reported war trauma, loss, living arrangements, treatment received, socioeconomic status) were not related to these findings. Parents were more likely to report an earlier onset of PTSD symptoms.This study suggests that PTSD in refugees may cluster in families. Whether this phenomenon is caused by a genetic susceptibility to trauma awaits further research. PTSD and depressive disorders in refugee populations, while often comorbid, appear to follow different courses over time.",0 +https://doi.org/10.1023/a:1025750209553,Acute psychophysiological arousal and posttraumatic stress disorder: A two-year prospective study,"This study investigated the role of acute arousal in the development of posttraumatic stress disorder (PTSD). Hospitalized motor vehicle accident survivors (n = 146) were assessed for acute stress disorder (ASD) within 1 month of the trauma, 6 months later, and reassessed for PTSD 2 years posttrauma (n = 87). Heart rates (HR) were assessed on the day of hospital discharge. Participants who had PTSD 2 years posttrauma had higher HR at hospital discharge than those without PTSD. A diagnosis of ASD or a resting HR of 95 beats per minute had moderate sensitivity (74%) and specificity (91%) in predicting PTSD. These findings suggest that caution is required in using acute HR as a predictor of longer-term PTSD following trauma.",0 +https://doi.org/10.1016/j.ijcard.2014.07.290,The association of posttraumatic stress disorder and quality of life during the first year after acute coronary syndrome,"Acute coronary syndrome [ACS, including unstable angina (UA) or myocardial infarction (MI)] events can be psychologically traumatic experiences for patients given their unpredictable, sudden onset and life-threatening nature [1]. Although posttraumatic stress disorder (PTSD) is commonly associated with index events of war or assault, PTSD is also associated with life-threatening illness and in particular ACS with approximately 12% of patients developing PTSD [1,2].",0 +https://doi.org/10.1016/j.psyneuen.2009.08.006,Low early morning plasma cortisol in posttraumatic stress disorder is associated with co-morbid depression but not with enhanced glucocorticoid feedback inhibition,"Co-morbid major depressive disorder (MDD) in individuals with posttraumatic stress disorder (PTSD) confers a more severe clinical course and is associated with distinct biologic abnormalities. Although dysregulation in the hypothalamic pituitary adrenal (HPA) axis has been well established in PTSD, the impact of commonly co-occuring MDD has received scant attention.Overnight (7p.m. to 7a.m.) plasma cortisol, adrenocorticotropic hormone (ACTH), dehydroepiandrosterone sulphate (DHEA-S) were measured at 30 min intervals in 9 participants with PTSD with MDD (PTSD+MDD), 9 with PTSD without MDD (PTSD-MDD) and 16 non-traumatized healthy controls. A low-dose dexamethasone suppression test was administered to evaluate feedback sensitivity to glucocorticoids. Linear mixed models with body mass index (BMI) and age as covariates and Bonferroni corrected post hoc tests assessed group differences.Compared to healthy controls, subjects with PTSD+MDD, but not those subjects with PTSD-MDD, exhibited lower basal plasma cortisol levels between 1:30 a.m. and 3:30 a.m. and at 4:30 a.m. and 6:30 a.m. (effect size d=0.75). Despite similar plasma ACTH levels between the three groups, the ACTH/cortisol ratio was higher in PTSD+MDD patients compared to controls. We obtained similar results when the patient and control groups were re-studied 1 week later, and when men and current smokers were excluded. Basal plasma DHEA-S levels, and cortisol and ACTH response to a low-dose dexamethasone suppression test were similar in all three groups.Lower early morning plasma cortisol levels and a high ACTH/cortisol ratio in subjects with PTSD and co-morbid MDD may not be due to enhanced peripheral sensitivity to glucocorticoids. A central abnormality in glucocorticoid regulation could explain HPA axis dysfunction in this subgroup.",0 +https://doi.org/10.4088/jcp.v66n0811,Posttraumatic Stress Disorder Among Israeli Ex-Prisoners of War 18 and 30 Years After Release,"Article AbstractBackground: The psychological responses to captivity were measured in a sample of former prisoners of war (POWs) 18 and 30 years after release from captivity. Method: 209 Israeli veterans of the 1973 Yom Kippur War (103 ex-POWs and 106 controls) who had taken part in a previous study conducted in 1991 participated in the current study conducted in 2003. The study assessed current rates of posttraumatic stress disorder (PTSD), changes in PTSD over time, and the contribution of captivity severity (objective and subjective), sociodemographic variables, and psychological appraisal and coping with captivity to predicting PTSD using standardized self-report questionnaires. Results: Twenty-three percent of the ex-POWs met PTSD criteria and were 10 times more likely than controls to experience deterioration in their psychological condition in the 12-year interval between the 2 assessments. Almost 20% of ex-POWs who did not meet PTSD criteria in 1991 met criteria in the current assessment, in comparison to almost 1% of the controls. Current PTSD was predicted by younger age at the time of captivity, by loss of emotional control and higher subjective appraisal of suffering in captivity, and by a greater number of PTSD symptoms in the 1991 assessment. Conclusion: It is important to follow up and offer treatment to former POWs. Special attention should be paid to those who lost emotional control in captivity and to those who felt that the conditions of their captivity were severe.",0 +https://doi.org/10.1002/jclp.20747,Shared and unique predictors of post-traumatic growth and distress,"This prospective longitudinal study compared pretraumatic, peritraumatic, and post-traumatic predictors of post-traumatic growth (PTG) and post-traumatic stress disorder (PTSD). A total of 103 Israeli former prisoners of the Yom Kippur War were followed over 30 years. Sociodemographic variables, trauma exposure, reactions in captivity, world assumptions, social support, and personality factors were assessed in 1991, and PTG and PTSD symptoms in 2003. Hierarchical regression modeling showed that although some predictors, namely, loss of control and active coping during captivity, predicted both PTG and PTSD, others predicted one outcome and not the other. Self-controllability predicted PTG while sociodemographic factors predicted PTSD when controlling for PTSD and PTG, respectively. The findings indicate that salutary and pathogenic trauma outcomes share some but not all precursors, underscoring their multifaceted relationship.",0 +https://doi.org/10.1037/a0024328,Associations between posttraumatic stress disorder symptom clusters and cigarette smoking.,"Understanding the relationship between Posttraumatic stress disorder (PTSD) and cigarette smoking has been difficult because of PTSD's symptomatic heterogeneity. This study examined common and unique lifetime cross-sectional relationships between PTSD symptom clusters [Re-experiencing (intrusive thoughts and nightmares about the trauma), Avoidance (avoidance of trauma-associated memories or stimuli), Emotional Numbing (loss of interest, interpersonal detachment, restricted positive affect), and Hyperarousal (irritability, difficulty concentrating, hypervigilance, insomnia)] and three indicators of smoking behavior: (1) smoking status; (2) cigarettes per day; and (3) nicotine dependence. Participants were adult respondents in the National Epidemiologic Survey of Alcohol and Related Conditions with a trauma history (n = 23,635). All four symptom clusters associated with each smoking outcome in single-predictor models (ps <. 0001). In multivariate models including all of the symptom clusters as simultaneous predictors, Emotional Numbing was the only cluster to retain a significant association with lifetime smoking over and above the other clusters, demographics, and Axis-I comorbidity (OR = 1.30, p < .01). While Avoidance uniquely associated with smoking status and nicotine dependence in multivariate models, these relations fell below significance after adjusting for demographics and comorbidity. No clusters uniquely associated with cigarettes per day. Hyperarousal uniquely related with nicotine dependence over and above the other clusters, demographics, and Axis-I comorbidity (OR = 1.51, p < .001). These results suggest the following: (a) common variance across PTSD symptom clusters contribute to PTSD's linkage with smoking in the American population; and (b) certain PTSD symptom clusters may uniquely associate with particular indicators of smoking behavior. These findings may clarify the underpinnings of PTSD-smoking comorbidity and inform smoking interventions for trauma-exposed individuals.",0 +https://doi.org/10.1017/s0954579408000035,Trajectories of maternal depression over 7 years: Relations with child psychophysiology and behavior and role of contextual risks,"Abstract This study examines the relation between the longitudinal course of maternal depression during the child's early life and children's psychophysiology and behavior at age 6.5 years. One hundred fifty-nine children of depressed and nondepressed mothers were followed from infancy through age 6.5 years. Growth mixture modeling was used to identify classes of depressed mothers based on the longitudinal course of the mother's depression. School-aged children of chronically depressed mothers were found to have elevated externalizing behavior problems, decreased social competence, reduced frontal brain activation (EEG power), and higher respiratory sinus arrhythmia reactivity. Children of mothers with decreasing and stable mild depression were found to have increased hyperactivity and attention problems compared to children of nondepressed mothers. Contextual risk factors were found to mediate the relation between maternal depression and child behavioral outcomes.",0 +https://doi.org/10.1097/01.nmd.0000235758.24586.b7,Risk Factors for Depression After a Disaster,"Environmental stressors such as mass disasters may contribute to an increased prevalence of depression within the population affected. We examined the prevalence of probable major depression and risk factors for depression in the 6-month period after the September 11, 2001, attacks on the World Trade Center among New York City (NYC) metropolitan residents. A total of 2700 persons who were representative of the NYC metropolitan area were included in this cross-sectional telephone survey. The prevalence of probable major depression in the 6 months after the attacks was 9.4%. Multivariate logistic regression covariates associated with the likelihood of probable major depression included being directly affected by the attacks, having a perievent panic attack, experiencing multiple life stressors, and having been exposed to previous traumatic events. Mass traumatic event exposure appears to be an independent environmental risk factor for depression in the postdisaster context; specific reactions such as perievent panic attacks may have prognostic value.",0 +https://doi.org/10.1177/0093854814556880,Posttraumatic Stress Disorder Increases Risk of Criminal Recidivism Among Justice-Involved Persons With Mental Disorders,"Posttraumatic stress disorder (PTSD) is a potentially important, yet understudied, mental disorder to consider in models of criminal recidivism. The present study sought to address this gap in the literature with a large-scale secondary analysis of observational data from a sample of justice-involved persons with mental disorders. Administrative data were reviewed for 771 adult jail detainees with mental disorders. Hierarchical logistic regression models showed that PTSD was associated with a greater likelihood of general (arrest for any new charge) and serious (arrest for a new felony charge) recidivism during the year following the index arrest, after controlling for risk conferred by a recent history of arrest, demographic characteristics, and other mental disorders. Furthermore, risk of rearrest for new charges was comparable for PTSD and substance use disorders. Findings show that PTSD increases risk of both general and serious recidivism and suggest it should be considered in interventions to reduce justice-system involvement.",0 +https://doi.org/10.1017/s2045796014000092,Association between traumatic events and post-traumatic stress disorder: results from the ESEMeD-Spain study,"The relative importance of traumatic events (TEs) in accounting for the social burden of post-traumatic stress disorder (PTSD) could vary according to cross-cultural factors. In that sense, no such studies have yet been conducted in the Spanish general population. The present study aims to determine the epidemiology of trauma and PTSD in a Spanish community sample using the randomly selected TEs method.The European Study of the Epidemiology of Mental Disorders (ESEMeD)-Spain is a cross-sectional household survey of a representative sample of adult population. Lifetime prevalence of self-reported TEs and lifetime and 12-month prevalence of PTSD were evaluated using the World Health Organization (WHO) Composite International Diagnostic Interview. Reports of PTSD associated with randomly selected TEs were weighted by the individual-level probabilities of TE selection to generate estimates of population-level PTSD risk associated with each TE.Road accident was the most commonly self-reported TE (14.1%). Sexual assault had the highest conditional risk of PTSD (16.5%). The TEs that contributed most to societal PTSD burden were unexpected death of a loved one (36.4% of all cases) and sexual assault (17.2%). Being female and having a low educational level were associated with low risk of overall TE exposure and being previously married was related to higher risk. Being female was related to high risk of PTSD after experiencing a TE.Having an accident is commonly reported among Spanish adults, but two TE are responsible for the highest burden associated with PTSD: the unexpected death of someone close and sexual assault. These results can help designing public health interventions to reduce the societal PTSD burden.",0 +https://doi.org/10.1016/j.pscychresns.2007.08.011,Abnormal recruitment of working memory updating networks during maintenance of trauma-neutral information in post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) is characterised by disturbances in concentration and memory, symptoms which are a source of further distress for patients. Related to this, abnormalities in underlying working memory (WM) systems have been identified [Clark, C.R., McFarlane, A.C., Morris, P., Weber, D.L., Sonkkilla, C., Shaw, M.E., Marcina, J., Tochon-Danguy, H.J., Egan, G.F., 2003. Cerebral function in posttraumatic stress disorder during verbal working memory updating: a positron emission tomography study. Biological Psychiatry 53, 474-481.], indicating dysfunction in left hemisphere brain regions. In this study, we performed functional magnetic resonance imaging (fMRI) in 13 patients with severe PTSD and matched non-traumatized Controls, during performance of visuo-verbal tasks that involved either maintenance or continual updating of word stimuli in WM. The PTSD group failed to show differential activation during WM updating, and instead appeared to show abnormal recruitment of WM updating network regions during WM maintenance. These regions included the bilateral dorsolateral prefrontal cortex (DLPFC) and the inferior parietal lobe (IPL). Several other regions were significantly more activated in Controls than in PTSD during WM updating, including the hippocampus, the anterior cingulate (AC), and the brainstem pons, key regions that are consistently implicated in the neurobiology of PTSD. These findings suggest compensatory recruitment of networks in PTSD normally only deployed during updating of WM and may reflect PTSD patients' difficulty engaging with their day-to-day environment.",0 +https://doi.org/10.1016/j.psyneuen.2008.05.007,Hostility is related to clusters of T-cell cytokines and chemokines in healthy men,"Hostility is a risk factor for adverse health outcomes as diverse as cardiovascular disease and post-traumatic stress disorder (PTSD). Cytokines have been suggested to mediate this relationship. We investigated whether in healthy men a relation existed between hostility and T-cell mitogen-induced cytokines and chemokines. Male Dutch military personnel (n=304) were included before deployment. Eleven cytokines and chemokines were measured in supernatants of T-cell mitogen-stimulated whole blood cultures by multiplex immunoassay. Factor analysis was used to identify clusters of cytokines and chemokines. In a regression analysis hostility was related to the cytokine/chemokine clusters, and the potential risk factors age, BMI, smoking, drinking, previous deployment, early life trauma and depression. Explorative factor analysis showed four functional clusters; a pro-inflammatory factor (IL-2, TNFalpha, IFNgamma), an anti-inflammatory factor (IL-4, IL-5, IL-10), IL-6/chemokine factor (IL-6, MCP-1, RANTES, IP-10), and MIF. Hostility was significantly related to decreased IL-6/chemokine secretion and increased pro- and anti-inflammatory cytokines. There was an inverse relation between age and hostility scores. Early life trauma and depression were positively and independently related to hostility as well. This study represents a novel way of investigating the relation between cytokines and psychological characteristics. Cytokines/chemokines clustered into functional factors, which were related to hostility in healthy males. Moreover this relation appeared to be independent of reported depression and early trauma.",0 +https://doi.org/10.1037/1040-3590.16.3.255,Construct Validity of the Posttraumatic Stress Disorder Checklist in Cancer Survivors: Analyses Based on Two Samples.,"The measurement of posttraumatic stress disorder (PTSD) is critically important for the identification and treatment of this disorder. The PTSD Checklist (PCL; F. W. Weathers and J. Ford, 1996) is a self-report measure that is increasingly used. In this study, the authors investigated the factorial validity of the PCL with data from 236 cancer survivors who received a bone marrow or stem cell transplantation. The authors examined the fit of these data with the clinical model of 3 symptom clusters for PTSD, as proposed in the Diagnostic and Statistical Manual of Mental Disorders, and alternative models tested in prior research. By using confirmatory factor analysis the authors found that a 4-first-order-factor model of PTSD provided the best fit. The relations of PTSD symptoms with sociodemographic and medical variables were also explored.",0 +https://doi.org/10.1016/j.jsat.2014.07.008,Use of prescription drugs and future delinquency among adolescent offenders,"

Abstract

Non-medical use of prescription drugs (NMUPD) by adolescents is a significant public health concern. The present study investigated the profile of NMUPD in 1349 adolescent offenders from the Pathways to Desistance project, and whether NMUPD predicted future delinquency using longitudinal data. Results indicated that increased frequency and recency of NMUPD in adolescent offenders are related to some demographic factors, as well as increased risk for violence exposure, mental health diagnoses, other drug use, and previous delinquency, suggesting that severity of NMUPD is important to consider. However, ANCOVA analyses found that NMUPD was not a significant predictor of drug-related, non-aggressive, or aggressive delinquency 12months later beyond other known correlates of delinquency. Age, sex, exposure to violence, lower socioeconomic status, more alcohol use, and having delinquency histories were more important than NMUPD in predicting future delinquency. These findings suggest that although NMUPD is an important risk factor relating to many correlates of delinquency, it does not predict future delinquency beyond other known risk factors.",0 +https://doi.org/10.1002/jts.20355,Financial and social circumstances and the incidence and course of PTSD in Mississippi during the first two years after Hurricane Katrina,"Hurricane Katrina was the most devastating natural disaster to hit the United States in the past 75 years. The authors conducted interviews of 810 persons who were representative of adult residents living in the 23 southernmost counties of Mississippi before Hurricane Katrina. The prevalence of posttraumatic stress disorder (PTSD) since Hurricane Katrina was 22.5%. The determinants of PTSD were female gender, experience of hurricane-related financial loss, postdisaster stressors, low social support, and postdisaster traumatic events. Kaplan-Meier survival curves suggest that exposure to both hurricane-related traumatic events and to financial and social stressors influenced the duration of PTSD symptoms. Postdisaster interventions that aim to improve manipulable stressors after these events may influence the onset and course of PTSD.",0 +https://doi.org/10.1017/s1355617709990671,Post-traumatic amnesia and the nature of post-traumatic stress disorder after mild traumatic brain injury,"Abstract The prevalence and nature of post-traumatic stress disorder (PTSD) following mild traumatic brain injury (MTBI) is controversial because of the apparent paradox of suffering PTSD with impaired memory for the traumatic event. In this study, 1167 survivors of traumatic injury (MTBI: 459, No TBI: 708) were assessed for PTSD symptoms and post-traumatic amnesia during hospitalization, and were subsequently assessed for PTSD 3 months later ( N = 920). At the follow-up assessment, 90 (9.4%) patients met criteria for PTSD (MTBI: 50, 11.8%; No-TBI: 40, 7.5%); MTBI patients were more likely to develop PTSD than no-TBI patients, after controlling for injury severity (adjusted odds ratio: 1.86; 95% confidence interval, 1.78–2.94). Longer post-traumatic amnesia was associated with less severe intrusive memories at the acute assessment. These findings indicate that PTSD may be more likely following MTBI, however, longer post-traumatic amnesia appears to be protective against selected re-experiencing symptoms. ( JINS , 2009, 15 , 862–867.)",0 +https://doi.org/10.1046/j.1525-1497.2001.016009606.x,The PHQ-9,"While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity.The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as ""0"" (not at all) to ""3"" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients.As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples.In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.",0 +https://doi.org/10.1080/0269905031000149506,Screening for substance abuse in individuals with traumatic brain injury,"To determine the utility of the CAGE, the Brief Michigan Alcohol Screening Test (BMAST) and the Substance Abuse Subtle Screening Inventory (SASSI-3) with individuals with traumatic brain injury (TBI), two studies were conducted examining the accuracy, sensitivity and specificity of these instruments.Data from self-report instruments were compared to a clinical interview, Structured Clinical Interview for DSM-IV (SCID), to determine the accuracy, sensitivity and specificity.Two studies were conducted. In study I, 100 individuals with TBI were screened for alcohol abuse using the CAGE and the resulting classifications were compared with those derived from the SCID. In study II, 223 individuals were screened for alcohol abuse and drug abuse using the BMAST and SASSI-3 and the results of these screenings were compared with diagnoses obtained by the SCID.The specificity of the self-report instruments was moderately high, ranging between 81-83%. The specificity of the CAGE for alcohol abuse both pre- and post-TBI was high, 96% and 86%, respectively. The sensitivity of the self-report instruments was most variable, ranging from 32-95%, with the SASSI face valid drug scale and the CAGE alcohol post-TBI indicating the most sensitivity, 95 and 91%, respectively.The findings suggest that the CAGE may be useful in screening for alcohol abuse and the face valid drug sub-scale of the SASSI-3 may be useful in screening for drug abuse in individuals with TBI.",0 +https://doi.org/10.1186/s40359-014-0027-2,Student-teacher relationship trajectories and mental health problems in young children,"This longitudinal study classified groups of children experiencing different trajectories of student-teacher relationship quality over the transition from preschool into school, and determined the strength of the association between different student-teacher relationship trajectories and childhood mental health problems in the second year of primary school.A community sample of 460 Australian children were assessed in preschool (age 4), the first school year (age 5), and second school year (age 6). Teachers at all three assessments reported on student-teacher relationship quality with the Student Teacher Relationship Scale. When the children were at preschool and in their second school year, parents and teachers rated children's mental health problems using the Strengths and Difficulties Questionnaire.Latent-class growth modelling identified two trajectories of student-teacher relationship quality: (1) a stable-high student-teacher relationship quality and (2) a moderate/declining student-teacher relationship quality trajectory. Generalised linear models found that after adjusting for family demographic characteristics, having a stable high quality student-teacher relationship trajectory was associated with fewer parent-rated and teacher-rated total mental health problems, and fewer conduct, hyperactivity, and peer problems, and greater prosocial behaviour at age 6. A stable high quality trajectory was also associated with fewer teacher-rated, but not parent-rated emotional symptoms. These effects remained after adjustment for levels of mental health problems at age 4.Findings suggest that early intervention and prevention strategies that focus on building stable high quality student-teacher relationships during preschool and children's transition into formal schooling, may help reduce rates of childhood mental health problems during the early school years.",0 +https://doi.org/10.1016/s0379-0738(96)01979-2,Duties of a psychiatric-neurological consultation/ liaison service in a prison setting,"Demonstrated are standards for diagnostic and therapeutic competence deriving from the duties of a psychiatric-neurological consultation/liaison service maintained in a German prison over a 4-year period. Homogeneous age distribution (32.5 +/- 4.4 years) and the lower social status of the patients characterized the mental disorders observed in the male multinational group of patients investigated (n = 170). These included schizophrenic, affective, neurotic and psychosocial stress disorders, alcohol and drug dependence and specific personality disorders. Besides tendencies towards dissimulation, culture-bound differences in symptomatology, the phenomenon of malingering and the reluctance of prisoners, by reason of their status as such, to divulge personal information on relevant aspects of personal identity were factors complicating the diagnostic process. Epileptic syndromes and lesions of the peripheral nervous system dominated the profile of neurological diseases, mandating experience in all established technical examination procedures of neurology. Therapeutic competence in psychiatry and neurology has to satisfy not only the diversity of the manifest diseases and disorders, calling for cooperation with various medical specialists and hospitals, it must also recognize particularly the limitations of therapy in a prison setting (e.g. observation of suicidal patients). Confidentiality and transparency of medical behavior are absolute variables in the treatment of prisoners that can be rather easily realized in a consultation/liaison service.",0 +https://doi.org/10.1002/cpp.1985,Posttraumatic Growth in Populations with Posttraumatic Stress Disorder-A Systematic Review on Growth-Related Psychological Constructs and Biological Variables,"Posttraumatic growth (PTG) and Posttraumatic Stress Disorder (PTSD) are possible consequences of trauma. PTG is supposed to emerge from cognitive processes and can have functional and dysfunctional aspects. This systematic review aims to identify and evaluate publications assessing PTG in adults diagnosed with PTSD in order to analyse the relationship between both constructs, how PTG is related to specific psychological variables and if there are biological variables linked to PTG. This extended review evaluates the quality of measures applied and is the first to study PTG only in populations meeting full PTSD criteria. In addition, the relationship between PTG and other relevant constructs, such as openness, optimism and social support, is explored. Our systematic literature search identified 140 studies of which 19 fulfilled our inclusion criteria; most of them used the Post-Traumatic Growth Inventory. Results indicate that trauma survivors with PTSD exhibit more PTG than those without PTSD and that PTG can be intensified during the therapeutic process whereat it is unclear whether PTG is a desirable outcome of PTSD therapy. Positive correlations between PTG and PTSD are reported. For diagnosed populations, we could not find strong evidence of a quadratic relationship between PTG and PTSD, although some studies support this hypothesis. Findings regarding the association of PTG with psychological variables are heterogeneous. Only one study focused on PTG as well as on biological variables (salivary cortisol) but did not discuss possible links between these two so far unconnected research fields in PTSD. Copyright © 2015 John Wiley & Sons, Ltd.Trauma survivors with PTSD develop more PTG than those without PTSD, it remains unclear whether PTSD and PTG are curvilinearly related. PTG can be enhanced through PTSD therapy, nevertheless one must not assume that PTG is a favorable treatment outcome since we do not know if the development of PTG during therapy promotes the reduction of PTSD symptoms. It is unclear whether PTG in PTSD sufferers is a constructive outcome of cognitive processes or a positive illusion in favor of avoidance and denial. Results regarding the association of personality factors, social support and PTG are inconsistent, studies on biological aspects of PTG are lacking.",0 +https://doi.org/10.1016/j.jaging.2013.03.002,Broadening the etiological discourse on Alzheimer's disease to include trauma and posttraumatic stress disorder as psychosocial risk factors,"Biomedical perspectives have long dominated research on the etiology and progression of Alzheimer's disease (AD); yet these approaches do not solely explain observed variations in individual AD trajectories. More robust biopsychosocial models regard the course of AD as a dialectical interplay of neuropathological and psychosocial influences. Drawing on this broader conceptualization, we conducted an extensive review of empirical and theoretical literature on the associations of trauma, posttraumatic stress disorder (PTSD) and AD to develop a working model that conceptualizes the role of psychosocial stressors and physiological mechanisms in the onset and course of AD. The proposed model suggests two pathways. In the first, previous life trauma acts as a risk factor for later-life onset of AD, either directly or mediated by PTSD or PTSD correlates. In the second, de novo AD experiential trauma is associated with accelerated cognitive decline, either directly or mediated through PTSD or PTSD correlates. Evidence synthesized in this paper indicates that previous life trauma and PTSD are strong candidates as psychosocial risk factors for AD and warrant further empirical scrutiny. Psychosocial and neurological-based intervention implications are discussed. A biopsychosocial approach has the capacity to enhance understanding of individual AD trajectories, moving the field toward ‘person-centered’ models of care. • Alzheimer's disease is influenced by both neurological and psychosocial factors. • Trauma and PTSD are strong psychosocial risk factor candidates. • Earlier life trauma is associated with later-life Alzheimer's disease onset. • Alzheimer's disease experiential trauma associated with illness progression.",0 +https://doi.org/10.1038/sj.mp.4002054,Reduced GABAA benzodiazepine receptor binding in veterans with post-traumatic stress disorder,"-aminobutyric acid (GABAA) receptors are thought to play an important role in modulating the central nervous system in response to stress. Animal data have shown alterations in the GABAA receptor complex by uncontrollable stressors. SPECT imaging with benzodiazepine ligands showed lower distribution volumes of the benzodiazepine-GABAA receptor in the prefrontal cortex of patients with post-traumatic stress disorder (PTSD) in one, but not in another study. The objective of the present study was to assess differences in the benzodiazepine-GABAA receptor complex in veterans with and without PTSD using [C]flumazenil and positron emission tomography (PET). Nine drug naive male Dutch veterans with deployment related PTSD and seven male Dutch veterans without PTSD were recruited, and matched for age, region and year of deployment. Each subject received a [C]flumazenil PET scan and a structural magnetic resonance imaging scan. Dynamic 3D PET scans with a total duration of 60 min were acquired, and binding in template based and manually defined regions of interest (ROI) was quantified using validated plasma input and reference tissue models. In addition, parametric binding potential images were compared on a voxel-by-voxel basis using statistical parametric mapping (SPM2). ROI analyses using both template based and manual ROIs showed significantly reduced [C]flumazenil binding in PTSD subjects throughout the cortex, hippocampus and thalamus. SPM analysis confirmed these results. The observed global reduction of [C]flumazenil binding in patients with PTSD provides circumstantial evidence for the role of the benzodiazepine-GABAA receptor in the pathophysiology of PTSD and is consistent with previous animal research and clinical psychopharmacological studies. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1682/jrrd.2008.08.0119,Neuropsychiatric diagnosis and management of chronic sequelae of war-related mild to moderate traumatic brain injury,"Soldiers with a traumatic brain injury (TBI) present with an array of neuropsychiatric symptoms that can be grouped into nosological clusters: (1) cognitive dysfunctions: difficulties in memory, attention, language, visuospatial cognition, sensory-motor integration, affect recognition, and/or executive function typically associated with neocortical damage; (2) neurobehavioral disorders: mood, affect, anxiety, posttraumatic stress, and psychosis, as well as agitation, sleep problems, and libido loss, that may have been caused by damage to the cortex, limbic system, and/or brain stem monoaminergic projection systems; (3) somatosensory disruptions: impaired smell, vision, hearing, equilibrium, taste, and somatosensory perception frequently caused by trauma to the sensory organs or their projections through the brain stem to central processing systems; (4) somatic symptoms: headache and chronic pain; and (5) substance dependence. TBI-related cognitive impairment is common in veterans who have served in recent conflicts in the Middle East and is often related to blasts from improvised explosive devices. Although neurobehavioral disorders such as depression and posttraumatic stress disorder commonly occur after combat, the presentation of such disorders in those with head injury may pass undetected with use of current diagnostic criteria and neuropsychological instruments. With a multidimensional approach (such as the biopsychosocial model) applied to each symptom cluster, psychological, occupational, and social dysfunction can be delineated and managed.",0 +https://doi.org/10.1176/appi.ajp.160.7.1337,The Predictive Power of Peritraumatic Dissociation and Acute Stress Symptoms for Posttraumatic Stress Symptoms: A Three-Month Prospective Study,"The authors prospectively examined the power of peritraumatic dissociation and acute stress symptoms in predicting posttraumatic stress disorder (PTSD) symptoms.Thirty-five assault victims were assessed with the Peritraumatic Dissociative Experiences Questionnaire within 24 hours of the assault. Participants were reassessed 2 weeks after the trauma with the Stanford Acute Stress Reaction Questionnaire and 3 months after the trauma with the Clinician-Administered PTSD Scale and the Impact of Event Scale. Correlational analyses and a hierarchical multiple regression were conducted.Peritraumatic dissociation and acute stress symptoms were correlated with later PTSD symptoms and diagnosis. Together, peritraumatic dissociation and acute stress symptoms accounted for 33% of the variance in PTSD symptoms.These results support earlier findings that peritraumatic dissociative experiences and acute stress are robust predictors of PTSD. Such symptoms may be of use for identifying at an early stage individuals at highest risk of remaining symptomatic. Future studies should investigate the predictive power of specific peritraumatic and acute stress disorder symptom clusters.",0 +https://doi.org/10.1016/j.comppsych.2015.04.001,Peritraumatic tonic immobility in a large representative sample of the general population: association with posttraumatic stress disorder and female gender,"Tonic immobility is an involuntary response to inescapable life-threatening events. Peritraumatic tonic immobility has been reported in convenience samples of female victims of sexual assault and in mixed-gender victims of different types of trauma. This study evaluated peritraumatic tonic immobility in a representative general population sample and its association with posttraumatic stress disorder (PTSD) and gender.3231 victims of traumatic events aged 15-75 years responded to the Tonic Immobility Scale. PTSD and traumatic events were assessed using the Composite International Diagnostic Interview (CIDI 2.1). We calculated the means and the standard deviations of Tonic Immobility Scale scores stratified by PTSD and gender. The association between tonic immobility scores and gender was explored controlling for potential confounders through a multiple linear regression model.Tonic immobility scores were more than double in those who met criteria for PTSD and were almost four points higher in women. Gender differences remained statistically significant even after adjustment for confounding variables.The cross-sectional and retrospective design may have given rise to recall bias. Results presented here may not apply to small and medium rural areas and the CIDI 2.1 can lead to a certain degree of misclassification.We have expanded the scope of previous investigations on peritraumatic tonic immobility which were based on convenience samples only, showing its occurrence in victims of traumatic events using a large representative sample of the general population. Furthermore, we confirmed in an unbiased sample the association between peritraumatic tonic immobility and PTSD and female gender.",0 +https://doi.org/10.1016/j.psychres.2012.09.021,"Symptoms of prolonged grief, depression, and adult separation anxiety: Distinctiveness and correlates","Research has shown that prolonged grief disorder (PGD) is a disorder distinct from other disorders including major depression and posttraumatic stress disorder (PTSD). This study aimed to extend this research by examining the distinctiveness of symptoms of PGD relative to symptoms of adult separation anxiety disorder, also taking into account depression. Data were available from 205 bereaved individuals who completed measures tapping these symptoms together with a complementary measure of mental and physical health. Findings showed that symptoms of PGD, depression, and adult separation anxiety disorder were better conceptualized as distinct dimensions instead of a unitary dimension of distress. Correlations between the three symptom clusters were moderate to large. Cause of loss was the single variable that was associated with all three symptom clusters with loss due to violent cause giving rise to more severe symptoms. All three symptom clusters were associated with lower concurrent mental and physical health.",0 +https://doi.org/10.3390/ijerph10062515,"A Cross-Sectional, Randomized Cluster Sample Survey of Household Vulnerability to Extreme Heat among Slum Dwellers in Ahmedabad, India","Extreme heat is a significant public health concern in India; extreme heat hazards are projected to increase in frequency and severity with climate change. Few of the factors driving population heat vulnerability are documented, though poverty is a presumed risk factor. To facilitate public health preparedness, an assessment of factors affecting vulnerability among slum dwellers was conducted in summer 2011 in Ahmedabad, Gujarat, India. Indicators of heat exposure, susceptibility to heat illness, and adaptive capacity, all of which feed into heat vulnerability, was assessed through a cross-sectional household survey using randomized multistage cluster sampling. Associations between heat-related morbidity and vulnerability factors were identified using multivariate logistic regression with generalized estimating equations to account for clustering effects. Age, preexisting medical conditions, work location, and access to health information and resources were associated with self-reported heat illness. Several of these variables were unique to this study. As sociodemographics, occupational heat exposure, and access to resources were shown to increase vulnerability, future interventions (e.g., health education) might target specific populations among Ahmedabad urban slum dwellers to reduce vulnerability to extreme heat. Surveillance and evaluations of future interventions may also be worthwhile.",0 +https://doi.org/10.4088/jcp.08m04794gre,Does Comorbid Posttraumatic Stress Disorder Affect the Severity and Course of Psychotic Major Depressive Disorder?,"Major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) are commonly comorbid conditions that result in greater severity, chronicity, and impairment compared with either disorder alone. However, previous research has not systematically explored the potential effects of the psychotic subtyping of MDD and comorbid PTSD.The sample in this retrospective case-control study conducted from December 1995 to August 2006 consisted of psychiatric outpatients with DSM-IV-diagnosed psychotic MDD with PTSD, psychotic MDD without PTSD, or nonpsychotic MDD with PTSD presenting for clinic intake. Clinical indices of severity, impairment, and history of illness were assessed by trained diagnosticians using the Structured Clinical Interview for DSM-IV Axis I Disorders supplemented by items from the Schedule for Affective Disorders and Schizophrenia.In terms of current severity and impairment, the psychotic MDD with PTSD (n = 34) and psychotic MDD only (n = 26) groups were similar to each other, and both tended to be more severe than the nonpsychotic MDD with PTSD group (n = 263). In terms of history of illness, the psychotic MDD with PTSD group tended to show greater severity and impairment relative to either the psychotic MDD only or nonpsychotic MDD with PTSD groups. Furthermore, the psychotic MDD with PTSD patients had an earlier time to depression onset than patients with either psychotic MDD alone or nonpsychotic MDD with PTSD, which appeared to contribute to the poorer history of illness demonstrated in the former group.Future research should explore the possibility of a subtype of psychotic depression that is associated with PTSD, resulting in a poorer course of illness. The current findings highlight the need for pharmacologic and psychotherapeutic approaches that can be better tailored to psychotic MDD patients with PTSD comorbidity.",0 +https://doi.org/10.1007/0-387-25610-5_4,Posttraumatic Disorders Following Injury: Assessment and Other Methodological Considerations,"Physical injury in civilian populations is a frequent event. In 2000, 11% of the U.S. population (approximately 30 million people) were treated in emergency departments following nonfatal injuries (National Centre for Injury Prevention and Control-Electronic Database, 2000). Not only does injury occur frequently, but it often occurs at a severity to be classified as a traumatic event. Breslau et al. (1991) found that a lifetime prevalence of serious injury or serious motor vehicle crash was 41.9%, rating second in frequency of traumatic events. The conditional risk for developing Posttraumatic Stress Disorder (PTSD) following serious accidents and injury is relatively low (Kessler et al., 1995); that is, the risk of developing PTSD in all those who are exposed to traumatic injury is low relative to other traumatic events such as interpersonal violence (Breslau et al., 1998). Nevertheless, serious injury is a leading cause of PTSD because of the frequency with which injury occurs. For example, Breslau et al. (1998) found that serious injury accounted for nearly one-quarter of the PTSD cases in their community sample. This was also the case in both the National Comorbidity Survey (Kessler et al., 1995) and the equivalent Australian study (Creamer et al., 2001). Taken together, although the conditional risk of developing PTSD following serious injury is low, the substantial frequency with which injury occurs makes injury one of the most frequent causes of PTSD. This chapter aims to orient both practitioner and researcher to the current status of research regarding PTSD following injury. However, when evaluating this literature and when conducting assessments with injury survivors, researchers and practitioners alike must be cognizant of a number of key issues that may impact on the diagnosis of PTSD. These factors include the following: differentiating among the physical, psychological, and environmental origin of symptoms; head injury and how it complicates assessment; the impact of secondary stressors; the influence of medications on symptom presentation; and the role of litigation. Appropriate attention to these factors will help to optimize the reliability and consistency of mental health assessments following injury.",0 +https://doi.org/10.1371/journal.pone.0019855,Signs of Mood and Anxiety Disorders in Chimpanzees,"In humans, traumatic experiences are sometimes followed by psychiatric disorders. In chimpanzees, studies have demonstrated an association between traumatic events and the emergence of behavioral disturbances resembling posttraumatic stress disorder (PTSD) and depression. We addressed the following central question: Do chimpanzees develop posttraumatic symptoms, in the form of abnormal behaviors, which cluster into syndromes similar to those described in human mood and anxiety disorders?In phase 1 of this study, we accessed case reports of chimpanzees who had been reportedly subjected to traumatic events, such as maternal separation, social isolation, experimentation, or similar experiences. We applied and tested DSM-IV criteria for PTSD and major depression to published case reports of 20 chimpanzees identified through PrimateLit. Additionally, using the DSM-IV criteria and ethograms as guides, we developed behaviorally anchored alternative criteria that were applied to the case reports. A small number of chimpanzees in the case studies met DSM-IV criteria for PTSD and depression. Measures of inter-rater reliability, including Fleiss' kappa and percentage agreement, were higher with use of the alternative criteria for PTSD and depression. In phase 2, the alternative criteria were applied to chimpanzees living in wild sites in Africa (n = 196) and chimpanzees living in sanctuaries with prior histories of experimentation, orphanage, illegal seizure, or violent human conflict (n = 168). In phase 2, 58% of chimpanzees living in sanctuaries met the set of alternative criteria for depression, compared with 3% of chimpanzees in the wild (p = 0.04), and 44% of chimpanzees in sanctuaries met the set of alternative criteria for PTSD, compared with 0.5% of chimpanzees in the wild (p = 0.04).Chimpanzees display behavioral clusters similar to PTSD and depression in their key diagnostic criteria, underscoring the importance of ethical considerations regarding the use of chimpanzees in experimentation and other captive settings.",0 +https://doi.org/10.1097/00006842-199703000-00003,"Posttraumatic Stress Symptoms, Intrusive Thoughts, Loss, and Immune Function after Hurricane Andrew","To examine the impact of and relationship between exposure to Hurricane Andrew, a severe stressor, posttraumatic stress symptoms and immune measures.Blood draws and questionnaires were taken from community volunteer subjects living in the damaged neighborhoods between 1 and 4 months after the Hurricane.The sample exhibited high levels of posttraumatic stress symptoms by questionnaire (33% overall; 76% with at least one symptom cluster), and 44% scored in the high impact range on the Impact of Events (IES) scale. A substantial proportion of variance in posttraumatic stress symptoms could be accounted for by four hurricane experience variables (damage, loss, life threat, and injury), with perceived loss being the highest correlate. Of the five immune measures studied Natural Killer Cell Cytotoxicity (NKCC) was the only measure that was meaningfully related (negatively) to both damage and psychological variables (loss, intrusive thoughts, and posttraumatic stress disorder (PTSD). White blood cell counts (WBCs) were significantly positively related with the degree of loss and PTSD experienced. Both NKCC (lower) and WBC were significantly related to retrospective self-reported increase of somatic symptoms after the hurricane. Overall, the community sample was significantly lower in NKCC, CD4 and CD8 number, and higher in NK cell number compared to laboratory controls. Finally, evidence was found for new onset of sleep problems as a mediator of the posttraumatic symptom-NKCC relationship.Several immune measures differed from controls after Hurricane Andrew. Negative (intrusive) thoughts and PTSD were related to lower NKCC. Loss was a key correlate of both posttraumatic symptoms and immune (NKCC, WBC) measures.",0 +https://doi.org/10.1159/000093522,Full and Partial Post-Traumatic Stress Disorder among World War II Prisoners of War,"<i>Background:</i> The aim of the study is to evaluate the frequency and characteristics of full and partial post-traumatic stress disorder (PTSD) among 66 World War II Nazi prisoners of war, some of whom had been deported to death camps. <i>Methods:</i> The Structured Clinical Interview for DSM-IV was used to assess the presence of PTSD and major depression. The Dissociative Experiences Scale and the 58-item version of the Hopkins Symptom Checklist were also administered. Partial PTSD was defined as the presence of at least one symptom in each of the clusters defined by DSM-IV. <i>Results:</i> Forty-eight percent of the subjects have a partial PTSD, while 20% reported the full syndrome. When compared to subjects with full PTSD, those with partial PTSD showed a significantly lower frequency of comorbid depression and lower levels of psychological distress, as measured by the Symptom Checklist. No differences were found with regards to dissociative symptoms and help-seeking. <i>Conclusions:</i> The problem of definition of PTSD partial syndromes deserves more attention in the literature.",0 +https://doi.org/10.1007/978-1-60327-329-9_1,"Post-Traumatic Stress Disorder: Definition, Prevalence, and Risk Factors","In this chapter, we provide the definition and diagnostic criteria for post-traumatic stress disorder (PTSD). Next, the prevalence data for this disorder are reviewed, with a particular focus on how prevalence rates vary with demographic characteristics (e.g., gender) and trauma type. The literature on risk and resilience factors for the development and maintenance of PTSD is then discussed. The chapter concludes with a discussion of contemporary statistical methods that may be used to advance our knowledge and understanding of PTSD.",0 +https://doi.org/10.1007/s00127-008-0446-6,Early childhood behavior trajectories and the likelihood of experiencing a traumatic event and PTSD by young adulthood,"This study modeled children's trajectories of teacher rated aggressive-disruptive behavior problems assessed at six time points between the ages of 6 and 11 and explored the likelihood of being exposed to DSM-IV qualifying traumatic events and posttraumatic stress disorder (PTSD) in 837 urban first graders (71% African American) followed-up for 15 years. Childhood trajectories of chronic high or increasing aggressive-disruptive behavior distinguished males more likely to be exposed to an assaultive violence event as compared to males with a constant course of low behavior problems (OR(chronic high) = 2.8, 95% CI = 1.3, 6.1 and OR(increasing) = 4.5, 95% CI = 2.3, 9.1, respectively). Among females, exposure to traumatic events and vulnerability to PTSD did not vary by behavioral trajectory. The findings illustrate that repeated assessments of disruptive classroom behavior during early school years identifies more fully males at increased risk for PTSD-level traumatic events, than a single measure at school entry does.",0 +https://doi.org/10.1093/ptr/10.4.435,Attachment Patterns and Working Alliance in Trauma Therapy for Victims of Political Violence,"We examined the development of alliance in therapy in different attachment groups in a naturalistic setting. The participants were 36 self-referred Palestinian political ex-prisoners, who were victims of torture and ill treatment and had sought psychotherapy. Their therapy lasted for 10-12 months. The analyses showed that the development of alliance during therapy followed different patterns across the attachment groups. Yet early alliance did not differ between the groups. For the autonomous individuals, alliance dropped in the middle of therapy, and increased back to its initial level by the end. Similarly, for the preoccupied individuals alliance decreased steeply in the middle of the therapy, and then increased even more steeply by the end. In contrast, for the dismissing individuals, alliance was approximately the same at the beginning and in the middle of the therapy, and then it decreased at the end.",0 +https://doi.org/10.1523/jneurosci.4450-05.2006,Chronic Stress Increases the Plasmalemmal Distribution of the Norepinephrine Transporter and the Coexpression of Tyrosine Hydroxylase in Norepinephrine Axons in the Prefrontal Cortex,"Norepinephrine (NE) potently modulates the cognitive and affective functions of the prefrontal cortex (PFC). Deficits in NE transmission are implicated in psychiatric disorders, and antidepressant drugs that block the NE transporter (NET) effectively treat these conditions. Our initial ultrastructural studies of the rat PFC revealed that most NE axons (85–90%) express NET primarily within the cytoplasm and lack detectable levels of the synthetic enzyme tyrosine hydroxylase (TH). In contrast, the remaining 10–15% of PFC NE axons exhibit predominantly plasmalemmal NET and evident TH immunoreactivity. These unusual characteristics suggest that most PFC NE axons have an unrecognized, latent capacity to enhance the synthesis and recovery of transmitter. In the present study, we used dual-labeling immunocytochemistry and electron microscopy to examine whether chronic cold stress, a paradigm that persistently increases NE activity, would trigger cellular changes consistent with this hypothesis. After chronic stress, neither the number of profiles exhibiting NET labeling nor their size was changed. However, the proportion of plasmalemmal NET nearly doubled from 29% in control animals to 51% in stressed rats. Moreover, the expression of detectable TH in NET-labeled axons increased from only 13% of profiles in control rats to 32% of profiles in stressed animals. Despite the consistency of these findings, the magnitude of the changes varied across individual rats. These data represent the first demonstration of activity-dependent trafficking of NET and expression of TH under physiological conditions and have important implications for understanding the pathophysiology and treatment of stress-related affective disorders.",0 +https://doi.org/10.1080/10615800902855781,Coping with displacement from Hurricane Katrina: predictors of one-year post-traumatic stress and depression symptom trajectories,"Abstract This study examined predictors of symptom trajectories of 93 adult survivors of Hurricane Katrina who were displaced and relocated to Colorado. Survivors were interviewed within six months of the hurricane and then again six months later. Four symptom trajectories were identified for clinical levels of depression and post-traumatic stress: resilient, recovered, delayed onset, and chronic. High levels of adaptive coping and coping efficacy characterized the resilient groups and low levels of both characterized the chronic groups. The recovered groups were characterized by low levels of adaptive coping coupled with high coping efficacy, and the delayed groups were characterized by high secondary control coping in the presence of low primary control coping, though some symptom-specific differences were found for these two groups. African American (67%) participants did not differ from European American (28%) participants in terms of membership in trajectory groups, though analyses revealed that displacement stress and positive religious coping were especially relevant predictors for African American participants. The results are interpreted in light of the Conservation of Resources Theory (Hobfoll, 2001) and implications for treatment and preventive intervention are discussed.",0 +https://doi.org/10.1007/s11896-009-9052-0,Risk and Resilience Factors among Italian Municipal Police Officers Exposed to Critical Incidents,Police officers are exposed to critical events as part of their duty which can affect their well-being. The present study examines the relationships between risk and protective factors and health outcome following critical incident exposure among police officers. Person-oriented analyses were applied to questionnaire data from a sample of 509 Italian municipal police officers. Two groups with different patterns of risk and protective factors were found by cluster analysis. One group (resilient officers) had higher levels of protective factors such as self-esteem and social support and lower levels of risk factors such as peritraumatic distress and perceived threat in comparison to the other group (non resilient police officers). The resilient group reported fewer traumatic stress reactions than the non resilient group in spite of a similar degree of exposure to critical incidents and better health than expected in spite of severe abuse. The two groups differed according to sleeping pills use but not for alcohol and smoking habits. Risk and protective factors could offer an explanation of resilience as an outcome. (,0 +https://doi.org/10.1111/j.1365-2850.2011.01702.x,The prevalence of long-term post-traumatic stress symptoms among adolescents after the tsunami in Aceh,"The aim of this study was to identify long-term post-traumatic stress disorder (PTSD) symptoms in Aceh 4.5 years after the tsunami and to examine whether certain factors affected the severity of PTSD symptoms among adolescents. The PTSD symptoms of 482 adolescents aged 11 to 19 years were assessed according to the Child Post-Traumatic Stress Reaction Index (CPTSD-RI). The severity of the disaster was identified by the Traumatic Exposure Severity Scale (TESS). Of the adolescents who completed the questionnaire, 54 (11.2%), 124 (25.7%), 196 (40.7%), 103 (21.4%) and 5 (1%), respectively, reported none, mild, moderate, severe and very severe symptoms on CPTSD-RI. Gender, loss of parents, somatic response and support level were significantly associated with the total score on CPTSD-RI (P < 0.05). The TESS-Occurrence Scale and CPTSD-RI were significantly correlated (r= 0.33, P < 0.05). The TESS-Distress Scale was significantly correlated with CPTSD-RI (r= 0.48, P < 0.05). The study indicated that the symptoms of PTSD, ranging from very severe to moderate, could persist for a long time after the tsunami and be affected by gender, loss of parents, somatic response, support level and severity of the disaster.",0 +https://doi.org/10.1177/0020764014547062,Long-term mental health outcome in post-conflict settings: Similarities and differences between Kosovo and Rwanda,"Background: Few studies investigated the long-term mental health outcome in culturally different post-conflict settings. This study considers two surveys conducted in Kosovo 8 years after the Balkans war and in Rwanda 14 years after the genocide. Methods: All participants ( n = 864 in Kosovo; n = 962 in Rwanda) were interviewed using the posttraumatic stress disorder (PTSD) and major depressive episode (MDE) sections of the Mini International Neuropsychiatric Interview (MINI) and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Results: Proportions of participants who met diagnostic criteria for either PTSD or MDE were 33.0% in Kosovo and 31.0% in Rwanda, with co-occurrence of both disorders in 17.8% of the Rwandan sample and 9.5% of the Kosovan sample. Among patients with PTSD, patterns of symptoms significantly differed in the two settings, with avoidance and inability to recall less frequent and sense of a foreshortened future and increased startle response more common in Rwanda. Significant differences were also observed in patients with MDE, with loss of energy and difficulties concentrating less frequent and suicidal ideation more common in Rwanda. Comorbid PTSD and MDE were associated with decreased SF-36 subjective mental and physical health scores in both settings, but significantly larger effects in Kosovo than in Rwanda. Conclusion: Culturally different civilian populations exposed to mass trauma may differ with respect to their long-term mental health outcome, including comorbidity, symptom profile and health perception.",0 +https://doi.org/10.1002/jts.20484,Longitudinal mental health screening results among postdeployed U.S. soldiers preparing to deploy again,"Mental health concerns have been documented in soldiers postdeployed from Iraq or Afghanistan, but information is limited regarding individuals directed to deploy again. Routine screening assessed symptoms of posttraumatic stress disorder, depression, anxiety, panic, and hazardous alcohol consumption among 443 soldiers after returning from deployment and again before the next deployment. Initial rates for meeting screening criteria were under 9% with most around 5%. The average number of symptoms reported for depression, anxiety, and alcohol consumption decreased from first to second screening, as did the percentage of participants who met screening criteria for hazardous alcohol consumption. No change was observed on other screening measures. The findings suggest that mental health symptoms remain stable or decline for soldiers repeating deployment.",0 +,"Serum chemical profile of feeder pigs, as influenced by market stress and feeding regimen.","Two hundred eighty-eight crossbred feeder pigs were used in 2 trials to determine the effects of feed and/or water deprivation at an auction market, and the effects of restricting the intake of the receiving diet on their serum chemical profile. The study also was designed to assess the value of the serum chemical profile as a diagnostic data base for stress disorders in feeder pigs. Performance data indicated that feeder pigs provided water only at the auction facilities lost significantly more weight than did those provided feed and water. Feeder pigs deprived of both feed and water were not significantly different in body weight from either group. Several serum chemical values (creatinine, triglycerides, cholesterol, blood urea nitrogen, and lactate dehydrogenase) were significantly influenced by feed deprivation, but not by feed and water deprivation. However, only the serum creatinine values were significantly different after the 24-hour posttransport period. There were no significant differences in pig weight or serum chemical values 84 days after pigs had arrived at the finishing unit. The serum chemical profile, widely used in human medicine, appears not to provide a reliable marker for identification of short-term nutritional deprivation, nor for transport stress in feeder pigs.",0 +https://doi.org/10.1016/j.psychres.2006.07.008,Delayed recall of childhood sexual abuse memories and the awakening rise and diurnal pattern of cortisol,"Traumatic stress associated with childhood sexual abuse (CSA) may result in chronic alterations of stress-sensitive neurochemical systems (e.g., the hypothalamic-pituitary-adrenal axis and sympathetic-adrenal medullary activity). Some authors have suggested that these alterations might help explain why some individuals, after a period of inability to remember, demonstrate delayed recall of CSA memories (i.e., ""recovered"" memories). The present study is the first study that explored morning cortisol responses and circadian cortisol profiles among women with recovered (n=7), repressed (n=8), or continuous (n=6) memories of CSA and women without a history of CSA (n=9). Although there were group differences in current depression and post-traumatic stress symptoms, we found no differences in cortisol awakening response or daytime profile between women reporting recovered, repressed, or continuous memories of CSA as compared to women without a history of CSA. Implications for neurobiological models intended to explain the delayed recall of CSA are discussed.",0 +,Posttraumatic Stress Disorder Among Firearm Assault Survivors: Risk and Resiliency Factors in Recovery from Violent Victimization,"Firearm violence in the United States has reached epidemic proportions, and yet little is known about the psychosocial impact of firearm assault on its survivors. This study set out to: (1) determine the rate of chronic Posttraumatic Stress Disorder (PTSD), and (2) to identify pre-assault factors, assault characteristics, and factors in the post-assault recovery environment that serve as risk or protective factors for the development of PTSD in a sample of firearm assault survivors. In addition, a qualitative analysis drew upon in-depth interviews with six firearm assault survivors about their recovery experience. Fifty-five firearm assault survivors recruited from an urban trauma center completed a number of measures assessing pre-assault factors, assault characteristics, factors in the post-assault recovery environment, and PTSD symptomatology. Fifty-eight percent of the sample met full diagnostic criteria for PTSD 3 to 36 months post-assault. Hierarchical multiple regression analysis supported a model in which negative change of outlook, assault severity, and adopting safeguarding behaviors served as risk factors for the presence of PTSD after firearm assault; while social support operated as a resiliency factor protecting individuals from development of PTSD after severe violent victimization. Qualitative analysis revealed a number of commonalities in the recovery experience for both impaired and resilient survivors. The findings suggest that firearm assault survivors are at high risk for the development of chronic PTSD. Further, the use of a high-risk screening tool that assesses risk and protective factors for the development of chronic PTSD may have important clinical applications in identifying victims most in need of clinical intervention. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1080/10538712.2014.964440,Impact of Traumatic Events on Posttraumatic Stress Disorder among Danish Survivors of Sexual Abuse in Childhood,"Childhood sexual abuse can be extremely traumatic and lead to lifelong symptomatology. The present study examined the impact of several demographic, abuse, and psychosocial variables on posttraumatic stress disorder severity among a consecutive sample of treatment-seeking, adult child sexual abuse survivors (N = 480). The child sexual abuse sample was characterized by severe trauma exposure, insecure attachment, and significant traumatization, with an estimated 77% suffering from posttraumatic stress disorder, more than twice the level of the comparison group. Regression analyses revealed risk factors associated with the development of posttraumatic stress disorder in which the strongest predictors being additional traumas, negative affectivity, and somatization. The findings add to existing research confirming the stressful nature of child sexual abuse and the variables that contribute to the development and severity of posttraumatic stress disorder.",0 +https://doi.org/10.1080/00207140208410089,Hypnotizability and trauma symptoms after burn injury,"This study investigated the association of trauma symptoms and hypnotizability in 43 hospitalized survivors of burn injury. Three to 17 days after the injury, participants rated the frequency of intrusive and avoidance symptoms and were interviewed with the posttraumatic stress disorder module of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-III-R. The Hypnotic Induction Profile was also administered at the postburn, hospital stage of recovery. Results indicated that when participants were divided into low, mid-range, and high hypnotizability categories, high hypnotizability was associated with more intrusive, avoidance, and arousal symptoms. Although causal relations cannot be assessed in this cross-sectional study, these results suggest that, as compared to the low and mid-range categories, high hypnotizables may experience a greater frequency of trauma symptoms after burn injury.",0 +https://doi.org/10.1177/0020764013502469,"The interrelationships between moral attitudes, posttraumatic stress disorder symptoms and mixed lateral preference in Israeli reserve combat troops","Background: Combat soldiers often encounter moral dilemmas during operational deployment, especially when an armed engagement is situated within a civilian setting. The study of moral dilemmas and posttraumatic stress disorder (PTSD) has mostly focused on the impact of war atrocities and moral injury. However, the relationship between moral attitudes and different combat-related pathologies has not been thoroughly addressed by quantitative studies. Aims: We aimed to assess the relationship between combatant’s moral attitudes, severity of PTSD symptoms and mixed lateral preference. Methods: Data on moral objection, PTSD severity and lateral preference were collected in a right-handed non-pathologic sample ( n = 147) of reserve combat troops in the Israel Defense Forces (IDF). Results: Nearly one-fifth (19.7%) of the reserve personnel who served in the occupied territories have reported high moral objection to the commands they were expected to act upon. This group of participants exhibited more PTSD symptoms and higher levels of mixed lateral preference. Multiple linear regression analyses revealed a mediating role of moral objection in the relationship between PTSD symptoms severity and lateral preference. Conclusions: Our findings suggest that moral objection has significant implications on combatant’s psychological and organic well-being. The findings highlight the need to include moral attitudes in research and clinical practice among combat personnel and veterans.",0 +https://doi.org/10.1016/j.neubiorev.2004.08.010,Psychological intimate partner violence: the major predictor of posttraumatic stress disorder in abused women,"Intimate partner violence (IPV) significantly impacts women mental and physical wellbeing and therefore represents a worldwide public health problem. A clear association between IPV and increased risk to develop posttraumatic stress disorder (PTSD) has been documented. However, few studies examined how different features of IPV (physical, psychological, sexual) interact with other traumatic stress experiences (physical, psychological and sexual childhood abuse and adulthood victimization by other/s than the partner) in determining PTSD. Women abused by the partner ( n =75) were compared with non-abused control women ( n =52). Information about sociodemographic profile and relevant personal characteristics was obtained through structured interviews. A comprehensive questionnaire was designed for a face-to-face interview in order to obtain detailed information about duration and frequency of the different types of violent acts above mentioned. The incidence and severity of symptoms of current PTSD were assessed with Echeburua's Severity of Symptom Scale of Posttraumatic Stress Disorder, a structured interview based on DSM-IV criteria. Women suffering from IPV had a significantly higher rate of PTSD symptomatology as compared to control women, whereas childhood abuse variables did not explain PTSD score variance. In addition, the severity of IPV was significantly and positively correlated with the intensity of PTSD symptoms. Women involved in an abusive relationship were more frequently exposed to other experiences of adulthood victimization, suggesting that their higher PTSD vulnerability could be a result of cumulative traumatic experiences. A relevant result of the correlation analysis was the strong, positive association between PTSD and each different type of IPV. In particular, the psychological component of intimate partner violence was the strongest predictor of posttraumatic stress disorder. This study underlines the importance of separating the effects of the different types of intimate partner abuse when taking into account its effects on women mental health.",0 +https://doi.org/10.1093/jurban/jti028,"Men's Pathways to Risky Sexual Behavior: Role of Co-Occurring Childhood Sexual Abuse, Posttraumatic Stress Disorder, and Depression Histories","Recent reports of sexually transmitted infection-rate increases among men indicate the need for renewed study of male sexual risk behavior to aid development of updated and novel risk reduction interventions. Men who have childhood sexual abuse (CSA) histories consistently report frequent sexual risk behavior. The objective of this sturdy is to explore whether posttraumatic stress disorder (PTSD) and depression are moderators and/or mediators of the association between CSA and sexual risk in adult men. A cross-sectional survey study employing random digit dial recruitment was administered to men aged 18-49 years from Philadelphia County. Two hundred ninety eight men were recruited and screened for CSA history, administered items from the Posttraumatic Stress Diagnostic Scale (PDS) and Center for Epidemiologic Studies- Depression (CES-D), and asked to estimate their number of lifetime sexual partners (LSPs). Effects of sociodemographic characteristics, CSA, PTSD, and depression on the number of LSPs were modeled using Poisson regression. Results show that 197 (66%) men participated; 43 (22%) had CSA histories. CSA was significantly associated with PTSD/depression (P=.03). Four sociodemographic variables (age, race, sexual identity, and education), CSA (incidence rate ratio, IRR=1.47, P<.001), PTSD (IRR=1.19, P=.04), depression (IRR=1.29, P=.001), all 2-way interactions, and the 3-way CSA/PTSD/depression interaction (IRR=11.00, P<.001) were associated with the number of LSPs (R2=0.27). In conclusion, sexual partnership patterns unique to men with CSA histories and comorbid PTSD/depression appear to lead to substantially higher numbers of LSPs. Estimates of this relationship may have been biased toward the null by underreporting that can occur with phone surveys. Cross-sectional studies do not support causal inferences; however, the identification of a moderating and mediating influence of PTSD/depression on the relationship between CSA and sexual risk behavior is important and suggests the need for future studies with larger samples that examine trajectories for CSA, psychiatric illness, and sexual partnerships.",0 +https://doi.org/10.1093/ije/dyp394,Cohort Profile: The Study of Health in Pomerania,"Henry Volzke, y Dietrich Alte,1y Carsten Oliver Schmidt, Dorte Radke, Roberto Lorbeer, Nele Friedrich, Nicole Aumann, Katharina Lau, Michael Piontek, Gabriele Born, Christoph Havemann, Till Ittermann, Sabine Schipf, Robin Haring, Sebastian E Baumeister, Henri Wallaschofski, Matthias Nauck, Stephanie Frick, Andreas Arnold, Michael Junger, Julia Mayerle, Matthias Kraft, Markus M Lerch, Marcus Dorr, Thorsten Reffelmann, Klaus Empen, Stephan B Felix, Anne Obst, Beate Koch, Sven Glaser, Ralf Ewert, Ingo Fietze, Thomas Penzel, Martina Doren, Wolfgang Rathmann, Johannes Haerting, Mario Hannemann, Jurgen Ropcke, Ulf Schminke, Clemens Jurgens, Frank Tost, Rainer Rettig, Jan A Kors, Saskia Ungerer, Katrin Hegenscheid, Jens-Peter Kuhn, Julia Kuhn, Norbert Hosten, Ralf Puls, Jorg Henke, Oliver Gloger, Alexander Teumer, Georg Homuth, Uwe Volker, Christian Schwahn, Birte Holtfreter, Ines Polzer, Thomas Kohlmann, Hans J Grabe, Dieter Rosskopf, Heyo K Kroemer, Thomas Kocher, Reiner Biffar,17,y Ulrich John20y and Wolfgang Hoffmann1y",0 +https://doi.org/10.3389/fnbeh.2014.00142,An updated animal model capturing both the cognitive and emotional features of post-traumatic stress disorder (PTSD),"The new-released Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines post-traumatic stress disorder (PTSD) as a ""trauma and stressor-related disorder"". PTSD pathogenesis relies on paradoxical changes of emotional memory processing induced by the trauma exposure and associated with emotional dysfunction. Several animal models of PTSD have been validated and are currently used. Each one mimics a particular subset of the disorder with particular emphasis, mainly driven by the past classification of PTSD in the DSM-4, on the emotional features. In view of the recent update in the DSM-5, our aim was to develop, by using well-validated paradigms, a modified model of PTSD able to mimic at the same time both the cognitive and emotional features of the disease. We exposed male rats to either a piece of worn cat collar or to a series of inescapable footshocks paired with a PTSD risk factor, i.e., social isolation. Animals were subsequently re-exposed to the conditioned contexts at different time intervals in order to test memory retention for the stressors. In addition, footshock-exposed rats were tested in the elevated-plus-maze and social interaction tests. We found that rats exposed to a cat collar exhibited an acute fear response that did not lead to enduring memory retention. Conversely, footshock-exposed rats expressed a successful retention of the stressful experience at 1, 7, 14, 21 and 56 post-exposure days. Footshock-exposed rats displayed an anxious behavioral profile in the social interaction test and a significantly reduced locomotor activity in the elevated-plus-maze test. These dysfunctions were not observed when animals were socially housed, thus highlighting a social buffering effect in the development of the pathology. Our results underline the good validity of a footshock-based paradigm paired with social isolation as a PTSD animal model, able to mimic at the same time both some of the enduring cognitive and emotional facets of the pathology.",0 +https://doi.org/10.1002/sim.2273,Power analyses for correlations from clustered study designs,"Power analysis constitutes an important component of modern clinical trials and research studies. Although a variety of methods and software packages are available, almost all of them are focused on regression models, with little attention paid to correlation analysis. However, the latter is arguably a simpler and more appropriate approach for modelling concurrent events, especially in psychosocial research. In this paper, we discuss power and sample size estimation for correlation analysis arising from clustered study designs. Our approach is based on the asymptotic distribution of correlated Pearson-type estimates. Although this asymptotic distribution is easy to use in data analysis, the presence of a large number of parameters creates a major problem for power analysis due to the lack of real data to estimate them. By introducing a surrogacy-type assumption, we show that all nuisance parameters can be eliminated, making it possible to perform power analysis based only on the parameters of interest. Simulation results suggest that power and sample size estimates obtained under the proposed approach are robust to this assumption.",0 +https://doi.org/10.1002/jts.20058,Risk and resilience in canine search and rescue handlers after 9/11,"Research has suggested that rescue workers are at increased risk for psychological distress. To determine whether 9/11 deployment was a significant risk factor for canine search and rescue handlers, 82 deployed handlers were compared to 32 nondeployed handlers on measures of posttraumatic stress disorder (PTSD), depression, anxiety, acute stress, and clinical diagnoses. Deployed handlers reported more PTSD and general psychological distress 6 months after 9/11. Among deployed handlers, prior diagnoses and peritraumatic reactions were associated with psychological distress whereas social support and training were protective. Results suggest that more extensive screening and prophylactic interventions for individuals with a history of mental illness could be beneficial. Future research should examine identified risk/resilience factors prospectively, and training and intervention should be designed accordingly.",0 +https://doi.org/10.1177/1363461508089764,Coming to Our Senses: Appreciating the Sensorial in Medical Anthropology,"This article supports the call for the sensorially engaged anthropological study of healing modalities, popular health culture, dietary practices, drug foods and pharmaceuticals, and idioms of distress. Six concepts are of central importance to sensorial anthropology: embodiment, the mindful body, mimesis, local biology, somatic idioms of distress, and 'the work of culture'. Fieldwork in South and Southeast Asia and North America illustrates how cultural interpretations associate bodily sensations with passions (strong emotions) and anxiety states, and bodily communication about social relations. Lay interpretations of bodily sensations inform and are informed by local understanding of ethnophysiology, health, illness, and the way medicines act in the body. Bodily states are manipulated by the ingestion of substances ranging from drug foods (e.g., sources of caffeine, nicotine, dietary supplements) to pharmaceuticals that stimulate or suppress sensations concordant with cultural values, work demands, and health concerns. Social relations are articulated at the site of the body through somatic modes of attention that index bodily ways of knowing learned through socialization, bodily memories, and the ability to relate to how another is likely to be feeling in a particular context. Sensorial anthropology can contribute to the study of transformative healing and trajectories of healthcare seeking and patterns of referral in pluralistic healthcare arenas.",0 +https://doi.org/10.1034/j.1600-0447.108.s419.1.x,Psychopharmacological treatment with lithium and antiepileptic drugs: suggested guidelines from the Danish Psychiatric Association and the Child and Adolescent Psychiatric Association in Denmark,"A subcommittee under the Danish Psychiatric Association and the Child and Adolescent Psychiatric Association in Denmark have recently developed national guidelines for the psychopharmacological treatment with lithium and antiepileptic drugs, and the present translation aims at contributing to the international discussion on the development of proper guidelines for the treatment of bipolar disorder. Among the antiepileptic drugs, the report deals with valproate, carbamazepine and lamotrigine and to a lesser extent with oxcarbazepine, gabapentin and topiramate. The various drugs will be reviewed, outlining the scientific evidence for mood-stabilizing properties and discussing major side effects, the most important interactions with other drugs and practical use. Special considerations during pregnancy and lactation, during treatment of children and adolescents and during treatment of the elderly will also be presented. Antidepressants and antipsychotics are beyond the scope of the report, but due to the mood-stabilizing properties of at least some of the atypical antipsychotics, these agents will be brought into some focus in connection with the overall treatment guidelines for the different phases of bipolar disorder given at the end of this report.",0 +https://doi.org/10.1186/1753-2000-6-15,Cost-utility analysis of different treatments for post-traumatic stress disorder in sexually abused children,"Post-traumatic stress disorder (PTSD) is diagnosed in 20% to 53% of sexually abused children and adolescents. Living with PTSD is associated with a loss of health-related quality of life. Based on the best available evidence, the NICE Guideline for PTSD in children and adolescents recommends cognitive behavioural therapy (TF-CBT) over non-directive counselling as a more efficacious treatment.A modelled economic evaluation conducted from the Australian mental health care system perspective estimates incremental costs and Quality Adjusted Life Years (QALYs) of TF-CBT, TF-CBT combined with selective serotonin reuptake inhibitor (SSRI), and non-directive counselling. The ""no treatment"" alternative is included as a comparator. The first part of the model consists of a decision tree corresponding to 12 month follow-up outcomes observed in clinical trials. The second part consists of a 30 year Markov model representing the slow process of recovery in non-respondents and the untreated population yielding estimates of long-term quality-adjusted survival and costs. Data from the 2007 Australian Mental Health Survey was used to populate the decision analytic model.In the base-case and sensitivity analyses, incremental cost-effectiveness ratios (ICERs) for all three active treatment alternatives remained less than A$7,000 per QALY gained. The base-case results indicated that non-directive counselling is dominated by TF-CBT and TF-CBT + SSRI, and that efficiency gain can be achieved by allocating more resources toward these therapies. However, this result was sensitive to variation in the clinical effectiveness parameters with non-directive counselling dominating TF-CBT and TF-CBT + SSRI under certain assumptions. The base-case results also suggest that TF-CBT + SSRI is more cost-effective than TF-CBT.Even after accounting for uncertainty in parameter estimates, the results of the modelled economic evaluation demonstrated that all psychotherapy treatments for PTSD in sexually abused children have a favourable ICER relative to no treatment. The results also highlighted the loss of quality of life in children who do not receive any psychotherapy. Results of the base-case analysis suggest that TF-CBT + SSRI is more cost-effective than TF-CBT alone, however, considering the uncertainty associated with prescribing SSRIs to children and adolescents, clinicians and parents may exercise some caution in choosing this treatment alternative.",0 +https://doi.org/10.1002/mds.25665,"Future of brain stimulation: New targets, new indications, new technology","In the last quarter of a century, DBS has become an established neurosurgical treatment for Parkinson's disease (PD), dystonia, and tremors. Improved understanding of brain circuitries and their involvement in various neurological and psychiatric illnesses, coupled with the safety of DBS and its exquisite role as a tool for ethical study of the human brain, have unlocked new opportunities for this technology, both for future therapies and in research. Serendipitous discoveries and advances in structural and functional imaging are providing abundant ""new"" brain targets for an ever-increasing number of pathologies, leading to investigations of DBS in diverse neurological, psychiatric, behavioral, and cognitive conditions. Trials and ""proof of concept"" studies of DBS are underway in pain, epilepsy, tinnitus, OCD, depression, and Gilles de la Tourette syndrome, as well as in eating disorders, addiction, cognitive decline, consciousness, and autonomic states. In parallel, ongoing technological development will provide pulse generators with longer battery longevity, segmental electrode designs allowing a current steering, and the possibility to deliver ""on-demand"" stimulation based on closed-loop concepts. The future of brain stimulation is certainly promising, especially for movement disorders-that will remain the main indication for DBS for the foreseeable future-and probably for some psychiatric disorders. However, brain stimulation as a technique may be at risk of gliding down a slippery slope: Some reports indicate a disturbing trend with suggestions that future DBS may be proposed for enhancement of memory in healthy people, or as a tool for ""treatment"" of ""antisocial behavior"" and for improving ""morality.""",0 +https://doi.org/10.1097/01.nmd.0000252010.19753.19,Psychological Distress of Rescue Workers Eight and One-Half Years After Professional Involvement in the Amsterdam Air Disaster,"This study examined specific and general psychological distress 8.5 years following the 1992 cargo aircraft crash in Amsterdam. Participants included 334 occupationally exposed fire fighters and 834 occupationally exposed police officers compared with reference groups of 194 fire fighters and 634 police officers who were exposed to duty-related stressors other than the disaster. On the standardized instruments of psychological distress, exposed fire fighters reported more somatic complaints and fatigue, while exposed police officers reported higher psychological distress on all aspects. The degree and type of exposure at the disaster site and other background factors were associated with several outcomes of psychological distress levels of exposed rescue workers. The disasters' aftermath of rumors about potential health consequences due to toxic exposure likely contributed to the long-lasting psychological distress of some of the rescue workers as well.",0 +https://doi.org/10.2174/1745017901309010075,PTSD Symptoms Mediate the Effect of Attachment on Pain and Somatisation after Whiplash Injury,"Introduction: The development of persistent pain post-whiplash injury is still an unresolved mystery despite the fact that approximately 50% of individuals reporting whiplash develop persistent pain. There is agreement that high initial pain and PTSD symptoms are indicators of a poor prognosis after whiplash injury. Recently attachment insecurity has been proposed as a vulnerability factor for both pain and PTSD. In order to guide treatment it is important to examine possible mechanisms which may cause persistent pain and medically unexplained symptoms after a whiplash injury. Aim: The present study examines attachment insecurity and PTSD symptoms as possible vulnerability factors in relation to high levels of pain and somatisation after sub-acute whiplash injury. Methods: Data were collected from 327 patients (women = 204) referred consecutively to the emergency unit after acute whiplash injury. Within 1-month post injury, patients answered a questionnaire regarding attachment insecurity, pain, somatisation, and PTSD symptoms. Multiple mediation analyses were performed to assess whether the PTSD symptom clusters mediated the association between attachment insecurity, pain, and somatisation. Results: A total of 15% fulfilled the DSM-IV symptom cluster criteria for a possible PTSD diagnosis and 11.6% fulfilled the criteria for somatisation. PTSD increased the likelihood of belonging to the moderate-severe pain group three-fold. In relation to somatisation the likelihood of belonging to the group was almost increased four-fold. The PTSD symptom clusters of avoidance and hyperarousal mediated the association between the attachment dimensions, pain, and somatisation. Conclusion: Acknowledging that PTSD is part of the aetiology involved in explaining persistent symptoms after whiplash, may help sufferers to gain early and more suited treatment, which in turn may prevent the condition from becoming chronic.",0 +https://doi.org/10.1037/rep0000056,"Trajectories of life satisfaction after traumatic brain injury: Influence of life roles, age, cognitive disability, and depressive symptoms.","(a) Identify life satisfaction trajectories after moderate to severe traumatic brain injury (TBI); (b) establish a predictive model for these trajectories across the first 5 years postinjury; and (c) describe differences in these life satisfaction trajectory groups, focusing on age, depressive symptoms, disability, and participation in specific life roles.Analysis of the longitudinal TBI Model Systems National Database was performed on data collected prospectively at 1-, 2-, and 5-years post-TBI. Participants (n = 3,012) had a moderate to severe TBI and were 16 years old and older.Four life satisfaction trajectories were identified across the first 5 years postinjury, including: stable satisfaction, initial satisfaction declining, initial dissatisfaction improving, and stable dissatisfaction. Age, depressive symptoms, cognitive disability, and life role participation as a worker, leisure participant, and/ or religious participant at 1-year postinjury significantly predicted trajectory group membership. Life role participation and depressive symptoms were strong predictors of life satisfaction trajectories across the first 5 years post-TBI.The previously documented loss of life roles and prevalence of depression after a moderate to severe TBI make this a vulnerable population for whom low or declining life satisfaction is a particularly high risk. Examining individual life role participation may help to identify relevant foci for community-based rehabilitation interventions or supports.",0 +https://doi.org/10.1007/s11414-014-9418-7,Individual and Community-Level Determinants of Mental and Physical Health After the Deepwater Horizon Oil Spill: Findings from the Gulf States Population Survey,"The 2010 Deepwater Horizon oil spill had enormous consequences on the environment. Prevalence of mental and physical health conditions among Gulf residents after the disaster, however, are still being assessed. The Gulf State Population Survey (GSPS) was a representative survey of 38,361 residents in four Gulf States and was conducted from December 2010 to December 2011. Analysis of the GSPS data showed that differences in individual characteristics and direct or indirect exposure to the disaster drove the individual-level variation in health outcomes (mental distress, physical distress, and depression). Direct exposure to the disaster itself was the most important determinant of health after this event. Selected county-level characteristics were not found to be significantly associated with any of our health indicators of interest. This study suggests that in the context of an overwhelming event, persons who are most directly affected through direct exposure should be the primary focus of any public health intervention effort. © 2014, National Council for Behavioral Health (outside the USA).",0 +https://doi.org/10.1037/0882-7974.8.4.606,Age differences in the psychological consequences of Hurricane Hugo.,"At 12, 18, and 24 months after Hurricane Hugo, 831 adults were interviewed regarding their disaster-related stressors and present psychological state. The study's purposes were to assess whether age influenced one's vulnerability to postdisaster stress and to evaluate four different perspectives on disaster recovery that have been previously used to explain age differences. Regression analyses demonstrated that disaster exposure had substantial and pervasive psychological effects. The analyses also revealed a curvilinear interaction between disaster exposure and age. Younger people exhibited the most distress in the absence of disaster, but middle-aged people did so in its presence. Differential exposure, resources, and inoculation all failed to explain these differences, however, the burden perspective had considerable explanatory power.",0 +https://doi.org/10.1007/s12207-014-9187-x,"PTSD, Endophenotypes, the RDoC, and the DSM-5","The search for endophenotypes that stand between genetics and disease has been applied to the diagnostic entity of Posttraumatic Stress Disorder (PTSD). Advances are being made in understanding the pathway to disorder in PTSD in terms of brain regions, neuronal networks, stress-related systems (e.g., the hypothalamic-pituitary-adrenal (HPA) axis), and their underlying genetic and neurogenetic bases. The latter are affected by gene-environmental interactions and epigenetic effects, and the environment and context reciprocally interrelate with them, as well. Therefore, a primary focus on (neuro)pathophysiological intermediates in the disease pathway, as appears emphasized in the research domain criteria (RDoC) approach to etiology of psychiatric disorder, and to which the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) subscribes, might detract from a more inclusive biopsychosocial approach that would be more applicable in the case of PTSD. The paper undertakes a comprehensive review of the recent literature in the areas of endophenotypes, neurogenetics, epigenetics, neural networks, HPA axis, neuronal networks, pathways, the PTSD five-factor model, allostasis, and the RDoC criteria for psychiatric diagnosis, and then returns to the topic of endophenotypes. Neuronal networks constitute one integrating area that could help in arriving at an appropriate model of PTSD endophenotype. Pathway analysis provides a rich field for discerning individual differences in PTSD development, more so than the static approach of using DSM-5 symptom criteria. A model of endophenotypes is presented, which considers these factors in relation to PTSD. The paper concludes with implications for the DSM-5, for practice and for court, especially that it would be premature to seek individual biomarkers of PTSD given the current state of knowledge, even if it is burgeoning. © 2014 Springer Science+Business Media New York.",0 +https://doi.org/10.1002/jts.22017,Social Information Processing in Anger Expression and Partner Violence in Returning U.S. Veterans,"We examined social information processing factors that could represent pathways through which posttraumatic stress disorder (PTSD) symptoms relate to anger expression and intimate partner violence (IPV) perpetration in returning U.S. veterans. The sample included 92 male Operation Enduring Freedom/Operation Iraqi Freedom veterans, primarily Caucasian (77.4%), with smaller numbers of African American, Asian, Hispanic or Latino, American Indian or Alaskan Native, and other minority participants (9.7%, 2.2%, 2.2%, 3.2%, and 5.3% respectively). The average age was 40.37 (SD = 9.63) years. Data were collected through self-report questionnaires (PTSD Checklist, State-Trait Anger Expression Scale, Revised Conflict Tactics Scales) and the Articulated Thoughts in Simulated Situations experimental protocol. Laboratory-based assessment of cognitive biases and hostile attributions were tested as mediators of associations between PTSD symptoms and anger expression and IPV. Among the PTSD symptom clusters, hyperarousal symptoms were most strongly associated with anger expression (r = .50) and IPV perpetration (r = .27). Cognitive biases mediated associations between PTSD total scores and 3 of 4 PTSD cluster scores as well as anger expression. Hostile attribution biases were also associated with IPV perpetration (r = .23). We discuss the implications of these findings for understanding social information processing mechanisms for the relationship between PTSD symptoms and aggression.",0 +https://doi.org/10.1016/j.chiabu.2013.04.001,Cumulative trauma and symptom complexity in children: A path analysis,"Multiple trauma exposures during childhood are associated with a range of psychological symptoms later in life. In this study, we examined whether the total number of different types of trauma experienced by children (cumulative trauma) is associated with the complexity of their subsequent symptomatology, where complexity is defined as the number of different symptom clusters simultaneously elevated into the clinical range. Children's symptoms in six different trauma-related areas (e.g., depression, anger, posttraumatic stress) were reported both by child clients and their caretakers in a clinical sample of 318 children. Path analysis revealed that accumulated exposure to multiple different trauma types predicts symptom complexity as reported by both children and their caretakers.",0 +https://doi.org/10.1111/jcpp.12339,Girls’ childhood trajectories of disruptive behavior predict adjustment problems in early adolescence,"It is widely recognized that early onset of disruptive behavior is linked to a variety of detrimental outcomes in males, later in life. In contrast, little is known about the association between girls' childhood trajectories of disruptive behavior and adjustment problems in early adolescence.This study used nine waves of data from the ongoing Pittsburgh Girls Study. A semiparametric group-based model was used to identify trajectories of disruptive behavior in 1,513 girls from age 6 to 12 years. Adjustment problems were characterized by depression, self-harm, Post Traumatic Stress Disorder (PTSD), substance use, interpersonal aggression, sexual behavior, affiliation with delinquent peers, and academic achievement at ages 13 and 14.Three trajectories of childhood disruptive behavior were identified: low, medium, and high. Girls in the high group were at increased risk for depression, self-harm, PTSD, illegal substance use, interpersonal aggression, early and risky sexual behavior, and lower academic achievement. The likelihood of multiple adjustment problems increased with trajectories reflecting higher levels of disruptive behavior.Girls following the high childhood trajectory of disruptive behavior require early intervention programs to prevent multiple, adverse outcomes in adolescence and further escalation in adulthood.",0 +https://doi.org/10.1023/b:jots.0000029262.42865.c2,The course of PTSD symptoms among Gulf War veterans: A growth mixture modeling approach,"Relatively little is known about the course of PTSD symptoms over time following trauma exposure. Accordingly, this study utilized a specialized structural equation modeling approach, growth mixture modeling, to examine the trajectory of PTSD symptoms across three time points in a sample of Gulf War veterans (n at Time 1 = 2,949, n at Time 2 = 2,313, and n at Time 3 = 1,327). Results were most consistent with a two-group model suggesting that the course of PTSD symptoms following the Gulf War was best characterized by two distinct growth curves: (1) low levels of PTSD symptoms with little increase over time and (2) higher levels of initial symptoms with a significant increase over time. Thus, it appears that response to Gulf War experiences is not homogeneous, and that a subset of individuals may experience relatively more PTSD symptoms over time. In addition, men, Whites, those reporting more education, and those reporting less combat exposure had a significantly higher probability of being classified into the less symptomatic group.",1 +https://doi.org/10.1176/ajp.154.8.1114,Full and partial posttraumatic stress disorder: findings from a community survey,"Full and partial posttraumatic stress disorder (PTSD) following trauma exposure were examined in a community sample in order to determine their prevalence and their relative importance and functional significance.A standardized telephone interview with a series of trauma probes and a DSM-IV PTSD checklist was administered to a random sample of 1,002 persons in a midsized Midwestern Canadian city. The authors determined current (i.e., 1-months) prevalence rates of full PTSD, i.e., all DSM-IV criteria, and partial PTSD, i.e., fewer than the required number of DSM-IV criterion C symptoms (avoidance/numbing) or criterion D symptoms (increased arousal). Additional questions about interference with functioning were also posed.The estimated prevalence of full PTSD was 2.7% for women and 1.2% for men. The prevalence of partial PTSD was 3.4% for women and 0.3% for men. Interference with work or school was significantly more pronounced in persons with full PTSD than in those with only partial symptoms, although the latter were significantly more occupationally impaired than traumatized persons without PTSD.These findings in an epidemiologic sample underscore observations from patient and military groups that many traumatized persons suffer from a subsyndromal form of PTSD. These persons with partial PTSD, although somewhat less impaired than persons with the full syndrome, nonetheless exhibit clinically meaningful levels of functional impairment in association with their symptoms. This subthreshold form of PTSD may be especially prevalent in women. Additional study of partial PTSD is warranted.",0 +https://doi.org/10.1002/jts.20334,Longitudinal linkages between perceived social support and posttraumatic stress symptoms: Sequential roles of social causation and social selection,"The authors examined social causation and social selection explanations for the association between perceptions of social support and psychological distress. Data came from a sample of 557 victims of natural disaster in Mexico. Structural equation modeling analyses indicated that social causation (more social support leading to less posttraumatic stress disorder [PTSD]) explained the support-to-distress relationship in the earlier postdisaster phase, 6 to 12 months after the impact. Both causal mechanisms emerged as significant paths in the midpoint of the study (12 and 18 months). Only social selection (more PTSD leading to less social support) accounted for the support-to-distress relationship at 18 to 24 months after the event. Interpersonal and social dynamics of disasters may explain why these two contrasting causal mechanisms emerged over time.",0 +https://doi.org/10.1227/neu.0b013e31820cd40d,Health-Related Quality of Life After Aneurysmal Subarachnoid Hemorrhage: Profile and Clinical Factors,"Health-related quality of life has recently been suggested as a supplement to the traditional neurological outcome measures from the patient's perspective according to the World Health Organization model and may capture the effects of other factors such as posttraumatic stress disorder and neuroendocrine dysfunction.To explore the profile and clinical factors of quality of life after aneurysmal subarachnoid hemorrhage using the data we obtained from the recently completed Intravenous Magnesium Sulphate After Aneurysmal Subarachnoid Hemorrhage (IMASH) trial.This study was registered at www.strokecenter.org/trials and www.ClinicalTrials.gov (NCT00124150). Data from a patient cohort obtained with the Short Form-36 questionnaire completed at 6 months were used for analysis.Patients with aneurysmal subarachnoid hemorrhage demonstrated a decrease in quality of life according to the Short Form-36 at 6 months. The physical and mental health scores correlated with the Extended Glasgow Outcome Scale and had the potential to avoid the ceiling effect. Multiple regression analyses showed that the physical component scores were related to age, World Federation of Neurological Surgeons grade, and chronic hydrocephalus and that the mental component scores were not related to the traditional prognostic factors.Subarachnoid hemorrhage caused a decrease in quality of life. Chronic hydrocephalus is related to a decrease in physical health quality of life.",0 +https://doi.org/10.1186/1753-2000-7-21,"Prevalence, comorbidity and predictors of anxiety disorders in children and adolescents in rural north-eastern Uganda","Child and adolescent anxiety disorders are the most prevalent form of childhood psychopathology. Research on child and adolescent anxiety disorders has predominantly been done in westernized societies. There is a paucity of data on the prevalence, comorbidity, and predictors of anxiety disorders in children and adolescents in non-western societies including those in sub-Saharan Africa. This paper investigates the prevalence, comorbidity, and predictors of anxiety disorders in children and adolescents in north-eastern Uganda.To determine the prevalence of DSM-IV anxiety disorders, as well as comorbidity patterns and predictors in children and adolescents aged 3 to 19 years in north-eastern Uganda.Four districts (Lira, Tororo, Kaberamaido and Gulu) in rural north-eastern Uganda participated in this study. Using a multi-stage sampling procedure, a sample of 420 households with children aged 3-19 years from each district was enrolled into the study. The MINI International Neuropsychiatric Interview for children and adolescents (MINI KID) was used to assess for psychiatric disorders in 1587 of 1680 respondents.The prevalence of anxiety disorders was 26.6%, with rates higher in females (29.7%) than in males (23.1%). The most common disorders in both males and females were specific phobia (15.8%), posttraumatic stress disorder (PTSD) (6.6%) and separation anxiety disorder (5.8%). Children below 5 years of age were significantly more likely to have separation anxiety disorder and specific phobias, while those aged between 14-19 were significantly more likely to have PTSD. Anxiety disorders were more prevalent among respondents with other psychiatric disorders; in respondents with two or more co-morbid psychiatric disorders the prevalence of anxiety disorders was 62.1%. Predictors of anxiety disorders were experience of war trauma (OR = 1.93, p < 0.001) and a higher score on the emotional symptom scale of the SDQ (OR = 2.58, p < 0.001). Significant socio-demograghic associations of anxiety disorders were found for female gender, guardian unemployment, living in permanent housing, living without parents, and having parents without education.The prevalence of anxiety disorders in children and adolescents in rural north-eastern Uganda is high, but consistent in terms of gender ratio and progression over time with a range of prior work in other contexts. Patterns of comorbidity and predictors of anxiety disorders in this setting are also broadly consistent with previous findings from western community studies. Both psychosocial stressors and exposure to war trauma are significant predictors of anxiety disorders.Prevention and treatment strategies need to be put in place to address the high prevalence rates of anxiety disorders in children and adolescents in Uganda.",0 +https://doi.org/10.1002/jcop.20017,Violence exposure in home and community: Influence on posttraumatic stress symptoms in Army recruits,"This study assessed the levels and types of violence exposure, levels of posttraumatic stress symptoms, and the relationship among exposure to violence, posttraumatic stress symptoms, and early discharge in U.S. Army recruits at Basic Combat Training (BCT). The study applied a modified ABCX model of family stress adaptation developed by McCubbin, Thompson, and McCubbin (1996). A sample of 779 BCT recruits were surveyed before training began. At the end of training, data was collected on those recruits who had been discharged before completion of training. Statistical measures of association were used to assess the relationship between the variables. Results supported all three of the hypotheses tested. Significant positive relationships were found between violence exposure and trauma symptoms, as well as levels of trauma symptoms and odds of early discharge. Patterns of association were found between types of exposure to community versus home violence and specific symptom clusters of traumatic stress.",0 +https://doi.org/10.1002/jts.21762,Trauma Exposure and Health: The Role of Depressive and Hyperarousal Symptoms,"Posttraumatic stress disorder (PTSD) and depressive symptoms have been theorized to mediate the relationship between trauma exposure and physical health symptoms. Although empirical evidence supports this premise, studies conducted to date have employed statistical mediation analyses that are now broadly criticized. Furthermore, the mediating roles of both PTSD and depressive symptoms have seldom been examined concurrently, and it remains unclear which PTSD symptom clusters uniquely mediate this relationship. The aim of the present study was to examine the mediating role of reexperiencing, avoidance/numbing, hyperarousal, and depressive symptoms in the relationship between trauma exposure and physical health symptoms. Participants were 516 Spanish female undergraduate students. Physical health symptoms were compared between those who reported trauma exposure (n = 266) and those who did not (n = 250). Data from trauma-exposed participants were analyzed using regression models with bootstrapping to test mediation. Results of the analyses showed that the trauma-exposed group reported significantly more physical health symptoms (r2 = .035). Hyperarousal and depressive symptoms uniquely mediated the relationship between trauma exposure and physical health symptoms. Our findings clarify some of the mechanisms by which negative health consequences occur subsequent to trauma exposure.",0 +https://doi.org/10.1016/j.jad.2010.10.032,Requiring both avoidance and emotional numbing in DSM-V PTSD: Will it help?,"The proposed DSM-V criteria for posttraumatic stress disorder (PTSD) specifically require both active avoidance and emotional numbing symptoms for a diagnosis. In DSM-IV, since both are included in the same cluster, active avoidance is not essential. Numbing symptoms overlap with depression, which may result in spurious comorbidity or overdiagnosis of PTSD. This paper investigated the impact of requiring both active avoidance and emotional numbing on the rates of PTSD diagnosis and comorbidity with depression.We investigated PTSD and depression in 835 traumatic injury survivors at 3 and 12 months post-injury. We used the DSM-IV criteria but explored the potential impact of DSM-IV and DSM-V approaches to avoidance and numbing using comparison of proportion analyses.The DSM-V requirement of both active avoidance and emotional numbing resulted in significant reductions in PTSD caseness compared with DSM-IV of 22% and 26% respectively at 3 and 12 months posttrauma. By 12 months, the rates of comorbid PTSD in those with depression were significantly lower (44% vs. 34%) using the new criteria, primarily due to the lack of avoidance symptoms.These preliminary data suggest that requiring both active avoidance and numbing as separate clusters offers a useful refinement of the PTSD diagnosis. Requiring active avoidance may help to define the unique aspects of PTSD and reduce spurious diagnoses of PTSD in those with depression.",0 +https://doi.org/10.1097/00005053-200204000-00002,HERITABILITY OF SOCIAL ANXIETY-RELATED CONCERNS AND PERSONALITY CHARACTERISTICS: A TWIN STUDY,"Negative evaluation fears figure prominently in the cognitive psychology of patients with social phobia. In this study, we examine the heritability of negative evaluation fears by using a twin sample. The authors also examine the relationships between negative evaluation fears and personality dimensions relevant to social phobia. Scores on the brief version of the Fear of Negative Evaluation Scale (BFNE) were examined in a sample of 437 (245 monozygotic and 192 dizygotic) twin pairs. Biometrical model fitting was conducted by using standard statistical methods. Genetic and environmental correlations with personality dimensions (from the Dimensional Assessment of Personality Pathology-Basic Questionnaire) were also calculated. Broad heritability estimate of the BFNE was 48%. Additive genetic effects and unique environmental effects emerged as the primary influences on negative evaluation fears. Genetic correlations between BFNE scores and the submissiveness, anxiousness, and social avoidance facets of the Dimensional Assessment of Personality Pathology-Basic Questionnaire were high (r(g) =.78 to.80). A cognitive dimension central to the phenomenology (and, perhaps, cause) of social phobia, the fear of being negatively evaluated, is moderately heritable. Moreover, the same genes that influence negative evaluation fears appear to influence a cluster of anxiety-related personality characteristics. Implications and limitations of these findings are discussed.",0 +https://doi.org/10.1021/acs.jproteome.5b00603,Gastrointestinal Symptoms and Altered Intestinal Permeability Induced by Combat Training Are Associated with Distinct Metabotypic Changes,"Physical and psychological stress have been shown to modulate multiple aspects of gastrointestinal (GI) physiology, but its molecular basis remains elusive. We therefore characterized the stress-induced metabolic phenotype (metabotype) in soldiers during high-intensity combat training and correlated the metabotype with changes in GI symptoms and permeability. In a prospective, longitudinal study, urinary metabotyping was conducted on 38 male healthy soldiers during combat training and a rest period using gas chromatography-mass spectrometry. The urinary metabotype during combat training was clearly distinct from the rest period (partial least-squares discriminant analysis (PLSDA) Q(2) = 0.581), confirming the presence of a unique stress-induced metabotype. Differential metabolites related to combat stress were further uncovered, including elevated pyroglutamate and fructose, and reduced gut microbial metabolites, namely, hippurate and m-hydroxyphenylacetate (p < 0.05). The extent of pyroglutamate upregulation exhibited a positive correlation with an increase in IBS-SSS in soldiers during combat training (r = 0.5, p < 0.05). Additionally, the rise in fructose levels was positively correlated with an increase in intestinal permeability (r = 0.6, p < 0.005). In summary, protracted and mixed psychological and physical combat-training stress yielded unique metabolic changes that corresponded with the incidence and severity of GI symptoms and alteration in intestinal permeability. Our study provided novel molecular insights into stress-induced GI perturbations, which could be exploited for future biomarker research or development of therapeutic strategies.",0 +https://doi.org/10.1007/s11136-012-0197-4,The association between post-traumatic stress disorder symptoms and the quality of life among Wenchuan earthquake survivors: the role of social support as a moderator,"Objective: To examine the role of the three types of social support as possible moderating factors between post-traumatic stress disorder (PTSD) and its relationship to two domains of the quality of life (QOL). Methods: A cross-sectional survey was done in a local area near the epicenter of the severe earthquake in Wenchuan. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), the standard Chinese 12-item Short Form (SF-12v2), and the Social Support Rating Scale (SSRS) were used to interview a total of 2,080 earthquake survivors in the one-year follow-up period. Multiple regressions were performed to evaluate the moderating role of social support on the relationship between PTSD and QOL. Results: Among survivors one-year after the Wenchuan earthquake, being a woman (p < 0.01), having a lower level of education (p < 0.01), having a lower level of income (p < 0.01), having a worse housing status (p < 0.05) and having a higher level of exposure (p < 0.05) were risk factors for a poorer QOL (DELTAR2 = 0.063). PTSD symptoms negatively influenced the QOL (DELTAR2 = 0.145), while social support positively influenced the QOL (DELTAR2 = 0.016). However, the interaction between social support and PTSD weakened the negative effect of PTSD on the QOL (DELTAR2 = 0.012). Subjective support and support availability moderated the association between PTSD and the QOL (DELTAR2 = 0.010). Conclusion: Subjective support and support availability are more useful strategies to improve the QOL of the earthquake survivors with PTSD symptoms. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1089/neu.2014.3585,"The Effects of Mild Traumatic Brain Injury, Post-Traumatic Stress Disorder, and Combined Mild Traumatic Brain Injury/Post-Traumatic Stress Disorder on Returning Veterans","United States veterans of the Iraqi (Operation Iraqi Freedom [OIF]) and Afghanistan (Operation Enduring Freedom [OEF]) conflicts have frequently returned from deployment after sustaining mild traumatic brain injury (mTBI) and enduring stressful events resulting in post-traumatic stress disorder (PTSD). A large number of returning service members have been diagnosed with both a history of mTBI and current PTSD. Substantial literature exists on the neuropsychological factors associated with mTBI and PTSD occurring separately; far less research has explored the combined effects of PTSD and mTBI. The current study employed neuropsychological and psychological measures in a sample of 251 OIF/OEF veterans to determine whether participants with a history of mTBI and current PTSD (mTBI+PTSD) have poorer cognitive and psychological outcomes than participants with mTBI only (mTBI-o), PTSD only (PTSD-o), or veteran controls (VC), when groups are comparable on intelligence quotient, education, and age. The mTBI+PTSD group performed more poorly than VC, mTBI-o, and PTSD-o groups on several neuropsychological measures. Effect size comparisons suggest small deleterious effects for mTBI-o on measures of processing speed and visual attention and small effects for PTSD-o on measures of verbal memory, with moderate effects for mTBI+PTSD on the same variables. Additionally, the mTBI+PTSD group was significantly more psychologically distressed than the PTSD-o group, and PTSD-o group was more distressed than VC and mTBI-o groups. These findings suggest that veterans with mTBI+PTSD perform significantly lower on neuropsychological and psychiatric measures than veterans with mTBI-o or PTSD-o. The results also raise the possibility of mild but persisting cognitive changes following mTBI sustained during deployment.",0 +https://doi.org/10.1080/02646838.2010.513048,Post‐traumatic stress disorder related to birth: a prospective longitudinal study in a French population,"The objective of the current study is to determine the prevalence of post‐traumatic stress disorder (PTSD) following birth in a French sample, as well as to examine predictive variables. This study collected data from women at four different times: 48 h, 1 month, 4 months and 9 months post‐partum. PTSD symptoms were measured using the Impact of Events Scale‐Revised (IES‐R). Predictive variables were examined with four questionnaires: the Labor Agentry Scale (LAS), the Multidimensional Scale of Perceived Social Support (MSPSS), the Edinburgh Postnatal Depression Scale (EPDS) and a researcher‐designed personal information form. PTSD rates varied from 5% (1 month post‐partum) to 2.9% (9 months post‐partum). Primiparity, birth preparation classes, transfer to a tertiary care centre, perception of external control, feeling of pain during birth and depressive symptoms were significant predictors of the global IES‐R score. Results provide a basis for considering changes in healthcare delivery and prevention prog...",0 +https://doi.org/10.1037/0022-006x.75.2.316,"Posttraumatic intrusion, avoidance, and social functioning: A 20-year longitudinal study.","The study assesses posttraumatic intrusion, avoidance, and social functioning among 214 Israeli combat veterans from the first Lebanon War with and without combat stress reaction (CSR) 1, 2, 3, and 20 years after the war. CSR veterans reported higher intrusion and avoidance than did non-CSR veterans. With time, there was a decline in these symptoms. In addition, intrusion and avoidance were associated with problems in social functioning on a given year, and they longitudinally predicted social dysfunction 2, 3, and 20 years after the war. CSR veterans presented stronger temporal covariations between intrusion-avoidance and social functioning. The findings suggest that CSR is a marker for future psychopathology and point to the role of avoidance in social dysfunction.",0 +https://doi.org/10.1016/j.jadohealth.2005.08.012,The Mental Health Impact of 9/11 on Inner-City High School Students 20 Miles North of Ground Zero,"To determine the rate of post-traumatic stress disorder (PTSD) after 9/11 in a sample of New York City high school students and associations among personal exposure, loss of psychosocial resources, prior mental health treatment, and PTSD.A total of 1214 students (grades 9 through 12) attending a large community high school in Bronx County, 20 miles north of ""Ground Zero,"" completed a 45-item questionnaire during gym class on one day eight months after 9/11. Students were primarily Hispanic (62%) and African American (29%) and lived in the surrounding neighborhood. The questionnaire included the PCL-T, a 17-item PTSD checklist supplied by the Office of Behavioral and Social Science Research of the National Institutes of Health (NIH). The PCL-T was scored following the DSM-IV criteria for PTSD requiring endorsement of at least one repeating symptom, two hyperarousal symptoms, and three avoidance symptoms. Bivariate analysis comparing PTSD with personal exposure, loss of psychosocial resources, and mental health variables was done and multiple logistic regression was used to identify significant associations.There were 7.4 % of students with the PTSD symptom cluster. Bivariate analysis showed a trend for females to have higher rates of PTSD (males [6%] vs. females [9%], p = .06] with no overall ethnic differences. Five of the six personal exposure variables, and both of the loss of psychosocial resources and mental health variables were significantly associated with PTSD symptom cluster. Multiple logistic regression analysis found one personal exposure variable (having financial difficulties after 9/11, odds ratio [OR] = 5.27; 95% confidence interval [CI] 2.9-9.7); both the loss of psychosocial resources variables (currently feeling less safe, OR = 3.58; 95% CI 1.9-6.8) and currently feeling less protected by the government, (OR = 4.04; 95% CI 2.1-7.7); and one mental health variable (use of psychotropic medication before 9/11, OR = 3.95; 95% CI 1.2-13.0) were significantly associated with PTSD symptom cluster.We found a rate of PTSD in Bronx students after 9/11 that was much higher than other large studies of PTSD in adolescents done before 9/11. Adolescents living in inner cities with high poverty and violence rates may be at high risk for PTSD after a terrorist attack. Students who still felt vulnerable and less safe eight months later and those with prior mental health treatment were four times more likely to have PTSD than those without such characteristics, highlighting the influence of personality and mental health on development of PTSD after a traumatic event.",0 +https://doi.org/10.1007/s10597-013-9662-y,Shifting the Odds of Lifelong Mental Illness Through an Understanding of the Profiles of Adolescents and Young Adults with Serious Mental Health Conditions,Every day families and mental health providers are called upon to make tough decisions in determining the best quality of care for adolescents and young adults with serious mental health conditions. This study profiles the behavioral and emotional needs and risk behaviors of adolescents and young adults seeking mental health services based on assessment of strengths and needs at program entry. © 2013 Springer Science+Business Media New York.,0 +https://doi.org/10.1007/s11126-007-9043-1,History of trauma and dissociative symptoms among patients with obsessive-compulsive disorder and social anxiety disorder,"We aimed to compare the history of trauma and the profile and severity of dissociative symptoms of patients with obsessive-compulsive disorder (OCD) to those of patients with social anxiety disorder (SAD). Patients with OCD (n = 34) and patients with SAD (n = 30) were examined with the following instruments: Trauma History Questionnaire (THQ), Dissociative Experience Scale (DES), Obsessive-Compulsive Inventory (OCI), Liebowitz Social Anxiety Scale (LSAS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Patients with OCD reported significantly lower rates of exposure to traumatic events. Nevertheless, the severity of dissociative symptoms was not significantly different between the groups. Regression analyses showed that, while the OCI scores better predicted the variance on DES scores in the OCD sample, the LSAS and the BAI better predicted the variance on the DES among patients with SAD. Patients with OCD are probably less vulnerable to some types of traumatic experiences. Dissociative symptoms may cut across different anxiety disorders. (",0 +https://doi.org/10.1001/archpsyc.55.6.553,A Prospective Study of Heart Rate Response Following Trauma and the Subsequent Development of Posttraumatic Stress Disorder,"Physiological arousal during traumatic events may trigger the neurobiological processes that lead to posttraumatic stress disorder (PTSD). This study prospectively examined the relationship between heart rate and blood pressure recorded immediately following a traumatic event and the subsequent development of PTSD.Eighty-six trauma survivors who presented at the emergency department of a general hospital were followed up for 4 months. Heart rate and blood pressure were recorded on arrival at the emergency department. Heart rate, anxiety, depression, and PTSD symptoms were assessed 1 week, 1 month, and 4 months later. The clinician-administered PTSD scale defined PTSD status at 4 months.twenty subjects (23%) met PTSD diagnostic criteria at the 4-month assessment (PTSD group), and 66 (77%) did not (non-PTSD group). Subjects who developed PTSD had higher heart rates at the emergency department (95.5+/-13.9 vs 83.3+/-10.9 beats per minute, t=4.4, P<.001) and 1 week later (77.8+/-11.9 vs 72.0+/-9.5 beats per minute, t=2.25, P<.03), but not after 1 and 4 months. The groups did not differ in initial blood pressure measurement. Repeated-measures analysis of variance (ANOVA) for heart rate showed a significant group effect (P<.02), time effect (P<.001), and group x time interaction (P<.001). The time effect and group x time interaction remained significant when adjusted for sex, age, trauma severity, immediate response, and dissociation during the traumatic event.Elevated heart rate shortly after trauma is associated with the later development of PTSD.",0 +https://doi.org/10.3109/08039489609081407,Cultural bias in suicidal behaviour among refugees with post-traumatic stress disorder,"The study was primarily designed to assess the prevalence of suicidal behaviour among asylum applicants diagnosed as having post-traumatic stress disorder (PTSD) and the impact of cultural bias factors (such as religion and nationality) in suicidal dynamics. The traumatic stressors reported in the study included being subjected to or forced to witness war atrocities, imprisonment, torture, sexual violence, other's suicide, and summary or mock executions. The study included 64 PTSD patients who were examined as part of a diagnostic and suicidal risk assessment after referral. Suicide risk assessments were assisted with scores of the SAD PERSONS Scale. Most PTSD patients reported suicidal behaviour. Nearly half of the refugees with PSTD diagnoses had a history of suicide attempts. Religious proscription or nationality was not found to be a significant deterrent of suicidal behaviour, and no differences between the various religious groups were established on this point. Another noteworthy finding in the pre...",0 +https://doi.org/10.2975/26.2002.132.144,The role of work in the recovery of persons with psychiatric disabilities.,"This study explored the role of work in the recovery of employed and unemployed persons with psychiatric disabilities. Fourteen persons with psychiatric disabilities participated in semi-structured interviews. Content analysis revealed that the experience of recovery was based on six major dimensions: self-definition, empowerment, connections to others, meaning of work, vocational future, and meaning of recovery. Differences in these six dimensions led to the identification of three profiles of recovery: recovery as uncertain, recovery as a self-empowering experience, and recovery as a challenging experience. Each profile described a specific context in which participation in work or avoidance of work can be understood and vocational interventions can be designed.",0 +https://doi.org/10.1016/j.jad.2015.05.057,Early identification of posttraumatic stress following military deployment: Application of machine learning methods to a prospective study of Danish soldiers,"Pre-deployment identification of soldiers at risk for long-term posttraumatic stress psychopathology after home coming is important to guide decisions about deployment. Early post-deployment identification can direct early interventions to those in need and thereby prevents the development of chronic psychopathology. Both hold significant public health benefits given large numbers of deployed soldiers, but has so far not been achieved. Here, we aim to assess the potential for pre- and early post-deployment prediction of resilience or posttraumatic stress development in soldiers by application of machine learning (ML) methods.ML feature selection and prediction algorithms were applied to a prospective cohort of 561 Danish soldiers deployed to Afghanistan in 2009 to identify unique risk indicators and forecast long-term posttraumatic stress responses.Robust pre- and early postdeployment risk indicators were identified, and included individual PTSD symptoms as well as total level of PTSD symptoms, previous trauma and treatment, negative emotions, and thought suppression. The predictive performance of these risk indicators combined was assessed by cross-validation. Together, these indicators forecasted long term posttraumatic stress responses with high accuracy (pre-deployment: AUC = 0.84 (95% CI = 0.81-0.87), post-deployment: AUC = 0.88 (95% CI = 0.85-0.91)).This study utilized a previously collected data set and was therefore not designed to exhaust the potential of ML methods. Further, the study relied solely on self-reported measures.Pre-deployment and early post-deployment identification of risk for long-term posttraumatic psychopathology are feasible and could greatly reduce the public health costs of war.",0 +https://doi.org/10.1007/s10916-015-0337-9,iMStrong: Deployment of a Biosensor System to Detect Cocaine Use,"Biosensor systems are increasingly promoted for use in behavioral interventions. Portable biosensors might offer advancement over self-report use and can provide improved opportunity for detection and intervention in patients undergoing drug treatment programs. Fifteen participants wore a biosensor wristband capable of detecting multiple physiologic markers of sympathetic nervous system (SNS) arousal for 30 days. Urine drug screening and drug use self-report were obtained twice per week. A parameter trajectory description method was applied to capture abrupt changes in magnitude of three measures of SNS activity: Electrodermal activity (EDA), skin temperature and motion. Drug use events detected by the biosensor were verified using a triad of parameters: the biosensor data, urine drug screens, and patient self-report of substance use. Twelve positive cocaine urine screens were identified. Thirteen self-reported episodes of cocaine use were recorded. Distinct episodes with biometric parameters consistent with cocaine use were identified on biosensor data. Eleven potential cocaine use episodes were identified by biosensors that were missed by both self-report and drug screening. Study participants found mobile biosensors to be acceptable, and compliance with the protocol was high. Episodes of cocaine use, as measured by supraphysiologic changes in biophysiometric parameters, were detected by analysis of biosensor data in instances when self-report or drug screening or both failed. Biosensors have substantial potential in detecting substance abuse, in understanding the context of use in real time, and in evaluating the efficacy of behavioral interventions for drug abuse.",0 +https://doi.org/10.1016/j.jpsychires.2014.07.014,"The cumulative effect of different childhood trauma types on self-reported symptoms of adult male depression and PTSD, substance abuse and health-related quality of life in a large active-duty military cohort","History of childhood trauma (CT) is highly prevalent and may lead to long-term consequences on physical and mental health. This study investigated the independent association of CT with symptoms of adult depression and posttraumatic stress disorder (PTSD), mental and physical health-related quality of life (HRQoL), as well as current tobacco consumption and alcohol abuse in a large homogenous cohort of 1254 never-deployed, young male Marines enrolled in the Marine Resiliency Study. Independent effects of CT history, number and type of CT on outcomes were analyzed using hierarchical multivariate logistic regression models. Our results suggested dose-dependent negative effect of an increasing number of trauma types of CT on depression, PTSD and HRQoL. Experience of single CT type demonstrated overall weak effects, while history of multiple CT types distinctively increased the likelihood of adult PTSD symptomology (OR: 3.1, 95% CI: 1.5-6.2), poor mental (OR: 2.3, 95% CI: 1.7-3.1) and physical HRQoL (OR: 1.4, 95% CI: 1.1-1.9). Risk for depression symptoms was similar for both single and multiple CT (OR: 2.2, 95% CI: 1.3-3.8 and OR: 2.1, 95% CI: 1.2-3.5 respectively). CT history had no effects on current tobacco use and alcohol abuse. Our study thus provides evidence for substantial additive effect of different CT types on adult mental and physical health with increasing levels of exposure.",0 +https://doi.org/10.1016/j.jpain.2009.03.011,Structure of Posttraumatic Stress Disorder Symptoms in Pain and Pain-Free Patients Scheduled for Major Surgery,"Factor-analytic studies of the structure of posttraumatic stress disorder (PTSD) symptoms have yielded inconsistent results. One of the reasons for the inconsistency may be that PTSD is highly comorbid with other disorders; the observed factor structure might depend on the particular comorbid disorder. One such disorder is chronic pain. The goal of the present study was to investigate whether PTSD symptom structure differs between pain and pain-free patients scheduled to undergo major surgery. Four hundred and forty-seven patients who were approached 7 to 10 days prior to scheduled surgery completed the PTSD Checklist-Civilian (PCL-C) Version and the Current Pain and Pain History Questionnaire; the latter was used to divide patients into pain (N = 175) and pain-free (N = 272) groups. Results showed that in pain-free patients, PTSD symptoms were best expressed as 2 symptom clusters (re-experiencing/avoidance; emotional numbing/hyperarousal) accounting for 52.4% of the variance. In pain patients, PTSD symptoms were best expressed as a single symptom cluster accounting for 51.1% of the variance. These results suggest different interrelationships among PTSD symptoms in these 2 populations. Results reflect the need for (1) controlling for pain in studies looking at PTSD-symptom expression and (2) further research on PTSD-symptom expression in pain populations.These results may have important implications for research on the comorbidity between PTSD and chronic pain, as well as for treatment of PTSD symptoms in patients presenting with pain problems.",0 +https://doi.org/10.1007/s10464-007-9134-z,"Distribution of Traumatic and Other Stressful Life Events by Race/Ethnicity, Gender, SES and Age: A Review of the Research","Much research has shown that reports of stressful life events are related to a wide variety of psychiatric and physical health outcomes. Relatively little research exists, however, on the distribution of the events according to gender, age, racial/ethnic background, and socioeconomic status (SES). Such information would help identify groups at greatest risk for further investigation. This paper presents a review of the relevant studies. We find that traumatic (e.g., life threatening) events appear to be more frequent for men, while men and women differ more consistently on types rather than on overall numbers of stressful events other than traumatic. Traumatic and other stressful events tend to be more frequent in low SES and racial/ethnic minorities groups, and finally, both traumatic and other stressful events are reported more by younger age groups in samples 18 years of age and older. The limitations and implications of these findings for further research and preventive interventions are discussed, especially the need for more detailed information about individual events.",0 +https://doi.org/10.1348/147608304x21400,Control theory and psychopathology: An integrative approach,"Perceptual control theory (PCT; Powers, 1973) is presented and adapted as a framework to understand the causes, maintenance, and treatment of psychological disorders. PCT provides dynamic, working models based on the principle that goal-directed activity arises from a hierarchy of negative feedback loops that control perception through control of the environment. The theory proposes that psychological distress arises from the unresolved conflict between goals. The present paper integrates PCT, control theory, and self-regulatory approaches to psychopathology and psychotherapy and recent empirical findings, particularly in the field of cognitive therapy. The approach aims to offer fresh insights into the role of goal conflict, automatic processes, imagery, perceptual distortion, and loss of control in psychological disorders. Implications for psychological therapy are discussed, including an integration of the existing work on the assessment of control profiles and the use of assertive versus yielding modes of control.",0 +https://doi.org/10.15557/pipk.2014.0019,Kompleksowa opieka nad dzieckiem z zespołem stresu pourazowego,"The essential feature of posttraumatic stress disorder (PTSD) is the development of characteristic symptoms following exposure to a traumatic event that arouses - intense fear, helplessness, or horror, or in children - disorganized or agitated behaviour. Symptoms are categorized into three clusters: persistent re-experiencing of the stressor, persistent avoidance of reminders and emotional numbing, and persistent symptoms of increased arousal. Childhood PTSD confers increased risk for a number of problems in later childhood, adolescence and adulthood. Among psychotherapies there is convincing evidence that trauma-focused therapies, that is that specifically address the child's traumatic experiences, are superior to nonspecific or nondirective therapies in resolving PTSD symptoms. Among the trauma-focused psychotherapies, TF-CBT has received the most empirical support for the treatment of childhood PTSD. The first step in the psychotherapy for posttraumatic stress disorder in children is helping the child gain a sense of mastery over the trauma and helping the child to feel safe again. In older children, gaining a sense of mastery includes the ability to recall, relate, narrate, and reconsider the trauma without feeling overwhelmed and without dissociating. Relaxation training and medication may be helpful in enabling the child to do this. In younger children, play provides an opportunity to work through the trauma. The victims of domestic violence especially required long-term psychological and psychiatric treatment. © PSYCHIATR. PSYCHOL.",0 +https://doi.org/10.1159/000100005,The Psychopathology of Posttraumatic Embitterment Disorders,"<i>Background:</i> The posttraumatic embitterment disorder (PTED) was introduced as a new subgroup of adjustment disorders. The trigger event in PTED is an exceptional, though normal negative life event that is experienced as a violation of basic beliefs and values. The predominant emotion in PTED is embitterment. This study presents first data on the psychopathological profile of PTED. <i>Method:</i> 48 inpatients were diagnosed by clinical judgment as suffering from PTED. Patients were then interviewed with the standardized Mini International Neuropsychiatric Interview (MINI) and an additional interview section on the diagnostic criteria for PTED. Patients also filled in the Symptom Checklist-90-Revision (SCL-90-R), and the Impact of Event Scale (IES-R). <i>Results:</i> According to the MINI68.8% of the patients fulfilled the criteria for adjustment disorders, 52.1% for major depression, 41.7% for dysthymia, and 35.4% for generalized anxiety disorders. 100% of patients reported that they were suffering from intrusive thoughts about the event. 97.9% of the patients complained about persistent negative mood, 91.7% about restlessness, 83.3% inhibition of drive and loss of interest, 77.1% phobic avoidance of places related to the event, and 75% resignation, but 91.7% reported normal mood when distracted. The SCL-90-R indicated a high load of general psychopathological complaints with an average positive symptom total score of 52.26. Characteristic were feelings of injustice (100%), embitterment (97.7%), and rage (91.7%). The IES-R scale indicated a high prevalence of posttraumatic stress, with an average total score of 3.23. The average duration of illness was 31.7 months. <i>Conclusions:</i> The PTED patients are suffering from severe, multiform, and disabling symptoms. Their clinical features pose difficult diagnostic problems. The predominant complaints about feelings of injustice, embitterment, and rage and the results of the IES speak for the importance of the critical event for the development and understanding of such disorders.",0 +https://doi.org/10.1097/ccm.0b013e3181feb824,Postintensive care unit psychological burden in patients with chronic obstructive pulmonary disease and informal caregivers: A multicenter study,"To determine the prevalence and risk factors of symptoms of anxiety, depression, and posttraumatic stress disorder-related symptoms in patients with chronic obstructive pulmonary disease and their relatives after an intensive care unit stay.Prospective multicenter study.Nineteen French intensive care units.One hundred twenty-six patients with chronic obstructive pulmonary disease who survived an intensive care unit stay and 102 relatives.None.Patients and relatives were interviewed at intensive care unit discharge and 90 days later to assess symptoms of anxiety and depression using Hospital Anxiety and Depression Scale (HADS) and posttraumatic stress disorder-related symptoms using the Impact of Event Scale (IES). At intensive care unit discharge, 90% of patients recollected traumatic psychological events in the intensive care unit. At day 90, we were able to conduct telephone interviews with 53 patients and 47 relatives. Hospital Anxiety and Depression Scale scores indicated symptoms of anxiety and depression in 52% and 45.5% of patients at intensive care unit discharge and in 28.3% and 18.9% on day 90, respectively. Corresponding prevalence in relatives were 72.2% and 25.7% at intensive care unit discharge and 40.4% and 14.9% on day 90, respectively. The Impact of Event Scale indicated posttraumatic stress disorder-related symptoms in 20.7% of patients and 29.8% of relatives on day 90. Peritraumatic dissociation assessed using the Peritraumatic Dissociative Experiences Questionnaire was independently associated with posttraumatic stress disorder-related symptoms in the patients and relatives. Previous intensive care unit experience and recollection of bothersome noise in the intensive care unit predicted posttraumatic stress disorder-related symptoms in the patients.Psychiatric symptoms were found to be common in a group of 126 patients with chronic obstructive pulmonary disease who survived an intensive care unit stay and their relatives at intensive care unit discharge and 90 days later. Peritraumatic dissociation at intensive care unit discharge was found to independently predict posttraumatic stress disorder-related symptoms in this sample of patients and relatives.",0 +,Rationale for iloperidone in the treatment of posttraumatic stress disorder.,"Multiple controlled efficacy studies are available to support the use of psychotropic medications in the treatment of posttraumatic stress disorder symptoms. Iloperidone, a recently approved atypical antipsychotic, has yet to be evaluated in such a manner. This unique agent has the highest affinity of all antipsychotics toward alpha-1 receptors. Antagonism of central nervous system alpha-1 receptors has been implicated in certain aspects of posttraumatic stress disorder, as evidenced by the beneficial role of prazosin in treating nightmares. Additional reduction in hypervigilance may occur through blockade of dopamine receptor D2 and serotonin receptors in the 5-HT2 family. Further investigation of iloperidone is warranted in the treatment of patients with posttraumatic stress disorder due to its unique receptor binding profile.",0 +https://doi.org/10.4103/0253-7176.108206,Compassion Fatigue and Burnout Amongst Clinicians: A Medical Exploratory Study,"Compassion fatigue is a broad term comprising of two components - burnout and secondary traumatic stress. The current study is aimed at identifying 'burnout' and 'compassion fatigue' among clinicians involved in care of individuals suffering from medical illness.A total of 60 clinicians were included in the study. A semi-structured questionnaire was administered to gather information related to personal, professional, anthropometric, and metabolic profile of the study participants. Professional Quality of Life Scale (ProQoL Version V) was used to assess burnout, compassion satisfaction and secondary traumatic stress. Analysis was carried out using the SPSS version 19.0.The mean age of clinicians was 46.68±11.06 (range 26-67 years). Burnout score was significantly higher in those involved in diabetology practice. Similarly, compassion satisfaction score was greater among those with greater years of practice as well as among those in private practice. Clinicians who reported a poor working condition, as opposed to good, had more burnout and less compassion satisfaction.The current study suggests that it is important to find out ways of decreasing burnout and compassion fatigue among clinicians.",0 +https://doi.org/10.1097/hrp.0b013e31828e8ef4,"Principles and neurobiological correlates of concentrative, diffuse, and insight meditation.","T he term meditation encompasses a broad variety of mental-training practices that vary between cultures and traditions, ranging from techniques designed to promote physical health, relaxation, and improved concentration, to exercises performed with farther-reaching goals, such as developing a heightened sense of well-being, cultivating altruistic behaviors, and, for some, attaining enlightenment. Meditation can be conceptualized as complex emotional and attentional regulatory practices in which mental and somatic events are affected by specific mental-training practices. Meditation is typically associated with a concurrent state of heightened vigilant awareness and reduced metabolic activity—which lead to improved physical health, psychological balance, and emotional stability. Not all meditation practices focus on the training of specific cognitive skills, and in those that do, the methodologies and outcomes often vary. It is therefore essential to be explicit about the type of meditation practice under investigation. Different types of meditation can be classified based on how the practitioner’s attentional processes are regulated and directed. In this article we focus on the two most common styles of meditation derived from Buddhist traditions: (1) concentrative, or focused-attention, meditation, and (2) diffuse, or open-monitoring, meditation. Concentrative meditation involves maintaining and continually refocusing attention on a chosen object, such as a body sensation, single point in space, color, object, sound, or affective state such as compassion. Open-monitoring meditation involves developing a present-centered and unattached/neutral mode of observation toward all sensational phenomena, including thoughts.",0 +https://doi.org/10.2217/npy.12.52,Clinical applications of electroconvulsive therapy and transcranial magnetic stimulation for the treatment of major depressive disorder: a critical review,"Depression is a common and debilitating psychiatric disorder that is often unable to be effectively treated with pharmacotherapeutic agents alone. Electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) are among several somatic therapies available for the treatment of major depression. The purpose of this article is to synthesize current information on ECT and repetitive TMS as treatments for pharmacotherapy-resistant major depression regarding its use in neuropsychiatric clinical practice. The current psychiatric literature indicates that both ECT and TMS are effective antidepressant treatments. ECT is a safe and highly effective treatment for depression. The literature also illustrates that TMS has a favorable side-effect profile, excellent tolerability and modest efficacy. To date, additional research is being conducted to further enhance ECT and TMS treatment, and to further define their role in treatment algorithms.",0 +https://doi.org/10.1016/j.ejpain.2008.10.003,Emotional numbing and pain intensity predict the development of pain disability up to one year after lateral thoracotomy,"Little is known about the factors that predict the transition of acute, time limited pain to chronic pathological pain following postero-lateral thoracotomy. The aim of the present prospective, longitudinal study was to determine the extent to which (1) pre-operative pain intensity, pain disability, and post-traumatic stress symptoms (PTSS) predict post-thoracotomy pain disability 6 and 12 months later; and (2) if these variables, assessed at 6 months, predict 12 month pain disability. Fifty-four patients scheduled to undergo postero-lateral thoracotomy for intrathoracic malignancies were recruited before surgery and followed prospectively for one year. The incidence of chronic post-thoracotomy pain was 68.1% and 61.1% at the 6 and 12 month follow-ups, respectively. Multiple regression analyses showed that neither pre-operative factors nor acute movement-evoked post-operative pain predicted 6 or 12 month pain disability. However, concurrent pain intensity and emotional numbing, but not avoidance symptoms, made unique, significant contributions to the explanation of pain disability at each follow-up (total R(2)=76.3.0% and 63.9% at 6 and 12 months, respectively, both p<0.0009). The relative contribution of pain intensity decreased, while that of emotional numbing increased with time, indicating a progressive de-coupling of pain intensity and disability and a concomitant strengthening of the link between emotional numbing and disability. This suggests that pain may serve as a traumatic stressor which causes increased emotional numbing. The results also support recent suggestions that avoidance and emotional numbing constitute separate PTSS clusters. Further research is required to determine the source(s) of emotional numbing after postero-lateral thoracotomy and effective interventions.",0 +https://doi.org/10.1016/j.injury.2015.06.018,Associations with duration of compensation following whiplash sustained in a motor vehicle crash,"Continued exposure to compensation systems has been reported as deleterious to the health of participants. Understanding the associations with time to claim closure could allow for targeted interventions aimed at minimising the time participants are exposed to the compensation system.To identify the associations of extended time receiving compensation benefits with the aim of developing a prognostic model that predicts time to claim closure.Prospective cohort study in people with whiplash associated disorder.Time to claim closure, in a privately underwritten fault based third party traffic crash insurance scheme in New South Wales, Australia.Cox proportional hazard regression modelling.Of the 246 participants, 25% remained in the compensation system longer than 24 months with 15% remaining longer than three years. Higher initial disability (Functional Rating Index≥25 at baseline) (HRR: 95% CI, 1.916: 1.324-2.774, p<0.001); and lower initial mental health as measured by SF-36 Mental Component Score (HRR: 95% CI, 0.973: 0.960-0.987, p<0.001) were significantly and independently associated with an increased time-to-claim closure. Shorter time to claim closure was associated with having no legal involvement (HRR: 95% CI, 1.911: 1.169-3.123, p=0.009); and, not having a prior claim for compensation (HRR: 95% CI, 1.523: 1.062-2.198, p=0.022).Health and insurance related factors are independently associated with time to claim closure. Both factors need to be considered by insurers in their assessment of complexity of claims. Interventions aimed at minimising the impact of these factors could reduce claimants' exposure to the compensation system. In turn insurers can potentially reduce claims duration and cost, while improving the health outcomes of claimants.",0 +https://doi.org/10.1016/j.janxdis.2014.01.005,The impact of PTSD symptoms on physical and mental health functioning in returning veterans,"This study aimed to determine the unique impact of PTSD symptoms, beyond other frequently examined factors on physical and mental health functioning in a sample of returning veterans. Assessments of 168 returning OEF/OIF veterans conducted an average of six months following return from deployment included measures of emotional disorders and the Short Form (36) Health Survey. Hierarchical multiple regressions revealed significant, unique contribution of Clinician-Administered PTSD Scale (CAPS) score above all other predictors in the model (demographics, severity of trauma exposure, physical injury, substance abuse and depressive symptoms), for both the physical (8%) and mental (6%) health aggregate scores, along with significant prediction of physical health (4-10%) and mental health (3-7%) subscale scores. The only other significant predictors were age for physical health scores, and depressive symptoms for mental health scores. PTSD criterion B (re-experiencing) symptoms uniquely predicted reduced physical health functioning and higher experience of bodily pain, while criterion D (hyperarousal) symptoms uniquely predicted lower feelings of energy/vitality and poorer perceptions of emotional health.",0 +https://doi.org/10.1177/1073191114552076,The Effectiveness of the Personality Assessment Inventory With Feigned PTSD,"Malingered posttraumatic stress disorder (PTSD) poses a formidable clinical challenge because of the apparent ease in feigning PTSD. As an additional confound, some patients with genuine PTSD produce elevated profiles on feigning indicators that are difficult to distinguish from feigned PTSD. The current study utilized 109 inpatients from a trauma unit to examine whether the Personality Assessment Inventory and the Detailed Assessment of Posttraumatic Stress can effectively differentiate between genuine and feigned PTSD. As a primary focus, Resnick’s model of malingered PTSD was evaluated with its three subtypes: pure malingering, partial malingering, and false imputation. They were tested on their ability to (a) effectively simulate PTSD and (b) avoid being classified as feigning. The partial malingering group proved to be the best feigning group in achieving these two goals. Overall, the Personality Assessment Inventory Malingering Index and Negative Distortion Scale were the most effective at identifying feigning.",0 +https://doi.org/10.1016/j.jad.2014.09.021,"Trajectories of posttraumatic stress symptoms (PTSS) after major war among Palestinian children: Trauma, family- and child-related predictors","Research shows great individual variation in changes in posttraumatic stress symptoms (PTSSs) after major traumas of terrorist attacks, military combat, and natural disasters. Earlier studies have identified specific mental health trajectories both in children and adults. This study aimed, first, to identify potential PTSS-related trajectories by using latent class growth analyses among children in a three-wave assessment after the 2008/2009 War on Gaza, Palestine. Second, it analyzed how family- and child related factors (e.g., attachment relations, posttraumatic cognitions (PTCs), guilt, and emotion regulation) associate with the trajectory class membership.The sample consisted of 240 Palestinian children (49.4% girls and 50.6% boys) of 10-13 years of age (M=11.29, SD=0.68), who completed PTSS (CRIES) assessments at 3 (T1), 5 (T2), and 11 (T3) months after the war. Children reported their personal exposure to war trauma, attachment style, cognitive trauma processing, and emotion regulation, and their parents reported family war trauma exposure and attachment style.Results revealed a three-trajectory solution, a majority of children belonging to the Recovery trajectory (n=183), and a minority belonged either to Resistant trajectory (n=29) or to Increasing symptoms trajectory (n=28). Low levels of negative posttraumatic cognitive appraisals, feelings of guilt and emotion regulation were characteristic of children in the Resistant trajectory as compared to Increasing symptoms trajectory. Father׳s attachment security was further associated with the Resistant trajectory membership. Children׳s attachment avoidance and high parental trauma were typical to children in Recovery trajectory (as compared to the Increasing symptoms trajectory).",1 +https://doi.org/10.1007/s00127-014-0908-y,Frequencies and predictors of barriers to mental health service use: a longitudinal study of Hurricane Ike survivors,"BackgroundThe majority of disaster survivors suffering from psychological symptoms do not receive mental health services. Research on barriers to service use among disaster survivors is limited by a lack of longitudinal studies of representative samples and investigations of predictors of barriers. The purpose of this study was to address these limitations through analysis of a three-wave population-based study of Hurricane Ike survivors (N = 658).MethodsFrequencies of preference, outcome expectancy, resource, and stigma barriers among participants with unmet mental health needs were documented and logistic regression using a generalized estimating equations approach explored predisposing (e.g., age), illness-related (e.g., posttraumatic stress) and enabling (e.g., insurance coverage) factors as predictors of each type of barrier.ResultsPreference barriers were most frequently cited at each wave, whereas stigma barriers were least frequently cited. Older age and higher emotional support predicted preference barriers; being a parent of a child under 18-years old at the time of the hurricane, higher generalized anxiety, and lack of insurance predicted resource barriers; and higher posttraumatic stress predicted stigma barriers.ConclusionsThese findings suggest that postdisaster practices targeting subpopulations most likely to have barriers to service use may be indicated.",0 +https://doi.org/10.1089/acm.2009.0510,"Outcome Evaluation of the Veterans Affairs Salt Lake City Integrative Health Clinic for Chronic Pain and Stress-Related Depression, Anxiety, and Post-Traumatic Stress Disorder","Objectives: The purpose of this longitudinal outcome research study was to determine the effectiveness of the Integrative Health Clinic and Program (IHCP) and to perform a subgroup analysis investigating patient benefit. The IHCP is an innovative clinical service within the Veterans Affairs Health Care System designed for nonpharmacologic biopsychosocial management of chronic nonmalignant pain and stress-related depression, anxiety, and symptoms of post-traumatic stress disorder (PTSD) utilizing complementary and alternative medicine and mind–body skills. Methods: A post-hoc quasi-experimental design was used and combined with subgroup analysis to determine who benefited the most from the program. Data were collected at intake and up to four follow-up visits over a 2-year time period. Hierarchical linear modeling was used for the statistical analysis. The outcome measures included: Health-Related Quality of Life (SF-36), the Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Subgroup comparisons included low anxiety (BAI < 19, n = 82), low depression (BDI < 19, n = 93), and absence of PTSD (n = 102) compared to veterans with high anxiety (BAI ≥ 19, n = 77), high depression (BDI > 19, n = 67), and presence of PTSD (n = 63). Results: All of the comparison groups demonstrated an improvement in depression and anxiety scores, as well as in some SF-36 categories. The subgroups with the greatest improvement, seen at 6 months, were found in the high anxiety group (Cohen's d = 0.52), the high-depression group (Cohen's d = 0.46), and the PTSD group (Cohen's d = 0.41). Conclusions: The results suggest IHCP is an effective program, improving chronic pain and stress-related depression, anxiety, and health-related quality of life. Of particular interest was a significant improvement in anxiety in the PTSD group. The IHCP model offers innovative treatment options that are low risk, low cost, and acceptable to patients and providers.",0 +https://doi.org/10.1038/mp.2015.134,SKA2 methylation is associated with decreased prefrontal cortical thickness and greater PTSD severity among trauma-exposed veterans,"Methylation of the SKA2 (spindle and kinetochore-associated complex subunit 2) gene has recently been identified as a promising biomarker of suicide risk. Based on this finding, we examined associations between SKA2 methylation, cortical thickness and psychiatric phenotypes linked to suicide in trauma-exposed veterans. About 200 trauma-exposed white non-Hispanic veterans of the recent conflicts in Iraq and Afghanistan (91% male) underwent clinical assessment and had blood drawn for genotyping and methylation analysis. Of all, 145 participants also had neuroimaging data available. Based on previous research, we examined DNA methylation at the cytosine-guanine locus cg13989295 as well as DNA methylation adjusted for genotype at the methylation-associated single nucleotide polymorphism (rs7208505) in relationship to whole-brain cortical thickness, posttraumatic stress disorder symptoms (PTSD) and depression symptoms. Whole-brain vertex-wise analyses identified three clusters in prefrontal cortex that were associated with genotype-adjusted SKA2 DNA methylation (methylation(adj)). Specifically, DNA methylation(adj) was associated with bilateral reductions of cortical thickness in frontal pole and superior frontal gyrus, and similar effects were found in the right orbitofrontal cortex and right inferior frontal gyrus. PTSD symptom severity was positively correlated with SKA2 DNA methylation(adj) and negatively correlated with cortical thickness in these regions. Mediation analyses showed a significant indirect effect of PTSD on cortical thickness via SKA2 methylation status. Results suggest that DNA methylation(adj) of SKA2 in blood indexes stress-related psychiatric phenotypes and neurobiology, pointing to its potential value as a biomarker of stress exposure and susceptibility.",0 +,"Predicting symptom clusters of posttraumatic stress disorder (PTSD) in Croatian war veterans: the role of socio-demographics, war experiences and subjective quality of life.","Previous research has documented multiple chains of risk in the development of PTSD among war veterans. However, existing studies were mostly carried out in the West, while they also did not analyze specific symptom clusters of PTSD. The aim of this study was to examine the role of socio-demographic characteristics, war experiences and subjective quality of life in the prediction of three clusters of PTSD symptoms (i.e., avoidance, intrusion, hyperarousal).This study comprised 184 male participants who have survived war imprisonment during the Croatian Homeland War in the period from 1991 to 1995. The data was collected through several self-report measuring instruments: questionnaire on socio-demographic data, war experiences (Questionnaire on Traumatic Combat and War Experiences), subjective quality of life (WHO-Five Well-being Index), and PTSD symptoms (Impact of Events Scale - Revised).The level of three symptom clusters of PTSD was found to be moderate to high, as indicated by the scores on the IES-R. Results of the three hierarchical regression analyses showed the following: traumatic war experiences were significant predictors of avoidance symptoms; traumatic war experiences and subjective quality of life were significant predictors of hyperarousal symptoms; and traumatic war experiences, material status and subjective quality of life were significant predictors of intrusion symptoms.These findings support the widespread belief that the development of war-related PTSD is accounted for by multiple chains of risk, while traumatic war experiences seem to be the only predictor of all three symptom clusters. Future research should put more emphasis on specific PTSD symptom clusters when investigating the etiopathogenesis of this disorder among war-affected populations.",0 +https://doi.org/10.1080/10926771.2013.834017,The Severity of Childhood Abuse and Neglect in Relationship to Post-Traumatic Stress Disorder Among Female Sex Workers in the Netherlands,"In this article, the relationship between childhood abuse and neglect and post-traumatic stress disorder (PTSD) in adulthood is examined in a sample of 123 female indoor sex workers in the Netherlands. It was hypothesized that the severity of childhood abuse and neglect is associated with the severity of PTSD. In this study, a substantial number of sex workers had experienced abuse, neglect, or both during childhood. Furthermore, a substantial number suffered from PTSD. Results show significant differences between sex workers suffering from PTSD and sex workers not suffering from PTSD, in the extent to which they have experienced abuse or neglect. Logistic regression analysis shows emotional abuse contributes significantly to the prediction of PTSD. Our findings suggest that the high rate of PTSD among sex workers might be partially related to childhood experiences, indicating that a number of sex workers might be traumatized before entering sex work.",0 +https://doi.org/10.1007/s10880-011-9266-z,A Pilot Study of Acute Stress Symptoms in Parents and Youth Following Diagnosis of Type I Diabetes,"The primary aims of this exploratory study were to determine the rate of occurrence of acute stress disorder (ASD) in children newly diagnosed with Type 1 diabetes and their parents, to examine relationships with demographic and psychosocial factors, and to examine the relationships between ASD symptom clusters and early adherence behavior (clinic attendance). The sample consisted of 102 parents of children ages 0-17 years and 40 youth ages 11-17 who were evaluated within three days of diabetes diagnosis. Eighteen percent of parents and 17% of youth reported subthreshold symptoms of ASD. Acute stress symptoms and demographic variables predicted clinic attendance, with a differential pattern evident in the responses of youth and their parents. These findings reinforce the importance of screening symptoms of ASD in youth with newly diagnosed diabetes and their parents to assist in identifying families who may be in need of additional support. © Springer Science+Business Media, LLC 2011.",0 +https://doi.org/10.1016/j.jagp.2013.01.064,"PTSD Is a Chronic, Fluctuating Disorder Affecting the Mental Quality of Life in Older Adults","Examine the longitudinal course of posttraumatic stress disorder (PTSD) in older adults and its influence on mental health quality of life (MHQoL).Evaluation performed at baseline, and 3 and 6 months postrandomization as part of a longitudinal trial.A total of 1,185 participants, with a mean (±SD) age of 73.53 (±5.98) years, at seven primary care sites (including five Veterans Affairs clinics), were divided into four groups, namely, no trauma (n = 661), trauma only (n = 319), partial PTSD (n = 114), and PTSD (n = 81), based on reports of trauma and associated PTSD symptoms.The prevalence of comorbid depression, anxiety, and alcohol use disorders, assessed using the Diagnostic and Statistical Manual, Fourth Edition, criteria and changes in MHQoL, as assessed by the Short Form-36 mental component score.At baseline, the PTSD group had higher frequencies of comorbid depression and anxiety disorders and worse MHQoL than the other groups. Both chronic (participants diagnosed with PTSD at all three assessments) and fluctuating (participants moving to or from one of the other groups) trajectories of course were observed during the follow-up period, which appeared to be separate from that of the comorbid disorders. Even after accounting for those comorbid disorders, PTSD had an independent association with poorer MHQoL at multiple time points, especially in men, whereas trauma without PTSD symptoms (trauma only) had better MHQoL.PTSD had chronic and fluctuating courses, with negative effects on MHQoL, while partial PTSD might represent a transitional state, underscoring the need to better identify and treat PTSD at any phase in later life.",0 +https://doi.org/10.1115/imece2013-63910,Response of Post-Mortem Human Head Under Primary Blast Loading Conditions: Effect of Blast Overpressures,"Blast induced neurotrauma (BINT), and posttraumatic stress disorder (PTSD) are identified as the “signature injuries” of recent conflicts in Iraq and Afghanistan. The occurrence of mild to moderate traumatic brain injury (TBI) in blasts is controversial in the medical and scientific communities because the manifesting symptoms occur without visible injuries. Whether the primary blast waves alone can cause TBI is still an open question, and this work is aimed to address this issue. We hypothesize that if a significant level of intracranial pressure (ICP) pulse occurs within the brain parenchyma when the head is subjected to pure primary blast, then blast induced TBI is likely to occur. In order to test this hypothesis, three post mortem human heads are subjected to simulated primary blast loading conditions of varying intensities (70 kPa, 140 kPa and 200 kPa) at the Trauma Mechanics Research Facility (TMRF), University of Nebraska-Lincoln. The specimens are placed inside the 711 mm × 711 mm square shock tube at a section where known profiles of incident primary blast (Friedlander waveform in this case) are obtained. These profiles correspond to specific field conditions (explosive strength and stand-off distance). The specimen is filled with a brain simulant prior to experiments. ICPs, surface pressures, and surface strains are measured at 11 different locations on each post mortem human head. A total of 27 experiments are included in the analysis. Experimental results show that significant levels of ICP occur throughout the brain simulant. The maximum peak ICP is measured at the coup site (nearest to the blast) and gradually decreases towards the countercoup site. When the incident blast intensity is increased, there is a statistically significant increase in the peak ICP and total impulse (p<0.05). Even after five decades of research, the brain injury threshold values for blunt impact cases are based on limited experiments and extensive numerical simulations; these are still evolving for sports-related concussion injuries. Ward in 1980 suggested that no brain injury will occur when the ICP<173 kPa, moderate to severe injury will occur when 173 kPa<ICP<235 kPa and severe injury will occur when ICP>235 kPa for blunt impacts. Based on these criteria, no injury will occur at incident blast overpressure level of 70 kPa, moderate to severe injuries will occur at 140 kPa and severe head injury will occur at the incident blast overpressure intensity of 200 kPa. However, more work is needed to confirm this finding since peak ICP alone may not be sufficient to predict the injury outcome.",0 +https://doi.org/10.1176/appi.ajp.160.2.371,Reduction of Nightmares and Other PTSD Symptoms in Combat Veterans by Prazosin: A Placebo-Controlled Study,"Prazosin is a centrally active alpha(1) adrenergic antagonist. The authors' goal was to evaluate prazosin efficacy for nightmares, sleep disturbance, and overall posttraumatic stress disorder (PTSD) in combat veterans.Ten Vietnam combat veterans with chronic PTSD and severe trauma-related nightmares each received prazosin and placebo in a 20-week double-blind crossover protocol.Prazosin (mean dose=9.5 mg/day at bedtime, SD=0.5) was superior to placebo for the three primary outcome measures: scores on the 1) recurrent distressing dreams item and the 2) difficulty falling/staying asleep item of the Clinician-Administered PTSD Scale and 3) change in overall PTSD severity and functional status according to the Clinical Global Impression of change. Total score and symptom cluster scores for reexperiencing, avoidance/numbing, and hyperarousal on the Clinician-Administered PTSD Scale also were significantly more improved in the prazosin condition, and prazosin was well tolerated.These data support the efficacy of prazosin for nightmares, sleep disturbance, and other PTSD symptoms.",0 +https://doi.org/10.1017/cbo9780511730030.006,Substance Use And Misuse After Disasters:,"Introduction Exposure to various traumatic events, as well as resulting disturbances such as posttraumatic stress disorder (PTSD), is associated with increased substance use (Breslau, Davis, & Schultz, 2003; Feldner, Babson, & Zvolensky, 2007; McFarlane, 1998; Morissette, Tull, Gulliver, Kamholz, & Zimering, 2007; Stewart, 1996). In particular, studies have shown that alcohol and tobacco consumption increase through both initiation of and increasing use of these substances. It is, however, unclear whether this is also true in the aftermath of large-scale catastrophes or disasters. The distinction between individual traumatic experiences and collective experiences (e.g., disasters) may be sometimes unclear (Galea, Nandi, & Vlahov, 2005). Moreover, comorbidity profiles of PTSD and substance use and misuse, as well as the population under study, may differ between types of trauma (Deering, Glover, Ready, Eddleman, & Alarcon, 1996). Insight into substance use and misuse after disaster is important for several reasons. First, similar to PTSD and other mental health disturbances, understanding the prevalence of substance use and misuse after disasters is necessary in estimating the need for mental health services (see Cao, McFarlane, & Klimidis, 2003) and in organizing programs to prevent prolonged and increased use to minimize adverse affects on health and functioning. Second, information on comorbidity (e.g., PTSD, depression), correlates, and predictors of substance use may help to identify victims who are at risk for substance disorders and increased substance use in the short, medium and/or long term. © Cambridge University Press 2009.",0 +https://doi.org/10.1007/0-387-25610-5_14,Comorbid Chronic Pain and Posttraumatic Stress Disorder Across the Lifespan: A Review of Theoretical Models,"(from the chapter) The primary aim of this chapter is to provide a critical review and synthesis of the existing literature investigating the relationship between chronic pain and posttraumatic stress disorder (PTSD). The chapter begins with a presentation of the diagnostic criteria, prevalence, and theoretical models of chronic pain and PTSD. Research is then presented describing the co-occurrence of the two disorders, and several theoretical models are highlighted that may serve to explain the similar mechanisms by which these two disorders may be maintained. This chapter then addresses how comorbid chronic pain and PTSD may present differently in youth, with consideration of how theoretical models of the comorbidity of pain and PTSD may be modified to incorporate developmental factors. Furthermore, the chapter helps to explicate how the experience of comorbid chronic pain and PTSD can vary from childhood to adulthood. Finally, the chapter closes with a section on implications for treatment as well as a call for continued research to further refine the models reviewed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.7205/milmed-d-12-00008,Interpersonal Conflict and Referrals to Counseling Among Married Soldiers Following Return From Deployment,"Deployment represents a significant potential strain on military families. The impact of postdeployment stresses may be increased if family coping resources are diminished by returning service members' physical injuries, mental health issues, or substance abuse. This article examines the health and mental health correlates of self-reported concerns regarding interpersonal conflict among married soldiers following return from deployment and the likelihood that soldiers acknowledging such concerns are referred to counseling services. Among 20,166 married Army soldiers completing Post-Deployment Health Reassessments, 18% reported having experienced serious interpersonal conflict with their spouse, family members, close friends, or coworkers. Results indicate that interpersonal conflict was more common among those who reported health problems, depression, post-traumatic stress disorder, and alcohol abuse. Among soldiers reporting interpersonal conflict and not already receiving services, 11% were referred to service. Findings support the need to communicate with soldiers and their spouses about the availability of services following return from deployment and to continue efforts to reduce stigma associated with seeking treatment.",0 +https://doi.org/10.1001/archpsyc.65.4.431,A Second Look at Prior Trauma and the Posttraumatic Stress Disorder Effects of Subsequent Trauma,"Previous studies showed increased probability of a posttraumatic stress disorder (PTSD) effect of trauma in persons who had experienced prior trauma. The evidence comes chiefly from retrospective data on earlier events, obtained from trauma-exposed persons with and without PTSD. A generally overlooked major limitation is the failure to assess the PTSD response to the prior trauma.To estimate the risk of PTSD after traumas experienced during follow-up periods in relation to respondents' prior traumatic events and PTSD.A cohort study of young adults interviewed initially in 1989, with repeated assessments during a 10-year follow-up.The sample was randomly selected from a large health maintenance organization in Southeast Michigan, representing the geographic area.The relative risk of PTSD precipitated by traumatic events occurring during follow-up periods in relation to prior exposure and PTSD that had occurred during preceding periods, estimated by general estimating equations (n = 990).The conditional risk of PTSD during the follow-up periods was significantly higher among trauma-exposed persons who had experienced prior PTSD, relative to those with no prior trauma (odds ratio, 3.01; 95% confidence interval, 1.52-5.97). After adjustment for sex, race, education, and preexisting major depression and anxiety disorders, the estimates were only marginally revised. In contrast, the conditional risk of PTSD during follow-up among trauma-exposed persons who had experienced prior traumatic events but not PTSD was not significantly elevated, relative to trauma-exposed persons with no prior trauma. The difference between the 2 estimates was significant (P = .005).Prior trauma increases the risk of PTSD after a subsequent trauma only among persons who developed PTSD in response to the prior trauma. The findings suggest that preexisting susceptibility to a pathological response to stressors may account for the PTSD response to the prior trauma and the subsequent trauma.",0 +https://doi.org/10.1016/j.jad.2015.04.026,The role of guilt in the development of post-traumatic stress disorder: A systematic review,"Post-traumatic stress disorder (PTSD) can be a debilitating condition associated with a myriad of emotions. Guilt is an important associated feature of PTSD that has received far less recognition than other symptoms often associated with fear and intense threat. The nature of the relationship between guilt and PTSD remains elusive and requires further clarification. The aim of the current paper was to review the extant literature regarding the link between guilt and PTSD.A systematic database search of PsycINFO, Medline, Embase and Web of Science identified articles that enabled examination of the guilt-PTSD relationship. A total of 27 articles met inclusion criteria for this review.There were cross-sectional relationships between guilt and PTSD symptomology with evidence of associations between PTSD symptoms and cognitions related to perceived wrong doing and self-blame. However, the direction of association between guilt and PTSD is unclear and possibly confounded by overlapping constructs such as shame.The review is constrained by the absence of longitudinal and experimental research and studies, which control for potential confounding variables. The reliability and validity of measures of guilt and PTSD is also not consistently reported.This review outlines four competing models of the guilt-PTSD relationship and examines existing evidence linking the two constructs. The current literature is too preliminary to offer any strong support for one model over the other. However, in critically appraising existing studies, this review helps to inform the design of future studies investigating the association between guilt and PTSD.",0 +https://doi.org/10.1016/j.mayocp.2012.07.002,Suicide in the US Army,"Suicide in the US Army is a high-profile public health problem that is complex and poorly understood. Adding to the confusion surrounding Army suicide is the challenge of defining and understanding individuals/populations dying by suicide. Data from recent studies have led to a better understanding of risk factors for suicide that may be specifically associated with military service, including the impact of combat and deployment on increased rates of psychiatric illness in military personnel. The next steps involve applying these results to the development of empirically supported suicide prevention approaches specific to the military population. This special article provides an overview of suicide in the Army by synthesizing new information and providing clinical pearls based on research evidence.",0 +https://doi.org/10.1016/j.whi.2011.04.013,Work-related quality of life and posttraumatic stress disorder symptoms among female veterans.,"Posttraumatic stress disorder (PTSD) can have pervasive, negative effects on multiple aspects of quality of life. We investigated the relationship between PTSD symptom clusters and work-related quality of life among female veterans. Although prior studies have shown that PTSD symptom clusters are differentially related to work-related quality of life, no study has assessed these relationships in women specifically.Participants were 253 female veterans with current PTSD. We assessed three components of work-related quality of life (employment status, clinician-rated occupational impairment, and self-rated occupational satisfaction) and performed analyses with and without adjusting for self-reported depression symptoms.None of the PTSD symptom clusters were associated with employment status. All PTSD symptom clusters had significant independent associations with occupational impairment. All PTSD symptom clusters except avoidance were significantly associated with lower occupational satisfaction, but none had independent associations with occupational satisfaction. No single PTSD symptom cluster emerged as most strongly associated with occupational outcomes. Symptoms of depression had substantial associations across all occupational outcomes, independent of PTSD symptoms.Knowledge about how PTSD relates to occupational outcomes in women veterans is important for addressing the needs of this growing segment of the VA patient population, in which PTSD is a prevalent condition. Because PTSD had differential relationships with the three components of work-related quality of life, measuring only one component, or using an aggregate measure, may obscure important distinctions. Resolving depression symptoms also may be integral to achieving meaningful recovery.",0 +https://doi.org/10.1007/s10865-013-9500-2,Treatment-related reductions in PTSD and changes in physical health symptoms in women,"This study examined the relationship between change in posttraumatic stress disorder (PTSD) symptoms over the course of PTSD treatment and the association with changes in general physical health symptoms. Both positive health habits (e.g., exercise) and negative (e.g., smoking), were examined to determine if they accounted for the association between changes in PTSD severity over time and changes in physical health. Participants were 150 women seeking treatment for PTSD. Latent growth curve modeling indicated a substantial relationship (R 2 = 34 %) between changes in PTSD and changes in physical health that occurred during and shortly following treatment for PTSD. However, there was no evidence to suggest that changes in health behaviors accounted for this relationship. Thus, PTSD treatment can have beneficial effects on self-reported physical health symptoms, even without direct treatment focus on health per se, and is not accounted for by shifts in health behavior. © 2013 Springer Science+Business Media New York (outside the USA).",0 +https://doi.org/10.1016/s0005-7967(00)00088-7,A prospective investigation of the role of cognitive factors in persistent Posttraumatic Stress Disorder (PTSD) after physical or sexual assault,"The effectiveness of psychological treatments for PTSD is likely to be enhanced by improved understanding of the factors involved in maintaining the disorder. Ehlers and Clark [A cognitive model of persistent posttraumatic stem disorder Behav. Res. Ther. 38 (2000) 319-345] recently proposed a cognitive model of maintenance. The current study aimed to investigate several cognitive factors highlighted in Ehlers and Clark's model using a prospective design. Fifty-seven victims of physical or sexual assault participated in the study. Cognitive factors were assessed within 4 months of assault and victims were followed-up 6 and 9 months after the assault. Cognitive variables which significantly predicted PTSD severity at both follow-ups were: cognitive processing style during assault (mental defeat, mental confusion, detachment); appraisal of assault sequelae (appraisal of symptoms, perceived negative responses of others, permanent change); negative beliefs about self and world; and maladaptive control strategies (avoidance/safety seeking). Relationships between early appraisals, control strategies, and processing styles and subsequent PTSD severity remained significant after statistically controlling for gender and perceived assault severity. These findings support the cognitive model of PTSD proposed by Ehlers and Clark and suggest that effective treatment will need to address these cognitive factors.",0 +https://doi.org/10.1358/dot.2006.42.12.1025704,Pharmacotherapy of post-traumatic stress disorder,"In the Diagnostic and Statistical Manual of Mental Disorders (DSM)-III, DSM-III-R and DSM-IV, the diagnosis of post-traumatic stress disorder (PTSD) requires the presence of three symptom clusters: re-experiencing, avoidance and hyperarousal. The selective serotonin reuptake inhibitors (SSRIs), in particular sertraline and paroxetine, have emerged as the treatment of choice for trauma victims experiencing these three symptom clusters. While not approved by the U.S. Food and Drug Administration, other pharmacological agents are often used, some for symptoms found in victims of early, chronic or extreme stress. Referred to as having type II trauma, complex PTSD, disorders of extreme stress and enduring personality change after catastrophic experience, these patients, with symptoms such as dissociation, somatization and self-injurious behavior, need to be recognized as suffering from a trauma-related disorder qualitatively different from that presently captured in the DSM-IV. In this paper we will refer to DSM-IV's construct as simple PTSD (sPTSD); to complex PTSD/disorders of extreme stress as cPTSD/DES; and to both as PTSD. We will review existing evidence for the efficacy of SSRIs in treating sPTSD as well as different pharmacological interventions that are necessary for the treatment of cPTSD/DES. In addition, since both sPTSD and cPTSD/DES frequently coexist with other mental disorders, treatment of comorbid PTSD will be addressed. Finally, given that existing rating scales are not designed to measure symptoms of cPTSD/DES, we will describe the Symptoms of Trauma Scale (SOTS), designed to measure symptoms of both sPTSD and cPTSD.",0 +https://doi.org/10.1080/13607863.2014.924901,Beware of multiple traumas in PTSD assessment: the role of reactivation mechanism in intrusive and hyper-arousal symptoms,"Post-traumatic stress disorder (PTSD) is a major public health problem defined by three symptom clusters: intrusion thoughts, avoidance mechanisms and hyper-arousal. Several authors have emphasized, that some or all of these symptoms related to a past traumatic experience could be reactivated, even after long asymptomatic periods. This study investigates the role of an additional trauma in the reactivation of a childhood trauma among a group of former hidden children (n = 65), the Jewish youths who spent World War II in various hideaway shelters in Nazi-occupied Europe. They were compared with a control group.The presence or absence of an additional trauma in adulthood was assessed and PTSD symptoms were measured by using the Impact of Event Scale-Revised.An additional trauma reactivates PTSD symptoms of intrusion thoughts and, marginally, symptoms of hyper-arousal. At the opposite, symptoms of avoidance were not reactivated.Our results confirm the role of an additional trauma in the reactivation of traumatic memories, related to an earlier trauma, in later life. Clinical and theoretical implications are discussed and perspectives are proposed.",0 +,ACUTE POST-TRAUMATIC STRESS DISORDER IN PRISONERS OF WAR RELEASED FROM DETENTION CAMPS,"The aim of the present study was to assess acute psychiatric disturbances in Croatian prisoners of war (POWs) released after 6-9 months of detention. Immediately (1-3 days) after exchange with the other side, 47 prisoners of war were examined at the Zagreb University Clinic for Infectious Diseases by a team of medical professionals to assess their physical and psychological health, and therapeutic needs. The team consisted of a general practitioner, surgeon, infectious diseases specialist, psychiatrist and clinical psychologist. All prisoners were active soldiers from Vukovar, and were of similar age, social background, combat activity and duration of detention. All were severely physically and psychically maltreated in the detention camp. Sixteen (34%) had symptoms of current post-traumatic stress syndrome as assessed by the Watsons PTSD questionnaire. In a structured clinical interview, all POWs reported at least 2 (average 8-9) symptoms of psychological disturbance. All POWs ranked the withdrawal of information on their families and the situation in Croatia as the most painful experience during detention. Minnesota Multiphasic Personality Inventory (MMPI-201 version) profiles of the prisoners of war showed a significant difference between the POWs with and without diagnosed PTSD on the paranoia scale. In conclusion, although only one third of the POWs released after 6-9 months of detention and torture had manifest PTSD, most had several symptoms of psychological disturbances with dominating anxiotic-depressive and psychosomatic reactions. Careful follow-up is needed to asses the extent and late consequences of polytrauma experienced by this high-risk group.",0 +https://doi.org/10.1175/1520-0434(1996)011<0329:halisf>2.0.co;2,Hurricane Andrew's Landfall in South Florida. Part II: Surface Wind Fields and Potential Real-Time Applications,"All available wind data associated with Hurricane Andrew’s passage were analyzed for periods corresponding to landfall south of Miami and emergence from southwest Florida. At landfall in southeast Florida, maximum sustained 1-min surface wind speeds VM1 reached just over 60 m s 01 in the northern eyewall over land; by the time Andrew exited the Florida peninsula, the peak value of VM1 over land decreased to 40 ‐ 45 m s 01 . Radar reflectivity observations from Tampa and Melbourne could not support an obvious correlation of convective cell development with coastal convergence during landfall on the southeast coast. On the southwest coast, however, convective cell development in the southern eyewall was supported by a coastal convergence maximum. Comparison of the wind swath with two independent Fujita-scale damage maps indicated that peak swath speeds compared well with damage-derived speed equivalents in the worst damaged areas but were higher than equivalents in moderately damaged areas. Comparison of the analysis maximum wind swath with an engineering survey of damaged homes suggests that homes exposed to a wide range of wind directions while subjected to high wind speeds suffered the most damage. Potential real-time applications of wind field products include warning dissemination, emergency management, storm surge and wave forecasting, and wind engineering. Development of damage assessment models for disaster mitigation is addressed from the viewpoint of an electrical utility.",0 +https://doi.org/10.1016/j.jpain.2015.10.019,Neuropathic Ocular Pain due to Dry Eye Is Associated With Multiple Comorbid Chronic Pain Syndromes,"Recent data show that dry eye (DE) susceptibility and other chronic pain syndromes (CPS) such as chronic widespread pain, irritable bowel syndrome, and pelvic pain, might share common heritable factors. Previously, we showed that DE patients described more severe symptoms and tended to report features of neuropathic ocular pain (NOP). We hypothesized that patients with a greater number of CPS would have a different DE phenotype compared with those with fewer CPS. We recruited a cohort of 154 DE patients from the Miami Veterans Affairs Hospital and defined high and low CPS groups using cluster analysis. In addition to worse nonocular pain complaints and higher post-traumatic stress disorder and depression scores (P < .01), we found that the high CPS group reported more severe neuropathic type DE symptoms compared with the low CPS group, including worse ocular pain assessed via 3 different pain scales (P < .05), with similar objective corneal DE signs. To our knowledge, this was the first study to show that DE patients who manifest a greater number of comorbid CPS reported more severe DE symptoms and features of NOP. These findings provided further evidence that NOP might represent a central pain disorder, and that shared mechanistic factors might underlie vulnerability to some forms of DE and other comorbid CPS.DE patients reported more frequent CPS (high CPS group) and reported worse DE symptoms and ocular and nonocular pain scores. The high CPS group reported symptoms of NOP that share causal genetic factors with comorbid CPS. These results imply that an NOP evaluation and treatment should be considered for DE patients.",0 +https://doi.org/10.1093/ije/dym013,Commentary: Women in combat and the risk of post-traumatic stress disorder and depression,"Studies among civilian populations have consistently shown that when compared with men, women have significantly higher prevalence rates of depression and anxiety disorders, including post-traumatic stress disorder (PTSD). Studies of general military populations in garrison have paralleled findings from civilian studies. Research on the gender differences associated with military deployment, such as Vietnam, Persian Gulf War, or peacekeeping operations, has found inconsistent results. These studies are not representative of current extended combat deployments in Iraq or Afghanistan, war zones that lack traditional front lines and in which women are serving in roles that put them at greater risk than in the past. Although women are excluded from serving in direct combat specialties, such as infantry or armour, and are therefore not at the same risk as male soldiers, they do serve in a variety of support positions where they travel outside military bases, work alongside combat soldiers, come under direct fire and may become casualties. These positions include military police, transportation, intelligence, pilots, medics, mechanics, civil affairs and other roles. Among the 3004 US fatalities from Iraq reported through 31 December 2006, 66 (2.2%) were women; among 127 UK fatalities, 3 (2.4%) were women. About two-thirds of these deaths involved hostile fire. In contrast, only one woman was reported to have died by hostile fire in Vietnam and five in the Persian Gulf War. An important unanswered question is whether there are gender differences in the risk of PTSD and other mental health problems among men and women exposed to similar levels of combat. The article by Dr Rona and colleagues is notable for being one of the first studies of gender differences in mental health concerns associated with deployment to the Iraq combat theatre. This study paves the way for future efforts to understand gender differences in the mental health impact of operations in Iraq and Afghanistan. The article reports a number of different findings among veterans of two wars and era controls that includes a trend analysis of changes in the health of UK military veterans between 1997 and 2005 in addition to the gender comparisons. The trend analysis is difficult to interpret due to the crosssectional design, lack of uniformity in the survey instruments (especially for the alcohol measure), demographic differences between the samples, differences in the prevalence of combat experiences and markedly different time frames for surveying following the return from deployment. Within the context of this larger effort, however, there are important comparisons of the prevalence of mental health concerns by gender for each cross-sectional deployed sample. Among the deployed Iraq War study group in the Rona et al. study, 26.7% of women compared with 19.8% of men reported high levels of psychological distress on the General Health Questionnaire (GHQ), a measure made up of questions pertaining mostly to depression. However, this difference in prevalence between men and women is considerably smaller than the differences found in most studies of civilian and non-deployed military populations. In terms of post-traumatic stress symptoms among Iraq War veterans, most notable was the lack of gender differences, which contrasts with the marked gender differences reported in many studies on PTSD in both civilian and military populations. In the study by Rona et al., 8.4% of women and 7.1% of men met the criteria for post-traumatic stress reaction and a smaller percentage met full criteria for PTSD. This finding suggests that combat deployment to Iraq is not associated with a higher risk of mental health problems among female compared with male service members, at least during the time frame that was measured, relatively proximal to homecoming. Some additional evidence from the United States supports the findings by Rona and colleagues regarding the minimal gender differences in mental health outcomes. All US troops receive a brief mental health assessment for depressive symptoms, posttraumatic stress symptoms, and concerns about family and relationship functioning when they return from deployment. Among the first 222 620 Army and Marine service members (10.6% of whom were women) who completed this assessment after returning from Iraq, 24% of the women reported some sort of mental health concern compared with 19% of the men, prevalences remarkably similar to the GHQ measures seen among UK–Iraq War service members. A more detailed survey was conducted among a sample of 2064 US soldiers (including 288 females) from infantry and combat support units during the middle of a year-long deployment to Iraq or Kuwait (August–October 2004). Among this sample, 13% of the male soldiers and 12% of the female y To accompany the article by Rona RJ, Fear NT, Hull L, Wessely S. ‘‘Women in novel occupational roles: mental health trends in the UK armed forces.’’",0 +https://doi.org/10.1002/jts.22030,Symptoms of PTSD Associated With Painful and Nonpainful Vicarious Reactivity Following Amputation,"Although the experience of vicarious sensations when observing another in pain have been described postamputation, the underlying mechanisms are unknown. We investigated whether vicarious sensations are related to posttraumatic stress disorder (PTSD) symptoms and chronic pain. In Study 1, 236 amputees completed questionnaires about phantom limb phenomena and vicarious sensations to both innocuous and painful sensory experiences of others. There was a 10.2% incidence of vicarious sensations, which was significantly more prevalent in amputees reporting PTSD-like experiences, particularly increased arousal and reexperiencing the event that led to amputation (φ = .16). In Study 2, 63 amputees completed the Empathy for Pain Scale and PTSD Checklist-Civilian Version. Cluster analyses revealed 3 groups: 1 group did not experience vicarious pain or PTSD symptoms, and 2 groups were vicarious pain responders, but only 1 had increased PTSD symptoms. Only the latter group showed increased chronic pain severity compared with the nonresponder group (p = .025) with a moderate effect size (r = .35). The findings from both studies implicated an overlap, but also divergence, between PTSD symptoms and vicarious pain reactivity postamputation. Maladaptive mechanisms implicated in severe chronic pain and physical reactivity posttrauma may increase the incidence of vicarious reactivity to the pain of others.",0 +https://doi.org/10.1001/archgenpsychiatry.2011.2287,Genome-wide Epigenetic Regulation by Early-Life Trauma,"Our genome adapts to environmental influences, in part through epigenetic mechanisms, including DNA methylation. Variations in the quality of the early environment are associated with alterations in DNA methylation in rodents, and recent data suggest similar processes in humans in response to early-life adversity.To determine genome-wide DNA methylation alterations induced by early-life trauma.Genome-wide study of promoter methylation in individuals with severe abuse during childhood. PATIENTS, SETTING, AND MAIN OUTCOME MEASURES: Promoter DNA methylation levels were profiled using methylated DNA immunoprecipitation followed by microarray hybridization in hippocampal tissue from 41 French-Canadian men (25 with a history of severe childhood abuse and 16 control subjects). Methylation profiles were compared with corresponding genome-wide gene expression profiles obtained by messenger RNA microarrays. Methylation differences between groups were validated on neuronal and nonneuronal DNA fractions isolated by fluorescence-assisted cell sorting. Functional consequences of site-specific promoter methylation were assessed by luciferase assays.We identified 362 differentially methylated promoters in individuals with a history of abuse compared with controls. Among these promoters, 248 showed hypermethylation and 114 demonstrated hypomethylation. Validation and site-specific quantification of DNA methylation in the 5 most hypermethylated gene promoters indicated that methylation differences occurred mainly in the neuronal cellular fraction. Genes involved in cellular/neuronal plasticity were among the most significantly differentially methylated, and, among these, Alsin (ALS2) was the most significant finding. Methylated ALS2 constructs mimicking the methylation state in samples from abused suicide completers showed decreased promoter transcriptional activity associated with decreased hippocampal expression of ALS2 variants.Childhood adversity is associated with epigenetic alterations in the promoters of several genes in hippocampal neurons.",0 +https://doi.org/10.1186/1471-244x-5-21,Posttraumatic stress disorder: An exploratory study examining rates of trauma and PTSD and its effect on client outcomes in community mental health,"BackgroundRates of trauma and Posttraumatic Stress Disorder (PTSD) were examined in order to compare the profile in clients of an Australian Public Mental Health Service with that reported in the international literature for clients with major mental illness and to explore the effect of this on client health outcomes. Potential factors contributing to increased levels of trauma/PTSD in this group of clients and the issue of causality between PTSD and subsequent mental illness was also explored.MethodsA convenience sample of 29 clients was screened for trauma and PTSD using the Posttraumatic Stress Diagnostic Scale™ (PDS) and selected outcome measures. Paired and independent samples t-test and ANOVA were applied to the data.ResultsHigh levels of undocumented trauma and PTSD were found. Twenty clients, (74%) reported exposure to multiple traumatic events; 33.3% (9) met DSM IV diagnostic criteria for PTSD. Significant difference was found for PTSD symptomatology, severity and impairment and for client and clinician-rated scores of Quality of Life (QOL) outcomes in the PTSD group. No effect for PTSD symptomatology on the Working Alliance (WA) was found. Factors that may influence higher rates of PTSD in this group were identified and included issues associated with the population studied, the predominance of assaultive violence found, and vulnerability and risks factors associated with re-traumatisation within the social and treating environments.ConclusionA similar trauma and PTSD profile to that reported in the international literature, including greater levels of trauma and PTSD and a poorer QOL, was found in this small sample of clients. It is postulated that the increased levels of trauma/PTSD as reported for persons with major mental illness, including those found in the current study, are primarily related to the characteristics of the population that access public mainstream psychiatric services and that these factors have specific implications for service delivery, and raise issues of efficiency and effectiveness of resource use in achieving successful outcomes in public mental health services for clients with co-morbid PTSD. Further research with a more rigorous design is needed to test these preliminary findings within Australian Community Mental Health Services.",0 +https://doi.org/10.1371/journal.pone.0061046,Stress-Induced Lipocalin-2 Controls Dendritic Spine Formation and Neuronal Activity in the Amygdala,"Behavioural adaptation to psychological stress is dependent on neuronal plasticity and dysfunction at this cellular level may underlie the pathogenesis of affective disorders such as depression and post-traumatic stress disorder. Taking advantage of genome-wide microarray assay, we performed detailed studies of stress-affected transcripts in the amygdala - an area which forms part of the innate fear circuit in mammals. Having previously demonstrated the role of lipocalin-2 (Lcn-2) in promoting stress-induced changes in dendritic spine morphology/function and neuronal excitability in the mouse hippocampus, we show here that the Lcn-2 gene is one of the most highly upregulated transcripts detected by microarray analysis in the amygdala after acute restraint-induced psychological stress. This is associated with increased Lcn-2 protein synthesis, which is found on immunohistochemistry to be predominantly localised to neurons. Stress-naïve Lcn-2(-/-) mice show a higher spine density in the basolateral amygdala and a 2-fold higher rate of neuronal firing rate compared to wild-type mice. Unlike their wild-type counterparts, Lcn-2(-/-) mice did not show an increase in dendritic spine density in response to stress but did show a distinct pattern of spine morphology. Thus, amygdala-specific neuronal responses to Lcn-2 may represent a mechanism for behavioural adaptation to psychological stress.",0 +https://doi.org/10.1891/0886-6708.9.1.31,Posttraumatic Stress Symptom Profiles of Battered Women: A Comparison of Survivors in Two Settings,"This study sought to develop a profile of posttraumatic stress symptoms experienced by battered women and to explore differences among subsamples. Two groups of survivors from five states were compared: 159 who had obtained help at domestic violence programs (DVP) and 33 who had obtained help at other types of programs (NDVP). They completed three self-report measures of posttraumatic stress and a fear questionnaire. Sixty percent of the women in the DVP group and 62% in the NDVP group met criteria for a diagnosis of posttraumatic stress disorder (PTSD). The most common symptoms were: nightmares intrusive memories of the abuse, avoiding reminders of it, and hyperarousal, and nightmares. DVP women experienced a variety of symptoms more frequently. Group differences in PTSD symptomatology were not present after statistically controlling for severity and frequency of the violence and length of time since the abusive relationship.",0 +https://doi.org/10.1179/2045772315y.0000000016,"Measuring resilience after spinal cord injury: Development, validation and psychometric characteristics of the SCI-QOL Resilience item bank and short form","To describe the development and psychometric properties of the Spinal Cord Injury--Quality of Life (SCI-QOL) Resilience item bank and short form.Using a mixed-methods design, we developed and tested a resilience item bank through the use of focus groups with individuals with SCI and clinicians with expertise in SCI, cognitive interviews, and item-response theory based analytic approaches, including tests of model fit and differential item functioning (DIF).We tested a 32-item pool at several medical institutions across the United States, including the University of Michigan, Kessler Foundation, the Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital and the James J. Peters/Bronx Department of Veterans Affairs medical center.A total of 717 individuals with SCI completed the Resilience items.A unidimensional model was observed (CFI=0.968; RMSEA=0.074) and measurement precision was good (theta range between -3.1 and 0.9). Ten items were flagged for DIF, however, after examination of effect sizes we found this to be negligible with little practical impact on score estimates. The final calibrated item bank resulted in 21 retained items.This study indicates that the SCI-QOL Resilience item bank represents a psychometrically robust measurement tool. Short form items are also suggested and computer adaptive tests are available.",0 +https://doi.org/10.1016/j.euroneuro.2012.05.010,Social vs. environmental stress models of depression from a behavioural and neurochemical approach,"Major depression is a mental disorder often preceded by exposure to chronic stress or stressful life events. Recently, animal models based on social conflict such as chronic social defeat stress (CSDS) are proposed to be more relevant to stress-induced human psychopathology compared to environmental models like the chronic mild stress (CMS). However, while CMS reproduces specifically core depressive symptoms such as anhedonia and helplessness, CSDS studies rely on the analysis of stress-induced social avoidance, addressing different neuropsychiatric disorders. Here, we study comparatively the two models from a behavioural and neurochemical approach and their possible relevance to human depression. Mice (C57BL/6) were exposed to CMS or CSDS for six weeks and ten days. Anhedonia was periodically evaluated. A battery of test applied during the fourth week after the stress procedure included motor activity, memory, anxiety, social interaction and helplessness. Subsequently, we examined glutamate, GABA, 5-HT and dopamine levels in the prefrontal cortex, hippocampus and brainstem. CMS induced a clear depressive-like profile including anhedonia, helplessness and memory impairment. CSDS induced anhedonia, hyperactivity, anxiety and social avoidance, signs also common to anxiety and posttraumatic stress disorders. While both models disrupted the excitatory inhibitory balance in the prefrontal cortex, CMS altered importantly this balance in the brainstem. Moreover, CSDS decreased dopamine in the prefrontal cortex and brainstem. We suggests that while depressive-like behaviours might be associated to altered aminoacid neurotransmission in cortical and brain stem areas, CSDS induced anxiety behaviours might be linked to specific alteration of dopaminergic pathways involved in rewarding processes.",0 +https://doi.org/10.1080/10926771.2014.904467,Cognitive Behavioral Therapy for PTSD: The Role of Complex PTSD on Treatment Outcome,"Posttraumatic stress disorder (PTSD) represents an often chronic and debilitating mental illness resulting from exposure to trauma. Although the most compelling evidence for the treatment of PTSD is cognitive behavioral therapy (CBT), many patients experience residual functional impairment, or relapse, suggesting that this approach does not work for all cases of PTSD. Repeated severe trauma, particularly during development, might increase the risk for a more intricate clinical profile, called complex PTSD (CPTSD), which might contribute to poorer treatment response. The following provides a comprehensive summary of the evidence examining whether CPTSD symptomatology is related to poorer treatment outcome of CBT, reviews the literature on the treatment of CPTSD, and offers insights into current issues and future directions of the construct.",0 +https://doi.org/10.1097/dmp.0b013e3181647b81,SWiFT: A Rapid Triage Tool for Vulnerable Older Adults in Disaster Situations,"ABSTRACT Background: In 2005, Hurricane Katrina caused extensive damage to parts of Mississippi, Louisiana, and Alabama, causing many people, including vulnerable older adults, to evacuate to safe surroundings. Approximately 23,000 evacuees—many of them 65 years old or older, frail, and lacking family to advocate for their care—arrived at the Reliant Astrodome Complex in Houston, Texas. There was no method for assessing the immediate and long-term needs of this vulnerable population. Methods: A 13-item rapid needs assessment tool was piloted on 228 evacuees 65 years old and older by the Seniors Without Families Team (SWiFT), to test the feasibility of triaging vulnerable older adults with medical and mental health needs, financial needs, and/or social needs. Results: The average age of the individuals triaged was 66.1 ± 12.72 (mean ± standard deviation [SD]) years. Of these, 68% were triaged for medical and or mental health needs, 18% were triaged for financial assistance, and 4% were triaged for social assistance. More than half of the SWiFT-triaged older adults reported having hypertension. Conclusions: The SWiFT tool is a feasible approach for triaging vulnerable older adults and provides a rapid determination of the level of need or assistance necessary for vulnerable older people during disasters. The tool was only piloted, thus further testing to determine reliability and validity is necessary. Potentially important implications for using such a tool and suggestions for preparing for and responding to disaster situations in which vulnerable older adults are involved are provided. ( Disaster Med Public Health Preparedness . 2008;2(Suppl 1):S45–S50)",0 +https://doi.org/10.1037/10649-000,Personality-guided therapy for posttraumatic stress disorder.,"This practical resource sheds light on the role personality factors play in the genesis and treatment of Posttraumatic Stress Disorder (PTSD). Using Theodore Millon's personality-guided psychology as a framework, the authors provide insight into this challenging disorder. They discuss factors that can help protect against stress or increase vulnerability to stress. They also explore the biological foundations of PTSD and offer practical guidance on how to assess PTSD and how to incorporate an understanding of personality in the formation of the therapeutic alliance.",0 +https://doi.org/10.1002/ajim.20876,Gender differences in probable posttraumatic stress disorder among police responders to the 2001 World Trade Center terrorist attack,"Police responders to the 2001 World Trade Center (WTC) disaster were previously reported to have an increased prevalence of probable posttraumatic stress disorder (PTSD).Four thousand seventeen police responders (3,435 men and 582 women) were interviewed 2-3 years after 9/11/01 as part of the World Trade Center Health Registry. Demographic, occupational, and event-specific risk factors were evaluated for probable PTSD, determined by DSM-IV criteria using the Posttraumatic Stress Checklist (PCL).Overall prevalence of probable PTSD was 8.3% (women: 13.9%; men: 7.4%, P < 0.001). Risk factors for both genders included 9/11-related injury and older age. For men, specific risk factors were: presence in WTC Towers on 9/11 and Hispanic ethnicity; and for women, witnessing horror and education less than a college degree.Significantly higher prevalence of probable PTSD was found for female police responders. Although consistent with civilian populations, this finding contrasts with other studies of PTSD and WTC rescue and recovery workers, and police prior to 9/11.",0 +https://doi.org/10.3109/00952990.2013.821477,"Self-reported cannabis use characteristics, patterns and helpfulness among medical cannabis users","Little research has investigated the demographic and symptom profile of medical cannabis users in states in the USA that have legalized cannabis use.In the present cross-sectional study, we investigated the demographic profile of 217 adults currently receiving medical cannabis, as well as differences in problematic use and perceived helpfulness in terms of (i) symptoms of psychological disorders and pain, and (ii) motives for use.Findings indicated that medical cannabis users (i) use and perceive cannabis to be beneficial for multiple conditions, some for which cannabis is not specifically prescribed or allowed at the state level; and (ii) report similar rates of disordered use as compared with population estimates among regular users. Furthermore, problematic cannabis use was predicted by several symptoms of psychological disorders (e.g. depression) and a variety of use motives (e.g. coping), while cannabis was reported as particularly helpful among those with several psychological symptoms (e.g. traumatic intrusions), as well as those reporting use for social anxiety reasons.Results are discussed in terms of future directions for research given the current debates regarding legalization of cannabis for medical purposes and, more generally, the lack of empirical data to inform such debates.",0 +https://doi.org/10.1176/ajp.139.1.52,Discriminant analysis of posttraumatic stress disorder among a group of Viet Nam veterans,"The authors designed a study to identify those independent variables which would statistically discriminate between a group of Viet Nam veterans who were experiencing posttraumatic stress disorder and those who were not. DSM-III criteria for diagnosis were used to measure and operationally define posttraumatic stress disorder. Five variables distinguished between groups: veterans with the disorder reported a negative perception of their family's helpfulness on return home, a higher level of combat, a more immediate discharge after the war, an external locus of control, and a more supportive attitude toward the war before they entered the service. The authors discuss the implications and limitations of these findings.",0 +https://doi.org/10.1200/jco.2011.39.5632,Evidence-Based Treatment of Anxiety in Patients With Cancer,"Anxiety is a dynamic response to perceived threat that is common among patients with cancer and fluctuates at critical points in the disease trajectory. A substantial minority of patients may experience clinically significant anxiety resulting from a range of potential etiologic factors. This review summarizes evidence-based recommendations for treatment of anxiety in oncology settings. Recommendations are based on the nature and time course of anxiety and the results of meta-analyses, systematic reviews, and individual trials in cancer populations. The evidence-based literature supports the use of psychosocial and psychopharmacologic treatments to prevent or alleviate anxiety symptoms. Conclusions are tempered by study heterogeneity and methodologic limitations and a lack of trials that included patients with clinically significant anxiety. In oncology settings, accessibility and acceptability of evidence-based treatments vary, and patients may seek a variety of resources to manage cancer concerns. Treatment planning should incorporate contributing factors to anxiety and patient preferences for psychiatric care.",0 +https://doi.org/10.1016/j.jpsychores.2012.05.011,Perceived injustice in fibromyalgia: Psychometric characteristics of the Injustice Experience Questionnaire and relationship with pain catastrophising and pain acceptance,"To validate a Spanish version of the Injustice Experience Questionnaire (IEQ), a measure of perceived injustice, in a fibromyalgia sample and to examine its relationship with pain catastrophising and pain acceptance.The IEQ was administered along with the Pain Visual Analogue Scale, the Fibromyalgia Impact Questionnaire, the Hospital Anxiety and Depression Scale, the Pain Catastrophizing Scale (PCS) and the Chronic Pain Acceptance Questionnaire (CPAQ) to 250 primary care patients with fibromyalgia.The IEQ had good test-retest reliability (intraclass correlation coefficient=0.98) and internal consistency (Cronbach's α=0.92). The factor structure obtained was similar to the original validation study. The multiple regression analyses showed that perceived injustice (PI) accounted for significant pain-related outcomes after controlling pain intensity, PCS and CPAQ. Principal component analysis of both the IEQ and the CPAQ taken together showed that the two constructs do not represent opposite extremes of the same dimension.The IEQ is a reliable assessment tool for measuring PI among patients with fibromyalgia. PI seems to be distinct from catastrophising, although the two constructs are very similar. The factor analysis showed that PI and acceptance represent related constructs, and this entails relevant implications for therapy, as acceptance-based interventions would be appropriate.",0 +https://doi.org/10.1371/journal.pone.0067435,Mild Transient Hypercapnia as a Novel Fear Conditioning Stimulus Allowing Re-Exposure during Sleep,"Studies suggest that sleep plays a role in traumatic memories and that treatment of sleep disorders may help alleviate symptoms of posttraumatic stress disorder. Fear-conditioning paradigms in rodents are used to investigate causal mechanisms of fear acquisition and the relationship between sleep and posttraumatic behaviors. We developed a novel conditioning stimulus (CS) that evoked fear and was subsequently used to study re-exposure to the CS during sleep.Experiment 1 assessed physiological responses to a conditioned stimulus (mild transient hypercapnia, mtHC; 3.0% CO2; n = 17)+footshock for the purpose of establishing a novel CS in male FVB/J mice. Responses to the novel CS were compared to tone+footshock (n = 18) and control groups of tone alone (n = 17) and mild transient hypercapnia alone (n = 10). A second proof of principle experiment re-exposed animals during sleep to mild transient hypercapnia or air (control) to study sleep processes related to the CS.Footshock elicited a response of acute tachycardia (30-40 bpm) and increased plasma epinephrine. When tone predicted footshock it elicited mild hypertension (1-2 mmHg) and a three-fold increase in plasma epinephrine. When mtHC predicted footshock it also induced mild hypertension, but additionally elicited a conditioned bradycardia and a smaller increase in plasma epinephrine. The overall mean 24 hour sleep-wake profile was unaffected immediately after fear conditioning.Our study demonstrates the efficacy of mtHC as a conditioning stimulus that is perceptible but innocuous (relative to tone) and applicable during sleep. This novel model will allow future studies to explore sleep-dependent mechanisms underlying maladaptive fear responses, as well as elucidate the moderators of the relationship between fear responses and sleep.",0 +https://doi.org/10.1016/j.ypmed.2015.03.017,World Trade Center disaster and sensitization to subsequent life stress: A longitudinal study of disaster responders,"The current study examined the role of World Trade Center (WTC) disaster exposure (hours spent working on the site, dust cloud exposure, and losing friend/loved one) in exacerbating the effects of post-disaster life stress on posttraumatic stress disorder (PTSD) symptoms and overall functioning among WTC responders.Participants were 18,896 responders (8466 police officers and 10,430 non-traditional responders) participating in the WTC Health Program who completed an initial examination between July, 2002 and April, 2010 and were reassessed an average of two years later.Among police responders, there was a significant interaction, such that the effect of post-disaster life stress on later PTSD symptoms and overall functioning was stronger among police responders who had greater WTC disaster exposure (β's=.029 and .054, respectively, for PTSD symptoms and overall functioning). This moderating effect was absent in non-traditional responders. Across both groups, post-disaster life stress also consistently was related to the dependent variables in a more robust manner than WTC exposure.The present findings suggest that WTC exposure may compound post-disaster life stress, thereby resulting in a more chronic course of PTSD symptoms and reduced functioning among police responders.",0 +https://doi.org/10.1093/jpepsy/13.4.555,Development of a Brief Coping Checklist for Use with Pediatric Populations,"Although the process of coping and utilization of coping strategies has received widespread attention in the adult literature, there is a relative dearth of information on these processes in children and adolescents. As the importance of assessing and teaching coping strategies becomes apparent in behavioral medicine with adults, such investigations need to be extended to pediatric populations. The present study describes the development of a brief coping checklist. Preliminary psychometric investigations conducted with healthy adolescents demonstrated adequate reliability at 3-day, 7-day, 14-day, and 10-week intervals and concurrent validity with previously established measures of coping. The utility of the checklist with pediatric patients and in particular chronically ill children is also examined.",0 +https://doi.org/10.1001/archpsyc.62.5.545,Psychopathology Among New York City Public School Children 6 Months After September 11,"Children exposed to a traumatic event may be at higher risk for developing mental disorders. The prevalence of child psychopathology, however, has not been assessed in a population-based sample exposed to different levels of mass trauma or across a range of disorders.To determine prevalence and correlates of probable mental disorders among New York City, NY, public school students 6 months following the September 11, 2001, World Trade Center attack.Survey.New York City public schools.A citywide, random, representative sample of 8236 students in grades 4 through 12, including oversampling in closest proximity to the World Trade Center site (ground zero) and other high-risk areas.Children were screened for probable mental disorders with the Diagnostic Interview Schedule for Children Predictive Scales.One or more of 6 probable anxiety/depressive disorders were identified in 28.6% of all children. The most prevalent were probable agoraphobia (14.8%), probable separation anxiety (12.3%), and probable posttraumatic stress disorder (10.6%). Higher levels of exposure correspond to higher prevalence for all probable anxiety/depressive disorders. Girls and children in grades 4 and 5 were the most affected. In logistic regression analyses, child's exposure (adjusted odds ratio, 1.62), exposure of a child's family member (adjusted odds ratio, 1.80), and the child's prior trauma (adjusted odds ratio, 2.01) were related to increased likelihood of probable anxiety/depressive disorders. Results were adjusted for different types of exposure, sociodemographic characteristics, and child mental health service use.A high proportion of New York City public school children had a probable mental disorder 6 months after September 11, 2001. The data suggest that there is a relationship between level of exposure to trauma and likelihood of child anxiety/depressive disorders in the community. The results support the need to apply wide-area epidemiological approaches to mental health assessment after any large-scale disaster.",0 +https://doi.org/10.1542/peds.2007-1648,The Human Capacity to Thrive in the Face of Potential Trauma,"For decades, researchers have documented remarkable levels of resilience in children who were exposed to corrosive early environments, such as those in which poverty or chronic maltreatment were present; however, relatively little research has examined resilience in children or adults who were exposed to isolated and potentially traumatic events. The historical emphasis on psychological and physiologic dysfunction after potentially traumatic events has suggested that such events almost always produce lasting emotional damage. Recent research, however, has consistently shown that across different types of potentially traumatic events, including bereavement, serious illness, and terrorist attack, upward of 50% of people have been found to display resilience. Research has further identified substantial individual variation in response to potentially traumatic events, including 4 prototypical and empirically derived outcome trajectories: chronic dysfunction, recovery, resilience, and delayed reactions. Factors that promote resilience are heterogeneous and include a variety of person-centered variables (eg, temperament of the child, personality, coping strategies), demographic variables (eg, male gender, older age, greater education), and sociocontextual factors (eg, supportive relations, community resources). It is surprising that some factors that promote resilience to potentially traumatic events may be maladaptive in other contexts, whereas other factors are more broadly adaptive. Given the growing evidence that resilience is common, psychotherapeutic treatment should be reserved for those in genuine need.",0 +,Does Time Heal all Wounds? : A Longitudinal Study of Development of Posttraumatic Stress Symptoms in Parents of Children With Cancer,Does Time Heal all Wounds? : A Longitudinal Study of Development of Posttraumatic Stress Symptoms in Parents of Children With Cancer,0 +https://doi.org/10.1002/pon.3132,Post-traumatic stress symptoms among mothers of children with leukemia undergoing treatment: a longitudinal study,"To assess post-traumatic stress symptoms (PTSS) in mothers of children over 2 years of leukemia treatment, to identify possible early family and child predictors of this symptomatology and to indicate the temporal trajectory of PTSS.Participants were 76 Italian mothers (mean age = 37.30 years; SD = 6.07) of children receiving treatment for acute lymphoblastic (n = 69) or myeloid (n = 7) leukemia. Mothers had 12.05 years of education (SD = 3.87), and their incomes were average (52.1%), high (26%) and low (21.9%) for Italian norms, never in poverty. The pediatric patients with leukemia were equally distributed by gender with their mean age of 7.10 years (SD = 4.18). Post-traumatic stress symptoms were measured by a 17-item checklist. Scales assessing anxiety, depression, physical (Brief Symptom Inventory 18) and cognitive functioning (Problem Scale), and life evaluation were also used. There were five assessment points: 1 week (T1), 1 month (T2), 6 months (T3), 12 months (T4) and 24 months post-diagnosis (T5).The main results indicated moderate presence of clinical PTSS (≥9 symptoms: 24% at T2, 18% at T3, 16% at T4 and 19% at T5) that remained stable across time points, whereas Brief Symptom Inventory 18 Global score decreased and life evaluation improved. A series of hierarchical regression models identified cognitive functioning early after the diagnosis as the best predictive factor of PTSS across time points.Specific psychological interventions could be devised for mothers at risk for short and long-term PTSS just after the diagnosis.",0 +https://doi.org/10.1080/15325024.2012.719342,Trajectories of Posttraumatic Stress Symptoms in Significant Others of Patients With Severe Traumatic Brain Injury,"Long-term psychological distress has been reported among significant others of patients who sustained a traumatic brain injury (TBI). This study examined the course and potential predictors of posttraumatic stress symptoms in a relative sample (N = 135) drawn from a national cohort study on severe TBI in Switzerland. Latent growth mixture model analyses revealed two main groups: Across 3, 6, and 12 months after the accident, 63% of the sample indicated fairly low symptom severity (“resilient” course), whereas 37% showed persistence of “higher distress” as indicated by elevated scores on the Impact of Event Scale–Revised. Group membership was significantly associated with self-reported dysfunctional disclosure style. Implications for research and practice are discussed.",0 +https://doi.org/10.1080/10538710903035263,"Child Sexual Abuse, Post-Traumatic Stress Disorder, and Substance Use: Predictors of Revictimization in Adult Sexual Assault Survivors","This study examined the unique effects of child sexual abuse simultaneously with post-traumatic stress disorder symptom clusters, problem drinking, and illicit drug use in relation to sexual revictimization in a community sample of female adult sexual assault victims. Participants (N=555) completed two surveys a year apart. Child sexual abuse predicted more post-traumatic stress disorder symptoms in adult sexual assault victims. Posttraumatic stress disorder numbing symptoms directly predicted revictimization, whereas other post-traumatic stress disorder symptoms (reexperiencing, avoidance, and arousal) were related to problem drinking, which in turn predicted revictimization. Thus, numbing symptoms and problem drinking may be independent risk factors for sexual revictimization in adult sexual assault victims, particularly for women with a history of childhood sexual abuse.",0 +https://doi.org/10.2466/pr0.99.3.747-750,"Characteristics of Successful Fakers versus Unsuccessful Fakers: Is Empathy, Intelligence, Or Personality Associated with Faking PTSD on the MMPI-2?","Moyer, Burkhardt, and Gordon found in 2002 that some individuals could fake PTSD on the MMPI-2. In light of these results, a follow-up study was conducted to assess whether attributes such as empathy, intelligence, subjectivity, or insightfulness influenced ability to fake a PTSD profile on the MMPI-2. 35 subjects from the previous study were divided into two groups, successful fakers and unsuccessful fakers. Analysis indicated no significant differences between groups on the measures of empathy or intelligence. However, a significant difference was found between groups on the Schizophrenia and Cynicism scales and falling just short of significance on the Hypochondriasis scale. These results suggested that individuals able to fake PTSD are more insightful and less subjective, which makes them better at role-playing.",0 +https://doi.org/10.1016/j.nlm.2013.06.008,"Cellular, molecular, and epigenetic mechanisms in non-associative conditioning: Implications for pain and memory","• Review behavioral sensitization in response to noxious stimulation or injury. • Review functional, synaptic, and cellular mechanisms of sensitization. • Review epigenetic mechanisms in learning- and pain-related sensitization. Sensitization is a form of non-associative conditioning in which amplification of behavioral responses can occur following presentation of an aversive or noxious stimulus. Understanding the cellular and molecular underpinnings of sensitization has been an overarching theme spanning the field of learning and memory as well as that of pain research. In this review we examine how sensitization, both in the context of learning as well as pain processing, shares evolutionarily conserved behavioral, cellular/synaptic, and epigenetic mechanisms across phyla. First, we characterize the behavioral phenomenon of sensitization both in invertebrates and vertebrates. Particular emphasis is placed on long-term sensitization (LTS) of withdrawal reflexes in Aplysia following aversive stimulation or injury, although additional invertebrate models are also covered. In the context of vertebrates, sensitization of mammalian hyperarousal in a model of post-traumatic stress disorder (PTSD), as well as mammalian models of inflammatory and neuropathic pain is characterized. Second, we investigate the cellular and synaptic mechanisms underlying these behaviors. We focus our discussion on serotonin-mediated long-term facilitation (LTF) and axotomy-mediated long-term hyperexcitability (LTH) in reduced Aplysia systems, as well as mammalian spinal plasticity mechanisms of central sensitization. Third, we explore recent evidence implicating epigenetic mechanisms in learning- and pain-related sensitization. This review illustrates the fundamental and functional overlay of the learning and memory field with the pain field which argues for homologous persistent plasticity mechanisms in response to sensitizing stimuli or injury across phyla.",0 +https://doi.org/10.1007/s11013-012-9279-6,"Baksbat (Broken Courage): The Development and Validation of the Inventory to Measure Baksbat, a Cambodian Trauma-based Cultural Syndrome of Distress","This article outlines the development and validation of an inventory measuring a Cambodian cultural syndrome of distress called 'baksbat' (broken courage). The inventory development phase involved ethnographic interviews with a preliminary group of 53 experts having knowledge or experience of baksbat. The initial ethnographically derived inventory with 32 items was developed and administered to a second group of 390 consecutive patients to assess factor loadings. The validation phase used confirmatory factor analysis (CFA) to test goodness-of-fit of four hypothesized factor models of the newly developed inventory in a third group of 159 participants. CFA confirms three-factor models that have the best goodness-of-fit, thus a 24-item baksbat inventory clustering of three-symptom categories was developed. Multiple regression, which assesses the relationship between the dependent variable (PTSD) and a subcluster of baksbat inventory (predictors), shows baksbat inventory accounts for 47 % of the total variance of symptoms in PTSD (R2 =.47). Of the three-symptom clusters, 'psychological distress' shows significant contribution to the total variance of symptoms in PTSD (β = .63, p < .001). Of significance, some symptoms of baksbat were independent from symptoms of PTSD with isolated symptoms that are culturally specific. These preliminary findings suggest that baksbat could be a potential Cambodian trauma-based syndrome with its own culturally validated inventory. © 2012 Springer Science+Business Media New York.",0 +https://doi.org/10.1186/1471-2458-11-797,Alert but less alarmed: a pooled analysis of terrorism threat perception in Australia,"Previous Australian research has highlighted disparities in community perceptions of the threat posed by terrorism. A study with a large sample size is needed to examine reported concerns and anticipated responses of community sub-groups and to determine their consistency with existing Australian and international findings.Representative samples of New South Wales (NSW) adults completed terrorism perception questions as part of computer assisted telephone interviews (CATI) in 2007 (N = 2081) and 2010 (N = 2038). Responses were weighted against the NSW population. Data sets from the two surveys were pooled and multivariate multilevel analyses conducted to identify health and socio-demographic factors associated with higher perceived risk of terrorism and evacuation response intentions, and to examine changes over time.In comparison with 2007, Australians in 2010 were significantly more likely to believe that a terrorist attack would occur in Australia (Adjusted Odd Ratios (AOR) = 1.24, 95%CI:1.06-1.45) but felt less concerned that they would be directly affected by such an incident (AOR = 0.65, 95%CI:0.55-0.75). Higher perceived risk of terrorism and related changes in living were associated with middle age, female gender, lower education and higher reported psychological distress. Australians of migrant background reported significantly lower likelihood of terrorism (AOR = 0.52, 95%CI:0.39-0.70) but significantly higher concern that they would be personally affected by such an incident (AOR = 1.57, 95%CI:1.21-2.04) and having made changes in the way they live due to this threat (AOR = 2.47, 95%CI:1.88-3.25). Willingness to evacuate homes and public places in response to potential incidents increased significantly between 2007 and 2010 (AOR = 1.53, 95%CI:1.33-1.76).While an increased proportion of Australians believe that the national threat of terrorism remains high, concern about being personally affected has moderated and may reflect habituation to this threat. Key sub-groups remain disproportionately concerned, notably those with lower education and migrant groups. The dissonance observed in findings relating to Australians of migrant background appears to reflect wider socio-cultural concerns associated with this issue. Disparities in community concerns regarding terrorism-related threat require active policy consideration and specific initiatives to reduce the vulnerabilities of known risk groups, particularly in the aftermath of future incidents.",0 +https://doi.org/10.1016/j.janxdis.2010.06.025,Examining the relation between posttraumatic stress disorder and suicidal ideation in an OEF/OIF veteran sample,"This study examined the relation between posttraumatic stress disorder (PTSD) and suicidal ideation among U.S. military veterans deployed during Operation Enduring Freedom and/or Operation Iraqi Freedom. Specific aims included investigation of (1) whether PTSD was associated with suicidal ideation after controlling for combat exposure and history of suicide attempt(s), (2) whether PTSD was associated with suicidal ideation absent a co-occurring depressive disorder (MDD) or alcohol use disorder (AUD), (3) whether co-occurring MDD or AUD increased risk of suicidal ideation among those with PTSD and (4) whether PTSD/MDD symptom clusters were differentially associated with suicidal ideation. Results pointed to unique effects associated with prior suicide attempt(s), PTSD and MDD. PTSD-diagnosed participants with co-occurring MDD or AUD were not significantly more likely to endorse suicidal ideation than PTSD-diagnosed participants without such comorbidity. The 'emotional numbing' cluster of PTSD symptoms and the 'cognitive-affective' cluster of MDD symptoms were uniquely associated with suicidal ideation.",0 +,"Second Generation Antipsychotics (SGAs) in children and adolescents: prescription, efficacy, safety and open questions","Objectives: In children and adolescents, antipsychotics are being used in large and increasing quantities for a wide range of disorders and psychopathology, including psychotic, mood, and disruptive behaviour disorders, as well as to treat irritability associated with autism, tic disorders, obsessive-compulsive disorder, posttraumatic stress disorder and aggression. Both in Europe and in the US, however, the majority of these clinical uses are off-label and they exceed the available database regarding efficacy and safety. Aim of this article is to succinctly review available data on antipsychotic efficacy and adverse effects in children and adolescents and provide a general guide for the evaluation and management of antipsychotic-related efficacy and adverse effects. Methods: Medline and PubMed (1970-2008) databases were searched for articles using keywords like child, adolescent, antipsychotics, clozapine, risperidone, paliperidone, olanzapine, quetiapine, ziprasidone, aripiprazole and the like; English language, humans and clinical trials were used as limits. Papers addressing double-blind studies were firstly considered as main source of information, open label studies and reviews only when appropriate. Results: Currently available evidence indicates an increase in the use of SGAs in paediatric population, with different antipsychotics showing similar efficacies (except clozapine for treatment-resistant early onset schizophrenia) with different tolerability/safetyprofiles (i.e., weight gain and metabolic syndrome with olanzapine, hyperprolactinaemia with risperidone). Although more data are needed, children and adolescents seem generally more susceptible than adults to develop sedation, acute EPSs, withdrawal dyskinesia, hyperprolactinaemia, and age-inappropriate weight gain with related metabolic abnormalities. Given the paucity of data (especially in the long term) it is difficult to conduct a careful risk-benefit assessment when choosing an antipsychotic treatment. Families and patients should be involved in the process of selecting appropriate treatments for each patient. Conclusions: Clinicians and researchers should use age appropriate side effect measures that also take severity and time course of adverse effects into account to help assessing and managing more comprehensively antipsychotic risks and benefits in a given individual. Safety and efficacy data should inform a careful antipsychotic selection that takes general probabilities and patient/family preferences into account. Adverse effects are generally more easily predicted than therapeutic efficacy and differences in efficacy between antipsychotics are generally smaller than those for adverse effects: initial treatment selection should be guided largely by varying adverse effect profiles across medications.",0 +https://doi.org/10.1176/ajp.151.8.1132,Initial reliability and validity of a new retrospective measure of child abuse and neglect,"This report presents initial findings on the reliability and validity of a new retrospective measure of child abuse and neglect, the Childhood Trauma Questionnaire.Two hundred eighty-six drug- or alcohol-dependent patients were given the Childhood Trauma Questionnaire as part of a larger test battery, and 40 of these patients were given the questionnaire again after an interval of 2 to 6 months. Sixty-eight of the patients were also given a structured interview for child abuse and neglect, the Childhood Trauma Interview, that was developed by the authors.Principal-components analysis of responses on the Childhood Trauma Questionnaire yielded four rotated orthogonal factors: physical and emotional abuse, emotional neglect, sexual abuse, and physical neglect. Cronbach's alpha for the factors ranged from 0.79 to 0.94, indicating high internal consistency. The Childhood Trauma Questionnaire also demonstrated good test-retest reliability over a 2- to 6-month interval (intraclass correlation = 0.88), as well as convergence with the Childhood Trauma Interview, indicating that patients' reports of child abuse and neglect based on the Childhood Trauma Questionnaire were highly stable, both over time and across type of instruments.These findings provide strong initial support for the reliability and validity of the Childhood Trauma Questionnaire.",0 +https://doi.org/10.1097/00006842-199711000-00004,Long-Term Outcome of Motor Vehicle Accident Injury,"To define the psychological outcome at 5 years of a sample of non-head-injured motor vehicle accident victims and identify baseline predictors.Self-report questionnaires were completed by 111 consecutive subjects who had been injured in a motor vehicle accident 5 years earlier and who had been assessed previously in a prospective 1-year study.Although most subjects reported a good outcome, a substantial minority described continuing social, physical, and psychological difficulties and a quarter of those studied suffered phobic anxiety about travel as a driver or passenger. There was little change in quality of life outcome and effects on travel between assessments at 3 months, 1 year, and 5 years. The prevalence of posttraumatic stress disorder remained approximately 10% throughout the follow-up; most early cases had remitted by 5 years, and a similar number of delayed new onsets had occurred between 1 year and 5 years. PTSD at 5 years was predicted by physical outcome and by postaccident intrusive memories and emotional distress. Compensation proceedings were initiated by 66 subjects and were often prolonged and a cause of distress. There were no significant associations with outcome. Trends for a poor outcome in claimants, especially those not settled at 5 years, may be due to their having more serious physical problems.Psychological complications are important and persistent after injury in a motor vehicle accident, are associated with adverse effects on everyday activities, and pose a challenge for consultation-liaison psychiatry.",0 +https://doi.org/10.1007/bf02229103,Diagnosing posttraumatic stress disorder with the MMPI clinical scales: A review of the literature,"A review of the literature resulted in 21 published studies that reported mean MMPI profile patterns for PTSD patients. Of these, six (29%) reported that the mean 8-2 profile pattern significantly differentiated PTSD patients from non-PTSD patients. The majority of studies found additional PTSD profile patterns reflecting nearly all of the MMPI clinical scales. The data indicate some common group profile patterns for inpatient veterans, prisoner's of war, and inpatient veteran substance abusers. The results also support the hypothesis that there is a continuum from inpatient to outpatient and veteran to civilian populations that corresponds with both symptom and stressor severity. It is concluded that although there is some typicality in similar populations, clinicians should expect heterogeneous MMPI profiles from PTSD patients representing a diversity of clinical symptoms and styles.",0 +https://doi.org/10.3402/ejpt.v6.27516,Using Bayesian statistics for modeling PTSD through Latent Growth Mixture Modeling: implementation and discussion,"After traumatic events, such as disaster, war trauma, and injuries including burns (which is the focus here), the risk to develop posttraumatic stress disorder (PTSD) is approximately 10% (Breslau & Davis, 1992). Latent Growth Mixture Modeling can be used to classify individuals into distinct groups exhibiting different patterns of PTSD (Galatzer-Levy, 2015). Currently, empirical evidence points to four distinct trajectories of PTSD patterns in those who have experienced burn trauma. These trajectories are labeled as: resilient, recovery, chronic, and delayed onset trajectories (e.g., Bonanno, 2004; Bonanno, Brewin, Kaniasty, & Greca, 2010; Maercker, Gäbler, O'Neil, Schützwohl, & Müller, 2013; Pietrzak et al., 2013). The delayed onset trajectory affects only a small group of individuals, that is, about 4-5% (O'Donnell, Elliott, Lau, & Creamer, 2007). In addition to its low frequency, the later onset of this trajectory may contribute to the fact that these individuals can be easily overlooked by professionals. In this special symposium on Estimating PTSD trajectories (Van de Schoot, 2015a), we illustrate how to properly identify this small group of individuals through the Bayesian estimation framework using previous knowledge through priors (see, e.g., Depaoli & Boyajian, 2014; Van de Schoot, Broere, Perryck, Zondervan-Zwijnenburg, & Van Loey, 2015).We used latent growth mixture modeling (LGMM) (Van de Schoot, 2015b) to estimate PTSD trajectories across 4 years that followed a traumatic burn. We demonstrate and compare results from traditional (maximum likelihood) and Bayesian estimation using priors (see, Depaoli, 2012, 2013). Further, we discuss where priors come from and how to define them in the estimation process.We demonstrate that only the Bayesian approach results in the desired theory-driven solution of PTSD trajectories. Since the priors are chosen subjectively, we also present a sensitivity analysis of the Bayesian results to illustrate how to check the impact of the prior knowledge integrated into the model.We conclude with recommendations and guidelines for researchers looking to implement theory-driven LGMM, and we tailor this discussion to the context of PTSD research.",0 +,"Latent change in discrete data: Unidimensional, multidimensional, and mixture distribution Rasch models for the analysis of repeated observations.","A survey of unidimensional, multidimensional, and mixture distribution Rasch models is presented with a particular focus on model applications for the analysis of change in repeated measures designs. A mover-stayer mixed Rasch model is specified for modeling global change in one of two latent subpopulations and for modeling stability in the other latent subpopulation. The application of unidimensional, multidimensional, and mixture distribution Rasch models for the analysis of change is illustrated using data on the development of understanding and solving arithmetic word problems in 1,030 2nd-3rd grade school children. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1080/15325024.2014.965978,Posttraumatic stress and physical health among adults: The role of coping mechanisms,"ABSTRACTThe purpose of the present study was to examine whether coping mechanisms predict physical health, after controlling for posttraumatic stress disorder (PTSD) symptom clusters in a non-clinical sample of adults. Data were collected from 483 adults through an online survey. Most of the participants (66.7%) reported lifetime exposure to at least one traumatic event. The final sample of this study included 319 trauma-exposed individuals. Results indicated that PTSD symptoms on the avoidance and hyperarousal clusters had significant positive relationships with self-reported physical health symptoms. After controlling for gender and PTSD, denial, behavioral disengagement, and self-blame significantly and positively predicted physical health symptoms.",0 +https://doi.org/10.1002/pon.3761,Posttraumatic stress symptoms predict impaired neutrophil recovery in stem cell transplant recipients,"Objective Despite the potentially life-saving effects of stem cell transplant (SCT), many transplant patients experience traumatic stress reactions due to mortality threat, interpersonal isolation, financial and occupational loss, and invasive medical procedures. Emerging evidence suggests that trauma-related stress symptoms (TSS) predict significant health complications following SCT. The aim of the current prospective study was to examine TSS in the acute aftermath of SCT as a predictor of neutrophil recovery following SCT, a crucial component of immune defense against infection. Methods Fifty-one autologous SCT recipients were assessed for TSS 7 days after SCT. Patients' absolute neutrophil counts were collected from medical charts for the first 30 days following SCT. Hierarchical linear growth modeling was used to test the hypothesis that TSS at day 7 would be associated with delayed recovery of neutrophil counts from days 9 to 30 post SCT, that is, when neutrophil counts began to recover. Results As hypothesized, TSS measured 7 days after SCT was significantly associated with slower neutrophil recovery even after pre-existing TSS, depression, distress related to physical symptoms, and potential medical confounds were statistically controlled. Exploratory analyses showed that of the TSS symptom clusters, re-experiencing symptoms and hyperarousal symptoms predicted neutrophil recovery, whereas avoidance symptoms did not. Conclusion Though traumatic stress symptoms may be a normative response to SCT, our findings suggest that TSS following SCT may interfere with neutrophil recovery and overall health. These results provide further insight as to potential mechanisms by which traumatic stress translates to poor medical outcomes for SCT patients. Copyright © 2015 John Wiley & Sons, Ltd.",0 +https://doi.org/10.4088/jcp.08m04754blu,Reduced Anterior Cingulate and Orbitofrontal Volumes in Child Abuse–Related Complex PTSD,"Article AbstractObjective: Classic posttraumatic stress disorder (PTSD) is associated with smaller hippocampus, amygdala, and anterior cingulate cortex (ACC) volumes. We investigated whether child abuse-related complex PTSD—a severe form of PTSD with affect dysregulation and high comorbidity—showed similar brain volume reductions. Method: We used voxel-based morphometry to measure gray matter concentrations in referred outpatients with child abuse-related complex PTSD (n = 31) compared to matched healthy nontraumatized controls (n = 28). Complex PTSD was diagnosed using the Structured Clinical Interview for DSM-IV-TR and the Structured Clinical Interview for Disorders of Extreme Stress. All respondents were scanned on a 1.5-T magnetic resonance system at the VU Medical Center, Amsterdam, The Netherlands, between September 2005 and February 2006. Results: As was hypothesized, patients with child abuse-related complex PTSD showed reductions in gray matter concentration in right hippocampus (PSVC corrected = .04) and right dorsal ACC (PSVC corrected = .02) compared to controls. In addition, a reduction in gray matter concentration in the right orbitofrontal cortex (OFC) was found. Severity of child abuse and PTSD-hyperarousal correlated negatively with ACC volume. Impulsivity correlated negatively with hippocampus volume, and anger, with hippocampus and OFC volume. Comorbidity of borderline personality disorder—compared to comorbid cluster C personality disorder—accounted for more extensive reductions in the ACC and OFC volume. Conclusions: In complex PTSD, not only the hippocampus and the ACC but also the OFC seem to be affected, even in the absence of comorbid borderline personality disorder. These results suggest that neural correlates of complex PTSD are more severe than those of classic PTSD.J Clin PsychiatrySubmitted: September 26, 2008; accepted July 7, 2009. Online ahead of print: July 13, 2010 (doi:10.4088/JCP.08m04754blu). Corresponding author: Kathleen Thomaes, MD, GGZ Ingeest, Department of Psychiatry, VU University Medical Center, A J Ernststraat 887, 1081 HL Amsterdam, The Netherlands (k.thomaes@vumc.nl).",0 +https://doi.org/10.5694/j.1326-5377.1977.tb99164.x,ACCIDENT LITIGANTS WITH NEUROTIC SYMPTOMS,"Experience gained from an examination of 750 consecutive litigants leads to the conclusion that the aetiology of neurotic symptoms after accidents is so complex that diagnostic labels implying single causation give a false and oversimplified picture. Terms such as compensation neurosis, traumatic neurosis, Mediterranean back, postconcussion syndrome and many others illustrate preconceived ideas of causation which are in most cases not warranted, and it is recommended that this group of patients be considered under the general label of sufferers from accident neurosis. The many symptoms which occur are discussed, and it is found that they present in such endless variety, and in varying severity from mild to completely disabling; they do not cluster in any consistent way to justify the delineating of discrete syndromes which are artificial and misleading; their existence confuses rather than clarifies our understanding of these unfortunate people. Language: en",0 +https://doi.org/10.1111/jcpp.12241,Different clinical courses of children exposed to a single incident of psychological trauma: a 30-month prospective follow-up study,"We investigated the distinct longitudinal trajectories of posttraumatic stress symptoms in a sample of 167 children, who witnessed death of two mothers of their schoolmates.The cohort was followed-up at 2 days (T1), 2 months (T2), 6 months (T3), and 30 months (T4) after the traumatic event. The children's posttraumatic stress symptoms (T1-T4), depression (T1, T3 and T4), state anxiety (T1, T3 and T4), and quality of life (T4) were assessed, along with parental stress related to child rearing (T4). Different trajectory patterns of the children's posttraumatic stress symptoms were identified using growth mixture modeling (GMM).Four different patterns of symptom change were identified, which were consistent with the prototypical model, and were named Recovery (19.9%), Resilience (72.7%), Chronic Dysfunction (1.8%), and Delayed Reactions (5.6%). Significant differences were found in depression and anxiety scores, children's quality of life, and parental rearing stress according to the distinct longitudinal trajectories of posttraumatic stress symptoms.The present study suggests that individual differences should be taken into account in the clinical course and outcome of children exposed to psychological trauma. The two most common trajectories were the Resilience and the Recovery types, together suggesting that over 90% of children were evidenced with a favorable 30-month outcome. The latent classes were associated with significant mean differences in depression and anxiety scores, supporting the clinical validity of the distinct trajectories.",1 +https://doi.org/10.1007/s00115-013-3988-0,[Trauma and stressor-related disorders: diagnostic conceptualization in DSM-5].,"The Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) includes a distinct diagnostic group of trauma and stressor-related disorders that has been set apart from anxiety disorders. From a perspective of adult psychiatry this new disorder category includes posttraumatic stress disorder (PTSD), acute stress disorder (ASD), and adjustment disorders. The PTSD is based on narrower trauma criteria that focus on acute life-threatening situations, serious injury, or sexual violence by way of direct confrontation, witnessing or indirect confrontation. Indirect confrontation, however, is reserved only for violent or accidental events that occurred to close family members or friends. The former A2 criterion of an intense emotional reaction to trauma has been removed. A deliberately broad approach to clinical PTSD phenomenology has created an empirically driven new cluster of persistent negative alterations in cognition and mood due to experiencing traumatic events. The ASD has been reconceptualized as an intense stress syndrome with a clear need of acute treatment during the early course after traumatic exposure. Adjustment disorders continue to emphasize maladaptive emotional and behavioral responses to unspecific, non-traumatic stressors in an intensity that is beyond social or cultural norms. Neither complex PTSD nor prolonged grief disorders have received an independent diagnostic status within DSM-5. With respect to stress-related disorders major divergences between DSM-5 and the future International Classification of Diseases 11 (ICD-11) are to be expected. © 2014 Springer-Verlag.",0 +https://doi.org/10.1002/pon.1658,Trajectories of psychological distress among Chinese women diagnosed with breast cancer,"Background: The distinct trajectories of psychological distress over the first year of the diagnosis with breast cancer (BC) and its determinants have not been explored. Methods: 285 of 405 Chinese women receiving surgery for BC were assessed at 5-day, 1-month, 4-month, and 8-month post-surgery on measures of psychological distress, optimism, treatment decision-making (TDM) difficulties, satisfaction with treatment outcome, satisfaction with medical consultation, and physical symptom distress. Latent growth mixture modelling identified trajectories of psychological response to BC. Multinominal logistic regression compared TDM difficulties, satisfaction with treatment outcome, satisfaction with medical consultation, optimism, and physical symptom distress, by distress pattern adjusted for age, education, employment status, and stage of disease. Results: Four distinct trajectories of distress were identified, namely, resilience (66%), chronic distress (15%), recovered (12%), and delayed-recovery (7%). TDM difficulties, optimism, satisfaction with consultation, and physical symptom distress predicted distress trajectories. Psychologically resilient women had less physical symptom distress at early post-surgery compared with women with other distress patterns. Compared with the resilient group, women in the recovered or chronic distress groups experienced greater TDM difficulties, whereas women in the delayed-recovery group reported greater dissatisfaction with the initial medical consultation. Women in the chronic distress group reported greater pessimistic outlook. Conclusion: Optimism and better early post-operative treatment outcomes predicted resilience to distress. Pre-operative interventions helping women to establish a realistic expectation of treatment outcome may minimize disappointment with treatment outcome and resultant distress, whereas post-operative rehabilitation should focus on symptom management. Copyright © 2009 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1016/s0140-6736(96)07492-2,Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study,"

Summary

Background

Plausible projections of future mortality and disability are a useful aid in decisions on priorities for health research, capital investment, and training. Rates and patterns of ill health are determined by factors such as socioeconomic development, educational attainment, technological developments, and their dispersion among populations, as well as exposure to hazards such as tobacco. As part of the Global Burden of Disease Study (GBD), we developed three scenarios of future mortality and disability for different age-sex groups, causes, and regions.

Methods

We used the most important disease and injury trends since 1950 in nine cause-of-death clusters. Regression equations for mortality rates for each cluster by region were developed from gross domestic product per person (in international dollars), average number of years of education, time (in years, as a surrogate for technological change), and smoking intensity, which shows the cumulative effects based on data for 47 countries in 1950–90. Optimistic, pessimistic, and baseline projections of the independent variables were made. We related mortality from detailed causes to mortality from a cause cluster to project more detailed causes. Based on projected numbers of deaths by cause, years of life lived with disability (YLDs) were projected from different relation models of YLDs to years of life lost (YLLs). Population projections were prepared from World Bank projections of fertility and the projected mortality rates.

Findings

Life expectancy at birth for women was projected to increase in all three scenarios; in established market economies to about 90 years by 2020. Far smaller gains in male life expectancy were projected than in females; in formerly socialist economies of Europe, male life expectancy may not increase at all. Worldwide mortality from communicable maternal, perinatal, and nutritional disorders was expected to decline in the baseline scenario from 17·2 million deaths in 1990 to 10·3 million in 2020. We projected that non-communicable disease mortality will increase from 28·1 million deaths in 1990 to 49·7 million in 2020. Deaths from injury may increase from 5·1 million to 8·4 million. Leading causes of disability-adjusted life years (DALYs) predicted by the baseline model were (in descending order): ischaemic heart disease, unipolar major depression, road-traffic accidents, cerebrovascular disease, chronic obstructive pulmonary disease, lower respiratory infections, tuberculosis, war injuries, diarrhoeal diseases, and HIV. Tobacco-attributable mortality is projected to increase from 3·0 million deaths in 1990 to 8·4 million deaths in 2020.

Interpretation

Health trends in the next 25 years will be determined mainly by the ageing of the world's population, the decline in age-specific mortality rates from communicable, maternal, perinatal, and nutritional disorders, the spread of HIV, and the increase in tobacco-related mortality and disability. Projections, by their nature, are highly uncertain, but we found some robust results with implications for health policy.",0 +https://doi.org/10.1016/j.jad.2013.03.004,Altered brain structural connectivity in post-traumatic stress disorder: A diffusion tensor imaging tractography study,"Post-traumatic stress disorder (PTSD) is characterized by dysfunction of several discrete brain regions such as medial prefrontal gyrus with hypoactivation and amygdala with hyperactivation. However, alterations of large-scale whole brain topological organization of structural networks remain unclear.Seventeen patients with PTSD in motor vehicle accident survivors and 15 normal controls were enrolled in our study. Large-scale structural connectivity network (SCN) was constructed using diffusion tensor tractography, followed by thresholding the mean factional anisotropy matrix of 90 brain regions. Graph theory analysis was then employed to investigate their aberrant topological properties.Both patient and control group showed small-world topology in their SCNs. However, patients with PTSD exhibited abnormal global properties characterized by significantly decreased characteristic shortest path length and normalized characteristic shortest path length. Furthermore, the patient group showed enhanced nodal centralities predominately in salience network including bilateral anterior cingulate and pallidum, and hippocampus/parahippocamus gyrus, and decreased nodal centralities mainly in medial orbital part of superior frontal gyrus.The main limitation of this study is the small sample of PTSD patients, which may lead to decrease the statistic power. Consequently, this study should be considered an exploratory analysis.These results are consistent with the notion that PTSD can be understood by investigating the dysfunction of large-scale, spatially distributed neural networks, and also provide structural evidences for further exploration of neurocircuitry models in PTSD.",0 +https://doi.org/10.7205/milmed.172.11.1144,Specific Symptoms Predict Suicidal Ideation in Vietnam Combat Veterans with Chronic Post-Traumatic Stress Disorder,"Previous research documented the elevated risk of suicide and suicidal ideation among Vietnam veterans with post-traumatic stress disorder (PTSD). The aim of the current study was to examine which Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, PTSD symptom clusters are most associated with suicidal ideation in this population. Fifty Vietnam combat veterans enrolled in treatment for PTSD responded to the Beck Scale for Suicide Ideation and were interviewed with the Clinician-Administered PTSD Scale. In linear regression analysis, it was found that the reexperiencing symptom cluster was significantly associated with suicidal ideation but the other two symptom clusters (avoidance/numbing and increased arousal) were not. Furthermore, scores on a measure of severity of combat exposure were not found to be significantly related to PTSD symptoms or suicidal ideation. The results of this study suggest the importance of reexperiencing symptoms for predicting which individuals with combat-related PTSD are most at risk for suicidal ideation and behavior.",0 +https://doi.org/10.1007/s11906-008-0005-2,Severe paroxysmal hypertension (Pseudopheochromocytoma),"Paroxysmal hypertension always engenders a search for a catecholamine-secreting pheochromocytoma. Yet 98% of people with paroxysmal hypertension do not have this tumor. The cause and management of paroxysmal hypertension remain a mystery, and the subject of remarkably few papers. This review presents an approach to understanding and successfully treating this disorder. Patients experience symptomatic blood pressure surges likely linked to sympathetic nervous system stimulation. A specific personality profile associated with this disorder suggests a psychological basis, attributable to repressed emotion related to prior emotional trauma or a repressive (nonemotional) coping style. Based on this understanding, three forms of intervention, alone or in combination, appear successful: antihypertensive therapy with agents directed at the sympathetically mediated blood pressure elevation (eg, combined (alpha)- and (beta)-blockade or central (alpha)-agonists such as clonidine); psychopharmacologic interventions including anxiolytic and/or antidepressant agents; and psychological intervention, particularly reassurance and increased psychological awareness. An appropriately selected intervention can reduce or eliminate attacks in most patients.",0 +https://doi.org/10.1176/ajp.155.12.1720,Testimony Psychotherapy in Bosnian Refugees: A Pilot Study,"Objective:The authors sought to describe the use of the testimony method of psychotherapy in a group of traumatized adult refugees from genocide in Bosnia-Herzegovina. Method:The subjects were 20 Bosnian refugees in Chicago who gave written informed consent to participate in a case series study of testimony psychotherapy. All subjects received testimony psychotherapy, averaging six sessions, approximately 90 minutes, weekly or biweekly. Subjects received standardized instruments for posttraumatic stress disorder (PTSD), depression, traumatic events, global functioning, and prior psychiatric history. The instruments were administered before treatment, at the conclusion of the treatment, and at the 2- and 6-month follow-ups.Results:The posttreatment assessments demonstrated significant decreases in the rate of PTSD diagnosis, PTSD symptom severity, and the severity of reexperiencing, avoidance, and hyperarousal symptom clusters. Depressive symptoms demonstrated a significant decrease, and there was a significant increase in scores on the Global Assessment of Functioning Scale. Two-month and 6-month follow-up assessments demonstrated further significant decreases in all symptoms and an increase in scores on the Global Assessment of Functioning Scale. Conclusions:This pilot study provides preliminary evidence that testimony psychotherapy may lead to improvements in PTSD and depressive symptoms, as well as to improvement of functioning, in survivors of state-sponsored violence. Am J Psychiatry 1998; 155: 1720-1726",0 +https://doi.org/10.1177/0886260595010002005,A Prospective Examination of Symptoms of Posttraumatic Stress Disorder in Victims of Nonsexual Assault,"Symptoms of posttraumatic stress disorder (PTSD) were examined prospectively in 84 non-sexual assault victims (53 women, 31 men) beginning shortly after the assault (mean = 18.68 days) and continuing weekly for 3 months. At the initial assessment, 71% of the women and 50% of the men met symptom criteria for PTSD. The incidence of PTSD decreased to 42% of the women and 32% of the men by the fourth assessment, and at the final assessment, 21% of the women but none of the men remained with PTSD. An examination of specific PTSD symptoms indicated that many subjects who were not diagnosed with PTSD at the final assessment retained significant symptoms of PTSD, particularly reexperiencing and arousal symptoms. The severity of PTSD did decrease significantly over the course of the study, but only in those groups who were not diagnosed with the disorder at the final assessment. Women who were diagnosed with PTSD at the final assessment did not show a significant decrease in symptom severity over the course of the study. The results are discussed with regard to implications for understanding the development and persistence of posttrauma pathology, and directions for future research are outlined.",0 +https://doi.org/10.1023/a:1024412931068,Responses to civilian war experiences: Predictors of psychological functioning and coping,"This study investigated civilian war trauma in Central American refugees, focusing on the diagnosis of posttraumatic stress disorder (PTSD) as related to war experience and demographic characteristics. Sixty eight percent of the refugees met the diagnostic criteria for PTSD. Diagnosis was best predicted by number of war experiences, severity of war trauma and level of anxiety/depression. Higher numbers of war experiences predicted PTSD severity, as did involvement in the legalization process, parenthood, and being a citizen of El Salvador. In examining the PTSD symptom cluster scores, it was found that number of war experiences was a significant predictor in all clusters. These results are helpful in increasing our knowledge about the role of war experiences in civilian PTSD and the unique situation of the Central American refugees.",0 +https://doi.org/10.1016/j.comppsych.2015.08.006,Posttraumatic stress symptoms and smoking among World Trade Center disaster responders: A longitudinal investigation,"The current longitudinal study examined posttraumatic stress disorder (PTSD) symptom severity in relation to smoking abstinence and reduction over time among responders to the World Trade Center (WTC) disaster.Participants were 763 police and 1881 non-traditional (e.g., construction workers) WTC responders who reported being smokers at an initial examination obtained between July 2002 and July 2011 at the WTC Health Program (WTC-HP). WTC responders were reassessed, on average, 2.5 years later.For police WTC responders, higher levels of WTC-related PTSD symptoms at the initial visit were associated with a decreased likelihood of smoking abstinence (OR=0.98, p=.002) and with decreased smoking reduction (β=-.06, p=.012) at the follow-up visit. WTC-related PTSD symptom severity was not related to likelihood of smoking abstinence or change in number of cigarettes smoked among non-traditional responders. Post hoc analyses suggested that for police, hyperarousal PTSD symptoms were predictive of decreased abstinence likelihood at the follow-up visit (OR=0.56, p=.006).The present findings suggest that PTSD symptoms may be differentially related to smoking behavior among police and non-traditional WTC responders in a naturalistic, longitudinal investigation. Future work may benefit from exploring further which aspects of PTSD (as compared to each other and to common variance) explain smoking maintenance.",0 +https://doi.org/10.1111/bjc.12002,The latent factor structure of acute stress disorder following bank robbery: Testing alternative models in light of the pending DSM-5,"Acute stress disorder (ASD) was introduced into the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) to identify posttraumatic stress reactions occurring within the first month after a trauma and thus help to identify victims at risk of developing posttraumatic stress disorder (PTSD). Since its introduction, research into ASD has focused on the prediction of PTSD, whereas only a few studies have investigated the latent structure of ASD. Results of the latter have been mixed. In light of the current proposal for the ASD diagnosis in the pending DSM-5, there is a profound need for empirical studies that investigate the latent structure of ASD prior to the DSM-5 being finalized.Based on previous factor analytic research, the DSM-IV, and the proposed DSM-5 formulation of ASD, four different models of the latent structure of ASD were specified and estimated.The analyses were based on a national study of bank robbery victims (N = 450) using the acute stress disorder scale.The results of the confirmatory factor analyses showed that the DSM-IV model provided the best fit to the data. Thus, the present study suggests that the latent structure of ASD may best be characterized according to the four-factor DSM-IV model of ASD (i.e., dissociation, re-experiencing, avoidance, and arousal) following exposure to bank robbery.The results are pertinent in light of the pending DSM-5 and add to the debate about the conceptualization of ASD. .",0 +https://doi.org/10.1111/jcpp.12167,Caregiver—child mental health: a prospective study in conflict and refugee settings,"Background In humanitarian settings, family-level drivers of mental health are insufficiently documented; we examined the strength of caregiver—child associations with two-wave, family-level Afghan data. Methods We recruited a gender-balanced sample of 681 caregiver—child dyads (n = 1,362 respondents) using stratified random-sampling in government schools in Kabul (364 dyads) and refugee schools in Peshawar (317 dyads). One year after baseline, we re-interviewed 64% of Kabul and 31% of Peshawar cohorts (n = 331 dyads, 662 respondents), retaining fewer Peshawar families due to refugee repatriation. In multivariable analyses adjusted for baseline, we assessed the extent to which caregiver mental health (Self-Report Questionnaire, SRQ-20) was associated with child symptom scores of post-traumatic stress (Child Revised Impact of Events Scale, CRIES), depression (Depression Self-Rating Scale, DSRS), psychiatric difficulties, impact, and prosocial strength (Strength and Difficulties Questionnaire, SDQ). Results Caregiver mental health was prospectively associated with all eight measures of child mental health at follow-up, adjusted for baseline. For post-traumatic stress, caregiver mental health had a predictive impact comparable to the child experiencing one or two lifetime trauma events. For depression, caregiver mental health approached the predictive impact of female gender. Thus a one SD change in caregiver SRQ-20 was associated with a 1.04 point change on CRIES and a 0.65 point change in DSRS. For multi-informant SDQ data, caregiver—child associations were strongest for caregiver ratings. For child-rated outcomes, associations were moderated by maternal literacy, a marker of family-level dynamics. Both adults and children identified domestic violence and quality of home life as independent risk and protective factors. Conclusions In the context of violence and displacement, efforts to improve child mental health require a thoughtful consideration of the mental health cascade across generations and the cluster of adversities that impact family wellbeing. We identify culturally meaningful leverage points for building family-level resilience, relevant to the prevention and intervention agenda in global mental health.",0 +https://doi.org/10.1136/bmj.322.7278.95,The invention of post-traumatic stress disorder and the social usefulness of a psychiatric category,"A central assumption behind psychiatric diagnoses is that a disease has an objective existence in the world, whether discovered or not, and exists independently of the gaze of psychiatrists or anyone else. In other words, neolithic people had post-traumatic stress disorder as have people in all epochs since. However, the story of post-traumatic stress disorder is a telling example of the role of society and politics in the process of invention rather than discovery. The diagnosis is a legacy of the American war in Vietnam and is a product of the post-war fortunes of the conscripted men who served there. They came home to find that they were being blamed for the war. Epithets like “babykiller” and “psychopath” were thrown at them by some who had watched on television the US military's atrocities against defenceless peasants. This reception was a primary factor in the well publicised difficulties—such as antisocial behaviour—that some military personnel had in readjusting to their peacetime roles. Those who were seen by psychiatrists were diagnosed as having an anxiety state, depression, substance misuse, personality disorder, or schizophrenia; these diagnoses were later supplanted by post-traumatic stress disorder. Early proponents of the diagnosis of post-traumatic stress disorder were part of the antiwar movement in the United States; they were angry that military psychiatry was being used to serve the interests of the military rather than those of the soldier-patients. The proponents lobbied hard for veterans to receive specialised medical care under the new diagnosis, which became the successor to the older diagnoses of battle fatigue and war neurosis. The new diagnosis was meant to shift the focus of attention from the details of a soldier's background and psyche to the fundamentally traumatogenic nature of war. This was a powerful and essentially political transformation: Vietnam veterans were to be seen …",0 +https://doi.org/10.5455/apd.36696,Posttraumatic stress disorder among Turkish veterans of the Southeast,"Objective: Traumatic events induced deliberately by humans such as terrorism causes posttraumatic stress disorder (PTSD) and other psychiatric disorders. Data analysis of the present study consists of two phases. At first phase, the prevalence of PTSD and depression comorbid to PTSD of veterans who were physically injured while doing their military service at South East Region was investigated. At the second phase, the role of risk factors of negative changes at the relationship with their environment and the need of psychological help on developing PTSD and depression comorbid to PTSD was examined. Methods: The study conducted with 247 southeast veterans. Age range of veterans is 24-49 (36.55±5.29). The years after the injury ranged from 2 to 28 years (15.35±5.3). All participants were evaluated with Demographic Information Questionnaire and Traumatic Stress Symptom Checklist (TSSC). Findings: The prevalence of PTSD was 29.6% (n=73), depression comorbid to PTSD 16.6% (n=41). There was a significant difference on PTSD and depression comorbid to PTSD among veterans who reported negative changes in the relationship with their environment and veterans who don’t reported negative changes in the relationship with their environment. Similarly, there was a significant difference on PTSD and depression comorbid to PTSD between veterans who need of psychological help and veterans who don’t need psychological help. However, there was no significant interaction effect among veterans who reported negative changes in the relationship with their environment and need of psychological help. Discussion: Southeast veterans are under the risk of direct death treat such as taking a part in battle or facing with mine explosion. Therefore, psychological and psychiatric services should be constituted to those who are physically injured and veterans who done military service at that region but not injured. Although it has been a long time, PTSD and depression comorbid to PTSD was found among southeast veterans who were exposed to frequent life-threatening traumatic experiences such as being in the middle of battle or stepping on mine. Since it is observed that both having a negative relationships with their surroundings and the need of psychological help increase the probability of PTSD and depression comorbid to PTSD, institutions which will provide psychological and psychiatric services to veterans deployed in the area should established. Key words:",0 +https://doi.org/10.1080/00207140903310790,"Hypnotizability, Posttraumatic Stress, and Depressive Symptoms in Metastatic Breast Cancer","This study assessed whether high hypnotizability is associated with posttraumatic stress and depressive symptoms in a sample of 124 metastatic breast cancer patients. Hypnotic Induction Profile Scores were dichotomized into low and high categories; posttraumatic intrusion and avoidance symptoms were measured with the Impact of Events Scale (IES); hyperarousal symptoms with items from the Profile of Mood States; and depressive symptoms with the Center for Epidemiologic Studies-Depression Scale. High hypnotizability was significantly related to greater IES total, IES intrusion symptoms, and depressive symptoms. A logistic regression model showed that IES total predicts high hypnotizability after adjusting for depressive symptoms and hyperarousal. The authors relate these results to findings in other clinical populations and discuss implications for the psychosocial treatment of metastatic breast cancer.",0 +https://doi.org/10.1037/0021-843x.107.3.508,Psychological predictors of chronic posttraumatic stress disorder after motor vehicle accidents.,"A prospective longitudinal study assessed 967 consecutive patients who attended an emergency clinic shortly after a motor vehicle accident, again at 3 months, and at 1 year. The prevalence of posttraumatic stress disorder (PTSD) was 23.1% at 3 months and 16.5% at 1 year. Chronic PTSD was related to some objective measures of trauma severity, perceived threat, and dissociation during the accident, to female gender, to previous emotional problems, and to litigation. Maintaining psychological factors, that is, negative interpretation of intrusions, rumination, thought suppression, and anger cognitions, enhanced the accuracy of the prediction. Negative interpretation of intrusions, persistent medical problems, and rumination at 3 months were the most important predictors of PTSD symptoms at 1 year. Rumination, anger cognitions, injury severity, and prior emotional problems identified cases of delayed onset.",0 +https://doi.org/10.4324/9780203102459,Disaster Resiliency,"Natural disasters in recent years have brought the study of disaster resiliency to the forefront. The importance of community preparedness and sustainability has been underscored by such calamities as Hurricane Katrina in 2005 and the Japanese tsunami in 2011. Natural disasters will inevitably continue to occur, but by understanding the concept of resiliency as well as the factors that lead to it, communities can minimize their vulnerabilities and increase their resilience. In this volume, editors Naim Kapucu, Christopher V. Hawkins, and Fernando I. Rivera gather an impressive array of scholars to provide a much needed re-think to the topic disaster resiliency. Previous research on the subject has mainly focused on case studies, but this book offers a more systematic and empirical assessment of resiliency, while at the same time delving into new areas of exploration, including vulnerabilities of mobile home parks, the importance of asset mapping, and the differences between rural and urban locations. Employing a variety of statistical techniques and applying these to disasters in the United States and worldwide, this book examines resiliency through comparative methods which examine public management and policy, community planning and development, and, on the individual level, the ways in which culture, socio-economic status, and social networks contribute to resiliency. The analyses drawn will lead to the development of strategies for community preparation, response, and recovery to natural disasters. Combining the concept of resiliency, the factors that most account for the resiliency of communities, and the various policies and government operations that can be developed to increase the sustainability of communities in face of disasters, the editors and contributors have assembled an essential resource to scholars in emergency planning, management, and policy, as well as upper-level students studying disaster management and policy. © 2013 Taylor & Francis.",0 +https://doi.org/10.1097/dbp.0b013e3181a7ee53,Patterns of Distress in African-American Mothers of Preterm Infants,"To examine inter-relationships among stress due to infant appearance and behavior in the neonatal intensive care unit (NICU), parental role alteration stress in the NICU, depressive symptoms, state anxiety, posttraumatic stress symptoms, and daily hassles exhibited by African-American mothers of preterm infants and to determine whether there were subgroups of mothers based on patterns of psychological distress.One hundred seventy-seven African-American mothers completed questionnaires on their psychological distress at enrollment during infant hospitalization and 2, 6, 12, 18, and 24 months after term.Psychological distress measures were intercorrelated. There were four latent classes of mothers: the low distress class with low scores on all measures; the high NICU-related stress class with high infant appearance and parental role stress and moderate scores on other measures; the high depressive symptoms class with high depressive symptoms and state anxiety and moderately elevated scores on NICU-related stress and posttraumatic stress symptoms; the extreme distress class with the highest means on all measures. Infants in the high stress class were sicker than infants in the other classes. The extreme distress class mothers averaged the lowest educational level. The classes differed on distress measures, worry about the child, and parenting stress through 24 months with the extreme distress class having the highest values.Although different types of maternal psychological distress were substantially related, there were distinct subgroups of mothers that were identifiable in the NICU. Moreover, these subgroups continued to differ on trajectories of distress and on their perceptions of the infants and parenting through 24 months after term.",0 +,Characteristics of posttraumatic stress disorder in ex prisoners of war.,"Post Traumatic Stress Disorder is a frequent consequence of surviving the stress of the war. The majority of research studies confirm that the severity, duration and the proximity to the traumatic events have significant influence on the outcome of surviving psychological trauma. There is also evidence that the prisoners of war who have survived severe, repetitive traumatization will develop PTSD more frequently, and that the characteristics and the severity of symptoms is more serious compared with the veterans of war who did not survive imprisonment. This paper analyzes the presence of the symptoms of PTSD according to frequency in a group of former prisoners of war and a group of war veterans who did not experience imprisonment. The research sample is comprised of subjects who were selected by the method of randomized stratified sample and divided an experimental and control group. Experimental subgroup E1 consist of 50 former prisoners of war who have sought psychiatric help after being released from the prisons, and subgroup E2 consist of 50 former prisoners of war who never sought psychiatric assistance. Control group is divided in subgroup K1 that consist of 30 veterans of war who did not survive imprisonment, and who have occasionally sought psychiatric assistance after the war, and subgroup K2 that consist of 30 veterans of war who did not survive imprisonment and who never sought psychiatric assistance. All subjects were male, none of them had any prior psychiatric history. The instruments used in the study were the following: general and sociobiographic questionnaire designed by the authors, traumatic events questionnaire which is a modified version of the Harvard Trauma Questionnaire, PTSD questionnaire designed according to DSM IV diagnostic criteria. Results in relation to degree of traumatic experience demonstrate that there is a significant statistical difference (P<0.005) between the experimental and control group. PTSP is statistically significantly more represented among the former prisoners of war than among the war veterans who were not detained in camps (P<0.05). Average scores for all symptom clusters (fear and helplessness, re-experiencing symptoms, avoidance symptoms, and hyper-arousal symptoms) were higher in the experimental group than in a control group.",0 +https://doi.org/10.1097/brs.0000000000000033,Differential changes in muscle composition exist in traumatic and nontraumatic neck pain.,"A population based cross-sectional study.To clarify relative constituents of viable muscle in 2-dimensional cross-sectional area (CSA) measures of ventral and dorsal cervical muscles in patients with chronic whiplash-associated disorders (WAD), idiopathic neck pain, and healthy controls.Previous data using T1-weighted magnetic resonance image demonstrated large amounts of neck muscle fat infiltration and increased neck muscle CSA in patients with chronic WAD but not in idiopathic neck pain or healthy controls.Magnetic resonance images were obtained for 14 cervical muscle regions in 136 females, including 79 with chronic whiplash, 23 with chronic idiopathic neck pain, and 34 healthy controls.Without fat removed, relative CSA of 7 of 14 muscle regions in the participants with chronic WAD was larger, 3 of 14 smaller and 4 of 14 similar to healthy individuals. When T1-weighted signal representing the lipid content of these muscles was removed, 8 of 14 relative muscle CSA in patients with whiplash were similar, 5 of 14 were smaller and only 1 of 14 was larger than those observed in healthy controls. Removal of fat from the relative CSA measurement did not alter findings between participants with idiopathic neck pain and healthy controls.These findings clarify that previous reports of increased relative CSA in patients with chronic whiplash represent cervical muscle pseudohypertrophy. Relative muscle CSA measures reveal atrophy in several muscles in both patients with WAD and idiopathic neck pain, which supports inclusion of muscle conditioning in the total management of these patients.3.",0 +https://doi.org/10.1016/j.suc.2014.05.012,On the Horizon,"This review demonstrates that many advances have been made in burn care that have made dramatic differences in mortality, clinical outcomes, and quality of life in burn survivors; however, much work remains. In reality, the current standard of care is insufficient and we cannot be satisfied with the status quo. We must strive for the following goals: no deaths due to burn, no scarring, and no pain. These particular goals have only begun to be confronted.",0 +https://doi.org/10.1207/s15327949pac0902_01,Personality and Trauma: Adult Attachment and Posttraumatic Distress Among Former Political Prisoners.,"Attachment patterns are especially salient in facing danger and threats to one's life. Earlier research has suggested that secure persons are protected and insecure persons vulnerable in conditions of traumatic stress. We argued that the general view may not apply to the complex person-trauma interaction that is characteristic to torture and ill-treatment. Rather, as Crittenden maintains, each attachment pattern involves a unique strategy that is the most adaptive solution, depending on the nature of the trauma. We hypothesized that the general view of the secure attachment pattern being protective, and the insecure patterns being unprotective, would apply when political prisoners are exposed to physical torture and ill-treatment. Whereas, when exposed to psychological torture involving interpersonal cruelty, securely attached persons would be more vulnerable than insecure. The hypotheses were examined among 176 Palestinian male former political prisoners living in the Gaza Strip. Their mental health was ...",0 +https://doi.org/10.1016/s0306-4530(02)00086-0,Plasma cortisol and neuropeptide Y in female victims of intimate partner violence,"The experience of intimate partner violence (physical and sexual violence) has been linked to psychiatric disorders such as posttraumatic stress disorder, yet data on the neuroendocrine profile in this population is sparse. This study sought to examine baseline plasma cortisol and neuropeptide Y (NPY) levels in female victims of intimate partner violence (IPV).Morning plasma samples were collected for cortisol and NPY determination in 22 women with histories of IPV (10 with current PTSD, 12 without current or lifetime PTSD) and 16 non-abused controls.Mean cortisol levels were significantly lower in IPV subjects compared with controls, but did not distinguish IPV subjects with and without PTSD. There were no significant differences in mean NPY levels between the groups. Neither cortisol nor NPY levels were significantly correlated with PTSD symptoms.These preliminary findings suggest that victims of IPV, like women traumatized by childhood abuse, may be characterized by alterations in hypothalamic-pituitary-adrenal axis functioning, however, further study is needed to identify specific stress system disturbances in this group.",0 +https://doi.org/10.1177/1099800415575343,A Diagnosis of Insomnia Is Associated With Differential Expression of Sleep-Regulating Genes in Military Personnel,"Sleep disturbance is a common and disturbing symptom in military personnel, with many individuals progressing to the development of insomnia, which is characterized by increased arousals, wakefulness after sleep onset, and distorted sleep architecture. The molecular mechanisms underlying insomnia remain elusive, limiting future therapeutic development to address this critical issue. We examined whole gene expression profiles associated with insomnia. We compared subjects with insomnia ( n = 25) to controls ( n = 13) without insomnia using microarray gene expression profiles obtained from peripheral samples of whole blood obtained from military personnel. Compared to controls, participants with insomnia had differential expression of 44 transcripts from 43 identified genes. Among the identified genes, urotensin 2 was downregulated by more than 6 times in insomnia participants, and the fold-change remained significant after controlling for depression, posttraumatic stress disorder, and medication use. Urotensin 2 is involved in regulation of orexin A and B activity and rapid eye movement during sleep. These findings suggest that differential expression of these sleep-regulating genes contributes to symptoms of insomnia and, specifically, that switching between rapid eye movement and nonrapid eye movement sleep stages underlies insomnia symptoms. Future work to identify therapeutic agents that are able to regulate these pathways may provide novel treatments for insomnia.",0 +https://doi.org/10.1176/appi.ajp.2013.12081133,A Trial of Prazosin for Combat Trauma PTSD With Nightmares in Active-Duty Soldiers Returned From Iraq and Afghanistan,"The authors conducted a 15-week randomized controlled trial of the alpha-1 adrenoreceptor antagonist prazosin for combat trauma nightmares, sleep quality, global function, and overall symptoms in active-duty soldiers with posttraumatic stress disorder (PTSD) returned from combat deployments to Iraq and Afghanistan.Sixty-seven soldiers were randomly assigned to treatment with prazosin or placebo for 15 weeks. Drug was titrated based on nightmare response over 6 weeks to a possible maximum dose of 5 mg midmorning and 20 mg at bedtime for men and 2 mg midmorning and 10 mg at bedtime for women. Mean achieved bedtime doses were 15.6 mg of prazosin (SD=6.0) and 18.8 mg of placebo (SD=3.3) for men and 7.0 mg of prazosin (SD=3.5) and 10.0 mg of placebo (SD=0.0) for women. Mean achieved midmorning doses were 4.0 mg of prazosin (SD=1.4) and 4.8 mg of placebo (SD=0.8) for men and 1.7 mg of prazosin (SD=0.5) and 2.0 mg of placebo (SD=0.0) mg for women. Primary outcome measures were the nightmare item of the Clinician-Administered PTSD Scale (CAPS), the Pittsburgh Sleep Quality Index, and the change item of the Clinical Global Impressions Scale anchored to functioning. Secondary outcome measures were the 17-item CAPS, the Hamilton Depression Rating Scale, the Patient Health Questionnaire-9, and the Quality of Life Index. Maintenance psychotropic medications and supportive psychotherapy were held constant.Prazosin was effective for trauma nightmares, sleep quality, global function, CAPS score, and the CAPS hyperarousal symptom cluster. Prazosin was well tolerated, and blood pressure changes did not differ between groups.Prazosin is effective for combat-related PTSD with trauma nightmares in active-duty soldiers, and benefits are clinically meaningful. Substantial residual symptoms suggest that studies combining prazosin with effective psychotherapies might demonstrate further benefit.",0 +https://doi.org/10.1177/1477370814538778,Delivering a Victim Impact Statement: Emotionally effective or counter-productive?,"Although the delivery of a Victim Impact Statement (VIS) in court is assumed to contribute to the healing and recovery process of victims of violent crimes, its effectiveness to facilitate emotional recovery is widely debated. The current longitudinal study is the first to empirically examine the psychological effects of delivering a VIS in terms of the two most important emotional reactions after crime: anger and anxiety. It extends previous findings by showing that the debate concerning the effectiveness of delivering a VIS is not a ‘black and white’ matter. In this article, we argue that the question should not be whether delivering a VIS ‘works’ or ‘doesn’t work’ for the victim, but for whom, and under which conditions. We show that delivering a VIS does not give rise to direct ‘therapeutic’ effects. However, we found that feelings of anger and anxiety decrease for victims who experience more control over their recovery process and higher levels of procedural justice.",0 +https://doi.org/10.1016/j.jpain.2013.05.007,Persistent Pain in Adolescents Following Traumatic Brain Injury,"Traumatic brain injury (TBI) is a leading cause of pediatric disability. Although persistent pain has been recognized as a significant postinjury complication, there is a paucity of data concerning the postinjury pain experience of youth. This study aimed to examine the prevalence of persistent pain in adolescents after TBI, identify risk factors for pain, and evaluate the impact of pain on adolescent health-related quality of life. Participants included 144 adolescents with mild to severe TBI who were followed over 36 months after injury. At 3-, 12-, 24-, and 36-month assessments, measures of pain intensity, depression, posttraumatic stress disorder, and health-related quality of life were completed by adolescents. Findings demonstrated that 24.3% of adolescents reported persistent pain (defined as usual pain intensity ≥3/10) at all assessment points after TBI. Female sex (odds ratio = 2.73, 95% confidence interval = 1.12-6.63) and higher levels of depressive symptoms at 3 months after injury (odds ratio = 1.26, 95% confidence interval = 1.12-1.43) were predictors of persistent pain at 36 months. Furthermore, mixed linear models indicated that early pain experience at 3 months following TBI was associated with a significantly poorer long-term health-related quality of life.This is the first study to examine the prevalence of persistent pain over long-term follow-up in adolescents after TBI and its impact on health-related quality of life. These findings indicate that adolescents with TBI may benefit from timely evaluation and intervention to minimize the development and impact of pain.",0 +https://doi.org/10.1093/arclin/acu038.220,C-39 * Resilience and Symptom Reporting following Mild Traumatic Brain Injury,"OBJECTIVE: The purpose of this study was to examine the relationship between resilience and symptom reporting following mild traumatic brain injury (mTBI). METHOD: Participants included 196 U.S. military service members (mean age = 29.2 years, SD = 8.4) who sustained a mTBI (78.8% 12 months post-injury). Three groups were derived based on self-reported resilience on the Response to Stressful Experiences Scale: low (n = 51), moderate (n = 71), and high (n = 74). Outcome measures included the Neurobehavioral Symptom Inventory (NSI) and PTSD Checklist-Civilian (PCL-C). RESULTS: There were significant main effects for all NSI and PCL-C total scores and symptom clusters (all p < .05). Pairwise comparisons revealed that the low resilience group reported greater symptomatology compared to the moderate and high resilience groups on the NSI and PCL-C total scores, NSI affective cluster, and PCL-C avoidance and hyperarousal clusters (all p < .005; d = .44-.83). Additionally, the low resilience group reported greater symptomatology compared to the high resilience group on the NSI somatic/sensory and cognitive clusters, and the PCL-C re-experiencing symptom cluster (all p < .05; d = .53-.75). Using logistic regression analyses, both the NSI and PCL-C total scores were significant predictors of high versus low resilience groups (both p < .01). However, the NSI and PCL-C total scores more reliably predicted the high resilience group (85.1% and 83.8% correctly classified, respectively) compared to the low resilience group (41.2% and 43.1% correctly classified). CONCLUSION(S): These results suggest that service members who have low resilience endorse greater symptomatology following mTBI compared to those who have high resilience.",0 +https://doi.org/10.1037/0022-006x.76.2.194,"The co-occurrence of childhood sexual abuse, adult sexual assault, intimate partner violence, and sexual harassment: A mediational model of posttraumatic stress disorder and physical health outcomes.","This study examined the co-occurrence of childhood sexual abuse, adult sexual assault, intimate partner violence, and sexual harassment in a predominantly African American sample of 268 female veterans, randomly sampled from an urban Veterans Affairs hospital women's clinic. A combination of hierarchical and iterative cluster analysis was used to identify 4 patterns of women's lifetime experiences of violence co-occurrence. The 1st cluster experienced relatively low levels of all 4 forms of violence; the 2nd group, high levels of all 4 forms; the 3rd, sexual revictimization across the lifespan with adult sexual harassment; and the 4th, high intimate partner violence with sexual harassment. This cluster solution was validated in a theoretically driven model that examined the role of posttraumatic stress disorder (PTSD) as a mediator of physical health symptomatology. Structural equation modeling analyses revealed that PTSD fully mediated the relationship between violence and physical health symptomatology. Consistent with a bio-psycho-immunologic theoretical model, PTSD levels more strongly predicted pain-related physical health symptoms compared to nonpain health problems. Implications for clinical interventions to prevent PTSD and to screen women for histories of violence in health care settings are discussed.",0 +https://doi.org/10.1111/bmsp.12008,Using mixture models with known class membership to address incomplete covariance structures in multiple-group growth models,"Multi-group latent growth modelling in the structural equation modelling framework has been widely utilized for examining differences in growth trajectories across multiple manifest groups. Despite its usefulness, the traditional maximum likelihood estimation for multi-group latent growth modelling is not feasible when one of the groups has no response at any given data collection point, or when all participants within a group have the same response at one of the time points. In other words, multi-group latent growth modelling requires a complete covariance structure for each observed group. The primary purpose of the present study is to show how to circumvent these data problems by developing a simple but creative approach using an existing estimation procedure for growth mixture modelling. A Monte Carlo simulation study was carried out to see whether the modified estimation approach provided tangible results and to see how these results were comparable to the standard multi-group results. The proposed approach produced results that were valid and reliable under the mentioned problematic data conditions. We also present a real data example and demonstrate that the proposed estimation approach can be used for the chi-square difference test to check various types of measurement invariance as conducted in a standard multi-group analysis.",0 +https://doi.org/10.1177/1094428104266510,History and Use of Relative Importance Indices in Organizational Research,"The search for a meaningful index of the relative importance of predictors in multiple regression has been going on for years. This type of index is often desired when the explanatory aspects of regression analysis are of interest. The authors define relative importance as the proportionate contribution each predictor makes to R 2 , considering both the unique contribution of each predictor by itself and its incremental contribution when combined with the other predictors. The purposes of this article are to introduce the concept of relative importance to an audience of researchers in organizational behavior and industrial/organizational psychology and to update previous reviews of relative importance indices. To this end, the authors briefly review the history of research on predictor importance in multiple regression and evaluate alternative measures of relative importance. Dominance analysis and relative weights appear to be the most successful measures of relative importance currently available. The authors conclude by discussing how importance indices can be used in organizational research.",0 +https://doi.org/10.1016/b978-0-444-52892-6.00009-x,Mild traumatic brain injury,"Mild traumatic brain injury (TBI) is common but accurate diagnosis and defining criteria for mild TBI and its clinical consequences have been problematic. Mild TBI causes transient neurophysiologic brain dysfunction, sometimes with structural axonal and neuronal damage. Biomarkers, such as newer imaging technologies and protein markers, are promising indicators of brain injury but are not ready for clinical use. Diagnosis relies on clinical criteria regarding depth and duration of impaired consciousness and amnesia. These criteria are particularly difficult to confirm at the least severe end of the mild TBI continuum, especially when relying on subjective, retrospective accounts. The postconcussive syndrome is a controversial concept because of varying criteria, inconsistent symptom clusters and the evidence that similar symptom profiles occur with other disorders, and even in a proportion of healthy individuals. The clinical consequences of mild TBI can be conceptualized as two multidimensional disorders: (1) a constellation of acute symptoms that might be termed early phase post-traumatic disorder (e.g., headache, dizziness, imbalance, fatigue, sleep disruption, impaired cognition), that typically resolve in days to weeks and are largely related to brain trauma and concomitant injuries; (2) a later set of symptoms, a late phase post-traumatic disorder, evolving out of the early phase in a minority of patients, with a more prolonged (months to years), sometimes worsening set of somatic, emotional, and cognitive symptoms. The later phase disorder is highly influenced by a variety of psychosocial factors and has little specificity for brain injury, although a history of multiple concussions seems to increase the risk of more severe and longer duration symptoms. Effective early phase management may prevent or limit the later phase disorder and should include education about symptoms and expectations for recovery, as well as recommendations for activity modifications. Later phase treatment should be informed by thoughtful differential diagnosis and the multiplicity of premorbid and comorbid conditions that may influence symptoms. Treatment should incorporate a hierarchical, sequential approach to symptom management, prioritizing problems with significant functional impact and effective, available interventions (e.g., headache, depression, anxiety, insomnia, vertigo).",0 +https://doi.org/10.1016/s0193-953x(05)70131-3,VICTIMIZATION OF WOMEN AND ITS IMPACT ON ASSESSMENT AND TREATMENT IN THE PSYCHIATRIC EMERGENCY SETTING,"An understanding of victimization is critical to the practice of emergency psychiatry. Victimization histories are disturbingly common among women presenting to the PES, particularly among frequent service users. The sequelae of victimization are both psychological and physical and often impair health and functioning across numerous domains. PTSD, BPD, and substance-use disorders are often seen among women with victimization histories, which can be particularly challenging for PES providers. Screening for trauma on PES presentation or history should not be overlooked in any person, including severely mentally ill, homeless, disabled, or elderly women. PES clinicians should remember to ask about victimization and pose questions privately in a direct and an open-ended format while conveying empathic validation. Clinical assessment of women with victimization histories in the PES should be guided by the principles of standard emergency psychiatry and be informed by an understanding of trauma. This includes a working knowledge of trauma dynamics, adherence to sound professional boundaries, and care not to retraumatize patients or re-enact perpetrator-victim dynamics. Voyeurism and regression should be avoided, particularly when eliciting trauma history. The PES should be a place for screening and acute intervention, not for conducting intensive trauma therapy. In the PES, the focus should remain on triage and treatment priorities, those of safety and stabilization, and carefully evaluating for substance use and psychosis. The PES ideally provides a ""holding environment"" that affords a balance of nurturing, limits, consistency, and communication. A basic knowledge of cognitive-behavioral interventions affording ""crisis survival strategies,"" such as DBT, can be particularly useful to PES clinicians. Clinicians also need to monitor issues of countertransference and the potential to be dismissive to these women with complex, comorbid, and chronic problems and diseases. The role for the use of psychotropic medication in PES cohorts with victimization histories should target acute symptoms. Involving regular providers of these decisions is advised to coordinate care and minimize splitting and risks of polypharmacy. Although the SSRIs are effective in symptom management of disorders related to victimization, patients must be reminded of the side-effect profile, particularly sexual dysfunction and withdrawal and discontinuation syndromes.",0 +https://doi.org/10.1023/a:1024733621595,Dissociative processes and symptoms of posttraumatic stress in Vietnam veterans,"The diagnostic taxonomy of posttraumatic stress disorder (PTSD) is a contentious issue. Commentators are divided as to whether PTSD should remain grouped with the anxiety disorders or conceptualized as a dissociative disorder. This study sought to clarify the issue by investigating the extent to which anxiety and dissociative processes differentially predict the severity of each of the three symptoms clusters in PTSD. Seventy-four Australian veterans of the Vietnam War were assessed on measures of dissociation, trait anxiety, and posttraumatic stress symptomatology. Multiple regression analyses showed that all three symptoms clusters were predicted by anxiety, but the clusters differed in the pattern of their relationship with dissociation variables. The failure of pathological dissociation to predict PTSD symptoms prompts a reconsideration of the point at which dissociative mechanisms may impact on this disorder. The findings are consistent with current classification of combat-related PTSD as an anxiety disorder.",0 +https://doi.org/10.3402/ejpt.v4i0.21308,The first president's pathway into ESTSS: memories and ideas for future issue. Patients as partners,"This article addresses Wolter De Loos' pathway into ESTSS that ended on 6th January 2004. His footsteps are still printed in the field of psychotraumatology as he showed the field how a physician was trying to integrate his working field with that of psychiatry, with a great passion for his patients. Erica M. Van der Schrieck-De Loos outlines the perspectives of her father as funding president of the ESTSS by using his Opening Address of the Fourth ESTSS Conference in 1995. This address emphasized that the mixture of righteousness and offence in warfare is ubiquitious and everlasting. The perspective of the first president's pathway has been integrated with the current vision of the author to show that the patient can be a partner of the healthcare team. A suggestion for ESTSS main objective number (8), contained within the ESTSS mission statement, is to involve patients as partners of the traumatic stress care team into accelerating traumatic stress care across Europe and beyond.",0 +https://doi.org/10.1016/s1836-9553(10)70029-1,Impact of Event Scale-Revised,,0 +https://doi.org/10.1016/j.apmr.2011.11.015,The Posttraumatic Stress Disorder Checklist as a Screening Measure for Posttraumatic Stress Disorder in Rehabilitation After Burn Injuries,"To determine the profile of posttraumatic stress disorder (PTSD) among outpatients with burn injuries referred to psychology in a rehabilitation hospital, and the utility of the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) as a screening measure for PTSD.Retrospective psychological chart review.Outpatient burn clinic of a rehabilitation hospital.Outpatients (N=132) with burns referred to psychology between December 1999 and January 2010.Psychological evaluation and self-report questionnaires measuring PTSD and depression.The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition to assess clinical diagnosis of disorders, PCL-C to measure PTSD, and the Beck Depression Inventory-II to measure depression.Of 132 outpatients, 127 (96%) had work-related injuries, 116 (88%) were men, and 16 (12%) were women. Mean age ± SD at injury was 39.0±11.1 years. Mean time from injury to assessment was 15.7±42.7 months. Burn etiology included: electrical (46.2%), scald (28.0%), flame (16.7%), chemical (5.3%), and contact (3.8%). Most patients (75%) were diagnosed with PTSD, either clinical (39.4%) or subclinical (35.6%). PTSD (clinical or subclinical) was frequently diagnosed in the following etiology groups: scald (85.7%), flame (77.3%), and electrical (74.6%). There were significant relationships between PTSD and depression (P<.001), and between subclinical PTSD and adjustment disorder (P<.03). PCL-C mean scores ± SD in the clinical and subclinical PTSD groups were 59.7±8.9 and 43.5±15.6, respectively. A PCL-C total score of 50 or higher had a sensitivity of 90% and specificity of 79% for PTSD diagnosis.There was a high prevalence of PTSD (clinical or subclinical) among outpatients with burns referred to psychology. Prospective screening of psychological symptoms, clinical assessment, and intervention is warranted, especially for patients with work-related burn injuries. Our results suggest that PCL-C is a useful screening measure for PTSD in patients with burns.",0 +https://doi.org/10.1016/j.juro.2009.07.042,Stress Induced Hypothalamus-Pituitary-Adrenal Axis Responses and Disturbances in Psychological Profiles in Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome,"Chronic pelvic pain in men has a strong relationship with biopsychosocial stress and central nervous system sensitization may incite or perpetuate the pain syndrome. We evaluated patients and asymptomatic controls for psychological factors and neuroendocrine reactivity under provoked acute stress conditions.Men with pain (60) and asymptomatic controls (30) completed psychological questionnaires including the Perceived Stress, Beck Anxiety, Type A behavior and Brief Symptom Inventory for distress from symptoms. Hypothalamic-pituitary-adrenal axis function was measured during the Trier Social Stress Test with serum adrenocorticotropin hormone and cortisol reactivity at precise times, before and during acute stress, which consisted of a speech and mental arithmetic task in front of an audience. The Positive and Negative Affective Scale measured the state of emotions.Patients with chronic pelvic pain had significantly more anxiety, perceived stress and a higher profile of global distress in all Brief Symptom Inventory domains (p <0.001), scoring in the 94th vs the 49th percentile for controls (normal population). Patients showed a significantly blunted plasma adrenocorticotropin hormone response curve with a mean total response approximately 30% less vs controls (p = 0.038) but no differences in any cortisol responses. Patients with pelvic pain had less emotional negativity after the test than controls, suggesting differences in cognitive appraisal.Men with pelvic pain have significant disturbances in psychological profiles compared to healthy controls and evidence of altered hypothalamic-pituitary adrenal axis function in response to acute stress. These central nervous system observations may be a consequence of neuropsychological adjustments to chronic pain and modulated by personality.",0 +https://doi.org/10.1002/da.22023,PROSPECTIVE INVESTIGATION OF MENTAL HEALTH FOLLOWING SEXUAL ASSAULT,"Comorbidity in psychological disorders is common following exposure to a traumatic event. Relatively little is known about the manner in which changes in the symptoms of a given type of psychological disorder in the acute period following a trauma impact changes in symptoms of another disorder. This study investigated the relationship between changes in posttraumatic stress disorder (PTSD), depression, and anxiety symptoms in the first 12 weeks following sexual assault.Participants were 126 women who had been sexually assaulted in the previous 4 weeks.Lower level mediation analyses revealed that changes in PTSD symptoms had a greater impact on changes in depression and anxiety than vice versa.The finding highlights the role of PTSD symptoms in influencing subsequent change in other psychological symptoms. These findings are discussed in the context of models detailing the trajectory of psychological disorders following trauma, and clinical implications are considered.",0 +https://doi.org/10.1002/dc.10386,Prostatic epithelial polyp diagnosed in a bladder wash,"Prostatic epithelial polyps, also known as adenomatous polyps or papillary adenomas with prostatic type epithelium, are uncommon lesions. These lesions typically involve the adult male urethra, trigone, or bladder dome. Diagnosis is usually made by biopsy. Presence of clusters of benign columnar cells in urine cytologic material can suggest the presence of such polyps and must be included in the differential diagnosis.",0 +https://doi.org/10.1089/cap.2013.0066,Prospective Evaluation of Parent Distress Following Pediatric Burns and Identification of Risk Factors for Young Child and Parent Posttraumatic Stress Disorder,"Early childhood is a high-risk time for exposure to potentially traumatic medical events. We have previously reported that 10% of young children continue to have posttraumatic stress disorder (PTSD) 6 months after burn injury. This study aimed to 1) document the prevalence and prospective change in parental psychological distress over 6 months following their child's burn injury and 2) identify risk factors for posttraumatic stress symptoms (PTSS) in young children and their parents.Participants were 120 parents of 1-6-year-old children with unintentional burn injuries. Data were collected within 2 weeks, 1 month, and 6 months of burn injury using developmentally sensitive diagnostic interviews and questionnaires.Within the first month, ∼ 25% of parents had a probable PTSD diagnosis, and moderate to extremely severe levels of depression, anxiety, and stress. Distress levels decreased significantly over time; however, 5% of parents still had probable PTSD at 6 months. Hierarchical multiple regression and path analyses indicated that parent posttraumatic stress reactions contributed significantly to the development and maintenance of child PTSS. Other risk factors for child PTSS included premorbid emotional and behavioral difficulties and larger burn size. Risk factors identified for parent PTSS included prior trauma history, acute distress, greater number of child invasive procedures, guilt, and child PTSS.The findings from this study suggest that parents' responses to a traumatic event may play a particularly important role in a young child's psychological recovery. However, further research is needed to confirm the direction of the relationship between child and parent distress. This study identified variables that could be incorporated into screening tools or targeted by early intervention protocols to prevent the development of persistent child and parent PTSS following medical trauma.",0 +https://doi.org/10.1007/s00484-014-0809-5,Impact of short-term heat stress on physiological responses and expression profile of HSPs in Barbari goats,"Six, nonpregnant, Barbari goats aged 4–5 years were selected for the study. For the first 6 days, the animals were kept in psychrometric chamber at thermoneutral temperature for 6 h each day to make them acclimated to climatic chamber. On the 7th day, the animals were exposed to 41 °C temperature for 3 h and then to 45 °C for the next 3 h. Cardinal physiological responses were measured, and blood samples (3 ml) were collected at 1-h interval during the heat exposure period and then once after 6 h of the heat exposure. The rectal temperature (RT) and respiratory rate (RR) increased significantly (P < 0.05) during the heat exposure compared to pre- and postexposure. The relative messenger RNA (mRNA) expression of heat shock protein (HSP)60, HSP70, and HSP90 increased significantly (P < 0.05) within 1 h after exposure to heat stress at 41 and 45 °C and decreased significantly (P < 0.05) in next 2 h but remain significantly (P < 0.05) elevated from preexposure. HSP105/110 relative mRNA expression level remained unchanged during the first 4 h, and thereafter, it increased significantly (P < 0.05) and reached the peak at 6 h. Relative protein expression pattern of HSPs during exposure to heat stress showed similar trend as observed for the relative mRNA expression. Given the response sensitivity and intensity of HSP genes to environmental stresses, HSP70 was found to be the most sensitive to temperature fluctuation, and it could be used as an important molecular biomarker to heat stress in animals. © 2014, ISB.",0 +https://doi.org/10.1002/jts.21993,Surveying Treatment Preferences in U.S. Iraq-Afghanistan Veterans With PTSD Symptoms: A Step Toward Veteran-Centered Care,en,0 +https://doi.org/10.1002/jts.22048,Posttraumatic Stress Disorder Symptom Clusters and Perpetration of Intimate Partner Violence: Findings From a U.S. Nationally Representative Sample,"Associations between posttraumatic stress disorder (PTSD) and perpetration of intimate partner violence (IPV) have not been extensively studied in nonveteran samples. Secondary analysis was conducted using a nationally representative U.S. sample and limited to those who reported being in a relationship in the past year (N = 25,652). This sample was mostly White (72.0%), the majority had completed high school/ general educational development (GED; 87.8%), about half were female (49.2%), and the mean age was 46.44 years (SD = 15.92). We hypothesized that a diagnosis of PTSD in the past year would be associated with greater perpetration of IPV and that the arousal/reactivity and intrusion symptom clusters would evidence the strongest associations with IPV. Consistent with expectations, a PTSD diagnosis in the past year was associated with greater perpetration of IPV, OR = 2.07, 95% CI [1.89, 2.26]. Among those with a PTSD diagnosis in the past year (n = 1,742), arousal/reactivity symptom cluster scores were associated with greater perpetration of IPV for both men and women, AOR = 1.27, 95% CI [1.11, 1.44]; intrusion symptom cluster scores were associated with perpetration of IPV for men only, AOR = 1.56, 95% CI [1.20, 2.04]; whereas negative cognitions/mood symptom cluster scores were only significant among women, AOR = 1.12, 95% CI [1.01, 1.24]. Results suggested that theoretical and empirical work linking PTSD and perpetration of IPV in military samples extends to the general population.",0 +https://doi.org/10.1007/s10960-004-5795-7,Are avoidance and numbing distinct PTSD symptom clusters?,"We present the conceptual basis and empirical evidence for considering avoidance and numbing as distinct posttraumatic stress disorder (PTSD) symptom clusters. The majority of data from factor analytic studies supports the position that avoidance and numbing are distinct symptom clusters. As well, the available data suggest that (a) different treatment modalities have differential effects on reducing avoidance but not numbing, (b) patients with more severe pretreatment numbing have poorer treatment outcomes, (c) avoidance and numbing have different patterns of correlation with depression, and (d) they have different correlations with physiological indices of attention. We conclude that avoidance and numbing are distinct PTSD symptom clusters. This distinction has implications for revising current diagnostic criteria. The recognition of this distinction may lead to advances in understanding and treating PTSD.",0 +https://doi.org/10.1155/2015/646345,Posttraumatic Stress and Posttraumatic Stress Disorder after Termination of Pregnancy and Reproductive Loss: A Systematic Review,"Objective . The aims of this systematic review were to integrate the research on posttraumatic stress (PTS) and posttraumatic stress disorder (PTSD) after termination of pregnancy (TOP), miscarriage, perinatal death, stillbirth, neonatal death, and failed in vitro fertilisation (IVF). Methods . Electronic databases (AMED, British Nursing Index, CINAHL, MEDLINE, SPORTDiscus, PsycINFO, PubMEd, ScienceDirect) were searched for articles using PRISMA guidelines. Results . Data from 48 studies were included. Quality of the research was generally good. PTS/PTSD has been investigated in TOP and miscarriage more than perinatal loss, stillbirth, and neonatal death. In all reproductive losses and TOPs, the prevalence of PTS was greater than PTSD, both decreased over time, and longer gestational age is associated with higher levels of PTS/PTSD. Women have generally reported more PTS or PTSD than men. Sociodemographic characteristics (e.g., younger age, lower education, and history of previous traumas or mental health problems) and psychsocial factors influence PTS and PTSD after TOP and reproductive loss. Conclusions . This systematic review is the first to investigate PTS/PTSD after reproductive loss. Patients with advanced pregnancies, a history of previous traumas, mental health problems, and adverse psychosocial profiles should be considered as high risk for developing PTS or PTSD following reproductive loss.",0 +https://doi.org/10.7205/milmed-d-02-3508,A Cross-Sectional Analysis of Clinical Outcomes Following Chiropractic Care in Veterans With and Without Post-Traumatic Stress Disorder,"This study was a cross-sectional analysis of clinical outcomes for 130 veteran patients with neck or low back complaints completing a course of care within the chiropractic clinic at the VA of Western New York in 2006. Multivariate analysis of variance (MANOVA) was utilized, comparing baseline and discharge scores for both the neck and low back regions and for those patients with and without post-traumatic stress disorder (PTSD). Patients with PTSD (n = 21) experienced significantly lower levels of score improvement than those without PTSD (n = 119) on self-reported outcome measures of neck and low back disability. These findings, coupled with the theorized relationships between PTSD and chronic pain, suggest that the success of conservative forms of management for veteran patients with musculoskeletal disorders may be limited by the presence of PTSD. Further research is warranted to examine the potential contributions of PTSD on chiropractic clinical outcomes with this unique patient population.",0 +https://doi.org/10.1016/s2215-0366(15)00418-6,Post-traumatic stress symptoms 5 years after military deployment to Afghanistan,,0 +,Post-traumatic Growth Inventory: Psychometric properties of the Arabic version in Palestinian adults.,"In the current study, we investigated the psychometric properties of an Arabic version of the posttraumatic growth inventory in an adult group of Palestinians in Gaza. The internal consistency of the total scale, as well as its sub-scales, was satisfactory. Furthermore, the scale significantly correlated with stress related growth. The experience of posttraumatic growth was not related to Post Traumatic Stress Disorder, but was significantly related to cumulative trauma. Cumulative Trauma predicted post traumatic growth. Using confirmatory factor analysis, a five, three, two and one factor, as well as a hierarchical structure models were compared. While the five, the three, the one and the hierarchical models were relatively satisfactory, the two factor model had the best fit to the data. The Arabic version of the instrument appeared to be a sound measure for the experience of posttraumatic growth in Palestinian adults. Further, a modest to moderate degree of posttraumatic growth was found in the current multiply traumatized sample. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1037/a0028518,The correspondence of daily and retrospective PTSD reports among female victims of sexual assault.,"Research addressing the association between daily and retrospective symptom reports suggests that retrospective reports are typically inflated. The present study examined the association between daily posttraumatic stress disorder (PTSD) symptom reports over 1 month and a corresponding retrospective report (PTSD Checklist [PCL]; Weathers et al., 1993) for both total scores and symptom clusters. The authors hypothesized that greater PTSD symptom instability and greater depression would be associated with poorer agreement between daily and retrospective reports. Data were collected from 132 female college students who were sexually assaulted. Multilevel modeling indicated very strong agreement between mean daily and retrospective reports for total scores and symptom clusters, with pseudo-R2 ranging from .55 to .77. Depression symptoms did not moderate this association, but daily-retrospective agreement was lowest for the avoidance cluster, which was also the most unstable. Finally, retrospective recall for each symptom cluster showed acceptable specificity to the corresponding daily symptom clusters. Overall, these findings suggest that retrospective memories for global PTSD symptoms and symptom clusters, as assessed by the PCL, are consistent with daily reports over a 1-month period. Implications for clinical assessment methodology are discussed.",0 +https://doi.org/10.1016/j.clinthera.2012.04.002,Are Selective Serotonin Reuptake Inhibitors Safe for Drivers? What is the Evidence?,"

Abstract

Background

Selective serotonin reuptake inhibitors (SSRIs) are widely used medications to treat several psychiatric diseases and, above all, depression. They seem to be as effective as older antidepressants but have a different adverse effect profile. Despite their favorable safety profile, little is known about their influence on traffic safety.

Objective

To conduct a literature review to summarize the current evidence on the role of SSRIs in traffic safety, particularly concerning undesirable effects that could potentially impair fitness to drive, experimental and pharmacoepidemiologic studies on driving impairment, 2 existing categorization systems for driving-impairing medications, and the European legislative procedures for assessing fitness to drive before issuing a driver's license and driving under the influence of medicines.

Methods

The article search was performed in the following electronic databases: MEDLINE, PsycINFO, ScienceDirect, and SafetyLit. The English-language scientific literature was searched using key words such as SSRIs and psychomotor performance, car crash or traffic accident, and adverse effects. For inclusion in this review, papers had to be full-text articles, refer to possible driving-related adverse effects, and be experimental or pharmacoepidemiologic studies on SSRIs and traffic accident risks. No restrictions concerning publication year were applied.

Results

Ten articles were selected as background information on driving-related adverse effects, and 15 articles were selected regarding experimental and pharmacoepidemiologic work. Regarding SSRI adverse effects, the most reported undesirable effects referring to driving impairment were anxiety, agitation, sleep disturbances, headache, increased risk of suicidal behavior, and deliberate self-harm. Regarding the remaining issues addressed in this article, inconsistencies were found between the outcomes of the selected experimental and epidemiologic studies and between the 2 existing categorization systems under evaluation. Some pitfalls of the current legislative scenario were identified as well.

Conclusions

Based on the current evidence, it was concluded that more experimental and epidemiologic research is needed to elucidate the relationship between SSRI use and traffic safety. Furthermore, a revision of the existing categorization systems and harmonized European legislation in the field of medication use and driving were highly recommended.",0 +https://doi.org/10.1097/00004583-199703000-00020,Traumatic Brain Injury in a Child Psychiatry Outpatient Clinic: A Controlled Study,"To demonstrate the similarity of children with a history of traumatic brain injury (TBI), particularly mild TBI, to matched children without such a history, within a child psychiatry outpatient clinic.This is a chart review of patients presenting to a child psychiatry outpatient clinic over a 3-year period. Children with TBI were matched by age, sex, race, and social class to children with no history of TBI. Axis I and II diagnoses, use of special education services, and IQ scores were compared.Seventy-four (5.6%) of 1,333 consecutive clinic cases had a definite TBI. Of these, 64 were mild. Only 3 of 59 comparisons that were made between TBI and control subjects were significant. A developmental communication disorder cluster was significantly more frequent in the TBI group. Autism and a pervasive developmental disorder cluster were significantly more frequent in the control group.In a child psychiatry clinic, patients with a history of TBI are virtually indistinguishable from matched children without TBI. Caution should be exercised before attributing the child's problems, especially long-term problems, to the TBI unless the injury was severe or the child is exhibiting related phobic or posttraumatic stress symptomatology.",0 +https://doi.org/10.7205/milmed-d-13-00075,Auricular Acupuncture: A Brief Introduction for Military Providers,"Injured veterans returning from Operation Iraqi Freedom and Operation Enduring Freedom often require long-term medical management for a variety of complex physical and mental health conditions. These conditions can be challenging to treat with conventional Western medicine practices alone. Recently, complementary and alternative medicine practices have been used within military settings, and have been well received by veterans. Auricular acupuncture is a practice that has provided veterans with a new approach to manage symptoms associated with a wide range of health conditions. This treatment has become an attractive treatment option because of its low cost, portability, minimal side effect profile, and ease of use in clinical and operational settings. Although formally trained Oriental medicine practitioners have historically performed these treatments, military health care providers are now receiving education and training to administer these treatments. This education and training allows military health care providers to expand their knowledge of acupuncture and provide this treatment to veterans across the continuum of care. The purpose of this article is to provide a fundamental description of auricular acupuncture and increase awareness of this treatment and its relevance to military settings.",0 +https://doi.org/10.1002/jts.21871,Moderating Effects of a Postdisaster Intervention on Risk and Resilience Factors Associated With Posttraumatic Stress Disorder in Chinese Children,en,0 +https://doi.org/10.1111/j.1556-3537.2012.01055.x,Healing with Plant Intelligence: A Report from Ayahuasca,"Numerous and diverse reports indicate the efficacy of shamanic plant adjuncts (e.g., iboga, ayahuasca, psilocybin) for the care and treatment of addiction, post-traumatic stress disorder, cancer, cluster headaches, and depression. This article reports on a first-person healing of lifelong asthma and atopic dermatitis in the shamanic context of the contemporary Peruvian Amazon and the sometimes digital ontology of online communities. The article suggests that emerging language, concepts, and data drawn from the sciences of plant signaling and behavior regarding “plant intelligence” provide a useful heuristic framework for comprehending and actualizing the healing potentials of visionary plant “entheogens” (Wasson 1971) as represented both through first-person experience and online reports. Together with the paradigms and practices of plant signaling, biosemiotics provides a robust and coherent map for contextualizing the often reported experience of plant communication with ayahuasca and other entheogenic plants. The archetype of the “plant teachers” (called Doctores in the upper Amazon) is explored as a means for organizing and interacting with this data within an epistemology of the “hallucination/perception continuum (Fischer 1975). “Ecodelic” is offered as a new linguistic interface alongside “entheogen” (Wasson 1971).",0 +https://doi.org/10.1002/jts.21817,Trauma-Related Correlates of Alcohol Use in Recently Deployed OEF/OIF Veterans,"The co-occurrence of posttraumatic stress disorder (PTSD) and alcohol use disorders (AUDs) is well documented. Little is known about the factors that contribute to alcohol use and the development of AUDs among military personnel following deployment. The primary aim of this study was to examine trauma-related correlates of alcohol use in recently deployed Operation Enduring Freedom/Operation Iraqi Freedom veterans. Members of the Rhode Island National Guard and Army Reserves (N = 238) completed an in-person, initial assessment an average of 6 months postdeployment. Multiple regression analyses examined predictors of drinking outcomes (combat exposure, total PTSD symptoms, and PTSD symptom clusters) after accounting for gender, age, and history of AUD. Results indicated that total PTSD symptoms, but not combat exposure, significantly predicted alcohol use at the initial assessment. When PTSD symptom clusters were considered separately, reexperiencing symptoms (Cluster B) were the strongest predictor of total alcohol use (B = 3.58, p = .002) and heavy drinking episodes (B = 0.31, p = .005). Implications for these findings include early identification of risk factors that could lead to the development of AUDs, and the importance of integrated treatment approaches for co-occurring PTSD and AUD among veterans postdeployment.",0 +https://doi.org/10.1080/07421656.2001.10129750,The Effectiveness of Art Therapy Interventions in Reducing Post Traumatic Stress Disorder (PTSD) Symptoms in Pediatric Trauma Patients,"Although post traumatic stress disorder (PTSD) in children has been extensively studied during the past 15 years, little research exists regarding the efficacy of treatment interventions. This report describes an outcome-based art therapy research project currently conducted at a large urban hospital trauma center. Included are the theoretical rationale and overview of an art therapy treatment intervention called the Chapman Art Therapy Treatment Intervention (CATTI) designed to reduce PTSD symptoms in pediatric trauma patients. Used in this study, the CATTI was evaluated for efficacy in measuring the reduction of PTSD symptoms at intervals of 1 week, 1 month, and 6 months after discharge from the hospital. An early analysis of the data does not indicate statistically significant differences in the reduction of PTSD symptoms between the experimental and control groups. However, there is evidence that the children receiving the art therapy intervention did show a reduction in acute stress symptoms.",0 +https://doi.org/10.1002/jts.20217,"Psychological symptoms of Turkish children and adolescents after the 1999 earthquake: Exposure, gender, location, and time duration",The authors describe their study of posttraumatic stress symptoms of children and adolescents after the 1999 earthquakes in Turkey. The rate of possible PTSD cases is also presented. The findings are reported as the results of two different studies. Location had a main effect on almost all of the dependent variables for both samples. The posttraumatic stress symptom scores for both groups significantly decreased 3 months after the initial assessment. The best predictors of the perceived posttraumatic stress symptoms for both children and adolescents were found to be perceived negative school performance and exposure.,0 +https://doi.org/10.1002/jts.20398,Longitudinal trajectories of cigarette smoking following rape,"Although prior research has identified increases in cigarette smoking following trauma exposure, no studies have examined longitudinal trajectories of smoking following rape. The present investigation identified and characterized longitudinal (< 3 months, 3-6 months, and > 6 months post-assault) trajectories of smoking (N = 152) following a rape in a sample of 268 sexual assault victims participating in a forensic medical exam. Further, the authors examined acute predictors of subsequent smoking trajectories. Of participants endorsing smoking post-rape, a two-class solution was identified, with the majority of participants (74.6%) evidencing moderate smoking with a slight decrease over time and remaining participants showing heavy smoking with a slight increase over time. Having sustained an injury, minority status, and post-examination distress all predicted subsequent smoking trajectory.",0 +https://doi.org/10.1016/s0145-2134(97)00129-4,The evaluation of Franco-Quebec victims of child sexual abuse and their mothers: The implementation of a standard assessment protocol,"There were two aims: first, to evaluate the feasibility of applying a standard assessment protocol to Franco-Quebec victims of child sexual abuse and nonoffending mothers; and second, to compare results from an initial sample with available data from English-speaking samples.A standard individual case study design was used for victims and mothers; and the satisfaction of the nine participating youth workers was assessed. Four self-report instruments for victims and five for mothers were chosen on the bases of workers' priorities, sensitivity to the impact of CSA, and the availability of published norms on English-speaking samples. Results are reported on 48 confirmed victims and 40 nonoffending mothers.The protocol was favorably received by the CPS workers, supervisors and all mothers and victims. Percentages of clinically distressed victims varied from highs of 68% on the externalization difficulties of the Child Behavior Checklist and 67% for 2- to 6-year-olds on the Child Sexual Behavior Inventory, to lows of 10% on hostility symptoms and 13% on the Dissociation Scale of the Trauma Symptom Check for Children. The rate of symptom-free children was lower (19%) and that of revictimization higher (30%) than most published estimates (Kendall-Tackett, Williams, & Finkelhor, 1993). Most mothers reported elevated emotional distress (depression, 59%) and symptoms of post-traumatic stress (intrusiveness, 67%). Although 87% of mothers believed the allegations, only 45% offered adequate emotional support.The implementation phase of this research was successful, given the positive reactions of workers and clients. Results on standard instruments from this French-speaking sample were similar to profiles of English-speaking victims and their mothers but firm conclusions on appropriate norms will require larger samples, cross cultural contrasts, and the evaluation of additional variables.",0 +https://doi.org/10.1037/0278-6133.23.1.67,The Impact of Rape on Women's Sexual Health Risk Behaviors.,"This study used cluster analysis to identify three patterns of sexual health risk behaviors in a sample of adult rape survivors (N=102). Women in the 1st cluster (high risk) reported substantial increases from pre- to postrape in their frequency of sexual activity, number of sexual partners, infrequency of condom use, and frequency of using alcohol and/or drugs during sex. The 2nd cluster (moderate risk) reported increases in frequency of sexual activity and number of partners but mitigated that risk with increased condom use. Survivors in the 3rd cluster (low risk) indicated that their sexual health behaviors had become much less risky postrape. An ecological model predicting cluster membership revealed that individual-level and contextual factors predict patterns of risk behaviors.",0 +https://doi.org/10.1176/appi.ajp.162.2.270,Symptoms of Posttraumatic Stress Disorder and Borderline Personality Disorder in Veterans of Operation Desert Storm,"OBJECTIVE: The present report is part of a follow-along investigation focusing on the evolution of trauma-related symptoms in veterans of Operation Desert Storm. The goal of the current report was to examine three hypotheses on the relationship between severity of war-related trauma, symptoms of posttraumatic stress disorder (PTSD), and symptoms of borderline personality disorder with a mixed retrospective/prospective design. METHOD: Ninety-four National Guard reservists completed self-administered measures of combat-related trauma, PTSD symptoms, and borderline personality disorder features after their Gulf War duty. RESULTS: Consistent with study hypotheses, prewar features of borderline personality disorder predicted variability in postwar PTSD symptoms beyond that predicted by combat exposure, combat exposure predicted variability in postwar features of borderline personality disorder, and PTSD severity assessed shortly after combat exposure accounted for additional variability in subsequent features of borderline personality disorder. CONCLUSIONS: Taken together, the present findings suggest that trauma, symptoms of PTSD, and features of borderline personality disorder are related to one another in a complex fashion that may exceed simple linear models. Clinical and research implications for the relationships among trauma, PTSD, and borderline personality disorder are discussed.",0 +https://doi.org/10.1177/0308022614557628,Predicting fears of intimacy among individuals with post-traumatic stress symptoms by their sensory profile,"Introduction The purpose of the research was: (1) to compare fears of intimacy between people with post-traumatic stress symptoms and healthy controls; (2) to examine the relationships between sensory processing patterns and fears of intimacy among people with post-traumatic stress symptoms; (3) to examine the ability of post-traumatic stress symptoms and sensory processing patterns to predict fears of intimacy. Method The study consisted of 60 people between 24 and 62 years old. Thirty of the participants had post-traumatic stress symptoms and the other 30 were healthy controls. All participants were involved in an intimate relationship. Participants completed the Post-traumatic Stress Disorder Symptom Scale, the Adolescent/Adult Sensory Profile, and the Fear of Close Personal Relationship Questionnaire. Findings Higher prevalence of extreme sensory sensitivity, avoidance, and low registration was found among the study group. These patterns significantly correlated with impaired emotional responses associated with intimacy. Low registration and group membership predicted fears of intimacy. Conclusion Sensory processing difficulties may contribute to the impaired intimate relationships of people with post-traumatic stress symptoms. Occupational therapists may help people with post-traumatic stress symptoms to be aware of their sensory processing difficulties and their impact on social/intimate relationships. This awareness may contribute to the person's ability to cope with post-traumatic stress symptoms, enable better emotional performance, and elevate quality of life.",0 +https://doi.org/10.1016/j.janxdis.2015.11.002,Exploring differences between the ICD-11 and DSM-5 models of PTSD: Does it matter which model is used?,"Alternative symptom profiles for posttraumatic stress disorder (PTSD) are presented in the DSM-5 and ICD-11. This study compared DSM-5 PTSD symptom profiles with ICD-11 PTSD symptom profiles among a large group of trauma-exposed individuals from Denmark. Covariates, and rates of co-occurrence with other psychiatric disorders were also investigated. A sample of treatment-seeking adult survivors of childhood sexual abuse (n=434) were assessed using self-report measures of PTSD and other psychiatric disorders. A significantly larger proportion of individuals met caseness for DSM-5 PTSD (60.0%) compared to ICD-11 PTSD (49.1%). This difference was largely attributable to low endorsement of the ICD-11 re-experiencing criteria. Replacement of the 'recurrent nightmares' symptom with the 'recurrent thoughts/memories' symptom seemed to balance the proportion of individuals meeting caseness for both taxonomies. Levels of co-occurrence with anxiety and thought disorder were higher for the DSM-5 model of PTSD compared to the ICD-11 model. Current results merit careful consideration in the selection of symptom indicators for the new ICD model of PTSD, particularly with respect to the re-experiencing symptom category.",0 +https://doi.org/10.1111/j.1526-4637.2008.00457.x,"Rationale, Design, and Baseline Findings from a Randomized Trial of Collaborative Care for Chronic Musculoskeletal Pain in Primary Care","This article describes the rationale, design, and baseline findings from an ongoing study of collaborative care for chronic musculoskeletal pain and comorbid depression.Cluster randomized clinical trial.Forty-two clinicians and 401 patients from five Veterans Affairs primary care clinics.The intervention was based on the chronic care model, and included patient and provider activation and education, patient assessment, outcomes monitoring, and feedback to providers over 12 months. The intervention team consisted of a full-time psychologist care manager and a part-time physician internist. Approaches included goal setting emphasizing function, patient activation and educating about fear avoidance, and care management.Main outcomes are Roland-Morris Disability Questionnaire (RMDQ) score, depression severity (Patient Health Questionnaire-9), and pain severity (Chronic Pain Grade Severity subscale) at 6 and 12 months.Fifteen percent of primary care patients mailed a study advertisement letter requested screening for the study. The mean age of enrolled patients was 62. Back and neck or joint pain diagnoses were present in 67% and 65% of patients, respectively. Mean pain duration was 15 years, and mean RMDQ score (range 0-24) was 14.7 (standard deviation = 4.4). Sixty-five percent of patients were receiving disability. Eighteen percent of patients met criteria for major depression, 17% for posttraumatic stress disorder, and 9% for alcohol misuse. Thirty-nine percent of patients felt strongly that experiencing pain was a sign of damage, and 60% reported strong avoidance of painful activities.These baseline data support the rationale to develop a multifaceted approach to treat chronic pain in primary care that includes detection and treatment of psychiatric comorbidity.",0 +https://doi.org/10.1111/j.0730-7659.2005.00340.x,Effectiveness of a Counseling Intervention after a Traumatic Childbirth: A Randomized Controlled Trial,"Adverse childbirth experiences can evoke fear and overwhelming anxiety for some women and precipitate posttraumatic stress disorder. The objective of this study was to assess a midwife-led brief counseling intervention for postpartum women at risk of developing psychological trauma symptoms.Of 348 women screened for trauma symptoms, 103 met inclusion criteria and were randomized into an intervention (n = 50) or a control (n = 53) group. The intervention group received face-to-face counseling within 72 hours of birth and again via telephone at 4 to 6 weeks postpartum. Main outcome measures were posttraumatic stress symptoms, depression, self-blame, and confidence about a future pregnancy.At 3-month follow-up, intervention group women reported decreased trauma symptoms, low relative risk of depression, low relative risk of stress, and low feelings of self-blame. Confidence about a future pregnancy was higher for these women than for control group women. Three intervention group women compared with 9 control group women met the diagnostic criteria for posttraumatic stress disorder at 3 months postpartum, but this result was not statistically significant.A high prevalence of postpartum depression and trauma symptoms occurred after childbirth. Although most women improved over time, the intervention markedly affected participants' trajectory toward recovery compared with women who did not receive counseling.A brief, midwife-led counseling intervention for women who report a distressing birth experience was effective in reducing symptoms of trauma, depression, stress, and feelings of self-blame. The intervention is within the scope of midwifery practice, caused no harm to participants, was perceived as helpful, and enhanced women's confidence about a future pregnancy.",0 +https://doi.org/10.1002/jclp.22177,Broad Clinical Phenotype and Facets of Emotion Regulation in Interpersonal Trauma Survivors,"This study examines broad-based psychopathology in a community sample of female survivors of interpersonal trauma. The extent to which facets of emotion regulation predict symptom presentation among this population is examined.Hierarchical cluster analysis examining symptoms of posttraumatic stress disorder, depression, somatization, and alcohol abuse was used to identify symptom clusters in an ethnically diverse sample (N = 205).Approximately 17% of the sample fell into a severe symptom group characterized by clinical levels of distress across all four disorders. The largest group (46%) was marked by subclinical distress across all four disorders, while the final group (37%) reported subclinical distress, but with a relative absence of alcohol abuse. Of the 6 emotion regulation subscales from the Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004), 2 consistently predicted group membership: nonacceptance and impulsivity.Cluster analyses revealed symptom clusters that may vary in their appropriateness for current posttrauma interventions. Implications for research and clinical practice are discussed.",0 +https://doi.org/10.1037/a0025954,Factors associated with chronicity in posttraumatic stress disorder: A prospective analysis of a national sample of women.,"The current study sought to identify factors associated with posttraumatic stress disorder (PTSD) chronicity over a 2-year time period in a national sample of adult women selected via random-digit dialing. Participants meeting diagnostic criteria for PTSD (n = 190) at the initial assessment were interviewed and certain baseline predictors of chronicity 2 years later were examined. Number of PTSD reexperiencing symptoms, rape history, and childhood history of physical assault were all predictive of chronicity at the follow-up assessment. No relationship emerged between remission status and treatment seeking, though approximately half who remitted did so without professional treatment. These risk factors for chronicity may help identify those individuals with PTSD who are most in need of intervention. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1081/ada-120020511,A Comparison Between Dually Diagnosed Inpatients with and without Axis II Comorbidity and the Relationship to Treatment Outcome,"The presence of a personality disorder (PD) has been associated with certain types of poor treatment outcomes in patients with substance use disorders (SUDs). The purpose of this study was to determine the prevalence of comorbid PDs in psychiatrically hospitalized adults with both non-SUD Axis I disorders and SUDs, and to assess the relationship between Axis II psychopathology and degree of pretreatment addiction severity and treatment outcome.One hundred consecutive inpatients admitted to a mixed dual diagnosis inpatient unit were assessed using semistructured interviews for SUDs, non-SUD Axis I disorders, and PDs. Pretreatment severity was assessed using a modified version of the Addiction Severity Index (ASI). Outcome measures were assessed both during hospitalization and at an initial follow-up appointment after discharge. Statistical analyses were performed comparing dually diagnosed patients with and without Axis II psychopathology.A significant number (53%) of the patients met criteria for at least one personality disorder. Of the PDs, Cluster B PDs were the most prevalent, particularly borderline personality disorder (74%) and antisocial personality disorder (66%). Dually diagnosed patients without an Axis II diagnosis had less severe pretreatment severity measures. During hospitalization, patients with Axis II disorders had higher levels of psychopathology on the Brief Symptom Inventory (BSI) subscales of sensitivity and hostility. However, there was no difference in overall degree of global improvement during hospitalization. During follow-up, patients with Axis II disorders were significantly less likely to be compliant in attending their initial follow-up appointment.Dual diagnosis inpatients with PDs appear to improve as much as patients without PDs during their inpatient hospitalizations; however, they appear to be less likely to be compliant with attending their initial follow-up appointment.",0 +https://doi.org/10.1016/s0005-7967(03)00105-0,Neuroticism and self-criticism associated with posttraumatic stress disorder in a nationally representative sample,"Broad and specific psychological traits may uniquely differentiate trauma victims with PTSD from trauma victims without PTSD, but there is a need for representative, population-based research. We investigated elevated neuroticism and self-criticism in association with the presence versus absence of PTSD in a nationally representative sample of adults who experienced a traumatic stressor. Respondents were from the National Comorbidity Survey Part II (N=5877) (). Individuals who experienced one or more traumatic events were selected (N=3238). In separate regression analyses, elevated levels of neuroticism and self-criticism were each significantly associated with PTSD among men and women who had experienced one or more traumatic events. After controlling for types of traumas experienced and other previously identified factors (Bromet, Sonnega, & Kessler, 1998. American Journal of Epidemiology, 147, 353-361), neuroticism remained significantly associated with PTSD in women and both neuroticism and self-criticism remained significant in men. Evidence from this nationally representative sample of adults who experienced traumatic events suggests that self-criticism and especially the broad personality domain of neuroticism may represent robust psychological dimensions associated with the presence of PTSD.",0 +https://doi.org/10.1007/s00038-014-0596-0,Maternal posttraumatic stress disorder symptom trajectories following Hurricane Katrina: An initial examination of the impact of maternal trajectories on the well-being of disaster-exposed youth,"ObjectivesThis study examined trajectories of posttraumatic stress disorder symptoms in impoverished mothers impacted by Hurricane Katrina, as well as how predictive the maternal trajectories were for youth posttraumatic stress symptoms 2 years post-Katrina.Methods360 mother participants displaced by Hurricane Katrina completed self-report measures across four time points related to Hurricane exposure, trauma history, and posttraumatic stress symptoms. Additionally, the youth offspring completed a self-report measure of posttraumatic stress symptoms.ResultsLatent Class Growth Analysis demonstrated three primary trajectories emerged among females impacted by Katrina, namely, (1) chronic (4 %), (2) recovering (30 %), and (3) resilient (66 %), respectively. These trajectories were significantly impacted by prior trauma history, but not hurricane exposure. Additionally, data indicated that children whose parents fell into the chronic PTS trajectory also reported high levels of PTS symptoms.ConclusionsThis study identified three main trajectories typical of female PTS symptoms following disaster and was the first known study to document associations between PTS outcomes among adults and their offspring impacted by a large natural disaster. Future research is warranted and should explore additional risk and protective factors that impact both the parental and child outcomes.",1 +https://doi.org/10.1002/da.20008,Comparison of nefazodone and sertraline for the treatment of posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) is a prevalent condition that has been shown to be responsive to pharmacotherapy. Few head-to-head comparisons of medications used in the treatment of PTSD have been published. This 12-week, randomized, double-blind study compares the effectiveness, safety, and tolerability of nefazodone and sertraline for the treatment of PTSD. Thirty-seven male and female outpatients meeting DSM-IV criteria for PTSD were randomly assigned to receive nefazodone (maximum dose 600 mg/day; average dose 463 mg/day) or sertraline (maximum dose 200/day; average dose 153 mg/day). The primary outcome measures were the 17-item total severity score of the Clinician Administered PTSD Scale, Part 2 (CAPS-2) and the Clinical Global Impression Improvement Scale (CGI-I). Other assessments included the Davidson Trauma Scale (DTS), the Top-8 PTSD Rating Scale, Sheehan Disability Scale (SDS), Montgomery-Asberg Depression Rating Scale (MADRS), Hamilton Anxiety Scale (HAM-A), and Pittsburgh Sleep Quality Index (PSQI). Twenty-six subjects had at least one post-randomization CAPS-2 assessment and were therefore included in the data analysis. There were no statistically significant differences between treatment groups on any of the outcome measures. There was a significant effect for time in both groups, indicating an improvement in PTSD symptoms, depression, sleep, and quality of life over time. CAPS-2 scores for all of the PTSD symptom clusters decreased significantly over time. This study did not find significant differences in the effectiveness of nefazodone and sertraline for the treatment of PTSD. Larger trials are warranted.",0 +https://doi.org/10.1089/cap.1999.9.203,Psychopharmacology of Pediatric Posttraumatic Stress Disorder,"To review the current knowledge of pharmacotherapy in the treatment of Post-traumatic Stress Disorder (PTSD) as it applies to children and adolescents and to provide a rational approach to medication use in Pediatric PTSD.The literature on the psychopharmacology of Pediatric PTSD is reviewed. Additionally, literature is reviewed on the neurobiological systems presumptively involved in trauma as well as studies in the pharmacology of adult PTSD, as they pertain to the treatment of Pediatric PTSD.There are too few studies in the current Pediatric PTSD literature to confirm treatment recommendations. Downward extrapolation from the adult literature combined with an understanding of the neurobiology of PTSD and its comorbid conditions may serve as the basis for a rational pharmacotherapy of PTSD in childhood. The effectiveness of targeting pharmacological agents at PTSD symptom clusters and associated comorbid conditions remains to be verified in controlled clinical trials.The state of psychopharmacology for Pediatric PTSD is in its earliest stages. While there are insufficient numbers of controlled pharmacological trials to make firm recommendations, the field requires a starting point for a rational psychopharmacological approach. Pharmacotherapy may provide symptom relief of both the debilitating primary symptoms and the comorbid conditions in children suffering from PTSD.",0 +https://doi.org/10.1097/00005053-199809000-00002,Physical Symptom Trajectories Following Trauma Exposure: Longitudinal Findings from the Normative Aging Study,"This study modeled physical symptom trajectories from ages 30 to 75 in 1079 older male military veterans who were assessed every 3 to 5 years since the 1960s. Combat exposure and noncombat trauma were used to define four groups: no trauma (N = 249), noncombat trauma only (N = 333), combat only (N = 152), and both combat and noncombat trauma (N = 345). Number of symptoms on the Cornell Medical Index physical symptom scale increased 29% per decade. Men who had experienced either combat or noncombat trauma did not differ from nonexposed men, but those who had experienced both combat and noncombat trauma had 16% more symptoms across all ages. There were no differences in age-related trajectories as a function of trauma history. In cross-sectional analysis, men with combat and noncombat trauma had more posttraumatic stress disorder symptoms, but not more depression symptoms, than men with either no trauma or noncombat trauma only. Discussion focuses on the importance of considering physical as well as psychological outcomes of exposure to traumatic events.",0 +https://doi.org/10.1093/ptj/78.9.951,Use of Generic Versus Region-Specific Functional Status Measures on Patients With Cervical Spine Disorders,"Few data exist to support the use of functional status measures on patients with disorders of the cervical spine. This study was designed to compare the construct validity and sensitivity to change of the Neck Disability Index (NDI) and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36).Patients (N = 146) with a variety of disorders of the cervical spine completed the NDI and the SF-36 prior to treatment. Following discharge from treatment, 69 of these patients completed a second NDI and SF-36.There was evidence for the construct validity and sensitivity to change of the NDI and the physical and mental component scores of the SF-36. The ability of the NDI and SF-36 to detect change varied, depending on the construct tested. The SF-36 was superior in some instances, and the NDI was superior in other instances. The NDI appears to measure both mental and physical health-related factors.There appears to be substantial overlap between the 2 measures. The use of both measures, therefore, is probably not necessary. [Riddle DL, Stratford PW. Use of generic versus region-specific functional measures on patients with cervical spine disorders.",0 +https://doi.org/10.1007/s10464-007-9156-6,"Community Resilience as a Metaphor, Theory, Set of Capacities, and Strategy for Disaster Readiness","Communities have the potential to function effectively and adapt successfully in the aftermath of disasters. Drawing upon literatures in several disciplines, we present a theory of resilience that encompasses contemporary understandings of stress, adaptation, wellness, and resource dynamics. Community resilience is a process linking a network of adaptive capacities (resources with dynamic attributes) to adaptation after a disturbance or adversity. Community adaptation is manifest in population wellness, defined as high and non-disparate levels of mental and behavioral health, functioning, and quality of life. Community resilience emerges from four primary sets of adaptive capacities--Economic Development, Social Capital, Information and Communication, and Community Competence--that together provide a strategy for disaster readiness. To build collective resilience, communities must reduce risk and resource inequities, engage local people in mitigation, create organizational linkages, boost and protect social supports, and plan for not having a plan, which requires flexibility, decision-making skills, and trusted sources of information that function in the face of unknowns.",0 +https://doi.org/10.1017/cbo9780511730030.019,Mental Health Treatments In The Wake Of Disaster,"INTRODUCTION There is overwhelming evidence that disasters can lead to a range of posttraumatic mental health problems. The aim of this chapter is to review the evidence for psychological and pharmacological approaches to treating people with adverse psychological reactions after disaster; specifically, we focus on interventions that can be provided in the short and intermediate phases after disaster. First we review common postdisaster psychiatric disorders. We then turn to describing and outlining the evidence for psychological approaches to treatment. Next we review pharmacological treatments for posttraumatic conditions. Finally, we comment on factors that influence the management of psychological approaches in the acute postdisaster environment. PSYCHOLOGICAL EFFECTS OF DISASTERS There is convergent evidence that an array of psychiatric disorders arise after disasters. Posttraumatic stress disorder (PTSD) is the most commonly identified, and the disorder is characterized by three clusters of symptoms, including reexperiencing of the traumatic event, avoidance and numbing, and hyperarousal. Symptoms need to be present for at least 1 month and cause clinically significant distress or impairment in functioning to fulfill criteria for PTSD. Rates of PTSD were reported in 34% of survivors of the Oklahoma City bombing (North et al., 1999) and 53% after Australian bushfires (McFarlane, 1986). Across studies, the prevalence of PTSD is higher among direct victims (30%–40%) than rescue personnel (10%–20%; Neria, Nandi, & Galea, 2007). © Cambridge University Press 2009.",0 +https://doi.org/10.1007/bf02688611,An event-related brain potential investigation of PTSD and PTSD symptoms in abused children,"We tested 186 children ranging in age from 6 years, 10 months to 13 years, 7 months; 174 suffered either physical and/or sexual abuse, and 12 were nonabused children. Abused subjects were grouped in four different ways. The primary grouping was based on whether subjects satisfied the DSM III-R criteria for posttraumatic stress disorder (PTSD). Secondary groupings were based upon the three symptom clusters used to make the PTSD diagnosis (arousal, avaidance, and reexperiencing). In each of these groupings three separate subgroups were formed with approximately 25 percent in the high and low symptom count subgroups and the remaining 50 percent in the middle symptom count subgroup.Subjects listened to four different intensity levels (65, 80, 95, and 102 dB) of a 1 KHz tone, pseudo-randomly ordered, while event-related brain potentials (ERPs) were recorded. Two separate blocks were used, one with short intervals (4±1 sec) between tones and the other with longer intervals (17±2 sec). PTSD subjects presented a greater P2-N2 ERP intensity gradient (i.e., a larger increase in the P2-N2 ERP component as tone intensity increased) than did abused subjects without PTSD. Abused subjects with the highest number of reexperiencing symptoms showed a similar P2-N2 augmenting effect when compared to those with the lowest number of reexperiencing symptoms. Subjects with the highest number of arousal symptoms showed a shallower intensity gradient for the N1-P2 ERP component than did those with fewer arousal symptoms. The results are discussed in relation to previous results reported on adults with PTSD and in terms of CNS processing of stimulus intensity information.",0 +https://doi.org/10.1007/s00213-007-0703-5,"The psychotherapeutic potential of MDMA (3,4-methylenedioxymethamphetamine): an evidence-based review","Aims and rationale: The purpose of this study was to review whether methylenedioxymethamphetamine (MDMA) has the appropriate pharmacodynamic profile to be a therapeutic agent. Materials and methods: Empirical descriptions of MDMA's subjective effects in humans will be reviewed to evaluate the proposal that MDMA has psychotherapeutic properties. The focus will be published evidence on its functional effects in therapeutic, medical, and other situations. Results: MDMA is a powerful central nervous system (CNS) stimulant which affects several neurotransmitter systems and intensifies a range of psychobiological functions. Its acute mood effects can be very positive and life enhancing, and the affirmative cognitions engendered during MDMA therapy may well endure afterwards. However, MDMA also has a number of potential anti-therapeutic characteristics. Acutely, it can also intensify negative cognitions, and these may similarly endure over time. Psychotherapists have found that setting, intention, and expectancy are crucial for a positive outcome, but these factors cannot be guaranteed. Post-MDMA, there is a period of neurotransmitter recovery when low moods predominate, and these may exacerbate psychiatric distress. The explanations proposed for MDMA-assisted therapy are all psychodynamic, and a neurochemical model needs to be outlined. It has been suggested that enduring therapeutic gains can follow a single session, but again, this lacks a clear psychopharmacological rationale. Finally, diathesis-stress models suggest that psychiatric individuals are more prone to acute and chronic abreactions to CNS stimulants such as MDMA. Conclusions: There are a number of issues which need to be addressed before it can be argued that MDMA might be clinically useful for psychotherapy. (",0 +https://doi.org/10.1111/j.1365-2605.2005.00530.x,The effect of paternal heat stress on protein profiles of pre-implantation embryos in the mouse,"The study was undertaken to compare the protein profiles of [35S]-methionine-labelled control-sired embryos with heat-sired embryos at 7, 14 or 21 days after mature fertile B6CBF F1 male mice were kept at 36 +/- 0.3 degrees C and 62 +/- 2.7% relative humidity for 24 h. One-dimensional gel electrophoresis and autoradiographs were used to examine the protein profiles between the two-cell embryos and the blastocysts. The results obtained demonstrate that paternal heat stress 7 or 14 days earlier did not apparently affect protein patterns of two-cell embryos, four-cell to eight-cell embryos, morulae or blastocysts. However, 21 days earlier, there were changes in protein patterns of two-cell embryos and abnormal embryos, but not the morulae. To further support and extend these results, two-dimensional gel electrophoresis and phosphorimaging were employed and the results obtained show that paternal heat stress 21 days before mating affected protein profiles of two-cell embryos and morulae in the mouse. Together, these findings have indicated that paternal heat stress affects most but not all protein patterns of pre-implantation embryos, which strongly supports our previous results demonstrating that paternal heat stress significantly reduced the developmental proportion of pre-implantation embryos in the mouse.",0 +https://doi.org/10.1016/j.janxdis.2011.03.007,Posttraumatic stress and sleep: Differential relations across types of symptoms and sleep problems,"Posttraumatic stress symptoms and self-reported sleep problems reliably covary. The current study investigated how posttraumatic stress symptom clusters (i.e., hyperarousal, avoidance, and reexperiencing) relate to trouble initiating and maintaining sleep and nightmares. Participants included traumatic event-exposed respondents from the NCS-R. Results suggested that posttraumatic stress symptom severity is related to trouble initiating and maintaining sleep and nightmares. Investigation of symptom clusters indicated that reexperiencing symptoms were related to trouble initiating and maintaining sleep and nightmares, while hyperarousal symptoms were related to trouble maintaining sleep and nightmares. Findings partially support both reexperiencing and hyperarousal-based models of the relation between sleep and posttraumatic stress.",0 +https://doi.org/10.1017/s0033291711001048,Perceptual processing advantages for trauma-related visual cues in post-traumatic stress disorder,"Intrusive re-experiencing in post-traumatic stress disorder (PTSD) comprises distressing sensory impressions from the trauma that seem to occur 'out of the blue'. A key question is how intrusions are triggered. One possibility is that PTSD is characterized by a processing advantage for stimuli that resemble those that accompanied the trauma, which would lead to increased detection of such cues in the environment.We used a blurred picture identification task in a cross-sectional (n=99) and a prospective study (n=221) of trauma survivors.Participants with acute stress disorder (ASD) or PTSD, but not trauma survivors without these disorders, identified trauma-related pictures, but not general threat pictures, better than neutral pictures. There were no group differences in the rate of trauma-related answers to other picture categories. The relative processing advantage for trauma-related pictures correlated with re-experiencing and dissociation, and predicted PTSD at follow-up.A perceptual processing bias for trauma-related stimuli may contribute to the involuntary triggering of intrusive trauma memories in PTSD.",0 +https://doi.org/10.1007/s12207-010-9078-8,Investigating Differences in Truthful and Fabricated Symptoms of Traumatic Stress over Time,"False allegations of victimization typically are accompanied by malingered emotional symptomology to corroborate claims. This analog study was designed to compare truthful and fabricated symptom profiles on measures of post-traumatic stress (i. e., Revised Impact of Event Scale, Post-Traumatic Stress Disorder (PTSD) Checklist, Trauma Symptom Inventory) and levels of symptom consistency over time. Participants (undergraduate students) described their mental health symptoms for both traumas at time 1 (N=291), time 2 (N=252, 3 month), and time 3 (N=181, 6 months). Results indicated that fabricated traumas were associated with inflated symptom profiles. Validity scales were not effective at discerning symptom veracity, although reports could be discriminated somewhat by atypical responding and clinical scales. PTSD symptoms in malingerers also were reported more consistently over time. This research offers applicable information for identifying feigned traumatic stress. © 2010 Springer Science + Business Media, LLC.",0 +https://doi.org/10.1097/jcp.0b013e318160f83b,Divalproex in the Treatment of Posttraumatic Stress Disorder,"To evaluate the efficacy of divalproex for the treatment of posttraumatic stress disorder (PTSD) hyperarousal symptom cluster.Under double-blind conditions, 85 US military veterans with PTSD were randomized to treatment with divalproex or placebo for 8 weeks. All patients who received at least 1 dose of medication and 1 postbaseline assessment (n = 82) were included in the efficacy population. The primary outcome measure was the hyperarousal subscale of the Clinician-Administered PTSD Scale.There were no significant intergroup differences in primary or secondary end points. The final mean (SD) divalproex dose and serum valproic acid level were 2309 +/- 507 mg/d and 82 +/- 30 mg/L, respectively.Divalproex monotherapy was not effective in the treatment of chronic PTSD in predominantly older male combat veterans. Further study is needed to determine the efficacy of divalproex in the management of PTSD in women or civilians or in combination with antidepressants.",0 +https://doi.org/10.1007/s10597-011-9371-3,Resilience and Distress: Israelis Respond to the Disengagement from Gaza and the Second Lebanese War,"Resilience and distress in Israeli society were assessed at three points in time: before and after the Israeli disengagement from Gaza, and after the second Lebanese war. A random sample of 366 Israelis was assessed for nation-related anxiety and hostility, personal resources and post-traumatic symptoms. The lowest levels of anxiety were observed at the second time point, after the disengagement. Respondents with high-resilience profiles showed lower levels of post-traumatic symptoms and higher levels of personal resources. The findings underscore Israelis' resilience and the importance of personal resources in ongoing nationally stressful situations. © 2011 Springer Science+Business Media, LLC.",0 +https://doi.org/10.1080/09638230410001729807,The psychological treatment of Post Traumatic Stress Disorder (PTSD) in adult refugees: A review of the current state of psychological therapies,"Background: Large numbers of refugees flee their countries of origin each year. A proportion of these people will have witnessed or experienced traumatic events and may be suffering from psychological distress requiring intervention.Aims: The article aims to review the literature relating to the psychological treatment of Post Traumatic Stress Disorder (PTSD) in adult refugees. The clinical implications of existing research and specific challenges faced by health services in meeting the mental health needs of non-western individuals are discussed.Method: A literature search of English language journals was conducted using the Web of Science, Medline and PsycInfo databases.Findings: There is a dearth of research in this area and the majority of studies conducted have significant methodological limitations. Despite this, the psychotherapeutic studies to date indicate some potentially effective treatments with traumatized refugees and have attempted to employ innovative treatment elements taking into account issues of diversity.Conclusions: Research and practice in this area is in its infancy and further research is necessary. Culturally sensitive adaptations of CBT seem promising and further research is needed to clarify the value of such specific elements in therapy. The need for greater therapist awareness of issues of diversity raises issues for training and continual professional development.",0 +https://doi.org/10.1348/014466507x235953,Cultural differences in personal identity in post-traumatic stress disorder,"This study investigated cultural differences in goals, self-defining memories, and self-cognitions in those with and without post-traumatic stress disorder (PTSD).Trauma survivors with and without PTSD, from independent and interdependent cultures (N=106) provided major personal goals, self-defining memories, and self-cognitions.Trauma survivors with PTSD from independent cultures reported more goals, self-defining memories, and self-cognitions that were trauma-related than non-PTSD trauma survivors from independent cultures. In contrast, for those from interdependent cultures, there was no difference between trauma survivors with and without PTSD in terms of trauma-centred goals, self-defining memories, and self-cognitions.The results suggest cultural variability in the impact of trauma on memory and identity, and highlight the need for contemporary models of PTSD to more explicitly consider culture in their accounts of PTSD. Clinical implications of these findings, such as cultural considerations in assessment and treating trauma relevant self-schema in cognitive therapy for PTSD, are discussed.",0 +https://doi.org/10.1016/j.avb.2005.05.001,A critique of the female sexual perpetrator research,"This paper critically reviewed the research literature on female sex-offenders based on all the identified studies with a sample exceeding 10 from 1989 to 2004. Thirteen studies were identified. Five exploratory studies were individually summarized and critiqued as a group. The eight comparative studies were individually discussed and critiqued. Strengths and weaknesses of the current research were discussed. Conclusions about the research and suggestions for future research were provided. Notable conclusions were: that female sex-offenders are more likely to have been sexually victimized than other populations, offended by themselves, and commit serious forms of sexual abuse. There are also some promising typologies for this heterogeneous population, but they need further replication.",0 +https://doi.org/10.4142/jvs.2014.15.2.283,Retrospective surveillance of metabolic parameters affecting reproductive performance of Japanese Black breeding cows,"This retrospective study was conducted to confirm the relationship between pre- and postpartum metabolic parameters and postpartum reproductive performance and to clarify seasonal characteristics of the metabolic parameters by using our metabolic profile test (MPT) database of Japanese Black breeding herds. In evaluation 1, MPT databases of blood samples from multiparous cows collected prepartum and postpartum were divided into two groups according to calving interval, and each MPT parameter was compared. In evaluation 2, the same MPT databases used in evaluation 1 were divided into two groups according to the sampling period. Significant differences were found in the prepartal total protein and postpartal γ-glutamyltransferase in evaluation 1. In evaluation 2, significant differences were found in the prepartal and postpartal total protein, albumin/globulin ratio, and glucose. Clear seasonal differences in MPT results emphasized the usefulness of the MPT in breeding cattle herds fed home-pasture roughage and suggest that unsatisfactory reproductive performance during hot periods reflects inadequate nutritional content of the diet and possible reduced feed intake due to heat stress.",0 +https://doi.org/10.1037/a0013596,The relationships between posttraumatic stress symptom clusters and marital intimacy among war veterans.,"This study examined (a) the relationships between posttraumatic stress disorder (PTSD) symptom clusters and marital intimacy among Israeli war veterans and (b) the role of self-disclosure and verbal violence in mediating the effects of PTSD avoidance and hyperarousal symptoms on marital intimacy. The sample consisted of 219 participants divided into 2 groups: ex-prisoners of war (ex-POWs; N = 125) and a comparison group of veterans who fought in the same war but were not held in captivity (N = 94). Ex-POWs displayed higher levels of PTSD symptoms and verbal violence and lower levels of self-disclosure than did controls. Although ex-POWs and controls did not differ in level of marital intimacy, they did, however, present a different pattern of relationships between PTSD clusters and intimacy. In ex-POWs, self-disclosure mediated the relations between PTSD avoidance and marital intimacy. Verbal aggression was also found via indirect effect of hyperarousal on marital intimacy. The results point to the importance of self-disclosure and verbal violence as interpersonal mechanisms for the relations between posttraumatic symptoms on marital intimacy of ex-POWs.",0 +https://doi.org/10.1080/15299730903143626,Predictors of the Development of Posttraumatic Stress Disorder Among Police Officers,"This retrospective study examined risk and protective factors for the development of posttraumatic stress disorder (PTSD) in a sample of 132 Canadian police officers. Structured interviews were conducted in order to assess the most distressing work-related traumatic events and determine diagnoses of full or partial PTSD. Participants completed self-administered questionnaires assessing several potential predictors. The results suggested that 7.6% of the participants developed full PTSD, whereas 6.8% had partial PTSD following an incident at work. A multiple logistic regression analysis indicated that the most potent risk factor for the development of full or partial PTSD was peritraumatic dissociation. Social support from colleagues during the event emerged as a significant protective factor. Clinical implications of the findings are discussed.",0 +https://doi.org/10.1080/15325024.2013.791797,Children's Coping in the Context of Disasters and Terrorism,"Disasters and terrorism present significant and often overwhelming challenges for children and families worldwide. Individual, family, and social factors influence disaster reactions and the diverse ways in which children cope. This article links conceptualizations of stress and coping to empirical knowledge of children's disaster reactions, identifies limitations in our current understanding, and suggests areas for future study of disaster coping. Coping strategies, developmental trajectories influencing coping, and the interplay between parent and child coping represent critical areas for advancing the field and for informing programs and services that benefit children's preparedness and foster resilience in the face of mass trauma.",0 +https://doi.org/10.1142/s0219635206001057,INTEGRATIVE ASSESSMENT OF BRAIN FUNCTION IN PTSD: BRAIN STABILITY AND WORKING MEMORY,"Posttraumatic Stress Disorder (PTSD) is characterized by symptoms of hyperarousal, avoidance and intrusive trauma-related memories and deficits in everyday memory and attention. Separate studies in PTSD have found abnormalities in electroencephalogram EEG, in event-related potential (ERP) and behavioral measures of working memory and attention. The present study seeks to determine whether these abnormalities are related and the extent to which they share this relationship with clinical symptoms. EEG data were collected during an eyes-open paradigm and a one-back working memory task. Behavioral and clinical data (CAPS) were also collected. The PTSD group showed signs of altered cortical arousal as indexed by reduced alpha power and an increased theta/alpha ratio, and clinical and physiological measures of arousal were found to be related. The normal relationship between theta power and ERP indices of working memory was not affected in PTSD, with both sets of measures reduced in the disordered group. Medication appeared to underpin a number of abnormal parameters, including P3 amplitude to targets and the accuracy, though not speed, of target detection. The present study helps to overcome a limitation of earlier studies that assess such parameters independently in different groups of patients that vary in factors such as comorbidity, medication status, gender and symptom profile. The present study begins to shed light on the relationship between these measures and suggests that abnormalities in brain working memory may be linked to underlying abnormalities in brain stability.",0 +https://doi.org/10.1111/j.1467-9450.1996.tb00667.x,Factor analysis of the impact of event scale with children in war,"To evaluate the psychometric properties of the Impact of Event Scale (IES scale) in children a study was conducted on 1787 children exposed to the warfare in Croatia, Bosnia and Herzegovina. The study group comprised 877 girls and 910 boys ranging in age from 6 to 15 years attending 28 arbitrary selected schools in Zagreb. High levels of posttraumatic reactions were found in the group of children. The pattern of endorsement and the factor structure of the IES scale were similar to that found in other samples. This supports the use of the IES in the assessment of posttraumatic stress reactions in children. Two factors emerged from a Principal Component Analysis, labeled intrusion (9 items), and avoidance (4 items). As in other studies, this study documented problems with several items (items 2, 12 and 15), items that should be considered omitted from the IES. Girls reported significantly more distress on 13 out of the 15 items. Both the overall IES score as well as the intrusion and avoidance score were significantly higher in girls than boys. The factor structure for boys and girls were very similar, and the reliability of the scale was adequate across different age groups and for subgroups of displaced and refugee children.",0 +https://doi.org/10.1097/00005053-199001000-00006,Combat Experience and Postservice Psychosocial Status as Predictors of Suicide in Vietnam Veterans,"The authors examined potential risk factors for suicide among 38 Vietnam veterans using 46 Vietnam veterans who died from motor vehicle accidents as a comparison group. The veterans were selected from Los Angeles County Medical Examiner's file (1977-1982). Data for these veterans were obtained from military service records, the coroner's reports, and the psychological autopsy conducted with the decedents' family members. No military service factor was associated with suicide. The characteristics of Vietnam veteran suicide cases were not substantially different from non-Vietnam veteran suicide cases with respect to known demographic risk factors. The psychological profile of Vietnam veteran suicide cases are also similar to non-Vietnam veteran suicide cases in most instances. Symptoms related to posttraumatic stress disorder were observed more frequently among suicide cases than accident cases. However, suicides were not associated with specific combat experiences or military occupation. The extent of combat experience in Vietnam per se as measured in this study is not a good predictor of suicide death.",0 +https://doi.org/10.1037/a0035887,Trajectories of life satisfaction five years after medical discharge for traumatically acquired disability.,"We studied the predictive impact of family satisfaction, marital status, and functional impairment on the trajectories of life satisfaction over the first 5 years following medical treatment for traumatic spinal cord injury, burns, or interarticular fractures (total N = 662). It was anticipated that fewer functional impairments, being married, and greater family satisfaction would predict higher life satisfaction trajectories.The Functional Independence Measure, the Family Satisfaction Scale, and the Life Satisfaction Index were administered 12, 24, 48, and 60 months postdischarge.Trajectory modeling revealed that greater functional impairment significantly predicted lower life satisfaction, regardless of injury type. However, this association diminished when marital status and family satisfaction were entered into the models. Greater family satisfaction and being married predicted greater life satisfaction across time. Moreover, there was no evidence for increases in life satisfaction trajectories over time: Trajectories were stable across time for all injury groups.Results suggest that being married and greater family satisfaction promote life satisfaction among those who traumatically acquire disability, and these beneficial effects may be more salient than the degree of functional impairment imposed by the condition.",0 +https://doi.org/10.1080/19361521.2013.732202,Behavioral and Emotional Profiles of Neglected Children,"This study explored the emotional and behavioral profiles of 41 neglected children, ages 6 to 12 years, who were compared with a control group of 41 children. The Achenbach System was used in order to describe emotional and behavioral profiles based on the Diagnostic Criteria of the DSM-IV [Diagnostic and Statistical Manual of Mental Disorders, 4th ed.]). Neglected children had more symptoms on DSM-IV Scales related to conduct or attention/hyperactivity problems. Based on the perceptions of teachers, children exposed to neglect showed more externalized and internalized problems as well as symptoms on DSM-IV Scales. Results supported the relevance of using the Diagnostic Criteria of the DSM-IV and the importance of getting the different perceptions of respondents to better understand the emotional and behavioral portrait of neglected children. © 2013",0 +https://doi.org/10.1186/1471-244x-9-7,"Post-conflict mental health needs: a cross-sectional survey of trauma, depression and associated factors in Juba, Southern Sudan","The signing of the Comprehensive Peace Agreement in January 2005 marked the end of the civil conflict in Sudan lasting over 20 years. The conflict was characterised by widespread violence and large-scale forced migration. Mental health is recognised as a key public health issue for conflict-affected populations. Studies revealed high levels of post-traumatic stress disorder (PTSD) amongst populations from Southern Sudan during the conflict. However, no studies have been conducted on mental health in post-war Southern Sudan. The objective of this study was to measure PTSD and depression in the population in the town of Juba in Southern Sudan; and to investigate the association ofdemographic, displacement, and past and recent trauma exposure variables, on the outcomes of PTSD and depression.A cross-sectional, random cluster survey with a sample of 1242 adults (aged over 18 years) was conducted in November 2007 in the town of Juba, the capital of Southern Sudan. Levels of exposure to traumatic events and PTSD were measured using the Harvard Trauma Questionnaire (original version), and levels of depression measured using the Hopkins Symptom Checklist-25. Multivariate logistic regression was used to analyse the association ofdemographic, displacement and trauma exposure variables on the outcomes of PTSD and depression. Multivariate logistic regression was also conducted to investigate which demographic and displacement variables were associated with exposure to traumatic events.Over one third (36%) of respondents met symptom criteria for PTSD and half (50%) of respondents met symptom criteria for depression. The multivariate logistic regression analysis showed strong associations of gender, marital status, forced displacement, and trauma exposure with outcomes of PTSD and depression. Men, IDPs, and refugees and persons displaced more than once were all significantly more likely to have experienced eight or more traumatic events.This study provides evidence of high levels of mental distress in the population of Juba Town, and associated risk-factors. Comprehensive social and psychological assistance is urgently required in Juba.",0 +https://doi.org/10.1038/sj.npp.1300523,Setting Apart the Affected: The Use of Behavioral Criteria in Animal Models of Post Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) affects about 20-30% of exposed individuals. Clinical studies of PTSD generally employ stringent criteria for inclusion in study populations, and yet in animal studies the data collection and analysis are generally expressed as a function of exposed vs nonexposed populations, regardless of individual variation in response. Prior data support an approach to animal models analogous to inclusion criteria in clinical studies. This series of studies sought to assess prevalence rates of maladaptive vs adaptive responses determined according to a more stringent approach to the concept of inclusion/exclusion criteria (cutoff behavioral criteria-CBC), consisting of two successive behavioral tests (elevated plus maze and acoustic startle response tests). The rats were exposed to stressors in two different paradigms; exposure to a predator and underwater trauma. The prevalence rates of maladaptive responses to stress in these two distinct models dropped over time from 90% in the acute phase to 25% enduring/maladaptive response at 7 days, to remain constant over 30 days. As setting the affected individuals apart from the unaffected approximates clinical studies, it might also help to clarify some of the pending issues in PTSD research.",0 +https://doi.org/10.1080/09638280410001708968,Psychological factors after traumatic amputation in landmine survivors: The bridge between physical healing and full recovery,"Limb loss due to a landmine injury is sudden and devastating. The resulting disability makes life challenging in a world where physical ability is the 'norm'. In order to better understand the psychological adjustments individuals make in their recovery from a landmine injury, the Landmine Survivors Network conducted an exploratory qualitative study to determine factors that contribute to an individual's recovery. The study examined psychosocial aspects, coping strategies, and resilience characteristics of limb loss survivors across differing cultural, societal and economic backgrounds.Eighty-five participants (68 persons of limb loss, 10 family members, seven service providers) were interviewed using a semi-structured protocol in the USA and an open-ended format in six landmine affected countries. Data analysis was completed using grounded theory analytic strategies.Data indicated that the survivors' acceptance of limb loss and their state of psychological recovery were greatly influenced by the individual's resilience characteristics, social support, medical care, economic situation and societal attitudes toward people with disabilities.Recovery from traumatic amputation in landmine survivors needs to be comprehensive and coordinated, and requires addressing the individual's physical, psychological, economic and social needs within the context of family, community, and the socio-cultural environment in which they live.",0 +https://doi.org/10.1177/008124631204200106,Culture and Posttraumatic Stress Disorder (PTSD): A Proposed Conceptual Framework,"It is widely accepted that the understanding of any psychological disorder needs to be contextualised within cultural parameters. The notion that current diagnostic taxonomies are not always universally applicable does not mean that all symptoms are not applicable. We present a framework that is aimed at being a starting point from which to delineate universal and culture specific elements of PTSD. The framework follows the possible influence of cultural factors on (a) the formation of an intrusive memory, (b) an understanding of how such a memory becomes pathological, and (c) how symptoms are expressed from the intrusive memory core of PTSD. While the framework presents certain elements (e.g. intrusive memory and core schemas) as centrally important, the focus is on a heuristic framework that allows for the study of the dynamic interaction between potentially universal and cultural factors and how this interaction may produce the symptom profile generally seen with PTSD. Tentative recommendations are made for a research agenda and are presented after a brief exploration of the strengths and weaknesses of such a framework.",0 +https://doi.org/10.1542/peds.2015-2861,Providing Psychosocial Support to Children and Families in the Aftermath of Disasters and Crises,"Disasters have the potential to cause short- and long-term effects on the psychological functioning, emotional adjustment, health, and developmental trajectory of children. This clinical report provides practical suggestions on how to identify common adjustment difficulties in children in the aftermath of a disaster and to promote effective coping strategies to mitigate the impact of the disaster as well as any associated bereavement and secondary stressors. This information can serve as a guide to pediatricians as they offer anticipatory guidance to families or consultation to schools, child care centers, and other child congregate care sites. Knowledge of risk factors for adjustment difficulties can serve as the basis for mental health triage. The importance of basic supportive services, psychological first aid, and professional self-care are discussed. Stress is intrinsic to many major life events that children and families face, including the experience of significant illness and its treatment. The information provided in this clinical report may, therefore, be relevant for a broad range of patient encounters, even outside the context of a disaster. Most pediatricians enter the profession because of a heartfelt desire to help children and families most in need. If adequately prepared and supported, pediatricians who are able to draw on their skills to assist children, families, and communities to recover after a disaster will find the work to be particularly rewarding.",0 +https://doi.org/10.1111/j.2044-8260.1992.tb00968.x,Crisis support and psychiatric symptomatology in adult survivors of the Jupiter cruise ship disaster,"The aim of the present study was to explore the relationship between crisis support and psychiatric symptomatology among adult survivors in the year following the Jupiter cruise ship disaster. Evidence is presented that support decreases over the following year, and that higher levels of crisis support are strongly related to better psychological outcome. Crisis support is shown to retain its association with symptomatology even when satisfaction with support is partialled out. These data are discussed with reference to the debate over the relative importance of received vs. perceived support.",0 +https://doi.org/10.1192/bjp.bp.105.017855,Risk factors for psychological and physical health problems after a man-made disaster,"There are few prospective studies on risk factors for health problems after disasters in which actual pre-disaster health data are available.To examine whether survivors' personal characteristics, and pre-disaster psychological problems, and disaster-related variables, are related to their post-disaster health.Two studies were combined: a longitudinal survey using the electronic medical records of survivors' general practitioners (GPs), from 1 year before to 1 year after the disaster, and a survey in which questionnaires were filled in by survivors, 3 weeks and 18 months after the disaster. Data from both surveys and the electronic medical records were available for 994 survivors.After adjustment for demographic and disaster-related variables, pre-existing psychological problems were significantly associated with post-disaster self-reported health problems and post-disaster problems presented presented to the to the GP. This association was found for both psychological and physical post-disaster problems.In trying to prevent long-term health consequences after disaster, early attention to survivors with pre-existing psychological problems, and to those survivors who are forced to relocate or are exposed to many stressors during the disaster, appears appropriate.",0 +https://doi.org/10.1097/00004850-199805000-00003,Treatment of posttraumatic stress disorder with nefazodone,"Selective serotonin reuptake inhibitors are useful in the treatment of posttraumatic stress disorder (PTSD), but have a number of side-effects which limit their acceptability. A newer serotonergic compound, nefazodone, has a different side-effect profile, thus making it a potentially promising compound to study. Seventeen private practice patients with PTSD were treated with nefazodone up to 600 mg/day for a maximum total treatment period of 12 weeks. All subjects were civilians, and were monitored for efficacy and side-effects at weeks 1, 2, 4, 6, 8 and 12. Nefazodone was associated with statistically significant improvement in mean scores on all six rating scales used to assess change from baseline in PTSD symptoms. Additionally, statistically significant improvement from baseline were seen for the intrusive, avoidant/numbing, and hyperarousal clusters on a global PTSD scale. Early improvements in nightmares and general sleep disturbance were observed. Overall, there was a 43% response rate at endpoint, or 60% in treatment completers, by observer rating. Side-effects (assessed on the Medication Effects Scale) were generally benign. Nefazodone was associated with clinical improvement in this population, and now needs to be studied in double-blind, placebo controlled, protocols.",0 +https://doi.org/10.1038/sj.npp.1301665,Variation in Mouse Basolateral Amygdala Volume is Associated With Differences in Stress Reactivity and Fear Learning,"A wealth of research identifies the amygdala as a key brain region mediating negative affect, and implicates amygdala dysfunction in the pathophysiology of anxiety disorders. Although there is a strong genetic component to anxiety disorders such as posttraumatic stress disorder (PTSD) there remains debate about whether abnormalities in amygdala function predispose to these disorders. In the present study, groups of C57BL/6 x DBA/2 (B x D) recombinant inbred strains of mice were selected for differences in volume of the basolateral amygdala complex (BLA). Strains with relatively small, medium, or large BLA volumes were compared for Pavlovian fear learning and memory, anxiety-related behaviors, depression-related behavior, and glucocorticoid responses to stress. Strains with relatively small BLA exhibited stronger conditioned fear responses to both auditory tone and contextual stimuli, as compared to groups with larger BLA. The small BLA group also showed significantly greater corticosterone responses to stress than the larger BLA groups. BLA volume did not predict clear differences in measures of anxiety-like behavior or depression-related behavior, other than greater locomotor inhibition to novelty in strains with smaller BLA. Neither striatal, hippocampal nor cerebellar volumes correlated significantly with any behavioral measure. The present data demonstrate a phenotype of enhanced fear conditioning and exaggerated glucocorticoid responses to stress associated with small BLA volume. This profile is reminiscent of the increased fear processing and stress reactivity that is associated with amygdala excitability and reduced amygdala volume in humans carrying loss of function polymorphisms in the serotonin transporter and monoamine oxidase A genes. Our study provides a unique example of how natural variation in amygdala volume associates with specific fear- and stress-related phenotypes in rodents, and further supports the role of amygdala dysfunction in anxiety disorders such as PTSD.",0 +https://doi.org/10.1080/15287394.2013.844087,Trusted Information Sources Used During and After Superstorm Sandy: TV and Radio were Used More Often than Social Media,"Health and safety professionals and the public are interested in the best methods of providing timely information about disasters. The objective of this study was to examine information sources used for Superstorm Sandy with respect to the storm, evacuation routes, shelters, safety, and health issues. Respondents in central New Jersey and Jersey shore communities were differentially impacted by the storm. Jersey shore respondents had higher evacuation rates (47% vs. 13%), higher flood waters in homes, longer power outages (average 23 vs. 6 d), and longer periods without Internet (29 vs. 6 d). Electricity outages disrupted both sources and receivers of communication. Both groups obtained most of their information regarding safety from television, radio, friends, and Web/e-mail. Information sources on health varied by location, with central Jersey respondents using mainly TV and the Web, and Jersey shore respondents obtaining health information from the radio and TV (before the storm). For information on evacuation routes, Jersey shore respondents obtained information from many sources, while central Jersey respondents obtained it from TV. Information on mold was largely obtained from friends and the Web, since mold issues were dealt with several weeks after Sandy. The reliance on traditional sources of information (TV, radio, friends) found in this study suggests that the extreme power outages rendered Web, cell phones, and social media on cell phones less usable, and suggests the need for an integrated communication strategy with redundancies that takes into account prolonged power outages over large geographical areas.",0 +https://doi.org/10.1016/j.psychres.2006.12.003,Measures of endothelial dysfunction in plasma of patients with posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) confers an increased cardiovascular risk. In 14 otherwise healthy patients with PTSD and in 14 age- and gender-matched non-PTSD controls, we investigated whether the categorical diagnosis of PTSD and severity of PTSD symptom clusters (i.e. re-experiencing, avoidance, arousal, and overall score) would be associated with plasma concentrations of three markers of endothelial dysfunction [soluble tissue factor (sTF), von Willebrand factor (VWF), and soluble intercellular adhesion molecule (sICAM)-1]. Compared with controls, patients had significantly higher sTF; this difference became nonsignificant when controlling for psychological distress. VWF and sICAM-1 levels were not significantly different between patients and controls. In the entire sample virtually all PTSD symptom clusters correlated significantly and positively with sTF and VWF but not with sICAM-1. The correlation between symptoms of re-experiencing and sTF was significantly different between patients and controls. Controlling for symptoms of anxiety and depression (i.e. psychological distress) rendered most associations between PTSD symptom clusters and sTF nonsignificant, whereas controlling for age retained significance of associations with VWF. Posttraumatic stress showed a continuous relationship with sTF and VWF, with the former relationship being partly affected by psychological distress. This suggests one mechanism by which posttraumatic stress could contribute to atherosclerosis.",0 +https://doi.org/10.1080/10538710802329940,"The Impact of Clergy-Perpetrated Sexual Abuse: The Role of Gender, Development, and Posttraumatic Stress","The literature on clergy-perpetrated sexual abuse suggests that there are two modal populations of survivors: boys and adult women. We review what is known about trauma and post-traumatic stress disorder following sexual abuse and explore the different treatment needs for these two survivor groups. For children, clergy-perpetrated sexual abuse can catastrophically alter the trajectory of psychosocial, sexual, and spiritual development. Depending on the age at which abuse occurred, adult clients may present with clinical issues that are more appropriate for a younger developmental stage. Additionally, the symptoms of traumatic stress may be misunderstood when clients conceptualize their abuse as an ""affair"" or ""consensual"" relationship. We discuss empirically supported treatments for post-traumatic stress disorder and potential adaptations for the needs of clergy-perpetrated sexual abuse survivors.",0 +https://doi.org/10.1017/cbo9780511994791.013,"Community resilience: concepts, assessment, and implications for intervention","Although stress research has emphasized individual well-being, many types of stress are experienced collectively: the events bring harm, pain, and loss to large numbers of people simultaneously. Natural disasters, terrorist attacks, war, political oppression, epidemics, and economic recessions happen to whole communities and, sometimes, whole societies. This is not to say that all exposed individuals experience the event identically; in a disaster, one person may lose a loved one, while another loses a home, and another only a few possessions. Nor is this to say that all exposed individuals respond identically; a person’s psychological, social, and material resources powerfully shape his or her capacity to cope and function effectively. When stress pervades the community, however, these factors tell only part of the story. To have an ecologically valid understanding of mass trauma, we must recognize that survivors are connected and dependent upon one another’s coping strategies. Their attributions and actions reflect a host of social influences, social comparisons, and emergent norms. They help each other but also compete for scarce resources. Household preparedness is vital, but one household can no more prepare for disaster than it could, on its own, protect itself from crime or disease, educate its children, or keep the roads safe. Consequently, an individual’s resilience is inextricably linked to the community’s ability to prepare for, respond to, and adapt to adverse conditions. Simply put, when problems are shared, so must be solutions. In recognition of such interdependencies, “community resilience” has emerged as a key concept for disaster readiness, although by no means limited to this one goal (Norris et al., 2008). This chapter will explore the concept of community resilience in some depth. Broadly, the chapter is organized into four sections. The first section provides our perspective on the meaning of resilience, including definitions that work across levels of analysis (individual, family, organization, community, society). The second section describes the adaptive capacities theorized to yield community resilience. This is followed by an outline of measurement strategies and challenges in assessing capacities, including some of our own pilot work. The concluding section makes recommendations for intervention and raises issues that need to be addressed in future research. © Cambridge University Press 2011.",0 +https://doi.org/10.1177/0020872815584426,Social issues and post-disaster recovery: A qualitative study in an Iranian context,"The physical impacts of a disaster are usually the most obvious impacts, and they are easily measured. However, there is not sufficient in-depth understanding of social issues arising after disasters. This qualitative study explored three main concepts regarding social issues after an earthquake in an Iranian context: social vulnerability, social uncertainty and confusion, and ignorance of local social capital. Negligence of social issues after disasters leads to delays in returning back to normal life. Policymakers are encouraged to take a comprehensive plan into account which considers these issues and facilitates the process of returning to normal life after earthquakes.",0 +https://doi.org/10.1097/00004583-200403000-00015,Victimization and Posttraumatic Stress Disorder Among Homeless Adolescents,"To examine street victimization and posttraumatic stress symptoms among urban homeless adolescents and to test whether emotional numbing and avoidance represent distinct posttraumatic stress disorder (PTSD) symptom clusters.Structured, private interviews were conducted with homeless adolescents (N = 374) in the Seattle metropolitan area (95% response rate) from 1995 to 1998.Eighty-three percent of street youths were physically and/or sexually victimized after leaving home. Approximately 18% of these youths met research criteria for PTSD. Results from a confirmatory factor analysis suggest that disaggregating symptoms of avoidance from symptoms of emotional numbing provides a better fit of the data than the current DSM-IV model in which these symptoms are combined in one factor.Sexual and physical victimization are serious threats for homeless adolescents, and those who are victimized are at risk for PTSD. Results challenge the belief that symptoms of avoidance and numbing represent one unified cluster in this population.",0 +https://doi.org/10.1185/030079903125001604,Post-traumatic stress disorder: symptom profiles in men and women,"To investigate the symptom frequencies of a relatively large sample of post-traumatic stress disorder (PTSD) sufferers and compare male and female symptom profiles.A total of 103 consecutive attendees at a clinic for PTSD were examined using a checklist of DSM-IV PTSD characteristics. The presence and absence of all symptoms was evaluated in a research interview. Some additional symptoms were also routinely asked about, such as mood lability, substance use, sex drive or libido. Symptom profiles of male and female sufferers of PTSD were compared using the chi-squared statistical test.Structured interview using checklist of DSM-IV PTSD characteristics.Certain symptoms were present in more than 30% of sufferers. Symptom frequencies for anxiety, insomnia, distressing and recurrent dreams, flashback imagery and intrusive thoughts, irritability, poor concentration, avoidance behaviour and detachment all reached frequencies above 70%. Some symptoms (such as inability to recall parts of the trauma and restricted affect) occurred in no more than 35% of sufferers.Men are significantly more likely than women to suffer with irritability (p < 0.05) and to use alcohol to excess (p < 0.05). Symptoms tend to follow an acute stress reaction, occur early and persist for many months. A case is made for restricting the diagnosis to the most prevalent symptoms and for including some often overlooked symptoms in the diagnostic guidelines, namely low mood, mood lability, and impaired libido.",0 +https://doi.org/10.1001/archpsyc.64.12.1427,Exposure to Hurricane-Related Stressors and Mental Illness After Hurricane Katrina,"Uncertainty exists about the prevalence, severity, and correlates of mental disorders among people exposed to Hurricane Katrina.To estimate the prevalence and associations between DSM-IV anxiety-mood disorders and hurricane-related stressors separately among prehurricane residents of the New Orleans metropolitan area and the remainder of the areas in Alabama, Louisiana, and Mississippi affected by Katrina.Community survey.A probability sample of 1043 English-speaking prehurricane residents of the areas affected by Hurricane Katrina was administered via telephone survey between January 19 and March 31, 2006. The survey assessed hurricane-related stressors and screened for 30-day DSM-IV anxiety-mood disorders.The K6 screening scale of anxiety-mood disorders and the Trauma Screening Questionnaire scale for posttraumatic stress disorder (PTSD), both calibrated against blinded structured clinical reappraisal interviews to approximate the 30-day prevalence of DSM-IV disorders.Prehurricane residents of the New Orleans metropolitan area were estimated to have a 49.1% 30-day prevalence of any DSM-IV anxiety-mood disorder (30.3% estimated prevalence of PTSD) compared with 26.4% (12.5% PTSD) in the remainder of the sample. The vast majority of respondents reported exposure to hurricane-related stressors. Extent of stressor exposure was more strongly related to the outcomes in the New Orleans metropolitan area subsample than the remainder of the sample. The stressors most strongly related to these outcomes were physical illness/injury and physical adversity in the New Orleans metropolitan area subsample and property loss in the remainder of the sample. Sociodemographic correlates were not explained either by differential exposure or reactivity to hurricane-related stressors.The high prevalence of DSM-IV anxiety-mood disorders, the strong associations of hurricane-related stressors with these outcomes, and the independence of sociodemographics from stressors argue that the practical problems associated with ongoing stressors are widespread and must be addressed to reduce the prevalence of mental disorders in this population.",0 +https://doi.org/10.1080/00273171.2011.589261,Bayesian Inference for Growth Mixture Models with Latent Class Dependent Missing Data,"Growth mixture models (GMMs) with nonignorable missing data have drawn increasing attention in research communities but have not been fully studied. The goal of this article is to propose and to evaluate a Bayesian method to estimate the GMMs with latent class dependent missing data. An extended GMM is first presented in which class probabilities depend on some observed explanatory variables and data missingness depends on both the explanatory variables and a latent class variable. A full Bayesian method is then proposed to estimate the model. Through the data augmentation method, conditional posterior distributions for all model parameters and missing data are obtained. A Gibbs sampling procedure is then used to generate Markov chains of model parameters for statistical inference. The application of the model and the method is first demonstrated through the analysis of mathematical ability growth data from the National Longitudinal Survey of Youth 1997 (Bureau of Labor Statistics, U.S. Department of Labor, 1997). A simulation study considering 3 main factors (the sample size, the class probability, and the missing data mechanism) is then conducted and the results show that the proposed Bayesian estimation approach performs very well under the studied conditions. Finally, some implications of this study, including the misspecified missingness mechanism, the sample size, the sensitivity of the model, the number of latent classes, the model comparison, and the future directions of the approach, are discussed.",0 +https://doi.org/10.1016/j.psym.2012.05.005,Metabolic Syndrome: Relative Risk Associated with Post-Traumatic Stress Disorder (PTSD) Severity and Antipsychotic Medication Use,"In recent years, numerous lines of converging evidence have revealed an association between post-traumatic stress disorder (PTSD) and impaired physical health outcomes, including cardiovascular disease and metabolic syndrome. Although these findings have been interpreted as indicating a direct association of PTSD with metabolic syndrome and obesity, previous studies have not addressed the important confound of antipsychotic drug usage in this population. Second generation antipsychotic medications themselves are associated with metabolic syndrome and obesity, and it is unclear whether the common utilization of these drugs in PTSD may account for some if not all of the observed metabolic problems.The present study examined the relative contributions of PTSD severity and use of antipsychotic medications to risk of metabolic syndrome among veterans.Cross-sectional clinical data, including five factors representing metabolic syndrome, psychiatric diagnoses, and medications were gathered from 253 veterans enrolling in mental health services. We used a logistic regression model to measure the relative association of antipsychotic medication use and PTSD severity on risk of metabolic syndrome.We found that antipsychotic medication usage was not uniquely associated with elevated risk of metabolic syndrome (Wald = 0.30, ns) when PTSD severity and other sociodemographic, psychiatric, and behavioral variables were accounted for. Furthermore, PTSD severity continued to be a significant and unique predictor of risk for metabolic syndrome (Wald = 4.04, p < 0.05).These findings suggest that chronic and moderately severe PTSD, independent of antipsychotic medications, is associated with increased risk of metabolic syndrome.",0 +https://doi.org/10.3109/02699052.2011.635365,A cognitive behaviour therapy (CBT) programme for anxiety following moderate–severe traumatic brain injury (TBI): Two case studies,"CBT is a potentially effective treatment for anxiety disorders following TBI; however, empirical evidence has mainly come from clients with mild TBI. This paper describes a CBT-based anxiety treatment programme adapted for clients with more severe injuries. Two case studies are provided to illustrate the implementation of the programme, as a step toward larger scale testing of the programme's feasibility.A manualised adapted CBT treatment manual was used to deliver CBT in a standardised manner to two clients, one with severe and one with moderate TBI. Outcome was evaluated using a single-subject design with repeated measures of anxiety, mood and coping style at pre- and post-CBT.The two clients demonstrated positive treatment response on either a measure of anxiety or a continuous measure of distress. Although neither demonstrated a clinically significant change according to the primary outcome measure (Hospital Anxiety and Depression Scale), they showed significant change in at least one corroborated measure of anxiety.This study suggests the potential utility of the adapted CBT programme for clients with moderate-severe TBI. Limitations of the single case studies were discussed, while noting how they would be addressed in a follow-up randomised controlled trial.",0 +https://doi.org/10.1188/02.onf.643-650,Recognizing and Responding to Post-Traumatic Stress Disorder in People With Cancer,"To describe post-traumatic stress disorder (PTSD) in patients with cancer and identify nursing assessment and intervention strategies.Discussion of recent research literature in relation to oncology nursing practice.4%-19% of patients with cancer experience symptoms of PTSD. When PTSD routinely is considered as a risk for patients with cancer, nurses can reframe intense psychological and physiologic reactions or patient distress as possible trauma reactions and implement appropriate interventions and referral.Patients with cancer may experience PTSD as a consequence of their cancer diagnosis, treatment, or a past traumatic episode. PTSD may interfere with patients' ability to tolerate treatment and return for crucial follow-up care. To date, no studies have explored interventions for PTSD in adult patients with cancer.Oncology nurses can help patients with PTSD by interpreting psychological symptoms with the possibility of PTSD in mind, screening for PTSD across the illness trajectory, providing emotional support, teaching coping strategies, and advocating for further assessment, medical treatment, and appropriate referral within the multidisciplinary care team.",0 +https://doi.org/10.1089/jwh.2005.14.285,Report from the CDC: Mental Health of Women in Postwar Afghanistan,"More than two decades of war and a culture that has denied women freedom of movement, access to healthcare, and education have affected the mental health status of Afghan women more than that of men. In 2002, the Centers for Disease Control and Prevention (CDC) conducted a national population-based mental health survey in Afghanistan. The prevalence of symptoms of depression was 73% (standard error [SE] 8.15) and 59% (SE 5.59), of symptoms of anxiety was 84% (SE 2.98) and 59% (SE 8.65), and of posttraumatic stress disorder (PTSD) was 48% (SE 6.19) and 32% (SE 4.22) for female and male respondents, respectively. Mean scores for social functioning were lower for women (52.00 [SE 2.77]) than for men (66.63 [SE 3.92]). Women had significantly lower mental health status and poorer social functioning than did men. Results of our survey underscore the need for financial donors and healthcare planners to address the current lack of mental healthcare resources, facilities, and trained mental healthcare professionals in Afghanistan and to establish mental health services directed at the specific needs of women. This study highlights the negative impact that war, restrictions in freedoms, and socioeconomic hardship have had on the mental health and social functioning of women in Afghanistan.",0 +https://doi.org/10.1111/j.1532-5415.2011.03407.x,Exposure to Trauma and Posttraumatic Stress Disorder Symptoms in Older Veterans Attending Primary Care: Comorbid Conditions and Self-Rated Health Status,"OBJECTIVES: Assess the prevalence of posttraumatic stress disorder (PTSD) symptomatology and its association with health characteristics in a geriatric primary care population. DESIGN: Cross-sectional screening assessments during a multisite trial for the treatment of depression, anxiety, and at-risk drinking. SETTING: Department of Veterans Affairs (VA)-based primary care clinics across the United States. PARTICIPANTS: Seventeen thousand two hundred five veterans aged 65 and older. MEASUREMENTS: Sociodemographic information, the General Health Questionnaire (GHQ-12), questions about death wishes and suicidal ideation, quantity and frequency of alcohol use, smoking, exposure to traumatic events, and PTSD symptom clusters. RESULTS: Twelve percent (2,041/17,205) of participants screened endorsed PTSD symptoms. Veterans with PTSD symptoms from some (partial PTSD) or each (PTSD all clusters) of the symptom clusters were significantly more likely to report poor general health, currently smoke, be divorced, report little or no social support, and have a higher prevalence of mental distress, death wishes, and suicidal ideation than those with no trauma history or those with trauma but no symptoms. Group differences were most pronounced for mental distress and least for at-risk drinking. Presence of PTSD all clusters was associated with poorer outcomes on all of the above-mentioned health characteristics than partial PTSD. CONCLUSION: PTSD symptoms are common in a substantial minority of older veterans in primary care, and careful inquiry about these symptoms is important for comprehensive assessment in geriatric populations.",0 +https://doi.org/10.1521/jscp.2011.30.9.960,Trajectories of Attachment Insecurities Over a 17-Year Period: A Latent Growth Curve Analysis of the Impact of War Captivity and Posttraumatic Stress Disorder,"In this study, we assessed the 17-year trajectories of attachment insecurities (anxiety and avoidance) and examined their relations to having been a prisoner of war and suffering from Posttraumatic Stress Disorder (PTSD). The sample included two groups of Israeli veterans from the 1973 Yom Kippur war: ex-prisoners of war and comparable control individuals who had not been held captive. They completed self-report measures of anxious and avoidant attachment and PTSD at three time points: 18, 30, and 35 years after the war. Ex-POWs were less secure with respect to attachment than the controls at the initial assessment, and although the controls experienced a decline in attachment insecurity over the 17-year period, the anxiety and avoidance scores of the ex-POWs increased over time. We also found that PTSD was associated with higher attachment insecurity scores at each time point, beyond the effect of war captivity. Implications of the findings for both attachment theory and the psychological effects of trau...",0 +https://doi.org/10.1037/a0020809,"Resource loss, resource gain, and psychological resilience and dysfunction following cancer diagnosis: A growth mixture modeling approach.","This study investigated trajectories of psychological distress and their relationships with change in psychosocial resources in the year following cancer diagnosis.Chinese colorectal cancer (CRC) patients (n = 234) were assessed within 12 weeks of diagnosis (T1) and again at 3-month (T2) and 12-month (T3) follow-ups. Growth mixture modeling was used to analyze the longitudinal data.Psychological distress was measured at the three time-points using Hospital Anxiety and Depression Scale (HADS).Growth mixture models identified four classes: chronic distress (7-9%), delayed distress (10-13%), recovery (13-16%), and resilient (65-67%). People in chronic distress were more likely to demonstrate loss in physical functioning and social relational quality than those in delayed distress, and loss in physical functioning, optimism, and hope than those in recovery, but more likely to demonstrate stability/gain in optimistic personalities than those in delayed distress and resilient. People in resilient were more likely to report stability/gain in optimistic personalities than those in delayed distress but not those in recovery.Understanding differential outcome trajectories and associated change in coping resources has implications for developing ongoing psychological services for cancer patients during the diagnosis and treatment process.",1 +https://doi.org/10.2174/18715273113126660196,Novel Approach to the Role of NMDA Receptors in Traumatic Brain Injury,"For more than two decades the intensive research effort on the role of NMDA receptors (NMDAR) in traumatic brain injury (TBI) and cerebral ischemia (stroke) was led by the observations that extracellular concentrations of glutamate and aspartate are elevated after the insult and play a major role in brain pathologies. Indeed, NMDAR antagonists were shown to improve post-injury recovery in animal models and subsequently, large scale placebocontrolled clinical trials in TBI and stroke were performed with NMDAR antagonists. However, all these trials have demonstrated either no benefit or even deleterious effects. The discrepancy between the animal and human studies prompted us to investigate the temporal changes of the NMDAR after brain insult in TBI and stroke mouse models. We found that the early hyperactivation of the NMDAR is followed by loss of functional NMDAR which persists for weeks. Such dynamic changes could well explain the discrepancies between the preclinical and clinical experience as well as suggest alternative modes of treatment, namely, activation, rather than blockade of the NMDAR in the sub-acute period after TBI and stroke. Stimulation of the glycine modulatory site of the glycine/NMDAR by the partial agonist Dcycloserine (DCS) when given at least 24 hrs after TBI or stroke was shown to improve recovery of neurobehavioral and cognitive functions. It was also shown to restore impaired hippocampal Long-Term potentiation (LTP) and induce expression of Brain Derived-Neurotrophic Factor (BDNF) in a TBI model and to improve somatosensory and cognitive function in a stroke model. Experiments to optimize the DCS treatment paradigm showed that similar benefits were demonstrated in TBI mice whether the drug was given as a single injection at 24 or 72 hrs post injury, or as double (24 and 48 hrs) or triple (24, 48 and 72 hrs) doses. Interestingly, beneficial effects of DCS were reported in a range of animal models of human diseases as well as in several clinical indications thought to involve disruptions in NMDAR function, such as drug addiction, post-traumatic stress disorder, Parkinson's disease, aging and psychiatric disorders. As DCS has a good safety profile, and is already in use in humans in several different indications, and based on studies with DCS in the mouse TBI model, a multi-center prospective randomized controlled clinical trial, aiming to assess the effect of a single dose of DCS on cognitive outcome in patients with moderate TBI has recently begun.",0 +https://doi.org/10.1186/s13690-015-0069-9,Degree of exposure and peritraumatic dissociation as determinants of PTSD symptoms in the aftermath of the Ghislenghien gas explosion,"This paper investigates risk factors for the development of posttraumatic stress symptoms in the different survivor groups involved in a technological disaster in Ghislenghien (Belgium). A gas explosion instantly killed five firefighters, one police officer and 18 other people. Moreover, 132 people were wounded among which many suffered severe burn injuries.In the framework of a large health survey of people potentially involved in the disaster, data were collected from 3,448 households, of which 7,148 persons aged 15 years and older, at 5 months (T1) and at 14 months (T2) after the explosion. Hierarchical regression was used to determine the significant predictors and to assess their proportion in variance accounted for.The degree of exposure to the disaster was a predictor of the severity of posttraumatic stress symptoms. Peritraumatic dissociation appeared to be the most important predictor of the development of posttraumatic stress symptoms at T1. But at T2, posttraumatic stress symptoms at T1 had become the most important predictor. Dissatisfaction with social support was positively linked to development of posttraumatic stress symptoms at T1 and to the maintenance of these symptoms at T2. Survivors who received psychological help reported significant benefits.In harmony with the findings from studies on technological disasters, at T1 6,0% of the respondents showed sufficient symptoms to meet all criteria for a full PTSD. At T2, 6,6% still suffered from posttraumatic stress symptoms. The symptoms of the different victim categories clearly indicated the influence of the degree of exposure on the development of posttraumatic stress symptoms. Problems inherent to retrospective scientific research after a disaster are discussed.",0 +https://doi.org/10.1017/s1352465812000148,The Role of Emotion in PTSD: Two Preliminary Studies,"Background: Two studies are presented that highlight the role of emotion in PTSD in which we examine what emotions in addition to anxiety may be present. Aims: The first aim was to assess the overall emotion profile across the five basic emotions of anxiety, sadness, anger, disgust, and happiness in clients attending a stress clinic. A small pilot study was also carried out to see how the emotion profiles impacted on outcome for CBT. Method: In Study 1, 75 consecutive attenders at a trauma service who were diagnosed with PTSD were assessed with a number of measures that included the Basic Emotions Scale. Results: The results showed that less than 50% of PTSD cases presented with anxiety as the primary emotion, with the remainder showing primary emotions of sadness, anger, or disgust rather than anxiety. A second pilot study involved the follow-up across exposure-based CBT of 20 of the participants from Study 1. Conclusions: The results suggest that anxiety-based PTSD is more likely to benefit from exposure than is non-anxiety based PTSD. Implications both for the classification and the treatment of PTSD are considered.",0 +https://doi.org/10.1186/1752-1505-7-21,"The association between post-traumatic stress-related symptoms, resilience, current stress and past exposure to violence: a cross sectional study of the survival of Quechua women in the aftermath of the Peruvian armed conflict","BackgroundThe long lasting resilience of individuals and communities affected by mass violence has not been given equal prominence as their suffering. This has often led to psychosocial interventions in post-conflict zones being unresponsive to local realities and ill-equipped to foster local strengths. Responding to the renewed interest in resilience in the field of violence and health, this study examines the resilience and post-traumatic responses of Indigenous Quechua women in the aftermath of the political violence in Peru (1980–2000).MethodsA cross-sectional study examined the relationship between resilience, post-traumatic responses, exposure to violence during the conflict and current life stress on 151 Quechua women participants. Purposive and convenience sampling strategies were used for recruitment in Ayacucho, the area most exposed to violence. The study instruments were translated to Quechua and Spanish and cross-culturally validated. Data was analyzed using hierarchical regression analysis. A locally informed trauma questionnaire of local idioms of distress was also included in the analysis.FindingsSixty percent of women (n = 91) were recruited from Ayacucho city and the rest from three rural villages; the mean age was 45 years old. Despite high levels of exposure to violence, only 9.3% of the sample presented a level of symptoms that indicated possible PTSD. Resilience did not contribute to the overall variance of post-traumatic stress related symptoms, which was predicted by past exposure to violence, current life stress, age, and schooling (R2 = .421). Resilience contributed instead to the variance of avoidance symptoms (Stand β = −.198, t = −2.595, p = 0.010) while not for re-experiencing or arousal symptoms.ConclusionsThese findings identified some of the pathways in which resilience and post-traumatic responses interrelate in the aftermath of violence; yet, they also point to the complexity of their relationship, which is not fully explained by linear associations, requiring further examination. Age and gender-sensitive health care is considered critical almost fifteen years after the end of the conflict. The notable resilience of Quechua women—despite exposure to a continuum of violence and social inequalities—also calls for enhanced recognition of women not only as victims of violence but also as complex social actors in the reconstruction of post-conflict societies.",0 +https://doi.org/10.1891/0886-6708.24.5.577,The Relationship Between Dating Violence and Psychosocial Problems in a Sample of Adolescent Pregnancy Termination Patients,"The relationship between dating violence and 13 psychosocial problems, conceptually organized into three symptom clusters--depressive, family problem, and posttraumatic stress--was investigated in a sample of adolescent pregnancy termination patients, ages 14 to 21. Results of a multivariate multiple-regression analysis indicated that, after controlling for age, ethnicity, general aggression problems, and problems with peers, dating violence was significantly related with the symptoms clusters. At the univariate level, the results suggested that dating violence was significantly related with self-esteem problems, guilt, and suicidal thinking from the depressive symptoms cluster and with guilt and stress from the posttraumatic stress cluster. The implications of these findings are discussed.",0 +https://doi.org/10.1037/a0019895,Imagery rehearsal therapy: An emerging treatment for posttraumatic nightmares in veterans.,"Nightmares are a common complaint among service members exposed to traumatic events, but prevailing paradigms are disposed to a view that nightmares are a secondary phenomenon untreatable with direct therapeutic intervention. Imagery rehearsal therapy is a cognitive-imagery approach with proven efficacy in the treatment of nightmares in civilian trauma victims. Imagery rehearsal therapy not only has potential to reduce nightmare intensity and frequency, but controlled studies show clinically meaningful decreases in all clusters of posttraumatic stress disorder symptoms as well as insomnia. Limited data support its use with combat veterans. Directions for future research with combat veterans are recommended. © 2010 American Psychological Association.",0 +https://doi.org/10.1007/s00127-014-0855-7,A systematic review of the comorbidity between PTSD and alcohol misuse,"Purpose This systematic review aimed to assess (1) the level of comorbidity of post-traumatic stress disorder (PTSD) and alcohol misuse reported in research studies since 2007 and (2) any associations found between specific PTSD symptom clusters and alcohol misuse. Methods A literature search was carried out to capture any papers published from 2007 to the end of July 2012. Six hundred and twenty abstracts were identified and reviewed, and 42 papers were included in the final review after applying inclusion and exclusion criteria. Results The prevalence of comorbid alcohol misuse in those with PTSD ranged from 9.8 to 61.3 %. The prevalence of comorbid PTSD in those with alcohol misuse ranged from 2.0 to 63.0 %, and the majority of prevalence rates were over 10.0 %. Almost all of the odds ratios representing the strength of association between the conditions across a variety of populations were significant, and those ranged from 1.1 to 4.87. Of the different PTSD symptom clusters, this review found most evidence for associations between alcohol misuse and both avoidance/numbing symptoms and hyperarousal symptoms. Conclusions Given that comorbidity appears to be common, the evidence from this systematic review supports the use of routine screening for comorbidity in populations who are known to have PTSD or alcohol misuse. © 2014 Springer-Verlag Berlin Heidelberg.",0 +https://doi.org/10.1007/s12160-015-9744-x,Acute Stress Disorder Symptoms Predict All-Cause Mortality Among Myocardial Infarction Patients: a 15-Year Longitudinal Study,"Studies have recognized myocardial infarction (MI) as a risk for acute stress disorder (ASD), manifested in dissociative, intrusive, avoidant, and hyperarousal symptoms during hospitalization.This study examined the prognostic role of ASD symptoms in predicting all-cause mortality in MI patients over a period of 15 years.One hundred and ninety-three MI patients filled out questionnaires assessing ASD symptoms during hospitalization. Risk factors and cardiac prognostic measures were collected from patients' hospital records. All-cause mortality was longitudinally assessed, with an endpoint of 15 years after the MI.Of the participants, 21.8 % died during the follow-up period. The decedents had reported higher levels of ASD symptoms during hospitalization than had the survivors, but this effect became nonsignificant when adjusting for age, sex, education, left ventricular ejection fraction, and depression. A series of analyses conducted on each of the ASD symptom clusters separately indicated that-after adjusting for age, sex, education, left ventricular ejection fraction, and depression-dissociative symptoms significantly predicted all-cause mortality, indicating that the higher the level of in-hospital dissociative symptoms, the shorter the MI patients' survival time.These findings suggest that in-hospital dissociative symptoms should be considered in the risk stratification of MI patients.",0 +https://doi.org/10.1016/j.psym.2011.01.036,A Systematic Review of Resilience in the Physically Ill,"Resilience is the capacity of individuals to maintain, or regain, their mental health in the face of significant adversity, including physical illness.We conducted a systematic review of resilience and related concepts in the physically ill to determine factors associated with predicting or promoting resilience.An electronic search of PsychInfo, Medline, and CINAHL databases between 1950 and May 2009 was performed using the terms resilience, and various types of physical illnesses. Inclusion criteria were broad and exclusion criteria were not published in English or not focused on resilience in physical illness.A total of 475 articles were retrieved and 52 articles met inclusion/exclusion criteria. Psychological factors associated with resilience were self-efficacy, self-esteem, internal locus of control, optimism, mastery, hardiness, hope, self-empowerment, acceptance of illness, and determination. Social support was highly predictive of, and associated with, resilience. Coping strategies such as positive cognitive appraisal, spirituality, active coping, and mastery were also associated with resilience. Resilience factors directly salient to physical illness such as self-care, adherence to treatment, health related quality of life, illness perception, pain perception, exercise adherence, and physical outcomes were also found.These findings need to be considered and when appropriate incorporated into the psychological and psychiatric care of physically ill individuals.",0 +,Antidepressant treatment of posttraumatic stress disorder.,"Recent large double-blind, placebo-controlled trials have indicated that sertraline is an effective and well-tolerated treatment for posttraumatic stress disorder (PTSD). The avoidance/numbing symptom cluster improved the most significantly with sertraline, but significant improvements were also noted for the intrusive/reexperiencing and arousal symptom clusters. Smaller double-blind, placebo-controlled trials have also indicated that fluoxetine is an effective treatment for PTSD. Multiple small, open studies with other selective serotonin reuptake inhibitors and newer antidepressants indicate that these medications show some promise. Older studies indicate some efficacy for tricyclic antidepressants, and monoamine oxidase inhibitors are a reasonable choice, particularly for intrusive/reexperiencing symptoms.",0 +https://doi.org/10.1002/jts.20216,Posttraumatic stress disorder and posttraumatic growth among Israeli ex-pows,"In this article, the authors present a prospective study that dealt with pathological (posttraumatic stress disorder; PTSD) and salutary (posttraumatic growth; PTG) outcomes of captivity and the correlates of those outcomes among a sample of ex-prisoners of war (POWs) and a control group of combat veterans. Posttraumatic stress disorder and its correlates were assessed in 1991 and 2003, and PTG was assessed in 2003. The results indicate that ex-POWs exhibited higher levels of PTSD and PTG than did the controls. In addition, both linear and quadratic associations between PTSD and PTG were found. The authors discuss some unresolved issues related to assessment of PTG and salutary outcomes, and outline directions for future research.",0 +https://doi.org/10.1016/s2215-0366(15)00309-0,"Inflammatory markers in post-traumatic stress disorder: a systematic review, meta-analysis, and meta-regression","Studies investigating inflammatory markers in post-traumatic stress disorder (PTSD) have yielded mixed results. The aim of our study was to compare concentrations of inflammatory markers in patients with PTSD compared with healthy controls.We did a meta-analysis and meta-regression of studies comparing inflammatory markers between patients with PTSD and healthy controls by searching PubMed, Embase, Scopus, Web of Science, and PsycINFO for articles published between Jan 1, 1960, and April 7, 2015. From eligible studies (ie, cross-sectional studies or baseline data from longitudinal studies of peripheral blood cytokine concentrations that compared adults with PTSD with healthy controls), we extracted outcomes of interest, such as mean and SD of peripheral blood cytokines, the time of day blood was collected, whether the study allowed patients with comorbid major depressive disorder in the PTSD group, whether patients were medication free, and severity of PTSD symptoms. We undertook meta-analyses whenever values of inflammatory markers were available in two or more studies. A random-effects model with restricted maximum-likelihood estimator was used to synthesise the effect size (assessed by standardised mean difference [SMD]) across studies.8057 abstracts were identified and 20 studies were included. Interleukin 6 (SMD 0.88; p=0.0003), interleukin 1β (SMD 1.42; p=0.045), and interferon γ (SMD 0.49; p=0.002) levels were higher in the PTSD group than in healthy controls. Subgroup meta-analysis of patients who were not given medication showed higher tumour necrosis factor α (TNFα; SMD 0.69, 95% CI 0.35-1.02; p<0.0001) in the PTSD group than the control group in addition to the aforementioned cytokines. TNFα (SMD 1.32, 0.13-2.50; p=0.003), interleukin 1β (SMD 2.35, 0.01-4.68; p=0.048), and interleukin 6 (SMD 1.75, 0.97-2.53; p<0.0001) levels remained increased in the PTSD group in a subgroup meta-analysis of studies that excluded comorbid major depressive disorder. Illness duration was positively associated with interleukin 1β levels (b=0.33, p<0.0001) and severity with interleukin 6 (b=0.02, p=0.042). A model composed of several variables-presence of comorbid major depressive disorder, use of psychotropic medications, assay used, and time of day blood was collected-explained the large amount of heterogeneity between interleukin 1β, interleukin 6, and C-reactive protein studies. Egger's linear regression test revealed a potential publication bias for interleukin 1β. Additionally, for most inflammatory markers, study heterogeneity was reported to be high (I(2)>75%).PTSD is associated with increased interleukin 6, interleukin 1β, TNFα, and interferon γ levels. This information might be useful for consideration of chronic low-grade inflammation as a potential target or biomarker in PTSD treatment. Use of psychotropic medication and presence of comorbid major depressive disorder were important moderators that might explain the inconsistency between results of previous studies. Our search strategy used a range of databases and we made exhaustive effort to acquire data by contacting the authors. Notably, high levels of between-study heterogeneity were recorded for most cytokine variables measured in our analysis. However, meta-regression analysis could explain a large amount of this heterogeneity.None.",0 +https://doi.org/10.2519/jospt.2011.3668,Pressure Pain Threshold Testing Demonstrates Predictive Ability in People With Acute Whiplash,"Longitudinal cohort study.To determine whether pressure pain threshold (PPT), tested at 2 standardized sites, could provide additional prognostic ability to predict short-term outcomes in people with acute whiplash, after controlling for age, sex, and baseline pain intensity.PPT may be a valuable assessment and prognostic indicator for people with whiplash-associated disorder. The extent to which PPT can predict short-term disability scores has yet to be explored in people with acute (of less than 30 days in duration) whiplash-associated disorder in a clinical setting.Eligible patients were recruited from community-based physiotherapy clinics in Canada. Baseline measurements included PPT, as well as pain intensity, age, and sex. Neck-related disability was collected with the Neck Disability Index 1 to 3 months after PPT testing. Multiple linear regression models were constructed to evaluate the unique contribution of PPT in the prediction of follow-up disability scores.A total of 45 subjects provided complete data. A regression model that included sex, baseline pain intensity, and PPT at the distal tibialis anterior site was the most parsimonious model for predicting short-term Neck Disability Index scores 1 to 3 months after PPT testing, explaining 38.6% of the variance in outcome. None of the other variables significantly improved the predictive power of the model.Sex, pain intensity, and PPT measured at a site distal to the injury were the most parsimonious set of predictors of short-term neck-related disability score, and represented promising additions to assessment of traumatic neck pain. Neither age nor PPT at the local site was able to explain significant variance beyond those 3 predictors. Limitations to interpretation are addressed.",0 +https://doi.org/10.3389/fpsyg.2015.00256,Catecholamine responses to virtual combat: implications for post-traumatic stress and dimensions of functioning,"Posttraumatic stress disorder (PTSD) symptoms can result in functional impairment among service members (SMs), even in those without a clinical diagnosis. The variability in outcomes may be related to underlying catecholamine mechanisms. Individuals with PTSD tend to have elevated basal catecholamine levels, though less is known regarding catecholamine responses to trauma-related stimuli. We assessed whether catecholamine responses to a virtual combat environment impact the relationship between PTSD symptom clusters and elements of functioning. Eighty-seven clinically healthy SMs, within 2 months after deployment to Iraq or Afghanistan, completed self-report measures, viewed virtual-reality (VR) combat sequences, and had sequential blood draws. Norepinephrine responses to VR combat exposure moderated the relationship between avoidance symptoms and scales of functioning including physical functioning, physical-role functioning, and vitality. Among those with high levels of avoidance, norepinephrine change was inversely associated with functional status, whereas a positive correlation was observed for those with low levels of avoidance. Our findings represent a novel use of a virtual environment to display combat-related stimuli to returning SMs to elucidate mind-body connections inherent in their responses. The insight gained improves our understanding of post-deployment symptoms and quality of life in SMs and may facilitate enhancements in treatment. Further research is needed to validate these findings in other populations and to define the implications for treatment effectiveness.",0 +https://doi.org/10.1016/j.anr.2015.03.002,Professional Quality of Life and Clinical Competencies among Korean Nurses,"Clinical competence among nurses is an essential requirement for the provision of safe and effective patient care. This study aims to classify types of professional quality of life experienced by Korean nurses, and examine the relationship between demographic and professional characteristics and clinical competence among nurses experiencing each type.A total of 335 nurses completed questionnaires assessing professional quality of life, clinical competence, and demographic and professional characteristics. Following identification of the underlying factors of professional quality of life, we classified participants into three clusters.There were significant differences in age, marital status, religion, educational status, and position between clusters. Results also revealed that nurses with high compassion satisfaction and low compassion fatigue (burnout, secondary traumatic stress) tended to have higher clinical competence.This study demonstrated that it is possible to directly examine the relationship between professional quality of life level and clinical competence among nurses. Thus, interventions to increase nurses' compassion satisfaction and relieve compassion fatigue are needed, as professional quality of life may affect clinical competence.",0 +,Pharmacotherapy for post-traumatic stress disorder - a systematic review and meta-analysis.,"Post-traumatic stress disorder (PTSD) is a prevalent and disabling condition. Evidence that PTSD is characterized by specific psychobiological dysfunctions has contributed to a growing interest in use of medication in its treatment.To assess the effects of medication in the treatment of PTSD.Systematic review of randomised controlled trials (RCTs) following the Cochrane Collaboration guidelines. A more detailed version of the review is published in the Cochrane Database of Systematic Reviews.We searched the Cochrane Depression, Anxiety and Neurosis Group specialised register, the Cochrane Central Register of Controlled Trials (Cochrane Library issue 4, 2004), MEDLINE (January 1966 - December 2004), PsycINFO (1966 - 2004), the National PTSD Center Pilots database, and the meta register module of the Controlled Trials database. Reference lists of retrieved articles were searched for additional studies. Two raters independently assessed RCTs for inclusion in the review, collated trial data, and assessed trial quality. Investigators were contacted to obtain missing data. Summary statistics were stratified by medication class, and by medication agent for the selective serotonin re-uptake inhibitors (SSRIs). Dichotomous and continuous measures were calculated using a random effects model, heterogeneity was assessed, and subgroup/sensitivity analyses were done.Thirty-five short-term (14 weeks or less) RCTs were included in the analysis (4 597 participants). Symptom severity for 17 trials was significantly reduced in the medication groups, relative to placebo (weighted mean difference (WMD) = -5.76, 95% confidence interval (CI)-8.16 - -3.36, N = 2 507). Similarly, summary statistics for responder status from 13 trials demonstrated overall superiority of a variety of medication agents compared with placebo (relative risk (RR) = 1.49, 95% CI: 1.28, 1.73, number needed to treat (NNT) = 4.85, N = 1 272). Medication and placebo response occurred in 59.1% (N = 644) and 38.5% (N = 628) of patients, respectively. Of the medication classes, evidence of treatment efficacy was most convincing for the SSRIs. Medication was also effective in reducing the severity of the PTSD re-experiencing/intrusion, avoidance/numbing, and hyperarousal symptom clusters in 9 trials (N = 1 304). In addition, medication was superior to placebo in reducing comorbid depression and disability. Medication was also less well tolerated than placebo. A narrative review of the 3 maintenance trials suggested that long-term medication may be required in treating PTSD.Medication treatments can be effective in treating PTSD, acting to reduce its core symptoms, as well as associated depression and disability, and should be considered as part of the treatment of this disorder. The findings of this review support the status of SSRIs as first-line agents in the pharmacotherapy of PTSD, as well as their value in longterm treatment. However, there remain important gaps in the evidence base, and there is a continued need for more effective agents in the management of PTSD.",0 +https://doi.org/10.1017/s095457941200003x,Resilience in developmental psychopathology: Contributions of the Project Competence Longitudinal Study,"Abstract Contributions of the Project Competence Longitudinal Study (PCLS) to resilience science and developmental psychopathology are highlighted in this article. Initiated by Norman Garmezy, the PCLS contributed models, measures, and methods, as well as working definitions of concepts like competence, developmental tasks, protective factors, and resilience. Findings from the study corroborated the feasibility of studying adaptation in a normative group of school children, identifying patterns of resilience, competence without major adversity, and maladaptive paths through life. Competence was multidimensional, showing continuity and change over time. Cascading effects across domains indicated that competence and problems spread over time. Thus, adult achievements in developmental tasks were rooted in childhood and adolescence. Young people who showed resilience had much in common with similarly successful peers who experienced less adversity over time, including high-quality relationships with parents and other adults, and good cognitive, as well as social–emotional, skills. Maladaptive youth in the study often faced high adversity with little adaptive capacity (internal or external) and tended to generate stressful experiences. Resilience often emerged in childhood and endured, but there also were late bloomers whose lives turned around in the transition to adulthood. The role of collaboration and mentorship in the PCLS is also discussed.",0 +,Profile of psychiatric patients presenting to a tertiary care emergency department of Karachi.,"This study reviewed the presentations of psychiatric patients admitted through the Emergency Department (ED), The Aga Khan University Hospital, Karachi. Psychiatric patients admitted through the ED to the psychiatry ward were compared to those admitted through the same units other than the psychiatry ward, from 2006 to 2010 using medical records. Psychiatric patients were defined as those in whom psychiatry consult was generated and 1127 cases were included in study. There were 550 (48.8%) female patients. Most common presentations in the ED were sleep-related problems (n=205, 15.9%) followed by aggressive behavior (n=191, 14.8%). Depression was the most common diagnosis made in the ED (n=331, 29.3%) and at the time of discharge from the hospital (n=354, 29.5%). Psychiatric patients presenting to the ED had signs and symptoms which one generally disregards. However, these minor indicators can lead to major events in a patient's life.",0 +https://doi.org/10.1111/j.1440-1819.1998.tb03274.x,Post-traumatic stress disorder in Asian refugees,"This study profiles 127 cases of Vietnamese, Cambodian, Laotian and Chinese refugee outpatients diagnosed with post-traumatic stress disorder (PTSD). Traumatic etiologies included victims of wars such as political refugees, concentration camp prisoners and victims of rape, severe personal losses (property or human lives). These traumata were experienced by our subjects during the period between the end of the Vietnam war in April 1975 and recent times, when they finally arrived in the USA. Clinical symptoms of these subjects reflected many influences of their oriental culture background and are characterized by internalization that needs to be overcome for assessment as well as for therapy. Symptomatic treatment with psychopharmacology and supportive therapy are helpful while cultural approaches have been adopted by many patients to reach the inner self pathology that could be of both mental and organic in nature. These facts need to be taken into consideration in the future description of the PTSD clinical picture. Recommendations are made for future PTSD studies in Vietnam, Cambodia and Laos, and to promote a global movement for prevention of any socio-political situation that may generate PTSD.",0 +https://doi.org/10.1152/japplphysiol.00412.2005,Thiol supplementation in aged animals alters antioxidant enzyme activity after heat stress,"Declines in oxidative and thermal stress tolerance are well documented in aging systems. It is thought that these alterations are due in part to reductions in antioxidant defenses. Although intracellular thiols are major redox buffers, their role in maintaining redox homeostasis is not completely understood, particularly during aging, where the reliance on antioxidant enzymes and proteins may be altered. To determine whether thiol supplementation improved the antioxidant enzyme profile of aged animals after heat stress, young and old Fischer 344 rats were treated with N-acetylcysteine (NAC; 4 mmol/kg ip) 2 h before heat stress. Liver tissue was collected before and 0, 30, and 60 min after heat stress. Aging was associated with a significant decline in tissue cysteine and glutathione (GSH) levels. There was also an age-related decrease in copper-zinc superoxide dismutase activity. Heat stress did not alter liver GSH, glutathione disulfide, or antioxidant enzyme activity. With NAC treatment, old animals took up more cysteine than young animals as reflected in an increase in liver GSH and a corresponding decrease in glutamate cysteine ligase activity. Catalase activity increased after NAC treatment in both age groups. Copper-zinc superoxide dismutase activity did not change with heat stress or drug treatment, whereas manganese superoxide dismutase activity was increased in old animals only. These data indicate that GSH synthesis is substrate limited in old animals. Furthermore, aged animals were characterized by large fluctuations in antioxidant enzyme balance after NAC treatment, suggesting a lack of fine control over these enzymes that may leave aged animals susceptible to subsequent stress.",0 +https://doi.org/10.1007/s00068-013-0271-9,Pain and quality of life 1 year after admission to the emergency department: factors associated with pain,"Objectives: This study describes the prevalence of pain in trauma patients 1 year after hospital admission and investigates separately health-related quality of life (QoL) for patients suffering severe pain and for those without pain. Moreover, psychosocial factors are examined for their impact on pain. Methods: Patients were contacted 12 months after admission in order to complete the following questionnaires: Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), Trauma Outcome Profile (TOP), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Impact of Event Scale-Revised (IES-R) and additional questions concerning satisfaction, work and financial status. Relevant pain at follow-up was defined as <80 points on the pain subscale of the TOP. Results: Two hundred and twenty patients were included. The Injury Severity Score (ISS) ranged from 1 to 41. Fifty-three percent (53 %) of patients suffered a severe trauma (ISS > 15). One year after injury, 55 % of patients had relevant pain according to the TOP. Patients with pain were older (41.4 vs. 34.4 years, p = 0.003) and had slightly more severe injuries (ISS 17.1 vs. 14.9, p = 0.115). There were significant differences between pain and no-pain patients on all domains of QoL (p < 0.001) and on the BDI, STAI and IES-R (p < 0.001). Pain patients more often experienced a stressful event and job-related and financial difficulties. Multivariate logistic regression analysis revealed post-traumatic stress disorder (PTSD) as the strongest predictor for pain [odds ratio (OR): 4.38, p = 0.015], followed by a stressful life event (OR: 4.08, p = 0.001). Discussion: Pain is strongly associated with psychosocial complaints 1 year after trauma. For the treatment of pain following a traumatic event, social reintegration and emotional regulation by means of occupational rehabilitation and psychotherapy should receive more attention. © 2013 Springer-Verlag Berlin Heidelberg.",0 +https://doi.org/10.1186/1753-2000-7-1,Analysis of prevalence of PTSD and its influencing factors among college students after the Wenchuan earthquake,"Abstract Background This study explored the prevalence and severity of post-traumatic stress disorder (PTSD) in college students who lived in earthquake center one year after the Wenchuan earthquake on May 12, 2008, the factors affecting the prevalence of PTSD was also investigated. Methods 2987 students studying at the senior normal school in Tibetan autonomous region which was one of the most devastated regions were selected for this study. The PTSD Checklist-Civilian Version (PCL-C) was used as a screening instrument. Results A total of 420 cases (14.1%) were diagnosed with PTSD, among which mild, moderate, severe and extreme symptoms were reported in 122, 185, 106 and 7 cases, respectively. The PTSD prevalence in college students lived in the severely affected area was significantly higher than that in the less severe area (P < 0.001). According to the multivariate logistic regression analysis, the students who were injured in the earthquake, those lost their first degree relative, and those confronted with dead bodies were more likely to express PTSD. Male students were more prone than female students to develop PTSD. However, the students who received psychological tutorship were less prone to express PTSD. Conclusions At one year after the earthquake, the PTSD rate in college students in the severely affected area was high. The social support, psychological help and rehabilitation project should be strengthened to improve their ability to cope with the trauma.",0 +https://doi.org/10.1002/jts.20178,Posttraumatic stress after a motor vehicle accident: A six-month follow-up study utilizing latent growth modeling,"Features of posttraumatic stress disorder (PTSD) for 596 survivors of motor vehicle accidents were examined by self-report measures at 1 week, 1 month, 3 months, and 6 months after the motor vehicle accident (MVA). Latent growth modeling was utilized to study the trend and predictors of the level of distress. Results indicated that 5-20% of the participants reported to have a significant level of posttraumatic stress in one, two, or three of the PTSD symptom clusters within the period studied. Survivors with significant acute stress 1 week after the MVA had a higher risk for developing chronic posttraumatic stress. Although the severity of intrusive and hyperarousal symptoms decreased over time, the severity of avoidance symptoms remained unchanged. Factors predicting the course of PTSD after an MVA are identified.",0 +https://doi.org/10.1517/14656566.2011.587121,Varenicline for tobacco dependence: panacea or plight?,"This review examines the postmarketing experience with varenicline, including case reports, newer clinical trials and secondary analyses of large clinical datasets.Varenicline has been shown to be an effective treatment in a broad range of tobacco users with medical, behavioral and diverse demographic characteristics. Recent studies finding excellent safety and efficacy in groups of smokers with diseases including chronic obstructive pulmonary disease are particularly encouraging and call for increased use of this medication for smoking cessation. Despite case reports of serious neuropsychiatric symptoms in patients taking varenicline, including changes in behavior and mood, causality has not been established. Recent analyses of large datasets from clinical trials have not demonstrated that varenicline is associated with more depression or suicidality than other treatments for smoking cessation.Now that additional clinical trials in specific populations and observational studies on treatment-seeking smokers outside of clinical trials have been published, we can be confident that varenicline remains the most efficacious monotherapy for smoking cessation and that its side-effect profile remains good. The risk-to-benefit ratio of receiving varenicline to quit smoking must include the increased chances of quitting smoking and avoiding the sizeable risks of smoked-caused disease and death that remain if tobacco addiction is not properly treated.",0 +https://doi.org/10.1037/0735-7028.36.3.227,APA's resilience initiative.,"Resilience is the human ability to adapt in the face of tragedy, trauma, adversity, hardship, and ongoing significant life stressors. Focus groups conducted by the APA Practice Directorate after the terrorist attacks of September 11, 2001, found people to be experiencing a chronic sense of stress and uncertainty for which they wanted to be more resilient. In response, APA launched its public education campaign, “The Road to Resilience,” in August 2002. A key component of the campaign is community outreach by psychologists, in which psychologists around the country bring information about resilience directly into their communities. This has allowed psychologists to help their communities and to help communities better understand the value of psychology.",0 +https://doi.org/10.1016/j.eurpsy.2014.05.002,The role of high-density lipoprotein cholesterol in risk for posttraumatic stress disorder: Taking a nutritional approach toward universal prevention,"Abstract Several cross-sectional studies, but no prospective studies, have reported an association between an abnormal lipid profile and posttraumatic stress disorder (PTSD). We hypothesized that an abnormal lipid profile might predict risk for developing PTSD. In this prospective study, we analyzed data from 237 antidepressant-naïve severely injured patients who participated in the Tachikawa Cohort of Motor Vehicle Accident Study. High-density lipoprotein cholesterol (HDL-C) levels at baseline were significantly lower in patients with PTSD than those without PTSD at 6 months after motor vehicle accident (MVA) and were inversely associated with risk for PTSD. In contrast, triglycerides (TG) at baseline were significantly higher in patients with PTSD than in those without PTSD at 6 months post-MVA and were positively associated with risk for PTSD. There was no clear association between low-density lipoprotein cholesterol or total cholesterol and risk for PTSD. In conclusion, low HDL-C and high TG may be risk factors for PTSD. Determining lipid profiles might help identify those at risk for PTSD after experiencing trauma.",0 +https://doi.org/10.1080/13811118.2012.695269,The Moderating Role of Distress Tolerance in the Relationship Between Posttraumatic Stress Disorder Symptom Clusters and Suicidal Behavior Among Trauma Exposed Substance Users in Residential Treatment,"The co-occurrence of posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) is associated with greater risk for suicidal behavior than either disorder alone. Research highlights the relevance of PTSD symptoms in particular to suicide risk within this population. Research has also provided support for an association between distress tolerance (DT) and both PTSD symptoms and suicidal behavior. This study examined the role of DT in the relationship between PTSD symptom severity and suicidal behavior in a sample of 164 SUD inpatients with a history of Criterion A traumatic exposure. Results indicated that DT moderated the relationship between PTSD symptoms (overall, re-experiencing, and hyperarousal) and medically attended suicide attempts, with the magnitude of the relationship increasing at higher levels of DT.",0 +https://doi.org/10.1037/a0030144,Reductions in traumatic stress following a coping intervention were mediated by decreases in avoidant coping for people living with HIV/AIDS and childhood sexual abuse.,"To examine whether (a) Living in the Face of Trauma (LIFT), a group intervention to address coping with HIV and childhood sexual abuse (CSA), significantly reduced traumatic stress over a 1-year follow-up period more than an attention-matched support group comparison intervention; and (b) reductions in avoidant coping over time mediated reductions in traumatic stress.In a randomized controlled trial, 247 participants completed measures of traumatic stress and avoidant coping at pre- and post intervention, and at 4-, 8-, and 12-month follow-ups. Latent growth curve modeling examined changes over the 5 time points; standardized path coefficients provide estimates of effects.As compared with the support intervention, the coping intervention led to a reduction in traumatic stress over time (b = -.20, p < .02). Participants in the coping intervention also reduced their use of avoidant coping strategies more than did participants in the support intervention (b = -.22, p < .05). Mediation analyses showed reductions in avoidant coping related to reductions in traumatic stress (b = 1.45, p < .001), and the direct effect of the intervention on traumatic stress was no longer significant (b = .04, ns), suggesting that changes in avoidant coping completely mediated intervention effects on traumatic stress.The LIFT intervention significantly reduced traumatic stress over time, and changes in avoidant coping strategies mediated this effect, suggesting a focus on current stressors and coping skills improvement are important components in addressing traumatic stress for adults living with HIV and CSA.",0 +https://doi.org/10.1080/07481187.2011.573177,"Associations Between Prolonged Grief Disorder, Depression, Posttraumatic Stress Disorder, and Anxiety in Rwandan Genocide Survivors","A number of studies have demonstrated that symptoms of prolonged grief disorder (PGD) represent a symptom cluster distinct from bereavement-related depression, anxiety, and posttraumatic stress disorder (PTSD). The aim of the present study was to confirm and extend these findings using the most recent criteria defining PGD. The authors interviewed a total of 400 orphaned or widowed survivors of the Rwandan genocide. The syndromes were strongly linked to each other with a high comorbidity. Principal axis factoring resulted in the emergence of 4 different factors. The symptoms of depression, along with the cognitive, emotional, and behavioral symptoms of PGD, loaded on the first factor, symptoms of anxiety on the second factor, symptoms of PTSD on the third factor, and the separation distress symptoms of PGD on the fourth factor. This indicates that the concept of PGD includes symptoms that are conceptually related to depression. However, the symptom cluster of separation distress presents a grief-specific dimension that may surface unrelated to depressive symptoms.",0 +https://doi.org/10.1046/j.1468-3083.2001.00278.x,The use of antidepressant drugs in dermatology.,"This paper provides an updated review of the use of antidepressant drugs in dermatology. Some of the psychiatric disorders that are usually comorbid with dermatological disorders and respond to antidepressants include major depressive disorder, obsessive compulsive disorder, body dysmorphic disorder, social phobia and post-traumatic stress disorder usually secondary to trauma and abuse during early life. Cutaneous symptoms may be the feature of a primary psychiatric disorder, e.g. cutaneous body image problems, dermatitis artefacta, neurotic excoriations and trichotillomania, or psychiatric syndromes may be comorbid with a primary dermatological disorder such as the association of major depressive disorder or social phobia with psoriasis and obsessive compulsive disorder with acne excoriee. Some of the salient pharmacological properties of the tricyclic antidepressants (TCAs) and the selective serotonin reuptake inhibitor (SSRI) antidepressants are reviewed. The review indicates that the SSRI antidepressants are potentially beneficial in the management of all the major psychiatric syndromes that are encountered in dermatological disorders. The generally more favourable side-effect profile of the SSRIs, such as lower cardiotoxicity in contrast to the TCAs, has made them the first-line agents for the treatment of depression. Furthermore, some of the pharmacological properties of the antidepressant agents that are not related to their antidepressant activity, such as the histamine H1 blocking effect of TCAs, such as doxepin, amitriptyline and trimipramine, are of benefit in dermatological conditions such as urticaria and pruritus. This paper reviews the general guidelines for use of antidepressants and salient drug-drug interactions resulting mainly from the inhibition of the cytochrome P450 (CYP) 2D6 and 3A3/4 isoenzymes by some of the SSRI antidepressants. Before prescribing an antidepressant agent, the specific guidelines, side-effect profile, drug-drug interactions and most current indications should always be obtained.",0 +https://doi.org/10.1001/archgenpsychiatry.2010.158,"Multisite Investigation of Traumatic Brain Injuries, Posttraumatic Stress Disorder, and Self-reported Health and Cognitive Impairments","Few large-scale, multisite investigations have assessed the development of posttraumatic stress disorder (PTSD) symptoms and health outcomes across the spectrum of patients with mild, moderate, and severe traumatic brain injury (TBI).To understand the risk of developing PTSD symptoms and to assess the impact of PTSD on the development of health and cognitive impairments across the full spectrum of TBI severity.Multisite US prospective cohort study.Eighteen level I trauma centers and 51 non-trauma center hospitals.A total of 3047 (weighted n = 10 372) survivors of multiple traumatic injuries between the ages of 18 and 84 years.Severity of TBI was categorized from chart-abstracted International Classification of Diseases, Ninth Revision, Clinical Modification codes. Symptoms consistent with a DSM-IV diagnosis of PTSD were assessed with the PTSD Checklist 12 months after injury. Self-reported outcome assessment included the 8 Medical Outcomes Study 36-Item Short Form Health Survey health status domains and a 4-item assessment of cognitive function at telephone interviews 3 and 12 months after injury.At the time of injury hospitalization, 20.5% of patients had severe TBI, 11.7% moderate TBI, 12.9% mild TBI, and 54.9% no TBI. Patients with severe (relative risk, 0.72; 95% confidence interval, 0.58-0.90) and moderate (0.63; 0.44-0.89) TBI, but not mild TBI (0.83; 0.61-1.13), demonstrated a significantly diminished risk of PTSD symptoms relative to patients without TBI. Across TBI categories, in adjusted analyses patients with PTSD demonstrated an increased risk of health status and cognitive impairments when compared with patients without PTSD.More severe TBI was associated with a diminished risk of PTSD. Regardless of TBI severity, injured patients with PTSD demonstrated the greatest impairments in self-reported health and cognitive function. Treatment programs for patients with the full spectrum of TBI severity should integrate intervention approaches targeting PTSD.",0 +https://doi.org/10.1016/j.drugalcdep.2012.01.003,"Prevalence and trends of benzodiazepine use among Veterans Affairs patients with posttraumatic stress disorder, 2003–2010","Although the Veterans Affairs and Department of Defense (VA/DoD) clinical guidelines for management of posttraumatic stress disorder (PTSD) recommend against routine benzodiazepine use, little is known about the trends and clinical and prescription profiles of benzodiazepine use since these guidelines were released in 2004. This retrospective study included 64,872 patients with a PTSD diagnosis received from care at facilities in VA Northwest Veterans Integrated Service Network (VISN 20) during 2003–2010. Annual prevalence of any use was defined as any prescription for benzodiazepines, and long-term use was defined as >90 days’ supply, in a year. Gender-specific logistic regressions were fit to estimate any and long-term benzodiazepine use, test for linear trends over 8-years and explore factors associated with trends. The trend of age-adjusted benzodiazepine use over 8-years rose significantly from 25.0 to 26.8% among men and 31.2 to 38.8% among women. Long-term use in men and women increased from 15.4 to 16.4% and 18.0 to 22.7%, respectively. Comorbid psychiatric and alcohol use disorders (AUD) were associated with a greater increase in long-term use of benzodiazepines. In 2010, 61% of benzodiazepine users received >90 days’ supply. Among those prescribed benzodiazepines long-term, 11% had AUD and 47% were also prescribed opioids long-term. Despite VA/DoD clinical guidelines recommending against routine use of benzodiazepines for PTSD, the adjusted prevalence of long-term use increased among men and women with PTSD in VISN 20. Widespread concomitant use of benzodiazepines and opioids suggests risk management systems and research on the efficacy and safety of these medications are needed.",0 +https://doi.org/10.5055/ajdm.2007.0041,"The impact of the refugee decision on the trajectory of PTSD, anxiety, and depressive symptoms among asylum seekers: A longitudinal study","To examine prospectively the trajectory of trauma-related psychiatric symptoms and disability amongst asylum seekers over the course of the refugee determination process. To identify the direct impact of the refugee decision on psychiatric symptoms by adjusting for other variables, namely sociodemographic characteristics, past trauma, and ongoing postmigration stresses.A prospective cohort study of asylum seekers recruited from a random sample of immigration agents in Sydney, Australia.Consecutive asylum seekers were referred for interview by immigration agents. Interviews were undertaken after the initial application and on average, 3.8 months after the refugee decision.Measures assessed premigration trauma and postmigration stressors. Mental health status was assessed using the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist-25. Functional impairment was assessed with the Medical Outcomes Study-Short Form 12.Sixty-two of 73 asylum seekers were retained at follow-up. The accepted (16) and rejected (46) groups did not differ on premigration trauma or baseline psychiatric symptoms. Postdecision, the accepted group showed substantial improvements in posttraumatic stress disorder, anxiety, depression, and in mental health functioning, whereas the rejected group maintained high levels of symptoms on all psychiatric indices.Establishing secure residency status for asylum seekers may be important to their recovery from trauma-related psychiatric symptoms. The practical and theoretical implications are discussed.",0 +https://doi.org/10.1016/j.socscimed.2014.03.036,"Gold mining on Mayan-Mam territory: Social unravelling, discord and distress in the Western highlands of Guatemala","This article examines the influence of a large-scale mining operation on the health of the community of San Miguel Ixtahuacán, Guatemala. An anti-colonial narrative approach informed by participatory action research principles was employed. Data collection included focus groups and one-on-one interviews from August to November of 2011. Over this period, we interviewed 15 Mam Mayan men and 41 women (n = 56) between the ages of 18 and 64 including health care workers, educators, spiritual leaders, agricultural workers and previous mine employees from 13 villages within the municipality. Participants' accounts pointed to community health experiences of social unravelling characterized by overlapping narratives of a climate of fear and discord and embodied expressions of distress. These findings reveal the interconnected mechanisms by which local mining operations influenced the health of the community, specifically, by introducing new threats to the safety and mental wellbeing of local residents.",0 +https://doi.org/10.1080/10538712.2014.896840,"Factor Structure, Reliability, and Known Groups Validity of the German Version of the Childhood Trauma Questionnaire (Short-Form) in Swiss Patients and Nonpatients","The Childhood Trauma Questionnaire-Short Form is the most widely used instrument to assess childhood trauma and has been translated into 10 languages. However, research into validity and reliability of these translated versions is scarce. The present study aimed to investigate the factor structure, internal consistency, reliability, and known-groups validity of the German Childhood Trauma Questionnaire-Short Form (Bernstein & Fink, 1998). Six-hundred and sixty-one clinical and nonclinical participants completed the German Childhood Trauma Questionnaire-Short Form. A confirmatory factor analysis was conducted to assess the 5-factor structure of the original Childhood Trauma Questionnaire-Short Form. To investigate known-groups validity, the confirmatory factor analysis latent factor levels between clinical and nonclinical participants were compared. The original 5-factor structure was confirmed, with only the Physical Neglect scale showing rather poor fit. As a conclusion, the results support the validity and reliability of the German Childhood Trauma Questionnaire-Short Form. It is recommended to use the German Childhood Trauma Questionnaire-Short Form to assess experiences of childhood trauma.",0 +https://doi.org/10.1002/jts.20406,A comparison of PTSD symptom patterns in three types of civilian trauma,"Posttraumatic stress disorder (PTSD) is assumed to be an equivalent syndrome regardless of the type of traumatic event that precipitated it. However, the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) and previous research suggest that the clinical presentation of PTSD varies by trauma type. This study compared PTSD symptom profiles in three types of civilian trauma: sexual assault (n = 86), motor vehicle accident (n = 162), and sudden loss of a loved one (n = 185). Groups differed in overall PTSD severity and displayed distinct PTSD symptom patterns. Results suggest that different trauma types lead to unique variants of the PTSD syndrome, which may result from different etiological factors and may require different treatment approaches.",0 +https://doi.org/10.1037/pas0000089,Item order effects in the evaluation of posttraumatic stress disorder symptom structure.,"Factor analytic research has demonstrated consistently that the 3-factor DSM-IV model of posttraumatic stress disorder (PTSD) symptom structure provides a poorer fit than alternative 4- and 5-factor models. In the current study we examined whether order of item presentation accounts for these findings. In a large sample (N = 1,311) of trauma-exposed undergraduates we conducted a series of confirmatory factor analyses using the PTSD Checklist and Posttraumatic Stress Diagnostic Scale, which present symptom items in the same order as DSM-IV, and the Detailed Assessment of Posttraumatic Stress, which presents items in a different order. Across all 3 measures the 3-factor DSM-IV model provided a relatively worse fit and the 5-factor dysphoric arousal model provided a relatively better fit compared with other tested models. We also examined the distinctiveness of 2 pairs of symptom clusters that appear in the dysphoric arousal model--avoidance versus numbing and dysphoric arousal versus anxious arousal--by comparing their patterns of associations with external correlates. Avoidance and numbing demonstrated differential associations with external correlates, as did dysphoric arousal and anxious arousal. Taken together, results indicate that order effects are unlikely to account for differences in relative fit between leading models of PTSD symptom structure. We discuss the need for future research in this area, especially studies designed to evaluate order effects more directly.",0 +https://doi.org/10.1037/a0018336,On the viability of PTSD Checklist (PCL) short form use: Analyses from Mississippi Gulf Coast Hurricane Katrina survivors.,"One measure commonly used to assess posttraumatic stress disorder is the PTSD Checklist (PCL). Lang and Stein (2005) extracted 4 subsets of PCL items, validating 2 of them for possible use in screening in primary care settings. The viability of the 4 item subsets was evaluated psychometrically in the present study with a sample of Hurricane Katrina survivors (N = 337). Corrected item-total and corrected item-cluster correlations were calculated and compared with those obtained by Lang and Stein. In addition, the sensitivity, specificity, and overall correct classification of the 4 item subsets were evaluated. With methodology approximating Lang and Stein's work, the current data would lead to the development of different screening versions of the PCL. Although some psychometric support was achieved (e.g., high sensitivity), use of the Lang and Stein PCL item subsets for screening natural disaster survivors appears unjustified on the basis of the present data.",0 +https://doi.org/10.1136/oemed-2014-102362.172,0429 Chronic Probable Posttraumatic Stress Disorder among Police Registrants in the World Trade Centre Health Registry Ten Years after 9/11/01,"

Objectives

The World Trade Centre Health Registry (WTCHR) prospectively follows a cohort of over 71 000 individuals who reported being directly exposed to the 9/11/01 terrorist attack. Among police registrants at Survey Wave 2, 5–6 years after 9/11/01, four unique trajectories of probable PTSD symptoms were identified: resilient (83%), recovered (2.5%), delayed onset (11.2%) and chronic (5.3%). The current study documents the longitudinal trajectories of PTSD in police officers exposed to the WTC attacks at Wave 3 (2011–2012), over 10 years since the WTC attack.

Method

We examined the prevalence of probable PTSD at the Wave 3 survey using a cut-off score of 44 or greater on the event-specific Posttraumatic Stress Disorder Checklist (PCL) and at least one re-experiencing symptom (DSM-IV criterion B), three avoidance or numbing symptoms (DSM-IV criterion C), and two hyperarousal symptoms (DSM-IV criterion D).

Results

Probable PTSD was 14.4% (95% CI 13.0–15.9%) at Wave 2 and 12.9% (95% CI, 11.6–14.3%) at Wave 3. Significant predictors of chronic probable PTSD 10 years post-disaster (n = 59/2241, 2.6%) include age 45–69 (aOR 3.16, 95% CI, 1.7–6.0), number of stressful events witnessed on 9/11/01 (aOR 3.00, 1.6–5.8), five or more stressful life events since 9/11/01 (aOR 5.42, 1.9–15.2), and unmet mental health care needs (aOR 6.86, 3.3–14.1). Protective factors include social support (aOR 0.34, 0.1–0.97) and number of close friends or relatives (aOR 0.92, 0.87–0.98).

Conclusions

Chronic probable PTSD among police responders continues to be a significant problem, associated both with intervening stressful life events and unmet mental health care needs.",0 +https://doi.org/10.1016/j.neuroscience.2011.09.032,Pharmacological inhibition of endocannabinoid degradation modulates the expression of inflammatory mediators in the hypothalamus following an immunological stressor,"The endocannabinoid system is an important regulator of the nervous, neuroendocrine, and immune systems, thus representing a novel therapeutic target for stress-related neuroinflammatory and psychiatric disorders. However, there is a paucity of data relating to the effects of endocannabinoids on neuroinflammatory mediators following an immune stress/challenge in vivo. This study investigated the effects of URB597, a selective inhibitor of fatty acid amide hydrolyase (FAAH), the enzyme that preferentially metabolizes anandamide, on lipopolysaccharide (LPS)-induced increases in the expression of immune mediators in the hypothalamus. Systemic administration of URB597 increased the levels of anandamide and the related N-acylethanolamines, N-palmitoylethanolamide, and N-oleoylethanolamide, but not 2-arachidonoyl glycerol, in the hypothalamus and spleen. URB597 attenuated the LPS-induced increase in interleukin (IL)-1β expression while concurrently augmenting the LPS-induced increase in suppressor of cytokine signalling (SOCS)-3 expression. In addition, URB597 tended to enhance and reduce the LPS-induced increase in IL-6 and IL-10 mRNA expression, respectively. LPS-induced increases in peripheral cytokine levels or plasma corticosterone were not altered by URB597. The present study provides evidence for a role for FAAH in the regulation of LPS-induced expression of inflammatory mediators in the hypothalamus. Improved understanding of endocannabinoid-mediated regulation of neuroimmune function has fundamental physiological and potential therapeutic significance in the context of stress-related disorders.",0 +https://doi.org/10.1371/journal.pone.0074657,Neural Correlates of Psychotherapy in Anxiety and Depression: A Meta-Analysis,"Several studies have used neuroimaging methods to identify neural change in brain networks associated to emotion regulation after psychotherapy of depression and anxiety. In the present work we adopted a meta-analytic technique specific to neuroimaging data to evaluate the consistence of empirical findings and assess models of therapy that have been proposed in the literature. Meta-analyses were conducted with the Activation Likelihood Estimation technique, which evaluates the overlap between foci of activation across studies. The analysis included 16 studies found in Pubmed (200 foci of activation and 193 patients). Separate meta-analyses were conducted on studies of 1) depression, post-traumatic stress disorder and panic disorder investigated with rest state metabolism (6 studies, 70 patients); 2) depression, post-traumatic stress disorder and panic disorder investigated with task-related activation studies (5 studies, 65 patients); 3) the previous studies considered jointly; and 4) phobias investigated with studies on exposure-related activation (5 studies, 57 patients). Studies on anxiety and depression gave partially consistent results for changes in the dorsomedial prefrontal cortex and in the posterior cingulated gyrus/precuneus. Several areas of change in the temporal lobes were also observed. Studies on the therapy of phobia were consistent with a reduction of activity in medial temporal areas. The cluster of change in the prefrontal cortex may refer to increased recruitment of control processes, as hypothesized by influential models of emotion regulation changes due to psychotherapy. However, not all areas associated with controlled emotion regulation were detected in the meta-analysis, while involvement of midline structures suggested changes in self-related information processing. Changes in phobia were consistent with reduced reactivity to phobic stimuli.",0 +https://doi.org/10.1016/j.jad.2014.12.008,"Comorbidity in pediatric bipolar disorder: Prevalence, clinical impact, etiology and treatment","Research on pediatric bipolar disorder (PBD) is providing a plethora of empirical findings regarding its comorbidity. We addressed this question through a systematic review concerning the prevalence, clinical impact, etiology and treatment of main comorbid disorders involved.A comprehensive database search was performed from 1990 to August 2014. Overall, 167 studies fulfilled the inclusion criteria.Bipolar youth tend to suffer from comorbid disorders, with highest weighted mean prevalence rate arising from anxiety disorders (54%), followed by attention deficit hyperactivity disorder (ADHD) (48%), disruptive behavior disorders (31%), and substance use disorders (SUD) (31%). Furthermore, evidence indicates that ADHD and anxiety disorders negatively affect the symptomatology, neurocognitive profile, clinical course and the global functioning of PBD. Likewise, several theories have been posited to explain comorbidity rates in PBD, specifically common risk factors, one disorder being a risk factor for the other and nosological artefacts. Lastly, randomized controlled trials highlight a stronger therapeutic response to stimulants and atomoxetine (vs. placebo) as adjunctive interventions for comorbid ADHD symptoms. In addition, research focused on the treatment of other comorbid disorders postulates some benefits from mood stabilizers and/or SGA.Epidemiologic follow-up studies are needed to avoid the risk of nosological artefacts. Likewise, more research is needed on pervasive developmental disorders and anxiety disorders, especially regarding their etiology and treatment.Psychiatric comorbidity is highly prevalent and is associated with a deleterious clinical effect on pediatric bipolarity. Different etiological pathways may explain the presence of these comorbid disorders among bipolar youth. Standardized treatments are providing ongoing data regarding their effectiveness for these comorbidities among bipolar youth.",0 +https://doi.org/10.1002/cpp.426,"The assessment of psychological symptoms of patients referred to community mental health teams: distress, chronicity and life interference","Mental health trusts are concerned to allocate scarce resources to those patients requiring secondary care services, rather than to those who can be managed in the community. It is important therefore to gain insight into the types of patient being referred into community mental health teams. This study was undertaken to explore this question. 421 patients completed the General Health Questionnaire and a newly devised symptom checklist, which allows assessment of distress/severity, chronicity and interference with life of individual symptoms. 81% of patients met criteria for caseness on the GHQ and those who did not still had a number of chronic symptoms. In regard to specific symptom profiles referred patients endorsed a wide variety of symptoms, related to anxiety, depression and impulse control. The most common anxiety symptom related to adjustment reactions and possibly post-traumatic stress. The most common mood symptom was mood instability, followed by fatigue and sleep problems. The majority of patients believed that they had had their symptoms and problems for longer than a year, indicating that many of the referrals to community teams are not short-term crises. Data suggests that the vast majority of referrals are appropriate but also point to a need for specific forms of intervention for the most common symptoms. Copyright © 2004 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1002/jts.21802,Gender Differences in Posttraumatic Stress Symptoms Among OEF/OIF Veterans: An Item Response Theory Analysis,"Establishing whether men and women tend to express different symptoms of posttraumatic stress in reaction to trauma is important for both etiological research and the design of assessment instruments. Use of item response theory (IRT) can reveal how symptom reporting varies by gender and help determine if estimates of symptom severity for men and women are equally reliable. We analyzed responses to the PTSD Checklist (PCL) from 2,341 U.S. military veterans (51% female) who completed deployments in support of operations in Afghanistan and Iraq (Operation Enduring Freedom/Operation Iraqi Freedom [OEF/OIF]), and tested for differential item functioning by gender with an IRT-based approach. Among men and women with the same overall posttraumatic stress severity, women tended to report more frequent concentration difficulties and distress from reminders whereas men tended to report more frequent nightmares, emotional numbing, and hypervigilance. These item-level gender differences were small (on average d = 0.05), however, and had little impact on PCL measurement precision or expected total scores. For practical purposes, men's and women's severity estimates had similar reliability. This provides evidence that men and women veterans demonstrate largely similar profiles of posttraumatic stress symptoms following exposure to military-related stressors, and some theoretical perspectives suggest this may hold in other traumatized populations.",0 +https://doi.org/10.1016/j.jad.2012.01.001,The role of executive function in posttraumatic stress disorder: A systematic review,"Although posttraumatic stress disorder (PTSD) has been associated with disturbances in verbal memory, studies examining executive functioning in PTSD show mixed results.A systematic review and meta-analysis were performed to compare executive functioning in patients with current PTSD and controls without any psychiatric disorder. Standard mean differences (SMD) in executive functioning scores were calculated using random-effects models. Covariates were added to examine whether differences exist between subgroups.Across 18 studies, 1080 subjects were included. In comparison with 431 exposed controls and 227 healthy controls, 422 people with PTSD showed significantly impaired executive functioning. Subgroup analyses revealed more pronounced differences between PTSD patients and exposed controls than healthy controls. Male gender, higher age, war trauma, and higher severity of co-morbid depressive symptoms were related to poorer executive functioning in PTSD patients compared to exposed controls.Due to insufficient data and heterogeneity, not all subgroup differences or characteristics could be taken into account.Overall, PTSD patients were found to show impaired executive functioning. Future research should further elucidate the subgroup effects and focus on clinical implications with regard to daily functioning and treatment outcome.",0 +,USING LATENT PROFILE MODELS AND UNSTRUCTURED GROWTH MIXTURE MODELS TO ASSESS THE NUMBER OF LATENT CLASSES IN GROWTH MIXTURE MODELING,"Growth mixture modeling has gained much attention in applied and methodological social science research recently, but the selection of the number of latent classes for such models remains a challenging issue. This problem becomes more serious when one of the key assumptions of this model, proper model-specification is violated. The current simulation study compared the performance of a linear growth mixture model in determining the correct number of latent classes against two less parametrically restricted options, a latent profile model and an unstructured growth mixture model. A variety of conditions were examined, both for properly and improperly specified models. Results indicate that prior to the application of linear growth mixture model, the unstructured growth mixture model is a promising way to identify the correct number of unobserved groups underlying the data by using most model fit indices across all the conditions investigated in this study. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1016/j.jaac.2010.02.011,Posttraumatic Stress Disorder Symptom Structure in Injured Children: Functional Impairment and Depression Symptoms in a Confirmatory Factor Analysis,"To examine the factor structure of posttraumatic stress disorder (PTSD) symptoms in children and adolescents who have experienced an acute single-incident trauma, associations between PTSD symptom clusters and functional impairment, and the specificity of PTSD symptoms in relation to depression and general distress.Examined PTSD symptom structure in two samples of children (8 to 17 years of age) assessed an average of 6 months after unintentional injury: (1) a combined dataset of 479 children assessed with a PTSD symptom checklist, and (2) a sample of 204 children assessed via a standardized clinical interview. We evaluated the fit of six alternative models for the factor structure of PTSD symptoms, and the association of PTS symptom clusters with indicators of functional impairment. We then evaluated three models for the structure of PTSD and depression symptoms jointly, to examine specificity of PTSD versus general distress or mood symptoms.In both samples, the DSM-IV 3-factor model fit the data reasonably well. Two alternative four-factor models fit the data very well: one that separates effortful avoidance from emotional numbing, and one that separates PTSD-specific symptoms from general emotional distress. Effortful avoidance and dysphoria symptoms were most consistently associated with impairment. The best-fitting model for PTSD and depression symptom clusters had three factors: PTSD-specific, depression-specific, and general dysphoria symptoms.The DSM-IV model for PTSD symptom categories was a reasonable fit for these child data, but several alternative models fit equally well or better, and suggest potential improvements to the current diagnostic criteria for PTSD in children.",0 +https://doi.org/10.1002/da.21889,"THE DISSOCIATIVE SUBTYPE OF POSTTRAUMATIC STRESS DISORDER: RATIONALE, CLINICAL AND NEUROBIOLOGICAL EVIDENCE, AND IMPLICATIONS","Background Clinical and neurobiological evidence for a dissociative subtype of posttraumatic stress disorder (PTSD) has recently been documented. A dissociative subtype of PTSD is being considered for inclusion in the forthcoming Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) to address the symptoms of depersonalization and derealization found among a subset of patients with PTSD. This article reviews research related to the dissociative subtype including antecedent, concurrent, and predictive validators as well as the rationale for recommending the dissociative subtype. Methods The relevant literature pertaining to the dissociative subtype of PTSD was reviewed. Results Latent class analyses point toward a specific subtype of PTSD consisting of symptoms of depersonalization and derealization in both veteran and civilian samples of PTSD. Compared to individuals with PTSD, those with the dissociative subtype of PTSD also exhibit a different pattern of neurobiological response to symptom provocation as well as a differential response to current cognitive behavioral treatment designed for PTSD. Conclusions We recommend that consideration be given to adding a dissociative subtype of PTSD in the revision of the DSM. This facilitates more accurate analysis of different phenotypes of PTSD, assist in treatment planning that is informed by considering the degree of patients’ dissociativity, will improve treatment outcome, and will lead to much-needed research about the prevalence, symptomatology, neurobiology, and treatment of individuals with the dissociative subtype of PTSD.",0 +https://doi.org/10.1023/a:1022641916705,,"Empirical evidence was provided on the utility of the Screen for Adolescent Violence Exposure (SAVE) in assessing adolescent exposure to school, home, and community violence. The SAVE was empirically developed on 1,250 inner-city adolescents, and obtained excellent reliability and validity. Both exploratory and confirmatory factor analyses identified three factors: Traumatic Violence, Indirect Violence, and Physical/Verbal Abuse. The SAVE demonstrated utility in classifying high- and low-violence participants, and correlated significantly with both objective crime data and theoretically relevant constructs (anger, posttraumatic stress symptoms, and internalizing/externalizing problems). Thus, the SAVE provides measurement of the stressor criterion associated with posttraumatic stress disorder, and allows quantification of severity of violence exposure by setting.",0 +https://doi.org/10.1176/appi.ajp.162.3.545,The Role of Peritraumatic Dissociation and Gender in the Association Between Trauma and Mental Health in a Palestinian Community Sample,"This research focused on gender-specific trauma exposure and mental health symptoms among Palestinians living in conditions of military violence. It also examined the gender-specific role of peritraumatic dissociation in moderating the association between lifetime trauma and mental health.A random sample of 311 Palestinian women and 274 men ages 16-60 years from the Gaza Strip participated. The subjects were asked about lifetime trauma and peritraumatic dissociation during their most severe traumatic experience. Mental health was indicated by total scores and diagnostic variables of posttraumatic stress disorder (PTSD), anxiety, mood (depression), and somatization disorders. Symptoms of hostility were assessed as a total score.The women reported a lower level of lifetime trauma than the men, but exposure to trauma was associated with PTSD among both genders. Exposure to lifetime trauma was further associated with anxiety, mood, and somatoform disorders only among women but not among men. No gender differences were found in the level of peritraumatic dissociation. Analyses on moderating effects showed that peritraumatic dissociation made both men and women more vulnerable to symptoms of hostility and men to depressive symptoms when they were exposed to lifetime trauma.The results are consistent with previous studies in more peaceful conditions: men experience more traumatic events, whereas exposure is associated with more severe psychiatric disorders among women. Peritraumatic dissociation as an acute response to trauma constituted a risk for mental health symptoms in both genders.",0 +https://doi.org/10.1177/1359105313483644,Posttraumatic reactions to an earthquake: Multidimensional scaling profile analysis of adolescent survivors,"The current study examined the prototypical profiles of posttraumatic stress reactions among a sample of 282 adolescent survivors of the 2008 Wenchuan earthquake in China. Based on a dimensional perspective, the results of profile analysis via multidimensional scaling (PAMS) model revealed a two-dimensional solution corresponding to four profiles: intrusion, avoidance/arousal, partial avoidance, and hyperarousal. These profiles of posttraumatic stress symptoms equally manifested across gender. In addition, the Intrusion Profile was found to be associated with more elevated psychological distress symptoms. Results are discussed with respect to the typical posttraumatic stress symptoms following the earthquake.",0 +https://doi.org/10.1097/yco.0b013e32833ead33,Effects of childhood development on late-life mental disorders,"To explore recent findings bridging childhood development and common late-life mental disorders in the elderly.We addressed aging as a part of the developmental process in central nervous system, typical and atypical neurodevelopment focusing on genetic and environmental risk factors and their interplay and links between psychopathology from childhood to the elderly, unifying theoretical perspectives and preventive intervention strategies.Current findings suggest that childhood development is strictly connected to psychiatric phenotypes across the lifespan. Although we are far from a comprehensive understanding of mental health trajectories, some initial findings document both heterotypic and homotypic continuities from childhood to adulthood and from adulthood to the elderly. Our review also highlights the urgent need for investigations on preventive interventions in individuals at risk for mental disorders.",0 +https://doi.org/10.1002/car.1083,"Profiles of adult survivors of severe sexual, physical and emotional institutional abuse in Ireland","Adult survivors of institutional abuse were interviewed with a comprehensive assessment protocol which included the Childhood Trauma Questionnaire, the Institutional Child Abuse Processes and Coping Inventory, the Structured Clinical Interviews for DSM IV axis I disorders and personality disorders, the Trauma Symptoms Inventory, a Life Problems Checklist, the Experiences in Close Relationships Inventory and the Kansas Marital Satisfaction Scale. Profiles were identified for subgroups who described severe sexual (N=60), physical (N=102), or emotional (N=85) abuse as their worst forms of maltreatment. Survivors of severe sexual abuse had the most abnormal profile, which was characterized by higher rates of all forms of child maltreatment and higher rates of posttraumatic stress disorder, alcohol and substance abuse, antisocial personality disorder, trauma symptoms, and life problems",0 +https://doi.org/10.1016/j.aap.2010.10.004,Predictive factors of chronic post-traumatic stress disorder 6 months after a road traffic accident,"This study sets out to identify risk factors for post-traumatic stress disorder (PTSD) after a road traffic accident with a view to improving prevention.The study used a prospective cohort of road traffic accident casualties. All subjects over 15 years of age were recruited in the course of an interview conducted while they were receiving care in a hospital of the Rhône area administrative département. Six months after their accident, they answered a self-administered postal questionnaire that included the Post-traumatic Check-List Scale (PCLS) in order to evaluate PTSD. Multivariate logistic regression analysis was conducted to compare those subjects with a PCLS score of 44 or over with those with a lower score, in order to identify factors that might be associated with PTSD.592 subjects (out of 1168) returned the 6-month questionnaire and 541 completed the PCLS test. One hundred subjects had a PCLS score ≥ 44, suggesting PTSD, and 441 subjects did not. The factors associated with PTSD were initial injury severity, post-traumatic amnesia, the feeling of not being responsible for their accident and persistent pain 6 months after it. A lower odds-ratio was associated with users of two-wheel than four-wheel motor vehicles (OR=0.4; 0.2-0.9).Besides predictive factors for PTSD (injury severity, post-traumatic amnesia and the feeling of not being responsible for their accident), our study suggested a reduced risk of PTSD among two-wheel motor vehicle users.",0 +https://doi.org/10.1176/ajp.152.8.1150,Trauma-related symptoms in veterans of Operation Desert Storm: a 2-year follow-up,"This study was a 2-year follow-up in an ongoing prospective examination of development of trauma-related symptoms over time in a community group of veterans of Operation Desert Storm.Sixty-two National Guard reservists, from one medical and one military police unit, completed the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder and a DSM-III-R-based posttraumatic stress disorder (PTSD) symptom scale 1 month, 6 months, and 2 years after returning from the Middle East. Differences in symptom severity over time were analyzed by using repeated measure analyses of variance.Scores on the Mississippi scale, but not the DSM-III-R PTSD scale, increased significantly over time. Symptoms of hyperarousal were more severe at all time points than were symptoms of reexperiencing or avoidance. Level of combat exposure, as reflected by the Desert Storm trauma questionnaire, was significantly associated with the score on the Mississippi scale at 2 years but not at 1 month or 6 months. All subjects who met the Mississippi scale's diagnostic criteria for PTSD at 1 or 6 months still met the criteria at 2 years.Although symptoms were relatively mild, there was an overall increase in PTSD symptoms over 2 years. The statistical relationship between level of combat exposure and PTSD symptoms at 2 years, and not before, suggests that it may take time for the consequences of traumatic exposure to become apparent. Moreover, degree of exposure may be important in predicting the eventual development of symptoms. Continued follow-up will address the evolution of PTSD symptoms in Gulf War veterans.",0 +https://doi.org/10.1001/archpsyc.63.11.1238,Intelligence and Other Predisposing Factors in Exposure to Trauma and Posttraumatic Stress Disorder,"Prospective data on standardized measures of early predispositions would allow a strong test of hypotheses about suspected risk factors of posttraumatic stress disorder (PTSD) and exposure to traumatic events.To prospectively examine the extent to which intelligence, anxiety disorders, and conduct problems in childhood influence the risk for PTSD and for exposure to traumatic events.A longitudinal study of a randomly selected sample assessed at age 6 years and followed up to age 17 years.Samples were randomly selected from the 1983-1985 newborn discharge lists of 2 major hospitals in southeast Michigan (N=823).Cohort members with follow-up data at age 17 years (n=713; 86.6% of the initial sample).Cumulative exposure up to age 17 years of qualifying traumatic events; DSM-IV PTSD among participants who have experienced 1 or more traumatic events.Youth with teacher ratings of externalizing problems above the normal range at age 6 years were at increased risk for exposure to assaultive violence (adjusted odds ratio, 2.6; 95% confidence interval, 1.4-4.9). Youth aged 6 years with an IQ greater than 115 had decreased risk for exposure to traumatic events (adjusted odds ratio for assaultive violence, 0.3; 95% confidence interval, 0.2-0.7); a decreased risk for nonassaultive trauma (adjusted odds ratio, 0.6; 95% confidence interval, 0.3-0.9); and a decreased conditional risk for PTSD (adjusted odds ratio, 0.2; 95% confidence interval, 0.1-0.9). The conditional risk for PTSD was increased for youth with anxiety disorders and teacher ratings of externalizing problems above the normal range at 6 years of age.The results of this prospective community study highlight the role of intelligence in avoidance of exposure to traumatic experiences and their PTSD effects. They underscore the need for investigating cognitive processes in persons' responses to traumatic experiences and the involvement of general intelligence in these processes.",0 +https://doi.org/10.1016/j.janxdis.2014.09.002,A historical review of trauma-related diagnoses to reconsider the heterogeneity of PTSD,"Based on the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, there are 636,120 ways for an individual to qualify for a diagnosis of posttraumatic stress disorder (PTSD) (Galatzer-Levy & Bryant, 2013). To unravel this heterogeneity, we examine the historical trajectory of trauma-related diagnoses. Our review addresses four traumas (i.e., combat, natural disaster, life-threatening accident and sexual assault) that have contributed the most to conceptual models of PTSD. Although these trauma types are all subsumed under the same diagnostic label, our literature review indicates that the psychological consequences of different traumatic experiences are traditionally studied in isolation. Indeed, most research addresses hypotheses regarding specific trauma types using samples of individuals selected for their experience with that specific event. We consider the possibility that PTSD is not a single, unified construct and what this means for future research and clinical applications.",0 +https://doi.org/10.1080/15299732.2012.710184,Trauma Typology as a Risk Factor for Aggression and Self-Harm in a Complex PTSD Population: The Mediating Role of Alterations in Self-Perception,"This study examined the role of prolonged, repeated traumatic experiences such as childhood and sectarian trauma in the development of posttraumatic aggression and self-harm. Forty-four adult participants attending therapy for complex trauma in Northern Ireland were obtained via convenience sampling. When social desirability was controlled, childhood emotional and physical neglect were significant correlates of posttraumatic hostility and history of self-harm. These relationships were mediated by alterations in self-perception (e.g., shame, guilt). Severity of sectarian-related experiences was not related to self-destructive behaviors. Moreover, none of the trauma factors were related to overt aggressive behavior. The findings have implications for understanding risk factors for posttraumatic aggression and self-harm, as well as their treatment.",0 +https://doi.org/10.1037/tra0000095,"Profiles of childhood trauma: Betrayal, frequency, and psychological distress in late adolescence.","With an emphasis on betrayal trauma, this study used latent profile analysis to examine how childhood traumas co-occur and whether trauma patterns differentially predicted psychological distress.A community sample of 806 adolescents and young adults participated. Youths reported their trauma histories, and lifetime DSM-IV disorders were assessed using a structured diagnostic interview.Latent profile analysis yielded 5 profiles: high betrayal trauma physical violence and emotional abuse (HBTPE), high betrayal trauma sexual and emotional abuse (HBTSE), low betrayal trauma (LBT), parent death (PD), and a no/low trauma profile. Logistic regression analyses compared youths in the no/low trauma profile to those in the trauma profiles. Youths in the HBTPE profile were more likely to have moderate/severe major depressive disorder (odds ratio [OR] = 2.92, 95% CI [1.16, 7.32]), posttraumatic stress disorder (OR = 4.33, 95% CI [1.34, 14.03]), and hallucinations (OR = 5.03, 95% CI [2.00, 12.67]); youths in the HBTSE and LBT profiles were more likely to experience hallucinations (OR = 3.19, 95% CI [1.21, 8.39] and OR = 3.20, 95% CI [1.01, 10.19], respectively); and youths in the PD profile were more likely to have moderate/severe depression (OR = 2.42, 95% CI [1.07, 5.43]).Specific trauma types co-occurred when considering type, level of betrayal, and frequency. The emergence of the 2 high betrayal trauma profiles, with differing symptom presentations, suggests that experiences of high betrayal traumas are not homogenous and specific trauma-focused interventions may be more appropriate for differing trauma profiles.",0 +,Brittle diabetes: psychopathological aspects.,"The term ""brittle"" is used to described an uncommon subgroup of type I diabetics whose lives are disrupted by severe glycaemic instability with repeated and prolonged hospitalization. Psychosocial problems are the major perceived underlying causes of brittle behaviour. Aim of this study is a systematic psychopathological assessment of brittleness using specific parameters of general psychopathology and personality traits following the multiaxial format (axis I and II) of the current DSM-IV-TR diagnostic criteria for mental disorders.Patients comprised 21 brittle type I diabetics and a case-control group of 21 stable diabetics, matched for age, gender, years of education, and diabetes duration. General psychopathology and the DSM-IV-TR personality traits/disorders were assessed using the Syptom Checklist-90-R (SCL-90-R) and the Millon Clinical Multiaxial Inventory-III (MCMI-III).The comparison for SCL-90-R parameters exclusively revealed higher scores in ""Phobic Anxiety"" subscale in brittle diabetics. No differences in all the other SCL-90-R primary symptom dimensions and in the three SCL-90-R global distress indices were observed between the two diabetic groups, as well as in the all MCMI-III clinical syndrome categories corresponding to DSM-IV-TR specific psychiatric disorders. However, brittle patients presented lower scores in MCMI-III compulsive personality traits and higher scores in paranoid, schizoid, schizotypal, antisocial, borderline, narcissistic, avoidant, dependent, depressive, and passive-aggressive personality traits.In this study, brittle diabetics show no differencies in terms of global severity of psychopathological distress and axis I specific DSM-IV-TR diagnoses in comparison with non-brittle subjects (except for phobic anxiety). Differently, brittle diabetics are characterized from less functional and maladaptive personality features and suffer more frequently and intensively from specific pathological personality traits of all DSM-IV-TR clusters.",0 +https://doi.org/10.1016/s0006-3223(95)00648-6,Relationships between hormonal profile and novelty seeking in combat-related posttraumatic stress disorder,"This study examines relationships between hormonal levels and novelty seeking in a group of 27 Vietnam veterans with combat-related posttraumatic stress disorder (PTSD). Novelty seeking in the veteran sample, measured by the Cloninger Tridimensional Personality Questionnaire (TPQ), was almost twice as high as previously published norms. A distinctive pattern of significant positive correlations was found between novelty seeking scores and serum total triiodothyronine (T3), free T3, the T3/free thyroxine (FT4) ratio, urinary norepinephrine and the norepinephrine/cortisol ratio, while a negative correlation was found between novelty seeking scores and urinary cortisol levels. The findings were confirmed by t test analyses of high vs low novelty seeking subgroups and do not appear to be related simply to the severity of PTSD. These preliminary findings indicate the need to include measures of characterological traits in psychoendocrine studies of PTSD and to investigate their possible usefulness in subtyping this disorder.",0 +https://doi.org/10.1002/jts.21709,Ethnic differences in symptoms among female veterans diagnosed with PTSD,"Among U.S. male Vietnam veterans, Hispanics have been shown to have higher rates of posttraumatic stress disorder (PTSD) than African Americans and non-Hispanic Whites (Kulka et al., 1990). In terms of gender, Tolin and Foa's (2006) meta-analysis suggested women experience higher rates of PTSD than men. This study examined ethnic differences in PTSD and other symptomatology among 398 female veterans (63% non-Hispanic White, 28% Hispanic, 9% African American) seeking treatment for PTSD from 1995 to 2009 at a Veterans Administration (VA) behavioral health clinic. The following symptom clusters were examined: anxiety/PTSD, depression, anger/hostility, and psychotic/dissociative symptoms. Few differences were found among the groups, suggesting the 3 ethnic groups studied were more similar than different. African American female veterans, however, scored higher on measuring ideas of persecution/paranoia, although this may reflect an adaptive response to racism. These findings warrant further investigation to elucidate this relationship.",0 +https://doi.org/10.3402/ejpt.v6.28766,Less is more? Assessing the validity of the ICD-11 model of PTSD across multiple trauma samples,"In the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the symptom profile of posttraumatic stress disorder (PTSD) was expanded to include 20 symptoms. An alternative model of PTSD is outlined in the proposed 11th edition of the International Classification of Diseases (ICD-11) that includes just six symptoms.The objectives of the current study are: 1) to independently investigate the fit of the ICD-11 model of PTSD, and three DSM-5-based models of PTSD, across seven different trauma samples (N=3,746) using confirmatory factor analysis; 2) to assess the concurrent validity of the ICD-11 model of PTSD; and 3) to determine if there are significant differences in diagnostic rates between the ICD-11 guidelines and the DSM-5 criteria.The ICD-11 model of PTSD was found to provide excellent model fit in six of the seven trauma samples, and tests of factorial invariance showed that the model performs equally well for males and females. DSM-5 models provided poor fit of the data. Concurrent validity was established as the ICD-11 PTSD factors were all moderately to strongly correlated with scores of depression, anxiety, dissociation, and aggression. Levels of association were similar for ICD-11 and DSM-5 suggesting that explanatory power is not affected due to the limited number of items included in the ICD-11 model. Diagnostic rates were significantly lower according to ICD-11 guidelines compared to the DSM-5 criteria.The proposed factor structure of the ICD-11 model of PTSD appears valid across multiple trauma types, possesses good concurrent validity, and is more stringent in terms of diagnosis compared to the DSM-5 criteria.",0 +https://doi.org/10.1111/camh.12050,Posttraumatic stress symptoms and structure among orphan and vulnerable children and adolescents in Zambia,"Background Scant information exists on posttraumatic stress disorder (PTSD) symptoms and structure in youth from developing countries. Methods We describe the symptom profile and exposure to trauma experiences among 343 orphan and vulnerable children and adolescents from Zambia. We distinguished profiles of posttraumatic stress symptoms using latent class analysis. Results Average number of trauma-related symptoms (21.6; range 0–38) was similar across sex and age. Latent class model suggested three classes varying by level of severity: low (31% of the sample), medium (45% of the sample), and high (24% of the sample) symptomatology. Conclusions Results suggest that PTSD is a continuously distributed latent trait.",0 +https://doi.org/10.7205/milmed-d-14-00119,Identifying Classes of Veterans With Multiple Risk Factors,"As researchers examine the efficacy of interventions that simultaneously target more than 1 symptom, it is important to identify ways to help guide research and program development. This study used electronic medical record data to examine the covariation of multiple risk factors regularly assessed among primary care patients. It also examined the health care utilization of those patients identifying where the health care system came in contact with them to help identify the ideal locations these interventions may be most often used. We obtained data for six risk factors, as well as the number of primary care, mental health, and emergency department visits, from Veteran patients with a primary care visit. There were three main groups of primary care patients, identified using latent class analysis and regression. Although the smallest group, the ""High Treatment Need"" group, had an increased probability of screening positive for all four risk factors, the post-traumatic stress disorder screen was a significant discriminator of this group from the others. Results show that this group had the greatest number of encounters in all health care locations suggesting significant opportunities for intervention. However, future research is needed to examine the current interventions offered and potential avenues where risk factors may be addressed simultaneously.",0 +https://doi.org/10.1080/14616730701868597,"Attachment styles, traumatic events, and PTSD: a cross-sectional investigation of adult attachment and trauma","The aim of the present study was to examine the association between post-traumatic stress disorder (PTSD) and adult attachment in a young adult population. A sample of 328 Danish students (mean age 29.2 years) from four different schools of intermediate education level were studied by the Harvard Trauma Questionnaire (HTQ), the Revised Adult Attachment Scale (RAAS), the Trauma Symptom Checklist (TSC), the Crisis Support Scale (CSS), the Coping Style Questionnaire (CSQ), and the World Assumption Scale (WAS). Attachment styles were associated with number of PTSD symptoms, negative affectivity, somatization, emotional coping, attributions, and social support. The distribution of attachment styles in relation to PTSD symptoms could be conceived as uni-dimensional.",0 +,The Posttraumatic Stress Disorder (PTSD) Family Workshop: A Pilot Study of Preliminary Outcomes and Effect Sizes of an Attachment-Based Intervention for Family Members of Veterans with Combat-Related PTSD,"Objective. Social support and secure attachment confer protection against the development of post traumatic stress disorder (PTSD) after trauma exposure. Yet there are few empirically-supported interventions for PTSD that address the impact on the family and significant relationships. This research is an intervention development study for ""The PTSD Family Workshop,"" an attachment-based group intervention for family members of veterans with combat-related PTSD. The study examines preliminary outcomes and treatment effect sizes and tests research hypotheses. Methods. Research hypotheses were tested through an adaptation of a partial crossover design. All research was conducted at the Stratton VA Medical Center and all participants were family members of veterans receiving treatment for combat-related PTSD. Intervention content includes PTSD psycho-education, a description of the impact of PTSD on their veterans and their important others and the factors that influence resilience and readjustment. Participants were recruited for participation in 4 group; each group being composed of an Immediate (n=17) and a Delay (n=11) condition. Participants completed standardized pre-test, post-delay and post-intervention assessments. Study domains included knowledge of PTSD, caregiver empathic concern, caregiver adaptive coping behavior and caregiver burden. Results. Data analyses revealed that participants who completed the PTSD Family Workshop reported a significant increase in their knowledge of PTSD, their empathic concern and their adaptive coping behaviors as compared to wait-list participants. Analyses of caregiver burden were not significant. Treatment effect sizes were calculated at d=1.66, d=.50 and d=.60 for knowledge of PTSD, caregiver empathic concern and caregiver adaptive coping behaviors respectively. Conclusion. Research findings support the development and study of innovative treatments for veterans with combat-related PTSD. Results are encouraging and suggest that brief intervention can be of benefit for family members of veterans with PTSD. Overall, this work increased access for psycho-education and support for family members of veterans in the VA system and provided preliminary data for a larger scale controlled study to test intervention efficacy and examine its relationship to outcomes for veterans. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0 +https://doi.org/10.1177/0004867414553948,Is implementation of the 2013 Australian treatment guidelines for posttraumatic stress disorder cost-effective compared to current practice? A cost-utility analysis using QALYs and DALYs,"Objective: To assess, from a health sector perspective, the incremental cost-effectiveness of three treatment recommendations in the most recent Australian Clinical Practice Guidelines for posttraumatic stress disorder (PTSD). The interventions assessed are trauma-focused cognitive behavioural therapy (TF-CBT) and selective serotonin reuptake inhibitors (SSRIs) for the treatment of PTSD in adults and TF-CBT in children, compared to current practice in Australia. Method: Economic modelling, using existing databases and published information, was used to assess cost-effectiveness. A cost-utility framework using both quality-adjusted life-years (QALYs) gained and disability-adjusted life-years (DALYs) averted was used. Costs were tracked for the duration of the respective interventions and applied to the estimated 12 months prevalent cases of PTSD in the Australian population of 2012. Simulation modelling was used to provide 95% uncertainty around the incremental cost-effectiveness ratios. Consideration was also given to factors not considered in the quantitative analysis but could determine the likely uptake of the proposed intervention guidelines. Results: TF-CBT is highly cost-effective compared to current practice at $19,000/QALY, $16,000/DALY in adults and $8900/QALY, $8000/DALY in children. In adults, 100% of uncertainty iterations fell beneath the $50,000/QALY or DALY value-for-money threshold. Using SSRIs in people already on medications is cost-effective at $200/QALY, but has considerable uncertainty around the costs and benefits. While there is a 13% chance of health loss there is a 27% chance of the intervention dominating current practice by both saving dollars and improving health in adults. Conclusion: The three Guideline recommended interventions evaluated in this study are likely to have a positive impact on the economic efficiency of the treatment of PTSD if adopted in full. While there are gaps in the evidence base, policy-makers can have considerable confidence that the recommendations assessed in the current study are likely to improve the efficiency of the mental health care sector.",0 +https://doi.org/10.1080/10705510701575396,Deciding on the Number of Classes in Latent Class Analysis and Growth Mixture Modeling: A Monte Carlo Simulation Study,"Mixture modeling is a widely applied data analysis technique used to identify unobserved heterogeneity in a population. Despite mixture models' usefulness in practice, one unresolved issue in the application of mixture models is that there is not one commonly accepted statistical indicator for deciding on the number of classes in a study population. This article presents the results of a simulation study that examines the performance of likelihood-based tests and the traditionally used Information Criterion (ICs) used for determining the number of classes in mixture modeling. We look at the performance of these tests and indexes for 3 types of mixture models: latent class analysis (LCA), a factor mixture model (FMA), and a growth mixture models (GMM). We evaluate the ability of the tests and indexes to correctly identify the number of classes at three different sample sizes (n = 200, 500, 1,000). Whereas the Bayesian Information Criterion performed the best of the ICs, the bootstrap likelihood ratio test ...",0 +https://doi.org/10.1046/j.1365-2850.2003.00526.x,Too tired to care? The psychological effects of working with trauma,"This quantitative and qualitative longitudinal study was designed to examine the effects on caregivers working therapeutically with seriously traumatized people. The participants were 13 healthcare workers seconded into a trauma and recovery team (TRT) set up to help those traumatized by the Omagh bombing on 15 August 1998. Quantitative data were collected using the Compassion Satisfaction/Fatigue Test and the Life Status Review Questionnaire. Qualitative data regarding positive and negative aspects of working with traumatized individuals, as well as caregiver's experience leaving the TRT, were gathered using open-ended questions contained in the final data set. These questionnaires were completed at four points in time: August 1998, December 1998, August 1999 and February 2001. Ethical approval for the study was gained from the Sperrin Lakeland Trust research committee. Analysis of the quantitative data indicated that levels of compassion fatigue and burnout increased, respectively, from 18.85 to 34.46 and 22.38 to 29.69 over the first year. Levels of compassion satisfaction decreased from 87.62 to 80.15, while levels of satisfaction with life (53.85 to 40.38) and life status (11.23 to 5.62) also decreased. Findings also demonstrated that compassion satisfaction is possibly a protective factor against compassion fatigue and burnout, in that caregivers with high compassion satisfaction scores were less likely to have corresponding high compassion fatigue and burnout scores. Findings from the qualitative data generated, revealed that team spirit and camaraderie, along with the satisfaction of seeing clients recover, were the most positive aspects of working in the team. Media interest, coping with and containing anger shown by bereaved relatives and dealing with the content of client's stories were the most negative. Themes to emerge from leaving the team included lack of understanding and support from non-trauma managers and an underestimation of the impact on caregivers of finishing in the team. Strategies that were found to be beneficial in helping to alleviate the negative effects of working with trauma were also elicited. This research has implications for practice, management and education.",0 +https://doi.org/10.1017/s0033291702005469,Characterizing the effects of sertraline in post-traumatic stress disorder,"Background. Sertraline has a proved efficacy in post-traumatic stress disorder (PTSD), but it is unknown which symptoms respond or in what sequence this occurs. Such information might be useful clinically and heuristically. Method. The study examined the effects of sertraline on the individual symptoms of PTSD. It also examined whether early changes in anger explained drug-induced change in other symptoms over time. Mixed models analysis was applied to datasets from two 12-week placebo-controlled trials of sertraline. A validated self-rating scale (DTS) was used to assess treatment efficacy. Results. Sertraline was superior to placebo on 15 of 17 symptoms, especially in the numbing and hyperarousal clusters. A strong effect was found on anger from week 1, which partly explained the subsequent effects of sertraline on other symptoms, some of which began to show significantly greater response to drug than to placebo at week 6 (emotional upset at reminders, anhedonia, detachment, numbness, hypervigilance) and week 10 (avoidance of activities, foreshortened future). Conclusions. Sertraline exercises a broad spectrum effect in PTSD. Effects are more apparent on the psychological rather than somatic symptoms of PTSD, with an early modulation of anger and, perhaps, other affects, preceding improvement in other symptoms.",0 +https://doi.org/10.1080/00140130701674406,The work compatibility improvement framework: preliminary findings of a case study for defining and measuring the human-at-work system,"Although researchers traditionally examined the 'risk' characteristics of work settings in health studies, few work models, such as the 'demand-control' and 'motivation-hygiene theory', advocated the study of the positive and the negative aspects of work for the ultimate improvement of work performance. The objectives of the current study were: (a) to examine the positive and negative characteristics of work in the machining department in a small manufacturing plant in the Midwest USA, and, (b) to report the prevalence of musculoskeletal and stress outcomes. A focus group consisting of worker experts from the different job categories in the machining department confirmed the management's concerns. Accordingly, 56 male and female workers, employed in three shifts, were surveyed on the demand/energizer profiles of work characteristics and self-reported musculoskeletal/stress symptoms. On average, one-fourth to one-third of the workers reported 'high' demand, and over 50% of the workers documented 'low' energizers for certain work domains/sub-domains, such as 'physical task content'/'organizational' work domains and 'upper body postural loading'/'time organization' work sub-domains. The prevalence of workers who reported 'high' musculoskeletal/stress disorder cases, was in the range of 25-35% and was consistent with the results of 'high' demands and 'low' energizers. The results of this case study confirm the importance of adopting a comprehensive view for work improvement and sustainable growth opportunities. It is paramount to consider the negative and positive aspects of work characteristics to ensure optimum organizational performance. The Work Compatibility Improvement Framework, proposed in the reported research, is an important endeavor toward the ultimate improvement and sustainable growth of human and organizational performance.",0 +https://doi.org/10.1080/00207411.2004.11043360,Post-traumatic Stress Disorder Symptoms in Children After the 1999 Marmara Earthquake in Turkey,"Objective: The aim of this study is to evaluate the symptoms of post-traumatic stress disorder in different age groups of children after the 1999 Marmara earthquake in Turkey. Method: The study included thirty-five patients, two to sixteen years old, who presented to the child and adolescent psychiatry department with symptoms of PTSD after the earthquake. An Earthquake Information Form and a Post-traumatic Stress Disorder Symptoms Checklist were filled out with clinical interviews of cases",0 +https://doi.org/10.1037/a0037593,Resilience in the initial year of caregiving for a family member with a traumatic spinal cord injury.,"Individuals who assume caregiving duties for a family member disabled in a traumatic injury often exhibit considerable distress, yet few studies have examined characteristics of those who may be resilient in the initial year of caregiving. Reasoning from the influential Pearlin model of caregiving (Pearlin & Aneshensel, 1994) and the resilience process model (Bonanno, 2005), we expected a significant minority of caregivers would be chronically distressed and another group would be resilient throughout the inaugural year of caregiving for a person with a traumatic spinal cord injury (SCI), and these groups would differ significantly in primary and secondary stress and in personal resources and mediators.Twenty men and 108 women who identified as caregivers for a family member who incurred a traumatic SCI consented to complete measures during the inpatient rehabilitation and at 1 month, 6 months, and 12 months postdischarge.Latent growth mixture modeling of depression symptoms over time revealed 3 groups of caregivers: chronic (24%), recovery (24%) and resilient (48%). The chronic group reported more anxiety, negative affect, and ill health than the other 2 groups throughout the year. The resilient group was best characterized by their enduring levels of positive affect and supportive social networks.A large percentage of individuals are resilient in the initial year of caregiving, and those who have problems adapting exhibit significant distress soon following the traumatic event. Early detection of and psychological interventions for individuals who have difficulty adjusting are indicated, as their distress is unlikely to abate untreated over the year.",0 +https://doi.org/10.1016/j.janxdis.2015.06.006,Characteristics of the traumatic stressors experienced by rural first responders,"First responders routinely experience work-related events that meet the definition of a traumatic stressor. Despite the high exposure to traumatic events, prevalence rates of posttraumatic stress disorder (PTSD) are relatively low. This discrepancy points to the potential value of identifying factors that distinguish those traumatic stressors that produce ongoing traumatic stress symptoms from those that do not. The present study surveyed 181 first responders from rural settings. A repeated-measures design was used to compare characteristics of traumatic stressors that were or were not associated with ongoing PTSD symptoms. A factor analysis revealed that distressing events were characterized by chaos and resource limitations. Consistent with contemporary models, two mediational analyses revealed that each event characteristic predicted peritraumatic dissociation and posttraumatic cognitions, which in turn predicted PTSD symptoms. Moreover, the effect of each event characteristic on PTSD symptoms was partially mediated by these cognitive processes.",0 +https://doi.org/10.1016/j.jpsychores.2010.09.017,A longitudinal investigation of posttraumatic stress disorder in patients with ovarian cancer,"Exposure to the aggressive and life-threatening nature of ovarian cancer and its treatment is potentially traumatic. However, little is known about the occurrence of posttraumatic stress disorder (PTSD) in these patients.A total of 121 women newly diagnosed with ovarian cancer were recruited into a prospective longitudinal study of the course of PTSD and the factors that predict its development and persistence. Between 82 and 111 were assessed at each of the four time points subsequent to their diagnosis, and 63 women provided complete data from the beginning of chemotherapy treatment, midtreatment, end of treatment and 3-months follow-up on PTSD.Between 36% and 45% of the total sample experienced PTSD at some point, with a nonsignificant but progressive increase in prevalence over time. Of those women with complete data, only 30% never experienced PTSD at any time. Most of the women were intermittent cases of PTSD (57%, n=36), while 13% (n=8) were persistent cases. Younger women were at higher risk of experiencing PTSD.The prevalence of women newly diagnosed with ovarian cancer with persistent PTSD is relatively low (13%); however, our findings highlight that the trajectory of the illness and its associated stressors may constitute an enormous challenge and may be perceived as traumatic and stressful for most of the women in our sample at least once. Repetitive screening for PTSD and the provision of psychological treatments could ameliorate PTSD symptoms.",0 +https://doi.org/10.1002/oti.93,Effects of trauma on children: occupational therapy to support recovery,"Each year millions of the world's children witness, are victimized by or participate in traumatic events, placing them at risk for developing post-traumatic stress disorder. If this disorder is left untreated, a child's developmental trajectory can be compromised. Occupational therapists are in key positions to recognize the signs and symptoms of post-traumatic stress in children that interfere with functioning. Expressive therapies, long used in occupational therapy practice, are well suited to help children achieve an adaptive response to trauma. Two brief case studies are presented, describing the application of occupational therapy using expressive media with children who experienced post-traumatic stress disorders. The results of this preliminary investigation suggest that occupational therapists working in early intervention programmes can be helpful in identifying children in need and in providing treatment based on expressive therapies, stress management and cognitive-behavioural modalities. Further research is recommended to examine the efficacy of different occupational therapy frames of reference in treating children with post-traumatic stress disorder. Copyright © 1999 Whurr Publishers Ltd.",0 +https://doi.org/10.1037/e579422006-001,What is Posttraumatic Stress Disorder?,"Our understanding of posttraumatic stress disorder (PTSD) has increased significantly over the last 2 decades. Although the cause of the condition is usually easy to determine in individual patients, the symptoms of PTSD are diverse and a mixture of psychological processes are involved. This article presents a broad overview of PTSD, including its definition according to DSM-IV and ICD-10 diagnostic criteria, and its clinical course with reference to its association with depression and other mental disorders. The article also briefly reviews the assessment of patients and considers physiologic features such as responses to startle stimuli that appear to be useful in diagnosing PTSD and in differentiating it from other anxiety disorders and depression. Finally, a brief overview of the treatment of PTSD is given, including psychological and biological treatment options.",0 +https://doi.org/10.1016/j.jemermed.2011.06.124,Post-traumatic Stress Disorder in an Emergency Department Population One Year after Hurricane Katrina,"Hurricane Katrina resulted in a significant amount of injury, death, and destruction.To determine the prevalence of, and risk factors for, symptoms of post-traumatic stress disorder (PTSD) in an emergency department (ED) population, 1 year after hurricane Katrina.Survey data including the Primary Care PTSD (PC-PTSD) screening instrument, demographic data, and questions regarding health care needs and personal loss were collected and analyzed.Seven hundred forty-seven subjects completed the survey. The PC-PTSD screen was positive in 38%. In the single variate analysis, there was a correlation with a positive PC-PTSD screen and the following: staying in New Orleans during the storm (odds ratio [OR] 1.73, 95% confidence interval [CI] 1.28-2.34), having material losses (OR 1.64, 95% CI 1.03-2.60), experiencing the death of a loved one (OR 1.96, 95% CI 1.35-1.87), needing health care during the storm (OR 2.01, 95% CI 1.48-2.73), and not having health care needs met during the storm (OR 2.00, 95% CI 1.26-3.18) or after returning to New Orleans (OR 2.29, 95% CI 1.40-3.73). In the multivariate analysis, the death of a loved one (OR 1.87, 95% CI 1.26-2.78), being in New Orleans during the storm (OR 1.69, 95% CI 1.22-2.33), and seeking health care during the storm (OR 1.69, 95% CI 1.22-2.35) were associated with positive PC-PTSD screens.There was a high prevalence of PTSD in this ED population surveyed 1 year after hurricane Katrina. By targeting high-risk patients, disaster relief teams may be able to reduce the impact of PTSD in similar populations.",0 +https://doi.org/10.1177/0956797612457389,Peace and War,"In the study reported here, we examined posttraumatic stress disorder (PTSD) symptoms in 746 Danish soldiers measured on five occasions before, during, and after deployment to Afghanistan. Using latent class growth analysis, we identified six trajectories of change in PTSD symptoms. Two resilient trajectories had low levels across all five times, and a new-onset trajectory started low and showed a marked increase of PTSD symptoms. Three temporary-benefit trajectories, not previously described in the literature, showed decreases in PTSD symptoms during (or immediately after) deployment, followed by increases after return from deployment. Predeployment emotional problems and predeployment traumas, especially childhood adversities, were predictors for inclusion in the nonresilient trajectories, whereas deployment-related stress was not. These findings challenge standard views of PTSD in two ways. First, they show that factors other than immediately preceding stressors are critical for PTSD development, with childhood adversities being central. Second, they demonstrate that the development of PTSD symptoms shows heterogeneity, which indicates the need for multiple measurements to understand PTSD and identify people in need of treatment.",1 +https://doi.org/10.4324/9780203818619,Population Mental Health,,0 +https://doi.org/10.1002/9781119998471.ch4,Pharmacotherapy of PTSD,,0 +,Standardized Self-Report Measures of Civilian Trauma and PTSD.,,0 +https://doi.org/10.1300/j013v30n04_03,Enhancing the Health Care Experiences of Adult Female Survivors of Childhood Sexual Abuse,"This article addresses the medical issues presented by women who were sexually abused in childhood and provides a detailed and direct link between the existing literature and its implications for the medical system. A profile of the sexual abuse survivor is given, including child sexual abuse (CSA) characteristics and sequelae that influence the adult female survivor's health. Post-traumatic Stress Disorder is outlined as part of a complex interplay of physiological and psychological symptomatology that can compromise the CSA survivor's ability to access health care treatment and forge a positive provider/patient relationship. This article emphasizes that effective treatment with sexual abuse survivors must include interdisciplinary collaboration among health care professionals. Management of the CSA patient, a case vignette illustrating salient themes, and finally, guidelines for the health care practitioner are presented.",0 +https://doi.org/10.1207/s15324826an0404_2,Neuropsychological Dysfunction in Severe Accidental Electrical Shock: Two Case Reports,"There has been a relative absence of studies that have longitudinally examined the neuropsychological profiles of women who have sustained severe accidental electrical shocks. A case is reported of a college-educated woman who received an estimated 120-V electrical shock. Neuropsychological assessments conducted at 2 months, and at 1 and 2 years postinjury, revealed a diversity of deficits indicative of diffuse, mild to moderate neurocognitive dysfunction, as well as symptomatology consistent with depression and posttraumatic stress disorder. For comparison, a second case of a man who received a 69,000-Velectrical injury is also presented. Although only minimal neurocognitive deficits were observed in this individual, he exhibited a similar psychological profile. The results of this study are discussed in light of the contrasting neurocognitive findings but consistent psychological presentations across the two cases.",0 +https://doi.org/10.1192/bjp.bp.108.050393,"Analysis of trauma exposure, symptomatology and functioning in Jewish Israeli and Palestinian adolescents","Background There has been no reported research comparing Jewish Israeli and Palestinian adolescents regarding the effect of ongoing political violence on adolescent psychosocial, family, post-traumatic stress disorder (PTSD) and aggression problems. Aims To compare Israeli and Palestinian responses regarding the relationship between exposure to traumatic events and psychosocial, behavioural, emotional and family problems. Method A cluster sample of youths aged 14–18 years, including 442 Jewish Israeli adolescents in Ariel, Haifa and Tel-Aviv, and 450 Palestinian adolescents in Gaza cities, villages and refugee camps were surveyed in 2006 using our Traumatic Events Questionnaire (TEV), the Brief Symptoms Inventory (BSI), the PTSD Symptom Scale – Interview (PSS–I), the Index of Peer Relations scale (IPR), Buss–Perry Aggression Questionnaire (BPAQ) and the MacMaster Family Assessment Device (FAD). Results Palestinian respondents had higher scores in the TEV, BSI, PSS–I and BPAQ questionnaires, and greater problems in functioning as revealed in the IPR and FAD. The social functioning of the adolescents with their peers predicted mental health symptoms and PTSD symptoms. Lower socioeconomic status predicted mental health symptoms, PTSD, pathology of participants' family functioning and the social functioning of the adolescents with their peers. Parents' education positively effected the FAD score and the avoidance item on the PSS–I, and religiosity improved the score on the FAD. Females reported more symptoms on the BSI and PSS–I than males, and males more symptoms on the FAD and IPR than females. Conclusions Both respondent groups had significant emotional and behavioural problems. Individual and community treatment, and community and social development, are likely to be useful for both populations, particularly Palestinians.",0 +https://doi.org/10.1037/a0034318,Personality heterogeneity in PTSD: Distinct temperament and interpersonal typologies.,"Researchers examining personality typologies of posttraumatic stress disorder (PTSD) have consistently identified 3 groups: low pathology, internalizing, and externalizing. These groups have been found to predict functional severity and psychiatric comorbidity. In this study, we employed Latent Profile Analysis to compare this previously established typology, grounded in temperament traits (negative emotionality; positive emotionality; constraint), to a novel typology rooted in interpersonal traits (dominance; warmth) in a sample of individuals with PTSD (n = 155). Using Schedule for Nonadaptive and Adaptive Personality (SNAP) traits to create latent profiles, the 3-group temperament model was replicated. Using Interpersonal Circumplex (IPC) traits to create latent profiles, we identified a 4-group solution with groups varying in interpersonal style. These models were nonredundant, indicating that the depiction of personality variability in PTSD depends on how personality is assessed. Whereas the temperament model was more effective for distinguishing individuals based on distress and comorbid disorders, the interpersonal model was more effective for predicting the chronicity of PTSD over the 10 year course of the study. We discuss the potential for integrating these complementary temperament and interpersonal typologies in the clinical assessment of PTSD.",0 +https://doi.org/10.1159/000353620,"Coping with Chronic Social Stress in Mice: Hypothalamic-Pituitary-Adrenal/ Sympathetic-Adrenal-Medullary Axis Activity, Behavioral Changes and Effects of Antalarmin Treatment: Implications for the Study of Stress-Related Psychopathologies","The aim of this study was to analyze the individual differences that lead to the development of psychopathological changes in response to chronic social stress. We also assessed the ability of an antagonist of the corticotrophin-releasing hormone (CRH) receptors to reverse the effects of stress. Male adult mice were exposed to repeated defeat experiences for 21 days using a sensorial contact model. After 18 days of defeat, two groups of subjects were established (active and passive), according to their behaviors during social confrontation. Antalarmin treatment was given for 4 and 6 days. The results corroborated previous data indicating that subjects who adopted a passive coping strategy had higher corticosterone levels after 21 days of defeat and decreased resting levels 3 days later. Moreover, they showed higher resting expression levels of hypothalamic CRH than their active counterparts. On day 24, the experimental animals were subjected to another social defeat to determine whether the stress response remained. The increase in corticosterone and hypothalamic CRH levels was similar for all of the stressed subjects, but the passive subjects also had a greater CRH response in the amygdala. Passive subjects had decreased levels of adrenal dopamine β-hydroxylase, tyrosine hydroxylase and plasma adrenaline compared to the active subjects, and lower plasma noradrenaline levels than manipulated controls. The passive profile of physiological changes in both the hypothalamic-pituitary-adrenal and sympathetic-adrenal-medullary (SAM) axes has been associated with changes related to mood disorders, such as posttraumatic stress disorder and depression. The active coping profile is characterized by similar corticosterone resting levels to controls and increased SAM activity. Both profiles showed alterations in the novel palatable and forced swimming tests, with the passive profile being the most vulnerable to the effects of stress in this last test. Pharmacological treatment with antalarmin failed to reverse the effects of stress.",0 +https://doi.org/10.1007/s11055-015-0190-9,The Role of Craniocerebral Trauma in the Dynamics of Combat-Related Post-Traumatic Stress Disorder,"Study aim: To address the question of the dynamics of the clinical signs of post-traumatic stress disorder (PTSD) and the strength of their relationship with organic changes in the brain. Materials and methods: A longitudinal observations study of 87 combat veterans during the Karabakh war of 1992-1994 was performed in 2009-2011. Two groups of patients were identified. Group 1 consisted of 45 veterans who had sustained mild combat-related craniocerebral trauma followed by the development of PTSD; group 2 consisted of 42 veterans with organic brain damage of traumatic origin. Full general somatic and neurological investigations of patients were undertaken, along with assessment of the patients' status using a set of psychometric and other scales (including scales for assessment of post-traumatic reactions-the Clinician-Administered PTSD Scale (CAPS) and the Mississippi Scale for Combat-Related PTSD). Results and conclusions: Analysis of patients' status during the study and comparison with data relating to the time at which trauma was sustained showed that the groups of patients with PTSD were characterized, despite some reduction in post-traumatic symptomatology, by a higher level of severity of all PTSD symptoms during the whole of the 15-18 years of disease development, with simultaneous increases in organic mental changes. In patients with organic brain lesions, the corresponding symptomatology was more severe immediately after the traumatic event than at the time of the study. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1142/s0219635208001873,"DEVELOPING AN INTEGRATED BRAIN, BEHAVIOR AND BIOLOGICAL RESPONSE PROFILE IN POSTTRAUMATIC STRESS DISORDER (PTSD)","The present study sought to determine a profile of integrated behavioral, brain and autonomic alterations in PTSD. Previous findings suggest that PTSD is associated with changes across electrophysiological (EEG and ERP), autonomic and cognitive/behavioral measures. In particular, PTSD has been associated with reduced cognitive performance, altered cortical arousal (measured by EEG), diminished late ERP component to oddball task targets (reduced P3 amplitude) and increased autonomic arousal relative to healthy controls. The present study examined measures of cognitive function, auditory oddball ERP components, autonomic function (heart rate and skin conductance) and EEG during resting conditions in 44 individuals with PTSD and 44 non-trauma-exposed controls, and predicted that an integrated profile of changes across a number of these measures would show a high level of sensitivity and specificity in discriminating PTSD from controls. Nine variables showing strongly significant (p < 0.002) between-group differences were entered into a discriminant function analysis. Four of these measures successfully discriminated the PTSD and non-PTSD groups: change in tonic arousal, duration of attention switching, working memory reaction time and errors of commission during visuospatial maze learning. Tonic arousal change contributed the most variance in predicting group membership. These results extend previous findings and provide an integrated biomarker profile that characterizes both PTSD and non-PTSD groups with a high degree of sensitivity and specificity. This outcome provides a platform for future studies to test how this profile of disturbances in autonomic and information processing may be unique to PTSD or may occur generically across clinical and/or other anxiety disorders.",0 +https://doi.org/10.1007/s00134-007-0829-2,Post-ICU consequences of patient wakefulness and sedative exposure during mechanical ventilation,"Objective: To determine the relationship between measures of critical illness (sedative/analgesic administration, wakefulness and organ dysfunction), intensive care unit (ICU) recall and symptoms of posttraumatic stress disorder. Design: Prospective, observational study with post-ICU follow-up. Setting: Medical and surgical ICUs at a teaching hospital. Patients: Two hundred seventy-seven subjects requiring > 36 h of mechanical ventilation were enrolled; 149 completed follow-up interviews 2 months later and 80 at 6 months. Interventions: None. Results: ICU recall was greater for events occurring at the end of critical illness; however, 18% of subjects had amnesia for the entire ICU course. Factual ICU recall was weakly associated with increased wakefulness during mechanical ventilation (r2 = 0.03-0.11, p< 0.05). Posttraumatic stress disorder prevalence was 17% at 2 months and 15% at 6 months. The avoidance-numbing cluster had the highest specificity (91%) for a formal diagnosis and the re-experiencing cluster had the lowest (69%). Recall of a delirious memory during critical illness was associated with more severe posttraumatic stress symptoms, but there was no association between posttraumatic stress symptoms and factual recall of ICU events. Neither ICU recall nor posttraumatic stress symptoms were associated with the intensity of sedative administration during mechanical ventilation. Posttraumatic stress symptoms were lowest in patients either the most awake during mechanical ventilation or the least awake. Conclusion: Wakefulness during mechanical ventilation has a greater influence on post-ICU recall and posttraumatic stress symptoms than sedative drug exposure or severity of illness. It is difficult to predict the future psychological consequences of an individual patient's critical illness. (",0 +https://doi.org/10.1214/aos/1176344136,Estimating the Dimension of a Model,"The problem of selecting one of a number of models of different dimensions is treated by finding its Bayes solution, and evaluating the leading terms of its asymptotic expansion. These terms are a valid large-sample criterion beyond the Bayesian context, since they do not depend on the a priori distribution.",0 +https://doi.org/10.7205/milmed-d-14-00188,Does Mental Health Stigma Change Across the Deployment Cycle?,"Prior research on mental health stigma in military personnel has been cross-sectional. We prospectively examined the course of perceived mental health stigma in a cohort of deployed U.S. combat Marines.Participants (N = 768) were assessed 1 month before a 7-month deployment to Afghanistan, and again at 1, 5, and 8 months postdeployment. We also examined three predictors of the course of stigma: post-traumatic stress disorder symptom severity, vertical and horizontal unit cohesion, and mental health treatment utilization while deployed.Perceptions of stigma remained largely stable across the deployment cycle, with latent growth curve analyses revealing a statistically significant but small decrease in stigma over time. Lower post-traumatic stress disorder symptoms and greater perceived vertical and horizontal support predicted decreases in stigma over time, whereas mental health treatment utilization in theater did not predict the course of stigma.Perceived stigma was low and largely stable over time.",0 +https://doi.org/10.1016/j.plefa.2009.10.004,Omega-3 polyunsaturated fatty acids and anxiety disorders,"

Abstract

Anxiety disorders are a common group of psychiatric illnesses which have significant personal, family and societal costs. Current treatments have limited efficacy in many patients highlighting a need for new therapeutic approaches to be explored. Anxiety disorders exhibit marked comorbity with mood disorders suggesting the existence of mechanistic similarities. Such a notion is supported by observations that some conventional pharmacotherapies are both effective antidepressants and anxiolytics. As such, given that omega-3 PUFA supplementation may be effective in the treatment of major depressive disorder it is reasonable to propose that they may also possess anxiolytic properties. Experimental data in support of such a hypothesis is currently lacking although reduced abundance of omega-3 PUFA have been reported in patients with anxiety, while supplementation with omega-3 PUFA appears to inhibit activation of the HPA axis and can ameliorate some of the symptoms of anxiety. Clinical investigations carried out to date have, however, involved small numbers of participants. Larger trials using a variety of omega-3 PUFA species in clinically well-defined patients with anxiety will be required to demonstrate a therapeutic role for omega-3 PUFA in these disorders. Given the excellent side effect profile of omega-3 PUFA as well as their strong theoretical rationale, such future trials appear justified.",0 +https://doi.org/10.2519/jospt.2009.2930,Measurement Properties of the Neck Disability Index: A Systematic Review,"Study Design Systematic review of clinical measurement. Objective To find and synthesize evidence on the psychometric properties and usefulness of the neck disability index (NDI). Background The NDI is the most commonly used outcome measure for neck pain, and a synthesis of knowledge should provide a deeper understanding of its use and limitations. Methods And Measures Using a standard search strategy (1966 to September 2008) and 4 databases (Medline, CINAHL, Embase, and PsychInfo), a structured search was conducted and supplemented by web and hand searching. In total, 37 published primary studies, 3 reviews, and 1 in-press paper were analyzed. Pairs of raters conducted data extraction and critical appraisal using structured tools. Ranking of quality and descriptive synthesis were performed. Results Horizon estimation suggested the potential for 1 missed paper. The agreement between raters on quality assessments was high (kappa = 0.82). Half of the studies reached a quality level greater than 70%. Failures to report clear psychometric objectives/hypotheses or to rationalize the sample size were the most common design flaws. Studies often focused on less clinically applicable properties, like construct validity or group reliability, than transferable data, like known group differences or absolute reliability (standard error of measurement [SEM] or minimum detectable change [MDC]). Most studies suggest that the NDI has acceptable reliability, although intraclass correlation coefficients (ICCs) range from 0.50 to 0.98. Longer test intervals and the definition of stable can influence reliability estimates. A number of high-quality published (Korean, Dutch, Spanish, French, Brazilian Portuguese) and commercially supported translations are available. The NDI is considered a 1-dimensional measure that can be interpreted as an interval scale. Some studies question these assumptions. The MDC is around 5/50 for uncomplicated neck pain and up to 10/50 for cervical radiculopathy. The reported clinically important difference (CID) is inconsistent across different studies ranging from 5/50 to 19/50. The NDI is strongly correlated (>0.70) to a number of similar indices and moderately related to both physical and mental aspects of general health. Conclusion The NDI has sufficient support and usefulness to retain its current status as the most commonly used self-report measure for neck pain. More studies of CID in different clinical populations and the relationship to subjective/work/function categories are required. J Orthop Sports Phys Ther 2009;39(5):400–417. doi:10.2519/jospt.2009.2930",0 +https://doi.org/10.1007/s11055-014-9930-5,Involvement of Anomalous Apoptosis in Impairments to Synaptic Plasticity in Post-Traumatic Stress Disorder,"Enzyme-linked immunosorbent assay was used to measure levels of apoptosis and synaptic plasticity marker proteins, i.e., annexin A5 and complexin 2 respectively, as well as the proinflammatory cytokine tumor necrosis factor alpha (TNF-alpha ), in serum from patients with post-traumatic stress disorder (PTSD) in comparison with healthy subjects. Correlations between these parameters were studied. The results obtained here showed that annexin A5 and complexin 2 concentrations in PTSD patients were significantly lower than normal, while TNF-alpha levels were higher. PTSD patients showed a positive correlation between annexin A5 and complexin 2 levels on the one hand, and a negative correlation between annexin A5 and TNF-alpha levels on the other. These data lead to the conclusion that the pathogenesis of PTSD is characterized by reduced apoptosis associated with defects in synaptic plasticity. It is suggested that anomalous apoptosis may also be among the factors supporting the development of the chronic inflammation typical of the pathogenesis of PTSD. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1037/0022-3514.88.6.984,Self-Enhancement Among High-Exposure Survivors of the September 11th Terrorist Attack: Resilience or Social Maladjustment?,"The authors examined self-enhancing bias as a predictor of adjustment among individuals in or near the World Trade Center during the September 11, 2001, terrorist attacks. Resilience was defined from categorical and continuous analyses of both participant self-report and friend and relative ratings of adjustment. Self-enhancement was associated with a resilient outcome, ratings of better adjustment prior to September 11th, greater positive affect, and reduced perceptions of social constraints. Additional analyses indicated that self-enhancers' reduced symptom levels were fully mediated by their low perceived social constraints. However, consistent with previous evidence suggesting a social cost to self-enhancement, at 18 months post-September 11th, self-enhancers' friends and relatives also rated them as decreasing in social adjustment and as being less honest.",0 +https://doi.org/10.1002/jts.20352,Does prior psychological health influence recall of military experiences? a prospective study,"In a prospective study, we evaluated pre- and postdeployment psychological health on recall of risk factors to assess recall bias. Measures of the General Health Questionnaire (GHQ), PTSD Checklist (PCL), and symptom clusters from the PCL were obtained from 681 UK military personnel along with information on traumatic and protective risk factors. Postdeployment psychological health was more important in explaining recall of traumatic experiences than predeployment psychological health. Predeployment intrusive cluster scores were highly associated with traumatic exposures. Postdeployment, but not predeployment GHQ showed small effects for most risk factors. With the exception of intrusive thoughts, there is insufficient evidence to suggest predeployment psychological status would be useful in correcting for recall bias in subsequent cross-sectional studies.",0 +https://doi.org/10.1348/135532599167842,When the killer suffers: Post-traumatic stress reactions following homicide,"Objectives. The present study aimed to consider the extent to which post-traumatic stress disorder (PTSD) occurs after homicide and to examine characteristics of the offence and the offender which contribute to the development of these symptoms. It was proposed that type of violence (reactive versus instrumental) would be related to PTSD symptoms. Using Blackburn's typology of violent offenders, it was also hypothesized that primary and secondary psychopath, controlled and inhibited types would demonstrate differing forms of violence, prevalences and patterns of post-traumatic stress symptoms following the homicide. Method. Eighty homicide perpetrators were allocated equally to the four offender types based on their profiles on the Special Hospitals Assessment of Personality and Socialisation (SHAPS). Each offender completed the Post-Traumatic Stress Disorder Interview and the violence displayed during the index offence was classified as either reactive or instrumental. Results. Of the total sample, 52% met criteria for current PTSD. Reactive violence and reporting that the offence was traumatic were related to a current diagnosis of PTSD. Differing prevalences and patterns of PTSD symptoms were noted for Blackburn's offender types. Primary psychopaths showed instrumental violence and were the least traumatized. Secondary psychopaths were the most symptomatic, but not necessarily due to involvement in the homicide. Controlled and inhibited types both typically displayed reactive violence and had higher levels of current PTSD symptoms related to involvement in the offence itself. Conclusions. The extent to which PTSD follows homicide is a function of both personality type and form of violence. The results can be understood in terms of the cognitive model of Meichenbaum (1996) and also the defining dimensions of Blackburn's typology.",0 +https://doi.org/10.1002/jts.21674,Behavioral markers of coping and psychiatric symptoms among sexually abused children,"The current study examined coping and psychiatric symptoms in a longitudinal sample of sexually abused children. Coping was behaviorally coded from children's forensic interviews in the aftermath of sexual abuse. Using principal components analysis, coping behaviors were found to cluster into 3 categories: avoidant, expressive, and positive affective coping. Avoidant coping had predictive utility for a range of psychiatric symptoms, including depressive, posttraumatic stress, anxiety, and dissociative symptoms as well as aggression and attention problems measured 8–36 months following the forensic interview. Specific behaviors, namely fidgetiness and distractibility, were also found to be associated with future symptoms. These findings suggest the predictive utility of avoidant behaviors in general, and fidgetiness and distractibility in particular, among sexually abused children.",0 +https://doi.org/10.1007/s10802-011-9508-4,Posttraumatic Stress Disorder Symptom Structure in Chinese Adolescents Exposed to a Deadly Earthquake,"This present study examined the structure of posttraumatic stress disorder (PTSD) symptoms in a large sample of Chinese adolescents exposed to a deadly earthquake. A total of 2,800 middle school students aged 12 to 18 years participated in the study 6 months after the ""Wenchuan Earthquake"". Results of confirmatory factor analysis indicated that a five-factor intercorrelated model composed of intrusion, avoidance, numbing, dysphoric arousal, and anxious arousal, fit data significantly better than both the four-factor numbing model King et al. (Psychological Assessment 10:90-96, 1998) and the four-factor dysphoria model Simms et al. (Journal of Abnormal Psychology 111:637-647, 2002). Further examination of the external convergent and discriminant validity revealed that except for the dysphoric arousal factor, the remaining four PTSD factors yielded significantly different correlations with external measures of anxiety vs. depression. The findings add to the limited literature on the factor structure of PTSD in youths and on the five-factor PTSD model. In addition, they provide more detail into the latent psychopathological processes of PTSD, and inform the forthcoming DSM-5. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1017/thg.2012.43,A Population-Based Study of Familial and Individual-Specific Environmental Contributions to Traumatic Event Exposure and Posttraumatic Stress Disorder Symptoms in a Norwegian Twin Sample,"Objective: Posttraumatic stress disorder (PTSD) is one of the only disorders in the Diagnostic and Statistical Manual of Mental Disorders that requires an environmental exposure. The relationship between liability factors for trauma exposure and those for PTSD symptoms following exposure are unclear. Methods: Exposure to a trauma and resulting PTSD symptoms were assessed in a sample of 2,794 members of the Norwegian Institute of Public Health Twin Panel. Results: In the full sample, 737 twins experienced a trauma. A modified causal, contingent, common pathway model was used to examine trauma exposure and liability for PTSD. Genetic and common environmental factors could not be distinguished, so a model that included only familial and individual specific components was fit. The best-fitting model suggested that familial factors played an important role in liability for trauma exposure and for resulting PTSD symptoms, and that there was a modest transmission between trauma exposure and subsequent PTSD symptoms. Conclusions: One third of the variance in liability of PTSD symptoms is due to familial factors, and of this, approximately one fifth overlaps with the familial liability for trauma exposure while the other four fifths of the variance is specific to the risk of PTSD symptoms following exposure. The hypothesis that PTSD is etiologically similar to exposures to a traumatic event is not supported, suggesting that the factors that confer risk for trauma do not overlap completely with those that confer risk for PTSD.",0 +https://doi.org/10.1016/j.ejpain.2003.10.008,"Pain and PTSD symptoms in female veterans⋆,⋆⋆","There has been growing empirical examination of the co-occurrence of pain and post-traumatic stress disorder (PTSD) symptoms, and existing evidence suggests that the symptoms associated with each have a close association. To date, however, the association has only been examined within samples of mostly male participants.In the present study, pain and PTSD symptoms were examined in a sample of 221 female veterans who utilised the VA Healthcare System between 1998 and 1999.Women who visited the clinic between 1998 and 1999 were mailed a self-report questionnaire package designed to elicit information regarding general health (including pain experiences), military and trauma history, childhood abuse and neglect, and PTSD symptoms. Analyses were conducted to identify differences in pain experience between those women classified as having PTSD, subsyndromal PTSD, and no PTSD. Analyses were also conducted to determine the degree to which pain-related (e.g., current pain, interference with activity) variables predicted PTSD symptom cluster scores.The three groups differed significantly on a number of pain-related variables. Analyses suggested that pain-related variables were significant predictors of PTSD symptom cluster scores.These results indicate that the association between pain and PTSD symptoms, previously observed in primarily male samples, is generalisable to females. Clinical implications and possible mechanisms of association are discussed.",0 +https://doi.org/10.1176/appi.ps.53.8.970,Posttraumatic Stress Disorder Among Cuban Children and Adolescents After Release From a Refugee Camp,"The authors compared self-reported symptoms of posttraumatic stress disorder (PTSD) in a cohort of Cuban children and adolescents with assessments of internalizing and externalizing behaviors by the children's teachers.Eighty-seven children and adolescents who had left Cuba by sea in the summer of 1994 and who had been confined to refugee camps for up to eight months before arriving in the United States were evaluated four to six months later. Self-reported symptoms of PTSD were assessed with the Post-Traumatic Stress Disorder Reactive Index, and internalizing and externalizing behaviors were assessed with the Child Behavioral Check List-Teacher Report Form.A majority of the children reported moderate to severe PTSD symptoms. The most common symptom clusters were avoidance (67 percent), regressive behaviors (64 percent), reexperiencing the traumatic events (60 percent), somatic symptoms (52 percent), and hyperarousal (51 percent). Eighty-six percent of the children reported that the refugee experience had severely affected most of their peers. A statistically significant dose-effect relationship was found between the number of stressors and the severity of self-reported PTSD symptoms. There was a modest relationship between withdrawn behavior and children's feelings that they would die at sea and witnessing violence at the camps. Age and witnessing violence in the camps were moderately associated with PTSD. Teachers' overall ratings of externalizing and internalizing behaviors did not produce any clinically significant findings.PTSD symptoms among refugee children and adolescents who have been exposed to multiple and prolonged stressors may continue unabated after the stressors are removed. The symptoms are experienced subjectively and may go unnoticed by adults.",0 +https://doi.org/10.1007/978-1-4899-7522-5_7,Systems of Care for Traumatized Children: The Example of a School-Based Intervention Model,"In this chapter we will describe the development of a system of care for children through educational systems. Providing a continuum of trauma services for Israeli school children during long periods of exposure to trauma focuses on an array of services ranging from prevention to intervention. The school-based intervention model incorporates principles of both community and clinical psychology. Traditionally, services have focused on those who have been identified as suffering from posttraumatic stress disorders or other clinical diagnoses. The continuum of trauma services model recognizes the importance of treating those who are suffering, while not overlooking the large, silent majority of the population who cope reasonably well through other trajectories. The provision of a range of services, from community interventions to clinical interventions within one system of care, forms one of the touchstones of this model. © Springer Science+Business Media New York 2015.",0 +https://doi.org/10.1017/ipm.2014.57,"Steroids, psychosis and poly-substance abuse","Objective To review consequences of the changing demographic profile of anabolic-androgenic steroid (AAS) use. Method Case report and review of key papers. Results We report here a case of a 19-year-old Irish male presenting with both medical and psychiatric side effects of methandrostenolone use. The man had a long-standing history of harmful cannabis use, but had not experienced previous psychotic symptoms. Following use of methandrostenolone, he developed rhabdomyolysis and a psychotic episode with homicidal ideation. Discussion Non-medical AAS use is a growing problem associated with medical, psychiatric and forensic risks. The population using these drugs has changed with the result of more frequent poly-substance misuse, potentially exacerbating these risks. Conclusion A higher index of suspicion is needed for AAS use. Medical personnel need to be aware of the potential side effects of their use, including the risk of violence. Research is needed to establish the magnitude of the problem in Ireland.",0 +https://doi.org/10.4314/ajpsy.v11i2.30263,Post traumatic stress disorder: undiagnosed cases in a tertiary inpatient setting,"Objective: Post traumatic stress disorder (PTSD) is a common, debilitating anxiety disorder characterized by emotional and physical symptoms that may occur after exposure to a severely traumatic event. Since it occurs commonly as a comorbid diagnosis with other mood- and anxiety disorders, we postulated that this disorder may be under- diagnosed in therapeutic wards where anxiety and mood disorders are treated. The study thus sought to determine the prevalence of undiagnosed PTSD in an inpatient population, and to compare the demographic details and comorbid diagnoses of subjects with and without PTSD. Method: The Clinician-administered PTSD Scale for DSM-IV (CAPS) was administered to 40 subjects who were inpatients in a therapeutic ward of a large psychiatric hospital and who had never had a diagnosis of PTSD before. Results:16 (40%) subjects met the DSM-IV criteria for PTSD. We did not find significant clinical differentiating factors between subjects with and without PTSD; however subjects with PTSD were more likely to use cannabis. Conclusions: PTSD remains undiagnosed in many patients admitted to therapeutic units. Keywords: Stress Disorders, Post-Traumatic; Diagnosis; Inpatients;African Journal of Psychiatry Vol. 11 (2) 2008 pp. 119-122",0 +https://doi.org/10.1179/106698111x13129729551949,Whiplash-associated disorder: musculoskeletal pain and related clinical findings,"The aim of this paper was to review the physical and psychological processes associated with whiplash-associated disorders. There is now much scientific data available to indicate the presence of disturbed nociceptive processing, stress system responses, muscle and motor changes as well as psychological factors in both acute and chronic whiplash-associated disorders. Some of these factors seem to be associated with the transition from acute to chronic pain and have demonstrated prognostic capacity. Further investigation is required to determine if these processes can be modified and if modification will lead to improved outcomes for this condition. The burden of whiplash injuries, the high rate of transition to chronicity, and evidence of limited effects of current management on transition rates demand new directions in evaluation and management. The understanding of processes underlying this condition is improving and this lays the foundation for the development of more effective management approaches.",0 +https://doi.org/10.1002/jts.20059,Event-list construction and treatment of exposure data in research on political violence,"Event lists are commonly applied for measuring exposure to various kinds of potentially stressful and traumatizing life events. Before making general conclusions about the psychological effects of exposure to such events, problematic issues related to the use of event-list data need to be discussed and resolved. This article focuses on issues related to the construction and application of event lists for measuring exposure to political violence such as issues related to reliability, the applicability of the additive assumption, whether to weight event-list items, and the possible consequences of incomplete event lists. Alternative future approaches to these measurement issues are also discussed.",0 +https://doi.org/10.1093/oxfordhb/9780195307030.013.0009,Neuroanatomy and Neuroimaging of Anxiety Disorders,"Neuroimaging methods can be used to examine functional brain differences between healthy individuals and those with anxiety disorders. After the brain regions implicated in the pathophysiology of anxiety disorders (e.g., amygdalo-cortical circuitry) are reviewed, neuroimaging studies of posttraumatic stress disorder (PTSD), social anxiety disorder (SAD), specific phobia (SP), and panic disorder (PD) that report activations in these regions are discussed. Studies of obsessive-compulsive disorder (OCD) implicate a distinct neurocircuitry profile (i.e., cortico-striatal-thalamic circuit) compared to the other anxiety disorders. Few neuroimaging studies of generalized anxiety disorder (GAD) have been conducted. In addition, results from functional connectivity analyses and the effects of treatment on neuroimaging findings are summarized.",0 +https://doi.org/10.1196/annals.1364.042,Longitudinal Assessment of Dissociation in Holocaust Survivors With and Without PTSD and Nonexposed Aged Jewish Adults,"The trajectory of posttraumatic stress disorder (PTSD) and PTSD-related symptoms in relation to aging is not well understood. We previously observed higher levels of dissociation as measured by the Dissociative Experiences Scale (DES) among older Holocaust survivors with, compared to those without, PTSD, though scores on the DES in Holocaust survivors were markedly lower than those that had been reported for younger cohorts. We undertook a longitudinal evaluation of dissociation in Holocaust survivors. Twenty-six Holocaust survivors with current PTSD, 30 Holocaust survivors without current PTSD, and 19 nonexposed were evaluated at the initial evaluation and subsequently 8.11 years later. Repeated measures analysis of variance (ANOVA) on the DES scores from these times demonstrated a significant main effect for time and a significant group by time interaction, reflecting a marked decline in Holocaust survivors, particularly those with PTSD. Controlling for age obliterated the effect of time, but not the group by time interaction. A similar pattern was shown with The Clinician Administered PTSD Scale (CAPS) scores. Different symptoms related to PTSD show different trajectories of change with age, with dissociation appearing to be less prominent with age.",0 +https://doi.org/10.1177/1524838005285914,Posttraumatic Shame and Guilt,"Posttraumatic shame and guilt are important dimensions of posttraumatic syndromes, including simple and complex post-traumatic stress disorder (PTSD). The concepts of posttraumatic shame and guilt have received little theoretical or empirical investigation in the field of traumatology. It is proposed that there are acute and prolonged states of posttraumatic shame and guilt that can be compared in their consequences across eight psychosocial dimensions: (a) self-attribution processes, (b) emotional states and capacity for affect regulation, (c) appraisal and interpretation of actions, (d) the impact of states of shame and guilt on personal identity, (e) suicidality, (f) defensive patterns, (g) proneness to psychopathology and PTSD, and (h) the dimensions of the self-structure adversely affected by states of posttraumatic shame and guilt. The experience of posttraumatic states of shame and guilt are associated with compounded affective processesin PTSD, depression, and substance use disorders.",0 +https://doi.org/10.1080/14789949.2013.877516,Offenders as victims: post-traumatic stress disorder and substance use disorder among male prisoners,"Background: Comorbid substance use disorder(s) and post-traumatic stress disorder (SUD-PTSD) is common among prisoners and linked to an increased risk of criminal recidivism; however, little is known about the characteristics of prisoners with this comorbidity. Aim: This study provides a preliminary examination of the clinical and criminal profile of male inmates with symptoms of SUD-PTSD, and examines whether this profile differs according to whether a person has experienced a trauma while in prison. Methods: Thirty male inmates from two correctional centres in Sydney, Australia, were recruited and assessed using a structured interview. Results: The sample reported extensive criminal, substance use and trauma histories. A history of substance dependence was almost universal (90%) and 56.7% met diagnostic criteria for PTSD with the remainder experiencing sub-threshold symptoms. Forty-three per cent reported a traumatic event while in prison. Those who had experienced trauma in prison, compared to those wh...",0 +https://doi.org/10.1002/jts.21781,"Predictors of Intimate Partner Violence Revictimization: The Relative Impact of Distinct PTSD Symptoms, Dissociation, and Coping Strategies","Psychological distress and coping strategies following intimate partner violence (IPV) victimization may impact survivors' risk for future IPV. The current study prospectively examined the impact of distinct posttraumatic stress disorder (PTSD) symptom clusters (reexperiencing, avoidance, numbing, and hyperarousal), dissociation, and coping strategies (engagement and disengagement coping) on IPV revictimization among recently abused women. Women (N = 69) who were seeking services for IPV and experienced their most recent episode of physical IPV between 2 weeks and 6 months prior to study enrollment completed measures of physical IPV, psychological distress, and coping strategies at baseline and at 6-month follow-up. The women averaged 36 years of age and 67% of the sample was African American. Separate Poisson regression analyses revealed that PTSD hyperarousal symptoms, dissociation, engagement coping, and disengagement coping each significantly predicted physical IPV revictimization at the 6-month follow-up (with effect sizes ranging from a 1.20-1.34 increase in the likelihood of Time 2 physical IPV with a 1 SD increase in the predictor). When these significant predictors were examined together in a single Poisson regression model, only engagement and disengagement coping were found to predict physical IPV revictimization such that disengagement coping was associated with higher revictimization risk (1.29 increase in the likelihood of Time 2 physical IPV with one SD increase in disengagement coping) and engagement coping was associated with lower revictimization risk (1.30 decrease in the likelihood of Time 2 physical IPV with one SD increase in engagement coping). The current findings suggest that coping strategies are important and potentially malleable predictors of physical IPV revictimization.",0 +,[Insufficient cooperativeness in forensic neuropsychiatric assessment: prevalence estimates of negative response bias].,"In the context of independent medical examinations, negative response bias in patients is a problem of primary importance, especially in cases where self-reported symptoms cannot be directly verified by the examiner. Estimates of the prevalence of uncooperativeness in neuropsychological evaluations demonstrated that invalid test profiles are to be expected in a sizable minority of examinees. However, no estimates have ever been published in German-speaking countries. Symptom validity was checked in 235 patients who reported cognitive symptoms after suffering an accident and who underwent forensic neuropsychiatric assessment. Patient classification was based on the results obtained with the Word Memory Test (WMT) or the Medical Symptom Validity Test (MSVT). When applying the recommended cutoffs for these tests, 44.3 percent of the sample was found to be classified as suspect for insufficient effort. In a subsample of 47 patients with claims of posttraumatic stress disorder 51.1 percent were found to score below the cutoffs. These findings underline the importance of modern methods for assessment of symptom validity in forensic contexts. Cooperativeness of compensation claimants cannot be assumed solely on the basis of clinical impression.",0 +https://doi.org/10.1037/0021-843x.113.2.189,All Symptoms Are Not Created Equal: The Prominent Role of Hyperarousal in the Natural Course of Posttraumatic Psychological Distress.,"This 3-wave longitudinal study examined the natural course of posttraumatic stress disorder symptoms using data collected from young adult survivors of community violence. Three key findings emerged. 1. Mean levels of distress for each symptom cluster decreased over time, with reexperiencing decreasing most rapidly. 2. Cross-lagged panel analysis revealed that hyperarousal strongly influences, but is not generally influenced by, other symptoms clusters. 3. Trajectory analysis demonstrated that respondents for whom hyperarousal was the most pronounced baseline symptom showed lower overall symptom improvement relative to trauma exposed counterparts for whom hyperarousal was a less prominent early symptom. Implications for theory, research, and clinical practice are discussed.",0 +https://doi.org/10.1002/jts.21792,Traumatic Stress Symptomatology After Child Maltreatment and Single Traumatic Events: Different Profiles,"The sequelae of child maltreatment tend to extend current posttraumatic stress disorder (PTSD) symptoms. This study examined this assumption, hypothesizing that (a) PTSD and trauma-related symptoms are more severe after single trauma than after child maltreatment; (b) symptoms unrelated to trauma are more severe after child maltreatment than after single trauma; and (c) a comorbid association of clinical PTSD with trauma-related symptoms is more prevalent after single trauma, whereas a comorbid association of clinical PTSD with trauma unrelated symptoms is more prevalent after child maltreatment. The Trauma Symptom Checklist for Children (TSCC) assessed PTSD and trauma-related symptoms in 256 children (83 children exposed to single trauma, 173 to child maltreatment). The Strengths and Difficulties Questionnaire (SDQ) assessed trauma-unrelated symptoms. Single-trauma children reported significantly more severe PTSD and trauma-related symptoms. Significantly more severe trauma unrelated symptoms were reported after child maltreatment. A significant relation was found between clinical PTSD and more severe trauma-related symptoms in both samples. Likelihood of children meeting PTSD symptoms after trauma seems to decrease when traumatization becomes more complex. Findings support our assumption that symptomatology of maltreated children extends current PTSD symptoms.",0 +https://doi.org/10.1080/15299732.2011.641496,Clinical Phenomenology of Childhood Abuse–Related Complex PTSD in a Population of Female Patients: Patterns of Personality Disturbance,"Complex posttraumatic stress disorder (PTSD) involves a variety of personality disturbances presumed to result from repeated interpersonal trauma such as child abuse. As Complex PTSD patients are a heterogeneous population, we searched for clinically relevant personality-based subtypes.This study used a cluster analysis of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), Axis II features within a sample of 71 female outpatients with systematically assessed child abuse-related Complex PTSD.Two main subtypes were found: adaptive and nonadaptive. The latter was further differentiated into withdrawn, alienated, suffering, and aggressive subtypes, characterized by different levels of introversion and disinhibition. Among the nonadaptive subtypes, the severity of Complex PTSD symptoms was lowest in the withdrawn (introverted only) subtype. The subtypes differed in their level of dissociation and depression but did not differ regarding PTSD symptoms, trauma history, or parental bonding characteristics.Confirming earlier findings, our study found personality-based Complex PTSD subtypes, which could implicate differential treatment needs and results.",0 +https://doi.org/10.1016/j.jpsychires.2005.12.002,Hippocampal volume in aging combat veterans with and without post-traumatic stress disorder: Relation to risk and resilience factors,"To examine whether there are post-traumatic stress disorder (PTSD) related differences in hippocampal volume in middle-aged and elderly veterans and to examine the relationship of neuroendocrine activity, memory performance, and measures of risk and resilience for PTSD to hippocampal volume in this cohort.Seventeen veterans with chronic PTSD and 16 veterans without chronic PTSD received an MRI scan followed by neuroendocrine assessment (24-h urinary cortisol excretion and the lysozyme IC(50-DEX), a measure of glucocorticoid receptor (GR) responsiveness), and cognitive testing.Veterans with PTSD did not differ from those without PTSD in hippocampal volume, but they did show significantly lower urinary cortisol levels, and poorer memory performance on the Wechsler Logical Memory test and Digit Span test. Smaller left hippocampal volumes were observed in veterans who developed PTSD in response to their first reported traumatic exposure, compared to veterans who had first experienced a traumatic event to which they did not develop PTSD, prior to experiencing a subsequent event that led to PTSD. In contrast, the two neuroendocrine measures were associated with risk factors related to early trauma exposure.Although hippocampal volume was not found to differ between subjects with and without PTSD, smaller hippocampal volumes in PTSD may be associated with specific risk and resilience factors. These may be distinct from vulnerability markers associated with increased responsiveness to glucocorticoids and/or other neuroendocrine measures that have been observed in combat-related PTSD.",0 +https://doi.org/10.1037/a0032953,"Memory deficits, postconcussive complaints, and posttraumatic stress disorder in a volunteer sample of veterans.","To better understand how memory impairment is related to postconcussive complaints and to posttraumatic stress disorder (PTSD) and whether these relationships remain after controlling for premorbid cognitive ability.We examined memory impairment, premorbid cognitive ability, postconcussive complaints, and symptoms of PTSD in 205 veterans, 135 of who gave a self-reported history of concussion and exposure to a traumatic life event. We limited our sample to those who gave good effort on cognitive testing according to a symptom validity measure.Although memory impairment was not associated with a history of concussion, it was associated with severity of postconcussive complaints. That association was no longer significant after controlling for premorbid IQ. A similar analysis yielded slightly different findings for PTSD. Memory impairment was associated with PTSD diagnosis, although it was not associated with severity of PTSD symptoms after controlling for premorbid ability.These data are consistent with multifactorial models of the etiology of postconcussion disorder and PTSD such as the ""burden of adversity hypothesis"" described by Brenner, Vanderploeg, and Terrio (2009). In such models, symptom severity and course of recovery are determined not only by trauma severity but (also) premorbid risk factors and postonset complications. (PsycINFO Database Record (c) 2013 APA, all rights reserved).",0 +https://doi.org/10.1016/j.bbi.2013.01.081,Association between posttraumatic stress disorder and inflammation: A twin study,"The association of posttraumatic stress disorder (PTSD) with cardiovascular disease risk may be mediated by inflammation. Our objective was to examine the association between PTSD and measures of inflammation and to determine whether these associations are due to shared familial or genetic factors. We measured lifetime history of PTSD using the Structured Clinical Interview for DSM-IV in 238 male middle-aged military veteran twin pairs (476 individuals), selected from the Vietnam Era Twins Registry, who were free of cardiovascular disease at baseline. We assessed inflammation using levels of high-sensitivity C-reactive protein (hsCRP), interleukin 6 (IL-6), fibrinogen, white blood cells, vascular cell adhesion molecule-1, and intercellular adhesion molecule-1 (ICAM-1). Geometric mean levels and percent differences by PTSD were obtained from mixed-model linear regression analyses with adjustment for potential confounders. Within-pair analysis was conducted to adjust for shared family environment and genetics (monozygotic pairs). Overall, 12.4% of participants had a lifetime history of PTSD. Adjusted mean levels of hsCRP and ICAM-1 were significantly higher among those with vs. without PTSD [hsCRP: 1.75 vs. 1.31mg/l (33% difference); ICAM-1: 319 vs. 293ng/ml (9% difference)]. Adjustment for depression rendered the association of PTSD with hsCRP non-statistically significant. For IL-6, no consistent association was seen. Within-pair analysis produced associations that were similar in direction for all three markers but lesser in magnitude for hsCRP and IL-6. There was no evidence of interaction by zygosity. Elevated hsCRP and ICAM-1 are associated with PTSD, and these associations may be confounded by shared non-genetic, antecedent familial and environmental factors.",0 +https://doi.org/10.1097/yco.0b013e3282f9b1f1,Ecstasy and other club drugs: a review of recent epidemiologic studies,"This review highlights the epidemiologic research on club drug use in the past year, with a focus on clinical epidemiology, social epidemiology, new methodological approaches, and alternative explanations for drug use behaviors.Although 3,4-methylenedioxy-N-methylamphetamine (MDMA) or ecstasy is currently classified as a type of hallucinogen and its withdrawal is not recognized in the Diagnostic and Statistical Manual of Mental Disorders, there is evidence for the association of withdrawal symptoms with MDMA abstinence. Findings from latent class analysis indicate that MDMA users have a significantly higher risk of dependence than lysergic acid diethylamide users. Research on sociodemographic factors associated with club drug use continues to be a main focus worldwide. New epidemiologic research methods have been developed to enable researchers to monitor real-time drug use behaviors and to conduct surveys on sensitive issues in public places. In addition to traditional behavioral models, researchers began to examine the club drug phenomenon in the context of economic environment.Recent findings on MDMA use further question the current drug classification in the diagnostic systems. Despite the continuous growth in the club drug research literature, there is no study on the influence of genetic factors on club drug use. More research in this area is needed.",0 +https://doi.org/10.1002/hup.1106,"Cognition and depression: the effects of fluvoxamine, a sigma-1 receptor agonist, reconsidered","Cognitive impairment is a primary feature of patients with major depressive disorder (MDD) and is characterised by stress-induced neural atrophy. Via alpha-adrenergic, anti-cholinergic and anti-histaminic activities, several antidepressants can cause significant counter-therapeutic cognitive impairment. Evidence is emerging of the involvement of sigma-1 receptor agonism in the mechanism of action of some antidepressants, notably fluvoxamine. Sigma-1 receptors are abundant in areas affected by depression/stress-induced cerebral atrophy and their ligands have a unique pharmacological profile; they may promote neurogenesis and initiate adaptive neural plasticity as a protection/reaction to stress. Fluvoxamine, as a potent sigma-1 receptor agonist, has shown ameliorating effects in animal models of psychosis, depression, stress, anxiety, obsessive-compulsive disorder (OCD) and aggression and has been shown to improve cognitive impairments. In humans, fluvoxamine may repair central nervous system (CNS) atrophy and restore cognitive function. The current review explores the mechanisms through which sigma-1 receptors can modulate cognitive function and examines how antidepressant therapy with fluvoxamine may help improve cognitive outcomes in patients with depression. Copyright © 2010 John Wiley & Sons, Ltd.",0 +https://doi.org/10.4324/9780203874318-15,Intensive cognitive therapy for post-traumatic stress disorder: Case studies,"There is good evidence from randomized controlled trials that cognitive therapy (CT) for post-traumatic stress disorder (PTSD) (Ehlers et al., 2009) is an effective treatment (Duffy, Gillespie, & Clark, 2007; Ehlers, Clark, Hackmann, McManus, & Fennell, 2005; Ehlers et al., 2003). Furthermore, CT has been successfully disseminated to routine clinical settings in which, in contrast to randomized trials, no exclusion criteria are applied (Duffy et al., 2007; Gillespie, Duffy, Hackmann, & Clark, 2002). Finally, CT has been shown to work for acute and chronic PTSD following from one or two events (Ehlers et al., 2003, 2005), and for very chronic PTSD following multiple traumas (Duffy et al., 2007). The efficacy and effectiveness of CT for PTSD is in line with the finding from recent meta-analyses that trauma-focused cognitive behaviour therapy (CBT) is effective in the treatment of PTSD (e.g., Bisson et al., 2007). Other effective forms of trauma-focused CBT are Foa’s Prolonged Exposure (Foa & Rothbaum, 1998; Foa et al., 2005) and Resick’s Cognitive Processing Therapy (Resick & Schnicke, 1993).",0 +https://doi.org/10.1007/bf00706695,PTSD in physically and sexually abused psychiatrically hospitalized children,"The history of sexual and physical abuse and the diagnosis of PTSD were examined in 98 psychiatrically hospitalized children. Relative to past studies, there was an increased incidence of abuse and of prevalence of PTSD. Specific instruments for assessing abuse and PTSD are suggested.",0 +https://doi.org/10.1300/j070v14n01_02,Childhood Sexual Abuse and Psychosomatic Symptoms in Irritable Bowel Syndrome,"Irritable bowel syndrome is characterized by chronic gastrointestinal symptoms without a demonstrable physical cause. In a subgroup of patients, irritable bowel syndrome may be part of a cluster of psychosomatic symptoms related to childhood sexual abuse. To investigate this possibility, the Dissociative Disorders Interview Schedule (DDIS), the Dissociative Experiences Scale (DES) and the Symptom Checklist-90 (SCL-90) were administered to 105 subjects with either irritable bowel syndrome, inflammatory bowel disease (Crohn's disease or ulcerative colitis), or other gastrointestinal disorders. The subjects in the three groups did not differ on the DES, the SCL-90 or most sections of the DDIS. However, subjects with irritable bowel syndrome reported much higher rates of childhood sexual abuse and psychosomatic symptoms.",0 +https://doi.org/10.1186/s12942-015-0008-6,The geography of post-disaster mental health: spatial patterning of psychological vulnerability and resilience factors in New York City after Hurricane Sandy,"Only very few studies have investigated the geographic distribution of psychological resilience and associated mental health outcomes after natural or man made disasters. Such information is crucial for location-based interventions that aim to promote recovery in the aftermath of disasters. The purpose of this study therefore was to investigate geographic variability of (1) posttraumatic stress (PTS) and depression in a Hurricane Sandy affected population in NYC and (2) psychological vulnerability and resilience factors among affected areas in NYC boroughs.Cross-sectional telephone survey data were collected 13 to 16 months post-disaster from household residents (N = 418 adults) in NYC communities that were most heavily affected by the hurricane. The Posttraumatic Stress Checklist for DSM-5 (PCL-5) was applied for measuring posttraumatic stress and the nine-item Patient Health Questionnaire (PHQ-9) was used for measuring depression. We applied spatial autocorrelation and spatial regimes regression analyses, to test for spatial clusters of mental health outcomes and to explore whether associations between vulnerability and resilience factors and mental health differed among New York City's five boroughs.Mental health problems clustered predominantly in neighborhoods that are geographically more exposed towards the ocean indicating a spatial variation of risk within and across the boroughs. We further found significant variation in associations between vulnerability and resilience factors and mental health. Race/ethnicity (being Asian or non-Hispanic black) and disaster-related stressors were vulnerability factors for mental health symptoms in Queens, and being employed and married were resilience factors for these symptoms in Manhattan and Staten Island. In addition, parental status was a vulnerability factor in Brooklyn and a resilience factor in the Bronx.We conclude that explanatory characteristics may manifest as psychological vulnerability and resilience factors differently across different regional contexts. Our spatial epidemiological approach is transferable to other regions around the globe and, in the light of a changing climate, could be used to strengthen the psychosocial resources of demographic groups at greatest risk of adverse outcomes pre-disaster. In the aftermath of a disaster, the approach can be used to identify survivors at greatest risk and to plan for targeted interventions to reach them.",0 +https://doi.org/10.1017/s0033291709005819,Diagnostic alterations for post-traumatic stress disorder: examining data from the National Comorbidity Survey Replication and National Survey of Adolescents,"Background Two alternative models of post-traumatic stress disorder (PTSD) appear to represent the disorder's latent structure better than the traditional Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) three-factor PTSD model. The present study examines the impact of using these structural models for the diagnosis of lifetime PTSD while retaining the DSM-IV PTSD's six-symptom diagnostic requirement. Method Data were gathered from large-scale, epidemiological datasets collected with adults (National Comorbidity Survey Replication) and adolescents (National Survey of Adolescents). Two alternative, empirically supported four-factor models of PTSD were compared with the DSM-IV three-factor PTSD diagnostic model. Results Results indicated that the diagnostic alterations resulted in substantially improved structural validity, downward adjustments of PTSD's lifetime prevalence (roughly 1 percentage point decreases in adults, 1–2.5 percentage point decreases in adolescents), and equivalent psychiatric co-morbidity and sociodemographic associations. Conclusions Implications for modifying PTSD diagnostic criteria in future editions of DSM are discussed.",0 +https://doi.org/10.1117/12.2177159,Remote stress detection using a visible spectrum camera,"Heart rate variability (HRV) can be an important indicator of several conditions that affect the autonomic nervous system, including traumatic brain injury, post-traumatic stress disorder and peripheral neuropathy. Recent work has shown that some of the HRV features can potentially be used for distinguishing a subject’s normal mental state from a stressed one. In all of these past works, HRV analysis is performed on the cardiac activity data acquired by conventional electrocardiography electrodes, which may introduce additional stress and complexity to the acquired data. In this paper we use remotely acquired time-series data extracted from the human facial skin reflectivity signal during rest and mental stress conditions to compute HRV driven features. We further apply a set of classification algorithms to distinguishing between these two states. To determine heart beat signal from the facial skin reflectivity, we apply Principal Component Analysis (PCA) for denoising and Independent Component Analysis (ICA) for source selection. To determine the signal peaks to extract the RR-interval time-series, we apply a threshold-based detection technique and additional peak conditioning algorithms. To classify RR-intervals, we explored classification algorithms that are commonly used for medical applications such as logistic regression and linear discriminant analysis (LDA). Goodness of each classifier is measured in terms of sensitivity/specificity. Results from each classifier are then compared to find the optimal classifier for stress detection. This work, performed under an IRB approved protocol, provides initial proof that remotely-acquired heart rate signal can be used for stress detection. This result shows promise for further development of a remote-sensing stress detection technique both for medical and deception-detection applications.",0 +https://doi.org/10.7205/milmed.172.5.456,Long-Term Course of Post-Traumatic Stress Disorder (PTSD) in German Soldiers: Effects of Inpatient Eye Movement Desensitization and Reprocessing Therapy and Specific Trauma Characteristics in Patients with Non-Combat-Related PTSD,"In this study, we retrospectively evaluated a patient population of 89 German soldiers who received inpatient treatment for post-traumatic stress disorder at the German Armed Forces Hospital in Hamburg from 1998 to 2003.Patients were nonrandomly assigned to a treatment group who received eye movement desensitization and reprocessing and a comparison group with general hospital treatment and relaxation training. Follow-up information was obtained 29 months post-treatment. Trauma-related symptoms were assessed using the Impact of Event Scale and the Post-Traumatic Stress Scale (PTSS-10) as parameters of improvement.The Impact of Event Scale showed that inpatient trauma therapy with eye movement desensitization and reprocessing significantly improved the course of post-traumatic stress disorder. In addition, the Impact of Event Scale indicated a significantly poorer long-term outcome for patients who had been confronted with death during their traumatic experience. Other factors tested were of no significant influence.These results may influence further treatment strategies for traumatized German soldiers.",0 +https://doi.org/10.1007/s10567-012-0124-9,Involving Parents in Indicated Early Intervention for Childhood PTSD Following Accidental Injury,"Accidental injuries represent the most common type of traumatic event to which a youth is likely to be exposed. While the majority of youth who experience an accidental injury will recover spontaneously, a significant proportion will go on to develop Post-Traumatic Stress Disorder (PTSD). And yet, there is little published treatment outcome research in this area. This review focuses on two key issues within the child PTSD literature-namely the role of parents in treatment and the timing of intervention. The issue of parental involvement in the treatment of child PTSD is a question that is increasingly being recognized as important. In addition, the need to find a balance between providing early intervention to at risk youth while avoiding providing treatment to those youth who will recover spontaneously has yet to be addressed. This paper outlines the rationale for and the development of a trauma-focused CBT protocol with separate parent and child programs, for use with children and adolescents experiencing PTSD following an accidental injury. The protocol is embedded within an indicated intervention framework, allowing for the early identification of youth at risk within a medical setting. Two case studies are presented in order to illustrate key issues raised in the review, implementation of the interventions, and the challenges involved. © 2012 Springer Science+Business Media, LLC.",0 +https://doi.org/10.1037/a0031314,Positive and negative emotion prospectively predict trajectories of resilience and distress among high-exposure police officers.,"Responses to both potentially traumatic events and other significant life stressors have been shown to conform to discrete patterns of response such as resilience, anticipatory stress, initial distress with gradual recovery, and chronic distress. The etiology of these trajectories is still unclear. Individual differences in levels of negative and positive emotion are believed to play a role in determining risk and resilience following traumatic exposure. In the current investigation, we followed police officers prospectively from academy training through 48 months of active duty, assessing levels of distress every 12 months. Using latent class growth analysis, we identified 4 trajectories closely conforming to prototypical patterns. Furthermore, we found that lower levels of self-reported negative emotion during academy training prospectively predicted membership in the resilient trajectory compared with the more symptomatic trajectories following the initiation of active duty, whereas higher levels of positive emotion during academy training differentiated resilience from a trajectory that was equivalently low on distress during academy training but consistently grew in distress through 4 years of active duty. These findings emerging from a prospective longitudinal design provide evidence that resilience is predicted by both lower levels of negative emotion and higher levels of positive emotion prior to active duty stressor exposure.",0 +https://doi.org/10.1111/1467-9450.00202,Posttraumatic symptomatology in children exposed to war,"This study examines affective and behavioral symptomatology in two groups of school-age children who were traumatized to different degrees during the war in Croatia (N = 1034). Six self-reported questionnaires were used to assess the following: number and type of war experiences, PTSD symptoms, anxiety, depression, psychosomatic symptoms, and psychosocial adaptation. Canonical discriminant analysis yielded a significant discriminant function that indicates moderate differentiation between the two groups of children according to the assessed symptoms. The results of a 2 x 2 x 2 ANOVAs (gender x age x level of traumatization) indicate that the children's reactions to war traumata varied in respect to all factors, as well as their interaction. The results indicate that gender differences are more prominent in older children. Older girls report more posttraumatic stress reactions, anxiety and depression, but at the same time seem better adapted than boys. Younger children, particularly those who survived more war even report more PTSD symptoms than older children.",0 +https://doi.org/10.1002/jts.20024,Is dissociation a multidimensional construct? Data from the Multiscale Dissociation Inventory,"The dimensionality of dissociation was examined in a combined sample of 1,326 general population, clinical, and university participants who completed the Multiscale Dissociation Inventory (MDI). Principal components analysis identified five moderately intercorrelated factors (mean r = .39): Disengagement, Identity Dissociation, Emotional Constriction, Memory Disturbance, and Depersonalization/Derealization. Differential relationships were found between individual MDI factors and demographics, trauma history, clinical status, posttraumatic stress, and scores on other dissociation measures. Surprisingly, after controlling for sex and age, trauma exposure accounted for only 3 to 7% of the variance in MDI factors. The notion of dissociation as a general trait was not supported. Instead, dissociation may represent a variety of phenomenologically distinct and only moderately related symptom clusters whose ultimate commonality is more theoretical than empirical.",0 +https://doi.org/10.1097/ta.0b013e318208fc74,Health-Related Quality of Life 2 Years to 7 Years After Burn Injury,"Knowledge concerning the trajectory and predictors of health-related quality of life (HRQoL) years after burn injury is fragmentary and these factors were therefore assessed using the EQ-5D questionnaire.Consecutive adult burn patients were included during hospitalization and assessed at 3 months, 6 months, and 12 months. In addition, an interview was performed at 2 years to 7 years postburn. Data concerning injury characteristics, sociodemographic variables, psychiatric disorders, and HRQoL were obtained.The EQ-5D dimension Mobility improved between hospitalization and 3 months, while Anxiety/Depression improved between 12 months and 2 years to 7 years. Other dimensions improved gradually. At 2 years to 7 years, only the dimensions Pain/Discomfort and Usual activities were lower than in the general population. In addition, overall HRQoL was lower than in the general population when measured by EQ VAS but not by EQ-5D index. EQ-5D index at 2 years to 7 years was predicted by EQ-5D index at 12 months and concurrent work status and pain. EQ VAS at 2 years to 7 years was predicted by previous assessments of work status, posttraumatic stress disorder and EQ VAS, and concurrent work status and substance abuse. Total amount of explained variance ranged between 17% and 57%.HRQoL after burn is conveniently screened by EQ VAS. Impairment after 2 years to 7 years is mainly reflected in the EQ dimensions Pain/Discomfort and Usual activities and can be predicted in part by information available before or at 12 months.",0 +https://doi.org/10.1007/s10072-012-1028-7,Drug-resistant chronic migraine: the Italian GON project,"Chronic daily headache is a major problem due to severe disability and high socio-economic costs. In the last years, some trials have shown potential benefit from new therapeutic approach by occipital neurostimulation techniques, already applied with some success for the treatment of chronic cluster headache. Due to the extremely heterogeneous population suffering from refractory chronic daily headaches, we propose a national multicenter experimental study involving Italian ANIRCEF Headache Centres with the aim to evaluate the efficacy of occipital neurostimulation in a selected group representative for the drug-resistant chronic migraine. Patients with chronic migraine according to Manzoni's modified IHS criteria-2011, with or without medication overuse headache, will be selected. Duration of illness should be at least 2 years and pharmacological refractoriness defined strictly for experimental-surgical purposes as those patients who have properly tried without success almost all available classes of prophylactic medications. Those presenting with medication overuse should have tried at least two previous detoxification treatments. A full psychopathological assessment will be performed by a psychiatrist, to exclude mainly psychotic disorder, ongoing severe status of an affective disorder, severe post traumatic stress disorder. Headache characteristics and abortive treatments used will be reported daily on a predisposed diary during 3-month baseline and continuously through the post implant follow up, while disability and QoL scale (MIDAS, SF-12) will be completed baseline, 6 and 12 months after implant. © Springer-Verlag 2012.",0 +https://doi.org/10.1016/j.jalz.2014.04.005,"Effects of traumatic brain injury and posttraumatic stress disorder on Alzheimer's disease in veterans, using the Alzheimer's Disease Neuroimaging Initiative","Both traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) are common problems resulting from military service, and both have been associated with increased risk of cognitive decline and dementia resulting from Alzheimer's disease (AD) or other causes. This study aims to use imaging techniques and biomarker analysis to determine whether traumatic brain injury (TBI) and/or PTSD resulting from combat or other traumas increase the risk for AD and decrease cognitive reserve in Veteran subjects, after accounting for age. Using military and Department of Veterans Affairs records, 65 Vietnam War veterans with a history of moderate or severe TBI with or without PTSD, 65 with ongoing PTSD without TBI, and 65 control subjects are being enrolled in this study at 19 sites. The study aims to select subject groups that are comparable in age, gender, ethnicity, and education. Subjects with mild cognitive impairment (MCI) or dementia are being excluded. However, a new study just beginning, and similar in size, will study subjects with TBI, subjects with PTSD, and control subjects with MCI. Baseline measurements of cognition, function, blood, and cerebrospinal fluid biomarkers; magnetic resonance images (structural, diffusion tensor, and resting state blood-level oxygen dependent (BOLD) functional magnetic resonance imaging); and amyloid positron emission tomographic (PET) images with florbetapir are being obtained. One-year follow-up measurements will be collected for most of the baseline procedures, with the exception of the lumbar puncture, the PET imaging, and apolipoprotein E genotyping. To date, 19 subjects with TBI only, 46 with PTSD only, and 15 with TBI and PTSD have been recruited and referred to 13 clinics to undergo the study protocol. It is expected that cohorts will be fully recruited by October 2014. This study is a first step toward the design and statistical powering of an AD prevention trial using at-risk veterans as subjects, and provides the basis for a larger, more comprehensive study of dementia risk factors in veterans.",0 +https://doi.org/10.1016/j.jpsychores.2014.09.002,The relation between parenting stress and adolescents' somatisation trajectories: A growth mixture analysis,"The impact of somatisation in adolescence is substantial. Knowledge on (predictors of) individual-level development of somatisation is necessary to develop tailored treatment. The current study assessed individual-level development of somatisation by means of latent mixed modelling. Parenting stress was included as a predictor of somatisation trajectory membership and within-trajectory variation.A total of 1499 adolescents and one of their parents (mostly the mother) agreed to participate. Questionnaires were administered when the adolescents were respectively 12-13 (T1), 13-14 (T2), and 14-15 (T3) years old. Adolescents reported on their somatisation, parents on their parenting stress.Four individual somatisation trajectories were found: increased, long-term low, long-term high, and decreased. Higher early parenting stress (T1) significantly predicted less favourable trajectory membership (increased and long-term high). The relation between later parenting stress (T2 and T3) and somatisation depended on trajectory membership. For adolescents in the long-term high and decreased somatisation trajectories, lower T2 and T3 parenting stress was related to higher somatisation, while for adolescents in the long-term low and increased trajectories, higher T2 and T3 parenting stress was related to higher somatisation.The results support a general recommendation to prevent the onset of high levels of parenting stress. In addition, for families in which high levels of parenting stress already exist, clinicians should be aware of natural fluctuations in parenting stress, its associated features (e.g., aspects of overall care, like looking for professional help) and of the consequences this might have for the adolescent.",0 +https://doi.org/10.1016/j.psychres.2013.09.012,Do gender and age moderate the symptom structure of PTSD? Findings from a national clinical sample of children and adolescents,"A substantial body of evidence documents that the frequency and intensity of posttraumatic stress disorder (PTSD) symptoms are linked to such demographic variables as female sex (e.g., Kaplow et al., 2005) and age (e.g., Meiser-Stedman et al., 2008). Considerably less is known about relations between biological sex and age with PTSD's latent factor structure. This study systematically examined the roles that sex and age may play as candidate moderators of the full range of factor structure parameters of an empirically supported five-factor PTSD model (Elhai et al., 2011). The sample included 6591 trauma-exposed children and adolescents selected from the National Child Traumatic Stress Network's Core Data Set. Confirmatory factor analysis using invariance testing (Gregorich, 2006) and comparative fit index difference values (Cheung and Rensvold, 2002) reflected a mixed pattern of test item intercepts across age groups. The adolescent subsample produced lower residual error variances, reflecting less measurement error than the child subsample. Sex did not show a robust moderating effect. We conclude by discussing implications for clinical assessment, theory building, and future research.",0 +https://doi.org/10.1007/bf02294359,Factor analysis and AIC,,0 +https://doi.org/10.1890/10-1493.1,"Ecosystem services and urban heat riskscape moderation: water, green spaces, and social inequality in Phoenix, USA","Urban ecosystems are subjected to high temperatures--extreme heat events, chronically hot weather, or both-through interactions between local and global climate processes. Urban vegetation may provide a cooling ecosystem service, although many knowledge gaps exist in the biophysical and social dynamics of using this service to reduce climate extremes. To better understand patterns of urban vegetated cooling, the potential water requirements to supply these services, and differential access to these services between residential neighborhoods, we evaluated three decades (1970-2000) of land surface characteristics and residential segregation by income in the Phoenix, Arizona, USA metropolitan region. We developed an ecosystem service trade-offs approach to assess the urban heat riskscape, defined as the spatial variation in risk exposure and potential human vulnerability to extreme heat. In this region, vegetation provided nearly a 25 degrees C surface cooling compared to bare soil on low-humidity summer days; the magnitude of this service was strongly coupled to air temperature and vapor pressure deficits. To estimate the water loss associated with land-surface cooling, we applied a surface energy balance model. Our initial estimates suggest 2.7 mm/d of water may be used in supplying cooling ecosystem services in the Phoenix region on a summer day. The availability and corresponding resource use requirements of these ecosystem services had a strongly positive relationship with neighborhood income in the year 2000. However, economic stratification in access to services is a recent development: no vegetation-income relationship was observed in 1970, and a clear trend of increasing correlation was evident through 2000. To alleviate neighborhood inequality in risks from extreme heat through increased vegetation and evaporative cooling, large increases in regional water use would be required. Together, these results suggest the need for a systems evaluation of the benefits, costs, spatial structure, and temporal trajectory for the use of ecosystem services to moderate climate extremes. Increasing vegetation is one strategy for moderating regional climate changes in urban areas and simultaneously providing multiple ecosystem services. However, vegetation has economic, water, and social equity implications that vary dramatically across neighborhoods and need to be managed through informed environmental policies.",0 +https://doi.org/10.1097/00005053-199911000-00005,Compensation-Seeking and Extreme Exaggeration of Psychopathology Among Combat Veterans Evaluated for Posttraumatic Stress Disorder,"We extended the work of Smith and Frueh (1996) by evaluating whether combat veterans classified as ""extreme exaggerators"" were more likely to be compensation-seeking, and to report greater levels of psychopathology across self-report instruments than ""nonexaggerators."" Of 119 veterans who completed the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) at an outpatient posttraumatic stress disorder (PTSD) clinic, 26 (22%) and 17 (14%) were identified as extreme exaggerators using two MMPI-2 validity indicators with stringent cutoffs (F-K > or = 22; F(p) > or = 8). These veterans were much more likely to be compensation seeking and scored much higher on self-report measures of various psychological symptoms than nonexaggerators, despite having lower rates of PTSD diagnoses and similar rates of other comorbid diagnoses. Findings suggest that the validity indices of the MMPI-2 can play a critical role, as a screening instrument, in identifying veterans who may be exaggerating their psychopathology to gain disability compensation.",0 +https://doi.org/10.1016/j.janxdis.2014.06.009,PTSD symptom severity and psychiatric comorbidity in recent motor vehicle accident victims: A latent class analysis,"We conducted a latent class analysis (LCA) on 249 recent motor vehicle accident (MVA) victims to examine subgroups that differed in posttraumatic stress disorder (PTSD) symptom severity, current major depressive disorder and alcohol/other drug use disorders (MDD/AoDs), gender, and interpersonal trauma history 6-weeks post-MVA. A 4-class model best fit the data with a resilient class displaying asymptomatic PTSD symptom levels/low levels of comorbid disorders; a mild psychopathology class displaying mild PTSD symptom severity and current MDD; a moderate psychopathology class displaying severe PTSD symptom severity and current MDD/AoDs; and a severe psychopathology class displaying extreme PTSD symptom severity and current MDD. Classes also differed with respect to gender composition and history of interpersonal trauma experience. These findings may aid in the development of targeted interventions for recent MVA victims through the identification of subgroups distinguished by different patterns of psychiatric problems experienced 6-weeks post-MVA.",0 +https://doi.org/10.1136/jnnp.2008.170191,Primary focal dystonia: evidence for distinct neuropsychiatric and personality profiles,"Primary focal dystonia (PFD) is characterised by motor symptoms. Frequent co-occurrence of abnormal mental conditions has been mentioned for decades but is less well defined. In this study, prevalence rates of psychiatric disorders, personality disorders and traits in a large cohort of patients with PFD were evaluated.Prevalence rates of clinical psychiatric diagnoses in 86 PFD patients were compared with a population based sample (n = 3943) using a multiple regression approach. Furthermore, participants were evaluated for personality traits with the 5 Factor Personality Inventory.Lifetime prevalence for any psychiatric or personality disorder was 70.9%. More specifically, axis I disorders occurred at a 4.5-fold increased chance. Highest odds ratios were found for social phobia (OR 21.6), agoraphobia (OR 16.7) and panic disorder (OR 11.5). Furthermore, an increased prevalence rate of 32.6% for anxious personality disorders comprising obsessive-compulsive (22.1%) and avoidant personality disorders (16.3%) were found. Except for social phobia, psychiatric disorders manifested prior to the occurrence of dystonia symptoms. In the self-rating of personality traits, PFD patients demonstrated pronounced agreeableness, conscientiousness and reduced openness.Patients with PFD show distinct neuropsychiatric and personality profiles of the anxiety spectrum. PFD should therefore be viewed as a neuropsychiatric disorder rather than a pure movement disorder.",0 +https://doi.org/10.1080/09602010802151532,A biopsychosocial deconstruction of “personality change” following acquired brain injury,"The judgement of personality change following acquired brain injury (ABI) is a powerful subjective and social action, and has been shown to be associated with a range of serious psychosocial consequences. Traditional conceptualisations of personality change (e.g., Lishman, 1998) have largely derived from individualist concepts of personality (e.g., Eysenck, 1967). These assume a direct link between neurological damage and altered personhood, accounting predominantly for their judgements of change. This assumption is found as commonly in family accounts of change as in professional discourse. Recent studies and perspectives from the overlapping fields of social neuroscience, cognitive approaches to self and identity and psychosocial processes following ABI mount a serious challenge to this assumption. These collectively identify a range of direct and indirect factors that may influence the judgement or felt sense of change in personhood by survivors of ABI and their significant others. These perspectives are reviewed within a biopsychosocial framework: neurological and neuropsychological deficits, psychological mechanisms and psychosocial processes. Importantly, these perspectives are applied to generate a range of clinical interventions that were not identifiable within traditional conceptualisations of personality changes following ABI.",0 +https://doi.org/10.1111/j.1469-7610.2004.00307.x,Psychopathology in female juvenile offenders,"Background: The aim was to document the spectrum of present and lifetime psychological disorders in female juvenile offenders, and to examine the relations between mental health status and socio-demographic, family and trauma variables. Method: One hundred juvenile offenders were matched with a comparison group of 100 females on age and socioeconomic status (SES). Psychological profiles and trauma histories of both groups were assessed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime Version (K-SADS-PL) and family functioning was assessed with the Family Adaptability and Cohesion Scale II (FACES II) self-report measure. Results: Rates of psychopathology were higher for offenders than non-offenders (p < .001), with particularly high levels of conduct disorder (91% v.1%, p < .001), substance abuse disorders (85% v. 5%, p < .001), depression (55% v. 25%, p < .001) and posttraumatic stress disorder (37% v. 4%, p < .001). In the offenders, 78% met the criteria for three or more diagnoses. The number of psychiatric diagnoses was the most significant factor associated with offender status (OR = 21.26, p < .001). Conclusions: There is a high prevalence of psychological disorder in females in juvenile justice custody and this has a very strong association with offender status. Because these co-morbid disorders are treatable, there is a clear opportunity to intervene to decrease psychological distress.",0 +https://doi.org/10.1007/s11920-004-0048-2,The University of California at Los Angeles post-traumatic stress disorder reaction index,"Over the past decade, the University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index has been one of the most widely used instruments for the assessment of traumatized children and adolescents. This paper reviews its development and modifications that have been made as the diagnostic criteria for post-traumatic stress disorder have evolved. The paper also provides a description of standard methods of administration, procedures for scoring, and psychometric properties. The Reaction Index has been extensively used across a variety of trauma types, age ranges, settings, and cultures. It has been broadly used across the US and around the world after major disasters and catastrophic violence as an integral component of public mental health response and recovery programs. The Reaction Index forms part of a battery that can be efficiently used to conduct needs assessment, surveillance, screening, clinical evaluation, and treatment outcome evaluation after mass casualty events.",0 +https://doi.org/10.1155/2002/418758,Theoretical Accounts of Gulf War Syndrome: From Environmental Toxins to Psychoneuroimmunology and Neurodegeneration,"Non-specific illness includes a wide variety of symptoms: behavioural (e.g., reduced food and water intake), cognitive (e.g., memory and concentration problems) and physiological (e.g., fever). This paper reviews evidence suggesting that such symptoms can be explained more parsimoniously as a single symptom cluster than as a set of separate illnesses such as Gulf War Syndrome (GWS) and chronic fatigue syndrome (CFS). This superordinate syndrome could have its biological basis in the activity of pro-inflammatory cytokines (in particular interleukin-1: IL-1), that give rise to what has become known as the 'sickness response'. It is further argued that the persistence of non-specific illness in chronic conditions like GWS may be (in part) attributable to a bio-associative mechanism (Ferguson and Cassaday, 1999). In the case of GWS, physiological challenges could have produced a non-specific sickness response that became associated with smells (e.g., petrol), coincidentally experienced in the Persian Gulf. On returning to the home environment, these same smells would act as associative triggers for the maintenance of (conditioned) sickness responses. Such associative mechanisms could be mediated through the hypothalamus and limbic system via vagal nerve innervation and would provide an explanation for the persistence of a set of symptoms (e.g., fever) that should normally be short lived and self-limiting. We also present evidence that the pattern of symptoms produced by the pro-inflammatory cytokines reflects a shift in immune system functioning towards a (T-helper-1) Th1 profile. This position contrasts with other immunological accounts of GWS that suggest that the immune system demonstrates a shift to a Th2 (allergy) profile. Evidence pertaining to these two contrasting positions is reviewed.",0 +https://doi.org/10.1037/a0016908,"Assessment and diagnosis of mild traumatic brain injury, posttraumatic stress disorder, and other polytrauma conditions: Burden of adversity hypothesis.","Military personnel returning from Iraq and Afghanistan have been exposed to physical and emotional trauma. Challenges related to assessment and intervention for those with posttraumatic stress disorder (PTSD) and/or history of mild traumatic brain injury (TBI) with sequelae are discussed, with an emphasis on complicating factors if conditions are co-occurring. Existing literature regarding cumulative disadvantage is offered as a means of increasing understanding regarding the complex symptom patterns reported by those with a history of mild TBI with enduring symptoms and PTSD.The importance of early screening for both conditions is highlighted. In addition, the authors suggest that current best practices include treating symptoms regardless of etiology to decrease military personnel and veteran burden of adversity.",0 +https://doi.org/10.1016/b978-0-12-800977-2.00002-4,Epigenetics in Posttraumatic Stress Disorder,"Reported exposure to traumatic event is relatively common within the general population (40–90%), but only a fraction of individuals will develop posttraumatic stress disorder (PTSD). Indeed, the lifetime prevalence of PTSD is estimated to range between 7% and 12%. The factors influencing risk or resilience to PTSD after exposure to traumatic events are likely both environmental, such as type, timing, and extent of trauma, and genetic. Recently, epigenetic mechanisms have been implicated in mediating altered risk for PTSD as they can reflect both genetic and environmental influences. In this chapter, we describe the accumulating evidences for epigenetic factors in PTSD highlighting the importance of sensitive periods as well as methodological aspects such as tissue availabilities for such studies. We describe studies using a candidate gene approach focusing mainly on key players in the stress hormone regulation that show epigenetic alterations both in humans and in animal models for PTSD. We also summarize the results of epigenome-wide studies reporting associations with PTSD. For the above, we focus on one epigenetic mechanism, DNA methylation, as it is so far the best studied for this disorder. Finally, we describe how epigenetic mechanisms could be responsible for the long-lasting effects of gene–environment interactions observed in PTSD.",0 +https://doi.org/10.1002/jts.20556,"Peritraumatic distress, posttraumatic stress disorder symptoms, and posttraumatic growth in victims of violence","This study explored whether peritraumatic distress and posttraumatic stress disorder (PTSD) symptoms are curvilinearly related to posttraumatic growth in victims of violence several years after victimization (Time 1; n = 678) and 6 months later (Time 2, n = 205). At both time points, curve estimation revealed linear and quadratic associations between peritraumatic distress and posttraumatic growth and quadratic associations between PTSD symptoms and posttraumatic growth. In multivariate regressions controlling for background variables, the linear peritraumatic distress and quadratic PTSD symptom terms remained significant predictors of posttraumatic growth Time 1 scores. For Time 2, the linear peritraumatic distress term remained significant, though only prior to controlling for posttraumatic growth Time 1 scores. The results suggest that peritraumatic distress enables growth after substantial time has elapsed since victimization.",0 +https://doi.org/10.1037/0090-5550.43.4.313,Classification of chronic pain patients with the Brief Symptom Inventory: Patient characteristics of cluster profiles.,"In this study, the psychological symptom patterns of individuals with chronic pain on the Brief Symptom Inventory (BSI) were cluster analyzed. Cluster analysis was initially performed on a large sample of people with chronic pain (n = 1,489) and then cross-validated on a smaller sample (n = 244). A 2-cluster solution was deemed most appropriate. The clusters reflected low- and high-profile elevations on all BSI subscales. Among persons in the smaller sample, high-profile participants were more likely to be involved in litigation, report a higher frequency of posttraumatic stress symptoms, and display poorer psychosocial functioning. The results suggest that the BSI subgroups are associated with psychosocial characteristics that may be important in terms of treatment planning and outcome.",0 +https://doi.org/10.1111/bmsp.12043,Bias in longitudinal data analysis with missing data using typical linear mixed-effects modelling and pattern-mixture approach: An analytical illustration,"We analytically derive the fixed-effects estimates in unconditional linear growth curve models by typical linear mixed-effects modelling (TLME) and by a pattern-mixture (PM) approach with random-slope-dependent two-missing-pattern missing not at random (MNAR) longitudinal data. Results showed that when the missingness mechanism is random-slope-dependent MNAR, TLME estimates of both the mean intercept and mean slope are biased because of incorrect weights used in the estimation. More specifically, the estimate of the mean slope is biased towards the mean slope for completers, whereas the estimate of the mean intercept is biased towards the opposite direction as compared to the estimate of the mean slope. We also discuss why the PM approach can provide unbiased fixed-effects estimates for random-coefficients-dependent MNAR data but does not work well for missing at random or outcome-dependent MNAR data. A small simulation study was conducted to illustrate the results and to compare results from TLME and PM. Results from an empirical data analysis showed that the conceptual finding can be generalized to other real conditions even when some assumptions for the analytical derivation cannot be met. Implications from the analytical and empirical results were discussed and sensitivity analysis was suggested for longitudinal data analysis with missing data.",0 +https://doi.org/10.1016/j.jad.2011.09.017,Long-term outcome of eight clinical trials of CBT for anxiety disorders: Symptom profile of sustained recovery and treatment-resistant groups,"Few clinical trials of cognitive behaviour therapy (CBT) for anxiety disorders have conducted follow-up beyond one year post-treatment. This paper summarises the long-term outcome of eight clinical trials of CBT for anxiety disorders in terms of diagnostic status, healthcare usage and symptom severity and compares the symptom profile of participants with the best and worst outcomes relative to chronic depression and the normal population.Follow-up at 2-14years with 396 patients (51% of those available to contact) employed structured diagnostic interview, assessment of healthcare usage and self-report measures of symptom severity. This paper concerns 336 participants who had either no disorder or at least one anxiety disorder and information on healthcare usage over the follow-up period.Only 38% recovered with little or no treatment over the follow-up period while 30% had a very poor outcome despite extensive treatment for anxiety over many years. The symptom profile of this 'treatment-resistant' group was comparable to 76 patients with chronic depression and significantly worse than normative data for psychiatric outpatients. Chronic anxiety disorder with co-morbid depression has a more severe symptom profile than chronic anxiety disorder alone.The follow-up sample, although broadly representative, may have a bias towards a more favourable picture of overall outcome.The long-term outcome of anxiety disorders, irrespective of diagnosis or active treatment, is diverse but with a tendency towards chronicity. Distinctions between acute and chronic presentations of common mental disorders are more important than distinctions between chronic anxiety and chronic depression.",0 +https://doi.org/10.5694/j.1326-5377.2007.tb01108.x,The relationship between compensable status and long‐term patient outcomes following orthopaedic trauma,"OBJECTIVE: To determine the relationship between compensable status in a compensation scheme and long-term outcomes after orthopaedic trauma. DESIGN AND SETTING: Prospective cohort study within two adult Level 1 trauma centres in Victoria, Australia. PARTICIPANTS: Blunt trauma patients aged 18-64 years, admitted between September 2003 and August 2004 with orthopaedic injuries and funded by the no-fault compensation scheme for transport-related injury, or deemed non-compensable. MAIN OUTCOME MEASURES: 12-item Short Form Health Survey (SF-12) and return to work or study at 12 months after injury. RESULTS: Of 1033 eligible patients, 707 (68.8%) provided follow-up data; 450 compensable and 247 non-compensable patients completed the study. After adjusting for differences across the groups (age, injury severity, head injury status, injury group, and discharge destination) using multivariate analyses, compensable patients were more likely than non-compensable patients to report moderate to severe disability at follow-up for the physical (adjusted odds ratio [AOR], 2.0; 95% CI, 1.3-2.9), and mental (AOR, 1.6; 95% CI, 1.1-2.5) summary scores of the SF-12. Compensable patients were less likely than non-compensable patients to have returned to work or study, even after adjusting for injury severity, age, head injury status and discharge destination (AOR, 0.6; 95% CI, 0.3-0.9). CONCLUSIONS: Patients covered by the no-fault compensation system for transport-related injuries in Victoria had worse outcomes than non-compensable patients. Language: en",0 +https://doi.org/10.1016/s0005-7967(01)00126-7,Cognitive predictors of posttraumatic stress disorder in children: results of a prospective longitudinal study,"The present study explored whether cognitive factors specified in the Ehlers and Clark model (Behav. Res. Ther. 38 (2000) 319) of posttraumatic stress disorder (PTSD) predict chronic PTSD in children who had experienced a road traffic accident. Children were assessed at 2 weeks, 3 months, and 6 months after the accident. Data-driven processing during the accident, negative interpretation of intrusive memories, alienation from other people, anger, rumination, thought suppression and persistent dissociation at initial assessment predicted PTSD symptom severity at 3 and 6 months. On the basis of sex and stressor severity variables, 14% of the variance of PTSD symptoms at 6 months could be explained. The accuracy of the prediction increased to 49% or 53% when the cognitive variables measured at initial assessment or 3 months, respectively, were taken into account.",0 +https://doi.org/10.14254/2071-789x.2015/8-4/16,Optimism and Consumption: Psychological Costs of Malaysia-Sulu Dispute,"This research aims to examine the moderating effect of optimism on the relationship between psychological cost and consumption level during disputes. Psychometric-based questionnaire was developed and distributed in March 2013 to find Sabahan had severe symptoms of stress. This stress level induced the consumption level and also leisure cost in attempts to overcome the dispute. Interestingly, those Sabahans who were more inclined to optimism-might rethink their consumption/spending decision making. In other words, there is a moderating effect of optimism on the relationship between stress level and consumption during disputes.",0 +https://doi.org/10.1037/a0014512,Posttraumatic stress disorder in parents of children with chronic illnesses: A meta-analysis.,"To estimate PTSD prevalence in parents of children with chronic illnesses or undergoing invasive procedures, and its association with higher risk of PTSD among parents.Sixteen studies reporting prevalence of PTSD in parents of children with chronic illnesses were identified through a systematic review in Pubmed, Web of Science, Pilots and PsycINFO databases.Pooled current PTSD prevalence was calculated for parents from these studies. Pooled PTSD prevalence ratios were obtained by comparing parents of children with chronic diseases with parents of healthy children. Meta-regression was used to identify variables that could account for the lack of homogeneity.Pooled PTSD prevalence was 19.6% in mothers, 11.6% in fathers, and 22.8% in parents in general (p < .001). Pooled prevalence ratio for the four studies reporting on mothers and comparison healthy groups was 4.2 (p < .001).The high prevalence of PTSD found in this population highlights the importance of promptly assessing and treating post-traumatic symptoms in parents of children with chronic diseases as a key step to prevent the negative consequences of PTSD and preserve their competency as caregivers.",0 +https://doi.org/10.1007/bf02294365,On structural equation modeling with data that are not missing completely at random,"A general latent variable model is given which includes the specification of a missing data mechanism. This framework allows for an elucidating discussion of existing general multivariate theory bearing on maximum likelihood estimation with missing data. Here, missing completely at random is not a prerequisite for unbiased estimation in large samples, as when using the traditional listwise or pairwise present data approaches. The theory is connected with old and new results in the area of selection and factorial invariance. It is pointed out that in many applications, maximum likelihood estimation with missing data may be carried out by existing structural equation modeling software, such as LISREL and LISCOMP. Several sets of artifical data are generated within the general model framework. The proposed estimator is compared to the two traditional ones and found superior.",0 +https://doi.org/10.1002/gps.1195,Vulnerability to post-traumatic stress disorder and psychological morbidity in aged holocaust survivors,"Objective Although high rates of post-traumatic stress disorder (PTSD) and psychological morbidity have been consistently reported in Holocaust survivors (HS), reports are inconsistent about which factors are associated with psychological morbidity. In a study of the oldest HS cohort yet reported, we aim to clarify why this variability exists by examining factors associated with PTSD and psychological morbidity, including for the first time measures of personality and defense mechanisms. Methods One hundred HS randomly selected from a convenience sample of 309 respondents to a survey of Jewish persons aged 60 years and older living in the community in Sydney were assessed using the following instruments: demographics, severity of trauma experienced, General Health Questionnaire (GHQ-28), PTSD diagnosis (DSM-IV), Brief Psychiatric Rating Scale, Impact of Events Scale, Defense Style Questionnaire, modified Eysenck Personality Inventory. Results Older age, experience of more severe trauma, use of immature defense mechanisms and higher neuroticism were associated with significant PTSD and psychological morbidity; severity of trauma was associated with PTSD and with more severe psychological morbidity. Conclusions A profile of survivors at-risk can be identified that may have application to survivors of more recent holocausts. Late life may be a period of vulnerability in the aftermath of severe trauma. Copyright © 2004 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1016/0278-5846(93)90004-c,Psychoneuroendocrine assessment of posttraumatic stress disorder: Current progress and new directions,1. Studies in our laboratory have used the psychoendocrine strategy to explore differences in basal hormone levels between patients with posttraumatic stress disorder (PTSD) and other groups. This approach has allowed us to explore the relationship between hormone levels and specific psychological and biological processes which appear to develop following exposure to extreme trauma. 2. The concurrent assessment of several hormonal systems provides an opportunity to explore differences in hormonal patterns in various psychiatric disorders. PTSD appears to be characterized by a specific profile of hormonal changes that is distinct from that of other diagnostic groups and normal controls. These findings raise the possibility that the psychoendocrine approach may be useful in further exploring the pathophysiology and diagnosis of PTSD. 3. This paper reviews psychoendocrine changes in PTSD and describes updated multivariate methods that further elucidate psychological and neurochemical correlates of hormonal alterations in this disorder.,0 +https://doi.org/10.7205/milmed.169.7.536,"Preventive Health Behaviors, Health-Risk Behaviors, Physical Morbidity, and Health-Related Role Functioning Impairment in Veterans with Post-Traumatic Stress Disorder","An examination of the relationships between health behaviors (preventive and risk-related), physician-diagnosed medical problems, role-functioning impairment because of physical morbidity, and post-traumatic stress disorder was conducted on a large cohort of consecutive treatment-seeking cases (N = 826) presenting to an outpatient Veterans Affairs post-traumatic stress disorder clinic. Results revealed that the sample rates of several medical conditions were markedly elevated when compared with general population rates for men of comparable age. The rates of smoking and other behavioral risk variables were greater than rates among men in the general population. Moreover, the majority of the sample did not engage in preventive health behaviors such as exercise and medical screening at levels consistent with health care guidelines. Physical role functioning indices of the SF-36 reveal greater role-functioning impairment because of physical morbidity in this psychiatric sample relative to the age adjusted general population norms. The health care implications of these data are discussed, as are areas for future research.",0 +https://doi.org/10.1007/s007870050091,Behavioural psychopathology of child sexual abuse in schoolgirls referred to a tertiary centre: A North London study,"The sexually abused girls in this study were a sub-sample of a group of girls referred to a Regional Centre for Psychotherapy for the whole of London, North Thames. An inclusion criterion was that they were psychologically symptomatic and so it is likely that they were more problematic cases causing concern in their locality. The control clinical group consisted of referrals to local Child and Family consultation services, were an opt-in matched sample and not a total clinic referral sample. In addition, the reasons for referral covered both child disorder and family problems. It is, therefore, important to bear in mind the differences between these two groups. Certain clear cut findings have emerged from this study. No disorders specific to child sexual abuse in girls were identified but the extent and severity of the disturbance in the sexually abused sample was most striking. In these girls an event (CSA), together with referral because of emotional symptoms, was associated with enhanced severity of disorder and comorbidity particularly with reference to a cluster of disorders comprising post-traumatic stress disorder, depressive disorder, anxiety disorders (general and separation), social phobias and reactive attachment disorder. In the community clinic sample the identified disorders were mainly those of separation anxiety disorders and adjustment. Wide comorbidity was common in the sexual abuse sample and also severity of impairment was notable when compared to the clinic sample. However, because of the selected nature of the abuse group the findings are not generalisable beyond the population from which they emerged. The view is advanced that there are strong grounds for exploring the utility of psychodynamic psychotherapy in similar samples of sexually abused girls. These findings are discussed in the light of the current literature.",0 +https://doi.org/10.1111/j.1600-0447.1983.tb09716.x,The Hospital Anxiety and Depression Scale,A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.,0 +https://doi.org/10.1007/s11920-015-0625-6,The Preeminence of Early Life Trauma as a Risk Factor for Worsened Long-Term Health Outcomes in Women,"Early life trauma (ELT) comprises an array of disturbingly common distressing experiences between conception and the beginning of adulthood with numerous and significant potential long-term, even transgenerational, health consequences of great public health concern, including depression, cardiovascular disease, and other psychiatric and medical disorders, and neurobiological, psychological, and behavioral effects which are sufficiently robust to confound many types of biomedical research. The impact of ELT on a woman’s health trajectory appears to vary with the specific characteristics of the ELT (e.g., type, number of different types, severity, and timing), the individual (e.g., age, genetics, epigenetics, personality, and cognitive factors), and the individual’s environment (e.g., level of social support and ongoing stressors) and to be mediated to a significant extent by persistent changes in a number of biological systems, dysregulation of those governing the stress response chief among them. Growing knowledge of the risk factors and pathophysiological mechanisms by which ELT confers diathesis to various poor health outcomes and the unique treatment–response profiles of women with ELT will lead to much needed improvements in prevention, diagnostic, and therapeutic efforts, including more effective psychotherapy and pharmacotherapy approaches, hopefully making strides toward improvements in the lives of women everywhere and ending countless cycles of intergenerational trauma-associated pathology. This article attempts to broadly summarize the current state of knowledge about the long-term sequelae of ELT for women’s health. © 2015, Springer Science+Business Media New York.",0 +https://doi.org/10.1016/s1359-1789(01)00066-0,The neurobiology of abandonment homicide,"A review is made of the typical modus operandi and psychological profile of uxoricide (wife murder) perpetrators. Typically, most had traumatic childhood and have current personality disorders (PD; typically Dependent, Passive–Aggressive, or Borderline PD). The uxoricide occurred during attempted abandonment of the relationship by the female and was characterized by extreme violence and elements of disorganized behavior by the perpetrator. A review is also made of the neuroanatomy and neurobiology of aggression. It is found that the orbitofrontal cortex (OFC) is implicated in control of aggressive impulses. This cortical area matures during the critical “rapprochement subphase” of early development (1.5–2 years). Attachment dysfunction during this period may interfere with critical development. It is found that low levels of serotonin (5-HT) and high levels of norepinephrine (NE) are implicated in aggression. It is also found that low levels of 5-HT and high levels of NE are long-term neurobiological sequelae of trauma. Attachment trauma can occur during the rapprochement subphase. It is suggested that a biological basis may serve to connect early trauma experience with a specific rage response to abandonment and spousal homicide. Neural networks containing malignant memories may be the neural mechanism by which perceived abandonment generates such symbolic terror and rage.",0 +https://doi.org/10.1080/00048670701392825,Prediction of Outcome for Veterans with Post-Traumatic Stress Disorder Using Constructs from the Transtheoretical Model of Behaviour Change,"Post-traumatic stress disorder (PTSD) is a disabling condition, sometimes unresponsive to treatment. The aim of the present study was to examine the predictive utility of constructs from the transtheoretical model of behaviour change (TTM) known to predict outcome for other disorders.A sample of 50 veterans presenting for a PTSD treatment programme provided data for this longitudinal study. Variables were assessed at four time-points during the treatment programme. Multiple regression and mixed-effects regression were utilized to determine the predictive utility of variables from the TTM.Allocated stage of change at the time of a 2 day introduction programme predicted follow-up symptom severity, but changes therein during treatment did not predict changes in symptom severity. However, changes in the continuous readiness-to-change variable and behavioural processes of change were predictive of such changes.Despite some difficulties in the application of the TTM to PTSD, the model does appear to predict treatment outcome. Veterans who have increased readiness to change and who make more use of behavioural processes of change are likely to have improved outcomes.",0 +https://doi.org/10.1016/b978-0-12-398393-0.00006-7,Pathological Modes of Remembering,"The experience of a severe stressor can lead to involuntary and persistent recollections of the event in some affected individuals. These unwanted spontaneous memories are usually accompanied by intense emotions and psychological distress, leaving the individual unable to cope. The present chapter aims to give a comprehensible introduction to the pathological consequences that may arise from the exposure to traumatic stress. It is an attempt to provide some insight into what can be considered a traumatic event, which natural stress reactions can be expected, what we know about risk factors for the development of posttraumatic stress disorder, and which dysfunctional strategies may contribute to the maintenance of the disorder.",0 +https://doi.org/10.1176/appi.ajp.158.12.1974,"Efficacy of Sertraline in Preventing Relapse of Posttraumatic Stress Disorder: Results of a 28-Week Double-Blind, Placebo-Controlled Study","The study examined the efficacy of sertraline, compared with placebo, in sustaining improvement and preventing relapse over 28 weeks in patients with posttraumatic stress disorder (PTSD) who had completed a 12-week double-blind, placebo-controlled acute treatment study and a subsequent 24-week open-label study of continuation treatment with sertraline.Ninety-six patients were randomly assigned, in a double-blind design, to 28 weeks of maintenance treatment with sertraline (50-200 mg, N=46; 78% were women) or placebo (N=50; 62% were women). Measures used in biweekly assessments included the Clinician-Administered PTSD Scale, the Impact of Event Scale, and the Clinical Global Impression severity and improvement ratings. Kaplan-Meier analyses were used to estimate time to discontinuation from the study due to relapse, relapse or study discontinuation due to clinical deterioration, and acute exacerbation.Continued treatment with sertraline yielded lower PTSD relapse rates than placebo (5% versus 26%). Patients who received placebo were 6.4 times as likely to experience relapse as were patients who received sertraline. Kaplan-Meier analyses confirmed the protective effect of sertraline in significantly extending time in remission. The ability of sertraline to sustain improvement was comparable across the three core PTSD symptom clusters (reexperiencing/intrusion, avoidance/numbing, and hyperarousal). A regression analysis found early response during acute treatment to be associated with a more than 16-fold reduced risk of relapse after placebo substitution. Sertraline, at a mean endpoint dose of 137 mg, was well tolerated, with no sertraline-related adverse events observed at a rate of 10% or higher.The results provide evidence for the ability of sertraline both to sustain improvement in PTSD symptoms and to provide prophylactic protection against relapse.",0 +https://doi.org/10.1016/j.avb.2015.01.001,Post-traumatic stress disorder as a consequence of bullying at work and at school. A literature review and meta-analysis,"Bullying has been established as a prevalent traumatic stressor both in school and at workplaces. It has been claimed that the mental and physical health problems found among bullied persons resembles the symptomatology of Post Traumatic Stress Disorder (PTSD). Yet, it is still unclear whether bullying can be considered as a precursor to PTSD. Through a review and meta-analysis of the research literature on workplace- and school bullying, the aims of this study were to determine: 1) the magnitude of the association between bullying and symptoms of PTSD, and 2) whether the clinical diagnosis of PTSD applies to the consequences of bullying. Altogether 29 relevant studies were identified. All had cross-sectional research designs. At an average, 57% of victims reported symptoms of PTSD above thresholds for caseness. A correlation of .42 (95% CI: .36–.48; p < .001) was found between bullying and an overall symptom-score of PTSD. Correlations between bullying and specific PTSD-symptoms were in the same range. Equally strong associations were found among children and adults. Two out of the three identified clinical diagnosis studies suggested that bullying is associated with the PTSD-diagnosis. Due to a lack of longitudinal research and structural clinical interview studies, existing literature provides no absolute evidence for or against bullying as a causal precursor of PTSD. • Summarizes research literature on the associations between bullying and PTSD • The majority of victims reports symptoms of PTSD. • Exposure to bullying is cross-sectionally associated with symptoms of PTSD. • No longitudinal studies and few studies with clinical diagnosis • It is not possible to determine causal associations between bullying and PTSD based on existing literature.",0 +https://doi.org/10.1177/0145445500245005,Promoting Independent Task Performance by Persons with Severe Developmental Disabilities through a New Computer-Aided System,"This study involved two experiments. In Experiment 1, a computer-aided system for promoting task performance by 6 persons with severe developmental disabilities was compared with a card system. The computer-aided system was portable and presented pictorial task instructions (one instruction per step) and prompts. In Experiment 2, the same systemwas used, but the number of instruction occasions was reduced. In one condition, the system presented all the instructions used in Experiment 1 but mostly in clusters rather than individually. In another, the system presented part of the Experiment 1 instructions. Three Experiment 1 participants also served in Experiment 2. Experiment 1 results indicated all 6 participants had higher percentages of correct steps with the computer system and preferred it to the card system. Experiment 2 results indicated that the condition in which the instructions were clusteredwas more effective for maintaining correct task performance. Implications of the findings were discussed.",0 +https://doi.org/10.1093/milmed/158.12.766,Family Violence: Clinical Indicators among Military and Post-Military Personnel,"Child and spouse abuse continues to be a critically important problem for the medical and mental health professions. Examined are recent clinical data and research addressing this most serious concern among military and post-military personnel. Criteria useful in the identification of risk persons and diagnosis and treatment of family violence are discussed. Specific attention is given to the diagnostic indicators, the abusing family profile, the traumatic process of abuse, and strategies relevant to psychiatric intervention. Guidelines for military mental health and medical professionals are explored.",0 +https://doi.org/10.1111/ene.12794,Psychopathological comorbidities in medication-overuse headache: a multicentre clinical study,"In medication-overuse headache (MOH) patients, the presence of psychopathological disturbances may be a predictor of relapse and poor response to treatment. This multicentre study aimed to assess the occurrence of psychopathological disorders in MOH patients by comparing the incidence of psychopathological disturbances with episodic migraine (EM) patients and healthy controls (HC).The psychopathological assessment of patients and HC involved the administrations of the Beck Depression Inventory, the Beck Anxiety Inventory, the Modified Mini International Neuropsychiatric Interview (M-MINI), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Leeds Dependence Questionnaire.The MOH, EM and HC groups (88, 129 and 102 subjects, respectively) differed significantly from each other for the presence of moderate/severe anxiety, whereas mood disorder and depression were revealed in similar proportions for both MOH and EM patients. By stratifying the M-MINI questionnaire results according to the number of psychiatric disorders, it was found that MOH patients had a more complex profile of psychiatric comorbidity. Furthermore, clinically relevant obsessive-compulsive disturbances for abused drugs assessed by Y-BOCS appeared to be more represented in the MOH group, whilst the prevalence of this trait in the EM group was comparable to that of HC (12.5%, 0.8% and 0%, respectively).Our study indicates the multiple presence of psychopathological comorbidities in patients with MOH. In light of this, it is recommended that the assessment of the psychopathological profile be included in an evaluation of MOH patients, allowing the clinician to more rapidly start an appropriate behavioural treatment, which would greatly improve MOH management.",0 +https://doi.org/10.1001/archpsyc.65.6.659,Treatment of Acute Stress Disorder,"Recent trauma survivors with acute stress disorder (ASD) are likely to subsequently develop chronic posttraumatic stress disorder (PTSD). Cognitive behavioral therapy for ASD may prevent PTSD, but trauma survivors may not tolerate exposure-based therapy in the acute phase. There is a need to compare nonexposure therapy techniques with prolonged exposure for ASD.To determine the efficacy of exposure therapy or trauma-focused cognitive restructuring in preventing chronic PTSD relative to a wait-list control group.A randomized controlled trial of civilians who experienced trauma and who met the diagnostic criteria for ASD (N = 90) seen at an outpatient clinic between March 1, 2002, and June 30, 2006.Patients were randomly assigned to receive 5 weekly 90-minute sessions of either imaginal and in vivo exposure (n = 30) or cognitive restructuring (n = 30), or assessment at baseline and after 6 weeks (wait-list group; n = 30).Measures of PTSD at the 6-month follow-up visit by clinical interview and self-report assessments of PTSD, depression, anxiety, and trauma-related cognition.Intent-to-treat analyses indicated that at posttreatment, fewer patients in the exposure group had PTSD than those in the cognitive restructuring or wait-list groups (33% vs 63% vs 77%; P = .002). At follow-up, patients who underwent exposure therapy were more likely to not meet diagnostic criteria for PTSD than those who underwent cognitive restructuring (37% vs 63%; odds ratio, 2.10; 95% confidence interval, 1.12-3.94; P = .05) and to achieve full remission (47% vs 13%; odds ratio, 2.78; 95% confidence interval, 1.14-6.83; P = .005). On assessments of PTSD, depression, and anxiety, exposure resulted in markedly larger effect sizes at posttreatment and follow-up than cognitive restructuring.Exposure-based therapy leads to greater reduction in subsequent PTSD symptoms in patients with ASD when compared with cognitive restructuring. Exposure should be used in early intervention for people who are at high risk for developing PTSD.",0 +https://doi.org/10.1007/s11606-006-0101-4,Prevalence of Depression–PTSD Comorbidity: Implications for Clinical Practice Guidelines and Primary Care-based Interventions,"Compared to those with depression alone, depressed patients with posttraumatic stress disorder (PTSD) experience more severe psychiatric symptomatology and factors that complicate treatment.To estimate PTSD prevalence among depressed military veteran primary care patients and compare demographic/illness characteristics of PTSD screen-positive depressed patients (MDD-PTSD+) to those with depression alone (MDD).Cross-sectional comparison of MDD patients versus MDD-PTSD+ patients.Six hundred seventy-seven randomly sampled depressed patients with at least 1 primary care visit in the previous 12 months. Participants composed the baseline sample of a group randomized trial of collaborative care for depression in 10 VA primary care practices in 5 states.The Patient Health Questionnaire-9 assessed MDD. Probable PTSD was defined as a Primary Care PTSD Screen > or = 3. Regression-based techniques compared MDD and MDD-PTSD+ patients on demographic/illness characteristics.Thirty-six percent of depressed patients screened positive for PTSD. Adjusting for sociodemographic differences and physical illness comorbidity, MDD-PTSD+ patients reported more severe depression (P < .001), lower social support (P < .001), more frequent outpatient health care visits (P < .001), and were more likely to report suicidal ideation (P < .001) than MDD patients. No differences were observed in alcohol consumption, self-reported general health, and physical illness comorbidity.PTSD is more common among depressed primary care patients than previously thought. Comorbid PTSD among depressed patients is associated with increased illness burden, poorer prognosis, and delayed response to depression treatment. Providers should consider recommending psychotherapeutic interventions for depressed patients with PTSD.",0 +https://doi.org/10.1016/j.dmr.2006.11.001,The Prevalence of Posttraumatic Stress Disorder Among Children and Adolescents Affected by Tsunami Disaster in Tamil Nadu,"The Asian earthquake and subsequent tsunami of December 2004, one of the largest natural disasters in recent history, resulted in the deaths of over 250,000 people and massive destruction in 8 countries. As with any disaster, children are at risk for developing short- and long-term psychological consequences, including posttraumatic stress disorder (PTSD). One area particularly affected by this disaster was southern India. Five hundred twenty-three juvenile survivors of the tsunami were studied to determine the prevalence of PTSD. The survey was conducted in 2 waves. Interviews were conducted by postgraduate psychiatric social work students, proficient in the local language of Tamil and trained in PTSD-related data collection. The Impact of Event Scale-8 items Tamil Version and Child Behaviour Checklist Post-traumatic Stress Disorder-Tamil Revised Version, with age-specific measures and validated for the local culture and language, were used for the study. Our study revealed a prevalence of 70.7% for acute PTSD and 10.9% for delayed onset PTSD. PTSD was more prevalent among girls and more severe among adolescents exposed to loss of life or property. These results indicate that PTSD is widely prevalent among the survivors of the tsunami, reinforcing the need to develop an effective, culturally sensitive outreach therapy strategy for them.",0 +https://doi.org/10.1002/jts.20307,"The association of exposure, risk, and resiliency factors with PTSD among Jews and Arabs exposed to repeated acts of terrorism in Israel","Israel has faced ongoing terrorism since the beginning of the Al Aqsa Intifada in September 2000. The authors examined risk and resiliency factors associated with posttraumatic stress disorder (PTSD) among 1,117 Jews and 394 Arab adult citizens of Israel during August and September 2004 through telephone interviews. Probable PTSD was found among 6.6% of Jews and 18.0% of Arabs. Predictors of probable PTSD in a multivariate model for Jews were refusal to report income, being traditionally religious, economic and psychosocial resource loss, greater traumatic growth, and lower social support. For Arabs, predictors were low education and economic resource loss among those exposed to terrorism. Findings for only those directly exposed to terrorism were similar to those for the overall national sample.",0 +https://doi.org/10.1080/02646830601117175,Symptoms of post‐traumatic stress disorder in couples after birth: association with the couple's relationship and parent–baby bond,"Recent research suggests a proportion of women develop post-traumatic stress disorder (PTSD) after childbirth. To date, the effects of postnatal PTSD on the couple's relationship and the parent-baby bond have not been examined. In the present study, 64 couples completed questionnaires about the birth, symptoms of PTSD, the couple's relationship and parent-baby bond 9 weeks after childbirth. Results showed 5% of men and women had severe symptoms of PTSD. Symptoms were strongly associated within couples and were related to similar birth factors for men and women. PTSD symptoms were associated with neither the parent-baby bond nor couple's relationship. The mother-baby bond was not associated with any variables measured in this study. However, the father-baby bond was associated with the couple's relationship. It is concluded that men and women have comparable levels of PTSD symptoms 9 weeks after birth. Furthermore, these results suggest postnatal symptoms of PTSD have little association with the couple's relationship or the parent-baby bond in the short term. However, further research is needed to address methodological considerations.",0 +https://doi.org/10.7205/milmed-d-14-00474,Cross-Sectional Analysis of Dutch Repatriated Service Members From Southern Afghanistan (2003–2014),"A systematic analysis of the complete medical support organization of the Dutch Armed Forces regarding repatriated service members from Afghanistan has not been performed so far.All information were collated in a specifically designed electronic database and gathered from the archive of the Central Military Hospital for all Dutch service members receiving treatment for wounds or diseases sustained in the Afghan theater from July 2003 till January 2014.Traumatic injuries were the main cause (63%, 141/223) of repatriation, and improvised explosive devices the major (67%, 60/89) mechanism of injury in the battle casualty group. The mean time between injury and medical evacuation from Afghanistan was 8 days, and this was reduced to 3.6 days in case of polytrauma casualties (ISS > 15).Sixty percent of all Dutch medical evacuations from Afghanistan were not directly related to combat operations. A standard medical examination/endurance test in the predeployment phase could be useful as screening tool in reduction of the disease nonbattle injury casualty rate. Shorter transport intervals might improve morbidity and mortality of casualties, a timeframe of 48 to 72 hours for receiving definitive treatment seems feasible. Further research is necessary to identify delay factors and possible improvements in the medical support organization.",0 +https://doi.org/10.1023/a:1024459305748,MMPI scales for diagnosing acute and chronic PTSD in civilians,"To develop new Minnesota Multiphasic Personality Inventory (MMPI) scales for diagnosing acute and chronic posttraumatic stress disorder (PTSD), 237 civilians with PTSD or panic disorder (controls) completed the MMPI-R. All 399 items were submitted to chi-square analysis to select those differentiating acute or chronic PTSD from controls. The analyses yielded an MMPI Acute PTSD scale (32 items) and a MMPI Chronic PTSD scale (41 items). Discriminating between acute PTSD and controls, the MMPI Acute PTSD scale had a hit rate of 83% and the MMPI Chronic PTSD scale produced a hit rate of 75% to 80%. Cross-validation produced similar hit rates. These scales scores were not substantially influenced by gender or types of traumatic events, and only the MMPI Acute PTSD scale seemed to not be sensitive to co-morbidity.",0 +https://doi.org/10.1177/1534765611430129,Taking care of staff: A comprehensive model of support for paramedics and emergency medical dispatchers.,"Following a brief overview of alternative Employee Assistance Programs (EAPs), this article proposes a comprehensive model of care for emergency service personnel. The pivotal element of the multilayered model is the Peer Support Officer (PSO) component providing early support to ambulance personnel following exposure to potentially traumatic events. After initial recruit training, peer supporters engage in professional supervision and annual psychological first aid education and counseling skill development workshops. The model is embedded within the workforce and is available to personnel for both work-related and personal matters. The success of the EAP relies on collaboration between the employer, professional counselors, and the trained peer support officers as well as extensive education and resilience building for employees. This article proposes that the model outlined offers high-profile, well-trained, and well-supervised peer support officers as an effective alternative to the more common approa...",0 +https://doi.org/10.1002/jts.20487,"PTSD symptom increases in Iraq-deployed soldiers: Comparison with nondeployed soldiers and associations with baseline symptoms, deployment experiences, and postdeployment stress","This prospective study examined: (a) the effects of Iraq War deployment versus non-deployment on pre- to postdeployment change in PTSD symptoms and (b) among deployed soldiers, associations of deployment/postdeployment stress exposures and baseline PTSD symptoms with PTSD symptom change. Seven hundred seventy-four U.S. Army soldiers completed self-report measures of stress exposure and PTSD symptom severity before and after Iraq deployment and were compared with 309 soldiers who did not deploy. Deployed soldiers, compared with non-deployed soldiers, reported increased PTSD symptom severity from Time 1 to Time 2. After controlling for baseline symptoms, deployment-related stressors contributed to longitudinal increases in PTSD symptoms. Combat severity was more strongly associated with symptom increases among active duty soldiers with higher baseline PTSD symptoms.",0 +https://doi.org/10.1016/0005-7916(94)90003-5,Eye movement desensitization and reprocessing in posttraumatic stress disorder: A pilot study using assessment measures,"Spectacular claims have been made regarding the efficacy of eye movement desensitization and reprocessing (EMDR) in the treatment of posttraumatic stress disorder (PTSD), but almost entirely on the basis of patients' reports and without objective criteria. This study reports on the treatment of eight patients with a diagnosis of PTSD who received EMDR treatment over four sessions. Assessment measures included two structured interviews, three self-report inventories, and the electromyogram (EMG). Assessments were conducted pre and posttreatment, and at 3-month follow-up. Despite some residual pathology at posttreatment and follow-up, significant improvements were obtained on all measures and across all PTSD symptom clusters. Compared with other treatments of PTSD, change was achieved in far fewer sessions.",0 +https://doi.org/10.1016/j.jad.2010.02.122,"P50 suppression, prepulse inhibition, and startle reactivity in the same patient cohort suffering from posttraumatic stress disorder","Psychophysiological alterations like impaired gating and increased startle have been reported in patients with posttraumatic stress disorder (PTSD). However, findings are inconsistent, and potential relationships to symptomatology remain unclear.The present study investigates two distinct operational measures of gating and startle reactivity within the same patients suffering from PTSD and their relationship to PTSD symptomatology.Prepulse inhibition of the acoustic evoked startle reflex, P50 suppression of auditory event related potentials, and startle reactivity were assessed in three distinct experiments in 27 PTSD patients and compared to 25 healthy control subjects.PTSD patients exhibited impaired P50 suppression and exaggerated startle. Lower P50 suppression was associated with higher levels of general psychopathology. Patients and control subjects did not differ in PPI.Some of the limitations include, that the control group compromised of non-trauma exposure subjects and menstrual cycle in female participants potentially affecting PPI was not controlled.Deficient P50 gating, not related to specific trauma or distinct symptom clusters reflects a robust finding in PTSD patients. In contrast, further research is needed to clarify whether PPI is affected in PTSD.",0 +https://doi.org/10.1007/s00737-006-0131-2,The HPA axis and perinatal depression: a hypothesis,"Episodes of depression and anxiety are as common during pregnancy as postpartum. Some start in pregnancy and resolve postpartum, others are triggered by parturition and some are maintained throughout. In order to determine any biological basis it is important to delineate these different subtypes. During pregnancy, as well as the rise in plasma oestrogen and progesterone there is a very large increase in plasma corticotropin releasing hormone (CRH), and an increase in cortisol. The latter reaches levels found in Cushing's syndrome and major melancholic depression. Levels of all these hormones drop rapidly on parturition. We here suggest that the symptoms of antenatal and postnatal depression may be different, and linked in part with differences in the function of the hypothalamic pituitary adrenal (HPA) axis. There are two subtypes of major depression, melancholic and atypical, with some differences in symptom profile, and these subtypes are associated with opposite changes in the HPA axis. Antenatal depression may be more melancholic and associated with the raised cortisol of pregnancy, whereas postnatal depression may be more atypical, triggered by cortisol withdrawal and associated with reduced cortisol levels. There is evidence that after delivery some women experience mild bipolar II depression, and others experience post traumatic stress disorder. Both of these are associated with atypical depression. It may also be that some women are genetically predisposed to depression of the melancholic type and some to depression of the atypical type. These women may be more or less vulnerable to depression at the different stages of the perinatal period. (",0 +https://doi.org/10.1192/bjp.bp.111.096222,Political violence and mental health in Nepal: prospective study,"Background Post-conflict mental health studies in low-income countries have lacked pre-conflict data to evaluate changes in psychiatric morbidity resulting from political violence. Aims This prospective study compares mental health before and after exposure to direct political violence during the People's War in Nepal. Method An adult cohort completed the Beck Depression Inventory and Beck Anxiety Inventory in 2000 prior to conflict violence in their community and in 2007 after the war. Results Of the original 316 participants, 298 (94%) participated in the post-conflict assessment. Depression increased from 30.9 to 40.6%. Anxiety increased from 26.2 to 47.7%. Post-conflict post-traumatic stress disorder (PTSD) was 14.1%. Controlling for ageing, the depression increase was not significant. The anxiety increase showed a dose–response association with conflict exposure when controlling for ageing and daily stressors. No demographic group displayed unique vulnerability or resilience to the effects of conflict exposure. Conclusions Conflict exposure should be considered in the context of other types of psychiatric risk factors. Conflict exposure predicted increases in anxiety whereas socioeconomic factors and non-conflict stressful life events were the major predictors of depression. Research and interventions in postconflict settings therefore should consider differential trajectories for depression v. anxiety and the importance of addressing chronic social problems ranging from poverty to gender and ethnic/caste discrimination.",0 +https://doi.org/10.1016/j.psyneuen.2015.01.001,Youth offspring of mothers with posttraumatic stress disorder have altered stress reactivity in response to a laboratory stressor,"Parental Posttraumatic Stress Disorder (PTSD), particularly maternal PTSD, confers risk for stress-related psychopathology among offspring. Altered hypothalamic-pituitary-adrenal (HPA) axis functioning is one mechanism proposed to explain transmission of this intergenerational risk. Investigation of this mechanism has been largely limited to general stress response (e.g., diurnal cortisol), rather than reactivity in response to an acute stressor. We examined cortisol reactivity in response to a laboratory stressor among offspring of mothers with a lifetime diagnosis of PTSD (n=36) and age- and gender- matched control offspring of mothers without PTSD (n=36). Youth (67% girls; mean age=11.4, SD=2.6) participated in a developmentally sensitive laboratory stressor and had salivary cortisol assessed five times (one pre-stress, one immediate post-stress, and three recovery measures, spaced 15min apart). Results were consistent with the hypothesis that offspring of mothers with PTSD would exhibit a dysregulated, blunted cortisol reactivity profile, and control offspring would display the expected adaptive peak in cortisol response to challenge profile. Findings were maintained after controlling for youth traumatic event history, physical anxiety symptoms, and depression, as well as maternal depression. This finding contributes to the existing literature indicating that attenuated HPA axis functioning, inclusive of hyposecretion of cortisol in response to acute stress, is robust among youth of mothers with PTSD. Future research is warranted in elucidating cortisol reactivity as a link between maternal PTSD and stress-related psychopathology vulnerability among offspring.",0 +https://doi.org/10.1016/j.janxdis.2015.03.007,The role of locus of control and coping style in predicting longitudinal PTSD-trajectories after combat exposure,"While longitudinal posttraumatic stress responses are known to be heterogeneous, little is known about predictors of those responses. We investigated if locus of control (LOC) and coping style are associated with long-term PTSD-trajectories after exposure to combat. Six hundred and seventy five Israeli soldiers with or without combat stress reaction (CSR) from the Lebanon war were assessed 1, 2, and 20 years after the war. Combat exposure, LOC, and coping style were then investigated as covariates of the trajectories of resilience, recovery, delayed onset, and chronicity. Symptomatic trajectories in the CSR and the non-CSR group were significantly associated to varying degrees with perceived life threat during combat (ORs: 1.76-2.53), internal LOC (0.77-0.87), emotional coping style (0.28-0.34), and low use of problem-focused coping (2.12-3.11). In conclusion, assessment of LOC and coping can aid prediction of chronic PTSD outcomes of combat exposure.",0 +https://doi.org/10.1016/j.psychres.2015.05.045,"Relationships between posttraumatic stress disorder (PTSD), dissociation, quality of life, hopelessness, and suicidal ideation among earthquake survivors","Researches have demonstrated that Posttraumatic stress disorder (PTSD) is one of the most common stress reactions in the face of disasters and significantly associated with a broad range of trauma-induced sequelaes including anxiety, depression, suicidality as well as functional impairments. To date, though many aspects of risk factors with respect to the development and maintenance of PTSD have been addressed, mediating role of dissociation has received relatively less attention. In the present study, we examined relations of PTSD with quality of life, hopelessness, suicidal ideation, and mediational effect of pathological dissociation in these connections. 583 subjects most of whom experienced a severe earthquake participated in the study after two years of the disaster. We found that being female, being single, earthquake exposure, and having greater suicidal ideation were significant predictors of PTSD symptom severity. Role-Physical, Bodily-Pain, General Health and Role-Emotional subscales of the SF-36 were inversely associated with PTSD symptom severity. Pathological dissociation significantly mediated the substantial associations between predictors and PTSD symptom clusters. Chronic dissociation appears to put trauma exposed individuals in jeopardy of prolonged posttraumatic reactions by mediating the negative influences of risk factors in the face of experienced earthquake.",0 +https://doi.org/10.1016/j.jadohealth.2011.05.017,Longitudinal Trajectories of Posttraumatic Stress Disorder Symptoms and Binge Drinking Among Adolescent Girls: The Role of Sexual Victimization,"Many studies have documented associations among sexual victimization (SV), posttraumatic stress disorder (PTSD) symptoms, and alcohol use; however, few have examined these associations longitudinally among adolescents. The present study evaluated the effect of SV on the longitudinal trajectory of PTSD symptoms and binge drinking (BD) among adolescent girls, a population known to have high rates of SV and alcohol use.Participants (N = 1,808 at wave 1) completed interviews regarding PTSD symptoms, BD, and SV experiences over approximately 3 years.Multilevel modeling revealed decreases in PTSD symptoms over the course of the study; however, compared with nonvictims, adolescents who were sexually victimized reported greater PTSD symptoms at wave 1 and maintained higher levels of PTSD symptoms over the course of the study after controlling for age. SV reported during the study also predicted an acute increase in PTSD symptoms at that occasion. BD increased significantly over the course of the study; however, SV did not predict initial BD or increases over time. SV reported during the study was associated with acute increases in BD at that occasion, although this effect diminished when participants reporting substance-involved rape were excluded.SV was associated with immediate and long-lasting elevations in PTSD symptoms, but not with initial or lasting elevations in BD over time, suggesting that adolescent victims have yet to develop problematic patterns of alcohol use to cope with SV. However, SV was associated with acute increases in PTSD symptoms and BD, suggesting a need for BD interventions to reduce alcohol-related SV.",0 +https://doi.org/10.1111/sltb.12040,Predictors of Suicidal Ideation in a Gender-Stratified Sample of OEF/OIF Veterans,"There is a growing concern about suicide among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans. We examined the role of postdeployment mental health in associations between deployment stressors and postdeployment suicidal ideation (SI) in a national sample of 2,321 female and male OEF/OIF veterans. Data were obtained via survey, and path analysis was used. For women and men, mental health symptoms largely accounted for associations between deployment stressors and SI; however, they only partly accounted for the sexual harassment and SI association among women. These findings enhance the understanding of the mental health profile of OEF/OIF veterans.",0 +https://doi.org/10.1016/j.jad.2010.11.031,Prevalence and correlates of respiratory and non-respiratory panic attacks in the general population,"Panic attacks are heterogeneous with regards to symptom profile. Subtypes of panic attacks have been proposed, of which the most investigated is respiratory panic attacks (RPA). Limited information exists about RPA in the general population.The prevalence and correlates of RPA and non-respiratory panic attacks (NRPA) were examined in a subsample (n=8.796) of individuals participating in a cross-sectional survey of the adult general population of six European countries. Panic attacks, mental disorders, and chronic physical conditions were assessed with the Composite International Diagnostic Interview (CIDI) 3.0. Data on use of health services and disability were obtained.The lifetime prevalence of RPA was 6.77 and the 12-month prevalence was 2.26. No robust associations of RPA with sociodemographic characteristics, mental disorders or physical conditions were found as compared to NRPA. RPA were associated with increased use of health services but similar disability in comparison to NRPA.Few direct data are available on the validity of the CIDI to assess RPA. Other definitions of RPA exist in the literature.Our findings suggest that there are very few differences between RPA and NRPA and do not support the need of subtyping panic attacks in current classification systems.",0 +https://doi.org/10.1073/pnas.1401660111,Expression profiling associates blood and brain glucocorticoid receptor signaling with trauma-related individual differences in both sexes,"Significance Because posttraumatic stress disorder (PTSD) occurs in a subset of trauma-exposed persons, expression profiling in the context of an animal model that focuses on individual differences in stress response permits identification of the relevant signaling pathways that lead to sustained impairment or resilience. The inclusion of blood and brain samples from both sexes is important because it allows the detection of convergent susceptibility pathways and concomitant identification of blood-based biomarkers. The across tissue and sex involvement of glucocorticoid receptor signaling with exposure-related individual differences suggests that targeting this signaling pathway may lead to a promising therapeutic strategy in PTSD.",0 +https://doi.org/10.1016/j.eurpsy.2010.06.006,Heart rate measured in the acute aftermath of trauma can predict post-traumatic stress disorder: A prospective study in motor vehicle accident survivors,"To determine whether increased physiological arousal immediately after trauma or at emergency admission can predict post-traumatic stress disorder (PTSD) in motor vehicle accident (MVA) survivors with physical injuries.We included 119 MVA survivors with physical injuries. In this prospective cohort study, heart rate (HR) and blood pressure (BP) were assessed during ambulance transport (T1) and at hospital admission (T2). One and four months after the accident, we assessed patients for PTSD (Davidson trauma scale, confirmed with the structured clinical interview for DSM-IV axis I disorders). Multivariate logistic regression models assessed the relationship between HR or BP and PTSD.PTSD was diagnosed in 54 (45.4%) patients at 1 month and in 39 (32.8%) at 4 months. In the multivariate analysis, HR at T1 or at T2 predicted PTSD at 1 month (OR=1.156, 95% CI [1.094;1.221] p<0.0001). Only HR at T1 (not at T2) predicted PTSD at 4 months (OR=1.059, 95% CI [1.013; 1.108] p=0.012). Injury severity predicted PTSD at 4 months (OR=1.207, 95% CI [1.085; 1.342] p=0.001). A cut-off of 84 beats per minute yielded a sensitivity of 62.5% and a specificity of 75.0% for PTSD.HR measured at the scene of MVA and severity of injury predicted PTSD 4 months later.",0 +https://doi.org/10.1016/j.brat.2003.07.010,Psychometric properties of the Impact of Event Scale—Revised,"This study investigated the psychometric properties of the Impact of Event Scale -- Revised (IES-R) in two samples of male Vietnam veterans: a treatment-seeking sample with a confirmed posttraumatic stress disorder (PTSD) diagnosis (N = 120) and a community sample with varying levels of traumatic stress symptomatolgy (N = 154). The scale showed high internal consistency (alpha = 0.96). Confirmatory factor analysis did not provide support for a three-factor solution corresponding to the three subscales of intrusion, avoidance, and hyperarousal. Exploratory factor analysis suggested that either a single, or a two-factor solution (intrusion/hyperarousal and avoidance), provide the best account of date. However, correlations among the subscales were higher in the community sample than in the treatment sample, suggesting that the IES-R may be sensitive to a more general construct of traumatic stress in those with lower symptom levels. The correlation between the IES-R and the PTSD Checklist was high (0.84) and a cutoff of 1.5 (equivalent to a total score of 33) was found to provide the best diagnostic accuracy.",0 +https://doi.org/10.1891/0886-6708.24.5.669,Resource Loss as a Predictor of Posttrauma Symptoms Among College Women Following the Mass Shooting at Virginia Tech,"We examined risk factors for posttrauma symptomatology, 2 and 6 months following the April 2007 mass shooting at Virginia Tech. Using a conservation of resources framework and a Web-based survey methodology, we prospectively evaluated the relations among preshooting distress, social support, resource loss, and posttrauma symptomatology in a sample of 293 female students enrolled at the university at the time of the shootings. Structural equation modeling supported that preshooting social support and distress predicted resource loss postshooting. Resource loss predicted symptomatology 2 months and 6 months after the shooting. Implications of the results for research and intervention following mass trauma are discussed. © 2009 Springer Publishing Company.",0 +https://doi.org/10.3402/ejpt.v3i0.17734,Prevalence of post-traumatic stress disorder among patients with substance use disorder: it is higher than clinicians think it is,"This study had three objectives. Firstly, the prevalence of post-traumatic stress disorder (PTSD) and trauma exposure was compared between individuals with and without substance use disorder (SUD). Secondly, we compared self-rating of PTSD and clinical judgement. Thirdly, an analysis of the characteristics of SUD/PTSD patients was performed.The sample consisted of 423 patients with SUD and 206 healthy controls. All individuals were screened on PTSD using the self-rating inventory for PTSD.Significantly higher numbers of PTSD and trauma exposure were found in the SUD group (resp. 36.6 and 97.4%). PTSD went frequently unnoticed when relying on clinical judgement alone. Patients with SUD/PTSD were significantly more often unemployed and had a lower educational level. Axis I comorbidity and especially depressive disorders were more common in the SUD/PTSD group.It is concluded that patients with SUD/PTSD are a substantial and vulnerable subgroup in addiction treatment facilities and that a systematic screening for PTSD is required.",0 +https://doi.org/10.1016/j.brat.2005.01.001,Anxiety sensitivity in traumatized Cambodian refugees: A discriminant function and factor analytic investigation,"We examined the psychometric properties and factor structure of a Cambodian translation of the Anxiety Sensitivity Index (ASI) and an Augmented ASI (the ASI supplemented with a 9-item addendum that assesses additional Cambodian concerns about anxiety-related sensations). Both the ASI and the Augmented ASI distinguished among three diagnostic groups: highest score, PTSD with panic disorder (PP group); next, panic disorder without PTSD (P group); and then, other disorders than PTSD or panic disorder (O group). In the discriminant function analysis using the Augmented ASI, the best classificatory predictor (PP vs. P vs. O) was an Addendum item (""It scares me when I stand up and feel dizzy""). The principal component analysis (oblimin rotation) of the ASI yielded a 3-factor solution (I, Weak Heart Concerns; II, Control Concerns; III, Social Concerns) and of the Augmented ASI, a 4-factor solution (I, Weak Heart Concerns; II, Control Concerns; III, Wind Attack Concerns; IV, Social Concerns). The item clustering within the factor solution of both the ASI and Augmented ASI illustrates the role of cultural syndromes in generating fear of mental and bodily events.",0 +https://doi.org/10.1001/jama.298.18.2141,Longitudinal Assessment of Mental Health Problems Among Active and Reserve Component Soldiers Returning From the Iraq War,"To promote early identification of mental health problems among combat veterans, the Department of Defense initiated population-wide screening at 2 time points, immediately on return from deployment and 3 to 6 months later. A previous article focusing only on the initial screening is likely to have underestimated the mental health burden.To measure the mental health needs among soldiers returning from Iraq and the association of screening with mental health care utilization.Population-based, longitudinal descriptive study of the initial large cohort of 88 235 US soldiers returning from Iraq who completed both a Post-Deployment Health Assessment (PDHA) and a Post-Deployment Health Re-Assessment (PDHRA) with a median of 6 months between the 2 assessments.Screening positive for posttraumatic stress disorder (PTSD), major depression, alcohol misuse, or other mental health problems; referral and use of mental health services.Soldiers reported more mental health concerns and were referred at significantly higher rates from the PDHRA than from the PDHA. Based on the combined screening, clinicians identified 20.3% of active and 42.4% of reserve component soldiers as requiring mental health treatment. Concerns about interpersonal conflict increased 4-fold. Soldiers frequently reported alcohol concerns, yet very few were referred to alcohol treatment. Most soldiers who used mental health services had not been referred, even though the majority accessed care within 30 days following the screening. Although soldiers were much more likely to report PTSD symptoms on the PDHRA than on the PDHA, 49% to 59% of those who had PTSD symptoms identified on the PDHA improved by the time they took the PDHRA. There was no direct relationship of referral or treatment with symptom improvement.Rescreening soldiers several months after their return from Iraq identified a large cohort missed on initial screening. The large clinical burden recently reported among veterans presenting to Veterans Affairs facilities seems to exist within months of returning home, highlighting the need to enhance military mental health care during this period. Increased relationship problems underscore shortcomings in services for family members. Reserve component soldiers who had returned to civilian status were referred at higher rates on the PDHRA, which could reflect their concerns about their ongoing health coverage. Lack of confidentiality may deter soldiers with alcohol problems from accessing treatment. In the context of an overburdened system of care, the effectiveness of population mental health screening was difficult to ascertain.",0 +https://doi.org/10.1142/s0219635204000592,"NEUROPHYSIOLOGICALLY-BASED MEAN-FIELD MODELLING OF TONIC CORTICAL ACTIVITY IN POST-TRAUMATIC STRESS DISORDER (PTSD), SCHIZOPHRENIA, FIRST EPISODE SCHIZOPHRENIA AND ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)","A recently developed quantitative model of cortical activity is used that permits data comparison with experiment using a quantitative and standardized means. The model incorporates properties of neurophysiology including axonal transmission delays, synaptodendritic rates, range-dependent connectivities, excitatory and inhibitory neural populations, and intrathalamic, intracortical, corticocortical and corticothalamic pathways. This study tests the ability of the model to determine unique physiological properties in a number of different data sets varying in mean age and pathology. The model is used to fit individual electroencephalographic (EEG) spectra from post-traumatic stress disorder (PTSD), schizophrenia, first episode schizophrenia (FESz), attention deficit hyperactivity disorder (ADHD), and their age/sex matched controls. The results demonstrate that the model is able to distinguish each group in terms of a unique cluster of abnormal parameter deviations. The abnormal physiology inferred from these parameters is also consistent with known theoretical and experimental findings from each disorder. The model is also found to be sensitive to the effects of medication in the schizophrenia and FESz group, further supporting the validity of the model.",0 +https://doi.org/10.1016/j.biopsych.2006.06.005,Posttraumatic Stress Disorder: Memory and Learning Performance in Children and Adolescents,"Despite the wealth of information in adult posttraumatic stress disorder (PTSD) literature, few studies have explored the memory and learning performance of trauma-exposed youth. This study examined if memory deficits are associated with PTSD or with trauma exposure in the absence of PTSD.Youth exposed to traumatic incidents underwent clinical interviews to diagnose PTSD and exclude major comorbid disorders. Youth with conditions that could impede performance on a memory scale (e.g., limited intellectual functioning, current substance abuse, psychopharmacological treatment) were excluded. Three groups of participants were identified (PTSD positives [n = 29], traumatized PTSD negatives [n = 62], and nontraumatized control subjects [n = 40]). Participants completed the Wide Range Assessment of Memory and Learning (WRAML).Youth with PTSD evidenced significantly lower scores on the WRAML General Memory, Verbal Memory, and Learning indices compared with nontraumatized control subjects. With the exception of Verbal Memory, youth with and without PTSD performed comparably on all other indices. Nonsignificant differences were noted on the Visual Memory Index.General memory and verbal memory impairments as evidenced in adult populations were observed among this sample of youth. Given the developmental trajectory of memory capabilities, the implications of such early trauma exposure and memory deficits are considered.",0 +https://doi.org/10.1002/1520-6629(199304)21:2<128::aid-jcop2290210206>3.0.co;2-5,Resource conservation as a strategy for community psychology,"Conservation of resources (COR) theory (Hobfoll, 1988, 1989) was applied to social intervention and research. COR theory depicts resource loss as disproportionately weighted in comparison to resource gain. COR theory further posits that to prevent resource loss or establish resources, other resources must be invested. Resources contribute to further resource gain, whereas lack of resources contributes to ongoing resource loss. Consequently, people, groups, or organizations that are endowed with strong personal or social resource reserves should better resist the deleterious effects of stress and withstand everyday challenges. One of the basic principles of the theory—that loss is disproportionately weighted compared to gain—was tested in two samples and strongly supported. Implications of the model for intervention were discussed.",0 +https://doi.org/10.1002/jts.20629,"Traumatic bereavement, acute dissociation, and posttraumatic stress: 14 years after the MSEstoniadisaster",en,0 +https://doi.org/10.1016/s0193-953x(05)70203-3,Overview and Clinical Presentation of Generalized Anxiety Disorder,"1. To distinguish GAD from panic disorder is not difficult if a patient has frequent, spontaneous panic attacks and agoraphobic symptoms, but many patients with GAD have occasional anxiety attacks or panic attacks. Such patients should be considered as having GAD. An even closer overlap probably exists between GAD and social phobia. Patients with clear-cut phobic avoidant behavior may be distinguished easily from patients with GAD, but patients with social anxiety without clear-cut phobic avoidant behavior may overlap with patients with GAD and possibly should be diagnosed as having GAD and not social phobia. The cardinal symptoms of GAD commonly overlap with those of social phobia, particularly if the social phobia is more general and not focused on a phobic situation. For example, free-floating anxiety may cause the hands to perspire and may cause a person to be shy in dealing with people in public, and thus many patients with subthreshold social phobic symptoms have, in the authors' opinion, GAD and not generalized social phobia. The distinction between GAD and obsessive-compulsive disorder, acute stress disorder, and posttraumatic stress disorder should not be difficult by definition. At times, however, it may be difficult to distinguish between adjustment disorder with anxious mood from GAD or anxiety not otherwise specified, particularly if the adjustment disorder occurs in a patient with a high level of neuroticism or trait anxiety or type C personality disorder. Table 2 presents features distinguishing GAD from other psychiatric disorders. 2. Lifetime comorbid diagnoses of other anxiety or depression disorders, not active for 1 year or more and not necessitating treatment during that time period, should not effect a diagnosis of current GAD. On the other hand, if concomitant depressive symptoms are present and if these are subthreshold, a diagnosis of GAD should be made, and if these are full threshold, a diagnosis of MDD should be made. 3. If GAD is primary and if no such current comorbid diagnosis, such as other anxiety disorders or MDD, is present, except for minor depression and dysthymia, or if only subthreshold symptoms of other anxiety disorders are present, GAD should be considered primary and treated as GAD; however, patients with concurrent threshold anxiety or mood disorders should be diagnosed according to the definitions of these disorders in the DSM-IV and ICD-10 and treated as such. 4. Somatization disorders are now classified separately from anxiety disorders. Some of these, particularly undifferentiated somatization disorder, may overlap with GAD and be diagnostically difficult to distinguish. The authors believe that, as long as psychic symptoms of anxiety are present and predominant, patients should be given a primary diagnosis of GAD. 5. Two major shifts in the DSM diagnostic criteria for GAD have markedly redefined the definition of this disorder. One shift involves the duration criterion from 1 to 6 months, and the other, the increased emphasis on worry and secondary psychic [table: see text] symptoms accompanied by the elimination of most somatic symptoms. This decision has had the consequence of orphaning a large population of patients suffering from GAD that is more transient and somatic in its focus and who typically present not to psychiatrists but to primary care physicians. Therefore, clinicians should consider using the ICD-10 qualification of illness duration of ""several months"" to replace the more rigid DSM-IV criterion of 6 months and to move away from the DSM-IV focus on excessive worry as the cardinal symptom of anxiety and demote it to only another important anxiety symptom, similar to free-floating anxiety. One also might consider supplementing this ICD-10 criterion with an increased symptom severity criterion as, for example, a Hamilton Anxiety Scale of 18. Finally, the adjective excessive, not used in the definition of other primary diagnostic criteria, such as depressed mood for MDD, should be omitted (Table 3). 6. One may want to consider the distinction of trait (chronic) from state (acute) anxiety, but whether the presence of some personality characteristics, particularly anxious personality or Cluster C personality and increased neuroticism, as an indicator of trait [table: see text] anxiety is a prerequisite for anxiety disorders; occurs independently of anxiety disorders; or is a vulnerability factor that, in some patients, leads to anxiety symptoms and, in others, does not, is unknown. 7. Symptoms that some clinicians consider cardinal for a diagnosis of GAD, such as extreme worry, obsessive rumination, and somatization, also are present in other disorders, such as MDD. (ABSTRACT TRUNCATED)",0 +https://doi.org/10.12740/app/17496,When the Foundations of Life have been Upset…. An Integrated Clinical and Experimental Study with Refugees and Asylum Seekers,"Aim of the study Recent research results in clinical psychology, health psychology and neurobiology underline the relationship between dissociative states, complex posttraumatic syndromes and borderline functioning . Our study is meant to investigate the traumatic hypothesis of borderline functioning and to develop appropriate psychotherapeutic measures based on artistic mediations. Subject or material and methods We undertook an integrated clinical and experimental study with a sample of 73 refugees and asylum seekers. In a second stage, those who suffered from PTSD or complex post-traumatic states were offered to attend arts psychotherapeutic sessions.. We combined a semi-structured biographical interview, a projective test, i.e. the Sentences Completion Test , for which we developed a new manner of interpretation , and psychometric scales, i.e. the HADS and the Index of Wellbeing . Furthermore, we analysed the artistic production with the help of original rating scales . Results With the help of non parametric multidimensional statistics, we extracted two profiles of personality functioning, linked either to repeated breaks, negligence and maltreatment from the beginning of life, or either to a recent external catastrophe, interrupting a continuous life course. Through the evaluation of the arts therapeutic sessions, we could note the first signs of resumption of the blocked process of subjectivation. Discussion The results of the study support the traumatogenic hypothesis of borderline functioning, as well as current clinical considerations concerning the defensive role of dissociation in complex posttraumatic states. Conclusions The study opens tracks for future research concerning an in depth investigation of the arts therapeutic process with traumatized people.",0 +https://doi.org/10.7205/milmed-d-13-00017,Psychometric Evaluation of the Moral Injury Events Scale,"Literature describing the phenomenology of the stress of combat suggests that war-zone experiences may lead to adverse psychological outcomes such as post-traumatic stress disorder not only because they expose persons to life threat and loss but also because they may contradict deeply held moral and ethical beliefs and expectations. We sought to develop and validate a measure of potentially morally injurious events as a necessary step toward studying moral injury as a possible adverse consequence of combat. We administered an 11-item, self-report Moral Injury Events Scale to active duty Marines 1 week and 3 months following war-zone deployment. Two items were eliminated because of low item-total correlations. The remaining 9 items were subjected to an exploratory factor analysis, which revealed two latent factors that we labeled perceived transgressions and perceived betrayals; these were confirmed via confirmatory factor analysis on an independent sample. The overall Moral Injury Events Scale and its two subscales had favorable internal validity, and comparisons between the 1-week and 3-month data suggested good temporal stability. Initial discriminant and concurrent validity were also established. Future research directions were discussed.",0 +https://doi.org/10.3109/15622975.2011.583270,Voluntary exercise does not ameliorate context memory and hyperarousal in a mouse model for post-traumatic stress disorder (PTSD),"We investigated the effects of voluntary wheel running as model for intervention on the development of contextual fear and hyperarousal in a mouse model of post-traumatic stress disorder (PTSD). Physical exercise in general has been associated with improved hippocampus-dependent memory performance both in animals and humans. However, studies that have tried to link physical exercise and contextual conditioning in an animal model of PTSD, revealed mixed findings.Here we tested contextual fear conditioning, generalized fear response, acoustic startle response and emotionality in C57BL/6NCrl mice which had free access to a running wheel for 28 days, compared with control animals which did not run and mice which did not receive a shock during the conditioning phase.We found no significant effects of voluntary running on the above-mentioned variables, except for enhanced anxiety levels in the Dark-Light-Box and O-Maze tests of running mice.Our results suggest that running as a model for intervention does not ameliorate contextual aversive learning but has the potency to change emotional behaviours.",0 +https://doi.org/10.1080/15325024.2011.635580,A Study of Posttraumatic Stress and Growth in Tsunami Relief Volunteers,"Twenty female relief volunteers who had participated in the post-tsunami relief operations in the coastal areas of Tamil Nadu, India, under the aegis of nongovernmental organizations and charitable trusts were assessed for posttraumatic stress, posttraumatic growth, and dissociative experiences. They also responded to a set of questions in order to determine the direction (upward-downward) of their counterfactual thoughts. The observed data were subjected to a multivariate analysis of variance and multiple discriminant analysis to identify the key underlying dimensions. The main effects of amnesia, depersonalization, percentage of dissociation, and family type were highly significant. Discriminant coefficients suggested the importance of relating to others and proactive coping. They also suggested the importance of intrusion, avoidance, and appreciation of life.",0 +https://doi.org/10.1007/bf00977234,The prevalence of lifetime and partial post-traumatic stress disorder in Vietnam theater veterans,,0 +https://doi.org/10.1002/acp.1282,‘Comparisons of traumatic and positive memories in people with and without PTSD profile’,"According to most post-traumatic stress disorder (PTSD) theories, memory mechanisms are involved in its development and maintenance. However, the specific memory characteristics responsible for this disorder are still not well known. In the present study, 210 participants having reported at least one traumatic experience were assigned to a PTSD or to a non-PTSD symptom profile group. Both groups rated their memories for their most traumatic and intense positive life events. We observed that the traumatic memories of PTSD profile participants were more clear, detailed and judged as significant compared with those of the non-PTSD profile group. However, participants in the first group acknowledged having more difficulties putting their traumatic memories into words and controlling these remembrances. These differences were absent in their positive memories. Additionally, clear relationships emerged between memory ratings and PTSD symptoms measures. Results are discussed according to fragmentation and superiority views of traumatic memories in PTSD. Copyright © 2006 John Wiley & Sons, Ltd. Language: en",0 +https://doi.org/10.1097/01.nmd.0000242971.84798.bc,Trajectory of Traumatic Stress Symptoms in the Aftermath of Extreme Natural Disaster,"This study investigated the trajectory of traumatic stress symptoms in the aftermath of the 2004 Southeast Asian earthquake-tsunami. A total of 265 adult Thai survivors were assessed at 2 weeks and 6 months following the earthquake-tsunami. The percentages of survivors reporting traumatic stress symptoms were 22% at 2 weeks and 30% at 6 months postdisaster. Four trajectories of traumatic stress symptoms were identified: 12% of survivors presented with chronic stress symptoms, 18% had a delayed onset, 10% showed improvement, and the remaining 60% maintained a stable emotional equilibrium. Among survivors, the chronic group was the oldest, the delayed group reported the lowest level of perceived government support, and the resilient group experienced the fewest postdisaster psychiatric symptoms. Results pointed to the need to broaden the conceptualization of postdisaster stress responding as well as to establish disaster psychiatry and related mental health activities in the region.",0 +https://doi.org/10.1037/1089-2680.7.3.237,"A Diathesis-Stress Model of Posttraumatic Stress Disorder: Ecological, Biological, and Residual Stress Pathways","The symptoms captured within the contemporary diagnostic definition of posttraumatic stress disorder (PTSD) have been studied for more than 100 years. Yet, even with increasingly advanced discoveries regarding the etiology of PTSD, a comprehensive and up-to-date etiological model that incorporates both medical and psychological research has not been described and systematically studied. The diathesis-stress model proposed here consolidates existing medical and psychological research data on etiological factors associated with PTSD into 3 causal pathways: residual stress, ecological, and biological. In combination, these pathways illuminate how PTSD might develop and who might be at higher risk for developing the disorder. Research and treatment implications related to the diathesis-stress model are discussed.",0 +https://doi.org/10.1080/15228932.2011.588925,Critically Evaluating Typologies of Internet Sex Offenders: A Psychological Perspective,"Understanding why indecent images of children are produced and collected involves issues beyond the legal definition of child pornography. An over-emphasis on a legal approach will not necessarily assist in the development of preventative and control strategies. This article provides a brief overview of the way in which the Internet can be misused for sexual gratification and has identified some of the issues that seem to be significant in understanding the nature and dimensions of Internet sexual offending. The main descriptive typologies that underpin research relating to Internet child sex offenders have been reviewed and critically evaluated. As discussed throughout this article, one of the most challenging issues continues to be the difficulty in placing Internet sex offenders into categories. The foregoing discussion indicates that Internet sex offenders comprise a heterogeneous population and that there appears to be a lack of a coherent and agreed framework for defining their activity.",0 +https://doi.org/10.1017/s1352465813001197,Randomized Controlled Trial of Group Cognitive Behavioural Therapy for Post-Traumatic Stress Disorder in Children and Adolescents Exposed to Tsunami in Thailand,"Background: Post-traumatic stress disorder (PTSD) is a common and debilitating consequence of natural disaster in children and adolescents. Accumulating data show that cognitive behavioural therapy (CBT) is an effective treatment for PTSD. However, application of CBT in a large-scale disaster in a setting with limited resources, such as when the tsunami hit several Asian countries in 2004, poses a major problem. Aims: This randomized controlled trial aimed to test for the efficacy of the modified version of CBT for children and adolescents with PSTD. Method: Thirty-six children (aged 10–15 years) who had been diagnosed with PSTD 4 years after the tsunami were randomly allocated to either CBT or wait list. CBT was delivered in 3-day, 2-hour-daily, group format followed by 1-month posttreatment self-monitoring and daily homework. Results: Compared to the wait list, participants who received CBT demonstrated significantly greater improvement in symptoms of PTSD at 1-month follow-up, although no significant improvement was observed when the measures were done immediately posttreatment. Conclusions: Brief, group CBT is an effective treatment for PTSD in children and adolescents when delivered in conjunction with posttreatment self-monitoring and daily homework.",0 +https://doi.org/10.1001/jama.2011.1052,"Prevalence of War-Related Mental Health Conditions and Association With Displacement Status in Postwar Jaffna District, Sri Lanka","Nearly 2.7 million individuals worldwide are internally displaced (seeking refuge in secure areas of their own country) annually by armed conflict. Although the psychological impact of war has been well documented, less is known about the mental health symptoms of forced displacement among internally displaced persons.To estimate the prevalence of the most common war-related mental health conditions, symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression, and to assess the association between displacement status and these conditions in postwar Jaffna District, Sri Lanka.Between July and September 2009, a cross-sectional multistage cluster sample survey was conducted among 1517 Jaffna District households including 2 internally displaced persons camps. The response rate was 92% (1448 respondents, 1409 eligible respondents). Two percent of participants (n = 80) were currently displaced, 29.5% (n = 539) were recently resettled, and 68.5% (n = 790) were long-term residents. Bivariable analyses followed by multivariable logistic regression models were performed to determine the association between displacement status and mental health.Symptom criteria of PTSD, anxiety, and depression as measured by the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist-25.The overall prevalences of symptoms of PTSD, anxiety, and depression were 7.0% (95% confidence interval [CI], 5.1%-9.7%), 32.6% (95% CI, 28.5%-36.9%), and 22.2% (95% CI, 18.2%-26.5%), respectively. Currently displaced participants were more likely to report symptoms of PTSD (odds ratio [OR], 2.71; 95% CI, 1.28-5.73), anxiety (OR, 2.91; 95% CI, 1.89-4.48), and depression (OR, 4.55; 95% CI, 2.47-8.39) compared with long-term residents. Recently resettled residents were more likely to report symptoms of PTSD (OR, 1.96; 95% CI, 1.11-3.47) compared with long-term residents. However, displacement was no longer associated with mental health symptoms after controlling for trauma exposure.Among residents of Jaffna District in Sri Lanka, prevalence of symptoms of war-related mental health conditions was substantial and significantly associated with displacement status and underlying trauma exposure.",0 +https://doi.org/10.1037/a0021865,Posttraumatic growth and posttraumatic distress: A longitudinal study.,"This longitudinal study examined the course and bidirectional relation between posttraumatic distress and posttraumatic growth (PTG). A sample of Israeli ex-prisoners of war and matched controls were followed over 17 years. Participants’ posttraumatic stress disorder (PTSD), depression, and anxiety symptoms were measured at three time-points. PTG was assessed twice. Applying an autoregressive cross-lagged modeling strategy, initial PTSD predicted subsequent PTG above and beyond PTG stability, but not vice versa. Cross-lagged relations of PTG to depression and anxiety were not significant. Moreover, analysis of PTG trajectory revealed that individuals with PTSD reported higher PTG levels across times than those without PTSD. Thus, growth is facilitated and maintained by endorsement rather than absence of PTSD. The findings are discussed in the context of the illusionary versus adaptive notion of PTG.",0 +https://doi.org/10.1348/135910705x71434,Post-traumatic stress disorder and illness perceptions over time following myocardial infarction and subarachnoid haemorrhage,"This study investigated post-traumatic stress disorder (PTSD) symptoms and illness perceptions in people who suffered the acute medical trauma of a myocardial infarction (MI) or a subarachnoid haemorrhage (SAH). The study tested hypotheses regarding changes in PTSD symptoms and illness perceptions over time, associations between PTSD and illness perceptions and cognitive predictors of PTSD.The study employed a longitudinal design and measured the illness perceptions and PTSD symptoms of an MI group (N=17) and a SAH group (N=27). Data were collected within 2 weeks of admission (T1), 6 weeks after admission (T2) and 3 months after admission (T3). Statistical analysis was undertaken to examine associations between illness perceptions and PTSD and to examine cognitive predictors of PTSD.The prevalence of PTSD within the total acute medical trauma sample was 16% at 2 weeks, 35% at 6 weeks and 16% at 3 months. Illness perception factors of identity, timeline (acute/chronic), consequences and emotional representation were strongly correlated with PTSD at all three time points. PTSD symptoms and illness perceptions were shown to have changed over time. The results also showed that several illness perception factors are significant predictors of PTSD.Both PTSD symptoms and illness perceptions changed significantly over time following an MI or SAH. Illness perception factors are significant predictors of PTSD.",0 +https://doi.org/10.1155/2012/970194,Mental Health Services Required after Disasters: Learning from the Lasting Effects of Disasters,"Disasters test civil administrations' and health services' capacity to act in a flexible but well-coordinated manner because each disaster is unique and poses unusual challenges. The health services required differ markedly according to the nature of the disaster and the geographical spread of those affected. Epidemiology has shown that services need to be equipped to deal with major depressive disorder and grief, not just posttraumatic stress disorder, and not only for victims of the disaster itself but also the emergency service workers. The challenge is for specialist advisers to respect and understand the existing health care and support networks of those affected while also recognizing their limitations. In the initial aftermath of these events, a great deal of effort goes into the development of early support systems but the longer term needs of these populations are often underestimated. These services need to be structured, taking into account the pre-existing psychiatric morbidity within the community. Disasters are an opportunity for improving services for patients with posttraumatic psychopathology in general but can later be utilized for improving services for victims of more common traumas in modern society, such as accidents and interpersonal violence.",0 +https://doi.org/10.3109/09540261.2012.692321,State of psychiatry in Denmark,"Danish psychiatry has gone through profound changes over the past two to three decades, reducing inpatient-based treatment and increasing outpatient treatment markedly. The number of patients treated has almost doubled, and the diagnostic profile has broadened, now including a substantial number of common mental disorders, in particular depression and anxiety. Furthermore, 'new' diagnostic groups are represented in the treatment statistics with steeply increasing incidences, e.g. attention deficit hyperactivity disorder (ADHD) and eating disorders, especially in the outpatient part of the statistics. Over the same 30 years, the number of available beds has been reduced by 60-70%; however, as the length of stay of inpatients has been reduced markedly, the departments are still able to treat a high number of patients. The financial budgeting of psychiatry is not increasing equivalently to the somatic specialities, handicapping development in psychiatry. Action has been taken to increase research activity in psychiatry. This is facilitated by an increasing interest among medical students and young graduate physicians attracted by the neuropsychiatric paradigm, rapidly implemented in Danish psychiatry.",0 +https://doi.org/10.1016/j.pnpbp.2015.01.002,Has psychiatry tamed the “ketamine tiger?” Considerations on its use for depression and anxiety,"Ketamine has been available for approximately 50 years as an anesthetic agent. It is known to have potent effects on the central nervous system glutamatergic system, in particular blockade of N-methyl-D-aspartate (NMDA) receptors. Based upon pre-clinical evidence of involvement of the glutamatergic system in mood disorders, studies have been undertaken to test the antidepressant properties of ketamine. Several well-controlled studies, along with open-label case series, have established that ketamine can have rapid antidepressant effects. Additionally, data exist showing benefits of ketamine in post-traumatic stress disorder as well as obsessive compulsive disorder. However, improvements in these conditions tend to be short-lived with single infusions of ketamine. Of concern, ketamine has been associated with neurotoxicity in pre-clinical rodent models and is well-known to cause psychotomimetic effects and addiction in humans. While ketamine has been proven safe for use in sub-anesthetic doses administered once or a few times, the safety profile of prolonged use has not been established. Aspects of safety, possible mechanisms of action, and future directions of ketamine research are discussed in addition to the clinical literature on its use in psychiatric conditions.",0 +https://doi.org/10.1016/j.janxdis.2013.04.003,Posttraumatic stress disorder in OEF/OIF veterans with and without traumatic brain injury,"Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) are presenting with high rates of co-occurring posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI). The purpose of this study was to compare the clinical presentations of combat-veterans with PTSD and TBI (N = 40) to those with PTSD only (N = 56). Results suggest that the groups present two distinct clinical profiles, with the PTSD + TBI group endorsing significantly higher PTSD scores, higher overall anxiety, and more functional limitations. The higher PTSD scores found for the PTSD + TBI group appeared to be due to higher symptom intensity, but not higher frequency, across PTSD clusters and symptoms. Groups did not differ on additional psychopathology or self-report of PTSD symptoms or executive functioning. Further analysis indicated PTSD severity, and not TBI, was responsible for group differences, suggesting that treatments implicated for PTSD would likely be effective for this population.",0 +https://doi.org/10.1007/s002130100859,Summary of a National Institute of Mental Health workshop: developing animal models of anxiety disorders,"There exists a wide range of animal models and measures designed to assess anxiety or fearfulness. However, the relationship between these models and clinical anxiety symptoms and syndromes is unclear. The National Institute of Mental Health convened a workshop to discuss the relationship between existing behavioral models of anxiety and the clinical profile of anxiety disorders. A second goal of this workshop was to outline various approaches towards modeling components of anxiety disorders.To briefly describe epidemiological and behavioral manifestations of clinical anxiety syndromes and how they relate to commonly employed animal models of anxiety. To describe approaches and considerations for developing, improving, and adapting anxiety models to better understand the neurobiology of anxiety.Clinicians, psychiatrists and clinical and basic neuroscientists presented data exemplifying different approaches towards understanding anxiety and the role of animal models. Panel members outlined what they considered to be critical issues in developing and employing animal models of anxiety.This review summarizes the discussions and conclusions of the workshop including recommendations for improving upon existing models and strategies for developing novel models.The probability of developing comprehensive animal models that accurately reflect the relative influences of factors contributing to anxiety disorder syndromes is quite low. However, ample opportunity remains to better define and extend existing models and behavioral measures related to specific processes that may be disrupted in anxiety disorders and to develop new models that consider the impact of combined factors in determining anxious behaviors.",0 +https://doi.org/10.1159/000112029,Obsessive-Compulsive Disorder and Posttraumatic Stress Disorder,"<i>Background: </i>Previous studies suggested an association between exposure to trauma or stressful life events and obsessive-compulsive disorder (OCD). This study investigates the hypothesis that traumatic events and posttraumatic stress disorders (PTSD) precede the onset of OCD. <i>Sampling and Methods:</i> 210 cases with OCD from university treatment facilities were compared with 133 sex- and age-matched controls from the adult general population. The data were derived from a German family study on OCD (GENOS). Direct interviews were carried out with the German version of the Schedule for Affective Disorders and Schizophrenia – Lifetime Version for Anxiety Disorders (DSM-IV). <i>Results:</i> Severe traumatization occurred in 6.2% of the OCD cases and in 8.3% of the controls. The lifetime prevalence rates of traumatization, PTSD and acute stress disorder were not different between the subjects with OCD and controls (p > 0.05). In 6 cases, acute stress disorder, subclinical or full PTSD preceded the onset of OCD, in 3 cases the trauma-related disorders and OCD occurred within the same year, in 5 other cases, the trauma-related disorders started after the onset of OCD. <i>Conclusion:</i> There is no significant association of traumatization or PTSD with OCD compared with controls. Given the low rate of trauma-related disorders occurring before (2.9%) or within (1.5%) the same year as the onset of OCD other factors than severe traumatic events determine the onset of OCD in most of the cases.",0 +https://doi.org/10.1080/13854046.2011.579174,Self-Report of Psychological Function Among OEF/OIF Personnel Who Also Report Combat-Related Concussion,"MMPI-2 RF profiles of 128 U.S. soldiers and veterans with history of concussion were examined. Participants evaluated in forensic (n = 42) and clinical (n = 43) settings showed significantly higher validity and clinical elevations relative to a research group (n = 43). In the full sample, a multivariate GLM identified main effects for disability claim status and Axis I diagnosis across numerous MMPI-2 RF scales. Participants with co-morbid PTSD and concussion showed significant Restructured Clinical and Specific Problem scale elevations relative to those without Axis I diagnosis. Participants with PTSD and active disability claims were especially prone to elevate on FBS/FBS-r and RBS. Implications for neuropsychologists who routinely administer the MMPI-2/RF in the context of combat-related concussion are discussed.",0 +https://doi.org/10.1186/s40303-015-0007-3,Metabolite profiling in posttraumatic stress disorder,"Traumatic stress does not only increase the risk for posttraumatic stress disorder (PTSD), but is also associated with adverse secondary physical health outcomes. Despite increasing efforts, we only begin to understand the underlying biomolecular processes. The hypothesis-free assessment of a wide range of metabolites (termed metabolite profiling) might contribute to the discovery of biological pathways underlying PTSD.Here, we present the results of the first metabolite profiling study in PTSD, which investigated peripheral blood serum samples of 20 PTSD patients and 18 controls. We performed liquid chromatography (LC) coupled to Quadrupole/Time-Of-Flight (QTOF) mass spectrometry. Two complementary statistical approaches were used to identify metabolites associated with PTSD status including univariate analyses and Partial Least Squares Discriminant Analysis (PLS-DA).Thirteen metabolites displayed significant changes in PTSD, including four glycerophospholipids, and one metabolite involved in endocannabinoid signaling. A biomarker panel of 19 metabolites classifies PTSD with 85% accuracy, while classification accuracy from the glycerophospholipid with the highest differentiating ability already reached 82%.This study illustrates the feasibility and utility of metabolite profiling for PTSD and suggests lipid-derived and endocannabinoid signaling as potential biological pathways involved in trauma-associated pathophysiology.",0 +https://doi.org/10.1007/s11524-012-9769-4,Public Health Consequences of Terrorism on Maternal–Child Health in New York City and Madrid,"Past research provides evidence for trajectories of health and wellness among individuals following disasters that follow specific pathways of resilience, resistance, recovery, or continued dysfunction. These individual responses are influenced by event type and pre-event capacities. This study was designed to utilize the trajectories of health model to determine if it translates to population health. We identified terrorist attacks that could potentially impact population health rather than only selected individuals within the areas of the attacks. We chose to examine a time series of population birth outcomes before and after the terrorist events of the New York City (NYC) World Trade Center (WTC) attacks of 2001 and the Madrid, Spain train bombings of 2004 to determine if the events affected maternal-child health of those cities and, if so, for how long. For percentages of low birth weight (LBW) and preterm births, we found no significant effects from the WTC attacks in NYC and transient but significant effects on rates of LBW and preterm births following the bombings in Madrid. We did find a significant positive and sustained effect on infant mortality rate in NYC following the WTC attacks but no similar effect in Madrid. There were no effects on any of the indicator variables in the comparison regions of New York state and the remainder of Spain. Thus, population maternal-health in New York and Madrid showed unique adverse effects after the terrorist attacks in those cities. Short-term effects on LBW and preterm birth rates in Madrid and long-term effects on infant mortality rates in NYC were found when quarterly data were analyzed from 1990 through 2008/2009. These findings raise questions about chronic changes in the population's quality of life following catastrophic terrorist attacks. Public health should be monitored and interventions designed to address chronic stress, environmental, and socioeconomic threats beyond the acute aftermath of events.",0 +https://doi.org/10.4088/jcp.13m08914,Latent Trajectories of Trauma Symptoms and Resilience,"To identify trajectories of posttraumatic stress disorder (PTSD) symptoms from before to 2.5 years after deployment and to assess risk factors for symptom fluctuations and late-onset PTSD.743 soldiers deployed to Afghanistan in 2009 were assessed for PTSD symptoms using the PTSD Checklist (PCL) at 6 occasions from predeployment to 2.5 years postdeployment (study sample = 561). Predeployment vulnerabilities and deployment and postdeployment stressors were also assessed.Six trajectories were identified: a resilient trajectory with low symptom levels across all assessments (78.1%) and 5 trajectories showing symptom fluctuations. These included a trajectory of late onset (5.7%), independently predicted by earlier emotional problems (OR = 5.59; 95% CI, 1.57-19.89) and predeployment and postdeployment traumas (OR = 1.10; 95% CI, 1.04-1.17 and OR = 1.13; 95% CI, 1.00-1.26). Two trajectories of symptom fluctuations in the low-to-moderate range (7.5% and 4.1%); a trajectory of symptom relief during deployment, but with a drastic increase at the final assessments (2.0%); and a trajectory with mild symptom increase during deployment followed by relief at return (2.7%) were also found. Symptom fluctuation was predicted independently by predeployment risk factors (depression [OR = 1.27; 95% CI, 1.16-1.39], neuroticism [OR = 1.10; 95% CI, 1.00-1.21], and earlier traumas [OR = 1.09; 95% CI, 1.03-1.16]) and deployment-related stressors (danger/injury exposure [OR = 1.20; 95% CI, 1.04-1.40]), but not by postdeployment stressors.The results confirm earlier findings of stress response heterogeneity following military deployment and highlight the impact of predeployment, perideployment, and postdeployment risk factors in predicting PTSD symptomatology and late-onset PTSD symptoms.",1 +https://doi.org/10.1521/psyc.65.3.240.20169,"60,000 Disaster Victims Speak: Part II. Summary and Implications of the Disaster Mental Health Research","On the basis of the literature reviewed in Part I of this two-part series (Norris, Friedman, Watson, Byrne, Diaz, and Kaniasty, this volume), the authors recommend early intervention following disasters, especially when the disaster is associated with extreme and widespread damage to property, ongoing financial problems for the stricken community, violence that resulted from human intent, and a high prevalence of trauma in the form of injuries, threat to life, and loss of life. Meeting the mental health needs of children, women, and survivors in developing countries is particularly critical. The family context is central to understanding and meeting those needs. Because of the complexity of disasters and responses to them, inter-agency cooperation and coordination are extremely important elements of the mental health response. Altogether, the research demands that we think ecologically and design and test societal- and community-level interventions for the population at large and conserve scarce clinical resources for those most in need.",0 +https://doi.org/10.1002/jts.21689,An examination of PTSD symptoms and relationship functioning in U.S. soldiers of the Iraq War over time,"We examined associations between overall posttraumatic stress disorder (PTSD) symptoms, symptom clusters of PTSD (reexperiencing, avoidance, dysphoria, and arousal), and relationship adjustment cross sectionally and longitudinally using self-report measures from a dyadic sample of U.S. National Guard soldiers from the Iraq war and their intimate partners (N = 49 couples). Results of multilevel modeling revealed that Time 1 PTSD symptom severity significantly predicted lower relationship adjustment as rated by partners at Time 2 after controlling for baseline relationship adjustment (β = −.20, p = .025). Total PTSD symptoms did not significantly predict soldiers' ratings of relationship adjustment at Time 2. For soldiers, the PTSD symptom cluster of dysphoria was uniquely and significantly related to relationship adjustment ratings both at Time 1 and at Time 2, controlling for Time 1 adjustment. For partners, none of the soldiers' PTSD symptoms clusters was uniquely associated with Time 1 relationship adjustment or with change in adjustment over time. In contrast, findings regarding the effect of relationship adjustment on changes in PTSD over time found that Time 1 relationship adjustment was not associated with changes in PTSD symptoms at Time 2.",0 +https://doi.org/10.1111/jpm.12264,"Exposure to war traumatic experiences, post-traumatic stress disorder and post-traumatic growth among nurses in Gaza","ACCESSIBLE SUMMARY: What is known on the subject? This study builds on existing research on war-related factors that may affect health-care staff by particularly focusing on trauma exposure in both professional and everyday life, as well as on correlates of later positive psychological changes. What this paper adds to existing knowledge? It shows that one in five nursing staff working in Gaza experienced post-traumatic stress symptoms within the clinical range, 2 years after an incursion on Gaza and after being exposed to substantial trauma during this period. Participants appeared to develop a variety of post-traumatic growth responses following trauma exposure. Although nurses experienced traumatic events both as civilians and in their health-care capacity, personal exposure was strongly associated with PTSD symptoms. What are the implications for practice? Support to nursing and other health-care professionals in war situations should entail different levels, remain available well after an acute conflict, and take into consideration both personal and practice-related traumatic events. Mental health nursing practitioners can play a pivotal role in this. ABSTRACT: Aim To establish the association between war traumatic experiences, post-traumatic stress disorder (PTSD) symptoms and post-traumatic growth among nurses in the Gaza Strip, 2 years after an incursion on Gaza, and during a period of ongoing trauma exposure. This study builds on existing evidence by considering exposure to personal and work-related traumatic events, and on factors associated with later positive psychological adaptation. METHODS The sample consisted of 274 randomly selected nurses in Gaza who completed the Gaza Traumatic Events Checklist, PTSD Checklist, and Posttraumatic Growth Inventory. RESULTS Of the nurses, 19.7% reported full PTSD. There was a significant relationship between traumatic events and PTSD scores; as well as between community-related traumatic events and post-traumatic growth. Participants reported a range of traumatic events, but PTSD and post-traumatic growth scores were more strongly associated with community rather than work-related traumas. DISCUSSION Nursing professionals experienced high levels of distress 2 years following an acute period of conflict, both as civilians and in their health-care capacity. Implications for Practice There is need for different levels of support for health-care staff in war-affected areas. Mental health nursing professionals have a central role in training, counselling and support to other health-care colleagues. Language: en",0 +https://doi.org/10.1007/s00127-011-0408-2,Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers,"PurposeWe sought to estimate the pooled current prevalence of posttraumatic stress disorder (PTSD) among rescue workers and to determine the variables implicated in the heterogeneity observed among the prevalences of individual studies.MethodsA systematic review covering studies reporting on the PTSD prevalence in rescue teams was conducted following four sequential steps: (1) research in specialized online databases, (2) review of abstracts and selection of studies, (3) review of reference list, and (4) contact with authors and experts. Prevalence data from all studies were pooled using random effects model. Multivariate meta-regression models were fitted to identify variables related to the prevalences heterogeneity.ResultsA total of 28 studies, reporting on 40 samples with 20,424 rescuers, were selected. The worldwide pooled current prevalence was 10%. Meta-regression modeling in studies carried out in the Asian continent had, on average, higher estimated prevalences than those from Europe, but not higher than the North American estimates. Studies of ambulance personnel also showed higher estimated PTSD prevalence than studies with firefighters and police officers.ConclusionsRescue workers in general have a pooled current prevalence of PTSD that is much higher than that of the general population. Ambulance personnel and rescuers from Asia may be more susceptible to PTSD. These results indicate the need for improving pre-employment strategies to select the most resilient individuals for rescue work, to implement continuous preventive measures for personnel, and to promote educational campaigns about PTSD and its therapeutic possibilities.",0 +https://doi.org/10.1097/00004583-199709000-00011,Gender and Comorbid Psychopathology in Adolescents With Alcohol Dependence,"Although several mental disorders have been shown to be common in adolescents with substance use disorders, prior studies have not specifically focused on alcohol dependence and have not had sufficient sample sizes to examine gender effects. This study contrasts mental disorder diagnoses and symptoms between a sample of adolescents with alcohol dependence and a community control sample of adolescents and incorporates gender analyses.Adolescents (aged 14 years 0 months to 18 years 0 months) with alcohol dependence (females: n = 55; males: n = 78) and community-dwelling control adolescents without substance use disorders (females: n = 44; males: n = 42) were assessed by means of a semistructured interview for DSM-III-R.While cannabis and hallucinogen use disorders were common in the alcohol dependence group, females and males had similar rates. Conduct disorder (CD), oppositional defiant disorder, attention-deficit hyperactivity disorder, major depression (MD), and posttraumatic stress disorder (PTSD) had significantly higher rates in the alcohol dependence than in the community control group. Depression and PTSD symptoms were more strongly associated with alcohol dependence in females than in males. A configural frequency analysis showed that CD and MD tended to occur together in both female and male adolescents with alcohol dependence.While alcohol-dependent females and males similarly exhibited more comorbid disorders than control adolescents, gender affects the relationship of alcohol dependence to MD and PTSD. Rather than reflecting distinct types, the comorbid disorders of CD and MD jointly characterize many adolescents with alcohol dependence.",0 +https://doi.org/10.1521/pedi.1990.4.4.391,MCMI and 16-PF With Vietnam Veterans: Profiles and Concurrent Validation of MCMI,"The issue of concurrent validation for the Millon Clinical Multiaxial Inventory (MCMI) is addressed. A carefully defined group of Vietnam veterans with posttraumatic stress disorder (PTSD) were identified (n = 60). They were given the MCMI and 16-PF Results showed that the passive—aggressive and avoidant personality styles (8-2) with schizoid and borderline features and symptoms of dysthymia and anxiety were characteristic of Vietnam veterans with PTSD on the MCMI. The 16-PF pattern of this group was one with low stens on Warmth, Emotional Stability, Happy-Go-Lucky, Boldness, Self-Discipline, and Extraversion; and high stens on Suspiciousness, Insecurity, Self-Sufficiency, and Anxiety. When each MCMI scale was inspected separately for correlates of the 16-PF, considerable concurrent validation resulted. Clinicians are encouraged to use these scales for the identification and personologic description of the PTSD disorder with veterans.",0 +https://doi.org/10.1016/j.neubiorev.2012.06.003,Neurocircuitry models of posttraumatic stress disorder and beyond: A meta-analysis of functional neuroimaging studies,"Over the past two decades a relatively large number of studies have investigated the functional neuroanatomy of posttraumatic stress disorder (PTSD). However, findings are often inconsistent, thus challenging traditional neurocircuitry models of PTSD. As evidence mounts that cognition and behavior is an emergent property of interacting brain networks, the question arises whether PTSD can be understood by examining dysfunction in large-scale, spatially distributed neural networks. We used the activation likelihood estimation quantitative meta-analytic technique to synthesize findings across functional neuroimaging studies of PTSD that either used a non-trauma (N=20) or trauma-exposed (N=19) comparison control group. In line with neurocircuitry models, our findings support hyperactive amygdala and hypoactive medial prefrontal regions, but suggest hyperactive hippocampi. Characterization of additional regions under a triple network model showed functional alterations that largely overlapped with the salience network, central executive network, and default network. However, heterogeneity was observed within and across the neurocircuitry and triple network models, and between results based on comparisons to non-trauma and trauma-exposed control groups. Nonetheless, these results warrant further exploration of the neurocircuitry and large-scale network models in PTSD using connectivity analyses.",0 +,Commentary: Developmental Trauma Disorder: A Missed Opportunity in DSM V.,"This is a commentary on the proposal of van der Kolk, et al. (2009) to include the diagnosis of developmental trauma disorder in the DSM V. As is now known, it was not accepted. Importantly, a commentary relating to this must include comments on both diagnosis and trauma in children. We will first comment on general issues of diagnostic systems in child psychiatry and then, if we are to use DSM V, why there should be a separate category for developmental trauma.",0 +,A psychological profile of Elian Gonzalez.,,0 +https://doi.org/10.1038/sj.mp.4002119,Trends in mental illness and suicidality after Hurricane Katrina,"A representative sample of 815 pre-hurricane residents of the areas affected by Hurricane Katrina was interviewed 5–8 months after the hurricane and again 1 year later as the Hurricane Katrina Community Advisory Group (CAG). The follow-up survey was carried out to study patterns-correlates of recovery from hurricane-related post-traumatic stress disorder (PTSD), broader anxiety-mood disorders and suicidality. The Trauma Screening Questionnaire screening scale of PTSD and the K6 screening scale of anxiety-mood disorders were used to generate DSM-IV prevalence estimates. Contrary to results in other disaster studies, where post-disaster mental disorder typically decreases with time, prevalence increased significantly in the CAG for PTSD (20.9 vs 14.9% at baseline), serious mental illness (SMI; 14.0 vs 10.9%), suicidal ideation (6.4 vs 2.8%) and suicide plans (2.5 vs 1.0%). The increases in PTSD-SMI were confined to respondents not from the New Orleans Metropolitan Area, while the increases in suicidal ideation-plans occurred both in the New Orleans sub-sample and in the remainder of the sample. Unresolved hurricane-related stresses accounted for large proportions of the inter-temporal increases in SMI (89.2%), PTSD (31.9%) and suicidality (61.6%). Differential hurricane-related stress did not explain the significantly higher increases among respondents from areas other than New Orleans, though, as this stress was both higher initially and decreased less among respondents from the New Orleans Metropolitan Area than from other areas affected by the hurricane. Outcomes were only weakly related to socio-demographic variables, meaning that high prevalence of hurricane-related mental illness remains widely distributed in the population nearly 2 years after the hurricane.",0 +https://doi.org/10.1111/j.1440-1819.2009.02052.x,Relationship of alexithymia and temperament and character dimensions with lifetime post-traumatic stress disorder in male alcohol-dependent inpatients,"Aims: The purpose of the present study was to evaluate the prevalence of lifetime post-traumatic stress disorder (PTSD) in male alcohol-dependent inpatients and to investigate the relationship of PTSD with alexithymia and temperament and character dimensions. Methods: Participants were 156 consecutively admitted male alcohol-dependent subjects. Patients were investigated using the Clinician-Administered PTSD Scale (CAPS), the Toronto Alexithymia Scale (TAS-20) and the Temperament and Character Inventory (TCI). Results: Among alcohol-dependent inpatients 32.1% were considered as having lifetime PTSD. Mean scores of alexithymia, novelty seeking (NS), harm avoidance (HA) and self-transcendence (ST) were higher in the PTSD group, whereas age and self-directedness (S) were lower. Among age and other factors of TAS-20, ‘difficulty in identifying feelings (DIF)’ predicted PTSD in a logistic regression model. When age and personality dimensions of TCI were taken as independent variables, S predicted PTSD in the logistic regression model. Finally, among subscales of TCI, ‘impulsiveness versus reflection’ (NS2) and ‘congruent second nature versus bad habits’ (S5) predicted PTSD. Conclusions: Alexithymia and personality traits, particularly high DIF and S scores are related with lifetime PTSD diagnosis, even when controlling for age among alcohol-dependent inpatients. Causal relationships between alexithymia, personality dimensions and PTSD, and their implications on treatment are not clear and should be evaluated in longitudinal studies.",0 +https://doi.org/10.1097/jcp.0b013e3181a45ed0,Association of Posttraumatic Stress Disorder With Increased Prevalence of Metabolic Syndrome,"Few studies have compared prevalence rates of metabolic abnormalities in antipsychotic-treated patients with different psychiatric disorders, including posttraumatic stress disorder (PTSD). In this study, we examined components of metabolic syndrome among middle-aged and older patients with psychiatric disorders.In the study, 203 outpatients older than 40 years and with psychotic symptoms that needed antipsychotic treatment were enrolled. Among them, 65 had a diagnosis of schizophrenia, 56 had dementia, 49 had mood disorder, and 33 had PTSD. Clinical evaluations included medical history, use of psychotropic and other medications, adverse effects, physical examination, and clinical laboratory tests for metabolic profiles.Overall, the prevalence rates of metabolic syndrome were 72% in patients with PTSD, 60% in those with schizophrenia, 58% in those with mood disorder, and 56% in those with dementia. There were significant differences in body mass index, diastolic blood pressure, waist circumference, and high-density lipoprotein cholesterol among the 4 diagnostic groups. Posttraumatic stress disorder, schizophrenia, and mood disorder groups had significantly higher body mass indexes compared with the dementia group. The PTSD group also had significantly higher diastolic blood pressure compared with the dementia and mood disorder groups.Posttraumatic stress disorder may be associated with worsened metabolic profile. The overall frequency of metabolic syndrome and its components in patients with PTSD taking antipsychotics seemed to be at least equivalent, if not slightly worse, compared with that in patients with schizophrenia, dementia, or a mood disorder.",0 +https://doi.org/10.1037/a0037967,Posttraumatic stress predicting depression and social support among college students: Moderating effects of race and gender.,"More than half of the students entering college report a history of potentially traumatic events; however, little is known about the relationship of trauma exposure and posttraumatic stress disorder (PTSD) symptomatology to college students' mental health and access to social support or whether these relationships may show variations as a function of race and gender. The purpose of this study was to explore whether the relationships between PTSD symptoms and both depression and social support were moderated by gender and race. Data were collected from 631 African American (AA) and 299 European American (EA) freshmen students attending 2 universities in the Southeast. The majority of the students (74.3% of the AA and 68.2% of the EA sample) reported lifetime exposure to at least 1 traumatic event. PTSD symptomatology was significantly and positively associated with depression symptoms for all groups (i.e., AA and EA males and females); however, the relationship between these 2 variables was strongest for EA men. Similarly, the relationship between PTSD symptoms on the avoidance cluster and social support was stronger for EA males than other groups; avoidance symptoms did not significantly predict social support for AA men.",0 +https://doi.org/10.1001/archinte.164.12.1306,Burden of Medical Illness in Women With Depression and Posttraumatic Stress Disorder,"Depression and posttraumatic stress disorder (PTSD) are important women's health issues. Depression is known to be associated with poor physical health; however, associations between physical health and PTSD, a common comorbidity of depression, have received less attention.To examine number of medical symptoms and physical health status in women with PTSD across age strata and benchmark them against those of women with depression alone or with neither depression nor PTSD.A random sample of Veterans Health Administration enrollees received a mailed survey in 1999-2000 (response rate, 63%). The 30 865 women respondents were categorized according to whether a health care provider had ever told them that they had PTSD, depression (without PTSD), or neither. Outcomes were self-reported medical conditions and physical health status measured with the Veterans SF-36 instrument, a version of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) modified for use in veteran populations.Across age strata, women with PTSD (n = 4348) had more medical conditions and worse physical health status (physical functioning, role limitations due to physical problems, bodily pain, and energy/vitality scales from the Veterans SF-36) than women with depression alone (n = 7580) or neither (n = 18 937). In age-adjusted analyses, the Physical Component Summary score was on average 3.4 points lower in women with depression alone and 6.3 points lower in women with PTSD than in women with neither (P<.001).Posttraumatic stress disorder is associated with a greater burden of medical illness than is seen with depression alone. The presence of PTSD may account for an important component of the excess medical morbidity and functional status limitations seen in women with depression.",0 +https://doi.org/10.3109/09593985.2015.1024299,Sincerity of effort versus feigned movement control of the cervical spine in patients with whiplash-associated disorders and asymptomatic persons: a case-control study.,"Cross-sectional design.To investigate whether the Fly Test can be used to differentiate patients with whiplash-associated disorders (WAD) from asymptomatic persons who deliberately feign symptoms and from WAD patients exaggerating symptoms.The lack of valid clinical tests makes it difficult to detect a justifiable cause for compensation claims in traumatic neck-pain disorders.The Fly Test recorded the accuracy of neck movements in patients with WAD (n = 34) and asymptomatic persons (n = 31). The participants followed a moving ""Fly"" on a computer screen with a cursor from sensors mounted on the head. Two conditions were tested, sincere versus feigned efforts. In the former, the participants moved their neck as accurately as possible. In the latter, a short text was presented describing a fictitious accident (asymptomatic group) or imagining more intense pain/suffering (WAD group), and the test was performed as affected by these more serious conditions. Amplitude accuracy (AA), time on target (ToT) and jerk index (JI) were compared across patterns, conditions and groups.The sincere effort in the WAD group was significant compared to the feigned effort of the asymptomatic group (p < 0.001). For AA, correct categorization of 81.5% of the performances was made, where a mean score above 5.5 mm differentiated feigned versus sincere efforts in asymptomatic and WAD groups (sensitivity 79.4%, specificity 67.7%). For ToT, score above 11% indicated correctly categorized WAD patients (sensitivity 82.4%, specificity 64.5%).The Fly Test can provide clinicians a clue when patients with mild to moderate pain/disability are feigning or exaggerating symptoms.",0 +https://doi.org/10.4321/s0213-61632013000100003,Demoralization and the longitudinal course of PTSD following Hurricane Mitch,"Background and Objectives: Numerous studies of disasters have used measures of non-specific distress as outcome measures. The utility of these measures as predictive of the long-term outcome of disasters has remained unclear, in particular the relationship with PTSD. This study examines whether demoralization is predictive and a useful concept to examine the long-term outcome of disaster related PTSD. Methods: The 1998 Hurricane Mitch that impacted Honduras was examined two-months (n = 800) and two-years following the disaster in a longitudinal community-based sample of 604 adults. Respondents were selected from a stratified sample in Tegucigalpa based on exposure and social economic status. PTSD diagnosed using the CIDI module at both periods of time. Demoralization was measured using the PERI-D at 2-months post-disaster. Results: The PERI-D, increased demoralization, was significantly associated with PTSD at two-month and two-years. In addition, increased demoralization was associated with increased risk of PTSD chronicity. Decreased demoralization was associated with PTSD remission. New onset PTSD was associated increased demoralization; however, the finding was not appreciated after controlling for potential confounders. Conclusions: Demoralization can be measured using a simple screening questionnaire that may be a useful in identifying individuals who may be at increased risk for PTSD in the short-term, as well as in the long-term following a disaster.",0 +,The shaping of vulnerability factors including core cognitive beliefs and their subsequent role in posttraumatic stress disorder and general clinical psychopathology,"ABSTRACT The present study examines the role of core beliefs in posttraumatic outcome including the development and maintenance of PTSD and general clinical psychopathology in a non-treatment seeking college-age population. Although trauma and clinical PTSD literatures are replete with references concerning the potential impact that traumatic and/or uncontrollable stressor(s) may have on cognitive schemata and their role in negative posttraumatic adjustment, little empirical research exists that delineates potentially important differences in the nature and quality of core belief systems for which both trauma and PTSD history are controlled. Unique aspects of the present study include: 1) the inclusion of two domains of core belief measures (i.e., early maladaptive schemas via the Schema Questionnaire as proposed by Young (1994) and the three basic personal belief systems as measured by the World Assumptions Scale (WAS) that have been posited by Janoff-Bulman (1985) as centrally related to traumatization experiences; 2) the examination of these broad ranging core belief systems in relation to other factors that have been found or proposed to be significantly related to PTSD development and/or maintenance, including aspects of the traumatic event(s), dissociation, and related areas of clinical symptomatology; and 3) the use of four specific study groups that controlled for both level of traumatization and PTSD symptomatology (no trauma; trauma without past or current PTSD; PTSD in remission; and PTSD current) to enhance conclusions regarding the most potent predictors of PTSD symptomatology by analyzing these factors simultaneously across progressive (i.e., continuous) levels of PTSD symptomatology, as well as between the discrete diagnostic groups. Three main overarching hypotheses were generated in this study, and related to: 1) the detection of general between-group differences between the four study groups on important indices of PTSD se verity, core beliefs, and measures of clinical symptomatology; 2) specific core beliefs that would predict PTSD symptomatology to a equal or greater extent than other important factors that have been related to posttraumatic adjustment, irrespective of depression status; and 3) cognitive specificity of core belief systems between major domains of clinical symptomatology (i.e., anxiety and depression) as well as within specific clinical domains (i.e., within types of anxiety). The results largely supported these hypotheses, where specific subtypes of core beliefs were strongly associated with posttraumatic outcome. In particular, the core belief of vulnerability demonstrated a highly consistent relationship with PTSD severity, as well as all domains of anxiety assessed within the study (i.e., state anxiety, anxiety sensitivity, and worry). This finding is consistent with Beck’s (1967) hypothesis that vulnerability schemata underlie the anxiety disorders. Furthermore, evidence was found both for the specificity of core cognitive beliefs between major domains of…",0 +https://doi.org/10.1016/j.cpr.2008.06.001,Corrigendum to “The relative efficacy of bona fide psychotherapies for treating post-traumatic stress disorder: A meta-analysis of direct comparisons” [Clinical Psychology Review 28 (2008) 766–75],"Reports an error in ""The relative efficacy of bona fide psychotherapies for treating post-traumatic stress disorder: A meta-analysis of direct comparisons"" by Steven G. Benish, Zac E. Imel and Bruce E. Wampold (Clinical Psychology Review, 2008[Jun], Vol 28[5], 746-758). There are three errors in the original analysis that appear in Table 1: The effect size for all measures should be d=.40 for Foa et al. (1999), while all measures and PTSD measures for Devilly & Spence (1999) should be d=.43 and d=.57, respectively. In the original analysis, data from Resick et al. (1988) was erroneously included in lieu of Resick (2002) including the quotation. The correct effect size for Resick et al. (2002) all measures and PTSD measures should be d=.31 and d=.27, respectively. (The following abstract of the original article appeared in record 2008-05435-003.) Psychotherapy has been found to be an effective treatment of post-traumatic stress disorder (PTSD), but meta-analyses have yielded inconsistent results on relative efficacy of psychotherapies in the treatment of PTSD. The present meta-analysis controlled for potential confounds in previous PTSD meta-analyses by including only bona fide psychotherapies, avoiding categorization of psychotherapy treatments, and using direct comparison studies only. The primary analysis revealed that effect sizes were homogenously distributed around zero for measures of PTSD symptomology, and for all measures of psychological functioning, indicating that there were no differences between psychotherapies. Additionally, the upper bound of the true effect size between PTSD psychotherapies was quite small. The results suggest that despite strong evidence of psychotherapy efficaciousness vis-a-vis no treatment or common factor controls, bona fide psychotherapies produce equivalent benefits for patients with PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1146/annurev.psych.58.110405.085650,Social Bonds and Posttraumatic Stress Disorder,"Retrospective and prospective studies consistently show that individuals exposed to human-generated traumatic events carry a higher risk of developing Posttraumatic Stress Disorder (PTSD) than those exposed to other kinds of events. These studies also consistently identify perceptions of social support both before and after a traumatic event as an important factor in the determining vulnerability to the development of PTSD. We review the literature on interpersonal traumas, social support and risk for PTSD and integrate findings with recent advances in developmental psychopathology, attachment theory and social neuroscience. We propose and gather evidence for what we term the social ecology of PTSD, a conceptual framework for understanding how both PTSD risk and recovery are highly dependent on social phenomena. We explore clinical implications of this conceptual framework.",0 +https://doi.org/10.1097/00004583-199510000-00021,PTSD Symptoms in Urban Adolescent Girls: Compounded Community Trauma,"To describe the assessments for exposure to violent events and posttraumatic stress disorder (PTSD) symptoms in a population of urban adolescent girls.Seventy-nine urban adolescent girls attending an adolescent medicine clinic were assessed via clinician-assisted self-report measures called the Adolescent Self-Report Trauma Questionnaire. The questionnaire gathered information on demographics, exposure to community and domestic violent events, and PTSD symptoms.The adolescents experienced between 8 and 55 different types of community and domestic violent events, with the mean number of violent events being 28. Hyperarousal cluster symptoms were present in 90%, reexperiencing clusters symptoms in 89%, and avoidance cluster symptoms in 80%, while 67% met symptom criteria for PTSD. Increased number of types of violent events was positively correlated with meeting PTSD criteria (p = .01) and with increased PTSD severity scores (p = .001).These urban adolescent girls have experienced prolonged and repeated exposure to multiple types of community as well as domestic violent events, via multiple modalities of contact, over time. They reported a high percentage of PTSD symptoms across all three symptom clusters. The authors propose the concept of ""compounded community trauma"" and discuss its marked impact on female adolescent development.",0 +https://doi.org/10.1111/j.1600-0447.2008.01248.x,"Ten-year follow-up study of PTSD diagnosis, symptom severity and psychosocial indices in aging holocaust survivors","We performed a longitudinal study of holocaust survivors with and without post-traumatic stress disorder (PTSD) by assessing symptoms and other measures at two intervals, approximately 10 years apart.The original cohort consisted of 63 community-dwelling subjects, of whom 40 were available for follow-up.There was a general diminution in PTSD symptom severity over time. However, in 10% of the subjects (n=4), new instances of delayed onset PTSD developed between time 1 and time 2. Self-report ratings at both assessments revealed a worsening of trauma-related symptoms over time in persons without PTSD at time 1, but an improvement in those with PTSD at time 1.The findings suggest that a nuanced characterization of PTSD trajectory over time is more reflective of PTSD symptomatology than simple diagnostic status at one time. The possibility of delayed onset trajectory complicates any simplistic overall trajectory summarizing the longitudinal course of PTSD.",0 +https://doi.org/10.1080/08039480310002688,Quantitative electroencephalogram (qEEG) in combat veterans with post-traumatic stress disorder (PTSD),"Only a small number of studies have used quantitative electroencephalography (qEEG) in research of the post-traumatic stress disorder (PTSD). The results are not consistent. The aim of the present investigation was to compare qEEG in combat veterans with and without PTSD. The hypothesis is that differences among qEEG characteristics will be found regarding the presence/absence of PTSD. Seventy-nine combat veterans with PTSD comprised the experimental group and 37 veterans without PTSD were included as controls. After the informed consent, they were investigated by the resting EEG recordings. The results demonstrate that PTSD veterans had decreased alpha power and increased beta power. These results suggest an altered neurobiology in PTSD. Various explanations have been offered for alpha activity decrease observed in PTSD veterans. Increased beta rhythm may play a role as a potential marker in differentiating subtypes of PTSD.",0 +https://doi.org/10.1016/s0140-6736(08)60638-8,Research on psychedelics moves into the mainstream,"The backlash against the recreational use of psychedelic drugs in the 1960s had a negative effect on research into their potential therapeutic benefit. But now attitudes are changing and work in this area is being revitalised, with several early-stage trials underway. Kelly Morris reports.",0 +https://doi.org/10.1080/10398560701354948,Open Trial of Interpersonal Psychotherapy for Chronic Post Traumatic Stress Disorder,"Objective: The aim of this study was to investigate the feasibility of adapting group-based interpersonal psychotherapy (IPT-G) for patients with chronic post traumatic stress disorder (PTSD). Methods: Thirteen subjects with DSM-IV-defined PTSD, with symptom duration greater than 12 months, entered the study, an 8-week treatment programme conducted in a clinical setting using IPT-G modified for the treatment of PTSD. Data obtained were analysed qualitatively and quantitatively. Results: All 13 subjects completed the treatment programme and showed significant improvement in social functioning, general wellbeing and depressive symptoms. Treatment completers demonstrated a moderate reduction in the avoidant symptom cluster of PTSD. These improvements appeared stable at 3-month follow-up. Benefits appeared to be associated with perceived intra-therapy progress in resolving identified IPT problem areas. Qualitative analysis found that themes of ‘reconnection’ and ‘interpersonal efficacy’ were core parts of the experience of the treatment. Conclusion: IPT-G modified for PTSD appears to be of modest symptomatic benefit, but may lead to improvement in social functioning, general psychological wellbeing and enhanced interpersonal functioning. Further studies are indicated.",0 +https://doi.org/10.1192/bjp.bp.107.039818,Influence of childhood adversity on health among male UK military personnel,"Background Exposure to childhood adversity may explain why only a minority of combatants exposed to trauma develop psychological problems. Aims To examine the association between self-reported childhood vulnerability and later health outcomes in a large randomly selected male military cohort. Method Data are derived from the first stage of a cohort study comparing Iraq veterans and non-deployed UK military personnel. We describe data collected by questionnaire from males in the regular UK armed forces ( n =7937). Results Pre-enlistment vulnerability is associated with being single, of lower rank, having low educational attainment and serving in the Army. Pre-enlistment vulnerability is associated with a variety of negative health outcomes. Two main factors emerge as important predictors of ill health: a ‘family relationships’ factor reflecting the home environment and an ‘externalising behaviour’ factor reflecting behavioural disturbance. Conclusions Pre-enlistment vulnerability is an important individual risk factor for ill health in military men. Awareness of such factors is important in understanding post-combat psychiatric disorder.",0 +https://doi.org/10.1037/a0039713,Polyvictimization: Latent profiles and mental health outcomes in a clinical sample of adolescents.,"Exposure to multiple traumatic events (polyvictimization) is a reliable predictor of deleterious health outcomes and risk behaviors in adolescence. The current study extends the literature on the prevalence and consequences of adolescent trauma exposure by (a) empirically identifying and characterizing trauma exposure profiles in a large, ethnically diverse, multi-site, clinical sample of adolescents, and (b) evaluating relations among identified profiles with demographic characteristics and clinical correlates.Data from the National Child Traumatic Stress Network Core Data Set were used to identify and characterize victimization profiles using latent class analysis in a sample of 3,485 adolescents (ages 13-18, 63% female, 35.7% White, 23.2% Black/African American, 35.0% Hispanic/Latino). Multiple measures of psychological distress and risk behaviors were evaluated as covariates of trauma exposure classes.Five trauma exposure classes, or profiles, were identified. Four classes-representing approximately half the sample-were characterized by polyvictimization. Polyvictimization classes were differentiated on number of trauma types, whether emotional abuse occurred, and whether emotional abuse occurred over single or multiple developmental epochs. Unique relations with demographic characteristics and mental health outcomes were observed.Results suggest polyvictimization is not a unidimensional phenomenon but a diverse set of trauma exposure experiences with unique correlates among youth. Further research on prevention of polyvictimization and mechanisms linking chronic trauma exposure, gender, and ethnicity to negative outcomes is warranted.",0 +https://doi.org/10.1016/j.pnpbp.2013.04.010,"Repeated administration of AC-5216, a ligand for the 18kDa translocator protein, improves behavioral deficits in a mouse model of post-traumatic stress disorder","Post-traumatic stress disorder (PTSD) is a severely disabling anxiety disorder that may occur following exposure to a serious traumatic event. It is a psychiatric condition that can afflict anyone who has experienced a life-threatening or violent event. Previous studies have shown that changes in 18 kDa translocator protein (TSPO) expression (or function), a promising target for treating neurological disorders without benzodiazepine-like side effects, may correlate with PTSD. However, few studies have investigated the anti-PTSD effects of TSPO ligands. AC-5216, a ligand for TSPO, induces anxiolytic- and anti-depressant-like effects in animal models. The present study aimed to determine whether AC-5216 ameliorates PTSD behavior in mice. Following the training session consisting of exposure to inescapable electric foot shocks, animals were administered AC-5216 daily during the behavioral assessments, i.e., situational reminders (SRs), the open field (OF) test, the elevated plus-maze (EPM) test, and the staircase test (ST). The results indicated that exposure to foot shocks induced long-term behavioral deficiencies in the mice, including freezing and anxiety-like behavior, which were significantly ameliorated by repeated treatment with AC-5216 but without any effect on spontaneous locomotor activity or body weight. In summary, this study demonstrated the anti-PTSD effects of AC-5216 treatment, suggesting that TSPO may represent a therapeutic target for anti-PTSD drug discovery and that TSPO ligands may be a promising new class of drugs for the future treatment of PTSD.",0 +,Long-term dynamic-oriented group psychotherapy of posttraumatic stress disorder in war veterans: prospective study of five-year treatment.,"To assess the effectiveness of the long-term group psychotherapy in the treatment of posttraumatic stress disorder (PTSD) in war veterans on the basis of clinical picture of PTSD, associated neurotic symptoms, and adopted models of psychological defense mechanisms.Prospective cohort study involved 59 war veterans who participated in dynamic-oriented supportive group psychotherapy for five years. The groups met once a week for 90 minutes. Forty-two veterans finished the program. The Clinician-Administered PTSD Scale structured interview was used to assess the intensity of PTSD. Crown-Crisp Index was used to evaluate other neurotic symptoms, and Life Style Questionnaire was used to assess the defense mechanisms. The assessments were done at the beginning of psychotherapy, after the second, and after the fifth year of treatment. Comorbid diagnoses, hospitalizations, and outpatient clinic treatments were also recorded.Long-term group psychotherapy reduced the intensity of PTSD symptoms in our patients (the difference between Clinician-Administered PTSD Scale score at the beginning and the end of treatment, F=9.103, P=0.001). Other neurotic symptoms and the characteristic profile of defense mechanisms did not change significantly during the course of treatment. Predominant defense mechanisms were projection (M=82.0-/+14.4) and displacement (M=69.0-/+16.8). None of the symptoms or defense mechanisms present at the beginning of the treatment changed significantly after two or five years of treatment. The number of diagnosed major depressive episodes, which increased after the second year of psychotherapy, decreased by the end of treatment.Psychotherapy can reduce the intensity of PTSD symptoms, but the changes in the personality of veterans with PTSD are deeply rooted. Traumatic experiences lead to the formation of rigid defense mechanisms, which cannot be significantly changed by long-term group psychotherapy.",0 +https://doi.org/10.1001/jama.292.5.585,Mental Health Symptoms Following War and Repression in Eastern Afghanistan,"Decades of armed conflict, suppression, and displacement resulted in a high prevalence of mental health symptoms throughout Afghanistan. Its Eastern province of Nangarhar is part of the region that originated the Taliban movement. This may have had a distinct impact on the living circumstances and mental health condition of the province's population.To determine the rate of exposure to traumatic events; estimate prevalence rates of symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety; identify resources used for emotional support and risk factors for mental health symptoms; and assess the present coverage of basic needs in Nangarhar province, Afghanistan.A cross-sectional multicluster sample survey of 1011 respondents aged 15 years or older, conducted in Nangarhar province during January and March 2003; 362 households were represented with a mean of 2.8 respondents per household (72% participation rate).Posttraumatic stress disorder symptoms and traumatic events using the Harvard Trauma Questionnaire; depression and general anxiety symptoms using the Hopkins Symptom Checklist; and resources for emotional support through a locally informed questionnaire.During the past 10 years, 432 respondents (43.7%) experienced between 8 and 10 traumatic events; 141 respondents (14.1%) experienced 11 or more. High rates of symptoms of depression were reported by 391 respondents (38.5%); anxiety, 524 (51.8%); and PTSD, 207 (20.4%). Symptoms were more prevalent in women than in men (depression: odds ratio [OR], 7.3 [95% confidence interval [CI], 5.4-9.8]; anxiety: OR, 12.8 [95% CI, 9.0-18.1]; PTSD: OR, 5.8 [95% CI, 3.8-8.9]). Higher rates of symptoms were associated with higher numbers of traumas experienced. The main resources for emotional support were religion and family. Medical care was reported to be insufficient by 228 respondents (22.6%).In this survey of inhabitants of Nangarhar province, Afghanistan, prevalence rates of having experienced multiple traumatic events and having symptoms of anxiety, depression, and PTSD were high. These findings suggest that mental health symptoms in this region should be addressed at the population and primary health care level.",0 +https://doi.org/10.1016/j.biopsych.2006.03.026,Decreased Cerebrospinal Fluid Allopregnanolone Levels in Women with Posttraumatic Stress Disorder,"Alterations in the gamma-amino-butyric acid (GABA) neurotransmitter system have been identified in some populations with posttraumatic stress disorder (PTSD).To further investigate factors of relevance to GABAergic neurotransmission in PTSD, we measured cerebrospinal fluid (CSF) levels of allopregnanolone and pregnanolone combined (ALLO: congeners that potently and positively modulate effects of GABA at the GABA(A) receptor), 5alpha-dihydroprogesterone (5alpha-DHP: the immediate precursor for allopregnanolone), dehydroepiandrosterone (DHEA: a negative modulator of GABA(A) receptor function), and progesterone with gas chromatography, mass spectrometry in premenopausal women with (n = 9) and without (n = 10) PTSD. Subjects were free of psychotropic medications, alcohol, and illicit drugs; all were in the follicular phase of the menstrual cycle except three healthy and four PTSD subjects receiving oral contraceptives.There were no group differences in progesterone, 5alpha-DHP, or DHEA levels. The PTSD group ALLO levels were < 39% of healthy group levels. The ALLO/DHEA ratio correlated negatively with PTSD re-experiencing symptoms (n = -.82, p < 008; trend) and with Profile of Mood State depression/dejection scores (n = -0.70, p < 0008).Low CSF ALLO levels in premenopausal women with PTSD might contribute to an imbalance in inhibitory versus excitatory neurotransmission, resulting in increased PTSD re-experiencing and depressive symptoms.",0 +https://doi.org/10.1080/10615806.2014.923844,A longitudinal study of the role of cortisol in posttraumatic stress disorder symptom clusters,"Research examining the role of cortisol in posttraumatic stress disorder (PTSD) has largely been cross-sectional studies and few studies have examined cortisol in relation to specific symptom clusters. Examining cortisol in relation to specific PTSD symptom clusters could aid in identifying candidates for symptom-specific treatments. Hence, cortisol was examined in relation to specific PTSD symptom clusters including reexperiencing, avoidance, numbing, and hyperarousal symptoms.A repeated-measures longitudinal design was utilized to predict PTSD symptom clusters.Mothers of children (N = 27) diagnosed with cancer completed a measure of PTSD, and they provided salivary cortisol samples at the time of their child's diagnosis as well as monthly for the following 12 months.Multi-level modeling analyses revealed that higher cortisol levels were significantly related to higher levels of numbing symptoms. Although numbing symptoms declined as cortisol levels declined across 12 months postcancer diagnosis, mothers with higher cortisol levels still reported more numbing symptoms. Reexperiencing, avoidance, and hyperarousal symptoms were not found to be related to cortisol level across time.The findings offer support for the role of cortisol in the manifestation of numbing symptoms. Further research is recommended with other trauma groups to maximize generalizations.",0 +,Counselling for post-traumatic stress disorder,"Post-traumatic stress disorder - definition, presentation and assessment a cognitive-behavioural conceptualization of post-traumatic stress disorder an overview of cognitive-behavioural counselling for PTSD/ counselling for acute PTSD - illustrative cases counselling for chronic PTSD - illustrative cases counselling for PTSD from prolonged duress (PDSD) - illustrative cases counselling for concurrent anxiety and depression counselling for concurrent irritability counselling for PTSD - service delivery.",0 +https://doi.org/10.1007/s12207-010-9066-z,Re-examination of the Controversial Coexistence of Traumatic Brain Injury and Posttraumatic Stress Disorder: Misdiagnosis and Self-Report Measures,"The coexistence of traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) remains a controversial issue in the literature. To address this controversy, we focused primarily on the civilian-related literature of TBI and PTSD. Some investigators have argued that individuals who had been rendered unconscious or suffered amnesia due to a TBI are unable to develop PTSD because they would be unable to consciously experience the symptoms of fear, helplessness, and horror associated with the development of PTSD. Other investigators have reported that individuals who sustain TBI, regardless of its severity, can develop PTSD even in the context of prolonged unconsciousness. A careful review of the methodologies employed in these studies reveals that investigators who relied on clinical interviews of TBI patients to diagnose PTSD found little or no evidence of PTSD. In contrast, investigators who relied on PTSD questionnaires to diagnose PTSD found considerable evidence of PTSD. Further analysis revealed that many of the TBI patients who were initially diagnosed with PTSD according to self-report questionnaires did not meet the diagnostic criteria for PTSD upon completion of a clinical interview. In particular, patients with severe TBI were often misdiagnosed with PTSD. A number of investigators found that many of the severe TBI patients failed to follow the questionnaire instructions and erroneously endorsed PTSD symptoms because of their cognitive difficulties. Because PTSD questionnaires are not designed to discriminate between PTSD and TBI symptoms or determine whether a patient's responses are accurate or exaggerated, studies that rely on self-report questionnaires to evaluate PTSD in TBI patients are at risk of misdiagnosing PTSD. Further research should evaluate the degree to which misdiagnosis of PTSD occurs in individuals who have sustained mild TBI.",0 +https://doi.org/10.1016/j.neuroimage.2007.12.010,Resilience after 9/11: Multimodal neuroimaging evidence for stress-related change in the healthy adult brain,"Exposure to psychological trauma is common and predicts long-term physical and mental health problems, even in those who initially appear resilient. Here, we used multimodal neuroimaging in healthy adults who were at different distances from the World Trade Center on 9/11/01 to examine the neural mechanisms that may underlie this association. More than 3 years after 9/11/01, adults with closer proximity to the disaster had lower gray matter volume in amygdala, hippocampus, insula, anterior cingulate, and medial prefrontal cortex, with control for age, gender, and total gray matter volume. Further analysis showed a nonlinear (first-order quadratic) association between total number of traumas in lifetime and amygdala gray matter volume and function in the whole group. Post hoc analysis of subgroups with higher versus lower levels of lifetime trauma exposure revealed systematic associations between amygdala gray matter volume, amygdala functional reactivity, and anxiety that suggest a nonlinear trajectory in the neural response to accumulated trauma in healthy adults.",0 +https://doi.org/10.1176/ajp.156.4.589,Acute and Chronic Posttraumatic Stress Disorder in Motor Vehicle Accident Victims,"This study reports the rates of acute and chronic posttraumatic stress disorder (PTSD) in a suburban community study group of 122 victims of serious motor vehicle accidents and a comparison group of 42 (who had been involved in minor, non-motor-vehicle accidents) followed over 12 months.Motor vehicle accident victims were systematically recruited and examined with comparison subjects at 1, 3, 6, 9, and 12 months after the accident. The authors used the Structured Clinical Interview for DSM-III-R to assess DSM-III-R axis I disorders including PTSD.One month after the accident, 34.4% of the motor vehicle accident victims met criteria for PTSD (versus 2.4% of the comparison subjects). Similarly, at 3 and 6 months, rates of PTSD were higher (25.2% and 18.2%) in the motor vehicle accident victims than in the comparison group. Female victims were 4.64 times more likely than male victims to have PTSD at 1 month. Victims with a history of PTSD were 8.02 times more likely at 1 month and 6.81 times more likely at 3 months to have PTSD than those without a history of PTSD. Having an axis II disorder increased the risk for PTSD at 6 months. After adjustment for a history of PTSD and potentially confounding variables, women were 4.39 times more likely than men to develop PTSD at 1 month but did not have a higher risk for chronic PTSD; at 6 months, those with an axis II disorder were at greater risk of PTSD.Rates of PTSD are high in victims of serious motor vehicle accidents and remain high 9 months later. Female victims have an increased risk of acute but not chronic PTSD. Individuals with a history of PTSD are at risk of acute and chronic PTSD. An axis II disorder increases the risk for chronic but not acute PTSD.",0 +https://doi.org/10.1089/neu.2013.3041,Early Trajectory of Psychiatric Symptoms after Traumatic Brain Injury: Relationship to Patient and Injury Characteristics,"Psychiatric disturbance is common and disabling after traumatic brain injury (TBI). Few studies have investigated the trajectory of psychiatric symptoms in the first 6 months postinjury, when monitoring and early treatment might prevent persistent difficulties. The aim of this study was to examine the trajectory of psychiatric symptoms 1-6 months post-TBI, the patient/injury characteristics associated with changes, and characteristics predictive of persisting symptoms. A secondary analysis was performed on data from a clinical trial with three data collection points. Across eight centers, 872 participants with complicated mild to severe TBI were administered the Brief Symptom Inventory (BSI) at 30, 90, and 180 days postinjury. Mixed-effects models were used to assess longitudinal changes in the BSI Global Severity Index (GSI). Multi-variate logistic regression was used to assess predictors of clinically significant GSI elevations persisting to 6 months post-TBI. In general, GSI scores improved over time. Women improved faster than men; race/ethnicity was also significantly associated with rate of change, with Hispanics showing the most and African Americans the least improvement. Clinically significant psychiatric symptoms (caseness) occurred in 42% of the sample at 6 months, and more than one type of symptom was common. Significant predictors of caseness included African American race, age from 30 to 60 years, longer post-traumatic amnesia (PTA) duration, pre-TBI unemployment, and pre-TBI risky alcohol use. Findings indicate that psychiatric symptoms are common in the first 6 months post-TBI and frequently extend beyond the depression and anxiety symptoms that may be most commonly screened. Patients with longer PTA and preinjury alcohol misuse may need more intensive monitoring for symptom persistence.",0 +https://doi.org/10.1023/a:1007762812848,Symptom structure of PTSD following breast cancer,"Identification of posttraumatic stress disorder (PTSD) symptoms and diagnoses in survivors of cancer is a growing area of research, but no published data exist regarding the symptom structure of PTSD in survivors of malignant disease. Findings from investigations of the PTSD symptom structure in other trauma populations have been inconsistent and have not been concordant with the re-experiencing, avoidance/numbing, and arousal symptom clusters specified in DSM-IV. The present study employed confirmatory factor analysis to evaluate the extent to which the implied second-order factor structure of PTSD was replicated in a sample of 142 breast cancer survivors. PTSD symptoms were measured using the PTSD Checklist--Civilian Version (PCL-C). Fit indices reflected a moderate fit of the symptom structure implied by the DSM-IV. These findings provide some tentative support for the DSM-IV clustering of PTSD symptoms and for the validity of cancer-related PTSD.",0 +https://doi.org/10.1002/jts.20443,Reformulating PTSD forDSM-V: Life after Criterion A,"The diagnosis of posttraumatic stress disorder has been criticized on numerous grounds, but principally for three reasons (a) the alleged pathologizing of normal events, (b) the inadequacy of Criterion A, and (c) symptom overlap with other disorders. The authors review these problems along with arguments why the diagnosis is nevertheless worth retaining in an amended form. A proposal for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) is put forward that involves abolishing Criterion A, narrowing the B criteria to focus on the core phenomena of flashbacks and nightmares, and narrowing the C and D criteria to reduce overlap with other disorders. The potential advantages and disadvantages of this formulation are discussed.",0 +https://doi.org/10.1037/a0020169,Diagnostic and clinical profiles of treatment-seeking men with and without substance use disorders.,"This study compared treatment-seeking men with and without a history of substance use disorders (SUD), both lifetime and current, on diagnostic and clinical variables in order to elucidate their clinical profile. Analyses revealed that men with a history of SUD were more likely meet criteria for a cluster B personality disorder, particularly borderline and antisocial personality disorder, and for anxiety disorders, particularly posttraumatic stress disorder (PTSD). Men with lifetime and current SUD reported a significantly higher frequency of hospitalizations and had lower scores on global functioning. Despite the high prevalence of SUD in this sample, depressive and anxiety disorders were the leading reasons for treatment seeking in this large outpatient psychiatric clinic. Implications of the observed diagnostic and clinical correlates of lifetime SUD among treatment-seeking men are discussed. © 2010 American Psychological Association.",0 +https://doi.org/10.1007/s00429-012-0478-2,The structure of Pavlovian fear conditioning in the amygdala,"Do different brains forming a specific memory allocate the same groups of neurons to encode it? One way to test this question is to map neurons encoding the same memory and quantitatively compare their locations across individual brains. In a previous study, we used this strategy to uncover a common topography of neurons in the dorsolateral amygdala (LAd) that expressed a learning-induced and plasticity-related kinase (p42/44 mitogen-activated protein kinase; pMAPK), following auditory Pavlovian fear conditioning. In this series of experiments, we extend our initial findings to ask to what extent this functional topography depends upon intrinsic neuronal structure. We first showed that the majority (87 %) of pMAPK expression in the lateral amygdala was restricted to principal-type neurons. Next, we verified a neuroanatomical reference point for amygdala alignment using in vivo magnetic resonance imaging and in vitro morphometrics. We then determined that the topography of neurons encoding auditory fear conditioning was not exclusively governed by principal neuron cytoarchitecture. These data suggest that functional patterning of neurons undergoing plasticity in the amygdala following Pavlovian fear conditioning is specific to memory formation itself. Further, the spatial allocation of activated neurons in the LAd was specific to cued (auditory), but not contextual, fear conditioning. Spatial analyses conducted at another coronal plane revealed another spatial map unique to fear conditioning, providing additional evidence that the functional topography of fear memory storing cells in the LAd is non-random and stable. Overall, these data provide evidence for a spatial organizing principle governing the functional allocation of fear memory in the amygdala. (",0 +https://doi.org/10.1177/1534765608320338,Relationships between psychopathological and demographic variables and posttraumatic growth among Holocaust survivors.,"The relationship between posttraumatic growth and posttraumatic stress disorder (PTSD) symptoms, depression, anxiety, and vulnerability, as well as demographic differences in growth was examined in a group of 23 Holocaust survivors. The posttraumatic growth aspect of spiritual change was found to correlate positively and significantly with the PTSD symptom clusters of intrusion, avoidance, and hyperarousal. Numerous demographic variables were also found to relate to posttraumatic growth including survivors' age during the Holocaust; the nature of their Holocaust experiences; and whether they were ever alone, without family, during their Holocaust experiences as well as survivor support group membership.",0 +https://doi.org/10.1037/a0031474,Meta-analysis of dropout in treatments for posttraumatic stress disorder.,"Many patients drop out of treatments for posttraumatic stress disorder (PTSD); some clinicians believe that trauma-focused treatments increase dropout.We conducted a meta-analysis of dropout among active treatments in clinical trials for PTSD (42 studies; 17 direct comparisons).The average dropout rate was 18%, but it varied significantly across studies. Group modality and greater number of sessions, but not trauma focus, predicted increased dropout. When the meta-analysis was restricted to direct comparisons of active treatments, there were no differences in dropout. Differences in trauma focus between treatments in the same study did not predict dropout. However, trauma-focused treatments resulted in higher dropout compared with present-centered therapy (PCT), a treatment originally designed as a control but now listed as a research-supported intervention for PTSD.Dropout varies between active interventions for PTSD across studies, but variability is primarily driven by differences between studies. There do not appear to be systematic differences across active interventions when they are directly compared in the same study. The degree of clinical attention placed on the traumatic event does not appear to be a primary cause of dropout from active treatments. However, comparisons of PCT may be an exception to this general pattern, perhaps because of a restriction of variability in trauma focus among comparisons of active treatments. More research is needed comparing trauma-focused interventions to trauma-avoidant treatments such as PCT.",0 +https://doi.org/10.1002/jts.20033,Mismatch of posttraumatic stress disorder (PTSD) symptoms andDSM-IV symptom clusters in a cancer sample: Exploratory factor analysis of the PTSD Checklist-Civilian Version,"The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994a) conceptualization of posttraumatic stress disorder (PTSD) includes three symptom clusters: reexperiencing, avoidance/numbing, and arousal. The PTSD Checklist-Civilian Version (PCL-C) corresponds to the DSM-IV PTSD symptoms. In the current study, we conducted exploratory factor analysis (EFA) of the PCL-C with two aims: (a) to examine whether the PCL-C evidenced the three-factor solution implied by the DSM-IV symptom clusters, and (b) to identify a factor solution for the PCL-C in a cancer sample. Women (N = 148) with Stage II or III breast cancer completed the PCL-C after completion of cancer treatment. We extracted two-, three-, four-, and five-factor solutions using EFA. Our data did not support the DSM-IV PTSD symptom clusters. Instead, EFA identified a four-factor solution including reexperiencing, avoidance, numbing, and arousal factors. Four symptom items, which may be confounded with illness and cancer treatment-related symptoms, exhibited poor factor loadings. Using these symptom items in cancer samples may lead to overdiagnosis of PTSD and inflated rates of PTSD symptoms.",0 +https://doi.org/10.1542/peds.111.6.e725,"Symptoms of Posttraumatic Stress Disorder in Parents of Transplant Recipients: Incidence, Severity, and Related Factors","Objective. To examine the incidence, severity, and factors related to posttraumatic stress disorder (PTSD) symptoms in parents of pediatric solid organ transplant recipients. Method. A total of 170 caregivers of pediatric transplant recipients completed self-report measures of psychological functioning between 10 and 38 months after their child’s most recent transplant. Demographic data, child health variables, and ratings of medical attitudes and social functioning were also collected to help explain individual differences in psychological functioning. Results. Although caregivers of pediatric transplant recipients did not report elevated levels of depression or anxiety, they did report elevated levels of PTSD symptoms. Multiple regression analyses revealed that PTSD symptoms were most strongly associated with parent reports of child health, family impact of the transplant, and attitudes toward medical caregivers. Conclusions. PTSD seems to be relatively common in parents of pediatric transplant recipients and may be largely the result of how parents perceive and interpret the transplant experience.",0 +https://doi.org/10.1089/neu.2015.3992,The Evolution of Post-Traumatic Stress Disorder following Moderate-to-Severe Traumatic Brain Injury,"Increasing evidence indicates that post-traumatic stress disorder (PTSD) may develop following traumatic brain injury (TBI), despite most patients having no conscious memory of their accident. This prospective study examined the frequency, timing of onset, symptom profile, and trajectory of PTSD and its psychiatric comorbidities during the first 4 years following moderate-to-severe TBI. Participants were 85 individuals (78.8% male) with moderate or severe TBI recruited following admission to acute rehabilitation between 2005 and 2010. Using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Disorders (SCID-I), participants were evaluated for pre- and post-injury PTSD soon after injury and reassessed at 6 months, 12 months, 2 years, 3 years, and 4 years post-injury. Over the first 4 years post-injury, 17.6% developed injury-related PTSD, none of whom had PTSD prior to injury. PTSD onset peaked between 6 and 12 months post-injury. The majority of PTSD cases (66.7%) had a delayed-onset, which for a third was preceded by subsyndromal symptoms in the first 6 months post-injury. PTSD frequency increased over the first year post-injury, remained stable during the second year, and gradually declined thereafter. The majority of subjects with PTSD experienced a chronic symptom course and all developed one or more than one comorbid psychiatric disorder, with mood, other anxiety, and substance-use disorders being the most common. Despite event-related amnesia, post-traumatic stress symptoms, including vivid re-experiencing phenomena, may develop following moderate-to-severe TBI. Onset is typically delayed and symptoms may persist for several years post-injury.",0 +,"Child-adolescent posttraumatic stress disorder: Prevalence, risk factors, and comorbidity.","(create) This chapter explores prevalence, risk factors, and comorbidity issues in child-adolescent posttraumatic stress disorder (PTSD)., (from the chapter) Topics include: child-adolescent posttraumatic stress disorder (PTSD): prevalence and risk factors; epidemiology of child-adolescent exposure to traumatic events; PTSD prevalence rates among clinical samples of stress-exposed children and adolescents (crime-related PTSD, war-related PTSD, disaster-related PTSD); comorbidity; risk factors; and implications for future research. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1037/h0079168,Buffalo Creek survivors in the second decade: Stability of stress symptoms.,"A follow-up study of 120 adult survivors of the Buffalo Creek dam collapse of 1972 showed group changes 14 years after the event. Decreased symptoms were noted in all areas, although significant psychopathology remained in about one-quarter of the survivors. A small group with delayed onset of symptoms was identified.",0 +https://doi.org/10.1037/a0025447,Factor structure of posttraumatic stress disorder symptoms in OEF/OIF veterans presenting to a polytrauma clinic.,"A significant number of Operation Iraqi Freedom/Operation Enduring Freedom (OEF/OIF) veterans are returning from deployment and presenting to Veterans Health Administration (VHA) polytrauma clinics with elevated rates of posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). Inherent to the accurate assessment and treatment of this diagnostically complex group of veterans is the assumption that the construct of PTSD is the same in this population as in other trauma groups. To our knowledge, no previous study has examined the structure of PTSD in this relevant and fast-growing population of treatment-seeking OEF/OIF veterans. Evidence suggests that the latent structure of PTSD symptoms is best represented by a four-factor model, rather than the three-factor model found in the current DSM-IV-TR. Thus, we examined the three and four-factor models using the PTSD Check List-Civilian (PCL-C) in a sample of treatment-seeking OEF/OIF veterans seen through a VHA polytrauma clinic.A chart review was conducted for OEF/OIF veterans (N = 361) seen through a VHA outpatient polytrauma clinic from September 2007 through August 2008. Participants completed the PCL-C as part of a comprehensive polytrauma evaluation.Confirmatory factor analyses showed that the DSM-IV-TR three-factor model did not fit the data well. A direct comparison showed that the four-factor model provided a superior fit relative to the three-factor model.Results extend the generalizability of the four-factor model to OEF/OIF veterans presenting to Veterans Health Administration (VHA) polytrauma clinics.",0 +https://doi.org/10.1007/s12264-012-1255-1,Resting-state fMRI studies in epilepsy,"Epilepsy is a disease characterized by abnormal spontaneous activity in the brain. Resting-state functional magnetic resonance imaging (RS-fMRI) is a powerful technique for exploring this activity. With good spatial and temporal resolution, RS-fMRI is a promising approach for accurate localization of the focus of seizure activity. Although simultaneous electroencephalogram-fMRI has been performed with patients in the resting state, most studies focused on activation. This mini-review focuses on RS-fMRI alone, including its computational methods and its application to epilepsy.",0 +https://doi.org/10.1080/17432979.2011.583060,Why verbal psychotherapy is not enough to treat Post Traumatic Stress Disorder: a Biosystemic approach to stress debriefing,"Clinical and common experience shows that the consequences of traumatic events (physical and sexual violence, natural or civil disasters, witnessing violent events, serious diseases or bereavements, etc.) on people's lives is one of the main causes of mental suffering. The prevalence of Post Traumatic Stress Disorder (PTSD) is estimated to be as low as 0.5–1% (Frans, Rimmo, Aberg, & Fredrikson, 2005) and as high as 9.5% (Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995). It is clear the important role psychotherapy plays in facing similar conditions and restoring a state of wellness; hence the need for specific methodologies of intervention based on scientific evidence. The purpose of this article is to illustrate how mind-body techniques may usefully be integrated into psychotherapy protocols and can be used in the prevention and treatment of symptoms related to PTSD. These techniques may empower the ‘body's innate intelligence’ and improve self-regulation when addressing factors such as trauma, mind/bod...",0 +https://doi.org/10.1371/journal.pone.0101491,World Trade Center Disaster Exposure-Related Probable Posttraumatic Stress Disorder among Responders and Civilians: A Meta-Analysis,"The World Trade Center (WTC) disaster on September 11, 2001 was an unprecedented traumatic event with long-lasting health consequences among the affected populations in the New York metropolitan area. This meta-analysis aimed to estimate the risk of probable posttraumatic stress disorder (PTSD) associated with specific types of WTC exposures. Meta-analytical findings from 10 studies of 3,271 to 20,294 participants yielded 37 relevant associations. The pooled summary odds ratio (OR) was 2.05 (95% confidence interval (CI): 1.82, 2.32), with substantial heterogeneity linked to exposure classification, cohort type, data source, PTSD assessment instrument/criteria, and lapse time since 9/11. In general, responders (e.g. police, firefighters, rescue/recovery workers and volunteers) had a lower probable PTSD risk (OR = 1.61; 95% CI: 1.39, 1.87) compared to civilians (e.g. residents, office workers, and passersby; OR = 2.71, 95% CI: 2.35, 3.12). The differences in ORs between responders and civilians were larger for physical compared to psychosocial exposure types. We also found that injury, lost someone, and witnessed horror were the three (out of six) most pernicious exposures. These findings suggest that these three exposures should be a particular focus in psychological evaluation and treatment programs in WTC intervention and future emergency preparedness efforts.",0 +https://doi.org/10.1089/jwh.2014.5078,Gender Differences in Posttraumatic Stress Disorder and Help Seeking in the U.S. Army,"Inconsistent findings between studies of gender differences in mental health outcomes in military samples have left open questions of differential prevalence in posttraumatic stress disorder (PTSD) among all United States Army soldiers and in differential psychosocial and comorbid risk and protective factor profiles and their association with receipt of treatment.This study assesses the prevalence and risk factors of screening positive for PTSD for men and women based on two large, population-based Army samples obtained as part of the 2005 and 2008 U.S. Department of Defense Surveys of Health Related Behaviors among Active Duty Military Personnel.The study showed that overall rates of PTSD, as measured by several cutoffs of the PTSD Checklist, are similar between active duty men and women, with rates increasing in both men and women between the two study time points. Depression and problem alcohol use were strongly associated with a positive PTSD screen in both genders, and combat exposure was significantly associated with a positive PTSD screen in men. Overall, active duty men and women who met criteria for PTSD were equally likely to receive mental health counseling or treatment, though gender differences in treatment receipt varied by age, race, social support (presence of spouse at duty station), history of sexual abuse, illness, depression, alcohol use, and combat exposure.The study demonstrates that the prevalence of PTSD as well as the overall utilization of mental health services is similar for active duty men compared with women. However, there are significant gender differences in predictors of positive PTSD screens and receipt of PTSD treatment.",0 +https://doi.org/10.1037/0022-0167.52.3.267,Coping Strategies as Mediators of the Relations Among Perceived Control and Distress in Sexual Assault Survivors.,"Two studies assessed whether coping strategies mediate the relations among 2 forms of perceived control (past and present control) and postassault distress among female sexual assault survivors. In Study 1, longitudinal data were gathered from 2 weeks to 1 year postassault (N = 171). Past control (behavioral self-blame) was associated with more distress partly because it was associated with greater social withdrawal. Present control (control over the recovery process) was associated with less distress partly because it was associated with less social withdrawal and more cognitive restructuring. In Study 2, cross-sectional data were gathered from a community sample of nonrecent survivors of sexual assault (N = 131). Coping strategies again mediated the relations among the measures of past and present control and distress.",0 +https://doi.org/10.1016/s0033-3182(96)71577-3,Posttraumatic Stress Disorder in Mothers of Pediatric Cancer Survivors,"Prevalence of posttraumatic stress disorder (PTSD) in 24 mothers of pediatric cancer survivors was compared with its prevalence among 23 mothers of healthy children. Significantly more mothers of pediatric cancer survivors were diagnosed with lifetime PTSD. Significant differences were also found in lifetime arousal, as well as current and lifetime reexperience and avoidance symptom clusters. Significant difference existed in the distribution of the number of prediagnosis high-magnitude events experienced by the mothers diagnosed with current PTSD as compared with the prediagnosis experience of the mothers who were not diagnosed with current PTSD. Illness severity, level of perceived family and extrafamilial social support, and Symptom Checklist-90-Revised global severity index scores did not significantly differ in the PTSD-positive and PTSD-negative groups.",0 +https://doi.org/10.1007/s10654-007-9216-0,"Prior health care utilization as a potential determinant of enrollment in a 21-year prospective study, the Millennium Cohort Study","Results obtained from self-reported health data may be biased if those being surveyed respond differently based on health status. This study was conducted to investigate if health, as measured by health care use preceding invitation, influenced response to invitation to a 21-year prospective study, the Millennium Cohort Study. Inpatient and outpatient diagnoses were identified among more than 68,000 people during a one-year period prior to invitation to enroll. Multivariable logistic regression defined how diagnoses were associated with response. Days spent hospitalized or in outpatient care were also compared between responders and nonresponders. Adjusted odds of response to the questionnaire were similar over a diverse range of inpatient and outpatient diagnostic categories during the year prior to enrollment. The number of days hospitalized or accessing outpatient care was very similar between responders and nonresponders. Study findings demonstrate that, although there are some small differences between responders and nonresponders, prior health care use did not affect response to the Millennium Cohort Study, and it is unlikely that future study findings will be biased by differential response due to health status prior to enrollment invitation.",0 +https://doi.org/10.1111/1467-8624.00178,"Attachment from Infancy to Early Adulthood in a High‐Risk Sample: Continuity, Discontinuity, and Their Correlates","This study explores the stability of attachment security and representations from infancy to early adulthood in a sample chosen originally for poverty and high risk for poor developmental outcomes. Participants for this study were 57 young adults who are part of an ongoing prospective study of development and adaptation in a high-risk sample. Attachment was assessed during infancy by using the Ainsworth Strange Situation (Ainsworth & Wittig) and at age 19 by using the Berkeley Adult Attachment Interview (George, Kaplan, & Main). Possible correlates of continuity and discontinuity in attachment were drawn from assessments of the participants and their mothers over the course of the study. Results provided no evidence for significant continuity between infant and adult attachment in this sample, with many participants transitioning to insecurity. The evidence, however, indicated that there might be lawful discontinuity. Analyses of correlates of continuity and discontinuity in attachment classification from infancy to adulthood indicated that the continuous and discontinuous groups were differentiated on the basis of child maltreatment, maternal depression, and family functioning in early adolescence. These results provide evidence that although attachment has been found to be stable over time in other samples, attachment representations are vulnerable to difficult and chaotic life experiences.",0 +https://doi.org/10.1016/j.beth.2012.04.003,Trajectories of Response to Treatment for Posttraumatic Stress Disorder,"Research on the predictors of response to cognitive-behavioral treatments for PTSD has often produced inconsistent or ambiguous results. We argue this is in part due to the use of statistical techniques that explore relationships among the entire sample of participants rather than homogeneous subgroups. Using 2 large randomized controlled trials of Cognitive Processing Therapy (CPT), CPT components, and Prolonged Exposure, we employed growth mixture modeling to identify distinct trajectories of treatment response and to determine the predictors of those trajectories. We determined that the participants' trajectories could be best represented by 2 latent classes, which we subsequently labeled responders (87% of the sample) and nonresponders (13% of the sample). Notably, there was not a separate class for partial responders. Assignment to the nonresponder class was associated with receiving the written accounts (WA) component of CPT, a pretreatment diagnosis of major depression (MDD), and more pretreatment hyperarousal symptoms. Thus, it appears that some individuals do not benefit from merely writing about their trauma and processing it with the therapist; they may also need to engage in cognitive restructuring to successfully ameliorate their symptoms. Additionally, those who meet criteria for MDD or have high levels of hyperarousal at the onset of treatment might require additional treatment or support.",0 +https://doi.org/10.1093/aje/kwj008,Chronic Multisymptom Illness Complex in Gulf War I Veterans 10 Years Later,"Prior research has demonstrated that shortly after the 1991 Gulf War (Gulf War I), chronic multisymptom illness (CMI) was more common among deployed veterans than among nondeployed veterans. The aims of the current study were to determine the prevalence of CMI among deployed and nondeployed veterans 10 years after Gulf War I, compare the distribution of comorbid conditions, and identify prewar factors associated with CMI. Cross-sectional data collected from 1,061 deployed veterans and 1,128 nondeployed veterans examined between 1999 and 2001 were analyzed. CMI prevalence was 28.9% among deployed veterans and 15.8% among nondeployed veterans (odds ratio = 2.16, 95% confidence interval: 1.61, 2.90). Deployed and nondeployed veterans with CMI had similarly poorer quality-of-life measures and higher prevalences of symptom-based medical conditions, metabolic syndrome, and psychiatric disorders. Diagnoses of prewar anxiety disorders (not related to post-traumatic stress disorder) and depression were associated with CMI among both deployed and nondeployed veterans. Nicotine dependence and veteran-reported physician-diagnosed infectious mononucleosis were associated with CMI among deployed veterans, and migraine headaches and gastritis were associated with CMI among nondeployed veterans. CMI continues to be substantially more prevalent among deployed veterans than among nondeployed veterans 10 years after Gulf War I, but it manifests similarly in both groups. It is likely to be a common, persistent problem among veterans returning from the current Gulf War.",0 +https://doi.org/10.1037/ccp0000031,Differential effects of prolonged exposure on posttraumatic stress disorder symptoms in female veterans.,"We compared the effect of Prolonged Exposure (PE) on posttraumatic stress disorder (PTSD) symptom clusters and individual symptoms relative to a nonspecific comparison therapy (present-centered therapy; PCT) to identify the unique benefits of PE. We used data from a 12-site randomized clinical trial that found PE to be more effective than PCT for reducing PTSD symptom severity.Participants were 284 female veterans and active duty soldiers with PTSD (M age = 44.8 years, range = 22-78; 45.4% non-White). Participants were randomized to 10 weekly sessions of PE or PCT and assessed before and after treatment and at 3- and 6-month follow-ups. The primary measure of PTSD symptoms and symptom clusters (reexperiencing, avoidance, numbing, and hyperarousal) was the Clinician-Administered PTSD Scale (CAPS; Weathers et al., 2001) but we also assessed self-reported PTSD using the PTSD Checklist-Specific Version (PCL; Weathers, Litz, Herman, Huska, & Keane, 1993).Almost all clinician-rated and self-reported symptoms improved from pre- to posttreatment in both conditions. In the analyses of clinician-rated PTSD, PE had greater benefit than PCT on avoidance and numbing clusters. PE also had greater benefit on most individual symptoms in these clusters as well as on distress related to reminders. In the analyses of self-reported PTSD, PE had greater benefit than PCT on all clusters and on most individual symptoms.PE may be especially helpful for individuals with significant avoidance and numbing. Giving patients information about how a treatment can help with the symptoms that create the greatest burden can facilitate choosing the treatment that is best for them.",0 +https://doi.org/10.1007/978-0-387-77650-7_5,General Growth Mixture Analysis with Antecedents and Consequences of Change,"Many studies of youth, adolescents, and adults related to delinquent, antisocial, and criminal offending, have utilized a language of trajectory typologies to describe individual differences in the behavioral course manifest in their longitudinal data. The two most common statistical methods currently in use are the semiparametric group-based modeling, also known as latent class growth analysis and general growth mixture analysis, with the latter method being the focus of this chapter. In concert with the growing popularity of these data-driven, group-based methods for studying developmental and life-course behavior trajectories have come active and spirited ontological discussions about the nature of the emergent trajectory groups resulting from the analyses. In this chapter, we presuppose that there are analytic, empirical, and substantive advantages inherent in using discrete components to (partially) describe population heterogeneity in longitudinal processes. Conceptually as well as empirically, we will discuss the use of auxiliary information in terms of antecedents and consequences of trajectory group membership. The inclusion of auxiliary information in growth mixture analysis is a necessary step in understanding as well as evaluating the fidelity and utility of the resultant trajectory profiles from a given study, regardless of one’s beliefs about the veracity of the method itself.",0 +https://doi.org/10.1037/0022-006x.76.2.272,Validating the Primary Care Posttraumatic Stress Disorder Screen and the Posttraumatic Stress Disorder Checklist with soldiers returning from combat.,"The purpose of the research was to assess the diagnostic efficiency of the Primary Care Posttraumatic Stress Disorder Screen (PC-PTSD) and the Posttraumatic Stress Disorder Checklist (PCL) as clinical screening tools for active duty soldiers recently returned from a combat deployment. A secondary goal was to examine the item-level characteristics of both the PC-PTSD and the PCL. A validation study conducted with a sample of 352 service members showed that both the PC-PTSD and PCL had good diagnostic efficiency. The overall diagnostic efficiency assessed by the area under the curve (AUC) was virtually the same for both the PC-PTSD and PCL. The most efficient cutoff values for the PC-PTSD were either 2 or 3 ""yes"" responses with the latter favoring specificity. For the PCL, the most efficient cutoff values were between 30 and 34, mirroring recommended PCL cutoff values from some studies in primary care settings. The examination of item characteristics suggested a 4-item PCL with an AUC virtually identical to that of the full PCL. Item analyses also identified that the most discriminate item in both scales pertained to symptoms of avoidance. Implications and limitations are discussed.",0 +https://doi.org/10.1111/j.1601-5215.2011.00623.x,Plasma brain-derived neurotrophic factor level may contribute to the therapeutic response to eye movement desensitisation and reprocessing in complex post-traumatic stress disorder: a pilot study,Plasma brain-derived neurotrophic factor level may contribute to the therapeutic response to eye movement desensitisation and reprocessing in complex post-traumatic stress disorder: a pilot study - Volume 24 Issue 6,0 +https://doi.org/10.1097/brs.0b013e3182388523,Prognosis After Whiplash Injury,"Nonsystematic review and discussion of prognosis after whiplash injury.To summarize the research and identify a research agenda for improving prognostic models after whiplash injury.With up to 50% of individuals failing to fully recover after whiplash injury, the capacity to determine a precise estimate of prognosis will be important. Systematic reviews note inconsistencies and shortcomings of research in this area.A nonsystematic review and discussion.Most prognostic whiplash studies are phase 1 (exploratory) studies with few confirmatory or validation studies yet available. It is recognized that whiplash is a heterogeneous condition and clinicians require prognostic indicators for clinical use. Although the evidence is not sufficiently strong to make firm recommendations, there are some prognostic factors that have shown consistency across studies and could be considered as preliminary flags or guides to gauge patients potentially at risk of poor recovery. These include pain and/or disability levels, neck range of movement, cold and mechanical hyperalgesia and psychological factors of recovery beliefs/expectations, post-traumatic stress symptoms, depression, and pain catastrophizing. It is not known whether these factors can be modified or whether modification will improve outcomes, thus they should not be considered directives for management. Research priorities identified to develop improved predictive models include confirmation and validation of factors identified in phase 1 studies; investigation of the interaction between variables; investigation of the predictive value of changes in variables over time; the inclusion of validated outcomes including measures of pain and disability as well as perceived recovery and psychological outcomes.The current evidence is not sufficiently robust to be able to confidently predict outcome after whiplash injury. A preliminary set of consistent factors has been proposed to assist clinicians in identifying individuals at risk of poor recovery. Directions for the development of improved prognostic models are discussed.",0 +https://doi.org/10.1097/01.phm.0000202095.51037.a3,Burn Rehabilitation,"ABSTRACTEsselman PC, Thombs BD, Magyar-Russell G, Fauerbach JA: Burn rehabilitation: State of the science. Am J Phys Med Rehabil 2006;85:383–413.",0 +https://doi.org/10.3357/asem.2403.2008,Cutaneous Vascular Responses to Hypercapnia During Whole-Body Heating,"Hypercapnia may be encountered in lung disease as well as during situations involving rebreathing of previously expired air (e.g., occupational diving). Inhibitory effects of elevated arterial carbon dioxide partial pressure on the central nervous system may result in impaired thermoregulation. This study tested the hypothesis that in heat-stressed subjects, cutaneous vascular responsiveness [expressed as cutaneous vascular conductance (CVC)] would be reduced during hypercapnic exposure.Four men and three women (mean - SD; age: 35 +/- 7 yr) rested supine while wearing a tube-lined suit perfused with 34 degrees C water (normothermia). Following normothermic data collection, 50 degrees C water was perfused through the suit to increase internal temperature approximately 1 degrees C (whole-body heating). In both thermal conditions, a normoxic-hypercapnic (5% CO2, 21% O2, balance N2) gas mixture was inspired while forearm skin blood flux (laser-Doppler flowmetry) was measured continuously and was used for calculation of CVC (skin blood flux/mean arterial pressure).End-tidal CO2 increased similarly throughout hypercapnic exposure during both normothermic and whole-body heating conditions (7.9 +/- 2.4 and 8.3 +/- 1.9 mmHg, respectively). However, CVC was not different between normocapnia and hypercapnia under either thermal condition (normothermia: 0.42 +/- 0.24 vs. 0.39 +/- 0.21 flux units/mmHg for normocapnia and hypercapnia, respectively; heat stress: 1.89 +/- 0.67 vs. 1.92 +/- 0.63 flux units/ mmHg for normocapnia and hypercapnia, respectively).Based on these findings, mild hypercapnia is unlikely to impair heat dissipation by reducing cutaneous vasodilation.",0 +,Post-traumatic stress disorder and color preference in released prisoners of war,"The Luscher Color Test was administered to a sample of 188 male ex-prisoners of war (aged 18-66 years), who underwent psychiatric and psychological examination. The aim of this study was to evaluate possible connections between PTSD symptom clusters and color preferences, and possible impact of post-war and post-imprisonment period on color choice. The obtained results showed a prevalence of 6.9% for full PTSD diagnosis and 38.8% for Partial PTSD diagnosis. Furthermore, we found increased preference for violet (dominantly in those with one symptom cluster) and green (dominantly in those with full PTSD or two symptom clusters) and decreased preference for red (all subgroups). The persistence of the post-trauma period influenced even more pronounced preference for green, and even lesser preference for red.",0 +https://doi.org/10.1017/s1461145707007912,Post-traumatic stress behavioural responses in inbred mouse strains: can genetic predisposition explain phenotypic vulnerability?,"Clinical studies of twin pairs and families of post-traumatic stress disorder (PTSD) patients raise questions as to possible genetic predisposition to PTSD. Studies using isogenic animal populations exposed to a stress paradigm could elucidate the relative contributions of genotype and environment to endophenotypic expression. The prevalence of individuals displaying severely compromised behavioural responses to predator scent stress (PSS) was assessed in six inbred strains of mice in an animal model of PTSD that classifies individuals into groups according to the degree of their behavioural response. The choice of strains was based on the frequent use of these mice in transgenic research. The prevalence of extreme behavioural response in the elevated plus maze and the acoustic startle response paradigms, performed in sequence, was assessed at baseline and 7 d after PSS exposure between and within strains, and compared to differences in circulating corticosterone levels. Narrow-sense trait heritability was determined by comparing the between-strain variance to the total variance. Although strain-specific differences in anxiety-like behaviours were demonstrated, the results revealed a significant degree of individual variability in response patterns within each of the inbred strains, yielding a baseline heritability factor for anxiety-like behaviours of 30%, but only 10% for response to stress exposure. Baseline anxiety-like behaviours were found not to be predictive of post-exposure behavioural responses. The response of the individual to stress is multifactorial and environmental factors play a predominant role in characterizing the individual response to stress exposure, although there are significant genetic underpinnings.",0 +https://doi.org/10.1017/s0033291713000597,Trajectories of PTSD risk and resilience in World Trade Center responders: an 8-year prospective cohort study,"Background Longitudinal symptoms of post-traumatic stress disorder (PTSD) are often characterized by heterogeneous trajectories, which may have unique pre-, peri- and post-trauma risk and protective factors. To date, however, no study has evaluated the nature and determinants of predominant trajectories of PTSD symptoms in World Trade Center (WTC) responders. Method A total of 10835 WTC responders, including 4035 professional police responders and 6800 non-traditional responders (e.g. construction workers) who participated in the WTC Health Program (WTC-HP), were evaluated an average of 3, 6 and 8 years after the WTC attacks. Results Among police responders, longitudinal PTSD symptoms were best characterized by four classes, with the majority (77.8%) in a resistant/resilient trajectory and the remainder exhibiting chronic (5.3%), recovering (8.4%) or delayed-onset (8.5%) symptom trajectories. Among non-traditional responders, a six-class solution was optimal, with fewer responders in a resistant/resilient trajectory (58.0%) and the remainder exhibiting recovering (12.3%), severe chronic (9.5%), subsyndromal increasing (7.3%), delayed-onset (6.7%) and moderate chronic (6.2%) trajectories. Prior psychiatric history, Hispanic ethnicity, severity of WTC exposure and WTC-related medical conditions were most strongly associated with symptomatic trajectories of PTSD symptoms in both groups of responders, whereas greater education and family and work support while working at the WTC site were protective against several of these trajectories. Conclusions Trajectories of PTSD symptoms in WTC responders are heterogeneous and associated uniquely with pre-, peri- and post-trauma risk and protective factors. Police responders were more likely than non-traditional responders to exhibit a resistant/resilient trajectory. These results underscore the importance of prevention, screening and treatment efforts that target high-risk disaster responders, particularly those with prior psychiatric history, high levels of trauma exposure and work-related medical morbidities.",1 +https://doi.org/10.1093/jpepsy/24.4.335,Posttraumatic stress in children following acute physical injury,"To prospectively assess the presence of posttraumatic stress disorder (PTSD) in children hospitalized following acute physical injury. The focus was identification of the incidence of PTSD, PTSD symptoms, and exploration of factors associated with development of PTSD symptoms and disorder.Forty children ages 8-17 were interviewed approximately 1 month following a serious injury and assessed for PTSD, pretrauma behavior problems, levels of peritraumatic fear, and posttraumatic thought suppression.Twenty-two and a half percent of participants met DSM-IV diagnostic criteria for PTSD; 47.5% met criteria for at least two of the three PTSD symptom clusters. Greater thought suppression was associated with increased symptoms of PTSD, as were the child's peritraumatic fear response and pretrauma internalizing behaviors.Results suggest that many children who have been hospitalized for physical trauma may be experiencing clinically significant PTSD symptomatology and may benefit from psychological as well as medical intervention.",0 +https://doi.org/10.1207/s15327876mp1802_1,Deployment Risk and Resilience Inventory: A Collection of Measures for Studying Deployment-Related Experiences of Military Personnel and Veterans,This article describes the development of an inventory to assess key psychosocial risk and resilience factors for military personnel and veterans deployed to war zones or other hazardous environmen...,0 +,Stress disorders following traumatic injury: Assessment and treatment considerations,"Traumatic injury is a relatively common occurrence, with approximately 40 million injury-related visits to emergency departments in the United States per year. Psychiatric complications of physical injury are a public health concern. Approximately 12% to 16% of survivors of traumatic injury are diagnosed with acute stress disorder (ASD), and 30% to 36% warrant a diagnosis of posttraumatic stress disorder (PTSD) 12 months after the traumatic event. Phenomena related to injury, such as blood loss, pain, administration of narcotic analgesics, and traumatic brain injury, as well as high rates of premorbid psychiatric and substance abuse and/or dependence disorders, often overlap with stress-related symptoms of psychological origin. This complicates the assessment of dissociative processes required for the diagnosis of ASD, as well as the three core PTSD symptom clusters (re-experiencing of the trauma, avoidance and numbing, and hyperarousal). This article reviews specific aspects of stress disorders in the context of traumatic injury, with a focus on aspects of assessment. Psychopharmacologic and behavioral treatment recommendations are also reviewed.",0 +,"Neighborhood disadvantage, stress, and drug use among adults.","This paper explores the relationships among neighborhood disadvantage, stress, and the likelihood of drug use in a sample of adults (N = 1,101). Using the 1995 Detroit Area Study in conjunction with tract-level data from the 1990 census, we find a positive relationship between neighborhood disadvantage and drug use, and this relationship remains statistically significant net of controls for individual-level socioeconomic status. Neighborhood disadvantage is moderately associated with drug related behaviors, indirectly through increased social stressors and higher levels of psychological distress among residents of disadvantaged neighborhoods. A residual effect of neighborhood disadvantage remains, net of a large number of socially relevant controls. Finally, results from interactive models suggest that the relationship between neighborhood disadvantage and drug use is most pronounced among individuals with lower incomes.",0 +,Practical assessment and evaluation of mental health problems following a mass disaster.,"Almost all individuals who experience a severe trauma will develop symptoms of posttraumatic stress disorder (PTSD) shortly after the traumatic event. Although the natural history of PTSD varies according to the type of trauma, most people do not develop enduring PTSD, and, in many of those who do, it resolves within 1 year without treatment. To the extent that is possible, maintenance of normal daily activities is believed to help patients cope more successfully in the aftermath of major trauma. In the case of a disaster such as the Asian tsunami, the whole community is involved, and it is impossible to continue with normal daily activities. To improve overall outcome after trauma, it would be optimal to identify individuals at increased risk for developing PTSD. This article describes screening and assessment tools for posttrauma mental health problems, particularly PTSD, and examines in more detail instruments that can be used in rapid field assessment of individuals who may be affected or who have already been identified and require monitoring. Self-rated instruments are most appropriate, but the choice of instrument will depend on the local situation and availability of appropriately validated questionnaires. The article also addresses important aspects of training nonmedical personnel in screening and assessment.",0 +https://doi.org/10.1176/ajp.143.9.1132,Symptom profiles of patients with DSM-III anxiety disorders,"The authors used symptom profiles, demographic data, and other variables to compare 316 patients representing all specific DSM-III anxiety disorders except posttraumatic stress disorder to each other and to published norms for both an unselected psychiatric outpatient population and normal subjects. The results support the grouping of these disorders, with the possible exception of obsessive-compulsive disorder, into one general diagnostic category of ""anxiety disorders."" The distinction between the specific diagnoses of simple phobia and social phobia was also supported; however, the differentiation between panic disorder, agoraphobia, and generalized anxiety was only weakly supported.",0 +https://doi.org/10.1111/j.1539-6924.2010.01580.x,"Economics of Disaster Risk, Social Vulnerability, and Mental Health Resilience","We investigate the relationship between exposure to Hurricanes Katrina and/or Rita and mental health resilience by vulnerability status, with particular focus on the mental health outcomes of single mothers versus the general public. We advance a measurable notion of mental health resilience to disaster events. We also calculate the economic costs of poor mental health days added by natural disaster exposure. Negative binomial analyses show that hurricane exposure increases the expected count of poor mental health days for all persons by 18.7% (95% confidence interval [CI], 7.44-31.14%), and by 71.88% (95% CI, 39.48-211.82%) for single females with children. Monthly time-series show that single mothers have lower event resilience, experiencing higher added mental stress. Results also show that the count of poor mental health days is sensitive to hurricane intensity, increasing by a factor of 1.06 (95% CI, 1.02-1.10) for every billion (U.S.$) dollars of damage added for all exposed persons, and by a factor of 1.08 (95% CI, 1.03-1.14) for single mothers. We estimate that single mothers, as a group, suffered over $130 million in productivity loss from added postdisaster stress and disability. Results illustrate the measurability of mental health resilience as a two-dimensional concept of resistance capacity and recovery time. Overall, we show that natural disasters regressively tax disadvantaged population strata.",0 +https://doi.org/10.7205/milmed-d-14-00488,Relationship BetweenToxoplasma gondiiand Mood Disturbance in Women Veterans,"Toxoplasma gondii is an intracellular protozoan parasite with zoonotic potential that causes acute and chronic diseases, which has been associated with schizophrenia, depression, bipolar disorder, and suicidal behavior. Military personnel may be at increased risk for exposure to the parasite when deployed to countries with high prevalence rates.Women Veterans were recruited to participate in the study at an event to recognize women Veterans and later through e-mails. Blood samples were collected from 70 women Veterans (mean age: 47 years) and analyzed for T. gondii IgG titer. Participants completed a demographic instrument, Center for Epidemiologic Studies Depression scale, Profile of Mood States (POMS), and Post-Traumatic Stress Disorder Checklist-Military.The infectivity rate was lower than the rate in the United States (11.4% [8 out of 70 were seropositive], but 6 of the 8 [75%] had been deployed outside the United States. Pearson correlations and t tests showed significant relationships between T. gondii seropositivity and Center for Epidemiologic Studies Depression score), POMS-depression, POMS-confusion, and POMS-anger subscale scores, and total mood disturbance score.This study is the first to describe biobehavioral relationships between chronic T. gondii infection, depression, and dysphoric moods in a military veteran population.",0 +https://doi.org/10.1007/s10566-013-9220-3,Preliminary Evidence for a Classroom Based Psychosocial Intervention for Disaster Exposed Children with Posttraumatic Stress Symptomatology,"Background: In 2004, a firework factory in a residential area of a large Danish city exploded. The children at the local school were screened for symptoms of posttraumatic stress disorder (PTSD) 16 months and 31/2 years after the incident. A large proportion of the children still suffered from a substantial number of symptoms 31/2 years after the incident. Thus, a treatment program designed to target PTSD symptoms in trauma-exposed children was established. Objectives: The first aim of this study was to provide preliminary evidence that a classroom-based psychosocial intervention program for children with posttraumatic stress would be associated with reductions in symptoms. The second aim was to evaluate the usefulness of the Darryl, a cartoon-based PTSD screening instrument. Methods: One hundred and eight children participated in the treatment program, all of whom fulfilled at least two out of the three DSM-IV PTSD symptom clusters. The children were screened for PTSD symptoms at baseline and 1 month after treatment using Darryl. Results: There was a statistically significant reduction in PTSD symptoms from pre-treatment to post-treatment. Furthermore, a logistic regression analysis revealed that being female, being young, and having a high PTSD score at baseline predicted a probable PTSD diagnosis post-treatment. Conclusion: The present study provides preliminary evidence of feasibility and that the treatment program described may help to alleviate PTSD symptoms children with chronic PTSD symptoms. Furthermore, the results indicated that the Darryl instrument is a useful screening tool for assessing PTSD symptoms in this sample of children. © 2013 Springer Science+Business Media New York.",0 +https://doi.org/10.1016/j.jad.2015.03.047,Latent profiles of PTSD symptoms in women exposed to intimate partner violence,"Studies have utilized latent class analysis (LCA) and latent profile analysis (LPA) to examine posttraumatic stress disorder (PTSD) symptom profiles in a range of populations. Further study is needed to explore symptom profiles among women exposed to intimate partner violence (IPV). The current study examined latent symptom profiles in a sample of IPV-exposed women, and explored trauma-related cognitive appraisals associated with these PTSD symptom presentations.An LPA was conducted using cross-sectional data from a non-treatment seeking community sample of women recruited following a police-reported incident of IPV by a male perpetrator (N=229). Multinomial regression analyses determined associations between latent profile membership and trauma-related appraisals.The LPA identified five PTSD symptom profiles: Low Symptom (46% of the sample); Low Symptom with High Hypervigilance (17%); Intermediate Symptom (16%); Intermediate Symptom with High Hypervigilance (11%); and High Symptom (10%). Trauma-related appraisals, including fear, alienation, and self-blame, were the strongest independent predictors of PTSD symptom profile membership.The study focused on female victims of IPV by a male partner, and findings may not generalize to other gender configurations (e.g. same-sex couples, male victims, etc.). The LPA is cross-sectional, and the stability of these profiles over time warrants further study.These findings suggest the need for careful consideration of differences among IPV-exposed women within the larger context of PTSD research and clinical intervention. Identifying latent subgroups may provide an empirical basis for practitioners to design and implement PTSD intervention efforts that are tailored to specific symptom profiles.",0 +https://doi.org/10.1007/s00404-015-3969-6,Psychiatric outcomes after childbirth: can posttraumatic growth protect me from disordered eating symptoms?,"Purpose: While many studies on mood disorder and posttraumatic stress disorder (PTSD) following childbirth have been conducted, little is known regarding posttraumatic growth (PTG) and disordered eating in the postpartum period. This study aims to (a) identify the typology of women following childbirth based on anxiety, depressive, PTSD symptoms and level of PTG and (b) evaluate whether these profiles differ on disordered eating symptoms. Methods: Up to 2 years after childbirth, 306 French-speaking mothers [mean age (SD) = 29.4 (4.6) years] completed questionnaires assessing PTSD, depressive, anxiety and disordered-eating symptoms and level of posttraumatic growth. Results: Four profiles were highlighted: a first one labeled growing cluster (22.2  \% of the sample, n = 68), a second one labeled low level of symptoms cluster (37.6  \% of the sample, n = 115), a third one labeled vulnerable cluster (21.6  \% of the sample, n = 66) and a last one labeled anxious–depressed–traumatized cluster (18.6  \% of the sample, n = 57). Our findings also highlight an impact of these profiles on disordered eating symptoms, suggesting that disordered eating in postpartum would not be the result of pregnancy. Conclusion: Consistent with our expectation, our findings suggest a potential protective role of posttraumatic growth on the development of disordered eating symptoms. Further researches focusing on traumatic experience, disordered eating and posttraumatic growth in postpartum are warranted.",0 +https://doi.org/10.1037/a0019783,Heterogeneity in the latent structure of PTSD symptoms among Canadian veterans.,"The current study used factor mixture modeling to identify heterogeneity (i.e., latent classes) in 2 well-supported models of posttraumatic stress disorder's (PTSD) factor structure. Data were analyzed from a clinical sample of 405 Canadian veterans evaluated for PTSD. Results were consistent with our hypotheses. Each PTSD factor model was best represented by 2 latent classes of participants, differing with respect to PTSD symptom severity. Furthermore, classes were most strongly distinguished by factor scores related to emotional numbing or dysphoria. For both factor models, class membership was significantly predicted by age and depression diagnosis. Implications of these findings are discussed.",0 +https://doi.org/10.1007/s10826-014-9934-3,"Posttraumatic Stress, Anxiety, and Depression Symptoms Among Children After Hurricane Katrina: A Latent Profile Analysis","This study utilized Latent Profile Analysis to identify typologies of distress (i.e., patterns of posttraumatic stress, anxiety, and depression symptoms) among children exposed to Hurricane Katrina. Outcomes and risk factors for these pattern groups were examined. Participants were children (n = 353; ages 8-15 years) affected by Hurricane Katrina. Children were assessed at 3 - 7 months (Time 1) and 14 - 17 months (Time 2) post-Katrina. Results identified three pattern groups (No Disturbance, PTS Only, and Mixed Internalizing) at Time 1. Children in the No Disturbance group reported the lowest levels of internal distress, while the Mixed Internalizing group reported the highest levels of internal distress at Time 2. The Mixed Internalizing and the PTS Only groups reported greater school problems than the No Disturbance group at Time 2. Perceived life threat and community violence exposure were risk factors associated with higher likelihood of falling in the PTS Only and Mixed Internalizing groups, compared to the No Disturbance group. Immediate loss and disruption was also a risk factor associated with a higher likelihood of falling in the PTS Only group, compared to the No Disturbance group. Finally, social support from parents or a classmate/friend was a significant protective factor associated with a lower likelihood of falling into a symptomatic pattern group.",0 +https://doi.org/10.1207/s15327752jpa6802_8,Symptom Overreporting in Combat Veterans Evaluated for PTSD: Differentiation on the Basis of Compensation Seeking Status,"We examined the role of compensation-seeking status on response patterns to self-report inventories of acute psychopathology and psychological distress in a group of 165 combat veterans evaluated for posttraumatic stress disorder (PTSD) at a Department of Veteran Affairs (VA) Medical Center. Veterans completed the Minnesota Multiphasic Personality Inventory-Revised, Beck Depression Inventory, Mississippi Scale for Combat-Related PTSD, a fixed-response format version of the Dissociative Experiences Scale, and Impact of Events Scale as part of a standard assessment battery. Results showed that compensation-seeking veterans endorsed dramatically higher levels of psychopathology across measures and produced sharply elevated ""fake-bad"" validity indices as compared to non-compensation-seeking veterans. Differences between the two groups on most scales and indices exceeded effect sizes of 1.0, even when effects of income, global assessment of functioning, and clinician-rated severity of PTSD were controlled for. It is suggested that the availability of VA disability compensation for combat-related PTSD impedes accurate initial assessment of veterans presenting for treatment and may impair estimation of long-term therapeutic outcome in this population.",0 +https://doi.org/10.1192/bjp.bp.111.093336,Assessing the ‘true’ effect of active antidepressant therapy v. placebo in major depressive disorder: use of a mixture model,"Background There is controversy about the implications of relatively small average drug–placebo differences observed in randomised controlled trials of antidepressant medications. Aims To investigate whether efficacy is better understood as a large effect in a subgroup of patients. Method The mixture model was used to identify patient subgroups (patients benefiting or not benefiting from treatment) to directly model the skewness of Montgomery–åsberg Depression Rating Scale (MADRS) scores at week 8. Results The MADRS scores improved by 15.9 points (95% CI 15.2–16.6) among patients who benefited from treatment. The proportion of patients who benefited from escitalopram and not from placebo treatment was 19.5%, corresponding to a number needed to treat of 5. Conclusions This model gave a considerably better fit to the data than the analysis of covariance model in which all patients were assumed to benefit from treatment. The small average antidepressant–placebo difference obscures a much larger effect in a clinically meaningful subgroup of patients.",0 +https://doi.org/10.1080/15299732.2014.908806,DSM–5’s Posttraumatic Stress Disorder with Dissociative Symptoms: Challenges and Future Directions,"The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, formally recognizes a dissociative subtype of posttraumatic stress disorder (PTSD; PTSD with dissociative symptoms). This nomenclative move will boost empirical and theoretical efforts to further understand the links between dissociation, trauma, and PTSD. This article examines the empirical literature showing that patients with PTSD can be divided into 2 different groups based on their neurobiology, psychological symptom profile, history of exposure to early relational trauma, and depersonalization/derealization symptoms. It then explores the conceptual and empirical challenges of conceiving 1 of these types as reflecting a ""dissociative"" type of PTSD. First, this classification is based on the presence of a limited subset of dissociative symptoms (i.e., depersonalization, derealization). This sets aside an array of positive and negative psychoform and somatoform dissociative symptoms that may be related to PTSD. Second, empirical evidence suggests heightened dissociation in PTSD compared to many other disorders, indicating that dissociation is relevant to PTSD more broadly rather than simply to the so-called dissociative subtype. This article sets out important issues to be examined in the future study of dissociation in PTSD, which needs to be informed by solid conceptual understandings of dissociation.",0 +,A new instrument to assess social functioning in mental health settings,"This article present a new social functioning self-report instrument in French language the Questionnaire de Fonctionnement Social (QFS), initially developed in order to assess social functioning in patients involved ingroup psychotherapy programs conducted in a specialist mental health setting. The psychometric analysis globally support the validity of the QFS and suggest that it performs similarly to other standardized measure of social functioning. Brief, easy to complete and score, the QFS seems to be an appropriate instrument for use not only in research protocols but also in clinical psychiatric settings. Within the often costly exercise of routine measurement, this short questionnaire should help identifying social dysfunctions otherwise not always recognized, making informed clinical decision and monitoring therapeutic responses. The QFS, while promising, needs further validation by study of its use namely in other settings (e.g. community mental health setting,...), with other patient groups (for instance, suffering from other mental disorders or chronic medical illnesses) and, more generally, with other non-clinical populations (e.g. pensioners, prisoners, refugees,...).",0 +,Trauma and stress-related disorders in German emergency physicians: the predictive role of personality factors.,"Emergency medical personnel (EMP) are repeatedly exposed to traumatic and stressful events with possible consequences on their mental wellbeing. Out of the group of EMP, we chose German Emergency Physicians (EP), because they represent a distinct group within the German pre-hospital emergency services. In this group, we studied the prevalence rates of posttraumatic stress disorder (PTSD), burnout and depression. We specifically focussed on the role of personality and other factors of vulnerability. Four hundred eighty-seven German EPs answered questionnaires with scales assessing probable PTSD, burnout, depression, and personality factors. Additionally, we asked for biographic, occupational and mental health information. More than 90% of the participants reported at least one traumatic event. We found low to moderate levels of stress-related disorders with 16.8% of participants meeting the criteria for probable PTSD, 4.1% for burnout, and 3.1% for clinical depression. We identified four clusters of personalities that were related to the prevalence of PTSD and depression. The type of personality seems to be more predictive of the development of trauma and stress-related disorders than the EPs' traumatic experiences.",0 +https://doi.org/10.1097/00001199-200605000-00005,Coping and Emotional Adjustment Following Traumatic Brain Injury,"To examine the association between coping style and emotional adjustment following traumatic brain injury.Thirty three individuals who had sustained a traumatic brain injury (mean duration of posttraumatic amnesia = 32 days) between 1(1/2) months and almost 7 years previously.Coping Scale for Adults, Hospital Anxiety and Depression Scale, Rosenberg Self-Esteem Scale, State-Trait Anger Expression Inventory, and the Sickness Impact Profile.Approximately 50% of the sample reported clinically significant levels of anxiety and depression. Coping characterized by avoidance, worry, wishful thinking, self-blame, and using drugs and alcohol was associated with higher levels of anxiety, depression, and psychosocial dysfunction and lower levels of self-esteem. Coping characterized by actively working on the problem and using humor and enjoyable activities to manage stress was associated with higher self-esteem. Lower premorbid intelligence (measured via the National Adult Reading Test) and greater self-awareness (measured via the Self-Awareness of Deficits Interview) were associated with an increased rate of maladaptive coping.The strong association between the style of coping used to manage stress and emotional adjustment suggests the possibility that emotional adjustment might be improved by the facilitation of more adaptive coping styles. It is also possible that improving emotional adjustment may increase adaptive coping. The development and evaluation of interventions aimed at facilitating adaptive coping and decreasing emotional distress represent important and potentially fruitful contributions to enhancing long-term outcome following brain injury.",0 +https://doi.org/10.1001/jamapsychiatry.2015.2132,Epidemiology ofDSM-5Drug Use Disorder,"Current information on the prevalence and sociodemographic and clinical profiles of individuals in the general population with DSM-5 drug use disorder (DUD) is limited. Given the present societal and economic context in the United States and the new diagnostic system, up-to-date national information is needed from a single uniform data source.To present nationally representative findings on the prevalence, correlates, psychiatric comorbidity, disability, and treatment of DSM-5 DUD diagnoses overall and by severity level.In-person interviews were conducted with 36,309 adults in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III, a cross-sectional representative survey of the United States. The household response rate was 72%; person-level response rate, 84%; and overall response rate, 60.1%. Data were collected April 2012 through June 2013 and analyzed from February through March 2015.Twelve-month and lifetime DUD, based on amphetamine, cannabis, club drug, cocaine, hallucinogen, heroin, nonheroin opioid, sedative/tranquilizer, and/or solvent/inhalant use disorders.Prevalences of 12-month and lifetime DUD were 3.9% and 9.9%, respectively. Drug use disorder was generally greater among men, white and Native American individuals, younger and previously or never married adults, those with lower education and income, and those residing in the West. Significant associations were found between 12-month and lifetime DUD and other substance use disorders. Significant associations were also found between any 12-month DUD and major depressive disorder (odds ratio [OR], 1.3; 95% CI, 1.09-1.64), dysthymia (OR, 1.5; 95% CI, 1.09-2.02), bipolar I (OR, 1.5; 95% CI, 1.06-2.05), posttraumatic stress disorder (OR, 1.6; 95% CI, 1.27-2.10), and antisocial (OR, 1.4; 95% CI, 1.11-1.75), borderline (OR, 1.8; 95% CI, 1.41-2.24), and schizotypal (OR, 1.5; 95% CI, 1.18-1.87) personality disorders. Similar associations were found for any lifetime DUD with the exception that lifetime DUD was also associated with generalized anxiety disorder (OR, 1.3; 95% CI, 1.06-1.49), panic disorder (OR, 1.3; 95% CI, 1.06-1.59), and social phobia (OR, 1.3; 95% CI, 1.09-1.64). Twelve-month DUD was associated with significant disability, increasing with DUD severity. Among respondents with 12-month and lifetime DUD, only 13.5% and 24.6% received treatment, respectively.DSM-5 DUD is a common, highly comorbid, and disabling disorder that largely goes untreated in the United States. These findings indicate the need for additional studies to understand the broad relationships in more detail; estimate present-day economic costs of DUDs; investigate hypotheses regarding etiology, chronicity, and treatment use; and provide information to policy makers about allocation of resources for service delivery and research. Findings also indicate an urgent need to destigmatize DUD and educate the public, clinicians, and policy makers about its treatment to encourage affected individuals to obtain help.",0 +,The relations between posttraumatic stress disorder symptoms and disorder of extreme stress (not otherwise specified) symptoms following war captivity.,"War captivity is a recognized pathogenic agent for both posttraumatic stress disorder (PTSD) symptoms and disorder of extreme stress not otherwise specified (DESNOS) symptoms, also known as Complex PTSD. However, the relationship between the two disorders remains unclear. While some scholars assume that the two diagnoses are overlapping and share the same predictors, others believe that the two diagnoses are relatively independent and differ in phenomenology and functional impairment. This study aims to assess both PTSD and DESNOS symptoms and their inter-relations among ex-prisoners of war (ex-POWs) and matched controls, 35 years after the end of the war.The sample included two groups of male Israeli veterans from the 1973 Yom Kippur War: ex-POWs (n = 176) and comparable veterans who had not been held captive (n = 118). PTSD and DESNOS symptoms, battlefield and captivity stressors, and ways of coping in captivity were assessed using self-report questionnaires in 2008.Ex-POWs reported a higher number of PTSD symptoms and higher rates of PTSD symptoms that fill criteria for the diagnosis of PTSD than controls. Furthermore, ex-POWs reported a higher number of DESNOS symptom clusters and higher rates of DESNOS symptoms that fill criteria for the diagnosis of DESNOS. Moreover, we found positive relationships between PTSD symptom clusters and DESNOS symptom clusters. Finally, weight loss and mental suffering in captivity, loss of emotional control and total number of DESNOS symptoms predicted total number of PTSD symptoms. However, only the total number of PTSD symptoms predicted the total number of DESNOS symptoms.This study demonstrated the heavy and extensive toll of war captivity, three decades after the ex-POWs' release from captivity. Importantly, approaching the publication of DSM-5, this study depicts both the high number of DESNOS symptom clusters alongside PTSD symptoms and highlights the complex relationship between the two diagnostic entities. Thus, DESNOS characteristics might be viewed as associated features of PTSD but also that the symptoms of PTSD are the core foundations of DESNOS.",0 +https://doi.org/10.1001/archinte.166.10.1092,A Brief Measure for Assessing Generalized Anxiety Disorder,"Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity.A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use.A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale.The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.",0 +https://doi.org/10.1001/jama.2010.599,Rates of Major Depressive Disorder and Clinical Outcomes Following Traumatic Brain Injury,"Uncertainties exist about the rates, predictors, and outcomes of major depressive disorder (MDD) among individuals with traumatic brain injury (TBI).To describe MDD-related rates, predictors, outcomes, and treatment during the first year after TBI.Cohort from June 2001 through March 2005 followed up by structured telephone interviews at months 1 through 6, 8, 10, and 12 (data collection ending February 2006).Harborview Medical Center, a level I trauma center in Seattle, Washington.Five hundred fifty-nine consecutively hospitalized adults with complicated mild to severe TBI.The Patient Health Questionnaire (PHQ) depression and anxiety modules were administered at each assessment and the European Quality of Life measure was given at 12 months.Two hundred ninety-seven of 559 patients (53.1%) met criteria for MDD at least once in the follow-up period. Point prevalences ranged between 31% at 1 month and 21% at 6 months. In a multivariate model, risk of MDD after TBI was associated with MDD at the time of injury (risk ratio [RR], 1.62; 95% confidence interval [CI], 1.37-1.91), history of MDD prior to injury (but not at the time of injury) (RR, 1.54; 95% CI, 1.31-1.82), age (RR, 0.61; 95% CI, 0.44-0.83 for > or = 60 years vs 18-29 years), and lifetime alcohol dependence (RR, 1.34; 95% CI, 1.14-1.57). Those with MDD were more likely to report comorbid anxiety disorders after TBI than those without MDD (60% vs 7%; RR, 8.77; 95% CI, 5.56-13.83). Only 44% of those with MDD received antidepressants or counseling. After adjusting for predictors of MDD, persons with MDD reported lower quality of life at 1 year compared with the nondepressed group.Among a cohort of patients hospitalized for TBI, 53.1% met criteria for MDD during the first year after TBI. Major depressive disorder was associated with history of MDD and was an independent predictor of poorer health-related quality of life.",0 +https://doi.org/10.1016/0191-8869(92)90262-n,"Crisis support, attributional style, coping style, and post-traumatic symptoms","Abstract Although disaster is believed to be aetiological in the development of post-traumatic stress disorder, there exist large unexplained individual differences in the severity and chronicity of symptoms. For this reason, attention has begun to focus on those variables that might mediate between disaster and subsequent outcome. One such variable is crisis support. However, it has been suggested that associations between self-report measures of support and symptoms may be a function of attributional style and coping style. It is shown in the present study that crisis support is able to predict symptoms over and above attributional style and coping style.",0 +https://doi.org/10.1002/pbc.25701,Psychosocial Interventions and Therapeutic Support as a Standard of Care in Pediatric Oncology,"Research indicates that a subset of youths with childhood cancer and their parents will experience significant psychological distress throughout the course of their illness. Importantly, the existing literature indicates that psychosocial support is beneficial in decreasing symptoms of distress in these families. The aim of the current review is to determine the extent of the evidence to support a standard of psychosocial care for children and their families throughout the cancer trajectory; thus, we examined the research related to psychosocial outcomes in youth with cancer and their parents.",0 +https://doi.org/10.1176/ajp.144.5.578,Posttraumatic stress disorder: the etiologic specificity of wartime stressors,"The authors examined the effects of wartime stressors in a sample of 69 Vietnam veterans who were psychiatric inpatients in a Veterans Administration hospital. Participation in atrocities and the cumulative exposure to combat stressors, each independently of the other, conferred a significant risk for posttraumatic stress disorder. In contrast, the effect of these war experiences on the onset of panic, major depression, and mania was not significant. The results indicate that extreme stressors are uniquely linked with posttraumatic stress disorder's characteristic cluster of symptoms but challenge DSM-III's implicit assumption that the reexperienced trauma is the stressor responsible for posttraumatic stress disorder.",0 +https://doi.org/10.1037/a0024848,The latent structure of acute stress disorder: A posttraumatic stress disorder approach.,"Acute stress disorder (ASD) was first included in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) to account for the psychological symptoms present during the one-month period between trauma exposure and a posttraumatic stress disorder (PTSD) diagnosis. The diagnostic criteria sets of both ASD and PTSD are similar; however, ASD includes additional dissociative items. Factor analytic research into ASD is rare, whereas there is a plethora of research on the factor structure of PTSD symptoms. This study tested whether the latent structure of ASD is similar to the latent structure of PTSD. Five models were tested by using data from Danish rape victims (N = 380); a unidimensional model, the DSM-IV 4-factor ASD model, a King, Leskin, King, and Weathers (1998) replication model, a Simms, Watson, and Doebbeling (2002) replication model, and a 3-factor model. Model fit was assessed by using a number of fit indices, including the root-mean-square error of approximation, comparative fit index, Tucker-Lewis index, and standardized root-mean-square residual. However, based on the fit indices, 3 models were deemed indistinguishable. Chi-square difference tests concluded that a 3-factor model and two 4-factor models did not differ in fit. Overall, the current 4-factor ASD latent structure proposed by the DSM-IV was not supported. A 3-factor structure was deemed preferential on the basis of parsimony. Furthermore, of all models, the unidimensional model provided the poorest fit to the data. These findings are pertinent given that the DSM-5 ASD task force is considering implementing either a 4-factor conceptualization or a unidimensional approach to the ASD diagnosis. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1016/j.neuropharm.2014.01.013,The role of DNA methylation in stress-related psychiatric disorders,"Epigenetic modifications in response to traumatic experience and stress are emerging as important factors in the long-term biological trajectories leading to stress-related psychiatric disorders, reflecting both environmental influences as well as individual genetic predisposition. In particular, recent evidence on DNA methylation changes within distinct genes and pathways but also on a genome-wide level provides new insights into the pathophysiology of stress related psychiatric disorders. This review summarizes current findings and concepts on DNA methylation changes in stress-related disorders with a focus on major depressive disorder and posttraumatic stress disorder (PTSD). We highlight studies of DNA methylation in animals and humans pertinent to these disorders, both focusing on candidate loci as well as genome-wide studies. We describe molecular mechanisms of how exposure to stress can induce long lasting changes in DNA methylation and how these may relate to the pathophysiology of depression and PTSD. We discuss data suggesting that DNA methylation, even in peripheral tissues, appears to be an informative reflection of environmental exposures on the genome and may have potential as a biomarker for the early prevention of stress-related disorders.",0 +https://doi.org/10.1016/j.chiabu.2013.08.018,A history in-care predicts unique characteristics in a homeless population with mental illness,"Multiple studies of homeless persons report an increased prevalence of a history in-care, but there is a dearth of information on associated outcomes or relevant demographic profiles. This information is critical to understanding if certain individuals are at elevated risk or might benefit from specific intervention. Here, we investigate how a history in-care relates to demographics and multiple outcome measures in a homeless population with mental illness. Using the Mini International Neuropsychiatric Interview (MINI), the Short-Form 12, and a trauma questionnaire, we investigated baseline differences in demographics and length of homelessness in the At Home/Chez Soi Trial (N=504) Winnipeg homeless population with and without a history in-care. Approximately 50% of the homeless sample reported a history in-care. This group was significantly more likely to be young, female, married or cohabitating, of Aboriginal heritage, have less education, and have longer lifetime homelessness. Individuals of Aboriginal heritage with a history in-care were significantly more likely to report a familial history of residential school. Individuals with a history in-care experienced different prevalence rates of Axis 1 mental disorders. Those with a history in-care also reported significantly more traumatic events (particularly interpersonal). A distinctive high-risk profile emerged for individuals with a history in-care. Sociocultural factors of colonization and intergenerational transmission of trauma appear to be particularly relevant in the trajectories for individuals of Aboriginal heritage. Given the high prevalence of a history in-care, interventions and policy should reflect the specific vulnerability of this population, particularly in regards to trauma-informed services.",0 +https://doi.org/10.1176/appi.ajp.2007.06101645,Differences in PTSD Prevalence and Associated Risk Factors Among World Trade Center Disaster Rescue and Recovery Workers,"This study compared the prevalence and risk factors of current probable posttraumatic stress disorder (PTSD) across different occupations involved in rescue/recovery work at the World Trade Center site.Rescue and recovery workers enrolled in the World Trade Center Health Registry who reported working at the World Trade Center site (N=28,962) were included in the analysis. Interviews conducted 2-3 years after the disaster included assessments of demographic characteristics, within-disaster and work experiences related to the World Trade Center, and current probable PTSD.The overall prevalence of PTSD among rescue/recovery workers was 12.4%, ranging from 6.2% for police to 21.2% for unaffiliated volunteers. After adjustments, the greatest risk of developing PTSD was seen among construction/engineering workers, sanitation workers, and unaffiliated volunteers. Earlier start date and longer duration of time worked at the World Trade Center site were significant risk factors for current probable PTSD for all occupations except police, and the association between duration of time worked and current probable PTSD was strongest for those who started earlier. The prevalence of PTSD was significantly higher among those who performed tasks not common for their occupation.Workers and volunteers in occupations least likely to have had prior disaster training or experience were at greatest risk of PTSD. Disaster preparedness training and shift rotations to enable shorter duration of service at the site may reduce PTSD among workers and volunteers in future disasters.",0 +https://doi.org/10.1002/jts.21827,"Relationships Among Predeployment Risk Factors, Warzone-Threat Appraisal, and Postdeployment PTSD Symptoms","Previous research indicates a relationship between perceived fear for one's safety (i.e., threat appraisal) and posttraumatic stress disorder (PTSD). This prospective study examined relationships among deployment- and predeployment-related variables, threat appraisal, and postdeployment PTSD symptom severity. Prior to Iraq deployment, 774 U.S. Army soldiers completed self-report measures assessing previous life stressors, deployment history, current (predeployment) PTSD symptoms, deployment preparedness, and unit cohesion. Following deployment, participants completed self-report measures assessing combat intensity, deployment threat appraisal, and current (postdeployment) PTSD symptoms. Structural equation modeling revealed that predeployment PTSD symptom severity, prior warzone deployment, unit cohesion, and preparedness were each independently associated with deployment threat appraisal, even after taking into account combat intensity. Deployment threat appraisal was associated with postdeployment PTSD severity. Results indicated that predeployment PTSD symptom severity, history of warzone deployment, and preparedness-risk factors previously thought to influence PTSD outcomes directly-were either partially or fully mediated by threat appraisal. The model explained 15% of the variance in deployment threat appraisal and 50% of the variance in postdeployment PTSD severity. Helping service members cope with exposure to extreme stress during deployment by modifying certain prewar risk factors may facilitate reduction of PTSD symptoms following deployment.",0 +https://doi.org/10.1177/1094428109341993,Determining the Relative Importance of Predictors in Logistic Regression: An Extension of Relative Weight Analysis,"Techniques such as dominance analysis and relative weight analysis have been proposed recently to evaluate more accurately predictor importance in ordinary least squares (OLS) regression. Similar questions of predictor importance also arise in instances where logistic regression is the primary mode of analysis. This article presents an extension of relative weight analysis that can be applied in logistic regression and thus aids in the determination of predictor importance. We briefly review relative importance techniques and then discuss a new procedure for calculating relative importance estimates in logistic regression. Finally, we present a substantive example applying this new approach to an example data set.",0 +https://doi.org/10.1016/j.psychres.2012.09.037,Impact of combat and non-military trauma exposure on symptom reduction following treatment for veterans with posttraumatic stress disorder,"Military veterans with posttraumatic stress disorder (PTSD) frequently report exposure to multiple other traumas in addition to their military experiences. This study aimed to examine the impact of exposure-related factors for military veterans with PTSD on recovery after participation in a group-based treatment program. Subjects included 1548 military veterans with PTSD participating in specialist veterans' PTSD programs across Australia. The study included measures of PTSD, depression, anxiety and alcohol use. Analyses of variance found higher combat exposure was associated with more severe PTSD at intake. No differences in PTSD intake severity were evident in those with additional non-military trauma. Severity of combat exposure did not affect treatment outcomes, although those with low combat exposure and additional non-military trauma (which included high rates of molestation) did report reduced symptom improvement. These findings have implications for considerations of optimal interventions for those with lower levels of combat exposure and additional non-military trauma.",0 +https://doi.org/10.1016/j.euroneuro.2013.10.009,Mortality rates between treated post-traumatic stress disorder Israeli male veterans compared to non-diagnosed veterans,"The literature suggests that post-traumatic stress disorder (PTSD) is associated with increased mortality. However, to date, mortality rates amongst veterans diagnosed with post-traumatic stress disorder have not been reported for Israeli veterans, who bear a different profile than veterans from other countries. This study aims to evaluate age-adjusted mortality rates amongst Israeli Defense Forces veterans with and without PTSD diagnosis. The study was carried out in a paired sample design with 2457 male veterans with treated PTSD and 2457 matched male veterans without a PTSD diagnosis. Data on PTSD and non-PTSD veterans was collected from the Rehabilitation Division of the Israeli Ministry of Defense (MOD) and the Israeli Defense Forces' (IDF) special unit for treatment of combat stress reaction. Mortality data were collected from the Ministry of the Interior (MOI) computerized database. Comparison of mortality rates between PTSD and non-PTSD veterans was done using paired observations survival analysis by applying a proportional hazards regression model. Overall no statistically significant difference in mortality rates was found between veterans with treated PTSD and veterans without PTSD. These findings hold even when excluding veterans who died in battle and including non-PTSD veterans who died before their matched PTSD veteran was diagnosed. However, among pairs with similar military jobs PTSD group had significantly less mortality. The results of this large national cohort suggest that treated PTSD is not associated with increased mortality. We submit that the lack of this association represents the ""net"" pathophysiology of PTSD due to the unique characteristics of the sample.",0 +https://doi.org/10.1007/s10940-010-9113-7,Group-Based Trajectory Modeling (Nearly) Two Decades Later,"The Author(s) 2010. This article is published with open access at Springerlink.com Nearly two decades have passed since the publication of ‘‘Age, Criminal Careers, and Population Heterogeneity: Specification and Estimation of a Nonparametric Mixed Poisson Model’’ by Nagin and Land (1993). In that article Nagin and Land laid out a statistical method that has come to be called group-based trajectory modeling. The principle objective of the paper was to address issues related to the ‘‘hot topic’’ of the time—the criminal career debate—not to lay out a new statistical methodology. As described in the paper’s abstract, these issues were: ‘‘First, is the life course of individual offending patterns marked by distinctive periods of quiescence? Second, at the level of the individual, do offending rates vary systematically with age? In particular, is the age-crime curve single peaked or flat? Third, are chronic offenders different from less active offenders? Do offenders themselves differ in systematic ways?’’ Figure 1 reports Nagin’s (2005) updated version of the trajectories reported in Nagin and Land (1993). The analysis is based on the classic dataset assembled by Farrington and West (1990), which includes data on convictions from age 10 to 32 in a sample of over 400 males from a poor neighborhood in London, England. A four group model, analyzed using the zero-inflated Poisson modeling option, was found to best fit the data. The largest trajectory group accounted for 69.5% of the population, and was composed of individuals who generally had no convictions. The three offending trajectories included an adolescentlimited group (12.4% of the population), which peaked sharply in late adolescence, and then declined to a near zero rate of offending by age 20, a high chronic trajectory (5.9% of the population) with a high-humped shaped trajectory and a low rate chronic trajectory that accounted for the remaining 12.2% of the population. Also, shown in the figure are 95% confidence intervals around each trajectory. The dominant legacy of Nagin and Land (1993), however, was not its answers to the specific questions listed in the abstract but the methodology itself. A review of applications",0 +https://doi.org/10.1037//0021-843x.109.2.188,Coping with Gulf War combat stress: Mediating and moderating effects.,,0 +,Thirty years of using a series of personality questionnaires constructed by computer.,"The series of personality questionnaires constructed using a computer was created on the basis of cybernetic theories of personality, which presupposes the existence of six conative control systems: a system for the regulation of defense responses, a system for the regulation of attack responses, a system for controlling physiological functions, a system for coordination of regulatory functions, system for integration of regulatory functions and system for regulation of activity. Six personality questionnaires measure the intensity of the following pathological personality tendencies: 1. neurasthenia and anxiety, 2. aggressiveness and impulsiveness, 3. conversive neurotic disorders, 4. psychotic dissociation, 5. psychotic regression and 6. extroversion-introversion.The sample consisted of 4368 persons: 3496 subjects without a diagnosis, and 872 patients with a psychiatric diagnosis. Participants had to fill in the six personality questionnaire. Data were collected anonymously, during psychological treatment at the Neuropsychiatric Hospital ""Dr. Ivan Barbot"" in Popovača, at the Department of Occupational Medicine and Transport and the Department of Mental Health and Addiction Prevention at Dr. Andrija Štampar Institute of Public Health and for the purpose of selection of candidates for employment in the period from 1984 until today. Basic metric characteristics were determined for all scales. Factor structure of the scales was determined using principal component analysis; as canonical discriminant analysis, polar taxons analysis and canonical correlation analysis are special cases of factor analysis, results of factor analysis were used for further processing.Results from earlier studies are replicated on much larger sample: metric characteristics of scales are very good, as in previous studies, similar structure of polar taxons was found and discrimination between healthy subjects ad those with psychiatric diagnoses was successful. Canonical correlation analysis showed interconnection of reactions on certain scales and extremely complex relationship between them which indirectly confirms the theoretical model on the basis of which the scales are formed.The usefulness of this scales is confirmed in clinical setting and in selection of candidates for employment.",0 +https://doi.org/10.1192/bjp.186.6.494,Symptoms of post-traumatic stress disorder after non-traumatic events: evidence from an open population study,"Post-traumatic stress disorder (PTSD) is the only psychiatric condition that requires a specific event to have occurred for its diagnosis.To gather evidence from the adult general population on whether life events (e.g. divorce, unemployment) generate as many symptoms of post-traumatic stress as traumatic events (e.g. accidents, abuse).Data on demographic characteristics and history of stressful events were collected through a written questionnaire sent to a random sample of 2997 adults. Respondents also filled out a PTSD symptom checklist, keeping in mind their worst event. Mean PTSD scores were compared, controlling for differences between the two groups. Differences in item scores and in the distribution of the total PTSD scores were analysed.Of the 1498 respondents, 832 were eligible for inclusion in our analysis. For events from the past 30 years the PTSD scores were higher after life events than after traumatic events; for earlier events the scores were the same for both types of events. These findings could not be explained by differences in demographics, history of stressful events, individual item scores, or the distribution of the total PTSD scores.Life events can generate at least as many PTSD symptoms as traumatic events. Our findings call for further studies on the specificity of traumatic events as a cause of PTSD.",0 +https://doi.org/10.1007/s00127-012-0541-6,Family cohesion and posttraumatic intrusion and avoidance among war veterans: a 20-year longitudinal study,"Background: The bi-directional relationships between combat-induced posttraumatic symptoms and family relations are yet to be understood. The present study assesses the longitudinal interrelationship of posttraumatic intrusion and avoidance and family cohesion among 208 Israeli combat veterans from the 1982 Lebanon War. Methods: Two groups of veterans were assessed with self-report questionnaires 1, 3 and 20 years after the war: a combat stress reaction (CSR) group and a matched non-CSR control group. Results: Latent Trajectories Modeling showed that veterans of the CSR group reported higher intrusion and avoidance than non-CSR veterans at all three points of time. With time, there was a decline in these symptoms in both groups, but the decline was more salient among the CSR group. The latter also reported lower levels of family cohesion. Furthermore, an incline in family cohesion levels was found in both groups over the years. Most importantly, Autoregressive Cross-Lagged Modeling among CSR and non-CSR veterans revealed that CSR veterans' posttraumatic symptoms in 1983 predicted lower family cohesion in 1985, and lower family cohesion, in turn, predicted posttraumatic symptoms in 2002. Conclusions: The findings suggest that psychological breakdown on the battlefield is a marker for future family cohesion difficulties. Our results lend further support for the bi-directional mutual effects of posttraumatic symptoms and family cohesion over time. © 2012 Springer-Verlag.",0 +https://doi.org/10.1007/s10286-012-0182-6,Autonomic dysfunction in women with chronic pelvic pain,"We compared the Autonomic Symptom Profile results in 16 women with chronic pelvic pain (CPP) and 15 age-matched healthy subjects. Moderately severe generalized autonomic symptomology occurs in women with CPP, but not in controls. Further study including autonomic testing is needed to confirm results and explore the mechanism of dysfunction.",0 +https://doi.org/10.1207/s15327558ijbm0401_6,You want to measure coping but your protocol’ too long: Consider the brief cope,"Studies of coping in applied settings often confront the need to minimize time demands on participants. The problem of participant response burden is exacerbated further by the fact that these studies typically are designed to test multiple hypotheses with the same sample, a strategy that entails the use of many time-consuming measures. Such research would benefit from a brief measure of coping assessing several responses known to be relevant to effective and ineffective coping. This article presents such a brief form of a previously published measure called the COPE inventory (Carver, Scheier, & Wcintraub, 1989), which has proven to be useful in health-related research. The Brief COPE omits two scales of the full COPE, reduces others to two items per scale, and adds one scale. Psychometric properties of the Brief COPE arc reported, derived from a sample of adults participating in a study of the process of recovery after Hurricane Andrew.",0 +https://doi.org/10.1097/00005650-200104000-00004,Posttraumatic Concerns: A Patient-Centered Approach to Outcome Assessment After Traumatic Physical Injury,"Approximately 2.5 million Americans are admitted to the hospital after traumatic physical injury each year. Few investigations have elicited patients' perspectives regarding posttraumatic outcomes.To identify and categorize physically injured trauma survivors' posttraumatic concerns.Prospective longitudinal investigation; trauma survivors were interviewed during the post-injury hospitalization and again 1, 4, and 12 months after the trauma.Ninety-seven, randomly selected, English speaking, hospitalized survivors of motor vehicle-crashes or assaults.At the end of each interview patients were asked, ""Of all the things that have happened to you since you were injured, what concerns you the most?"" Using an iterative process and working by consensus, investigators categorized patient concerns in content domains. Concern domains were then compared with established measures of posttraumatic stress disorder (PTSD) symptoms and limitations in physical functioning.Seven categories of posttraumatic concerns were identified. During the course of the year, 73% of patients expressed physical health concerns, 58% psychological concerns, 53% work and finance concerns, 40% social concerns, 10% legal concerns, 10% medical concerns, and 20% uncodable concerns. Rater agreement on concern categorization was substantial (kappa = 0.72). The mean number of concerns expressed per patient gradually decreased over time (1 month mean = 1.51; 12 month mean = 1.26) and resembled the trajectories of PTSD symptoms and functional limitations.The concerns of physically injured trauma survivors are readily elicited and followed up during the course of the year after injury. Open-ended inquiry regarding posttraumatic concerns may complement standardized outcome assessments by identifying and contextualizing the outcomes of greatest importance to patients.",0 +https://doi.org/10.1017/cbo9780511730030.013,Child Mental Health in the Aftermath of Disaster: A Review of PTSD Studies,"INTRODUCTION Epidemiological investigations provide strong evidence that experiencing disaster-related traumatic events in childhood can have significant adverse psychopathological consequences (Hoven et al., 2005; La Greca, Silverman, Vernberg, & Prinstein, 1996; Lonigan, Shannon, Finch, Jr., Daugherty, & Taylor, 1991). Clearly, understanding how such exposure to disaster affects children's mental health and psychosocial development is important, both for elucidating vulnerabilities specific to children, and for informing and guiding appropriate responses, including treatment, which fosters resilience and speeds recovery. The greatest promise for advancing knowledge on this topic depends upon systematic assessment, using diagnostic-based measures in well-designed, longitudinal investigations of representative samples of children (in sufficient numbers) to allow for meaningful analyses. Unfortunately, to date, no study with children that includes all of these elements could be identified. As a nascent field of inquiry, disaster mental health research in children is now ideally poised to review its own recent research, including emphasis and approach, so as to determine a future trajectory. In an effort to stimulate and facilitate this process and to identify critical knowledge gaps, this chapter systematically examines the extant literature, focusing on methodological issues. In an effort to identify lacunae in our collective research agenda, we offer a conceptual typology, or classification schema, for reviewing the kinds of disasters that have been studied and the research methods employed. © Cambridge University Press 2009.",0 +https://doi.org/10.1521/psyc.2007.70.4.320,Community Resilience and the Principles of Mass Trauma Intervention,"Drawing upon literatures in several disciplines, Norris and colleagues (in press) concluded that the resilience of communities, and consequently the wellness of communities, rests upon a network of adaptive capacities, particularly Economic Development, Social Capital, Information and Communication, and Community Competence. There are numerous ways in which efforts to build community resilience might also achieve the five essential elements of mass trauma intervention explicated by Hobfoll and colleagues. Thus, it is argued here that efforts to reduce risk and resource inequities, engage local people in mitigation, create organizational linkages, boost and protect social supports, cultivate trusted and responsible information resources, and enhance decision–making skills will augment more specific intervention efforts to promote safety, calming, efficacy, hope, and connectedness in the aftermath of mass trauma. Many of these outcomes require systems and social changes that can be the target of intervention efforts before as well as after disasters.",0 +https://doi.org/10.1002/1097-4679(199309)49:5<663::aid-jclp2270490508>3.0.co;2-a,NEO-PI profiles in PTSD as a function of trauma level,"One hundred Vietnam veterans with combat-related PTSD were administered the NEO Personality Inventory (NEO-PI) and the Combat Exposure Scale and were sorted into three groups based on trauma exposure level. Results indicate no significant differences among the personality profiles of the three trauma-exposed groups. A normative NEO-PI profile for persons diagnosed with combat-related PTSD is presented, characterized by an extremely high Neuroticism score (T > 75) and an extremely low Agreeableness score (T < 25).",0 +https://doi.org/10.1176/appi.ajp.157.2.255,Auditory Startle Response in Trauma Survivors With Posttraumatic Stress Disorder: A Prospective Study,"Previous studies have shown elevated autonomic responses to startling tones in trauma survivors with chronic posttraumatic stress disorder (PTSD). The origin of these abnormal responses is obscure. The present study attempted to clarify this issue by prospectively evaluating responses to sudden, loud tones in individuals who arrived at a hospital emergency room after psychologically traumatic events.By using a previously established protocol, autonomic and muscular responses to the tones were evaluated at 1 week, 1 month, and 4 months after the traumatic event. Structured diagnostic interviews performed at 4 months classified subjects into groups with (N=36) and without (N=182) PTSD, which were further subdivided according to the presence or absence of major depressive disorder as follows: neither PTSD nor depression (N=166), depression alone (N=16), PTSD alone (N=21), and both PTSD and depression (N=15).The groups showed comparable physiological responses to the tones at 1 week posttrauma. However, at 1 and 4 months posttrauma, the subjects with PTSD showed a greater heart rate response and required more stimulus trials to reach the criteria of skin conductance and orbicularis oculi electromyogram nonresponse. These findings were not significantly influenced by comorbid depression and were not explained by the severity of the traumatic event or by the intensity of the initial symptoms.Differences in physiological response to startling tones develop along with PTSD in the months that follow a traumatic event. This pattern supports the theories that associate PTSD with progressive neuronal sensitization.",0 +https://doi.org/10.1016/j.paid.2015.08.053,"Post-traumatic stress symptom, metacognition, emotional schema and emotion regulation: A structural equation model","Abstract Objective The present study aimed to assess the direct and indirect impacts of the metacognition, emotional schema and emotion regulation in prediction of post-traumatic stress (PTS) symptom. Method Participants consisted of 678 high school students from earthquake-stricken areas of eastern Azerbaijan selected from Varzaghan, Ahar and Heris by multistage cluster sampling. PTSD Symptom Scale—Self Report (PSS-SR), Metacognition Questionnaire—Adolescent Version (MCQ-A), Leahy Emotional Schema Scale (LESS) and Difficulties in Emotion Regulation Scale (DERS) were utilized for data collection. SPSS software and LISREL software were used for data analysis. Results The results of SEM and path analysis indicated the direct and indirect (through emotion regulation) impacts of metacognition and also indirect (through emotion regulation) impact of emotional schema on PTS symptom. Model examination presented the good fitness of the proposed theoretical model. Conclusions Consistent with metacognitive model and also emotional schema model, results of this study indicated the impact of metacognition and emotional schema on post-traumatic stress symptom through emotion regulation. This finding emphasizes that both metacognitive and emotional factors are important in explanation of PTS symptom.",0 +https://doi.org/10.1002/1097-4679(198711)43:6<643::aid-jclp2270430602>3.0.co;2-r,Five psychosocial variables related to the existence of Post-Traumatic Stress Disorder symptoms,"Sixty Vietnam veterans from a midwestern VA Medical Center were surveyed to determine the relationship between symptoms of Post-Traumatic Stress Disorder (PTSD) and five psychosocial variables: Intensity of combat experienced in Vietnam, current subjective impact of the previously experienced stress of Vietnam experiences, current level of life stress, extent and nature of social support available to the veteran during the first year of return from Vietnam, and pre-service psychosocial functioning. A stepwise discriminant function analysis revealed that combat intensity, current impact of the previously experienced events in Vietnam, and current level of life stress correctly classified 75% of the total cases. These findings were supported by other lines of analyses, including tests of correlation and stepwise regression analysis. Current levels of life stress, especially disruption in interpersonal relationships, also were associated significantly with PTSD symptoms. These findings are consistent with previous reports on the etiology and correlates of PTSD symptoms and suggest the existence of a quantifiable constellation of symptoms associated with psychological sequelae of severely stressful trauma.",0 +,Post traumatic stress disorder in armed robbery victims and ex-prisoners of war,"The aim of this study was to examine the prevalence of Post Traumatic Stress Disorder (PTSD) symptom clusters in 72 armed robbery victims (AR) at their work place. 19 were assaulted twice or three times, while 15 suffered mild or minor physical injury. Subjects were 47 female and 25 male employees who were having 1 to 11 months of sick leave period at the time of examination. According to psychiatric examination 38.9% fulfilled criteria for PTSD, while others had different combination of symptoms. Statistical analysis showed that the whole group dominantly expressed persistent re-experience of the event, followed by arousal symptoms. Those with full PTSD diagnosis did not differ from others in age, level of education, number of assaults, length of sick leave period or the fact that they had or had not been physically injured. No difference was found between those who suffered only one attack and those who were assaulted two or three times in a short period of time. The repetition of identical or very similar trauma situation did not contribute to the increased number of psychological problems measured by PTSD scales. Additionally we compared the structure of PTSD in AR victims and in a group of 100 male ex-prisoners of war (ex-POW). The results indicate greater occurrence of full PTSD in AR group, as well as re-experience and arousal symptoms combination in those with partial PTSD, while ex-POW group dominantly showed arousal symptoms as isolated cluster, followed by combination of re-experience and arousal symptoms.",0 +https://doi.org/10.1016/s0002-9343(97)89443-0,Screening in special populations: A “case study” of recent vietnamese immigrants,"

Purpose

To determine how the medical and social profile of a particular special population, Vietnamese immigrants, should be used to tailor screening protocols that differ from those designed for the general population.

Patients and methods

A consecutive series of Vietnamese immigrants living in the United States for less than 6 months were evaluated by interviewer-administered standardized questionnaire and medical record review. A total of 99 new Vietnamese immigrants (47 women and 52 men) aged 19 to 71 years presenting for primary care to two neighborhood health centers between October 1994 and June 1995 were identified. Data collected included smoking status, alcohol use (CAGE questionnaire), depression (Vietnamese Depression Scale [VDS]), PPD status, stool ova and parasites, hepatitis B and syphilis serologies.

Results

Overall, 32% were smokers and significantly more men than women smoked (54% vs. 9%) (P <.00001). Although 24% of patients used alcohol, none responded positively to any of the CAGE questions. Using the VDS, 17% (17 of 99) were depressed; age 40 and older was the only sociodemographic factor associated with depression (P <.00001). Ova or parasites were found in 51% (41 of 80), and 63% of those infected (26 of 41) required treatment for pathogenic infections. Seventy percent (66 of 94) tested positive on the tuberculin skin test (PPD), and antituberculous medication was recommended in 39% (37 of 94). Eighty-three percent (80 of 96) had been exposed to hepatitis B, and 14% (13 of 96) were chronic hepatitis B carriers.

Conclusions

Caring for special populations provides an opportunity to institute appropriate unique screening tests not recommended for the general population. In the case of new Vietnamese immigrants, routine screening protocols should include the following: testing for tuberculosis by PPD, stool ova and parasite examinations, hepatitis B serologies, and assessment for depression and smoking status. The CAGE questionnaire may not be an effective instrument for detecting alcohol abuse in this particular population.",0 +https://doi.org/10.1016/j.injury.2012.08.034,Procedural justice and quality of life in compensation processes,"There is considerable evidence that being involved in compensation processes has a negative impact on claimants' health. Previous studies suggested that this negative effect is caused by a stressful compensation process: claimants suffered from a lack of communication, a lack of information, and feelings of distrust. However, these rather qualitative findings have not been quantitatively investigated yet. This observational study aimed to fill this gap of knowledge, investigating the claimants' perceived fairness of the compensation process, the provided information, and the interaction with lawyers and insurance companies, in relation to the claimants' quality of life.Participants were individuals injured in traffic accidents, older than 18 years, who were involved in a compensation process in the Netherlands. They were recruited by three claims settlement offices. Outcome measures were procedural, interactional, and informational justice, and quality of life.Participants (n=176) perceived the interaction with lawyers to be fairer than the interaction with insurance companies (p<.001). The length of hospital stay was positively associated with procedural justice (β=.31, p<.001). Having trunk/back injury was negatively related to procedural justice (β=-.25, p=.001). Whiplash injury and length of time involved in the claim process were not associated with any of the justice scales. Finally, procedural justice was found to be positively correlated with quality of life (rs=.22, p=.004).The finding that the interaction with insurance companies was considered less fair than the interaction with lawyers may imply that insurers could improve their interaction with claimants, e.g. by communicating more directly. The result that claimants with mild injuries and with trunk/back injuries considered the compensation process to be less fair than those with respectively severe injuries and injuries to other body parts suggests that especially the former two require an attentive treatment. Finally, the fact that procedural justice was positively correlated with quality of life could implicate that it is possible to improve claimants' health in compensation processes by enhancing procedural justice, e.g. by increasing the ability for claimants to express their views and feelings and by involving claimants in the decision-making process.",0 +https://doi.org/10.1371/journal.pone.0119929,Flooding and Mental Health: A Systematic Mapping Review,"Floods are the most common type of global natural disaster. Floods have a negative impact on mental health. Comprehensive evaluation and review of the literature are lacking.To systematically map and review available scientific evidence on mental health impacts of floods caused by extended periods of heavy rain in river catchments.We performed a systematic mapping review of published scientific literature in five languages for mixed studies on floods and mental health. PUBMED and Web of Science were searched to identify all relevant articles from 1994 to May 2014 (no restrictions).The electronic search strategy identified 1331 potentially relevant papers. Finally, 83 papers met the inclusion criteria. Four broad areas are identified: i) the main mental health disorders-post-traumatic stress disorder, depression and anxiety; ii] the factors associated with mental health among those affected by floods; iii) the narratives associated with flooding, which focuses on the long-term impacts of flooding on mental health as a consequence of the secondary stressors; and iv) the management actions identified. The quantitative and qualitative studies have consistent findings. However, very few studies have used mixed methods to quantify the size of the mental health burden as well as exploration of in-depth narratives. Methodological limitations include control of potential confounders and short-term follow up.Floods following extreme events were excluded from our review.Although the level of exposure to floods has been systematically associated with mental health problems, the paucity of longitudinal studies and lack of confounding controls precludes strong conclusions.We recommend that future research in this area include mixed-method studies that are purposefully designed, using more rigorous methods. Studies should also focus on vulnerable groups and include analyses of policy and practical responses.",0 +https://doi.org/10.1037//0021-843x.110.3.392,Patterns of recovery from trauma: The use of intraindividual analysis.,"Patterns of recovery from sexual and nonsexual assault were examined. Two studies containing data from female victims of these assaults were analyzed. In Study 1, victims (N = 101) underwent 12 weekly assessments with measures of posttraumatic stress disorder (PTSD), depression, and state anxiety. In Study 2, victims (N = 108) underwent monthly assessments on the same measures. The authors examined the effects of type of trauma and time of peak reaction on long-term recovery using intraindividual analysis of change. In both studies, initial and peak reactions of rape victims were more severe than were those of nonsexual assault victims on all measures of psychopathology. Victims with delayed peak reaction exhibited more severe pathology at the final assessment than did victims with early peak reaction. Results of Study 2 indicated a slower recovery rate from sexual than nonsexual assault; in Study 1 a similar pattern of recovery emerged. The advantages of an individual-focused, longitudinal approach to recovery from a trauma are discussed.",0 +https://doi.org/10.1016/j.injury.2014.02.015,Psychosocial care for seriously injured children and their families: A qualitative study among Emergency Department nurses and physicians,"Approximately one in five children who sustain a serious injury develops persistent stress symptoms. Emergency Department nurses and physicians have a pivotal role in psychosocial care for seriously injured children. However, little is known about staff's views on this role.Our aim was to investigate Emergency Department staff's views on psychosocial care for seriously injured children.We conducted semi-structured interviews with 20 nurses and physicians working in an Australian Paediatric Emergency Department. We used purposive sampling to obtain a variety of views. The interviews were transcribed verbatim and major themes were derived in line with the summative analysis method. We also mapped participants' strategies for child and family support on the eight principles of Psychological First Aid (PFA).Five overarching themes emerged: (1) staff find psychosocial issues important but focus on physical care; (2) staff are aware of individual differences but have contrasting views on vulnerability; (3) parents have a central role; (4) staff use a variety of psychosocial strategies to support children, based on instinct and experience but not training; and (5) staff have individually different wishes regarding staff- and self-care. Staff elaborated most on strategies related to the PFA elements 'contact and engagement', 'stabilization', 'connection with social supports' and least on 'informing about coping'.The strong notion of individual differences in views suggests a need for training in psychosocial care for injured children and their families. In addition, further research on paediatric traumatic stress and psychosocial care in the ED will help to overcome the current paucity of the literature. Finally, a system of peer support may accommodate wishes regarding staff care.",0 +https://doi.org/10.1016/j.jad.2006.02.025,"Toward an integrative model of the spectrum of mood, behavioral and personality disorders based on fear and anger traits: I. Clinical implications","Current formal psychiatric approaches to nosology are plagued by an unwieldy degree of heterogeneity with insufficient appreciation of the commonalities of emotional, personality, behavioral, and addictive disorders. We address this challenge by building a spectrum model that integrates the advantages of Cloninger's and Akiskalian approaches to personality and temperament while avoiding some of their limitations. We specifically propose that ""fear"" and ""anger"" traits--used in a broader connotation than in the conventional literature--provide an optimum basis for understanding how the spectra of anxiety, depressive, bipolar, ADHD, alcohol, substance use and other impulse-control, as well as cluster B and C personality disorders arise and relate to one another. By erecting a bidimensional approach, we attempt to resolve the paradox that apparently polar conditions (e.g. depression and mania, compulsivity and impulsivity, internalizing and externalizing disorders) can coexist without cancelling one another. The combination of excessive or deficient fear and anger traits produces 4 main quadrants corresponding to the main temperament types of hyperthymic, depressive, cyclothymic and labile individuals, which roughly correspond to bipolar I, unipolar depression, bipolar II and ADHD, respectively. Other affective temperaments resulting from excess or deficiency of only fear or anger include irritable, anxious, apathetic and hyperactive. Our model does not consider schizophrenia. We propose that ""healthy"" or euthymic individuals would have average or moderate fear and anger traits. We further propose that family history, course and comorbidity patterns can also be understood based on fear and anger traits. We finally discuss the implications of the new derived model for clinical diagnosis of the common psychiatric disorders, and for subtyping depression and anxiety as well as cognitive and behavioral styles. We submit this proposed schema represented herein as a heuristic attempt to build bridges between basic and clinical science.",0 +https://doi.org/10.1016/s0165-1781(98)00094-8,The two-factorial symptom structure of post-traumatic stress disorder: depression–avoidance and arousal–anxiety,"The first part of this study showed that the DSM-III-R symptom structure of post-traumatic stress disorder (PTSD), i.e. criteria B (reexperience), C (avoidance-numbing), and D (arousal), and, consequently the diagnosis of PTSD, could not be validated in fire and car-accident victims. The aims of this study were to: (i) determine the factors as well as their structure in the symptoms of PTSD; and (ii) develop a new classification or typology of PTSD. Exploratory and confirmatory factor analyses and cluster analyses were employed to: (i) examine the factors in PTSD symptomatology; and (ii) find and validate adequate diagnostic criteria for PTSD. The Composite International Diagnostic Interview (CIDI), PTSD Module, was used between 7 and 9 months after the traumatic event in a study group of 185 victims of two different traumatic events, i.e. 130 fire and 55 car-accident victims. Our findings support the existence of two factors, i.e. a first labeled 'depression-avoidance (DAV) dimension', as it contains items reminiscent of depression and avoidance, and a second labeled 'the anxiety-arousal (AA) dimension', as it contains symptoms reminiscent of anxiety and increased arousal. Cluster analysis yielded two clusters, i.e. a cluster of subjects with PTSD cases and another with non-cases. Our PTSD algorithm was significantly less restrictive than the DSM-III-R diagnosis of PTSD. There are only quantitative, but no qualitative, differences between the cluster analytically derived classes.PTSD is not a well-delineated clinical entity, as there is a clinical continuum from PTSD non-cases to cases with less and more severe DAV and AA symptoms. It is more appropriate to express PTSD in terms of general severity of PTSD and severity of the DAV and AA dimensions.",0 +https://doi.org/10.1016/j.psychres.2015.04.024,"Longitudinal linkages between posttraumatic stress disorder and posttraumatic growth in adolescent survivors following the Wenchuan earthquake in China: A three-wave, cross-lagged study","The aim of this study is to examine the longitudinal relationships between posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) among adolescent survivors of the 2008 Wenchuan earthquake in China. The participants in our study included 245 adolescent survivors who were randomly selected from several primary and secondary schools in the counties of Wenchuan, which are the areas most severely affected by the Wenchuan earthquake. Participants completed the Revised Child PTSD Symptom Scale and the Posttraumatic Growth Inventory (PTGI) at 3.5 years after the earthquake (T1), 4.5 years after the earthquake (T2), and 5.5 years after the earthquake (T3). The results found that PTSD reported in T1 and T2 predicted subsequent PTG reported at T2 and T3 and that PTG did not predict PTSD from T1 to T3. In addition, the cross-sectional correlation between PTSD and PTG weakened from T1 to T3. These results indicate that PTSD and PTG can coexist in individuals after a traumatic experience, and they further suggest that the reduction in PTSD does not indicate the appearance of PTG.",0 +https://doi.org/10.7205/milmed-d-09-00085,The Role of Emotional Numbing in Sexual Functioning Among Veterans of the Iraq and Afghanistan Wars,"Post-traumatic stress disorder (PTSD) negatively impacts sexuality, yet few studies have evaluated which component of PTSD contributes to this known association. The present study examined which of four PTSD clusters (numbing, avoidance, intrusiveness, and hyperarousal) was most closely linked to sexual problems in a sample of 197 veterans from the Iraq or Afghanistan wars. Newly registered veterans completed a packet of questionnaires including standardized measures of PTSD and questions regarding sexual functioning. A stepwise logistic regression was performed to examine the relationship between symptom cluster and sexual functioning. As predicted, only the numbing cluster was retained in the regression model. The numbing cluster appears to be intimately tied to sexual functioning, assessment of which should be part of a comprehensive evaluation during the postdeployment readjustment phase. Those exhibiting numbing symptoms should be thoroughly assessed for sexual functioning problems and referred for treatment as necessary.",0 +https://doi.org/10.1111/j.1365-2702.2007.01966.x,Predictors of healthy behaviour in long-term survivors of childhood cancer,"Aim. The objective of this study was to examine the factors contributing to healthy behaviour in young adult long-term survivors of childhood cancer. Background. Young adult childhood cancer survivors can adopt more healthy behaviour than the general population as a way to minimize the adverse consequences, that is, late effects of cancer and its treatment. Knowledge about the predictors of healthy behaviour in childhood cancer survivors can help providers assist young adult survivors with minimizing late effects. Design and methods. A cross-sectional correlational design and convenience sampling were used. Data were collected by mailed survey. Study measures included an investigator-developed demographic and disease form, the Mishel Uncertainty in Illness Scale-Community, the Post-traumatic Stress Disorder Index and the Health Promoting Lifestyle Profile II. Fifty-one per cent (N = 46) of eligible survivors responded to the survey. Data from 45 participants were used in the analyses. Results. 43·3% of variance in healthy behaviour was explained by a model that included uncertainty (β = −0·37, p = 0·007), post-traumatic stress symptoms (β = −0·10, p = −0·44), interactions with primary care providers (β = 0·33, p = 0·01) and a history of special educational assistance (β = −0·23, p = 0·06). Conclusion. Young adult childhood cancer survivors who have higher levels of uncertainty, higher levels of symptoms of post-traumatic stress, lower frequency of primary healthcare interaction and poorer cognitive resources were more likely to report lower levels of healthy behaviour. Relevance to clinical practice. The findings can guide the clinical assessment of young adult survivors with regard to their health behaviours and needs they may have for education and supportive care. Findings also help inform the design of health promotion interventions for this specific group of cancer survivors.",0 +https://doi.org/10.1002/(sici)1097-4679(199902)55:2<217::aid-jclp9>3.0.co;2-i,"Differential diagnosis of PTSD, schizophrenia, and depression with the MMPI-2","This study used 102 male, veteran, psychiatric inpatients to describe patterns of MMPI-2 clinical and content scales that most accurately discriminate among patients diagnosed with PTSD, schizophrenia, and depression. Single scale accuracy classification using scales PK and PS was unacceptably low. Optimally weighted scales, including PK, Sc, BIZ, and ANX, correctly classified 70% of the patients. Suggestions for facilitating the use of formal decision rules are offered. © 1999 John Wiley & Sons, Inc. J Clin Psychol 55: 217–223, 1999.",0 +,[Psychopathological profile of battered women according to age].,"In this paper, differential psychopathological consequences in battered women according to age were analysed in a sample of 148 victims seeking psychological treatment in a Family Violence Centre. The younger victims exposed to intimate partner violence suffered more often from physical violence and were at higher risk for their lives than the older ones. The prevalence rate of posttraumatic stress disorder (PTSD) was higher (42%) in the younger victims than in the older ones (27%). Likewise, younger victims were affected by more depressive symptoms and lower self-esteem than the older ones. The severity of PTSD in the younger victims was related to the presence of forced sexual relationship but in the older ones, it was related to the perceived threat to their lives. Implications of this study for clinical practice and future research in this field are commented upon.",0 +https://doi.org/10.1016/j.comppsych.2013.07.006,Anxiety disorders as early stages of malignant psychopathological long-term outcomes: results of the 10-years prospective EDSP Study,"Introduction: Epidemiological studies consistently evidence that anxiety, depressive and substance use disorders are the most frequent mental disorders in adults with high rates of comorbidity. Little long-term outcome research has examined the psychopathological developmental trajectories which would allow for conclusions regarding improved early identification and targeted intervention. Methods: A representative community sample (N = 3,021; age 14-24) was prospectively followed-up over 10 years. Mental disorders were assessed using a standardized diagnostic interview (DSM-IV/M-CIDI). Results: While anxiety disorders reveal the earliest onset in childhood and adolescents, the incidence for depressive and substance use disorders increases in adolescence and young adulthood. Two thirds of those with an anxiety, depressive, or substance use disorder reveal comorbidity with an average of 3.3 diagnoses (SD = 1.7). Among those with any comorbidity, 79.1% meet criteria for a substance use disorder, 52.8% for a depressive disorder, and 59.6% for an anxiety disorder. While anxiety disorders emerge temporally primary in the majority of comorbid cases (74.2%), substance use (67.5%) and depressive disorders (71.8%) are mostly secondary onset conditions. Circumscribed phobias (specific phobia, social phobia, phobia NOS) and panic attacks increase the risk for onset of comorbid - more complex - anxiety disorders (GAD, panic disorder, agoraphobia, OCD, PTSD) (Hazard Ratio (HR) = 2.5, p < .001). Survival analyses with Cox regressions revealed that the higher the overall number of anxiety diagnoses, the greater the risk for subsequent substance use disorders (HR1 vs 0 Anx = 1.5, HR2 vs 0 Anx = 2.3, HR3+ vs 0 Anx = 2.6; p < .001), depression (HR1 vs 0 Anx = 2.0,HR2 vs 0 Anx = 2.6,HR3+ vs 0 Anx = 3.6; p < .001), and suicidality (HR1 vs 0 Anx = 3.8,HR2 vs 0 Anx = 4.8,HR3+ vs 0 Anx = 21.8; p < .001). Conclusions: Childhood and adolescent anxiety syndromes and disorders are an important gateway for unfavourable long-term psychopathological outcomes. Findings support 'sequential comorbidity' or 'staging models of psychopathology' which suggest that an early cascade of anxiety conditions contributes to a substantial proportion of adult substance use and depressive disorders, possibly due to self-medication and demoralization. Such models are of potential usefulness for diagnostic and treatment planning purposes, emphasizing the need for early identification and targeted interventions to prevent the onset of anxiety disorders and a cascade of secondary psychopathology.",0 +https://doi.org/10.1037/a0018041,Coping effectiveness and coping diversity under traumatic stress.,"The effectiveness of different strategies of coping and the impact of coping diversity were tested under traumatic stress conditions. Participants were 632 U.S. soldiers stationed in Iraq (mean age = 27.7, 98% male). Results indicate that four of nine functional coping strategies (including some emotion-focused coping) as defined by the COPE scale were inversely related to psychological symptom, whereas five of six dysfunctional strategies were positively related. Overall, in comparison to the norm group, soldiers showed a depressed level of functional coping strategies. Hierarchical regression, used to control for demographics and coping strategy intercorrelations, indicated that positive reinterpretation, emotional social support, and humor were most strongly related to lower psychological symptoms, whereas venting emotions, denial, mental disengagement, behavioral disengagement, and alcohol and drug use were related to higher levels of psychological symptoms. Two indices of coping diversity were tested. The index more strongly related to higher psychological adjustment was the sum of deviations from the mean of specific coping strategies combined with the alignment of functional and dysfunctional strategy clusters. Implications for research and application were discussed.",0 +https://doi.org/10.1891/jcop.20.2.201,Anxiety Sensitivity as a Moderator of the Relation Between Trauma Exposure Frequency and Posttraumatic Stress Symptomatology,"The present study tested if the global anxiety sensitivity construct and its constituent factors (i.e., physical, mental incapacitation, and social concerns) moderate the relation between traumatic event exposure frequency and posttraumatic stress symptomatology. Participants were 61 rural young adults who reported experiencing at least 1 lifetime traumatic event. Consistent with prediction, anxiety sensitivity total and subfactor levels moderated the relation between trauma exposure frequency and posttraumatic stress symptomatology. These moderating effects were above and beyond variance accounted for by the respective anxiety sensitivity and stress main effects as well as other theoretically relevant factors (e.g., negative affectivity). Findings are discussed in relation to better understanding cognitive-based individual difference factors associated with posttraumatic stress symptomatology.",0 +https://doi.org/10.1002/icd.483,On growth curves and mixture models,"The multilevel model of change and the latent growth model are flexible means to describe all sorts of population heterogeneity with respect to growth and development, including the presence of sub-populations. The growth mixture model is a natural extension of these models. It comes at hand when information about sub-populations is missing and researchers nevertheless want to retrieve developmental trajectories from sub-populations. We argue that researchers have to make rather strong assumptions about the sub-populations or latent trajectory classes in order to retrieve existing population differences. A simulated example is discussed, showing that a sample of repeated measures drawn from two sub-populations easily leads to the mistaken inference of three sub-populations, when assumptions are not met. The merits of methodological advises on this issue are discussed. It is concluded that growth mixture models should be used with understanding, and offer no free way to growth patterns in unknown sub-populations. Copyright © 2006 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1023/a:1024465902416,Predictors of chronic posttraumatic stress symptoms following burn injury: Results of a longitudinal study,"The authors' goal was to examine the course and predictors of posttraumatic stress symptoms among persons hospitalized for burns. A total of 301 participants completed self-report measures assessing peritraumatic mental state, anxiety related to pain, and posttraumatic stress symptoms. Twenty-six percent of the participants were suffering from posttraumatic stress symptoms at 2-3 weeks postburn and 15% of them at 12 months postburns. In general, a decrease in symptoms was observed over time, although a substantial part of the participants with acute stress symptoms suffers from chronic posttraumatic stress symptoms 1-year postburn. Symptoms were predicted by anxiety measures and objective factors, such as female gender, locus, and severity of injury.",0 +https://doi.org/10.1124/jpet.112.200915,"ADX71743, a Potent and Selective Negative Allosteric Modulator of Metabotropic Glutamate Receptor 7: In Vitro and In Vivo Characterization","Metabotropic glutamate receptor 7 (mGlu(7)) has been suggested to be a promising novel target for treatment of a range of disorders, including anxiety, post-traumatic stress disorder, depression, drug abuse, and schizophrenia. Here we characterized a potent and selective mGlu(7) negative allosteric modulator (NAM) (+)-6-(2,4-dimethylphenyl)-2-ethyl-6,7-dihydrobenzo[d]oxazol-4(5H)-one (ADX71743). In vitro, Schild plot analysis and reversibility tests at the target confirmed the NAM properties of the compound and attenuation of L-(+)-2-amino-4-phosphonobutyric acid-induced synaptic depression confirmed activity at the native receptor. The pharmacokinetic analysis of ADX71743 in mice and rats revealed that it is bioavailable after s.c. administration and is brain penetrant (cerebrospinal fluid concentration/total plasma concentration ratio at C(max) = 5.3%). In vivo, ADX71743 (50, 100, 150 mg/kg, s.c.) caused no impairment of locomotor activity in rats and mice or activity on rotarod in mice. ADX71743 had an anxiolytic-like profile in the marble burying and elevated plus maze tests, dose-dependently reducing the number of buried marbles and increasing open arm exploration, respectively. Whereas ADX71743 caused a small reduction in amphetamine-induced hyperactivity in mice, it was inactive in the mouse 2,5-dimethoxy-4-iodoamphetamine-induced head twitch and the rat conditioned avoidance response tests. In addition, the compound was inactive in the mouse forced swim test. These data suggest that ADX71743 is a suitable compound to help unravel the physiologic role of mGlu(7) and to better understand its implication in central nervous system diseases. Our in vivo tests using ADX71743, reported here, suggest that pharmacological inhibition of mGlu(7) is a valid approach for developing novel pharmacotherapies to treat anxiety disorders, but may not be suitable for treatment of depression or psychosis.",0 +https://doi.org/10.1016/j.genhosppsych.2013.10.004,"The association between childhood trauma and lipid levels in an adult low-income, minority population","BACKGROUND: The objective of this study is to investigate the association between childhood trauma and lipid profiles in adults from a highly traumatized population at-risk for cardiovascular disease. METHOD: We recruited 452 participants, primarily African-American and of low socioeconomic status, from general medical clinics in a large urban hospital. We performed direct comparisons, univariate analysis of variance and regression analyses together and separated by sex, examining the associations of child abuse, body mass index, lipid lowering drug use, blood pressure, age, and substance use to HDL levels and HDL/LDL ratios. RESULTS: A history of moderate to severe levels of childhood trauma and abuse was associated with a significant decrease in HDL levels (P≤.01) and HDL/LDL ratios (P≤.001) relative to males with low levels of abuse. This relationship held when the status of lipid-lowering drugs was considered. When controlling for age, substance abuse, tobacco use, and adult trauma, the effects of childhood trauma remained significant. We found a significant child abuse by sex interaction on HDL/LDL ratios [F(1,369)=13.0, P≤.0005] consistent with a differential effect of trauma on dyslipidemia in male but not female subjects. CONCLUSIONS: Our data suggest that childhood trauma exposure, obtained with self-report measures, may contribute to increased risk of cardiovascular disease by way of stress-mediated alterations of lipid concentration and composition in male, but not female, subjects. Language: en",0 +https://doi.org/10.1093/ije/dyr096,Profile of two cohorts: UK and US prospective studies of military health,"Abstract : In the United Kingdom and United States, these two independent cohort studies have been instituted to prospectively study the health of service personnel and veterans. From comparisons with baseline information, these studies are designed to better inform the military and the public on how best to protect the health of their armed forces and better understand the long-term risks of some occupational exposures that extend beyond military communities. In order to do this, these studies consider: 1) The underlying physical and mental health of the military populations before, during, and after military service; and 2) The specific effects of deployment, deployment-related exposures, and other occupational exposures upon personnel compared with unexposed subgroups. Whilst previous studies have attempted to address these topics, they have often been limited in their generalisability to all service branches and components of the military, or previous population-based methodologies have been largely limited to cross-sectional or retrospective methods. Although follow-up to the National Vietnam Veterans Readjustment Survey, called the National Vietnam Veterans Longitudinal Study, is still ongoing, this study is focused on a single deployment. Similarly, the Air Force Health study, a 20-year longitudinal study of approximately 20,000 Vietnam veterans, assessed potential health effects associated with exposure to aerial spraying of dioxins. Here, we present two prospective, longitudinal, multi-service studies of active duty and Reserve/National Guard personnel that will continue to follow participants even after they have left military service. We describe these two studies in detail, comparing study populations, methodology, and the published literature so far. Potential areas for future collaboration are also explored. By understanding the inherent similarities and differences between these two cohorts and leveraging each study?s unique strengths and strategies to minimize",0 +https://doi.org/10.1016/j.chiabu.2015.02.007,"Associations between body mass index, post-traumatic stress disorder, and child maltreatment in young women","The objective of this study was to examine interrelationships between child maltreatment, post-traumatic stress disorder (PTSD) and body mass index (BMI) in young women. We used multinomial logistic regression models to explore the possibility that PTSD statistically mediates or moderates the association between BMI category and self-reported childhood sexual abuse (CSA), physical abuse (CPA), or neglect among 3,699 young women participating in a population-based twin study. Obese women had the highest prevalence of CSA, CPA, neglect, and PTSD (p<.001 for all). Although all three forms of child maltreatment were significantly, positively associated with overweight and obesity in unadjusted models, only CSA was significantly associated with obesity after adjusting for other forms of maltreatment and covariates (OR=2.21, 95% CI: 1.63, 3.00). CSA and neglect, but not CPA, were associated with underweight in unadjusted models; however, after adjusting for other forms of maltreatment and covariates, the associations were no longer statistically significant (OR=1.43, 95% CI: 0.90-2.28 and OR=2.16, 95% CI: 0.90-5.16 for CSA and neglect, respectively). Further adjustment for PTSD generally resulted in modest attenuation of effects across associations of child maltreatment forms with BMI categories, suggesting that PTSD may, at most, be only a weak partial mediator of these associations. Future longitudinal studies are needed to elucidate the mechanisms linking CSA and obesity and to further evaluate the role of PTSD in associations between child maltreatment and obesity.",0 +https://doi.org/10.1080/08870440903287926,"Relationships between explanatory style, posttraumatic growth and posttraumatic stress disorder symptoms among Chinese breast cancer patients","Many existing models posit that cognitive processing style is an important factor affecting self-perceived positive changes. In this study, the effects of explanatory style (the manner in which people cognitively process and explain why they experience good and bad events) on both posttraumatic growth (PTG) and posttraumatic stress disorder (PTSD) symptoms were examined among 90 Chinese women with breast cancer. It was found that explanatory style for good events, but not for bad events, was significantly associated with self-reported PTG. Women who attributed the causes of positive events to internal, global and stable factors tended to report more posttraumatic growth. In contrast, explanatory style for bad events, as opposed to good events, was significantly and positively correlated with PTSD symptoms. Among the three dimensions of explanatory style (internal, stable and global), the tendency to globalise the causes of good and bad events were the most important predictors of self-reported PTG and PTSD symptoms, respectively. While enhancing an optimistic explanatory style for bad events might reduce posttraumatic stress symptoms, cultivating an optimistic explanatory style for good events is likely to increase self-perceived positive changes after breast cancer diagnosis and treatment.",0 +https://doi.org/10.1111/jns.12087,Post-traumatic stress symptoms in Guillain-Barré syndrome patients after prolonged mechanical ventilation in ICU: a preliminary report,"Thirty percent of Guillain-Barré syndrome (GBS) patients require mechanical ventilation (MV) in intensive care unit (ICU). Post-traumatic stress disorder (PTSD) is found in ICU survivors, and the traumatic aspects of intubation and MV have been previously reported as risk factors for PTSD after ICU. Our objective was to determine long-term PTSD or post-traumatic stress symptoms (PTSS) in GBS patients after prolonged MV in ICU. We assessed GBS patients who had MV for more than 2 months. PTSD was assessed using Horowitz Impact of Event Scale (IES), IES-Revisited (IES-R), and the Post-traumatic CheckList Scale; functional outcome using Rankin and Barthel scales; quality of life (QoL) using Nottingham Health Profile (NHP) and 36-Item Short Form Health Survey (SF-36) and depression using Hospital Anxiety and Depression Scale (HAD) and Beck questionnaire. Thirteen patients could be identified and analyzed. They had only mild disability. They were neither anxious nor depressed with an anxiety HAD at 5 (4-11.5), a depression HAD at 1 (0-3.5) and a Beck at 1 (0-5). QoL was mildly decreased in our population with a NHP at 78.5 (12.8-178.8) and mild decreased SF-36. Compared with the French population, the SF-36 sub-categories were, however, not statistically different. Twenty-two percentage of our 13 patients had PTSD and PTSS with a Horowitz IES at 12 (2-29), and an IES-R at 16 (2-34.5). Although severe GBS patients requiring prolonged MV had good functional recovery and no difference in QoL, they had a high incidence of PTSS.",0 +https://doi.org/10.1371/journal.pone.0037690,Modelling Psychological Responses to the Great East Japan Earthquake and Nuclear Incident,"The Great East Japan (Tōhoku/Kanto) earthquake of March 2011 was followed by a major tsunami and nuclear incident. Several previous studies have suggested a number of psychological responses to such disasters. However, few previous studies have modelled individual differences in the risk perceptions of major events, or the implications of these perceptions for relevant behaviours. We conducted a survey specifically examining responses to the Great Japan earthquake and nuclear incident, with data collected 11-13 weeks following these events. 844 young respondents completed a questionnaire in three regions of Japan; Miyagi (close to the earthquake and leaking nuclear plants), Tokyo/Chiba (approximately 220 km from the nuclear plants), and Western Japan (Yamaguchi and Nagasaki, some 1000 km from the plants). Results indicated significant regional differences in risk perception, with greater concern over earthquake risks in Tokyo than in Miyagi or Western Japan. Structural equation analyses showed that shared normative concerns about earthquake and nuclear risks, conservation values, lack of trust in governmental advice about the nuclear hazard, and poor personal control over the nuclear incident were positively correlated with perceived earthquake and nuclear risks. These risk perceptions further predicted specific outcomes (e.g. modifying homes, avoiding going outside, contemplating leaving Japan). The strength and significance of these pathways varied by region. Mental health and practical implications of these findings are discussed in the light of the continuing uncertainties in Japan following the March 2011 events.",0 +https://doi.org/10.1111/j.1751-7893.2010.00199.x,Prevalence of post-traumatic stress disorder in first-episode psychosis,"Psychosis can be considered one of the most severe stressors that an individual may face. Previous studies have suggested that the traumatic experience of psychotic symptoms and hospitalization may provoke a post-traumatic type reaction.The aim of this study was to establish the point prevalence of post-traumatic stress disorder (PTSD) among patients recovering from a first-episode of psychosis in Singapore, and to elucidate the factors associated with it.Patients from the Early Psychosis Intervention Programme in Singapore, who were recovering from their first psychotic episode, participated in this study. Diagnoses were made using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) - Text Revised Axis I Disorders. The Clinician-Administered PTSD Scale, an interviewer-rated semi-structured interview, was used to diagnose PTSD.Sixty-one patients (30 males, 31 females) were recruited. Twelve (19.7%) patients were diagnosed with PTSD. Hospitalization for treatment, whether compulsory or otherwise, did not increase the rate of PTSD. The Chinese ethnic group had lower risk of developing PTSD (adjusted odds ratio 0.14, P = 0.018).There was a high prevalence of PTSD in patients recovering from their first psychotic episode. This study raises awareness among clinicians and hopes to promote early recognition and treatment of PTSD so as to potentially improve outcome.",0 +https://doi.org/10.1177/0004867411430877,Childhood trauma increases the risk of post-traumatic stress disorder in response to first-episode psychosis,"Objective: To investigate the relationship between childhood trauma, post-traumatic stress symptoms due to the experience of childhood trauma, and post-traumatic stress symptoms due to the experience of psychosis. Method: The current study assessed childhood trauma and post-traumatic stress disorder (PTSD) symptoms as a result of both childhood trauma and psychosis using the Impact of Events Scale - Revised, in a group of 36 people with first-episode psychosis. Results: Reported rates of clinical level post-psychotic PTSD symptoms, childhood trauma and childhood trauma-related clinical level PTSD symptoms were 47% (95% CI 31–64%), 64% (95% CI 48–80%) and 39% (95% CI 23–55%), respectively. Reporting childhood trauma increased the risk of developing post-psychosis PTSD 27-fold (95% CI 2.96–253.80, p = 0.01). Having childhood trauma-related PTSD increased the risk of developing post-psychosis PTSD 20-fold (95% CI 3.38–123.25, p = 0.01). These risks were not explained by illness factors such as duration of untreated psychosis, age of onset or severity of psychotic symptoms. Those without post-psychotic PTSD symptoms at clinical levels were unlikely to report childhood trauma (6%; 95% CI 3–8%). Conclusions: These results suggest the cognitive, social and biological consequences of childhood trauma can prevent effective recovery from the trauma of acute first-episode psychosis resulting in post-psychotic PTSD. Treatment strategies for post-psychotic PTSD must address childhood trauma and related PTSD.",0 +https://doi.org/10.1016/j.sleep.2012.02.014,Associations between Pittsburgh Sleep Quality Index factors and health outcomes in women with posttraumatic stress disorder,"The Pittsburgh Sleep Quality Index (PSQI) is a widely used measure of subjective sleep disturbance in clinical populations, including individuals with posttraumatic stress disorder (PTSD). Although the severity of sleep disturbance is generally represented by a global symptom score, recent factor analytic studies suggest that the PSQI is better characterized by a two- or three-factor model than a one-factor model. This study examined the replicability of two- and three-factor models of the PSQI, as well as the relationship between PSQI factors and health outcomes, in a female sample with PTSD.The PSQI was administered to 319 women with PTSD related to sexual or physical assault. Confirmatory factor analyses tested the relative fit of one-, two-, and three-factor solutions. Bivariate correlations were performed to examine the shared variance between PSQI sleep factors and measures of PTSD, depression, anger, and physical symptoms.Confirmatory factor analyses supported a three-factor model with Sleep Efficiency, Perceived Sleep Quality, and Daily Disturbances as separate indices of sleep quality. The severity of symptoms represented by the PSQI factors was positively associated with the severity of PTSD, depression, and physical symptoms. However, these health outcomes correlated as much or more with the global PSQI score as with PSQI factor scores.These results support the multidimensional structure of the PSQI. Despite this, the global PSQI score has as much or more explanatory power as individual PSQI factors in predicting health outcomes.",0 +https://doi.org/10.1037/a0017831,Trajectories of PTSD and substance use disorders in a longitudinal study of personality disorders.,"This study investigated the co-occurrence of posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) in a sample (N = 668) recruited for personality disorders and followed longitudinally as part of the Collaborative Longitudinal Personality Disorders Study. The study both examined rates of co-occurring disorders at baseline and temporal relationships between PTSD and substance use disorders over 4 years. Subjects with a lifetime history of PTSD at baseline had significantly higher rates of SUDs (both alcohol and drug) than subjects without PTSD. Latent class growth analysis, a relatively novel approach used to analyze trajectories and identify homogeneous subgroups of participant on the basis of probabilities of PTSD and SUD over time, identified 6 classes, which were compared with respect to a set of functioning and personality variables. The most consistent differences were observed between the group that displayed low probabilities of both SUD and PTSD and the group that displayed high probabilities of both.",0 +https://doi.org/10.1300/j229v07n01_03,Dissociative Symptomatology in Posttraumatic Stress Disorder and Disorders of Extreme Stress,"ABSTRACT The present study was designed to assess differences in dissociative symptoms in adults with Posttraumatic Stress Disorder (PTSD) vs. PTSD plus Disorders of Extreme Stress Not Otherwise Specified (DESNOS). This study was done for two reasons: (1) to better understand the clinical profile of DESNOS clients in order to inform more effective treatment, and (2) to further empirical research on the validity of the DESNOS construct. To assess severity of dissociative symptoms, the authors administered the Dissociative Experiences Scale (DES) to 155 participants with PTSD. Using the Structured Interview for Disorders of Extreme Stress (SIDES), participants were divided into two groups: those who also met criteria for DESNOS and those who did not. DES means are provided for the two groups. Participants with PTSD plus DESNOS scored higher than participants with only PTSD on the measure of dissociative symptomatology, particularly on the DES scales that tap absorption/fantasy and depersonalization/derealization. The two groups did not differ on the amnesia subscale of the DES. Findings support the construct validity of the DESNOS concept and further delineate the clinical profiles of community-based PTSD with and without DESNOS, thus contributing to the knowledge base on the assessment of complex adaptations to trauma.",0 +https://doi.org/10.1111/j.1600-0722.2006.00384.x,Psychological trauma exposure and trauma symptoms among individuals with high and low levels of dental anxiety,"This questionnaire-based study investigated the traumatic background and trauma-related symptomatology among 141 treatment-seeking individuals with high levels of dental anxiety and among a low-anxious reference group consisting of 99 regular dental patients. The highly anxious individuals reported a significantly higher number of traumatic events, both within and outside the dental or medical setting, than those in the reference group (73% vs. 21%). Horrific experiences in the dental setting were the most common traumatic events reported. Of the highly anxious individuals, 46.1% indicated suffering from one or more of the post-traumatic stress disorder (PTSD) symptom clusters (re-experiencing, avoidance, loss of interest, and insomnia), while in the reference group this percentage was 6%. Severity of dental anxiety was significantly associated with number of screening criteria for specific phobia and the extent to which the anxious subjects displayed symptoms of post-traumatic stress. Two variables were uniquely predictive for positive diagnostic screens for dental phobia and PTSD: having experienced a horrific dental treatment and having been a victim of a violent crime. In conclusion, post-traumatic symptoms are common accompaniments of severe forms of dental anxiety and are experienced even when dental treatment is not imminent.",0 +https://doi.org/10.1097/00005053-198612000-00004,"Development, Reliability, and Validity of a Dissociation Scale","Dissociation is a lack of the normal integration of thoughts, feelings, and experiences into the stream of consciousness and memory. Dissociation occurs to some degree in normal individuals and is thought to be more prevalent in persons with major mental illnesses. The Dissociative Experiences Scale (DES) has been developed to offer a means of reliably measuring dissociation in normal and clinical populations. Scale items were developed using clinical data and interviews, scales involving memory loss, and consultations with experts in dissociation. Pilot testing was performed to refine the wording and format of the scale. The scale is a 28-item self-report questionnaire. Subjects were asked to make slashes on 100-mm lines to indicate where they fall on a continuum for each question. In addition, demographic information (age, sex, occupation, and level of education) was collected so that the connection between these variables and scale scores could be examined. The mean of all item scores ranges from 0 to 100 and is called the DES score. The scale was administered to between 10 and 39 subjects in each of the following populations: normal adults, late adolescent college students, and persons suffering from alcoholism, agoraphobia, phobic-anxious disorders, posttraumatic stress disorder, schizophrenia, and multiple personality disorder. Reliability testing of the scale showed that the scale had good test-retest and good split-half reliability. Item-scale score correlations were all significant, indicating good internal consistency and construct validity. A Kruskal-Wallis test and post hoc comparisons of the scores of the eight populations provided evidence of the scale's criterion-referenced validity.(ABSTRACT TRUNCATED AT 250 WORDS)",0 +,Exposure of French EMS providers to violence,"Objectives: Evaluate the problem of violence in French EMS system and characterize assaults. Study design: Multicentric, descriptive, open study. Patients and methods: A questionnaire was given to a sample of prehospital care providers in Paris area. People were asked about assaults during their careers, typology of the assaults and consequences. Results are presented in percentage and means. Results: Two hundred seventy-six questionnaires were returned. One or more assaults were recounted by 23% (61/271) of the sample (median of 8 ± 7 years experience on the job). The injuries were bruises in 40% (17/43), wounds in 9% (4/43) and fractures in 2% (1/43). Only 4% of assaults were followed by sick leave, 15% by a complaint. After the assaults, 4% (2/45) reported having got therapy against post-traumatic stress disorder. Eighty-eight per cent reported verbal threat and 41% physical threat. Thirteen per cent (25/200) were threatened with a knife and 12% (23/200) with a gun. Only 9% (24/270) had a formal training for management of violence. Conclusion: Formal training in the management of violent encounters and prevention of post-traumatic stress should be developed.",0 +https://doi.org/10.1007/s00127-011-0443-z,Impact of pre-enlistment antisocial behaviour on behavioural outcomes among UK military personnel,"Purpose: Concern has been raised over alleged increases in antisocial behaviour by military personnel returning from the deployment in Iraq and Afghanistan. US-based research has shown that post-deployment violence is related not only to combat experience, but also to pre-enlistment antisocial behaviour (ASB). This study aimed to examine the association between pre-enlistment ASB and later behavioural outcomes, including aggression, in a large randomly selected UK military cohort. Methods: Baseline data from a cohort study of 10,272 UK military personnel in service at the time of the Iraq war in 2003 were analysed. The associations between pre-enlistment ASB and a range of socio-demographic and military variables were examined as potential confounders. Logistic regression analyses were performed to examine the relationship between pre-enlistment ASB and military behavioural outcomes such as severe alcohol use, violence/aggression and risk-taking behaviour, controlling for confounders. Results: 18.1% were defined as having displayed preenlistment ASB. Pre-enlistment ASB was significantly associated with factors such as younger age, low educational achievement, male gender, non-officer rank, Army personnel, being a regular, increasing time spent on the deployment and having a combat role. Pre-enlistment ASB was associated with increased risk of negative behavioural outcomes (severe alcohol misuse, outbursts of anger or irritability, fighting or assaultative behaviour and risk-taking behaviour), after controlling for confounders, suggesting that such background information may identify individuals who are more vulnerable to subsequent behavioural disturbance. Conclusion: The results of this study suggest that those already demonstrating ASB prior to joining the military are more likely to continue on this trajectory, thus emphasising the importance of considering pre-enlistment behaviour when exploring the aetiology of aggression in military personnel. © Springer-Verlag 2011.",0 +https://doi.org/10.1016/j.brainres.2004.06.052,A distinct neurochemical profile in WKY rats at baseline and in response to acute stress: implications for animal models of anxiety and depression,"Wistar-Kyoto (WKY) rats exhibit hyperresponsive neuroendocrine and behavioral responses to stress that exceed normal controls and are especially prone to develop stress-induced depressive disorder. Pharmacological studies indicate altered serotonin (5-HT), norepinephrine (NE) and dopamine (DA) systems functioning in WKY rats, yet no attempt has been made to provide a comprehensive assessment of the neurochemical profile for WKY rats as compared to the outbred progenitor controls, Wistar rats. To this end, male, WKY and Wistar rats (N=6/group) were exposed to an acute forced-swim stress or were left untreated as controls. The prefrontal cortex (PFCtx), striatum, nucleus accumbens (NAS), and amygdala were assayed for levels of NE, DA and 5-HT, as well as major metabolites, by high-pressure liquid chromatography (HPLC) with electrochemical detection. In a separate experiment, designed to assess baseline and stress-induced neuroendocrine activation, male, Wistar and WKY rats (N=6/group) were exposed to an acute forced-swim stress of 15 min or were left untreated as controls. Animals were killed immediately after the test (T=0), 30 min after the test (T=30) or 60 min after the test (T=60), and control animals were killed immediately after weighing. After decapitation, trunk blood was collected and plasma was isolated by centrifugation and analyzed for corticosterone by immunoassay. The neurochemical results demonstrate distinct patterns of baseline and stress-induced monoamine turnover in WKY rats, including alterations to DA and 5-HT turnovers in prefrontal cortex and nucleus accumbens, two critical brain areas implicated in anxiety, depression and drug reward. The neuroendocrine results indicate that WKY rats exhibited a sustained corticosterone response to acute stress, as compared to Wistar controls. Overall, these data are predicted to be useful for understanding the anxiety- and depressive-like behavioral phenotype exhibited by these animals and for increased understanding of the role genetic background in altering neurochemical function.",0 +https://doi.org/10.1097/nmd.0b013e31820446a8,Mental Health Outcomes and Predictors of Chronic Disorders After the North Sea Oil Rig Disaster,"The present study examined long-term mental health outcomes following a major disaster, including the relative risks (RR) of developing psychiatric disorders. Trauma exposure and predisaster vulnerability factors were examined as predictors of chronic psychopathology. Standardized questionnaires measuring psychological distress were completed 5½ months, 14 months, 5 years, and 27 years after the disaster. Twenty seven years after the disaster, 48 (79%) survivors and a matched comparison group of 62 (78%) nondisaster-exposed controls were assessed using the Structured Clinical Interview for DSM-IV, axis I Disorders. The prevalence of posttraumatic stress disorder among the survivors was 6.1%, and the risk of having a psychiatric disorder was more than 3 times higher than in the comparison group (RR = 3.44, 95% confidence interval = 1.6-7.6). Disaster exposure and general neurotic personality predicted chronic psychopathology, which was reported by 20.9% of the participants. Findings from this study suggest that increased risk of psychopathology persists 27 years after disaster. Both disaster exposure and vulnerable personality are important predictors of chronic psychopathology.",0 +https://doi.org/10.1016/s1054-3589(10)58002-5,Chemistry and Pharmacology of GABAB Receptor Ligands,"This chapter presents new clinical applications of the prototypic GABA(B) receptor agonist baclofen for the treatment of addiction by drugs of abuse, such as alcohol, cocaine, nicotine, morphine, and heroin, a novel baclofen prodrug Arbaclofen placarbil, the GABA(B) receptor agonist AZD3355 (Lesogabaran) currently in Phase 2 clinical trials for the treatment of gastroesophageal reflux disease, and four positive allosteric modulators of GABA(B) receptors (CGP7930, GS39783, NVP-BHF177, and BHFF), which have less propensity for the development of tolerance due to receptor desensitization than classical GABA(B) receptor agonists. All four compounds showed anxiolytic affects. In the presence of positive allosteric modulators the ""classical"" GABA(B) receptor antagonists CGP35348 and 2-hydroxy-saclofen showed properties of partial GABA(B) receptor agonists. Seven micromolar affinity GABA(B) receptor antagonists, phaclofen; 2-hydroxy-saclofen; CGP's 35348, 36742, 46381, 51176; and SCH50911, are discussed. CGP36742 (SGS742) showed statistically significant improvements of working memory and attention in a Phase 2 clinical trial in mild, but not in moderate Alzheimer patients. Eight nanomolar affinity GABA(B) receptor antagonists are presented (CGP's 52432, 54626, 55845, 56433, 56999, 61334, 62349, and 63360) that were used by pharmacologists for numerous in vitro and in vivo investigations. CGP's 36742, 51176, 55845, and 56433 showed antidepressant effects. Several compounds are also available as radioligands, such as [(3)H]CGP27492, [(3)H]CGP54626, [(3)H]CGP5699, and [(3)H]CGP62349. Three novel fluorescent and three GABA(B) receptor antagonists with very high specific radioactivity (>2,000 Ci/mmol) are presented. [(125)I]CGP64213 and the photoaffinity ligand [(125)I]CGP71872 allowed the identification of GABA(B1a) and GABA(B1b) receptors in the expression cloning work.",0 +https://doi.org/10.1046/j.1440-1754.2003.00124.x,Children and war†,"Children bear disproportionate consequences of armed conflict. The 21st century continues to see patterns of children enmeshed in international violence between opposing combatant forces, as victims of terrorist warfare, and, perhaps most tragically of all, as victims of civil wars. Innocent children so often are the victims of high-energy wounding from military ordinance. They sustain high-energy tissue damage and massive burns - injuries that are not commonly seen in civilian populations. Children have also been deliberately targeted victims in genocidal civil wars in Africa in the past decade, and hundreds of thousands have been killed and maimed in the context of close-quarter, hand-to-hand assaults of great ferocity. Paediatricians serve as uniformed military surgeons and as civilian doctors in both international and civil wars, and have a significant strategic role to play as advocates for the rights and welfare of children in the context of the evolving 'Laws of War'. One chronic legacy of contemporary warfare is blast injury to children from landmines. Such blasts leave children without feet or lower limbs, with genital injuries, blindness and deafness. This pattern of injury has become one of the post-civil war syndromes encountered by all intensivists and surgeons serving in four of the world's continents. The continued advocacy for the international ban on the manufacture, commerce and military use of antipersonnel landmines is a part of all paediatricians' obligation to promote the ethos of the Laws of War. Post-traumatic stress disorder remains an undertreated legacy of children who have been trapped in the shot and shell of battle as well as those displaced as refugees. An urgent, unfocused and unmet challenge has been the increase in, and plight of, child soldiers themselves. A new class of combatant comprises these children, who also become enmeshed in the triad of anarchic civil war, light-weight weaponry and drug or alcohol addiction. The International Criminal Court has outlawed as a War Crime, the conscription of children under 15 years of age. Nevertheless, there remain more than 300000 child soldiers active and enmeshed in psychopathic violence as part of both civil and international warfare. The typical profile of a child soldier is of a boy between the ages of 8 and 18 years, bonded into a group of armed peers, almost always an orphan, drug or alcohol addicted, amoral, merciless, illiterate and dangerous. Paediatricians have much to do to protect such war-enmeshed children, irrespective of the accident of their place of birth. Only by such vigorous and maintained advocacy can the world's children be better protected from the scourge of future wars.",0 +,"Resilience and other stability concepts in ecology: notes on their origin, validity and usefulness","Resilience and other stability concepts in ecology: notes on their origin, validity and usefulness",0 +https://doi.org/10.3109/08039488.2012.732113,Post-traumatic stress disorder among asylum seekers and refugees in Istanbul may be predicted by torture and loss due to violence,"Background: Turkey is both a source and target for asylum seekers seeking refugee status in countries of European Union. There is a scarcity of research on the mental health issues of asylum seekers and refugees residing in Turkey. Aims: This study aimed: 1) to provide clinical and demographic information on asylum seekers and refugees receiving mental health services from a non-governmental refugee support program in Istanbul between 2005 and 2007, and 2) to evaluate the differences between patients diagnosed with post-traumatic stress disorder (PTSD) with those who did not meet criteria. Methods: The study was conducted at the Mental Health Division of the Refugee Advocacy Support Group. Between July 2005 and February 2007, 1209 asylum seekers applied to the support group; 75 of these individuals (6.2%) were referred for psychiatric evaluation while 57 were diagnosed as having a psychopathology. The number of analyzed subjects was 57. Results: PTSD and major depressive disorder were the most common diagnoses (55.2% for both). The most common criteria of PTSD reported were problems in concentration and social isolation (97.3% for both). Suffering torture and losing a significant other due to violence were found to be associated with a diagnosis of PTSD. Conclusions: This study is the first of its kind to be conducted on a mixed refugee population residing in Turkey and focusing on their mental health problems. Our results should be tested within larger samples of refugees residing in different cities of Turkey.",0 +https://doi.org/10.1016/j.jad.2011.04.028,Psychological resilience in OEF–OIF Veterans: Application of a novel classification approach and examination of demographic and psychosocial correlates,"A growing number of studies have examined the prevalence and correlates of psychopathology in Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF-OIF), but few have examined determinants of resilience in this population. This study employed a novel approach to classify psychological resilience in a cross-sectional sample of OEF-OIF Veterans. A total of 272 predominantly older reserve/National Guard OEF/OIF Veterans completed a mail survey that assessed combat exposure, psychopathology, psychosocial functioning, and aspects of social support. Cluster analysis of scores on measures of combat exposure and PTSD symptoms revealed that a three-group solution best fit the data: Controls (low combat exposure, low PTSD symptoms); PTSD (high combat exposure, high PTSD symptoms); and Resilient (high combat exposure, low PTSD symptoms). Compared to the PTSD group, the Resilient group was more likely to be in a relationship and active duty; they also scored lower on a measure of psychosocial dysfunction, and higher on measures of psychological resilience and postdeployment social support. Logistic regression analysis revealed that being in a relationship, having fewer psychosocial difficulties, and reporting greater perceptions of purpose/control and family support and understanding were significantly associated with resilient group membership. Results of this study demonstrate a novel approach to classifying psychological resilience and suggest that interventions to mitigate psychosocial difficulties, enhance perceptions of purpose and control, and bolster family support and understanding may help promote resilience to combat-related PTSD in OEF-OIF Veterans.",0 +https://doi.org/10.1097/ta.0b013e31819adc36,Head Injury as a PTSD Predictor Among Oklahoma City Bombing Survivors,"The aim of the Oklahoma City (OKC) bombing retrospective review was to investigate the relationship between physical injury, environmental contributors, and psychiatric disorders such as posttraumatic stress disorder (PTSD) in an event-based, matched design study focused on injury.The 182 selected participants were a random subset of the 1,092 direct survivors from the OKC bombing. Only 124 of these 182 cases had a full complement of medical/clinical data in the OKC database. These 124 cases were assessed to explore relationships among PTSD diagnoses, levels of blast exposure, and physical injuries. Associations among variables were statistically tested using contingency analysis and logistic regression.Comparison of the PTSD cases to symptoms/diagnoses reported in the medical records reveals a statistically significant association between PTSD and head/brain injuries associated with head acceleration. PTSD was not highly correlated with other injuries. Although blast pressure and impulse were highly correlated with head injuries, the correlation with PTSD was not statistically significant. Thus, a correlation between blast pressure and PTSD may exist, but higher fidelity pressure calculations are required to elucidate this potential relationship.This study provides clear evidence that head injury is associated with subsequent PTSD, giving caregivers' information on what physical injuries may suggest the development of psychologic disorders to aid them in developing a profile for the identification of future survivors of terrorist attacks and Warfighters with brain injuries and potential PTSD.",0 +https://doi.org/10.3109/02699052.2015.1043948,Resilience and symptom reporting following mild traumatic brain injury in military service members,"The purpose of this study was to examine the relationship between resilience and symptom reporting following mild traumatic brain injury (mTBI). It was hypothesized that, as resilience increases, self-reported symptoms would decrease.Cross-sectional design.Participants were 142 US military service members who sustained a mTBI, divided into three resilience groups based on participants' responses on the Response to Stressful Experiences Scale: Moderate (n = 42); High (n = 51); and Very High (n = 49). Participants completed the Neurobehavioral Symptom Inventory (NSI) and PTSD Checklist-Civilian Version (PCL-C) within 12 months following injury.There were significant main effects for the NSI total score, cognitive cluster and affective cluster, as well as for the PCL-C total score, avoidance cluster and hyperarousal cluster. Pairwise comparisons revealed that there was a negative relationship between resilience and self-reported symptoms overall. Specifically, participants with higher resilience reported fewer post-concussion and PTSD-related symptoms than participants with lower levels of resilience.These findings underscore the important role that resilience plays in symptom expression in military service members with mTBI and suggest that research on targeted interventions to increase resilience in the acute phase following injury is indicated.",0 +,Longitudinal Cluster Analysis with Applications to Growth Trajectories,"Longitudinal studies play a prominent role in health, social, and behavioral sciences as well as in the biological sciences, economics, and marketing. By following subjects over time, temporal changes in an outcome of interest can be directly observed and studied. An important question concerns the existence of distinct trajectory patterns. One way to discover potential patterns in the data is through cluster analysis, which seeks to separate objects (individuals, subjects, patients, observational units) into homogeneous groups. There are many ways to cluster multivariate data. Most methods can be categorized into one of two approaches: nonparametric and model-based methods. The first approach makes no assumptions about how the data were generated and produces a sequence of clustering results indexed by the number of clusters k=2,3,... and the choice of dissimilarity measure. The later approach assumes data vectors are generated from a finite mixture of distributions. The bulk of the available clustering algorithms are intended for use on data vectors with exchangeable, independent elements and are not appropriate to be directly applied to repeated measures with inherent dependence.Multivariate Gaussian mixtures are a class of models that provide a flexible parametric approach for the representation of heterogeneous multivariate outcomes. When the outcome is a vector of repeated measurements taken on the same subject, there is often inherent dependence between observations. However, a common covariance assumption is conditional independence---that is, given the mixture component label, the outcomes for subjects are independent. In Chapter 2, I study, through asymptotic bias calculations and simulation, the impact of covariance misspecification in multivariate Gaussian mixtures. Although maximum likelihood estimators of regression and prior probability parameters are not consistent under misspecification, they have little asymptotic bias when mixture components are well separated or if the assumed correlation is close to the truth even when the covariance is misspecified. I also present a robust standard error estimator and show that it outperforms conventional estimators in simulations and can provide evidence that the model is misspecified. The main goal of a longitudinal study is to observed individual change over time; therefore, observed trajectories have two prominent features: level and shape of change over time. These features are typically associated with baseline characteristics of the individual. Grouping by shape and level separately provides an opportunity to detect and estimate these relationships. Although many nonparametric and model-based methods have been adapted for longitudinal data, most fail to explicitly group individuals according to the shape of their repeated measure trajectory. Some methods are thought to group by shape, but the dissimilarity between trajectories is not defined in terms of any one specific feature of the data. Rather, the methods are based on the entire vector and cluster trajectories by the level because it tends to dominate the variability between data vectors. These methods discover shape groups only if level and shape are correlated. To fulfill the need for clustering based explicitly on shape, I propose three methods Chapter 4 that are adaptations of available algorithms. One approach is to use a dissimilarity measure based on estimated derivatives of functions underlying the trajectories. One challenge for this approach is estimating the derivatives with minimal bias and variance. The second approach explicitly models the variability in the level within a group of similarly shaped trajectories using a mixture model resulting in a multilayer mixture model. One difficulty with this method comes in choosing the number of shape clusters. Lastly, vertically shifting the data by subtracting the subject-specific mean directly removes the level prior to modeling. This non-invertible transformation can result in singular covariance matrixes, which makes parameter estimation difficult. In theory, all of these methods should cluster based on shape, but each method has shortfalls. I compare these methods with existing clustering methods in a simulation study in Chapter 5 and find that the vertical shifted mixture model outperforms the existing and other proposed methods. A subset of the clustering methods are then compared on a real data set of childhood growth trajectories from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) study in Chapter 6. Vertically shifting the data prior to fitting a mixture model results in groups based on the shape of their growth over time in contrast to the standard mixture model assuming either conditional independence or a more general correlation. The group means do not drastically change between methods for this data set, but group membership differs enough to impact inference about the relationship between baseline covariates and distinct groups.",0 +https://doi.org/10.1016/j.drugalcdep.2009.12.012,"Childhood trauma and dissociation in patients with alcohol dependence, drug dependence, or both—A multi-center study","The aims of this study were to examine the level of dissociative symptoms in patients with different substance related disorders (alcohol dependence, drug dependence, and combined alcohol and drug dependence), and to investigate the influence of potentially traumatic events in childhood, age, gender, and posttraumatic stress disorder on the relationship between dissociative symptoms and type of substance abuse.Of the 459 participants (59.7% male) 182 (39.7%) were alcohol-dependent (A), 154 (33.6%) were drug-dependent (D), and 123 (26.8%) were dependent on both, alcohol and drugs (AD) based on the DSM-IV criteria for a current diagnosis. Participants completed the Childhood Trauma Questionnaire (CTQ) and the Dissociative Experiences Scale (DES). The International Diagnostics Checklist (IDCL) was administered to diagnose PTSD.Higher levels of dissociation were observed in patients with drug dependence as compared to patients with mere alcohol dependence (mean DES group A: 9.9+/-8.8; group D: 12.9+/-11.7; group AD: 15.1+/-11.3). However, when severity of potentially traumatic events in childhood, PTSD, age and gender were included in the analysis, the influence of the type of substance abuse did not prove to be statistically significant. The variable most strongly related to dissociative symptoms was severity of potentially traumatic events in childhood, in particular emotional abuse, even after controlling for PTSD and other potential confounders.It seems appropriate to screen SUD patients for dissociative symptoms, especially those with a more complex risk profile including (additional) drug abuse, female gender, younger age and most importantly a history of childhood trauma.",0 +https://doi.org/10.1016/j.jad.2015.09.071,Discriminant validity and gender differences in DSM-5 posttraumatic stress disorder symptoms,"The posttraumatic stress disorder (PTSD) literature is replete with investigations of factor structure, however, few empirical studies have examined discriminant validity and the moderating role of gender on factor structure and symptom expression. This study aimed to address these gaps.An online, population-based study of 3175 Australian adults was conducted. This study analyzed data from 642 participants who reported a traumatic event. Overall, 10.2% (13.4% females, 7.6% males) met diagnostic criteria for current PTSD.Confirmatory factor analyses indicated that eight factor models provided excellent fit to the data. The DSM-5 model, anhedonia and hybrid models provided strong fit to the data, based on statistical fit indices and parsimony. The models' factors were significantly associated with a number of external correlates. Factor structure was gender invariant for the three models, albeit significant latent mean-level differences were apparent in relation to the intrusion/re-experiencing and alterations in arousal and reactivity factors. Bonferroni-adjusted Wald chi-square tests indicated significant gender differences in four DSM-5 PTSD symptoms: females reported significantly higher rates of negative beliefs, diminished interest, restricted affect and sleep disturbance symptoms compared to men.Response rate to the survey was low. However, the number of respondents who completed the survey was high and population weights were employed to account for self-selection biases and aid generalizability.The findings provide support for the DSM-5, anhedonia and hybrid models compared to alternative models based on DSM-5 symptoms. Discriminant validity analyses indicated similar patterns of significant associations with the transdiagnostic factors, potentially suggesting that all the PTSD factors are related to non-specific distress. Further research investigating how gender influences PTSD symptom expression is warranted, including possible gender differences in symptom item interpretation.",0 +https://doi.org/10.1177/1534765613476098,Test of the trauma outcome process assessment model: One model of individual and environmental factors to explain adjustment.,"The Trauma Outcome Process Assessment (TOPA) is a theoretical model, based on a large body of empirical research establishing key variables that consistently are associated with a range of outcomes...",0 +https://doi.org/10.1111/bjc.12001,Predicting post-traumatic stress disorder following first onset acute coronary syndrome: Testing a theoretical model,"This research identified which theoretically predicted factors (Joseph, Williams, & Yule, 1997) were associated with the severity of post-traumatic stress disorder (PTSD) symptoms 1 and 6 months following onset of acute coronary syndrome (ACS). Predictor variables included event factors, peri-traumatic distress; and maintaining factors including coping strategies, social support, re-appraisal of event threat, and beliefs about the nature of ACS. Associations with alexithymia were also explored.One hundred and fifty participants completed questionnaires in hospital and at 1- and 6-month follow-up.Hierarchical multiple regression including both baseline and contemporaneous variables explained 52 and 42% of the variance in PTSD symptoms at each follow-up. At 1-month follow-up, predictors of PTSD symptoms were as follows: peri-traumatic distress, concern over symptoms, illness comprehension, and lack of social support. At 6-month follow-up, predictors were: peri-traumatic distress, lack of social support, use of problem-focused coping, and continued symptoms.The Joseph et al. model was generally supported. The data allow some degree of prediction of high risk individuals and suggest some possible interventions.",0 +https://doi.org/10.1002/jts.20528,Internalizing and externalizing personality styles and psychopathology in OEF-OIF veterans,"Previous research with other trauma populations demonstrated that internalizing and externalizing personality styles are associated with different PTSD comorbidities. The present study tested this association in two distinct Operation Enduring Freedom–Operation Iraqi Freedom (OEF/OIF) combat samples. Cluster analysis was used to categorize subtypes, which were compared on measures of PTSD, depression, anxiety, and substance use. Internalizers showed the highest rates of PTSD and depression. Externalizers had higher rates of alcohol problems in one sample only, whereas the other sample showed more substance misuse. In general, these findings suggest that this method of classifying trauma survivors is useful in OEF/OIF populations. Results suggest some differences across this population in terms of how substance use issues are expressed in externalizers.",0 +https://doi.org/10.1037/1040-3590.76.4.461,In their own words: Trauma and substance abuse in the lives of formerly homeless women with serious mental illness.,"In-depth interviews were conducted with 13 formerly homeless mentally ill women to capture their individual life trajectories of mental illness, substance abuse, and trauma in their own words. Cross-case analyses produced 5 themes: (a) betrayals of trust, (b) graphic or gratuitous nature of traumatic events, (c) anxiety about leaving their immediate surroundings (including attending group treatment programs), (d) desire for one's own space, and (e) gender-related status loss and stigmatization. Findings suggest formerly homeless mentally ill women need (and want) autonomy, protection from further victimization, and assistance in restoring status and devalued identity. Avenues for intervention include enhanced provider training, addressing experiences of betrayal and trauma, and more focused attention to current symptoms rather than previous diagnoses.",0 +https://doi.org/10.1016/j.comppsych.2008.11.006,A multidimensional spectrum approach to post-traumatic stress disorder: comparison between the Structured Clinical Interview for Trauma and Loss Spectrum (SCI-TALS) and the Self-Report instrument (TALS-SR),"Dimensional approaches to psychiatric disorders have shown an increased relevance in the ongoing debate for the forthcoming Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. In line with previously validated instruments for the assessment of different mood, anxiety, eating and psychotic spectra, we tested the validity and reliability of a newly developed Structured Clinical Interview for Trauma and Loss Spectrum (SCI-TALS). The instrument is based on a multidimensional approach to post-traumatic stress spectrum that includes a range of threatening or frightening experiences, as well as a variety of potentially significant losses, to which an individual can be exposed. Furthermore, it explores the spectrum of the peritraumatic reactions and post-traumatic symptoms that may ensue from either type of life events, targeting soft signs and subthreshold conditions, as well as temperamental and personality traits that may constitute risk factors for the development of the disorder. The aim of the present study is to describe the reliability of the self-report version of the SCI-TALS: the TALS-SR. Thirty patients with PTSD and thirty healthy control subjects were assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Half of the patients and controls received the TALS-SR first and the SCI-TALS after 15 days; for the other half of the sample, the order of administration was reversed. Agreement between the self-report and the interview formats was substantial. Intraclass correlation coefficients ranged from 0.934 to 0.994, always exceeding the threshold of 0.90. Our findings provide substantial support for the reliability of the TALS-SR questionnaire.",0 +https://doi.org/10.1037/a0035164,Multiple risk-behavior profiles of smokers with serious mental illness and motivation for change.,"Individuals with serious mental illness (SMI) are dying on average 25 years prematurely. The leading causes are chronic preventable diseases. In the context of a tobacco-treatment trial, this exploratory study examined the behavioral risk profiles of adults with SMI to identify broader interventional needs.Recruited from five acute inpatient psychiatry units, participants were 693 adult smokers (recruitment rate = 76%, 50% male, 45% Caucasian, age M = 39, 49% had income < $10,000) diagnosed with mood disorders (71%), substance-use disorders (63%), posttraumatic stress disorder (39%), psychotic disorders (25%), and attention deficit-hyperactivity disorder (25%). The Staging Health Risk Assessment, the primary measure used in this study, screened for risk status and readiness to change 11 health behaviors, referencing the period prior to acute hospitalization.Participants averaged 5.2 (SD = 2.1) risk behaviors, including smoking (100%), high-fat diet (68%), inadequate fruits/vegetables (67%), poor sleep (53%), physical inactivity (52%), and marijuana use (46%). The percent prepared to change ranged from 23% for tobacco and marijuana to 76% for depression management. Latent class analysis differentiated three risk groups: the global higher risk group included patients elevated on all risk behaviors; the global lower risk group was low on all risks; and a mood and metabolic risk group, characterized by inactivity, unhealthy diet, sleep problems, and poor stress and depression management. The global higher risk group (11% of sample) was younger, largely male, and had the greatest number of risk behaviors and mental health diagnoses; had the most severe psychopathologies, addiction-treatment histories, and nicotine dependence; and the lowest confidence for quitting smoking and commitment to abstinence.Most smokers with SMI engaged in multiple risks. Expanding targets to treat co-occurring risks and personalizing treatment to individuals' multibehavioral profiles may increase intervention relevance, interest, and impact on health.",0 +https://doi.org/10.1016/s0084-3970(08)70829-6,"Efficacy and Safety of Topiramate Monotherapy in Civilian Posttraumatic Stress Disorder: A Randomized, Double-Blind, Placebo-Controlled Study","Objective: This double-blind, placebo-controlled trial assessed efficacy and safety of topiramate monotherapy in civilian posttraumatic stress disorder (PTSD). Method: Outpatients (18-64 years) with DSM-IV non-combat-related PTSD and Clinician-Administered PTSD Scale (CAPS) scores (greater-than or equal to) 50 were eligible. Topiramate was started at 25 mg/day and titrated by 25-50 mg/week to 400 mg/day or maximum tolerated dose. Data were collected between April 26, 2002, and February 4, 2004. Primary efficacy, change in total CAPS score, and secondary efficacy measures were assessed by analysis of covariance in the intent-to-treat (ITT) population with last observation carried forward. Results: The ITT population comprised 38 patients with mean (plus or minus) SD baseline total CAPS scores of 88.3 (plus or minus) 13.8 (topiramate, N = 19) and 91.1 (plus or minus) 13.7 (placebo, N = 19). Although a decrease in total CAPS score was noted (topiramate, -52.7; placebo, -42.0), this difference was not statistically significant (p = .232). Topiramate-treated patients exhibited significant reductions in reexperiencing symptoms (CAPS cluster B: topiramate, 74.9%; placebo, 50.2%; p = .038) and Treatment Outcome PTSD scale (topiramate, 68.0%; placebo, 41.6%; p = .025). Reductions approaching statistical significance, based on a nominal p value, were noted in mean total Clinical Global Impressions-Improvement Scale scores (topiramate, 1.9 (plus or minus) 1.2; placebo, 2.6 (plus or minus) 1.1; p = .055). Conclusion: These preliminary results suggest that further, adequately powered studies of topiramate for the treatment of civilian PTSD are warranted.",0 +https://doi.org/10.1016/j.janxdis.2014.11.004,An evaluation of the DSM-5 factor structure for posttraumatic stress disorder in survivors of traumatic injury,"Confirmatory factor analytic studies of the latent structure of DSM-5 PTSD symptoms using self-report data (Elhai et al., 2012; Miller et al., 2013) have found that the four-factor model implied by the DSM-5 diagnostic criteria provided adequate fit to their data. However, the fit of this model is yet to be assessed using data derived from gold standard structured interview measures. This study evaluated the fit of the DSM-5 four-factor model and an alternative four-factor model in 570 injury survivors six years post-injury using the Clinician Administered PTSD Scale (Blake et al., 1990), updated to include items measuring new DSM-5 symptoms. While both four-factor models fitted the data well, very high correlations between the 'Intrusions' and 'Avoidance' factors in both models and between the 'Negative Alterations in Cognitions and Mood' and 'Arousal and Reactivity' factors in the DSM-5 model and the 'Dysphoria' and 'Hyperarousal' factors in the alternative model were evident, suggesting that a more parsimonious two-factor model combining these pairs of factors may adequately represent the latent structure. Such a two-factor model fitted the data less well according to χ(2) difference testing, but demonstrated broadly equivalent fit using other fit indices. Relationships between the factors of each of the four-factor models and the latent factors of Fear and Anxious-Misery/Distress underlying Internalizing disorders (Krueger, 1999) were also explored, with findings providing further support for the close relationship between the Intrusion and Avoidance factors. However, these findings also suggested that there may be some utility to distinguishing Negative Alterations in Cognition and Mood symptoms from Arousal and Reactivity symptoms, and/or Dysphoria symptoms from Hyperarousal symptoms. Further studies are required to assess the potential discriminant validity of the two four-factor models.",0 +https://doi.org/10.1007/s10802-015-0086-8,Developmental Patterns of Adverse Childhood Experiences and Current Symptoms and Impairment in Youth Referred For Trauma-Specific Services,"By the time children reach adolescence, most have experienced at least one type of severe adversity and many have been exposed to multiple types. However, whether patterns of adverse childhood experiences are consistent or change across developmental epochs in childhood is not known. Retrospective reports of adverse potentially traumatic childhood experiences in 3 distinct developmental epochs (early childhood, 0- to 5-years-old; middle childhood, 6- to 12-years-old; and adolescence, 13- to 18-years-old) were obtained from adolescents (N = 3485) referred to providers in the National Child Traumatic Stress Network (NCTSN) for trauma-focused assessment and treatment. Results from latent class analysis (LCA) revealed increasingly complex patterns of adverse/traumatic experiences in middle childhood and adolescence compared to early childhood. Depending upon the specific developmental epoch assessed, different patterns of adverse/traumatic experiences were associated with gender and with adolescent psychopathology (e.g., internalizing/externalizing behavior problems), and juvenile justice involvement. A multiply exposed subgroup that had severe problems in adolescence was evident in each of the 3 epochs, but their specific types of adverse/traumatic experiences differed depending upon the developmental epoch. Implications for research and clinical practice are identified.",0 +https://doi.org/10.1001/jama.282.18.1737,Validation and Utility of a Self-report Version of PRIME-MD<SUBTITLE>The PHQ Primary Care Study</SUBTITLE>,"The Primary Care Evaluation of Mental Disorders (PRIME-MD) was developed as a screening instrument but its administration time has limited its clinical usefulness.To determine if the self-administered PRIME-MD Patient Health Questionnaire (PHQ) has validity and utility for diagnosing mental disorders in primary care comparable to the original clinician-administered PRIME-MD.Criterion standard study undertaken between May 1997 and November 1998.Eight primary care clinics in the United States.Of a total of 3000 adult patients (selected by site-specific methods to avoid sampling bias) assessed by 62 primary care physicians (21 general internal medicine, 41 family practice), 585 patients had an interview with a mental health professional within 48 hours of completing the PHQ.Patient Health Questionnaire diagnoses compared with independent diagnoses made by mental health professionals; functional status measures; disability days; health care use; and treatment/referral decisions.A total of 825 (28%) of the 3000 individuals and 170 (29%) of the 585 had a PHQ diagnosis. There was good agreement between PHQ diagnoses and those of independent mental health professionals (for the diagnosis of any 1 or more PHQ disorder, kappa = 0.65; overall accuracy, 85%; sensitivity, 75%; specificity, 90%), similar to the original PRIME-MD. Patients with PHQ diagnoses had more functional impairment, disability days, and health care use than did patients without PHQ diagnoses (for all group main effects, P<.001). The average time required of the physician to review the PHQ was far less than to administer the original PRIME-MD (<3 minutes for 85% vs 16% of the cases). Although 80% of the physicians reported that routine use of the PHQ would be useful, new management actions were initiated or planned for only 117 (32%) of the 363 patients with 1 or more PHQ diagnoses not previously recognized.Our study suggests that the PHQ has diagnostic validity comparable to the original clinician-administered PRIME-MD, and is more efficient to use.",0 +https://doi.org/10.1111/head.12216,Headache Diagnoses Among Iraq and Afghanistan War Veterans Enrolled in VA: A Gender Comparison,"To examine the prevalence and correlates of headache diagnoses, by gender, among Iraq and Afghanistan War Veterans who use Department of Veterans Affairs (VA) health care.Understanding the health care needs of recent Veterans, and how these needs differ between women and men, is a priority for the VA. The potential for a large burden of headache disorders among Veterans seeking VA services exists but has not been examined in a representative sample.We conducted a historical cohort study using national VA inpatient and outpatient data from fiscal year 2011. Participants were all (n = 470,215) Iraq and Afghanistan War Veteran VA users in 2011; nearly 13% were women. We identified headache diagnoses using International Classification of Diseases (ICD-9) diagnosis codes assigned during one or more VA inpatient or outpatient encounters. Descriptive analyses included frequencies of patient characteristics, prevalence and types of headache diagnoses, and prevalence of comorbid diagnoses. Prevalence ratios (PR) with 95% confidence intervals (CI) were used to estimate associations between gender and headache diagnoses. Multivariate models adjusted for age and race. Additional models also adjusted for comorbid diagnoses.In 2011, 56,300 (11.9%) Veterans received a headache-related diagnosis. While controlling for age and race, headache diagnoses were 1.61 times more prevalent (95% CI = 1.58-1.64) among women (18%) than men (11%). Most of this difference was associated with migraine diagnoses, which were 2.66 times more prevalent (95% CI = 2.59-2.73) among women. Cluster and post-traumatic headache diagnoses were less prevalent in women than in men. These patterns remained the same when also controlling for comorbid diagnoses, which were common among both women and men with headache diagnoses. The most prevalent comorbid diagnoses examined were depression (46% of women with headache diagnoses vs 40% of men), post-traumatic stress disorder (38% vs 58%), and back pain (38% vs 46%).Results of this study have implications for the delivery of post-deployment health services to Iraq and Afghanistan War Veterans. Migraine and other headache diagnoses are common among Veterans, particularly women, and tend to occur in combination with other post-deployment health conditions for which patients are being treated.",0 +https://doi.org/10.1186/1752-1505-6-8,Short and longer-term psychological consequences of Operation Cast Lead: documentation from a mental health program in the Gaza Strip,"There is growing recognition of the psychological impact of adversity associated with armed conflict on exposed civilian populations. Yet there is a paucity of evidence on the value of mental health programs in these contexts, and of the chronology of psychological sequelae, especially in prolonged conflicts with repeated cycles of extreme violence. Here, we describe changes in the psychological profile of new patients in a mental health program after the military offensive Cast Lead, in the context of the prolonged armed conflict involving the Gaza Strip.This study analyses routinely collected program data from a Médecins Sans Frontières mental health program in the Gaza Strip spanning 2007-2011. Data consist of socio-demographic as well as clinical baseline and follow-up data on new patients entering the program. Comparisons were made through Chi square and Fisher's exact tests, univariate and multivariate logistic and linear regression.PTSD, depression and other anxiety disorders were the most frequent psychopathologies, with 21% having multiple diagnoses. With a median of nine sessions, clinical improvement was recorded for 83% (1122/1357), and more common for those with separation anxiety, acute and posttraumatic disorders as principal diagnosis (855/1005), compared to depression (141/183, p<0.01). Noted changes proximal to Operation Cast Lead were: a doubling in patient case load with a broader socio-economic background, shorter interval from an identified traumatic event to seeking care, and a rise in diagnoses of acute and posttraumatic stress disorders. Sustained changes included: high case load, more distal triggering events, and increase in diagnoses of other anxiety disorders (especially for children 15 years and younger) and depression (especially for patients 16 years and older).Evolving changes in patient volume, diagnoses and recall period to triggering events suggest a lengthy and durable effect of an intensified exposure to violence in a context of prolonged conflict. Our findings suggest that mental health related humanitarian relief in protracted conflicts might need to prepare for an increase in patients with changing profiles over an extended period following an acute flare-up in violence.",0 +,"The impact of being afforded a college education on posttraumatic growth, trauma resilience, and academic resilience in individuals exposed to trauma","Trauma resilience has many definitions and trajectories; however, theorists remain consistent on the idea that some individuals who endure trauma do not succumb to its impact, but instead flourish in its aftermath. Research that focuses on individuals who do exhibit symptoms, yet go on to achieve notable feats is important to understanding how various paths of resilience and growth interact and can be encouraged. The purpose of this study was to examine the factors associated with being provided a college education on trauma resilience, academic resilience, and posttraumatic growth in ""at risk"" students who have experienced a traumatic event. Participants included approximately 146 individuals (77 Males, 69 Females) named as Horatio Alger Association of Distinguished Americans' National Scholars who exemplify academic resiliency and were selected based on their ability to demonstrate integrity and perseverance in overcoming adversity. Participants were asked to complete an electronic survey designed to assess whether or not the participant meets criteria for Posttraumatic Stress Disorder (PTSD), shows posttraumatic growth as a result of facing adversity, and/or shows academic resilience. Qualitative questions were utilized to uncover themes or factors related to the student's ability to be resilient. Results indicated that as the number of events that the participants were exposed to increased, participants were less likely to meet criteria for a PTSD diagnosis. Second, there was not a significant relationship found between posttraumatic growth and academic resilience, but a significant relationship was found between posttraumatic growth and trauma resilience. Lastly, the most commonly supported theme reported by participants as being influential in their growth, ability to make meaning of their past adversities, and academic success was learning that there were other individuals who had been through similar adversities and had persevered. Recognizing the aspects of the program that were the most beneficial to the students can not only provide insight into why this group of at-risk students were resilient, but can also illuminate the needs of other at-risk students in their journeys towards resiliency. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0 +https://doi.org/10.1016/j.socscimed.2009.03.043,Looking for resilience: Understanding the longitudinal trajectories of responses to stress,"Taking advantage of two large, population-based, and longitudinal datasets collected after the 1999 floods in Mexico (n=561) and the September 11, 2001 terrorist attacks in New York (n=1267), we examined the notion that resilience may be best understood and measured as one member of a set of trajectories that may follow exposure to trauma or severe stress. We hypothesized that resistance, resilience, recovery, relapsing/remitting, delayed dysfunction, and chronic dysfunction trajectories were all possible in the aftermath of major disasters. Semi-parametric group-based modeling yielded the strongest evidence for resistance (no or mild and stable symptoms), resilience (initially moderate or severe symptoms followed by a sharp decrease), recovery (initially moderate or severe symptoms followed by a gradual decrease), and chronic dysfunction (moderate or severe and stable symptoms), as these trajectories were prevalent in both samples. Neither Mexico nor New York showed a relapsing/remitting trajectory, and only New York showed a delayed dysfunction trajectory. Understanding patterns of psychological distress over time may present opportunities for interventions that aim to increase resilience, and decrease more adverse trajectories, after mass traumatic events.",1 +https://doi.org/10.1007/978-3-319-09241-6_6,Psychosocial Risk Factors in Women: Special Reference to Depression and Posttraumatic Stress Disorder,"Women have a higher susceptibility than men to a set of psychosocial factors that have been linked to increased risk of ischemic heart disease (IHD), such as depression, early life adversities, and posttraumatic stress disorder (PTSD). In this chapter we discuss the notion that these psychosocial risk factors, particularly if they are present at young age, may set a trajectory of increased IHD risk in women, even though clinical events may occur years later. Emerging data suggest that young women are uniquely susceptible to the adverse cardiovascular effects psychosocial stress, which can result in earlier onset of IHD or more adverse prognosis if the disease is already manifest. Women’s vulnerability to psychosocial stress could also play a role in sex differences in the pathophysiology of IHD; for example it could help explain their higher propensity to abnormal coronary vasomotion and micro-vascular disease, which has been described in women compared with men. Young women are severely under-represented in studies of cardiovascular disease. In future research, it will be crucial to study women earlier in their life to better understand the risk pathways linking psychosocial stress to IHD risk, in order to devise successful preventive and treatment strategies to ameliorate such risk. © Springer International Publishing Switzerland 2015.",0 +https://doi.org/10.1080/15374410802148251,Child and Adolescent Mental Health Research in the Context of Hurricane Katrina: An Ecological Needs-Based Perspective and Introduction to the Special Section,This article introduces the special section on child and adolescent mental health research in the context of Hurricane Katrina. We outline the purpose and intent of the special section and present an integrative perspective based on broad contextual theories of human development with which to think about the impact of disasters like Katrina. The perspective emphasizes multiple levels of influence on mental health and normal development through the impairment of multiple human needs. The perspective helps show the interconnections among the diverse theoretical and methodological paradigms that are utilized to understand the impact of disasters on youth and may help to guide future research.,0 +https://doi.org/10.1093/jpepsy/jsi002,Psychosocial Predictors of Distress in Parents of Children Undergoing Stem Cell or Bone Marrow Transplantation,"To examine psychosocial predictors of distress (mood disturbance, perceived stress, caregiver burden) in parents of children undergoing stem cell or bone marrow transplantation (BMT).Measures of prior illness experiences, premorbid child behavior problems, family environment, social support, and parental coping behavior were obtained from the resident parents of 151 children prior to the children's admission for BMT. Parents subsequently completed assessments of their mood disturbance, perceived stress, and caregiving burden on a weekly basis through week +6 post-BMT, and then monthly through month +6 post-BMT.Significant changes were observed in parental distress across the course of BMT. After correcting for demographic and medical factors, several significant predictors of parental distress trajectories were identified, including prior parent and patient illness-related distress, premorbid child internalizing behavior problems, the family relationship dimensions of the family environment, and parental avoidant coping behaviors. Multivariable models were developed using a hierarchical modeling approach. The best-fit model accounted for approximately 50% of the variance in parental global distress.Subgroups of parents at higher risk for increased distress during the acute phase of transplant have been identified. These findings can help target parents who may be in greater need of intervention aimed at reducing transplant-related distress.",0 +https://doi.org/10.1001/archpsyc.1993.01820160019002,A Twin Study of Genetic and Environmental Contributions to Liability for Posttraumatic Stress Symptoms,"We studied 4042 Vietnam era veteran monozygotic and dizygotic male twin pairs to determine the effects of heredity, shared environment, and unique environment on the liability for 15 self-reported posttraumatic stress disorder symptoms included in the symptom categories of reexperiencing the trauma, avoidance of stimuli related to the trauma, and increased arousal. Quantitative genetic analysis reveals that inheritance has a substantial influence on liability for all symptoms. Symptoms in the reexperiencing cluster and one symptom in the avoidance and numbing cluster are strongly associated with combat exposure, and monozygotic pairs are more highly concordant for combat exposure than dizygotic pairs. By fitting a bivariate genetic model, we show that there are significant genetic influences on symptom liability, even after adjusting for differences in combat exposure; genetic factors account for 13% to 30% of the variance in liability for symptoms in the reexperiencing cluster, 30% to 34% for symptoms in the avoidance cluster, and 28% to 32% for symptoms in the arousal cluster. There is no evidence that shared environment contributes to the development of posttraumatic stress disorder symptoms.",0 +https://doi.org/10.1097/01.chi.0000174463.60987.69,Children in Adoptive Families: Overview and Update,"To summarize the past 10 years of published research concerning the 2% of American children younger than 18 years old who are adoptees.Review recent literature on developmental influences, placement outcome, psychopathology, and treatment.Adoption carries developmental opportunities and risks. Many adoptees have remarkably good outcomes, but some subgroups have difficulties. Traditional infant, international, and transracial adoptions may complicate adoptees' identity formation. Those placed after infancy may have developmental delays, attachment disturbances, and posttraumatic stress disorder. Useful interventions include preventive counseling to foster attachment, postadoption supports, focused groups for parents and adoptees, and psychotherapy.Variables specific to adoption affect an adopted child's developmental trajectory. Externalizing, internalizing, attachment, and posttraumatic stress disorder symptoms may arise. Child and adolescent psychiatrists can assist both adoptive parents and children.",0 +https://doi.org/10.1002/jts.22064,Developmental Trajectories and Predictors of Prosocial Behavior Among Adolescents Exposed to the 2008 Wenchuan Earthquake,"This longitudinal study examined the developmental trajectories of prosocial behavior and related predictors among adolescents exposed to the 2008 Wenchuan earthquake. At 6-, 18-, and 30-months postearthquake, we followed a sample of 1,573 adolescents. Self-report measures were used to assess earthquake exposure, postearthquake negative life events, prosocial behavior, symptoms of posttraumatic stress disorder, depression, anxiety, social support, and coping style. Data were analyzed using growth mixture modeling and multinomial logistic regressions. Four trajectories of postearthquake prosocial behavior were identified in the sample: (a) high/enhancing (35.0%), (b) high/stable (29.4%), (c) low/declining (33.6%), and (d) low/steeply declining (2.0%). Female gender, more social support, and greater positive coping were significant factors related to a higher probability of developing the high/enhancing trajectory. These findings may be helpful for us to identify adolescents with poor prosocial behavior after exposure to earthquakes so as to provide them with appropriate intervention.",0 +https://doi.org/10.1097/hrp.0000000000000035,Preclinical Perspectives on Posttraumatic Stress Disorder Criteria in DSM-5,"Posttraumatic stress disorder (PTSD) now sits within the newly created ""Trauma- and Stressor-Related Disorders"" section of the Diagnostic and Statistical Manual of Mental Disorders (fifth edition; DSM-5). Through the refinement and expansion of diagnostic criteria, the DSM-5 version better clarifies the broad and pervasive effects of trauma on functioning, as well as the impact of development on trauma reactions. Aggressive and dissociative symptoms are more thoroughly characterized, reflecting increasing evidence that reactions to trauma often reach beyond the domains of fear and anxiety (these latter domains were emphasized in DSM-IV). These revised criteria are supported by decades of preclinical and clinical research quantifying traumatic stress-induced changes in neurobiological and behavioral function. Several features of the DSM-5 PTSD criteria are similarly and consistently represented in preclinical animal models and humans following exposure to extreme stress. In rodent models, for example, increases in anxiety-like, helplessness, or aggressive behavior, along with disruptions in circadian/neurovegetative function, are typically induced by severe, inescapable, and uncontrollable stress. These abnormalities are prominent features of PTSD and can help us in understanding the pathophysiology of this and other stress-associated psychiatric disorders. In this article we examine some of the changes to the diagnostic criteria of PTSD in the context of trauma-related neurobiological dysfunction, and discuss implications for how preclinical data can be useful in current and future clinical conceptualizations of trauma and trauma-related psychiatric disorders.",0 +https://doi.org/10.1016/j.comppsych.2008.09.001,Posttraumatic stress disorder symptoms in adolescents: risk factors versus resilience moderation,"Exposure to community violence and trauma, stress, and childhood abuse and neglect have been identified as risk factors for the development of posttraumatic stress disorder (PTSD) symptoms among adolescents. Although evidence suggests that resilience may moderate the relationship between some of these risk factors and PTSD symptoms, no studies to date have examined these risk factors collectively.Our first aim was to examine the relationship between exposure to community violence, childhood abuse and neglect, perceived stress, and PTSD symptoms. Our second aim was to examine the extent to which resilience moderated the relationship between risk factors and PTSD symptoms.A convenience sample of 787 participants was drawn from 5 public secondary schools in the Cape Town metropole of South Africa. The participants were invited to complete a battery of questionnaires on a single occasion.Of the participants, 48.3% were Black, 58.6% were female, and 31.6% were in grade 8. After controlling for covariates, we found that exposure to community violence, perceived stress, and childhood abuse and neglect together accounted for 33.4% of the variance in PTSD symptoms (F(8,778) = 71.06, P < .001). Nevertheless, resilience moderated the relationship between childhood abuse and symptoms of PTSD (beta = .09, t(786) = 2.88, P < .001), where the independent effect of childhood abuse and neglect on PTSD symptoms was significantly reduced with increasing resilience. Resilience did not, however, interact with exposure to community violence or perceived levels of stress to influence PTSD symptoms.High levels of exposure to community violence, perceived stress, and childhood abuse and neglect may contribute to the development of PTSD symptoms in South African adolescents. However, high levels of resilience may buffer the negative effects of childhood abuse and neglect.",0 +https://doi.org/10.1027/1614-0001/a000047,Stepping Off the Hedonic Treadmill,"Theorists have long maintained that people react to major life events but then eventually return to a setpoint of subjective well-being. Yet prior research is inconclusive regarding the extent of interindividual variability. Recent theoretical models suggest that there should be heterogeneity in long-term stress responding ( Bonanno, 2004 ; Muthén & Muthén, 2000 ). To test this idea, we used latent growth mixture modeling to identify specific patterns of individual variation in response to three major life events (bereavement, divorce, and marriage). A four-class trajectory solution provided the best fit for bereavement and marriage, while a three-class solution provided the best fit for divorce. Relevant covariates predicted trajectory class membership. The modal response across events was a relatively flat trajectory (i.e., no change). Nevertheless, some trajectories diverged sharply from the modal response. Despite the tendency to maintain preevent levels of SWB, there are multiple and often divergent trajectories in response to bereavement, divorce, and marriage, underscoring the essential role of individual differences.",0 +https://doi.org/10.1016/j.jad.2014.05.023,Negative affectivity as a transdiagnostic factor in patients with common mental disorders,"Screening and monitoring systems are increasingly used in psychotherapy, but it has been questioned whether outcome measurement using multiple questionnaires is warranted. Arguably, type and number of assessment instruments should be determined by empirical research. This study investigated the latent factor structure of a multi-dimensional outcome measurement strategy used in English services aligned to the Improving Access to Psychological Therapies (IAPT) programme.Factor analyses and structural equation models were performed on 11,939 intake assessments of outpatients accessing an IAPT service between 2008 and 2010. We examined whether three routinely employed instruments (PHQ-9 for depression, GAD-7 for anxiety, WSAS for functional impairment) assess empirically different dimensions.The instruments were found to assess mainly one general dimension and only some items of the GAD-7 and WSAS assess unique variance beyond this general dimension. In a structural equation model the disorder-specific factor scores were predicted by patients׳ diagnostic categories.Since a large naturalistic data base was used, missing data for diagnoses and scale items were encountered. Diagnoses were obtained with brief case-finding measures rather than structured diagnostic interviews.Although the items seem to address mostly one dimension, some variance is due to differences between individuals in anxiety and impairment. While this generally supports multi-dimensional assessment in a primary care population, the clinical upshot of the study is to concentrate attention on transdiagnostic factors as a target for treatment.",0 +https://doi.org/10.12968/bjon.2011.20.19.1256,Serving within the British army: research into mental health benefits,"The mental health (MH) of soldiers remains extremely newsworthy and is regularly featured in high profile media forums that focus on post-traumatic stress disorder. However, the authors feel that there are distinct benefits to serving within the Army, and that it provides effective occupational medical, MH and welfare support. This research study explores potential benefits and stressors of being in the Army and provides an overview of Army mental health services (AMHS) through the perspectives of AMHS personnel, 84% of which were nurses. The study indicated that the Army can provide a protective community, sharing a bond based on common values and experiences. The Army can provide soldiers with career opportunities that are not available in civilian life, and there are opportunities to develop an employment profile, enhanced by internal and external educational training, and encapsulated within a progressive career pathway. The Army can also be seen to offer an escape route, preventing soldiers entering a life of crime, and supplying the stable family these soldiers had never experienced. The provision of leadership, within an environment where soldiers are valued and stigma is not tolerated can potentially shield against MH problems.",0 +https://doi.org/10.1016/j.jad.2012.04.011,Sympathetic system modulation to treat post-traumatic stress disorder (PTSD): A review of clinical evidence and neurobiology,A review of clinical evidence and neurobiology on the effects of modulation of sympathetic system modulation to treat post-traumatic stress disorder (PTSD) is being presented . The review provides an overview of currently available treatments followed by efficacy of orally effective sympathetic blocking agents. The main focus of the review is the application of stellate ganglion blocks (SGBs) or a local anesthetic blockade of the sympathetic ganglion in the neck.,0 +https://doi.org/10.1016/j.comppsych.2004.03.010,Dissociative experiences in obsessive-compulsive disorder and trichotillomania: Clinical and genetic findings,"A link between dissociation proneness in adulthood and self-reports of childhood traumatic events (including familial loss in childhood, sexual/physical abuse and neglect) has been documented. Several studies have also provided evidence for an association between dissociative experiences and trauma in patients with various psychiatric disorders, including post-traumatic stress disorder, borderline personality, dissociative identity and eating disorders. Based on the relative paucity of data on dissociation and trauma in obsessive-compulsive disorder (OCD) and trichotillomania (TTM), the primary objective of this study was to examine the relationship between trauma and dissociative experiences (DE) in these two diagnostic groups. Furthermore, the availability of clinical and genetic data on this sample allowed us to explore clinical and genetic factors relevant to this association. A total of 110 OCD and 32 TTM patients were compared with respect to the degree of dissociation (using the Dissociative Experiences Scale [DES]) and childhood trauma (using the Childhood Trauma Questionnaire [CTQ]). Patients were classified on the DES as either ""high"" (mean DES score >/= 30) or ""low"" (mean DES score < 30) dissociators. Additional clinical and genetic factors were also explored with chi-square and t tests as appropriate. A total of 15.8% of OCD patients and 18.8% of TTM patients were high dissociators. OCD and TTM groups were comparable on DES and CTQ total scores, and in both OCD and TTM groups, significant positive correlations were found between mean DES scores and mean CTQ subscores of emotional abuse, physical abuse, sexual abuse, and physical neglect. In the OCD group, high dissociators were significantly younger than low dissociators, and significantly more high dissociators than low dissociators reported a lifetime (current and past) history of tics (P <.001), Tourette's syndrome (P =.019), bulimia nervosa (P =.003), and borderline personality disorder (P =.027). In the TTM group, significantly more high dissociators than low dissociators reported (lifetime) kleptomania (P =.005) and depersonalisation disorder (P =.005). In the Caucasian OCD patients (n = 114), investigation of genetic polymorphisms involved in monoamine function revealed no significant differences between high and low dissociator groups. This study demonstrates a link between childhood trauma and DE in patients with OCD and TTM. High dissociative symptomatology may be present in a substantial proportion of patients diagnosed with these disorders. High dissociators may also be differentiated from low dissociators on some demographic features (e.g., lower age) and comorbidity profile (e.g., increased incidence of impulse dyscontrol disorders). Additional work is necessary before conclusions about the role of monoaminergic systems in mediating such dissociation can be drawn.",0 +https://doi.org/10.1017/s0033291702006074,Short screening scales to monitor population prevalences and trends in non-specific psychological distress,"Background. A 10-question screening scale of psychological distress and a six-question short-form scale embedded within the 10-question scale were developed for the redesigned US National Health Interview Survey (NHIS). Methods. Initial pilot questions were administered in a US national mail survey ( N = 1401). A reduced set of questions was subsequently administered in a US national telephone survey ( N = 1574). The 10-question and six-question scales, which we refer to as the K10 and K6, were constructed from the reduced set of questions based on Item Response Theory models. The scales were subsequently validated in a two-stage clinical reappraisal survey ( N = 1000 telephone screening interviews in the first stage followed by N = 153 face-to-face clinical interviews in the second stage that oversampled first-stage respondents who screened positive for emotional problems) in a local convenience sample. The second-stage sample was administered the screening scales along with the Structured Clinical Interview for DSM-IV (SCID). The K6 was subsequently included in the 1997 ( N = 36116) and 1998 ( N = 32440) US National Health Interview Survey, while the K10 was included in the 1997 ( N = 10641) Australian National Survey of Mental Health and Well-Being. Results. Both the K10 and K6 have good precision in the 90th–99th percentile range of the population distribution (standard errors of standardized scores in the range 0·20–0·25) as well as consistent psychometric properties across major sociodemographic subsamples. The scales strongly discriminate between community cases and non-cases of DSM-IV/SCID disorders, with areas under the Receiver Operating Characteristic (ROC) curve of 0·87–0·88 for disorders having Global Assessment of Functioning (GAF) scores of 0–70 and 0·95–0·96 for disorders having GAF scores of 0–50. Conclusions. The brevity, strong psychometric properties, and ability to discriminate DSM-IV cases from non-cases make the K10 and K6 attractive for use in general-purpose health surveys. The scales are already being used in annual government health surveys in the US and Canada as well as in the WHO World Mental Health Surveys. Routine inclusion of either the K10 or K6 in clinical studies would create an important, and heretofore missing, crosswalk between community and clinical epidemiology.",0 +https://doi.org/10.1002/jts.20669,Role of risk factors proximate to time of trauma in the course of PTSD and MDD symptoms following traumatic injury,"Questions exist regarding whether posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are unique sequelae of trauma or a manifestation of a single form of psychopathology. Using latent growth modeling, we examined the role of risk factors occurring within 48 hours of the time of trauma on the course of PTSD and MDD symptoms over an 8-month period in 163 participants recruited from a level 1 surgical trauma center. Both PTSD and MDD symptoms showed peak prevalence by 1 month and significantly decreased over 7 months. Greater postinjury pain and PTSD symptoms (measured within 48 hours of trauma) predicted higher rates of both PTSD and MDD symptoms at 1 month. Other predictors were unique to each disorder. Results suggest that PTSD and MDD are related consequences of trauma.",0 +https://doi.org/10.1007/s00787-007-0618-z,Post-traumatic stress disorder symptom clusters in Turkish child and adolescent trauma survivors,"This study identified post-traumatic stress disorder (PTSD) symptom clusters in Turkish children and adolescents who experienced the 1999 Marmara Earthquake, which was classified as one of the world's six deadliest earthquakes in the 20th century. Two hundred ninety three children and adolescents (152 females and 141 males between the ages of 8 and 15) living in Izmit, the epicenter of the earthquake, participated in this study. The Post-Traumatic Stress Disorder Reaction Index for Children (CPTSD-RI) was administered to assess PTSD symptoms. A confirmatory factor analysis (CFA), using data from the CPTSD-RI, was conducted to determine whether the DSM-IV-TR symptom structure of PTSD was valid in Turkish children and adolescents. The CFA model supported the three-symptom cluster model. Limitations and implications for future research studies are included in the discussion. (",0 +,Post traumatic stress psychopathology 8 years after a flooding in Italy,"Objective: Post Traumatic Stress Psychopathology (PTSP) was assessed among village's inhabitants 8 years after the 1996 Versilia flooding in Italy. Methods: The sample was formed by 61 subjects. The Davidson Trauma Scale (DTS) was used to evaluate PTSP. Gender and two class of age (young and old subjects) were considered as demographic characteristics. Results: No significant differences resulted on DTS total and factor scores between female and male subjects. On the contrary, significant differences emerged on Hyperarousal Total and Hyperarousal Frequency between young and old subjects. People considered having enough symptoms for full Post Traumatic Stress Disorder (PTSD) were 45.9% (N=28), while 35.8% (N=20) had subthreshold PTSD, and 21.3% (N=13) had no PTSD. In the full PTSD subgroup old subject had a mean Hyperarousal Frequency significantly higher than young subjects, while in the subthreshold PTSD subgroup old subjects have a mean score on Intrusion Frequency, Intrusion Severity, Total Intrusion, Total Frequency and Total score significantly higher than young subjects. Conclusion: This study confirms that the traumatic impact of a flooding on a population hit some years before is not time-limited, showing the persistence of a high level of PTSP 8 years later. Old subjects showed on Hyperarousal Total and Hyperarousal Frequency within the whole sample, on Hyperarousal Frequency within the full PTSD subgroup, and on all Intrusion clusters, Total Frequency and Total score in the subthreshold PTSD subgroup, significantly higher scores than young subjects. Further specific research is needed in the elderly, in order to facilitate a better understanding of PTSP that is present in this unique population.",0 +https://doi.org/10.1016/s0887-6185(97)00049-2,Posttraumatic Stress Disorder and Work-Related Injury,"The literature indicates a substantial overlap between chronic pain and posttraumatic stress disorder (PTSD) symptoms in individuals who sustain accidental injury. To date, however, there have been no studies of PTSD symptoms in individuals who experience work-related injury. Consequently, we assessed 139 consecutive injured workers using the Modified PTSD Symptom Scale (Falsetti, Resnick, & Kirkpatrick, 1993), as well as a number of general measures of psychopathology. Most participants reported chronic pain and all were receiving workers compensation. Results indicated that 34.7% and 18.2% of the sample reported symptoms consistent with PTSD and partial PTSD, respectively. When PTSD symptom frequency and severity were considered criterion variables in multiple regression analyses, depression was found to be significantly associated with the former and anxiety sensitivity, social fears, and somatic focus with the later. Finally, these measures of general psychopathology correctly classified 78.6% of individuals with PTSD and 81.3% of those with no PTSD. These results suggest that a considerable proportion of injured workers display symptoms consistent with PTSD and that these symptoms are related to general negative affect. Implications, including the suggestion of clinical intake screening of PTSD in this population, are discussed.",0 +https://doi.org/10.1016/j.comppsych.2014.08.014,Epigenetic findings for PTSD and lower respiratory symptoms in male WTC responders,"After the World Trade Center (WTC) attack on 9/11/2001, the CDC established a consortium of clinics (WTC-Health Programs) in the NY-metropolitan area to detect, monitor and treat WTC-related health problems occurring among responders to the disaster. More than 25% of these responders (∼30,000) have WTC-related post-traumatic stress disorder (PTSD) and lower respiratory symptoms. These two conditions are often co-morbid (OR = 2.5). Longitudinal findings indicate that WTC-PTSD is associated with an increased risk of new-onset respiratory disease (but not vice versa). One explanation for this finding is that PTSD can result in a chronic stress response, including immunologic dysregulation. Epigenetics is a promising approach to elucidating biological processes underlying the PTSD-lower respiratory symptoms link. To further our understanding of the association among responders, the current study investigated DNA methylation patterns in peripheral blood of WTC responders and examined associations between methylation, PTSD symptom severity (PTSD Checklist [PCL]), and lower respiratory symptoms. Participants were 224 male (mean/ SD age = 49.6/8.1), primarily Caucasian (78%) responders enrolled in the WTC Health Program. Methylation was assessed with HumanMethylation450 BeadChip. As expected, no CpG site reached genome-wide significance (lowest p-value: 10-6). However, a network-based approach revealed that PTSD symptoms are correlated with reduced methylation in CpG sites that belong to a cluster of highly interacting genes involved in regulation of NF-κB transcription factor activity (fdr < 2 × 10-2). NF-κB is a protein complex that plays a significant role in regulating the immune response. The observed effect was driven primarily by sites within immunoregulatory genes TLR9, DAB2IP, TAOK3, and TRAF3, with the strongest effect on cg16302310 in the promoter region of TLR9. This site correlated significantly both with PTSD symptoms (r = -0.29, p = 3.91 × 10-5) and lower respiratory symptoms (r = -0.18, p = 0.01), indicating that demethylation of TLR9 is associated with greater symptom severity. The association between PTSD symptoms and lower respiratory symptoms was reduced when controlling for cg16302310 (p =0.04), which suggests that methylation mediates the PTSD-lower respiratory symptoms link. These results are a promising step in understanding the biologicalmechanisms underlying PTSD, lower respiratory symptoms, and their comorbidity. Specifically, our data build upon previous work that has implicated NF-κB and TLR9 in PTSD and highlights a potential pathway from PTSD to lower respiratory symptoms. Future work is needed to assess the observed relations longitudinally to evaluate directionality and to investigate the downstream effects of these epigenetic differences.",0 +https://doi.org/10.1300/j146v06n01_06,Violence Exposure and PTSD Among Delinquent Girls,"This study focuses on the unique trauma histories of incarcerated girls. In particular, this study draws upon data obtained from 100 incarcerated adolescent girls, highlighting areas of similarity to and difference from incarcerated boys, including: overall levels of traumatic violence exposure, exposure to unique forms of traumatic violence, psychological symptomatology, and hypothesized trajectories of involvement in serious delinquent activity. In addition, a case example is presented to illustrate our hypotheses about the trajectories of adolescent girls' involvement in serious delinquent behavior, as well as the prominent role of early trauma histories and repeat victimization in these trajectories.",0 +https://doi.org/10.1007/s10802-006-9068-1,"Parent and Child Agreement for Acute Stress Disorder, Post-Traumatic Stress Disorder and other Psychopathology in a Prospective Study of Children and Adolescents Exposed to Single-Event Trauma","Examining parent-child agreement for Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorder (PTSD) in children and adolescents is essential for informing the assessment of trauma-exposed children, yet no studies have examined this relationship using appropriate statistical techniques. Parent-child agreement for these disorders was examined by structured interview in a prospective study of assault and motor vehicle accident (MVA) child survivors, assessed at 2-4 weeks and 6 months post-trauma. Children were significantly more likely to meet criteria for ASD, as well as other ASD and PTSD symptom clusters, based on their own report than on their parent's report. Parent-child agreement for ASD was poor (Cohen's kappa = -.04), but fair for PTSD (Cohen's kappa = .21). Agreement ranged widely for other emotional disorders (Cohen's kappa = -.07-.64), with generalised anxiety disorder found to have superior parent-child agreement (when assessed by phi coefficients) relative to ASD and PTSD. The findings support the need to directly interview children and adolescents, particularly for the early screening of posttraumatic stress, and suggest that other anxiety disorders may have a clearer presentation post-trauma.",0 +https://doi.org/10.1016/j.comppsych.2008.09.011,Reliability and validity of the Korean version of the Impact of Event Scale-Revised,"The aim of this study was to explore the reliability and validity of the Impact of Event Scale-Revised Korean version (IES-R-K), a self-report scale for assessment of posttraumatic stress disorder (PTSD).The original Impact of Event Scale-Revised was translated into Korean, and the comparability of content was verified through back-translation procedures. This multicenter study included 93 patients with PTSD, 73 nonpsychotic psychiatric patients, and 88 healthy controls drawn from 18 hospitals across the country. The subjects were assessed using IES-R-K, Clinician-Administered PTSD Scale (CAPS), Beck Depression Inventory, and State Trait Anxiety Inventory (STAI; state anxiety subscale [STAI-S], trait anxiety subscale [STAI-T]) scales.In the reliability test, Cronbach alpha coefficient and test-retest reliability were .93 and 0.91, respectively, indicating that the IES-R-K has good internal consistency. One-way analysis of variance revealed significant differences in IES-R-K scores among the patients with PTSD, nonpsychotic psychiatric patients, and healthy controls (F = 139.1, P < .001). Duncan post hoc test showed the significant differences among the 3 groups. To assess the validity of the IES-R-K, correlation coefficient between the IES-R-K and CAPS, STAI-S, and STAI-T was calculated. We found that there was a relatively high degree of correlation between the IES-R-K and CAPS (r = 0.92, P < .001). However, there was a relatively less degree of correlation between STAI-S and STAI-T and IES-R-K (r = 0.30, P < .001). Taken these together, IES-R-K showed good discriminant validity.The IES-R-K showed good reliability and validity for the assessment of PTSD symptom severity. The IES-R-K is a useful instrument for assessing PTSD symptoms in Korea.",0 +https://doi.org/10.1037/a0016179,Posttraumatic stress symptoms in children after Hurricane Katrina: Predicting the need for mental health services.,"The purpose of this study was to examine factors related to the development of posttraumatic stress symptoms in children and adolescents after Hurricane Katrina. It was hypothesized that a positive correlation would exist between trauma exposure variables and symptoms indicating need for mental health services experienced 2 years after Hurricane Katrina. Specifically, the authors hypothesized that experiences associated with natural disaster including personal loss, separation from family and/or community, and lack of community support as well as previous loss or trauma would be related to increased symptomatology in both children and adolescents. This study included 7,258 children and adolescents from heavily affected Louisiana parishes. Measures included the Hurricane Assessment and Referral Tool for Children and Adolescents developed by the National Child Traumatic Stress Network (NCTSN, 2005). Results were generally supportive of our hypotheses, and specific exposure and demographic variables were found to be strongly related to posttraumatic stress symptoms in children and adolescents.",0 +https://doi.org/10.1136/jech.2006.057273,"Predictors of symptoms of post-traumatic stress disorder after the AZF chemical factory explosion on 21 September 2001, in Toulouse, France","To analyse in the general population the prevalence and predictors of symptomatology consistent with post-traumatic stress disorder (S-PTSD) 18 months after an industrial explosion.Cross-sectional survey.A random sample of 1191 city inhabitants, including an oversample of the immediate area (<3 km). S-PTSD was measured by the self-administered Impact of Event Scale-Revised. The relation between S-PTSD and individual vulnerability factors, immediate exposure and post-trauma factors was analysed by gender.S-PTSD was more prevalent in the immediate area than in the peripheral area (women 19% vs 8%; men 8% vs 2%, p<0.01). In the immediate area, S-PTSD was independently associated with birth outside France (men: OR(a) = 13.9, 95% CI 3.7 to 52.8; women: OR(a) = 2.1, 95% CI 1.0 to 4.2), age more than 40 years (men: OR(a) = 4.3, 95% CI 1.01 to 18.2; women: OR(a) = 2.3, 95% CI 1.1 to 4.5), previous psychotropic treatment (men: OR(a) = 11.5, 95% CI 2.4 to 53.6), proximity to the explosion (less educated men only) (OR(a) = 9.3, 95% CI 1.9 to 44.7), rescue efforts (men: OR(a) = 5.2, 95% CI 1.5 to 18.2), temporarily uninhabitable home (men: OR(a) = 5.8, 95% CI 1.9 to 18.1), personal injury (women: OR(a) = 3.7, 95% CI 1.7 to 8.4), financial difficulties (men: OR(a) = 17.4, 95% CI 4.2 to 72.1; women: OR(a) = 3.4, 95% CI 1.7 to 7.1) and inconvenience due to closure of public services (women: OR(a) = 4.1, 95% CI 1.6 to 9.9).Individual vulnerability, exposure and post-trauma factors were associated with S-PTSD. Vulnerable subgroups, defined by low socioeconomic characteristics may warrant focused screening after such disasters.",0 +https://doi.org/10.1186/1477-7525-5-26,The predictive value of post-traumatic stress disorder symptoms for quality of life: a longitudinal study of physically injured victims of non-domestic violence,"Little is known about longitudinal associations between post-traumatic stress disorder (PTSD) and quality of life (QoL) after exposure to violence. The aims of the current study were to examine quality of life (QoL) and the predictive value of post-traumatic stress disorder (PTSD) for QoL in victims of non-domestic violence over a period of 12 months.A single-group (n = 70) longitudinal design with three repeated measures over a period of 12 months were used. Posttraumatic psychological symptoms were assessed by using the Impact of Event Scale, a 15-item self-rating questionnaire comprising two subscales (intrusion and avoidance) as a screening instrument for PTSD. The questionnaire WHOQOL-Bref was used to assess QoL. The WHOQOL-BREF instrument comprises 26 items, which measure the following broad domains: physical health, psychological health, social relationships, and environment. Results of the analysis were summarized by fitting Structural Equation Modelling (SEM).For each category of PTSD (probable cases, risk level cases and no cases), the mean levels of the WHOQOL-Bref subscales (the four domains and the two single items) were stable across time of assessment. Individuals who scored as probable PTSD or as risk level cases had significantly lower scores on the QoL domains such as physical health, psychological health, social relationships and environmental than those without PTSD symptoms. In addition, the two items examining perception of overall quality of life and perception of overall health in WHOQOL showed the same results according to PTSD symptoms such as QoL domains. PTSD symptoms predicted lower QoL at all three assessments. Similarly PTSD symptoms at T1 predicted lower QoL at T2 and PTSD symptoms at T2 predicted lower QoL at T3.The presence of PTSD symptoms predicted lower QoL, both from an acute and prolonged perspective, in victims of non-domestic violence. Focusing on the individual's perception of his/her QoL in addition to the illness may increase the treatment priorities and efforts.",0 +https://doi.org/10.1089/jwh.2014.5001,Depression and Posttraumatic Stress Disorder Among Women with Vulvodynia: Evidence from the Population-Based Woman to Woman Health Study,"Psychological disorders may affect the pain experience of women with vulvodynia, but evidence remains limited. The present study aimed to describe the magnitude of the association of depression and posttraumautic stress disorder (PTSD) with the presence of vulvodynia in a nonclinical population from southeastern Michigan.Baseline data from 1,795 women participating in the Woman to Woman Health Study, a multiethnic population-based study, was used for this analysis. Validated screening questionnaires were conducted to assess vulvodynia, depression, and PTSD. Modified Poisson regression models with a robust variance estimation were used to estimate prevalence ratios (PR) and their 95% confidence intervals (CI) for the association between vulvodynia status and two mental health conditions, depression and PTSD.In the adjusted models, women who screened positive for depression had a 53% higher prevalence of having vulvodynia (PR=1.53; 95% CI: 1.12, 2.10) compared with women who screened negative for depression. Women who screened positive for PTSD had more than a two-fold increase in the prevalence of having vulvodynia (PR=2.37; 95% CI: 1.07, 5.25) compared with women who screened negative for PTSD.The increased prevalence of vulvodynia among those screening positive for depression or PTSD suggests that these disorders may contribute to the likelihood of reporting vulvodynia. Alternatively, vulvodynia, depression, and PTSD may have a common pathophysiological and risk profile. Prospective studies are needed to improve our understanding of the temporal relation between mental health conditions and vulvar pain.",0 +https://doi.org/10.1023/b:jots.0000038484.15488.3d,Social acknowledgment as a victim or survivor: A scale to measure a recovery factor of PTSD,"The development and validation of a new measure of social acknowledgment as a victim or survivor is presented, whose items were derived from previous research on social recovery factors of post-traumatic stress disorder. The Social Acknowledgment Questionnaire (SAQ) was administered to nontreatment seeking traumatized persons—178 former political prisoners in East Germany and 151 recently traumatized interpersonal crime victims. Principal components analysis yielded three factors—Recognition as victim, General disapproval, and Family disapproval. The factors showed high internal consistency and good test-retest reliability; correlated moderately to strong with measures of PTSD severity, social support, and reluctance to talk about the trauma. In comparison to a conventional measure of social support, the SAQ predicted comparably better between persons with high- and low-PTSD severity.",0 +https://doi.org/10.4088/jcp.v59n0904,Open Trial of Nefazodone for Combat-Related Posttraumatic Stress Disorder,"Because of its ability to block 5-HT2 receptors postsynaptically and inhibit 5-HT reuptake presynaptically and/or its enhancement of sleep quality, nefazodone may be useful for symptom management in posttraumatic stress disorder (PTSD) patients.Ten patients with combat-related DSM-IV posttraumatic stress disorder (PTSD) entered an open-label 12-week trial of nefazodone with a 4-week follow-up, beginning with 100 mg/day and increasing as necessary to achieve a maximal response or until reaching a maximum dosage of 600 mg/day.Nefazodone was well tolerated, and no significant changes in sexual function were reported. Based on Clinical Global Impressions-Improvement scores, all 10 patients were rated as much improved. All PTSD symptoms (except self-reported PTSD reexperiencing symptoms), sleep, and clinician-rated depression significantly improved at week 12. At follow-up, significant changes were maintained, and self-reported PTSD reexperiencing symptoms had also significantly improved. Effect sizes for all changed symptoms were moderate to large at week 12 and at follow-up. Self-reported and clinician-rated anger significantly improved. Self-reported depression failed to improve. Improvement in social and occupational functioning was minimal.These preliminary data suggest that nefazodone may be effective in reducing the 3 primary PTSD symptom clusters and may be particularly helpful in improving sleep and decreasing anger.",0 +,Neuropsychiatric profile of a case of post traumatic stress disorder following an electric shock.,"Exposure to extraordinary stressors or life-threatening events has been shown to result in negative cognitive, behavioural and emotional outcomes including the cluster of symptoms constituting Post Traumatic Stress Disorder (PTSD). This disorder has most often been studied in military veterans and victims of abuse who also show high rates of comorbid conditions. We report a case of PTSD following an electrical injury in a patient with no past psychiatric history. Implications for a full range of examinations including comprehensive neuropsychiatric testing are discussed. Results suggest that such approach addresses the complexity of a differential diagnosis between organic and psychiatric dysfunctions.",0 +https://doi.org/10.1080/17441692.2014.972426,"Social interaction in the aftermath of conflict-related trauma experiences among women in Walungu Territory, Democratic Republic of Congo","The aim of this study was to understand the relative contribution of posttraumatic stress disorder (PTSD)- and non-PTSD-associated reductions in social interaction among a group of adult Congolese women (N = 701) who have experienced multiple and different traumatic events and are participating in a village livestock microfinance programme. The two main outcomes were frequency of (1) family/community members visiting women's homes and (2) women visiting family/community members in their home. Bivariate and multivariable linear regression was used to understand relationships between multiple and grouped trauma experiences, PTSD, depression and social interaction. The majority of women (51.6%) reported rarely or never visiting family/community members or having family/community members visit the woman's home (54.9%). In the multivariable model, material deprivation was significantly associated with fewer visits in the woman's home. Exposure to certain conflict-related traumas, but not material deprivation, was significantly associated with fewer visits to the homes of family/community members. Increased symptoms of PTSD were significantly associated with fewer visitors in woman's home and fewer visits to the homes of family/community members. A better understanding of the social effects of conflict on individuals and local communities is necessary to support rebuilding of local communities.",0 +https://doi.org/10.1037/a0033013,Awake/sleep cortisol levels and the development of posttraumatic stress disorder in injury patients with peritraumatic dissociation.,"Differences in the time of day that cortisol is sampled and failure to consider the impact of peritraumatic dissociation have been hypothesized as factors possibly contributing to the inconsistent findings in research examining associations between cortisol levels soon after trauma exposure and the subsequent development of posttraumatic stress disorder (PTSD). The present study examined associations between urinary cortisol levels during wake and sleep times soon after a serious injury and the subsequent development of PTSD in adult patients reporting low or high peritraumatic dissociative (PD) symptoms. Thirty-nine injury patients (20 with high and 19 with low PD symptoms) provided a 15-hour (6 PM to 9 AM) urine sample at 3-weeks post-injury and completed the Clinician Administered PTSD Scale at a 7-week follow-up. Participants collected their urine during wake and sleep times separately. Results showed that in the total sample and in the high PD group, wake, but not sleep, cortisol levels were lower in patients who developed PTSD compared to those who did not. A multiple linear regression analysis revealed a significant main effect of PD and a non-significant interaction between wake cortisol and PD in predicting PTSD symptom severity. In addition, results showed that PD was a better predictor of PTSD symptom severity than wake cortisol levels. These results were consistent with prior research indicating lower afternoon/evening cortisol levels in PTSD and strong associations between PD and PTSD, but did not support the existence of subgroups of PTSD patients (dissociators versus non-dissociators) who may differ in basal cortisol levels.",0 +https://doi.org/10.1016/j.cnr.2004.06.003,Differing psychotropic profiles of the anticonvulsants in bipolar and other psychiatric disorders,"Abstract Several compounds from the anticonvulsant category have played a major role in therapeutic approaches to bipolar illness, particularly carbamazepine, valproate, and lamotrigine. At the same time there is little evidence that covert seizures underlie the affective disorders, or that all anticonvulsants are effective acute antimanic or mood stabilizing agents. For example, recent FDA-approved anticonvulsants (gabapentin, the gamma-aminobutyric acid (GABA) re-uptake inhibitor tiagabine, and topiramate) that exert major effects on GABAergic systems and increase brain GABA in patients as measured by magnetic resonance spectroscopy, do not appear to be effective acute antimanic agents based on controlled clinical trials or detailed open observations. This raises the question as to what mechanistic properties within the anticonvulsant class are associated with positive effects in bipolar illness; candidates include blockade of sodium channels and decreased release of glutamate, decreased calcium influx through the NMDA receptor, increases in potassium efflux, as well as a variety of aminergic effects and effects on gene expression. With the exception of lamotrigine, mood stabilizers (including lithium, valproate, and carbamazepine) appear to be better acute and prophylactic antimanics than antidepressants, and preliminary data suggest this for zonisamide as well. Some of the anticonvulsants appear useful in targeting a variety of other syndromes and ones that are often comorbid with bipolar illness, including anxiety disorders, substance abuse disorders, migraine, eating disorders, and obesity. Gabapentin is effective in panic anxiety and social phobia as well as chronic pain syndromes, whereas a large range of anticonvulsants may be useful in the treatment of sleep disorders and paroxysmal components of posttraumatic stress disorder. Recent data indicate that topiramate has the ability to reduce alcohol intake and craving in patients with primary alcoholism compared with placebo, and both topiramate and zonisamide share the positive side effect of inducing weight loss of a magnitude similar to that achieved with the FDA-approved weight-loss drug sibutramine. Thus, while there is an apparent absence of seizures in bipolar illness, and anticonvulsant efficacy is not sufficient for classifying the psychotropic properties of these agents, some of the mechanisms that are pertinent to inhibiting paroxysmal discharges in the epilepsies may also be pertinent to the wide range of primary or adjunctive uses of the anticonvulsants in a range of neuropsychiatric disorders.",0 +https://doi.org/10.1002/da.20300,Does the evocation of traumatic memories confound subsequent working memory performance in posttraumatic stress disorder (PTSD)?,"The role of heightened arousal has been previously discussed as a contributor to neurocognitive impairment in posttraumatic stress disorder (PTSD). To investigate whether psychological effects (distraction, re-location of resources) elicited by the evocation of traumatic memories impact on subsequent cognitive performance in PTSD, two parallel versions of a working memory task were administered to 33 trauma-exposed participants (15 with and 18 without PTSD). Between first and second working memory assessment a trauma-related interview was conducted including the narration of the trauma. Levels of working memory impairment in PTSD patients remained unchanged. This study provides preliminary evidence that neurocognitive impairment is not secondary to psychological effects induced by the evocation of traumatic memories. Nevertheless, it is recommended that future PTSD research should devote more care to the order in which trauma-related and other dependent variables such as cognitive tests are presented to participants. Depression and Anxiety 25:175–179, 2008. © 2008 Wiley-Liss, Inc.",0 +https://doi.org/10.1207/s15327752jpa7002_9,Use of the Hand Test in the Assessment of Combat-Related Stress,"This study investigated the effectiveness of the Hand Test in discriminating the differential symptomatology of posttraumatic stress (PTS) in Vietnam combat veterans (VCVs). Participants were 108 VCV outpatients, 85 of whom met the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) criteria for posttraumatic stress disorder (PTSD), and 23 patients that were found to meet some, but not the minimum criteria, required for a diagnosis of PTSD by the DSM-IV. The latter group of patients was classified into a subclinical PTSD, posttraumatic stress symptoms (PTSS) group. Results showed higher levels of overall psychopathology, a vulnerable capacity for coping, and a tendency for feelings of inadequacy and inferiority in the PTSD group. The PTSD group also exhibited more limited interaction with the world around them than the PTSS group, which may be indicative of withdrawal, apathy, or a lack of concern with environmental activities and goals. These findings are discussed in relation to the assessment, understanding, and treatment of PTS symptomatology and PTSD.",0 +https://doi.org/10.1002/da.20790,Recovery from PTSD following Hurricane Katrina,"We examined patterns and correlates of speed of recovery of estimated posttraumatic stress disorder (PTSD) among people who developed PTSD in the wake of Hurricane Katrina.A probability sample of prehurricane residents of areas affected by Hurricane Katrina was administered a telephone survey 7-19 months following the hurricane and again 24-27 months posthurricane. The baseline survey assessed PTSD using a validated screening scale and assessed a number of hypothesized predictors of PTSD recovery that included sociodemographics, prehurricane history of psychopathology, hurricane-related stressors, social support, and social competence. Exposure to posthurricane stressors and course of estimated PTSD were assessed in a follow-up interview.An estimated 17.1% of respondents had a history of estimated hurricane-related PTSD at baseline and 29.2% by the follow-up survey. Of the respondents who developed estimated hurricane-related PTSD, 39.0% recovered by the time of the follow-up survey with a mean duration of 16.5 months. Predictors of slow recovery included exposure to a life-threatening situation, hurricane-related housing adversity, and high income. Other sociodemographics, history of psychopathology, social support, social competence, and posthurricane stressors were unrelated to recovery from estimated PTSD.The majority of adults who developed estimated PTSD after Hurricane Katrina did not recover within 18-27 months. Delayed onset was common. Findings document the importance of initial trauma exposure severity in predicting course of illness and suggest that pre- and posttrauma factors typically associated with course of estimated PTSD did not influence recovery following Hurricane Katrina.",0 +https://doi.org/10.1016/j.jaac.2011.03.001,Posttraumatic Stress Disorder in Infants and Young Children Exposed to War-Related Trauma,"Although millions of the world's children are growing up amidst armed conflict, little research has described the specific symptom manifestations and relational behavior in young children exposed to wartime trauma or assessed factors that chart pathways of risk and resilience.Participants included 232 Israeli children 1.5 to 5 years of age, 148 living near the Gaza Strip and exposed to daily war-related trauma and 84 controls. Children's symptoms were diagnosed, maternal and child attachment-related behaviors observed during the evocation of traumatic memories, and maternal psychological symptoms and social support were self-reported.PTSD was diagnosed in 37.8% of war-exposed children (n = 56). Children with PTSD exhibited multiple posttraumatic symptoms and substantial developmental regression. Symptoms observed in more than 60% of diagnosed children included nonverbal representation of trauma in play; frequent crying, night waking, and mood shifts; and social withdrawal and object focus. Mothers of children with PTSD reported the highest depression, anxiety, and posttraumatic symptoms and the lowest social support, and displayed the least sensitivity during trauma evocation. Attachment behavior of children in the Exposed-No-PTSD group was characterized by use of secure-base behavior, whereas children with PTSD showed increased behavioral avoidance. Mother's, but not child's, degree of trauma exposure and maternal PTSD correlated with child avoidance.Large proportions of young children exposed to repeated wartime trauma exhibit a severe posttraumatic profile that places their future adaptation at significant risk. Although more resilient children actively seek maternal support, avoidance signals high risk. Maternal well-being, sensitive behavior, and support networks serve as resilience factors and should be the focus of interventions for families of war-exposed infants and children.",0 +https://doi.org/10.1146/annurev.clinpsy.2.022305.095305,"Posttraumatic Stress Disorder: Etiology, Epidemiology, and Treatment Outcome","Posttraumatic stress disorder (PTSD) results from exposure to a traumatic event that poses actual or threatened death or injury and produces intense fear, helplessness, or horror. U.S. population surveys reveal lifetime PTSD prevalence rates of 7% to 8%. Potential reasons for varying prevalence rates across gender, cultures, and samples exposed to different traumas are discussed. Drawing upon a conditioning model of PTSD, we review risk factors for PTSD, including pre-existing individual-based factors, features of the traumatic event, and posttrauma social support. Characteristics of the trauma, particularly peritraumatic response and related cognitions, and posttrauma social support appear to confer the greatest risk for PTSD. Further work is needed to disentangle the interrelationships among these factors and elucidate the underlying mechanisms. Based upon existing treatment outcome studies, we recommend use of exposure therapies and anxiety management training as first-line treatment for PTSD. Among psychopharmacological treatments, selective serotonin reuptake inhibitors evidence the strongest treatment effects, yet these effects are modest compared with psychological treatments.",0 +https://doi.org/10.1016/j.math.2013.02.002,Content not quantity is a better measure of muscle degeneration in whiplash,"Whiplash associated disorder (WAD) represents an enormous economic, social and personal burden. Five out of 10 people with WAD never fully recover and up to 25% continue to have moderate to severe pain-related disability. Unfortunately, clear and definitive reasons as to why half of individuals with WAD recover uneventfully and the other half do not, remain elusive. Identifying the factors that can reliably predict outcome holds considerable importance for not only WAD, but arguably for other acute musculoskeletal traumas. The precise pathology present in WAD has been controversial and often biased by outdated models. Fortunately, a combination of new measurement technology that illuminates pain processing, physical and social functioning and post-traumatic stress responses (and possibly markers of altered muscle size/shape/physiology) is providing a clearer picture of the multisystem pathophysiology in individuals with persistent WAD. The aim of this professional issues paper is to illuminate the clinical and research communities with regards to the growing body of knowledge for determining the trajectory of a patient with whiplash.",0 +https://doi.org/10.2147/nedt.1.2.109.61049,Nitric oxide as inflammatory mediator in post-traumatic stress disorder (PTSD): evidence from an animal model,"Post-traumatic stress disorder (PTSD) is a severe anxiety disorder that may develop after experiencing or witnessing a traumatic event. Recent clinical evidence has suggested the involvement of neurodegenerative pathology in the illness, particularly with brain imaging studies revealing a marked reduction in hippocampal volume. Of greater significance is that these anatomical changes appear to be positively correlated with the degree of cognitive deficit noted in these patients. Stress-induced increases in plasma cortisol have been implicated in this apparent atrophy. Although not definitive, clinical studies have observed a marked suppression of plasma cortisol in PTSD. The basis for hippocampal neurodegeneration and cognitive decline therefore remains unclear. Stress and glucocorticoids increase glutamate release, which is recognized as an important mediator of glucocorticoid-induced neurotoxicity. Recent preclinical studies have also noted that glutamate and nitric oxide (NO) play a causal role in anxiety-related behaviors. Because of the prominent role of NO in neuronal toxicity, cellular memory processes, and as a neuromodulator, nitrergic pathways may have an important role in stress-related hippocampal degenerative pathology and cognitive deficits seen in patients with PTSD. This paper reviews the preclinical evidence for involvement of the NO-pathway in PTSD, and emphasizes studies that have addressed these issues using time-dependent sensitization - a putative animal model of PTSD.",0 +https://doi.org/10.1037/a0036025,A group therapy approach to treating combat posttraumatic stress disorder: Interpersonal reconnection through letter writing.,"Many who have served in a war zone carry deep emotional wounds that go beyond the typical symptom clusters of reexperiencing, avoidance/numbing, and hyperarousal that comprise a diagnosis of posttraumatic stress disorder (PTSD). Specifically, many combatants experience unresolved grief, guilt, and shame caused by losses and traumatic experiences suffered in war, called ""moral injury"" by some clinicians and researchers (e.g., Litz et al., 2009; Shay, 1994). We describe the aspects of human attachment that set the stage for grief, guilt, and shame, and outline the 3-phase group therapy model we have implemented in a clinical setting to foster the reconnection of severed human bonds. Special attention is paid to killing and related phenomena that are unique to combat PTSD. The program phases include psychoeducation, trauma-focused therapy, and aftercare, which focuses on assisting the veterans in reconnecting with their families and communities. The use of letter writing as an intervention is illustrated through case examples, and clinical outcomes are anecdotally described.",0 +https://doi.org/10.1037/a0016907,Post-acute polytrauma rehabilitation and integrated care of returning veterans: Toward a holistic approach.,"Throughout the history of war, exposure to combat has been associated with clusters of physical and psychological symptoms labeled in various ways, from ""hysteria"" to ""shell shock"" in World War I to ""polytrauma"" in Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF).To describe the historical conceptualizations of combat injury and the ways they are relevant to developing current rehabilitation strategies, discuss the symptom complex presented by OEF/OIF veterans, and describe key elements and principles of holistic, integrated care for post-acute OEF/OIF veterans.A conceptualization of rehabilitation recognizing a final common pathway of functional disability and suffering is proposed, and both systematic and treatment-specific aspects at the core of a veteran-centered holistic approach are discussed.",0 +https://doi.org/10.1023/a:1020572505095,Cancer-Related Intrusive Thoughts as an Indicator of Poor Psychological Adjustment at 3 or More Years After Breast Surgery: A Preliminary Study,"Intrusive thoughts are one of the re-experiencing symptoms in posttraumatic stress disorder, and have been suggested as a predictor for the continuous presence of psychological distress in cancer survivors. The aim of this preliminary study was to examine the possibility of using cancer-related intrusive thoughts (CITs) as an indicator of psychological distress and adjustment after breast surgery. A consecutive series of ambulatory breast cancer survivors at 3 or more years after surgery were given the Structured Clinical Interview for DSM-IV (SCID) and self-report questionnaires, including Profile Of Mood States (POMS), Impact of Event Scale (IES) and Mental Adjustment to Cancer (MAC) scale, to measure psychological distress and/or adjustment. The SCID identified a history of CITs in 34 (46 \% ) of the 74 participants. No significant differences were found in the POMS and IES psychological distress scores between subjects with and without a history of CITs. Subjects with a history of CITs showed significantly higher levels of anxious preoccupation, one of the MAC subscale scores. The association continued to be significant after controlling for potential confounders such as social support, depression, avoidance, arousal, and neuroticism. The results indicated that CITs might be useful for indicating poor psychological adjustment, but not distress, in patients at 3 or more years after breast surgery.",0 +https://doi.org/10.1080/17405620600783526,Emotion regulation in relation to social functioning: An investigation of child self-reports,"Relations between child self-reports of specific aspects of emotion regulation and specific aspects of social functioning in school were studied in two samples (N = 129/135) of 8- to 9-year-old children. The newly developed child self-report measure had significant relations to parent (Sample 1) and teacher (Sample 2) ratings of emotion regulation. In line with expectations (Rydell, Berlin, & Bohlin, 2003), poor regulation of anger and exuberance was associated with externalizing problems in both samples, poor regulation of fear had associations with social anxiety or internalizing problems in the two samples and poor regulation of sadness had marginal relations to internalizing problems in one sample. In both samples, good regulation of all emotions except fear was associated with prosocial behaviour. In Sample 1, several independent effects of child self-reports of emotion regulation on outcomes were demonstrated after controlling for parent reports of emotion regulation.",0 +,Resilience to potential trauma: Toward a lifespan approach.,,0 +https://doi.org/10.1177/0020764012453233,Prevalence and predictors of stress disorders following two earthquakes,"Background: Studies about stress disorders following a disaster have mainly been based on single-event trauma with little emphasis on multiple traumas. Aims: This study investigated the prevalence and predictors of stress disorders following two earthquakes in China. Methods: Subjects were randomly sampled from 11 villages in rural China. A total of 624 subjects were administered with the 12-item General Health Questionnaire (GHQ-12), Symptom Checklist -90-R (SCL-90-R), Coping Style Scale and Social Support Rating Scale. This was followed by a structural clinical interview using the Chinese translation of the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV-TR axis 1 disorders (SCID-I-P) for acute stress disorder (ASD) and post-traumatic stress disorder (PTSD). Results: The prevalence of ASD and PTSD was 15% and 29%, respectively. Regression analysis indicated that high intensity of trauma exposure, lower educational level, subjective feeling of economic status and psychological stress after the first earthquake significantly predicted the outcome of PTSD. Conclusions: The study suggested that the prevalence of stress disorders in two earthquakes were higher than that experienced in a single disaster. The intensity of trauma exposure, low educational level, bad subjective feeling of economic status, and psychological stress after the first earthquake could be used to identify survivors at risk of developing PTSD in two earthquakes.",0 +https://doi.org/10.1016/j.jad.2013.12.014,Social support barriers and mental health in terrorist attack survivors,"To expand our understanding of social support and mental health, we introduce a measure of social support barriers and investigate the relationship between these barriers, social support, mental health and gender in survivors of the terrorist attack on Utøya Island, Norway.Survivors (N=285) were interviewed face to face. We used confirmatory factor analysis (CFA) to assess the latent factor structure of the Social Support Barriers Scale and perceived social support (FSSQ), and linear regression analyses to investigate the associations between social support variables and mental health (PTSD-RI and HSCL-8).The CFA indicated that social support barriers and perceived social support were two separable latent constructs. Social support barriers were highly associated with posttraumatic stress reactions (adjusted regression coefficient=0.38, 95% CI=0.29-0.47. p<0.001) as well as with psychological distress (adjusted regression coefficient=0.35, 95% CI=0.26-0.43, p<0.001). In contrast, neither perceived social support nor gender was associated with mental health after adjustment for barriers.Most analyses were based on cross-sectional data. This is the first study to use a quantitative measure of social support barriers.Social support barriers may be a new opening to understand the relationship between social support and mental health and may have a role in explaining why women are at increased risk for mental health problems. Clinicians should explore not only perceived social support but also barriers to making use of these resources when consulting young people facing major life adversities.",0 +https://doi.org/10.1186/s12888-015-0565-z,Parental intimate partner homicide and its consequences for children: protocol for a population-based study,"The loss of a parent due to intimate partner homicide has a major impact on children. Professionals involved have to make far-reaching decisions regarding placement, guardianship, mental health care and contact with the perpetrating parent, without an evidence base to guide these decisions. We introduce a study protocol to a) systematically describe the demographics, circumstances, mental health and wellbeing of children bereaved by intimate partner homicide and b) build a predictive model of factors associated with children's mental health and wellbeing after intimate partner homicide.This study focuses on children bereaved by parental intimate partner homicide in the Netherlands over a period of 20 years (1993 - 2012). It involves an incidence study to identify all Dutch intimate partner homicide cases between 1993 and 2012 by which children have been bereaved; systematic case reviews to describe the demographics, circumstances and care trajectories of these children; and a mixed-methods study to assess mental health, wellbeing, and experiences regarding decisions made and care provided.Clinical experience and initial research suggest that the children involved often need long-term intensive mental health and case management. The costs of these services are extensive and the stakes are high. This study lays the foundation for an international dataset and evidence-informed decision making.",0 +,Examining the relationship between race-related stressors and post-traumatic stress disorder among African American male Vietnam veterans,"It is estimated that 1,700,000 Vietnam War veterans have experienced ""clinically serious stress reaction symptoms"" (National Center for Post Traumatic Stress Disorder, 2005). Of this figure, all ethnic minorities (except for Japanese) reported the greatest life time prevalence of posttraumatic stress disorder (PTSD) compared to Whites (Kulka, Schlenger, Fairbank, Hough, Jordan, Marmar, & Weiss, 1990). The National Vietnam Veterans Readjustment Study (NVVRS) found that African American Vietnam War veterans had greater exposure to war stressors and had more predisposing factors than Whites (Kulka et al., 1990). The Race-Related Stressor Scale (RRSS) is the only instrument that exists to measure race-related stressors that contribute uniquely and substantially to PTSD symptoms and generalized psychiatric distress in an ethnic minority Vietnam Veteran sample. A previous study found that race-related stressors account for a significant proportion of the variance in PTSD symptoms of Asian American Vietnam Veterans (Loo, Fairbank, Scurfield, Ruch, King, Adams, & Chemtob, 2001). Although African American Vietnam War veterans are one of the most frequently studied samples, no instrument exists to measure race-related exposure accounting for their PTSD symptoms. There are two purposes of this study: Primary is to adapt and validate the RRSS using an African American Vietnam Veteran sample, and secondary is to examine the amount of variability the adapted RRSS accounts for in PTSD and generalized psychiatric distress symptoms. This new measure will be called the Vietnam Racial Stressor Scale for African American Vietnam Veterans (VRSS). The construct validity of the adapted RRSS will be examined by investigating the relationship between the VRSS, PTSD, and general psychiatric distress symptoms, controlling for military rank and exposure to combat. The temporal stability of the VRSS will be assessed using Cronbach's Alpha method. Results of the temporal stability of the VRSS will be compared to Loo et al., (2001) RRSS temporal stability for Asian American Vietnam War veterans. A general discussion of the temporal stability comparisons between the RRSS and its adaptations will suggest the generalizability of the RRSS with other Vietnam War veteran ethnic groups. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1196/annals.1454.045,Children's Environmental Health in the Twenty-First Century,"In the twenty-first century, the global burden of disease trends are the result of complex interaction among rapid industrialization and urbanization, unsustainable use of natural resources, and population growth. In addition, global environmental changes due to climate change, ozone depletion, desertification/deforestation, loss of biodiversity, and increased used of some biotechnologies are having an important impact on human health. Many other factors also play an important role in the population's health response to global environmental threats, including poverty, malnutrition, poor sanitation, and infectious diseases. Worldwide, the burden of environmental disease is much higher for children than adults, especially in young children under 5 years of age. Quantification of the burden of diseases attributable to environment shows that environmental risk factors can contribute to more than one-third of the disease burden in children, a fraction of disease that could be prevented. Children are often exposed to multiple environmental threats combined with other behavioral, social, and economic risk factors. Many of the environmental health risk factors are shared among children's home, school, and community. Therefore, an integrated approach should be considered in order to create healthy environments for children. The promotion of safe environments for children has to involve decision makers, nongovernmental organizations (NGOs), families, and various sectors including health, education, housing, environment, agriculture, industry, transport, and energy. Multiple initiatives have been proposed from collection, evaluation, and dissemination of information on children's health and the potential environmental threats to research, monitoring, risk assessment, and policies to improve the environmental conditions and ultimately children's growth and development.",0 +https://doi.org/10.1016/j.jbtep.2011.12.001,The relationship between cognitive control and posttraumatic stress symptoms,"Recently researchers have theorized that individual differences in cognitive control (i.e., the ability to complete goal-directed behavior by actively maintaining information while inhibiting irrelevant information) may elucidate processes involved in disorders characterized by intrusive thoughts and memories. By this account, the relationship between cognitive control and emotional disorders would be specific to symptoms associated with intrusive cognitions, such as re-experiencing symptoms of posttraumatic stress disorder (PTSD).In the present study, 77 undergraduate participants with a self-reported history of trauma exposure were administered assessments of cognitive control (working memory capacity; WMC), PTSD symptoms, trait anxiety, and depression. PTSD symptoms from each of the three symptom clusters (re-experiencing, avoidance, and hyperarousal) were predicted from trait anxiety, depression, and WMC performance scores using separate regression models.After controlling for trait anxiety and depression, there was a negative, statistically significant relationship between cognitive control and re-experiencing symptoms but not avoidance or hyperarousal symptoms.The study was completed cross-sectionally and did not include a diagnostic assessment of PTSD.Findings add to extant literature suggesting a relationship between cognitive control and intrusive cognitions. Moreover, the present study expands the current literature by demonstrating the specificity of this relationship within individuals with varying degrees of PTSD symptom severity.",0 +https://doi.org/10.53841/bpsadm.2017.9.1.20,Computerised Test Generation for Cross-National Military Recruitment: A Handbook,"“‘Computerised Test Generation for Cross-National Military Recruitment’ by Prof. Sidney H. Irvine is a handbook for use in occupational psychology, test construction and psychometrics. The book describes the development of the British Army Recruitment Battery (BARB) by Prof. Irvine and his colleagues at the University of Plymouth. BARB is a computer-administered selection battery that is still in use to this day and is capable of developing new parallel tests for every candidate in the recruitment process. In telling the story, Sidney Irvine describes not only the development of the battery itself, funded by the UK Ministry of Defence, but all the work that went on before and afterwards, in the United Kingdom, with European allies and in the United States. Prof. Irvine argues that judicious application of the current state-of-the art in psychometric selection tests can be used to maximise retention and minimise attrition. As such, this long-awaited book will be of great interest to psychologists, psychometricians, test developers, those involved in personnel selection and all with an interest in military history, in particular the history of military science. With a foreword and chapter introductions from a worldwide array of subject matter experts, the book also has a full subject index and an extensive bibliography. I commend it heartily.” — Professor Jamie Hacker Hughes CPsychol CSci FBPsS, Former Defence Consultant Advisor in Clinical Psychology, Ministry of Defence, United Kingdom. © 2014 The author and IOS Press. All rights reserved.",0 +https://doi.org/10.1016/j.jad.2015.08.039,The association between latent depression subtypes and remission after treatment with citalopram: A latent class analysis with distal outcome,"The objectives were to characterize latent depression subtypes by symptoms, evaluate sex differences in and examine correlates of these subtypes, and examine the association between subtype and symptom remission after citalopram treatment.Latent class analysis was applied to baseline data from 2772 participants in the Sequenced Treatment Alternatives to Relieve Depression trial. Indicators were from the Quick Inventory of Depressive Symptomatology. Separate multinomial logistic models identified correlates of subtypes and the association between subtype and the distal outcome of remission.Four latent subtypes were identified: Mild (men: 37%, women: 27%), Moderate (men: 24%, women: 21%), Severe with Increased Appetite (men: 13%, women: 22%), and Severe with Insomnia (men: 26%, women: 31%). Generalized anxiety disorder, bulimia, and social phobia were correlated with Severe with Increased Appetite and generalized anxiety disorder, post-traumatic stress disorder, and social phobia with Severe with Insomnia. Relative to those with the Mild subtype, those with Severe with Increased Appetite (odds ratiomen (OR): 0.48; 95% confidence interval (CI): 0.25-0.92; OR women: 0.59; 95% CI: 0.41-0.86) and those with Severe Depression with Insomnia (ORmen: 0.65; 95% CI: 0.41-1.02; ORwomen: 0.45; 95% CI: 0.32-0.64) were less likely to achieve remission.The sample size limited exploration of higher order interactions.Insomnia and increased appetite distinguished latent subtypes. Sex and psychiatric comorbidities differed between the subtypes. Remission was less likely for those with the severe depression subtypes. Sleep disturbances, appetite changes, and other mental disorders may play a role in the etiology and treatment of depression.",0 +https://doi.org/10.1080/01621459.1988.10478722,A Test of Missing Completely at Random for Multivariate Data with Missing Values,"Abstract A common concern when faced with multivariate data with missing values is whether the missing data are missing completely at random (MCAR); that is, whether missingness depends on the variables in the data set. One way of assessing this is to compare the means of recorded values of each variable between groups defined by whether other variables in the data set are missing or not. Although informative, this procedure yields potentially many correlated statistics for testing MCAR, resulting in multiple-comparison problems. This article proposes a single global test statistic for MCAR that uses all of the available data. The asymptotic null distribution is given, and the small-sample null distribution is derived for multivariate normal data with a monotone pattern of missing data. The test reduces to a standard t test when the data are bivariate with missing data confined to a single variable. A limited simulation study of empirical sizes for the test applied to normal and nonnormal data suggests th...",0 +,The Brain and Propranolol Pharmacokinetics in the Elderly.,"Propranolol, a non-selective β-blocker, has been found to have a tremendous array of indications. Recent evidence has suggested that propranolol may be effective in patients suffering from post-traumatic stress disorder by suppressing activity in the amygdala and thereby inhibiting emotional memory formation. Dosage requirements have been well established in the pediatric and adult population, however, there has been no definitive geriatric dose recommended in the package inserts made available to the public. The aim of this paper is to use pharmacokinetic simulations in order to establish a pharmacokinetic profile dosage equivalent for the elderly as has been found in young patients. After completing the Monte-Carlo simulations for the elderly and young patients, a single 10mg dose in the elderly has shown comparable pharmacokinetic profiles as found in young patients administered a 40mg single dose.",0 +https://doi.org/10.1002/cpp.545,Memory performance and dysfunctional cognitions in recent trauma victims and patients with post-traumatic stress disorder,"In order to investigate whether cognitive dysregulation contributed to memory impairment in trauma patients, recent trauma victims, post-traumatic stress disorder (PTSD) patients and healthy controls were compared with regard to verbal memory and dysfunctional cognitions. There were no significant group differences with regard to verbal memory. Concerning dysfunctional cognitions, recent trauma victims hardly differed from controls, unlike PTSD patients, who showed more negative appraisal, more dysfunctional thought control strategies and externality than controls. None of them were related to memory performance in the recent trauma group, and there was a negative correlation with distraction strategy in PTSD patients. In recent trauma victims, negative appraisal increased with time since the trauma. Copyright © 2007 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1111/j.1469-7610.2011.02520.x,The mutual prospective influence of child and parental post-traumatic stress symptoms in pediatric patients,"Previous studies found notable rates of post-traumatic stress symptoms (PTSS) and post-traumatic stress disorder (PTSD) in pediatric patients and their parents and suggest a significant association between child and parent PTSS. However, little is known about mutual influences between child and parental PTSS over time. This study prospectively examined the presence of PTSS and PTSD and the mutual influence of child and parental PTSS in a large sample of pediatric patients with different medical conditions. A total of 287 children (aged 6.5-16 years) and their mothers (n = 239) and fathers (n = 221) were assessed at 5-6 weeks and 1 year after an accident or a new diagnosis of cancer or diabetes mellitus type 1 in the child. At the first assessment 11.1% and at the second assessment 10.2% of the children had moderate to severe PTSS. At 5-6 weeks 29.3% of mothers and 18.6% of fathers met criteria for PTSD. At 1 year the rates were 14.6% for mothers and 7.9% for fathers. There were considerable differences of PTSS among different medical diagnostic groups in children and parents. Mothers were more vulnerable than fathers. Structural equation analysis revealed that initially high PTSS in mothers and fathers were longitudinally related to poorer recovery from PTSS in the child. Cross-lagged effects from the child to the parents and from one parent to the other were not significant. This study highlights the long-term influence of parental PTSS on the child's recovery after trauma and calls for a family systems approach and for early interventions in the treatment of traumatized pediatric patients.",0 +https://doi.org/10.1111/j.1526-4610.2008.00917.x,Post-Traumatic Stress Disorder in Episodic and Chronic Migraine,"To assess and contrast the relative frequency of self-reported post-traumatic stress disorder (PTSD) in patients with episodic migraine and chronic/ transformed migraine.Several risk factors have been identified as risk factors for chronification of headache disorders. Childhood abuse has been suggested as a risk factor for chronic pain in adulthood. In addition depression, as well as several other psychiatric disorders, are co-morbid with migraine. Recent data suggest that PTSD may be more common in headache sufferers than in the general population.This was a prospective, pilot study conducted at a headache center. Adult subjects with episodic, chronic, or transformed migraine were included. Demographic information, depression history, body mass index (BMI), and headache characteristics were obtained. PTSD was assessed using the life events checklist (LEC) and the PTSD checklist, civilian version (PCL-C). We contrasted the data from episodicmigraineurs and chronic/transformed migraine participants (CM) and conducted multivariate analyses, adjusting for covariates.Of the 60 participants included, 91.7% were female with a mean age of 41.4+/-12.5 years old. EM was diagnosed in 53.3% and CM in 46.7%. The mean BMI was not significantly different between groups. In contrast, the relative frequency of depression was significantly greater in subjects with CM (55.2%) than EM (21.9%, P=.016). There was no significant difference in the percentage of participants reporting at least 1 significant traumatic life event (LE) or in the mean number of traumatic LEs between EM and CM participants. However, the relative frequency of PTSD reported on the PCL in CM (42.9%) was significantly greater as compared to EM (9.4%, P=.0059. After adjusting for depression and other potential confounders, the difference remained significant P=.023).PTSD is more common in CM than in episodic migraineurs. This suggests that PTSD may be a risk factor for headache chronification, pending longitudinal studies to test this hypothesis.",0 +https://doi.org/10.1016/j.whi.2015.05.003,Posttraumatic Stress Disorder Symptom Severity and Socioeconomic Factors Associated with Veterans Health Administration Use among Women Veterans,"The Veterans Health Administration (VA) has historically focused on treating men. Although women veterans' VA use is increasing, they remain more likely than male veterans to receive their care in non-VA settings. To date, there is limited research on factors associated with VA use among women. We examined the relationship between demographic, civilian, military, and health-related variables with past-year VA use among women veterans.Women veterans were recruited over the internet to participate in an anonymous national survey (n = 617) in 2013. An empirically derived decision tree was computed using signal detection software for iterative receiver operator characteristics (ROC) to identify variables with the best sensitivity/specificity balance associated with past-year VA use.ROC analysis indicated that 85% of participants with high posttraumatic stress disorder (PTSD) and depressive symptoms and who were younger than 54 years of age used VA in the past year. Of those who were 54 years of age or older and had very high PTSD symptoms, 94% used the VA in the last year. By contrast, only 40% of participants with relatively lower PTSD symptoms had VA past-year use, although among these individuals, VA past-year use increased to 65% for those with a relatively lower income.Findings suggest that greater PTSD symptoms, depressive symptoms, and low income correlate with VA use, with very high PTSD symptoms in older groups, high PTSD symptoms coupled with high depressive symptoms in younger groups, and low income in those with lower PTSD symptoms each associated with greater past-year VA use. Ensuring PTSD assessment and treatment, and addressing socioeconomic factors, may be key strategies for health care delivered directly or through contract with VA facilities.",0 +https://doi.org/10.1037/a0030060,Identifying latent trajectories of personality disorder symptom change: Growth mixture modeling in the longitudinal study of personality disorders.,"Although previous reports have documented mean-level declines in personality disorder (PD) symptoms over time, little is known about whether personality pathology sometimes emerges among nonsymptomatic adults, or whether rates of change differ qualitatively among symptomatic persons. Our study sought to characterize heterogeneity in the longitudinal course of PD symptoms with the goal of testing for and describing latent trajectories. Participants were 250 young adults selected into two groups using a PD screening measure: those who met diagnostic criteria for a DSM-III-R PD (PPD, n = 129), and those with few PD symptoms (NoPD, n = 121). PD symptoms were assessed three times over a 4-year study using semistructured interviews. Total PD symptom counts and symptoms of each DSM-III-R PD were analyzed using growth mixture modeling. In the NoPD group, latent trajectories were characterized by stable, minor symptoms; the rapid or gradual remission of subclinical symptoms; or the emergence of symptoms of avoidant, obsessive-compulsive, or paranoid PD. In the PPD group, three latent trajectories were evident: rapid symptom remission, slow symptom decline, or a relative absence of symptoms. Rapid remission of PD symptoms was associated with fewer comorbid disorders, lower Negative Emotionality, and greater Positive Emotionality and Constraint, whereas emergent personality dysfunction was associated with comorbid PD symptoms and lower Positive Emotionality. In most cases, symptom change for one PD was associated with concomitant changes in other PDs, depressive symptoms, and anxiety. These results indicate that the longitudinal course of PD symptoms is heterogeneous, with distinct trajectories evident for both symptomatic and nonsymptomatic individuals. The prognosis of PD symptoms may be informed by an assessment of personality and comorbid psychopathology.",0 +https://doi.org/10.12740/pp/32214,Diagnosis of Posttraumatic Stress Disorder (PTSD) by the Structured Clinical Interview SCID-I,"Cel Trafna i rzetelna diagnoza pourazowego zaburzenia stresowego jest ważna w praktyce klinicznej, orzecznictwie i badaniach naukowych. Celem badania było określenie właściwości psychometrycznych polskiej wersji ustrukturalizowanego wywiadu klinicznego SCID-I-PTSD, przeznaczonego do diagnozy pourazowego zaburzenia stresowego w oparciu o kryteria DSM-IV-TR. Metoda W badaniu uwzględniono dane od pięciuset dwudziestu sześciu uczestników wypadków drogowych. Podstawę diagnozy klinicznej stanowił wywiad SCID-I-PTSD. Osoby badane wypełniały także zestaw narzędzi samoopisowych służących do oceny objawów PTSD (PDS), depresji (BDI-II), lęku (STAI) i potraumatycznych przekonań (PTCI). Wyniki Pomiar za pomocą wywiadu cechuje wysoka rzetelność oraz trafność zbieżna i różnicowa. W porównaniu do narzędzia samoopisowego wywiad SCID-I-PTSD charakteryzuje się wyższą specyficznością. Pozycje wywiadu wykazują dobre własności psychometryczne (za wyjątkiem pozycji C3) oraz brak stronniczości w odniesieniu do płci. Analizy nie pozwoliły na jednoznaczne określenie struktury czynnikowej objawów PTSD. Wnioski Otrzymane wyniki pozwalają twierdzić, że ustrukturalizowany wywiad kliniczny SCID-I, część poświęcona badaniu PTSD, wchodząca w skład Modułu F (zaburzenia lękowe) stanowi trafne i rzetelne narzędzie diagnozy pourazowego zaburzenia stresowego.",0 +https://doi.org/10.1056/nejmoa040603,"Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care","The current combat operations in Iraq and Afghanistan have involved U.S. military personnel in major ground combat and hazardous security duty. Studies are needed to systematically assess the mental health of members of the armed services who have participated in these operations and to inform policy with regard to the optimal delivery of mental health care to returning veterans.We studied members of four U.S. combat infantry units (three Army units and one Marine Corps unit) using an anonymous survey that was administered to the subjects either before their deployment to Iraq (n=2530) or three to four months after their return from combat duty in Iraq or Afghanistan (n=3671). The outcomes included major depression, generalized anxiety, and post-traumatic stress disorder (PTSD), which were evaluated on the basis of standardized, self-administered screening instruments.Exposure to combat was significantly greater among those who were deployed to Iraq than among those deployed to Afghanistan. The percentage of study subjects whose responses met the screening criteria for major depression, generalized anxiety, or PTSD was significantly higher after duty in Iraq (15.6 to 17.1 percent) than after duty in Afghanistan (11.2 percent) or before deployment to Iraq (9.3 percent); the largest difference was in the rate of PTSD. Of those whose responses were positive for a mental disorder, only 23 to 40 percent sought mental health care. Those whose responses were positive for a mental disorder were twice as likely as those whose responses were negative to report concern about possible stigmatization and other barriers to seeking mental health care.This study provides an initial look at the mental health of members of the Army and the Marine Corps who were involved in combat operations in Iraq and Afghanistan. Our findings indicate that among the study groups there was a significant risk of mental health problems and that the subjects reported important barriers to receiving mental health services, particularly the perception of stigma among those most in need of such care.",0 +https://doi.org/10.1007/978-0-387-72007-4_18,PTSD (Post-Traumatic Stress Disorder) in Later Life,"(from the chapter) Posttraumatic stress disorder (PTSD) is a stress reaction characterized by symptoms of reexperiencing, avoidance/numbing, and hyperarousal following 1 month or more an exposure to extreme trauma. Trauma at late life is plentiful and treatable. Data of the past two decades do not suggest that older adults are at greater risk than younger adults for poor psychosocial outcomes following exposure to trauma. There is simply insufficient evidence to conclude that trauma causes more negative psychosocial consequences in older adults. Empirically supported therapies that apply to younger groups have applicability to older groups as well. The six-step model proposed here, which incorporates key elements of traditional cognitive and behavioral therapies but also expands them to include a trauma focus, is a comprehensive treatment for acute or chronic PTSD. The model treats the whole person with PTSD problems. Memories are modified or transformed directly only as a last resort. Throughout, factors related specifically to aging, mourning for losses, giving meaning to experiences, reestablishing self-coherence and self-continuity, achieving ego integration, and culture and social support are integrated. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.4321/s0213-61632011000400005,"Bipolar Disorder Comorbidity in Anxiety Disorders: Relationship to demographic profile, symptom severity, and functional impairment","Background and Objectives: High rates of comorbidity between anxiety dis- orders and bipolar disorder (BD) have been reported. Studies on the impact of BD comor- bidity in individuals with a principal anxiety disorder have been limited. Methods: Individuals (N = 186) seeking anxiety disorder treatment completed ques- tionnaires and a diagnostic interview. Anxious individuals with comorbid BD were com- pared to anxious individuals with comorbid depression, and individuals with an anxiety disorder only. Results: Anxious individuals with BD were more likely to report being single, separated or divorced, and to present with greater substance abuse and comorbidity than individuals with an anxiety disorder only. Anxious individuals with BD also presented with lower household income than anxious individuals with depression, and individuals with anxiety only. Anxious individuals with either comorbid BD or comorbid depression reported greater functional impairment and more severe symptoms than individuals with anxiety only. Conclusions: Overall, the presence of comorbid BD was associated with demographic and clinical factors that have been previously shown to adversely affect treatment out- come in people with anxiety disorders.",0 +https://doi.org/10.1111/acps.12041,Schizophrenia patients with and without Post-traumatic Stress Disorder (PTSD) have different mood symptom levels but same cognitive functioning,"Objective To investigate differences in cognitive function and level of psychopathology in patients with schizophrenia (SZ) with or without psychological traumatization/post-traumatic stress disorder (PTSD). We hypothesized that traumatized patients with or without PTSD would have more severe cognitive impairments because of the neuropathological changes associated with PTSD, and more severe psychopathology compared with non-traumatized SZ patients. Method Seventy-five SZ patients with traumatization and 217 SZ patients without traumatization were evaluated regarding the symptoms and cognitive functioning, using standard symptom scales (PANSS; CDSS) and a neuropsychological test battery (IQ, verbal memory, attention, working memory, psychomotor speed, and executive functioning). Results No significant differences were observed between the groups in cognitive test performance. The patients in the traumatized group with PTSD showed significantly more current depression than the non-traumatized group (P = 0.012). Conclusion The findings did not support the hypothesis that the presence of comorbid PTSD/traumatization in SZ is associated with increased cognitive impairment. The increase in current depression in SZ with comorbid traumatization suggests that more severe psychopathology is associated with traumatization.",0 +https://doi.org/10.1111/hiv.12223,Factors associated with risk of depression and relevant predictors of screening for depression in clinical practice: a cross-sectional study among HIV-infected individuals in Denmark,"Depression and psychiatric disorders are frequent among HIV-infected individuals. The aim of this study was to determine the prevalence of depression and describe the psychiatric history of HIV-infected individuals in an out-patient clinic in Denmark and to identify factors of clinical importance that may be used to identify patients at risk of depression.In 2013, 212 HIV-infected patients were included in a questionnaire study. We used the Beck Depression Inventory II (BDI-II) to assess the prevalence and severity of depressive symptoms. Patients with a BDI-II score ≥ 20 were offered a clinical evaluation by a consultant psychiatrist. Logistic regression was used to determine predictors associated with risk of depression.Symptoms of depression (BDI-II score ≥ 14) were observed in 75 patients (35%), and symptoms of moderate to major depression (BDI-II score ≥ 20) in 55 patients (26%). There was also a high prevalence of co-occurring mental illness. In a multivariate model, self-reported stress, self-reported perception that HIV infection affects all aspects of life, self-reported poor health, not being satisfied with one's current life situation, previous alcohol abuse, nonadherence to antiretroviral therapy and previously having sought help because of psychological problems were independently associated with risk of depression.Symptoms of depression and co-occurring mental illness are under-diagnosed and under-treated among HIV-infected individuals. We recommend that screening of depression should be conducted regularly to provide a full psychiatric profile to decrease the risk of depression and improve adherence and quality of life in this population.",0 +,Disaster preparedness and the chronic disease needs of vulnerable older adults.,"About 80% of older adults have at least one chronic condition that makes them more vulnerable than healthy people during a disaster. These chronic conditions - combined with the physiological, sensory, and cognitive changes experienced as part of aging - result in frail older adults having special needs during emergencies. Planning and coordination among public health and emergency preparedness professionals and professionals who provide services for the aging are essential to meet these special needs. Several tools and strategies already exist to help prepare these professionals to protect and assist older adults during a disaster. These include having professionals from diverse fields work and train in coalitions, ensuring that advocates for older adults participate in community-wide emergency preparedness, and using community mapping data to identify areas where many older adults live.",0 +https://doi.org/10.1016/j.janxdis.2008.01.016,The PTSD Symptom Scale's latent structure: An examination of trauma-exposed medical patients,"Several studies have employed confirmatory factor analysis (CFA) to evaluate the latent structure of posttraumatic stress disorder (PTSD) assessment measures among various trauma-exposed populations. Findings have generally failed to support the current three-factor DSM-IV PTSD conceptualization, demonstrating the need to consider alternative models. The present study used CFA to evaluate seven models, including intercorrelated and hierarchical versions of two models with the most empirical support. Data were utilized from a heterogeneous trauma-exposed sample of general medical patients (n=252). Based on several indices, the three-factor DSM-IV PTSD model was shown to be inferior to alternative models. The strongest support was found for an intercorrelated four-factor model, separating avoidance and numbing symptoms into distinct factors. Validity for this model was partially supported by divergent relations between factors and external variables. Implications of the results are discussed, and a framework is proposed for resolving discrepant findings in the PTSD CFA literature.",0 +https://doi.org/10.1177/1359104508100135,Young Offenders' Experiences of Traumatic Life Events: A Qualitative Investigation,"This investigation aimed to look at how a group of young offenders attending an inner-city youth offending team experienced adverse and traumatic life events. A qualitative approach was used and semi-structured interviews were conducted with eight young offenders about their perceptions of difficult experiences and the effects of such events. The interviews were analysed using Interpretative Phenomenological Analysis (Smith, Jarman, & Osborn, 1999). Analysis of the accounts yielded a number of themes. Young offenders experienced violence at home, in the community and in custody. Instability and transitions emerged as important themes in relation to school and home. Deprivation was experienced both in terms of poverty and the literal and emotional absence of parents. A variety of cognitive, emotional and behavioural responses to adverse/traumatic experiences were identified, including a blocking out of painful experience and aggression to self and others. There were barriers to seeking or making use of professional support. Custody appeared to offer an opportunity to reflect on and re-evaluate life trajectory. The study concluded that greater consideration of trauma when carrying out assessments would enable ;at risk' young offenders to be identified using clinical interviewing along side standardized measures to aid assessment of the complexity and uniqueness of the response to trauma.",0 +https://doi.org/10.1002/da.20612,Prevalence and risk factors for posttraumatic stress disorder: a cross-sectional study among survivors of the Wenchuan 2008 earthquake in China,"Background: The impact of the May 2008 Wenchuan earthquake, measuring a massive 8.0 on the surface wave magnitude scale, on public health in China has been significant and multifaceted. In light of extant data on prevalence and risk factors for posttraumatic stress disorder (PTSD) after other natural diasters, we collected data from the Wenchuan earthquake survivors to estimate the prevalence of PTSD and to characterize a range of PTSD risk factors. Methods: A cross-sectional multicluster sample survey of 446 respondents (201 from the Qiang ethnic-minority group, 245 the majority Han Chinese group) was conducted in August 2008 in Beichuan county, Sichuan province, a region that was severely affected by the earthquake. In total, 240 households were represented, with a mean of 2.2 respondents per household. Data were collected from structured interviews and the Harvard Trauma Questionnaire (HTQ) and DSM-IV criteria were used to diagnose PTSD. Results: The prevalence of PTSD was 45.5% (203/446). Low household income, being from an ethnic minority, living in a shelter or temporary house, death in family, and household damage were factors significantly related to increased odds of PTSD. Conclusions: PTSD is common after a major disaster. Postdisaster mental health recovery programs that include early identification, ongoing monitoring, preventive and intervention programs, and sustained psychosocial support are needed for the highest-risk population, namely, the bereaved, people without incomes and those with serious household damage. These populations may also benefit from governmental and nongovernmental programs that provide social and economic support, as suggested by earlier studies. Depression and Anxiety, 2009. © 2009 Wiley-Liss, Inc.",0 +https://doi.org/10.1016/j.jpsychires.2012.04.002,Pre-trauma verbal ability at five years of age and the risk of post-traumatic stress disorder in adult males and females,"Previous studies have shown that high cognitive ability, measured in childhood and prior to the experience of traumatic events, is protective of PTSD development. Our aim was to test if the association between pre-trauma verbal ability ascertained at 5 years with DSM-IV lifetime post-traumatic stress disorder (PTSD) at 21 years was subject to effect modification by gender, trauma type or prior behaviour problems. Using a prospective birth cohort of young Australians, we found that both trauma type and behaviour problems did not change the association between cognitive ability and PTSD. During multivariate analysis, testing for the interactive effect of gender revealed that verbal ability was linearly and inversely associated with PTSD in females only, with those in the lowest verbal ability quintile having strongly increased odds of PTSD (OR=3.89: 95% CI; 1.50, 10.10) compared with those in the highest quintile. A graph of the interaction revealed lower verbal ability placed females, but not males, at an increased risk of PTSD. Our results indicate that lower verbal ability in early childhood is a vulnerability factor for PTSD in females but not in males, and may constitute a gender-specific risk factor responsible for part of the increased risk of PTSD found in females compared with males.",0 +https://doi.org/10.7205/milmed-d-14-00626,Adverse Childhood Events and the Risk for New-Onset Depression and Post-Traumatic Stress Disorder Among U.S. National Guard Soldiers,"This article examines the relationship between childhood adversity and postdeployment new-onset psychopathology among a sample of U.S. National Guard personnel deployed during Operation Iraqi Freedom and Operation Enduring Freedom with no history of post-traumatic stress disorder (PTSD) or depression. We recruited a sample of 991 Ohio Army National Guard soldiers and conducted structured interviews to assess traumatic event exposure, a history of childhood adversity, and postdeployment depression, and PTSD, consistent with the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition. We assessed childhood adversity by using questions from the Childhood Adverse Events Survey. In multivariable logistic models, a history of any childhood adversity was significantly associated with new-onset depression, but not PTSD, postdeployment. This finding suggests that a history of childhood adversity is predisposing for new-onset depression, among U.S. National Guard soldiers who were deployed with no prior history of PTSD or depression. This highlights the centrality of childhood experience for the production of mental health among soldiers.",0 +https://doi.org/10.1590/s1135-57272010000200003,[Heat health warning systems: possibilities of improvement].,"In the summer of 2003 the temperatures reached were responsible for a large number of deaths in Europe. A year after this fact, many countries had implemented some sort of plan of prevention against excessive temperatures. Plans that had already shown its ability to prevent a large proportion of avoidable mortality in other latitudes. Since then, a lot of papers have been published providing new data on health effects of a heat wave, which can help increase the efficiency of these prevention plans. Knowing the weather conditions at risk, defining ""heat wave"" or to take into account the time that the plan should be active from the study of the relationship between temperature and their effects on health, to identify weather patterns that modulate the relationship between temperature and mortality, locate the profile of people at risk or to develop protocols for action as accurately as possible and based on scientific knowledge are elements drawn from studies carried on in recent years that should be taken into account.",0 +https://doi.org/10.1002/jts.22073,"PTSD Symptom Trajectories in Disaster Volunteers: The Role of Self-Efficacy, Social Acknowledgement, and Tasks Carried Out","Millions of volunteers respond after disasters, with a 24% to 46% risk of developing posttraumatic stress disorder (PTSD). It is unclear which symptom trajectories develop and how they differ between core (volunteering before the disaster) and noncore volunteers (joining after the disaster) and which factors predict trajectories. Symptoms of PTSD were assessed at 6-, 12-, and 18-months postearthquake in 449 volunteers in Indonesia. Demographics, previous mental health service use, self-efficacy, social acknowledgment, and type of tasks were assessed at 6 months. In both core and noncore volunteers, 2 PTSD symptom trajectories emerged: a resilient trajectory (moderate levels of symptoms with a slow decrease over time; 90.9%) and a chronic trajectory (higher levels of symptoms with an increase over time; 9.1%). In both trajectories, core volunteers had fewer symptoms than noncore volunteers. Core volunteers in the chronic trajectory were characterized by having sought prior mental help, reported lower levels of self-efficacy and social acknowledgment, and were more likely to have provided psychosocial support to beneficiaries (Cramér's V = .17 to .27, partial η(2) = .02 to .06). Aid organizations should identify and follow up chronic PTSD trajectories in volunteers, including the noncore, who may be out of sight to the organization after the acute response phase.",1 +https://doi.org/10.1159/000207457,Hallmarks of Posttraumatic Stress: Symptom Z-Scores in a Tsunami-Affected Tourist Population,"<i>Background:</i> To date, little research has been published on the prominence of the various psychiatric symptoms that result from exposure to a natural disaster. In our study of stress-related symptoms among Norwegian tourists who were repatriated after the 2004 southeast Asian tsunami, we evaluated to what extent symptom scores differed between individuals who were exposed to the disaster and those who were not. <i>Methods:</i> Participants (n = 899) completed a questionnaire via post 6 months after the disaster. The participants were categorized according to their level of exposure to the disaster: danger exposed (caught or chased by the waves), nondanger exposed (other disaster-related stressors) and not exposed. Symptoms were assessed by the General Health Questionnaire (GHQ-28), the Post Traumatic Symptom Scale (PTSS-10), and the Impact of Event Scale – Revised (IES-R). We used z-transformation of symptom scores (Z-scores) to evaluate the extent to which symptom scores among disaster-exposed individuals differed from those in the nonexposed reference group. <i>Results:</i> The IES-R revealed the greatest differences between nonexposed and disaster-exposed individuals. Hyperarousal was the most prominent symptom cluster that related to disaster exposure, followed by intrusion and then avoidance. Symptoms of anxiety, social dysfunction, withdrawal, somatization and feelings of guilt were more closely linked to exposure than were symptoms of depression. <i>Conclusions:</i> Our results indicate that symptoms of hyperarousal may be more closely linked to acute exposure to a natural disaster such as a tsunami than other symptoms of psychological distress.",0 +https://doi.org/10.1016/j.brainres.2009.03.029,"Anxiety, cognition, and habit: A multiple memory systems perspective","Consistent with a multiple systems approach to memory organization in the mammalian brain, numerous studies have differentiated the roles of the hippocampus and dorsal striatum in ""cognitive"" and ""habit"" learning and memory, respectively. Additional research indicates that activation of efferent projections of the basolateral amygdala (BLA), a brain region implicated in mammalian emotion, modulates memory processes occurring in other brain structures. The present brief review describes research designed to link these general concepts by examining the manner in which emotional state may influence the relative use of multiple memory systems. In a dual-solution plus-maze task that can be acquired using either hippocampus-dependent or dorsal striatal-dependent learning, acute pre-training or pre-retrieval emotional arousal (restraint stress/inescapable foot shock, exposure to the predator odor TMT, or peripheral injection of anixogenic drugs) biases rats towards the use of habit memory. Moreover, intra-BLA injection of anxiogenic drugs is sufficient to bias rats towards the use of dorsal striatal-dependent habit memory. In single-solution plus-maze tasks that require the use of either cognitive or habit learning, intra-BLA infusions of anxiogenic drugs result in a behavioral profile indicating an impairing effect on hippocampus-dependent memory that effectively produces enhanced habit learning by eliminating competitive interference between cognitive and habit memory systems. It is speculated that the predominant use of habit memory that can be produced by anxious and/or stressful emotional states may have implications for understanding the role of learning and memory processes in various human psychopathologies, including for example post-traumatic stress disorder and drug addiction.",0 +https://doi.org/10.1002/da.20823,Testing the dimensionality of posttraumatic stress responses in young Chinese adult earthquake survivors: further evidence for “dysphoric arousal” as a unique PTSD construct,"This study investigated an alternative five-factor diagnostic model for posttraumatic stress disorder (PTSD) symptoms, and tested external convergent and discriminant validity of the model in a young Chinese sample of earthquake survivors.A total of 938 participants (456 women, 482 men) aged 15-20 years were recruited from a vocational school originally located in Beichuan County Town which was almost completely destroyed by the ""Wenchuan Earthquake."" The participants were administrated with the PTSD Checklist and the Hopkins Symptoms Checklist-25 12 months after the earthquake.The results of confirmatory factor analysis showed that the five-factor intercorrelated model (intrusion, avoidance, numbing, dysphoric arousal, and anxious arousal) fit the data significantly better than the four-factor numbing model proposed by King et al. (1998: Psychol Assess 10:90-96) and the four-factor dysphoria model proposed by Simms et al. (2002: J Abnorm Psychol 111:637-647). Further analyses indicated that four out of five PTSD factors yielded significantly different correlations with external measures of anxiety versus depression.The findings provide further empirical evidence in favor of the five-factor diagnostic model of PTSD, and carry implications for the upcoming DSM-5.",0 +https://doi.org/10.1016/j.ajp.2014.07.003,"Clinical and neuropsychological correlates of major depression following post-traumatic brain injury, a prospective study","Major depression disorder (MDD) is the most frequent psychiatric complication after traumatic brain injury (TBI), with a prevalence of 14-77%. The aim of this study was to analyse the psychiatric sequelae of TBI, and to identify the neuropsychological and psychopathological correlates of post-TBI MDD in order to highlight their differences from those of primary MDD.This was a longitudinal, prospective, case-control study. Sixteen patients with closed brain injury, and a lesion revealed by computed tomography (CT), were recruited and were evaluated one (T1), three (T3) and six (T6) months after discharge from Neurosurgery Department; the controls were six patients with MDD. The psychiatric symptoms were evaluated using brief psychiatric rating scale (BPRS), Hamilton depression rating scale (HRSD), Beck depression inventory scale (BDI), Hamilton anxiety rating scale (HRSA), global assessment of functioning (GAF) and instrumental activity of daily living (IADL). Neuropsychological profiles were assessed by using neuropsychological tests, focused on memory and frontal-executive functioning.At T1, MDD was observed in 10 cases (62.5%), a manic episode in 12.5%, and post-traumatic stress disorder in 6.5%. At T3 and T6, MDD was diagnosed in, respectively, eight (50%) and six cases (37.5%). Post TBI MDD had less severe depressive symptoms, showed greater social isolation and hostility and more cognitive deficits in comparison with the control group.MDD is a frequent TBI complication. Patients with post-TBI MDD have a specific psychopathological profile characterised by a less severe depressive symptomatology and a neuropsychological pattern that is significantly associated with greater deficits in cognitive functions than those with primary MDD.",0 +https://doi.org/10.1097/dbp.0000000000000236,Behavioral Problems and Service Utilization in Children with Chronic Illnesses Referred for Trauma-Related Mental Health Services,"Given its prevalence and impact on health and well-being, children's exposure to traumatic experiences is of growing importance to pediatricians and other medical providers. Little is known, however, about the traumatic experiences profiles, trauma-related sequelae, and service use patterns of youth with chronic or recurrent medical problems/disabilities. This study aimed to fill this research gap.Participants were children less than 18 years of age who were referred for assessment and/or treatment services at one of the 56 National Child Traumatic Stress Network centers from 2004 to 2010 across the United States and had experienced at least one of 13 types of traumatic experience(s) (n = 9885; mean = 11 years, SD = 4.3; 52.3% girls). Generalized linear mixed models were used to examine associations among types of trauma, emotional and behavioral problems, and rates of service utilization adjusting for treatment center-level random effects, demographic characteristics, and the total number of types of trauma exposures.Among children seeking treatment for traumatic stress, those with comorbid medical problems/disabilities had different demographic characteristics, different types of trauma exposure, and more service utilization in multiple sectors before trauma treatment entry than those without comorbid medical problems/disabilities. Those without comorbid medical problems/disabilities had higher levels of some types of traumatic exposures, associated symptoms, and higher levels of behavioral problems at home, school, or day care. Those with medical disorders/disabilities were at 30% to 40% higher odds of meeting clinical criteria for hyperarousal and re-experiencing posttraumatic stress disorder symptoms, used more medical and mental health services for trauma, and had more emotional and behavioral concerns.Given that pediatricians are more likely to see children with medical disabilities and concerns than those without, there is an opportunity to ask directly about traumatic exposures and associated symptoms and provide support and interventions to promote resilience. Integrating trauma screening and mental health services into medical care could be especially beneficial for children with chronic medical conditions.",0 +https://doi.org/10.7205/milmed-d-14-00448,Mindfulness-Based Stress Reduction for Veterans Exposed to Military Sexual Trauma: Rationale and Implementation Considerations,"Military sexual trauma (MST) represents a significant public health concern among military personnel and Veterans and is associated with considerable morbidity and suicide risk. It is estimated that 22% of Veteran women and 1% of Veteran men experienced sexual assault or repeated, threatening sexual harassment during their military service. Exposure to traumatic stress has detrimental effects on emotion regulation, which refers to a set of strategies used to modulate different components of emotion at different points on the trajectory of an emotional response. Mindfulness-based interventions offer approaches to health that focus on mind and body practices that can help regulate the experience and expression of difficult emotions. Mindfulness-based stress reduction (MBSR) is an evidence-based therapy shown to be effective for depression, anxiety, and post-traumatic stress disorder. This article discusses the rationale for providing MBSR to Veterans who have been exposed to MST. The article also discusses ways to facilitate implementation of this practice in the U.S. Department of Veterans Affairs health care system. We address potential barriers to care and ways to facilitate implementation at the patient, provider, organization/local, and policy levels. MBSR is likely to be an important component of a comprehensive approach to care for Veterans exposed to MST.",0 +https://doi.org/10.1037/a0038039,A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder.,"Posttraumatic stress disorder (PTSD) is associated with regional alterations in brain structure and function that are hypothesized to contribute to symptoms and cognitive deficits associated with the disorder. We present here the first systematic meta-analysis of neurocognitive outcomes associated with PTSD to examine a broad range of cognitive domains and describe the profile of cognitive deficits, as well as modifying clinical factors and study characteristics. This report is based on data from 60 studies totaling 4,108 participants, including 1,779 with PTSD, 1,446 trauma-exposed comparison participants, and 895 healthy comparison participants without trauma exposure. Effect-size estimates were calculated using a mixed-effects meta-analysis for 9 cognitive domains: attention/working memory, executive functions, verbal learning, verbal memory, visual learning, visual memory, language, speed of information processing, and visuospatial abilities. Analyses revealed significant neurocognitive effects associated with PTSD, although these ranged widely in magnitude, with the largest effect sizes in verbal learning (d = -.62), speed of information processing (d = -.59), attention/working memory (d = -.50), and verbal memory (d =-.46). Effect-size estimates were significantly larger in treatment-seeking than community samples and in studies that did not exclude participants with attention-deficit/hyperactivity disorder, and effect sizes were affected by between-group IQ discrepancies and the gender composition of the PTSD groups. Our findings indicate that consideration of neuropsychological functioning in attention, verbal memory, and speed of information processing may have important implications for the effective clinical management of persons with PTSD. Results are further discussed in the context of cognitive models of PTSD and the limitations of this literature.",0 +https://doi.org/10.1016/j.cpr.2015.02.007,Psychological interventions for post-traumatic stress disorder and comorbid substance use disorder: A systematic review and meta-analysis.,"Co-morbid post-traumatic stress disorder (PTSD) and substance use disorder (SUD) are common, difficult to treat, and associated with poor prognosis. This review aimed to determine the efficacy of individual and group psychological interventions aimed at treating comorbid PTSD and SUD, based on evidence from randomised controlled trials. Our pre-specified primary outcomes were PTSD severity, drug/alcohol use, and treatment completion. We undertook a comprehensive search strategy. Included studies were rated for methodological quality. Available evidence was judged through GRADE. Fourteen studies were included. We found that individual trauma-focused cognitive-behavioural intervention, delivered alongside SUD intervention, was more effective than treatment as usual (TAU)/minimal intervention for PTSD severity post-treatment, and at subsequent follow-up. There was no evidence of an effect for level of drug/alcohol use post-treatment but there was an effect at 5-7 months. Fewer participants completed trauma-focused intervention than TAU. We found little evidence to support the use of individual or group-based non-trauma-focused interventions. All findings were judged as being of low/very low quality. We concluded that there is evidence that individual trauma-focused psychological intervention delivered alongside SUD intervention can reduce PTSD severity, and drug/alcohol use. There is very little evidence to support use of non-trauma-focused individual or group-based interventions.",0 +https://doi.org/10.1192/bjp.182.2.158,Flashbacks and post-traumatic stress disorder: the genesis of a 20th-century diagnosis,"It has been argued that post-traumatic stress disorder (PTSD) is a timeless condition, which existed before it was codified in modern diagnostic classifications but was described by different names such as 'railway spine' and 'shellshock'. Others have suggested that PTSD is a novel presentation that has resulted from a modern interaction between trauma and culture.To test whether one core symptom of PTSD, the flashback, has altered in prevalence over time in soldiers subjected to the intense stress of combat.Random selections were made of UK servicemen who had fought in wars from 1854 onwards and who had been awarded war pensions for post-combat disorders. These were studied to evaluate the incidence of flashbacks in defined, at-risk populations.The incidence of flashbacks was significantly greater in the most recent cohort, veterans of the 1991 Persian Gulf War; flashbacks were conspicuous by their absence in ex-servicemen from the Boer War and the First and Second World Wars.Although this study raises questions about changing interpretations of post-traumatic illness, it supports the hypothesis that some of the characteristics of PTSD are culture-bound. Earlier conflicts showed a greater emphasis on somatic symptoms.",0 +https://doi.org/10.1136/bmjopen-2013-003097,"Effects of telephone health mentoring in community-recruited chronic obstructive pulmonary disease on self-management capacity, quality of life and psychological morbidity: a randomised controlled trial","To assess benefits of telephone-delivered health mentoring in community-based chronic obstructive pulmonary disease (COPD).Cluster randomised controlled trial.Tasmanian general practices: capital city (11), large rural (3), medium rural (1) and small rural (16).Patients were invited (1207) from general practitioner (GP) databases with COPD diagnosis and/or tiotropium prescription, response rate 49% (586), refused (176) and excluded (criteria: smoking history or previous study, 68). Spirometry testing (342) confirmed moderate or severe COPD in 182 (53%) patients.By random numbers code, block stratified on location, allocation by sequentially numbered, opaque and sealed envelopes.Health mentor (HM) group received regular calls to manage illness issues and health behaviours from trained community health nurses using negotiated goal setting: problem solving, decision-making and action planning.usual care (UC) group received GP care plus non-interventional brief phone calls.Measured at 0, 6 and 12 months, the Short Form 36 (SF-36) and St George's Respiratory Questionnaire (SGRQ, primary); Partners In Health (PIH) Scale for self-management capacity, Hospital Anxiety and Depression Scale (HADS), Center for Epidemiologic Studies-Depression (CES-D) questionnaire, Post-Traumatic Stress Disorder Checklist, Satisfaction with life and hospital admissions (secondary).182 participants with COPD (age 68±8 years, 62% moderate COPD and 53% men) were randomised (HM=90 and UC=92). Mixed model regression analysis accounting for clustering, adjusting for age, gender, smoking status and airflow limitation assessed efficacy (regression coefficient, β, reported per 6-month visit). There was no difference in quality of life between groups, but self-management capacity increased in the HM group (PIH overall 0.15, 95% CI 0.03 to 0.29; knowledge domain 0.25, 95% CI 0.00 to 0.50). Anxiety decreased in both groups (HADS A 0.35; 95% CI -0.65 to -0.04) and coping capacity improved (PIH coping 0.15; 95% CI 0.04 to 0.26).Health mentoring improved self-management capacity but not quality of life compared to regular phone contact, which itself had positive effects where decline is generally expected.",0 +https://doi.org/10.1080/17405629.2013.859574,From prematurity to parenting stress: The mediating role of perinatal post-traumatic stress disorder,"Preterm delivery may lead to the emergence of symptoms of Post-Traumatic Stress disorder (PTSD), which may, in turn, affect the quality of the mother-child relationship. The aim of this study is to shed light on the development of parenting stress in mothers of preterm and full-term children. It is hypothesized that PTSD symptoms mediate the relationship between preterm/full-term birth and the levels of parenting stress. Perinatal PTSD, parenting stress and social support were assessed in 156 mothers of full-term children and 87 mothers of preterm children. Mothers of preterm children experienced more post-traumatic stress and parenting stress than mothers of full-term children. However, the relationship between preterm delivery and subsequent levels of parenting stress was mediated by PTSD symptoms. These findings suggest that the maternal perception of childbirth as a traumatic experience and the subsequent development of PTSD symptoms are pivotal in the emergence of parenting stress.",0 +https://doi.org/10.1016/j.jpsychires.2012.10.008,In the shadow of terror: Posttraumatic stress and psychiatric co-morbidity following bombing in Iraq: The role of shattered world assumptions and altered self-capacities,"Whilst research has looked at posttraumatic stress disorder (PTSD) and psychiatric co-morbidity among civilians exposed to bombing, there is a lack of longitudinal data on the development of these outcomes and the psychological factors associated with them, particularly among Iraqi civilians. This study aimed to: investigate 1) the trajectory of PTSD and psychiatric co-morbidity following bombing among civilians in Iraq and 2) the link between shattered world assumptions, altered self-capacities and identified health outcomes. One hundred and eighty (F = 90, M = 90) Iraqi civilians exposed to first time bombing were recruited approximately one month (time 1) after the bombing and five months (time 2) after the baseline assessment. A control group data (178, F = 91, M = 87) from people who were not exposed to bombing was also collected. They completed the Posttraumatic Stress Diagnostic Scale, the General Health Questionnaire-28, the World Assumptions Questionnaire and the Inventory of Altered Self-Capacities. The results showed that there was a significant decline in the proportion of people meeting the screening criteria for PTSD and psychiatric co-morbidity symptoms over time. For the cross-sectional analysis, controlling for demographic variables, regression analysis showed that severity of the bombing (β = .16), controllability of events (β = -.21), safety and vulnerability (β=.31) and affect dysregulation (β = .37) significantly predicted PTSD time 1. Controllability of events (β = -.20) and affect dysregulation (β = .37) also predicted psychiatric co-morbidity at time 1. For the prospective analysis, controlling for PTSD and psychiatric co-morbidity at time 1, none of these dimensions predicted PTSD and psychiatric co-morbidity at time 2. Findings are discussed in terms of individual resilience. It can be concluded that following bombing, civilians developed PTSD and psychiatric co-morbidity which declined over time. Civilians' perceptions of their ability to control events in the world and regulate their affect had a short term impact on the severity of these symptoms.",0 +https://doi.org/10.1111/j.1464-410x.2009.08560.x,"Safety and efficacy of sildenafil citrate in treating erectile dysfunction in patients with combat-related post-traumatic stress disorder: a double-blind, randomized and placebo-controlled study","To evaluate the safety and efficacy of sildenafil citrate for treating erectile dysfunction (ED) in patients with combat-related post-traumatic stress disorder (PTSD).In all, 266 combat-exposed war veterans with ED (aged 37-59 years) were recruited. They met the Diagnostic and Statistical Manual of Mental Disorders-IV criteria for PTSD according to the Structured Clinical Interview for Patients, Investigator Version. The patients were also evaluated with the Clinician-Administered PTSD Scale, both to establish the diagnosis of PTSD and to measure symptom severity. Only patients with psychogenic ED were included in the study. Patients with comorbid conditions (diabetes mellitus, hypercholesterolaemia, hypertension, Peyronie's disease) and smokers of more than five cigarettes daily were excluded. The patients were randomly divided into a group of 133 who received 100 mg of on-demand sildenafil 0.75-2 h before sexual stimulation, and 133 who received placebo. Patients were asked to use > or =16 doses or attempts at home. The efficacy of the treatments was assessed every four attempts during treatment, and at the end of the study, using responses to the 15-question International Index of Erectile Function (IIEF), Sexual Encounter Profile diary questions 2 and 3, Erectile Dysfunction Inventory of Treatment Satisfaction questionnaire, patients' event logs of sexual activity, and a Global Assessment Question about erections.Sildenafil did not produce significantly and substantially greater improvement than placebo in each of the primary and secondary outcome measures (P = 0.08). A normal EF domain score (> or =26) at endpoint was reported by 13 (9.8%), and 11 (8.3%) of patients on the sildenafil and placebo regimens, respectively (P = 0.09). Patients treated with sildenafil had no statistically significantly greater improvement in the five sexual function domains of the IIEF questionnaire than those treated with placebo (P = 0.08). The incidences of treatment-emergent adverse events were significantly greater in the sildenafil arm than in the placebo group (P = 0.01).Sildenafil is no better than placebo in treating PTSD-emergent ED. Further randomized clinical trials are warranted in combat veterans and other populations with PTSD to better elucidate the role of phosphodiesterase type 5 inhibitors in treating PTSD-emergent ED.",0 +https://doi.org/10.1017/s0033291713002286,Combat exposure severity as a moderator of genetic and environmental liability to post-traumatic stress disorder,"Background Twin studies of veterans and adults suggest that approximately 30–46% of the variance in post-traumatic stress disorder (PTSD) is attributable to genetic factors. The remaining variance is attributable to the non-shared environment, which, by definition, includes combat exposure. This study used a gene by measured environment twin design to determine whether the effects of genetic and environmental factors that contribute to the etiology of PTSD are dependent on the level of combat exposure. Method The sample was drawn from the Vietnam Era Twin Registry (VETR) and included 620 male–male twin pairs who served in the US Military in South East Asia during the Vietnam War era. Analyses were based on data from a clinical diagnostic interview of lifetime PTSD symptoms and a self-report measure of combat exposure. Results Biometric modeling revealed that the effects of genetic and non-shared environment factors on PTSD varied as a function of level of combat exposure such that the association between these factors and PTSD was stronger at higher levels of combat exposure. Conclusions Combat exposure may act as a catalyst that augments the impact of hereditary and environmental contributions to PTSD. Individuals with the greatest exposure to combat trauma were at increased risk for PTSD as a function of both genetic and environmental factors. Additional work is needed to determine the biological and environmental mechanisms driving these associations.",0 +https://doi.org/10.1007/0-387-23846-8_15,Prevention and Treatment of Post-Traumatic Stress Disorder in Adolescents,"(create) Post-Traumatic Stress Disorder (PTSD) has a significant negative impact on the biological, psychological, and social development of those youth who develop the disorder following exposure to a traumatic event (Pynoos, 1994). Given the frequency with which young people today experience traumatic events, the authors feel that it is important that we develop a model for primary prevention and health promotion in those youth who have experienced trauma. In this chapter the authors look at individual, family and social risk factors and protective factors related to PTSD; evidence-based treatment interventions; psychopharmacology for PTSD; and prevention of PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1111/ene.12274,Sex-related and non-sex-related comorbidity subtypes of tic disorders: a latent class approach,"Recent evidence suggests that there may be more than one Gilles de la Tourette syndrome (GTS)/tic disorder phenotype. However, little is known about the common patterns of these GTS/tic disorder-related comorbidities. In addition, sex-specific phenomenological data of GTS/tic disorder-affected adults are rare. Therefore, this community-based study used latent class analyses (LCA) to investigate sex-related and non-sex-related subtypes of GTS/tic disorders and their most common comorbidities.The data were drawn from the PsyCoLaus study (n = 3691), a population-based survey conducted in Lausanne, Switzerland. LCA were performed on the data of 80 subjects manifesting motor/vocal tics during their childhood/adolescence. Comorbid attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder, depressive, phobia and panic symptoms/syndromes comprised the selected indicators. The resultant classes were characterized by psychosocial correlates.In LCA, four latent classes provided the best fit to the data. We identified two male-related classes. The first class exhibited both ADHD and depression. The second class comprised males with only depression. Class three was a female-related class depicting obsessive thoughts/compulsive acts, phobias and panic attacks. This class manifested high psychosocial impairment. Class four had a balanced sex proportion and comorbid symptoms/syndromes such as phobias and panic attacks. The complementary occurrence of comorbid obsessive thoughts/compulsive acts and ADHD impulsivity was remarkable.To the best of our knowledge, this is the first study applying LCA to community data of GTS symptoms/tic disorder-affected persons. Our findings support the utility of differentiating GTS/tic disorder subphenotypes on the basis of comorbid syndromes.",0 +,Post traumatic stress disorder and adaptive capacity in victims of intimate partner violence,"The goal of this article was to identify the existing relationship between Post Traumatic Stress Disorder (PTSD) and the adaptive capacity in a group of victims of intimate partner violence residing in Medellin (Colombia). The sample consisted of 26 people, both male and female selected from different health and social centers. The instruments used were the PTSD Symptom Severity Scale and the Maladjustment Scale. Descriptive statistics and Pearson's Correlation Coefficient were used for data analysis. The results reinforce the initiative of considering PTSD as a diagnostic category unmistakably associated to intimate partner violence; 84.2% of the sample reported Post Traumatic Stress Disorder symptomatology, mainly avoidance and hyperarousal, as well as somatic manifestations. Maladjustment levels were highly elevated, 93.2% average, the areas with the lowest level of adaptive capacity were marital life and family life, while maladjustment levels exhibited significant associations with overall PTSD and hyperarousal (p <0.01). In general, the participants exhibited emotional affliction in their responses, characterized by the presence of somatic anxiety, an intense fear of re-experiencing the abuse situations and a marked response of increased arousal.",0 +,An Integration of American Nontraditional and Mesoamerican Traditional Approaches as a Treatment Model for Traumatic Stress and Post-Traumatic Stress Disorder (PTSD),"Traumatic stress and Post-Traumatic Stress Disorder (PTSD) are rampant in American culture, even within nuclear families. This may cause disorganization of attachment bonds and increase the likelihood of PTSD when exposed to future traumatic events. The objective of this study is to assess the similarities and differences among psychotherapeutic treatment modalities employed in the United States, Cognitive Behavioral Therapy (CBT); Eye Movement Desensitization and Reprocessing (EMDR); Structured Intervention for Trauma for Children, Adolescents and Parents (SITCAP); Hypnosis; and finally Curanderismo, a Mesoamerican traditional treatment modality with similar practices to those found in Transpersonal Psychology for the treatment of PTSD. This heuristic study consists of interviews with co-researchers gathered in urban settings in the United States; urban, rural, and jungle settings in Mexico; and the personal and professional experiences of the researcher with both modalities. This study includes description of the therapeutic use of the temazcal (a Mesoamerican sweat lodge); limpias (a ritualized clearing of the subtle energy field); the medicinal and spiritual applications of herbalism; shamanic ritual; and the platica (a specific and highly interpersonal counseling style employed by curanderos), and the significance of holism and equilibrium in the Mesoamerican healing paradigm. In addition to these, this discussion also presents the role of prayer and interpersonal touch related to healing traumatic stress, and PTSD. An analysis of the results produced the development of an integrated healing model to reflect the positive aspects of all researched modalities toward efficacious treatments for traumatic stress and PTSD. Finally, this research examines and discusses the implications, limitations, and future research of this model for trauma treatment and research. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1177/1524838008315869,Cognitive–Behavioral Theory and Preparation for Professionals at Risk for Trauma Exposure,"Military personnel, emergency first responders, and others whose work environments include exposure to traumatic events are at risk for developing posttraumatic stress disorder (PTSD). To help prevent negative sequelae, there is a strong need to identify well-operationalized, empirically supported, theoretically framed models of healthy adaptation to potentially traumatic events. Cognitive–behavioral theories (CBTs) describe etiological factors in trauma, guide research that has identified risk for PTSD, and help develop interventions that can effectively reduce posttrauma symptomatology. In this article, the authors draw on CBT and empirical research on post-traumatic stress to propose possible cognitive–behavioral mechanisms in trauma adaptation. They then suggest directions for future research, including areas for prevention interventions for at-risk professionals.",0 +,Psychometric Properties and Confirmatory Factor Analysis of the Posttraumatic Stress Disorder Checklist for Chinese Survivors of Road Traffic Accidents,"Abstract Objectives: To examine the psychometric properties and factor structure of the Chinese version of the Posttraumatic Stress Disorder Checklist. Participants and Methods: A total of 481 survivors of road traffic accidents completed the Posttraumatic Stress Disorder Checklist, Impact of Event Scale-Revised, and General Health Questionnaire 1 week after a road traffic accident. Their responses were studied to investigate the factor structure and validity of the Posttraumatic Stress Disorder Checklist. To examine the diagnostic utility of the Checklist, an independent sample of 45 road traffic accident survivors completed the Posttraumatic Stress Disorder Checklist and the Clinician-administered Post-traumatic Disorder Scale 1 month after their road traffic accidents. Results: A hierarchical 4-factor model was identified as providing the best account of the data for the Posttraumatic Stress Disorder Checklist. The diagnostic efficiency of the mixed scoring criteria, using a minimum symptom score of 4 with either a total score of 44 or 50, was confirmed as a means of screening for post-traumatic stress disorder. Conclusions: The Chinese version of the Posttraumatic Stress Disorder Checklist was found to have satisfactory reliability and validity. Key words: Accidents, traffic; Life change events; Questionnaires; Stress disorders, post-traumatic ... (ProQuest: ... denotes formula omitted.) Introduction According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV),1 the prevalence of acute stress disorder in individuals exposed to trauma ranges from 14 to 33%. In the adult population the lifetime prevalence of post-traumatic stress disorder (PTSD) found in community-based studies is approximately 8%. However, there are few psychometrically sound Chinese language PTSD-related assessment instruments for clinical and research use. Although the Chinese version of the Impact of Event Scale-Revised (IES-R) has been proven a useful means of examining traumatic stress, the items included do not bear a direct reference to the diagnostic criteria in the DSM-IV.2-6 The PTSD Checklist (PCL)7 is a 17-item, selfreported rating scale instrument that parallels DSM-IV's diagnostic criteria B, C, and D for PTSD. Thus, the PCL may yield information that has greater predictive validity on a diagnostic level than the IES-R. The PCL's structure may also enable researchers to draw more precise comparisons with data derived from PTSD-relevant interviews such as the Clinician-administered PTSD Scale (CAPS).8 The PCL's diagnostic sensitivities and specificities in different languages have been demonstrated. This includes the English version,7,9,10 French version,11 and Spanish version.12 As it takes only a short period, roughly 5 minutes, to administer the PCL, it compares favourably with the 40 to 60 minutes needed for diagnostic interviews (e.g. CAPS), making the PCL a good candidate as a screening tool for PTSD. There is a need for PTSD-related assessment instruments in Chinese, so this study was conducted to investigate the psychometric properties of the Chinese version of the PCL and to provide preliminary results for guiding future use of the PCL as a valid and reliable PTSD assessment instrument in Chinese. This study aimed to examine the psychometric properties of the Chinese version of the PCL when applied to survivors of road traffic accidents (RTAs) attending accident and emergency (A&E) services. Data collected from 481 respondents 1 week after experiencing a RTA were used to study the internal consistency, reliability, and factor structure of the PCL. Given the personal impact, nature and recency of the event, data from RTA survivors at this point should enable us to understand the psychometric properties of the PCL. The concurrent validity of the PCL was examined by studying its relationship with self-reported measures of general psychological distress and posttraumatic stress, respectively. …",0 +https://doi.org/10.1007/bf02102947,Understanding acute psychological distress following natural disaster,"A household probability sample of 229 adults was interviewed four to seven months after the Sierra Madre earthquake (June 28, 1991; Los Angeles County). The study predicted psychological distress from these variables: demographics, traumatic event history, low magnitude event history, earthquake related threat perceptions, and earthquake related resource loss. Based on the Conservation of Resources (COR) stress model, it was predicted that resource loss would be central in predicting psychological distress. Three major hypotheses were supported: (1) resource loss was positively associated with psychological distress; (2) resource loss predicted psychological distress when other predictors were statistically controlled; and (3) resource loss was associated with mild to moderate elevations in of psychological distress. The findings support COR stress theory. Theoretical and practical implications are discussed.",0 +https://doi.org/10.1016/j.neuropharm.2013.07.005,Risperidone ameliorates post-traumatic stress disorder-like symptoms in modified stress re-stress model,"The management for post-traumatic stress disorder (PTSD) involves chronic administration of drugs. We have modified the stress re-stress (SRS) model to study the effect of chronic administration of risperidone (RIS) after induction of PTSD in rats. On day-1 (D-1) rats underwent training session for elevated-plus maze (EPM) test. On D-2, rats were subjected to stress protocol of 2 h restraint and 20 min forced-swim test (FST) followed by halothane anesthesia. The rats were exposed to re-stress (FST) on D-8 and at six day intervals on D-14, D-20, D-26 and D-32. The rats were treated with RIS (0.01, 0.1 and 1.0 mg/kg; p.o. ) and standard drug, paroxetine (PAX; 10.0 mg/kg; p.o. ) from D-8 to D-32. RIS (0.1 mg/kg) and PAX ameliorated SRS-induced immobility. RIS in median dose reversed SRS-induced hypocorticosteronemia both in urine and plasma. RIS in median dose improved SRS-induced behavioral perturbations such as memory impairment and anxiety-like behavior in EPM and Y-maze tests. RIS (0.1 mg/kg) reversed SRS-induced increase in amygdalar serotonin level. RIS (0.1 mg/kg) increased the expression of hippocampal MR thereby reversing the SRS-induced decrease in MR/GR ratio. Pearson's analysis of data on D-32 showed that there was significant correlation of plasma corticosterone, amygdalar serotonin and hippocampal ratio of mineralocorticoid (MR)/glucocorticoid receptor (GR) with SRS-induced behavioral abnormalities. Hence, median dose of RIS shows anti-PTSD-like effect in the modified SRS model. PAX had earlier onset of action in ameliorating behavioral effects of PTSD compared to RIS. However, RIS showed anti-PTSD like effect in sub-therapeutic dose. The mode of anti-PTSD action of RIS seems to involve the HPA-axis and serotonergic system, whereas PAX did not show any significant action on these pathways. The effect of repeated treatment of drugs for PTSD can be evaluated using the modified SRS model. • Modified SRS showed PTSD related behavioral abnormalities. • RIS in median dose reversed SRS-induced hypocorticosteronemia in urine and plasma. • RIS improved SRS-induced behavioral abnormalities. • RIS reversed SRS-induced decrease in MR:GR in hippocampus. • Modified SRS can be used to evaluate repeated drug treatment schedules for PTSD.",0 +https://doi.org/10.1002/jts.20692,Examining posttraumatic stress symptoms in a national sample of homicide survivors: Prevalence and comparison to other violence victims,en,0 +https://doi.org/10.2174/1389450111314070002,Therapeutic Prospects of PPARs in Psychiatric Disorders: A Comprehensive Review,"Peroxisome Proliferator-Activated Receptors (PPARs) are a family of nuclear receptors whose activation modulates the gene expression that underlies both the glucid-lipid and the inflammation pathways. While many PPARs agonists have been used for years as medication for metabolic disorders, an increasing attention is being currently dedicated to these drugs for inflammation-related pathologies. Within the psychiatric field, it has recently appeared that inflammatory processes are highly suspected in the pathophysiology of several important disorders, such as schizophrenia and mood disorders. By their anti-inflammatory properties, PPARs might have a disease-modifying action that could help in improving the outcome of patients. Furthermore, recent data suggest that PPARs could also modulate the expression of some neurotransmission factors. Therefore, PPARs may directly modify the information processing, and have a potential symptomatic action on several psychiatric disorders. At last, PPARs action of metabolic regulation could have a role on corrective or even preventive strategies against the metabolic adverse events that are commonly observed with some current psychiatric medications, notably antipsychotics. This triple potential action profile of PPARs modulators is investigated in this article, successively for schizophrenia spectrum disorders and mood disorders. Theoretical involvements of PPARs are also discussed for the treatment of Post- Traumatic Stress Disorder and Personality Disorders. At the time of the emerging concept of psychoneuroimmunology, PPARs open original therapeutic prospects for the psychiatric research.",0 +https://doi.org/10.1007/s11920-015-0597-6,Children’s Disaster Reactions: the Influence of Family and Social Factors,"This review examines family (demographics, parent reactions and interactions, and parenting style) and social (remote effects, disaster media coverage, exposure to secondary adversities, and social support) factors that influence children’s disaster reactions. Lower family socioeconomic status, high parental stress, poor parental coping, contact with media coverage, and exposure to secondary adversities have been associated with adverse outcomes. Social support may provide protection to children in the post-disaster environment though more research is needed to clarify the effects of certain forms of social support. The interaction of the factors described in this review with culture needs further exploration. © 2015, Springer Science+Business Media New York.",0 +https://doi.org/10.1016/s0193-953x(18)30113-8,Post-Traumatic Stress Disorder in the Military Veteran,"Post-traumatic stress disorder (PTSD) has followed in the wake of wars throughout history, even wars that have been brief and successful. Soldiers are at marked risk for chronic functional impairment as well as specific psychiatric conditions such as dysthymia, panic disorders, obsessive disorder, and others. Premilitary functioning and genetics play definite roles in the likelihood of developing PTSD, whereas long-term outcome depends upon a number of additional factors such as severity of combat exposure and chronic physical disabilities. Primary prevention, understandably, is both desirable and difficult, and secondary prevention is both attainable and effective. Likewise, treatment is significantly effective in some, but not all, veterans.",0 +https://doi.org/10.1177/2167702614549800,Changing for Better or Worse? Posttraumatic Growth Reported by Soldiers Deployed to Iraq,"There has been increased interest in self-perceived posttraumatic growth, but few longitudinal studies have focused on its relationship with posttraumatic stress. Self-perceived growth is generally thought to facilitate adjustment, but some researchers have proposed that it reflects a dysfunctional coping strategy that impedes adjustment and leads to posttraumatic stress. In this prospective longitudinal study, we examined the relationship between self-perceived posttraumatic growth and stress. Participants were soldiers deployed to Iraq. They were tested before their deployment ( N = 479) and again 5 months ( n = 382; 80%) and 15 months ( n = 331; 69%) after returning home. Cross-lagged panel analysis indicated that more perceived growth 5 months postdeployment was associated with more posttraumatic stress 15 months postdeployment, even after we controlled for stressor severity, posttraumatic stress at 5 months, and potential predeployment confounders (extraversion, neuroticism, and cognitive ability). Findings suggest that it may be counterproductive to promote perceived growth to enhance adjustment after traumatic events.",0 +https://doi.org/10.1007/s00127-006-0107-6,Prevalence of psychiatric disorders three years after the 1999 earthquake in Turkey: Marmara Earthquake Survey (MES),"Background: The objective of the study is to describe the community prevalence of psychiatric disorder, mainly posttraumatic stress disorder (PTSD) and Major Depressive Disorder (MDD) 3 years after a devastating earthquake. Methods: Three years after the Marmara Earthquake, 683 individuals from the epicentre were randomly selected to form a representative sample and were assessed with Composite International Diagnostic Interview (CIDI), General Health Questionnaire (GHQ), Traumatic Stress Symptom Checklist (TSSC) and Beck Depression Inventory (BDI). Results: The 36 months prevalence of PTSD and MDD after the Marmara Earthquake were 19.2% and 18.7% respectively. The current prevalence of PTSD and MDD in the affected community was found to be 11.7% and 10.5%, respectively. PTSD and MDD were the most prevalent disorders after the disaster and showed a decrease over time. However, only 38.9% of the PTSD cases identified at any time over the 3 years were in remission at the 3rd-year. The co-occurrence of MDD with PTSD resulted in a decrease in the rate of recovery from PTSD. MDD was also the most prevalent disorder accompanying PTSD. Of all the subjects 37.5% with PTSD still met the MDD criteria at the 3rd year postearthquake. Conclusions: In comparison with the data from pre-earthquake national mental health profile, the present study showed that the prevalence of MDD, panic disorder, OCD, GAD, social phobia and special phobias were still higher in the affected region 3 years after the earthquake. (",0 +https://doi.org/10.3736/jcim20090205,Effects of a formula of components from Shengmai Powder on glucocorticoid receptor in rats after thermal injury,"To investigate the effects of a formula of components from Shengmai Powder, a compound traditional Chinese herbal medicine, on glucocorticoid receptor (GR) in rats after thermal injury.A total of 32 male SD rats were randomly assigned into normal control group, untreated group, ginsenosides group and components group, with 8 rats in each group. Rats in the normal control group were intragastrically administered with normal saline (NS) at room temperature once daily. Rats in the untreated group were treated with NS before thermal injury, and rats in the components group and ginsenosides group were once daily treated with a mixture of aqueous extracts of Ophiopogonis Japoni, Fructus schizandrae Chinensis and ginsenosides and ginsenosides respectively. Rats were administered for one week. After the last administration, rats in the untreated group and treated groups underwent thermal injury for one hour, and then were sacrificed immediately by decapitation. Blood serum was collected, and the serum corticosterone (CS) and adrenocorticotropic hormone (ACTH) levels were determined with enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (RIA) respectively. The liver, lung and kidney homogenates were used to determine the GR binding capacity by radioligand receptor binding assay. The results were analyzed by one point analysis.GR binding capacities in liver, lung and kidney cytosols in the untreated group were obviously lower than those in the normal control group (P<0.01). The GR binding capacities in the liver and lung cytosols in the components group and the ginsenosides group were significantly higher than those in the untreated group (P<0.01), but no significant difference was found in kidney cytosol. Compared with the ginsenosides group, GR binding capacity in liver cytosol in the components group was increased (P<0.01), but there were no noticeable differences when compared with the GR binding capacities in lung and kidney cytosols. Serum CS and ACTH levels of the normal rats were (66+/-16)microg/L and (59+/-18) ng/L respectively. There were significant differences in CS and ACTH levels between the normal control group and the other groups (P<0.01), in which the serum CS and ACTH levels were (113+/-33)microg/L and (125+/-20) ng/L, (123+/-26) microg/L and (110+/-30) ng/L and (118+/-17) microg/L and (115+/-35) ng/L respectively. But there was no significant difference between the untreated group and the other treated groups.The formula of components from Shengmai Powder can enhance the effect of ginsenosides in up-regulating GR in rats after thermal injury.",0 +https://doi.org/10.4324/9780203874318-20,Cognitive therapy for people with post-traumatic stress disorder to multiple events: Working out where to start,"(create) Many people presenting for help with post-traumatic stress disorder (PTSD) have re-experiencing symptoms relating to more than one traumatic event and this can be daunting to clinicians. Although there is now a substantial literature on working with single-incident PTSD, less is available to help clinicians working with those with PTSD to multiple events. Despite over 25 years of epidemiological research on the prevalence of traumatic events and PTSD, the proportion of this population with PTSD to more than one event remains unclear. Many clinicians have argued that the psychological effects of isolated traumatic events and repeated trauma are different and require different treatment. Herman (1992) proposed a phased model of treatment for people who have experienced multiple traumatic events. The first priority is ensuring safety. This includes reducing the risk of further trauma (e.g., organizing alternative accommodation for victims of domestic violence), reducing self-harm, improving affect-regulation, and controlling dissociation. The second phase, 'remembrance', involves providing a detailed account of the trauma so that it can be incorporated within an autobiographical narrative. In the third, 'reconnection' phase, a sense of self is (re-)established encompassing more than their identity as a trauma survivor. Most guidance for clinicians working with people with PTSD to multiple events refers to themes likely to be important, such as trust and intimacy, or describes particular treatment approaches, such as testimony or narrative exposure therapy. Advice regarding the order in which to work on memories relates to constructing a hierarchy of trauma memories and collaborative decision-making with clients (Hembree, Rauch, & Foa, 2003). Control over treatment and sensitive pacing of the work are, clearly, essential for clients whose control was taken away during the trauma. However, greater attention to the cognitive factors within the formulation and the relationship between the traumatic events assists with this process. It can help identify which re-experiencing symptoms can be treated most quickly, giving the client an early experience of success, which can hearten them to tackle even more distressing memories. People with PTSD to multiple traumatic events fall into different groups, which tend to have distinct presentations: (1) people with PTSD to multiple events in childhood, often physical or sexual abuse; (2) people with PTSD to multiple events in adulthood, including victims of domestic violence, people in high-risk occupational groups such as emergency personnel, and asylum-seekers and refugees; and (3) people with PTSD to traumatic events in both childhood and adulthood. The two cases presented in this chapter represent differing presentations of this third group. All aspects of treatment needed for PTSD to single events are also required for the treatment of PTSD to multiple events. The emphasis here is on additional elements useful with PTSD to multiple events. There are some issues particular to specific groups-those with histories of childhood abuse are likely to present with more dissociative symptoms, for example-but the same general principles apply across groups. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1002/jts.20399,The latent structure of posttraumatic stress disorder among adolescents,"Debate has arisen over whether posttraumatic stress disorder (PTSD) is most accurately conceptualized as representing a discrete clinical syndrome or an extreme reaction to traumatic life events. Recent taxometric research using predominantly adult samples appears to support a dimensional model of PTSD, raising questions about the utility of current psychiatric nosology which depicts PTSD as a distinct entity. The present study sought to use taxometric procedures to examine the latent structure of posttraumatic stress reactions among a national epidemiologic sample of 2,885 adolescents. Results were consistent with previous taxometric studies in supporting a dimensional model of posttraumatic stress reactions. The implications of these findings for public policy, as well as the etiology and assessment of posttraumatic stress reactions, are discussed.",0 +https://doi.org/10.1016/j.comppsych.2015.08.008,Demoralisation syndrome does not explain the psychological profile of community-based asylum-seekers,"Demoralisation syndrome (DS) has been advanced as a construct that features hopelessness, meaninglessness, and existential distress. Demoralisation and DS have predominantly been considered secondary only to illness; hence there is scant research on demoralisation or DS in populations affected by extreme environmental stress.The current study aimed to determine the prevalence of demoralisation, its predictors, and the relevance of DS in a community-based forced-migrant population.A convenience sample of 131 adult asylum-seekers (n=98) and refugees (n=33) without recognised mental disorders in Melbourne, Australia, were assessed cross-sectionally on posttraumatic stress, anxiety, depression, post-migration stress, and demoralisation. Socio-demographic data were analysed with relevant clinical data. Predictive aims were investigated using bivariate statistical tests and exploratory aims were investigated using correlational and linear regression analyses.Seventy nine percent of the sample met criteria for demoralisation (asylum-seekers=83%; refugees=66%), with asylum-seekers being 2.55 (95% C.I.=1.03-6.32, Z=2.03, p=.04) times more likely to be demoralised than refugees. No relationship between demoralisation and time in the refugee determination process emerged. The regression model explained 47.5% of variance in demoralisation scores for the total sample F(9,111)=13.07, p<.0001, with MDD and anxiety score making unique significant contributions.Demoralisation was widespread through the asylum-seeker and refugee population and its prevalence was attributable to a range of social and psychiatric factors. However, DS had little explanatory power for psychiatric morbidity, which was more suggestive of a pan-distress symptom complex.",0 +https://doi.org/10.4088/jcp.v68n1019,"Suicidality, Psychopathology, and Gender in Incarcerated Adolescents in Austria","Article AbstractObjective: Delinquent juveniles are at extreme risk for suicide with death rates 4 times higher than in the general population. Whereas psychopathologic risk factors for suicidal behavior in nonforensic adolescent populations are well defined, psychopathologies associated with suicidality in delinquent juveniles are not yet clear. The objective of this study was to determine gender-specific psychopathologic profiles associated with suicidality in detained juveniles. Method: The Massachusetts Youth Screening Instrument-Second Version, the Youth Self-Report, and the Mini-International Neuropsychiatric Interview for children and adolescents were used to investigate juveniles in an Austrian pretrial detention facility. The study sample consisted of all juveniles entering the system between March 2003 and January 2005. Of the 370 eligible participants, 319 completed the study (53 girls and 266 boys; age range, 14 to 21 years; mean = 16.67, SD = 1.45 years). Results: We found significantly higher prevalence rates of both current (p < .01) and lifetime (p < .001) suicidality in girls than in boys. Suicidal boys exhibited more psychopathology and a wider range of psychopathology compared to nonsuicidal boys. For suicidal girls, psychopathologies appeared more circumscribed (all relevant p values < .04). Using signal detection methods, major depressive disorder, attention-deficit/hyperactivity disorder, and social phobia identified boys athighest risk of suicidality, while a diagnosis of posttraumatic stress disorder identified girls at highest risk. Conclusions: Suicidality levels are high in delinquent adolescents, especially in girls. Psychopathologic risk factors seem to be gender specific in this population. Not only depression, but also psychopathologies that usually do not arouse strong suspicion for an association with suicidal behavior, i.e., social phobia and ADHD in boys and PTSD in girls, might increase suicide risk. Further research in other countries is needed to replicate our results with respect to sociocultural influences.",0 +https://doi.org/10.1007/bf00962638,Minnesota Multiphasic Personality Inventory (MMPI)-derived psychopathology subtypes among former prisoners of war (POWs): Replication and extension,"Psychopathology and symptom patterns identified among former prisoners of war (POWs) by Sutker, Winstead, Goist, Malow, and Allain (1986) were replicated in an independent sample of 51 former POWs with similar personal backgrounds and military experiences. Data collection instruments included the Minnesota Multiphasic Personality Inventory (MMPI), self-report measures of anxiety and depression, and a structured clinical interview including a POW Trauma Index. Two prototypic MMPI profile patterns were identified using modal profile analysis (Skinner & Lei, 1980). Both were highly similar in shape and elevation to those reported in the previous investigation. Multiprofile-multisample analysis produced prototypic profile patterns which were accurate representations of profiles identified in separate analyses of the derivation and replication samples (r's ≥.96). Representing unique constellations of clinical features, profile subtypes were associated differentially with confinement stress severity, postservice adjustment, and nature and extent of stress-induced symptomatology. © 1988 Plenum Publishing Corporation.",0 +https://doi.org/10.1111/j.1526-4610.2006.00564.x,Pharmacological Management of Mood and Anxiety Disorders in Headache Patients,"There is emerging evidence that treatment of comorbid mood and anxiety disorders can improve headache treatment outcome when implemented within a comprehensive program. Effective treatment for comorbid mood and anxiety disorders requires screening headache patients and accurately diagnosing specific psychiatric disorders when present. Specific dual-action antidepressant, anticonvulsant, and atypical antipsychotic medications can serve as dual agents that simultaneously treat both headaches and a mood or anxiety disorder. Serotonin reuptake inhibitors and most other antidepressant, anxiolytic, and mood-stabilizing medications are generally ineffective for headache prophylaxis. However, they can be safely added to a headache regimen for treatment of a comorbid psychiatric disorder. Treatment of comorbid psychiatric disorders in headache patients requires patient education about the psychiatric disorder, its treatment, possible side-effects, and expected benefits. Clinicians need to be sensitive to possible stigma that some patients fear from a psychiatric diagnosis or its treatment.",0 +https://doi.org/10.1017/s003329171100256x,"Exposure, probable PTSD and lower respiratory illness among World Trade Center rescue, recovery and clean-up workers","Background Thousands of rescue and recovery workers descended on the World Trade Center (WTC) in the wake of the terrorist attack of September 11, 2001 (9/11). Recent studies show that respiratory illness and post-traumatic stress disorder (PTSD) are the hallmark health problems, but relationships between them are poorly understood. The current study examined this link and evaluated contributions of WTC exposures. Method Participants were 8508 police and 12 333 non-traditional responders examined at the WTC Medical Monitoring and Treatment Program (WTC-MMTP), a clinic network in the New York area established by the National Institute for Occupational Safety and Health (NIOSH). We used structural equation modeling (SEM) to explore patterns of association among exposures, other risk factors, probable WTC-related PTSD [based on the PTSD Checklist (PCL)], physician-assessed respiratory symptoms arising after 9/11 and present at examination, and abnormal pulmonary functioning defined by low forced vital capacity (FVC). Results Fewer police than non-traditional responders had probable PTSD (5.9% v . 23.0%) and respiratory symptoms (22.5% v . 28.4%), whereas pulmonary function was similar. PTSD and respiratory symptoms were moderately correlated ( r =0.28 for police and 0.27 for non-traditional responders). Exposure was more strongly associated with respiratory symptoms than with PTSD or lung function. The SEM model that best fit the data in both groups suggested that PTSD statistically mediated the association of exposure with respiratory symptoms. Conclusions Although longitudinal data are needed to confirm the mediation hypothesis, the link between PTSD and respiratory symptoms is noteworthy and calls for further investigation. The findings also support the value of integrated medical and psychiatric treatment for disaster responders.",0 +https://doi.org/10.1023/a:1022003126168,The prevalence of PTSD following the violent death of a child and predictors of change 5 years later,"In this study, we examined the violent death bereavement trajectories of 173 parents by following them prospectively for 5 years after their children's deaths by accident, suicide, homicide, or undetermined causes. Using latent growth curve methodology, we examined how the initial level of PTSD and the rate of change over time were influenced by 9 predictors: the deceased children's causes of death, parents' gender, self-esteem, 3 coping strategies, perceived social support, concurrent levels of mental distress, and an intervention offered in early bereavement. Six of the nine factors predicted initial levels of PTSD; however, only parents' gender and perceived social support predicted change in PTSD over the 5-year time frame. Five years postdeath, 3 times as many study mothers (27.7%) met diagnostic criteria for PTSD and twice as many study fathers (12.5%) met diagnostic criteria for PTSD compared with the normative samples.",0 +https://doi.org/10.1080/026990598122566,Traumatic brain injury and posttraumatic stress disorder: a preliminary investigation of neuropsychological test results in PTSD secondary to motor vehicle accidents,This study investigated the effect of traumatic brain injury on the development of posttraumatic stress disorder (PTSD). Subjects were 107 motor vehicle accident survivors including 38 individuals who were diagnosed with posttraumatic stress disorder (PTSD). Neuropsychological testing was administered to all subjects during an initial diagnostic evaluation. Results showed that subjects who had lost consciousness during their MVA had greater impairment on speed dependent tests and delayed recall of verbal material. Subjects who suffered traumatic brain injury (TBI) were also found to have developed PTSD as often as those who had not reported TBI. Implications for future research and clinical utility are discussed.,0 +https://doi.org/10.1176/ajp.150.7.1030,Validity of the Dissociative Experiences Scale in screening for multiple personality disorder: a multicenter study,"The Dissociative Experiences Scale has proved a reliable and valid instrument to measure dissociation in many groups, but its capacity to distinguish patients with multiple personality disorder from patients with other psychiatric disorders has not yet been conclusively tested.A discriminant analysis was performed to classify 1,051 subjects as having or not having multiple personality disorder. Another discriminant analysis was performed on a subgroup of 883 subjects more closely representing patients in a typical psychiatric facility in terms of base rates of dissociative disorders. A cutoff score of 30 was also used to classify subjects, and Bayes's theorem, which allows for the calculation of the positive predictive value and the negative predictive value of a screening test, was applied.According to discriminant analysis of the total study group, the scale's sensitivity was 76% and its specificity was also 76%; according to discriminant analysis of the more representative subgroup, the scale's sensitivity was 76% and its specificity was 85%. Use of the cutoff score of 30 produced similar results. Results of the application of Bayes's theorem showed that 17% of the subjects scoring 30 or higher would actually have multiple personality disorder and 99% of those scoring less than 30 would not have multiple personality disorder.These results indicate that the Dissociative Experiences Scale performs quite well as a screening instrument to identify subjects with multiple personality disorder. In addition, the consistency of responses to scale items across centers indicates that the symptoms reported by patients with multiple personality disorder are highly similar across diverse geographic centers. This consistency supports the reliability and validity of the diagnosis of multiple personality disorder across centers.",0 +https://doi.org/10.3402/ejpt.v3i0.17303,"Personality, posttraumatic stress and trauma type: factors contributing to posttraumatic growth and its domains in a Turkish community sample","Posttraumatic growth (PTG) is conceptualized as a positive transformation resulting from coping with and processing traumatic life events. This study examined the contributory roles of personality traits, posttraumatic stress (PTS) severity and their interactions on PTG and its domains, as assessed with the Posttraumatic Growth Inventory Turkish form (PTGI-T). The study also examined the differences in PTG domains between survivors of accidents, natural disasters and unexpected loss of a loved one.The Basic Personality Traits Inventory, Posttraumatic Diagnostic Scale, and PTGI-T were administered to a large stratified cluster community sample of 969 Turkish adults in their home settings.The results showed that conscientiousness, agreeableness, and openness to experience significantly related to the total PTG and most of the domains. The effects of extraversion, neuroticism and openness to experience were moderated by the PTS severity for some domains. PTG in relating to others and appreciation of life domains was lower for the bereaved group.Further research should examine the mediating role of coping between personality and PTG using a longitudinal design.",0 +https://doi.org/10.1111/jcpp.12350,"Trauma memories, mental health, and resilience: a prospective study of Afghan youth","Background Studies of war-affected youth have not yet examined how trauma memories relate to prospective changes in mental health and to subjective or social experiences. Methods We interviewed a gender-balanced, randomly selected sample of Afghan child-caregiver dyads (n = 331, two waves, 1 year apart). We assessed lifetime trauma with a Traumatic Event Checklist, past-year events with a checklist of risk and protective events, and several child mental health outcomes including posttraumatic distress (Child Revised Impact of Events Scale, CRIES) and depression. We examined the consistency of trauma recall over time, identified mental health trajectories with latent transition modeling, and assessed the predictors of posttraumatic distress and depression trajectories with multinomial logistic regressions. Results From baseline to follow-up, reports of lifetime trauma significantly changed (p ≤ 0.01). A third of the cohort reported no trauma exposure; only 10% identified the same event as their most distressing experience. We identified four CRIES trajectories: low or no distress (52%), rising distress (15%), declining distress (21%), and sustained high distress (12%). Youth with chronic posttraumatic distress were more likely to be girls (OR = 5.78, p ≤ 0.01), report more trauma exposure at baseline (OR = 1.55, p ≤ 0.05) and follow-up (OR = 5.96, p ≤ 0.01), and experience ongoing domestic violence (OR = 4.84, p ≤ 0.01). The risks of rising distress and sustained distress showed a steady increase for youth recalling up to four traumatic experiences. Depression and CRIES trajectories showed weak comorbidity. Conclusions Memories of violent events are malleable, embedded in social experiences, and present heterogeneous associations with posttraumatic distress. Our study provides insights on resilience and vulnerability to multiple adverse childhood experiences, highlighting research and clinical implications for understanding trauma in conflict-affected youth.",0 +https://doi.org/10.1007/s12671-014-0346-7,"Mindfulness Skills, Anxiety Sensitivity, and Cognitive Reactivity in Patients with Posttraumatic Stress Disorder","In trauma-exposed individuals, those with relatively high levels of mindfulness skills tend to have lower levels of symptoms. Mindfulness has also been associated with decreased anxiety sensitivity and cognitive reactivity, and vulnerability factors related to posttraumatic and depressive symptom severity. In this cross-sectional study, our aim was to further investigate the associations among mindfulness skills, anxiety sensitivity, cognitive reactivity, and symptom severity in patients with posttraumatic stress disorder (PTSD). Outpatients with PTSD (N = 101) filled out questionnaires. All facets of mindfulness correlated negatively with reactivity measures and with symptom severity, except for the facet observe. In hierarchical multiple regression analysis, describe, non-judgment, and non-reactivity predicted PTSD symptom severity above and beyond anxiety sensitivity and trauma exposure severity. Describe, act with awareness, and non-judgment also predicted depressive symptom severity above and beyond cognitive reactivity and number of experienced traumatic events. In conclusion, mindfulness skills were indeed uniquely related to symptom severity and cognitive reactivity measures. Our results furthermore support a five-facet model of mindfulness. In addition, the outcomes are a cross-cultural contribution to research on the relevance of mindfulness skills in the treatment of PTSD. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1016/j.jad.2015.08.043,Intranetwork and internetwork functional connectivity alterations in post-traumatic stress disorder,"A large number of previous neuroimaging studies have explored the functional alterations of post-traumatic stress disorder (PTSD). However, abnormalities in the functional architecture of resting-state networks in PTSD were rarely elucidated.This study used independent component analysis to explore the resting-state intranetwork and internetwork functional connectivity differences between 20 PTSD patients and 20 matched healthy controls (HCs).Selective alterations of intranetwork and internetwork intrinsic functional connectivities were found in the PTSD patients. Compared with HCs, the PTSD patients exhibited significantly decreased network connectivity within the anterior default mode network, posterior default mode network (pDMN), salience network (SN), sensory-motor network, and auditory network. Furthermore, the PTSD patients exhibited increased internetwork connectivity between SN and pDMN.This study lacked recruitment of trauma-exposed HCs, which limits our ability to determine whether the alterations are caused by PTSD or trauma exposure.The findings suggested that the PTSD patients exhibited abnormal functional connectivity at the brain network level. Notably, the enhanced internetwork connectivity between SN and pDMN in the PTSD patients may be associated with hyperarousal and heightened anxiety in PTSD.",0 +https://doi.org/10.1177/136346150103800302,Individual and Collective Traumatic Memories: A Qualitative Study of Post-Traumatic Stress Disorder Symptoms in Two Latin American Localities,"A qualitative analysis of material from a number of field trips to Peru and Colombia shows the diagnosis of post-traumatic stress disorder (PTSD) to be culture related. When a local community consists of collective, functional units, as in some Peruvian villages, people have a tendency to not react solely with conventional PTSD symptoms, or to have the attitude that traumatic memory should be treated with crisis intervention. This is in contrast to some villages in Colombia where people are more individualistically oriented and reactions to trauma are more concerned with guilt and shame. In Peru, psychosocial work is carried out mostly by strengthening the construction of the local community, whereas in Colombia, individual psychological interventions are more widely used and accepted. The study demonstrates that the concept of traumatic memory should be considered in both collective and individual aspects, depending on the nature of the underlying organisation of society and culture.",0 +https://doi.org/10.1016/j.drugalcdep.2014.04.013,Frequent binge drinking five to six years after exposure to 9/11: Findings from the World Trade Center Health Registry,"Exposure to 9/11 may have considerable long-term impact on health behaviors, including increased alcohol consumption. We examined the association between frequent binge drinking, posttraumatic stress disorder (PTSD), and number of 9/11-specific experiences among World Trade Center Health Registry (Registry) enrollees five-to-six years after 9/11.Participants included 41,284 lower Manhattan residents, workers, passers-by, and rescue/recovery workers aged 18 or older without a pre-9/11 PTSD diagnosis who completed Wave 1 (2003-2004) and Wave 2 (2006-2007) interviews. Frequent binge drinking was defined as consuming five or more drinks on five or more occasions in the prior 30 days at Wave 2. Probable PTSD was defined as scoring 44 or greater on the PTSD Checklist. 9/11 exposure was measured as the sum of 12 experiences and grouped as none/low (0-1), medium (2-3), high (4-5) and very high (6+).Frequent binge drinking was significantly associated with increasing 9/11 exposure and PTSD. Those with very high and high exposures had a higher prevalence of frequent binge drinking (13.7% and 9.8%, respectively) than those with medium and low exposures (7.5% and 4.4%, respectively). Upon stratification, very high and high exposures were associated with frequent binge drinking in both the PTSD and no PTSD subgroups.Our findings suggest that 9/11 exposure had an impact on frequent binge drinking five-to-six years later among Registry enrollees. Understanding the effects of traumatic exposure on alcohol use is important to identify risk factors for post-disaster alcohol misuse, inform policy, and improve post-disaster psychological and alcohol screening and counseling.",0 +https://doi.org/10.1097/jgp.0b013e3181b4bf20,AAGP Position Statement: Disaster Preparedness for Older Americans: Critical Issues for the Preservation of Mental Health,"The Disaster Preparedness Task Force of the American Association for Geriatric Psychiatry was formed after Hurricane Katrina devastated New Orleans to identify and address needs of the elderly after the disaster that led to excess health disability and markedly increased rates of hopelessness, suicidality, serious mental illness (reported to exceed 60% from baseline levels), and cognitive impairment. Substance Abuse and Mental Health Services Administration (SAMHSA) outlines risk groups which fail to address later effects from chronic stress and loss and disruption of social support networks. Range of interventions recommended for Preparation, Early Response, and Late Response reviewed in the report were not applied to elderly for a variety of reasons. It was evident that addressing the needs of elderly will not be made without a stronger mandate to do so from major governmental agencies (Federal Emergency Management Agency [FEMA] and SAMHSA). The recommendation to designate frail elderly and dementia patients as a particularly high-risk group and a list of specific recommendations for research and service and clinical reference list are provided.",0 +https://doi.org/10.1007/s11336-008-9077-9,Regularized Finite Mixture Models for Probability Trajectories,"Finite mixture models are widely used in the analysis of growth trajectory data to discover subgroups of individuals exhibiting similar patterns of behavior over time. In practice, trajectories are usually modeled as polynomials, which may fail to capture important features of the longitudinal pattern. Focusing on dichotomous response measures, we propose a likelihood penalization approach for parameter estimation that is able to capture a variety of nonlinear class mean trajectory shapes with higher precision than maximum likelihood estimates. We show how parameter estimation and inference for whether trajectories are time-invariant, linear time-varying, or nonlinear time-varying can be carried out for such models. To illustrate the method, we use simulation studies and data from a long-term longitudinal study of children at high risk for substance abuse.",0 +https://doi.org/10.4088/jcp.14m09091,Dimensional Structure of <em>DSM-5</em> Posttraumatic Stress Disorder Symptoms,"To evaluate the prevalence of DSM-5 posttraumatic stress disorder (PTSD) and factor structure of PTSD symptomatology in a nationally representative sample of US veterans and examine how PTSD symptom clusters are related to depression, anxiety, suicidal ideation, hostility, physical and mental health-related functioning, and quality of life.Data were analyzed from the National Health and Resilience in Veterans Study, a nationally representative survey of 1,484 US veterans conducted from September through October 2013. Confirmatory factor analyses were conducted to evaluate the factor structure of PTSD symptoms, and structural equation models were constructed to examine the association between PTSD symptom clusters and external correlates.12.0% of veterans screened positive for lifetime PTSD and 5.2% for past-month PTSD. A 5-factor dysphoric arousal model and a newly proposed 6-factor model both fit the data significantly better than the 4-factor model of DSM-5. The 6-factor model fit the data best in the full sample, as well as in subsamples of female veterans and veterans with lifetime PTSD. The emotional numbing symptom cluster was more strongly related to depression (P < .001) and worse mental health-related functioning (P < .001) than other symptom clusters, while the externalizing behavior symptom cluster was more strongly related to hostility (P < .001).A total of 5.2% of US veterans screened positive for past-month DSM-5 PTSD. A 6-factor model of DSM-5 PTSD symptoms, which builds on extant models and includes a sixth externalizing behavior factor, provides the best dimensional representation of DSM-5 PTSD symptom clusters and demonstrates validity in assessing health outcomes of interest in this population.",0 +https://doi.org/10.1007/978-1-4614-9354-9_2,Understandings of Coping: A Critical Review of Coping Theories for Disaster Contexts,"This chapter addresses the behavior, thoughts, experiences, and feelings of individuals who have been exposed to strain and stress. First, we introduce the many different approaches associated with both psychological and broader social science-based understandings of coping. We then analyze the extent to which these approaches can be applied in a disaster-related context. In the first part of this chapter, we examine the person-centered coping models that dominate stress research in mainstream psychological approaches. These models are similar to the goal-based models of human nature in which the basic motivation of human beings is to move toward goals while avoiding threats. Depending on the model in question, the main focus lies either in the cognitive processes of appraisal and emotion regulation, attribution of meaning, and religious forms of coping or on the conceptualization as a mental health problem. In contrast, resource-oriented coping theories emphasize the social and material contexts of stress processes. Social contexts and interactions are also more central to the field of community psychology and in the research on social support. Sociology and related social sciences have even broader models in which community coping and resilience of communities are studied as a social or collective process. When considering community resilience, or the application of social capital or local knowledge, the coping resources of larger social units are of primary importance, as collective meanings, emotions, and agency come to the fore. © 2014 Springer Science+Business Media, LLC. All rights are reserved.",0 +https://doi.org/10.1016/j.adolescence.2006.05.005,Developmental trajectories of adolescent popularity: A growth curve modelling analysis,"Growth curve modelling was used to examine developmental trajectories of sociometric and perceived popularity across eight years in adolescence, and the effects of gender, overt aggression, and relational aggression on these trajectories. Participants were 303 initially popular students (167 girls, 136 boys) for whom sociometric data were available in Grades 5-12. The popularity and aggression constructs were stable but non-overlapping developmental dimensions. Growth curve models were run with SAS MIXED in the framework of the multilevel model for change [Singer, J. D., & Willett, J. B. (2003). Applied longitudinal data analysis. Oxford, UK: Oxford University Press]. Sociometric popularity showed a linear change trajectory; perceived popularity showed nonlinear change. Overt aggression predicted low sociometric popularity but an increase in perceived popularity in the second half of the study. Relational aggression predicted a decrease in sociometric popularity, especially for girls, and continued high-perceived popularity for both genders. The effect of relational aggression on perceived popularity was the strongest around the transition from middle to high school. The importance of growth curve models for understanding adolescent social development was discussed, as well as specific issues and challenges of growth curve analyses with sociometric data.",0 +https://doi.org/10.1146/annurev-publhealth-032013-182435,Mental Health Consequences of Disasters,"We present in this review the current state of disaster mental health research. In particular, we provide an overview of research on the presentation, burden, correlates, and treatment of mental disorders following disasters. We also describe challenges to studying the mental health consequences of disasters and discuss the limitations in current methodologies. Finally, we offer directions for future disaster mental health research.",0 +https://doi.org/10.1016/j.jad.2008.06.007,Validity of the Hospital Anxiety and Depression Scale to assess depression and anxiety following traumatic brain injury as compared with the Structured Clinical Interview for DSM-IV,"Rating scales are often used in the assessment of depression and anxiety in traumatic brain injury (TBI), but few have been validated for use with this population. Overlap of symptoms between such disorders and TBI may lead to under- or over-diagnosis of depression or anxiety.100 participants with mild to severe TBI, and 87 informants, were interviewed using the SCID-IV (Axis I). The HADS was administered at the same time.According to the SCID-IV, 34 participants were diagnosed with major depression and 36 with an anxiety disorder. Higher HADS scores were associated with a greater likelihood of depression and anxiety. However, the ""clinical"" categories of the HADS did not strongly correspond with the clinical diagnoses of depression and anxiety. Compared with SCID diagnoses, the depression subscale of the HADS had a sensitivity of 62% and a specificity of 92%. The anxiety subscale had a sensitivity of 75% and a specificity of 69%. Positive predictive and negative predictive values were calculated.This study included mostly moderate to severe TBI individuals, recruited from a rehabilitation hospital. Therefore, they may not necessarily be representative of the entire TBI population.The HADS was a reliable measure of emotional distress in this TBI sample; however the cut-off scores and categories were not useful in predicting caseness of depression and anxiety. Clinicians should be mindful of the sequelae of TBI that may confound the scores yielded in rating scales and should follow up with a psychiatric interview when diagnosis is unclear.",0 +https://doi.org/10.3389/fpsyg.2012.00449,Neural Systems for Cognitive and Emotional Processing in Posttraumatic Stress Disorder,"Individuals with posttraumatic stress disorder (PTSD) show altered cognition when trauma-related material is present. PTSD may lead to enhanced processing of trauma-related material, or it may cause impaired processing of trauma-unrelated information. However, other forms of emotional information may also alter cognition in PTSD. In this review, we discuss the behavioral and neural effects of emotion processing on cognition in PTSD, with a focus on neuroimaging results. We propose a model of emotion-cognition interaction based on evidence of two network models of altered brain activation in PTSD. The first is a trauma-disrupted network made up of ventrolateral PFC, dorsal anterior cingulate cortex (ACC), hippocampus, insula, and dorsomedial PFC that are differentially modulated by trauma content relative to emotional trauma-unrelated information. The trauma-disrupted network forms a subnetwork of regions within a larger, widely recognized network organized into ventral and dorsal streams for processing emotional and cognitive information that converge in the medial PFC and cingulate cortex. Models of fear learning, while not a cognitive process in the conventional sense, provide important insights into the maintenance of the core symptom clusters of PTSD such as re-experiencing and hypervigilance. Fear processing takes place within the limbic corticostriatal loop composed of threat-alerting and threat-assessing components. Understanding the disruptions in these two networks, and their effect on individuals with PTSD, will lead to an improved knowledge of the etiopathogenesis of PTSD and potential targets for both psychotherapeutic and pharmacotherapeutic interventions.",0 +https://doi.org/10.1007/s11920-015-0566-0,Life Course Epidemiology of Trauma and Related Psychopathology in Civilian Populations,"Traumatic events are ubiquitous exposures that interact with life course events to increase risk of acute psychopathology and alter mental health trajectories. While the majority of persons exposed to trauma experience mild to moderate psychological distress followed by a return to pre-trauma health, many persons exposed to trauma experience substantial distress that lasts for several years. Therefore, in an effort to understand why exposure to trauma can provoke such a range of reactions, we apply a life course approach that considers the complex accumulation and interaction of life experiences that range from social to biological factors, which occur over the life span-from gestation to death and across generations. We present this evidence in three categories: genetics and biology, individual exposures, and community experiences, followed by discussing challenges in existing research and directions for future study.",0 +https://doi.org/10.1097/00004583-199509000-00012,Adolescent Survivors of “Ethnic Cleansing”: Observations on the First Year in America,"To describe the psychiatric assessments and trauma testimonies of 12 Bosnian adolescents newly resettled in America.Twelve Bosnian adolescents who experienced the massive psychic trauma of ""ethnic cleansing"" were assessed during the first year after their resettlement in the United States. Assessments consisted of systematic, trauma-focused, clinical interviews that included standard assessment scales of posttraumatic stress disorder (PTSD) and depression, as well as the opportunity to give testimony about their experiences.PTSD was diagnosed in 25% of subjects and depressive disorders in 17%. Reexperiencing cluster symptoms were present in 50%, avoidance cluster symptoms in 31%, and hyperarousal cluster symptoms in 29%.The relatively low rate of PTSD in this sample (in comparison with adult survivors of ""ethnic cleansing"" and with Cambodian adolescent survivors) may be attributable to normal prior development, time-limited adversity, lack of physical or sexual traumas, rejoining nuclear families, or insufficient time for the development of delayed-onset PTSD. It may also be a reflection of the resiliency of adolescence.",0 +https://doi.org/10.1002/da.1082,Fluvoxamine treatment in veterans with combat-related post-traumatic stress disorder,"This study was designed to investigate the efficacy of the antidepressant fluvoxamine in the treatment of combat-related post-traumatic stress disorder (PTSD). Fifteen veterans with combat-related PTSD and no other psychiatric diagnosis except depression were recruited to participate in a 14-week open-label study of fluvoxamine. Patients underwent a 30-day washout period and were rated with the Clinician Administered PTSD Scale (CAPS), Mississippi Scale, Beck Depression Inventory (BDI), Hamilton Rating Scale for Depression (HAM-D) and Hamilton Rating Scale for Anxiety (HAM-A) at baseline, and every 2 weeks until week 14. Three patients stopped fluvoxamine prematurely due to side effects and 7 withdrew consent before completing the 14-week trial. Eight patients completed at least 8 weeks of treatment. The total daily dose of fluvoxamine ranged from 100 to 300 mg with a mean daily dose of 150 mg at week 14. Intent-to-treat analysis revealed a significant improvement in total CAPS scores, and in the intrusion and the avoidance/numbing subscales. The CAPS hyperarousal scores did not change significantly. HAM-A score also improved significantly. No significant changes were seen on the Mississippi scale, HAM-D, or Beck Depression Inventory in the intent-to-treat analysis. In summary, our study shows that fluvoxamine appears to improve combat-related PTSD symptoms but not depressive symptoms. The high attrition rate and lack of a placebo group limits the conclusions of our study. Controlled studies of fluvoxamine in the treatment of PTSD are warranted. Depression and Anxiety 15:29–33, 2002. © 2002 Wiley-Liss, Inc.",0 +https://doi.org/10.1176/appi.ajp.162.12.2295,Peritraumatic and Persistent Dissociation in the Presumed Etiology of PTSD,"Dissociative responses that occur at the time of a trauma (peritraumatic dissociation) have been described as a major risk factor for subsequent posttraumatic stress disorder (PTSD). The current study evaluated peritraumatic dissociation and PTSD from a multivariate perspective, along with a less-investigated phenomenon: trauma-specific dissociation that begins during or after an event and continues until the time of assessment (persistent dissociation).In two studies, 52 local community participants and 386 participants from the general population with histories of exposure to at least one traumatic event were assessed for the presence of PTSD and were administered measures of dissociation and peritraumatic distress.In both studies, peritraumatic dissociation, persistent dissociation, peritraumatic distress, and generalized dissociative symptoms were associated with PTSD by univariate analyses. However, multivariate analyses in both studies indicated that PTSD status was no longer related to peritraumatic dissociation once other variables (especially persistent and generalized dissociation) were taken into account. In contrast, persistent dissociation was a strong predictor at univariate and multivariate levels.Trauma-related persistent dissociation is a substantial predictor of PTSD, whereas peritraumatic dissociation ceases to predict PTSD at the multivariate level. These findings suggest that it is less what happens at the time of a trauma (e.g., disrupted encoding) that predicts PTSD than what occurs thereafter (i.e., persistent avoidance).",0 +https://doi.org/10.1016/j.jpsychires.2015.02.015,The role of childhood maltreatment in the altered trait and global expression of personality in cocaine addiction,"Drug addictions are debilitating disorders that are highly associated with personality abnormalities. Early life stress (ELS) is a common risk factor for addiction and personality disturbances, but the relationships between ELS, addiction, and personality are poorly understood.Ninety-five research participants were assessed for and grouped by ELS history and cocaine dependence. NEO-FFI personality measures were compared between the groups to define ELS- and addiction-related differences in personality traits. ELS and cocaine dependence were then examined as predictors of personality trait scores. Finally, k-means clustering was used to uncover clusters of personality trait configurations within the sample. Odds of cluster membership across subject groups was then determined.Trait expression differed significantly across subject groups. Cocaine-dependent subjects with a history of ELS (cocaine+/ELS+) displayed the greatest deviations in normative personality. Cocaine dependence significantly predicted four traits, while ELS predicted neuroticism and agreeableness; there was no interaction effect between ELS and cocaine dependence. The cluster analysis identified four distinct personality profiles: Open, Gregarious, Dysphoric, and Closed. Distribution of these profiles across subject groups differed significantly. Inclusion in cocaine+/ELS+, cocaine-/ELS+, and cocaine-/ELS- groups significantly increased the odds of expressing the Dysphoric, Open and Gregarious profiles, respectively.Cocaine dependence and early life stress were significantly and differentially associated with altered expression of individual personality traits and their aggregation as personality profiles, suggesting that individuals who are at-risk for developing addictions due to ELS exposure may benefit from personality centered approaches as an early intervention and prevention.",0 +https://doi.org/10.1002/jts.20281,PTSD symptom clusters associated with physical health and health care utilization in rural primary care patients exposed to natural disaster,"This study investigated the influence of exposure to a tornado disaster and disaster-related posttraumatic stress disorder (PTSD) symptomatology on physical health complaints and primary health care utilization among rural medical patients. One-hundred five patients completed self-report measures assessing disaster exposure, PTSD symptoms, and self-reported physical health complaints. Objective rates of health care utilization were gathered by a review of medical records. Tornado disaster exposure and generalized psychological distress were associated with physical health complaints one year following the disaster. After controlling for age, gender, and levels of predisaster health care utilization, PTSD Cluster C (avoidance) symptoms were associated with increased rates of postdisaster health care utilization. Implications of these findings for interventions within the medical system are discussed.",0 +https://doi.org/10.1016/j.janxdis.2013.03.011,Prevalence and duration of PTSD in survivors 6 years after a natural disaster,"The present study aimed to examine the prevalence of posttraumatic stress disorder (PTSD) in survivors with low levels of risk factors for PTSD. The sample included 142 adults (58% women, 54% university education, 93% employed/students/retired) on vacation in Southeast Asia during the 2004 Indian Ocean disaster. Semi-structured clinical interviews (SCID-I) were performed after 6 years including PTSD, depression, specific phobia, and alcohol abuse. The 6-year prevalence of PTSD was 11.3% and the current prevalence was 4.2%, with onset mainly within 1 month and remission within 3 years post-disaster. Suicidal ideation and comorbidity were common in PTSD cases. Lifetime prevalence of depression was 19%, specific phobia 7%, and alcohol abuse 4%. The findings suggest elevated levels of PTSD but not other disorders as compared with general population samples, but still lower levels than other disaster samples. Despite benign circumstances, however, the course and burden of PTSD were comparable to similar studies.",0 +https://doi.org/10.1016/s0277-9536(02)00452-5,"Dimensions of trauma associated with posttraumatic stress disorder (PTSD) caseness, severity and functional impairment: a study of Bosnian refugees resettled in Australia","Refugee survivors of inter-ethnic warfare vary greatly in the extent and range of their trauma experiences. Discerning which experiences are most salient to generating and perpetuating disorders such as posttraumatic stress disorder (PTSD) is critical to the mounting rational strategies for targeted psychosocial interventions. In a sample of Bosnian Muslim refugees (n=126) drawn from a community centre and supplemented by a snowball sampling method, PTSD status and associated disability were measured using the clinician-administered PTSD Scale (CAPS) for DSM-IV. A principal components analysis (PCA) based on a pool of trauma items yielded four coherent trauma dimensions: Human Rights Violations, Threat to Life, Traumatic Loss and Dispossession and Eviction. A cluster analysis identified three subgroupings according to extent of trauma exposure. There were no differences in PTSD risk for the group most exposed to human rights violations (internment in concentration camps, torture) compared to the general war-exposed group. Logistic regression analysis using the dimensions derived from the PCA indicated that Threat to Life alone of the four trauma factors predicted PTSD status, a finding that supports the DSM-IV definition of a trauma. Both Threat to Life and Traumatic Loss contributed to symptom severity and disability associated with PTSD. It may be that human rights violations pose a more general threat to the survivor's future psychosocial adaptation in areas of functioning that extend beyond the confines of PTSD.",0 +,"INTERACTIONS OF IMMUNOLOGICAL, PSYCHOLOGICAL, HORMONAL, AND NUTRITIONAL ALTERATIONS IN WAR-RELATED CHRONIC STRESS","Background and purpose: Stress-induced effects on neuroendocrine and immune functions are well established. The nature of relations in these multidirectionally interacting allostatic systems is difficult to evaluate in humans. To assess the complex responses to war-related chronic stress we used multivariate statistical model analysis. Materials and methods: Twenty-nine detainees released from the concentration camp and 15 controls were included in the study. Psychological status was assessed by COR-NEX2 and Hamilton tests, nutritional status by serum albumin and total protein levels, and endocrine status by serum cortisol, (beta)-endorphin, prolactin, T3 and T4 levels. Immune status was estimated by flow cytometric enumeration of the lymphocyte subpopulations, NK and phagocytic activities and serum cytokines (IL-2, TNF, IFN) levels. To assess the relations between psychological, nutritional, endocrine and immune statuses representet by sets of several variables each, multivariate canonical correlation and cluster analysis were aplyed. Results: Although no causal relationship can be inferred from this study, multiple interactions were established between the statuses examined. Psychological and nutritional variables correlated with T lymphocyte activation and non-specific immune functions while hormonal and psychological statuses, being in correlation, contributed to the relation with immunofunctional variables. By cluster analysis, all variables employed were structured into four clusters, reflecting more or less the same relation among the psychological, endocrine, immune and nutritional statuses. Conclusion: The multivariate model analyses employed confirmed the prevailing influence of chronic stress on hormonal and immunological responses, although in order to arrive at a more reliable interpretation of such complex interactions, some other important variables and larger sample size should be employed.",0 +https://doi.org/10.4324/9780203943694,Combat Stress Injury,,0 +https://doi.org/10.1002/da.21891,THE ANXIETY SPECTRUM AND THE REFLEX PHYSIOLOGY OF DEFENSE: FROM CIRCUMSCRIBED FEAR TO BROAD DISTRESS,"Guided by the diagnostic nosology, anxiety patients are expected to show defensive hyperarousal during affective challenge, irrespective of the principal phenotype. In the current study, patients representing the whole spectrum of anxiety disorders (i.e., specific phobia, social phobia, panic disorder with or without agoraphobia, obsessive-compulsive disorder, generalized anxiety disorder (GAD), posttraumatic stress disorder(PTSD)), and healthy community control participants, completed an imagery-based fear elicitation paradigm paralleling conventional intervention techniques. Participants imagined threatening and neutral narratives as physiological responses were recorded. Clear evidence emerged for exaggerated reactivity to clinically relevant imagery--most pronounced in startle reflex responding. However, defensive propensity varied across principal anxiety disorders. Disorders characterized by focal fear and impairment (e.g., specific phobia) showed robust fear potentiation. Conversely, for disorders of long-enduring, pervasive apprehension and avoidance with broad anxiety and depression comorbidity (e.g., PTSD secondary to cumulative trauma, GAD), startle responses were paradoxically diminished to all aversive contents. Patients whose expressed symptom profiles were intermediate between focal fearfulness and broad anxious-misery in both severity and chronicity exhibited a still heightened but more generalized physiological propensity to respond defensively. Importantly, this defensive physiological gradient--the inverse of self-reported distress--was evident not only between but also within disorders. These results highlight that fear circuitry could be dysregulated in chronic, pervasive anxiety, and preliminary functional neuroimaging findings suggest that deficient amygdala recruitment could underlie attenuated reflex responding. In summary, adaptive defensive engagement during imagery may be compromised by long-term dysphoria and stress-a phenomenon with implications for prognosis and treatment planning.",0 +https://doi.org/10.1016/j.janxdis.2008.01.018,The factor structure of Posttraumatic Stress Disorder symptoms among bereaved individuals: A confirmatory factor analysis study,"Posttraumatic Stress Disorder (PTSD) is defined in DSM-IV as an anxiety disorder that encompasses symptom-clusters of reexperiencing, avoidance, and hyperarousal. Several studies have examined the factor structure of PTSD symptoms. To our knowledge, no studies have yet examined the factor structure of loss-related PTSD symptoms in samples exclusively comprised of bereaved individuals. Such an examination is important because it can advance our understanding of the stability of the structure of PTSD symptoms across groups confronted with different aversive life-events and of processes underlying the occurrence of PTSD symptoms after loss. In this study, five alternative models of the factor structure of PTSD symptoms were examined in a sample of 347 mourners. Results showed that, in this group, PTSD symptoms are best conceptualized as forming four factors: reexperiencing, avoidance, dysphoria, and hyperarousal. Patterns of correlations with depression and complicated grief supported the validity of the model.",0 +https://doi.org/10.1037/0033-2909.99.1.20,Emotional processing of fear: Exposure to corrective information.,"In this article we propose mechanisms that govern the processing of emotional information, particularly those involved in fear reduction. Emotions are viewed as represented by information structures in memory, and anxiety is thought to occur when an information structure that serves as program to escape or avoid danger is activated. Emotional processing is denned as the modification of memory structures that underlie emotions. It is argued that some form of exposure to feared situations is common to many psychotherapies for anxiety, and that confrontation with feared objects or situations is an effective treatment. Physiological activation and habituation within and across exposure sessions are cited as indicators of emotional processing, and variables that influence activation and habituation of fear responses are examined. These variables and the indicators are analyzed to yield an account of what information must be integrated for emotional processing of a fear structure. The elements of such a structure are viewed as cognitive representations of the stimulus characteristic of the fear situation, the individual's responses in it, and aspects of its meaning for the individual. Treatment failures are interpreted with respect to the interference of cognitive defenses, autonomic arousal, mood state, and erroneous ideation with reformation of targeted fear structures. Applications of the concepts advanced here to therapeutic practice and to the broader study of psychopathology are discussed.",0 +https://doi.org/10.1207/s15327752jpa7303_10,Complexities in Complex Posttraumatic Stress Disorder in Inpatient Women: Evidence From Cluster Analysis of MCMI-III Personality Disorder Scales,"Herman's (1992a) clinical formulation of complex posttraumatic stress disorder (PTSD) captures the extensive diagnostic comorbidity seen in patients with a history of repeated interpersonal trauma and severe psychiatric disorders. Yet the sheer breadth of symptoms and personality disturbance encompassed by complex PTSD limits its descriptive usefulness. This study employed cluster analysis of the MCMI-III (Millon, 1994) personality disorder scales to determine whether there is meaningful heterogeneity within a group of 227 severely traumatized women who were treated in a specialized inpatient program. The analysis distinguishes 5 clinically meaningful clusters, which we label alienated, withdrawn, aggressive, suffering, and adaptive. The study examined differences among these 5 personality disorder clusters on the MCMI-III clinical syndrome scales, as well as on the Brief Symptom Inventory (Derogatis, 1993), Dissociative Experiences Scale (E. M. Bernstein & Putnam, 1986), Adult Attachment Scale (Collins & Read, 1990), and Childhood Trauma Questionnaire (D.P. Bernstein, 1995). We present a classification-tree method for determining the cluster membership of new cases and discuss the implications of the findings for diagnostic assessment, treatment, and research.",0 +https://doi.org/10.1017/cbo9780511994791.010,Toward a lifespan approach to resilience and potential trauma,"As much as we might wish it otherwise, bad things happen: war, natural disaster, the death of close friends and relatives, serious accidents, senseless abuse or violence at the hand of others, and so on. Any of these things can and all too often do happen, and at every stage of life. Epidemiological data indicate that most adults experience at least one and usually several potentially traumatic events (PTE) during the course of their lives (Norris, 1992; Kessler et al., 1995; Breslau et al., 2000), and that most children are also exposed to such experiences (Copeland et al., 2007). It is important to note, however, that life event research typically relies on retrospective accounts, which more than likely underestimate the frequency of PTEs. Indeed, a recent study that measured life events among college students over a four-year period using a weekly internet survey reported an average of six PTEs per student (Lalande & Bonanno, 2011). Perhaps because acutely aversive events are so dreaded, both clinicians and the lay public tend to assume that they will almost always result in lasting emotional damage. The available evidence, however, suggests a more complex and far more encouraging picture. To emphasize the pronounced individual differences in the way people react to adversity, we emphasize that such events are only “potentially traumatic” (Norris, 1992; Bonanno, 2004), for the simple reason that not everyone experiences them as traumatic. Most people in fact cope with PTEs remarkably well (Bonanno, 2004, 2005; Bonanno & Mancini, 2008). Although some do, in fact, endure lasting emotional difficulties, the vast majority of people exposed to extreme adversity recover a semblance of their normal level of functioning within several months to several years after the event, and many if not most show little evidence of more than transient disruptions in functioning. © Cambridge University Press 2011.",0 +https://doi.org/10.1521/jscp.2014.33.3.207,Attachment-Related Consequences of War Captivity and Trajectories of Posttraumatic Stress Disorder: A 17-Year Longitudinal Study,"Attachment security contributes to resilience in times of stress, but it can be disrupted by traumatic events that shatter positive views of self and others. We followed Israeli ex-POWs of the Yom Kippur War over 17 years and examined associations between trajectories of posttraumatic stress disorder (PTSD) and disruptions in the regulatory functions of the attachment system. Fifty-nine ex-POWs and 39 control veterans from the same war who had reported on PTSD 18, 30, and 35 years after the war performed laboratory cognitive tasks assessing activation of mental representations of security in response to threat and the ability of these representations to color neutral stimuli with positive affect and reduce access to trauma-related thoughts. As compared to controls, ex-POWs with persistent PTSD over the 17-year period exhibited dramatic disruptions in the soothing and healing functions of attachment security representations. These disruptions were not evident among ex-POWs with a worsening PTSD trajectory or a stable resilience trajectory. The implications of attachment-system functioning for understanding posttraumatic processes are discussed.",0 +https://doi.org/10.1002/jts.20075,Multisample cross-validation of a model of childhood posttraumatic stress disorder symptomatology,"This study is the latest advancement of our research aimed at best characterizing children's posttraumatic stress reactions. In a previous study, we compared existing nosologic and empirical models of PTSD dimensionality and determined the superior model was a hierarchical one with three symptom clusters (Intrusion/Active Avoidance, Numbing/Passive Avoidance, and Arousal; Anthony, Lonigan, & Hecht, 1999). In this study, we cross-validate this model in two populations. Participants were 396 fifth graders who were exposed to either Hurricane Andrew or Hurricane Hugo. Multisample confirmatory factor analysis demonstrated the model's factorial invariance across populations who experienced traumatic events that differed in severity. These results show the model's robustness to characterize children's posttraumatic stress reactions. Implications for diagnosis, classification criteria, and an empirically supported theory of PTSD are discussed.",0 +https://doi.org/10.1016/j.jpain.2004.02.227,"Race, age, and gender influences among clusters of african american and white patients with chronic pain","

Abstract

Racial and ethnic minorities, older people, and women are differentially affected by chronic pain. This study aimed to identify the experiences of adult African Americans and whites with chronic pain while identifying patient clusters on the basis of clinical characteristics as well as race, age, and gender influences within and between clusters. Three clusters of patients with chronic pain were identified within race, age, and gender categories: chronic pain syndrome, good pain control, and disability with mild syndrome. African American and younger patients experiencing chronic pain were more likely to present with chronic pain syndrome. African American patients presenting with chronic pain syndrome or disability with mild pain syndrome reported a higher disability than their counterparts. Older patients and women within the good pain control cluster reported a lower level of (1) pain and depression and (2) depression, respectively. Older patients presenting with a disability with mild syndrome also reported lower pain and depression. Despite similar physical, emotional, and pain characteristics, this study confirmed that the chronic pain experience differs across racial and age groups. Further study is necessary to evaluate how these factors influence pain services among an ethnically diverse population across the age continuum.

Perspective

This study found important racial and age-related variability in the symptom severity of patients with chronic pain presenting with similar physical, emotional, and pain characteristics to a tertiary care pain center. These findings have important clinical implications on chronic pain assessment and management.",0 +https://doi.org/10.1023/b:jots.0000038476.87634.9b,Postdisaster PTSD over four waves of a panel study of Mexico's 1999 flood,"Samples of adults representative of Tezuitlán, Puebla and Villahermosa, Tobasco (combined N = 561), were interviewed 6, 12, 18, and 24 months after the devastating 1999 floods and mudslides in Mexico. Current DSM-IV PTSD and major depressive disorder (MDD) were assessed with the Composite International Diagnostic Interview. At Wave 1, PTSD was highly prevalent (24% combined), especially in Tezuitlán (46%), which had experienced mass casualties and displacement. Both linear and quadratic effects of time emerged, as PTSD symptoms initially declined but subsequently stabilized. Differences between cities lessened as time passed. Comorbidity between PTSD and MDD was substantial. The findings demonstrate that the international health community needs to be prepared for epidemics of PTSD when disasters strike developing areas of the world.",0 +https://doi.org/10.1111/j.1365-2826.2009.01913.x,An Association Between Stress-Induced Disruption of the Hypothalamic-Pituitary-Adrenal Axis and Disordered Glucose Metabolism in an Animal Model of Post-Traumatic Stress Disorder,"Retrospective clinical reports suggesting that traumatic stress populations display an increased propensity for glucose metabolism disorders were examined in a controlled prospective animal model. Stress-induced behavioural and hypothalamic-pituitary-adrenal (HPA) axis response patterns were correlated to central and peripheral parameters of glucose metabolism and signalling, and to body measurements in Sprague–Dawley rats exposed to predator scent stress. Forty days post-exposure, fasting blood glucose and insulin levels, oral glucose tolerance test, body weight and white adipose tissue mass, systemic corticosterone levels and brain expression of insulin receptor (IR) and insulin-sensitive glucose transporter 4 (GLUT4) protein levels were evaluated. In a second experiment inbred strains with hyper- (Fischer) and hypo- (Lewis) reactive HPA axes were employed to assess the association of metabolic data with behavioural phenomenology versus HPA axis response profile. For data analysis, animals were classified according to their individual behavioural response patterns (assessed at day 7) into extreme, partial and minimal response groups. The exposed Sprague–Dawley rats fulfilling criteria for extreme behavioural response (EBR) (20.55%) also exhibited significant increases in body weight, abdominal circumference and abdominal white adipose tissue mass; a hyperglycaemic oral glucose tolerance test; and fasting hyperglycaemia, hyperinsulinaemia and hypercorticosteronemia, whereas minimal responders (MBR) and control animals displayed no such disturbances. Hippocampal and hypothalamic expression of IR and GLUT4 protein were significantly lower in EBR than in MBR and control rats. The inbred strains showed no metabolic differences at baseline. Exposed Fischer rats displayed hyperglycaemia and hyperinsulinaemia, whereas Lewis rats did not. A significant protracted disorder of glucose metabolism was induced by exposure to a stress paradigm. This metabolic response was associated with the characteristic pattern of HPA axis (corticosterone) response, which underlies the behavioural response to stress.",0 +https://doi.org/10.1207/s15327906mbr3604_02,Cluster Analysis as a Method of Recovering Types of Intraindividual Growth Trajectories: A Monte Carlo Study,"There has been increased interest in and application of cluster analysis in longitudinal applications to identify distinctive developmental patterns of intraindividual change. This article used Monte Carlo experiments to evaluate the adequacy of cluster analysis to recover group membership based on simulated latent growth curve (LGC) models. The simulated LGC models were manipulated by varying growth parameters (e.g., elevation, dispersion, and shape) for subpopulation growth curves (e.g., linear and quadratic growth models). The evaluation of cluster analysis to recover individual membership in these growth curve subpopulations was completed via the Kappa statistics. Cluster analysis failed to recover adequately growth subtypes when the difference between growth curves was shape only. It was much more successful when the distance between initial mean levels was large (e.g., difference of two standard deviations), independent of difference in the shape of the growth curves. Tentative guidelines were proposed to facilitate the evaluation of the adequacy of a cluster analytic solution to recover subtype heterogeneity in longitudinal (intraindividual) growth curves.",0 +https://doi.org/10.4088/jcp.08m04896,A 6-Month Follow-Up Study of Posttraumatic Stress and Anxiety/Depressive Symptoms in Korean Children After Direct or Indirect Exposure to a Single Incident of Trauma,"Article AbstractObjectives: The aims of this study were to examine the symptoms of posttraumatic stress and anxiety/depression in Korean children after direct or indirect exposure to a single incident of trauma during a fire-escape drill and to assess the incidence of psychiatric disorders in this population.Method: A total of 1,394 students who attended the elementary school at which the traumatic event took place were evaluated using self-administered questionnaires (the Child Posttraumatic Stress Disorder-Reaction Index , State Anxiety Scale of the State-Trait Anxiety Inventory for Children , and Children's Depression Inventory ), as well as structured diagnostic interviews (Diagnostic Interview Schedule for Children, Version-IV ) at 2 days (time point 1), 2 months (time point 2), and 6 months (time point 3) after the incident. The 335 students who witnessed the accident were defined as the direct-exposure group, and the remaining students (n = 1,059) were defined as the indirect- exposure group. The study was conducted from May to November 2007.Results: At time point 1, the prevalence of severe posttraumatic stress disorder (PTSD), anxiety, and depressive symptoms was 18.2%, 5.5%, and 3.4%, respectively. The prevalence of severe PTSD symptoms, as measured by the CPTSD-RI, was significantly higher in the direct-exposure group than in the indirect-exposure group (36.6% vs 12.7%, respectively; P < .001). At time point 2, the prevalence of severe PTSD symptoms was 7.4% (14.0% in the direct- exposure group and 4.9% in the indirect-exposure group, P < .001). The mean total CPTSD-RI score was significantly higher (P < .001) in the direct-exposure group than in the indirect-exposure group. At time point 3, thirty-eight of the 58 subjects (65.5%) evaluated with the DISC-IV in the direct-exposure group had 1 or more of the 7 anxiety/depressive disorders assessed, including subthreshold diagnoses. Among the diagnoses meeting full DSM-IV criteria for each disorder, agoraphobia was the most prevalent (22.4%), followed by generalized anxiety disorder (13.8%), separation anxiety disorder (6.9%), PTSD (5.2%), and social phobia (5.2%). When the subthreshold diagnoses were considered along with the full syndrome diagnoses, separation anxiety disorder was the most common diagnosis (41.4%), followed by agoraphobia (34.5%), obsessive-compulsive disorder (22.4%), PTSD (20.7%), and social phobia (20.7%).Conclusions: The results of this study provide important evidence that various anxiety/depressive disorders, in addition to PTSD, might follow after direct or indirect exposure to trauma. Our findings highlight the importance of comprehensive screening for psychiatric problems in children exposed to trauma of any scale.Submitted: November 25, 2008; accepted February 11, 2009. Online ahead of print: June 16, 2009.Corresponding author: Dr Jae-Won Kim, Department of Child and Adolescent Psychiatry, College of Medicine, Seoul National University Hospital, 28 Yongon-Dong, Chongno-Gu, Seoul, Korea (adore412@paran.com).",0 +https://doi.org/10.1016/j.biopsych.2013.01.019,Posttraumatic Stress Disorder and Impaired Autonomic Modulation in Male Twins,"Posttraumatic stress disorder (PTSD) has been linked to increased morbidity. An inflexibility of the autonomic nervous system might be the underlying mechanism. We aimed to assess whether PTSD and combat trauma exposure are associated with lower heart rate variability (HRV), a measure of autonomic function and a predictor of death.We measured HRV by power spectral analysis on 24-hour ambulatory electrocardiogram in 459 middle-aged veteran male twins. Combat trauma was assessed with the combat exposure scale, and current and remitted PTSD was assessed with the Structured Clinical Interview for Psychiatry Disorders. Mixed-effects regression models were used to test associations of PTSD and HRV between and within twin pairs.Of all twins, 211 had combat exposure, 31 had current PTSD, and 43 had remitted PTSD. Current PTSD was inversely associated with very-low-frequency and low-frequency HRV both in individual twins and within 20 pairs discordant for current PTSD. Twins with current PTSD had a 49% lower low-frequency HRV than their brothers without PTSD (p<.001). Remitted PTSD was not associated with HRV. Results were robust to adjustment for depression and other risk factors. Combat exposure was inversely associated with most HRV frequencies, but this association mostly diminished after adjustment for current PTSD.In middle-aged veteran men, combat exposure and current PTSD are associated with measures of autonomic inflexibility previously shown to have prognostic significance. The negative health impact of combat exposure on autonomic function is mediated largely through PTSD and might reverse with remission of PTSD.",0 +https://doi.org/10.1017/s0033291711002765,Stress sensitization following a disaster: a prospective study,"Background According to the stress sensitization hypothesis, prior exposure to extreme stressors may lead to increased responsiveness to subsequent stressors. It is unclear whether disaster exposure is associated with stress sensitization and, if so, whether this effect is lasting or temporary. This study aimed to investigate the occurrence and duration of stress sensitization prospectively following a major disaster. Method Residents affected by a fireworks disaster ( n =1083) participated in surveys 2–3 weeks (T1), 18–20 months (T2) and almost 4 years (T3) after the disaster. Participants reported disaster exposure, including direct exposure, injury and damage to their home at T1, and also stressful life events (SLEs) at T2 and T3. Feelings of anxiety and depression, concentration difficulty, hostility, sleep disturbance, and intrusion and avoidance of disaster-related memories were used as indicators of distress. Results Residents whose home was completely destroyed responded with greater distress to SLEs reported 18–20 months following the disaster than residents whose home was less damaged. There were no differences in stress responsiveness almost 4 years after the disaster. Conclusions During the first years after a disaster, stress sensitization may occur in disaster survivors who experienced extreme disaster exposure. Stress sensitization may explain the persistence or progression of distress over time following extreme stressor exposure.",0 +https://doi.org/10.4324/9780203893104,Treating Traumatized Children,"Ford, Pat-Horenczyk, Brom, Introduction. Layne, Beck, Rimmasch, Southwick, Moreno, Hobfoll, Promoting Resilient Posttraumatic Adjustment in Childhood and Beyond: Unpacking Life Events, Adjustment Trajectories, Resources, and Interventions. PART I: Risk and Protective Factors. Pat-Horenczyk, Rabinowitz, Rice, Tucker-Levin, The Search for Risk and Protective Factors in Childhood PTSD: From Variables to Processes. Cohen, Parenting in the Throes of Traumatic Events: Risks and Protection. Keren, Tyano, A Developmental Approach: Looking at the Specificity of Reactions to Trauma in Infants. Knight, Geltman, Ellis, Physical and Mental Health Functioning in Sudanese Unaccompanied Minors. Bifulco, Risk and Resilience in Young Londoners. PART II: Resilience. Brom, Kleber, Resilience as the Capacity for Processing Traumatic Experiences. Hobfoll, Horsey, Lamoureux, Resiliency and Resource Loss in Times of Terrorism and Disaster: Lessons Learned for Children and Families and Those Left Untaught. Tol, Jordans, Reis, Jong, Ecological Resilience: Working with child-related psychosocial resources in war-affected communities. Meichenbaum, Bolstering Resilience: Benefiting from Lessons Learned. PART III. Recovery: Empirically-based Systemic Interventions for Traumatized Children. Ford, Albert, Hawke, Prevention and Treatment Interventions for Traumatized Children: Restoring Children's Capacities for Self-Regulation. Van Horn, Lieberman, Using Dyadic Therapies to Treat Traumatized Young Children. DeRosa, Pelcovitz, Group Treatment for Chronically Traumatized Adolescents: Igniting SPARCS of Change. Saltzman, Babayon, Lester, Beardslee, Pynoos, Family-Based Treatment for Child Traumatic Stress: A Review and Report on Current Innovations. Kagan, Transforming Troubled Children into Tomorrow's Heroes. Pat-Horenzcyk, Ford, Brom, Toward A Developing Science and Practice of Childhood Traumatic Stress: Concluding Comments",0 +https://doi.org/10.1037/0022-006x.72.5.879,Cognitive Changes During Prolonged Exposure Versus Prolonged Exposure Plus Cognitive Restructuring in Female Assault Survivors With Posttraumatic Stress Disorder.,"The authors report on changes in cognitions related to posttraumatic stress disorder (PTSD) among 54 female survivors of sexual and nonsexual assault with chronic PTSD who completed either prolonged exposure alone or in combination with cognitive restructuring. Treatment included 9-12 weekly sessions, and assessment was conducted at pretreatment, posttreatment, and a modal 12-month follow-up. As hypothesized, treatment that included prolonged exposure resulted in clinically significant, reliable, and lasting reductions in negative cognitions about self, world, and self-blame as measured by the Posttraumatic Cognitions Inventory. The hypothesis that the addition of cognitive restructuring would augment cognitive changes was not supported. Reductions in these negative cognitions were significantly related to reductions in PTSD symptoms. The addition of cognitive restructuring did not significantly augment the cognitive changes. Theoretical implications of the results are discussed.",0 +https://doi.org/10.1007/s11920-015-0578-9,The Use of Debriefing With Children,"The debate over the use of psychological debriefing in the early aftermath of a traumatic event has raged for decades, yet little attention has been paid to its use with perhaps the most vulnerable of victims, children and adolescents. While recommendations against the use of group debriefing with adults seem to have been made based on research of individual debriefing, recommendations regarding its use with children have been made based on the adult literature. In this review, we outline the possible mechanisms of harm and benefit of debriefing with a discussion of developmental concerns. The available empirical and nonempirical literature on the use of debriefing with youth is summarized. While research does not currently evidence harm in the use of debriefing with children, there is no strong support for its use either. We present both clinical considerations and research implications as they relate to debriefing as well as what this debate has taught us about the challenges to disseminating and evaluating early crisis interventions in general. © 2015, Springer Science+Business Media New York.",0 +https://doi.org/10.1017/s0033291798006667,Development of the World Health Organization WHOQOL-BREF Quality of Life Assessment,"Background. The paper reports on the development of the WHOQOL-BREF, an abbreviated version of the WHOQOL-100 quality of life assessment. Method. The WHOQOL-BREF was derived from data collected using the WHOQOL-100. It produces scores for four domains related to quality of life: physical health, psychological, social relationships and environment. It also includes one facet on overall quality of life and general health. Results. Domain scores produced by the WHOQOL-BREF correlate highly (0·89 or above) with WHOQOL-100 domain scores (calculated on a four domain structure). WHOQOL-BREF domain scores demonstrated good discriminant validity, content validity, internal consistency and test–retest reliability. Conclusion. These data suggest that the WHOQOL-BREF provides a valid and reliable alternative to the assessment of domain profiles using the WHOQOL-100. It is envisaged that the WHOQOL-BREF will be most useful in studies that require a brief assessment of quality of life, for example, in large epidemiological studies and clinical trials where quality of life is of interest. In addition, the WHOQOL-BREF may be of use to health professionals in the assessment and evaluation of treatment efficacy.",0 +https://doi.org/10.1111/j.1365-2648.2005.03560.x,"Post-traumatic stress disorder, depression, anxiety and quality of life in patients with traffic-related injuries","This paper reports a study to investigate and follow-up relationships between post-traumatic stress disorder, anxiety, depression and quality of life in patients after traffic-related injuries.Worldwide, traffic accidents kill 1.2 million people and injure 50 million people per year. Accidental injuries are fourth in the top five causes of death in Taiwan. For survivors, traffic accidents not only cause physical impairments, but also psychological trauma, such as post-traumatic stress disorder, depression and anxiety, all of which affect the quality of life.An exploratory, correlational design was used, and participants were recruited consecutively. Data were collected at 1 and 6 weeks post-injury for 64 patients from two major medical centres in Taiwan. Instruments were the New Injury Severity Scale, Post-traumatic Stress Disorder Reaction Index, Beck Depression Inventory, State Anxiety Inventory and Medical Outcomes Study Questionnaire. The data were collected in 2002.Statistically significant improvements occurred in depression, anxiety and the quality of life between week 1 and week 6 (P<0.05); high levels of post-traumatic stress disorder symptoms at week 1 (87.5%) and at week 6 (82.8%) showed no statistically significant improvement. There was a positive correlation between post-traumatic stress disorder and depression (r=0.70, P<0.001) and between post-traumatic stress disorder and anxiety (r=0.57, P<0.001), and a negative correlation between post-traumatic stress disorder and quality of life (r=-0.47, P<0.001). Depression was the most important variable to predict post-traumatic stress disorder at week 6, with depression levels at week 6 being a more powerful predictor than those at week 1. Regression analysis revealed that depression (19%) at week 1, depression at week 6 (45%), anxiety (3.8%) at week 6 and post-traumatic stress disorder (5.8%) explained a statistically significant amount of the variance at week 6.The findings suggest that traffic accidents have an impact on people's psychosocial wellbeing. Healthcare professionals need to implement interventions to decrease post-traumatic stress disorder, depression and anxiety to increase the quality of life for patients following traffic injuries.",0 +https://doi.org/10.1016/j.socscimed.2009.06.030,Explosive anger as a response to human rights violations in post-conflict Timor-Leste,"Over several decades, clinicians have documented a pattern of explosive anger amongst survivors of gross human rights violations. Yet there is a dearth of epidemiological research investigating explosive anger in post-conflict countries. In the present study undertaken in Timor-Leste between March and November 2004, we identified an indigenous descriptor for explosive anger, including this index in the East Timor Mental Health Epidemiological Needs Study, a small area total population survey of 1544 adults living in an urban and a rural area. Other measures included indices of past trauma events, post-traumatic stress and general psychological distress, and socio-demographic variables. We found that 38% of the population reached the defined threshold of one attack of explosive anger a month (average=1 episode every 2-3 days). Only a minority of persons with explosive anger reached threshold scores for post-traumatic stress and general psychological distress. High levels of trauma exposure represented the strongest predictor of explosive anger. Latent class analysis identified three sub-groups with explosive anger: young trauma-affected adults living in the capital city who were unemployed; an older group, predominantly men, who had experienced extensive violence, including combat, assault and torture; and a less well characterized group of women. The findings offer support for a sequential model of explosive anger in which experiences of past persecution are compounded by frustrations in the post-conflict environment. The data provide a foundation for exploring further the role of trauma-induced anger in the cycles of violence that are prevalent in post-conflict countries.",0 +https://doi.org/10.1177/2167702614545480,ICD–11 Complex PTSD in U.S. National and Veteran Samples,"The 11th edition of the International Classification of Diseases ( ICD–11) is under development, and current proposals include major changes to trauma-related psychiatric diagnoses, including a heavily restricted definition of posttraumatic stress disorder (PTSD) and the addition of complex PTSD (CPTSD). We aimed to test the postulates of CPTSD in samples of 2,695 community participants and 323 trauma-exposed military veterans. CPTSD prevalence estimates were 0.6% and 13% in the community and veteran samples, respectively; one quarter to one half of those with PTSD met criteria for CPTSD. There were no differences in trauma exposure across diagnoses. A factor mixture model with two latent dimensional variables and four latent classes provided the best fit in both samples: Classes differed by their level of symptom severity but did not differ as a function of the proposed PTSD versus CPTSD diagnoses. These findings should raise concerns about the distinctions between CPTSD and PTSD proposed for ICD–11.",0 +https://doi.org/10.1371/journal.pone.0070084,"Early PTSD Symptom Trajectories: Persistence, Recovery, and Response to Treatment: Results from the Jerusalem Trauma Outreach and Prevention Study (J-TOPS)","Uncovering heterogeneities in the progression of early PTSD symptoms can improve our understanding of the disorder's pathogenesis and prophylaxis.To describe discrete symptom trajectories and examine their relevance for preventive interventions.Latent Growth Mixture Modeling (LGMM) of data from a randomized controlled study of early treatment. LGMM identifies latent longitudinal trajectories by exploring discrete mixture distributions underlying observable data.Hadassah Hospital unselectively receives trauma survivors from Jerusalem and vicinity.Adult survivors of potentially traumatic events consecutively admitted to the hospital's emergency department (ED) were assessed ten days and one-, five-, nine- and fifteen months after ED admission. Participants with data at ten days and at least two additional assessments (n = 957) were included; 125 received cognitive behavioral therapy (CBT) between one and nine months.We used LGMM to identify latent parameters of symptom progression and tested the effect of CBT on these parameters. CBT consisted of 12 weekly sessions of either cognitive therapy (n = 41) or prolonged exposure (PE, n = 49), starting 29.8±5.7 days after ED admission, or delayed PE (n = 35) starting at 151.8±42.4 days. CBT effectively reduced PTSD symptoms in the entire sample.Latent trajectories of PTSD symptoms; effects of CBT on these trajectories.THREE TRAJECTORIES WERE IDENTIFIED: Rapid Remitting (rapid decrease in symptoms from 1- to 5-months; 56% of the sample), Slow Remitting (progressive decrease in symptoms over 15 months; 27%) and Non-Remitting (persistently elevated symptoms; 17%). CBT accelerated the recovery of the Slow Remitting class but did not affect the other classes.The early course of PTSD symptoms is characterized by distinct and diverging response patterns that are centrally relevant to understanding the disorder and preventing its occurrence. Studies of the pathogenesis of PTSD may benefit from using clustered symptom trajectories as their dependent variables.",1 +https://doi.org/10.1016/j.ajem.2009.07.018,Heightened pain perception in illicit substance–using patients in the ED: implications for management,"Substance users are commonly perceived to overstate their pain. Few data exist comparing pain intensity, perception, and related psychiatric comorbidities in the emergency department (ED) population. To compare pain severity, duration, interference with function, and psychiatric and mood disturbance in substance-using (SU) and non–substance-using (NSU) patients in the ED. This is a cross-sectional study. The setting is in an urban ED. Participants are SU and NSU patients in moderate to severe pain (numerical rating scale, 5-10). Outcome measures are as follows: pain intensity and duration, other painful conditions, pain-related functional interference (0-10), psychiatric disorders, and mood distress (profile of mood scale, 0-44). Of the 148 patients who enrolled, 28 (19%) reported recent illicit substance use (SU) and 120 (81%) did not (NSU). The SU patients' mean pain intensity was 8.96 (confidence interval [CI], 7.47-8.14) vs 7.81 (CI, 8.48-9.45) for NSU ( P = .003). The SU patients reported higher levels of pain interference. Fifty-four percent of SU patients vs 31% of NSU patients reported a psychiatric illness ( P = .02). Mean Profile of Mood State score was higher in SU (32.3; CI, 27.4-37.1) than in NSU (22.5; CI, 20.2-24.8; P < .001). Chronic pain was reported by 29% of SU patients vs 16% of NSU patients, and 75% of SU patients vs 58% of NSU patients reported another concurrent painful condition ( P = .10). The SU patients report more severe pain and functional interference, more psychiatric illness and mood distress, and more chronically painful conditions. Given the complex interplay between pain, substance use, and mood disorders, increased attention should be paid to identifying patients with these associated conditions and to facilitating appropriate referrals. Effective treatment of this challenging patient population requires treating the entirety of their medical, psychiatric, and addictive diseases.",0 +https://doi.org/10.1111/j.1440-1819.2005.01447.x,The effectiveness of mirtazapine in the treatment of post-traumatic stress disorder: A 24-week continuation therapy,"Few studies for the long-term effects of antidepressants on post-traumatic stress disorder (PTSD) have been conducted. The aim of the present study was to investigate the effectiveness of mirtazapine during the 24-week continuation treatment in patients with PTSD. Out of 15 patients who participated in the previous 8-week short-term study, 12 patients completed 24-week continuation treatment with mirtazapine. The effectiveness was evaluated at week 12 and week 24 using Impact of Event Scale-Revised (IES-R), Short PTSD Rating Interview (SPRINT), Interviewer-Administered Structured Interview for PTSD (SIP) and Montgomery-Asberg Depression Rating Scale (MADRS). The tolerability of continuation treatment was also reported. The scores on the IES-R, SPRINT, SIP and MADRS were significantly reduced over time from baseline to week 24, the end-point (F=36.1, d.f.=4, P<0.001; F=106.3, d.f.=4, P<0.001; F=121.1, d.f.=4, P<0.001; F=198.9, d.f.=4, P<0.001). On post-hoc analysis, the scores of all four measures were significantly reduced at the end point since week 8. However, after Bonferroni's correction, that was statistically significant in SPRINT only. The number of patients whose scores were reduced over 50% in all four scales had a tendency of incremental increase from three at week 8 to eight at the end point (P=0.063). No serious drug-related side-effects occurred. These results suggest that the mirtazapine may be effective in the continuation treatment of PTSD as well as short-term treatment. Further and better-designed studies are necessary.",0 +https://doi.org/10.1037/a0018239,Impact of age on long-term cognitive function after traumatic brain injury.,"To examine the association of age and time postinjury with cognitive outcome 5-22 years following traumatic brain injury (TBI), in relation to matched uninjured controls.One hundred twelve participants with mild to very severe TBI, aged 16-81 years at the time of injury, were cognitively assessed on measures of processing speed and attention, verbal and visual memory, executive function, and working memory. Results were compared with those of 112 healthy controls individually matched for current age, gender, education, and estimated IQ.Older injured individuals performed worse than did younger injured individuals across all cognitive domains, after controlling for the performance of controls. In relation to matched controls, long-time survivors performed disproportionately worse than did more recently injured individuals, irrespective of age.After maximum spontaneous recovery from TBI, poorer cognitive functioning appears to be associated with both older age at the time of injury and increased time postinjury. These findings have implications for prognosis, early treatment recommendations, and long-term issues of differential diagnosis and management planning.",0 +https://doi.org/10.1192/bjp.173.6.482,Dose-effect relationships of trauma to symptoms of depression and post-traumatic stress disorder among Cambodian survivors of mass violence,"The dose-effect relationships of cumulative trauma to the psychiatric symptoms of major depression and post-traumatic stress disorder (PTSD) in a community study of Cambodian survivors of mass violence were evaluated.In 1990, a survey of 1000 households was conducted in a Thai refugee camp (Site 2) using a multi-stage random sampling design. Trauma history and psychiatric symptoms were assessed for two time periods. Analysis used linear dose-response regression modelling.993 Cambodian adults reported a mean of 14 Pol Pot era trauma events and 1.3 trauma events during the past year. Symptom categories of depression, PTSD, dissociative and culturally dependent symptoms exhibited strong dose-effect responses with the exception of avoidance. All symptom categories, except avoidant symptoms, were highly correlated.Cumulative trauma continued to affect psychiatric symptom levels a decade after the original trauma events. The diagnostic validity of PTSD criteria, with the notable exception of avoidance, was supported. Inclusion of dissociative and culturally dependent symptoms increased the cultural sensitivity of PTSD.",0 +https://doi.org/10.1016/j.rpto.2014.06.003,Personalidad y resiliencia en un cuerpo especial de la Policía Nacional de España,"Resumen Se valora la relacion entre datos sociodemograficos, personalidad y resiliencia en una muestra de 348 policias masculinos de las unidades de intervencion policial (UIP) de Espana (N = 348) entre los 23 y los 38 anos (M = 26.88, DT = 3.12). Los resultados mostraron que la edad y el nivel educativo junto con la dominancia, la escrupulosidad, perseverancia, control de los impulsos y emociones estaban muy relacionados con la resiliencia. Ademas, el 66% de la varianza en resiliencia vendria dado por cuatro variables: la edad y el nivel academico y el teson y el control de las emociones. Se discute la importancia de algunas variables socio-demograficas y diferencias individuales como predictoras del nivel de resiliencia en profesionales especializados de la policia y se abren algunas vias de trabajo para el estudio de la resiliencia en otros colectivos profesionales expuestos de forma constante a situaciones de extrema adversidad.",0 +https://doi.org/10.1037/0022-006x.76.1.92,Longitudinal trajectories and predictors of adolescent suicidal ideation and attempts following inpatient hospitalization.,"Remarkably little is known regarding the temporal course of adolescent suicidal ideation and behavior, the prediction of suicidal attempts from changes in suicidal ideation, or the prediction of suicidal attempts after accounting for suicidal ideation as a predictor. A sample of 143 adolescents 12-15 years old was assessed during psychiatric inpatient hospitalization and again at 3, 6, 9, 15, and 18 months postdischarge through a series of structured interviews and parent- and adolescent-reported instruments. Symptoms of depression, posttraumatic stress disorder, externalizing psychopathology, hopelessness, and engagement in several forms of self-injurious/suicidal behaviors (i.e., suicide threats/gestures, plans, nonsuicidal self-injury [NSSI]) were assessed. Latent growth curve analyses revealed a period of suicidal ideation remission between baseline and 6 months following discharge, as well as a subtle period of suicidal ideation reemergence between 9 and 18 months postdischarge. Changes in suicidal ideation predicted suicide attempts. After accounting for the effects of suicidal ideation, baseline suicide threats/gestures also predicted future suicide attempts. Higher adolescent-reported depressive symptoms, lower parent-reported externalizing symptoms, and higher frequencies of NSSI predicted weaker suicidal ideation remission slopes. Findings underscore the need for more longitudinal research on the course of adolescent suicidality.",0 +https://doi.org/10.2466/pr0.1990.66.2.623,Adapted Character Styles of Vietnam Veterans with Posttraumatic Stress Disorder,"A total of 189 male Vietnam veterans who were admitted to a specialized inpatient treatment program were evaluated using the Millon Clinical Multiphasic Personality Inventory to assess character styles. The veterans were assessed for Posttraumatic Stress Disorder by using a subscale of the Minnesota Multiphasic Personality Inventory (MMPI) and 72% of the patients were classified as having Posttraumatic Stress Disorder. The character styles of passive-aggressive, schizoid, avoidant, and borderline were significantly associated with these patients. The most common 2-point profile was passive-aggressive and avoidant (8-2 or 2–8) and was significantly related to the diagnosis. While drug and alcohol abuse were common problem areas for the entire sample, the profile of patients with Posttraumatic Stress was different from those of substance abusers. These results indicate that treating Vietnam veterans with this disorder requires adopting strategies which include a character style focus as well as a symptom focus.",0 +https://doi.org/10.1186/1753-2000-3-33,"A pilot study on peritraumatic dissociation and coping styles as risk factors for posttraumatic stress, anxiety and depression in parents after their child's unexpected admission to a Pediatric Intensive Care Unit","To study the prevalence of posttraumatic stress disorder (PTSD), anxiety and depression in parents three months after pediatric intensive care treatment of their child and examine if peritraumatic dissocation and coping styles are related to these mental health problems.This is a prospective cohort study and included parents of children unexpectedly admitted to the Pediatric Intensive Care Unit (PICU) from January 2006 to March 2007. At three months follow-up parents completed PTSD (n = 115), anxiety and depression (n = 128) questionnaires. Immediately after discharge, parents completed peritraumatic dissocation and coping questionnaires. Linear regression models with generalized estimating equations examined risk factors for mental health problems.Over 10% of the parents were likely to meet criteria for PTSD and almost one quarter for subclinical PTSD. Respectively 15% to 23% of the parents reported clinically significant levels of depression and anxiety. Peritraumatic dissocation was most strongly associated with PTSD, anxiety as well as depression. Avoidance coping was primarily associated with PTSD.A significant number of parents have mental health problems three months after unexpected PICU treatment of their child. Improving detection and raise awareness of mental health problems is important to minimize the negative effect of these problems on parents' well-being.",0 +,Mental health diagnoses and counseling among pilots of remotely piloted aircraft in the United States Air Force.,"Remotely piloted aircraft (RPA), also known as drones, have been used extensively in the recent conflicts in Iraq and Afghanistan. Although RPA pilots in the U.S. Air Force (USAF) have reported high levels of stress and fatigue, rates of mental health (MH) diagnoses and counseling in this population are unknown. We calculated incidence rates of 12 specific MH outcomes among all active component USAF RPA pilots between 1 October 2003 and 31 December 2011, and by various demographic and military variables. We compared these rates to those among all active component USAF manned aircraft (MA) pilots deployed to Iraq/Afghanistan during the same period. The unadjusted incidence rates of all MH outcomes among RPA pilots (n=709) and MA pilots (n=5,256) were 25.0 per 1,000 person-years and 15.9 per 1,000 person-years, respectively (adjusted incidence rate ratio=1.1, 95% confidence interval=0.9-1.5; adjusted for age, number of deployments, time in service, and history of any MH outcome). Th ere was no significant difference in the rates of MH diagnoses, including post-traumatic stress disorder, depressive disorders, and anxiety disorders between RPA and MA pilots. Military policymakers and clinicians should recognize that RPA and MA pilots have similar MH risk profiles.",0 +https://doi.org/10.1300/j069v19n01_03,Psychopathology in Substance Abusing Women Reporting Childhood Sexual Abuse,"This study compared MMPI-2 profiles and evaluated the ability of the MMPI-2 and its two new post-traumatic stress scales (PK and PS) to discriminate women in outpatient substance abuse treatment reporting positive (n = 24) and negative (n = 69) child sexual abuse histories. T-tests revealed significantly higher mean scores for the sexual abuse group for the following scales: F, 1, 2, 3, 4, 6, 7, and 8. A discriminant analysis yielded a linear function of L, F, 3, 5, 8, and PK that correctly categorized 75% with positive histories and 77% with negative histories. The optimal cutoff PK score was 17, which correctly classified 75% and 46% of those reporting positive and negative abuse histories, respectively. These findings support early identification of abuse survivors among substance abusing women and suggests that the MMPI-2 may be useful in patient-treatment matching.",0 +https://doi.org/10.1177/1363461514531316,Historical trauma: Politics of a conceptual framework,"The concept of historical trauma (HT) is compelling: Colonialism has set forth cumulative cycles of adversity that promote morbidity and mortality at personal and collective levels, with especially strong mental health impacts. Yet as ongoing community-based as well as scholarly discussions attest, lingering questions continue to surround HT as a framework for understanding the relationships between colonialism and indigenous mental health. Through an overview of 30 recent peer-reviewed publications that aim to clarify, define, measure, and interpret how HT impacts American Indian and Alaska Native (AIAN) mental health, this paper examines how the conceptual framework of HT has circulated in ways shaped by interactions among three prominent research approaches: evidence-based, culturally relevant, and decolonizing. All define current approaches to AIAN mental health research, but each sets forth different conceptualizations of the connections between colonialism and psychological distress. The unfolding trajectory of research about HT reflects persistent tensions in how these frameworks interact, but also possibilities for better integrating them. These considerations aim to advance conversations about the politics of producing knowledge about AIAN mental health, and support ongoing calls for greater political pluralism in mental health research.",0 +https://doi.org/10.3109/00048679709062687,Adverse Psychological Impact of Operative Obstetric Interventions: A Prospective Longitudinal Study,"Objective: This paper reports the findings of a prospective longitudinal study of 272 nulliparous pregnant women, which investigated as one of its objectives the psychological sequelae of obstetric procedures. Method: Participants completed structured interviews and standardised, published psychometric questionnaires, including the Rosenberg Self-Esteem Scale and the Profile of Mood States late in pregnancy and again early in the postpartum period. Results: Little evidence was found to support the notion that the total number of obstetric interventions was linked to a deterioration in postpartum mood. Significant adverse psychological effects were associated with the mode of delivery. Those women who had spontaneous vaginal deliveries were most likely to experience a marked improvement in mood and an elevation in self-esteem across the late pregnancy to early postpartum interval. In contrast, women who had Caesarean deliveries were significantly more likely to experience a deterioration in mood and a diminution in self-esteem. The group who experienced instrumental intervention in vaginal deliveries fell midway between the other two groups, reporting neither an improvement nor a deterioration in mood and self-esteem. Conclusions: The findings of this study suggest that operative intervention in first childbirth carries significant psychological risks rendering those who experience these procedures vulnerable to a grief reaction or to posttraumatic distress and depression.",0 +https://doi.org/10.1037/tra0000057,Investigating the dissociative subtype of posttraumatic stress disorder in a sample of traumatized detained youth.,"In this study, we tested the validity of a dissociative subtype in a sample of 225 detained adolescents (142 boys, 83 girls) likely meeting full or partial criteria for posttraumatic stress disorder (PTSD). Competing theories of dissociation pose controversy regarding dissociation as a taxon versus a continuum, and results of the current study contribute to this debate by providing evidence of distinct group differences between those high and low in dissociation. Mixture modeling revealed 2 groups of youth with differing levels of depersonalization/derealization dissociative symptoms. Differences between the 2 groups of youth were investigated regarding trauma exposure and several posttraumatic reactions: posttraumatic stress symptoms (PTSS), emotion dysregulation, and emotional numbing. Compared with youth classified in the low-dissociation group, youth who exhibited high levels of dissociation demonstrated higher levels of total PTSS, posttraumatic symptom clusters of emotional numbing, intrusion, and associated features, as well as reporting more difficulties with emotion dysregulation. To test theory regarding the factors that increase the likelihood of persistent dissociation, bootstrapped regression analyses were performed to examine the possibility of an indirect effect of peritraumatic dissociation. Results consistent with statistical mediation suggested that the presence of peritraumatic dissociation at the time of trauma may contribute to the continuation of dissociative symptoms as a more generalized pattern. The results of the current study have implications for clinical treatment with traumatized youth.",0 +https://doi.org/10.1007/s00787-009-0745-9,Over-time changes in PTSD and depression among children surviving the 1999 Istanbul earthquake,"Objective: To follow-up on child and adolescent victims with full criteria of PTSD and depression, and to examine the impact of treatment. Method: One to two months following a 7.4-magnitude quake in Turkey, 160 students were examined by self-report questionnaire, psychiatric interview, clinician-administered post-traumatic stress disorder scale (CAPS), and depression and anxiety inventories. At baseline, 96 students were diagnosed with PTSD, and 49 had comorbid depression with anxiety symptoms. After 18-20 months, 74 of 96 students were found and reassessed by psychiatric interview and CAPS; 25 had been treated with cognitive-behavioral therapy (CBT) and pharmocotherapy, and 49 did not have any treatment. Binary logistic regression was used to identify significant predictors of persistent PTSD. Variables entered included pre-quake, quake and post-quake factors, having co-morbid depression upon initial interview, receipt of drug therapy, and number of months of CBT. Results: At follow-up, many had symptoms of PTSD with anxiety, but only 14 subjects met the full criteria of PTSD, and four students had major depression with anxiety symptoms. Only one variable-having been in serious personal danger during the quake (e.g., trapped in the house or under rubble)-was significantly associated with being symptomatic at follow-up. Conclusion: Regardless of receipt of treatment, diagnoses of PTSD and depression were much reduced. More research is needed about resiliency factors. © 2009 Steinkopff Verlag Darmstadt.",0 +https://doi.org/10.1089/cap.2013.0042,Resilience and Trajectories of Posttraumatic Stress Among Youth Exposed to Disaster,"Multiple trajectories of posttraumatic stress (PTS) symptoms are hypothesized following disaster in a number of theoretical perspectives. Increasingly, those with rapidly declining, transient, or stable low symptoms are defined as resilient. This article examines trajectories to understand acute reactions to disaster, and explores the need to define resilience as more than just symptom trajectories.An urban school-based sample of youth exposed to both hurricanes Katrina and Gustav (n=141; grades 4 through 8) were assessed for PTS symptoms at 12 months and 6 months pre-Gustav (Times 1 and 2); and then again at 1 month post-Gustav (Time 3).Data indicated that there were significant decreases in mean PTS symptoms post-Gustav, but individual trajectories were identified consistent with theory. Whereas an ostensibly resilient group was identified (stable low symptoms), results suggest that the group was heterogeneous in terms of disaster experiences, and that those with low symptoms but relatively high Katrina disaster exposure had a unique coping style.Results provide prospective data to support theories of multiple trauma exposure trajectories, and highlight the importance of empirically identifying resilient youth in terms of both functioning and level of risk exposure in disaster samples.",0 +https://doi.org/10.1177/0269881113495119,MDMA assisted psychotherapy found to have a large effect for chronic post-traumatic stress disorder,"Comments on an article by Peter Oehen et al. (see record 2012-34703-005). Oehen et al. (2013) reported a well-designed, randomized, double-blind, active placebo controlled trial of MDMA assisted psychotherapy in a small sample (N=12) of participants with resistant, chronic post-traumatic stress disorder (PTSD). Given that the sample is small, the statistical power of the study using analysis of variance is low. A potential solution is to express the findings in terms of effect sizes using Cohen's d, which is a way of estimating the magnitude of the difference between two means that is independent of the sample size. In that case, a d value of 0.20 is considered to be a small effect, 0.50 a medium effect and 0.80 a large effect. Thus, given than the full dose group had higher baseline levels of both clinician-observed and self-reported PTSD symptoms than the active placebo group, authors can say that these subjects with resistant, chronic PTSD showed, on average, a substantial improvement in PTSD symptoms over the course of MDMA assisted psychotherapy. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0 +https://doi.org/10.1023/a:1024808413887,,"Findings from a longitudinal study are presented on the relationships between the problems and stresses resulting from Hurricane Andrew and posthurricane minor deviant behavior. The sample (N = 4,978) included Hispanic, African-American, and White non-Hispanic middle school students enrolled in Dade County, Florida public schools. Two waves of data were collected prior to the hurricane; a third was obtained approximately 6 months following the storm. Results indicated that females were likely to report higher levels of hurricane-related stress symptoms than males. After controlling for prehurricane levels of minor deviance, family support, and race/ethnicity, hurricane stress symptom level remained a significant predictor of posthurricane minor deviant behavior. The findings lend support to stress theories of social deviance.",0 +https://doi.org/10.4236/psych.2014.58096,Risk Factors for Posttraumatic Stress Disorder in Haitian Students,"The aim of this study was to assess the prevalence of posttraumatic stress disorder (PTSD) in undergraduate students after the Haiti earthquake on January 12, 2010, as well as to identify the risk factors involved in the development of PTSD symptoms in this sample. Evaluations concerning depression, anxiety, risk and protective factors, and PTSD symptoms were conducted in 246 Haitian undergraduate students enrolled in a Dominican private university. Results indicate a prevalence of 36% for PTSD 2 years after the earthquake, with a high prevalence also of depression (31.7%) and anxiety (21.1%). Some of the risk factors identified are being female, a history of psychiatric treatment, and the amount of personal and material losses. The instauration of crisis management and follow-up protocols after traumatic events was deemed to be needed. Further research is necessary to study the long-term effects of this tragedy, not only in undergraduate students, but also in the working class Haitian immigrants living in the Dominican Republic.",0 +https://doi.org/10.1016/j.pain.2008.05.006,Quantitative testing of pain perception in subjects with PTSD – Implications for the mechanism of the coexistence between PTSD and chronic pain,"Post-traumatic stress disorder (PTSD) often co-occurs with chronic pain. Neither the underlying mechanism of this comorbidity nor the nature of pain perception among subjects with PTSD is well defined. This study is the first systematic and quantitative evaluation of pain perception and chronic pain in subjects with PTSD. The study group consisted of 32 outpatients with combat- and terror-related PTSD, 29 outpatients with anxiety disorder and 20 healthy controls. Quantitative somatosensory testing included the measurement of warm, cold, light touch and heat-pain thresholds and responses to acute suprathreshold heat and mechanical stimuli. Chronic pain was characterized, and levels of PTSD and anxiety symptomatology were assessed by self-report questionnaires. Subjects with PTSD exhibited higher rates of chronic pain, more intense chronic pain and more painful body regions compared with the other two groups. PTSD severity correlated with chronic pain severity. Thresholds of subjects with PTSD were significantly higher than those of subjects with anxiety and healthy controls, but they perceived suprathreshold stimuli as being much more intense than the other two groups. These results suggest that subjects with PTSD exhibit an intense and widespread chronic pain and a unique sensory profile of hyposensitivity to pain accompanied by hyper-reactivity to suprathreshold noxious stimuli. These features may be attributed to the manner with which PTSD subjects emotionally interpret and respond to painful stimuli. Alternatively, but not mutually exclusive, the findings may reflect altered sensory processing among these subjects.",0 +https://doi.org/10.1016/j.socscimed.2009.08.018,"Anger, PTSD, and the nuclear family: A study of Cambodian refugees","This study profiles the family-directed anger of traumatized Cambodian refugees, all survivors of the Pol Pot genocide (1975–1979), who were patients at a psychiatric clinic in Lowell, MA, USA. We focus on the nuclear family (NF) unit, the NF unit defined as the patient's “significant other” (i.e. spouse or boyfriend/girlfriend) and children. Survey data were collected from a convenience sample of 143 Cambodian refugee patients from October 2006 to August 2007. The study revealed that 48% (68/143) of the patients had anger directed toward a NF member in the last month, with anger directed toward children being particularly common (64 of the 143 patients, or 49% [64/131] of the patients with children). NF-type anger was severe, for example, almost always resulting in somatic arousal (e.g., causing palpitations in 91% [62/68] of the anger episodes) and often in trauma recall and fears of bodily dysfunction. Responses to open-ended questions revealed the causes of anger toward a significant other and children, the content of anger-associated trauma recall, and what patients did to gain relief from anger. A type of cultural gap, namely, a linguistic gap (i.e., the parent's lack of English language skills and the child's lack of Khmer language skills), seemingly played a role in generating conflict and anger. NF-type anger was associated with PTSD presence. The effect of anger on PTSD severity resulted in part from anger-associated trauma recall and fears of bodily dysfunction, with 54% of the variance in PTSD severity explained by that regression model. The study: 1) suggests that among traumatized refugees, family-related anger is a major clinical concern; 2) illustrates how family-related anger may be profiled and investigated in trauma-exposed populations; and 3) gives insights into how family-related anger is generated in such populations.",0 +https://doi.org/10.31887/dcns.2003.5.3/lstaner,Sleep and anxiety disorders,"Sleep disturbances-particularly insomnia - are highly prevalent in anxiety disorders and complaints such as insomnia or nightmares have even been incorporated in some anxiety disorder definitions, such as generalized anxiety disorder and posttraumatic stress disorder. In the first part of this review, the relationship between sleep and anxiety is discussed in terms of adaptive response to stress. Recent studies suggested that the corticotropin-releasing hormone system and the locus ceruleus-autonomic nervous system may play major roles in the arousal response to stress. It has been suggested that these systems may be particularly vulnerable to prolonged or repeated stress, further leading to a dysfunctional arousal state and pathological anxiety states, Polysomnographic studies documented limited alteration of sleep in anxiety disorders. There is some indication for alteration in sleep maintenance in generalized anxiety disorder and for both sleep initiation and maintenance in panic disorder; no clear picture emerges for obsessive-compulsive disorder or posttraumatic stress disorder. Finally, an unequivocal sleep architecture profile that could specifically relate to a particular anxiety disorder could not be evidenced; in contrast, conflicting results are often found for the same disorder. Discrepancies between studies could have been related to illness severity, diagnostic comorbidity, and duration of illness. A brief treatment approach for each anxiety disorder is also suggested with a special focus on sleep.",0 +https://doi.org/10.1017/s0954579411000186,Foundations of posttraumatic stress disorder: Does early life trauma lead to adult posttraumatic stress disorder?,"Abstract The effects of childhood abuse are diverse, and although pathology is not the only outcome, psychiatric illness, including posttraumatic stress disorder (PTSD), can develop. However, adult PTSD is less common among those who experienced single-event traumas as children than it is among those who experienced childhood abuse. In addition, PTSD is more common among adults than children who experienced childhood abuse. Such evidence raises doubt about the direct, causal link between childhood trauma and adult PTSD. The experience of childhood trauma, and in particular abuse, has been identified as a risk factor for subsequent development of PTSD following exposure to adult trauma, and a substantial literature identifies revictimization as a factor that plays a pivotal role in this trajectory. The literature on the developmental effects of childhood abuse and pathways to revictimization, when considered in tandem with the biological effects of early stress in animal models, may provide some explanations for this. Specifically, it seems possible that permanent sensitization of the hypothalamic–pituitary–adrenal axis and behavioral outcomes are a consequence of childhood abuse, and these combine with the impact of retraumatization to sustain, perpetuate, and amplify symptomatology of those exposed to maltreatment in childhood.",0 +https://doi.org/10.1016/j.wpsyc.2012.05.008,Outcomes and moderators of a preventive schoolbased mental health intervention for children affected by war in Sri Lanka: a cluster randomized trial,"We aimed to examine outcomes, moderators and mediators of a preventive school-based mental health intervention implemented by paraprofessionals in a war-affected setting in northern Sri Lanka. A cluster randomized trial was employed. Subsequent to screening 1,370 children in randomly selected schools, 399 children were assigned to an intervention (n=199) or waitlist control condition (n=200). The intervention consisted of 15 manualized sessions over 5 weeks of cognitive behavioral techniques and creative expressive elements. Assessments took place before, 1 week after, and 3 months after the intervention. Primary outcomes included post-traumatic stress disorder (PTSD), depressive, and anxiety symptoms. No main effects on primary outcomes were identified. A main effect in favor of intervention for conduct problems was observed. This effect was stronger for younger children. Furthermore, we found intervention benefits for specific subgroups. Stronger effects were found for boys with regard to PTSD and anxiety symptoms, and for younger children on pro-social behavior. Moreover, we found stronger intervention effects on PTSD, anxiety, and function impairment for children experiencing lower levels of current war-related stressors. Girls in the intervention condition showed smaller reductions on PTSD symptoms than waitlisted girls. We conclude that preventive school-based psychosocial interventions in volatile areas characterized by ongoing war-related stressors may effectively improve indicators of psychological wellbeing and posttraumatic stress-related symptoms in some children. However, they may undermine natural recovery for others. Further research is necessary to examine how gender, age and current war-related experiences contribute to differential intervention effects.",0 +https://doi.org/10.1038/npp.2014.34,Genetic Association Analysis of 300 Genes Identifies a Risk Haplotype in SLC18A2 for Post-traumatic Stress Disorder in Two Independent Samples,"The genetic architecture of post-traumatic stress disorder (PTSD) remains poorly understood with the vast majority of genetic association studies reporting on single candidate genes. We conducted a large genetic study in trauma-exposed European-American women (N=2538; 845 PTSD cases, 1693 controls) by testing 3742 SNPs across more than 300 genes and conducting polygenic analyses using results from the Psychiatric Genome-Wide Association Studies Consortium (PGC). We tested the association between each SNP and two measures of PTSD, a severity score and diagnosis. We found a significant association between PTSD (diagnosis) and SNPs (top SNP: rs363276, odds ratio (OR)=1.4, p=2.1E-05) in SLC18A2 (vesicular monoamine transporter 2). A haplotype analysis of 9 SNPs in SLC18A2, including rs363276, identified a risk haplotype (CGGCGGAAG, p=0.0046), and the same risk haplotype was associated with PTSD in an independent cohort of trauma-exposed African-Americans (p=0.049; N=748, men and women). SLC18A2 is involved in transporting monoamines to synaptic vesicles and has been implicated in a number of neuropsychiatric disorders including major depression. Eight genes previously associated with PTSD had SNPs with nominally significant associations (p<0.05). The polygenic analyses suggested that there are SNPs in common between PTSD severity and bipolar disorder. Our data are consistent with a genetic architecture for PTSD that is highly polygenic, influenced by numerous SNPs with weak effects, and may overlap with mood disorders. Genome-wide studies with very large samples sizes are needed to detect these types of effects.",0 +https://doi.org/10.1111/j.1600-0838.2010.01217.x,Examination of fatigue development in elite soccer in a hot environment: a multi-experimental approach,"The study examines fatigue in elite soccer played in hot conditions. High-profile soccer players (n=20) were studied during match play at ∼31 °C. Repeated sprint and jump performances were assessed in rested state and after a game and activity profile was examined. Additionally, heart rate (HR), blood lactate, muscle temperature and body mass changes were determined. Repeated sprint and jump performances were reduced (P<0.05) by 2.6% and 8.2%, respectively, after the game. The fatigue index in the repeated sprint test was 6.0±0.7% after the game compared with 1.7±1.0% at rest (P<0.05). High-intensity running was 57±4% lower (P<0.05) during the last 15-min interval of the game compared with the first 15-min period. No differences were observed in mean HR or blood lactates between halves. Muscle temperature was 40.5±0.4 °C after the first half, which was 0.8±0.2 °C higher (P<0.05) than after the second half. Net fluid loss during the game was >2% of the body mass. Correlations were observed between net-fluid loss and repeated sprint test fatigue index after the game (r=0.73, P<0.05) and Yo-Yo intermittent recovery, level 1 test performance and high-intensity running during the final 15 min of the game (r=0.51, P<0.05). The study provides direct evidence of compromised repeated sprint and jump performances induced by soccer match play and pronounced reduction in high-intensity running toward the end of an elite game played in a hot environment. This fatigue could be associated training status and hyperthermia/dehydration.",0 +https://doi.org/10.1177/0020764008095929,Traumatic Events and Mental Health in the Community: a New Zealand Study,"Background: Adverse mental health effects in response to a variety of distressing events in specific populations are well documented. However, comparatively little research has been conducted within large community samples outside North America. Aims: To assess the prevalence and psychological impact of specific traumatic events in a New Zealand community sample. Methods: Prevalence and psychological impact of 12 traumatic events was examined in a community sample of 1,500 New Zealand adults using a three-stage cluster sampling method. Traumatic events, psychological distress, psychological well-being, and post-traumatic stress disorder symptoms were assessed using modifi ed versions of the Traumatic Stress Schedule, Mental Health Inventory, and Civilian Mississippi Scale. The effects of age, gender and ethnicity were controlled for while assessing impact of traumatic events. Results: Sixty-one per cent of the sample experienced trauma events in their lifetime, with 9% experiencing events in the past year. Accident-related events were most common in the present sample. Violent crime produced the greatest impact. Tests of interactions involving age, gender, and ethnicity were not significant. Conclusions: New Zealand community-residing individuals experience post-traumatic stress symptoms, reduced psychological well-being, and increased psychological distress following the experience of violent crime and accidents specifically. Study limitations and suggestions for future research are discussed.",0 +https://doi.org/10.1017/s0033291706008282,"Epidemiology of trauma, post-traumatic stress disorder (PTSD) and co-morbid disorders in Chile","Background. In this study we examined the prevalence rates of post-traumatic stress disorder (PTSD), types of trauma most often associated with PTSD, the co-morbidity of PTSD with other lifetime psychiatric disorders, which disorders preceded PTSD, and gender differences in PTSD and trauma exposure in a representative sample of Chileans. Method. The DSM-III-R PTSD and antisocial personality disorder modules from the Diagnostic Interview Schedule (DIS) and modules for a range of DSM-III-R diagnoses from the Composite International Diagnostic Interview (CIDI) were administered to a representative sample of 2390 persons aged 15 to over 64 years in three cities in Chile. Results. The lifetime prevalence of PTSD was 4·4% (2·5% for men and 6·2% for women). Among persons exposed to trauma, rape was most strongly associated with PTSD. Onset of PTSD significantly increased the risk of developing each of the 10 other tested disorders. Among those exposed to trauma, women were significantly more likely to develop PTSD, after controlling for assaultive violence. Conclusions. This study highlights the importance of investigating the prevalence of PTSD, patterns of co-morbidity of PTSD, and gender differences in PTSD in non-English-speaking countries.",0 +https://doi.org/10.1111/1552-6909.12300,Late and Long‐Term Effects of Breast Cancer Treatment and Surveillance Management for the General Practitioner,"To examine the most common long-term and late effects of breast cancer treatment, the American Society of Clinical Oncology guidelines for surveillance, and recommendations for the primary care provider's role in delivering breast cancer survivorship care.A comprehensive literature review was conducted using CINAHL, PubMed, Google Scholar, and hand searches using the search terms breast cancer, survivor, and long-term or late effects.Articles published in English from 2002 to 2012 that addressed the long-term or late effects of adults with breast cancer were included.Findings are discussed categorically, including the most common late and long-term psychosocial effects from relevant studies.Topics relevant to survivors included challenges to psychosocial, emotional, and cognitive well-being; satisfaction with life; sexuality; body image; anxiety; fear of recurrence and post-traumatic stress disorder; depression; cognitive dysfunction challenges to physical well-being; adverse cardiovascular events; fatigue; lymphedema; musculoskeletal symptoms; accelerated bone loss and fractures; pain; skin changes due to radiation; disease recurrence; and new breast cancers.With earlier detection methods and improvements in treatment options making breast cancer a highly survivable disease, there are more survivors of breast cancer than ever. The clinicians' role in survivorship care is more important than ever to manage the potential long-term and late effects of treatment, physical and emotional well-being, and recurrent disease surveillance. However, the clinician's role in cancer follow-up care is often poorly defined leading to a lack of awareness about the needs of survivors of breast cancer, suboptimal communication between providers and survivors, and an overall deficiency in quality care.",0 +https://doi.org/10.1016/j.jad.2014.05.033,Self-injurious behaviors in posttraumatic stress disorder: An examination of potential moderators,"Despite increasing evidence for a relation between posttraumatic stress disorder (PTSD) and self-injurious behaviors (SIB), limited research has examined the factors that may moderate the associations between PTSD and both nonsuicidal SIB (deliberate self-harm; DSH) and suicidal SIB (suicide attempts). Nonetheless, research suggests that characteristics of the traumatic event, co-occurring borderline personality disorder (BPD), and emotion dysregulation may influence the relations between PTSD and SIB. Thus, the aim of this study was to examine the moderating role of these factors in the association between PTSD and SIB (including history and frequency of DSH and suicide attempts, and DSH versatility) among a sample of substance use disorder inpatients with ( n =116) and without ( n =130) a history of PTSD. Results from stepwise regression analyses indicate that sexual assault-related PTSD predicted suicide attempt frequency and DSH versatility among those with PTSD. Furthermore, results from hierarchical linear and logistic regression analyses suggest that co-occurring BPD moderates the relationship between PTSD and both DSH history and versatility and emotion dysregulation moderates the relationship between PTSD and DSH frequency. Specifically, the relations between PTSD and DSH outcomes were stronger among participants with co-occurring BPD and higher levels of emotion dysregulation. This study is limited by its reliance on cross-sectional, self-report data. Despite limitations, findings suggest distinct risk factors for suicide attempts and DSH, and highlight the importance of examining characteristics of the trauma and associated BPD and emotion dysregulation in assessing risk for SIB in PTSD.",0 +https://doi.org/10.1016/j.apj.2014.06.001,Valoración psicológica en delitos de violencia de género mediante el Inventario Clínico y Multiaxial de Millon III (MCMI-III),"In this study, psychological assessment of 127 women presenting charges of gender-based violence (GVB) and 55 male suspects, were analyzed by the MCMI-III, as well as the influence of sociodemographic data and GVB features on these MCMI-III scores. Average age of women was 36.25 (SD = 10.48) and average age of men was 42.54 years old (SD = 12.93). Both groups were referred to the Legal Medicine Institute by the Woman Violence Court and all of them were administered the Millon Clinical Multiaxial Inventory III (MCMI-III). Differential profiles according to age, maltreatment duration and years of cohabitation were obtained. Women presented high scores in Social desirability, Compulsive personality, Anxiety, Dysthymia, Somatization and Depression. Men presented Narcissistic features, Depression and Substance abuse. As maltreatment extended in time, Schizoid, Depressive and Self-destructive features increased in women, as well as Dysthymia and PTSD, obtaining lower scores on Social desirability and Histrionic personality.",0 +https://doi.org/10.1210/en.2005-0859,"Dynamics of in Vivo Release of Molt-Inhibiting Hormone and Crustacean Hyperglycemic Hormone in the Shore Crab, Carcinus maenas","Very little is known regarding the release patterns or circulating titers of neuropeptides in crustaceans, in particular those concerned with regulation of molting hormone (ecdysteroid) synthesis, molt-inhibiting hormone (MIH), and crustacean hyperglycemic hormone (CHH), which is also an adaptive hormone, centrally important in carbohydrate metabolism. Furthermore, the currently accepted model of molt control is founded on an untested hypothesis suggesting that molting can proceed only after decline in MIH titer. Accordingly, we measured simultaneous circulating neuropeptide profiles for both MIH and CHH by RIA of purified hemolymph during the molt cycle at fine temporal scale during day/night cycles and seasonally. For CHH we additionally determined release patterns after physiologically relevant stress. Results show that both hormones are released exclusively and episodically, rather than continuously, with notably short half-lives in circulation, suggesting dynamic and short-lived variations in levels of both hormones. During the molt cycle, there are no overt changes in MIH titer, except a massive and unprecedented increase in MIH during late premolt, just before ecdysis. The function of this hormone surge is unknown. Treatment with various stressors (hypoxia, temperature shock) showed that CHH release occurs extremely rapidly, within minutes of stress. Release of CHH after stressful episodes during premolt (when gut endocrine cells synthesize large quantities of CHH) is exclusively from the sinus gland: CHH from the gut is never involved in the stress response. The results show a hitherto unsuspected dynamism in release of MIH and CHH and suggest that currently accepted models of molt control must be reconsidered.",0 +https://doi.org/10.1016/j.tics.2013.05.005,A causal model of post-traumatic stress disorder: disentangling predisposed from acquired neural abnormalities,"Discriminating neural abnormalities into the causes versus consequences of psychopathology would enhance the translation of neuroimaging findings into clinical practice. By regarding the traumatic encounter as a reference point for disease onset, neuroimaging studies of post-traumatic stress disorder (PTSD) can potentially allocate PTSD neural abnormalities to either predisposing (pre-exposure) or acquired (post-exposure) factors. Based on novel research strategies in PTSD neuroimaging, including genetic, environmental, twin, and prospective studies, we provide a causal model that accounts for neural abnormalities in PTSD, and outline its clinical implications. Current data suggest that abnormalities within the amygdala and dorsal anterior cingulate cortex represent predisposing risk factors for developing PTSD, whereas dysfunctional hippocampal-ventromedial prefrontal cortex (vmPFC) interactions may become evident only after having developed the disorder.",0 +,Analysis of a case series of workers with mobbing syndrome,"Mobbing represents nowadays a major challenge for Occupational Medicine. We examined, during the last seven years, 253 patients who asked medical assistance for psychopathological problems by them ascribed to mobbing in the working environment. All patients underwent occupational health visit, psychological counselling (including personality tests administration), and psychiatric evaluation. A clinical picture probably due to mobbing was diagnosed in 37 workers: 2 cases of Post-Traumatic Stress Disorder (PTSD), 33 of Adjustment Disorder (AD), and 2 of anxiety disorder. Regarding mobbing typology, we found 19 cases of vertical mobbing (by an employer/manager to employees), 14 cases of strategic mobbing, 3 cases of horizontal mobbing (among colleagues), and one non intentional mobbing. In conclusion, a pure mobbing syndrome was diagnosed in a lower proportion than that reported by other investigators. The described interdisciplinary approach appears useful for the diagnostic assessment of suspect mobbing cases, that in turn is crucial for prognosis and treatment, as well as in relation to medico-legal issues and work-related compensation claims.",0 +https://doi.org/10.1007/s10566-014-9249-y,Disasters and Depressive Symptoms in Children: A Review,"Background Disasters are destructive, potentially traumatic events that affect millions of youth each year.ObjectiveThe purpose of this paper was to review the literature on depressive symptoms among youth after disasters. Specifically, we examined the prevalence of depression, risk factors associated with depressive symptoms, and theories utilized in this research area.MethodsWe searched MEDLINE, PsycInfo, and PubMed electronic databases for English language articles published up to May 1, 2013. Reference lists from included studies were reviewed to capture additional studies. Only quantitative, peer reviewed studies, conducted with youth under the age of 18 years, that examined postdisaster depressive symptoms were included. Seventy-two studies met inclusion criteria. Prevalence of depressive symptoms, disaster type, correlates of depressive symptoms, and theories of depressive symptoms were reviewed.ResultsOnly 27 studies (38 %) reported on prevalence rates among youth in their sample. Prevalence rates of depression among youth postdisaster ranged from 2 to 69 %. Potential risk factors were identified (e.g., female gender, exposure stressors, posttraumatic stress symptoms). Theories were examined in less than one-third of studies (k = 21).ConclusionsGiven the variability in prevalence rates, difficulty identifying a single profile of youth at risk for developing depressive symptoms, and lack of a unifying theory emerging from the studies, recommendations for future research are discussed. Use of established batteries of assessments could enable comparisons across studies. Merging existing theories from children’s postdisaster and depression literatures could aid in the identification of risk factors and causal pathways.",0 +https://doi.org/10.1002/1097-4679(198705)43:3<337::aid-jclp2270430306>3.0.co;2-u,Key determinants of the MMPI-PTSD subscale: Treatment considerations,"Seventy-five “in country” Vietnam combat psychiatric inpatients were given a battery of measures upon admission to the medical center. These included the MMPI, VETS Adjustment Scale, State-Trait Anxiety Scale, Rotter Locus of Control, Profile of Mood Scale, and a variation of the Figley Stress Scale that measures current stress. Post-traumatic stress disorder (PTSD) was determined by the MMPI-PTSD subscale. Ten of the battery variables were used as predictors for a multiple regression analysis on the MMPI-PTSD subscale. Results yielded a multiple R of .89 for two predictors, Figley Stress Scale and Rotter Locus of Control (external). Patients with PTSD, therefore, suffer most from perceived and experienced current stressors and a low sense of control. Arguments are made for more present-centered and interpersonal strategies in the treatment of PTSD combat veterans.",0 +https://doi.org/10.1111/gbb.12102,Understanding posttraumatic stress disorder: insights from the methylome,"Genome-wide association studies (GWAS) have identified numerous disease-associated variants; however, these variants have a minor effect on disease and explain only a small amount of the heritability of complex disorders. The search for the missing heritability has shifted attention to rare variants, copy number variants, copy neutral variants and epigenetic modifications. The central role of epigenetics, and specifically DNA methylation, in disease susceptibility and progression has become more apparent in recent years. Epigenetic mechanisms facilitate the response to environmental changes and challenges by regulating gene expression. This makes the study of DNA methylation in psychiatric disorders such as posttraumatic stress disorder (PTSD) highly salient, as the environment plays such a vital role in disease aetiology. The epigenome is dynamic and can be modulated by numerous factors, including learning and memory, which are important in the context of PTSD. Numerous studies have shown the effects of early life events, such as maternal separation and traumas during adulthood, on DNA methylation patterns and subsequent gene expression profiles. Aberrations in adaptive DNA methylation contribute to disease susceptibility when an organism is unable to effectively respond to environmental demands. Epigenetic mechanisms are also involved in higher order brain functions. Dysregulation of methylation is associated with neurodevelopmental and neurodegenerative cognitive disorders, affective disorders, addictive behaviours and altered stress responses. A thorough understanding of how the environment, methylome and transcriptome interact and influence each other in the context of fear and anxiety is integral to our understanding and treatment of stress-related disorders such as PTSD.",0 +https://doi.org/10.1016/j.jad.2014.12.007,Functional significance of a novel 7-factor model of DSM-5 PTSD symptoms: Results from the National Health and Resilience in Veterans Study,"While posttraumatic stress disorder (PTSD) symptoms in the recently published Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are clustered into four factors, emerging confirmatory factor analytic studies suggest that this disorder is best characterized by seven symptom clusters, including re-experiencing, avoidance, negative affect, anhedonia, externalizing behaviors, and anxious and dysphoric arousal symptoms. To date, however, data are lacking regarding the relation between this novel model of DSM-5 PTSD symptoms and measures of clinical significance in this population (e.g., functioning).Using data from the National Health and Resilience in Veterans Study (NHRVS), a contemporary, nationally representative sample of 1484 U.S. veterans, we evaluated clinical and functional correlates of a novel 7-factor model of DSM-5 PTSD symptoms.Differential patterns of associations were observed between DSM-5 PTSD symptom clusters, and psychiatric comorbidities, suicidal ideation, hostility, and functioning and quality of life. Anhedonia symptoms, in particular, were strongly related to current depression, as well as reduced mental functioning and quality of life. Externalizing behaviors were most strongly related to hostility, supporting the convergent validity of this construct.Cross-sectional design and employment of self-report measures.These results suggest that a more refined 7-factor model of DSM-5 PTSD symptoms may provide greater specificity in understanding associations with comorbid psychopathology, suicidal ideation, and functioning and quality of life in U.S. veterans. They further suggest that prevention and treatment efforts that target distinct aspects of the PTSD phenotype may be more effective in mitigating key clinical and functional outcomes in this population.",0 +https://doi.org/10.1016/j.brat.2007.05.002,Randomized controlled evaluation of an early intervention to prevent post-rape psychopathology,"A randomized between-group design was used to evaluate the efficacy of a video intervention to reduce post-traumatic stress disorder (PTSD) and other mental health problems, implemented prior to the forensic medical examination conducted within 72 h post-sexual assault. Participants were 140 female victims of sexual assault (68 video/72 nonvideo) aged 15 years or older. Assessments were targeted for 6 weeks (Time 1) and 6 months (Time 2) post-assault. At Time 1, the intervention was associated with lower scores on measures of PTSD and depression among women with a prior rape history relative to scores among women with a prior rape history in the standard care condition. At Time 2, depression scores were also lower among those with a prior rape history who were in the video relative to the standard care condition. Small effects indicating higher PTSD and Beck Anxiety Inventory (BAI) scores among women without a prior rape history in the video condition were observed at Time 1. Accelerated longitudinal growth curve analysis indicated a videoxprior rape history interaction for PTSD, yielding four patterns of symptom trajectory over time. Women with a prior rape history in the video condition generally maintained the lowest level of symptoms.",0 +https://doi.org/10.1016/j.brat.2010.05.021,Facial asymmetry detection in patients with body dysmorphic disorder,"Cognitive-behavioral models of body dysmorphic disorder (BDD) propose that individuals with BDD may possess a better or more developed sense of aestheticality than do individuals without BDD. Evidence for this proposition, however, is limited. One perceptual process that could contribute to heightened aestheticality is the ability to detect differences in symmetry. In this experiment we tested whether individuals with BDD (n=20), relative to individuals with obsessive compulsive disorder (OCD; n=20) and healthy controls (n=20), show an enhanced ability to detect differences in the symmetry of others' faces, symmetry of dot arrays, and/or show a greater preference for symmetrical faces. Individuals with BDD were not significantly more accurate in detecting differences in facial symmetry or dot arrays relative to individuals with OCD and healthy controls. Individuals with OCD took longer to make facial symmetry judgments than did individuals in the other two groups. All participants, regardless of diagnostic group, preferred more symmetrical faces than nonsymmetrical ones. Taken together, our results do not support a heightened perceptual ability or evaluative preference for symmetry among individuals with BDD.",0 +https://doi.org/10.1002/jts.20684,Peritraumatic and trait dissociation differentiate police officers with resilient versus symptomatic trajectories of posttraumatic stress symptoms,"Research has consistently demonstrated that stress reactions to potentially traumatic events do not represent a unified phenomenon. Instead, individuals tend to cluster into prototypical response patterns over time including chronic symptoms, recovery, and resilience. We examined heterogeneity in a posttraumatic stress disorder (PTSD) symptom course in a sample of 178 active-duty police officers following exposure to a life-threatening event using latent growth mixture modeling (LGMM). This analysis revealed 3 discrete PTSD symptom trajectories: resilient (88%), distressed-improving (10%), and distressed-worsening (2%). We further examined whether trait and peritraumatic dissociation distinguished these symptom trajectories. Findings indicate that trait and peritraumatic dissociation differentiated the resilient from the distressed-improving trajectory (trait, p < .05; peritraumatic, p < .001), but only peritraumatic dissociation differentiated the resilient from the distressed-worsening trajectory (p < .001). It is essential to explore heterogeneity in symptom course and its predictors among active-duty police officers, a repeatedly exposed group. These findings suggest that police officers may be a highly resilient group overall. Furthermore, though there is abundant evidence that dissociation has a positive linear relationship with PTSD symptoms, this study demonstrates that degree of dissociation can distinguish between resilient and symptomatic groups of individuals.",1 +https://doi.org/10.7490/f1000research.1094896.1,Selective blockade of 2-arachidonoylglycerol hydrolysis affects learning and memory performance while slowing down epileptogenesis in rodents,"Background: Endocannabinoids (eCBs) play a key neuromodulatory role in the central nervous system, regulating appetite, cognition, emotion, mood and pain by activation of cannabinoid (CB1) receptors. Alterations in the eCB system has been associated with disease in several major therapeutic areas. In particular, changes in tissue concentrations of their natural lipid ligands, N-arachidonoylethanolamine (anandamide) and 2-arachidonoyglycerol (2-AG) have been observed in neurological and psychiatric disorders, observations which have fueled considerable pharmaceutical interest in developing eCB-manipulating drugs to treat these conditions. These include compounds that act at CB1 receptors or inhibit anandamide degradation by fatty acid amide hydrolase (FAAH). Much less attention focused on the identification of drugs that modify 2-AG levels via manipulation of the serine hydrolase monoacylglycerol lipase (MAGL), its principal degradative enzyme. Here we report the pharmacological profile of a potent and selective MAGL inhibitor, Compound A. Methods: MAGL selectivity and activity of Compound A were determined in in vitro and ex vivo biochemical assays, followed by a pharmacokinetic study to measure its brain exposure in mice. The effects of Compound A were then evaluated using rodent models with a focus on cognition and epilepsy tests since there is recent evidence that the modulation of 2-AG levels affects cognitive processes and seizure activity. Results: Compound A behaves as a highly selective and competitive reversible inhibitor of mouse and human MAGL (IC50=29 and 3.8 nM, respectively). It does not affect the activities of other human serine hydrolases or interact with a panel of selected kinases, neurotransmitter transporters, ion channels and receptors, including the binding of a highaffinity ligand to CB1 and CB2 receptors. Ex vivo assays confirmed the degree of selectivity across eCBs as Compound A decreased MAGL activity (ID50=2.7mg/kg po), while increasing levels of 2-AG (MED=3mg/kg po) in the absence of effect on other serine hydrolase substrates. Compound A demonstrated excellent brain permeability in the mouse (brain/plasma 4.3 at 10 mg/kg po). In a preliminary experiment, Compound A was found to decrease in vitro long term potentiation in rat hippocampus. This finding is in line with those of behavioral experiments showing that Compound A affected learning performance in the novel object recognition task (NOR), the Y-maze (YM) and the Morris water maze test, suggesting alterations in episodic, working and spatial memory. The effects of Compound A in the NOR and YM were antagonized by rimonabant suggesting that they were mediated by CB1 receptors. It is noteworthy that no tolerance to the effects of the drug was observed in the latter test upon repeated administration for 5 days. Interestingly, the effects of Compound A in the NOR were similar to those observed following genetic deletion of MAGL, supporting further the role of 2-AG in the intrinsic modulation of cognitive processes. In acute seizure tests in mice, Compound A was inactive over a wide dose-range in the 6-Hz model and after the administation of the convulsants pentylenetetrazole and kainate. However, in the mouse corneal kindling model of partial epilepsy, repeated administration of Compound A for 2 weeks delayed the acquisition and decreased the expression of kindled seizures, suggesting antiepileptogenic and anticonvulsant activities. Conclusions: These findings demonstrate that selective pharmacological or genetic blockade of 2-AG hydrolysis affects memory performance, suggesting that MAGL inhibitors may be of limited utility as therapeutic agents for CNS disorders. However, it cannot be totally excluded that they may serve to treat psychopathologies hallmarked by an inability to extinguish maladaptive behaviors, such as posttraumatic stress syndrome and obsessive-compulsive disorder. Finally, our study reveals a previously unsuspected role of 2-AG in epileptogenesis process, a finding which deserves further investigation to determine t e therapeutic potential of MAGL inhibitors as antiepileptic drugs.",0 +https://doi.org/10.1080/15299730903143550,Does Language of Retrieval Affect the Remembering of Trauma?,"Semantic and episodic bilingual memory has been extensively researched. Research has also been conducted in the area of autobiographical memory. This study investigated traumatic bilingual memories. This study was a preliminary exploration of possible differences in the reporting of the intensity of 3 clusters of posttraumatic stress disorder symptoms and 5 specific characteristics of traumatic memory in the first versus second languages of bilingual (Spanish-English) individuals who sustained traumatic experiences in childhood. Participants were 19 Spanish-English coordinate bilingual individuals. A repeated measures design examined the prediction that, regardless of the order in which language was presented (whether Spanish-English or English-Spanish), bilingual participants would rate the intensity of specific symptoms and characteristics of traumatic memory higher in their first language. It is hypothesized that the first language is most closely connected to early experience between the self and the first other. Additionally, the relation between affect and first language is different from the relation between affect and second language. P. Janet (1919/1925) and current trauma research suggest that traumatic memories may be encoded differently from ordinary memories. Matching language at the time that traumatic memories were experienced with the later language of retrieval may significantly facilitate the healing process by allowing unique access to traumatic memories through the first language.",0 +https://doi.org/10.1037/a0021529,"Pretrauma problems, prior stressor exposure, and gender as predictors of change in posttraumatic stress symptoms among physically injured children and adolescents.","This study addressed predictors of change in posttraumatic stress symptoms (PTSS) among youths who had experienced physical injuries. The influences of pretrauma internalizing and externalizing problems, prior stressor exposure, and gender were investigated. Additionally, gender was examined as a moderator of the associations between internalizing problems and PTSS, externalizing problems and PTSS, and prior stressor exposure and PTSS.Participants were 157 children and adolescents (75% male; age M = 13.30 years, SD = 3.60; 44% Caucasian, 39% African American, 13% Hispanic, and 4% other) admitted to 2 hospitals for physical injuries. Youths and their parents completed measures of PTSS (Child Posttraumatic Stress Reaction Index), internalizing and externalizing problems (Child Behavior Checklist), and prior stressor exposure (Coddington Life Events Scale, Child) during the hospital stay; youths completed up to 3 additional PTSS assessments targeted at 3, 6, and 12 months postinjury.Multilevel regression analyses revealed a significant average decline in PTSS over time (p < .05) that followed a curvilinear trajectory. Externalizing problems, prior stressor exposure, and female gender predicted higher initial PTSS levels (p < .05). Gender moderated the influence of internalizing problems, externalizing problems, and prior stressor exposure on decline in PTSS over time (p < .05). Patterns of recovery for those with high and low levels of each characteristic differed for girls and boys.Findings suggest targets for clinical consideration, both with respect to identifying subgroups of children and adolescents that may warrant early assessment and monitoring and timing of more directed PTSS treatment intervention.",0 +https://doi.org/10.1016/j.infbeh.2015.10.004,Patterns of psychological distress in mothers of preterm infants.,"Mothers of preterm infants experience significant psychological distress, with elevated levels of inter-correlated depressive, stress, anxiety and post-traumatic stress symptoms. In a sample of racially and ethnically diverse mothers of preterm infants, we identified differing patterns of psychological distress during infant hospitalization and examined the effect of these psychological distress patterns on longitudinal trajectories of each psychological distress measure and on maternal perceptions of the child over the first year of the infant's life. Mothers of preterm infants (N=232) completed five questionnaires assessing depressive symptoms, anxiety, post-traumatic stress symptoms, stress due to infant appearance, and stress due to parental role alteration during enrollment during the neonatal hospitalization, discharge, and at 2, 6, and 12 months of age adjusted for prematurity. Latent class analysis on the enrollment psychological distress variables allowed us to identify five sub-groups of mothers exhibiting similar patterns of psychological distress, differing primarily in degree and type: low distress, moderate distress, high NICU-related distress, high depressive and anxiety symptoms, and extreme distress. These classes continued to show different longitudinal trajectories for the psychological distress measures through 12 months corrected age. Mothers in the extreme distress class and, to a lesser degree, mothers in the high depressive and anxiety symptom class remained at risk of significant psychological distress one year after discharge and had less positive perceptions of their child (greater worry and higher perceptions of child vulnerability). In conclusion, distinctive sub-groups of mothers during hospitalization had different patterns of psychological distress throughout the 12-month period and may require different interventions in the NICU.",0 +https://doi.org/10.1002/jts.20497,Posttraumatic stress disorder symptoms and functional impairment among OEF and OIF National Guard and Reserve veterans,"The aims of the present investigation were (a) to examine associations between posttraumatic stress disorder (PTSD; diagnosis and symptoms) and different aspects of functioning, severity, and subjective distress among Operation Iraqi Freedom and Operation Enduring Freedom National Guard and Reserve veterans, and (b) to examine the unique contribution of PTSD symptom clusters to different aspects of functioning and distress. Participants were 124 veterans who had returned from war-zone deployment. A PTSD diagnosis and PTSD symptoms were significantly associated with nearly all of the psychosocial functioning and distress measures, controlling for Axis I disorders and other covariates. Of the PTSD symptom clusters, numbing/avoidance symptoms were the strongest predictors of interpersonal and social functioning, and hyperarousal symptoms were the strongest predictors of overall severity and distress.",0 +https://doi.org/10.1007/s10903-014-9995-9,Specific Trauma Subtypes Improve the Predictive Validity of the Harvard Trauma Questionnaire in Iraqi Refugees,"Trauma exposure contributes to poor mental health among refugees, and exposure often is measured using a cumulative index of items from the Harvard Trauma Questionnaire (HTQ). Few studies, however, have asked whether trauma subtypes derived from the HTQ could be superior to this cumulative index in predicting mental health outcomes. A community sample of recently arrived Iraqi refugees (N = 298) completed the HTQ and measures of posttraumatic stress disorder (PTSD) and depression symptoms. Principal components analysis of HTQ items revealed a 5-component subtype model of trauma that accounted for more item variance than a 1-component solution. These trauma subtypes also accounted for more variance in PTSD and depression symptoms (12 and 10%, respectively) than did the cumulative trauma index (7 and 3%, respectively). Trauma subtypes provided more information than cumulative trauma in the prediction of negative mental health outcomes. Therefore, use of these subtypes may enhance the utility of the HTQ when assessing at-risk populations.",0 +https://doi.org/10.1001/archpsyc.62.6.593,Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication,"Little is known about lifetime prevalence or age of onset of DSM-IV disorders.To estimate lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the recently completed National Comorbidity Survey Replication.Nationally representative face-to-face household survey conducted between February 2001 and April 2003 using the fully structured World Health Organization World Mental Health Survey version of the Composite International Diagnostic Interview.Nine thousand two hundred eighty-two English-speaking respondents aged 18 years and older.Lifetime DSM-IV anxiety, mood, impulse-control, and substance use disorders.Lifetime prevalence estimates are as follows: anxiety disorders, 28.8%; mood disorders, 20.8%; impulse-control disorders, 24.8%; substance use disorders, 14.6%; any disorder, 46.4%. Median age of onset is much earlier for anxiety (11 years) and impulse-control (11 years) disorders than for substance use (20 years) and mood (30 years) disorders. Half of all lifetime cases start by age 14 years and three fourths by age 24 years. Later onsets are mostly of comorbid conditions, with estimated lifetime risk of any disorder at age 75 years (50.8%) only slightly higher than observed lifetime prevalence (46.4%). Lifetime prevalence estimates are higher in recent cohorts than in earlier cohorts and have fairly stable intercohort differences across the life course that vary in substantively plausible ways among sociodemographic subgroups.About half of Americans will meet the criteria for a DSM-IV disorder sometime in their life, with first onset usually in childhood or adolescence. Interventions aimed at prevention or early treatment need to focus on youth.",0 +https://doi.org/10.2190/il.19.4.c,"Intergenerational Transmission, Attitudes, and Post-Traumatic Stress Disorder in Times of War: A Comparison between Elderly People and Their Adult Offspring after the Second Lebanon War (2006) and Casting Lead Operation (2008)","Background: While the effects of war on individuals, age groups, and communities have been thoroughly studied, there has been relatively little mention in the literature regarding its differential effects on adult children and their elderly parents and grandparents. Methods: Three hundred thirty-eight participants (167 elderly parents and 171 adult offspring) living in the northern and southern regions of Israel, were interviewed after the Second Lebanon War (2006) and the Casting Lead Operation (2008). (A military operation took place at the Israeli southern border as a reaction to the 7 years of missiles bombing from the Gaza strip to the Israeli civilians.) The participants were sampled by a cluster sampling. Findings: Elderly population experiences higher levels of PTSD symptoms than their adult children do. Women experience higher levels of PTSD symptoms than men and Israeli Arabs and Druze more than Israeli Jews. Conclusions: A policy should be enacted among the local authorities and the governmental offices that would ensure accessibility to and the ability to provide proper care for the elderly population during times of war or terror events. In addition, it is important to setup local teams in every local community to deal with the level of mental and emotional preparedness of the home front and its inhabitants, in case the latter should again become part of the human casualties of the wars and terrorist events that occur in Israel.",0 +https://doi.org/10.3402/ejpt.v5.23870,"Traumatic experiences, alexithymia, and posttraumatic symptomatology: a cross-sectional population-based study in Germany","Previous studies have established an association between number of traumatic experiences and alexithymia. The present study examines this relationship in a large-scale representative sample of the German general population (N=2,507) and explores the potential mediating effects of posttraumatic symptomatology, particularly avoidance/numbing.Alexithymia was assessed with the German version of the Toronto Alexithymia Scale (TAS-20). Posttraumatic symptomatology was operationalized by the symptom score of the modified German version of the Posttraumatic Symptom Scale, and traumatic experiences were assessed with the trauma list of the Munich Composite International Diagnostic Interview. Two mediation analyses were conducted.Of the total sample, 24.2% (n=606) reported at least one traumatic experience, 10.6% (n=258) were classified as alexithymic, and 2.4% (n=59) fulfilled the criteria of posttraumatic stress disorder (PTSD). Participants who had survived five or more traumatic experiences had significantly higher alexithymia sum scores. The PTSD symptom cluster avoidance/numbing mediated the association between the number of traumatic experiences and alexithymia.Our findings illustrate an association between number of traumatic experiences and alexithymia and the influence of emotional avoidance and numbing within this relationship. The significant relationship between alexithymia and number of traumatic experiences in a general population sample further supports the concept of multiple and complex traumatization as associated with alexithymia. The results suggest the importance of further investigations determining the causal impact of alexithymia both as a potential premorbid trait and as consequence of traumatization. Lastly, future investigations are needed to clarify alexithymia as a distinct trauma-relevant characteristic for better diagnostics and specialized trauma-integrative therapy.",0 +https://doi.org/10.1080/0164212x.2013.819466,The Sensory Profile of People With Post-Traumatic Stress Symptoms,"Thirty participants with post-traumatic stress (PTS) symptoms and 30 healthy controls completed the Post-Traumatic Stress Disorder Symptom Scale (PSS-SR) and the Adolescent/Adult Sensory Profile (AASP). Participants with PTS symptoms vacillated between sensory sensitivity, sensation avoiding, and low registration. Sensation avoiding and low registration correlated with intrusive thoughts related to PTS. Discriminant Analysis classified 73% of the study group and 80% of the controls. PTS may be related to hypersensitivity and low registration. Further studies about the sensory profile of people with PTS symptoms may contribute to research and optimize evaluation and intervention for people with PTSD.",0 +https://doi.org/10.1002/jts.20636,Disaster survivors in their third decade: Trajectories of initial stress responses and long-term course of mental health,en,1 +https://doi.org/10.1249/01.mss.0000174895.19639.ed,Epidemiology of Hospitalizations and Deaths from Heat Illness in Soldiers,"Serious heat illness has received considerable recent attention due to catastrophic heat waves in the United States and Europe, the deaths of high-profile athletes, and military deployments.This study documents heat illness hospitalizations and deaths for the U.S. Army from 1980 through 2002. Hospitalization data were obtained from the Total Army Injury Health Outcomes Database (TAIHOD) coded according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). North Atlantic Treaty Organization Standardization Agreement codes were searched for heat injuries in an effort to detect cases that were not found during the ICD-9-CM search.Five-thousand two-hundred forty-six soldiers were hospitalized, and 37 died due to heat illness. Our results indicate: 1) approximately 60% reduction in hospitalization rates (fewer heat exhaustion cases) over the 22-yr period; 2) fivefold increase in heat stroke hospitalization rates (1.8 per 100,000 in 1980 to 14.5 per 100,000 in 2001); 3) heat stroke cases were associated with dehydration (17%), rhabdomyolysis (25%), and acute renal failure (13%); 4) lower hospitalizations rates among African and Hispanic Americans compared with Caucasians (incidence density ratio, 0.76 [95% confidence interval, 0.71-0.82]; 5) greater rates of hospitalizations and heat strokes among recruits from northern than southern states (incidence density ratio, 1.69 [95% confidence interval, 1.42-1.90]; and 6) greater rates of hospitalizations and heat strokes among women than men (incidence density ratio, 1.18 [95% confidence interval, 1.09-1.27]).Exertional heat illness continues to be a military problem during training and operations. Whereas the hospitalization rate of heat illness is declining, heat stroke has markedly increased.",0 +https://doi.org/10.1037//1040-3590.12.2.210,Development and preliminary validation of a brief broad-spectrum measure of trauma exposure: The Traumatic Life Events Questionnaire.,"This article describes the development and preliminary validation of a brief questionnaire that assesses exposure to a broad range of potentially traumatic events. Items were generated from multiple sources of information. Events were described in behaviorally descriptive terms, consistent with Diagnostic and Statistical Manual of Mental Disorders IV posttraumatic stress disorder stressor criterion A1. When events were endorsed, respondents were asked if they experienced intense fear, helplessness, or horror (stressor criterion A2). In separate studies with college students, Vietnam veterans, battered women, and residents of a substance abuse program, most items possessed adequate to excellent temporal stability. In a study comparing questionnaire and structured-interview inquiries of trauma history, the 2 formats yielded similar rates of disclosure. Preliminary data on positive predictive power are also presented.",0 +https://doi.org/10.1097/01.alc.0000156129.98265.57,Sertraline in the Treatment of Co-occurring Alcohol Dependence and Posttraumatic Stress Disorder,"Background: Posttraumatic stress disorder (PTSD) frequently co-occurs with alcohol use disorders. This study investigated the use of sertraline, a serotonin reuptake inhibitor, in treating co-occurring symptoms of alcohol dependence and PTSD. Methods: A total of 94 individuals with current alcohol dependence and PTSD were randomly assigned to receive sertraline (150 mg/day) or placebo for 12 weeks. Post hoc cluster analysis of baseline characteristics was used to define subgroups of participants. Results: There was a significant decrease in alcohol use during the trial in both the sertraline and the placebo groups. Cluster analysis revealed significant medication group by cluster interactions for alcohol-related outcomes. Sertraline-treated participants with less severe alcohol dependence and early-onset PTSD had significantly fewer drinks per drinking day (p < 0.001). For participants with more severe alcohol dependence and later onset PTSD, the placebo group had significantly greater decreases in drinks per drinking day (p < 0.01) and average number of drinks consumed per day (p < 0.05). Conclusions: There may be subtypes of alcohol-dependent individuals who respond differently to serotonin reuptake inhibitor treatment. Further investigation of differential responders may lead to improvements in the pharmacological treatment of co-occurring alcohol dependence and PTSD.",0 +https://doi.org/10.1016/j.rehab.2015.11.002,What are the disruptive symptoms of behavioral disorders after traumatic brain injury? A systematic review leading to recommendations for good practices,"Behavioral disorders are major sequelae of severe traumatic brain injury. Before considering care management of these disorders, and in the absence of a precise definition for TBI-related behavioral disorder, it is essential to refine, according to the data from the literature, incidence, prevalence, predictive factors of commonly admitted disruptive symptoms. Systematic review of the literature targeting epidemiological data related to behavioral disorders after traumatic brain injury in order to elaborate good practice recommendations according to the methodology established by the French High Authority for Health. Two hundred and ninety-nine articles were identified. The responsibility of traumatic brain injury (TBI) in the onset of behavioral disorders is unequivocal. Globally, behavioral disorders are twice more frequent after TBI than orthopedic trauma without TBI (Masson et al., 1996). These disorders are classified into disruptive primary behaviors by excess (agitation 11–70%, aggression 25–39%, irritability 29–71%, alcohol abuse 7–26% drug abuse 2–20%), disruptive primary behaviors by default (apathy 20–71%), affective disorders – anxiety – psychosis (depression 12–76%, anxiety 0.8–24,5%, posttraumatic stress 11–18%, obsessive-compulsive disorders 1.2–30%, psychosis 0.7%), suicide attempts and suicide 1%. The improvement of care management for behavioral disorders goes through a first step of defining a common terminology. Four categories of posttraumatic behavioral clinical symptoms are defined: disruptive primary behaviors by excess, by default, affective disorders-psychosis-anxiety, suicide attempts and suicide. All these symptoms yield a higher prevalence than in the general population. They impact all of life's domains and are sustainable over time.",0 +https://doi.org/10.1002/nbm.2910,Perfusion deficits in patients with mild traumatic brain injury characterized by dynamic susceptibility contrast MRI,"Perfusion deficits in patients with mild traumatic brain injury (TBI) from a military population were characterized by dynamic susceptibility contrast perfusion imaging. Relative cerebral blood flow (rCBF) was calculated by a model-independent deconvolution approach from the tracer concentration curves following a bolus injection of gadolinium diethylenetriaminepentaacetate (Gd-DTPA) using both manually and automatically selected arterial input functions (AIFs). Linear regression analysis of the mean values of rCBF from selected regions of interest showed a very good agreement between the two approaches, with a regression coefficient of R = 0.88 and a slope of 0.88. The Bland-Altman plot also illustrated the good agreement between the two approaches, with a mean difference of 0.6 ± 12.4 mL/100 g/min. Voxelwise analysis of rCBF maps from both approaches demonstrated multiple clusters of decreased perfusion (p < 0.01) in the cerebellum, cuneus, cingulate and temporal gyrus in the group with mild TBI relative to the controls. MRI perfusion deficits in the cerebellum and anterior cingulate also correlated (p < 0.01) with neurocognitive results, including the mean reaction time in the Automated Neuropsychological Assessment Metrics and commission error and detection T-scores in the Continuous Performance Test, as well as neurobehavioral scores in the Post-traumatic Stress Disorder Checklist-Civilian Version. In conclusion, rCBF calculated using AIFs selected from an automated approach demonstrated a good agreement with the corresponding results using manually selected AIFs. Group analysis of patients with mild TBI from a military population demonstrated scattered perfusion deficits, which showed significant correlations with measures of verbal memory, speed of reaction time and self-report of stress symptoms.",0 +https://doi.org/10.1002/da.21944,EVIDENCE FOR A DISSOCIATIVE SUBTYPE OF PTSD BY LATENT PROFILE AND CONFIRMATORY FACTOR ANALYSES IN A CIVILIAN SAMPLE,"Dissociative symptoms are increasingly recognized in individuals with posttraumatic stress disorder (PTSD). The aim of this study was to investigate the prevalence of derealization and depersonalization symptoms via latent profile analyses (LPAs) in a civilian PTSD sample and examine the relationship between PTSD and dissociative symptoms via factor analytic methods.A civilian sample of individuals with PTSD predominantly related to childhood abuse (n = 134) completed a diagnostic interview for PTSD and comorbid psychiatric disorders. LPAs and confirmatory factor analyses (CFAs) were performed on the severity scores for PTSD, derealization, and depersonalization symptoms.LPAs extracted three groups, one of which was uniquely characterized by high derealization and depersonalization symptoms, and accounted for 25% of the sample. Individuals in the dissociative subgroup also showed a higher number of comorbid Axis I disorders and a more significant history of childhood abuse and neglect. CFAs suggested the acceptance of a five factor solution in which dissociative symptoms are distinct from but correlate significantly with the core PTSD symptom clusters.The results from LPAs and CFAs are concordant with the concept of a dissociative subtype in patients with PTSD and suggest that symptoms of derealization-depersonalization and the core symptoms of PTSD are positively correlated. Thought should be given to including a dissociative subtype of PTSD in the DSM-5.",0 +https://doi.org/10.1186/1745-6215-15-195,Developmentally adapted cognitive processing therapy for adolescents and young adults with PTSD symptoms after physical and sexual abuse: study protocol for a randomized controlled trial,"Although childhood sexual and/or physical abuse (CSA/CPA) is known to have severe psychopathological consequences, there is little evidence on psychotherapeutic interventions for adolescents and young adults suffering from post-traumatic stress disorder (PTSD). Equally sparse are data on moderators of treatment response on PTSD-related epigenetic changes, health care costs and loss of productivity, alterations in cognitive processing, and on how successful interventions affect all of these factors. Early treatment may prevent later (co)morbidity. In this paper, we present a study protocol for the evaluation of a newly developed psychotherapeutic manual for PTSD after CSA/CPA in adolescents and young adults - the Developmentally Adapted Cognitive Processing Therapy (D-CPT).In a multicenter randomized controlled trial (RCT) D-CPT is compared to treatment as usual (TAU). A sample of 90 adolescent outpatients aged 14 to 21 years will be randomized to one of these conditions. Four assessments will be carried out at baseline, at end of treatment, and 3 and 6 months after end of therapy. Each time, patients will be assessed via clinical interviews and a wide range of questionnaires. In addition to PTSD symptoms and comorbidities, we will evaluate moderators of treatment response, epigenetic profiles, direct and indirect costs of this disorder, and neurophysiological processing of threat cues in PTSD and their respective changes in the course of these two treatments (D-CPT and TAU).The study will provide new insights in the understudied field of PTSD in adolescents and young adults. A newly developed intervention will be evaluated in this therapeutically underserved population. Results will provide data on treatment efficacy, direct and indirect treatment costs, as well as on associations of treatment outcome and PTSD intensity both to epigenetic profiles and to the neurobiological processing of threat cues. Besides, they will help to learn more about the psychopathology and possible new objective correlates of PTSD.Germanctr.de identifier: DRKS00004787.",0 +https://doi.org/10.1017/s0033291710000528,Trajectories of stress reactions and somatization symptoms among war veterans: a 20-year longitudinal study,"Background There is considerable evidence that immediate and long-term stress reactions are associated with increased somatic symptomatology. However, because of the scarcity of long-term longitudinal studies, the trend of mutual change of these factors has not been assessed. This study examined the chronological inter-relationships between post-traumatic stress reactions and somatization symptoms among combatants over a 20-year period. Method Two groups of veterans were assessed 1, 2, 3 and 20 years after their participation in the 1982 Lebanon War: a clinical group of veterans who had been diagnosed with combat stress reaction (CSR) on the battlefield ( n =363), and a matched control group of veterans ( n =301). Results The CSR veterans reported higher initial levels of intrusion and avoidance and a steeper decline in those symptoms over time in comparison to the control group. The former also reported higher initial levels of somatization symptoms than the latter. In addition, over the years, stress reactions were positively associated with somatization symptoms. For both study groups, in the first years after the war, stress reaction symptoms predicted somatization symptoms. However, with time, the trend was reversed and somatization symptoms predicted stress reactions. Conclusions The findings suggest that CSR is a marker for future stress reactions and somatization symptoms, and indicate a long-term role for these symptoms in veterans' psychological distress.",0 +https://doi.org/10.1097/00005053-199212000-00004,Chronic Posttraumatic Stress Disorder and Diagnostic Comorbidity in a Disaster Sample,"Research has indicated significant comorbid psychopathology with chronic posttraumatic stress disorder (PTSD) in samples of war veterans. The present paper examines the issue of comorbidity in a disaster sample to learn whether findings from veterans generalized to this event. A total of 193 subjects exposed to the Buffalo Creek dam collapse of 1972 were examined 14 years later using diagnoses derived from the Structured Clinical Interview for DSM-III (SCID). Past and present PTSD was found in a significant portion of the sample. Major depression was the next most common diagnosis and was highly related to PTSD. Anxiety disorders were also common. The overlap with other diagnoses was quite similar to that found in a sample of Vietnam veterans we studied earlier, except that the disaster sample had fewer dysthymic disorders, substance abusers, and antisocial personality disorders. Possible explanations for comorbidity in chronic PTSD were discussed and it was suggested that the morphology of PTSD may be quite stable in at least some other nonveteran trauma populations.",0 +https://doi.org/10.1016/j.jaac.2011.01.008,Attending to the Mental Health of War-Affected Children: The Need for Longitudinal and Developmental Research Perspectives,,0 +https://doi.org/10.1111/j.1745-7599.2012.00811.x,Mothers going to war: The role of nurse practitioners in the care of military mothers and families during deployment,"Purpose Many military women are being called to separate from their children to go to war. Most previous research has focused upon paternal, rather than, maternal, separation. The purpose of this article is to describe the experience of military mothers and their children during wartime deployments with clinical implications for nurse practitioners (NPs) in military or community settings. Data sources Using grounded theory methods, 37 active duty and reserve component military women participated in a one-time interview. Included were women who deployed for at least 4 months to Iraq or Afghanistan and had at least one child under the age of 12 during the separation. Conclusions Military families present unique challenges for NPs. Mother deployments offer opportunities for intervention and anticipatory guidance across the trajectory of the separation. Military women's emotional and physical health must be supported before, during, and following deployment. Implications for practice NPs are ideally positioned to support military families. During deployment, the NP's focus may shift to care of the children and their caregiver. Before and at reintegration, NPs are in a key position to intervene early for posttraumatic stress and support family readjustment.",0 +https://doi.org/10.1017/s0033291798007363,Panic disorder following torture by suffocation is associated with predominantly respiratory symptoms,"Background. We previously reported that in panic disorder a history of near-suffocation is associated with predominantly respiratory panic attacks. It might be hypothesized that the near-suffocation experienced in certain kinds of torture is also associated with the development of predominantly respiratory panic attacks. Methods. A sample of patients who had experienced torture ( N =14) was drawn from an Anxiety Disorders Clinic in South Africa. Subjects were questioned about symptoms of panic disorder, post-traumatic stress disorder and depression. Results. Patients with a history of torture by suffocation were more likely than other patients to complain of predominantly respiratory symptoms during panic attacks. These patients also demonstrated higher levels of depressive symptoms. Conclusions. While various interpretations of the data can be made, it is possible that torture by suffocation is associated with a specific symptomatic profile. Were such an association to be replicated, this would perhaps support the suffocation alarm hypothesis of panic disorder and provide evidence that specific environmental factors play a role in the development of this alarm.",0 +https://doi.org/10.1109/bsn.2013.6575525,Wearable sensors can assist in PTSD diagnosis,Post-traumatic stress disorder (PTSD) currently is diagnosed via subjective reports of experiences related to the traumatic event. More objective measures are needed to assist clinicians in diagnosis. Physiological activity was recorded from 58 participants. Participants in the No Trauma/No PTSD group had no trauma exposure and no PTSD diagnosis. Trauma Exposed/No PTSD participants had experienced a traumatic event but did not have PTSD. PTSD participants had experienced a traumatic event and had PTSD. Baseline and emotionally evocative stimulus-related sensor data were collected. Features were extracted from each sensor stream and submitted to statistical analysis. Significant group differences were present during the viewing of two virtual reality videos. Features were submitted to discriminant function analysis to assess classification accuracy. Classification accuracy was between 89 and 92%. The results from this study suggest the utility of objective physiological measures obtained from wearable sensors in assisting with PTSD diagnosis.,0 +https://doi.org/10.1034/j.1600-0447.2000.101001046.x,"Traumatic events and post-traumatic stress disorder in the community: prevalence,risk factors and comorbidity","Lifetime and 12-month prevalence of traumatic events and DSM-IV post-traumatic stress disorder as well as risk factors and comorbidity patterns were investigated in a representative community sample (n = 3021, aged 14-24 years).Traumatic events and PTSD were assessed with the Munich Composite International Diagnostic Interview (CIDI).Although 26% of male subjects and 17.7% of female subjects reported at least one traumatic event, only a few qualified for a full PTSD diagnosis (1% of males and 2.2% of females). Traumatic events and PTSD were strongly associated with all other mental disorders examined. PTSD occurred as both a primary and a secondary disorder.The prevalence of PTSD in this young German sample is considerably lower than reported in previous US studies. However, the conditional probability for PTSD after experiencing traumas, risk factors and comorbidity patterns are quite similar. Traumatic events and full PTSD may increase the risk for other disorders, and vice versa.",0 +https://doi.org/10.1002/jts.2490100404,Adult memories of childhood trauma: A naturalistic clinical study,"The clinical evaluations of 77 adult psychiatric outpatients reporting memories of childhood trauma were reviewed. A majority of patients reported some degree of continuous recall. Roughly half (53%) said they had never forgotten the traumatic events. Two smaller groups described a mixture of continuous and delayed recall (17%) or a period of complete amnesia followed by delayed recall (16%). Patients with and without delayed recall did not differ significantly in the proportions reporting corroboration of their memories from other sources. Idiosyncratic, trauma-specific reminders and recent life crises were most commonly cited as precipitants to delayed recall. A previous psychotherapy was cited as a factor in a minority (28%) of cases. By contrast, intrusion of new memories after a period of amnesia was frequently cited as a factor leading to the decision to seek psychotherapy. The implications of these findings are discussed with respect to the role of psychotherapy in the process of recovering traumatic memories.",0 +https://doi.org/10.1097/psy.0000000000000109,Psychophysiological Response to Virtual Reality and Subthreshold Posttraumatic Stress Disorder Symptoms in Recently Deployed Military,"Subthreshold posttraumatic stress disorder (PTSD) has garnered recent attention because of the significant distress and functional impairment associated with the symptoms as well as the increased risk of progression to full PTSD. However, the clinical presentation of subthreshold PTSD can vary widely and therefore is not clearly defined, nor is there an evidence-based treatment approach. Thus, we aim to further the understanding of subthreshold PTSD symptoms by reporting the use of a virtual combat environment in eliciting distinctive psychophysiological responses associated with PTSD symptoms in a sample of subthreshold recently deployed US service members.Heart rate, skin conductance, electromyography (startle), respiratory rate, and blood pressure were monitored during three unique combat-related virtual reality scenarios as a novel procedure to assess subthreshold symptoms in a sample of 78 service members. The Clinician-Administered PTSD Scale was administered, and linear regression analyses were used to investigate the relationship between symptom clusters and physiological variables.Among the range of psychophysiological measures that were studied, regression analysis revealed heart rate as most strongly associated with Clinician-Administered PTSD Scale-based measures hyperarousal (R = 0.11, p = .035,) reexperiencing (R = 0.24, p = .001), and global PTSD symptoms (R = 0.17, p = .003).Our findings support the use of a virtual reality environment in eliciting physiological responses associated with subthreshold PTSD symptoms.",0 +https://doi.org/10.1186/1471-244x-12-175,What are the risk factors for the comorbidity of posttraumatic stress disorder and depression in a war-affected population? a cross-sectional community study in South Sudan,"BackgroundLimited data exists on the association of war trauma with comorbid posttraumatic stress disorder (PTSD)-depression in the general population of low-income countries. The present study aimed to evaluate socioeconomic and trauma-related risk factors associated with PTSD, depression, and PTSD-depression comorbidity in the population of Greater Bahr el Ghazal States, South Sudan.MethodsIn this cross-sectional community study (n=1200) we applied the Harvard Trauma Questionnaire (HTQ) and MINI International Neuropsychiatric Interview (MINI) to investigate the prevalence of PTSD, depression, and PTSD-depression comorbidity. Multinomial logistic regression analyses were conducted to examine the association between these disorders, previous trauma exposure, sociodemographic, and socioeconomic factors.ResultsPTSD only was found in 331 (28%) and depression only in 75 (6.4%) of the study population. One hundred and twelve (9.5%) of the participants had PTSD-depression comorbid diagnosis. Exposure to traumatic events and socioeconomic disadvantage were significantly associated with having PTSD or PTSD-depression comorbidity but not with depression. Participants with a comorbid condition were more likely to be socioeconomic disadvantaged, have experienced more traumatic events, and showed higher level of psychological distress than participants with PTSD or depression alone.ConclusionsIn individuals exposed to war trauma, attention should be given to those who may fulfill criteria for a diagnosis of both PTSD and depression.",0 +https://doi.org/10.1037/0022-006x.76.1.39,Posttraumatic stress symptoms mediate the relation between childhood sexual abuse and nonsuicidal self-injury.,"Prior research consistently has shown a strong relation between childhood abuse and nonsuicidal self-injury (NSSI), yet it is unclear why this relation exists. The authors examined 2 specific posttraumatic stress disorder (PTSD) symptom clusters as potential mechanisms through which childhood abuse may be related to NSSI. Participants were 86 adolescents (78% female, 22% male; 73% Caucasian, 27% other races/ethnicities; mean age = 17.03 years, range = 12-19 years) who completed measures of childhood abuse, Diagnostic and Statistical Manual of Mental Disorders (4th ed.) PTSD symptoms, and NSSI. Analyses revealed a significant relation between childhood sexual abuse in particular and the presence and frequency of NSSI. Moreover, data supported a theoretical model in which PTSD reexperiencing and avoidance/numbing symptoms independently mediate this relation. Future research must test the temporal relation between childhood sexual abuse, PTSD symptoms, and NSSI and identify additional pathways to engagement in NSSI.",0 +https://doi.org/10.1037/0893-164x.13.2.98,A clinical profile of women with posttraumatic stress disorder and substance dependence.,"To assess the clinical characteristics of women with posttraumatic stress disorder (PTSD) and substance dependence, 28 women with both disorders were compared with 29 women with PTSD alone on a wide battery of lifetime and current clinical measures. The dual-diagnosis women consistently had a more severe clinical profile, including worse life conditions (e.g., physical appearance, opportunities in life), both as children and as adults; greater criminal behavior; a higher number of lifetime suicide attempts; a greater number having a sibling with a drug problem; and fewer outpatient psychiatric treatments. One discrepant finding, however, was their lower rate of major depression. Interestingly, the 2 groups did not differ in number or type of lifetime traumas, PTSD onset or severity, family history of substance use; coping style, functioning level, psychiatric symptoms, or sociodemographic characteristics. Treatment implications and methodological limitations are discussed.",0 +https://doi.org/10.4088/jcp.13m08466,Latent Class Analysis of Personality Disorders in Adults With Posttraumatic Stress Disorder,"Article AbstractObjective: To characterize predominant typologies of co-occurring personality disorders among adults with posttraumatic stress disorder (PTSD) and examine their relation to Axis I comorbidities, health-related quality of life, and course and treatment of PTSD. Method: Latent class analysis was conducted on the 10 DSM-IV personality disorders in a nationally representative sample of 2,463 adults with a lifetime diagnosis of PTSD from Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Results: Three latent classes of personality disorders were identified: a borderline-dysregulated class (11.4%), an obsessive-paranoid class (13.1%), and a no/low personality disorders class (75.5%). The borderline-dysregulated and obsessive-paranoid classes were more likely than the no/low personality disorder class to have a broad range of comorbid Axis I diagnoses and to have ever attempted suicide (ORs = 1.50-8.01), and they reported lower mental health-related quality of life. The borderline-dysregulated class was less likely than the no/low personality disorder class to have experienced remission of their most recent episode of PTSD (OR = 0.54; 95% CI, 0.38-0.75) and was more likely to have been prescribed medication for PTSD (OR = 1.65; 95% CI, 1.20-2.28) and to have used alcohol and drugs to mitigate their PTSD symptoms (OR = 2.77; 95% CI, 1.62-4.74). The obsessive-paranoid class was more likely than the no/low personality disorders class to report sexual assault as their worst trauma (OR = 2.22; 95% CI, 1.36-3.61) and had an earlier age at onset of PTSD symptoms compared to the other 2 classes. Conclusions: Among US adults with PTSD, the 10 DSM-IV personality disorders can be classified into 3 ""person-based"" typologies, which are differentially associated with comorbid Axis I disorders, mental health-related quality of life, and clinical and treatment characteristics of this disorder. These results suggest that comprehensive assessment of personality disorders may help inform etiologic models and treatment approaches for PTSD. J Clin Psychiatry © Copyright 2013 Physicians Postgraduate Press, Inc. Submitted: March 12, 2013; accepted July 15, 2013. Online ahead of print: December 10, 2013 (doi:10.4088/JCP.13m08466). Corresponding author: Jack Tsai, VA Connecticut Healthcare System, 950 Campbell Ave, 151D, West Haven, CT 06516 (Jack.Tsai@yale.edu).",0 +https://doi.org/10.1080/09540120902893258,"Stressful or traumatic life events, post-traumatic stress disorder (PTSD) symptoms, and HIV sexual risk taking among men who have sex with men","The present study assessed the presence of post-traumatic stress disorder (PTSD) symptoms in response to stressful or traumatic life events and their impact on HIV risk behaviors and associated psychosocial variables among men who have sex with men (MSM). Participants (n=189; 60% HIV-infected) who were recruited by notices posted in a community health clinic and via a modified respondent-driven sampling technique completed a behavioral assessment survey. Sixty percentage of participants screened positive for having PTSD symptoms using the startle, physiological arousal, anger, and numbness screening instrument. After controlling for race, sexual self-identification, and HIV status, multivariable logistic regression analyses revealed that screening in for having PTSD symptoms was significantly associated with having engaged in unprotected anal (insertive or receptive) sex in the past 12 months, over and above any effects of whether or not a traumatic/stressful event occurred during the year (adjusted odds ratio [OR] = 2.72; p<0.02; 95% confidence interval [CI] = 1.19-6.20). In addition, MSM with PTSD symptoms were more likely to have clinically significant depressive symptoms (adjusted OR = 3.50; p<0.001) and/or symptoms of social anxiety (adjusted OR = 2.87; p<0.01; 95% CI = 1.48-5.62). The current study, in the context of other research documenting the high rates of co-occurring psychosocial issues facing MSM, points to the importance of incorporating coping with these issues in HIV and sexually transmitted disease prevention and care interventions.",0 +,The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection.,"A 36-item short-form (SF-36) was constructed to survey health status in the Medical Outcomes Study. The SF-36 was designed for use in clinical practice and research, health policy evaluations, and general population surveys. The SF-36 includes one multi-item scale that assesses eight health concepts: 1) limitations in physical activities because of health problems; 2) limitations in social activities because of physical or emotional problems; 3) limitations in usual role activities because of physical health problems; 4) bodily pain; 5) general mental health (psychological distress and well-being); 6) limitations in usual role activities because of emotional problems; 7) vitality (energy and fatigue); and 8) general health perceptions. The survey was constructed for self-administration by persons 14 years of age and older, and for administration by a trained interviewer in person or by telephone. The history of the development of the SF-36, the origin of specific items, and the logic underlying their selection are summarized. The content and features of the SF-36 are compared with the 20-item Medical Outcomes Study short-form.",0 +https://doi.org/10.1007/978-3-642-16638-9_46,Interactive Stories for Health Interventions,"In recent years, there has been an increasing interest in exploring virtual environments and computer aided interactive stories as tools in developing health promotion and disease prevention interventions. Applications have been developed to address a range of health related conditions, including stress [1], risky behaviors [2] and post-traumatic stress disorder(PTSD) [3].",0 +https://doi.org/10.1176/appi.ajp.2009.09050617,The Psychiatric Sequelae of Traumatic Injury,"Traumatic injury affects millions of people each year. There is little understanding of the extent of psychiatric illness that develops after traumatic injury or of the impact of mild traumatic brain injury (TBI) on psychiatric illness. The authors sought to determine the range of new psychiatric disorders occurring after traumatic injury and the influence of mild TBI on psychiatric status.In this prospective cohort study, patients were drawn from recent admissions to four major trauma hospitals across Australia. A total of 1,084 traumatically injured patients were initially assessed during hospital admission and followed up 3 months (N=932, 86%) and 12 months (N=817, 75%) after injury. Lifetime psychiatric diagnoses were assessed in hospital. The prevalence of psychiatric disorders, levels of quality of life, and mental health service use were assessed at the follow-ups. The main outcome measures were 3- and 12-month prevalence of axis I psychiatric disorders, levels of quality of life, and mental health service use and lifetime axis I psychiatric disorders.Twelve months after injury, 31% of patients reported a psychiatric disorder, and 22% developed a psychiatric disorder that they had never experienced before. The most common new psychiatric disorders were depression (9%), generalized anxiety disorder (9%), posttraumatic stress disorder (6%), and agoraphobia (6%). Patients were more likely to develop posttraumatic stress disorder (odds ratio=1.92, 95% CI=1.08-3.40), panic disorder (odds ratio=2.01, 95% CI=1.03-4.14), social phobia (odds ratio=2.07, 95% CI=1.03-4.16), and agoraphobia (odds ratio=1.94, 95% CI=1.11-3.39) if they had sustained a mild TBI. Functional impairment, rather than mild TBI, was associated with psychiatric illness.A significant range of psychiatric disorders occur after traumatic injury. The identification and treatment of a range of psychiatric disorders are important for optimal adaptation after traumatic injury.",0 +https://doi.org/10.1037/a0020590,Psychometric properties of the Posttraumatic Stress Checklist among young African-American men and women.,"Research has demonstrated the validity and reliability of the Posttraumatic Stress Checklist (PCL) in predominantly Caucasian samples. However, there has not been a study that examined the psychometric properties of the PCL specifically for African Americans. The present paper is an examination of the factor structure, internal stability, reliability, and predictive validity of the PCL among a sample of young African American men and women. Confirmatory factor analysis indicated better support for a two-factor model than for a three-factor model reflecting the three diagnostic symptom clusters of posttraumatic stress disorder. High internal consistency and marginal test-retest reliability were observed. The positive predictive power of the PCL in the present study was far lower than that observed in previous studies; several potential explanations for this finding are discussed. © 2011 American Psychological Association.",0 +https://doi.org/10.1007/s10926-015-9598-x,Psychosocial Adaptation to Disability Within the Context of Positive Psychology: Findings from the Literature,"Purpose This purpose of this article is to review of the trends of research that examined positive psychology constructs in the context of adapting to chronic illness and disability (CID). This article examines the empirical findings on the relationships between six selected positive psychology-associated constructs (optimism, hope, resilience, benefit-finding, meaning-making, and post-traumatic growth) and adaptation to disability. Methods Six positive psychology constructs were selected to represent the trends found in recent literature published on CID. The process of choosing these six variables included reviewing chapters on positive psychology and CID, reviewing the top rehabilitation journals that typically publish articles on psychosocial adaptation to CID, using search engines to find relevant journal articles published since the year 2000, and selecting the most important constructs based on the authors’ professional judgment. Conclusion The available evidence supports the unique benefits of these six positive psychology constructs in predicting successful adaptation to a range of disabling conditions. Based on the available findings, the authors offer four suggestions for occupational rehabilitation researchers. © 2015, Springer Science+Business Media New York (outside the USA).",0 +https://doi.org/10.1177/1039856213486309,Unconscious relational traumatic memory and its relevance to ‘everyday’ clinical psychiatry,"Objective: The aim of this paper is to demonstrate the relevance of the concept of unconscious relational traumatic memory to ‘everyday’ clinical psychiatry. Method: One clinical vignette and concepts from the Conversational Model of Psychotherapy are used to consider the potential relevance of this type of memory. Conclusions: The influence of modern classification systems and the dominance of the paradigm of ‘biological psychiatry’ over the last 30 years have together led to an emphasis on diagnosis and treatment by symptom cluster. This perspective may overlook both the patient’s current psycho-social context and their personal history. An understanding of unconscious relational traumatic memory may assist in both the conceptualisation and the treatment of many patients, particularly those adults who have been abused in childhood, where the link between the early experiences and the late manifestations are frequently lost.",0 +https://doi.org/10.1016/j.eurpsy.2011.10.005,Characteristics Associated With Use of Homeopathic Drugs for Psychiatric Symptoms in the General Population,"Abstract Objective To explore which patient characteristics are associated in naturalistic conditions with the lifetime use of homeopathic treatment for psychiatric symptoms. Method Lifetime use of psychotropic treatment was explored in a sample of 36,785 persons, participating in the Mental Health Survey in the General Population. Characteristics associated with use of homeopathic treatments, associated or not with conventional psychotropic drugs, were explored using multivariate analyses. Results Use of homeopathic treatment for psychiatric symptoms was reported by 1.3% of persons. Younger age, female gender and high educational level were associated with use of homeopathy. Half of homeopathy users presented at least one Mini International Neuropsychiatric Interview (MINI) diagnosis, most frequently anxiety disorders. Their diagnostic profile was similar to that of persons reporting use of anxiolytics or hypnotics. Compared to persons with no lifetime use of psychotropic drugs, persons using homeopathy were more likely to present with a diagnosis of mood disorder or anxiety disorder. Compared to those using conventional psychotropic drugs, they presented less frequently with psychiatric disorders, with the exception of anxiety disorders. Conclusion Homeopathic treatment for psychiatric symptoms appears to be used mainly to reduce anxiety symptoms in the general population.",0 +https://doi.org/10.3390/ijerph120505090,"Prevalence of Mental Disorders in 6–16-Year-Old Students in Sichuan Province, China","To investigate the point prevalence of mental disorders in school students, multistage cluster stratified random sampling and two-phase survey methods were used to identify 40 primary and middle schools. The students were screened using the Chinese version of the Child Behavior Checklist and diagnosed using the Mini International Neuropsychiatric Interview. The prevalence of behavioral problems was 19.13%. The prevalence of behavioral problems significantly differed by sex, age, city of residence, and caretaker. The six-month prevalence of any mental disorder was 15.24% (95% CI: 15.49%-16.97%). Psychiatric disorders were more prevalent in boys (17.33%) relative to girls (13.11%; p < 0.01). The prevalence of mental disorders significantly differed by community and caretaker, and 36.46% of students exhibited comorbidity. Results demonstrated important mental health issues, with a high incidence of comorbidities, in this population. Students' mental health requires increased attention, particularly in poverty-stricken areas and left-behind children and adolescents.",0 +https://doi.org/10.1002/da.22372,BELONGING PROTECTS AGAINST POSTDEPLOYMENT DEPRESSION IN MILITARY PERSONNEL,"Depression among U.S. military personnel has received relatively little empirical attention compared to posttraumatic stress disorder, despite evidence that depression is associated with poor psychosocial outcomes and increased suicide risk. Even less is known about factors that protect against depression in military populations.A sample of 168 active duty Air Force convoy operators completed self-report measures of depression, posttraumatic stress, and sense of ""belonging"" before deploying to Iraq, and again at 1, 3, 6, and 12 months following their return. Linear growth modeling was used to test the associations of the variables over time.Mean depression scores remained low and stable across the deployment and 12-month follow-up period. Increased depression severity was significantly associated with low belonging (P < .001) and with posttraumatic stress symptoms (P < .001) at every time point.Relatively small, predominantly male sample utilizing self-report methods.A sense of belongingness may protect service members from depression at all stages of the deployment cycle, from predeployment preparations through deployment and postdeployment adjustment.",0 +https://doi.org/10.1097/00006842-197905000-00004,Impact of Event Scale: A Measure of Subjective Stress,"Clinical, field, and experimental studies of response to potentially stressful life events give concordant findings: there is a general human tendency to undergo episodes of intrusive thinking and periods of avoidance. A scale of current subjective distress, related to a specific event, was based on a list of items composed of commonly reported experiences of intrusion and avoidance. Responses of 66 persons admitted to an outpatient clinic for the treatment of stress response syndromes indicated that the scale had a useful degree of significance and homogeneity. Empirical clusters supported the concept of subscores for intrusions and avoidance responses.",0 +https://doi.org/10.1023/a:1014335312219,Children exposed to warfare: A longitudinal study,"Following the 1991 Gulf War a group of 94 children in Iraq were interviewed at 6 months, 1 year, and 2 years after the war. The group was exposed to the bombing of a shelter where more than 750 were killed. Selected items from different inventories, including the Impact of Event Scale (IES) assessed children's reactions. Results reveal that children continue to experience sadness and remain afraid of losing their family. Although there was no significant decline in intrusive and avoidance reactions as measured by the IES from 6 months to 1 year following the war, reactions were reduced 2 years after the war. However, the scores were still high, indicating that symptoms persist, with somewhat diminished intensity over time.",0 +https://doi.org/10.1037/a0030647,“Dissociation in posttraumatic stress disorder part II: How theoretical models fit the empirical evidence and recommendations for modifying the diagnostic criteria for PTSD”: Correction to Dalenberg and Carlson (2012).,"Reports an error in ""Dissociation in Posttraumatic Stress Disorder Part II: How Theoretical Models Fit the Empirical Evidence and Recommendations for Modifying the Diagnostic Criteria for PTSD"" by Constance Dalenberg and Eve B. Carlson (Psychological Trauma: Theory, Research, Practice, and Policy, Advanced Online Publication, May 14, 2012, np). There was an error in the section, ""Models 5 and 5a: The Component and Subtype Models."" The paragraph that began, ""Taxometric studies of dissociation in PTSD are also relevant to the Subtype model . . ."" has been replaced with a paragraph that begins, ""One taxometric study of dissociation in PTSD is also relevant to the Subtype model . . ."" (The following abstract of the original article appeared in record 2012-12663-001.) The purpose of this article is to examine how closely six theoretical models fit the empirical evidence reviewed in Part 1 on the relationship between trauma and dissociation and to apply the resulting conclusions to make recommendations about diagnostic criteria for PTSD. We describe six models for the relationships among traumatic stress, dissociation, and PTSD, including models for fantasy-proneness, mediation, comorbidity, interactional comorbidity, component, and subtype. The research reviewed strongly supports component and subtype models of the relationship between dissociation and PTSD, and recommendations are made for including dissociative symptoms in the diagnostic criteria for PTSD in ICD-11 and DSM-5 and adding either a dissociative subtype or a complex PTSD diagnosis in both diagnostic systems. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1080/15504260802620293,Co-morbid Post-traumatic Stress Disorder and Opioid Dependence Syndrome,"Post-traumatic stress disorder (PTSD) is common among patients with opioid dependence syndrome. The aim of this study was to find the prevalence of PTSD in patients with opioid dependence and to examine the relationship of PTSD with the severity of dependence on opioids in patients attending an outpatient clinic for drug treatment services. An interview using the Maudsley Addiction Profile, the Severity of Dependence Scale, the Impact of Events Scale, and ICD-10 clinical criteria was conducted in a large urban center for addiction treatment in the central United Kingdom. Seventy patients with opioid dependence syndrome were interviewed. On interview, 30% of the patients met ICD-10 criteria for PTSD. Clinically significant levels of intrusive (45.7%) and avoidant (65.7%) symptoms were reported. Participants with PTSD reported higher perceived rate of childhood threat to life including sexual abuse, physical abuse, and witnessing physical fights between parents. In adulthood, the main traumatic events were ...",0 +https://doi.org/10.1177/1066480713488530,Grief Counseling and Crisis Intervention in Hospital Trauma Units,"The demand for family counselors implementing crisis intervention and grief counseling in hospital trauma units continues to increase. Thus, this article provides a review of the nature of family counselors working with individuals and families affected by traumatic brain injury (TBI) and medical trauma in hospitals. Specifically, the article presents (a) unique aspects of crisis intervention and grief services provided in hospital trauma units, (b) effective rapport building strategies for family counselors working with families in crisis from TBI, (c) multidisciplinary collaboration in hospitals, (d) diagnostic approaches and common mental health disorders following TBI, (e) ethical issues working in hospitals, (f) family-focused grief therapy and stages of grief interventions, and (g) implications with a case example of a family counselor working with a family affected by TBI.",0 +https://doi.org/10.1521/bumc.2011.75.4.295,"Suicide-nearness assessed with PORT, the Percept-genetic Object-Relation Test: A replication and a reliability study","To determine the reliability and validity of a previously identified ""suicide cluster"" in the Percept-genetic Object-Relation Test (PORT), which test documents subliminal perception of object-relation pictures, 20 suicide attempters and 70 controls were investigated. The correspondence between scores assigned by two judges was 95%-100%. The suicide-cluster signs in PORT, notably ""lack of attachment relationships"" and ""Motor activity,"" were significant. Differences between the results of this and the previous study are discussed as is the role of psychiatric disorder in suicide.",0 +https://doi.org/10.1037/a0035303,Validation of the five-factor model of PTSD symptom structure among delinquent youth.,"This study compared the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM–IV–TR; American Psychiatric Association, 2000) diagnostic 3-factor structure of posttraumatic stress disorder (PTSD) symptoms with leading 4-factor models and the newly proposed 5-factor dysphoric arousal model in a sample of 1,363 juvenile-justice-involved adolescents (990 boys, 373 girls). Structural equation modeling suggested that the 5-factor dysphoric arousal model fit significantly better than each of the other models. The model fit better for girls than for boys, and girls evidenced stronger factor loadings for items on all but the Anxious Arousal factor. The factors of the 5-factor model were then tested as mediators of the association between interpersonal and noninterpersonal trauma and mental health problems. Interpersonal trauma was associated with PTSD symptoms for boys and girls, whereas noninterpersonal trauma exposure was only associated with PTSD symptoms for boys, despite equal levels of exposure across genders, suggesting that girls may be more sensitive to the effects of interpersonal, but not noninterpersonal, trauma. Patterns in mediation were moderated by gender, as girls’ data showed stronger paths leading to depression/anxiety, somatic complaints, and suicidal ideation through PTSD symptoms, whereas for boys, paths were stronger leading to anger/irritability symptoms. Mediation results suggested differential patterns of influence for dysphoric versus anxious arousal and also indicate the importance of numbing for delinquent youth. These results add to the evidence base supporting the 5-factor dysphoric arousal model in establishing developmentally sensitive criteria for the diagnosis of PTSD among traumatized youth.",0 +https://doi.org/10.1002/cpp.441,A test of the assumptions of the transtheoretical model in a post-traumatic stress disorder population,"Prior reports suggest an ambivalence regarding treatment in individuals with Post-Traumatic Stress Disorder (PTSD). A model that accommodates such ambivalence is the Transtheoretical Model of Behavior Change (TTM, also known as the Stages-of-Change Model). Fifty veterans presenting for treatment completed self-report measures (94% response rate) that assessed disorder variables and constructs relating to the TTM. While the relationships between the components of each specific construct were found to be consistent with the findings of other studies and a number of predicted relationships between variables were confirmed, many results were inconsistent with the TTM. Notwithstanding questions about the suitability of the self-report measures, the unique characteristics of the veteran sample and the small sample size, the results suggest that the assumptions of the TTM were not met in veterans with PTSD. Copyright © 2005 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1111/j.1526-4637.2006.00185.x,Localization of Pain and Self-Reported Rape in a Female Community Sample,"Studies suggest that rape increases risk of medically unexplained pain in women. At present it is not clear whether rape is associated with pain at specific locations or at multiple locations. In this study we tested the hypothesis that rape was associated with a preferential increase in risk of pelvic pain that was not explained by pain at other sites.We relied on an existing community study that oversampled women with fibromyalgia and major depression. Localization was assessed by asking about pain at four sites: pelvic region; jaw/face; headache; and lower back. Three groups were identified using a structured telephone interview: Abuse Only (sexual/physical abuse excluding rape); Rape+Abuse (rape in addition to other sexual/physical abuse); and No Abuse.Compared with the No Abuse group, the Rape+Abuse group was eight times more likely to have pelvic pain and 3.7 times more likely to have jaw/face pain after we controlled for the effect of widespread pain. Rape was not associated with lower back pain or headache. The Abuse Only group did not show a preferential increase in risk of pain at any of the four locations that were assessed. After controlling for pain at other locations, we found that the Rape + Abuse group was 10 times more likely to report pelvic pain than the No Abuse group (P<0.005).In accord with the localization hypothesis, self-reported rape was uniquely associated with pelvic pain. Future efforts to account for pain in the aftermath of rape must specify a mechanism that can simultaneously cause widespread pain as well as increase risk of localized pain.",0 +https://doi.org/10.1037/a0034889,Diagnostic accuracy of the Posttraumatic Stress Disorder Checklist–Civilian Version in a representative military sample.,"This study aimed to assess the diagnostic accuracy of the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C; Weathers, Litz, Herman, Huska, & Keane, 1993) and to establish the most accurate cutoff for prevalence estimation of posttraumatic stress disorder (PTSD) in a representative military sample compared to a clinical interview. Danish soldiers (N = 415; 94.4% male, mean age 26.6 years) were assessed with the PCL-C and the Structured Clinical Interview for the DSM-IV (SCID; First, Spitzer, Gibbon, & Williams, 2002) 2.5 years after their return from deployment to Afghanistan. Diagnostic accuracy of the PCL-C was assessed through receiver operating characteristic curve analysis. The PCL-C displayed high overall accuracy (area under the curve = .95, confidence interval [.92, .98]) and performed well (sensitivity > .70 and specificity ≥ .90), with cutoff scores ranging from 37 to 44. When including sensitivity values a little below .70 (.69), the PCL-C performed well for cutoff levels up to 53. Prevalence of PTSD varied considerably with the application of different cutoff values and scoring methods. Our results show that the PCL-C is a relevant and valid tool for screening for probable PTSD in active military samples. However, it is of great importance that cutoff scores be chosen based on the sample and the purpose of the particular study or screening.",0 +https://doi.org/10.1177/153476560300900203,A college community's vicarious stress reaction to September 11th terrorism.,"This study examined the effects of vicarious exposure to the September 11 terrorist attacks in an academic community, just after the three-month period that delineates acute from chronic post-traumatic stress. An entire academic community of 1693 students, faculty, and staff was surveyed electronically regarding their perceived stress symptoms and coping behaviors. The survey yielded a 37 percent response rate. About 76 percent showed one or more substantial symptoms of stress, and 32 percent showed three or more. The most prominent symptom clusters involved persistent avoidance and persistent arousal. Respondents primarily relied on coping through optimism, reassessing priorities and relationships, giving and receiving support, and becoming better informed on terrorism-related topics. Differences in symptoms and coping preferences were found based on sex, group (student, faculty, staff), and exposure to previous crisis. This study indicates that despite time and distance from the site of the terrorism, all segments of a college community continue to experience some degree of distress. Such distress can interfere with academic performance, personal health, and relationship stability. Rather than rely on formal support service delivery, most appear to rely on established interpersonal relationships. This suggests that providing support to vicarious victims in the future might emphasize training for friends and family, rather than relying on established service delivery systems. Language: en",0 +https://doi.org/10.1080/15434610500406376,Physical Health Symptoms in Peacekeepers: Has the Role of Deployment Stress Been Overrated?,"Using a prospective design, physical health symptoms were examined in a sample of 198 peacekeepers. At pre-deployment, general life stressors and pre-deployment stress symptoms were significant predictors of physical health symptoms. At post-deployment, physical health symptoms were predicted by pre-existing physical health symptoms and stress symptoms reported before and after the mission; mission-related stressors were not associated with physical health symptoms. In addition, stress symptoms mediated the relationship between exposure and physical symptoms. Finally, the hyperarousal symptom cluster was a better predictor of physical health complaints than the other symptom clusters. Implications and limitations are discussed.",0 +https://doi.org/10.1177/1534765612457220,Exploring combat-related loss and behavioral health among OEF/OIF veterans with chronic PTSD and mTBI.,"While combat-related loss is likely to result in the development of lingering stress responses, little is known about its impact on behavioral health. The purpose of this study was to present preliminary results on war-related losses and behavioral health among Operations Enduring Freedom/Iraqi Freedomveterans. Veterans who suffered losses, to include noncombat losses (relationships back home) that occurred while the combatant was in the combat theater, reported more stress, depressive symptoms, and combat experiences. Outcomes were worse for veterans reporting two losses. Most notable was the decline in social support as losses increased. Also of note, avoidance and arousal symptom clusters were the most endorsed. While the pattern was more pronounced for those experiencing loss, results were consistent regardless of number of losses. Language: en",0 +https://doi.org/10.1080/07448481.2015.1057145,Typologies of Childhood Exposure to Violence: Associations With College Student Mental Health,"This study examined typologies of childhood violence exposure (CVE) and the associations of profiles with current demographic characteristics and mental health in emerging adulthood.The study evaluated a sample of college students from 2 US geographic regions (Midwest, n = 195; Southeast, n = 200).An online questionnaire (collected 2013-2014) assessed CVE and current mental health. Latent class analysis was used to identify typologies of CVE. Follow-up analyses were conducted to distinguish differences between typologies in demographic characteristics and mental health.Four distinct profiles emerged: High-Exposed, Domestic-Exposed, Community-Exposed, and Low-Exposed. High- and Domestic-Exposed groups were more likely to be first-generation college students and to experience symptoms of psychopathology.This study offers a unique presentation of CVE profiles and a nuanced interpretation of their differential relationship to current demographic characteristics and mental health. It may befit university mental health initiatives to engage first-generation students and utilize comprehensive assessments of previous victimization.",0 +,Post-traumatic stress disorder symptomatology among American Indian Vietnam veterans : mediators and moderators of the stress-illness relationship,"Results from the National Vietnam Veterans Readjustment Study (NVSRS) reported high rates of Post-traumatic Stress Disorder (PTSD) among Vietnam Theater veterans compared to rates in the Vietnam Era and others of the veterans' generation. Prevalence rates were even higher among minority groups, specifically Blacks and Hispanics. Results from the American Indian Vietnam Veterans Project (AIVVP) suggested that American Indian Vietnam veterans were also at increased risk for PTSD. However, not all American Indian veterans with high levels of trauma exposure developed PTSD, which suggests that other contributing factors specific to American Indian populations may also affect their vulnerability to PTSD outcomes. The objective of this study was to identify potential predictors of PTSD symptomatology across three military timeframes and to examine the relationships among personal resources, trauma, and PTSD symptomatology in American Indian Vietnam veterans. It was hypothesized that high levels of social support and ethnic identity may enhance one's psychosocial resilience to stress, resulting in positive health outcomes. This study was based on AIVVP data collected by the National Center for American Indian and Alaska Native Mental Health Research (NCAIANMHR) at the University of Colorado Health Sciences Center. Interviews with 621 American Indian Vietnam veterans living on or near their reservations assessed predisposing factors, characteristics of military service, military and nonmilitary trauma, personal resources, and PTSD symptomatology. The results of hierarchical linear regression analyses showed a strong relationship between social support and PTSD symptomatology across all time flames. Although results did not support the stress-buffering hypothesis, combat trauma and social support during the military interacted significantly. In addition, post-military social support appeared to mediate the relationship between trauma and PTSD symptomatology. Identifying a relationship between social support and PTSD has implications for the development of interventions used to treat PTSD in ethnic minorities. The impact of personal resources on PTSD symptomatology may be important for traumatic survivors and long-term strategies for victims of PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1176/ajp.154.12.1690,Posttraumatic Stress Disorder and Functioning and Quality of Life Outcomes in a Nationally Representative Sample of Male Vietnam Veterans,"Although posttraumatic stress disorder (PTSD) is a highly prevalent and often chronic condition, the relationship between PTSD and functioning and quality of life remains incompletely understood.The authors undertook an archival analysis of data from the National Vietnam Veterans Readjustment Study. The study subjects consisted of the nationally representative sample of male Vietnam veterans who participated in the National Vietnam Veterans Readjustment Study. The authors estimated PTSD at the time of the interview with the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder. They examined the following outcomes: diminished well-being, physical limitations, bed day in the past 2 weeks, compromised physical health status, currently not working, and perpetration of violence. Logistic models were used to determine the association between PTSD and outcome; adjustment was made for demographic characteristics and comorbid psychiatric and other medical conditions.The risks of poorer outcome were significantly higher in subjects with PTSD than in subjects without PTSD in five of the six domains. For the outcome domains of physical limitations, not working, compromised physical health, and diminished well-being, these significantly higher risks persisted even in the most conservative logistic models that removed the shared effects of comorbid psychiatric and other medical disorders.The suffering associated with combat related-PTSD extends beyond the signs and symptoms of the disorder to broader areas of functional and social morbidity. The significantly higher risk of impaired functioning and diminished quality of life uniquely attributable to PTSD suggests that PTSD may well be the core problem in this group of difficult to treat and multiply afflicted patients.",0 +https://doi.org/10.4324/9780203852927,Protecting Children from Violence,"Providing an evidence-based understanding of the causes and consequences of violence against children, experts in the field examine the best practices used to help protect children from violence. Various types of violence are reviewed including physical and sexual abuse, (cyber-)bullying, human trafficking, online predators, abductions, and war. In addition, it reviews the various perpetrators of such violence including parents and relatives, strangers, other children, and societal institutions. The possible outcomes of such violence including physical injuries, death, depression, anxiety, post-traumatic stress disorders, and damage to the social fabric of the local community are also explored. To enhance accessibility, each contributor addresses common themes: • Opening case studies dramatically illustrate the human cost of abuse and neglect • Empirically driven estimates of the scope of problem to better understand who is at risk and why • Empirically driven testing of interventions to maximize effectiveness of programs • How current research compares to public perception and the impact on public policy • The worldwide problem of violence against children • Evidence-based recommendations for reducing violence against children. The book opens with a review of the history of the problem, the methodological approaches used to study it, and current –best practice— prevention strategies. The methods used to identify peer victims are then explored. Next child eyewitness memory is examined including the most effective techniques for maximizing the retrieval of information. This is followed by the research on missing and abducted children including the effectiveness of recovery programs such as supermarket campaigns and forensic age profiles. Next how the Internet is used in the victimization of children is explored including tips to help protect children online. Public attitudes toward sex offender registration laws are then reviewed followed by vulnerabilities that include genetic, neuropsychological, temperamental, cognitive, perceptual and social factors. International perspectives on protecting children from violence and global health inequities are then addressed. The book concludes with recommendations for future research. Contributors are noted scholars from a broad range of disciplines. As such, the book appeals to researchers and advanced students in developmental, counseling, clinical, cognitive, evolutionary, and social psychology, as well as sociology, social work, criminal justice, education, and law enforcement. © 2010 by Psychology Press. All rights reserved.",0 +https://doi.org/10.1016/j.psychres.2014.03.038,Somatic symptoms and health-related quality of life among treatment-seeking Canadian Forces personnel with PTSD,"This study examined the association between somatic complaints and health-related quality of life (HR-QoL) in treatment-seeking Canadian military personnel with military-related Posttraumatic Stress Disorder (PTSD). Current and former Canadian Forces (CF) members attending the Parkwood Hospital Operational Stress Injury Clinic in London, Ontario (N=291) were administered self-report questionnaires assessing number and severity of somatic complaints, PTSD and depressive symptom severity, and mental and physical health-related quality of life (HR-QoL) prior to commencing treatment. Regression analyses were used to identify the role of somatic complaints on physical and mental HR-QoL, after controlling for PTSD symptom cluster and depressive symptom severity. Somatic symptom severity accounted for only a small amount of the variance in mental HR-QoL after accounting for PTSD symptom cluster and depressive symptom severity, but accounted for a larger proportion of the variance in physical HR-QoL after accounting for PTSD cluster and depressive symptom severity. Understanding the role of somatization in the symptom-presentation of military personnel with PTSD may provide additional avenues for treatment with this population.",0 +https://doi.org/10.1108/dpm-07-2013-0130,Framing disaster resilience,"Purpose – To confront the increasingly devastating impacts of disasters and the challenges that climate change is posing to disaster risk management (DRM) there is an imperative to further develop DRM. The resilience approach is emerging as one way to do this, and in the last decade has been strongly introduced into the policy arena, although it is not new for DRM practitioners and researchers. Nevertheless, resilience is a highly contested issue, and there is no agreed definition of it, which has resulted in confusion for stakeholders when applying it to practice. Therefore, the purpose of this paper is to investigate how resilience is framed by researchers and DRM practitioners. Design/methodology/approach – The analytical framework used was Hajer's “social-interactive discourse theory”, combined with analysis of government documents, in-depth interviews with practitioners and observation of field and practices within the context of the Natural Disaster Resilience Program in Queensland, Australia. Findings – One of the key findings is that the idea of “bouncing back” is central to the resilience discourse but different interpretations of this idea results in real-world implications. Three different ways (storylines) in which practitioners construct the meaning of disaster resilience emerge from this study. Importantly the divergences between these storylines reveal possibilities for reframing to occur and these could lead to different policy options and practices. Originality/value – The results presented in this paper offer empirical evidence on how resilience is understood on the ground, contributing to extending resilience theory and informing DRM and resilience practice.",0 +https://doi.org/10.1016/0885-3924(95)00083-b,"Pain, coping, and adjustment in patients with burns: Preliminary findings from a prospective study","We prospectively examined the associations between procedural pain during hospitalization and coping and adjustment 1 month postdischarge in 43 patients treated at a major regional burn center for burns extensive enough to require at least 5 days of daily wound debridement procedures. Both patients and nurses provided ratings of patient pain, which were summarized and aggregated across a 5-day period. Results indicated that those subjects with higher pain scores also reported poorer adjustment as measured by scores on the Brief Symptoms Inventory and the Sickness Impact Profile. Moreover, these associations remained significant after partialling out the effects of preburn adjustment. Hierarchical regression analyses revealed evidence that seeking social support had a moderating effect on the association between pain and scores on a measure of posttraumatic stress disorder.",0 +https://doi.org/10.1016/j.psyneuen.2008.10.012,No PTSD-related differences in diurnal cortisol profiles of genocide survivors,"Posttraumatic stress disorder (PTSD) has been associated with reduced cortisol levels. Opposing results have been interpreted as resulting from methodological differences between studies. We investigated the diurnal profile of salivary cortisol in a population of highly traumatized adult males from Rwanda with and without PTSD, who spent the whole day of examination together under a maximally standardized schedule. Besides the detection of PTSD-related alterations in cortisol release we aimed at determining physiologically relevant effects of cumulative trauma exposure on HPA functioning in interaction with or independent of diagnosis. There were no differences in the diurnal pattern of cortisol release between subjects with and without PTSD. We observed an increasing prevalence of PTSD with increasing number of different traumatic event types experienced, replicating earlier results on a “building-block effect” of multiple traumatization. However, size of cumulative exposure was not related to any of the cortisol measures. The results suggest that besides methodological constraints also confounding factors not previously controlled for, e.g., sex differences or current life stress, might contribute to the diverging results of lowered, unchanged or enhanced cortisol secretion in PTSD. Future research should therefore closely monitor these possible confounds to optimize models for cortisol in research on stress-dependent illnesses.",0 +https://doi.org/10.1080/09602010244000453,"Post-traumatic stress disorder and traumatic brain injury: A review of causal mechanisms, assessment,and treatment","In this paper we explore the evidence for post-traumatic stress disorder (PTSD) after traumatic brain injury (TBI). We examine its possible mediating mechanisms after brain injury, the evidence for its occurrence, risk, and protective factors, and the implications for intervention and service demands. In the first section we review the current literature relevant to cause, maintenance, and treatment of PTSD in general, before addressing issues associated with the assessment and management of PTSD after TBI. It is argued that PTSD may occur after a brain injury, and can be, relatively, a common disorder. However, explanatory mechanisms for its occurrence may be speculative. In this context, we argue, assessment and treatment need to be carefully considered, and comprehensive.",0 +https://doi.org/10.1080/13548506.2012.726364,"Prevalence of post-traumatic stress symptoms and associated factors in tuberculosis (TB), TB retreatment and/or TB–HIV co-infected primary public health-care patients in three districts in South Africa","High rates of tuberculosis (TB) and TB/HIV co-infection is often linked with mental health issues such as post-traumatic stress disorder (PTSD) symptoms, which is further associated with poor health outcomes. In a country such as South Africa where rates of these infectious diseases are high, it is concerning that there is limited/no data on prevalence rates of mental disorders such as PTSD and its associated factors. Therefore, the aim of this study was to establish the prevalence of PTSD symptoms and associated factors in TB, TB retreatment and/or TB-HIV co-infected primary public health-care patients in three districts in South Africa. Brief screening self-report tools were used to measure: PTSD symptoms, psychological distress (anxiety and depression) and alcohol misuse. Other relevant measures, such as adherence to medication, stressful life events and sexual risk-taking behaviours, were obtained through structured questions. A total of 4900 public primary care adult patients from clinics in high TB burden districts from three provinces in South Africa participated. All the patients screened positive for TB (either new or retreatment cases). The prevalence of PTSD symptoms was 29.6%. Patients who screened positive for PTSD symptoms and psychological distress were more likely to be on antidepressant medication. Factors that predicted PTSD symptoms were poverty, residing in an urban area, psychological distress, suicide attempt, alcohol and/or drug use before sex, unprotected sex, TB-HIV co-infected and the number of other chronic conditions. Health-care systems should be strengthened to improve delivery of mental health care, by focusing on existing programmes and activities, such as those which address the prevention and treatment of TB and HIV.",0 +https://doi.org/10.1371/journal.pone.0047339,The Long-Term Impact of Physical and Emotional Trauma: The Station Nightclub Fire,"Survivors of physical and emotional trauma experience enduring occupational, psychological and quality of life impairments. Examining survivors from a large fire provides a unique opportunity to distinguish the impact of physical and emotional trauma on long-term outcomes. The objective is to detail the multi-dimensional long-term effects of a large fire on its survivor population and assess differences in outcomes between survivors with and without physical injury.This is a survey-based cross-sectional study of survivors of The Station fire on February 20, 2003. The relationships between functional outcomes and physical injury were evaluated with multivariate regression models adjusted for pre-injury characteristics and post-injury outcomes. Outcome measures include quality of life (Burn Specific Health Scale-Brief), employment (time off work), post-traumatic stress symptoms (Impact of Event Scale-Revised) and depression symptoms (Beck Depression Inventory). 104 fire survivors completed the survey; 47% experienced a burn injury. There was a 42% to 72% response rate range. Although depression and quality of life were associated with burn injury in univariate analyses (p<0.05), adjusted analyses showed no significant relationship between burn injury and these outcomes (p = 0.91; p = .51). Post-traumatic stress symptoms were not associated with burn injury in the univariate (p = 0.13) or adjusted analyses (p = 0.79). Time off work was the only outcome in which physical injury remained significant in the multivariate analysis (p = 0.03).Survivors of this large fire experienced significant life disruption, including occupational, psychological and quality of life sequelae. The findings suggest that quality of life, depression and post-traumatic stress outcomes are related to emotional trauma, not physical injury. However, physical injury is correlated with employment outcomes. The long-term impact of this traumatic event underscores the importance of longitudinal and mental health care for trauma survivors, with attention to those with and without physical injuries.",0 +https://doi.org/10.5603/ait.2014.0009,Psychologiczne reakcje członków rodzin chorych leczonych na oddziałach intensywnej terapii,"The environment of the intensive care unit (ICU) is burdensome to a patient and the patient's family. There is a higher risk of depression, anxiety and stress-related disorders in the ICU patients' family members. In relatives of critically ill patients, the cluster of adverse psychological reactions, such as: anxiety, acute stress disorder, posttraumatic stress disorder, depression and complicated grief, is called post-intensive care syndrome - family (PICS-F). These complications may affect the relatives' ability to perform the role of a caregiver and it can also hinder their daily functioning. Apart from negative psychological consequences experienced after a loved one's stay in the ICU, there are also some positive changes observed in patient's relatives called posttraumatic growth. In this review, the psychological repercussions in the ICU patient's family and the means to prevent their undesirable responses are discussed.",0 +https://doi.org/10.1207/s15327752jpa7502_3,Rorschach Correlates of Sexual Abuse: Trauma Content and Aggression Indexes,"This study compared Rorschach records of nondissociative outpatients with histories of (a) definite sexual abuse (n = 22), (b) suspected but unconfirmed sexual abuse (n = 13), or (c) no sexual abuse (n = 43) on selected variables hypothesized to be associated with sexual abuse. As predicted, clients with definite sexual abuse scored significantly higher than clients known not to be sexually abused on Armstrong and Loewenstein's (1990) Trauma Content index (TC/R), with an effect size greater than 1 SD. Contrary to prediction, there was no significant difference in the frequency of their Aggressive Past (AgPast; Gacono & Meloy, 1994) scores. AgPast scores, however, did positively correlate with sexual abuse that was violent or sadistic. As a test of discriminant validity, we hypothesized that 2 Rorschach variables (PER and Sc) would be unrelated to sexual abuse. This was supported by our data. Although TC/R was strongly associated with the presence and severity of sexual abuse, it could not discriminate sexually abused from nonsexually abused clients with great accuracy. The TC/R score is 1 factor among many that can be used to assess the validity of clients' claims of past sexual abuse.",0 +https://doi.org/10.7205/milmed-d-11-00185,Former Combatants in Liberia: The Burden of Possible Traumatic Brain Injury Among Demobilized Combatants,"To provide a better understanding of any associations between Disarmament, Demobilization, and Reintegration, previous head injury, and mental health symptoms among former combatants in Liberia.A cluster-sampled national survey of the adult household-based Liberian population.Former combatants with reported head injury were more likely to experience major depressive disorder symptoms, suicidal ideation and attempts, and current substance abuse. Former combatants with head injury are 2.83 times more likely to have major depressive disorder symptoms, and those with suspected traumatic brain injury are five times more likely to have post-traumatic stress disorder.The poor mental health of former combatants in Liberia, both child and adult, might be mitigated if Disarmament, Demobilization, and Reintegration programming assessed participants for head trauma and traumatic brain injury using simple screening methods. The specific health and mental health needs of ex-combatants--a highly vulnerable group--will need to be addressed by Liberia. If left untreated, ex-combatants with high rates of suicidal ideation and post-traumatic stress disorder might be susceptible to re-recruitment into new conflicts in the region.",0 +https://doi.org/10.1097/yic.0b013e32832d6c18,"Risk of lipid abnormality with haloperidol, olanzapine, quetiapine, and risperidone in a Veterans Affairs population","Second-generation antipsychotics can cause lipid elevations at a greater rate than older typical antipsychotics. This risk may not be equivalent amongst the second-generation antipsychotics. We conducted a computerized, retrospective, nonrandomized, case-control analysis of 6331 patients receiving antipsychotics. For each patient, the first prescription for at least 60 continuous days for four antipsychotics [haloperidol (HALD), olanzapine (OLANZ), quetiapine (QUET), or risperidone (RISP)] was analyzed for total cholesterol, low-density lipoprotein, high-density lipoprotein (HDL), and triglycerides (TGL). Mean HDL was lower during OLANZ treatment than with RISP (P = 0.03) or QUET (P = 0.001). TGL were higher during OLANZ (P = 0.0007) or QUET treatment (P = 0.006) than RISP. In dichotomous analyses, odds ratios on the percentage of participants having abnormal cholesterol (P = 0.0003), low-density lipoprotein (P = 0.001), or TGL (P = 0.0001) during medication were in the order: OLANZ > QUET > RISP > HALD. For HDL, the results were less robust but the percentage of participants were in the order: OLANZ>RISP = HALD = QUET. In treatment-emergent analyses of patients without lipid abnormalities during an unmedicated baseline period, there was a greater risk of developing new HDL abnormality with OLANZ than RISP (P<0.05). In conclusion, treatment with RISP or HALD was associated with a more favorable lipid profile than with OLANZ or QUET.",0 +https://doi.org/10.1002/ajim.22000,Longitudinal mental health impact among police responders to the 9/11 terrorist attack,"Background Among police responders enrolled in the World Trade Center Health Registry (WTCHR), Post-traumatic Stress Disorder (PTSD) was almost twice as prevalent among women as men 2–3 years after the 9/11 attacks. Methods Police participants in the WTCHR Wave 1 survey 2–3 years after 9/11/01, were reassessed for probable PTSD at Wave 2, 5–6 years after 9/11/01, using PCL DSM-IV criteria. Results Police participants in the Wave 2 survey included 2,527 men, 413 women. The prevalence of “Probable PTSD” was 7.8% at Wave 1 and 16.5% at Wave 2. Mean PCL scores increased from 25.1 to 29.9 for men and 28.6 to 32.2 for women. Prevalence of PTSD was higher for women than for men at Wave 1 (χ2 = 10.882, P = 0.002), but not Wave 2 (χ2 = 2.416, P = 0.133). Other risk factors included losing one's job after 9/11 and being disabled. Conclusions Prevalence of probable PTSD among police doubled between 2003–2004 and 2006–2007. After the 2-year time span, the gender difference was no longer significant; prevalence of PTSD symptoms increased and there was a substantial amount of co-morbidity with other mental health problems. Further development of prevention and intervention strategies for police responders with symptoms of PTSD is needed. The observed upward trend in PCL scores over time in police officers with PCL scores less than 44, suggests that PTSD prevention and intervention strategies should be applied to all police affected by the 9/11 attacks, not limited just to those with PTSD symptoms. Am. J. Ind. Med. 55:297–312, 2012. © 2011 Wiley Periodicals, Inc.",0 +https://doi.org/10.1007/bf03379560,Trauma-related Structural Dissociation of the Personality,"Abstract Many traumatized individuals alternate between re-experiencing their trauma and being detached from, or even relatively unaware of the trauma and its effects. At first sight one may be inclined to conceptualize detachment from trauma and re-experiencing of trauma as mental states. However, on closer scrutiny it becomes apparent that in both cases a range or cluster of states rather than a singular state is involved. For example, being detached from trauma does not itself exclude being joyful, ashamed, sexually aroused, or curious at times, and re-experiencing trauma can encompass states such as fleeing, freezing, and being in pain or being analgesic. In this paper we relate detachment from trauma and re-experiencing trauma to emotional operating systems (Panksepp, 1998) and functional systems (Fanselow & Lester, 1988), briefly addressed as action systems. Action systems control a range of functions, but some are more complex than others. Reexperiencing trauma will be associated with the inborn and evolutionary derived defensive system that is evoked by severe threat, in particular threat to the integrity of the body. As a complex system, it encompasses various subsystems, such as flight, freeze, and fight. Detachment from trauma, in our view, is associated with several action systems (Panksepp, 1998), i.e., the ones that control functions in daily life (e.g., exploration of the environment, energy control), and the ones that are dedicated to survival of the species (e.g., reproduction, attachment to and care for offspring). In this context we will maintain that severe threat may provoke a structural dissociation of the premorbid personality (Van der Hart, 2000). In its primary form this dissociation is between the defensive system on one hand, and the systems that involve managing daily life and survival of the species on the other hand. To summarize the essence of the theory of structural dissociation of the personality, we argue (1) that traumatic experiences, especially when they occur early in life and involve severe threat to the integrity of the body, may activate psychobiological action systems that have been developed by evolution, and (2) that due to extreme stress levels and classical as well as evaluative conditioning to traumatic memories these systems may remain unintegrated to varying degrees.",0 +https://doi.org/10.3760/cma.j.issn.0254-6450.2010.02.012,Epidemiological investigation on major depressive disorder in the most heavily damaged areas from Wenchuan earthquake in 2008,"OBJECTIVE: To assess the prevalence, demographic characteristics, risk factors and protective factors on major depression disorder (MDD) among the affected people in the epicenter, 7 months after the 2008-earthquake in Wenchuan, China. METHODS: Stratified multistage cluster randomization was conducted to choose 14 503 subjects aged 15 years or over in the city of Dujiangyan, Beichuan county and Qingchuan county, Sichuan province. We used the general health questionnaire (GHQ-12) as the screening instrument, and the structured clinical interview for DSM-IV-TR axis I disorder-patient edition (SCID-I/P) as the tool for diagnosis. RESULTS: There were 180 persons diagnosed as MDD with other 13 asymptomatic ones. The point prevalence of MDD was 1.27% and the lifetime prevalence was 1.36%. Risk factors were including:being female (OR = 1.56, 95%CI: 1.136 ∼ 2.143, P 20 000 Yuan (OR = 2.54, 95% CI: 1.38 - 4.68, P Language: zh",0 +https://doi.org/10.1002/jts.20653,Heterogeneity in clinical presentations of posttraumatic stress disorder among medical patients: Testing factor structure variation using factor mixture modeling,"The present study used factor mixture modeling to explore empirically defined subgroups of psychological trauma victims based on confirmatory factor analysis (CFA) and latent class analysis of posttraumatic stress disorder (PTSD) symptoms. We sampled 310 medical patients with a history of trauma exposure. Confirmatory factor analysis revealed that the 4-factor emotional numbing PTSD model yielded the best model fit. Using latent factor means derived from this model and the 4-factor dysphoria PTSD model (indexing severity on PTSD factors), 3 latent classes of participants were identified using factor mixture modeling. The 3-class model fit the data very well and was validated against external measures of anxiety and rumination.",0 +https://doi.org/10.1016/j.jad.2016.02.037,The influence of pre-deployment cognitive ability on post-traumatic stress disorder symptoms and trajectories: The Danish USPER follow-up study of Afghanistan veterans,"New trajectories of PTSD symptoms have recently been identified in war exposed army veterans. The aim of this army veterans study was to examine whether pre-deployment cognitive ability is associated with the risk of developing PTSD symptoms or non-resilient PTSD trajectories.Follow up study in 428 Danish soldiers, deployed to Afghanistan in 2009, who were assessed at six occasions from pre-deployment to three years post-deployment. Pre-deployment vulnerabilities, deployment and homecoming stressors were measured. Pre-deployment cognitive test scores on Børge Priens Prøve (based on logical, verbal, numerical and spatial reasoning) were converted to a mean of 100 and with a standard deviation of 15.Higher pre-deployment cognitive ability scores were associated with lower risk of PTSD symptoms as assessed by the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) 2.5 years post-deployment (OR=0.97; 95% CI 0.95-1.00) after adjustment for educational length, baseline PCL-C score and perceived war-zone stress. Compared to a resilient trajectory, a non-resilient relieved-worsening trajectory (high baseline mental symptoms, being symptom free during deployment and a drastic increase in PTSD symptoms at the final assessments of PTSD symptoms) had significantly lower cognitive scores by a mean difference of 14.5 (95% CI 4.7-24.3). This trajectory (n=9) comprised 26.5% of soldiers with moderate-severe PTSD symptoms 2.5 years post-deployment.We confirmed an inverse association between pre-deployment cognitive ability and risk of PTSD symptoms, and observed significantly lower mean pre-deployment cognitive scores in one non-resilient PTSD trajectory. If replicated, this might inform relevant prevention efforts for soldiers at pre-deployment.",0 +,Conditioning and ethological models of anxiety disorders: stress-in-dynamic-context anxiety models.,"(from the chapter) argue that the central shortcoming of traditional behavioral models has been their failure to consider the dynamic context in which stressors occur in a person's life / by ignoring the powerful effect of dynamic contextual factors on the impact of those stressors, behavioral models have appeared to be much more simplistic than they need to be and to have far less explanatory power than we know they can have / refer to the more traditional models as Stress-in-Total-Isolation Anxiety models (SITIA models) / present an alternative model in which we show that stress must always be considered in a dynamic context rather than in isolation in determining the outcome of exposure to stress the relevant dynamic contextual factors that we will consider include constitutional factors such as temperament, past experiential history (including general factors such as a history of exposure to uncontrollable life events as well as specific factors such as prior traumatic conditioning events), current contextual factors at the time of a stressor (such as whether there are already reliable predictors of the stressor, or the nature of the conditioned stimulus relative to the nature of the unconditioned stimulus, or whether the stressor can be controlled), and future modification of the impact of the stressor (through processes such as forgetting and other memory modifications, as well as through later experiences with other stressors) / refer to these models as the Stress-in-Dynamic-Context Anxiety models (SIDCA models) specific phobias [vicarious conditioning of fears and phobias, sources of individual differences in the acquisition of fears and phobias, selective associations in the conditioning of fears and phobias, persistence of fears and phobias] / social phobia [preparedness and conditioning models of social phobia; direct traumatic conditioning, observational conditioning, and social phobia; temperamental variables and social phobia; uncontrollability and social phobia] / panic disorder and agoraphobia / generalized anxiety disorder / posttraumatic stress disorder (PTSD) / obsessive-compulsive disorder [animal models of compulsive behaviors, anxiety reduction theory, preparedness and the nonrandom distribution of obsessive thoughts and compulsive behaviors] (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +,Anxiety and alcohol use disorders: comorbidity and treatment considerations.,"The co-occurrence of anxiety disorders and alcohol use disorders (AUDs) is relatively common and is associated with a complex clinical presentation. Sound diagnosis and treatment planning requires that clinicians have an integrated understanding of the developmental pathways and course of this comorbidity. Moreover, standard interventions for anxiety disorders or AUDs may need to be modified and combined in targeted ways to accommodate the unique needs of people who have both disorders. Optimal combination of evidence-based treatments should be based on a comparative balance that considers the advantages and disadvantages of sequential, parallel, and integrated approaches.",0 +https://doi.org/10.1017/cbo9780511544132,9/11: Mental Health in the Wake of Terrorist Attacks,"Does terrorism have a unique and significant emotional and behavioral impact among adults and children? In what way does the impact of terrorism exceed the individual level and affect communities and specific professional groups, and test different leadership styles? How were professional communities of mental health clinicians, policy-makers and researchers mobilized to respond to the emerging needs post disaster? What are the lessons learned from the work conducted after 9/11, and the implications for future disaster mental health work and preparedness efforts? Yuval Neria and his team are uniquely placed to answer these questions having been involved in modifying ongoing trials and setting up new ones in New York to address these issues straight after the attacks. No psychiatrist, mental health professional or policy-maker should be without this book.",0 +https://doi.org/10.1111/j.1440-1819.2008.01842.x,"Factors impacting on psychological distress and recovery after the 2004 Niigata-Chuetsu earthquake, Japan: Community-based study","This study was undertaken 5 months after the 2004 Niigata-Chuetsu earthquake in Japan to assess factors that impacted on psychological distress and its recovery.Three thousand and twenty-six adult victims who lived in temporary shelter and in seriously damaged areas were evaluated by questionnaire. The questionnaire queried subject profile, degree of house damage, health status, and psychological distress using a 5-point scale before, immediately and 5 months after the earthquake.Immediately after the earthquake, 59.3% of the subjects had psychological distress. At 5 months after the earthquake, however, this percentage decreased to 21.8%. The psychological distress immediately after the earthquake was significantly serious in victims who: (i) were female; (ii) felt stronger fear of the earthquake and the aftershocks; (iii) lived at home or office after the earthquake; and (iv) were injured due to the earthquake or suffered from sickness after the earthquake. In contrast, the factors impairing psychological recovery 5 months after the earthquake were as follows: (i) being with unfamiliar member(s) during the night after the earthquake; (ii) serious house damage; (iii) living in temporary shelter or at a relative's home after the earthquake; and (iv) physical illness after the earthquake.Despite differences between disasters, these results were consistent with those in some previous studies and may be useful for long-term mental care support.",0 +https://doi.org/10.1023/a:1007706727869,Prevalence of personality disorders among combat veterans with posttraumatic stress disorder,"Many combat veterans with PTSD have co-occurring symptoms of other forms of psychopathology; however, there have been limited studies examining personality disorders among this population. The few extant studies typically have assessed only two or three personality disorders or examined a small sample, resulting in an incomplete picture and scope of comorbidity. This study assessed all DSM-III-R personality disorders in 107 veterans in a specialized, inpatient unit. Using the Structured Clinical Interview for DSM-III-R Personality Disorders, 79.4% of the participants were diagnosed with at least one personality disorder: 29.9% received only one diagnosis, 21.5% had two, 15.9% had three, and 12.1% had four or more. The most frequent single diagnoses were Avoidant (47.2%), Paranoid (46.2%), Obsessive-Compulsive (28.3%), and Antisocial (15.1%) personality disorders.",0 +https://doi.org/10.1080/09084282.2012.737881,Using Pattern Analysis Matching to Differentiate TBI and PTSD in a Military Sample,"Distinguishing between traumatic brain injury (TBI) residuals and the effects of posttraumatic stress disorder (PTSD) during neuropsychological evaluation can be difficult because of significant overlap of symptom presentation. Using a standardized battery of tests, an artificial neural network was used to create an algorithm to perform pattern analysis matching (PAM) functions that can be used to assist with diagnosis. PAM analyzes a patient's neuropsychological data and provides a best fit classification, according to one of four groups: TBI, PTSD, malingering/invalid data, or ""other"" (depressed/anxious/postconcussion syndrome/normal). The original PAM was modeled on civilian data; the current study was undertaken using a database of 100 active-duty army service personnel who were referred for neuropsychological assessment in a military TBI clinic. The PAM classifications showed 90% overall accuracy when compared with clinicians' diagnoses. The PAM function is able to classify detailed neuropsychological profiles from a military population with a high degree of accuracy and is able to distinguish between TBI, PTSD, malingering/invalid data, or ""other."" PAM is a useful tool to help with clinical decision-making.",0 +https://doi.org/10.1097/01.xme.0000413056.01946.40,Addictive profile in juvenile delinquents admitted to correctional institutions in relation to personality characteristics,"Introduction A strong correlation and connection has been observed between drug use and delinquency, as most youths in juvenile commitment programs are involved with drugs compared with nondelinquent youths. Aim of the study The aim of this study was to determine the relationship between substance use among delinquent adolescents and personality characteristics and its impact on mental health. Methods Fifty juvenile delinquent adolescents from among juveniles admitted to two correctional institutes as well as 50 control juveniles were selected. Informed consent was taken. Psychometric analyses were conducted using the Addiction Severity Index, the Eysenck Personality Questionnaire, and The Adolescent and Adult Psychological State Inventory. Results Of the juvenile delinquents, 28% were found to be using nicotine, 22% were using cannabis, and 24% were using polysubstances. They expressed more symptoms of adjustment disorder, generalized anxiety disorder, depression, phobia, post-traumatic stress disorder, attention deficiency hyperactivity disorder, and conduct disorder, and the difference was statistically significant between cases and controls. There were statistically significant differences between cases and controls as regards all the personality dimensions, including extraversion, neuroticism, and psychoticism. In all, 25% of juvenile delinquents suffered from moderate to severe problems with regard to employment, legal, psychiatric, and social problems, as assessed by the Addiction Severity Index. There were statistically significant differences between male and female delinquents as regards employment, psychiatric, and social problems as assessed by the Addiction Severity Index. Conclusion Community and correctional systems must be established to provide psychiatric services to the youth, as juvenile delinquents with psychiatric disorders pose a challenge for the juvenile justice system and, after their release, for the larger mental health system. © 2012 Okasha Institute of Psychiatry, Ain Shams University.",0 +https://doi.org/10.1111/add.12167,Randomized controlled trial of cognitive behaviour therapy for comorbid post-traumatic stress disorder and alcohol use disorders,"Aims This study aimed to test the efficacy of integrated cognitive behaviour therapy (CBT) for coexisting post traumatic stress disorder (PTSD) and alcohol use disorders (AUD). Setting Clinics across Sydney, Australia.Design Randomized controlled trial of 12 once-weekly individual sessions of either integrated CBT for PTSD and AUD(integrated therapy, IT; n = 33) or CBT for AUD plus supportive counselling (alcohol-support, AS; n = 29). Blind assessments were conducted at baseline and post-treatment and at 5 [standard deviation (SD) = 2.25] and 9.16(SD = 3.45) months post-treatment. Participants Sixty-two adults with concurrent PTSD and AUD. Measurements Outcomes included changes in alcohol consumption (time-line follow-back), PTSD severity [clinician-administered PTSD scale (CAPS)], alcohol dependence and problems, and depression and anxiety. Findings Reductions in PTSD severity were evident in both groups. IT participants who had received one or more sessions of exposure therapy exhibited a twofold greater rate of clinically significant change in CAPS severity at follow-up than AS participants [IT60%, AS 39%, odds ratio (OR): 2.31, 95% confidence interval (CI): 1.06, 5.01]. AS participants exhibited larger reductions than IT participants in alcohol consumption, dependence and problems within the context of greater treatment from other services during follow-up. Results lend support to a mutually maintaining effect between AUD and PTSD. Conclusions Individuals with severe and complex presentations of coexisting post-traumatic stress disorder(PTSD) and alcohol use disorders (AUD) can derive substantial benefit from cognitive behaviour therapy targeting AUD, with greater benefits associated with exposure for PTSD. Among individuals with dual disorders, these therapies can generate significant, well-maintained treatment effects on PTSD, AUD and psychopathology.",0 +https://doi.org/10.1002/jclp.22092,Substantial Symptom Changes in Naturalistic Recovery from Aversive Events,"Researchers have recommended examining trajectories of recovery from aversive events, including sudden gains and spikes. We examined rates, attributions for, and outcomes associated with substantial symptom improvements and brief exacerbations after aversive events.Sixty-three women completed questionnaire measures of mood, depression, and posttraumatic stress disorder symptoms. They used a Life History Calendar (LHC) to draw the trajectory of symptom levels from the event to the present, and were interviewed regarding the course of their symptoms. Based on the LHC and interview, we coded whether each participant experienced substantial improvements and/or brief exacerbations and reasons for them.Participants frequently experienced substantial improvements and brief exacerbations, most of which they attributed to external events. Substantial improvements-but not substantial brief exacerbations-were associated with significantly lower symptom levels.Substantial improvements are similar to sudden gains in therapy samples. Substantial improvements in avoidance and mood have positive, bidirectional effects on each other.",0 +https://doi.org/10.1080/09638280902738441,Post-traumatic growth in people living with a serious medical condition and its relations to physical and mental health: A systematic review,"The diagnosis of a life-threatening illness can be an extremely stressful, traumatic experience. However, many survivors report also various positive changes, referred in empirical literature as post-traumatic growth (PTG). Empirical studies that documented stress disorders and PTG in patients and survivors of life-threatening diseases are reviewed in three areas: Predictors of PTG, relationships between PTG and indicators of mental health and the impact of PTG on the process of convalescence.The literature review was completed by making use of three major databases - PsycINFO, PILOTS and Medline.The majority of the studies investigated PTG and its relationships to health indicators after the diagnosis of cancer, HIV/AIDS, cardiac disease, multiple sclerosis and rheumatoid arthritis. The review indicated that quality of social support, patients' coping strategies and several indicators of mental and physical health were consistently associated with post-traumatic growth. Associations between growth and health-related variables (e.g. physical deficits, pain, depression, anxiety) varied depending on different study design (cross-sectional versus longitudinal) and the sample composition (patients versus symptom-free survivors). Several findings are disease-specific.The results point to the potential adaptive significance of PTG. More research is needed to investigate specific disease-related profiles of PTG and the complex mechanisms, which underlie the relationships between PTG and the process of convalescence. This knowledge may help to foster the overall positive adjustment of chronically ill patients.",0 +https://doi.org/10.1016/j.addbeh.2014.04.027,"Posttraumatic stress disorder, smoking, and cortisol in a community sample of pregnant women","The prevalence of posttraumatic stress disorder (PTSD) in the United States is higher among pregnant women than women generally. PTSD is related to adverse birth outcomes via physiological and behavioral alterations, such as smoking.We utilize salivary cortisol measures to examine how traumatic stress, smoking and the hypothalamic-pituitary-adrenal axis interact. Pregnant women (n=395) gave cortisol specimens as part of a cohort study of PTSD and pregnancy at three health systems in the Midwestern United States. Women were divided into three groups: nonsmokers, quitters (who stopped smoking during pregnancy), and pregnancy smokers. Mean cortisol values at three points, sociodemographics, trauma history, and PTSD were compared across groups. We assessed the association of smoking group and PTSD with late afternoon cortisol levels.Smokers, quitters, and nonsmokers differed on demographic risk factors and PTSD symptom load. Late afternoon and bedtime cortisol measures were significantly positively correlated with smoking in pregnancy, with smokers with PTSD presenting the highest cortisol levels. Regression analysis showed that smoking in pregnancy was associated with higher late afternoon cortisol in an additive manner with PTSD symptoms.Smoking appears to have a different relationship with cortisol level for those with and without PTSD. This is the first study to show additive effects of smoking and PTSD on cortisol levels in pregnant women. Since high cortisol, smoking, and PTSD have been shown to adversely affect perinatal outcomes, and since those continuing to smoke in pregnancy had the highest PTSD symptom load, PTSD-specific smoking cessation programs in maternity settings are warranted.",0 +https://doi.org/10.1111/j.1360-0443.2008.02247.x,Alcohol use trajectories among adults in an urban area after a disaster: evidence from a population-based cohort study,"Alcohol use increased in the New York City (NYC) metropolitan area in the first months after the 11 September 2001 terrorist attacks.To investigate alcohol use trajectories in the NYC metropolitan area in the 3 years after 11 September and examine the relative contributions of acute exposure to the attacks and ongoing stressors to these trajectories.We used a population-based cohort of adults recruited through a random-digit-dial telephone survey in 2002; participants completed three follow-up interviews over 30 months.The NYC metropolitan area.A total of 2752 non-institutionalized adult residents of NYC.We used growth mixture models to assess trajectories in levels of total alcohol consumption and bingeing in the past 30 days, and predictors of these trajectories.We identified five trajectories of alcohol consumption levels and three bingeing trajectories. Predictors of higher levels of use over time included ongoing stressors, traumatic events and lower income. Ongoing exposure to stressors and low income also play a central role in bingeing trajectories.While point-in-time mass traumatic events may matter in the short term, their contribution subsides over time. Accumulated stressors and traumatic events, in contrast, lead to higher levels of consumption among respondents already vulnerable to high alcohol use. Interventions to mitigate post-disaster stressors may have substantial benefit in reducing alcohol abuse in the medium- to long term.",0 +https://doi.org/10.1037/a0018420,Expressive flexibility.,"Previous research has examined the consequences of either expressing or suppressing emotion using between-subjects designs. However, emotion theorists have argued that adaptation depends not so much on one regulatory process but rather on the ability to flexibly regulate emotion in accord with situational demands. To test this idea, Bonanno, Papa, Lalande, Westphal, and Coifman (2004) developed a within-subjects experimental paradigm to measure expressive flexibility (EF) and showed that EF predicted better self-reported adjustment over a 2-year period. The current investigation extends this research by (1) demonstrating the stability of EF across a 3-year period, (2) replicating the association between EF and positive adjustment using a more objective measure of adjustment (obtained from participants' close friends rather than based on self-report), and (3) by showing that the positive relation between EF and adjustment was particularly salient in the context of high levels of cumulative life stress when EF was measured under conditions of immediate threat (presence of a subliminal threat prime).",0 +https://doi.org/10.1708/468.5541,[Short-term psychological consequences of car accidents: an empirical study].,"AIM: Aim of this study is to investigate short-term (3 and 5 months) psychological consequences of severe motor-vehicle accidents. METHODS: The sample under investigation is composed of two groups: 8 survivors of severe motor-vehicle accidents with spinal cord injuries (SCI) hospitalized in a Spinal Cord Unit, and 6 survivors who did not require hospitalization. All subjects were assessed twice, three and five months after the accident, on a variety of measures including the CAPS and the BDI-SF. RESULTS: Prevalence of PTSD in the total sample was, 3 months after the accident, 14% with no significant differences between the two groups; some peculiarities in the symptomathological profile emerged as much as subjects with SCI experience avoidance of trauma-related stimuli more frequently. An overall decline in frequency and severity of post-traumatic symptoms between the two assessments was observed in the total sample, though some components (Criterion C symptoms) showed no relevant variations over time. Finally, depressive symptoms, which were characterized by higher severity in the SCI group, showed a significant decline between the two assessments. DISCUSSION: Our data, although based on a limited sample, might help in tailoring psychological interventions for prevention and treatment of PTSD in survivors of severe motor accidents. Language: it",0 +https://doi.org/10.1016/j.psychres.2015.06.015,A systematic review of probable posttraumatic stress disorder in first responders following man-made mass violence,"The current study was a systematic review examining probable posttraumatic stress disorder (PTSD) in first responders following man-made mass violence. A systematic literature search yielded 20 studies that fit the inclusion criteria. The prevalence rates of probable PTSD across all 20 studies ranged from 1.3% to 22.0%. Fifteen of the 20 articles focused on first responders following the September 11th terrorist attacks and many of the studies used the same participant recruitment pools. Overall, the results of the systematic review described here suggest that our understanding of PTSD in first responders following man-made mass violence is based on a very small set of articles that have focused on a few particular events. This paper is meant to serve as a call for additional research and to encourage more breadth in the specific incidents that are examined.",0 +https://doi.org/10.1016/j.psychres.2012.03.035,Predictors of PTSD trajectories following captivity: A 35-year longitudinal study,"Although war captivity is a potent pathogen for psychiatric illness, little is known about the long-term trajectories of post-traumatic stress disorder (PTSD) among ex-prisoners of wars (ex-POWs). This study aimed to assess the long-term trajectories of PTSD and their predictors following war captivity. Three follow-ups (1991, 2003, 2008) were conducted over 35 years of 164 Israeli ex-POWs and185 comparable combatants from the 1973 Yom Kippur War. Ex-POWs reported higher PTSD rates than controls at all three assessments. Four trajectories of PTSD were identified: chronic PTSD, delayed PTSD, recovery and resilience. The majority of POWs reported delayed PTSD, while the majority of controls were classified as resilient. While PTSD rates remained relatively stable over time among controls, a steep increase in rates was observed among POWs between 1991 and 2003, followed by stabilization in rates between 2003 and 2008. Finally, subjective experience of captivity was the variable that best distinguished between the resilience and PTSD groups of ex-POWs, followed by participation in previous wars and negative life events during childhood. War captivity carries long-lasting psychiatric implications, even decades after release. Aging processes, as well as unique stressors that exist in Israel, may account for the elevated PTSD rates found here.",0 +https://doi.org/10.1177/0020764008096100,Parenting Support and PTSD in Children of a War Zone,"The protective role of parenting factors on the mental well-being of children exposed to war trauma remains an under-researched area.To establish the relationship between perceived positive parenting support and post-traumatic stress disorder (PTSD) symptoms in children exposed to war trauma.A random sample of 412 children aged 12-16 years was selected from the Gaza Strip and was assessed using the Gaza Traumatic Events Checklist (GTEC), the SCID (DSM-IV) and the Perceived Parenting Support Scale (PPSS).Palestinian children were exposed to different types of war-traumatic events. The number of exposed traumatic events was independently associated with the severity of post-traumatic symptoms scores or the diagnosis of PTSD, while perceived parenting support was found to act as a protective factor in this association.Interventions in war zones need to ensure the minimal possible disruption to communities and family units, and to involve parents in preventive or treatment programmes for children exposed to trauma.",0 +https://doi.org/10.1016/j.pnpbp.2006.12.010,Single prolonged stress increases contextual freezing and the expression of glycine transporter 1 and vesicle-associated membrane protein 2 mRNA in the hippocampus of rats,"Rats subjected to single prolonged stress (SPS) show enhanced HPA negative feedback, exaggerated acoustic startle response, and enhanced contextual freezing 7 days after SPS, and accordingly, SPS is an animal model of PTSD. To elucidate the influence of contextual fear on gene expression in the hippocampus of SPS rats, we used cDNA microarray followed by real-time quantitative PCR analyses to compare the hippocampal gene expression profiles between rats that were or were not subjected to SPS during exposure to contextual fear. In the behavioral experiments, spontaneous locomotor activity was measured 7 days after SPS. Twenty-four hours after footshock conditioning (7 days after SPS), freezing behavior was measured during re-exposure to the chamber in which footshock was delivered. Based on the behavioral analysis, rats subjected to SPS exhibited a significant enhancement of contextual freezing compared to rats not subjected to SPS, without any changes in locomotor activity. Analyses using cDNA microarray and RT-PCR showed that the hippocampal levels of glycine transporter 1 (Gly-T1) and vesicle-associated membrane protein 2 (VAMP2) mRNA in rats subjected to SPS were significantly increased relative to sham-treated rats. Administration of SPS alone did not affect the expression of these 2 genes. These findings suggest that the upregulation of Gly-T1 and VAMP2 in the hippocampus may be, at least in part, involved in the enhanced susceptibility to contextual fear in rats subjected to SPS.",0 +https://doi.org/10.1037/a0037304,Sexual assault-characteristics effects on PTSD and psychosocial mediators: A cluster-analysis approach to sexual assault types.,"Using cluster analysis, we investigated the effects of assault characteristics (i.e., level of violence, subjective distress, alcohol consumption, perpetrator identity) on PTSD symptoms, and whether these effects are mediated by postassault social and psychological reactions. A large community sample of women sexual assault survivors completed 2 mail surveys at a 1-year interval. In line with prior research, cluster analyses revealed the existence of 3 general categories of sexual assault, which we described as ""high violence,"" ""alcohol-related,"" and ""moderate sexual severity."" Alcohol-related assaults resulted in fewer PTSD symptoms than high-violence assaults at Time 1, but not at Time 2. Alcohol-related and violent assaults resulted in more PTSD symptoms than moderate-severity assaults at both times. The effect of assault-characteristics clusters on Time 2 PTSD was mediated by Time 1 self-blame and turning against social reactions. The importance of considering effects of violence and alcohol consumption during the assault to better understand postassault PTSD, including implications for theory and practice, are discussed.",0 +,The SCID-II and DIB-R interviews: diagnostic association with poor outcome risk factors in Borderline Personality Disorder.,"This study assesses whether patients diagnosed with Borderline Personality Disorder (BPD) according to the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) or the Revised Diagnostic Interview for Borderlines (DIB-R) present differences in factors associated with risk of poor outcome. Three hundred fifty-two patients were evaluated with SCID-II and DIB-R. Patients diagnosed as BPD according to one or both instruments were compared in BPD poor outcome risk factors. The analysis was conducted on the participants who were assigned to SCID-II (n = 135) and SCID-II/DIB-R (n = 126) groups. The group diagnosed with BPD according the combined SCID-II/DIB-R interview showed a significantly greater association with risk of poor outcome predictors, such as total number of comorbid Axis II disorders, number of BPD criteria, presence of comorbid paranoid personality disorder, and worse occupational status. No differences between groups were found in the affective instability BPD criterion, self-reported impulsivity, post-traumatic stress disorder, major depressive disorder or presence of any cluster C comorbidity. The observed differences were large enough to advise caution in generalizing findings from studies without considering what measurement was used for the BPD diagnosis.",0 +,Commentary: Stalking risk profile.,"Paul Mullen and his colleagues have developed a Stalking Risk Profile that is the latest model for assessing and managing stalkers. The model includes an assessment of the nature of the relationship between the stalker and his victim; the stalker's motivations; the general psychological, psychopathological, and social realities of the stalker; the circumstances of the victim, and the legal and mental health context. The model is not an actuarial scale, but rather an assessment to be used on a case-by-case basis. It recommends certain standardized tests as part of the assessment. The Stalker Risk Profile is the most thorough risk assessment to date. It includes victim variables and provides specifics for assessment and specifics for treatment of the stalker.",0 +,Children and Disasters: Understanding Impact and Enabling Agency,"From a child rights perspective disaster impacts affect not only a child’s basic right to survival and development, but cut across their right to participate and for decisions to be made in their best interests. Child-centred approaches recognise the role and rights of children as citizens and agents of change, seeking to engage them in DRR/CCA (Disaster Risk Reduction/Climate Change Adaptation) decision-making and accountability processes and supporting child-centred community-based programmes of action. The research produced two papers, one on Undertanding Impacts of disasters on child welfare, and the second to identify the factors which create an enabling environment for children to engage in climate change and disaster risk reduction. This report synthesises the research outputs to produce a comprehensive report looking into the need both for child sensitive programmes to tackle disasters and climate change, but also at the need for child participation in programming and policy.",0 +https://doi.org/10.1111/jne.12300,Salivary Oxytocin and Vasopressin Levels in Police Officers With and Without Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) is characterised by symptoms associated with maladaptive fear and stress responses, as well as with social detachment. The neuropeptides oxytocin (OT) and arginine vasopressin (AVP) have been associated with both regulating fear and neuroendocrine stress responsiveness and social behaviour. However, there is only limited evidence for dysregulated peripheral OT and AVP levels in PTSD patients. The present study aimed to investigate basal salivary OT and AVP levels in trauma-exposed male and female police officers with and without PTSD. Saliva samples were collected during rest and OT and AVP levels were determined using a radioimmunoassay. Men and women were analysed separately, having adjusted for differences in trauma history, and for hormonal contraception use in women. The results showed that male PTSD patients had lower basal salivary OT levels, and did not differ in AVP levels compared to male trauma-exposed healthy controls after adjusting for childhood emotional abuse. There were no significant differences in basal salivary OT and AVP levels in women. Our findings indicate potential dysfunctioning of the OT system in male PTSD patients. Future studies are needed to replicate these findings and to further unravel the relationship between the OT and AVP systems, sex, trauma history and PTSD.",0 +https://doi.org/10.1016/j.psychres.2015.05.082,Longitudinal measures of hostility in deployed military personnel,"Increases in anger and hostility are commonly found after military deployment. However, it is unknown how anger and hostility develop over time, and which veterans are more at risk for developing these complaints. Data of 745 veterans one month before deployment to Afghanistan and one, six, twelve and 24 months after deployment were analyzed in a growth model. Growth mixture modeling revealed four classes based on their growth in hostility. Most of the participants belonged to a low-hostile group or a mild-hostile group that remained stable over time. Two smaller groups were identified that displayed increase in hostility ratings after deployment. The first showed an immediate increase after deployment. The second showed a delayed increase between twelve and 24 months after deployment. No groups were identified that displayed a decrease of hostility symptoms over time. Multinomial logistic regression was applied to predict group membership by age, education, early trauma, deployment stressors and personality factors. This study gains more insight into the course of hostility over time, and identifies risk factors for the progression of hostility.",0 +https://doi.org/10.1016/s0006-3223(01)01105-2,A pilot longitudinal study of hippocampal volumes in pediatric maltreatment-related posttraumatic stress disorder,"Adult posttraumatic stress disorder (PTSD) is associated with decreased hippocampal volumes; however, decreased hippocampal volumes were not seen in pediatric maltreatment-related PTSD. We examined hippocampal volumes longitudinally to determine if a history of childhood traumatic stress alters hippocampal growth during puberty.Magnetic resonance imaging was used to measure temporal lobes, amygdala, and hippocampal volumes in nine prepubertal maltreated subjects with pediatric maltreatment-related PTSD and nine sociodemographically matched healthy nonmaltreated yoked control subjects at baseline and after at least 2 years follow-up (during the later stages of pubertal development) using identical equipment and measurement methodology.Temporal lobe, amygdala and hippocampal volumes did not differ between groups at baseline, follow-up, or across time.Whereas these data are from a small sample, the results do not support hippocampal changes in pediatric maltreatment-related PTSD.",0 +,PTSD in Service Members and New Veterans of the Iraq and Afghanistan Wars: A Bibliography and Critique,,0 +https://doi.org/10.1177/0013164405284033,Investigating Subtypes of Child Development,"Two classification methods, latent class cluster analysis and cluster analysis, are used to identify groups of child behavioral adjustment underlying a sample of elementary school children aged 6 to 11 years. Behavioral rating information across 14 subscales was obtained from classroom teachers and used as input for analyses. Both the procedures and results were compared. The latent class cluster analysis uncovered three classes representing differing levels of children's behavioral adjustment (well adjusted, average adjustment, functionally impaired), whereas the cluster analysis uncovered seven groups of child behavior. Results show a high degree of overlap, and each procedure offers unique information toward classifying child behavior.",0 +https://doi.org/10.7205/milmed-d-12-00019,Deployment Risk Factors and Postdeployment Health Profiles Associated With Traumatic Brain Injury in Heavy Drinking Veterans,"Along with post-traumatic stress disorder (PTSD), mild traumatic brain injury (mTBI) is considered one of the ""signature wounds"" of combat operations in Iraq (Operation Iraqi Freedom [OIF]) and Afghanistan (Operation Enduring Freedom [OEF]), but the role of mTBI in the clinical profiles of Veterans with other comorbid forms of post-deployment psychopathology is poorly understood. The current study explored the deployment risk and postdeployment health profiles of heavy drinking OIF and OEF Veterans as a function of mTBI. Sixty-nine heavy-drinking OIF/OEF Veterans were recruited through a Veterans' Affairs Medical Center and completed questionnaires and structured interviews assessing war-zone experiences, postdeployment drinking patterns, and PTSD symptoms. Veterans with positive mTBI screens and confirmed mTBI diagnoses endorsed higher rates of combat experiences, including direct and indirect killing, and met criteria for PTSD at a higher rate than Veterans without a history of mTBI. Both PTSD and combat experiences independently predicted screening positive for mTBI, whereas only combat experiences predicted receiving a confirmed mTBI diagnosis. mTBI was not associated with any dimension of alcohol use. These results support a growing body of literature linking mTBI with PTSD.",0 +https://doi.org/10.1186/1471-244x-13-148,Is legal status impacting outcomes of group therapy for posttraumatic stress disorder with male asylum seekers and refugees from Iran and Afghanistan?,"Abstract Background Legal status and other resettlement stressors are known to impact mental health of asylum seekers and refugees. However, the ways in which they interact with treatment of posttraumatic stress disorder (PTSD) with these populations is still poorly understood. The aim of this study was to examine whether legal status and other resettlement stressors influence outcomes of a trauma-focused group PTSD treatment within a day-treatment setting with asylum seekers and refugees. Methods Sixty six male Iranian and Afghan patients with PTSD residing in the Netherlands were assessed with self-rated symptom checklists for PTSD, anxiety and depression, and a demographic questionnaire one week before and two weeks after the treatment. Multivariate linear regression analysis was used to examine the impact of legal status and living arrangements on the treatment outcomes per symptom domain. Results The results suggest that both asylum seekers and refugees can be helped with their mental health complaints with a trauma-focused group therapy for PTSD regardless of their legal status. Obtaining a refugee status in a course of the treatment appears to improve the treatment outcomes. Conclusions Legal status is impacting outcomes of group therapy for PTSD with male asylum seekers and refugees. Asylum seekers may benefit from group treatment regardless of unstable living conditions.",0 +https://doi.org/10.1097/lgt.0000000000000166,Presence of Spontaneous Pain and Comorbid Pain Conditions Identifies Vulvodynia Subgroups,"The aims of the study were to define the heterogeneity of vulvodynia by determining data-driven subgroups within the vulvodynia diagnosis using exploratory cluster analysis and to characterize the subgroups identified.Included were participants in the longitudinal population-based study of vulvodynia in southeast Michigan who screened positive for vulvodynia at least once during the study. A cluster analysis using variables reflecting vulvar pain characteristics and comorbid pain conditions was conducted. Variables reflecting best separation of clusters were used to assign participants to subgroup categories. Demographic, psychiatric, general health, and other vulvar pain characteristics were summarized for each subgroup, followed by multinomial regression and pairwise comparisons of subgroups on these factors.Of 441 women screening positive for vulvodynia during the course of the study, 393 were eligible on the basis of data requirements. Cluster analysis suggested that best subgroup separation was based on the following 2 variables: (1) presence or absence of spontaneous vulvar pain and (2) presence or absence of other comorbid pain conditions. Subgroups did not differ by age or ethnicity. The subgroup having spontaneous pain and other comorbid conditions demonstrated greatest morbidity in general health measures, psychiatric disorders, and other vulvar pain measures. Primary versus secondary vulvodynia did not vary between subgroups and did not assist in subgroup separation in the cluster analysis.Subgroups based on exploratory cluster analysis demonstrated that presence of spontaneous pain and the presence of comorbid pain conditions resulted in best separation of groups. Presence of both spontaneous pain and other comorbid pain conditions identified the group with greatest morbidity.",0 +https://doi.org/10.1016/j.eurpsy.2014.05.003,Prevalence of Mental Health Symptoms in Dutch Military Personnel Returning from Deployment to Afghanistan: A 2-year Longitudinal Analysis,"Abstract Objective: Recent studies in troops deployed to Iraq and Afghanistan have shown that combat exposure and exposure to deployment-related stressors increase the risk for the development of mental health symptoms. The aim of this study is to assess the prevalence of mental health symptoms in a cohort of Dutch military personnel prior to and at multiple time-points after deployment. Methods: Military personnel ( n = 994) completed various questionnaires at 5 time-points; starting prior to deployment and following the same cohort at 1 and 6 months and 1 and 2 years after their return from Afghanistan. Results: The prevalence of symptoms of fatigue, PTSD, hostility, depression and anxiety was found to significantly increase after deployment compared with pre-deployment rates. As opposed to depressive symptoms and fatigue, the prevalence of PTSD was found to decrease after the 6-month assessment. The prevalence of sleeping problems and hostility remained relatively stable. Conclusions: The prevalence of mental health symptoms in military personnel increases after deployment, however, symptoms progression over time appears to be specific for various mental health symptoms. Comprehensive screening and monitoring for a wide range of mental health symptoms at multiple time-points after deployment is essential for early detection and to provide opportunities for intervention. Declaration of interest: This project was funded by the Dutch Ministry of Defence.",0 +https://doi.org/10.1007/s00127-012-0493-x,Adjustment disorders: prevalence in a representative nationwide survey in Germany,"ObjectivesThis is the first study to estimate the prevalence of adjustment disorder (AjD) in the general population. A new conceptualisation of AjD as a stress response syndrome was applied, which allowed AjD to be assessed directly from its symptom profile, including intrusive, avoidance and failure-to-adapt symptoms (Maercker et al., Psychopathology 40:135–146, 2007).MethodsPrevalence rates of distressing life events and AjD were estimated from a representative sample of the German general population (n = 2,512) with a broad age range (14–93 years). A questionnaire including a life events checklist and self-rating questions that assessed AjD symptoms and symptom duration were personally handed out by an interviewer.ResultsThe prevalence of AjD fulfilling the criterion of clinically significant impairment was 0.9%; a further 1.4% of the sample was diagnosed with AjD without fulfilling the impairment criterion. In ~72.5% of AjD cases, symptoms had developed 6–24 months prior to assessment. AjD was most often associated with acute events such as moving or chronic stressors such as serious illness, conflicts at the respondent’s job or with friends or neighbours (with ~5% conditional probability each).ConclusionsThe results correspond with the few other studies that have examined the prevalence of AjD, even though a new conceptualisation of the disorder was used. Explorative results regarding the duration of AjD syndromes and symptoms call for further redefinition and empirical investigation of this under-researched mental condition.",0 +https://doi.org/10.1521/psyc.2014.77.4.386,Exploring the Longitudinal Trajectories of Posttraumatic Stress Disorder in Injured Trauma Survivors,"Objective: The goal of this study was to examine the longitudinal trajectories of posttraumatic stress disorder (PTSD) symptoms in a sample of acutely injured hospitalized civilian trauma survivors who participated in a randomized clinical trial. Prior longitudinal descriptive research has shown that there are distinct trajectories of PTSD symptoms over time in trauma survivors. Limited clinical trial research exists that describes the patterns of the trajectories as well as the risk factors that influence the trajectories for seriously injured trauma-exposed patients. Method: Semiparametric, group-based approach trajectory modeling was used to examine four group trajectories of a subset of data obtained from a previous longitudinal clinical trial. Trajectories examined included resilience, recovery, relapsing/remitting, and chronic symptom patterns. One hundred and ninety-four patients who participated in the randomized clinical trial were assessed at baseline in the days and weeks after injury and then randomized. The associations between previously identified PTSD risk factors and the four trajectories were examined. Results: The risk factors of ethnocultural minority status, psychiatric history, additional life stressors, and depressive symptoms, as well as intervention versus control group status, were found to significantly affect the probability of trajectory group membership for PTSD symptom severity. Conclusions: These findings suggest that there is a need for early PTSD interventions that anticipate differences in injured patients' PTSD trajectory profiles. Stepped care intervention procedures may optimally address the diverse PTSD trajectory patterns observed in injured trauma survivors through the tailoring of intervention timing and dosing.",0 +https://doi.org/10.1016/j.janxdis.2013.01.007,The association between posttraumatic stress symptoms and functional impairment during ongoing conflict in the Democratic Republic of Congo,"► Evaluated the impact of PTSD on perceived health and physical and social functioning. ► Data were collected from 93 adults living in Bunia, Eastern Democratic Republic of Congo. ► People with PTSD reported poor health and high disability scores compared to those without PTSD. ► Of the three PTSD symptom clusters, hyperarousal was most strongly associated with disability. ► People with PTSD had greater health problems, difficulty with social contact and functioning. The Democratic Republic of Congo (DRC) has suffered from a bloody conflict for more than a decade. More than 5,400,000 people died from war-related causes since 1998 and exposure to violence was wide-spread. This study investigated the impact of posttraumatic stress disorder (PTSD) symptoms on perceived health and physical and social functioning, filling an important gap in the current literature. Data were collected from a sample of 93 adults living in Bunia, Eastern Democratic Republic of Congo. Structured in-person interviews included the PTSD section of the Composite International Diagnostic Interview and the World Health Organization Disability Assessment Scale. Additional questions were included to assess social resources. Study recruitment was balanced to achieve equal representation of both sexes and each quarter of town. Forty percent met symptom criteria for probable PTSD. Individuals with PTSD reported poor perceived general health and had high disability scores compared to those without PTSD. Of the three PTSD symptom clusters, hyperarousal was most strongly associated with disability. Individuals with PTSD were significantly more emotionally affected by their health problems than those without PTSD (85% versus 41%), had more difficulties in activities involving social contact (54% versus 16%) and in doing their daily work (54% versus 20%). The impact of war-related violence on mental health is severe in the DRC. Psychosocial interventions developed in conflict areas might be best targeted primarily to supporting social functioning and reducing hyperarousal. Implications for clinical treatment and future directions are discussed.",0 +https://doi.org/10.1001/jama.296.5.519,Neuropsychological outcomes of army personnel following deployment to the Iraq war.,"The effects of war-zone deployment on neuropsychological health remain poorly understood. Neuropsychological performance deficits serve as sensitive measures of neural dysfunction and are often associated with psychosocial and occupational problems. Previous studies have not conducted objective neuropsychological assessments both before and after a major war-zone deployment.To examine objective neuropsychological outcomes of Iraq War deployment in a large military cohort.The Neurocognition Deployment Health Study, a prospective, cohort-controlled study conducted at military installations. This report centers on 961 male and female active-duty Army soldiers drawn from the larger cohort. Deploying Army soldiers (n = 654) were examined prior to deployment to Iraq (April-December 2003) and shortly after return (within a mean of 73 days [median, 75 days]; January-May 2005) from Iraq deployment. A comparison group of soldiers (n = 307) similar in military characteristics but not deploying overseas during the study was assessed in sessions timed to be as close as possible to the assessment of deployers. Military unit sampling procedures facilitated representation of combat, combat support, and combat service support functions among both deployers and nondeployers.Individually administered, performance-based neuropsychological tasks. Estimates (beta; the unstandardized parameter estimate) for the absolute differences in adjusted mean outcome scores between deployed and nondeployed groups were determined using generalized estimating equations.Multiple linear regression analyses adjusted for battalion membership revealed that Iraq deployment, compared with nondeployment, was associated with neuropsychological compromise on tasks of sustained attention (beta = 0.11; P<.001), verbal learning (beta = -1.51; P = .003), and visual-spatial memory (beta = -3.82; P<.001). Iraq deployment was also associated with increased negative state affect on measures of confusion (beta = 1.40; P<.001) and tension (beta = 1.24; P<.001). In contrast, deployment was associated with improved simple reaction time (beta = 4.30; P = .003). Deployment effects remained statistically significant after taking into account deployment-related head injury and stress and depression symptoms.Deployment to Iraq is associated with increased risk of neuropsychological compromise. Findings point to the need to investigate further the impact of deployment on neural functioning. Public health implications include consideration of neuropsychological compromise in health prevention and postdeployment clinical and occupational management.",0 +https://doi.org/10.1037/per0000062,Predictors of treatment response to an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder.,"Despite evidence for the efficacy of several treatments for deliberate self-harm (DSH) within borderline personality disorder (BPD), predictors of response to these treatments remain unknown. This study examined baseline demographic, clinical, and diagnostic predictors of treatment response to an adjunctive emotion regulation group therapy (ERGT) for DSH among women with BPD. A recent RCT provided evidence for the efficacy of this ERGT (relative to a treatment-as-usual only waitlist condition). Participants in this study include the full intent-to-treat sample who began ERGT (across treatment and waitlist conditions; n = 51). Baseline diagnostic and clinical data were collected at the initial assessment, and outcome measures of DSH and self-destructive behaviors, emotion dysregulation/avoidance, and BPD symptoms (among others) were administered at pretreatment, posttreatment, and 3- and 9-months posttreatment. Notably, both demographic variables and characteristics of participants' ongoing therapy in the community had minimal impact on treatment response. However, several indicators of greater severity in domains relevant to this ERGT (i.e., baseline emotion dysregulation and BPD criteria, lifetime and recent DSH, and past-year hospitalization and suicide attempts) predicted better responses during treatment and follow-up across the primary targets of treatment. Likewise, several co-occurring disorders (i.e., social phobia, panic disorder, and a cluster B personality disorder) predicted greater improvements in BPD symptoms during treatment or follow-up. Finally, although co-occurring generalized anxiety disorder, posttraumatic stress disorder, and cluster A and C personality disorders were associated with poorer treatment response during follow-up, most of these effects reflected a lack of continued improvements during this period (vs. worsening of symptoms).",0 +https://doi.org/10.1016/j.neuropharm.2011.02.027,Biomarkers of PTSD: Neuropeptides and immune signaling,"The biological underpinnings for participation of the immune system in the pathogenesis of Posttraumatic Stress Disorder (PTSD) include evidence for cross-talk between the stress and immune systems, as well as more recently discovered roles for immune system mediators in core behavioral functions such as adult neurogenesis, as well as in processes that underlay synaptic plasticity, such as learning and memory. This article reviews the expanding body of literature on immune system mediators in the periphery and the central nervous system (CNS) in chronic PTSD along with the evidence for increased peripheral inflammation, and excess morbidity and mortality. CNS inflammation has been implicated in the pathogenesis of depression. This literature is briefly reviewed, along with evidence for a possible role for CNS inflammation in PTSD symptoms, especially in individuals who have PTSD with co-morbid depression. Whether the immune system is involved in risk and resilience, or evolution of PTSD symptoms following a trauma event remains to be determined, although hypotheses have been advanced. This paper reviews the current evidence including the novel hypothesis that cellular immunity is implicated in PTSD risk and resilience. Potential research implications and directions are discussed. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0 +https://doi.org/10.1007/s11524-008-9317-4,An Overview of 9/11 Experiences and Respiratory and Mental Health Conditions among World Trade Center Health Registry Enrollees,"To date, health effects of exposure to the September 11, 2001 disaster in New York City have been studied in specific groups, but no studies have estimated its impact across the different exposed populations. This report provides an overview of the World Trade Center Health Registry (WTCHR) enrollees, their exposures, and their respiratory and mental health outcomes 2-3 years post-9/11. Results are extrapolated to the estimated universe of people eligible to enroll in the WTCHR to determine magnitude of impact. Building occupants, persons on the street or in transit in lower Manhattan on 9/11, local residents, rescue and recovery workers/volunteers, and area school children and staff were interviewed and enrolled in the WTCHR between September 2003 and November 2004. A total of 71,437 people enrolled in the WTCHR, for 17.4% coverage of the estimated eligible exposed population (nearly 410,000); 30% were recruited from lists, and 70% were self-identified. Many reported being in the dust cloud from the collapsing WTC Towers (51%), witnessing traumatic events (70%), or sustaining an injury (13%). After 9/11, 67% of adult enrollees reported new or worsening respiratory symptoms, 3% reported newly diagnosed asthma, 16% screened positive for probable posttraumatic stress disorder (PTSD), and 8% for serious psychological distress (SPD). Newly diagnosed asthma was most common among rescue and recovery workers who worked on the debris pile (4.1%). PTSD was higher among those who reported Hispanic ethnicity (30%), household income < $25,000 (31%), or being injured (35%). Using previously published estimates of the total number of exposed people per WTCHR eligibility criteria, we estimate between 3,800 and 12,600 adults experienced newly diagnosed asthma and 34,600-70,200 adults experienced PTSD following the attacks, suggesting extensive adverse health impacts beyond the immediate deaths and injuries from the acute event.",0 +https://doi.org/10.1080/15299730903318467,Symptoms of Trauma and Traumatic Memory Retrieval in Adult Survivors of Childhood Sexual Abuse,"We examined posttraumatic stress symptoms and the memory retrieval process in 2 groups of adult survivors of childhood sexual abuse: 29 participants who reported having memories of their abuse prior to entering therapy (PM) and 13 who reported no memories of abuse prior to therapy (NPM). Participants were asked to indicate on checklists symptoms of constriction, hyperarousal, and intrusion experienced (a) prior to entering therapy and (b) during the surfacing of a memory while in therapy. Overall, the findings indicate that for both groups the same cluster of posttraumatic stress symptoms occurred prior to therapy and during therapy and that there was a continuity of symptoms over time. Participants were also asked to fully describe details of their traumatic memories as these details emerged prior to and/or during therapy. We determined that (a) there were striking similarities in the detailed recall of trauma memories for both groups; (b) memories of abuse emerged in substantial perceptual, somatic, and emotional detail over time before developing into a narrative; (c) the amount of detail remembered increased in the PM group during therapy; (d) members of the NPM group were more kinesthetic than visual in their orientation to the world and may not have had access to the visual information that would associate their symptoms to their abuse; and (e) triggers of traumatic memories were largely the result of internal rather than external stimuli, and these triggers happened primarily outside of therapy sessions.",0 +https://doi.org/10.1002/jts.21759,Impact of Evidence-Based Standardized Assessment on the Disability Clinical Interview for Diagnosis of Service-Connected PTSD: A Cluster-Randomized Trial,"Posttraumatic stress disorder (PTSD) is one of the fastest growing compensated medical conditions. The present study compared usual disability examiner practices for PTSD with a standardized assessment that incorporates evidence-based assessments. The design was a multicenter, cluster randomized, parallel-group study involving 33 clinical examiners and 384 veterans at 6 Veterans Affairs medical centers. The standardized group incorporated the Clinician Administered PTSD Scale and the World Health Organization Disability Assessment Schedule-II into their assessment interview. The main outcome measures were completeness and accuracy of PTSD diagnosis and completeness of functional assessment. The standardized assessments were 85% complete for diagnosis compared to 30% for nonstandardized assessments (p < .001), and, for functional impairment, 76% versus 3% (p < .001). The findings demonstrate that the quality of PTSD disability examination would be improved by using evidence-based assessment.",0 +https://doi.org/10.1037/0021-843x.111.3.462,An analysis of the internalizing and externalizing behaviors of traumatized urban youth with and without PTSD.,"To test the differential validity of the posttraumatic stress disorder (PTSD) classification, 3 groups of youths (PTSD, traumatized PTSD negatives, and controls) were examined. Youth with major comorbid disorders were excluded. On the basis of an analysis of parent-derived Child Behavior Checklist (CBCL) ratings, significant variations in CBCL scores were associated with PTSD but not with exposure to exceptional stress in the absence of PTSD. The results also indicated that traumatic exposure without the development of PTSD was not associated with higher estimates of psychopathology.",0 +https://doi.org/10.1080/13825580601025924,MMPI-2 Patterns in Electrical Injury: A Controlled Investigation,"The psychological consequences of electrical injury (EI) are many. Depression, posttraumatic stress disorder, anxiety, and somatic preoccupation are often concomitant with this type of injury (Kelley, Pliskin, Meyer, & Lee, 1994). The present study utilized the MMPI-2 as a tool for characterizing profiles of psychological distress in EI. We examined MMPI-2 profiles in 79 EI patients and their relationship to both injury parameters (i.e., time since injury, LOC, voltage), and extra-diagnostic factors, such as litigation status. EI patient profiles were also compared to individuals with mild traumatic brain injury (TBI), and chronic pain sufferers (CP). Results indicated that in EI, clinical elevations (T > or = 65) were found on the Hs and Hy scales, and approached clinical levels on the D scale. The injury parameter of time since injury was predictive of a distinctive profile, with individuals in the post acute phase experiencing more distress. Compared to other clinical groups, MMPI-2 scores on the Hs and Hy scales were significantly higher within the EI cohort as compared with their CP peers, with higher scores on the Pd scale for CP than EI. No statistically significant differences emerged between the EI and TBI groups. However, TBI patients showed significant elevations on Hy and D compared to CP, and EI patients endorsed more somatic symptoms than CP patients. Implications of these findings and future directions will be discussed.",0 +https://doi.org/10.1038/npp.2014.239,Abnormal Structure of Fear Circuitry in Pediatric Post-Traumatic Stress Disorder,"Structural brain studies of adult post-traumatic stress disorder (PTSD) show reduced gray matter volume (GMV) in fear regulatory areas including the ventromedial prefrontal cortex (vmPFC) and hippocampus. Surprisingly, neither finding has been reported in pediatric PTSD. One possibility is that they represent age-dependent effects that are not fully apparent until adulthood. In addition, lower-resolution MRI and image processing in prior studies may have limited detection of such differences. Here we examine fear circuitry GMV, including age-related differences, using higher-resolution MRI in pediatric PTSD vs healthy youth. In a cross-sectional design, 3 T anatomical brain MRI was acquired in 27 medication-free youth with PTSD and 27 healthy non-traumatized youth of comparable age, sex, and IQ. Voxel-based morphometry was used to compare GMV in a priori regions including the medial prefrontal cortex and amygdala/hippocampus. Compared with healthy youth, PTSD youth had reduced GMV but no age-related differences in anterior vmPFC (BA 10/11, Z=4.5), which inversely correlated with PTSD duration. In contrast, although there was no overall group difference in hippocampal volume, a group × age interaction (Z=3.6) was present in the right anterior hippocampus. Here, age positively predicted hippocampal volume in healthy youth but negatively predicted volume in PTSD youth. Within the PTSD group, re-experiencing symptoms inversely correlated with subgenual anterior cingulate cortex (sgACC, Z=3.7) and right anterior hippocampus (Z=3.5) GMV. Pediatric PTSD is associated with abnormal structure of the vmPFC and age-related differences in the hippocampus, regions important in the extinction and contextual gating of fear. Reduced anterior vmPFC volume may confer impaired recovery from illness, consistent with its role in the allocation of attentional resources. In contrast, individual differences in sgACC volume were associated with re-experiencing symptoms, consistent with the role of the sgACC in fear extinction. The negative relationship between age and hippocampal volume in youth with PTSD may suggest an ongoing neurotoxic process over development, which further contributes to illness expression. Future studies employing a longitudinal design would be merited to further explore these possibilities.",0 +https://doi.org/10.1023/a:1022067512964,Factor analysis of treatment response in posttraumatic stress disorder,"Factor analysis is applied to the symptoms of posttraumatic stress disorder (PTSD) to reduce the multidimensional symptom space to 2 dimensions; 1 dimension strongly correlated with depressive symptoms and 1 independent dimension weakly correlated with depressive symptoms. These factors are used to assess whether the effectiveness of an antidepressant medication is due to its antidepressant effect. The treatment is shown to be effective in both dimensions. The factor analysis sheds light on the symptom structure of PTSD, supports PTSD as a distinct psychiatric disorder, and supports the current diagnostic criteria.",0 +https://doi.org/10.1097/bcr.0b013e3181921f42,Using QMethodology to Identify Reasons for Distress in Burn Survivors Postdischarge,"Reasons for distress after burn injuries have not been codified based on any type of acceptable empirical or statistical technique. The unique design methodology proposed in this study can identify the most common reasons cited for causing distress in burn survivors after discharge. A Q-sort task was developed with the assistance of our burn advisory group. After identifying 50 possible reasons for distress after discharge, each reason was placed on a laminated game card. In compliance with Qmethodology, a game board was developed that allowed patients to rank order each reason from ""not causing distress"" to ""causing significant distress."" A total of 69 burn survivors were enrolled in the study at four different time points: 1 month, 6 months, 1 year and 2 years postdischarge. After factor analysis, four factors accounted for all of the participants across time points. This indicates that at least four distinct groups of people can be categorized according to themes raised in rating reasons for distress. This Q-sort technique allowed us to capture the complexity of conceptualizing human distress by categorizing clusters of reported problems into similar groups. This methodology shows great promise for developing interventions that target unique needs of burn survivors.",0 +https://doi.org/10.1080/10437797.2015.1001269,Guest Editorial—Introduction to the Special Issue,"This special issue in the Journal of Social Work Education is a forum for professional and scholarly discourse on military social work education initiatives developed to educate and train social work professionals and students for practice with military personnel, veterans, and their families across the micro–macro continuum. Special emphasis was given to educational and technological trends, innovations, and challenges related to educating the next generation of social workers to provide evidence-based services to a new generation of veterans that incorporate the CSWE’s (2010) advanced knowledge and practice behaviors in military social work and NASW’s (2012) practice standards. Additional focus was given to university–community and university–military partnerships, collaborations, and initiatives that involve community and military stakeholders. Quantitative, qualitative, mixed methods, and conceptual manuscripts from researchers, educators, and practitioners on military social work education and practice were solicited from the professional social work community. In this special issue we highlight select exemplars of the social work profession’s unique contributions to military social work education. The issue is divided into two sections: (1) discourse on the integration of military social work into professional social work education and (2) innovative military social work education and training programs for doctoral and master’s students, student veterans, and licensed social work professionals—many including program evaluation and other research components. Each section is described in following paragraphs, including a brief overview of representative manuscripts. Integration of Military Social Work Into Professional Social Work Education Four manuscripts highlight military social work as a field of practice requiring specialized knowledge and skills, teaching strategies based on the CSWE competencies and advanced practice behaviors in military social work, the inclusion of military and veteran culture in social work education curricula, and adapting social work field placements for training in military social work practice. Wooten presents a rationale for military social work as a specialized field of practice, the need for military social work education, and opportunities and challenges for professional social work education. She delineates foundation and advanced knowledge in military social work and concludes by proposing an integrated model of intellectual capital to guide strategic planning for professional military social work education in addition to professional infrastructure needed to develop intellectual capital in military social work. For social work educators unfamiliar with military and veteran culture, Daley provides examples of teaching strategies based on CSWE’s advanced practice behaviors in military social work for integration into social work courses, specifically focusing on their application to CSWE’s Educational Policy and Accreditation Standards (EPAS; CSWE, 2008). He identifies foundation and advanced year military social work educational goals based on EPAS 2.1.1 to 2.1.10 and suggests that the infusion of military social work across the social work curriculum will assist students and faculty in becoming more sensitive to the issues faced by military service members, veterans, and their families. Continuing the application of CSWE’s EPAS to military social work education, Canfield and Weiss proposes the inclusion of military-related material into the foundation courses of undergraduate and graduate social work education because social workers providing services in civilian settings not focused on military-related difficulties may encounter military personnel, veterans, and families who seek services outside of the DoD and VA. Key issues, military examples, and resources are recommended for the integration of military culture into human behavior in the social environment, generalist practice, research methods, and social policy core curricula. With a focus on field education as the signature pedagogy of social work education, Selber, Chavkin, and Biggs advance a promising field instruction model in military social work with the growing student veteran population on American campuses. This innovative approach to field education expands placement opportunities beyond the VA for professional training in service delivery to current and past military cohorts.",0 +https://doi.org/10.1016/j.apnu.2007.05.002,Clinical Presentation and Therapeutic Interventions for Posttraumatic Stress Disorder Post-Katrina,"It has been almost 2 years since Hurricane Katrina struck the Gulf Coast. These 2 years can be characterized by constant struggle and pain as the people try to reattain some semblance of life as they knew it before Katrina struck. Some have chosen to leave their ancestral homes, homes where they were raised and where they, in turn, raised their own families. Those who did leave are able, in some way, to reestablish some semblance of normality, but those who stayed showed manifestations of and dealt with psychological trauma. These manifestations include regression, inattentiveness, aggressiveness, somatic complaints, irritability, social withdrawal, nightmares, and crying. Longer lasting effects may include depression, anxiety, adjustment disorders, and interpersonal or academic difficulties. These postdisaster manifestations can linger or remain hidden until well after the traumatic event and could persist for years. This article presents issues about the effects of Katrina on the mental health of the people of New Orleans. It discusses the profile of posttraumatic stress disorder and presents evidence-based review of interventions the health care provider can implement to care for those who continue to suffer the effects of this horrific disaster.",0 +https://doi.org/10.1177/070674379604100707,Posttraumatic Stress Disorder and Motor Vehicle Accidents: A Multidisciplinary Overview,"Objective: Motor vehicle accidents (MVA) may result in intractable disability. This paper investigates posttraumatic stress disorder (PTSD) as a potential cause. Method: The literature was reviewed for recent studies on prevalence, symptom profile, and outcome of PTSD. Results: PTSD is prevalent in roughly 10% of survivors of MVAs during the first year. Comorbid depression and pain are common. Medical complications, psychophysiological reactivity, and possibly litigation may slow remission. Phobic symptoms can persist for years. Mood disturbance may augment the impact of pain on daily living and on self-perceived disability. Conclusion: Recently developed screening instruments, structured interviews, and behavioural approach tests yield quantitative and reliable assessments of symptom severity. Cognitive–behavioural intervention and antidepressants may improve coping, ease fear, and reduce the impact of pain.",0 +https://doi.org/10.1097/fbp.0000000000000069,Animal models of post-traumatic stress disorder and recent neurobiological insights,"Post-traumatic stress disorder (PTSD) is a complex psychiatric disorder characterized by the intrusive re-experiencing of past trauma, avoidant behavior, enhanced fear, and hyperarousal following a traumatic event in vulnerable populations. Preclinical animal models do not replicate the human condition in its entirety, but seek to mimic symptoms or endophenotypes associated with PTSD. Although many models of traumatic stress exist, few adequately capture the complex nature of the disorder and the observed individual variability in susceptibility of humans to PTSD. In addition, various types of stressors may produce different molecular neuroadaptations that likely contribute to the various behavioral disruptions produced by each model, although certain consistent neurobiological themes related to PTSD have emerged. For example, animal models report traumatic stress-induced and trauma reminder-induced alterations in neuronal activity in the amygdala and prefrontal cortex, in agreement with the human PTSD literature. Models have also provided a conceptual framework for the often-observed combination of PTSD and comorbid conditions such as alcohol use disorder. Future studies will continue to refine preclinical PTSD models in hope of capitalizing on their potential to deliver new and more efficacious treatments for PTSD and associated psychiatric disorders.",0 +https://doi.org/10.1016/s0145-2134(02)00381-2,Assessing adolescent mental health in war-affected societies: the significance of symptoms,"To compare the use of self-report symptom checklists with qualitative methods for assessing adolescent psychological well-being in a war-affected society.A school-based sample of three hundred and thirty seven 13- to 15-year-olds from two communities on opposite sides of the Bosnian conflict (183 from Gorazde, 154 from Foca) completed the Hopkins Symptoms Checklist and the Harvard Trauma Questionnaire. A gender balanced sub-sample of 40 adolescents was selected on the basis of their combined checklist scores, including equal numbers of high and low scorers from each side. Over the following 6 months this sub-sample was assessed (blind to checklist scores) with qualitative methods that included narrative interviews of child and parent, and participant observation. School marks were taken as a measure of social function.QUALITATIVE: Some children identified as ""less well"" by qualitative methods denied having symptoms. Some children identified as ""well"" had symptoms with no pathological significance for them. The lifeline revealed that feeling ""less well"" could be more related to post-war circumstances than war events. QUANTITATIVE: The two symptom checklist items have shown good internal consistency and discriminant validity. However, comparison with the overall well being revealed that still in 9/40 of cases the reported presence or absence of symptoms did not correspond to the well being of the child. Items of the two questionnaires did not discriminate reliably between children identified as ""well"" and ""less well"" by other means.Self-report checklists may be useful as a public health measure to assess the prevalence of psychological distress in war affected areas, but they are not an adequate means of clinical screening. Checklists used in combination with other qualitative approaches make it possible to identify those in need and avoid unnecessary pathologizing.",0 +https://doi.org/10.1007/bf00930020,Prior experience as a moderator of disaster impact on anxiety symptoms in older adults,"As participants in a panel study, 234 older adults were interviewed before, as well as after, serious flooding occurred in southeastern Kentucky. Floods are not uncommon in this area, but these were more widespread than most, and resulted in both previously exposed and newly exposed subsamples of disaster victims. Flood impact was measured at both personal and community levels. With preflood symptoms controlled, there were modest flood effects on both trait anxiety and weather-specific distress in older adults without prior flood experience, but no flood effects in older adults who had been in floods before. Thus, the study provides support for the ""inoculation hypothesis"" and other conceptualizations that emphasize the advantage of being familiar or experienced with a stressor that is at hand. An implication is that ""experienced"" victims could be a valuable resource in prevention efforts.",0 +https://doi.org/10.1037/12323-004,Assessment and treatment in polytrauma contexts: Traumatic brain injury and posttraumatic stress disorder.,"(from the chapter) Military personnel deployed to Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) return from combat with injuries that were fatal in previous wars. This is partially due to more rapid and sophisticated medical responses on the battlefield and partially to improved protective equipment, such as Kevlar vests (Sayer et al., 2008; Warden, 2006). Protective gear and armored vehicles protect soldiers from mortal internal injuries but not from bodily trauma or concussive brain injuries. Recent studies have found that the great majority of injuries were due to explosions, and many involve more than one area of the body (i.e., polytrauma; Sayer et al., 2008). Physical injury during deployment is associated with a higher prevalence of PTSD postdeployment (J. E. Kennedy et al., 2007; Stein & McAllister, 2009). In a recent survey, 9% of soldiers returning from deployment without physical injury screened positive for PTSD (Hoge et al., 2008); however, the rate was almost double (16%) among those reporting bodily injury during deployment. This rate is similar to an earlier study assessing the increased risk of PTSD due to combat-related injury (Koren, Norman, Cohen, Berman, & Klein, 2005). Finally, another postdeployment survey of veterans revealed that the incidence of PTSD increased with the number of injury mechanisms: 14% for one, 29% for two, and 51% for three or more (Schneiderman, Braver, & Kang, 2008). This chapter focuses on how to adapt the assessment and treatment of posttraumatic stress disorder (PTSD) to returning veterans with polytraumatic injuries, especially when the polytrauma involves a traumatic brain injury (TBI). We begin with a review of the empirical literature addressing the prevalence of PTSD in polytrauma populations and the degree to which polytrauma alters PTSD severity and treatment response. Although the evidence base regarding best models of clinical management of PTSD when accompanied by TBI is in its infancy, we present suggestions for assessment of polytrauma and outline techniques and tools useful in optimizing psychosocial and psychopharmacological PTSD treatment interventions in polytrauma contexts. (PsycINFO Database Record (c) 2015 APA, all rights reserved)",0 +https://doi.org/10.1016/s0140-6736(06)69320-3,Mental health of Iraqi children,,0 +https://doi.org/10.1111/jcpp.12021,Annual Research Review: Positive adjustment to adversity - trajectories of minimal-impact resilience and emergent resilience,"Background: Research on resilience in the aftermath of potentially traumatic life events (PTE) is still evolving. For decades, researchers have documented resilience in children exposed to corrosive early environments, such as poverty or chronic maltreatment. Relatively more recently, the study of resilience has migrated to the investigation of isolated PTE in adults. Methods: In this article, we first consider some of the key differences in the conceptualization of resilience following chronic adversity versus resilience following single-incident traumas, and then describe some of the misunderstandings that have developed about these constructs. To organize our discussion, we introduce the terms emergent resilience and minimal-impact resilience to represent trajectories of positive adjustment in these two domains, respectively. Results: We focused in particular on minimal-impact resilience, and reviewed recent advances in statistical modeling of latent trajectories that have informed the most recent research on minimal-impact resilience in both children and adults and the variables that predict it, including demographic variables, exposure, past and current stressors, resources, personality, positive emotion, coping and appraisal, and flexibility in coping and emotion regulation. Conclusions: The research on minimal-impact resilience is nascent. Further research is warranted with implications for a multiple levels of analysis approach to elucidate the processes that may mitigate or modify the impact of a PTE at different developmental stages.",0 +https://doi.org/10.1891/0739-6686.33.249,Military Personnel With Traumatic Brain Injuries and Insomnia Have Reductions in PTSD and Improved Perceived Health Following Sleep Restoration: A Relationship Moderated by Inflammation,"Background: Up to one-third of deployed military personnel sustain a traumatic brain injury (TBI). TBIs and the stress of deployment contribute to the vulnerability for chronic sleep disturbance, resulting in high rates of insomnia diagnoses as well as symptoms of posttraumatic stress disorder (PTSD), depression, and declines in health-related quality of life (HRQOL). Inflammation is associated with insomnia; however, the impact of sleep changes on comorbid symptoms and inflammation in this population is unknown. Methods: In this study, we examined the relationship between reported sleep changes and the provision of the standard of care, which could include one or more of the following: cognitive behavioral therapy (CBT), medications, and continuous positive airway pressure (CPAP). We compared the following: (a) the group with a decrease in the Pittsburgh Sleep Quality Index (PSQI; restorative sleep) and (b) the group with no change or increase in PSQI (no change). Independent t tests and chi-square tests were used to compare the groups on demographic and clinical characteristics, and mixed between-within subjects analysis of variance tests were used to determine the effect of group differences on changes in comorbid symptoms. Linear regression models were used to examine the role of inflammation in changes in symptoms and HRQOL. Results: The sample included 70 recently deployed military personnel with TBI, seeking care for sleep disturbances. Thirty-seven participants reported restorative sleep and 33 reported no sleep changes or worse sleep. The two groups did not differ in demographic characteristics or clinical symptoms at baseline. The TBI + restored sleep group had significant reductions in PTSD and depression over the 3-month period, whereas the TBI + no change group had a slight increase in both PTSD and depression. The TBI + restored sleep group also had significant changes in HRQOL, including the following HRQOL subcomponents: physical functioning, role limitations in physical health, social functioning, emotional well-being, energy/fatigue, and general health perceptions. In a linear regression model using a forced entry method, the dependent variable of change in C-reactive protein (CRP) concentrations was significantly related to changes in PTSD symptoms and HRQOL in the TBI + restored sleep group, with R2 = 0.43, F33,3 = 8.31, p \textless .01. Conclusions: Military personnel with TBIs who have a reduction in insomnia symptoms following a standard-of-care treatment report less severe symptoms of depression and PTSD and improved HRQOL, which relate to decreased plasma concentrations of CRP. These findings suggest that treatment for sleep disturbances in this TBI + military population is associated with improvements in health and decreases in inflammation. The contributions of inflammation-induced changes in PTSD and depression in sleep disturbances in TBI + military personnel require further study. (PsycINFO Database Record (c) 2016 APA, all rights reserved)",0 +https://doi.org/10.1037/a0015996,Family functioning and posttraumatic stress disorder in adolescent survivors of childhood cancer.,"This study investigated family functioning and relationships between family functioning and posttraumatic stress disorder (PTSD) in adolescent survivors of childhood cancer. To assess family functioning, 144 adolescent cancer survivors 1 to 12 years post-cancer treatment (M = 5.3 years) and their parents completed the Family Assessment Device (FAD). To assess PTSD, adolescents were administered a structured diagnostic interview. Nearly half (47%) of the adolescents, one fourth (25%) of mothers, and one third (30%) of fathers reported poor family functioning, exceeding the clinical cutoff on 4 or more FAD subscales. Families in which the cancer survivor had PTSD (8% of the sample) had poorer functioning than other families in the areas of problem solving, affective responsiveness, and affective involvement. Three fourths of the adolescents with PTSD came from families with categorically poor family functioning. A surprisingly high rate of poor family functioning was reported in these families of adolescent cancer survivors. Adolescents with PTSD were more than 5 times as likely to emerge from a poorly functioning family compared with a well-functioning one. This study provides evidence that family functioning is related to cancer-related posttraumatic reactions in adolescent survivors.",0 +https://doi.org/10.1186/1471-2458-6-230,Impaired psychological recovery in the elderly after the Niigata-Chuetsu Earthquake in Japan:a population-based study,"An earthquake measuring 6.8 on the Richter scale struck the Niigata-Chuetsu region of Japan at 5.56 P.M. on the 23rd of October, 2004. The earthquake was followed by sustained occurrence of numerous aftershocks, which delayed reconstruction of community lifelines. Even one year after the earthquake, 9,160 people were living in temporary housing. Such a devastating earthquake and life after the earthquake in an unfamiliar environment should cause psychological distress, especially among the elderly.Psychological distress was measured using the 12-item General Health Questionnaire (GHQ-12) in 2,083 subjects (69% response rate) who were living in transient housing five months after the earthquake. GHQ-12 was scored using the original method, Likert scoring and corrected method. The subjects were asked to assess their psychological status before the earthquake, their psychological status at the most stressful time after the earthquake and their psychological status at five months after the earthquake. Exploratory and confirmatory factor analysis was used to reveal the factor structure of GHQ12. Multiple regression analysis was performed to analyze the relationship between various background factors and GHQ-12 score and its subscale.GHQ-12 scores were significantly elevated at the most stressful time and they were significantly high even at five months after the earthquake. Factor analysis revealed that a model consisting of two factors (social dysfunction and dysphoria) using corrected GHQ scoring showed a high level of goodness-of-fit. Multiple regression analysis revealed that age of subjects affected GHQ-12 scores. GHQ-12 score as well as its factor 'social dysfunction' scale were increased with increasing age of subjects at five months after the earthquake.Impaired psychological recovery was observed even at five months after the Niigata-Chuetsu Earthquake in the elderly. The elderly were more affected by matters relating to coping with daily problems.",0 +https://doi.org/10.1097/00004850-200609000-00002,Topiramate in the treatment of trichotillomania: an open-label pilot study,"There is a need for an effective medication for the treatment of trichotillomania (TTM), which is an impulse control disorder characterized by chronic hair-pulling. Topiramate has shown promising results in the treatment of impulse-control disorders. The present open-label pilot study investigated the efficacy and safety of topiramate in 14 adults with TTM. Patients received 16 weeks of flexible dose treatment (50-250 mg/day), followed by a flexible dose taper over 2-4 weeks. The primary outcome measure was the Massachusetts General Hospital Hair-Pulling Scale (HPS), whereas secondary outcome measures were the Clinical Global Impression (CGI) Scale, the Montgomery-Asberg Depression Rating Scale, the Hamilton Rating Scale for Anxiety and the Disability Profile. A repeated measures analysis of variance on the intent-to-treat sample was implemented to evaluate treatment response. The primary outcome measure (HPS) indicated that the severity of hair-pulling in adults with TTM who completed the 16-week study (n=9) decreased significantly from baseline to the treatment endpoint (F=5.05; P=0.0002). Although the CGI-Improvement scores suggested that hair-pulling was not significantly reduced, six of nine trial completers were classified as responders. None of the other measures showed significant differences compared to baseline. Five patients dropped out owing to adverse effects. These results suggest that topiramate may be useful in the treatment of TTM. Future studies should investigate the efficacy of topiramate in an appropriately powered randomized placebo-controlled trial.",0 +https://doi.org/10.1001/jama.1984.03350140051025,Detecting Alcoholism,,0 +https://doi.org/10.1016/j.ajp.2012.07.002,Subjective models of psychological disorders: Mental health professional's perspectives,"This exploratory study is an extension of previous studies which have applied personal construct theory (PCP) methodology toward a better understanding of the structure and dynamics of multidisciplinary mental (and physical) health care (Kirkcaldy and Pope, 1992; Kirkcaldy et al., 1993, 2000, 2005; Kirkcaldy and Siefen, 1999). In this study we wanted to use similar cluster statistical analyses, not unlike PCP analysis, to identify the diverse subjective models of psychological ailments such as anxiety, depression, psychosis, mania, obsessive compulsive disorder (OCD), post stress traumatic disorder (PTSD), etc., using not the idiosyncratic constructs generated by individual triadic element comparisons, but by selecting those constructs which have been clearly identified in various psychiatric and psychological rating scales (e.g. somatic preoccupation, social withdrawal, conceptual disorganization, hostility, disinhibition and controlling). Clinical experts (psychological psychotherapists, and medical psychotherapist and psychiatrist) each with over 25 years of clinical and research experience were required to complete the ratings of each disorder listed in terms of the pre-formulated behavioral, emotional and cognitive concepts. What emerged are several multivariate (grid) analyses based on mental health professionals' perception of diverse elements (disorders) and their interrelationship derived from the similarity of composite profiles of ill-related constructs. Overall, the analyses revealed clear associations between the subjective evaluations of psychological ailments suggesting some uniformity in mental health assessment of such disorders. The implications of these findings are discussed within the theoretical framework of improved mental health care.",0 +https://doi.org/10.1007/s00127-009-0011-y,PTSD onset and course following the World Trade Center disaster: findings and implications for future research,"We sought to identify common risk factors associated with posttraumatic stress disorder (PTSD) onset and course, including delayed, persistent, and remitted PTSD following a major traumatic exposure.Based on a prospective study of New York City adults following the World Trade Center disaster (WTCD), we conducted baseline interviews with 2,368 persons one year after this event and then at follow-up 1 year later to evaluate changes in current PTSD status based on DSM-IV criteria.Baseline analysis suggested that current PTSD, defined as present if this occurred in the past 12 months, was associated with females, younger adults, those with lower self-esteem, lower social support, higher WTCD exposure, more lifetime traumatic events, and those with a history of pre-WTCD depression. At follow-up, current PTSD was associated with Latinos, non-native born persons, those with lower self-esteem, more negative life events, more lifetime traumatic events, and those with mixed handedness. Classifying respondents at follow-up into resilient (no PTSD time 1 or 2), remitted (PTSD time 1, not 2), delayed (no PTSD time 1, but PTSD time 2), and persistent (PTSD both time 1 and 2) PTSD, revealed the following: compared to resilient cases, remitted ones were more likely to be female, have more negative life events, have greater lifetime traumatic events, and have pre-WTCD depression. Delayed cases were more likely to be Latino, be non-native born, have lower self-esteem, have more negative life events, have greater lifetime traumas, and have mixed handedness. Persistent cases had a similar profile as delayed, but were the only cases associated with greater WTCD exposures. They were also likely to have had a pre-WTCD depression diagnosis. Examination of WTCD-related PTSD at follow-up, more specifically, revealed a similar risk profile, except that handedness was no longer significant and WTCD exposure was now significant for both remitted and persistent cases.PTSD onset and course is complex and appears to be related to trauma exposure, individual predispositions, and external factors not directly related to the original traumatic event. This diagnostic classification may benefit from additional conceptualization and research as this relates to changes in PTSD status over time.",0 +https://doi.org/10.1016/j.nurt.2006.10.003,Use of antiepileptic drugs for nonepileptic conditions: Psychiatric disorders and chronic pain,"Antiepileptic drugs (AEDs) are commonly utilized for nonepileptic conditions, including various psychiatric disorders and pain syndromes. Evidence for their benefit in these nonepileptic conditions varies widely among different drugs, but there is, in general, a paucity of published multicenter randomized double-blind trials. Variable levels of evidence suggest that lamotrigine and the vagal nerve stimulator have antidepressant properties. Carbamazepine, valproate, lamotrigine, and oxcarbazepine appear to have mood stabilizing properties while gabapentin, pregabalin, and tiagabine have anxiolytic benefits. Barbiturates, topiramate, and possibly phenytoin may precipitate or exacerbate depression. Underlying depression and anxiety symptoms may be exacerbated by levetiracetam, while psychotic symptoms have rarely been reported with topiramate, levetiracetam, and zonisamide. Pregabalin, gabapentin, carbamazepine, and oxcarbazepine have been used to treat neuropathic pain such as postherpetic neuralgia, and diabetic polyneuropathy. Topiramate and divalproex sodium have utility in the prophylaxis or acute treatment of migraine. Further rigorous studies are needed to clarify the utility of AEDs in nonepileptic conditions.",0 +https://doi.org/10.1002/j.2051-5545.2008.tb00139.x,Neurobehavioral sequelae of traumatic brain injury: evaluation and management,"Traumatic brain injury (TBI) is a worldwide public health problem. Over the last several decades, improvements in acute care have resulted in higher survival rates. Unfortunately, the majority of survivors of moderate and severe TBI have chronic neurobehavioral sequelae, including cognitive deficits, changes in personality and increased rates of psychiatric illness. These neurobehavioral problems are understandable in the context of the typical profile of regional brain damage associated with trauma. This paper presents an overview of the neurobehavioral sequelae of TBI and outlines issues to consider in the evaluation and management of these challenges.",0 +https://doi.org/10.1016/s0005-7894(89)80066-8,Post-traumatic stress disorder: current status and future directions,"Provides an overview of current research in posttraumatic stress disorder (PTSD) to provide impetus for studies that will advance the understanding of the effects of high level stressors on individuals in society today. It is suggested that the most important factors that need to be studied in PTSD involve the biological, psychological, and social resources that interact with individuals' experiences of traumatic events. Research on reactions to different types of trauma and on other disorders that develop following exposure to extreme stress is reviewed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1542/peds.2013-0713,Evaluation of an Early Risk Screener for PTSD in Preschool Children After Accidental Injury,"OBJECTIVES: To evaluate the effectiveness and most powerful selection of predictors of an early screening tool for posttraumatic stress disorder (PTSD) in a sample of 87 children ages 2 to 6 years after unintentional injury. METHODS: The examined screener was administered within 6 to 13 days post accident and consisted of an adapted version of the Pediatric Emotional Distress Scale (PEDS), the PEDS-ES (PEDS Early Screener), and questions on 5 additional risk factors (preexisting child behavioral problems, parental preexisting chronic mental or physical illness, pretraumatic life events in the family, parental feelings of guilt, parental posttraumatic stress). The PTSD Semi-structured Interview and Observational Record for Infants and Young Children served as criterion measure 6 months after the accident. A case was deemed positive when meeting criteria for full or partial PTSD. RESULTS: Use of the PEDS-ES without the additional risk factors performed best, with good sensitivity (85%) and moderate specificity (63%) for full or partial PTSD. CONCLUSIONS: The PEDS-ES allows for successful early screening of preschool-aged children after single accidental trauma. It may be used within a stepped-care model for early identification of individuals designated for possible secondary preventative interventions.",0 +https://doi.org/10.1093/pan/mpq025,Latent Class Modeling with Covariates: Two Improved Three-Step Approaches,"Researchers using latent class (LC) analysis often proceed using the following three steps: (1) an LC model is built for a set of response variables, (2) subjects are assigned to LCs based on their posterior class membership probabilities, and (3) the association between the assigned class membership and external variables is investigated using simple cross-tabulations or multinomial logistic regression analysis. Bolck, Croon, and Hagenaars (2004) demonstrated that such a three-step approach underestimates the associations between covariates and class membership. They proposed resolving this problem by means of a specific correction method that involves modifying the third step. In this article, I extend the correction method of Bolck, Croon, and Hagenaars by showing that it involves maximizing a weighted log-likelihood function for clustered data. This conceptualization makes it possible to apply the method not only with categorical but also with continuous explanatory variables, to obtain correct tests using complex sampling variance estimation methods, and to implement it in standard software for logistic regression analysis. In addition, a new maximum likelihood (ML)—based correction method is proposed, which is more direct in the sense that it does not require analyzing weighted data. This new three-step ML method can be easily implemented in software for LC analysis. The reported simulation study shows that both correction methods perform very well in the sense that their parameter estimates and their SEs can be trusted, except for situations with very poorly separated classes. The main advantage of the ML method compared with the Bolck, Croon, and Hagenaars approach is that it is much more efficient and almost as efficient as one-step ML estimation.",0 +https://doi.org/10.1002/da.20621,"PTSD, depression, and their comorbidity in relation to suicidality: cross-sectional and prospective analyses of a national probability sample of women","A growing body of literature implicates major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) as risk factors for suicidal ideation (SI) and suicide attempts (SA), though research has not adequately examined their differential contributions to increasing suicide risk prospectively or cross-sectionally.The contribution of these disorders and their comorbidity to SI and SA was examined using a national household probability sample of women (N=3,085) and covarying for trauma history, substance abuse, and demographic variables.Cross-sectional analyses indicated that lifetime comorbidity of MDD and PTSD were associated with much higher prevalence of SI than either diagnosis alone; prevalence of SI was elevated and comparable for PTSD and MDD only. Comorbid diagnosis and PTSD only groups displayed greater prevalence of SA than those with MDD only. Lastly, a 2-year prospective analysis indicated that PTSD only at baseline was predictive of greater subsequent SI risk than MDD only, though comorbid diagnosis did not differ from either PTSD only or MDD only.PTSD appears to be a particularly strong predictor of SI and SA. Overall, only 16% of women with lifetime SA did not have a history of MDD or PTSD, highlighting the importance of assessing these variables when assessing suicide risk.",0 +https://doi.org/10.1371/journal.pone.0145188,Mental Health Functioning in the Human Rights Field: Findings from an International Internet-Based Survey,"Human rights advocates play a critical role in promoting respect for human rights world-wide, and engage in a broad range of strategies, including documentation of rights violations, monitoring, press work and report-writing, advocacy, and litigation. However, little is known about the impact of human rights work on the mental health of human rights advocates. This study examined the mental health profile of human rights advocates and risk factors associated with their psychological functioning. 346 individuals currently or previously working in the field of human rights completed an internet-based survey regarding trauma exposure, depression, posttraumatic stress disorder (PTSD), resilience and occupational burnout. PTSD was measured with the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) and depression was measured with the Patient History Questionnaire-9 (PHQ-9). These findings revealed that among human rights advocates that completed the survey, 19.4% met criteria for PTSD, 18.8% met criteria for subthreshold PTSD, and 14.7% met criteria for depression. Multiple linear regressions revealed that after controlling for symptoms of depression, PTSD symptom severity was predicted by human rights-related trauma exposure, perfectionism and negative self-appraisals about human rights work. In addition, after controlling for symptoms of PTSD, depressive symptoms were predicted by perfectionism and lower levels of self-efficacy. Survey responses also suggested high levels of resilience: 43% of responders reported minimal symptoms of PTSD. Although survey responses suggest that many human rights workers are resilient, they also suggest that human rights work is associated with elevated rates of PTSD and depression. The field of human rights would benefit from further empirical research, as well as additional education and training programs in the workplace about enhancing resilience in the context of human rights work.",0 +https://doi.org/10.1097/nmd.0b013e318208314e,Axis-I Comorbidity in Female Patients With Dissociative Identity Disorder and Dissociative Identity Disorder Not Otherwise Specified,"The aim of this study was to investigate axis-I comorbidity in patients with dissociative identity disorder (DID) and dissociative disorder not otherwise specified (DDNOS). Using the Diagnostic Interview for Psychiatric Disorders, results from patients with DID (n = 44) and DDNOS (n = 22) were compared with those of patients with posttraumatic stress disorder (PTSD) (n = 13), other anxiety disorders (n = 14), depression (n = 17), and nonclinical controls (n = 30). No comorbid disorders were found in nonclinical controls. The average number of comorbid disorders in patients with depression or anxiety was 0 to 2. Patients with dissociative disorders averagely suffered from 5 comorbid disorders. The most prevalent comorbidity in DDNOS and DID was PTSD. Comorbidity profiles of patients with DID and DDNOS were very similar to those in PTSD (high prevalence of anxiety, somatoform disorders, and depression), but differed significantly from those of patients with depression and anxiety disorders. These findings confirm the hypothesis that PTSD, DID, and DDNOS are phenomenologically related syndromes that should be summarized within a new diagnostic category.",0 +https://doi.org/10.1016/s0924-9338(03)00043-9,Prediction of the occurrence and intensity of post-traumatic stress disorder in victims 32 months after bomb attack,"Our objective was to identify factors that predict occurrence and severity of post-traumatic stress disorder (PTSD) after a terrorism attack.We evaluated 32 victims of a bomb attack in a Paris subway in December 1996 at 6 and 32 months.Sociodemographic characteristics, clinical data and physical injuries were used to predict PTSD occurrence and severity in 32 victims. The Watson's PTSD Inventory (PTSD-I) and the Impact of Event Scale (IES) by Horowitz were used to evaluate occurrence and severity of PTSD, respectively.Thirty-nine percent of participants met PTSD criteria at 6 months, 25% still had PTSD at 32 months. Women had PTSD 32 months after the bomb attack more frequently than men. Employment predicted PTSD severity at 32 months. PTSD scores assessed by PTSD-I at 6 months were significantly and positively associated with IES scores at 32-month follow-up (r = 0.55, P = 0.004). Psychotropic drug use before the bomb attack significantly predicted PTSD occurrence and severity at 6 and 32 months. In a linear regression model, physical injuries, employment status and psychotropic drug use before the bomb attack were independent predictors of severity of PTSD at 32 months.Bomb attack exposure resulted in persisting PTSD in a significant proportion of victims; the severity was predicted at 32 months by physical injuries and psychotropic drug use before the terrorism attack and by the PTSD score few months after the bomb attack.",0 +https://doi.org/10.1002/jts.21704,"Association between posttraumatic stress, depression, and functional impairments in adolescents 24 months after traumatic brain injury","The degree to which postinjury posttraumatic stress disorder (PTSD) and/or depressive symptoms in adolescents are associated with cognitive and functional impairments at 12 and 24 months after traumatic brain injury (TBI) is not yet known. The current study used a prospective cohort design, with baseline assessment and 3-, 12-, and 24-month followup, and recruited a cohort of 228 adolescents ages 14-17 years who sustained either a TBI (n = 189) or an isolated arm injury (n = 39). Linear mixed-effects regression was used to assess differences in depressive and PTSD symptoms between TBI and arm-injured patients and to assess the association between 3-month PTSD and depressive symptoms and cognitive and functional outcomes. Results indicated that patients who sustained a mild TBI without intracranial hemorrhage reported significantly worse PTSD (Hedges g = 0.49, p = .01; Model R(2) = .38) symptoms across time as compared to the arm injured control group. Greater levels of PTSD symptoms were associated with poorer school (η(2) = .07, p = .03; Model R(2) = .36) and physical (η(2) = .11, p = .01; Model R(2) = .23) functioning, whereas greater depressive symptoms were associated with poorer school (η(2) = .06, p = .05; Model R(2) = .39) functioning.",0 +https://doi.org/10.1080/15228932.2014.918475,An Examination of the CROPS and BASC-2-SRP-A among Adjudicated Youth,"This study explored the Behavior Assessment System for Children Second Edition Self Report of Personality-Adolescent (BASC-2-SRP-A) and the Child Report of Post-traumatic Stress (CROPS) profiles of a sample of adjudicated youth. Results were consistent with previous research, indicating that 56% of CROPS scores fell within the clinically significant range. Cronbach’s alpha indicated good internal consistency of the 26-item CROPS. In addition, Anxiety was found to contribute most to distinguishing between the clinically significant and clinically non-significant CROPS groups, followed by the Social Stress and Somatization subscales. Gender differences, implications, and future directions are discussed.",0 +https://doi.org/10.1016/j.beth.2010.04.004,Emotion Regulation Difficulties in Trauma Survivors: The Role of Trauma Type and PTSD Symptom Severity,"Two different hypotheses regarding the relationship between emotion regulation and PTSD are described in the literature. First, it has been suggested that emotion regulation difficulties are part of the complex sequelae of early-onset chronic interpersonal trauma and less common following late-onset or single-event traumas. Second, PTSD in general has been suggested to be related to emotion regulation difficulties. Bringing these two lines of research together, the current study aimed to investigate the role of trauma type and PTSD symptom severity on emotion regulation difficulties in a large sample of trauma survivors (N=616). In line with the hypotheses, PTSD symptom severity was significantly associated with all variables assessing emotion regulation difficulties. In addition, survivors of early-onset chronic interpersonal trauma showed higher scores on these measures than survivors of single-event and/or late-onset traumas. However, when controlling for PTSD symptom severity, the group differences only remained significant for 2 out of 9 variables. The most robust findings were found for the variable ""lack of clarity of emotions."" Implications for future research, theoretical models of trauma-related disorders, and their treatment will be discussed.",0 +,Post-traumatic stress disorders in children and adolescents,"(from the chapter) Children and adolescents surviving a life-threatening disaster show a wide range of symptoms which tend to cluster around signs of re-experiencing the traumatic event, trying to avoid dealing with the emotions that this gives rise to, and a range of signs of increased physiological arousal. There may be considerable co-morbidity with depression, generalized anxiety or pathological grief reactions. Topics include: manifestations of stress reactions in children and adolescents; effects on younger children (risk and protective factors age, gender, ability and attainment, family factors, prevalence, single vs repeated or chronic stressors, objective factors, subjective factors, single vs multiple traumas, disorders of extreme stress not otherwise specified); developmental issues (case examples); assessing posttraumatic stress disorder (PTSD) in children; treatment of PTSD (critical incident stress debriefing, group treatments, individual treatment, contingency planning). (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1016/j.psychres.2014.11.055,Portuguese version of the PTSD Checklist-Military Version (PCL-M)-I: Confirmatory Factor Analysis and reliability,"The PTSD Checklist-Military Version (PCL-M) is a brief self-report instrument widely used to assess Post-traumatic Stress Disorder (PTSD) symptomatology in war Veterans, according to DSM-IV. This study sought out to explore the factor structure and reliability of the Portuguese version of the PCL-M. A sample of 660 Portuguese Colonial War Veterans completed the PCL-M. Several Confirmatory Factor Analyses were conducted to test different structures for PCL-M PTSD symptoms. Although the respecified first-order four-factor model based on King et al.'s model showed the best fit to the data, the respecified first and second-order models based on the DSM-IV symptom clusters also presented an acceptable fit. In addition, the PCL-M showed adequate reliability. The Portuguese version of the PCL-M is thus a valid and reliable measure to assess the severity of PTSD symptoms as described in DSM-IV. Its use with Portuguese Colonial War Veterans may ease screening of possible PTSD cases, promote more suitable treatment planning, and enable monitoring of therapeutic outcomes.",0 +,Family Resilience Following a Physical Trauma and Efficient Support Interventions: A Critical Literature Review,"The concept of resilience was first associated with physics and engineering, but it has since held the interest of thinkers and researchers from many other fields, including ecology, economics, computer science, and social science. The definition has also been expanded to now include family and community. Thus, the concept of resilience has been modified according to the various contexts or fields of interest with which it is associated. From an etymological perspective, the term resilience is comprised of the prefix re, meaning again, and salire, meaning jump (Anaut, 2008; Poilpot, 2003). In physics, resilience refers to the capacity of a material to resist a shock (Murry, 2004), whereas in ecology, it refers to a species' or an ecosystem's capacity to return to normal functioning or development following a trauma (Holling, 1973). In economics, resilience is the capacity for an economy to get back on track following a crash or crisis (Richemond, 2003), and in computer science, it is the quality of a system that ensures it continues to function properly in spite of defects of one or several components (Collin, 2013). In psychology, individual resilience refers to the ability to succeed, live, and continue to grow despite adversity (Cyrulnik, 2002, 2003, 2006; Tisseron, 2007). Researchers in nursing, for their part, generally retain the same definition of resilience as those in psychology; specifically that individual resilience is the ability to successfully navigate changes and difficulties (Mandleco & Peery, 2000; Wagnild & Young, 1993). Definitions Several definitions of family resilience have been developed in the past few years, most of which seem to be inspired by individual resilience, but when studied in a family context the concept becomes more complex. For some authors, family resilience refers to the success of family members in overcoming difficulties in the wake of a trauma (Black & Lobo, 2008), or represents the strength a family taps into to change its dynamic in order to solve the problems encountered (Delage, 2004, 2008; Lee et al., 2004; McCubbin & McCubbin, 1988, Walsh, 2006). According to Michael Ungar (2010), family resilience necessarily includes interactions with the environment in which the family evolves. In other words, it is important to consider the family's environment when talking about resilience. Moreover, again according to Ungar (2010), family resilience is influenced by what transpired before, during, and after the trauma, hence the reference to a process. Recently, Genest (2012) studied the process of resilience, which she defined as complex and multidimensional, in order to develop a theoretical model of resilience in families grieving the loss of an adolescent who committed suicide. Genest defines family resilience as a process during which a family confronted with a traumatic situation, despite the psychological and physical suffering endured, overcame it. Without a doubt, the most important contribution of her research is its pragmatic aspect, which proposes intervention methods for health care professionals according to the different types of resilience observed in the families interviewed during this process. For his part, Gauvin-Lepage (2013) conducted an empirical study with the aim of co-constructing the elements of an intervention program that would support the resilience process of families of adolescents with a moderate or severe traumatic brain injury, involving both families and rehabilitation professionals. The research process allowed the author to define family resilience as: (...) a complex human process that is deployed when a family is confronted with a trauma. Thus, the family will undertake a fluctuating process of transformation, according to the meaning it ascribes to the situation. The interrelation of elements inherent to the family and its environment will influence this process, positively or negatively, to achieve a positive reconstruction of the life project. …",0 +https://doi.org/10.1007/s12207-014-9186-y,One Quintillion Ways to Have PTSD Comorbidity: Recommendations for the Disordered DSM-5,"Galatzer-Levy and Bryant (Perspect Psychol Sci 8:651-662, 2013) have calculated the number of ways that Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; American Psychiatric Association, 2013) posttraumatic stress disorder (PTSD) symptoms can be combined as over 600,000. They concluded that the amount is astounding and the category is rendered amorphous. PTSD often occurs in the context of polytrauma or comorbidity. The epidemiological literature indicates that the most common comorbid conditions in cases of PTSD include major depressive disorder (MDD), chronic pain, neurocognitive disorder due to traumatic brain injury (e.g., mild), and alcohol use disorder, with premorbid personality disorder possible, as well (which we consider as exacerbated due to the traumatic incident at issue, as in borderline personality disorder). We calculated the possible symptom combinations for each of these disorders and then in comorbid combination with PTSD (e.g., PTSD with MDD, but also when all six conditions are present). The number of symptom combinations in full polytrauma involving all six conditions listed is truly astounding, over one quintillion. Also, we reviewed the range of PTSD comorbidities, which adds to the symptom heterogeneity in cases. We make recommendations to prioritize symptoms in disorders as primary (e.g., unique, marker), secondary (e.g., core essential), and tertiary (e.g., common, cross-diagnostic). The latter tertiary type of symptoms in a disorder, if any, should be kept apart in its own criterion. This approach might help make the next version of the DSM more clinically useful both to clinicians and to court. © 2014 Springer Science+Business Media New York.",0 +https://doi.org/10.1016/j.burns.2014.10.018,Which factors influence the development of post-traumatic stress disorder in patients with burn injuries? A systematic review of the literature,"This article aims to discover which variables influence the development of post-traumatic stress disorder in patients with burn injuries. It will also consider whether it is possible to predict which burns patients will develop PTSD.Post-traumatic stress disorder is an important psychopathology for burned patients as it can affect both physical outcomes and quality of life for those affected. Research states that PTSD may be identified in up to 30% of burns patients, making it relatively common.A systematic review of the literature was carried out using four databases. Eleven articles were identified from these searches, and were then analysed thematically to draw out common ideas.Gender, extraversion and neuroticism, attribution of blame, capacity for forgiveness, the event as a disaster or non-disaster, alcohol consumption and peri-traumatic emotional response were all found to influence burns patients' risk of developing PTSD.While it is possible to identify the factors that put burns patients are greater risk of developing PTSD, it is not possible to accurately predict who will go on to develop PTSD due to the interplay between variables and individual differences. Focus should instead be on screening for PTSD and timely recognition of intrusive symptoms.",0 +https://doi.org/10.1186/1471-2458-14-199,Factors influencing social and health outcomes after motor vehicle crash injury: an inception cohort study protocol,"There is growing evidence that health and social outcomes following motor vehicle crash injury are related to cognitive and emotional responses of the injured individual, as well as relationships between the injured individual and the compensation systems with which they interact. As most of this evidence comes from other states in Australia or overseas, investigation is therefore warranted to identify the key determinants of health and social outcomes following injury in the context of the New South Wales motor accident insurance scheme.In this inception cohort study, 2400 participants, aged 17 years or more, injured in a motor vehicle crash in New South Wales will be identified though hospital emergency departments, general and physiotherapy practitioners, police records and a government insurance regulator database. Participants will be initially contacted through mail. Baseline interviews will be conducted by telephone within 28 days of the injury and participants will be followed up with interviews at 6, 12 and 24 months post-injury. Health insurance and pharmaceutical prescription data will also be collected.The study results will report short and long term health and social outcomes in the study sample. Identification of factors associated with health and social outcomes following injury, including related compensation factors will provide evidence for improved service delivery, post-injury management, and inform policy development and reforms.Australia New Zealand Clinical trial registry identification number--ACTRN12613000889752. Available at: ANZCTR Registered FISH Study.",0 +https://doi.org/10.1177/0004867415625814,"Childhood adversities: Social support, premorbid functioning and social outcome in first-episode psychosis and a matched case-control group","Objective: The establishment of childhood adversities as risk factors for non-affective psychosis has derived a need to consider alternative interpretations of several psychosis-related factors. This paper sought to examine premorbid adjustment trajectories and social outcome factors in relation to childhood adversities. Perceived support has been found to decrease the risk of post-traumatic stress disorder, and we wished to compare perceived support in people with first-episode psychosis to non-clinical control persons and explore its relation to childhood adversities. Method: Every individual presenting with a non-affective first-episode psychosis (F20–29, except F21) in Region Zealand over a 2-year period was approached for participation and the 101 consenting participants were matched to 101 people with no psychiatric disorders. Comprehensive demographic data were collected. Assessment instruments included the Premorbid Assessment Scale, the Global Assessment of Functioning scale and the Childhood Trauma Questionnaire. The latter represented the childhood adversities in addition to parental separation and institutionalization. Results: There were no associations between number of childhood adversities and different social or academic premorbid trajectories. Those with more adversities had lower global functioning the year prior to treatment start and reported lower rates of perceived support during childhood along with less current face-to-face contact with family members. Lack of peer support remained a significant predictor of psychosis when adversities were adjusted for; peer support diminished the risk of psychosis caused by childhood adversities by 10%. Conclusion: Childhood adversities may not predict specific premorbid trajectories, but have an effect on global functioning when the psychosis has begun. Perceived support, especially from peers, may be important in the development of psychosis, and those with more adversities may represent a vulnerable subgroup who need more assistance to increase and maintain supportive networks.",0 +https://doi.org/10.1080/15504263.2013.778930,"Relationships Among Depression, PTSD, Methamphetamine Abuse, and Psychosis","Objective: Research suggests several possible associations among methamphetamine abuse, psychotic symptoms, depression, and posttraumatic stress disorder (PTSD), but the exact nature and clinical significance of these associations is unclear. Individuals who abuse methamphetamine increasingly present in hospital emergency rooms with acute psychiatric symptoms. The aim of this study was to identify patterns of depressive symptoms and explore predictors of acute versus sustained depressive symptoms in individuals who abuse methamphetamine and who have had psychotic symptoms. Methods: This longitudinal study, conducted in Vancouver, British Columbia, included 295 participants with methamphetamine use disorder who were seeking psychiatric help for depressive or psychotic symptoms, assessed at baseline and monthly for 6 months. Measures included substance use (including frequency, quantity, and route of administration), family history of psychosis and depression, trauma exposure, and PTSD symptoms. Results: Tr...",0 +https://doi.org/10.1002/ajmg.c.31467,"Epigenetics and child abuse: Modern-day darwinism - The miraculous ability of the human genome to adapt, and then adapt again","It has long been recognized that early adversity can have life-long consequences, and the extent to which this is true is gaining increasing attention. A growing body of literature implicates Adverse Childhood Experiences, including physical, sexual, and emotional abuse, in a broad range of negative health consequences including adult psychopathology, cardiovascular, and immune disease. Increasing evidence from animal, clinical, and epidemiological studies highlight the critical role of epigenetic programing, such as DNA methylation and histone modification, in altering gene expression, brain structure and function, and ultimately life-course trajectories. This review outlines our developing insight into the interplay between our human biology and our changing environment, and explores the growing evidence base for how interventions may prevent and ameliorate damage inflicted by toxic stress in early life.",0 +https://doi.org/10.1016/j.janxdis.2008.07.004,Numbing symptoms as predictors of unremitting posttraumatic stress disorder,"This prospective longitudinal study examined the ability of re-experiencing, avoidance, numbing, and hyperarousal symptoms to predict persistence of posttraumatic stress disorder (PTSD) in disaster workers followed for 2 years. Cluster analyses suggested that overall severity was the best predictor of PTSD at follow up, but for groups with PTSD of moderate severity, numbing symptoms were also associated with PTSD at the 2-year follow up. Regression analyses with all four symptom groups as independent variables found that only numbing and re-experiencing symptoms predicted PTSD at the 1 year follow up, and only numbing symptoms predicted PTSD at the 2-year follow up. Findings suggest that numbing symptom severity could be used as a risk index of very chronic PTSD, especially when the overall PTSD severity falls in the moderate range.",0 +https://doi.org/10.1007/s11414-011-9263-x,Discrepancy in Diagnosis and Treatment of Post-traumatic Stress Disorder (PTSD): Treatment for the Wrong Reason,"In primary care (PC), patients with post-traumatic stress disorder (PTSD) are often undiagnosed. To determine variables associated with treatment, this cross-sectional study assessed 592 adult patients for PTSD. Electronic medical record (EMR) review of the prior 12 months assessed mental health (MH) diagnoses and MH treatments [selective serotonin reuptake inhibitor (SSRI) and/or ≥1 visit with MH professional]. Of 133 adults with PTSD, half (49%; 66/133) received an SSRI (18%), a visit with MH professional (14%), or both (17%). Of those treated, 88% (58/66) had an EMR MH diagnosis, the majority (71%; 47/66) depression and (18%; 12/66) PTSD. The odds of receiving MH treatment were increased 8.2 times (95% CI 3.1-21.5) for patients with an EMR MH diagnosis. Nearly 50% of patients with PTSD received MH treatment, yet few had this diagnosis documented. Treatment was likely due to overlap in the management of PTSD and other mental illnesses.",0 +https://doi.org/10.1111/j.1752-0606.2008.00064.x,"Linking Human Systems: Strengthening Individuals, Families, And Communities in the Wake of Mass Trauma","This article presents an overview of the philosophy and practical principles underlying the Linking Human Systems Approach based on the theory of resilience in individuals, families, and communities facing crisis, trauma, and disaster. The Link Approach focuses on tapping into the inherent strength of individuals and their families and emphasizes resilience rather than vulnerability. It has been successfully used in combating critical public health problems, such as addiction, HIV/AIDS, and recovery from major trauma or disaster. Also, three specific models of Link intervention aimed at the individual, family, and community levels are discussed, with special emphasis on the family-level intervention. These interventions are directed toward mobilizing resources for long-term physical, emotional, psychological, and spiritual healing.",0 +https://doi.org/10.1007/s12207-015-9231-5,Dimensions and Dissociation in PTSD in the DSM-5: Towards Eight Core Symptoms,"The article reviews the literature on the dimensional (factor) structure of posttraumatic stress disorder (PTSD) as presented in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; American Psychiatric Association, 2013). The DSM-5 PTSD diagnostic category contains 20 symptoms split into four factors. Also, the article considers the literature on the dissociative subtype, which is found in a minority of PTSD cases. The literature shows that the DSM (Diagnostic and Statistical Manual of Mental Disorders) over the years has moved from a three-dimensional structure in prior DSMs to one with four dimensions in the DSM-5. However, the research reviewed queries whether the DSM-5’s four dimensions are consistent with the empirical literature; in this regard, models with five and six dimensions were the first to suggest alternatives. Moreover, in the literature, the DSM-5 symptoms appear to group into as many as seven dimensions, which are as follows: re-experiencing, avoidance, negative affect, anhedonia, externalizing behavior, anxious arousal, and dysphoric arousal (Armour et al., Journal of Psychiatric Research 61: 106–113, 2015; Wang et al., Journal of Anxiety Disorders 31: 90–97, 2015). In particular, the two DSM-5 dimensions of negative alterations in cognitions and mood and alterations in arousal and reactivity appear to be subdivided into five dimensions. Generally, the 20 PTSD symptoms and their suggested factors that are found in the literature could prove unwieldy to clinicians. Moreover, they allow for much heterogeneity in symptom expression among PTSD cases. In response, the article presents a model of PTSD based on the seven-factor dimensional structure emerging in the literature, as well as another factor associated with the dissociation subtype, but with one core or primary symptom specified for each of the dimensions. The article considers forensic implications of the newer models on PTSD’s dimensional structure. © 2015, Springer Science+Business Media New York.",0 +https://doi.org/10.1017/s003329170002105x,The List of Threatening Experiences: a subset of 12 life event categories with considerable long-term contextual threat,"In a survey of a random sample of the general population recent life events, collected and rated for long-term contextual threat according to the methods of Brown & Harris (1978), were also recorded where possible on an inventory of life event categories (Tennant & Andrews, 1977). Of the 82.5% of all events collected which were covered by the inventory, 12 of the 67 event categories accounted for 77% of life events with an aetiologicaly significant rating of marked or moderate long-term threat. Where practical and economic constraints oblige research workers to choose the inventory method, a brief list of event categories, such as the List of Threatening Experiences, is recommended in preference to much longer lists.",0 +https://doi.org/10.1037/1528-3542.3.1.30,"Emotionality, emotion regulation, and adaptation among 5- to 8-year-old children.","This study investigated relations between emotionality, emotion regulation, and children's behavioral adaptation in a longitudinal design. Mothers rated emotionality and emotion regulation related to anger, fear, and positive emotions-exuberance for 151 children at age 5 and later at age 6 years 6 months. Emotionality and emotion regulation measures were modestly related. Preschool ratings at age 6 (n = 125), maternal ratings at age 6 years 6 months (n = 133), and elementary school ratings at age 8 (n = 135) of problems and competence were also collected. High anger emotionality and low regulation of positive emotions and exuberance predicted externalizing problem behavior and prosocial behavior. High fear emotionality and low fear regulation predicted internalizing problem behavior. There were few interactive effects of emotionality and regulation.",0 +https://doi.org/10.1016/j.jad.2011.02.011,An examination of the structure of posttraumatic stress disorder in relation to the anxiety and depressive disorders,"The nature and structure of posttraumatic stress disorder (PTSD) has been the subject of much interest in recent times. This research has been represented by two streams, the first representing a substantive body of work which focuses specifically on the factor structure of PTSD and the second exploring PTSD's relationship with other mood and anxiety disorders. The present study attempted to bring these two streams together by examining structural models of PTSD and their relationship with dimensions underlying other mood and anxiety disorders. PTSD, anxiety and mood disorder data from 989 injury survivors interviewed 3-months following their injury were analyzed using a series of confirmatory factor analyses (CFA) to identify the optimal structural model. CFA analyses indicated that the best fitting model included PTSD's re-experiencing (B1-5), active avoidance (C1-2), and hypervigilance and startle (D4-5) loading onto a Fear factor (represented by panic disorder, agoraphobia and social phobia) and the PTSD dysphoria symptoms (numbing symptoms C3-7 and hyperarousal symptoms D1-3) loading onto an Anxious Misery/Distress factor (represented by depression, generalized anxiety disorder and obsessive compulsive disorder). The findings have implications for informing potential revisions to the structure of the diagnosis of PTSD and the diagnostic algorithm to be applied, with the aim of enhancing diagnostic specificity.",0 +https://doi.org/10.1002/1520-6629(199404)22:2<121::aid-jcop2290220208>3.0.co;2-d,Differential responses to trauma: Migration-related discriminants of post-traumatic stress disorder among Southeast Asian refugees,"This study examined possible differentiating experiences between Post-Traumatic Stress Disorder (PTSD) and non-PTSD refugees, after matching them on certain demographic characteristics and exposure to trauma. Previous research on predictors of PTSD usually has not controlled for differences in trauma exposure between the comparison groups. By examining individuals who have had similar traumatic histories, this study more clearly identified some factors implicated in the development of PTSD among Southeast Asians. To increase comparability with previous PTSD research, all events were assessed with reference to three time frames involving premigration, migration, and postmigration periods. The role of anger reactions was also examined in view of previous findings from the veteranbased PTSD research. Finally, this study ascertained the influence of acculturation and cultural identity orientation because these variables often have been implicated in the adjustment of Asian Americans. Results from the present study indicate that respondents with PTSD appeared to experience and express much more anger and were more dependent on public assistance. They were also less engaged in maintaining their cultural traditions and ties. However, more life changes and a trend toward more separations and reunifications with family members were evidenced for those without PTSD. The implications of these findings in developing community intervention strategies for Southeast Asian refugees who have experienced trauma are discussed.",0 +https://doi.org/10.1017/s0033291707001006,Early predictors of chronic post-traumatic stress disorder in assault survivors,"ABSTRACT Background Some studies suggest that early psychological treatment is effective in preventing chronic post-traumatic stress disorder (PTSD), but it is as yet unclear how best to identify trauma survivors who need such intervention. This prospective longitudinal study investigated the prognostic validity of acute stress disorder (ASD), of variables derived from a meta-analysis of risk factors for PTSD, and of candidate cognitive and biological variables in predicting chronic PTSD following assault. Method Assault survivors who had been treated for their injuries at a metropolitan Accident and Emergency (A&E) Department were assessed with structured clinical interviews to establish diagnoses of ASD at 2 weeks ( n =222) and PTSD at 6 months ( n =205) after the assault. Candidate predictors were assessed at 2 weeks. Results Most predictors significantly predicted PTSD status at follow-up. Multivariate logistic regressions showed that a set of four theory-derived cognitive variables predicted PTSD best (Nagelkerke R 2 =0·50), followed by the variables from the meta-analysis (Nagelkerke R 2 =0·37) and ASD (Nagelkerke R 2 =0·25). When all predictors were considered simultaneously, mental defeat, rumination and prior problems with anxiety or depression were chosen as the best combination of predictors (Nagelkerke R 2 =0·47). Conclusion Questionnaires measuring mental defeat, rumination and pre-trauma psychological problems may help to identify assault survivors at risk of chronic PTSD.",0 +https://doi.org/10.1016/j.schres.2010.10.029,Increased Framingham 10-year risk of coronary heart disease in middle-aged and older patients with psychotic symptoms,"The Framingham 10-risk of coronary heart disease (CHD) has been a widely studied estimate of cardiovascular risk in the general population. However, few studies have compared the relative risk of developing CHD in antipsychotic-treated patients with different psychiatric disorders, especially in older patients with psychotic symptoms. In this study, we compared the 10-year risk of developing CHD among middle-aged and older patients with psychotic symptoms to that in the general population.We analyzed baseline data from a study examining metabolic and cardiovascular effects of atypical antipsychotics in patients over age 40 with psychotic symptoms. After excluding patients with prior history of CHD and stroke, 179 subjects were included in this study. Among them, 68 had a diagnosis of schizophrenia, 42 mood disorder, 38 dementia, and 31 PTSD. Clinical evaluations included medical and pharmacologic treatment history, physical examination, and clinical labs for metabolic profiles. Using the Framingham 10-year risk of developing CHD based on the Framingham Heart Study (FHS), we calculated the risk CHD risk for each patient, and then compared relative risk in each psychiatric diagnosis to the risks reported in the FHS.The mean age of entire sample was 63 (range 40-94) years, 68% were men. The Framingham 10-year risk of CHD was increased by 79% in schizophrenia, 72% in PTSD, 61% in mood disorder with psychosis, and 11% in dementia relative to the risk in general population from the FHS.In this sample of middle-aged and older patients with psychotic symptoms, we found a significantly increased 10-year risk of CHD relative to the estimated risk from FHS, with the greatest increased risk for patients with schizophrenia and PTSD. Development of optimally tailored prevention and intervention efforts to decrease different risk components in these patients could be an important step to help decrease the risks of CHD and overall mortality in this vulnerable population.",0 +https://doi.org/10.1080/16506073.2014.916745,Aerobic Exercise Reduces Symptoms of Posttraumatic Stress Disorder: A Randomized Controlled Trial,"Evidence suggests aerobic exercise has anxiolytic effects; yet, the treatment potential for posttraumatic stress disorder (PTSD) and responsible anxiolytic mechanisms have received little attention. Emerging evidence indicates that attentional focus during exercise may dictate the extent of therapeutic benefit. Whether benefits are a function of attentional focus toward or away from somatic arousal during exercise remains untested. Thirty-three PTSD-affected participants completed two weeks of stationary biking aerobic exercise (six sessions). To assess the effect of attentional focus, participants were randomized into three exercise groups: group 1 (attention to somatic arousal) received prompts directing their attention to the interoceptive effects of exercise, group 2 (distraction from somatic arousal) watched a nature documentary, and group 3 exercised with no distractions or interoceptive prompts. Hierarchal linear modeling showed all groups reported reduced PTSD and anxiety sensitivity (AS; i.e., fear of arousal-related somatic sensations) during treatment. Interaction effects between group and time were found for PTSD hyperarousal and AS physical and social scores, wherein group 1, receiving interoceptive prompts, experienced significantly less symptom reduction than other groups. Most participants (89%) reported clinically significant reductions in PTSD severity after the two-week intervention. Findings suggest, regardless of attentional focus, aerobic exercise reduces PTSD symptoms.",0 +https://doi.org/10.7205/milmed-d-04-0208,Is Poor Sleep in Veterans a Function of Post-Traumatic Stress Disorder?,"Substantial research has demonstrated an association between post-traumatic stress disorder (PTSD) and quality of sleep, particularly in veteran populations. The exact nature of this relationship, however, is not clear. The possibility that poor sleep is a more general experience among veterans has not been explored to date, with most studies focusing only on veteran populations with PTSD. This pilot study aimed to explore whether sleep disturbance is common to veterans generally or simply those with PTSD. Data were collected from a community sample of 152 Australian Vietnam war veterans, 87 of whom did not meet criteria for PTSD. All those with PTSD and 90% of those without PTSD reported clinically significant sleep disturbance, indicating that serious sleep problems are common across the veteran population. Despite the limitations of this initial study, these results highlight the importance of ensuring that research into sleep disorders in veterans with PTSD pays attention to the potential etiological role of other military factors, including deployments.",0 +https://doi.org/10.1111/j.2044-8260.2011.02017.x,A real-world study of the effectiveness of DBT in the UK National Health Service,"Objectives. Dialectical behavioral therapy (DBT) has gained widespread popularity as a treatment for borderline personality disorder (BPD), and its efficacy has been demonstrated in several trials. The aim of this study was to evaluate the effectiveness of DBT delivered by staff with a level of training readily achievable in National Health Service care settings for individuals with a Cluster B personality disorder. Design. Randomized control trial methodology was used to compare DBT to treatment as usual (TAU). Method. Forty-two participants entered the trial. Diagnostic and outcome measures were undertaken at assessment, at 6 months, and at 1 year. The clinical outcomes in routine evaluation – outcome measure (CORE-OM) were utilized as the primary outcome measure. Results. Both the DBT and TAU groups improved on the range of measures employed. The DBT group showed a slightly greater decrease in CORE-OM risk scores, suicidality, and post-traumatic stress disorder symptom severity. However, the TAU group showed comparable reductions in all measures and a larger decrease in para-suicidal behaviours and risk. Conclusions. DBT may be an effective treatment delivered by community outpatient services for individuals with a Cluster B personality disorder. Further studies are needed to consider the impact of experience and adherence to DBT in improving outcome.",0 +https://doi.org/10.4135/9781452230559,Evidence-Based Practice with Women: Toward Effective Social Work Practice with Low-Income Women Evidence-based practice with women: Toward effective social work practice with low-income women,"This one-of-a-kind book presents evidence-based coverage of the assessment and treatment of the most common mental health disorders among women, particularly low-income women. For each disorder-depression, post-traumatic stress disorder and trauma (including sexual abuse), generalized anxiety disorder, substance use disorder, and borderline personality disorder-the authors include assessment instruments and detailed case examples that illustrate the assessment and treatment recommendations. © 2011 by SAGE Publications, Inc.",0 +https://doi.org/10.1186/1751-0759-4-7,"Posttraumatic growth, posttraumatic stress disorder and resilience of motor vehicle accident survivors","Abstract Background Although some previous studies have suggested that posttraumatic growth (PTG) is comprised of several factors with different properties, few have examined both the association between PTG and posttraumatic stress disorder (PTSD) and between PTG and resilience, focusing on each of the factors of PTG. This study aimed to examine the hypothesis that some factors of PTG, such as personal strength, relate to resilience, whereas other factors, such as appreciation of life, relate to PTSD symptoms among Japanese motor vehicle accident (MVA) survivors. Methods This cross-sectional study was performed with 118 MVA survivors at 18 months post MVA. Data analyzed included self-reporting questionnaire scores on the Posttraumatic Growth Inventory (PTGI), the Impact of Event Scale- Revised (IES-R), and the Sense of Coherence (SOC) scale, which is one of the most widely used scales for measuring resilience. Correlations between scores on the PTGI and IES-R, the PTGI and SOC scale, and the IES-R and SOC scale were established by calculating Spearman's correlation coefficients. Results PTGI was positively correlated with both SOC and PTSD symptoms, in spite of an inverse relationship between SOC and PTSD symptoms. Relating to others, new possibilities, and personal strength on the PTGI were correlated positively with SOC, and spiritual change and appreciation of life on the PTGI were positively correlated with PTSD symptoms. Conclusions Some factors of PTG were positively correlated with resilience, which can be regarded as an outcome of coping success, whereas other factors of PTG were positively correlated with PTSD symptoms, which can be regarded as signifying coping effort in the face of enduring distress. These findings contribute to our understanding of the psychological change experienced by MVA survivors, and to raising clinicians' awareness of the possibility that PTG represents both coping effort coexisting with distress and outcome of coping success.",0 +https://doi.org/10.1016/j.avb.2010.12.007,The traumatic stress response in child maltreatment and resultant neuropsychological effects,"Child maltreatment is a pervasive problem in our society that has long-term detrimental consequences to the development of the affected child such as future brain growth and functioning. In this paper, we surveyed empirical evidence on the neuropsychological effects of child maltreatment, with a special emphasis on emotional, behavioral, and cognitive process–response difficulties experienced by maltreated children. The alteration of the biochemical stress response system in the brain that changes an individual’s ability to respond efficiently and efficaciously to future stressors is conceptualized as the traumatic stress response. Vulnerable brain regions include the hypothalamic–pituitary–adrenal axis, the amygdala, the hippocampus, and prefrontal cortex and are linked to children’s compromised ability to process both emotionally-laden and neutral stimuli in the future. It is suggested that information must be garnered from varied literatures to conceptualize a research framework for the traumatic stress response in maltreated children. This research framework suggests an altered developmental trajectory of information processing and emotional dysregulation, though much debate still exists surrounding the correlational nature of empirical studies, the potential of resiliency following childhood trauma, and the extent to which early interventions may facilitate recovery.",0 +https://doi.org/10.1037/tra0000089,Unique relations between counterfactual thinking and DSM–5 PTSD symptom clusters.,"Cognitive models of posttraumatic stress disorder (PTSD) propose that rumination about a trauma may increase particular symptom clusters. One type of rumination, termed counterfactual thinking (CFT), refers to thinking of alternative outcomes for an event. CFT centered on a trauma is thought to increase intrusions, negative alterations in mood and cognitions (NAMC), and marked alterations in arousal and reactivity (AAR). The theorized relations between CFT and specific symptom clusters have not been thoroughly investigated. Also, past work has not evaluated whether the relation is confounded by depressive symptoms, age, gender, or number of traumatic events experienced.The current study examined the unique associations between CFT and PTSD symptom clusters according to the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013) in 51 trauma-exposed treatment-seeking individuals.As predicted, CFT was associated with all PTSD symptom clusters. After controlling for common predictors of PTSD symptom severity (i.e., age, depressive symptoms, and number of traumatic life events endorsed), we found CFT to be significantly associated with the intrusion and avoidance symptom clusters but not the AAR or NAMC symptom clusters.Results from the present study provide further support for the role of rumination in specific PTSD symptom clusters above and beyond symptoms of depression, age, and number of traumatic life events endorsed. Future work may consider investigating interventions to reduce rumination in PTSD. (PsycINFO Database Record",0 +https://doi.org/10.1176/ajp.148.5.592,"Posttraumatic stress disorder after a school shooting: effects of symptom threshold selection and diagnosis by DSM-III, DSM-III-R, or proposed DSM-IV","The purpose of the study was to investigate the effect of symptom threshold and criteria set selections on the diagnosis of posttraumatic stress disorder (PTSD) in adults and children exposed to a man-made disaster and determine how well DSM-III and its successors agree.Data gathered in the course of a voluntary clinical screening for PTSD in 66 adults and 64 children 6 to 14 months after exposure to a school shooting were analyzed according to DSM-III, DSM-III-R, and proposed DSM-IV criteria for PTSD diagnosis and cluster endorsement using liberal (occurring at least a little of the time), moderate (occurring at least some of the time), and conservative (occurring at least much or most of the time) symptom thresholds.Within DSM-III, DSM-III-R, and proposed DSM-IV, selection of liberal, moderate, and conservative symptom thresholds had robust effects on rates of diagnoses; liberal thresholds allowed the greatest frequencies of diagnosis. Compared with DSM-III and proposed DSM-IV, DSM-III-R generally diagnosed the fewest cases. Agreements between DSM-III-R and proposed DSM-IV were good, while agreements between DSM-III and its successors varied for children and adults.Diagnostic rates and agreements were complexly influenced by interactions among threshold and revisions in symptom clusters. The present study suggests that attempts to refine PTSD classification consider specification of symptom threshold intensity and supports the view that modification of criteria sets be undertaken with caution.",0 +https://doi.org/10.3200/jrlp.139.5.439-457,The General Self-Efficacy Scale: Multicultural Validation Studies,"General self-efficacy is the belief in one's competence to cope with a broad range of stressful or challenging demands, whereas specific self-efficacy is constrained to a particular task at hand. Relations between general self-efficacy and social cognitive variables (intention, implementation intentions, outcome expectancies, and self-regulation), behavior-specific self-efficacy, health behaviors, well-being, and coping strategies were examined among 1,933 respondents in 3 countries: Germany (n = 633), Poland (n = 359), and South Korea (n = 941). Participants were between 16 and 86 years old, and some were dealing with stressful situations such as recovery from myocardial events or tumor surgery. Perceived self-efficacy was measured by means of the General Self-Efficacy Scale (R. Schwarzer & M. Jerusalem, 1995). Meta-analysis was used to determine population effect sizes for four sets of variables. Across countries and samples, there is consistent evidence for associations between perceived self-efficacy and the variables under study confirming the validity of the psychometric scale. General self-efficacy appears to be a universal construct that yields meaningful relations with other psychological constructs.",0 +https://doi.org/10.1016/0010-440x(92)90047-t,"The relationship between anxiety and depression: A clinical comparison of generalized anxiety disorder, dysthymic disorder, panic disorder, and major depressive disorder","This study examined the relationship between the chronic disorders, generalized anxiety disorder (GAD) and dysthymic disorder (DD), and the more acute disorders, panic disorder (PD) and major depressive disorder (MDD) in 110 psychiatric outpatients with diagnoses of either PD, MDD, GAD, or DD. Pure, mixed, and early-/late-onset forms of the chronic disorders were compared with each other and then with PD and MDD on clinical measures and psychiatric history. Minimal differences were found between pure GAD and mixed GAD or between pure DD and mixed DD. The chronic disorders, DD and GAD, had distinct clinical symptom profiles when compared with each other and appeared more closely related to their parent disorders than to each other. However, despite these similarities, there were significant differences between DD and MDD in contrast to the minimal differences between GAD and PD, providing less support for GAD as a valid diagnostic category separate from PD. Comparisons of early-/late-onset DD and GAD showed more severe symptoms in late-onset DD, in contrast to more severe symptoms in early-onset GAD. These varying patterns of symptom severity may warrant study for further syndromal delineation.",0 +https://doi.org/10.1016/j.socscimed.2012.10.026,Association of exposure to intimate-partner physical violence and potentially traumatic war-related events with mental health in Liberia,"Liberia's wars between 1989 and 2003 resulted in hundreds of thousands of casualties and millions of victims. Gender-based violence was widespread during the conflict. Since the end of the war, however, little attention has been paid to ongoing violence against women, especially within the household. This research examines the relationships between intimate-partner physical violence, war experiences, and mental health nearly ten years after the end of the war. The study is based on a nationwide cross-sectional, multistage stratified cluster random survey of 4501 adults using structured interviews during a six-week period in November and December 2010. The main outcome measures are prevalence of intimate-partner physical violence, exposure to potentially traumatic war-related events, symptoms of Post-Traumatic Stress Disorder (PTSD) and depression. Among adult women, 37.7% (95%CI, 34.9-40.5; n = 852/2196) reported lifetime exposure to intimate-partner physical violence and 24.4% (95%CI, 22.1-26.9; n = 544/2196) reported incidence of intimate-partner physical violence over a one-year recall period. Among men, 23.2% (95%CI, 20.8-25.9, n = 475/2094) reported having severely beaten their spouse or partner over their lifetime; the incidence over the one-year recall was 12.2% (95%CI, 10.4-14.2, n = 259/2094). Among adult residents in Liberia, 10.6% (95%CI, 9.5-11.7, n = 546/4496) met the criteria for symptoms of depression, and 12.6% (95% CI, 11.5-13.9, n = 608/4496) met the criteria for symptoms of PTSD. Intimate-partner physical violence as a victim and as a perpetrator was significantly associated with exposure to potentially traumatic war-related events, especially among men. Among women, experiencing intimate-partner physical violence was associated with symptoms of PTSD and depression. Among men, perpetrating intimate-partner physical violence was associated with symptoms of PTSD and depression after adjusting for exposure to potentially traumatic war-related events. These findings suggest that intimate-partner physical violence may be a continued stressor in post-war societies that needs to be recognized and addressed as part of the reconstruction effort.",0 +https://doi.org/10.1089/neu.2014.3640,Neuronal DNA Methylation Profiling of Blast-Related Traumatic Brain Injury,"Long-term molecular changes in the brain resulting from blast exposure may be mediated by epigenetic changes, such as deoxyribonucleic acid (DNA) methylation, that regulate gene expression. Aberrant regulation of gene expression is associated with behavioral abnormalities, where DNA methylation bridges environmental signals to sustained changes in gene expression. We assessed DNA methylation changes in the brains of rats exposed to three 74.5 kPa blast overpressure events, conditions that have been associated with long-term anxiogenic manifestations weeks or months following the initial exposures. Rat frontal cortex eight months post-exposure was used for cell sorting of whole brain tissue into neurons and glia. We interrogated DNA methylation profiles in these cells using Expanded Reduced Representation Bisulfite Sequencing. We obtained data for millions of cytosines, showing distinct methylation profiles for neurons and glia and an increase in global methylation in neuronal versus glial cells (p<10(-7)). We detected DNA methylation perturbations in blast overpressure-exposed animals, compared with sham blast controls, within 458 and 379 genes in neurons and glia, respectively. Differentially methylated neuronal genes showed enrichment in cell death and survival and nervous system development and function, including genes involved in transforming growth factor β and nitric oxide signaling. Functional validation via gene expression analysis of 30 differentially methylated neuronal and glial genes showed a 1.2 fold change in gene expression of the serotonin N-acetyltransferase gene (Aanat) in blast animals (p<0.05). These data provide the first genome-based evidence for changes in DNA methylation induced in response to multiple blast overpressure exposures. In particular, increased methylation and decreased gene expression were observed in the Aanat gene, which is involved in converting serotonin to the circadian hormone melatonin and is implicated in sleep disturbance and depression associated with traumatic brain injury.",0 +https://doi.org/10.1089/cap.2008.0148,"Attention-Deficit/Hyperactivity Disorder Diagnosis, Co-Morbidities, Treatment Patterns, and Quality of Life in a Pediatric Population in Central and Eastern Europe and Asia","Attention deficit/hyperactivity disorder (ADHD) is often poorly understood, and treatment practices are variable. This 12-month, prospective, observational study provides information about the diagnosis, co-morbidities, treatment patterns, and quality of life (QOL) of patients aged 6–17 years with ADHD symptoms from eastern Asia and central and eastern Europe. Here, we present baseline data for the 1068 enrolled and eligible patients in the study (median age 8 years, 82.2% male). Patients were grouped into two cohorts based on whether they were prescribed psycho- and/or pharmacotherapy (n = 794) or not (n = 274) at study entry. On average, patients receiving treatment were significantly older (9.1 vs. 8.4 years, p < 0.001), more severely ill (Clinical Global Impressions [CGI]-ADHD-S, 4.6 vs. 4.2, p < 0.001; Child Symptom Inventory-4 Parent Checklist (CSI-4) ADHD:C, 35.2 vs. 31.9, p < 0.001), and had significantly higher CSI-4 symptom severity scores relating to various co-morbidities than patients not receiving treatment. At study initiation, patient's health-related QOL was significantly impaired as measured on the Child Health and Illness Profile–Child Edition (CHIP-CE) rating scale, with significantly more impairment in the treated group of patients for the Comfort, Risks Avoidance, and Achievement domains. These results provide a description of ADHD and treatment practices in these regions and establish a baseline for gauging changes over time in the study sample.",0 +https://doi.org/10.1016/j.apnu.2013.10.010,Posttraumatic Stress Disorder and Posttraumatic Growth Among Adult Survivors of Wenchuan Earthquake After 1 Year: Prevalence and Correlates,"

Abstract

This study investigates the prevalence and predictors for posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) in adult survivors 1year after the 2008 Wenchuan earthquake. Questionnaires were used to collect the data. PTSD was assessed using the PTSD Check List-Civilian (PCL-C), and PTG was assessed using the Post Traumatic Growth Inventory (PTGI). A total of 2,300 individuals were involved in the survey with 2,080 completing the questionnaire, a response rate of 90.4%. The PTSD prevalence estimate in this study was found to be 40.1%, and the prevalence for PTG among the participants was measured at 51.1%. A bivariate correlation analysis indicated that there was a positive association between PTG and PTSD. In the conclusions, possible explanations for the findings and implications for future research are discussed.",0 +https://doi.org/10.1176/appi.ajp.2014.13121571,Influences of Maternal and Paternal PTSD on Epigenetic Regulation of the Glucocorticoid Receptor Gene in Holocaust Survivor Offspring,"Differential effects of maternal and paternal posttraumatic stress disorder (PTSD) have been observed in adult offspring of Holocaust survivors in both glucocorticoid receptor sensitivity and vulnerability to psychiatric disorder. The authors examined the relative influences of maternal and paternal PTSD on DNA methylation of the exon 1F promoter of the glucocorticoid receptor (GR-1F) gene (NR3C1) in peripheral blood mononuclear cells and its relationship to glucocorticoid receptor sensitivity in Holocaust offspring.Adult offspring with at least one Holocaust survivor parent (N=80) and demographically similar participants without parental Holocaust exposure or parental PTSD (N=15) completed clinical interviews, self-report measures, and biological procedures. Blood samples were collected for analysis of GR-1F promoter methylation and of cortisol levels in response to low-dose dexamethasone, and two-way analysis of covariance was performed using maternal and paternal PTSD as main effects. Hierarchical clustering analysis was used to permit visualization of maternal compared with paternal PTSD effects on clinical variables and GR-1F promoter methylation.A significant interaction demonstrated that in the absence of maternal PTSD, offspring with paternal PTSD showed higher GR-1F promoter methylation, whereas offspring with both maternal and paternal PTSD showed lower methylation. Lower GR-1F promoter methylation was significantly associated with greater postdexamethasone cortisol suppression. The clustering analysis revealed that maternal and paternal PTSD effects were differentially associated with clinical indicators and GR-1F promoter methylation.This is the first study to demonstrate alterations of GR-1F promoter methylation in relation to parental PTSD and neuroendocrine outcomes. The moderation of paternal PTSD effects by maternal PTSD suggests different mechanisms for the intergenerational transmission of trauma-related vulnerabilities.",0 +https://doi.org/10.1089/apc.2009.0231,HIV-Related Posttraumatic Stress Disorder: Investigating the Traumatic Events,"This study examined the relationship between the experience of various HIV-related events (receiving the diagnosis, receiving treatment, experiencing physical symptoms, self-disclosing HIV positive status, and witnessing HIV-related death) and posttraumatic stress symptoms in a sample of 100 gay men living with HIV. Self-report data revealed that 65% met criteria for having experienced a traumatic event in accordance with the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR) posttraumatic stress disorder (PTSD) criterion A. The experience of shame, humiliation, or guilt during an event was measured but not found to be a significant indicator of having been traumatized. A total of 33% qualified for a PTSD diagnosis. Stepwise multiple regression analysis showed that receiving medical treatment, experiencing physical symptoms, and witnessing HIV-related death were most associated with HIV-related PTSD symptoms. Given that multiple HIV-related events are potentially traumatic, the screening, assessment and treatment for HIV-related PTSD may need to be considered by HIV services.",0 +https://doi.org/10.1080/15228932.2014.973773,MACI Scores of African American Males in a Forensic Setting: Are We Measuring What We Think We Are Measuring?,"In this study, confirmatory factor analyses were used to examine scores on the Millon Adolescent Clinical Inventory (MACI) in adolescent, African American males in a forensic setting (N = 496; Mage = 15.96, SDage = 1.32). Results from the study do not support the model proposed by Millon and suggest the MACI may not yield valid or reliable scores in forensic populations of adolescent, African American males. Because MACI scores could be misleading in African American males, the authors argue that the MACI and other trait-scales not validated in this group be used with extreme caution—especially in settings where African Americans are disproportionately represented.",0 +https://doi.org/10.1080/13854040903307250,A Brief Overview of Traumatic Brain Injury (TBI) and Post-Traumatic Stress Disorder (PTSD) Within the Department of Defense,The current conflicts in the Middle East have yielded increasing awareness of the acute and chronic effect of traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). The increasing frequency of exposure to blast and multiple deployments potentially impact the probability that a service member may sustain one of these injuries. The 2008 International Conference on Behavioral Health and Traumatic Brain Injury united experts in the fields of behavioral health and traumatic brain injury to address these significant health concerns. This article summarizes current Department of Defense (DOD) initiatives related to TBI and PTSD.,0 +https://doi.org/10.1002/jts.20526,Internalizing and externalizing classes in posttraumatic stress disorder: A latent class analysis,"Using latent class analysis (LCA) the typology of personality profiles of veterans with posttraumatic stress disorder (PTSD) was examined based on internalizing/externalizing dimensions of psychopathology. Latent class analysis on Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Personality Psychopathology-5 (PSY-5) scale data from 299 Australian combat veterans with PTSD supported the model, identifying an optimal 4-class solution, with PTSD externalizing class defined by aggressiveness and disconstraint, high and moderate internalizing classes differentiated on the extent of elevations in introversion and negative emotionality and elevation of psychoticism in the high internalizing class and a simple PTSD class with normal range scores. The model was validated using external self-report and psychiatric-interview-derived diagnoses. A second exploratory LCA using broader comorbidity indicators (MMPI-2 Restructured Clinical scales) demonstrated some support for, although limitations in, using nonpersonality measures to identify these classes directly.",0 +https://doi.org/10.1016/j.mppsy.2008.01.010,Comorbidity of personality disorders and mental illnesses,"Abstract Mental illness and personality disorder often occur in the same person. Although concern has been expressed that this may be due to overlapping diagnostic criteria, many different studies have confirmed this finding. Various models have been proposed to explain the association, and it is likely that different models will be relevant to different associations. Associations between specific personality disorders and categories of mental illness include those between Cluster A personality disorders and schizophrenia, Cluster B personality disorders and substance misuse and post-traumatic stress disorder, and Cluster C personality disorders and depression, eating disorders and a number of neurotic disorders.",0 +https://doi.org/10.1007/s12035-015-9180-8,Distinct Hippocampal Expression Profiles of lncRNAs in Rats Exhibiting a PTSD-like Syndrome,"Posttraumatic stress disorder (PTSD) refers to a series of clinical syndromes, including symptoms such as nightmares, hallucinations, severe anxiety, fear, and trauma related to the environment. These symptoms tend to occur after intense psychological trauma or physiological stress. Long non-coding RNAs (lncRNAs) have been shown to play key roles in various biological processes, although it is unknown whether they have important functions in PTSD. Here, we present the first study exploring the connection between lncRNAs and a PTSD-like syndrome in rats. We find distinct expression profiles of lncRNAs between PTSD-like syndrome rats and a control group, which provides information for further research on the differentiation of PTSD and transdifferentiation between the PTSD-like syndrome and the control group. This information will be helpful for finding new therapeutic targets for the treatment of PTSD. © 2015 Springer Science+Business Media New York",0 +https://doi.org/10.1080/10615800802179860,Patterns of emotion regulation and psychopathology,"Emotion regulatory strategies such as higher expressive suppression and lower cognitive reappraisal may be associated with increased psychopathology (Gross & John, 2003). Yet, it is unclear whether these strategies represent distinct cognitive styles associated with psychopathology, such that there are individuals who are predominantly ""suppressors"" or ""reappraisers."" Using cluster analysis, we examined whether women with and without exposure to potentially traumatic events evidence distinct patterns of emotion regulation frequency, capacity, suppression, and cognitive reappraisal. Four patterns emerged: high regulators; high reappraisers/low suppressors; moderate reappraisers/low suppressors; and low regulators. Individuals who reported infrequently and ineffectively regulating their emotions (low regulators) also reported higher depression, anxiety, and posttraumatic stress disorder (PTSD). In contrast, individuals who reported frequently and effectively using reappraisal and low levels of suppression (high reappraisers/low suppressors) reported the lowest levels of these symptoms, suggesting that this specific combination of emotion regulation may be most adaptive. Our findings highlight that the capacity to regulate emotions and the ability to flexibly apply different strategies based on the context and timing may be associated with reduced psychopathology and more adaptive functioning.",0 +https://doi.org/10.1176/appi.neuropsych.17.3.350,Diagnostic Criteria for Postconcussional Syndrome After Mild to Moderate Traumatic Brain Injury,,0 +https://doi.org/10.1016/j.jpsychires.2014.03.003,Posttraumatic stress disorder and depressive symptoms: Joined or independent sequelae of trauma?,"The nature of co-morbidity between posttraumatic stress disorder (PTSD) and depression has been the subject of much controversy. This study addresses this issue by investigating associations between probable PTSD and depressive symptoms in a prospective, longitudinal sample of combat veterans. Symptoms of PTSD and depression were assessed at 3 points of time (i.e., 1991, 2003, 2008) over a period of 17 years utilizing the PTSD Inventory and the SCL-90 (Derogatis, 1977). Two groups of combat veterans, 275 former prisoners of war (ex-POWs) and 219 matched combatants (controls), were assessed. Data were analyzed using descriptive statistics, latent variable modeling, and confirmatory factor analysis. A series of χ 2 tests revealed that the prevalence proportions of depressive symptoms and probable PTSD were higher among ex-POWs compared to controls at all time points. The prevalence of depressive symptoms was higher than the prevalence of PTSD symptoms in both groups at the each of the times. Latent Trajectories Modeling (LTM) indicated that while ex-POWs' PTSD symptom severity increased over time, the severity of symptoms remained stable among controls. Parallel Process Latent Growth Modeling (PLGM) revealed a positive bi-directional relationship whereby PTSD symptoms mediated the affect of captivity on depressive symptoms and depressive symptoms mediated the affect of captivity on PTSD symptoms over time. Utilizing Confirmatory Factor Analysis (CFA), a single factor model emerged for depressive and PTSD symptoms. The findings suggest that while depression and PTSD seem to be different long-term manifestations of traumatic stress, accounted for in part by the severity of the trauma, they both may be parts of a common general traumatic stress construct. Clinical and theoretical implications of these findings are discussed.",0 +https://doi.org/10.1097/jom.0b013e3182a2a60a,A Practical Measure of Workplace Resilience,"To develop an effective measure of resilience at work for use in individual work-related performance and emotional distress contexts.Two separate cross-sectional studies investigated: (1) exploratory factor analysis of 45 items putatively underpinning workplace resilience among 397 participants and (2) confirmatory factor analysis of resilience measure derived from Study 1 demonstrating a credible model of interaction, with performance outcome variables among 194 participants.A 20-item scale explaining 67% of variance, measuring seven aspects of workplace resilience, which are teachable and capable of conscious development, was achieved. A credible model of relationships with work engagement, sleep, stress recovery, and physical health was demonstrated in the expected directions.The new scale shows considerable promise as a reliable instrument for use in the area of employee support and development.",0 +https://doi.org/10.1016/j.jad.2012.11.002,Posttraumatic stress disorder symptom trajectories in Hurricane Katrina affected youth,"This study examined trajectories of posttraumatic stress disorder symptoms in Hurricane Katrina affected youth.A total of 426 youth (51% female; 8-16 years old; mean age=11 years; 75% minorities) completed assessments at 4 time points post-disaster. Measures included Hurricane impact variables (initial loss/disruption and perceived life threat); history of family and community violence exposure, parent and peer social support, and post-disaster posttraumatic stress symptoms.Latent class growth analysis demonstrated that there were three distinct trajectories of posttraumatic stress disorder symptoms identified for this sample of youth (resilient, recovering, and chronic, respectively). Youth trajectories were associated with Hurricane-related initial loss/disruption, community violence, and peer social support.The results suggest that youth exposed to Hurricane Katrina have variable posttraumatic stress disorder symptom trajectories. Significant risk and protective factors were identified. Specifically, youth Hurricane and community violence exposure increased risk for a more problematic posttraumatic stress disorder symptom trajectory, while peer social support served as a protective factor for these youth. Identification of these factors suggests directions for future research as well as potential target areas for screening and intervention with disaster exposed youth.The convenience sample limits the external validity of the findings to other disaster exposed youth, and the self-report data is susceptible to response bias.",1 +https://doi.org/10.1016/j.euroneuro.2012.08.006,Trajectory in obsessive-compulsive disorder comorbidities,"The main goal of this study is to contribute to the understanding of the trajectory of comorbid disorders associated with obsessive-compulsive disorder (OCD) according to the first manifested psychiatric disorder and its impact in the clinical course of OCD and subsequent psychiatric comorbidities. One thousand and one OCD patients were evaluated at a single time point. Standardized instruments were used to determine the current and lifetime psychiatric diagnoses (Structured Clinical Interview for DSM-IV Axis I and for impulse-control disorders) as well as to establish current obsessive-compulsive, depressive and anxiety symptom severity (Yale-Brown Obsessive-Compulsive Scale; Dimensional Yale-Brown Obsessive-Compulsive Scale, Beck Depression and Anxiety Inventories and the OCD Natural History Questionnaire). To analyze the distribution of comorbidities according to age at onset Bayesian approach was used. Five hundred eight patients had the first OC symptom onset till the age of 10 years old. The first comorbidity to appear in the majority of the sample was separation anxiety disorder (17.5%, n=175), followed by ADHD (5.0%, n=50) and tic disorders (4.4%, n=44). OCD patients that presented with separation anxiety disorder as first diagnosis had higher lifetime frequency of post-traumatic stress disorder (p=0.003), higher scores in the Sexual/Religious dimension (p=0.04), Beck Anxiety (p<0.001) and Depression (p=0.005) Inventories. OCD patients that initially presented with ADHD had higher lifetime frequencies of substance abuse and dependence (p<0.001) and worsening OCD course (p=0.03). OCD patients that presented with tic disorders as first diagnosis had higher lifetime frequencies of OC spectrum disorders (p=0.03). OCD is a heterogeneous disorder and that the presence of specific comorbid diagnoses that predate the onset of OCD may influence its clinical presentation and course over the lifetime.",0 +https://doi.org/10.1016/j.socscimed.2009.10.022,"Conflict, violence, and health: Setting a new interdisciplinary agenda",,0 +https://doi.org/10.1007/978-3-319-17335-1_3,The Epidemiology of Post-traumatic Stress Disorder: A Focus on Refugee and Immigrant Populations,"(from the chapter) Despite of the great variability in study findings on rates and risks for posttraumatic stress disorder (PTSD) in general, PTSD has to be considered as a possible diagnosis in refugees and asylum seekers with suspected psychiatric symptoms, since these populations are particularly vulnerable groups which are more commonly and often repeatedly exposed to life's adversities preflight, while on flight and even after resettlement in another country, or when internally displaced in a stable part of the home country. The findings on prevalence rates of PTSD are quite heterogeneous and may also vary within the same population over time. Risk factors for PTSD may be more consistent over time and population group studied. Among the factors most frequently found to be associated with increased risk for PTSD is having a psychiatric history prior to the trauma. A meta-analysis by Brewin et al, (2000) also found childhood abuse and a family history of psychiatric disorders to be consistently associated with PTSD risk. The study further found low socioeconomic status, low level of education, low intelligence, life stress, lack of social support, trauma severity, adverse childhood and previous trauma to be consistently but to a differing degree related to an increased risk for PTSD. While protective effects of higher levels of intelligence have also been shown in a large prospective study in a cohort of adolescents independent of social and educational status, no explanatory model has yet been established. (PsycINFO Database Record (c) 2015 APA, all rights reserved)",0 +,Interfering with the reconsolidation of traumatic memory: sirolimus as a novel agent for treating veterans with posttraumatic stress disorder.,"Development of novel treatment approaches for combat-related posttraumatic stress disorder (PTSD) is critical, given the increasing prevalence of PTSD in veterans returning from war zone deployment. Established preclinical research using protein synthesis inhibitors (such as sirolimus) to interfere with fear memory reconsolidation provides a compelling rationale for investigation in humans.This double-blind, placebo-controlled translational pilot study examined the effects of pairing reactivation of a trauma memory with a single administration of sirolimus on the frequency and intensity of PTSD symptoms in male combat veterans.Primary analyses found no significant differences between treatment groups on any of the clinical or physiologic outcome measures. In an exploratory analysis of a subsample of post-Vietnam-era veterans who had more recent combat trauma, PTSD symptom scores fell significantly more in these veterans than in controls.The post-Vietnam-era veteran findings suggest that further investigation of this pairing of sirolimus with traumatic memory reactivation may be warranted. Theoretically, interference with the reconsolidation of fear memories could ameliorate military-related psychological trauma symptoms. Future research should focus on veterans of more recent eras whose traumatic memories may be less entrenched and more amenable to pharmacologic modification within this procedure.",0 +https://doi.org/10.1097/00004583-199111000-00011,Malignant Memories: PTSD in Children and Adults after a School Shooting,"Sixty-four children and 66 adults were screened for post-traumatic stress disorder 6 to 14 months after a school shooting. Although there were no differences in overall frequencies of DSM-III-R diagnoses or cluster endorsements, there were developmental influences. Post-traumatic stress disorder was associated more with emotional states recalled from the disaster than with proximity. Emotional states mediated the formation of malignant memories leading to symptomatology, suggesting that postdisaster intervention be offered on the basis of degree of emotional reaction as well as proximity.",0 +https://doi.org/10.1016/s0924-9338(11)72957-1,Correlation between lipid profile and different types of aggressive behaviour in combatants,"Objectives At present there is a discussion whether cholesterol level, aggression and violence are connected for they are characteristic behavioral patterns in combatants suffering particularly from PTSD. Method With the help of the Aggressive Behaviour Assessment Scale we examined 337 combatants and 116 healthy people, also we held an additional investigation of serum concentration of lipid profile. Reliability of results was evaluated by the Mann-Whitney U-test. Also the correlation analysis (Spearman rank correlation coefficient) was carried out. Results Combatants showed an integrated overall index of aggression twice as much in comparison with the control group (2,44 ± 0,09 and 1,08 ± 0,08, Ð < 0,00001), impulsive aggression was five times greater (2,08 ± 0,12 and 0,39 ± 0,06, Ð < 0,00001), premeditated aggression was 1,7-fold (3,15 ± 0,11 and 1,78 ± 0,13, Ð < 0,00001). The highest points of emotional (impulsive, hostile) aggressive behaviour revealed negative links with concentrations of cholesterol (r = −0,109, Ð < 0,05), LDL total cholesterol (r = −0,109, Ð < 0,05), triglycerides (−0,137 ≥ r ≥ −0,108, Ð < 0,05). Certain positions of premeditated (instrumental) aggression positively correlated with level of total cholesterol (0,140 ≥ r ≥ 0,126, Ð < 0,01), LDL total cholesterol (0,141 ≥ r ≥ 0,161, Ð < 0,01). Conclusions Reduction of cholesterol level and its most atherogenic fractions increases intensity of impulsive aggression and diminishes instrumental aggression of aggressive behaviour whereas increase of lipid profile leads to opposite results. The obtained data can be of great importance for treatment and prophylaxis of cardio-vascular disorders which are so typical for combat veterans.",0 +,Diagnosis and management of post-traumatic stress disorder.,"Although post-traumatic stress disorder (PTSD) is a debilitating anxiety disorder that may cause significant distress and increased use of health resources, the condition often goes undiagnosed. The lifetime prevalence of PTSD in the United States is 8 to 9 percent, and approximately 25 to 30 percent of victims of significant trauma develop PTSD. The emotional and physical symptoms of PTSD occur in three clusters: re-experiencing the trauma, marked avoidance of usual activities, and increased symptoms of arousal. Before a diagnosis of PTSD can be made, the patient's symptoms must significantly disrupt normal activities and last for more than one month. Approximately 80 percent of patients with PTSD have at least one comorbid psychiatric disorder. The most common comorbid disorders include depression, alcohol and drug abuse, and other anxiety disorders. Treatment relies on a multidimensional approach, including supportive patient education, cognitive behavior therapy, and psychopharmacology. Selective serotonin reuptake inhibitors are the mainstay of pharmacologic treatment.",0 +https://doi.org/10.1037/a0028916,A lifespan perspective on terrorism: Age differences in trajectories of response to 9/11.,"A terrorist attack is an adverse event characterized by both an event-specific stressor and concern about future threats. Little is known about age differences in responses to terrorism. This longitudinal study examined generalized distress, posttraumatic stress responses, and fear of future attacks following the September 11, 2001 (9/11) terrorist attacks among a large U.S. national sample of adults (N = 2,240) aged 18-101 years. Individuals completed Web-based surveys up to 6 times over 3 years post 9/11. Multilevel models revealed different age-related patterns for distress, posttraumatic stress, and ongoing fear of future attacks. Specifically, older age was associated with lower overall levels of general distress, a steeper decline in posttraumatic stress over time, and less change in fear of future terrorist attacks over the 3 years. Understanding age differences in response to the stress of terrorism adds to the growing body of work on age differences in reactions to adversity.",0 +,Posttraumatic Stress Disorder and its Relationship with Attachment Styles and Dimensions,"Treatment studies for posttraumatic stress disorder (PTSD) consistently show a portion of participants with poor treatment outcomes. Bowlby.s attachment theory is one framework for understanding PTSD. Research has begun investigating relationships between PTSD and attachment and has found relationships between PTSD symptoms and attachment across attachment styles. The purpose of the current study was to extend this research by investigating relationships between a person.s own PTSD symptoms and attachment style and dimensions. The study used a correlational approach with a convenience sample of adults diagnosed with PTSD (N = 80). The research questions sought to (a) examine the relationships between a person.s predominating PTSD symptom cluster and their scores on the two attachment dimensions that combine to form attachment styles, and (b) accurately classify participants into their attachment style based on their three PTSD symptom cluster scores. Participants completed the Experiences in Close Relationships- Revised (ECR-R) and PTSD Checklist- Specific (PCL-S) via a secure website. MANOVA was used for the first research question and multiple discriminant analysis (MDA) for the second. MANOVA results were nonsignificant but MDA results classified participants at a greater-than-chance rate. The MDA classification results provide implications for positive social change by supplying preliminary evidence for relationships between a person.s own PTSD symptoms and attachment style, suggesting that personalizing PTSD treatment protocols according to a person.s attachment style may improve treatment outcomes for people with PTSD. More research is needed to determine mediating variables between these constructs as well as how attachment considerations may be most effectively implemented in treatment. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1155/2014/141396,Effects of Stress and MDMA on Hippocampal Gene Expression,"MDMA (3,4-methylenedioxymethamphetamine) is a substituted amphetamine and popular drug of abuse. Its mood-enhancing short-term effects may prompt its consumption under stress. Clinical studies indicate that MDMA treatment may mitigate the symptoms of stress disorders such as posttraumatic stress syndrome (PTSD). On the other hand, repeated administration of MDMA results in persistent deficits in markers of serotonergic (5-HT) nerve terminals that have been viewed as indicative of 5-HT neurotoxicity. Exposure to chronic stress has been shown to augment MDMA-induced 5-HT neurotoxicity. Here, we examine the transcriptional responses in the hippocampus to MDMA treatment of control rats and rats exposed to chronic stress. MDMA altered the expression of genes that regulate unfolded protein binding, protein folding, calmodulin-dependent protein kinase activity, and neuropeptide signaling. In stressed rats, the gene expression profile in response to MDMA was altered to affect sensory processing and responses to tissue damage in nerve sheaths. Subsequent treatment with MDMA also markedly altered the genetic responses to stress such that the stress-induced downregulation of genes related to the circadian rhythm was reversed. The data support the view that MDMA-induced transcriptional responses accompany the persistent effects of this drug on neuronal structure/function. In addition, MDMA treatment alters the stress-induced transcriptional signature.",0 +https://doi.org/10.1037/a0029730,The prevalence and latent structure of proposed DSM-5 posttraumatic stress disorder symptoms in U.S. national and veteran samples.,"The Diagnostic and Statistical Manual, Fourth Edition (DSM-IV) is currently undergoing revisions in advance of the next edition, DSM-5. The DSM-5 posttraumatic stress disorder workgroup has proposed numerous changes to the PTSD diagnosis. These include the addition of new symptoms, revision of existing ones, and a new four-cluster organization (Friedman, Resick, Bryant, & Brewin, 2011). We conducted two Internet-based surveys to provide preliminary information about how proposed changes might impact PTSD prevalence and clarify the latent structure of the new symptom set. We used a newly developed instrument to assess event exposure and lifetime and current DSM-5 PTSD symptoms among a nationally representative sample of American adults (N = 2,953) and a clinical convenience sample of U.S. military veterans (N = 345). Results from both samples indicated that the originally proposed DSM-5 symptom criteria (i.e., requiring 1 B, 1 C, 3 D, and 3 E symptoms) yielded considerably lower PTSD prevalence estimates compared with DSM-IV estimates. These estimates were more comparable when the DSM-V D and E criteria were relaxed to 2 symptoms each (i.e., the revised proposal). Confirmatory factor analyses (CFA) indicated that the factor structure implied by the four-symptom criteria provided adequate fit to the data in both samples, and a DSM-5 version of a dysphoria model (Simms, Watson, & Doebbeling, 2002) yielded modest improvement in fit. Item-response theory and CFA analyses indicated that the psychogenic amnesia and new reckless/self-destructive behavior symptom deviated from the others in their respective symptom clusters. Implications for final formulations of DSM-5 PTSD criteria are discussed.",0 +https://doi.org/10.1002/ajmg.b.30786,Mood and anxiety disorders in females with the FMR1 premutation,"Fragile X syndrome (FXS) is a model for studying the relative contributions of genetic and environmental factors to psychiatric disorders in mothers of children with disabilities. Here, we examine the frequency and predictors of mood and anxiety disorders in mothers with the FMR1 premutation. Ninety-three females with the FMR1 premutation were in the study and were compared to 2,159 women from the National Comorbidity Survey Replication (NCS-R) dataset. Mood and anxiety disorders were assessed using the SCID-I. Our data reflect elevated lifetime major depressive disorder (MDD), lifetime panic disorder without agoraphobia and current agoraphobia without panic disorder in the FMR1 premutation sample. Also, we found a low frequency of lifetime social phobia, specific phobia, and post-traumatic stress disorders and current specific phobia in the FMR1 premutation sample. The profile of MDD in the FMR1 premutation sample was not episodic or comorbid with an anxiety disorder, as in the NCS-R dataset. Never having been married and smaller CGG repeat length were associated with increased likelihood of MDD while increased children with FXS in the family and greater child problem behaviors were associated with increased likelihood of an anxiety disorder in the FMR 1 premutation group. Major depression in females with the FMR1 premutation may not be characterized as an episodically chronic recurrent disorder as it is in community samples and may have a genetic basis given the relationship with CGG repeat length and lack of association with all child and most demographic factors.",0 +https://doi.org/10.1111/j.1440-1819.2010.02065.x,Peritraumatic Distress Inventory as a predictor of post-traumatic stress disorder after a severe motor vehicle accident,"Aim: The aim of this study was to examine the utility of the Peritraumatic Distress Inventory (PDI) as a predictor of subsequent post-traumatic stress disorder (PTSD) in severe motor vehicle accident survivors. Methods: Patients consecutively admitted to the intensive care unit were assessed immediately and 1 month after accidents in this prospective study. The predictive value for post-traumatic stress symptoms at 1 month of the PDI at initial assessment was examined by using multivariate regression analysis. Moreover, the accuracy of the PDI as a predictor of PTSD was determined using receiver operator characteristic curve analysis. Post-traumatic stress symptoms were assessed using the Impact of Event Scale – Revised questionnaire, and PTSD was assessed using the Clinician-Administered PTSD Scale. Results: Seventy-nine patients completed the Impact of Event Scale – Revised questionnaire, and 64 patients participated in a structured interview. Of 64 patients, 13 met the diagnostic criteria of full or partial PTSD. The PDI was an independent predictor of post-traumatic stress symptoms (P = 0.003). The data indicated that a cut-off score of 23 maximized the balance between sensitivity (77%) and specificity (82%) in this study. Compared with negative predictive value (93%), positive predictive value was not high (53%). Conclusion: The study suggests the predictive usefulness of the PDI for subsequent PTSD in accident survivors. Its adequate usage should be further elaborated.",0 +https://doi.org/10.1097/00004714-200006000-00014,Fluvoxamine Reduces Physiologic Reactivity to Trauma Scripts in Posttraumatic Stress Disorder,"This study assessed the effect of open-label fluvoxamine treatment for posttraumatic stress disorder (PTSD), depressive symptoms, and physiologic arousal to trauma cues. Baseline psychometric ratings and physiologic assessments of heart rate and blood pressure responses to individualized, taped trauma scripts were determined for 16 patients with PTSD and 16 mentally healthy age- and gender-matched control subjects exposed to at least 1 serious trauma. Patients with PTSD had greater autonomic reactivity than control subjects at baseline, with physiologic measures correlating with the severity of the PTSD for the combined groups. Discriminant analyses indicated that systolic blood pressure best classified patients with PTSD (75% sensitivity) and control subjects (100% specificity), with a stepwise discriminant analysis showing that combined physiologic variables correctly classified 75% of patients with PTSD and 100% of control subjects. After 10 weeks of fluvoxamine treatment (100-300 mg/day), patients' PTSD, depression, and physiologic reactivity improved significantly. Medicated patients with PTSD could not be distinguished statistically from untreated control subjects in any physiologic measure. This dampening of autonomic reactivity after drug treatment corroborates subjective measures of improvement, validating the reported efficacy of fluvoxamine in this open trial.",0 +https://doi.org/10.7205/milmed.172.5.451,Post-Traumatic Stress Disorder and Depression in Health Care Providers Returning from Deployment to Iraq and Afghanistan,"This study examines risk factors for post-traumatic stress disorder (PTSD), depression, and mental health care use among health care workers deployed to combat settings.Anonymous surveys were administered to previously deployed workers at a military hospital. PTSD and depression were assessed by using the PTSD Checklist and the Patient Health Questionnaire depression scale, respectively. Deployment exposures and perceived threats during deployment were also assessed.There were 102 respondents (36% response rate). Nine percent (n=9) met the criteria for PTSD and 5% (n=5) met the criteria for depression. Direct and perceived threats of personal harm were risk factors for PTSD; exposure to wounded or dead patients did not increase risk. Those who met the criteria for PTSD were more likely to seek mental health care after but not before their deployment.For health care workers returning from a warfare environment, threat of personal harm may be the most predictive factor in determining those with subsequent PTSD.",0 +,"Primary malignant brain tumours, psychosocial distress and the intimate partner experience: what do we know?","From the time of diagnosis of a primary malignant brain tumour (PMBT) and throughout the illness trajectory, the patient and intimate partner face many psychosocial challenges ranging from fear and uncertainty to hope and loss (Fox & Lantz, 1998; Janda et al., 2007; Kvale, Murthy, Taylor, Lee, & Nabors, 2009). While many patients diagnosed with cancer may go on to live with cancer as a chronic illness, this may not be said of individuals diagnosed with a PMBT, in particular those diagnosed with a glioma, the most common form of brain tumour (Gupta & Sarin, 2002). Gliomas are associated with a short disease trajectory and multiple deficits (functional, cognitive and psychiatric). What makes the PMBT experience unique from other cancers is that the intimate partner must not only deal with the diagnosis of cancer in their spouse, but also the accompanying personality, functional and behavioural changes wrought by the disease, as well as grieve the loss of the person they once knew (Sherwood et al., 2004). These multi-dimensional deficits are thought to place the intimate partner, as caregiver, at greater risk for adverse psychosocial effects such as anxiety, depression and post traumatic stress (Goebel, von Harscher, & Mehdorn, 2011; Keir, Farland, Lipp, & Friedman, 2009). The following discussion will provide an overview of the extant literature on the experience of living with a PMBT from the intimate partner (spouse) perspective with a particular emphasis on how intimate partners cope. The intimate partner is considered to be the heterosexual or same-sex, married or common-law partner of the patient. Highlights from the psychotherapy practice of the author will be used to further strengthen the need for more research, education and enhanced practice to more effectively meet the unique needs of this under-researched and supported population.",0 +https://doi.org/10.1521/bumc.2008.72.3.179,Posttraumatic stress disorder following traumatic injury: Narratives as unconscious indicators of psychopathology,"Current conventional assessment methodologies used to diagnose posttraumatic stress disorder (PTSD) rely heavily on symptom counts obtained from clinical interviews or self-report questionnaires. Such measures may underestimate the impact of traumatic events, particularly in individuals who deny or repress emotional distress. This case report illustrates the use of two methods of narrative analysis to assess unconscious representations of PTSD. Linguistic analysis and a computerized analysis of referential activity were able to capture unconscious aspects of the traumatic experience.",0 +https://doi.org/10.1080/10926771.2014.920456,Patterns in Blame Attributions in Maltreated Youth: Association with Psychopathology and Interpersonal Functioning,"This investigation explored patterns of blame attributions in 128 youth, primarily (87%) female, with maltreatment histories. Second, the study also evaluated the relative variance in posttraumatic stress disorder (PTSD) symptom severity, emotional distress, and interpersonal functioning outcomes, accounted for by age, abuse characteristics, and blame attribution patterns. Cluster analyses revealed distinctive blame profiles: high perpetrator blame, moderate perpetrator blame, high self-blame, high perpetrator/high self-blame, and low perpetrator/low self-blame. Regression analyses yielded significant models, accounting for 15% to 34% of the variance of outcomes. Most notably, youth endorsing a high perpetrator/high self-blame (i.e., compounded blame) attribution pattern reported poorer outcomes as compared to youth presenting with other blame profiles. Maltreatment type and age differences were not demonstrated across clusters. Implications and limitations are discussed.",0 +https://doi.org/10.1017/cbo9780511994791.015,Loss and grief: the role of individual differences,"It is an unfortunate but inevitable fact of life that virtually all of us must face: people we are close to die. Despite this universality, researchers and theorists have long assumed that bereavement almost always results in significant, and sometimes incapacitating, distress. Curiously, the absence of distress after loss has itself been considered pathological and a likely harbinger of future difficulties (Middleton et al., 1993). When bereaved persons fail to display the expected distress reaction, some have maintained that they are suppressing their grief (Middleton et al., 1993) or lack an attachment to their spouse (Fraley & Shaver, 1999). Indeed, emotional expression following loss – particularly negative emotions – has long been considered cathartic, a necessary ingredient of healthy adjustment (Freud, 1957). Perhaps for this reason, bereaved people who appear outwardly resilient and who resume their lives with minimal disruptions have often been thought to possess extraordinary coping abilities. However, this idea has increasingly come under fire (Bonanno, 2004). In fact, most bereaved people experience relatively transient disruptions in their ability to function effectively. Furthermore, research increasingly shows that there is a marked diversity in how people respond to loss. Indeed, it appears that three primary patterns or trajectories adequately describe most people’s response to interpersonal loss. The largest category, usually from 50% to 60%, is characterized by stable, healthy levels of psychological and physical functioning relatively soon after a loss, or “resilience” (Bonanno, 2004; Mancini & Bonanno, 2006). A second category of bereaved persons (20–25%) displays more acute and persistent levels of distress but gradually they too recover their bearings and return to their former level of functioning. The most problematic reaction is found among those with a persistent syndrome of a sometimes incapacitating distress that may take years to resolve. This pattern, often described as “complicated grief” (Bonanno et al., 2007), is relatively rare, typically occurring in 10–15% of grievers (Bonanno & Kaltman, 2001). Two other types of bereavement response have also emerged recently, although they typically characterize only a small proportion of grievers. These include a chronic form of distress that predated the loss and is exacerbated in its aftermath (Bonanno et al., 2002; Mancini et al., 2011) and dramatic improvement following loss (A.D. Mancini, I. Galatzer-Levy, & G.A. Bonanno, unpublished data). Although each is quite uncommon (5–10%), these patterns have been confirmed using different methods and samples, suggesting that they are veridical. © Cambridge University Press 2011.",0 +https://doi.org/10.1016/j.jclinepi.2012.04.010,Classifying developmental trajectories over time should be done with great caution: a comparison between methods,"In the analysis of data from longitudinal cohort studies, there is a growing interest in the analysis of developmental trajectories in subpopulations of the cohort under study. There are different advanced statistical methods available to analyze these trajectories, but in the epidemiologic literature, most of those are never used. The purpose of the present study is to compare five statistical methods to detect developmental trajectories in a longitudinal epidemiological data set.All five statistical methods (K-means clustering, a ""two-step"" approach with mixed modeling and K-means clustering, latent class analysis [LCA], latent class growth analysis [LCGA], and latent class growth mixture modeling [LCGMM]) were performed on a real-life data set and two manipulated data sets. The first manipulated data set contained four different linear developments over time, whereas the second contained two linear and two quadratic developments.For the real-life data set, all five classification methods revealed comparable trajectories. Regarding the manipulated data sets, LCGA performed best in detecting linear trajectories, whereas none of the methods performed well in detecting a combination of linear and quadratic trajectories. Furthermore, the optimal solution for LCA and LCGA contained more classes compared with LCGMM.Although LCGA and LCGMM seem to be preferable above the more simple methods, all classification methods should be applied with great caution.",0 +https://doi.org/10.1080/15374416.2014.913249,Narrative Focus Predicts Symptom Change Trajectories in Group Treatment for Traumatized and Bereaved Adolescents,"Growing evidence supports the effectiveness of Trauma and Grief Component Therapy for Adolescents (TGCT-A) in reducing posttraumatic stress disorder (PTSD) symptoms and maladaptive grief (MG) reactions. This pilot study explored whether the specific focus of students' narratives (i.e., focus on trauma vs. focus on loss) as shared by TGCT-A group members would predict initial pretreatment levels, as well as pre- to posttreatment change trajectories, of PTSD symptoms and MG reactions. Thirty-three adolescents from three middle schools completed a 17-week course of group-based TGCT-A. PTSD and MG symptoms were assessed at pretreatment, twice during treatment, and at posttreatment. The focus (trauma vs. loss) of each student's narrative was coded using transcripts of members' narratives as shared within the groups. The reliable change index showed that 61% of students reported reliable pre-post improvement in either PTSD symptoms or MG reactions. Students whose narratives focused on loss both reported higher starting levels and showed steeper rates of decline in MG reactions than students whose narratives focused on trauma. In contrast, students whose narratives focused on trauma reported higher starting levels of PTSD than students who narrated loss experiences. However, narrative focus was not significantly linked to the rate at which PTSD symptoms declined over the course of treatment. This study provides preliminary evidence that TGCT-A treatment components are associated with reduced PTSD symptoms and MG reactions. Loss-focused narratives, in particular, appear to be associated with greater decreases in MG reactions.",0 +,The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care.,"A method for comparing death rates of groups of injured persons was developed, using hospital and medical examiner data for more than two thousand persons. The first step was determination of the extent to which injury severity as rated by the Abbreviated Injury Scale correlates with patient survival. Substantial correlation was demonstrated. Controlling for severity of the primary injury made it possible to measure the effect on mortality of additional injuries. Injuries that in themselves would not normally be life-threatening were shown to have a marked effect on mortality when they occurred in combination with other injuries. An Injury Severity Score was developed that correlates well with survival and provides a numerical description of the overall severity of injury for patients with multiple trauma. Results of this investigation indicate that the Injury Severity Score represents an important step in solving the problem of summarizing injury severity, especially in patients with multiple trauma.",0 +https://doi.org/10.1016/s1525-5069(02)00505-4,Treatment of nonepileptic seizures,"Studies on nonepileptic seizures (NES) provide dichotomous data sets: extensive observational findings, but a paucity of controlled treatment data. Psychosocial stressors, whose full impact may lie outside a patient's awareness, often underlie NES. These stressors, along with patient's learned patterns of coping, may bring forth or potentiate comorbid psychiatric disorders. Patients with NES often have dysfunction in emotion regulation and family dynamics, as well as unemployment/disability. High percentages of comorbid disorders such as major depressive disorder, post-traumatic stress disorder, and cluster B personality with impulsivity (all disorders associated with serotonin system function) also exist in the NES population. The preliminary observational evidence suggests that specific psychotherapies and pharmacotherapy directed at comorbid conditions may be the most effective treatment for NES.",0 +https://doi.org/10.1016/j.janxdis.2011.08.013,Posttraumatic stress disorder in DSM-5: Estimates of prevalence and symptom structure in a nonclinical sample of college students,"We empirically investigated recent proposed changes to the posttraumatic stress disorder (PTSD) diagnosis for DSM-5 using a non-clinical sample. A web survey was administered to 585 college students using the Stressful Life Events Screening Questionnaire to assess for trauma exposure but with additions for the proposed traumatic stressor changes in DSM-5 PTSD. For the 216 subjects endorsing previous trauma exposure and nominating a worst traumatic event, we administered the original PTSD Symptom Scale based on DSM-IV PTSD symptom criteria and an adapted version for DSM-5 symptoms, and the Center for Epidemiological Studies-Depression Scale. While 67% of participants endorsed at least one traumatic event based on DSM-IV PTSD's trauma classification, 59% of participants would meet DSM-5 PTSD's proposed trauma classification. Estimates of current PTSD prevalence were .4-1.8% points higher for the DSM-5 (vs. the DSM-IV) diagnostic algorithm. The DSM-5 symptom set fit the data very well based on confirmatory factor analysis, and neither symptom set's factors were more correlated with depression.",0 +https://doi.org/10.1186/1745-0179-1-17,,"Research has suggested that organized violence and torture have long-term psychological effects that persist throughout the lifespan. The present survey aimed at examining the prevalence of posttraumatic stress disorder (PTSD), and other disorders and symptoms, all present in old age, as long-term consequences of politically motivated violence in a comparison design.A group of former political detainees (N = 59, mean age 73.5 years) who had been arrested by the Romanian communist regime were compared to an age- and gender-matched control group (N = 39). PTSD was assessed using a structured clinical interview (CIDI). The investigation of the clinical profile was further accomplished by self-rating measures for anxiety, depression, and health-related functioning, as well as by clinician-administrated interviews for substance abuse, dissociation, and somatization symptoms.Lifetime prevalence of PTSD was 54%. In the case of participants left untreated, PTSD persisted, often over four decades, such that current PTSD was diagnosed still in a third of the survivors. Other clinical conditions such as somatization, substance abuse, dissociative disorders, and major depression were also common among the former political detainees and often associated with current PTSD.Our findings suggest that political detention may have long-term psychological consequences that outlast the changes in the political system.",0 +,Neural correlates of observation of disgusting images in subjects with first episode psychosis and post-traumatic stress disorder.,"The aim of this study was to analyze neural responses to disgusting images in individuals with first episode psychosis and post-traumatic stress disorder (PTSD). Although anhedonia is a common symptom in both disorders we expected that they would be associated with different neurophysiological abnormalities and patterns of activation. We recruited three groups of participants: 13 individuals with first episode psychosis, 10 individuals with PTSD who had survived the April 2009 L’Aquila earthquake and 25 healthy controls matched for age and education. All individuals participated in a functional imaging experiment in which they watched six alternating blocks of disgusting and scrambled images whilst undergoing scanning with a General Electric 1.5T whole-body scanner. We estimated individuals'’ beta-weights, extracting 22 clusters corresponding to 22 significant areas. Findings were consistent with other neuroimaging studies; the active areas (i.e. amygdala, insula, inferior and medial frontal gyrus) have consistently been associated with emotional experiences. Statistical analysis revealed important group differences in intensity and direction (positive or negative) of signal from baseline during disgusting condition. Although these results are preliminary they show that functional neuroimaging techniques may make a valuable contribution to differential diagnosis of first episode psychosis and PTSD.",0 +https://doi.org/10.1080/02699050110034334,Post-traumatic stress disorder symptoms following a head injury: does amnesia for the event influence the development of symptoms?,"There is controversy as to whether PTSD can develop following a brain injury with a loss of consciousness. However, no studies have specifically examined the influence of the memories that the individuals may or may not have on the development of symptoms.To consider how amnesia for the traumatic event effects the development and profile of traumatic stress symptoms.Fifteen hundred case records from an Accident and Emergency Unit were screened to identify 371 individuals with traumatic brain injury who were sent questionnaires by post. The 53 subsequent valid responses yielded three groups: those with no memory (n = 14), untraumatic memories (n = 13) and traumatic memories (n = 26) of the index event. The IES-R was used as a screening measure followed by a structured interview (CAPS-DX) to determine caseness and provide details of symptom profile.Groups with no memories or traumatic memories of the index event reported higher levels of psychological distress than the group with untraumatic memories. Ratings of PTSD symptoms were less severe in the no memory groups compared to those with traumatic memories.Psychological distress was associated with having traumatic or no memories of an index event. Amnesia for the event did not protect against PTSD; however, it does appear to protect against the severity and presence of specific intrusive symptoms.",0 +,The needs of primary care mental health service users: a Q-sort study.,"Background Within scientific and policy literature, the broader needs and preferences of the service user are usually described as being relatively homogenous for any particular condition. Additionally, despite common adult mental health problems being a huge burden to primary care services, there has been little research into the client's perspective of their needs regarding such difficulties. The aim of this research was thus to uncover the issues and preferences for this sample.Method The attitudes of 28 service users were explored through use of a Q-methodology approach. This procedure involves statistical analysis of the order that participants rank pertinent statements associated with the area of study.Results Five independent factors (clusters of preferences) were identified. These differed over issues associated with: relationships with service providers, access/barriers associated with services, information provision, stigma, choices associated with therapy and the care pathway, medication and complementary approaches, as well as social support.Discussion The study suggests that differing individual needs exist within diagnostic categories which, unless considered, may impede service engagement. Issues associated with the implications for service delivery for these differing clusters of perceived needs and viewpoints are outlined.",0 +https://doi.org/10.1177/008124630503500106,The Role of Temperament in the Development of Post-Traumatic Stress Disorder Amongst Journalists,"The literature indicates that journalists, who have been exposed to traumatic situations, risk developing Post-traumatic Stress Disorder (PTSD). Certain temperament traits, such as neuroticism and compulsiveness, have been found to increase vulnerability to the development of PTSD amongst police officers. Few research studies have investigated temperament and a sense of coherence as factors mediating occupational stress in journalists exposed to trauma. The aim of this study was to address this dearth by investigating whether differences in the experience of trauma, temperament traits and a sense of coherence amongst journalists will influence the degree of PTSD experienced. The Impact of Event Scale-Revised was used to divide journalists into three groups, namely, those with minor reactions ( n=10), moderate reactions ( n=24) and severe reactions of clinical importance ( n=16). Analyses of variance followed by Scheffé post hoc multiple comparisons technique indicated statistically significant differences between the three groups regarding experience of trauma as measured by the Trauma Questionnaire, temperament traits as measured by the Zuckerman-Kuhlman Personality Questionnaire and sense of coherence as measured by the Sense of Coherence Questionnaire. The results show that various factors could have an impact on how journalists deal with the traumatic stories they cover, as well as their personal outcomes after covering these stories. Journalists who develop severe PTSD differ in terms of their perceptions of the trauma, temperament profiles and sense of coherence, which impacts on their way of coping with the traumatic situations they face daily.",0 +https://doi.org/10.1158/0008-5472.can-04-0711,Acquisition of Resistance to Butyrate Enhances Survival after Stress and Induces Malignancy of Human Colon Carcinoma Cells,"Abstract Acquired resistance to apoptosis by tumor cells remains a major obstacle for cancer treatment, and hence the analysis of resistance to apoptosis constitutes a major goal in the development of antitumoral drugs. We have established a butyrate-resistant human colon adenocarcinoma cell line (BCS-TC2.BR2) from nontumorigenic BCS-TC2 cells to analyze whether the acquisition of such phenotype confers resistance to apoptosis and stress. Although BCS-TC2.BR2 cells exhibited a more differentiated phenotype than the parental BCS-TC2 cells, higher butyrate concentrations remained capable of additionally enhancing their differentiation without inducing apoptosis. Survival rates of BCS-TC2.BR2 cells after glucose deprivation and heat shock were higher than those of parental cells, revealing a stress-resistant phenotype. These findings were accompanied by key differences between parental and butyrate-resistant cells in gene expression profiles and the acquisition of in vivo tumorigenicity. In conclusion, cells gaining resistance to an endogenous physiological modulator of growth, differentiation, and apoptosis concurrently acquired resistance to other agents that influence cell survival.",0 +https://doi.org/10.2165/00042310-200117160-00001,Sertraline: the first SSRI to be approved for the specific treatment of post-traumatic stress disorder,"Sertraline is the first selective serotonin re-uptake inhibitor (SSRI) to be approved for the treatment of patients with post-traumatic stress disorder (PTSD). Sertraline 50 to 200mg once daily for 12 weeks has shown efficacy in 2 of 3 double-blind, placebo-controlled trials conducted in US civilians. Overall response rates were 53 and 60% for patients receiving sertraline compared with 32 and 39% for patients receiving placebo in the 2 positive studies. A post hoc analysis of these studies indicated that sertraline was effective at alleviating PTSD symptoms in women but efficacy in men was not clearly established. Sertraline also failed to show significant effects compared with placebo in 2 clinical trials conducted in patients with predominantly combat-induced PTSD. Sertraline is generally well tolerated showing an adverse event profile similar to other SSRIs. Adverse events occuring with greater frequency than placebo in controlled trials were insomnia, nausea and diarrhoea.",0 +https://doi.org/10.1371/journal.pone.0120493,Effect of the Interplay between Trauma Severity and Trait Neuroticism on Posttraumatic Stress Disorder Symptoms among Adolescents Exposed to a Pipeline Explosion,"While numerous studies have explored relevant factors of posttraumatic stress disorder (PTSD) symptoms, there have been few joint investigations of trauma severity and trait neuroticism on the development of PTSD symptoms. This study aims to assess the involvement and interrelationship of trauma severity and neuroticism in the expression of PTSD symptoms among adolescents exposed to an accidental explosion.Six hundred and sixty-two adolescents were recruited from a junior middle school closest to the 2013 pipeline explosion site in China and were assessed using the Explosion Exposure Questionnaire, the NEO Five Factor Inventory-Neuroticism Subscale (FFI-N), and the PTSD Checklist-Civilian (PCL-C). A battery of hierarchical multiple regression analyses and two-way ANOVAs were performed to examine the effect of trauma severity and trait neuroticism on adolescent PTSD symptoms.Eighty-seven adolescents (13.1%) showed PTSD symptoms after the pipeline explosion. Correlation analysis showed that all the factors of explosion exposure and trait neuroticism were positively associated with adolescent PTSD symptoms. Being male and younger was linked to lower risk for PTSD symptoms. The regression models identified explosion exposure and neuroticism as independent risk factors for PTSD symptoms, and the interactions between trait neuroticism and trauma exposure (personal casualty, degree of influence, total traumatic severity) were related to PTSD symptoms.The results highlight the role of trauma exposure and trait neuroticism as risk factors for PTSD symptoms. Therefore, the combination of these two factors should be investigated in clinical settings due to an augmented risk for more severe PTSD symptoms.",0 +https://doi.org/10.3233/nre-141059,Positive psychology in rehabilitation medicine: A brief report,"The field of positive psychology has grown exponentially within the last decade. To date, however, there have been few empirical initiatives to clarify the constructs within positive psychology as they relate to rehabilitation medicine. Character strengths, and in particular resilience, following neurological trauma are clinically observable within rehabilitation settings, and greater knowledge of the way in which these factors relate to treatment variables may allow for enhanced treatment conceptualization and planning.The goal of this study was to explore the relationships between positive psychology constructs (character strengths, resilience, and positive mood) and rehabilitation-related variables (perceptions of functional ability post-injury and beliefs about treatment) within a baseline data set, a six-month follow-up data set, and longitudinally across time points.Pearson correlations and supplementary multiple regression analyses were conducted within and across these time points from a starting sample of thirty-nine individuals with acquired brain injury (ABI) in an outpatient rehabilitation program.Positive psychology constructs were related to rehabilitation-related variables within the baseline data set, within the follow-up data set, and longitudinally between baseline positive psychology variables and follow-up rehabilitation-related data.These preliminary findings support relationships between character strengths, resilience, and positive mood states with perceptions of functional ability and expectations of treatment, respectively, which are primary factors in treatment success and quality of life outcomes in rehabilitation medicine settings. The results suggest the need for more research in this area, with an ultimate goal of incorporating positive psychology constructs into rehabilitation conceptualization and treatment planning.",0 +https://doi.org/10.1093/milmed/164.4.261,Minnesota Multiphasic Personality Inventory-2 Validity Patterns: An Elucidation of Gulf War Syndrome,"The potential effects of psychological distress on physical symptoms observed in Persian Gulf War veterans were evaluated in 48 veterans using neuropsychological evaluation that included personality assessment (the Minnesota Multiphasic Personality Inventory-2). Cluster analysis of the validity scales resulted in a solution with two viable subgroups. Members of cluster 1 had significantly higher scores on five Minnesota Multiphasic Personality Inventory-2 clinical scales, a measure of trait anxiety, and a number of subjective complaints, as well as lower scores on a task of attention. Neuropsychological functioning did not otherwise differ between the groups, Contributions of personality style in coping with physical and mental health stressors were indicated. Experience of distress appeared to be attributable to individual differences rather than factors that have been associated with the elusive Gulf War syndrome. Persian Gulf War veterans' emotional reactions to clinical laboratory findings, perceptions of exposure risks, war experience, and stress may represent a variation of post-traumatic stress disorder.",0 +https://doi.org/10.1016/j.janxdis.2013.09.011,The role of sleep disturbance in the relationship between post-traumatic stress disorder and suicidal ideation,"• PTSD symptoms indirectly predicted suicidal ideation via comorbid sleep disturbances, but had no direct effect. • Polyvictimization predicted sleep disturbances and suicidal ideation independently of PTSD or major depression . • No relationships were substantively altered after adjusting for comorbid major depression. We tested if the risk of suicidal ideation in individuals with PTSD symptoms was dependent on comorbid sleep disturbance. Our cross-sectional sample included 2465 participants with complete data from the 21 year follow-up of the Mater University Study of Pregnancy (MUSP), a birth cohort study of young Australians. Using structural equation modelling with indirect pathways we found that 12 month PTSD symptoms did not directly predict suicidal ideation at 21 when adjusting for major depression symptoms, polyvictimization and gender. However, PTSD symptoms had an indirect effect on suicidal ideation via past-month sleep disturbance. Our results suggest that increased suicidal ideation in those with PTSD may result from the fact that PTSD sufferers often exhibit other comorbid psychiatric conditions which are themselves known to predict suicidal behaviours. Sleep disturbance may be targeted in those who experience PTSD to help prevent suicidal ideation.",0 +https://doi.org/10.1177/0956797614551750,Optimism and Death,"The course of depression in relation to myocardial infarction (MI), commonly known as heart attack, and the consequences for mortality are not well characterized. Further, optimism may predict both the effects of MI on depression as well as mortality secondary to MI. In the current study, we utilized a large population-based prospective sample of older adults ( N = 2,147) to identify heterogeneous trajectories of depression from 6 years prior to their first-reported MI to 4 years after. Findings indicated that individuals were at significantly increased risk for mortality when depression emerged after their first-reported MI, compared with resilient individuals who had no significant post-MI elevation in depression symptomatology. Individuals with chronic depression and those demonstrating pre-event depression followed by recovery after MI were not at increased risk. Further, optimism, measured before MI, prospectively differentiated all depressed individuals from participants who were resilient.",0 +https://doi.org/10.1177/10778019922181239,Type and Severity of Abuse and Posttraumatic Stress Disorder Symptoms Reported by Women Who Killed Abusive Partners,"This study investigated the type, severity, and frequency of Posttraumatic Stress Disorder (PTSD) symptoms experienced by battered women prior to killing male partners. Eighteen women were assessed for frequency and severity of lifetime PTSD symptoms and type of abuse endured. Correlations were performed between clusters of PTSD symptoms and composites of violent experiences. It was found that before killing male partners, these battered women suffered moderate to high levels of PTSD symptom frequency and severity, except for an inability to recall important aspects of the trauma. Significant canonical correlations were found between the frequency and severity of PTSD symptoms and the severity of types of abuses inflicted.",0 +https://doi.org/10.1080/13854046.2013.802017,Neuropsychological Effects of Self-Reported Deployment-Related Mild TBI and Current PTSD in OIF/OEF Veterans,"Current combat veterans are exposed to many incidents that may result in mild traumatic brain injury (mTBI) and/or posttraumatic stress disorder (PTSD). While there is literature on the neuropsychological consequences of PTSD only (PTSD-o) and mTBI alone (mTBI-o), less has been done to explore their combined (mTBI+PTSD) effect. The goal of this study was to determine whether Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) veterans with mTBI+PTSD have poorer cognitive and psychological outcomes than veterans with PTSD-o, mTBI-o, or combat exposure-only. The final sample included 20 OIF/OEF veterans with histories of self-reported deployment mTBI (mTBI-o), 19 with current PTSD (PTSD-o), 21 with PTSD and self-reported mTBI (mTBI+PTSD), and 21 combat controls (CC) (no PTSD and no reported mTBI). Groups were formed using structured interviews for mTBI and PTSD. All participants underwent comprehensive neuropsychological testing, including neurocognitive and psychiatric feigning tests. Results of cognitive tests revealed significant differences in performance in the mTBI+PTSD and PTSD-o groups relative to mTBI-o and CC. Consistent with previous PTSD literature, significant differences were found on executive (switching) tasks, verbal fluency, and verbal memory. Effect sizes tended to be large in both groups with PTSD. Thus, PTSD seems to be an important variable affecting neuropsychological profiles in the post-deployment time period. Consistent with literature on civilian mTBI, the current study did not find evidence that combat-related mTBI in and of itself contributes to objective cognitive impairment in the late stage of injury.",0 +https://doi.org/10.1207/s15327752jpa4903_1,MCMI Characteristics of DSM-III Posttraumatic Stress Disorder in Vietnam Veterans,Compared the MCMI profiles of 25 veterans with a diagnosis of Posttraumatic Stress Disorder (PTSD) with those of 25 veterans carrying psychiatric disorders which typically cause problems in the differential diagnosis of PTSD. The PTSD group had higher elevations on nine of the 20 MCMI scales (all ps less than .05). Profiles were also significantly different in shape and scatter. A discriminant analysis accounted for 100% of the variance and correctly classified 88% of the patients. Resulting MCMI profiles appear to be consistent with DSM-III criteria for PTSD.,0 +https://doi.org/10.1007/s10879-015-9302-7,The Enhancement of Natural Resilience in Trauma Interventions,"Resilience following trauma is the rule, not the exception. The minority of individuals who go on to suffer chronic pathology such as posttraumatic stress disorder (PTSD) will likely benefit from a number of evidence-based treatments. The study of resilience provides a new framework to examine and build upon these existing therapies. This article outlines an evidence-based theoretical model for understanding psychotherapy for PTSD through the lens of resilience. Specifically, we explore three broad factors thought to underlie resilience: social support, returning to daily routine, and meaning making. We review the literature regarding the impact of these factors on natural recovery after a trauma as well as treatment response. We connect these processes to interventions and techniques used in several empirically supported therapies, highlighting compatibility and synergy with therapeutic goals. With this review, we aim to map our existing knowledge about resilience onto theoretical models of treatment efficacy to broaden our conceptualization of treatment mechanisms and spur new ideas to improve clinical outcomes for those suffering due to trauma.",0 +https://doi.org/10.1016/j.psyneuen.2014.08.004,Cortisol augmentation of a psychological treatment for warfighters with posttraumatic stress disorder: Randomized trial showing improved treatment retention and outcome,"Prolonged exposure (PE) therapy for post-traumatic stress disorder (PTSD) in military veterans has established efficacy, but is ineffective for a substantial number of patients. PE is also associated with high dropout rates. We hypothesized that hydrocortisone augmentation would enhance symptom improvement and reduce drop-out rates by diminishing the distressing effects of traumatic memories retrieved during imaginal exposure. We also hypothesized that in responders, hydrocortisone augmentation would be more effective in reversing glucocorticoid indices associated with PTSD than placebo augmentation.Twenty-four veterans were randomized to receive either 30 mg oral hydrocortisone or placebo prior to PE sessions 3-10 in a double-blind protocol. Glucocorticoid receptor sensitivity was assessed in cultured peripheral blood mononuclear cells (PBMC) using the in vitro lysozyme inhibition test and was determined before and after treatment. Intent-to-treat analysis was performed using latent growth curve modeling of treatment effects on change in PTSD severity over time. Veterans who no longer met diagnostic criteria for PTSD at post-treatment were designated as responders.Veterans randomized to hydrocortisone or placebo augmentation did not differ significantly in clinical severity or glucocorticoid sensitivity at pre-treatment. Hydrocortisone augmentation was associated with greater reduction in total PTSD symptoms compared to placebo, a finding that was explained by significantly greater patient retention in the hydrocortisone augmentation condition. A significant treatment condition by responder status interaction for glucocorticoid sensitivity indicated that responders to hydrocortisone augmentation had the highest pre-treatment glucocorticoid sensitivity (lowest lysozyme IC50-DEX) that diminished over the course of treatment. There was a significant association between decline in glucocorticoid responsiveness and improvement in PTSD symptoms among hydrocortisone recipients.The results of this pilot study suggest that hydrocortisone augmentation of PE may result in greater retention in treatment and thereby promote PTSD symptom improvement. Further, the results suggest that particularly elevated glucocorticoid responsiveness at pre-treatment may identify veterans likely to respond to PE combined with an intervention that targets glucocorticoid sensitivity. Confirmation of these findings will suggest that pharmacologic interventions that target PTSD-associated glucocorticoid dysregulation may be particularly helpful in promoting a positive clinical response to PTSD psychotherapy.",0 +https://doi.org/10.1177/0004867412465125,Enhanced cortisol suppression following administration of low-dose dexamethasone in first-episode psychosis patients,"Impaired regulation of the hypothalamic-pituitary-adrenal (HPA) axis and hyper-activity of this system have been described in patients with psychosis. Conversely, some psychiatric disorders such as post-traumatic stress disorder (PTSD) are characterised by HPA hypo-activity, which could be related to prior exposure to trauma. This study examined the cortisol response to the administration of low-dose dexamethasone in first-episode psychosis (FEP) patients and its relationship to childhood trauma.The low-dose (0.25 mg) Dexamethasone Suppression Test (DST) was performed in 21 neuroleptic-naïve or minimally treated FEP patients and 20 healthy control participants. Childhood traumatic events were assessed in all participants using the Childhood Trauma Questionnaire (CTQ) and psychiatric symptoms were assessed in patients using standard rating scales.FEP patients reported significantly higher rates of childhood trauma compared to controls (p = 0.001) and exhibited lower basal (a.m.) cortisol (p = 0.04) and an increased rate of cortisol hyper-suppression following dexamethasone administration compared to controls (33% (7/21) vs 5% (1/20), respectively; p = 0.04). There were no significant group differences in mean cortisol decline or percent cortisol suppression following the 0.25 mg DST. This study shows for the first time that a subset of patients experiencing their first episode of psychosis display enhanced cortisol suppression.These findings suggest there may be distinct profiles of HPA axis dysfunction in psychosis which should be further explored.",0 +https://doi.org/10.2340/16501977-0333,Functional status after intensive care: A challenge for rehabilitation professionals to improve outcome,"To examine restrictions in daily functioning from a rehabilitation perspective in patients one year after discharge from the intensive care unit, and to identify prognostic factors for functional status.Cross-sectional design.Consecutive patients who were admitted to the intensive care unit for more than 48 h (n = 255).One year after intensive care, functional status (Sickness Impact Profile) as primary outcome, and Quality of Life (SF-36), anxiety and depression (Hospital Anxiety Depression Scale), and post-traumatic stress disorder (Impact of Events Scale) were evaluated.Fifty-four percent of the patients had restrictions in daily functioning. Walking and social activities were most frequently restricted (30-60% of the patients). Quality of life was lower than the general Dutch population. Symptoms of anxiety and depression were found in 14%, and post-traumatic stress disorder in 18%. Severity of illness at admission and length of stay in the intensive care unit were identified as prognostic factors, although they explained only 10% of functional status.The high prevalence of long-lasting restrictions in physical, social and psychological functioning among patients who stayed in the intensive care unit for at least 2 days implies that these patients are a potential target population for rehabilitation medicine. Multidisciplinary therapies need to be developed and evaluated in order to improve outcome.",0 +https://doi.org/10.1037/a0021353,The importance of the peritraumatic experience in defining traumatic stress.,"In the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev., DSM-IV-TR; American Psychiatric Association, 2000), posttraumatic stress disorder (PTSD) Criterion A2 stipulates that an individual must experience intense fear, helplessness, or horror during an event that threatened the life or physical integrity of oneself or others to be eligible for the PTSD diagnosis. In considering this criterion, we describe its origins, review studies that have examined its predictive validity, and reflect on the intended purpose of the criterion and how it complements the mission of the DSM. We then assert that the predictive validity of Criterion A2 may not be an appropriate metric for evaluating its worth. We also note that the current Criterion A2 may not fully capture all the salient aspects of the traumatic stress response. To support this claim, we review empirical research showing that individuals adapt to extreme environmental events by responding in a complex and coordinated manner. This complex response set involves an individual's appraisal regarding the degree to which the event taxes his or her resources, as well as a range of other cognitions (e.g., dissociation), felt emotions (e.g., fear), physiological reactions (e.g., heart rate increase), and behaviors (e.g., tonic immobility). We provide evidence that these response components may be associated with the subsequent development of PTSD. We then describe the challenges associated with accurately assessing an individual's traumatic stress response. We conclude with a discussion of the need to consider the individual's immediate response when defining a traumatic stressor.",0 +https://doi.org/10.1016/j.jad.2015.02.009,The coherence and correlates of intermittent explosive disorder amongst West Papuan refugees displaced to Papua New Guinea,"Questions remain about the nosological status of intermittent explosive disorder (IED) as a universal diagnosis. Cross-cultural studies are needed to establish whether IED symptoms form a coherent pattern and are distinguishable from other related symptom constellations. A study amongst a refugee population also allows further inquiry of the relationship between exposure to potentially traumatic events (PTEs) and other adversities with the IED constellation. In the present study amongst West Papuan refugees residing in Port Moresby, Papua New Guinea, we apply culturally adapted interview modules to assess symptoms of IED, post-traumatic stress disorder (PTSD), and depression, as well as the potentially traumatic events (PTEs) of conflict and ongoing adversity in the post-migration environment. Latent class analysis yielded a PTSD class (23%), a posttraumatic depressive class (14%), an IED class (12%), and a low/no symptom class (49%). Compared to the low/no-symptom class, the PTSD class had high levels of exposure to all PTE domains including childhood-related adversities, witnessing murder, human rights trauma, and traumatic losses, as well as ongoing adversity relating to displacement and separation from families, safety concerns, and lack of access to basic needs and health care. The posttraumatic depression class had greater exposure to traumatic losses and childhood-related adversities, higher levels of stress relating to material loss and deprivation, as well as to displacement and separation from families. In contrast, the IED class was distinguished only by the ongoing stress of displacement and separation from families in the homeland. Our findings provide support for the phenomenological distinctiveness of IED symptoms in this transcultural setting. Although not exclusive to IED, conditions of long-term displacement and separation appear to be a source of ongoing anger and explosive aggression amongst this population.",0 +https://doi.org/10.1016/j.biopsych.2012.08.016,Cortisol Response to Social Stress in Parentally Bereaved Youth,"Parental bereavement is associated with increased risk for psychiatric illness and functional impairment in youth. Dysregulated hypothalamic-pituitary-adrenal (HPA) axis functioning may be one pathway through which bereaved children experience increased risk for poor outcomes. However, few studies have prospectively examined the association between parental bereavement and cortisol response while accounting for psychiatric disorders in both youth and their caregivers.One-hundred and eighty-one bereaved and nonbereaved offspring and their caregivers were assessed at multiple time points over a 5-year period after parental death. Offspring participated in an adaptation of the Trier Social Stress Task (TSST), and salivary cortisol samples were collected before and after exposure to social stressors. Mixed models for repeated measures were used to analyze the effects of bereavement status, psychiatric disorder in both offspring and caregiver, and demographic indices on trajectories of cortisol response.After controlling for demographic variables and offspring depression, bereaved offspring demonstrated significantly different trajectories of cortisol response compared with nonbereaved offspring, characterized by higher total cortisol output and an absence of cortisol reactivity to acute social stress. Within the bereaved group, offspring of parents who died by sudden natural death demonstrated significant cortisol reactivity to social stress compared with offspring whose parents died by suicide, who demonstrated more blunted trajectory of cortisol response.Parentally bereaved youth demonstrate higher cortisol output than nonbereaved youth but are less able to mount an acute response in the face of social stressors.",0 +https://doi.org/10.1002/1097-4679(199103)47:2<205::aid-jclp2270470205>3.0.co;2-w,A factor analysis of the DSM-III post-traumatic stress disorder criteria,"The authors factor analyzed DSM-III-based post-traumatic stress disorder symptom ratings made on 131 Vietnam-veteran PTSD patients. Five factors--termed Intrusive Thoughts and Their Effects, Increased Arousal, Impoverished Relationships, Guilt, and Cognitive Interference--emerged. The factor structure gave more support to Laufer, Brett and Gallops' conceptualization of PTSD than to the Horowitz, DSM-III, or DSM-III-R systems. It also generated suggestions for future editions of the diagnostic manual.",0 +https://doi.org/10.1037/a0013397,A memory-based model of posttraumatic stress disorder: Evaluating basic assumptions underlying the PTSD diagnosis.,"In the mnemonic model of posttraumatic stress disorder (PTSD), the current memory of a negative event, not the event itself, determines symptoms. The model is an alternative to the current event-based etiology of PTSD represented in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000). The model accounts for important and reliable findings that are often inconsistent with the current diagnostic view and that have been neglected by theoretical accounts of the disorder, including the following observations. The diagnosis needs objective information about the trauma and peritraumatic emotions but uses retrospective memory reports that can have substantial biases. Negative events and emotions that do not satisfy the current diagnostic criteria for a trauma can be followed by symptoms that would otherwise qualify for PTSD. Predisposing factors that affect the current memory have large effects on symptoms. The inability-to-recall-an-important-aspect-of-the-trauma symptom does not correlate with other symptoms. Loss or enhancement of the trauma memory affects PTSD symptoms in predictable ways. Special mechanisms that apply only to traumatic memories are not needed, increasing parsimony and the knowledge that can be applied to understanding PTSD.",0 +https://doi.org/10.1371/journal.pone.0125761,Psychological Resilience after Hurricane Sandy: The Influence of Individual- and Community-Level Factors on Mental Health after a Large-Scale Natural Disaster,"Several individual-level factors are known to promote psychological resilience in the aftermath of disasters. Far less is known about the role of community-level factors in shaping postdisaster mental health. The purpose of this study was to explore the influence of both individual- and community-level factors on resilience after Hurricane Sandy. A representative sample of household residents (N = 418) from 293 New York City census tracts that were most heavily affected by the storm completed telephone interviews approximately 13–16 months postdisaster. Multilevel multivariable models explored the independent and interactive contributions of individual- and community-level factors to posttraumatic stress and depression symptoms. At the individual-level, having experienced or witnessed any lifetime traumatic event was significantly associated with higher depression and posttraumatic stress, whereas demographic characteristics (e.g., older age, non-Hispanic Black race) and more disaster-related stressors were significantly associated with higher posttraumatic stress only. At the community-level, living in an area with higher social capital was significantly associated with higher posttraumatic stress. Additionally, higher community economic development was associated with lower risk of depression only among participants who did not experience any disaster-related stressors. These results provide evidence that individual- and community-level resources and exposure operate in tandem to shape postdisaster resilience.",0 +,[Application of the Children's Impact of Event Scale (Chinese Version) on a rapid assessment of posttraumatic stress disorder among children from the Wenchuan earthquake area].,"To explore the reliability and validity of the Children's Impact of Event Scale (Chinese version, CRIES-13) and to determine the value and the optimal cutoff point of the score of CRIES-13 in screening posttraumatic stress disorder (PTSD), so as to provide evidence for PTSD prevention and identify children at risk in Wenchuan earthquake areas.A total of 253 children experienced the Wenchuan earthquake were tested through Stratified random cluster sampling. The authors examined CRIES-13's internal consistency, discriminative validity and predictive value of the cut-off. PTSD was assessed with the DSM-IV criteria. Area under the curve while sensitivity, specificity and Youden index were computed based on the receiver operating characteristic curve analysis. Optimal cutoff point was determined by the maximum of Youden index.20.9% of the subjects were found to have met the DSM-IV criteria for PTSD 7 months after the Wenchuan earthquake accident. The Cronbach's coefficient of CRIES-13 was 0.903 and the mean inter-item correlation coefficients ranged from 0.283 to 0.689, the correlation coefficient of the three factors with the total scale scores ranged from 0.836 to 0.868 while the correlation coefficient among the three factors ranged from 0.568 to 0.718, PTSD cases indicated much higher scores than non-PTSD cases, the Youden index reached maximum value when the total score approached 18 in CRIES-13 with sensitivity and specificity as 81.1% and 76.5% respectively. Consistency check showed that there were no significant differences between the results of CRIES-13 score >/= 32 and clinical diagnosis (Kappa = 0.529) from the screening program.CRIES-13 appeared to be a reliable and valid measure for assessing the posttraumatic stress symptoms among children after the earthquake accident in the Wenchuan area. The CRIES-13 seemed to be a useful self-rating diagnostic instrument for survivors with PTSD symptoms as a clinical concern by using a 18 cut-off in total score. Consistency check showed that there was no significant difference between the screening result of CRIES-13 score >/= 32 and clinical diagnosis.",0 +https://doi.org/10.1111/j.1460-9568.2006.05253.x,Decreased N-acetyl-aspartate levels in anterior cingulate and hippocampus in subjects with post-traumatic stress disorder: a proton magnetic resonance spectroscopy study,"The purpose of this study was to investigate the concentration of N-acetyl-aspartate (NAA) in the brain and its relationship with clinical characteristics in patients with post-traumatic stress disorder (PTSD). Proton magnetic resonance spectroscopy was performed in order to measure NAA concentrations in the anterior cingulate cortex (ACC) and bilateral hippocampus in 26 subjects with fire-related PTSD, who were survivors of a subway fire in South Korea, and 25 age- and sex-matched healthy comparison subjects. There were decreased NAA levels in the ACC (t = -3.88, d.f. = 49, P < 0.001) and bilateral hippocampus (right, t = -3.88, d.f. = 49, P < 0.001; left, t = -3.62, d.f. = 49, P < 0.001) in the PTSD group relative to the healthy comparison group. Also, NAA levels of the ACC (r = -0.43, n = 26, P = 0.027) and bilateral hippocampus (right, r = -0.48, n = 26, P = 0.013; left, r = -0.40, n = 26, P = 0.04) were negatively correlated with re-experience symptom scores in subjects with PTSD. In conclusion, our findings suggest that subjects with PTSD had decreased neuronal viabilities in the ACC and bilateral hippocampus, and that these deficits may play an important role in the pathophysiology of PTSD, especially regarding the re-experiencing of traumatic events.",0 +https://doi.org/10.3109/0167482x.2010.503330,Management of post traumatic stress disorder after childbirth: a review,"Prevalence and risk factors for the development of post traumatic stress disorder (PTSD) after childbirth is well described in the literature. However, its management and treatment has only begun to be investigated. The aim of this article is to describe the studies that examine the effects of interventions on PTSD after childbirth. MedLine, PILOTS, CINAHL and ISI Web of Science databases were systematically searched for randomised controlled trials, pilot studies and case studies using key words related to PTSD, childbirth, treatment and intervention. The reference lists of the retrieved articles were also used to supplement the search. A total of nine studies were retrieved. Seven studies that examined debriefing or counselling were identified; six randomised controlled trials and one pilot study. Also found were one case report describing the effects of cognitive behavioural therapy (CBT) on two women, and one pilot study of eye movement desensitisation and reprocessing (EMDR). Overall, there is limited evidence concerning the management of women with PTSD after childbirth. The results agree with the findings from the non-childbirth related literature: debriefing and counselling are inconclusively effective while CBT and EMDR may improve PTSD status but require investigation in controlled trials before conclusions could be drawn.",0 +https://doi.org/10.1002/da.22396,FACTORS ASSOCIATED WITH POSTTRAUMATIC STRESS DISORDER FOLLOWING MODERATE TO SEVERE TRAUMATIC BRAIN INJURY: A PROSPECTIVE STUDY,"This study prospectively examined the relationship between preinjury, injury-related, and postinjury factors and posttraumatic stress disorder (PTSD) following moderate to severe traumatic brain injury (TBI).Two hundred and three participants were recruited during inpatient admission following moderate to severe TBI. Participants completed an initial assessment soon after injury and were reassessed at 3, 6, and 12 months, 2, 3, 4, and 5 years postinjury. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-fourth edition was used to diagnose pre- and postinjury PTSD and other psychiatric disorders. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Inventory (QOLI) were used to evaluate functional and psychosocial outcome from 6 months postinjury.The frequency of PTSD ranged between 0.5 and 9.4% during the 5-year period, increasing throughout the first 12 months and declining thereafter. After controlling for other predictors, shorter posttraumatic amnesia duration (odds ratio = 0.96, 95% CI = 0.92-1.00), other concurrent psychiatric disorder (odds ratio = 14.22, 95% CI = 2.68-75.38), and lower GOSE (odds ratio = 0.38, 95% CI = 0.20-0.72) and QOLI scores (odds ratio = 0.97, 95% CI = 0.95-0.97) were associated with greater odds of having injury-related PTSD.The results of this study indicate that while shorter posttraumatic amnesia duration is associated with PTSD, greater TBI severity does not prevent PTSD from evolving. Patients with PTSD experienced high rates of psychiatric comorbidity and poorer functional and quality of life outcomes after TBI.There is a need to direct clinical attention to early identification and treatment of PTSD following TBI to improve outcomes.",0 +https://doi.org/10.1097/00005053-198808000-00008,Elevation of Urinary Norepinephrine/Cortisol Ratio in Posttraumatic Stress Disorder,"We have previously reported the unusual combination of low urinary free cortisol levels with high urinary norepinephrine excretion in posttraumatic stress disorder (PTSD) patients in comparison with four other patient groups: major depressive disorder, endogenous type; bipolar I, manic; paranoid schizophrenia; undifferentiated schizophrenia. Cortisol levels alone did not distinguish PTSD from paranoid schizophrenia patients and norepinephrine levels alone did not distinguish PTSD from bipolar I, manic, patients. In further consideration of these findings, we have found that combining the values for the two systems in a norepinephrine/cortisol (N/C) ratio provides a measure that significantly distinguishes PTSD from all the other patient groups throughout the hospitalization period. The N/C ratio was more than twice as high in the PTSD group than in all the other patient groups in the first sample following hospital admission, in the mean sample during hospitalization, and in the last sample before discharge. The mean N/C ratio for the PTSD group was 2.54, compared with a mean of .99 for the other four groups, which ranged from .81 to 1.18. The diagnostic sensitivity was 78% and the specificity was 94% for correct classification of PTSD in our sample. These preliminary findings yield further encouragement for exploring multivariate strategies, using hormonal ratios or profiles, in an effort to increase the diagnostic sensitivity of neuroendocrine criteria in the assessment of psychiatric patients.",0 +https://doi.org/10.1097/01.mrr.0000088443.78481.c4,Psychosocial adaptation to spinal cord injury as a function of time since injury,"The literature on the relationship between time since injury (TSI) and the clinical unfolding of psychosocial adaptation to disability has yielded mixed results. In this exploratory study we have attempted to compare two groups of people who sustained spinal cord injury (SCI)--namely, short-term TSI versus long-term TSI--on the patterns of psychosocial reactions to their medical condition. Using the initial pool of participants (n=317), two ""extreme'"" TSI groups were created (short-term TSI, composed of people whose injuries occurred within the last 4 years, and long-term TSI, comprising people whose injuries occurred 20 or more years ago). A two-group discriminant function analysis (DFA) applied to the eight subscales of the Reactions to Impairment and Disability Inventory (RIDI) yielded a significant function that was most closely associated with reactions of denial, shock and generalized anger, suggesting a non-acceptance of the condition among the more recently injured. Further analyses were then separately applied to the two groups of civilians and veterans with SCI. The resultant DFAs yielded functions suggesting somewhat different group patterns from the original one. Results are discussed within the context of the literature drawn from the fields of post-traumatic stress disorder (PTSD) and related traumatic experiences.",0 +https://doi.org/10.1016/j.annepidem.2011.11.003,"Potentially Modifiable Pre-, Peri-, and Postdeployment Characteristics Associated With Deployment-Related Posttraumatic Stress Disorder Among Ohio Army National Guard Soldiers","To evaluate potentially modifiable deployment characteristics-- predeployment preparedness, unit support during deployment, and postdeployment support-that may be associated with deployment-related posttraumatic stress disorder (PTSD).We recruited a sample of 2616 Ohio Army National Guard (OHARNG) soldiers and conducted structured interviews to assess traumatic event exposure and PTSD related to the soldiers' most recent deployment, consistent with DSM-IV criteria. We assessed preparedness, unit support, and postdeployment support by using multimeasure scales adapted from the Deployment Risk and Resilience Survey.The prevalence of deployment-related PTSD was 9.6%. In adjusted logistic models, high levels of all three deployment characteristics (compared with low) were independently associated with lower odds of PTSD. When we evaluated the influence of combinations of deployment characteristics on the development of PTSD, we found that postdeployment support was an essential factor in the prevention of PTSD.Results show that factors throughout the life course of deployment-in particular, postdeployment support-may influence the development of PTSD. These results suggest that the development of suitable postdeployment support opportunities may be centrally important in mitigating the psychological consequences of war.",0 +https://doi.org/10.1016/j.chiabu.2014.03.001,Mental health correlates of victimization classes among homeless youth,"Literature reports high rates of street victimization among homeless youth and recognizes psychiatric symptoms associated with such victimization. Few studies have investigated the existence of victimization classes that differ in type and frequency of victimization and how youth in such classes differ in psychiatric profiles. We used latent class analysis (LCA) to examine whether classes of homeless youth, based on both type and frequency of victimization experiences, differ in rates of meeting diagnostic criteria for major depressive episodes and posttraumatic stress disorder (PTSD) in a sample of homeless youth (N=601) from three regions of the United States. Results suggest youth who experience high levels of direct and indirect victimization (high-victimization class) share similarly high rates of depressive episodes and PTSD as youth who experience primarily indirect victimization only (witness class). Rates of meeting criteria for depressive episodes and PTSD were nearly two and three times greater, respectively, among the high victimization and witness classes compared to youth who never or rarely experienced victimization. Findings suggest the need for screening and intervention for homeless youth who report direct and indirect victimization and youth who report indirect victimization only, while prevention efforts may be more relevant for youth who report limited victimization experience.",0 +https://doi.org/10.1080/15299732.2013.844218,Dissociative Depression Among Women with Fibromyalgia or Rheumatoid Arthritis,"The aim of this study was to inquire about the possible relations of childhood trauma, anger, and dissociation to depression among women with fibromyalgia or rheumatoid arthritis. Fifty female patients diagnosed as having fibromyalgia (n = 30) or rheumatoid arthritis (n = 20) participated in the study. The Childhood Trauma Questionnaire, Somatoform Dissociation Questionnaire (SDQ), Dissociation Questionnaire (DIS-Q), Beck Depression Inventory (BDI), Spielberger State-Trait Anger Expression Inventory, and Dissociative Disorders Interview Schedule were administered to all participants. Women with a lifetime diagnosis of depressive disorder had higher scores for somatoform and psychoform dissociation than the nondepressive patients. However, childhood trauma scores did not differ between the 2 groups. In regression analysis, current severity of depression (BDI) was predicted by psychoform dissociation (DIS-Q) and lower education, and lifetime diagnosis of major depression was predicted by somatoform dissociation (SDQ). Whereas childhood emotional neglect predicted somatoform dissociation, psychoform dissociation was predicted by childhood sexual abuse. Mental processing of anger seems to be 1 of the dimensions of psychodynamics in trauma-related depressive conditions. In the context of the perceived threat of loss of control due to expressed anger and mental disintegration, somatoform dissociation seems to contribute to overmodulation of emotions in dissociative depression. Among patients suffering from physical illness with possible psychosomatic dimensions, assessment of somatoform dissociation in addition to psychoform dissociation may be helpful to understand diverse psychopathological trajectories emerging in the aftermath of childhood adversities. The recently proposed category of ""dissociative depression"" (Sar, 2011) seems to be a promising concept for future research on psychosomatic aspects of traumatic stress.",0 +,"Trauma and women: course, predictors, and treatment.","Posttraumatic stress disorder (PTSD) resulting from aggravated assault, rape, or noncrime trauma affects over 4 million women in the United States, according to retrospective studies. Prospective studies reviewed here found that 3 months post assault the prevalence of PTSD was 48% in rape victims and 25% in nonsexual crime victims. Prolonged exposure treatment and stress inoculation training are both effective psychotherapeutic treatments for PTSD. Prolonged exposure involves having the patient relive the traumatic memory and recount the event in detail. This description is audiotaped and the patient is asked to listen to it as part of assigned homework. In vivo exposure to feared objects or situations is also assigned as homework. Stress inoculation training consists of teaching patients a variety of techniques for managing anxiety, including controlled breathing, deep muscle relaxation, thought-stopping, cognitive restructuring, preparation for stressors, covert modeling, and role-play. Both treatments have been proven to be effective alone and in combination in ameliorating chronic PTSD in women after traumatic sexual or nonsexual assault. This efficacy was maintained for 3 months of follow-up.",0 +https://doi.org/10.1016/j.janxdis.2009.02.003,"The structure of acute posttraumatic stress symptoms: ‘Reexperiencing’, ‘Active avoidance’, ‘Dysphoria’, and ‘Hyperarousal’","Empirical data have challenged chronic posttraumatic stress disorder (PTSD) consisting of three dimensions. In the present study we aimed to determine the factor structure of acute posttraumatic symptoms in two recently traumatized samples. In sample 1, 203 civilian trauma survivors were administered the Davidson Trauma Scale (DTS) approximately 1 week posttrauma. In sample 2, 182 civilian treatment seeking trauma survivors completed the DTS at an average of 41.4 days posttrauma. Our confirmatory factor analyses indicated that a 4-factor intercorrelated model provided the best representation of the data in both samples. The four factors are best described as reexperiencing, active avoidance, dysphoria , and hyperarousal. For acute posttraumatic symptoms, the empirical data suggest to split the avoidance cluster into ‘Active avoidance’ and ‘Dysphoria’—confirming findings in studies on chronic PTSD. In future revisions of the DSM, the diagnostic criteria for PTSD may need to be adapted to fit the research findings.",0 +https://doi.org/10.1016/j.comppsych.2015.09.010,"Reactions of Oklahoma City bombing survivors to media coverage of the September 11, 2001, attacks","This study explored the effects of media coverage of a terrorist incident in individuals remote from the location of a major attack who had directly experienced a prior terrorist incident.Directly-exposed survivors of the 1995 Oklahoma City bombing, initially studied six months after the incident, and indirectly-affected Oklahoma City community residents were assessed two to seven months after the September 11, 2001, attacks. Survivors were assessed for a diagnosis of bombing-related posttraumatic stress disorder (PTSD) at index and follow up, and emotional reactions and September 11 media behavior were assessed in all participants.Among the three investigated forms of media (television, radio, and newspaper), only television viewing was associated with 9/11-related posttraumatic stress reactions. Exposure to the Oklahoma City bombing was associated with greater arousal in relation to the September 11 attacks, and among survivors, having developed bombing-related PTSD was associated with higher scores on all three September 11 posttraumatic stress response clusters (intrusion, avoidance, and arousal). Although time spent watching television coverage of the September 11 attacks and fear-related discontinuation of media contact were not associated with Oklahoma City bombing exposure, discontinuing September 11 media contact due to fear was associated with avoidance/numbing in the full sample and in the analysis restricted to the bombing survivors.Surviving a prior terrorist incident and developing PTSD in relation to that incident may predispose individuals to adverse reactions to media coverage of a future terrorist attack.",0 +https://doi.org/10.1016/j.cpem.2014.09.002,Code Triage: Integrating the National Children's Disaster Mental Health Concept of Operations Across Health Care Systems,"This article describes the National Children's Disaster Mental Health Concept of Operations (“CONOPS”) model as a method to address discrepancies between research advances that have been made and the typical methods of providing mental health services to children after disasters. Three key CONOPS strategies are described: (1) the PsySTART Disaster Mental Health Triage System, (2) a child-focused Incident Action Plan (IAP), and (3) a continuum of risk stepped-care model that matches the level of evidence-based treatment interventions with the level of identified risk using a stepped-care framework. Together, these strategies provide an integrated “disaster systems of care” method for the needs of children. With the goal to strengthen the resilience of children, the CONOPS provides clear operational strategies to facilitate mental health care addressing the full continuum of risk and resilience in the child population. Adapting this tool to health care systems i s a vital step to improving mental health services and resilience outcomes for children after a disaster.",0 +https://doi.org/10.3402/ejpt.v2i0.6018,"Attachment typologies and posttraumatic stress disorder (PTSD), depression and anxiety: a latent profile analysis approach","Bartholomew (1990) proposed a four category adult attachment model based on Bowlby's (1973) proposal that attachment is underpinned by an individual's view of the self and others. Previous cluster analytic techniques have identified four and two attachment styles based on the Revised Adult Attachment Scale (RAAS). In addition, attachment styles have been proposed to meditate the association between stressful life events and subsequent psychiatric status.The current study aimed to empirically test the attachment typology proposed by Collins and Read (1990). Specifically, LPA was used to determine if the proposed four styles can be derived from scores on the dimensions of closeness/dependency and anxiety. In addition, we aimed to test if the resultant attachment styles predicted the severity of psychopathology in response to a whiplash trauma.A large sample of Danish trauma victims (N=1577) participated. A Latent Profile Analysis was conducted, using Mplus 5.1, on scores from the RAAS scale to ascertain if there were underlying homogeneous attachment classes/subgroups. Class membership was used in a series of one-way ANOVA tests to determine if classes were significantly different in terms of mean scores on measures of psychopathology.The three class solution was considered optimal. Class one was termed Fearful (18.6%), Class two Preoccupied (34.5%), and Class three Secure (46.9%). The secure class evidenced significantly lower mean scores on PTSD, depression, and anxiety measures compared to other classes, whereas the fearful class evidenced significantly higher mean scores compared to other classes.The results demonstrated evidence of three discrete classes of attachment styles, which were labelled secure, preoccupied, and fearful. This is in contrast to previous cluster analytic techniques which have identified four and two attachment styles based on the RAAS.In addition, Securely attached individuals display lower levels of psychopathology post whiplash trauma.",0 +https://doi.org/10.1002/eat.20324,Is multi-impulsive bulimia a distinct type of bulimia nervosa: Psychopathology and EMA findings,"To determine if clinically defined multi-impulsive bulimia (MIB) can be validated using an empirical classification approach.One hundred and twenty-five women who met DSM-IV criteria for bulimia nervosa were interviewed and completed a two-week EMA protocol. Participants who reported at least three highly impulsive behaviors were compared to participants who did not report such impulsive behavior. Also, Latent Class Analysis (LCA) was conducted to determine if the MIB classification could be replicated empirically.LCA produced a two-class solution consistent with the traditional clinical approach to MIB classification. In both approaches, MIB was associated with higher levels of anxiety disorders, child abuse, and daily self-damaging behaviors than the non-MIB class.Clinical classification of MIB was empirically supported through LCA. Although the classes failed to differ in bulimic behavior, MIB appears to represent a group of bulimic individuals with significant trauma histories and associated psychopathology.",0 +,POSTTRAUMATIC STRESS DISORDER SYMPTOMS AND THEIR COMORBIDITY WITH OTHER DISORDERS IN ELEVEN TO SIXTEEN YEARS OLD ADOLESCENTS IN THE CITY OF BAM,"Objectives: The aim of this study was to assess the symptoms of Posttraumatic Stress Disorder (PTSD) and the comorbidity of depression, anxiety, anger and dissociation with PTSD based on gender difference between two groups of earthquake-stricken boys and girls in the city of Bam and comparing it with normal adolescents in Tehran. Method: One thousand 11-16 year old students (300 boys and 700 girls) in the city of Bam selected using multi-step cluster sampling in two educational levels as the experimental group, and 3042 eleven to sixteen year old students from Tehran as the control group were examined. Data were gathered using Syndrome Checklist for Children (form A) and Interview form of Post Trauma Stress Scale (interview form). Data were then analyzed using correlation, independent t, chi-square (2), and Kruskal Wallis. Results: Adolescents who had experienced the traumatic events showed higher levels of depression, anxiety, posttraumatic stress, anger and dissociation in comparison with normal adolescents (p < 0.01). In the group with PTSD, frequency of all PTSD symptoms except anger symptoms was higher in girls than in boys. However, the frequency of pathological syndromes (T > 65) was more evident in boys than in girls, but was non-significant. The prevalence of PTSD in the experimental group was 20%. Conclusion: There is a high comorbidity between symptoms of PTSD and other symptoms, which leads to a higher report of PTSD prevalence. Even though psychological vulnerability was higher in boys than in girls, it seems that gender role expectance in the expression of emotions and the method of describing the symptoms play a role in this issue. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0 +,[Intensification of post-traumatic stress disorder of Siberian deportees from the North-East region of Poland].,"AIM Presentation of Post-Traumatic Stress Disorder based on the approach of various authors concentrating, upon the concept of the American classification: DSM III (1980) and DSM IV (1994). We acknowledged the necessity of displaying empirical results of intensification of PTSD among the population in the region of North-East part of Poland. METHOD In our analysis, we stressed the importance of the distant in time, psychological consequences of dwelling in extremely difficult living conditions that often threatened the life of those who had been deported to Siberia between 1939 and 1956. 40 Siberian deportees (20 men and 20 women) were examined. The method of PTSD-Interview (PTSD-I) was used here in order to obtain, in each individual case, the indicatory number indispensable for the statistical analysis. RESULTS AND CONCLUSION An average result of PTSD intensification in the case of women reaches a very level and in the case of men it is even higher. The disparity between the average results of women and of men are statistically significant (p<0.05). This research has confirmed the assumptions that suffering from trauma in the early stage of development (within the age range of 8-15) leaves a permanent mark in the human psyche. Statistical analysis revealed a high level of intensification of PTSD among the population of the Siberian deportees from the North-East region of Poland.",0 +https://doi.org/10.1521/pedi.1999.13.3.199,Commonality and Specificity of Personality Disorder Profiles in Subjects with Trauma Histories,"Recently, attention has been drawn to a range of disturbances in personality functioning that commonly characterize individuals with a history of severe or prolonged trauma. Many of these features overlap with criteria for some of the Axis II personality disorders. The current study investigated the similarity of personality disorder features in different samples of patients with trauma histories, and specificity of such features compared to other psychiatric samples. Profiles of Axis II features, based on relative frequencies of individual disorder “diagnoses” derived from a common measure (Personality Diagnostic Questionnaire-Revised), were compared in three trauma samples: male Vietnam combat veterans with PTSD, female inpatients with a history of childhood sexual abuse, and female outpatients with a history of childhood sexual abuse. The PDQ-R derived profiles in each of the three trauma samples were then compared with similar PDQ-R derived profiles in published reports of psychiatric samples selected for other diagnoses. Each of the three Spearman rank correlations among the three trauma samples were significant, ranging from .72 to .94. There was a clear pattern of higher correlations within the trauma samples (average correlation of .81) than between the trauma and nontrauma samples (average correlations of. 11, .36, and .25 between the nontrauma samples and the combat sample, inpatient sexual abuse sample, and outpatient sexual abuse sample, respectively). The findings suggest that a pattern of personality disorder features may be distinctly associated with individuals with trauma histories, at least of the type examined here. Future studies using more clinically valid measures of personality features and including other types of trauma samples are needed to determine the generalizability of the current findings.",0 +https://doi.org/10.1037/e517322011-174,Psychosocial Effects of War Experiences Among Displaced Children in Southern Darfur,"This study focused on assessing the psychosocial effects of the long standing, high intensity, and guerrilla-style of warfare among displaced children in Southern Darfur. The goal was to better understand the etiology, prognosis, and treatment implications for traumatic reactions, depression, and grief symptoms in this population. Three hundred thirty-one children aged 6-17 from three IDP Camps were selected using a quota sampling approach and were administered a Demographic Questionnaire, Child Post Traumatic Stress Reaction Index, Child Depression Inventory, and the Expanded Grief Inventory. Forty-three percent were girls and 57% were boys. The mean age of the children was 12 years. Results found that children were exposed to a very large Dumber of war experiences with no significant differences between genders for types of exposure, including rape, but with older children (13-17 years) facing a larger number of exposures than younger children (6-12 years). Out of the 16 possible war experiences, the mean number was 8.94 (SD = 3.27). Seventy-five percent of the children met the DSM-IV criteria for PTSD, and 38% exhibited clinical symptoms of depression. The percentage of children endorsing significant levels of grief symptoms was 20%. Increased exposure to war experiences led to higher levels of: 1) traumatic reactions; 2) depression; and 3) grief symptoms. Of the 16 war experiences, abduction, hiding to protect oneself, being raped, and being forced to kill or hurt family members were most predictive of traumatic reactions. Being raped, seeing others raped, the death of a parent/s, being forced to fight, and having to hide to protect oneself were the strongest predictors of depressive symptoms. War experiences such as abduction, death of one's parent/s, being forced to fight, and having to hide to protect oneself were the most associated with the child's experience of grief. In addition to Total Grief, Traumatic Grief, Existential Grief, and Continuing Bonds were measured in these children, Although trauma, depression, and grief often exist as co-morbid disorders, the mechanisms and pathways of these is less understood. In this study we used Structural Equation Modeling to better understand the complex interaction and trajectories of these three symptoms evolving from war exposure and loss. This study is the first of its kind to assess the psychosocial effects of war experiences among children currently living in war zone areas within Sudan. It identifies some of the most prevalent war-related atrocities and their varying impact on the children's psychological well-being and overall adjustment. Implications for planning mental health interventions are discussed. (",0 +https://doi.org/10.1016/j.psyneuen.2011.07.004,Neuroendocrine response to CRF stimulation in veterans with and without PTSD in consideration of war zone era,"Alterations in hypothalamic–pituitary–adrenal (HPA) axis activity have been observed in Gulf War veterans with posttraumatic stress disorder (PTSD) which differ from those observed in other veteran groups, raising the possibility that there is a unique neuroendocrine profile in this group of veterans. This study seeks to further characterize the effects of PTSD, military cohort (Vietnam, 1991 Gulf War, Operations Enduring Freedom/Iraqi Freedom (OEF/OIF)), and their interaction on the neuroendocrine response to synthetic corticotrophin-releasing factor (CRF) stimulation. 51 male veterans were studied consisting of 21 from the Vietnam era, 16 from the Gulf War era, and 14 from the OEF/OIF era. 16 of these veterans were deployed to a war zone and had chronic PTSD (PTSD+), 25 were deployed to a war zone and did not have chronic PTSD (PTSD−), and 10 were not deployed to a war zone and did not have PTSD (non-exposed). The participants underwent the CRF stimulation test in the afternoon (approximately 2:00 p.m.), which measures the integrity and sensitivity of the pituitary–adrenal axis. Plasma cortisol and adrenocorticotropic hormone (ACTH) were measured at baseline and at intervals over a 2 h period following intravenous administration of 1 μg/kg of ovine CRF (o-CRF, max 100 μg). In a small subset of participants, dehydroepiandrosterone (DHEA) and cortisol binding globulin (CBG) were also assessed. There was a significant group by era interaction in the response of ACTH to CRF, in addition to a main effect of group (PTSD+, PTSD−, non-exposed). The interaction reflected that group differences were only evident in the Gulf War cohort; among Gulf War era veterans, the PTSD+ group had higher elevations in ACTH levels following CRF than the PTSD− group and the non-exposed group. Additionally, the peak change in ACTH was associated with a self-reported environmental exposure (pyridostigmine bromide ingestion) which has been found to be linked to the excess morbidity found in Gulf War veterans. Self-reported childhood trauma was greater in veterans of the Gulf War than Vietnam or OEF/OIF, but did not account for the observed differences. There was a significant effect of group on the cortisol response to CRF, reflecting greater responsivity in both of the deployed groups (PTSD+ and PTSD−) compared to the non-exposed group which could be accounted for by baseline differences in cortisol levels; unlike the ACTH response, the cortisol response did not differ by era. There were no effects of group, era, or their interaction on the DHEA and CBG response to CRF. A uniform pattern of PTSD-related alterations in the response to intravenous CRF was not found. Rather, PTSD-related alterations were found only in veterans of the 1991 Gulf War, and were characterized by an enhanced pituitary response to CRF which may reflect increased sensitivity of pituitary corticotrophs or CRF hyposecretion. Together with previous neuroendocrine findings, the data suggest the HPA axis is dysregulated in Gulf War veterans in unique ways which may reflect the long-term effects of environmental exposures in addition to disease effects. Further work is needed to characterize these effects and their impact on long-term psychological and medical outcomes.",0 +https://doi.org/10.1186/s12889-015-1739-9,The perceptions and experiences of people injured in motor vehicle crashes in a compensation scheme setting: a qualitative study,"The evidence that compensation related factors are associated with poor recovery is substantial but these measures are generic and do not consider the complexity of scheme design. The objectives of this study were to understand people's perceptions and experiences of the claims process after sustaining a compensable injury in a motor vehicle crash (including why people seek legal representation); and to explore ways to assist people following a compensable injury and improve their experience with the claims process.A qualitative study in a Compulsory Third Party (CTP) personal injury scheme covering the state of New South Wales (NSW), Australia. A series of five focus groups, with a total of 32 participants who had sustained mild to moderate injuries in a motor vehicle crash, were conducted from May to June 2011 with four to eight attendees in each group. These were audio-recorded and transcribed. The methodology was based on a grounded theory approach using thematic analysis and constant comparison to generate coding categories for themes. Data saturation was reached. Analyst triangulation was used to ensure credibility of the results.Five primary themes were identified: complexity of the claims process; requirement of legal representation; injury recovery expectations; importance of timely healthcare decision making; and improvements for injury recovery. Some participants struggled, finding the claims process stressful and subsequently sought legal advice; whilst others reported a straight forward recovery, helpful insurer interactions and no legal representation. Most participants were influenced by injury recovery expectations, and timely healthcare decision making. To assist with injury recovery, access to objective information about the claims process using online technology and social media was considered paramount.Participants had contrasting injury recovery experiences and their perceptions of the claims process differed and were influenced by injury recovery expectations, and timeliness of healthcare decision making. Improvements to the claims process are required, including: simplification or streamlining (possibly using online technology and/or social media to reduce paperwork); and providing access to objective information. There is a need to trial early interventions and new claims management policies that could improve injury recovery and satisfaction with the claims process.",0 +https://doi.org/10.1017/s1352465800015861,"Coping and Personality as Predictors of Post-Traumatic Intrusions, Numbing, Avoidance and General Distress: A Study of Victims of the Perth Flood","Trauma symptoms, coping and personality were assessed in 44 victims of the Perth flood. The sample was characterized by high levels of intrusions, numbness, arousal and general emotional distress. General levels of symptomatology were predicted by two coping strategies: emotion-focused coping and thought suppression. Overall trauma symptoms and emotion-focused coping were associated with the personality trait of neuroticism. These data are consistent with the Wells and Matthews (1994a) model of affective disorders and stress. The model proposes that certain types of emotion-focused coping tend to lead to greater access to negative self-beliefs, and that thought suppression tends to prime subsequent intruding thoughts. A second personality trait, private self-consciousness, was associated with relatively greater levels of numbing symptoms, and relatively lower levels of arousal symptoms. This patterning of symptoms may result from use of ruminative coping strategies. Hence, intrusions of trauma-related material are not simply a function of automatic activation of a fear network, but are also influenced by the person's voluntary efforts to deal with the aftermath of the event.",0 +https://doi.org/10.1521/psyc.67.2.164.35963,Can We Influence the Trajectory of Psychological Consequences to Terrorism?,"This article makes two significant contributions to the field of disaster and emergency mental health. First, it contributes to the existing knowledge regarding response to, and recovery from, events involving large-scale trauma. It does so by confirming previous findings as well as adding new information. Second, the findings of the study raise both puzzling and intriguing challenges to the profession and the country as we struggle to expand our knowledge and come to grips with the “new normal” faced by the United States. In a field where research is not nearly as extensive and complete as it needs to be and where we are far too dependent on extrapolation from other types of traumatic events, any and all research directly on disasters and terrorism is welcome. Longitudinal studies, even with rather short periods between samples, are especially needed. This study contributes by replication earlier findings regarding such factors as exposure, the impact of status factors such as gender, and the importance of social support. Other findings are tantalizing in both what they tell us and what they do not. We learn for example that a significant number of people turn to alcohol, medications, or drugs to feel better. What we cannot know from the study is the extent to which this coping strategy is nonproblematic use or abuse. To what extent is the drug use licit or illicit? These distinctions are important not only from a scientific and intervention perspective but also from a public policy, program development, and funding perspective. The study also demonstrates a significant gap in the existing models of understanding and intervening with the largest of catastrophic events. The science, practice, and appreciation for the importance of emergency and disaster mental health response has, and continues, to grow. However, most of our models are based on events that are far more limited in scope than the psychosocial sequelae that this study tells us attend the events of September 11, 2001. We have models for natural disaster. We have models for smaller-scale violent events. We do not have models for understanding and providing response and recovery from national disasters. This study documents the national nature of fear, distress, and changed behavior brought on by these types of events. While we may Psychiatry 67(2) Summer 2004 164",0 +https://doi.org/10.5334/pb-50-1-2-49,"Anxious and Depressive Avoidance and Symptoms of Prolonged Grief, Depression, and Post-Traumatic Stress Disorder","Following loss, people can develop symptoms of depression, Post-Traumatic Stress Disorder (PTSD), or Complicated Grief (CG) – also termed Prolonged Grief Disorder (PGD). A recent cognitive-behavioural model has proposed that avoiding confrontation with the reality of the loss (called “anxious avoidance” [AA]) and refraining from activities that could foster adjustment (called “depressive avoidance” [DA]) both play a critical role in CG/PGD. The present study examined this assumption, using self-reported data from 161 mourners. Findings showed that items constituting AA and DA represented two distinct factors. Both factors were strongly correlated with other measures of bereavement-related avoidance and both accounted for a unique part of the explained variance in CG/PGD severity, beyond relevant background variables, negative cognitions, and concomitant symptom-levels of depression and PTSD. DA also explained unique variance in depression beyond these variables. Moreover, AA and DA mediated the linkages of neuroticism, attachment anxiety, and attachment avoidance with symptom-levels of CG/PGD.",0 +https://doi.org/10.1017/s2045796013000206,Linking abuse and recovery through advocacy: an observational study,"Aims. High numbers of psychiatric service users experience domestic violence, yet limited interventions exist for these victims. We piloted a domestic violence intervention for community mental health services to explore the feasibility of a future cluster randomized controlled trial. Methods. Quasi-experimental controlled design within five Community Mental Health Teams (three intervention and two control teams). The intervention comprised domestic violence training for clinicians' and referral to domestic violence advocacy for service users. Clinicians' ( n = 29) domestic violence knowledge, attitudes and behaviours were assessed before and 6 months post-training. Service users' ( n = 34) safety behaviours, unmet needs, quality of life and frequency/severity of abuse were examined at baseline and 3 months follow-up. Process evaluation data were also collected. Results. Clinicians receiving the intervention reported significant improvements in domestic violence knowledge, attitudes and behaviours at follow-up ( p < 0.05). Service users receiving the intervention reported significant reductions in violence ( p < 0.001) and unmet needs at follow-up ( p < 0.05). Conclusions. Interventions comprising domestic violence training for clinicians and referral to domestic violence advocacy may improve responses of psychiatric services. Low rates of identification among teams not receiving training suggest that future trials using service user outcomes are unlikely to be feasible. Therefore, other methods of evaluation are needed.",0 +https://doi.org/10.3109/10408444.2015.1038499,Pharmaceuticals and personal care products: A critical review of the impacts on fish reproduction,"Research in environmental toxicology involving pharmaceuticals and personal care products (PPCPs) has increased greatly over the last 10-15 years. Much research has been focused on the endocrine-disrupting potential of PPCPs, as they relate to negative population impacts of aquatic organisms. This review assesses the current data on the reported effects of PPCPs on fish reproduction with an emphasis on fecundity, a predictor of population effects. Studies of both individual PPCPs and PPCP mixtures are presented. As the majority of individual PPCP studies reviewed demonstrate negative effects on fish fecundity, we relate these findings to detected surface water concentrations of these compounds. Very few studies involving PPCP mixtures have been conducted; however, the need for these types of studies is warranted as fish are most likely exposed to mixtures of PPCPs in the wild. In addition, laboratory and field assessments of wastewater treatment plant (WWTP) effluents, a major source of PPCPs, are reviewed. Much of the data provided from these assessments are variable and do not generally demonstrate negative impacts on reproduction, or the studies are unable to directly associate observed effects with WWTP effluents. Finally, future research considerations are outlined to provide an avenue into understanding how wild populations of fish are affected by PPCPs. These considerations are aimed at determining the adaptation potential of fish exposed to mixtures of PPCPs over multiple generations. As global use of PPCPs continually rises, the need to discern the effects of chronic exposure to PPCPs is greatly increased.",0 +https://doi.org/10.1177/1363461509105819,Problemas de Nervos: A Multivocal Symbol of Distress for Portuguese Immigrants,"This article outlines research on a previous unstudied form of suffering specific to the Portugese immigrant community: problemas de nervos. Thirty-two Portuguese immigrant women (in Waterloo, ON and Boston, MA) were interviewed and each completed a questionnaire. Cluster analysis demonstrated that problemas de nervos has many meanings. The study profiled symptoms, causes and therapies associated with four variations of this culture-specific form of distress: “ mal da cabeca” meaning problems with/in the head (e.g., lack of control, visions); “ aflição” meaning affliction (e.g., nervous attacks, heart problems); immigration stress (causing sleep disturbances); and, conflicts with others (resulting in pressure within the body). None of the symptom clusters reported matched criteria for a DSM-IV-TR diagnosis, suggesting that problemas de nervos represents an idiomatic rather than universal expression of distress.",0 +https://doi.org/10.1097/00004714-200204000-00013,Double-Blind Placebo-Controlled Pilot Study of Sertraline in Military Veterans With Posttraumatic Stress Disorder,"The efficacy of sertraline in the treatment of civilian posttraumatic stress disorder (PTSD) has been established by two large placebo-controlled trials. The purpose of the current pilot study was to obtain preliminary evidence of the efficacy of sertraline in military veterans suffering from PTSD. Outpatient Israeli military veterans with a DSM-III-R diagnosis of PTSD were randomized to 10 weeks of double-blind treatment with sertraline (50-200 mg/day; N = 23, 83% male, mean age = 41 years) or placebo (N = 19, 95% male, mean age = 38 years). Efficacy was evaluated by the Clinician-Administered PTSD Scale (CAPS-2) and by Clinical Global Impression Scale-Severity (CGI-S) and -Improvement (CGI-I) ratings. Consensus responder criteria consisted of a 30% or greater reduction in the CAPS-2 total severity score and a CGI-I rating of ""much"" or ""very much"" improved. The baseline CAPS-2 total severity score was 94.3 +/- 12.9 for sertraline patients, which is notably higher than that reported for most studies of civilian PTSD. On an intent-to-treat endpoint analysis, sertraline showed a numeric but not statistically significant advantage compared with placebo on the CAPS-2 total severity and symptom cluster scores. In the study completer analysis, the mean CGI-I score was 2.4 +/- 0.3 for sertraline and 3.4 +/- 0.3 for placebo (t = 2.55, df = 30, p = 0.016), CGI-I responder rates were 53% for sertraline and 20% for placebo (chi2 = 3.62, df = 1, p = 0.057), and combined CGI-I and CAPS-2 responder rates (>or=30% reduction in baseline CAPS-2 score) were 41% for sertraline and 20% for placebo (chi2 = 1.39, df = 1, p = 0.238). Sertraline treatment was well tolerated, with a 13% discontinuation rate as a result of adverse events. This pilot study suggests that sertraline may be an effective treatment in patients with predominantly combat-induced PTSD, although the effect size seems to be somewhat smaller than what has been reported in civilian PTSD studies. Adequately powered studies are needed to confirm these results and to assess whether continued treatment maintains or further improves response.",0 +https://doi.org/10.1038/sj.mp.4002109,WFS1 gene as a putative biomarker for development of post-traumatic syndrome in an animal model,"Post-traumatic stress disorder (PTSD) is an anxiety disorder that may develop after the experiencing or witnessing of a life-threatening event. PTSD is defined by the coexistence of three clusters of symptoms: re-experiencing, avoidance and hyperarousal, which persist for at least 1 month in survivors of the event (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition). Using an established model of PTSD, we addressed the well-accepted clinical finding that only a minority (about 20%) of the individuals exposed to a traumatic event develop PTSD. Moreover, we followed individual rat behavior for up to a month, and then treated the PTSD-like animals with citalopram. Our data demonstrate high face (20% of rats exposed to a reminder of the stressor develop symptoms characteristic of PTSD) and predictive (response to citalopram) validities. Based on these validities we identified alterations in the Wolframin gene in the CA1 and amygdala regions, specifically in exposed PTSD-like rats, which were normalized after treatment with citalopram. We suggest the Wolframin gene as a putative biomarker for PTSD. Since Wolframin gene undergoes alternative splicing and has polymorphism in the population, it may serve a future marker for identification of the vulnerable population exposed to a traumatic event. © 2009 Nature Publishing Group All rights reserved.",0 +https://doi.org/10.1521/pedi.2012.26.3.368,Gender Differences in a Clinical Sample of Patients with Borderline Personality Disorder,"The aim of the study was to investigate gender differences and similarities in patients with borderline personality disorder (BPD) with respect to Axis I comorbidity, Axis II comorbidity, general psychopathology (Symptom Checklist 90-Revised), and dimensional personality traits (NEO-Personality-Inventory Revised [NEO-PI-R] and the Dimensional Assessment of Personality Profile Basic questionnaire [DAPP-BQ]). Fifty-seven men and 114 women with BPD were included in the study. Regarding Axis I and II disorders in an exploratory analysis, men with BPD more often fulfilled the diagnostic criteria for binge eating disorder, antisocial personality disorder, narcissistic personality disorder, and conduct disorder in childhood, whereas women had higher frequencies of bulimia nervosa, posttraumatic stress disorder, and panic disorder with agoraphobia. After correcting for multiple tests, only the gender differences in narcissistic and antisocial personality disorder remained significant. In the SCL-90-R profile, no significant gender differences could be identified. In the exploratory analysis of the dimensional personality traits, women showed higher rates on the NEO-PI-R main factors (Neuroticism and Agreeableness) compared to men. In the DAPP-BQ profile, men reached higher sores on the main factor, Dissocial Behavior. When correcting for multiple tests, gender differences still existed for Neuroticism and Dissocial Behavior. Our results argue for gender differences in Axis I and II comorbidity and dimensional personality traits in BPD. However, in general, more similarities than differences were shown in this study.",0 +https://doi.org/10.1097/01.nmd.0000146911.52616.22,"The Course of PTSD, Major Depression, Substance Abuse, and Somatization After a Natural Disaster","Flood research has used a variety of methods, yielding inconsistent findings. Universal definitions of illness are paramount to the science of psychiatric epidemiology of disasters. St. Louis area survivors (N = 162) of the Great Midwestern Floods of 1993 received a structured diagnostic assessment at 4 and 16 months postdisaster, with 88% follow-up. The purpose of the assessment was to examine predisaster and postdisaster rates of disorders and symptoms. Flood-related posttraumatic stress disorder was diagnosed in 22% and 16% at index and follow-up, respectively. Comorbidity with major depression determined whether the posttraumatic stress disorder would have remitted by 1 year later. Nearly one half of the men in the sample had a pre-existing alcohol use disorder. Virtually no new substance abuse followed the floods, and hence, substance abuse did not develop in response to the disaster or as part of coping with its aftermath. Somatization disorder was not observed; new somatoform symptoms represented a fraction of postflood somatic complaints. Findings are inconsistent with causal attribution of floods in the etiology of alcohol abuse and somatization. Methodological differences may account for much of the apparent discrepancy of these findings, with recent reports of increased alcohol use and somatic symptoms observed after other disasters.",0 +https://doi.org/10.1111/j.1467-8624.2010.01465.x,Children of Katrina: Lessons Learned About Postdisaster Symptoms and Recovery Patterns,"Trauma symptoms, recovery patterns, and life stressors of children between the ages of 9 and 18 (n = 387) following Hurricane Katrina were assessed using an adapted version of the National Child Traumatic Stress Network Hurricane Assessment and Referral Tool for Children and Adolescents (National Child Traumatic Stress Network, 2005). Based on assessments 2 and 3 years after the hurricane, most children showed a decrease in posttraumatic stress and depression symptoms over time. Students were also classified into outcome trajectories of stress resistant, normal response and recovery, delayed breakdown, and breakdown without recovery (A. S. Masten & J. Obradovic, 2008). Age, gender, and life stressors were related to these recovery patterns. Overall, the findings highlight the importance of building and maintaining supportive relationships following disasters.",0 +https://doi.org/10.1097/01.xme.0000461678.30239.4f,Psychosocial profile of a sample of Egyptian children with rheumatic heart disease,"Objectives Early-onset physical morbidity is likely to affect the emotional balance and behavioral adaptation of children and adolescents. Few published studies have investigated psychological morbidity in children with rheumatic heart diseases (RHD). Our work aims to explore the psychiatric symptoms in addition to total competence and quality of life in a sample of Egyptian children with RHD in comparison with those with no RHD and with healthy controls. Participants and methods Children (age 6-18 years) with RHD (n=24), those with congenital or other heart diseases (non-RHD) (n=23), and healthy control children (n=28) were recruited. The Arabic version of the Child Behavior Checklist was completed by parents. Results After adjustment for different socioeconomic statuses, all children with heart diseases were found to show more internalizing problems and post-traumatic stress compared with healthy children. Non-RHD children showed more generalized and social anxiety, whereas those with RHD showed higher levels of obsessive-compulsive problems. Conclusion Children with heart diseases suffer from high internalizing psychological stress. More effort needs to be made for the early identification and management of psychological morbidity in children with RHD, especially for anxiety and obsessive compulsive symptoms. © 2015 Institute of Psychiatry, Ain Shams University.",0 +https://doi.org/10.1080/13854046.2014.894576,"Normative Data for the Neurobehavioral Symptom Inventory (NSI) and Post-Concussion Symptom Profiles Among TBI, PTSD, and Nonclinical Samples","The Neurobehavioral Symptom Inventory (NSI) is a self-report measure of symptoms commonly associated with Post-Concussion Syndrome (PCS) that may emerge after mild traumatic brain injury (mTBI). Despite frequent clinical use, no NSI norms have been developed. Thus, the main objective of this study was to establish NSI normative data using the four NSI factors (i.e., vestibular, somatic, cognitive, and affective) identified by Vanderploeg, Silva, et al. ( 2014 ) among nonclinical epidemiological samples of deployed and non-deployed Florida National Guard members as well as a reference sample of Guard members with combat-related mTBI. In addition, NSI subscale profile patterns were compared across four distinct subgroups (i.e., non-deployed-nonclinical, deployed-nonclinical, deployed-mTBI, and deployed-PTSD). The deployed-nonclinical group endorsed greater PCS symptom severity than the non-deployed group, and the mTBI group uniformly endorsed more symptoms than both nonclinical groups. However, the PTSD group endorsed higher symptom severity relative to the other three subgroups. As such, this highlights the non-specificity of PCS symptoms and suggests that PTSD is associated with higher symptom endorsement than mTBI.",0 +https://doi.org/10.1177/0886260504267549,Post-Traumatic Stress Disorder (PTSD),"This article discusses the biomedical and the social constructionist models applied to response to trauma, presents the prevalence and the etiology of post-traumatic stress disorder (PTSD), and describes its biological and psychological correlates in children and adults. It concludes that future research might benefit from investigating factors that may protect people who have been exposed to an event likely to be traumatic from presenting with PTSD symptoms, and factors that may affect the longitudinal course of PTSD and treatment effectiveness.",0 +https://doi.org/10.1007/s10880-008-9131-x,Optimal Scoring of the Multidimensional Pain Inventory in a Chronic Pain Sample,"The Multidimensional Pain Inventory (MPI) is one of the most commonly used self-report instruments in pain settings. The MPI can be used to classify patients into three clusters or its nine scales can be treated as dimensions in efforts to understand patient heterogeneity. Previous research suggests the existence of a fourth cluster, whose members have been labeled 'repressors,' that emerges with the addition of a defensiveness scale to the MPI. The current paper compared the abilities of MPI cluster and dimensional models with and without a measure of defensiveness to capture variability in validating variables related to personality, psychopathology, physical functioning, and treatment outcome in a chronic pain sample. Results suggest that dimensional models consistently outperform cluster models in explaining variance in outcome variables, and that the addition of a measure of defensiveness increments the validity offered by the MPI scales. Implications for the assessment of pain patients are discussed. (",0 +https://doi.org/10.1016/j.psyneuen.2005.06.010,Altered cortisol awakening response in posttraumatic stress disorder,"An altered function of the hypothalamic-pituitary-adrenal axis is assumed to be characteristic for Posttraumatic Stress Disorder (PTSD), although there is inconsistent empirical evidence. Only few studies examined the awakening cortisol response and a daytime profile in PTSD. Salivary cortisol levels were measured at seven intervals from awakening until 8 PM in trauma-exposed subjects with (N=29) and without PTSD (N=19) and in 15 non-exposed controls. While the three groups did not differ with respect to their first cortisol level immediately after awakening, the expected cortisol increase to awakening 15-60 min later was significantly lower in PTSD patients compared to non-PTSD subjects and healthy controls. This effect remained stable when trauma-exposed subjects with comorbid major depression were excluded from the analysis. A significant negative correlation between the overall cortisol secretion (AUC(G)) and overall PTSD symptomatology and hyper-arousal symptoms was found. The findings are discussed in light of the hypothesis of a counterregulation of hyper-arousal symptoms and chronic stress in PTSD.",0 +https://doi.org/10.1080/13669877.2014.896401,Concerns and perceptions immediately following Superstorm Sandy: ratings for property damage were higher than for health issues,"Governmental officials, health and safety professionals, early responders, and the public are interested in the perceptions and concerns of people faced with a crisis, especially during and immediately after a disaster strikes. Reliable information can lead to increased individual and community preparedness for upcoming crises. The objective of this research was to evaluate concerns of coastal and central New Jersey residents within the first 100 days of Superstorm Sandy's landfall. Respondents living in central New Jersey and Jersey shore communities were differentially impacted by the storm, with shore residents having higher evacuation rates (47% vs. 13%), more flood waters in their homes, longer power outages (average 23 vs. 6 days), and longer periods without Internet (29 vs. 6 days). Ratings of concerns varied both among and within categories as a function of location (central vs. coastal New Jersey), stressor level (ranging from 1 to 3 for combinations of power outages, high winds, and flooding), and demographics. Respondents were most concerned about property damage, health, inconveniences, ecological services, and nuclear power plants in that order. Respondents from the shore gave higher ratings to the concerns within each major category, compared to those from central Jersey. Four findings have implications for understanding future risk, recovery, and resiliency: (1) respondents with the highest stressor level (level 3) were more concerned about water damage than others, (2) respondents with flood damage were more concerned about water drainage and mold than others, (3) respondents with the highest stressor levels rated all ecological services higher than others, and (4) shore respondents rated all ecological services higher than central Jersey residents. These data provide information to design future preparedness plans, improve resiliency for future severe weather events, and reduce public health risk.",0 +https://doi.org/10.7314/apjcp.2015.16.9.4115,Clustering Asian and North African Countries According to Trend of Colon and Rectum Cancer Mortality Rates: an Application of Growth Mixture Models,"Colorectal cancer is the second most common cause of cancer death with half a million deaths per year. Incidence and mortality rates have demonstrated notable changes in Asian and African countries during the last few decades. In this study, we first aimed to determine the trend of colorectal cancer mortality rate in each Institute for Health Metrics and Evaluation (IHME) region, and then re-classify them to find more homogenous classes.Our study population consisted of 52 countries of Asia and North Africa in six IHME pre-defined regions for both genders and age-standardized groups from 1990 to 2010.We first applied simple growth models for pre-defined IHME regions to estimate the intercepts and slopes of mortality rate trends. Then, we clustered the 52 described countries using the latent growth mixture modeling approach for classifying them based on their colorectal mortality rates over time.Statistical analysis revealed that males and people in high income Asia pacific and East Asia countries were at greater risk of death from colon and rectum cancer. In addition, South Asia region had the lowest rates of mortality due to this cancer. Simple growth modeling showed that majority of IHME regions had decreasing trend in mortality rate of colorectal cancer. However, re-classification these countries based on their mortality trend using the latent growth mixture model resulted in more homogeneous classes according to colorectal mortality trend.In general, our statistical analyses showed that most Asian and North African countries had upward trend in their colorectal cancer mortality. We therefore urge the health policy makers in these countries to evaluate the causes of growing mortality and study the interventional programs of successful countries in managing the consequences of this cancer.",0 +https://doi.org/10.1080/0269905031000114045,Post-traumatic stress disorder in children following road traffic accidents: a comparison of those with and without mild traumatic brain injury,"It is now recognized that post-traumatic stress disorder (PTSD) can occur following road traffic accidents, but controversy exists about the possibility of PTSD in people sustaining traumatic brain injury (TBI). The present investigation examined the frequency, course and comorbidity of PTSD in children with and without mild TBI after traffic accidents.Interviews were conducted with 43 children and their parents 6 weeks after a traffic accident,assessing PTSD and associated symptomatology. Fourteen children sustained mild TBI and 29 had no TBI. A sub-set (n=32) was re-interviewed 7 weeks later.Children both with and without TBI reported PTSD symptomatology, but no significant group differences were found. At initial assessment, 74% of children were classified as having clinically significant PTSD symptomatology (86% and 69% in groups with and without TBI, respectively), which was strongly associated with report of general anxiety. At follow-up, PTSD symptomatology decreased, but 44% remained symptomatic (38% and 46% for those with and without TBI, respectively). Child and parental report of PTSD symptomatology were not significantly correlated.Presence of mild TBI did not influence the likelihood of experiencing PTSD symptomatology following a traffic accident. Given that PTSD symptomatology is a common consequence of traffic accidents in children, there is a clear need for provision of systematic assessment and, where appropriate, the implementation of intervention strategies to treat children.",0 +,[Heat waves: health impacts].,"During the summer of 2003, record high temperatures were reported across Europe, causing thousands of casualties. Heat waves are sporadic recurrent events, characterised by intense and prolonged heat, associated with excess mortality and morbidity. The most frequent cause of death directly attributable to heat is heat stroke but heat waves are known to cause increases in all-cause mortality, specially circulatory and respiratory mortality. Epidemiological studies demonstrate excess casualties cluster in specific risk groups. The elderly, those with chronic medical conditions and the socially isolated are particularly vulnerable. Air conditioning is the strongest protective factor against heat-related disorders. Heat waves cause disease indirectly, by aggravating chronic disorders, and directly, by causing heat-related illnesses (HRI). Classic HRI include skin eruptions, heat cramps, heat syncope, heat exhaustion and heat stroke. Heat stroke is a medical emergency characterised by hyperthermia and central nervous system dysfunction. Treatment includes immediate cooling and support of organ-system function. Despite aggressive treatment, heat stroke is often fatal and permanent neurological damage is frequent in those who survive. Heat related illness and death are preventable through behavioural adaptations, such as use of air conditioning and increased fluid intake. Other adaptation measures include heat emergency warning systems and intervention plans and environmental heat stress reduction. Heat related mortality is expected to rise as a consequence of the increasing proportion of elderly persons, the growing urban population, and the anticipated increase in number and intensity of heat waves associated with global warming. Improvements in surveillance and response capability may limit the adverse health conditions of future heat waves. It is crucial that health professionals are prepared to recognise, prevent and treat HRI and learn to cooperate with local health agencies.",0 +https://doi.org/10.1176/ajp.152.12.1705,Conflict between current knowledge about posttraumatic stress disorder and its original conceptual basis,"The author's goal was to explore the historical, political, and social forces that have played a major role in the acceptance of the idea of trauma as a cause of the specific symptoms of posttraumatic stress disorder (PTSD) and to discuss the impact that current research findings have had on some of the initial conceptualizations of the disorder.The conceptual origins of PTSD are described, and the literature on the prevalence, longitudinal course, phenomenology, and neurobiology of PTSD is reviewed.Paradoxically, there are a series of findings that support the idea that PTSD is a distinct diagnostic entity, but these are different from those originally developed from psychosocial theory and stress research.PTSD has been a controversial diagnosis and is again at a vulnerable point. It is imperative that the field address how current findings challenge the original conceptualizations of this disorder so that the next generation of conceptual issues can be formulated.",0 +https://doi.org/10.1016/j.jpsychires.2013.09.008,Impaired fear inhibition learning predicts the persistence of symptoms of posttraumatic stress disorder (PTSD),"Recent cross-sectional studies have shown that the inability to suppress fear under safe conditions is a key problem in people with posttraumatic stress disorder (PTSD). The current longitudinal study examined whether individual differences in fear inhibition predict the persistence of PTSD symptoms. Approximately 2 months after deployment to Afghanistan, 144 trauma-exposed Dutch soldiers were administered a conditional discrimination task (AX+/BX-). In this paradigm, A, B, and X are neutral stimuli. X combined with A is paired with a shock (AX+ trials); X combined with B is not (BX- trials). Fear inhibition was measured (AB trials). Startle electromyogram responses and shock expectancy ratings were recorded. PTSD symptoms were measured at 2 months and at 9 months after deployment. Results showed that greater startle responses during AB trials in individuals who discriminated between danger (AX+) and safety (BX-) during conditioning, predicted higher PTSD symptoms at 2 months and 9 months post-deployment. The predictive effect at 9 months remained significant after controlling for critical incidents during previous deployments and PTSD symptoms at 2 months. Responses to AX+ or BX- trials, or discrimination learning (AX+ minus BX-) did not predict PTSD symptoms. It is concluded that impaired fear inhibition learning seems to be involved in the persistence of PTSD symptoms.",0 +https://doi.org/10.1016/j.amepre.2007.03.019,Childhood Adversity and Combat as Predictors of Depression and Post-Traumatic Stress in Deployed Troops,"Previous studies have shown a relationship between childhood adversity and health outcomes in adulthood. The military represents a segment of the young working population that faces unique hazards that may be worsened by previous adverse life experiences. To date, no comprehensive studies of childhood adversity have been conducted with military samples that have included combat troops before and after a combat deployment.Surveys were administered in 2003 to 4529 male soldiers who had not deployed to Iraq, and in 2004 to a separate group of 2392 male soldiers 3 months after returning from Iraq. The main predictor was adverse childhood experiences, an aggregated construct representing incremental exposure to six types of traumatic childhood experiences. This construct correlated with depression and post-traumatic stress disorder rates, as well as symptom scores. For the post-Iraq sample, analyses were conducted to assess whether individuals with childhood trauma were affected differently by exposure to combat.The likelihood of screening positive for depression and post-traumatic stress disorder was significantly higher for individuals reporting exposure to two or more categories of childhood adversity. Core analyses showed that adverse childhood experiences were a significant predictor of mental health symptoms, beyond the expected contribution of combat.This study confirms the high prevalence of adverse childhood experiences and the association of these experiences with key mental health outcomes. In addition, the results highlight the importance of considering pre-enlistment childhood traumatic experiences as well as the level of combat exposure in the treatment of military personnel returning from combat operations.",0 +,EMG biofeedback-assisted desensitization treatment for Vietnam combat veterans Post-Traumatic Stress Disorder.,"Employed an electromyogram (EMG) biofeedback-induced desensitization procedure (EMG-D) in the treatment of 8 Vietnam combat veterans with a 7-yr history of chronic post-traumatic stress disorder (PTSD) and frequent recurring nightmares and/or flashbacks that were anxiety-evoking events. 16 PTSD Ss (aged 29-42 yrs) were assigned to the EMG-D group or a control group. Analysis of forehead muscle tension over a 2 yr follow-up indicated that the Ss in the EMG-D condition had significantly reduced their muscle tension and showed continued improved functioning. Ss reported a few instances of recurrence of their nightmares and/or flashbacks; however, they were essentially anxiety-free episodes. No significant reduction in muscle tension, recurring nightmares, or flashbacks was found for Ss in the control group. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1023/a:1024453618638,"Atrocities exposure in Vietnam combat veterans with chronic posttraumatic stress disorder: Relationship to combat exposure, symptom severity, guilt, and interpersonal violence","Vietnam combat veterans (N = 151) with chronic posttraumatic stress disorder (PTSD) completed measures of atrocities exposure, combat exposure, PTSD symptom severity, guilt and interpersonal violence. PTSD symptom severity, guilt and interpersonal violence rates were similar to previously reported studies that examined treatment seeking combat veterans with PTSD. Controlling for combat exposure, endorsement of atrocities exposure was related to PTSD symptom severity, PTSD B (reexperiencing) symptoms, Global Guilt, Guilt Cognitions, and cognitive subscales of Hindsight-Bias/Responsibility and Wrongdoing. These results are discussed in the context of previous research conducted regarding atrocities exposure and PTSD.",0 +https://doi.org/10.1192/bjp.bp.108.059139,Long-term mental health of Vietnamese refugees in the aftermath of trauma,"Background There is no long-term prospective study (> 20 years) of the mental health of any refugee group. Aims To investigate the long-term course and predictors of psychological distress among Vietnamese refugees in Norway. Method Eighty Vietnamese refugees, 57% of the original cohort previously interviewed in 1982 ( T 1 ) and 1985 ( T 2 ), completed a self-report questionnaire prior to a semi-structured interview. Mental health was measured using the Symptom Checklist–90–Revised (SCL–90–R). Results The SCL–90–R mean Global Severity Index (GSI) decreased significantly from T 1 to T 3 (2005–6), but there was no significant change in the percentage reaching threshold scores (GSI =1.00). Trauma-related mental disorder on arrival and the trajectory of symptoms over the first 3 years of resettlement predicted mental health after 23 years. Conclusions Although the self-reported psychological distress decreased significantly over time, a substantial higher proportion of the refugee group still remained reaching threshold scores after 23 years of resettlement compared with the Norwegian population. The data suggest that refugees reaching threshold scores on measures such as the SCL–90–R soon after arrival warrant comprehensive clinical assessment.",0 +https://doi.org/10.1037/a0028210,Trauma and posttraumatic stress symptoms predict alcohol and other drug consequence trajectories in the first year of college.,"College matriculation begins a period of transition into adulthood, one that is marked by new freedoms and responsibilities. This transition also is marked by an escalation in heavy drinking and other drug use as well as a variety of use-related negative consequences. Trauma and symptoms of posttraumatic stress disorder (PTSD) may affect alcohol and drug problems and, thus, may be a point of intervention. Yet, no studies have examined trauma, PTSD, and alcohol and drug problem associations during this developmental period. The present study provides such an examination.Matriculating college students (N = 997) completed surveys in September (Time 1) and at 5 subsequent time points (Time 2-Time 6) over their 1st year of college. With latent growth analysis, trajectories of alcohol- and drug-related consequences were modeled to examine how trauma (No Criterion A Trauma, Criterion A Only, No PTSD Symptoms) and PTSD (partial or full) symptom status predicted these trajectories.Results showed substantial risk for alcohol- and other drug-related negative consequences that is conferred by the presence of PTSD at matriculation. Those with both partial and full PTSD started the year with more alcohol and drug consequences. These individuals showed a steeper decrease in consequences in the 1st semester, which leveled off as the year progressed. Both alcohol and drug consequences remained higher for those in the PTSD group throughout the academic year. Hyperarousal symptoms showed unique effects on substance consequence trajectories. Risk patterns were consistent for both partial and full PTSD symptom presentations. Trajectories did not vary by gender.Interventions that offer support and resources to students entering college with PTSD may help to ameliorate problem substance use and may ultimately facilitate a stronger transition into college and beyond.",0 +https://doi.org/10.1002/brb3.323,RORA and posttraumatic stress trajectories: main effects and interactions with childhood physical abuse history,"Longitudinal studies of posttraumatic stress (PTS) have documented environmental factors as predictors of trajectories of higher, versus lower, symptoms, among them experiences of childhood physical abuse. Although it is now well-accepted that genes and environments jointly shape the risk of PTS, no published studies have investigated genes, or gene-by-environment interactions (GxEs), as predictors of PTS trajectories. The purpose of this study was to fill this gap.We examined associations between variants of the retinoid-related orphan receptor alpha (RORA) gene and trajectory membership among a sample of predominantly non-Hispanic Black urban adults (N = 473). The RORA gene was selected based on its association with posttraumatic stress disorder (PTSD) in the first PTSD genome wide association study. Additionally, we explored GxEs between RORA variants and childhood physical abuse history.We found that the minor allele of the RORA SNP rs893290 was a significant predictor of membership in a trajectory of consistently high PTS, relatively to a trajectory of consistently low PTS. Additionally, the GxE of rs893290 with childhood physical abuse was significant. Decomposition of the interaction showed that minor allele frequency was more strongly associated with membership in consistently high or decreasing PTS trajectories, relative to a consistently low PTS trajectory, among participants with higher levels of childhood physical abuse.The results of the study provide preliminary evidence that variation in the RORA gene is associated with membership in trajectories of higher PTS and that these associations are stronger among persons exposed to childhood physical abuse. Replication and analysis of functional data are needed to further our understanding of how RORA relates to PTS trajectories.",0 +https://doi.org/10.9745/ghsp-d-15-00093,Prevalence and Incidence of Traumatic Experiences Among Orphans in Institutional and Family-Based Settings in 5 Low- and Middle-Income Countries: A Longitudinal Study,"Policy makers struggling to protect the 153 million orphaned and separated children (OSC) worldwide need evidence-based research on the burden of potentially traumatic events (PTEs) and the relative risk of PTEs across different types of care settings.The Positive Outcomes for Orphans study used a 2-stage, cluster-randomized sampling design to identify 1,357 institution-dwelling and 1,480 family-dwelling orphaned and separated children in 5 low- and middle-income countries (LMICs) in sub-Saharan Africa and Asia. We used the Life Events Checklist developed by the National Center for Posttraumatic Stress Disorder to examine self-reported PTEs among 2,235 OSC ages 10-13 at baseline. We estimated prevalence and incidence during 36-months of follow-up and compared the risk of PTEs across care settings. Data collection began between May 2006 and February 2008, depending on the site.Lifetime prevalence by age 13 of any PTE, excluding loss of a parent, was 91.0% (95% confidence interval (CI) = 85.6, 94.5) in institution-dwelling OSC and 92.4% (95% CI = 90.3, 94.0) in family-dwelling OSC; annual incidence of any PTE was lower in institution-dwelling (23.6% [95% CI = 19.4, 28.7]) than family-dwelling OSC (30.0% [95% CI = 28.1, 32.2]). More than half of children in institutions (50.3% [95% CI = 42.5, 58.0]) and in family-based care (54.0% [95% CI = 50.2, 57.7]) had experienced physical or sexual abuse by age 13. Annual incidence of physical or sexual abuse was lower in institution-dwelling (12.9% [95% CI = 9.6, 17.3]) than family-dwelling OSC (19.4% [95% CI = 17.7, 21.3]), indicating statistically lower risk in institution-dwelling OSC (risk difference = 6.5% [95% CI = 1.4, 11.7]).Prevalence and incidence of PTEs were high among OSC, but contrary to common assumptions, OSC living in institutions did not report more PTEs or more abuse than OSC living with families. Current efforts to reduce the number of institution-dwelling OSC may not reduce incidence of PTEs in this vulnerable population. Protection of children from PTEs should be a primary consideration, regardless of the care setting.",0 +https://doi.org/10.1016/j.bbr.2015.02.051,Alterations in cognitive flexibility in a rat model of post-traumatic stress disorder,"Exposure to stressful or traumatic events is associated with increased vulnerability to post-traumatic stress disorder (PTSD). This vulnerability may be partly mediated by effects of stress on the prefrontal cortex (PFC) and associated circuitry. The PFC mediates critical cognitive functions, including cognitive flexibility, which reflects an organism's ability to adaptively alter behavior in light of changing contingencies. Prior work suggests that chronic or acute stress exerts complex effects on different forms of cognitive flexibility, via actions on the PFC. Similarly, PFC dysfunction is reported in PTSD, as are executive function deficits. Animal models that permit study of the effects of stress/trauma on cognitive flexibility may be useful in illuminating ways in which stress-linked cognitive changes contribute to PTSD. Here, we examined the behavioral effects of a rodent model of PTSD - single prolonged stress (SPS) - on performance of two forms of cognitive flexibility: reversal learning and strategy set-shifting. SPS did not impair acquisition of either a response or visual-cue discrimination but did cause slight impairments in the retrieval of the visual-cue rule. During response discrimination reversal, SPS rats made more perseverative errors. In comparison, during set-shifting from the visual-cue to response discrimination, SPS rats did not show enhanced perseveration, but did display increased never-reinforced errors, indicative of impairment in selecting a novel strategy. These data demonstrate that SPS leads to a complex and intriguing pattern of deficits in flexible responding and suggest that impairments in executive functioning associated with PTSD could, in part, be a neuro-cognitive consequence of trauma exposure.",0 +https://doi.org/10.1016/j.janxdis.2014.10.006,"The impact of disaster work on community volunteers: The role of peri-traumatic distress, level of personal affectedness, sleep quality and resource loss, on post-traumatic stress disorder symptoms and subjective health","Disaster work has shown to cause PTSD symptoms and subjective health complaints in professional emergency personnel. However, very little is known about how disaster work affects community volunteers. This first time longitudinal study examined factors contributing to post-traumatic stress disorder symptoms (PTSD) and subjective health complaints in volunteers working in an earthquake setting. At six and eighteen months post disaster, a sample of 506 Indonesian Red Cross volunteers were assessed using the Impact of Event Scale-Revised and the Subjective Health Complaints Inventory. Factors analyzed in relation to the outcomes included: peri-traumatic distress, level of personal affectedness by the disaster, sleep quality and loss of resources as a consequence of the disaster. At 18 months post-disaster the findings showed high levels of PTSD symptoms and subjective health complaints. Quality of sleep was related to both outcomes but resource loss only to PTSD symptoms. Neither peri-traumatic distress nor level of affectedness by the disaster (external versus directly affected volunteers), were predictive of symptoms. This study indicates that characteristics of disaster work e.g. low quality of sleep, may be an important contributor to PTSD symptoms and subjective health complaints in volunteers.",0 +https://doi.org/10.1016/j.scitotenv.2014.02.048,Health concerns and perceptions of central and coastal New Jersey residents in the 100days following Superstorm Sandy,"Superstorm Sandy made landfall in New Jersey 29–30 October 2012 (130 km/h winds), and many residents were evacuated, were without power for days to several weeks, and suffered property damages or lost their homes. The objective of this study was to understand health concerns within 100 days of this devastating storm that might improve recovery, future preparedness, and resilience. We conducted a survey of New Jersey residents in central (N = 407) and shore communities (n = 347) about health concerns before, during, and after Superstorm Sandy . People were interviewed at public places, town hall and FEMA meetings, health and university centers, and other gathering places. 47% of shore and 13% of central Jersey respondents evacuated. Both populations were concerned about agents of destruction, survival needs, and possessions before and during the storm, but they were mainly concerned about survival needs thereafter. During the storm, medical issues were the greatest concern for shore respondents (23%) vs secure and safe food and water (29%) for central respondents. Medical concerns increased after the storm. In the future, 42% of shore respondents would prepare more, while 51% of central residents would buy more supplies; 20% (shore) and 11% (central) would heed future evacuation warnings. Before Sandy many residents did not heed warnings and evacuation orders, but worried about property damage, while during and after their major concerns were personal and community health. Prevention of future health and property impacts could be enhanced by stronger evacuation enforcement, better preparedness information, greater attention to the possibility of prolonged power outages, and more attention to medical needs during and after a storm. • Within 100 days of Superstorm Sandy 754 people in New Jersey were interviewed. • Nearly half of people living along the shore evacuated, and were without electricity for some time. • During the storm, the major concerns for shore residents were medical issues (23%). • Medical concerns increased following the storm for shore residents. • Stress, respiratory problems, and access to medications were major medical concerns.",0 +https://doi.org/10.1080/15374410801955771,Psychiatric Impairment Among Adolescents Engaging in Different Types of Deliberate Self-Harm,"This retrospective chart review study of 227 participants examined the psychiatric profiles of outpatient adolescents ages 12 to 19 years (M = 15.08 years, SD = 1.72 years) engaging in different types of deliberate self-harm (DSH) behaviors. Participants were divided into four groups: no deliberate self-harm (NoDSH; n = 119), nonsuicidal self-injury only (NSSI only; n = 30), suicide attempt only (n = 38), and suicide attempt plus NSSI (n = 40). Those who attempted suicide were more likely to have major depressive disorder and/or posttraumatic stress disorder than those who engaged in NSSI only. Those who engaged in any type of DSH were more likely to have features of borderline personality disorder than those who did not engage in DSH. The suicidal ideation levels of those in the NSSI group were similar to those in the NoDSH group. Findings offer empirical support for the importance of distinguishing between suicidal and nonsuicidal self-harm behaviors.",0 +https://doi.org/10.1080/00207594.2012.691975,"Child physical abuse and neglect in Kenya, Zambia and the Netherlands: A cross-cultural comparison of prevalence, psychopathological sequelae and mediation by PTSS","This study compared the prevalence of self-reported childhood physical abuse and neglect and the associated psychopathological sequelae among Kenyan, Zambian, and Dutch university students. In addition, we sought to find out the differentiated role of posttraumatic stress symptoms (PTSS) in mediating the associations between childhood maltreatment experiences and psychopathology symptoms. The sample consisted of 862 university students from Kenya (n = 375), Zambia (n = 182), and The Netherlands (n = 305) who completed the Personal and Relationships Profile (PRP). Results showed that physical abuse was highly prevalent in Kenya (59%) and Zambia (40%), and that neglect was even more prevalent than physical abuse in Zambia and The Netherlands at 59%, 54%, and 42% for the Kenyan, Zambian, and Dutch samples respectively. Neglect was associated with psychopathological symptoms in all three samples, whereas physical abuse was associated with psychopathological sequelae in the Kenyan and Zambian samples only. PTSS mediated the association between neglect and psychopathology symptoms in the Dutch sample and between physical abuse and psychopathology symptoms in the Dutch and Kenyan samples. We conclude that physical abuse and neglect are associated with psychopathology symptoms independently of country and cultural context. However, the pathways through which physical abuse and neglect may lead to psychopathological sequelae may be dependent on perceptions of specific parental behavior in different sociocultural contexts.",0 +https://doi.org/10.1002/14651858.cd007944,Multiple session early psychological intervention to prevent and treat post-traumatic stress disorder,,0 +https://doi.org/10.2147/ndt.s87332,Altered blood oxygen level-dependent signal variability in chronic post-traumatic stress disorder during symptom provocation,"Recent research suggests that variability in brain signal provides important information about brain function in health and disease. However, it is unknown whether blood oxygen level-dependent (BOLD) signal variability is altered in post-traumatic stress disorder (PTSD). We aimed to identify the BOLD signal variability changes of PTSD patients during symptom provocation and compare the brain patterns of BOLD signal variability with those of brain activation.Twelve PTSD patients and 14 age-matched controls, who all experienced a mining accident, underwent clinical assessment as well as fMRI scanning while viewing trauma-related and neutral pictures. BOLD signal variability and brain activation were respectively examined with standard deviation (SD) and general linear model analysis, and compared between the PTSD and control groups. Multiple regression analyses were conducted to explore the association between PTSD symptom severity and these two brain measures across all subjects as well as in the PTSD group.PTSD patients showed increased activation in the middle occipital gyrus compared with controls, and an inverse correlation was found between PTSD symptom severity and brain activation in the hippocampus and anterior cingulate cortex/medial prefrontal cortex. Brain variability analysis revealed increased SD in the insula, anterior cingulate cortex/medial prefrontal cortex, and vermis, and decreased SD in the parahippocapal gyrus, dorsolateral prefrontal cortex, somatosensory cortex, and striatum. Importantly, SD alterations in several regions were found in both traumatic and neutral conditions and were stratified by PTSD symptom severity.BOLD signal variability may be a reliable and sensitive biomarker of PTSD, and combining brain activation and brain variability analysis may provide complementary insight into the neural basis of this disorder.",0 +https://doi.org/10.1016/s0140-6736(13)60354-2,Violent offending by UK military personnel deployed to Iraq and Afghanistan: a data linkage cohort study,"

Summary

Background

Violent offending by veterans of the Iraq and Afghanistan conflicts is a cause for concern and there is much public debate about the proportion of ex-military personnel in the criminal justice system for violent offences. Although the psychological effects of conflict are well documented, the potential legacy of violent offending has yet to be ascertained. We describe our use of criminal records to investigate the effect of deployment, combat, and post-deployment mental health problems on violent offending among military personnel relative to pre-existing risk factors.

Methods

In this cohort study, we linked data from 13 856 randomly selected, serving and ex-serving UK military personnel with national criminal records stored on the Ministry of Justice Police National Computer database. We describe offending during the lifetime of the participants and assess the risk factors for violent offending.

Findings

2139 (weighted 17·0%) of 12 359 male UK military personnel had a criminal record for any offence during their lifetime. Violent offenders (1369 [11·0%]) were the most prevalent offender types; prevalence was highest in men aged 30 years or younger (521 [20·6%] of 2728) and fell with age (164 [4·7%] of 3027 at age >45 years). Deployment was not independently associated with increased risk of violent offending, but serving in a combat role conferred an additional risk, even after adjustment for confounders (violent offending in 137 [6·3%] of 2178 men deployed in a combat role vs 140 (2·4%) of 5797 deployed in a non-combat role; adjusted hazard ratio 1·53, 95% CI 1·15–2·03; p=0·003). Increased exposure to traumatic events during deployment also increased risk of violent offending (violent offending in 104 [4·1%] of 2753 men with exposure to two to four traumatic events vs 56 [1·6%] of 2944 with zero to one traumatic event, 1·77, 1·21–2·58, p=0·003; and violent offending in 122 [5·1%] of 2582 men with exposure to five to 16 traumatic events, 1·65, 1·12–2·40, p=0·01; test for trend, p=0·032). Violent offending was strongly associated with post-deployment alcohol misuse (violent offending in 120 [9·0%] of 1363 men with alcohol misuse vs 155 [2·3%] of 6768 with no alcohol misuse; 2·16, 1·62–2·90; p<0·0001), post-traumatic stress disorder (violent offending in 25 [8·6%] of 344 men with post-traumatic stress disorder vs 221 [3·0%] of 7256 with no symptoms of post-traumatic stress disorder; 2·20, 1·36–3·55; p=0·001), and high levels of self-reported aggressive behaviour (violent offending in 56 [6·7%] of 856 men with an aggression score of six to 16 vs 22 [1·2%] of 1685 with an aggression score of zero; 2·47, 1·37–4·46; p=0·003). Of the post-traumatic stress disorder symptoms, the hyperarousal cluster was most strongly associated with violent offending (2·01, 1·50–2·70; p<0·0001).

Interpretation

Alcohol misuse and aggressive behaviour might be appropriate targets for interventions, but any action must be evidence based. Post-traumatic stress disorder, though less prevalent, is also a risk factor for violence, especially hyperarousal symptoms, so if diagnosed it should be appropriately treated and associated risk monitored.

Funding

Medical Research Council and the UK Ministry of Defence.",0 +https://doi.org/10.1016/s0749-3797(01)00433-0,Effect of the incident at Columbine on students' violence- and suicide-related behaviors,This study examined the impact that the violent incident at Columbine High School may have had on reports of behaviors related to violence and suicide among U.S. high school students.Nationally representative data from the 1999 Youth Risk Behavior Survey (YRBS) were analyzed using logistic regression analyses.Students who completed the 1999 YRBS after the Columbine incident were more likely to report feeling too unsafe to go to school and less likely to report considering or planning suicide than were students who completed the 1999 YRBS before the incident.These results highlight how an extreme incident of school violence can affect students nationwide.,0 +https://doi.org/10.1016/j.biopsych.2014.03.028,Subthreshold Posttraumatic Stress Disorder in the World Health Organization World Mental Health Surveys,"

Abstract

Background

Although only a few people exposed to a traumatic event (TE) develop posttraumatic stress disorder (PTSD), symptoms that do not meet full PTSD criteria are common and often clinically significant. Individuals with these symptoms sometimes have been characterized as having subthreshold PTSD, but no consensus exists on the optimal definition of this term. Data from a large cross-national epidemiologic survey are used in this study to provide a principled basis for such a definition.

Methods

The World Health Organization World Mental Health Surveys administered fully structured psychiatric diagnostic interviews to community samples in 13 countries containing assessments of PTSD associated with randomly selected TEs. Focusing on the 23,936 respondents reporting lifetime TE exposure, associations of approximated DSM-5 PTSD symptom profiles with six outcomes (distress-impairment, suicidality, comorbid fear-distress disorders, PTSD symptom duration) were examined to investigate implications of different subthreshold definitions.

Results

Although consistently highest outcomes for distress-impairment, suicidality, comorbidity, and PTSD symptom duration were observed among the 3.0% of respondents with DSM-5 PTSD rather than other symptom profiles, the additional 3.6% of respondents meeting two or three of DSM-5 criteria B–E also had significantly elevated scores for most outcomes. The proportion of cases with threshold versus subthreshold PTSD varied depending on TE type, with threshold PTSD more common following interpersonal violence and subthreshold PTSD more common following events happening to loved ones.

Conclusions

Subthreshold DSM-5 PTSD is most usefully defined as meeting two or three of DSM-5 criteria B–E. Use of a consistent definition is critical to advance understanding of the prevalence, predictors, and clinical significance of subthreshold PTSD.",0 +https://doi.org/10.1038/ijo.2015.128,Developmental trajectories of adiposity from birth until early adulthood and association with cardiometabolic risk factors,"Objective: To identify developmental trajectories of adiposity from birth until early adulthood, and to investigate how they relate with cardiometabolic risk factors at 21 years of age. Methods: Participants' weight and height measurements were obtained using the EPITeen cohort protocol at 13, 17 and 21 years of age, and extracted from child health books as recorded during health routine evaluations since birth. Blood pressure, triglycerides, cholesterol and insulin resistance (HOMA-IR) were assessed at 21 years. Trajectories were defined using 719 participants contributing 11 459 measurements. The individual growth curves were modelled using mixed-effects fractional polynomial, and the trajectories were estimated using normal mixture modelling for model-based clustering. Differences in cardiometabolic risk factors at 21 years according to adiposity trajectories were estimated through analysis of covariance (ANCOVA), and adjusted means are presented. Results: Two trajectories-'Average body mass index (BMI) growth' (80.7%) and 'Higher BMI growth' (19.3%)-were identified. Compared with those in 'Average BMI growth', 'Higher BMI growth' participants were more frequently delivered by caesarean section, mothers were younger and had higher BMI, and parental education was lower; and at 21 years showed higher adjusted mean systolic (111.6 vs 108.3mmHg, P < 0.001) and diastolic blood pressure (71.9 vs 68.4mmHg, P < 0.001), and lower highdensity lipoprotein cholesterol (53.3 vs 57.0 mg dl-1, P = 0.001). As there was a significant interaction between trajectories and sex, triglycerides and HOMA-IR were stratified by sex and we found significantly higher triglycerides, in males, and higher HOMA-IR in both sexes in 'Higher BMI growth' trajectory. All the differences were attenuated after adjustment for BMI at 21 years. Conclusions: In this long-term follow-up, we were able to identify two adiposity trajectories, statistically related to the BMI and cardiometabolic profile in adulthood. Our results also suggest that the impact of the adiposity trajectory on cardiometabolic profile is mediated by current BMI. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1007/s10597-006-9075-2,The Trauma Recovery Group: A Cognitive-Behavioral Program for Post-Traumatic Stress Disorder in Persons with Severe Mental Illness,"To address the problem of post-traumatic stress disorder (PTSD) in severe mental illness, the Trauma Recovery Group, a mixed gender cognitive-behavioral program, was developed and piloted at a community mental health center. The 21-week program includes breathing retraining, education about PTSD, cognitive restructuring, coping with symptoms, and making a recovery plan. Eighty clients were assessed at baseline and 41 provided follow-up data. Retention in the group was good: 59%. Treatment completers improved significantly in PTSD symptoms and diagnosis, depression, and post-traumatic cognitions, but dropouts did not. The results support the feasibility of the program and suggest it produces clinical benefits. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1016/j.acap.2015.07.004,Pediatric Adverse Childhood Experiences: Implications for Life Course Health Trajectories,"lems have their origins early in life. 1 The timing, intensity, and cumulative burden of adversities, especially in the relative absence of protective factors, can affect gene expression, the conditioning of stress responses, and the development of immune system function. Individuals affected by a high burden of adverse experiences may adopt compensatory high-risk behaviors that can further erode their health and mental health. Not all adversity occurs in childhood(eg,military combat),but a highburden of cumulative intrafamilial (child maltreatment, domestic violence, impaired caregiving) and other adversities (income and food insecurity) in childhood can have profound lifelong effects unless mitigated by protective factors within the family or the community, or through specific interventions. Two of the articles in this issue indicate that the impact of intrafamilial adverse childhood experiences (ACEs) on health and mental health begin to manifest in childhood. Kerker et al 2 used the nationally representative longitudinal National Survey of Child and Adolescent Well-Being study toassessthe ACEscoresofchildrenunder theageof6years who remained at home after child protective investigation and found they were similar to those of children who were removed and placed in foster/kinship care. The authors also reported that higher ACE scores in this population were associated with more mental health (Child Behavior Checklist score >64) and chronic medical problems, and, for preschool children, lower social scores. Earlier studies of children informally placed with kinship caregivers after child welfare investigation showed a high prevalence of health problems, although fewer mental health problems, compared to children in nonrelative foster care, indicating that almost all children involved with child welfare are at high risk for poor outcomes that may be rooted in cumulative childhood trauma. 3 In a second article in this issue, Thompson et al 4 used LONGSCAN longitudinal data to",0 +https://doi.org/10.1080/10253890802302908,Modulation of stress by imidazoline binding sites: Implications for psychiatric disorders,"In this review, we present evidence for the involvement of imidazoline binding sites (IBS) in modulating responses to stress, through central control of monoaminergic and hypothalamo-pituitary-adrenal (HPA) axis activity. Pharmacological and physiological evidence is presented for differential effects of different IBS subtypes on serotoninergic and catecholaminergic pathways involved in control of basal and stress-stimulated HPA axis activity. IBS ligands can modulate behavioural and neuroendocrine responses in animal models of stress, depression and anxiety, and a body of evidence exists for alterations in central IBS expression in psychiatric patients, which can be normalised partially or fully by treatment with antidepressants. Dysfunction in monoaminergic systems and the HPA axis under basal and stress-induced activation has been extensively reported in psychiatric illnesses. On the basis of the literature, we suggest a potential therapeutic role for selective IBS ligands in the treatment of depression and anxiety disorders.",0 +https://doi.org/10.1016/j.drugalcdep.2013.04.009,Factor structure of PTSD symptoms in opioid-dependent patients rating their overall trauma history,"The current standard for posttraumatic stress disorder (PTSD) diagnosis is a 3-factor model (re-experiencing, avoidance, and hyperarousal). Two 4-factor models of PTSD, the emotional numbing model (re-experiencing, avoidance, emotional numbing, and hyperarousal) and the dysphoria model (re-experiencing, avoidance, dysphoria, and hyperarousal), have considerable empirical support in the extant literature. However, a newer 5-factor model of PTSD has been introduced that is receiving interest. The 5-factor model differs from the four-factor models in its placement of three symptoms (irritability, sleep disturbance, and concentration difficulties) into a separate cluster termed dysphoric arousal. We empirically compared the theoretical factor structures of 3-, 4-, and 5-factor models of PTSD symptoms to find the best fitting model in a sample of opioid-dependent hospitalized patients.Confirmatory factor analyses were conducted on the 17 self-reported PTSD symptoms of the Posttraumatic Checklist - Civilian Version (PCL-C) in a sample of 151 men and women with opioid dependence.Both four-factor models fit the observed data better than the three-factor model of PTSD; the dysphoria model was preferred to the emotional numbing model in this sample. The recently introduced five-factor model fit the observed data better than either four factor model.PTSD is a heterogeneous disorder comprised of symptoms of re-experiencing, avoidance, numbing, and dysphoria. Three symptoms, irritability, sleep disturbance, and concentration difficulties, may represent a unique latent construct separate from these four symptom clusters in opioid-dependent populations who have experienced traumatic events.",0 +https://doi.org/10.1002/acp.3027,A Longitudinal Examination of Overgeneral Memory and Psychopathology in Children Following Recent Trauma Exposure,"Summary This study represents the first longitudinal examination of the trajectory of overgeneral memory (OGM) in children and how this relates to psychopathology immediately after trauma exposure. We recruited fifty 7- to 17-year-olds who had experienced an accidental injury that resulted in hospital admission. Assessment of psychological symptoms, OGM and cognitive processes proposed to drive OGM was completed at three points over a 6-month period post-trauma. We found that OGM was not related to depressive symptoms and that time since trauma exposure moderated the relationship between post-traumatic stress disorder symptoms and OGM. Although no relationship was found in the first 3 months following trauma, OGM was protective against post-traumatic stress disorder symptoms at 6 months post-trauma. Despite models of OGM (e.g. Williams et al., 2007) emphasising the role of rumination and executive control in explaining OGM, we found no evidence that they were related to OGM. Copyright © 2014 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1089/jwh.2007.0694,Using Mental Health Indicators to Identify Postdisaster Gender-Based Violence among Women Displaced by Hurricane Katrina,"Assessment of gender-based violence (GBV) among internally displaced persons (IDPs) is at best difficult. In complex humanitarian disasters, GBV inquiry can sometimes be dangerous and may lead to underestimation of the true prevalence. We developed a method of identifying women who have greater odds of having been exposed to postdisaster GBV (PDGBV) using mental health indicators.We systematically random sampled IDPs living in travel trailer parks in Louisiana and Mississippi and interviewed respondents using a health needs assessment survey during an 8-week period in April and May 2006. Women (n = 194) were screened for GBV and symptoms of depression.Women were on average 43.3 years old (range 18-85). Of the nine symptoms assessed with the Patient Health Questionnaire-9 (PHQ-9), four were associated with PDGBV. Among women with sleep dysregulation, the odds of PDGBV were 2.5 times higher in comparison with women without sleep dysregulation (95% CI 1.2-5.1). Appetite dysregulation increased the odds by 3.8 (95% CI 1.4-10.3), low self-esteem increased the odds by 2.3 (95% CI 1.2-4.6), and suicidal ideation increased the odds by 2.7 (95% CI 1.1-6.7). The internal consistency reliability of this symptom cluster was higher among women with PDGBV. Women screening positive on all four symptoms were 2.7 times more likely to have experienced PDGBV (95% CI 1.03-7.1).Several but not all symptoms of depression indicated exposure to PDGBV. Sleeping dysregulation, appetite dysregulation, low self-esteem, and suicidal ideation should be considered secondary indicators useful for identifying the prevalence of PDGBV exposure among female IDPs. This model may be useful for identifying women with exposure to PDGBV in settings where direct questioning may not be safe and reliable.",0 +https://doi.org/10.1016/j.pain.2010.10.014,Post-traumatic stress disorder moderates the relation between documented childhood victimization and pain 30 years later,"Cross-sectional designs and self-reports of maltreatment characterize nearly all the literature on childhood abuse or neglect and pain in adulthood, limiting potential for causal inference. The current study describes a prospective follow up of a large cohort of individuals with court-documented early childhood abuse or neglect (n=458) and a demographically matched control sample (n=349) into middle adulthood (mean age 41), nearly 30 years later, comparing the groups for risk of adult pain complaints. We examine whether Post-Traumatic Stress Disorder (PTSD) mediates or moderates risk of pain. Assessed prospectively across multiple pain measures, physically and sexually abused and neglected individuals generally showed a significant (p<.05) but notably small (η(2)=.01) increased risk of pain symptoms in middle adulthood. Although PTSD was associated with both childhood victimization (p<.01) and risk of middle adulthood pain (p<.001), it did not appear to mediate the relationship between victimization and pain. However, across all pain outcomes other than medically unexplained pain, PTSD robustly interacted with documented childhood victimization to predict adult pain risk: Individuals with both childhood abuse/neglect and PTSD were at significantly increased risk (p<.001, η(2) generally=.05-.06) of pain. After accounting for the combined effect of the two factors, neither childhood victimization nor PTSD alone predicted pain risk. Findings support a view that clinical pain assessments should focus on PTSD rather than make broad inquiries into past history of childhood abuse or neglect.",0 +,"[Influence of educational status, burn area and coping behaviors on the complication of psychological disorders in severely burned patients].","To discuss how the educational status, burn area and coping behaviors influence the psychological disorders in severely burned patients.Sixty-four severely burned patients hospitalized in Guangzhou Red Cross Hospital, Guangdong Provincial Work Injury Rehabilitation Center, and Guangdong General Hospital were enrolled with cluster random sampling method. Data of their demography and situation of burns were collected. Then their coping behavior, psychological disorders including anxiety, depression and post-traumatic stress disorder (PTSD) plus its core symptoms of flashback, avoidance, and hypervigilance were assessed by medical coping modes questionnaire, self-rating anxiety scale (SAS), self-rating depression scale (SDS), PTSD checklist-civilian version (PCL-C) respectively. Correlation was analyzed between demography, burn area, coping behavior and psychological disorders. The predictive powers of educational status, burn area and coping behaviors on the psychological disorders were analyzed. The qualitative variables were assigned values. Data were processed with t test, Spearman rank correlation analysis, and multiple linear regression analysis.(1) The patients scored (19.0 ± 3.4) points in confrontation coping behavior, which showed no statistically significant difference from the domestic norm score (19.5 ± 3.8) points (t = -1.13, P > 0.05). The patients scored (16.6 ± 2.4) and (11.0 ± 2.2) points in avoidance and resignation coping behaviors, which were significantly higher than the domestic norm score (14.4 ± 3.0), (8.8 ± 3.2) points (with t values respectively 7.06 and 7.76, P values both below 0.01). The patients' standard score of SAS, SDS, PCL-C were (50 ± 11), (54 ± 11), and (38 ± 12) points. Respectively 89.1% (57/64), 60.9% (39/64), 46.9% (30/64) of the patients showed anxiety, depression, and PTSD symptoms. (2) Four independent variables: age, gender, marital status, and time after burns, were correlated with the psychological disorders, but the correlativity was not statistically significant (with rs values from -0.089 to 0.245, P values all above 0.05). Educational status was significantly negatively correlated with anxiety, depression, PTSD and its core symptoms of flashback, avoidance (with rs values from -0.361 to -0.253, P values all below 0.05). Educational status was negatively correlated with hypervigilance, but the correlativity was not statistically significant (rs = -0.187, P > 0.05). Burn area was significantly positively correlated with the psychological disorders (with rs values from 0.306 to 0.478, P values all below 0.05). Confrontation coping behavior was positively correlated with the psychological disorders, but the correlativity was not statistically significant (with rs values from 0.121 to 0.550, P values all above 0.05). Avoidance coping behavior was correlated with the psychological disorders, but the correlativity was not statistically significant (with rs values from -0.144 to 0.193, P values all above 0.05). Resignation coping behavior was significantly positively correlated with the psychological disorder (with rs values from 0.377 to 0.596, P values all below 0.01). (3) Educational status had predictive power on the anxiety, PTSD and flash back symptoms of patients (with t values from -2.19 to -2.02, P values all below 0.05), but not on depression, avoidance and hypervigilance (with t values from -1.95 to -0.99, P values all above 0.05). Burn area had no predictive power on the psychological disorders (with t values from 0.55 to 1.78, P values all above 0.05). Resignation coping behavior had predictive power on the psychological disorders (with t values from 3.10 to 6.46, P values below 0.01). Confrontation and avoidance coping behaviors had no predictive power on the psychological disorders (with t values from 0.46 to 2.32 and -0.89 and 1.75 respectively, P values all above 0.05).The severely burned patients with lower educational status, larger burn area, and the more frequently adapted resignation coping behavior are more likely to suffer from anxiety, depression, and PTSD.",0 +https://doi.org/10.1016/j.jpsychires.2014.08.017,Quantitative forecasting of PTSD from early trauma responses: A Machine Learning application,"There is broad interest in predicting the clinical course of mental disorders from early, multimodal clinical and biological information. Current computational models, however, constitute a significant barrier to realizing this goal. The early identification of trauma survivors at risk of post-traumatic stress disorder (PTSD) is plausible given the disorder's salient onset and the abundance of putative biological and clinical risk indicators. This work evaluates the ability of Machine Learning (ML) forecasting approaches to identify and integrate a panel of unique predictive characteristics and determine their accuracy in forecasting non-remitting PTSD from information collected within 10 days of a traumatic event. Data on event characteristics, emergency department observations, and early symptoms were collected in 957 trauma survivors, followed for fifteen months. An ML feature selection algorithm identified a set of predictors that rendered all others redundant. Support Vector Machines (SVMs) as well as other ML classification algorithms were used to evaluate the forecasting accuracy of i) ML selected features, ii) all available features without selection, and iii) Acute Stress Disorder (ASD) symptoms alone. SVM also compared the prediction of a) PTSD diagnostic status at 15 months to b) posterior probability of membership in an empirically derived non-remitting PTSD symptom trajectory. Results are expressed as mean Area Under Receiver Operating Characteristics Curve (AUC). The feature selection algorithm identified 16 predictors, present in ≥ 95% cross-validation trials. The accuracy of predicting non-remitting PTSD from that set (AUC = .77) did not differ from predicting from all available information (AUC = .78). Predicting from ASD symptoms was not better then chance (AUC = .60). The prediction of PTSD status was less accurate than that of membership in a non-remitting trajectory (AUC = .71). ML methods may fill a critical gap in forecasting PTSD. The ability to identify and integrate unique risk indicators makes this a promising approach for developing algorithms that infer probabilistic risk of chronic posttraumatic stress psychopathology based on complex sources of biological, psychological, and social information.",0 +https://doi.org/10.1007/978-3-319-18866-9_1,"Traumatic Stress in Overview: Definition, Context, Scope, and Long-Term Outcomes","Trauma in the form of natural disasters, war, and other catastrophic events is ubiquitous. Exposure to traumatic events has been recognized as part of the human experience and has the potential to impact subsequent development across the life span, although individual responses to trauma vary widely. In this chapter, we discuss common sources of trauma and their long-term impacts from the perspective of conservation of resources (COR) theory. In brief, COR theory posits that traumatic stress is a dynamic psychological process that occurs in response to the rapid and often momentous loss of key valued resources. COR theory corollaries include the notions that loss is developmental and tends to occur in negative spirals, the impact of loss outweighs the positive impact of gain, and individuals with fewer reserves of resources are more sensitive to loss and gain (Hobfoll, Stress, culture, and community: The psychology and philosophy of stress, 2004). Common reactions to trauma such as posttraumatic stress disorder (PTSD) are introduced with an emphasis on how reactions unfold over time. Moreover, these reactions interact with the broader social context to produce cycles of loss observed at the individual, community, and cultural levels.",0 +https://doi.org/10.1523/jneurosci.3565-07.2007,Stress and Disease: Is Being Female a Predisposing Factor?,"Does heightened stress sensitivity predispose an individual toward disease? Our Society for Neuroscience mini-symposium examines the link between stress and disease onset, exploring sex differences and whether there is an increased female predisposition. This session specifically addresses the",0 +https://doi.org/10.1016/j.psychres.2010.10.034,Protective factors for posttraumatic stress disorder symptoms in a prospective study of police officers,"Although police officers are frequently exposed to potentially traumatic incidents, only a minority will develop chronic posttraumatic stress disorder (PTSD). Identifying and understanding protective factors could inform the development of preventive interventions; however, few studies have examined this. In the present prospective study, 233 police officers were assessed during academy training and again following 2 years of police service. Caucasian race, less previous trauma exposure, and less critical incident exposure during police service as well as greater sense of self-worth, beliefs of greater benevolence of the world, greater social support and better social adjustment, all assessed during academy training, were associated with lower PTSD symptoms after 2 years of service. Positive personality attributes assessed during training with the NEO Five-Factor Personality Inventory were not associated with lower PTSD symptoms. In a hierarchical linear regression model, only Caucasian race, lower critical incident exposure during police service, greater assumptions of benevolence of the world and better social adjustment during training remained predictive of lower PTSD symptoms after 2 years of police service. These results suggest that positive world assumptions and better social functioning during training may protect police officers from critical incident related PTSD.",0 +https://doi.org/10.1080/08975353.2014.910031,Intervening With Immigrant Families: An Integrative Systems Perspective,"Give me your tired, your poor,Your huddled masses yearning to breathe free.The wretched refuse of your teeming shore.Send these, the homeless, tempest-tossed to me.I lift my lamp beside the golden door!(Emma Lazarus, New Colossus, 1883; embossed on the plaque mounted inside the pedestal of the Statue of Liberty)One of the massive trends affecting a myriad of families that has accelerated around the world in the past three and a half decades is immigration—with scores of people leaving their homelands to move to countries they hope will be safer and provide a less turbulent environment in which to reside and raise their families. Such families often encounter enormous problems in their new and sometimes ethnocentric, uninviting, even to the point of hostile environments. In this article, some of the problems and issues encountered and ways therapists can enhance client families’ understanding of their situation, their feelings about it, and how better to cope and problem solve will be explored from an inte...",0 +https://doi.org/10.4088/jcp.14m09075,Longitudinal Analysis of Latent Classes of Psychopathology and Patterns of Class Migration in Survivors of Severe Injury,"Little research to date has explored the typologies of psychopathology following trauma, beyond development of particular diagnoses such as posttraumatic stress disorder (PTSD). The objective of this study was to determine the longitudinal patterns of these typologies, especially the movement of persons across clusters of psychopathology.In this 6-year longitudinal study, 1,167 hospitalized severe injury patients who were recruited between April 2004-February 2006 were analyzed, with repeated measures at baseline, 3 months, 12 months, and 72 months after injury. All patients met the DSM-IV criterion A1 for PTSD. Structured clinical interviews were used to assess psychiatric disorders at each follow-up point. Latent class analysis and latent transition analysis were applied to assess clusters of individuals determined by psychopathology. The Mini International Neuropsychiatric Interview (MINI) and Clinician-Administered PTSD Scale (CAPS) were employed to complete diagnoses.Four latent classes were identified at each time point: (1) Alcohol/Depression class (3 months, 2.1%; 12 months, 1.3%; and 72 months, 1.1%), (2) Alcohol class (3 months, 3.3%; 12 months, 3.7%; and 72 months, 5.4%), (3) PTSD/Depression class (3 months, 10.3%; 12 months, 11.5%; and 72 months, 6.4%), and (4) No Disorder class (3 months, 84.2%; 12 months, 83.5%; and 72 months, 87.1%). Latent transition analyses conducted across the 2 transition points (12 months and 72 months) found consistently high levels of stability in the No Disorder class (90.9%, 93.0%, respectively) but lower and reducing levels of consistency in the PTSD/Depression class (81.3%, 46.6%), the Alcohol/Depression class (59.7%, 21.5%), and the Alcohol class (61.0%, 36.5%), demonstrating high levels of between-class migration.Despite the array of psychiatric disorders that may develop following severe injury, a 4-class model best described the data with excellent classification certainty. The high levels of migration across classes indicate a complex pattern of psychopathology expression over time. The findings have considerable implications for tailoring multifocused interventions to class type, as well as flexible stepped care models, and for the potential development and delivery of transdiagnostic interventions targeting underlying mechanisms.",0 +https://doi.org/10.1016/j.pain.2012.03.007,Does injury compensation lead to worse health after whiplash? A systematic review,"One might expect that injury would leave injured parties better off than they would otherwise have been, yet many believe that does more harm than good. This study systematically reviews the evidence on this compensation hypothesis in relation to compensable whiplash injuries. PubMed, CINAHL, EMBASE, PEDro, PsycInfo, CCTR, Lexis, and EconLit were searched from the date of their inception to April 2010 to locate longitudinal studies, published in English, comparing the health outcomes of adults exposed/not exposed to compensation-related factors. Studies concerning serious neck injuries, using claimants only, or using proxy measures of health outcomes were excluded. Eleven studies were included. These examined the effect of lawyer involvement, litigation, claim submission, or previous claims on pain and other health outcomes. Among the 16 results reported were 9 statistically significant negative associations between compensation-related factors and health outcomes. Irrespective of the compensation-related factor involved and the health outcome measured, the quality of these studies was similar to studies that did not find a significant negative association: most took some measures to address selection bias, confounding, and measurement bias, and none resolved the potential for reverse causality bias that arises in the relationship between compensation-related factors and health. Unless ambiguous causal pathways are addressed, one cannot draw conclusions from statistical associations, regardless of their statistical significance and the extent of measures to address other sources of bias. Consequently, there is no clear evidence to support the idea that and its related processes lead to worse health.",0 +https://doi.org/10.1142/s0219635205000719,INTEGRATIVE ASSESSMENT OF BRAIN AND COGNITIVE FUNCTION IN POST-TRAUMATIC STRESS DISORDER,"The present study combined neuropsychological and electrophysiological measures to obtain a comprehensive profile of the everyday attentional and memory dysfunction reported in PTSD. The event-related potential (ERP) literature has consistently found abnormalities in late components (N2, P3) reflecting working memory (WM) function. However, the neuropsychological profile reported in the literature has considerable variation. The present study examined ERP activity in 33 PTSD participants and matched controls during a standard two-tone auditory oddball task. Neuropsychological assessment was carried out using a task battery assessing a wide range of cognitive functions. Consistent with previous work, the PTSD group showed delayed N2 latency and reduced P3 target amplitude, together with slower and less accurate target detection. Scalp topography provided evidence of widespread abnormality during WM function, but with strongest effects broadly over the left hemisphere. Neuropsychological testing found concomitant difficulties on factorial measures of verbal memory retention/access and sustained attention but enhanced performance on measures of immediate recall. This integrative pattern of effects reflects a specific impairment in the operation of working memory systems that guide ongoing, planned behavior and that facilitate the acquisition and retention of new memories.",0 +https://doi.org/10.1080/13548506.2011.579991,HIV infection associated post-traumatic stress disorder and post-traumatic growth – A systematic review,"The phenomenon of post-traumatic stress has been well documented in the literature as a lasting mental health condition associated with exposure to traumatic life events. The diagnosis and experience of human immunodeficiency virus (HIV) disease may be such a trauma. On the other hand, the phenomenon of post-traumatic growth (PTG) has been described, whereby people show positive mental health growth in the face of such trauma. This systematic review was set out to explore post-traumatic stress disorder (PTSD) and PTG in people with HIV to monitor prevalence, measurement and efficacy of interventions to reduce stress and/or promote growth. Standardised review techniques were used to track reports on both PTSD and PTG. A total of 206 papers were retrieved from the PTSD and HIV searches, and 13 from the PTG and HIV searches. After reviewing the papers for inclusion according to adequacy and relevance criteria and to remove duplicates, 33 PTSD papers and three PTG were available for full coding. Prevalence of PTSD in HIV ranged from 5% to 74%, which were much greater than the 7-10% in the general population. Seven studies showed a relation between trauma and PTSD, while six showed a link between PTSD diagnosis and reduced antiretroviral treatment adherence. Women were more likely to be diagnosed with PTSD. Only three intervention reports were identified that fitted our inclusion criteria. All of these reported on psychological interventions for HIV+ individuals with trauma. The interventions utilised HIV education, training in coping techniques and support groups. Only coping interventions were shown to be effective. PTG was under researched but showed a promising avenue of study. There needs to be harmonised measurement and the evidence base would need strengthening in order to build on the understanding of the impact of PTSD and PTG over the course of HIV disease. There is good evidence to associate HIV diagnosis and experiences during the course of illness as traumatic. PTSD has been shown to be prevalent and there seems to be good evidence to incorporate standardised measures to track the course of the disorder. There is extremely limited evidence that interventions may affect the course of symptom experience. The evidence and insight into PTG show promise but is currently inadequate.",0 +https://doi.org/10.1097/ta.0b013e31822a30b8,A Prospective Longitudinal Study of Posttraumatic Stress Disorder Symptom Trajectories After Burn Injury,"Psychologic problems are common after burns, and symptoms of posttraumatic stress disorder (PTSD) are some of the most prevalent. Risk factors for PTSD have been identified, but little is known about the onset and course of these symptoms. The objective was to investigate whether there are different PTSD symptom trajectories after burns.Ninety-five adults with burns were enrolled in a prospective study from in-hospital treatment until 12 months after burn. Symptoms of PTSD were assessed with the Impact of Event Scale-Revised and scores at 3, 6, and 12 months after the burn were used in a cluster analysis to detect trajectories. The trajectories were compared regarding known risk factors for PTSD using non-parametric analysis of variance.Four clusters were identified: (1) resilient, with low levels of PTSD symptoms that decreased over time; (2) recovery, with high levels of symptoms that gradually decreased; (3) delayed, with moderate symptoms that increased over time; and (4) chronic, with high levels of symptoms over time. The trajectories differed regarding several risk factors for PTSD including life events, premorbid psychiatric morbidity, personality traits, avoidant coping, in-hospital psychologic symptoms, and social support. The resilient trajectory consistently had fewer of the risk factors and differed the most from the chronic trajectory.There are subgroups among patients with burns that have different patterns of PTSD symptom development. These findings may have implications for clinical practice, such as the timing of assessment and the management of patients who present with these symptoms.",0 +https://doi.org/10.1016/j.jpsychires.2015.09.011,Amygdala response predicts trajectory of symptom reduction during Trauma-Focused Cognitive-Behavioral Therapy among adolescent girls with PTSD,"Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is the gold standard treatment for pediatric PTSD. Nonetheless, clinical outcomes in TF-CBT are highly variable, indicating a need to identify reliable predictors that allow forecasting treatment response. Here, we test the hypothesis that functional neuroimaging correlates of emotion processing predict PTSD symptom reduction during Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) among adolescent girls with PTSD. Thirty-four adolescent girls with PTSD related to physical or sexual assault were enrolled in TF-CBT, delivered in an approximately 12 session format, in an open trial. Prior to treatment, they were engaged in an implicit threat processing task during 3T fMRI, during which they viewed faces depicting fearful or neutral expressions. Among adolescent girls completing TF-CBT (n = 23), slopes of PTSD symptom trajectories during TF-CBT were significantly related to pre-treatment degree of bilateral amygdala activation while viewing fearful vs neutral images. Adolescents with less symptom reduction were characterized by greater amygdala activation to both threat and neutral images (i.e., less threat-safety discrimination), whereas adolescents with greater symptom reduction were characterized by amygdala activation only to threat images. These clinical outcome relationships with pre-treatment bilateral amygdala activation remained when controlling for possible confounding demographic or clinical variables (e.g., concurrent psychotropic medication, comorbid diagnoses). While limited by a lack of a control group, these preliminary results suggest that pre-treatment amygdala reactivity to fear stimuli, a component of neurocircuitry models of PTSD, positively predicts symptom reduction during TF-CBT among assaulted adolescent girls, providing support for an objective measure for forecasting treatment response in this vulnerable population.",0 +https://doi.org/10.1016/j.chc.2005.11.008,Mental Health Problems in Juvenile Justice Populations,"The limited literature on mental health problems in juvenile justice population has reported that most youth in juvenile justice hold psychiatric pathology. Although conduct disorder and substance abuse are the most prevalent conditions in this population, many other diagnoses can be found at alarmingly high rates; research on other diagnoses (eg, autism, psychosis) is limited. This finding underscores the necessity of implementing adequate diagnostic assessment within forensic settings and of developing interventions programs that take into account the presence of psychiatric problems.",0 +https://doi.org/10.1186/1471-244x-8-38,Factors associated with post-traumatic stress disorder and depression amongst internally displaced persons in northern Uganda,"The 20 year war in northern Uganda between the Lord's Resistance Army and the Ugandan government has resulted in the displacement of up to 2 million people within Uganda. The purpose of the study was to measure rates of post-traumatic stress disorder (PTSD) and depression amongst these internally displaced persons (IDPs), and investigate associated demographic and trauma exposure risk factors.A cross-sectional multi-staged, random cluster survey with 1210 adult IDPs was conducted in November 2006 in Gulu and Amuru districts of northern Uganda. Levels of exposure to traumatic events and PTSD were measured using the Harvard Trauma Questionnaire (original version), and levels of depression were measured using the Hopkins Symptom Checklist-25. Multivariate logistic regression was used to analyse the association of demographic and trauma exposure variables on the outcomes of PTSD and depression.Over half (54%) of the respondents met symptom criteria for PTSD, and over two thirds (67%) of respondents met symptom criteria for depression. Over half (58%) of respondents had experienced 8 or more of the 16 trauma events covered in the questionnaire. Factors strongly linked with PTSD and depression included gender, marital status, distance of displacement, experiencing ill health without medical care, experiencing rape or sexual abuse, experiencing lack of food or water, and experiencing higher rates of trauma exposure.This study provides evidence of exposure to traumatic events and deprivation of essential goods and services suffered by IDPs, and the resultant effect this has upon their mental health. Protection and social and psychological assistance are urgently required to help IDPs in northern Uganda re-build their lives.",0 +https://doi.org/10.1002/jts.20333,A confirmatory factor analysis of the acute stress disorder interview,"Acute stress disorder (ASD) was introduced in 1994 to describe posttraumatic stress reactions that occur in the initial month after trauma exposure. Although it comprises the distinct symptom clusters of dissociation, reexperiencing, avoidance, and arousal, there have been no confirmatory factor analyses of the construct. In this study, 587 individuals admitted to five major hospitals after traumatic injury were administered the Acute Stress Disorder Interview. Forty-four participants met criteria for ASD. Confirmatory factor analysis based on the four symptom clusters described the Acute Stress Disorder Interview responses. These data provide the first confirmatory factor analysis of the ASD symptoms, and are discussed in terms of the 4-factor models repeatedly found in samples of chronic posttraumatic stress disorder.",0 +https://doi.org/10.1097/psy.0b013e31824f888f,Combat-Exposed War Veterans at Risk for Suicide Show Hyperactivation of Prefrontal Cortex and Anterior Cingulate During Error Processing,"Suicide is a significant public health problem. Suicidal ideation (SI) increases the risk for completed suicide. However, the brain basis of SI is unknown. The objective of this study was to examine the neural correlates of self-monitoring in individuals at risk for suicide. We hypothesized that combat veterans with a history of SI relative to those without such a history would show altered activation in the anterior cingulate cortex and related circuitry during self-monitoring.Two groups of combat-exposed war veterans (13 men with and 13 men without history of SI) were studied. Both the SI and non-SI participants had two or more of the following: a) current major depressive disorder, b) current posttraumatic stress disorder, and c) history of mild traumatic brain injury, and each subject performed a validated stop task during functional magnetic resonance imaging. Error-related activation was compared between the SI and non-SI groups.The SI group demonstrated more error-related activation of the anterior cingulate (8256 mm(3), t = 2.51) and prefrontal cortex (i.e., clusters >2048 mm(3), voxelwise p < .05). The SI and non-SI participants showed similar behavioral task performance (i.e., mean error rate, F values < 0.63, p values > .43; and mean reaction times, F = 0.27, p = .61).These findings suggest neural correlates of altered self-monitoring in individuals with a history of SI and may further suggest that functional magnetic resonance imaging could be used to identify individuals at risk for suicide before they engage in suicidal behavior.",0 +,The study of intensity and frequency of posttraumatic stress disorder (PTSD) resulting from war in Ilam city,"Post-traumatic stress disorder (PTSD) is a set of a person's reactions to stresses which are beyond one's mental capacity and precedes a severe stress. The aim of this Research was to study the intensity and frequency of posttraumatic stress disorder (PTSD) resulting from war in Ilam city. This descriptive- analytic study was investigated the PTSD among the residents of Ilam city who were involved directly or indirectly in the war issues. The sample size was 5110 people chosen through cluster sampling technique. Data were analyzed through statistical methods such as K2 test, t-test, linear regression test, and variance analysis in SPSS software. The results of the study revealed that 26 of the cases who had residence background in Ilam city during Iraqi war against Iran suffered from mental disorder (PTSD). Most of these patients were married, illiterate, or primary educated people and mostly the young and middle aged housewives. The war-induced posttraumatic stress disorder has had negative effects on different aspects of Ilam city residents' health. Therefore, identifying the vulnerable groups to apply medical treatment seemed important and necessary.",0 +https://doi.org/10.1093/jpepsy/jsv068,Predictors of Posttraumatic Stress Symptom Trajectories in Parents of Children Exposed to Motor Vehicle Collisions,"Following child trauma, parents are at risk of developing posttraumatic stress disorder (PTSD), either owing to their direct involvement or from hearing of their child's involvement. Despite the potential impact of a parent's development of PTSD on both the parent and child, little is known about what may place a parent at increased risk.PTSD symptoms were assessed ≤ 4 weeks, 6 months, and 3 years post-trauma, along with a range of potential risk factors, in a sample of parents of 2-10-year-old children who were involved in a motor vehicle collision.Two symptom trajectories were identified: Those parents whose symptoms remained low across all time points and those whose symptoms remained elevated at 6 months post-trauma and declined by 3 years. Subjective threat, thought suppression, and maladaptive cognitions about damage to the child were identified as key predictors of poorer outcomes.",1 +https://doi.org/10.1192/bjp.180.3.205,Impact of Event Scale: psychometric properties,"Background For more than 20 years, the Impact of Event Scale (IES) has been widely used as a measure of stress reactions after traumatic events. Aims To review studies that evaluated the IES's psychometric properties. Method Literature review. Results The results indicated that the IES's two-factor structure is stable over different types of events, that it can discriminate between stress reactions at different times after the event, and that it has convergent validity with observer-diagnosed post-traumatic stress disorder. The use of IES in many psychopharmacological trials and outcome studies is supportive of the measure's clinical relevance. Conclusions The IES is a useful measure of stress reactions after a range of traumatic events, and it is valuable for detecting individuals who require treatment.",0 +https://doi.org/10.1016/s0010-440x(97)90059-6,Psychophysiologic assessment of mental imagery of stressful events in israeli civilian posttraumatic stress disorder patients,"This study explored the physiological responses of posttraumatic stress disorder (PTSD) patients to reminders of a stressful event that had preceded the onset of their illness and was not related to its cause: the SCUD missile alarms of the Gulf War. A mental-imagery technique used in previous studies of PTSD was used. Three 30-second audiotapes were presented to each subject, including (1) the Gulf War's missile alarm, (2) a radio announcement of a terrorist attack, and (3) a standardized relaxing scene. Subjects were instructed to imagine each event as vividly as possible while heart rate (HR), skin conductance (SC), and left lateral frontalis electromyogram (EMG) responses were measured. The responses of 12 outpatients with PTSD were compared with those of panic disorder patients (n = 11), survivors of traumatic events who had not developed PTSD (n = 9), and mentally healthy subjects with no lifetime history of major trauma (n = 19). Multivariate analysis of variance (MANOVA) for the three physiological measures showed a significant group difference during imagery of the Gulf War alarm, with PTSD subjects showing higher SC and EMG responses than the others. The differences remained significant when age, level of distress during the war, and concurrent anxiety were controlled for. There were no group differences in responses to the other stimuli. We conclude that, PTSD patients may either acquire and maintain prolonged conditioned responses to various stressors during their life span or become sensitized to reminders of past traumata following the onset of their illness. Heightened conditionability may be expressed before the trauma in subjects who are liable to develop PTSD.",0 +https://doi.org/10.1001/jamapsychiatry.2013.1137,A Multisite Analysis of the Fluctuating Course of Posttraumatic Stress Disorder,"Delayed-onset posttraumatic stress disorder (PTSD) accounts for approximately 25% of PTSD cases. Current models do not adequately explain the delayed increases in PTSD symptoms after trauma exposure.To test the roles of initial psychiatric reactions, mild traumatic brain injury (MTBI), and ongoing stressors on delayed-onset PTSD.In this prospective cohort study, patients were selected from recent admissions to 4 major trauma hospitals across Australia. A total of 1084 traumatically injured patients were assessed during hospital admission from April 1, 2004, through February 28, 2006, and 785 (72.4%) were followed up at 3, 12, and 24 months after injury.Severity of PTSD was determined at each assessment with the Clinician-Administered PTSD Scale.Of those who met PTSD criteria at 24 months, 44.1% reported no PTSD at 3 months and 55.9% had subsyndromal or full PTSD. In those who displayed subsyndromal or full PTSD at 3 months, PTSD severity at 24 months was predicted by prior psychiatric disorder, initial PTSD symptom severity, and type of injury. In those who displayed no PTSD at 3 months, PTSD severity at 24 months was predicted by initial PTSD symptom severity, MTBI, length of hospitalization, and the number of stressful events experienced between 3 and 24 months.These data highlight the complex trajectories of PTSD symptoms over time. This study also points to the roles of ongoing stress and MTBI in delayed cases of PTSD and suggests the potential of ongoing stress to compound initial stress reactions and lead to a delayed increase in PTSD symptom severity. This study also provides initial evidence that MTBI increases the risk of delayed PTSD symptoms, particularly in those with no acute symptoms.",0 +https://doi.org/10.1093/jpepsy/jsj058,Posttraumatic Growth in Adolescent Survivors of Cancer and Their Mothers and Fathers,"To describe posttraumatic growth (PTG) following childhood cancer survival and its association with demographic and disease/treatment variables, perceived treatment severity and life threat, and posttraumatic stress symptoms (PTSS).Adolescent survivors of cancer (N = 150, ages 11-19), at least 1 year after treatment, and their mothers (N = 146) and fathers (N = 107) completed self-report measures of perceived treatment intensity and PTSS and a semistructured interview designed to identify posttraumatic responses and indicators of PTG including perceived positive changes for self, relationships, and life goals.A majority of adolescents and their mothers and fathers reported PTG. Greater perceived treatment severity and life threat, but not objective disease severity, was associated with PTG. PTG and PTSS were positively associated for the adolescent cancer survivors. Diagnosis after age 5 resulted in more perceived benefit and greater PTSS for adolescent survivors.Clarification of the concept and measurement of PTG after childhood cancer is warranted, as are prospective studies of the association of PTG and PTSS and the role of demographic variables and illness-specific appraisals.",0 +https://doi.org/10.1037/a0022196,Posttraumatic stress disorder and intimate relationship problems: A meta-analysis.,"The authors conducted a meta-analysis of empirical studies investigating associations between indices of posttraumatic stress disorder (PTSD) and intimate relationship problems to empirically synthesize this literature.A literature search using PsycINFO, Medline, Published International Literature on Traumatic Stress (PILOTS), and Dissertation Abstracts was performed. The authors identified 31 studies meeting inclusion criteria.True score correlations (ρ) revealed medium-sized associations between PTSD and intimate relationship discord (ρ = .38, N = 7,973, K = 21), intimate relationship physical aggression perpetration (ρ = .42, N = 4,630, K = 19), and intimate relationship psychological aggression perpetration (ρ = .36, N = 1,501, K = 10). The strength of the association between PTSD and relationship discord was higher in military (vs. civilian) samples, and when the study was conducted in the United States (vs. other country), and the study represented a doctoral dissertation (vs. published article). The strength of the association between PTSD and physical aggression was higher in military (vs. civilian) samples, males (vs. females), community (vs. clinical) samples, studies examining PTSD symptom severity (vs. diagnosis), when the physical aggression measure focused exclusively on severe violence (vs. a more inclusive measure), and the study was published (vs. dissertation). For the PTSD-psychological aggression association, 98% of the variance was accounted for by methodological artifacts such as sampling and measurement error; consequently, no moderators were examined in this relationship.Findings highlight a need for the examination of models explaining the relationship difficulties associated with PTSD symptomatology and interventions designed to treat problems in both areas.",0 +https://doi.org/10.1080/13284200903353072,Analysis of suicidal behaviour in Israeli veterans and terror victims with post-traumatic stress disorder by using the computerised Gottschalk–Gleser scales,"Abstract The primary objective of this study was to identify the vulnerability factors for suicide attempts in an Israeli sample, with the help of the Gottschalk–Gleser content analysis scales. The respondents were divided into four groups: suicide attempters; controls; post-traumatic stress disorder and depressed patients who did not report suicidal behaviour; and suicide ideators. The significant results represent conscious and unconscious psychological states, which suicide attempters have in common and can be seen as potential suicide risk factors. The main recurring risk-related themes are hopelessness, sickness, deterrents, frustrated dependency strivings, total anxiety and total depression.",0 +https://doi.org/10.3402/ejpt.v6.27515,Applications of Latent Growth Mixture Modeling and allied methods to posttraumatic stress response data,"Scientific research into mental health outcomes following trauma is undergoing a revolution as scientists refocus their efforts to identify underlying dimensions of health and psychopathology. This effort is in stark contrast to the previous focus which was to characterize individuals based on Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic status (Insel et al., 2010). A significant unresolved issue underlying this shift is how to characterize clinically relevant populations without reliance on the categorical definitions provided by the DSM. Classifying individuals based on their pattern of stress adaptation over time holds significant promise for capturing inherent inter-individual heterogeneity as responses including chronicity, recovery, delayed onset, and resilience can only be determined longitudinally (Galatzer-Levy & Bryant, 2013) and then characterizing these patterns for future research (Depaoli, Van de Schoot, Van Loey, & Sijbrandij, 2015). Such an approach allows for the identification of phenominologically similar patterns of response to diverse extreme environmental stressors (Bonanno, Kennedy, Galatzer-Levy, Lude, & Elfstom, 2012; Galatzer-Levy & Bonanno, 2012; Galatzer-Levy, Brown, et al., 2013; Galatzer-Levy, Burton, & Bonanno, 2012) including translational animal models of stress adaptation (Galatzer-Levy, Bonanno, Bush, & LeDoux, 2013; Galatzer-Levy, Moscarello, et al., 2014). The empirical identification of heterogeneous stress response patterns can increase the identification of mechanisms (Galatzer-Levy, Steenkamp, et al., 2014), consequences (Galatzer-Levy & Bonanno, 2014), treatment effects (Galatzer-Levy, Ankri, et al., 2013), and prediction (Galatzer-Levy, Karstoft, Statnikov, & Shalev, 2014) of individual differences in response to trauma.METHODological and theoretical considerations for the application of Latent Growth Mixture Modeling (LGMM) and allied methods such as Latent Class Growth Analysis (LCGA) for the identification of heterogeneous populations defined by their pattern of change over time will be presented (Van De Schoot, 2015). Common pitfalls including non-identification, over identification, and issues related to model specification will be discussed as well as the benefits of applying such methods along with the theoretical grounding of such approaches.LGMM and allied methods have significant potential for improving the science of stress pathology as well as our understanding of healthy adaptation (resilience).",0 +https://doi.org/10.1017/s1092852900019118,Abuse and Neglect in Childhood: Relationship to Personality Disorder Diagnoses,"Childhood history of abuse and neglect has been associated with personality disorders and has been observed in subjects with lifetime histories of suicidality and self-injury. Most of these findings have been generated from inpatient clinical samples.This study evaluated self-rated indices of sustained childhood abuse and neglect in an outpatient sample of well-characterized personality disorder subjects (n=182) to determine the relative associations of childhood trauma indices to specific personality disorder diagnoses or clusters and to lifetime history of suicide attempts or gestures. Subjects met criteria for ~2.5 Axis II diagnoses and 24% reported past suicide attempts. The Childhood Trauma Questionnaire was administered to assess five dimensions of childhood trauma exposure (emotional, physical, and sexual abuse, and emotional and physical neglect). Logistic regression was employed to evaluate salient predictors among the trauma measures for each cluster, personality disorder, and history of attempted suicide and self-harm. All analyses controlled for gender distribution.Seventy-eight percent of subjects met dichotomous criteria for some form of childhood trauma; a majority reported emotional abuse and neglect. The dichotomized criterion for global trauma severity was predictive of cluster B, borderline, and antisocial personality disorder diagnoses. Trauma scores were positively associated with cluster A, negatively with cluster C, but were not significantly associated with cluster B diagnoses. Among the specific diagnoses comprising cluster A, paranoid disorder alone was predicted by sexual, physical, and emotional abuse. Within cluster B, only antisocial personality disorder showed significant associations with trauma scores, with specific prediction by sexual and physical abuse. For borderline personality disorder, there were gender interactions for individual predictors, with emotional abuse being the only significant trauma predictor, and only in men. History of suicide gestures was associated with emotional abuse in the entire sample and in women only; self-mutilatory behavior was associated with emotional abuse in men.These results suggest that childhood emotional abuse and neglect are broadly represented among personality disorders, and associated with indices of clinical severity among patients with borderline personality disorder. Childhood sexual and physical abuse are highlighted as predictors of both paranoid and antisocial personality disorders. These results help qualify prior observations of the association of childhood sexual abuse with borderline personality disorder.",0 +https://doi.org/10.1097/00005053-199905000-00006,Postconcussive Symptoms and Posttraumatic Stress Disorder after Mild Traumatic Brain Injury,"Postconcussive symptoms after mild traumatic brain injury (MTBI) may be exacerbated by anxiety associated with posttraumatic stress. The aim of this study was to investigate the relationship between postconcussive symptoms and posttraumatic stress disorder (PTSD) in an MTBI population. Survivors of motor vehicle accidents who either sustained an MTBI (N = 46) or no TBI (N = 59) were assessed 6 months posttrauma for PTSD and postconcussive symptoms. Postconcussive symptoms were more evident in MTBI patients with PTSD than those without PTSD, and in MTBI patients than non-TBI patients. Further, postconcussive symptoms were significantly correlated with PTSD symptoms. These findings indicate that postconcussive symptoms may be mediated by an interaction of neurological and psychological factors after MTBI.",0 +https://doi.org/10.1002/da.22465,PTSD SYMPTOMS ACROSS PREGNANCY AND EARLY POSTPARTUM AMONG WOMEN WITH LIFETIME PTSD DIAGNOSIS,"Little is known about trajectories of PTSD symptoms across the peripartum period in women with trauma histories, specifically those who met lifetime PTSD diagnoses prior to pregnancy. The present study seeks to identify factors that influence PTSD symptom load across pregnancy and early postpartum, and study its impact on postpartum adaptation.The current study is a secondary analysis on pregnant women with a Lifetime PTSD diagnosis (N = 319) derived from a larger community sample who were interviewed twice across pregnancy (28 and 35 weeks) and again at 6 weeks postpartum, assessing socioeconomic risks, mental health, past and ongoing trauma exposure, and adaptation to postpartum.Using trajectory analysis, first we examined the natural course of PTSD symptoms based on patterns across peripartum, and found four distinct trajectory groups. Second, we explored factors (demographic, historical, and gestational) that shape the PTSD symptom trajectories, and examined the impact of trajectory membership on maternal postpartum adaptation. We found that child abuse history, demographic risk, and lifetime PTSD symptom count increased pregnancy-onset PTSD risk, whereas gestational PTSD symptom trajectory was best predicted by interim trauma and labor anxiety. Women with the greatest PTSD symptom rise during pregnancy were most likely to suffer postpartum depression and reported greatest bonding impairment with their infants at 6 weeks postpartum.Screening for modifiable risks (interpersonal trauma exposure and labor anxiety) and /or PTSD symptom load during pregnancy appears critical to promote maternal wellbeing.",0 +https://doi.org/10.1037/0022-006x.71.3.528,"Gender, victimization, and outcomes: Reconceptualizing risk.","Large-scale studies of gender differences in psychopathological reactions to victimization have focused on posttraumatic stress disorder, overlooking other trauma-related disorders. The present study expands this literature with a contextualized examination of interpersonal aggression exposure and sequelae. Using k-means cluster analysis on a sample of 16,000, the authors identified 8 distinct profiles of exposure to sexual violence, physical assault, stalking, and emotional abuse. Analyses of covariance then suggested links among victimization profile, gender, and mental and physical health. Results revealed no meaningful interactive effects of gender and interpersonal aggression on outcomes, once lifetime exposure to aggressive events was adequately taken into account. These findings argue against theories of female victims' greater vulnerability to pathological outcomes, instead linking risk to exposure history.",0 +https://doi.org/10.1891/0886-6708.vv-d-12-00090,The Impact of Childhood Maltreatment on PTSD Symptoms Among Female Survivors of Intimate Partner Violence,"Objective: Intimate partner violence (IPV) survivors often report histories of childhood maltreatment, yet the unique contributions of childhood maltreatment on IPV survivors' distinct posttraumatic stress disorder (PTSD) symptoms remain inadequately understood. Method: Using interview and self-report measures, we examined IPV as a potential mediator of the association between childhood maltreatment and severity of PTSD symptom clusters (reexperiencing, avoidance, numbing, and hyperarousal) among a sample of 425 women seeking help for recent IPV. Results: Structural equation modeling demonstrated that while both childhood maltreatment and IPV were both positively associated with PTSD symptom clusters, IPV did not mediate the association between childhood maltreatment and severity of PTSD symptom clusters among acute IPV survivors. Conclusions: Childhood maltreatment has persistent effects on the PTSD symptoms of IPV survivors, suggesting that child maltreatment may need to be addressed in addition to IPV during PTSD treatment. © 2013 Springer Publishing Company.",0 +https://doi.org/10.1037/a0019307,Mental health pathways from interpersonal violence to health-related outcomes in HIV-positive sexual minority men.,"We examined mental health pathways between interpersonal violence (IPV) and health-related outcomes in HIV-positive sexual minority men engaged with medical care.HIV-positive gay and bisexual men (N = 178) were recruited for this cross-sectional study from 2 public HIV primary care clinics that treated outpatients in an urban setting. Participants (M age = 44.1 years, 36% non-White) filled out a computer-assisted survey and had health-related data extracted from their electronic medical records. We used structural equation modeling to test associations among the latent factors of adult abuse and partner violence (each comprising indicators of physical, sexual, and psychological abuse) and the measured variables: viral load, health-related quality of life (HRQOL), HIV medication adherence, and emergency room (ER) visits. Mediation was tested for the latent construct mental health problems, comprising depression, anxiety, symptomatology of posttraumatic stress disorder, and suicidal ideation.The final model demonstrated acceptable fit, chi(2)(123) = 157.05, p = .02, CFI = .95, TLI = .94, RMSEA = .04, SRMR = .06, accounting for significant portions of the variance in viral load (13%), HRQOL (41%), adherence (7%), and ER visits (9%), as well as the latent variable mental health problems (24%). Only 1 direct link emerged: a positive association between adult abuse and ER visits.Findings indicate a significant role of IPV and mental health problems in the health of people living with HIV/AIDS. HIV care providers should assess for IPV history and mental health problems in all patients and refer for evidence-based psychosocial treatments that include a focus on health behaviors.",0 +https://doi.org/10.1016/j.ijotn.2012.03.006,Ten years follow-up of trauma-related psychological distress in a cohort of patients with acute traumatic hand injury,"Summary Though early psychological symptoms after an acute traumatic hand injury have been described, there remains a need for knowledge concerning the trajectory of the individual's response over time to the traumatic event. The purpose of this study was to describe psychological distress related to the traumatic experience in a cohort of patients with acute traumatic hand injury in a 10-year perspective. Patients were recruited consecutively at a hand surgery department. Data were collected by means of mailed questionnaires one week, three months, one year and 10years after the accident. Eighty-three patients participated in all four measurements. Their experience of psychological distress related to the trauma differed significantly during the 10years ( p",0 +https://doi.org/10.1016/j.sjpain.2011.06.004,Psychiatric (axis I) and personality (axis II) disorders in patients with burning mouth syndrome or atypical facial pain,"Abstract Background and aims Burning mouth syndrome (BMS) and atypical facial pain (AFP) are often persistent idiopathic pain conditions that mainly affect middle-aged and elderly women. They have both been associated with various psychiatric disorders. This study examined current and lifetime prevalence of psychiatric axis I (symptom-based) and II (personality) disorders in patients with chronic idiopathic orofacial pain, and investigated the temporal relationship of psychiatric disorders and the onset of orofacial pain. Method Forty patients with BMS and 23 patients with AFP were recruited from Turku university hospital clinics. Mean age of the patients was 62.3 years (range 35–84) and 90% were female. BMS and AFP diagnoses were based on thorough clinical evaluation, and all patients had undergone clinical neurophysiological investigations including blink reflex and thermal quantitative tests. Current and lifetime DSM-IV diagnoses of axis I and II disorders were made on clinical basis with the aid of SCID-I and II-interviews. The detected prevalence rates and their 95% confidence intervals based on binomial distribution were compared to three previous large population-based studies. Results Of the 63 patients, 26 (41.3%) had had an axis I disorder that preceded the onset of orofacial pain, and 33 (52.4%) had had a lifetime axis I disorder. Rate of current axis I disorders was 36.5%, indicating that only about 16% of lifetime disorders had remitted, and they tended to run chronic course. The most common lifetime axis I disorders were major depression (30.2%), social phobia (15.9%), specific phobia (11.1%), and panic disorder (7.9%). Twelve patients (19.0%) had at least one cluster C personality disorder already before the emergence of orofacial pain. Patients with cluster C personality disorders are characterized as fearful and neurotic. None of the patients had cluster A (characterized as odd and eccentric) or B (characterized as dramatic, emotional or erratic) personality disorders. The most common personality disorders were obsessive–compulsive personality (14.3%), dependent personality (4.8%), and avoidant personality (3.2%). The majority of the patients (54%) had also one or more chronic pain conditions other than orofacial pain. In almost all patients (94%) they were already present at the onset of orofacial pain. Conclusions Our results suggest that major depression, persistent social phobia, and neurotic, fearful, and obsessive–compulsive personality characteristics are common in patients with chronic idiopathic orofacial pain. Most psychiatric disorders precede the onset of orofacial pain and they tend to run a chronic course. Implications We propose that the high psychiatric morbidity, and comorbidity to other chronic pain conditions, in chronic idiopathic orofacial pain can be best understood in terms of shared vulnerability to both chronic pain and specific psychiatric disorders, most likely mediated by dysfunctional brain dopamine activity.",0 +https://doi.org/10.1016/s0277-9536(99)00399-8,The experience of chronic illness and post-traumatic stress disorder: the consequences of cumulative adversity,"In this paper the experiences of the chronically ill are examined to explore the impact of post-traumatic stress disorder (PTSD), accumulated burden of adversity and trauma spectrum disorder on subsequent illness and coping behaviors. Individuals experiencing chronic diseases have been studied with regard to depression, anxiety and a variety of coping maladaptions, but negligible attention has been given to the PTSD potential of chronic disease over the life course. Yet, growing evidence suggests that the traumatogenic potential of chronic diseases, some sudden and unexpected onsets, and the traumatogenic changes in life circumstance, may produce maladaptive illness coping over the life course. More importantly, attention needs to focus on the additive effect of co-morbid life events and the traumatic potential of invasive medical therapies. Consideration of PTSD and a continuum of cumulative adversity provide a more complex and fully drawn understanding of the circumstances surrounding chronic illness coping and reasons for maladaptive coping following invasive therapies and changes in the disease trajectory. The pathophysiology that produces a chronic diseases does not begin at symptom onset, and the psychosocial strategies to cope with a chronic illness, whether efficacious or maladaptive, also do not begin at symptom onset, but develops over the life course.",0 +https://doi.org/10.1007/s10896-010-9331-7,Patterns and Perceptions of Intimate Partner Violence Committed by Returning Veterans with Post-Traumatic Stress Disorder,"Data from a recent mixed-methods study conducted among Veterans of Iraq and Afghanistan diagnosed with Post-Traumatic Stress Disorder (PTSD) raise important questions regarding the occurrence of Intimate Partner Violence (IPV) in this population. Three case studies illustrate two main findings. First, Veterans and family members participating in the study described three patterns of partner violence-violence committed in anger; dissociative violence; and parasomniac/hypnopompic violence-suggesting that distinct patterns of IPV may emerge in relation to PTSD symptoms. Second, participants' descriptions suggest that common ideas about PTSD and war-related suffering can play an important role in influencing how Veterans and their partners respond to episodes of partner violence. It is important for those providing care to PTSD-diagnosed Veterans and their partners to understand when and how partner violence may occur, and how both parties may perceive and respond to it, in order to aid in developing appropriate plans for coping and safety-seeking. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1093/milmed/163.8.505,Reactions to Rape: A Military Forensic Psychiatrist's Perspective,"Accusations of rape or sexual harassment are currently very high-profile in the military. This article discusses rape allegations in the military legal system from a psychiatric perspective. The original definition of ""rape trauma syndrome"" and subsequent psychiatric thinking about the diagnosis are briefly outlined. Common reactions seen in military victims in this era are described. A prototypical military case is presented. An adequate evaluation of an alleged victim is outlined. Credentials and preparation of an expert witness are also briefly discussed, with cautions about the use of expert testimony in cases of alleged sexual assault and rape trauma syndrome.",0 +https://doi.org/10.1017/s0954579407070149,"Attachment, personality, and psychopathology among adult inpatients: Self-reported romantic attachment style versus Adult Attachment Interview states of mind","The present study examined self-reported romantic attachment style and Adult Attachment Interview (AAI) states of mind regarding early attachment relationships, personality dimensions, and psychopathology in a psychiatric sample of trauma survivors. Inpatients (N = 80) admitted to a hospital trauma treatment program were administered the Experiences in Close Relationships Scale, AAI, Millon Clinical Multiaxial Inventory-III, Dissociative Experiences Scale, and Dissociative Disorder Interview Schedule. Self-report and AAI attachment classifications were not related, and different results emerged for the two measures. Self-reported romantic attachment style was significantly associated with personality dimensions, with fearful adults showing the most maladaptive personality profiles. Findings suggested that self-report dimensions of self and other independently contribute to different forms of psychological dysfunction. AAI unresolved trauma was uniquely associated with dissociation and posttraumatic stress disorder, whereas unresolved trauma and unresolved loss jointly contributed to schizotypal and borderline personality disorder scores. The differences in findings between the two measures are discussed with a view toward the developmental and clinical implications.",0 +https://doi.org/10.1016/s0163-8343(03)00022-7,Psychiatric morbidity and posttraumatic symptoms among earthquake victims in primary care clinics,"Three months after the devastating Chi-Chi earthquake (magnitude of 7.3 on the Richter scale) struck the central area of Taiwan, 663 victims were screened for psychiatric morbidity at a local general hospital in a community mental health program. The rate of psychiatric morbidity as defined by the 12-item Chinese Health Questionnaire as greater than 4, was 24.5%. Posttraumatic symptoms were still prevalent. The rate of posttraumatic stress disorder was 11.3%, and the rate of partial PTSD was 32.0%. Variables associated with the presence of psychiatric morbidity and posttraumatic symptoms included female gender, old age, financial loss, obsessive trait, and nervous trait. A disproportionate use of mental health services (18%) was found, suggesting an urgent need to deliver mental health care to disaster victims at local medical settings. In addition, health care professionals who work with the earthquake victims need to be promptly and efficiently trained in mental health crisis intervention.",0 +https://doi.org/10.4088/jcp.14com09452,Resilience and Other Reactions to Military Deployment: The Complex Task of Identifying Distinct Adjustment Trajectories,"of psychological resilience to the effects of military deployment and some insight into the factors underlying it. In addition, they present evidence of a wide array of other adjustment trajectories following military deployment. In relation to resilience, 78% of Danish soldiers experienced minimal posttraumatic stress disorder (PTSD) symptoms before deployment and up to 2.5 years after. These results are consistent with other recent investigations of soldiers’ capacity to weather the stress of war. For example, Bonanno and colleagues 2 found that 83% of American military personnel deployed to Iraq and Afghanistan showed low levels of posttraumatic stress symptoms both before and up to 5 years after their deployment. Similarly, Dickstein and colleagues, 3 in a longitudinal study of American peacekeepers in Kosovo, found that over 80% showed minimal PTSD symptoms before their deployment and no increase in distress after it. Indeed, there can be little doubt that the considerable majority of soldiers are able to return to their normal levels of functioning after deployment to a war zone. The human capacity to endure and even thrive under conditions of acute stress, once considered rare or a reflection of extraordinary coping abilities, is now increasingly recognized as normative, 4 the rule rather than the exception. In response to events as diverse as bereavement, traumatic injury, life-threatening disease, and even terrorist attack, 5 most people are able to",0 +https://doi.org/10.1080/15402002.2012.683903,Insomnia and Symptoms of Post-traumatic Stress Disorder Among Women Veterans,"Women will account for 10% of the Veteran population by 2020, yet there has been little focus on sleep issues among women Veterans. In a descriptive study of 107 women Veterans with insomnia (mean age = 49 years, 44% non-Hispanic white), 55% had probable post traumatic stress disorder (PTSD) (total score ≥33). Probable PTSD was related to more severe self-reported sleep disruption and greater psychological distress. In a regression model, higher PTSD Checklist-Civilian (PCL-C) total score was a significant independent predictor of worse insomnia severity index score while other factors were not. Women Veterans preferred behavioral treatments over pharmacotherapy in general, and efforts to increase the availability of such treatments should be undertaken. Further research is needed to better understand the complex relationship between insomnia and PTSD among women Veterans.",0 +https://doi.org/10.1017/s0033291709992248,Longitudinal associations between post-traumatic distress and depressive symptoms following a traumatic event: a test of three models,"Background Symptoms of post-traumatic stress disorder (PTSD) and depression are highly co-morbid following a traumatic event. Nevertheless, decisive evidence regarding the direction of the relationship between these clinical entities is missing. Method The aim of the present study was to examine the nature of this relationship by comparing a synchronous change model (PTSD and depression are time synchronous, possibly stemming from a third common factor) with a demoralization model (i.e. PTSD symptoms causing depression) and a depressogenic model (i.e. depressive symptoms causing PTSD symptoms). Israeli adult victims of single-event traumas ( n =156) were assessed on measures of PTSD and depression at 2, 4 and 12 weeks post-event. Results A cross-lagged structural equation modeling (SEM) analysis provided results consistent with the synchronous change model and the depressogenic model. Conclusions Depressive symptoms may play an important role in the development of post-traumatic symptoms.",0 +https://doi.org/10.1016/j.neuropharm.2011.02.008,Executive function and PTSD: Disengaging from trauma,"Neuropsychological approaches represent an important avenue for identifying susceptibility and resiliency factors relating to the development and maintenance of posttraumatic stress disorder (PTSD) symptoms post-trauma. This review will summarize results from prospective longitudinal and retrospective cross-sectional studies investigating executive function associated with PTSD. This research points specifically towards subtle impairments in response inhibition and attention regulation that may predate trauma exposure, serve as risk factors for the development of PTSD, and relate to the severity of symptoms. These impairments may be exacerbated within emotional or trauma-related contexts, and may relate to dysfunction within dorsal prefrontal networks. A model is presented concerning how such impairments may contribute to the clinical profile of PTSD and lead to the use of alternative coping styles such as avoidance. Further neuropsychological research is needed to identify the effects of treatment on cognitive function and to potentially characterize mechanisms of current PTSD treatments. Knowledge gained from cognitive and neuroscientific research may prove valuable for informing the future development of novel, more effective, treatments for PTSD. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0 +https://doi.org/10.1002/ajmg.b.32167,Blood-based gene-expression predictors of PTSD risk and resilience among deployed marines: A pilot study,"Susceptibility to PTSD is determined by both genes and environment. Similarly, gene-expression levels in peripheral blood are influenced by both genes and environment, and expression levels of many genes show good correspondence between peripheral blood and brain. Therefore, our objectives were to test the following hypotheses: (1) pre-trauma expression levels of a gene subset (particularly immune-system genes) in peripheral blood would differ between trauma-exposed Marines who later developed PTSD and those who did not; (2) a predictive biomarker panel of the eventual emergence of PTSD among high-risk individuals could be developed based on gene expression in readily assessable peripheral blood cells; and (3) a predictive panel based on expression of individual exons would surpass the accuracy of a model based on expression of full-length gene transcripts. Gene-expression levels were assayed in peripheral blood samples from 50 U.S. Marines (25 eventual PTSD cases and 25 non-PTSD comparison subjects) prior to their deployment overseas to war-zones in Iraq or Afghanistan. The panel of biomarkers dysregulated in peripheral blood cells of eventual PTSD cases prior to deployment was significantly enriched for immune genes, achieved 70% prediction accuracy in an independent sample based on the expression of 23 full-length transcripts, and attained 80% accuracy in an independent sample based on the expression of one exon from each of five genes. If the observed profiles of pre-deployment mRNA-expression in eventual PTSD cases can be further refined and replicated, they could suggest avenues for early intervention and prevention among individuals at high risk for trauma exposure.",0 +https://doi.org/10.1007/s11920-006-0061-8,Personality and anxiety disorders,"Personality traits and most anxiety disorders are strongly related. In this article, we review existing evidence for ways in which personality traits may relate to anxiety disorders: 1) as predisposing factors, 2) as consequences, 3) as results of common etiologies, and 4) as pathoplastic factors. Based on current information, we conclude the following: 1) Personality traits such as high neuroticism, low extraversion, and personality disorder traits (particularly those from Cluster C) are at least markers of risk for certain anxiety disorders; 2) Remission from panic disorder is generally associated with partial ""normalization"" of personality traits; 3) Anxiety disorders in early life may influence personality development; 4) Anxiety disorders and personality traits are usefully thought of as spectra of common genetic etiologies; and 5) Extremes of personality traits indicate greater dysfunction in patients with anxiety disorders.",0 +https://doi.org/10.4088/jcp.14com09450,Beyond Categorical Classifications: The Importance of Identifying Posttrauma Symptom Trajectories and Associated Negative Outcomes,,0 +https://doi.org/10.1371/journal.pone.0064762,"Posttraumatic Stress Disorder and Not Depression Is Associated with Shorter Leukocyte Telomere Length: Findings from 3,000 Participants in the Population-Based KORA F4 Study","A link between severe mental stress and shorter telomere length (TL) has been suggested. We analysed the impact of Posttraumatic Stress Disorder (PTSD) on TL in the general population and postulated a dose-dependent TL association in subjects suffering from partial PTSD compared to full PTSD.Data are derived from the population-based KORA F4 study (2006-2008), located in southern Germany including 3,000 individuals (1,449 men and 1,551 women) with valid and complete TL data. Leukocyte TL was measured using a quantitative PCR-based technique. PTSD was assessed in a structured interview and by applying the Posttraumatic Diagnostic Scale (PDS) and the Impact of Event Scale (IES). A total of 262 (8.7%) subjects qualified for having partial PTSD and 51 (1.7%) for full PTSD. To assess the association of PTSD with the average TL, linear regression analyses with adjustments for potential confounding factors were performed.The multiple model revealed a significant association between partial PTSD and TL (beta = -0.051, p = 0.009) as well as between full PTSD and shorter TL (beta = -0.103, p = 0.014) indicating shorter TL on average for partial and full PTSD. An additional adjustment for depression and depressed mood/exhaustion gave comparable beta estimations.Participants with partial and full PTSD had significantly shorter leukocyte TL than participants without PTSD. The dose-dependent variation in TL of subjects with partial and full PTSD exceeded the chronological age effect, and was equivalent to an estimated 5 years in partial and 10 years in full PTSD of premature aging.",0 +https://doi.org/10.1016/j.jsat.2010.01.013,Posttraumatic stress disorder's role in integrated substance dependence and depression treatment outcomes,"Posttraumatic stress disorder (PTSD) frequently co-occurs with depression and substance use disorder (SUD). This study investigates the impact of PTSD diagnosis on treatment outcomes of 178 veterans treated for depression and SUD, with Integrated Cognitive-Behavioral Therapy (ICBT) or 12-Step Facilitation Therapy (TSF). Percentage days abstinent (PDA) and Hamilton Depression Rating Scale total score (HDRS total) trajectories were created. PDA was similar through initial follow-up; however, by 18 months, ICBT participants without PTSD had better PDA (M = 91%) than those without PTSD in TSF (M = 76%) and those with PTSD in either group (M = 75%-77%). Across time, participants with PTSD had higher depression levels than those without PTSD but benefited similarly from treatment (main effect, p < .004). Both conditions demonstrated reductions in average HDRS at 18 months (M = 17%-29%). Findings highlight the need to assess for PTSD and to investigate how to treat concomitant SUD, depression, and PTSD.",0 +https://doi.org/10.1371/journal.pone.0095796,Depletion of FKBP51 in Female Mice Shapes HPA Axis Activity,"Psychiatric disorders such as depressive disorders and posttraumatic stress disorder are a major disease burden worldwide and have a higher incidence in women than in men. However, the underlying mechanism responsible for the sex-dependent differences is not fully understood. Besides environmental factors such as traumatic life events or chronic stress, genetic variants contribute to the development of such diseases. For instance, variations in the gene encoding the FK506 binding protein 51 (FKBP51) have been repeatedly associated with mood and anxiety. FKBP51 is a negative regulator of the glucocorticoid receptor and thereby of the hypothalamic-pituitary-adrenal axis that also interacts with other steroid hormone receptors such as the progesterone and androgen receptors. Thus, the predisposition of women to psychiatric disorders and the interaction of female hormones with FKBP51 and the glucocorticoid receptor implicate a possible difference in the regulation of the hypothalamic-pituitary-adrenal axis in female FKBP51 knockout (51KO) mice. Therefore, we investigated neuroendocrine, behavioural and physiological alterations relevant to mood disorders in female 51KO mice. Female 51KOs and wild type littermates were subjected to various behavioural tests, including the open field, elevated plus maze and forced swim test. The neuroendocrine profile was investigated under basal conditions and in response to an acute stressor. Furthermore, we analysed the mRNA expression levels of the glucocorticoid receptor and corticotrophin release hormone in different brain regions. Overall, female 51KO mice did not display any overt behavioural phenotype under basal conditions, but showed a reduced basal hypothalamic-pituitary-adrenal axis activity, a blunted response to, and an enhanced recovery from, acute stress. These characteristics strongly overlap with previous studies in male 51KO mice indicating that FKBP51 shapes the behavioural and neuroendocrine phenotype independent of the sex of the individual.",0 +https://doi.org/10.1007/s10926-006-9039-y,Prospective Analysis of Factors Associated with Work Reentry in Patients with Accident-Related Injuries,"Introduction: The objective of this study was to investigate the influence of accidents, the physical and psychological consequences, the patient's predisposition as well as work-related cognitions on return to work (RTW) post accident. Despite the costs of time-off from work after accidental injuries, very few investigations have been carried out so far. Method: In a consecutive sample, 163 patients were investigated directly and 12 months after an accident. Results: 32% of the patients had a poor occupational integration 12 months after an accident. As predictors for return to work were found type of prior work: laborer (OR=4.34; 1.79-10.50 CI 95%), type of accident: recreational (OR=0.27; 0.11-0.69 CI 95%) and subjective perception of the accident severity (OR=0.98; 0.96-0.99 CI 95%). Conclusion: Laborers after a traffic or work accident, who estimate the accident as severe, are at greater risk of developping long-term disability. Future efforts should be conducted especially for this target group. © 2006 Springer Science+Business Media, Inc.",0 +https://doi.org/10.1177/1073191115615212,The Dissociative Subtype of PTSD Scale: Initial Evaluation in a National Sample of Trauma-Exposed Veterans,"The fifth edition of the Diagnostic and Statistical Manual includes a dissociative subtype of posttraumatic stress disorder, but no existing measures specifically assess it. This article describes the initial evaluation of a 15-item self-report measure of the subtype called the Dissociative Subtype of Posttraumatic Stress Disorder Scale (DSPS) in an online survey of 697 trauma-exposed military veterans representative of the U.S. veteran population. Exploratory factor analyses of the lifetime DSPS items supported the intended structure of the measure consisting of three factors reflecting derealization/depersonalization, loss of awareness, and psychogenic amnesia. Consistent with prior research, latent profile analyses assigned 8.3% of the sample to a highly dissociative class distinguished by pronounced symptoms of derealization and depersonalization. Overall, results provide initial psychometric support for the lifetime DSPS scales; additional research in clinical and community samples is needed to further validate the measure.",0 +https://doi.org/10.1037/tra0000060,Early PTSD symptom sub-clusters predicting chronic posttraumatic stress following sexual assault.,"Contemporary models of PTSD disaggregate this disorder into sub-clusters that differentially impact functioning. Severity of different types of PTSD symptoms in the acute posttrauma period may be predictive of the course of PTSD over time. Few research studies, however, have examined the predictive utility of PTSD sub-clusters. This study sought to determine the relative predictive validity of 4 sub-clusters, namely reexperiencing, strategic avoidance, emotional numbing, and hyperarousal, assessed within 1 month of a sexual assault. Women (N=120) who had been sexually assaulted completed self-report measures at 1 and 4 months postassault. Linear regression analyses revealed that early reexperiencing and emotional numbing sub-clusters uniquely contributed to the prediction of PTSD symptoms at month 4 (strategic avoidance and hyperarousal did not). To help explain and contextualize these findings, we explored the extent to which posttraumatic cognitions mediated the relationship between acute reexperiencing and emotional numbing and later PTSD symptoms. Simultaneous multiple mediation analyses revealed that general negative cognitions about the self significantly mediated the relationship between both reexperiencing and emotional numbing and month 4 PTSD symptoms. These findings have significant clinical implications, pointing to the importance of targeting posttraumatic cognitions in the acute posttrauma phase.",0 +https://doi.org/10.1037/1082-989x.8.3.378,A Realistic Perspective on Pattern Representation in Growth Data: Comment on Bauer and Curran (2003).,"D. J. Bauer and P. J. Curran (2003) cautioned that results obtained from growth mixture models may sometimes be inaccurate. The problem they addressed occurs when a growth mixture model is applied to a single, general population of individuals but findings incorrectly support the conclusion that there are 2 subpopulations. In an artificial sampling experiment, they showed that this can occur when the variables in the population have a nonnormal distribution. A realistic perspective is that although a healthy skepticism to complex statistical results is appropriate, there are no true models to discover. Consequently, the issue of model misspecification is irrelevant in practical terms. The purpose of a mathematical model is to summarize data, to formalize the dynamics of a behavioral process, and to make predictions. All of this is scientifically valuable and can be accomplished with a carefully developed model, even though the model is false.",0 +https://doi.org/10.1016/s0887-6185(97)00013-3,Differentiating Post-Traumatic Stress Disorder (PTSD) from Major Depression (MDD) and Generalized Anxiety Disorder (GAD),"Questions about the differential diagnosis of Post-Traumatic Stress Disorder (PTSD) have been raised since this category was reformulated in DSM-III ( APA, 1980 ). Clinicians have reported difficulties distinguishing PTSD from other categories, particularly from Major Depressive and Generalized Anxiety Disorders (MDD and GAD). Diagnostic validity can be established in several ways (e.g., through clinical descriptive studies, laboratory experiments, family history studies, etc.). In this paper, we describe one approach to validation thus far not applied to PTSD: This approach centers directly on whether clinicians can distinguish PTSD from other diagnostic categories. Experienced clinicians were asked to rate the extent to which a common set of 90 symptom items characterized PTSD, MDD , and GAD. Ratings were analyzed with multivariate and univariate analyses of variance and covariance, multiple discriminant function analysis, and factor analysis; moreover, characteristics of raters were examined for possible influences. Results indicated that clinicians readily distinguish PTSD from MDD and GAD as well as MDD from GAD. Findings are presented in terms of univariate analyses, 34 best discriminating items, and factors specifying dimensions differentiating the syndromes of PTSD, MDD, and GAD. Rater characteristics did not influence diagnostic accuracy, although significant differences in magnitude of symptom intensity were found. © 1997 Elsevier Science Ltd",0 +https://doi.org/10.1037/a0035081,Reducing refugee mental health disparities: A community-based intervention to address postmigration stressors with African adults.,"Refugees resettled in the United States have disproportionately high rates of psychological distress. Research has demonstrated the roles of postmigration stressors, including lack of meaningful social roles, poverty, unemployment, lack of environmental mastery, discrimination, limited English proficiency, and social isolation. We report a multimethod, within-group longitudinal pilot study involving the adaptation for African refugees of a community-based advocacy and learning intervention to address postmigration stressors. We found the intervention to be feasible, acceptable, and appropriate for African refugees. Growth trajectory analysis revealed significant decreases in participants' psychological distress and increases in quality of life, and also provided preliminary evidence of intervention mechanisms of change through the detection of mediating relationships whereby increased quality of life was mediated by increases in enculturation, English proficiency, and social support. Qualitative data helped to support and explain the quantitative data. Results demonstrate the importance of addressing the sociopolitical context of resettlement to promote the mental health of refugees and suggest a culturally appropriate, and replicable model for doing so.",0 +https://doi.org/10.1186/1471-2288-10-99,Assessing nonresponse bias at follow-up in a large prospective cohort of relatively young and mobile military service members,"BackgroundNonresponse bias in a longitudinal study could affect the magnitude and direction of measures of association. We identified sociodemographic, behavioral, military, and health-related predictors of response to the first follow-up questionnaire in a large military cohort and assessed the extent to which nonresponse biased measures of association.MethodsData are from the baseline and first follow-up survey of the Millennium Cohort Study. Seventy-six thousand, seven hundred and seventy-five eligible individuals completed the baseline survey and were presumed alive at the time of follow-up; of these, 54,960 (71.6%) completed the first follow-up survey. Logistic regression models were used to calculate inverse probability weights using propensity scores.ResultsCharacteristics associated with a greater probability of response included female gender, older age, higher education level, officer rank, active-duty status, and a self-reported history of military exposures. Ever smokers, those with a history of chronic alcohol consumption or a major depressive disorder, and those separated from the military at follow-up had a lower probability of response. Nonresponse to the follow-up questionnaire did not result in appreciable bias; bias was greatest in subgroups with small numbers.ConclusionsThese findings suggest that prospective analyses from this cohort are not substantially biased by non-response at the first follow-up assessment.",0 +https://doi.org/10.1016/j.pain.2012.05.004,Assessment and validation of prognostic models for poor functional recovery 12 months after whiplash injury: A multicentre inception cohort study,"Uncertainty surrounds prognostic factors after whiplash injury. Previously we identified a prognostic model for 6-month pain-related disability in a cohort of 80 participants with acute whiplash. Predictors included initial disability, older age, decreased cold pain thresholds, decreased neck rotation movement, posttraumatic stress symptoms and decreased sympathetic vasoconstriction. The objective of this study was to externally validate this model. In a multicentre inception cohort study, 286 participants with acute whiplash (I, II or III) were assessed at <3 weeks and 12 months after injury. The Neck Disability Index (NDI) was the outcome. Observed and predicted NDI scores were generated using the published equation of the original model. Model discrimination between participants with no or mild disability from those with moderate to severe disability was examined by receiver operating characteristic curves. Initial NDI and cold pain threshold predicted current observed 12-month NDI scores (r(2) = 0.50, 95% confidence interval 0.42 to 0.58). There was a significant site effect, and the estimated marginal mean ± SE of 12-month NDI for Iceland (27.6 ± 1.79%) was higher than the other 3 sites (Melbourne 11.2 ± 5.03%, Canada 16.4 ± 2.36%, Brisbane 16.8 ± 1.17%). After adjusting for site, age and Impact of Events Scale scores regained significance (r(2) = 0.56, 95% confidence interval 0.48 to 0.64). The tested model was not precise in predicting NDI as a continuous variable. However, it found good accuracy to discriminate participants with moderate to severe disability at 12 months (area under the receiver operating characteristic curve 0.89 [95% confidence interval 0.84-0.94], P<.001) which is clinically useful.",0 +https://doi.org/10.1016/j.psychres.2012.09.020,Posttraumatic stress and depression symptoms as correlates of deliberate self-harm among community women experiencing intimate partnerviolence,"Deliberate self-harm (DSH) among women in the general population is correlated separately with posttraumatic stress, depression, and abuse during childhood and adulthood. The prevalence of these DSH correlates is particularly high among women exposed to intimate partner violence (IPV), yet few studies have examined DSH among this high-risk population and none have examined these correlates simultaneously. Two hundred and twelve IPV-victimized women in the community participated in a 2-h retrospective interview. One-third reported current or past DSH. Discriminant analysis was used to examine which posttraumatic stress and depression symptoms and types of current IPV and childhood abuse were uniquely associated with current DSH. Findings show that women who currently use DSH reported greater severity of posttraumatic stress numbing symptoms and more severe sexual IPV compared to women who used DSH only in the past. Examining factors that are associated with women's current DSH in this population is critical so that a focus on DSH can be integrated into the treatment plans of women who are receiving mental health care, but also so that women who are not receiving such care can be referred to adequate mental health services.",0 +https://doi.org/10.1097/nmd.0b013e3181b975f8,Routine Work Environment Stress and PTSD Symptoms in Police Officers,"This study examined the relationship between routine work environment stress and posttraumatic stress disorder (PTSD) symptoms in a sample of police officers (N = 180) who were first assessed during academy training and reassessed 1-year later. In a model that included gender, ethnicity, traumatic exposure prior to entering the academy, current negative life events, and critical incident exposure over the last year, routine work environment stress was most strongly associated with PTSD symptoms. We also found that routine work environment stress mediated the relationship between critical incident exposure and PTSD symptoms and between current negative life events and PTSD symptoms. Ensuring that the work environment is functioning optimally protects against the effects of duty-related critical incidents and negative life events outside police service.",0 +https://doi.org/10.1037/a0038780,Predictors of posttraumatic stress disorder among police officers: A prospective study.,"This prospective study examined risk and protective factors in the development of posttraumatic stress disorder (PTSD) in a sample of 83 police officers. Structured interviews were conducted in order to assess the most recent work-related traumatic event and establish diagnoses of acute stress disorder (ASD) and full or partial PTSD. Police officers were assessed between 5 and 15 days, and at 1 month, 3 months, and 12 months after the event. They also completed self-administered questionnaires assessing several potential predictors. Predictive analyses about the onset of PTSD were based on a 4-step nested random-effect linear regression. Overall, results showed that the modulation of PTSD symptomatology was associated with some pretraumatic (i.e., emotional coping strategies and number of children), peritraumatic (i.e., physical and emotional reactions and dissociation), and posttraumatic factors (i.e., ASD, depression symptoms, and seeking psychological help at the employee assistance program and at the police union between the event and Time 1). Clinical implications of these findings are discussed and key directions for future studies are proposed.",0 +https://doi.org/10.1001/archpsyc.62.12.1343,The Structure of Posttraumatic Stress Disorder,"Latent structure analysis of DSM-IV posttraumatic stress disorder (PTSD) can help clarify how persons who experience traumatic events might be sorted into clusters with respect to their symptom profiles. Classification of persons exposed to traumatic events into clinically homogeneous groups would facilitate further etiologic and treatment research, as well as research on the relationship of trauma and PTSD with other disorders.To examine empirically the structure underlying PTSD criterion symptoms and identify discrete classes with similar symptom profiles.Data on PTSD symptoms from trauma-exposed subsets of 2 community samples were subjected to latent class analysis. The resultant classes were studied in associations with trauma type and indicators of impairment.The first sample is from the Detroit Area Survey of Trauma (1899 trauma-exposed respondents with complete data) and the second is from a mid-Atlantic study of young adults conducted by The Johns Hopkins University Prevention Research Center, Baltimore, Md (1377 trauma-exposed respondents with complete data).Respondents in the 2 community samples who experienced 1 or more qualifying PTSD-level traumatic events.Number, size, and symptom profiles of latent classes.In both samples, analysis yielded 3 classes: no disturbance, intermediate disturbance, and pervasive disturbance. The classes also varied qualitatively, with emotional numbing distinguishing the class of pervasive disturbance, a class that approximates the subset with DSM-IV PTSD. Members of the pervasive disturbance class were far more likely to report use of medical care and disruptions in life or activities.The 3-class structure separates trauma-exposed persons with pervasive disturbance (a class that approximates DSM-IV PTSD) from no disturbance and intermediate disturbance, a distinction that also helps identify population subgroups with low risk for any posttrauma disturbance. The results suggest that the structure of PTSD is ordinal and configurational and that emotional numbing differentiates the class with pervasive disturbance. These results should motivate prospective research of persons who have experienced trauma to trace the emergence of posttrauma symptoms and the timing of emotional numbing relative to other symptoms.",0 +https://doi.org/10.1002/jts.20383,The contribution of prior psychological symptoms and combat exposure to post Iraq deployment mental health in the UK military,"This study assessed the contribution of baseline psychological symptoms, combat exposure, and unit support in the etiology of posttraumatic stress disorder (PTSD), and psychological distress. From 2004-2006, 67% of a random sample of 2,820 participants who had been assessed for psychological symptoms in 2002 were reassessed. Baseline psychological symptoms, combat exposure, and unit support factors were associated with the outcomes and the effect sizes for combat exposure were marked for PTSD symptoms. Adjustment for baseline psychological symptoms did not modify the pattern of association of group cohesion and combat exposures. The authors concluded that combat exposure and group cohesion have an effect on mental health outcomes independent of previous mental health status, which explains why screening prior to deployment is ineffective.",0 +https://doi.org/10.1016/j.jadohealth.2008.01.012,Connectedness in the Lives of Children and Adolescents: A Call for Greater Conceptual Clarity,"Studies of the role of connectedness in the health and development of children and adolescents are accumulating rapidly. Although findings are uniformly consistent in documenting its correlation with a host of health indicators, the construct is in need of substantial conceptual clarification to maximize its research and applied utility. Current conceptualizations and operationalizations inconsistently span a wide spectrum of varied elements of social experience--including the quality of a relationship, the degree of liking an environment or relationship, the quality of performance in an environment or relationship, the possession of feelings or attitude states, and a combination of states and the behaviors that antecede them--resulting in an ability to adequately understand what the construct is and how, why, and when it is most protective. This paper documents this variability in an effort to sensitize researchers, practitioners, and policy makers to the complexity of the construct. It further describes one ongoing, multicultural research project that is currently informing international health initiatives as an illustration of one approach to addressing the complexity with goals of precision, parsimony, cultural sensitivity, and applied utility.",0 +https://doi.org/10.1001/jama.2009.1121,Asthma and Posttraumatic Stress Symptoms 5 to 6 Years Following Exposure to the World Trade Center Terrorist Attack,"The World Trade Center Health Registry provides a unique opportunity to examine long-term health effects of a large-scale disaster.To examine risk factors for new asthma diagnoses and event-related posttraumatic stress (PTS) symptoms among exposed adults 5 to 6 years following exposure to the September 11, 2001, World Trade Center (WTC) terrorist attack.Longitudinal cohort study with wave 1 (W1) enrollment of 71,437 adults in 2003-2004, including rescue/recovery worker, lower Manhattan resident, lower Manhattan office worker, and passersby eligibility groups; 46,322 adults (68%) completed the wave 2 (W2) survey in 2006-2007.Self-reported diagnosed asthma following September 11; event-related current PTS symptoms indicative of probable posttraumatic stress disorder (PTSD), assessed using the PTSD Checklist (cutoff score > or = 44).Of W2 participants with no stated asthma history, 10.2% (95% confidence interval [CI], 9.9%-10.5%) reported new asthma diagnoses postevent. Intense dust cloud exposure on September 11 was a major contributor to new asthma diagnoses for all eligibility groups: for example, 19.1% vs 9.6% in those without exposure among rescue/recovery workers (adjusted odds ratio, 1.5 [95% CI, 1.4-1.7]). Asthma risk was highest among rescue/recovery workers on the WTC pile on September 11 (20.5% [95% CI, 19.0%-22.0%]). Persistent risks included working longer at the WTC site, not evacuating homes, and experiencing a heavy layer of dust in home or office. Of participants with no PTSD history, 23.8% (95% CI, 23.4%-24.2%) reported PTS symptoms at either W1 (14.3%) or W2 (19.1%). Nearly 10% (9.6% [95% CI, 9.3%-9.8%]) had PTS symptoms at both surveys, 4.7% (95% CI, 4.5%-4.9%) had PTS symptoms at W1 only, and 9.5% (95% CI, 9.3%-9.8%) had PTS symptoms at W2 only. At W2, passersby had the highest rate of PTS symptoms (23.2% [95% CI, 21.4%-25.0%]). Event-related loss of spouse or job was associated with PTS symptoms at W2.Acute and prolonged exposures were both associated with a large burden of asthma and PTS symptoms 5 to 6 years after the September 11 WTC attack.",0 +https://doi.org/10.1371/journal.pone.0076146,"Inflammation and Oxidative Stress Are Elevated in the Brain, Blood, and Adrenal Glands during the Progression of Post-Traumatic Stress Disorder in a Predator Exposure Animal Model","This study sought to analyze specific pathophysiological mechanisms involved in the progression of post-traumatic stress disorder (PTSD) by utilizing an animal model. To examine PTSD pathophysiology, we measured damaging reactive oxygen species and inflammatory cytokines to determine if oxidative stress and inflammation in the brain, adrenal glands, and systemic circulation were upregulated in response to constant stress. Pre-clinical PTSD was induced in naïve, male Sprague-Dawley rats via a predator exposure/psychosocial stress regimen. PTSD group rats were secured in Plexiglas cylinders and placed in a cage with a cat for one hour on days 1 and 11 of a 31-day stress regimen. In addition, PTSD group rats were subjected to psychosocial stress whereby their cage cohort was changed daily. This model has been shown to cause heightened anxiety, exaggerated startle response, impaired cognition, and increased cardiovascular reactivity, all of which are common symptoms seen in humans with PTSD. At the conclusion of the predator exposure/psychosocial stress regimen, the rats were euthanized and their brains were dissected to remove the hippocampus, amygdala, and pre-frontal cortex (PFC), the three areas commonly associated with PTSD development. The adrenal glands and whole blood were also collected to assess systemic oxidative stress. Analysis of the whole blood, adrenal glands, and brain regions revealed oxidative stress increased during PTSD progression. In addition, examination of pro-inflammatory cytokine (PIC) mRNA and protein demonstrated neurological inflammatory molecules were significantly upregulated in the PTSD group vs. controls. These results indicate oxidative stress and inflammation in the brain, adrenal glands, and systemic circulation may play a critical role in the development and further exacerbation of PTSD. Thus, PTSD may not be solely a neurological pathology but may progress as a systemic condition involving multiple organ systems.",0 +https://doi.org/10.4314/eamj.v83i5.9434,Psychometric properties of an African symptoms check list scale: the Ndetei-Othieno-Kathuku scale,"To profile and quantify the psychometric properties of the NOK (Ndetei-Othieno-Kathuku) scale against internationally used Gold-standards and benchmarks for mild psychiatric disorders and post-traumatic stress disorders and to provide a potential easy to administer culture sensitive instrument for screening and assessing those with possible psychiatric disorders for the Kenyan and similar social-cultural situations.Cross-Sectional quantitative study.A psychiatric clinical consultation setting and Kyanguli Secondary School psychotrauma counselling clinical set-up.Survivors of the Nairobi USA Embassy bombing who were referred for psychiatric treatment and survivors of a fire disaster from a rural Kenyan school (Kyanguli School fire disaster) including students, parents of the diseased children and staff members.Positive correlation was found between the NOK and all the instruments. The highest correlations were between the NOK and the BDI and SCL-90 (r = 0.557 to 0.786). The differences between the NOK scores among the different groups were statistically significant (F ratio = 13.54 to 160.34, p < 0.01). The reliability coefficient (internal consistency) of the scale, alpha = 0.9733. Other item statistics and correlations of the scale are discussed.It is concluded that the NOK has high concurrent and discriminant validity as well as a high internal consistency and that it can be used for the rapid assessment of psychotrauma victims of all age groups; and stress in general in similar age groups in the local setting. It is culture appropriate and sensitive.",0 +,Shame-based identity and chronic post-traumatic stress disorder in help -seeking combat veterans,"The long-term effects of post-traumatic stress disorder (PTSD) have been previously investigated. However, developmental and identity issues around trauma and shame have been less extensively examined. For some combat veterans, relief from the primary symptoms of PTSD is a struggle for much of the postwar adjustment period. Moreover, secondary problems associated with living with trauma have substantial impact on veterans' sense of self, capacity for interpersonal relationships, and making meaning of their lives. The current investigation examined relationships between self-reported symptom distress and shame on postwar adjustment of combat veterans. Specifically, the study investigated how shame and sense of self were related to PTSD, depression, trait anxiety, vulnerability, self-handicapping, hope, and overall quality of life. This investigation used archival data that are part of a larger longitudinal study. Correlational, repeated measures, and multivariate analyses examined how symptom distress and resilience measures were related to premilitary, military, and postmilitary factors. Participants completed self-report symptom distress measures and family of origin and demographic questionnaires. Repeated measures on symptom distress were collected at baseline, 2 months, 6 months, and 12 months post-baseline. Twelve hypotheses were postulated regarding how chronic PTSD and shame were related to long term adjustment. Findings contributed substantive new information on relationships among shame, symptom distress, and psychological trauma. Correlational analyses showed significant and positive relationships between shame and symptom distress measures including depression, trait anxiety, vulnerability, PTSD, and self-handicapping. Shame was negatively associated with hope and quality of life. Longitudinal data showed chronic PTSD and shame were amenable to treatment. While treatment data showed initial improvement in all symptom distress measures, maintenance of treatment gains was difficult, with six and twelve month symptom measures returning to near baseline. Multivariate analyses yielded no differences on family factors of chaos, loss, and ethnicity. Socioeconomic status was associated with decreased hope and quality of life. Convergence among the findings indicated a reciprocal relationship between shame and PTSD which warrants continued empirical investigation. Implications for theory, research, and practice are discussed.",0 +https://doi.org/10.1097/00005053-199007000-00006,Characteristics of Patients with Multiple Personality and Dissociative Disorders on Psychological Testing,"We describe a new psychological testing procedure used on a consecutive series of 14 patients with multiple personality and dissociative disorders who met DSM-III-R and research criteria for dissociative disorders. Once dissociative phenomena were accounted for in testing, most patients displayed response patterns markedly different from those of schizophrenic and borderline patients. Patients showed striking variability on cognitive and projective tests, often related to posttraumatic intrusions. Rorschach protocols showed unusual thinking accompanied by psychological complexity and highly developed self-observing capacity. In contrast to classical conceptualizations about these patients, most subjects had personality profiles that were intellectualized, obsessive, and introversive, not histrionic or labile.",0 +https://doi.org/10.1016/s0165-0327(02)00218-5,Partial posttraumatic stress disorder revisited,"It is thought that the decision rule for a positive diagnosis of Posttraumatic Stress Disorder (PTSD) may be too restrictive, leaving too many victims of a trauma out in the cold for care, compensation, etc. Several authors have proposed the concept of Subthreshold or Partial PTSD (PPTSD). This concept considers that a subject may present a number of symptoms below threshold for criteria C or D (subthreshold syndromes) and may even present without any symptom for one or more of the criteria B, C and D (partial syndromes).Data have been collected by means of the Composite International Diagnostic Interview (CIDI) PTSD-module, in a group exposed to two different traumatic events (130 fire victims and 55 car accident victims). The syndrome patterns has been assessed by means of hierarchical class analyses. Each of the criteria B, C and D has been analyzed separately, showing the symptom patterns as hierarchically order clusters.Depending on the threshold used for criterion C (i.e. 3 or 2 symptoms), 18.4 and 22.7% of the subjects respectively satisfy the criteria for PTSD. 8.7% of the subjects show subthreshold syndromes. 60.7% of the subjects show partial syndromes and 16.7% of the subjects have partial syndromes while fulfilling criterion F, i.e. a clinically significant impairment in functioning.The results show a considerable number of partial and subthreshold syndromes. It is argued that subthreshold syndromes and partial syndromes, which fulfill criterion F, should be regarded as specific nosological categories or as specified PTSD subcategories, i.e. subsyndromal or partial PTSD.",0 +https://doi.org/10.1016/j.jpsychores.2015.05.016,One-year trajectories of depression and anxiety symptoms in older patients presenting in general practice with musculoskeletal pain: A latent class growth analysis,"Distinguishing transient from persistent anxiety and depression symptoms in older people presenting to general practice with musculoskeletal pain is potentially important for effective management. This study sought to identify distinct post-consultation depression and anxiety symptom trajectories in adults aged over 50years consulting general practice for non-inflammatory musculoskeletal pain.Self-completion questionnaires, containing measures of anxiety and depressive symptoms, age, gender, pain status, coping and social status were mailed within 1week of the consultation and at 3, 6 and 12months. Latent class growth analysis was used to identify anxiety and depression symptoms trajectories, which were ascertained with cut-off score ≥8 on Hospital Anxiety and Depression Scale subscales. Associations between baseline characteristics and cluster membership were examined using multivariate multinomial logistic regression analysis (the 3-step approach).Latent class growth analyses determined a 3-cluster anxiety model (n=499) and a 3-cluster depression model (n=501). Clusters identified were: no anxiety problem (44.1%), persistent anxiety problem (33.9%) and transient anxiety symptoms (22.2%); no depression problem (74.1%), persistent depression problem (22.0%) and gradual depression symptom recovery (4.0%). Widespread pain, interference with valued activities, coping by increased behavioral activities, catastrophizing, perceived lack of instrumental support, age ≥70years, being female, and performing manual/routine work were associated with anxiety and/or depression clusters.Older people with non-inflammatory musculoskeletal pain are at high risk of persistent anxiety and/or depression problems. Biopsychosocial factors, such as pain status, coping strategies, instrumental support, performing manual/routine work, being female and age ≥70years, may help identify patients with persistent anxiety and/or depression.",0 +https://doi.org/10.1002/jclp.20715,Alexithymia and posttraumatic stress: subscales and symptom clusters,"This study examined the relationship between the emotion-regulating factor alexithymia and the occurrence of posttraumatic stress disorder (PTSD) after critical incidents in a nonclinical sample of 136 nurses and ambulance personnel working in military facilities. The results showed that alexythima accounts for variance in PTSD symptoms. Breaking PTSD into its 4 symptom clusters, alexithymia was found to predict numbing and hyperarousal symptoms but not avoidance or reexperiencing symptoms. Finally, the rarely investigated, but clinically relevant, distinctive subdimensions of alexithymia were examined in relation to the 4 PTSD clusters. The difficulty identifying feelings subscale contributed most to the numbing and hyperarousal PTSD subscales. Clinical implications and future research directions are discussed.",0 +https://doi.org/10.1001/jama.293.1.30,"Mental Health Status of World Trade Center Rescue and Recovery Workers and Volunteers—New York City, July 2002–August 2004","After the September 11, 2001, attacks on the World Trade Center (WTC), a comprehensive screening program was established to evaluate the physical and mental health of rescue and recovery workers and volunteers. Persons were eligible for this program if they participated in the WTC rescue or recovery efforts and met specific time criteria for exposure to the site. During July 16, 2002--August 6, 2004, the program evaluated 11,768 workers and volunteers. This report summarizes data analyzed from a subset of 1,138 of the 11,768 participants evaluated at the Mount Sinai School of Medicine during July 16--December 31, 2002. On the basis of one or more standardized screening questionnaires, approximately half (51%) of participants met threshold criteria for a clinical mental health evaluation. Continued surveillance is needed to assess the long-term psychological impact of the aftermath of the 9/11 attacks and to determine needs for continued treatment.",0 +https://doi.org/10.1093/jpepsy/jsr105,The Factor Structure of Traumatic Stress in Parents of Children With Cancer: A Longitudinal Analysis*,"To determine the factor structure of posttraumatic stress symptoms (PTSS) and assess its stability over time among parents of children diagnosed with cancer.Parents of children with cancer included in a longitudinal study completed the posttraumatic stress disorder (PTSD) Checklist-Civilian Version 2 weeks (n = 249) and 2 (n = 234) and 4 (n = 203) months after their child's diagnosis. Confirmatory factor analysis (CFA) was used to assess 3 models of the underlying dimensions of PTSD and invariance tests were used to assess stability over time.A longitudinal CFA with the factors reexperiencing, avoidance, dysphoria, and hyperarousal provided best fit to the data. Invariance testing suggested that the pattern and size of loadings were equivalent across the three assessments. Discussions Findings tentatively suggest that PTSS among parents of children with cancer consist of four factors. Implications for research and clinical practice are discussed.",0 +https://doi.org/10.1111/j.1469-7610.2010.02321.x,The Child and Family Traumatic Stress Intervention: Secondary prevention for youth at risk of developing PTSD,"This pilot study evaluated the effectiveness of a four-session, caregiver-child Intervention, the Child and Family Traumatic Stress Intervention (CFTSI), to prevent the development of chronic posttraumatic stress disorder (PTSD) provided within 30 days of exposure to a potentially traumatic event (PTE).One-hundred seventy-six 7 to 17-year-old youth were recruited through telephone screening based on report of one new distressing posttraumatic stress symptom after a PTE. Of those, 106 youth were randomly assigned to the Intervention (n = 53) or a four-session supportive Comparison condition (N = 53). Group differences in symptom severity were assessed using repeated measures with mixed effects models of intervention group, time, and the interaction of intervention and time. Logistic regression analyses were performed to assess treatment condition and any subsequent traumas experienced as predictors for full and partial PTSD diagnosis at 3-month follow-up. An exploratory chi-square analysis was performed to examine the differences in PTSD symptom criteria B, C, and D at follow-up.At baseline, youth in both groups had similar demographics, past trauma exposures and symptom severity. At follow-up, the Intervention group demonstrated significantly fewer full and partial PTSD diagnoses than the Comparison group on a standardized diagnostic measure of PTSD. Also, there was a significant group by time interaction for Trauma Symptom Checklist for Children's Posttraumatic Stress and Anxiety Indices as the CFTSI group had significantly lower posttraumatic and anxiety scores than the Comparison group.The results suggest that a caregiver-youth, brief preventative early intervention for youth exposed to a PTE is a promising approach to preventing chronic PTSD.",0 +https://doi.org/10.1093/eurpub/ckn113,Health and ill health of asylum seekers in Switzerland: an epidemiological study,"Although the focus of health care for people seeking asylum in Western European countries is usually on communicable diseases, there is little data about the general health care need of this population. In this study, we investigated the actual burden of disease among asylum seekers.Data were collected from a Swiss Health Maintenance Organisation (HMO; a type of managed care organization in which physicians act as gate keepers) that was set up specifically to provide health care for asylum seekers. The data included socio-demographic characteristics, international classification of diseases (ICD-10) diagnoses and number of clinic visits. Descriptive statistics were used to assess the types of health problems and the number of clinic visits. Logistic regression analysis was used to determine whether age, gender or country or region of origin was predictive in terms of incidence of disease as diagnosed by using ICD classifications.The total number of asylum seekers (mean age 22 years; 38% women) enrolled in the HMO from 2000 through 2003 was 979. Half of this group came from the former country of Yugoslavia. The remainder came primarily from sub-Saharan Africa, Turkey, Iraq and Sri Lanka. The most common health problems encountered in the population included musculoskeletal diseases, respiratory diseases, depression and post-traumatic stress disorder. The prevalence of all disease clusters was significantly associated with age. One-fifth of the population did not request health care at all during the time they were enrolled in the HMO. It is not known whether those who did not visit the medical clinic did not require health care or just chose not to request clinic services.The most frequent health problems encountered in the study population were chronic medical conditions, not communicable acute diseases. Although health care services provided to asylum seekers usually focus on episodic acute care, what this group actually needs is continuity of care.",0 +https://doi.org/10.1016/j.jad.2014.04.067,Posttraumatic stress disorder and suicide in 5.9 million individuals receiving care in the veterans health administration health system,"Post-traumatic stress disorder (PTSD) confers risk for suicidal ideation and suicide attempts but a link with suicide is not yet established. Prior analyses of users of the Veterans health administration (VHA) Health System suggest that other mental disorders strongly influence the association between PTSD and suicide in this population. We examined the association between PTSD and suicide in VHA users, with a focus on the influence of other mental disorders.Data were based on linkage of VA National Patient Care Database records and the Centers for Disease Control and Prevention׳s National Death Index, with data from fiscal year 2007-2008. Analyses were based on multivariate logistic regression and structural equation models.Among users of VHA services studied (N=5,913,648), 0.6% (N=3620) died by suicide, including 423 who had had been diagnosed with PTSD. In unadjusted analysis, PTSD was associated with increased risk for suicide, with odds ratio, OR (95% confidence interval, 95% CI)=1.34 (1.21, 1.48). Similar results were obtained after adjustment for demographic variables and veteran characteristics. After adjustment for multiple other mental disorder diagnoses, PTSD was associated with decreased risk for suicide, OR (95% CI)=0.77 (0.69, 0.86). Major depressive disorder (MDD) had the largest influence on the association between PTSD and suicide.The analyses were cross-sectional. VHA users were studied, with unclear relevance to other populations.The findings suggest the importance of identifying and treating comorbid MDD and other mental disorders in VHA users diagnosed with PTSD in suicide prevention efforts.",0 +https://doi.org/10.1111/1467-9450.00105,Measuring post-traumatic stress: A psychometric evaluation of symptom- and coping questionnaires based on a Norwegian sample,"The purpose of this study was to evaluate the psychometric characteristics of the Norweigian versions of the Impact of Event Scale, the Post Traumatic Stress Scale-10 item version and General Coping Questionnaire-30 item version. A group of 40 male and 56 female medical students was tested one week and four months after having started dissection of cadavers for the first time. The results showed that all scales had good internal consistency and test-retest reliability. The student sample scored lower on the IES and PTSS-10 than comparable groups of traumatized subjects. A gender difference emerged, with female subjects scoring higher than male subjects. The factor analysis of the instruments indicated good construct validity for the symptom scales. The analysis of content validity related to DSM IV criteria indicated that the IES and PTSS-10 may have some limitations in their predictive validity of PTSD. Taken together, the three scales have shown good psychometric properties and could be used in future research and clinical work.",0 +https://doi.org/10.4088/jcp.12r08225,Meta-Analysis of the Efficacy of Treatments for Posttraumatic Stress Disorder,"Posttraumatic stress disorder (PTSD) is an important mental health issue in terms of the number of people affected and the morbidity and functional impairment associated with the disorder. The purpose of this study was to examine the efficacy of all treatments for PTSD.PubMed, MEDLINE, PILOTS, and PsycINFO databases were searched for randomized controlled clinical trials of any treatment for PTSD in adults published between January 1, 1980, and April 1, 2012, and written in the English language. The following search terms were used: post-traumatic stress disorders, posttraumatic stress disorder, PTSD, combat disorders, and stress disorders, post-traumatic.Articles selected were those in which all subjects were adults with a diagnosis of PTSD based on DSM criteria and a valid PTSD symptom measure was reported. Other study characteristics were systematically collected. The sample consisted of 137 treatment comparisons drawn from 112 studies.Effective psychotherapies included cognitive therapy, exposure therapy, and eye movement desensitization and reprocessing (g = 1.63, 1.08, and 1.01, respectively). Effective pharmacotherapies included paroxetine, sertraline, fluoxetine, risperidone, topiramate, and venlafaxine (g = 0.74, 0.41, 0.43, 0.41, 1.20, and 0.48, respectively). For both psychotherapy and medication, studies with more women had larger effects and studies with more veterans had smaller effects. Psychotherapy studies with wait-list controls had larger effects than studies with active control comparisons.Our findings suggest that patients and providers have a variety of options for choosing an effective treatment for PTSD. Substantial differences in study design and study participant characteristics make identification of a single best treatment difficult. Not all medications or psychotherapies are effective.",0 +https://doi.org/10.1111/j.1755-5949.2010.00188.x,A Double-Blind Randomized Controlled Trial To Study the Efficacy of Topiramate in a Civilian Sample of PTSD,"To evaluate the efficacy and tolerability of topiramate in patients with posttraumatic stress disorder (PTSD).We conducted a 12-week double-blind, randomized, placebo-controlled study comparing topiramate to placebo. Men and women aged 18-62 years with diagnosis of PTSD according to DSM-IV were recruited from the outpatient clinic of the violence program of Federal University of São Paulo Hospital (Prove-UNIFESP), São Paulo City, between April 2006 and December 2009. Subjects were assessed for the Clinician-Administered Posttraumatic Stress Scale (CAPS), Clinical Global Impression, and Beck Depression Inventory (BDI). After 1-week period of washout, 35 patients were randomized to either group. The primary outcome measure was the CAPS total score changes from baseline to the endpoint.82.35% of patients in the topiramate group exhibited improvements in PTSD symptoms. The efficacy analysis demonstrated that patients in the topiramate group exhibited significant improvements in reexperiencing symptoms: flashbacks, intrusive memories, and nightmares of the trauma (CAPS-B; P= 0.04) and in avoidance/numbing symptoms associated with the trauma, social isolation, and emotional numbing (CAPS-C; P= 0.0001). Furthermore, the experimental group demonstrated a significant difference in decrease in CAPS total score (topiramate -57.78; placebo -32.41; P= 0.0076). Mean topiramate dose was 102.94 mg/d. Topiramate was generally well tolerated.Topiramate was effective in improving reexperiencing and avoidance/numbing symptom clusters in patients with PTSD. This study supports the use of anticonvulsants for the improvement of symptoms of PTSD.",0 +https://doi.org/10.1192/bjp.bp.113.143610,Risk of stroke among patients with post-traumatic stress disorder: nationwide longitudinal study,"Background Previous evidence has shown positive associations between post-traumatic stress disorder (PTSD) and hypertension, dyslipidaemia and diabetes mellitus, which are all risk factors for stroke, but the role of PTSD in the subsequent development of stroke is still unknown. Aims To investigate the temporal association between PTSD and the development of stroke. Method Identified from the Taiwan National Health Insurance Research Database, 5217 individuals aged 18 years, with PTSD but with no history of stroke, and 20 868 age- and gender-matched controls were enrolled between 2002 and 2009, and followed up until the end of 2011 to identify the development of stroke. Results Individuals with PTSD had an increased risk of developing any stroke (hazard ratio (HR) 3.37, 95% CI 2.44–4.67) and ischaemic stroke (HR = 3.47, 95% CI 2.23–5.39) after adjusting for demographic data and medical comorbidities. Sensitivity tests showed consistent findings (any stroke HR = 3.02, 95% CI 2.13–4.28; ischaemic stroke HR = 2.89, 95% CI 1.79–4.66) after excluding the first year of observation. Conclusions Individuals with PTSD have an increased risk of developing any stroke and ischaemic stroke. Further studies are required to investigate the underlying mechanisms.",0 +https://doi.org/10.1037/1040-3590.15.2.205,Multidimensional Personality Questionnaire profiles of veterans with traumatic combat exposure: Externalizing and internalizing subtypes.,"This study used the Multidimensional Personality Questionnaire (MPQ; A. Tellegen, in press) to identify personality-based subtypes of posttraumatic response. Cluster analyses of MPQs completed by combat veterans revealed subgroups that differed on measures relating to the externalization versus internalization of distress. The MPQ profile of the externalizing cluster was defined by low Constraint and Harmavoidance coupled with high Alienation and Aggression. Individuals in this cluster also had histories of delinquency and high rates of substance-related disorder. In comparison, the MPQ profile of the internalizing cluster was characterized by lower Positive Emotionality, Alienation, and Aggression and higher Constraint, and individuals in this cluster showed high rates of depressive disorder. These findings suggest that dispositions toward externalizing versus internalizing psychopathology may account for heterogeneity in the expression of posttraumatic responses, including patterns of comorbidity.",0 +https://doi.org/10.1016/j.comppsych.2004.07.020,Cluster analysis of obsessive-compulsive spectrum disorders in patients with obsessive-compulsive disorder: clinical and genetic correlates,"Comorbidity of certain obsessive-compulsive spectrum disorders (OCSDs; such as Tourette's disorder) in obsessive-compulsive disorder (OCD) may serve to define important OCD subtypes characterized by differing phenomenology and neurobiological mechanisms. Comorbidity of the putative OCSDs in OCD has, however, not often been systematically investigated. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition , Axis I Disorders-Patient Version as well as a Structured Clinical Interview for Putative OCSDs (SCID-OCSD) were administered to 210 adult patients with OCD (N = 210, 102 men and 108 women; mean age, 35.7 ± 13.3). A subset of Caucasian subjects (with OCD, n = 171; control subjects, n = 168), including subjects from the genetically homogeneous Afrikaner population (with OCD, n = 77; control subjects, n = 144), was genotyped for polymorphisms in genes involved in monoamine function. Because the items of the SCID-OCSD are binary (present/absent), a cluster analysis (Ward's method) using the items of SCID-OCSD was conducted. The association of identified clusters with demographic variables (age, gender), clinical variables (age of onset, obsessive-compulsive symptom severity and dimensions, level of insight, temperament/character, treatment response), and monoaminergic genotypes was examined. Cluster analysis of the OCSDs in our sample of patients with OCD identified 3 separate clusters at a 1.1 linkage distance level. The 3 clusters were named as follows: (1) “reward deficiency” (including trichotillomania, Tourette's disorder, pathological gambling, and hypersexual disorder), (2) “impulsivity” (including compulsive shopping, kleptomania, eating disorders, self-injury, and intermittent explosive disorder), and (3) “somatic” (including body dysmorphic disorder and hypochondriasis). Several significant associations were found between cluster scores and other variables; for example, cluster I scores were associated with earlier age of onset of OCD and the presence of tics, cluster II scores were associated with female gender and childhood emotional abuse, and cluster III scores were associated with less insight and with somatic obsessions and compulsions. However, none of these clusters were associated with any particular genetic variant. Analysis of comorbid OCSDs in OCD suggested that these lie on a number of different dimensions. These dimensions are partially consistent with previous theoretical approaches taken toward classifying OCD spectrum disorders. The lack of genetic validation of these clusters in the present study may indicate the involvement of other, as yet untested, genes. Further genetic and cluster analyses of comorbid OCSDs in OCD may ultimately contribute to a better delineation of OCD endophenotypes.",0 +https://doi.org/10.1002/jts.21886,Externalizing and Internalizing Subtypes of Posttraumatic Psychopathology and Anger Expression,"Subtypes of posttraumatic psychopathology were replicated and extended in 254 female veterans with posttraumatic stress disorder (PTSD). Cluster analyses on Minnesota Multiphasic Personality Inventory-2 and Personality Psychopathology Five scales (Harkness, McNulty, & Ben-Porath, ) yielded internalizing and externalizing psychopathology dimensions, with a third low psychopathology group (simple PTSD). Externalizers were higher than the internalizers and the simple PTSD groups on the antisocial, substance, and aggression scales; internalizers were higher on depression and anxiety scales. Further validation included an independent measure of psychopathology to examine anger (Buss-Durkee Hostility Inventory, [BDHI]; Buss & Durkee, ). Externalizers were higher on extreme behavioral anger scales (assault and verbal hostility); and externalizers and internalizers were higher than the simple PTSD subjects on other anger scales. Positive correlations between the BDHI scales and the PTSD symptom of ""irritability and anger outbursts"" were found across scales in the total sample (range: r = .19-.36), on the assault scale in externalizers (r = .59), and the verbal hostility scale in both internalizers (r = .30) and simple PTSD (r = .37) groups, suggesting the broad utility of the symptom in the diagnosis. The results demonstrate the generalizability of the internalizing/externalizing typology to the female veteran population and highlight clinically relevant distinctions in anger expression within PTSD.",0 +https://doi.org/10.3109/02699052.2011.597044,Interdisciplinary rehabilitation of mild TBI and PTSD: A case report,"Prevalence of mild traumatic brain injury (mTBI) or concussion on the battlefield in Iraq/Afghanistan has resulted in its designation as a 'signature injury'. Civilian studies have shown that negative expectations for recovery may lead to worse outcomes. While there is concern that concussion screening procedures in the Veteran's Affairs Healthcare System and the Department of Defence could fuel negative expectations, leading to negative iatrogenic effects, it has been difficult to document this in clinical settings. The aim of this report is to describe the case of a veteran with comorbid mTBI/PTSD with persistent symptoms of unknown aetiology and the effects of provider communications on the patient's recovery.Case report of a veteran with reported mTBI, including provider communications, neuropsychological test results and report of functioning after changes in provider messages.Two-years post-mTBI, the patient attributed cognitive difficulties to his brain injury, but neuropsychological assessment found that his cognitive profile was consistent with psychological rather than neurological dysfunction. After providers systematically emphasized expectations of recovery, the patient's daily functioning improved.This case illustrates difficulties in mass screening for and treating mTBI. Recommendations for improvement include clinician training in effectively communicating positive expectations of recovery after concussion.",0 +,When a soldier returns home from Iraq and/or Afghanistan with post -traumatic stress disorder: The lived experience of the spouse,"This study takes a broad look at the effects of a soldier's post-traumatic stress disorder (PTSD) symptomology on the dependent spouse, including anger, emotional distancing, and sleep disturbances a discussed by the participants. Domestic violence in the relationship was suggested to be one of the major factors in the participant's decision-making process. This study can be used as a first step in the development of programs aimed at maintaining family unity as well as increasing the safety of family members. This study is designed to investigate feelings, experiences, and major decisions military dependent spouses make when their Army soldier returns from Iraq and/or Afganistan with PTSD. This study uses qualitative methodology to obtain rich descriptions of the feelings and experiences of military dependants due to the soldier's PTSD symptomology. This study is meant to give other researchers a foundation upon which to create treatment methods that will benefit the Army community. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1016/j.burns.2005.01.009,"The café fire on New Year's Eve in Volendam, the Netherlands: description of events","The café fire at Volendam occurred shortly after midnight on the first of January 2001 and resulted in one of the worst mass burn incidents in recent Dutch history. The aim of this study was to provide insight into medical and organisational requirements of a major burns incident.Shortly after the fire, two university hospitals and a burn center in the region of the accident developed a plan for evaluation of medical care given during and after this major burn incident. A multidisciplinary research group investigated the management of victims at the scene, in the emergency departments (ED) and during admission in the hospitals. All 245 casualties were included in this study.A brief severe fire occurred in a crowded cafe with around 350 young visitors on a small embankment of a relatively isolated town, resulting in a unusually high number of severely injured burn victims. Four died immediately. The ensuing rescue effort was hampered by poor access and chaotic circumstances. At the scene of the incident, mobile medical teams ensured orderly transport and treatment priority for the injured. There were 245 victims with a median total body surface area burned of 12%. Inhalation injury was present in 96 patients. A total of 182 victims were admitted, with 112 to intensive care. Ten patients died in the hospital. Seventy-eight patients were secondarily transported, many to specialised centers in the Netherlands and abroad. In total, 36 hospitals in three countries participated.An incident with high numbers of burn victims poses a challenge to any health care system. The difficult circumstances at the site demonstrated the need for robust organisational structures. The primary and secondary distribution of patients required coordination, general hospitals were able to provide initial medical care to these major burn casualties.",0 +https://doi.org/10.1016/j.psychres.2008.07.019,Lifetime manic–hypomanic symptoms in post-traumatic stress disorder: Relationship with the 18 kDa mitochondrial translocator protein density,"Initially explored in military settings, post-traumatic stress disorder (PTSD) has shown increasing prevalence in the general population. The high comorbidity rates between bipolar disorder (BD) and PTSD have raised the issue of whether some characteristics of BD could represent risk factors for PTSD. In combat-related PTSD, the 18 kDa mitochondrial translocator protein (TSPO), essential for steroid synthesis, was found to be decreased. Aims of the present study were: 1) the assessment of the TSPO mitochondrial density in lymphomonocytes from civilian patients with non-combat-related PTSD, without current or lifetime Axis I mood comorbidity, versus controls; 2) the exploration of the correlations between TSPO density and the presence of comorbid manic/hypomanic lifetime spectrum symptoms. Assessments included the Structured Clinical Interview for DSM-IV (SCID), the Impact of Event Scale (IES), and the lifetime Mood Spectrum Self-Report (MOODS-SR). Blood samples were processed to assess TSPO binding parameters in lymphomonocyte mitochondrial membranes. PTSD patients showed a significant decrease in TSPO density, without changes in mitochondrial citrate synthase activity. Further, TSPO density correlated with the number of lifetime manic/hypomanic spectrum symptoms. For the first time, TSPO density was found to be decreased in non-war-related PTSD and such decreases correlated with comorbid manic/hypomanic spectrum symptoms, indicating a possible role of sub-threshold bipolar comorbidity in PTSD-related neurobiological dysregulation.",0 +https://doi.org/10.1177/0049124101029003005,A SAS Procedure Based on Mixture Models for Estimating Developmental Trajectories,"This article introduces a new SAS procedure written by the authors that analyzes longitudinal data (developmental trajectories) by fitting a mixture model. The TRAJ procedure fits semiparametric (discrete) mixtures of censored normal, Poisson, zero-inflated Poisson, and Bernoulli distributions to longitudinal data. Applications to psychometric scale data, offense counts, and a dichotomous prevalence measure in violence research are illustrated. In addition, the use of the Bayesian information criterion to address the problem of model selection, including the estimation of the number of components in the mixture, is demonstrated.",0 +https://doi.org/10.1097/nmd.0b013e3181d106a9,Initial Stress Responses in Relation to Outcome After Three Decades,"The present study aimed at predicting posttraumatic stress 5 and 27 years after the North Sea oil rig disaster. The predictions were based on the initial levels of stress responses and the early recovery as reported in 1980. The Posttraumatic Stress Scale (PTSS) was used at 3 measure points. From 1980, data from 69 survivors were used in latent growth modeling. Follow-up studies included 65 survivors and 85 matched unexposed oil-rig workers in 1985; and 47 and 62 in 2007. In 1985, the survivors had higher total PTSS scores and more frequent endorsements on most single PTSS-items than the comparison group. In 2007, a few single items remained different. The initial levels of stress responses and the early recovery rate predicted the long-term outcomes after 5 and 27 years. Initial screenings may be helpful in the early detection of posttraumatic stress in the very long-term perspective.",0 +https://doi.org/10.1002/jts.21804,What Is the Typical Response to Sexual Assault? Reply to Bonanno (2013),"We respond to Bonanno's (2013) comment on our longitudinal evaluation of sexual assault survivors. Bonanno posits that minor disruption in functioning is the modal response to any stressor or trauma, yet most women we studied had marked initial symptoms in the immediate months following assault, which gradually improved over time. We argue that sexual violence is one example of intentional and malicious victimization, which differs from other experiences studied by Bonanno, such as spinal cord injury. Our study also differed from most previous studies in that it specifically examined the acute reactions period, which is the only period that can distinguish between resilience and recovery: Both trajectories ultimately involve good adaptation, but are distinguished by the degree of initial postevent disruption. We address Bonanno's contention that our results should be dismissed on methodological and statistical grounds. Our findings suggest that prior research about the frequency of resilience may in part be confounded by the degree and type of stress exposure.",0 +https://doi.org/10.1038/npp.2015.79,The Dissociative Subtype of Posttraumatic Stress Disorder: Unique Resting-State Functional Connectivity of Basolateral and Centromedial Amygdala Complexes,"Previous studies point towards differential connectivity patterns among basolateral (BLA) and centromedial (CMA) amygdala regions in patients with posttraumatic stress disorder (PTSD) as compared with controls. Here we describe the first study to compare directly connectivity patterns of the BLA and CMA complexes between PTSD patients with and without the dissociative subtype (PTSD+DS and PTSD-DS, respectively). Amygdala connectivity to regulatory prefrontal regions and parietal regions involved in consciousness and proprioception were expected to differ between these two groups based on differential limbic regulation and behavioral symptoms. PTSD patients (n=49) with (n=13) and without (n=36) the dissociative subtype and age-matched healthy controls (n=40) underwent resting-state fMRI. Bilateral BLA and CMA connectivity patterns were compared using a seed-based approach via SPM Anatomy Toolbox. Among patients with PTSD, the PTSD+DS group exhibited greater amygdala functional connectivity to prefrontal regions involved in emotion regulation (bilateral BLA and left CMA to the middle frontal gyrus and bilateral CMA to the medial frontal gyrus) as compared with the PTSD-DS group. In addition, the PTSD+DS group showed greater amygdala connectivity to regions involved in consciousness, awareness, and proprioception-implicated in depersonalization and derealization (left BLA to superior parietal lobe and cerebellar culmen; left CMA to dorsal posterior cingulate and precuneus). Differences in amygdala complex connectivity to specific brain regions parallel the unique symptom profiles of the PTSD subgroups and point towards unique biological markers of the dissociative subtype of PTSD.",0 +https://doi.org/10.1007/s12144-015-9362-6,Understanding Resilience and Other Trajectories of Psychological Distress: a Mixed-Methods Study of Low-Income Mothers Who Survived Hurricane Katrina,"Recent longitudinal studies in the aftermath of natural disasters have shown that resilience, defined as a trajectory of consistently low symptoms, is the modal experience, although other trajectories representing adverse responses, including chronic or delayed symptom elevations, occur in a substantial minority of survivors. Although these studies have provided insight into the prototypical patterns of postdisaster mental health, the factors that account for these patterns remain unclear. In the current analysis, we aimed to fill this gap through a mixed-methods study of female participants in the Resilience in Survivors of Katrina (RISK) study. Latent class growth analysis identified six trajectories of psychological distress in the quantitative sample (n=386). Qualitative analysis of in-depth interviews with 54 participants identified predisaster, disaster-related and postdisaster experiences that could account for the trends in the quantitative data. In particular, preexisting and gains in psychosocial resources (e.g., emotion regulation, religiosity) and positive postdisaster impacts (e.g., greater neighborhood satisfaction, improved employment opportunities) were found to underlie resilience and other positive mental health outcomes. Conversely, experiences of childhood trauma, and pre and postdisaster stressors (e.g., difficulties in intimate partner relationships) were common among participants in trajectories representing adverse psychological responses. Illustrative case studies that exemplify each trajectory are presented. The results demonstrate the utility of mixed-methods analysis to provide a richer picture of processes underlying postdisaster mental health.",0 +https://doi.org/10.1016/0005-7967(94)00067-t,Short-term follow-up of post-traumatic stress symptoms in motor vehicle accident victims,"Ninety-eight victims of recent motor vehicle accidents (MVA), who sought medical attention as a result of the MVA, were followed up prospectively 6 months after the initial assessment, using Keller, Lavori, Friedman, Nielsen, Endicott, McDonald-Scott and Andreasen's (Archives of General Psychiatry, 44, 540-548, 1987) LIFE methodology so that month-by-month changes in post-traumatic stress disorder (PTSD) symptoms could be determined. For the 40 MVA victims who initially met the full criteria for PTSD, 10 no longer met the criteria 4 months after the initial assessment, a decrease significant at the P < 0.01 level, and 20 no longer met the full criteria at 6 months (P < 0.001). On a symptom-by-symptom basis, there were significant declines among the fraction of those who initially met the criteria for PTSD for all avoidance and numbing symptoms by the 6-month follow-up, whereas most of the hyperarousal symptoms did not show significant declines.",0 +https://doi.org/10.1037/1076-8998.10.4.310,Chronicity of Psychological Strain in Occupational Settings and the Accuracy of the General Health Questionnaire.,"This article examines the proposition that the traditional scoring method of the General Health Questionnaire (GHQ) underestimates the number of respondents classified as ""cases."" A revised ""chronic"" scoring method (the CGHQ) is used and demonstrates superior construct validity and greater sensitivity. A comparison of the CGHQ and GHQ also shows the CGHQ to be a superior criterion measure. These claims are demonstrated by survey data gathered from 3 occupational samples (Ns=11,637, 2,253, and 2,124). Results show that the CGHQ is more appropriate as a screening instrument for psychological morbidity. Tests of construct validity also favor the CGHQ with only a slight advantage for predictive validity in terms of variance explained. The more desirable statistical properties of the CGHQ result in a reduction of significant interaction terms and are strongly recommended in future studies as a means of controlling Type I errors when tests of moderation are examined.",0 +https://doi.org/10.3109/00048674.2010.551279,Clinical and Cognitive Correlates of Psychiatric Comorbidity in Delusional Disorder Outpatients,"Objectives: The aims of this study were to investigate the prevalence, as well as the clinical, cognitive, and functional correlates of psychiatric comorbidity in patients with delusional disorder (DD). Methods: Eighty-six outpatients with DSM-IV DD were evaluated for psychiatric comorbidity on Axis I disorders using the Mini International Neuropsychiatry Interview (MINI). The following instruments were administered: the Standardized Assessment of Personality (SAP), the Positive and Negative Symptom Scale (PANSS), the Montgomery-Asberg Depression Rating Scale (MADRS), a neuropsychological battery (consisting of measures for attention, verbal and working memory, and executive functions), the Sheehan Disability Inventory (SDI), and the Global Assessment of Functioning (GAF) scale. A socio-demographic and clinical questionnaire was also completed. Results: Forty-six percent of the subjects had at least one additional lifetime psychiatric diagnosis, the most common being depressive disorders (N = 16, 32.6%), followed by anxiety disorders (N = 8, 14%). DD with comorbid Axis I disorders (N = 40, 46.5%) was associated with a specific syndromic constellation (more common cluster C personality psychopathology, somatic delusions, olfactory and gustatory hallucinations, and suicide risk), and greater severity of the psychopathology, particularly as regards emotional dysregulation (total and general PANSS scales, MADRS, and perceived stress SDI scoring). In contrast, DD without psychiatric comorbidity – “pure” DD – (N = 46, 53.5%) was associated with worse overall neurocognitive performance, mainly in working memory. There were no differences in functionality between the two groups (as per the GAF and SDI total, work, social and family life disability scores). Conclusions: Our findings reveal one type of DD with associated psychiatric comorbidity with greater emotion-related psychopathology and another “pure” DD, without psychiatric comorbidity, related to worse global cognitive functioning. Treatment for DD should address both types of processes.",0 +https://doi.org/10.1176/appi.ajp.158.12.1982,"Efficacy and Safety of Paroxetine Treatment for Chronic PTSD: A Fixed-Dose, Placebo-Controlled Study","This study evaluated the efficacy and safety of paroxetine for the treatment of patients with chronic posttraumatic stress disorder (PTSD).Outpatients with chronic PTSD according to DSM-IV criteria and a score of 50 or more on the Clinician-Administered PTSD Scale, part 2, were randomly assigned to take placebo (N=186), 20 mg/day of paroxetine (N=183), or 40 mg/day of paroxetine (N=182) for 12 weeks. Efficacy was assessed by examining the change in total score from baseline to endpoint on the Clinician-Administered PTSD Scale, part 2, and rates of response (""very much improved"" or ""much improved"") for global improvement on the Clinical Global Impression scale.Paroxetine-treated patients in both dose groups demonstrated significantly greater improvement on primary outcome measures compared to placebo-treated patients in the intent-to-treat analysis. Moreover, paroxetine treatment resulted in statistically significant improvement compared to placebo on all three PTSD symptom clusters (reexperiencing, avoidance/numbing, and hyperarousal), social and occupational impairment, and comorbid depression. Paroxetine was effective for both men and women. Treatment response did not vary by trauma type, time since trauma, or severity of baseline PTSD or depressive symptoms. Both doses were well tolerated.Doses of 20 and 40 mg/day of paroxetine are effective and well tolerated in the treatment of adults with chronic PTSD.",0 +https://doi.org/10.1039/c4mb00404c,Systems biology approach to understanding post-traumatic stress disorder,This review paper presents known biological facts about PTSD and the mathematical/systems biology tools used to understand the underpinning molecular principles.,0 +https://doi.org/10.1002/ab.21554,Personality Assessment Inventory internalizing and externalizing structure in veterans with posttraumatic stress disorder: Associations with aggression,"Posttraumatic stress disorder (PTSD) is associated with aggressive behavior in veterans, and difficulty controlling aggressive urges has been identified as a primary postdeployment readjustment concern. Yet only a fraction of veterans with PTSD commit violent acts. The goals of this study were to (1) examine the higher-order factor structure of Personality Assessment Inventory (PAI) scales in a sample of U.S. military veterans seeking treatment for PTSD; and (2) to evaluate the incremental validity of higher-order latent factors of the PAI over PTSD symptom severity in modeling aggression. The study sample included male U.S. Vietnam (n = 433) and Iraq/Afghanistan (n = 165) veterans who were seeking treatment for PTSD at an outpatient Veterans Affairs (VA) clinic. Measures included the Clinician Administered PTSD Scale, the PAI, and the Conflict Tactics Scale. The sample was randomly split into two equal subsamples (n's = 299) to allow for cross-validation of statistically derived factors. Parallel analysis, variable clustering analysis, and confirmatory factor analyses were used to evaluate the factor structure, and regression was used to examine the association of factor scores with self-reports of aggression over the past year. Three factors were identified: internalizing, externalizing, and substance abuse. Externalizing explained unique variance in aggression beyond PTSD symptom severity and demographic factors, while internalizing and substance abuse did not. Service era was unrelated to reports of aggression. The constructs of internalizing versus externalizing dimensions of PTSD may have utility in identifying characteristics of combat veterans in the greatest need of treatment to help manage aggressive urges. Aggr. Behav. 9999:XX-XX, 2014. Published 2014. This article is a U.S. Government work and is in the public domain in the USA. Language: en",0 +https://doi.org/10.1111/j.1521-0391.2012.12008.x,Frequency and Severity of Comorbid Mood and Anxiety Disorders in Prescription Opioid Dependence,"Background and Objectives Comorbid substance use disorders and mood and anxiety disorders are associated with more severe psychiatric symptoms, social and occupational impairment, and economic burden. To date, the majority of research has focused on comorbidity in illicit drug users, rather than prescription drug users. To address this gap in the literature, the present cross-sectional study investigated the clinical profiles of individuals with prescription opioid dependence with or without comorbid mood and anxiety disorders. Methods Ninety individuals with prescription opioid use were recruited to participate in the study procedures. All participants completed a structured clinical interview and series of self-report measures. Results and Conclusions Of the 85 individuals with prescription opioid dependence, 47.1% (n = 40) were diagnosed with a comorbid mood or anxiety disorder. The findings showed that individuals with prescription opioid dependence and comorbid mood and anxiety disorders demonstrated significantly more severe alcohol use, psychiatric symptoms, and sleep impairment than individuals without comorbidity. Scientific Significance The findings highlight the frequency and severity of co-occurring mood and anxiety disorders in individuals with prescription opioid dependence and suggest that integrated interventions are needed to address these growing problems. (Am J Addict 2013; 22:261–265)",0 +https://doi.org/10.1080/09540260500104540,REM sleep behaviour disorder: Clinical profiles and pathophysiology,"Rapid eye movement (REM) sleep behaviour disorder (RBD) is a parasomnia characterized by the intermittent loss of electromyographic atonia normally present during REM sleep and the emergence of purposeful complex motor activity associated with vivid dreams. Rapid eye movement sleep behaviour disorder usually affects older males and can be either idiopathic or symptomatic of various underlying disorders, in particular neurodegenerative diseases; in the latter case, RBD may be a prodromal symptom of the neurological disease. Several brainstem regions have been implicated in RBD pathophysiology, although the exact mechanism of the disorder in humans remains to be clarified. On clinical grounds, differentiation of RBD should be made from several non-REM parasomnias and other aberrant behaviours occurring during sleep. Rapid eye movement sleep behaviour disorder can be diagnosed on the basis of a systematic medical, neurological and psychiatric evaluation of the patient, assisted by a standard polysomnographic recording that includes continuous overnight videotaping; a brain imaging study is mandatory when an underlying brain disease is being suspected. Clonazepam at bedtime is the treatment of choice for RBD; alternatively, melatonin or pramipexole can be administered when clonazepam is contraindicated.",0 +https://doi.org/10.1097/ta.0b013e31824416aa,Predictors of acute posttraumatic stress disorder symptoms following civilian trauma,"Posttraumatic stress disorder (PTSD) is associated with significant morbidity following injury. The incidence and risk factors for PTSD are not well described in the civilian trauma population. We proposed to screen all trauma patients in the outpatient trauma clinic for acute PTSD symptoms and identify risk factors for PTSD.We prospectively screened 1,386 injured patients who presented for follow-up in trauma clinic (January 2009 to September 2010) using an established PTSD screening test (PTSD Checklist-Civilian, PCL-C). A PCL-C score of ≥35, with a known sensitivity of >85% for PTSD, was considered screen-positive (PCL-C-POS). Backward stepwise logistic regression was used to determine independent risk factors for PCL-C-POS.Over 25% of trauma clinic patients met the threshold for positive PTSD screen (PCL-C-POS). The highest incidence (43%) was in patients who sustained assault (blunt or penetrating). Regression analysis revealed that age <55 years, female gender, motor vehicle collision, and assaultive mechanism (blunt or penetrating, excluding self-inflicted or accidental injury) were independent predictors of PCL-C-POS status. As the severity of symptoms increased (higher PCL-C scores), the risk associated with assaultive mechanism significantly increased in a dose-response fashion (p < 0.05).This study confirms the high incidence of acute PTSD symptoms in trauma patients and supports the feasibility of PTSD screening in the outpatient trauma clinic. Among all mechanisms of injury, patients who sustain interpersonal violence are at the highest risk of developing acute PTSD symptoms. These results suggest that PTSD screening in outpatient trauma clinic may allow early detection and referral of patients with PTSD.II.",0 +,[Factors affecting the diagnosis of post-traumatic stress disorder after a terrorist attack].,"On 3 January 2008 explosives placed in an automobile on a thoroughfare in Diyarbakir, southeastern Turkey exploded in a terrorist attack. The aim of this study was to determine the risk factors for the diagnosis of and the rate of post-traumatic stress disorder (PTSD) among individuals who were eye- or earwitnesses to the explosion 1 and 3 months after the explosion.Among the residents and workers in close proximity to the explosion site, 216 individuals who were eye- or earwitnesses to the explosion were included in the study. A sociodemographic data form and a traumatic stress symptom scale were administered to the participants 1 and 3 months following the explosion.In all, 12.5% of the participants were diagnosed with PTSD 1 month post-explosion versus 9.6% 3 months post-explosion. While history of psychiatric disorder and physical injury were risk factors for PTSD 1 month post-explosion, risk factors 3 months post-explosion was history of psychiatric disorder.PTSD occurs at high rates in individuals exposed to terrorist attacks. More studies following such events are required in Turkey. In light of these results it is advised that individuals at risk of PTSD receive therapeutic and preventive interventions provided by mental health professionals.",0 +https://doi.org/10.3389/fnins.2015.00328,Identification of resilient individuals and those at risk for performance deficits under stress,"Human task performance is affected by exposure to physiological and psychological stress. The ability to measure the physiological response to stressors and correlate that to task performance could be used to identify resilient individuals or those at risk for stress-related performance decrements. Accomplishing this prior to performance under severe stress or the development of clinical stress disorders could facilitate focused preparation such as tailoring training to individual needs. Here we measure the effects of stress on physiological response and performance through behavior, physiological sensors, and subjective ratings, and identify which individuals are at risk for stress-related performance decrements. Participants performed military-relevant training tasks under stress in a virtual environment, with autonomic and hypothalamic-pituitary-adrenal axis (HPA) reactivity analyzed. Self-reported stress, as well as physiological indices of stress, increased in the group pre-exposed to socioevaluative stress. Stress response was effectively captured via electrodermal and cardiovascular measures of heart rate and skin conductance level. A resilience classification algorithm was developed based upon physiological reactivity, which correlated with baseline unstressed physiological and self-reported stress values. Outliers were identified in the experimental group that had a significant mismatch between self-reported stress and salivary cortisol. Baseline stress measurements were predictive of individual resilience to stress, including the impact stress had on physiological reactivity and performance. Such an approach may have utility in identifying individuals at risk for problems performing under severe stress. Continuing work has focused on adapting this method for military personnel, and assessing the utility of various coping and decision-making strategies on performance and physiological stress.",0 +,Direct and indirect predictors of traumatic stress and distress in orphaned survivors of the 1994 Rwandan Tutsi genocide,"Millions of children grow into adulthood having experienced severe war and ethnic conflict as children. One such group is orphaned child and adolescent survivors of the 1994 Rwandan Tutsi Genocide, in which one-seventh of the Rwandan population was murdered over the course of 100 days. After the genocide, many of these children took on the responsibility of caring and providing for other child survivors. Research has documented that child survivors of the genocide are at increased risk of mental health concerns (Dyregrov, Gupta, Gjestad, & Mukanoheli, 2000; Schaal & Elbert, 2006). However, differences in PTSD symptoms in Rwandan orphan survivors have not been fully explained by genocide exposure. This dissertation consists of two manuscripts that used path analysis to identify modifiable factors that contribute to mental health outcomes for orphaned heads of household (OHH) in Rwanda, over and above genocide exposure. Participants were 100 OHH who were members of a community organization. Data came from genocide testimonies that were given in 2002 and assessments of post-genocide mental health and risk factors that were collected in a 2008/2009 follow-up of 61 of the 100 original participants. The first manuscript used cognitive models of posttraumatic stress disorder (PTSD) as a framework for investigating whether linguistic components of genocide testimonies predict PTSD symptoms. Results were somewhat consistent with cognitive models and indicated that the way survivors described their genocide experiences predicted PTSD symptoms six years later. The second manuscript investigated whether post-genocide social-ecological risk factors predict distress and traumatic stress. Lack of education substantially predicted both distress and traumatic stress, lack of resources significantly predicted lower educational attainment, and social support predicted distress. After accounting for post-genocide risk factors, genocide experiences still directly predicted distress and traumatic stress. Implications for intervention and research are discussed. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0 +https://doi.org/10.1053/j.apnu.2003.11.005,"Trauma, posttraumatic stress disorder symptom clusters, and physical health symptoms in postabused women","The purpose of this retrospective, descriptive-correlational research was to examine the relationships between violent and nonviolent trauma, posttraumatic stress disorder (PTSD) and its symptom clusters of avoidance, intrusive/re-experiencing, and hyperarousal, and self-reported physical health symptoms in 50 postabused women. Results indicated: (1) PTSD hyperarousal and avoidance symptom clusters were positively associated with physical health symptoms, and (2) childhood physical abuse accounted for a significant and unique portion of the variance in physical health symptoms. The results highlight the need for health care practitioners in all settings to assess for a history of trauma in a woman's life.",0 +https://doi.org/10.1016/j.chiabu.2013.07.012,Childhood maltreatment and post-traumatic stress disorder among incarcerated young offenders,"Young offenders have a high prevalence of mental illness and a large proportion report experiencing a number of traumatic events during childhood, but there is little research exploring this association. This study describes the prevalence of, and association between, child maltreatment and post-traumatic stress disorder (PTSD) among young offenders. The study uses data collected as part of the 2009 NSW Young People in Custody Health Survey which was conducted in nine juvenile detention centers. This paper reports on findings from the baseline questionnaires and 18-months of re-offending data. The analysis included 291 participants who were assessed for PTSD and child maltreatment. The sample was 88% male, 48% Aboriginal, with an average age of 17 years (range 13–21 years). One in five (20%) participants were diagnosed with PTSD, with females significantly more likely to have PTSD than males (40% vs. 17%, p < 0.05). Over half (60%) of young offenders reported any child abuse or neglect, with females nearly 10 times more likely to report three or more kinds of severe child maltreatment than males. The main correlate for a diagnosis of PTSD was having three or more kinds of severe child maltreatment (OR = 6.73, 95% CI: 1.06–42.92). This study provides evidence for the need to comprehensively assess child abuse and neglect among young offenders in order to provide appropriate treatment in custody and post-release.",0 +https://doi.org/10.1037/0022-006x.72.5.909,A Longitudinal Analysis of PTSD Symptom Course: Delayed-Onset PTSD in Somalia Peacekeepers.,"Posttraumatic stress disorder (PTSD) typically follows an acute to chronic course. However, some trauma victims do not report significant symptoms until a period of time has elapsed after the event. Although originally dismissed as an artifact of retrospective methodologies, recent prospective studies document apparent instances of delayed-onset PTSD. Little is known currently about factors associated with the delayed onset of PTSD. This study was designed to examine the course of PTSD in a sample of 1,040 U.S. military peacekeepers who served in Somalia. A small but nontrivial subset of participants endorsed clinically significant levels of PTSD after a period of minimal distress, the magnitude of which cannot be ascribed to minor waxing and waning of symptoms. War-zone exposure and perceived meaningfulness of the mission, as rated by soldiers after returning to the United States, predicted symptom course over the next 18 months.",0 +https://doi.org/10.1016/j.socscimed.2009.09.039,"Human rights, transitional justice, public health and social reconstruction","Mass violence, armed conflict, genocide, and complex humanitarian emergencies continue to create major social and public health disasters at the dawn of the 21st Century. Transitional justice, a set of policies designed to address the effects of war on traumatized communities and bring justice, lies at the nexus of public health, conflict, and social reconstruction. Despite the paucity of empirical evidence, advocates of transitional justice have claimed that it can alleviate the effects of trauma, deter future violence, and bring about social reconstruction in war-affected communities. Empirical evidence--including new data and analyses presented in this article--suggests a link between trauma, mental health and attitudes towards and responses to transitional justice programs, but there has been little theoretical discussion about the intersection between public health and transitional justice, and even less empirical research to generate discussion between these two fields. Yet, public health professionals have an important role to play in assessing the impact of transitional justice on communities affected by mass violence. In this paper, we offer a conceptual model for future research that seeks to examine the relationship between transitional justice programs and their potential value to the fields of medicine and public health and discuss the methodological issues and challenges to a comprehensive evaluation of this relationship. To illustrate the discussion, we examine new data and analyses from two cases of contemporary conflicts, eastern Democratic Republic of Congo (DRC) and northern Uganda.",0 +https://doi.org/10.1117/12.2051148,Heart rate variability (HRV): an indicator of stress,"Heart rate variability (HRV) can be an important indicator of several conditions that affect the autonomic nervous system, including traumatic brain injury, post-traumatic stress disorder and peripheral neuropathy [3], [4], [10] & [11]. Recent work has shown that some of the HRV features can potentially be used for distinguishing a subject’s normal mental state from a stressed one [4], [13] & [14]. In all of these past works, although processing is done in both frequency and time domains, few classification algorithms have been explored for classifying normal from stressed RRintervals. In this paper we used 30 s intervals from the Electrocardiogram (ECG) time series collected during normal and stressed conditions, produced by means of a modified version of the Trier social stress test, to compute HRV-driven features and subsequently applied a set of classification algorithms to distinguish stressed from normal conditions. To classify RR-intervals, we explored classification algorithms that are commonly used for medical applications, namely 1) logistic regression (LR) [16] and 2) linear discriminant analysis (LDA) [6]. Classification performance for various levels of stress over the entire test was quantified using precision, accuracy, sensitivity and specificity measures. Results from both classifiers were then compared to find an optimal classifier and HRV features for stress detection. This work, performed under an IRB-approved protocol, not only provides a method for developing models and classifiers based on human data, but also provides a foundation for a stress indicator tool based on HRV. Further, these classification tools will not only benefit many civilian applications for detecting stress, but also security and military applications for screening such as: border patrol, stress detection for deception [3],[17], and wounded-warrior triage [12].",0 +https://doi.org/10.1037/ccp0000036,The influence of the dissociative subtype of posttraumatic stress disorder on treatment efficacy in female veterans and active duty service members.,"A dissociative subtype of posttraumatic stress disorder (PTSD) was recently added to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; American Psychiatric Association, 2013) and is thought to be associated with poor PTSD treatment response.We used latent growth curve modeling to examine data from a randomized controlled trial of prolonged exposure and present-centered therapy for PTSD in a sample of 284 female veterans and active duty service members with PTSD to test the association between the dissociative subtype and treatment response.Individuals with the dissociative subtype (defined using latent profile analysis) had a flatter slope (p = .008) compared with those with high PTSD symptoms and no dissociation, such that the former group showed, on average, a 9.75 (95% confidence interval [-16.94, -2.57]) lesser decrease in PTSD severity scores on the Clinician Administered PTSD Scale (Blake et al., 1995) over the course of the trial. However, this effect was small in magnitude. Dissociative symptoms decreased markedly among those with the subtype, though neither treatment explicitly addressed such symptoms. There were no differences as a function of treatment type.Results raise doubt about the common clinical perception that exposure therapy is not effective or appropriate for individuals who have PTSD and dissociation, and provide empirical support for the use of exposure treatment for individuals with the dissociative subtype of PTSD.",0 +https://doi.org/10.1016/j.jad.2011.03.041,Age at onset in Canadian OCD patients: Mixture analysis and systematic comparison with other studies,"This study aimed to determine the distributions of the age at onset (AAO) using mixture analysis and better develop the understanding of AAO as a clinical feature of obsessive-compulsive disorder.Mixture analysis was used to identify sub-groups characterized by differences in AAO. Clinical features were analyzed for differences in AAO sub-groups using mixture analysis. Comparisons were made with AAO cut-offs used in previous studies using the 2-Sample Kolmogorov-Smirnov Test.Mixture analysis of our sample (n=196) yielded a combination of 2 normal theoretical distributions with means (SD) of 9.66 (3.12) for the early-onset sub-group and 21.1 (8.36) years for the late-onset sub-group. The sub-groups were divided by a cut-off of 15 years. As expected, a negative correlation was found between AAO and duration of illness. The early-onset subjects had significantly lower age at the time of the assessment and they tended to have more often panic attacks but were treated less often with benzodiazepines and other anti-anxiety medications. The comparison analysis showed significant difference in the AAO distribution between our sample and four other study samples.Our findings support the notion that different AAO sub-groups correspond with differences in clinical presentations of obsessive-compulsive disorder.",0 +https://doi.org/10.1002/jcop.21654,RESILIENCE AND RECOVERY IN AMERICAN SĀMOA: A CASE STUDY OF THE 2009 SOUTH PACIFIC TSUNAMI,"Case study methodology was used to explore the culturally situated response and recovery efforts following a tsunami in American Sāmoa. Data indicated that cultural mechanisms were effective in meeting physical needs but insufficient to manage the emotional trauma caused by such a large-scale event. Samoan cultural norms strongly discourage uncontrolled emotional expression outside of ritualized grieving events. Disruptions in social networks and activities, combined with a lack of available emotional support, resulted in significant psychological distress for many survivors. Sixteen months after the tsunami residents continued to exhibit numerous symptoms of posttraumatic stress. In response to this need for emotional support, some groups within American Sāmoa are setting an example of how their culture can adapt by forging new, culturally grounded methods for addressing emotional needs that arose in the wake of the tsunami. Findings are analyzed through the lens of the social support deterioration deterrence model and activity settings theory.",0 +https://doi.org/10.1001/jama.290.5.627,Mental Health and Health-Related Quality of Life Among Adult Latino Primary Care Patients Living in the United States With Previous Exposure to Political Violence,"Although political violence continues in parts of Central America, South America, and Mexico, little is known about its relationship to the health of Latino immigrants living in the United States.To determine (1) rates of exposure to political violence among Latino adult primary care patients who have immigrated to the United States from Central America, South America, and Mexico and its impact on mental health and health-related quality of life and (2) frequency of disclosure of political violence to primary care clinicians.Two-stage cluster design survey of a systematic sample of Latino immigrant adults in 3 community-based primary care clinics in Los Angeles, conducted from July 2001 to February 2002.Reports of exposure to political violence in home country before immigrating to the United States and communication with clinicians about political violence; self-reported measures of health-related quality of life using the Medical Outcomes Study Short Form 36 (MOS SF-36); symptoms of depression, anxiety, and alcohol disorders using the Primary Care Evaluation of Mental Disorders (PRIME-MD); and symptoms of posttraumatic stress disorder (PTSD) using the PTSD Checklist-Civilian Version (PCL-C).A total of 638 (69%) of 919 eligible patients participated. The nonresponse rates did not differ by age, sex, recruitment sites, or clinic sessions. In weighted analyses, 54% of participants reported political violence experiences in their home countries, including 8% who reported torture. Of those exposed to political violence, 36% had symptoms of depression and 18% had symptoms of PTSD vs 20% and 8%, respectively, among those not exposed to political violence. Controlling for age, sex, country, years lived in the United States, acculturation, income, health insurance status, and recruitment site in a subsample of 512 participants (56%), those who reported political violence exposure were more likely to meet symptom criteria for PTSD (adjusted odds ratio [AOR], 3.4; 95% confidence interval [CI], 1.4-8.4) and to have symptoms of depression (AOR, 2.8; 95% CI, 1.4-5.4) and symptoms of panic disorder (AOR, 4.8; 95% CI, 1.6-14.4) than participants not reporting political violence. Those exposed to political violence reported more chronic pain and role limitations due to physical problems, as well as worse physical functioning and lower perceptions of general health than those who were not exposed to political violence. Only 3% of the 267 patients who had experienced political violence reported ever telling a clinician about it after immigrating; none reported their current physician asking about political violence.Latino immigrants in primary care in Los Angeles have a high prevalence of exposure to political violence before immigrating to the United States and associated impairments in mental health and health-related quality of life.",0 +https://doi.org/10.1080/03069885.2013.793784,Degrees of resilience: profiling psychological resilience and prospective academic achievement in university inductees,"University inductees may be increasingly vulnerable to stressors during transition into higher education (HE), requiring psychological resilience to achieve academic success. This study aimed to profile inductees' resilience and to investigate links to prospective end of year academic outcomes. Scores for resilience were based on a validated Connor Davison Resilience Scale (CD-RISC) drawn from 1534 inductees in a single UK university. A four-stage analysis revealed that incremental resilience was more facilitative of females' prospective academic attainment, but less functional and more convoluted for males. This large, distinctive study has implications for student support practices and highlights that the relationship between resilience and academic achievement requires further consideration in HE.",0 +https://doi.org/10.1192/bjp.bp.112.113514,Post-traumatic stress symptoms among former child soldiers in Sierra Leone: follow-up study,"Background Former child soldiers are at risk of developing post-traumatic stress disorder (PTSD); however, the trajectory of symptoms has yet to be examined. Aims The risk and protective factors associated with PTSD symptom change among former child soldiers in Sierra Leone were investigated. Method Data from 243 former child soldiers (mean age 16.6 years, 30% female) were analysed. Results Self-reported rates of possible PTSD using standard cut-off points declined from 32% to 16% 4 years later ( P <0.05). Symptoms of PTSD at baseline were significantly associated with war experiences ( P <0.01) and post-conflict family abuse ( P <0.001). Reliable improvement in symptoms was reported by 30%. In growth models examining symptom change, worsening of symptoms was associated with death of a parent ( P <0.05) and post-conflict stigma ( P <0.001). Protective effects were observed for increases in family acceptance ( P <0.001). Conclusions The findings indicated improvement in PTSD symptoms among former child soldiers despite limited access to care. Family and community support played a vital part in promoting psychological adjustment.",0 +https://doi.org/10.1097/00005053-199504000-00008,Psychometric Properties of the Dissociative Experiences Scale,"The test-retest reliability of the Dissociative Experiences Scale (DES; Bernstein EM, Putnam FW [1986] Development, reliability, and validity of a dissociation scale. The Journal of Nervous and Mental Disease 174:727-735) in a clinical sample was found to be .93 for the total DES score and .95, .89, and .82 for the three subscale scores of amnesia, depersonalization-derealization, and absorption (dissociative identity disorder [DID], DSM-IV), respectively. Test-retest reliabilities within diagnostic groups of multiple personality disorder, dissociative disorder not otherwise specified, and a general other category of psychiatric diagnoses were obtained for total and subscale scores on the DES. These ranged from .78 to .96. Tests of mean scores across the two test sessions showed the total and subscale scores to be temporally stable. The DES was also found to be highly internally consistent: Cronbach's alphas of .96 and .97 were observed for the total DES scores taken at times 1 and 2, respectively. Construct validity of the DES was demonstrated by differentiation among the subscale scores in a repeated-measures analysis of variance (F[2,154] = 32.03, p < or = .001). Normality and general distribution issues were also addressed and provided a rationale for using the DES with parametric statistics. Reasons why the DES (as it was originally designed) is not appropriate as a dependent measure in outcome research are discussed, along with needed future research. Implications of the findings for the clinical usefulness of the DES as a diagnostic instrument are noted.",0 +https://doi.org/10.1080/10615809908250477,Posttraumatic stress disorder in the new zealand police: The moderating role of social support following traumatic stress,"It has been consistently demonstrated that social support affects psychological outcomes following the experience of trauma. Information processing theories of traumatic stress and empirical evidence suggest a model of social support and Posttraumatic Stress Disorder (PTSD) aetiology, in which emotional support and disclosure moderates the effects of trauma. This model was tested using survey data from 527 New Zealand Police officers. The results showed that all support variables had significant negative main effects on PTSD symptoms. Trauma was positively related to PTSD symptoms and this relationship was moderated by police officers' attitudes to expressing emotions at work and emotional support from peers. These results have implications for the provision of support for workers whose job places them at risk of experiencing multiple trauma.",0 +,Comorbidities and psychotic illness. Part 1: Philosophy and clinical consequences.,"This article aims at addressing the implications of defining 'comorbidity' within the field of psychiatry. We have looked at the standard definition of comorbidity and then discussed whether this definition can be applied to comorbidities in psychiatry. While comorbidities in physical illness are clearly the coexistence of two independent illnesses, Comorbidities in Mental illness are the result of the polygenic nature of mental illnesses, especially in psychotic illness whether schizophrenia or bipolar disorder. As a consequence, often the comorbidities of psychiatric illness are caused by two conditions which have in common the presence of particular single nucleotide polymorphisms (snps), which regulate the metabolism of neurotransmitters or the presence of neurotrophic factors . Thus inevitably, many such comorbidities are inextricably linked. We discuss the consequences of this form of comorbidity for the description, classification, and risk profile of mental illness.",0 +https://doi.org/10.1111/1467-8624.00086,"Trajectories of Boys' Physical Aggression, Opposition, and Hyperactivity on the Path to Physically Violent and Nonviolent Juvenile Delinquency","A semi-parametric mixture model was used with a sample of 1,037 boys assessed repeatedly from 6 to 15 years of age to approximate a continuous distribution of developmental trajectories for three externalizing behaviors. Regression models were then used to determine which trajectories best predicted physically violent and nonviolent juvenile delinquency up to 17 years of age. Four developmental trajectories were identified for the physical aggression, opposition, and hyperactivity externalizing behavior dimensions: a chronic problem trajectory, a high level near-desister trajectory, a moderate level desister trajectory, and a no problem trajectory. Boys who followed a given trajectory for one type of externalizing problem behavior did not necessarily follow the same trajectory for the two other types of behavior problem. The different developmental trajectories of problem behavior also led to different types of juvenile delinquency. A chronic oppositional trajectory, with the physical aggression and hyperactivity trajectories being held constant, led to covert delinquency (theft) only, while a chronic physical aggression trajectory, with the oppositional and hyperactivity trajectories being held constant, led to overt delinquency (physical violence) and to the most serious delinquent acts.",0 +https://doi.org/10.1037/0003-066x.59.1.20,"Loss, Trauma, and Human Resilience: Have We Underestimated the Human Capacity to Thrive After Extremely Aversive Events?","Many people are exposed to loss or potentially traumatic events at some point in their lives, and yet they continue to have positive emotional experiences and show only minor and transient disruptions in their ability to function. Unfortunately, because much of psychology's knowledge about how adults cope with loss or trauma has come from individuals who sought treatment or exhibited great distress, loss and trauma theorists have often viewed this type of resilience as either rare or pathological. The author challenges these assumptions by reviewing evidence that resilience represents a distinct trajectory from the process of recovery, that resilience in the face of loss or potential trauma is more common than is often believed, and that there are multiple and sometimes unexpected pathways to resilience.",0 +https://doi.org/10.1023/a:1013042222084,A qualitative analysis of posttraumatic stress among Mexican victims of disaster,"In unstructured interviews, 24 Mexicans described survivors' responses to disasters in Guadalajara, Jalisco (n = 9), Homestead, Florida (n = 6), and Puerto Angel, Oaxaca (n = 9). This analysis assessed the extent to which symptom descriptions corresponded to the 17 criterion symptoms of PTSD. Nineteen participants (79%) mentioned from 1 to 9 criterion symptoms. Event-related distress, hypervigilance, recurrent recollections, and avoiding reminders were described most often. Only 3 criterion symptoms were never described. Twenty participants (83%) provided 109 separate expressions that could not be classified specifically as criterion symptoms. These phrases were sorted by 9 independent Mexican volunteers and cluster analyzed. Clusters composed of ataques de nervios, depression, lasting trauma, and somatic complaints provided the best description of the data.",0 +https://doi.org/10.1016/j.jpain.2014.07.002,Longitudinal Interactions of Pain and Posttraumatic Stress Disorder Symptoms in U.S. Military Service Members Following Blast Exposure,"

Abstract

Military personnel returning from conflicts in Iraq and Afghanistan often endorse pain and posttraumatic stress disorder (PTSD) symptoms, either separately or concurrently. Associations between pain and PTSD symptoms may be further complicated by blast exposure from explosive munitions. Although many studies have reported on the prevalence and disability associated with polytraumatic injuries following combat, less is known about symptom maintenance over time. Accordingly, this study examined longitudinal interactive models of co-occurring pain and PTSD symptoms in a sample of 209 military personnel (mean age = 27.4 years, standard deviation = 7.6) who experienced combat-related blast exposure. Autoregressive cross-lagged analysis examined longitudinal associations between self-reported pain and PTSD symptoms over a 1-year period. The best-fitting covariate model indicated that pain and PTSD were significantly associated with one another across all assessment periods, χ2 (3) = 3.66, P = .30, Tucker-Lewis index = .98, comparative fit index = 1.00, root mean squared error of approximation = .03. PTSD symptoms had a particularly strong influence on subsequent pain symptoms. The relationship between pain and PTSD symptoms is related to older age, race, and traumatic brain injury characteristics. Results further the understanding of complex injuries among military personnel and highlight the need for comprehensive assessment and rehabilitation efforts addressing the interdependence of pain and co-occurring mental health conditions.

Perspective

This longitudinal study demonstrates that pain and PTSD symptoms strongly influence one another and interact across time. These findings have the potential to inform the integrative assessment and treatment of military personnel with polytrauma injuries and who are at risk for persistent deployment-related disorders.",0 +https://doi.org/10.1097/00002508-200505000-00008,Chronic Pain and Posttraumatic Stress Symptoms in Litigating Motor Vehicle Accident Victims,"There has been little research examining chronic pain and posttraumatic stress symptoms in persons injured in motor vehicle accidents. The purpose of this study was to evaluate differences in physical injury and impairment, psychological distress, and pain coping strategies in litigating chronic pain patients low and high in motor vehicle accident-related posttraumatic stress symptoms.A total of 160 consecutive chronic pain patients referred for psychological-legal assessment underwent semistructured interview and testing. The testing battery included the Minnesota Multiphasic Personality Inventory-2, the Multidimensional Pain Inventory, the Sickness Impact Profile, and the Coping Strategies Questionnaire. Using the sample-specific median split of 18 posttraumatic stress symptoms on the Minnesota Multiphasic Personality Inventory-2 Posttraumatic Stress Disorder scale, chronic pain patients were categorized as evidencing low or high levels of posttraumatic stress symptoms.The findings indicate that participants evidencing high posttraumatic stress symptoms had more physical impairment, psychological distress, and maladaptive pain coping strategies and were more likely to be treated with antidepressants, other medications, and psychological management than participants evidencing low posttraumatic stress symptoms. A discriminant function analysis was performed using the full combination of physical injury and impairment, psychological distress, and pain coping variables in the prediction of posttraumatic stress symptom-defined group membership. The resulting discriminant function accounted for 61% of the between-group variance and correctly classified 92% of participants who were low in posttraumatic stress symptoms and 88% of participants who were high in posttraumatic stress symptoms.Chronic pain and posttraumatic stress symptoms in litigating motor vehicle accident victims are associated with increased physical and psychological morbidity.",0 +,A Diathesis-Stress Approach to Post-Traumatic Stress Disorder Symptoms Associated with an HIV Diagnosis: Implications for Medication Non-adherence.,"Introduction. We fit a diathesis-stress model with childhood trauma and neuroticism as predictors of depressive and HIV-related PTSD symptomatology in a sample of HIV+ Latino men who have sex with men (MSM). We then examined the impact of depressive and HIV-related PTSD symptomatology on medication adherence. We hypothesized the primary stressor from the diathesis-stress model to be symptoms of dissociation at the time of being diagnosed with HIV. Method. We sampled 149 Latino adult MSM living with HIV at a local HIV treatment clinic in El Paso, Texas. We administered all surveys in paper-and-pencil form, with viral loads and CD4 cell counts extracted from medical charts. Specifically, data were collected on self-reported histories of childhood abuse, trait levels of neuroticism, acculturation to non-Latino culture, accumulated life stressors, depression, HIV and non HIV-related post-traumatic stress symptoms, resilience, functional impairment and medication adherence. All participants were interviewed in either English or Spanish and paid $30 for their participation. Interviews lasted approximately two hours. Results. We observed high levels of childhood sexual abuse (22%) and trauma overall, as well as high rates of mild-to-moderate symptoms of depression (30%). Self-reported medication adherence was high across all measures. We found support for our hypothesized path model as a test of the theoretical structure proposed by the diathesis-stress model. All fit indices were indicative of good model fit. In addition, we found support for the diathesis-stress interaction with dissociation symptoms at the time of diagnosis moderating the relationship between childhood trauma and HIV-related PTSD symptoms. As hypothesized, our regression analyses revealed depression to be negatively correlated with adherence. PTSD symptoms related to HIV were positively associated with adherence, the opposite direction of that hypothesized. Conclusion. The diathesis-stress framework adequately models the relationship among childhood trauma, current levels of psychological distress, and the stress of being diagnosed with HIV. Furthermore, psychological distress is negatively associated with adherence and overall quality of life. Implications for interventions are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0 +https://doi.org/10.4088/jcp.11m07348,"A 30-Month Prospective Follow-up Study of Psychological Symptoms, Psychiatric Diagnoses, and Their Effects on Quality of Life in Children Witnessing a Single Incident of Death at School","We explored the course of trauma-related psychological symptoms and psychiatric diagnoses in 167 children who, as fourth graders, witnessed death at school and assessed the long-term effects of their symptoms on quality of life and their parents' rearing stress.167 children were evaluated using diverse self-rating symptom scales at 2 days (T1: May 19, 2007), 2 months (T2: July 16, 2007), 6 months (T3: November 12-17, 2007), and 30 months (T4: November 16-21, 2009) after the accident. All children were interviewed with the Diagnostic Interview Schedule for Children-Version IV (DISC-IV) at T1. High-risk children were assessed with the DISC-IV at T3 and T4. Children's quality of life and parental stress were assessed in all children and parents using the Parenting Stress Index and the Child Health and Illness Profile at T4.The mean scores and prevalence of severe posttraumatic stress disorder (PTSD) and anxiety symptoms decreased significantly over time (P < .001), but depressive symptoms did not. Although the prevalence of DISC-IV-based diverse anxiety disorders decreased significantly over time, 45% of high-risk subjects evaluated with the DISC-IV met criteria for an anxiety or depressive disorder at T4. Linear and logistic regression analyses showed that depressive symptoms at 6 months predicted more severe parental stress (β = 0.51; odds ratio [OR] = 2.88), less satisfaction (β = -0.25; OR = 2.66), and lower achievement (β = -0.41; OR = 1.50) at 30 months. PTSD symptoms were not associated with parental stress or quality of life at T4.This study provides new evidence regarding the long-term course of trauma-related symptoms and diagnostic changes in children exposed to a single trauma. Children's depressive symptoms predicted lower children's quality of life and higher parental rearing stress after 2 years. Careful assessment and management of depressive symptoms can potentially reduce parental stress and improve quality of life of children.",0 +https://doi.org/10.1016/j.cpr.2009.08.004,Mild traumatic brain injury and posttraumatic stress disorder in returning veterans: Perspectives from cognitive neuroscience,"A significant proportion of military personnel deployed in support of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) has been exposed to war-zone events potentially associated with traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD). There has been significant controversy regarding healthcare policy for those service members and military veterans who returned from OEF/OIF deployments with both mild TBI and PTSD. There is currently little empirical evidence available to address these controversies. This review uses a cognitive neuroscience framework to address the potential impact of mild TBI on the development, course, and clinical management of PTSD. The field would benefit from research efforts that take into consideration the potential differential impact of mild TBI with versus without persistent cognitive deficits , longitudinal work examining the trajectory of PTSD symptoms when index trauma events involve TBI, randomized clinical trials designed to examine the impact of mild TBI on response to existing PTSD treatment interventions, and development and examination of potential treatment augmentation strategies.",0 +https://doi.org/10.1080/1068316x.2014.951643,The importance of looking credible: the impact of the behavioural sequelae of post-traumatic stress disorder on the credibility of asylum seekers,"Memory difficulties following traumatic experiences have been found to result in testimonial inconsistencies, which can affect credibility judgements in asylum decisions. No investigations have looked into how/whether the behavioural sequelae of post-traumatic stress disorder (PTSD) affect decisions. This study aimed to investigate this by looking at whether observable symptoms of PTSD can be confused with perceived cues to deception. An actor performed four versions of a fictional ‘asylum interview’ that contained differing levels of pre-defined ‘deception’ and ‘trauma’ behaviours. Four groups of students (total n = 118) each watched a different interview. They gave subjective ratings of credibility, plus quantitative and qualitative information about the factors that influenced their judgements. Despite the content of the interviews remaining the same, significant differences in credibility ratings were found between interviews; with the interview containing both ‘trauma’ and ‘deception’ behaviours bein...",0 +https://doi.org/10.1111/j.1440-1819.2008.01862.x,"Clinical evaluation of paroxetine in post-traumatic stress disorder (PTSD): 52-week, non-comparative open-label study for clinical use experience","The present study was a 52-week, non-comparative, open-label study of flexible dose paroxetine (20-40 mg) in 52 Japanese post-traumatic stress disorder (PTSD) patients in order to obtain clinical experience regarding efficacy and safety in regular clinical practice.Efficacy was measured using the Clinician-Administered PTSD Scale One Week Symptom Status Version (CAPS-SX).The mean change from baseline in CAPS-SX total score was -19.1, -22.8 and -32.3 at weeks 4, 12 and 52, respectively, and that in the Clinical Global Impression (CGI) Severity of Illness score was -1.1 at week 12 and -1.7 at week 52. A total of 46.9% were CGI responders at week 12, while 67.3% were improved on the CGI at week 52. Of 52 subjects who entered into the drug treatment, 25 completed the study. Only one patient withdrew from the study due to lack of efficacy. In patients who were rated as 'moderately ill' or less at baseline, the proportion of CGI responders at end-point was higher at a dose of 20 mg/day than at higher doses, whereas in patients rated as 'markedly ill' or more, it was higher at 30 and 40 mg/day, suggesting that severely ill patients could benefit from higher doses.Paroxetine appeared generally tolerated in short- and long-term use, and the safety profile in this study was consistent with international trials and other Japanese populations (i.e. patients suffering from depression, panic disorder or obsessive-compulsive disorder). Although the study was not conducted in double-blind fashion, the current findings suggest that paroxetine may contribute to clinically meaningful improvement that is maintained during long-term use and is generally well tolerated.",0 +https://doi.org/10.1026/1616-3443/a000150,Schutz- und Risikofaktoren für Traumafolgestörungen,"Theoretischer Hintergrund: Schutzfaktoren und Risikofaktoren tragen zur Prognose, Indikation und Interventionsplanung bei Menschen nach traumatischen Ereignissen bei. Bisherige systematische Reviews fassen die Befunde bis maximal 2007 zusammen und fokussieren auf Posttraumatische Belastungsstörungen. Fragestellung: Systematisches Review unter Einschluss der Befunde für die Jahre 2007 bis 2010 und Berücksichtigung weiterer Traumafolgestörungen. Methode: Analyse von 13 systematischen Reviews und 29 prospektiven Originalarbeiten zu Schutz- und Risikofaktoren für Traumafolgestörungen nach Typ-I-Traumata. Ergebnisse: Es werden Befunde zu prätraumatischen (Soziodemographie, Biographie, psychische Störungen, Persönlichkeitsfaktoren), peritraumatischen (Art und Schwere des Ereignisses, psychische Verfassung während des Ereignisses, peritraumatische Reaktion) und posttraumatischen Faktoren (akute psychische Symptome, Kognitionen, Coping, Vermeidungsverhalten, soziale Unterstützung, zusätzliche Stressoren) dargestellt. Schlussfolgerungen: Vor allem peri- und posttraumatische Schutz- und Risikofaktoren eignen sich für die Vorhersage von Traumafolgestörungen.",0 +https://doi.org/10.1111/j.1532-5415.2007.01558.x,Identifying Trajectories of Depressive Symptoms for Women Caring for Their Husbands with Dementia,"To use an innovative statistical method, Latent Class Trajectory Analysis (LCTA), to identify and describe subgroups (called trajectories) of caregiver depressive symptoms in a national sample of wives providing informal care for their husbands with dementia.Longitudinal.Community.Respondents to the National Longitudinal Caregiver Survey were wife caregivers of veterans with dementia who were identified through Veterans Affairs hospitals nationally.Mean number of depressive symptoms as measured using the Center for Epidemiologic Studies Depression scale (CES-D, 20-item scale).Overall mean depressive symptoms of wife caregivers were 6.2 of 20, below the cutpoint (8 or 9/20) associated with clinical depression. Four distinct trajectories of caregiver depressive symptoms were identified. The trajectory with the highest number of symptoms (11.9 of 20), contained one-third of the sample. Another third had mean depressive symptoms virtually identical to the overall sample mean. The final third were divided between two trajectories, low depressive symptoms (mean CES-D, 3.0/20, 22% of sample) and very low (mean CES-D, 0.8/20, 14% of sample). Approximately two-thirds of the sample members were in a depressive symptom trajectory, with substantially higher or lower numbers of symptoms than the overall mean. Two subjective measures asked of wife caregivers (desire for more help, life satisfaction) were significantly associated with membership in the highest depressive symptom trajectory.LCTA identified important depressive symptom subgroups of wife caregivers. A population-averaging method identified a mean effect that was similar to the effect in one-third of the cases but substantially different from that in two-thirds of the cases.",0 +https://doi.org/10.1097/00005053-199106000-00007,Pharmacotherapy for Southeast Asian Psychiatric Patients,"Refugees have been demonstrated to be at high risk for developing major depressive and posttraumatic stress disorders, but are often not able to benefit from modern advances in psychopharmacology. Besides difficulties in cross-cultural psychiatric diagnosis, problems also arise from cultural differences in the expectation of drug effects and in compliance. Recent evidence has suggested that pharmacokinetic and pharmacodynamic profiles of various psychotropic medications may be different in Asians than in non-Asian patients, leading to differences in dosage requirements and side effect profiles. These issues and their relevance to the care of refugee patients are reviewed.",0 +https://doi.org/10.1097/bcr.0b013e3181cb8ee6,Growth Curve Trajectories of Distress in Burn Patients,"Psychological adjustment after a major burn injury is a significant concern to providers and patients alike. Although efforts have been made to identify associated risk factors, little is known about heterogeneity in the levels or trajectories of adjustment in this population. This study used a novel application of Growth Mixture Modeling to identify subgroups of patients based on their longitudinal self-reported distress using the Brief Symptom Inventory (BSI). Data were drawn from the database of the Burn Model Systems project, a prospective, multisite, cohort study of major burn injury survivors. The BSI was used to assess symptoms in-hospital and at 6, 12, and 24 months postburn. Participants' T scores on the BSIs Global Severity Index provided a continuous measure of psychological distress. Analyses were conducted using participants' Global Severity Index T scores to discern distinct classes of respondents with similar trajectories across the 2-year follow-up. Results from the Growth Mixture Modeling analysis produced an ordered four-class model of psychological recovery from a major burn. Groups represented the equivalent of high, subthreshold, mild, and minimal symptom severity. Covariates significantly affected the intercept and slope of each class, as well as prediction of group assignment. These analyses demonstrate differences between individual recoveries after a major burn. Psychological distress symptoms remain largely stable over time and highlight the psychological vulnerability of this patient population.",1 +https://doi.org/10.1002/hup.2263,A process-based approach to characterizing the effect of acute alprazolam challenge on visual paired associate learning and memory in healthy older adults,"Objective Alprazolam is a benzodiazepine that, when administered acutely, results in impairments in several aspects of cognition, including attention, learning, and memory. However, the profile (i.e., component processes) that underlie alprazolam-related decrements in visual paired associate learning has not been fully explored. Methods In this double-blind, placebo-controlled, randomized cross-over study of healthy older adults, we used a novel, “process-based” computerized measure of visual paired associate learning to examine the effect of a single, acute 1-mg dose of alprazolam on component processes of visual paired associate learning and memory. Results Acute alprazolam challenge was associated with a large magnitude reduction in visual paired associate learning and memory performance (d = 1.05). Process-based analyses revealed significant increases in distractor, exploratory, between-search, and within-search error types. Analyses of percentages of each error type suggested that, relative to placebo, alprazolam challenge resulted in a decrease in the percentage of exploratory errors and an increase in the percentage of distractor errors, both of which reflect memory processes. Conclusions Results of this study suggest that acute alprazolam challenge decreases visual paired associate learning and memory performance by reducing the strength of the association between pattern and location, which may reflect a general breakdown in memory consolidation, with less evidence of reductions in executive processes (e.g., working memory) that facilitate visual paired associate learning and memory. Copyright © 2012 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1192/pb.bp.110.030379,Trauma and post-traumatic stress disorder in a drug treatment community service,"Aims and method A cross-sectional study aiming to assess the prevalence of trauma and post-traumatic stress disorder (PTSD) in a community substitution treatment sample, and to assess and compare the characteristics of traumatic experience, substance use, and psychological and social factors in those with and without PTSD. All assessments were completed during the interview which took approximately 1.5 h. Results The prevalence for current PTSD was 26.2% and for lifetime PTSD 42.9%. Traumatic experiences were extremely common, with two or more reported by 92.9% of the sample. The two groups differed significantly on the majority of psychological functioning and social variables, with women experiencing higher rates of PTSD and the non-PTSD group having lower rates of psychological impairment. Clinical implications The research supported findings from previous studies. The very high incidence of traumatic experiences has not been reported before. Training and information about trauma and PTSD for substance misuse workers are therefore necessary so that PTSD can be more easily detected and treated.",0 +https://doi.org/10.1586/erd.12.31,"Psychological vulnerability, ventricular tachyarrhythmias and mortality in implantable cardioverter defibrillator patients: is there a link?","Implantable cardioverter defibrillator (ICD) therapy is the first-line treatment for the prevention of sudden cardiac death. Despite the demonstrated survival benefits of the ICD, predicting which patients will die from a ventricular tachyarrhythmia remains a major challenge. So far, psychological factors have not been considered as potential risk markers that might enhance the prediction of sudden cardiac death. This article evaluates the evidence for a link between psychological vulnerability, ventricular tachyarrhythmias and mortality and the pathways that might explain such a link. This review demonstrates that there is cumulative evidence supporting a link between psychological vulnerability and risk of ventricular tachyarrhythmias and mortality in ICD patients independent of disease severity and other biomedical risk factors. It may be premature to include psychological factors in risk algorithms, but information on the psychological profile of the patient may help to optimize the management and care of these patients in clinical practice.",0 +https://doi.org/10.1002/jts.21707,Intervention effectiveness among war-affected children: A cluster randomized controlled trial on improving mental health,"We examined the effectiveness of a psychosocial intervention in reducing mental health symptoms among war-affected children, and the role of peritraumatic dissociation in moderating the intervention impact on posttraumatic stress symptoms (PTSS). School classes were randomized into intervention (n = 242) and waitlist control (n = 240) conditions in Gaza, Palestine. The intervention group participated in 16 extracurriculum sessions of teaching recovery techniques (TRT) and the controls received normal school-provided support. Participants were 10- to 13-year-old Palestinian girls (49.4%) and boys (50.6%). Data on PTSS, depressive symptoms, and psychological distress were collected at baseline (T1), postintervention (T2), and 6-month follow-up (T3). Peritraumatic dissociation was assessed only at baseline. Regression analyses that took regression to the mean and cluster sampling into account were applied. The results on intervention effectiveness were specific to gender and peritraumatic dissociation. At T2, the intervention significantly reduced the proportion of clinical PTSS among boys, and both the symptom level (R(2) = .24), and proportion of clinical PTSS among girls who had a low level of peritraumatic dissociation. The results have implications for risk-specific tailoring of psychosocial interventions in war conditions.",0 +https://doi.org/10.1093/milmed/156.5.223,Psychosocial Stress in Marine Corps Officers,"Stress research in military populations has largely been devoted to specialized situations ""at risk"" for high levels of stress, such as combat, recruit training, sea duty, as well as post-traumatic stress in veterans. Though the armed forces continue to train for war during peacetime, military personnel also carry out administrative, executive, and technical job functions not directly related to combat preparations. Little data exists researching stress experienced in military non-combat environments. A study was conducted assessing levels of stress of 900 Marine Corps officers assigned to various headquarters and stations. Randomly selected participants completed the Derogatis Stress Profile (DSP). The study examined stress as a function of rank and the individual officer's perception of stress. Total stress levels of the subjects were compared to those used to norm the DSP.",0 +https://doi.org/10.1017/s1049023x14001241,Multi-disciplinary Care for the Elderly in Disasters: An Integrative Review,"Abstract Introduction Older adults are disproportionately affected by disaster. Frail elders, individuals with chronic diseases, conditions, or disabilities, and those who live in long-term care facilities are especially vulnerable. Purpose The purpose of this integrative review of the literature was to describe the system-wide knowledge and skills that multi-disciplinary health care providers need to provide appropriate care for the elderly during domestic-humanitarian and disaster-relief efforts. Data sources A systematic search protocol was developed in conjunction with a research librarian. Searches of PubMed, CINAHL, and PsycINFO were conducted using terms such as Disaster, Geological Processes, Aged, Disaster Planning, and Vulnerable Populations. Forty-six articles met criteria for inclusion in the review. Conclusions Policies and guidance regarding evacuating versus sheltering in place are lacking. Tenets of elderly-focused disaster planning/preparation and clarification of legal and ethical standards of care and liability issues are needed. Functional capacity, capabilities, or impairments, rather than age, should be considered in disaster preparation. Older adults should be included in disaster planning as population-specific experts. Implications for Practice A multifaceted approach to population-specific disaster planning and curriculum development should include consideration of the biophysical and psychosocial aspects of care, ethical and legal issues, logistics, and resources. Johnson HL , Ling CG , McBee EC . Multi-disciplinary care for the elderly in disasters: an integrative review . Prehosp Disaster Med . 2015 ; 30 ( 1 ): 1 - 8 .",0 +https://doi.org/10.1080/00332747.2015.1051451,A Longitudinal Study of Secondary Posttraumatic Growth in Wives of Ex-POWs.,"The current study aimed to investigate (a) ""secondary"" posttraumatic growth (PTG) in wives of former prisoners of war (ex-POWs) and its association to husbands' captivity, husbands' posttraumatic stress disorder (PTSD), and husbands' PTSD trajectories; and (b) the bidirectional relationships over time between wives' posttraumatic stress symptoms (PTSS) and PTG.The study compared 116 wives of Israeli ex-POWs from the 1973 Yom Kippur War with 56 wives of a matched control group of non-POW combat veterans. Wives were divided into groups according to husbands' captivity status, husbands' PTSD status, and husbands' PTSD trajectories; and ANOVAs and MANOVAs were conducted to assess group differences in PTSS and PTG, both cross-sectionally and longitudinally. Autoregressive cross-lag modeling was also used to assess bidirectional relationships between wives' PTSS and PTG over time.Wives of ex-POWs with PTSD reported significantly higher PTG compared with wives of ex-POWs without PTSD and wives of controls. While PTG and PTSS remained stable over time, importantly, the Time 1 (T1) level of PTG predicted avoidance symptoms at Time 2 (T2); the higher the wives' PTG at T1, the higher their avoidance symptoms at T2, but not vice versa.These findings support the notion that ""secondary PTG"" exists. They also strengthen the theory that growth and distress can co-occur. Finally, the finding that PTG predicted subsequent avoidance symptoms suggests that PTG does not prevent the future development of distress.",0 +https://doi.org/10.1002/9780470756669.ch15,Coping with Missing Data,,0 +https://doi.org/10.4135/9781483375366.n24,Communication in Military Families Across the Deployment Cycle,,0 +https://doi.org/10.1002/pon.3623,Post-traumatic stress symptoms in cancer survivors: relationship to the impact of cancer scale and other associated risk factors,"The purpose of this study was to determine the prevalence of post-traumatic stress symptoms in a sample of cancer survivors and to investigate their association with the impact of cancer, depressive symptoms, and social support.We administered a survey to participants in a cancer survivor registry. It included: Post-Traumatic Stress Disorder Checklist-Civilian version (PCL-C), Impact of Cancer Scale (IOC) v.2, and measures of social support, income, and long-term effects of cancer. We performed multivariate analyses to estimate associations between PCL-C and other variables. PCL-C score was examined as a continuous dependent variable and categorically.Responses were available from 162 cancer survivors. Mean age was 51 years (standard deviation (SD) 16); mean time since diagnosis was 11 years (SD 10). Mean PCL-C score was 27 (SD 9, range 17-64); 29% of the sample scored 30 and above, 13% scored 38 and above, 7% scored 44 and above. Linear regression indicated that PCL-C scores were significantly associated with the IOC negative impact summary scale (NIS) (p < 0.001), depressive symptoms (p = 0.003), less social support (p = 0.02), and lower income (p = 0.03). NIS subscale analyses showed that two subscales, life interference (LI) and worry (W), were significantly correlated with PCL-C score (LI: p < 0.001; W: p = 0.02).In this study, the IOC NIS was associated with endorsement of PTSD symptoms. Assessing survivors for PTSD symptoms with the PCL-C could detect those individuals in need of psychosocial support. The IOC may be useful for identifying target areas for interventions to reduce these symptoms among cancer survivors.",0 +https://doi.org/10.1016/j.genhosppsych.2008.08.001,Quetiapine-induced peripheral edema,"Quetiapine fumarate is an atypical antipsychotic with relatively benign side-effect profile. Here we report a rare side-effect of quetiapine use. This is the second reported case of peripheral edema with quetiapine use. Unaware of this rare side-effect, patient had to endure extensive investigations.",0 +https://doi.org/10.1186/1471-244x-7-8,"Post-traumatic stress disorder in children and adolescents one year after a super-cyclone in Orissa, India: exploring cross-cultural validity and vulnerability factors","It has been asserted that psychological responses to disasters in children and adolescents vary widely across cultures, but this has rarely been investigated. The objectives of the study were to clinically evaluate the construct of traumatic stress symptoms and disorder in children and adolescents after a super-cyclone in Orissa, India; to find out the prevalence at one year; compare the effect in high and low exposure areas and study the factors associated with it.Clinical examination of children and adolescents (n = 447) was done, supplemented by a symptoms checklist based on International Classification of Mental and Behavioural Disorders, Diagnostic Criteria for Research and a semi-structured questionnaire for disaster related experiences.A majority of children had post-traumatic symptoms. Post-traumatic stress disorder (PTSD) was present in 30.6% (95% confidence interval: 26.4 to 34.9), and an additional 13.6% had sub-syndromal PTSD. Parents or teachers reported mental health concerns in 7.2% subjects, who were a minor proportion (12.8%) of subjects with any syndromal diagnosis (n = 196). Significantly more (43.7%) children in high exposure areas had PTSD than that (11.2%) in low exposure areas (p < 0.001). Depression was significantly associated with PTSD. Binary logistic regression analysis indicated that high exposure, lower educational level and middle socioeconomic status significantly predicted the outcome of PTSD. Extreme fear and perceived threat to life during the disaster, death in family, damage to home, or staying in shelters were not significantly associated with PTSD.Following natural disaster PTSD is a valid clinical construct in children and adolescents in Indian set up; and though highly prevalent it may be missed without clinical screening. Its manifestation and associated factors resembled those in other cultures.",0 +https://doi.org/10.1097/fbp.0b013e32833d8bc9,"Brain-derived neurotrophic factor in traumatic brain injury, post-traumatic stress disorder, and their comorbid conditions: role in pathogenesis and treatment","As US military service members return from the wars in Iraq and Afghanistan with elevated rates of traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD), attention has been increasingly focused on TBI/PTSD comorbidity, its neurobiological mechanisms, and novel and effective treatment approaches. TBI and PTSD, and their comorbid conditions, present with a spectrum of common clinical features such as sleep disturbance, depression, anxiety, irritability, difficulty in concentrating, fatigue, suicidality, chronic pain, and alterations in arousal. These TBI and PTSD disorders are also thought to be characterized by overlapping neural mechanisms. Both conditions are associated with changes in hippocampal, prefrontal cortical, and limbic region function because of alterations in synaptogenesis, dendritic remodeling, and neurogenesis. Neural changes in TBI and PTSD result from pathophysiological disturbances in metabolic, cytotoxic, inflammatory, and apoptic processes, amongst other mechanisms. Neurotrophins have well-established actions in regulating cell growth and survival, differentiation, apoptosis, and cytoskeleton restructuring. A body of research indicates that dysregulation of neural brain-derived neurotrophic factor (BDNF) is found in conditions of TBI and PTSD. Induction of BDNF and activation of its intracellular receptors can produce neural regeneration, reconnection, and dendritic sprouting, and can improve synaptic efficacy. In this review, we consider treatment approaches that enhance BDNF-related signaling and have the potential to restore neural connectivity. Such treatment approaches could facilitate neuroplastic changes that lead to adaptive neural repair and reverse cognitive and emotional deficits in both TBI and PTSD.",0 +https://doi.org/10.1016/j.psychres.2014.04.033,"The heritability of mental health and wellbeing defined using COMPAS-W, a new composite measure of wellbeing","Mental health is not simply the absence of mental illness; rather it is a distinct entity representing wellness. Models of wellbeing have been proposed that emphasize components of subjective wellbeing, psychological wellbeing, or a combination of both. A new 26-item scale of wellbeing (COMPAS-W) was developed in a cohort of 1669 healthy adult twins (18-61 years). The scale was derived using factor analysis of multiple scales of complementary constructs and confirmed using tests of reliability and convergent validity. Bivariate genetic modeling confirmed its heritability. From an original 89 items we identified six independent subcomponents that contributed to wellbeing. The COMPAS-W scale and its subcomponents showed construct validity against psychological and physical health behaviors, high internal consistency (average r=0.71, Wellbeing r=0.84), and 12-month test-retest reliability (average r=0.62, Wellbeing r=0.82). There was a moderate contribution of genetics to total Wellbeing (heritability h(2)=48%) and its subcomponents: Composure (h(2)=24%), Own-worth (h(2)=42%), Mastery (h(2)=40%), Positivity (h(2)=42%), Achievement (h(2)=32%) and Satisfaction (h(2)=43%). Multivariate genetic modeling indicated genetic variance was correlated across the scales, suggesting common genetic factors contributed to Wellbeing and its subcomponents. The COMPAS-W scale provides a validated indicator of wellbeing and offers a new tool to quantify mental health.",0 +https://doi.org/10.1016/j.psychres.2010.10.002,Posttraumatic stress disorder and psychiatric co-morbidity following stroke: The role of alexithymia,"More research is needed to further our understanding of posttraumatic stress disorder symptoms (PTSD) and psychiatric co-morbidity following stroke, especially the trajectories of such symptoms over time. Previous studies suggest that exposure to a traumatic experience such as stroke is not sufficient to explain the etiology of PTSD. Alexithymia may be involved, but its relationships with PTSD and psychiatric co-morbidity following stroke remains unclear. This study aims to address these knowledge gaps. While in hospital, stroke patients (n=90) completed questionnaires assessing PTSD symptoms, psychiatric co-morbidity, alexithymia and physical disability. PTSD symptoms and psychiatric co-morbidity were re-assessed approximately 3 months post-stroke (n=78). The severity of post-stroke PTSD did not change significantly over time, while psychiatric co-morbidity reduced significantly. Alexithymia, in particular difficulty in identifying feelings, was associated with severity of post-stroke PTSD and psychiatric co-morbidity at baseline, but after adjusting for these, there was no significance 3 months post-stroke. We suggest that patients' difficulty in identifying feelings had a role to play in influencing relatively short-term rather than long-term PTSD and co-morbid psychiatric symptoms. Alternatively, PTSD could be interpreted as driving the alexithymic characteristics.",0 +https://doi.org/10.1016/j.janxdis.2011.11.012,Posttraumatic stress disorder symptom severity predicts aggression after treatment,"This study examined the relation between posttraumatic stress disorder (PTSD) severity and aggression (verbal, psychological, and physical aggression) in a longitudinal dataset. Participants were 175 males in PTSD residential treatment who were assessed at pre-treatment, post-treatment, and at 4-month follow-up. Post-treatment PTSD severity predicted aggression at post-treatment and 4-month follow-up, adjusting for age, pre-treatment PTSD severity, and pre-treatment aggression. When examining the relation between aggression and specific PTSD symptom clusters, post-treatment Reexperiencing, Avoidance/Numbing and Hyperarousal symptoms predicted aggression at posttreatment and 4-month follow-up. These results support the hypothesis that post-treatment PTSD severity may be an important marker of post-treatment aggression risk and may offer unique information important to clinicians and patients focused on the development and maintenance of adaptive, non-aggressive relationships after intensive PTSD treatment.",0 +https://doi.org/10.1016/j.psc.2008.06.008,Paraphilia from a Dissociative Perspective,"A dissociative structural model of the psyche can account for a wide range of symptoms across many DSM-IV categories, including sexual compulsions and addictions. The model leads to a distinct overall plan of treatment and a set of operationalized interventions aimed at integration of the self, rather than suppression of impulses. The model could be tested first in epidemiological studies and later in treatment outcome studies.",0 +https://doi.org/10.1016/j.biopsych.2015.02.003,Glucocorticoid Functioning in Male Combat Veterans with Posttraumatic Stress Disorder and Mild Traumatic Brain Injury,"Explored glucocorticoid functioning in male combat veterans with posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). Of the total sample of 122 male veterans, 32 reported one or more brain injuries with loss of consciousness lasting <10 min and were designated as having a history of mTBI. To evaluate the influence of PTSD and mTBI on neuroendocrine measures, a series of linear regression equations was estimated. Combat veterans with mTBI also tended to have less severe current and lifetime PTSD symptoms whether comorbid with PTSD or not. Veterans who reported a history of mTBI were rated as having lower current reexperiencing, hyperarousal, and total CAPS scores compared with veterans without prior history of mTBI. Follow-up analyses on the current CAPS intensity and frequency scores revealed that the lower reexperiencing and hyperarousal scores in people with mTBI were attributed to lower frequency, but not lower intensity. Insofar as PTSD has been shown to be associated with greater glucocorticoid sensitivity, the two conditions may have opposing effects when they are present in the same individual. Group contrasts comparing people with PTSD with people without PTSD on measures reflecting glucocorticoid receptor sensitivity may be diminished if the presence of TBI is not considered. (PsycINFO Database Record (c) 2015 APA, all rights reserved)",0 +https://doi.org/10.1179/2045772314y.0000000295,Psychosocial correlates of depression following spinal injury: A systematic review,"Spinal cord injury (SCI) studies have identified a range of psychosocial risk and protective factors for depression post-injury. This study presents the first systematic and quantitative review of this body of research.Twenty-four studies (N=3172 participants) were identified through electronic database searches. Studies were evaluated according to recommended guidelines on Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). The significance and magnitude of the relationships between standardised measures of depression and psychosocial outcome were examined using Pearson's effect size r, 95% confidence intervals and fail-safe Ns. Effect sizes were categorised according to the ICF psychosocial domains.STROBE ratings indicated discrepancies in procedural detail and statistical analyses. Individual personal variables including affective feelings, and thoughts and beliefs specific to SCI demonstrated the strongest relationship with depression self-ratings. Life satisfaction, disability acceptance, environmental supports and community participation had a medium to strong association, helping to reduce vulnerability to depression. Longitudinal studies revealed that symptoms of depression continued to impact on psychosocial outcome up to 10 years post-injury, although this was based on limited data.Assessment of psychosocial factors in the acute stages of SCI rehabilitation can inform evidence-based interventions to treat and manage depressive symptomatology in the short to longer-term. Future studies would benefit from adopting a unified approach to the measurement of depression post-SCI to help inform targeted treatment.",0 +https://doi.org/10.1017/s1352465801001126,DO COGNITIVE AND EXPOSURE TREATMENTS IMPROVE VARIOUS PTSD SYMPTOMS DIFFERENTLY? A RANDOMIZED CONTROLLED TRIAL,"This study (part of a larger one whose main outcomes were reported by Marks, Lovell, Noshirvani, Thrasher, & Livanou, 1998) investigated the impact of exposure therapy and cognitive restructuring alone and combined on the individual symptoms of PTSD and on associated features. Exposure therapy was expected to act mainly on fear and avoidance, and cognitive restructuring mainly on detachment, restricted range of affect, and associated features of PTSD. Seventy-seven PTSD outpatients were randomly allocated to one of four treatments: 1) exposure alone; 2) cognitive restructuring alone; 3) combined exposure and cognitive restructuring; or 4) relaxation (placebo control). The active treatments were superior to relaxation in improving clusters of PTSD symptoms and associated features and some but not all individual symptoms and associated features of PTSD. Exposure and cognitive restructuring improved almost all individual symptoms similarly.",0 +https://doi.org/10.1037/0021-843x.105.4.617,A prospective examination of delayed onset PTSD secondary to motor vehicle accidents.,"Seven participants who did not meet the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; American Psychiatric Association, 1987) criteria for posttraumatic stress disorder (PTSD) 1-4 months post- motor vehicle accident (MVA) and developed delayed onset PTSD during a 1-year follow-up interval were compared with 38 MVA controls who did not develop PTSD, as well as to 62 MVA participants who met criteria for acute onset PTSD on variables related to demographics, pre-MVA functioning, post-MVA functioning, and follow-up. The delayed onset participants were more symptomatic at the time of the initial interview than the controls. The delayed onset participants had poorer social support than the controls prior to and after the MVA. For the month prior to the MVA, the delayed onset participants had lower Global Assessment of Functioning scores than the controls.",0 +https://doi.org/10.1007/s00213-005-0213-2,Fluoxetine and norfluoxetine stereospecifically and selectively increase brain neurosteroid content at doses that are inactive on 5-HT reuptake,"It has recently become more clearly understood that in human brain pathophysiology, neurosteroids play a role in anxiety disorders, premenstrual syndrome, postpartum depression, posttraumatic stress disorder, and depression. In the treatment of major depression, recent clinical studies indicate that the pharmacological profiles of fluoxetine and fluvoxamine are correlated with the ability of these drugs to increase the brain and cerebrospinal fluid content of allopregnanolone (Allo), a potent positive allosteric modulator of gamma-aminobutyric acid (GABA) action at GABAA receptors. Thus, the neurosteroid-induced positive allosteric modulation of GABA action at GABA A receptors is facilitated by fluoxetine or its congeners (i.e., paroxetine, fluvoxamine, sertraline), which may not block 5-HT reuptake at the doses currently prescribed in the clinic. However, these doses are effective in the treatment of premenstrual dysphoria, anxiety, and depression. In socially isolated mice, we tested the hypothesis that fluoxetine, norfluoxetine, and other specific serotonin reuptake inhibitor (SSRI) congeners stereoselectively upregulate neurosteroid content at doses insufficient to inhibit 5-HT reuptake; although they potentiate pentobarbital-induced sedation and exert antiaggressive action. Very importantly, the inhibition of 5-HT reuptake lacks stereospecificity and requires fluoxetine and norfluoxetine doses that are 50-fold greater than those required to increase brain Allo content, potentiate the action of pentobarbital, or antagonize isolation-induced aggression. Based on these findings, it could be inferred that the increase of brain Allo content elicited by fluoxetine and norfluoxetine, rather than the inhibition selective of 5-HT reuptake, may be operative in the fluoxetine-induced remission of the behavioral abnormalities associated with mood disorders. Therefore, the term ""SSRI"" may be misleading in defining the pharmacological profile of fluoxetine and its congeners. To this extent, the term ""selective brain steroidogenic stimulants"" (SBSSs) could be proposed. (",0 +https://doi.org/10.1002/jts.22004,Psychological Inflexibility and Psychopathology in 9-1-1 Telecommunicators,"Mental health in 9-1-1 telecommunicators has been understudied in comparison to other emergency responders. This study enrolled a sample of telecommunicators from across the United States (N = 808). As measured by self-report, the prevalence of current probable posttraumatic stress disorder (PTSD) was 17.6% to 24.6%; it was 23.9% for probable major depression. Structural equation modeling revealed a significant direct effect of psychological inflexibility on psychopathology (path coefficient = .32) when considered among duty-related distress and dissociation, neuroticism, anger, and emotion dysregulation. The results provided further evidence of the adverse psychological effects of duty-related trauma exposure, including exposure that is vicarious in nature. The results indicate a need for prevention and intervention in this population, with psychological inflexibility as a potential target in these efforts.",0 +,Post-traumatic stress disorder (PTSD) treatment experience in Bedford East - audit and reaudit.,"Post-traumatic stress disorder (PTSD) can develop following exposure to a stressful event of an exceptionally threatening or catastrophic nature. Symptoms experienced by PTSD suffers can include re-experiencing the trauma through intrusive 'flashbacks' and recurrent dreams or nightmares, avoidance of stimuli associated with the stressor, hyperarousal, emotional blunting and an inability to remember aspects of the period of exposure to the stressor. We performed an audit of the treatment of PTSD in patients under the care of the Bedford East Mental Health Team to examine the psychological and pharmacological treatments currently being used and compared these with data collected in 2008. In summary, in the last 2 years there has been an increase in the identification of PTSD patients in Bedford East. These patients are a group with high levels of comorbidities and risk factors, and are challenging to treat. As a result of this, a wide range of agents including antidepressants with augementation, mood stabilizers and antipsychotic agents are used in their treatment, many of which are outside of NICE guidelines. There appears to be less availability of psychological therapy in these patients than we would expect. We discuss reasons for this and suggest possible solutions.",0 +https://doi.org/10.1016/s0362-3319(97)90049-5,Effects of the 1992 Los Angeles civil unrest: Post traumatic stress disorder symptomatology among law enforcement officers,"Abstract This study examined the psychological impact of the April 29, 1992 Los Angeles civil unrest on the stress levels of law enforcement officers. Levels of Post Traumatic Stress Disorder (PTSD) symptomatology in Los Angeles Police Department (LAPD) officers assigned to a major riot area were evaluated. Factors implicated in individual coping processes after a traumatic event were examined. Furthermore, police officers' perceptions of the event were examined. One hundred forty-one officers (123 males, 18 females) assigned to two South Central Los Angeles police precincts during the Los Angeles, April 1992 disturbances replied to the questionnaire. The questionnaire included four instruments: The Mississippi Scale for Combat-Related PTSD, Moos' Coping Responses Inventory, the Police Perception Survey, and a demographic survey. The results indicate that 17 percent of the officers who responded are experiencing stress symptomatology. Findings further indicate that these officers are twice as likely to use approximately twice the avoidance coping strategies than are their counterparts without symptomatology. Results indicate a positive relationship of PTSD symptomatology with cognitive avoidance, acceptance or resignation, and emotional discharge; and they suggest an inverse relationship between PTSD symptomatology and seeking support and information, and seeking alternative rewards.",0 +https://doi.org/10.1016/0005-7967(94)90123-6,Psychological morbidity associated with motor vehicle accidents,"Fifty victims of recent motor vehicle accidents (MVAs), who had sought medical attention after their accidents, were assessed for possible psychological morbidity as a result of the accident. Forty age, gender-matched controls were also assessed with the same instruments. Forty-six percent of the MVA victims met the criteria for current post-traumatic stress disorders (PTSD) as a result of the accident while 20% showed a sub-syndromal version (the reexperiencing symptom cluster plus either the avoidance/numbing cluster or the over-arousal cluster) of PTSD. Although all MVA victims showed some form of driving reluctance, only 1 S met the criteria for driving phobia. Those MVA victims who met the criteria for PTSD or sub-syndromal PTSD were significantly more likely to have experienced previous trauma, other than a serious MVA, and were more likely (P = 0.008) to have previously met the criteria for PTSD as a result of that trauma. Forty-eight percent of MVA victims who met the criteria for current PTSD also met the criteria for current major depression. Significantly more current MVA-PTSDs had suffered previous major depressive episodes.",0 +https://doi.org/10.1016/j.jad.2013.07.024,"Children's risk and resilience following a natural disaster: Genetic vulnerability, posttraumatic stress, and depression","We examined children's risk and resilience following a natural disaster, evaluating the role of stress, social support, and two genetic markers: the short allele of the serotonin transporter gene (5-HTTLPR), and the met allele of the Brain-Derived Neurotrophic Factor (BDNF).Under high levels of hurricane exposure or hurricane-related stressors, we expected children displaying the markers would report greater symptoms of posttraumatic stress disorder (PTSD) and depression than children without these markers. Social support was explored as an additional moderating variable.Eight months after Hurricane Ike, 116 children (M age=8.85 years, SD=.89; 54% girls) residing in Galveston, Texas, provided saliva samples and completed measures of hurricane exposure and stress, and symptoms of PTSD and depression; 80 also completed a social support measure.For BDNF, analyses revealed several Gene by Environment interactions; greater stress was related to more symptoms of PTSD and depression, and this effect was stronger for children with the met allele. No findings emerged for 5-HTTLPR. Stressors and social support also were associated with children's PTSD and depressive symptoms.Findings should be tempered by the relatively small sample, especially for analysis that included social support.The met allele (BDNF) may play a role in children's disaster reactions. Further research should consider the complex interplay between genes, stressors, support, and psychological outcomes over time.",0 +https://doi.org/10.2466/pr0.103.3.819-826,A Victim Typology of Sexual Harassment,"A clinical sample of 20 sexual harassment victims who were successful in obtaining damage awards for trauma through the judicial system were sources of this descriptive study. Ratings of physical coercion of the harassment, MMPI–2 scores, and ratings on DSM–IV symptoms were analyzed. The majority of subjects met the DSM–IV criteria of Post-Traumatic Stress Disorder. A cluster analysis identified four clusters of harassment victims, described as older-mature, younger-mature, anxious-guilty, and expressive-adaptive based on MMPI–2 scores and symptoms.",0 +https://doi.org/10.1016/j.jpsychires.2012.06.011,Post-traumatic stress disorder and medication adherence: Results from the Mind Your Heart Study,"Patients with post-traumatic stress disorder (PTSD) are at increased risk for adverse outcomes from comorbid medical conditions. Medication non-adherence is a potential mechanism explaining this increased risk.We examined the association between PTSD and medication adherence in a cross-sectional study of 724 patients recruited from two Department of Veterans Affairs Medical Centers between 2008 and 2010. PTSD was assessed using the Clinician Administered PTSD Scale. Medication adherence was assessed using a standardized questionnaire. Ordinal logistic regression models were used to calculate the odds ratios (ORs) for medication non-adherence in patients with versus without PTSD, adjusting for potential confounders.A total of 252 patients (35%) had PTSD. Twelve percent of patients with PTSD reported not taking their medications as prescribed compared to 9% of patients without PTSD (unadjusted OR 1.85, 95% CI 1.37-2.50, P<0.001). Forty-one percent of patients with PTSD compared to 29% of patients without PTSD reported forgetting medications (unadjusted OR 1.90, 95% CI 1.44-2.52, P<0.001). Patients with PTSD were also more likely to report skipping medications (24% versus 13%; unadjusted OR 2.01, 95% CI 1.44-2.82, P<0.001). The association between PTSD and non-adherence remained significant after adjusting for demographics, depression, alcohol use, social support, and medical comorbidities (adjusted OR 1.47, 95% CI 1.03-2.10, P=0.04 for not taking medications as prescribed and 1.95, 95% CI 1.31-2.91, P=0.001 for skipping medications).PTSD was associated with medication non-adherence independent of psychiatric and medical comorbidities. Medication non-adherence may contribute to the increased morbidity and mortality observed in patients with PTSD.",0 +https://doi.org/10.1093/ije/25.2.331,The Australian Vietnam Veterans Health Study: III. Psychological Health of Australian Vietnam Veterans and its Relationship to Combat,"Self-reported psychiatric status of Australian Vietnam war veterans was determined 20-25 years after the war and its relation to combat was investigated.A simple random sample of Australian Army Vietnam veterans was interviewed nationally using standardized interviews and self-completion tests to assess the prevalence of lifetime and current psychiatric illness and its relationship to combat. Army records were used to extract data on the cohort for use in regression-based adjustment for non-response.The conditions mainly affecting the Australian veterans were alcohol abuse or dependence, post-traumatic stress disorder, somatization disorder were significantly related to combat exposure but not with posting to a combat unit. Less than half of the current one-month diagnoses were related to combat, possibly because of low power conferred by the relative rarity of these conditions.The results confirm a range of psychological problems in former warriors may linger 20 or more years from their war exposure and may be directly affected by exposure to war trauma.",0 +https://doi.org/10.1097/01.ta.0000245972.83948.1a,Predictors of General Health After Major Trauma,"Traumatic injury is a leading contributor to the global burden of disease, yet there has been little research on possible predictors of general health after major trauma. This study aims to explore possible predictors of general health after major physical trauma.A survey was performed of 731 surviving consecutive adult patients presenting to a major trauma center with accidental major trauma, between 1 year and 5 years postinjury. Data pertaining to general patient factors, injury severity factors, socioeconomic factors, and claim-related factors were abstracted from the hospital trauma database and the questionnaire. Multiple linear regression was used to develop a predictive model for the main outcome, the physical and mental component summaries of the SF-36 General Health Survey.One hundred and forty nine patients were excluded, 93 refused to participate, and 134 did not respond, leaving 355 participants. On multivariate analysis, better physical health was significantly associated with increasing time since the injury and lower Injury Severity Scores (p = 0.03 and 0.02, respectively). Having a settled compensation claim, having an unsettled compensation claim, and using a lawyer were independently associated with poor physical health (p = 0.02, 0.006, and <0.0001, respectively). Measures of injury severity or socioeconomic status were not associated with mental health. However, having an unsettled compensation claim was strongly associated with poor mental health (p < 0.0001).General health after major physical trauma is more strongly associated with factors relating to compensation than with the severity of the injury. Processes involved with claiming compensation after major trauma may contribute to poor patient outcomes.",0 +https://doi.org/10.20982/tqmp.05.1.p011,Latent Class Growth Modelling: A Tutorial,The present work is an introduction to Latent Class Growth Modelling (LCGM). LCGM is a semi‐parametric statistical technique used to analyze longitudinal data. It is used when the data follows a pattern of change in which both the strength and the direction of the relationship between the independent and dependent variables differ across cases. The analysis identifies distinct subgroups of individuals following a distinct pattern of change over age or time on a variable of interest. The aim of the present tutorial is to introduce readers to LCGM and provide a concrete example of how the analysis can be performed using a real‐world data set and the SAS software package with accompanying PROC TRAJ application. The advantages and limitations of this technique are also discussed.,0 +https://doi.org/10.1080/15374410802148178,Reconsideration of Harm's Way: Onsets and Comorbidity Patterns of Disorders in Preschool Children and Their Caregivers Following Hurricane Katrina,"This study examined posttraumatic stress disorder (PTSD) and comorbid disorders in 70 preschool children (ages 3-6) and their caregivers following Hurricane Katrina. Children's rate of PTSD was 50.0% using age-modified criteria. The rate of PTSD was 62.5% for those who stayed in the city and 43.5% in those who evacuated. Of those with PTSD, 88.6% had at least one comorbid disorder, with oppositional defiant disorder and separation anxiety disorder being most common. Caregivers' rate of PTSD was 35.6%, of which 47.6% was new post-Katrina. No children and only 2 caregivers developed new non-PTSD disorders in the absence of new PTSD symptoms. Differences by race and gender were largely nonsignificant. Children's new PTSD symptoms correlated more strongly to caregivers with new symptoms compared to caregivers with old or no symptoms.",0 +https://doi.org/10.1016/j.brainres.2012.10.048,Alterations in the cortical thickness and the amplitude of low-frequency fluctuation in patients with post-traumatic stress disorder,"The core neuropsychological processes underlying post-traumatic stress disorder (PTSD) have yet to be elucidated, and the association between anatomical and functional deficits in PTSD remains largely unknown. The aim of our study was to investigate the alterations in cortical thickness and amplitude of low-frequency fluctuation (ALFF) in PTSD patients resulting from motor vehicle accidents (MVCs), and to explore the association of cortical thickness and ALFF with the severity of PTSD symptoms. A total of 20 PTSD patients and 20 healthy controls were recruited and examined by high-resolution structural MRI combined with resting-state fMRI. The results showed significant decrease in cortical thickness in the left BA10, BA32 and BA45 and the right superior temporal gyrus in PTSD patients. The ALFF value in PTSD patients increased significantly in the left BA10 and BA32 and the right cerebellum. Linear regression revealed that decreased cortical thickness and increased ALFF in the BA10 were associated with the increased PTSD scores. These findings suggest that the structural integrity and resting-state function in the BA10 play an important role in the pathogenesis of PTSD. ► PTSD patients had focal cortex thinning in the left BA10, BA32, BA45. ► PTSD patients had significantly increased ALFF in the left BA10, BA32 and right cerebellum. ► Cortical thickness and ALFF in the BA10 were associated with PTSD scores.",0 +https://doi.org/10.1037/fam0000177,Cognitive–behavioral conjoint therapy for PTSD improves various PTSD symptoms and trauma-related cognitions: Results from a randomized controlled trial.,"Numerous studies document an association between posttraumatic stress disorder (PTSD) and impairments in intimate relationship functioning, and there is evidence that PTSD symptoms and associated impairments are improved by cognitive-behavioral conjoint therapy for PTSD (CBCT for PTSD; Monson & Fredman, 2012). The present study investigated changes across treatment in clinician-rated PTSD symptom clusters and patient-rated trauma-related cognitions in a randomized controlled trial comparing CBCT for PTSD with waitlist in a sample of 40 individuals with PTSD and their partners (N = 40; Monson et al., 2012). Compared with waitlist, patients who received CBCT for PTSD immediately demonstrated greater improvements in all PTSD symptom clusters, trauma-related beliefs, and guilt cognitions (Hedge's gs -.33 to -1.51). Results suggest that CBCT for PTSD improves all PTSD symptom clusters and trauma-related cognitions among individuals with PTSD and further supports the value of utilizing a couple-based approach to the treatment of PTSD.",0 +https://doi.org/10.1023/a:1024784711484,"Effects of attribution of responsibility for motor vehicle accidents on severity of PTSD symptoms, ways of coping, and recovery over six months","In light of Delahanty et al.'s (1997) identification of attribution of responsibility for a motor vehicle accident (MVA) as a powerful determinant of initial level of distress from the trauma and of early remission of PTSD, we reexamined data from Blanchard and Hickling's (1997) prospective follow-up of 158 MVA survivors. Despite differences between the two samples (Delahanty sample recruited from hospitals 2-3 weeks post-MVA and predominantly male; our sample recruited from outpatient care 1-4 months post-MVA and predominantly female) we replicated Delahanty's findings: those with PTSD who blame themselves for the MVA are less symptomatic initially and recover more rapidly in the first 6 months than those with PTSD who blame another party for the accident.",0 +https://doi.org/10.1016/j.burns.2013.08.008,"Outcome of occupational electrical injuries among French electric company workers: A retrospective report of 311 cases, 1996–2005","This study reviewed records of all electrical incidents involving work-related injury to employees Electricité de France (EDF) from 1996 through 2005 and analysed data for 311 incidents. The results are compared with 1231 electrical incidents that occurred during 1970-1979 and 996 incidents during 1980-1989. A total of 311 electrical incidents were observed. The medical consequences of electrical incident remain severe and particularly, the current fatality rate (3.2%) is similar to that recorded in the 1980s (2.7%) and 1970s (3.3%). Among individuals with non-fatal incidents, any change has occurred in the prevalence of permanent functional sequelae (23.6% in the 1970s vs. 27.6% in the 1980s and 32.5% currently). An increase in the incidence of neuropsychiatric sequelae (5.4% in the 1980s vs. 13% currently) has been observed and they are now the second most common type of sequelae after those directly related to burns. Among the neurological sequelae, peripheral nervous system disorders are the most common, as observed in the 1980s. Since the definition of post-traumatic stress disorder (PTSD) has changed between the two periods, we can only report that the current prevalence of PTSD is 7.6%. This study emphasises the need for specific management of neurological and psychological impairments after electrical injuries, including especially early recognition and initiation of effective treatment.",0 +,"Can physiologic assessment and side effects tease out differences in PTSD trials? A double-blind comparison of citalopram, sertraline, and placebo.","Effects of double-blind treatment of chronic posttraumatic stress disorder (PTSD) with 2 SSRIs and placebo on emotional symptoms and autonomic reactivity were assessed prospectively. PTSD subjects received citalopram (n=25), sertraline (n=23), or placebo (n=10) for 10 weeks, with psychophysiologic assessments performed before and after treatment. Intent-to-treat analysis showed that all treatment groups improved significantly in total symptoms of PTSD (as measured by the Clinician Administered PTSD Scale), all 3 PTSD symptom clusters, and sleep time. However, subtle differences in improvements in PTSD symptom clusters, physiologic reactivity, and reported adverse events were identified. Citalopram treated subjects significantly lowered systolic and diastolic blood pressures, while sertraline and placebo treated patients significantly lowered only systolic blood pressure reactivity to individualized trauma scripts. The sertraline group showed significantly more improvement in avoidance/numbing symptoms than both other groups. Considering side effects, subjects on sertraline reported more gastrointestinal problems, with early terminators having more insomnia. Early terminators on citalopram reported more fatigue and appetite changes than other treatment groups, with completers reporting more sexual dysfunction. Results support a class effect of SSRIs in treating PTSD symptoms, but suggest a possible differential effect of drugs on symptom clusters, physiologic parameters, and side effects that may have clinical relevance. Implications of symptom reduction noted in the smaller placebo group are discussed relative to recent concerns about increasing placebo response in clinical trials.",0 +,Neurobiological and clinical consequences of stress : from normal adaptation to post-traumatic stress disorder,"This groundbreaking volume is the most thorough and up-to-date exploration of the laboratory, clinical, and theoretical aspects of post-traumatic stress disorder (PTSD) and related stress disorders ever published. The book reviews the entire spectrum of stress responses--from normal to pathological reactions--and brings together the very latest results from basic and clinical research. It provides for the first time critical, authoritative information that will help in the diagnosis and treatment of PTSD. This comprehensive volume provides an invaluable historical and conceptual framework by which to understand post-traumatic stress disorder, emphasizing throughout the homology between the normal stress response and the pathophysiology of PTSD. The book is divided into four major sections that logically progress from basic neurobiological research on stress to neurobiological models of stress and PTSD to specific research on PTSD and clinical issues regarding diagnosis and treatment",0 +https://doi.org/10.1002/jts.22029,Prolonged Exposure Therapy With Veterans and Active Duty Personnel Diagnosed With PTSD and Traumatic Brain Injury,"The present study used archival clinical data to analyze the delivery and effectiveness of prolonged exposure (PE) and ancillary services for posttraumatic stress disorder (PTSD) among Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans (N = 69) with histories of mild to severe traumatic brain injury (TBI). Data from standard clinical assessments of veterans and active duty personnel treated in both inpatient and outpatient programs at 2 Department of Veteran Affairs medical centers were examined. Symptoms were assessed with self-report measures of PTSD (PTSD Checklist) and depression (Beck Depression Inventory-II) before and throughout therapy. Mixed linear models were utilized to determine the slope of reported symptoms throughout treatment, and the effects associated with fixed factors such as site, treatment setting (residential vs. outpatient), and TBI severity were examined. Results demonstrated significant decreases in PTSD, B = -3.00, 95% CI [-3.22, -2.78]; t(210) = -13.5; p < .001, and in depressive symptoms, B = -1.46, 95% CI [-1.64, -1.28]; t(192) = -8.32; p < .001. The effects of PE treatment did not differ by clinical setting and participants with moderate to severe injuries reported more rapid gains than those with a history of mild TBI. The results provide evidence that PE may well be effective for veterans with PTSD and TBI.",0 +https://doi.org/10.1891/0047-2220.34.3.41,"Post-traumatic Stress Disorder (PTSD), Life Satisfaction and Work Personality: Exploring the Relationship with Disability","This research focused on Post-traumatic Stress Disorder (PTSD) and its relationship to life satisfaction and developmental work personality. The participants were women of low socioeconomic status and consisted of three groups: women not seeking employment; women pursuing their GED prior to seeking employment; and women with disabilities in readiness to work programs. Significant correlations exist between both the Developmental Work Personality Scale (DWPS) and the Life Satisfaction Scale, and PTSD symptoms for the entire group. Separate analyses for each group indicated significant correlations for the women with disabilities between levels of PTSD symptoms, developmental work personality, and life satisfaction. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1016/j.brat.2007.11.005,Expressed emotion and causal attributions in relatives of post-traumatic stress disorder patients,"This study investigates the relationship between expressed emotion (EE) and causal attributions in relatives of post-traumatic stress disorder (PTSD) patients, and examines the contributions of EE and attributions to patient outcomes. Thirty-eight relatives of patients with PTSD participating in a treatment trial were assessed on EE, causal attributions for patient problems and nature of attributions. Patients’ PTSD symptoms at 6 and 12 months were assessed. Criticism and hostility in relatives were associated with attributing problems to factors controllable by patients. Relatives with marked emotional over-involvement (EOI) had an attributional profile similar to low EE relatives. Deficits in normal behaviour (“negative symptoms”) were perceived as more controllable, internal and stable than were more obvious signs of an illness or mental health problem such as hypervigilance and intrusive thoughts and nightmares (“positive symptoms”). Irritability or anger was perceived as more controllable and personal than any other problem. Hostility was associated with less psychological understanding. EE (hostility) but not attributions was found to predict clinical outcome. The results are consistent with previous studies of relatives of schizophrenia patients. The study suggests a need for interventions, which focus on helping relatives to reappraise the impact of PTSD.",0 +https://doi.org/10.1002/hup.2522,Pharmacology for sleep disturbance in PTSD,"Symptoms of sleep disturbance, particularly nightmares and insomnia, are a central feature of post-traumatic stress disorder (PTSD). Emerging evidence suggests that specific treatment of PTSD-related sleep disturbance improves other symptoms of the disorder, which in turn suggests that such disturbance may be fundamental to development and maintenance of the disorder. This mini-review focuses on pharmacological treatment of sleep disturbance in adult PTSD (specifically, studies testing the efficacy of antidepressants, adrenergic inhibiting agents, antipsychotics and benzodiazepine and non-benzodiazepine hypnotics). We conclude that only prazosin, an adrenergic inhibiting agent, has had its efficacy established by multiple randomised controlled trials. There is also high-level evidence supporting use of eszopiclone, as well as risperidone and olanzapine as adjunct therapy. Antidepressants such as sertraline, venlafaxine and mirtazapine, benzodiazepines such as alprazolam and clonazepam and non-benzodiazepine hypnotics such as zolpidem appear ineffective in treating PTSD-related sleep disturbance. Most studies that report reduced frequency of nightmares and insomnia also report decreases in overall symptom severity. Such findings suggest that (i) sleep disruption is central to PTSD; (ii) treating sleep disruption may be an effective way to address other symptoms of the disorder and (iii) PTSD symptoms tend to cluster together in predictable ways.",0 +https://doi.org/10.1016/j.psychres.2008.01.001,Verbal learning and memory impairments in posttraumatic stress disorder: The role of encoding strategies,"The present study examined mechanisms underlying verbal memory impairments in patients with posttraumatic stress disorder (PTSD). Earlier studies have reported that the verbal learning and memory alterations in PTSD are related to impaired encoding, but the use of encoding and organizational strategies in patients with PTSD has not been fully explored. This study examined organizational strategies in 21 refugees/immigrants exposed to war and political violence who fulfilled DSM-IV criteria for chronic PTSD compared with a control sample of 21 refugees/immigrants with similar exposure, but without PTSD. The California Verbal Learning Test was administered to examine differences in organizational strategies and memory. The semantic clustering score was slightly reduced in both groups, but the serial cluster score was significantly impaired in the PTSD group and they also reported more items from the recency region of the list. In addition, intrusive errors were significantly increased in the PTSD group. The data support an assumption of changed memory strategies in patients with PTSD associated with a specific impairment in executive control. However, memory impairment and the use of ineffective learning strategies may not be related to PTSD symptomatology only, but also to self-reported symptoms of depression and general distress.",0 +https://doi.org/10.1017/s1041610214001884,Age differences in PTSD among Canadian veterans: age and health as predictors of PTSD severity,"ABSTRACT Background: To date, few studies have investigated age differences in posttraumatic stress disorder (PTSD) symptoms and none has examined age differences across symptom clusters: avoidance, re-experiencing, and hyperarousal. The first objective of this study was to investigate age differences in PTSD and its three symptom clusters. The second objective was to examine age and indices of health as predictors of PTSD symptom severity. Methods: Participants were 104 male veterans, aged 22 to 87 years, receiving specialized mental health outpatient services. Assessments included measures of health-related quality of life, pain severity, number of chronic health conditions, and symptoms of PTSD, both in total and on the symptom clusters. Results: There were significant age differences across age groups, with older veterans consistently reporting lower PTSD symptom severity, both in total and on each of the symptom clusters. Hierarchical regression analyses indicated that the inclusion of health indices accounted for significantly more variance in PTSD symptoms over and above that accounted for by age alone. Pain severity was a significant predictor of PTSD total and the three symptom clusters. Conclusions : This is the first study to report lower levels of PTSD severity among older veterans across symptom clusters. These findings are discussed in relation to age differences in the experiencing and processing of emotion, autobiographical memory, and combat experiences. This study also emphasizes the importance of assessing pain in those with symptoms of PTSD, particularly older veterans who are less likely to receive specialized mental healthcare.",0 +,"Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining ""whiplash"" and its management.",,0 +https://doi.org/10.1111/j.1365-2826.2010.02089.x,"Stress Controversies: Post-Traumatic Stress Disorder, Hippocampal Volume, Gastroduodenal Ulceration*","Stress in mammals triggers a neuroendocrine response mediated by the hypothalamic-pituitary-adrenal axis and the autonomic nervous system. Increased activity of these two systems induces behavioural, cardiovascular, endocrine and metabolic cascades that enable the individual to fight or flee and cope with the stress. Our understanding of stress and stress-response mechanisms is generally robust. Here, however, we review three themes that remain controversial and perhaps deserve further scrutiny and investigation before they achieve canonical status. The themes are, first, hypocortisolaemia in post-traumatic stress disorder (PTSD). A reduction rather than a stress-induced increase in adrenal glucocorticoid levels, as seen in major depressive disorder (MDD), is puzzling and furthermore is not a consistent feature of PTSD. Overall, studies on PTSD show that glucocorticoid levels may be normal or higher or lower than normal. The second theme concerns the reduction in volume of the hippocampus in MDD attributed to the neurotoxicity of hypercortisolaemia. Again, as for hypocortisolaemia in PTSD, reduced hippocampal volume in MDD has been found in some but not all studies. Third, the discovery of a causal association between Helicobacter pylori and peptic ulcers apparently brought to an end the long-held view that peptic ulceration was caused predominantly by stress. However, recent studies suggest that stress can cause peptic ulceration in the absence of H. pylori. Predictably, the aetiological pendulum of gastric and duodenal ulceration has swung from 'all stress' to 'all bacteria' followed by a sober realisation that both factors may play a role. This raises the question as to whether stress and H. pylori interact, and if so how? All three controversies are of clinical significance, pose fundamental questions about stress mechanisms and offer important areas for future research.",0 +https://doi.org/10.1037/tra0000052,Veterans’ PTSD symptoms and their partners’ desired changes in key relationship domains.,"There is a growing literature investigating the connection between veterans' posttraumatic stress disorder (PTSD) symptoms and intimate relationship problems. Little to no work, however, has examined the connection between veterans' PTSD symptoms and their partners' perceptions of specific relationship areas in need of change. We examined associations between overall PTSD symptoms and symptom cluster scores with partners' desired changes in the areas of intimacy, shared activities, and responsibilities. The sample consisted of 249 male veterans of different service eras and their female partners. Results indicated that veterans' PTSD symptoms were associated with greater desired changes from their partners in the veterans' intimacy behaviors and participation in shared activities. When examining the contribution of each symptom cluster individually, only the veterans' emotional numbing symptoms emerged as a significant unique predictor and were associated with partners' desired changes in intimacy. The findings suggest that intimacy and shared activities may be relevant areas to address in PTSD treatment for veterans and their partners and highlight the particular significance of emotional numbing symptoms to intimacy in veterans' relationships.",0 +https://doi.org/10.5694/j.1326-5377.1993.tb138006.x,Undiagnosed post‐traumatic stress disorder following motor vehicle accidents,"OBJECTIVES: To determine the pattern of emergence of post-traumatic stress disorder (PTSD) among motor vehicle accident victims and to examine the influence of PTSD on subsequent levels of disability. DESIGN: A longitudinal study of motor vehicle accident victims one month and 18 months after the accident. SUBJECTS: Twenty-four motor vehicle accident victims admitted by the trauma team at the Royal Adelaide Hospital. A 52% response rate was achieved. MAIN OUTCOME MEASURES: Post-traumatic stress disorder as diagnosed by the Diagnostic Interview Schedule and disability as measured with the Sickness Impact Profile. RESULTS: Eighteen months after their accidents, six of the 24 subjects had clinically significant PTSD and one was considered borderline. None had been previously diagnosed or treated. The group with PTSD had higher scores on all measures of psychological distress one month after the accident and were more likely to use immature psychological defences. There was no association between physical outcome (measured with the modified Glasgow Outcome Scale) at six months and subsequent diagnosis of PTSD. However, the group with PTSD had higher levels of disability on assessment with the Sickness Impact Profile, particularly in the domain of social functioning. The results suggest PTSD was associated with work-related dysfunction equal to that associated with severe physical handicap. CONCLUSION: The data from this pilot study suggest that PTSD after motor vehicle accidents is an important cause of disability, which may also become the focus for damages in litigation. Thus, there is a need for further investigation of the early patterns of distress and to design preventive programs for victims of road accidents. Language: en",0 +https://doi.org/10.1016/j.jpsychires.2013.11.003,Trajectories of suicidal ideation and posttraumatic stress symptoms among former prisoners of war: A 17-year longitudinal study,"War captivity is one of the most severe human-inflicted traumatic experiences with wide and substantial long-term negative effects. However, only one retrospective study examined suicidal ideation (SI) among ex-prisoners of war (ex-POWs). This study aimed to prospectively assess SI among ex-POWs and its associations with posttraumatic stress disorder (PTSD) symptoms over a 17-year period. Two groups of male Israeli veterans from the 1973 Yom Kippur War were examined: ex-POWs and comparable veterans who were not taken captive. Both groups were assessed via self-report measures of SI and PTSD symptoms at three time points: T1 18 (1991), T2 30 (2003), and T3 35 (2008) years after the war. Latent growth curve modeling (LGM) results showed that ex-POWs reported higher levels of SI at T2 and T3 and a pattern of increase in SI levels trajectory over time, compared to control veterans. Furthermore, among ex-POWs, PTSD symptoms at T1 contributed to the increase in rate of change in SI overtime. In addition, PTSD symptoms affected SI at the same measurement, above and beyond above the trajectories of SI. Clinical implications of these findings for the relations between captivity trauma and suicidality are discussed.",0 +https://doi.org/10.1016/j.euroneuro.2004.09.009,Higher cerebrospinal fluid homovanillic acid levels in depressed patients with comorbid posttraumatic stress disorder,"Major depression and posttraumatic stress disorder (PTSD) are often comorbid, resulting in more impairment compared than with either diagnosis alone. Both major depression and PTSD are thought to be associated with monoamine transmitter abnormalities. This study compared clinical features and cerebrospinal fluid (CSF) monoamine metabolites in drug-free depressed subjects with a current major depressive episode (MDE) without comorbid PTSD, subjects with a current MDE and comorbid PTSD, and healthy volunteers. Depressed subjects with comorbid PTSD had higher CSF homovanillic acid (HVA) levels compared with depressed subjects without comorbid PTSD or healthy volunteers. Higher HVA was present after adjustment for sex, lifetime aggression severity and depression scores, alcoholism, tobacco smoking, comorbid cluster B personality disorder, reported childhood abuse, and psychosis. We found no group difference in CSF 5-hydroxyindolacetic acid (5-HIAA) and 3-methoxy-4-hydroxyphenylglycol (MHPG) levels. Higher dopaminergic activity may contribute to alterations in memory and other cognitive functions, anhedonia, and hypervigilance observed in PTSD.",0 +https://doi.org/10.1017/s1355617710001207,"Comparison of Concussive Symptoms, Cognitive Performance, and Psychological Symptoms Between Acute Blast-Versus Nonblast-Induced Mild Traumatic Brain Injury","Blast-related head injuries are one of the most prevalent injuries among military personnel deployed in service of Operation Iraqi Freedom. Although several studies have evaluated symptoms after blast injury in military personnel, few studies compared them to nonblast injuries or measured symptoms within the acute stage after traumatic brain injury (TBI). Knowledge of acute symptoms will help deployed clinicians make important decisions regarding recommendations for treatment and return to duty. Furthermore, differences more apparent during the acute stage might suggest important predictors of the long-term trajectory of recovery. This study evaluated concussive, psychological, and cognitive symptoms in military personnel and civilian contractors (N = 82) diagnosed with mild TBI (mTBI) at a combat support hospital in Iraq. Participants completed a clinical interview, the Automated Neuropsychological Assessment Metric (ANAM), PTSD Checklist-Military Version (PCL-M), Behavioral Health Measure (BHM), and Insomnia Severity Index (ISI) within 72 hr of injury. Results suggest that there are few differences in concussive symptoms, psychological symptoms, and neurocognitive performance between blast and nonblast mTBIs, although clinically significant impairment in cognitive reaction time for both blast and nonblast groups is observed. Reductions in ANAM accuracy were related to duration of loss of consciousness, not injury mechanism.",0 +https://doi.org/10.3168/jds.2009-2756,Short communication: Genetic trends of milk yield under heat stress for US Holsteins,"Data included 90,242,799 test-day milk records from 5,402,484 Holstein cows in the first 3 parities and 9,326,754 animals in the pedigree. Additionally, daily temperature-humidity indexes from 202 weather stations were available. Analyses were done by a random regression model in which each parity was treated as a separate trait and that accounted for heat stress. The fixed effects included herd test-day, age at calving, milking frequency, and days in milk classes. Random effects included additive genetic, permanent environment, and herd-year effects, all fit as random regressions. Five covariates in the random regressions included linear splines with 4 knots at 5, 50, 200, and 305 DIM and a function of a temperature-humidity index (THI). Mixed model equations were solved by using an iteration on data approach with a preconditioned conjugate gradient algorithm. Genetic trends for daily milk yield in absence of heat stress (intercept) were 0.140 kg/yr, 0.172 kg/yr, and 0.168 kg/yr for the first, second, and third parity, respectively. Genetic trends for decline of milk yield at temperature of 5 degrees C THI over the threshold of sensitivity to heat stress were -0.002 kg/yr, -0.035 kg/yr, and -0.038 kg/yr, for first, second, and third parity, respectively. Genetic profiles were created by contrasting the 100 most and 100 least heat-tolerant bulls for the official proofs. The most heat-tolerant bulls transmitted lower production and dairy form but higher fertility, productive life, and type, especially udder and locomotion traits. In later parities, the type advantages were smaller. Test-day records capture only a fraction of information due to heat stress, and the real trends for heat stress may be stronger. Studies on heat stress for production should include records on later parities.",0 +https://doi.org/10.1016/s0022-3956(02)00058-4,Psychopharmacological treatment in PTSD: a critical review,"Posttraumatic stress disorder (PTSD) is a prevalent psychiatric disorder that is heterogeneous in its nature, and often presents with other psychiatric comorbidities. As a result, empirical research on effective pharmacotherapy for PTSD has produced complex findings. This article reviews the existing research literature on pharmacological treatments for PTSD, identifies the most effective treatments, and where possible examines their mechanism of action with respect to the neurobiology of PTSD.We examined reports of clinical trials of psychotropic agents carried out with PTSD patients and published in peer-reviewed journals, as well as reports from presentations at scientific meetings between 1966 and 2001.Numerous medications are effective in treating PTSD. These include tricyclic antidepressants, monoamine oxidase inhibitors, and serotonin reuptake inhibitors. Considering reported overall efficacy and side effects profiles, selective serotonin reuptake inhibitors emerge as the preferred first line treatment for PTSD. Mood stabilizers, atypical neuroleptics, adrenergic agents, and newer antidepressants also show promise, but require further controlled trials to clarify their place in the pharmacopoeia for PTSD.There is clear evidence for effective pharmacotherapy of PTSD. Future improvements in the treatment of this disorder await further clinical trials and neurobiological research.",0 +https://doi.org/10.1177/070674371205700209,Peritraumatic Distress and the Course of Posttraumatic Stress Disorder Symptoms: A Meta-Analysis,"Objective: To examine how peritraumatic distress modulates the severity of posttraumatic stress disorder (PTSD) according to the timing of the PTSD symptom assessments. Method: A systematic literature review of English- and French-language studies having administered the Peritraumatic Distress Inventory (PDI) was conducted. Meta-analyses were performed on correlations relating PDI and PTSD symptom scores obtained from the sampled studies. The meta-analyses, which included calculations of regression slopes, took into consideration the time at which PTSD symptoms were assessed following the traumatic event and the timing of the PDI assessment. Results: The literature review yielded a total of 22 studies. The meta-analysis performed over all studies resulted in a pooled correlation coefficient of 0.55 between the PDI and PTSD symptom scores. Meta-regression analyses conducted over all data revealed no apparent decrease in the correlations according to the timing of the PTSD symptom assessments. However, there were numerical or statistically significant declines in regression slopes when the meta-regressions were separately conducted on studies having administered the PDI either within, or following, a 1-month period after a traumatic event. Conclusions: While PDI or PTSD symptom score correlations remain generally significant, they tend to decline as time elapses between the traumatic event and the PTSD assessment. This suggests there may be factors other than peritraumatic distress that increasingly account for the long-term trajectory PTSD symptoms.",0 +https://doi.org/10.1007/s11940-009-0043-3,Pharmacologic treatment of impulsive aggression with antiepileptic drugs,"Aggressive behavior is a major concern in mental health and criminal justice settings. Although pharmacotherapy is often used in the treatment of the violent individual, no medication is presently approved by the US Food and Drug Administration specifically for such use. In recent years, antiepileptic drugs (AEDs) have become increasingly popular for the management of impulsive (reactive) aggressive behavior. The research literature has implicated several neurobiologic deficits associated with impulsive aggression, including reduced central serotonergic functioning, executive dysfunction, and prefrontal deficits. It has been suggested that the neurobiologic deficits specific to impulsive aggressive behavior may serve as indicators of an ineffective behavioral control system. A review of the literature finds that AEDs, particularly those that block sodium channels and/or have GABA-related mechanisms of action, are effective in reducing the frequency and intensity of impulsive aggressive outbursts both when used as the primary agent of treatment and as an adjunct to ongoing pharmacotherapy. Strong evidence for efficacy in impulsive aggression exists from randomized controlled trials for most of the common AEDs (phenytoin, carbamazepine, oxcarbazepine, lamotrigine, valproate/ divalproex sodium, topiramate). Additional controlled studies are needed for tiagabine and gabapentin. Of the common AEDs, only levetiracetam has been shown to be ineffective in the treatment of impulsive aggression. It is important to note that the anti-aggressive effects seen with the AEDs appear to be specific to the impulsive form of aggression. Individuals who display premeditated aggression do not seem to benefit from this type of treatment. Clinically, we recommend phenytoin (initial dose 100 mg three times daily) as the AED of first choice for the treatment of impulsive aggressive outbursts. This recommendation is based on this drug's limited side effect profile (compared with the other AEDs) and the large amount of empiric data supporting its clinical efficacy in impulsive aggression. In the event that the impulsive aggressive individual does not respond to pharmacotherapy with phenytoin, carbamazepine (initial dose 150 mg three times daily) and valproate/divalproex sodium (initial dose 250 mg three times daily) have both proved to be effective secondary options. (",0 +https://doi.org/10.14735/amko2015177,Anxio- depressive Syndrome – Biopsychosocial Model of Supportive Care,"Acute stress in patients experiencing cancer diagnosis and the post-traumatic stress disorder in cancer survivors results in impaired overall quality of life mainly due to associated psychological and physical alterations, including anxiety, depression, sleep disturbances, cognitive dysfunctions, fatigue, pain, cachexia and others. Recent studies revealed a new insight into molecular mechanisms contributing to the development of cancer-related co morbidities. It has been shown that adverse psychosomatic reactions including cancer depression to emotional cancer distress result from neuroendocrinne dysfunctions, disruption of the hypothalamus- pituitary-adrenal axis and sympathetic nervous system, serotonin-dopamine interactions and circadian sleep- wake rhythm disruption.The aim of the present study was to evaluate clinical studies oriented toward elucidation of the hypothesis that cancer-related anxio- depressive syndrome is the major disorder leading to the development of accompanying psychosomatic disruptions.The data of the biopsychosocial approach in the treatment of cancer presented in the current literature were collecting using appropriate electronic databases and were elaborated in the form of meta-analysis of 24 selected publications.According to relevant clinical studies, psychosocial interventions and psychopharmacological treatment has been shown to reduce cancer symptomatology and to improve the ability of patients to cope with the disease. Thus, one of the key pillars of supportive care in oncology is stress reduction. Cognitive- behavioral interventions and group psychosocial therapies have shown to reduce stress from the diagnosis and treatment, to palliate depression and to help in restoring the circadian rhythm. Psychopharamacological interventions are the most useful approaches in the reduction of stress-induced cancer comorbidities. In the presented study, a plausible role of stress reduction in the protection of cancer patients from posttraumatic and anxio- depressive syndrome, physical and psychical suffering, from decrease of patients quality of life, ability to cope with the disease and cooperate in cancer treatment has been analyzed.Implementation of the biopsychosocial model of cancer care needs further cooperation between behavioral scientists and clinical oncologists attempted to elucidate further possibilities of psychosocial and pharmacological interventions leading to the regulation of stress-induced alterations of the neurotransmitter system and neuroendocrinne dysfunctions reduction of cancer-related co morbidities and improvement of patients survival time.",0 +https://doi.org/10.1080/00071668.2011.628639,Sex-based responses of plasma creatine kinase in broilers to thermoneutral constant and cyclic high temperatures,"1. The plasma creatine kinase (CK) activities of male and female broilers under different temperature regimens were studied to investigate the suitability of plasma CK as an indicator of muscle damage due to heat exposure (HE). 2. This study characterises the responses of plasma CK concentration of Arbor Acres broilers to thermoneutral (TN) constant (22°C) or warm cyclic (WC) temperatures (ranging from 27·9°C to 37·9°C). 3. The daily mean CK of the females tended to be higher than those of the males, and significant differences in plasma CK were observed between the genders during the first 5-d test period, namely 2-d TN constant and 3-d WC temperatures. 4. During a 5-d HE to the WC regimens, CK of both genders fluctuated with HE time but exhibited somewhat different profiles. Specifically, the daily mean CK of the females was significantly higher on d 5 of HE than any other daily means, whereas significant difference in daily CK of the males occurred on d 4 of HE. 5. Repetitive blood sampling over 5 d of HE had significant effects on the plasma CK of the females regardless of the number of repeated bleeding times. 6. Profiles of the plasma CK for each gender during d 1 of HE were similar to those under the TN condition, implying that heat stress affects the range of broiler plasma CK concentration but with a 1-d lag. 7. Plasma CK activities of female and male broilers showed a response to HE. However, both the gender and the time of blood sampling should be taken into account when plasma CK is used as an indicator of HE for market-size broilers.",0 +https://doi.org/10.1097/bcr.0b013e3181b48102,Preliminary Evidence for the Effects of Morphine on Posttraumatic Stress Disorder Symptoms in One- to Four-Year-Olds With Burns,"This study tested the hypothesis that very young children who received more morphine for acute burns would have larger decreases in posttraumatic symptoms 3 to 6 months later. This has never before been studied in very young children, despite the high frequency of burns and trauma in this age group. Seventy 12- to 48-month-old nonvented children with acute burns admitted to a major pediatric burn center and their parents participated. Parents were interviewed at three time points: during their child's hospitalization, 1 month, and 3 to 6 months after discharge. Measures included the Child Stress Disorders Checklist - Burn Version (CSDC-B). Chart reviews were conducted to obtain children's morphine dosages during hospitalization. Mean equivalency dosages of morphine (mg/kg/d) were calculated to combine oral and intravenous administrations. Eleven participants had complete 3 to 6-month data on the CSDC. The correlation between average morphine dose and amount of decrease in posttraumatic stress disorder symptoms on the CSDC (r = -0.32) was similar to that found in studies with older children. The correlation between morphine dose and amount of decrease in symptoms on the arousal cluster of the CSDC was significant (r = -0.63, P < .05). Findings from the current study suggest that, for young children, management of pain with higher doses of morphine may be associated with a decreasing number of posttraumatic stress disorder symptoms, especially those of arousal, in the months after major trauma. This extends, with very young children, the previous findings with 6- to 16-year olds.",0 +https://doi.org/10.5888/pcd9.110134,Predictors of Risk and Resilience for Posttraumatic Stress Disorder Among Ground Combat Marines: Methods of the Marine Resiliency Study,"The Marine Resiliency Study (MRS) is a prospective study of factors predictive of posttraumatic stress disorder (PTSD) among approximately 2,600 Marines in 4 battalions deployed to Iraq or Afghanistan. We describe the MRS design and predeployment participant characteristics. Starting in 2008, our research team conducted structured clinical interviews on Marine bases and collected data 4 times: at predeployment and at 1 week, 3 months, and 6 months postdeployment. Integrated with these data are medical and career histories from the Career History Archival Medical and Personnel System (CHAMPS) database. The CHAMPS database showed that 7.4% of the Marines enrolled in MRS had at least 1 mental health diagnosis. Of enrolled Marines, approximately half (51.3%) had prior deployments. We found a moderate positive relationship between deployment history and PTSD prevalence in these baseline data.",0 +https://doi.org/10.1016/j.janxdis.2011.06.002,Confirmatory factor analysis of posttraumatic stress symptoms in Brazilian primary care patients: An examination of seven alternative models,"► The DSM-IV-TR postulates that PTSD symptoms are organized into 3 clusters. ► However, recent factor analytical studies tend to favor 4-factor, first-order models. ► 805 Brazilian primary care patients filled out the PCL-C and a CFA was conducted. ► A 4-factor, first-order solution including a numbing cluster provided the best fit. ► The results uphold the cross-cultural validity of the 4-factor, first-order model. The DSM-IV-TR postulates that PTSD symptoms are organized into 3 clusters. This assumption has been challenged by growing number of factor analytical studies, which tend to favor 4-factor, first-order models. Our objective was to investigate whether the clusters of PTSD symptoms identified in North American and European studies could be replicated in a Brazilian sample composed of 805 primary care patients living in hillside slums. Volunteers were asked to fill out the Brazilian version of the Posttraumatic Stress Disorder Checklist—Civilian Version and a confirmatory factor analysis of this scale was conducted with the software LISREL 8.80. Seven models were tested and a 4-factor, first-order solution including an emotional numbing cluster was found to provide the best fit. Although PTSD has been characterized by some critics as a Western culture-specific disorder lacking universal validity, our results seem to uphold the cross-cultural validity of the 4-factor, first-order model.",0 +https://doi.org/10.1016/j.socscimed.2015.04.007,Longitudinal interplay between posttraumatic stress symptoms and coping self-efficacy: A four-wave prospective study,"Trauma-related coping self-efficacy (CSE), the perceived capability to manage one's personal functioning and the myriad environmental demands of the aftermath of potentially traumatic events (PTE), has been shown to affect psychological outcomes after these events. Aim of the present four-wave study was to examine the cross-lagged relationships between CSE and posttraumatic stress disorder (PTSD) symptoms following PTEs in order to examine direction of influence. Levels of CSE and PTSD symptoms were measured with 4-month intervals. In addition, prospectively assessed personality traits and general self-efficacy perceptions as well as peritraumatic distress were entered in the analyses. The study sample consists of adult respondents of a representative internet panel who experienced PTE in the six months before T1, and did not experience any new PTE or life event between T1 and T3 (N = 400). Respondents were administered the coping self-efficacy scale (CSE-7), impact of event scale (IES) and arousal items of IES-R at each wave (T1 through T3), as well as questions on peritraumatic stress and prospectively measured personality traits (T0). Results of structural equation modeling showed that the effect of CSE on subsequent PTSD symptom levels was dominant. CSE significantly predicted subsequent symptoms, over and above earlier symptom levels, with higher CSE associated with lower PTSD. Symptoms in turn, did not predict subsequent levels of CSE. Higher peritraumatic distress was associated with both higher initial PTSD symptoms and lower initial CSE levels. Higher levels of the personality traits of emotional stability and agreeableness were associated with higher initial CSE levels. This supports a model in which CSE perceptions play an important role in recovery from trauma.",0 +https://doi.org/10.1017/s0033291713002924,Dimensional structure and course of post-traumatic stress symptomatology in World Trade Center responders,"Background Post-traumatic stress disorder (PTSD) in response to the World Trade Center (WTC) disaster of 11 September 2001 (9/11) is one of the most prevalent and persistent health conditions among both professional (e.g. police) and non-traditional (e.g. construction worker) WTC responders, even several years after 9/11. However, little is known about the dimensionality and natural course of WTC-related PTSD symptomatology in these populations. Method Data were analysed from 10 835 WTC responders, including 4035 police and 6800 non-traditional responders who were evaluated as part of the WTC Health Program, a clinic network in the New York area established by the National Institute for Occupational Safety and Health. Confirmatory factor analyses (CFAs) were used to evaluate structural models of PTSD symptom dimensionality; and autoregressive cross-lagged (ARCL) panel regressions were used to examine the prospective interrelationships among PTSD symptom clusters at 3, 6 and 8 years after 9/11. Results CFAs suggested that five stable symptom clusters best represent PTSD symptom dimensionality in both police and non-traditional WTC responders. This five-factor model was also invariant over time with respect to factor loadings and structural parameters, thereby demonstrating its longitudinal stability. ARCL panel regression analyses revealed that hyperarousal symptoms had a prominent role in predicting other symptom clusters of PTSD, with anxious arousal symptoms primarily driving re-experiencing symptoms, and dysphoric arousal symptoms primarily driving emotional numbing symptoms over time. Conclusions Results of this study suggest that disaster-related PTSD symptomatology in WTC responders is best represented by five symptom dimensions. Anxious arousal symptoms, which are characterized by hypervigilance and exaggerated startle, may primarily drive re-experiencing symptoms, while dysphoric arousal symptoms, which are characterized by sleep disturbance, irritability/anger and concentration difficulties, may primarily drive emotional numbing symptoms over time. These results underscore the importance of assessment, monitoring and early intervention of hyperarousal symptoms in WTC and other disaster responders.",0 +https://doi.org/10.1016/j.drugalcdep.2015.07.984,Development of a brief cannabis use disorder screening tool: The CUDIT Short-Form,"Aims: The aim of the present study was to develop and test the diagnostic utility of a shortened 3-item version of the Cannabis Use Disorder Identification Test - Revised (CUDIT-R) for the purpose of brief and effective screening within primary care and other medical settings. Methods:Ashort form of the CUDIT-R was developed using Item Response Theory (IRT) and traditional statistical methods, with data from two community samples of cannabis users representing two countries. Four item selection methods (Rasch Regression, Test Characteristic Curve, Logistic Regression, Discriminant Function Analysis) were employed to identify the most optimal 3-item shortened version. The diagnostic ability of the short forms was evaluated using receiver operating characteristic curves. Results: Using a cut score of 2, the 3-item CUDIT-Short Form (reliability alpha = .66 sample 1; .80 sample 2) identified 78.26% of participants in sample 1 and 78.31% of participants in sample 2 who met DSM-5 criteria for CUD, with 98% agreement in sample 1 and 93% agreement in sample 2 with the full CUDIT-R on CUD classifications using a cut score of 13. Specificity was 76.70 and 78.00 in sample 1 and 2, respectively. Conclusions: The CUDIT-Short Form (CUDIT-SF) may be useful in busy clinical settings for a stepwise screening. Further validation of this shortened version with larger samples and in different settings is warranted.",0 +https://doi.org/10.1093/epirev/mxu007,Mental Health Among Reserve Component Military Service Members and Veterans,"Since 2001, the US military has increasingly relied on National Guard and reserve component forces to meet operational demands. Differences in preparation and military engagement experiences between active component and reserve component forces have long suggested that the psychiatric consequences of military engagement differ by component. We conducted a systematic review of prevalence and new onset of psychiatric disorders among reserve component forces and a meta-analysis of prevalence estimates comparing reserve component and active component forces, and we documented stage-sequential drivers of psychiatric burden among reserve component forces. We identified 27 reports from 19 unique samples published between 1985 and 2012: 9 studies reporting on the reserve component alone and 10 reporting on both the reserve component and the active component. The pooled prevalence for alcohol use disorders of 14.5% (95% confidence interval: 12.7, 15.2) among the reserve component was higher than that of 11.7% (95% confidence interval: 10.9, 12.6) among the active component, while there were no component differences for depression or post-traumatic stress disorder. We observed substantial heterogeneity in prevalence estimates reported by the reserve component. Published studies suggest that stage-sequential risk factors throughout the deployment cycle predicted alcohol use disorders, post-traumatic stress disorder and, to a lesser degree, depression. Improved and more standardized documentation of the mental health burden, as well as study of explanatory factors within a life-course framework, is necessary to inform mitigating strategies and to reduce psychiatric burden among reserve component forces.",0 +https://doi.org/10.1016/j.pnpbp.2006.01.008,Human brain evolution and the “Neuroevolutionary Time-depth Principle:” Implications for the Reclassification of fear-circuitry-related traits in DSM-V and for studying resilience to warzone-related posttraumatic stress disorder,"The DSM-III, DSM-IV, DSM-IV-TR and ICD-10 have judiciously minimized discussion of etiologies to distance clinical psychiatry from Freudian psychoanalysis. With this goal mostly achieved, discussion of etiological factors should be reintroduced into the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). A research agenda for the DSM-V advocated the “development of a pathophysiologically based classification system”. The author critically reviews the neuroevolutionary literature on stress-induced and fear circuitry disorders and related amygdala-driven, species- atypical fear behaviors of clinical severity in adult humans. Over 30 empirically testable/falsifiable predictions are presented. It is noted that in DSM-IV-TR and ICD-10, the classification of stress and fear circuitry disorders is neither mode-of-acquisition-based nor brain-evolution-based. For example, snake phobia (innate) and dog phobia (overconsolidational) are clustered together. Similarly, research on blood-injection-injury-type-specific phobia clusters two fears different in their innateness: 1) an arguably ontogenetic memory-trace-overconsolidation-based fear (hospital phobia) and 2) a hardwired (innate) fear of the sight of one's blood or a sharp object penetrating one's skin. Genetic architecture-charting of fear-circuitry-related traits has been challenging. Various, non-phenotype-based architectures can serve as targets for research. In this article, the author will propose one such alternative genetic architecture. This article was inspired by the following: A) Nesse's “Smoke-Detector Principle”, B) the increasing suspicion that the “smooth” rather than “lumpy” distribution of complex psychiatric phenotypes (including fear-circuitry disorders) may in some cases be accounted for by oligogenic (and not necessarily polygenic) transmission, and C) insights from the initial sequence of the chimpanzee genome and comparison with the human genome by the Chimpanzee Sequencing and Analysis Consortium published in late 2005. Neuroevolutionary insights relevant to fear circuitry symptoms that primarily emerge overconsolidationally (especially Combat related Posttraumatic Stress Disorder) are presented. Also introduced is a human-evolution-based principle for clustering innate fear traits. The “Neuroevolutionary Time-depth Principle” of innate fears proposed in this article may be useful in the development of a neuroevolution-based taxonomic re-clustering of stress-triggered and fear-circuitry disorders in DSM-V. Four broad clusters of evolved fear circuits are proposed based on their time-depths: 1) Mesozoic (mammalian-wide) circuits hardwired by wild-type alleles driven to fixation by Mesozoic selective sweeps; 2) Cenozoic (simian-wide) circuits relevant to many specific phobias; 3) mid Paleolithic and upper Paleolithic ( Homo sapiens -specific) circuits (arguably resulting mostly from mate-choice-driven stabilizing selection); 4) Neolithic circuits (arguably mostly related to stabilizing selection driven by gene–culture co-evolution). More importantly, the author presents evolutionary perspectives on warzone-related PTSD, Combat-Stress Reaction, Combat-related Stress, Operational-Stress, and other deployment-stress-induced symptoms. The Neuroevolutionary Time-depth Principle presented in this article may help explain the dissimilar stress-resilience levels following different types of acute threat to survival of oneself or one's progency (aka DSM-III and DSM-V PTSD Criterion-A events). PTSD rates following exposure to lethal inter-group violence (combat, warzone exposure or intentionally caused disasters such as terrorism) are usually 5–10 times higher than rates following large-scale natural disasters such as forest fires, floods, hurricanes, volcanic eruptions, and earthquakes. The author predicts that both intentionally-caused large-scale bioevent-disasters, as well as natural bioevents such as SARS and avian flu pandemics will be an exception and are likely to be followed by PTSD rates approaching those that follow warzone exposure. During bioevents, Amygdala-driven and locus-coeruleus-driven epidemic pseudosomatic symptoms may be an order of magnitude more common than infection-caused cytokine-driven symptoms. Implications for the red cross and FEMA are discussed. It is also argued that hospital phobia as well as dog phobia, bird phobia and bat phobia require re-taxonomization in DSM-V in a new “overconsolidational disorders” category anchored around PTSD. The overconsolidational spectrum category may be conceptualized as straddling the fear circuitry spectrum disorders and the affective spectrum disorders categories, and may be a category for which Pitman's secondary prevention propranolol regimen may be specifically indicated as a “morning after pill” intervention. Predictions are presented regarding obsessive-compulsive disorder (OCD) (e.g., female-pattern hoarding vs. male-pattern hoarding) and “culture-bound” acute anxiety symptoms (taijin-kyofusho, koro, shuk yang, shook yong, suo yang, rok-joo, jinjinia-bemar, karoshi, gwarosa, Voodoo death). Also discussed are insights relevant to pseudoneurological symptoms and to the forthcoming Dissociative-Conversive disorders category in DSM-V, including what the author terms fright-triggered acute pseudo-localized symptoms (i.e., pseudoparalysis, pseudocerebellar imbalance, psychogenic blindness, pseudoseizures, and epidemic sociogenic illness). Speculations based on studies of the human abnormal-spindle-like, microcephaly-associated ( ASPM ) gene, the microcephaly primary autosomal recessive ( MCPH ) gene, and the forkhead box p2 ( FOXP2 ) gene are made and incorporated into what is termed “The pre- FOXP2 Hypothesis of Blood-Injection-Injury Phobia.” Finally, the author argues for a non-reductionistic fusion of “distal (evolutionary) neurobiology” with clinical “proximal neurobiology,” utilizing neurological heuristics. It is noted that the value of re-clustering fear traits based on behavioral ethology, human-phylogenomics-derived endophenotypes and on ontogenomics (gene–environment interactions) can be confirmed or disconfirmed using epidemiological or twin studies and psychiatric genomics.",0 +https://doi.org/10.1037/e454572006-001,Soldier Dimensions and Operational Readiness in U.S. Army Forces Deployed to Kosovo,"Abstract : The impact of military deployments on soldiers has been assessed from combat to peacekeeping to humanitarian missions. In a recent study of U.S. Army units deployed to Kosovo in support of a multinational peacekeeping mission, soldier attitudes and health were surveyed on site, mid-way during a 6-month deployment. In all, 1,718 soldiers were surveyed, 53.0% were junior enlisted, 34.5% were non-commissioned officers, and 12.5% were officers. In addition, 15 focused soldier and leader interviews were conducted. Key findings included: (a) Soldiers in Kosovo experienced nearly four times the number of traumatic events had higher rates of depression, slept less and were under higher strain compared to soldiers who did not have such experiences. (b) Soldiers' attitude about peacekeeping missions and military deployments became more negative over the course of the Kosovo deployment. (c) Confidence in leadership was high, although it declined somewhat during the deployment. These findings indicate that deployments involving peacekeeping operations can impact readiness on a broad range of soldier dimensions. These effects, however, can be both positive and negative. Only by addressing and understanding both aspects of a deployment will we be able to ensure that soldier and unit readiness remains high.",0 +https://doi.org/10.1001/jama.295.9.1023,"Mental Health Problems, Use of Mental Health Services, and Attrition From Military Service After Returning From Deployment to Iraq or Afghanistan","The US military has conducted population-level screening for mental health problems among all service members returning from deployment to Afghanistan, Iraq, and other locations. To date, no systematic analysis of this program has been conducted, and studies have not assessed the impact of these deployments on mental health care utilization after deployment.To determine the relationship between combat deployment and mental health care use during the first year after return and to assess the lessons learned from the postdeployment mental health screening effort, particularly the correlation between the screening results, actual use of mental health services, and attrition from military service.Population-based descriptive study of all Army soldiers and Marines who completed the routine postdeployment health assessment between May 1, 2003, and April 30, 2004, on return from deployment to Operation Enduring Freedom in Afghanistan (n = 16,318), Operation Iraqi Freedom (n = 222,620), and other locations (n = 64,967). Health care utilization and occupational outcomes were measured for 1 year after deployment or until leaving the service if this occurred sooner.Screening positive for posttraumatic stress disorder, major depression, or other mental health problems; referral for a mental health reason; use of mental health care services after returning from deployment; and attrition from military service.The prevalence of reporting a mental health problem was 19.1% among service members returning from Iraq compared with 11.3% after returning from Afghanistan and 8.5% after returning from other locations (P<.001). Mental health problems reported on the postdeployment assessment were significantly associated with combat experiences, mental health care referral and utilization, and attrition from military service. Thirty-five percent of Iraq war veterans accessed mental health services in the year after returning home; 12% per year were diagnosed with a mental health problem. More than 50% of those referred for a mental health reason were documented to receive follow-up care although less than 10% of all service members who received mental health treatment were referred through the screening program.Combat duty in Iraq was associated with high utilization of mental health services and attrition from military service after deployment. The deployment mental health screening program provided another indicator of the mental health impact of deployment on a population level but had limited utility in predicting the level of mental health services that were needed after deployment. The high rate of using mental health services among Operation Iraqi Freedom veterans after deployment highlights challenges in ensuring that there are adequate resources to meet the mental health needs of returning veterans.",0 +https://doi.org/10.1023/a:1011157800050,"Genetic and environmental influences on the relationship among combat exposure, posttraumatic stress disorder symptoms, and alcohol use","The role of genetic and environmental influences on the relationship between combat exposure, posttraumatic stress disorder (PTSD) symptoms, and alcohol use were examined in 4072 male-male twin pairs who served in the United States military during the Vietnam era (1965-1975). Results indicate that the relationship between combat and alcohol use and between PTSD symptom factors and alcohol use were both substantially influenced by genetic factors. Findings are most consistent with a shared vulnerability model for the etiology of the association between PTSD symptoms and alcohol use. Specific unique environmental factors were more important than genetic factors for PTSD symptoms, and both factors were equally important for alcohol use. Further support is also found for the role of the unique environment in PTSD symptoms.",0 +https://doi.org/10.1002/jts.20663,The course of mental health disorders after a disaster: Predictors and comorbidity,en,0 +https://doi.org/10.1002/pmh.1227,Post-traumatic stress disorder and the outcome of dialectical behaviour therapy for borderline personality disorder,"Individuals with borderline personality disorder (BPD) and comorbid post-traumatic stress disorder (PTSD) have a worse prognosis than individuals with BPD alone. A common view is that the emotional instability and impulsivity of BPD should be treated before attempting to address trauma. However, PTSD symptoms may interfere with patients' ability to benefit from such 'stabilizing' treatments.The effect of BPD-PTSD comorbidity on self-harm and BPD symptom outcomes was evaluated in 89 patients receiving dialectical behaviour therapy, using multilevel modelling.Patients with comorbid BPD-PTSD showed a trend towards elevated BPD symptoms throughout the treatment year (β = 2.12, 95% CI = -0.21-4.44, p = 0.07). There was a three-way interaction between PTSD comorbidity, treatment completion and time, whereby PTSD comorbidity was associated with less reduction in self-harm frequency over time, but only in those completing the full 12 months of treatment (incident risk ratio = 1.16, 95% CI = 1.04-1.30, p < 0.01).Patients with comorbid PTSD had a poorer outcome from dialectical behaviour therapy than those with BPD alone, possibly because of the negative impact of unaddressed trauma. The results provide further grounds for recently developed treatments targeting BPD traits and PTSD symptoms simultaneously.",0 +https://doi.org/10.1521/ijgp.2006.56.2.127,Falling Forever: The Price of Chronic Shock,"Manifestations of chronic shock and annihilation anxiety-including autistic defenses, chaotic relationships, disorganized attachment, split-off affective states, and vulnerability to disintegration--exist side by side with apparent ego strength and high functioning, even in nonabused patients. Chronic shock stemming from uncontained distress and failed dependency during childhood can persist throughout the lifespan, creating ripples of dysfunction that mask as character distortion and contribute to therapeutic impasse. Patients rely on omnipotent defenses to provide a sense of ""having skin"" in the face of the fear of breakdown, striving to avoid vulnerability, and trying to insulate themselves from shock experience. Although the relinquishment of autistic defenses and subsequent integration of disowned affect states are overwhelming and painful, patients can emerge from this process with significant shifts in intrapsychic, interpersonal, and existential/spiritual functioning. Clinical material from one psychodynamic psychotherapy group tracks the group process and growth trajectories of seven group members struggling with chronic shock. The ability to recognize subtle dissociative states is a valuable tool in the repertoire of the group psychotherapist.",0 +https://doi.org/10.1016/j.psychres.2014.03.004,Heterogeneous depression responses to chronic pain onset among middle-aged adults: A prospective study,"Studies on depression response to chronic pain are limited by lack of clarification of different forms of response patterns and cross-sectional measures. The current study examined heterogeneous long-term patterns of depression response to chronic pain onset prospectively using the mixture modeling technique. Depression symptoms prior to and following pain onset over a course of six years were charted in a nationally representative middle-aged sample. Four distinct depression symptom trajectories emerged. The resilience (72.0%) trajectory describes a pattern of no/minimal depression symptoms prior to and following pain onset. The post-pain depression trajectory (11.4%) describes a pattern of low depression at baseline and increasing symptoms following pain onset. The chronic depression (6.8%) trajectory is characterized by persistently high depression symptoms irrespective of pain onset. The prior depression improved (9.8%) trajectory describes a pattern of high depression at baseline and gradually declining symptoms following pain onset. Self-rated health at both baseline and following pain onset predicted the resilience trajectory. Baseline self-rated health distinguished the post-pain depression and chronic depression trajectories. Individuals in the prior depression improved trajectory were older and had more chronic illnesses at baseline but fewer illnesses following pain onset, compared to those in the resilience or post-pain depression trajectory.",0 +https://doi.org/10.1097/nmd.0b013e31816a62c6,The Psychological Impact of a Catastrophic Earthquake,"Aim of the present study was to retrospectively assess the impact of a catastrophic earthquake in a sample of 121 survivors, 50 years after the event. Mean age +/- SD of the responders was 72.2 +/- 6.1 years. The majority of the victims (78%) acknowledged a strong overall impact of the earthquake on their lives, and almost all of them had intense recollection of the event at its anniversary. The most frequent symptom during the 6 months after the earthquake was persistent remembering or ""reliving"" of the event; women had considerably more often recurrent dreams of the earthquake and distress than did men. Women and young adults at the time of the earthquake appear to be the most vulnerable groups regarding the psychological effects of the event.",0 +https://doi.org/10.1002/da.20907,"Prolonged exposure therapy: past, present, and future","Depression and AnxietyVolume 28, Issue 12 p. 1043-1047 The Cutting Edge Prolonged exposure therapy: past, present, and future† Edna B. Foa Ph.D., Corresponding Author Edna B. Foa Ph.D. foa@mail.med.upenn.edu Center for the Treatment and Study of Anxiety, University of Pennsylvania, 3535 Market Street, 6th Floor, Philadelphia, PA 19104Center for the Treatment and Study of Anxiety, University of Pennsylvania, 3535 Market Street, 6th Floor, Philadelphia, PA 19104Search for more papers by this author Edna B. Foa Ph.D., Corresponding Author Edna B. Foa Ph.D. foa@mail.med.upenn.edu Center for the Treatment and Study of Anxiety, University of Pennsylvania, 3535 Market Street, 6th Floor, Philadelphia, PA 19104Center for the Treatment and Study of Anxiety, University of Pennsylvania, 3535 Market Street, 6th Floor, Philadelphia, PA 19104Search for more papers by this author First published: 01 December 2011 https://doi.org/10.1002/da.20907Citations: 157 † No conflict of interest was declared. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume28, Issue12December 2011Pages 1043-1047 RelatedInformation",0 +https://doi.org/10.1038/sj.npp.1300432,An Increased Capacity for Adrenal DHEA Release is Associated with Decreased Avoidance and Negative Mood Symptoms in Women with PTSD,"We recently found increased adrenal cortisol responses to adrenocorticotropic hormone (ACTH)1-24 and increased pituitary ACTH and adrenal cortisol responses to corticotropin-releasing factor in premenopausal women with chronic post-traumatic stress disorder (PTSD) compared to healthy nontraumatized subjects. This pattern of hypothalamic-pituitary-adrenal axis (HPA) hyper-reactivity has been previously seen in healthy individuals treated with the antiglucocorticoid mifepristone. We therefore investigated whether endogenous plasma levels of antiglucocorticoids such as dehydroepiandrosteroine (DHEA) and progesterone were increased in premenopausal women with PTSD at baseline or in response to adrenal activation by ACTH1-24. The study revealed that DHEA responses to 250 microg ACTH1-24 were increased in 13 PTSD subjects compared to 13 healthy nontraumatized subjects, while DHEA levels were generally increased in the PTSD subjects compared to seven healthy traumatized subjects. Cortisol responses to ACTH1-24 were also higher in the women with PTSD, while progesterone levels and responses were not different among the three groups. In addition, among the PTSD subjects, the peak change in DHEA in response to ACTH1-24 was negatively correlated with the total Clinician Administered PTSD Scale score, while the peak DHEA to cortisol ratio was inversely associated with negative mood symptoms measured by the Profile of Mood States scale. This work suggests that an increased capacity for DHEA release in response to extreme adrenal activation may influence the pattern of HPA axis adaptation to extreme stress, as well as mitigate the severity of PTSD and negative mood symptoms in premenopausal women with PTSD.",0 +https://doi.org/10.1002/9780470669280.ch18,A Constructivist Perspective on Post-Traumatic Stress in Children and Adolescents,"(from the chapter) It is clear from the extant literature that different types of trauma exposure can differentially impact children at different stages of development, and that professionals must take into account the full range of internalizing and externalizing symptoms that so often co-occur with symptoms of posttraumatic stress disorder (PTSD). Although symptom management and reduction are often a critical component of treatment, we agree with the propositions by Wood and colleagues that (1) trauma exposure and subsequent responses are best understood via a social/ecological framework, and (2) it is critical to conceptualize the exposure, reaction, and response as primarily disruptions to a child's sense of self-efficacy. Consistent with these propositions, we utilize a framework for approaching post-traumatic stress in children that allows the symptoms to be targeted while simultaneously addressing the child's disrupted identity and social embeddedness. In this chapter, we will present a constructivist framework for understanding and intervening with post-traumatic stress reactions in childhood and adolescence. Although we base much of our thinking on traditional personal construct psychology, the perspective has been extended and reformulated by other constructivist scholars, including ourselves. We will begin with a consideration of how personal constructs and personal identity develop in childhood. Next, we will consider adolescent development from a constructivist perspective. Then, we will turn attention to how traumatic experiences can serve to disrupt identity and personal functioning across these two developmental periods. Finally, we will present a constructivist approach to assisting children and adolescents in adapting to life after a traumatic disruption. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0 +https://doi.org/10.1177/2167702614551766,Pretraumatic Stress Reactions in Soldiers Deployed to Afghanistan,"Posttraumatic Stress Disorder is a diagnosis related to the past. Pre-traumatic stress reactions, as measured by intrusive involuntary images of possible future stressful events and their associated avoidance and increased arousal, have been overlooked in the PTSD literature. Here we introduce a scale that measures pre-traumatic stress reactions providing a clear future-oriented parallel to the posttraumatic stress reactions described in the diagnostic criteria for PTSD. We apply this pre-traumatic stress reactions checklist (PreCL) to Danish soldiers before, during, and after deployment to Afghanistan. The PreCL has good internal consistency and is highly correlated with a standard measure of PTSD symptoms. The PreCL as answered before the soldiers' deployment significantly predicted level of PTSD symptoms during and after their deployment, while controlling for baseline PTSD symptoms and combat exposure measured during and after deployment. The findings have implications for the conceptualization of PTSD, screening, and treatment.",0 +https://doi.org/10.1007/s10879-015-9299-y,From Postimpact to Reconstruction: Considerations When Treating Traumatized Child and Adolescent Clients,"Longitudinal data analyses have revealed that children and adolescents may encounter several distinct recovery stages and trajectories following exposure to a traumatic event. As recent dissemination efforts have increased the availability of training in various empirically-supported treatments, mental health service providers may struggle to identify among these approaches a treatment that is best suited to address the needs of an individual client. Treatment planning should take into consideration the severity of distress symptoms, as well as the timing, mode of delivery, and the setting of intervention. In this paper we provide an overview of assessment and emerging treatment approaches that can be used across various phases of recovery. We also identify a framework for making treatment decisions based on existing research. Finally, we propose next steps for research and practice in the area of treating traumatized children and adolescents.",0 +https://doi.org/10.1097/mpg.0000000000000262,Depression Subtypes in Pediatric Inflammatory Bowel Disease,"The association between inflammatory bowel disease (IBD) and depression provides a unique opportunity to understand the relation between systemic inflammation and depressive symptom profiles.Youth (n = 226) ages 9 to 17 years with comorbid IBD and depression underwent psychiatric assessment and evaluation of IBD activity. Latent profile analysis (LPA) identified depressive subgroups based on similar responses to the Children's Depression Rating Scale-Revised. Demographic factors, depression severity, anxiety, IBD activity, inflammatory markers, IBD-related medications, and illness perception were evaluated as predictors of profile membership.Mean age was 14.3 years; 75% had Crohn disease; 31% were taking systemic corticosteroids. Mean depressive severity was moderate, whereas IBD activity, which reflects inflammation, was mild. LPA identified 3 subgroups: Profile-1 (mild, 75%) had diverse low-grade depressive symptoms and highest quality of life; Profile-2 (somatic, 19%) had severe fatigue, appetite change, anhedonia, decreased motor activity, and depressed mood with concurrent high-dose steroid therapy and the highest IBD activity; and Profile-3 (cognitive, 6%) had the highest rates of self-reported depressive symptoms, ostomy placements, and anxiety with IBD symptoms in the relative absence of inflammation.Evidence was found for 3 depression profiles in youth with IBD and depression. Our analyses determined that patients with predominantly somatic or cognitive symptoms of depression comprised 25% of our cohort. These findings may be used to design subgroup-specific interventions for depression in adolescents with IBD and other physical illnesses associated with systemic inflammation.",0 +https://doi.org/10.1186/1477-7525-12-85,"Building resiliency: a cross-sectional study examining relationships among health-related quality of life, well-being, and disaster preparedness","Worldwide, disaster exposure and consequences are rising. Disaster risk in New Zealand is amplified by island geography, isolation, and ubiquitous natural hazards. Wellington, the capital city, has vital needs for evacuation preparedness and resilience to the devastating impacts and increasing uncertainties of earthquake and tsunami disasters. While poor quality of life (QoL) is widely-associated with low levels of engagement in many health-protective behaviors, the relationships among health-related quality of life (HrQoL), well-being, and preparedness are virtually unknown.We hypothesized that QoL and well-being affect household evacuation preparedness. We performed a quantitative epidemiologic survey (cross-sectional design) of Wellington adults. Our investigation assessed health-promoting attributes that build resiliency, conceptualized as health-protective attitudes and behaviors. Multidimensional QoL variables were measured using validated psychometric scales and analyzed for associations with evacuation preparedness, and we determined whether age and gender affected these relationships.We received 695 survey responses (28.5% response rate; margin of error ±3.8%; 80% statistical power to detect true correlations of 0.11 or greater). Correlational analyses showed statistically significant positive associations with evacuation preparedness for spiritual well-being, emotional well-being, and life satisfaction. No associations were found for mental health, social well-being, or gender; physical health was weakly negatively associated. Evacuation preparedness increased with age. Regression analyses showed that overall health and well-being explained 4.6-6.8% of the variance in evacuation preparedness. Spiritual well-being was the only QoL variable that significantly and uniquely explained variance in preparedness.How well-being influences preparedness is complex and deeply personal. The data indicate that multidimensional readiness is essential, and meaningfulness is an important factor. Inadequate levels of tangible preparedness actions are accompanied by gaps in intangible readiness aspects, such as: 1) errors in perceived exposure to and salience of natural hazards, yielding circumscribed risk assessments; 2) unfamiliarity with the scope and span of preparedness; 3) underestimating disaster consequences; and 4) misinterpreting the personal resources required for self-managing disaster and uncertainty. Our results highlight that conceptualizing preparedness to include attitudes and behaviors of readiness, integrating well-being and meaningfulness into preparedness strategies, and prioritizing evacuation planning are critical for resiliency as a dynamic process and outcome.",0 +,"Alternate forms of adjustment in adult women survivors of CSA: The relationship between wellness, resilience, and post-traumatic growth","Women disproportionately experience victimization as children, with at least one in five women reporting a history of child sexual abuse. The short and long term effects, both physical and emotional, are significant, negative, and pervasive, making CSA a critical physical and mental health issue for a significant portion of women in the United States. However, while many survivors experience negative long-term effects, a significant portion do not. This study addressed the need for greater attention to factors which depathologize this population, particularly the experiences of survivorship and how these are expressed in terms of wellness, resilience and post-traumatic growth (PTG). A sample of 163 adult women survivors completed an online survey comprised of instruments measuring wellness, resilience, PTG, and post-traumatic stress. A series of correlations revealed positive relationships between wellness factors and resilience, and wellness factors and PTG. Negative correlations were found between PTS symptoms and Resilience, and PTS symptoms and Wellness. Resilience and PTG were negatively correlated, a finding contrary to the conceptualization in the literature. A MANOVA and a series of linear regressions analyzed factors that might contribute to the variance in the major constructs. The results of the MANOVA indicated that the relationship to the perpetrator only affected PTS symptoms: women abused by a relative had significantly higher PTS symptoms. The results of the linear regressions indicated that the variables (current age, additional childhood maltreatment, reported current impact of CSA, CSA severity, and age at onset of abuse) accounted for a very small percentage of the variance in Wellness (16%) and Resilience (10%), and a greater amount of variance in total PTS symptoms (39%). The variables did not account for a significant amount of variance in PTG. The largest contributor of the variance in Wellness, Resilience, and PTS symptoms was the current impact of CSA while CSA severity was a significant contributor to PTS symptoms. A series of t-tests were conducted to analyze the difference between the wellness of this sample and the wellness reported by the normative group. Results indicated that the women in this sample had significantly lower Creative Self, Social Self, and Essential Self wellness but had significantly higher Physical Self wellness. No significant difference was found for Total Wellness and Coping Self wellness. The results of the final analysis, a hierarchical linear regression, indicated that above and beyond demographic variables, Resilience by far, and PTG, to a much smaller degree, were significant predictors of the variance in wellness factors. Additional research is necessary in order to further explore the relationships between wellness factors, resilience, and PTG.",0 +https://doi.org/10.1176/ajp.150.4.620,Psychophysiologic assessment of traumatic imagery in Israeli civilian patients with posttraumatic stress disorder,"This study used a script-driven imagery technique, previously used with combat veterans, to assess physiologic responses of Israeli survivors of noncombat traumas.Each subject had experienced an event meeting DSM-III-R criterion A for posttraumatic stress disorder (PTSD). The subjects were classified on the basis of the full DSM-III-R criteria into a current PTSD group (N = 13) and a non-PTSD group (N = 13). Thirty-second scripts describing each subject's personal traumatic event, as well as other events, were prepared. The scripts incorporated subjective visceral and muscular responses reported to have accompanied each experience. In the laboratory, the scripts were read one at a time to the subject, who was instructed to imagine each event portrayed as vividly as possible, while heart rate, skin conductance, and left lateral frontalis electromyogram levels were measured.Multivariate analysis of variance revealed that the physiologic responses of the PTSD subjects during imagery of their personal traumatic experiences were significantly greater than those of the non-PTSD subjects. This difference was not explained by age, gender, or rated severity of the traumatic event. A physiologic discriminant function derived from previously studied Vietnam veterans correctly classified nine of the 13 PTSD subjects (sensitivity = 69%) and 10 of the 13 non-PTSD subjects (specificity = 77%).These results replicate previous findings of heightened physiologic responses during personal combat imagery in male American war veterans and extend them to a group of male and female Israeli civilian victims of trauma, supporting the robustness of physiologic responding during personal traumatic imagery as a measure of PTSD.",0 +https://doi.org/10.3402/ejpt.v5.25097,"Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis","There has been debate regarding whether Complex Posttraumatic Stress Disorder (Complex PTSD) is distinct from Borderline Personality Disorder (BPD) when the latter is comorbid with PTSD.To determine whether the patterns of symptoms endorsed by women seeking treatment for childhood abuse form classes that are consistent with diagnostic criteria for PTSD, Complex PTSD, and BPD.A latent class analysis (LCA) was conducted on an archival dataset of 280 women with histories of childhood abuse assessed for enrollment in a clinical trial for PTSD.THE LCA REVEALED FOUR DISTINCT CLASSES OF INDIVIDUALS: a Low Symptom class characterized by low endorsements on all symptoms; a PTSD class characterized by elevated symptoms of PTSD but low endorsement of symptoms that define the Complex PTSD and BPD diagnoses; a Complex PTSD class characterized by elevated symptoms of PTSD and self-organization symptoms that defined the Complex PTSD diagnosis but low on the symptoms of BPD; and a BPD class characterized by symptoms of BPD. Four BPD symptoms were found to greatly increase the odds of being in the BPD compared to the Complex PTSD class: frantic efforts to avoid abandonment, unstable sense of self, unstable and intense interpersonal relationships, and impulsiveness.Findings supported the construct validity of Complex PTSD as distinguishable from BPD. Key symptoms that distinguished between the disorders were identified, which may aid in differential diagnosis and treatment planning.",0 +https://doi.org/10.1111/j.1526-4610.2005.00269.x,Traumatic Stressors and Post-Traumatic Stress Disorder Symptoms in Headache Patients,"The aim of this study was to assess the prevalence of significant traumatic stressors and post-traumatic stress disorder (PTSD) symptoms in a headache population.Several recent publications have emphasized the relationship between life stressors and/or daily hassles and recurrent headaches. However, little is known about the prevalence and impact of major traumatic stressors in patients with recurrent headaches.Eighty patients with either migraine or tension-type headache completed a PTSD checklist. Data were compared with those from patients with chronic masticatory muscle pain of similar intensity and duration.Almost 64% of the headache patients reported one or more major traumatic stressors. This percentage was not significantly different from that of the comparison group, and fell within the broad range reported for exposure to traumatic stressors in epidemiologic studies with nonpatient populations. One out of 6 patients in the total headache sample, and 1 out of 4 of those reporting a traumatic stressor, reported symptoms suggestive of current PTSD. The prevalence of current PTSD-like symptomatology reported by the headache patients was comparable to that of the comparison group of the present study, but higher than that reported for the general population in the available literature printed in English. Traumatic stressors most often reported were not related to direct physical trauma, but rather associated with loss or serious illness of a loved one.Exposure to traumatic events in patients with a primary diagnosis of recurrent headaches is similar to that reported for chronic masticatory muscle pain patients or nonpatient populations. However, symptoms consistent with a diagnosis of current PTSD appear to be more frequent in patients with recurrent headaches than reported in the scientific literature printed in English for nonpatient populations. Screening for PTSD symptomatology is recommended as part of the routine clinical evaluation of headache.",0 +https://doi.org/10.1176/appi.ajp.161.8.1370,"Acute Stress Disorder, Posttraumatic Stress Disorder, and Depression in Disaster or Rescue Workers","The events of Sept. 11, 2001, highlighted the importance of understanding the effects of trauma on disaster workers. To better plan for the health care of disaster workers, this study examined acute stress disorder, posttraumatic stress disorder (PTSD), early dissociative symptoms, depression, and health care utilization in disaster workers.Exposed disaster workers (N=207) and unexposed comparison subjects (N=421) were examined at 2, 7, and 13 months after an airplane crash.Exposed disaster workers had significantly higher rates of acute stress disorder, PTSD at 13 months, depression at 7 months, and depression at 13 months than comparison subjects. Those who were younger and single were more likely to develop acute stress disorder. Exposed disaster workers with acute stress disorder were 3.93 times more likely to be depressed at 7 months. Those with high exposure and previous disaster experience or who had acute stress disorder were more likely to develop PTSD. Similarly, those who were depressed at 7 months were 9.5 times more likely to have PTSD. Those who were depressed at 13 months were 7.96 times more likely to also meet PTSD criteria. More exposed disaster workers than comparison subjects obtained medical care for emotional problems at 2, 7, and 13 months. Overall, 40.5% of exposed disaster workers versus 20.4% of comparison subjects had acute stress disorder, depression at 13 months, or PTSD.Exposed disaster workers are at increased risk of acute stress disorder, depression, or PTSD and seek care for emotional problems at an increased rate.",0 +https://doi.org/10.1002/smi.2615,Positive Psychological Factors are Associated with Lower PTSD Symptoms among Police Officers: Post Hurricane Katrina,"Following Hurricane Katrina, police officers in the New Orleans geographic area faced a number of challenges. This cross-sectional study examined the association between resilience, satisfaction with life, gratitude, posttraumatic growth, and symptoms of posttraumatic stress disorder in 84 male and 30 female police officers from Louisiana. Protective factors were measured using the Connor–Davidson Resilience scale, Satisfaction with Life Scale, the Gratitude Questionnaire, and the Posttraumatic Growth inventory. Symptoms of posttraumatic stress disorder were measured using the Posttraumatic Stress Disorder Checklist—Civilian (PCL-C). Potential associations were measured using linear regression and analysis of variance. Models were adjusted for age, sex, race, education, and alcohol. Mean PCL-C symptoms were 29.5 ± 14.5 for females and 27.8 ± 12.1 for males. Adjusted mean levels of PCL-C symptoms significantly decreased as quartiles of resilience (p < .001), satisfaction with life (p < .001), and gratitude (p < .001) increased. In contrast, PCL-C symptoms were not associated with posttraumatic growth in this sample. These results indicate that positive factors such as resilience, satisfaction with life, and gratitude may help mitigate symptoms of posttraumatic stress disorder. To further explore these relationships, longitudinal follow-up in a larger population would be of interest. Copyright © 2014 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1016/j.yebeh.2013.08.006,Diagnosis of probable psychogenic nonepileptic seizures in the outpatient clinic: Does gender matter?,"Psychogenic nonepileptic seizures (PNESs) are paroxysmal events of altered behavior that outwardly resemble epilepsy but are caused by psychiatric disease. The diagnosis of probable PNESs can be made in the outpatient clinic prior to video-EEG monitoring by identification of specific PNES predictors and specific elements of seizure semiology from the clinical history. Since psychiatric disease may have distinct mechanisms between women and men, the objective of this study was to determine if gender-specific differences exist in PNES predictors and PNES semiology. Such differences could be used to optimize the accuracy of outpatient diagnosis of probable PNESs. Medical records of male and female patients with video-EEG diagnosis of definite PNESs were retrospectively reviewed for occurrence of PNES predictors. In addition, PNES semiology was analyzed de novo from video-EEG records and categorized into previously established semiology clusters. Eighty-six patients were included in the analysis (59 women and 27 men). We found significantly lower rates of reported physical and sexual abuse, lower rates of previous psychiatric diagnosis, and lower rates of chronic pain in male patients with no significant differences in rates of other PNES predictors. Furthermore, we found no difference in PNES semiology between men and women, with both groups experiencing similar rates of major motor, minor motor, and nonmotor semiology. In conclusion, our results lend support to the idea that distinct risk factor criteria but similar semiology criteria should be used for the diagnosis of probable PNESs in the outpatient clinic in men and women.",0 +https://doi.org/10.1080/00223891.1990.9674025,MMPI Configural Interpretation as Applied to Posttraumatic Stress Disorder in Vietnam Veterans,"This study investigated the systems of Minnesota Multiphasic Personality Inventory (MMPI) configural interpretation of Skinner and Jackson (1978) and Kunce (1979) with Vietnam veterans with posttraumatic stress disorder (PTSD). MMPI profiles of four groups differing in combat exposure were compared on four MMPI configural variables from Kunce (1979) and Skinner and Jackson (1978). The four groups were (a) PTSD sufferers, (b) Vietnam combat veterans without PTSD, (c) Vietnam noncombat veterans, and (d) Vietnam era veterans. All groups were further divided into hospitalized versus nonhospitalized subgroups. Dependent variables were Skinner and Jackson's (a) sociopathic modal profile, (b) neurotic profile, (c) psychotic profile, and (d) Kunce's emotional expression (enthusiastic-reserved) dimension. Results indicated that hospitalized PTSD subjects had significantly higher scores on Skinner and Jackson's neurotic profile; both hospitalized and nonhospitalized PTSD subjects had higher scores on the psychotic profile and were more ""reserved"" on Kunce's emotional expression dimension. Results were interpreted in terms of configural MMPI interpretation systems and the adjustment of Vietnam veterans with PTSD. PTSD was viewed as exhibiting cognitive, somatic, and affective features.",0 +https://doi.org/10.1023/a:1007810200460,PTSD severity and health perceptions in female victims of sexual assault,"In women with chronic posttraumatic stress disorder (PTSD), poor physical health may be related to their PTSD symptoms through an underlying negative affect or distress that accompanies the disorder, through the PTSD symptoms in general, or specifically through the chronic hyperarousal present in the disorder. The current study examined the relative contribution of these factors to reported physical symptoms in female victims of sexual assault. Seventy-six women with chronic PTSD were assessed, using measures of stressful life events, psychological difficulties, and perceived health. Negative life events, anger, depression, and PTSD severity were all related to self-reported physical symptoms; however, PTSD severity predicted self-reported physical symptoms beyond these other variables. Contrary to our hypothesis, the reexperiencing cluster of PTSD, and not the hyperarousal cluster, was related to self-reported physical symptoms.",0 +https://doi.org/10.1016/s0140-6736(10)60672-1,What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study,"Concerns have been raised about the psychological effect of continued combat exposure and of repeated deployments. We examined the consequences of deployment to Iraq and Afghanistan on the mental health of UK armed forces from 2003 to 2009, the effect of multiple deployments, and time since return from deployment.We reassessed the prevalence of probable mental disorders in participants of our previous study (2003-05). We also studied two new randomly chosen samples: those with recent deployment to Afghanistan, and those who had joined the UK armed forces since April, 2003, to ensure that the final sample continued to be representative of the UK armed forces. Between November, 2007, and September, 2009, participants completed a questionnaire about their deployment experiences and health outcomes.9990 (56%) participants completed the study questionnaire (8278 regulars, 1712 reservists). The prevalence of probable post-traumatic stress disorder was 4.0% (95% CI 3.5-4.5; n=376), 19.7% (18.7-20.6; n=1908) for symptoms of common mental disorders, and 13.0% (12.2-13.8; n=1323) for alcohol misuse. Deployment to Iraq or Afghanistan was significantly associated with alcohol misuse for regulars (odds ratio 1.22, 95% CI 1.02-1.46) and with probable post-traumatic stress disorder for reservists (2.83, 1.23-6.51). Regular personnel in combat roles were more likely than were those in support roles to report probable post-traumatic stress disorder (1.87, 1.26-2.78). There was no association with number of deployments for any outcome. There was some evidence for a small increase in the reporting of probable post-traumatic stress disorder with time since return from deployment in regulars (1.13, 1.03-1.24).Symptoms of common mental disorders and alcohol misuse remain the most frequently reported mental disorders in UK armed forces personnel, whereas the prevalence of probable post-traumatic stress disorder was low. These findings show the importance of continued health surveillance of UK military personnel.UK Ministry of Defence.",0 +https://doi.org/10.1016/j.paid.2015.04.035,Differential mediating effects of PTSD symptom clusters on alcohol use and sleep in university students with trauma experiences: A multi-group analysis,"This study investigates the differential mediating pathways of PTSD symptom clusters in the relationship between traumatic events and alcohol use or poor sleep quality in a sample of university students with traumatic life experiences using a path analysis. Gender difference was also examined using multi-group analysis. Male (N = 1471) and female (N = 528) university students completed an online mental health survey consisting of the Life Event Checklist, the Impact of Event Scale-Revised, the CAGE Questionnaire, and the Pittsburgh Sleep Quality Index. Results showed that traumatic events had a direct impact on both alcohol use and poor sleep quality. The indirect impact of traumatic events on alcohol use appeared to be through PTSD-avoidance, and the indirect impact of traumatic events on poor sleep quality appeared to be through PTSD-intrusion and PTSD-hyperarousal. A multi-group analysis showed that male students are 3.25 times more likely to use alcohol in response to traumatic stress than female students. Our findings suggest that there are differential mediating mechanisms of PTSD symptom clusters underlying alcohol use or poor sleep quality following traumatic events, indicating the importance of developing symptom-tailored therapeutic intervention.",0 +https://doi.org/10.1188/10.onf.160-167,Post-Traumatic Stress Disorder in Israeli Survivors of Childhood Cancer,"To investigate the prevalence, symptom severity, and risk factors associated with post-traumatic stress disorder (PTSD) in childhood cancer survivors.Descriptive, correlational study.Follow-up clinic in Petach Tikva, Israel.Convenience sample of 70 adult Israeli survivors of childhood cancer.Questionnaires (the Post-Traumatic Diagnostic Scale and the Multidimensional Scale of Perceived Social Support) were distributed to participants, and demographic and clinical data were obtained from medical records.Post-traumatic stress, social support, and clinical and demographic data.Twenty (29%) of the participants met the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for PTSD; 10% experienced mild, 40% moderate, and 50% moderate to severe symptoms. Only 16% of the sample did not experience any symptoms of PTSD. A statistically significant negative relationship was found between PTSD symptom scores and the current age of the respondent (r(s) = -0.27, p = 0.03) and time since medical treatment (r(s) = -0.34, p = 0.004) but not any other demographic or clinical variables or social support.Higher severity of PTSD symptoms was found, possibly because of local living conditions. Most clinical and demographic variables were not risk factors. This population should be studied further in an effort to prevent PTSD via early diagnosis.Oncology nurses should be aware of the potential risk factors (recent completion of treatment and younger current age) and the high prevalence and severity of PTSD among survivors of childhood cancer to identify patients at higher risk and develop programs that prevent, limit, and treat PTSD.",0 +https://doi.org/10.1016/j.jpsychires.2014.10.012,Dimensional structure of DSM-5 posttraumatic stress symptoms: Support for a hybrid Anhedonia and Externalizing Behaviors model,"Several revisions to the symptom clusters of posttraumatic stress disorder (PTSD) have been made in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Central to the focus of this study was the revision of PTSD's tripartite structure in DSM-IV into four symptom clusters in DSM-5. Emerging confirmatory factor analytic (CFA) studies have suggested that DSM-5 PTSD symptoms may be best represented by one of two 6-factor models: (1) an Externalizing Behaviors model characterized by a factor which combines the irritability/anger and self-destructive/reckless behavior items; and (2) an Anhedonia model characterized by items of loss of interest, detachment, and restricted affect. The current study conducted CFAs of DSM-5 PTSD symptoms assessed using the PTSD Checklist for DSM-5 (PCL-5) in two independent and diverse trauma-exposed samples of a nationally representative sample of 1484 U.S. veterans and a sample of 497 Midwestern U.S. university undergraduate students. Relative fits of the DSM-5 model, the DSM-5 Dysphoria model, the DSM-5 Dysphoric Arousal model, the two 6-factor models, and a newly proposed 7-factor Hybrid model, which consolidates the two 6-factor models, were evaluated. Results revealed that, in both samples, both 6-factor models provided significantly better fit than the 4-factor DSM-5 model, the DSM-5 Dysphoria model and the DSM-5 Dysphoric Arousal model. Further, the 7-factor Hybrid model, which incorporates key features of both 6-factor models and is comprised of re-experiencing, avoidance, negative affect, anhedonia, externalizing behaviors, and anxious and dysphoric arousal symptom clusters, provided superior fit to the data in both samples. Results are discussed in light of theoretical and empirical support for the latent structure of DSM-5 PTSD symptoms.",0 +https://doi.org/10.1016/s0191-8869(00)00220-8,The Crisis Support Scale: psychometric qualities and further validation,"The objective of the present study was to provide a further validation of the Crisis Support Scale, which is a short scale for measuring social support after a crisis has occurred. The data from eleven trauma studies of 4213 subjects were used to investigate the psychometric properties of the scale and the differences that emerge due to age, gender, and type of trauma. The scale appears to be very robust. Some aspects of crisis support seem to decrease as time goes by while others increase. Women survivors report less support than men both right after the trauma and later on. The younger survivors tend to report the least support in the acute phase although this picture is reversed later on. The various types of trauma have different item profiles, which supports the concurrent validity of the scale.",0 +https://doi.org/10.1002/smi.1403,"Post-traumatic Stress Disorder, Anxiety and Depression among the Elderly: A Survey of the Hard-hit Areas a Year after the Wenchuan Earthquake","Few studies to date have examined psychological sequelae of natural disasters among the elderly in China. The aim of this study was to investigate the prevalence rates of probable post-traumatic stress disorder (PTSD), anxiety and depression in the elderly survivors a year after the Wenchuan earthquake as well as to analyse related risk factors. The community-based sample of the study consisted of 284 elderly survivors (≥60 years). PTSD was assessed by the PTSD Checklist--Civilian version, and anxiety and depression were assessed by the Hopkins Symptoms Checklist. In total, the estimated prevalence rates of probable PTSD, anxiety and depression were 26.3%, 42.9% and 35.2%, respectively. Nearly a fifth of the elderly participants reported symptoms that meet the criteria for all three of these mental disorders. Results indicated that some factors associated with earthquake-exposure intensity, which included loss of livelihood, bereavement, injury and initial fear during the earthquake, were among the significant risk factors for these mental disorders. Women had a higher risk of suffering from probable anxiety as compared to men. Finally, the significance and limitations of this study were also discussed.",0 +https://doi.org/10.1179/2042618613y.0000000053,Chronic post-traumatic headache: clinical findings and possible mechanisms,"Chronic post-traumatic headache (CPTHA), the most frequent complaint after traumatic brain injury (TBI), dramatically affects quality of life and function. Despite its high prevalence and persistence, the mechanism of CPTHA is poorly understood. This literature review aimed to analyze the results of studies assessing the characteristics and sensory profile of CPTHA in order to shed light on its possible underlying mechanisms. The search for English language articles published between 1960 and 2013 was conducted in MEDLINE, CINAHL, and PubMed. Studies assessing clinical features of headache after TBI as well as studies conducting quantitative somatosensory testing (QST) in individuals with CPTHA and in individuals suffering from other types of pain were included. Studies on animal models of pain following damage to peripheral tissues and to the peripheral and central nervous system were also included. The clinical features of CPTHA resembled those of primary headache, especially tension-type and migraine headache. Positive and negative signs were prevalent among individuals with CPTHA, in both the head and in other body regions, suggesting the presence of local (cranial) mechanical hypersensitivity, together with generalized thermal hypoesthesia and hypoalgesia. Evidence of dysfunctional pain modulation was also observed. Chronic post-traumatic headache can result from damage to intra- and pericranial tissues that caused chronic sensitization of these tissues. Alternatively, although not mutually exclusive, CPTHA might possibly be a form of central pain due to damage to brain structures involved in pain processing. These, other possibilities, as well as risk factors for CPTHA are discussed at length.",0 +https://doi.org/10.1016/j.cpr.2013.12.002,Etiology of depression comorbidity in combat-related PTSD: A review of the literature,"Posttraumatic stress disorder is often diagnosed with other mental health problems, particularly depression. Although PTSD comorbidity has been associated with more severe and chronic symptomology, relationships among commonly co-occurring disorders are not well understood. The purpose of this study was to review the literature regarding the development of depression comorbid with combat-related PTSD among military personnel. We summarize results of commonly tested hypotheses about the etiology of PTSD and depression comorbidity, including (1) causal hypotheses, (2) common factor hypotheses, and (3) potential confounds. Evidence suggests that PTSD may be a causal risk factor for subsequent depression; however, associations are likely complex, involving bidirectional causality, common risk factors, and common vulnerabilities. The unique nature of PTSD-depression comorbidity in the context of military deployment and combat exposure is emphasized. Implications of our results for clinical practice and future research are discussed.",0 +https://doi.org/10.1016/j.smrv.2008.02.001,Sleep and post-traumatic stress disorder: A roadmap for clinicians and researchers,"The three reviews in this issue of Sleep Medicine Reviews present formulations based on emerging findings that relate to sleep disturbances in posttraumatic stress disorders (PTSD). This set of papers is a timely selection for Sleep Medicine Reviews. PTSD is now recognized to be a prevalent disorder that confers considerable distress and morbidity. Appreciation of the significance of the disorder is increasing in relation to recent and ongoing wars, acts of terrorism, and natural disasters. People who experience traumatic stress often have a strong and intuitive appreciation of the importance of sleep to their emotional adaptation and as a contributor to their distress. This awareness is conveyed to clinicians who treat PTSD who in turn recognize the importance of targeting disturbed sleep with their treatments. The past 20 years has seen burgeoning research in the neurobiology of PTSD with much of the emphasis being neuroendocrinology and brain imaging. Achieving a coherent characterization of sleep dysregulation in PTSD and its integration with models of PTSD pathogenesis has challenged the field. Progress toward these goals and the promise of achieving them are highlighted by these manuscripts. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1037/a0016677,"Assessing posttraumatic stress disorder with or without reference to a single, worst traumatic event: Examining differences in factor structure.","The authors examined the effects of a methodological manipulation on the Posttraumatic Stress Disorder (PTSD) Checklist's factor structure: specifically, whether respondents were instructed to reference a single worst traumatic event when rating PTSD symptoms. Nonclinical, trauma-exposed participants were randomly assigned to 1 of 2 PTSD assessment conditions: referencing PTSD symptoms to their worst trauma (trauma-specific group, n = 218) or to their overall trauma history in general (trauma-general group, n = 234). A 3rd group of non-trauma-exposed participants (n = 464) rated PTSD symptoms globally from any stressful event. Using confirmatory factor analysis, the authors show that the 4-factor PTSD model proposed by D. W. King, G. A. Leskin, L. A. King, and F. W. Weathers (1998; separating effortful avoidance and emotional numbing) demonstrated the best model fit for trauma-general and non-trauma-exposed participants. The 4-factor PTSD model proposed by L. J. Simms, D. Watson, and B. N. Doebbeling (2002; emphasizing a general dysphoria factor) demonstrated the best model fit for trauma-specific participants. Measurement invariance testing revealed that non-trauma-exposed participants were different from both trauma-exposed groups on factor structure parameters, but trauma groups were not substantially different from each other.",0 +https://doi.org/10.1007/s00127-009-0073-x,Brief measure of posttraumatic stress reactions: Impact of Event Scale-6,"BACKGROUND: The Impact of Event Scale-revised (IES-R) is one of the most widely used measures of posttraumatic stress reactions. However, for some purposes, such as large epidemiological studies, there is a need for briefer instruments. The aim of this study was to develop and validate an abbreviated version of the IES-R that could capture the three current symptom clusters of posttraumatic stress disorder (PTSD). METHODS: Stepwise multiple regression was applied to abbreviate the IES-R in one sample. The abbreviated version was then tested in three separate samples of individuals exposed to different kinds of potentially traumatic events. Agreement with a reference measure of PTSD, the PTSD checklist (PCL), was calculated for the abbreviated and the full-scale versions of IES. RESULTS: The abbreviation procedure resulted in a subset of six items (the IES-6), which correlated highly (pooled correlation = 0.95) with the IES-R across samples. Correlations between the IES-6 and IES-R subscales were somewhat lower (r = 0.78-0.94). Both the IES-6 and IES-R were in high agreement with the PCL. CONCLUSION: The IES-6 appears to be a robust brief measure of posttraumatic stress reactions. It may be useful for research in epidemiological studies, and it may also have a role as a screening instrument in clinical practice.",0 +https://doi.org/10.3109/09638288.2013.834985,The moderation of resilience on the negative effect of pain on depression and post-traumatic growth in individuals with spinal cord injury,"To determine the moderating effect of resilience on the negative effects of chronic pain on depression and post-traumatic growth.Community-dwelling individuals with SCI (n = 37) were recruited at short-term admission for yearly regular health examination. Participants completed self-rating standardized questionnaires measuring pain, resilience, depression and post-traumatic growth. Hierarchical linear regression analysis was performed to identify the moderating effect of resilience on the relationships of pain with depression and post-traumatic growth after controlling for relevant covariates.In the regression model of depression, the effect of pain severity on depression was decreased (β was changed from 0.47 to 0.33) after entering resilience into the model. In the final model, both pain and resilience were significant independent predictors for depression (β = 0.33, p = 0.038 and β = -0.47, p = 0.012, respectively). In the regression model of post-traumatic growth, the effect of pain severity became insignificant after entering resilience into the model. In the final model, resilience was a significant predictor (β = 0.51, p = 0.016).Resilience potentially mitigated the negative effects of pain. Moreover, it independently contributed to reduced depression and greater post-traumatic growth. Our findings suggest that resilience might provide a potential target for intervention in SCI individuals.",0 +https://doi.org/10.1186/1471-244x-13-9,The Peritraumatic Behavior Questionnaire: development and initial validation of a new measure for combat-related peritraumatic reactions,"Abstract Background Posttraumatic stress disorder (PTSD) is one of the most commonly observed stress-related conditions following combat exposure and its effective prevention is a high health-care priority. Reports of peritraumatic reactions have been shown to be highly associated with PTSD among combat exposed service members. However, existing instruments measuring peritraumatic symptoms were not specifically developed to assess combat-related peritraumatic stress and each demonstrates a different peritraumatic focus. We therefore developed the Peritraumatic Behavior Questionnaire (PBQ), a new military-specific rating scale focused upon the wide range of symptoms suggestive of combat-related peritraumatic distress in actively deployed Service Members. This study describes the development of the PBQ and reports on the psychometric properties of its self-rated version (PBQ-SR). Methods 688 Marine infantry service members were retrospectively assessed by the PBQ-SR within the scope of the Marine Resiliency Study after their deployment to war zone. Participants have been additionally assessed by a variety of questionnaires, as well as clinical interviews both pre and post-deployment. Results The PBQ-SR demonstrated satisfactory internal consistency, convergent and discriminant validity, as well as high correlation with trait dissociation prior to deployment. Component analysis suggested a latent bi-dimensional structure separating a peritraumatic emotional distress and physical awareness factor. The PBQ-SR total score showed high correlation to general anxiety, depression, poorer general health and posttraumatic symptoms after deployment and remained a significant predictor of PTSD severity, after controlling for those measures. The suggested screening cut-off score of 12 points demonstrated satisfactory predictive power. Conclusions This study confirms the ability of the PBQ-SR to unify the underlying peritraumatic symptom dimensions and reliably assess combat-related peritraumatic reaction as a general construct. The PBQ-SR demonstrated promise as a potential standard screening measure in military clinical practice, while It’s predictive power should be established in prospective studies.",0 +https://doi.org/10.1176/appi.ajp.162.7.1320,Longitudinal Course of Posttraumatic Stress Disorder and Posttraumatic Stress Disorder Symptoms in a Community Sample of Adolescents and Young Adults,"OBJECTIVE: Few studies have focused on the natural course of posttraumatic stress disorder (PTSD) and its determinants in samples of the general population. The authors examined determinants of remission and chronicity of PTSD and associations with other disorders in a prospective community sample. METHOD: The data were drawn from a prospective, longitudinal epidemiological study of adolescents and young adults (age 14–24 years) in Munich, Germany (N=2,548). The course of PTSD from baseline to follow-up 34–50 months later was studied in 125 respondents with DSM-IV PTSD or subthreshold PTSD at baseline. RESULTS: Although 52% of the PTSD cases remitted during the follow-up period, 48% showed no significant remission of PTSD symptoms. Respondents with a chronic course were more likely to experience new traumatic event(s) during follow-up (odds ratio=5.21, 95% confidence interval [CI]=1.95–13.92), to have higher rates of avoidant symptoms at baseline (odds ratio=10.16, 95% CI=1.73–59.51), and to report more help seeking (odds ratio=5.50, 95% CI=1.04–29.05), compared to respondents with remission. Rates of incident somatoform disorder (odds ratio=4.24, 95% CI=1.60–11.19) and other anxiety disorders (odds ratio=4.07, 95% CI=1.15–14.37) were also significantly associated with a chronic course. CONCLUSIONS: PTSD is often a persistent and chronic disorder. Specific symptom clusters—especially avoidant symptoms—might be associated with the course of PTSD. In addition, the occurrence of new traumatic events differentiates PTSD cases with a chronic course from those with remission.",0 +https://doi.org/10.1001/archgenpsychiatry.2010.70,Meta-analytical Comparison of Voxel-Based Morphometry Studies in Obsessive-Compulsive Disorder vs Other Anxiety Disorders,"Whether obsessive-compulsive disorder (OCD) is adequately classified as an anxiety disorder is a matter of considerable debate.To quantitatively compare structural brain changes in OCD and other anxiety disorders using novel voxel-based meta-analytical methods and to generate an online database to facilitate replication and further analyses by other researchers.The PubMed, ScienceDirect, and Scopus databases were searched between 2001 (the date of the first voxel-based morphometry study in any anxiety disorder) and 2009. All voxel-based morphometry studies comparing patients with any anxiety disorder and healthy controls were retrieved. Manual searches were also conducted. Authors were contacted soliciting additional data.Thirty-seven data sets were identified, of which 26 (including 639 patients with anxiety disorders and 737 healthy controls) met inclusion criteria.Coordinates were extracted from clusters of significant gray matter difference between patients and controls. Demographic, clinical, and methodological variables were extracted from each study or obtained from the authors.Patients with anxiety disorders (including OCD) showed decreased bilateral gray matter volumes in the dorsomedial frontal/anterior cingulate gyri. Individuals with OCD had increased bilateral gray matter volumes (vs healthy controls and vs individuals with other anxiety disorders) in the lenticular/caudate nuclei, while patients with other anxiety disorders (mainly panic and posttraumatic stress disorders) had decreased gray matter volumes in the left lenticular nucleus. The findings remained largely unchanged in quartile and jackknife sensitivity analyses. Controlling for potential confounders such as age or antidepressant medication had little impact on the results.The meta-analysis consistently revealed common as well as distinct neural substrates in OCD and other anxiety disorders. These results have implications for the current debate surrounding the classification of OCD in the DSM-V.",0 +https://doi.org/10.3109/02699052.2014.976594,The contribution of psychological factors to recovery after mild traumatic brain injury: Is cluster analysis a useful approach?,"Outcomes after mild traumatic brain injury (MTBI) vary, with slow or incomplete recovery for a significant minority. This study examines whether groups of cases with shared psychological factors but with different injury outcomes could be identified using cluster analysis.This is a prospective observational study following 147 adults presenting to a hospital-based emergency department or concussion services in Christchurch, New Zealand. This study examined associations between baseline demographic, clinical, psychological variables (distress, injury beliefs and symptom burden) and outcome 6 months later. A two-step approach to cluster analysis was applied (Ward's method to identify clusters, K-means to refine results).Three meaningful clusters emerged (high-adapters, medium-adapters, low-adapters). Baseline cluster-group membership was significantly associated with outcomes over time. High-adapters appeared recovered by 6-weeks and medium-adapters revealed improvements by 6-months. The low-adapters continued to endorse many symptoms, negative recovery expectations and distress, being significantly at risk for poor outcome more than 6-months after injury (OR (good outcome) = 0.12; CI = 0.03-0.53; p < 0.01).Cluster analysis supported the notion that groups could be identified early post-injury based on psychological factors, with group membership associated with differing outcomes over time. Implications for clinical care providers regarding therapy targets and cases that may benefit from different intensities of intervention are discussed.",0 +,"Predictors of battered women's use of intimate partner violence (IPV): A focus on IPV exposure, post-traumatic stress disorder (PTSD) and threat appraisal (TA).","The purpose of this study was to examine the prevalence and motivations of battered women's use of intimate partner violence (IPV), as well as to identify predictors of battered women's use of IPV. Using logistic regressions, we examined the predictive utility of women's exposure to IPV, women's symptoms of post-traumatic stress disorder (PTSD) and women's threat appraisal (TA) in explaining women's use of IPV. Using a series of logistic regressions, we also examined PTSD and TA as mediators of the relationship between women's exposure to IPV and women's use of IPV. Women were recruited from various help-seeking sites, as part of a longitudinal study of battered women's experiences. Prevalence rates were reported for all women (n = 285) who completed the third follow-up interview, during which women's use of IPV was assessed. In addressing the hypotheses related to this study, the sample included responses form 152 women who continued to have contact with their abusive partners in the assessed three month period between the third and fourth follow-up interviews. Approximately 70% of women reported having used IPV at some point in their relationships, and approximately 90% of women cited self-defense as a motivation. Statistical analyses found that IPV exposure and TA predicted whether women used IPV, but PTSD was not a significant predictor. Further, TA was not found to mediate the relationship between women's exposure to IPV and women's use of IPV. Findings are discussed within the framework of social, legal and clinical implications. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1037/0090-5550.53.2.162,Posttraumatic stress disorder and major depression in veterans with spinal cord injury.,"Objective: To explore the relationship between posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) in veterans with spinal cord injury and to compare those results with results found in veterans who had sustained other traumatic injuries. Method: To investigate the relationship between PTSD and MDD in persons with spinal cord injury, the authors examined whether individuals endorsed overlapping items on measures of both disorders, evaluated the contribution of overlapping items to comorbid diagnosis, and conducted an exploratory factor analysis. Results: The overlapping symptoms between the 2 disorders did not fully explain the high rate of comorbidity, although participants who endorsed a symptom common to MDD and PTSD on 1 measure were likely to endorse the corresponding item on another measure. In both samples, items loaded on separate PTSD and MDD factors. Conclusion: MDD and PTSD appear to represent independent reactions to trauma in those individuals who had experienced either a nonspinal cord injury or a spinal cord injury. This research also provides an initial investigation of some of the possible ways that MDD and PTSD are related by addressing psychometric issues inherent in their measurement. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.3402/ejpt.v4i0.19825,Predicting criminality from child maltreatment typologies and posttraumatic stress symptoms,"The associations between childhood abuse and subsequent criminality and posttraumatic stress disorder (PTSD) are well known. However, a major limitation of research related to childhood abuse and its effects is the focus on one particular type of abuse at the expense of others. Recent work has established that childhood abuse rarely occurs as a unidimensional phenomenon. Therefore, a number of studies have investigated the existence of abuse typologies.The study is based on a Danish stratified random probability survey including 2980 interviews of 24-year-old people. The sample was constructed to include an oversampling of child protection cases. Building on a previous latent class analysis of four types of childhood maltreatment, three maltreatment typologies were used in the current analyses. A criminality scale was constructed based on seven types of criminal behavior. PTSD symptoms were assessed by the PC-PTSD Screen.Significant differences were found between the two genders with males reporting heightened rates of criminality. Furthermore, all three maltreatment typologies were associated with criminal behavior with odds ratios (ORs) from 2.90 to 5.32. Female gender had an OR of 0.53 and possible PTSD an OR of 1.84.The independent association of participants at risk for PTSD and three types of maltreatment with criminality should be studied to determine if it can be replicated, and considered in social policy and prevention and rehabilitation interventions.",0 +https://doi.org/10.1016/j.janxdis.2008.01.013,The effects of direct versus witnessed threat on emergency department healthcare workers: implications for PTSD criterion A.,"We compared post-traumatic stress disorder (PTSD) symptom severity and symptom cluster profiles in hospital emergency department (ED) medical staff (N=100) who experienced an emotionally distressing work event that presented either a direct threat to themselves or a witnessed threat to patients. The two groups displayed similar levels of PTSD symptoms, however, they differed on symptom profiles and work consequences. The direct threat group experienced significantly greater fear during the event, more ongoing arousal symptoms, and more job dissatisfaction than the witnessed threat group. The witnessed threat group was more likely to appraise their PTSD symptoms as reflecting personal weakness. Overall, the results point to the need for further research to identify distinctive features of responses to different types of traumatic stressors.",0 +,"The assessment of optimistic self-beliefs: Comparison of the Chinese, Indonesian, Japanese, and Korean versions of the general self-efficacy scale",,0 +https://doi.org/10.1037/met0000034,Fitting a linear–linear piecewise growth mixture model with unknown knots: A comparison of two common approaches to inference.,"A linear-linear piecewise growth mixture model (PGMM) is appropriate for analyzing segmented (disjointed) change in individual behavior over time, where the data come from a mixture of 2 or more latent classes, and the underlying growth trajectories in the different segments of the developmental process within each latent class are linear. A PGMM allows the knot (change point), the time of transition from 1 phase (segment) to another, to be estimated (when it is not known a priori) along with the other model parameters. To assist researchers in deciding which estimation method is most advantageous for analyzing this kind of mixture data, the current research compares 2 popular approaches to inference for PGMMs: maximum likelihood (ML) via an expectation-maximization (EM) algorithm, and Markov chain Monte Carlo (MCMC) for Bayesian inference. Monte Carlo simulations were carried out to investigate and compare the ability of the 2 approaches to recover the true parameters in linear-linear PGMMs with unknown knots. The results show that MCMC for Bayesian inference outperformed ML via EM in nearly every simulation scenario. Real data examples are also presented, and the corresponding computer codes for model fitting are provided in the Appendix to aid practitioners who wish to apply this class of models.",0 +https://doi.org/10.1037/ser0000053,Functional correlates of military sexual assault in male veterans.,"Despite research findings that similar numbers of male and female veterans are affected by military sexual trauma (MST), there has been considerably less research on the effects of MST specific to male veterans. The aim of the present study was to provide preliminary data describing functional correlates of military sexual assault (MSA) among male Iraq/Afghanistan-era veterans to identify potential health care needs for this population. We evaluated the following functional correlates: posttraumatic stress disorder (PTSD) symptoms, depression symptoms, alcohol use, drug use, suicidality, social support, violent behavior in the past 30 days, incarceration, disability eligibility status, and use of outpatient mental health treatment. We compared 3 groups: (a) male veterans who endorsed a history of MSA (n = 39), (b) a general non-MSA sample (n = 2,003), and (c) a matched non-MSA sample (n = 39) identified by matching algorithms on the basis of factors (e.g., age, education, adult premilitary sexual trauma history, childhood sexual and physical trauma history, and race) that could increase veterans' vulnerability to the functional correlates examined. MSA in men was associated with greater PTSD symptom severity, greater depression symptom severity, higher suicidality, and higher outpatient mental health treatment, above and beyond the effects of vulnerability factors. These findings suggest that, for male veterans, MSA may result in a severe and enduring overall symptom profile requiring ongoing clinical management.",0 +https://doi.org/10.1016/j.neubiorev.2014.04.003,Grey matter reduction associated with posttraumatic stress disorder and traumatic stress,"In recent decades, many imaging studies have reported brain structural alterations in posttraumatic stress disorder (PTSD). However, due to differences in the selection of control subjects, it is difficult to conclude whether the observed alterations were related to disease or traumatic stress. The present study was to provide a quantitative voxelwise meta-analysis of grey matter (GM) changes in PTSD relative to either trauma-exposed controls without PTSD (TEC) or non-traumatised healthy controls (HC) separately and to conduct a systematic review of voxel-based morphometry (VBM) studies that compared trauma-exposed individuals with HC to explore the effect of traumatic stress. GM reduction was identified in the medial prefrontal cortex in PTSD compared to both TEC and HC. Additional GM reduction was also observed in PTSD in the left hippocampus, left middle temporal gyrus and right superior frontal gyrus compared with TEC. Additionally, GM decreased in the left occipital cortex in PTSD compared with HC. The present study delimited the significant differences among VBM results in PTSD research when different control groups were chosen.",0 +https://doi.org/10.1016/j.janxdis.2013.09.010,Longitudinal course of anxiety sensitivity and PTSD symptoms in cognitive-behavioral therapies for PTSD,"Anxiety sensitivity (AS) has been conceptualized as trait-like vulnerability and maintenance factor for PTSD. Although recent literature has demonstrated its malleability during treatment, few have examined its influence on and effect from PTSD treatment. Using multilevel regression analyses we examined: (a) changes in AS during treatment and (b) whether pre-treatment AS predicted PTSD treatment response, in sample of female victims of interpersonal trauma receiving one of three treatments (cognitive processing therapy, cognitive processing therapy-cognitive, and written accounts). Participants exhibited reductions in total ASI scores from pre- to post-treatment. Growth curve modeling revealed slightly different trajectories of PTSD symptoms as a function of pre-treatment AS, and overall decreases in PTSD symptoms during treatment were not associated with pretreatment AS. Pretreatment AS dimensions impacted PTSD total scores and symptoms clusters differentially. Clinical and theoretical implications for these results are discussed.",0 +https://doi.org/10.1016/j.mehy.2005.06.034,Identification of gene markers based on well validated and subcategorized stressed animals for potential clinical applications in PTSD,"Post-traumatic stress disorder (PTSD) is a complex mental disorder that can develop in response to traumatic experiences. The molecular mechanisms underlying the pathology of PTSD are poorly understood, and this lack of knowledge hampers our ability to find superior therapeutic approaches to the treatment of this disorder. There are two main reasons for our lack of study in this area: here is no sufficiently validated animal model and lack of large-scale studies for the search of underlying molecular mechanisms. Thus, to promote research on PTSD (especially its molecular mechanisms) and to set molecular basis for searching novel medications of this disorder, large-scale, genome-wide interrogation of a significant amount of genes based upon a well validated animal model is demanded. We hypothesize that a significant number of genes are involved in PTSD. It is only with a large number of these genes identified in specific samples of PTSD-related population, and then it is possible for a sufficient understanding of the pathology at the molecular level of a PTSD, as well as for enhancing the PTSD's therapeutic and preventative strategies. Two prerequisites are needed for testing this hypothesis: (1) relative pure samples from a well validated animal model; and (2) genome-wide screening of PTSD molecular targets. For the animal model, we suggest to use the predator-exposure paradigm, in which rats are exposed to a predator, this model has previously been evaluated behaviorally well emulated the clinical symptoms of PTSD. For a better stringency, three criteria can be used to further validate this animal model: analogous (similarity of behavior), predictive (predictability of drug response) and biological mechanism (e.g., electrophysiological and pathological change in amygdala). For large-scale molecular target screening, the new microarray technology, which can profile expression of tens of thousands genes simultaneously, is the method of choice. The validity and practicability of this hypothesis and the strategy for its testing have been supported by our preliminary laboratory data.",0 +https://doi.org/10.1098/rsfs.2014.0008,Resilience in the aftermath of war trauma: a critical review and commentary,"The resilience construct has received a great deal of attention as a result of the long wars in Iraq and Afghanistan. The discourse about resilience, especially the promise of promoting it and mitigating risk for serious post-traumatic negative outcomes among service members and veterans, is hopeful and encouraging. Remarkably, most service members exposed to horrific war trauma are not incapacitated by the experience. Yet, resilience is elusive and fleeting for many veterans of war. In this paper, I address some of the complexities about resilience in the context of exposure to war stressors and I offer some assumptions and heuristics that stem from my involvement in the dialogue about resilience and from experiences helping prevent post-traumatic stress disorder among active-duty service members with military trauma. My goal is to use my observations and applied experiences as an instructive context to raise critical questions for the field about resilience in the face of traumatic life-events.",0 +https://doi.org/10.1176/appi.ajp.162.3.560,Posttraumatic Stress Disorder Comorbid With Major Depression: Factors Mediating the Association With Suicidal Behavior,"OBJECTIVE: The purpose of the study was to determine if patients with a history of major depressive episode and comorbid posttraumatic stress disorder (PTSD) have a higher risk for suicide attempt and differ in other measures of suicidal behavior, compared to patients with major depressive episode but no PTSD. In addition, to explore how PTSD comorbidity might increase risk for suicidal behavior in major depressive episode, the authors investigated the relationship between PTSD, cluster B personality disorder, childhood sexual or physical abuse, and aggression/impulsivity. METHOD: The subjects were 230 patients with a lifetime history of major depressive episode; 59 also had lifetime comorbid PTSD. The demographic and clinical characteristics of subjects with and without PTSD were compared. Multivariate analysis was used to examine the relationship between suicidal behavior and lifetime history of PTSD, with adjustment for clinical factors known to be associated with suicidal behavior. RESULTS: Patients with a lifetime history of PTSD were significantly more likely to have made a suicide attempt. The groups did not differ with respect to suicidal ideation or intent, number of attempts made, or maximum lethality of attempts. The PTSD group had higher objective depression, impulsivity, and hostility scores; had a higher rate of comorbid cluster B personality disorder; and were more likely to report a childhood history of abuse. However, cluster B personality disorder was the only independent variable related to lifetime suicide attempts in a multiple regression model. CONCLUSIONS: PTSD is frequently comorbid with major depressive episode, and their co-occurrence enhances the risk for suicidal behavior. A higher rate of comorbid cluster B personality disorder appears to be a salient factor contributing to greater risk for suicidal acts in patients with a history of major depressive episode who also have PTSD, compared to those with major depressive episode alone.",0 +https://doi.org/10.1146/annurev.clinpsy.1.102803.143925,Dissociative Disorders,"The dissociative disorders, including “psychogenic” or “functional” amnesia, fugue, dissociative identity disorder (DID, also known as multiple personality disorder), and depersonalization disorder, were once classified, along with conversion disorder, as forms of hysteria. The 1970s witnessed an “epidemic” of dissociative disorder, particularly DID, which may have reflected enthusiasm for the diagnosis more than its actual prevalence. Traditionally, the dissociative disorders have been attributed to trauma and other psychological stress, but the existing evidence favoring this hypothesis is plagued by poor methodology. Prospective studies of traumatized individuals reveal no convincing cases of amnesia not attributable to brain insult, injury, or disease. Treatment generally involves recovering and working through ostensibly repressed or dissociated memories of trauma; at present, there are few quantitative or controlled outcome studies. Experimental studies are few in number and have focused largely on state-dependent and implicit memory. Depersonalization disorder may be in line for the next “epidemic” of dissociation.",0 +https://doi.org/10.1002/pon.3710,Perceived cognitive impairment in Chinese patients with breast cancer and its relationship with post-traumatic stress disorder symptoms and fatigue,"Objective Clinical reports have shown that adjuvant chemotherapy has a negative impact on perceived cognitive impairment (PCI) of patients with breast cancer; however, evidence concerning the effects of psychological factors such as post-traumatic stress disorder (PTSD) symptoms on PCI is limited, especially in relation to Chinese patients with breast cancer. This research investigated the associations between psychological factors and PCI in Chinese women with breast cancer. Methods In total, 204 women with breast cancer were assessed for PCI, PTSD symptoms, fatigue, anxiety, and depression using self-report measures. Hierarchical linear regression was conducted to investigate the associations between the variables of interest and PCI. Results Two hundred and two women were included in the final analysis; two of those originally tested were excluded because of missing data. A univariate analysis showed that PCI was significantly related to education, PTSD symptoms (re-experience, avoidance, and hyperarousal), fatigue, depression, anxiety, and undergoing chemotherapy or radiotherapy. Hierarchical linear regression revealed that PTSD symptoms and fatigue (ΔR2 = 0.26, P < 0.001) independently accounted for PCI in Chinese women with breast cancer regardless of age, education level, chemotherapy and radiotherapy. Hyperarousal was the only contributing PTSD symptom to PCI (B = −1.24, SE = 0.33, β = −0.39, P < 0.001). Conclusions Besides chemotherapy, PTSD symptoms, especially hyperarousal, and fatigue are important risk factors for significant PCI and are therefore worthy of further investigation. Copyright © 2014 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1097/00004583-199107000-00001,Anxiety Disorders of Childhood and Adolescence: A Critical Review,"The 1980s were a decade of advancement in the knowledge of anxiety disorders in children and adolescents; this sets the stage for research achievements in the 1990s. This review examines the anxiety disorders of childhood and adolescence (separation anxiety disorder, overanxious disorder, and avoidant disorder), including prevalence rates, demographic profiles, comparisons of clinical presentations in different developmental age groups, and comorbidity patterns. Fears and simple phobias, obsessive-compulsive disorder, post-traumatic stress disorder, and panic disorder in children and adolescents are also evaluated. The controversy of whether panic attacks occur in prepubertal children is addressed. A brief review of behavioral and pharmacological treatment studies is included. Future directions for research are suggested.",0 +https://doi.org/10.1080/026990599121836,The influence of traumatic brain injury on acute stress disorder and post-traumatic stress disorder following motor vehicle accidents,"This study compared the acute stress disorder and post traumatic stress disorder PTSD symptom profiles in motor vehicle accident survivors who sustained a mild traumatic brain injury MTBI or no TBI. Consecutive adult patients who sustained a MTBI n=79 and no TBI n=92 were assessed for acute stress disorder within 1 month of their trauma and reassessed for PTSD MTBI: n=63; non TBI; n=72 6 months post trauma. Comparable rates of acute stress disorder and PTSD were reported in MTBI and non TBI patients. Intrusive memories and fear and helplessness in response to the trauma were reported less frequently by MTBI than non TBI patients at the acute phase. Six months post trauma fewer MTBI patients than non TBI reported fear and helplessness in response to the trauma. These findings suggest that, whereas impaired consciousness at the time of a trauma may reduce the frequency of traumatic memories in the initial month post trauma, MTBI does not result in a different profile of longer term PTSD.",0 +https://doi.org/10.1111/jcpp.12420,Trajectories of post-traumatic stress disorder symptoms among youth exposed to both natural and technological disasters,"Theorists and researchers have demonstrated multiple trajectories of symptoms following disasters (Ecology and Society, 13, 2008, 9), highlighting the importance of obtaining more knowledge about exposed youth who demonstrate resilience as well as those who suffer chronic difficulties. This paper examines trajectories of post-traumatic stress disorder (PTSD) symptoms following exposure to hurricanes and the Deepwater Horizon Oil Spill to increase understanding of resilience and chronic reactions to both natural and technological disasters.A multiwave longitudinal design was used to follow N = 4,619 youth who were evaluated for PTSD symptoms, hurricane exposure, and oil spill exposure/stress at four time points over a period of 4 years. Trajectories were identified with cluster analyses and multilevel modeling.Individual trajectories were statistically identified consistent with theory. The largest group exhibited stable-low symptoms (52%), a second group showed steep declines following initial symptoms (21%), a third group exhibited increasing symptoms (18%), and a fourth group showed stable-high symptoms (9%). Both hurricane exposure and oil spill stress predicted trajectories and overall levels of PTSD symptoms.Results identified an effect of oil spill stress and hurricane exposure on symptom levels and trajectories of exposed youth. Results provide prospective data to support theories of multiple symptom trajectories following disasters and reinforce the importance of research that utilizes a developmental perspective to consider the long-term effects of disasters in youth. Findings highlight the importance of identifying symptoms and predictors of resilience as well as factors that contribute to resilience.",0 +https://doi.org/10.1007/978-3-319-18866-9_4,When Multiple Disasters Strike: Louisiana Fishers in the Aftermath of Hurricanes and the British Petroleum Deepwater Horizon Oil Spill,"Relatively few studies in the research literature on technological disasters include commercial fishers whose livelihood, culture, and way of life are all deeply tied to bayous and natural waterways for generations. In this chapter, we address the impact of the 2010 British Petroleum (BP) Deepwater Horizon oil spill on commercial fishers sampled from two coastal parishes (counties) in south Louisiana. The individuals who provided the qualitative interviews upon which this chapter is based were participants in a larger study on long-term recovery from Hurricanes Katrina and Rita that devastated the US Gulf Coast in 2005. All respondents were exposed to the 2005 Hurricanes Katrina and Rita, the 2008 Hurricanes Gustav and Ike, and most recently the 2010 BP oil spill. We begin with a brief review of the literature on the psychosocial impact of disasters and examine the related concept of cumulative adversity. Content analysis of qualitative data from interviews conducted at least 12 months after the oil spill yielded three emergent themes which we present here: (1) Troubled Present, Uncertain Future; (2) Environmental Devastation; and (3)The “Pileup” Effect After a Decade of Disasters. Implications for individuals and families who have been directly impacted by the BP oil spill are considered.",0 +https://doi.org/10.1037/1082-989x.4.2.139,"Analyzing developmental trajectories: A semiparametric, group-based approach.","Carnegie Mellon UniversityA developmental trajectory describes the course of a behavior over age or time. Agroup-based method for identifying distinctive groups of individual trajectorieswithin the population and for profiling the characteristics of group members isdemonstrated. Such clusters might include groups of increasers. decreasers,and no changers. Suitably defined probability distributions are used to handle 3data types—count, binary, and psychometric scale data. Four capabilities are dem-onstrated: (a) the capability to identify rather than assume distinctive groups oftrajectories, (b) the capability to estimate the proportion of the population followingeach such trajectory group, (c) the capability to relate group membership probabil-ity to individual characteristics and circumstances, and (d) the capability to use thegroup membership probabilities for various other purposes such as creating profilesof group members.",0 +https://doi.org/10.1159/000337265,"Examining the Overlap between Bipolar Disorder, Nonaffective Psychosis, and Common Mental Disorders Using Latent Class Analysis","While dimensional models of psychopathology have delineated two broad factors underlying common mental disorders--internalizing and externalizing--it is unclear where bipolar disorder and nonaffective psychoses fit in relation to this structure and to each other. Given their low prevalence rates in the general population, these disorders generally tend to be excluded from such models. The current study used the person-centered approach of latent class analysis (LCA) to evaluate this question.LCA of diagnostic data from an epidemiological sample, the National Comorbidity Survey (n = 5,877), was undertaken. Diagnoses utilized in analyses included mania, nonaffective psychoses, specific phobia, social phobia, agoraphobia, panic disorder, major depression, dysthymia, generalized anxiety disorder, post-traumatic stress disorder, alcohol dependence, drug dependence, and conduct disorder.Results indicated that a 5-class LCA model optimally fit the data. Four of the classes mirrored those found in dimensional models--a class with few disorders, and 3 others with primarily fear, distress, and externalizing disorders. However, the fifth class--which is not evident in dimensional models--was unique in that it was the only one in which individuals demonstrated significant probabilities of both manic episodes and nonaffective psychoses in addition to markedly high levels of internalizing and externalizing disorders.This finding has important implications for nosological classification of psychopathology.",0 +https://doi.org/10.1002/jclp.21828,Depression and Anxiety Among Coronary Heart Disease Patients: Can Affect Dimensions and Theory Inform Diagnostic Disorder-Based Screening?,"Objectives To examine the association between low positive affect, somatic anxiety and general distress with affective disorders, anxious misery, and visceral fear among coronary heart disease patients. Participants Patients awaiting a coronary revascularization procedure (N = 158; 20.9% female; median age = 65, interquartile range 58–73) underwent structured interview with the Mini-International Neuropsychiatric Interview. Patients completed a brief version of the Mood and Anxiety Symptom Questionnaire (i.e., Anxiety Depression Distress Inventory-27) and a measure of Type D personality. Results Somatic anxiety scores yielded an area under the curve (AUC) = .784 and 75.0% sensitivity and 68.5% specificity in relation to panic disorder. Low positive affect yielded AUC = .811 and 70.4% sensitivity and 77.1% specificity for major depression. General distress yielded AUC = .795 and 75.0% sensitivity and 72.5% specificity for generalized anxiety disorder. No affective dimension was optimally associated with the anxious misery or visceral fear cluster. Trait negative affect was not a suitable screener for any disorder. Conclusions The Anxiety Depression Distress Inventory-27 dimensions of low positive affect and somatic anxiety provided optimal detection of depression and panic disorder, respectively, as hypothesized, supporting discriminant validity.",0 +https://doi.org/10.1007/s10880-011-9241-8,"Some Thoughts on Trauma, Pain, Posttraumatic Stress Disorder and Traumatic Brain Injury","Aversive learning and memory processes are common in pain and post-traumatic stress disorder (PTSD) and involve some of the same brain areas such as the amygdala, the insula and the anterior cingulate cortex. It is very likely that the deficient extinction of fear or pain responses is the core deficit in these disorders rather than enhanced acquisition. There is a great need for comparative studies for these disorders and their combination and specifically for the analysis of neuropsychological and neurobiological mechanisms that may partially be overlapping between these disorders. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1016/j.comppsych.2003.09.012,Peritraumatic dissociation as a predictor of post-traumatic stress disorder: a critical review,"In psychiatric literature, dissociative reactions at the time of a traumatic event (i.e., peritraumatic dissociation) are considered to be risk factors for the development of post-traumatic stress disorder (PTSD). In this article, we critically review research concerned with the link between peritraumatic dissociation and PTSD. Our main point is that studies in this area heavily rely on retrospective reports of dissociative reactions during the trauma. We argue that this methodology has important limitations since people in general and PTSD patients in particular find it difficult to give accurate descriptions of past emotional states. Restrictive factors that play a role in this context have to do with forgetting, attribution, and malingering.",0 +https://doi.org/10.1016/j.genhosppsych.2010.07.007,Risk factors for chronic post-traumatic stress disorder (PTSD) in SARS survivors,"Post-traumatic stress disorder (PTSD) is one of the most prevalent long-term psychiatric diagnoses among survivors of severe acute respiratory syndrome (SARS). The objective of this study was to identify the predictors of chronic PTSD in SARS survivors. PTSD at 30 months after the SARS outbreak was assessed by the Structured Clinical Interview for the DSM-IV . Survivors' demographic data, medical information and psychosocial variables were collected for risk factor analysis. Multivariate logistic regression analysis showed that female gender as well as the presence of chronic medical illnesses diagnosed before the onset of SARS and avascular necrosis were independent predictors of PTSD at 30 months post-SARS. Associated factors included higher-chance external locus of control, higher functional disability and higher average pain intensity. The study of PTSD at 30 months post-SARS showed that the predictive value of acute medical variables may fade out. Our findings do not support some prior hypotheses that the use of high dose corticosteroids is protective against the development of PTSD. On the contrary, the adversity both before and after the SARS outbreak may be more important in hindering recovery from PTSD. The risk factor analysis can not only improve the detection of hidden psychiatric complications but also provide insight for the possible model of care delivery for the SARS survivors. With the complex interaction of the biopsychosocial challenges of SARS, an integrated multidisciplinary clinic setting may be a superior approach in the long-term management of complicated PTSD cases.",0 +https://doi.org/10.1056/nejmsa035373,End-of-Life Care and the Effects of Bereavement on Family Caregivers of Persons with Dementia,"Although family caregiving has been intensively studied in the past decade, little attention has been paid to the impact of end-of-life care on caregivers who are family members of persons with dementia or to the caregivers' responses to the death of the patient.Using standardized assessment instruments and structured questions, we assessed the type and intensity of care provided by 217 family caregivers to persons with dementia during the year before the patient's death and assessed the caregivers' responses to the death.Half the caregivers reported spending at least 46 hours per week assisting patients with activities of daily living and instrumental activities of daily living. More than half the caregivers reported that they felt they were ""on duty"" 24 hours a day, that the patient had frequent pain, and that they had had to end or reduce employment owing to the demands of caregiving. Caregivers exhibited high levels of depressive symptoms while providing care to the relative with dementia, but they showed remarkable resilience after the death. Within three months of the death, caregivers had clinically significant declines in the level of depressive symptoms, and within one year the levels of symptoms were substantially lower than levels reported while they were acting as caregivers. Seventy-two percent of caregivers reported that the death was a relief to them, and more than 90 percent reported belief that it was a relief to the patient.End-of-life care for patients with dementia was extremely demanding of family caregivers. Intervention and support services were needed most before the patient's death. When death was preceded by a protracted and stressful period of caregiving, caregivers reported considerable relief at the death itself.",0 +https://doi.org/10.1001/jama.298.5.555,Association of Trauma and PTSD Symptoms With Openness to Reconciliation and Feelings of Revenge Among Former Ugandan and Congolese Child Soldiers,"Tens of thousands of the estimated 250,000 child soldiers worldwide are abused or have been abused during the last decade in Africa's Great Lakes Region. In the process of rebuilding the war-torn societies, it is important to understand how psychological trauma may shape the former child soldiers' ability to reconcile.To investigate the association of posttraumatic stress disorder (PTSD) symptoms and openness to reconciliation and feelings of revenge in former Ugandan and Congolese child soldiers.Cross-sectional field study of 169 former child soldiers (aged 11-18 years) in rehabilitation centers in Uganda and the Democratic Republic of the Congo, conducted in 2005.Potentially traumatic war-related experiences assessed via a sample-specific events scale; PTSD symptoms assessed using the Child Posttraumatic Stress Disorder Reaction Index (CPTSD-RI), with a score of 35 or higher indicating clinically important PTSD symptoms; and openness to reconciliation and feelings of revenge assessed via structured questionnaires.Children participating in this study were a mean of 15.3 years old. These former child soldiers reported that they had been (violently) recruited by armed forces at a young age (mean [SD], 12.1 [2] years), had served a mean of 38 months (SD, 24 months), and had been demobilized a mean of 2.3 months before data collection (SD, 2.4 months). The children were exposed to a high level of potentially traumatic events (mean [SD], 11.1 [2.99]). The most commonly reported traumatic experiences were having witnessed shooting (92.9%), having witnessed someone wounded (89.9%), and having been seriously beaten (84%). A total of 54.4% reported having killed someone, and 27.8% reported that they were forced to engage in sexual contact. Of the 169 interviewed, 59 (34.9%; 95% confidence interval, 34.4%-35.4%) had a PTSD symptom score higher than 35. Children who showed more PTSD symptoms had significantly less openness to reconciliation (rho= -0.34, P < .001) and more feelings of revenge (rho= 0.29, P < .001).PTSD symptoms are associated with less openness to reconciliation and more feelings of revenge among former Ugandan and Congolese child soldiers. The effect of psychological trauma should be considered when these children are rehabilitated and reintegrated into civilian society.",0 +https://doi.org/10.1037/a0023976,"The structure of PTSD among two cohorts of returning soldiers: Before, during, and following deployment to Iraq.","Evidence suggests either a four-factor emotional numbing or dysphoria model likely reflects the underlying structure of posttraumatic stress disorder (PTSD). Questions remain as to which of these structures best represents PTSD, how the structure changes with time, the applicability of models to returning veterans, and the validity of the symptom clusters. The present study addresses these questions among two longitudinal samples of National Guard soldiers assessed prior to, during, and following a combat deployment to Iraq. Findings support a four-factor intercorrelated dysphoria model of PTSD that remains stable across samples and time points. Differential associations were observed among PTSD symptom clusters over time and between symptom clusters and both depression and combat exposure, supporting important distinctions between symptom clusters.",0 +https://doi.org/10.1053/apnu.2002.34391,Risk factors for pediatric posttraumatic stress disorder after traumatic injury,"The purpose of this study was to identify risk factors that may be predictive of posttraumatic stress disorder (PTSD) in children after a traumatic injury. The study was a retrospective review of data collected from 337 pediatric trauma patients treated in a multidisicplinary outpatient clinic. Results from Chi-square and t-test analyses indicated that gender, ethnicity, age, and injury severity were not risk factors for PTSD. However, mechanism of injury, specifically a gun shot wound (p =.001), was associated with development of PTSD, as was body area of injury, specifically the abdomen (p =.001). Psychiatric screening of patients with gun shot wounds and wounds to the abdomen may help with the early identification and treatment of PTSD.",0 +,Health-related quality of life (HRQoL) in veterans with chronic posttraumatic stress disorder (PTSD) and tobacco dependence,"Posttraumatic Stress Disorder (PTSD) is a psychiatric condition in which the experience of a traumatic event results in symptoms including intrusive memories and/or nightmares related to the trauma, avoidance of stimuli associated with the trauma, emotional numbing, and increased vigilance and irritability from pre- to post-trauma. Health-Related Quality of Life (HRQoL) is a construct designed to measure the effect of disease on physical, social/role, psychological/emotional, and cognitive functioning. Tobacco use is associated with both PTSD and HRQoL. PTSD is associated with higher rates of smoking than the national average (45% versus 23%). Additionally, smokers have well-documented negative health outcomes, and smoking is a major predictor of poorer HRQoL in the general population across both physical and mental health domains. PTSD is not generally associated in the public opinion with negative health consequences in the way that cigarette smoking is. However, PTSD has been causally linked with negative health outcomes, namely cardiovascular disease and metabolic syndrome. There are a lack of studies that examine the relationship between tobacco dependence and HRQoL, specifically in a PTSD population. Studies examining the effect of quitting smoking on HRQoL in the chronic tobacco dependent, PTSD population are also lacking. The proposed study aimed to examine the effect of post-treatment smoking status on post-treatment HRQoL scores by testing whether the interaction between quitting smoking and changes in PTSD symptom severity and/or depression severity from pre- to post-treatment predicted improvement in physical HRQoL from pre- to post-treatment. Hypotheses were tested using hierarchical linear modeling. Results indicated that reductions in PTSD symptom severity, particularly the numbing and hyperarousal symptom clusters, from pre- to post-treatment predicted improvement in the SF-36 Vitality and General Health subscales from pre- to post-treatment. We also found that PTSD and depressive symptoms differentially predicted the SF-36 subscales, and achievement of prolonged abstinence was associated with higher physical HRQoL scores. Our findings provide further evidence of a strong relationship between PTSD, tobacco dependence, and poor physical health status and HRQoL. Clinically, it may be important to examine HRQoL as a PTSD and depression treatment outcome. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0 +https://doi.org/10.1016/0010-440x(89)90066-7,Traumatic Stress Disorder: Diagnostic and clinical issues in former prisoners of war,Examined are a variety of clinical issues in the diagnosis and treatment of Posttraumatic Stress Disorder (PTSD) of former prisoners of war (POWs). Difficulties and complexities in understanding and diagnosing PTSD in former POWs presenting symptomatic complaints associated with this disorder are explored. Data collected on former POWs complaining of PTSD and diagnosed by DSM-III-R criteria revealed Minnesota Multiphasic Personality Inventory (MMPI) and Millon Clinical Multiaxial Inventory (MCMI) clinical profiles appropriate for clinical application. Comparative data between German-held and Japanese-held POWs experiencing PTSD and adjustment-related stressors are discussed. Import on clinical strategies with diagnosed patients suggests both behavioral approaches to treatment and future directions in research.,0 +https://doi.org/10.1016/s0165-0327(11)70004-0,Aripiprazole: A clinical review of its use for the treatment of anxiety disorders and anxiety as a comorbidity in mental illness,"Although anxiety disorders are common, optimal treatment is elusive. More than half of anxiety patients treated with an adequate course of antidepressants fail to fully improve: treatment resistance, residual symptoms, and recurrence/relapse remain a challenge. Recently, atypical antipsychotics have been considered for treatment-resistant anxiety disorders. This review will explore the available data for the role of aripiprazole in the treatment of anxiety.PubMed and conference abstracts were searched for randomized, double-blind studies that investigated the efficacy of aripiprazole in anxiety; its efficacy in bipolar disorder and depression was also explored for comparison.A number of studies have shown atypical antipsychotics to be effective in anxiety, and currently available data suggest that aripiprazole augmentation in patients with anxiety disorders is likely as effective as other atypical antipsychotic drugs. Although there have been no randomized, controlled trials, aripiprazole has been found to be effective in treating anxiety disorders in two open-label trials. This combined with the larger data base demonstrating its utility in bipolar disorder and depression, its safety profile and its unique mechanism of action, make aripiprazole for anxiety an intriguing avenue of exploration.Data from large randomized, controlled trials on the use of atypical antipsychotics for anxiety in general, and aripiprazole in particular, are currently lacking.The results of open-label trials of aripiprazole in anxiety provide enough support to warrant its further study. This, combined with a larger data base demonstrating its utility in bipolar disorder and depression, its safety profile and its unique mechanism of action, make aripiprazole for anxiety an intriguing avenue of exploration.",0 +https://doi.org/10.1111/j.1545-5300.2007.00205.x,Traumatic Loss and Major Disasters: Strengthening Family and Community Resilience,"This article presents the core principles and value of a family and community resilience-oriented approach to recovery from traumatic loss when catastrophic events occur. In contrast to individually based, symptom-focused approaches to trauma recovery, this multisystemic practice approach contextualizes the distress in the traumatic experience and taps strengths and resources in relational networks to foster healing and posttraumatic growth. The intertwining of trauma and traumatic losses is discussed. Key family and social processes in risk and resilience in traumatic loss situations are outlined. Case illustrations, model programs, and intervention guidelines are described in situations of community violence and major disasters to suggest ways to foster family and community resilience.",0 +https://doi.org/10.1016/j.chiabu.2012.03.004,Childhood trauma exposure in Iraq and Afghanistan war era veterans: Implications for posttraumatic stress disorder symptoms and adult functional social support,"This study examined the relationship among childhood trauma, posttraumatic stress disorder (PTSD) symptoms, and adult social support in a large sample of veterans who served in the military after 09/11/2001, with a specific focus on the potential role of the PTSD avoidance and numbing cluster as intervening in the association between childhood abuse and adult functional social support.Participants were 1,301 veterans and active duty soldiers who have served in the military since 09/11/2001; a subsample of these participants (n=482) completed an inventory of current functional social support. Analyses included linear regression and nonparametric bootstrapping procedures.After controlling for combat exposure, exposure to childhood trauma was associated with PTSD symptoms in adulthood. Further, PTSD symptoms, and particularly PTSD avoidance/numbing cluster symptoms, intervened in the relationship between childhood trauma and adult functional social support.Findings support the association of childhood trauma (both abuse related and other, non-abuse related trauma) with PTSD symptoms in military personnel and veterans, even after accounting for combat exposure. Additionally, the avoidance and numbing symptom cluster of childhood trauma-based PTSD may be particularly salient in compromising one's subsequent ability to garner functional social support in adulthood.",0 +https://doi.org/10.1097/ajp.0000000000000052,MPI Profile Classifications and Associated Clinical Findings Among Litigating Motor Vehicle Collision Patients,"The purpose of this study was to examine differences in precollision, pericollision, and postcollision clinical variables across litigating motor vehicle collision (MVC) patients who were classified as Dysfunctional (DYS), Interpersonally Distressed (ID), or Adaptive Copers (ACs) based on Multidimensional Pain Inventory (MPI) profile classifications.A sample of 240 MVC patients who sustained serious physical injuries and experienced MVC-related chronic pain completed the MPI and provided responses to a semistructured psycholegal interview designed to elicit injury-related and pain-related symptoms and treatments, determine the presence and impact of precollision experiences, and render psychiatric diagnoses and ratings of psychological disability.A significant multivariate effect of MPI profile group on postcollision variables was revealed, with the DYS and ID groups reporting more pain sites than the AC group and the DYS group receiving more recommendations for treatment than the AC group. Larger proportions of the DYS and ID groups were diagnosed as experiencing major depressive disorder than the AC group. A rating of total psychological disability was applied most often to members of the ID group, with partial psychological disability applied most often to members of the DYS group, and no psychological disability applied most often to members of the AC group.This study extends the MPI literature by establishing the usefulness of the measure in determining those reports of MVC-related pain and emotional distress that are most likely to be associated with postcollision psychological disability. The current study supports the usefulness of MPI profile classifications in identifying MVC patients who are likely to require and benefit from intensive psychological and other rehabilitative interventions.",0 +https://doi.org/10.1111/nyas.12280,Nonlinear developmental trajectory of fear learning and memory,"The transition into and out of adolescence is a unique developmental period during which neuronal circuits are particularly susceptible to modification by experience. Adolescence is associated with an increased incidence of anxiety disorders in humans, and an estimated 75% of adults with fear-related disorders met diagnostic criteria as children and adolescents. Conserved neural circuitry of rodents and humans has facilitated neurodevelopmental studies of behavioral and molecular processes associated with fear learning and memory that lie at the heart of many anxiety disorders. Here, we review the nonlinear developmental aspects of fear learning and memory during a transition period into and out of adolescence and provide a discussion of the molecular mechanisms that may underlie these alterations in behavior. We provide a model that may help to inform novel treatment strategies for children and adolescents with fear-related disorders.",0 +https://doi.org/10.1007/s10862-015-9511-0,Main and Interactive Effects of Mental Contamination and Tolerance of Negative Emotions in Relation to Posttraumatic Stress Symptoms Following Sexual Trauma,"Mental contamination, an internal sense of dirtiness that originates in the absence of physical contact with a stimulus, has been implicated in the exacerbation of posttraumatic stress (PTS) symptoms following sexual trauma. In addition, evidence suggests that associations between PTS-related risk factors and PTS symptoms may depend on the degree to which one can tolerate experiencing negative emotions. To better understand the association between mental contamination and PTS symptoms, we examined main and interactive effects of mental contamination and tolerance of negative emotions in relation to PTS symptoms, including specific symptom clusters, in a community sample of women who experienced sexual trauma (N = 101). Tolerance of negative emotions moderated the association between mental contamination and PTS symptoms (total symptom severity, intrusion cluster, and cognitive/mood alterations cluster). These results indicate that difficulties tolerating negative emotions may be a necessary condition for mental contamination to relate to PTS symptoms following sexual trauma.",0 +https://doi.org/10.1080/10673220902996775,Differential Patterns of HPA Activity and Reactivity in Adult Posttraumatic Stress Disorder and Major Depressive Disorder,"Despite a number of overlapping symptoms, individuals with posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) often display hypothalamic-pituitary-adrenal (HPA) profiles that appear quite different from one another. This review describes the patterns of HPA-axis activity and reactivity in healthy individuals compared to individuals with these two disorders. Measures of HPA-axis activity and reactivity include cortisol levels at rest, in response to the dexamethasone suppression test (DST), and in response to psychological stress. The research reviewed presents the possibility of diagnostic specificity with regard to HPA function. In particular, the differential response pattern to the DST suggests that, while it cannot be considered a pure diagnostic tool, it should be one measure taken into consideration during diagnosis.",0 +https://doi.org/10.1080/10615806.2013.832219,Life outcomes influenced by war-related experiences during the Gulf crisis,"This study examined the life outcomes of children exposed to the Gulf crisis in 1990-1991. We expected war-trauma exposure and psychological distress symptoms to predict poorer educational and occupational outcomes. Participants were 151 Kuwaiti citizens who were assessed during childhood (in 1993; M age = 10.6 years), and who were reassessed 10 years later in young adulthood (in 2003; M age = 21.2 years). Participants completed measures of intelligence, war-trauma exposure, posttraumatic stress symptoms, anxiety symptoms, depressive symptoms, intervening life events, and life outcomes. Results indicated that war-trauma exposure negatively impacted children's educational and occupational outcomes as young adults. Boys with higher levels of war-trauma exposure were less likely to attend University. Posttraumatic stress and anxiety symptoms also predicted poorer educational and occupational outcomes. However, this relationship was not significant when we accounted for children's intelligence. Depressive symptoms were not predictive of children's educational or occupational outcomes. Results suggest that war-trauma exposure may have life-altering effects on children. Tailored, early interventions are needed for children exposed to war traumas.",0 +https://doi.org/10.1007/s11524-010-9447-3,"Psychological Distress among Adolescents in Chengdu, Sichuan at 1 Month after the 2008 Sichuan Earthquake","A devastating earthquake occurred on May 12, 2008 in Sichuan, China. This study investigated the prevalence and factors in association with psychological problems among secondary school students living in Chengdu (90 km away from the disaster epicenter) in June 2008. In a cross-sectional survey, 3,324 secondary students self-administered a structured questionnaire in classroom setting. Validated scales were used in this study. Among all respondents, 22.3% reported post-traumatic stress disorder (PTSD); 22.6% were probable depression cases; 10.6% reported suicidal ideation; and 14.1% would like to receive psychological counseling. No gender differences were found. While social/emotional support from teachers or peers (OR from 0.40 to 0.78) and exposure to positive news reports (OR from 0.59 to 0.62) were found protective, prior experience of severe mental distress (OR from 1.60 to 2.68) and corporal punishment (OR from 1.31 to 1.58), worry about future aftershocks (OR from 1.64 to 3.11), absence from school when it was not closed (OR from 1.38 to 1.48), exposures to scary or sorrowful disaster media coverage (OR from 1.39 to 2.07), post-disaster visits to affected sites (OR from 1.51 to 1.59), separation from parents (OR = 1.61), etc., were risk factors predictive of some of the aforementioned psychological problems. Negative mental health impacts were prevalent among the respondents. Teachers, parents, and the mass media are all important in maintaining good mental health among adolescents that are indirectly affected by the severe earthquake. The results have important implications for earthquake preparedness and relief work in the future.",0 +https://doi.org/10.1016/j.metabol.2012.08.020,"Lifetime experiences, the brain and personalized medicine: An integrative perspective","The aim of personalized medicine is to base medical prevention and therapy on the unique health and disease susceptibility profile of each individual. Starting from this idea, we briefly discuss the meaning of the word 'personalized' before analyzing the practical content of personalized healthcare. From a medical perspective, knowledge of a person encompasses both biological and biographical perspectives. The latter includes significant events and experiences throughout the person's lifespan, from conception to the present, in which epigenetic influences play an important role. In practice, we believe personalized medicine should emphasize the development and maintenance of a healthy nervous system. The neurobiological processes involved here depend heavily on the psychosocial environment, in particular the presence of responsible, caring adults and integration in a reasonably fair society. A healthy brain subsequently promotes good health throughout life, both through direct, favorable influences on the body's intrinsic biological pathways, and indirectly by enabling the person to engage in supportive relationships, make wise decisions and take good care of him/herself. From a public health perspective, we conclude that hi-tech personalized medicine based on detailed bio-molecular mapping, monitoring and tailored drug interventions holds promise only as part of a wider, socio-culturally informed approach to the person.",0 +https://doi.org/10.1176/ajp.151.4.554,PTSD among Israeli former prisoners of war and soldiers with combat stress reaction: a longitudinal study,"The aim of this study was to assess the long-term impact of war captivity and combat stress reaction on rates of posttraumatic stress disorder (PTSD) in Israeli veterans of the 1973 Yom Kippur war.One hundred sixty-four former prisoners of war (POWs), 112 veterans who had had combat stress reaction, and 184 combat veteran comparison subjects filled out the PTSD Inventory, a self-report scale based on the DSM-III-R criteria for PTSD. The inventory diagnoses past and present PTSD, assesses its intensity, and provides a symptom profile.Thirty-seven percent of the veterans who had had combat stress reaction, 23% of the former POWs, and 14% of the comparison subjects had had diagnosable PTSD at some time in the past. The current rates were 13%, 13%, and 3%, respectively. The results showed different recovery rates over time: almost two-thirds of the veterans with combat stress reaction who had had PTSD in the past recovered, while less than one-half of the POW group showed this improvement.These findings indicate that small but significant proportions of the POWs and veterans with combat stress reaction were still suffering from PTSD almost two decades after the war. The different recovery rates in the two groups may reflect the differences in duration and severity of stressors, the impact of immediate intervention on long-term adjustment, or both.",0 +https://doi.org/10.1037/a0023868,Late-onset posttraumatic stress disorder following a disaster: A longitudinal study.,"In disaster survivors, the occurrence of mental health problems beyond the immediate aftermath of the disaster has repeatedly been reported. The aim of the present study was to evaluate the course of symptoms and mental health services (MHS) utilization in late-onset posttraumatic stress disorder (PTSD) four years following a disaster and to examine whether late-onset PTSD can be explained within a longitudinal framework of PTSD. Residents affected by a fireworks disaster (N 1083) participated in surveys 2–3 weeks (T1), 18 months (T2), and almost 4 years (T3) following the disaster. PTSD was assessed at T2 and T3. Participants endorsing disaster-related late-onset PTSD (PTSD at T3 only) were compared to participants endorsing persistent PTSD (at both T2 and T3), recovered PTSD (at T2 only), and no PTSD using latent growth modeling and multinomial logistic regression. Participants endorsing late-onset PTSD comprised 4% of the total sample. They reported high initial intrusion and avoidance and experienced progression of avoidance/numbing and hyperarousal symptoms. They were more likely than all other participants to use MHS at T3. Late-onset PTSD was associated with high education level, severe disaster exposure, number of reported stressful life events, and perceived lack of social support. These results suggest that individuals with late-onset PTSD are likely to endorse prodromal distress, but experience clinically relevant symptom progression leading to increased MHS utilization. Stressful life events and perceived lack of social support may contribute to PTSD symptom progression. Foreseeable stressors in the aftermath of a disaster may be a target for secondary prevention of late-onset PTSD.",0 +https://doi.org/10.1159/000345358,The Impact of Adverse Life Events on Clinical Features and Interaction with Gene Variants in Mood Disorder Patients,"<b><i>Background:</i></b> Adverse life events are precipitating and maintenance factors for mood and anxiety disorders. However, the impact of such events on clinical features and treatment response is still unclear. <b><i>Sampling and Methods:</i></b> The aim of this study was to investigate whether specific adverse events (early parental loss and physical abuse) influence clinical features in a sample of 1,336 mood disorder patients, and whether genetic parameters interact with adverse events to influence treatment outcomes in a subsample of 252 subjects. Participants were collected in the context of a European multicenter study and treated with antidepressants at adequate doses for at least 4 weeks. We focused on two genes (BDNF and CREB1) due to prior evidence of association with treatment outcomes in the same sample. <b><i>Results:</i></b> Patients with a history of physical abuse had higher suicidal risk (including history of attempts), comorbid panic disorder, posttraumatic stress disorder and alcohol dependence compared to non-abused patients. Experience of early parental loss was a less detrimental type of life stressor. Treatment response was not affected by adverse events. No gene-environment interaction was found with genetic variations, using a corrected significance level. <b><i>Conclusions:</i></b> A limitation of the present study is that the subsample is too small for detecting gene-environment interactions. The clinical message of our findings is that mood disorder patients with a history of physical abuse showed a worse clinical profile, characterized by higher comorbid Axis I psychopathology and increased suicidal behavior.",0 +https://doi.org/10.1016/j.jpsychires.2009.01.004,"Association of trauma exposure with psychiatric morbidity in military veterans who have served since September 11, 2001","This study examined the association of lifetime traumatic stress with psychiatric diagnostic status and symptom severity in veterans serving in the US military after 9/11/01.Data from 356 US military veterans were analyzed. Measures included a standardized clinical interview measure of psychiatric disorders, and paper-and-pencil assessments of trauma history, demographic variables, intellectual functioning, posttraumatic stress disorder (PTSD) symptoms, depression, alcohol misuse, and global distress.Ninety-four percent of respondents reported at least one traumatic stressor meeting DSM-IV criterion A for PTSD (i.e., life threatening event to which the person responded with fear, helplessness or horror), with a mean of four criterion A traumas. Seventy-one percent reported serving in a war-zone, with 50% reporting occurrence of an event meeting criterion A. The rate of current psychiatric disorder in this sample was: 30% PTSD, 20% major depressive disorder, 6% substance abuse or dependence and 10% for the presence of other Axis I psychiatric disorders. After accounting for demographic covariates and combat exposure, childhood physical assault and accident/disasters were most consistently associated with increased likelihood of PTSD. However, PTSD with no comorbid major depressive disorder or substance use disorder was predicted only by combat exposure and adult physical assault. Medical/unexpected-death trauma and adult physical assault were most consistently associated with more severe symptomatology.Particular categories of trauma were differentially associated with the risk of psychiatric diagnosis and current symptom severity. These findings underscore the importance of conducting thorough assessment of multiple trauma exposures when evaluating recently post-deployed veterans.",0 +https://doi.org/10.1007/s00406-005-0559-9,Regional cerebral blood flow during auditory recall in 47 subjects exposed to assaultive and non–ssaultive trauma and developing or not posttraumatic stress disorder,"Objective: Psychological trauma leads to posttraumatic stress disorder (PTSD) in susceptible subjects. The aim of this study was to investigate the differences in regional cerebral blood flow (rCBF) between two groups of subjects exposed to different types of traumatic stressor either developing or not developing PTSD. Method: Twenty subjects developing (S) and 27 not developing (NS) PTSD after being exposed to either earlier person-under-the- train accident (NA) or being assaulted in the underground environment (A) were included in the study. 99mTc-HMPAO SPECT was performed and the uptake in 29 regions of the brain (VOIs), bilaterally, was assessed. rCBF distribution was compared, using analysis of variance (ANOVA), between groups (S/NS) and type (A/NA) during a situation involving an auditory evoked re-experiencing of the traumatic event. Discriminant analysis was applied to test the concordance between clinical diagnosis and SPECT findings. Results: In the general analyses significant differences were found between groups and types and there was a significant hemisphere null type interaction. S showed higher CBF than NS and so did A as compared to NA, particularly in the right hemisphere. Discriminant analysis correctly classified 66% of cases (p < 0001) in testing S/NS and 72% (p < 0001) in testing NA/A. Conclusions: Under recall of their traumatic experience we found higher relative CBF distribution values in S as compared to NS. CBF was higher in the right hemisphere and particularly in assaulted subjects. These findings underscore the role upon trauma recall of both the right hemisphere and the nature of the stressing event.",0 +https://doi.org/10.1037/a0027587,Frontal brain asymmetry in depression with comorbid anxiety: A neuropsychological investigation.,"The approach-withdrawal model posits that depression and anxiety are associated with a relative right asymmetry in frontal brain activity. Most studies have tested this model using measures of cortical brain activity such as electroencephalography. However, neuropsychological tasks that differentially use left versus right frontal cortical regions can also be used to test hypotheses from the model. In two independent samples (Study 1 and 2), the present study investigated the performance of currently depressed individuals with or without a comorbid anxiety disorder and healthy controls on neuropsychological tasks tapping primarily left (verbal fluency) or right (design fluency) frontal brain regions. Across both samples, results indicated that comorbid participants performed more poorly than depressed only and control participants on design fluency, while all groups showed equivalent performance on verbal fluency. Moreover, comorbid participants showed ""asymmetrical"" performance on these two tasks (i.e., poorer design [right frontal] relative to verbal [left frontal] fluency), whereas depressed only and control participants showed approximately symmetrical profiles of performance. Results from these two samples suggest an abnormal frontal asymmetry in neurocognitive performance driven primarily by right frontal dysfunction among anxious-depressed individuals and highlight the importance of considering comorbid anxiety when examining frontal brain functioning in depression.",0 +https://doi.org/10.1007/s10508-013-0196-8,Predictors of Posttraumatic Stress in Parents of Children Diagnosed with a Disorder of Sex Development,"The aims of the current study were twofold: (1) to assess the prevalence/severity of posttraumatic stress symptoms (PTSS) as well as cognitive and emotional responses in parents whose children were diagnosed with a disorder of sex development (DSD); and (2) to assess factors which contributed to PTSS. We hypothesized that parents would show elevated levels of PTSS and that negative cognitive and/or emotional responses would be predictive. Participants were parents of children diagnosed with a DSD. Thirty-six mothers and 11 fathers completed a measure of posttraumatic stress and reported difficulties in the domains of cognition (e.g.; confusion) and emotion (e.g.; grief). Using multiple regression, we determined factors contributing to parental PTSS. Reported PTSS was high: 31 % of mothers and 18 % of fathers met the threshold for caseness for Posttraumatic Stress Disorder. Regression included: child sex, parent sex, child age at diagnosis, years since diagnosis, genital ambiguity, father occupation, cognitive confusion, and emotional distress. Only cognitive confusion contributed significantly to variance in PTSS. Parents of children with DSD may experience the diagnosis as traumatic, evidenced by high rates of PTSS in the current report. Assessment of reactions to their children's diagnoses revealed that cognitive confusion, and not emotional distress, predicted PTSS. In this case, direct cognitive interventions may be applicable. Though psychological support is widely recommended, no detailed intervention has been offered. Our findings suggest that we may directly apply models successful in other areas of pediatrics, such as pediatric oncology. Future studies may assess the usefulness of such an intervention. © 2013 Springer Science+Business Media New York.",0 +https://doi.org/10.1016/j.burns.2009.06.167,Memories of pain after burn injury—The patients’ experience,"Pain after burns is a major clinical problem and researchers continue to report that burn pain remains undertreated. Adequate pain management could contribute to the prevention of posttraumatic stress disorder and can give a growing sense of patient's self-confidence and strength. Freedom from pain might be unrealistic, but the objective should be to reduce pain as much as possible. The purpose of this study was to describe burn patient's experiences and memories of pain during burn care and to acquire a deeper understanding of how patients cope with the experience. The study method was qualitative and interviews were conducted with 12 adult burn patients (eight men and four women) 6 to 12 months postburn (mean = 7 months). The mean burn size for the group was 10.6% mean of TBSA and the mean stay in hospital was 16 days. The interviews were analyzed using Kvale's method for structuring analysis. The patient's experiences and memories of pain during the trajectory of care were clearly described by the informants during the interviews. Four themes were identified for pain: becoming aware of pain, allowing oneself to feel pain, different pain experiences, and fragile body surface. Four themes were identified for coping: pragmatic coping, allowing someone to care for you, carrying the pain, and perspectives on the trauma. Both good and bad memories were recorded during the care trajectory, and it is evident that the patient has to carry the pain experience by themselves to a large extent. © 2010 by the American Burn Association.",0 +https://doi.org/10.1080/136515001300225141,Post-traumatic stress disorder: A review for the general psychiatrist,"Post-traumatic stress disorder affects about one in every hundred of the population at any particular time. Aetiological factors include genetics, personality, a background of psychiatric problems, the personal meaning of the traumatic event, issues of proximity or intensity, childhood abuse, and the initial emotional response to stress. Many precipitants are known, ranging from combat through rape or torture to difficult parturition. Core symptoms are reflective of the traumatic precipitant. Prolonged symptoms are associated with prior psychiatric or physical problems, poverty, repeated assault, alcohol or drug abuse, and cultural factors. Co-morbidity is high, especially for depression, alcohol and drug misuse. Reduced hippocampal volume, corticosteroid abnormalities, and adrenergic overactivity have been described. The use of official criteria and specific measuring instruments help in differential diagnosis. Management needs to be tailored to the needs of the individual and the stage of the disorder, and includes psychotherapy, antidepressants, and the newer eye-movement desensitization and reprocessing approach. ( Int J Psych Clin Pract 2001; 5:11-18).",0 +https://doi.org/10.1007/s12207-014-9192-0,Assessing the Latent Factor Association Between the Dysphoria Model of PTSD and Positive and Negative Affect in Trauma Victims from India,"The recent release of the DSM-5 comes with the division of posttraumatic stress disorder (PTSD) symptoms across four symptom clusters (American Psychiatric Association, 2013). This division is based on the support garnered by two four-factor models; Emotional Numbing (King et al., 1998) and Dysphoria (Simms et al., 2002) and a five-factor model; Dysphoric Arousal (Elhai et al., 2011). Much debate centered on the validity of the Dysphoria factor as a non-specific factor of PTSD within the Dysphoria model. In line with this, we assessed relations between the four factors of the Dysphoria model (Simms et al., 2002) and positive (PA) and negative affect (NA) in natural disaster victims (N = 200) from Leh, India, using the PTSD checklist (PCL-S) and Positive and Negative Affect Schedule (PANAS short form). Confirmatory factor analysis was implemented to assess the best-fitting model for both the PCL (PTSD) and the PANAS (affect). Two optimal models (the Dysphoria model and a two-factor model for affect) were subsequently used to assess latent variable associations across constructs. It was hypothesized that differential associations between latent factors would be evident with the Dysphoria factor being highly correlated with negative affect compared to alternative PTSD factors. Significant correlations were found between factors of the Dysphoria model and NA (0.52-0.65, p < 0.001). Comparing the association of pairs of PTSD factors with NA and PA, Wald's tests revealed that no single PTSD factor was more related to NA than the other. Avoidance and Hyperarousal factors were correlated with PA. Results are discussed in line with literature questioning Dysphoria factor's unique association with general distress. © 2014 Springer Science+Business Media New York.",0 +https://doi.org/10.1080/02699931.2013.775109,Attentional interference by threat and post-traumatic stress disorder: the role of thought control strategies.,"Attentional interference by threat is associated with PTSD, but the mechanisms of this relationship remain unclear. Attentional interference might be related to increased use of maladaptive thought control strategies, such as suppressing unwanted thoughts (thought suppression) or replacing threatening thoughts with everyday concerns (worry), which increase PTSD risk. Conversely, attentional interference might be associated with reduced use of adaptive strategies, such as talking about threatening thoughts (social control), which decrease PTSD risk. This study tested if thought control strategies mediate the relationship between attentional interference and PTSD. Sixty-one male Vietnam-era veterans completed measures of PTSD symptoms and thought control strategies. Participants also completed a Visual Search Task measuring attentional interference, which required participants to identify a target letter string among a group of threat or neutral words. Attentional interference by threat was related to PTSD symptoms, and mediation analyses revealed significant indirect effects of attentional interference through thought suppression and worry. Attentional interference was related to re-experiencing and avoidance, but not hyperarousal, symptom clusters. Thought suppression was a unique mediator for re-experiencing, whereas thought suppression and worry both mediated the relationship with avoidance. These results offer evidence for maladaptive thought control strategies as a mechanism linking attentional biases for threat to PTSD.",0 +,Antisocial behavior and the combat veteran. A review (with special reference to the Vietnam conflict).,"The popular image of the Vietnam veteran, reinforced by such movies as Rambo and sensational press reporting, is that of a poorly controlled, impulsively violent character with a criminal record and a history of heroin addiction and alcoholism. Such a profile has also been regularly described in clinical studies of veterans receiving psychiatric attention and is congruent with the prevailing attitude of suspicion and mistrust towards the returning warrior reported in the anthropological, psychoanalytic, and historical literatures. Defense lawyers have increasingly advanced allegedly war-caused psychiatric disturbances as a defense for their veteran-clients' criminal behaviors. However, there is now considerable evidence from controlled studies that Vietnam veterans' levels of drug addiction, alcoholism, violence, criminal convictions, and suicide are no different from those manifested by young men from similar socioeconomic backgrounds who have not seen military service. This paper reviews these studies and cautions that excessive attention paid by the medical and legal professions to the high profile deviant behavior of a small and atypical group of the veteran population will defect attention from the unobtrusive, but disabling, readjustment difficulties faced by many more of their peers.",0 +https://doi.org/10.1002/jts.21931,Investigating the Construct of Trauma-Related Acquired Callousness Among Delinquent Youth: Differences in Emotion Processing,"This study tested theories regarding differences in emotion processing among youth characterized by primary versus acquired callous-unemotional (CU) traits in a sample of 417 detained adolescents (306 boys, 111 girls). Mixture modeling identified 2 groups of youth high in CU, but with different levels of posttraumatic stress symptoms consistent with theoretical conceptualizations of acquired CU as being linked to trauma. Differences between the 2 groups of youth were investigated regarding 3 dimensions of emotion processing: emotion regulation, numbing, and recognition. Compared to youth classified in the primary group, youth classified as acquired CU demonstrated greater difficulty with lack of clarity (OR = 0.53), and nonacceptance of emotions, (OR = 0.57), general numbing of emotions (OR = 0.87), and recognition of disgust (OR = 0.18). Differences in emotion processing reported by youth in the 2 groups are consistent with theories regarding acquired callousness as related to emotional detachment in the aftermath of posttraumatic distress. The results of the current study have implications for the classification of primary and acquired CU, as well as the clinical treatment of youth with these characteristics.",0 +https://doi.org/10.1159/000367600,Symptom Profiles in Depersonalization and Anxiety Disorders: An Analysis of the Beck Anxiety Inventory,"Background: Depersonalization disorder (DPD) entails distressing alterations in self-experiencing. However, it has long been recognized that depersonalisation symptoms occur in other disorders, particularly anxiety and panic. One strand of research proposes that depersonalization phenomenology arises through altered autonomic arousal in response to stress. Sampling and Methods: We sought to examine profiles of anxiety symptoms through a secondary data analysis of individual items and factor subscales on the Beck Anxiety Inventory (BAI), comparing two relatively large patient samples with DPD or with a variety of anxiety conditions, respectively. The DPD sample (n = 106) had a lower overall BAI score than the combined anxiety disorders group (n = 525). Results: After controlling for this as well as for potential confounders such as age and gender, the DPD group presented significantly lower scores on the panic subscale, marginally lower scores on the autonomic subscale and significantly higher scores on the neurophysiological subscale of the BAI. Conclusions: These differences imply similarities between the cognitive components of DPD and anxiety disorders while physiological experiences diverge. The findings encourage future research looking at direct physiological measures and longitudinal designs to confirm the mechanisms underlying different clinical manifestations of anxiety.",0 +https://doi.org/10.1176/appi.ajp.162.5.963,Does Memory of a Traumatic Event Increase the Risk for Posttraumatic Stress Disorder in Patients With Traumatic Brain Injury? A Prospective Study,"The present study examined prospectively the relationship between memory of the traumatic event and subsequent development of posttraumatic stress disorder (PTSD). More specifically, the aims of this study were to 1) investigate the possibility that lack of memory of the traumatic event might be a protective factor; 2) assess whether memory of the traumatic event equally affects the three symptom clusters of PTSD: reexperiencing, avoidance, and hyperarousal; and 3) explore the predictive value of memory of the traumatic event for the development of subsequent PTSD in the immediate aftermath of the event.One hundred twenty subjects with mild traumatic brain injury who were hospitalized for observation were assessed immediately after the trauma and followed up 1 week, 3 months, and 6 months later. All participants underwent psychiatric evaluation and self-assessment of their memory of the traumatic event.Overall, 17 (14%) of the participants met full criteria for PTSD at 6 months. Subjects with memory of the traumatic event were significantly more likely to develop PTSD than those without memory of the traumatic event; the difference between the groups resulted primarily from the reexperiencing cluster. Logistic regression analysis revealed that memory of the traumatic event within the first 24 hours is a strong predictor of PTSD 6 months after the event.Our study indicated that memory of a traumatic event is a strong predictor and a potential risk factor for subsequent development of PTSD. Future studies are needed to show whether these findings can be generalized to other traumatic conditions.",0 +https://doi.org/10.3109/01674820209093413,Traumatic Stress after Childbirth: The Role of Obstetric Variables,"In a sample of 1550 recently delivered women, traumatic stress after childbirth was studied in relation to obstetric variables. A post-traumatic stress disorder (PTSD) symptom profile and traumatic stress symptoms were assessed by means of the Traumatic Event Scale (TES). Obstetric data comprised delivery mode, duration of the second stage of labor (the time from cervical dilation of 10 cm to partus) and the use of analgesia/anesthesia. Traumatic stress symptoms and having a PTSD symptom profile were both significantly related to the experience of an emergency cesarean section or an instrumental vaginal delivery. It is of clinical importance, however, that most women with a PTSD symptom profile were found in the normal vaginal delivery group (NVD). This implies that a normal vaginal delivery can be experienced as traumatic, just as an emergency cesarian section is not necessarily traumatic. Traumatic stress symptoms were neither substantially correlated to the duration of the second stage of labor, nor to the use of analgesia/anesthesia.",0 +https://doi.org/10.1037/11468-004,Attachment Bases of Emotion Regulation and Posttraumatic Adjustment.,,0 +https://doi.org/10.2147/jpr.s91924,The Toronto General Hospital Transitional Pain Service: development and implementation of a multidisciplinary program to prevent chronic postsurgical pain,"Chronic postsurgical pain (CPSP), an often unanticipated result of necessary and even life-saving procedures, develops in 5-10% of patients one-year after major surgery. Substantial advances have been made in identifying patients at elevated risk of developing CPSP based on perioperative pain, opioid use, and negative affect, including depression, anxiety, pain catastrophizing, and posttraumatic stress disorder-like symptoms. The Transitional Pain Service (TPS) at Toronto General Hospital (TGH) is the first to comprehensively address the problem of CPSP at three stages: 1) preoperatively, 2) postoperatively in hospital, and 3) postoperatively in an outpatient setting for up to 6 months after surgery. Patients at high risk for CPSP are identified early and offered coordinated and comprehensive care by the multidisciplinary team consisting of pain physicians, advanced practice nurses, psychologists, and physiotherapists. Access to expert intervention through the Transitional Pain Service bypasses typically long wait times for surgical patients to be referred and seen in chronic pain clinics. This affords the opportunity to impact patients' pain trajectories, preventing the transition from acute to chronic pain, and reducing suffering, disability, and health care costs. In this report, we describe the workings of the Transitional Pain Service at Toronto General Hospital, including the clinical algorithm used to identify patients, and clinical services offered to patients as they transition through the stages of surgical recovery. We describe the role of the psychological treatment, which draws on innovations in Acceptance and Commitment Therapy that allow for brief and effective behavioral interventions to be applied transdiagnostically and preventatively. Finally, we describe our vision for future growth.",0 +https://doi.org/10.1016/j.jad.2013.04.009,"Differentiating army suicide attempters from psychologically treated and untreated soldiers: A demographic, psychological and stress-reaction characterization","Suicide is the leading cause of death in most armies during peace-time. The recent dramatic rise in suicides in the US Army further focuses attention on the causes of suicidal behavior in the military.This study investigated demographic characteristics, psychological profile and stress-related risk factors associated with suicide attempts in Israelis aged 18-21 years, who served in the Army in 2009. Soldiers who attempted suicide (N=60) were compared to soldiers treated by a mental health professional, but reported no suicidal behavior (N=58), and to controls (N=50).Suicide attempters had lower socioeconomic status and less cognitive ability compared with treated soldiers and untreated control soldiers. Only 25% of the suicide attempters had received mental healthcare prior to the attempt. The majority of the attempts were non-lethal (86.2%), and only 5.2% used firearms. Attempters had more previous suicide attempts (37.9%) and deliberate selfharm incidents (19.3%), compared to almost no such behaviors in the other two groups. Following the suicide attempt, 77% were diagnosed with moderate to severe mental disorders, 44.8% personality disorders and 8.6% mood disorders. Attempters reported higher levels of general stress compared to their peers in the other two groups. Being away from home and obeying authority were especially more stressful in attempters.Young soldiers are less prone to seek mental health assistance, despite suffering from higher levels of stress. Screening is required to detect soldiers at risk for suicidal behavior and preventive intervention will require active outreach.",0 +https://doi.org/10.1080/16506079708412038,"Exposure therapy for post-traumatic stress disorder: Its relative efficacy, limitations and optimal application","Abstract Post-traumatic stress disorder (PTSD) is a very debilitating psychological disturbance that follows the experience of traumatic events. Exposure therapy has shown good treatment efficacy in earlier treatment outcome studies on PTSD. Only a few other behavioral treatments have shown equal effectiveness, and exposure is usually a necessary treatment component in the others. This paper presents a short review of controlled treatment outcome studies on PTSD. The relative efficacy of exposure therapy compared to other treatments is discussed and factors that can hinder and enhance its effectiveness are reviewed. In the discussion section some methodological pitfalls in the treatment outcome studies are discussed.",0 +https://doi.org/10.7205/milmed-d-13-00177,In-Person and Video-Based Post-Traumatic Stress Disorder Treatment for Veterans: A Location–Allocation Model,"Post-traumatic stress disorder (PTSD) is associated with poor health but there is a gap between need and receipt of care. It is useful to understand where to optimally locate in-person care and where video-based PTSD care would be most useful to minimize access to care barriers, care outside the Veterans Affairs system, and total costs. We developed a service location systems engineering model based on 2010 to 2020 projected care needs for veterans across New England to help determine where to best locate and use in-person and video-based care. This analysis determined specific locations and capacities of each type of PTSD care relative to patient home locations to help inform allocation of mental health resources. Not surprisingly Massachusetts, Connecticut, and Rhode Island are well suited for in-person care, whereas some rural areas of Maine, Vermont, and New Hampshire where in-patient services are infeasible could be better served by video-based care than external care, if the latter is even available. Results in New England alone suggest a potential $3,655,387 reduction in average annual total costs by shifting 9.73% of care to video-based treatment, with an average 12.6 miles travel distance for the remaining in-person care.",0 +https://doi.org/10.1016/j.jpsychires.2014.09.003,Elucidating dimensions of posttraumatic stress symptoms and their functional correlates in disaster-exposed adolescents,"The aim of this study was to elucidate the dimensional structure of posttraumatic stress disorder (PTSD) and potential moderators and functional correlates of this structure in disaster-affected adolescents. A population-based sample of 2000 adolescents aged 12-17 years (M = 14.5 years; 51% female) completed interviews on post-tornado PTSD symptoms, substance use, and parent-adolescent conflict between 4 and 13 months (M = 8.8, SD = 2.6) after tornado exposure. Confirmatory factor analyses revealed that all models fit well but a 5-factor dysphoric arousal model provided a statistically significantly better representation of adolescent PTSD symptoms compared to 4-factor dysphoria and emotional numbing models. There was evidence of measurement invariance of the dysphoric arousal model across gender and age, although girls and older adolescents aged 15-17 years had higher mean scores than boys and younger adolescents aged 12-14 years, respectively, on some PTSD dimensions. Differential magnitudes of association between PTSD symptom dimensions and functional correlates were observed, with emotional numbing symptoms most strongly positively associated with problematic substance use since the tornado, and dysphoric arousal symptoms most strongly positively associated with parent-adolescent conflict; both correlations were significantly larger than the corresponding correlations with anxious arousal. Taken together, these results suggest that the dimensional structure of tornado-related PTSD symptomatology in adolescents is optimally characterized by five separate clusters of re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal symptoms, which showed unique associations with functional correlates. Findings emphasize that PTSD in disaster-exposed adolescents is not best conceptualized as a homogenous construct and highlight potential differential targets for post-disaster assessment and intervention.",0 +https://doi.org/10.1111/j.1745-9125.1993.tb01133.x,"AGE, CRIMINAL CAREERS, AND POPULATION HETEROGENEITY: SPECIFICATION AND ESTIMATION OF A NONPARAMETRIC, MIXED POISSON MODEL*","This article addresses three issues that are central to the criminal career debate. First, is the life course of individual offending patterns marked by distinctive periods of quiescence? Second, at the level of the individual, do offending rates vary systematically with age? In particular, is the age-crime curve single peaked or flat? Third, are chronic offenders different from less active offenders? Do offenders themselves differ in systematic ways? Using a new approach to the analysis of individual criminal careers—based on nested, mixed Poisson models in which the mixing distribution is estimated nonparametrically—we analyze a panel data set that tracks a sample of males for more than 20 years. Our results provide empirical evidence in support of some features of criminal propensity theory and some in support of conventional criminal careers theory. In support of latent-trait criminal propensity theory, the individual-level average offense rate (per unit of time) varies as a function of observable individual-level characteristics and unobservable heterogeneity among individuals, and the age trajectory of the offense rate is generally single peaked rather than flat. On the other hand, in support of conventional criminal careers theory, models that incorporate a parameter that permits periods of active as well as inactive offending across age have greater explanatory power than those that do not. In addition, the nonparametric, discrete approximation to the population distribution of unobservable heterogeneity in the individual-level mean offense rate facilitates identification of four classes of offenders—nonoffenders as well as individual-level characteristics that are unique to each group. Problems of theoretical explanation and empirical generalizability of these results are described.",0 +https://doi.org/10.1186/1471-2458-14-491,Unmet mental health care need 10–11 years after the 9/11 terrorist attacks: 2011–2012 results from the World Trade Center Health Registry,"There is little current information about the unmet mental health care need (UMHCN) and reasons for it among those exposed to the World Trade Center (WTC) terrorist attacks. The purpose of this study was to assess the level of UMHCN among symptomatic individuals enrolled in the WTC Health Registry (WTCHR) in 2011-2012, and to analyze the relationship between UMHCN due to attitudinal, cost, and access factors and mental health symptom severity, mental health care utilization, health insurance availability, and social support.The WTCHR is a prospective cohort study of individuals with reported exposure to the 2001 WTC attacks. This study used data from 9,803 adults who completed the 2003-2004 (Wave 1) and 2011-2012 (Wave 3) surveys and had posttraumatic stress disorder (PTSD) or depression in 2011-2012. We estimated logistic regression models relating perceived attitudinal, cost and access barriers to symptom severity, health care utilization, a lack of health insurance, and social support after adjusting for sociodemographic characteristics.Slightly more than one-third (34.2%) of study participants reported an UMHCN. Symptom severity was a strong predictor of UMHCN due to attitudinal and perceived cost and access reasons. Attitudinal UMHCN was common among those not using mental health services, particularly those with relatively severe mental health symptoms. Cost-related UMHCN was significantly associated with a lack of health insurance but not service usage. Access-related barriers were significantly more common among those who did not use any mental health services. A higher level of social support served as an important buffer against cost and access UMHCN.A significant proportion of individuals exposed to the WTC attacks with depression or PTSD 10 years later reported an UMHCN, and individuals with more severe and disabling conditions, those who lacked health insurance, and those with low levels of social support were particularly vulnerable.",0 +https://doi.org/10.1016/j.ijnurstu.2012.06.011,Parenting burn-injured children in India: A grounded theory study,"Burn injury is one of the major traumas that a child can experience. Parents of burn-injured children experience anxiety, depression, guilt and post traumatic stress disorders as they care for their burn-injured children. Such empirical evidence related to effects of burns on parents and parenting process is unavailable from low and middle income countries like India.The aim of the study was to discover the process of parenting burn-injured children in India. The objective of this paper is to present one of the substantive processes ""Enduring the Blame"" that emerged from the data.Constructivist grounded theory methodology was used to explore the experiences of parenting burn-injured children.The study was conducted through a tertiary hospital that provided advanced paediatric burn care in a town in South India.Nine mothers, nine fathers, three grandmothers and one aunt from 12 families of children who were 15 years or younger and had sustained greater than 20% total body surface burns were purposively included.Twenty-two semi structured individual or family interviews were conducted in Tamil over a period of one year. The interview started with an overview question and then was followed by trigger questions as the participants shared their experiences. Second interviews were conducted with three participants in three families for theoretical saturation purposes.Mothers and fathers encountered blame from family members, health professionals, strangers, and their burn-injured children along the burn injury trajectory. They suffered double trauma of their child's burn and the blame. Parenting their burn-injured child involved a process of ""Enduring the Blame."" Enduring the Blame included four stages: internalizing blame, submitting to blame, rising above blame, and avoiding blame.Encouraging and assisting parents in caring for their children instead of blaming is a vital component of paediatric burn care. Parents will benefit from ongoing assessment and psychological interventions that will provide emotional support. Studying the perceptions of health professionals and the burn-injured children will help in further clarification of blame related issues and developing a parenting theory.",0 +https://doi.org/10.1300/j070v16n03_03,Sex Differences in the Experience of Unwanted Sexual Attention and Behaviors During Childhood,"Girls receive considerable amounts of unwanted sexual attention (UWSA) and behaviors (UWSB). Less is known about boys' unwanted sexual experiences. The primary goal of this study was to obtain a descriptive profile of the types and perpetrators of childhood UWSA/B. Secondary goals were to examine sex differences in emotional reactions to UWSA/B and influence of perpetrator. As many as 100 male and 100 female undergraduates completed the Exposure to Sexual Attention Scale and the Emotional Reaction Checklist. Results indicated that the majority of participants experienced UWSA/B during childhood, with females reporting higher rates of UWSB than males. Sex differences were also observed regarding types of perpetrators and emotional reactions. Findings are discussed as they relate to the sociocultural norms in which children are reared.",0 +https://doi.org/10.1016/j.psychres.2009.08.021,Is prolonged grief distinct from bereavement-related posttraumatic stress?,"Prolonged grief disorder (PGD) (previously called complicated grief (CG)) is proposed as a distinct post loss syndrome, with its own core symptoms. A key issue concerning the diagnostic validity of PGD is whether it can reliably be distinguished from related psychiatric outcomes following bereavement. This study therefore sought to determine whether the core symptoms of PGD could be distinguished from those of bereavement-related anxiety, depression and posttraumatic stress disorder (PTSD). Data were derived from a community sample of 223 bereaved adults in Croatia. PGD symptomatology was measured using the Revised Inventory of Complicated Grief. Depression and anxiety symptoms were measured using the Beck Depression and Anxiety Inventories, respectively. The intrusion and avoidance symptoms of PTSD were assessed using the Revised Impact of Event Scale. The distinctiveness of the five symptom clusters was examined using principal component analysis (PCA). Symptoms of prolonged grief, depression, anxiety, PTSD-intrusion, and PTSD-avoidance clustered together into five distinct factors. These results support the phenomenological distinctiveness of prolonged grief symptoms, from those of bereavement-related anxiety, depression and, for the first time, PTSD.",0 +https://doi.org/10.1016/j.psychres.2013.10.038,Acute effects of trauma-focused research procedures on participant safety and distress,"The ethical conduct of research on posttraumatic stress disorder (PTSD) requires assessing the risks to study participants. Some previous findings suggest that patients with PTSD report higher distress compared to non-PTSD participants after trauma-focused research. However, the impact of study participation on participant risk, such as suicidal/homicidal ideation and increased desire to use drugs or alcohol, has not been adequately investigated. Furthermore, systematic evaluation of distress using pre- and post-study assessments, and the effects of study procedures involving exposure to aversive stimuli, are lacking. Individuals with a history of PTSD (n=68) and trauma-exposed non-PTSD controls (n=68) responded to five questions about risk and distress before and after participating in research procedures including a PTSD diagnostic interview and a behavioral task with aversive stimuli consisting of mild electrical shock. The desire to use alcohol or drugs increased modestly with study participation among the subgroup (n=48) of participants with current PTSD. Participation in these research procedures was not associated with increased distress or participant risk, nor did study participation interact with lifetime PTSD diagnosis. These results suggest some increase in distress with active PTSD but a participant risk profile that supports a favorable risk-benefit ratio for conducting research in individuals with PTSD.",0 +https://doi.org/10.1080/10629360600810434,Fully conditional specification in multivariate imputation,"The use of the Gibbs sampler with fully conditionally specified models, where the distribution of each variable given the other variables is the starting point, has become a popular method to create imputations in incomplete multivariate data. The theoretical weakness of this approach is that the specified conditional densities can be incompatible, and therefore the stationary distribution to which the Gibbs sampler attempts to converge may not exist. This study investigates practical consequences of this problem by means of simulation. Missing data are created under four different missing data mechanisms. Attention is given to the statistical behavior under compatible and incompatible models. The results indicate that multiple imputation produces essentially unbiased estimates with appropriate coverage in the simple cases investigated, even for the incompatible models. Of particular interest is that these results were produced using only five Gibbs iterations starting from a simple draw from observed marginal distributions. It thus appears that, despite the theoretical weaknesses, the actual performance of conditional model specification for multivariate imputation can be quite good, and therefore deserves further study. © 2006 Taylor & Francis.",0 +https://doi.org/10.1016/s0306-4603(96)00071-8,Prevalence and correlates of heavy smoking in Vietnam veterans with chronic posttraumatic stress disorder,"A study was conducted to investigate smoking patterns in 445 Vietnam veterans with and without posttraumatic stress disorder (PTSD). Combat veterans with PTSD reported similar occurrence of smoking (53%) compared to combat veterans without PTSD (45%). For those who smoked, combat veterans with PTSD reported a significantly higher rate of heavy smoking (> or = 25 cigarettes daily): 28% of combat veterans without PTSD were heavy smokers and 48% of combat veterans with PTSD were heavy smokers. PTSD diagnosis and heavy smoking status were independently and differentially related to motives for smoking. In combat veterans with PTSD, heavy smoking status was positively related to total health complaints, lifetime health complaints, health complaints in the past year, negative health behaviors, total PTSD symptoms, DSM-IV C cluster (avoidance and numbing) and D cluster (hyperarousal) PTSD symptoms. Heavy smoking status was also associated with fewer positive health behaviors.",0 +https://doi.org/10.1016/s0005-7967(01)00069-9,Posttraumatic stress disorder after motor vehicle accidents: 3-year follow-up of a prospective longitudinal study,"The paper presents a 3-year follow-up of a prospective longitudinal study of posttraumatic stress disorder (PTSD) after motor vehicle accidents (J. Abnormal Psychol., 107 (1998) 508). Participants were 546 patients who had been assessed when attending an emergency clinic shortly after a motor vehicle accident, and at 3 months and 1 year afterwards. The prevalence of posttraumatic stress disorder PTSD at 3 years was 11%. Maintaining psychological factors, i.e. negative interpretation of intrusions, rumination, thought suppression and anger cognitions, were important in predicting the persistence of PTSD at 3 years, as were persistent health and financial problems after the accident. Other predictors were female sex, hospital admission for injuries, perceived threat and dissociation during the accident, and litigation.",0 +https://doi.org/10.1017/s204579601100031x,The trauma symptom inventory: Italian validation of an instrument for the assessment of post-traumatic symptoms,"Aim. The trauma symptom inventory (TSI; Briere, 1995) is a useful instrument for the assessment of post-traumatic and common trauma-related mental health symptoms. The purpose of the study was to validate the Italian version of the original TSI. Methods. Participants from non-clinical ( n = 285), clinical ( n = 110) and post-traumatic ( n = 30) samples completed the TSI as part of a battery that included self-report measures of trauma exposure [MMPI-2 PK scale and Impact of Event Scale-Revised (IES-R)] and of psychological symptoms [brief symptom inventory (BSI) and symptom questionnaire (SQ)]. TSI validity scales were compared with MMPI-2 validity scales in order to assess convergent validity. Results. The TSI Italian version showed adequate internal consistency reliability and a good convergent validity. Discriminant function analysis indicates a classification accuracy of TSI scales of 90% for true-positive and 91.4% for true-negative post-traumatic stress disorder (PTSD) cases. A revised three-factor structural model, which demonstrated an adequate and the best fit for the data, was proposed. Conclusions. The study extended the generalization and validity of TSI and provided some suggestions for eventually revisiting factorial structure of the questionnaire.",0 +,Sensitization and kindling: Implications for the evolving neural substrates of post-traumatic stress disorder.,"(from the chapter) suggest that some of the principles involved in laying down the differential memory traces of sensitization and kindling may be useful bridging structures for considering parallel processes in different neural substrates that could be occurring in the related processes of stress sensitization and memory ""branding"" in posttraumatic stress disorder (PTSD) / suggest that these [2 behavioral] models may provide a primitive template for considering how acute or repeated stressors may not only leave permanent memory traces, but also affect the biochemistry and microstructure of the brain, potentially by impacting immediate-early-gene and late-effector-gene expression / stress sensitization and kindling also have their own spatiotemporal unfolding of cascades of neurobiological events that may have important mechanistic and pharmacotherapeutic implications cocaine sensitization / kindling: evolving neural substrates revealed by in situ hybridization and pharmacology / implications of sensitization and kindling for development and evolution of PTSD (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1177/136346150203900303,The Khmer ‘Weak Heart’ Syndrome: Fear of Death from Palpitations,"According to the Khmer conception, a person suffering ‘weak heart’ ( khsaoy beh daung) has episodes of palpitations on slight provocation (e.g. triggered by orthostasis, anger, a noise, worry, an odor or exercise) and runs the risk of dying of heart arrest during these periods of palpitations; too, the sufferer typically has other symptoms attributed to the purported cardiac dysfunction: fatigue, shortness of breath, and orthostatic dizziness. Many Khmer refugees suffer this cultural syndrome, an anxious–dysphoria ontology, most probably of French colonial provenance. The syndrome demonstrates considerable overlap with those Western illness categories that feature panic attacks, in particular post-traumatic stress disorder (PTSD) and panic disorder. In a psychiatric clinic survey, 60 percent (60/100) of those assessed believed themselves to currently suffer ‘weak heart’; 90 percent (54/60) of those considering themselves to suffer from ‘weak heart’ thought that palpitations (e.g., those resulting from a loud noise or orthostasis) might result in death. The article illustrates the profoundly culturally constructed nature of ‘cardiac sensations,’ located in a specific historical trajectory and episteme; too, the article suggests that trauma may result more in panic disorder than ‘PTSD’ when autonomic arousal symptoms (in the present case, palpitations) are considered potentially life-threatening.",0 +https://doi.org/10.1111/jrh.12017,Prevalence of and Factors Associated With Subclinical Posttraumatic Stress Symptoms and PTSD in Urban and Rural Areas of Montana: A Cross-Sectional Study,"Posttraumatic stress disorder (PTSD) is an important clinical problem, but little is known about PTSD in rural, nonclinical populations. To better understand PTSD in rural areas, we examined the prevalence and risk and protective factors in urban, rural, and highly rural communities in Montana for both subclinical posttraumatic stress symptoms (PTSS) and PTSD.We compared the prevalence of PTSS and PTSD in urban, rural, and highly rural communities in bivariate and multivariable regression analyses using self-reported cross-sectional survey data from the Montana Health Matters study (N = 3,512), a state-representative household-based survey done in 2010-2011. We also explore potential risk and protective factors for PTSS and PTSD and whether risk and protective factors for each differ by rurality.There were no differences in the level of PTSS by rurality in bivariate or multivariate models, and the bivariate relationship between rurality and PTSD became nonsignificant in a multivariate model. Only locus of control was predictive for PTSS; however, gender, age, marital status, income, employment status, community fit, locus of control, and religiosity were associated with PTSD. Some risk and protective factors operate differently by rurality.Although our findings are subject to weaknesses common to cross-sectional data and are based on questionnaire reports, it appears that there are different risk and protective factors for PTSS and PTSD, suggesting that PTSD may be qualitatively different from PTSS. Furthermore, differences in risk and protective factors across urban and rural communities suggest more attention is needed to understand PTSD in rural communities.",0 +https://doi.org/10.1037/a0023237,Personality-based latent classes of posttraumatic psychopathology: Personality disorders and the internalizing/externalizing model.,"Prior research using the Brief Form of the Multidimensional Personality Questionnaire (MPQ-BF; Patrick, Curtin, & Tellegen, 2002) has shown evidence of 3 temperament-based subtypes--termed internalizing, externalizing, and simple PTSD--among individuals with symptoms of posttraumatic stress disorder (PTSD; Miller, Greif, & Smith, 2003). This study sought to replicate and extend research in this area by conducting a latent profile analysis of higher order temperament scales from the MPQ-BF using a new sample of 208 veterans with symptoms of PTSD. Results suggest that a 3-class solution reflecting internalizing, externalizing, and simple subtypes of posttraumatic psychopathology provided the best fit to the data. The externalizing subtype was characterized by features of antisocial, borderline, histrionic, and narcissistic personality disorders on the International Personality Disorder Examination (Loranger, 1999) as well as low levels of constraint and high levels of negative emotionality on the MPQ-BF. In contrast, individuals in the internalizing class exhibited features of schizoid and avoidant personality disorders, low levels of positive emotionality, and high levels of negative emotionality. The simple subtype was defined by low levels of comorbid personality disorder features and relatively normal personality profiles. Findings support the reliability of this typology and support the relevance of the internalizing and externalizing model to the structure of personality disorders.",0 +https://doi.org/10.1007/s10608-015-9730-4,A Longitudinal Study of Emotional Distress Intolerance and Psychopathology Following Exposure to a Potentially Traumatic Event in a Community Sample,"This study focused on better understanding the association between anxiety sensitivity (AS), distress tolerance (DT), and psychopathology, including posttraumatic stress, depression, panic and suicidality, in the aftermath of a potentially traumatizing event. A community-based sample of 151 adults exposed to the Mount Carmel Forest Fire Disaster were assessed within 30-days of exposure (T1) and then at 3- (T2) and 6-month (T3) follow-up intervals. At T1, AS, DT, and psychopathology symptoms loaded on a single common latent factor reflecting Emotional Avoidance and Distress; whereas by T2 AS-DT and psychopathology symptoms diverged into distinct latent variables—Emotional Distress Intolerance and Distress Post-Trauma, respectively. Levels of Emotional Distress and Avoidance at T1 predicted levels of Emotional Distress Intolerance as well as Distress Post-Trauma at T2. Finally, levels of Emotional Intolerance at T2 predicted levels of Distress Post-Trauma at T3 above and beyond the strong stability effects of Distress Post-Trauma over time. Findings are discussed with respect to their theoretical and clinical implications for understanding and promoting resilience to, and recovery following, exposure to potentially traumatic events.",0 +https://doi.org/10.1097/psy.0000000000000179,Posttraumatic Stress Disorder and the Risk of Respiratory Problems in World Trade Center Responders,"Posttraumatic stress disorder (PTSD) is associated with high medical morbidity, but the nature of this association remains unclear. Among responders to the World Trade Center (WTC) disaster, PTSD is highly comorbid with lower respiratory symptoms (LRS), which cannot be explained by exposure alone. We sought to examine this association longitudinally to establish the direction of the effects and evaluate potential pathways to comorbidity.18,896 responders (8466 police and 10,430 nontraditional responders) participating in the WTC-Health Program were first evaluated between 2002 and 2010 and assessed again 2.5 years later. LRS were ascertained by medical staff, abnormal pulmonary function by spirometry, and probable WTC-related PTSD with a symptom inventory.In both groups of responders, initial PTSD (standardized regression coefficient: β = 0.20 and 0.23) and abnormal pulmonary function (β = 0.12 and 0.12) predicted LRS 2.5 years later after controlling for initial LRS and covariates. At follow-up, LRS onset was 2.0 times more likely and remission 1.8 times less likely in responders with initial PTSD than in responders without. Moreover, PTSD mediated, in part, the association between WTC exposures and development of LRS (p < .0001). Initial LRS and abnormal pulmonary function did not consistently predict PTSD onset.These analyses provide further evidence that PTSD is a risk factor for respiratory symptoms and are consistent with evidence implicating physiological dysregulation associated with PTSD in the development of medical conditions. If these effects are verified experimentally, treatment of PTSD may prove helpful in managing physical and mental health of disaster responders.",0 +https://doi.org/10.1007/s10608-011-9362-2,Experiential Avoidance Mediates the Association Between Behavioral Inhibition and Posttraumatic Stress Disorder,"Despite the large body of research on the risk factors for posttraumatic stress disorder (PTSD), few studies have examined specific personality factors that may be associated with risk for PTSD or the potential mechanisms that may underlie the association between personality and PTSD. Thus, this study sought to examine the relation between the behavioral inhibition system (BIS), a motivational brain-based system associated with the experience of anxiety, and probable posttraumatic stress disorder (PTSD) status. Further, we examined the mediating role of experiential avoidance in the relation between BIS sensitivity and PTSD. Participants included 291 undergraduates who indicated they had experienced a potentially traumatic event at some point in their life. As expected, significant associations were found between BIS sensitivity, experiential avoidance, and probable PTSD status. Results indicated that BIS scores significantly predicted probable PTSD status above and beyond other relevant covariates, including anxiety symptom severity. Further, this association was found to be fully mediated by experiential avoidance. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1037/a0012570,"Further validation of the IDAS: Evidence of convergent, discriminant, criterion, and incremental validity.","The authors explicated the validity of the Inventory of Depression and Anxiety Symptoms (IDAS; D. Watson et al., 2007) in 2 samples (306 college students and 605 psychiatric patients). The IDAS scales showed strong convergent validity in relation to parallel interview-based scores on the Clinician Rating version of the IDAS; the mean convergent correlations were .51 and .62 in the student and patient samples, respectively. With the exception of the Well-Being Scale, the scales also consistently demonstrated significant discriminant validity. Furthermore, the scales displayed substantial criterion validity in relation to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) mood and anxiety disorder diagnoses in the patient sample. The authors identified particularly clear and strong associations between (a) major depression and the IDAS General Depression, Dysphoria and Well-Being scales, (b) panic disorder and IDAS Panic, (c) posttraumatic stress disorder and IDAS Traumatic Intrusions, and (d) social phobia and IDAS Social Anxiety. Finally, in logistic regression analyses, the IDAS scales showed significant incremental validity in predicting several DSM-IV diagnoses when compared against the Beck Depression Inventory-II (A. T. Beck, R. A. Steer, & G. K. Brown, 1996) and the Beck Anxiety Inventory (A. T. Beck & R. A. Steer, 1990).",0 +https://doi.org/10.3109/13651501.2012.704383,Psychopathology in a sample of candidate patients for bariatric surgery,"The prevalence of morbid obesity and the popularity of bariatric surgery have grown in recent years. Many surgical protocols require that the candidates undergo a pre-operative psychological evaluation. We describe the psychopathological characteristics of both clinical syndromes (Axis I of the DSM-IV), as well as personality disorders (Axis II of the DSM-IV), in a sample of morbidly obese patients accepted as bariatric surgery candidates and who participate in a specific surgery preparatory programme, and we analyze its relationship with personality clusters.The Millon Clinical Multiaxial Inventory-III (MCMI-III) scores from 50 patients attending for bariatric surgery were cluster analyzed in hopes of identifying clinical subgroups corresponding to typical personality profiles.With regard to personality disorders, the highest prevalence was found in the histrionic disorder, followed by obsessive- compulsive disorder. Cluster analysis revealed three personality profiles, which were validated by examining demographics, morphological variables, scores on anxiety and depression psychometric scales, and MCMI-III clinical scales scores. Groups were different in virtually all the MCMI-III clinical scores, as well as in depression and trait anxiety, with Cluster 3 presenting the worst scores.These findings suggest that morbidly obese patients are heterogeneous in their psychological profiles, highlighting Cluster C disorders.",0 +https://doi.org/10.1037/h0099382,The Deepwater Horizon Oil Spill and the Mississippi Gulf Coast: Mental health in the context of a technological disaster.,"A significant percentage of disaster survivors experience negative psychological, physical, and social outcomes after a disaster. The current study advances the literature concerning the Deepwater Horizon Oil Spill (the Gulf Oil Spill) while addressing weaknesses of previous research. The current study includes a clinical sample of 1,119 adults receiving mental health services in the coastal counties of Mississippi after the Gulf Oil Spill. The levels of clinical symptoms reported on the Depression Anxiety Stress Scales (DASS-21) and PTSD Checklist (PCL-S) were examined in relation to other domains of functioning potentially affected by the spill (finances, social relationships, and physical health). Participants reported substantial worsening of their functioning across each life domain. Furthermore, chronic problems in living related to the Gulf Oil Spill were significantly associated with higher levels of psychological distress, although the pattern differed somewhat for persons living above and below the poverty line, with lower income individuals reporting a higher level of overall distress. These data support the perspective that the experience of the Gulf Oil Spill is strongly associated with a deleterious effect on mental health symptoms.",0 +https://doi.org/10.1038/sc.2009.42,Co-occurring medical and mental illness and substance use disorders among veteran clinic users with spinal cord injury patients with complexities,"Longitudinal analysis of SCI registry merged with VHA administrative-data and Medicare claims files (FY1999-2002).To estimate the prevalence of mental illness (MI) and substance use disorders (SUDs) among veteran health administration (VHA) clinic users with spinal cord injuries (SCI) and examine subgroup variations by demographic, socioeconomic characteristics, and duration and level of SCI.VHA clinic users (N=8338) with SCI who were alive by the end of FY2002.ICD-9-CM codes were used to identify individual MI (anxiety disorders, bipolar, depressive disorders, psychoses, post-traumatic stress disorder (PTSD) and schizophrenia) and categories of SUDs (tobacco, alcohol and drug abuse). Chi-square tests and multinomial logistic regression were used to examine the demographic and socio-economic profile of VHA users with SCI and MI and/or SUD.Over a 2-year period, 46% VHA users with SCI had either a MI or SUDs: 20% had MI only; 12% had SUD only and 14% had both. The most common MI was depressive disorder (27%) and tobacco use was highly prevalent (19%). African-Americans (versus whites) were less likely to be diagnosed with MI only. Increased duration of SCI lowered the likelihood of MI and/or SUDs. Mood and anxiety disorders were highly prevalent in veterans with SCI with chronic physical conditions such as diabetes, heart disease, hypertension, and respiratory diseases.Mental illness and SUDs are highly prevalent in the VHA population with SCI and is complicated by the high rates of chronic physical conditions, presenting challenges in their healthcare management.",0 +https://doi.org/10.1097/00131746-200409000-00004,Comparability of Telephone and Face-to-Face Interviews in Assessing Patients with Posttraumatic Stress Disorder,"Structured clinical interviews are very important in the area of mental health research and services. Prior research comparing the reliability and validity of face-to-face and phone interviews has found high levels of agreement. This project compared the results of face-to-face and phone interviews for two widely used measures: The Clinician-Administered PTSD Scale (CAPS) for assessing posttraumatic stress disorder diagnostic status and symptom severity and the Hamilton Rating Scale for Depression (Ham-D) to determine the severity of major depressive disorder.Subjects were 34 veterans recruited from applicants to the PTSD Assessment and Intervention program at the Cincinnati VA Medical Center. Order of interview (in-person or phone) was determined using random assignment within a counterbalanced framework. After attaining satisfactory levels of interrater reliability, four clinicians independently and blindly evaluated the subjects.Pearson correlation coefficients between face-to-face and phone interviews revealed high consistency (CAPS r = 0.745, HAM-D r = 0.748). The level of agreement between the two methods was 82% for the CAPS and 85% for the HAM-D. Diagnostic thresholds for the CAPS and HAM-D, after adjusting for the interview order and time elapsed between interviews, did not differ between the two groups (p = 0.31 for the CAPS and p = 0.96 for the HAM-D). High levels of agreement were achieved between the two methods (kappa = 0.75 for the CAPS using a cutoff of 65 and 0.70 for the HAM-D). The high sensitivity, specificity, and predictive values support the reliability of the phone-interview method.Phone interviews are a reliable method of interviewing for use in assessing patients for posttraumatic stress disorder and major depressive disorder.",0 +https://doi.org/10.1002/jclp.21962,Losing the Symptoms: Weight Loss and Decrease in Posttraumatic Stress Disorder Symptoms,"Posttraumatic stress disorder (PTSD) has frequently been found to have an effect on the development of obesity, a relationship usually thought of as unidirectional. The purpose of this study was to examine whether the level of PTSD symptoms would decrease as a result of weight loss.In a repeated measures design, PTSD symptoms, depression symptoms, social support, and weight were assessed in obese participants during 16 weeks at a weight loss facility.The participants' body mass index decreased significantly, and concurrently, a significant decline in the level of PTSD symptoms and depression symptoms was observed.The beneficial effects of weight loss on depression are consistent with previous work. The decline in the level of PTSD symptoms simultaneously with weight loss is an important and positive effect that has not been reported previously.",0 +https://doi.org/10.1192/bjp.182.6.532,The Aberfan disaster: 33-year follow-up of survivors,"Experiencing life-threatening events often contributes to the onset of such psychiatric conditions as post-traumatic stress disorder (PTSD). Children can develop PTSD; however, there is controversy over whether PTSD symptoms decrease or persist over time.To examine the long-term effects of surviving the 1966 Aberfan disaster in childhood.Survivors (n=41) were compared with controls (n=72) matched for age and background. All were interviewed using the Composite International Diagnostic Interview, measures of current health and social satisfaction, and the General Health Questionnaire. The survivor group also completed the Impact of Event Scale to assess current levels of PTSD.Nineteen (46%; 95% CI 31-61) survivors had had PTSD at some point since the disaster, compared with 12 (20%; 95% CI 10-30) controls (OR=3.38 (95% CI 1.40-8.47)). Of the survivors,12 (29%; 95% CI 15-43) met diagnostic criteria for current PTSD. Survivors were not at a significantly increased risk of anxiety, depression or substance misuse.Trauma in childhood can lead to PTSD, and PTSD symptoms can persist for as long as 33 years into adult life. Rates of other psychopathological disorders are not necessarily raised after life-threatening childhood trauma.",0 +https://doi.org/10.1007/s00787-013-0463-1,Longitudinal follow-up of the mental health of unaccompanied refugee minors,"Despite growing numbers of unaccompanied refugee minors (UMs) in Europe, and evidence that this group is at risk of developing mental health problems, there still remain important knowledge gaps regarding the development of UMs' mental health during their trajectories in the host country and, in particular, the possible influencing role of traumatic experiences and daily stressors therein. This study therefore followed 103 UMs from the moment they arrived in Belgium until 18 months later. Traumatic experiences (SLE), mental health symptoms (HSCL-37A, RATS) and daily stressors (DSSYR) were measured at arrival in Belgium, after 6 and 18 months. UMs reported generally high scores on anxiety, depression and post-traumatic stress disorder (PTSD). Linear mixed model analysis showed no significant differences in mental health scores over time, pointing towards the possible long-term persistence of mental health problems in this population. The number of traumatic experiences and the number of daily stressors leaded to a significant higher symptom level of depression (daily stressors), anxiety and PTSD (traumatic experiences and daily stressors). European migration policies need to reduce the impact of daily stressors on UMs' mental health by ameliorating the reception and care facilities for this group. Moreover, regular mental health screenings are needed, in combination with, if needed, adapted psychosocial and therapeutic care. © 2013 Springer-Verlag",0 +https://doi.org/10.4088/jcp.09m05405blu,Peritraumatic Heart Rate and Posttraumatic Stress Disorder in Patients With Severe Burns,"Previous studies have suggested a link between heart rate (HR) following trauma and the development of posttraumatic stress disorder (PTSD). This study expands on previous work by evaluating HR in burn patients followed longitudinally for symptoms of acute stress disorder (ASD) and PTSD.Data were collected from consecutive patients admitted to the Johns Hopkins Burn Center, Baltimore, Maryland, between 1997 and 2002. Patients completed the Stanford Acute Stress Reaction Questionnaire (n = 157) to assess symptoms of ASD. The Davidson Trauma Scale was completed at 1 (n = 145), 6 (n = 106), 12 (n = 94), and 24 (n = 66) months postdischarge to assess symptoms of PTSD. Heart rate in the ambulance, emergency room, and burn unit were obtained by retrospective medical chart review.Pearson correlations revealed a significant relationship between HR in the ambulance (r = 0.32, P = .016) and burn unit (r = 0.30, P = .001) and ASD scores at baseline. Heart rate in the ambulance was related to PTSD avoidance cluster scores at 1, 6, 12, and 24 months. In women, HR in the ambulance was correlated with PTSD scores at 6 (r = 0.65, P = .005) and 12 (r = 0.78, P = .005) months. When covariates (gender, β-blockers, Brief Symptom Inventory Global Severity Index score) were included in multivariate linear regression analyses, ambulance HR was associated with ASD and PTSD scores at baseline and 1 month, and the interaction of ambulance HR and gender was associated with PTSD scores at 6 and 12 months. Multivariate logistic regression results were similar at baseline and 12 months, which included an HR association yet no interaction at 6 months and a marginal interaction at 1 month.While peritraumatic HR is most robustly associated with PTSD symptom severity, HR on admission to burn unit also predicts the development of ASD. Gender and avoidance symptoms appear particularly salient in this relationship, and these factors may aid in the identification of subgroups for which HR serves as a biomarker for PTSD. Future work may identify endophenotypic measures of increased risk for PTSD, targeting subgroups for early intervention.",0 +https://doi.org/10.1016/j.psychres.2012.04.027,Examination of the trait facets of the five-factor model in discriminating specific mood and anxiety disorders,"Structural models of the mood and anxiety disorders postulate that each disorder has a shared component that can account for comorbidity and its own unique component that distinguishes it from others. The principal aim of the current study was to determine the extent to which the 30 facets of the Five-Factor Model (FFM), as measured by the Revised NEO Personality Inventory (NEO PI-R), contribute to the identification of the unique component in mood and anxiety disorders in treatment-seeking clinical samples. Participants (N=610) were psychiatric outpatients with principal DSM-IV diagnoses (Diagnostic and Statistical Manual-IV; American Psychiatric Association, 1994) diagnoses of major depressive disorder (MDD), post-traumatic stress disorder (PTSD), generalized social phobia (GSP), panic disorder with/without agoraphobia (PD; PD/A) or obsessive-compulsive disorder (OCD). Results suggest that approximately half of the variance in differences between these diagnoses is associated with specific characteristics represented by the FFM facets. Unique personality profiles for the MDD, GSP, PTSD and, to a lesser extent, OCD groups emerged. Broad traits of the FFM, when broken into more narrow components at the facet level, contribute significantly to the identification of unique aspects associated with specific mood and anxiety disorders. The integration of lower and higher levels of structural examination of the mood and anxiety disorders is discussed.",0 +https://doi.org/10.1016/s0145-2134(97)00014-8,What determines post-traumatic stress disorder symptomatology for survivors of childhood sexual abuse?,"The aim of this paper was to ascertain which childhood abuse experiences are associated with post-traumatic stress disorder (PTSD) symptomatology for women survivors of childhood sexual abuse (CSA).Seventy-three women attending a Family Health Counselling Service's Sexual Abuse Program were invited to participate in a study looking at the effectiveness of sexual abuse counselling. Initially, the women completed a series of self-report questionnaires including a measure of PTSD symptoms, and were interviewed about childhood abuse experiences.PTSD symptoms were associated with higher levels of all psychopathology. However, more interestingly, the severity of PTSD symptoms was also associated with the extent of CSA which involved actual sexual intercourse. This association of repeated abuse involving sexual intercourse with PTSD symptoms was still significant (partial coefficient = .30, p, .000) even when controlling for general level of psychopathology.One of the long-term effects of child sexual abuse (CSA) is post-traumatic stress disorder (PTSD), and the women who reported multiple abusive episodes which involved sexual intercourse had increased symptoms of PTSD.",0 +https://doi.org/10.1002/bmc.531,Chromatographic characterization of substance P endopeptidase in the rat brain reveals affected enzyme activity following heat stress,"This paper describes a study of substance P endopeptidase (SPE)-like activity in various regions of the brain from male rats subjected to heat stress (HS). The enzyme activity was found to be affected in several brain areas including cerebellum, cerebral cortex, hippocampus, hypothalamus[sol ]thalamus and the spinal cord following HS. Significant increases in SPE activity were observed in, for example, hippocampus and the spinal cord. SPE-containing extracts from hippocampus were pooled and subsequently purified by size exclusion chromatography (using a Superdex® 75 HR column) and by anion-exchange chromatography (using Resource Q® column). The gel permeation chromatography separated the SPE-like activity into two fractions, one of which was suggested to be identical to neutral endopeptidase owing to its molecular size and inhibitory profile. The other active enzyme fraction behaved in conformity with SPE, previously identified in human cerebrospinal fluid. The activity of the purified fraction of these two enzymes was found to be increased (27%) in HS-treated animals. Copyright © 2005 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1016/j.neuropharm.2011.03.012,Twin studies of posttraumatic stress disorder: Differentiating vulnerability factors from sequelae,"Posttraumatic stress disorder (PTSD) is defined by one's response to an environmental event. However, genetic factors are important in determining people's response to that event, and even their likelihood of being exposed to particular traumatic events in the first place. Classical twin designs can decompose genetic and environmental sources of variance. Such studies are reviewed extensively elsewhere, and we cover them only briefly in this review. Instead, we focus primarily on the identical co-twin control design. This design makes it possible to resolve the ""chicken-egg"" dilemma inherent in standard case-control designs, namely, distinguishing risk from sequelae. Abnormalities that are present in both the twin with PTSD and the unaffected co-twin suggest pre-existing vulnerability indicators. These include smaller hippocampal volume, large cavum septum pellucidum, more neurological soft signs, lower general intellectual ability, and poorer performance in the specific cognitive abilities of executive function, attention, declarative memory, and processing of contextual cues. In contrast, abnormalities in a twin with PTSD that are not present in the identical co-twin suggest consequences of PTSD or trauma exposure. These include psychophysiological responding, higher resting anterior cingulate metabolism, event-related potential abnormalities associated with attentional processes, recall intrusions, and possibly some types of chronic pain. Most co-twin control studies of PTSD have been small and come from the same twin registry of middle-aged male veterans. Consequently, there is a great need for replication and extension of the findings, particularly in women and younger individuals. The creation of new twin registries would do much toward accomplishing this goal. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0 +https://doi.org/10.1080/10826080701204623,"Posttraumatic Stress Disorder, Gender, and Problem Profiles in Substance Dependent Patients","Patients with a chronic and severe substance-use disorder who also have a history of posttraumatic stress disorder (PTSD) are thought to have a unique set of problems. The present study assessed psychiatric disorders, psychosocial problems, and traumatic events with structured interviews in 747 men and 693 women enrolling in urban opioid substitution treatment programs from 1995 to 2001. Participants with versus without a history of PTSD were more likely to have a history of many other psychiatric disorders and demonstrated more current and historical medical, employment, family/social, and psychiatric problems. PTSD was generally unrelated to substance-use disorder severity or diagnoses, with the exception of an increased risk of alcohol dependence. Women were more likely than men to have experienced sexual assault, and less likely to have been physically assaulted, although these events precipitated PTSD at equivalent rates across gender. In contrast, witnessing or hearing about the death or injury of others was more likely to precipitate PTSD in women than men. Female gender, exposure to combat, sexual assault, or physical assault, and a history of major mood or anxiety disorder were the best predictors of PTSD in this group. Study limitations are noted.",0 +https://doi.org/10.3402/ejpt.v4i0.22897,Lessons learned about psychosocial responses to disaster and mass trauma: an international perspective,"At the 13th meeting of the European Society for Traumatic Stress Studies in 2013, a symposium was held that brought together international researchers and clinicians who were involved in psychosocial responses to disaster. A total of six disasters that occurred in five countries were presented and discussed. Lessons learned from these disasters included the need to: (1) tailor the psychosocial response to the specific disaster, (2) provide multi-dimensional psychosocial care, (3) target at-risk population groups, (4) proactively address barriers in access to care, (5) recognise the social dimensions and sources of resilience, (6) extend the roles for mental health professionals, (7) efficiently coordinate and integrate disaster response services, and (8) integrate research and evaluation into disaster response planning.",0 +https://doi.org/10.1002/cpp.1768,"Combat Experiences, Pre-Deployment Training, and Outcome of Exposure Therapy for Post-Traumatic Stress Disorder in Operation Enduring Freedom/Operation Iraqi Freedom Veterans","The association between exposure to multiple potentially traumatic events (PTEs) and subsequent increased risk of post-traumatic stress disorder (PTSD) is well established. However, less is known about the relation between exposure to numerous PTEs, as is typical with military service, and treatment outcome. Furthermore, there has been little research examining military specific protective factors, such as pre-deployment preparedness, on PTSD treatment response. The current study investigated combat exposure and potential moderators of treatment outcome for exposure therapy in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans with PTSD. One hundred and eleven OEF/OIF veterans diagnosed with PTSD participated in 8 weeks of exposure therapy. Results indicated that increased combat exposure was associated with a reduced rate of change in PTSD symptoms but not depression symptoms. These findings were consistent across two measures of combat exposure. There was preliminary support for the moderating effect of pre-deployment preparedness on the association between combat exposure and treatment response. Together, these findings suggest that increased combat exposure is associated with poor treatment response in veterans with PTSD; however, this can be reduced by elevated pre-deployment preparedness.",0 +https://doi.org/10.1002/jts.20452,Identifying PTSD personality subtypes in a workplace trauma sample,"The authors sought to identify personality clusters derived from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Personality Psychopathology Five Scales in a sample of workplace claimants with posttraumatic stress disorder (PTSD). Three clusters—low pathology, internalizing, and externalizing were recovered similar to those obtained by M. W. Miller and colleagues (2003, 2004, 2007) in samples of combat veterans and sexual assault victims. Internalizers and externalizers scored comparably on measures of PTSD symptom severity, general distress, and negative affect. Internalizers were uniquely characterized by anhedonia and depressed mood; externalizers by antisocial behavior, substance abuse, and anger/aggression.",0 +https://doi.org/10.1016/j.psyneuen.2015.09.003,A novel locus in the oxidative stress-related gene ALOX12 moderates the association between PTSD and thickness of the prefrontal cortex,"Oxidative stress has been implicated in many common age-related diseases and is hypothesized to play a role in posttraumatic stress disorder (PTSD)-related neurodegeneration (Miller and Sadeh, 2014). This study examined the influence of the oxidative stress-related genes ALOX 12 and ALOX 15 on the association between PTSD and cortical thickness. Factor analyses were used to identify and compare alternative models of the structure of cortical thickness in a sample of 218 veterans. The best-fitting model was then used for a genetic association analysis in White non-Hispanic participants (n=146) that examined relationships between 33 single nucleotide polymorphisms (SNPs) spanning the two genes, 8 cortical thickness factors, and each SNP×PTSD interaction. Results identified a novel ALOX12 locus (indicated by two SNPs in perfect linkage disequilibrium: rs1042357 and rs10852889) that moderated the association between PTSD and reduced thickness of the right prefrontal cortex. A whole-cortex vertex-wise analysis showed this effect to be localized to clusters spanning the rostral middle frontal gyrus, superior frontal gyrus, rostral anterior cingulate cortex, and medial orbitofrontal cortex. These findings illustrate a novel factor-analytic approach to neuroimaging-genetic analyses and provide new evidence for the possible involvement of oxidative stress in PTSD-related neurodegeneration.",0 +https://doi.org/10.1002/pon.3719,Correlates of post-traumatic stress symptoms and growth in cancer patients: a systematic review and meta-analysis,"Objective The aim of this study is to examine the relationships among demographic, medical, and psychosocial factors and post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG) in oncology populations. Method A systematic search identified k = 116 relevant studies published between 1990 and 2012. Meta-analyses synthesized results from studies that reported data on correlates of PTSS (k = 26) or PTG (k = 48). A meta-analysis was performed for k = 5 studies reporting the correlation between PTSS and PTG. Results Post-traumatic stress symptoms were associated with depression (r = 0.56), anxiety (r = 0.65), distress (r = 0.62), social support (r = −0.33), and physical quality of life (r = −0.44). PTG was associated with age (r = −0.08), gender (r = −0.15), distress (r = −0.16), depression (r = −0.06), social support (r = 0.30), optimism (r = 0.27), positive reappraisal (r = 0.46), spirituality (r = 0.33), and religious coping (r = 0.36). There was a small positive relationship between PTSS and PTG (r = 0.13). Conclusions Post-traumatic stress symptoms and PTG appear to be independent constructs, rather than opposite ends of a single dimension. This is reflected in a small relationship between these variables and different psychosocial correlates. PTSS were strongly associated with variables reflecting a general state of negative affect. Optimism, spirituality, and positive coping styles were associated with PTG. It remains unclear how they are associated with PTSS, given the lack of relevant studies. Longitudinal research is required to examine how psychosocial factors influence the relationship between PTSS and PTG. Copyright © 2014 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1016/j.cpr.2007.10.005,The relative efficacy of bona fide psychotherapies for treating post-traumatic stress disorder: A meta-analysis of direct comparisons,"Psychotherapy has been found to be an effective treatment of post-traumatic stress disorder (PTSD), but meta-analyses have yielded inconsistent results on relative efficacy of psychotherapies in the treatment of PTSD. The present meta-analysis controlled for potential confounds in previous PTSD meta-analyses by including only bona fide psychotherapies, avoiding categorization of psychotherapy treatments, and using direct comparison studies only. The primary analysis revealed that effect sizes were homogenously distributed around zero for measures of PTSD symptomology, and for all measures of psychological functioning, indicating that there were no differences between psychotherapies. Additionally, the upper bound of the true effect size between PTSD psychotherapies was quite small. The results suggest that despite strong evidence of psychotherapy efficaciousness vis-à-vis no treatment or common factor controls, bona fide psychotherapies produce equivalent benefits for patients with PTSD.",0 +https://doi.org/10.1682/jrrd.2006.12.0166,Posttraumatic stress disorder and posttraumatic stress disorder-like symptoms and mild traumatic brain injury,"In this article, we review the literature on posttraumatic stress disorder (PTSD) and PTSD-like symptoms that can occur along with mild traumatic brain injury (TBI) and concussion, with specific reference to concussive injuries in the military. We address four major areas: (1) clinical aspects of TBI and PTSD, including diagnostic criteria, incidence, predictive factors, and course; (2) biological overlap between PTSD and TBI; (3) comorbidity between PTSD and other mental disorders that can occur after mild TBI; and (4) current treatments for PTSD, with specific considerations related to treatment for patients with mild TBI or concussive injuries.",0 +https://doi.org/10.1037/abn0000009,Child anxiety symptoms related to longitudinal cortisol trajectories and acute stress responses: Evidence of developmental stress sensitization.,"Cross-sectional research suggests that individuals at risk for internalizing disorders show differential activation levels and/or dynamics of stress-sensitive physiological systems, possibly reflecting a process of stress sensitization. However, there is little longitudinal research to clarify how the development of these systems over time relates to activation during acute stress, and how aspects of such activation map onto internalizing symptoms. We investigated children's (n = 107) diurnal hypothalamic-pituitary-adrenal activity via salivary cortisol (morning and evening levels) across 29 assessments spanning 6+ years, and related longitudinal patterns to acute stress responses at the end of this period (age 9-10). Associations with child psychiatric symptoms at age 10 were also examined to determine internalizing risk profiles. Increasing morning cortisol levels across assessments predicted less of a cortisol decline following interpersonal stress at age 9, and higher cortisol levels during performance stress at age 10. These same profiles of high and/or sustained cortisol elevation during psychosocial stress were associated with child anxiety symptoms. Results suggest developmental sensitization to stress-reflected in rising morning cortisol and eventual hyperactivation during acute stress exposure-may distinguish children at risk for internalizing disorders.",0 +https://doi.org/10.1186/s13030-015-0041-5,"Depression, anxiety and major adverse cardiovascular and cerebrovascular events in patients following coronary artery bypass graft surgery: a five year longitudinal cohort study","Although depression and anxiety have been implicated in risk for major adverse cardiovascular and cerebrovascular events (MACCE), a theoretical approach to identifying such putative links is lacking. The objective of this study was to examine the association between theoretical conceptualisations of depression and anxiety with MACCE at the diagnostic and symptom dimension level.Before coronary artery bypass graft (CABG) surgery, patients (N = 158; 20.9 % female) underwent a structured clinical interview to determine caseness for depression and anxiety disorders. Depression and anxiety disorders were arranged into the distress cluster (major depression, dysthymia, generalized anxiety disorder, post-traumatic stress disorder) and fear cluster (panic disorder, agoraphobia, social phobia). Patients also completed the self-report Mood and Anxiety Symptom Questionnaire, measuring anhedonia, anxious arousal and general distress/negative affect symptom dimensions. Incident MACCE was defined as fatal or non-fatal; myocardial infarction, unstable angina pectoris, repeat revascularization, heart failure, sustained arrhythmia, stroke or cerebrovascular accident, left ventricular failure and mortality due to cardiac causes. Time-to-MACCE was determined by hazard modelling after adjustment for EuroSCORE, smoking, body mass index, hypertension, heart failure and peripheral vascular disease.In the total sample, there were 698 cumulative person years of survival for analysis with a median follow-up of 4.6 years (interquartile range 4.2 to 5.2 years) and 37 MACCE (23.4 % of total). After covariate adjustment, generalized anxiety disorder was associated with MACCE (hazard ratio [HR] = 2.79, 95 % confidence interval [CI] 1.00-7.80, p = 0.049). The distress disorders were not significantly associated with MACCE risk (HR = 2.14; 95 % CI .92-4.95, p = 0.077) and neither were the fear-disorders (HR = 0.24, 95 % CI .05-1.20, p = 0.083). None of the symptom dimensions were significantly associated with MACCE.Generalized anxiety disorder was significantly associated with MACCE at follow-up after CABG surgery. The findings encourage further research pertaining to generalized anxiety disorder, and theoretical conceptualizations of depression, general distress and anxiety in persons undergoing CABG surgery.",0 +https://doi.org/10.1037/fam0000170,PTSD symptoms and marital adjustment among ex-POWs’ wives.,"This study prospectively assessed the implications of war captivity and former prisoners of war's (ex-POWs) posttraumatic stress disorder (PTSD) and PTSD trajectory on their wives' marital adjustment, adjusting for their secondary traumatization (ST). Results show that marital adjustment of the wives of ex-POWs with PTSD (N = 66) was lower compared to wives of ex-POWs (N = 37) and combat veterans (N = 55) without PTSD symptoms. Investigating the possible mechanism underlying the lower marital adjustment, via a mediating model, indicated that husbands' PTSD symptoms mediated the association between captivity and the wives' marital adjustment. Moreover, husbands' PTSD trajectories assessed over 17 years were implicated in their wives' marital adjustment; wives of ex-POWs with chronic PTSD reported lower marital adjustment compared to wives of resilient ex-POWs. The substantial novelty was revealed in prospective deterioration found in dyadic adjustment among wives of ex-POWs with delayed PTSD, but not for wives of chronic or resilient ex-POWs. Implications for research and practice are discussed.",0 +https://doi.org/10.1016/j.neulet.2014.05.054,Connecting combat-related mild traumatic brain injury with posttraumatic stress disorder symptoms through brain imaging,"Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) may share common symptom and neuropsychological profiles in military service members (SMs) following deployment; while a connection between the two conditions is plausible, the relationship between them has been difficult to discern. The intent of this report is to enhance our understanding of the relationship between findings on structural and functional brain imaging and symptoms of PTSD. Within a cohort of SMs who did not meet criteria for PTSD but were willing to complete a comprehensive assessment within 2 months of their return from combat deployment, we conducted a nested case-control analysis comparing those with combat-related mTBI to age/gender-matched controls with diffusion tensor imaging, resting state functional magnetic resonance imaging and a range of psychological measures. We report degraded white matter integrity in those with a history of combat mTBI, and a positive correlation between the white matter microstructure and default mode network (DMN) connectivity. Higher clinician-administered and self-reported subthreshold PTSD symptoms were reported in those with combat mTBI. Our findings offer a potential mechanism through which mTBI may alter brain function, and in turn, contribute to PTSD symptoms.",0 +,Community Assessment of Psychic Experiences (CAPE) and Trauma and Loss Spectrum (TALS) 12 months after an earthquake in Italy,"Methods Assessments included the Trauma and Loss Spectrum Self-Report and Community Assessment of Psychic Experiences (CAPE). Significant associations were seen between trauma-related measures and subclinical symptoms of psychosis and depression scores. Results Trauma related measures are associated with a weak increase in the subclinical positive and negative dimensions of psychosis, and a modest increase in the subclinical depressive dimension.",0 +https://doi.org/10.1016/j.bbr.2015.07.039,Rapastinel (GLYX-13) has therapeutic potential for the treatment of post-traumatic stress disorder: Characterization of a NMDA receptor-mediated metaplasticity process in the medial prefrontal cortex of rats,"Rapastinel (GLYX-13) is a NMDA receptor modulator with glycine-site partial agonist properties. It is a robust cognitive enhancer and shows rapid and long-lasting antidepressant properties in both animal models and in humans. Contextual fear extinction (CFE) in rodents has been well characterized and used extensively as a model to study the neurobiological mechanisms of post-traumatic stress disorder (PTSD). Since CFE is NMDA receptor modulated and neural circuitry in the medial prefrontal cortex (MPFC) regulates both depression and PTSD, studies were undertaken to examine the effects of rapastinel for its therapeutic potential in PTSD and to use rapastinel as a tool to study its underlying glutamatergic mechanisms. A 21-day chronic mild unpredictable stress (CUS) rat model was used to model depression and PTSD. The effects of CUS alone compared to No CUS controls, and the effects of rapastinel (3 mg/kg IV) on CUS-treated animals were examined. The effect of rapastinel was first assessed using CUS-treated rats in three depression models, Porsolt, sucrose preference, and novelty-induced hypophagia tests, and found to produce a complete reversal of the depressive-like state in each model. Rapastinel was then assessed in a MPFC-dependent positive emotional learning paradigm and in CFE and again a reversal of the impairments induced by CUS treatment was observed. Both synaptic plasticity and metaplasticity, as measured by the induction of long-term potentiation in rat MPFC slice preparations, was found to be markedly impaired in CUS-treated animals. This impairment was reversed when CUS-treated rats were administered rapastinel and tested 24 h later. Transcriptomic analysis of MPFC mRNA expression in CUS-treated rats corroborated the link between rapastinel's behavioral effects and synaptic plasticity. A marked enrichment in both the LTP and LTD connectomes in rapastinel-treated CUS rats was observed compared to CUS-treated controls. The effects of rapastinel on depression models, PEL, and most importantly on CFE demonstrate the therapeutic potential of rapastinel for the treatment of PTSD. Moreover, rapastinel appears to elicit its therapeutic effects through a NMDA receptor-mediated, LTP-like, metaplasticity process in the MPFC.",0 +,Long-term trajectories of PTSD or resilience in former East German political prisoners.,"Studies on the long-term consequences of traumatization found different diagnostic trajectories: chronic, recovered, delayed and resilient. This distinction, however, was never studied in victims of torture or severe political persecution. We aimed to verify the trajectory classes of PTSD empirically and to analyze potential predictors of such trajectories. Former political prisoners from East Germany, first interviewed in 1995, were re-assessed fourteen years later. In 1995, retrospective symptom reports dating back to shortly after the prisoners' release dates were assessed. Predictors of the four different trajectories were divided into pre-trauma, peri-trauma, and post-trauma factors. As a result, the four long-term trajectories were validated in the current sample with the following percentages: chronic (36%), resilient (27%), recovered (26%) and delayed (11%) trajectories. Trajectories were mainly distinguished by pre- and post-traumatic factors, e.g. pre-trauma education or post-trauma disclosure opportunities. We conclude that the four long-term trajectories of trauma sequelae deserve more attention to adequately deal with survivors of severe persecution. Furthermore, the specific predictors of long-term trajectory deserve more attention for re-integration or in rehabilitation.",0 +https://doi.org/10.1300/j465v28n02_04,Effects of a Behavioral Sleep Medicine Intervention on Trauma Symptoms in Adolescents Recently Treated for Substance Abuse,"This study tested whether improvement in sleep by an integrative, behavioral sleep intervention was associated with improvement in traumatic stress (TS) symptoms in a sample of 20 adolescents who were recently treated for substance abuse. Sleep was measured throughout the intervention via daily sleep diaries, and traumatic stress symptoms were assessed by the Global Appraisal of Individual Needs (GAIN) at baseline, post-intervention, 3-months post-intervention, and 12-months post-intervention. Individuals with more time in bed and more total sleep time at the beginning of the intervention had more improvement in TS symptom trajectories across the intervention and at the 12-month follow-up assessment. Interaction trends also emerged indicating that adolescents who, throughout the sleep intervention, went to bed later and fell asleep faster had greater improvements in TS symptoms over time. Overall, these results indicate that stimulus control, a therapy that encourages patients to attempt sleep only when they are sleepy, may be particularly helpful for adolescents with TS symptoms, sleep disturbances, and substance abuse histories.",0 +https://doi.org/10.1002/1097-4679(199509)51:5<626::aid-jclp2270510507>3.0.co;2-f,What's in a name? The MMPI-2 PTSD scales,"The MMPI-2 post-traumatic stress disorder scales (PK and PS) were examined with a sample of 96 outpatient anxiety disorder and 97 outpatient traffic accident subjects. PK and PS correlated .96 and showed highly similar correlations with MMPI-2 validity, clinical, content and supplementary scales for both groups, which indicated that these scales are indices of MMPI first-factor variance. This was supported by separate principal components analyses for each group, in which PK and PS contributed the most variance to the first component. Although the groups showed different MMPI-2 mean profiles, neither PK nor PS contributed to discriminant function classification of group members. It is suggested that PK and PS are indices of general emotional distress and maladjustment; implications for their use in diagnosing post-traumatic stress disorder were discussed.",0 +https://doi.org/10.1126/science.277.5328.918,Neighborhoods and Violent Crime: A Multilevel Study of Collective Efficacy,"It is hypothesized that collective efficacy, defined as social cohesion among neighbors combined with their willingness to intervene on behalf of the common good, is linked to reduced violence. This hypothesis was tested on a 1995 survey of 8782 residents of 343 neighborhoods in Chicago, Illinois. Multilevel analyses showed that a measure of collective efficacy yields a high between-neighborhood reliability and is negatively associated with variations in violence, when individual-level characteristics, measurement error, and prior violence are controlled. Associations of concentrated disadvantage and residential instability with violence are largely mediated by collective efficacy.",0 +https://doi.org/10.1186/s12888-015-0551-5,Prevalence and factors associated with Posttraumatic Stress Disorder seven years after the conflict in three districts in northern Uganda (The Wayo-Nero Study),"Research on the prevalence of Posttraumatic Stress Disorder (PTSD) is still limited in low income countries yet PTSD can be a public health problem in post conflict areas. In order to respond to the burden of PSTD in northern Uganda, an area that experienced civil strife for over two decades, we need accurate data on its (PTSD) prevalence and the associated risk factors to facilitate public mental health planning.This study employed a cross-sectional study design and data collection was undertaken in three districts in northern Uganda: Gulu, Amuru and Nwoya. Respondents were aged 18 years and above and were randomly selected at community level. A total of 2400 respondents were interviewed using a structured questionnaire in the three study districts. In this study, multivariate logistic regression was employed to analyze the associations of socio-demographic factors, trauma related variables and the outcome of PTSD.The prevalence of Posttraumatic Stress Disorder (PTSD) in the study population was 11.8 % (95 % CI: 10.5 %, 13.1 %) with a prevalence of 10.9 % (95 % CI: 9.3 %, 12.5 %) among female respondents and 13.4 % (95 % CI: 11.2 %, 15.7 %) among male respondents. Quite a number of factors were strongly associated with PTSD. Overall, a respondent had experienced 9 negative life events. In a multivariate logistic regression, the factors that were strongly associated with PTSD were: exposure to war trauma events, childhood trauma, negative life events, negative copying style and food insecurity. The findings also indicate no association between sex, age and PTSD.The prevalence rate of PTSD in the study communities is unacceptably high. Quite a number of factors were associated with PTSD. Effective public mental health services are needed that combine treatment (medical) psychological and social welfare programs especially at community level to address the high burden of PTSD. Longitudinal studies are also recommended to continuously assess the trends in PTSD in the study communities and remedial action taken.",0 +https://doi.org/10.1016/j.psychres.2011.03.002,"Association of FKBP5, COMT and CHRNA5 polymorphisms with PTSD among outpatients at risk for PTSD","To the Editor: Several genetic components for posttraumatic stress disorder (PTSD) have been identified, including biologic pathways involving the hypothalamic–pituitary–adrenocortical, locus coeruleus/noradrenergic, and the limbic systems (Broekman, et al., 2007; Koenen, 2007; Rauch and Drevets, 2009). In our IRB-approved study, lifetime PTSD was assessed among adult outpatients with chronic, non-malignant pain, a condition commonly associated with PTSD (McFarlane, 2010). We assessed PTSD with an instrument widely used in previous epidemiologic studies (Boscarino et al., 2010). We examined genetic markers using a multivariate design that assessed single nucleotide polymorphisms (SNPs) located within the FK506 binding protein-5 (FKBP5), catechol-O-methyltransferase (COMT), and cholinergic receptor nicotinic alpha3/alpha-5 (CHRNA3/CHRNA5) gene clusters. SNPs were selected using agnostic LD tagging with consideration of prior evidence and functional annotation (Erlich, et al., 2010). The COMT gene is associated with anxiety disorders, psychosis, depression, and other conditions involving catecholamine pathway regulation (Craddock, et al., 2006; Montag et al., 2008). This gene is also associated with PTSD (Kolassa et al., 2010). The FKBP5 gene regulates glucocorticoid receptor sensitivity, is functionally involved in HPA stress axis activity, and is associated with PTSD (Binder, 2009; Gillespie, et al., 2009). The CHRNA3/5 gene cluster, which encodes components of the nicotinic acetylcholine receptor, is associated with nicotine dependence, smoking, and other substance misuse (Erlich, et al., 2010). PTSD is also associated with cigarette smoking and substance use (Boscarino et al., 2006; Fu et al., 2007). Using trained interviewers and following informed consent, we completed diagnostic interviews with 502 subjects and collected DNA to determine if FKBP5, COMT, and CHRNA3/5 SNPs were associated with PTSD (mean age = 55, S.D. = 13.4; PTSD = 15%, 95% CI = 11.7–18.1%). Non-Caucasian patients were excluded from this analysis. Genotyping was performed on an Applied BioSystems 7500 real-time PCR platform, using TaqMan kits. Using multivariate logistic regressions that included demographic (age, gender, income, education, and marital status) and environmental (trauma exposure, childhood adversity, and neuroticism) variables, 3 of 9 SNPs examined were associated with PTSD (p<0.05), including one within each of the FKBP5 (rs9470080), COMT (rs4680), and CHRNA5 (rs16969968) genes. A count of risk alleles in these 3 loci was also associated with PTSD (OR = 1.65, 95% CI = 1.25–2.16, p = 0.000426), suggesting that those with 4 or more PTSD risk alleles had ~ 7 times greater risk of PTSD, compared to those with no risk alleles (1.65 × 4 = 6.6). We also included opioid dependence, reported pain, number of pain prescriptions, and ancestry (Northern European, Eastern European, and Sothern European/Other) in the model as a final analysis step, but this did not alter the results. Examination of risk-allele counts by PTSD status suggested that the “AA” genotype of the rs16969968 (CHRNA5) and rs4680 (COMT), and the “TT” genotype of rs9470080 (FKBP5) are more common among PTSD cases. Since our logistic regression detected a complex interaction between allele count × trauma exposure × childhood adversity × neuroticism (p = 0.029), we used Answer Tree Chi-square Automatic Interaction Detection to examine these effects (SPSS, Chicago, IL). This confirmed interactions with risk-allele count, indicating that those with higher risk-allele counts and exposure to higher trauma, higher childhood adversity, and higher neuroticism, were at much greater risk for PTSD. Conversely, those with no risk alleles appeared highly resilient to PTSD, regardless of environmental exposures. This is the first study to report that SNP markers rs16969968, rs9470080, and rs4680, were each individually associated with PTSD and that a cumulative allele model using these SNPs was associated with higher PTSD risk. FKBP5 polymorphisms are known to regulate the cortisol-binding affinity and nuclear translocation of the glucocorticoid receptor and polymorphisms at this locus have been associated with PTSD. COMT polymorphisms have been found to affect fear extinction and are thought to play a role in anxiety disorders and PTSD. The CHRNA gene has been associated with nicotine dependence and PTSD is associated with cigarette smoking and other substance misuse. Additional research is recommended to confirm these findings. The involvement of the CHRNA gene in PTSD, fear circuitry, and stress regulation is biologically plausible and worthy of further investigation.",0 +https://doi.org/10.1207/s15327752jpa8102_10,MMPI-2 As a Predictor of Change in PTSD Symptom Clusters: A Further Analysis of the Forbes et al. (2002) Data Set,"In this study, we reanalyzed the Forbes et al. (2002) data set to examine the Minnesota Multiphasic Personality Inventory (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) as a differential predictor of change across posttraumatic stress disorder symptom clusters following treatment in 141 Vietnam veterans. A series of partial correlation and linear multivariate regression analyses, controlling for initial symptom severity, identified several scales predictive of symptom change. None of the MMPI-2 scales, however, emerged as predictors of change in reexperiencing symptoms. Social alienation and marital distress were the most potent predictors for avoidance symptoms. Anger, alcohol use, and hypomania were the most potent predictors for the hyperarousal symptoms. Of the personality disorders, borderline personality was the strongest predictor of change in the avoidance and hyperarousal clusters. Further replication of the findings of this article and those reported by Forbes et al. (2002) is required.",0 +https://doi.org/10.1016/s0005-7967(01)00123-1,Posttraumatic stress disorder in the emergency room: exploration of a cognitive model,"Ehlers and Clark (Behav. Res. Ther., 38 (2000) 319) recently proposed a cognitive model of posttraumatic stress disorder (PTSD). In this study, we examined two facets of this model, appraisal and peritraumatic dissociation, in the context of a hospital emergency room. Fifty-one emergency room personnel completed questionnaires measuring posttraumatic stress symptoms, interpretations of traumatic events experienced while working in the emergency room and subsequent intrusive recollections, and peritraumatic dissociation. Twelve percent of participants met formal diagnostic criteria for PTSD, and 20% met PTSD symptom criteria. As predicted, both negative appraisals of the trauma and of intrusive recollections were associated with increased PTSD severity. Although peritraumatic dissociation did not correlate with overall PTSD symptom severity, it was associated with the reexperiencing symptom cluster. Discussion focuses on the factors associated with PTSD in emergency room professionals and implications for intervention.",0 +https://doi.org/10.4088/jcp.v65n0909,An Open-Label Study of Levetiracetam for the Treatment of Social Anxiety Disorder,"Social anxiety disorder is a disabling condition characterized by excessive fear and avoidance of social and performance situations. While a variety of effective pharmacotherapies exists, many patients do not fully respond to or tolerate available agents. Preclinical and early clinical experience with levetiracetam, a novel anticonvulsant agent, suggests that levetiracetam has anxiolytic properties and a favorable adverse event profile. Levetiracetam thus warrants systematic evaluation as a treatment option for anxiety disorders.Twenty adult outpatients who were recruited through advertisement and clinical referral and who met DSM-IV criteria for social anxiety disorder, generalized type, participated in this 8-week open-label, flexible-dose study from November 2002 to December 2003. Participants were required to have scores of >/= 50 on the Liebowitz Social Anxiety Scale (LSAS) and >/= 4 on the Clinical Global Impressions-Severity of Illness scale (CGI-S) at baseline. The presence of comorbid depression and anxiety disorders were permitted as long as social anxiety disorder was the primary disorder. Levetiracetam was initiated at 250 mg/day for the first week and flexibly titrated up to a maximum of 3000 mg/day (1500 mg b.i.d.). The primary outcome measure was change in the LSAS score at endpoint.There was a clinically significant 20.5-point decrease in LSAS scores in the intent-to-treat, last-observation-carried-forward analysis (t = 3.1; p <.01, N = 20). There were also significant reductions in CGI-S (p <.01) and Hamilton Rating Scale for Anxiety (p <.02) scores.This pilot study supports the safety and potential efficacy of a novel agent, levetiracetam, for the treatment of social anxiety disorder. Larger controlled trials are warranted to confirm these results.",0 +https://doi.org/10.1177/0886260514555866,Affective Dispositions and PTSD Symptom Clusters in Female Interpersonal Trauma Survivors,"Interpersonal trauma (IPT) against women can have dire psychological consequences including persistent maladaptive changes in the subjective experience of affect. Contemporary literature has firmly established heightened negative affect (NA) as a risk and maintenance factor for posttraumatic stress disorder (PTSD). However, the relationship between NA and PTSD symptoms is not well understood within IPT survivors, the majority of whom are female, as much of this research has focused on combat veterans. In addition, the connection between positive affect (PA) and PTSD symptoms has yet to be examined. With increased emphasis on ""negative alterations in cognitions and mood . . ."" as an independent symptom cluster of PTSD in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5), understanding the relationship between self-reported affectivity and the classic PTSD symptom clusters may be increasingly useful in differentiating symptom presentations of trauma-related psychopathology. The current study directly compared self-reported trait NA and PA with total severity and frequency cluster scores from the Clinician-Administered PTSD Scale (CAPS) in 54 female survivors of IPT who met criteria for PTSD. Results identify NA (but not PA) as a consistent predictor of total PTSD symptoms and, specifically, re-experiencing symptoms.",0 +https://doi.org/10.1016/j.jaac.2013.10.004,Transforming Trajectories for Traumatized Children,,0 +https://doi.org/10.1371/journal.pone.0119732,Posttraumatic Stress in Survivors 1 Month to 19 Years after an Airliner Emergency Landing,"Posttraumatic stress (PTS) is common in survivors from life-threatening events. Little is known, however, about the course of PTS after life threat in the absence of collateral stressors (e.g., bereavement, social stigma, property loss) and there is a scarcity of studies about PTS in the long term. This study assessed the short- and long-term course of PTS, and the influence of gender, education and age on the level and course of PTS, in survivors from a non-fatal airliner emergency landing caused by engine failure at an altitude of 1 km. There were 129 persons on board. A survey including the Impact of Event Scale was distributed to 106 subjects after 1 month, 4 months, 14 months, and 25 months, and to 95 subjects after 19 years (response rates 64-83%). There were initially high levels of PTS. The majority of changes in PTS occurred from 1 to 4 months after the event. There were small changes from 4 to 25 months but further decrease in PTS thereafter. Female gender was associated with higher levels of PTS whereas gender was unrelated to the slope of the short- and long-term trajectories. Higher education was related to a quicker recovery although not to initial or long-term PTS. Age was not associated with PTS. The present findings suggest that a life-threatening experience without collateral stressors may produce high levels of acute posttraumatic stress, yet with a benign prognosis. The findings further implicate that gender is unrelated to trajectories of recovery in the context of highly similar exposure and few collateral stressors.",0 +,[The typology of chronic posttraumatic stress disorder].,"Psychopathological chronic posttraumatic stress disorder (PTSD) was studied in relation to clinical peculiarities of depression included in PTSD structure. One hundred and sixty-five patients, 124 men and 41 women, aged 25-48 years, were examined in general outpatient clinics. PTSD duration was from 6 to 24 months. A stress was caused by situations related to combat events (60.6%), close person's death (25.4%), assault with physical and moral violence (8.2%) and rape (5.8%). With regard to depression structure and dominating affect, 4 PTSD types--anxious (36.6%), dysphoric (26.1%), apathic (20%) and somatoform (17.7%), were distinguished. Also, their significance for the formation of patient's personality features is emphasized. A role of depression in syndrome formation in chronic PTSD is suggested.",0 +https://doi.org/10.1016/s0140-6736(11)61180-x,Persistence of multiple illnesses in World Trade Center rescue and recovery workers: a cohort study,"More than 50,000 people participated in the rescue and recovery work that followed the Sept 11, 2001 (9/11) attacks on the World Trade Center (WTC). Multiple health problems in these workers were reported in the early years after the disaster. We report incidence and prevalence rates of physical and mental health disorders during the 9 years since the attacks, examine their associations with occupational exposures, and quantify physical and mental health comorbidities.In this longitudinal study of a large cohort of WTC rescue and recovery workers, we gathered data from 27,449 participants in the WTC Screening, Monitoring, and Treatment Program. The study population included police officers, firefighters, construction workers, and municipal workers. We used the Kaplan-Meier procedure to estimate cumulative and annual incidence of physical disorders (asthma, sinusitis, and gastro-oesophageal reflux disease), mental health disorders (depression, post-traumatic stress disorder [PTSD], and panic disorder), and spirometric abnormalities. Incidence rates were assessed also by level of exposure (days worked at the WTC site and exposure to the dust cloud).9-year cumulative incidence of asthma was 27·6% (number at risk: 7027), sinusitis 42·3% (5870), and gastro-oesophageal reflux disease 39·3% (5650). In police officers, cumulative incidence of depression was 7·0% (number at risk: 3648), PTSD 9·3% (3761), and panic disorder 8·4% (3780). In other rescue and recovery workers, cumulative incidence of depression was 27·5% (number at risk: 4200), PTSD 31·9% (4342), and panic disorder 21·2% (4953). 9-year cumulative incidence for spirometric abnormalities was 41·8% (number at risk: 5769); three-quarters of these abnormalities were low forced vital capacity. Incidence of most disorders was highest in workers with greatest WTC exposure. Extensive comorbidity was reported within and between physical and mental health disorders.9 years after the 9/11 WTC attacks, rescue and recovery workers continue to have a substantial burden of physical and mental health problems. These findings emphasise the need for continued monitoring and treatment of the WTC rescue and recovery population.Centers for Disease Control and Prevention and National Institute for Occupational Safety and Health.",0 +https://doi.org/10.1300/j229v04n04_06,Post-Traumatic Stress Disorder in Adults with Serious Mental Illness and Substance Abuse,"Post-Traumatic Stress Disorder continues to be under-diagnosed among individuals with severe mental illness and substance abuse. In a convenience sample of 64 patients with severe mental disorders being treated at an urban outpatient clinic, 24% met full criteria for PTSD based upon a comprehensive assessment protocol while only 3% were diagnosed with PTSD by clinicians in the medical record (Cochran's Q = 11.267, df 1, p <.001). In contrast, there was a high rate of diagnostic agreement for psychotic and affective illnesses as well as substance abuse. More attention needs to be given to systematically assessing PTSD among severely mentally ill and dually diagnosed individuals because even highly skilled diagnosticians miss the complex presentation of symptoms with which these patients present for treatment.",0 +https://doi.org/10.3389/fpsyt.2015.00170,Different Neural Mechanisms Underlie Deficits in Mental Flexibility in Post-Traumatic Stress Disorder Compared to Mild Traumatic Brain Injury,"Mental flexibility is a core executive function that underlies the ability to adapt to changing situations and respond to new information. Individuals with post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) complain of a number of executive function difficulties, one of which is mental inflexibility or an inability to switch between concepts. While the behavioral presentation of mental inflexibility is similar in those with PTSD or mTBI, we hypothesized that the differences in their etiology would manifest as differences in their underlying brain processing. The neural substrates of mental flexibility have been examined with a number of neuroimaging modalities. Functional magnetic resonance imaging has elucidated the brain regions involved, whereas electroencephalography has been applied to understand the timing of the brain activations. Magnetoencephalography, with its high temporal and spatial resolution, has more recently been used to delineate the spatiotemporal progression of brain processes involved in mental flexibility and has been applied to the study of clinical populations. In a number of separate studies, our group has compared the source localization and brain connectivity during a mental flexibility set-shifting task in a group of soldiers with PTSD and civilians with an acute mTBI. In this article, we review the results from these studies and integrate the data between groups to compare and contrast differences in behavioral, neural, and connectivity findings. We show that the different etiologies of PTSD and mTBI are expressed as distinct neural profiles for mental flexibility that differentiate the groups despite their similar clinical presentations.",0 +,Full Information Estimation in the Presence of Incomplete Data,,0 +https://doi.org/10.1097/01.nmd.0000198143.63662.fb,Do People Turn to Religion in Times of Stress?,"This study examined the effect of health-related stress on changes in religiousness in a sample of elderly, medically ill patients. Patients admitted to Duke University Medical Center (N = 745) were interviewed at baseline and 3-month follow-up. Increases in illness severity (from baseline to follow-up) were associated with decreases in both organizational and private religiousness at follow-up. Effect of illness severity on organizational religiousness was statistically mediated by changes in physical activity, while its effect on private religiousness remained significant after controlling for physical activity. These findings encourage further research investigating causal relationships between stress and religion, as well as identifying measures of religiousness that may capture this construct in the medically ill population.",0 +https://doi.org/10.1002/pon.3838,The mediating effect of self-efficacy in the relationship between social support and post-traumatic stress disorder symptoms among patients with central system tumors in China: a cross-sectional study,"Post-traumatic stress disorder (PTSD) is a disorder that can affect people following the experience of a traumatic event. Few studies have researched on PTSD symptoms of patients with central nervous system tumors. In this study, we aim to examine the association between social support and PTSD symptoms and to explore the mediating effect of self-efficacy in this relationship among patients with central nervous system tumors in China.Questionnaires consisting of the Post-traumatic Stress Checklist-Civilian Version, the Duke-UNC Functional Social Support Questionnaire, the General Self-Efficacy Scale, as well as demographic and clinical factors were used to collect information of patients with central nervous system tumors in Liaoning Province, China. A total of 222 patients (effective response rate of 66.1%) became our subjects. Hierarchical linear regression analyses were performed to explore the association between social support and PTSD symptoms and the mediating effect of self-efficacy.After adjusting for demographic characteristics and tumor type, social support was negatively associated with the total score of PTSD symptoms (β = -0.342, P < 0.01). Social support explained 8.8% of the variance in PTSD symptoms. Self-efficacy was found to partially mediate the relationship between social support and PTSD symptoms.Self-efficacy partially mediated the relationship between social support and PTSD symptoms. Interventions focusing on both social support and self-efficacy might be more useful than interventions only targeting either of them.",0 +https://doi.org/10.1007/s11136-012-0280-x,"Longitudinal analysis of the relationship between PTSD symptom clusters, cigarette use, and physical health-related quality of life","Purpose: Posttraumatic stress disorder (PTSD) symptoms, particularly numbing and hyperarousal symptoms, are related to poor physical health-related quality of life (HRQoL). Tobacco dependence is also associated with poor HRQoL, and individuals with PTSD may smoke at higher rates than the general population. Our study aimed to examine the impact of quitting smoking and changes in PTSD symptoms over time on changes in physical HRQoL. Methods: The study used archival data from enrollees (N = 943) in a smoking cessation clinical trial for veterans with PTSD (VA Cooperative study #519). Results: Two of the physical HRQoL domains were sensitive to changes in PTSD symptoms over time: General Health and Vitality. Conclusions: Our findings suggest that particular physical HRQoL domains may be subject to improvement if PTSD symptoms decrease over time. © 2012 Springer Science+Business Media Dordrecht.",0 +https://doi.org/10.1891/0886-6708.25.1.62,Lifetime Victimization and Psychological Distress: Cluster Profiles of Out of Treatment Drug-Involved Women,K-means clustering techniques were used to identify four cluster profi les characterized by unique patterns of victimization and psychological distress and further differentiated by distinct patterns of risk and protection across multiple life domains among a sample of 149 crack-using women. Results of this study suggest that important differences exist in patterns of victimization and psychological distress among drug-involved women. Identifi cation of this variation can be used to tailor intervention strategies to the particular needs of different subgroups within the population of crack-using women. © 2010 Springer Publishing Company.,0 +https://doi.org/10.1016/j.biopsych.2014.06.015,Elevated Risk for Autoimmune Disorders in Iraq and Afghanistan Veterans with Posttraumatic Stress Disorder,"Posttraumatic stress disorder (PTSD) is associated with endocrine and immune abnormalities that could increase risk for autoimmune disorders. However, little is known about the risk for autoimmune disorders among individuals with PTSD.We conducted a retrospective cohort study of 666,269 Iraq and Afghanistan veterans under age 55 who were enrolled in the Department of Veterans Affairs health care system between October 7, 2001, and March 31, 2011. Generalized linear models were used to examine if PTSD, other psychiatric disorders, and military sexual trauma exposure increased risk for autoimmune disorders, including thyroiditis, inflammatory bowel disease, rheumatoid arthritis, multiple sclerosis, and lupus erythematosus, adjusting for age, gender, race, and primary care visits.PTSD was diagnosed in 203,766 veterans (30.6%), and psychiatric disorders other than PTSD were diagnosed in an additional 129,704 veterans (19.5%). Veterans diagnosed with PTSD had significantly higher adjusted relative risk (ARR) for diagnosis with any of the autoimmune disorders alone or in combination compared with veterans with no psychiatric diagnoses (ARR = 2.00; 95% confidence interval, 1.91-2.09) and compared with veterans diagnosed with psychiatric disorders other than PTSD (ARR = 1.51; 95% confidence interval, 1.43-1.59; p < .001). The magnitude of the PTSD-related increase in risk for autoimmune disorders was similar in women and men, and military sexual trauma exposure was independently associated with increased risk in both women and men.Trauma exposure and PTSD may increase risk for autoimmune disorders. Altered immune function, lifestyle factors, or shared etiology may underlie this association.",0 +https://doi.org/10.1590/s1516-44462006005000066,"Nosological profile and prevalence of common mental disorders of patients seen at the Family Health Program (FHP) units in Petrópolis, Rio de Janeiro","OBJECTIVES: This study aims to detect the prevalence of common mental disorders among patients seen by doctors at family health program units in Petrópolis-RJ, and to establish their nosological profile. METHOD: The population of the study included all 18 to 65-year-old patient who attended any family health program units included in the study during a 30-day period, between August and December 2002 (n = 714). The prevalence of common mental disorders was assessed using the General Health Questionnaire, 12 item version. In order to establish the nosological profile, the Composite International Diagnostic Interview was administered to all common mental disorders positive patients who accepted to return (n = 215). RESULTS: At the cut-off point of 2/3 the common mental disorders prevalence was 56% and for 4/5, it was 33%. The most frequent nosological categories found among common mental disorders positive patients were depression and anxiety categories along with posttraumatic stress disorder, somatoform pain disorder and dissociative disorders. There was a high frequency of comorbidity, especially between anxiety, depression, somatoform and dissociative disorders. CONCLUSIONS: The common mental disorders prevalence and the nosological profile found in FHP were similar to those of other primary care studies in Brazil, but some disorders (posttraumatic stress disorder, somatoform pain disorder and dissociative disorders) that had not been previously studied in this context were also very frequent. The high common mental disorders prevalence found reinforces the urgent need for systematic inclusion of this level of care in mental health assistance planning.",0 +https://doi.org/10.1002/mpr.1464,Establishing a methodology to examine the effects of war-zone PTSD on the family: the family foundations study,"Military deployment may adversely affect not only returning veterans, but their families, as well. As a result, researchers have increasingly focused on identifying risk and protective factors for successful family adaptation to war-zone deployment, re-integration of the returning veteran, and the longer-term psychosocial consequences of deployment experienced by some veterans and families. Post-traumatic stress disorder (PTSD) among returning veterans may pose particular challenges to military and military veteran families; however, questions remain regarding the impact of the course of veteran PTSD and other potential moderating factors on family adaptation to military deployment. The Family Foundations Study builds upon an established longitudinal cohort of Army soldiers (i.e. the Neurocognition Deployment Health Study) to help address remaining knowledge gaps. This report describes the conceptual framework and key gaps in knowledge that guided the study design, methodological challenges and special considerations in conducting military family research, and how these gaps, challenges, and special considerations are addressed by the study.",0 +,Predictors of outcome following a short multimodal rehabilitation program for patients with whiplash associated disorders.,"Patients with whiplash associated disorders (WAD) may present with physical and psychological symptoms which persist long after the initial onset of pain. Several studies have shown that therapeutic exercise for motor and sensorimotor control combined with manual therapy in a multimodal rehabilitation (MMR) program is effective at improving pain and disability in patients with neck disorders. To date, no studies have investigated which self-reported physical or psychological symptoms are predictive of response to this MMR program.To determine which baseline features can predict outcome following a 3-week MMR program in patients with WAD.Observational prospective cohort study.Outpatient rehabilitation clinic.Thirty-seven patients aged >18 years with a diagnosis of WAD grade II or III.The MMR program included manual therapy, motor control and sensorimotor control training according to the clinical impairments of each patient. Patients were assessed before and after treatment for their physical and psychological symptoms by means of self-reported questionnaires. Regression models were estimated with pain intensity, disability and post-traumatic stress symptoms (PTSS) as outcomes.After treatment, patients exhibited significant improvements in all evaluated outcomes (all P<0.01). Regression models accounting for 35% and 36% of the variance in pain intensity outcomes included average pain intensity over the previous week and pain catastrophizing as significant predictors. Disability and pain catastrophizing were predictors of changes in disability following the MMR program explaining 49% of the variance in the model. Furthermore, higher PTSS at baseline was a significant predictor of PTSS after treatment, explaining 55% of the variance in the model.Improved outcomes on pain intensity, disability and PTSS following a MMR program could be partially predicted based on the patient's initial presentation.This knowledge may assist clinicians in predicting outcome following a MMR program inclusive of specific exercise therapy and manual therapy in patients with WAD.",0 +,Managing anger and aggression in patients with posttraumatic stress disorder.,"Posttraumatic stress disorder was categorized as a clinical entity in 1980 in response to assertions by trauma survivors (particularly Vietnam veterans) and their clinicians that existing diagnostic categories failed to adequately describe their symptoms. The diagnostic features of the current DSM-IV diagnosis have been expanded, and the concept of the disorder is still evolving. Posttraumatic stress disorder rarely occurs in ""pure"" form, and individuals suffering from the disorder commonly meet criteria for Axis I and Axis II disorders. Research is now emerging that supports the prevalence of aggression in posttraumatic stress disorder. Treatment approaches vary, but pharmacotherapy aimed at targeting individual symptoms or clusters can promote mood stabilization. This article discusses the evolving concept of posttraumatic stress disorder as a clinical entity, the association of anger and aggression with the disorder, and the psychopharmacologic approaches to treatment.",0 +https://doi.org/10.1002/da.22012,The Effect of Draft DSM-V Criteria on Posttraumatic Stress Disorder Prevalence,"This study was designed to examine the concordance of proposed DSM-V posttraumatic stress disorder (PTSD) criteria with DSM-IV classification rules and examine the impact of the proposed DSM-V PTSD criteria on prevalence.The sample (N = 185) included participants who were recruited for studies focused on trauma and health conducted at an academic medical center and VA medical center in the southeastern United States. The prevalence and concordance between DSM-IV and the proposed DSM-V classifications were calculated based on results from structured clinical interviews. Prevalence rates and diagnostic efficiency indices including sensitivity, specificity, area under the curve (AUC), and Kappa were calculated for each of the possible ways to define DSM-V PTSD.Ninety-five percent of the sample reported an event that met both DSM-IV PTSD Criterion A1 and A2, but only 89% reported a trauma that met Criterion A on DSM-V. Results examining concordance between DSM-IV and DSM-V algorithms indicated that several of the algorithms had AUCs above 0.90. The requirement of two symptoms from both Clusters D and E provided strong concordance to DSM-IV (AUC = 0.93; Kappa = 0.86) and a greater balance between sensitivity and specificity than requiring three symptoms in both Clusters D and E.Despite several significant changes to the diagnostic criteria for PTSD for DSM-V, several possible classification rules provided good concordance with DSM-IV. The magnitude of the impact of DSM-V decision rules on prevalence will be largely affected by the DSM-IV PTSD base rate in the population of interest.",0 +https://doi.org/10.1007/s004840050071,Circulatory response to hyperthermia during acute normovolaemic haemodilution,"Cats anaesthetized with a mixture of chloralose and urethane were exposed to heat stress in two groups. In the first group (n=10) of control animals, the effect of heat stress on haemodynamic variables was recorded at control haematocrit (HCT) of 42.0±1.0%. In a second group, the effect of heat stress was studied after induction of acute normovolaemic haemodilution (HCT of 13.0±1.0%). Haemodilution was induced to a maximum of 60% replacement of blood with dextran (mol.wt. 150000). Heat stress was induced by surface heating and core body temperature was raised from 37° C to 42° C. The effect of heat stress and haemodilution on various haemodynamic variables, viz. left ventricular pressure (LVP), left ventricular contractility (LVdP/dtmax), heart rate (HR), cardiac output (CO), arterial blood pressure (ABP), right atrial pressure (RAP), and arterial blood PO2, PCO2 and pH was examined. Haemodilution produced significant (P<0.05) increases in HR and CO but there were no significant (P>0.05) changes in ABP, RAP, LVdP/dtmax and total peripherial resistance (TPR). Hyperthermia caused a significant fall (P<0.05) in TPR. However, the percentage fall in TPR was higher in the control group. On exposure to heat stress, there were significant (P<0.05I increases in HR and CO in both the groups; however, HR and CO values were significantly (P<0.05) higher in the haemodiluted group compared to the control. The latter findings could be due either to the higher basal values of these variables with the fall in HCT or to inefficient cardiovascular regulatory mechanisms. The lack of efficient regulatory control under such severe stress conditions makes the cardiovascular system of anaemic animals more vulnerable to heat stress. In conclusion, the results of the present study showed deleterious effects of heat stress in both the groups. The higher values of HR and CO in the haemodiluted group may be responsible for circulatory failure at low HCT values, indicating a higher risk in the haemodiluted group as compared to the control group. © ISB 1998.",0 +https://doi.org/10.1016/0005-7967(94)00075-u,The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories,"The psychometric properties of the Depression Anxiety Stress Scales (DASS) were evaluated in a normal sample of N = 717 who were also administered the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The DASS was shown to possess satisfactory psychometric properties, and the factor structure was substantiated both by exploratory and confirmatory factor analysis. In comparison to the BDI and BAI, the DASS scales showed greater separation in factor loadings. The DASS Anxiety scale correlated 0.81 with the BAI, and the DASS Depression scale correlated 0.74 with the BDI. Factor analyses suggested that the BDI differs from the DASS Depression scale primarily in that the BDI includes items such as weight loss, insomnia, somatic preoccupation and irritability, which fail to discriminate between depression and other affective states. The factor structure of the combined BDI and BAI items was virtually identical to that reported by Beck for a sample of diagnosed depressed and anxious patients, supporting the view that these clinical states are more severe expressions of the same states that may be discerned in normals. Implications of the results for the conceptualisation of depression, anxiety and tension/stress are considered, and the utility of the DASS scales in discriminating between these constructs is discussed.",0 +https://doi.org/10.1016/j.genhosppsych.2014.07.007,Cross-sectional psychosocial evaluation of heart transplantation candidates,"Heart transplantation (HT) is a potentially life-saving procedure for people with terminal cardiac disease. In the last decades researchers of HT programs have attempted to identify the existence of psychosocial factors that might influence the clinical outcome before and after the transplantation. The main objective of this study was to describe epidemiological, psychiatric and psychological features of a large sample of HT candidates.Cross-sectional, observational and descriptive study. A psychiatric and psychological assessment of 125 adult patients was performed at the moment of being included in the HT waiting list, between 2006 and 2012. The assessment consisted in: Clinical, epidemiological and psychosocial form; Spanish version of Hospital Anxiety and Depression Scale; Structured Clinical Interview for DSM-IV axis I disorders; Coping questionnaire (COPE); Five Factors Inventory Revised (NEO-FFI-R); Apgar-Family questionnaire and the Multidimensional Health Locus of Control scale.Axis I diagnoses were present in a 30.4% of patients. COPE showed that this group of patients used most frequently engagement strategies. Personality factors profile of NEO-FFI-R were similar to general population and locus of control scale also presented similar scores compared with other chronic diagnostic groups. Statistically significant associations were found between personality factors and COPE scales/dimensions and psychopathology, mainly neuroticism and disengagement.This is the first study to assess systematically psychosocial factors in a large sample of HT candidates. We have found that around one third of these patients have a psychiatric disorder. Neuroticism and disengagement coping styles can serve as markers of emotional distress.",0 +https://doi.org/10.1002/pon.3577,Identification of posttraumatic growth trajectories in the first year after breast cancer surgery,"Background Empirical studies of the relationship between posttraumatic growth (PTG) and adjustment outcomes reveal a fairly inconclusive picture. We argue that the inconsistent findings are likely due to the heterogeneity of the PTG experience over time. In this regard, we predicted that individuals with different PTG trajectories vary in the level of adjustment and the correlational patterns between PTG and adjustment. Methods Participants were 124 Taiwanese women who underwent surgery for breast cancer. Measures of PTG and adjustment variables, including positive affect, negative affect, mental and physical quality of life, anxiety, and depression, were assessed at 1 day and 3, 6, and 12 months after surgery. A group-based trajectory model was used to identify subpopulations of individuals who shared homogenous growth patterns. Then, we determined whether the trajectory predicted adjustment at 12 months after surgery. The correlations between PTG and adjustment outcomes were computed in each subpopulation across every time point. Results The patients were categorized into the following four groups, which showed very different patterns of PTG change over the first year after breast cancer surgery: stable high (27.4%), high decreasing (39.4%), low increasing (16.9%), and low decreasing (16.9%). Differences in the level of adjustment at 12 months and the patterns of the correlations across time were found among these latent subgroups Conclusions This study was the first longitudinal examination of PTG trajectories and their different levels of adjustment. The findings support our argument that identifying distinct PTG trajectories can better determine the nature of the relationship between PTG and adjustment. Copyright © 2014 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1002/nur.10060,Patterns of mental distress following the violent death of a child and predictors of change over time,"We observed 173 parents bereaved by the violent death of an adolescent or young adult child. Data were collected 4, 12, 24, and 60 months postdeath. Using latent growth modeling, we examined how initial levels of mental distress and the rate of change over time are influenced by nine predictors: parents' gender, self-esteem, three coping strategies, perceived social support, negative life stressors, posttraumatic stress disorder (PTSD) symptoms, and an intervention offered in the early bereavement period. The results support a multiple-risk and -protective factor model of loss accommodation. Parents' gender, self-esteem, and affective and repressive coping were predictive of changes in mental distress over time. Although parents' initial levels of PTSD were the best predictor of baseline mental distress, they did not predict reductions in distress 5 years later. Theoretical, empirical, and clinical implications are discussed.",0 +https://doi.org/10.1016/j.jad.2015.01.043,PTSD symptom presentation across the deployment cycle,"Symptom-level variation in posttraumatic stress disorder (PTSD) has not yet been examined in the early post-deployment phase, but may be meaningful etiologically, prognostically, and clinically.Using latent class analysis (LCA), we examined PTSD symptom heterogeneity in a cohort of participants from the Marine Resiliency Study (MRS), a longitudinal study of combat Marines deployed to Iraq and Afghanistan (N=892). Typologies of PTSD symptom presentation were examined at one month pre-deployment and again one, five, and eight months post-deployment.Heterogeneity in PTSD symptom presentation was evident at each assessment point, and the degree of symptom heterogeneity (i.e., the number of classes identified) differed by time point. Symptom patterns stabilized over time from notable symptom fluctuations during the early post-deployment period to high, medium, and low symptom severity by eight months post-deployment. Hypervigilance and exaggerated startle were frequently endorsed by participants in the initial month post-deployment. Flashbacks, amnesia, and foreshortened future were infrequently endorsed. Greater combat exposure, lifespan trauma, and avoidant coping generally predicted worse outcomes.Data were self-report and may have limited generalizability due to our lack of women and inclusion of only combat Marines. Attrition and re-ranging of data resulted in significant missing data and affected the representativeness of the sample.Symptom-level variability is highest in the month following deployment and then stabilizes over time. Should post-deployment assessments occur too soon, they may capture common and transient early post-deployment reactions, particularly anxious arousal.",0 +https://doi.org/10.1016/j.apmr.2015.07.006,Longitudinal Study of Headache Trajectories in the Year After Mild Traumatic Brain Injury: Relation to Posttraumatic Stress Disorder Symptoms,"To examine headache trajectories among persons with mild traumatic brain injury (MTBI) in the year after injury and the relation of headache trajectory to posttraumatic stress disorder (PTSD) at 1 year postinjury.Prospective, longitudinal study.Participants were recruited through a university medical center and participated in follow-up assessments by telephone.Prospectively enrolled individuals (N=212) within 1 week of MTBI who were hospitalized for observation or other system injuries. Participants were assessed at baseline and 3, 6, and 12 months postinjury.Not applicable.Participants rated average headache pain intensity using the 0 to 10 numerical rating scale at each assessment period. The PTSD Checklist-Civilian Version was completed at 12 months postinjury.Latent class growth analysis produced a 4-trajectory group model, with groups labeled resolved, worsening, improving, and chronic. Multivariate regression modeling revealed that younger age and premorbid headache correlated with membership in the worse trajectory groups (worsening and chronic; P<.001). Univariate regression revealed a significant association between PTSD and membership in the worse trajectory groups (P<.001).Headache is common in the year after MTBI, with younger people, persons who previously had headaches, and persons with PTSD more likely to report chronic or worsening headache. Further research is needed to examine whether PTSD symptoms exacerbate headaches or whether problematic headache symptoms exacerbate PTSD.",0 +https://doi.org/10.1016/j.adolescence.2010.06.009,Cognitive behaviour therapy for adolescent offenders with mental health problems in custody,"Many studies have identified high levels of mental health problems among adolescents in custody and there is increasing evidence that mental health problems in this population are associated with further offending and mental health problems into adulthood. Despite recent improvements in mental health provision within custodial settings there is little evidence of structured interventions being offered or of their effectiveness being evaluated. A cognitively based intervention was developed and offered to adolescents with a variety of mental health problems in different secure settings, and the outcomes compared with a control group. Although this small-scale study did not identify significant differences in outcomes for the two groups, both recruitment and retention in therapy were good, and potential candidates were not excluded on the basis of learning difficulties or co-morbidity. The study demonstrated the viability of a delivering cognitively based intervention for common mental health problems within secure settings.",0 +https://doi.org/10.1080/10705511.2014.937322,Evaluation of a Bayesian Approach to Estimating Nonlinear Mixed-Effects Mixture Models,"The growth mixture model has become increasingly popular, given the willingness to acknowledge developmental heterogeneity in populations. Typically, linear growth mixture models, based on polynomials or piecewise functions, are used in substantive applications and evaluated quantitatively through simulation. Growth mixture models that follow inherently nonlinear trajectories, referred to as nonlinear mixed-effects mixture models, have received comparatively little attention—likely due to estimation complexity. Previous work on the estimation of these models has involved multistep routines (Kelley, 2008), maximum likelihood estimation (MLE) via the E-M algorithm (Harring, 2005, 2012), Taylor series expansion and MLE within the structural equation modeling framework (Grimm, Ram, & Estabrook, 2010), and MLE by adaptive Gauss–Hermite quadrature (Codd & Cudeck, 2014). This article proposes and evaluates the use of Bayesian estimation with OpenBUGS (Lunn, Spiegelhalter, Thomas, & Best, 2009), a free program, a...",0 +https://doi.org/10.4324/9780203754399-14,Autism and Trauma: Autistic Post-traumatic Developmental Disorder,"(from the chapter) The author notes that autistic patients fall into natural sub-groupings with shared characteristics. The author's clinical attempts to reach these inaccessible children has led to conceptualizing sub-groupings on the basis of symptoms, which includes meta-psychological factors based on the author's experience of the way the children present. This chapter proposes an Autistic Post-Traumatic Developmental Disorder (APTDD) sub-group, drawing attention to a similarity between the nature of the symptomatology in a small sub-group of children with autism and the symptomatology of posttraumatic stress disorder (PTSD) in children who are not autistic. The author suggests that it is the impact of trauma in infancy which precipitates in an autistic withdrawal, leading to developmental delay, and thus proposes the term APTDD to describe the condition. Links are made to the work of neurobiologists, and clinical vignettes are given as illustrations, including those of 2 male children. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1016/j.jadohealth.2009.11.212,"Poly-Victimization and Risk of Posttraumatic, Depressive, and Substance Use Disorders and Involvement in Delinquency in a National Sample of Adolescents","

Abstract

Purpose

Adolescents exposed to multiple forms of psychological trauma (""poly-victimization,"" Finkelhor et al. Child Abuse Negl 2007;31:7–26) may be at high risk for psychiatric and behavioral problems. This study empirically identifies trauma profiles in a national sample of adolescents to ascertain correlates of poly-victimization.

Methods

Latent Class analyses and logistic regression analyses were used with data from the National Survey of Adolescents to identify trauma profiles and each profile's risk of posttraumatic stress disorder, major depressive disorder, substance use disorders, and delinquency involvement and deviant peer group relationships. Poly-victimization classes were also compared to classes with trauma exposure of lesser complexity.

Results

Six mutually exclusive trauma profiles (latent classes) were identified. Four classes were characterized by high likelihood of poly-victimization, including abuse victims (8%), physical assault victims (9%), and community violence victims (15.5%). Poly-victimization class members, especially abuse and assault victims, were more likely than do youth traumatized by witnessing violence or exposure to disaster/accident trauma to have psychiatric diagnosis and (independent of psychiatric diagnoses or demographics) to be involved in delinquency with delinquent peers.

Conclusions

Poly-victimization is prevalent among adolescents and places youth at high risk for psychiatric impairment and for delinquency. Moreover, poly-victimized youths' risk of delinquency cannot be fully accounted for by posttraumatic stress disorder, depression, or substance use problems, suggesting that adolescent healthcare providers should consider poly-victimization as a risk for behavioral and legal problems even when PTSD, depression, or addiction symptoms are not clinically significant.",0 +https://doi.org/10.1016/j.biopsycho.2014.07.011,Aberrant EEG functional connectivity and EEG power spectra in resting state post-traumatic stress disorder: A sLORETA study,"The aim of the present study was to explore the modifications of EEG power spectra and EEG connectivity of resting state (RS) condition in patients with post-traumatic stress disorder (PTSD). Seventeen patients and seventeen healthy subjects matched for age and gender were enrolled. EEG was recorded during 5min of RS. EEG analysis was conducted by means of the standardized Low Resolution Electric Tomography software (sLORETA). In power spectra analysis PTSD patients showed a widespread increase of theta activity (4.5-7.5Hz) in parietal lobes (Brodmann Area, BA 7, 4, 5, 40) and in frontal lobes (BA 6). In the connectivity analysis PTSD patients also showed increase of alpha connectivity (8-12.5Hz) between the cortical areas explored by Pz-P4 electrode. Our results could reflect the alteration of memory systems and emotional processing consistently altered in PTSD patients.",0 +https://doi.org/10.1037/a0024457,"Predeployment, deployment, and postdeployment risk factors for posttraumatic stress symptomatology in female and male OEF/OIF veterans.","[Correction Notice: An erratum for this article was reported in Vol 120(4) of Journal of Abnormal Psychology (see record 2011-19996-001). In the article there was an error in the affiliation bylines for Rani Elwy and Susan Eisen. Their affiliations should have been listed as Edith Nourse Rogers Memorial Veterans Hospital and Department of Health Policy and Management, Boston University School of Public Health.] Prior research on risk factors for posttraumatic stress symptomatology (PTSS) in war-exposed Veterans has revealed both direct and indirect mechanisms of risk that span predeployment, deployment, and postdeployment timeframes. The aims of the present study were to identify the mechanisms through which previously documented risk factors contribute to PTSS in a national sample of 579 female and male Veterans deployed to Afghanistan for Operation Enduring Freedom (OEF) or to Iraq for Operation Iraqi Freedom (OIF), as well as to examine the extent to which results mirror associations observed among Vietnam Veterans (King, King, Foy, Keane, & Fairbank, 1999). Consistent with conservation of resources (COR) theory (Hobfoll, 1989, 2001), findings indicated that PTSS is accounted for by multiple chains of risk, many originating in predeployment experiences that place Veterans at risk for additional stress exposure, and foretell difficulty accessing resources in the face of subsequent stressors. Importantly, the majority of previously documented mechanisms were replicated in this study, suggesting key pathways through which risk factors may contribute to PTSS across different Veteran populations. Results also revealed a number of novel risk mechanisms for OEF/OIF female Veterans, particularly with respect to the role of deployment family relationships in risk for PTSS.",0 +https://doi.org/10.1136/bmjopen-2015-009427,"Protocol for a prospective, longitudinal, cohort study of postconcussive symptoms in children: the Take C.A.Re (Concussion Assessment and Recovery Research) study","A substantial minority of children who sustain a concussion suffer prolonged postconcussive symptoms. These symptoms can persist for more than 1 month postinjury and include physical, cognitive, behavioural and emotional changes. Those affected can develop significant disability, diminishing their quality of life. The precise prevalence of postconcussive symptoms following child concussion is unclear, with heterogeneous and at times conflicting results published regarding factors that predict children at risk for developing long-lasting postconcussive symptoms. The aim of the Take C.A.Re (Concussion Assessment and Recovery Research) study is to provide an in-depth multidimensional description of the postconcussive recovery trajectories from a physical, neurocognitive and psychosocial perspective in the 3 months following concussion, with a focus on the early postconcussive period, and identification of factors associated with prolonged recovery.Take C.A.Re is a prospective, longitudinal study at a tertiary children's hospital, recruiting and assessing patients aged 5-<18 years who present to the emergency department with a concussion and following them at 1-4 days, 2 weeks, 1 month and 3 months postinjury. Multiple domains are assessed: postconcussive symptoms, balance and coordination, neurocognition, behaviour, quality of life, fatigue, post-traumatic stress symptoms, parental distress and family burden. 'Delayed recovery' is operationalised as the presence of ≥ 3 symptoms on the Post Concussive Symptoms Inventory rated as worse compared with baseline. Main analyses comprise analysis of variance (recovery trajectories, delayed vs normal recovery groups) and regression analyses of predictors of recovery (preinjury, acute and family factors).Ethical approval has been obtained through the Royal Children's Hospital Melbourne Human Research Ethics Committee (33122). We aim to disseminate the findings through international conferences, international peer-reviewed journals and social media.ACTRN12615000316505.",0 +https://doi.org/10.1016/j.socscimed.2005.11.059,Before and after the 1999 Chi-Chi earthquake: Traumatic events and depressive symptoms in an older population,"Natural disasters, such as earthquakes, can have deleterious consequences for physical and psychological health. In this study, we investigate variability in resilience to depressive symptoms in the aftermath of a massive earthquake that struck Taiwan in 1999. We analyze data on 1160 older individuals from a national, longitudinal survey with interviews before and after the earthquake. This survey contains extensive information on physical and cognitive function, depressive symptoms, socio-demographic characteristics and earthquake-related exposure and experiences. We estimate regression models to identify risk factors associated with the presence of depressive symptoms after the disaster, controlling for health status and the presence of depressive symptoms beforehand. We pay special attention to how socio-demographic factors moderate the psychological impact of the earthquake. Results indicate that persons of low socioeconomic status (SES), socially isolated individuals, and women reported higher levels of depressive symptoms than their respective counterparts, as did persons who experienced damage to their homes. The psychological effects of damage were strongest among those aged 54-70. The findings suggest that people who experience damage to their home during a disaster are at risk of experiencing depressive symptoms, with the elderly being more resilient than the near-elderly.",0 +https://doi.org/10.1002/jts.21904,Anger: Cause or Consequence of Posttraumatic Stress? A Prospective Study of Dutch Soldiers,"Many studies have shown that individuals with posttraumatic stress disorder (PTSD) experience more anger over time and across situations (i.e., trait anger) than trauma-exposed individuals without PTSD. There is a lack of prospective research, however, that considers anger levels before trauma exposure. The aim of this study was to prospectively assess the relationship between trait anger and PTSD symptoms, with several known risk factors, including baseline symptoms, neuroticism, and stressor severity in the model. Participants were 249 Dutch soldiers tested approximately 2 months before and approximately 2 months and 9 months after their deployment to Afghanistan. Trait anger and PTSD symptom severity were measured at all assessments. Structural equation modeling including cross-lagged effects showed that higher trait anger before deployment predicted higher PTSD symptoms 2 months after deployment (β = .36), with stressor severity and baseline symptoms in the model, but not with neuroticism in the model. Trait anger at 2 months postdeployment did not predict PTSD symptom severity at 9 months, and PTSD symptom severity 2 months postdeployment did not predict subsequent trait anger scores. Findings suggest that trait anger may be a pretrauma vulnerability factor for PTSD symptoms, but does not add variance beyond the effect of neuroticism.",0 +https://doi.org/10.1016/j.brat.2008.10.009,Psychosocial predictors of chronic Post-Traumatic Stress Disorder in Sri Lankan tsunami survivors,"This study aimed to determine whether psychological factors associated with Post-Traumatic Stress Disorder (PTSD) identified in Western samples generalize to low Social-Economical-Status (SES) populations in an underdeveloped Asian country. The study included 113 survivors of the 2004-tsunami on the south coast of Sri Lanka, recruited from 4 preschools and 10 villages for displaced persons. With logistic regressions the relations between interview-based PTSD diagnosis and psychological factors were assessed, controlling for putative confounders. Fifteen months post-trauma the prevalence of PTSD was 52.2%. Multivariate analyses indicated that negative interpretation of tsunami-memories was significantly (P<0.005) related to PTSD. Of the putative confounders, gender and (non-replaced) lost work equipment were related to current PTSD (P<0.05). The results indicate that the relation between negative interpretation of trauma memories and PTSD is quite universal, suggesting that interventions focusing on this factor may be important in treatment of tsunami survivors who are suffering from chronic PTSD.",0 +https://doi.org/10.1176/appi.ajp.162.12.2302,A Prospective Study of Posttraumatic Stress and Depressive Reactions Among Treated and Untreated Adolescents 5 Years After a Catastrophic Disaster,"This study evaluated 1) the natural course of posttraumatic stress and depressive reactions among untreated adolescents from two cities in an earthquake zone (Gumri and Spitak) and one at the periphery (Yerevan) who were differentially exposed to the 1988 Spitak earthquake in Armenia and 2) the effectiveness of brief trauma/grief-focused psychotherapy among adolescents from Gumri.One hundred twenty-five adolescents were assessed with the Child Posttraumatic Stress Disorder Reaction Index (CPTSD-RI) and the Depression Self-Rating Scale (DSRS) at 1.5 and 5 years postearthquake. At 1.5 years, trauma/grief-focused group and individual psychotherapy was provided over 6 weeks to a group of students in Gumri.CPTSD-RI scores among untreated adolescents from Gumri and Spitak subsided significantly but mildly at follow-up, with scores from Spitak, the city at the epicenter, remaining above the cutoff for a diagnosis of PTSD. DSRS scores increased mildly in both earthquake cities but only significantly in Gumri. Among treated adolescents in Gumri, improvement in CPTSD-RI scores was three times that of the untreated Gumri comparison group. The treated group also tended to improve on their DSRS scores, whereas these scores worsened significantly among untreated subjects.Untreated adolescents exposed to severe trauma are at risk for chronic PTSD and depressive symptoms. Brief trauma/grief-focused psychotherapy is effective in reducing PTSD symptoms and halting the progression of depression. This study supports the implementation of mental health intervention programs in schools after disasters to reduce trauma-related psychopathology.",0 +https://doi.org/10.1001/jamapsychiatry.2013.3080,Association Between Traumatic Brain Injury and Risk of Posttraumatic Stress Disorder in Active-Duty Marines,"Whether traumatic brain injury (TBI) is a risk factor for posttraumatic stress disorder (PTSD) has been difficult to determine because of the prevalence of comorbid conditions, overlapping symptoms, and cross-sectional samples.To examine the extent to which self-reported predeployment and deployment-related TBI confers increased risk of PTSD when accounting for combat intensity and predeployment mental health symptoms.As part of the prospective, longitudinal Marine Resiliency Study (June 2008 to May 2012), structured clinical interviews and self-report assessments were administered approximately 1 month before a 7-month deployment to Iraq or Afghanistan and again 3 to 6 months after deployment. The study was conducted at training areas on a Marine Corps base in southern California or at Veterans Affairs San Diego Medical Center. Participants for the final analytic sample were 1648 active-duty Marine and Navy servicemen who completed predeployment and postdeployment assessments. Reasons for exclusions were nondeployment (n = 34), missing data (n = 181), and rank of noncommissioned and commissioned officers (n = 66).The primary outcome was the total score on the Clinician-Administered PTSD Scale (CAPS) 3 months after deployment.At the predeployment assessment, 56.8% of the participants reported prior TBI; at postdeployment assessment, 19.8% reported sustaining TBI between predeployment and postdeployment assessments (ie, deployment-related TBI). Approximately 87.2% of deployment-related TBIs were mild; 250 of 287 participants (87.1%) who reported posttraumatic amnesia reported less than 24 hours of posttraumatic amnesia (37 reported ≥ 24 hours), and 111 of 117 of those who lost consciousness (94.9%) reported less than 30 minutes of unconsciousness. Predeployment CAPS score and combat intensity score raised predicted 3-month postdeployment CAPS scores by factors of 1.02 (P < .001; 95% CI, 1.02-1.02) and 1.02 (P < .001; 95% CI, 1.01-1.02) per unit increase, respectively. Deployment-related mild TBI raised predicted CAPS scores by a factor of 1.23 (P < .001; 95% CI, 1.11-1.36), and moderate/severe TBI raised predicted scores by a factor of 1.71 (P < .001; 95% CI, 1.37-2.12). Probability of PTSD was highest for participants with severe predeployment symptoms, high combat intensity, and deployment-related TBI. Traumatic brain injury doubled or nearly doubled the PTSD rates for participants with less severe predeployment PTSD symptoms.Even when accounting for predeployment symptoms, prior TBI, and combat intensity, TBI during the most recent deployment is the strongest predictor of postdeployment PTSD symptoms.",0 +https://doi.org/10.1017/s2045796014000110,Risk of post-traumatic stress disorder following traumatic events in a community sample,"Aims. Post-traumatic stress disorder (PTSD) is typically associated with high-risk population groups, but the risk of PTSD that is associated with trauma experienced in the community, and effect of changes in diagnostic criteria in DSM-5 on prevalence in the general population, is unknown. Methods. Cross-sectional analysis of population-based data from 4558 adults aged 25–83 years resident in Caerphilly county borough, Wales, UK. Exposure to different traumatic events was assessed using categorisation of free-text descriptions of trauma. PTSD caseness was determined using items assessing Diagnostic and Statistical Manual IV (DSM-IV) and DSM-5 A criteria and the Traumatic Screening Questionnaire. Results. Of the 4558 participants, 1971 (47.0%) reported a traumatic event. The most common DSM-IV A1 qualifying trauma was life-threatening illnesses and injuries (13.6%). The highest risk of PTSD was associated with assaultive violence [34.1%]. The prevalence of PTSD using DSM-IV A criteria was 14.3% (95% confidence interval [CI] = 12.8, 15.9%). Using DSM-5 A criteria reduced the prevalence to 8.0 (95% CI = 6.9, 9.4%), primarily due to exclusion of DSM-IV A1 qualifying events, such as life-threatening illnesses. Conclusions. Nearly one-half of a general community sample had experienced a traumatic event and of these around one in seven was a DSM-IV case of PTSD. Although the majority of research has concentrated on combat, rape and assaultive violence, life threatening illness is a more common cause of PTSD in the community. Removal of this traumatic event in DSM-5 could reduce the number of cases of PTSD by around 6.0%.",0 +,"Development and utilization of a psychometric instrument for measuring quality of life in burn patients, 1976 to 1996.","Our Burn Specific Health Scale was initially developed in 1978. Using a number of existing health scales, including the sickness impact profile, a depression scale, and the activities of daily living scale, and a large number of burn specific items derived from staff and patients, we eventually developed an 80 item instrument. This instrument was divided into four domains each containing 20 items of equal weight. The instrument was validated sequentially with intrarater, interrater and global validation systems, and subsequently compared with a number of other health and mental scales during which it performed very well. We now have longitudinal data which link this measurement system of quality of life to pre-injury educational level, to post-injury, stress disorder and predictability of return to work. The results indicate that total burn size has little to do with quality of life after recovery, and that a number of other factors play a bigger role, which will be presented.",0 +https://doi.org/10.1097/nmd.0b013e3181f9804c,"Childhood Adversity, Mental Disorder Comorbidity, and Suicidal Behavior in Schizotypal Personality Disorder","Schizotypal personality disorder (SPD) is a serious and relatively common psychiatric disorder, yet remains understudied among the personality disorders. The current study examines the psychiatric correlates of SPD in a representative epidemiologic sample, utilizing data from the National Epidemiological Survey on Alcohol and Related Conditions (N = 34,653). Multiple logistic regression compared people with SPD to the general population across a broad range of childhood adversities, comorbid psychiatric disorders, and suicidal behavior. SPD was strongly associated with many adverse childhood experiences. After adjusting for confounding factors, SPD was independently associated with major depression and several anxiety disorders, including post-traumatic stress disorder. Interestingly, SPD was more strongly associated with borderline and narcissistic personality disorders than cluster A personality disorders. Individuals with SPD were also more likely to attempt suicide. As a whole, these results suggest that individuals with SPD experience significant morbidity and may be at increased risk of mortality.",0 +https://doi.org/10.1080/15299730802139139,Clinical Profile Differences Between PTSD-Diagnosed Military Veterans and Crime Victims,Few studies have conducted symptom comparisons across different trauma-exposed populations. Evidence linking different types of trauma to variations in clinical presentation would have potential implications for the assessment and treatment of trauma-related psychopathology. The current study evaluated whether military veterans (n = 187) and civilian crime victims (n = 47) diagnosed with posttraumatic stress disorder differ in their self-reported posttraumatic symptoms as measured by the Trauma Symptom Inventory. A multivariate profile analysis revealed that military-related trauma is associated with more severe posttraumatic symptoms than criminal victimization and suggested that these 2 types of trauma have statistically distinct symptom profiles. Some potential implications of these findings and considerations for future research are discussed.,0 +https://doi.org/10.1176/appi.ajp.162.12.2287,Video Testimony of Long-Term Hospitalized Psychiatrically Ill Holocaust Survivors,"Many Holocaust survivors who have both psychotic disorders and residual symptoms of posttraumatic stress disorder (PTSD) remain chronically hospitalized in psychiatric institutions. This study investigated the clinical benefits of a therapeutic process facilitating a detailed videotaped account of traumatic experience (testimony method) in elderly long-term hospitalized Holocaust survivors.Twenty-four schizophrenia patients (mean age=72.2 years) who were chronically hospitalized in Israeli state psychiatric hospitals underwent assessment by blind rating with a battery of psychiatric rating scales before and 4 months after extensive videotaped interview. The rating scales included the Positive and Negative Syndrome Scale; Clinical Global Impression (CGI); Mini-Mental State Examination (MMSE); Clinician-Administered PTSD Scale, Form 2; and Structured Interview for Disorders of Extreme Stress. Full pre- and postinterview data were available for 21 patients.Thirty-eight percent of the patients met the criteria for PTSD at the first interview, compared with only 19% at the second interview. The patients had significant reductions in functional impairment and in the severity and intensity of all posttraumatic symptom clusters (intrusion, avoidance, hyperarousal); the avoidance cluster showed the most reduction. Eleven subjects had an improvement of 30% or more in total posttraumatic severity score. No differences in Positive and Negative Syndrome Scale, MMSE, Structured Interview for Disorders of Extreme Stress, and CGI total scores were noted postinterview or between the two preinterview evaluation batteries in the comparison group. Female patients had a higher prevalence of PTSD symptoms. Total Clinician-Administered PTSD Scale, Form 2, scores and total Positive and Negative Syndrome Scale scores were inversely correlated both at baseline and at follow-up.Study observations suggest clinical benefits of the testimony method in the alleviation of many posttraumatic symptoms, but not psychosis, in a cohort of psychiatrically ill Holocaust survivors, despite an interval of as many as 60 years since the traumatic events. The findings have implications for care and rehabilitation of patients many years after acute traumatic events.",0 +https://doi.org/10.1097/nmd.0b013e3182392bfb,The Influence of Posttraumatic Stress Disorder Numbing and Hyperarousal Symptom Clusters in the Prediction of Physical Health Status in Veterans With Chronic Tobacco Dependence and Posttraumatic Stress Disorder,"Smoking and PTSD are predictors of poor physical health status. This study examined the unique contribution of PTSD symptoms in the prediction of the SF-36 physical health status subscales accounting for cigarette smoking, chronic medical conditions, alcohol and drug use disorders, and depression. This study examined baseline interview and self-report data from a national tobacco cessation randomized, controlled trial (Veterans Affairs Cooperative Study 519) that enrolled tobacco-dependent veterans with chronic PTSD (N = 943). A series of blockwise multiple regression analyses indicated that PTSD numbing and hyperarousal symptom clusters explained a significant proportion of the variance across all physical health domains except for the Physical Functioning subscale, which measures impairments in specific physical activities. Our findings further explain the impact of PTSD on health status by exploring the way PTSD symptom clusters predict self-perceptions of health, role limitations, pain, and vitality.",0 +https://doi.org/10.1016/j.ajp.2014.05.003,Examining posttraumatic stress disorder's latent structure between treatment-seeking and non-treatment-seeking Filipinos,"The discourse of latent structure of posttraumatic stress disorder (PTSD) has been extensive in trauma literature. Although findings have been consistent in rejecting DSM-IV-TR's three-factor model, alternative models are still fervently argued. This study contributes to the discussion by examining and comparing PTSD factor structure of the three most validated models—numbing model (King et al., 1998), dysphoria model (Simms et al., 2002), and dysphoric arousal model (Elhai et al., 2011b)—and determining if these are generalizable across treatment-seeking and non-treatment-seeking Filipinos with exposure to trauma events.Filipino-Tagalog version of Harvard Trauma Questionnaire (HTQ; Mollica et al., 1992) was administered to a sample of 737 treatment-seeking (n=526) and non-treatment-seeking (n=211) Filipinos who experienced and witnessed varied trauma events. Confirmatory factor analysis (CFA) was conducted involving the three models in order to determine the best-fitting model and generalizability across samples.Results showed that all three models achieved excellent fit, with dysphoric arousal model slightly fitting better than numbing and dysphoria models in both treatment-seeking and non-treatment-seeking samples. Series of invariance testing, however, indicated that although dysphoric arousal model fits significantly better than dysphoria model, it did not significantly differ from numbing model. Results revealed that aside from the factor loadings, the two groups are noninvariant in all parameters. Treatment-seeking sample had larger intercepts, factor variances and covariances and factor means than non-treatment-seeking group.The findings strongly contribute to the literature by showing how the type of groupings (treatment-seeking vs. non-treatment-seeking) moderates PTSD latent structure. It affirms the suggestion of Biehn et al. (2012) to be cautious in concluding the generalizability of PTSD models in the context that type of participants moderates PTSD's factor structure.",0 +https://doi.org/10.1016/j.brat.2004.11.004,Psychiatric and behavioral problems in aggressive drivers,"Motor vehicle accidents (MVAs) are a leading cause of accidental death and injury, and aggressive driving has been identified as a risk factor for MVAs. Assessing psychiatric and behavioral disturbances in aggressive drivers is germane to the development of prevention and intervention programs for this population. The present study compared the prevalence of psychiatric diagnoses and behavioral problems in young adult drivers with self-reported high driving aggression to that of drivers with low driving aggression. Aggressive drivers evidenced a significantly higher current and lifetime prevalence of Oppositional Defiant Disorder, Alcohol and Substance Use Disorders, and Cluster B Personality Disorders, and a significantly greater lifetime prevalence of Conduct Disorder, Attention-Deficit/Hyperactivity Disorder, and Intermittent Explosive Disorder. Aggressive drivers also had a significantly greater prevalence of self-reported problems with anger, as well as a greater family history of anger problems and conflict. The findings suggest that prevention and intervention programs designed to reduce aggressive driving may need to address the presence of psychiatric and behavioral problems that could potentially complicate treatment or impede responses to treatment.",0 +https://doi.org/10.1111/j.1744-6570.2007.00080.x,A MULTIDIMENSIONAL APPROACH FOR EVALUATING VARIABLES IN ORGANIZATIONAL RESEARCH AND PRACTICE,"One of the most difficult tasks facing industrial-organizational psychologists is evaluating the importance of variables, especially new variables, to be included in the prediction of some outcome. When multiple regression is used, common practices suggest evaluating the usefulness of new variables by showing incremental validity beyond the set of existing variables. This approach assures that the new variables are not statistically redundant with this existing set, but this approach attributes any shared criterion-related validity to the existing set of variables and none to the new variables. More importantly, incremental validity alone fails to answer the question directly about the importance of variables included in a regression model—arguably the more important statistical concern for practitioners. To that end, the current article reviews 2 indices of relative importance, general dominance weights and relative weights, which may be used to complement incremental validity evidence and permit organizational decision makers to make more precise and informed decisions concerning the usefulness of predictor variables. We illustrate our approach by reanalyzing the correlation matrices from 2 published studies.",0 +,The vicarious experience of posttraumatic stress disorder or symptoms in family members of trauma patients: Differences between ICU and non-ICU families,"This dissertation is part of a larger study investigating the degree to which family members and trauma patients experience early symptoms of Posttraumatic Stress Disorder (PTSD/S). This data was gathered for a protocol approved by the Stanford University Medical Center Institutional Review Board, under the direction of principle investigator, Eve Carlson, PhD. This dissertation's primary question investigated the differences between family members of Intensive Care Unit (ICU) patients and family members of less critical inpatients with regard to Posttraumatic Stress Disorder symptoms (PTSD/S). Also examined were PTSD/S differences between males and females, those with advanced degrees and those without, those with happy childhoods and unhappy childhoods, and those who reported greater socioeconomic status and those who had less resources. Thirty-six family members of ICU patients and family members of less medically critical inpatients participated in this study. They completed self-report questionnaires; a demographic survey, the Posttraumatic Cognitions Inventory-revised (PTCI-R) and the Screen for Posttraumatic Stress Symptoms Questionnaire (SPTSS). Participants were not invited to participate if they were exceedingly distressed, did not speak English well enough to give or understand the consent form, or if their loved one was not expected to recover to pre-injury health. The main limitation for this dissertation was the small participant pool. Also the PTCI-R was revised again by the principle investigator, reducing generalizability from this sample to other groups. The data gathered pertaining to financial security, educational achievement, and childhood experiences came from the larger study's specific demographic questionnaire, and varied in sensitivity. Participants were assessed almost immediately after the traumatic event, making the term ""post traumatic stress"" somewhat inaccurate. More specific and valid measures may have been useful to increase the reliability of this dissertation's findings, as would multiple time points after the trauma. Clinical implications include the need for staff education about family members. ICU and non-ICU families endure similar levels of stress, despite vastly different medical prognoses of their loved ones. Also family history may be an important factor in individual resilience to acute stress. Future research in the field of vicarious trauma could benefit this and other previously overlooked populations exposed to traumas of others. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1037/a0036068,Quantifying heterogeneity attributable to polythetic diagnostic criteria: Theoretical framework and empirical application.,"Heterogeneity within psychiatric disorders is both theoretically and practically problematic: For many disorders, it is possible for 2 individuals to share very few or even no symptoms in common yet share the same diagnosis. Polythetic diagnostic criteria have long been recognized to contribute to this heterogeneity, yet no unified theoretical understanding of the coherence of symptom criteria sets currently exists. A general framework for analyzing the logical and mathematical structure, coherence, and diversity of Diagnostic and Statistical Manual diagnostic categories (DSM-5 and DSM-IV-TR) is proposed, drawing from combinatorial mathematics, set theory, and information theory. Theoretical application of this framework to 18 diagnostic categories indicates that in most categories, 2 individuals with the same diagnosis may share no symptoms in common, and that any 2 theoretically possible symptom combinations will share on average less than half their symptoms. Application of this framework to 2 large empirical datasets indicates that patients who meet symptom criteria for major depressive disorder and posttraumatic stress disorder tend to share approximately three-fifths of symptoms in common. For both disorders in each of the datasets, pairs of individuals who shared no common symptoms were observed. Any 2 individuals with either diagnosis were unlikely to exhibit identical symptomatology. The theoretical and empirical results stemming from this approach have substantive implications for etiological research into, and measurement of, psychiatric disorders.",0 +https://doi.org/10.3109/13651501.2012.745573,Differences on adolescent life goal profile scale between a clinical and non-clinical adolescent sample,"This study aimed to determine similarities and differences on perceived importance and perceived attainability of life goals between a clinical and non-clinical adolescent sample.244 students and 54 adolescent patients completed the Adolescent Life Goal Profile Scale (ALGPS). The ALGPS measures perceived importance and perceived attainability of four main life goal categories: Relations, Generativity, Religion, and Achievements. As a control, we used five measures of mental health, quality of life, and personality.There were no differences on perceived importance on the Generativity, Religion, and Achievement life goal factor, but patients perceived relation-oriented goals less important than non-patients. Perceived attainability of life goals factors was lower for patients on all life goals except for Generativity. Compared to non-patients, patients were less happy and satisfied and had lower sense of coherence and self-efficacy. Patients were also less emotionally stable, had lower conscientiousness, but higher intellect.Though patients appear less content with life in general than non-patients, chances are that they uphold their concern and care for others, remain devoted in their religious stand, and stay committed to their achievement-related goals. The lower perceived importance of relations within the patient group should be awarded clinical attention.",0 +https://doi.org/10.1016/j.brat.2006.03.015,PTSD symptom trajectories: From early to chronic response,"This study aimed to identify posttraumatic stress disorder (PTSD) symptom trajectories across the first 12 months following traumatic injury. Three hundred and seven consecutively admitted injury survivors were assessed for severity of PTSD symptoms just prior to discharge, and at 3 and 12 months postinjury. Growth modeling was used to determine the curve that best fit the trajectory for each symptom cluster over the 12-month period. Individuals with 12-month PTSD showed significantly higher re-experiencing, arousal, and avoidance symptoms at eight days posttrauma relative to those without, and these symptoms escalated over time. Those without PTSD maintained their relatively low symptom levels. These findings highlight that individuals who will go onto develop PTSD have a distinctly different symptom course than those who recover.",0 +https://doi.org/10.1002/jts.22039,Temporal Associations Among Chronic PTSD Symptoms in U.S. Combat Veterans,"The present study examined fluctuation over time in symptoms of posttraumatic stress disorder (PTSD) among 34 combat veterans (28 with diagnosed PTSD, 6 with subclinical symptoms) assessed every 2 weeks for up to 2 years (range of assessments = 13-52). Temporal relationships were examined among four PTSD symptom clusters (reexperiencing, avoidance, emotional numbing, and hyperarousal) with particular attention to the influence of hyperarousal. Multilevel cross-lagged random coefficients autoregression for intensive time series data analyses were used to model symptom fluctuation decades after combat experiences. As anticipated, hyperarousal predicted subsequent fluctuations in the 3 other PTSD symptom clusters (reexperiencing, avoidance, emotional numbing) at subsequent 2-week intervals (rs = .45, .36, and .40, respectively). Additionally, emotional numbing influenced later reexperiencing and avoidance, and reexperiencing influenced later hyperarousal (rs = .44, .40, and .34, respectively). These findings underscore the important influence of hyperarousal. Furthermore, results indicate a bidirectional relationship between hyperarousal and reexperiencing as well as a possible chaining of symptoms (hyperarousal → emotional numbing → reexperiencing → hyperarousal) and establish potential internal, intrapersonal mechanisms for the maintenance of persistent PTSD symptoms. Results suggested that clinical interventions targeting hyperarousal and emotional numbing symptoms may hold promise for PTSD of long duration.",0 +,Physical and emotional health of Gulf War veteran women.,"Numerous questions have been raised about the health consequences to veterans of the Gulf War but most particularly to issues concerning women, who were deployed in unprecedented numbers. Little is known about the health consequences to women of wartime stressors, in general, or the environmental and job-related exposures specific to the theater of the Gulf War.A stratified sample of 525 women participated in the study following the war and again in a follow-up study 2 yr later. The sampling frame was stratified on component of the U.S. Air Force (active, guard or reserve), deployment (in the theater or elsewhere), and parental status (parent or nonparent). Measures included items concerning general physical health, gender-specific health, the ""Gulf War Syndrome,"" and the emotional responses to war, including symptoms of post-traumatic stress disorder (PTSD).Multiple statistical analyses were used to describe women's physical and emotional health at two time points following the war. Women deployed to the theater reported significantly more general as well as gender-specific health problems than did women deployed elsewhere. A cluster of common health problems included: skin rash, cough, depression, unintentional weight loss, insomnia, and memory problems. Women serving in the theater also reported a significant increase in several gender-specific problems compared to women deployed elsewhere.Findings suggest the need for follow-up of a cluster of specific health effects, including those concerning gynecologic and reproductive health.",0 +https://doi.org/10.1007/s11920-015-0621-x,A Review of Transcranial Magnetic Stimulation as a Treatment for Post-Traumatic Stress Disorder,"Patients with post-traumatic stress disorder (PTSD) may fail to achieve adequate relief despite treatment with psychotherapy, pharmacotherapy, or complementary medicine treatments. Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation procedure that can alter neuronal activity through administration of various pulse sequences and frequencies. TMS may theoretically have promise in correcting alterations observed in patients with PTSD. While the precise treatment location and pulse sequences remain undefined, current evidence suggests two promising targets, the right dorsolateral prefrontal cortex and the medial prefrontal cortex. The beneficial effects may be due to the secondary or indirect regulation of other brain structures that may be involved in the mood regulatory network. TMS may be an effective part of a comprehensive treatment program for PTSD, although significant work remains to define optimal treatment parameters and clarify how it fits within a broader traditional treatment program.",0 +https://doi.org/10.1007/s10802-009-9300-x,Posttraumatic Stress Symptoms and Trajectories in Child Sexual Abuse Victims: An Analysis of Sex Differences Using the National Survey of Child and Adolescent Well-Being,"Very few studies have prospectively examined sex differences in posttraumatic stress symptoms and symptom trajectories in youth victimized by childhood sexual abuse. This study addresses that question in a relatively large sample of children, drawn from the National Survey of Child and Adolescent Well-Being, who were between the ages of 8-16 years and who were reported to Child Protective Services for alleged sexual abuse. Sex differences were examined using t tests, logistic regression, and latent trajectory modeling. Results revealed that there were not sex differences in victims' posttraumatic stress symptoms or trajectories. Whereas caseworkers substantiated girls' abuse at higher rates than boys' abuse and rated girls significantly higher than boys on level of harm, there were not sex differences in three more objective measures of abuse severity characteristics. Overall, higher caseworker ratings of harm predicted higher initial posttraumatic stress symptom levels, and substantiation status predicted shallower decreases in trauma symptoms over time. Implications for theory and intervention are discussed.",0 +https://doi.org/10.1037/a0020195,Prevalence and consequences of disaster-related illness and injury from hurricane ike.,"To explore the extent to which disasters may be a source of injury and disability in community populations, we examined the prevalence and short-term consequences of disaster-related illness and injury for distress, disability, and perceived needs for care.A random population survey was conducted 2-6 months after Hurricane Ike struck Galveston Bay on September 13, 2008.The sample was composed of 658 adults representative of Galveston and Chambers Counties, Texas.The prevalences of personal injury (4%) and household illness (16%) indicated that approximately 7,700 adults in the two-county area were injured, and another 31,500 adults experienced household-level illness. Risk for injury/illness increased with area damage and decreased with evacuation. In bivariate tests, injury or illness or both were related to all outcome measures. In multivariate analyses that controlled for co-occurring stressors representing trauma, loss, adversities, and community effects, injury or illness or both were associated with global stress, posttraumatic stress, dysfunction, days of disability, and perceived needs for care, but not with depression or anxiety.The associations of injury with distress and disability suggest that community programs should reach out to injured persons for early mental health and functional assessments and, where indicated, intervene in ways that reduce further disability and need for complex rehabilitative services. The results also point to the potential effectiveness of evacuation incentives with regard to the prevention of disaster-related injury and disability.",0 +https://doi.org/10.1016/j.dcn.2014.07.006,"Easy to remember, difficult to forget: The development of fear regulation","Fear extinction learning is a highly adaptive process that involves the integrity of frontolimbic circuitry. Its disruption has been associated with emotional dysregulation in stress and anxiety disorders. In this article we consider how age, genetics and experiences shape our capacity to regulate fear in cross-species studies. Evidence for adolescent-specific diminished fear extinction learning is presented in the context of immature frontolimbic circuitry. We also present evidence for less neural plasticity in fear regulation as a function of early-life stress and by genotype, focusing on the common brain derived neurotrophin factor (BDNF) Val66Met polymorphism. Finally, we discuss this work in the context of exposure-based behavioral therapies for the treatment of anxiety and stress disorders that are based on principles of fear extinction. We conclude by speculating on how such therapies may be optimized for the individual based on the patient's age, genetic profile and personal history to move from standard treatment of care to personalized and precision medicine.",0 +https://doi.org/10.1017/cbo9780511994791.001,Preface,"Humans are remarkably resilient in the face of crises, traumas, disabilities, attachment losses, and ongoing adversities. In fact, resilience to stress and trauma may be the norm rather than the exception. However, to date, most research in the field of traumatic stress has focused on neurobiological, psychological, and social factors associated with trauma-related psychopathology and deficits in psychosocial functioning. While much has been learned in these areas of research, particularly about post-traumatic stress disorder (PTSD), far less is known about resilience to stress and healthy adaptation to stress and trauma. The study of resilience is enormously challenging. The first hurdle involves definition. Currently, there is no single agreed-upon definition of resilience in the clinical or scientific literature. In a review of the published literature on risk, vulnerability, resistance, and resilience, Layne and colleagues (2007) described the lack of precision and numerous terminological inconsistencies in the meanings of these concepts, and identified at least eight distinct meanings for the term “resilience.” For example, definitions of resilience have ranged from symptom-free functioning following trauma exposure (Bonanno et al., 2006) to positive adaptation despite adversity (Garmezy, 1993), and even to enhanced psychobiological regulation of stress/fear-related brain circuitry, neurotransmitters, and hormones (Charney, 2004). The American Psychological Association (2010) has defined resilience as “the process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of threat.” © Cambridge University Press 2011.",0 +https://doi.org/10.1007/s12207-014-9196-9,Assessing Latent Level Associations Between PTSD and Dissociative Factors: Is Depersonalization and Derealization Related to PTSD Factors More So than Alternative Dissociative Factors?,"Posttraumatic stress disorder (PTSD) criteria in DSM-5 included a dissociative diagnostic subtype characterized by a depersonalization item and a derealization item. Researchers have queried whether this was too restrictive, as alternative dissociative symptomatology may also be characteristic of the subtype. The current study utilized data from 318 Northern Irish students, of which 165 were trauma exposed. Participants were assessed for PTSD symptomatology based on DSM-5 criteria via a modified version of the PTSD Symptom Scale-Self-Report (PSS-5) and dissociative experiences via the Dissociative Experiences Scale (DES). Confirmatory factor analysis of PTSD and DES models revealed an optimal four-factor DSM-5 PTSD model including reexperiencing, avoidance, negative alterations in mood and cognitions, and alterations in hyperarousal and reactivity factors, and an optimal three-factor DES model including absorption, amnesia, and depersonalization/derealization factors. When comparing the correlations between depersonalization/derealization and the four PTSD factors, significant Wald tests of parameter constraints revealed that depersonalization/derealization is more related to alterations in arousal and reactivity (r = .432) compared to avoidance (r = .289), χ 2 (1, N = 165) = 8.352, p = .004. We discuss whether the mechanism for comorbid PTSD and dissociation may be related to PTSD’s arousal factor.",0 +https://doi.org/10.1037/a0022249,Psychosocial outcomes of telephone-based counseling for adults with an acquired physical disability: A meta-analysis.,"The delivery of mental health services by telephone, referred to as telecounseling, has the potential to improve the health outcomes of adults with an acquired physical disability in a cost-effective way. However, the efficacy of this form of treatment requires further evaluation before it is used on a larger scale.This meta-analysis provides a critical and quantitative evaluation of the impact of telephone-administered psychological interventions on the psychosocial functioning of adults with an acquired physical disability caused by spinal cord injury, limb amputation, severe burn injury, stroke, or multiple sclerosis.A comprehensive search of eight electronic databases identified eight studies (N = 658 participants) that compared treatment efficacy to that of matched control groups. Differences in the psychosocial outcomes of treatment and control participants were examined using Cohen's d effect sizes. Fail-safe Ns and 95% confidence intervals were used to evaluate the significance of these results.Significant improvements in coping skills and strategies (overall d = 0.57), community integration (overall d = 0.45), and depression (overall d = 0.44) were observed immediately after telecounseling, with modest improvements in quality of life maintained at 12 months post-intervention (overall d = 0.37).The results suggest that telecounseling is an effective treatment modality for adults adjusting to a physical disability; however, further trials are needed to establish the long term psychosocial benefits.",0 +https://doi.org/10.1093/oxfordhb/9780195399066.013.0015,Family Models of Posttraumatic Stress Disorder,"Abstract This chapter reviews the extant literature on the interpersonal aspects of posttraumatic stress disorder (PTSD), with a focus on couple and family models of PTSD. Topics include the association of PTSD with a variety of family relationship problems in a range of traumatized populations. The role of relevant interpersonal constructs in the development and maintenance of PTSD (e.g., social support, attachment) and the psychological effects of PTSD symptoms on family members and their relations are discussed. In addition, models that take into account a range of relationship variables and the likely bi-directional association between individual and family functioning in PTSD are presented. Future directions for theory and research, as well as the clinical implications of this work are outlined.",0 +https://doi.org/10.1037/0021-843x.116.2.329,Confirmatory factor analysis of the PTSD Checklist and the Clinician-Administered PTSD Scale in disaster workers exposed to the World Trade Center Ground Zero.,"Although posttraumatic stress disorder (PTSD) factor analytic research has yielded little support for the DSM-IV 3-factor model of reexperiencing, avoidance, and hyperarousal symptoms, no clear consensus regarding alternative models has emerged. One possible explanation is differential instrumentation across studies. In the present study, the authors used confirmatory factor analysis to compare a self-report measure, the PTSD Checklist (PCL), and a structured clinical interview, the Clinician-Administered PTSD Scale (CAPS), in 2,960 utility workers exposed to the World Trade Center Ground Zero site. Although two 4-factor models fit adequately for each measure, the latent structure of the PCL was slightly better represented by correlated reexperiencing, avoidance, dysphoria, and hyperarousal factors, whereas that of the CAPS was slightly better represented by correlated reexperiencing, avoidance, emotional numbing, and hyperarousal factors. After accounting for method variance, the model specifying dysphoria as a distinct factor achieved slightly better fit. Patterns of correlations with external variables provided additional support for the dysphoria model. Implications regarding the underlying structure of PTSD are discussed.",0 +https://doi.org/10.1176/appi.ps.201300453,Timing of Mental Health Treatment and PTSD Symptom Improvement Among Iraq and Afghanistan Veterans,"This study examined demographic, military, temporal, and logistic variables associated with improvement of posttraumatic stress disorder (PTSD) among Iraq and Afghanistan veterans who received mental health outpatient treatment from the U.S. Department of Veterans Affairs (VA) health care system. The authors sought to determine whether time between last deployment and initiating mental health treatment was associated with a lack of improvement in PTSD symptoms.The authors conducted a retrospective analysis of existing medical records of Iraq and Afghanistan veterans who enrolled in VA health care, received a postdeployment PTSD diagnosis, and initiated treatment for one or more mental health problems between October 1, 2007, and December 31, 2011, and whose records contained results of PTSD screening at the start of treatment and approximately one year later (N=39,690).At the start of treatment, 75% of veterans diagnosed as having PTSD had a positive PTSD screen. At follow-up, 27% of those with a positive screen at baseline had improved, and 43% of those with a negative screen at baseline remained negative. A negative PTSD screen at follow-up was associated with female gender, older age, white race, having never married, officer rank, non-Army service, closer proximity to the nearest VA facility, and earlier initiation of treatment after the end of the last deployment.Interventions to reduce delays in initiating mental health treatment may improve veterans' treatment response. Further studies are needed to test interventions for particular veteran subgroups who were less likely than others to improve with treatment.",0 +https://doi.org/10.1023/a:1024773202939,Dissociative symptoms in acute stress disorder,"This study provides a profile of symptoms, and particularly dissociative symptoms, in the diagnosis of acute stress disorder (ASD) following motor vehicle accidents (MVAs). Consecutive adult non-brain-injured admissions to a major trauma hospital (N = 92) were assessed between 2 days and 4 weeks following an MVA. Presence of ASD was determined by a structured clinical interview. The occurrence of full and subsyndromal ASD was approximately 13% and 21%, respectively. The majority of those who met criteria for subsyndromal ASD did not meet the ASD criteria for dissociation. At least 80% of individuals who reported derealization also reported reduced awareness and depersonalization. This significant overlap between dissociative symptoms questions the discriminatory power and conceptual independence of the dissociative criteria. These findings suggest the need for a more refined conceptual and operational understanding of dissociative symptoms in the acute trauma stage.",0 +https://doi.org/10.1192/bjp.bp.111.096552,Trajectories of trauma symptoms and resilience in deployed US military service members: Prospective cohort study,"Background Most previous attempts to determine the psychological cost of military deployment have been limited by reliance on convenience samples, lack of pre-deployment data or confidentiality and cross-sectional designs. Aims This study addressed these limitations using a population-based, prospective cohort of US military personnel deployed in support of the operations in Iraq and Afghanistan. Method The sample consisted of US military service members in all branches including active duty, reserve and national guard who deployed once ( n = 3393) or multiple times ( n = 4394). Self-reported symptoms of post-traumatic stress were obtained prior to deployment and at two follow-ups spaced 3 years apart. Data were examined for longitudinal trajectories using latent growth mixture modelling. Results Each analysis revealed remarkably similar post-traumatic stress trajectories across time. The most common pattern was low–stable post-traumatic stress or resilience (83.1% single deployers, 84.9% multiple deployers), moderate–improving (8.0%, 8.5%), then worsening–chronic posttraumatic stress (6.7%, 4.5%), high–stable (2.2% single deployers only) and high–improving (2.2% multiple deployers only). Covariates associated with each trajectory were identified. Conclusions The final models exhibited similar types of trajectories for single and multiple deployers; most notably, the stable trajectory of low post-traumatic stress pre- to post-deployment, or resilience, was exceptionally high. Several factors predicting trajectories were identified, which we hope will assist in future research aimed at decreasing the risk of post-traumatic stress disorder among deployers.",1 +https://doi.org/10.1007/s11920-015-0576-y,Coping and Social Support in Children Exposed to Mass Trauma,"The goal of this paper was to critically evaluate the literature on children coping with mass trauma published between the years 2011 and 2014 and to emphasize interesting and important findings with the aim of proposing a new comprehensive model for better understanding the process of coping with these events in this unique developmental stage. Using a variety of databases, 26 research papers were selected. The papers were divided into two main categories, natural and manmade disasters. The findings suggest that several areas in this context still lack foundational knowledge and should be further investigated. Thus, it has been suggested that future research should emphasize the developmental stage of the children, the cultural context and atmosphere in which the investigated children grow up and live, and the type of event (acute vs. chronic; natural vs. manmade). A more comprehensive coping model which addresses these omissions and combines main theories is suggested for use in future research as well. © 2015, Springer Science+Business Media New York.",0 +https://doi.org/10.1007/s12207-010-9071-2,Simulating Emotional Responses in Posttraumatic Stress Disorder: An fMRI Study,"This study tested the extent to which coached participants can simulate the neural responses of participants with posttraumatic stress disorder (PTSD) when they are presented with signals of fear. Functional magnetic resonance imaging (fMRI) was used to study blood oxygenation level-dependent signal during the presentations of fearful and neutral faces under both conscious and nonconscious (masked) conditions. Participants comprised 12 patients with PTSD and 12 trauma-exposed controls who were instructed to simulate PTSD. During conscious fear processing, simulators showed greater activation in the left amygdala and medial prefrontal cortex (MPFC) than PTSD participants. By contrast, during nonconscious processing, PTSD participants had greater MPFC activation than simulators. These findings suggest that coached simulators produce a profile of 'over-responding' to fear when controlled conscious processing is possible, but are not able to simulate the exaggerated medial prefrontal responses observed in PTSD participants under conditions of nonconscious processing. © 2010 Springer Science + Business Media, LLC.",0 +https://doi.org/10.1111/j.2044-8260.1989.tb00823.x,"Locus of control and combat-related post-traumatic stress disorder: The intervening role of battle intensity, threat appraisal and coping","The study examined the role of control expectancies in the formation of posttraumatic stress disorder (PTSD) among Israeli soldiers combat stress reactions (battle shock) casualties of the Lebanon War (1982). A random sample of 104 soldiers who fought in the Lebanon War and were identified as combat stress reaction casualties were clinically interviewed and given a battery of self-report questionnaires a year after their participation in combat. In general, the components of Lazarus' stress-illness model were predictive of the severity of PTSD. Greater appraisal of threat, more negative emotions, and more emotion-focused coping were all found to predict a larger number of PTSD symptoms. Path analyses were performed separately for soldiers who reported that they were under high battle intensity and those who were under relatively low battle intensity. For low battle intensity, externals suffered more PTSD than internals. This relationship was due mainly to the indirect effects of locus of control via threat appraisal. These significant relationships were not found when battle intensity was high. The implications of the findings for the study of combat stress reactions and for the stress-illness model are discussed. The relative impact of generalized control expectancies and situational factors are examined for the various components of the model.",0 +https://doi.org/10.1080/17523281.2011.598462,Childhood trauma among individuals with co-morbid substance use and post-traumatic stress disorder,"BACKGROUND: Little is known about the impact of childhood trauma (CT) on the clinical profile of individuals with co-occurring substance use disorder (SUD) and post traumatic stress disorder (PTSD). AIMS: To compare the clinical characteristics of individuals with SUD+PTSD who have a history of CT with SUD+PTSD individuals who have experienced trauma during adulthood only. METHOD: Data were collected on 103 individuals as part of a randomised controlled trial examining the efficacy of an integrated psychosocial treatment for SUD+PTSD. Participants were recruited from substance use treatment services, community referrals and advertising. Data were collected on demographic characteristics, substance use and treatment histories, lifetime trauma exposure, and current physical and mental health functioning. RESULTS: The vast majority (77%) of the sample had experienced at least one trauma before the age of 16, with 55% of those endorsing childhood sexual abuse. As expected individuals with a CT history, as compared to without, evidenced significantly longer duration of PTSD. Those with a CT history also had more extensive lifetime trauma exposure, an earlier age of first intoxication, and reported more severe substance use (e.g., a greater number of drug classes used in their lifetime, higher severity of dependence scores and greater number of drug treatment episodes). CONCLUSION: Individuals with co-morbid SUD+PTSD who have experienced CT present with a more severe and chronic clinical profile in relation to a number of trauma and substance use characteristics, when compared to individuals with adulthood only trauma histories. It is therefore important for SUD+PTSD treatment planning that CT be carefully assessed.",0 +https://doi.org/10.1080/13811118.2013.776456,"Marital Status, Life Stressor Precipitants, and Communications of Distress and Suicide Intent in a Sample of United States Air Force Suicide Decedents","Life stressor precipitants and communications of distress and suicide intent were examined among a sample of United States Air Force (USAF) married versus unmarried suicide decedents. A total of 100 death investigations conducted by the Office of Special Investigations on active duty USAF suicides occurring between 1996 and 2006 were retrospectively reviewed. Married decedents were twice as likely 1) to have documented interpersonal conflict 24 hours prior to suicide and 2) to have communicated suicide intent to peers or professionals. Themes of distress communication for all decedents were intrapersonal (perceived stress, depression, psychological pain) and interpersonal (thwarted belongingness, rejection, loneliness). Suicide prevention programs and policies are encouraged to adapt efforts to the unique needs of married and unmarried individuals.",0 +https://doi.org/10.1016/j.comppsych.2010.10.006,Patterns of comorbidity among mental disorders: a person-centered approach,"Abstract Objective Comorbidity poses a major challenge to conventional methods of diagnostic classification. Although dimensional models of psychopathology have shed some light on this issue, the reason for interrelationships among dimensions is unclear. The current study employed an alternative approach to characterizing patterns of comorbidity among common mental disorders by modeling them instead as clusters by using latent class analysis (LCA). Method Latent class analyses of Diagnostic and Statistical Manual of Mental Disorders diagnoses from two nationally representative epidemiological samples—the National Comorbidity Survey and National Comorbidity Survey–Replication datasets—were undertaken. Results Within each dataset, LCA yielded 5 latent classes exhibiting distinctive profiles of diagnostic comorbidity: a fear class (all phobias and panic disorder), a distress class (depression, generalized anxiety disorder, dysthymia), an externalizing class (alcohol and drug dependence, conduct disorder), a multimorbid class (highly elevated rates of all disorders), and a few-disorders class (very low probability of all disorders). Whereas some disorders were relatively specific to certain classes, others (major depression, posttraumatic stress disorder, social phobia) appeared to be evident across all classes. Profiles for the five classes were highly similar across the two samples. When bipolar I disorder was added to the LCA models, in both samples, it occurred almost exclusively in the multimorbid class. Conclusions Comorbidity among mental disorders in the general population appears to occur in a finite number of distinct patterns. This finding has important implications for efforts to refine existing diagnostic classification schemes, as well as for research directed at elucidating the etiology of mental disorders.",0 +https://doi.org/10.1371/journal.pone.0076618,A Community Study of the Psychological Effects of the Omagh Car Bomb on Adults,"The main aims of the study were to assess psychological morbidity among adults nine months after a car bomb explosion in the town of Omagh, Northern Ireland and to identify predictors of chronic posttraumatic stress disorder symptoms.A questionnaire was sent to all adults in households in The Omagh District Council area. The questionnaire comprised established predictors of PTSD (such as pre-trauma personal characteristics, type of exposure, initial emotional response and long-term adverse physical or financial problems), predictors derived from the Ehlers and Clark (2000) cognitive model, a measure of PTSD symptoms and the General Health Questionnaire.Among respondents (n = 3131) the highest rates of PTSD symptoms and probable casesness (58.5%) were observed among people who were present in the street when the bomb exploded but elevated rates were also observed in people who subsequently attended the scene (21.8% probable caseness) and among people for whom someone close died (11.9%). People with a near miss (left the scene before the explosion) did not show elevated rates. Exposure to the bombing increased PTSD symptoms to a greater extent than general psychiatric symptoms. Previously established predictors accounted for 42% of the variance in PTSD symptoms among people directly exposed to the bombing. Predictors derived from the cognitive model accounted for 63%.High rates of chronic PTSD were observed in individuals exposed to the bombing. Psychological variables that are in principle amenable to treatment were the best predictors of PTSD symptoms. Teams planning treatment interventions for victims of future bombings and other traumas may wish to take these results into account.",0 +https://doi.org/10.1001/dmp.2011.48,"Trends in Probable PTSD in Firefighters Exposed to the World Trade Center Disaster, 2001–2010","ABSTRACT Objective: We present the longest follow-up, to date, of probable posttraumatic stress disorder (PTSD) after the 2001 terrorist attacks on the World Trade Center (WTC) in New York City firefighters who participated in the rescue/recovery effort. Methods: We examined data from 11 006 WTC-exposed firefighters who completed 40 672 questionnaires and reported estimates of probable PTSD by year from serial cross-sectional analyses. In longitudinal analyses, we used separate Cox models with data beginning from October 2, 2001, to identify variables associated with recovery from or delayed onset of probable PTSD. Results: The prevalence of probable PTSD was 7.4% by September 11, 2010, and continued to be associated with early arrival at the WTC towers during every year of analysis. An increasing number of aerodigestive symptoms (hazard ratio [HR] 0.89 per symptom, 95% confidence interval [CI] 0.86-.93) and reporting a decrease in exercise, whether the result of health (HR 0.56 vs no change in exercise, 95% CI 0.41-.78) or other reasons (HR 0.76 vs no change in exercise, 95% CI 0.63-.92), were associated with a lower likelihood of recovery from probable PTSD. Arriving early at the WTC (HR 1.38 vs later WTC arrival, 95% CI 1.12-1.70), an increasing number of aerodigestive symptoms (HR 1.45 per symptom, 95% CI 1.40–1.51), and reporting an increase in alcohol intake since September 11, 2001 (HR 3.43 vs no increase in alcohol intake, 95% CI 2.67-4.43) were associated with delayed onset of probable PTSD. Conclusions: Probable PTSD continues to be associated with early WTC arrival even 9 years after the terrorist attacks. Concurrent conditions and behaviors, such as respiratory symptoms, exercise, and alcohol use also play important roles in contributing to PTSD symptoms. ( Disaster Med Public Health Preparedness . 2011;5:S197-S203)",0 +https://doi.org/10.1177/0032258x0107400103,Post-Traumatic Stress Reactions in Victims of Motor Accidents,"This article assesses the incidence and types of PSTD, causes and symptoms of the condition, diagnosis and assessment, treatment and prediction of litigation as well as remission. Two questions of particular interest to the legal profession are considered: the length of time and other factors needed for the prediction of post-traumatic stress and the time elapsing before normal patterns of behaviour reoccur. Also discussed is the difference in the prevalence of PTSD in the sexes. Physical injuries both to the brain and to other parts of the body, specifically whiplash, are assessed. A number of case studies for post-traumatic stress are analysed and predictions for successfully applied treatment are provided. There is also a section dealing specifically with the effect of post-traumatic stress on children. (A)",0 +https://doi.org/10.1080/0312407x.2013.862558,“Black Saturday” and its Aftermath: Reflecting on Postdisaster Social Work Interventions in an Australian Trauma Hospital,"AbstractSocial workers at The Alfred, a major tertiary referral teaching hospital in Melbourne, Australia, played a key role in providing psychosocial support to patients and their families following the 2009 Black Saturday bushfires in the State of Victoria. Faced with the highest number of casualties ever admitted simultaneously, and the media and community involvement surrounding the national disaster, new practice challenges emerged that led to tensions when compared to everyday practice. This article examines three challenges identified in the team's critical reflections—managing privacy and publicity; negotiating the boundaries of professional practice; and managing the impact of the work. These practice challenges are considered in light of relevant trauma and disaster literature that addresses the importance of promoting self-efficacy, hope, and connectedness; forming collective narratives of survivorship and resilience; negotiating the ethical questions of service intimacy and intensity; and impl...",0 +https://doi.org/10.1191/030913200701540465,Social and ecological resilience: are they related?,"This article defines social resilience as the ability of groups or communities to cope with external stresses and disturbances as a result of social, political and environmental change. This definition highlights social resilience in relation to the concept of ecological resilience which is a characteristic of ecosystems to maintain themselves in the face of disturbance. There is a clear link between social and ecological resilience, particularly for social groups or communities that are dependent on ecological and environmental resources for their livelihoods. But it is not clear whether resilient ecosystems enable resilient communities in such situations. This article examines whether resilience is a useful characteristic for describing the social and economic situation of social groups and explores potential links between social resilience and ecological resilience. The origins of this interdisciplinary study in human ecology, ecological economics and rural sociology are reviewed, and a study of the impacts of ecological change on a resource-dependent community in contemporary coastal Vietnam in terms of the resilience of its institutions is outlined.",0 +https://doi.org/10.1176/ajp.151.6.895,Posttraumatic stress disorder in elderly and younger adults after the 1988 earthquake in Armenia,"This study was undertaken 1 1/2 years after the 1988 earthquake in Armenia to assess the frequency and severity of posttraumatic stress reactions among elderly and younger adult victims and to assess the relation of exposure, age, sex, and death of a family member to these reactions.One hundred seventy-nine subjects of both sexes were evaluated with the Posttraumatic Stress Disorder (PTSD) Reaction Index. A subgroup of 60 individuals were also assessed for PTSD with the DSM-III-R criteria.There was a strong association between the presence of severe symptoms on the index and a DSM-III-R diagnosis of PTSD. Elderly and younger adult victims in cities closer to the epicenter (higher exposure) had significantly higher index scores than elderly and adult victims in more distant locations. In comparison with previous studies of natural disasters, much greater rates of chronic severe posttraumatic stress reactions were found among the highly exposed individuals. Although there was no difference in total mean score on the Posttraumatic Stress Disorder Reaction Index, a significant difference in symptom profile was found between the elderly and younger adults; the elderly scored higher on arousal symptoms and lower on intrusive symptoms. There was a positive correlation between loss of family members and severity of posttraumatic stress reaction.These findings indicate that after a major natural disaster with subsequent multiple adversities, a substantial proportion of the adult population may experience severe and chronic posttraumatic stress reactions. The risk factors identified in this study may prove useful in screening exposed individuals for appropriate treatment.",0 +https://doi.org/10.1111/papt.12087,Post-traumatic stress disorder and depression co-occurrence: Structural relations among disorder constructs and trait and symptom dimensions,"Post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) in response to trauma co-occur at high rates. A better understanding of the nature of this co-occurrence is critical to developing an accurate conceptualization of the disorders. This study examined structural relations among the PTSD and MDD constructs and trait and symptom dimensions within the framework of the integrative hierarchical model of anxiety and depression.Study participants completed clinician-rated and self-report measures during a pre-treatment assessment.The sample consisted of 200 treatment-seeking individuals with a primary DSM-IV PTSD diagnosis. Structural equation modelling was used to examine the relationship between the constructs.The trait negative affect/neuroticism construct had a direct effect on both PTSD and MDD. The trait positive affect/extraversion construct had a unique, negative direct effect on MDD, and PTSD had a unique, direct effect on the physical concerns symptoms construct. An alternative model with the PTSD and MDD constructs combined into an overall general traumatic stress construct produced a decrement in model fit.These findings provide a clearer understanding of the relationship between co-occurring PTSD and MDD as disorders with shared trait negative affect/neuroticism contributing to the overlap between them and unique trait positive affect/extraversion and physical concerns differentiating them. Therefore, PTSD and MDD in response to trauma may be best represented as two distinct, yet strongly related constructs.In assessing individuals who have been exposed to trauma, practitioners should recognize that co-occurring PTSD and MDD appears to be best represented as two distinct, yet strongly related constructs. Negative affect may be the shared vulnerability directly influencing both PTSD and MDD; however, in the presence of both PTSD and MDD, low positive affect appears to be more specifically related to MDD and fear of physical sensations to PTSD, which is information that could be used by practitioners in the determination of treatment approach. Overall, these findings are clinically relevant in that they may inform assessment, treatment planning, and ultimately diagnostic classification.",0 +https://doi.org/10.1001/jama.2010.1086,Association of Sexual Violence and Human Rights Violations With Physical and Mental Health in Territories of the Eastern Democratic Republic of the Congo,"Studies from the Eastern Region of the Democratic Republic of the Congo (DRC) have provided anecdotal reports of sexual violence. This study offers a population-based assessment of the prevalence of sexual violence and human rights abuses in specific territories within Eastern DRC.To assess the prevalence of and correlations with sexual violence and human rights violations on residents of specific territories of Eastern DRC including information on basic needs, health care access, and physical and mental health.A cross-sectional, population-based, cluster survey of 998 adults aged 18 years or older using structured interviews and questionnaires, conducted over a 4-week period in March 2010.Sexual violence prevalence and characteristics, symptoms of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), human rights abuses, and physical and mental health needs among Congolese adults in specific territories of Eastern DRC.Of the 1005 households surveyed 998 households participated, yielding a response rate of 98.9%. Rates of reported sexual violence were 39.7% (95% confidence interval [CI], 32.2%-47.2%; n = 224/586) among women and 23.6% (95% CI, 17.3%-29.9%; n = 107/399) among men. Women reported to have perpetrated conflict-related sexual violence in 41.1% (95% CI, 25.6%-56.6%; n = 54/148) of female cases and 10.0% (95% CI, 1.5%-18.4%; n = 8/66) of male cases. Sixty-seven percent (95% CI, 59.0%-74.5%; n = 615/998) of households reported incidents of conflict-related human rights abuses. Forty-one percent (95% CI, 35.3%-45.8%; n = 374/991) of the represented adult population met symptom criteria for MDD and 50.1% (95% CI, 43.8%-56.3%; n = 470/989) for PTSD.Self-reported sexual violence and other human rights violations were prevalent in specific territories of Eastern DRC and were associated with physical and mental health outcomes.",0 +,Post-traumatic stress disorder in parents of children hospitalized in the neonatal intensive care unit (NICU): medical and demographic risk factors.,"Post-traumatic stress disorder (PTSD) among parents of neonates hospitalized in the Neonatal Intensive Care Units (NICU) stays an underestimated problem. We determined the incidence of PTSD in parents and pointed out medical and demographic risk factors for PTSD in neonates hospitalized in the NICU.The study involved 39 mothers and 27 fathers of 42 infants aged 1 to 16 months who were hospitalized in the NICU of a Children's University Hospital during the neonatal period. As a measure of PTSD we used the Polish version of the Impact of Event Scale-Revised (IES-R). The current level of stress was measured using the Perceived Stress Scale (PSS-10). The author's questionnaire contained demographic and medical information on the infants hospitalized in the NICU and their parents. Data were statistically analyzed.The incidence of PTSD and levels of stress did not differ in the group of mothers and fathers. There was a statistically significant difference in the severity of PTSD symptoms in general (p=0.006) and the severity of symptoms of intrusion (p=0.009) and arousal (p=0.015), which were more pronounced in mothers of children hospitalized in the NICU than in their fathers. In the multivariate models perceived stress was the only predictor that significantly affected the rate of PTSD symptoms in parents.Since PTSD is a very common problem in parents of children hospitalized in the NICU and estimating the risk of its occurrence on the basis of collected data is not possible, the parents of all those children should be considered at high risk.",0 +https://doi.org/10.1080/10911359.2013.795049,A Bioecological Model of Deployment Risk and Resilience,"A deployment risk and resilience model is proposed to describe military service and deployment-related factors influencing post-deployment reintegration and post-deployment behavioral health. Adapted from the resiliency model, it is a multiphasic framework consistent with biopsychosocial and strengths-based perspectives by focusing on vulnerability, risk, and resilience resulting from military service, deployment experiences, and feedback loops that occur over the life course. The article is divided into three broad sections that discuss (1) theoretical underpinnings of the model, (2) key components of the model, and (3) future directions for military social work practice.",0 +,[The burn patient: factors associated with post-traumatic stress disorder and directions for intervention].,"AIM: Starting from the evidence that not all burn patients develop a post-traumatic stress disorder (PTSD), the aim of this overview was to describe variables, which favour the development of the disorder following to burn injury and to delineate directions for a treatment. METHODS: We searched articles in English related to PTSD in the population suffering from burns in the PubMed database, using the key word 'burn' in combination with: PTSD, traumatic event, trauma, ASD, and psychological factors. We concentrated our attention on articles published in the last decade (January 1998-March 2010). RESULTS: We found 32 articles. The risk factors concurring in the onset of PTSD are the presence of post-traumatic symptoms in the first following weeks to the burn, the avoidant coping, nevroticism, the presence of psychiatric disorder before the trauma, and the degree of disfigurement. The principal protective factors emerged from the review are the search of social or emotional support and extraversion. Information related to the treatment of these patients is scarce. CONCLUSIONS: The literature underlines the importance of the individual vulnerability to the development of PTSD in burn patients, besides the experience itself of a traumatic event. These patients must face peculiar and specific problems, therefore, with the purpose to odevelop a suitable intervention, it would be useful to appraise, besides the physical and psychosocial implications of the burn, the psychological characteristics of each patient, to articulate a treatment that may account for the complexity of the burn patient. Language: it",0 +https://doi.org/10.1017/s1041610211000366,PTSD in the elderly: the interaction between trauma and aging,"ABSTRACT Background: Because an increasingly large cohort of individuals is approaching their elderly years, there is concern about how the healthcare system will cope with the greater demands placed upon it. One area of concern is the impact of trauma and post traumatic stress disorder (PTSD) in the aged. Although several reviews have highlighted the lack of knowledge and research on the topic, there still remain gaps in the literature. Nevertheless, some recent behavioral, endocrinological and neuroimaging studies may provide new insights into the discussion. The central aims of this paper are to summarize the etiological, epidemiological and clinical aspects of PTSD, trauma, and the elderly, and to integrate this knowledge with (i) what is known about PTSD in adults, and (ii) the behavioral, hormonal and cerebral changes associated with healthy aging. Methods: A comprehensive search was performed with ISI Web of Science and PubMed for articles pertinent to the psychology and biology of PTSD, trauma, and the elderly. Results: There exist both significant similarities and differences between adults and elderly with PTSD concerning cognitive and biological profile. Evidence suggests that PTSD in the elderly does not follow a simple clinical trajectory. Conclusions: PTSD in the elderly must be considered within the context of normal aging. Strong claims about an interaction between PTSD and aging are difficult to make due to sample heterogeneity, but it is clear that PTSD in this age group presents unique aspects not seen in younger cohorts. Further research must integrate their studies with the biological, psychological, and social changes already associated with the aging process.",0 +https://doi.org/10.1620/tjem.230.151,Premenstrual Symptoms and Posttraumatic Stress Disorder in Japanese High School Students 9 Months after the Great East-Japan Earthquake,"On March 11, 2011, the Great East-Japan Earthquake occurred and a massive tsunami hit the northeastern coast of Japan. Catastrophic disasters such as earthquakes and war cause tremendous damage, not only physically but also mentally. Posttraumatic stress disorder (PTSD) is an anxiety disorder that occurs in the aftermath of a traumatic event. Premenstrual syndrome (PMS) is a cluster of psychological and somatic symptoms that are limited to the late luteal phase of the menstrual cycle. Premenstrual dysphoric disorder (PMDD) is considered a severe form of PMS. To determine the relationship between premenstrual symptoms and natural disaster-induced PTSD among Japanese adolescent girls, we conducted a cross-sectional study. Overall, 1489 high school students who belong to two high schools in Sendai, the largest city in northeastern Japan, were assessed 9 months after the earthquake. These schools are located inland, far from the seashore, and were not damaged by the tsunami. Premenstrual symptoms were assessed using the Premenstrual Symptoms Questionnaire, and PTSD symptoms were assessed using the Japanese-language version of Impact of Event Scale-Revised, which is a widely used self-assessment questionnaire about PTSD symptoms. We analyzed the data of 1,180 girls who completed the questionnaires and 118 girls (10.0%) were classified as having PTSD. The prevalence rates of PMDD and moderate to severe PMS increased according to the comorbidity of PTSD (p < 0.001), showing a correlation between the severity of PMS/PMDD and natural disaster-induced PTSD. The comorbidity of PMS/PMDD and PTSD may complicate the follow-up of both conditions.",0 +https://doi.org/10.1016/j.comppsych.2010.09.005,"Trauma exposure characteristics, past traumatic life events, coping strategies, posttraumatic stress disorder, and psychiatric comorbidity among people with anaphylactic shock experience","This study investigated the interrelationship between trauma exposure characteristics, past traumatic life events, coping strategies, posttraumatic stress disorder (PTSD) symptoms, and psychiatric comorbidity among people after anaphylactic shock experience. The design was cross-sectional in that 94 people with anaphylactic shock experience responded to a postal survey. They completed the Posttraumatic Stress Disorder Checklist, the General Health Questionnaire 28, and the COPE Scale. They also answered questions on trauma exposure characteristics. The control group comprised 83 people without anaphylaxis. Twelve percent of people with anaphylactic shock experience fulfilled the diagnostic criteria for full PTSD. As a group, people with anaphylaxis reported significantly more past traumatic life events and psychiatric comorbidity than did the control. Partial least squares analysis showed that trauma exposure characteristics influenced postanaphylactic shock PTSD symptoms and psychiatric comorbidity, which, in turn, influenced coping strategies. People could develop PTSD and psychiatric comorbidity symptoms after their experience of anaphylactic shock. The way they coped with anaphylactic shock was affected by the severity of these symptoms. Past traumatic life events had a limited role to play in influencing outcomes.",0 +https://doi.org/10.1093/jpepsy/jsv036,Profiles of Connectedness: Processes of Resilience and Growth in Children With Cancer,"Identified patterns of connectedness in youth with cancer and demographically similar healthy peers.Participants included 153 youth with a history of cancer and 101 youth without a history of serious illness (8-19 years). Children completed measures of connectedness, posttraumatic stress symptoms (PTSS), and benefit-finding. Parents also reported on children's PTSS.Latent profile analysis revealed four profiles: high connectedness (45%), low connectedness (6%), connectedness primarily to parents (40%), and connectedness primarily to peers (9%). These profiles did not differ by history of cancer. However, profiles differed on PTSS and benefit-finding. Children highly connected across domains displayed the lowest PTSS and highest benefit-finding, while those with the lowest connectedness had the highest PTSS, with moderate PTSS and benefit-finding for the parent and peer profiles.Children with cancer demonstrate patterns of connectedness similar to their healthy peers. Findings support connectedness as a possible mechanism facilitating resilience and growth.",0 +https://doi.org/10.1016/j.comppsych.2008.06.006,"Cumulative effect of multiple trauma on symptoms of posttraumatic stress disorder, anxiety, and depression in adolescents","Recent literature has indicated that exposure to multiple traumatic events in adults is associated with high levels of posttraumatic stress disorder (PTSD), anxiety, and depression. Against the backdrop of stressful life events and childhood abuse and neglect, we investigated the cumulative effect of multiple trauma exposure on PTSD, anxiety, and depression in an adolescent sample. One thousand one hundred forty 10th-grade learners from 9 Cape Town (South Africa) schools completed questionnaires on stressful life experiences; trauma exposure; and symptoms of anxiety, depression, and PTSD. Our population of interest for this study was adolescents between the ages of 14 and 18 years who had been exposed to serious, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition , qualifying traumatic events. The final sample size was thus 922. Rates of trauma exposure, PTSD, depression, and anxiety were high. Controlling for sex, stressful life experiences in the past year, and childhood adversity, we found an effect of cumulative trauma exposure effect on PTSD and depression, with an increase in the number of traumas linearly associated with an increase in symptoms of PTSD (F (4,912) = 7.60, P < .001) and depression (F (4,912) = 2.77, P < .05). We did not find a cumulative effect on anxiety. Our findings indicate that adolescents exposed to multiple traumas are more likely to experience more severe symptoms of PTSD and depression than those who experience a single event, with this effect independent of childhood adversity and everyday stressful life experiences. Exposure to multiple trauma, however, does not seem to be associated with more severe anxiety symptoms.",0 +https://doi.org/10.1016/s2221-6189(14)60066-4,Different profiles of mental and physical health and stress hormone response in women victims of intimate partner violence,"To analyse the individual differences in the impact that intimate male partner violence (IPV) has on a woman's depressive and posttraumatic stress disorder (PTSD) symptomatology, and to determine the association of the different profiles of mental dysfunction with cortisol and dehydroepiandrosterone (DHEA) basal saliva levels as well as physical health symptoms. A cross-sectional study was carried out in which IPV victims ( n =73) and control non-abused ( n =31) women participated. Information was obtained through structured interviews and saliva samples were collected for hormonal assays under baseline conditions. There were three profiles of mental symptoms in IPV subjects: no symptoms ( n =19); with depressive symptoms ( n =36), and depressive/PTSD symptom ( n =18). None of the non-abused women had depressive or PTSD symptoms. The stress hormone response differed between groups. Only the IPV-depressive group had higher evening cortisol, and both morning and evening DHEA, but lower morning cortisol/DHEA ratio than non-abused women. Furthermore, there were differences between the IPV groups. The IPV-depressive group had lower morning cortisol and morning cortisol/DHEA ratio than the IPV-no symptoms and lower morning cortisol/DHEA ratio than the IPV-depressive/PTSD group. With respect to the physical symptoms there was an association between the mean of symptoms and the profile of mental health, the incidence being higher in the depressive/PTSD group than in the other groups. This study demonstrates that there are individual differences in the impact that IPV has on the stress response and health status in women victims.",0 +https://doi.org/10.1097/bcr.0b013e3181d0f523,Psychometric Properties of the Impact of Event Scale-Revised in Patients One Year After Burn Injury,"Burn injury can be a life-threatening and traumatic event. Despite considerable risk for psychological morbidity, few outcome measures have been evaluated. The aim of this study was to examine the psychometric properties of a Swedish version of the Impact of Event Scale-Revised (IES-R) in patients 1 year after burn injury (N = 147). A principal component analysis was performed, and the results supported the three-factor structure of the IES-R. High internal consistency and intelligible associations with concurrent psychological symptoms and known risk factors for distress after trauma indicate satisfactory psychometric properties. Thus, the study supports the use of the IES-R as a screening tool for measuring traumatic distress after burn.",0 +https://doi.org/10.1371/journal.pone.0119754,Innovative Training with Virtual Patients in Transcultural Psychiatry: The Impact on Resident Psychiatrists’ Confidence,"Virtual patients are now widely accepted as efficient and safe training tools in medical education, but very little is known about their implementation in psychiatry, especially in transcultural clinical care of traumatized refugee patients.This study aimed at assessing the impact of training with a virtual patient on confidence in providing clinical care for traumatized refugee patients.The authors developed an educational tool based on virtual patient methodology portraying the case of ""Mrs. K"", a traumatized refugee woman with symptoms of PTSD and depression. A group (N=32) of resident psychiatrists tested the system and their confidence in different aspects of providing clinical care for this patient group was evaluated pre- and post-test by using a validated confidence questionnaire. Cronbach's α was calculated for all clusters. Changes between pre- and post-test were compared by using the matched-pair t-test, binomial distribution for exact significance test and a calculation of effect sizes (Cohen's d).A statistically significant improvement was exhibited in overall confidence (mean Δ: 0.34; p<0.0001; d: 0.89) as well as in four more specific domains of clinical care, with the area of identifying and evaluating trauma-related diagnoses and disability showing the most prominent improvement (mean Δ: 0.47; p<0.0001; d: 1.00).This VP-system can lead to physicians' improvement of confidence in providing transcultural clinical care for traumatized refugee patients. Further research is required to investigate improvement in actual performance and cognitive outcomes with several VPs and in a long-term effect perspective.",0 +https://doi.org/10.1096/fasebj.27.1_supplement.533.12,Time‐dependent Development of Social Stress Caused by Repeated Exposures to Aggressors Simulating Features of Post‐traumatic Stress Disorder (PTSD),"A utility criterion of a PTSD mouse model is recruiting a stressor with systematically variable intensity. An ideal stressor should maintain a 'dose-response relationship' with the subjects' behavioral shift. A typical PTSD model includes a brief exposure to foot or tail shock. We developed a model that involves repeated exposures (either 5-day or 10-day) to trained conspecific aggressors (Agg). A contextual reminder study evaluating a cluster of ethogram identified PTSD-like (acute- and persistent-) syndromes such as incubation, extinction and desensitization of fear responses. Pathophysiological consequences supported the model. This model reflects the combat-like situation where life-threatening events occur repeatedly and randomly. The direct relationship of PTSD-risk with deployment frequency further justifies the model. Agg induced stress intensity can only be elevated by prolonging the exposure. The risk of habituation can thereby defeat the 'dose-response' relationship. We addressed this concern by evaluating the time-dependent behavioral shift of the subject mice (C57BL/6j). Subsets of subject mice were withdrawn from the Agg-exposure (Agg-E) schedule at regular intervals and their psycho-patho-physiological characters were evaluated. A regression model elucidated the temporal relationship of Agg-E stress with the psychological alteration.",0 +https://doi.org/10.1016/j.jad.2012.07.004,Comorbidity of personality disorders in anxiety disorders: A meta-analysis of 30 years of research,"A comprehensive meta-analysis to identify the proportions of comorbid personality disorders (PD) across the major subtypes of anxiety disorders (AD) has not previously been published.A literature search identified 125 empirical papers from the period 1980-2010 on patients with panic disorders, social phobia, generalised anxiety, obsessive-compulsive (OCD) and post-traumatic stress disorder (PTSD). Several moderators were coded.The rate of any comorbid PD was high across all ADs, ranging from .35 for PTSD to .52 for OCD. Cluster C PDs occurred more than twice as often as cluster A or B PDs. Within cluster C the avoidant PD occurred most frequently, followed by the obsessive-compulsive and the dependent PD. PTSD showed the most heterogeneous clinical picture and social phobia was highly comorbid with avoidant PD. A range of moderators were examined, but most were non-significant or of small effects, except an early age of onset, which in social phobia increased the risk of an avoidant PD considerably. Gender or duration of an AD was not related to variation in PD comorbidity.Blind rating of diagnoses was recorded from the papers as an indication of diagnostic validity. However, as too few studies reported it the validity of the comorbid estimates of PD was less strong.The findings provided support to several of the proposed changes in the forthcoming DSM-5. Further comorbidity studies are needed in view of the substantial changes in how PDs will be diagnosed in the DSM-5.",0 +https://doi.org/10.1016/j.jad.2013.07.020,Post-traumatic stress disorder in DSM-5: Estimates of prevalence and criteria comparison versus DSM-IV-TR in a non-clinical sample of earthquake survivors,"The latest edition of DSM (DSM-5) introduced important revisions to PTSD symptomatological criteria, such as a four-factor model and the inclusion of new symptoms. To date, only a few studies have investigated the impact that the proposed DSM-5 criteria will have on prevalence rates of PTSD.An overall sample of 512 adolescents who survived the L'Aquila 2009 earthquake and were previously investigated for the presence of full and partial PTSD, using DSM-IV-TR criteria, were reassessed according to DSM-5 criteria. All subjects completed the Trauma and Loss Spectrum-Self Report (TALS-SR).A DSM-5 PTSD diagnosis emerged in 39.8% of subjects, with a significant difference between the two sexes (p<0.001), and an overall 87.1% consistency with DSM-IV-TR. Most of the inconsistent diagnoses that fulfilled DSM-IV-TR criteria but not DSM-5 criteria can be attributed to the subjects not fulfilling the new criterion C (active avoidance). Each DSM-5 symptom was more highly correlated with its corresponding symptom cluster than with other symptom clusters, but two of the new symptoms showed moderate to weak item-cluster correlations. Among DSM-5 PTSD cases: 7 (3.4%) endorsed symptom D3; 151 (74%) D4; 28 (13.7%) both D3 and D4; 75 (36.8%) E2.The use of a self-report instrument; no information on comorbidity; homogeneity of study sample; lack of assessment on functional impairment; the rates of DSM-IV-TR qualified PTSD in the sample was only 37.5%.This study provides an inside look at the empirical performance of the DSM-5 PTSD criteria in a population exposed to a natural disaster, which suggests the need for replication in larger epidemiological samples.",0 +https://doi.org/10.1517/14656566.3.10.1489,Review of sertraline in post-traumatic stress disorder,"Sertraline (Zoloft trade mark, Pfizer) is a selective serotonin re-uptake inhibitor (SSRI) with proven efficacy in the treatment of post-traumatic stress disorder (PTSD). PTSD is a serious, complex and often chronic mental illness that may follow exposure to a traumatic event. The high prevalence of traumatic events and PTSD in the general population and the resulting distress and dysfunction present a need for the systematic study of the efficacy and effectiveness of treatments for PTSD. Sertraline offers advantages over the older antidepressants, including demonstrated efficacy in PTSD, improved tolerability and low risk of lethality in overdose. Sertraline's efficacy, favourable tolerability profile and relatively weak effect on the cytochrome P450 system are factors that contribute to make it a first-line agent of choice in the treatment of PTSD.",0 +https://doi.org/10.1007/s10862-005-0634-6,Personality Assessment Inventory (PAI) Profiles of Male Veterans With Combat-Related Posttraumatic Stress Disorder,"The Personality Assessment Inventory (PAI; L. C. Morey, 1991) is a promising tool for the assessment of Posttraumatic Stress Disorder (PTSD), but few studies have examined the PAI profiles of individuals with the diagnosis. In this study, the PAI was administered to 176 combat veterans with PTSD. Results showed significant elevations on scales measuring depression, somatic complaints, anxiety, anxiety-related disorders, schizophrenia, and negative impression management. The Traumatic Stress subscale was the highest point in the mean score profile and was moderately correlated with several established measures of PTSD. Veterans with and without comorbid major depression differed on PAI scales assessing depression, anxiety, and warmth. Analysis of two-point codetypes for the PAI and the MMPI-2 revealed substantial heterogeneity in symptom endorsement on both instruments, suggesting that there may be no clear ""PTSD profile"" on either instrument. Results provide a reference point for future work with the PAI in PTSD samples. (",0 +https://doi.org/10.1002/jclp.21845,"The PTSD Checklist-Civilian Version: Reliability, Validity, and Factor Structure in a Nonclinical Sample","We examined the reliability, validity, and factor structure of the posttraumatic stress diorder (PTSD) Checklist-Civilian Version (PCL-C; Blanchard, Jones-Alexander, Buckley, & Forneris, 1996) among unselected undergraduate students.Participants were 471 undergraduate students at a large university in the Eastern United States and were not preselected based on trauma history or symptom severity.The PCL-C demonstrated good internal consistency and retest reliability. Compared with alternative measures of PTSD, the PCL-C showed favorable patterns of convergent and discriminant validity. In contrast to previous research using samples with known trauma exposure, we found support for both 1-factor and 2-factor models of PTSD symptoms.Overall, the PCL-C appears to be a valid and reliable measure of PTSD symptoms, even among nonclinical samples, and is superior to some alternative measures of PTSD. The factor structure among nonclinical samples may not reflect each of the PTSD symptom ""clusters"" (i.e., reexperiencing, avoidance/numbing, and hyperarousal).",0 +https://doi.org/10.1097/00005053-199607000-00002,Evidence for Response Set Effects in Structured Research Interviews,"The Addiction Severity Index and NIMH Diagnostic Interview Schedule data of 20 methadone-maintained subjects with ""fake bad"" invalid profiles on the Personality Assessment Inventory, 15 methadone-maintained subjects with ""fake good"" invalid profiles, and 158 methadone-maintained subjects with valid profiles were compared. The findings revealed a number of significant group differences on both measures with the highest scores for the fake bad subjects and lowest scores for the fake good subjects. These findings suggest that the response sets exhibited in response to the Personality Assessment Inventory questionnaire extended to performance during the two semi-structured interviews. There was no indication that interviewers were aware of misrepresentation. The limitations of the findings and alternative interpretations of the data are considered.",0 +https://doi.org/10.1037/0002-9432.76.4.468,Profile of children investigated for sexual abuse: Association with psychopathology symptoms and services.,"Sexually abused children may have poor mental health because of their victimization as well as preexisting or co-occurring family problems. However, few studies consider psychopathology in relation to both abuse and other family experiences. This study uses data from the National Survey of Child and Adolescent Well-Being (NSCAW) to create latent subgroups of 553 children investigated for sexual abuse. The study investigates children's psychological symptoms and child welfare service (CWS) patterns to understand how children's needs relate to mental health services. Analyses were conducted by child age: 3-7, 8-11, and 12-14. Factor mixture modeling and regression analyses were used. Results show meaningful subgroups of children that relate to different symptom patterns. Among 3- to 7-year-olds, behavioral symptoms are associated with caregiver domestic violence and mental illness. Among 8- to 11-year-olds, depressive symptoms are associated with severe abuse and multiple family problems, whereas posttraumatic stress is associated with chronic, unresolved abuse. Although many children received mental health services, services are not well matched to children's needs--the substantiation status of the abuse explains services. Implications for CWS and mental health services are discussed.",0 +,Post Traumatic Stress Disorder: Cognitive Therapy with Children and Young People,"Post traumatic stress disorder develops after exposure to one or more terrifying events that have caused, or threatened to cause the sufferer grave physical harm. This book discusses how trauma-focused cognitive therapy can be used to help children and adolescents who suffer from post traumatic stress disorder. Cognitive therapy is frequently used to treat adults who suffer from PTSD with proven results. Post Traumatic Stress Disorder provides the therapist with instructions on how CT models can be used with children and young people to combat the disorder. Based on research carried out by the authors, this book covers: assessment procedures and measures formulation and treatment planning trauma focused cognitive therapy methods common hurdles. The authors provide case studies and practical tips, as well as examples of self-report measures and handouts for young people and their parents which will help the practitioner to prepare for working with this difficult client group. Post Traumatic Stress Disorder is an accessible, practical, clinically relevant guide for professionals and trainees in child and adolescent mental health service teams who work with traumatized children and young people.",0 +https://doi.org/10.1016/j.injury.2008.08.045,The injury profile after the 2008 earthquakes in China,"The 8.0 magnitude earthquake that struck China on May 12, 2008, was the deadliest earthquake in 30 years. Most hospitals were destroyed and limited facilities were available for medical service in the earthquake regions. Over the first 5 days, three general hospitals and one children's hospital admitted 1770 injured individuals.We retrospectively collected data on 1770 injured subjects in three general hospitals (n=1723) and one children's hospital (n=47) in the quake-area during the first 5 days after the event. The diagnosis for the injuries was based on the final hospital diagnosis made by the physicians and classified by two-independent researchers using the International Statistical Classification of Diseases and Related Health Problems ICD-10 (WHO ICD-10 Code.1993). To ensure the accuracy of the information, any questionable data was reviewed by phone with hospital staff.In three general hospitals, 848 patients (48%) were male and 922 (52%) were female. Nine percent (n=84) of females and 8.8% (n=75) of males were over the age of 75. Four (0.4%) females and 5 (0.5%) males were less than 1-year old. The most common injuries were the injuries of the knee, lower leg, ankle and foot (36%), followed by head injuries (18%). In the children's hospital, 31 (65%) of the patients were males and 16 (35%) were females. 40% of the subjects were 10-14, while 21% were less than 1-year old. The most frequently seen injuries were also of the knee, lower leg, ankle or foot (19%), and of the abdomen, lower back, lumbar spine and pelvis, and hip and thigh (15%).We gathered information from resources in Chinese, which at the time contained more records on this event than any documents in English. The age of the patients ranged from 7 days to 84 years old. Subjects over age 75 and children between 10 and 14 were the largest population in their respective hospitals, indicating that these groups required the greatest medical resources. The injury profile presented here serves as a reference not only for present injury intervention but also for future earthquake disaster response.",0 +,Stressor characteristics and post-traumatic stress disorder symptom dimensions in war victims.,"To evaluate how the type of trauma is related to specific symptom patterns in patients with post-traumatic stress disorder (PTSD) according to the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) criteria.A total of 136 PTSD patients exposed to war-related traumatic experiences were divided in four groups: 79 veterans, 18 former prisoners (who witnessed or were subject to torture or frequent assaults), 15 victims of rape, and 24 refugees from Bosnia and Herzegovina. Each group was homogenous in regard to traumatic experiences.Significant inter-group differences were found in symptoms listed in the DSM-IV criteria, and under criteria C (avoidance) and D (arousal). No such differences were observed in symptoms listed under criterion B (intrusive symptoms). The results indicate that stressor characteristics may play a role not only in the variety of symptoms exhibited, but particularly in the number of avoidance and arousal symptoms. Victims of rape tended to present with more avoidance symptoms and fewer hyperarousal symptoms, whereas former prisoners and veterans tended to report more hyperarousal symptoms. Rape victims and former prisoners also reported more symptoms than the other groups.There is a strong indication that stressor characteristics influence the variety and number of exhibited intrusive, avoidance, and arousal symptoms. More research is needed to precisely define individual symptom dimensions possibly relating to particular stressor characteristics. Additional studies are needed to determine whether PTSD, as it is currently defined in the DSM-IV, is really a homogenous diagnostic category.",0 +https://doi.org/10.1016/j.cppeds.2010.10.008,The Quality of Life of Young Children and Infants with Chronic Medical Problems: Review of the Literature,"The question ""what makes a good quality of life?"" is a philosophical one which could be thought immune to scientific investigations. However, over the last few decades there has been great progress in developing tools to quantify quality of life (QoL) to make comparisons between different health states, evaluate the effectiveness of medical interventions, and describe the life trajectories of individuals or groups. Using a series of vignettes, we explore and review the biomedical literature to demonstrate how QoL is affected by chronic health conditions in childhood, and how it evolves as individuals pass into adulthood. Individuals experiencing serious chronic illnesses generally have reduced health-related QoL: their health status has significant repercussions of their everyday life, but scores are usually much better than healthy individuals expect, and better than physicians predict. Global QoL is more than a health status concept. QoL is a complex relationship between objectivity and subjectivity; it requires substantial and valid facts, and it defines itself by an interpretation of health within different schemes of values: societal, medical, and those of the subject themselves. QoL is dynamic; purely physical influences diminish as individuals age, and psychosocial factors become much more important. Resilience frequently allows adaptation to adverse health states, leading to acceptable QoL for most children with disabilities.",0 +https://doi.org/10.1037/mil0000077,Clarifying Heterogeneity of Daytime and Nighttime Symptoms of Posttraumatic Stress in Combat Veterans With Insomnia,"Daytime and nighttime symptoms of posttraumatic stress disorder (PTSD) are common among combat veterans and military service members. However, there is a great deal of heterogeneity in how symptoms are expressed. Clarifying the heterogeneity of daytime and nighttime PTSD symptoms through exploratory clustering may generate hypotheses regarding ways to optimally match evidence-based treatments to PTSD symptom profiles. We used mixture modeling to reveal clusters based on six daytime and nighttime symptoms of 154 combat veterans with insomnia and varying levels of PTSD symptoms. Three clusters with increasing symptom severity were identified (N1=50, N2=70, N3=34). These results suggest that, among veterans with insomnia, PTSD symptoms tend to exist on a continuum of severity, rather than as a categorical PTSD diagnosis. Hypotheses regarding possible targeted treatment strategies for veterans within each identified cluster, as well as ways to generalize these methods to other groups within the military, are discussed.",0 +https://doi.org/10.1146/annurev-statistics-010814-020403,Using Longitudinal Complex Survey Data,"Common features of longitudinal surveys are complex sampling designs, which must be maintained and extended over time; measurement errors, including memory errors; panel conditioning or time-in-sample effects; and dropout or attrition. In the analysis of longitudinal survey data, both the theory of complex samples and the theory of longitudinal data analysis must be combined. This article reviews the purposes of longitudinal surveys and the kinds of analyses that are commonly used to address the questions these surveys are designed to answer. In it, I discuss approaches to incorporating the complex designs in inference, as well as the complications introduced by time-in-sample effects and by nonignorable attrition. I also outline the use and limitations of longitudinal survey data in supporting causal inference and conclude with some summary remarks.",0 +https://doi.org/10.3402/ejpt.v6.27503,Latent Growth Mixture Models to estimate PTSD trajectories,"No abstract available. (Published: 2 March 2015) Citation: European Journal of Psychotraumatology 2015, 6 : 27503 - http://dx.doi.org/10.3402/ejpt.v6.27503 This paper is part of the Special Issue: Estimating PTSD trajectories . More papers from this issue can be found at http://www.ejpt.net",0 +https://doi.org/10.1016/j.socscimed.2009.09.029,"War exposure, daily stressors, and mental health in conflict and post-conflict settings: Bridging the divide between trauma-focused and psychosocial frameworks","This paper seeks to bridge the divisive split between advocates of trauma-focused and psychosocial approaches to understanding and addressing mental health needs in conflict and post-conflict settings by emphasizing the role that daily stressors play in mediating direct war exposure and mental health outcomes. The authors argue that trauma-focused advocates tend to overemphasize the impact of direct war exposure on mental health, and fail to consider the contribution of stressful social and material conditions (daily stressors). Drawing on the findings of recent studies that have examined the relationship of both war exposure and daily stressors to mental health status, a model is proposed in which daily stressors partially mediate the relationship of war exposure to mental health. Based on that model, and on the growing body of research that supports it, an integrative, sequenced approach to intervention is proposed in which daily stressors are first addressed, and specialized interventions are then provided for individuals whose distress does not abate with the repair of the social ecology.",0 +https://doi.org/10.1016/j.drugalcdep.2006.08.025,Changes in PTSD symptomatology during acute and protracted alcohol and cocaine abstinence,"Previous research with substance users has demonstrated, across a variety of psychiatric disorders, significant decreases in psychological symptoms during early substance abstinence. To build on this literature, the current study prospectively assessed trauma symptomatology over 28 days during acute and protracted cocaine and alcohol abstinence. Participants were 162 male and female cocaine and/or alcohol dependent outpatients who reported a history of trauma. Trauma-related symptoms and substance use were assessed at 2, 5, 10, 14, 21, and 28 days following last substance use. For participants who were known to relapse, assessments began again after the last day of substance use. Latent growth modeling was employed to estimate changes in posttraumatic stress disorder (PTSD) symptoms. Consistent with studies of other psychiatric syndromes, PTSD symptoms declined across the 28-day study period regardless of withdrawal substance (i.e., cocaine or alcohol). The majority of change in trauma symptoms occurred within 2 weeks of last substance use. Moreover, while trauma symptoms for the PTSD participants were more severe than those reported by the non-PTSD participants, trauma symptoms declined across the study period at the same rate irrespective of PTSD status.",0 +https://doi.org/10.1016/j.addbeh.2007.06.001,Behavioral couples therapy for comorbid substance use disorders and combat-related posttraumatic stress disorder among male veterans: An initial evaluation,"Outcomes after behavioral couples therapy (BCT) were compared for 19 dually diagnosed veterans with combat-related PTSD and a substance use disorder (SUD, primarily alcohol dependence) and 19 veterans with SUD only. Clients with and without comorbid PTSD had very similar pre-treatment clinical profiles on dimensions of substance misuse, relationship functioning, and psychological symptoms. Further, both PTSD and non-PTSD clients showed good compliance with BCT, attending a high number of BCT sessions, taking Antabuse, and going to AA. Finally, both PTSD and non-PTSD groups improved from before BCT to immediately after and 12 months after BCT. Specific improvements noted were increased relationship satisfaction and reductions in drinking, negative consequences of drinking, male-to-female violence, and psychological distress symptoms. Extent and pattern of improvement over time were similar whether the client had PTSD or not. The present results suggest that BCT may have promise in treating clients with comorbid SUD and combat-related PTSD.",0 +https://doi.org/10.4161/hv.4589,Smallpox Vaccination: Comparison of Self-Reported and Electronic Vaccine Records in the Millennium Cohort Study,"In December 2002, the US Government implemented policy to immunize health workers, first responders, and military personnel against smallpox in preparation for a possible bioterrorist attack. Self-reported vaccination data are commonly used in epidemiologic research and may be used to determine vaccination status in a public health emergency. To establish a measure of reliability, the agreement between self-reported smallpox vaccination and electronic vaccination records was examined using data from the Millennium Cohort Study. Descriptive measures and a kappa statistic were calculated for data from 54,066 Millennium Cohort Study participants. Multivariable modeling adjusting for potential confounders was used to investigate vaccination agreement status and health metrics, as measured by the Short Form 36-Item Health Survey for Veterans (SF-36V) and hospitalization data. Substantial agreement (kappa =0.62) was found between self-report and electronic recording of smallpox vaccination. Of all participants with an electronic record of smallpox vaccination, 90% self-reported being vaccinated; and of all participants with no electronic record of vaccination, 82% self-reported not receiving a vaccination. There was no significant difference in hospitalization experience prior to questionnaire completion between vaccinated and unvaccinated participants. While overall scores on the SF-36V suggested a healthy population, participants whose self-reported vaccination status did not match electronic records had slightly lower adjusted mean scores for some scales. These results indicate strong reliability in self-reported smallpox vaccination and also suggest that discordant reporting of smallpox vaccination is not associated with substantial differences in health among Millennium Cohort participants.",0 +https://doi.org/10.1001/archpediatrics.2009.56,Screening for Traumatic Exposure and Posttraumatic Stress Symptoms in Adolescents in the War-Affected Eastern Democratic Republic of Congo,"To explore adolescent mental health in the eastern Democratic Republic of Congo, scene of a complex emergency since 1996.Community cross-sectional data obtained using a cluster sample approach.From November 5, 2007, through February 5, 2008, we assessed 13 secondary schools in 4 selected health zones in the Ituri district.One thousand forty-six adolescents and young adults aged 13 to 21 years completed a self-report questionnaire.War-related traumatic events, posttraumatic stress symptoms, and sociodemographic variables.The Adolescent Complex Emergency Exposure Scale, specifically designed for this region, screened for exposure to potentially traumatic events, and the Impact of Event Scale-Revised measured symptoms of posttraumatic stress consistent with Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria.Among the 477 girls (45.6%) and 569 boys (54.4%) in the study, 95.0% reported at least 1 traumatic event. On average, adolescents were exposed to 4.71 traumatic events, with higher exposure rates reported in boys, older groups, rural and urban areas, and respondents whose mother or father was dead. Of 990 respondents, 52.2% met symptom criteria for posttraumatic stress disorder. Symptom scores were strongly related to cumulative trauma exposure; however, the strength of this relationship differed slightly across living area groups for girls.Adolescents in the eastern Democratic Republic of Congo are highly exposed to political violence, putting them at a considerable risk--mediated by living area and sex--to develop posttraumatic stress symptoms.",0 +https://doi.org/10.1176/appi.ajp.162.7.1381,Acute Stress Disorder and Posttraumatic Stress Disorder in Children and Adolescents Involved in Assaults or Motor Vehicle Accidents,"OBJECTIVE: The authors investigated acute stress disorder and later posttraumatic stress disorder (PTSD) in children and adolescents who had been involved in assaults or motor vehicle accidents. METHOD: They interviewed 93 patients 10–16 years old who were seen in an emergency department for having been assaulted or involved in a motor vehicle accident within 4 weeks after the assault or accident to assess acute stress disorder. At 6 months, they reinterviewed 64 (68.8%) of the patients to assess PTSD. RESULTS: At initial interview, 18 (19.4%) of the 93 patients had acute stress disorder and 23 (24.7%) met all acute stress disorder criteria except dissociation. At 6 months, eight of the 64 patients (12.5%) had PTSD. Acute stress disorder and PTSD did not differ in prevalence between patients who had been assaulted and those who had been in accidents. Sensitivity and specificity statistics and regression modeling revealed that the diagnosis of acute stress disorder was a good predictor of later PTSD but that dissociation did not play a significant role. CONCLUSIONS: Acute stress disorder has merit as a predictor of later PTSD in children and adolescents, but dissociation has questionable utility.",0 +https://doi.org/10.1089/jwh.2008.1165,Sexual Function Outcomes in Women Treated for Posttraumatic Stress Disorder,"This study examined dysfunctional sexual behavior and sexual concerns in women treated for posttraumatic stress disorder (PTSD). There were three objectives: to characterize the relationship between symptoms of PTSD and sexual outcomes, to examine the effect of treatment on sexual outcomes, and to examine the relationship between change in PTSD and change in sexual outcomes.Female veterans and active duty personnel with PTSD (n = 242), 93% of whom had experienced sexual trauma, were randomly assigned to receive 10 weekly sessions of either Prolonged Exposure or Present-Centered Therapy. PTSD and sexual outcomes were assessed before and after treatment and then 3 and 6 months later.At baseline, the reexperiencing, numbing, and hyperarousal symptom clusters were related to one or both sexual outcomes. Although prior analyses had shown that Prolonged Exposure resulted in better PTSD outcomes, there were no differences between treatments for either dysfunctional sexual behavior or sexual concerns. However, loss of PTSD diagnosis was associated with improvements in sexual concerns.The findings suggest that clinically meaningful improvements in PTSD are necessary in order to reduce sexual problems in traumatized women.",0 +https://doi.org/10.1002/jts.21732,"Modeling PTSD Symptom Clusters, Alcohol Misuse, Anger, and Depression as They Relate to Aggression and Suicidality in Returning U.S. Veterans","Suicidal ideation and aggression are common correlates of posttraumatic stress disorder (PTSD) among U.S. Iraq and Afghanistan war veterans. The existing literature has established a strong link between these factors, but a more nuanced understanding of how PTSD influences them is needed. The current study examined the direct and indirect relationships between PTSD symptom clusters and suicidal ideation in general aggression (without a specified target) regarding depression, alcohol misuse, and trait anger. Participants were 359 (92% male) U.S. Iraq/Afghanistan war veterans. Path analysis results suggested that the PTSD numbing cluster was directly (β = .28, p < .01) and indirectly (β = .17, p = .001) related through depression. The PTSD hyperarousal cluster was indirectly related to suicidal ideation through depression (β = .13, p < .001). The PTSD reexperiencing cluster was directly related to aggression (β = .17, p < .05), whereas the PTSD numbing and hyperarousal clusters were indirectly related to aggression through trait anger (β = .05, p < .05; β = .20, p < .001). These findings indicate that adjunct treatments aimed at stabilizing anger, depression, and alcohol misuse may help clinicians ameliorate the maladaptive patterns often observed in veterans. These results also point to specific manifestations of PTSD and co-occurring conditions that may inform clinicians in their attempts to identify at risk veterans and facilitate preventative interventions.",0 +https://doi.org/10.1016/j.euroneuro.2010.11.012,"A selective neurokinin-1 receptor antagonist in chronic PTSD: A randomized, double-blind, placebo-controlled, proof-of-concept trial","The substance P-neurokinin-1 receptor (SP-NK(1)R) system has been extensively studied in experimental models of stress, fear, and reward. Elevated cerebrospinal fluid (CSF) SP levels were reported previously in combat-related PTSD. No medication specifically targeting this system has been tested in PTSD. This proof-of-concept randomized, double-blind, placebo-controlled trial evaluated the selective NK(1)R antagonist GR205171 in predominately civilian PTSD. Following a 2-week placebo lead-in, 39 outpatients with chronic PTSD and a Clinician-Administered PTSD Scale (CAPS) score ≥50 were randomized to a fixed dose of GR205171 (N=20) or placebo (N=19) for 8weeks. The primary endpoint was mean change from baseline to endpoint in the total CAPS score. Response rate (≥50% reduction in baseline CAPS) and safety/tolerability were secondary endpoints. CSF SP concentrations were measured in a subgroup of patients prior to randomization. There was significant improvement in the mean CAPS total score across all patients over time, but no significant difference was found between GR205171 and placebo. Likewise, there was no significant effect of drug on the proportion of responders [40% GR205171 versus 21% placebo (p=0.30)]. An exploratory analysis showed that GR205171 treatment was associated with significant improvement compared to placebo on the CAPS hyperarousal symptom cluster. GR205171 was well-tolerated, with no discontinuations due to adverse events. CSF SP concentrations were positively correlated with baseline CAPS severity. The selective NK(1)R antagonist GR205171 had fewer adverse effects but was not significantly superior to placebo in the short-term treatment of chronic PTSD. (ClinicalTrials.gov Identifier: NCT 00211861, NCT 00383786).",0 +https://doi.org/10.1016/j.janxdis.2004.06.003,Symptom structure of posttraumatic stress disorder in a nationally representative sample,"Diagnostic criteria (e.g., Diagnostic and Statistical Manual of Mental Disorders , 4th ed.) for posttraumatic stress disorder (PTSD) posit three symptom clusters including reexperiencing, avoidance/numbing, and hyperarousal. Factor analytic studies have suggested several alternative models of PTSD symptomatology . It is uncertain whether these new models are widely generalizable as most studies have relied on relatively select treatment seeking samples (e.g., combat veterans). To address this limitation, confirmatory factor analysis was applied to symptom data from National Comorbidity Survey respondents with a lifetime history of PTSD ( n = 429). Several models were tested. The model comprised of four intercorrelated factors (reexperiencing, avoidance, numbing, and hyperarousal) received the strongest support, but did not meet all the goodness-of-fit criteria. A follow-up principal-components analysis yielded a four-factor solution, with factors representing dysphoria , cued reexperiencing and avoidance, uncued reexperiencing and hyperarousal, and trauma-related rumination. The theoretical and clinical implications of these findings are discussed.",0 +https://doi.org/10.1136/bmj.g2919,Wagner's migraine and other stories . . .,,0 +https://doi.org/10.1097/sla.0b013e31826bc313,A Randomized Stepped Care Intervention Trial Targeting Posttraumatic Stress Disorder for Surgically Hospitalized Injury Survivors,"To test the effectiveness of a stepped care intervention model targeting posttraumatic stress disorder (PTSD) symptoms after injury.Few investigations have evaluated interventions for injured patients with PTSD and related impairments that can be feasibly implemented in trauma surgical settings.The investigation was a pragmatic effectiveness trial in which 207 acutely injured hospitalized trauma survivors were screened for high PTSD symptom levels and then randomized to a stepped combined care management, psychopharmacology, and cognitive behavioral psychotherapy intervention (n = 104) or usual care control (n = 103) conditions. The symptoms of PTSD and functional limitations were reassessed at 1, 3, 6, 9, and 12 months after the index injury admission.Regression analyses demonstrated that over the course of the year after injury, intervention patients had significantly reduced PTSD symptoms when compared with controls [group by time effect, CAPS (Clinician-Administered PTSD Scale): F(2, 185) = 5.50, P < 0.01; PCL-C (PTSD Checklist Civilian Version): F(4, 185) = 5.45, P < 0.001]. Clinically and statistically significant PTSD treatment effects were observed at the 6-, 9-, and 12-month postinjury assessments. Over the course of the year after injury, intervention patients also demonstrated significant improvements in physical function [MOS SF-36 PCS (Medical Outcomes Study Short Form 36 Physical Component Summary) main effect: F(1, 172) = 9.87, P < 0.01].Stepped care interventions can reduce PTSD symptoms and improve functioning over the course of the year after surgical injury hospitalization. Orchestrated investigative and policy efforts could systematically introduce and evaluate screening and intervention procedures for PTSD at US trauma centers. (clinicaltrials.gov identifier: NCT00270959).",0 +https://doi.org/10.1016/j.biopsych.2013.02.022,The Role of Memory-related Gene WWC1 (KIBRA) in Lifetime Posttraumatic Stress Disorder: Evidence from Two Independent Samples from African Conflict Regions,"Posttraumatic stress disorder (PTSD) results from the formation of a strong memory for the sensory-perceptual and affective representations of traumatic experiences, which is detached from the corresponding autobiographical context information. Because WWC1, the gene encoding protein KIBRA, is associated with long-term memory performance, we hypothesized that common WWC1 alleles influence the risk for a lifetime diagnosis of PTSD.Traumatic load and diagnosis of current and lifetime PTSD were assessed in two independent African samples of survivors from conflict zones who had faced severe trauma (n = 392, Rwanda, and n = 399, Northern Uganda, respectively). Array-based single nucleotide polymorphism (SNP) genotyping was performed. The influence of WWC1 tagging SNPs and traumatic load on lifetime PTSD was estimated by means of logistic regression models with correction for multiple comparisons in the Rwandan sample. Replication analysis was performed in the independent Ugandan sample.An association of two neighboring SNPs in almost complete linkage disequilibrium, rs10038727 and rs4576167, with lifetime PTSD was discovered in the Rwandan sample. Although each traumatic event added to the probability of lifetime PTSD in a dose-dependent manner in both genotype groups, carriers of the minor allele of both SNPs displayed a diminished risk (p = .007, odds ratio = .29 [95% confidence interval = .15-.54]). This effect was confirmed in the independent Ugandan sample.This study reveals an association between two WWC1 SNPs and the likelihood of PTSD development, indicating that this memory-related gene might be involved in processes that occur in response to traumatic stress and influence the strengthening of fear memories.",0 +https://doi.org/10.1016/0277-9536(94)90222-4,Psychological distress in survivors of residential fires,This paper presents preliminary findings from an ongoing study of survivors of residential fires. The purpose of this study was to examine psychological distress and extent of loss in order to provide a psychological profile of survivors overtime. The sample (N = 69) was drawn consecutively from the database of residential fires available through the Philadelphia Fire Department. Levels of psychological distress were measured as well as reports of symptoms consistent with the diagnostic criteria for Post-traumatic Stress Disorder. The major findings indicate that residential fires caused significant and sustained distress. An agenda for further research and for services to survivors of these fires is presented.,0 +https://doi.org/10.1007/s13365-015-0380-9,"Post-traumatic stress is associated with verbal learning, memory, and psychomotor speed in HIV-infected and HIV-uninfected women","The prevalence of post-traumatic stress disorder (PTSD) is higher among HIV-infected (HIV+) women compared with HIV-uninfected (HIV-) women, and deficits in episodic memory are a common feature of both PTSD and HIV infection. We investigated the association between a probable PTSD diagnosis using the PTSD Checklist-Civilian (PCL-C) version and verbal learning and memory using the Hopkins Verbal Learning Test in 1004 HIV+ and 496 at-risk HIV- women. HIV infection was not associated with a probable PTSD diagnosis (17% HIV+, 16% HIV-; p = 0.49) but was associated with lower verbal learning (p < 0.01) and memory scores (p < 0.01). Irrespective of HIV status, a probable PTSD diagnosis was associated with poorer performance in verbal learning (p < 0.01) and memory (p < 0.01) and psychomotor speed (p < 0.001). The particular pattern of cognitive correlates of probable PTSD varied depending on exposure to sexual abuse and/or violence, with exposure to either being associated with a greater number of cognitive domains and a worse cognitive profile. A statistical interaction between HIV serostatus and PTSD was observed on the fine motor skills domain (p = 0.03). Among women with probable PTSD, HIV- women performed worse than HIV+ women on fine motor skills (p = 0.01), but among women without probable PTSD, there was no significant difference in performance between the groups (p = 0.59). These findings underscore the importance of considering mental health factors as correlates to cognitive deficits in women with HIV.",0 +https://doi.org/10.1002/jts.21749,Trauma History and Psychopathology in War-Affected Refugee Children Referred for Trauma-Related Mental Health Services in the United States,"There is an increasing need to deliver effective mental health services to refugee children and adolescents across the United States; however, the evidence base needed to guide the design and delivery of services is nascent. We investigated the trauma history profiles, psychopathology, and associated behavioral and functional indicators among war-affected refugee children presenting for psychological treatment. From the National Child Traumatic Stress Network's Core Data Set, 60 war-affected refugee children were identified (51.7% males, mean age = 13.1 years, SD = 4.13). Clinical assessments indicated high rates of probable posttraumatic stress disorder (30.4%), generalized anxiety (26.8%), somatization (26.8%), traumatic grief (21.4%), and general behavioral problems (21.4%). Exposure to war or political violence frequently co-occurred with forced displacement; traumatic loss; bereavement or separation; exposure to community violence; and exposure to domestic violence. Academic problems and behavioral difficulties were prevalent (53.6% and 44.6%, respectively); however, criminal activity, alcohol/drug use, and self-harm were rare (all < 5.45%). These findings highlight the complex trauma profiles, comorbid conditions, and functional problems that are important to consider in providing mental health interventions for refugee children and adolescents. Given the difficulties associated with access to mental health services for refugees, both preventive and community-based interventions within family, school, and peer systems hold particular promise.",0 +,Psychiatric emergencies (part I): psychiatric disorders causing organic symptoms.,"Psychiatric emergencies are conditions that mostly destabilize the already frenetic activity of the Emergency Department. Sometimes the emergency is clearly referable to primitive psychiatric illness. Other times, psychiatric and organic symptoms can independently coexist (comorbidity), or develop together in different conditions of substance abuse, including alcohol and prescription drugs. Differentiating between substance induced and pre-existing psychiatric disorder (dual diagnosis) may be difficult, other than controversial issue. Finally, an organic disease can hide behind a psychiatric disorder (pseudopsychiatric emergency). In this review (part I), psychiatric disorders that occur with organic symptoms are discussed. They include: (1) anxiety, conversion and psychosomatic disorders, and (2) simulated diseases. The physiologic mechanisms of the stress reaction, divided into a dual neuro-hormonal response, are reviewed in this section: (1) activation of the sympathetic nervous system and adrenal medulla with catecholamine production (rapid response), and (2) activation of the hypothalamic-pituitary-adrenal axis with cortisol production (slow response). The concept of the fight-or-flight response, its adaptive significance and the potential evolution in paralyzing response, well showing by Yerkes-Dodson curve, is explained. Abnormal short- and long-term reactions to stress evolving toward well codified cluster of trauma and stressor-related disorders, including acute stress disorder, adjustment disorder and post-traumatic stress disorder, are examined. A brief review of major psychiatric disorder and related behaviour abnormalities, vegetative symptoms and cognitive impairment, according to DMS IV-TR classification, are described. Finally, the reactive psychic symptoms and behavioral responses to acute or chronic organic disease, so called ""somatopsychic disorders"", commonly occurring in elderly and pediatric patients, are presented. The specific conditions of post-operative and intensive care unit patients, and cancer and HIV positive population are emphasized.",0 +https://doi.org/10.1002/jts.21803,How Prevalent Is Resilience Following Sexual Assault?: Comment on Steenkamp et al. (2012),"Steenkamp, Dickstein, Salters-Pedneault, Hofmann, and Litz (2012) analyzed latent trajectories of posttraumatic stress disorder (PTSD) symptoms on data obtained in the early months following a single-incident sexual assault. In contrast to previous studies of potentially traumatic events, they did not observe a trajectory of minimal symptoms or resilience, which they argued occurred because sexual assault involves more severe and direct trauma exposure than examined in previous studies. Although sexual assault is an aversive and challenging event, it seems highly unlikely that at least some sexual assault survivors would not be resilient. Steenkamp et al.'s failure to observe resilience can easily be explained on purely methodological grounds. Most notably, their findings were probably heavily influenced by sampling bias. Additionally, their sample size was too small and had too much missing data for the kinds of latent trajectory modeling they attempted.",0 +https://doi.org/10.1080/15325024.2010.491748,Exploratory Factor Analysis of the Greek Adaptation of the PTSD Checklist—Civilian Version,"The Diagnostic and Statistical Manual of Mental Disorders (4th edition; DSM-IV) conceptualization of posttraumatic stress disorder (PTSD) includes three symptom clusters or sequelae: reexperiencing, avoidance/numbing, and hyperarousal. The PTSD Checklist–Civilian Version (PCL-C) is based on the DSM-IV criteria. In the current study, we conducted an exploratory factor analysis (EFA) of the PCL-C using a sample of 312 adults. We examined whether the Greek adaptation of the PCL-C evidenced the three-factor solution given by the DSM-IV symptom cluster or the four-factor solution implied in other studies. The EFA was used to extract three- and four-factor solutions. The EFA identified a three-factor solution that included reexperiencing, avoidance/numbing, and hyperarousal supporting the DSM-IV PTSD symptoms.",0 +https://doi.org/10.3389/fpsyt.2013.00066,Therapeutic Action of Fluoxetine is Associated with a Reduction in Prefrontal Cortical miR-1971 Expression Levels in a Mouse Model of Posttraumatic Stress Disorder,"MicroRNAs (miRNA) are a class of small non-coding RNAs that have recently emerged as epigenetic modulators of gene expression in psychiatric diseases like schizophrenia and major depression. So far, miRNAs have neither been studied in patients suffering from posttraumatic stress disorder (PTSD) nor in PTSD animal models. Here, we present the first study exploring the connection between miRNAs and PTSD. Employing our previously established PTSD mouse model, we assessed miRNA profiles in prefrontal cortices (PFCs) dissected from either fluoxetine or control-treated wildtype C57BL/6N mice 74 days after their subjection to either a single traumatic electric footshock or mock-treatment. Fluoxetine is an antidepressant known to be effective both in PTSD patients and in mice suffering from a PTSD-like syndrome. Screening for differences in the relative expression levels of all potential miRNA target sequences of miRBase 18.0 by pairwise comparison of the PFC miRNA profiles of the four mouse groups mentioned resulted in identification of five miRNA candidate molecules. Validation of these miRNA candidates by reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) revealed that the therapeutic action of fluoxetine in shocked mice is associated with a significant reduction in mmu-miR-1971 expression. Furthermore, our findings suggest that traumatic stress and fluoxetine interact to cause distinct alterations in the mouse PFC miRNA signature in the long-term.",0 +https://doi.org/10.1007/s12207-010-9092-x,"Trends in Psychological/Psychiatric Injury and Law: Continuing Education, Practice Comments, Recommendations","This literature review of the major topics in the field of psychological/psychiatric injury and law is aimed at developing commentary for practice in the area. The field is a fast-developing one, with over ten major topics that it needs to integrate. In particular, the present review focuses current work on: law (evidence, tort); forensic psychology; assessment and testing; psychological injuries (posttraumatic stress disorder, chronic pain, traumatic brain injury, other); the APA DSM-5 draft (Diagnostic and statistical manual of mental disorders; American Psychiatric Association 2010); malingering; causality; multicultural considerations; disability; the American Medical Association (AMA) Guides to the evaluation of permanent impairment (Rondinelli et al. 2008); models; and treatment. At the end of each section of the article, practice comments introduce critical issues in applying the research to psychological work in the area. Whether undertaking tort evaluations, disability, and treatment plan assessments or treating individuals with psychological injuries, the professional needs state-of-the-art information in all the areas listed in order to remain scientifically informed, comprehensive, and impartial. The article concludes with recommendations for an integrated field in psychological/psychiatric injury and law, study in the field, research in its major areas, best practice policies, for example in assessment and treatment, and model building. © 2010 Springer Science + Business Media, LLC.",0 +https://doi.org/10.1016/j.amepre.2006.12.015,Anthrax Vaccination in the Millennium CohortValidation and Measures of Health,"Background In 1998, the United States Department of Defense initiated the Anthrax Vaccine Immunization Program. Concerns about vaccine-related adverse health effects followed, prompting several studies. Although some studies used self-reported vaccination data, the reliability of such data has not been established. The purpose of this study was to compare self-reported anthrax vaccination to electronic vaccine records among a large military cohort and to evaluate the relationship between vaccine history and health outcome data. Methods Between September 2005 and February 2006 self-reported anthrax vaccination was compared to electronic records for 67,018 participants enrolled in the Millennium Cohort Study between 2001 and 2003 using kappa statistics. Multivariable modeling investigated vaccination concordance as it pertains to subjective health (functional status) and objective health (hospitalization) metrics. Results Greater than substantial agreement (kappa=0.80) was found between self-report and electronic recording of anthrax vaccination. Of all participants with electronic documentation of anthrax vaccination, 98% self-reported being vaccinated; and of all participants with no electronic record of vaccination, 90% self-reported not receiving a vaccination. There were no differences between vaccinated and unvaccinated participants in overall measures of health. Only the subset of participants who self-reported anthrax vaccination, but had no electronic confirmation, differed from others in the cohort, with consistently lower measures of health as indicated by Medical Outcomes Study 36-Item Short Form Health Survey for Veterans (SF-36V) scores. Conclusions These results indicate that military members accurately recall their anthrax vaccinations. Results also suggest that anthrax vaccination among Millennium Cohort participants is not associated with self-reported health problems or broad measures of health problems severe enough to require hospitalization. Service members who self-report vaccination with no electronic documentation of vaccination, however, report lower measures of physical and mental health and deserve further research. In 1998, the United States Department of Defense initiated the Anthrax Vaccine Immunization Program. Concerns about vaccine-related adverse health effects followed, prompting several studies. Although some studies used self-reported vaccination data, the reliability of such data has not been established. The purpose of this study was to compare self-reported anthrax vaccination to electronic vaccine records among a large military cohort and to evaluate the relationship between vaccine history and health outcome data. Between September 2005 and February 2006 self-reported anthrax vaccination was compared to electronic records for 67,018 participants enrolled in the Millennium Cohort Study between 2001 and 2003 using kappa statistics. Multivariable modeling investigated vaccination concordance as it pertains to subjective health (functional status) and objective health (hospitalization) metrics. Greater than substantial agreement (kappa=0.80) was found between self-report and electronic recording of anthrax vaccination. Of all participants with electronic documentation of anthrax vaccination, 98% self-reported being vaccinated; and of all participants with no electronic record of vaccination, 90% self-reported not receiving a vaccination. There were no differences between vaccinated and unvaccinated participants in overall measures of health. Only the subset of participants who self-reported anthrax vaccination, but had no electronic confirmation, differed from others in the cohort, with consistently lower measures of health as indicated by Medical Outcomes Study 36-Item Short Form Health Survey for Veterans (SF-36V) scores. These results indicate that military members accurately recall their anthrax vaccinations. Results also suggest that anthrax vaccination among Millennium Cohort participants is not associated with self-reported health problems or broad measures of health problems severe enough to require hospitalization. Service members who self-report vaccination with no electronic documentation of vaccination, however, report lower measures of physical and mental health and deserve further research.",0 +https://doi.org/10.1177/0333102410378051,"Post-traumatic stress disorder, drug abuse and migraine: New findings from the National Comorbidity Survey Replication (NCS-R)","Post-traumatic stress disorder (PTSD) has been shown to be associated with migraine and drug abuse.This was an analysis of data from the National Comorbidity Survey Replication (NCS-R) to evaluate the association of PTSD in those with episodic migraine (EM) and chronic daily headache (CDH).Our sample consisted of 5,692 participants. Lifetime and 12-month prevalence rates of PTSD were increased in those with EM and CDH. After adjustments, the lifetime odds ratio (OR) of PTSD was greater in those with EM (OR 3.07 confidence interval [CI]: 2.12, 4.46) compared to those without headache; was greater in men than women with EM (men: OR 6.86; CI: 3.11, 15.11; women: OR 2.77; CI: 1.83, 4.21); and was comparable or greater than the association between migraine with depression or anxiety. The lifetime OR of PTSD was also increased in CDH sufferers. The OR of illicit drug abuse was not increased in those with EM or CDH unless co-occurring with PTSD or depression.The lifetime and 12-month OR of PTSD is increased in those with migraine or CDH, and is greater in men than women with migraine. The lifetime and 12-month OR of illicit drug abuse is not increased in those with migraine or CDH unless co-occurring with PTSD or depression.",0 +https://doi.org/10.1146/annurev.psych.54.101601.145112,Progress and Controversy in the Study of Posttraumatic Stress Disorder,"Research on posttraumatic stress disorder (PTSD) has been notable for controversy as well as progress. This article concerns the evidence bearing on the most contentious issues in the field of traumatic stress: broadening of the definition of trauma, problems with the dose-response model of PTSD, distortion in the recollection of trauma, concerns about “phony combat vets,” psychologically toxic guilt as a traumatic stressor, risk factors for PTSD, possible brain-damaging effects of stress hormones, recovered memories of childhood sexual abuse, and the politics of trauma.",0 +https://doi.org/10.1177/1524838013493520,Individual and Collective Dimensions of Resilience Within Political Violence,"Research has documented a link between political violence and the functioning of individuals and communities. Yet, despite the hardships that political violence creates, evidence suggests remarkable fortitude and resilience within both individuals and communities. Individual characteristics that appear to build resilience against political violence include demographic factors such as gender and age, and internal resources, such as hope, optimism, determination, and religious convictions. Research has also documented the protective influence of individuals’ connection to community and their involvement in work, school, or political action. Additionally, research on political violence and resilience has increasingly focused on communities themselves as a unit of analysis. Community resilience, like individual resilience, is a process supported by various traits, capacities, and emotional orientations toward hardship. This review addresses various findings related to both individual and community resilience within political violence and offers recommendations for research, practice, and policy.",0 +https://doi.org/10.1089/neu.2013.3283,Impact of Depression and Post-Traumatic Stress Disorder on Functional Outcome and Health-Related Quality of Life of Patients with Mild Traumatic Brain Injury,"The impact of disability following traumatic brain injury (TBI), assessed by functional measurement scales for TBI or by health-related quality of life (HRQoL), may vary because of a number of factors, including presence of depression or post-traumatic stress disorder (PTSD). The aim of this study was to assess prevalence and impact of depression and PTSD on functional outcome and HRQoL six and 12 months following mild TBI. We selected a sample of 1919 TBI patients who presented to the emergency department (ED) followed by either hospital admission or discharge to the home environment. The sample received postal questionnaires six and 12 months after treatment at the ED. The questionnaires included items regarding socio-demographics, the 36-item Short-Form Health Survey (SF-36), the Perceived Quality of Life Scale (PQoL), the Beck Depression Inventory, and the Impact of Event Scale. A total of 797 (42%) TBI patients completed the six-month follow-up survey. Depression and PTSD prevalence rates at both the six- and 12-month follow-up were 7% and 9%, respectively. Living alone was an independent predictor of depression and/or PTSD at six- and 12-month follow-up. Depression and PTSD were associated with a significantly decreased functional outcome (measured with Glasgow Outcome Scale Extended) and HRQoL (measured using the SF-36 and the PQoL). We conclude that depression and/or PTSD are relatively common in our sample of TBI patients and associated with a considerable decrease in functional outcome and HRQoL.",0 +https://doi.org/10.1007/s11136-015-1215-0,"Trajectories and associated factors of quality of life, global outcome, and post-concussion symptoms in the first year following mild traumatic brain injury","Purpose: To investigate the associated factors and change trajectories of quality of life (QoL), global outcome, and post-concussion symptoms (PCS) over the first year following mild traumatic brain injury (mTBI).Methods: This was a prospective longitudinal study of 100 participants with mTBI from neurosurgical outpatient departments in Chiayi County District Hospitals in Taiwan. The checklist of post-concussion syndromes (CPCS) was used to assess PCS at enrollment and at 1, 3, and 12 months after mTBI; the glasgow outcome scale extended (GOSE), the quality of life after brain injured (QOLIBRI), Chinese version, and the Short Form 36 Health Survey (SF-36), Taiwan version, were used to assess mTBI global outcome and QoL at 1, 3, and 12 months after mTBI.Results: Latent class growth models (LCGMs) indicated the change trajectories of QOLIBRI, PCS SF-36, MCS SF-36, GOSE, and PCS. Classes of trajectory were associated with age >40 years, unemployment at 1 month after injury, and educational level <12 years. Univariate analysis revealed that employment status at 1 month post-injury was correlated with the trajectories of QOLIBRI, PCS SF-36, MCS SF-36, and GOSE, but not PCS.Conclusions: Employment status was the most crucial associated factor for QoL in individuals with mTBI at the 1-year follow-up. Future studies should explore the benefits of employment on QoL of individuals with mTBI. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal abstract)",0 +,Select non-coding RNA in blood components provide novel clinically accessible biological surrogates for improved identification of traumatic brain injury in OEF/OIF Veterans.,"This study was designed to identify clinically accessible molecular biomarkers of mild traumatic brain injury (mTBI) that could be used to help identify returning Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) Veterans who are suffering from the effects of mTBI. While analyzing the expression profile of small non-coding RNAs in peripheral blood mononuclear cells (PBMCs) from an OEF/OIF veteran study cohort using a high throughput array chip platform, we identified 18 candidate small non-coding RNA biomarkers that are differentially regulated in PBMCs of mTBI compared to non-TBI control cases. Independent quantitative real-time polymerase chain reaction assays confirmed that 13 of these candidate small RNA biomarker species are, indeed, significantly down-regulated in PBMCs of mTBI compared to non-TBI control veteran cases. Based on unsupervised clustering analysis, we identified a 3-biomarker panel which was most able to distinguish mTBI from non-TBI control veteran cases with high accuracy, selectivity and specificity. The majority of mTBI cases in our biomarker study were co-morbid with Post-Traumatic Stress Disorder (PTSD), and thus our non-TBI control cases were selected to match PTSD diagnoses. Therefore, our identified panel of 3 small RNA biomarkers likely represents a biological index selective for mTBI. Outcomes from our studies suggest that additional applications of the clinically accessible small non-coding RNA biomarkers to current diagnostic criteria may lead to improved mTBI detection and more sensitive outcome measures for clinical trials. Future studies exploring the physiological relevance of mTBI biomarkers will also provide a better understanding of the biological mechanisms underlying mTBI and insights into novel therapeutic targets for mTBI.",0 +https://doi.org/10.1002/smi.1318,"Affective personality type, post-traumatic stress disorder symptom severity and post-traumatic growth in victims of violence","The current study explored the differential association between affective personality type, post-traumatic stress disorder (PTSD) symptom severity, and post-traumatic growth (PTG) in victims of violence (N = 113). Relying on previous research, median cut off-scores on the Positive and Negative Affect Schedule Short Form were used to classify participants as high affective [i.e. high positive affectivity (PA) and high negative affectivity (NA)], self-actualizing (i.e. high PA and low NA), self-destructive (i.e. low PA and high NA) and low affective (i.e. low PA and low NA). Results indicated that the self-destructive and high affective personality styles were strongly associated with increased PTSD symptoms severity. High affective personality type was found to be the only significant predictor of PTG. Results, study limitations and directions for future research were discussed. Copyright © 2010 John Wiley & Sons, Ltd.",0 +,Assessing the psychometric properties of a supplementary PK Scale embedded in the Minnesota Multiphasic Personality Inventory -Adolescent (MMPI-A) in detecting post-traumatic stress disorder (PTSD),"This study explored the validity of the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A; Butcher et al., 1992) PK Scale (Cashel, Ovaert and Holliman, 2000) to assess symptoms of Post-Traumatic Stress Disorder (PTSD) within an inpatient adolescent sample. The present research sought to expand upon the Cashel et al. (2000) study by assessing the predictive and comparative validity of the MMPI-A PK Scale. Information was gathered from the archival data of 631 adolescents who were referred to the assessment service of Four Winds Hospital. Adolescents were 13-18 years old and predominantly female (57.9%). The MMPI-A PK Scale significantly related to the following self-reported traumas measured by the Children's Trauma Questionnaire (CTQ; Bernstein & Fink, 1998): emotional abuse (r = .31, p < .01), sexual abuse (r = .14, p < .01) and physical abuse (r = .08, p < .05), respectively. Significant negative relationships between emotional neglect (r = .23, p < .01) and physical neglect (r .09, p < .05) were also found. The MMPI-A PK Scale significantly related to the Trauma Content Index (TC/R; Armstrong & Loewenstein, 1990), which was applied to Rorschach protocols (r = .14, p < .01) scored using Exner's Comprehensive System (CS; Exner, 2003). The relationships between the MMPI-A PK Scale and features associated with the presence of trauma, as measured by the Trauma Symptom Checklist for Children (TSCC; Briere, 1996), were explored. The MMPI-A PK Scale correlated highest with the Depression (DEP) clinical scale of the TSCC (r = .69, p < .01). The relationship between the MMPI-A PK Scale and the Posttraumatic Stress (PTS) clinical scale of the TSCC (r = .59, p < .01) was also significant and indicative of a moderate correlation. As a measure of PTSD symptoms, the MMPI-A PK Scale evidenced low to typical predictive validity (AUC = .696) when compared to the PTS scale. Other significant relationships between the MMPI-A PK Scale and the clinical scales of the TSCC were discussed. The MMPI-A PK Scale, as a diagnostic measure, performed similarly to the PTS scale. ROC analyses compared both the MMPI-A PK Scale and the PTS to discharge chart diagnosis. Both measures evidenced low to typical predictive validity (AUC = .613 and AUC = .621, respectively). The sensitivity and specificity of the MMPI-A PK Scale was also reviewed and compared to the sensitivity and specificity of the other measures. Implications, limitations and additional directions for future research were discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1111/jpm.12192,"Nursing students’ post-traumatic growth, emotional intelligence and psychological resilience","Accessible summary Nursing students in the present sample who have experienced childhood adversity have a certain level of post-traumatic growth. If introduced into nursing curricula, emotional intelligence interventions may increase emotional coping resources and enhance social skills for nurses, which may benefit their long-term occupational health. As researchers consider personal resilience a strategy for responding to workplace adversity in nurses, resilience building should be incorporated into nursing education. This is a preliminary study that may guide future investigations of the curvilinear relationship rather than linear relationship between post-traumatic growth and positive factors in the special sample of nursing students. Abstract Resilience, emotional intelligence and post-traumatic growth may benefit nursing students’ careers and personal well-being in clinical work. Developing both their emotional intelligence and resilience may assist their individual post-traumatic growth and enhance their ability to cope with clinical stress. To investigate the relationships among post-traumatic growth, emotional intelligence and psychological resilience in vocational school nursing students who have experienced childhood adversities, a cross-sectional research design with anonymous questionnaires was conducted and self-report data were analysed. The Childhood Adversities Checklist (Chinese version), Posttraumatic Growth Inventory, Emotional Intelligence Scale and the 10-item Connor–Davidson Resilience Scale were used. Survey data were collected from 202 Chinese vocational school nursing students during 2011. Post-traumatic growth was associated with emotional intelligence and psychological resilience. Results indicated a curvilinear relationship between emotional intelligence and post-traumatic growth, and between psychological resilience and post-traumatic growth. Moderate-level emotional intelligence and psychological resilience were most associated with the greatest levels of growth. The results imply that moderate resilience and emotional intelligence can help nursing students cope with adversity in their future clinical work. This study first provided preliminary data suggesting the curvilinear relationship rather than linear relationship between post-traumatic growth and positive factors in the sample of nursing students.",0 +https://doi.org/10.1038/nrn3339,Biological studies of post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) is the only major mental disorder for which a cause is considered to be known: that is, an event that involves threat to the physical integrity of oneself or others and induces a response of intense fear, helplessness or horror. Although PTSD is still largely regarded as a psychological phenomenon, over the past three decades the growth of the biological PTSD literature has been explosive, and thousands of references now exist. Ultimately, the impact of an environmental event, such as a psychological trauma, must be understood at organic, cellular and molecular levels. This Review attempts to present the current state of this understanding on the basis of psychophysiological, structural and functional neuroimaging, and endocrinological, genetic and molecular biological studies in humans and in animal models.",0 +https://doi.org/10.1192/bjp.180.4.363,Dissociation and post-traumatic stress disorder: two prospective studies of road traffic accident survivors,"Dissociative symptoms during trauma predict post-traumatic stress disorder (PTSD), but they are often transient. It is controversial whether they predict chronic PTSD over and above what can be predicted from other post-trauma symptoms.To investigate prospectively the relationship between dissociative symptoms before, during and after a trauma and other psychological predictors, and chronic PTSD.Two samples of 27 and 176 road traffic accident survivors were recruited. Patients were assessed shortly after the accident and followed at intervals over the next 6 months. Assessments included measures of dissociation, memory fragmentation, data-driven processing, rumination and PTSD symptoms.All measures of dissociation, particularly persistent dissociation 4 weeks after the accident, predicted chronic PTSD severity at 6 months. Dissociative symptoms predicted subsequent PTSD over and above the other PTSD symptom clusters. Memory fragmentation and data-driven processing also predicted PTSD. Rumination about the accident was among the strongest predictors of subsequent PTSD symptoms.Persistent dissociation and rumination 4 weeks after trauma are more useful in identifying those patients who are likely to develop chronic PTSD than initial reactions.",0 +https://doi.org/10.1186/1471-244x-8-81,Early trauma-focused cognitive-behavioural therapy to prevent chronic post-traumatic stress disorder and related symptoms: A systematic review and meta-analysis,"Early trauma-focused cognitive-behavioural therapy (TFCBT) holds promise as a preventive intervention for people at risk of developing chronic post-traumatic stress disorder (PTSD). The aim of this review was to provide an updated evaluation of the effectiveness of early TFCBT on the prevention of PTSD in high risk populations.We performed a systematic literature search in international electronic databases (MEDLINE, EMBASE, PsycINFO, CENTRAL, CINAHL, ISI and PILOTS) and included randomised controlled trials comparing TFCBT delivered within 3 months of trauma, to alternative interventions. All included studies were critically appraised using a standardised checklist. Two independent reviewers selected studies for inclusion and assessed study quality. Data extraction was performed by one reviewer and controlled by another. Where appropriate, we entered study results into meta-analyses.Seven articles reporting the results of five RCTs were included. All compared TFCBT to supportive counselling (SC). The study population was patients with acute stress disorder (ASD) in four trials, and with a PTSD diagnosis disregarding the duration criterion in the fifth trial. The overall relative risk (RR) for a PTSD diagnosis was 0.56 (95% CI 0.42 to 0.76), 1.09 (95% CI 0.46 to 2.61) and 0.73 (95% CI 0.51 to 1.04) at 3-6 months, 9 months and 3-4 years post treatment, respectively. A subgroup analysis of the four ASD studies only resulted in RR = 0.36 (95% CI 0.17 to 0.78) for PTSD at 3-6 months. Anxiety and depression scores were generally lower in the TFCBT groups than in the SC groups.There is evidence for the effectiveness of TFCBT compared to SC in preventing chronic PTSD in patients with an initial ASD diagnosis. As this evidence originates from one research team replications are necessary to assess generalisability. The evidence about the effectiveness of TFCBT in traumatised populations without an ASD diagnosis is insufficient.",0 +https://doi.org/10.1093/clipsy.9.4.439,Risking connection with our clients: Implications for the current state of the therapeutic relationship.,"In response to Hansen, Lambert, and Forman (2002), we discuss major caveats for research in which quantitative research methodology is applied to psychotherapy outcome studies. First, quantitative methodology fits more easily into a medical/disease model of mental illness than a truly psychological model of mental health. Second, results from quantitative outcome research are often misused when the findings are overgeneralized to individuals whose psychological profiles and treatment needs are dissimilar to the research samples. Third, quantitative studies fail to consider the therapeutic alliance as a critical factor in psychotherapy outcome. We describe Risking Connection, a training curriculum we coauthored with colleagues at the Traumatic Stress Institute, that highlights the centrality of healing relationships in psychotherapy with adult trauma survivors.",0 +https://doi.org/10.4324/9780203893104-8,"Promoting “resilient” posttraumatic adjustment in childhood and beyond: “Unpacking” life events, adjustment trajectories, resources, and interventions",,0 +https://doi.org/10.1080/21641846.2013.795085,Chronic fatigue syndrome/fibromyalgia: a “stress-adaptation” model,"Background: A symptom cluster consisting of ‘medically-unexplained’ chronic fatigue, effort intolerance and widespread pain is a complex and still poorly understood condition. Purpose: To demonstrate the theoretical and clinical value of a biopsychosocially-oriented ‘stress-adaptation’ model for this multi-symptom illness. Methods: Clinical observation and review of the relevant literature. Results: Symptoms and functional limitations of these patients may reflect a loss of normal physical, mental and emotional adaptability, primarily based on stress system dysregulation. Conclusions: The proposed stress-adaptation model may facilitate diagnosis, defy dualistic causal thinking, and offer tailor-made treatment options to help patients find a better balance in their lives",0 +https://doi.org/10.3928/00485713-20090201-05,The Duration of Deployment and Sensitization to Stress,,0 +https://doi.org/10.7205/milmed-d-14-00229,Spatial Typologies of Care: Understanding the Implications of the Spatial Distribution of Off-Base Civilian Behavioral Health Providers Who Accept TRICARE Prime to Service Persons and Their Dependents,"Over the last decade, demand for services from military treatment facilities (MTFs) has frequently exceeded capacity resulting in increased usage of off-base civilian Tricare providers (OCTP). This capacity shortage has been particularly acute for mental health care. At many installations, OCTPs are the main source of mental health care for military personnel and their families. Utilizing data on the location of mental health OCTPs and demographic data, we examine the spatial accessibility of mental health OCTPs around five military installations. Variation exists in the spatial accessibility of mental health OCTPs depending on the geographic context of an installation. There is a mild correlation between the number of mental health OTCPs proximate to a base and the beneficiaries enrolled in an MTF. There is a strong correlation between the size of the general population proximate to an installation and the number of mental health OCTMPs present. Installations located in densely populated areas had high ratios of mental health OCTPs to the MTF beneficiary population but not when the civilian demand on these providers was accounted for. This study's findings open several avenues for future research and policy aimed at increasing the effectiveness of the mental health OCTP network.",0 +https://doi.org/10.1007/s00127-013-0709-8,The role of stress sensitization in progression of posttraumatic distress following deployment,"Purpose: Military personnel exposed to combat are at risk for experiencing post-traumatic distress that can progress over time following deployment. We hypothesized that progression of post-traumatic distress may be related to enhanced susceptibility to post-deployment stressors. This study aimed at examining the concept of stress sensitization prospectively in a sample of Dutch military personnel deployed in support of the conflicts in Afghanistan. Method: In a cohort of soldiers (N = 814), symptoms of post-traumatic stress disorder (PTSD) were assessed before deployment as well as 2, 7, 14, and 26 months (N = 433; 53 %) after their return. Data were analyzed using latent growth modeling. Using multiple group analysis, we examined whether high combat stress exposure during deployment moderated the relation between post-deployment stressors and linear change in post-traumatic distress after deployment. Results: A higher baseline level of post-traumatic distress was associated with more early life stressors (standardized regression coefficient = 0.30, p < 0.001). In addition, a stronger increase in posttraumatic distress during deployment was associated with more deployment stressors (standardized coefficient = 0.21, p < 0.001). A steeper linear increase in posttraumatic distress post-deployment (from 2 to 26 months) was predicted by more post-deployment stressors (standardized coefficient = 0.29, p < 0.001) in high combat stress exposed soldiers, but not in a less combat stress exposed group. The group difference in the predictive effect of post-deployment stressors on progression of post-traumatic distress was significant (χ2(1) = 7.85, p = 0.005). Conclusions: Progression of post-traumatic distress following combat exposure may be related to sensitization to the effects of post-deployment stressors during the first year following return from deployment. © 2013 Springer-Verlag Berlin Heidelberg.",0 +https://doi.org/10.1016/j.pscychresns.2005.07.003,Abnormal frontal and parietal activity during working memory updating in post-traumatic stress disorder,"This study used event-related potentials (ERPs) to investigate the timing and scalp topography of working memory in post-traumatic stress disorder (PTSD). This study was designed to investigate ERPs associated with a specific working memory updating process. ERPs were recorded from 10 patients and 10 controls during two visual tasks where (a) targets were a specific word or (b) targets were consecutive matching words. In the first task, nontarget words are not retained in working memory. In the second task, as in delay-match-to-sample tasks, a non-target word defines a new target identity, so these words are retained in working memory. This working memory updating process was related to large positive ERPs over frontal and parietal areas at 400-800 ms, which were smaller in PTSD. Estimation of cortical source activity indicated abnormal patterns of frontal and parietal activity in PTSD, which were also observed in regional cerebral blood flow [Clark, C.R., McFarlane, A.C., Morris, P., Weber, D.L., Sonkkilla, C., Shaw, M., Marcina, J., Tochon-Danguy, H., Egan, G., 2003. Cerebral function in posttraumatic stress disorder during verbal working memory updating: a positron emission tomography study. Biological Psychiatry 53, 474-481]. Frontal and parietal cortex are known to be involved in distributed networks for working memory processes, interacting with medial temporal areas during episodic memory processes. Abnormal function in these brain networks helps to explain everyday concentration and memory difficulties in PTSD.",0 +https://doi.org/10.1097/00002508-200006000-00006,Prevalence and Impact of Posttraumatic Stress Disorder-Like Symptoms on Patients With Fibromyalgia Syndrome,"Traumatic events can result in a set of symptoms including nightmares, recurrent and intrusive recollections, avoidance of thoughts or activities associated with the traumatic event, and symptoms of increased arousal such as insomnia and hypervigilance. These posttraumatic stress disorder (PTSD)-like symptoms are frequently observed in persons with chronic pain syndromes. Little is known about how these two phenomena interact with one another. The present study evaluated PTSD-like symptoms in patients with fibromyalgia syndrome (FMS) and examined the relation between PTSD-like symptoms and problems associated with FMS.Ninety-three consecutive patients underwent a comprehensive FMS evaluation and completed self-report questionnaires measuring PTSD-like symptoms, disability, and psychosocial responses to their pain condition. Subjects were divided in two groups based on level of self-reported PTSD-like symptoms.Approximately 56% of the sample reported clinically significant levels of PTSD-like symptoms (PTSD+). The PTSD+ patients reported significantly greater levels of pain (p < 0.01), emotional distress (p < 0.01), life interference (p < 0.01), and disability (p < 0.01) than did the patients without clinically significant levels of PTSD-like symptoms (PTSD-). Over 85% of the PTSD+ patients compared with 50% of the PTSD- patients demonstrated significant disability. Based on response to the Multidimensional Pain Inventory, a significantly smaller percentage of PTSD+ patients were classified as adaptive copers (15%) compared with the PTSD- group (48.2%).Results suggest that PTSD-like symptoms are prevalent in FMS patients and may influence adaptation to this chronic illness. Clinicians should assess the presence of these symptoms, as the failure to attend to them in treatment may impede successful outcomes.",0 +https://doi.org/10.1016/j.jad.2013.06.057,Combat veterans with PTSD after mild TBI exhibit greater ERPs from posterior-medial cortical areas while appraising facial features.,"Posttraumatic stress disorder (PTSD) worsens prognosis following mild traumatic brain injury (mTBI). Combat personnel with histories of mTBI exhibit abnormal activation of distributed brain networks-including emotion processing and default mode networks. How developing PTSD further affects these abnormalities has not been directly examined. We recorded electroencephalography in combat veterans with histories of mTBI, but without active PTSD (mTBI only, n=16) and combat veterans who developed PTSD after mTBI (mTBI+PTSD, n=16)-during the Reading the Mind in the Eyes Test (RMET), a validated test of empathy requiring emotional appraisal of facial features. Task-related event related potentials (ERPs) were identified, decomposed using independent component analysis (ICA) and localized anatomically using dipole modeling. We observed larger emotional face processing ERPs in veterans with mTBI+PTSD, including greater N300 negativity. Furthermore, greater N300 negativity correlated with greater PTSD severity, especially avoidance/numbing and hyperarousal symptom clusters. This correlation was dependent on contributions from the precuneus and posterior cingulate cortex (PCC). Our results support a model where, in combat veterans with histories of mTBI, larger ERPs from over-active posterior-medial cortical areas may be specific to PTSD, and is likely related to negative self-referential activity.",0 +https://doi.org/10.2105/ajph.2009.181842,"Posttraumatic Stress Disorder and HIV Risk Among Poor, Inner-City Women Receiving Care in an Emergency Department","Objectives. We examined the associations between posttraumatic stress disorder (PTSD) and HIV risk behaviors among a random sample of 241 low-income women receiving care in an urban emergency department. Methods. We recruited participants from the emergency department waiting room during randomly selected 6-hour blocks of time. Multivariate analyses and propensity score weighting were used to examine the associations between PTSD and HIV risk after adjustment for potentially confounding sociodemographic variables, substance use, childhood sexual abuse, and intimate partner violence. Results. A large majority of the sample self-identified as Latina (49%) or African American (44%). Almost one third (29%) of the participants met PTSD criteria. Women who exhibited symptoms in 1 or more PTSD symptom clusters were more likely than women who did not to report having had sex with multiple sexual partners, having had sex with a risky partner, and having experienced partner violence related to condom use in the preceding 6 months. Conclusions. The high rate of PTSD found in this sample and the significant associations between PTSD symptom clusters and partner-related risk behaviors highlight the need to take PTSD into account when designing HIV prevention interventions for low-income, urban women.",0 +https://doi.org/10.1037/a0032512,"An empirical exploration of the dynamics of anorexia nervosa: Representations of self, mother, and father.","Extensive clinical reports and a few empirical investigations indicate that a disrupted relationship with mother and a distorted sense of self are central to Anorexia Nervosa (AN). The present study explores these observations further using the Differentiation–Relatedness Scale (D–RS) to compare AN patients’ descriptions of mother, father, and self with those of matched general psychiatric (PC) and nonclinical controls (NC). Results indicate that the AN group is distinguished from the PC group by significantly lower D–R (Differentiation–Relatedness) for mother, and significantly higher D–R for self, as well as a tendency for greater DEQ Self–Criticism (p .05, one–tailed). Stepwise discriminant analysis indicates that an equation of D–R Self, D-R Mother, and DEQ Neediness, as well as the interaction of D–R Mother and DEQ Neediness, significantly (p .0001) discriminates 80.5% of the total sample (66.7% of the AN, 73.3% of the PC, and 87.2%",0 +https://doi.org/10.1016/s0005-7894(89)80069-3,Victim and crime factors associated with the development of crime-related post-traumatic stress disorder,"This study examined the relationships between the development of Crime-Related Post-Traumatic Stress Disorder (CR-PTSD) and selected victim and crime characteristics. The sample consisted of 391 adult female residents of Charleston County, South Carolina, of whom 294 were crime victims assessed for CR-PTSD. Comparisons of CR-PTSD positive (n=82) and CR-PTSD negative (n=212) groups found significant differences on the variables of current age, years since most recent crime, experiencing a completed rape, perceiving a life threat during a crime, and sustaining physical injury during a crime. No differences existed on other assessed victim or crime variables. Hierarchical multiple regression analysis found that life threat, physical injury, and completed rape each made significant individual contributions to explaining CR-PTSD. Hierarchical discriminant function analysis correctly classified 80.6% of the respondents. Rape, life threat, and physical injury had a synergistic effect on CR-PTSD in that victims whose crime history included all three elements were 8.5 times more likely to have developed CR-PTSD than those with none of the three elements. Rape was associated with CR-PTSD after controlling for the effects of violence and dangerousness, suggesting that rape has other elements important to the development of CR-PTSD.",0 +https://doi.org/10.1002/jts.20112,Characterizing time in longitudinal trauma research,"Despite the proliferation of longitudinal trauma research, careful attention to timing of assessments is often lacking. Patterns in timing of assessments, alternative time structures, and the treatment of time as an outcome are discussed and illustrated using trauma data.",0 +https://doi.org/10.1002/da.20825,SLC6A4 methylation modifies the effect of the number of traumatic events on risk for posttraumatic stress disorder,"Background: Posttraumatic stress disorder (PTSD) is a common and debilitating mental disorder that occurs following exposure to a traumatic event. However, most individuals do not develop PTSD following even a severe trauma, leading to a search for new variables, such as genetic and other molecular variation, associated with vulnerability and resilience in the face of trauma exposure. Method: We examined whether serotonin transporter (SLC6A4) promoter genotype and methylation status modified the association between number of traumatic events experienced and PTSD in a subset of 100 individuals from the Detroit Neighborhood Health Study. Results: Number of traumatic events was strongly associated with risk of PTSD. Neither SLC6A4 genotype nor methylation status was associated with PTSD in main effects models. However, SLC6A4 methylation levels modified the effect of the number of traumatic events on PTSD after controlling for SLC6A4 genotype. Persons with more traumatic events were at increased risk for PTSD, but only at lower methylation levels. At higher methylation levels, individuals with more traumatic events were protected from this disorder. This interaction was observed whether the outcome was PTSD diagnosis, symptom severity, or number of symptoms. Conclusions: Gene-specific methylation patterns may offer potential molecular signatures of increased risk for and resilience to PTSD. Depression and Anxiety, 2011. © 2011 Wiley-Liss, Inc.",0 +https://doi.org/10.3402/ejpt.v6.27514,"Latent trajectory studies: the basics, how to interpret the results, and what to report","In statistics, tools have been developed to estimate individual change over time. Also, the existence of latent trajectories, where individuals are captured by trajectories that are unobserved (latent), can be evaluated (Muthén & Muthén, 2000). The method used to evaluate such trajectories is called Latent Growth Mixture Modeling (LGMM) or Latent Class Growth Modeling (LCGA). The difference between the two models is whether variance within latent classes is allowed for (Jung & Wickrama, 2008). The default approach most often used when estimating such models begins with estimating a single cluster model, where only a single underlying group is presumed. Next, several additional models are estimated with an increasing number of clusters (latent groups or classes). For each of these models, the software is allowed to estimate all parameters without any restrictions. A final model is chosen based on model comparison tools, for example, using the BIC, the bootstrapped chi-square test, or the Lo-Mendell-Rubin test.To ease the use of LGMM/LCGA step by step in this symposium (Van de Schoot, 2015) guidelines are presented which can be used for researchers applying the methods to longitudinal data, for example, the development of posttraumatic stress disorder (PTSD) after trauma (Depaoli, van de Schoot, van Loey, & Sijbrandij, 2015; Galatzer-Levy, 2015). The guidelines include how to use the software Mplus (Muthén & Muthén, 1998-2012) to run the set of models needed to answer the research question: how many latent classes exist in the data? The next step described in the guidelines is how to add covariates/predictors to predict class membership using the three-step approach (Vermunt, 2010). Lastly, it described what essentials to report in the paper.When applying LGMM/LCGA models for the first time, the guidelines presented can be used to guide what models to run and what to report.",0 +,Emotional and behavioural difficulties in children referred to an early intervention program following child sexual abuse,"Many children suffer emotional and behavioural difficulties following trauma, however, children are not at equal risk for developing such difficulties following abuse (e.g., Kendell-Tackett, Williams, & Finkelhor, 1993). A detailed review of the literature indicated the need for an empirical investigation into the occurrence of Post Traumatic Stress Symptoms (PTSS) and other psychopathology in children and adolescents following Child Sexual Abuse (CSA). This project investigated the occurrence of psychopathology in children who experienced CSA. In particular, it examined the degree to which children and adolescents experience PTSS following CSA. Further, the study endeavoured to identify caregiver-related variables, abuse details, parenting behaviour, family functioning, and child coping strategies which predicted maladjustment following CSA. The first study (Chapter 4) involved 175 children aged between 8 and 16 years, and their primary caregivers. The purpose of this study was to develop and assess the psychometric properties of a measure of parenting behaviour that could be used in subsequent studies. As parenting behaviour has been linked with the development of psychopathology in children, an economical, reliable and valid measure of the dimensions of parenting behaviour of interest (parental support and overcontrol) was required. Based on existing measures of parenting behaviour, the Parent Support-Control Questionnaire (PSCQ) was developed. It was hypothesised that two central dimensions, namely parental warmth/support and overcontrol/protection, would be supported by factor analysis. The results of this study supported this hypothesis: a two-factor solution offered the most parsimonious explanation. Adequate internal and test-retest reliability, and convergent and discriminant validity were identified. The second study (Chapter 5) was conducted with 92 children (19 boys; 73 girls) aged 6 - 15 years who were referred and accepted into an early intervention program following the experience of sexual abuse. Children were accepted for the program if they had experienced sexual abuse within the previous three years, if the abuse had been formally substantiated, and if they had a primary caregiver willing to participate in the program. Children were excluded from the study if they continued to have regular contact with the perpetrator, had an IQ less than 70, or had a diagnosis of psychosis or pervasive developmental disorder. Assessment of children's emotional and behavioural adjustment as reported by children and their caregivers revealed that a significant majority of children experienced difficulties in the clinical range following CSA. Recent literature and findings in the current thesis indicate that there is considerable variability in symptom expression after CSA. A range of behaviours in the clinical range, including anxiety, depression, dissociation and post traumatic stress symptoms, were reported by caregivers and children. Despite previous reports that approximately 30% of children present as symptom free at the time of first assessment (e.g., Finkelhor & Berliner, 1995), only 2.2% of children in this sample were asymptomatic at initial presentation. In addition to general psychopathology, 31.4% of the sample reported PTSS indicative of a DSM-IV diagnosis of Post Traumatic Stress Disorder (PTSD). The three symptom clusters in the DSM-IV diagnostic criteria for PTSD (i.e., re-experiencing, avoidance, and hypervigilance) were not supported in preliminary analyses. Instead, it is suggested that PTSD can best be conceptualised as existing on a continuum for children following sexual abuse, with children showing elevations across the full spectrum of PTSD symptoms. This finding is more consistent with a single-dimension conceptualisation of PTSD. A discussion is offered about the developmental trajectory after trauma. Controversy surrounding the DSM-IV diagnostic criteria for PTSD is discussed, and modification of these criteria for use with children is recommended. A transactional model, based on the work of Spaccarelli (1994) was outlined in the third study (Chapter 7), as a basis for understanding differences in the occurrence of psychopathology following CSA. Specifically, it was hypothesised that poor adjustment following CSA is associated with abuse of high severity, a caregiver who has a history of abuse in her own childhood and high levels of psychopathology, a family environment with high levels of dysfunction, parenting behaviour characterised by low levels of support and high levels of control, and the child's reliance on avoidant coping strategies. The results of the current investigation provide some support for the model. Caregiver-reported anxiety and family dysfunction were significantly associated with child adjustment. Further, family functioning mediated the influence of caregiver anxiety on child adjustment. Contrary to prediction, parenting behaviour characterised by low support and high control was not significantly related to poor adjustment. Child-reported adjustment data revealed that an avoidant coping style was significantly associated with poor outcome following sexual abuse. Interestingly, the nature of the abuse was not related to child or parent report of difficulties following CSA. The results indicate that, following the experience of CSA, a high proportion of children experience psychopathology in the clinical range. Since affected children can continue to experience difficulties in adolescence and adulthood, early intervention is paramount. Of great clinical relevance is the finding that the factors significantly associated with poor adjustment, are those factors that are more amendable to change (e.g., coping style) rather than the characteristics of the abuse itself (e.g., frequency and duration of abuse). Findings are discussed in terms of identification of risk factors for poor adjustment following CSA, and presented as a guide clinicians could use in the selection of treatment goals for a particular case and in designing an individualised treatment program. Limitations associated with the present program of research are discussed. Recommendations are made for future research.",0 +https://doi.org/10.1016/j.bbr.2014.09.006,Identifying profiles of recovery from reward devaluation in rats,"In humans and other mammals, the unexpected loss of a resource can lead to emotional conflict. Consummatory successive negative contrast (cSNC) is a laboratory model of reward devaluation meant to capture that conflict. In this paradigm, animals are exposed to a sharp reduction in the sucrose concentration of a solution after several days of access. This downshift in sucrose content leads to behavioral responses such as the suppression of consumption and physiologic responses including elevation of corticosterone levels. However, response heterogeneity in cSNC has yet to be explored and may be relevant for increasing the validity of this model, as humans demonstrate clinically meaningful heterogeneity in response to resource loss. The current analysis applied latent growth mixture modeling to test for and characterize heterogeneity in recovery from cSNC among rats (N=262). Although most animals exhibited recovery of consummatory behavior after a sharp drop in consumption in the first postshift trial (Recovery class; 83%), two additional classes were identified including animals that did not change their consumption levels after downshift (No Contrast class; 6%), and animals that exhibited an initial response similar to that of the Recovery class but did not recover to preshift consumption levels (No Recovery class; 11%). These results indicate heterogeneity in recovery from reward loss among rats, which may increase the translatability of this animal model to understand diverse responses to loss among humans.",0 +https://doi.org/10.1097/jcp.0b013e3182968962,The Association of Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate With Anxiety Sensitivity and Electronic Diary Negative Affect Among Smokers With and Without Posttraumatic Stress Disorder,"Posttraumatic stress disorder (PTSD) is associated with increased smoking initiation, maintenance, and relapse. Dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS) are neurosteroids that have been associated with mood measures as well as smoking status, and nicotine is associated with increased DHEA and DHEAS levels. Given the difficulties with mood experienced by smokers with PTSD, the purpose of the current study was to evaluate the association between negative affect and anxiety sensitivity with DHEA and DHEAS levels. Ninety-six smokers with and without PTSD provided blood samples for neurosteroid analyses and completed self-report measures of anxiety sensitivity and electronic diary ratings of negative affect. As expected, PTSD smokers reported higher levels of anxiety sensitivity (F(1,94) = 20.67, partial η2 = 0.18, P < 0.0001) and negative affect (F(1,91) = 7.98, partial η2 = 0.08, P = 0.006). After accounting for age and sex, DHEAS was significantly inversely associated with both anxiety sensitivity (F(3,92) = 6.97, partial η2 = 0.07, P = 0.01) and negative affect (F(3,87) = 10.52, partial η2 = 0.11, P = 0.002) across groups. Effect sizes indicated that these effects are moderate to high. No significant interactions of diagnosis and DHEA(S) levels with mood measures were detected. Given that nicotine is known to elevate DHEA(S) levels, these results suggest that DHEAS may serve as a biomarker of the association between mood and nicotine among smokers. Implications for the results include (1) the use of DHEAS measurement across time and across quit attempts and (2) the potential for careful use of DHEA supplementation to facilitate abstinence during smoking cessation.",0 +https://doi.org/10.1037/a0028014,The predictive validity of the PTSD Checklist in a nonclinical sample of combat-exposed National Guard troops.,"After returning from an extended combat deployment to Iraq, 348 National Guard soldiers were administered the PTSD Checklist (PCL-M), and the Beck Depression Inventory II (BDI-II) followed, on average, 3 months later by structured diagnostic interviews including the Clinician-Administered PTSD Scale (CAPS) for the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). There were 6.5% of the soldiers who met diagnostic criteria for posttraumatic stress disorder (PTSD) based on structured interview. The predictive validity of the PCL was examined and contrasted with the predictive validity of the BDI-II in identifying soldiers meeting CAPS diagnosis for PTSD. The best identified PCL cut scores produced between 65% and 76% false positive errors when used as the sole source for identification of enduring PTSD. Comparison of prediction between the PCL and the BDI-II in identifying PTSD suggested that both instruments may be operating through tapping generalized distress rather than specific aspects of the disorder.",0 +https://doi.org/10.7205/milmed-d-01-5808,"An Exploratory Study of Neuroimaging, Neurologic, and Neuropsychological Findings in Veterans With Traumatic Brain Injury and/or Posttraumatic Stress Disorder","Seventy-two veterans with traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), or both participated in assessment procedures to evaluate between group differences. Half the sample was randomly selected for magnetic resonance imaging (MRI). Neurologic examinations were conducted using the Neurologic Rating Scale (NRS). Neuropsychological measures included the Paced Auditory Serial Addition Test (PASAT), Rey Auditory Verbal Learning Test (RAVLT), Conners' Continuous Performance Test II (CPT II), and Halstead Impairment Index (HII) including the Booklet Category Test (BCT). Data were analyzed using linear regression. Participants with moderate/ severe TBI were significantly more likely to have trauma-related imaging findings, and more severe TBI predicted lower scores on the NRS. No significant between-group differences were identified on the HII, PASAT, RAVLT, or CPT II. TBI group performance was significantly better on the BCT. More severe TBI predicted abnormal imaging findings and lower NRS scores. Hypothesized between-group differences on neuropsychological measures were not supported.",0 +https://doi.org/10.2298/vsp1005411s,Gender differences in victims of war torture: Types of torture and psychological consequences,"Background/Aim. Torture for political reasons is an extreme violence in interpersonal relations resulting in not only acute psychiatric disorders but also very often in very severe and far reaching negative consequences for the overall psychosocial functioning of a victim. The aim of this study was to investigate gender differences in types of torture and psychological consequences in subjects who experienced war torture. Methods. A sample (410 men and 76 women) included clients of 'Centre for rehabilitation of torture victims - IAN, Belgrade' who experienced torture in prisons and concentration camps during civil wars in ex-Yugoslavia 1991-1995 and 1999. Types of Torture Questionnaire with 81 items was used for collecting data about forms of torture. Symptom Checklist 90-Revised (SCL-90- R) was used for assessing type and intensity of psychological symptoms, and Impact of Event Scale (IES) was used to estimate posttraumatic complaints. Results. A gender difference was found for 33 types of torture: 28 more frequent in men, and 5 in women. Factor analysis of torture types revealed three factors explaining 29% of variance: 'common torture', 'sadistic torture', and 'sexual torture'. Discriminant analysis revealed significant gender difference concerning the factors. 'Common torture' and 'sadistic torture' were more prominent in men, and 'sexual torture' was more present in women. Higher scores on depression, anxiety, somatization, interpersonal sensitivity and obsessive-compulsive dimensions on SCL-90-R were found in women. General score and scores of subscales (intrusion and avoidance) on IES were significantly higher in women. Conclusion. Women exposed to war torture experienced less torture techniques and shorter imprisonment than men, but had more frequent and severe symptoms of posttraumatic stress disorder and other psychological symptoms. Gender differences in posttraumatic symptomatology can not be explained exclusively by gender differences in types of torture found in this study.",0 +https://doi.org/10.1111/j.1521-0391.2010.00075.x,The Association of Trauma and PTSD with the Substance Use Profiles of Alcohol- and Cocaine-Dependent Out-of-Treatment Women,The association of trauma and posttraumatic stress disorder (PTSD) with alcohol and cocaine use is explored to determine if there is additive risk associated with dual dependence. Data were collected from out-of-treatment women enrolled in an HIV-prevention study. Women who experienced a DSM-IV qualifying event (n = 791) were stratified into four substance use groups based on lifetime alcohol and cocaine use. Women with lifetime comorbid alcohol and cocaine dependence experienced significantly more traumatic events and had a higher prevalence of violent events and lifetime diagnosis of PTSD and PTSD-related impairment. There is added risk for associated trauma and subsequent PTSD among women who have dual substance dependence.,0 +,Health-related quality of life two years after injury due to terrorism.,"During the past few decades, terrorist acts have been an unfortunate reality worldwide. There is a striking paucity of research investigating the multitude of long-term outcomes after severe physical injury due to terrorist attacks, a unique subgroup of trauma patients. The purpose of this study was to provide a profile of the long-term health-related quality of life (HR-QOL) after injury due to terrorist attacks and to explore the relationships between Post Traumatic Stress Disorder (PTSD), occupational status and injury severity with HR-QOL.We included 35 survivors of terrorist attacks living in the community, two years on average after the injury, mean age at follow-up = 32.1 (±13.8), mean Injury Severity Score (ISS) = 27 (±14.2). The subjects were recruited from consecutive admissions to a rehabilitation department in a tertiary care center between September 2000 - June 2004. Most of the subjects suffered multiple trauma. The main outcome measures were the Short-Form Health Survey (SF-36), Post Traumatic Diagnostic Scale and return to work rates.The mean scores on 6/8 of the SF-36 subscales were significantly lower among the survivors compared to normative population norms. Post Traumatic Stress Disorder (PTSD) was found in 39% of the sample and 43% did not resume their main occupation two years after the injury. Multivariate analysis of variance of PTSD and occupational status (returned vs. did not return to work) on quality of life scores revealed significant main effects for both PTSD (p=. 000) and occupational status (p=. 005) with no interaction effect (p=. 476). No significant correlations were found between injury severity and the SF-36 scores.This study demonstrated the long-term impact of injury due to terrorism. Results showed independent effects of PTSD and occupational status on health related quality of life, two years after injury. These findings suggest that this group may benefit from intervention focusing on their emotional and occupational status in order to improve their quality of life.",0 +,Harvard Trauma Questionnaire Urdu translation: the only cross-culturally validated screening instrument for the assessment of trauma and torture and their sequelae.,"Violence is on the increase all over the world. The method, manner and quantum of such actions remain little explored. The common man has clearly received the message of power through the barrel of a gun. In Pakistan the major battle field of ethnic, political, sectarian and communal conflicts was Sindh and Punjab. Trauma and torture leaves a permanent scar on the survivor. It has physical, psychological and social sequelae. The two major psychiatric illnesses associated with trauma and torture are your major Depression and post traumatic stress disorder. The Harvard Trauma Questionnaire (HTQ) measures symptoms associated with diagnostic criteria for post-traumatic stress disorder as defined by DSMIII R manual and symptoms. Obtaining accurate knowledge of traumatic event and symptoms and properly classifying them into a diagnostic system is fundamental for providing effective treatment and good therapeutic intervention. Therefore an attempt is made to translate the HTQ, the only cross-culturally validated screening instrument for the assessment of trauma and torture related to mass violence and their sequelae [corrected].",0 +https://doi.org/10.15288/jsad.2014.75.859,Parental Alcohol History Differentially Predicts Offspring Disorders in Distinct Subgroups in Israel,"Objective: The association between alcoholism in parents and related disorders in their offspring is well established in cultures with intermediate/high alcohol consumption, but not in those with low consumption, such as Israel. This study investigated differences in parental transmission of alcohol problems and related psychopathology between immigrants from the former Soviet Union (FSU) to Israel and other Israelis—two Israeli subgroups with differing alcohol consumption behaviors and social norms. Method: A total of 1,347 adults from a household sample were interviewed. Regression analyses were used to examine associations between parental alcohol problems and participant disorders: alcohol, nicotine, and cannabis use disorders (AUD, NUD, CUD); antisocial personality disorder (ASPD); major depressive disorder (MDD); and posttraumatic stress disorder (PTSD). We also examined the associations of parental alcohol problems with participant disorders characterized with two latent factors: externalizing (EXT: AUD, NUD, CUD, ASPD) and internalizing (INT: MDD, PTSD). Differential parental transmission of alcohol problems in FSU (n = 315) and non-FSU (n = 1,032) Israelis was examined with statistical interaction. Results: Among emigrants from the FSU, parental alcohol problems predicted AUD, NUD, CUD, ASPD, PTSD, EXT, and INT (mean ratios = 1.38–4.83). In non-FSU Israelis, parental alcohol problems predicted only ASPD and PTSD (mean ratios = 1.08–4.09). Significant interactions were observed for AUD, CUD, PTSD, and EXT; each relationship was stronger in FSU Israelis and null (AUD, CUD, EXT) or less robust (PTSD) in other Israelis. Conclusions: Parental alcohol problems were related to substance use and psychiatric disorders differently in FSU and other Israelis, two groups with different alcohol consumption levels and drinking norms. We propose that, in social contexts that vary in the degree to which they constrain alcohol behavior, underlying genetic predispositions may manifest as different disorders.",0 +https://doi.org/10.1016/j.cpr.2009.05.001,Post-traumatic stress disorder and suicidal behavior: A narrative review,"There is a large literature investigating the underlying mechanisms, risk factors and demographics of suicidal thoughts and behaviors across a number of psychiatric disorders, such as, major depression , anxiety and schizophrenia. However, less research has focused on the relationship between Post-Traumatic Stress Disorder (PTSD) and suicide. There were two broad aims of this review. The first was to assess the extent to which PTSD is associated with suicide, and the second was to determine the effects of co-morbid disorders on this relationship. Overall, there was a clear relationship between PTSD and suicidal thoughts and behaviors irrespective of the type of trauma experienced. Very few studies directly examined whether depression was a mediating factor in the relationships reported. However, where this was investigated, the presence of co-morbid depression appeared to boost the effect of PTSD on suicidality . It was noteworthy that hardly any studies had investigated concepts thought to be key in other domains of research into suicidality, such as, feelings of entrapment, defeat and hopelessness.",0 +https://doi.org/10.1016/j.jbtep.2005.05.003,World assumptions and the role of trauma in borderline personality disorder,"The present study tested whether borderline personality disorder (BPD) is characterized by specific worldviews as hypothesized by cognitive models, using Janoff-Bulman's [(1989) Social Cognition, 7, 113-136] world assumptive model of negative effects of trauma. A second aim of this study was to investigate the role of trauma in the content of worldviews of BPD patients. Fifteen BPD patients, 14 patients with Cluster C personality disorders (PD), 19 patients with axis-I psychopathology and 21 non-patients filled out the World Assumptions Scale, the Personality Disorder Belief Questionnaire, a childhood trauma checklist (assessing physical, emotional and sexual abuse) and the BPD Checklist (severity of BPD psychopathology). BPD patients appear to view the world as malevolent and perceive less luck independent of trauma but dependent of BPD psychopathology. Furthermore, BPD patients have low self-worth and persist in specific beliefs independent of trauma or severity of BPD psychopathology. Pretzer's theory of BPD can be largely supported through Janoff-Bulman's world assumptive model. World assumptions of BPD patients can better be explained by the severity of BPD psychopathology than by the presence of trauma.",0 +https://doi.org/10.12740/pp/20380,Diagnostic mistakes in Post-Traumatic Stress Disorder. The problem of symptom overlap with Depression,"Cel The overlap between symptoms of PTSD and MDD is substantial. PTSD symptoms arise after a traumatic experience and the trauma is present in all of the diagnostic clusters. In individuals who have experienced a trauma a long time previously, it is difficult to establish the exact moment of onset of their symptoms in relation to the trauma suffered. We proposed to raise awareness among operators who may encounter this problem, with the aim of providing them with valuable help in order to achieve a correct differential diagnosis. Metoda A sample of subjects suffering from PTSD without comorbidity was assessed to confirm the diagnosis and the severity of post-traumatic symptoms. The Kruskal-Wallis test was used to compare any modifications in the parameters analyzed through the Davidson Trauma Scale with the presence and severity of depressive symptoms as evaluated by the Hamilton-D scale. Wyniki Half of the PSTD patients recruited showed values of HAM-D > 18, although an active Major Depressive Episode was clinically excluded. Symptom of ""numbing"", despite being different from the apathy experienced in depression, is identified as a depressive symptom by the HAM-D. Wnioski Giving prevalence to depressive symptoms may be misleading for diagnosis and ultimately result in inappropriate treatment.",0 +https://doi.org/10.1097/01.bcr.0000236823.08124.1c,Planning for Burn Disasters: Lessons Learned From One Hundred Years of History,"The terrorist attacks of September 11th have prompted interest in developing plans to manage thousands of burn casualties. There is little actual experience in the United States in managing disasters of this magnitude. As an alternative, lessons may be learned from the historical experiences of previous civilian burn or fire disasters occurring in this country. A review of relevant medical, fire service, and popular literature pertaining to civilian burn or fire disasters occurring in the United States between the years 1900 and 2000 was performed. In the 20th century, 73 major U.S. fire or burn disasters have occurred. With each disaster prompting a strengthening of fire regulations or building codes, the number of fatalities per incident has steadily decreased. Detailed examination of several landmark fires demonstrated that casualty counts were great but that most victims had fatal injuries and died on the scene or within 24 hours. A second large cohort comprised the walking wounded, who required minimal outpatient treatment. Patients requiring inpatient burn care comprise a small percentage of the total casualty figure but consume enormous resources during hospitalization. Burn mass casualty incidents are uncommon. The number of casualties per incident decreased over time. In most fire disasters, the majority of victims either rapidly die or have minimal injuries and can be treated and released. As a result, most disasters produce fewer than 25 to 50 patients requiring inpatient burn care. This would be a rational point to begin burn center preparations for mass casualty incidents. A robust outpatient capability to manage the walking wounded is also desirable.",0 +https://doi.org/10.1007/s12160-010-9221-5,Disaggregating the Relationship Between Posttraumatic Stress Disorder Symptom Clusters and Chronic Orofacial Pain: Implications for the Prediction of Health Outcomes with PTSD Symptom Clusters,"Research has established a significant relationship between posttraumatic stress disorder (PTSD) symptoms and pain; however, very little research has examined the differential role of PTSD symptom clusters on pain outcomes.(a) To confirm the most appropriate PTSD symptom factor structure for an orofacial pain population and (b) to test a model of prediction of pain outcomes with PTSD symptom clusters.The study was a cross-sectional, retrospective case series of 411 female patients with orofacial pain (mean 41.0 years, SD 13.1). A series of structural equation modeling analyses were conducted to examine five competing models of PTSD symptom clusters.Two four-factor models of PTSD symptom clusters fit the data reasonably well, and differing PTSD symptom clusters predicted different components of pain.To increase predictive utility for pain and for a wide range of health disorders, researchers should examine the unique predictive power of PTSD symptom clusters rather than examining a one-factor model of PTSD symptoms.",0 +https://doi.org/10.1097/00043764-200203000-00015,Risk Factors for Multisymptom Illness in US Army Veterans of the Gulf War,"This research study examined the prevalence of symptoms and identified risk factors for reported symptoms among a group of Army Gulf War (GW) veterans. A survey was mailed to all members of the Ft. Devens cohort in 1997, representing the third assessment of a group that consisted of 2949 US Army soldiers deployed to the Gulf, and was studied initially in 1991. A total of 1290 subjects responded to the mailed survey; aggressive follow-up methods to address non-response bias were employed. Subjects were classified as having multisymptom illness if they reported symptoms from at least two of three symptom categories (fatigue, mood-cognition, musculoskeletal). Sixty percent of the respondents met criteria for multisymptom illness. Female gender, lower levels of education, psychological symptoms, self-reported use of a medical clinic in the Gulf, ingestion of anti-nerve gas pills (pyridostigmine bromide), anthrax vaccination, tent heaters, exposure to oil fire smoke, and chemical odors were significantly related to multisymptom illness in logistic regression analyses. Analyses in which subjects were stratified by level of psychological symptoms revealed different sets of GW-service environmental exposures and suggest that subgroups of GW veterans may have different sets of risk factors.",0 +https://doi.org/10.1017/s0033291708002808,Complex trauma of war captivity: a prospective study of attachment and post-traumatic stress disorder,"Background Victims of war captivity sometimes suffer from complex post-traumatic stress disorder (PTSD), a unique form of PTSD that entails various alterations in personality. These alterations may involve changes in attachment orientation. Method The sample comprised two groups of veterans from the 1973 Yom Kippur War: 103 ex-prisoners of war (ex-POWs) and 106 comparable control veterans. They were assessed at two points in time, 18 years and 30 years after the war. Results Ex-POWs suffered from more post-traumatic symptoms than controls at both measurements points and these symptoms increased only among ex-POWs from Time 1 to Time 2. In addition, both attachment anxiety and attachment avoidance increased with time among ex-POWs, whereas they decreased slightly or remained stable among controls. Finally, the increases in attachment anxiety and avoidance were positively associated with the increase in post-traumatic symptoms among both study groups. Further analyses indicated that early PTSD symptoms predicted later attachment better than early attachment predicted later PTSD symptoms. Conclusions The results suggest that: (1) complex traumas are implicated in attachment orientations and PTSD symptoms even many years after captivity; (2) there is an increase in attachment insecurities (anxiety, avoidance) and an increase in PTSD symptoms decades after the captivity; (3) and post-traumatic stress symptoms predict attachment orientations better than attachment orientations predict an increase in PTSD symptoms.",0 +https://doi.org/10.1177/1073191112442800,Measurement Differences From Rating Posttraumatic Stress Disorder Symptoms in Response to Differentially Distressing Traumatic Events,"The authors explored differences in posttraumatic stress disorder (PTSD) symptoms as a result of rating symptoms from two separate, differentially distressing traumatic events. In an initial sample of 400 nonclinical participants, the authors inquired through a web survey about previous psychological trauma, instructing participants to nominate their most distressing and second most distressing traumatic events experienced. Using the PTSD Checklist, participants rated their PTSD symptoms separately from these worst and second worst events. Using the four-factor emotional numbing PTSD model in confirmatory factor analysis, results demonstrated evidence supporting separation of PTSD symptom rating sets from two differentially distressing traumas—specifically, the worst and second worst events. Measurement invariance tests revealed that factor loadings did not vary between the worst and second worst event PTSD ratings; item thresholds (indexing symptom severity) differed. Results generally support the recommended PTSD assessment protocol instructing participants to rate PTSD symptoms from a single, worst index event.",0 +https://doi.org/10.1177/008124630103100302,The Role of Psychopathology and Personality in Rage-Type Homicide: A Review,"This article reviews the role of psychopathology and personality in offenders who have committed acts of rage-type murder. The possible role of depression, PTSD, psychotic disorders, intellectual functioning and alcohol/drug abuse are critically considered. It is argued that although some forms of psychopathology may be indicated in some cases, these still remain in the minority. This seems to be consistent with findings that describe such offenders as ‘apparently normal’. In an attempt to explain this further, the character profile and psychodynamics of personality are reviewed. A pattern of overcontrol is isolated as a key theme that best explains the ‘apparent normality’ of the rage-type offender. The relevance of the DSM-IV classification system of personality disorders for understanding this kind of criminal is considered. It is argued that a particular type of borderline personality organisation, not isolated by the DSM-IV system, best explains this character pattern.",0 +https://doi.org/10.1176/ajp.156.3.360,Acute Stress Disorder and Posttraumatic Stress Disorder in Victims of Violent Crime,"OBJECTIVE: In a group of crime victims recruited from the community, the authors investigated the ability of both a diagnosis of acute stress disorder and its component symptoms to predict posttraumatic stress disorder (PTSD) at 6 months. METHOD: A mixed-sex group of 157 victims of violent assaults were interviewed within 1 month of the crime. At 6-month follow-up 88% were reinterviewed by telephone and completed further assessments generating estimates of the prevalence of PTSD. RESULTS: The rate of acute stress disorder was 19%, and the rate of subsequent PTSD was 20%. Symptom clusters based on the DSM-IV criteria for acute stress disorder were moderately strongly interrelated. All symptom clusters predicted subsequent PTSD, but not as well as an overall diagnosis of acute stress disorder, which correctly classified 83% of the group. Similar predictive power could be achieved by classifying the group according to the presence or absence of at least three reexperiencing or arousal symptoms. Logistic regression indicated that both a diagnosis of acute stress disorder and high levels of reexperiencing or arousal symptoms made independent contributions to predicting PTSD. CONCLUSIONS: This exploratory study provides evidence for the internal coherence of the new acute stress disorder diagnosis and for the symptom thresholds proposed in DSM-IV. As predicted, acute stress disorder was a strong predictor of later PTSD, but similar predictive power may be possible by using simpler criteria. (Am J Psychiatry 1999; 156:360–366)",0 +https://doi.org/10.1016/j.psychres.2014.07.064,"The factor structure of psychiatric comorbidity among Iraq/Afghanistan-era veterans and its relationship to violence, incarceration, suicide attempts, and suicidality","The present research examined how incarceration, suicide attempts, suicidality, and difficulty controlling violence relate to the underlying factor structure of psychiatric comorbidity among a large sample of Iraq/Afghanistan-era veterans (N=1897). Diagnostic interviews established psychiatric diagnoses; self-report measures assessed history of incarceration, difficulty controlling violence, suicide attempts, and suicidality. A 3-factor measurement model characterized by latent factors for externalizing-substance-use disorders (SUD), distress, and fear provided excellent fit to the data. Alcohol-use disorder, drug-use disorder, and nicotine dependence were indicators on the externalizing-SUD factor. Posttraumatic stress disorder and depression were indicators on the distress factor. Panic disorder, social phobia, specific phobia, and obsessive-compulsive disorder were indicators on the fear factor. Incarceration was exclusively predicted by the externalizing-SUD factor. Difficulty controlling violence, suicidality, and suicide attempts were exclusively predicted by the distress factor. Contrary to hypotheses, the path from the externalizing/SUD factor to difficulty controlling violence was not significant. Taken together, these findings suggest that the distress factor of psychiatric comorbidity is a significant risk factor for suicidality, suicide attempts, and difficulty controlling violence and could help to explain the frequent co-occurrence of these critical outcomes among returning Iraq/Afghanistan veterans.",0 +https://doi.org/10.1155/2014/212614,Personality Profile of Parents of Children with Attention Deficit Hyperactivity Disorder,"Objectives. The present study was carried out aiming to identify the personality profile of parents of children with Attention Deficit Hyperactivity Disorder (ADHD). Methods. This study is of a descriptive, analytic, cross-sectional type in which parents of 6–12-year-old children with ADHD who were referred to the Bozorgmehr Psychiatric Clinic, affiliated with Tabriz University of Medical Sciences, were enrolled. ADHD was diagnosed according to the criteria of DSM-IV-TR and a quasi-structured diagnostic interview (K-SADS-PL). The personality profile of the parents was assessed with the Millon Clinical Multiaxial Inventory-III (MCMI-III). Results. According to the findings of this study, the most common personality problems based on the assessment scales in the MCMI-III belonged to the clinical patterns of depressive personality in 43 persons (25.3%), histrionic personality in 34 persons (20%), and compulsive personality in 29 persons (17.1%). According to discriminant analysis, four scales of somatoform, sadistic, dependence, and though disorder were direct and antisocial scale was reverse significant predictors of membership in the women group. Conclusion. According to the findings of this pilot study, personality disorders are prevalent in parents of ADHD children and mothers suffer from personality disorders more than fathers.",0 +https://doi.org/10.1186/1471-244x-9-34,"Violence and post-traumatic stress disorder in Sao Paulo and Rio de Janeiro, Brazil: the protocol for an epidemiological and genetic survey","violence is a public health major concern, and it is associated with post-traumatic stress disorder and other psychiatric outcomes. Brazil is one of the most violent countries in the world, and has an extreme social inequality. Research on the association between violence and mental health may support public health policy and thus reduce the burden of disease attributable to violence. The main objectives of this project were: to study the association between violence and mental disorders in the Brazilian population; to estimate the prevalence rates of exposure to violence, post-traumatic stress disorder, common metal disorder, and alcohol hazardous use and dependence: and to identify contextual and individual factors, including genetic factors, associated with the outcomes.one phase cross-sectional survey carried out in Sao Paulo and Rio de Janeiro, Brazil. A multistage probability to size sampling scheme was performed in order to select the participants (3000 and 1500 respectively). The cities were stratified according to homicide rates, and in Sao Paulo the three most violent strata were oversampled. The measurements included exposure to traumatic events, psychiatric diagnoses (CIDI 2.1), contextual (homicide rates and social indicators), and individual factors, such as demographics, social capital, resilience, help seeking behaviours. The interviews were carried between June/2007 February/2008, by a team of lay interviewers. The statistical analyses will be weight-adjusted in order to take account of the design effects. Standardization will be used in order to compare the results between the two centres. Whole genome association analysis will be performed on the 1 million SNP (single nucleotide polymorphism) arrays, and additional association analysis will be performed on additional phenotypes. The Ethical Committee of the Federal University of Sao Paulo approved the study, and participants who matched diagnostic criteria have been offered a referral to outpatient clinics at the Federal University of Sao Paulo and Federal University of Rio de Janeiro.",0 +https://doi.org/10.2466/pms.1999.89.2.607,Conceptualizing a Better Understanding of Diagnosing and Treating Posttraumatic Stress Disorder: A Review of Two Case Studies,"Clinical and epidemiological studies have supported the belief that human beings exposed to stressful life events are vulnerable to the symptomatology consistent with posttraumatic stress disorder (PTSD). However, early detection of symptoms consistent with PTSD oftentimes does not occur within the medicolegal arena. The importance of an early and accurate diagnosis is emphasized. Fortunately, the diagnosis of PTSD has become more clearly conceptualized in the DSM-IV criteria. Many of the characteristics consistent with this diagnosis are measured through the use of relatively recently developed and refined psychometric measures including the Posttraumatic Stress Diagnostic Scale, the Trauma Symptom Inventory, and the Personality Assessment Inventory-2. Additional measures including the Computerized Response Bias Test, the Word Memory Test, and the Validity Indicator Profile can detect exaggeration of symptoms without using specific tests for symptom validity. These measures, as well as biochemical determinations, are reviewed and presented along with the over-all structured clinical interviews and mental status examinations of two patients for a better understanding of the multimethod approach which establishes the reliability of the PTSD diagnosis.",0 +https://doi.org/10.1080/0164212x.2015.1027842,Occupational Preferences of People Who Have Experienced Sexual Assault,"This study explored how individuals who have experienced sexual assault engage in occupations that require touch. Fifty-seven participants who reported a history of sexual assault and 347 participants who did not report such a history responded to a pilot instrument which was created to analyze college students’ engagement in occupations. Results were categorized into indices to isolate different types of touch. Results suggest that there is a statistically significant difference in the way these two groups go about their daily routines of engaging in occupations, particularly those that involve passive, unexpected, social, and light touch.",0 +https://doi.org/10.1037/pro0000020,Clinical approaches to addressing spiritual struggle in veterans with PTSD.,"Trauma survivors often face difficult spiritual challenges as they attempt to reconcile the experience of trauma with their spiritual/religious beliefs. Spirituality has been found to be associated with a range of indices of well-being, and it is a component of many clients' coping skills and treatment strategies. However, many clinicians do not routinely assess or incorporate this domain of functioning in psychological services. This article describes a model for conceptualizing how trauma can impact spirituality by reviewing the possible consequences of each posttraumatic stress disorder (PTSD) symptom cluster on clients' belief systems and spiritual practices. Specific implications for treatment are described for each symptom cluster. A case study highlights many of the spirituality issues and intervention options described in this model. Ethical issues surrounding addressing spiritual factors in trauma survivors are considered, and clinicians are encouraged to further explore this domain with their clients. © 2015 American Psychological Association.",0 +https://doi.org/10.1097/00006199-200607000-00006,"Uncertainty, Posttraumatic Stress, and Health Behavior in Young Adult Childhood Cancer Survivors","Young adult survivors of childhood cancer are at risk for medical late effects, some of which can be managed through health promotion behaviors. However, chronic uncertainty about the future can lead to the development of posttraumatic stress symptoms (PTSS) that can interfere with health promotion behaviors.To test a mediating model for the relationships among uncertainty, PTSS, and health promotion behaviors in young adult survivors of childhood cancer.The design was cross-sectional correlational. A convenience sample was used, and the data were collected using a mailed survey. Study measures included the Mishel Uncertainty in Illness Scale-Community Form, the Posttraumatic Stress Disorder Index, and the Health Promoting Lifestyle Profile II.Forty-six (51.1%) of the eligible survivors responded to the invitation to participate in the study. The analysis was based on data from 45 survivors. The results show that the relationship between PTSS and health promotion behaviors was mediated by uncertainty.Uncertainty is a suitable target for theory-based nursing interventions used to boost health promotion behaviors in young adult survivors of childhood cancer.",0 +https://doi.org/10.1016/j.comppsych.2013.07.064,Longitudinal trajectories of World Trade Center (WTC)-related PTSD symptoms in police and non-traditional WTC responders,"Background: Tens of thousands of traditional and non-traditional first responders were involved in rescue and recovery operations following the September 11th terrorist attacks. These responders endured unprecedented hazardous working conditions and psychological stressors while working at Ground Zero and/or the Staten Island landfill. Previous cross-sectional studies have examined the prevalence of posttraumatic stress disorder (PTSD) in WTC responders; however, little is known about longitudinal trajectories of PTSD symptoms in this population. In this study, we evaluated longitudinal trajectories of World Trade Center (WTC)-related PTSD symptoms in more than 10,000 police and non-traditional WTC responders; we then identified pre-, peri-, and post-9/11 determinants of these trajectories. Methods: Latent growth mixture modeling (LGMM) was utilized to characterize the nature of WTC-related PTSD symptom trajectories amongst 10,835 WTC responders, including 4,035 police responders and 6,800 nontraditional responders, who attended monitoring visits at the CDCestablished WTC Health Program (WTC-HP) an average of 3, 6, and 8 years post-9/11. Multinomial logistic regression analyses were then conducted to assess determinants of the WTC-related PTSD symptom trajectories. Results: LGMM analyses revealed that a 4-class solution optimally characterized longitudinal PTSD symptoms in police WTC responders: resistant (77.8%), delayed-onset (8.5%), recovering (8.4%), and severe chronic (5.3%). In non-traditional WTC responders, a 6-class solution was optimal: resistant (58.0%), recovering (12.3%), severe chronic (9.5%), subsyndromal increasing (7.3%), delayed-onset (6.7%), and moderate chronic (6.2%). A greater proportion of police responders manifested a resilient trajectory (77.8%) compared to non-traditional responders (58.0%). In both police and non-traditional responder groups, increased severity of WTC exposure, prior psychiatric history, greater number of WTC-related medical conditions, and Hispanic ethnicity were strongly associated with symptomatic PTSD trajectories. Family and work social support while working at the WTC site was a protective factor for both groups, while early arrival was protective among nontraditional responders. Conclusion: This study is the first of which we are aware to examine longitudinal trajectories of WTC-related PTSD trajectories in WTC responders. A greater proportion of police responders manifested a resilient trajectory compared to non-traditional responders, which is likely attributable to their greater training and disaster preparedness. These results suggest that greater training in disaster preparedness, as well as peri-disaster familial and work support may help protect against deleterious psychological outcomes in disaster responders, particularly those with risk factors such as prior psychiatric history, Hispanic ethnicity, greater severity of traumatic exposure, and any disaster-related medical co-morbidities.",0 +https://doi.org/10.3390/bs4040471,Objective Neuropsychological Deficits in Post-Traumatic Stress Disorder and Mild Traumatic Brain Injury: What Remains Beyond Symptom Similarity?,"This exploratory study intends to characterize the neuropsychological profile in persons with post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) using objective measures of cognitive performance. A neuropsychological battery of tests for attention, memory and executive functions was administered to four groups: PTSD (n = 25), mTBI (n = 19), subjects with two formal diagnoses: Post-traumatic Stress Disorder and Mild Traumatic Brain Injury (mTBI/PTSD) (n = 6) and controls (n = 25). Confounding variables, such as medical, developmental or neurological antecedents, were controlled and measures of co-morbid conditions, such as depression and anxiety, were considered. The PTSD and mTBI/PTSD groups reported more anxiety and depressive symptoms. They also presented more cognitive deficits than the mTBI group. Since the two PTSD groups differ in severity of PTSD symptoms but not in severity of depression and anxiety symptoms, the PTSD condition could not be considered as the unique factor affecting the results. The findings underline the importance of controlling for confounding medical and psychological co-morbidities in the evaluation and treatment of PTSD populations, especially when a concomitant mTBI is also suspected.",0 +,Biological and psychological monitoring of training status during an entire season in top kayakers.,"The aim of this study was to analyze changes in selected biological and psychological variables in a group of top level kayakers along a 42-week training season.Eight top junior sprint kayakers (age=16.8±2.1) (5 men and 3 women) with international competitive experience participated in the research. During the 42-wk season the subjects were tested in three occasions: (T1) in the second week of the general training period, (T2) at the beginning of the specific training period, (T3) at the beginning of the competitive training period. Firstly, subjects were asked to complete the Recovery-Stress Questionnaire for Athletes (RESTQ-Sport) and the Profile of Mood States (POMS) questionnaires, and Borg´s rate of perceived exertion scale (RPE). Immediately after, blood samples were collected and white blood cells, creatine kinase (CK), C-reactive protein (CRP), myeloperoxidase protein levels (MPO) and glutathione status were determined. ANOVA with repeated measures was used to determine the differences between tests.From the hematological and biochemical measures only total leukocytes changed significantly, increasing at T3 when compared to T1. There were no differences along the entire season in both RESTQ-Sport and POMS scores or indices. Concerning performance, the group improved their maximal strength (+17.4% in bench-press 1RM) and their specific-distance time (+9.8%). The main finding of the present study was that training was well-balanced between stress and recovery because while specific performance increased, signs of overtraining were not found.Training monitoring in athletes should be performed in a multilevel approach using measurements of performance as well as biological or psychological parameters.",0 +,A prospective study of the relation between posttraumatic stress and physical health symptoms,"This ex post facto prospective study investigated whether symptoms of posttraumatic stress disorder (PTSD) are associated with increased physical health problems, while controlling for base-rates of symptoms and individual differences in neuroticism. Dutch army soldiers completed standardized questionnaires before they were deployed to Iraq (n = 479), and about 5 months (n = 382; 80%) and 15 months (n = 331; 69%) after their return home. PTSD-symptoms were evaluated by questionnaires and clinical interviews. The results showed that, on average, participants with PTSD at 5 months reported increased physical problems after deployment. PTSD-symptoms at 5 months predicted coexisting physical symptoms, after controlling for demographic variables, military factors, injury sustained on deployment, war-zone exposure on deployment, baseline physical problems, baseline PTSD-symptoms, and neuroticism. PTSD-symptoms at 5 months also predicted physical problems at 15 months, while controlling for physical symptoms at 5 months. The results suggest that posttraumatic stress contributes to physical symptoms. Clinicians are advised to be attentive to PTSD when individuals present with physical symptoms, and to pay attention to physical symptoms in patients diagnosed with PTSD.",0 +https://doi.org/10.1016/j.biopsycho.2015.03.018,The role of frontal EEG asymmetry in post-traumatic stress disorder,"Frontal alpha asymmetry, a biomarker derived from electroencephalography (EEG) recordings, has often been associated with psychological adjustment, with more left-sided frontal activity predicting approach motivation and lower levels of depression and anxiety. This suggests high relevance to post-traumatic stress disorder (PTSD), a disorder comprising anxiety and dysphoria symptoms. We review this relationship and show that frontal asymmetry can be plausibly linked to neuropsychological abnormalities seen in PTSD. However, surprisingly few studies (k = 8) have directly addressed frontal asymmetry in PTSD, mostly reporting that trait frontal asymmetry has little (if any) predictive value. Meanwhile, preliminary evidence suggest that state-dependent asymmetry during trauma-relevant stimulation distinguishes PTSD patients from resilient individuals. Thus, exploring links between provocation-induced EEG asymmetry and PTSD appears particularly promising. Additionally, we recommend more fine-grained analyses into PTSD symptom clusters in relation to frontal asymmetry. Finally, we highlight hypotheses that may guide future research and help to fully apprehend the practical and theoretical relevance of this biological marker.",0 +https://doi.org/10.1016/j.theriogenology.2007.06.023,Effect of maternal heat-stress on follicular growth and oocyte competence in Bos indicus cattle,"The objective was to determine whether exposure of Gir (Bos indicus) cows to heat-stress (HS) causes immediate and delayed deleterious effect on follicular dynamics, hormonal profile and oocyte competence. The cows were kept in tie-stalls for an adaptive thermoneutral period of 28 days (Phase I, Days -28 to -1). In Phase II (Days 0-28) cows were randomly allocated into control (CG, n=5) and HS (HS, n=5) treatments. The HS cows were placed in an environmental chamber at 38 degrees C and 80% relative humidity (RH) during the day and 30 degrees C, 80% RH during the night for 28 days. The CG group was maintained in shaded tie-stalls (ambient temperature) for 28 days. During Phase III (Days 28-147) animals were placed in tie-stalls (Days 28-42) followed by pasture (Days 42-147) under thermoneutrality. In each phase, weekly ovum pick up (OPU) sessions were to evaluate follicular development, morphology of cumulus-oocyte complexes (COCs), and developmental competence after in vitro maturation, fertilization, and culture. Serum concentrations of progesterone (P(4)) and cortisol were evaluated by radioimmunoassay. Exposure of Gir cows to HS had no immediate effect on reproductive function, but exerted a delayed deleterious effect on ovarian follicular growth, hormone concentrations, and oocyte competence. Heat-stress increased the diameter of the first and second largest follicles from Days 28 to 49. Indeed, HS increased the number of >9 mm follicles (characterized as follicular codominance) during this phase. Cows exposed to HS had longer periods of non-cyclic activity (P(4)<1 ng/mL), as well as shorter estrous cycles. However, HS did not affect cortisol concentration as compared to CG. Although HS had no significant effect on cleavage rate, it reduced blastocyst development during Phase III. In conclusion, long-term exposure of B. indicus cattle to HS had a delayed deleterious effect on ovarian follicular dynamics and oocyte competence.",0 +https://doi.org/10.3109/00048671003601400,"A study on the relationship between posttraumatic stress disorder in flood victim parents and children in Hunan, China.","To explore the relationship between posttraumatic stress disorder (PTSD) in flood victim parents and children in Hunan, China.Using the method of multistage cluster random sampling, we conducted a retrospective investigation on 3,698 families in Hunan, China who suffered from flooding in 1998. Investigators held face-to-face interviews with the parents and children of the families. The diagnosis of PTSD was made according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. The comparison of rate of PTSD positive in the groups of children with different characteristics was done by chi-square test. In the evaluation of the impact of parent PTSD on PTSD in their children, we used a multivariable logistic regression model to re-estimate the adjusted Odds Ratio and its confidence interval. We did this after the possible confounding variables were adjusted for. Additionally, the Odds Ratio and its confidence interval were estimated under the condition of a single variable.A total of 4,327 children and the parents of 3,292 families were included for analysis; 203 (4.7%) of 4,327 children and 740 (11.2%) of 6,584 parents were diagnosed with PTSD. We found that the PTSD positive rate is significantly higher in the children with disaster-related experience. The rate of beating their children in PTSD positive fathers (54.9%) was higher than that of PTSD negative fathers (51.2%). No correlation was found between mothers' PTSD and beating their children. The risk of developing PTSD is higher for children living in the families with PTSD parents.The rate of PTSD in 7-14-year-old children is 4.7% in areas in Hunan, China, who suffered from flooding in 1998. The possibility for children to develop PTSD is increased in families with PTSD parents.",0 +https://doi.org/10.1016/j.apnu.2014.05.008,The Factor Structure of Posttraumatic Stress Disorder Symptoms in Patients With Traumatic Spinal Cord Injuries,"The current study investigated the factor structure of posttraumatic stress disorder (PTSD) symptoms in a sample of 256 patients with traumatic spinal cord injuries (SCI) in China. The confirmatory factor analysis results showed that a five-factor model composed of intrusion, avoidance, emotional numbing, dysphoric arousal, and anxious arousal fits the data significantly better than the tripartite DSM-IV model and the two well-supported four-factor models, and the C3 symptom (inability to recall important aspect of the trauma) loaded weakly on its corresponding factor. Implications and limitations for the results are discussed.",0 +https://doi.org/10.1080/13575279.2015.1126229,Posttraumatic stress disorder in children exposed to intimate partner violence: the clinical picture of physiological arousal symptoms,"ABSTRACTIn recent years, researchers have focused on acquiring a better understanding of the development of posttraumatic stress disorder (PTSD) in children under the age of six following exposure to chronic trauma, such as intimate partner violence (IPV). Despite a number of empirical studies on early childhood PTSD, few have examined how children differ in the clinical presentation of PTSD symptomatology. There may be wide variability in the presentation of symptoms within the four clusters of PTSD symptoms: re-experiencing, alterations in physiological arousal, negative alterations in cognitions and mood, and avoidance. Symptoms of physiological arousal may be particularly difficult for parents and therapists to identify and report on because many of these symptoms are internal sensations (e.g. racing heart beat), and they are most often evaluated out of context (e.g. in reports of past behaviour). Thus, little is known about the presentation of these symptoms in preschoolers. To better identify physio...",0 +https://doi.org/10.1001/jama.2009.1085,Probable Posttraumatic Stress Disorder and Disability in Cambodia,"Millions of Cambodians suffered profound trauma during the Khmer Rouge era (1975 to 1979). A joint United Nations-Cambodian tribunal (the ""Khmer Rouge trials"") was empanelled in 2006 to prosecute top Khmer Rouge leaders and began substantive hearings in March 2009.To establish the prevalence of probable posttraumatic stress disorder (PTSD) among adult Cambodians and to assess correlates of PTSD symptoms and disability with perceived justice, desire for revenge, and knowledge of and attitudes toward the trials.A national probability sample of 1017 Cambodians was assembled using a multistage, stratified cluster design, including 813 adults older than 35 years who had been at least 3 years old during the Khmer Rouge era and 204 adults aged 18 to 35 years who had not been exposed to the Khmer Rouge era. Face-to-face interviews were conducted between December 2006 and August 2007.Prevalence of probable PTSD using the PTSD Checklist, Civilian version (cutoff score of 44), and mental and physical disability using the Medical Outcomes Study 12-item Short Form Health Survey.The prevalence of current probable PTSD was 11.2% (95% confidence interval [CI], 8.6%-13.9%) overall and 7.9% (95% CI, 3.8%-12.0%) among the younger group and 14.2% (95% CI, 11.0%-17.3%) in the older group. Probable PTSD was significantly associated with mental disability (40.2% vs 7.9%; adjusted odds ratio [AOR], 7.80; 95% CI, 3.90-15.60) and physical disability (39.6% vs 20.1%; AOR, 2.60; 95% CI, 1.26-5.39). Although Cambodians were hopeful that the trials would promote justice, 87.2% (n = 681) of those older than 35 years believed that the trials would create painful memories for them. In multivariate analysis, respondents with high levels of perceived justice for violations during the Khmer Rouge era were less likely to have probable PTSD than those with low levels (7.4% vs 12.7%; AOR, 0.54; 95% CI, 0.34-0.86). Respondents with high levels of desire for revenge were more likely to have probable PTSD than those with low levels (12.0% vs 7.2%), but the difference was not statistically significant in the multivariate analysis (AOR, 1.76; 95% CI, 0.99-3.11).Probable PTSD is common and associated with disability in Cambodia. Although Cambodians had positive attitudes toward the trials, most were concerned that the trials would bring back painful memories. Now that the trials have begun, longitudinal research is needed to determine the impact of the trials on Cambodians' mental health.",0 +https://doi.org/10.1016/j.bbi.2008.12.007,Salivary cortisol among American Indians with and without posttraumatic stress disorder (PTSD): Gender and alcohol influences,"Disruptions in hypothalamic-pituitary-adrenal regulation and immunity have been associated with posttraumatic stress disorder (PTSD). We examined the association of PTSD with diurnal rhythms in salivary cortisol in a convenience sample from a population-based study of male and female American Indians. Subjects with and without PTSD were identified from American Indians living on/near a Northern Plains reservation as part of a larger study. Over two days diurnal saliva samples were collected by staff at the University of Colorado Denver Clinical Research Center at waking, 30min after waking, before lunch, and before dinner. Generalized estimating equations linear regression models investigated the influence of PTSD on cortisol over time. The association of a lifetime diagnosis of PTSD with salivary cortisol level was assessed in subjects with complete data (PTSD: n=27; no PTSD n=32) for age, gender, and alcohol consumption in the past month. Subject mean age was 44 years, and 71% were women. When stratified by gender, women with a lifetime diagnosis of PTSD had significantly higher mean cortisol levels throughout the day than women without PTSD (p=0.01); but there was no significant association between PTSD and cortisol levels in men (p=0.36). The cortisol awakening response - the difference in cortisol levels from waking to 30min after waking - was not associated with PTSD in men or women. A lifetime diagnosis of PTSD may influence diurnal cortisol among American Indian women. These effects were independent of influences of current alcohol use/abuse. The unexpected elevation in cortisol in American Indian women with a lifetime diagnosis of PTSD may reflect acute anxiety associated with experiencing a number of novel tests in a strange location (e.g., cardiac imaging, medical, dental exams, etc.), or concurrent depression.",0 +https://doi.org/10.1037/a0015877,Family functioning predicts outcomes for veterans in treatment for chronic posttraumatic stress disorder.,"A longitudinal framework was used to examine the competing hypotheses of (a) whether family functioning predicts changes in posttraumatic stress disorder (PTSD) symptoms or (b) whether PTSD symptoms predict changes in family functioning. Veterans (N = 311) admitted to a treatment program completed a series of questionnaires at 3 time points: at intake, from intake to completion of a treatment program, and at the 6-month follow-up. Alcohol use and general mental health symptoms were also measured at intake. A cross-lagged panel model using structural equation modeling analyses indicated that family functioning was a moderate predictor of PTSD symptoms at posttreatment and at the 6-month follow-up. PTSD was not a significant predictor of family functioning across time and alcohol use, and general mental health symptoms did not affect the overall findings. Further analyses of PTSD symptom clusters indicated that the avoidance symptom cluster was most strongly related to family functioning. Targeting family relationships for treatment may be important in the future for veterans with PTSD.",0 +https://doi.org/10.1002/da.21892,BRAIN ACTIVATION TO FACIAL EXPRESSIONS IN YOUTH WITH PTSD SYMPTOMS,"Objective This study examined activation to facial expressions in youth with a history of interpersonal trauma and current posttraumatic stress symptoms (PTSS) compared to healthy controls (HC). Design and analysis Twenty-three medication-naive youth with PTSS and 23 age- and gender-matched HC underwent functional magnetic resonance imaging (fMRI) while viewing fearful, angry, sad, happy, and neutral faces. Data were analyzed for group differences in location of activation, as well as timing of activation during the early versus late phase of the block. Using SPM5, significant activation (P < .05 FWE [Family-Wise Error] corrected, extent = 10 voxels) associated with the main effect of group was identified. Activation from selected clusters was extracted to SPSS software for further analysis of specific facial expressions and temporal patterns of activation. Results The PTSS group showed significantly greater activation than controls in several regions, including the amygdala/hippocampus, medial prefrontal cortex, insula, and ventrolateral prefrontal cortex, and less activation than controls in the dorsolateral prefrontal cortex (DLPFC). These group differences in activation were greatest during angry, happy, and neutral faces, and predominantly during the early phase of the block. Post hoc analyses showed significant Group × Phase interactions in the right amygdala and left hippocampus. Conclusions Traumatic stress may impact development of brain regions important for emotion processing. Timing of activation may be altered in youth with PTSS.",0 +https://doi.org/10.1002/pon.894,"Fear of recurrence, sense of coherence and posttraumatic stress disorder in haematological cancer survivors","The diagnosis and treatment of cancer has been shown to precipitate posttraumatic stress disorder (PTSD) in some cancer survivors. However few studies have considered the links between cancer-related PTSD and theoretical models of PTSD. This study considers a cognitive model of PTSD by examining the relationship between sense of coherence, and fear of recurrence to posttraumatic stress symptomatology (PTSS) in haematological cancer survivors. Thirty-six participants completed the PTSD Checklist-Civilian Version (PCL-C), the Impact of Events Scale-Revised (IES-R), the sense of coherence scale and two measures of fear of recurrence. Two measures of fear of recurrence were included as no fear of recurrence measures had previously been assessed for reliability and validity on British populations. Seventeen percent of the sample met DSM-IV diagnostic criteria for PTSD. Statistically significant relationships were found between sense of coherence and fear of recurrence and PTSS, raising questions about the possibility of using this construct as a screening measure for vulnerability to PTSD. A relationship was also found between fear of recurrence and PTSS suggesting that cancer-related PTSS may fit within the theoretical model of PTSD considered. Further examination of factors affecting the onset, maintenance and treatment of PTSD in this population is required.",0 +https://doi.org/10.7205/milmed.171.9.857,The Trauma Symptom Inventory: Factors Associated with Invalid Profiles in a Sample of Combat Veterans with Post-Traumatic Stress Disorder,"The assessment of combat-related post-traumatic stress disorder (PTSD) relies upon self-reported symptoms and the need for indicators of valid reporting is critical. The Trauma Symptom Inventory (TSI) is a testing instrument specific to PTSD which includes validity scales. In a pilot study examining the use of the TSI with combat veterans, 50 male veterans diagnosed with PTSD were administered the TSI. Nineteen percent of the profiles were invalid, all but one based on the Atypical Response Scale. Differences between veterans with valid and invalid TSI profiles are examined in terms of demographic and historical factors, TSI profiles, and individual scale items. The model best able to predict invalid profiles included high scores on subscales measuring dissociative experiences and tension reduction behaviors. Implications for the interpretation of TSI validity scales in assessing combat-related PTSD are discussed.",0 +https://doi.org/10.1016/j.jclinepi.2006.04.008,Millennium Cohort: The 2001–2003 baseline prevalence of mental disorders in the U.S. military,"

Abstract

Objectives

The 12-month prevalence of common mental illnesses in the United States is estimated to be 26%, accounting for an increasing fraction of all disability in the general population. The U.S. military is a unique group involved in response and defense during times of conflicts and disasters. The mental health of service members affects organizational productivity and effectiveness and is of great importance to the health of U.S. military members and public health in general.

Study Design and Setting

In the present report, the authors describe the baseline prevalence of mental disorders in a large U.S. military cohort, the Millennium Cohort, established for a 22-year longitudinal study of the health effects of military service. Using crude and weighted prevalence and multivariable logistic regression, the mental health morbidity of the Millennium Cohort is reported for various demographics.

Results

These analyses suggest that although the cohort compares favorably to other populations, there are military subpopulations, including women, younger, less educated, single, white, short-term service, enlisted, and Army members, who are at greater odds for some mental disorders.

Conclusion

With ongoing U.S. involvement in combat operations around the world, these baseline data are essential to assessing long-term mental health morbidity in U.S. military service members.",0 +https://doi.org/10.1023/a:1024740929231,MMPI-2 data for Australian Vietnam veterans with combat-related PTSD,"Considerable attention has been devoted to the MMPI in the assessment of combat-related PTSD. To date, published data have focused almost exclusively on American Vietnam veterans. This study investigated MMPI-2 profiles of 100 Australian Vietnam veterans admitted to an intensive PTSD treatment program. Comparisons with United States (U.S.) data suggested strong similarities between the American and Australian populations in terms of F-scale elevations and typical 3-point code types (8-7-2). However, the American samples showed relatively higher elevations of Scales 4 and 6, suggesting social alienation and a tendency to externalize, while a subgroup of Australian veterans showed a greater propensity for somatization (Scale 1). The results provide overall support for the generalizability of American MMPI data to an alternative cultural group of combat veterans.",0 +https://doi.org/10.1097/00004850-200501000-00009,"Trauma, resilience and saliostasis: effects of treatment in post-traumatic stress disorder","There has been growing interest in the concept of resilience and the question as to whether psychotropic medications or psychosocial treatments might have resilience-enhancing effects. This pilot study investigates resilience in a sample of patients with post-traumatic stress disorder (PTSD) before and after treatment. Effects of treatment with tiagabine, fluoxetine, sertraline alone, and sertraline with cognitive behavioural therapy on resilience were assessed using the Connor-Davidson Resilience Scale (CD-RISC). Changes in resilience after treatment were measured and response to treatment was predicted from demographic, resilience and baseline disability measures. Changes in resilience following treatment were statistically significant. Items that showed the greatest change related to confidence, control, coping, knowing where to turn for help and adaptability. Items showing the least change related to religious and existential aspects of resiliency, effort, acting on a hunch, decision-making and goals. In linear and logistic regression models, gender, baseline CD-RISC score, baseline Sheehan Disability Scale score and an individual item from the CD-RISC scale, 'Sense of Humor', were significant predictors of response to treatment. Treatment of PTSD significantly improved resilience and reduced symptoms in this sample. Further controlled studies are indicated.",0 +https://doi.org/10.1002/jclp.10074,A cluster analysis of symptom patterns and adjustment in Vietnam combat veterans with chronic posttraumatic stress disorder,"This study investigated whether a subgroup of veterans with malignant posttraumatic stress syndrome, as described by Rosenheck (1985) and Lambert et al. (1996), could be identified via cluster analysis within two samples of Vietnam veterans with combat-related posttraumatic stress disorder (PTSD). In the initial subsample (n = 157), four clusters were identified, including a subgroup that scored consistently higher on measures of interpersonal violence and current physical problems. Similar results were found in the cross-validation subsample (n = 156). These results provide support for the theoretical concept of malignant PTSD and suggest that veterans with chronic PTSD are not homogenous. Whereas some manifest extreme levels of both functional impairment and PTSD symptomatology, others exhibit markedly less functional impairment despite manifesting clinically significant levels of PTSD. Clinicians can consider this heterogeneity in their treatment decisions.",0 +https://doi.org/10.1037/0021-843x.105.2.237,Prediction of posttraumatic stress symptoms in children after Hurricane Andrew.,"The authors used an integrative conceptual model to examine the emergence of posttraumatic stress disorder (PTSD) symptoms in 568 elementary school- age children 3 months after Hurricane Andrew. The model included 4 primary factors: Exposure to Traumatic Events, Child Characteristics, Access to Social Support, and Children's Coping. Overall, 62% of the variance in children's self-reported PTSD symptoms was accounted for by the 4 primary factors, and each factor improved overall prediction of symptoms when entered in the analyses in the order specified by the conceptual model. The findings suggest that the conceptual model may be helpful to organize research and intervention efforts in the wake of natural disasters.",0 +https://doi.org/10.1186/1471-227x-14-11,"Trauma exposure, posttraumatic stress disorder and the effect of explanatory variables in paramedic trainees","Abstract Background Emergency healthcare workers, including trainees and individuals in related occupations are at heightened risk of developing posttraumatic stress disorder (PTSD) and depression owing to work-related stressors. We aimed to investigate the type, frequency, and severity of direct trauma exposure, posttraumatic stress symptoms and other psychopathology amongst paramedic trainees. In order to create a risk profile for individuals who are at higher occupational risk of developing PTSD, we examined risk and resilience factors that possibly contributed to the presence and severity of posttraumatic symptomatology. Methods Paramedic trainees (n = 131) were recruited from a local university. A logistic regression analysis was conducted using the explanatory variables age, gender, population group, trauma exposure, depression, alcohol abuse, alcohol dependence, resilience and social support. Results 94% of paramedic trainees had directly experienced trauma, with 16% meeting PTSD criteria. A high rate of depression (28%), alcohol abuse (23%) and chronic perceived stress (7%) and low levels of social support was found. The number of previous trauma exposures, depression, resilience and social support significantly predicted PTSD status and depression had a mediating effect. Conclusion There is a need for efficient, ongoing screening of depressive and PTSD symptomatology in trauma exposed high risk groups so that early psychological supportive interventions can be offered.",0 +https://doi.org/10.1002/jts.21829,"Posttraumatic Stress Disorder Symptom Clusters, Alcohol Misuse, and Women's Use of Intimate Partner Violence","Exploring how PTSD and alcohol misuse relate to women's use of intimate partner violence (IPV) is vital to develop our understanding of why some women may engage in IPV, which can serve to maximize intervention efforts for women. This study examined the extent to which posttraumatic stress disorder (PTSD) symptom clusters are directly and indirectly related to women's use of IPV through pathways involving alcohol misuse while controlling for severity of women's IPV victimization. The sample was comprised of substance-using, low socioeconomic status community women (N = 143) currently experiencing IPV victimization. The majority of the sample was African American (n = 115, 80.42%). This sample had an average annual household income of $14,368.68 (SD = $12,800.68) and the equivalent of a high school education (11.94 years, SD = 1.32). Path analyses indicated that the strongest statistical relationship emerged between women's use of IPV and women's IPV victimization. PTSD reexperiencing and numbing symptom severity was related to women's use of psychological, minor physical, and severe physical IPV; however, these relationships were indirect through alcohol misuse. Findings lend preliminary support for the application of the self-medication hypothesis to the study of PTSD, alcohol misuse, and IPV among women.",0 +https://doi.org/10.1089/cpb.2006.9.234,Hippocampus Function Predicts Severity of Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) is often accompanied by memory problems and abnormal brain structure, particularly within the hippocampus. We implemented a cross-species, hippocampal-dependent task--the virtual Morris Water task--to assess hippocampal function in people with PTSD and age-matched controls during functional magnetic resonance imaging (fMRI). Performance on the task was equivalent between the groups. However, when correlating fMRI-derived hippocampal activity during this task with PTSD severity, we observe a -0.84 correlation, indicating that those with reduced hippocampal activity show more severe PTSD symptoms. This correlation is not explained by differences in task performance, IQ, duration since trauma, nor time with PTSD. Hence, PTSD severity is predicted by functionally assessing the hippocampus using the virtual Morris water task, suggesting that this task may be used to identify those at risk for developing PTSD following a trauma.",0 +https://doi.org/10.4088/jcp.11m06956,PTSD comorbidity and suicidal ideation associated with PTSD within the Ohio Army National Guard.,"To study the relation between posttraumatic stress disorder (PTSD) psychiatric comorbidity and suicidal ideation in a representative sample of Ohio Army National Guard soldiers.Using retrospective data collected on the telephone from a random sample of 2,616 National Guard soldiers who enrolled in a 10-year longitudinal study (baseline data collected November 2008-November 2009), we examined (1) the prevalence of other psychopathologies among those with DSM-IV-diagnosed PTSD compared to those without PTSD and (2) the association between PTSD comorbidity and suicidal ideation (reporting thoughts of being better off dead or hurting themselves). All analyses were carried out using logistic regression.Of guard members with PTSD in the last year, 61.7% had at least 1 other psychopathology; 20.2% had at least 2 other co-occurring conditions. The most common co-occurring psychopathology was depression. While those with PTSD overall were 5.4 (95% CI, 3.8-7.5) times more likely to report suicidality than those without PTSD, those who had at least 2 additional conditions along with PTSD were 7.5 (95% CI, 3.0-18.3) times more likely to report suicidal ideation at some point in their lifetime than those with PTSD alone.Soldiers with PTSD were at increased risk for suicidality, and, among those with PTSD, those with at least 2 additional conditions were at the highest risk of suicidal ideation. Future research should address the mechanisms that contribute to multimorbidity in this population and the appropriate treatment methods for this high-risk group.",0 +https://doi.org/10.1080/08974454.2013.842518,Trauma and Posttraumatic Stress Disorder Among Substance-Using Women Entering Cook County Jail,"In the United States, the number of incarcerated women continues to rise each year, with African American women having the highest incarceration rates. Many women enter prisons and jails with an extensive trauma history, though little is known about the percentage of these individuals suffering from posttraumatic stress disorder (PTSD) and specific trauma exposures they have had based on factors such as homelessness, degree of substance problems, and race. The present study examines a largely African American substance-using population of incarcerated women to determine the impact of various factors on specific traumas reported. We found that individuals reporting symptoms meeting criteria for PTSD had experienced the highest average number of traumas, and those who had ever been homeless also experienced many and varied trauma exposures compared with those who had never been homeless. Higher substance problems were also associated with more trauma exposure. Fewer than 10 percent of the sample met full cr...",0 +https://doi.org/10.1146/annurev-statistics-022513-115701,"Breaking Bad: Two Decades of Life-Course Data Analysis in Criminology, Developmental Psychology, and Beyond","Studies of human development require longitudinal data analysis methods that describe within- and between-individual variation in developmental and behavioral trajectories. This article reviews life-course data analysis methods for modeling these trajectories, as well as their application in studies of antisocial behavior and of crime in childhood, in adolescence, and throughout life. We set the stage by introducing growth curve (hierarchical linear) models. We focus our review on finite mixture models for life-course data, known as group-based trajectory and growth mixture models. We then discuss how these models are applied within criminology and developmental psychology, recent controversies over their substantive use and interpretation, and important issues of statistical practice and the challenges they raise. Building on the critical literature, we offer several recommendations for the applied users of the models. Finally, we present the most recent method of examining behavioral trajectories in criminology, the unimodal curve registration (UCR) approach. We briefly contrast the UCR model with growth curve and finite mixture models for life-course data analysis.",0 +https://doi.org/10.1037/1040-3590.20.2.131,Change in posttraumatic stress disorder symptoms: Do clinicians and patients agree?,"This study assessed the longitudinal association between clinician and patient ratings of posttraumatic stress disorder (PTSD) symptoms over the course of 2 different randomized clinical trials of veterans with chronic PTSD. One trial, the Department of Veterans Affairs Cooperative Study 420 (CSP 420; N = 360) compared trauma-focused and present-centered group therapies, and the 2nd trial compared cognitive processing theory and a waitlist control condition (N = 60). Linear mixed effects modeling revealed significant associations between clinician ratings (Clinician-Administered PTSD Scale; CAPS; D. D. Blake et al., 1990) and patient ratings (Posttraumatic Stress Disorder Checklist; PCL; F. W. Weathers, B. T. Litz, J. A. Herman, J. A. Huska, & T. M. Keane, 1993) in total and symptom clusters of PTSD. Contrary to hypothesis, the amount of change on the CAPS ranged from .75 to .82 standard deviations for every 1 standard deviation change on the PCL. The CAPS and PCL were more closely associated in the trauma-focused vs. present-centered treatment condition in CSP 420, and especially regarding hyperarousal symptoms. When comparing categorization of clinically significant change on the CAPS and PCL, the authors found no differences in the percentages of agreement between clinicians and patients in improvement and exacerbation. The value of multimodal assessment of PTSD treatment outcomes is discussed.",0 +https://doi.org/10.1186/1475-2832-3-8,,"BACKGROUND: Peritraumatic response, as currently assessed by Posttraumatic Stress Disorder (PTSD) diagnostic criterion A2, has weak positive predictive value (PPV) with respect to PTSD diagnosis. Research suggests that indicators of peritraumatic autonomic activation may supplement the PPV of PTSD criterion A2. We describe the development and factor structure of the STRS (Shortness of Breath, Tremulousness, Racing Heart, and Sweating), a one page, two-minute checklist with a five-point Likert-type response format based on a previously unpublished scale. It is the first validated self-report measure of peritraumatic activation of the autonomic nervous system. METHODS: We selected items from the Potential Stressful Events Interview (PSEI) to represent two latent variables: 1) PTSD diagnostic criterion A, and 2) acute autonomic activation. Participants (a convenience sample of 162 non-treatment seeking young adults) rated the most distressing incident of their lives on these items. We examined the factor structure of the STRS in this sample using factor and cluster analysis. RESULTS: Results confirmed a two-factor model. The factors together accounted for 68% of the variance. The variance in each item accounted for by the two factors together ranged from 41% to 74%. The item loadings on the two factors mapped precisely onto the two proposed latent variables. CONCLUSION: The factor structure of the STRS is robust and interpretable. Autonomic activation signs tapped by the STRS constitute a dimension of the acute autonomic activation in response to stress that is distinct from the current PTSD criterion A2. Since the PTSD diagnostic criteria are likely to change in the DSM-V, further research is warranted to determine whether signs of peritraumatic autonomic activation such as those measured by this two-minute scale add to the positive predictive power of the current PTSD criterion A2. Additionally, future research is warranted to explore whether the four automatic activation items of the STRS can be useful as the basis for a possible PTSD criterion A3 in the DSM-V.",0 +https://doi.org/10.1111/nhs.12127,The presence of post-traumatic stress disorder symptoms in earthquake survivors one month after a mudslide in southwest China,"The psychological impact of a mudslide on survivors of the Wenchuan earthquake in China and the risk factors for development of disaster-related post-traumatic stress disorder (PTSD) were investigated. The study design was cross-sectional and included 1321 survivors who had endured both an earthquake and a mudslide. Participants filled out a self-report questionnaire. One month after the mudslide, the rate of PTSD symptoms was 18.7%. Females, the elderly, those with lower educational levels, those that lacked social support, those who did not take precautionary measures, those living with children below 6 years of age, and those who had higher exposure to traumatic events experienced a higher level of PTSD symptoms. Results indicated that timely rescue, abundant material help, and mental rehabilitation after a disaster play important roles in recovery, and that there are still some high-risk groups that need attention, care, and effective intervention from healthcare professionals and society.",0 +https://doi.org/10.1016/j.jad.2012.10.028,Personal and familial correlates of bipolar (BP)-I disorder in children with a diagnosis of BP-I disorder with a positive child behavior checklist (CBCL)-severe dysregulation profile: A controlled study,"Although the DSM-IV provides explicit criteria for the diagnosis of BP-I disorder, this is a complex diagnosis that requires high levels of clinical expertise. Previous work shows children with a unique profile of the CBCL of high scores (2SD) on the attention problems (AP), aggressive behavior (AGG), and anxious-depressed (AD) (A-A-A) subscales are more likely than other children to meet criteria for BP-I disorder in both epidemiological and clinical samples. However, since not all BP-I disorder children have a positive profile questions remain as to its informativeness, particularly in the absence of an expert diagnostician.Analyses were conducted comparing personal and familial correlates of BP-I disorder in 140 youth with a structured interview and an expert clinician based DSM-IV diagnosis of BP-I disorder with (N=80) and without (N=60) a positive CBCL- Severe Dysregulation profile, and 129 controls of similar age and sex without ADHD or a mood disorder. Subjects were comprehensively assessed with structured diagnostic interviews and wide range of functional measures. We defined the CBCL-severe dysregulation profile as an aggregate cut-off score of ≥ 210 on the A-A-A scales.BP-I probands with and without a positive CBCL-severe dysregulation profile significantly differed from Controls in patterns of psychiatric comorbidity, psychosocial and psychoeducational dysfunction, and cognitive deficits, as well as in their risk for BP-I disorder in first degree relatives.Because the sample was referred and largely Caucasian, findings may not generalize to community samples and other ethnic groups.A positive CBCL-severe dysregulation profile identifies a severe subgroup of BP-I disorder youth.",0 +https://doi.org/10.1001/archpsyc.1997.01830130087016,Psychiatric Sequelae of Posttraumatic Stress Disorder in Women,"The risk for first-onset major depression, anxiety, and substance use disorders associated with prior posttraumatic stress disorder (PTSD) was estimated in a sample of women.The National Institute of Mental Health Diagnostic Interview Schedule, revised according to DSM-III-R, was used to measure lifetime psychiatric disorders in a stratified random sample of 801 mothers of children, who participated in a study of cognitive and psychiatric outcomes by level of birth weight. Cox proportional hazards models with time-dependent covariates were used to calculate the hazards ratios of first onset of other disorders following PTSD.The lifetime prevalence of traumatic events was 40% and of PTSD, 13.8%. Posttraumatic stress disorder signaled increased risks for first-onset major depression (hazards ratio, 2.1) and alcohol use disorder (hazards ratio, 3.0). The risk for major depression following PTSD was of the same magnitude as the risk for major depression following other anxiety disorders. Women with preexisting anxiety and PTSD had significantly increased risk for first-onset major depression. Additional analysis showed that preexisting major depression increased women's vulnerability to the PTSD-inducing effects of traumatic events and risk for exposure to traumatic events.Posttraumatic stress disorder influences the risk for first-onset major depression and alcohol use disorder. The causal explanation of these temporally secondary disorders is unclear and might involve the effect of PTSD or underlying vulnerabilities exposed by the traumatic experience.",0 +https://doi.org/10.1111/jopy.12010,Heterogeneous Patterns of Stress Over the Four Years of College: Associations With Anxious Attachment and Ego-Resiliency,"Objective A growing body of literature suggests that college students display alarming rates of psychological distress. However, studies of responses to significant life stressors in other contexts have found that people respond in heterogeneous ways and that attachment style and ego-resiliency mitigate the effects of stressors on mental health. Method Individual differences in distress among a cohort of students (N = 157; Mean age = 18.8 years, 62.6% female) across the four years of college were analyzed using latent class growth analysis. Trajectories were then regressed on levels of anxious and avoidant attachment and ego-resiliency. Results Four discrete patterns emerged characterized by healthy and maladaptive patterns of stress response, indicating that students respond to college in heterogeneous ways. Several patterns showed significant variability in distress by semester. Low levels of anxious but not avoidant attachment predicted membership in the stable-low distress or resilient class while ego-resiliency predicted membership in both the resilient and moderate distress classes. Conclusions Findings indicate that low levels of anxious attachment and the ability to flexibly cope with adversity may be associated with better mental health throughout college. Implications from stress response and developmental perspectives are discussed.",0 +https://doi.org/10.1002/da.22247,RISK FACTORS FOR ANXIETY DISORDERS: COMMON AND SPECIFIC EFFECTS IN A NATIONAL SAMPLE,"Anxiety disorders and major depressive disorder (MDD) often co-occur and share a broad range of risk factors. The goal of this study was to examine whether the co-occurrence of anxiety disorders and MDD could be explained by an underlying latent factor and whether the risk factors exert their effect exclusively through this factor, directly on each disorder, or through a combination of effects at both levels.Data were drawn from a large, nationally representative sample. Confirmatory factor analysis was used to identify the latent structure of anxiety disorders. A multiple indicators multiple causes (MIMIC) approach was used to assess the common and specific effects of risk factors for anxiety disorders.A one-factor model provided a good fit to the co-occurrence of anxiety disorders. Low self-esteem, family history of depression, female sex, childhood sexual abuse, White race, years of education, number of traumatic experiences, and disturbed family environment increased the risk of anxiety disorders and MDD through their effect on the latent factor. There were also several direct effects of the covariates on the disorders, indicating that the effect of the covariates differed across disorders.Risk for anxiety disorders and MDD appears to be mediated partially by a latent variable underlying anxiety disorders and MDD, and partially by disorder-specific effects. These findings may contribute to account for the high rates of comorbidity among disorders, identify commonalities in the etiologies of these disorders, and provide clues for the development of unified preventive interventions.",0 +https://doi.org/10.3233/nre-130901,Selecting the appropriate psychotherapies for individuals with traumatic brain injury: What works and what does not?,"When traditional psychotherapy is provided to patients with traumatic brain injuries (TBIs), the primary focus is on treating mood changes such as depression, anxiety or anger. However, traditional psychotherapeutic methods developed specifically for mood changes fall short when treating most TBI patients. In large part, this is because the psychological adjustment difficulties that most TBI patients face are linked to life-altering changes that are interwoven with permanent physical, cognitive, and social sequelae. In addition, mood changes in TBI patients are also caused by vocational and financial losses.The sudden onset of these unfamiliar and interdependent problems necessitates a psychotherapeutic approach that acknowledges the inherent challenges of coping with multiple life-altering changes. For patients who experience a shattered sense of self, interventions need to be explored to make life meaningful following a TBI.An existentially-oriented approach is introduced in the following steps: (1) identifying pre-injury future expectations, (2) examining how the TBI has altered these expectations, (3) grieving the loss of the expected future, and (4) developing a realistic future that is existentially meaningful.Pivotal gains are achieved when patients rebuild their lives according to their own core values.TBI patients can benefit from existential psychotherapy.",0 +,Partial least squares based gene expression analysis in posttraumatic stress disorder.,"Posttraumatic stress disorder (PTSD) is an adverse psychological response to traumatic events. Microarray technology for large-scale gene expression analysis facilitates the identification of signatures that underlie the pathogenesis of PTSD. Previous studies mostly used variance/regression analysis without considering array specific factors. We aim to investigate the underlying mechanism of PTSD through partial least squares (PLS) based analysis.With a gene expression profile data set for 17 chronic PTSD patients and 16 controls recovered from psychological trauma from the Gene Expression Omnibus (GEO) database, we performed Partial Least Square (PLS) based analysis.We acquired 230 down-regulated genes and 335 up-regulated genes. Significantly increased representations of dysregulated genes in immune, endocrine and nervous pathways were identified. Among the top 5 hub genes in the network, PRKCA has been reported to be related with PTSD before. Three other genes, TP53, EP300 and CALM1 might also contribute to the pathogenesis of PTSD since they are all related with other neuronal disorders.Our findings shed light on expression signatures of PTSD with the hope to give further theoretical supports for future therapeutic study.",0 +https://doi.org/10.1037/0022-006x.73.3.561,A Longitudinal Study of Retirement in Older Male Veterans.,"In this study, the authors examined the effect of retirement on psychological and physical symptoms in 404 older male veterans who were taking part in an ongoing longitudinal study. Hierarchical linear modeling was used to analyze symptom trajectories from preretirement, peri-retirement, and postretirement periods in veterans with either lifetime full or partial posttraumatic stress disorder (PTSD), trauma exposure only, or no traumatic exposure. As expected, the PTSD group experienced greater increases in psychological and physical symptoms during retirement, relative to the other groups. Retirement due to poor health in the PTSD group did not account for the findings regarding physical symptoms. Results indicate that clinicians should recognize and address the potential for older individuals with PTSD to experience difficulties during retirement.",0 +https://doi.org/10.1016/j.jflm.2012.12.005,Using the Excess Heat Factor (EHF) to predict the risk of heat related deaths,"Extremes of climate are not uncommon in Australia and heatwaves are not infrequent. Periods of high ambient temperature may result in clusters of heat related deaths, which may place strain on forensic facilities. This paper describes the formulation of the Excess Heat Factor using meteorological data to provide a means of predicting death resulting from periods of extreme heat stress. The 2009 South Australian heatwave had the highest ranked Excess Heat Factor in Adelaide's records. There were 58 heat related deaths, with the bulk of the heat related deaths following the peak Excess Heat Factor value (144 °C(2)). The 2008 heatwave had a lower peak Excess Heat Factor value (36 °C(2)); there was only one heat related death, which followed the peak in the Excess Heat Factor. It is proposed that calculation of the Excess Heat Factor from meteorological data could provide a means to predict and identify heat related deaths resulting from extreme weather conditions.",0 +https://doi.org/10.1080/16506073.2015.1004191,Differential Effects of Anxiety Sensitivity Components in the Relation Between Emotional Non-Acceptance and Post-traumatic Stress Symptoms Among Trauma-Exposed Treatment-Seeking Smokers,"Anxiety sensitivity (AS), defined as the extent to which individuals believe anxiety and anxiety-related sensations have harmful consequences, may play an important explanatory role in the relation between emotional non-acceptance and the expression of traumatic stress symptoms among trauma-exposed smokers. This investigation examined whether lower-order dimensions of AS (cognitive, physical, and social concerns) differentially explain the relation between emotional non-acceptance and post-traumatic stress (PTS) symptom clusters (re-experiencing, avoidance, hyperarousal) among trauma-exposed daily smokers (N = 169, 46% female; Mage = 41, SD = 12.3). AS and its lower-order facets of cognitive and social concerns were found to mediate the relations between emotional non-acceptance and avoidance and hyperarousal PTS symptoms. Using a multiple mediation model, the mediational effect of AS cognitive concerns for the relation between emotional non-acceptance and post-traumatic avoidance symptoms was found to be uniquely evident relative to social and physical concerns. All observed AS effects were evident above and beyond the variance accounted for by gender, number of traumatic event exposure types, negative affectivity, number of cigarettes smoked per day, and alcohol use problems. The present findings suggest cognitive-based AS concerns may play a mechanistic role in the relation between emotional non-acceptance and certain PTS symptoms among trauma-exposed daily smokers.",0 +https://doi.org/10.1037/a0028591,The latent structure of posttraumatic stress disorder: Different models or different populations?,"Factor analytic studies of the structure of self-reported posttraumatic stress disorder (PTSD) symptoms have consistently supported two 4-factor models; the ""Dysphoria"" and the ""Emotional Numbing"" model. The fit of both models has been satisfactory; however, it has been difficult to unequivocally determine which model is best. This study aimed to test the hypothesis that there is no single ""correct"" model, but rather that the models represent different subpopulations. A confirmatory factor 2-class mixture model was specified with the Dysphoria model in one class and the Emotional Numbing model in the other. This model was tested using data from participants from 4 trauma groups. This model fitted the data better than 1 and 2-class models of the Dysphoria, Emotional Numbing, and cross-factor loading model. It was concluded that the search for the ""correct"" model of PTSD based on the assumption of a single homogenous population may not be a worthwhile research endeavor.",0 +https://doi.org/10.1037/1040-3590.10.2.176,Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample.,"The factor structure, reliability, and validity of the Depression Anxiety Stress Scales (DASS; S. H. Lovibond & P. F. Lovibond, 1995) and the 21-item short form of these measures (DASS-21) were examined in nonclinical volunteers (n = 49) and patients with Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) diagnoses of panic disorder (n = 67), obsessive-compulsive disorder (n = 54), social phobia (n = 74), specific phobia (n = 17), and major depressive disorder (n = 46). This study replicates previous findings indicating that the DASS distinguishes well between features of depression, physical arousal, and psychological tension and agitation and extends these observations to the DASS-21. In addition, the internal consistency and concurrent validity of the DASS and DASS-21 were in the acceptable to excellent ranges. Mean scores for the various groups were similar to those in previous research, and in the expected direction. The implications of these findings are discussed.",0 +https://doi.org/10.1016/s0005-7967(03)00071-8,Posttraumatic stress disorder and psychosocial functioning within two samples of MVA survivors,"To examine criterion F variables of PTSD, the psychosocial functioning of two samples of motor vehicle accident (MVA) survivors was investigated. Within each sample, comparisons between MVA survivors with and without PTSD were conducted on four psychosocial functioning indices at three time points. In addition, the relationships between specific PTSD symptom clusters and psychosocial functioning indices were examined. The study revealed that, in general, MVA survivors with PTSD evidenced poorer psychosocial functioning than did survivors without PTSD. The emotional numbing symptoms of PTSD emerged as the most consistent predictors of the psychosocial functioning indices. The implications of these findings to the comprehensive treatment of PTSD are discussed.",0 +https://doi.org/10.1056/nejmsa013404,Psychological Sequelae of the September 11 Terrorist Attacks in New York City,"The scope of the terrorist attacks of September 11, 2001, was unprecedented in the United States. We assessed the prevalence and correlates of acute post-traumatic stress disorder (PTSD) and depression among residents of Manhattan five to eight weeks after the attacks.We used random-digit dialing to contact a representative sample of adults living south of 110th Street in Manhattan. Participants were asked about demographic characteristics, exposure to the events of September 11, and psychological symptoms after the attacks.Among 1008 adults interviewed, 7.5 percent reported symptoms consistent with a diagnosis of current PTSD related to the attacks, and 9.7 percent reported symptoms consistent with current depression (with ""current"" defined as occurring within the previous 30 days). Among respondents who lived south of Canal Street (i.e., near the World Trade Center), the prevalence of PTSD was 20.0 percent. Predictors of PTSD in a multivariate model were Hispanic ethnicity, two or more prior stressors, a panic attack during or shortly after the events, residence south of Canal Street, and loss of possessions due to the events. Predictors of depression were Hispanic ethnicity, two or more prior stressors, a panic attack, a low level of social support, the death of a friend or relative during the attacks, and loss of a job due to the attacks.There was a substantial burden of acute PTSD and depression in Manhattan after the September 11 attacks. Experiences involving exposure to the attacks were predictors of current PTSD, and losses as a result of the events were predictors of current depression. In the aftermath of terrorist attacks, there may be substantial psychological morbidity in the population.",0 +https://doi.org/10.1016/j.jad.2015.05.051,Avoidance symptoms and delayed verbal memory are associated with post-traumatic stress symptoms in female victims of sexual violence,"Victimization by sexual violence is strongly associated with the development of posttraumatic stress disorder (PTSD). While several psychological and cognitive factors are known to be associated with PTSD prognosis, multivariable analysis is scarce. This study examined factors affecting the severity of PTSD symptoms in early stage of traumatic experience of sexual violence, including initial post-traumatic symptoms and cognitive characteristics.Participants were recruited from the center for women and children victims of violence in a university hospital. Thirty-four sexual assault victims were assessed at the baseline and the second visit one to five months after the baseline. At the baseline, an array of posttraumatic symptoms and cognitive functions were measured: at follow-up, PTSD symptoms were determined by Clinician Administered PTSD Scale.Stepwise multiple regression showed that avoidance symptoms (β = 0.551, P < 0.01) and delayed verbal memory (β = -0.331, P < 0.05) at early stage of trauma predicted the severity of PTSD symptoms one to five month later. The regression model, factoring in avoidance and delayed verbal memory, showed a 34.9% explanatory power regarding the PTSD symptom severity.This study suggests that avoidance symptoms and verbal memory at the early stage of trauma are associated with later PTSD symptoms. It is also suggested that early intervention targeting avoidance symptoms may be beneficial in decreasing PTSD symptoms.",0 +https://doi.org/10.1016/j.janxdis.2013.12.001,Post-traumatic stress disorder among adult survivors of the Wenchuan earthquake in China: a repeated cross-sectional study.,"The objective of the study was to examine trends in the prevalence of Posttraumatic Stress Disorder (PTSD) in Wenchuan, China, over the four-year period following its 2008 earthquake, and to explore the risk factors related to current PTSD. Chi-square analysis and multivariate logistic regression analysis were used to assess PTSD morbidity and identify associated risk factors. The results indicated that the prevalence of PTSD was 58.2% at two months, 22.10% at 8 months, 19.8% at 14 months, 19.0% at 26 months, and 8.0% at about 44 months after the earthquake. Female gender, being married, low education, non-drinking, and poor self-perceived health status were significantly associated with PTSD during the early period following the earthquake. Depression was significantly associated with survivors' PTSD throughout the study period.",0 +,Neuroendocrinology and psychiatric illness,"Evidence for a role of neurohormones in psychiatric disease is greatest for illnesses in the affective disorder spectrum, which we argue includes melancholic and atypical depression, anorexia nervosa, bulimia nervosa, posttraumatic stress disorder, and panic disorder. These illnesses are associated with signs of hypothalamic dysfunction and have similar profiles of neuroendocrine dysregulation. In contrast, the data are much less clear for an intrinsic role of neuroendocrine dysregulation in schizophrenia, obsessive-compulsive disorder, or other anxiety disorders. This difference may reflect the fact that schizophrenia and obsessive-compulsive disorder represent more 'structural' abnormalities, or it may reflect greater diagnostic heterogeneity, which makes the elucidation of specific alterations in neurohormonal systems impossible.",0 +https://doi.org/10.1007/s11205-013-0297-8,Questioning Psychosocial Resilience After Flooding and the Consequences for Disaster Risk Reduction,"This paper questions George Bonanno’s concept of resilience as “relatively stable, healthy levels of psychological and physiological functioning” (Bonanno in Am Psychol 59(1):20–28, 2004) following potentially traumatic events (PTE). It agrees with Bonanno’s claim that significant numbers of people may suffer from mental disorders following a PTE, but disagrees that the majority of people are resilient. Furthermore it argues that we should not see PTEs as one event, but as involving a number of stressors and having a variety of consequences. Drawing on fieldwork carried out in Rajni village, Bihar following the 2008 Kosi River flooding, it documents, 18 months post flood, that flood onset gave rise to symptoms related to Post Traumatic Stress Disorder (primarily re-experiencing). The villagers’ primary concern was livelihood loss which, together with their lack of hope for the future, led to symptoms of depression. It argues that mental health issues should be fully integrated into Disaster Risk Reduction plans and policies, which are likely to be included in the Post-2015 Millennium Development Goals. In addition to supporting mental health interventions, the paper suggests that deep socio-cultural changes are necessary to ensure improvements in mental health.",0 +https://doi.org/10.1111/j.0956-7976.2004.00705.x,The Importance of Being Flexible,"Researchers have documented the consequences of both expressing and suppressing emotion using between-subjects designs. It may be argued, however, that successful adaptation depends not so much on any one regulatory process, but on the ability to flexibly enhance or suppress emotional expression in accord with situational demands. We tested this hypothesis among New York City college students in the aftermath of the September 11th terrorist attacks. Subjects' performance in a laboratory task in which they enhanced emotional expression, suppressed emotional expression, and behaved normally on different trials was examined as a prospective predictor of their adjustment across the first two years of college. Results supported the flexibility hypothesis. A regression analysis controlling for initial distress and motivation and cognitive resources found that subjects who were better able to enhance and suppress the expression of emotion evidenced less distress by the end of the second year. Memory deficits were also observed for both the enhancement and the suppression tasks, suggesting that both processes require cognitive resources.",0 +https://doi.org/10.1037//0021-843x.109.4.624,Posttraumatic stress disorder and retrospectively reported stressor exposure: A longitudinal prediction model.,"There has been recent concern about the degree to which posttraumatic stress disorder (PTSD) symptomatology influences reports of prior exposure to highly stressful life events. In this longitudinal study of 2,942 male and female Gulf War veterans, the authors documented change in stressor reporting across 2 occasions and the association between change and PTSD symptom severity. A regression-based cross-lagged analysis was used to examine the relationship between PTSD symptom severity and later reported stressor exposure. Shifts in reporting over time were modestly associated with PTSD symptom severity. The cross-lagged analysis revealed a marginal association between Time 1 PTSD symptom severity and Time 2 reported stressor exposure for men and suggested that later reports of stressor exposure are primarily accounted for by earlier reports and less so by earlier PTSD symptomatology.",0 +https://doi.org/10.1002/pon.1761,The valence of attentional bias and cancer-related rumination in posttraumatic stress and posttraumatic growth among women with breast cancer,"Objective: To examine the effects of self-reported attentional bias on posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG) through the potential mediator of cancer-related rumination. Design: A cross-sectional survey design was used and women with breast cancer (N=170) were recruited. Measures: Attentional biases, cancer-related ruminations, PTSD symptoms, and PTG were assessed. Results: Negative attentional bias and negative cancer-related rumination were positively related to PTSD symptoms following cancer diagnosis and treatments, but they were not related to PTG. Positive attentional bias and positive cancer-related rumination were positively related to PTG, but positive attentional bias was not related to PTSD symptoms. Findings showed that negative cancer-related rumination partially mediated the relationship between negative attentional bias and PTSD symptoms, while positive cancer-related rumination partially mediated the relationship between positive attentional bias and PTG. Conclusion: Findings support that there are differential trajectories to PTSD symptoms and PTG with respect to different valence of habitual attentional style and cancer-related rumination. They may serve as potential therapeutic leverages in the alleviation of PTSD symptoms and facilitation of PTG following cancer diagnosis and treatments. Copyright © 2010 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1016/j.ajp.2012.05.001,A synopsis of recent influential papers published in psychiatric journals (2010–2011) from the Arab World,"Six recent and influential papers that have appeared in the three leading psychiatry journals from the Arab region are summarized in this review. The first paper examined the prevalence of eating disorders (EDs) in rural and urban secondary school girls in Sharkia; more EDs were found among urban than rural population. The second study reported the high prevalence of Post Traumatic Stress Disorder (PTSD) in primary school children in Iraq in context of the present situation in Iraq dominated by violence creating a traumatizing atmosphere for the population, especially children. The third paper reported that substance dependent patients manifest elevated traits of impulsivity; emotionally driven impulsivity in particular predicted substance related problems. The fourth study reported significant cognitive impairments at illness onset in a large sample of patients with a first psychotic episode. The fifth paper, investigated the cultural imprint on symptom profile of mood disorders. Culture effect on mood disorder was more prominent in depression than in mania. The last article examined the relations between social circumstances, medical morbidity, locus of control and depression in elderly patients suffering from medical conditions. Overall, the papers describe a wide spectrum of research initiatives in the Arab World that are likely to have implications for global mental health.",0 +https://doi.org/10.1007/s11839-014-0462-6,A one-year follow-up of post-traumatic stress disorder (PTSD) symptoms and perceived social support in cancer,"Aims Diagnosis of post-traumatic stress disorder (PTSD) symptoms in cancer patients fluctuates over the course of cancer according to the timing of assessment. In this longitudinal study, the prevalence of PTSD symptoms and the association between PTSD symptoms and the buffering variable of perceived social support were examined at one year follow-up.",0 +,Antidepressants: update on new agents and indications.,"A number of antidepressants have emerged in the U.S. market in the past two decades. Selective serotonin reuptake inhibitors have become the drugs of choice in the treatment of depression, and they are also effective in the treatment of obsessive-compulsive disorder, panic disorder, and social phobia. New indications for selective serotonin reuptake inhibitors include post-traumatic stress disorder, premenstrual dysphoric disorder, and generalized anxiety disorder. Extended-release venlafaxine has recently been approved by the U.S. Food and Drug Administration for the treatment of generalized anxiety disorder. Mirtazapine, which is unrelated to the selective serotonin reuptake inhibitors, is unique in its action--stimulating the release of norepinephrine and serotonin. The choice of antidepressant drug depends on the agent's pharmacologic profile, secondary actions, and tolerability. Sexual dysfunction related to the use of antidepressants may be addressed by reducing the dosage, switching to another agent, or adding another drug to overcome the sexual side effects. Augmentation with lithium or triiodothyronine may be useful in patients who are partially or totally resistant to antidepressant treatment. Finally, tapering antidepressant medication may help to avoid discontinuation syndrome or antidepressant withdrawal.",0 +https://doi.org/10.1002/pmh.1183,Borderline personality disorder subtypes: A factor analysis of the DSM-IV criteria,"This study examined the underlying factor structure of the DSM-IV criteria to determine whether the diagnosis could be classified into subtypes. It also sought to enhance the clinical interpretation of any identified subtypes by examining their relation to comorbid axis I and II disorders. In 95 treatment-seeking adults (82 women, 13 men), attending a psychiatric outpatient clinic principle components analysis yielded support for three subtypes: ‘affect dysregulation’, ‘rejection sensitivity’ and ‘mentalization failure’. Results of logistic regression analyses indicated that the affect dysregulation subtype was associated with the comorbid diagnosis of generalized anxiety and panic disorder and other cluster B and C personality disorders. The mentalization failure subtype was found to be predictive of posttraumatic stress disorder and other cluster B personality disorders. With further research, confirmation of these subtypes may inform diagnostic revisions and appropriate treatment regimes that are individually designed to target the patients' core symptoms. Copyright © 2012 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1097/01.nmd.0000110287.16635.8e,Chronicity in Posttraumatic Stress Disorder and Predictors of the Course of Posttraumatic Stress Disorder Among Primary Care Patients,"The present study examined the course of posttraumatic stress disorder (PTSD) in a sample of 84 primary care patients. More specifically, this study investigated the role of Axis I comorbidity, psychosocial impairment, and treatment participation in the maintenance of an episode of chronic PTSD and whether patients at follow-up met criteria for PTSD (full remission) or continued to exhibit residual PTSD symptoms and impairment (partial PTSD). Diagnostic structured interviews established all clinical diagnoses and information on the course of anxiety disorder symptoms, psychosocial functioning, and treatment status. Using a prospective, longitudinal design, this study found that during the first 2 years of follow-up, the probability of no longer meeting full DSM-IV criteria for PTSD was .69, and .18 for full remission from PTSD. The number of comorbid anxiety disorders and degree of psychosocial impairment at intake were significantly related to remission status (i.e., full and partial PTSD). This study suggests that, in a primary care setting, PTSD is a persistent illness, and that many subjects who have recovered from PTSD continue to suffer from subthreshold symptoms of PTSD.",0 +,"Acute stress disorder in hospitalised victims of 26/11-terror attack on Mumbai, India.","The 26/11 terror attacks on Mumbai have been internationally denounced. Acute stress disorder is common in victims of terror. To find out the prevalence and to correlate acute stress disorder, 70 hospitalised victims of terror were assessed for presence of the same using DSM-IV TR criteria. Demographic data and clinical variables were also collected. Acute stress disorder was found in 30% patients. On demographic profile and severity of injury, there were some interesting observations and differences between the victims who developed acute stress disorder and those who did not; though none of the differences reached the level of statistical significance. This study documents the occurrence of acute stress disorder in the victims of 26/11 terror attack.",0 +https://doi.org/10.1176/ajp.152.1.110,Sleep events among veterans with combat-related posttraumatic stress disorder,"Sleep disturbances are important features of posttraumatic stress disorder (PTSD); however, the published data characterizing PTSD sleep phenomena are limited. The authors report on the phenomenology and physiological correlates of symptomatic sleep events in PTSD.The study data included survey results that addressed sleep symptoms during the past month in combat veterans with and without PTSD (N = 58), sleep diary records of awakenings from combat veterans with PTSD hospitalized on an inpatient rehabilitation unit (N = 52), and overnight polysomnography recordings obtained from 21 medication-free combat veterans with PTSD and eight healthy comparison subjects not exposed to combat.Recurrent awakenings, threatening dreams, thrashing movements during sleep, and awakenings with startle or panic features represented the most prevalently reported sleep-related symptoms. Laboratory findings of longer time awake, micro-awakenings, and a trend for patients to exhibit body and limb movements during sleep are consistent with the subjectively reported symptom profile. Prospectively assessed symptomatic awakenings featured startle or panic symptoms or anxiety related to threatening dreams. Laboratory findings revealed a trend for the symptomatic awakenings (with and without dream recall) to be disproportionately preceded by REM sleep, and the two recorded awakenings with objective physiological arousal were preceded by REM.PTSD features intrusions into sleep of more highly aroused behaviors and states, which appear partially conditioned to REM sleep.",0 +https://doi.org/10.4088/jcp.10m06121blu,Is Trauma a Causal Agent of Psychopathologic Symptoms in Posttraumatic Stress Disorder?,"Article Abstract Objective: The diagnosis of posttraumatic stress disorder (PTSD) is unique in that its criteria are embedded with a presumed causal agent, viz, a traumatic event. This assumption has come under scrutiny as a number of recent studies have suggested that many symptoms of PTSD may not necessarily be the result of trauma and may merely represent general psychiatric symptoms that would have existed even in the absence of a trauma event but are subsequently misattributed to it. The current study tests this hypothesis. Method: A case-control twin study conducted between 1996-2001 examined psychopathologic symptoms in a national convenience sample of 104 identical twin pairs discordant for combat exposure in Vietnam, with (n = 50) or without (n = 54) combat-related PTSD (DSM-IV-diagnosed) in the exposed twin. Psychometric measures used were the Symptom Checklist-90-Revised, the Clinician-Administered PTSD Scale, and the Mississippi Scale for Combat-Related PTSD. If a psychopathologic feature represents a factor that would have existed even without traumatic exposure, then there is a high chance that it would also be found at elevated rates in the non-trauma-exposed, identical cotwins of trauma-exposed twins with PTSD. In contrast, if a psychopathologic feature is acquired as a result of an environmental factor unique to the exposed twin, eg, the traumatic event, their cotwins should not have an increased incidence of the feature. Results: Combat veterans with PTSD demonstrated significantly higher scores (P < .0001) on the Symptom Checklist-90-Revised and other psychometric measures of psychopathology than their own combat-unexposed cotwins (and than combat veterans without PTSD and their cotwins). Conclusions: These results support the conclusion that the majority of psychiatric symptoms reported by combat veterans with PTSD would not have been present were it not for their exposure to traumatic events. J Clin Psychiatry Submitted: March 17, 2010; accepted July 8, 2010. Online ahead of print: September 7, 2010 (doi:10.4088/JCP.10m06121blu). Corresponding author: Mark W. Gilbertson, PhD, Department of Research Service, Manchester VA Medical Center, 718 Smyth Rd, Manchester, NH 03104 (mark.gilbertson@va.gov).",0 +https://doi.org/10.1002/pon.1606,Psychological distress related to patterns of family functioning among Japanese childhood cancer survivors and their parents,"Family functioning appears to be a predictor of psychological distress among childhood cancer survivors and their family members; however, relatively little is known about patterns in those families that are psychologically at-risk. The purpose of this study was to identify distinct clusters of families that include childhood cancer survivors, and to evaluate differences between the clusters with respect to anxiety, depression, and post-traumatic stress symptoms (PTSS).Childhood cancer survivors and their parents (247 individuals: 88 adolescent cancer survivors, 87 mothers, and 72 fathers) completed self-report questionnaires. Perceptions of family functioning were assessed using the Family Relationship Index and its three dimensions (cohesiveness, expressiveness, and conflict), and individuals were classified into groups via a cluster analytic approach. State-trait anxiety, depression, and PTSS were assessed to all of the participants.The individuals were classified into three types: One cluster featured high cohesiveness, high expressiveness, and low conflict ('Supportive-type', n=102); a second cluster featured low cohesiveness, low expressiveness, and high conflict ('Conflictive-type', n=32); and a third cluster had moderate cohesiveness, moderate expressiveness, and moderate conflict ('Intermediate-type', n=113). Among the three types, an analysis of variance revealed that 'Conflictive-type' members had the highest levels of PTSS, depression, and state-trait anxiety.These findings suggest that perceptions of family functioning are related to psychological distress in family members of childhood cancer survivors. A family-focused intervention might be a useful approach to targeting emotional distress in these families, particularly for families with a 'Conflictive-type' family member.",0 +,Perpetration of gross human rights violations in South Africa: association with psychiatric disorders.,"A nationally representative study of psychiatric disorders in South Africa provided an opportunity to study the association between perpetration of human rights violations (HRVs) during apartheid and psychiatric disorder. Prior work has suggested an association between perpetration and post-traumatic stress disorder (PTSD), but this remains controversial.Subjects reported on their perpetration of human rights violations, purposeful injury, accidental injury and domestic violence. Lifetime and 12-month prevalence of DSM-IV (Diagnostic and Statistical Manual, 4th edition) disorders were assessed with Version 3.0 of the World Health Organization Composite International Diagnostic Interview (CIDI 3.0). Socio-demographic characteristics of these groups were calculated. Odds ratios for the association between the major categories of psychiatric disorders and perpetration were assessed.HRV perpetrators were more likely to be male, black and more educated, while perpetrators of domestic violence (DV) were more likely to be female, older, married, less educated and with lower income. HRV perpetration was associated with lifetime and 12-month anxiety and substance use disorders, particularly PTSD. Purposeful and DV perpetration were associated with lifetime and 12-month history of all categories of disorders, whereas accidental perpetration was associated most strongly with mood disorders.Socio-demographic profiles of perpetrators of HRV and DV in South Africa differ. While the causal relationship between perpetration and psychiatric disorders deserves further study, it is possible that some HRV and DV perpetrators were themselves once victims. The association between accidental perpetration and mood disorder also deserves further attention.",0 +https://doi.org/10.1517/14656566.7.14.1977,Tiagabine in anxiety disorders,"GABA has been implicated in both the aetiology and treatment of anxiety. Tiagabine is currently the only selective GABA reuptake inhibitor available in US markets; it exerts its action via GAT-1 transporter blockade presynaptically, facilitating GABA neurotransmission. Preclinical studies and current human studies suggest tiagabine possesses anxiolytic properties. The anxiolytic properties of tiagabine have also been suggested in a number of case series, open-label studies and placebo-controlled studies in patients with different anxiety disorders. Throughout these studies, tiagabine has been reasonably tolerated; the most commonly reported adverse events include dizziness, headache and nausea. Tiagabine may be a useful addition to currently available drugs for anxiety; however, the data from small open-label investigations remain to be confirmed in larger controlled studies.",0 +https://doi.org/10.1186/s12888-015-0480-3,The structure of post-traumatic stress disorder and complex post-traumatic stress disorder amongst West Papuan refugees,"The validity of applying the construct of post-traumatic stress disorder (PTSD) across cultures has been the subject of contention. Although PTSD symptoms have been identified across multiple cultures, questions remain whether the constellation represents a coherent construct with an interpretable factor structure across diverse populations, especially those naïve to western notions of mental disorder. An important additional question is whether a constellation of Complex-PTSD (C-PTSD) can be identified and if so, whether there are distinctions between that disorder and core PTSD in patterns of antecedent traumatic events. Our study amongst West Papuan refugees in Papua New Guinea (PNG) aimed to examine the factorial structure of PTSD based on the DSM-IV, DSM-5, ICD-10 and ICD-11 definitions, and C-PTSD according to proposed ICD-11 criteria. We also investigated domains of traumatic events (TEs) and broader psychosocial effects of conflict (sense of safety and injustice) associated with the factorial structures identified.Culturally adapted measures were applied to assess exposure to conflict-related traumatic events (TEs), refugees' sense of safety and justice, and symptoms of PTSD and C-PTSD amongst 230 West Papuan refugees residing in Port Morseby, PNG.Confirmatory factor analysis (CFA) supported a unitary construct of both ICD-10 and ICD-11 PTSD, comprising the conventional symptom subdomains of intrusion, avoidance, and hyperarousal. In contrast, CFA did not identify a unitary construct underlying C-PTSD. The interaction of witnessing murders and sense of injustice was associated with both the intrusion and avoidance domains of PTSD, but not with the unique symptom clusters characterizing C-PTSD.Our findings support the ICD PTSD construct and its three-factor structure in this transcultural refugee population. Traumatic experiences of witnessing murder associated with a sense of injustice were specifically related to the intrusion and avoidance domains of PTSD. The unitary nature of C-PTSD across cultures remains in question.",0 +https://doi.org/10.1111/sltb.12118,The Relationship Between Posttraumatic Stress Symptoms and Suicide Ideation Among Child Survivors Following the Wenchuan Earthquake,"The association between posttraumatic stress disorder (PTSD) symptoms and suicide ideation was examined in a sample of 2,298 child survivors of the Wenchuan earthquake. Results indicated that intrusion, avoidance, hyperarousal symptom clusters, and PTSD total score were significantly associated with suicide ideation. Except for intrusion, other measures of PTSD remained as statistically significant correlates of suicide ideation even after controlling for age, gender, direct exposure, indirect exposure, and depression. Furthermore, results showed that PTSD symptoms had an indirect influence on suicide ideation that was mediated by depression. The findings suggest that avoidance and hyperarousal symptom clusters of PTSD may be two important indicators of suicide ideation among child survivors of the Wenchuan earthquake. Implications of the results for intervention and prevention of suicide behavior are discussed.",0 +https://doi.org/10.1097/nmd.0000000000000086,Symptoms of the Anxiety Disorders in a Perinatal Psychiatric Sample,"Symptoms of anxiety are a central feature of perinatal mental health, yet the anxiety disorders have received considerably less attention than depression in both perinatal research and practice. The present investigation involved a retrospective review of the clinical records of 334 patients seen at a psychiatric day hospital program serving pregnant and postpartum women. We examined the frequency with which the patients in this setting reported symptoms of anxiety, clinical correlates of elevated anxiety, and patterns of diagnosis in the clinical record. The results suggest that anxiety symptoms are very common in this population and that the presence of anxiety is associated with a more severe clinical profile, including higher rates of suicidality and increased use of psychotropic medications during pregnancy and postpartum. Although anxiety symptom levels were markedly elevated in this sample, anxiety disorders were diagnosed at relatively low rates. Implications for clinical practice, including discharge and treatment planning, are discussed.",0 +https://doi.org/10.1097/00004836-200607000-00012,The Impact of Chronic Hepatitis C and Comorbid Psychiatric Illnesses on Health-related Quality of Life,"To determine the relative impact of chronic hepatitis C (CHC) and comorbid psychiatric illness on the health-related quality of life (HRQoL).Psychiatric conditions are more common among patients with CHC but their relative influence on HRQoL is not well understood.We identified 864 veterans who had previously completed a veteran-specific HRQoL questionnaire (SF-36V) as part of the 1999 VA Large Health Survey with known HCV antibody (anti-HCV) status before the survey. For 201 anti-HCV(+) and 663 anti-HCV(-) patients, we compared the HRQoL status and the prevalence of 6 major psychiatric diagnoses. We conducted multiple regression analyses to measure the effect of anti-HCV status and psychiatric comorbidity.Compared with the anti-HCV(-) group, anti-HCV(+) veterans were more likely to have alcohol dependence (P<0.001), depression (P=0.01), or posttraumatic stress disorder (PTSD) (P<0.004). The anti-HCV(+) group also reported lower HRQoL on 4 of the 8 SF-36V subscales (P<0.01) and the mental component summary scale (P<0.001). Even after adjusting for demographic variables and comorbid psychiatric illness, anti-HCV(+) patients reported a significantly lower mental component summary score (P<0.01) than did anti-HCV(-) patients. Multiple regression analysis found that depression and PTSD predicted lower HRQoL scores for all 8 HRQoL subscales (P<0.01) and both the physical (P<0.001) and mental component (P<0.03) summary scales independent of anti-HCV status.The HRQoL is significantly impaired in veterans with CHC, particularly the mental health components of HRQoL. In contrast, comorbid depression and PTSD are associated with both lower physical and mental components of HRQol, independent of CHC.",0 +https://doi.org/10.1017/dmp.2015.118,"Gulf Coast Resilience Coalition: An Evolved Collaborative Built on Shared Disaster Experiences, Response, and Future Preparedness","For close to a decade, the Gulf Coast of the United States has been in almost constant disaster recovery mode, and a number of lessons have been learned concerning disaster recovery and behavioral health. The purpose of this report was to describe the natural development of a Gulf Coast Resilience Coalition (GCRC).The GCRC methods began with state-specific recovery goals following Hurricane Katrina in 2005 and transitioned to a shared multistate and multidiscipline coalition. The coalition's effectiveness is demonstrated through continuation, procurement of funding to provide response services, and increased membership to ensure sustainability.The coalition has enhanced response, recovery, and resilience by providing strategic plans for dissemination of knowledge; post-disaster surveillance and services; effective relationships and communication with local, state, and regional partners; disaster response informed by past experience; a network of professionals and community residents; and the ability to improve access to and efficiency of future behavioral health coordination through an organized response.The GCRC can not only improve readiness and response, but work toward a shared vision of improved overall mental and behavioral health and thus resilience, with beneficial implications for the Gulf South and other communities as well.",0 +https://doi.org/10.1016/j.comppsych.2009.04.001,Clinical characteristics of depressed outpatients previously overdiagnosed with bipolar disorder,"The diagnosis of bipolar disorder in depressed patients requires the ascertainment of prior episodes of mania and hypomania. Several research reports and commentaries have suggested that bipolar disorder is underrecognized and that many patients with nonbipolar major depressive disorder have, in fact, bipolar disorder. In a previous article from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we reported the opposite phenomenon-that bipolar disorder is often overdiagnosed in psychiatric outpatients. An important question that has not been previously examined is whether there is a particular clinical or demographic profile associated with bipolar disorder overdiagnosis among depressed patients. Forty psychiatric outpatients with current major depressive disorder reported having been previously diagnosed with bipolar disorder, which was not confirmed when interviewed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID). Psychiatric diagnoses, clinical and demographic variables were compared in these 40 patients and 233 depressed patients who were not diagnosed with bipolar disorder. Patients were interviewed by a highly trained diagnostic rater who administered the SCID for DSM-IV Axis I disorders, the Structured Interview for DSM-IV Personality for DSM-IV Axis II disorders, and the Schedule for Affective Disorders and Schizophrenia for clinical features of depression. The depressed patients who were overdiagnosed with bipolar disorder were diagnosed with a significantly higher number of Axis I disorders and were more likely to be diagnosed with specific phobia, posttraumatic stress disorder, and drug abuse/dependence. The patients overdiagnosed with bipolar disorder were also significantly more likely to be diagnosed with a current personality disorder and were more chronically ill with greater psychosocial impairment. Thus, the results suggest that depressed outpatients who had previously been overdiagnosed with bipolar disorder were more chronically and severely ill than depressed outpatients who had not been overdiagnosed.",0 +https://doi.org/10.1037/0022-006x.74.5.841,"Urban teens: Trauma, posttraumatic growth, and emotional distress among female adolescents.","Urban teens face many traumas, with implications for potential growth and distress. This study examined traumatic events, posttraumatic growth, and emotional distress over 18 months among urban adolescent girls (N = 328). Objectives were to (a) describe types of traumatic events, (b) determine how type and timing of events relate to profiles of posttraumatic growth, and (c) prospectively examine effects of event type and posttraumatic growth on short- and long-term emotional distress with controls for pre-event distress. Results indicate that type of event was related to profiles of posttraumatic growth, but not with subsequent emotional distress. When baseline emotional distress was controlled, posttraumatic growth was associated with subsequent reductions in short- and long-term emotional distress. Implications for future research and clinical practice with adolescents are addressed.",0 +https://doi.org/10.1300/j146v03n01_07,Posttraumatic Response and Children Exposed to Parental Violence,"Summary In this article some of the literature on children's responses to natural and person-created trauma are discussed. In addition, data relevant to children's posttraumatic response as a result of exposure to interparental violence are presented. Using a factor analytic procedure, the study attempted to examine how the DSM-IV symptom clusters for Posttraumatic Stress Disorder come together for this sample of children. General suggestions are made regarding possible intervention with exposed children experiencing posttraumatic symptoms.",0 +https://doi.org/10.1016/j.cpr.2005.10.002,A systematic and conceptual review of posttraumatic stress in childhood cancer survivors and their parents,"Recent years have witnessed a rapid acceleration in the recognition and documentation of posttraumatic stress disorder (PTSD) and posttraumatic stress symptomatology (PTSS) in childhood cancer survivors and their parents. However, applicability of PTSD both diagnostically and conceptually to cancer-related traumatic responses remains poorly articulated within the current literature. Following an outline of childhood cancer and PTSD, this paper critically examines the applicability of such a diagnosis to this clinical population. It then systematically reviews the current evidence base (24 studies) on PTSD and PTSS in childhood cancer survivors and their parents. Prevalence of PTSD and PTSS, as well as associated predictors, in this clinical population varies widely. Findings are considered in the light of a number of contemporary theories of PTSD. Limitations within current conceptualizations of PTSD are highlighted with respect to the nature of cancer as a traumatic event and the specific features of traumatic stress manifestations in childhood cancer survivors and their parents. Finally, a number of pertinent research areas are elucidated which are argued to warrant further investigation.",0 +https://doi.org/10.1016/j.jad.2009.04.004,Clinical features of patients with treatment-emergent suicidal behavior following initiation of paroxetine therapy,"Understanding suicidal behavior is an important component of assessing suicidality in psychiatric patients. GlaxoSmithKline (GSK) conducted a meta-analysis of randomized, placebo-controlled trials to compare suicidality in adult patients treated with paroxetine vs. placebo. The goal was to identify emergent clinical characteristics of patients with definitive suicidal behavior (DSB: preparatory act, suicide attempt, completed suicide).The dataset comprised 14,911 patients from 57 placebo-controlled paroxetine trials. Possible cases of suicidality were identified and were blindly reviewed by an expert panel, which categorized cases as suicidal or non-suicidal. DSB incidences were compared between paroxetine and placebo. Clinical narratives and case report forms for major depressive disorder (MDD) and anxiety disorder patients with DSB were reviewed. For MDD, rating scale items relating to suicidality, insomnia, agitation, and anxiety were examined.Overall (all indications) there were no differences between paroxetine and placebo for DSB (50/8958 [0.56%] vs. 40/5953 [0.67%], respectively; OR=1.2 [CI 0.8, 1.9]; p=0.483). However, in patients with major depressive disorder (MDD), the incidence of DSB was greater for paroxetine (11/3455 [0.32%] vs. 1/1978 [0.05%], OR=6.7 [CI 1.1, 149.4]; p=0.058). Review of the 11 paroxetine MDD cases revealed common clinical features: symptomatic improvement; younger age (18-30 years); psychosocial stressors; overdose as method; and absent/mild suicidal ideation at the visit prior to the event. There was no evidence for a consistent adverse event profile or onset of akathisia/agitation or a manic/mixed state. Anxiety disorder patients with DSB had a heterogeneous clinical picture.Limitations to the study include the relatively small number of cases and the retrospective nature of the study.DSB incidence was similar between paroxetine and placebo overall, but a higher frequency of DSB was found for paroxetine in MDD patients, driven by young adults aged < or =30 years. Most MDD patients with DSB improved prior to the attempt and experienced a psychosocial stressor. Patients should receive careful monitoring for suicidality during paroxetine therapy.",0 +https://doi.org/10.1111/j.1600-0404.2007.00827.x,Five-year outcome after mild head injury: a prospective controlled study,"To study the prevalence of post-concussion symptoms (PCS) 5-7 years after mild head injury (MHI) and to investigate whether patients suffer from more symptoms than the normal population.We conducted a 5- to 7-year follow-up of patients (n = 89) with MHI. Post-concussion symptoms were quantified with the Rivermead Post Concussion Symptoms Questionnaire (RPQ) and health-related quality of life (HRQL) was measured with the EuroQol-5D (EQ-5D). We also quantified subjective general health state with the EuroQol Visual Analogue Scale (EQ-VAS). An age- and sex-matched, but otherwise randomly chosen control group of 89 persons was recruited from the National Population Registry for a cross-sectional comparison. Twenty-eight patients (30%) and 27 (30%) controls responded.Patients reported significantly (P = 0.017) more PCS (median RPQ score 10, 95% CI 2-20) than controls (median 2, 95% CI 0-4). They also reported significantly (P = 0.008) lower HRQL (median EQ-5D score 0.866, 95% CI 0.796-1.000) than controls (1.000, 95% CI 1.000-1.000), but there was no difference between the groups in their subjective ratings of general health state.Patients reported significantly more PCS and lower HRQL 5 to 7 years after MHI than age- and sex-matched controls from the normal population.",0 +https://doi.org/10.1093/intqhc/mzr032,Developing a function impairment measure for children affected by political violence: a mixed methods approach in Indonesia,"Practitioners in political violence-affected settings would benefit from rating scales that assess child function impairment in a reliable and valid manner when designing and evaluating interventions. We developed a procedure to construct child function impairment rating scales using resources available in low- and middle-income countries.We applied a mixed methods approach. First, rapid ethnographic methods (brief participant observation, collection of diaries and a focus group with children) were used to select daily activities that best represented children's functioning. Second, rating scales based on these activities were examined for their psychometric properties. Construct validity was assessed through a confirmatory factor analysis procedure.Central Sulawesi, Indonesia.Qualitative data were collected for 53 children and psychometric testing was done with 403 children [average age: 9.9 (SD = 1.21), 49% girls] and 385 parents.Using locally available resources, we developed separate child-rated and parent-rated scales, both containing 11 items. The child-rated scale evidenced good internal, test-retest and inter-rater reliability and acceptable convergent and discriminant validity. Construct validity was confirmed by fit of the theorized factor structure-a social-ecological clustering of daily activities.The procedure resulted in a reliable and valid rating scale to assess child function impairment in the context of political violence. Practitioners can apply this procedure to develop new locally adequate rating scales to strengthen epidemiological surveys, baseline assessments, monitoring and evaluation and eventually, interventions. Further research should address the importance of gender differences and criterion-related validity.",0 +https://doi.org/10.1080/15228932.2011.562826,Vulnerability Factors in the Explanation of Workplace Aggression: The Construction of a Theoretical Framework,"Although workplace aggression is a well-known problem, research on workplace aggression merely focuses on perpetrators' typologies, and workplace-related victim research remains under-represented. In this article, we theoretically explore possible associations between victims' coping strategies, type-D personality, negative childhood experiences, attention-deficit/hyperactivity disorder, and posttraumatic stress disorder and work-related victimization. Through an intensive literature study and the incorporation of existing theories, under which is the precipitation theory, we develop a theoretical framework of vulnerability factors for experiencing workplace violence. Future directions of this theoretical framework and practical implications of the results after empirically exploring the theoretical pathways are suggested.",0 +https://doi.org/10.1080/16506073.2011.632436,Exploration of a Factor Mixture-Based Taxonic-Dimensional Model of Anxiety Sensitivity and Transdiagnostic Psychopathology Vulnerability Among Trauma-Exposed Adults,"The aim of this study was to evaluate the associations between a factor mixture-based taxonic-dimensional model of anxiety sensitivity (AS) and posttraumatic stress, panic, generalized anxiety, depression, psychiatric multimorbidity, and quality of life among a young adult sample exposed to traumatic stress (N = 103, n (females) = 66, M (age) = 23.68 years, SD (age) = 9.55). Findings showed support for the conceptual and operational utility of the AS taxonic-dimensional model with respect to concurrent transdiagnostic vulnerability among trauma-exposed adults. Specifically, relative to the low-AS group, the high-AS group demonstrated elevated levels of panic, depressive, and posttraumatic stress symptom severity as well as greater psychiatric multimorbidity and poorer quality of life. Furthermore, past-month MDD, GAD, PTSD, and panic attacks occurred nearly exclusively among the high-AS group. Continuous AS physical and psychological concerns scores were found to be significantly related to levels of panic and posttraumatic stress symptom severity, psychiatric multimorbidity as well as panic attack status only among the high-AS group and not among the low-AS group. Findings are discussed with respect to their implications for the conceptual and operational utility of the FMM-based taxonic-dimensional model of AS, related vulnerability for psychopathology in the context of trauma, and the clinical implications of these findings for assessment and intervention.",0 +https://doi.org/10.1002/1097-4679(198901)45:1<76::aid-jclp2270450111>3.0.co;2-h,Psychometric detection of fabricated symptoms of combat-related post-traumatic stress disorder: A systematic replication,Vietnam veterans with post-traumatic stress disorder (n = 11) and two other groups of Vietnam veterans (n = 24) instructed to fabricate symptoms of post-traumatic stress disorder completed the MMPI. A discriminant function analysis that used scale F and the post-traumatic stress disorder subscale correctly classified 91% of the subjects. This systematic replication supports the utility of the MMPI as a component in evaluating the validity of self-reported symptoms of post-traumatic stress disorder in Vietnam veterans.,0 +https://doi.org/10.1037/a0030359,Latent class differences explain variability in PTSD symptom changes during cognitive processing therapy for veterans.,"Despite demonstrated effectiveness of cognitive-behavioral psychotherapies for posttraumatic stress disorder (PTSD), there is limited research on the trajectory of PTSD symptom change during the course of these therapies. In addition, existent findings are mixed, making it difficult to know how individuals' PTSD symptoms will change from week to week during psychotherapy. The study presented here uses general growth mixture modeling (GGMM) to test the hypothesis that multiple latent classes will explain individual differences in PTSD symptom change during the course of cognitive processing therapy (CPT). Participants were 207 U.S. military veterans with PTSD who received CPT through an outpatient Veterans Affairs PTSD treatment program. Participants were mostly male (89%), White (81%), and averaged 42 years old. The PTSD Checklist (PCL), Clinician-Administered PTSD Scale (CAPS), and the Beck Depression Inventory-II (BDI-II) were administered at pre- and posttreatment; the PCL was also administered weekly to assess PTSD symptom changes during CPT. GGMM showed that a quadratic growth model with three distinct latent classes best explained the trajectory of PTSD symptom reductions during CPT. The following variables significantly predicted latent class membership: age; ethnicity; having combat as the worst trauma; and pretreatment PCL, CAPS, and BDI-II scores. In turn, class membership significantly predicted posttreatment PCL, BDI-II, and CAPS scores. This study is novel in showing that latent class differences in PTSD symptom reductions are useful in explaining why individuals exhibit variable rates of PTSD symptom change during psychotherapy and differing outcomes after psychotherapy. These findings may improve the ability to more accurately anticipate individual differences in PTSD symptom changes and responses to psychotherapy. © 2012 American Psychological Association.",0 +https://doi.org/10.2302/kjm.61.15,Mental Health and Psychosocial Support after the Great East Japan Earthquake,"Since the Great East Japan Earthquake, Keio University School of Medicine has, at the request of the Tokyo Metropolitan Government, provided mental health and psychosocial support to those living in Soma City in Fukushima Prefecture. This report covers the types of support provided in Soma City and discusses previous studies that were used as the model for current support practice and the results gained from actual performance. Also included is a summary of the objectives that were or were not achieved for medical support compared with recommendations from previous studies. Furthermore, future directions for medical support are also discussed.",0 +https://doi.org/10.1111/j.1365-2702.2006.01588.x,Factual memories of ICU: recall at two years post-discharge and comparison with delirium status during ICU admission - a multicentre cohort study,"Aims and objective. To examine the relationship between observed delirium in ICU and patients’ recall of factual events up to two years after discharge. Background. People, the environment, and procedures are frequently cited memories of actual events encountered in ICU. These are often perceived as stressors to the patients and the presence of several such stressors has been associated with the development of reduced health-related quality of life or post-traumatic stress syndrome. Design. Prospective cohort study using interview technique. Method. The cohort was assembled from 152 patients who participated in a previously conducted multi-centre study of delirium incidence in Australian ICUs. The interviews involved a mixture of closed- and open-ended questions. Qualitative responses regarding factual memories were analysed using thematic analysis. A five-point Likert scale with answers from ‘always’ to ‘never’ was used to ask about current experiences of dream, anxiety, sleep problems, fears, irritability and/or mood swings. Scoring ranged from 6 to 30 with a mid-point value of 18 indicating a threshold value for the diagnosis of post-traumatic stress syndrome. A P-value of <0·05 was considered significant for all analyses. Results. Forty-one (40%) out of 103 potential participants consented to take part in the follow-up interview; 18 patients (44%) had been delirious and 23 patients (56%) non-delirious during the ICU admission. The non-participants (n = 62) formed a control group to ensure a representative sample; 83% (n = 34) reported factual memories either with or without recall of dreaming. Factual memories were significantly less common (66% cf. 96%) in delirious patients (OR 0·09, 95%CI 0·01–0·85, p = 0·035). Five topics emerged from the thematic analysis: ‘procedures’, ‘staff’, ‘comfort’, ‘visitors’, and ‘events’. Based on the current experiences, five patients (12%, four non-delirious and one delirious) scored ≥18 indicative of symptoms of post-traumatic stress syndrome; this did not reach statistical significance. Memory of transfer out of ICU was less frequent among the delirious patients (56%, n = 10) than among the non-delirious patients (87%, n = 20) (p = 0·036). Conclusion. Most patients have factual memories of their ICU stay. However, delirious patients had significantly less factual recall than non-delirious patients. Adverse psychological sequelae expressed as post-traumatic stress syndrome was uncommon in our study. Every attempt must be made to ensure that the ICU environment is as hospitable as possible to decrease the stress of critical illness. Post-ICU follow-up should include filling in the ‘missing gaps’, particularly for delirious patients. Ongoing explanations and a caring environment may assist the patient in making a complete recovery both physically and mentally. Relevance to clinical practice. This study highlights the need for continued patient information, re-assurance and optimized comfort. While health care professionals cannot remove the stressors of the ICU treatments, we must minimize the impact of the stay. It must be remembered that most patients are aware of their surroundings while they are in the ICU and it should, therefore, be part of ICU education to include issues regarding all aspects of patient care in this particularly vulnerable subset of patients to optimize their feelings of security, comfort and self-respect.",0 +https://doi.org/10.1016/s0006-3223(96)00489-1,Enhanced Dexamethasone Suppression of Plasma Cortisol in Adult Women Traumatized by Childhood Sexual Abuse,"A study was undertaken to determine if female survivors of childhood and/or adolescent sexual abuse (CSA) would exhibit hypothalamic-pituitary-adrenal (HPA) axis abnormalities characteristic of patients with combat-related posttraumatic stress disorder (PTSD)--i.e., enhanced cortisol suppression to low-dose dexamethasone and increased density of lymphocyte glucocorticoid receptors. Nineteen women who reported experiencing severe CSA and 21 nonvictimized women participated in a low-dose (0.5 mg) dexamethasone suppression test and donated blood for measurement of lymphocyte glucocorticoid receptor binding. Women with CSA had significantly enhanced suppression of plasma cortisol in response to 0.5 mg dexamethasone compared to the nonvictimized women. These observations are consistent with findings in male veterans with combat-related PTSD. They suggest that this pattern of HPA axis dysfunction may be a characteristic sequel of psychiatric disorders that occur following a range of traumatic experiences. This HPA axis profile is different than that associated with acute stress or with major depressive disorder.",0 +https://doi.org/10.1007/s10862-015-9522-x,"Emotional Distress Intolerance, Experiential Avoidance, and Anxiety Sensitivity: The Buffering Effect of Attentional Control on Associations with Posttraumatic Stress Symptoms","A number of individual difference factors, including emotional distress intolerance (EDI), experiential avoidance (EA), and anxiety sensitivity (ASI), have been implicated in the development and maintenance of posttraumatic stress (PTS) symptomatology. Attentional control (AC) has been shown to serve as a protective factor against the development of maladaptive psychological outcomes across a number of studies, even among those with outcome-specific vulnerabilities. The purpose of the present study was to examine AC as a moderator of the relations between three constructs pertaining to the way that people relate to their internal experiences (i.e., EDI, EA, AS) and PTS symptoms among a trauma exposed community sample (N = 903). As predicted, AC moderated the relations between each individual difference factor and PTS symptoms, such that as attentional control decreased, the strength of the association between each individual difference factor and PTS symptoms increased. Study results suggest that AC abilities may be one factor that differentiates those who recover from trauma from those who do not, even among those who may be vulnerable for developing PTS symptomatology. Clinical implications and results of a PTS cluster level analysis will be discussed.",0 +https://doi.org/10.1111/j.1539-6924.2005.00694.x,The 2003 Heat Wave in France: Dangerous Climate Change Here and Now,"In an analysis of the French episode of heat wave in 2003, this article highlights how heat wave dangers result from the intricate association of natural and social factors. Unusually high temperatures, as well as socioeconomic vulnerability, along with social attenuation of hazards, in a general context where the anthropogenic contribution to climate change is becoming more plausible, led to an excess of 14,947 deaths in France, between August 4 and 18, 2003. The greatest increase in mortality was due to causes directly attributable to heat: dehydration, hyperthermia, heat stroke. In addition to age and gender, combinatorial factors included preexisting disease, medication, urban residence, isolation, poverty, and, probably, air pollution. Although diversely impacted or reported, many parts of Europe suffered human and other losses, such as farming and forestry through drought and fires. Summer 2003 was the hottest in Europe since 1500, very likely due in part to anthropogenic climate change. The French experience confirms research establishing that heat waves are a major mortal risk, number one among so-called natural hazards in postindustrial societies. Yet France had no policy in place, as if dangerous climate were restricted to a distant or uncertain future of climate change, or to preindustrial countries. We analyze the heat wave's profile as a strongly attenuated risk in the French context, as well as the causes and the effects of its sudden shift into amplification. Research and preparedness needs are highlighted.",0 +https://doi.org/10.1037/0021-843x.112.4.646,Epidemiology of Trauma and Posttraumatic Stress Disorder in Mexico.,"Prevalence rates of trauma and posttraumatic stress disorder (PTSD) were estimated from a probability sample of 2,509 adults from 4 cities in Mexico. PTSD was assessed according to Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) criteria using the Composite International Diagnostic Interview (CIDI; WHO, 1997). Lifetime prevalence of exposure and PTSD were 76% and 11.2%, respectively. Risk for PTSD was highest in Oaxaca (the poorest city), persons of lower socioeconomic status, and women. Conditional risk for PTSD was highest following sexual violence, but nonsexual violence and traumatic bereavement had greater overall impact because of their frequency. Of lifetime cases, 62% became chronic; only 42% received medical or professional care. The research demonstrates the importance of expanding the epidemiologic research base on trauma to include developing countries around the world.",0 +https://doi.org/10.1002/imhj.21515,EMOTION REGULATION IN MOTHERS AND YOUNG CHILDREN FACED WITH TRAUMA,"The present study investigated maternal emotion regulation as mediating the association between maternal posttraumatic stress symptoms and children's emotional dysregulation in a community sample of 431 Israeli mothers and children exposed to trauma. Little is known about the specific pathways through which maternal posttraumatic symptoms and deficits in emotion regulation contribute to emotional dysregulation. Inspired by the intergenerational process of relational posttraumatic stress disorder (PTSD), in which posttraumatic distress is transmitted from mothers to children, we suggest an analogous concept of relational emotion regulation, by which maternal emotion regulation problems may contribute to child emotion regulation deficits. Child emotion regulation problems were measured using the Child Behavior Checklist-Dysregulation Profile (CBCL-DP; T.M. Achenbach & I. Rescorla, 2000), which is comprised of three subscales of the CBCL: Attention, Aggression, and Anxiety/Depression. Maternal PTSD symptoms were assessed by the Posttraumatic Diagnostic Scale (E.B. Foa, L. Cashman, L. Jaycox, & K. Perry, 1997) and maternal emotion regulation by the Difficulties in Emotion Regulation Scale (K.L. Gratz & L. Roemer, 2004). Results showed that the child's emotion regulation problems were associated with both maternal posttraumatic symptoms and maternal emotion dysregulation. Further, maternal emotion regulation mediated the association between maternal posttraumatic symptoms and the child's regulation deficits. These findings highlight the central role of mothers' emotion regulation skills in the aftermath of trauma as it relates to children's emotion regulation skills. The degree of mothers' regulatory skills in the context of posttraumatic stress symptoms reflects a key process through which the intergenerational transmission of trauma may occur. Study results have critical implications for planning and developing clinical interventions geared toward the treatment of families in the aftermath of trauma and, in particular, the enhancement of mothers' emotion regulation skills after trauma.",0 +https://doi.org/10.1017/s0033291715000884,Longitudinal trajectories of post-traumatic stress disorder symptoms among adolescents after the Wenchuan earthquake in China,"Background This study examines the patterns and predictors of post-traumatic stress disorder (PTSD) symptom trajectories among adolescent survivors following the Wenchuan earthquake in China. Method A total of 1573 adolescent survivors were followed up at 6, 12, 18 and 24 months post-earthquake. Participants completed the Posttraumatic Stress Disorder Self-Rating Scale (PTSD-SS), Adolescent Self-Rating Life Events Checklist, Social Support Rate Scale, and the Simplified Coping Style Questionnaire. Distinct patterns of PTSD symptom trajectories were established through grouping participants based on time-varying changes of developing PTSD (i.e. reaching the clinical cut-off on the PTSD-SS). Multivariate logistic regressions were used to examine predictors for trajectory membership. Results PTSD prevalence rates at 6, 12, 18 and 24 months were 21.0, 23.3, 13.5 and 14.7%, respectively. Five PTSD symptom trajectories were observed: resistance (65.3% of the sample), recovery (20.0%), relapsing/remitting (3.3%), delayed dysfunction (4.2%) and chronic dysfunction (7.2%). Female gender and senior grade were related to higher risk of developing PTSD symptoms in at least one time point, whereas being an only child increased the possibility of recovery relative to chronic dysfunction. Family members’ injury/loss and witness of traumatic scenes could also cause PTSD chronicity. More negative life events, less social support, more negative coping and less positive coping were also common predictors for not developing resistance or recovery. Conclusions Adolescents’ PTSD symptoms showed an anniversary reaction. Although many adolescents remain euthymic or recover over time, some adolescents, especially those with the risk factors noted above, exhibit chronic, delayed or relapsing symptoms. Thus, the need for individualized intervention with these adolescents is indicated.",0 +https://doi.org/10.1002/acp.894,Splintered memories or vivid landmarks? Qualities and organization of traumatic memories with and without PTSD,"SUMMARY One hundred and eighty-one students answered a standardized questionnaire on Post-Traumatic Stress Disorder (PTSD): 25 reported trauma(s) and indicated a pattern of after-effects that matched a PTSD symptom profile, whereas 88 indicated trauma(s) but no PTSD symptom profile. Both groups answered a questionnaire addressing the recollective quality, integration and coherence of the traumatic memory that currently affected them most. Participants with a PTSD symptom profile reported more vivid recollection of emotion and sensory impressions. They reported more observer perspective in the memory (seeing themselves ‘from the outside’), but no more fragmentation. They also agreed more with the statement that the trauma had become part of their identity, and perceived more thematic connections between the trauma and current events in their lives. The two groups showed different patterns of correlations which indicated different coping styles. Overall, the findings suggest that traumas form dysfunctional reference points for the organization of other personal memories in people with PTSD symptoms, leading to fluctuations between vivid intrusions and avoidance. Copyright # 2003 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1016/s0163-8343(98)00021-8,Complex posttraumatic stress disorder: evidence from the primary care setting,"Sexual abuse is a common problem among female primary care medical patients. There is a wide spectrum of long-term sequelae, ranging from mild to the complex symptom profiles consistent with the theories of a posttraumatic sense of identity. Generally, the latter occurs in the context of severe, chronic abuse, beginning in childhood and often compounded by the presence of violence, criminal behavior, and substance abuse in the family of origin. In this study we search for empirical evidence for the existence of a complex posttraumatic stress syndrome in 99 women patients at 3 family practice outpatient clinics who report a history of sexual abuse. A structured interview was administered by trained female interviewers to gather data on family history and psychiatric symptoms and diagnoses. Empirical evidence from cluster analysis of the data supports the theory of a complex posttraumatic syndrome. The severity gradient based on symptoms roughly parallels the severity gradient based on childhood abuse and sociopathic behavior and violence in the family of origin, with the most severely abused subjects characterized by symptom patterns that fit the description of a complex posttraumatic stress syndrome.",0 +https://doi.org/10.4088/jcp.v62n0808,Virtual Reality Exposure Therapy for Vietnam Veterans With Posttraumatic Stress Disorder,"Virtual reality (VR) integrates real-time computer graphics, body-tracking devices, visual displays, and other sensory input devices to immerse a participant in a computer-generated virtual environment that changes in a natural way with head and body motion. VR exposure (VRE) is proposed as an alternative to typical imaginal exposure treatment for Vietnam combat veterans with posttraumatic stress disorder (PTSD).This report presents the results of an open clinical trial using VRE to treat Vietnam combat veterans who have DSM-IV PTSD. In 8 to 16 sessions, 10 male patients were exposed to 2 virtual environments: a virtual Huey helicopter flying over a virtual Vietnam and a clearing surrounded by jungle.Clinician-rated PTSD symptoms as measured by the Clinician Administered PTSD Scale, the primary outcome measure, at 6-month follow-up indicated an overall statistically significant reduction from baseline (p = .0021) in symptoms associated with specific reported traumatic experiences. All 8 participants interviewed at the 6-month follow-up reported reductions in PTSD symptoms ranging from 15% to 67%. Significant decreases were seen in all 3 symptom clusters (p < .02). Patient self-reported intrusion symptoms as measured by the Impact of Event Scale were significantly lower (p < .05) at 3 months than at baseline but not at 6 months, although there was a clear trend toward fewer intrusive thoughts and somewhat less avoidance.Virtual reality exposure therapy holds promise for treating PTSD in Vietnam veterans.",0 +https://doi.org/10.1520/jfs16101j,Behavior and the Law Reconsidered: Psychological Syndromes and Profiles,"Recently, a new concept of behavior and the law has emerged which looks beyond the defendant's satisfaction of the elements which define the charge. This formulation, which considers not simply the objective facts but motive, intent, and circumstance, has marked a legal shift from diminished capacity to diminished responsibility. Still in evolution, this trend has challenged the relationship between law and the behavioral sciences, and prompted serious reconsideration of the role of each. This paper examines the landmarks of the movement, considers its implications, and looks to the future.",0 +https://doi.org/10.1016/s0022-3999(01)00296-3,The validity of the Hospital Anxiety and Depression Scale,"To review the literature of the validity of the Hospital Anxiety and Depression Scale (HADS).A review of the 747 identified papers that used HADS was performed to address the following questions: (I) How are the factor structure, discriminant validity and the internal consistency of HADS? (II) How does HADS perform as a case finder for anxiety disorders and depression? (III) How does HADS agree with other self-rating instruments used to rate anxiety and depression?Most factor analyses demonstrated a two-factor solution in good accordance with the HADS subscales for Anxiety (HADS-A) and Depression (HADS-D), respectively. The correlations between the two subscales varied from.40 to.74 (mean.56). Cronbach's alpha for HADS-A varied from.68 to.93 (mean.83) and for HADS-D from.67 to.90 (mean.82). In most studies an optimal balance between sensitivity and specificity was achieved when caseness was defined by a score of 8 or above on both HADS-A and HADS-D. The sensitivity and specificity for both HADS-A and HADS-D of approximately 0.80 were very similar to the sensitivity and specificity achieved by the General Health Questionnaire (GHQ). Correlations between HADS and other commonly used questionnaires were in the range.49 to.83.HADS was found to perform well in assessing the symptom severity and caseness of anxiety disorders and depression in both somatic, psychiatric and primary care patients and in the general population.",0 +https://doi.org/10.1111/head.12200,Post-Traumatic Stress Disorder in U.S. Soldiers With Post-Traumatic Headache,"To determine the impact of post-traumatic stress disorder (PTSD) on headache characteristics and headache prognosis in U.S. soldiers with post-traumatic headache.PTSD and post-concussive headache are common conditions among U.S. Army personnel returning from deployment. The impact of comorbid PTSD on the characteristics and outcomes of post-traumatic headache has not been determined in U.S. Army soldiers.A retrospective cohort study was conducted among 270 consecutive U.S. Army soldiers diagnosed with post-traumatic headache at a single Army neurology clinic. All subjects were screened for PTSD at baseline using the PTSD symptom checklist. Headache frequency and characteristics were determined for post-traumatic headache subjects with and without PTSD at baseline. Headache measures were reassessed 3 months after the baseline visit, and were compared between groups with and without PTSD.Of 270 soldiers with post-traumatic headache, 105 (39%) met screening criteria for PTSD. There was no significant difference between subjects with PTSD and those without PTSD with regard to headache frequency (17.2 vs 15.7 headache days per month; P = .15) or chronic daily headache (58.1% vs 52.1%; P = .34). Comorbid PTSD was associated with higher headache-related disability as measured by the Migraine Disability Assessment Score. Three months after the baseline neurology clinic visit, the number of subjects with at least 50% reduction in headache frequency was similar among post-traumatic headache cases with and without PTSD (25.9% vs 26.8%).PTSD is prevalent among U.S. Army soldiers with post-traumatic headache. Comorbid PTSD is not associated with more frequent headaches or chronic daily headache in soldiers evaluated at a military neurology clinic for chronic post-traumatic headache. Comorbid PTSD does not adversely affect short-term headache outcomes, although prospective controlled trials are needed to better assess this relationship.",0 +,Risk factors in combat stress reaction--a study of Israeli soldiers in the 1982 Lebanon war.,"Identification des variables demographiques, militaires et de personnalite susceptibles d'etre predicteur de reactions de stress au combat. Les comparaisons des donnees concernant les blessures physiques et les atteintes psychiques lors de la guerre du Liban en 1982 indiquent qu'il existe des degres variables de vulnerabilite au stress du combattant. On esquisse un profil composite type du soldat a haut risque",0 +https://doi.org/10.1037/a0025766,I'll be working my way back: A qualitative synthesis on the trauma experience of children.,"Children who experience some kind of traumatic event, such as losing a sibling, witnessing war, or being the victim of abuse or an accident, all have the need to process this event. Few theories exist about the development of posttraumatic stress disorder, specifically in traumatized children. Therefore, a synthesis of qualitative research is conducted in which the available qualitative studies on the children’s perspective on traumatic experiences are integrated. A total of 17 English-language peer-reviewed articles were selected and a thematic synthesis was carried out. The core themes in the findings pertain to three domains: the individual, the family, and the community. We found a qualitative synthesis beneficial for creating a complete picture of children dealing with trauma and for strengthening the emerging theory. (aut. ref.)",0 +https://doi.org/10.1186/1744-859x-7-24,Risk factors predict post-traumatic stress disorder differently in men and women,"About twice as many women as men develop post-traumatic stress disorder (PTSD), even though men as a group are exposed to more traumatic events. Exposure to different trauma types does not sufficiently explain why women are more vulnerable.The present work examines the effect of age, previous trauma, negative affectivity (NA), anxiety, depression, persistent dissociation, and social support on PTSD separately in men and women. Subjects were exposed to either a series of explosions in a firework factory near a residential area or to a high school stabbing incident.Some gender differences were found in the predictive power of well known risk factors for PTSD. Anxiety predicted PTSD in men, but not in women, whereas the opposite was found for depression. Dissociation was a better predictor for PTSD in women than in men in the explosion sample but not in the stabbing sample. Initially, NA predicted PTSD better in women than men in the explosion sample, but when compared only to other significant risk factors, it significantly predicted PTSD for both men and women in both studies. Previous traumatic events and age did not significantly predict PTSD in either gender.Gender differences in the predictive value of social support on PTSD appear to be very complex, and no clear conclusions can be made based on the two studies included in this article.",0 +https://doi.org/10.1017/s0033291703001612,Estimating post-traumatic stress disorder in the community: lifetime perspective and the impact of typical traumatic events,"Background. Community surveys have assessed post-traumatic stress disorder (PTSD) in relation to traumatic events designated by respondents as the worst they have ever experienced. An assessment of PTSD in relation to all reported traumas would impose too great a burden on respondents, a considerable proportion of whom report multiple traumas. The ‘worst event’ method is efficient for identifying persons with PTSD, but may overestimate the conditional probability of PTSD associated with the entire range of PTSD-level traumas. In this report, we evaluate this potential bias. Method. The Detroit Area Survey of Trauma ( n =2181) estimated the PTSD risk from two samples of traumas: (1) a representative sample of traumas formed by selecting a random trauma from each respondent's list of traumas; and (2) traumas designated by respondents as the worst (the standard method). Results. Both estimation methods converged on key findings, including identifying trauma types with the highest probability of PTSD and sex differences in the risk of PTSD. Compared to the random events, the ‘worst event’ method yielded a moderately higher conditional probability for PTSD (0·136 v . 0·092). The bias was due almost entirely to the deviation of the distribution of the worst events from expected values, if all event types had equal prior selection probabilities. Direct adjustment, setting the distribution equal to expected values and applying the observed probabilities of PTSD associated with individual event types brought the estimate close to the unbiased estimate, based on the randomly selected traumas. Conclusions. Only the ‘worst event’ method can be used as a short-cut to assessing all traumas. The bias in the estimated risk of PTSD is modest and is attenuated by direct adjustment.",0 +https://doi.org/10.31887/dcns.2008.10.1/hcrgrunze,The effectiveness of anticonvulsants in psychiatric disorders,"Anticonvulsant drugs are widely used in psychiatric indications. These include mainly alcohol and benzodiazepine withdrawal syndromes, panic and anxiety disorders, dementia, schizophrenia, affective disorders, bipolar affective disorders in particular, and, to some extent, personality disorders. A further area in which neurology and psychiatry overlap is pain conditions, in which some anticonvulsants, and also typical psychiatric medications such as antidepressants, are helpful. From the beginning of their psychiatric use, anticonvulsants have also been used to ameliorate specific symptoms of psychiatric disorders independently of their causality and underlying illness, eg, aggression, and, more recently, cognitive impairment, as seen in affective disorders and schizophrenia. With new anticonvulsants currently under development, it is likely that their use in psychiatry will further increase, and that psychiatrists need to learn about their differential efficacy and safety profiles to the same extent as do neurologists.",0 +https://doi.org/10.1080/07481180490249201,DEATH ANXIETY AS A PREDICTOR OF POSTTRAUMATIC STRESS LEVELS AMONG INDIVIDUALS WITH SPINAL CORD INJURIES,"Because the onset of a spinal cord injury may involve a brush with death and because serious injury and disability can act as a reminder of death, death anxiety was examined as a predictor of posttraumatic stress levels among individuals with disabilities. This cross-sectional study used multiple regression and multivariate multiple regression to examine whether death denial and death awareness predicted posttraumatic stress disorder (PTSD) among veterans and civilians with spinal cord injuries (N = 313). The results indicated that death anxiety (after controlling for demographic and disability-related variables) predicted a significant amount of the total levels of posttraumatic stress reactions among individuals with spinal cord injuries. Further, death awareness, pain level, and spiritual/religious coping significantly predicted the posttraumatic stress clusters of reexperiencing, avoidance, and hyperarousal. Death denial significantly predicted only hyperarousal. Because death anxiety predicts various aspects of PTSD reactions, one possible therapeutic implication is that addressing death-related topics may help to reduce PTSD reactions. Further research is needed to better ascertain the possible causality among these variables.",0 +https://doi.org/10.1037/0022-0167.54.3.344,Coping style use predicts posttraumatic stress and complicated grief symptom severity among college students reporting a traumatic loss.,"Problem-focused coping, and active and avoidant emotional coping were examined as correlates of grief and posttraumatic stress disorder (PTSD) severity among 123 college students reporting the unexpected death of an immediate family member, romantic partner, or very close friend. The authors administered to participants, via the Internet, 5 survey instruments that measured demographic characteristics, traumatic event exposure (Stressful Life Events Screening Questionnaire; L. Goodman, C. Corcoran, K. Turner, N. Yuan, & B. L. Green, 1998), complicated grief (CG) severity (Inventory of Complicated Grief-Revised-Short Form; A. E. Latham & H. G. Prigerson, 2004; H. G. Prigerson & S. C. Jacobs, 2001), PTSD severity (PTSD Checklist; F. W. Weathers, B. T. Litz, D. S. Herman, J. A. Huska, & T. M. Keane, 1993), and coping style use (Brief COPE; C. S. Carver, 1997). Results demonstrated that CG and PTSD severity were both significantly positively correlated with problem-focused, and active and avoidant emotional coping styles. The authors used path analysis to control for time since the loss and trauma frequency and found that only avoidant emotional coping remained significant in predicting CG and PTSD severity. Results are discussed in terms of their clinical implications for treating individuals with traumatic losses.",0 +https://doi.org/10.1037//0882-7974.15.4.627,Age and emotional response to the Northridge earthquake: A longitudinal analysis.,"Cross-sectional studies have found older adults to have lower levels of emotional distress after natural disasters. The maturation hypothesis suggests that older adults are less reactive to stress events, whereas the inoculation hypothesis argues that prior experience with disaster is protective. One hundred and sixty-six adults aged 30 to 102 were interviewed regarding the 1994 Northridge earthquake. Longitudinal data were available on depressed mood before and after the earthquake. The maturation hypothesis was generally not supported. The young-old were least depressed; however, this age difference was present prior to the earthquake. The old-old showed lowest levels of earthquake-specific rumination, but age did not buffer the relationship between damage exposure and rumination. The inoculation hypothesis was supported for depressed mood. Prior earthquake experience was related to lower postearthquake depression scores.",0 +,Blood pressure among immigrants to Israel from areas affected by the Chernobyl disaster.,"OBJECTIVES: To validate and analyze apparent association of hypertension with exposures to radiation at Chernobyl among immigrants to Israel from the contaminated areas. METHODS: Data were collected in 1991 and 1994 from two samples of persons who immigrated to Israel from the contaminated zone around the Chernobyl nuclear power plant. The first sample were self-referred for evaluation in a clinic by whole-body cesium measurement, physical examination, and questionnaire (N = 756, 328 from less exposed and 438 from more exposed areas). The second wave data were collected in 1994 during home interviews for evaluation of psychosocial factors associated with their experience (N = 708, 121 from more exposed and 253 from less exposed areas). In the second study a referent group was included (n = 334) who were matched by age, sex, and year of immigration who immigrated from other areas outside of the contaminated zone. Estimates of exposure were based on the IAEA map of ground-level cesium isotope (137Cs) contamination. RESULTS: In the 1991 sample, 21% from high exposure areas and 16% from less exposed areas had elevated systolic blood pressure (> 140 mmHg). Elevated diastolic blood pressure (> 90 mmHg) had a similar difference between more and less exposed groups (21% and 16%). Age- and sex-specific analyses showed that statistically different levels were found in the older age groups. In the 1994 sample, we confirmed a relationship between exposure and elevated blood pressure. 33% of those from the more exposed areas and 34% of those from less exposed areas had elevated systolic blood pressure, compared with 23% of the comparison group, with a similar trend found in diastolic blood pressure. The relationship between exposure and blood pressure was accentuated in the group of respondents who had high scores on PTSD symptoms. Of the psychological variables analyzed, systolic blood pressure was most strongly related to cancer-related anxiety and somatization. A discriminant function analysis showed that three variables: age, reporting a significant loss from the Chernobyl accident, and fear of cancer correctly differentiated 72% of those with normal and high blood pressure. CONCLUSIONS: There is a relationship between exposure to Chernobyl and high blood pressure, partly due to the psychological reactions to the accident.",0 +https://doi.org/10.1037/a0032572,Sleep disturbances predict later trauma-related distress: Cross-panel investigation amidst violent turmoil.,"Sleep disturbances, including trouble falling and remaining asleep and recurrent nightmares, are symptoms of posttraumatic stress. A growing body of literature indicates that sleep disturbance may also convey vulnerability for the continuation of other symptoms of posttraumatic stress, including fear, anxiety, and heightened arousal. However, longitudinal research, which could help understand how these relationships unfold over time, has been limited.The longitudinal relationships between sleep disturbance and posttraumatic stress were investigated in 779 Palestinian adults randomly selected and interviewed twice during the period from April 2008 to November 2008, amid ongoing violent political turmoil. The recruitment method produced a representative sample and excellent retention. Cross-panel structural equation modeling was used to examine relationships between sleep and distress across two study periods.Results indicated that initial sleep problems were associated with increased posttraumatic stress disorder (PTSD), depression, and intrapersonal resource loss at follow-up 6 months later, but initial PTSD, depression, and intrapersonal resource loss were not associated with increased sleep problems at follow-up.Sleep problems may confer vulnerability to longer-term distress in the presence of ongoing political violence. Future research should examine whether interventions targeting trauma-related sleep problems may improve prevention and treatment for PTSD and related disorders.",0 +https://doi.org/10.1192/bjp.bp.114.145516,Trajectory of post-traumatic stress following traumatic injury: 6-year follow-up,"Background Traumatic injuries affect millions of patients each year, and resulting post-traumatic stress disorder (PTSD) significantly contributes to subsequent impairment. Aims To map the distinctive long-term trajectories of PTSD responses over 6 years by using latent growth mixture modelling. Method Randomly selected injury patients ( n = 1084) admitted to four hospitals around Australia were assessed in hospital, and at 3, 12, 24 and 72 months. Lifetime psychiatric history and current PTSD severity and functioning were assessed. Results Five trajectories of PTSD response were noted across the 6 years: (a) chronic (4%), (b) recovery (6%), (c) worsening/recovery (8%), (d) worsening (10%) and (e) resilient (73%). A poorer trajectory was predicted by female gender, recent life stressors, presence of mild traumatic brain injury and admission to intensive care unit. Conclusions These findings demonstrate the long-term PTSD effects that can occur following traumatic injury. The different trajectories highlight that monitoring a subset of patients over time is probably a more accurate means of identifying PTSD rather than relying on factors that can be assessed during hospital admission.",1 +https://doi.org/10.1016/s0163-8343(02)00207-4,Screening for post-traumatic stress disorder in female Veteran’s Affairs patients: validation of the PTSD checklist,"We evaluated the screening validity of a self-report measure for post traumatic stress disorder (PTSD), the PTSD Checklist (PCL), in female Veterans Affairs (VA) patients. All women seen for care at the VA Puget Sound Health Care system from October 1996-January 1999 (n=2,545) were invited to participate in a research interview. Participants (n=282) completed the 17-item PCL, followed by a gold standard diagnostic interview for PTSD, the Clinician Administered PTSD Scale (CAPS). Thirty-six percent of the participants (n=100) met CAPS diagnostic criteria for current PTSD. Receiver Operating Characteristic (ROC) analysis was used to evaluate the screening performance of the PCL. The area under the ROC curve was 0.86 (95% CI 0.82-0.90). A PCL score of 38 optimized the performance of the PCL as a screening test (sensitivity 0.79, specificity 0.79). The PCL performed well as a screening measure for the detection of PTSD in female VA patients.",0 +https://doi.org/10.1111/j.1475-3588.2008.00502.x,Trauma-Focused Cognitive Behavioural Therapy for Children and Parents,"Trauma-focused cognitive behavioural therapy (TF-CBT) for children and parents is an evidence based treatment approach for traumatised children. Evaluation of TF-CBT includes several randomised controlled trials, effectiveness studies and ongoing studies for children experiencing sexual abuse, domestic violence, traumatic grief, terrorism, disasters and multiple traumas. The model of TF-CBT described here is a flexible, components-based model that provides children and parents with stress management skills prior to encouraging direct discussion and processing of children's traumatic experiences. TF-CBT components are summarised by the acronym PRACTICE: Psychoeducation, Parenting skills, Relaxation skills, Affective modulation skills, Cognitive coping skills, Trauma narrative and cognitive processing of the traumatic event(s), In vivo mastery of trauma reminders, Conjoint child-parent sessions, and Enhancing safety and future developmental trajectory. Currently this model of TF-CBT is being adapted and implemented both within the USA and internationally.",0 +https://doi.org/10.1037/mil0000092,A Preliminary Study of DSM–5 PTSD Symptom Patterns in Veterans by Trauma Type,"Posttraumatic stress disorder (PTSD) has a primary etiology in experiencing psychological trauma and the subsequent psychological sequelae ( American Psychiatric Association, 2013). There are multi...",0 +https://doi.org/10.1037/a0033324,The Child PTSD Symptom Scale: An update and replication of its psychometric properties.,"The psychometric properties of the child PTSD Symptom Scale (CPSS) were examined in 2 samples. Sample 1 (N = 185, ages 6-17 years) consisted of children recruited from hospitals after accidental injury, assault, and road traffic trauma, and assessed 6 months posttrauma. Sample 2 (N = 68, ages 6-17 years) comprised treatment-seeking children who had experienced diverse traumas. In both samples psychometric properties were generally good to very good (internal reliability for total CPSS scores = .83 and .90, respectively). The point-biserial correlation of the CPSS with posttraumatic stress disorder (PTSD) diagnosis derived from structured clinical interview was .51, and children diagnosed with PTSD reported significantly higher symptoms than non-PTSD children. The CPSS demonstrated applicability to be used as a diagnostic measure, demonstrating sensitivity of 84% and specificity of 72%. The performance of the CPSS Symptom Severity Scale to accurately identify PTSD at varying cutoffs is reported in both samples, with a score of 16 or above suggested as a revised cutoff.",0 +https://doi.org/10.1186/1471-2458-13-469,Disability associated with exposure to traumatic events: results from a cross-sectional community survey in South Sudan,"BackgroundThere is a general lack of knowledge regarding disability and especially factors that are associated with disability in low-income countries. We aimed to study the overall and gender-specific prevalence of disability, and the association between exposure to traumatic events and disability in a post-conflict setting.MethodsWe conducted a cross-sectional community based study of four Greater Bahr el Ghazal States, South Sudan (n = 1200). The Harvard Trauma Questionnaire (HTQ) was applied to investigate exposure to trauma events. Disability was measured using the Washington Group Short Measurement Set on Disability, which is an activity-based scale derived from the WHO’s International Classification of Disability, Functioning and Health.ResultsThe estimated prevalence of disability (with severe difficulty) was 3.6% and 13.4% for disability with moderate difficulties. No gender differences were found in disability prevalence. Almost all participants reported exposure to at least one war-related traumatic event. The result of a hierarchical regression analysis showed that, for both men and women, exposure to traumatic events, older age and living in a polygamous marriage increased the likelihood of having a disability.ConclusionsThe finding of association between traumatic experience and disability underlines the precariousness of the human rights situation for individuals with disability in low-income countries. It also has possible implications for the construction of disability services and for the provision of health services to individuals exposed to traumatic events.",0 +https://doi.org/10.1017/s0790966700000288,Childbirth-related post-traumatic stress disorder and its treatment,"Abstract The phenomenon of childbirth-related post-traumatic stress disorder (PTSD) has become more widely recognised in recent years following changes in 1994 to the DSM criteria regarding how a traumatic event was defined. Emerging literature has predominately focused on prevalence rates and risk factors associated with this condition and on the use of debriefing techniques as an attempt to reduce or prevent the development of postnatal PTSD. However, little is known about the efficacy of psychological interventions that have been used to treat PTSD among postnatal women. This review summarises the limited evidence supporting the use of such treatments and discusses the significant challenges in developing and implementing psychological interventions for childbirth-related PTSD.",0 +https://doi.org/10.1056/nejmc1001716,Morphine after Combat Injury and Post-Traumatic Stress Disorder,"Comments on an article by T. L. Holbrook et al. (see record 2010-00923-002). As medical providers currently deployed in Iraq, we read the article by Holbrook et al. with great interest. If confirmed, the association of morphine use with reductions in post-traumatic stress disorder (PTSD) would provide another important indication for the administration of morphine to battlefield casualties. We note that the investigators analyzed morphine use in level 1 or 2 facilities and that the morphine was administered intravenously in 98% of recipients. First, clinicians would benefit from knowing whether morphine was associated with adverse outcomes among patients treated at the facilities studied. Second, it is standard training for Navy corpsmen and Army medics to administer morphine and oral transmucosal fentanyl to patients before they reach these facilities. In addition, the ""fragments from blast - NOS [not otherwise specified]"" mechanism of injury was independently and strongly associated with the absence of PTSD in both models 1 and 2. Although we acknowledge that the numbers of injuries incurred through this mechanism were small, knowledge of the circumstances surrounding these injuries might lead to testable hypotheses for research aimed at elucidating factors associated with PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.3402/ejpt.v4i0.19979,The role of major depression in neurocognitive functioning in patients with posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) frequently co-occur after traumatic experiences and share neurocognitive disturbances in verbal memory and executive functioning. However, few attempts have been made to systematically assess the role of a comorbid MDD diagnosis in neuropsychological studies in PTSD.The purpose of the current study is to investigate neurocognitive deficits in PTSD patients with and without MDD. We hypothesized that PTSD patients with comorbid MDD (PTSD+MDD) would have significantly lower performance on measures of verbal memory and executive functioning than PTSD patients without MDD (PTSD-MDD).Participants included in this study were 140 treatment-seeking outpatients who had a diagnosis of PTSD after various single traumatic events and participated in a randomized controlled trial comparing different treatment types. Baseline neuropsychological data were compared between patients with PTSD+MDD (n=84) and patients with PTSD-MDD (n=56).The PTSD+MDD patients had more severe verbal memory deficits in learning and retrieving words than patients with PTSD alone. There were no differences between the groups in recall of a coherent paragraph, recognition, shifting of attention, and cognitive interference.The results of this study suggest that a more impaired neurocognitive profile may be associated with the presence of comorbid MDD, with medium-sized group differences for verbal memory but not for executive functioning. From a clinical standpoint, being aware that certain verbal memory functions are more restricted in patients with comorbid PTSD and MDD may be relevant for treatment outcome of trauma-focused psychotherapy.",0 +https://doi.org/10.1016/j.socscimed.2014.05.025,The impact of housing displacement on the mental health of low-income parents after Hurricane Katrina,"Previous studies in the aftermath of natural disasters have demonstrated relationships between four dimensions of displacement - geographic distance from the predisaster community, type of postdisaster housing, number of postdisaster moves, and time spent in temporary housing - and adverse psychological outcomes. However, to date no study has explored how these dimensions operate in tandem. The literature is further limited by a reliance on postdisaster data. We addressed these limitations in a study of low-income parents, predominantly non-Hispanic Black single mothers, who survived Hurricane Katrina and who completed pre and postdisaster assessments (N = 392). Using latent profile analysis, we demonstrated three profiles of displacement experiences within the sample: (1) returned, characterized by return to a predisaster community; (2) relocated, characterized by relocation to a new community, and (3) unstably housed, characterized by long periods in temporary housing and multiple moves. Using regression analyses, we assessed the relationship between displacement profiles and three mental health outcomes (general psychological distress, posttraumatic stress, and perceived stress), controlling for predisaster characteristics and mental health indices and hurricane-related experiences. Relative to participants in the returned profile, those in the relocated profile had significantly higher general psychological distress and perceived stress, and those in the unstably housed profile had significantly higher perceived stress. Based on these results, we suggest interventions and policies that reduce postdisaster housing instability and prioritize mental health services in communities receiving evacuees.",0 +https://doi.org/10.1037/0022-006x.66.6.883,Children's predisaster functioning as a predictor of posttraumatic stress following Hurricane Andrew.,"This study examined (a) children's predisaster behavioral and academic functioning as a predictor of posttraumatic stress (PTS) following Hurricane Andrew and (b) whether children who were exposed to the disaster would display a worsening of prior functioning. Fifteen months before the disaster, 92 4th through 6th graders provided self-reports of anxiety; peers and teachers rated behavior problems (anxiety, inattention, and conduct) and academic skills. Measures were repeated 3 months postdisaster; children also reported PTS symptoms and hurricane-related experiences (i.e., exposure). PTS symptoms were again assessed 7 months postdisaster. At 3 months postdisaster, children's exposure to the disaster, as well as predisaster ratings of anxiety, inattention, and academic skills, predicted PTS symptoms. By 7 months, only exposure, African American ethnicity, and predisaster anxiety predicted PTS. Prior anxiety levels also worsened as a result of exposure to the disaster. The findings have implications for identifying and treating children at risk for stress reactions following a catastrophic disaster.",0 +https://doi.org/10.1001/jama.296.5.537,Mental Health Problems Among Adults in Tsunami-Affected Areas in Southern Thailand,"On December 26, 2004, an undersea earthquake occurred off the northwestern coast of Sumatra, Indonesia. The tsunami that followed severely affected all 6 southwestern provinces of Thailand, where 5395 individuals died, 2991 were unaccounted for, and 8457 were injured.To assess the prevalence of symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression among individuals residing in areas affected by the tsunami in southern Thailand as part of a public health emergency response and rapid assessment.A multistage, cluster, population-based mental health survey was conducted from February 15 to 22, 2005, of random samples of displaced (n = 371) and nondisplaced persons in Phang Nga province (n = 322) and nondisplaced persons in the provinces of Krabi and Phuket (n = 368). Data were collected using an interviewer-administered questionnaire on handheld computers. A surveillance follow-up survey of the displaced persons (n = 371) and nondisplaced persons (n = 322) in Phang Na was conducted in September 2005.Medical Outcomes Study-36 Short-Form Health Survey SF-36 to assess self-perceived general health, bodily pain, and social and emotional functioning; the Harvard Trauma Questionnaire to assess tsunami-specific traumatic events; and the Hopkins Checklist-25 to detect symptoms of anxiety and depression.Participation rates for displaced and nondisplaced persons in the rapid assessment survey were 69% and 58%, respectively. Symptoms of PTSD were reported by 12% of displaced and 7% of nondisplaced persons in Phang Nga and 3% of nondisplaced persons in Krabi and Phuket. Anxiety symptoms were reported by 37% of displaced and 30% of nondisplaced persons in Phang Nga and 22% of nondisplaced persons in Krabi and Phuket. Symptoms of depression were reported by 30% of displaced and 21% of nondisplaced persons in Phang Nga and 10% of nondisplaced persons in Krabi and Phuket. In multivariate analysis, loss of livelihood was independently and significantly associated with symptoms of all 3 mental health outcomes (PTSD, anxiety, and depression). In the 9-month follow-up surveillance survey of 270 (73%) displaced and 250 (80%) nondisplaced participants in Phang Nga, prevalence rates of symptoms of PTSD, anxiety, and depression among displaced persons decreased to 7%, 24.8%, and 16.7%, respectively, and among nondisplaced persons, prevalence rates decreased to 2.3%, 25.9%, and 14.3%, respectively.Among survivors of the tsunami in southern Thailand, elevated rates of symptoms of PTSD, anxiety, and depression were reported 8 weeks after the disaster, with higher rates for anxiety and depression than PTSD symptoms. Nine months after the disaster, the rates of those reporting these symptoms decreased but were still elevated. This information is important for directing, strengthening, and evaluating posttsunami mental health needs and interventions.",0 +https://doi.org/10.1016/j.socscimed.2010.03.023,"Suffering, hope, and entrapment: Resilience and cultural values in Afghanistan","A critical health-related issue in war-affected areas is how people make sense of adversity and why they show resilience in a high-risk environment. In Afghanistan, the burden of poor mental health arises in contexts of pervasive poverty, social inequality, and persistent violence. In 2006, we conducted face-to-face interviews with 1011 children (age 11-16) and 1011 adult caregivers, randomly selected in a school-based survey in three northern and central areas. Participants narrated their experiences as part of a systematic health survey, including an open-ended questionnaire on major life stressors and solutions to mitigate them. Responses were analysed using an inductive thematic approach and categorised for quantitative presentation, producing a conceptual model. For adults, the primary concern is repairing their ""broken economy,"" the root of all miseries in social, educational, governance, and health domains. For students, frustrations focus on learning environments as well as poverty, as education is perceived as the gateway to upward social and economic mobility. Hope arises from a sense of moral and social order embodied in the expression of key cultural values: faith, family unity, service, effort, morals, and honour. These values form the bedrock of resilience, drive social aspirations, and underpin self-respect and dignity. However, economic impediments, social expectations, and cultural dictates also combine to create entrapment, as the ability to realise personal and social aspirations is frustrated by structural inequalities injurious to health and wellbeing. This study contributes to a small but growing body of work on resilience in public health and conflict settings. It demonstrates that culture functions both as an anchor for resilience and an anvil of pain, and highlights the relevance of ethnographic work in identifying what matters most in formulating social and public health policies to promote a hopeful future.",0 +https://doi.org/10.1002/jts.21916,Gender Differences in the Associations of PTSD Symptom Clusters With Relationship Distress in U.S. Vietnam Veterans and Their Partners,"Research has consistently linked symptoms of posttraumatic stress disorder (PTSD) with relationship distress in combat veterans and their partners. Studies of specific clusters of PTSD symptoms indicate that symptoms of emotional numbing/withdrawal (now referred to as negative alterations in cognition and mood) are more strongly linked with relationship distress than other symptom clusters. These findings, however, are based predominantly on samples of male veterans. Given the increasing numbers of female veterans, research on potential gender differences in these associations is needed. The present study examined gender differences in the multivariate associations of PTSD symptom clusters with relationship distress in 465 opposite-sex couples (375 with male veterans and 90 with female veterans) from the National Vietnam Veterans Readjustment Study. Comparisons of nested path models revealed that emotional numbing/withdrawal symptoms were associated with relationship distress in both types of couples. The strength of this association, however, was stronger for female veterans (b = .46) and female partners (b = .28), compared to male veterans (b = .38) and male partners (b = .26). Results suggest that couples-based interventions (e.g., psychoeducation regarding emotional numbing symptoms as part of PTSD) are particularly important for both female partners of male veterans and female veterans themselves.",0 +https://doi.org/10.1111/j.1469-8986.2007.00537.x,Polysomnographically measured sleep abnormalities in PTSD: A meta-analytic review,"Although sleep complaints are common among patients with Posttraumatic stress disorder (PTSD), polysomnographic studies examining sleep abnormalities in PTSD have produced inconsistent results. To clarify discrepant findings, we conducted a meta-analytic review of 20 polysomnographic studies comparing sleep in people with and without PTSD. Results showed that PTSD patients had more stage 1 sleep, less slow wave sleep, and greater rapid-eye-movement density compared to people without PTSD. We also conducted exploratory analyses aimed at examining potential moderating variables (age, sex, and comorbid depression and substance use disorders). Overall, studies with a greater proportion of male participants or a low rate of comorbid depression tended to find more PTSD-related sleep disturbances. These findings suggest that sleep abnormalities exist in PTSD, and that some of the inconsistencies in prior findings may be explained by moderating variables.",0 +https://doi.org/10.15288/jsad.2013.74.727,Transitional Life Events and Trajectories of Cigarette and Alcohol Use During Emerging Adulthood: Latent Class Analysis and Growth Mixture Modeling,"Emerging adulthood (ages 18-25 years) has been associated with elevated substance use. Transitional life events (TLEs) during emerging adulthood in relation to substance use are usually examined separately, rather than as a constellation. The purposes of this study were (a) to explore distinct subgroups experiencing various TLEs during emerging adulthood, (b) to identify heterogeneous trajectories of cigarette and alcohol use during emerging adulthood, and (c) to examine the association of TLEs with cigarette and alcohol use trajectories.Five waves of longitudinal data (mean age range: 19.5-26.0 years) were used from a community-based drug prevention program (n = 946, 49.9% female). Distinct subgroups of emerging adults who experienced various TLEs were identified using latent class analysis. Cigarette and alcohol use were examined using a latent growth mixture model.A three-class model fit the data best in identifying TLE subgroups (new family, college attenders [NFCA]; uncommitted relationships, college attenders [URCA]; hibernators [HBN]). Three-trajectory models fit the data best for cigarette and alcohol use during emerging adulthood. The TLE categories were significantly associated with the cigarette (p < .05) and alcohol use groups (p < .001); specifically, the URCA and HBN groups were significantly more likely to be classified as accelerating cigarette users, relative to NFCA (ps < .05). The NFCA and HBN groups were significantly more likely to be classified as accelerating alcohol users, relative to URCA (ps < .01).To characterize an ""at-risk"" emerging adult group for cigarette and alcohol use over time, a range of life events during emerging adulthood should be considered. Interventions tailored to young adulthood may benefit from targeting the absence of these life events typifying ""independence"" as a potential marker for underlying substance use problems and provide supplemental screening methods to identify young adults with similar issues.",0 +https://doi.org/10.1089/jwh.2011.3415,Risk Factors and Health Profiles of Recent Migrant Women Who Experienced Violence Associated with Pregnancy,"Background: Violence associated with pregnancy is a major public health concern, but little is known about it in recent migrant women. This study looked at (1) risk factors for violence associated with pregnancy among newly arrived migrant women in Canada and (2) if those who experienced violence associated with pregnancy had a different health profile or use of healthcare services for themselves or their infants during pregnancy and up to 4 months postpartum compared to other childbearing migrant women. Methods: Pregnant migrant women in Canada <5 years were recruited in 12 hospitals in 3 large cities between 2006 and 2009 and followed to 4 months postpartum. Data were collected on maternal background, migration history, violence associated with pregnancy, maternal and infant physical and mental health, and services used. Results: Of a total of 774 pregnant migrant women, 59 (7.6%) women reported violence associated with pregnancy. Migrant women who experienced violence, compared to those who did not, were at increased risk of violence if they lived without a partner, were asylum seekers, migrated <2 years ago, or had less than high school education. Women who reported violence were less likely to have up-to-date vaccinations, take folic acid before pregnancy, more likely to commence prenatal care after 3 months gestation and to not use contraceptives after birth. They were also more likely to have a history of miscarriage and report more postpartum pain and increased bleeding. They were also more likely to have inadequate social support and report more depression, anxiety, somatization, and posttraumatic stress disorder (PTSD) on standardized tests. No differences were found in the health status of the infants of women who experienced violence compared to those who did not. Conclusions: Clinicians should sensitively ask recent migrant women (asylum seekers, refugees, and nonrefugee immigrants) about violence associated with pregnancy and appropriately assess, treat, and refer them.",0 +,Police suicide--a Web surveillance of national data,"Considerable research has been done on suicide in police work. It appears that the volume of literature on this topic has led to considerable controversy concerning the accuracy and validity of police suicide rates. This topic has given rise to a wide variety of speculative, often wildly exaggerated figures being circulated in the law enforcement community and media, much of which is not based on verifiable research or gathered in an organized, useful manner that can be shared and scrutinized. Such figures have been taken at face value, translated into widely varying rates and profiles that, because they lack any substantiation, do little to help and much to impede the meaningful development of programs that can address the problems of police stress, trauma, posttraumatic stress, suicide, and the promotion of improved general health in the law enforcement community. This paper represents an empirical attempt to gather descriptive police suicide data from all fifty states in the U.S. for one year--2008--and record it in a cohesive manner that may be useful to researchers, police agencies, and program developers.",0 +https://doi.org/10.1192/bjp.186.6.536,Going to war does not have to hurt: preliminary findings from the British deployment to Iraq,"We carried out a brief longitudinal mental health screen of 254 members of the UK's Air Assault Brigade before and after deployment to Iraq last year. Analysis of General Health Questionnaire (GHQ-28) scores before and after deployment revealed a lower score after deployment (mean difference=0.93, 95% CI 0.35-1.52). This indicated a highly significant relative improvement in mental health (P < 0.005). Moreover, only 9 of a larger sample of 421 (2%) exceeded cut-off criteria on the Trauma Screening Questionnaire. These findings suggest that war is not necessarily bad for psychological health.",0 +https://doi.org/10.2147/prbm.s52268,Potential of eye movement desensitization and reprocessing therapy in the treatment of post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) continues to attract both empirical and clinical interest due to its complex symptom profile and the underlying processes involved. Recently, research attention has been focused on the types of memory processes involved in PTSD and hypothesized neurobiological processes. Complicating this exploration, and the treatment of PTSD, are underlying comorbid disorders, such as depression, anxiety, and substance use disorders. Treatment of PTSD has undergone further reviews with the introduction of eye movement desensitization and reprocessing (EMDR). EMDR has been empirically demonstrated to be as efficacious as other specific PTSD treatments, such as trauma-focused cognitive behavioral therapy. There is emerging evidence that there are different processes underlying these two types of trauma treatment and some evidence that EMDR might have an efficiency advantage. Current research and understanding regarding the processes of EMDR and the future direction of EMDR is presented.",0 +https://doi.org/10.1159/000073030,Prevalence and Risk Factors of Posttraumatic Stress Disorder in Older Adults,"Posttraumatic stress disorder (PTSD) has scarcely been researched in the elderly. There is no population-based information on prevalence and risk factors in older persons. Patients with PTSD are often not recognized or incorrectly diagnosed. As the disorder has great implications for the quality of life, a correct diagnosis and treatment are crucial. Increased knowledge on vulnerability factors for PTSD can facilitate diagnostic procedures and health management in the elderly.PTSD cases were found following a two-phase sampling procedure: a random selection of 1,721 subjects were screened and in 422 subjects a psychiatric diagnostic interview was administered. Prevalence of PTSD and subthreshold PTSD were calculated. Vulnerability factors regarding demographics, physical health, personality, social factors, recent distress and adverse events in early childhood were assessed.6-month prevalence of PTSD and of subthreshold PTSD was 0.9 and 13.1%, respectively. The strongest vulnerability factors for both PTSD and subthreshold PTSD were neuroticism and adverse events in early childhood.This is the first population-based study on PTSD in older persons. With a 6-month prevalence of almost 1% the disease is not rare. Comparisons with younger populations suggest some accumulation of cases among older people reflecting the chronic risk factors, which are found in this study: neuroticism and adverse events in early childhood.",0 +https://doi.org/10.1097/00006842-200105000-00008,Psychogenic Lowering of Urinary Cortisol Levels Linked to Increased Emotional Numbing and a Shame-Depressive Syndrome in Combat-Related Posttraumatic Stress Disorder,"The purpose of the study was to search for the intrapsychic correlates of individual differences in cortisol levels in male Vietnam combat veterans with posttraumatic stress disorder.The study involved measurement of urinary cortisol levels and clinical assessment with a broad profile of psychometric tests during a single 48-hour period in 30 inpatients.The main finding by both correlation and t test analyses was a significant inverse relationship between urinary cortisol levels and a symptom complex composed of two closely interrelated clinical subgroupings, ""disengagement"" (principally involving emotional numbing) and ""shame-laden depression.""The findings support the concept that cortisol levels reflect the ongoing balance between the undifferentiated emotional arousal state of engagement (associated with higher cortisol levels) and opposing antiarousal disengagement defense mechanisms (associated with lower cortisol levels). It appears that the low cortisol levels often seen in patients with posttraumatic stress disorder are psychogenic and reflect a dominating effect of disengagement coping strategies, which represent secondary compensatory adaptations during the chronic course of this disorder to counteract primary arousal symptoms, especially those related to an intractable shame-laden depressive syndrome. The psychoendocrine findings suggest that the relatively inconspicuous clinical feature of shame resulting from both the primary and secondary traumatizations is a particularly powerful, preoccupying, and overwhelming source of emotional engagement. Shame may represent a ""sleeper"" that is worthy of greater attention in both research and clinical efforts to understand the pathogenesis and psychopathology of this devastating stress-related disorder.",0 +https://doi.org/10.1037/a0030963,Meaning-making appraisals relevant to adjustment for veterans with spinal cord injury.,"The purpose of the present study was to conduct a mixed-methods investigation of meaning-making appraisals generated from spinal cord injury survivors' narratives of their injury experience. The sample consisted of 79 participants from an urban midwestern Veterans Affairs facility. The study design was cross-sectional and incorporated semistructured, face-to-face interviews, taking approximately 1 hr to complete. Measures of posttraumatic stress disorder, depression, psychological well-being, and purpose in life were completed as part of the interview. A data analytic approach based on grounded theory that allowed qualitative themes to be transformed to quantitative data was employed. Seven salient meaning-making themes were identified. Significant relationships were identified between certain meaning-making themes (e.g., identity integration positively related to positive growth), and certain themes were also significantly related to postinjury psychological health and distress separately (e.g., perceived burden on others was significantly related to greater depression scores). Findings are discussed within the context of clinical interventions that foster positive posttrauma outcomes.",0 +https://doi.org/10.1016/j.addbeh.2011.02.005,Hurt people who hurt people: Violence amongst individuals with comorbid substance use disorder and post traumatic stress disorder,"The association between substance use disorder (SUD) and the perpetration of violence has been well documented. There is some evidence to suggest that the co-occurrence of post traumatic stress disorder (PTSD) may increase the risk for violence. This study aims to determine the prevalence of violence perpetration and examine factors related to violence amongst individuals with comorbid SUD and PTSD.Data was collected via interview from 102 participants recruited to a randomised controlled trial of an integrated treatment for comorbid SUD and PTSD.The interview addressed demographics, perpetration of violent crime, mental health including aggression, substance use, PTSD, depression, anxiety and borderline personality disorder.Over half of participants reported committing violence in their lifetime and 16% had committed violence in the past month. Bivariate associations were found between violence perpetration and trait aggression, higher levels of alcohol and cannabis use, lower levels of other opiate use, and experiencing more severe PTSD symptoms, particularly in relation to hyperarousal. When entered into a backward stepwise logistic regression however, only higher levels of physical aggression and more severe PTSD hyperarousal symptoms remained as independent predictors of violence perpetration.These findings highlight the importance of assessing for PTSD amongst those with SUD particularly in forensic settings. They also indicate that it is the hyperarousal symptoms of PTSD specifically that need to be targeted by interventions aimed at reducing violence amongst individuals with SUD and PTSD.",0 +https://doi.org/10.1007/s11013-014-9393-8,A Village Possessed by “Witches”: A Mixed-Methods Case–Control Study of Possession and Common Mental Disorders in Rural Nepal,"In Nepal, spirit possession is a common phenomenon occurring both in individuals and in groups. To identify the cultural contexts and psychosocial correlates of spirit possession, we conducted a mixed-method study in a village in central Nepal experiencing a cluster of spirit possession events. The study was carried out in three stages: (1) a pilot study consisting of informal interviews with possessed individuals, observations of the possession spells, and video recording of possession events; (2) a case–control study comparing the prevalence of symptoms of common mental disorders in women who had and had not experienced possession; and (3) a follow-up study with focus group discussions and in-depth interviews with possessed and non-possessed men and women, and key informants. Quantitative results indicated that possessed women reported higher rates of traumatic events and higher levels of symptoms of mental disorder compared to non-possessed women (Anxiety 68 vs. 18 %, Depression 41 vs. 19 %, and PTSD 27 vs. 0 %). However, qualitative interviews with possessed individuals, family members, and traditional healers indicated that they did not associate possession states with mental illness. Spirit possession was viewed as an affliction that provided a unique mode of communication between humans and spirits. As such, it functioned as an idiom of distress that allowed individuals to express suffering related to mental illness, socio-political violence, traumatic events, and the oppression of women. The study results clearly indicate that spirit possession is a multi-dimensional phenomenon that cannot be mapped onto any single psychiatric or psychological diagnostic category or construct. Clinical and public health efforts to address spirit possession must take the socio-cultural context and systemic dynamics into account to avoid creating iatrogenic illness, undermining coping strategies, and exacerbating underlying social problems.",0 +https://doi.org/10.1037/a0027312,Links between child and adolescent trauma exposure and service use histories in a national clinic-referred sample.,"The National Child Traumatic Stress Network (NCTSN) is a federally funded child mental health service initiative designed to raise the standard of care and increase access to evidence-based services for traumatized children and their families across the United States. As part of the quality improvement goal, a Core Data Set (CDS) was established to standardize data collection and examine treatment outcomes across participating centers. This paper describes baseline demographic characteristics, prevalence of trauma exposure, and service use for children and adolescents served by a broad range of NCTSN service delivery centers. Data were collected from children 0–18 years (52% girls, 82% were 6–18 years old) who reported exposure to at least one trauma and who received trauma-related services (n 11,104). Approximately half the sample was White; more than three quarters reported exposure to multiple types of trauma. Sixty-three percent were eligible for state- or federally funded insurance. The two most commonly reported traumatic events were traumatic loss/separation/bereavement and domestic violence. Number and type of trauma exposure varied by gender and age. Type and number of services utilized prior to entering an NCTSN center varied by number of trauma exposures. Systematically assessing children’s trauma exposure provides clinically useful information, particularly for those exposed to multiple types of traumatic events. Identifying subgroups, and markers of risk for trauma-related sequelae, may inform policies, programs, and best practices to meet specific needs of children and families. Future research may clarify high-risk trauma profiles for coordinated utilization of systems of care.",0 +https://doi.org/10.1016/j.jphys.2013.12.004,Physiotherapy management of whiplash-associated disorders (WAD),[Sterling M (2014) Physiotherapy management of whiplash-associated disorders (WAD). Journal of Physiotherapy 60: 5–12],0 +https://doi.org/10.1037/a0026971,"Selecting a linear mixed model for longitudinal data: Repeated measures analysis of variance, covariance pattern model, and growth curve approaches.","With increasing popularity, growth curve modeling is more and more often considered as the 1st choice for analyzing longitudinal data. Although the growth curve approach is often a good choice, other modeling strategies may more directly answer questions of interest. It is common to see researchers fit growth curve models without considering alterative modeling strategies. In this article we compare 3 approaches for analyzing longitudinal data: repeated measures analysis of variance, covariance pattern models, and growth curve models. As all are members of the general linear mixed model family, they represent somewhat different assumptions about the way individuals change. These assumptions result in different patterns of covariation among the residuals around the fixed effects. In this article, we first indicate the kinds of data that are appropriately modeled by each and use real data examples to demonstrate possible problems associated with the blanket selection of the growth curve model. We then present a simulation that indicates the utility of Akaike information criterion and Bayesian information criterion in the selection of a proper residual covariance structure. The results cast doubt on the popular practice of automatically using growth curve modeling for longitudinal data without comparing the fit of different models. Finally, we provide some practical advice for assessing mean changes in the presence of correlated data.",0 +https://doi.org/10.2105/ajph.2007.120915,Mental Health in Sumatra After the Tsunami,"Objectives. We assessed the levels and correlates of posttraumatic stress reactivity (PTSR) of more than 20000 adult tsunami survivors by analyzing survey data from coastal Aceh and North Sumatra, Indonesia. Methods. A population-representative sample of individuals interviewed before the tsunami was traced in 2005 to 2006. We constructed 2 scales measuring PTSR by using 7 symptom items from the Post Traumatic Stress Disorder (PTSD) Checklist–Civilian Version. One scale measured PTSR at the time of interview, and the other measured PTSR at the point of maximum intensity since the disaster. Results. PTSR scores were highest for respondents from heavily damaged areas. In all areas, scores declined over time. Gender and age were significant predictors of PTSR; markers of socioeconomic status before the tsunami were not. Exposure to traumatic events, loss of kin, and property damage were significantly associated with higher PTSR scores. Conclusions. The tsunami produced posttraumatic stress reactions across a wide region of Aceh and North Sumatra. Public health will be enhanced by the provision of counseling services that reach not only people directly affected by the tsunami but also those living beyond the area of immediate impact.",0 +https://doi.org/10.1097/00005053-199205000-00006,Urinary Catecholamine Excretion and Severity of PTSD Symptoms in Vietnam Combat Veterans,"In the present study, we replicated and extended our previous findings of increased 24-hour urinary catecholamine excretion in posttraumatic stress disorder (PTSD). Dopamine, norepinephrine, and epinephrine concentrations were measured in 22 male patients with PTSD (14 inpatients and eight outpatients) and in 16 nonpsychiatric normal males. The PTSD inpatients showed significantly higher excretion of all three catecholamines compared with both outpatients with PTSD and normal controls. Dopamine and norepinephrine, but not epinephrine, levels were significantly correlated with severity of PTSD symptoms in the PTSD group as a whole. In particular, these catecholamines seemed related to intrusive symptoms. None of the catecholamines were correlated with severity of depression. The findings support the hypothesis of an enhanced sympathetic nervous system activation in PTSD, and suggest that increased sympathetic arousal may be closely linked to severity of certain PTSD symptom clusters.",0 +https://doi.org/10.1192/bjp.159.4.547,Reactions of Police Officers to Body-Handling after a Major Disaster a Before-and-After Comparison,"This study reports the results of an unusual opportunity to follow up a group of police officers who were involved in body-handling duties following the Piper Alpha disaster, and for whom there were available data from pre-disaster assessments. In addition, after these duties, the officers were compared with a matched control group of officers who had not been involved in such work. The comparisons failed to demonstrate high levels of post-traumatic distress or psychiatric morbidity. The results are interpreted in terms of issues such as the officers' own coping strategies, and major organisational and managerial factors.",0 +https://doi.org/10.1080/08870440701671362,"Well-being, posttraumatic growth and benefit finding in long-term breast cancer survivors","This study evaluates posttraumatic growth, benefit finding and well-being, and their mutual association in a random sample of disease-free 10-year breast cancer survivors. The population-based Eindhoven Cancer Registry (ECR) was used to select all women diagnosed with breast cancer in 1993 in six hospitals. Of the 254 breast cancer survivors, 183 (72%) returned a completed questionnaire. Measures included the Posttraumatic Growth Inventory (posttraumatic growth), the Perceived Disease Impact Scale (benefit finding) and the CentERdata Health monitor (life satisfaction, health status and psychological well-being). Self-reported health status and psychological well-being were similar in survivors compared to general population norms, whereas life satisfaction was significantly higher among survivors. In addition, posttraumatic growth was seen in the following domains: relationships with others, personal strength and appreciation of life. The number of patients reporting benefit finding was high (79%, N = 145). Benefit finding showed a moderately positive correlation with posttraumatic growth. In addition, women who stated that their satisfaction with life was high reported higher levels of posttraumatic growth in comparison to women who did not. Radiotherapy was negatively associated with posttraumatic growth. Women with a higher tumour stage at diagnosis experienced less benefit finding in comparison to women with a lower tumour stage at diagnosis. The above results can help to identify those patients who will probably experience posttraumatic growth and benefit finding after cancer. However, it is important to be aware that the positive effects of cancer on a patient's life do not occur in all cancer patients and all phases of the disease trajectory.",0 +https://doi.org/10.1002/1097-4679(199407)50:4<502::aid-jclp2270500404>3.0.co;2-j,Cluster analysis of MCMI and MCMI-II on chronic PTSD victims,"A cluster analysis was used to identify groups of inpatients with confirmed post-traumatic stress disorder (PTSD) due to combat. In Study 1 the MCMI was administered to 256 subjects, in addition to the MMPI, PTSD measures, and background variables. Three clusters resulted: a Traumatic Personality (8-2), Schizoid Influence (8-2-1), and Antisocial Influence (8-6). Comparison on the MCMI symptom scales, MMPI, and PTSD scales showed that the Antisocial Influence cluster was ""healthier"" on all measures. The Schizoid Influence was most psychopathological. In Study 2 the MCMI-II was administered to 136 new subjects who met the same criteria as in Study 1. Four clusters resulted: Global (1-2-6A-6B-8A-8B), Subclinical (1), Aggressive (6A-6B-8A), and Detached/Self-defeating (1-2-8A-8B).",0 +https://doi.org/10.1016/s0010-440x(03)00111-1,Affective and anxiety comorbidity in post-traumatic stress disorder treatment trials of sertraline,"Comorbidity of mood and anxiety disorders is common in patients suffering from post-traumatic stress disorder (PTSD). The current study evaluated the efficacy and tolerability of sertraline in a subgroup of PTSD patients suffering from anxiety or depression comorbidity. Two multicenter, 12-week, double-blind, flexible-dose US studies of adult outpatients from the general population with a DSM-III-R diagnosis of PTSD evaluated the safety and efficacy of sertraline (50 to 200 mg/d) compared to placebo in the treatment of PTSD. The total severity score of the Clinician-Administered PTSD Scale (CAPS-2) and the Davidson Trauma Scale (DTS) were used to examine the effect of comorbidity on treatment outcome. Among the combined 395 subjects enrolled in the two trials, 32.9% had a comorbid depressive diagnosis (no anxiety diagnosis), 6.3% had a comorbid anxiety disorder diagnosis (no depression), 11.4% had both a depression and anxiety disorder diagnosis, and 49.4% had no comorbidity. The correlation, at baseline, between Hamilton Depression Rating Scale (HAM-D) total score and the three CAPS-2 clusters was 0.37 for the re-experiencing/intrusion cluster, 0.52 for the avoidance/numbing cluster, and 0.45 for the hyperarousal cluster. Patients suffering from PTSD complicated by a current diagnosis of both depression and an anxiety disorder showed the highest baseline CAPS-2 cluster score severity. Patients treated with sertraline improved significantly (P <.05) compared to placebo on both the CAPS-2 and DTS whether or not they had a comorbid depressive or anxiety disorder. Sertraline was well tolerated. The presence of comorbidity was associated with a modest and mostly nonspecific increase in the side effect burden of approximately 10% to 20% on both study treatments. Patients suffering from dual depression and anxiety disorder comorbidity benefited from somewhat higher doses (147 mg v 125 mg; P =.08). Similarly, the presence of dual comorbidity resulted in a modest but nonsignificant increase in the mean time to response from 4.5 weeks to 5.5 weeks. We conclude that sertraline (50 to 200 mg/d) is effective and well tolerated in the treatment of PTSD for patients suffering from a current, comorbid depressive or anxiety disorders.",0 +,"Posttraumatic growth and its relationship to pre-, peri-, and post-surgical psychological factors","Depression and posttraumatic stress have been found to be important factors following cardiac surgery. Posttraumatic growth (PTG), however, has not been investigated following cardiac surgery, although it has been assessed regarding other health conditions. The current study assessed PTG at 3 to 6 years post coronary artery bypass graft (CABG) surgery among 31 participants (mean age 68.6, SD 10.9; 58.1% male and 41.9% female), and compared to data collected at the time of surgery (pre-surgical depression, trauma history, and posttraumatic stress; peri-surgical appraisals of fear, helplessness, and life-threat). PTG was also assessed among the full sample of 39 participants in relation to their post-surgical depression and surgery-related posttraumatic stress. Differences in the Post Traumatic Growth Inventory scores were compared to presurgical, peri-surgical, and post-surgical psychological factors. Participants with High PTG had higher levels of depression prior to heart surgery ( F (1, 29) = 4.20, p <.05). Participants with High PTG reported more fearfulness and perceived life threat in relation to the change in their cardiac condition (F (1, 28) = 4.49, p <.05) and (F (1, 28) = 4.97, p <.05), respectively. No differences were found between High and Low PTG groups on presurgical posttraumatic stress, nor were group differences found in regard to post-surgical depression or traumatic stress. Through investigation of a previously neglected population with regard to PTG, the current study supports previous findings that those with moderate psychological resources may have the most to gain from experiencing a traumatic event (McMillen et al., 1997) as well as findings that individuals who perceive more potential for harm develop more PTG (Linley and Joseph, 2004). (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1007/s11916-010-0117-7,Posttraumatic Headache: A Review,"There has been intense controversy about postconcussion syndrome (PCS) since Erichsen's publication in 1866 on railway brain and spine. Headache as a result of trauma is one of the most common secondary headache types. Posttraumatic headache (PTH) remains a very controversial disorder, particularly with relation to chronic PTH following mild closed-head injury. PTH is one of several symptoms of PCS, and therefore may be accompanied by additional cognitive, behavioral, and somatic problems. PTH also is an important public health issue due to its associated disability and often refractory clinical course. While current awareness of PTH has become more prominent due to increased scrutiny given to both combat-related and sports-related head injuries, directed treatment remains a difficult challenge for physicians. Because of the frequently associated medicolegal aspects, PTH is one of physicians' least favorite types to treat. The article reviews both PCS and PTH.",0 +https://doi.org/10.1186/1471-244x-9-23,"Returning home: forced conscription, reintegration, and mental health status of former abductees of the Lord's Resistance Army in northern Uganda","BackgroundSince the late 1980s, the Lord's Resistance Army (LRA), a spiritualist rebel group in northern Uganda, has killed and mutilated thousands of civilians and abducted an estimated 52,000 to 75,000 people to serve as soldiers, porters, and sex slaves for its commanders. This study examines the types of violence to which former abductees have been exposed and the extent to which these acts have affected their psychological well-being.MethodsThis is a cross-sectional study of 2,875 individuals selected through a multi-stage stratified cluster sampling design conducted in 8 districts of northern Uganda. Multivariate logistic regressions were performed with symptoms for Post-traumatic Stress Disorder (PTSD) and depression as the main outcome measures.ResultsOne-third of the respondents (33%) self-reported having experienced abduction (49% among the Acholi, the largest tribal group in northern Uganda). Over half (56%) of all the respondents and over two-thirds of those who experienced abduction met the criteria for symptoms of post-traumatic stress disorder (PTSD). Multivariate analysis shows that several factors increased the risk of former LRA abductees developing symptoms of PTSD. These factors included gender (females were more susceptible than males), being a member of the Acholi ethnic group, participating in or witnessing a cumulative number of traumatic events, and encountering difficulties re-integrating into communities after abduction. Factors associated with increased risk of meeting criteria for symptoms of depression included older age of males at the time of abduction, lower score on social relationship scale, high incidence of general traumatic event exposure, high incidence of forced acts of violence, and problems reintegrating into communities after abduction.ConclusionAbduction and forced conscription of civilians has affected the psychological well-being of a significant number of northern Ugandans. The sources of psychological trauma are multiple, ranging from witnessing to being forced to commit violent acts, and compounded by prolonged exposure to violence, often for months or years. Community-based mental health care services and reintegration programs are needed to facilitate the reintegration of former abductees back into their communities.",0 +https://doi.org/10.1348/147608305x53684,Two subjective factors as moderators between critical incidents and the occurrence of post traumatic stress disorders: Adult attachment and perception of social support,"This paper presents the result of a research which investigated the influence of the subjective factors ‘adult attachment style’ and ‘perception of social support’ in the occurrence of post traumatic stress disorders (PTSD) in a population of 544 subjects working for a security company and the Belgian Red Cross. The analysis of the results suggests that ‘adult attachment style’ and ‘perception of social support’ moderate between a critical incident and the occurrence of a PTSD. In other words, these independent variables differentiate between individuals who are more, and who are less prone, to suffer from a PTSD after having experienced a critical incident. The results of this research shed light on subjective risk factors related to PTSD. The findings can also suggest guidelines for the treatment of individuals suffering from a PTSD.",0 +https://doi.org/10.1371/journal.pone.0117597,The Effect of Financial Compensation on Health Outcomes following Musculoskeletal Injury: Systematic Review,"The effect of financial compensation on health outcomes following musculoskeletal injury requires further exploration because results to date are varied and controversial. This systematic review identifies compensation related factors associated with poorer health outcomes following musculoskeletal injury. Searches were conducted using electronic medical journal databases (Medline, CINAHL, Embase, Informit, Web of Science) for prospective studies published up to October 2012. Selection criteria included: prognostic factors associated with validated health outcomes; six or more months follow up; and multivariate statistical analysis. Studies solely measuring return to work outcomes were excluded. Twenty nine articles were synthesised and then assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology to determine evidence levels. The results were mixed. There was strong evidence of an association between compensation status and poorer psychological function; and legal representation and poorer physical function. There was moderate evidence of an association between compensation status and poorer physical function; and legal representation and poorer psychological function. There was limited evidence of an association between compensation status and increased pain. In seven studies the association depended on the outcome measured. No studies reported an association between compensation related factors and improved health outcomes. Further research is needed to find plausible reasons why compensation related factors are associated with poorer health following musculoskeletal injury.",0 +https://doi.org/10.1037/1040-3590.9.4.445,The validation of a self-report measure of posttraumatic stress disorder: The Posttraumatic Diagnostic Scale.,"The present article reports on the development and validation of a self-report measure of posttraumatic stress disorder (PTSD), the Posttraumatic Diagnostic Scale (PTDS), that yields both a PTSD diagnosis according to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994; DSM-IV) criteria and a measure of PTSD symptom severity. Two-hundred forty-eight participants who had experienced a wide variety of traumas (e.g., accident, fire, natural disaster, assault, combat) were administered the PTSD module of the Structured Clinical Interview (SCID; Spitzer, Williams, Gibbons, & First, 1990), the PTDS, and scales measuring trauma-related psychopathology. The PTDS demonstrated high internal consistency and test-retest reliability, high diagnostic agreement with SCID, and good sensitivity and specificity. The satisfactory validity of the PTDS was further supported by its high correlations with other measures of trauma-related psychopathology. Therefore, the PTDS appears to be a useful tool for screening and assessing current PTSD in clinical and research settings.",0 +https://doi.org/10.1016/s0890-8567(09)66570-9,Traumatic Brain Injury in a Child Psychiatry Inpatient Population: A Controlled Study,"To extend our findings from child psychiatry outpatients to child psychiatry inpatients regarding the similarity of children with a history of traumatic brain injury (TBI), particularly mild TBI, to matched children without such a history.This is a chart review of patients consecutively admitted to a child psychiatry inpatient unit over a 5-year period. Children with TBI were matched by age, sex, race, and social class to children with no history of TBI. Axis I and II diagnoses and diagnostic clusters and use of special education services and IQ scores were compared.Fifty-six (8.1%) of 694 consecutive patients admitted had a definite TBI. Not one of more than 50 variables compared between TBI and control subjects was significantly different.In a child psychiatry inpatient unit, patients with a history of TBI were virtually indistinguishable from matched children without TBI. Caution should be exercised before attributing the child's problems, especially long-term problems, to the TBI unless the injury was severe or the child is exhibiting related phobic or posttraumatic stress symptomatology.",0 +https://doi.org/10.1002/jts.20109,Disaster research methods: Past progress and future directions,"Published results for 225 disaster studies were coded on methodological variables, severity of effects, and event year. Methods varied greatly, but cross-sectional, after-only designs, convenience sampling, and small samples were modal. Samples that were assessed before the disaster, selected for reasons of convenience, or were large tended to show less severe effects than other samples. Developing countries were underrepresented overall, but not in recent years. Certain desirable study characteristics (longitudinal designs, representative samples) have been decreasing in prevalence over time, whereas others (early first assessment) have been increasing. Innovations such as latent trajectory modeling or hierarchical linear modeling might advance the field's ability to capture the complexity of disasters, but the field still needs to attend to the fundamentals of sound epidemiologic research.",0 +https://doi.org/10.1037/a0019492,To lump or to split? Comparing individuals with traumatic and nontraumatic limb loss in the first year after amputation.,"To compare individuals with traumatic (TE) vs. nontraumatic (NTE) amputation etiology on pain, psychological, and social variables over the first 12 months postamputation, and to explore changes in mean levels of and correlations between these variables over time.There were 111 adults with newly acquired limb loss.A VA medical center and a Level I trauma hospital in a large metropolitan area.Characteristic Pain Severity, Pain Interference, Patient Health Questionnaire depression module, Posttraumatic Stress Disorder Checklist, Social Constraints Scale, Aversive Emotional Support Scale, Centers for Disease Control and Prevention single item Social Support measure, single item loneliness measure.The NTE group was significantly older, had lower income, and had greater medical comorbidity, preamputation pain, and physical disability. The etiology groups did not differ significantly in mean levels of outcome variables except that the TE group reported greater aversive emotional support at 6 and 12 months. The TE group demonstrated a quadratic change in pain interference, with highest levels at 6 months and a linear increase in social constraints. Both etiology groups showed a linear increase in PTSD symptoms over time. Correlations between physical, psychological, and social distress were observed earlier in the year for the NTE group.Despite significant demographic and preamputation experience differences, few differences in outcomes emerged by etiology group in the first year after amputation. Findings suggest that the year after amputation may be a time of greater change for those with traumatic amputation compared to those with nontraumatic amputation.",0 +https://doi.org/10.1097/nmd.0000000000000228,Anger in the UK Armed Forces,"We assessed the strength of the association of several mental health problems, childhood difficulties, and combat role with anger, as well as the contribution of these factors to explain anger assessed by population attributable fraction (PAF). A total of 9885 UK service personnel, some of them deployed to Iraq and Afghanistan, participated in the study. There was a strong or intermediate association between cases and subthreshold cases of symptoms of posttraumatic stress disorder, psychological distress, multiple physical symptoms and alcohol misuse, having a combat role, childhood adversity, and childhood antisocial behavior with anger. The PAF for any mental health problem and combat role and childhood difficulties was 0.64 (95% confidence interval [CI], 0.56-0.70) and increased to 0.77 (95% CI, 0.69-0.83) if subthreshold cases were included. Anger is a frequent component of mental disorders; health care professionals need to be aware of the interference of anger in the management of mental illness and that anger infrequently presents as an isolated phenomenon.",0 +https://doi.org/10.1111/ajop.12054,The challenges of reintegration for service members and their families.,"The ongoing wars in Afghanistan and Iraq have posed a number of reintegration challenges to service members. Much of the research focuses on those service members experiencing psychological problems and being treated at the VA. In this article, we contend that much of the distress service members experience occurs following deployment and is a consequence of the difficulties encountered during their efforts to successfully reintegrate into their families and communities. We propose a new conceptual framework for intervening in this reintegration distress that is psycho-educational in nature as well as a new delivery model for providing such services. An example of this new intervention framework is presented.",0 +https://doi.org/10.1097/nmd.0b013e31825322fe,Prevalence of Delayed-Onset Posttraumatic Stress Disorder in Military Personnel,"Delayed-onset posttraumatic stress disorder (PTSD) is defined as onset at least 6 months after a traumatic event. This study investigates the prevalence of delayed-onset PTSD in 1397 participants from a two-phase prospective cohort study of UK military personnel. Delayed-onset PTSD was categorized as participants who did not meet the criteria for probable PTSD (assessed using the PTSD Checklist Civilian version) at phase 1 but met the criteria by phase 2. Of the participants, 3.5% met the criteria for delayed-onset PTSD. Subthreshold PTSD, common mental disorder (CMD), poor/fair self-reported health, and multiple physical symptoms at phase 1 and the onset of alcohol misuse or CMD between phases 1 and 2 were associated with delayed-onset PTSD. Delayed-onset PTSD exists in this UK military sample. Military personnel who developed delayed-onset PTSD were more likely to have psychological ill-health at an earlier assessment, and clinicians should be aware of the potential comorbidity in these individuals, including alcohol misuse. Leaving the military or experiencing relationship breakdown was not associated.",0 +https://doi.org/10.1016/j.jad.2012.08.021,Killing and latent classes of PTSD symptoms in Iraq and Afghanistan veterans,"Our goal was to better understand distinct PTSD symptom presentations in Iraq and Afghanistan Veterans ( N =227) and to determine whether those who killed in war were at risk for being in the most symptomatic class. We used latent class analysis of responses to the PTSD checklist and logistic regression of most symptomatic class. We found that a four-class solution best fit the data, with the following profiles emerging: High Symptom (34% of participants), Intermediate Symptom (41%), Intermediate Symptom with Low Emotional Numbing (10%), and Low Symptom (15%). The largest group of individuals who reported killing (45%) was in the High Symptom class, and those who killed had twice the odds of being in the most symptomatic PTSD class, compared to those who did not kill. Those who endorsed killing a non-combatant ( OR =4.56, 95% CI [1.77, 11.7], p<0.01) or killing in the context of anger or revenge ( OR =4.63, 95% CI =[1.89, 11.4], p<0.001) were more likely to belong to the most symptomatic PTSD class, compared to those who did not kill. The study was retrospective and cross-sectional. The results may not generalize to veterans of other wars. Killing in war may be an important indicator of risk for developing frequent and severe PTSD symptoms. This has implications for the mental healthcare of veterans, providing evidence that a comprehensive evaluation of returning veterans should include an assessment of killing experiences and reactions to killing.",0 +https://doi.org/10.1521/psyc.65.3.207.20173,"60,000 Disaster Victims Speak: Part I. An Empirical Review of the Empirical Literature, 1981–2001","Results for 160 samples of disaster victims were coded as to sample type, disaster type, disaster location, outcomes and risk factors observed, and overall severity of impairment. In order of frequency, outcomes included specific psychological problems, nonspecific distress, health problems, chronic problems in living, resource loss, and problems specific to youth. Regression analyses showed that samples were more likely to be impaired if they were composed of youth rather than adults, were from developing rather than developed countries, or experienced mass violence (e.g., terrorism, shooting sprees) rather than natural or technological disasters. Most samples of rescue and recovery workers showed remarkable resilience. Within adult samples, more severe exposure, female gender, middle age, ethnic minority status, secondary stressors, prior psychiatric problems, and weak or deteriorating psychosocial resources most consistently increased the likelihood of adverse outcomes. Among youth, family factors were primary. Implications of the research for clinical practice and community intervention are discussed in a companion article (Norris, Friedman, and Watson, this volume).",0 +https://doi.org/10.3402/ejpt.v5.24221,Evidence of symptom profiles consistent with posttraumatic stress disorder and complex posttraumatic stress disorder in different trauma samples,"The International Classification of Diseases, 11th version (ICD-11), proposes two related stress and trauma-related disorders, posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). A diagnosis of CPTSD requires that in addition to the PTSD symptoms, an individual must also endorse symptoms in three major domains: (1) affective dysregulation, (2) negative self-concepts, and (3) interpersonal problems. This study aimed to determine if the naturally occurring distribution of symptoms in three groups of traumatised individuals (bereavement, sexual victimisation, and physical assault) were consistent with the ICD-11, PTSD, and CPTSD specification. The study also investigated whether these groups differed on a range of other psychological problems.Participants completed self-report measures of each symptom group and latent class analyses consistently found that a three class solution was best. The classes were ""PTSD only,"" ""CPTSD,"" and ""low PTSD/CPTSD."" These classes differed significantly on measures of depression, anxiety, dissociation, sleep disturbances, somatisation, interpersonal sensitivity, and aggression. The ""CPTSD"" class in the three samples scored highest on all the variables, with the ""PTSD only"" class scoring lower and the ""low PTSD/CPTSD"" class the lowest.This study provides evidence to support the diagnostic structure of CPTSD and indicted that CPTSD is associated with a broad range of other psychological problems.",0 +https://doi.org/10.1093/jpepsy/jsq035,Parental Response to Child Injury: Examination of Parental Posttraumatic Stress Symptom Trajectories Following Child Accidental Injury,Trajectory analyses were used to empirically differentiate patterns of posttraumatic stress symptoms in parents following child accidental injury and explore the relationship between parent and child recovery patterns.Parent (n = 189) self-reported symptoms from acute to 2 years post accident were examined to (1) identify distinct parent symptom trajectories; (2) identify risk factors; and (3) explore the patterns of children and parents together.Analysis revealed three distinct symptom trajectory groups for parents: resilient (78%); clinical level acute symptoms that declined to below clinical level by 6 months (recovery 8%); and chronic subclinical (14%). Children of resilient parents were most likely to be resilient. Half of the children of parents with chronic subclinical trajectories were likely to have chronic trajectories.Clinicians cannot rely only on clinical level symptoms in parents to identify high risk families but include families where the parent has subclinical level symptoms.,1 +https://doi.org/10.1016/j.ygcen.2013.02.006,Origin of chordate peptides by horizontal protozoan gene transfer in early metazoans and protists: Evolution of the teneurin C-terminal associated peptides (TCAP),"► The teneurin C-terminal associated peptides (TCAP) are a highly conserved signaling peptide family. ► TCAP and the teneurin–proprotein system play a major role in neurological development, processing and regulation of stress. ► The TCAP-teneurin system originated in the metazoan by a horizontal gene transfer event in a choanoflagellate. The teneurin C-terminal associated peptides (TCAP) are found at the extracellular face in C-terminal region of the teneurin transmembrane proteins. One of these peptides, TCAP-1 is independently transcribed as a smaller bioactive peptide that possesses a number of stress response-attenuating activities. The teneurin-TCAP system appears to be the result of a horizontal gene transfer from a prokaryotic proteinaceous polymorphic toxin to a choanoflagellate. In a basal metazoan, the TCAP region has been modified from a toxin to a soluble intercellular signaling system. New studies indicate that the teneurin-TCAP system form a complex signaling system associated with adhesion, cytoskeletal regulation and intracellular signaling. TCAP-1 is highly conserved in all vertebrates and in mammals, inhibits corticotropin-releasing factor (CRF)-associated stress. Using the TCAP-teneurin system as a model, it is likely that numerous peptide systems in the Chordata began as a result of horizontal gene transfer from prokaryotes early in metazoan ancestry.",0 +https://doi.org/10.1080/10705511.2014.935678,Power of Latent Growth Curve Models to Detect Piecewise Linear Trajectories,"Latent curve models (LCMs) have been used extensively to analyze longitudinal data. However, little is known about the power of LCMs to detect nonlinear trends when they are present in the data. This simulation study was designed to investigate the Type I error rates, rates of nonconvergence, and the power of LCMs to detect piecewise linear growth and mean differences in the slopes of the 2 joined longitudinal processes represented by the piecewise model. The impact of 7 design factors was examined: number of time points, growth magnitude (slope mean), interindividual variability, sample size, position of the turning point, and the correlation of the intercept and the second slope as well between the 2 slopes. The results show that previous results based on linear LCMs cannot be fully generalized to a nonlinear model defined by 2 linear slopes. Interestingly, design factors specific to the piecewise context (position of the turning point and correlation between the 2 growth factors) had some effects on th...",0 +https://doi.org/10.1207/s15327752jpa8403_03,Assessment of Accurate Self-Knowledge,"Despite ongoing theoretical interest in the accuracy of self-knowledge and its implications for mental health, few researchers have yet to tackle this topic directly. This may be due, in part, to several factors that make assessing individual differences in accurate self-knowledge especially difficult. In this article, we present a method for the assessment of accurate self-knowledge that relies on information gathered from the self, knowledgeable others, and observations of behavior in the laboratory, and we provide psychometric support for this newly developed assessment procedure. Specifically, we present evidence for internal consistency reliability, convergent and discriminant validity, and criterion-related validity. Other researchers interested in studying the accuracy of self-knowledge might wish to adopt this procedure in their own research endeavors.",0 +https://doi.org/10.1002/jts.21798,Salivary Cortisol Lower in Posttraumatic Stress Disorder,"Altered cortisol has been demonstrated to be lower in those with posttraumatic stress disorder (PTSD) in most studies. This cross-sectional study evaluated salivary cortisol at waking and 30 minutes after, and at bedtime in 51 combat veterans with PTSD compared to 20 veterans without PTSD. It also examined the relationship of cortisol to PTSD symptoms using 2 classifications: the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV; American Psychiatric Association, 1994) and the more recent 4-factor classification proposed for DSM-5. The PTSD group had lower cortisol values than the control group, F(6, 69) = 3.35, p = .006. This significance did not change when adding age, body mass index, smoking, medications affecting cortisol, awakening time, sleep duration, season, depression, perceived stress, service era, combat exposure, and lifetime trauma to the model. Post hoc analyses revealed that the PTSD group had lower area-under-the-curve ground and waking, 30 min, and bedtime values; the cortisol awakening response and area-under-the-curve increase were not different between groups. The 4-factor avoidance PTSD symptom cluster was associated with cortisol, but not the other symptom clusters. This study supports the finding that cortisol is lower in people with PTSD.",0 +https://doi.org/10.1097/jom.0b013e3182028f91,Comorbidity and Labor Force Activity Among People With Psychiatric Disorders,"Comorbidity among people with psychiatric disorders with respect to other health conditions is extensive yet is rarely explored in-depth in occupational studies. We investigated how other ICD-10 comorbidity impacted on the labor force activity of people with psychiatric disorders.A secondary analysis of data files was conducted provided by the Australian Bureau of Statistics (ABS) from a 2003 population survey (N = 36,088). The reference group was working age community residents without long-term health conditions.Comorbidity with a broad range of ICD-10 health conditions can be characterized by both type and extent of comorbidity. Both dimensions are needed to explain impacts on labor force activity.Health professionals, policymakers, and administrators can utilize these results to identify people with psychiatric disorders and comorbidity profiles most likely to need more intensive vocational services.",0 +https://doi.org/10.31887/dcns.2002.4.4/fchaouloff,Neurogenetics of emotional reactivity to stress in animals,"There is much evidence for the involvement of central monoaminergic systems, the key targets of stress, in the regulation of mood. Animal and human findings indicate that genetics play a role in the etiology of mood disorders, and so we selected divergent inbred rat strains according to their anxiety-related behaviors on exposure to novel environments. We compared these strains for psychoneuroendocrine response to stressors and/or antidepressants. Molecular genetic studies were also performed to localize the genomic regions associated with these strain-dependent anxiety profiles. We then examined human results indicating that allelic variations in the serotonin transporter (5-HTT) may play a role in the etiology of neuroticism and depression. Thus, we compared inbred rat strains for the 5-HTT, with regard to central and peripheral (platelet) protein expression and function, and the consequences of local application of a selective serotonin reuptake inhibitor (SSRI) on extracellular serotonin (5-HT) levels. Our results indicate that spontaneously hypertensive rats and Lewis rats (LEW) selectively diverge in terms of anxiety-related behaviors and that this divergence is located on chromosome 4. The use of social defeat in LEW and the analysis of its psychoneuroendocrine consequences strongly suggest that such a paradigm, which is sensitive to repeated SSRI treatment, models posttraumatic stress disorder. The Wistar-Kyoto rat may be an adequate model to study the consequences of a genetically driven hypersensitivity to stress and noradrenergic antidepressants. Our most recent findings show that the Fischer 344 and LEW strains differ in protein expression and function of hippocampal and platelet 5-HTT; the divergence in protein expression is not due to allelic variations in the gene-coding sequences and leads to marked differences in extracellular 5-HT levels under basal conditions or SSRI. These examples illustrate how the use of inbred rat strains may complement our knowledge on the genetics of behavior, in the same way as the use of transgenic mice.",0 +https://doi.org/10.1080/07294360.2015.1011099,"The impact of a natural disaster: under- and postgraduate nursing education following the Canterbury, New Zealand, earthquake experiences","While natural disasters have been reported internationally in relation to the injury burden, role of rescuers and responders, there is little known about the impact on education in adult professional populations. A 7.1 magnitude earthquake affected the Canterbury region of New Zealand on 4 September 2010 followed by more than 13,000 aftershocks in the three years to September 2013. As part of a larger study, a mixed method survey was used to explore factors impacting nurses engaged in education through polytechnic and university courses. This paper presents factors that were self-identified by students as supporting their ability to continue with education. Participants were recruited from three nursing settings: undergraduate nursing students, Registered Nurses (RNs) engaged in post-registration education and RNs engaged in postgraduate courses. A total of 290 participants took part in the study. A number of factors identified by participants could be addressed in pre-disaster course planning and curricu...",0 +https://doi.org/10.1017/s0033291714000853,Integrating fragmented evidence by network meta-analysis: relative effectiveness of psychological interventions for adults with post-traumatic stress disorder,"Background. To summarize the available evidence on the effectiveness of psychological interventions for patients with post-traumatic stress disorder (PTSD). Method. We searched bibliographic databases and reference lists of relevant systematic reviews and meta-analyses for randomized controlled trials that compared specific psychological interventions for adults with PTSD symptoms either head-to-head or against control interventions using non-specific intervention components, or against wait-list control. Two investigators independently extracted the data and assessed trial characteristics. Results. The analyses included 4190 patients in 66 trials. An initial network meta-analysis showed large effect sizes (ESs) for all specific psychological interventions (ESs between −1.10 and −1.37) and moderate effects of psychological interventions that were used to control for non-specific intervention effects (ESs −0.58 and −0.62). ES differences between various types of specific psychological interventions were absent to small (ES differences between 0.00 and 0.27). Considerable between-trial heterogeneity occurred ( τ 2 = 0.30). Stratified analyses revealed that trials that adhered to DSM-III/IV criteria for PTSD were associated with larger ESs. However, considerable heterogeneity remained. Heterogeneity was reduced in trials with adequate concealment of allocation and in large-sized trials. We found evidence for small-study bias. Conclusions. Our findings show that patients with a formal diagnosis of PTSD and those with subclinical PTSD symptoms benefit from different psychological interventions. We did not identify any intervention that was consistently superior to other specific psychological interventions. However, the robustness of evidence varies considerably between different psychological interventions for PTSD, with most robust evidence for cognitive behavioral and exposure therapies.",0 +,Conceptual and methodological issues in developmental psychopathology research,,0 +https://doi.org/10.1177/1043454205283573,Use of Family Management Styles in Family Intervention Research,Family management styles (FMSs) explain some of the complexities embedded in a family with a child who has chronic illness. The FMS typologies provide descriptions of family adjustment and management of care. These 5 distinct patterns may be valuable in tailoring and evaluating family interventions in research.,0 +https://doi.org/10.1348/014466500163266,Attitudes to emotional expression and personality in predicting post-traumatic stress disorder,"To test hypotheses derived from a suggestion of Williams (1989) that negative attitudes towards emotional expression act as a predisposing or maintaining factor for post-traumatic stress reactions following a traumatic event.The study employed a prospective design in which attitudes to emotional expression, the 'Big Five' personality factors (Costa & McCrae, 1992a) and initial symptoms and injury severity within 1 week of a road traffic accident were used to predict the development of post-traumatic stress disorder 6 weeks post-accident.Sixty victims of road traffic accidents randomly selected from attenders at a large A&E department were assessed by questionnaire and interview. Measures comprised a 4-item scale relating to emotional expression, standardized scales for intrusion and avoidance features of traumatic experiences, and for anxiety and depression and the NEO-FFI Five Factor Personality Inventory. Forty-five of these participants responded to a postal questionnaire follow-up. In this survey the battery was repeated and also included a self-report diagnostic measure of post-traumatic stress disorder (PTSD).The percentage of the sample meeting DSM-IV diagnostic criteria for PTSD at 6 weeks post-trauma was 30.8%. A small but significant relationship was found for negative attitudes to emotional expression at 1 week to predict intrusive symptoms and diagnosis at 6 weeks, over and above the independent relationships of initial symptoms, initial injury severity, personality and coping. The emotional expression measure was largely stable between the two points of measurement. More negative attitudes to emotional expression were related to less openness, extraversion and agreeableness personality domains.Some support for the hypotheses was found in relation to the development of PTSD and for the status of attitudes to emotion as a stable trait related to personality factors. The potential importance of attitudes to emotional expression in therapy and other work is discussed.",0 +https://doi.org/10.1016/j.healun.2006.11.013,Parenting Stress and Parental Post-traumatic Stress Disorder in Families After Pediatric Heart Transplantation,"There has been little research on the stress experienced by parents of children who have undergone heart transplantation.Parents of 52 consecutive pediatric heart transplant recipients completed questionnaires assessing illness-related parenting stress and post-traumatic stress symptoms at a routine clinic visit. Medical charts were reviewed retrospectively to gather peri- and post-operative information.The average age of patients at transplant was 12 years (range 1 to 18 years), and participation occurred 3 months to 10 years post-transplant (median 2.5 years). Nearly 40% of parents indicated moderately severe to severe post-traumatic stress symptoms. Ten of the 52 participating parents met DSM-IV-TR clinical diagnostic criteria for current post-traumatic stress disorder. Parents also identified significant levels of illness-related parenting stress in the areas of communication around the child's illness, emotional distress, managing the child's medical care, and balancing role functions.Illness-related parenting stress and post-traumatic stress symptoms are significant concerns among parents of pediatric heart transplant patients. Parents' psychologic functioning post-transplant should be routinely assessed and addressed by transplant teams.",0 +https://doi.org/10.1037/a0029010,Associations of postdeployment PTSD symptoms with predeployment symptoms in Iraq-deployed Army soldiers.,"Prior to deployment, military personnel may experience a range of symptoms typically associated with posttraumatic stress disorder (PTSD); however, the relationship of specific preexisting symptoms characteristic of PTSD to postdeployment PTSD symptoms is not well understood. This prospective study examined (a) pre- to postdeployment changes in reexperiencing, avoidance, numbing, and hyperarousal symptoms among Iraq-deployed military personnel, and (b) pre- to postdeployment associations among these symptom groupings. Seven-hundred and seventy-four U.S. Army soldiers completed the PTSD Checklist pre- and postdeployment to Iraq. Participants demonstrated increases in reexperiencing, avoidance, and hyperarousal symptom severity but not in severity of numbing symptoms from pre- to postdeployment. Predeployment numbing was positively correlated with all postdeployment symptom clusters, and predeployment hyperarousal was positively correlated with postdeployment hyperarousal, reexperiencing, and numbing. Findings highlight the role of preexisting numbing and hyperarousal symptoms in the evolution of PTSD symptoms following trauma exposure. © 2012 American Psychological Association.",0 +,"The impact of gender, non-military trauma and combat exposure on the development of Post-Traumatic Stress Disorder (PTSD) in the Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MA-MIRECC)","Post-Traumatic Stress Disorder (PTSD) is a significant public health concern, both in the United States and internationally, as well as in civilian populations and among those who serve their country in the military. Those who are exposed to a number of different kinds of potentially traumatic events are at risk of developing Post-Traumatic Stress Disorder. A number of factors, however, have been identified that may put certain people at an increased risk for developing Post-Traumatic Stress Disorder. These factors include, but are not limited to, female gender, having been exposed to multiple traumatic events throughout one's life, being exposed to certain types of potentially traumatic events, and being exposed to military combat. The present study was a secondary analyses of a sample of veterans returning from serving in Operation Iraqi Freedom/Operation Enduring Freedom/Operation New Dawn, who were surveyed as part of the multisite Department of Veterans Affairs Mid-Atlantic VISN-6 Mental Illness Research, Education and Clinical Centers (MIRECC). The present study examined the role of gender in the development of Post-Traumatic Stress Disorder, whether those who have been exposed to potentially traumatic non-combat events, and combat, are more likely to experience Post-Traumatic Stress Disorder, and whether gender and non-combat trauma act synergistically in predicting Post-Traumatic Stress Disorder. When examined along with demographic factors, including age, race, marital status, working status, and education status, gender did not add to the prediction of PTSD above the contribution of demographic variables such as age race, marital status. When controlling for non-combat trauma and combat exposure, gender was found to significantly predict PTSD. And while these three variables independently predicted PTSD, the interaction of non-combat trauma and combat exposure did not vary meaningfully according to gender. Finally, when considering different levels of combat exposure, gender did not significantly predict PTSD based on the extent of combat experienced. Given the lack of consensus in the broader literature, the present study's findings have important implications regarding clarifying the relationship between gender and Post-Traumatic Stress Disorder and may increase understanding regarding the mechanisms behind any gender differences in Post-Traumatic Stress Disorder. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0 +https://doi.org/10.1037/0033-2909.133.1.25,"If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans.","The notion that chronic stress fosters disease by activating the hypothalamic-pituitary-adrenocortical (HPA) axis is featured prominently in many theories. The research linking chronic stress and HPA function is contradictory, however, with some studies reporting increased activation, and others reporting the opposite. This meta-analysis showed that much of the variability is attributable to stressor and person features. Timing is an especially critical element, as hormonal activity is elevated at stressor onset but reduces as time passes. Stressors that threaten physical integrity, involve trauma, and are uncontrollable elicit a high, flat diurnal profile of cortisol secretion. Finally, HPA activity is shaped by a person's response to the situation; it increases with subjective distress but is lower in persons with posttraumatic stress disorder.",0 +https://doi.org/10.1176/ajp.155.5.625,Relationship Between Acute Stress Disorder and Posttraumatic Stress Disorder Following Mild Traumatic Brain Injury,"The aim of this study was to index the frequency of occurrence of acute stress disorder following mild traumatic brain injury and to determine its utility in predicting posttraumatic stress disorder (PTSD).Consecutive adult patients who sustained a mild traumatic brain injury following a motor vehicle accident (N = 79) were assessed for acute stress disorder within 1 month of their trauma with the Acute Stress Disorder Inventory, a structured clinical interview based on DSM-IV criteria. Patients were followed up 6 months after the trauma (N = 63) and were administered the PTSD module of the Composite International Diagnostic Interview.Acute stress disorder was diagnosed in 14% of patients, and at follow-up 24% satisfied criteria for PTSD. Six months after the trauma PTSD was diagnosed in 82% of patients who had been diagnosed with acute stress disorder and in 11% of those who had not been diagnosed with acute stress disorder.These findings point to the frequency of PTSD following mild traumatic brain injury. While the criteria for acute stress disorder are useful in identifying those individuals who are at risk of developing chronic PTSD, the findings suggest that current criteria require modification in order to optimally predict PTSD following mild traumatic brain injury.",0 +https://doi.org/10.1002/jts.21941,Postcancer Experiences of Childhood Cancer Survivors: How Is Posttraumatic Stress Related to Posttraumatic Growth?,"Understanding posttraumatic growth (PTG) and the factors associated with PTG among cancer survivors is important to improve their quality of life. This study examined PTG among 225 Korean adolescents and young adults between 15 years and 39 years of age who survived childhood cancer (58.5% males and 41.5% females). We explored the relationships between PTG and several sociodemographic and medical variables, and whether the relationships between PTG and posttraumatic stress disorder (PTSD) symptoms were linear or curvilinear. The Posttraumatic Stress Diagnostic Scale (PDS) and the Posttraumatic Growth Inventory (PTGI) were used to assess PTSD symptoms and PTG, respectively. In addition to the effects of sociodemographic and medical variables, there were linear effects of PDS on PTGI (R(2) change = .03, p = .008). No evidence of a curvilinear relationship between PDS and PTGI was found. Higher PDS scores were associated with lower PTGI scores (β = -.18). Older age (β = .41) and shorter time since diagnosis (β = -.42) were associated with greater PTGI. Understanding the factors that were associated with PTG among Korean adolescent and young adult survivors of cancer adds to the knowledge on PTG and may help develop services to promote PTG in this group.",0 +,A Cross-sectional Study on the Current Prevalence of Post-traumatic Stress Disorder in Adults Orphaned by Tangshan Earthquake in 1976,"Objectives:To investigate the current prevalence and risk factors of post-traumatic stress disorder in people orphaned by Tangshan earthquake in 1976.Methods:Two hundreds and sixty adults orphaned by the earthquake were interviewed to determine whether they were suffering from PTSD according to Chinese Classification and Diagnostic Criteria for Mental Disorder,the third Revised Edition(CCMD-3).All the subjects were divided into two groups,PTSD group and normal group.The assessed variables included subjective traumatic experiences during the earthquake,post-traumatic reactions,and current mental health status.Logistic regression analysis was conducted to identify risk factors of PTSD.Results:32(12.00%) cases were diagnosed as PTSD among 260 orphans.In comparison with orphans without PTSD,orphans with PTSD had significantly higher SAS(47.8±14.5/40.3±10.3),SDS(53.0±12.0/45.2±11.7)and SCL-90 total score(156.6±65.5/127.9±41.0),P0.05.In a stepwise logistic regression model,six risk factors were significantly correlated with the development of PTSD including age at the time of the earthquake(OR=4.5),EPQ-N score(OR=0.2),EPQ-E score(OR=5.5),strong posttraumatic spiritual pain(OR=3.5),recurrent nightmare(OR=5.4),and negative coping style(OR=3.9).Conclusions:30 years later the prevalence of PTSD in those orphaned survivors is still high and PTSD were significantly correlated with adolescence,severity of traumatic events,stressful reaction post earthquake,personality characteristics as well as negative coping style.",0 +https://doi.org/10.1002/bsl.825,Diagnostic profiles of offenders in substance abuse treatment programs,"This study examined the association of Axis I and Axis II disorders among offenders who were in prison-based substance abuse treatment in a national multi-site study. Participants (N = 280) received a psychosocial assessment and a structured diagnostic interview in two separate sessions. Logistic regression models examined the association between lifetime mood and anxiety disorders with two personality disorders, and the relationship of Axis I and Axis II disorders (alone and in combination) to pre-treatment psychosocial functioning. Over two-thirds of the sample met criteria for at least one mental disorder. Borderline personality disorder was strongly associated with having a lifetime mood disorder (odds ratio = 7.5) or lifetime anxiety disorder (odds ratio = 8.7). Individuals with only an Axis II disorder, or who had both Axis I and Axis II disorders, had more severe problems in psychosocial functioning than those without any disorder. Clinical treatment approaches need to address this heterogeneity in diagnostic profiles, symptom severity, and psychosocial functioning.",0 +https://doi.org/10.1037/hea0000084,Deployment stressors and physical health among OEF/OIF veterans: The role of PTSD.,"There is a large body of literature documenting the relationship between traumatic stress and deleterious physical health outcomes. Although posttraumatic stress disorder (PTSD) symptoms have been proposed to explain this relationship, previous research has produced inconsistent results when moderating variables such as gender or type of traumatic stressor are considered. Within a large sample of Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) Veterans, the current study examined if deployment stressors (i.e., combat stress, harassment stress) contributed unique variance to the prediction of physical health symptoms (i.e., pain, nonpain) beyond the effects of PTSD symptoms.A total of 2,332 OEF/OIF Veterans, with equal representation of women and men, completed a series of self-report measures assessing deployment stressors, PTSD symptoms, and physical health symptoms.RESULTS revealed that harassment, but not combat stress, added unique variance in the prediction of pain and nonpain symptoms after accounting for PTSD symptoms.This study extends the existing literature by demonstrating the unique influence of harassment stress on physical health outcomes. Specifically, the relationship between combat stress and physical health symptoms appears to be explained mainly by an individual's experience of PTSD symptoms, whereas the relationship between harassment stress and physical health symptoms is not fully explained by PTSD symptoms, suggesting that other variables may be involved in the pathway from harassment stress to physical health symptoms.",0 +https://doi.org/10.1188/11.onf.e61-e71,Mindfulness-Based Stress Reduction Among Breast Cancer Survivors: A Literature Review and Discussion,"To evaluate and discuss existing studies of mindfulness-based stress reduction (MBSR) among breast cancer survivors.Articles published from 1987-2009 were retrieved using MEDLINE®, CINAHL®, Ovid, and Scopus. Key words, including mindfulness-based stress reduction and mindfulness meditation, were combined with breast cancer.The search resulted in 26 articles that were narrowed down to 16 by selecting only quantitative studies of MBSR conducted with breast cancer (n = 7) or heterogeneous types of cancer in which the predominant cancer was breast cancer (n = 9). Most studies were one-group pre- and post-test design and examined the effect of MBSR on psychological outcomes. Overall, the studies had large effect sizes on perceived stress and state anxiety and medium effect sizes on symptoms of stress and mood disturbance. Four studies measured biologic outcomes and had small effect sizes, except cytokine production, which showed a large effect size at 6- and 12-month follow-ups.Future studies using randomized, control trials and longitudinal, repeated-measures designs are needed. Studies conducted with heterogeneous types of cancer and gender should be analyzed and the results reported separately.The comprehensive summary and critical discussion of existing studies of MBSR usage among breast cancer survivors provide essential information that can be used by nurses and others working in the healthcare setting.",0 +https://doi.org/10.1016/j.janxdis.2007.11.002,Media exposure and dimensions of anxiety sensitivity: Differential associations with PTSD symptom clusters,"The present investigation examined the impact of anxiety sensitivity (AS) and media exposure on posttraumatic stress disorder (PTSD) symptoms. Reactions from 143 undergraduate students in Hamilton, Ontario were assessed in the Fall of 2003 to gather information on anxiety, media coverage, and PTSD symptoms related to exposure to a remote traumatic event (September 11th). Regression analyses revealed that the Anxiety Sensitivity Index (ASI; [Peterson, R. A., & Reiss, S. (1992). Anxiety Sensitivity Index manual, 2nd ed. Worthington, Ohio: International Diagnostic Systems]) and State-Trait Anxiety Inventory trait form (STAI-T; [Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970). State-trait anxiety inventory. Palo Alto, California: Consulting Psychologists Press]) total scores were significant predictors of PTSD symptoms in general. The ASI total score was also a significant predictor of hyperarousal and avoidance symptoms. Subsequent analyses further demonstrated differential relationships based on subscales and symptom clusters. Specifically, media exposure and trait anxiety predicted hyperarousal and re-experiencing symptoms, whereas the ASI fear of somatic sensations subscale significantly predicted avoidance and overall PTSD symptoms. Implications and directions for future research are discussed.",0 +https://doi.org/10.1002/jps.23495,Pharmacokinetics and Metabolism of SRX246: A Potent and Selective Vasopressin 1a Antagonist,"SRX246 is a potent, highly selective, orally bioavailable vasopressin 1a receptor antagonist that represents a novel mechanism of action for the treatment of mood disorders. The compound previously showed efficacy in animal models of mood disorders and excellent safety and tolerability in healthy volunteers in phase I clinical trials. In this study, SRX246 was further characterized in rats and dogs. In vitro determinations of permeability, protein binding, hepatocyte metabolism, and cytochrome P450 enzyme inhibition and in vivo assessments of pharmacokinetics were conducted. In parallel artificial membrane permeability assay (PAMPA) and PAMPA-blood-brain barrier models, SRX246 was comparable to highly permeable, orally active pharmaceuticals. SRX246 hydrochloride salt was 95.5 ± 1.7%, 95.9 ± 1.3%, and 98.6 ± 0.4% bound to rat, dog, and human serum proteins, respectively, and was stable in serum after a 4 h incubation at 37°C. P450 enzyme inhibition results showed a very low potential for drug-drug interactions. Metabolism in primary hepatocytes demonstrated that SRX246 was stable in humans and moderately metabolized in dogs and rats. Plasma pharmacokinetics findings showed a half-life (T½ ) of 2 and 6 h in rat and dog, respectively. Rat brain levels following a single oral dose were approximately 20% of plasma values with a T½ of 6 h. The observed profile for SRX246 supports further development.",0 +https://doi.org/10.1111/j.1751-7893.2010.00173.x,Post-traumatic stress symptoms and trauma exposure in youth with first episode bipolar disorder,"To examine the prevalence of trauma exposure as well as the rates and effects of post-traumatic stress disorder (PTSD) in adolescents with bipolar disorder following a first manic episode.Adolescents (12-18 years) with DSM-IV bipolar I disorder and experiencing their first manic or mixed episode were recruited. Participants underwent structured diagnostic interviews, completed the Trauma Symptom Checklist for Children (TSCC), and were prospectively evaluated using diagnostic, symptomatic and functional assessments over the course of 12 months.Seventy-six adolescents (14.9 +/- 1.7 years) completed the TSCC and 66% (50 individuals) reported exposure to traumatic events. Two (3%) subjects met DSM-IV criteria for PTSD, 11 (14%) had post-traumatic stress t-scores > or = 65, the threshold for clinically significant symptoms. Subjects with and without post-traumatic stress t-scores > or = 65 did not differ in demographic characteristics. When compared by t-score, TSCC subscores of the first episode bipolar adolescents were similar to normative data. Regression models incorporating TSCC subcomponents, did not predict syndromic recovery or recurrence or symptomatic recovery.Rates of PTSD were lower in this sample of bipolar adolescents at the time of their first hospitalization compared with rates in samples of bipolar adults. These differences coupled with the low incidence of PTSD and trauma symptoms in this young sample suggests that bipolar disorder may be a risk factor for the development of PTSD later in the course of illness or following recurrent affective episodes.",0 +https://doi.org/10.1037/a0037764,Emotion regulation difficulties and posttraumatic stress disorder symptom cluster severity among trauma-exposed college students.,"The present investigation examined the role of emotion regulation difficulties in predicting severity of the 3 posttraumatic stress disorder (PTSD) symptom clusters (i.e., reexperiencing, hyperarousal, avoidance) in a sample of undergraduates who reported exposure to at least 1 DSM-IV-TR Criterion A traumatic event (n = 297; 77.1% female, Mage = 20.46, SD = 4.64, range = 18-50 years). Results indicated that greater difficulties with emotional acceptance significantly predicted greater avoidance and hyperarousal symptom severity above and beyond the effects of number of trauma types endorsed and negative affect. Emotion regulation difficulties were not significantly predictive of reexperiencing symptom severity. Results from an exploratory analysis indicated that greater difficulties with emotional acceptance and greater difficulties accessing effective emotion regulation strategies when upset significantly predicted the DSM-5 negative alterations in cognitions and mood symptom cluster. These findings suggest that difficulties accepting one's emotional responses, in particular, may heighten emotional responding to and avoidance of trauma-related cues. Thus, individuals who experience such difficulties may be more likely to experience negative outcomes after experiencing a traumatic event.",0 +https://doi.org/10.1002/jts.20697,Treatment of complex PTSD: Results of the ISTSS expert clinician survey on best practices,"This study provides a summary of the results of an expert opinion survey initiated by the International Society for Traumatic Stress Studies Complex Trauma Task Force regarding best practices for the treatment of complex posttraumatic stress disorder (PTSD). Ratings from a mail-in survey from 25 complex PTSD experts and 25 classic PTSD experts regarding the most appropriate treatment approaches and interventions for complex PTSD were examined for areas of consensus and disagreement. Experts agreed on several aspects of treatment, with 84% endorsing a phase-based or sequenced therapy as the most appropriate treatment approach with interventions tailored to specific symptom sets. First-line interventions matched to specific symptoms included emotion regulation strategies, narration of trauma memory, cognitive restructuring, anxiety and stress management, and interpersonal skills. Meditation and mindfulness interventions were frequently identified as an effective second-line approach for emotional, attentional, and behavioral (e.g., aggression) disturbances. Agreement was not obtained on either the expected course of improvement or on duration of treatment. The survey results provide a strong rationale for conducting research focusing on the relative merits of traditional trauma-focused therapies and sequenced multicomponent approaches applied to different patient populations with a range of symptom profiles. Sustained symptom monitoring during the course of treatment and during extended follow-up would advance knowledge about both the speed and durability of treatment effects.",0 +https://doi.org/10.1007/s11930-008-0027-4,Childhood sexual abuse: Effects on female sexual function and its treatment,"For many woman survivors of childhood sexual abuse, there are long-term sexual sequelae, such as hypersexual activity and avoidance, although the trajectory to each type of response remains unclear. Female survivors of childhood sexual abuse have problems with intimate relationships and some survivors may also complain of multiple health problems and use emergency room services at a higher rate than women who were not sexually abused. Although the health care provider is in a position to screen for childhood sexual abuse, care must be taken to maintain trust if referring the survivor for psychotherapy, specifically sex therapy, which can be the treatment of choice. This article reviews the effect of childhood sexual abuse in female sexual function and provides general treatment recommendations.",0 +https://doi.org/10.1023/a:1007789409330,"Exploring the roles of emotional numbing, depression, and dissociation in PTSD","Some researchers consider emotional numbing a cardinal feature of posttraumatic stress disorder (PTSD). Others view numbing symptoms as representing an overlap between PTSD, depression, and dissociation. In this study, we examined the ability of early emotional numbing, depression, and dissociation symptoms to predict PTSD. One-hundred sixty-one women who were recent victims of sexual or nonsexual assault were assessed prospectively for 12 weeks. Emotional numbing, depression, and dissociation were each associated with initial PTSD severity. Notably, regression analyses revealed that after depression and dissociation were accounted for, early numbing contributed to the prediction of later PTSD.",0 +https://doi.org/10.1016/j.jpain.2008.07.005,Body Mass Index and Quality of Life: Examining Blacks and Whites With Chronic Pain,"Obesity contributes to several chronic pain conditions, negatively affecting quality of life (QOL). However, obesity's relationship with chronic pain is poorly understood. This prospective survey study examines obesity's role in chronic pain and subsequent impact on QOL. Black and white patients with chronic pain (N = 183, 18-50 years of age, 64% women, 50% black) were studied to determine predictors for the presence of body mass index (BMI) information in medical records, group BMI differences, and how BMI and pain contribute to mental/physical outcomes. BMI was calculated by using medical records nearest the enrollment date. Sociodemographic data, sleep, pain, functioning, disability, and depression were measured. BMI data were available for 143 subjects (78%), with blacks having a higher BMI (P = .002). Black (P = .08), people with higher pain (P < .01), affective distress (P < .01), and post-traumatic stress disorder scores (P = .07) were less likely to have their BMI recorded. Path analysis tested relationships between sociodemographics, BMI and pain with functioning, depression, and disability. BMI was positively associated with black race and age and predicted poorer physical functioning and greater disability. Pain was not predicted by race or age but was associated with all outcomes. These findings support assessing BMI when managing chronic pain and its negative impact on QOL, especially for minority patients.This study examines the relationships among sociodemographic factors, BMI, and QOL in chronic pain. Our results demonstrate significant racial disparity among chronic pain patients in assessing BMI and quality of pain care. These findings support obesity's negative impact on overall health and the importance of measuring BMI in patients with chronic pain, especially racial and ethnic minorities.",0 +https://doi.org/10.1037/a0030032,Functional independence in pediatric-onset spinal cord injury: Two levels of mediation.,"To test 3 models that examine the relationship of posttraumatic stress (PTS), family functioning (FF), and level of spinal cord injury (SCI) to functional independence (FI) among patients with pediatric-onset SCI.Participants were 109 pediatric spinal cord injury patients, ages 11-24 years, from 2 surgical and rehabilitation hospitals. Data from 2 previous cross-sectional studies included the Posttraumatic Diagnostic Scale, the Family Assessment Device, and the Pediatric Orthopedic Surgeons of North America Pediatric Musculoskeletal Functional Health Questionnaire. Path analyses were used to test 3 hypothesized models: that PTS would mediate the relationship between FF and FI, that PTS Avoidance symptoms would mediate the relationship between other PTS symptom clusters and FI, and that these 2 models would show adequate fit to the data when integrated into an overarching model to depict the interrelationship of level of SCI (tetraplegia v. paraplegia), FF, PTS symptom clusters, and FI.Results from the first model indicated that PTS mediated the relationship between FF and FI. In addition, the Avoidance symptom cluster of PTS mediated the relationships between PTS Reexperiencing symptoms and FI and between the PTS Arousal symptom cluster and FI. A third model integrated the previous 2 models and supported these 2 levels of mediation.Level of SCI related directly to FI, and PTS mediated the relationship between FF and FI; PTS Avoidance mediated the relationships between Intrusive Reexperiencing and FI and between PTS Arousal and FI.",0 +https://doi.org/10.1111/j.1743-6109.2009.01273.x,"Associations Between Coerced Anal Sex and Psychopathology, Marital Distress and Non-Sexual Violence","There is a dearth of scientific data on anal intercourse in heterosexual relationships. Likewise, anal sex within marital relationships has yet to be fully explored.Among a representative sample of married women in the Iranian capital, Tehran, we aimed to determine the association of self-reported coerced anal sex with: (i) self-reported coerced vaginal sex; (ii) self-reported non-sexual violence; (iii) psychopathology; and (iv) marital attitude.The data presented here were obtained from the Family Violence Survey conducted in Tehran in 2007. A total of 230 married Iranian women were selected via a multi-cluster sampling method from four different randomized regions. The subjects' sociodemographic data, psychological distress (Symptom Check List; SCL-90-R), personality, and relationship characteristics (Personal and Relationships Profile), and marital attitude (Marital Attitude Survey) were gathered. In addition, the participants' self-reported histories of lifetime victimization through all types of violence by the husband, including coerced anal and vaginal sex as well as psychological and physical assault (Conflict Tactic Scales-Revised; CTS-2), were collected.There were associations between self-reported victimization through coerced anal and vaginal sex (P < 0.001), psychological (P < 0.001), and physical aggression (P < 0.001). Those reporting to have been forced into anal intercourse cited higher rates of paranoid and psychotic features, jealousy, attribution of problems to one's own behavior, conflict, and male dominance, as well as lower expectations of improvement in one's marital relationship.In marital relationships, women are at a higher risk of coerced anal sex if subjected to other types of sexual or non-sexual violence. Higher rates of psychopathology and poorer marital relationships are also allied to self-reported anal sexual coercion.",0 +https://doi.org/10.1023/a:1015215630493,A prospective analysis of trauma exposure: The mediating role of PTSD symptomatology,"Trauma exposure has been associated with increased risk of exposure to additional traumatic events. Reactions to trauma exposure, specifically PTSD symptomatology, may mediate the link between trauma exposure and later traumatic events. Data from a longitudinal sample of Gulf War veterans (N = 2,949) were analyzed using a series of regression models. Higher levels of combat exposure were related to increased reports of PTSD symptomatology immediately upon return as well as increased reports of traumatic events in the 2 years following the Gulf War. PTSD symptomatology partially mediated the link between combat exposure and later trauma. Symptom clusters were also analyzed separately as potential mediators. Implications for the treatment of PTSD and prevention of exposure to multiple traumas are discussed.",0 +https://doi.org/10.1002/jts.21760,"Attachment, Personality Characteristics, and Posttraumatic Stress Disorder in U.S. Veterans of Iraq and Afghanistan","U.S. veterans of Iraq and/or Afghanistan (N = 116) completed an Internet survey with questions related to attachment style in intimate relationships, personality factors, and posttraumatic stress disorder (PTSD). Participants completed the PTSD Checklist-Military, Experiences in Close Relationships Scale-Short Form, and the International Personality Item Pool Big Five Short Form Questionnaire. Most participants were male and Caucasian. Hierarchical linear regression analysis results indicated that emotional stability (β = −.46, p < .001) and attachment avoidance (β = .20, p < .05) were associated with PTSD symptom severity (adjusted R2 = .63). An interaction between conscientiousness and attachment anxiety was found (β = −.26, p < .001; ΔR2 = .06), with secure attachment moderating the relationship between conscientiousness and PTSD symptom severity. Results of this study indicate that emotional stability, conscientiousness, and secure relationship attachment styles (low attachment anxiety and avoidance) are important for postcombat mental health.",0 +https://doi.org/10.1002/1097-4679(199201)48:1<136::aid-jclp2270480119>3.0.co;2-h,Comparison of the MMPI-PTSD subscale with PTSD and substance abuse patient populations,"War-related PTSD frequently presents as a dual disorder. Questions have been raised about whether the MMPI-PTSD subscale developed by Keane. Malloy, and Fairbank (1984) is identifying a separate PTSD syndrome or is a measure of generalized distress common to various diagnostic categories, including substance abuse. In this study, veterans with PTSD with and without substance abuse were compared to veterans with substance abuse only on the MMPI-PTSD subscale (n = 22 in each of the four categories). Results support the ability of the test to distinguish between groups of veterans with PTSD and those with substance abuse only. The findings lend indirect support to the validity of a distinct PTSD symptom cluster.",0 +https://doi.org/10.1097/00005053-200107000-00003,Function after Motor Vehicle Accidents: A Prospective Study of Mild Head Injury and Posttraumatic Stress,"Relationships among mild traumatic brain injury (MTBI), posttraumatic stress (PTS), and function were examined in 99 motor vehicle accident (MVA) admissions: 64 in an MTBI group and 35 in a no-MTBI comparison group. Assessments occurred within the first month and at 6 to 9 months. At follow-up, the sample was moderately disabled on the Sickness Impact Profile (SIP), 71% satisfied on the Reintegration of Normal Living Index (RNL), and 42% had returned to work. Only the SIP Psychosocial score was significantly different for MTBI groups; 24% of the sample showed definite symptoms of PTS. This group was significantly more disabled on the SIP, less satisfied on the RNL, and less likely to return to work. The proportion of variance in outcome explained in each model ranged from 32% (Physical SIP) to 44% (RNL). Results suggest the need for clinicians to be more aware of the strong influence of PTS on functional outcomes.",0 +,"Mental disorders, treatment response, mortality and serum cholesterol: a new holistic look at old data.","The importance of cholesterol for physical and psychological well-being has been recognized for several decades. Changes in serum cholesterol levels may have a direct impact on mental performance, behavior, treatment response, survival and expected lifetime duration.To examine the association between various mental disorders (schizophrenia, bipolar disorder, depression, generalized anxiety disorder, panic disorders, post-traumatic stress disorder and other mental disorders) and cholesterol levels, and to discuss the possible treatment implications.A MEDLINE search, citing articles from 1966 onward, supplemented by a review of bibliographies, was conducted to identify relevant studies. Criteria used to identify studies included (1) English language, (2) published studies with original data in peer-reviewed journals.Clinical investigations of cholesterolemia in patients with major mental disorders have produced very conflicting results. Hypercholesterolemia has been reported in patients with schizophrenia, obsessive-compulsive disorders, panic disorder, generalized anxiety disorder, PTSD. Low cholesterol level has been reported in patients with major depression, dissociative disorder, antisocial personality disorder, borderline personality disorder. It seems that both high and low serum total cholesterol may be associated with a higher risk of the premature death.Our current knowledge on the relation between cholesterolemia and mental disorders is poor and controversial. No definite or reliable insight into a pathophysiological link between cholesterol levels and mental disorders, treatment response and mortality rate is available. The lipoprotein profile, rather than total cholesterol levels, seems to be important.",0 +https://doi.org/10.1080/15504261003701445,"Unique Patterns of Substance Misuse Associated With PTSD, Depression, and Social Phobia","OBJECTIVES: This study investigated the relations between post-trauma psychopathology and substance abuse in a sample of trauma-exposed college students (n = 136) assigned to four groups based on primary diagnosis: posttraumatic stress disorder, depression, social phobia, or well-adjusted (participants who had low levels of distress). Groups were compared on a series of dimensions of substance use/abuse. RESULTS: Participants in the PTSD group evidenced greater substance use and abuse than those in the social phobia and well-adjusted groups on several dimensions and greater alcohol consumption than the depressed group. Correlation analyses suggested that most dimensions of substance abuse were related more strongly to avoidance and numbing (cluster C) symptoms than to reexperiencing and hyperarousal. CONCLUSIONS: The present findings suggest that trauma-related psychopathology may be associated with a more hazardous pattern of substance use than depression and social phobia.",0 +https://doi.org/10.1016/j.puhe.2006.10.021,Humiliation: the invisible trauma of war for Palestinian youth,"To investigate the influence of exposure to humiliation in war-like conditions on health status in 10th- and 11th-grade students living in the Ramallah District, West Bank, Occupied Palestinian Territory.A stratified single-stage cluster sample of 3415 students from cities, towns, villages and refugee camps of the Ramallah District.Survey questions were derived from the World Health Organization's Health Behaviour in School-aged Children Survey, the Gaza Community Mental Health Programme Traumatic Event Checklist, and focus group discussions with young people. The survey questionnaire was completed by students in their classrooms, under the supervision of a trained field worker.There was a significant association between a high number of subjective health complaints and demographic variables, particularly for females compared with males, and refugee camp dwellers compared with village dwellers. In addition, exposure to humiliation was significantly associated with an increased number of subjective health complaints. Students experiencing three forms of humiliation were found to be 2.5 times more likely to report a high number of subjective health complaints compared with those who had never been exposed to humiliation (52% vs 21%), while those experiencing four forms of humiliation were three times more likely to report a high number of subjective health complaints (62% vs 21%). A multiple logistic regression model revealed that humiliation was significantly associated with a high number of subjective health complaints, even after adjusting for sex, residence and other measures of exposure to violent events. The odds ratio of reporting a high number of subjective health complaints increased as the number of forms of humiliation increased, with values of 1.69, 2.67, 4.43 and 7.49 for reporting a high number of subjective health complaints when exposed to one, two, three or four forms of humiliation, respectively, compared with those who had never been exposed to humiliation.The results of this study demonstrate that humiliation induced by conflict and war-like conditions constitutes an independent traumatic event that is associated with negative health outcomes in its own right, regardless of exposure to other violent/traumatic events. Based on these findings, it is proposed that humiliation should be included as an indicator of mental health status in research that investigates the consequences of war and conflict on the health of populations.",0 +https://doi.org/10.3390/md9112256,"Tasco®, a Product of Ascophyllum nodosum, Imparts Thermal Stress Tolerance in Caenorhabditis elegans","Tasco(®), a commercial product manufactured from the brown alga Ascophyllum nodosum, has been shown to impart thermal stress tolerance in animals. We investigated the physiological, biochemical and molecular bases of this induced thermal stress tolerance using the invertebrate animal model, Caenorhabiditis elegans. Tasco(®) water extract (TWE) at 300 μg/mL significantly enhanced thermal stress tolerance as well as extended the life span of C. elegans. The mean survival rate of the model animals under thermal stress (35 °C) treated with 300 μg/mL and 600 μg/mL TWE, respectively, was 68% and 71% higher than the control animals. However, the TWE treatments did not affect the nematode body length, fertility or the cellular localization of daf-16. On the contrary, TWE under thermal stress significantly increased the pharyngeal pumping rate in treated animals compared to the control. Treatment with TWE also showed differential protein expression profiles over control following 2D gel-electrophoresis analysis. Furthermore, TWE significantly altered the expression of at least 40 proteins under thermal stress; among these proteins 34 were up-regulated while six were down-regulated. Mass spectroscopy analysis of the proteins altered by TWE treatment revealed that these proteins were related to heat stress tolerance, energy metabolism and a muscle structure related protein. Among them heat shock proteins, superoxide dismutase, glutathione peroxidase, aldehyde dehydrogenase, saposin-like proteins 20, myosin regulatory light chain 1, cytochrome c oxidase RAS-like, GTP-binding protein RHO A, OS were significantly up-regulated, while eukaryotic translation initiation factor 5A-1 OS, 60S ribosomal protein L18 OS, peroxiredoxin protein 2 were down regulated by TWE treatment. These results were further validated by gene expression and reporter gene expression analyses. Overall results indicate that the water soluble components of Tasco(®) imparted thermal stress tolerance in the C. elegans by altering stress related biochemical pathways.",0 +https://doi.org/10.1093/aje/kwm212,When Epidemiology Meets the Internet: Web-based Surveys in the Millennium Cohort Study,"Almost 60% of American households were connected to the Internet in 2001, when the Millennium Cohort Study, the largest longitudinal study ever undertaken by the Department of Defense, was launched. To facilitate survey completion, increase data integrity, and encourage cohort retention while maintaining the highest standards of participant privacy, an online questionnaire was made available on the World Wide Web in addition to a traditional paper questionnaire sent via US mail. Over 50% of 77,047 participants chose to enroll in the study via the Web, affording substantial cost savings to the project. Using multivariable logistic regression, the authors compared the demographic and health characteristics of Web responders with those of paper responders. Web responders were slightly more likely to be male, to be younger, to have a high school diploma or college degree, and to work in information technology or another technical occupation. Web responders were more likely to be obese and to smoke more cigarettes and were less likely to be problem alcohol drinkers and to report occupational exposures. Question completion rates were 98.3%, on average, for both Web and paper responders. Web responders provided more complete contact information, including their e-mail addresses. These results demonstrate the value of survey research conducted over the Internet in concert with traditional mail survey strategies.",0 +https://doi.org/10.1017/s0033291703008894,Post-traumatic stress disorder among patients with chronic pain and chronic fatigue,"Fibromyalgia (FM), a chronic pain condition of unknown aetiology often develops following a traumatic event. FM has been associated with post-traumatic stress disorder (PTSD) and major depression disorder (MDD).Patients seen in a referral clinic (N=571) were evaluated for FM and chronic fatigue syndrome (CFS) criteria. Patients completed questionnaires, and underwent a physical examination and a structured psychiatric evaluation. Critical components of the diagnostic criteria of FM (tender points and diffuse pain) and CFS (persistent debilitating fatigue and four of eight associated symptoms) were examined for their relationship with PTSD.The prevalence of lifetime PTSD was 20% and lifetime MDD was 42%. Patients who had both tender points and diffuse pain had a higher prevalence of PTSD (OR=3.4, 95% CI 2.0-5.8) compared with those who had neither of these FM criteria. Stratification by MDD and adjustment for sociodemographic factors and chronic fatigue revealed that the association of PTSD with FM criteria was confined to those with MDD. Patients with MDD who met both components of the FM criteria had a three-fold increase in the prevalence of PTSD (95% CI 1.5-7.1); conversely, FM patients without MDD showed no increase in PTSD (OR=1.3, 95% CI 0.5-3.2). The components of the CFS criteria were not significantly associated with PTSD.Optimal clinical care for patients with FM should include an assessment of trauma in general, and PTSD in particular. This study highlights the importance of considering co-morbid MDD as an effect modifier in analyses that explore PTSD in patients with FM.",0 +https://doi.org/10.1080/026990596124106,Post-traumatic stress disorder in brain injury patients,"In the absence of the recognition of the emotional sequelae following traumatic brain injury (TBI), many patients are deprived of adequate treatment. The purpose of the current study is to evaluate the prevalence of post-traumatic stress disorder (PTSD) and explore the clinical picture among TBI patients. Twenty four outpatients with diagnosed head injuries following various traumas filled out standardized questionnaires, assessing post-traumatic residuals. Thirty-three per cent of these patients met criteria for PTSD diagnosis. The clinical picture of PTSD following TBI is somewhat distinguished from those following other traumatic events. Issues concerning the specific nature of the syndrome following TBI, and the difficulties in differentiating between PTSD and postconcussive syndrome, are discussed.",0 +https://doi.org/10.1111/cpsp.12070,Posttraumatic stress disorder in DSM‐5: New criteria and controversies.,"The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) featured extensive changes to the posttraumatic stress disorder (PTSD) diagnosis. PTSD was moved out of the anxiety disorders into a new class of “trauma- and stressor-related disorders,” and the definition of what constitutes a traumatic experience was revised. Three new symptoms were added, existing ones were modified, and a new four-cluster organization and diagnostic algorithm were introduced. Finally, a new dissociative subtype was added to the diagnosis. We review these changes, discuss some of the controversies surrounding them, and then introduce a new debate involving a radically different conceptualization of PTSD proposed for International Classification of Diseases, 11th edition.",0 +https://doi.org/10.1093/jpepsy/jst015,Trauma Reactions in Mothers and Fathers After Their Infant's Cardiac Surgery,"To investigate the prevalence and nature of trauma symptoms in mothers and fathers of infants who had cardiac surgery.Parents of infants who underwent cardiac surgery before 3 months of age were recruited at the time of surgery. 77 mothers and 55 fathers completed the Acute Stress Disorder Scale 1 month after their infant was discharged from hospital.26 of 77 (33.8%) mothers and 10 of 55 (18.2%) fathers satisfied criteria for acute stress disorder. For all symptom clusters, except dissociation, mothers had significantly higher mean scores (and therefore higher levels of symptoms) than did fathers, ps = .01, -.02. 83 percent of parents endorsed at least 1 trauma symptom and 11.4% endorsed only 1 symptom at a clinical level. Symptoms of dissociation were the most commonly endorsed by both parents, with each symptom in that cluster being endorsed at a clinical level by at least 26% of parents.Consistent with our hypotheses, approximately one-third of parents overall, as well as one-third of mothers and close to one-fifth of fathers, experienced trauma symptoms consistent with a diagnosis of acute stress disorder. Most parents experienced at least one symptom at a clinical level, with symptoms of dissociation being the most commonly endorsed symptom cluster. These findings highlight the need for clinical supports for parents.",0 +https://doi.org/10.1016/j.janxdis.2014.07.006,Identification of anxiety sensitivity classes and clinical cut-scores in a sample of adult smokers: Results from a factor mixture model,"Anxiety sensitivity (AS), a multidimensional construct, has been implicated in the development and maintenance of anxiety and related disorders. Recent evidence suggests that AS is a dimensional-categorical construct within individuals. Factor mixture modeling was conducted in a sample of 579 adult smokers (M age=36.87 years, SD=13.47) to examine the underlying structure. Participants completed the Anxiety Sensitivity Index-3 and were also given a Structured Clinical Interview for DSM-IV-TR. Three classes of individuals emerged, a high AS (5.2% of the sample), a moderate AS (19.0%), and a normative AS class (75.8%). A cut-score of 23 to identify high AS individuals, and a cut-score of 17 to identify moderate-to-high AS individuals were supported in this study. In addition, the odds of having a concurrent anxiety disorder (controlling for other Axis I disorders) were the highest in the high AS class and the lowest in the normative AS class.",0 +https://doi.org/10.5271/sjweh.3420,Occurrence of delayed-onset post-traumatic stress disorder: a systematic review and meta-analysis of prospective studies,"Post-traumatic stress disorder (PTSD) develops according to consensus criteria within the first 1-6 months after a horrifying traumatic event, but it is alleged that PTSD may develop later. The objective was to review the evidence addressing occurrence of PTSD with onset >6 months after a traumatic event (delayed-onset PTSD).Through a systematic search in PubMed, EMBASE, and PsycINFO, we identified 39 studies with prospective ascertainment of PTSD. A meta-analysis was performed in order to obtain a weighted estimate of the average proportion of delayed-onset PTSD cases, and meta-regression was used to examine effects of several characteristicsDelayed-onset PTSD was reported in all studies except one, and the average prevalence across all follow-up time was 5.6% [95% confidence interval (95% CI) 4.3-7.3%]. The proportion with delayed-onset PTSD relative to all cases of PTSD was on average 24.5% (95% CI 19.5-30.3%) with large variation across studies. In six studies with sub-threshold symptom data, delayed-onset PTSD seemed most likely an aggravation of early symptoms. The proportion with delayed-onset PTSD was almost twice as high among veterans and other professional groups compared to non-professional victims.Descriptive follow-up data suggest that PTSD may manifest itself >6 months after a traumatic event, delayed-onset PTSD most often, if not always, is preceded by sub-threshold PTSD symptoms, and a higher proportion of PTSD cases are delayed among professional groups. Contextual factors and biased recall may inflate reporting of PTSD and a cautious interpretation of prevalence rates seems prudent.",0 +https://doi.org/10.7205/milmed-d-11-00168,Are Effort Measures Sensitive to Cognitive Impairment?,"The basic premise of symptom validity tests (SVTs) is that appropriate effort can be assessed because the designs of SVT measures are thought to be insensitive to all but the most extreme forms of impairment of memory. In patients with mild traumatic brain injury in particular, it is thought that failure on effort measures consistently reflects poor effort or even conscious exaggeration of symptoms. This study examines the issue of SVT failure as a reflection of cognitive impairment and/or neuropsychiatric impairment by presenting cases of three patients who were given full neuropsychological batteries but in each case failed the Word Memory Test (WMT), a verbal recognition SVT measure. One patient who failed the WMT was probably in the early stages of dementia. The WMT fit the ""Genuine Memory Impaired Profile"". Two mild traumatic brain injury patients failed the WMT but their patterns of performance suggested that cognitive deficits influenced WMT performance. In determining the validity of neuropsychological test data in the individual case, it is recommended that the examiner consider whether cognitive impairment could affect performance on effort measures and the recommended cut score. Also, it is recommended that examiners use multiple indicators of effort.",0 +,Prevention of Heat Stress Disorders in the Workplace,"The intensive summer heat in Japan led to the death of 47 workers due to incidence of heat stroke in 2010. A notable cluster was observed during the first three days after the start of working in a hot environment. The construction industry accounted for 64% of all lethal cases, and the Wet Bulb Globe Temperature (WBGT) of 28°C or higher demonstrated an increasing tendency for lost workdays due to heat stress disorders. Lack of specific symptoms and signs strengthens the importance of prevention. Obedience to orders from employers in uncontrollable hot, humid environments requires thermoregulation dependent on sweating. Loss of lowconcentrated sodium in sweat causes temporary hypernatremia, followed by a shift in interstitial fluid to serum and secretion of arginine-vasopressin to adjust osmolarity; however, massive water intake sometimes leads to excessive serum dilution causing temporary hyponatremia, expressed as heat cramps. The complex risk of heat stroke in the workplace can be categorized into four principal causes: physical labor, hot and humid environment, long hours of work and short break times, and protective clothing. The Labour Standards Bureau, Ministry of Health, Labour and Welfare of Japan, noticed WBGT standard values based on ISO 7243 and ACGIH TLVs",0 +https://doi.org/10.1111/bjd.13379,Propranolol and central nervous system function: potential implications for paediatric patients with infantile haemangiomas,"Given its improved safety profile compared with systemic corticosteroids, propranolol has become the mainstay treatment of infantile haemangioma (IH) worldwide. There is evidence, mainly from adult volunteer studies, that propranolol use is associated with central nervous system (CNS) effects. Impairment to short- and long-term memory, psychomotor function, sleep quality and mood with relatively low doses and durations of treatment have been reported. The exact magnitude of CNS effects resulting from propranolol use, especially in the early developmental stages and for prolonged periods of use, is not currently known. These effects may not be readily recognizable and require specialized assessment of cognitive function not routinely performed. Furthermore, there may be a delay between exposure and cognitive defects. The evidence to date provides a strong rationale to proceed with caution when prescribing propranolol for IH: treatment should be used only when indicated (in the presence of ulceration, impairment of a vital function or risk of permanent disfigurement) and for a limited duration, and the benefits of treatment should be weighed carefully against potential adverse events before treatment is initiated. This narrative review describes the evidence for an effect of propranolol use on CNS function from volunteer and patient studies, including IH.",0 +https://doi.org/10.1111/j.1600-0447.1996.tb09810.x,Familial vulnerability factors to post-traumatic stress disorder in male military veterans,"The question has been frequently raised about whether there are emotional disorders that predispose to post-traumatic stress disorder (PTSD). We do know that those with PTSD do have many comorbid disorders, but due to the difficulty in performing prospective studies it is hard to tell what is cause and what is effect. This study bypassed the problem caused by comorbidity by examining family history of four proband groups: PTSD, mixed anxiety disorders, coexisting anxiety and depressive disorders, and screened normal controls. Two questions were examined. First, whether family history predicted who experienced combat situations and second, whether the proband groups could be distinguished by family history. Logistic regression identified two variables that predicted the experience of combat: major depression (odds ratio 2.17) and the DSM-III dramatic personality disorder cluster (odds ratio 1.36). Although there was considerable overlap, family history variables distinguished PTSD from other proband groups. Overall, the pattern of psychopathology in the families of the PTSD probands most closely resembled that in the families of the coexisting anxiety and depressive disorders probands. We conclude that family history methods may be an addition to possible variables that predict who will be exposed to combat and also that family history variables may be able to distinguish a PTSD population from some other types of emotional disorders.",0 +https://doi.org/10.1016/j.comppsych.2010.06.045,Epigenetic profiles associated with psychopathology in a community-based epidemiologic sample,"Background: Recent work suggests epigenetic differences may contribute to the etiology of psychiatric disorders. Here, we investigate whether methylation profiles can distinguish between individuals with and without lifetime psychopathology in a community-based epidemiologic sample. Methods: Using whole blood-derived genomic DNA from a subset (n = 100) of participants in the Detroit Neighborhood Health Study, we assessed genome-wide methylation microarray profiles in individuals affected by lifetime PTSD (n = 23) and lifetime depression (n = 33), respectively. Bioinformatic analyses were performed on the genes uniquely methylated and unmethylated in each group. Results: Individuals with PTSD showed epigenomic profiles characterized by decreased methylation in immune system-related genes and increased methylation in gene clusters involved in neurogenesis and sensory perception of sound. Among individuals with depression, epigenomic profiles were characterized by decreased methylation in lipoprotein-related gene sets and increased methylation in gene sets involved in brain development and tryptophan metabolism. For both disorders, epigenomic profiles were associated with disease classes predominated by psychopathologic conditions among the unmethylated gene sets identified from PTSD-and depression-free individuals, respectively, suggesting that individuals with these conditions possess higher methylation levels in these psychopathology-associated gene sets. Conclusion: Genome-wide methylation profiles distinguish individuals affected by psychopathology in a manner consistent with functions previously implicated in the etiology of these disorders.",0 +https://doi.org/10.1007/s12671-015-0400-0,"Longitudinal Evaluation of the Relationship Between Mindfulness, General Distress, Anxiety, and PTSD in a Recently Deployed National Guard Sample","Mindfulness has increasingly been shown to be a resilience-promoting factor against the negative effects of stress and anxiety. While there is considerable literature evidencing that higher levels of mindfulness are associated with decreased stress and anxiety in civilian cross-sectional studies, fewer studies have examined this relationship utilizing longitudinal designs with recently deployed National Guard soldiers. The present study examined the resilience-promoting effects of mindfulness on symptoms of post-traumatic stress disorder (PTSD), anxiety, and general distress with members of Aviation (N = 52) and Infantry (N = 146) battalions of the Army National Guard who recently returned from deployment. Each study participant completed measures at two time points (3 and 12 months post-deployment) to examine whether mindfulness predicted symptom reporting over time. Overall, findings suggest that time 1 mindfulness is a significant predictor of time 2 general distress, anxiety, and the hyperarousal symptom cluster, but not time 2 total PTSD. Consistent with previous studies, these findings suggest that mindfulness measures may be useful for identifying soldiers at risk and resilient for post-deployment psychological distress. The implications for different diagnostic frameworks and criteria are considered. © 2015, Springer Science+Business Media New York.",0 +https://doi.org/10.1002/(sici)1097-4679(199712)53:8<847::aid-jclp9>3.0.co;2-c,Minnesota multiphasic personality inventory profiles of Vietnam combat veterans with posttraumatic stress disorder and their children,"Forty children of 28 fathers who are Vietnam veterans with posttraumatic stress disorder (PTSD) completed the Minnesota Multiphasic Personality Inventory. Each of the fathers had at least one elevated clinical scale. Fathers averaged eight elevated clinical scales, and compared to more recent norms, fathers averaged seven elevated clinical scales. Seventy-eight percent of the children had at least one clinically elevated scale (averaging three elevated clinical scales). Compared to contemporary normal adolescents and adults, 65% of children had at least one clinically elevated scale (still averaging three elevated clinical scales). No consistent MMPI profile patterns emerged within or across the two groups. No gender differences were detected among child MMPI profiles. Forty percent of the children reported illegal drug use, and 35% reported behavior problems. Fifteen percent of children reported previous violent behavior. Eighty-three percent of the children reported elevated Cook-Medley hostility scores as compared to an age-matched national normative sample. Children with higher PK scores were also significantly more likely to report higher Cook-Medley hostility scores. Forty-five percent of children reported significant elevations on the PTSD/PK subscales.",0 +https://doi.org/10.1007/s00127-013-0731-x,Prevalence and trajectory of psychopathology among child and adolescent survivors of disasters: a systematic review of epidemiological studies across 1987–2011,"Aims: The goal of this paper was to systematically review evidence on (1) the potential magnitude of the psychopathological impacts of community-wide disasters on child and adolescent survivors, and (2) the long-term course or trajectory of disaster-induced psychopathology among children and adolescents. Methods: The PubMed/MEDLINE and PsycINFO databases were searched from their respective inception through December 2011. All of the resulting epidemiological studies of child and adolescent survivors following community-wide disasters were examined. Results: Sixty cross-sectional studies and 25 longitudinal or long-term follow-up studies were identified. The estimated rates of posttraumatic stress disorder (PTSD) and depression among child and adolescent survivors varied greatly across the included studies, ranging from 1.0 to 95 % and 1.6 to 81 %, respectively, while the reported rates of diagnosable PTSD according to the DSM-IV criteria and diagnosable depression ranged from 1.0 to 60 % and 1.6 to 33 %, respectively. The long-term courses of psychopathology among youthful survivors were summarized. Methodological issues with those studies were discussed. Conclusions: The empirical findings summarized in this review highlight the importance of psychosocial intervention at early postdisaster stages for child and adolescent survivors. The methodological flaws revealed by this review indicate the need for continued attempts to better understand the epidemiology and trajectory of psychopathological problems among youthful survivors. © 2013 Springer-Verlag Berlin Heidelberg.",0 +https://doi.org/10.7205/milmed-d-04-1507,Evaluation of the Efficacy of Pharmacotherapy and Psychotherapy in Treatment of Combat-Related Post-Traumatic Stress Disorder: A Meta-Analytic Review of Outcome Studies,"A meta-analysis was conducted to examine the relative effectiveness of the broad-based treatments for combat-related post-traumatic stress disorder (PTSD). The analysis includes 13 pharmacotherapy studies and 12 psychotherapy studies obtained from a PsychINFO database search and a reference search. Studies of pharmacotherapy treatment efficacy demonstrated a significantly greater decrease in reducing PTSD symptoms, t (22) = -2.74, p = 0.01, d = 0.05. A random coefficient analysis supports this finding with significance determined at p < 0.001 for the fixed effects in the models. A limited examination of depression as a frequently comorbid disorder indicated pharmacotherapy also demonstrated a significantly greater decrease than psychotherapy in depression symptoms, t (15.77) = -2.26, p = 0.04, d = 0.16. Differences between treatments are discussed as potentially reflective of assignment to treatments and assessment techniques as well as therapeutic effects.",0 +https://doi.org/10.1037/10099-001,Analysis of longitudinal data using latent variable models with varying parameters.,"Lt-fwt Latent Variable Growth Modeling with Multilevel Data Bengt Muthen * Graduate School of Education z B r y k & Raudenbush, 1992; Goldstein, 1987), less work has been done i n the area of latent variables. T h i s paper was presented at the U C L A conference Latent Variable Modelling with Applications to Causality, March 19-20, 1994. T h e research was supported by a grant from the Office of Educa- tional Research and Improvement, Department of Education to the National Center for Research on Evaluation, Standards, and Student Testing ( C R E S S T ) and grant A A 08651-01 from N 1 A A A . I thank Siek-Toon K h o o , Guanghan L i u , and Ginger Nelson GofT for helpful assistance. Ua^TdeU M^obJb^ l(",0 +https://doi.org/10.1016/j.apnu.2015.08.011,Probable Post-Traumatic Stress Disorder and Its Predictors in Disaster-Bereaved Survivors: A Longitudinal Study After the Sichuan Earthquake,"This study examined the trajectory of probable PTSD prevalence and severity, and analyzed the predictors for PTSD severity in bereaved survivors at 6 months and 18 months after the 2008 Sichuan earthquake. This was a longitudinal study with 226 bereaved survivors sampled at 6 months and 18 months post-earthquake. The instrument used in the study was the revised version of the Impact of Event Scale. The results showed that the prevalence of probable PTSD in bereaved survivors decreased significantly from 38.9% at 6 months to 16.8% at 18 months post-earthquake. Loss of a child, being directly exposed to the death of family members and property loss during the earthquake, and mental health services utilization after the earthquake were significant predictors for PTSD severity at both assessments. These findings can contribute to post-disaster psychological rescue work. The bereaved survivors at high risk for more severe PTSD should be particularly targeted.",0 +https://doi.org/10.1177/070674379904400104,Biological Factors Associated with Susceptibility to Posttraumatic Stress Disorder,"Because only a proportion of persons exposed to traumatic events develop posttraumatic stress disorder (PTSD), it has become important to elucidate the factors that increase the risk for the development of PTSD following trauma exposure as well as the factors that might serve to protect individuals from developing this condition. Putative risk factors for PTSD may describe the index traumatic event or characteristics of persons who experience those events. Recent data have implicated biological and familial risk factors for PTSD. For example, our recent studies have demonstrated an increased prevalence of PTSD in the adult children of Holocaust survivors, even though these children, as a group, do not report a greater exposure to life-threatening (Diagnostic and Statistical Manual of Mental Disorders [DSM-IV] Criterion A) events. These studies are reviewed. It is difficult to know to what extent the increased vulnerability to PTSD in family members of trauma survivors is related to biological or genetic phenomena, as opposed to experiential ones, because of the large degree of shared environment in families. In particular, at-risk family members, such as children, may be more vulnerable to PTSD as a result of witnessing the extreme suffering of a parent with chronic PTSD rather than because of inherited genes. But even if the diathesis for PTSD were somehow “biologically transmitted” to children of trauma survivors, the diathesis is still a consequence of the traumatic stress in the parent. Thus, even the most biological of explanations for vulnerability must at some point deal with the fact that a traumatic event has occurred.",0 +https://doi.org/10.1081/ja-120034015,Cognitive Transformation as a Marker of Resilience,"Individuals often report positive, transformative changes in response to adversity. Cognitive transformation involves a turning point in a person's life characterized by: (1) the recognition that coping with adversity resulted in new opportunities; and, (2) the reevaluation of the experience from one that was primarily traumatic or threatening to one that is growth-promoting. Cognitive transformation often signifies enhanced adaptation to adverse circumstances, and thus, is a marker of resilience. The present study examined the relationship of cognitive transformation to indicators of resilience among 35 acutely bereaved young adults and a nonbereaved comparison group. Findings strongly supported the hypothesis that transformation predicts resilience, and may reduce one's risk trajectory to enhance adaptation. Results are discussed in terms of their implications for research on resilience, and on recovery from acute or chronic adverse circumstances, including addiction.",0 +https://doi.org/10.1037/a0037272,Different profiles of acute stress disorder differentially predict posttraumatic stress disorder in a large sample of female victims of sexual trauma.,"This study aimed to test the dimensional structure of acute stress disorder (ASD). Latent profile analysis was conducted on scores from the Acute Stress Disorder Scale (Bryant, Moulds, & Guthrie, 2000) using a large sample of female victims of sexual trauma. Four distinct classes were found. Two of the classes represented high and low levels of ASD, and the high ASD class was associated with a high probability of subsequent posttraumatic stress disorder (PTSD). There were 2 intermediate classes that were differentiated by the number of arousal symptoms, and the class with high levels of arousal symptoms had a higher risk of PTSD. The results suggested that ASD is best described by qualitatively and quantitatively differing subgroups in this sample, whereas previous research has assumed ASD to be dimensional. This may explain the limited success of using ASD to predict subsequent PTSD. (PsycINFO Database Record (c) 2014 APA, all rights reserved).",0 +https://doi.org/10.1037/a0019699,Assessment of dysregulated children using the Child Behavior Checklist: A receiver operating characteristic curve analysis.,"Disorders of self-regulatory behavior are common reasons for referral to child and adolescent clinicians. Here, the authors sought to compare 2 methods of empirically based assessment of children with problems in self-regulatory behavior. Using parental reports on 2,028 children (53% boys) from a U.S. national probability sample of the Child Behavior Checklist (CBCL; T. M. Achenbach & L. A. Rescorla, 2001), the receiver operating characteristic curve analysis was applied to compare scores on the Posttraumatic Stress Problems Scale (PTSP) of the CBCL with the CBCL Dysregulation Profile (DP), identified using latent class analysis of the Attention Problems, Aggressive Behavior, and Anxious/Depressed scales of the CBCL. The CBCL-PTSP score demonstrated an area under the curve of between .88 and .91 for predicting membership in the CBCL-DP profile for boys and for girls. These findings suggest that the CBCL-PTSP, which others have shown does not uniquely identify children who have been traumatized, does identify the same profile of behavior as the CBCL-DP. Therefore, the authors recommend renaming the CBCL-PTSP the Dysregulation Short Scale and provide some guidelines for the use of the CBCL-DP scale and the CBCL-PTSP in clinical practice.",0 +https://doi.org/10.1016/j.ijlp.2006.03.006,What can we learn from the first community-based epidemiological study on stalking in Germany?,"There is a lack of community-based studies on prevalence rates of stalking and the impact of stalking on victims in continental European countries. The authors published the first community-based epidemiological study on stalking in Germany. The purpose of this paper is to discuss possible implications of these epidemiological data for the mental health system, forensic psychiatry and legal regulations in Germany. For these reasons some data of our epidemiological study are outlined and reanalyzed. To examine lifetime and point prevalence rates of stalking, behavioural and psychological consequences for victims and the impact of stalking on current psychological well-being in a German community sample, a postal survey was conducted with 2000 inhabitants randomly selected from Mannheim (response rate 34.2%, n=679). The survey included a stalking questionnaire and the WHO-5 well-being scale. Almost 12% of the respondents reported having been stalked. This study identified a high lifetime prevalence of stalking in the community. Effects on victims' psychological health were significant and there was a high rate of physical (31%) and sexual (19%) violence in the context of stalking. Our data suggest that the phenomenon deserves more attention in future forensic psychiatric research and practice. Implications for forensic psychiatric assessment and treatment of stalkers as well as for management of stalking victims are discussed.",0 +,Mitochondrial peripheral-type benzodiazepine receptor and DHEAS levels in patients with post-traumatic stress disorder and combat complications,"Introduction: Post-Traumatic Stress Disorder (PTSD) is an highly invalidating anxiety disorder, which onset is related to the exposure to a traumatic event. First explored in military contexts, this disorder has recently shown increasing prevalence in the general population. In the last years, neurosteroids showed to be implicated in many psychiatric disorders, such as anxiety disorders. The Peripheral Benzodiazepine Receptor (PBR) is a mitochondrial protein that takes part in the constitution of a pore in the membrane, which opening has a crucial role in the regulation of neurosteroids synthesis. In stressful conditions, alterations in the levels of PBR expression and of some steroids were highlighted, particularly in patients with chronic PTSD combat related. Methods: Aim of the present study was to assess mitochondrial PBR density and serum neurosteroid DHEAS levels, in a sample of patients with PTSD or Traumatic Grief (LT) vs. healthy controls. All subjects were enrolled at the Clinica Psichiatrica 2(degrees) of the University of Pisa and assessed by SCID, Inventory of Complicated Grief and Impact of Event Scale. Results: Results of the present study show a significant reduction in lymphocyte PBR density in patients with PTSD vs. controls (p < 0.01). Reduced DHEAS levels, with respect to controls, were found in PTSD and TG subjects (in these latest p < 0.05). Conclusions: These data suggest PBR involvement in chronic PTSD related to non combat trauma. Moreover, patients with LT show a different PBR density profile with respect to that of patients with PTSD, suggesting a nosographic autonomy of these two clinical entities. The statistically significant alterations in serum DHEAS levels found in LT patients, vs. both PTSD patients and controls, further support this hypothesis.",0 +https://doi.org/10.1007/s13753-014-0009-2,Psychological Resilience Building in Disaster Risk Reduction: Contributions from Adult Education,"This article discusses three questions: What opportunities exist to enhance psychological resilience in adults? Why should psychological resilience promotion be considered an important disaster risk reduction strategy? What contribution can adult education make to such a strategy? Psychological resilience is presented as relational and somewhat malleable, even in adulthood. Although psychological resilience building is often overlooked in social-level disaster risk reduction efforts, it is a key strategy for social resilience building. Questions regarding the extent to which mental resilience can be improved and the techniques with which to do so may be answered by research in the field of adult education. Basic learning and teaching research fundamentals are suggested to create psychological resilience-building strategies in adults.",0 +https://doi.org/10.1007/s00134-014-3337-1,Offering the opportunity for family to be present during cardiopulmonary resuscitation: 1-year assessment,"Purpose: To evaluate the psychological consequences among family members given the option to be present during the CPR of a relative, compared with those not routinely offered the option. Methods: Prospective, cluster-randomized, controlled trial involving 15 prehospital emergency medical services units in France, comparing systematic offer for a relative to witness CPR with the traditional practice among 570 family members. Main outcome measure was 1-year assessment included proportion suffering post-traumatic stress disorder (PTSD), anxiety and depression symptoms, and/or complicated grief. Results: Among the 570 family members [intention to treat (ITT) population], 408 (72 %) were evaluated at 1 year. In the ITT population (N = 570), family members had PTSD-related symptoms significantly more frequently in the control group than in the intervention group [adjusted odds ratio, 1.8; 95 % confidence interval (CI) 1.1-3.0; P = 0.02] as did family members to whom physicians did not propose witnessing CPR [adjusted odds ratio, 1.7; 95 % CI 1.1-2.6; P = 0.02]. In the observed cases population (N = 408), the proportion of family members experiencing a major depressive episode was significantly higher in the control group (31 vs. 23 %; P = 0.02) and among family members to whom physicians did not propose the opportunity to witness CPR (31 vs. 24 %; P = 0.03). The presence of complicated grief was significantly greater in the control group (36 vs. 21 %; P = 0.005) and among family members to whom physicians did not propose the opportunity to witness resuscitation (37 vs. 23 %; P = 0.003). Conclusions: At 1 year after the event, psychological benefits persist for those family members offered the possibility to witness the CPR of a relative in cardiac arrest. © 2014 Springer-Verlag.",0 +https://doi.org/10.1016/j.chiabu.2003.06.002,The role of social support in well-being and coping with self-reported stressful events in adolescents,"This study investigated the role that social support plays in well-being and in coping after a stressful event in a group of non-clinical adolescents. Furthermore, this study aimed at replicating the finding that adolescents who reported sexual abuse reported more symptoms and less adequate coping strategies than adolescents who reported another type of stressful event or no stressful episode.Eight hundred and twenty adolescents between 12 and 18 years of age filled out questionnaires assessing social support (Social Support Questionnaire, Sarason, Shearin, Pierce, & Sarason, 1987), trauma-related symptoms (Trauma Symptom Checklist for Children, Briere, 1996), behavior problems (Youth Self-Report, Achenbach, 1991), and coping (How I Cope Under Pressure Scale, Ayers, Sandler, West, & Roosa, 1996).42% of the adolescents reported a stressful experience, and 4.4% reported sexual abuse. Sexually abused adolescents reported more stress-related symptoms and used more avoidance and fewer support-seeking coping strategies than the other adolescents. The main-effect hypothesis of social support was sustained, but social support did not moderate the relation between a stressful event and coping. Yet, a trend was found suggesting that high support from the family was associated with less avoidance coping and more support-seeking in adolescents who reported a non-sexually abusive, stressful event.Our findings show that a highly perceived availability of social support is directly associated with fewer trauma-related symptoms, especially in adolescents who are non-sexually abused. For adolescents who reported a sexual or another type of stressful event, social support did not play a different role in coping.",0 +https://doi.org/10.1080/10926771.2014.964434,"Posttraumatic Stress Symptoms, Aggression, and Substance Use Coping among Young Adults","This study examined how the symptom clusters of posttraumatic stress disorder (PTSD) were related to substance use and self-reported aggression in a college sample. There were 358 participants (ages 18–24) who completed surveys to assess PTSD symptoms, substance use as coping, and aggression. Hierarchical regressions tested for the effects of PTSD symptoms (total symptoms as well as cluster symptoms) on self-reported aggression, along with the main and interaction effects of substance use coping on these relationships. The hyperarousal cluster of PTSD was the only group of symptoms significantly related to aggression. There was an interaction between avoidance symptoms and substance use coping on aggression such that under conditions of high substance use coping, aggression increased regardless of avoidance symptoms; however, the relationship between avoidance and aggression was stronger under conditions of low substance use coping, with greater aggression as avoidance symptoms and low substance use copin...",0 +https://doi.org/10.1111/j.1749-6632.1997.tb48298.x,"Acute Post-Rape Plasma Cortisol, Alcohol Use, and PTSD Symptom Profile among Recent Rape Victims",This study presents the acute post-rape plasma cortisol alcohol use and post-traumatic stress disorder (PTSD) symptom profile among 37 recent female rape victims. Subjects were victims of rape who reported the crime to the police and who received forensic medical examinations within 72 hours post-rape. A total of 15 (41%) women reported alcohol use not related to PTSD status. Cortisol was significantly negative associated with the time of post-rape. A nonsignificant association was seen for the main effect of alcohol use and in the interaction of alcohol use and prior history of assault. The association of history for assault with lower cortisol levels showed a significant effect for the history of assault. Apparent levels were found among newly assaulted women using alcohol. Women with assault histories irrespective of alcohol use showed low levels of cortisol. About 22 (71%) women met the cutoff criteria for PTSD. A main effect was observed in the presence of crime-related PTSD associated with cortisol showing a higher cortisol level. Basing from the results it can be concluded that alcohol use is associated with high levels of cortisol in women with no rape history. Moreover cortisol levels were lower in both alcohol users and nonusers which have been victimized.,0 +https://doi.org/10.1001/jama.300.6.655,School-Based Mental Health Intervention for Children Affected by Political Violence in Indonesia,"Little is known about the efficacy of mental health interventions for children exposed to armed conflicts in low- and middle-income settings. Childhood mental health problems are difficult to address in situations of ongoing poverty and political instability.To assess the efficacy of a school-based intervention designed for conflict-exposed children, implemented in a low-income setting.A cluster randomized trial involving 495 children (81.4% inclusion rate) who were a mean (SD) age of 9.9 (1.3) years, were attending randomly selected schools in political violence-affected communities in Poso, Indonesia, and were screened for exposure (> or = 1 events), posttraumatic stress disorder, and anxiety symptoms compared with a wait-listed control group. Nonblinded assessment took place before, 1 week after, and 6 months after treatment between March and December 2006.Fifteen sessions, over 5 weeks, of a manualized, school-based group intervention, including trauma-processing activities, cooperative play, and creative-expressive elements, implemented by locally trained paraprofessionals.We assessed psychiatric symptoms using the Child Posttraumatic Stress Scale, Depression Self-Rating Scale, the Self-Report for Anxiety Related Disorders 5-item version, and the Children's Hope Scale, and assessed function impairment as treatment outcomes using standardized symptom checklists and locally developed rating scales.Correcting for clustering of participants within schools, we found significantly more improvement in posttraumatic stress disorder symptoms (mean change difference, 2.78; 95% confidence interval [CI], 1.02 to 4.53) and maintained hope (mean change difference, -2.21; 95% CI, -3.52 to -0.91) in the treatment group than in the wait-listed group. Changes in traumatic idioms (stress-related physical symptoms) (mean change difference, 0.50; 95% CI, -0.12 to 1.11), depressive symptoms (mean change difference, 0.70; 95% CI, -0.08 to 1.49), anxiety (mean change difference, 0.12; 95% CI, -0.31 to 0.56), and functioning (mean change difference, 0.52; 95% CI, -0.43 to 1.46) were not different between the treatment and wait-listed groups.In this study of children in violence-affected communities, a school-based intervention reduced posttraumatic stress symptoms and helped maintain hope, but did not reduce traumatic-stress related symptoms, depressive symptoms, anxiety symptoms, or functional impairment.isrctn.org Identifier: ISRCTN25172408.",0 +https://doi.org/10.1016/j.jad.2012.08.041,Children's symptoms of posttraumatic stress and depression after a natural disaster: Comorbidity and risk factors,"The current study examined rates of comorbidity among children's symptoms of posttraumatic stress (PTS) and depression after a natural disaster, Hurricane Ike. We also compared children with comorbid symptoms to children without comorbid symptoms, examining recovery, severity of symptoms, and risk factors.Children (n=277; 52% girls; 38% Hispanic, 28% White, 19% Black; grades 2-4) were assessed at 8 and 15 months postdisaster. Children completed measures of PTS and depressive symptoms at both time points and measures of exposure and recovery stressors at 8 months postdisaster.At 8 months postdisaster, 13% of children reported elevated PTS-only, 11% depression-only, and 10% comorbid symptoms of PTS and depression. At 15 months postdisaster, 7% of children reported elevated PTS-only, 11% depression-only, and 7% comorbid symptoms of PTS and depression. Children with comorbid symptoms of PTS and depression had poorer recovery, more severe symptoms, and they reported greater exposure and recovery stressors.We lacked information on children's predisaster functioning and diagnostic interview of psychological distress symptoms.Children with comorbid symptoms need to be identified early postdisaster. Levels of stressors should be monitored postdisaster, as highly stressed youth have difficulties recovering and may need help. Interventions should be tailored for children with comorbid symptoms of PTS and depression.",0 +https://doi.org/10.1089/cap.2012.0119,An Open-Label Study of Guanfacine Extended Release for Traumatic Stress Related Symptoms in Children and Adolescents,"The purpose of this open-label pilot study was to investigate the effectiveness and tolerability of guanfacine extended release (GXR) 1-4 mg given in the evening, on the symptoms of traumatic stress (reexperiencing, avoidance, overarousal), generalized anxiety, and functional impairment in children and adolescents with a history of traumatic stress with or without posttraumatic stress disorder (PTSD). As many of our sample had associated attention-deficit/hyperactivity disorder (ADHD) symptoms, we also assessed whether the presence of traumatic stress symptoms impaired the effectiveness of GXR in the treatment of comorbid ADHD symptoms.Participants were 19 children and adolescents 6-18 years of age, with current traumatic stress symptoms. In an 8 week open-label design, each patient's scores on parent-, child-, and clinician-reported symptom rating scales assessing traumatic stress symptoms, generalized anxiety, ADHD symptoms, functional impairment, and global symptom severity and improvement (n=17) were evaluated off and on GXR using χ(2) goodness-of-fit tests, paired t tests, and repeated measures analyses of variance (ANOVAs). To examine patterns of change in outcome measures across treatment, MPlus software was used to conduct linear growth curves modeled with individual-varying times of observation (i.e., random slopes).Using an average GXR daily dose of 1.19 mg±0.35 mg and an average weight-adjusted daily dose of 0.03 mg/kg±0.01 mg/kg, significant differences were found on all symptom severity measures. Parent reported UCLA Reaction Index scores assessing cluster B (reexperiencing), C (avoidant), and D (overarousal) symptoms significantly improved. In the presence of PTSD symptoms, children with ADHD experienced significantly improved ADHD symptom scores, suggesting that comorbidity does not attenuate an ADHD symptom response to GXR therapy. Medication was generally well tolerated.Within the limits of an open-label, hypothesis-generating pilot study, our results suggest that the α2A-adrenoceptor agonist GXR may have therapeutic effects in the treatment of PTSD symptoms in traumatically stressed children and adolescents. The effective dose may be lower than that found for ADHD. Our pilot study supports the need for further controlled research on the effects of GXR and other α2A-adrenoceptor agonists in pediatric disorders of traumatic stress.",0 +https://doi.org/10.1016/j.amp.2013.07.014,Traumatisme psychique des victimes d’agressions sexuelles avec possible soumission chimique. Prise en charge UMJ,"Resume Chaque annee, de nombreuses personnes portent plainte pour agression sexuelle avec suspicion de soumission chimique. Les circonstances sont souvent les memes : un contexte festif avec une forte alcoolisation, puis une amnesie avec un reveil difficile et les stigmates d’une activite sexuelle. Les victimes attendent que l’examen effectue aux UMJ apporte la preuve de l’agression et de l’administration de produits a leur insu. Selon une etude menee aux UMJ de l’Hotel-Dieu, dans la majorite des cas, seule l’alcoolisation massive est responsable des symptomes, ce qui entraine un grand sentiment de culpabilite chez les plaignants. La plupart d’entre eux presentent une forte anxiete et des symptomes de psycho-traumatisme. La prise de conscience d’une certaine forme de responsabilite dans le deroulement des faits accroit leur desarroi. Chez les personnes rendues vulnerables par des antecedents traumatiques, le risque de passage a l’acte suicidaire peut etre accru. Une prise en charge empathique et chaleureuse des soignants des UMJ, ainsi qu’une plus juste repartition des responsabilites peuvent aider a la reconstruction des personnes qui seront alors orientees vers les professionnels du reseau pour une prise en charge globale medico-psycho-sociale.",0 +https://doi.org/10.1016/j.jneumeth.2015.03.016,Investigating the psychosocial determinants of child health in Africa: The Drakenstein Child Health Study,"Early life psychobiological and psychosocial factors play a key role in influencing child health outcomes. Longitudinal studies may help elucidate the relevant risk and resilience profiles, and the underlying mechanisms that impact on child health, but there is a paucity of birth cohort data from low and middle-income countries (LMIC). We describe the rationale for and present baseline findings from the psychosocial component of the Drakenstein Child Health Study (DCHS).We review the psychosocial measures used in the DCHS, a multidisciplinary birth cohort study in a peri-urban area in South Africa, and provide initial data on psychological distress, depression, substance use, and exposure to traumatic stressors and intimate partner violence (IPV). These and other measures will be assessed longitudinally in mothers in order to investigate associations with child neurodevelopmental and health outcomes.Baseline psychosocial data is presented for mothers (n=634) and fathers (n=75) who have completed antenatal assessments to date. The sample of pregnant mothers is characterized by multiple psychosocial risk factors, including a high prevalence of psychological distress and depression, high levels of substance use, and high exposure to traumatic stressors and IPV.These data are consistent with prior South African studies which have documented a high prevalence of a multitude of risk factors during pregnancy. Further longitudinal assessment of mothers and children may clarify the underlying psychobiological and psychosocial mechanisms which impact on child health, and so inform clinical and public health interventions appropriate to the South African and other LMIC contexts.",0 +https://doi.org/10.1016/j.neuropharm.2011.04.023,Animal model for PTSD: From clinical concept to translational research,"In humans, the diagnosis of PTSD is made only if an individual exhibits a certain number of symptoms from each of three quite well defined symptom clusters over a certain period of time. Animal behavioral studies, however, have generally tended to overlook this aspect and have commonly regarded the entire group of animals subjected to certain study conditions as homogeneous. Thus, in an attempt to develop animal models of long-term chronic behavioral responses to stress (i.e. PTSD) in a comparable manner to human diagnosis, we applied cut-off inclusion/exclusion criteria to behavioral data for a cohort of animals exposed to a stress paradigm. This grouped them as behaviorally affected or unaffected by the stress. This model takes into account the variability in degree of the individual's response to the stress paradigm, thereby modeling the fact that not all humans exposed to traumatic stress respond with affective disorder. This article will present and discuss findings from a series of studies employing a model of individual behavioral response classification. This article will discuss the concept of the model and its background and present a selection of studies employing and examining the model, alongside the underlying translational rationale of each. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0 +https://doi.org/10.3109/10550499809034484,Posttraumatic Stress Disorder and Cocaine Dependence: Order of Onset,"To investigate differences between patients whose posttraumatic stress disorder (PTSD) preceded their cocaine dependence and vice versa, 33 patients with comorbid PTSD and cocaine dependence were divided into two groups: one in which the traum and PTSD occurred before onset of cocaine dependence (primary PTSD) and one in which the PTSD occurred after cocaine dependence was established (primary cocaine). In the primary-PTSD group, the trauma was generally childhood abuse. In the primary-cocaine group, the trauma was generally associated with the procurement and use of cocaine. In the primary PTSD group, there were significantly more women, more other Axis I diagnoses, more Cluster B and C Axis II diagnoses, and more benzodiazepine and opiate use. In the primary-cocaine group, there was a trend toward more cocaine use in the previous month. Significant clinical differences between these two groups may warrant different types of treatment or differing treatment emphasis.",0 +https://doi.org/10.1017/s0033291705005246,Effects of psychotherapy on hippocampal volume in out-patients with post-traumatic stress disorder: a MRI investigation,"Background. Magnetic resonance imaging (MRI) studies have especially reported smaller hippocampal volume in patients with post-traumatic stress disorder (PTSD), most of them war or sexual abuse victims. The present study compares the hippocampal volumes of out-patients with PTSD who had low co-morbidity rates to those of trauma-exposed control subjects without PTSD, and measures hippocampal volume changes in these patients after brief eclectic psychotherapy. We hypothesized that smaller hippocampal volumes are specific to PTSD and that hippocampal volume changes after effective psychotherapy would be measurable. Method. Eighteen patients with PTSD and 14 traumatized control subjects were examined with MRI. In a randomized clinical trial, the PTSD patients were assigned to treatment ( n =9) or waiting-list group ( n =9). After the former received psychotherapy for 4 months, the MRI was repeated on both PTSD groups. Three temporal lobe structures were manually segmented: hippocampus, amygdala, and parahippocampal gyrus. Volumetric analysis was used to measure grey matter, white matter, and cerebrospinal fluid. Results. PTSD patients had significantly smaller hippocampal volumes at baseline (total 13·8%, right 13·5%, left 14·1%) compared to the control subjects. After effective psychotherapy, however, no volume changes were found in the smaller hippocampi. Conclusions. We confirmed previous findings of smaller hippocampal volume in PTSD in a new population made up of out-patients who experienced different types of traumas, reducing co-morbidity to a minimum. Smaller hippocampal volumes did not change after effective psychotherapy, even while symptoms resolved.",0 +https://doi.org/10.1177/088626001016007001,MMPI-2 Assessment of Differential Post-Traumatic Stress Disorder Patterns in Combat Veterans and Sexual Assault Victims,"This study compared MMPI-2 profiles and trauma-specific subscales of the MMPI-2 in groups of combat veterans and sexual assault victims. Analyses indicated a trend toward externalizing symptoms for combat veterans and internalizing symptoms for sexual assault survivors. For diagnostic classification purposes, the PS scale was found to best differentiate post-traumatic stress disorder (PTSD) cases from non-PTSD cases for the combat group, whereas the F-2-8 standard decision rule best differentiated the sexual trauma group from comparisons. These results suggest that type of trauma experienced is a key variable in understanding the patient and dictates the need for different therapeutic focuses. In addition, the results suggest that the MMPI-2 PTSD scales provide a reasonable classification of PTSD status.",0 +https://doi.org/10.1097/nmd.0000000000000430,Factor Structure of the PTSD Checklist for DSM-5,"Scarce data are available regarding the dimensional structure of Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) posttraumatic stress disorder (PTSD) symptoms and how factors relate to external constructs. We evaluated six competing models of DSM-5 PTSD symptoms, including Anhedonia, Externalizing Behaviors, and Hybrid models, using confirmatory factor analyses in a sample of 412 trauma-exposed college students. We then examined whether PTSD symptom clusters were differentially related to measures of anger and impulsivity using Wald chi-square tests. The seven-factor Hybrid model was deemed optimal compared with the alternatives. All symptom clusters were associated with anger; the strongest association was between externalizing behaviors and anger (r = 0.54). All symptom clusters, except re-experiencing and avoidance, were associated with impulsivity, with the strongest association between externalizing behaviors and impulsivity (r = 0.49). A seven-factor Hybrid model provides superior fit to DSM-5 PTSD symptom data, with the externalizing behaviors factor being most strongly related to anger and impulsivity.",0 +https://doi.org/10.1002/jts.21914,Prospective Trajectories of Posttraumatic Stress in College Women Following a Campus Mass Shooting,"In a sample with known levels of preshooting posttraumatic stress (PTS) symptoms, we examined the impact of a campus mass shooting on trajectories of PTS in the 31 months following the shooting using latent growth mixture modeling. Female students completed 7 waves of a longitudinal study (sample sizes ranged from 812 to 559). We identified 4 distinct trajectories (n = 660): (a) minimal impact-resilience (60.9%), (b) high impact-recovery (29.1%), (c) moderate impact-moderate symptoms (8.2%), and (d) chronic dysfunction (1.8%). Individuals in each trajectory class remained at or returned to preshooting levels of PTS approximately 6 months postshooting. The minimal impact-resilience class reported less prior trauma exposure (η(2) = .13), less shooting exposure (η(2) = .07), and greater emotion regulation skills than all other classes (η(2) > .30). The chronic dysfunction class endorsed higher rates of experiential avoidance prior to the shooting than the minimal-impact resilient and high impact-recovery classes (η(2) = .15), as well as greater shooting exposure than the high impact-recovery class (η(2) = .07). Findings suggest that preshooting functioning and emotion regulation distinguish between those who experience prolonged distress following mass violence and those who gradually recover.",1 +https://doi.org/10.3928/00485713-20090728-04,The Prevalence of PTSD across War Eras and the Effect of Deployment on PTSD:a Systematic Review and Meta-analysis,,0 +https://doi.org/10.1007/s00737-015-0560-x,Women’s experiences of symptoms of posttraumatic stress disorder (PTSD) after traumatic childbirth: a review and critical appraisal,"This paper critically analyses nine studies on postnatal posttraumatic stress disorder (PTSD) following traumatic childbirth, in order to find common themes of PTSD symptoms, using the cognitive model of PTSD as a guide; it critically appraised one of the studies in depth and it attempted to explain the lived experience of women suffering from postnatal PTSD following traumatic childbirth and the suitability of cognitive behavioural therapy (CBT) for postnatal PTSD. This paper found that women following traumatic childbirth do experience postnatal PTSD; postnatal PTSD symptoms are similar to PTSD symptoms of other events and that CBT for PTSD of other events is just as effective for postnatal PTSD. Future recommendations include more qualitative studies with interpretative phenomenological approach in order to establish evidence-based CBT treatment for this client group, and more referrals need to be sent to the psychological services for CBT intervention.",0 +,Development of Child Posttraumatic Stress Disorder in Pediatric Trauma Victims: The Impact of Initial Child and Caregiver PTSD Symptoms on the Development of Subsequent Child PTSD,"Following a child's traumatic injury, both the child and his/her parents often report significant levels of posttraumatic stress disorder (PTSD) symptoms. Although many studies have identified predictors of PTSD at varying times post-trauma, few have longitudinally examined mechanisms through which child PTSD symptoms (PTSS) develop over time. Additionally, there is limited research on the interaction between caregiver and child PTSS. Determination of initial acute responses in both the caregiver and child that predict increased risk for persistent child PTSD will allow for greater specificity in identifying at-risk families and will inform the design of novel family-focused interventions. One hundred and eighteen child traumatic injury victims aged 8-18 years and their primary caregivers were interviewed in-hospital and at 2- and 6-weeks post-trauma to assess the development and maintenance of child PTSS. At each time point, depressive and PTSD symptomatology of both the child and caregiver were measured. Results revealed that child in-hospital levels of hyperarousal predicted child 2-week PTSS; however, child in-hospital levels of avoidance were found to predict child PTSS at 6-weeks post-trauma. Furthermore, post-hoc analyses revealed that high levels of child in-hospital re-experiencing symptoms and high levels of caregiver in-hospital avoidance symptoms significantly interacted to predict child 6-week PTSS, particularly in girls. The results of the current study underscore the importance of examining specific symptoms of PTSD and focus on the impact of familial distress on child post-traumatic adjustment. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +,Psychobiology of posttraumatic stress disorder.,"(from the introduction) This volume summarizes the major findings and themes in the psychobiology of posttraumatic stress disorder (PTSD). One of the major points highlighted in this volume concerns the biological or pathophysiological differences between PTSD, stress, and other psychiatric disorders. The 1st section of this volume deals with the epidemiological and phenomenological studies that objectified the important clinical observations on the prevalence of trauma and its manifestations. The 2nd section represents the core of the psychobiological studies of chronic PTSD in adults. The 3rd section introduces an important framework that is becoming increasingly recognized in trauma studies-the developmental perspective. The 4th section deals with the biology of normal and traumatic memories in both animals and humans. The 5th section provides theoretical models to explain the way that traumatic experiences might be potentiated to pathological states. The 6th section provides an analysis of the influences of biological studies on the treatment of PTSD., (from the book) This volume is a result of a conference entitled Psychobiology of Posttraumatic Stress Disorder sponsored by the New York Academy of Sciences and held on September 7-10, 1996 in New York, New York. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.4088/jcp.11m07311,Prescribing Trends in Veterans With Posttraumatic Stress Disorder,"The revised Department of Veterans Affairs (VA) and Department of Defense Clinical Practice Guideline for Management of Post-Traumatic Stress recommends against long-term use of benzodiazepines to manage posttraumatic stress disorder (PTSD). An analysis of recent trends among veterans receiving care for PTSD in the VA noted a decreasing proportion receiving benzodiazepines. The authors examined prescribing patterns for other medications to better understand the general context in which the changes in benzodiazepine prescribing have occurred in the VA.Administrative VA data from fiscal years 1999 through 2009 were used to identify veterans with PTSD using ICD-9 codes extracted from inpatient discharges and outpatient encounters. Prescribing of antidepressants, antipsychotics, and hypnotics was determined for each fiscal year using prescription drug files.The proportion of veterans receiving either of the 2 Clinical Practice Guideline-recommended first-line pharmacotherapy treatments for PTSD, selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, increased from 49.7% in 1999 to 58.9% in 2009. In addition to reduced benzodiazepine prescriptions, the overall frequency of antipsychotic use declined 6.1%, from 20.0% in 1999 to 13.9% in 2009. Nonbenzodiazepine hypnotic prescribing tripled when zolpidem was added to the VA national formulary in 2008. Buspirone prescribing decreased steadily, while prazosin prescribing expanded nearly 7-fold.This work highlights several clinically important trends in prescribing over the past decade among veterans with PTSD that are generally consistent with the revised VA/Department of Defense Clinical Practice Guideline recommendations. However, the findings illustrate the limitations of administrative data and point to a need to supplement this work with a qualitative examination of PTSD prescribing from interviews with providers to better understand the strategies used to make medication management decisions.",0 +https://doi.org/10.1002/jts.20091,PTSD and depression after the Madrid March 11 train bombings,"The March 11, 2004, train bombings in Madrid, Spain, caused the largest loss of life from a single terrorist attack in modern European history. We used a cross-sectional random digit dial survey of Madrid residents to assess the prevalence of posttraumatic stress disorder (PTSD) and major depression in the general population of Madrid 1 to 3 months after the March 11 train bombings. Of respondents 2.3% reported symptoms consistent with PTSD related to the March 11 bombings and 8.0% of respondents reported symptoms consistent with major depression. The prevalence of PTSD was substantially lower, but the prevalence of depression was comparable to estimates reported after the September 11 attacks in Manhattan. The findings suggest that across cities, the magnitude of a terrorist attack may be the primary determinant of the prevalence of PTSD in the general population, but other factors may be responsible for determining the population prevalence of depression.",0 +https://doi.org/10.1038/npp.2014.132,Cannabinoids Prevent the Effects of a Footshock Followed by Situational Reminders on Emotional Processing,"Posttraumatic stress disorder (PTSD) can develop following exposure to a traumatic event. Hence, what we do in the first few hours after trauma exposure may alter the trajectory of PTSD. We examined whether cannabinoids can prevent the effects of a single footshock followed by situational reminders (SRs) on emotional processing. Rats were exposed to a footshock (1.5 mA, 10 s) on day 1 followed by exposure to SRs of the shock on days 3 and 5. The CB1/2 receptor agonist WIN55,212-2 or vehicle were injected intraperitoneally 2 h after the shock. After 1 week, PTSD-like symptoms were examined. Exposure to SRs exacerbated the effects of the shock as rats exposed to shock and SRs, but not shock alone, showed impaired extinction of the traumatic event, impaired plasticity in the hippocmapal-accumbens pathway, enhanced latency to startle, and altered expression of CB1 receptors (CB1r) and glucocorticoid receptors (GRs) in the CA1, basolateral amygdala (BLA) and prefrontal cortex (PFC). WIN55,212-2 prevented the effects of the shock and SRs on extinction, plasticity, and startle response. WIN55,212-2 normalized the shock/SR-induced upregulation in CB1r in the PFC, and CA1 and GRs in the CA1, with no effect on BLA downregulation of CB1r and GRs. Shock and SRs caused lasting (1 week) alterations in emotional processing associated with changes in GR and CB1r expression in brain areas related to PTSD. WIN55,212-2 administered after trauma exposure prevented these alterations via PFC- and CA1-CB1r and CA1-GRs.",0 +https://doi.org/10.1007/s10880-013-9376-x,Health-Related Outcomes Associated with Patterns of Risk Factors in Primary Care Patients,"It is important to find ways to identify prevalent co-occurring health risk factors to help facilitate treatment programming. One method is to use electronic medical record (EMR) data. Funderburk et al. (J Behav Med 31:525-535, 2008) used such data and latent class analysis to identify three classes of individuals based on standard health screens administered in Veterans Affairs primary care clinics. The present study extended these results by examining the health-related outcomes for each of these identified classes. Follow-up data were collected from a subgroup of the original sample (N = 4,132). Analyses showed that class assignment predicted number of diagnoses associated with the diseases that the health screens target and number of primary care behavioral health, and emergency room encounters. The findings illustrate one way an EMR can be used to identify clusters of individuals presenting with multiple health risk factors and where the healthcare system comes in contact with them. © 2013 Springer Science+Business Media New York (outside the USA).",0 +https://doi.org/10.1001/jama.284.5.569,"Mental Health, Social Functioning, and Attitudes of Kosovar Albanians Following the War in Kosovo","The 1998-1999 war in Kosovo had a direct impact on large numbers of civilians. The mental health consequences of the conflict are not known.To establish the prevalence of psychiatric morbidity associated with the war in Kosovo, to assess social functioning, and to identify vulnerable populations among ethnic Albanians in Kosovo.Cross-sectional cluster sample survey conducted from August to October 1999 among 1358 Kosovar Albanians aged 15 years or older in 558 randomly selected households across Kosovo.Nonspecific psychiatric morbidity, posttraumatic stress disorder (PTSD) symptoms, and social functioning using the General Health Questionnaire 28 (GHQ-28), Harvard Trauma Questionnaire, and the Medical Outcomes Study Short-Form 20 (MOS-20), respectively; feelings of hatred and a desire for revenge among persons surveyed as addressed by additional questions.Of the respondents, 17.1% (95% confidence interval [CI], 13.2%-21.0%) reported symptoms that met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for PTSD; total mean score on the GHQ-28 was 11.1 (95% CI, 9.9-12.4). Respondents reported a high prevalence of traumatic events. There was a significant linear decrease in mental health status and social functioning with increasing amount of traumatic events (PAbstract

Background

Research has examined how physical and sexual intimate partner violence (IPV) victimization increases sexual risk behavior, yet research is lacking on 1) the effect of psychological IPV on sexual risk behavior and 2) factors through which psychological IPV may be linked to sexual risk behavior.

Methods

The current study examined the relationship between psychological IPV and sexual risk behavior controlling for other forms of IPV (i.e., physical and sexual) in a sample of 186 human immunodeficiency virus (HIV)-negative community women currently experiencing IPV. Further, this study examined the potential mediating effects of four posttraumatic stress disorder (PTSD) symptom severity clusters (i.e., re-experiencing, avoidance, numbing, and hyperarousal) on this relationship.

Findings

Results revealed that greater severity of psychological IPV was uniquely and directly related to greater sexual risk behavior. Additionally, of the four PTSD symptom severity clusters, only avoidance symptom severity mediated the relationship between psychological IPV and sexual risk behavior.

Conclusion

Implications for addressing psychological IPV and PTSD to improve women's sexual health outcomes are discussed.",0 +https://doi.org/10.1037/a0018415,Resilience in the face of coping with a severe physical injury: A study of trajectories of adjustment in a rehabilitation setting.,"Despite the popularity of the concept of resilience, little research has been conducted on populations in physical rehabilitation settings. Our purpose was to identify three trajectories of psychological adjustment to an acquired severe physical injury characterized by resilience, recovery, or distress in a longitudinal design.Eighty inpatients with a severe injury at a rehabilitation hospital. The participants had spinal cord injury or multiple traumas.Classification into the three trajectories was based on symptoms of psychological distress (posttraumatic stress disorder, depression, anxiety, and negative affect) and participants' level of positive affect at admission to and discharge from the rehabilitation hospital.The most common trajectory was the resilience trajectory (54%), followed by the recovery trajectory (25%) and the distress trajectory (21%). The most interesting differences between the trajectories were the result of optimism, affect, social support, and pain. Trait negative and positive affect predicted classification into the trajectories.An adaptation pattern characterized by resilience was found to be the most common response to an acquired severe injury, and trait affect predicts the outcome pattern. Interventions based on resilience are discussed.",0 +https://doi.org/10.3389/fneur.2014.00198,Military Personnel with Chronic Symptoms Following Blast Traumatic Brain Injury Have Differential Expression of Neuronal Recovery and Epidermal Growth Factor Receptor Genes,"Approximately one-quarter of military personnel who deployed to combat stations sustained one or more blast-related, closed-head injuries. Blast injuries result from the detonation of an explosive device. The mechanisms associated with blast exposure that give rise to traumatic brain injury (TBI), and place military personnel at high risk for chronic symptoms of post-concussive disorder (PCD), post-traumatic stress disorder (PTSD), and depression are not elucidated.To investigate the mechanisms of persistent blast-related symptoms, we examined expression profiles of transcripts across the genome to determine the role of gene activity in chronic symptoms following blast-TBI. Active duty military personnel with (1) a medical record of a blast-TBI that occurred during deployment (n = 19) were compared to control participants without TBI (n = 17). Controls were matched to cases on demographic factors including age, gender, and race, and also in diagnoses of sleep disturbance, and symptoms of PTSD and depression. Due to the high number of PCD symptoms in the TBI+ group, we did not match on this variable. Using expression profiles of transcripts in microarray platform in peripheral samples of whole blood, significantly differentially expressed gene lists were generated. Statistical threshold is based on criteria of 1.5 magnitude fold-change (up or down) and p-values with multiple test correction (false discovery rate <0.05).There were 34 transcripts in 29 genes that were differentially regulated in blast-TBI participants compared to controls. Up-regulated genes included epithelial cell transforming sequence and zinc finger proteins, which are necessary for astrocyte differentiation following injury. Tensin-1, which has been implicated in neuronal recovery in pre-clinical TBI models, was down-regulated in blast-TBI participants. Protein ubiquitination genes, such as epidermal growth factor receptor, were also down-regulated and identified as the central regulators in the gene network determined by interaction pathway analysis.In this study, we identified a gene-expression pathway of delayed neuronal recovery in military personnel a blast-TBI and chronic symptoms. Future work is needed to determine if therapeutic agents that regulate these pathways may provide novel treatments for chronic blast-TBI-related symptoms.",0 +https://doi.org/10.1046/j.1439-0272.2002.00512.x,Genital heat stress in men of barren couples: a prospective evaluation by means of a questionnaire,"Exposure to genital heat stress among men of barren couples was evaluated in a prospective study. Five hundred and forty-two consecutive patients referred for andrological examination were asked to complete a specific questionnaire at their first visit. For 449 patients who answered all questions, the individual score values could be calculated by scoring each answer with points. Patients with 'idiopathic' oligoasthenoteratozoospermia had significantly higher score values when compared with men showing normozoospermia (P < 0.01), 'symptomatic' oligoasthenoteratozoospermia as a result of defined andrological disorders (P < 0.01), cryptozoospermia (P < 0.01) or other pathological semen profiles (P < 0.05). These data support the hypothesis that patients with 'idiopathic' oligoasthenoteratozoospermia are more exposed to genital heat stress than normozoospermic men. Moreover, in patients with a varicocele impairment semen quality was associated with significantly higher score values compared with the subgroup of men with normal semen profiles (P < 0.05). In contrast, the score values did not significantly differ between equivalent subgroups of men with a history of a retractile testis. Our observations indicate that the questionnaire used in the present study allows an integrative assessment of genital heat stress, which is superior to single factor analysis. Notably, the group of men with 'idiopathic' oligoasthenoteratozoospermia showed the highest mean score values for 10 of the 18 questions compared with the other groups. Prolonged sitting in a vehicle represented the only single factor with significantly different score values in patients with 'idiopathic' oligoasthenoteratozoospermia and those with normozoospermia (P < 0.05).",0 +https://doi.org/10.1177/0049124106292364,Advances in Group-Based Trajectory Modeling and an SAS Procedure for Estimating Them,"This article is a follow-up to Jones, Nagin, and Roeder (2001), which described an SAS procedure for estimating group-based trajectory models. Group-based trajectory is a specialized application of finite mixture modeling and is designed to identify clusters of individuals following similar progressions of some behavior or outcome over age or time. This article has two purposes. One is to summarize extensions of the methodology and of the SAS procedure that have been developed since Jones et al. The other is to illustrate how group-based trajectory modeling lends itself to presentation of findings in the form of easily understood graphical and tabular data summaries.",0 +https://doi.org/10.1586/14737175.7.2.107,Paroxetine: current status in psychiatry,"Paroxetine is a selective serotonin reuptake inhibitor (SSRI) with antidepressant and anxiolytic properties. It is commercially available in both an immediate-release (paroxetine) and a controlled-release formulation (paroxetine CR). The latter product was developed to improve gastrointestinal tolerability. Paroxetine is the most potent inhibitor of the reuptake of serotonin among the available SSRIs. It has approved indications for the treatment of major depression, obsessive-compulsive disorder, panic disorder, generalized anxiety disorder, post-traumatic stress disorder and social phobia in adults. Paroxetine CR is approved for the treatment of major depression, social anxiety disorder, panic disorder and premenstrual dysphoric disorder in adults. While the overall efficacy of paroxetine appears to be comparable with other SSRIs in the treatment of major depression, it is approved for use in a wider variety of anxiety disorders than any other antidepressant. Long-term data suggest that paroxetine is effective in preventing relapse or recurrence of depression for up to 1 year. Limited data show that paroxetine maintains a therapeutic response over 1 year in obsessive-compulsive disorder and up to 6 months in panic disorder. The side-effect profile of paroxetine is largely similar to that of the other SSRIs, although paroxetine tends to be more sedating and constipating in some patients, perhaps due to its anticholinergic activity. The potential for discontinuation syndrome and weight gain appears to be slightly higher with paroxetine than with other SSRIs. This review focuses on the immediate release and controlled-release formulations of paroxetine. It summarizes the efficacy and tolerability data for both formulations, with a particular emphasis on paroxetine CR which was introduced in 2002. It also discusses emerging evidence in other clinical areas and recent data that have led to modifications in the safety profile of paroxetine.",0 +https://doi.org/10.3389/fpsyt.2014.00127,"Psycho-Trauma, Psychosocial Adjustment, and Symptomatic Post-Traumatic Stress Disorder among Internally Displaced Persons in Kaduna, Northwestern Nigeria","In April 2011, a post election violent conflict in Northern Nigeria led to resettlement of internally displaced persons (IDPs) in a camp in Kaduna, the worst affected state. We set out to determine prevalence and socio-demographic factors associated with post-traumatic stress disorder (PTSD) among IDPs. We also determined types of psycho-trauma experienced by the IDPs and their psychosocial adjustment.Cross-sectional systematic random sampling was used to select 258 adults IDPs. We used Harvard trauma questionnaire to diagnose ""symptomatic PTSD,"" composite international diagnostic interview (CIDI) for diagnosis of depression, and communal trauma event inventory to determine exposure to psycho-trauma. We assessed social adjustment using social provision scale. Multiple logistic regression analysis was used to determine independent predictors of PTSD.Of the 258 IDPs, 109 (42.2%) had a diagnosis of PTSD, 204 (79.1%) had poor living conditions, and only 12 (4.7%) had poor social provision. The most frequent psycho-traumas were destruction of personal property (96.1%), been evacuated from their town (96%) and witnessing violence (88%). More than half (58%) of IDPs had experienced 11-15 of the 19 traumatic events. Independent predictors of PTSD among respondents were having a CIDI diagnosis of depression (adjusted odds ratios 3.5, 95% confidence interval 1.7-7.5; p = 0.001) and witnessing death of a family member (3.7, 1.2-11.5; p = 0.0259).We concluded that exposure to psycho-trauma among IDPs in Kaduna led to post conflict PTSD. Death of a family member and co-morbid depression were independent predictors of PTSD among IDPs. Though their living condition was poor, the IDPs had good psychosocial adjustment. We recommended a structured psychosocial intervention among the IDP targeted at improving living condition and dealing with the psychological consequences of psycho-trauma.",0 +,Posttraumatic stress disorder in primary care with special reference to personality disorder comorbidity.,"Posttraumatic stress disorder (PTSD) is a common and disabling disturbance in primary care. Few studies have been carried out in primary care samples and none have taken into consideration the association between PTSD and personality disorder.To describe prevalence and risk factors of PTSD and its comorbidity with personality disorder.General practice centre in Valencia (Spain).Patients who had experienced at least one traumatic event in their lives were selected from a random sample attending a primary healthcare centre in Valencia and blindly assessed by trained professionals. Patients suffering from PTSD were compared with those who were not. PTSD and personality disorder diagnoses were established using CIDI and SCID-II interviews respectively. Sex, age at the time of experiencing trauma, frequency, multiplicity and type of trauma, dissociative symptoms, personality disorder and severity of PTSD were subjected to multivariate analysis to estimate the probability of developing PTSD and its duration.Life prevalence rate was 14% and current prevalence 9%. Dissociative symptoms and personality disorder were significantly associated with PTSD. Cluster analysis based on age, frequency and type of trauma revealed the existence of one subgroup composed mainly of women who had experienced frequent body-contact trauma at an early age, developed severe PTSD and suffer from a variety of personality disorders, particularly paranoid personality disorder. Time to the complete disappearance of symptoms was only explained by the initial severity of PTSD.PTSD is a frequent disorder in general practice and it is often associated with personality disorder. Women who experienced high frequency body-contact traumatic events at an early age often suffer from personality disorder and present a particularly severe form of PTSD deserving referral to specialised care.",0 +https://doi.org/10.1192/bjp.bp.106.030569,Post-traumatic stress disorder in serious accidental injury: 3-year follow-up study,"Background Long-term data on post-traumatic stress disorder (PTSD) following accidents are scarce. Aims To assess and predict PTSD in people 3 years after severe accidental injury. Method Severely injured patients were recruited consecutively from the intensive care unit ( n =121) and assessed within 1 month of the trauma. Follow-up interviews were conducted 6 months, 12 months and 36 months later; 90 patients participated in all four interviews. Symptoms were assessed using the Clinician-Administered PTSD Scale. Results Post-traumatic stress disorder was diagnosed in 6% of patients 2 weeks after the accident, in 2% after 1 year and in 4% after 3 years. Robust predictors of later PTSD symptom level were intrusive symptoms shortly after the accident and biographical risk factors. There were individual changes over time between the categories PTSD, sub-threshold PTSD and no PTSD. Whereas PTSD symptom severity was low or decreased for most of the patients, some of them showed an increase or a delayed onset. Patients with persisting PTSD symptoms at 6 months and patients with delayed onset of symptoms are at risk of long-term PTSD. Conclusions The prevalence of PTSD was low over the whole period of 3 years.",0 +,"The Harvard Trauma Questionnaire. Validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees.","There are no valid and reliable cross-cultural instruments capable of measuring torture, trauma, and trauma-related symptoms associated with the DSM-III-R diagnosis of posttraumatic stress disorder (PTSD). Generating such standardized instruments for patients from non-Western cultures involves particular methodological challenges. This study describes the development and validation of three Indochinese versions of the Harvard Trauma Questionnaire (HTQ), a simple and reliable screening instrument that is well received by refugee patients and bicultural staff. It identifies for the first time trauma symptoms related to the Indochinese refugee experience that are associated with PTSD criteria. The HTQ's cultural sensitivity may make it useful for assessing other highly traumatized non-Western populations.",0 +https://doi.org/10.1007/s11055-013-9798-9,Formation of an Anxious-Depressive State in an Experimental Model of Post-Traumatic Stress Disorder in Prenatally Stressed Female Rats,"The characteristics of the formation of a pathological state in an experimental model of post-traumatic stress disorder (PTSD) in adult female rats born to mothers subjected to daily restraint stress during the last third of pregnancy were studied. Both control and prenatally stressed female rats developed a pathological state after severe combined stress and subsequent restress, with long-lasting increases in anxiety and enhanced fast feedback inhibition of stress-related hypophyseal-adrenocortical system (HAS) activity. However, while development of the pathological state in control animals progressed to the anxiety type, prenatally stressed animals developed not only anxiety, but also increased depression-like behavior, i.e., an anxiety-depression disorder developed. These data are interpreted in the light of the interaction between the characteristics of HAS activity in prenatally stressed females and the predisposition of these animals to developing poststress pathology. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1002/jts.20404,"Posttyphoon prevalence of posttraumatic stress disorder, major depressive disorder, panic disorder, and generalized anxiety disorder in a Vietnamese sample","In 2006, typhoon Xangsane struck Vietnam and disrupted a large-scale mental health needs analysis in the Da Nang province of Vietnam. Recruitment of new participants was halted, and the design of study was altered to that of a pre-/post-event investigation in which 798 of the original 4,982 participants were re-interviewed. This produced the first pre-post disaster epidemiological study. Specifically, risk and protective factors were evaluated with respect to probable mental health ""caseness"" on the bases of the World Health Organization Short Response Questionnaire (SRQ-20) 7/8 cutoff (i.e., scores of 8 or more). Caseness prevalence was 20.7% pre-disaster and 27.1% post-disaster. Specific risk factors associated with mental health caseness included poor health, extreme peri-disaster fear, and experienced injury. Religious affiliation appeared to be a protective factor. In contrast to US samples, gender was not predictive of outcome.",0 +https://doi.org/10.1080/15325020701742136,Coping Strategies in Daily Life as Protective and Risk Factors for Post Traumatic Stress in Motor Vehicle Accident Survivors,"To investigate the role of a general coping style in the development and maintainance of PTSD-like symptoms, we investigated 44 survivors of severe motor vehicle accidents. Coping was assessed using a German instrument. We also included personality traits such as neuroticism and extraversion, peritraumatic and cognitive factors that are linked to both PTSD and coping in daily life. Stepwise regressions were computed to explain overall PTSD symptoms and symptom clusters (intrusion, avoidance, hyperarousal). Extraversion and neuroticism, cognitive factors, and subjective trauma characteristics predicted total PTSD severity and the symptom clusters, respectively. Additionally, the results indicate that the coping of a person in daily life plays a role in the development and maintenance of PTSD symptoms. We identified both protective factors such as situation control and self-aggrandizement and risk factors such as avoidance and self-blame.",0 +https://doi.org/10.1186/1129-2377-15-35,"Recurrent headache and interpersonal violence in adolescence: the roles of psychological distress, loneliness and family cohesion: the HUNT study","Recurrent headache is the most common and disabling pain condition in adolescence. Co-occurrence of psychosocial adversity is associated with increased risk of chronification and functional impairment. Exposure to interpersonal violence seems to constitute an important etiological factor. Thus, knowledge of the multiple pathways linking interpersonal violence to recurrent headache could help guide preventive and clinical interventions. In the present study we explored a hypothetical causal model where the link between exposure to interpersonal violence and recurrent headache is mediated in parallel through loneliness and psychological distress. Higher level of family cohesion and male sex is hypothesized to buffer the adverse effect of exposure to interpersonal violence on headache.The model was assessed using data from the cross-sectional, population-based Young-HUNT 3 study of Norwegian adolescents, conducted from 2006-2008. A cohort of 10 464 adolescents were invited. The response rate was 73% (7620), age ranged from 12 and 20 years, and 50% (3832) were girls. The study comprised self-report measures of exposure to interpersonal violence, loneliness, psychological distress and family cohesion, in addition to a validated interview on headache, meeting the International Classification of Headache Disorders criteria. Recurrent headache was defined as headache recurring at least monthly during the past year, and sub-classified into monthly and weekly headache, which served as separate outcomes.In Conditional Process Analysis, loneliness and psychological distress consistently posed as parallel mediating mechanisms, indirectly linking exposure to interpersonal violence to recurrent headache. We found no substantial moderating effect of family cohesion or sex.Loneliness and psychological distress seem to play crucial roles in the relationship between exposure to interpersonal violence and recurrent headache. To facilitate coping and recovery, it may be helpful to account for these factors in preventive and clinical interventions. Trauma-informed, social relationship-based interventions may represent a major opportunity to alter trajectories of recurrent headache.",0 +https://doi.org/10.1521/psyc.2012.75.1.76,Bereavement and Mental Health after Sudden and Violent Losses: A Review,"This paper reviews the literature on the psychological consequences of sudden and violent losses, including disaster and military losses. It also reviews risk and resilience factors for grief and mental health and describes the effects and possible benefit of psychosocial interventions. The review shows gaps in the literature on grief and bereavement after sudden and violent deaths. Still, some preliminary conclusions can be made. Several studies show that a sudden and violent loss of a loved one can adversely affect mental health and grief in a substantial number of the bereaved. The prevalence of mental disorders such as post-traumatic stress disorder (PTSD), major depressive disorder (MDD), and prolonged grief disorder (PGD, also termed complicated grief) varies widely, however, from study to study. Also, mental health disorders are more elevated after sudden and violent losses than losses following natural deaths, and the trajectory of recovery seems to be slower. Several factors related to the circumstances of the loss may put the bereaved at heightened risk for mental distress. These factors may be differentially related to different outcomes; some increase the risk for PTSD, others for PGD. Given the special circumstances, bereavement following sudden and violent death may require different interventions than for loss from natural death. Recommendations for future research and clinical implications are discussed.",0 +https://doi.org/10.1016/j.whi.2013.07.006,A New Vulnerable Population? The Health of Female Partners of Men Recently Released from Prison,"Abstract Background Despite a growing literature on the consequences of having a romantic partner incarcerated on women's risk of contracting sexually transmitted infections, little research considers the broader health profile of the female partners of ever-imprisoned men. Methods We use data from the Relate Project ( n  = 332), a unique cross-sectional survey of recently released men and their female partners (2009–2011), to demonstrate that the female partners of recently released men suffer from a variety of health risks and conditions. We also examine the health conditions of females by their own incarceration history. Findings We find that these women engage in poor health behaviors including smoking, drug use, and excessive alcohol consumption and have high levels of health conditions including asthma, hypertension, anxiety, and depression. The vulnerability of women who had themselves been incarcerated in jails or prisons was especially acute. The number of risky background characteristics such as dropping out of high school (45%) and spending time in foster care or a group home (36%) were staggeringly high for ever-imprisoned women, as were their rates of anxiety (50%), depression (59%), and posttraumatic stress disorder (45%). Conclusions Results reveal that the health of the female partners of recently released men is at least as poor as that of their male partners, suggesting a degree of vulnerability that has yet to be considered in the medical or public health literature and a population that desperately needs medical attention with the full rollout of the Affordable Care Act in 2014.",0 +https://doi.org/10.1007/s00127-014-0973-2,Community integration after deployment to Afghanistan: a longitudinal investigation of Danish soldiers,"Methods: In a prospective, longitudinal study of Danish soldiers deployed to Afghanistan in 2009 (N = 743), we assessed community reintegration difficulties 2.5 years after home coming (study sample: N = 454). Furthermore, symptoms of posttraumatic stress disorder (PTSD) were assessed before, during, and after deployment. Trajectories of PTSD symptoms from a previously published latent growth mixture modeling analysis were used to address whether community reintegration difficulties differ as a result of course and level of PTSD symptoms. Objective: In the years following military deployment, soldiers may experience problems integrating into the community. However, little is known about the nature and prevalence of these problems and if they relate to posttraumatic symptomatology. Results: Between 3.6 and 18.0 % reported to have some, a lot, or extreme difficulties in reintegration domains such as interpersonal functioning, productivity, community involvement, and self-care. Mean level of reintegration difficulties differed significantly across six PTSD symptom trajectories (range 6.35–36.00); with more symptomatic trajectories experiencing greater community reintegration difficulties. Conclusions: Reintegration difficulties after deployment are present in less than 20 % of Danish soldiers who return from Afghanistan. Difficulties are greater in individuals who follow symptomatic PTSD trajectories in the first years following deployment than in those who follow a low-stable trajectory with no or few symptoms.",0 +https://doi.org/10.1002/jclp.1149,MMPI-2 profiles of Gulf and Vietnam combat veterans with chronic posttraumatic stress disorder,"The current study examined service era differences in a sample of 172 Gulf and Vietnam outpatient veterans with combat-related posttraumatic stress disorder (PTSD). Participants completed the MMPI-2 and several additional self-report measures of symptom severity (PTSD, depression, anxiety, hostility, and health complaints). Results indicated that MMPI-2 profiles differed significantly according to service era with Vietnam veterans scoring higher on scales 2, 8, and 0 and lower on scale 9 than did Gulf veterans. Examination of group means derived from parametric analysis of MMPI-2 data suggested a mean two-point code type of 2-8/8-2 for Vietnam veterans and 1-8/8-1 for Gulf veterans. In contrast, when the data were examined using descriptive techniques based on frequency counts of individual MMPI-2 profiles, the most frequently occurring two-point codetype was 7-8/8-7 for Vietnam veterans, and 6-8/8-6 for Gulf veterans. In addition, Gulf veterans reported a greater number of total health complaints than Vietnam veterans, whereas Vietnam veterans reported a greater number of physician-diagnosed physical conditions. Potential advantages of incorporating descriptive approaches versus parametric methods when examining profile data are also presented.",0 +https://doi.org/10.1111/j.1468-1331.2011.03469.x,A clinical profile of 103 patients with secondary movement disorders: correlation of etiology with phenomenology,"Studying patients with secondary movement disorders (SMD) provides a unique opportunity to determine the correlation between the etiology and phenomenology of movement disorders.This was a prospective study of 103 patients (43 women, 60 men; age=28.7±17.3 years; range=2-70 years) with SMD, in a tertiary hospital over 4 years.The mean age of onset of SMD was 24.3±19.7 years, and duration of symptoms was 4.3±7.1 years (42 days to 40 years). Patients with pure tremor, pure dystonia (DYS), or a combination of tremor with dystonia had longest latency (10.9-18.5 months), whereas those with parkinsonism (PAR) and hemiballismus (HMB) had shorter latency (2.7-3.0 weeks). Pure dystonia was most prevalent (30.1%) followed by dystonia plus (13.6%), tremor (12.6%), PAR (11.7%), HMB (8.7%), mixed SMD (7.8%), tremor with dystonia (6.8%), myoclonus (5.8%), and chorea (2.9%). In approximately 60% of patients, the underlying etiologies were vascular (VAS), infections, and space-occupying lesions (SOL), and 25% had SMD following trauma or hypoxia (HYP). With reference to specific etiologies, the most frequent SMDs were tremor following SOL (46%), post-traumatic syndromes (25%), dystonia following HYP (56%), VAS lesions (50%), and infections (28%). With reference to specific SMDs, the most common etiologies were VAS for dystonia (39%), SOL for tremor (67%), and PAR (31%), and both SOL and trauma (37.5% each) for tremor with dystonia.Our study highlights the spectrum of SMDs and the lack of correlation between types of SMDs and underlying etiologies. Preventable causes such as infections, HYP, trauma, and kernicterus still play a major role in pathogenesis of SMD.",0 +https://doi.org/10.1089/neu.2013.3244,"Significant Improvements in Cognitive Performance Post-Transcranial, Red/Near-Infrared Light-Emitting Diode Treatments in Chronic, Mild Traumatic Brain Injury: Open-Protocol Study","This pilot, open-protocol study examined whether scalp application of red and near-infrared (NIR) light-emitting diodes (LED) could improve cognition in patients with chronic, mild traumatic brain injury (mTBI). Application of red/NIR light improves mitochondrial function (especially in hypoxic/compromised cells) promoting increased adenosine triphosphate (ATP) important for cellular metabolism. Nitric oxide is released locally, increasing regional cerebral blood flow. LED therapy is noninvasive, painless, and non-thermal (cleared by the United States Food and Drug Administration [FDA], an insignificant risk device). Eleven chronic, mTBI participants (26-62 years of age, 6 males) with nonpenetrating brain injury and persistent cognitive dysfunction were treated for 18 outpatient sessions (Monday, Wednesday, Friday, for 6 weeks), starting at 10 months to 8 years post- mTBI (motor vehicle accident [MVA] or sports-related; and one participant, improvised explosive device [IED] blast injury). Four had a history of multiple concussions. Each LED cluster head (5.35 cm diameter, 500 mW, 22.2 mW/cm(2)) was applied for 10 min to each of 11 scalp placements (13 J/cm(2)). LEDs were placed on the midline from front-to-back hairline; and bilaterally on frontal, parietal, and temporal areas. Neuropsychological testing was performed pre-LED, and at 1 week, and 1 and 2 months after the 18th treatment. A significant linear trend was observed for the effect of LED treatment over time for the Stroop test for Executive Function, Trial 3 inhibition (p=0.004); Stroop, Trial 4 inhibition switching (p=0.003); California Verbal Learning Test (CVLT)-II, Total Trials 1-5 (p=0.003); and CVLT-II, Long Delay Free Recall (p=0.006). Participants reported improved sleep, and fewer post-traumatic stress disorder (PTSD) symptoms, if present. Participants and family reported better ability to perform social, interpersonal, and occupational functions. These open-protocol data suggest that placebo-controlled studies are warranted.",0 +https://doi.org/10.3390/bs4010072,Ethnic Differences in Personality Disorder Patterns among Women Veterans Diagnosed with PTSD,"Personality Disorders (PDs) impair the ability to function socially and occupationally. PD prevalence rates among veterans who have also been diagnosed with posttraumatic stress disorder (PTSD) range from 45%-79%. This study examined ethnic differences in PDs assessed with the Millon Clinical Multiaxial Inventory-III in 260 non-Hispanic white (64%), Hispanic (27%), and African American (9%), mostly single, women veterans in treatment for PTSD. After adjusting for covariates including number and sexual-nature of trauma, findings revealed the adjusted odds ratio of having a cluster A PD was almost three times higher for African Americans (p = 0.046) then the other two ethnic groups, which may be driven by the paranoid PD scale and potentially reflects an adaptive response to racial discrimination. In cluster designation analysis, the odds were twice as high of having a cluster B PD with childhood trauma (p = 0.046), and a cluster C PD with sexual trauma (p = 0.004), demonstrating the significance of childhood and sexual trauma on long-term chronic personality patterns in women veterans. These results highlight the importance of using instruments with demonstrated diagnostic validity for minority populations.",0 +https://doi.org/10.1016/j.jflm.2014.04.013,When range of motion is not enough: Towards an evidence-based approach to medico-legal reporting in whiplash injury,Whiplash injury medico-legal reporting has traditionally been focused upon identifying restrictions in range of motion and identifying the presence of tender areas in the cervical spine in an effort both to diagnose the condition and to offer a prognosis. There have been considerable advances in this field over the last decade however that calls into question such a diminutive approach. This paper reviews the contemporary evidence base for the medico-legal assessment of whiplash injury and identifies a body of literature that strongly implicates a Claimant's physiological and psychological stress response as a key medico-legal marker in predicting prognosis following whiplash injury.,0 +https://doi.org/10.1080/13607863.2014.941325,Long-term psychological outcomes in older adults after disaster: relationships to religiosity and social support,"Natural disasters are associated with catastrophic losses. Disaster survivors return to devastated communities and rebuild homes or relocate permanently, although the long-term psychological consequences are not well understood. The authors examined predictors of psychological outcomes in 219 residents of disaster-affected communities in south Louisiana.Current coastal residents with severe property damage from the 2005 Hurricanes Katrina and Rita, and exposure to the 2010 British Petroleum Deepwater Horizon oil spill were compared and contrasted with former coastal residents and an indirectly affected control group. Participants completed measures of storm exposure and stressors, religiosity, perceived social support, and mental health.Non-organizational religiosity was a significant predictor of post-traumatic stress disorder (PTSD) in bivariate and multivariate logistic regressions. Follow-up analyses revealed that more frequent participation in non-organizational religious behaviors was associated with a heightened risk of PTSD. Low income and being a coastal fisher were significant predictors of depression symptoms in bivariate and multivariate models. Perceived social support had a protective effect for all mental health outcomes, which also held for symptoms of depression and GAD in multivariate models.People who experienced recent and severe trauma related to natural and technological disasters are at risk for adverse psychological outcomes in the years after these events. Individuals with low income, low social support, and high levels of non-organizational religiosity are also at greater risk. Implications of these data for current views on the post-disaster psychological reactions and the development of age-sensitive interventions to promote long-term recovery are discussed.",0 +https://doi.org/10.1117/12.842510,"Transcranial LED therapy for cognitive dysfunction in chronic, mild traumatic brain injury: two case reports","Two chronic, traumatic brain injury (TBI) cases are presented, where cognitive function improved following treatment with transcranial light emitting diodes (LEDs). At age 59, P1 had closed-head injury from a motor vehicle accident (MVA) without loss of consciousness and normal MRI, but unable to return to work as development specialist in internet marketing, due to cognitive dysfunction. At 7 years post-MVA, she began transcranial LED treatments with cluster heads (2.1” diameter with 61 diodes each – 9x633nm, 52x870nm; 12-15mW per diode; total power, 500mW; 22.2 mW/cm 2 ) on bilateral frontal, temporal, parietal, occipital and midline sagittal areas (13.3 J/cm 2 at scalp, estimated 0.4",0 +https://doi.org/10.15270/49-3-49,AN INTERGENERATIONAL PERSPECTIVE ON RISK AND PROTECTIVE FACTORS IN MULTI-PROBLEM POOR FAMILES LIVING IN CAPE TOWN,At the time of the research the first author was employed as a social worker at a welfare organisation in the Cape Peninsula with a case load of over 300 clients. About 30 of these cases were multi-problem families who had been receiving social work services over at least three generations. The concern was that these multi-problem poor families seemed to be immobilised and found it difficult to break out of the cycle of poverty and welfare dependency,0 +https://doi.org/10.1016/j.burns.2010.12.018,Prevalence and co-morbidity of psychiatric disorders 1–4 years after burn,"Currently, little is known about psychiatric disorders in the period following on the first year after burn. We examined the prevalence of DSM-IV Axis I disorders in burn patients 1-4 years after burn, using a standardized structured clinical interview and comparing findings with a representative general population sample.Ninety patients admitted to five burn centres were assessed with the 12-month Composite International Diagnostic Interview. Results were compared to an age and gender matched nation based norm group.Twelve-month prevalence for any DSM-IV study disorder was 39%. Prevalence for any after burn onset disorder was 28%. Most prevailing were major depression (10%), generalized anxiety disorder (10%), and PTSD (7%). The comorbidity-proportions for PTSD and generalized anxiety disorder where the highest. Fifty-seven percent of all burn onset disorders started within 1 year after the trauma and 21% within the next year. Burn patients had significantly higher prevalence rates for DSM-IV disorders than people from the general population sample.Psychiatric morbidity among burn patients, 1-4 years after burn, is considerable and higher than what may be expected in the general population. A 2-year follow-up for anxiety and depression disorder is warranted.",0 +https://doi.org/10.3168/jds.s0022-0302(04)73434-7,Genetic Components of Days Open Under Heat Stress,"A reaction norm approach was used to estimate the genetic parameters of days open (DO) with a model that accounted for heat stress. Data included DO records for Georgia, Tennessee, and North Carolina in the Southeastern United States. A fixed effect model included herd-year, month of calving (MOC), age of cow, and a regression on 305-d milk yield. The reaction norm model additionally included the effect of animal with random regression on a heat stress index (HI), calculated as the standardized solutions to MOC derived from the fixed effect model; the residual variance was assumed to be a function of the HI. The shape of the distribution of the HI was close to a sinusoidal function with the highest value in March/April and the lowest value in September. Genetic and residual variances and heritabilities were highest for spring calvings and lowest for fall calvings. The variance associated with the random regression of the highest level of HI was 33% of the genetic variance of the regular animal genetic effect. Genetic correlation between these effects was 0.67. As a validation, DO data were grouped into 4 seasons of calving and treated as different traits. A 4-trait mixed linear model that included the fixed effects listed above except MOC, was used to analyze the grouped data. In general, the estimates of genetic and residual variances of the multiple trait analyses followed those of the reaction norm model. Genetic correlations of spring with summer, and fall with winter were both 0.90. Genetic correlations between spring/summer and fall/winter were around 0.80. The reaction norm model for DO allows inexpensive genetic evaluation of fertility under heat stress. Results of such an evaluation may strongly depend on editing criteria and model specifications.",0 +https://doi.org/10.1371/journal.pone.0029969,Target Identification for Stereotactic Thalamotomy Using Diffusion Tractography,"Stereotactic targets for thalamotomy are usually derived from population-based coordinates. Individual anatomy is used only to scale the coordinates based on the location of some internal guide points. While on conventional MR imaging the thalamic nuclei are indistinguishable, recently it has become possible to identify individual thalamic nuclei using different connectivity profiles, as defined by MR diffusion tractography.Here we investigated the inter-individual variation of the location of target nuclei for thalamotomy: the putative ventralis oralis posterior (Vop) and the ventral intermedius (Vim) nucleus as defined by probabilistic tractography. We showed that the mean inter-individual distance of the peak Vop location is 7.33 mm and 7.42 mm for Vim. The mean overlap between individual Vop nuclei was 40.2% and it was 31.8% for Vim nuclei. As a proof of concept, we also present a patient who underwent Vop thalamotomy for untreatable tremor caused by traumatic brain injury and another patient who underwent Vim thalamotomy for essential tremor. The probabilistic tractography indicated that the successful tremor control was achieved with lesions in the Vop and Vim respectively.Our data call attention to the need for a better appreciation of the individual anatomy when planning stereotactic functional neurosurgery.",0 +https://doi.org/10.1002/jts.20076,Factor structure of posttraumatic stress among Western New York undergraduates following the September 11th terrorist attack on the World Trade Center,"The structure of posttraumatic stress is of both theoretical and clinical interest. In the present study, seven models of posttraumatic stress were compared using confirmatory factor analysis. A sample of 528 Western New York undergraduate students was assessed 1 and 3 months after the September 11th, 2001 terrorist attacks. At the Month 1 assessment, the current three-factor Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) model, which consists of Intrusions, Avoidance/Numbing, and Hyperarousal, did not provide a good fit to the data; however, a four-factor model consisting of factors labeled Intrusions, Avoidance, Dysphoria, and Hyperarousal did fit the data well and provided better fit than the three-factor model and other competing models. Importantly, Dysphoria spans symptoms from the traditional DSM Numbing and Hyperarousal clusters. The four-factor model continued to fit the data well at Month 3. These findings parallel the results of earlier studies which suggest that a four-factor model better reflects the nature of posttraumatic stress than do simpler models, including the DSM. The present work is consistent with a dimensional model of stress responses and calls for further longitudinal work in this area.",0 +https://doi.org/10.1016/s0306-4530(97)00053-x,Cerebrospinal fluid and plasma β-endorphin in combat veterans with post-traumatic stress disorder,"Opioid-mediated analgesia develops in experimental animals following traumatic stress and increased opioid-mediated analgesia has been observed in combat veterans with post-traumatic stress disorder (PTSD). These observations have led to the hypothesis that increased central nervous system (CNS) opioidergic activity exists in patients with PTSD. However, direct CNS data on opioid peptide concentrations and dynamics in patients with PTSD are lacking. We withdrew cerebrospinal fluid (CSF) via a flexible, indwelling subarachnoid catheter over a 6-h period and determined hourly CSF concentrations of immunoreactive beta-endorphin (ir beta END) in 10 well-characterized combat veterans with PTSD and nine matched normal volunteers. Blood was simultaneously withdrawn to obtain plasma for ir beta END. PTSD symptom clusters, as measured by the CAPS, were correlated with neuroendocrine data. Mean CSF ir beta END was significantly greater in patients with PTSD compared with normals and there was a negative correlation between the ir beta END and PTSD intrusive and avoidant symptoms of PTSD. No intergroup difference between plasma ir beta END was found, nor was there a significant correlation between CSF and plasma ir beta END. Immunoreactive beta-lipotropin (ir beta LPH) and pro-opiomelanocortin (irPOMC), both precursors of beta END, were much more plentiful in human CSF than was beta-endorphin itself, as has been previously reported. It remains to be determined whether the increased CNS opioid concentrations predate traumatic stress, thereby conferring a vulnerability to dissociative states and PTSD itself, or result from the trauma. The negative correlation between CSF ir beta END and avoidant and intrusive symptoms suggests that CNS hypersecretion of opioids might constitute an adaptive response to traumatic experience. Poor correlation between CSF and plasma ir beta END limits use of plasma measures to assess CNS opioid activity.",0 +,Symptoms of posttraumatic stress disorder in young males diagnosed with testicular or lymphatic cancer,"Testicular and lymphatic cancers (Hodgkin's and non-Hodgkin's disease) are among the most common cancers in young males aged 18 to 45. It has recently been acknowledged that symptoms of posttraumatic stress disorder (PTSD) may be present following a cancer diagnosis, with incidence varying between 1.9% to 35.1% (Kangas, Henry & Bryant, 2002). This project aimed to explore the cancer related symptoms of PTSD and distress, to determine the frequency of PTSD symptoms in young male cancer patients, to establish a timeline for PTSD symptoms in the first year following a cancer diagnosis, to identify risk factors that were predictive of PTSD symptoms, and to report on the coping and posttraumatic growth experienced by survivors. In study 1, verbatim accounts of 22 survivors of either testicular or lymphatic cancer were collected retrospectively. Qualitative data was analyzed according to the Miles and Huberman (1984) approach. Survivors' appraisal of their diagnosis as a being a shock and a threat were common, as were and anxious anticipation, avoidance, and denial. In the treatment phase, despair and discouragement were most common. In the long-term, PTSD symptoms (increased presence of intrusions and avoidance) and delayed emotional reactions were reported. Optimism was common in early coping and many reported posttraumatic growth in the long-term survival phase. These findings were consistent with the social-cognitive transition model of adjustment (Brennan, 2001). In study 2, newly diagnosed cancer patients (n=92) and community controls (n=88) were recruited and followed prospectively over a period of 12 months. Severe PTSD symptoms were observed in up to 14.3% of cancer patients in the first year following diagnosis, compared to 5.7% of controls. Repeated measure analyses of variance (ANOVAs) revealed that cancer patients had higher levels of PTSD symptoms, at time 2 and 4 on the IES, at times 2, 3 and 4 on the PCL-C, at time 2 for depression, and at times 1 and 2 for anxiety than controls, but were not different in perceived stress, nor in quality of life. Furthermore, there was a significant increase in PTSD symptoms over time. Initial scores of PTSD were the only significant predictor of PTSD at time 4. Furthermore, there was a significant increase in PTSD symptoms over time for the cancer group, but not for controls. Taken together these results suggest that distress in the form of depression and anxiety was elevated but tended to diminish over time. Moreover, early manifestations of PTSD strongly predict later PTSD symptoms and there was an increase in PTSD symptoms over time. Avoidance and denial were common at the time of diagnosis, but intrusions gradually became more important. This may indicate that a form of cognitive processing of the stressful experience is taking place and allows some survivors to revisit their existing life assumptions and experience differing levels of posttraumatic growth. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1007/s10862-007-9058-9,Psychometric Status and Clinical Utility of the MAYSI-2 with Girls and Boys in Juvenile Detention,"This study replicates and extends studies of the Massachusetts Youth Screening Instrument, Version 2 (MAYSI-2) in a sample of 479 urban, rural, and suburban 12-16 year old youths (68% boys; 41% African American, 23% Latino) consecutively admitted to juvenile detention centers. Six principal components replicated the MAYSI-2 factor-analytically-derived subscales except for Depression/Anxiety, and suggested modifications of specific items in each sub-scale. Findings supported the internal consistency and validity of the modified MAYSI-2 sub-scales. Few gender differences emerged, except that girls reported higher levels of hopelessness and trauma than boys. Five sub-groups were identified based on component profiles: (1) non-clinical, (2) addiction, somatic problems, and suicidality, (3) anger problems, (4) thought disturbance, and (5) addiction and traumatic stress. The findings support the validity of the MAYSI-2 for juvenile justice mental health screening while highlighting possible refinements in scoring in order to identify delinquent youths with distinctive psychosocial risks and needs. © 2007 Springer Science+Business Media, LLC.",0 +https://doi.org/10.1016/j.jad.2012.10.010,"Complex trauma and intimate relationships: The impact of shame, guilt and dissociation","This study examined dissociation, shame, guilt and intimate relationship difficulties in those with chronic and complex PTSD. Little is known about how these symptom clusters interplay within the complex PTSD constellation. Dissociation was examined as a principle organizing construct within complex PTSD. In addition, the impact of shame, guilt and dissociation on relationship difficulties was explored.Sixty five treatment-receiving adults attending a Northern Irish service for conflict-related trauma were assessed on measures of dissociation, state and trait shame, behavioral responses to shame, state and trait guilt, complex PTSD symptom severity and relationship difficulties.Ninety five percent (n=62) of participants scored above cut-off for complex PTSD. Those with clinical levels of dissociation (n=27) were significantly higher on complex PTSD symptom severity, state and trait shame, state guilt, withdrawal in response to shame and relationship preoccupation than subclinical dissociators (n=38). Dissociation and state and trait shame predicted complex PTSD. Fear of relationships was predicted by dissociation, complex PTSD and avoidance in response to shame, while complex PTSD predicted relationship anxiety and relationship depression.The study was limited to a relatively homogeneous sample of individuals with chronic and complex PTSD drawn from a single service.Complex PTSD has significant consequences for intimate relationships, and dissociation makes an independent contribution to these difficulties. Dissociation also has an organizing effect on complex PTSD symptoms.",0 +https://doi.org/10.1037/a0015681,"A multivariate contextual analysis of torture and cruel, inhuman, and degrading treatments: Implications for an evidence-based definition of torture.","Current thinking on what constitutes torture in a detention/interrogation setting focuses solely on particular procedures, without regard for contextual factors that mediate traumatic stress. The present study examined stressor interactions that determined severity and psychological impact of captivity stressors in 432 torture survivors in former Yugoslavia countries and Turkey. A principal components analysis of 46 captivity stressors measured by an Exposure to Torture Scale identified meaningful stressor clusters, which suggested that multiple detention procedures were used in combination to maximize their impact. Perceived torture severity related to 'cruel, inhuman, and degrading' treatments (CIDT) but not to physical torture. Posttraumatic stress disorder related to war-related captivity, deprivation of basic needs, sexual torture, and exposure to extreme temperatures, isolation, and forced stress positions but not to physical torture. CIDT increased posttraumatic stress disorder risk by 71%. Fear- and helplessness-inducing effects of captivity and CIDT appear to be the major determinants of perceived severity of torture and psychological damage in detainees. Considerations on what constitutes torture need to take into account the contextual processes in a captivity setting that mediate these effects.",0 +https://doi.org/10.1089/neu.2014.3660,Clusters of Low18F-Fluorodeoxyglucose Uptake Voxels in Combat Veterans with Traumatic Brain Injury and Post-Traumatic Stress Disorder,"Individuals with mild traumatic brain injury (TBI) show diminished metabolic activity when studied with positron emission tomography (PET) with (18)F-fluorodeoxyglucose (FDG). Since blast injury may not be localized in the same specific anatomical areas in every patient or may be diffuse, significance probability mapping may be vulnerable to false-negative detection of abnormalities. To address this problem, we used an anatomically independent measure to assess PET scans: increased numbers of contiguous voxels that are 2 standard deviations below values found in an uninjured control group. We examined this in three age-matched groups of male patients: 16 veterans with a history of mild TBI, 17 veterans with both mild TBI and post-traumatic stress disorder (PTSD), and 15 veterans without either condition. After FDG administration, subjects performed a modified version of the California Verbal Learning Task. Clusters of low uptake voxels were identified by computing the mean and standard deviation for each voxel in the healthy combat veteran group and then determining the voxel-based z-score for the patient groups. Abnormal clusters were defined as those that contained contiguous voxels with a z-score <-2. Patients with mild TBI alone and patients with TBI+PTSD had larger clusters of low uptake voxels, and cluster size significantly differentiated the mild TBI groups from combat controls. Clusters were more irregular in shape in patients, and patients also had a larger number of low-activity voxels throughout the brain. In mild TBI and TBI+PTSD patients, but not healthy subjects, cluster volume was significantly correlated with verbal learning during FDG uptake.",0 +https://doi.org/10.1016/j.ijlp.2013.04.012,Is there a recognizable post-incarceration syndrome among released “lifers”?,"It has been suggested that released prisoners experience a unique set of mental health symptoms related to, but not limited to, post-traumatic stress disorder. We sought to empirically assess whether there is a recognizable post-incarceration syndrome that captures the unique effects of incarceration on mental health. We conducted in-depth life interviews with 25 released ""lifers"" (individuals serving a life sentence), who served an average of 19 years in a state correctional institution. We assessed to what extent the symptoms described by the participants overlapped with other mental disorders, most notably PTSD. The narratives indicate a specific cluster of mental health symptoms: In addition to PTSD, this cluster was characterized by institutionalized personality traits, social-sensory disorientation, and alienation. Our findings suggest that post-incarceration syndrome constitutes a discrete subtype of PTSD that results from long-term imprisonment. Recognizing Post-Incarceration Syndrome may allow for more adequate recognition of the effects of incarceration and treatment among ex-inmates and ultimately, successful re-entry into society.",0 +https://doi.org/10.3109/13651501.2012.667113,Predictors of the long-term course of comorbid PTSD: A naturalistic prospective study,"The study examined the long-term course of posttraumatic stress disorder (PTSD) by analyzing rates of recurrence and the predictive value of comorbid psychiatric disorders and psychosocial functioning.This study is based on diagnostic assessments administered at intake and subsequent follow-up interviews over a period of 15 years in a sample of 90 anxiety-disordered patients with comorbid PTSD who participated in the Harvard Brown Anxiety Research project (HARP). Kaplan-Meier life table analysis revealed a 0.20 probability of full remission during the 15 years of follow-up.Latent growth model (LGM) analysis revealed that the number of trauma exposures was a predictor of a worse course of PTSD but only during some intervals of the 15-year follow-up. Subjects with full social phobia were more likely to experience worsening of PTSD over time in comparison with subjects with less severe social phobia. Role functioning in the areas of household and employment was a significant predictor of a declining course of PTSD.These findings revealed the dynamic nature of the predictive value of traumatic experiences, the deleterious effect of social phobia and the long term effect of psychosocial functioning on the course of PTSD. Implications for treatment planning and development of interventions for PTSD are discussed.",0 +https://doi.org/10.2298/vsp0501017s,Comorbidity of posttraumatic stress disorder and mild closed head injury in war veterans: Endocrinological and psychological profiles,"To determine the degree of psychological and endocrinological changes in war veterans with the diagnosis of Chronic Posttraumatic Stress Disorder (PTSD) regarding presence/absence of comorbid mild closed head injury (mCHI) caused by explosive devices.Two groups of PTSD inpatients, with (n = 37), and without (n = 86) sustained blast trauma followed by mCHI were formed during the psychiatric treatment. Participants were interviewed by experienced clinicians who used the PTSD Interview (PTSD-I). In addition, patients completed the Symptom Checklist-90-Revised (SCL-90-R). Serum levels of ten hormones were assessed: triiodothyronine, thyroxine, thyrotropin-stimulating hormone, prolactin, luteinizing hormone, follicle-stimulating hormone, and insulin, by radioimmunoassays and hydrocortisone, growth hormone and testosterone by fluoroimmunoassays.Veterans with comorbid mCHI and PTSD showed significantly higher level of amnesia for traumatic event as well as of somatization on the SCL-90-R. Significant differences of hormone levels were not found.The results didn't support the hypothesis on specific PTSD subgroup characterized by history of mCHI and consecutive postconcussion syndrome. The absence of differences in levels of hormones indicated the dominant role of psychogenic trauma in the etiology of hormone disbalance in chronic PTSD. Amnesia for traumatic event in war veterans with comorbid PTSD and mCHI was easily explained by neurogenic peritraumatic amnesia due to the blast trauma, but it did not affect either quality of intensity or posttraumatic symptoms as well as endocrinological parameters.",0 +https://doi.org/10.1097/ta.0b013e31809fec16,Factors Influencing Outcome After Orthopedic Trauma,"Background: Some recent studies have suggested that certain types of orthopedic trauma result in ongoing disability and that factors other than injury severity or location may influence outcome. This study aimed to evaluate outcome 12 months and 2 years after severe orthopedic trauma, as measured on the Short Form (SF)-36 Health Survey, relative to a control group, to examine change over time and to examine which demographic, injury-related and psychological factors are associated with persisting disability. Methods: One hundred thirteen orthopedic trauma patients, recruited during rehabilitation, and 61 demographically similar uninjured controls were followed up at 1 and 2 years postinjury. Measures included the SF-36 Health Survey, Symptom Checklist-90-R, Brief Pain Inventory, Hospital Anxiety and Depression Scales, and Posttraumatic Stress Disorder Checklist-Specific. Results: Results indicated presence of significant ongoing disability in all SF-36 physical and mental health domains, significant ongoing psychologic adjustment problems, including posttraumatic stress disorder (PTSD) symptoms, and pain, with little or no improvement between 1 and 2 years postinjury. The presence of ongoing pain, anxiety, depression or PTSD symptoms were the strongest predictors of outcome on most variables, with older age also contributing to negative outcomes. Injury severity and type did not predict outcome, although those with lower limb fractures had greater pain and poorer physical outcomes that those with fractures in other locations. Conclusions: This study has highlighted pain and PTSD symptoms as frequent and disabling factors after othropedic trauma. There is clearly a need to focus on alleviating these problems as part of the rehabilitation process.",0 +https://doi.org/10.1016/s0005-7967(96)00068-x,Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples,"The psychometric properties of the Depression Anxiety Stress Scales (DASS) were evaluated in two studies using large clinical samples (N = 437 and N = 241). In Study 1, the three scales comprising the DASS were shown to have excellent internal consistency and temporal stability. An exploratory factor analysis (principal components extraction with varimax rotation) yielded a solution that was highly consistent with the factor structure previously found in nonclinical samples. Between-groups comparisons indicated that the DASS distinguished various anxiety and mood disorder groups in the predicted direction. In Study 2, the conceptual and empirical latent structure of the DASS was upheld by findings from confirmatory factor analysis. Correlations between the DASS and other questionnaire and clinical rating measures of anxiety, depression, and negative affect demonstrated the convergent and discriminant validity of the scales. In addition to supporting the psychometric properties of the DASS in clinical anxiety and mood disorders samples, the results are discussed in the context of current conceptualizations of the distinctive and overlapping features of anxiety and depression.",0 +https://doi.org/10.1348/014466506x171540,The structure of PTSD symptoms: A test of alternative models using confirmatory factor analysis,"This study aimed to examine the structure of self-reported post-traumatic stress disorder (PTSD) symptoms.Based on previous factor analytic findings and the DSM-IV formulation, six confirmatory factor models were specified and estimated that reflected different symptom clusters.The analyses were based on responses from 1116 participants who had suffered whiplash injuries and screened for full or subclinical PTSD using the Harvard Trauma Questionnaire.A correlated four-factor model with re-experiencing, avoidance, dysphoria and arousal factors fitted the data very well. Correlations with criteria measures showed that these factors were associated with other trauma related variables in a theoretically predictable way and showed evidence of unique predictive utility.These results concur with previous research findings using different trauma populations but do not reflect the current DSM-IV symptom groupings.",0 +https://doi.org/10.1037//1082-989x.6.1.18,Analyzing developmental trajectories of distinct but related behaviors: A group-based method.,"This article presents a group-based method to jointly estimate developmental trajectories of 2 distinct but theoretically related measurement series. The method will aid the analysis of comorbidity and heterotypic continuity. Three key outputs of the model are (a) for both measurement series, the form of the trajectory of distinctive subpopulations; (b) the probability of membership in each such trajectory group; and (c) the joint probability of membership in trajectory groups across behaviors. This final output offers 2 novel features. First, the joint probabilities can characterize the linkage in the developmental course of distinct but related behaviors. Second, the joint probabilities can measure differences within the population in the magnitude of this linkage. Two examples are presented to illustrate the application of the method.",0 +https://doi.org/10.1177/0886260514552275,Real-World Barriers to Assessing and Treating Mental Health Problems With IPV Survivors,"Barriers to assessing and treating mental health problems with intimate partner violence (IPV) survivors were identified with qualitative responses from 62 IPV helping professionals who participated in an online survey question. Data were analyzed using a concept mapping approach, which resulted in following eight distinct clusters: (a) unsure, (b) limited IPV specific resources, (c) barriers to access, (d) systems-taboos, (e) immediate crisis needs, (f) fear-stigma, (g) offender’s control and (h) cultural concerns. The opinions expressed in these clusters help to better explain logistic, relational, and intrapersonal obstacles that can limit women IPV survivors’ ability to receive care for mental health conditions. Extending previous quantitative work by the authors (Simmons, Whalley, & Beck, 2014), the current portion of this project generates new ways of looking at barriers to service delivery, which can be used to develop theory and guide further research.",0 +https://doi.org/10.1016/0010-440x(85)90075-6,Posttraumatic stress disorder: Characteristics and pharmacological response in the veteran population,Abstract A retrospective chart review was conducted on all patients with the primary diagnosis of posttraumatic stress disorder (PTSD) admitted over a one-year period to a Veterans Administration Medical Center. The data base consisted of 14 Vietnam veterans and one World War II veteran. The purpose of the review was to compare the symptom profile of combat veterans to the established DSM III criteria for PTSD and to evaluate the efficacy of pharmacotherapy. The veterans' symptomatology was much more complex than described in DSM III and the currently employed drug therapy appears to be generally inadequate in treating combat-related PTSD.,0 +https://doi.org/10.1097/01.ta.0000197562.34651.df,The Mind Does Matter: Psychological and Physical Recovery After Musculoskeletal Trauma,"Posttraumatic psychopathology (PTP) is important to the orthopedic surgeon because it appears to be much more common than might have been suspected and may complicate the recovery from musculoskeletal injury. We have investigated the relationship between physical and psychological recovery in victims of musculoskeletal trauma.A prospective cohort of 200 patients with musculoskeletal injuries were studied, correlating development of psychopathology (measured by the General Health Questionnaire) and functional outcome (measured by Short Form-36, Sickness Impact Profile, and Musculoskeletal Function Assessment) 2 and 6 months after their injuries.Pre-existing psychological disturbance was found in 11% of our patients; this figure rose to 46% of patients at 2 months but fell to 22% at 6 months. The posttraumatic disturbance correlated strongly with impaired functional outcome as measured by all three outcomes measures (total and category scores) (p < 0.05).The strong correlation of PTP with impaired functional outcome after musculoskeletal trauma stresses that it is a significant problem. Further research is required to determine whether an approach that combines physical and psychological treatment can improve patient outcomes.",0 +https://doi.org/10.1016/s0005-7967(03)00147-5,A short form of the metacognitions questionnaire: properties of the MCQ-30,"The metacognitions questionnaire (MCQ) measures individual differences in a selection of metacognitive beliefs, judgments and monitoring tendencies considered important in the metacognitive model of psychological disorders. The development and properties of a shortened 30-item version of the MCQ, the MCQ-30, are reported. Construct validity was evaluated by confirmatory and exploratory factor analysis. Overall, the fit indices suggested an acceptable fit to a five-factor model consistent with the original MCQ. Exploratory factor analysis supported a five-factor structure, which was almost identical to the original solution obtained in previous studies with the full MCQ. The five factors are cognitive confidence, positive beliefs about worry, cognitive self-consciousness, negative beliefs about uncontrollability of thoughts and danger, and beliefs about need to control thoughts. The MCQ-30 showed good internal consistency and convergent validity, and acceptable to good test–retest reliability. Positive relationships between metacognitions and measures of worry and obsessive–compulsive symptoms provided further support for the validity of the measure and the metacognitive theory of intrusive thoughts. The psychometric properties of MCQ-30 suggest that the instrument is a valuable addition to the assessment of metacognitions that has the advantage of being more economical to use compared with the original MCQ.",0 +https://doi.org/10.1177/070674370705200406,Immediate and Sustained Psychological Impact of an Emerging Infectious Disease Outbreak on Health Care Workers,"Objective: To assess the immediate and sustained psychological health of health care workers who were at high risk of exposure during the severe acute respiratory syndrome (SARS) outbreak. Methods: At the peak of the 2003 SARS outbreak, we assessed health care workers in 2 acute care Hong Kong general hospitals with the Perceived Stress Scale (PSS-10). One year later, we reassessed these health care workers with the PSS-10, the 21-Item Depression and Anxiety Scale (DASS-21), and the Impact of Events Scale-Revised (IES-R). We recruited high-risk health care workers who practised respiratory medicine and compared them with nonrespiratory medicine workers, who formed the low-risk health care worker control group. Results: In 2003, high-risk health care workers had elevated stress levels (PSS-10 score = 17.0) that were not significantly different from levels in low-risk health care worker control subjects (PSS-10 score = 15.9). More high-risk health care workers reported fatigue, poor sleep, worry about health, and fear of social contact, despite their confidence in infection-control measures. By 2004, however, stress levels in the high-risk group were not only higher (PSS-10 score = 18.6) but also significantly higher than scores among low-risk health care worker control subjects (PSS-10 score = 14.8, P < 0.05). In 2004, the perceived stress levels in the high-risk group were associated with higher depression, anxiety, and posttraumatic stress scores ( P < 0.001). Posttraumatic stress scores were a partial mediator of the relation between the high risk of exposure to SARS and higher perceived stress. Conclusions: Health care workers who were at high risk of contracting SARS appear not only to have chronic stress but also higher levels of depression and anxiety. Front-line staff could benefit from stress management as part of preparation for future outbreaks.",0 +https://doi.org/10.1177/1049732310377181,Narrative Methods in a Study of Trauma Recovery,"Multiple narrative perspectives can guide narrative research. The complexity of health narratives presents a significant challenge. Trauma recovery accounts are health narratives demonstrating successes as well as struggles. In this article, I describe a large-scale narrative study in which specific qualitative methods were combined to fit research aims, stories elicited, and emergent questions in the analysis process. Under my direction, an interdisciplinary team conducted this constructivist, feminist, narrative study describing the trauma recovery process. The study was focused on success or thriving in women surviving childhood maltreatment. I took an advocacy stance in favor of participants’ interests, as is commensurate with a critical feminist standpoint. Through initial analyses the research team constructed a trauma recovery process termed “becoming resolute.” Subanalyses were focused on key relationships, life trajectories, self-strategies, and perceptual changes. My purpose is to explain the various kinds and levels of analysis used here to provide options for others studying recovery narratives.",0 +https://doi.org/10.1002/jts.20361,Posttraumatic growth in adolescence: Examining its components and relationship with PTSD,"To address gaps in the literature, this study examined the components of posttraumatic growth, and the relationship between growth and posttraumatic stress disorder (PTSD). Participants were from a pooled sample of 4,054 Israeli adolescents exposed to terror of whom 210 (5.5%) met criteria for PTSD. Measures included the Child Post-Traumatic Stress Reaction Index and Posttraumatic Growth Inventory. Principal components analysis showed two correlated components of outward and intrapersonal growth. Regression modeling showed that the relationship between the growth and PTSD measures was linear and curvilinear (inverted-U). These results replicated accounting for heterogeneity in PTSD, exposure and subsamples. Collectively, the results imply that posttraumatic growth in adolescence is characterized by two robust components, and is greatest at moderate posttraumatic stress levels.",0 +https://doi.org/10.1007/s00787-003-0339-x,Posttraumatic stress reactions among children following the Athens earthquake of September 1999,"The objective of the present study was to assess symptoms of posttraumatic stress disorder (PTSD), depression and anxiety among children 6 months after they had been exposed to an earthquake (EQ) affecting the north-western suburbs of Athens in September 1999. A total of 115 children attending two elementary schools located at the epicentre of the EQ were assessed. A group of 48 children not affected by the EQ attending a school not affected by the EQ were used as controls. The children and their parents completed a number of questionnaires. Overall, there was a high rate (78%) of severe to mild PTSD symptoms in the EQ exposed group. Additionally, a substantial proportion of these children scored above criteria (32%) for depression compared to the control group (12.5%). Severe or moderate symptoms of PTSD were associated with high scores of depression (p = 0.002). The relationship between PTSD symptoms and anxiety was limited to the ""avoidance"" factor of the anxiety questionnaire (p = 0.029). Those who were most likely to be affected were children alone at the time of the EQ, and children who sustained injuries. In summary, countries where EQs are frequent should be prepared to offer psychological support to a substantial proportion of children presenting with PTSD and depressive symptoms and should educate and prepare children to cope with these events.",0 +https://doi.org/10.1002/jts.20431,Nonresponse to a population-based postdisaster postal questionnaire study,"We examined nonparticipation in a 2-year postdisaster mail survey of Norwegian tourists evacuated from countries affected by the 2004 tsunami. One hundred seventy-one persons out of a random sample of 330 nonparticipants were telephone interviewed concerning disaster exposure, current posttraumatic stress reactions, and reasons for not participating. Fewer nonparticipants than participants had been in a place directly affected by the tsunami. Nonparticipants reported less perceived threat of death and lower levels of posttraumatic stress reactions. Reasons for not participating were “lack of interest or time” (39.2%), “lack of relevant experiences” (32.2%), and “too personal or emotionally disturbing” (15.2%). Our findings suggest that postdisaster studies may be biased in the direction of more severe disaster exposure and pronounced posttraumatic stress reactions.",0 +https://doi.org/10.1016/j.cbpra.2011.09.001,"Acceptance and Mindfulness Techniques as Applied to Refugee and Ethnic Minority Populations With PTSD: Examples From ""Culturally Adapted CBT""","Abstract In this article we illustrate how we utilize acceptance and mindfulness techniques in our treatment (Culturally Adapted CBT, or CA-CBT) for traumatized refugees and ethnic minority populations. We present a Nodal Network Model (NNM) of Affect to explain the treatment's emphasis on body-centered mindfulness techniques and its focus on psychological flexibility. We explain the definition of mindfulness that guides our treatment, and we outline a typology of mindfulness states and show how many of the techniques in our treatment can be analyzed by these categories. We argue that acceptance and mindfulness are therapeutic for refugees and minority populations for several reasons. These include their increasing psychological flexibility, decreasing somatic distress, decreasing rumination, serving as emotion regulation techniques, decreasing the attentional bias to threat, and forming part of a new adaptive processing mode (which in CA-CBT centers on psychological flexibility). We describe the specific ways we teach acceptance and mindfulness with Latino and Southeast Asian refugee populations and present case examples of the treatment of a traumatized Latino and Cambodian patient.",0 +https://doi.org/10.1038/nrn3530,Effects of Schedule I drug laws on neuroscience research and treatment innovation,"Many psychoactive drugs are used recreationally, particularly by young people. This use and its perceived dangers have led to many different classes of drugs being banned under national laws and international conventions. Indeed, the possession of cannabis, 3,4.methylenedioxy-.N.methylamphetamine (MDMA; also known as ecstasy) and psychedelics is stringently regulated. An important and unfortunate outcome of the controls placed on these and other psychoactive drugs is that they make research into their mechanisms of action and potential therapeutic uses - for example, in depression and post-.traumatic stress disorder - difficult and in many cases almost impossible. © 2013 Macmillan Publishers Limited. All rights reserved.",0 +https://doi.org/10.1037/a0020775,"Hurricane-related exposure experiences and stressors, other life events, and social support: Concurrent and prospective impact on children's persistent posttraumatic stress symptoms.","We investigated the influence of hurricane exposure, stressors occurring during the hurricane and recovery period, and social support on children's persistent posttraumatic stress (PTS).Using a 2-wave, prospective design, we assessed 384 children (54% girls; mean age = 8.74 years) 9 months posthurricane, and we reassessed 245 children 21 months posthurricane. Children completed measures of exposure experiences, social support, hurricane-related stressors, life events, and PTS symptoms.At Time 1, 35% of the children reported moderate to very severe levels of PTS symptoms; at Time 2, this reduced to 29%. Hurricane-related stressors influenced children's persistent PTS symptoms and the occurrence of other life events, which in turn also influenced persistent PTS symptoms. The cascading effects of hurricane stressors and other life events disrupted children's social support over time, which further influenced persistent PTS symptoms. Social support from peers buffered the impact of disaster exposure on children's PTS symptoms.The effects of a destructive hurricane on children's PTS symptoms persisted almost 2 years after the storm. The factors contributing to PTS symptoms are interrelated in complex ways. The findings suggest a need to close the gap between interventions delivered in the immediate and short-term aftermath and those delivered 2 years or more postdisaster. Such interventions might focus on helping children manage disaster-related stressors and other life events as well as bolstering children's support systems.",0 +https://doi.org/10.5665/sleep.4826,Sleep Quality Among Low-Income Young Women in Southeast Texas Predicts Changes in Perceived Stress Through Hurricane Ike,"To document the time course of perceived stress among women through the period of a natural disaster, to determine the effect of sleep quality on this time course, and to identify risk factors that predict higher levels of perceived stress.Longitudinal study from 2006-2012.Community-based family planning clinics in southeast Texas.There were 296 women aged 18-31 y who experienced Hurricane Ike, September 2008.Cohen Perceived Stress Scale (PSS) was administered every 2 mo from 6 mo before to 12 mo after Hurricane Ike. Sleep quality was assessed 1 mo after Hurricane Ike using the Pittsburg Sleep Quality Index (PSQI). Good sleep was defined as a PSQI summary score < 5, and poor sleep as a score ≥ 5. Hurricane Ike stressors (e.g., property damage, subjective stressors) and pre-Ike lifetime major life events and emotional health (e.g., emotional dysregulation, self-control) were also assessed.Over the entire period of 18 mo (6 mo before and 12 mo after the hurricane), perceived stress was significantly higher among poor sleepers compared to good sleepers, and only good sleepers showed a significant decrease in perceived stress after Hurricane Ike. In addition, a higher level of perceived stress was positively associated with greater Ike damage among poor sleepers, whereas this correlation was not observed among good sleepers. In the final multivariate longitudinal model, Ike-related subjective stressors as well as baseline major life events and emotional dysregulation among poor sleepers predicted higher levels of perceived stress over time; among good sleepers, additional factors such as lower levels of self-control and having a history of a psychiatric disorder also predicted higher levels of perceived stress.Sleep quality after Hurricane Ike, an intense natural disaster producing substantial damage, impacted changes in perceived stress over time. Our findings suggest the possibility that providing victims of disasters with effective interventions to improve sleep quality could help to reduce their perceived stress over time.",0 +https://doi.org/10.1007/s10608-011-9385-8,Identification of Child Sexual Abuse Survivor Subgroups Based on Early Maladaptive Schemas: Implications for Understanding Differences in Posttraumatic Stress Disorder Symptom Severity,"Cognitive models have informed understanding of the development, maintenance, and treatment of posttraumatic stress disorder (PTSD). Limited research, however, has examined the relationship of early maladaptive schemas (EMS; Young in Cognitive therapy for personality disorders: A schema-focused approach (rev. ed.). Professional Resource Press, Sarasota, 1994) to PTSD among trauma survivors. The current study, using a sample of 127 female child sexual abuse (CSA) survivors, applied a model-based clustering procedure (Mclust; Fraley and Raftery in MCLUST Version 3 for R: Normal Mixture Modeling and Model-based Clustering, Technical Report No. 504, Department of Statistics, University of Washington, 2006) to the 15 subscales of the Young Schema Questionnaire-Short Form (YSQ-S; Young and Brown in Young Schema Questionnaire- short form. Cognitive Therapy Center, New York, 1994) and revealed three clusters differentiated primarily by level of schema elevation. Women in the cluster characterized by the highest schema scores reported the most severe PTSD symptoms. A discriminant analysis indicated that schemas of Mistrust/ Abuse, Vulnerability to Harm, and Emotional Deprivation contributed most to distinguishing women differentiated on the basis of presumptive PTSD diagnostic status. Results underscore the importance of cognitive factors in the development and/or maintenance of PTSD symptoms and suggest possible treatment targets for cognitive therapy with CSA survivors. ©Springer Science+Business Media, LLC 2011.",0 +https://doi.org/10.1037/a0012591,"The structure of distress following trauma: Posttraumatic stress disorder, major depressive disorder, and generalized anxiety disorder.","The current report used confirmatory factor analysis to examine the latent structures of both key features and associated symptoms of three disorders that commonly develop following a traumatic event: posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD). Participants were 228 motor-vehicle accident survivors who sought treatment for emotional difficulties. PTSD, MDD, and GAD were assessed with a combination of self-report and interview-based measures. The results of construct level analyses suggested that PTSD, MDD, and GAD are distinguishable but highly correlated disorders following a traumatic event. Symptom level analyses supported a model where the Reexperiencing, Avoidance, and Hypervigilance factors were subsumed under the PTSD construct. However, in this model the Dysphoria factor was a higher order construct correlated with the PTSD, MDD, and GAD factors, suggesting that the Dysphoria cluster may not be unique to PTSD. Diagnostic and theoretical implications of these results are discussed.",0 +https://doi.org/10.1200/jco.2014.32.15_suppl.e20557,A meta-analysis of prevalence rates and moderating factors for cancer-related post-traumatic stress disorder.,e20557 Background: Systematic reviews highlight a broad range of PTSD prevalence estimates in cancer survivors. This meta-analysis was conducted to provide a general prevalence estimate of signific...,0 +https://doi.org/10.1097/01.pra.0000452561.98286.1e,Prazosin in the Treatment of PTSD,"Posttraumatic stress disorder (PTSD) often follows a chronic course, and the disorder is resistant to treatment with antidepressants and cognitive-behavioral therapy in a proportion of patients. Prazosin, an a1-adrenoceptor blocker, has shown some promise in treating chronic PTSD. A review of this literature was conducted via a search of MEDLINE and SUMMON, using keywords such as PTSD, prazosin, treatment, and resistance. At least 10 clinical studies of prazosin in the treatment of PTSD, including open-label and randomized controlled trials, have been published. All of these studies support the efficacy of prazosin either for treating nightmares and improving sleep or for reducing the severity of PTSD. Treatment of PTSD with prazosin is usually initiated at a dose of 1 mg, with monitoring for hypotension after the first dose. The dose is then gradually increased to maintenance levels of 2-6 mg at night. Studies of military patients with PTSD have used higher doses (e.g., 10-16 mg at night). Prazosin has also been studied in younger and older adults with PTSD and in patients with alcohol problems, in whom it was found to reduce cravings and stress responses. Prazosin offers some hope for treating resistant cases of PTSD in which recurrent nightmares are problematic, with a relatively rapid response within weeks. It is suggested that large-scale civilian trials of prazosin be done, as well as studies concerning the use of prazosin in acute PTSD and as a potential preventive agent.",0 +https://doi.org/10.1002/pon.1367,Posttraumatic growth and PTSD symptomatology among colorectal cancer survivors: a 3-month longitudinal examination of cognitive processing,"The experience of cancer can be understood as a psychosocial transition, producing both positive and negative outcomes. Cognitive processing may facilitate psychological adjustment.Fifty-five post-treatment, colorectal cancer survivors (M=65.9 years old; SD=12.7), an average of 13 months post-diagnosis, were recruited from a state cancer registry and completed baseline and 3-month questionnaires assessing dispositional (social desirability), cognitive processing (cognitive intrusions, cognitive rehearsal), and psychological adjustment variables (posttraumatic growth (PTG), posttraumatic stress disorder (PTSD) symptomatology, depression, anxiety, positive affectivity).PTSD symptomatology was positively associated with depression, anxiety, and negatively associated with positive affectivity. In contrast, PTG scores were unrelated to PTSD symptomatology, depression, anxiety, and positive affectivity. In addition, PTG was independent of social desirability. Notably, after controlling for age at diagnosis and education, multiple regression analyses indicated that cognitive processing (intrusions, rehearsal) was differentially predictive of psychological adjustment. Baseline cognitive intrusions predicted 3-month PTSD symptomatology and there was a trend for baseline cognitive rehearsal predicting 3-month PTG.Additional research is needed to clarify the association between PTG and other indices of psychological adjustment, further delineate the nature of cognitive processing, and understand the trajectory of PTG over time for survivors with colorectal cancer.",0 +https://doi.org/10.1016/j.psym.2015.03.007,The Use of Transdermal Therapeutic Systems in Psychiatric Care: A Primer on Patches,"Numerous currently available medications that act in the central nervous system can be delivered transdermally. Such medications include cholinesterase inhibitors for dementia, methylphenidate (MPH) for attention-deficit hyperactivity disorder, monoamine oxidase inhibitors (MAOIs) for depression, dopamine agonists for Parkinson disease and restless leg syndrome, and clonidine for attention-deficit hyperactivity disorder and impulse-control disorders.This article aims to review the literature related to transdermal delivery systems from the perspective of clinical practice and research related to their use in the treatment of psychiatric conditions.Most of the currently available transdermal systems have psychotropic properties or utility in the behavioral health arena and, therefore, are of clinical relevance to consultation-liaison psychiatrists or practitioners of psychosomatic medicine. We discuss their efficacy and safety profiles. We provide a table of these agents and their uses.Transdermal delivery (i.e., patches) for medicines with psychotropic properties allows mental health providers to customize therapy for patients by altering the duration of therapy, minimizing first-pass metabolism and the potential for drug-drug interactions, and decreasing the risk for gastrointestinal irritation.",0 +https://doi.org/10.1516/rfee-lkpn-b7tf-kpdu,Are psychodynamic and psychoanalytic therapies effective? A review of empirical data,"There is a need for empirical outcome research in psychodynamic and psychoanalytic therapy. However, both the approach of empirically supported therapies (EST) and the procedures of evidence-based medicine (EBM) have severe limitations making randomised controlled trials (RCTs) an absolute standard. After a critical discussion of this approach, the author reviews the empirical evidence for the efficacy of psychodynamic psychotherapy in specific psychiatric disorders. The review aims to identify for which psychiatric disorders RCTs of specific models of psychodynamic psychotherapy are available and for which they are lacking, thus providing a basis for planning further research. In addition, results of process research of psychodynamic psychotherapy are presented. As the methodology of RCTs is not appropriate for psychoanalytic therapy, effectiveness studies of psychoanalytic therapy are reviewed as well. Studies of psychodynamic psychotherapy published between 1960 and 2004 were identified by a computerised search using Medline, PsycINFO and Current Contents. In addition, textbooks and journal articles were used. Twenty-two RCTs were identified of which 64% had not been included in the 1998 report by Chambless and Hollon. According to the results, for the following psychiatric disorders at least one RCT providing evidence for the efficacy of psychodynamic psychotherapy was identified: depressive disorders (4 RCTs), anxiety disorders (1 RCT), post-traumatic stress disorder (1 RCT), somatoform disorder (4 RCTs), bulimia nervosa (3 RCTs), anorexia nervosa (2 RCTs), borderline personality disorder (2 RCTs), Cluster C personality disorder (1 RCT), and substance-related disorders (4 RCTs). According to results of process research, outcome in psychodynamic psychotherapy is related to the competent delivery of therapeutic techniques and to the development of a therapeutic alliance. With regard to psychoanalytic therapy, controlled quasi-experimental effectiveness studies provide evidence that psychoanalytic therapy is (1) more effective than no treatment or treatment as usual, and (2) more effective than shorter forms of psychodynamic therapy. Conclusions are drawn for future research.",0 +https://doi.org/10.1007/bf02691199,Acute versus chronic post-traumatic stress disorder,"A photographic lens and filter model is presented which outlines six steps between a person’s perception of stressful life events and their possible eventual development of an illness. Persons developing acute post-traumatic stress disorder differ markedly in their processing of early steps in the model compared to those who go on to suffer from chronic post-traumatic stress disorder. Persons with the acute disorder, with high likelihood of recovery, generally have had enriching early life experiences, use psychological defenses to a moderate degree, and demonstrate ample coping capabilities. Those going on to the chronic disorder, who frequently don’t recover, often report impoverished early life experiences, employ psychological defenses to an extreme degree, and show a paucity of coping skills. These differences are illustrated by histories from survivors of a terrorist bombing and by observations made by the author of returned prisoners of war and civilian hostages.",0 +https://doi.org/10.1006/nlme.2002.4083,Effects of Stress Hormones on Traumatic Memory Formation and the Development of Posttraumatic Stress Disorder in Critically Ill Patients,"A majority of patients after intensive care treatment report traumatic memories from their stay in the intensive care unit (ICU). Traumatic memories can be associated with the development of posttraumatic stress disorder (PTSD) in a subpopulation of these patients. In contrast to other patient populations at risk for PTSD, patients in the ICU often receive exogenously administered stress hormones like epinephrine, norepinephrine, or cortisol for medical reasons and are extensively monitored. ICU patients therefore represent a suitable population for studying the relationship between stress hormones, traumatic memories, and the development of PTSD. Studies in long-term survivors of ICU treatment demonstrated a clear and vivid recall of different categories of traumatic memory such as nightmares, anxiety, respiratory distress, or pain with little or no recall of factual events. The number of categories of traumatic memory recalled increased with the total administered dosages of stress hormones (both catecholamines and cortisol), and the evaluation of these categories at different time points after discharge from the ICU showed better memory consolidation with higher dosages of stress hormones administered. However, the administration of stress doses of cortisol to critically ill patients resulted in more complex findings as it caused a significant reduction in PTSD symptoms measured after recovery. This effect can possibly be explained by a differential influence of cortisol on memory. Increased serum cortisol levels not only result in consolidation of emotional memory but are also known to cause a temporary impairment in memory retrieval which appears to be independent of glucocorticoid effects on memory formation. Disrupting retrieval mechanisms with glucocorticoids during critical illness may therefore act protectively against the development of PTSD by preventing recall of traumatic memories. Our findings indicate that stress hormones influence the development of PTSD through complex and simultaneous interactions on memory formation and retrieval. Our studies also demonstrate that animal models of aversive learning are useful in analyzing and predicting clinical findings in critically ill humans.",0 +https://doi.org/10.1016/j.jpsychores.2015.01.003,The common link between functional somatic syndromes may be central sensitisation,"Functional somatic syndromes are common and disabling conditions that all include chronic pain, and which may be related to central nervous system sensitisation. Here, we address the concept of central sensitisation as a physiological basis for the functional somatic syndromes.A narrative review of the current literature on central sensitisation and physiological studies in the functional somatic syndromes.Central sensitisation may be a common neurophysiological process that is able to explain non-painful as well as painful symptoms in these disorders. Furthermore, central sensitisation may represent an endophenotypic vulnerability to the development of these syndromes that potentially explains why they cluster together.Further research is needed to verify these findings, including prospective studies and the standardisation of combined methods of investigation in the study of central sensitisation in functional somatic syndromes. In turn, this may lead to new explanatory mechanisms and treatments being evaluated. Our conclusions add to the debate over the nomenclature of these syndromes but importantly also provide an explanation for our patients.",0 +https://doi.org/10.3389/fnbeh.2013.00055,Heterogeneity in threat extinction learning: substantive and methodological considerations for identifying individual difference in response to stress,"Pavlovian threat (fear) conditioning (PTC) is an experimental paradigm that couples innate aversive stimuli with neutral cues to elicit learned defensive behavior in response to the neutral cue. PTC is commonly used as a translational model to study neurobiological and behavioral aspects of fear and anxiety disorders including Posttraumatic Stress Disorder (PTSD). Though PTSD is a complex multi-faceted construct that cannot be fully captured in animals PTC is a conceptually valid model for studying the development and maintenance of learned threat responses. Thus, it can inform the understanding of PTSD symptomatology. However, there are significant individual differences in posttraumatic stress that are not as of yet accounted for in studies of PTC. Individuals exposed to danger have been shown to follow distinct patterns: some adapt rapidly and completely (resilience) others adapt slowly (recovery) and others failure to adapt (chronic stress response). Identifying similar behavioral outcomes in PTC increases the translatability of this model. In this report we present a flexible methodology for identifying individual differences in PTC by modeling latent subpopulations or classes characterized by defensive behavior during training. We provide evidence from a reanalysis of previously examined PTC learning and extinction data in rats to demonstrate the effectiveness of this methodology in identifying outcomes analogous to those observed in humans exposed to threat. By utilizing Latent Class Growth Analysis (LCGA) to test for heterogeneity in freezing behavior during threat conditioning and extinction learning in adult male outbred rats (n = 58) three outcomes were identified: rapid extinction (57.3%), slow extinction (32.3%), and failure to extinguish (10.3%) indicating that heterogeneity analogous to that in naturalistic human studies is present in experimental animal studies strengthening their translatability in understanding stress responses in humans.",0 +https://doi.org/10.1016/s0145-2134(97)00178-6,Potential Mediators of Post-Traumatic Stress Disorder in Child Witnesses to Domestic Violence,"The aim was to examine variables that might mediate the incidence of Post-Traumatic Stress Disorder (PTSD) in child witnesses to domestic violence. These variables included age, gender, locus of control, self-blame, perception of threat, active versus palliative coping style, maternal emotional health plus aspects of the violence witnessed (intensity, frequency, age of child when first witnessing violence, and time since the last violent episode).Following screening for other PTSD inducing experiences, a sample of 20 child witnesses to domestic violence, 15 matched control children, and their mothers were assessed using the following tools: The Straus Conflict Tactics Scale; the Child Post-Traumatic Stress Reaction Index; the Nowicki-Strickland Locus of Control Scale; the General Health Questionnaire, and a Screening Questionnaire designed to elicit qualitative information from both children and mothers including data about any other potential PTSD inducing stressor the subject child may have been exposed to.None of the factors under examination were found to contribute significantly to the severity levels of Post-Traumatic Stress Disorder in relation to witness status.The small sample size of the study necessitates that the results be interpreted with caution. Nevertheless the findings indicate that the impact of witnessing domestic violence, in terms of PTSD, is not mediated by factors such as maternal emotional well-being, age and gender of the child, or the child's style of coping with parental conflict. Evidence that variables specifically related to the violence witnessed did not mediate the impact suggests that all domestic violence may have severe and long-term impact on child witnesses.",0 +https://doi.org/10.1017/s0033291705005751,"The relationship between post-traumatic stress disorder, depression and cardiovascular disease in an American Indian tribe","Background. Empirical findings suggest that psychiatric illness is associated with cardiovascular disease (CVD). The purpose of this study was to compare the strength of the association of lifetime post-traumatic stress disorder (PTSD) and lifetime major depression on CVD among Northern Plains American Indians. Method. A total of 1414 participants aged 18–57 years completed a structured interview that assessed psychiatric diagnoses, alcohol abuse/dependence, self-reported CVD, and traditional CVD risk factors including age, sex, education, diabetes, high blood pressure, and smoking. Logistic regression analyses compared the odds ratios of CVD in participants with and without diagnosed PTSD or major depression. Results. The rates of lifetime PTSD and major depression were 15% and 8% respectively. CVD was more commonly reported by participants with PTSD than by those without PTSD (12% v . 5%, p [les ]0·01). Likewise, more participants with major depression reported CVD than did their non-depressed counterparts (14% v . 6%, p [les ]0·05). PTSD was significantly associated with CVD even after controlling for traditional CVD risk factors and major depression (odds ratio 2·0, confidence interval 1·1–3·8). In contrast, the association of major depression with CVD was not significant after accounting for both traditional risk factors and PTSD. Conclusions. Rates of PTSD are high in American Indian communities. Rising CVD rates in this population may be better understood if PTSD is considered along with other traditional risk factors. Future research should examine the association and mechanisms of PTSD and CVD prospectively. Such data could lead to more effective CVD prevention efforts for American Indians.",0 +https://doi.org/10.4135/9781412986311.n19,Latent Variable Analysis: Growth Mixture Modeling and Related Techniques for Longitudinal Data,,0 +https://doi.org/10.1002/jts.20624,Predictors of rape: Findings from the National Survey of Adolescents,"The current report examines data for 872 female adolescents obtained during the initial and follow-up interviews of the National Survey of Adolescents, a nationally representative sample. Lifetime prevalence of violence exposure reported was 12% and 13% for sexual assault, 19% and 10% for physical assault/punishment, and 33% and 26% for witnessing violence at Waves I and II, respectively. Racial/ethnic status, posttraumatic stress disorder (PTSD), childhood sexual abuse (CSA), and family drug problems emerged as significant predictors of new rape. Each of the PTSD symptom clusters significantly predicted new rape and analyses supported the mediational role of PTSD between CSA and new rape. African American or other racial identity was associated with lower risk.",0 +https://doi.org/10.1097/htr.0b013e3182a1cd4e,Preliminary Examination of the Impact of Traumatic Brain Injury and Posttraumatic Stress Disorder on Self-Regulated Learning and Academic Achievement Among Military Service Members Enrolled in Postsecondary Education,"Delineate the effects of self-reported traumatic brain injury (TBI) or posttraumatic stress disorder (PTSD) on self-regulated learning and academic achievement for university-enrolled military Service members.Students (N = 192) from 8 regionally diverse universities, representing an estimated 6% of Service members enrolled across schools.Public universities that are members of the Servicemember Opportunity College consortium.Cross-sectional study evaluating the relationships between self-reported TBI, PTSD, and self-regulated learning variables and their contribution to academic achievement.Self-report of military service; symptoms of TBI and PTSD; self-regulation strategies including effort, time/environment regulation, and academic self-efficacy; and grade point average (GPA).There was no effect of self-reported TBI or PTSD on GPA, effort regulation, or time/environment regulation strategies; however, participants with TBI or PTSD reported significantly lower academic self-efficacy. Multiple regression analysis revealed self-efficacy was the strongest predictor of GPA among all participants, followed by military rank.The sample consisted of high achieving students responsive to a university administrator, which raises the possibility of sampling bias. Because of the low recruitment rate for this study and lack of published research on this subject, replicating the results is necessary before drawing generalizable conclusions about the population.",0 +https://doi.org/10.1177/0886260515590125,Sense of Coherence as a Determinant of Psychological Well-Being Across Professional Groups of Aid Workers Exposed to War Trauma,"The present study aims to test whether sense of coherence (SOC) acts as a determinant of positive psychological functioning in aid workers directly exposed to warfare. Specifically, we performed multiple regression analyses to compare different groups of aid workers in terms of the effects of SOC and cumulative trauma on their psychological distress. Palestinian helpers, both professional and non-professional ( N = 159) completed three self-reported measures: the General Health questionnaire, Sense of Coherence Scale, and Impact of Events Scale. The findings bear out the predictive power of SOC and posttraumatic stress disorder (PTSD) in relation to mental health across different professional groups. In particular, volunteers without a specific professional profile, psychiatrists, medical doctors, and less markedly counselors seemed to protect their mental health through a SOC. Clinical implications and recommendations for training and supervision are discussed.",0 +https://doi.org/10.1016/j.neuropharm.2011.04.028,Pain and post traumatic stress disorder – Review of clinical and experimental evidence,"Pain and Post Traumatic Stress Disorder (PTSD) are highly comorbid conditions. Patients with chronic pain have higher rates of PTSD. Likewise, patients with PTSD are often diagnosed with numerous chronic pain conditions. Despite the high pain-PTSD comorbidity, the neurobehavioral mechanisms underlying this phenomenon are incompletely understood and only recently researchers have started investigating it using experimental models. In this article, we systematically review the substantial clinical evidence on the co-occurrence of pain and PTSD, and the limited experimental evidence of pain processing in this disorder. We provide a detailed overview of the psychophysical and brain imaging experiments that compared somatosensory and pain processing in PTSD and non-PTSD populations. Based on the presented evidence, an extensive body of literature substantiates the clinical coexistence of pain and PTSD in patients but the limited experimental data show inconsistent results highlighting the need for well-controlled future studies. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0 +https://doi.org/10.1093/aje/kwn084,Psychiatric Diagnoses in Historic and Contemporary Military Cohorts: Combat Deployment and the Healthy Warrior Effect,"Research studies have identified heightened psychiatric problems among veterans of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). However, these studies have not compared incidence rates of psychiatric disorders across robust cohorts, nor have they documented psychiatric problems prior to combat exposure. The authors' objectives in this study were to determine incidence rates of diagnosed mental disorders in a cohort of Marines deployed to combat during OIF or OEF in 2001-2005 and to compare these with mental disorder rates in two historical and two contemporary military control groups. After exclusion of persons who had been deployed to a combat zone with a preexisting psychiatric diagnosis, the cumulative rate of post-OIF/-OEF mental disorders was 6.4%. All psychiatric conditions except post-traumatic stress disorder occurred at a lower rate in combat-deployed personnel than in personnel who were not deployed to a combat zone. The findings suggest that psychiatric disorders in Marines are diagnosed most frequently during the initial months of recruit training rather than after combat deployment. The disproportionate loss of psychologically unfit personnel early in training creates a ""healthy warrior effect,"" because only those persons who have proven their resilience during training remain eligible for combat.",0 +https://doi.org/10.1016/j.addbeh.2003.08.041,"Smoking patterns, symptoms of PTSD and depression: Preliminary findings from a sample of severely battered women","Intimate partner violence (IPV) is a public health problem that significantly impacts the physical and emotional well-being of women. In addition to the health risk associated with violence exposure, female victims of IPV are at increased risk of engaging in damaging health behaviors, including cigarette smoking. The present study examined patterns of cigarette smoking, using the Fagerström Test for Nicotine Dependence (FTND), and explored its association with sociodemographic factors, characteristics of physical, psychological, and sexual forms of IPV, symptoms of posttraumatic stress disorder (PTSD), and depression within 62 female victims of severe battering. Fifty-eight percent of the total sample reported that they were current smokers. Within the group of current smokers, women who evidenced greater symptoms of nicotine-related physical dependence (NRPD) were more likely to be unemployed, have less education, experience more recent violence, more severe IPV-related sexual coercion, more IPV-related dominance/isolation, and more severe symptoms of PTSD and depression. In addition, greater symptoms of NRPD were significantly and positively associated with PTSD clusters of reexperiencing and arousal. Implications for these preliminary findings were discussed and directions for future research were detailed.",0 +https://doi.org/10.1080/15374410802148228,"Social Support, Discrimination, and Coping as Predictors of Posttraumatic Stress Reactions in Youth Survivors of Hurricane Katrina","This study examined the influence of aspects of the post–Hurricane Katrina recovery environment (i.e., discrimination, social support) and coping behaviors on children's posttraumatic stress reactions (symptoms of posttraumatic stress disorder [PTSD], anxiety, and depression). Data corresponding to 46 youth (M = 11.43 years; 39% girls; 33% African American, 67% European American) revealed that greater helpfulness from extrafamilial sources of social support predicted lower levels of child-rated symptoms of PTSD, anxiety, and depression. A positive predictive relation was found between helpfulness from professional support sources and PTSD, perhaps suggesting that parents whose children were experiencing higher PTSD symptom levels sought professional support and reported it to be helpful. Youths' avoidant coping behaviors predicted both PTSD and anxiety symptoms. Discrimination, active coping, and familial support did not predict any of the posttraumatic stress reactions assessed in this study.",0 +https://doi.org/10.1016/j.brat.2010.05.019,An examination of the construct validity of posttraumatic stress disorder with veterans using a revised criterion set,"Ongoing concerns exist in the literature regarding the construct of posttraumatic stress disorder (PTSD) and how to best conceptualize and measure this disorder. We compared the traditional DSM-IV PTSD symptom criteria (i.e., symptoms from clusters B, C, and D) to a revised criterion set that omits overlapping mood and other anxiety symptoms on PTSD prevalence, PTSD diagnostic caseness, associated psychiatric comorbidity, functional status, and structural validity using a cross-sectional, multi-site primary care sample of 747 veterans. After removing items theorized to overlap with mood and other anxiety disorders, PTSD prevalence was identical using both criterion sets (i.e., 12%). Overall, there were few statistically significant differences in PTSD caseness, associated psychiatric comorbidity, functional status, and structural validity across the two diagnostic criterion sets. These data provide further support that removing items that overlap with other psychiatric disorders does not significantly impact the prevalence of PTSD, its associated comorbidity and functional impairment, or its structural validity. Although the revised criterion set represents a more parsimonious model, the current study findings generally support the strong construct validity of PTSD. The implications of these study findings for research and clinical practice are discussed.",0 +https://doi.org/10.1023/a:1007729116133,"Relationships among trauma exposure, chronic posttraumatic stress disorder symptoms, and self-reported health in women: Replication and extension","Fifty-two women who served during the Vietnam era were assessed for war-zone exposure, traumatic life events, post-traumatic stress disorder (PTSD), and self-reported health status. Symptoms of PTSD were examined as mediators in the relationship between traumatic exposure and subsequent reports of health problems. Results showed that PTSD symptoms accounted significantly for variance in health problems reported by women with prior traumatic stressor exposure. When the cardinal symptom domains of PTSD (re-experiencing, numbing, avoidance, hyper-arousal) were analyzed separately, the symptom cluster representing hyper-arousal accounted uniquely for the variance associated with health complaints, beyond that contributed by other symptom clusters. Discussion of the results focuses on mechanisms underlying the relationship between specific symptoms of PTSD and self-reported health. Implications for intervention within the medical system are also considered.",0 +https://doi.org/10.1037/0033-2909.130.2.228,Cognitive Approaches to Posttraumatic Stress Disorder: The Evolution of Multirepresentational Theorizing.,"The evolution of multirepresentational cognitive theorizing in psychopathology is illustrated by detailed discussion and analysis of a number of prototypical models of posttraumatic stress disorder (PTSD). Network and schema theories, which focus on a single, explicit aspect/format of mental representation, are compared with theories that focus on 2 or more explicit representational elements. The author argues that the latter theories provide a more complete account of PTSD data, though are not without their problems. Specifically, it is proposed that at least 3 separate representational elements-associative networks, verbal/propositional representations, and schemas-are required to generate a comprehensive cognitive theory of PTSD. The argument that the development of multirepresentational cognitive theory in PTSD is a paradigm case for the development of similar theories in other forms of psychopathology is elaborated, and a brief agenda is proposed promoting 2 levels of theorizing-deep, formal theory alongside more localized, applied theory.",0 +https://doi.org/10.1007/s00127-013-0756-1,"Configurations of early risk and their association with academic, cognitive, emotional and behavioural outcomes in middle childhood","PURPOSE: Risk factors for children's development are multifarious and co-occur, having cumulative as well as individual impacts. Yet common configurations of early childhood risks remain little understood. The current study aimed to identify patterns of early risk exposure and to examine their relationship with diverse outcomes in middle childhood. METHODS: Using latent class analysis in a large, community-based, UK sample (N = 13,699), we examined 13 putative risk factors to identify patterns of exposure. RESULTS: Four risk configurations were identified: low (65 %), socio-demographic (14 %), family dysfunction (12 %), and multiple (9 %) risk classes. As expected, children in the low risk group fared best on all outcome measures, and those with multiple risk, worst. Importantly, specificity in associations with outcomes emerged, such that cognitive outcomes were predominantly linked with socio-demographic adversities, emotional difficulties with family dysfunction, and conduct problems increased across risk classes. CONCLUSIONS: Better understanding of configurations of childhood risk exposures may help to target resources for children in need.",0 +https://doi.org/10.1002/ajhb.20981,Are cortisol profiles a stable trait during child development?,"Exposure to stressful experiences can increase vulnerability to adverse health outcomes. A potential neuroendocrine mechanism mediating the link between stress and health is the hypothalamic-pituitary-adrenal (HPA) system, with a key role attributed to the glucocorticoid hormone cortisol. Retrospective and cross sectional clinical studies of humans and experimental studies with nonhuman primates and rodents suggest that traumatic experiences during critical periods in development may have permanent effects on HPA regulation, which in turn can have deleterious effects on health. Here I report results from a continuous 20-year study (1988-2009) of children in a rural community on Dominica. Sequential data on cortisol levels, social stressors, and health in naturalistic, everyday conditions are examined to assess developmental trajectories of HPA functioning. Saliva aliquots were assayed for cortisol in concert with monitoring of growth, morbidity, and social environment. Analyses here include data from 1989 to 1999 for 147 children aged 3-16 years with >100 saliva samples each. Cortisol values were standardized by elapsed time since wake-up. Results do not support the hypothesis that traumatic stress during childhood causes permanent general elevation of cortisol levels.",0 +https://doi.org/10.1002/jclp.22100,Elucidating Posttraumatic Stress Symptom Profiles and Their Correlates Among Women Experiencing Bidirectional Intimate Partner Violence,"This study employed latent class analysis to identify profiles of women experiencing intimate partner violence (IPV) based on the severity of posttraumatic stress disorder (PTSD) symptoms.Self-report data from a sample of 369 women experiencing bidirectional IPV was used.A 3-class solution comprising low, moderate, and high PTSD severity profiles best fit the data. Profiles were differentially related to whether IPV victimization was considered traumatic (PTSD criterion A); whether functioning was impaired as a result of PTSD symptoms (PTSD criterion F); whether the woman met full diagnostic criteria for PTSD; depression symptom severity; and severity of psychological, physical, and sexual IPV victimization and use of IPV. An extremely high percentage of women in the high (96%) and moderate (88%) severity classes experienced functional impairment, although many did not meet full diagnostic criteria for PTSD.Findings support the need for interventions individually tailored to one's treatment needs based on the nature of one's traumatic stressor and the impact of PTSD on daily functioning.",0 +https://doi.org/10.1159/000090897,Morphometric and Psychometric Comparisons between Non-Substance-Abusing Patients with Posttraumatic Stress Disorder and Normal Controls,"<i>Background:</i> Hippocampal decrease in size in response to posttraumatic stress disorder (PTSD) is still a subject of controversy. The aims of this study were to: (1) confirm previous hippocampus findings in PTSD patients compared to controls, using ethnically similar study groups where alcohol and drug abuse were non-existent; (2) test influence of disease duration as well as depression scores on possible morphological changes; (3) test whether the voxel-based morphometry (VBM) data confirm the group differences seen in the region of interest (ROI) analysis, and (4) test the associations between the cognitive test scores and the morphological changes. <i>Methods:</i> VBM and ROI-based analysis were applied in 23 patients and 17 healthy controls. Culture-neutral cognitive tests were used. <i>Results:</i> The ROI-based method showed significantly decreased gray matter volumes for global hippocampal volume, as in a separate analysis of left and right sides in the PTSD group. Total volume of the hippocampus was significantly decreased on the left side, as in the global assessment. A multiple regression VBM model showed significant voxel clusters for group affiliation in the right hippocampus, modelling lowering of gray matter associated with the PTSD group. Disease duration was shown to be negatively correlated to bilateral hippocampal volume and high depression score to bilateral gray matter parahippocampal volume. No significant correlations were found between hippocampal or parahippocampal volumes and cognitive functions. <i>Conclusion:</i> The present and previous studies showed that morphologic differences do not appear to be due to drug or alcohol abuse. The VBM data partially confirm the group differences seen in the ROI-based method in the medial temporal lobe. The fact that the significantly lower score on the short-term memory test in the PTSD group is not correlated to hippocampal volume may suggest a more general basis for such memory impairment.",0 +https://doi.org/10.1177/1359104511426408,The validity of the DSM-IV PTSD criteria in children and adolescents: A review,"Objective: DSM-V is on its way and doubts have been raised regarding the validity of pediatric PTSD. It is the goal of the current review to critically review the empirical literature on PTSD in youth. Method: A search of PsycINFO, PubMed and reference lists was conducted. Empirical information considered relevant regarding the validity of the criteria was collected. Results/Conclusions: The validity of the symptom criteria and clusters varies, with the Avoidance/Numbing cluster outperforming the Re-experiencing—and Arousal cluster. Factor analytic findings suggest that Arousal criterion D4 should be placed within the Re-experiencing cluster, and that the Avoidance/Numbing cluster should be split up. Some non-DSM-IV PTSD symptoms, among which guilt, have considerable validity in trauma-exposed youth and their inclusion in DSM-V PTSD should be considered. As for preschool children, alternative criteria are recommended that are more developmentally sensitive.",0 +https://doi.org/10.1207/s15327752jpa7502_11,Feigning Combat-Related Posttraumatic Stress Disorder on the Personality Assessment Inventory,"This study examined whether individuals who were instructed on the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) criteria for posttraumatic stress disorder (PTSD) could feign PTSD on the Personality Assessment Inventory (PAI; Morey, 1991). The study also investigated whether PAI indexes of symptom exaggeration, the Negative Impression Management (NIM) scale and the Malingering index, could identify individuals feigning PTSD. The diagnostic rule for PTSD (Morey, 1991, 1996) was applied to the profiles of a group of 23 veterans with combat-related PTSD and 23 male undergraduates instructed to malinger PTSD. Seventy percent of the student malingerers produced profiles that received diagnostic consideration for PTSD. The NIM cutting score (> or = 8) was highly effective in detecting simulation of PTSD but resulted in the misclassification of a large number of true PTSD cases. There were no significant differences in the overall efficiency of the test with various validity criteria. We discuss the implications of these findings for the use of the PAI in the diagnosis of combat-related PTSD.",0 +https://doi.org/10.1016/s0740-5472(97)00120-7,Use of self-report measures of crime-related posttraumatic stress disorder with substance use disordered patients,"Researchers have documented that approximately three-quarters of all patients in treatment for a substance use disorder (SUD) report a history of sexual or physical assault and that at least 25% of treatment-seeking SUD patients suffer from crime-related posttraumatic stress disorder (CR-PTSD). To address the pressing need to accurately evaluate symptoms associated with victimization, a battery of self-report instruments and a semi-structured interview were administered to 114 SUD patients. More than 90% of the SUD patients reported some type of victimization and approximately 38% met criteria for current CR-PTSD. The self-report battery correctly classified CR-PTSD status in 79% of the respondents with a sensitivity rate of 82% and a specificity rate of 74%. The results indicate that: (a) there is a high prevalence of CR-PTSD in SUD patients, (b) CR-PTSD should be evaluated in every SUD patient, and (c) the self-report battery utilized in the present study may serve as a valid tool for an initial CR-PTSD screening or to supplement a clinical interview.",0 +https://doi.org/10.1300/j070v13n01_06,Involvement in High-Profile Child Sexual Abuse Controversies: Costs and Benefits,"The costs and benefits associated with participation in conflicts around child sexual abuse are explored. Using qualitative data from interviews with 40 high-profile participants, findings suggest that professionals experience both positive and negative consequences as a result of their involvement. Costs identified include attacks and misrepresentations, harm to health or emotional well-being, and career losses or changes. Benefits included personal growth, a sense of personal satisfaction, and career enhancement. Women were found to have experienced more impacts overall than men. Psychological theories about stress and coping and sociological theories about social movement participation are used to explore why people remain committed despite the risks associated with participation. Material rewards, commitment to change, the development of a highly salient identity, and the support of social networks may be contributing factors.",0 +https://doi.org/10.1055/s-0035-1544241,Neuropsychiatric Disturbances Associated with Traumatic Brain Injury: A Practical Approach to Evaluation and Management,"Traumatic brain injury (TBI) causes a wide variety of neuropsychiatric disturbances associated with great functional impairments and low quality of life. These disturbances include disorders of mood, behavior, and cognition, and changes in personality. The diagnosis of specific neuropsychiatric disturbances can be difficult because there is significant symptom overlap. Systematic clinical evaluations are necessary to make the diagnosis and formulate a treatment plan that often requires a multipronged approach. Management of TBI-associated neuropsychiatric disorders should always include nonpharmacological interventions, including education, family involvement, supportive and behavioral psychotherapies, and cognitive rehabilitation. Pharmacological treatments include antidepressants, anticonvulsants, antipsychotics, dopaminergic agents, and cholinesterase inhibitors. However, evidence-based treatments are extremely limited, and management relies on clinical empiricism and resemblance of TBI neuropsychiatric symptom profiles with those of idiopathic psychiatric disorders. Although the understanding of TBI-associated neuropsychiatric disorders has improved in the last decade, further research is needed including prospective, longitudinal studies to explore biomarkers that will assist with management and prognosis as well as randomized-controlled studies to validate pharmacological and nonpharmacological treatments. The current review summarizes the available literature in support of a structured, systematic evaluation approach and treatment options as well as recommendations for further research directions.",0 +https://doi.org/10.1002/jts.20576,Frequency and severity approaches to indexing exposure to trauma: The Critical Incident History Questionnaire for police officers,"The Critical Incident History Questionnaire indexes cumulative exposure to traumatic incidents in police by examining incident frequency and rated severity. In over 700 officers, event severity was negatively correlated (r(s) = -.61) with frequency of exposure. Cumulative exposure indices that varied emphasis on frequency and severity-using both nomothetic and idiographic methods-all showed satisfactory psychometric properties and similar correlates. All indices were only modestly related to posttraumatic stress disorder (PTSD) symptoms. Ratings of incident severity were not influenced by whether officers had ever experienced the incident. Because no index summarizing cumulative exposure to trauma had superior validity, our findings suggest that precision is not increased if frequency is weighted by severity.",0 +https://doi.org/10.1176/ajp.145.3.281,Toward rational pharmacotherapy for posttraumatic stress disorder: an interim report,"There is growing evidence that medication can alleviate symptoms associated with posttraumatic stress disorder (PTSD). Recent research also suggests that PTSD has a unique biological profile consisting of alterations in sympathetic arousal, the neuroendocrine system, and the sleep/dream cycle. This profile distinguishes PTSD from both major depression and panic disorder. Medication appears to alleviate PTSD symptoms associated with sympathetic hyperarousal and intrusive recollections of the trauma but seems ineffective against avoidant symptoms. Pharmacotherapy alone is rarely sufficient to provide complete remission of PTSD. Symptom relief provided by medication facilitates the patient's participation in individual, behavioral, or group psychotherapy.",0 +https://doi.org/10.1080/10253890701768613,Acute episodes of predator exposure in conjunction with chronic social instability as an animal model of post-traumatic stress disorder,"People who are exposed to horrific, life-threatening experiences are at risk for developing post-traumatic stress disorder (PTSD). Some of the symptoms of PTSD include persistent anxiety, exaggerated startle, cognitive impairments and increased sensitivity to yohimbine, an alpha(2)-adrenergic receptor antagonist. We have taken into account the conditions known to induce PTSD, as well as factors responsible for long-term maintenance of the disorder, to develop an animal model of PTSD. Adult male Sprague-Dawley rats were administered a total of 31 days of psychosocial stress, composed of acute and chronic components. The acute component was a 1-h stress session (immobilization during cat exposure), which occurred on Days 1 and 11. The chronic component was that on all 31 days the rats were given unstable housing conditions. We found that psychosocially stressed rats had reduced growth rate, reduced thymus weight, increased adrenal gland weight, increased anxiety, an exaggerated startle response, cognitive impairments, greater cardiovascular and corticosterone reactivity to an acute stressor and heightened responsivity to yohimbine. This work demonstrates the effectiveness of acute inescapable episodes of predator exposure administered in conjunction with daily social instability as an animal model of PTSD.",0 +https://doi.org/10.1016/j.psyneuen.2015.11.008,Oxytocin improves compassion toward women among patients with PTSD,"Although impairments in social skills, including empathic abilities, are common in post-traumatic stress disorder (PTSD), the ability to feel compassion-a pro-social behavior that is based on empathy and drives us to help others-has never been assessed among these patients. The first aim of this study was to examine whether patients with PTSD suffer from deficits in compassion and to examine the association between the clusters of PTSD symptoms and these deficits. Furthermore, given that intranasal oxytocin (OT) has been suggested to possibly modulate social behaviors, the second aim of this study was to investigate whether intranasal OT may enhance compassion in these patients. Using a randomized, double-blind, placebo-controlled crossover design, we administered 24 IU of OT and placebo at a one-week interval to 32 patients with PTSD and to 30 matched healthy control participants. The results indicate that patients with PTSD exhibit deficits in compassion and that the numbing cluster emerged as the key predictor of those deficits. Moreover, the results indicate that a single intranasal dose of OT enhances compassion toward women (but not towards men), both in patients with PTSD and in controls. These results offer support for recent suggestions that intranasal OT may potentially be an effective pharmacological intervention for patients with PTSD.",0 +https://doi.org/10.1111/1467-6494.00152,Doing and Being Well (for the Most Part): Adaptive Patterns of Narrative Self-Evaluation During Bereavement,"Narrative self-evaluation patterns were studied in relation to longitudinal measures of adaptation to the death of a spouse in midlife. Narrative self-evaluations, identified in open-ended interview transcripts at 6 months post-loss, were coded as either positive or negative and as either doing-based (evaluations of ""what one does"") or being-based (evaluations of ""what one is""). These narrative variables were then compared with separate, clinical-interview measures of grief at 6, 14, and 25 months post-loss. Results confirmed 3 predictions. First, participants who made an optimal proportion of positive to negative self-evaluations (approximately a 5:1 positive-to-negative ratio) had lower grief levels over time than did those who made either higher or lower proportions. Second, the tendency to focus on evaluations of what one does rather than what one is predicted lower grief levels over time. Third, participants who directly integrated doing-based and being-based self-evaluations had lower grief levels over time than those who did not link the 2 evaluations. Implications for the narrative construction of personal meaning and identity in relation to adaptation are discussed.",0 +https://doi.org/10.1037/e609072012-137,Relationships between dissociation and posttraumatic stress disorder,"(from the chapter) A review of the relationship between dissociation and PTSD is discussed by Simeon in Chapter 4. She suggests that four models can be identified to account for the association. The first model (comorbidity) views PTSD and dissociation as separate entities that may co-occur because of the nosological link to a common etiological factor (i.e., traumatic stress). The second model (shared risk factors) suggests that the link between PTSD and dissociation is through a common psychological and/or biological vulnerability (i.e., a diathesis). The third model (shared pathogenesis) posits that PTSD and dissociation have common pathogenetic mechanisms that are activated by trauma. The final model (same disorder) suggests that PTSD and dissociation are inseparable, with the current nosology unnecessarily creating artificial distinctions between them. While acknowledging that no model effectively accounts for the relationship between PTSD and dissociation, Simeon concludes that the first model, comorbidity, best captures the current data. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1007/s00520-015-2799-1,"Identifying trajectory clusters in breast cancer survivors’ supportive care needs, psychosocial difficulties, and resources from the completion of primary treatment to 8 months later","Purpose: This study aimed to chart patterns of simultaneous trajectories over 8 months in breast cancer survivors’ (BCS) supportive care needs, psychological distress, social support, and posttraumatic growth. Clusters of BCS among these trajectories were identified and characterized. Methods: Of 426 BCS study participants, 277 (65 %) provided full assessments in the last week of primary cancer treatment and 4 and 8 months later. Latent trajectories were obtained using growth mixture modeling for patients who responded to all scores for at least one time point (n = 348). Then, classification of BCS was performed by hierarchical agglomerative clustering on axes derived from a multiple factor analysis of trajectory assignments. Self-esteem, attachment security, and satisfaction with care were assessed at baseline. Results: Four trajectory clusters were identified, including two BCS subgroups (63 %) with low needs and low psychological distress. Two others (37 %) exhibited high or increasing needs and concerning levels of psychological distress. These latter clusters were characterized by higher insecure attachment, lower satisfaction with care, and either lower education or younger age, and having undergone chemotherapy. Conclusion: More than a third of BCS present unfavorable patterns in supportive care needs over 8 months after primary cancer treatment. Identified psychosocial and cancer care characteristics point to targets for enhanced BCS supportive care.",0 +https://doi.org/10.1159/000348451,Dialectical Behaviour Therapy for Post-traumatic Stress Disorder after Childhood Sexual Abuse in Patients with and without Borderline Personality Disorder: A Randomised Controlled Trial,"<b><i>Background:</i></b> Post-traumatic stress disorder (PTSD) with co-occurring severe psychopathology such as borderline personality disorder (BPD) is a frequent sequel of childhood sexual abuse (CSA). CSA-related PTSD has been effectively treated through cognitive-behavioural treatments, but it remains unclear whether success can be achieved in patients with co-occurring BPD. The aim of the present study was to determine the efficacy of a newly developed modular treatment programme (DBT-PTSD) that combines principles of dialectical behaviour therapy (DBT) and trauma-focused interventions. <b><i>Methods:</i></b> Female patients (n = 74) with CSA-related PTSD were randomised to either a 12-week residential DBT-PTSD programme or a treatment-as-usual wait list. About half of the participants met the criteria for co-occurring BPD. Individuals with ongoing self-harm were not excluded. The primary outcomes were reduction of PTSD symptoms as assessed by the Clinician-Administered PTSD Scale (CAPS) and by the Posttraumatic Stress Diagnostic Scale (PDS). Hierarchical linear models were used to compare improvements across treatment groups. Assessments were carried out by blinded raters at admission, at end of treatment, and at 6 and 12 weeks post-treatment. <b><i>Results:</i></b> Under DBT-PTSD the mean change was significantly greater than in the control group on both the CAPS (33.16 vs. 2.08) and the PDS (0.70 vs. 0.14). Between-group effect sizes were large and highly significant. Neither a diagnosis of BPD nor the severity or the number of BPD symptoms was significantly related to treatment outcome. Safety analyses indicated no increase in dysfunctional behaviours during the trial. <b><i>Conclusion: </i></b>DBT-PTSD is an efficacious treatment of CSA-related PTSD, even in the presence of severe co-occurring psychopathology such as BPD.",0 +https://doi.org/10.1007/978-3-319-13060-6_6,Trauma and Stressor-Related Disorders,"This chapter focuses on gender differences in trauma exposure and the development of posttraumatic sequelae over the life course. First, we review the prevalence of trauma exposure and posttraumatic sequelae with particular attention to comorbidity and disability or impairment. Second, we review psychobiological processes that explain risk for various types of posttraumatic sequelae with a focus on gender and comorbidity. Third, we review the DSM-5 diagnostic criteria for various disorders associated with trauma exposure. Fourth, we review the best available instruments designed to assess these disorders. Fifth, we review the current best practices for treatment of these conditions including psychopharmacology, psychotherapy, and combined approaches designed to treat comorbid conditions. We conclude that despite a large body of research documenting gender differences in trauma exposure and trauma-related disorders much work remains to be done in this area. © Springer International Publishing Switzerland 2015.",0 +https://doi.org/10.1016/j.childyouth.2010.06.024,"A mental health intervention for rural, foster children from methamphetamine-involved families: Experimental assessment with qualitative elaboration","Abstract This mixed method study describes the cultural adaptation, implementation and impact of a mental health intervention for individual rural children aged 7–17 from methamphetamine-involved families who are in foster care. Features of the culturally-shaped intervention include: 1) close collaboration with local professionals who provide the intervention over a seven month period; 2) provision of the intervention in and around children's homes; and 3) the use of local storytelling traditions in a narrative- and relationship-based intervention. As a group, children (N = 15) showed problematic levels of Childhood Behavior Checklist (CBCL) externalizing and total problem behaviors and symptoms of PTSD/dissociation during the pretest. Children were randomly assigned to an experimental group who received the intervention immediately (n = 8), or a wait-list control group (n = 7) who received the intervention at the end of the study. There was a significant interaction effect of time (pre and post test) and group on externalizing behavior with the trajectory of the experimental group improving while that of the control group worsened. Gains made by the experimental group were maintained over a seven month follow-up period. Comparative case studies, individual qualitative interviews and open-ended questionnaires provided rich elaboration of participants' experiences and illuminated complexities and challenges of the intervention.",0 +https://doi.org/10.1016/s2215-0366(15)00368-5,Post-traumatic stress symptoms 5 years after military deployment to Afghanistan: an observational cohort study,"Deployment can put soldiers at risk of developing post-traumatic stress symptoms. Despite several longitudinal studies, little is known about the timing of an increase in post-traumatic stress symptoms relative to pre-deployment. Longitudinal studies starting pre-deployment, in which participants are repeatedly measured over time, are warranted to assess the timing of an increase in symptoms to ultimately assess the timing of an increase in treatment demand after deployment.In this large observational cohort study, Dutch military personnel who were deployed to Afghanistan as part of the International Security Assistance Forces between March, 2005, and September, 2008, were assessed for post-traumatic stress symptoms with the Self-Rating Inventory for Post-traumatic Stress Disorder (SRIP) questionnaire. Participants were assessed 1 month before deployment and followed up at 1 month, 6 months, 12 months, 2 years, and 5 years after deployment, with changes in SRIP scores compared with pre-deployment using a mixed model analysis. The primary outcome was the total score of post-traumatic stress symptoms measured with SRIP at pre-deployment and the five follow-up assessments, with a score of 38 used as the cutoff to indicate substantial post-traumatic stress symptoms.Between March, 2005, and September, 2008, 1007 participants were recruited to this study. The results show two important effects of deployment on post-traumatic stress symptoms. A short-term symptom increase within the first 6 months after deployment (symptom increase coefficient for SRIP score vs pre-deployment [β] 0·99, 95% CI 0·50-1·48); and a long-term symptom increase at 5 years after deployment (β 1·67, 1·14-2·20).This study underlines the importance of long-term monitoring of the psychological health of soldiers after deployment because early detection of symptoms is essential to early treatment, which is related to improved psychological health.Dutch Ministry of Defense.",1 +https://doi.org/10.4172/2167-1222.1000167,Skin Conductance Response during Laboratory Stress in Combat Veterans with Post Traumatic Stress Disorder,"The primary objective was to assess skin conductance response (SCR) to a laboratory stressor in combat veterans with posttraumatic stress disorder (PTSD) compared to controls. The secondary objective was to evaluate the relationship between SCR and PTSD symptom clusters.15 combat/ PTSD, 15 combat/no PTSD, 15 no combat/no PTSD veterans had their SCR recording during aversive pictures from the International Affective Picture Scale.The groups had similar demographics and medical history (all p>.05). SCR was different between groups (F(2,42) = 4.34, p=.02). The combat/PTSD group had the highest response compared to both control groups. Numbing-avoiding was predictive of SCR (F(1,42)=12.72, p=.001), while re-experiencing and hyper-arousal were not (p's>.05).Increased SCR in the PTSD group validates previous studies. Numbing-avoiding PTSD cluster scores correlated with SCR values. These findings support current PTSD therapies that reduce avoidance behaviors.",0 +https://doi.org/10.1002/jclp.10135,Clinical presentations in combat veterans diagnosed with posttraumatic stress disorder,"This article investigated subtypes of symptom patterns among male combat veterans diagnosed with posttraumatic stress disorder (PTSD) through a cluster analysis of their Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Graham, Ben-Porath, Tellegen, Dahlstrom, & Kaemmer, 2001) clinical and validity scales. Participants were 126 veterans seeking outpatient treatment for combat-related PTSD at a Veterans Affairs Medical Center. Two well-fitting MMPI-2 cluster solutions (a four-cluster solution and a three-cluster solution) were evaluated with several statistical methods. A four-cluster solution was determined to best fit the data. Follow-up analyses demonstrated between-cluster differences on MMPI-2 ""fake bad"" scales and content scales, the Beck Depression Inventory (BDI; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961), Dissociative Experiences Scale (DES; Bernstein & Putnam, 1986), Mississippi Combat PTSD scale (M-PTSD; Keane, Caddall, & Taylor, 1988), and Clinician-Administered PTSD Scale (CAPS-1; Blake et al., 1990). Clusters also were different in disability-seeking status, employment status, and income. Implications for research and clinical practice using the MMPI-2 with combat veterans presenting with PTSD are briefly addressed.",0 +https://doi.org/10.1016/j.puhe.2009.09.017,"Prevalence of post-traumatic stress disorder in Sichuan Province, China after the 2008 Wenchuan earthquake","To estimate the prevalence of post-traumatic stress disorder (PTSD) and assess the associated risk factors among earthquake survivors in different areas after the Wenchuan earthquake in China.Cross-sectional multicluster sample surveys were employed using data collected from two counties.Surveys were conducted separately in Beichuan and Langzhong Counties in Sichuan Province, with a total of 1002 respondents. Beichuan County was damaged more severely than Langzhong County during the earthquake in May 2008. A total of 426 households were represented in the data, with a mean of 2.2 respondents per household. Data were collected using structured interviews and the Harvard Trauma Questionnaire.The prevalence of suspected PTSD was 45.5% (n=203) in Beichuan County (heavily damaged) and 9.4% (n=52) in Langzhong County (moderately damaged). Household income, living conditions (settlements), deaths in families and household damage were significantly related to the prevalence of suspected PTSD in heavily damaged areas.Interventions designed to reduce PTSD among populations affected by the May 2008 earthquake should focus on individuals with no household income, those living in shelters or temporary houses, those with damaged households, and those who experienced a death in the family. Governments should support income-generating activities and improve living conditions. Trained field personnel can assist with PTSD assessments and referrals, and existing rural healthcare services should be used to provide treatment for common psychiatric disorders.",0 +https://doi.org/10.1097/00004850-200403000-00005,"Remission in post-traumatic stress disorder (PTSD): effects of sertraline as assessed by the Davidson Trauma Scale, Clinical Global Impressions and the Clinician-Administered PTSD scale","Rates of remission were examined in two controlled 12-week studies of sertraline and placebo for post-traumatic stress disorder (PTSD). The performance of three scales was evaluated: the self-rated Davidson Trauma Scale (DTS), and two interviewer scales: the Clinician Administered PTSD Scale (CAPS) and Clinical Global Impressions (CGI). Sertraline proved significantly superior to placebo with respect to remission on all three ratings. Rates of remission were very similar for all scales, ranging from 23.1-26.3% for sertraline and 13.9-14.9% for placebo. Traditional thresholds for the CAPS and DTS were tested relative to the CGI and to each other. The CAPS and DTS thresholds of < 20 and < 18 were found to be valid.",0 +https://doi.org/10.1097/00003643-201306001-00312,The locomotor and behavioral patterns following both a singleinjection and double-injection rat model of subarachnoid hemorrhage,"Background and Goals of Study: Subarachnoid hemorrhage (SAH) has been described in humans to be associated with depression, anxiety and post-traumatic stress disorder. Yet, possibly due to the lack of experimental studies, little is known of the mechanism for post-SAH emotional and behavioral disturbances. Therefore, there is a great need for the development of animal models for post-SAH behavioral abnormalities. This study describes the neuro-behavioral profile of rats following both a single-injection and double-injection model of SAH. Materials and Methods: SAH was induced in 48 rats by 0.3 ml injection of autologous arterial blood into the cisterna magnum (single-injection model). Post-SAH vasospasm was induced in 24 of these rats by a second injection of blood into the cisterna magnum after 24 hours (double-injection model). 0.3 ml of saline was injected into the cisterna magnum of 24 additional rats (sham group). Neurological performance was measured at 24, 48 hours, 1, 2 and 3 weeks following SAH. 3 weeks after SAH, four behavioral tests were performed for the duration of 6 consequent days: open field test, sucrose preference test, elevated plus maze test and swimming test. Results and Discussion: There was impaired neurological performance by 24 hours following SAH (P< 0.0001). For the open field test, the double-injection model was associated with less total travel distance (P< 0.005), reduced mean velocity (P< 0.005), and less travel distance and time spent in the central part of the field (P< 0.05). Sucrose preference was impaired after SAH (P< 0.01). For the plus maze test, the single-injection model was associated with less open arm entries (P< 0.005), decreased time spent in open arms (P< 0.0005), decreased closed arm entries (P< 0.01), and decreased platform entries (P< 0.005). There was decreased time spent on the platform in rats after SAH (P< 0.005). There was more immobility time during the swimming test in both the single-injection (P< 0.005) and double-injection (P< 0.05) groups compared to the control group. Conclusions: The main finding of this study was that both, the single and double injection rat models of SAH, were associated with considerable behavioral disturbances including locomotor abnormalities, increased anxiety and depressive behavior.",0 +https://doi.org/10.1177/1078390315620609,Resilience Intervention for Young Adults With Adverse Childhood Experiences,"BACKGROUND: Adverse childhood experiences (ACEs) are correlated with risk behaviors of smoking, disordered eating, and alcohol and substance abuse. Such behaviors can lead to significant public health problems of chronic obstructive pulmonary disease, obesity, liver disease, and hypertension, yet some individuals do not appear to suffer negative consequences but rather bounce back. OBJECTIVE: To pilot the feasibility and potential efficacy of the Empower Resilience Intervention to build capacity by increasing resilience and health behaviors and decreasing symptoms and negative health behaviors with young adults in an educational setting who have had ACEs. DESIGN: A two-group pre–post repeated measures design to compare symptoms, health behaviors, and resilience and written participant responses. RESULTS: There was a statistically significant cohort by time interaction for physical activity in the intervention group. There was no significant change in risk behaviors or resilience score by cohort. Young adults in the intervention group reported building strengths, reframing resilience, and creating support connections. CONCLUSIONS: An increase in health behavior is theoretically consistent with this strengths-based intervention. Evaluating this intervention with a larger sample is important. Interrupting the ACE to illness trajectory is complex. This short-term empower resilience intervention, however, holds promise as an opportunity to reconsider the negative effects of the trauma of the past and build on strengths to develop a preferred future.",0 +https://doi.org/10.1016/s0079-6123(06)62018-9,Heat acclimation and cross-tolerance against novel stressors: genomic–physiological linkage,"Heat acclimation (AC) is a ""within lifetime"" reversible phenotypic adaptation, enhancing thermotolerance and heat endurance via a transition to ""efficient"" cellular performance when acclimatory homeostasis is reached. An inseparable outcome of AC is the development of cross-tolerance (C-T) against novel stressors. This chapter focuses on central plasticity and the molecular-physiological linkage of acclimatory and C-T responses. A drop in temperature thresholds (T-Tsh) for activation of heat-dissipation mechanisms and an elevated T-Tsh for thermal injury development imply autonomic nervous system (ANS) and cytoprotective network involvement in these processes. During acclimation, the changes in T-Tsh for heat dissipation are biphasic. Initially T-Tsh drops, signifying the early autonomic response, and is associated with perturbed peripheral effector cellular performance. Pre-acclimation values return when acclimatory homeostasis is achieved. The changes in the ANS suggest that acclimatory plasticity involves molecular and cellular changes. These changes are manifested by the activation of central peripheral molecular networks and post-translational modifications. Sympathetic induction of elevated HSP 72 reservoirs, with faster heat shock response, is only one example of this. The global genomic response, detected using gene-chips and cluster analyses imply upregulation of genes encoding ion channels, pumps, and transporters (markers for neuronal excitability) in the hypothalamus at the onset of AC and down regulation of metabotrophic genes upon long term AC. Peripherally, the transcriptional program indicates a two-tier defense strategy. The immediate transient response is associated with the maintenance of DNA and cellular integrity. The sustained response correlates with long-lasting cytoprotective-signaling networks. C-T is recorded against cerebral hypoxia, hyperoxia, and traumatic brain injury. Using the highly developed ischemic/reperfused heart model as a baseline, it is evident that C-T stems via protective shared pathways developed with AC. These comprise constitutive elevation of HIF 1alpha and associated target pathways, HSPs, anti-apoptosis, and antioxidative pathways. Collectively the master regulators of AC and C-T are still enigmatic; however, cutting-edge investigative techniques, using a broad molecular approach, challenge current ideas, and the data accumulated will pinpoint novel pathways and provide new perspectives.",0 +https://doi.org/10.1186/1756-0500-5-199,Effects of a dolphin interaction program on children with autism spectrum disorders – an exploratory research,"Interaction programs involving dolphins and patients with various pathologies or developmental disorders (e.g., cerebral palsy, intellectual impairment, autism, atopic dermatitis, post-traumatic stress disorder, depression) have stimulated interest in their beneficial effects and therapeutic potential. However, the true effects observed in different clinical and psycho-educational setups are still controversial.An evaluation protocol consisting of the Childhood Autism Rating Scale (CARS), Psychoeducational Profile-Revised (PEP-R), Autism Treatment Evaluation Checklist (ATEC), Theory of Mind Tasks (ToM Tasks) and a custom-made Interaction Evaluation Grid (IEG) to evaluate behavioural complexity during in-pool interactions was applied to 10 children diagnosed with Autism Spectrum Disorders. The ATEC, ToM Tasks and CARS results show no benefits of the dolphin interaction program. Interestingly, the PEP-R suggests some statistically significant effects on 'Overall development score', as well as on their 'Fine motor development', 'Cognitive performance' and 'Cognitive verbal development'. Also, a significant evolution in behavioural complexity was shown by the IEG.This study does not support significant developmental progress resulting from the dolphin interaction program.",0 +https://doi.org/10.1016/j.injury.2011.01.002,Clinical evaluation of the Trauma Outcome Profile (TOP) in the longer-term follow-up of polytrauma patients,"No sufficiently validated disease-specific instrument is available to assess patient outcome after polytrauma. The aim of this investigation was to test the recently published Trauma Outcome Profile (TOP) in the longer-term outcome of multiply injured patients.Single centre validation study on the TOP in comparison with objective and subjective measures of patient, injury or treatment characteristics and longer-term outcome (e.g. medical outcomes study Short Form-36, SF-36; Nottingham Health Profile, NHP; working capacity), at least 2 years following trauma in 117 survivors of polytrauma (injury severity score, ISS>16), using comparative analysis and correlation testing of prospectively collected data.Patients' mean weighted self-rating with regard to the 10 single TOP dimensions of Health Related Quality of Life (HRQoL, 0-100) ranged from lowest values for mental functioning (52.6+33.5) to highest values for daily activities (79.0+27.5). The rate of persons who indicated an abnormal level of function or pain increased significantly from pre-injury status (2% and 5%, resp.) to 46% for both values at longer-term follow-up (p<0.001). Observed associations between single dimensions or TOP component summary scores with the corresponding values from general HRQol instruments, such as the SF-36, resulted in R (Pearson) up to 0.85. Survivors of polytrauma who presented with a reduced working capacity (RWC) at longer-term follow-up in all TOP dimensions included a significantly higher rate of patients conspicuous for a relevantly reduced outcome compared with those with a non reduced working capacity (NRWC) (posttraumatic stress disease, PTSD: p<0.05; all other dimensions: p<0.001). Patients with a RWC were characterised by an almost fivefold probability of reduced outcome with regard to the TOP dimensions 'social interaction' or 'satisfaction' (odds ratio, OR 12.4 (95% CI 5.1-30.1) and 12.5 (4.0-39.0), resp.).This first clinical and methodological evaluation in a well defined cohort of polytrauma patients found the TOP to be a reliable and well discriminating score covering both relevant general and trauma-specific aspects of longer-term outcome. Despite these promising primary results, until further validation, the TOP should be used together with already accepted HRQoL measures to allow adequate international comparison of data in the future.",0 +https://doi.org/10.1007/s11136-007-9201-9,Effect of trauma on quality of life as mediated by mental distress and moderated by coping and social support among postconflict displaced Ethiopians,"Objective: An understanding of how quality of life is affected by severe trauma and mental distress may facilitate better intervention strategies for postconflict internally displaced persons, by identifying mediators, moderators, and independent risk factors. We investigate the pathways involved in this process and also study the moderating roles of coping strategies and perceived social support. Method: A random sample of 1193 (62% women) internally displaced Ethiopian adults living in shelters in Addis Ababa were interviewed with instruments capturing the relevant concepts, including SCL-90-R and WHOQOL-BREF. Path analysis was employed to elaborate the mediating and moderating effects. Self-reported living conditions were also assessed. Results: Mental distress increased and quality of life decreased with age. Mental distress mediated the effects of trauma in reducing the quality of life, and some trauma also reduced quality of life directly. These effects remained after adjusting for living conditions. Living conditions were related to quality of life also on their own. Coping strategies and perceived social support influenced mental distress and quality of life directly as well as indirectly by moderation, in part gender specific. Conclusions: Intervention strategies aimed at reducing mental distress, modifying coping strategies, and encouraging social support may turn out to be useful in increasing the overall quality of life in postconflict situations, and are worth considering as complements to strategies that improve the living conditions. © 2007 Springer Science+Business Media B.V.",0 +https://doi.org/10.1176/appi.ajp.157.4.626,Two-Year Prospective Evaluation of the Relationship Between Acute Stress Disorder and Posttraumatic Stress Disorder Following Mild Traumatic Brain Injury,"To assess the ability of acute stress disorder to predict posttraumatic stress disorder (PTSD), the relationship between acute stress disorder and PTSD over the 2 years following mild traumatic brain injury was determined.Survivors of motor vehicle accidents who sustained mild traumatic brain injuries were assessed for acute stress disorder within 1 month of the trauma (N=79) and for PTSD at 6 months (N=63) and 2 years (N=50) posttrauma.Acute stress disorder was diagnosed in 14% of the patients. Among the patients who participated in all three assessments, 80% of the subjects who met the criteria for acute stress disorder were diagnosed with PTSD at 2 years. Of the total initial group, 73% of those diagnosed with acute stress disorder had PTSD at 2 years.This study provides further support for the utility of the acute stress disorder diagnosis as a predictor of PTSD but indicates that the predictive power of the diagnostic criteria can be increased by placing greater emphasis on reexperiencing, avoidance, and arousal symptoms.",0 +https://doi.org/10.1177/070674370204701003,"Epidemiologic Studies of Trauma, Posttraumatic Stress Disorder, and other Psychiatric Disorders","This paper reviews recent epidemiologic studies of posttraumatic stress disorder (PTSD) in the general population. Estimates of the prevalence of exposure to traumatic events vary with the method used to ascertain trauma exposure and the definition of the stressor criterion. Changes in the DSM-IV definition of ""stressor"" have increased the number of traumatic events experienced in the community that can be used to diagnose PTSD and thus, the number of PTSD cases. Risk factors for PTSD in adults vary across studies. The 3 factors identified as having relatively uniform effects are 1) preexisting psychiatric disorders, 2) a family history of disorders, and 3) childhood trauma. In civilian populations, women are at a higher risk for PTSD than are men, following exposure to traumatic events. Most community residents have experienced 1 or more PTSD-level traumas in their lifetime, but only a few succumb to PTSD. Trauma victims who do not succumb to PTSD are not at an elevated risk for the subsequent onset of major depression or substance use disorders, compared with unexposed persons.",0 +https://doi.org/10.1016/j.janxdis.2009.10.002,Testing alternative factor models of PTSD and the robustness of the dysphoria factor,"This study first aimed to examine the structure of self-reported posttraumatic stress disorder (PTSD) symptoms using three different samples. The second aim of the paper was to test the robustness of the factor analytic model when depression scores were controlled for.Based on previous factor analytic findings and the DSM-IV formulation, six confirmatory factor models were specified and estimated that reflected different symptom clusters. The best fitting model was subsequently re-fitted to the data after including a depression variable.The analyses were based on responses from 973 participants across three samples. Sample 1 consisted of 633 parents who were members of 'The National Association of Infant Death' and who had lost a child. Sample 2 consisted of 227 victims of rape, who completed a questionnaire within 4 weeks of the rape. Each respondent had been in contact with the Centre for Rape Victims (CRV) at the Aarhus University Hospital, Denmark. Sample 3 consisted of 113 refugees resident in Denmark. All participants had been referred to a treatment centre which focused on rehabilitating refugees through treatment for psychosocial integration problems (RRCF: Rehabliterings og Revliderings Centre for Flygtninge). In total 500 participants received a diagnosis of PTSD/sub-clinical PTSD (Sample 1, N=214; 2, N=176; 3, N=110).A correlated four-factor model with re-experiencing, avoidance, dysphoria, and arousal factors provided the best fit to the sample data. The average attenuation in the factor loadings was highest for the dysphoria factor (M=-.26, SD=.11) compared to the re-experiencing (M=-.14, SD=.18), avoidance (M=-.10, SD=.21), and arousal (M=-.09, SD=.13) factors.With regards to the best fitting factor model these results concur with previous research findings using different trauma populations but do not reflect the current DSM-IV symptom groupings. The attenuation of dysphoria factor loadings suggests that dysphoria is a non-specific component of PTSD.",0 +https://doi.org/10.1080/15298868.2015.1037791,Investigation of the Relation Between PTSD Symptoms and Self-Compassion: Comparison Across DSM IV and DSM 5 PTSD Symptom Clusters,Self-compassion is posited to protect against posttraumatic stress disorder (PTSD) symptoms after exposure to traumatic events. Prior work has suggested self-compassion may only be related to avoidance symptoms using DSM IV criteria. Changes to the diagnosis in DSM 5 may have changed these relations. The current study examined the relation between self-compassion and PTSD symptoms using DSM IV and DSM 5 criteria. PTSD symptoms and self-compassion were evaluated in two trauma-exposed samples using measures that corresponded to DSM IV and DSM 5 criteria. Self-compassion was negatively correlated with aggregated PTSD symptoms for DSM IV and DSM 5. Self-compassion was correlated with avoidance symptoms for DSM IV but was correlated with all symptom clusters for the DSM 5. These results suggest that self-compassion may protect against PTSD symptoms using the most recent diagnostic criteria.,0 +https://doi.org/10.1177/107319110100800210,The Detection of Malingered Posttraumatic Stress Disorder with MMPI-2 Fake Bad Indices,"This investigation explored the effect of posttraumatic stress disorder (PTSD) simulation on Minnesota Multiphasic Personality Inventory-2 (MMPI-2) responses, to detect malingered from genuine PTSD. Sixty-four adult PTSD outpatients at a child sexual abuse (CSA) survivor treatment program were compared with 85 adult college students instructed and trained to malinger PTSD. MMPI-2 overreporting indices examined were F, F-Fb, F-K, F(p), Ds2, O-S, OT, and FBS. A stepwise discriminant analysis identified F(p), F-K, and O-S as the best malingering predictors. A predictive discriminant analysis yielded good hit rates for the model, with impressive cross-validation results. Cutoff scores were assessed for the model's predictors. Clinical implications for detecting malingered PTSD using the MMPI-2 are discussed.",0 +https://doi.org/10.1176/ajp.142.6.741,"Posttraumatic stress disorder, hypnotizability, and imagery","Twenty-six Vietnam veterans were studied to determine the relationship between posttraumatic stress disorder and hypnotizability. The intensity of their posttraumatic stress disorder was measured by a self-report. Their hypnotizability scores, vividness of imagery scores, and symptomatic profiles were also ascertained. Veterans with low or no posttraumatic stress disorder scores had normal hypnotizability scores and normal imagery scores, whereas those with high posttraumatic stress disorder scores had high hypnotizability scores and high imagery scores. The authors conclude that either combat traumas enhanced hypnotic potential in some veterans or that veterans with excellent hypnotic potential to begin with were more susceptible to posttraumatic stress.",0 +https://doi.org/10.1016/j.beth.2011.03.001,"Psychometric Properties of the Mobility Inventory for Agoraphobia: Convergent, Discriminant, and Criterion-Related Validity","Aims of this study were (a) to summarize the psychometric literature on the Mobility Inventory for Agoraphobia (MIA), (b) to examine the convergent and discriminant validity of the MIA's Avoidance Alone and Avoidance Accompanied rating scales relative to clinical severity ratings of anxiety disorders from the Anxiety Disorders Interview Schedule (ADIS), and (c) to establish a cutoff score indicative of interviewers' diagnosis of agoraphobia for the Avoidance Alone scale. A meta-analytic synthesis of 10 published studies yielded positive evidence for internal consistency and convergent and discriminant validity of the scales. Participants in the present study were 129 people with a diagnosis of panic disorder. Internal consistency was excellent for this sample, α=.95 for AAC and .96 for AAL. When the MIA scales were correlated with interviewer ratings, evidence for convergent and discriminant validity for AAL was strong (convergent r with agoraphobia severity ratings=.63 vs. discriminant rs of .10-.29 for other anxiety disorders) and more modest but still positive for AAC (.54 vs. .01-.37). Receiver operating curve analysis indicated that the optimal operating point for AAL as an indicator of ADIS agoraphobia diagnosis was 1.61, which yielded sensitivity of .87 and specificity of .73.",0 +https://doi.org/10.1016/j.bbi.2010.12.001,Suppressed monocyte gene expression profile in men versus women with PTSD,"There have been several attempts to use gene microarrays from peripheral blood mononuclear cells to identify new biological pathways or targets for therapy in Posttraumatic Stress Disorder (PTSD). The few studies conducted to date have yielded an unclear pattern of findings, perhaps reflecting the use of heterogeneous samples of circulating immune cells for analysis. We used gene microarrays on a homogeneous sample of circulating monocytes to test the hypothesis that chronic PTSD would be associated with elevated inflammatory activity and to identify new pathways dysregulated in the disorder. Forty-nine men (24 PTSD+ and 25 age-matched trauma-exposed PTSD- controls) and 18 women (10 PTSD+ and 8 age-matched PTSD- controls) were recruited. Gene expression microarray analysis was performed on CD14+ monocytes, immune cells that initiate and respond to inflammatory signaling. Male subjects with PTSD had an overall pattern of under-expression of genes on monocytes (47 under-expressed versus 4 over-expressed genes). A rigorous correction for multiple comparisons and verification with qPCR showed that of only 3 genes that were differentially expressed, all were under-expressed. There was no transcriptional evidence of chronic inflammation in male PTSD+ subjects. In contrast, preliminary data from our pilot female PTSD+ subjects showed a relatively balanced pattern of increased and decreased expression of genes and an increase in activity of pathways related to immune activation. The results indicate differential patterns of monocyte gene expression in PTSD, and the preliminary data from our female pilot subjects are suggestive of gender dimorphism in biologic pathways activated in PTSD. Changes in immune cell gene expression may contribute to medical morbidity in PTSD.",0 +https://doi.org/10.4306/pi.2015.12.2.190,The Psychometric Properties of the Korean Version of the Verbal Abuse Questionnaire in University Students,"The aim of the present study was to examine the psychometric properties of the Korean Verbal Abuse Questionnaire (K-VAQ) that consists of 15 items related with life-time verbal aggression exposure.A total of 5814 university students who agreed to take part in the study completed the K-VAQ, the Korean version of the Life Event CheckList (LEC-K) and Impact of Event Scale-Revised (K-IES-R). Internal consistency was checked by using item-total item correlation and Cronbach's alpha coefficient. Exploratory and confirmatory factor analyses were performed, and convergent and concurrent validity levels were examined. Finally, a cluster analysis was conducted to verify the validity of the cutoff point of the K-VAQ.The Cronbach's alpha correlation coefficient was 0.9. The K-VAQ showed a single factor structure which explained 55.34% of the total variance. The K-VAQ was significantly associated with the LEC-K (r=0.24) and K-IES-R (r=0.28), indicating good convergent validity and concurrent validity. The cluster analysis provided four clusters of trauma experiences: high, moderate, low, and minimal, with K-VAQ ranges of 43-81, 20-42, 7-19, and 0-6, respectively. In a further investigation, a K-VAQ score of 40 was found to be the appropriate cutoff point to delineate the highly verbally abused group, as used in the previous studies. A sum of 36.5% of the highly verbally abused group reported to show substantial symptoms of PTSD (K-IES-R score >22).The present findings suggest that the K-VAQ has good psychometric properties for assessing verbal aggression among the Korean population.",0 +https://doi.org/10.1017/s1352465805002419,The Children's Revised Impact of Event Scale (CRIES): Validity as a Screening Instrument for PTSD,"The Children's Revised Impact of Event Scale (CRIES) is a brief child-friendly measure designed to screen children at risk for Posttraumatic Stress Disorder (PTSD). It has good face and construct validity, a stable factor structure, correlates well with other indices of distress, and has been used to screen very large samples of at-risk-children following a wide range of traumatic events. However, few studies have examined the scale's validity against a structured diagnostic interview based on the DSM-IV criteria for PTSD. In the present study, the CRIES and the PTSD section of the Anxiety Disorders Interview Schedule-Child and Parent Version (ADIS-CP) were administered to a sample of children and adolescents ( n =63) recruited from hospital accident and emergency rooms and the validity of the CRIES as a screening tool evaluated. Cutoff scores were chosen from this sample with a low base-rate of PTSD (11.1%) to maximize sensitivity and minimize the likelihood that children with a diagnosis of PTSD would fail to be identified. Cutoff scores were then cross-validated in a sample of 52 clinically referred children who had a high base-rate of PTSD (67.3%). A cutoff score of 30 on the CRIES-13 and a cutoff score of 17 on the CRIES-8 maximized sensitivity and specificity, minimized the rate of false negatives, and correctly classified 75–83% of the children in the two samples. The CRIES-8 (which lacks any arousal items) worked as efficiently as the CRIES-13 (which includes arousal items) in correctly classifying children with and without PTSD. Results are discussed in light of the current literature and of the need for further development of effective screens for children at-risk of developing PTSD.",0 +https://doi.org/10.1016/j.psychres.2008.11.016,Olfactory anhedonia and negative olfactory alliesthesia in depressed patients,"The present study aimed to investigate olfactory anhedonia and olfactory negative alliesthesia in depressed patients. Two odorants, one with pleasant (vanillin), and one with unpleasant (butyric acid) hedonic valence were evaluated by 30 depressed inpatients and 30 controls (healthy subjects, matched by age and gender). Participants explored the hedonic valence, intensity (discrimination) and perceived quality (identification) of 16 different stimuli (3 concentrations of odorants, their 9 combinations, and 1 control containing distilled water). The hedonic perception showed that patients perceived the unpleasant odorant as significantly more unpleasant than controls (olfactory negative alliesthesia). Concerning the intensity ratings, controls were able to discriminate between all concentrations of odorants, while patients discriminated between the different concentrations only for the unpleasant component and not for the vanillin (olfactory anhedonia). Regarding the identification task in an iso-intense unmixed odorants mixture, patients perceived significantly less the pleasant odorant than the unpleasant one (olfactory anhedonia), whereas controls perceived both odorants equally well. These results support the notion of an olfactory perception impairment in depression. Further studies are needed to replicate these findings and to confirm that such olfactory anhedonia or/and olfactory negative alliesthesia could be a state or a trait of depression.",0 +https://doi.org/10.1007/s10182-011-0171-4,Growth mixture models in longitudinal research,"Latent growth curve models as structural equation models are extensively discussed in various research fields (Curran and Muthén in Am. J. Community Psychol. 27:567-595, 1999; Duncan et al. in An introduction to latent variable growth curve modeling. Concepts, issues and applications, 2nd edn., Lawrence Earlbaum, Mahwah, 2006; Muthén and Muthén in Alcohol. Clin. Exp. Res. 24(6):882-891, 2000a; in J. Stud. Alcohol. 61:290-300, 2000b). Recent methodological and statistical extension are focused on the consideration of unobserved heterogeneity in empirical data. Muthén extended the classic structural equation approach by mixture components, i. e. categorical latent classes (Muthén in Marcouldies, G. A., Sckumacker, R. E. (eds.), New developments and techniques in structural equation modeling, pp. 1-33, Lawrance Erlbaum, Mahwah, 2001a; in Behaviometrika 29(1):81-117, 2002; in Kaplan, D. (ed.), The SAGE handbook of quantitative methodology for the social sciences, pp. 345-368, Sage, Thousand Oaks, 2004). The paper discusses applications of growth mixture models with data on delinquent behavior of adolescents from the German panel study Crime in the modern City (CrimoC) (Boers et al. in Eur. J. Criminol. 7:499-520, 2010; Reinecke in Delinquenzverläufe im Jugendalter: Empirische Überprüfung von Wachstums- und Mischverteilungsmodellen, Institut für sozialwissenschaftliche Forschung e. V., Münster, 2006a; in Methodology 2:100-112, 2006b; in van Montfort, K., Oud, J., Satorra, A. (eds.), Longitudinal models in the behavioral and related sciences, pp. 239-266, Lawrence Erlbaum, Mahwah, 2007). Observed as well as unobserved heterogeneity will be considered with growth mixture models. Special attention is given to the distribution of the outcome variables as counts. Poisson and negative binomial distributions with zero inflation are considered in the proposed growth mixture models variables. Different model specifications will be emphasized with respect to their particular parameterizations. © 2011 Springer-Verlag.",0 +https://doi.org/10.1080/02646838.2015.1031646,Post-traumatic stress disorder following childbirth: an update of current issues and recommendations for future research,"Objective: This paper aimed to report the current status of research in the field of post-traumatic stress disorder following childbirth (PTSD FC), and to update the findings of an earlier 2008 paper. Background: A group of international researchers, clinicians and service users met in 2006 to establish the state of clinical and academic knowledge relating to PTSD FC. A paper identified four key areas of research knowledge at that time. Methods: Fourteen clinicians and researchers met in Oxford, UK to update the previously published paper relating to PTSD FC. The first part of the meeting focused on updating the four key areas identified previously, and the second part on discussing new and emerging areas of research within the field. Results: A number of advances have been made in research within the area of PTSD FC. Prevalence is well established within mothers, several intervention studies have been published, and there is growing interest in new areas: staff and pathways; prevention and early interven...",0 +https://doi.org/10.1016/j.socscimed.2011.11.022,"Uses and abuses of the resilience construct: Loss, trauma, and health-related adversities",,0 +,"Social Support, Posttraumatic Stress, and Postpartum Depressive Symptomatology among Japanese Women","Background: In Japan, 13% of new mothers suffered from elevated postpartum depressive symptomatology (PPDS), and one-third of women had posttraumatic stress (PTS) symptoms following birth. Western researchers reported that women with elevated PPDS often had more PTS symptoms following birth. Although the importance of social support to alleviate PTS or PPDS has been reported, the role of social support in the relationship between PTS and PPDS is not known. Understanding how social support affects the relationship between PTS and PPDS is necessary to develop effective interventions to prevent elevated PPDS. Purpose: To examine the role of social support in the relationship between PTS and PPDS among Japanese women. Design and Methods: This study was a cross-sectional secondary data analysis. The study sample consisted of 207 Japanese women between one and three months after giving birth. Based on the Stress Process Model, two conceptual models (moderation and mediation), consisting of four study concepts (PPDS, PTS, social support, and maternal background factors) were examined, as well as the prediction model to examine the direct effect of each predictor on PPDS. PPDS was measured with the Postpartum Depression Screening Scale Short Form. PTS was measured with two items of posttraumatic stress disorder symptoms. Social support (by a partner/others) was measured with the adaptation of the Medical Outcomes Study Social Support Survey. Both multiple linear regressions and path analyses were used to examine the proposed models. Results: Ninety-seven (46.9%) women had elevated PPDS. One hundred two (49.3%) women experienced at least one PTS symptom. PTS following birth ( = .24), health promotion behaviors ( = -.31), partner support ( = -.15), others' support ( = - .14), physical health problems ( = .14), and parity ( = -.13) had significant direct effects on PPDS (R2 = .30). However, neither a moderating effect of social support on the relationship between PTS and PPDS nor a mediating effect of PTS on the relationship between social support and PPDS was supported in this study. Conclusions: Mental health care focusing on PTS following birth will contribute to preventing depressive symptoms. From the current study results, alternative moderation and mediation models that include coping or self-concepts are suggested for future study. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0 +https://doi.org/10.1016/j.pscychresns.2013.07.013,Regional homogeneity and resting state functional connectivity: Associations with exposure to early life stress,"Early life stress (ELS) confers risk for psychiatric illness. Previous literature suggests ELS is associated with decreased resting-state functional connectivity (rs-FC) in adulthood, but there are no studies of resting-state neuronal activity in this population. This study investigated whether ELS-exposed individuals demonstrate resting-state activity patterns similar to those found in PTSD. Twenty-seven adults (14 with at least moderate ELS), who were medication-free and without psychiatric or medical illness, underwent MRI scans during two 4-minute rest periods. Resting-state activity was examined using regional homogeneity (ReHo), which estimates regional activation patterns through indices of localized concordance. ReHo values were compared between groups, followed by rs-FC analyses utilizing ReHo-localized areas as seeds to identify other involved regions. Relative to controls, ELS subjects demonstrated diminished ReHo in the inferior parietal lobule (IPL) and superior temporal gyrus (STG). ReHo values were inversely correlated with ELS severity. Secondary analyses revealed decreased rs-FC between the IPL and right precuneus/posterior cingulate, left fusiform gyrus, cerebellum and caudate in ELS subjects. These findings indicate that ELS is associated with altered resting-state activity and connectivity in brain regions involved in trauma-related psychiatric disorders. Future studies are needed to evaluate whether these associations represent potential imaging biomarkers of stress exposure.",0 +https://doi.org/10.1176/ajp.154.6.752,Prevalence and risk factors for posttraumatic stress disorder among chemically dependent adolescents,"OBJECTIVE: This study ascertained the prevalence of posttraumatic stress disorder (PTSD) among chemically dependent adolescents and identified factors that influence the risk of PTSD after a qualifying trauma. METHOD: The study group consisted of 297 adolescents aged 15-19 years who met the DSM-III-R criteria for dependence on alcohol or other drugs and who were receiving treatment in seven publicly funded Massachusetts facilities. PTSD and other axis I diagnoses were assessed by the Diagnostic Interview Schedule. Data on risk factors were collected by a specially constructed interview schedule. RESULTS: The lifetime prevalence of PTSD was 29.6% (24.3% for males and 45.3% for females), and the current prevalence was 19.2% (12.2% for males and 40.0% for females). These prevalences reflect a high occurrence of traumatic exposures and a high case rate among those who experienced trauma. The risk of PTSD varied with the nature of the trauma, the number of traumas experienced, psychiatric comorbidity, and familial characteristics. The higher rate of PTSD among females was due to a greater frequency of rape, which carries a high risk of PTSD development, and to a high rate of comorbid conditions. CONCLUSIONS: The lifetime prevalence of PTSD among these chemically dependent adolescents is five times that reported for a community sample of adolescents. This extremely high rate provides new understanding of the etiologic connection between PTSD and chemical dependence and has implications for their treatment.",0 +https://doi.org/10.1016/j.hazards.2004.02.001,Resilience to natural hazards: How useful is this concept?,"Resilience is widely seen as a desirable system property in environmental management. This paper explores the concept of resilience to natural hazards, using weather-related hazards in coastal megacities as an example. The paper draws on the wide literature on megacities, coastal hazards, hazard risk reduction strategies, and resilience within environmental management. Some analysts define resilience as a system attribute, whilst others use it as an umbrella concept for a range of system attributes deemed desirable. These umbrella concepts have not been made operational to support planning or management. It is recommended that resilience only be used in a restricted sense to describe specific system attributes concerning (i) the amount of disturbance a system can absorb and still remain within the same state or domain of attraction and (ii) the degree to which the system is capable of self-organisation. The concept of adaptive capacity, which has emerged in the context of climate change, can then be adopted as the umbrella concept, where resilience will be one factor influencing adaptive capacity. This improvement to conceptual clarity would foster much-needed communication between the natural hazards and the climate change communities and, more importantly, offers greater potential in application, especially when attempting to move away from disaster recovery to hazard prediction, disaster prevention, and preparedness.",0 +https://doi.org/10.1002/clc.4960260303,Understanding implantable cardioverter defibrillator shocks and storms: Medical and psychosocial considerations for research and clinical care,"The experience of shock is the distinguishing feature for patients with implantable cardioverter defibrillators (ICDs) and is associated with diminished psychological functioning and quality of life. Multiple shocks and ICD storm are a relatively common event among patients with ICDs (10-20%) and may present specific challenging medical and psychological management for the attending health care providers. This paper examines the medical and psychological aspects of ICD shocks and storms and describes a model of biopsychosocial management for patients following the experience of ICD storm. Successful management of patients post shock includes the use of antiarrhythmic medications and careful attention to the causality of the shocks via stored electrograms. The psychological management includes specific attention to debriefing post-shock feelings and attributions, preventing avoidance behavior, and facilitating positive ""return to life"" actions. Preliminary research examining formal psychosocial treatment supports a cognitive behavioral strategy to reduce psychological distress and facilitate quality of life. Collectively, these data suggest that interdisciplinary management of patients with multiple ICD shocks or the experience of ICD storm is advised, and routine psychological consultation may be indicated for the patient post ICD storm to reduce the possibility of symptoms of post-traumatic stress.",0 +https://doi.org/10.1002/mpr.186,Validity of PTSD in a sample of refugee children: can a separate diagnostic entity be justified?,"The objective of this study was to examine the construct validity of PTSD in a sample of refugee children from the Middle East – more specifically, to assess whether associations between traumatic events and specific PTSD symptoms were more outspoken than (1) the associations of PTSD symptoms with non-traumatic exposures, and (2) the associations of violent exposures with symptoms other than PTSD-symptoms. Parents of 311 refugee children from the Middle East were interviewed concerning their children's traumatic experiences and mental health symptoms. The specific PTSD symptoms did not cluster in a factor analysis. The PTSD symptom complex was significantly predicted not only by violent exposures (mother tortured, OR 8.2, p < 0.005; father disappeared OR 3.2, p < 0.05) but also by indicators of family interaction and parents' occupational situation. The two identified violent exposures had significant independent associations with a series of symptoms including symptoms other than those of PTSD (rs ranging from 0.25 to 0.44, p < 0.001). Thus it does not seem sufficient to focus solely on PTSD symptomatology when assessing the mental health needs of refugee children. Copyright © 2006 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1007/s10862-011-9248-3,Factor Structure of the PTSD Checklist in a Sample of OEF/OIF Veterans Presenting to Primary Care: Specific and Nonspecific Aspects of Dysphoria,"Although DSM-IV-TR diagnostic criteria for posttraumatic stress disorder (PTSD) include three primary symptom clusters, recent evidence from confirmatory factor analyses suggest that the latent structure of PTSD is better represented by four factors, which will likely be reflected in the upcoming DSM-5. Given this likely transition from three to four clusters, the present study sought to examine specific and non-specific aspects of dysphoria in the factor structure of PTSD symptoms in a sample of OEF/OIF combat veterans presenting to a Veterans Affairs primary care clinic. PTSD symptoms were assessed using the PCL-M (Weathers et al. 1993). Results from confirmatory factor analyses suggested that a dysphoria factor involving a number of non-specific distress symptoms may be an important part of the PTSD symptom profile. After controlling for variance due to general psychological distress, we further found that factor loadings on the dysphoria factor were attenuated but continued to significantly load onto the factor, suggesting that dysphoria may be a specific part of the PTSD symptom constellation.",0 +https://doi.org/10.1016/j.jad.2008.02.007,Consistent impaired verbal memory in PTSD: A meta-analysis,"Qualitative review papers have indicated that verbal memory impairment is found to be the most consistent cognitive impairment related to PTSD. These review papers have used qualitative methods to describe the effects, and consequently they have not been able to estimate the strength of the memory-PTSD association. This meta-analysis of 28 studies examined the empirical evidence for this relationship, and factors affecting the results. Overall, the results showed medium effect sizes in patients with PTSD compared to controls on verbal memory across studies. Marked impairment was found in the patient groups compared to healthy controls, while modest impairment was found compared to exposed non-PTSD controls. Meta-analyses found strongest effects in war veterans compared to sexual and physical assault related PTSD. Rather unexpectedly no effect was found for the sexually abused PTSD groups compared to exposed controls. The analyses further showed that the effect was dependent on the test procedures used. The studies using WMS and AVLT had stronger effects than studies using CVLT. Insufficient data were available to analyze a more complete attention–memory profile. This meta-analysis confirms that verbal memory impairment is present in adults with PTSD, and they are consistent across studies. This impairment should be the focus of work in clinical settings.",0 +https://doi.org/10.1177/0886260504263872,Acute Stress Disorder as a Predictor of Post-Traumatic Stress Disorder in Physical Assault Victims,"The authors’objective was to examine the ability of acute stress disorder (ASD) and other trauma-related factors in a group of physical assault victims in predicting post-traumatic stress disorder (PTSD) 6 months later. Subjects included 214 victims of violence who completed a questionnaire 1 to 2 weeks after the assault, with 128 participating in the follow-up. Measures included the Harvard Trauma Questionnaire, the Trauma Symptom Checklist, and the Crisis Support Scale. Twenty-two percent met the full PTSD diagnosis and 22% a subclinical PTSD diagnosis. Previous lifetime shock due to a traumatic event happening to someone close, threats during the assault, and dissociation explained 56% of PTSD variance. Inability to express feelings, hypervigilance, impairment, and hopelessness explained another 15% of PTSD variance. The dissociative, the reexperiencing, the avoidant, and the arousal criteria of the ASD diagnosis correctly classified 79% of the subsequent PTSD cases.",0 +,Individual and Group Factors that Affect Resilience and Mediate the Relationship between Resilience and the Development of Posttraumatic Stress Disorder in ICU Nurses,"The purpose of this research was to determine the significant individual and group characteristics that affected resilience in intensive care unit (ICU) nurses and whether those significant characteristics had a direct or indirect effect on the development of posttraumatic stress disorder (PTSD) mediated through resilience. An adaptation of the Nurse as Wounded Healer (N-WH) theory was also tested, which added resilience as a concept to facilitate self-healing, transformation and transcendence of trauma experienced in the ICU. This was a secondary database analysis that included 744 ICU nurses from around the United States. Participants were mailed a self-report survey that included demographic, anxiety, depression, PTSD and resilience measures. The factors that significantly affected resilience included: whether the ICU nurse had children, the number of years practicing, type of nursing degree, generational cohort affiliation, and type of unit the nurse was working in. Structural equation modeling (SEM) in MplusTM was used to model the direct and indirect effects of the significant variables on the development of PTSD mediated through resilience. Children and years practicing as an ICU nurse had direct effects on the development of PTSD. When compared with the medical ICU (MICU), the cardiac ICU, cardiothoracic surgery ICU and other ICUs had significant indirect effects on the development of PTSD mediated through the Personal Competence sub-scale of resilience. ICU nurses with a graduate degree had a significant indirect effect on the development of PTSD mediated through the Leadership sub-scale of resilience, when compared to ICU nurses with a bachelor degree of science in nursing (BSN). The results supported the adapted version of the NWH theory. Based on the findings of this research, having children, years practicing, type of nursing degree and ICU unit type had significant direct or indirect effects on the development of PTSD mediated through the Personal Competence and Leadership subscales of resilience. Future research is needed to describe the potentially unique characteristics of each unit type and to identify modifiable individual and organizational factors to help inform tailored resilience interventions in the ICU. (PsycINFO Database Record (c) 2015 APA, all rights reserved)",0 +https://doi.org/10.1038/srep08844,The relationship between response inhibition and posttraumatic stress symptom clusters in adolescent earthquake survivors: An event-related potential study,"Posttraumatic stress disorder (PTSD) patients experience impaired response inhibition. Little is known about the relationship between response inhibition abnormalities and distinct PTSD symptom clusters. This study investigated the relationship between response inhibition processing and a five-factor model of posttraumatic stress symptomatology in adolescents. The event-related potentials of 54 unmedicated adolescent earthquake survivors (age 15-18 years) were recorded as they completed a Go/NoGo task. The PTSD Checklist-Specific Stressor Version (PCL-S) was used to assess PTSD symptoms. Regression analyses were conducted to examine the associations between the five symptom-cluster model and response inhibition processing. The results revealed that the avoidance symptom cluster score, but not the numbing or other clusters' scores, was positively associated with NoGo-P3 latency. These results suggest that a specific PTSD symptom cluster--avoidance--has a distinct association with the slowed speed of the late step of response inhibition processing, i.e., decision or success of response inhibition in adolescent earthquake survivors.",0 +https://doi.org/10.1097/00005053-200210000-00005,DAILY CHARTING OF POSTTRAUMATIC STRESS SYMPTOMS: A PILOT STUDY,"This pilot study describes a prospective life-charting method for posttraumatic stress (PTS) symptoms. This method summarizes daily symptoms, functional impairment, life events, substance use, and treatment. Findings include experience with 17 cases over periods lasting from 3 to 25 months, with a description of 4 case examples that are characteristic of the pilot sample. People with posttraumatic stress disorder (PTSD) can complete day charting of their symptoms over an extended period of time. Some people reported that day charting distressed them mildly as they analyzed daily thoughts or feelings that they ordinarily avoided or pushed from awareness. Nonetheless, most people reported that they learned and benefited from daily symptom charting. In addition to enhancing patient self-understanding (or ""insight""), the method may prove useful in assessing treatments for PTSD. Finally, these preliminary findings have suggested hypotheses regarding the clinical phenomenology and course of PTSD. For example, PTS symptom cluster exacerbation, severity, and duration appear to be highly consistent within any given patient, but highly variable across patients. Daily charting of PTS symptoms over prolonged periods is feasible. This prospective PTSD symptom charting method may have therapeutic, clinical, and research potential for understanding individual and group patterns in PTSD over time.",0 +https://doi.org/10.1111/j.1365-2788.2005.00764.x,Post-traumatic stress disorder in young people with intellectual disability,"Post-traumatic stress disorder (PTSD) is common and treatable. There is extensive research on people of average intelligence yet little on individuals with developmental disabilities.We report two people with intellectual disability (ID) who experienced PTSD. The relevance of their developmental difficulties, social and communication profiles, attentional skills, and causes of these, to their presentations is discussed.Both individuals have fragile X syndrome and severe ID. One has Diagnostic and Statistical Manual - 4th Edition (DSM-IV) autistic disorder; the other DSM-IV attention deficit-hyperactivity disorder. They experienced developmental and psychological regressions, new challenging behaviours and exacerbations of existing ones coincident with emotional trauma. PTSD symptoms and phenomena were identifiable despite intellectual and communicatory impairments.Presentation of PTSD is influenced by degree and cause of ID, social circumstances, social and communicatory skills, nature and timing of traumatic experience and subsequent management. The paucity of literature suggests it is missed frequently in individuals with ID who risk having problems misattributed to other causes with potential for inappropriate interventions.",0 +https://doi.org/10.1016/j.apmr.2004.11.036,Predictors of Psychosocial Adaptation Among People With Spinal Cord Injury or Disorder,"To examine the influence of disability-related medical and psychologic variables on psychosocial adaptation to spinal cord injury or disorder (SCI/D).A structural equation modeling design linking 3 sets of predictive variables to an outcome measure of adaptation.Two outpatient SCI clinics (1 veteran, 1 civilian) in Texas.Veterans (n=181) and civilians (n=132) with SCI/D.Not applicable.The adaptation outcome was measured by 2 subscales (acknowledgment, adjustment) of the Reactions to Impairment and Disability Inventory (RIDI) and by the Quality of Life Scale. The predictive variables were measured by a demographic questionnaire, 3 subscales (intrusion, re-experiencing, hyperarousal) of the Purdue Posttraumatic Stress Disorder-Revised scale, the McMordie-Templer Death Anxiety Scale, and 3 subscales (anxiety, depression, denial) of the RIDI.Goodness-of-fit indices suggested that a revised model of adaptation was a moderately good fit to the data. The revised model of adaptation indicated that there were medium total effects (direct plus indirect) on psychosocial adaptation by 2 latent variables (disability severity and impact, negative affectivity) and small total effects on psychosocial adaptation by disengagement coping. The latent factor of disengagement coping had the strongest direct effect on adaptation (although not statistically significant). Disability severity and impact had medium indirect effects and negative affectivity had small indirect effects on psychosocial adaptation. All of the aforementioned effects had a negative coefficient.Negative emotional responses (eg, depression, anxiety) to SCI/D, disengagement-type coping (eg, disability denial, avoidance), and the severity and impact of disability were related to lower levels of adaptation to SCI/D.",0 +https://doi.org/10.1176/ajp.149.5.671,Posttraumatic stress disorder in an urban population of young adults: risk factors for chronicity,"Despite progress in epidemiologic research on posttraumatic stress disorder (PTSD), little is known about factors that distinguish chronic from nonchronic PTSD. In a previous report, the authors identified a set of personal predispositions associated with PTSD following traumatic events in a general population sample of young adults. The purpose of this analysis was to identify characteristics of chronic PTSD and examine whether any of the suspected risk factors for PTSD was associated specifically with chronic PTSD.A random sample of 1,007 21- to 30-year-old members of a large health maintenance organization in the Detroit area was interviewed, using the National Institute of Mental Health Diagnostic Interview Schedule (DIS), revised for DSM-III-R. The analysis was performed on data from 394 respondents who reported traumatic events, of whom 93 met criteria for PTSD. Chronic PTSD was defined as duration of symptoms for 1 year or more.Persons with chronic PTSD (N = 53) had, on the average, a significantly higher total number of PTSD symptoms and higher rates of overreactivity to stimuli that symbolized the stressor and interpersonal numbing than persons with nonchronic PTSD. The rates of one or more additional anxiety or affective disorders and a variety of medical conditions were higher in persons with chronic than nonchronic PTSD. Family history of antisocial behavior and female sex were associated specifically with chronic PTSD.The findings suggest that chronic PTSD may be associated with specific risk factors and clinical features. Longitudinal data on the course of PTSD are needed to determine whether the distinct features and the medical and psychiatric histories of persons with chronic PTSD are complications attendant on a chronic course or coexisting disturbances that inhibit recovery.",0 +,[Post-traumatic stress disorder (PTSD): the syndrome with multiple faces].,"We choose to discuss from the PTSD's point of view because this diagnostic reference is commonly used. We wish outline its restrictive sight which could prevent the professional from having a diagnosis of PTSD. We don't want to say there is a PTSD everywhere but it appears to us that a traumatic reading can be a precious advantage for the clinician to establish a real therapeutic relation with some patients. Post-traumatic syndrome differs from the majority of other diagnostic categories as it includes in its criteria the presumptive cause of the trauma (criterion A). In the case that this syndrome originates in war experiences, the presumed cause presents itself as an exceptional event overcoming the individual's resources. The notion of war traumatisation has been extended to other events such as catastrophes, physical attacks, rapes, child and wife battering, and sexual abuses. But the events which cause PTSD (Post-Traumatic Stress Disorder) are significantly more numerous. It can be seen that medical events such as giving birth, miscarriage, heart attack, cancer, or hospitalisation following resuscitation may give rise to PTSD. Further, people experiencing prolonged periods of distress may equally develop a post-traumatic syndrome without any particular event having occurred to surpass their defences. It's the case of the Prolonged Duress Stress Disorder (PDSD). The series of discontinuous stress ""waste"" the psychic balance and may give rise, at one moment, to posttraumatic symptoms described in DSM, without any specific stressful event. The existence of criterion A is therefore not a necessary prerequisite in establishing a diagnosis of PTSD. It is, in fact, very difficult to predict which events could cause a PTSD, and this, especially, as the subjective aspects count at least as much as the objective aspects. The clinician should have to carefully explore how the patient experienced the event or, how he apprehended the event itself and it's outcome, if he wants get the traumatic range of a life event. The feeling of deep distress, the feeling of being trapped, the loss of control, the collapse of basic beliefs, the feeling that one's life is in jeopardy, that the physical integrity is (really or in one's imagination) threatened, the feeling of helplessness, are quite as much clues for a possible PTSD which hides behind others clinical manifestations either psychological or somatic. Furthermore, the ""pure"" form described in the DSM and grouping together three further criteria (reliving events, avoiding stimuli associated with the trauma, hyper-reactivity) is extremely rare in the chronic form. An untreated post-traumatic syndrome evolves with time and may present, initially, with very different pathological symptoms giving rise to equally varied diagnoses. Different etiopathogenic models propose to account for the PTSD 's heterogeneous appearance and instability with time. The comorbidity concept sees the PTSD as an independent entity other independent pathologies coexist with. The typologic concept suggests that the PTSD is an independent entity which shows different clinical appearances based on symptomatic descriptions. The ""cascade"" concept suggests to see the PTSD as an independent entity which offers, with time, different symptomatic appearances, in evolution, because of events caused by after effects, in different areas of the PTSD itself. All of these concepts outline the transnosologic appearance of the PTSD which makes it hardly recognizable. The ""chronic"" syndrome is rarely diagnosed forming a real challenge to prevention. In effect, the present authors insist on the crucial nature of early detection of PTSD since the greater the time elapsed the more difficult it becomes due to the evolutionary aspect of the syndrome, which initially has more readily recognizable symptoms. The consequences of an unrecognised PTSD are serious and affect both the individual and his immediate family and friends, contributing further to the aggravation of the problems. When a PTSD is diagnosed, it can allow the clinician to further a more global care which will help the patient to get a better recovery. With patients who suffered an infarct, the treatment of PTSD which prevents their recovery will help to go back to the way they lived before the event. It has been showed how important could be the PTSD detection on the severe burned people's pain control. Thus it seems to be crucial for the clinician to keep this diagnosis in mind alongside any other.",0 +https://doi.org/10.1159/000082817,The Role of Endogenous Opioids in the Placebo Effect in Post-Traumatic Stress Disorder,"The concept of the placebo effect has received a considerable attention over the past several decades. The placebo effect has been observed in different psychiatric disorders, including post-traumatic stress disorder (PTSD), a chronic and severe disorder precipitated by exposure to a psychologically distressing event. The placebo response rates in patients with PTSD range from 19% to 62%. A considerable number of research publications suggest that endogenous opioids are involved in the mechanisms of the placebo effect. Endogenous opioid peptides play an important role in stress response and in the pathophysiology of PTSD. Therefore, endogenous opioids may be involved in the neurobiology of the placebo effect in PTSD. Possibly, the endogenous opioid system mediates the effect of placebo on all 3 PTSD symptom clusters (re-experiencing symptoms, avoidance and numbing, and physiologic arousal). The placebo effect-related activation of the endogenous opioid system may result in an improvement in intrusive symptomatology and symptoms of increased arousal because the administration of exogenous opioids improve these symptoms. The placebo effect-related activation of the endogenous opioid system may have a mood-enhancing effect, and, consequently, diminish avoidance and numbing. Multiple neurotransmitter and neuroendocrine pathways may be involved in the mechanisms of the placebo effect in PTSD. Further studies of the neurobiology of the placebo effect on patients with PTSD and other psychiatric disorders may produce interesting and important results.",0 +https://doi.org/10.1177/107319119400100308,Latent Structure of the Mississippi Scale for Combat-Related Post-Traumatic Stress Disorder: Exploratory and Higher-Order Confirmatory Factor Analyses,"A series of factor analyses evaluated the dimensionality of the Mississippi Scale for Combat-Related Post-Traumatic Stress Disorder. Over 2,200 Vietnam theater and era veterans were divided into three random subsamples, each of which was used in a separate stage of analysis. Initial exploratory factor analyses suggested an underlying single-factor solution. In the second subsample, a second-order solution comprised of a general factor subsuming several first-order factors was supported using chi-square difference testing. This model was successfully replicated with the third subsample. Cumulative evidence suggests that the latent structure of the Mississippi Scale is best represented as an umbrella Post-Traumatic Stress Disorder (PTSD) factor leading to four subsidiary facets or dimensions.",0 +https://doi.org/10.1007/s00213-013-3099-4,The effect of intranasal oxytocin treatment on conditioned fear extinction and recall in a healthy human sample,"To improve outcomes for patients undergoing extinction-based therapies (e.g., exposure therapy) for anxiety disorders such as post-traumatic stress disorder (PTSD), there has been interest in identifying pharmaceutical compounds that might facilitate fear extinction learning and recall. Oxytocin (OT) is a mammalian neuropeptide that modulates activation of fear extinction-based neural circuits and fear responses. Little is known, however, about the effects of OT treatment on conditioned fear responding and extinction in humans.The purpose of the present study was to assess the effects of OT in a fear-potentiated startle task of fear conditioning and extinction.A double-blind, placebo-controlled study of 44 healthy human participants was conducted. Participants underwent a conditioned fear acquisition procedure, after which they were randomized to treatment group and delivered OT (24 IU) or placebo via intranasal (IN) spray. Forty-five minutes after treatment, participants underwent extinction training. Twenty-four hours later, subjects were tested for extinction recall.Relative to placebo, the OT group showed increased fear-potentiated startle responding during the earliest stage of extinction training relative to placebo; however, all treatment groups showed the same level of reduced responding by the end of extinction training. Twenty-four hours later, the OT group showed significantly higher recall of extinction relative to placebo.The current study provides preliminary evidence that OT may facilitate fear extinction recall in humans. These results support further study of OT as a potential adjunctive treatment for extinction-based therapies in fear-related disorders.",0 +https://doi.org/10.1016/j.jad.2012.11.024,Factor mixture model of anxiety sensitivity and anxiety psychopathology vulnerability,"The purpose of the present study was to shed light on the latent structure and nature of individual differences in anxiety sensitivity (AS) and related risk for psychopathology.The present study evaluated the latent structure of AS using factor mixture modeling (FMM; Lubke and Muthén, 2005) and tested the relations between the observed FMM-based model of AS and psychopathology in a large, diverse adult clinical research sample (N=481; 57.6% women; M(SD)(age)=36.6(15.0) years).Findings showed that a two-class three-factor partially invariant model of AS demonstrated significantly better fit than a one-class dimensional model and more complex multi-class models. As predicted, risk conferred by AS taxonicity was specific to anxiety psychopathology, and not to other forms of psychopathology.The sample was not epidemiologic, self-report and psychiatric interview data were used to index AS and psychopathology, and a cross-sectional design limited inference regarding the directionality of observed relations between AS and anxiety psychopathology.Findings are discussed with respect to the nature of AS and related anxiety psychopathology vulnerability specifically, as well as the implications of factor mixture modeling for advancing taxonomy of vulnerability and psychopathology more broadly.",0 +https://doi.org/10.1037/mil0000034,A Longitudinal Comparison of Posttraumatic Stress Disorder and Depression Among Military Service Components,"The purpose of this study was to longitudinally investigate PTSD and depression between Reserve, National Guard, and active duty continuously and dichotomously. The study consisted of Millennium Cohort Study participants and used self-reported symptoms. Repeated measures modeling assessed PTSD and depression continuously and dichotomously over time. A subanalysis among only recently deployed personnel was conducted. Of the 52,653 participants for the PTSD analysis, the adjusted PCL-C means were 34.6 for Reservists, 34.4 for National Guardsmen, and 34.7 for active duty members, respectively. Of the 53,073 participants for depression analysis, the adjusted PHQ-9 means were 6.8, 6.7, and 7.2, respectively. In dichotomous models, Reservists and National Guardsmen did not have a higher risk of PTSD or depression compared with active duty members. Among deployers, Reservists and National Guardsmen had higher odds (odds ratio = 1.16, 95% confidence limit [CL] [1.01, 1.34] and OR = 1.19, 95% CL [1.04, 1.36], resp...",0 +https://doi.org/10.1001/archgenpsychiatry.2010.54,Prevalence of Mental Health Problems and Functional Impairment Among Active Component and National Guard Soldiers 3 and 12 Months Following Combat in Iraq,"A growing body of literature has demonstrated the association of combat in Iraq and Afghanistan with postdeployment mental health problems, particularly posttraumatic stress disorder (PTSD) and depression. However, studies have shown varying prevalence rates of these disorders based on different case definitions and have not assessed functional impairment, alcohol misuse, or aggressive behavior as comorbid factors occurring with PTSD and depression.To (1) examine the prevalence rates of depression and PTSD using several case definitions including functional impairment, (2) determine the comorbidity of alcohol misuse or aggressive behaviors with depression or PTSD, and (3) compare rates between Active Component and National Guard soldiers at the 3- and 12-month time points following their deployment to Iraq.Population-based, cross-sectional study.United States Army posts and National Guard armories.A total of 18 305 US Army soldiers from 4 Active Component and 2 National Guard infantry brigade combat teams.Between 2004 and 2007, anonymous mental health surveys were collected at 3 and 12 months following deployment.Current PTSD, depression, functional impairment, alcohol misuse, and aggressive behavior.Prevalence rates for PTSD or depression with serious functional impairment ranged between 8.5% and 14.0%, with some impairment between 23.2% and 31.1%. Alcohol misuse or aggressive behavior comorbidity was present in approximately half of the cases. Rates remained stable for the Active Component soldiers but increased across all case definitions from the 3- to 12-month time point for National Guard soldiers.The prevalence rates of PTSD and depression after returning from combat ranged from 9% to 31% depending on the level of functional impairment reported. The high comorbidity with alcohol misuse and aggression highlights the need for comprehensive postdeployment screening. Persistent or increased prevalence rates at 12 months compared with 3 months postdeployment illustrate the persistent effects of war zone service and provide important data to guide postdeployment care.",0 +https://doi.org/10.2165/00023210-199810050-00006,Opioid Receptor Antagonists in Psychiatry,"Naltrexone has proved useful in a variety of psychopathological states, Mainly it has been used in long term therapy of heroin addicts. More recently it has been addressed to the treatment of alcoholics, Anecdoctical observations and research data suggest its use also in the field of Mental Illnesses (Eating disorders, Gilles de la Tourette syndrome and Obsessive Compulsive Disorder, Schizophrenia, Self Injuring Behaviours, Autism, Tricotillomania, Post-traumatic stress disorder). In this paper we will briefly discuss the use of opioid antagonists in drug addicts and then we will review the evidence for future development for other psychiatric illnesses. Examined data suggest that opioid antagonists be effective on symptomathologic clusters common to different clinical entities.",0 +https://doi.org/10.1037/0893-3200.19.3.430,Patterns of Posttraumatic Stress Symptoms in Parents of Childhood Cancer Survivors.,"Posttraumatic stress (PTS) symptoms have been reported in mothers and fathers of childhood cancer survivors; however, little is known about patterns of PTS in these families. Cluster analysis was applied to the Posttraumatic Stress Disorder (PTSD) Reaction Index scores of 98 couples parenting adolescent childhood cancer survivors to describe patterns of PTS in families, yielding the following 5 clusters: Minimal PTS, Mothers Elevated, Disengaged, Fathers Elevated, and Elevated PTS. The clusters were validated using data from a structured psychiatric interview, an additional self-report measure of PTS, and an index of family functioning. These clinically meaningful patterns reveal that a majority of families had at least one parent with moderate to severe PTS, which supports development of family-based interventions for this population.",0 +https://doi.org/10.1007/s00127-015-1073-7,Predicting time to emergency department return for anxiety disorders and acute stress reactions in children and adolescents: a cohort study,"Purpose: While studies indicate that few children with anxiety disorders receive specialized mental health care, significant knowledge gaps exist for the mental health care trajectory outside of specialized care. We examined whether physician-based care after an emergency department (ED) visit for mental health care predicted time to ED return. Methods: We conducted a retrospective cohort study using administrative data from Alberta, Canada. Included in the cohort were 8075 children <18 years discharged from an ED (104 EDs in total), April 2002–September 2010, following a visit for an anxiety disorder or acute stress reaction. We used a multivariable Cox proportional hazards model to estimate time to ED return for mental health care (censored at 90 days). The variables of interest were: number and type of physician visits 30 days after index visit. We adjusted for sociodemographics, clinical acuity, comorbidity, and recent history of ED mental health care in the model. Results: Within 30 days of ED discharge, multiple physician follow-up visits were associated with shorter return time (adjusted HR 1.24, 95 % CI 1.08–1.43). A single physician follow-up visit was associated with longer return time (adjusted HR 0.68, 95 % CI 0.58–0.79). Physician follow-up visits for mental health care were associated with shorter return time (adjusted HR 2.5, 95 % CI 2.21–2.83). Conclusions: Following an index visit, ED return by children with anxiety disorders or acute stress reactions is associated with specific characteristics of subsequent physician visits. Improving physician use of evidence-based treatment and family access to coordinated services may reduce costly hospital-based care. © 2015, Springer-Verlag Berlin Heidelberg.",0 +https://doi.org/10.1017/s1041610214002026,Typologies of posttraumatic stress disorder in treatment-seeking older adults,"ABSTRACT Background: While it is well known that posttraumatic stress disorder (PTSD) is characterized by heterogeneous symptom clusters, little is known about predominant typologies of PTSD symptoms in older adults. Methods: Latent profile analyses (LPAs) were employed to evaluate predominant typologies of PTSD symptoms in a sample of 164 treatment-seeking older adults with childhood war-related trauma. Multinomial logistic regressions were conducted to evaluate predictors of class membership. Results: LPAs revealed that a 3-class solution best fit the data. These included an Intermediate Disturbance class (50.0%) and two Pervasive Disturbance classes, which differed with respect to severity of avoidance symptoms (Pervasive Disturbance-Low Avoidance: 33.5%, Pervasive Disturbance-High Avoidance: 16.5%). A greater number of traumatic events predicted membership in the Pervasive Disturbance classes. The Pervasive Disturbance-Low Avoidance class had a higher level of education than the Pervasive Disturbance-High Avoidance class. Compared to the Intermediate Disturbance class, the Pervasive Disturbance classes had the highest levels of depression, anxiety and somatization symptoms. Conclusion: These results suggest that PTSD in treatment-seeking older adults may be characterized by three predominant typologies, which are differentiated by overall severity and avoidance symptoms, lifetime trauma burden, education level, and comorbid depression, anxiety, and somatization symptoms. These results underscore the importance of considering heterogeneity in the phenotypic presentation of PTSD in assessment and treatment approaches for this disorder in older adults.",0 +https://doi.org/10.1016/j.janxdis.2009.08.006,"A preliminary examination of the relationships between posttraumatic stress symptoms and crack/cocaine, heroin, and alcohol dependence","High rates of co-occurrence between posttraumatic stress (PTS) and substance use disorders (SUDs) have led to the suggestion that substance use among individuals experiencing PTS symptoms might serve a self-medication function. However, research is still needed to provide a more comprehensive evaluation of the unique associations between PTS symptom clusters and substances (licit and illicit) with both anxiolytic/depressant and stimulant properties. Consequently, this study examined the relationship between severity of different PTS symptom clusters and heroin, crack/cocaine, and alcohol dependence among 48 treatment-seeking SUD patients with a history of traumatic exposure. No evidence was found for a relationship between PTS symptom clusters and crack/cocaine or alcohol dependence; however, results suggested a relationship between hyperarousal and avoidance (inversely related) symptoms and heroin dependence. Results are discussed in terms of their implications for understanding motivations underlying the substance of choice among individuals with PTS symptoms, as well as the development of treatments for co-occurring PTS and SUDs.",0 +https://doi.org/10.1097/00004714-200304000-00012,Low-Dose Risperidone as Adjunctive Therapy for Irritable Aggression in Posttraumatic Stress Disorder,"Increased aggressive behavior can occur in association with posttraumatic stress disorder (PTSD). This study tested the hypothesis that low-dose risperidone reduces aggression and other PTSD-related symptoms in combat veterans. Subjects were male combat veterans with PTSD who scored 20 or higher on cluster D (hyperarousal) of the Patient Checklist for PTSD-Military Version (PCL-M). Subjects were randomly assigned to either risperidone or placebo treatment groups. Drugs were administered over a 6-week treatment period in a double-blind manner. Subjects received either risperidone (0.5 mg/day; n = 7) or matched placebo (n = 8) tablets during the first 2 weeks of the treatment period. The dose of risperidone could then be increased up to 2.0 mg/day on the basis of response. Prerandomization psychotropic regimens were continued. Subjects were evaluated with the PCL-M and the Overt Aggression Scale-Modified for Outpatients (OAS-M). In comparison with placebo treatment, reductions in scores between baseline and the last week of treatment were significantly greater for OAS-M irritability and PCL-M cluster B (intrusive thoughts) subscales and on the PCL-M total scale. These results suggest that low-dose risperidone administration reduces irritability and intrusive thoughts in combat-related PTSD.",0 +,Psychological consequences of war trauma and postwar social stressors in women in Bosnia and Herzegovina.,"To assess the consequences of psychotrauma in civilian women in Herzegovina who were exposed to prolonged and repetitive traumatic war events and postwar social stressors.The study included a cluster sample of 367 adult women, divided into two groups. One group (n=187) comprised women from West Mostar who were exposed to serious war and posttraumatic war events. The other group (n=180) comprised women from urban areas in Western Herzegovina who were not directly exposed to war destruction and material losses, but experienced war indirectly, through military drafting of their family members and friends. Demographic data on the women were collected by a questionnaire created for the purpose of this study. Data on trauma exposure and posttraumatic stress disorder (PTSD) symptoms were collected by Harvard Trauma Questionnaire (HTQ)--Bosnia-Herzegovina version. General psychological symptoms were determined with Symptom Check List-90-revised (SCL-90-R). Data on postwar stressors were collected by a separate questionnaire.In comparison with the control group, women from Western Mostar experienced significantly more traumatic events (mean+/-standard deviation [SD], 3.3+/-3.2 vs 10.1+/-4.9, respectively, t=15.91; P<0.001) and had more posttraumatic symptoms (12.3+/-10.3 vs 21.2+/-10.9, respectively, t=8.42; P<0.001). They also had significantly higher prevalence of PTSD (4.4% vs 28.3%, respectively; chi(2)=52.56; P<0.001). The number of traumatic events experienced during the war was positively associated with postwar stressful events both in the West Mostar group (r=0.223; P=0.002) and control group (r=0.276; P<0.001). Postwar stressful events contributed both to the number and intensity of PTSD symptoms and all general psychological symptoms measured with SCL-90 questionnaire, independently from the number of experienced traumatic war events.Long-term exposure to war and postwar stressors caused serious psychological consequences in civilian women, with PTSD being only one of the disorders in the wide spectrum of posttraumatic reactions. Postwar stressors did not influence the prevalence of PTSD but they did contribute to the intensity and number of posttraumatic symptoms.",0 +https://doi.org/10.1080/17523281.2013.873071,Post-traumatic stress disorder symptom clusters predicting substance abuse in adolescents,"The majority of studies exploring the mental health disorders, post-traumatic stress disorder (PTSD) and substance use disorders (substance abuse (SA) and dependence), have shown high co-morbidity rates in adolescents, indicating a well-established relationship. However, only a few studies have attempted to examine the functional mechanisms believed to underlie this common form of co-morbidity, and no studies have been carried out in adolescent samples. Knowledge is thus lacking on how specific PTSD symptom clusters may account for the development of specific types of problematic substance use in adolescents. Therefore, we studied this issue in relation to alcohol abuse (AA) and drug abuse (DA) in a probability sample of Danish 15–18-year-olds (n = 1988) in the form of an online survey using self-report questionnaires following the Diagnostic and statistical manual of mental disorders, fourth edition [DSM-IV; APA. (1994). Washington, DC: Author]. After demographic and substance-related variables were cont...",0 +https://doi.org/10.7205/milmed.172.11.1190,Characteristics of Heart Rate Variability in War Veterans with Post-Traumatic Stress Disorder after Myocardial Infarction,"The goal of the study was to evaluate differences in heart rate variability (HRV) among post-myocardial infarction (MI) patients, depending on their participation in the Croatian war and on established diagnoses of post-traumatic stress disorder (PTSD).The study included 34 male war veterans with diagnosed PTSD who had suffered a first MI and 34 age-matched post-MI patients without PTSD. Cardiac autonomic balance was evaluated through HRV analysis.There were no differences in the mean R-R interval or overall HRV between the analyzed groups. Post-MI patients with PTSD had lower values for the square root of the mean of squared successive differences in R-R intervals (p = 0.02), the percentage of R-R intervals that were > or =50 milliseconds different from the previous interval (p = 0.03), and the high-frequency component (p = 0.03) but had higher values for the low-frequency component (p = 0.01) and the low-frequency/high-frequency ratio (p = 0.02), compared with post-MI patients without PTSD.Post-MI patients with PTSD have higher sympathetic and lower parasympathetic heart rate modulation activity, compared with patients with MI and no PTSD.",0 +https://doi.org/10.1177/0886260515619750,Measurement Invariance of the Brief Symptom Inventory in Survivors of Torture and Trauma,"The United States accepts more refugees than any other industrialized nation. As refugee populations grow, mental health professionals must implement culturally and ethnically appropriate strategies to assess and treat individuals from diverse backgrounds. Culture can exert a powerful and often misunderstood influence on psychological assessment, and few structured measures have been demonstrated to have adequate cross-cultural validity for use with diverse and vulnerable populations such as survivors of torture. This study examined the factor structure and equivalency of underlying construct(s) of psychological distress as measured by the Brief Symptom Inventory (BSI) in three samples who had survived torture and other severe trauma from Tibet, West Africa and the Punjab region of India. Confirmatory factor analyses provided support for configural invariance of a two-factor model across the three samples, suggesting that the two latent factors of Complex Dysphoria and Somatic Distress were present in each subgroup. The data provide additional support for the strict invariance model in the West African–Tibetan dyad suggesting that scores are comparable across those two groups. Implications for research and treatment are discussed.",0 +https://doi.org/10.1016/j.biopsych.2005.09.023,Daytime Prazosin Reduces Psychological Distress to Trauma Specific Cues in Civilian Trauma Posttraumatic Stress Disorder,"Persons with posttraumatic stress disorder (PTSD) whose trauma-related nightmares improve or resolve with bedtime administration of the alpha-1 adrenergic antagonist prazosin often continue to experience PTSD symptoms during the day. This study addressed whether daytime prazosin compared to placebo would alleviate psychological distress provoked experimentally by a trauma-related word list included in the emotional Stroop (E-Stroop) paradigm.Eleven persons with civilian trauma PTSD who continued to experience daytime PTSD symptoms despite a stable bedtime prazosin dose that suppressed trauma-related nightmares were studied. Prazosin and placebo were administered on two different occasions in the early afternoon followed two hours later by the E-Stroop. Effects of drug on psychological distress were assessed by the Profile of Mood States (POMS).POMS total score and an ""emotional distress"" POMS subscale score following trauma-related words were significantly lower in the prazosin than placebo condition. There were no treatment effects on E-Stroop completion time. In 10 subjects who continued open label daytime prazosin, there was a reduction in global PTSD illness severity at 2-week follow-up.Daytime prazosin pretreatment reduced psychological distress specifically to trauma cues. Adding daytime prazosin to bedtime prazosin may further reduce overall PTSD illness severity and distress.",0 +https://doi.org/10.1177/1363461509105815,A Qualitative Study of Mental Health Problems among Children Displaced by War in Northern Uganda,"While multiple studies have found that children affected by war are at increased risk for a range of mental health problems, little research has investigated how mental health problems are perceived locally. In this study we used a previously developed rapid ethnographic assessment method to explore local perceptions of mental health problems among children and adults from the Acholi ethnic group displaced by the war in northern Uganda. We conducted 45 free list interviews and 57 key informant interviews. The rapid assessment approach appears to have worked well for interviewing caretakers and children aged 10-17 years. We describe several locally defined syndromes: two tam/par/kumu (depression and dysthymia-like syndromes), ma lwor (a mixed anxiety and depression-like syndrome), and a category of conduct problems referred to as kwo maraco/gin lugero. The descriptions of these local syndromes were similar to western mood, anxiety and conduct disorders, but included culture-specific elements.",0 +https://doi.org/10.1016/b978-0-444-63521-1.00039-x,Post-traumatic stress disorder and traumatic brain injury,"Disentangling the effects of ""organic"" neurologic damage and psychological distress after a traumatic brain injury poses a significant challenge to researchers and clinicians. Establishing a link between traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) has been particularly contentious, reflecting difficulties in establishing a unique diagnosis for conditions with overlapping and sometimes contradictory symptom profiles. However, each disorder is linked to a variety of adverse health outcomes, underscoring the need to better understand how neurologic and psychiatric risk factors interact following trauma. Here, we present data showing that individuals with a TBI are more likely to develop PTSD, and that individuals with PTSD are more likely to develop persistent cognitive sequelae related to TBI. Further, we describe neurobiological models of PTSD, highlighting how patterns of neurologic damage typical in TBI may promote or protect against the development of PTSD in brain-injured populations. These data highlight the unique course of PTSD following a TBI and have important diagnostic, prognostic, and treatment implications for individuals with a dual diagnosis.",0 +https://doi.org/10.1002/jts.21737,Treatment Improves Symptoms Shared by PTSD and Disordered Eating,"Eating disorders and posttraumatic stress disorder (PTSD) are debilitating conditions that frequently co-occur. Although the two disorders have different clinical presentations, they share associated features, including cognitive disturbances, emotion dysregulation, dissociation, and impulsivity. We hypothesized that reductions in PTSD symptoms following cognitive processing therapy (CPT) and its treatment components (CPT without the written account or the written account only) would be associated with improvements in symptoms common to PTSD and eating disorders. Participants in the current investigation included women with PTSD (N = 65) who reported a history of rape or physical assault, were in a randomized dismantling study of CPT, and completed the Eating Disorder Inventory-2 (EDI-2) at pre- and posttreatment. Latent growth modeling results indicated that decreases in PTSD symptom scores were significantly associated with reductions in the Impulse Regulation, Interoceptive Awareness, Interpersonal Distrust, Ineffectiveness, and Maturity Fears subscales of the EDI-2. Thus, PTSD treatment affected symptoms shared by PTSD and eating disorders. Currently, there are no clear guidelines for treatment of comorbid PTSD and eating disorders. Traditional CPT may impact symptoms common to both, but additional therapy may be needed for specific disordered eating attitudes and behaviors.",0 +https://doi.org/10.1016/s0006-3223(98)00276-5,Predicting the development of posttraumatic stress disorder from the acute response to a traumatic event,"Posttraumatic stress disorder (PTSD) is a psychiatric condition that is directly precipitated by an event that threatens a person's life or physical integrity and that invokes a response of fear, helplessness, or horror. In recent years it has become clear that only a proportion of those exposed to fear-producing events develop or sustain PTSD. Thus, it seems that an important challenge is to elucidate aberrations in the normal fear response that might precipitate trauma-related psychiatric disorder. This paper summarizes the findings from recent studies that examined the acute and longer term biological response to traumatic stress in people appearing to the emergency room immediately following trauma exposure. In the aggregate, these studies have demonstrated increased heart rate and lower cortisol levels at the time of the traumatic event in those who have PTSD at a follow-up time compared to those who do not. In contrast, certain features associated with PTSD, such as intrusive symptoms and exaggerated startle responses, are only manifest weeks after the trauma. The findings suggest that the development of PTSD may be facilitated by an atypical biological response in the immediate aftermath of a traumatic event, which in turn leads to a maladaptive psychological state.",0 +,"Risk of trauma exposure and posttraumatic stress disorder: An examination of the separate and combined effects of race, gender, and social context","Posttraumatic Stress Disorder (PTSD) is a debilitating psychiatric disorder that affects approximately 7.7 million U.S. adults. A central criterion of a PTSD diagnosis is an exposure to an external traumatic stressor. Yet, surprisingly little research has focused on the role of the larger social context that shapes these exposures. Most PTSD research focuses on the separate effects of individual-level risk factors like gender and race, while the effects of macro-level factors like poverty are primarily used as control variables in regression models. Little is known about how the larger structural environment, and factors like racial residential and economic segregation impact PTSD risk, or whether examining the combined effects of risk factors like race, gender, and poverty might shift our understanding. The primary aims of this dissertation were two-fold: First, a stratified analysis was conducted to provide a fundamental understanding of race differences in trauma exposure/PTSD risk by examining within-group effects of gender, race, and poverty status, both alone and in combination, and testing for between-group differences in these effects. Second, discrete-time analysis and life-tables were used to examine the relationship between PTSD risk and incarceration, an exposure chosen to capture the effects of the U.S. macro-level social context due to its differential impact on the Black population. Study results showed the expected gender differences in PTSD risk. However, considerable variation in the pattern of risk was observed when the effects of race and gender were considered together, finding that African American females experienced greater disorder risk, and that non-Hispanic White males experienced greater risk when poverty status was considered. Prison exposure was found to be a significant predictor of lifetime PTSD, after accounting for the effects and timing of a comprehensive list of traumatic exposures. Race differences in the effect of incarceration exposure on PTSD risk were not found. These dissertation findings have implications for future PTSD research. Notably, these findings suggest that a better accounting of social contextual factors and the combined effects of sociodemographic and socioeconomic factors can improve our understanding of the disorder and those who are at most risk. (PsycINFO Database Record (c) 2015 APA, all rights reserved)",0 +https://doi.org/10.1016/j.pain.2010.02.013,Compensation claim lodgement and health outcome developmental trajectories following whiplash injury: A prospective study,"This study aimed to identify distinctive trajectories for pain/disability and posttraumatic stress disorder (PTSD) symptoms following whiplash injury and to examine the effect of injury compensation claim lodgement on the trajectories. In a prospective study, 155 individuals with whiplash were assessed at <1month, 3, 6 and 12months post injury. Outcomes at each time point were Neck Disability Index (NDI) and the Posttraumatic Stress Diagnostic Scale (PDS). Group-based trajectory analytical techniques were used to identify outcome profiles. The analyses were then repeated after including third party compensation claim lodgment as a binary time-changing covariate. Three distinct NDI trajectories were determined: (1) Mild: mild or negligible pain/disability for the entire 12 months (45%), (2) Moderate: initial moderate pain/disability that decreased to mild levels by 3 months (39%) and (3) Chronic-severe: severe pain/disability persisting at moderate/severe levels for 12 months (16%). Three distinct PTSD trajectories were also identified: (1) Resilient: mild symptoms throughout (40%), (2) Recovering: initial moderate symptoms declining to mild levels by 3months (43%) and (3) Chronic moderate-severe: persistent moderate/severe symptoms throughout 12 months (17%). Claim submission had a detrimental effect on all trajectories (p<0.001) except for the Chronic-severe NDI trajectory (p=0.098). Following whiplash injury, there are distinct pathways of recovery for pain/ disability and PTSD symptoms. Management of whiplash should consider the detrimental association of compensation claim with psychological recovery and recovery of those with mild to moderate pain/disability levels. However, claim lodgement has no significant association with a more severe pain and disability trajectory.",1 +https://doi.org/10.1186/1477-7525-9-56,Quality of life in Croatian Homeland war (1991-1995) veterans who suffer from post-traumatic stress disorder and chronic pain,"The aim of this study was to investigate the quality of life in Croatian homeland war veterans who suffer from post-traumatic stress disorder and chronic low back pain (LBP).A total of 369 participants were included, classified in four study groups: those with post-traumatic stress disorder (PTSD; N = 59), those with both PTSD and lower back pain (PTSD+LBP; N = 80), those with isolated LBP (N = 95) and controls (N = 135). WHOQOL-BREF survey was used in the estimation of quality of life. The data were analysed using statistical methods and hierarchical clustering.The results indicated a general pattern of lowering quality of life in participants with both psychological (PTSD) and physical (LBP) burden. The average overall quality of life was 2.82 ± 1.14 for the PTSD+LBP group, 3.29 ± 1.28 for the PTSD group, 4.04 ± 1.25 for the LBP group and 4.48 ± 0.80 for the controls (notably, all the pair-wise comparisons were significantly different at the level of P < 0.001, except for the pair LBP-controls, which was insignificant). This result indicated that quality of life was reduced for 9.9% in patients with LBP, 26.6% in patients with PTSD and 37.1% in PTSD+LBP, suggesting strong synergistic effect of PTSD and LBP. The analysis also identified several clusters of participants with different pattern of quality of life related outcomes, reflecting the complex nature of this indicator.The results of this study reiterate strong impact of PTSD on quality of life, which is additionally reduced if the patient also suffers from LBP. PTSD remains a substantial problem in Croatia, nearly two decades after the beginning of the 1991-1996 Homeland war.",0 +https://doi.org/10.1007/bf00802091,Predictors of temporal patterns of psychiatric distress during 10 years following the nuclear accident at Three Mile Island,"The present study examines psychiatric symptom levels during a 10-year period in a community sample of mothers of young children. All were identified in the early aftermath of the 1979 Three Mile Island nuclear accident, and followed through the accident's 1989 anniversary. Cluster analysis was used to identify long-term distress profiles during the study period; women's temporal profiles were found to be either (a) stable and at low, clinically nonsignificant levels of distress across all measurement points or (b) at consistently elevated, clinically significant levels that varied with the timing of postaccident events such as the restart of the undamaged reactor and the 10th anniversary. Subsequent multivariate analyses indicated that preaccident characteristics, as well as parameters reflecting respondents' initial involvement with, and reactions to the accident, were important for distinguishing between women within the two temporal profile groups. Implications of the results for both policy formulation and continued research on significant environmental stressors is discussed.",0 +https://doi.org/10.1192/bjp.166.4.525,Post-Traumatic Stress Disorder (PTSD) after Childbirth,"Background There has been discussion about the possible occurrence of post-traumatic stress disorder (PTSD) in mothers after difficult childbirth. Method Four cases with a symptom profile suggestive of PTSD commencing within 48 hours of childbirth are presented. Results The PTSD was in each case associated with the delivery. In each case, there was an associated depressive illness. All four had persistent disorders, and two had difficulties with mother/infant attachment. Conclusion As confirmed by other reports, the prevalence of PTSD associated with childbirth is a matter of concern.",0 +https://doi.org/10.1371/journal.pone.0060991,Symptoms and Subjective Quality of Life in Post-Traumatic Stress Disorder: A Longitudinal Study,"Evidence suggests that post-traumatic stress disorder (PTSD) is associated with substantially reduced subjective quality of life (SQOL). This study aimed to explore whether and how changes in the levels of PTSD symptom clusters of intrusion, avoidance and hyperarousal are associated with changes in SQOL.Two samples with PTSD following the war in former Yugoslavia were studied, i.e. a representative sample of 530 people in five Balkan countries and a non-representative sample of 215 refugees in three Western European countries. They were assessed on average eight years after the war and re-interviewed one year later. PTSD symptoms were assessed on the Impact of Event Scale - Revised and SQOL on the Manchester Short Assessment of Quality of Life. Linear regression and a two-wave cross lagged panel analysis were used to explore the association between PTSD symptom clusters and SQOL.The findings in the two samples were consistent. Symptom reduction over time was associated with improved SQOL. In multivariable analyses adjusted for the influence of all three clusters, gender and time since war exposure, only changes in hyperarousal symptoms were significantly associated with changes in SQOL. The two-wave cross-lagged panel analysis suggested that the link between hyperarousal symptoms and SQOL is bidirectional.Low SQOL of patients with war-related PTSD is particularly associated with hyperarousal symptoms. The findings suggest a bidirectional influence: a reduction in hyperarousal symptoms may result in improved SQOL, and improvements in SQOL may lead to reduced hyperarousal symptoms.",0 +https://doi.org/10.1017/dmp.2013.21,Trauma Signature Analysis of the Great East Japan Disaster: Guidance for Psychological Consequences,"Abstract Objectives On March 11, 2011, Japan experienced the largest earthquake in its history. The undersea earthquake launched a tsunami that inundated much of Japan's eastern coastline and damaged nuclear power plants, precipitating multiple reactor meltdowns. We examined open-source disaster situation reports, news accounts, and disaster-monitoring websites to gather event-specific data to conduct a trauma signature analysis of the event. Methods The trauma signature analysis included a review of disaster situation reports; the construction of a hazard profile for the earthquake, tsunami, and radiation threats; enumeration of disaster stressors by disaster phase; identification of salient evidence-based psychological risk factors; summation of the trauma signature based on exposure to hazards, loss, and change; and review of the mental health and psychosocial support responses in relation to the analysis. Results Exposure to this triple-hazard event resulted in extensive damage, significant loss of life, and massive population displacement. Many citizens were exposed to multiple hazards. The extremity of these exposures was partially mitigated by Japan's timely, expert-coordinated, and unified activation of an evidence-based mental health response. Conclusions The eastern Japan disaster was notable for its unique constellation of compounding exposures. Examination of the trauma signature of this event provided insights and guidance regarding optimal mental health and psychosocial responses. Japan orchestrated a model response that reinforced community resilience. ( Disaster Med Public Health Preparedness . 2013;0:1-14)",0 +https://doi.org/10.1037/tra0000026,DSM–5 posttraumatic stress disorder symptoms associated with suicide behaviors in veterans.,"A connection between suicidality and posttraumatic stress disorder (PTSD) has been consistently demonstrated; however, the underlying relationship between suicidality and PTSD remains unclear. The aim of this study was to examine patterns of DSM-5 PTSD symptom endorsement that differentiated veteran participants with and without a history of suicide behaviors. We enrolled 95 veterans, 32 of whom reported no suicide ideation (SI) or suicide attempts (SA). The 63 remaining participants reported a history of SI, with 28 of the 63 also reporting a historical SA. Participants completed a standardized diagnostic interview (Structured Clinical Interview for DSM-IV-TR; First, Spitzer, Gibbon, & Williams, 2002), structured interview of suicidal behaviors (Columbia-Suicide Severity Rating Scale; Posner et al., 2011), and selected clinical measures. Veterans who reported SI and/or SA were more likely to meet criteria for PTSD on DSM-5 than were veterans who reported neither SI nor SA. Participants who reported SA were more likely to meet criteria for clusters C and D. Finally, at the symptom level, those who reported SI were more likely to report experiencing feelings of alienation. Those who reported a SA were more likely to report avoidance of thoughts and feelings, inability to recall an important aspect of their trauma, persistent negative beliefs, diminished interest, and feelings of alienation. These findings suggest that targeting specific symptoms of PTSD may aid in treatment of suicidal thoughts and behaviors associated with PTSD.",0 +https://doi.org/10.1016/j.adolescence.2015.01.003,Service use patterns and mental health symptoms among adolescents exposed to multiple types of trauma,"Few studies have explored how different trauma experiences influence service use. This study explores patterns of service use amongst 6483 adolescents aged between 13 and 18, and examines if such patterns are associated with trauma profiles, demographic variables, and mental health disorders. Data from the National Comorbidity Survey--Adolescent Supplement (NCS-A) were used. A latent class analysis identified four adolescent trauma sub-groups: 'high risk', 'sexual risk' 'non-sexual risk', and 'low risk'. Regression analysis was used to explore the relationship between service use, trauma classes, and mental health outcomes. Significant relationships were found between service use, trauma sub-groups, demographics and mental health outcomes. Despite the effectiveness of mental health services, only a minority of adolescents exposed to different traumas use such resources. However, this study may go some way towards providing an understanding of the trauma backgrounds, demographic predictors and mental health disorders associated with service use.",0 +https://doi.org/10.1080/15374416.2012.684274,Exposure to Political Conflict and Violence and Posttraumatic Stress in Middle East Youth: Protective Factors,"We examine the role of family- and individual-level protective factors in the relation between exposure to ethnic-political conflict and violence and posttraumatic stress among Israeli and Palestinian youth. Specifically, we examine whether parental mental health (lack of depression), positive parenting, children's self-esteem, and academic achievement moderate the relation between exposure to ethnic-political conflict/violence and subsequent posttraumatic stress (PTS) symptoms. We collected three waves of data from 901 Israeli and 600 Palestinian youths (three age cohorts: 8, 11, and 14 years old; approximately half of each gender) and their parents at 1-year intervals. Greater cumulative exposure to ethnic-political conflict/violence across the first 2 waves of the study predicted higher subsequent PTS symptoms even when we controlled for the child's initial level of PTS symptoms. This relation was significantly moderated by a youth's self-esteem and by the positive parenting received by the youth. In particular, the longitudinal relation between exposure to violence and subsequent PTS symptoms was significant for low self-esteem youth and for youth receiving little positive parenting but was non-significant for children with high levels of these protective resources. Our findings show that youth most vulnerable to PTS symptoms as a result of exposure to ethnic-political violence are those with lower levels of self-esteem and who experience low levels of positive parenting. Interventions for war-exposed youth should test whether boosting self-esteem and positive parenting might reduce subsequent levels of PTS symptoms.",0 +https://doi.org/10.1177/1524838013487805,"Resilience, Trauma, Context, and Culture","This article reviews the relationship between factors associated with resilience, and aspects of the individual’s social ecology (environment) that promote and protect against the negative impact of exposure to traumatic events. It is shown that the Environment × Individual interactions related to resilience can be understood using three principles: (1) Resilience is not as much an individual construct as it is a quality of the environment and its capacity to facilitate growth (nurture trumps nature); (2) resilience looks both the same and different within and between populations, with the mechanisms that predict positive growth sensitive to individual, contextual, and cultural variation (differential impact); and (3) the impact that any single factor has on resilience differs by the amount of risk exposure, with the mechanisms that protect against the impact of trauma showing contextual and cultural specificity for particular individuals (cultural variation). A definition of resilience is provided that highlights the need for environments to facilitate the navigations and negotiations of individuals for the resources they need to cope with adversity. The relative nature of resilience is discussed, emphasizing that resilience can manifest as either prosocial behaviors or pathological adaptation depending on the quality of the environment.",0 +https://doi.org/10.1176/appi.ajp.159.6.941,Predicting Posttraumatic Distress in Hospitalized Trauma Survivors With Acute Injuries,"Each year approximately 2.5 million Americans are hospitalized after sustaining traumatic physical injuries. Few investigations have comprehensively screened for posttraumatic symptomatic distress or identified predictors of posttraumatic stress disorder (PTSD) in representative samples of surgical inpatients.The subjects were 101 randomly selected survivors of motor vehicle crashes or assaults who were interviewed while hospitalized and 1, 4, and 12 months after injury. In the surgical ward, inpatients were screened for PTSD, depressive, and dissociative symptoms, for prior trauma, for pre-event functioning, and for alcohol and drug intoxication. Patient demographic and injury characteristics were also recorded. Random coefficient regression models were used to assess the association between these clinical, injury, and demographic characteristics and PTSD symptom levels over the year after the injury.Of the 101 surgical inpatients, 73% screened positive for high levels of symptomatic distress and/or substance intoxication. At 1, 4, and 12 months after the injury, 30%-40% reported symptoms consistent with a diagnosis of PTSD. High ward PTSD symptom levels were the strongest and most parsimonious predictor of persistent symptoms over the course of the year. Greater prior trauma, stimulant intoxication, and female gender were also associated with higher symptom levels. Increasing injury severity, however, was not associated with higher PTSD symptom levels.Clinical and demographic characteristics readily identifiable at the time of surgical inpatient hospitalization predict PTSD symptoms over the year after injury. Effectiveness trials that test screening and intervention procedures for at-risk inpatients should be developed.",0 +https://doi.org/10.1080/00224499.2012.750639,Sexual Orientation and Gender Identity/Expression Related Peer Victimization in Adolescence: A Systematic Review of Associated Psychosocial and Health Outcomes,"This article reviews research on psychosocial and health outcomes associated with peer victimization related to adolescent sexual orientation and gender identity or expression. Using four electronic databases and supplementary methods, we identified 39 relevant studies. These studies were published between 1995 and 2012 and conducted in 12 different countries. The studies were diverse in terms of their approaches to sampling participants, assessing participants' sexual orientation, operationalizing peer victimization, and with regard to the psychosocial and health outcomes studied in relation to peer victimization. Despite the methodological diversity across studies, there is fairly strong evidence that peer victimization related to sexual orientation and gender identity or expression is associated with a diminished sense of school belonging and higher levels of depressive symptoms; findings regarding the relationship between peer victimization and suicidality have been more mixed. Peer victimization related to sexual orientation and gender identity or expression is also associated with disruptions in educational trajectories, traumatic stress, and alcohol and substance use. Recommendations for future research and interventions are discussed.",0 +https://doi.org/10.1016/s2215-0366(14)00120-5,Turn on and tune in to evidence-based psychedelic research,"For many people, words such as psychedelic and LSD (lysergic acid diethylamide) refer only to dangerous drugs of abuse. Less well known is that tens of thousands of patients were treated effectively with psychedelic drugs in the 1950s and 1960s,1 and that these drugs had almost become part of mainstream medicine by the time they became demonised and research was halted for 40 years.",0 +https://doi.org/10.1016/0005-7967(96)00033-2,Psychometric properties of the PTSD checklist (PCL),"The psychometric properties of the PTSD Checklist (PCL), a new, brief, self-report instrument, were determined on a population of 40 motor vehicle accident victims and sexual assault victims using diagnoses and scores from the CAPS (Clinician Administered PTSD Scale) as the criteria. For the PCL as a whole, the correlation with the CAPS was 0.929 and diagnostic efficiency was 0.900 versus CAPS. Examination of the individual items showed wide ranging values of individual item correlations ranging from 0.386 to 0.788, and with diagnostic efficiencies of 0.700 or better for symptoms. We support the value of the PCL as a brief screening instrument for PTSD.",0 +https://doi.org/10.1016/j.addbeh.2015.09.014,Longitudinal investigation of interpersonal trauma exposure and alcohol use trajectories,"The current longitudinal study examined associations between interpersonal potentially traumatic events (PTEs; i.e., sexual or physical assault) and changes in alcohol consumption among incoming college students.1197 students (68% female) participating in a university-wide research study were included in analyses. Assessments were administered at three time-points and included measures of alcohol use, PTEs (Life Events Checklist), and a screener for possible PTSD symptoms (abbreviated Primary Care PTSD Screen). Linear growth curve models were fit to the three repeated measures of alcohol quantity and frequency to determine the role of pre-college and college-onset interpersonal PTEs and possible PTSD symptoms on patterns of alcohol use.Pre-college interpersonal PTE was associated with greater baseline alcohol use for female but not male students. College-onset interpersonal PTE predicted greater alcohol use at concurrent and future assessments for women but not men, beyond the effects of pre-college PTE. Pre-college possible PTSD symptoms did not predict baseline or change in alcohol use.There may be a stronger and longer-lasting impact of interpersonal PTE for college women compared to men on alcohol phenotypes, although replication in studies oversampling men endorsing interpersonal PTE is needed.",0 +https://doi.org/10.1177/070674371405900902,"Posttraumatic Stress Disorder in Adults: Impact, Comorbidity, Risk Factors, and Treatment","During the last 30 years, there has been a substantial increase in the study of posttraumatic stress disorder (PTSD). Several high-profile traumatic events, such as the wars in Afghanistan and Iraq, and the terrorist attacks of September 11 on the World Trade Center, have led to a greater public interest in the risk and protective factors for PTSD. In this In Review paper, I discuss some of the important advances in PTSD. The paper provides a concise review of the evolution of PTSD diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, impact of PTSD in the community, an overview of the established risk factors for developing PTSD, and assessment and treatment. Throughout the paper, controversies and clinical implications are discussed.",0 +https://doi.org/10.1097/01.ccm.0000069512.10544.40,Exposure to high stress in the intensive care unit may have negative effects on health-related quality-of-life outcomes after cardiac surgery,"Up to 20% of patients do not show improvements in health-related quality of life (HRQL) after cardiac surgery, despite apparently successful surgical procedures. We sought to determine whether failed improvements in HRQL after cardiac surgery are associated with the development of traumatic memories and chronic stress states as a result of high perioperative stress exposure.Prospective cohort study.A 10-bed cardiovascular intensive care unit of a tertiary care university hospital.A total of 148 cardiac surgical patients.None.The patients were evaluated for traumatic memories from postoperative treatment in the cardiovascular intensive care unit (defined as the subjective recollection of pain, respiratory distress, anxiety/panic, and nightmares), symptoms of chronic stress, including those of posttraumatic stress disorder, and HRQL preoperatively (at baseline) and at 6 months after cardiac surgery. A state of chronic stress was defined as the development of posttraumatic stress disorder at 6 months after surgery. Factors predicting the decline in HRQL were determined by multivariable linear regression. Twenty-seven patients (18.2%) had posttraumatic stress disorder at 6 months after cardiac surgery; seven of these patients (4.8%) had evidence of preexisting posttraumatic stress disorder before undergoing cardiac surgery. Patients with new posttraumatic stress disorder at 6 months after cardiac surgery had a significantly higher number of traumatic memories from postoperative treatment in the cardiovascular intensive care unit (p =.01). A multiple regression model included the number of traumatic memories from the intensive care unit and stress symptom scores at 6 months after heart surgery as predictors for variations in physical HRQL outcome scores (R2 =.30, p <.04). Stress symptom scores were the most significant predictors of mental health HRQL outcomes (R2 =.52, p <.01).Exposure to high stress in the cardiovascular intensive care unit can have negative effects on HRQL outcomes of cardiac surgery.",0 +https://doi.org/10.1002/jts.20104,Ten years after the genocide: Trauma confrontation and posttraumatic stress in Rwandan adolescents,"A decade after the 1994 Rwandan genocide, we interviewed a total of 68 Rwandan orphans about their war experiences and posttraumatic stress disorder (PTSD) symptoms. The two samples comprised youth living either in a child-headed household (CHH) or in an orphanage. All had been exposed to extreme levels of violence and 41% had witnessed the murder of their own mother or father. Of the sample, 44% had PTSD. PTSD vulnerability was greater for youth who at the time of the study lived in CHH than those in an orphanage; it was also higher in those aged 8 to 13 during the outbreak of the genocide than those aged 3 to 7 at the time. Furthermore, a significant relationship was found between the number of traumatic experiences and subsequent stress responses.",0 +https://doi.org/10.1002/jcop.21598,COMMUNITY NEEDS AMONG SERVICE MEMBERS AFTER RETURN FROM COMBAT DEPLOYMENT,"To build on research concerning the development of postdeployment community-based programs, we surveyed active duty soldiers from two Brigade Combat Teams (N = 693; N = 1,385) after return from a combat deployment. The Brigade Combat Teams were located on different installations in rural areas representing 2 large military communities. The survey included an assessment about a range of community services (social events, cultural integration opportunities, family, chaplain, and mental health services, etc.). We also examined whether ratings of services varied as a function of Posttraumatic Stress Disorder symptoms, deployment experiences, organizational leadership and support, and attitudinal variables related to mental health. Differences in ratings between the 2 communities suggest the measure detected perceptions of community needs that are idiosyncratic to the particular community, and may be useful for informing program planning and service needs.",0 +https://doi.org/10.1056/nejmp058024,Mental Health Care Needs among Recent War Veterans,"Fifteen percent or more of some populations of veterans of the Vietnam War and the 1991 Gulf War have received diagnoses of post-traumatic stress disorder (PTSD).1,2 Given this history and the fact that U.S. troops in Iraq and Afghanistan are serving for prolonged periods in a hazardous combat environment, we expect the mental health care needs of our newest veterans to be great. In a survey of 3671 Army soldiers and Marines who were involved in combat in Iraq and Afghanistan, up to 17 percent of those returning reported symptoms consistent with major depression, generalized anxiety, or PTSD.3 Since . . .",0 +https://doi.org/10.1093/jpepsy/jsv088,"Commentary: Key Issues, Concluding Thoughts, and Future Directions for the Study of Trauma and Child Health","Although the majority of children experience at leastone potentially traumatic event (PTE) by adolescence(Copeland, Keeler, Angold, & Costello, 2007;Costello, Erkanli, Fairbank, & Angold, 2002), previ-ous research offered little empirical foundation or con-ceptual guidance regarding relationships betweentrauma and child health. The papers included in thisSpecial Issue collectively offer informed directions andillustrate excellent examples of programs of researchseeking to elucidate the complex associations betweenchild traumatic stress and physical health. Preliminaryfindings and theoretical advances presented through-out this Special Issue underscore the importance ofcontinued efforts on this front.In the sections below, we consider each group ofstudies in this Special Issue, highlighting their key con-tributions. We also reflect on this Special Issue and of-fer recommendations for advancing science andpractice in this important area of child health.Maltreatment and VictimizationThe consequences of child maltreatment and victimiza-tion are a serious public health concern. Millions ofchildren experience maltreatment and victimization ev-ery year. Over 679,000 cases of abuse were confirmedin the United States in 2013 alone (U.S. Department ofHealth and Human Services & on Children, 2013), androughly 15–30% of youth report experiencing peer vic-timization (i.e., receiving physical or psychologicalharm from peers; Dinkes, Cataldi, Lin-Kelly, S Luxenberg, Limber, & Olweus, 2014).The considerable negative mental health consequencesof maltreatment and victimization are well documented(Banyard, Williams & Siegel, 2001; De Bellis et al.,2002; Landoll et al., 2015; Widom, Czaja, Wilson,Allwood, & Chauhan, 2013), but the impact of mal-treatment and victimization on child health are only be-ginning to be understood (Sachs-Ericsson, Blazer, Plant,A Springer, Sheridan, Kuo, & Carnes,2007). Several articles in this Special Issue build on thisimportant literature and reflect considerable progress inunderstanding key relationships between maltreatmentand victimization and child health.Importantly, it is currently unclear when adversephysical health effects of childhood maltreatment andvictimization emerge. Research has primarily focusedon the relationship between maltreatment and victimi-zation and adult health conditions (Afifi, Mota,MacMillan, & Sareen, 2013, Goodwin, Hoven,Murison, & Hotopf, 2003; Springer et al., 2007;seeArias, 2004 for a review). In a rare exception, in this is-sue, Gooding, Milliren, Austin, Sheridan, andMcLaughlin (2015) compared arterial pressure and cir-culation in adolescents who reported abuse with thosewho did not, and found that abused youth had higherresting diastolic blood pressure and blunted diastolicand systolic blood pressure reactivity to laboratorystressors. This study contributes to a growing body ofliterature documenting that the health effects of mal-treatment and victimization are evident in childhood(McLaughlin, Sheridan, Alves, & Mendes, 2014).An important next step is to understand whetherspecific types of maltreatment and victimization placeyouth at differential risk for adverse health outcomes.Past research has largely focused on the general impact",0 +https://doi.org/10.1016/j.janxdis.2014.04.002,Changes in trauma-potentiated startle with treatment of posttraumatic stress disorder in combat Veterans,"Emotional Processing Theory proposes that habituation to trauma-related stimuli is an essential component of PTSD treatment. However, the mechanisms underlying treatment-related habituation are not well understood. We examined one psychophysiological measure that holds potential for elucidating the biological processes involved in treatment response: trauma-potentiated startle response. Seventeen OEF/OIF combat Veterans participated in the study and completed three assessments using a trauma-potentiated startle paradigm over PTSD treatment. Results revealed different patterns of trauma-potentiated startle across treatment for responders and nonresponders, but no differences in within task habituation. Responders showed an increase followed by a decrease in trauma-potentiated startle, whereas nonresponders showed a relatively flat response profile. Results suggested that PTSD patients who engage with emotional content as demonstrated by greater startle reactivity may be more likely to respond to PTSD treatment. Furthermore, trauma-potentiated startle shows promise as an objective measure of psychophysiological responses involved in PTSD recovery.",0 +https://doi.org/10.1016/j.jpsychires.2011.11.013,Support for a novel five-factor model of posttraumatic stress symptoms in three independent samples of Iraq/Afghanistan veterans: A confirmatory factor analytic study,"A large body of confirmatory factor analytic studies of posttraumatic stress disorder (PTSD) symptoms has demonstrated the superiority of 4-factor dysphoria and emotional numbing models over the DSM-IV model. Recently, a novel 5-factor model, which separates the DSM-IV hyperarousal symptom cluster into distinct dysphoric and anxious arousal clusters, has been identified. However, little research has evaluated the best-fitting representation of PTSD symptoms in veterans of the Iraq and Afghanistan wars.Confirmatory factor analyses were used to examine the factor structure of the PTSD Checklist in three independent samples of Iraq/Afghanistan veterans, including two community samples and a treatment-seeking sample.In all three samples, a novel model with five correlated factors reflecting symptoms of re-experiencing, avoidance, emotional numbing, dysphoric arousal, and anxious arousal provided a significantly better representation of PTSD symptoms than the DSM-IV, dysphoria, and numbing models. This model also showed evidence of ""excellent fit"" in the community samples according to empirically-defined benchmarks.These findings suggest that PTSD symptomatology in both community and treatment-seeking Iraq/Afghanistan veterans may be best represented by a 5-factor model that separates the DSM-IV PTSD hyperarousal symptom cluster into distinct dysphoric arousal and anxious arousal clusters.",0 +https://doi.org/10.7490/f1000research.1098143.1,Effects of early life trauma on affective executive control and white matter integrity in veterans with and without PTSD,"Background: Prior studies have illustrated the impact of early life trauma (ELT) and adult onset PTSD on affective executive control. We aimed at examining the interaction between a history of ELT and current PTSD diagnosis on performance on an affective executive control task and white matter integrity. Methods: 225 Veterans from TRACTS of the VABHS were grouped for current PTSD diagnosis (PTSD+ = 134 / PTSD- = 91) and for a history of ELT (ELT+ = 65, ELT- = 160). All subjects performed the Affective Go/No-Go task of the CANTAB and errors, as well as reaction time, were the variables of interest. Participants also underwent a diffusion-tensor imaging scan. Results: There was no significant interaction between ELT and PTSD on AGN. ELT+ subjects showed a significantly greater number of errors on the AGN [F (1,219) = 8.46, p. < .004]. There was no main effect of ELT on FA, however there was a significant interaction (p. <.05, corrected) between ELT and reaction time on FA for both positive (widespread clusters) and negative targets (left cingulate bundle). Conclusions: PTSD diagnosis is not associated with impaired performance in our study, though individuals with a history of ELT showed greater number of errors across both positive and negative valence. The interaction between FA and reaction time in the ELT group suggests altered neurodevelopmental trajectories leading to potential deficits in behavior. This may constitute a risk factor for later psychopathology.",0 +https://doi.org/10.1007/s00127-014-0978-x,Suicidality and posttraumatic stress disorder (PTSD) in adolescents: a systematic review and meta-analysis,"Purpose: There is growing evidence in the literature that a diagnosis of Posttraumatic Stress Disorder (PTSD) is an important contributory factor to suicidality in adolescents. However, there is no existing review of the literature examining the relationship between PTSD and suicidality in adolescents. This study aims to provide the first systematic review and meta-analysis of the association between PTSD and suicidality in adolescents. Methods: Five bibliographic databases (Medline, EMBASE, PsycINFO, Web of Science and PILOT) were screened for suitable articles. Twenty-eight studies (which provided 28 independent samples) were included in the review. The overall meta-analyses of the association between PTSD and suicidality were followed by subgroup and meta-regression analyses. Results: A highly significant positive association was found between PTSD and suicidality (d = 0.701, 95 % CI 0.555-0.848). The subgroup and meta-regression analyses showed that the association between PTSD and suicidality persisted whilst adjusting for various sources of between-study heterogeneity, such as, different levels of severity of suicidality, target groups, and methodological quality of the studies. Conclusions: Suicidality in adolescents with PTSD is a major problem which requires further research effort. The implications of these results are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.3389/fpsyt.2014.00088,"Conditioned Fear Associated Phenotypes as Robust, Translational Indices of Trauma-, Stressor-, and Anxiety-Related Behaviors","Posttraumatic stress disorder (PTSD) is a heterogeneous disorder that affects individuals exposed to trauma (e.g., combat, interpersonal violence, and natural disasters). It is characterized by hyperarousal, intrusive reminders of the trauma, avoidance of trauma-related cues, and negative cognition and mood. This heterogeneity indicates the presence of multiple neurobiological mechanisms underlying the development and maintenance of PTSD. Fear conditioning is a robust, translational experimental paradigm that can be employed to elucidate these mechanisms by allowing for the study of fear-related dimensions of PTSD (e.g., fear extinction, fear inhibition, and generalization of fear) across multiple units of analysis. Fear conditioning experiments have identified varying trajectories of the dimensions described, highlighting exciting new avenues of targeted, focused study. Additionally, fear conditioning studies provide a translational platform to develop novel interventions. The current review highlights the versatility of fear conditioning paradigms, the implications for pharmacological and non-pharmacological treatments, the robustness of these paradigms to span an array of neuroscientific measures (e.g., genetic studies), and finally the need to understand the boundary conditions under which these paradigms are effective. Further understanding these paradigms will ultimately allow for optimization of fear conditioning paradigms, a necessary step towards the advancement of PTSD treatment methods.",0 +https://doi.org/10.1089/tmj.2013.0337,A Pilot Trial of Telephone-Based Collaborative Care Management for PTSD Among Iraq/Afghanistan War Veterans,"Collaborative care and care management are cornerstones of Primary Care-Mental Health Integration (PC-MHI) and have been shown to reduce depressive symptoms. Historically, the standard of Veterans Affairs (VA) collaborative care was referring patients with posttraumatic stress disorder (PTSD) to specialty care. Although referral to evidence-based specialty care is ideal, many veterans with PTSD do not receive such care. To address this issue and reduce barriers to care, VA currently recommends veterans with PTSD be offered treatment within PC-MHI as an alternative. The current project outlines a pilot implementation of an established telephone-based collaborative care model-Translating Initiatives for Depression into Effective Solutions (TIDES)-adapted for Iraq/Afghanistan War veterans with PTSD symptoms (TIDES/PTSD) seen in a postdeployment primary care clinic.Structured medical record extraction and qualitative data collection procedures were used to evaluate acceptability, feasibility, and outcomes.Most participants (n=17) were male (94.1%) and white (70.6%). Average age was 31.2 (standard deviation=6.4) years. TIDES/PTSD was successfully implemented within PC-MHI and was acceptable to patients and staff. Additionally, the total number of care manager calls was positively correlated with number of psychiatry visits (r=0.63, p<0.05) and amount of reduction in PTSD symptoms (r=0.66, p<0.05). Overall, participants in the pilot reported a significant reduction in PTSD symptoms over the course of the treatment (t=2.87, p=0.01).TIDES can be successfully adapted and implemented for use among Iraq/Afghanistan veterans with PTSD. Further work is needed to test the effectiveness and implementation of this model in other sites and among veterans of other eras.",0 +https://doi.org/10.1002/jts.20611,Enhancing self-report assessment of PTSD: Development of an item bank,"The authors report results of work to enhance self-report posttraumatic stress disorder (PTSD) assessment by developing an item bank for use in a computer-adapted test. Computer-adapted tests have great potential to decrease the burden of PTSD assessment and outcomes monitoring. The authors conducted a systematic literature review of PTSD instruments, created a database of items, performed qualitative review and readability analysis, and conducted cognitive interviews with veterans diagnosed with PTSD. The systematic review yielded 480 studies in which 41 PTSD instruments comprising 993 items met inclusion criteria. The final PTSD item bank includes 104 items representing each of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association [APA], 1994), PTSD symptom clusters (reexperiencing, avoidance, and hyperarousal), and 3 additional subdomains (depersonalization, guilt, and sexual problems) that expanded the assessment item pool.",0 +https://doi.org/10.1136/qshc.2009.032870,"The natural history of recovery for the healthcare provider ""second victim"" after adverse patient events","When patients experience unexpected events, some health professionals become ""second victims"". These care givers feel as though they have failed the patient, second guessing clinical skills, knowledge base and career choice. Although some information exists, a complete understanding of this phenomenon is essential to design and test supportive interventions that achieve a healthy recovery.The purpose of this article is to report interview findings with 31 second victims. After institutional review board approval, second victim volunteers representing different professional groups were solicited for private, hour-long interviews. The semistructured interview covered demographics, participant recount of event, symptoms experienced and recommendations for improving institutional support. After interviews, transcripts were analyzed independently for themes, followed by group deliberation and reflective use with current victims.Participants experienced various symptoms that did not differ by sex or professional group. Our analysis identified six stages that delineate the natural history of the second victim phenomenon. These are (1) chaos and accident response, (2) intrusive reflections, (3) restoring personal integrity, (4) enduring the inquisition, (5) obtaining emotional first aid and (6) moving on. We defined the characteristics and typical questions second victims are desperate to have answered during these stages. Several reported that involvement in improvement work or patient safety advocacy helped them to once again enjoy their work.We now believe the post-event trajectory is largely predictable. Institutional programs could be developed to successfully screen at-risk professionals immediately after an event, and appropriate support could be deployed to expedite recovery and mitigate adverse career outcomes.",0 +https://doi.org/10.1002/jts.20672,The longitudinal course of PTSD among disaster workers deployed to the World Trade Center following the attacks of September 11th,"This study examined the long-term mental health outcomes of 2,960 nonrescue disaster workers deployed to the World Trade Center site in New York City following the September 11, 2001 (9/11) terrorist attacks. Semistructured interviews and standardized self-report measures were used to assess the prevalence of posttraumatic stress disorder (PTSD) and other psychopathology 4 and 6 years after the attacks. Clinician-measured rates of PTSD and partial PTSD 4-years posttrauma were 8.4% and 8.9%, respectively, in a subsample of 727 individuals. Rates decreased to 5.8% and 7.7% for full and partial PTSD 6 years posttrauma. For the larger sample, self-report scores revealed probable PTSD and partial PTSD prevalence to be 4.8% and 3.6% at 4 years, and 2.4% and 1.8% at 6 years. Approximately 70% of workers never met criteria for PTSD. Although PTSD rates decreased significantly over time, many workers remained symptomatic, with others showing delayed-onset PTSD. The strongest predictors of ongoing PTSD 6 years following 9/11 were trauma history (odds ratio (OR) = 2.27, 95% confidence interval (CI) [1.06, 4.85]); the presence of major depressive disorder 1-2 years following the trauma (OR = 2.80, 95% CI [1.17, 6.71]); and extent of occupational exposure (OR = 1.31, 95% CI [1.13, 1.51]). The implications of the findings for both screening and treatment of disaster workers are discussed.",0 +https://doi.org/10.4067/s0718-48082015000300009,Resiliencia en adultos: una revisión teórica,"The objective of this study is to make a theoretical review on resilience in adults between the year 2000 and 2011. A search of papers published in the databases Scopus, PsycInfo, Psicodoc, Web of Science and summaries Dialnet and ISOC (Social Sciences and Humanities) was performed. In total, 418 items were found that met the inclusion criteria. We conclude that in the studies published between 200 and 2011 on resilience in adults prevail cross-sectional studies, published in English, quantitative, and using samples from USA. Resilience is related psychological disorders. It is emphasized the need to include resilience in health education programs to improve ways of coping in the context of risk and adversity.",0 +https://doi.org/10.1080/10926771.2014.893276,PTSD Symptom Patterns Following Traumatic and Nontraumatic Events,"This study extends research examining posttraumatic stress disorder symptoms following different types of potentially traumatic events. Specifically, the study examined and compared the symptom patterns observed in those who suffered a major accident, the unexpected death of a loved one, or sexual assault. Based on recent findings, this project also examines those who reported nontraumatic (but stressful) events, as well as comparing symptom patterns across gender. Findings suggest different types of traumas might be associated with differences in severity and patterns of symptoms for women (but not for men), suggesting symptom patterns manifest differently in men and women. Results also call into question the assumption that traumatic events demonstrate different symptom patterns than other types of events.",0 +https://doi.org/10.1002/jts.21898,Unique PTSD Clusters Predict Intention to Seek Mental Health Care and Subsequent Utilization in US Veterans with PTSD Symptoms,"Many veterans return from deployment with posttraumatic stress disorder (PTSD), but most attend only a limited number of mental health care visits. Although global PTSD relates to seeking mental health care, it is unclear whether specific features of PTSD inform the low rates of mental health care utilization. This study examined PTSD cluster severities of avoidance, reexperiencing, dysphoria, and hyperarousal as predictors of intention to seek mental health care and prospective treatment utilization. US veterans with at least subthreshold PTSD (N = 189) completed a PTSD symptom measure and indicated whether they intended to seek mental health care. Prospective Department of Veterans Affairs mental health care utilization was extracted from the medical record. At the bivariate level, each cluster was positively associated with a positive intention to seek mental health care and prospective treatment utilization. In multivariate models, however, dysphoria severity (OR = 1.16, 95% CI [1.06, 1.26]) was uniquely and positively correlated with intention to seek mental health care, whereas higher avoidance severity (IRR = 0.86, 95% CI [0.76, 0.98]) predicted lower treatment utilization, and higher reexperiencing severity (IRR = 1.07, 95% CI [1.01, 1.14]) predicted greater treatment utilization. It is critical to tailor interventions to target specific features of PTSD and to meet patients where they are.",0 +https://doi.org/10.1001/jamapsychiatry.2014.666,Association of Symptoms Following Mild Traumatic Brain Injury With Posttraumatic Stress Disorder vs Postconcussion Syndrome,"A proportion of patients experience long-lasting symptoms following mild traumatic brain injury (MTBI). The postconcussion syndrome (PCS), included in the DSM-IV, has been proposed to describe this condition. Because these symptoms are subjective and common to other conditions, there is controversy whether PCS deserves to be identified as a diagnostic syndrome.To assess whether persistent symptoms 3 months following head injury are specific to MTBI or whether they are better described as part of posttraumatic stress disorder (PTSD).We conducted a prospective cohort study of injured patients recruited at the adult emergency department of the University Hospital of Bordeaux from December 4, 2007, to February 25, 2009.At 3-month follow-up, we compared the prevalence and risk factors for PCS and PTSD. Multiple correspondence analyses were used to assess clustering of symptoms and their associations with the type of injury.We included 534 patients with head injury and 827 control patients with other nonhead injuries. Three months following the trauma, 21.2% of head-injured and 16.3% of nonhead-injured patients fulfilled the DSM-IV diagnosis of PCS; 8.8% of head-injured patients fulfilled the diagnostic criteria for PTSD compared with 2.2% of control patients. In multivariate analysis, MTBI was a predictor of PTSD (odds ratio, 4.47; 95% CI, 2.38-8.40) but not of PCS (odds ratio, 1.13; 95% CI, 0.82-1.55). Correspondence analysis suggested that symptoms considered part of PCS behave similarly to PTSD symptoms in the hyperarousal dimension. None of these 22 symptoms showed any pattern of clustering, and no clear proximity with head or nonhead injury status could be found.Persistent subjective symptoms frequently reported 3 months after MTBI are not specific enough to be identified as a unique PCS and should be considered part of the hyperarousal dimension of PTSD.",0 +https://doi.org/10.1016/0022-3999(67)90010-4,The social readjustment rating scale,"IN PREVIOUS studies [l] it has been established that a cluster of social events requiring change in ongoing life adjustment is significantly associated with the time of illness onset. Similarly, the relationship of what has been called ‘life stress,’ ‘emotional stress,’ ‘object loss,’ etc. and illness onset has been demonstrated by other investigations [2-131. It has been adduced from these studies that this clustering of social or life events achieves etiologic significance as a necessary but not sufficient cause of illness and accounts in part for the time of onset of disease. Methodologically, the interview or questionnaire technique used in these studies has yielded only the number and types of events making up the cluster. Some estimate of the magnitude of these events is now required to bring greater precision to this area of research and to provide a quantitative basis for new epidemiological studies of diseases. This report defines a method which achieves this requisite. METHOD",0 +,Psychophysiology of structural imagery in post-traumatic stress disorder.,"Discusses psychophysiological symptoms associated with posttraumatic stress disorder (PTSD), noting that an approach to PTSD involving a brain model can account for the paradoxical nature of disconnections of cognitive and affective processing in response to severe stress. The structural-imagery approach to PTSD capitalizes on the natural capacity of the equilibrium and nonequilibrium seeking processes of the unconscious brain and conscious mind to overcome the functional disconnection syndromes associated with extreme stress. A case example of a male accident victim suffering from an acute post-traumatic stress reaction is presented. (33 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1192/bjp.180.5.441,Psychiatry of whiplash neck injury,"The psychiatric outcome of whiplash neck injury is controversial.To describe outcomes and predictors as compared with other types of road accident injury.Consecutive emergency department attenders (n=1148; whiplash 278) assessed by self-report at baseline, 3 months, 1 year and 3 years.Moderate to severe pain was reported by 27% of whiplash sufferers at 1 year and by 30% at 3 years. Psychiatric consequences were common and persistent. Whiplash victims and those with bony injury were more likely to seek compensation. Accident and early post-accident psychosocial variables predicted the pain at 1 year. Claiming compensation at 3 months predicted the pain at 1 year for those with whiplash or bony injury.There is no special psychiatry of whiplash neck injury. Psychological variables and consequences are important following whiplash in a similar manner to other types of injury.",0 +https://doi.org/10.1080/02791072.2012.736803,Helium Inhalation in Adolescents: Characteristics of Users and Prevalence of Use,"Although helium-related fatalities and concerns about potentially harmful effects of helium use have increased in recent years, virtually nothing is known about the epidemiology of helium inhalation in adolescents. This exploratory investigation examined the prevalence and correlates of helium inhalation in a large sample of at-risk youth. Study participants were 723 Missouri adolescents (M age = 15.5, SD = 1.2) in residential treatment for delinquent behavior. More than one-in-nine (N = 81, 11.5%) adolescents had inhaled helium with the intention of getting high, and one-third (N = 27, 34.2%) of helium users reported they actually did get high when they inhaled helium. Helium users were significantly more likely to be Caucasian, to live in rural/small town areas, and to have histories of mental illness, auditory hallucinations, and alcohol and marijuana use than nonusers. Helium users also reported significantly more current psychiatric distress, suicidality, traumatic life experiences, and antisocial attitudes, traits, and behaviors than nonusers. Helium inhalation was prevalent in this sample and many such users reported getting high while using helium. Helium users had psychosocial profiles similar to those of volatile solvent users, suggesting that they may be at substantial risk for a variety of adverse health outcomes.",0 +https://doi.org/10.3109/02699052.2013.873821,"PTSD and TBI co-morbidity: Scope, clinical presentation and treatment options","Primary objective: To summarize the literature on post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) and their co-morbidity, focusing on diagnosis, clinical symptoms and treatment issues relevant to the clinician.Research design: Review of the literature.Methods and procedures: Pubmed searches were performed using the terms post-traumatic stress disorder, traumatic brain injury, sleep, cognitive, depression, anxiety, treatment and combinations of these terms. Those articles relevant to the objective were included.Main outcomes and results: This study presents pathophysiological, neuroimaging and clinical data on co-morbid PTSD and TBI. It reviews associated conditions, emphasizing the impact of cognitive and sleep problems. It summarizes the emerging literature on treatment effectiveness for co-morbid PTSD and TBI, including psychotherapy, pharmacotherapy and cognitive rehabilitation.Conclusions: Both PTSD and TBI commonly occur in the general population, both share some pathophysiological characteristics and both are associated with cognitive impairment and sleep disruption. PTSD and TBI present with a number of overlapping symptoms, which can lead to over-diagnosis or misdiagnosis. Both conditions are associated with co-morbidities important in diagnosis and treatment planning. More research is needed to elucidate what treatments are effective in PTSD and TBI co-morbidity and on factors predictive of treatment success.",0 +https://doi.org/10.1080/13554794.2014.890727,Working memory training with tDCS improves behavioral and neurophysiological symptoms in pilot group with post-traumatic stress disorder (PTSD) and with poor working memory,"This pilot study investigated the feasibility of treating people suffering from both post-traumatic stress disorder (PTSD) and poor working memory by employing a combination of computerized working memory training and transcranial direct current stimulation (tDCS). After treatment, all four participants showed clinically significant improvements on a range of cognitive and emotional performance measures. Moreover, these improvements were accompanied by theoretically significant neurophysiological changes between pre- and post-treatment electroencephalographic (EEG) recordings. Specifically, the P3a component of participants' event related potentials (ERP) in response to novelty stimuli, characteristically abnormal in this clinical population, shifted significantly toward database norms. So, participants' initially slow alpha peak frequency (APF), theorized to underlie impaired cognitive processing abilities, also increased in both frequency and amplitude as a result of treatment. On the basis of these promising results, more extensive controlled studies are warranted.",0 +https://doi.org/10.1016/j.psyneuen.2009.10.009,The impact of maternal childhood abuse on maternal and infant HPA axis function in the postpartum period,"Early life trauma, particularly child abuse, has been associated with aberrations in hypothalamic–pituitary–adrenal (HPA) axis functioning in adulthood. However, the relationship of early abuse and later adult neuroendocrine changes may be moderated by additional factors such as comorbid psychopathology and recent life stress. Parental exposure to child abuse may have transgenerational effects, with offspring of abuse victims showing similar neuroendocrine profiles as their mothers. The majority of previous studies in this area focus on adult offspring, and the degree to which the effects of parental child abuse can be detected earlier in the development of the offspring remains obscure. The current study utilized a clinical sample of women with a history of MDD ( N = 126), to examine the effects of maternal early life sexual and physical abuse (Childhood Trauma Questionnaire (CTQ)) on both maternal and infant salivary cortisol levels during a laboratory stress paradigm at 6 months postpartum. Maternal child abuse was associated with steeper declines in cortisol in the mothers and lower baseline cortisol in their infants. Comorbid maternal PTSD, current maternal depressive symptoms, and recent life stressors were significant moderators of maternal cortisol change. Maternal abuse history was associated with increases in cortisol levels in those mothers who experienced these additional stressors. Similarly, a history of early maternal abuse and comorbid PTSD was associated with greater increases in infant cortisol levels. Maternal childhood abuse was associated with HPA axis function in both the mother and the infant during the postpartum period.",0 +https://doi.org/10.1080/15504263.2013.779157,Does Posttraumatic Stress Disorder Affect Post-Treatment Methamphetamine Use?,"Although trauma is a well-established risk factor for substance use disorders, little is known about the association between posttraumatic stress disorder (PTSD) and treatment outcomes among methamphetamine users. In the present study, we examine the relationship between PTSD and post-treatment methamphetamine use outcomes, hospitalizations, and overall psychiatric impairment.Using data from 526 adults in the largest psychosocial clinical trial of methamphetamine users conducted to date, this study examined: (1) treatment outcomes of methamphetamine users with concomitant PTSD three years after psychosocial treatment for methamphetamine dependence; and (2) PTSD symptom clusters as risk factors for post-treatment relapse to methamphetamine use.PTSD was associated with poorer methamphetamine use outcomes; methamphetamine use frequency throughout the 3-year follow-up was significantly greater among individuals with a PTSD diagnosis, and those with PTSD had more than five times the odds of reporting methamphetamine use in the 30 days prior to the follow-up interview, OR= 5.2, 95% CI [2.0-13.3]. Additionally, higher levels of other Axis I psychopathology were observed among methamphetamine users with PTSD. Avoidance and arousal symptoms predicted post-treatment methamphetamine use.Addressing these high risk PTSD symptoms and syndromes in methamphetamine users may be helpful as a means of improving treatment outcomes in this population.",0 +https://doi.org/10.1016/j.aquatox.2014.11.020,1H NMR based metabolomics approach to study the toxic effects of herbicide butachlor on goldfish (Carassius auratus),"Butachlor, one of the most widely used herbicides in agriculture, has been reported with high ecotoxicity to aquatic plants and animals. In this study, a (1)H NMR based metabolomics approach combined with histopathological examination and biochemical assays was applied to comprehensively investigate the toxic effects of butachlor on four important organs (gill, brain, liver and kidney) of goldfish (Carassius auratus) for the first time. After 10 days' butachlor exposure at two dosages of 3.2 and 0.64 μmol/L, fish tissues (gill, brain, liver and kidney) and serum were collected. Histopathological inspection revealed severe impairment of gill filaments and obvious cellular edema in livers and kidneys. The increase of glutathione peroxidase (GSH-Px) activity in gill and methane dicarboxylic aldehyde (MDA) level in four tissues reflected the disturbance of antioxidative system in the intoxicated goldfish. Serum lactate dehydrogenase (LDH) activity and creatinine (CRE) level were increased in butachlor exposure groups, suggesting liver and kidney injuries induced by butachlor. Orthogonal signal correction partial least-squares discriminant analysis (OSC-PLS-DA) of NMR profiles disclosed metabolic changes that were related to the toxic effects of butachlor including oxidative stress, disorder of energy metabolism and amino acids metabolism, and disturbance of neurotransmitter balance in butachlor exposed goldfish. This integrated metabolomics approach provided a molecular basis underlying the toxicity of butachlor and demonstrated that metabolomics was a powerful and highly effective approach to elucidate the toxicity and underlying mechanisms of herbicides and pesticides, applicable for their risk assessment.",0 +https://doi.org/10.1002/jts.21981,Feasibility of a Screening Program for At-Risk Children Following Accidental Injury,en,0 +https://doi.org/10.1080/10640260802016670,Profile of 50 Women with Midlife-Onset Eating Disorders,"The aim of this study was to present a detailed profile of 50 women eating disorder (ED) inpatients who reported first ED onset at age 40 or above. We assessed patients' sociodemographics, severity-of-illness, comorbid diagnoses, personality profiles, and short-term treatment outcomes. Compared to patients of more traditional young adult ages, results revealed unique features of midlife-onset ED inpatients, including less severe and less common self-reported ED symptomology measured by the EDI-2; a predominance of pure restricting behaviors and rarity of bulimia; similar rates of co-occurring depression and anxiety but of less severity; fewer substance use disorders with a predominance of sedating/calming substance usage; many fewer Cluster C diagnoses on Axis II; substantially greater histories of sexual abuse; and different MMPI-2 profiles emphasizing much greater denial. The corresponding needs among midlife-onset ED inpatients for specialized assessment and treatment interventions are considered.",0 +https://doi.org/10.2147/nedt.2006.2.4.475,Psychopharmacology of topiramate: from epilepsy to bipolar disorder,"Topiramate (TPM) is one of the novel antiepileptic drugs and exhibits a wide range of mechanisms of action. Efficacy of TPM has been demonstrated in partial-onset seizures and primary generalized seizures in adults and children, as both monotherapy and adjunctive therapy. More recently, TPM has been proposed as an add-on treatment for patients with lithium-resistant bipolar disorder, especially those displaying rapid-cycling and mixed states. This paper reviews the multiple mechanisms of action and the tolerability profile of TPM in the light of its therapeutic potential in affective disorders. Studies of TPM in bipolar disorder are evaluated, and the efficacy and tolerability issues as a mood stabilizing agent are discussed.",0 +https://doi.org/10.1093/med:psych/9780195172492.003.0025,Psychological Resilience in the Face of Terrorism,,0 +https://doi.org/10.1007/s11199-006-9346-y,Gender Group Differences in Coping with Chronic Terror: The Israeli Scene,"Gender group differences in terror-stress, cognitive appraisals, ways of coping with terror, and stress reactions were explored in a sample of Israeli adults following prolonged exposure to political violence. Data were gathered at the height of the Al-Aqsa Intifada uprising (May/July 2002) from a sample of 707 adult participants (60% women and 40% men) residing in Haifa and northern Israel. Israeli women reported that they were more distressed by political violence than the men did, and they also appraised the crisis situation as more threatening and less manageable. Women reported using more problem-focused as well as emotion-focused coping than men did; both men and women used a mixture of coping strategies. Compared to men, women reported that they experienced more somatic symptoms and more frequent posttraumatic stress symptoms than men did. Negative affectivity was found to mediate gender differences in appraisals, coping, and outcomes. Overall, the nexus of relations among key variables was found to be highly similar for men and women. These data suggest that women may be more reactive to chronic political violence situations than men are. The data are discussed and explicated in the context of stress and coping theory and prior research on political violence and community disasters. © 2006 Springer Science+Business Media, Inc.",0 +https://doi.org/10.1515/mgrsd-2015-0017,"Regional economic resilience: concepts, empirics and a critical review","Abstract Regional (economic) resilience and resilient thinking have gained considerable attention in recent years. My aim with this work is to throw light on some of the underlying aspects of regional economic resilience and resilient thinking. In the current study I give an overview of the notion, key concepts, main empirical results and planning tasks concerning regional (economic) resilience as well as outlining some of the criticisms. Finally, I provide some suggestions for studies in resilience and resilient thinking for future research agendas. The main results of the study is my own belief in the concept of regional economic resilience, and an overview and comparison of regional (economic) resilience literature and empirics that lead me to highlight some of the shortcomings of the research topic.",0 +https://doi.org/10.1017/s0033291708002778,Risk factors for post-traumatic stress disorder among UK Armed Forces personnel,"Background There is considerable interest in understanding further the factors that increase the risk of post-traumatic stress disorder (PTSD) for military personnel. This study aimed to investigate the relative contribution of demographic variables; childhood adversity; the nature of exposure to traumatic events during deployment; appraisal of these experiences; and home-coming experiences in relation to the prevalence of PTSD ‘caseness’ as measured by a score of ⩾50 on the PTSD Checklist (PCL) in UK Armed Forces personnel who have been deployed in Iraq since 2003. Method Data were drawn from the first stage of a retrospective cohort study comparing UK military personnel who were deployed to the 2003 Iraq War with personnel serving in the UK Armed Forces on 31 March 2003 but who were not deployed to the initial phase of war fighting. Participants were randomly selected and invited to participate. The response rate was 61%. We have limited these analyses to 4762 regular service individuals who responded to the survey and who have been deployed in Iraq since 2003. Results Post-traumatic stress symptoms were associated with lower rank, being unmarried, having low educational attainment and a history of childhood adversity. Exposure to potentially traumatizing events, in particular being deployed to a ‘forward’ area in close contact with the enemy, was associated with post-traumatic stress symptoms. Appraisals of the experience as involving threat to one's own life and a perception that work in theatre was above an individual's trade and experience were strongly associated with post-traumatic stress symptoms. Low morale and poor social support within the unit and non-receipt of a home-coming brief (psycho-education) were associated with greater risk of post-traumatic stress symptoms. Conclusions Personal appraisal of threat to life during the trauma emerged as the most important predictor of post-traumatic stress symptoms. These results also raise the possibility that there are important modifiable occupational factors such as unit morale, leadership, preparing combatants for their role in theatre which may influence an individual's risk of post-traumatic stress symptoms. Therefore interventions focused on systematic preparation of personnel for the extreme stress of combat may help to lessen the psychological impact of deployment.",0 +https://doi.org/10.1023/b:qure.0000031337.73269.64,The Relationship Between Quality of Life and Psychiatric Impairment for a Taiwanese Community Post-Earthquake,"This purpose of this study was to investigate the relationship between quality of life and psychiatric impairment in a Taiwanese community located near the epicenter of the 1999 earthquake, as assessed four to six months after the natural catastrophe. Trained assistants interviewed the 4223 respondents using the disaster-related psychological screening test (DRPST), an instrument specifically designed and validated by senior psychiatrists for assessment of psychiatric impairment after natural catastrophe. Additionally, the 36-Item Short-Form Health Survey (SF-36) was used to evaluate quality of life. The collected results were analyzed using Windows SPSS 10.0 software. Psychiatric impairment rated moderate to severe was assessed for 1448 (34.3%) of the responding residents. The 4223 respondents were divided into 4 psychiatric-impairment groups based on DPRST score: healthy (n = 952); mild impairment (n = 1823); moderate impairment (n = 1126); and, severe impairment (n = 322). The four groups were compared for a number of salient factors, including gender, age, current marital status and psychiatricimpairment score, to determine impact on quality of life. Respondents assessed as psychiatrically impaired tended to be older, female, divorced/widowed, and less educated, and they were more likely to have experienced major familial financial loss as an immediate consequence of the earthquake. Further, the greater the severity of the psychiatric impairment, the lower the scores for quality of life, for both the physical and mental aspects of this important general indicator.",0 +https://doi.org/10.1037//0021-843x.103.1.117,Dissociative tendencies and dissociative disorders.,"Although dissociative disorders are relatively rare, dissociative experiences are rather common in everyday life. Dissociative tendencies appear to be modestly related to other dimensions of personality, such as hypnotizability, absorption, fantasy proneness, and some facets of openness to experience. These dispositional variables may constitute diathesis, or risk factors, for dissociative psychopathology, but more complex models relating personality to psychopathology may be more appropriate. The dissociative disorders raise fundamental questions about the nature of self and identity and the role of consciousness and autobiographical memory in the continuity of personality.",0 +https://doi.org/10.1016/j.jad.2015.03.049,Genome-wide association study of posttraumatic stress disorder in a cohort of Iraq–Afghanistan era veterans,"Posttraumatic stress disorder (PTSD) is a psychiatric disorder that can develop after experiencing traumatic events. A genome-wide association study (GWAS) design was used to identify genetic risk factors for PTSD within a multi-racial sample primarily composed of U.S. veterans.Participants were recruited at multiple medical centers, and structured interviews were used to establish diagnoses. Genotypes were generated using three Illumina platforms and imputed with global reference data to create a common set of SNPs. SNPs that increased risk for PTSD were identified with logistic regression, while controlling for gender, trauma severity, and population substructure. Analyses were run separately in non-Hispanic black (NHB; n = 949) and non-Hispanic white (NHW; n = 759) participants. Meta-analysis was used to combine results from the two subsets.SNPs within several interesting candidate genes were nominally significant. Within the NHB subset, the most significant genes were UNC13C and DSCAM. Within the NHW subset, the most significant genes were TBC1D2, SDC2 and PCDH7. In addition, PRKG1 and DDX60L were identified through meta-analysis. The top genes for the three analyses have been previously implicated in neurologic processes consistent with a role in PTSD. Pathway analysis of the top genes identified alternative splicing as the top GO term in all three analyses (FDR q < 3.5 × 10(-5)).No individual SNPs met genome-wide significance in the analyses.This multi-racial PTSD GWAS identified biologically plausible candidate genes and suggests that post-transcriptional regulation may be important to the pathology of PTSD; however, replication of these findings is needed.",0 +https://doi.org/10.1080/19361521.2012.671743,Introduction to Part I: Trauma and Juvenile Delinquency: Dynamics and Developmental Mechanisms,"This article introduces the first part of a two-part special issue featuring new directions in research on traumatized youth in the juvenile justice system. The articles in this issue focus on research devoted to investigating the underlying development mechanisms accounting for the associations among exposure to traumatic events, posttraumatic stress reactions, and delinquent behavior. The articles in this issue advance our understanding of these questions by expanding the scope of research to include the study of complex trauma as well as the differentiation between primary psychopathic traits among youth versus secondary psychopathy borne of trauma. In addition, studies are included targeting specific theoretically-derived mediators of the relations between childhood adversity and delinquency, including depressive cognitions, as well as specific symptom clusters of posttraumatic stress. The remaining articles shed light on the differential roles that trauma and demographic factors play in predicting recidivism and mental health functioning among youth involved in the juvenile justice system, including gender, ethnicity, age, and sexual minority status. Taken together, these studies suggest important directions for the development of effective interventions to target trauma-related sequelae among troubled youth and their families. © 2012",0 +https://doi.org/10.1080/02791072.2014.877321,History and Future of the Multidisciplinary Association for Psychedelic Studies (MAPS),"This article describes the teenage vision of the founder of the Multidisciplinary Association for Psychedelic Studies (MAPS) that humanity's future would be aided by the therapeutic and spiritual potential of psychedelic substances. The article traces the trajectory of MAPS from inception in 1986 to its present, noting future goals with respect to research, outreach, and harm reduction. MAPS was created as a non-profit psychedelic pharmaceutical company in response to the 1985 scheduling of 3,4-methylenedioxymethamphetamine (MDMA). Overcoming many hurdles, MAPS developed the first double-blind, placebo-controlled trial of MDMA-assisted psychotherapy for posttraumatic stress disorder (PTSD) and plans for FDA prescription approval in 2021. MAPS' program of research expanded to include a trial of lysergic acid diethylamide (LSD)-assisted psychotherapy for anxiety when facing life-threatening illness, observational studies of ibogaine in the treatment of addiction, and studies of MDMA for social anxiety in people with autism spectrum disorders. MAPS meets the challenges of drug development through a clinical research team led by a former Novartis drug development professional experienced in the conduct, monitoring, and analysis of clinical trials. MAPS' harm-reduction efforts are intended to avoid backlash and build a post-prohibition world by assisting non-medical users to transform difficult psychedelic experiences into opportunities for growth.",0 +https://doi.org/10.1017/s1461145707008139,Stress hormones and post-traumatic stress disorder in civilian trauma victims: a longitudinal study. Part II: The adrenergic response,"The aim of the study was to prospectively evaluate the association between the occurrence of post-traumatic stress disorder (PTSD) and the adrenergic response to the traumatic event, and additionally, to explore the link between PTSD and the initial norepinephrine:cortisol ratio. Plasma levels and urinary excretion of norepinephrine (NE) were measured in 155 survivors of traumatic events during their admission to a general hospital emergency room (ER) and at 10 d, 1 month and 5 months later. Symptoms of peri-traumatic dissociation, PTSD and depression were assessed in each follow-up session. The Clinician-Administered PTSD Scale (CAPS) conferred a diagnosis of PTSD at 5 months. Trauma survivors with (n=31) and without (n=124) PTSD had similar levels of plasma NE, urinary NE excretion, and NE:cortisol ratio in the ER. Plasma NE levels were lower in subjects with PTSD at 10 d, 1 month, and 5 months. There was a weak but significant positive correlation between plasma levels of NE in the ER and concurrent heart rate, and a negative correlation between NE in the ER and dissociation symptoms. Peripheral levels of NE, shortly after traumatic events, are poor risk indicators of subsequent PTSD among civilian trauma victims. Simplified biological models may not properly capture the complex aetiology of PTSD.",0 +https://doi.org/10.2466/pr0.1995.76.1.139,MMPI Scores of Female Victims,"Samples of MMPIs of women who were victims of abuse or manifested a Posttraumatic Stress Disorder were drawn from two private practice settings, one urban and one in a small town. Each PTSD sample included 21 persons. For comparison, two contrast samples of 15 persons each were drawn from the same populations. A cut-off point of T = 65 for PK yielded a 69% hit rate for classifying PTSD and contrast subjects. Since scores on PS and PK were so highly correlated, no independent analyses were warranted. Although the PTSD group yielded a more elevated mean profile, there were no characteristic 2-point codes. Therefore, PK is more useful in identifying Posttraumatic Stress Disorder than either profile elevation or configuration.",0 +https://doi.org/10.1037/a0023927,Peritraumatic dissociation and experiential avoidance as prospective predictors of posttraumatic stress symptoms.,"Peritraumatic dissociation (PD) and experiential avoidance (EA) have been implicated in the etiology of posttraumatic stress symptomatology (PTSS); however, the function of these two factors in the onset and maintenance of PTSS following a potentially traumatic event is unclear. The temporal relationships between EA, PD, and the four clusters of PTSS proposed by the Simms/Watson dysphoria model (Simms, Watson, & Doebbeling, 2002) were examined in a three-wave prospective investigation of 532 undergraduate women participating in an ongoing longitudinal study at the time of a campus shooting. Path analyses indicated that preshooting EA predicted greater PD, intrusions, and dysphoria symptoms approximately one month postshooting. PD was associated with increased symptomatology across all four clusters 1-month postshooting, while 1-month postshooting EA was associated with higher dysphoria and hyperarousal symptoms eight months postshooting. PD had a significant indirect effect on all four PTSS clusters eight months postshooting via 1-month postshooting symptom reports. The results suggest that both EA and PD show unique influences as risk factors for PTSS following a potentially traumatic event.",0 +,Aggression in war veterans suffering from posttraumatic stress disorder with co-morbid alcoholism.,"For thousands of years it has been known that aggression as a symptom appears in numerous psychiatric disorders and diseases. During the last decade the appearance of the aggressive behavior related to the posttraumatic stress disorder (PTSD) has been frequently investigated, often associated with war trauma. The goal of this study is to analyze the impact of alcoholism on a way war veterans suffering from chronic PTSD express and control aggression. The sample included 240 war veterans with chronic PTSD. The subjects were divided in two groups. PTSD group (n=147) and controlled group composed of those suffering from alcoholism in addition to PTSD (n=93). In this study, the following psychological instruments were used: The Harvard trauma questionnaire for PTSD diagnosis (HTQ); the questionnaire for self-evaluation of aggression (STAXI); The Profile Index Emotion (PIE); questionnaire for auto-diagnosis of alcoholism (CAGE). The obtained results indicate that subjects who have PTSD with co-morbid alcoholism are more deprived, aggressive (p < 0.001) and oppositional (p < 0.05) in comparison to subjects whose PTSD is not combined with alcoholism (PIE). The aggression is statistically more expressed in subjects with PTSD who have also been diagnosed with alcoholism on all subscales in comparison to subjects with PTDS who have not been diagnosed with alcoholism: the current state of aggression, the general state of aggression, aggression towards an unfair treatment, aggression directed inwards and outwards (p < 0.001); aggression towards nonspecific provocation and a general way of expressing aggression (p < 0.05) (STAXI). Subjects that had PTSD combined with alcoholism show a higher degree of aggression in comparison to subjects with PTDS who are not diagnosed with alcoholism.",0 +,Posttraumatic stress disorder: the burden to the individual and to society.,"Little is known about the total population prevalence and societal costs of posttraumatic stress disorder (PTSD); this report reviews relevant literature on these topics.A literature search of computerized databases for published reports on trauma and PTSD was conducted. This literature was reviewed to find data on general population exposure to trauma, conditional risk of PTSD among those exposed to trauma both in focused samples of trauma victims and in general population samples, and the adverse consequences of PTSD.PTSD was found to be a commonly occurring disorder that often has a duration of many years and is frequently associated with exposure to multiple traumas. The impairment associated with PTSD in U.S. samples, where the majority of research on these consequences has been carried out, is comparable to, or greater than, that of other seriously impairing mental disorders. Risk of suicide attempts is particularly high among people with PTSD. Available evidence suggests that the prevalence of PTSD and the adverse emotional and psychological consequences of PTSD are much greater in the many countries around the world that are in the midst of armed conflicts involving political, racial, or ethnic violence.PTSD is a highly prevalent and impairing condition. Only a minority of people with PTSD obtain treatment. Early and aggressive outreach to treat people with PTSD could help reduce the enormous societal costs of this disorder.",0 +https://doi.org/10.1016/j.yebeh.2005.10.003,Posttraumatic stress disorder and major depressive disorder is common in parents of children with epilepsy,"The purpose of the study was to determine the prevalence of posttraumatic stress disorder (PTSD), posttraumatic stress symptoms (PTSS), and major depressive disorder (MDD) in parents of children with epilepsy.Parents (77 mothers and 3 fathers) of children with epilepsy were administered the Structured Clinical Interview for DSM-IV (SCID), PTSD and MDD modules, and the General Health Questionnaire (GHQ).The prevalence of both PTSD and MDD was 31.5%. Fifty-six percent (n = 14) of the participants with PTSD had a diagnosis of MDD. PTSD symptom clusters were very prevalent in the parents of children with epilepsy. Reexperiencing and arousal symptom clusters were more frequent (88.8 and 80% respectively) than the avoidance and numbing symptom cluster (32.5%).These findings suggest that a significant proportion of parents of children with epilepsy experience PTSD and MDD. Increased awareness of the clinical presentations of these disorders may help clinicians to develop preventive and intervention strategies for parents of children with epilepsy.",0 +https://doi.org/10.1017/s0033291714000968,Longitudinal epigenetic variation of DNA methyltransferase genes is associated with vulnerability to post-traumatic stress disorder,"Epigenetic differences exist between trauma-exposed individuals with and without post-traumatic stress disorder (PTSD). It is unclear whether these epigenetic differences pre-exist, or arise following, trauma and PTSD onset.In pre- and post-trauma samples from a subset of Detroit Neighborhood Health Study participants, DNA methylation (DNAm) was measured at DNA methyltransferase 1 (DNMT1), DNMT3A, DNMT3B and DNMT3L. Pre-trauma DNAm differences and changes in DNAm from pre- to post-trauma were assessed between and within PTSD cases (n = 30) and age-, gender- and trauma exposure-matched controls (n = 30). Pre-trauma DNAm was tested for association with post-trauma symptom severity (PTSS) change. Potential functional consequences of DNAm differences were explored via bioinformatic search for putative transcription factor binding sites (TFBS).DNMT1 DNAm increased following trauma in PTSD cases (p = 0.001), but not controls (p = 0.067). DNMT3A and DNMT3B DNAm increased following trauma in both cases (DNMT3A: p = 0.009; DNMT3B: p < 0.001) and controls (DNMT3A: p = 0.002; DNMT3B: p < 0.001). In cases only, pre-trauma DNAm was lower at a DNMT3B CpG site that overlaps with a TFBS involved in epigenetic regulation (p = 0.001); lower pre-trauma DNMT3B DNAm at this site was predictive of worsening of PTSS post-trauma (p = 0.034). Some effects were attenuated following correction for multiple hypothesis testing.DNAm among trauma-exposed individuals shows both longitudinal changes and pre-existing epigenetic states that differentiate individuals who are resilient versus susceptible to PTSD. These distinctive DNAm differences within DNMT loci may contribute to genome-wide epigenetic profiles of PTSD.",0 +https://doi.org/10.1007/s00127-009-0176-4,A person-centred approach to modelling population experiences of trauma and mental illness,"Background: Exposure to traumatic events has been implicated in the onset and development of a range of psychiatric disorders. People can be exposed to multiple traumatic events and previous research suggests that traumatic experiences may cluster at the individual level. Methods: This study aimed to examine the distribution of traumatic experiences in a large nationally representative sample using latent class analysis, and estimate the relationship between these classes and a number of demographic and clinical variables. Data from the National Comorbidity Survey was used. Results: Four latent classes, each representative of a range of traumatic experiences were identified. The classes were labelled 'high risk' (class 1), 'exposure to non-sexual adult interpersonal/non-interpersonal trauma' (class 2), 'intermediate risk/sexual abuse' (class 3), and 'low risk' (class 4). Each of the latent classes was predicted by several of the demographic variables. In addition, membership of classes 1, 2, and 3 increased the risk of each of the clinical variables. Conclusions: The findings have clinical implications for the assessment of trauma histories across a range of psychiatric diagnoses. © 2010 Springer-Verlag.",0 +https://doi.org/10.1111/j.1600-0447.1989.tb09236.x,Disaster severity and emotional disturbance: implications for primary mental health care in developing countries,"ABSTRACT Two months following the 1987 earthquakes in Ecuador, 150 patients in the primary health care clinics of the area were screened for emotional problems; 40% of them were emotionally distressed. Risk factors included not being married, reporting poor physical or emotional health, and having ill-defined physical complaints. The findings from this research are discussed in relation to a disaster of much greater intensity, whose victims were studied by the authors, utilizing the same instrument and research design. The comparison between these 2 groups of disaster victims revealed that: 1) the prevalence of emotional distress was smaller among the Ecuador victims, but the frequency of symptoms among the distressed was similar for both groups; 2) the symptom profiles were remarkably similar; and 3) the most frequent symptoms and the strongest predictors of emotional distress were very similar. These findings support a focused training of health care workers on selected emotional problems that are regularly present among victims of different disasters.",0 +https://doi.org/10.1111/dar.12229,Implementation of integrated therapies for comorbid post-traumatic stress disorder and substance use disorders in community substance abuse treatment programs,"The high prevalence of trauma and post-traumatic stress disorder (PTSD) in individuals with substance use disorders (SUDs) presents a number of treatment challenges for community treatment providers and programs in the USA. Although several evidence-based, integrated therapies for the treatment of comorbid PTSD/SUD have been developed, rates of utilisation of such practices remain low in community treatment programs.The goal of this article was to review the extant literature on common barriers that prevent adoption and implementation of integrated treatments for PTSD/SUD among substance abuse community treatment programs.Organisational, provider-level and patient-level factors that drive practice decisions were discussed, including organisational philosophy of care policies, funding and resources, as well as provider and patient knowledge and attitudes related to implementation of new integrated treatments for comorbid PTSD and SUD.Understanding and addressing these community treatment challenges may facilitate use of evidence-based integrated treatments for comorbid PTSD and SUD.",0 +https://doi.org/10.1007/s11013-013-9324-0,Normal Grief and Complicated Bereavement Among Traumatized Cambodian Refugees: Cultural Context and the Central Role of Dreams of the Dead,"This article profiles bereavement among traumatized Cambodian refugees and explores the validity of a model of how grief and post-traumatic stress disorder (PTSD) interact in this group to form a unique bereavement ontology, a model in which dreams of the dead play a crucial role. Several studies were conducted at a psychiatric clinic treating Cambodian refugees who survived the Pol Pot genocide. Key findings included that Pol Pot deaths were made even more deeply disturbing owing to cultural ideas about “bad death” and the consequences of not performing mortuary rites; that pained recall of the dead in the last month was common (76 % of patients) and usually caused great emotional and somatic distress; that severity of pained recall of the dead was strongly associated with PTSD severity (r = .62); that pained recall was very often triggered by dreaming about the dead, usually of someone who died in the Pol Pot period; and that Cambodians have a complex system of interpretation of dreams of the deceased that frequently causes those dreams to give rise to great distress. Cases are provided that further illustrate the centrality of dreams of the dead in the Cambodian experiencing of grief and PTSD. The article shows that not assessing dreams and concerns about the spiritual status of the deceased in the evaluation of bereavement results in “category truncation,” i.e., a lack of content validity, a form of category fallacy.",0 +https://doi.org/10.1176/appi.ajp.158.5.788,Posttraumatic Stress and Depressive Reactions Among Nicaraguan Adolescents After Hurricane Mitch,"This study determined the severity of posttraumatic stress and depressive reactions among Nicaraguan adolescents after Hurricane Mitch and the relationship of these reactions to objective and subjective features of hurricane exposure, death of a family member, forced relocation, and thoughts of revenge.Six months after the hurricane, 158 adolescents from three differentially exposed cities were evaluated by using a hurricane exposure questionnaire, the Child Posttraumatic Stress Disorder Reaction Index, and the Depression Self-Rating SCALE:Severe levels of posttraumatic stress and depressive reactions were found among adolescents in the two most heavily affected cities. Severity of posttraumatic stress and depressive reactions and features of objective hurricane-related experiences followed a ""dose-of-exposure"" pattern that was congruent with the rates of death and destruction across cities. Level of impact (city), objective and subjective features, and thoughts of revenge accounted for 68% of the variance in severity of posttraumatic stress reaction. Severity of posttraumatic stress reaction, death of a family member, and sex accounted for 59% of the variance in severity of depression.After a category 5 hurricane, adolescents in heavily affected areas with extreme objective and subjective hurricane-related traumatic features of exposure experience severe and chronic posttraumatic stress and comorbid depressive reactions. The recovery of the severely affected Nicaraguan adolescents is vital to the social and economic recovery of a country ravaged by years of political violence and poverty. These findings strongly indicate the need to incorporate public mental health approaches, including systematic screening and trauma/grief-focused interventions, within a comprehensive disaster recovery program.",0 +https://doi.org/10.7205/milmed-d-09-00132,Substance Use and Mental Health Trends Among U.S. Military Active Duty Personnel: Key Findings From the 2008 DoD Health Behavior Survey,"Examine substance use and mental health issues among U.S. military personnel.Data were from the 2008 (and before) population-based Department of Defense Health Related Behavior Surveys. The sample size for the 2008 survey was 28,546 (70.6% response rate).Analyses examined substance use, stress, depression, post-traumatic stress disorder (PTSD), suicidal ideation and attempts, deployment, and job satisfaction. Trends show reductions in tobacco use and illicit drug use, but increases in prescription drug misuse, heavy alcohol use, stress, PTSD, and suicidal attempts. Deployment exacerbated some of these behavior changes. Despite the demanding lifestyle, job satisfaction was high.The military has shown progress in decreasing cigarette smoking and illicit drug use. Additional emphasis should be placed on understanding increases in prescription drug misuse, heavy alcohol use, PTSD, and suicide attempts, and on planning additional effective interventions and prevention programs. Challenges remain in understanding and addressing military mental health needs.",0 +https://doi.org/10.1159/000287610,On Freedom and Induction,"Traumatizing events and traumatizing conflicts may lead to defense mechanisms which in the course of time become part of character formation. In psychosomatic medicine much attention has been paid in the past to the so-called psychosomatic character profiles. Though discussions about psychosomatic specificity have remained controversial, it still seems advisable to take into account the power of induction of specific defense strategies. In this paper special attention is paid to the fact that asthmatics, patients suffering from hypertension or coronary heart disease, as well as patients suffering from other psychosomatic syndromes, and even patients suffering from carcinoma may induce their own defense strategies in interviewers and therapists, who usually are not sufficiently aware of the fact of such transference phenomena. A distortion of the normal psychotherapeutic process is more often a result of induction processes than has been thought of.",0 +https://doi.org/10.5093/in2013a5,Eficacia del MMPI-A en casos forenses de acoso escolar: Simulación y daño psicológico,"The efficacy of forensic evaluation of the psychological injury based on the MMPI-2 and a clinical interview has been continuously supported by literature. Nevertheless, there is no evidence of the efficacy of the MMPI for adolescents (MMPI-A) for bullying cases. To contrast the efficacy of the MMPI-A in bullying cases, 107 adolescents ranged from 14 to 18 years old (M = 14.85) endorsed the Spanish adaptation of the MMPI-A under standard and malingering instructions. The results showed a high adolescent ability (91.6% for posttraumatic stress disorder, ranging from 60 to 90% for comorbid posttraumatic stress disorders) to malinger both the direct (posttraumatic stress disorder) and indirect (depression, anxiety, psychosomatic problems, problems in interpersonal relationships) psychological injury. Four malingering strategies were identified in malingering protocols: indiscriminate symptom endorsement, symptom severity, obvious symptoms, and infrequent symptoms. The F, F1, F2 and K standard validity scales discriminated significantly and with a large effect size between genuine and malingered responding. Likewise, the F-K index and the L and K < 45 and F < 80 profile discriminated significantly and with a large effect size between genuine and malingered responding. The study of cases revealed excellent classification rates of the standard validity scales (K < 40) and indices for malingered (true positives) and honest (false positives) responding. Implications for forensic practice are discussed.",0 +https://doi.org/10.1177/1079063208317463,Childhood Maltreatment and Cluster B Personality Pathology in Female Serious Offenders,"The authors examined early maltreatment among serious female offenders at a maximum-security correctional facility, contrasting the maltreatment histories of inmates with and without Cluster B personality pathology. Women were interviewed regarding the frequency of 13 indicators of psychological or physical abuse perpetrated by maternal or paternal caregivers and the frequency of 10 types of sexual abuse perpetrated by persons at least 5 years older. Reports were based on inmates' recollected worst years of maltreatment before age 16. Women in both diagnostic groups reported substantial early maltreatment. Cluster B inmates reported higher levels and a greater variety of maternal and paternal physical and psychological abuse but were not distinguished from non—Cluster B inmates on levels of childhood sexual abuse. Inmates reported more physical and psychological abuse from maternal than paternal caregivers. The results document the high levels of childhood maltreatment of female prisoners and the relevance of this history to personality pathology.",0 +https://doi.org/10.1007/s12671-011-0064-3,Mindful Awareness and Non-judging in Relation to Posttraumatic Stress Disorder Symptoms,"The objective of this cross-sectional study was to assess group differences between veterans with and without posttraumatic stress disorder (PTSD) in mindful awareness and mindful non-judging. The relationships between mindfulness and PTSD symptom clusters were also evaluated. Three age and gender-matched groups, (1) 15 combat veterans with PTSD, (2) 15 combat veterans without PTSD, and (3) 15 non-combat veterans without PTSD, completed the Mindful Attention Awareness Scale and the Accept without Judgment Scale. PTSD status was determined with the Clinician Administered PTSD Scale and excluded disorders screened with the Structured Clinical Interview for DSM-IV. Mindfulness scale group differences were assessed with analysis of variance. Mindfulness and the PTSD symptom clusters relationships were assessed with hierarchical regression analysis. There were group differences on mindful non-judging (F(2,44) = 7.22, p = .002) but not mindful awareness (p > .05). Combat exposure accounted for significant variation in PTSD symptoms (hyper-arousal 47%; numbing-avoiding 32%; re-experiencing 23%). Mindfulness accounted for a significant percentage variance of PTSD symptoms (re-experiencing 32%; numbing-avoiding 19%, hyper-arousal 16%), beyond combat exposure effects, although only mindful non-judging was significant in the model. This study confirms in a clinical sample that mindful non-judging is associated with PTSD symptoms and could represent a meaningful focus for treatment.",0 +https://doi.org/10.1001/jama.300.6.663,Alcohol Use and Alcohol-Related Problems Before and After Military Combat Deployment,"High rates of alcohol misuse after deployment have been reported among personnel returning from past conflicts, yet investigations of alcohol misuse after return from the current wars in Iraq and Afghanistan are lacking.To determine whether deployment with combat exposures was associated with new-onset or continued alcohol consumption, binge drinking, and alcohol-related problems.Data were from Millennium Cohort Study participants who completed both a baseline (July 2001 to June 2003; n=77,047) and follow-up (June 2004 to February 2006; n=55,021) questionnaire (follow-up response rate = 71.4%). After we applied exclusion criteria, our analyses included 48,481 participants (active duty, n = 26,613; Reserve or National Guard, n = 21,868). Of these, 5510 deployed with combat exposures, 5661 deployed without combat exposures, and 37 310 did not deploy.New-onset and continued heavy weekly drinking, binge drinking, and alcohol-related problems at follow-up.Baseline prevalence of heavy weekly drinking, binge drinking, and alcohol-related problems among Reserve or National Guard personnel who deployed with combat exposures was 9.0%, 53.6%, and 15.2%, respectively; follow-up prevalence was 12.5%, 53.0%, and 11.9%, respectively; and new-onset rates were 8.8%, 25.6%, and 7.1%, respectively. Among active-duty personnel, new-onset rates were 6.0%, 26.6%, and 4.8%, respectively. Reserve and National Guard personnel who deployed and reported combat exposures were significantly more likely to experience new-onset heavy weekly drinking (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.36-1.96), binge drinking (OR, 1.46; 95% CI, 1.24-1.71), and alcohol-related problems (OR, 1.63; 95% CI, 1.33-2.01) compared with nondeployed personnel. The youngest members of the cohort were at highest risk for all alcohol-related outcomes.Reserve and National Guard personnel and younger service members who deploy with reported combat exposures are at increased risk of new-onset heavy weekly drinking, binge drinking, and alcohol-related problems.",0 +https://doi.org/10.1016/j.bbr.2014.03.039,Peripartum depression and anxiety as an integrative cross domain target for psychiatric preventative measures,"Exposure to high levels of early life stress has been identified as a potent risk factor for neurodevelopmental delays in infants, behavioral problems and autism in children, but also for several psychiatric illnesses in adulthood, such as depression, anxiety, autism, and posttraumatic stress disorder. Despite having robust adverse effects on both mother and infant, the pathophysiology of peripartum depression and anxiety are poorly understood. The objective of this review is to highlight the advantages of using an integrated approach addressing several behavioral domains in both animal and clinical studies of peripartum depression and anxiety. It is postulated that a greater focus on integrated cross domain studies will lead to advances in treatments and preventative measures for several disorders associated with peripartum depression and anxiety.",0 +https://doi.org/10.1007/s10802-013-9748-6,Symptoms of Post-Traumatic Stress Disorder in Bereaved Children and Adolescents: Factor Structure and Correlates,"This study investigated the factor structure and correlates of posttraumatic stress-disorder (PTSD) symptoms among children and adolescents confronted with the death of a loved one. Three hundred thirty-two bereaved children and adolescents (aged 8-18; 56.9 % girls) who all received some form of psychosocial support after their loss, completed self-report measures of PTSD, together with measures tapping demographic and loss-related variables, depression, prolonged grief, and functional impairment. Parent-rated indices of impairment were also collected. We first evaluated the fit of six alternative models of the factor structure of PTSD symptoms, using confirmatory factor analyses. Outcomes showed that the 4-factor numbing model from King et al. (Psychological Assessment 10, 90-96, 1998), with distinct factors of reexperiencing, avoidance, emotional numbing, and hyperarousal fit the data best. Of all participants, 51.5 % met DSM-IV criteria for PTSD. PTSD-status and scores on the PTSD factors varied as a function of age and gender, but were unrelated to other demographic and loss-related variables. PTSD-status and scores on the PTSD factors were significantly associated symptom-levels of depression, prolonged grief, and functional impairment. Findings complement prior evidence that the DSM-IV model of the factor structure of PTSD symptoms may not represent the best conceptualization of these symptoms and highlight the importance of addressing PTSD symptoms in children and adolescents seeking help after bereavement. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.3402/ejpt.v6.25216,Analyzing small data sets using Bayesian estimation: the case of posttraumatic stress symptoms following mechanical ventilation in burn survivors,"Background : The analysis of small data sets in longitudinal studies can lead to power issues and often suffers from biased parameter values. These issues can be solved by using Bayesian estimation in conjunction with informative prior distributions. By means of a simulation study and an empirical example concerning posttraumatic stress symptoms (PTSS) following mechanical ventilation in burn survivors, we demonstrate the advantages and potential pitfalls of using Bayesian estimation. Methods : First, we show how to specify prior distributions and by means of a sensitivity analysis we demonstrate how to check the exact influence of the prior (mis-) specification. Thereafter, we show by means of a simulation the situations in which the Bayesian approach outperforms the default, maximum likelihood and approach. Finally, we re-analyze empirical data on burn survivors which provided preliminary evidence of an aversive influence of a period of mechanical ventilation on the course of PTSS following burns. Results : Not suprisingly, maximum likelihood estimation showed insufficient coverage as well as power with very small samples. Only when Bayesian analysis, in conjunction with informative priors, was used power increased to acceptable levels. As expected, we showed that the smaller the sample size the more the results rely on the prior specification. Conclusion : We show that two issues often encountered during analysis of small samples, power and biased parameters, can be solved by including prior information into Bayesian analysis. We argue that the use of informative priors should always be reported together with a sensitivity analysis.",0 +https://doi.org/10.1111/j.1527-3458.2005.tb00035.x,"An Overview of SSR149415, a Selective Nonpeptide Vasopressin V1b Receptor Antagonist for the Treatment of Stress-Related Disorders","Vasopressin (AVP) and corticotropin-releasing factor (CRF) are key mediators in the organism's neuro-adaptive response to stress. Through pituitary and central vasopressin V(1b) receptors, AVP participates in the control of the hypothalamic-pituitary-adrenal axis (HPA) and is involved in various emotional processes. SSR149415 is the first selective, orally active vasopressin V(1b) receptor antagonist yet described. It is a competitive antagonist with nanomolar affinity for animal and human V(1b) receptors and displays a highly selective profile with regard to a large number of receptors or enzymes. In vitro, SSR149415 potently antagonizes functional cellular events associated with V(1b) receptor activation by AVP, such as intracellular Ca(2+) increase or proliferation in various cell systems. Pharmacological studies, performed by measuring ACTH secretion induced by various stimulants such as hormones (AVP or AVP + CRF) or physical stress (restraint or forced swimming stress and dehydration) in conscious rats or mice, confirm the antagonist profile of SSR149415 and its efficacy in normalizing ACTH secretion in vivo. SSR149415 is active by the oral route, at doses from 3 mg/kg, it potentiates CRF effect and displays a long-lasting oral effect in the different models. At 10 mg/kg p.o. its duration of action is longer than 4 h. This molecule also decreases anxiety and exerts marked antidepressant-like activity in several predictive animal models. The anxiolytic effects of SSR149415 have been demonstrated in various Generalized Anxiety Disorders (GAD) models (four-plate, punished drinking, elevated plus-maze, light dark, mouse defense test battery, fear-potentiated startle and social interaction tests). It is as effective as the benzodiazepine diazepam in the acute stress exposure test. SSR149415 has similar efficacy to the reference antidepressant drug, fluoxetine, in acute (forced-swimming) and chronic (chronic mild stress and subordination stress) situations in rodents. SSR149415 also reduces offensive aggression in the resident-intruder model in mice and hamsters. Depending on the model, the minimal effective doses are in the range of 1-10 mg/kg i.p. or 3-10 mg/kg p.o. SSR149415 is devoid of adverse effects on motor activity, sedation, memory or cognitive functions and produces no tachyphylaxis when administered repeatedly. It is well-tolerated in animals and humans and exhibits an adequate ADME profile. Thus, SSR149415 is a new dual anxiolytic/antidepressant compound, which appears to be free of the known side effects of classical anxiolytic/antidepressant drugs. Clinical trials are in progress, they will hopefully demonstrate its therapeutical potential for treating stress-related disorders.",0 +https://doi.org/10.1016/j.bbr.2011.09.004,Early fear as a predictor of avoidance in a rat model of post-traumatic stress disorder,"Exposure of humans and animals to an intensely fearful experience can lead to an enduring behavioral profile involving fear and avoidance. The present study examined if rats that show more fear to a novel tone one day after exposure to footshocks exhibit more avoidance-like responses over a 4-week period. Rats were exposed to an episode of moderately intense footshock (5×2s episodes of 1.5mA presented randomly over 3min). Shock rats that exhibited a high level of fear (HR) to a novel tone one day after the shock exposure showed more avoidance of open spaces and novel rats when compared to shock rats that exhibited a lower level of fear to the novel tone (LR). Similarly, HR emitted more ultrasonic vocalization in the dysphoric range (20-30kHz) when placed in a novel chamber or the chamber in which shock was given. This study highlights the importance of early fear as a contributing factor for the development of lasting changes in avoidance. These results also support the view that the presence of an intense peritraumatic stress response may be a predictor of the subsequent development of a lasting negative emotional state in humans exposed to trauma.",0 +https://doi.org/10.1080/14622200701488418,Post-traumatic stress disorder and smoking: A systematic review,"We conducted a systematic review of what is known about the relationship between post-traumatic stress disorder (PTSD) and smoking to guide research on underlying mechanisms and to facilitate the development of evidence-based tobacco treatments for this population of smokers. We searched Medline, PsychINFO, and the Cochrane Central Register of Controlled Trials and identified 45 studies for review that presented primary data on PTSD and smoking. Smoking rates were high among clinical samples with PTSD (40%-86%) as well as nonclinical populations with PTSD (34%-61%). Most studies showed a positive relationship between PTSD and smoking and nicotine dependence, with odds ratios ranging between 2.04 and 4.52. Findings also suggest that PTSD, rather than trauma exposure itself, is more influential for increasing risk of smoking. A small but growing literature has examined psychological factors related to smoking initiation and maintenance and the overlapping neurobiology of PTSD and nicotine dependence. Observational studies indicate that smokers with PTSD have lower quit rates than do smokers without PTSD. Yet a few tobacco cessation treatment trials in smokers with PTSD have achieved quit rates comparable with controlled trials of smokers without mental disorders. In conclusion, the evidence points to a causal relationship between PTSD and smoking that may be bidirectional. Specific PTSD symptoms may contribute to smoking and disrupt cessation attempts. Intervention studies that test behavioral and pharmacological interventions designed specifically for use in patients with PTSD are needed to reduce morbidity and mortality in this population.",0 +https://doi.org/10.1016/s0191-8869(02)00200-3,"The relationship between neuroticism, pre-traumatic stress, and post-traumatic stress: a prospective study","Abstract The personality trait of Neuroticism has been repeatedly associated with symptoms of post-traumatic stress disorder (PTSD). However, the nature of this relationship is unclear. There are at least two possible interpretations: neuroticism might be a risk factor for PTSD symptoms, or, alternatively, the relationship might be based on content overlap in arousal symptoms. With a prospective design, this study tested both possibilities. About 1370 women volunteers completed questionnaires early in pregnancy, measuring neuroticism and ‘baseline’ arousal symptoms, and for every 2 months thereafter until 1 month after the due date of birth. Of these, 126 had a pregnancy loss, and most of them were assessed for PTSD symptoms 1 month later. The results showed that pre-trauma neuroticism strongly predicted PTSD symptoms, and particularly PTSD arousal symptoms, after pregnancy loss. However, neuroticism was also strongly related to pre-trauma arousal. After statistically controlling for pre-trauma arousal symptoms, the relationship between neuroticism and PTSD symptoms after pregnancy loss was no longer significant. In other words, neuroticism did not predict rises in these symptoms from pre to post-trauma. This suggests that PTSD arousal symptoms tap a specific aspect of neuroticism, and that content-overlap largely accounts for the relationship between neuroticism and PTSD symptoms.",0 +https://doi.org/10.1097/00005053-199311000-00006,Posttraumatic Stress Disorder Symptoms and Precombat Sexual and Physical Abuse in Desert Storm Veterans,"The purpose of this research was to study the association between precombat sexual and physical abuse and combat-related posttraumatic stress disorder (PTSD) symptoms in a clinical sample of male and female Desert Storm veterans. Two hundred ninety-seven veterans provided data on precombat sexual and physical abuse, precombat psychiatric problems, sociodemographics, Desert Storm combat exposure, and PTSD symptomatology using the Mississippi Scale. Men reported significantly higher levels of combat exposure, and women described significantly more frequent precombat abuse. Precombat-abused veterans reported more frequent precombat psychiatric histories. Analysis of covariance revealed that gender significantly modified the impact of precombat abuse on combat-related and other PTSD symptomatology after adjusting for precombat psychiatric history and level of combat exposure. Specifically, females describing precombat abuse reported much greater PTSD symptomatology than did females denying precombat abuse. These results in conjunction with previous research suggest that a relationship between precombat abuse and combat-related PTSD may exist. Prospective, longitudinal studies of both men and women are needed.",0 +https://doi.org/10.1080/09540120412331319741,Post-traumatic stress disorder among recently diagnosed patients with HIV/AIDS in South Africa,"This study examined the prevalence of and factors associated with post-traumatic stress disorder in recently diagnosed HIV/AIDS patients in South Africa. One hundred and forty-nine (44 male, 105 female) recently diagnosed HIV/AIDS patients (mean duration since diagnosis = 5.8 months, SD = 4.1) were evaluated. Subjects were assessed using the MINI International Neuropsychiatric Interview (MINI), the Carver Brief COPE coping scale and the Sheehan Disability Scale. In addition, previous exposures to trauma and past risk behaviours were assessed. Twenty-two patients (14.8%) met criteria for PTSD. Current psychiatric conditions more likely to be associated with PTSD included major depressive disorder (29% in PTSD patients versus 7% in non-PTSD patients, p = 0.004), suicidality (54% versus 11%, p = 0.001) and social anxiety disorder (40% versus 13%, p = 0.04). Further patients with PTSD reported significantly more work impairment and demonstrated a trend towards higher usage of alcohol as a means of coping. Discriminant function analysis indicated that female gender and a history of sexual violation in the past year were significantly associated with a diagnosis of PTSD. Patients whose PTSD was a direct result of an HIV/AIDS diagnosis (8/22) did not differ from other patients with PTSD on demographic or clinical features. In the South African context, PTSD is not an uncommon disorder in patients with HIV/AIDS. In some cases, PTSD is secondary to the diagnosis of HIV/AIDS but in most cases it is seen after other traumas, with sexual violation and intimate partner violence in women being particularly important.",0 +https://doi.org/10.1017/cbo9780511663239.010,Traumatic events and post-traumatic stress disorder,"(from the chapter) Examines the role of traumatic events in the development of anxiety disorders in children, particularly posttraumatic stress disorder (PTSD), differentiating between single acute events and chronic and/or repeated ones. The relationships is placed between traumatic event and stress reaction within a developmental psychopathological context by looking at risk and protective factors in the etiology and maintenance of stress reactions. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1002/jts.22031,Relationship Between Peer Victimization and Posttraumatic Stress Among Primary School Children,"Peer victimization is a common stressor experienced by children. Although peer victimization has been studied extensively, few studies have examined the potential link between peer victimization and posttraumatic stress disorder (PTSD), and no studies of which we are aware have examined this link among children in primary school. The paucity of studies examining the link between PTSD and peer victimization in primary school is surprising because peer victimization occurs more frequently and is more likely to be physical among 7- and 8-year-old children. This study assessed the relationship between peer victimization and PTSD in a sample of 358 elementary school children (ages 6-11 years). Results indicated that peer victimization accounted for 14.1% of PTSD symptom severity among boys and 10.1% among girls. Additionally, we found gender differences in the types of peer victimization that were most associated with PTSD symptom severity (d = 0.38). The long-term developmental consequences that may be associated with peer victimization-linked PTSD symptomatology are discussed.",0 +https://doi.org/10.1017/s0033291700027859,Development and validation of the Computerized Clinician Administered Post-Traumatic Stress Disorder Scale-1-Revised,"Synopsis A computer administered version of the clinician administered post-traumatic stress disorder (PTSD) scale-1 was developed to assess PTSD in subjects presenting with psychological symptoms following exposure to a traumatic event. Both forms were administered to 40 subjects who met the Diagnostic and Statistical Manual, third edition, revised (DSM-III-R) criteria for exposure to a significantly traumatic stressor. Inter-observer reliability was demonstrated with a kappa statistic of 0·90. The computer version had a sensitivity of 0·95 and a specificity 0·95. A correlation of 0·95 was found between the two versions and the mean score difference was non-significant. The computer form demonstrated adequate internal reliability and test–retest reliability. Overall results suggest the computer version is a valid and reliable measure of PTSD.",0 +https://doi.org/10.1016/j.comppsych.2011.07.002,Prospective investigation of a PTSD personality typology among individuals with personality disorders,"This study investigated the replicability of a previously proposed personality typology of posttraumatic stress disorder (PTSD, and explored stability of cluster membership over a 6-month period. Participants with current PTSD (n = 156) were drawn from the Collaborative Longitudinal Personality Disorders Study (CLPS). The CLPS project tracked a large sample of individuals who met criteria for 1 of 4 target diagnoses (borderline, schizotypal, avoidant, and obsessive-compulsive) and a contrast group of individuals who met criteria for depression but no personality disorder. A cluster analysis using scales from the Schedule of Nonadaptive and Adaptive Personality yielded 3 clusters: ""internalizing,"" ""externalizing,"" and ""low pathology."" Using K-means cluster analysis, the results did not replicate previous work. Using Ward's method, the hypothesized 3-cluster structure was confirmed at baseline but did not demonstrate temporal stability at 6 months.",0 +https://doi.org/10.1111/j.1526-4637.2005.05005.x,Relationship Between Post-traumatic Stress Disorder and Pain in Two American Indian Tribes,"To estimate the association of lifetime post-traumatic stress disorder (PTSD) and pain in American Indians, and determine if tribe, sex, cultural and psychosocial factors, or major depression influence the magnitude of this association.A cross-sectional probability sample survey completed between 1997 and 2000. A structured interview was conducted by trained, tribal members to gather information on demographic and cultural features, physical health status, psychiatric disorders, and functional status.General community.A total of 3,084 individuals randomly selected from the tribal rolls of a Southwestern (N = 1,446) and a Northern Plains (N = 1,638) tribal group who were 15-54 years of age and lived on or within 20 miles of their reservations.Bodily pain subscale of the Short Form-36. Linear regression models were fit to examine the association between lifetime PTSD and pain, adjusting for demographic, cultural, psychosocial features, painful medical conditions, and major depression.The prevalence of lifetime PTSD was 16% in the Southwestern and 14% in the Northern Plains; women were nearly twice as likely as men to have lifetime PTSD in both tribes. The final adjusted model demonstrated that mean Short Form-36 bodily pain subscale scores were lower (indicating more pain) among individuals with lifetime PTSD than those without lifetime PTSD. Effect modification by tribe, sex, and depression was not observed.Lifetime PTSD was strongly associated with bodily pain in this rural sample of American Indians. Clinicians should be aware of, and address, the link between physical pain syndromes and PTSD.",0 +https://doi.org/10.3109/10401230109148952,A Prospective Study of Coping After Exposure to a Mass Murder Episode,"In a study of 136 survivors of a mass murder spree, multidimensional scaling identified clusters of responses mapping from 75 coping behaviors described by victims. This powerful method identified three coping dimensions: (a) Active Outreach versus Passive Isolation, (b) Informed Pragmatism versus Abandonment of Control, and (c) Reconciliation/Acceptance versus Evading the Status Quo. These coping dimensions were used to predict change in psychiatric status prospectively assessed with structured diagnostic interviews at index 3-4 months after the event and follow-up assessments 1 and 3 years later. Statistically significant changes in the positive direction on each of the three dimensions in this study were associated with reductions of 47-79% of the odds for acute postdisaster major depression, posttraumatic stress disorder (PTSD), and any non-PTSD disorder. These findings suggest mechanisms for development of therapeutic techniques capitalizing on encouraging active outreach, informed focus and pragmatism, and reconciliation and acceptance, and reduction of passive and isolative behaviors, resignation of control, and avoidance of realities of the postdisaster situation.",0 +https://doi.org/10.1016/j.chc.2009.03.005,"Event Trauma in Early Childhood: Symptoms, Assessment, Intervention","Expanding research over the last two decades has documented that very young children's responses to an event trauma will involve the same three basic categories of posttraumatic symptomatology observed in older children and adults that is, reexperiencing, numbing/avoidance, and hyperarousal. The ways in which these three symptom clusters will be manifested in very young children and recent progress in the establishment of developmentally sensitive and reliable criteria for the diagnosis of posttraumatic stress disorder (PTSD) in this age group are described. In addition to PTSD symptomatology, three additional factors that differentiate young children's responses to a trauma from those of older children and adults-their cognitive immaturity, their developmental vulnerability, and the relational context of early trauma given young children's dependence on caregivers-also are discussed. Principles of assessment and treatment are then described. These discussions emphasize the importance of normalizing traumatic responses, supporting the parent-child relationship and restoring trust, desensitizing the child's distress to traumatic reminders, helping the child and parents to process and develop a meaningful narrative of the traumatic event through expressive therapeutic techniques, and promoting effective strategies of restoration and repair.",0 +https://doi.org/10.1111/sjop.12094,The mental health of unaccompanied refugee minors on arrival in the host country,"Despite increasing numbers of unaccompanied refugee minors (UM) in Europe and heightened concerns for this group, research on their mental health has seldom included the factor ""time since arrival."" As a result, our knowledge of the mental health statuses of UM at specific points in time and over periods in their resettlement trajectories in European host countries is limited. This study therefore examined the mental health of UM shortly after their arrival in Norway (n = 204) and Belgium (n = 103) through the use of self-report questionnaires (HSCL-37A, SLE, RATS, HTQ). High prevalence scores of anxiety, depression and posttraumatic stress disorder (PTSD) symptoms were found. In addition, particular associations were found with the number of traumatic events the UM reported. The results indicate that all UM have high support needs on arrival in the host country. Longitudinal studies following up patterns of continuity and change in their mental health during their trajectories in the host country are necessary.",0 +https://doi.org/10.36076/ppj.2002/5/149,Evaluation of the Psychological Status in Chronic Low Back Pain: Comparison with General Population,"Multiple studies have documented a strong association between chronic low back pain and psychopathology including personality disorders, depressive disorders, anxiety, and somatoform disorders along with non-specific issues such as emotion, anger and drug dependency. However, depression, anxiety and somatization appear to be crucial. There are no controlled trials in interventional pain management settings. This study was designed to evaluate 40 individuals without pain or psychotherapeutic drug therapy, Group I, control group; and Group II, chronic low back pain group with 40 chronic low back pain patients. All the participants were tested utilizing Pain Patient Profile (P3). Significant differences were found among various clinical syndromes with generalized anxiety disorder, somatoform disorder, and depression, with 0% vs 20%, 0% vs 20%, and 5% vs 30% in Group I and Group II consecutively. This evaluation showed that clinical syndromes were seen in a greater proportion of patients with chronic low back pain emphasizing the importance of evaluation of the patients for generalized anxiety disorder, somatoform disorder, and for depression.",0 +https://doi.org/10.1016/s0301-2115(96)02605-x,Rape-related psychotraumatic syndromes,"This study took place in a forensic center for rape victims. Our aims were: first, to explore the longitudinal course of post-traumatic stress disorder (PTSD) and prevalence of disorders over the 6-month period following rape, then second, to group these disorders into syndromes related to chronic PTSD whilst remaining distinct from it, and third, to establish some predictive factors for chronic PTSD.92 rape victims consecutively admitted to the center were regularly interviewed over a 6-month period by a psychiatrist.The paper confirms that rape leads to a high proportion of PTSD. Generally speaking, the psychopathology following rape is severe. PTSD at 6 months is associated with phobic and dissociative disorders. It is further associated with a cluster of symptoms arising after rape that we term borderline-like. Incestuous rape is a predictive factor for PTSD at 6 months.In the aftermath of rape several semiologically distinct psychotraumatic syndromes exist.",0 +https://doi.org/10.1177/036215379502500414,The Treatment of Post-Traumatic Stress Disorder Using Redecision Therapy,"This article describes the use of redecision therapy in the treatment of post-traumatic stress disorder. In traumatic situations, people make decisions that appear to increase their possibility of ...",0 +https://doi.org/10.1016/j.jad.2011.06.057,Examining the dimensionality of combat-related posttraumatic stress and depressive symptoms in treatment-seeking OEF/OIF/OND veterans,"This study examined the factor structure of two of the most commonly used screening measures of posttraumatic stress disorder and depression in 164 treatment-seeking veterans who served in Operations Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND).Exploratory factor analysis was used to assess the dimensionality of items from the Posttraumatic Stress Disorder Checklist-Military Version (PCL-M) and the Patient Health Questionnaire-9 (PHQ-9). Regression analyses were then conducted to examine associations between factor scores of the resulting factor solution and measures of alcohol use, cognitive coping, psychological resilience, social support, and healthcare utilization.A four-factor solution was found that consisted of clusters of symptoms reflecting reexperiencing/avoidance, detachment/numbing, hopelessness/depression, and bodily disturbance. Scores on the detachment/numbing factor were uniquely related to alcohol use, whereas scores on the hopelessness/depression factor was uniquely associated with emergency room visits. Compared to conventional PCL-M and PHQ-9 total scores, the four-factor solution explained 2 to 10% more variance in scores on measures of alcohol use, cognitive coping, psychological resilience, social support, and healthcare utilization.This study was limited by a small sample size and cross-sectional design.Combat-related posttraumatic stress disorder and depressive symptoms in treatment-seeking OEF/OIF/OND veterans may be better conceptualized by four dimensions of reexperiencing/avoidance, detachment/numbing, hopelessness/depression, and bodily disturbance symptoms. This symptom structure may provide greater utility when examining other outcomes of interest in this population.",0 +https://doi.org/10.1348/135910708x373445,What predicts post-traumatic stress following spinal cord injury/,"Spinal cord injury (SCI) is a severe, traumatic event and recently research into the role of post-traumatic stress disorder (PTSD) subsequent to the injury has become of increasing interest. This study has been conducted in order to investigate potential risk factors for the development of post-traumatic stress disorder symptoms in those with SCI.This cross-sectional study used multiple regression analysis to look for associations between post-traumatic stress symptom severity, SCI-related factors and previously identified risk factors for PTSD such as dysfunctional cognitions, demographic factors and personality predispositions (neuroticism, alexithymia).A total of 102 participants with SCI completed measures of post-traumatic stress severity, acceptance of injury, post-traumatic cognitions, social support, neuroticism and alexithymia. In addition, information about type, level and cause of the SCI was assessed.High levels of post-traumatic stress symptoms were found. Potential risk factors for the development of PTSD were negative cognitions of self and neuroticism. Variables that added to the variance explained by the models included time since injury and difficulty identifying feelings. Acceptance of injury was mediated by negative cognitions of the self and neuroticism.The study highlights the need for services to be aware of the psychological difficulties experienced by this client group. An important finding is that the acceptance of the injury is mediated by negative cognitions of the self which need to be identified as potential risk factors in order to prevent the development of post-traumatic symptoms in this population.",0 +https://doi.org/10.1176/appi.ajp.2015.14121572,Prospective Longitudinal Evaluation of the Effect of Deployment-Acquired Traumatic Brain Injury on Posttraumatic Stress and Related Disorders: Results From the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS),"Traumatic brain injury (TBI) is increasingly recognized as a risk factor for deleterious mental health and functional outcomes. The purpose of this study was to examine the strength and specificity of the association between deployment-acquired TBI and subsequent posttraumatic stress and related disorders among U.S. Army personnel.A prospective, longitudinal survey of soldiers in three Brigade Combat Teams was conducted 1-2 months prior to an average 10-month deployment to Afghanistan (T0), upon redeployment to the United States (T1), approximately 3 months later (T2), and approximately 9 months later (T3). Outcomes of interest were 30-day prevalence postdeployment of posttraumatic stress disorder (PTSD), major depressive episode, generalized anxiety disorder, and suicidality, as well as presence and severity of postdeployment PTSD symptoms.Complete information was available for 4,645 soldiers. Approximately one in five soldiers reported exposure to mild (18.0%) or more-than-mild (1.2%) TBI(s) during the index deployment. Even after adjusting for other risk factors (e.g., predeployment mental health status, severity of deployment stress, prior TBI history), deployment-acquired TBI was associated with elevated adjusted odds of PTSD and generalized anxiety disorder at T2 and T3 and of major depressive episode at T2. Suicidality risk at T2 appeared similarly elevated, but this association did not reach statistical significance.The findings highlight the importance of surveillance efforts to identify soldiers who have sustained TBIs and are therefore at risk for an array of postdeployment adverse mental health outcomes, including but not limited to PTSD. The mechanism(s) accounting for these associations need to be elucidated to inform development of effective preventive and early intervention programs.",0 +https://doi.org/10.1016/j.injury.2011.11.012,"Comparative analysis of trends in paediatric trauma outcomes in New South Wales, Australia","

Abstract

Paediatric trauma centres seek to optimise the care of injured children. Trends in state-wide paediatric care and outcomes have not been examined in detail in Australia. This study examines temporal trends in paediatric trauma outcomes and factors influencing survival and length of stay. A retrospective review was conducted using data from the NSW Trauma Registry during 2003–2008 for children aged 15 years and younger who were severely injured (injury severity score>15). To examine trauma outcomes descriptive statistics and multivariable logistic and linear regression were conducted. There were 1138 children severely injured. Two-thirds were male. Road trauma and falls were the most common injury mechanisms and over one-third of incidents occurred in the home. Forty-eight percent of violence-related injuries were experienced by infants aged less than 1 year. For the majority of children definitive care was provided at a paediatric trauma centre, but less than one-third of children were taken directly to a paediatric trauma centre post-injury. Children who received definitive treatment at a paediatric trauma centre had between 3 and 6 times higher odds of having a survival advantage than if treated at an adult trauma centre. The number of severe injury presentations to the 14 major trauma centres in NSW remains constant. It is possible that injury prevention measures are having a limited effect on severe injury in NSW. This research provides stimulus for change in the provision and co-ordination in the delivery of trauma care for injured children.",0 +https://doi.org/10.1177/0309132511423350,Geographies of health and climate change,"Climate change presents significant challenges for human health and well-being and geography is contributing a growing field of knowledge relating to these processes. We outline here key dimensions of the debate, pointing to areas where human geographers can make a particularly strong contribution. These include: issues of adaptation and resilience; sustainability; environmental justice and socially unequal impacts of climate change; and psychological as well as physical impacts of environment on health. Key themes in the emerging research agenda include the significance of affect and emotion for the perception and communication of hazard and risk associated with the health impacts of climate change. Also, understanding exposure to health risks of climate change requires knowledge of complex and individually variable daily action spaces and residential mobility over the lifecourse. We argue for research that considers complex processes operating at various geographical scales, linking arguments about ‘global health’ with the more local and individual processes that contribute to health determinants. Much of the literature on health impacts of climate change demonstrates socially and geographically unequal effects, which often exacerbate existing health disparities. This highlights the links between this field of health geography and other geographical research concerned with sustainability and environmental justice.",0 +https://doi.org/10.1097/01.nmd.0000110286.10445.ab,Early Symptom Predictors of Chronic Distress in Gulf War Veterans,"Although there is evidence that specific early hyperarousal, avoidance, and emotional numbing symptoms are associated with later posttraumatic stress disorder (PTSD) symptomatology among veterans, little is known about predictors of later non-PTSD-related psychological symptoms. One and 2 years after serving in the Gulf War, 348 military reservists were assessed for severity of war zone stress, PTSD, psychological distress, and stress-mediated physical complaints. Overall PTSD symptomatology and emotional numbing and hyperarousal symptom clusters increased over time, whereas re-experiencing and avoidance symptoms showed no change. Emotional numbing and hyperarousal symptoms at 1 year predicted generalized distress, depression, anxiety, hostility, and somatic symptoms at 2 years, whereas re-experiencing and avoidance symptoms did not. Findings highlight the importance of targeting early emotional numbing and hyperarousal symptom clusters to reduce longer-term psychological distress.",0 +https://doi.org/10.1136/jramc-131-03-02,Post-traumatic Stress Disorder (Traumatic War Neurosis) and Concurrent Psychiatric illness Among Australian Vietnam Veterans. A Controlled Study,"Depression, anxiety, irritability with unpredictable explosions of aggressive behaviour, impulsivity, suicidal actions and substance abuse have been repeatedly observed among ex-servicemen from World War II in psychiatric treatment settings. In the most recent American Psychiatric Association classification of mental disorders the category of Post Traumatic Stress Disorder (PTSD) was introduced, replacing the earlier Traumatic War Neurosis and the above cluster of symptoms were included as associated features of this disorder. Two recent uncontrolled studies on U.S. Vietnam veterans receiving psychiatric care supported the linkage of PTSD with these abnormalities. However, the present controlled study found these associated features occurred with equal frequencies among one group of psychiatrically hospitalised Australian Vietnam veterans with PTSD and another group not so afflicted. Reservations, then, should be harboured about ascribing all the presented psychopathology and behavioural abnormalities of ex-servicemen to the stress of their war service.",0 +https://doi.org/10.1016/j.neubiorev.2016.02.005,Genetics of glucocorticoid regulation and posttraumatic stress disorder—What do we know?,"CASTRO-VALE, I., E.F.C. van Rossum, J.C. Machado, R. Mota-Cardoso and D. Carvalho. Genetics of glucocorticoid regulation and posttraumatic stress disorder-What do we know? NEUROSCI. BIOBEHAV. REV. 43 (1) XXX-XXX, 2014 - Posttraumatic stress disorder (PTSD) develops in a small proportion of those who have been exposed to a traumatic event. Genetic factors are estimated to be responsible for 30% of the variance in PTSD risk. Dysfunction of the hypothalamic-pituitary-adrenal (HPA)-axis in PTSD has been found, particularly hypersensitivity of the glucocorticoid receptor (GR). In this review we aim to understand the genetic factors that influence glucocorticoid function in PTSD. Glucocorticoid action is regulated by a corticotrophin-releasing hormone, arginine vasopressin (AVP)/oxytocin pathway, GR, and regulators such as co-chaperone FKBP5. Single nucleotide polymorphisms (SNPs) in the GR gene, CRHR1 gene and FKBP5 gene affect HPA-axis sensitivity. The GR gene SNP BclI has been associated with hypersensitivity to glucocorticoids and PTSD symptoms. FKBP5 gene SNPs interacted with childhood adversity to moderate PTSD risk and in particular, the rs9470080 SNP was independently associated with lifetime PTSD. SNPs in the CRHR1 gene were also associated with PTSD risk. Gene-environment interaction studies have highlighted the importance of multifactorial vulnerability in PTSD, with epigenetic mechanisms contributing to the equation.",0 +https://doi.org/10.1080/13811110903478997,Post-Traumatic Stress Disorder and Suicide Risk: A Systematic Review,"There is a gap in the literature regarding suicide risk among traumatized individuals with post-traumatic stress disorder (PTSD) and this article aims to systematically review literature on the relationship between PTSD and suicidal behavior and ideation. A meta-analysis of 50 articles that examined the association between PTSD and past and current suicidal ideation and behavior was conducted. There was no evidence for an increased risk of completed suicide in individuals with PTSD. PTSD was associated with an increased incidence of prior attempted suicide and prior and current suicidal ideation. Controlling for other psychiatric disorders (including depression) weakened, but did not eliminate, this association. The evidence indicates that there is an association between PTSD and suicidality with several factors, such as concurrent depression and the pre-trauma psychiatric condition, possibly mediating this relationship. There are significant clinical implications of the reported relationship for suicide risk assessment and therapy, and further studies might help to understand the mediating pathways between PTSD and increased suicide risk.",0 +https://doi.org/10.4088/jcp.14m09438,Response to Psychotherapy for Posttraumatic Stress Disorder,"Neuropsychological studies have consistently demonstrated impaired verbal memory in posttraumatic stress disorder (PTSD). Trauma-focused treatment for PTSD is thought to rely on memory, but it is largely unknown whether treatment outcome is influenced by memory performance. The aim of the study, therefore, was to examine the relationship between verbal memory performance and treatment response to trauma-focused psychotherapy.Participants were referred to our outpatient clinic and recruited between December 2003 and January 2009 upon diagnosis of PTSD according to DSM-IV. Secondary analyses of a randomized controlled trial comparing eye movement desensitization and reprocessing therapy (n = 70) and brief eclectic psychotherapy (n = 70), a cognitive-behavioral intervention, are reported. Response to treatment was measured by self-reported PTSD symptom severity (Impact of Event Scale-Revised) over 17 weeks. Pretreatment verbal memory measures (California Verbal Learning Test, Rivermead Behavioral Memory Test) were included in the mixed linear model analyses in order to investigate the influence of memory on treatment outcome.Pretreatment encoding, short-term retrieval, long-term retrieval, and recognition performance were significantly associated with treatment response in terms of self-reported PTSD symptom severity for both treatments (P ≤ .013). Receiver operating characteristic curves predicting treatment response with pretreatment memory indices showed that 75.6% of the patients could be correctly classified as responder.Poor verbal memory performance represents a risk factor for worse treatment response to trauma-focused psychotherapy. Memory measures can be helpful in determining which patients are unable to benefit from trauma-focused psychotherapy. Future research should explore how treatment perspectives of patients with poor verbal memory can be improved.ISRCTN.com identifier: ISRCTN64872147.",0 +https://doi.org/10.25772/d9s2-vq28,EFFICACY OF A COGNITIVE-BEHAVIORAL TREATMENT FOR INSOMNIA AMONG AFGHANISTAN AND IRAQ (OEF/OIF) VETERANS WITH PTSD,"EFFICACY OF A COGNITIVE-BEHAVIORAL TREATMENT FOR INSOMNIA AMONG AFGHANISTAN AND IRAQ (OEF/OIF) VETERANS WITH PTSD By Skye Ochsner Margolies, M.A. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2011. Major Director: Scott Vrana, Ph.D. Professor Department of Psychology Sleep disturbances are a core and salient feature of PTSD and can maintain or exacerbate associated symptoms. Recent research demonstrates that cognitive-behavioral sleep-focused interventions improve sleep disturbances as well as PTSD symptoms. The present study is a randomized controlled trial comparing Cognitive Behavioral Therapy for Insomnia (CBT-I) to a waitlist control group. Conducted at a Veterans Affairs Medical Center, the study: 1) compared subjective outcome measures of sleep amongst veterans assigned to either a treatment group (CBT-I) or a waitlist control group; (2) examined the influence of the intervention on measures of PTSD, general mood and daytime functioning, comparing veterans in a treatment group to those in a waitlist control group and (3) examined the effect of the CBT-I intervention using objective measures of sleep for veterans included in the treatment arm of the study. Study participants were (n = 40) combat veterans who served in Afghanistan and/or Iraq (OEF/OIF). Participants were randomized to either a CBT-I treatment group or a waitlist control group. Those in the treatment condition participated in four CBT-I sessions over six weeks. CBT-I included sleep restriction, stimulus control, cognitive restructuring, sleep education, sleep hygiene and imagery rehearsal therapy. All participants completed subjective and objective measures at baseline and post-treatment. At six weeks post treatment, veterans who participated in CBT-I reported improved sleep, a reduction in PTSD symptom severity and PTSD-related nightmares, as well as a reduction in depression and distressed mood compared to veterans in the waitlist control group. When controlling for current participation in evidence-based PTSD treatment, veterans in the CBT-I group reported a reduction in PTSD symptom severity while their waitlist counterparts demonstrated an increase in these PTSD symptoms. Veterans in the treatment group also reported improved objectively measured sleep quality between baseline and posttreatment. These data suggest that CBT-I is an effective treatment for insomnia, nightmares and PTSD symptoms in OEF/OIF veterans with combat related PTSD and should be used as an adjunctive therapy to standard PTSD treatment.",0 +,Children's well-being after the war in Kosovo: survey in 2000.,"To assess special health and psychosocial needs of Albanian children in Kosovo shortly after the dramatic ethnic conflict in this part of former Yugoslavia in 1999.The survey included representative samples of school-age children (n=813), parents (n=41), and teachers (n=31) from six public schools in Prishtina and surrounding area. The measuring instruments included a standardized inventory of children's coping behavior in stressful situations (Ryan-Wegner Coping Style Inventory, SCSI), and survey questionnaires for children, parents, and school teachers, which were also used in a parallel study in Bosnia and Herzegovina (Sarajevo) on comparable survey samples. The study was accomplished in April 2000, ie, only a few months after the crisis in Kosovo.At the time of the survey, many children in Prishtina and surrounding area lived in unhealthy and dangerous physical environment. There were frequent lack of electricity (74%), lack of safe drinking water (68%), garbage on the streets (63%), and firearms, explosive devices, and mine fields in close environment (45%). Many of them showed signs and symptoms of ill health, including frequent headaches (60%), stomach ache (41%), frequent high fever (32%), and sleeplessness (18%). Most of them felt unsafe on the streets (61%). Many of them had rather unhealthy eating habits, such as not having breakfast regularly (16%) or not having a morning snack (60%). Three major groups of stressors were identified as having impact on children's health and psychosocial well-being in Kosovo, as follows: 1) lack of cultural and social security resources at home and in the community at large (20% of common variance explained); 2) poor physical and mental health conditions (14% of common variance); and 3) school-related stressors (11% of common variance). Similarly, parents and teachers also lived and worked under stressful life conditions. Many parents feared the impact of traumatic war experiences on children's health (54%), and school teachers noticed high rates of children's learning and behavioral disorders (84%). Factor analysis of the SCSI proved the hypothesis that in stressful situations children tend to use two major coping strategies: either active, ie, object-focused coping (13% of variance explained) or passive, ie, self-focused coping (10% of variance explained), the later being more typical for younger children. The pattern of stressors and coping behaviors were similar to stressors impacting physical and mental health of children in Sarajevo, although there were a number of culture-specific differences.Environmental, educational, and social conditions must be respected in assessing impact of war and conflict on children. Promotion of solidarity, tolerance, and mutual support among children from different ethnic and cultural backgrounds should be encouraged.",0 +https://doi.org/10.1016/j.jsat.2011.02.012,Baseline functioning among individuals with posttraumatic stress disorder and alcohol dependence,"Comorbid posttraumatic stress disorder (PTSD) and alcohol dependence (AD) may lead to a complicated and potentially severe treatment profile. Our study examined 167 individuals with both PTSD and AD compared with 105 individuals with PTSD without an alcohol use disorder (AUD) and 240 individuals with AD without PTSD on baseline psychosocial functioning. We hypothesized that individuals with PTSD/AD would be more socially and functionally impaired than individuals with only one disorder. Results indicated that participants with PTSD/AD were more likely to be unemployed, have less education, and report less income and were less likely to live with a partner than the participants with only a single disorder. However, they did not differ on symptom severity within these disorders (drinking frequency/quantity, PTSD, and anxiety symptoms) with the exception of depression and alcohol craving. This contradicts clinical lore that comorbid patients are more impaired at treatment initiation and adds support for concurrent treatment as not only feasible but also possibly ideal for these patients.",0 +https://doi.org/10.1016/j.amepre.2008.07.009,Cigarette Smoking and Military Deployment,"The stress of military deployment may compound occupational stress experienced in the military and manifest in maladaptive coping behaviors such as cigarette smoking. The current study describes new smoking among never-smokers, smoking recidivism among past smokers, and change in daily smoking among smokers in relation to military deployment.The Millennium Cohort is a 21-year longitudinal study. The current analysis utilized participants (N=48,304) who submitted baseline data (July 2001-June 2003) before the current conflicts in Iraq and Afghanistan and follow-up data (June 2004-January 2006) on health measures. New smoking was identified among baseline never-smokers, smoking recidivism among baseline past smokers, and increased or decreased daily smoking among baseline smokers. Analyses were conducted March 2007-April 2007.Among never-smokers, smoking initiation was identified in 1.3% of nondeployers and 2.3% of deployers. Among past smokers, smoking resumption occurred in 28.7% of nondeployers and 39.4% of those who deployed. Smoking increased 44% among nondeployers and 57% among deployers. Those who deployed and reported combat exposures were at 1.6 times greater odds of initiating smoking among baseline never-smokers (95% CI=1.2, 2.3) and at 1.3 times greater odds of resuming smoking among baseline past smokers when compared to those who did not report combat exposures. Other deployment factors independently associated with postdeployment smoking recidivism included deploying for >9 months and deploying multiple times. Among those who smoked at baseline, deployment was not associated with changes in daily amount smoked.Military deployment is associated with smoking initiation and, more strongly, with smoking recidivism, particularly among those with prolonged deployments, multiple deployments, or combat exposures. Prevention programs should focus on the prevention of smoking relapse during or after deployment.",0 +https://doi.org/10.1002/jts.21853,Patterns of Multiple Victimization Among Maltreated Children in Navy Families,"The current study examined the cumulative risk associated with children's exposure to multiple types of parent-inflicted victimization. The sample was comprised of 195 children who were 7 to 17 years old (64.1% female and 48.2% non-White) at the time of referral to the United States Navy's Family Advocacy Program due to allegations of sexual abuse, physical abuse, or parental intimate partner violence. We conducted an exploratory latent class analysis to identify distinct subgroups of children based on lifetime victimization. We hypothesized that at least 2 classes or subgroups would be identified, with 1 characterized by greater victimization and poorer outcomes. Results indicated that 3 classes of children best fit the data: (a) high victimization across all 3 categories, (b) high rates of physical abuse and witnessing intimate partner violence, and (c) high rates of physical abuse only. Findings indicated that the high victimization class was at greatest risk for alcohol and substance use, delinquent behavior, and meeting criteria for posttraumatic stress disorder (PTSD) and/or depression 1 year later (odds ratio = 4.53). These findings highlight the serious mental health needs of a small but significantly high-risk portion of multiply victimized children entering the child welfare system.",0 +https://doi.org/10.1046/j.1524-4741.2001.007001025.x,"Distress, Coping, and Social Support Among Rural Women Recently Diagnosed with Primary Breast Cancer","This study examined distress, coping, and group support among a sample of rural women who had been recently diagnosed with breast cancer. We recruited 100 women who had been diagnosed with primary breast cancer at one of two time points in their medical treatment: either within a window up to 3 months after their diagnosis of breast cancer, or within 6 months after completing medical treatment for breast cancer. Their mean age was 58.6 years (SD = 11.6), and 90% were of white/European American ethnicity. Women completed a battery of demographic and psychosocial measures prior to being randomized into a psychoeducational intervention study, and then again 3 months later at a follow-up assessment. The focus of this article is on the women's self-reported psychosocial status at baseline. Many of the women experienced considerable traumatic stress regarding their breast cancer. However, this distress was not reflected in a standard measure of mood disturbance that is frequently used in intervention research (the Profile of Mood States). The average woman considered her diagnosis of breast cancer to be among the four most stressful life events that she had ever experienced. Also, women on average reported a high level of helplessness/hopelessness in coping with their cancer. On average, women felt that they ""often"" (but not ""very often"") received instrumental assistance, emotional support, and informational support. Women varied considerably in which kind of social group provided them with the most support, with as many reporting that they found the greatest support in spiritual/church groups or within their family units as with breast or general cancer groups. These results suggest that among these rural women with breast cancer, distress with the diagnosis of breast cancer must be carefully assessed, as women who are highly distressed about their breast cancer may not report general mood disturbance. Furthermore, the kinds of groups that rural women with breast cancer experience as most supportive need to be identified so that psychosocial interventions can be matched to breast cancer patients' individual needs.",0 +https://doi.org/10.1016/j.neuro.2012.06.001,Event-related potential patterns associated with hyperarousal in Gulf War illness syndrome groups,"An exaggerated response to emotional stimuli is one of the several symptoms widely reported by veterans of the 1991 Persian Gulf War. Many have attributed these symptoms to post-war stress; others have attributed the symptoms to deployment-related exposures and associated damage to cholinergic, dopaminergic, and white matter systems. We collected event-related potential (ERP) data from 20 veterans meeting Haley criteria for Gulf War Syndromes 1-3 and from 8 matched Gulf War veteran controls, who were deployed but not symptomatic, while they performed an auditory three-condition oddball task with gunshot and lion roar sounds as the distractor stimuli. Reports of hyperarousal from the ill veterans were significantly greater than those from the control veterans; different ERP profiles emerged to account for their hyperarousability. Syndromes 2 and 3, who have previously shown brainstem abnormalities, show significantly stronger auditory P1 amplitudes, purported to indicate compromised cholinergic inhibitory gating in the reticular activating system. Syndromes 1 and 2, who have previously shown basal ganglia dysfunction, show significantly weaker P3a response to distractor stimuli, purported to indicate dysfunction of the dopaminergic contribution to their ability to inhibit distraction by irrelevant stimuli. All three syndrome groups showed an attenuated P3b to target stimuli, which could be secondary to both cholinergic and dopaminergic contributions or disruption of white matter integrity.",0 +https://doi.org/10.2165/00023210-200216060-00006,Spotlight on Paroxetine in Psychiatric Disorders in Adults*,"Paroxetine is a selective serotonin reuptake inhibitor (SSRI), with antidepressant and anxiolytic activity. In 6- to 24-week well designed trials, oral paroxetine 10 to 50 mg/day was significantly more effective than placebo, at least as effective as tricyclic antidepressants (TCAs) and as effective as other SSRIs and other antidepressants in the treatment of major depressive disorder. Relapse or recurrence over 1 year after the initial response was significantly lower with paroxetine 10 to 50 mg/day than with placebo and similar to that with imipramine 50 to 275 mg/day. The efficacy of paroxetine 10 to 40 mg/day was similar to that of TCAs and fluoxetine 20 to 60 mg/day in 6- to 12-week trials in patients aged (greater-than or equal to)60 years with major depression. Paroxetine 10 to 40 mg/day improved depressive symptoms to an extent similar to that of TCAs in patients with comorbid illness, and was more effective than placebo in the treatment of dysthymia and minor depression. Paroxetine 20 to 60 mg/day was more effective than placebo after 8 to 12 weeks' treatment of obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder (social phobia), generalised anxiety disorder (GAD) and post-traumatic stress disorder (PTSD). Improvement was maintained or relapse was prevented for 24 weeks to 1 year in patients with OCD, panic disorder, social anxiety disorder or GAD. The efficacy of paroxetine was similar to that of other SSRIs in patients with OCD and panic disorder and similar to that of imipramine but greater than that of 2'chlordesmethyldiazepam in patients with GAD. Paroxetine is generally well tolerated in adults, elderly individuals and patients with comorbid illness, with a tolerability profile similar to that of other SSRIs. The most common adverse events with paroxetine were nausea, sexual dysfunction, somnolence, asthenia, headache, constipation, dizziness, sweating, tremor and decreased appetite. In conclusion, paroxetine, in common with other SSRIs, is generally better tolerated than TCAs and is a first-line treatment option for major depressive disorder, dysthymia or minor depression. Like other SSRIs, paroxetine is also an appropriate first-line therapy for OCD, panic disorder, social anxiety disorder, GAD and PTSD. Notably, paroxetine is the only SSRI currently approved for the treatment of social anxiety disorder and GAD, which makes it the only drug of its class indicated for all five anxiety disorders in addition to major depressive disorder. Thus, given the high degree of psychiatric comorbidity of depression and anxiety, paroxetine is an important first-line option for the treatment of major depressive disorder, OCD, panic disorder, social anxiety disorder, GAD and PTSD.",0 +https://doi.org/10.9758/cpn.2013.11.2.96,"Low-frequency, Repetitive Transcranial Magnetic Stimulation for the Treatment of Patients with Posttraumatic Stress Disorder: a Double-blind, Sham-controlled Study","Several studies have suggested that repetitive transcranial magnetic stimulation (rTMS) of the right prefrontal cortex may be useful in the treatment of posttraumatic stress disorder (PTSD). The aim of this study was to compare the effect of rTMS on the right prefrontal cortex with that of sham stimulation among patients with PTSD.In total, 18 patients with PTSD were randomly assigned to the 1-Hz low-frequency rTMS group or the sham group for 3 weeks. Primary efficacy measures were the Clinician-Administered PTSD Scale (CAPS) and its subscales, assessed at baseline and at 2, 4, and 8 weeks.All CAPS scores improved significantly over the study period. We found significant differences in the re-experiencing scores (F=7.47, p=0.004) and total scores (F=6.45, p=0.008) on the CAPS. The CAPS avoidance scores showed a trend toward significance (F=2.74, p=0.055), but no significant differences in the CAPS hyperarousal scores were observed.The present study showed low-frequency rTMS to be an effective and tolerable option for the treatment of PTSD. Trials using variable indices of rTMS to the right prefrontal cortex and explorations of the differences in the effects on specific symptom clusters may be promising avenues of research regarding the use of rTMS for PTSD.",0 +https://doi.org/10.1016/j.jpsychores.2014.11.017,"Indirect associations of combat exposure with post-deployment physical symptoms in U.S. soldiers: Roles of post-traumatic stress disorder, depression and insomnia","To characterize the indirect associations of combat exposure with post-deployment physical symptoms through shared associations with post-traumatic stress disorder (PTSD), depression and insomnia symptoms.Surveys were administered to a sample of U.S. soldiers (N = 587) three months after a 15-month deployment to Iraq. A multiple indirect effects model was used to characterize direct and indirect associations between combat exposure and physical symptoms.Despite a zero-order correlation between combat exposure and physical symptoms, the multiple indirect effects analysis did not provide evidence of a direct association between these variables. Evidence for a significant indirect association of combat exposure and physical symptoms was observed through PTSD, depression, and insomnia symptoms. In fact, 92% of the total effect of combat exposure on physical symptoms scores was indirect. These findings were evident even after adjusting for the physical injury and relevant demographics.This is the first empirical study to suggest that PTSD, depression and insomnia collectively and independently contribute to the association between combat exposure and post-deployment physical symptoms. Limitations, future research directions, and potential policy implications are discussed.",0 +https://doi.org/10.1038/sj.npp.1300862,Effect of Sertraline on Glucocorticoid Sensitivity of Mononuclear Leukocytes in Post-Traumatic Stress Disorder,"This study examined the effects of sertraline (SER) on glucocorticoid sensitivity in mononuclear leukocytes (MNL) from eight subjects with current post-traumatic stress disorder (PTSD) and nine comparison subjects. In all, 60 ml of blood was withdrawn by venipuncture at 0800, and MNL were isolated from blood and divided into two portions: the first contained live cells incubated with a series of concentrations of dexamethasone (DEX); the second contained cells incubated with similar concentrations of DEX+2 muM SER. Group difference in the concentrations of DEX required to inhibit lysozyme activity by 50% were evaluated under conditions of DEX-only and DEX+SER using analysis of covariance (ANCOVA). A significant Group x Condition interaction reflected that SER altered the lysozyme IC(50-DEX) in the direction of decreasing sensitivity to glucocorticoids in PTSD while having no uniform effect in cells from comparison subjects. The data provide support for the idea that glucocorticoid receptors might be more responsive to antidepressants in PTSD than in persons without PTSD. Insofar as increased sensitivity to glucocorticoids has been linked with PTSD, the actions of SER on the lysozyme IC(50-DEX) suggest that this medication may target a biologic alteration associated with PTSD pathophysiology.",0 +https://doi.org/10.1177/1073858411435706,Genetic Polymorphisms Influence Recovery from Traumatic Brain Injury,"Traumatic brain injury (TBI) is a major public health concern in both civilian and military populations. Recently, genetics studies have begun to identify individual differences in polymorphisms that could affect recovery and outcome of cognitive and social processes following TBI. This review considers the potential for polymorphisms to influence six specific cognitive and social functions, which represent the most prominent domains of impairment following TBI: working memory, executive function, decision making, inhibition and impulsivity, aggression, and social and emotional function. Examining the influence of polymorphisms on TBI outcome has the potential to contribute to an understanding of variations in TBI outcome, aid in the triaging and treatment of TBI patients, and ultimately lead to targeted interventions based on genetic profiles.",0 +https://doi.org/10.1371/journal.pone.0007720,"A Decade Later, How Much of Rwanda's Musculoskeletal Impairment Is Caused by the War in 1994 and by Related Violence?","In 1994 there was a horrific genocide in Rwanda following years of tension, resulting in the murder of at least 800,000 people. Although many people were injured in addition to those killed, no attempt has been made to assess the lasting burden of physical injuries related to these events. The aim of this study was to estimate the current burden of musculoskeletal impairment (MSI) attributable to the 1994 war and related violence.A national cross-sectional survey of MSI was conducted in Rwanda. 105 clusters of 80 people were selected through probability proportionate to size sampling. Households within clusters were selected through compact segment sampling. Enumerated people answered a seven-question screening test to assess whether they might have an MSI. Those who were classed as potential cases in the screening test were examined and interviewed by a physiotherapist, using a standard protocol that recorded the site, nature, cause, and severity of the MSI. People with MSI due to trauma were asked whether this trauma occurred during the 1990-1994 war or during the episodes that preceded or followed this war. Out of 8,368 people enumerated, 6,757 were available for screening and examination (80.8%). 352 people were diagnosed with an MSI (prevalence=5.2%, 95% CI=4.5-5.9%). 106 cases of MSI (30.6%) were classified as resulting from trauma, based on self-report and the physiotherapist's assessment. Of these, 14 people (13.2%) reported that their trauma-related MSI occurred during the 1990-1994 war, and a further 7 (6.6%) that their trauma-related MSI occurred during the violent episodes that preceded and followed the war, giving an overall prevalence of trauma-related MSI related to the 1990-1994 war of 0.3% (95% CI=0.2-0.4%).A decade on, the overall prevalence of MSI was relatively high in Rwanda but few cases appeared to be the result of the 1994 war or related violence.",0 +https://doi.org/10.22605/rrh1667,"Exposure to traumatic events, prevalence of posttraumatic stress disorder and alcohol abuse in Aboriginal communities","Generations of Aboriginal people have been exposed to strings of traumatic events with devastating psychosocial health consequences, including psychiatric morbidities and mortalities, and medical complications. Posttraumatic Stress Disorder (PTSD) is a psychiatric morbidity directly linked to traumatic events. Despite research findings indicating traumatic exposure and resultant PTSD in Indigenous communities, little attention has been given to this condition in mental healthcare delivery. Consequently, clinical and psychosocial interventions are misguided and failed to deliver positive outcomes. The objective of this study is to explore the relationship between exposure to traumatic events, prevalence of PTSD and alcohol abuse in remote Aboriginal communities in Western Australia.A combination of structured clinical interview and multiple survey questionnaires - Composite International Diagnostic Interview (CIDI), and Impact of Events Scale (IES), Alcohol Use Disorder Identification Test (AUDIT) and Indigenous Trauma Profile (ITP) - were administered to 221 Indigenous participants aged 18 to 65 years.The overwhelming majority, 97.3% (n=215) of participants were exposed to traumatic events. Analysis of CIDI results using DSM-IV diagnostic criteria shows a life time prevalence of 55.2% (n=122) for PTSD, 20% (n=44) for major depression (recurrent) and 2.3% (n=5) for a single episode. A total of 96% (n=212) participants reported consuming a drink containing alcohol and 73.8% (n=163) met diagnostic criteria for alcohol use related disorders, abuse and dependence. Of participants who met the PTSD diagnostic criteria, 91% (n=111) met diagnostic criteria for alcohol use related disorders. Other impacts of trauma such as other anxiety disorders, dysthymic disorder and substances abuses were also identified.The rate of exposure to traumatic events and prevalence of PTSD are disproportionately higher in the communities studied than the national average and one of the highest recorded in survivors of specific traumatic events in the world. A very high rate of alcohol abuse and dependence in participants who met diagnostic criteria for PTSD demonstrates correlation between alcohol abuse and PTSD. It also suggests that alcohol is used as self-medication.",0 +https://doi.org/10.1186/1471-2407-10-279,Hopefulness predicts resilience after hereditary colorectal cancer genetic testing: a prospective outcome trajectories study,"Genetic testing for hereditary colorectal cancer (HCRC) had significant psychological consequences for test recipients. This prospective longitudinal study investigated the factors that predict psychological resilience in adults undergoing genetic testing for HCRC.A longitudinal study was carried out from April 2003 to August 2006 on Hong Kong Chinese HCRC family members who were recruited and offered genetic testing by the Hereditary Gastrointestinal Cancer Registry to determine psychological outcomes after genetic testing. Self-completed questionnaires were administered immediately before (pre-disclosure baseline) and 2 weeks, 4 months and 1 year after result disclosure. Using validated psychological inventories, the cognitive style of hope was measured at baseline, and the psychological distress of depression and anxiety was measured at all time points.Of the 76 participating subjects, 71 individuals (43 men and 28 women; mean age 38.9 +/- 9.2 years) from nine FAP and 24 HNPCC families completed the study, including 39 mutated gene carriers. Four patterns of outcome trajectories were created using established norms for the specified outcome measures of depression and anxiety. These included chronic dysfunction (13% and 8.7%), recovery (0% and 4.3%), delayed dysfunction (13% and 15.9%) and resilience (76.8% and 66.7%). Two logistic regression analyses were conducted using hope at baseline to predict resilience, with depression and anxiety employed as outcome indicators. Because of the small number of participants, the chronic dysfunction and delayed dysfunction groups were combined into a non-resilient group for comparison with the resilient group in all subsequent analysis. Because of low frequencies, participants exhibiting a recovery trajectory (n = 3 for anxiety and n = 0 for depression) were excluded from further analysis. Both regression equations were significant. Baseline hope was a significant predictor of a resilience outcome trajectory for depression (B = -0.24, p < 0.01 for depression); and anxiety (B = -0.11, p = 0.05 for anxiety).The current findings suggest that hopefulness may predict resilience after HCRC genetic testing in Hong Kong Chinese. Interventions to increase the level of hope may be beneficial to the psychological adjustment of CRC genetic testing recipients.",0 +https://doi.org/10.1080/15374410802148210,The Moderating Effects of Maternal Psychopathology on Children's Adjustment Post–Hurricane Katrina,This study investigated the role of maternal psychopathology in predicting children's psychological distress in a disaster-exposed sample. Participants consisted of 260 children (ages 8-16) recruited from public schools and their mothers. These families were displaced from New Orleans because of Hurricane Katrina in 2005. Assessment took place 3 to 7 months postdisaster. Hierarchical regression analyses revealed that global maternal psychological distress and maternal posttraumatic stress disorder moderated the relation between child hurricane exposure and mother-reported child internalizing and externalizing symptoms.,0 +https://doi.org/10.1016/j.psychres.2015.03.011,Identifying latent profiles of posttraumatic stress and major depression symptoms in Canadian veterans: Exploring differences across profiles in health related functioning,"Posttraumatic stress disorder (PTSD) has been consistently reported as being highly comorbid with major depressive disorder (MDD) and as being associated with health related functional impairment (HRF). We used archival data from 283 previously war-zone deployed Canadian veterans. Latent profile analysis (LPA) was used to uncover patterns of PTSD and MDD comorbidity as measured via the PTSD Checklist-Military version (PCL-M) and the Patient Health Questionnaire-9 (PHQ-9). Individual membership of latent classes was used in a series of one-way ANOVAs to ascertain group differences related to HRF as measured via the Short-Form-36 Health Survey (SF-36). LPA resulted in three discrete patterns of PTSD and MDD comorbidity which were characterized by high symptoms of PTSD and MDD, moderate symptoms, and low symptoms. All ANOVAs comparing class membership on the SF-36 subscales were statistically significant demonstrating group differences across levels of HRF. The group with the highest symptoms reported the worst HRF followed by the medium and low symptom groups. These findings are clinically relevant as they demonstrate the need for continual assessment and targeted treatment of co-occurring PTSD and MDD.",0 +https://doi.org/10.1080/09638280500287320,"Clinical expression profiles of complex regional pain syndrome, fibromyalgia and a-specific repetitive strain injury: More common denominators than pain?","To systematically evaluate and compare the clinical manifestations, disease course, risk factors and demographic characteristics of Complex Regional Pain Syndrome type 1 (CRPS), fibromyalgia (FM) and a-specific Repetitive Strain Injury (RSI).A literature search was performed using terms related to the aforementioned topics and diseases. Only original clinical studies that included at least 20 subjects were eligible.Fifty-nine studies on CRPS, 73 on FM and 7 on a-specific RSI were identified. The diseases show similarities in age distribution, male-female ratio, pain characteristics and sensory signs and symptoms. Motor, autonomic and trophic changes are frequently reported in CRPS, but only occasionally in FM and RSI. Systemic symptoms are found in patients with CRPS and FM, and in a subgroup of patients with RSI. In all three disorders, symptoms usually start locally, but may spread to other body regions later, which, in the case of FM, is a prerequisite for diagnosis. Disease onset is always, usually, or occasionally of traumatic origin in RSI, CRPS and FM, respectively. Anxiety and depression are more frequent in patients compared to controls, but probably not very different from patients with other pain conditions or chronic diseases.Apart from some obvious differences between CRPS, FM and RSI, the similarities are conspicuous. The common features of CRPS, FM and a-specific RSI may suggest that a common pathway is involved, but until patients with these type of symptoms are assessed with a uniform assessment procedure, a thorough comparison cannot be made. A systematic evaluation of patients with a suspected diagnosis of CRPS, FM or RSI, may lead to a better appreciation of the differences and similarities in these diseases and help to unravel the underlying mechanisms.",0 +https://doi.org/10.1080/09515070.2012.682563,Distinguishing between treatment efficacy and effectiveness in post-traumatic stress disorder (PTSD): Implications for contentious therapies,Research psychologists often complain that practitioners disregard research evidence whilst practitioners sometimes accuse researchers of failing to produce evidence with sufficient ecological validity. We discuss the tension that thus arises using the specific illustrative examples of two treatment methods for post-traumatic stress disorder: eye movement desensitisation and reprocessing and exposure-based interventions. We discuss the contextual reasons for the success or failure of particular treatment models that are often only tangentially related to the theoretical underpinnings of the models. We discuss what might be learnt from these debates and develop recommendations for future research.,0 +https://doi.org/10.1007/s10995-015-1772-4,Birth Outcomes in a Disaster Recovery Environment: New Orleans Women After Katrina,"To examine how the recovery following Hurricane Katrina affected pregnancy outcomes.308 New Orleans area pregnant women were interviewed 5-7 years after Hurricane Katrina about their exposure to the disaster (danger, damage, and injury); current disruption; and perceptions of recovery. Birthweight, gestational age, birth length, and head circumference were examined in linear models, and low birthweight (<2500 g) and preterm birth (<37 weeks) in logistic models, with adjustment for confounders.Associations were found between experiencing damage during Katrina and birthweight (adjusted beta for high exposure = -158 g) and between injury and gestational age (adjusted beta = -0.5 days). Of the indicators of recovery experience, most consistently associated with worsened birth outcomes was worry that another hurricane would hit the region (adjusted beta for birthweight: -112 g, p = 0.08; gestational age: -3.2 days, p = 0.02; birth length: -0.65 cm, p = 0.06).Natural disaster may have long-term effects on pregnancy outcomes. Alternately, women who are most vulnerable to disaster may be also vulnerable to poor pregnancy outcome.",0 +https://doi.org/10.3402/ejpt.v6.26406,Latent profile analysis and principal axis factoring of the DSM-5 dissociative subtype,"A dissociative subtype has been recognized based on the presence of experiences of depersonalization and derealization in relation to DSM-IV posttraumatic stress disorder (PTSD). However, the dissociative subtype has not been assessed in a community sample in relation to the revised DSM-5 PTSD criteria. Moreover, the 20-item PTSD Checklist for DSM-5 (PCL-5) currently does not assess depersonalization and derealization.We therefore evaluated two items for assessing depersonalization and derealization in 557 participants recruited online who endorsed PTSD symptoms of at least moderate severity on the PCL-5.A five-class solution identified two PTSD classes who endorsed dissociative experiences associated with either 1) severe or 2) moderate PTSD symptom severity (D-PTSD classes). Those in the severe dissociative class were particularly likely to endorse histories of childhood physical and sexual abuse. A principal axis factor analysis of the symptom list identified six latent variables: 1) Reexperiencing, 2) Emotional Numbing/Anhedonia, 3) Dissociation, 4) Negative Alterations in Cognition & Mood, 5) Avoidance, and 6) Hyperarousal.The present results further support the presence of a dissociative subtype within the DSM-5 criteria for PTSD.",0 +https://doi.org/10.1192/apt.bp.109.007773,Evolution of secure services for women in England,"Summary Patients detained at high and medium security reveal significant gender differences in the presentation of psychopathology, mental disorder and social and offending profiles. However, secure mental health services in England, like prisons, generally fail to recognise the core importance of the differing biopsychosocial development in women and the impact of life experiences on women's subsequent biopsychosocial functioning. As a consequence, women are often inadequately provided for in services dictated by the identified needs, risks and responsiveness of men. The lack of clinically appropriate facilities for women may account for the increased frequency with which women are readmitted to medium security and for their longer admissions to both high and medium secure care. New tertiary services are developing as a result of the lessons learnt while providing gender-blind care. However, further development is required to ensure that women receive services of the same quality, range and nature of those received by men.",0 +https://doi.org/10.1002/jts.20668,Prolonged grief among traumatically bereaved relatives exposed and not exposed to a tsunami,"Numerous studies on the mental health consequences of traumatic exposure to a disaster compare those exposed to those not exposed. Relatively few focus on the effect of the death of a close relative caused by the disaster-suffering a traumatic bereavement. This study compared the impact on 345 participants who lost a close relative in the 2004 Indian Ocean tsunami, but who were themselves not present, to 141 who not only lost a relative, but also were themselves exposed to the tsunami. The focus was on psychological distress assessed during the second year after the sudden bereavement. Findings were that exposure to the tsunami was associated with prolonged grief (B = 3.81) and posttraumatic stress reactions (B = 6.65), and doubled the risk for impaired mental health. Loss of children increased the risk for psychological distress (prolonged grief: B = 6.92; The Impact of Event Scale-Revised: B = 6.10; General Health Questionnaire-12: OR = 2.34). Women had a higher frequency of prolonged grief. For men, loss of children presented a higher risk for prolonged grief in relation to other types of bereavement (B = 6.36 vs. loss of partner). Further long-term follow-up could deepen the understanding of how recovery after traumatic loss is facilitated.",0 +https://doi.org/10.1002/jts.21913,Mobilizing Victim Services: The Role of Reporting to the Police,"Victim assistance programs have grown dramatically in response to the victim's rights movement and concern over difficulty navigating victim services. Evidence, however, indicates that very few victims seek assistance. The present study examined factors associated with victim service use including reporting to the police, the victim's demographic characteristics, the victim's injury, offender's use of a weapon, the victim's relationship to the offender, and the victim's mental and physical distress. Data came from a subset of the National Crime Victimization Survey 2008-2011 (N = 4,746), a stratified multistage cluster sample survey of persons age 12 years and older in the United States. Logistic regression models indicated that fewer than 10% of victims of violent crime sought help from victim services. Reporting to the police increased the odds of seeking services by 3 times. In addition, the odds of victims attacked by an intimate partner seeking services were 4.5 times greater than victims attacked by strangers. Findings suggest that additional exploratory work is needed in uncovering the mechanism of police involvement in linking victims to services. Specifically, do police understand what services are available to victims and why are police more likely to inform some types of victims about services more than others?",0 +https://doi.org/10.1016/j.ccell.2006.05.014,Workplace Violence: A Primer for Critical Care Nurses,"This review illustrates the various types of workplace violence nurses can encounter in critical care settings. Lack of a clear definition of workplace violence impedes research on the topic; however, the typology offered by the UIIPRC provides a framework to guide further studies of physical and nonphysical workplace violence. Further investigation of individual and organizational factors will assist nurses and agencies in identifying effective methods to manage, prevent, educate, and respond to each type of workplace violence. Fear, burnout, anxiety, depression, and acute and posttraumatic stress disorders are some of the sequelae that can occur after an incident of workplace violence. Debriefing strategies should be a fundamental component of workplace violence policies to prevent the development of longterm consequences. Additional research is needed on all types of workplace violence, as well as research addressing the needs of specialized setting, such as critical care unit. Critical care nurses have valuable insights regarding the risks they face on their units and should be part of a multidisciplinary team developing policies and workplace violence prevention and education programs.",0 +https://doi.org/10.1016/j.janxdis.2012.10.006,Assessing the fit of the Dysphoric Arousal model across two nationally representative epidemiological surveys: The Australian NSMHWB and the United States NESARC,"Since the initial inclusion of PTSD in the DSM nomenclature, PTSD symptomatology has been distributed across three symptom clusters. However, a wealth of empirical research has concluded that PTSD's latent structure is best represented by one of two four-factor models: Numbing or Dysphoria. Recently, a newly proposed five-factor Dysphoric Arousal model, which separates the DSM-IV's Arousal cluster into two factors of Anxious Arousal and Dysphoric Arousal, has gathered support across a variety of trauma samples. To date, the Dysphoric Arousal model has not been assessed using nationally representative epidemiological data. We employed confirmatory factor analysis to examine PTSD's latent structure in two independent population based surveys from American (NESARC) and Australia (NSWHWB). We specified and estimated the Numbing model, the Dysphoria model, and the Dysphoric Arousal model in both samples. Results revealed that the Dysphoric Arousal model provided superior fit to the data compared to the alternative models. In conclusion, these findings suggest that items D1-D3 (sleeping difficulties; irritability; concentration difficulties) represent a separate, fifth factor within PTSD's latent structure using nationally representative epidemiological data in addition to single trauma specific samples.",0 +https://doi.org/10.1016/s0304-3959(03)00050-2,Prognostic factors of whiplash-associated disorders: a systematic review of prospective cohort studies,"We present a systematic review of prospective cohort studies. Our aim was to assess prognostic factors associated with functional recovery of patients with whiplash injuries. The failure of some patients to recover following whiplash injury has been linked to a number of prognostic factors. However, there is some inconsistency in the literature and there have been no systematic attempts to analyze the level of evidence for prognostic factors in whiplash recovery. Studies were selected for inclusion following a comprehensive search of MEDLINE, EMBASE, CINAHL, the database of the Dutch Institute of Allied Health Professions up until April 2002 and hand searches of the reference lists of retrieved articles. Studies were selected if the objective was to assess prognostic factors associated with recovery; the design was a prospective cohort study; the study population included at least an identifiable subgroup of patients suffering from a whiplash injury; and the paper was a full report published in English, German, French or Dutch. The methodological quality was independently assessed by two reviewers. A study was considered to be of 'high quality' if it satisfied at least 50% of the maximum available quality score. Two independent reviewers extracted data and the association between prognostic factors and functional recovery was calculated in terms of risk estimates. Fifty papers reporting on twenty-nine cohorts were included in the review. Twelve cohorts were considered to be of 'high quality'. Because of the heterogeneity of patient selection, type of prognostic factors and outcome measures, no statistical pooling was able to be performed. Strong evidence was found for high initial pain intensity being an adverse prognostic factor. There was strong evidence that for older age, female gender, high acute psychological response, angular deformity of the neck, rear-end collision, and compensation not being associated with an adverse prognosis. Several physical (e.g. restricted range of motion, high number of complaints), psychosocial (previous psychological problems), neuropsychosocial factors (nervousness), crash related (e.g. accident on highway) and treatment related factors (need to resume physiotherapy) showed limited prognostic value for functional recovery. High initial pain intensity is an important predictor for delayed functional recovery for patients with whiplash injury. Often mentioned factors like age, gender and compensation do not seem to be of prognostic value. Scientific information about prognostic factors can guide physicians or other care providers to direct treatment and to probably prevent chronicity.",0 +,A clinical handbook/practical therapist manual for assessing and treating adults with post-traumatic stress disorder (PTSD).,"(from the preface) This ""Therapist Handbook/Manual"" arose out of a 7 yr intensive period during which [the author had] been deeply involved in work with clients (adults, adolescents, and children) who have been traumatized by natural and technological disasters and due to traumatic events of intentional human design. [The author's assessment and treatment of clients who experience posttraumatic stress disorder (PTSD) and in training both inpatient and outpatient mental health staff constitutes] the basis of the present manual on work with adults. . . . Each Section has a statement of objectives, section summaries, ""how to"" guidelines, critical evaluations of the field as well as a test of [one's] level of ""expertise."" (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1007/s10591-015-9353-7,Treatment of Intimate Partner Violence Perpetration Among Male Veterans: An Example of a Comprehensive Approach,"Intimate partner violence (IPV) is a significant and enduring public health problem, affecting as many as 5 million women annually in the United States. As a microcosm of society, military families experience such violence at rates equal to or higher than civilian counterparts. IPV is a complex problem often fueled by an equally complex mixture of risk factors, including substance abuse, childhood abuse and trauma, PTSD, depression, personality disorders, and various other stressors. The United States Department of Veterans Affairs provides healthcare to nearly nine million Veterans annually, including for IPV and the related risk factors. This article describes the risk factors for IPV, as well as the challenges associated with effectively treating it. Given the complexity of the problem, the need for an interdisciplinary, comprehensive approach to treatment is emphasized. An example of such a program is described. © 2015, Springer Science+Business Media New York.",0 +https://doi.org/10.1016/j.jpainsymman.2006.09.031,Validation of the French Version of the Brief Pain Inventory in Canadian Veterans Suffering from Traumatic Stress,"Although pain is a significant clinical problem in individuals suffering from post-traumatic stress disorder (PTSD), reliable and valid measures of pain for this population are lacking. The goal of this study was to validate the Brief Pain Inventory (BPI) in French-speaking veterans suffering from PTSD (n=130). We administered the BPI, as well as measures of PTSD, health status, quality of life, and social desirability, to veterans being assessed or treated for PTSD at a Veterans Affairs Canada clinic. The BPI showed strong internal consistency, as evidenced by Cronbach's alphas of 0.90 and 0.92 for the severity and interference subscales, respectively. Similar to previous findings, a two-factor structure (pain severity and pain interference) was found using an exploratory factor analysis. The two factors explained nearly 73% of the variance of the instrument. The BPI was also strongly correlated with health status and quality of life in the physical domain. In this veteran sample, nearly 87% of the veterans suffered from significant current pain. Veterans in our sample reported rates of pain severity that were similar to or higher than most of those reported by cancer patients and others with significant physical disability/illness. Overall, the French version of the BPI is a reliable, valid measure of pain in PTSD-suffering populations. Pain is a major issue in veterans with PTSD, and should be screened for with instruments such as the BPI.",0 +https://doi.org/10.1523/jneurosci.0771-15.2015,From Memory Impairment to Posttraumatic Stress Disorder-Like Phenotypes: The Critical Role of an Unpredictable Second Traumatic Experience,"Arousal and stress critically regulate memory formation and retention. Increasing levels of stress produce an inverted U-shaped effect on cognitive performance, including the retention of explicit memories, and experiencing a severe stress during a traumatic event may lead to posttraumatic stress disorder (PTSD). The molecular mechanisms underlying the impairing effect of a severe stress on memory and the key contribution of traumatic experiences toward the development of PTSD are still unknown. Here, using increasing footshock intensities in an inhibitory avoidance paradigm, we reproduced the inverted U-shaped curve of memory performance in rats. We then show that the inverted U profile of memory performance correlates with an inverted U profile of corticosterone level in the circulation and of brain-derived neurotrophic factor, phosphorylated tropomyosin-receptor kinase B, and methyl CpG binding protein in the dorsal hippocampus. Furthermore, training with the highest footshock intensity (traumatic experience) led to a significant elevation of hippocampal glucocorticoid receptors. Exposure to an unpredictable, but not to a predictable, highly stressful reminder shock after a first traumatic experience resulted in PTSD-like phenotypes, including increased memory of the trauma, high anxiety, threat generalization, and resistance to extinction. Systemic corticosterone injection immediately after the traumatic experience, but not 3 d later, was sufficient to produce PTSD-like phenotypes. We suggest that, although after a first traumatic experience a suppression of the corticosterone-dependent response protects against the development of an anxiety disorder, experiencing more than one trauma (multiple hits) is a critical contributor to the etiology of PTSD.",0 +https://doi.org/10.1176/appi.ps.54.10.1380,"Posttraumatic Stress Disorder, Alcohol Use, and Perceived Safety After the Terrorist Attack on the Pentagon","The authors examined posttraumatic stress disorder (PTSD), alcohol use, and perceptions of safety in a sample of survivors of the September 11, 2001, terrorist attack on the Pentagon.Analyses were conducted to examine the effect of past traumatic experience, trauma exposure, initial emotional response, and peritraumatic dissociation on probable PTSD, substance use, and perceived safety among 77 survivors seven months after the attack.Eleven respondents (14 percent) had PTSD. Those with PTSD reported higher levels of initial emotional response and peritraumatic dissociation. Ten respondents (13 percent) reported increased use of alcohol. Women were more than five times as likely as men to have PTSD and almost seven times as likely to report increased use of alcohol. Persons with higher peritraumatic dissociation were more likely to develop PTSD and report increased alcohol use. Those with lower perceived safety at seven months had higher initial emotional response and greater peritraumatic dissociation and were more likely to have PTSD, to have increased alcohol use, and to be female.The association of perceived safety with gender, the presence of PTSD, and increased alcohol use among survivors of the terrorist attack on the Pentagon warrants further study.",0 +https://doi.org/10.1177/0265407514558958,Trajectories of perceived social support among low-income female survivors of Hurricane Katrina,"The purpose of this study was to explore trajectories of perceived social support among low-income women who survived Hurricane Katrina, and were surveyed prior to the hurricane and approximately one and four years thereafter ( N = 562). Latent class growth analysis provided evidence of the following four trajectories of perceived support: High Increasing (35.9%), High Decreasing (20.3%), Low Stable (41.1%), and Low Decreasing (2.7%). Bereavement was significantly predictive of membership in the Low Stable trajectory, relative to the High Increasing and High Decreasing trajectories. Higher psychological distress and indicators of greater social network size, density, and closeness were significantly predictive of membership in the Low Decreasing trajectory, relative to the High Increasing and High Decreasing trajectories.",0 +https://doi.org/10.1016/s0892-0362(03)00035-7,Long-term effects of acute perinatal asphyxia on rat maternal behavior,"In this study we used a rat model of graded perinatal asphyxia to study the long-term consequences of this manipulation on rat maternal behavior at adulthood. Rats were delivered by cesarean (C) section and the pups, still in the uterus horns, were placed into a water bath at 37 degrees C for periods of 0 (controls) or 20 min (asphyxia). Subsequently, female pups were given to surrogate mothers, weaned at 21 days postnatally and then left undisturbed until adulthood, when they were mated. Once they gave birth, on postnatal days (Pnds) 1, 3, 5, 7, 9, 11 and 13 they were observed in the home cage five times per day to assess their maternal behavior in an undisturbed condition. In addition, maternal behavior was observed for 30 min in a novel cage on Pnds 4 and 8. Perinatal asphyxia affected maternal behavior in the home cage, hypoxic females being more often found outside the nest area and performing more often behaviors such as self-grooming. Principal component analysis confirmed a more 'active' behavioral profile for hypoxic females. Hypoxic mothers were characterized by a longer latency to perform on-nest behavior and by a reduced frequency of pup retrieval and licking in the novel cage. No significant differences in corticosterone secretion in response to an acute stressor were found in dams belonging to the different treatments or in the body weights of the offspring. These results are suggestive of an arousal deficit due to perinatal hypoxia and point to the dopaminergic system as a potential neurochemical target for an early hypoxic insult.",0 +,Assessment of social support among veterans with military-related post- traumatic stress disorder : a study of the Social Support Questionnaire,"Numerous studies in the past 20 years have found an inverse correlation between social support and post-traumatic stress disorder (PTSD). However, the social support literature is encumbered by a wide-spread inconsistency of social support measurement, with many studies not using existing validated measures. Identifying a valid social support measure with clinical utility among veterans diagnosed with war-related (PTSD) would be a helpful resource for clinicians. Using data from 689 veterans seeking treatment from a VA PTSD program, the reliability, factor structure, and construct validity of the Social Support Questionnaire (SSQ; Sarason, Levine, Basham, & Sarason, 1983) were evaluated. The hypothesis of this study was based on the theoretical assumption that social support (as measured by the SSQ), would be inversely correlated with severity of PTSD symptoms (as measured by the Mississippi Scale for War-related PTSD; Keane, Caddell & Taylor, 1988) and depression (as measured by the Beck Depression Inventory; Beck, 1961). In this study, the SSQ scores were found to inversely correlate at a low, but statistically significant level, with both PTSD and depression scores. Principal axes factor analysis found that the two subscales of the SSQ were each measuring one factor. The correlation between the SSQ ""N"" scores and ""S"" scores suggest that these subscales are measuring different components of social support. Numerous implications for research and clinical practice are discussed. This study is the first to psychometrically evaluate a measure of current social support for use among war veterans diagnosed with PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1016/j.janxdis.2013.11.002,A person-centered analysis of posttraumatic stress disorder symptoms following a natural disaster: Predictors of latent class membership,"The present study applied latent class analysis to a sample of 810 participants residing in southern Mississippi at the time of Hurricane Katrina to determine if people would report distinct, meaningful PTSD symptom classes following a natural disaster. We found a four-class solution that distinguished persons on the basis of PTSD symptom severity/pervasiveness (Severe, Moderate, Mild, and Negligible Classes). Multinomial logistic regression models demonstrated that membership in the Severe and Moderate Classes was associated with potentially traumatic hurricane-specific experiences (e.g., being physically injured, seeing dead bodies), pre-hurricane traumatic events, co-occurring depression symptom severity and suicidal ideation, certain religious beliefs, and post-hurricane stressors (e.g., social support). Collectively, the findings suggest that more severe/pervasive typologies of natural disaster PTSD may be predicted by the frequency and severity of exposure to stressful/traumatic experiences (before, during, and after the disaster), co-occurring psychopathology, and specific internal beliefs.",0 +https://doi.org/10.1186/1471-2474-13-136,Subgroups of musculoskeletal pain patients and their psychobiological patterns – The LOGIN study protocol,"Pain conditions of the musculoskeletal system are very common and have tremendous socioeconomic impact. Despite its high prevalence, musculoskeletal pain remains poorly understood and predominantly non-specifically and insufficiently treated.The group of chronic musculoskeletal pain patients is supposed to be heterogeneous, due to a multitude of mechanisms involved in chronic pain. Psychological variables, psychophysiological processes, and neuroendocrine alterations are expected to be involved. Thus far, studies on musculoskeletal pain have predominantly focused on the general aspects of pain processing, thus neglecting the heterogeneity of patients with musculoskeletal pain. Consequently, there is a need for studies that comprise a multitude of mechanisms that are potentially involved in the chronicity and spread of pain. This need might foster research and facilitate a better pathophysiological understanding of the condition, thereby promoting the development of specific mechanism-based treatments for chronic pain. Therefore, the objectives of this study are as follows: 1) identify and describe subgroups of patients with musculoskeletal pain with regard to clinical manifestations (including mental co-morbidity) and 2) investigate whether distinct sensory profiles or 3) distinct plasma levels of pain-related parameters due to different underlying mechanisms can be distinguished in various subgroups of pain patients.We will examine a population-based chronic pain sample (n = 100), a clinical tertiary care sample (n = 100) and pain-free patients with depression or post-traumatic stress disorder and pain-free healthy controls (each n = 30, respectively). The samples will be pain localisation matched by sex and age to the population-based sample. Patients will undergo physical examination and thorough assessments of mental co-morbidity (including psychological trauma), perceptual and central sensitisation (quantitative sensory testing), descending inhibition (conditioned pain modulation, the diffuse noxious inhibitory control-like effect), as well as measurement of the plasma levels of nerve growth factor and endocannabinoids.The identification of the underlying pathophysiologic mechanisms in different subgroups of chronic musculoskeletal pain patients will contribute to a mechanism-based subgroup classification. This will foster the development of mechanism-based treatments and holds promise to treat patients more sufficient.",0 +https://doi.org/10.1007/s10880-007-9051-1,Fear of Hypoglycemia and Self Reported Posttraumatic Stress in Adults with Type I Diabetes Treated by Intensive Regimens,"This study investigated the prevalence of hypoglycemic fear (FH) and hypoglycemia-specific posttraumatic stress (PTS) among individuals with Type I diabetes. Over 25% of participants met diagnostic criteria for current PTSD. High percentages of participants endorsed PTS symptom clusters, suggesting that individuals may be experiencing distress without necessarily meeting diagnostic criteria. Hierarchical multiple regression analyses revealed that perceived threat of death from hypoglycemia and FH were significantly related to PTS. Number of recent hypoglycemic episodes did not predict PTS/PTSD. Depression and nonspecific anxiety did not contribute to the statistical prediction of PTSD, suggesting that symptomatology endorsed represents hypoglycemia-specific anxiety rather than global psychological distress. The hypothesis that greater PTS symptomatology would relate to poorer glycemic control was unsubstantiated. Perceived death-threat from hypoglycemia and nonspecific anxiety were the only variables that contributed to prediction of glycemic control, suggesting that PTS did not represent a significant barrier for glycemic control in this sample. © Springer Science+Business Media, LLC 2007.",0 +https://doi.org/10.1037/a0029256,"Trajectories of resilience, depression, and anxiety following spinal cord injury.","To investigate longitudinal trajectories of depression and anxiety symptoms following spinal cord injury (SCI) as well as the predictors of those trajectories.A longitudinal study of 233 participants assessed at 4 time points: within 6 weeks, 3 months, 1 year, and 2 years from the point of injury. Data were analyzed using latent growth mixture modeling to determine the best-fitting model of depression and anxiety trajectories. Covariates assessed during hospitalization were explored as predictors of the trajectories.Analyses for depression and anxiety symptoms revealed 3 similar latent classes: a resilient pattern of stable low symptoms, a pattern of high symptoms followed by improvement (recovery), and delayed symptom elevations. A chronic high depression pattern also emerged but not a chronic high anxiety pattern. Analyses of predictors indicated that compared with other groups, resilient patients had fewer SCI-related quality of life problems, more challenge appraisals and fewer threat appraisals, greater acceptance and fighting spirit, and less coping through social reliance and behavioral disengagement.Overall, the majority of SCI patients demonstrated considerable psychological resilience. Models for depression and anxiety evidenced a pattern of elevated symptoms followed by improvement and a pattern of delayed symptoms. Chronic high depression was also observed but not chronic high anxiety. Analyses of predictors were consistent with the hypothesis that resilient individuals view major stressors as challenges to be accepted and met with active coping efforts. These results are comparable to other recent studies of major health stressors.",0 +https://doi.org/10.1080/08039480500319506,"A comparison of gains after treatment at a psychiatric outpatient clinic in patients with cluster A+B, or cluster C personality disorders, and non-psychotic axis I disorders","Few studies exist on the outcome of patients with personality disorders (PDs) treated at ordinary outpatient clinics. This study examines the gains of such patients 2 years after treatment start at an outpatient clinic. Three patient groups were sampled: cluster A + B PDs, cluster C PDs and axis I disorders. Fifty-eight patients (53%) were amenable to follow-up, and they did not show less psychopathology than the non-compliers. All patients had structured interviews and filled in questionnaires. Patients in the PDs cluster A + B group showed considerable gains, while that was not found for the PDs cluster C and Axis I disorder groups. Since almost all patients received long-term psychotherapy sometimes combined with antidepressant drugs, the finding that such a treatment mainly shows gains in more severely disturbed PDs patients should be replicated in larger samples at ordinary psychiatric outpatient clinics.",0 +https://doi.org/10.1016/j.seizure.2006.05.011,Prevalence of epilepsy and comorbidity of psychiatric disorders in Iran,"To determine the lifetime prevalence of self- and other relative informants-reported epilepsy in nationwide study among Iranian adults of aged 18 years and over and to study the association of epilepsy with lifetime history of the psychiatric disorders.Twenty-five thousand one hundred and eighty individual were selected through a randomized clustered sampling method from all the Iranian households; interviewed and used epilepsy questionnaire face-to-face at home in year 2001. From 12,398,235 households residing in Iran, 7795 families selected from 1559 clusters, 997 clusters were in urban and 582 were in rural areas, each cluster with 5 households were studied. The response rate was 90%.The prevalence of epilepsy was 1.8%. Epilepsy was more common in females, unemployed and higher educational level. It was not significantly associated with the age group, marital status and residential areas. The most common psychiatric disorders in subjects with epilepsy were major depressive disorder and obsessive compulsive disorder. The rate of lifetime suicidal attempt was 8.1%.Lifetime prevalence of epilepsy in Iran is not low. As the other communities, it is more common in females and unemployed. However, in contrast with the other studies, it was not more common among some age groups and unmarried and low educated subjects.",0 +https://doi.org/10.1017/s003329171200102x,Adverse childhood experiences in relation to mood and anxiety disorders in a population-based sample of active military personnel,"Background Although it has been posited that exposure to adverse childhood experiences (ACEs) increases vulnerability to deployment stress, previous literature in this area has demonstrated conflicting results. Using a cross-sectional population-based sample of active military personnel, the present study examined the relationship between ACEs, deployment related stressors and mood and anxiety disorders. Method Data were analyzed from the 2002 Canadian Community Health Survey – Canadian Forces Supplement (CCHS-CFS; n = 8340, age 18–54 years, response rate 81%). The following ACEs were self-reported retrospectively: childhood physical abuse, childhood sexual abuse, economic deprivation, exposure to domestic violence, parental divorce/separation, parental substance abuse problems, hospitalization as a child, and apprehension by a child protection service. DSM-IV mood and anxiety disorders [major depressive disorder, post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic attacks/disorder and social phobia] were assessed using the Composite International Diagnostic Interview (CIDI). Results Even after adjusting for the effects of deployment-related traumatic exposures (DRTEs), exposure to ACEs was significantly associated with past-year mood or anxiety disorder among men [adjusted odds ratio (aOR) 1.34, 99% confidence interval (CI) 1.03–1.73, p < 0.01] and women [aOR 1.37, 99% CI 1.00–1.89, p = 0.01]. Participants exposed to both ACEs and DRTEs had the highest prevalence of past-year mood or anxiety disorder in comparison to those who were exposed to either ACEs alone, DRTEs alone, or no exposure. Conclusions ACEs are associated with several mood and anxiety disorders among active military personnel. Intervention strategies to prevent mental health problems should consider the utility of targeting soldiers with exposure to ACEs.",0 +https://doi.org/10.1016/j.brat.2004.05.001,Emotion-specific and emotion-non-specific components of posttraumatic stress disorder (PTSD): implications for a taxonomy of related psychopathology,"Many cognitive theories of posttraumatic stress disorder (PTSD), including our own SPAARS model, propose that one basis of the disorder is the cognitive system’s persistent failure to resolve discrepancies between trauma-related information and the content of pre-existing mental representations, such as schemas. This leads to the characteristic PTSD symptom pattern of re-experiencing and avoidance of trauma-related material. Furthermore, the nature of this unresolved discrepancy revolves around appraisals of threat and the corresponding emotion profile in PTSD is therefore predominantly intense fear and anxiety. This paper argues that this general framework can be extended to discrepancies around other appraisal dimensions such as loss, and consequently to other emotions such as sadness. A localized taxonomy is therefore proposed comprising emotional disorders that resemble PTSD in their basic patterns of re-experiencing and avoidance symptoms—what we call their ‘emotion-non-specific component’—but that differ from PTSD in terms of the core emotions involved—what we call their ‘emotion-specific component’. The clinical and nosological implications of this argument are discussed.",0 +https://doi.org/10.1016/j.biopsycho.2014.03.009,Interleukin-6 and soluble interleukin-6 receptor levels in posttraumatic stress disorder: Associations with lifetime diagnostic status and psychological context,"This study correlated lifetime PTSD diagnostic status with interleukin-6 (IL-6) and soluble IL-6 receptor (sIL-6R) levels, and tested whether these correlations are sensitive to psychological context. Midlife women attended two research visits where blood was drawn (beginning of visits) and saliva and oral mucosal transudate were collected (beginning and end of visits) to measure IL-6 and sIL-6R. Women were classified as PTSD-/- (past and current symptoms below subsyndromal levels), PTSD+/- (past symptoms at or above subsyndromal levels), or PTSD+/+ (past and current symptoms at or above subsyndromal levels). PTSD+/+ women, compared to the other women, showed more negative emotion at the beginning of the visits, higher salivary IL-6 levels at the beginning versus end of visits, and positive correlations between negative emotion, salivary IL-6, and plasma sIL-6R. Their plasma sIL-6R levels exceeded those of the PTSD+/- women. Overall, IL-6 sensitivity to anticipation and to negative emotions, and higher sIL-6R levels, differentiated persistent versus remitted PTSD.",0 +https://doi.org/10.1002/jts.21720,Is DSM-IV criterion A2 associated with PTSD diagnosis and symptom severity?,"The diagnostic criteria for posttraumatic stress disorder (PTSD) have received significant scrutiny. Several studies have investigated the utility of Criterion A2, the subjective emotional response to a traumatic event. The American Psychiatric Association (APA) has proposed elimination of A2 from the PTSD diagnostic criteria for DSM-5; however, there is mixed support for this recommendation and few studies have examined A2 in samples at high risk for PTSD such as veterans. In the current study of 908 veterans who screened positive for a traumatic event, A2 was not significantly associated with having been told by a doctor that the veteran had PTSD. Those who endorsed A2, however, reported greater PTSD symptom severity in the 3 DSM-IV symptom clusters of reexperiencing (d = 0.45), avoidance (d = 0.61), and hyperarousal (d = 0.44), and A2 was significantly associated with PTSD symptom severity for all 3 clusters (R2 = .25, .25, and .27, respectively) even with trauma exposure in the model. Thus, although A2 may not be a necessary criterion for PTSD diagnosis, its association with PTSD symptom severity warrants further exploration of its utility.",0 +,Effects of melatonin on anxiety- like behaviors induced by post–traumatic stress disorder in rat,"Introduction: Post traumatic stress disorder (PTSD) is an anxiety disorder. This study was aimed to evaluate the effect of multiple injections of melatonin on anxiety like behaviors induced by PTSD. Materials and methods: PTSD induced in 60 male wistar rats, by combining the shock and single-prolonged stress method (S&SPS). Animals received electric shock (1 mA, 2s) for 5 days, and then on the day 6 they underwent three stages of SPS (restrained for 2 hours, forced swimming for 20 minutes and anesthetized by diethyl ether for 15 minutes). Seven days after PTSD induction, elevated plus maze (EPM) and open field tests were performed to measure anxiety profile. Animals received multiple subcutaneous injections of melatonin (5, 10, 15 mg/kg) or saline, within the 7 days after PTSD. Results: The control (saline) and treated (melatonin) groups showed significant differences in the percentage of time spent in open arms of the EPM. Melatonin, at dose of 15mg/kg, significantly increased the time spent in open arms of the EPM than the corresponding control group. Animals who received 10mg/kg melatonin showed a significant increase in crossing behavior in open field test than the corresponding control group. Conclusion: Our study showed that melatonin is able to reduce PTSD-induced anxiety-like behaviors in rats.",0 +https://doi.org/10.1177/0004867414541816,Response to Fergusson and Boden: The psychological impact of major disasters,,0 +https://doi.org/10.1007/s00221-015-4273-1,DSM-5 personality traits discriminate between posttraumatic stress disorder and control groups,"The relevance of personality traits to the study of psychopathology has long been recognized, particularly in terms of understanding patterns of comorbidity. In fact, a multidimensional personality trait model reflecting five higher-order personality dimensions-negative affect, detachment, antagonism, disinhibition, and psychoticism-is included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and represented in the Personality Inventory for DSM-5 (PID-5). However, evaluation of these dimensions and underlying personality facets within clinical samples has been limited. In the present study, we utilized the PID-5 to evaluate the personality profile elevation and composition of 150 control veterans and 35 veterans diagnosed with posttraumatic stress disorder (PTSD). Results indicated that veterans with PTSD endorsed significantly more personality pathology than control veterans, with scores on detachment and psychoticism domains most clearly discriminating between the two groups. When personality domain scores were considered as parts of each subject's personality profile, a slightly different picture emerged. Specifically, the PTSD composition was primarily characterized by detachment and negative affect, followed by disinhibition, psychoticism, and antagonism in that order of relative importance. The profile of the control group was significantly different, mostly accounted for differences in antagonism and psychoticism. Using these complementary analytic strategies, the findings demonstrate the relevance of personality pathology to PTSD, highlight internalizing features of PTSD, and pave the way for future research aimed at evaluating the role of shared maladaptive personality traits in underlying the comorbidity of PTSD and related disorders.",0 +https://doi.org/10.1007/s10899-012-9323-z,"Racial Discrimination, Post Traumatic Stress, and Gambling Problems among Urban Aboriginal Adults in Canada","Little is known about risk factors for problem gambling (PG) within the rapidly growing urban Aboriginal population in North America. Racial discrimination may be an important risk factor for PG given documented associations between racism and other forms of addictive behaviour. This study examined associations between racial discrimination and problem gambling among urban Aboriginal adults, and the extent to which this link was mediated by post traumatic stress. Data were collected via in-person surveys with a community-based sample of Aboriginal adults living in a mid-sized city in western Canada (N = 381) in 2010. Results indicate more than 80 % of respondents experienced discrimination due to Aboriginal race in the past year, with the majority reporting high levels of racism in that time period. Past year racial discrimination was a risk factor for 12-month problem gambling, gambling to escape, and post traumatic stress disorder (PTSD) symptoms in bootstrapped regression models adjusted for confounders and other forms of social trauma. Elevated PTSD symptoms among those experiencing high levels of racism partially explained the association between racism and the use of gambling to escape in statistical models. These findings are the first to suggest racial discrimination may be an important social determinant of problem gambling for Aboriginal peoples. Gambling may be a coping response that some Aboriginal adults use to escape the negative emotions associated with racist experiences. Results support the development of policies to reduce racism directed at Aboriginal peoples in urban areas, and enhanced services to help Aboriginal peoples cope with racist events. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1186/1471-2458-10-207,Prediction of posttraumatic stress disorder among adults in flood district,"Flood is one of the most common and severe forms of natural disasters. Posttraumatic stress disorder (PTSD) is a common disorder among victims of various disasters including flood. Early prediction for PTSD could benefit the prevention and treatment of PTSD. This study aimed to establish a prediction model for the occurrence of PTSD among adults in flood districts.A cross-sectional survey was carried out in 2000 among individuals who were affected by the 1998 floods in Hunan, China. Multi-stage sampling was used to select subjects from the flood-affected areas. Data was collected through face-to-face interviews using a questionnaire. PTSD was diagnosed according to DSM-IV criteria. Study subjects were randomly divided into two groups: group 1 was used to establish the prediction model and group 2 was used to validate the model. We first used the logistic regression analysis to select predictive variables and then established a risk score predictive model. The validity of model was evaluated by using the model in group 2 and in all subjects. The area under the receiver operation characteristic (ROC) curve was calculated to evaluate the accuracy of the prediction model.A total of 2336 (9.2%) subjects were diagnosed as probable PTSD-positive individuals among a total of 25,478 study subjects. Seven independent predictive factors (age, gender, education, type of flood, severity of flood, flood experience, and the mental status before flood) were identified as key variables in a risk score model. The area under the ROC curve for the model was 0.853 in the validation data. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of this risk score model were 84.0%, 72.2%, 23.4%, and 97.8%, respectively, at a cut-off value of 67.5 in the validation data.A simple risk score model can be used to predict PTSD among victims of flood.",0 +https://doi.org/10.1023/a:1024474204233,Consistency of retrospective reporting about exposure to traumatic events,"Lifetime exposure to traumatic events was assessed by means of a multimethod protocol applied to 76 male military veterans. Consistency of retrospective reporting was determined for physical and sexual assault and abuse, accidents, disasters, combat and warzone experiences, serious illness or injury, and hazardous duty. Findings demonstrate that respondents are generally consistent in reporting traumatic events, although the majority report more events upon reevaluation. Reporting about traumatic events shows some variation as a function of the life epoch in which events occurred, whether they were directly or indirectly experienced, and the type of trauma involved. Discussion addresses memory-related processes triggered by trauma evaluation or tied to characteristics of events themselves as potential sources of inconsistency.",0 +https://doi.org/10.1016/s0005-7967(99)00030-3,Factors associated with outcome of cognitive-behavioural treatment of chronic post-traumatic stress disorder,"The study examined factors that were associated with outcome in the treatment of PTSD. A trial of cognitive therapy compared to imaginal exposure of chronic PTSD showed that although clinical improvements were obtained after treatment and at 6 month follow-up one type of treatment was not significantly superior to the other. Characteristics of the patient, the trauma and treatment and of pretreatment clinical measures were investigated as predictors of PTSD outcome. Eleven variables were significantly associated with the pre- to post-treatment change in CAPS severity scores. Of these, three (duration of therapy, gender and suicide risk) were selected into a step-wise multiple regression equation to explain 36.5% of the outcome. Similarly, nine variables were significant associated with the pretreatment to follow-up change with three variables (number of missed therapy sessions, residential status and co-morbid GAD) being selected into the equation and explaining 36.9% of the outcome. The best predictor of outcome was inconsistent attendance at therapy.",0 +https://doi.org/10.3109/08039488.2015.1005023,The course of PTSD in naturalistic long-term studies: High variability of outcomes. A systematic review,"With a lifetime prevalence of 8% posttraumatic stress disorder (PTSD) is one of the most common mental disorders; nevertheless, its longitudinal course is largely unknown.Our aim was to conduct a systematic review summarizing available findings on the prospective, naturalistic long-term course of PTSD and its predictors.Databases MEDLINE and PsycINFO were searched. Main selection criteria were: 1) naturalistic cohort study with a follow-up period of at least 3 years, 2) adult participants with observer-rated or probable PTSD at baseline.Twenty-four cohorts (25 studies) were retrieved (14 with observer-assessed, 10 with probable PTSD). In total, they comprised about 10,500 participants with PTSD at baseline that were included in the long-term follow-ups. Studies investigating patient populations with observer-assessed PTSD found that between 18% and 50% of patients experienced a stable recovery within 3-7 years; the remaining subjects either facing a recurrent or a more chronic course. Outcomes of community studies and studies investigating probable PTSD varied considerably (remission rates 6-92%). Social factors (e.g. support) as well as comorbid physical or mental health problems seem to be salient predictors of PTSD long-term course and special focus should be laid on these factors in clinical settings.Included studies differed notably with regard to applied methodologies. The resulting large variability of findings is discussed. More standardized systematic follow-up research and more uniformed criteria for remission and chronicity are needed to gain a better insight into the long-term course of PTSD.",0 +,Benzodiazepines in clinical practice: consideration of their long-term use and alternative agents.,"Despite increasing focus on the use of antidepressants and other agents for the treatment of anxiety, benzodiazepines have remained a mainstay of anxiolytic pharmacotherapy due to their robust efficacy, rapid onset of therapeutic effect, and generally favorable side effect profile. In this article, we examine issues related to the long-term use of benzodiazepines, including concerns about the development of therapeutic tolerance, dose escalation, and adverse cognitive effects. We also consider currently available alternatives to benzodiazepines and novel mechanisms of action that may prove fruitful in the development of future generations of anxiolytics.",0 +https://doi.org/10.1371/journal.pone.0030405,Familial Linkage between Neuropsychiatric Disorders and Intellectual Interests,"From personality to neuropsychiatric disorders, individual differences in brain function are known to have a strong heritable component. Here we report that between close relatives, a variety of neuropsychiatric disorders covary strongly with intellectual interests. We surveyed an entire class of high-functioning young adults at an elite university for prospective major, familial incidence of neuropsychiatric disorders, and demographic and attitudinal questions. Students aspiring to technical majors (science/mathematics/engineering) were more likely than other students to report a sibling with an autism spectrum disorder (p = 0.037). Conversely, students interested in the humanities were more likely to report a family member with major depressive disorder (p = 8.8×10(-4)), bipolar disorder (p = 0.027), or substance abuse problems (p = 1.9×10(-6)). A combined PREdisposition for Subject MattEr (PRESUME) score based on these disorders was strongly predictive of subject matter interests (p = 9.6×10(-8)). Our results suggest that shared genetic (and perhaps environmental) factors may both predispose for heritable neuropsychiatric disorders and influence the development of intellectual interests.",0 +https://doi.org/10.1111/j.1601-183x.2012.00833.x,ApoE isoform-dependent deficits in extinction of contextual fear conditioning,"The three major human apoE isoforms (apoE2, apoE3 and apoE4) are encoded by distinct alleles (ϵ2, ϵ3 and ϵ4). Compared with ϵ3, ϵ4 is associated with increased risk to develop Alzheimer's disease (AD), cognitive impairments in Parkinson's disease (PD), and other conditions. In contrast, a recent study indicated an increased susceptibility to the recurring and re-experiencing symptom cluster of Post-Traumatic Stress Disorder (PTSD), as well as related memory impairments, in patients carrying at least one ϵ2 allele. Contextual fear conditioning and extinction are used in human and animal models to study this symptom cluster. In this study, acquisition (day 1, training), consolidation (day 2, first day of re-exposure) and extinction (days 2–5) of conditioned contextual fear in human apoE2, apoE3 and apoE4 targeted replacement and C57BL/6J wild-type (WT) mice was investigated. Male and female apoE2 showed acquisition and retrieval of conditioned fear, but failed to exhibit extinction. In contrast, WT, apoE3 and apoE4 mice showed extinction. While apoE2 mice exhibited lower freezing in response to the context on day 2 than apoE3 and apoE4 mice, this cannot explain their extinction deficit as WT mice exhibited similar freezing levels as apoE2 mice on day 2 but still exhibited extinction. Elevating freezing through extended training preserved extinction in controls, but failed to ameliorate extinction deficits in apoE2 animals. These data along with clinical data showing an association of apoE2 with susceptibility to specific symptom clusters in PTSD supports an important role for apoE isoform in the extinction of conditioned fear.",0 +https://doi.org/10.1097/00004703-199708000-00004,Psychosocial Consequences of Bone Marrow Transplantation in Donor and Nondonor Siblings,"We investigated the psychosocial effects of bone marrow transplantation (BMT) on siblings of transplant recipients. We asked how donor siblings compared with nondonor siblings on quantitative measures of behavior, psychological distress, and sense of self. Participants included 44 siblings (21 donors and 23 nondonors, ages 6-18 yr) of surviving pediatric BMT patients. On self-report measures, donors reported significantly more anxiety and lower self-esteem than nondonors. On teacher-rated scales, donors showed significantly more adaptive skills in school. On these same scales, nondonors showed significantly more school problems than donors. One-third of the siblings in each group reported a moderate level of post-traumatic stress reaction. Exploratory multiple regression analyses point to factors that might influence sibling adjustment and suggest counseling strategies and avenues for future research.",0 +https://doi.org/10.1080/10926771.2014.882464,Sudden Unexpected Versus Violent Death and PTSD Symptom Development,"Changes to posttraumatic stress disorder (PTSD) trauma criterion in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) have been an area of much scrutiny and debate. One of the proposed changes included removing sudden unexpected death (SUD) from the list of potentially traumatic events. This study tested the extent to which unexpected death differed from violent death and other traumas as measured by PTSD symptoms. Our results indicated a significant difference in symptom development between those experiencing sudden violent death and sudden unexpected, but nonviolent, death. Additional analyses at the DSM–IV symptom cluster level, as well as with Simms, Watson, and Doebbeling’s (2002) factor structure of PTSD symptoms, suggested further distinctions between event types and symptom development. The extent to which SUD should be included in the trauma criterion is considered.",0 +https://doi.org/10.1089/apc.2005.19.110,Risk Factors Associated with Posttraumatic Stress Disorder Symptomatology in HIV-Infected Women,"This study examined risk factors for posttraumatic stress disorder (PTSD) symptomatology in a sample of 102 HIV-positive women. The magnitude of HIV-related PTSD symptoms was associated with a greater number of HIV-related physical symptoms, more extensive history of pre-HIV trauma, less perceived availability of social support, greater degree of perceived stigma, and greater degree of negative life events. Hierarchical multiple regression analysis revealed three individual predictors of PTSD symptomatology: total impact of negative life events, total stigma score, and total number of present symptoms. Stigma emerged as the strongest individual predictor. Social support failed to moderate relationships between PTSD symptomatology and HIV-related physical symptoms and negative life events. These findings may inform helping professionals about risk factors associated with PTSD symptomatology in HIV-positive women.",0 +https://doi.org/10.1001/archpsyc.1987.01800240031005,Life Threat and Posttraumatic Stress in School-age Children,"One hundred fifty-nine children (14.5% of the student body) were sampled after a fatal sniper attack on their elementary school playground. Systematic self-reports of posttraumatic stress disorder (PTSD) symptoms were obtained by use of a child PTSD Reaction Index. Analysis of variance revealed significant differences by exposure but not by sex, ethnicity, or age. Additional analyses were conducted of individual item response, overall severity of PTSD reaction, symptom grouping, and previous life events. The results provide strong evidence that acute PTSD symptoms occur in school-age children with a notable correlation between proximity to the violence and type and number of PTSD symptoms. Sampling at approximately one month after the trauma provided adequate delineation among exposure groups. The symptom profile of highly exposed children lends validity to the diagnosis of acute PTSD in childhood.",0 +https://doi.org/10.1017/s0033291711000201,"A randomized, double-blind, placebo-controlled trial on the efficacy and tolerability of sertraline in Iranian veterans with post-traumatic stress disorder","Background Unlike civilian post-traumatic stress disorder (PTSD), the efficacy of sertraline for the treatment of combat-related PTSD has not yet been proven. The present study aimed to evaluate the clinical efficacy of sertraline against combat-related PTSD in a randomized, double-blind, placebo-controlled trial. Method Seventy Iranian veterans of the Iran–Iraq war who met the DSM-IV criteria for diagnosis of PTSD were randomized to receive either flexibly dosed sertraline (50–200 mg/day) ( n =35, completers=32) or placebo ( n =35, completers=30) for 10 weeks. Efficacy was evaluated by the Impact of Event Scale – Revised (IES-R) and the Clinical Global Impression scale – Severity (CGI-S) and Improvement (CGI-I) ratings. Responder criteria were defined as a ⩾30% reduction in the IES-R total score plus a CGI-I rating of ‘much’ or ‘very much’ improved. Results On both intention-to-treat (ITT) and per protocol (completer) methods of analysis, the mean reductions in the IES-R total and subscale (re-experiencing/intrusion, avoidance/numbing and hyperarousal) scores ( p <0.001) and also in the CGI-S score ( p <0.01) were significantly greater in the sertraline group than in the placebo group. For the CGI-I, the mean endpoint score was significantly lower in the sertraline group than in the placebo group ( p ⩽0.001). The number of responders in the sertraline group was significantly higher than in the placebo group (44% v . 3%, p ⩽0.001). Sertraline was well tolerated, with a 6% discontinuation rate as a result of adverse reactions. Conclusions The results of this study suggest that sertraline can be an effective, safe and tolerable treatment for combat-related PTSD in Iranian veterans.",0 +https://doi.org/10.1097/01.yco.0000228753.87613.01,"Mental health, educational and social needs of young offenders in custody and in the community","The purpose of this review is to highlight recent findings from research on mental health, educational and social needs of young offenders and the implications for key agencies that commission or provide services.Young offenders have high levels of morbidity in a number of areas, including mental health. A substantial number of young offenders have learning disabilities, which has implications for educational provision and delivering interventions. Other learning problems, such as low reading and comprehension ages, also have consequences for society in a number of areas, including occupational functioning and the associated development of a skilled workforce. There is some evidence that female offenders and persistent offenders are particularly at risk of psychosocial problems. Need is often unmet due to the lack of adequate assessment. Other reasons include inaccessibility of services and difficulties experienced in engaging young people in treatment. Young offenders in the community and those from ethnic minorities are particularly at risk of having poor access to services.Providing services for young offenders requires investment from all the agencies in prioritising their needs. Research can continue to contribute by informing policy and practice, although further understanding of the developmental trajectories of high-risk groups is still needed.",0 +https://doi.org/10.1126/science.345.6192.18,High hopes,"Psychedelic drugs fell from grace in the 1960s. Now, scientists are rediscovering them as potential treatments for a range of illnesses.",0 +https://doi.org/10.1001/archgenpsychiatry.2011.1385,"Common Heritable Contributions to Low-Risk Trauma, High-Risk Trauma, Posttraumatic Stress Disorder, and Major Depression","Understanding the relative contributions of genetic and environmental factors to trauma exposure, posttraumatic stress disorder (PTSD), and major depressive disorder (MDD) is critical to developing etiologic models of these conditions and their co-occurrence.To quantify heritable influences on low-risk trauma, high-risk trauma, PTSD, and MDD and to estimate the degree of overlap between genetic and environmental sources of variance in these 4 phenotypes.Adult twins and their siblings were ascertained from a large population-based sample of female and male twin pairs on the basis of screening items for childhood sexual abuse and physical abuse obtained in a previous assessment of this cohort.Structured psychiatric telephone interviews.Total sample size of 2591: 996 female and 536 male twins; 625 female and 434 male nontwin siblings.Lifetime low- and high-risk trauma exposure, PTSD, and MDD.In the best-fitting genetic model, 47% of the variance in low-risk trauma exposure and 60% of the variance in high-risk trauma exposure was attributable to additive genetic factors. Heritable influences accounted for 46% of the variance in PTSD and 27% of the variance in MDD. An extremely high degree of genetic overlap was observed between high-risk trauma exposure and both PTSD (r = 0.89; 95% CI, 0.78-0.99) and MDD (r = 0.89; 95% CI, 0.77-0.98). Complete correlation of genetic factors contributing to PTSD and to MDD (r = 1.00) was observed.The evidence suggests that almost all the heritable influences on high-risk trauma exposure, PTSD, and MDD, can be traced to the same sources; that is, genetic risk is not disorder specific. Individuals with a positive family history of either PTSD or MDD are at elevated risk for both disorders and should be closely monitored after a traumatic experience for symptoms of PTSD and MDD.",0 +https://doi.org/10.1186/1471-2164-9-432,Heat stress-responsive transcriptome analysis in heat susceptible and tolerant wheat (Triticum aestivum L.) by using Wheat Genome Array,"Abstract Background Wheat is a major crop in the world, and the high temperature stress can reduce the yield of wheat by as much as 15%. The molecular changes in response to heat stress are poorly understood. Using GeneChip ® Wheat Genome Array, we analyzed genome-wide gene expression profiles in the leaves of two wheat genotypes, namely, heat susceptible 'Chinese Spring' (CS) and heat tolerant 'TAM107' (TAM). Results A total of 6560 (~10.7%) probe sets displayed 2-fold or more changes in expression in at least one heat treatment ( f alse d iscovery r ate, FDR, α = 0.001). Except for heat shock protein (HSP) and heat shock factor (HSF) genes, these putative heat responsive genes encode transcription factors and proteins involved in phytohormone biosynthesis/signaling, calcium and sugar signal pathways, RNA metabolism, ribosomal proteins, primary and secondary metabolisms, as well as proteins related to other stresses. A total of 313 probe sets were differentially expressed between the two genotypes, which could be responsible for the difference in heat tolerance of the two genotypes. Moreover, 1314 were differentially expressed between the heat treatments with and without pre-acclimation, and 4533 were differentially expressed between short and prolonged heat treatments. Conclusion The differences in heat tolerance in different wheat genotypes may be associated with multiple processes and mechanisms involving HSPs, transcription factors, and other stress related genes. Heat acclimation has little effects on gene expression under prolonged treatments but affects gene expression in wheat under short-term heat stress. The heat stress responsive genes identified in this study will facilitate our understanding of molecular basis for heat tolerance in different wheat genotypes and future improvement of heat tolerance in wheat and other cereals.",0 +https://doi.org/10.1093/scan/nsv053,Post-traumatic stress and age variation in amygdala volumes among youth exposed to trauma,"Theoretically, normal developmental variation in amygdala volumes may be altered under conditions of severe stress. The purpose of this article was to examine whether posttraumatic stress moderates the association between age and amygdala volumes in youth exposed to traumatic events who are experiencing symptoms of post-traumatic stress disorder (PTSD). Volumetric imaging was conducted on two groups of youth aged 9-17 years: 28 with exposure to trauma and PTSD symptoms (boys = 15, girls = 13) and 26 matched (age, IQ) comparison youth (Controls; boys = 12, girls = 14). There was a significant group by age interaction in predicting right amygdala volumes. A positive association between age and right amygdala volumes was observed, but only in PTSD youth. These associations with age remained when controlling for IQ, total brain volumes and sex. Moreover, older youth with PTSD symptoms had relatively larger right amygdala volumes than controls. Findings provide evidence that severe stress may influence age-related variation in amygdala volumes. Results further highlight the importance of utilizing age as an interactive variable in pediatric neuroimaging research, in so far as age may act as an important moderator of group differences.",0 +https://doi.org/10.1037/a0025871,Combat veterans' symptoms of PTSD and partners' distress: The role of partners' perceptions of veterans' deployment experiences.,"Romantic partners of combat veterans with posttraumatic stress disorder (PTSD) report elevated relationship and psychological distress. One recent study suggests that this association may be weaker when partners perceive that veterans experienced higher levels of traumatic deployment events, but such results have not yet been replicated. We replicated and extended these findings in a sample of 206 National Guard service members who deployed overseas since 2001 and their partners. We used multivariate structural equation models to explore whether partners' perceptions of service members' deployment experiences moderated the associations of severity of service members' overall PTSD and specific PTSD clusters with partners' psychological and relationship distress. The significant association of overall PTSD symptom severity with partners' distress was not moderated by partners' perceptions. When examining PTSD symptoms at the cluster level, only the numbing/withdrawal cluster was significantly associated with distress. However, this association was moderated by partners' perceptions of service members' deployment experiences, such that the associations weakened as these perceptions increased. These results are in line with research indicating that the avoidance cluster of PTSD symptoms is particularly detrimental for partners of those with PTSD. Furthermore, they indicate that such symptoms are associated with less distress in partners who perceive that service members experienced high levels of potentially traumatic deployment events. Such perceptions may be linked with external attributions for symptoms, which suggests that psychoeducation regarding the causes of PTSD and the totality of PTSD symptoms may be useful in intervening with such partners.",0 +https://doi.org/10.1111/j.1399-5618.2007.00489.x,Predictors of trait aggression in bipolar disorder,"Although aggressive behavior has been associated with bipolar disorder (BD), it has also been linked with developmental factors and disorders frequently found to be comorbid with BD, making it unclear whether or not it represents an underlying biological disturbance intrinsic to bipolar illness. We therefore sought to identify predictors of trait aggression in a sample of adults with BD.Subjects were 100 bipolar I (n = 73) or II (n = 27) patients consecutively evaluated in the Bipolar Disorders Research Program of the New York Presbyterian Hospital-Payne Whitney Clinic. Diagnoses were established using the Structured Clinical Interview for the DSM-IV (SCID-I) and Cluster B sections of the SCID-II. Mood severity was rated by the Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS). Histories of childhood maltreatment were assessed via the Childhood Trauma Questionnaire (CTQ), while trait aggression was measured by the Brown-Goodwin Aggression Scale (BGA).In univariate analyses, significant relationships were observed between total BGA scores and CTQ total (r = 0.326, p = 0.001), childhood emotional abuse (r = 0.417, p < 0.001), childhood physical abuse (r = 0.231, p = 0.024), childhood emotional neglect (r = 0.293, p = 0.004), post-traumatic stress disorder (t = -2.843, p = 0.005), substance abuse/dependence (t = -2.914, p = 0.004), antisocial personality disorder (t = -2.722, p = 0.008) and borderline personality disorder (t = -5.680, p < 0.001) as well as current HDRS (r = 0.397, p < 0.001) and YMRS scores (r = 0.371, p < 0.001). Stepwise multiple regression revealed that trait aggression was significantly associated with: (i) diagnoses of comorbid borderline personality disorder (p < 0.001); (ii) depressive symptoms (p = 0.001); and (iii) manic symptoms (p < 0.001).Comorbid borderline personality disorder and current manic and depressive symptoms each significantly predicted trait aggression in BD, while controlling for confounding factors. The findings have implications for nosologic distinctions between bipolar and borderline personality disorders, and the developmental pathogenesis of comorbid personality disorders as predisposing to aggression in patients with BD.",0 +,A Multilevel Approach To Social Support As A Key Determinant Of Post-Traumatic Stress Disorder Onset And Trajectories After A Mass Traumatic Event,"Types of social support and the meaning attributed to each type vary across individuals, contexts and time. Widely studied across disciplines is the role of social support during periods of distress. Factors at multiple levels of social support (individual, network, and community) are often important predictors of psychopathology, including post-traumatic stress disorder (PTSD), in the aftermath of such events. The trajectory of PTSD after traumatic event exposure, in turn, varies markedly between individuals, differing with regards to onset, symptom patterns, recurrence, comorbidity, response to intervention, and recovery. Recent literature has considered how each of these levels may influence the development and persistence of PTSD. This dissertation is an attempt to bring together substantively overlapping, but disciplinarily siloed discussions related to how individual, network, and community levels of social support contribute to mental health functioning in the aftermath of a population-level disaster. The data demonstrate a clear association between individual (and not network) level social support covariates and PTSD onset as well as resilience/recovery and chronic PTSD. Delayed onset PTSD, on the other hand, was equally associated with network-level variables. Community level variables were excluded from the analyses as they did not show a robust pattern of association with PTSD trajectories in preliminary analyses. Given these findings, it is arguable that the history of defining social support simply as one's actual network or how one perceives of his/her network fails to capture the relational nature of social support as an exchange of resources between two or more unique individuals that can prove beneficial or harmful to the functioning of the recipient. Moreover, this paper argues that individual level social support, which includes individual characteristics and behaviors, is central to the successful exchange of resources (interpersonal and professional) and subsequently to health. Keywords: social support, posttraumatic stress disorder, resources, distress, disaster, trauma (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0 +https://doi.org/10.1177/107319119800500205,Factor Structure of the State-Trait Anger Expression Inventory for Middle-Aged Men and Women,"Recently, Forgays, Forgays, and Spielberger (in press) reported the first exploratory factor analysis of the total 44-item State-Trait Anger Expression Inventory (STAXI) by gender. The analyses were based on a sample of over 700 male and female university students and identified quite well six of the original STAXI scales and subscales. In addition, a seventh factor, ""Feel-Like-Expressing-Anger,"" emerged for women. In the present study, we examined the STAXI responses from a middle-aged adult population. Exploratory factor analyses replicated the majority of the original structure of the STAXI measure including a Feel-Like-Expressing-Anger factor for men and women. In addition, we employed confirmatory factor analyses and cross-validation procedures to test the validity of Spielberger's (1988) AHA! model. Based on these procedures, we found (a) that a seven-factor model provided a better fit than a six-factor solution for each gender and (b) evidence of robust gender differences for two factors: Feel-Like-Expressing Anger and State Anger. These gender differences are consistent with the social costs for anger expression in women and the social benefits for men.",0 +,The detection of psychiatric illness by questionnaire,,0 +https://doi.org/10.1097/00004583-199910000-00012,Predicting DSM‐III-R Disorders From the Youth Self‐Report: Analysis of Data From a Field Study,"To predict DSM-III-R diagnoses from Youth Self-Report (YSR) scores.The Diagnostic Interview Schedule for Children Version 2.1c (DISC-2.1c) and YSR were administered to 289 homeless adolescents. Stepwise discriminant analysis identified YSR scales contributing to predictions of DSM-III-R disorders. Paper-and-pencil prediction rules based on YSR ""borderline"" or ""clinical"" scores were evaluated.Statistically significant discriminant functions for disruptive disorders, depressive disorders, manic disorders, attention-deficit hyperactivity disorder, schizophrenia, and posttraumatic stress disorder, each based on a unique pair of YSR scales, produced overall hit rates of 0.66 to 0.90. Paper-and-pencil predictions produced comparable results. The weakest overall predictions were for the disruptive behaviors; the best rule (""IF Aggressive OR Delinquent is at least borderline THEN predict oppositional defiant disorder or conduct disorder"") produced a 0.72 hit rate. The strongest overall predictions were for schizophrenia; the best prediction rule (""IF [Thought Problems AND Delinquent are at least borderline] AND [at least one is clinical] THEN predict schizophrenia"") produced a 0.87 hlt rate.While the success rates reported here are specific to this sample, it appears that the YSR has good ability to predict DSM-III-R diagnoses as determined by the DISC. Furthermore, it was demonstrated that categorical diagnoses can be treated as locations or cluster sectors in a multidimensional space.",0 +https://doi.org/10.1007/s004060070034,Psychiatric morbidity and comorbidity following accidental man-made traumatic events: incidence and risk factors,"The aims of this study were to examine the incidence and risk factors of major depression, bipolar disorder, psychoactive substance use, psychotic and anxiety disorders in relation to post-traumatic stress disorders (PTSD) in a study group exposed to two different traumatic events, i. e. 128 fire and 55 motor vehicle accident victims. Data have been collected 7–9 months after the traumatic event. The diagnosis of axis-I diagnoses, other than PTSD, was made according to DSM-III-R criteria using the Structured Interview according to the DSN-III-R. The incidence of new-onset major depression was 13.4%, generalised anxiety disorder (GAD) 12.6%, agoraphobia 10.2% and psychoactive substance use disorders 6%. Simple phobia, panic disorder and obsessive compulsive disorder had a much lower incidence (< 2.0%). Fifty-one percent of the victims with PTSD had one or more addition axis-I diagnoses, major depression (26.2%), agoraphobia (21.0%) and generalised anxiety disorder (24.6%) being the most common. Physical injury was the single best predictor for major depression. The best predictors for the development of new-onset anxiety disorders, other than PTSD, were: type and horror of the trauma, the extent of physical injury, the loss of control during the traumatic event, contextual stimuli, younger age and female sex. In conclusion: comorbid disorders, such as depression, GAD and agoraphobia, commonly occur within the first few months after man-made accidental traumata. Trauma variables, which are known to be related to the development of PTSD, are also related to the occurrence of these comorbid disorders.",0 +https://doi.org/10.1002/cpp.670,Treatment of post-traumatic stress disorder in children using cognitive behavioural writing therapy,"This study evaluated the effectiveness of Cognitive Behavioral Writing Therapy (CBWT) in 23 children (age 8-18 years) in the Netherlands, who experienced a range of single and recurrent traumatic experiences. CBWT uses exposure, cognitive restructuring and social sharing.At pre-test, post-test and follow-up, post-traumatic stress disorder (PTSD) symptoms, depressive symptoms, trauma-related cognitions and general behavioural problems were assessed.At post-test there was a significant reduction of all symptoms, and this effect was maintained at 6 months follow-up. The mean amount of treatment sessions needed was 5.5.This study shows that short-term CBWT is a potentially effective intervention for clinically referred traumatized children. There is now a clear need of establishing the effectiveness of CBWT in a randomized, controlled trial.This first study indicates CBWT is a promising treatment, which can easily be used in clinical practice.",0 +https://doi.org/10.1192/bjp.184.3.247,Post-traumatic stress and disability,"Post-traumatic stress is thought to account for significant disability. It is also known to be highly comorbid with other psychiatric conditions such as depression and alcohol dependence.To determine the relationship between post-traumatic stress, depression, alcohol dependence and disability.Seventy armed services personnel were assessed for DSM-IV diagnoses of post-traumatic stress disorder, major depressive disorder and alcohol dependence, and with continuous measures of symptoms of post-traumatic stress, depression and alcohol dependence following a traumatic event. These variables, as predictors of disability (using the Sheehan Disability Scale), were analysed using multivariate analysis of variance, analysis of covariance and multiple regression backward elimination models.No significant interaction was found for the diagnostic variables even after controlling for the continuous symptom measures. In the regression models, symptoms of depression were a significant predictor of total disability (R(2)=0.39). Symptoms of alcohol dependence and post-traumatic stress did not significantly predict disability.Since post-traumatic stress was not found to be associated with disability, its clinical importance may be questionable.",0 +https://doi.org/10.1177/074823379401000523,Neuropsychology and Psychology of MCS,"Neurological symptoms are frequently reported by patients with multiple chemical sensitivities (MCS). Methods to compare the psychiatric, personality, and neuropsychological function of patients with MCS, chronic fatigue syndrome (CFS), and normal controls are described. Increased rates of Axis I psychiatric diagnoses are observed in the literature for MCS and CFS subjects relative to controls. Findings on the MMPI-2 and the Toronto Alexithymia Scale reveal prof iles consistent with the tendency to report somatic rather than emotional symptoms in response to stress. However, many of the reported somatic symptoms also coincide with those found in neurologic disorders. The overall neuropsychological prof ile for MCS subjects does not reflect cognitive impairment. Relative to normal controls, the only difference in neuropsychological performance observed is reduced recognition of nontarget designs on a visual memory task. More fruitful areas for future psychological research will include measurement of the interaction between behavioral response styles and attentional processes in cognition, as well as observations under controlled challenge conditions.",0 +https://doi.org/10.1017/cbo9780511781919.010,Post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD), which is characterized by intrusive memories, marked avoidance of trauma reminders, affective numbing, and hyperarousal following a traumatic experience was introduced into the diagnostic nomenclature in 1980 with the publication by the American Psychiatric Association of DSM-III. Since then, a large body of research on the presentation and treatment of PTSD has been assembled. A number of efficacious cognitive–behavioral therapies (CBTs) are now offered, such as prolonged exposure and cognitive processing therapy (CPT; [3]), and the rates of successful treatment in a variety of populations are improving. Symptoms and diagnostic criteria In the DSM-IV-TR, there are six diagnostic criteria (Criterion A-F) that must be present for a diagnosis of PTSD. First, the individual must have experienced a traumatic event (Criterion A) during which: (1) the person experienced or witnessed an event or events that involved actual threatened death or serious injury, or a threat to the physical integrity of oneself or others; and (2) the person's reaction involved intense fear, helplessness, or horror (in children this may present as agitated or disorganized behavior). Examples of traumatic events include serious threats to life or physical integrity such as military combat, sexual assault, motor vehicle accidents, physical assault, natural or human-made disasters, or witnessing violence or severe human suffering. The symptoms of PTSD are categorized into three clusters in DSM-IV (Criterion B, C, and D): intrusive recollection, avoidance and numbing, and hyperarousal symptoms. © Cambridge University Press 2010.",0 +https://doi.org/10.1037/rep0000050,"Resilience, traumatic brain injury, depression, and posttraumatic stress among Iraq/Afghanistan war veterans.","We examined the prospective influence of the resilient, undercontrolled, and overcontrolled personality prototypes on depression and posttraumatic stress disorder (PTSD) symptoms among Iraq/Afghanistan war veterans. After accounting for the possible influence of combat exposure, we expected that the resilient prototype would predict lower depression and PTSD over time and would be associated with adaptive coping strategies, higher social support, lower psychological inflexibility, and higher self-reported resilience relative to overcontrolled and undercontrolled prototypes, independent of traumatic brain injury (TBI) status.One hundred twenty-seven veterans (107 men, 20 women; average age = 37) participated in the study. Personality was assessed at baseline, and PTSD and depression symptoms were assessed 8 months later. Path analysis was used to test the direct and indirect effects of personality on distress.No direct effects were observed from personality to distress. The resilient prototype did have significant indirect effects on PTSD and depression through its beneficial effects on social support, coping and psychological inflexibility. TBI also had direct effects on PTSD.A resilient personality prototype appears to influence veteran adjustment through its positive associations with greater social support and psychological flexibility, and lower use of avoidant coping. Low social support, avoidant coping, and psychological inflexibility are related to overcontrolled and undercontrolled personality prototypes, and these behaviors seem to characterize veterans who experience problems with depression and PTSD over time. A positive TBI status is directly and prospectively associated with PTSD symptomology independent of personality prototype. Implications for clinical interventions and future research are discussed.",0 +https://doi.org/10.1016/j.pain.2011.04.019,Pain symptomatology and pain medication use in civilian PTSD,"The comorbidity of pain syndromes and trauma-related syndromes has been shown to be high. However, there have been limited data, especially in civilian medical populations, on the role of trauma-related disorders such as posttraumatic stress disorder (PTSD) on chronic pain and pain medication use. We analyzed 647 general hospital patients in primary care and obstetrics and gynecological waiting rooms for the experience of trauma and PTSD-related stress disorders. PTSD symptoms were found to be significantly positively correlated with pain ratings (r=.282, P<0.001) and pain-related functional impairment (r=0.303, P<0.001). Those with a current PTSD diagnosis had significantly higher subjective pain and pain-related impairment ratings than those with no PTSD. Furthermore, those with a current diagnosis of PTSD were significantly more likely to have used opioid analgesics for pain control compared to those without a diagnosis of PTSD (χ(2)=8.98, P=0.011). When analyzing the separate PTSD symptom subclusters (re-experiencing, avoidance, and hyperarousal), all symptom clusters were significantly related to pain and pain-related impairment ratings, but only the avoidance cluster was significantly related to prior opioid pain medication use. We conclude that PTSD and trauma-related disorders are common in impoverished medical populations and that their presence should be examined in patients with pain syndromes. Furthermore, these data suggest that PTSD and pain may share a vulnerability pathway, including the endogenous opioid neurotransmission systems.",0 +https://doi.org/10.1002/hipo.10203,Habituation to stress and dexamethasone suppression in rats with selective basal forebrain cholinergic lesions,"Previous studies suggest a role for basal forebrain cholinergic neurons in enhancing the inhibitory influence of the hippocampus and medial prefrontal cortex (mPFC) on glucocorticoid stress responses mediated by the hypothalamic-pituitary-adrenocortical (HPA) axis. An inhibitory action of the basal forebrain cholinergic (BFC) system may occur through facilitation of stress-related information processing and maintenance of glucocorticoid receptor (GR) expression and negative feedback signaling in these target regions. The current study investigated the possibility that BFC input to the hippocampus contributes to habituation of the glucocorticoid response following repeated exposure to a stressor. Cholinergic lesions were made by microinjections of the immunotoxin 192 IgG-saporin into the medial septum/vertical limb of the diagonal band, and 3 weeks later rats were subjected to six daily sessions of restraint stress. Blood samples taken before, during and after acute stress revealed a significant increase in peak activation and protracted elevation of corticosterone in cholinergic lesioned rats. After 5 days of repeated stress, however, both groups habituated to the stressor, as indicated by similarly low corticosterone profiles throughout both the response and recovery period. Against that habituated background, rats were administered a dexamethasone challenge on day 6, so that feedback status could be examined. Dexamethasone-induced suppression of endogenous corticosterone before, during, and after stress was significantly attenuated in lesioned rats. The profile of dysfunction in glucocorticoid regulation after selective cholinergic lesions in young animals may be relevant to the adrenocortical hyperactivity and negative feedback deficits seen in conditions such as normal aging and Alzheimer's dementia, in which integrity of the basal forebrain cholinergic system is compromised. © 2004 Wiley-Liss, Inc.",0 +https://doi.org/10.1016/s0193-953x(03)00027-3,Predictors of response in anxiety disorders,"Anxiety disorder variables such as duration, severity of illness, and comorbidity with other anxiety or mood disorders appear to identify individuals who are at the greatest risk of treatment nonresponse. Conversely, in accord with clinical experience, shorter periods of illness, less severe illness, being treatment naive, and the absence of comorbidity tend to identify patients who are likely to respond robustly to medication management. Symptom clusters in OCD and PTSD are promising as a means of stratifying those more likely to respond to standard pharmacologic treatment. The presence of hoarding or sexual obsessions seems to presage poorer response in OCD, while the presence of dissociative symptoms in PTSD has been linked to high nonspecific treatment response rates to placebo. Genotyping individuals with respect to genes that are thought to have an important role in the underlying disease process, such as the work with the 5HTTL-PR allele, is exciting and is perhaps the first glimmer of using genotyping to identify treatment strategies or to predict the likelihood or speed of response. The use of neuroimaging as a means of identifying individuals who may respond favorably to pharmacologic or neurosurgical intervention is still in its infancy. As a strategy, it may help combine symptom severity and response variables into a clear neurobiologic vulnerability model of illness. In the future, it may be possible to identify specific treatment interventions for specific patterns of abnormal metabolic rates in certain areas of the brain. However, it should be emphasized that such an approach has not been empirically demonstrated in a rigorous experimental context at this time.",0 +https://doi.org/10.1016/j.biopsych.2006.06.004,"Neurocircuitry Models of Posttraumatic Stress Disorder and Extinction: Human Neuroimaging Research—Past, Present, and Future","The prevailing neurocircuitry models of anxiety disorders have been amygdalocentric in form. The bases for such models have progressed from theoretical considerations, extrapolated from research in animals, to in vivo human imaging data. For example, one current model of posttraumatic stress disorder (PTSD) has been highly influenced by knowledge from rodent fear conditioning research. Given the phenomenological parallels between fear conditioning and the pathogenesis of PTSD, we have proposed that PTSD is characterized by exaggerated amygdala responses (subserving exaggerated acquisition of fear associations and expression of fear responses) and deficient frontal cortical function (mediating deficits in extinction and the capacity to suppress attention/response to trauma-related stimuli), as well as deficient hippocampal function (mediating deficits in appreciation of safe contexts and explicit learning/memory). Neuroimaging studies have yielded convergent findings in support of this model. However, to date, neuroimaging investigations of PTSD have not principally employed conditioning and extinction paradigms per se. The recent development of such imaging probes now sets the stage for directly testing hypotheses regarding the neural substrates of fear conditioning and extinction abnormalities in PTSD.",0 +https://doi.org/10.1037/a0030713,Predictors of susceptibility and resilience in an animal model of posttraumatic stress disorder.,"Animal models of posttraumatic stress disorder (PTSD) are based on fear conditioning where innocuous cues elicit reactions that originally occur to traumatic events--a core feature of PTSD. Another core feature is hyperarousal--exaggerated reactions to stressful events. One limitation of animal models of PTSD is that group effects do not model the sporadic incidence of PTSD. We developed an animal model of PTSD in which rabbit nictitating membrane responses become exaggerated as a function of classical conditioning to a tone conditioned stimulus (CS) paired with a shock unconditioned stimulus (US). Exaggerated responses to the US are a form of hyperarousal termed conditioning-specific reflex modification (CRM) and occur in the absence of the CS. Inspecting data across several experiments, we determined 25% of our rabbits exhibit strong CRM despite all subjects having high levels of conditioning. To determine how prone rabbits were to CRM (susceptibility) or how resistant (resilience), we examined data from 135 rabbits analyzing for factors during CS-US pairings and during US prescreening that would predict CRM. We found the magnitude of CRM was correlated with the onset latency and area of conditioned responding during CS-US pairings and with the peak latency of a response during US pretesting. In an animal model of PTSD that more accurately reflects clinical prevalence, we can begin to predict susceptibility not only during responding to a stressful conditioning situation but also during a screening process before the stressful situation takes place. The results suggest relatively innocuous testing may help detect PTSD after trauma and screen for it before trauma occurs.",0 +https://doi.org/10.1016/s0165-1781(01)00285-2,"A twin study of generalized anxiety disorder symptoms, panic disorder symptoms and post-traumatic stress disorder in men","Generalized anxiety disorder (GAD), panic disorder (PD) and post-traumatic stress disorder (PTSD) often co-occur. We investigated whether and to what degree genetic and environmental contributions overlap among symptoms of GAD, symptoms of PD and PTSD. Subjects were 3327 monozygotic and dizygotic male-male twin pair members of the Vietnam Era Twin Registry who participated in a 1992 telephone administration of the Diagnostic Interview Schedule Version 3 Revised (DIS3R). Genetic model fitting was performed to estimate the magnitude of genetic and environmental contributions to the lifetime co-occurrence of GAD symptoms, PD symptoms and PTSD. The liability for GAD symptoms was due to a 37.9% additive genetic contribution common to PD symptoms and PTSD. Liability for PD symptoms was due to a 20.7% additive genetic contribution common to GAD symptoms and PTSD, and a 20.1% additive genetic influence specific to PD symptoms. Additive genetic influences common to symptoms of GAD and PD accounted for 21.3% of the genetic variance in PTSD. Additive genetic influences specific to PTSD accounted for 13.6% of the genetic variance in PTSD. Remaining variance for all three disorders was due to unique environmental factors both common and specific to each phenotype. These results suggest that these disorders each have etiologically distinct components and also have significant genetic and unique environmental contributions in common.",0 +https://doi.org/10.1089/10445460252943551,"Comparison of Response to a Selective Serotonin Reuptake Inhibitor in Children, Adolescents, and Adults with Posttraumatic Stress Disorder","Although the pathophysiology of posttraumatic stress disorder (PTSD) is considered multifactorial, empirical evidence suggests that serotonergic dysregulation may characterize the disorder. The efficacy of the selective serotonin reuptake inhibitors (SSRIs) in treating essential symptoms (re-experiencing, avoidance, numbing, hyperarousal) in both adults and children is likely to involve potentiation of this neurotransmitter.This study compared outcome in an 8-week open trial of citalopram (an SSRI) in children/adolescents and adults with a Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnosis of PTSD.Twenty-four children/adolescents and 14 adults assessed for PTSD severity at baseline were followed up on citalopram treatment (20-40 mg/day) at two-weekly intervals over 8 weeks. The Clinician-Adminstered PTSD Scale (CAPS) and the Clinical Global Improvement Scale (CGI) were used as outcome measures.Although there were no significant differences in outcome measures between children/adolescents (n = 24) and adults (n = 14), both groups had significant reductions in mean CAPS total scores, symptom cluster scores, and CGI ratings at endpoint.Although the SSRIs have established efficacy and safety in the treatment of adult PTSD, literature on their use in child and adolescent PTSD is sparse. Controlled data are needed to support the clinical perception that SSRIs are agents of choice in the treatment of pediatric PTSD.",0 +https://doi.org/10.1176/ajp.150.7.1020,Personality disorders in treatment-seeking combat veterans with posttraumatic stress disorder,"Many patients with posttraumatic stress disorder (PTSD) appear to have co-occurring symptoms of character pathology; however, to date there have been no empirical studies of comorbid clinician-rated axis II personality disorders in war veterans with chronic PTSD. The authors' objective was to assess DSM-III-R personality disorders in treatment-seeking combat veterans with PTSD.They used the Personality Disorder Examination, a standardized diagnostic interview for DSM-III-R axis II disorders, to assess DSM-III-R personality disorders in 34 patients with PTSD; 18 of the subjects were inpatients and 16 were outpatients.A high rate of character pathology was observed in both inpatient and outpatient groups. The most frequent disorders for which criteria were met were borderline, obsessive-compulsive, avoidant, and paranoid personality disorders. Inpatients had a higher rate of nearly every personality disorder than did outpatients. Inpatients were significantly more likely to meet diagnostic criteria for paranoid, schizotypal, avoidant, and self-defeating personality disorders.War-related PTSD in treatment-seeking Vietnam veterans is often accompanied by diffuse, debilitating, and enduring impairments in character. Subtyping patients with PTSD on the basis of specific axis II profiles may aid in the selection of more specific and effective treatments.",0 +https://doi.org/10.1056/nejme078235,Disentangling Mild Traumatic Brain Injury and Stress Reactions,"The study by Hoge and colleagues in this issue of the Journal provides an important profile of the sequelae of mild traumatic brain injury in military personnel after combat.1 The findings demonstrate that mild traumatic brain injury results in increased rates of psychological, health, and functional problems. Although the study provides strong evidence for impairments in military personnel serving in Iraq and Afghanistan, it also raises a number of critical questions concerning the impairments that may be attributed to mild traumatic brain injury. One striking finding from this study is that although mild traumatic brain injury predicted a range of . . .",0 +https://doi.org/10.1556/jba.3.2014.4.2,Compulsive sexual behavior among male military veterans: Prevalence and associated clinical factors,"Compulsive sexual behavior (CSB) is highly prevalent among men, often co-occurring with psychiatric disorders and traumatic experiences. Psychiatric disorders and trauma are highly prevalent among military veterans, yet there is a paucity of research on CSB among military samples. The aim of this study was to examine the prevalence of and factors associated with CSB among male military veterans.Surveys were administered to veterans of Operations Iraqi Freedom, Enduring Freedom, or New Dawn at baseline (n = 258), 3 months(n = 194), and 6 months (n = 136). Bivariate analyses and Generalized Estimating Equations were utilized to estimate associations between CSB and the following variables: psychiatric co-morbidity, childhood physical or sexual trauma, pre- and post-deployment experiences, TV/ Internet usage, and sociodemographics. Associations between CSB and specific PTSD symptom clusters were also examined.CSB was reported by 16.7% of the sample at baseline. Several variables were associated with CSB in bivariate analyses; however, only PTSD severity, childhood sexual trauma, and age remained significant in multivariable GEE models. The PTSD symptom cluster re-experiencing was most strongly associated with CSB.This exploratory study suggests that CSB is prevalent amongst veterans returning from combat and is associated with childhood trauma and PTSD, particularly re-experiencing.Further study is needed to identify the mechanisms linking PTSD and CSB, define the context and severity of CSB in veterans, and examine the best ways to assess and treat CSB in VA clinical settings.",0 +https://doi.org/10.1016/j.jpsychires.2006.06.009,Evidence for low-grade systemic proinflammatory activity in patients with posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) may increase cardiovascular risk but the psychophysiological mechanisms involved are elusive. We hypothesized that proinflammatory activity is elevated in patients with PTSD as diagnosed by the Clinician Administered PTSD Scale (CAPS) interview. Plasma levels of proinflammatory C-reactive protein (CRP), interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α, and of anti-inflammatory IL-4 and IL-10 were measured in 14 otherwise healthy PTSD patients and in 14 age- and gender-matched healthy non-PTSD controls. Levels of TNF-α ( p = 0.038; effect size Cohen’s d = 0.58) and of IL-1β ( p = 0.075, d = 0.68) were higher in patients than in controls. CRP ( d = 0.10), IL-6 ( d = 0.18), IL-4 ( d = 0.42), and IL-10 ( d = 0.37) were not significantly different between groups. Controlling for traditional cardiovascular risk factors, mood, and time since trauma revealed lower IL-4 in patients than in controls ( p = 0.029) and rendered group differences in TNF-α and IL-1β insignificant. In all subjects, TNF-α correlated with total (frequency and intensity) PTSD symptom cluster of re-experiencing ( r = 0.49, p = 0.008), avoidance ( r = 0.37, p = 0.050), and hyperarousal ( r = 0.42, p = 0.026), and with PTSD total symptom score ( r = 0.37, p = 0.054). Controlling for time since trauma attenuated these associations. The correlation between IL-1β and total avoidance symptoms ( r = 0.42, p = 0.028) became insignificant when controlling for anxiety and depression. IL-4 correlated with total hyperarousal symptoms ( r = −0.38, p = 0.047), and after controlling for systolic blood pressure and smoking status, with PTSD total symptom score ( r = −0.41, p = 0.035). PTSD patients showed a low-grade systemic proinflammatory state, which, moreover, was related to PTSD symptom levels suggesting one mechanism by which PTSD could contribute to atherosclerotic disease.",0 +https://doi.org/10.1016/j.neuropharm.2011.01.040,Enduring sensorimotor gating abnormalities following predator exposure or corticotropin-releasing factor in rats: A model for PTSD-like information-processing deficits?,"A deficit in prepulse inhibition (PPI) can be one of the clinically observed features of post-traumatic stress disorder (PTSD) that is seen long after the acute traumatic episode has terminated. Thus, reduced PPI may represent an enduring psychophysiological marker of this illness in some patients. PPI is an operational measure of sensorimotor gating and refers to the phenomenon in which a weak stimulus presented immediately before an intense startling stimulus inhibits the magnitude of the subsequent startle response. The effects of stress on PPI have been relatively understudied, and in particular, there is very little information on PPI effects of ethologically relevant psychological stressors. We aimed to develop a paradigm for evaluating stress-induced sensorimotor gating abnormalities by comparing the effects of a purely psychological stressor (predator exposure) to those of a nociceptive physical stressor (footshock) on PPI and baseline startle responses in rats over an extended period of time following stressor presentation. Male Sprague-Dawley rats were exposed (within a protective cage) to ferrets for 5 min or left in their homecage and then tested for PPI immediately, 24 h, 48 h, and 9 days after the exposure. The effects of footshock were evaluated in a separate set of rats. The effects seen with stressor presentation were compared to those elicited by corticotropin-releasing factor (CRF; 0.5 and 3 μg/6 μl, intracerebroventricularly). Finally, the effects of these stressors and CRF administration on plasma corticosterone were measured. PPI was disrupted 24 h after ferret exposure; in contrast, footshock failed to affect PPI at any time. CRF mimicked the predator stress profile, with the lowdose producing a PPI deficit 24 h after infusion. Interestingly, the high dose also produced a PPI deficit 24 h after infusion, but with this dose, the PPI deficit was evident even 9d later. Plasma corticosterone levels were elevated acutely (before PPI deficits emerged) by both stressors and CRF, but returned to normal control levels 24 h later, when PPI deficits were present. Thus, predator exposure produces a delayed disruption of PPI, and stimulation of CRF receptors recapitulates these effects. Contemporaneous HPA axis activation is neither necessary nor sufficient for these PPI deficits. These results indicate that predator exposure, perhaps acting through CRF, may model the delayed-onset and persistent sensorimotor gating abnormalities that have been observed clinically in PTSD, and that further studies using this model may shed insight on the mechanisms of information-processing deficits in this disorder. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0 +https://doi.org/10.1002/jts.21888,Posttraumatic Stress and Stigma in Active-Duty Service Members Relate to Lower Likelihood of Seeking Support,"Posttraumatic stress disorder (PTSD) is a common mental health concern for returning service members. Social support is a robust predictor of resiliency and recovery from PTSD; however, barriers to seeking support are understudied. PTSD and anticipated enacted stigma from family and friends were explored as correlates of the likelihood of seeking support among 153 Iraq/Afghanistan U.S. service members. Results showed that PTSD (r = -.31, p < .001) and anticipated enacted stigma (r = -.22, p ≤ .01) were negatively associated with likelihood of seeking support. Post hoc analyses showed that only dysphoria (r = -.32, p < .001) was significantly related to the likelihood of seeking support after accounting for anticipated enacted stigma and other PTSD clusters. Implications of these findings and ways to increase likelihood of seeking support are discussed.",0 +https://doi.org/10.4081/monaldi.2012.122,"Post-traumatic stress disorder, emotional processing and Inappropriate Implantable Cardioverter-Defibrillator Shocks: clinical consideration by a single case report","Introduction. Even though an overwhelming amount of evidence supports the clinical efficacy and safety of the implantable cardioverter defibrillator (ICD), inappropriate shocks for atrial arrhythmias with rapid ventricular conduction or for abnormal sensing results in multiple adverse effects Presentation. In this study we present the case of a 59- year-old woman who was admitted to hospital for ICD implantation with a past medical history that was positive for non-ischemic dilated cardiomyopathy, congestive heart failure (NYHA class III), atrial fibrillation, essential hypertension and a recent episode of syncope. Since in the 18 months follow-up the patient suffered many inappropriate shocks, we investigated the association of the presence of a PTSD (Post- Traumatic-Stress-Disorder) prior to implantation and a specific profile of cognitive processing emotions, with the effectiveness of the ICD. Emotional distress states and cognitive thoughts preceding ICD shock inappropriate episode were recorded by structured mobile diary (eMotional-ICDiary©). We outlined how the presence of a highly traumatic event which had occurred 6 years previously was related to a recurrence of a combination of moderate distress and cognitive thoughts, associated with episodes of Inappropriate Shock. A psycho-diagnostic examination and the administration of the Emotional Processing Scale (EPS-25) and Emotional Regulation Questionnaire (ERQ) outlined that the patient presented a profile of cognitive processing of emotions characterized by elevated levels of unprocessed emotions, low appraisal and high suppression emotional regulation strategy. Conclusion. The observations gathered in this single case are a good starting point for further research in order to check if the post-traumatic stress disorder and a specific cognitive profile connected to the processing of emotions are associated with the presence of inappropriate ICD shocks. Further larger sample studies are required in this area.",0 +https://doi.org/10.1002/jts.20389,"PTSD in Vietnamese Americans following Hurricane Katrina: Prevalence, patterns, and predictors","One year after Hurricane Katrina devastated New Orleans, we assessed 82 adults from a population-based sample of the Vietnamese American community who had participated in a larger study of immigration weeks before the disaster. Although 21% met criteria for partial posttraumatic stress disorder (PTSD), only 5% of the sample met all PTSD criteria. Avoidance/numbing symptoms did not form a coherent cluster and were seldom confirmed, but intrusion, arousal, and interference were common. Severity of exposure to the floodwaters, property loss, and subjective trauma were independently related to PTSD symptoms. Symptoms were highest among participants who were low in acculturation or who had high Katrina exposure in combination with prolonged stays in transition camps during emigration.",0 +https://doi.org/10.1080/07347332.2010.498458,Long-Term Adjustment of Survivors of Ovarian Cancer Treated for Advanced-Stage Disease,"This study described the long-term adjustment of 42 ovarian cancer survivors diagnosed with advanced-stage disease with no evidence of recurrence, a mean of 6.1 years postdiagnosis. 64% of survivors' mental health was at or above the norm of medical outpatients (Mental Health Inventory-17). No patients reported post-traumatic stress disorder at a diagnosable level (Post-Traumatic Stress Disorder (PTSD) Checklist-Civilian). The majority of survivors (> or = 75%) reported a positive impact of cancer on their lives (Impact of Cancer Scale) and excellent social support (Medical Outcomes Study Social Support Survey). However, a subset of survivors reported needing more help than was received regarding emotional problems (28.9%).",0 +https://doi.org/10.1080/10615800701303215,"Psychological and health problems in a geographically proximate population time-sampled continuously for three months after the September 11th, 2001 terrorist incidents","This study assessed the mental and physical health status and psychological problems related to the September 11th terrorist incidents among a representative sample of adults living near New York City, using continuously time-sampled data collected throughout 2001. Prevalence estimates for poor mental or physical health after September 11th (October through December) were comparable to those for the entire year of 2001 (i.e. approximately 33%). Psychological problems related to the terrorist incidents were reported by more than half of the respondents, and appeared to peak in prevalence approximately two to three months following the incidents, followed by a decline in the next month and subsequent year. Poor mental health, female gender, media re-exposure, and ongoing or increased alcohol use were risk factors for psychological problems, while older age (65+ years old) and being married were protective factors. Risk factors for poor physical and mental health or psychological problems were generally stable over the three-month period following September 11th, but some changes were identified consistent with stage models of post-disaster psychological adjustment. Implications are discussed for using continuous time-sampling as a strategy to research patterns of relatively acute stress-related sequelae of terrorism in populations whose members are affected despite primarily not having been at the disaster epicenter.",0 +https://doi.org/10.1016/j.pain.2008.02.019,Course and prognostic factors of whiplash: A systematic review and meta-analysis ☆,"We conducted a systematic review and meta-analysis of prospective cohort studies of subjects with acute whiplash injuries. The aim was to describe the course of recovery, pain and disability symptoms and also to assess the influence of different prognostic factors on outcome. Studies were selected for inclusion if they enrolled subjects with neck pain within six weeks of a car accident and measured pain and/or disability outcomes. Studies were located via a sensitive search of electronic databases; Medline, Embase, CINAHL, Cochrane database, ACP Journal club, DARE and Psychinfo and through hand-searches of relevant previous reviews. Methodological quality of all studies was assessed using a six item checklist. Sixty-seven articles, describing 38 separate cohorts were included. Recovery rates were extremely variable across studies but homogeneity was improved when only data from studies of more robust methodological quality were considered. These data suggest that recovery occurs for a substantial proportion of subjects in the initial 3 months after the accident but after this time recovery rates level off. Pain and disability symptoms also reduce rapidly in the initial months after the accident but show little improvement after 3 months have elapsed. Data regarding the prognostic factors associated with poor recovery were difficult to interpret due to heterogeneity of the techniques used to assess such associations and the way in which they are reported. There was also wide variation in the measurement of outcome and the use of validated measures would improve interpretability and comparability of future studies.",0 +https://doi.org/10.1007/s10072-013-1343-7,Anatomical and neuropsychological effects of cluster munitions,"The aim of this article is to investigate the effects of cluster munitions on the different environmental, anatomical and neuropsychological levels. We conducted a study to explore the effects of sub-munitions on Lebanese victims. The study included a total of 407 cases that have been subjected to the detonation of unexploded sub-munitions in Lebanon, between 2006 and 2011. In our series, 356 casualties were injured and 51 were dead. 382 were males and 25 were females. We recorded 83 cases of amputations, and injuries involving cranio-facial regions, thorax, abdomen, and upper and lower extremities. These injuries lead to loss of function, body disfiguration, and chronic pain caused by the injuries or the amputations, as well as post-traumatic stress disorder. The peripheral nervous system was mostly affected and patients suffered from significant psychosocial tribulations. Cluster munitions harm human beings and decrease biodiversity. Survivors suffer from physical and psychological impairments. Laws should be passed and enforced to ban the use of these detrimental weapons that have negative effects on ecosystem and societal levels. © 2013 Springer-Verlag Italia.",0 +https://doi.org/10.1093/milmed/164.3.174,The Mental Health Status of Women in the Navy and Marine Corps: Preliminary Findings from the Perceptions of Wellness and Readiness Assessment,"The 1995 Perceptions of Wellness and Readiness Assessment was designed to provide baseline health and risk-factor information on the physical and mental health status of women in the U.S. Navy and Marine Corps and to make comparisons both within military subpopulations and with civilian populations. A population-based, multi-stage, cluster sample of 782 active duty Navy and Marine Corps women and men were administered a structured computerized telephone interview to make Diagnostic and Statistical Manual-III-R psychiatric diagnoses. Estimates were 40 and 21% for overall lifetime and 1-year prevalence of psychiatric disorders, respectively. Women had about five times the risk of experiencing post-traumatic stress disorder than men and about twice the risk of a major depressive episode. Of all personnel meeting diagnostic criteria for an active mental disorder, only 19% sought mental health care in the last year. Women generally sought treatment more readily than men.",0 +,"[The relationship between depression, anxiety and heart disease - a psychosomatic challenge].","Depressive and cardiological disorders present a major comorbidity. Their manifold interrelations may be best analysed within a biopsychosocial model of disease.A systematic research was done on empirical studies published during the last 15 years and dealing with epidemiological, etiopathogenetic and therapeutic dimensions of the comorbidity of depression, anxiety and heart disease.From an epidemiological perspective recurrent depressions are associated with a significantly increased risk of coronary heart disease. Depressive disorders play a major role in triggering critical cardiac events, e.g. myocardial infarction. The prevalence rates of depressive disorders in various cardiological conditions are significantly higher than the frequencies that can be expected in healthy general population. Depression shows a negative impact on the somatic morbidity and mortality during the further course of illness. Anxiety and posttraumatic stress disorders seem to be interrelated with cardiological conditions in quite a similar way, probably contributing even more negatively to critical and lethal cardiological events than depression. From an etiopathogenetic perspective some clusters of depressive symptoms seem to be linked to cardiotoxicity more closely than other, vital exhaustion, anhedonia, and hopelessness probably mediating a special risk. In any case, postmyocardial infarct depression that proves treatment-resistent indicates a negative prognosis of the prevailing cardiological condition. On a level of psychological and psychosocial constructs type-A personality, anger/hostility, type-D personality, and alexithymia have been explored regarding its proper pathogenetic role. Psychological and psychopathological variables have to be set into a context of psychosocial stressors on the one hand, and have to be simultaneously analysed with various underlying psycho- and neurobiological variables on the other. Above all, HPA- and sympathicomedullary dysfunctions, reduced heart rate variability, altered functions of thrombocytes, and increased proinflammatory processes have to be recognized as significantly contributing to the pathophysiology both of depression and of heart condition. Neurobiological aspects of anxiety and posttraumatic stress disorders must be interlinked with these underpinnings of depression. Differential effects on critical cardiological events must be supposed. From a therapeutic perspective several RCTs demonstrate that SSRIs may safely and efficiently treat depressive disorders in cardiological conditions, and may even improve the general somatic prognosis. Cognitive-behavioural psychotherapies have been empirically validated in treating depression and anxiety with cardiological patients. So far, however, a differential indication of psychopharmacological versus psychotherapeutic approaches has not been proved yet.Depression and anxiety disorders in patients with heart disease paradigmatically define a psychosomatic-somatopsychic challenge to any health delivery system. A psychosomatic perspective may best be practised within a Consultation-Liaison psychiatric service that cooperates continuously and closely with cardiological departments and experts.",0 +https://doi.org/10.1016/j.genhosppsych.2015.02.010,The role of early pharmacotherapy in the development of posttraumatic stress disorder symptoms after traumatic injury: an observational cohort study in consecutive patients,"Pharmacological intervention during traumatic memory consolidation has been suggested to prevent posttraumatic stress disorder (PTSD). The aim of this study was to examine the association between prescription of early pharmacotherapy and the risk of developing PTSD symptoms following traumatic injury.The use of opiate analgesics, beta-adrenergic blockers, corticosteroids and benzodiazepines within 48 h postinjury was documented based on hospital charts for 629 Level 1 trauma center patients. PTSD symptoms were assessed using structured clinical interviews. Primary outcome was 6-week PTSD symptoms. Secondary outcomes were PTSD diagnoses at 6 weeks and during 1 year posttrauma.Linear regression analyses showed that opiate administration within 48 h was negatively associated with PTSD symptoms at 6 weeks (β=-0.14, P=.009) after controlling for demographic and injury-related characteristics and concurrent pharmacotherapy. Fewer patients with opiates had a PTSD diagnosis at 6 weeks (P=.047) and during 1 year posttrauma (P=.013) than patients with none of the specified pharmacotherapies. Low prescription frequency of beta-blockers (3.8%), corticosteroids (2.2%) and benzodiazepines (7.8%) precluded further examination of their role in the development of PTSD symptoms because of limited statistical power.This study suggests a possible beneficial influence of opiate administration within 48 h posttrauma on the development of PTSD symptoms. Future studies may evaluate the effectiveness of inhospital opiate analgesics compared to placebo in preventing PTSD and may focus on the mechanisms underlying the effect of opiates in preventing PTSD.",0 +https://doi.org/10.3389/fnbeh.2014.00213,"Neurobehavioral, neuropathological and biochemical profiles in a novel mouse model of co-morbid post-traumatic stress disorder and mild traumatic brain injury","Co-morbid mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) has become the signature disorder for returning combat veterans. The clinical heterogeneity and overlapping symptomatology of mTBI and PTSD underscore the need to develop a preclinical model that will enable the characterization of unique and overlapping features and allow discrimination between both disorders. This study details the development and implementation of a novel experimental paradigm for PTSD and combined PTSD-mTBI. The PTSD paradigm involved exposure to a danger-related predator odor under repeated restraint over a 21day period and a physical trauma (inescapable footshock). We administered this paradigm alone, or in combination with a previously established mTBI model. We report outcomes of behavioral, pathological and biochemical profiles at an acute timepoint. PTSD animals demonstrated recall of traumatic memories, anxiety and an impaired social behavior. In both mTBI and combination groups there was a pattern of disinhibitory like behavior. mTBI abrogated both contextual fear and impairments in social behavior seen in PTSD animals. No major impairment in spatial memory was observed in any group. Examination of neuroendocrine and neuroimmune responses in plasma revealed a trend towards increase in corticosterone in PTSD and combination groups, and an apparent increase in Th1 and Th17 proinflamatory cytokine(s) in the PTSD only and mTBI only groups respectively. In the brain there were no gross neuropathological changes in any groups. We observed that mTBI on a background of repeated trauma exposure resulted in an augmentation of axonal injury and inflammatory markers neurofilament L and ICAM-1. Our observations thus far suggest that this novel stress-trauma-related paradigm may be a useful model for investigating further the overlapping and distinct spatio-temporal and behavioral/biochemical relationship between mTBI and PTSD experienced by combat veterans.",0 +https://doi.org/10.1159/000330887,Quality of Life after Traumatic Injury: A Latent Trajectory Modeling Approach,"<b><i>Background:</i></b> It is largely unknown how quality of life (QoL) changes following accidental injuries. Equally, the mechanisms underlying such changes have not yet been identified in detail. This study of injured accident survivors aimed to: (1) detect a model of change which best explains the observed course of QoL, and (2) identify potential predictor variables. <b><i>Methods:</i></b> 323 injured accident survivors were interviewed within 2 weeks of the trauma, and followed up at 6 and 12 months. Latent trajectory modeling was used to analyze the fit of three potential trajectories regarding the observed course of general QoL as measured by the Questions on Life Satisfaction questionnaire. <b><i>Results:</i></b> The trajectory model adopting a negative square-root change fitted the observed data best, meaning that shortly after the accident, general QoL decreased strongly with diminishing negative changes occurring later on. Early and prolonged QoL impairment was largely attributable to the initial level of posttraumatic stress as measured by the Clinician-Administered PTSD Scale. To a lesser extent, depressive symptoms also predicted change in subjective QoL, while injury severity showed no direct effect; rather, its impact on QoL was mediated by initial posttraumatic stress. By contrast, reduced occupational functioning was attributable to injury severity rather than psychopathology. <b><i>Conclusions:</i></b> When treating injured accident survivors, clinicians should consider symptoms of posttraumatic stress and comorbid depression in order to prevent or mitigate negative changes in QoL.",0 +https://doi.org/10.1038/tp.2015.95,Behavioral inhibition in childhood predicts smaller hippocampal volume in adolescent offspring of parents with panic disorder,"Behavioral inhibition (BI) is a genetically influenced behavioral profile seen in 15-20% of 2-year-old children. Children with BI are timid with people, objects and situations that are novel or unfamiliar, and are more reactive physiologically to these challenges as evidenced by higher heart rate, pupillary dilation, vocal cord tension and higher levels of cortisol. BI predisposes to the later development of anxiety, depression and substance abuse. Reduced hippocampal volumes have been observed in anxiety disorders, depression and posttraumatic stress disorder. Animal models have demonstrated that chronic stress can damage the hippocampal formation and implicated cortisol in these effects. We, therefore, hypothesized that the hippocampi of late adolescents who had been behaviorally inhibited as children would be smaller compared with those who had not been inhibited. Hippocampal volume was measured with high-resolution structural magnetic resonance imaging in 43 females and 40 males at 17 years of age who were determined to be BI+ or BI- based on behaviors observed in the laboratory as young children. BI in childhood predicted reduced hippocampal volumes in the adolescents who were offspring of parents with panic disorder, or panic disorder with comorbid major depression. We discuss genetic and environmental factors emanating from both child and parent that may explain these findings. To the best of our knowledge, this is the first study to demonstrate a relationship between the most extensively studied form of temperamentally based human trait anxiety, BI, and hippocampal structure. The reduction in hippocampal volume, as reported by us, suggests a role for the hippocampus in human trait anxiety and anxiety disorder that warrants further investigation.",0 +https://doi.org/10.1037/a0035263,Traumatic brain injury and PTSD screening efforts evaluated using latent class analysis.,"To empirically identify latent classes of service members according to persistent postconcussive symptom patterns and to characterize the identified classes relative to other postdeployment variables including posttraumatic stress disorder (PTSD) and mild traumatic brain injury (TBI) screening results. Such comparisons may directly inform policy regarding these routine assessments and translate to improved treatment decisions.Self-report data were obtained for 12,581 combat-exposed male U.S. Navy and Marine Corps personnel who returned from deployment in 2008-2009 and completed a Post-Deployment Health Assessment (PDHA) and an associated Post-Deployment Health Reassessment (PDHRA). Persistent postconcussive symptoms indicated on the PDHRA were used as manifest variables in a latent class analysis yielding 4 distinct classes: systemic, cognitive/behavioral, comorbid, and nonpresenting.Although the nonpresenting class endorsed few or no postconcussive symptoms, the systemic and cognitive/behavioral classes displayed elevated likelihoods of neurological and mental health symptoms, respectively. Members of the comorbid class had an increased probability of reporting a wide range of symptoms across both domains. Characterization of identified classes suggested that class membership may indicate the presence or absence of persistent conditions resulting from head injury and/or mental health issues. Under this assumption, estimated class membership probabilities implied a rate of probable neurological injury among this sample to be 17.9%, whereas the standard assessments aimed at identifying repercussions of mild TBI reported a positive screening rate of only 13.1%.Findings suggest that the routinely administered PDHA and PDHRA appear to underestimate the true prevalence of service members experiencing postdeployment health problems. Supplemental items or an alternative screening algorithm incorporating persistent postconcussive symptoms may enable identification of additional cases requiring treatment following return from deployment.",0 +https://doi.org/10.1521/psyc.2012.75.3.236,Resilience and Variability Following Oil Spill Disasters,"© 2012 Guilford Publications, Inc. George A. Bonanno, Ph.D., is Professor of Clinical Psychology in the Department of Counseling and Clinical Psychology at Columbia University in New York City. Address correspondence to George Bonanno, Deparatment of Counseling and Clinical Psychology, Teachers College Box 218, Columbia University, 525 W. 120th Street, New York, NY 10027. E-mail: Gab38@columbia.edu Commentary on “Lessons Learned from the Exxon Valdez Oil Spill” Bonanno",0 +https://doi.org/10.1176/ajp.151.6.902,Peritraumatic dissociation and posttraumatic stress in male Vietnam theater veterans,"The aim of this study was to determine the reliability and validity of a proposed measure of peritraumatic dissociation and, as part of that effort, to determine the relationship between dissociative experiences during disturbing combat trauma and the subsequent development of posttraumatic stress disorder (PTSD).A total of 251 male Vietnam theater veterans from the Clinical Examination Component of the National Vietnam Veterans Readjustment Study were examined to determine the relationship of war zone stress exposure, retrospective reports of dissociation during the most disturbing combat trauma events, and general dissociative tendencies with PTSD case determination.The total score on the Peritraumatic Dissociation Experiences Questionnaire--Rater Version was strongly associated with level of posttraumatic stress symptoms, level of stress exposure, and general dissociative tendencies and weakly associated with general psychopathology scales from the MMPI-2. Logistic regression analyses supported the incremental value of dissociation during trauma, over and above the contributions of level of war zone stress exposure and general dissociative tendencies, in accounting for PTSD case determination.These results provide support for the reliability and validity of the Peritraumatic Dissociation Experiences Questionnaire--Rater Version and for a trauma-dissociation linkage hypothesis: the greater the dissociation during traumatic stress exposure, the greater the likelihood of meeting criteria for current PTSD.",0 +https://doi.org/10.1037/0033-2909.133.2.183,Gender differences in posttraumatic stress disorder.,"One of the most consistent findings in the epidemiology of posttraumatic stress disorder (PTSD) is the higher risk of this disorder in women. Explanations reviewed within a psychobiological model of PTSD suggest that women's higher PTSD risk may be due to the type of trauma they experience, their younger age at the time of trauma exposure, their stronger perceptions of threat and loss of control, higher levels of peri-traumatic dissociation, insufficient social support resources, and greater use of alcohol to manage trauma-related symptoms like intrusive memories and dissociation, as well as gender-specific acute psychobiological reactions to trauma. This review demonstrates the need for additional research of the gender differences in posttraumatic stress. Recommendations are made for clinical practice.",0 +https://doi.org/10.1016/j.socscimed.2011.05.009,"Work-related critical incidents in hospital-based health care providers and the risk of post-traumatic stress symptoms, anxiety, and depression: A meta-analysis","This meta-analysis reviewed existing data on the impact of work-related critical incidents in hospital-based health care professionals. Work-related critical incidents may induce post-traumatic stress symptoms or even post-traumatic stress disorder (PTSD), anxiety, and depression and may negatively affect health care practitioners' behaviors toward patients. Nurses and doctors often cope by working part time or switching jobs. Hospital administrators and health care practitioners themselves may underestimate the effects of work-related critical incidents. Relevant online databases were searched for original research published from inception to 2009 and manual searches of the Journal of Traumatic Stress, reference lists, and the European Traumatic Stress Research Database were conducted. Two researchers independently decided on inclusion and study quality. Effect sizes were estimated using standardized mean differences with 95% confidence intervals. Consistency was evaluated, using the I(2)-statistic. Meta-analysis was performed using the random effects model. Eleven studies, which included 3866 participants, evaluated the relationship between work-related critical incidents and post-traumatic stress symptoms. Six of these studies, which included 1695 participants, also reported on the relationship between work-related critical incidents and symptoms of anxiety and depression. Heterogeneity among studies was high and could not be accounted for by study quality, character of the incident, or timing of data collection. Pooled effect sizes for the impact of work-related critical incidents on post-traumatic stress symptoms, anxiety, and depression were small to medium. Remarkably, the effect was more pronounced in the longer than in the shorter term. In conclusion, this meta-analysis supports the hypothesis that work-related critical incidents are positively related to post-traumatic stress symptoms, anxiety, and depression in hospital-based health care professionals. Health care workers and their supervisors should be aware of the harmful effects of critical incidents and take preventive measures.",0 +https://doi.org/10.1016/j.comppsych.2010.10.001,The relationship between substance use and posttraumatic stress disorder in a methadone maintenance treatment program,"Posttraumatic stress disorder (PTSD) is frequently linked with substance abuse. The self-medication hypothesis suggests that some people may use illicit substances in an attempt to self-treat psychiatric symptoms. This study explores the relationship between substance abuse and PTSD symptom clusters in a methadone maintenance population.Clients of a methadone maintenance program at a public Drug and Alcohol Service were invited to complete the PTSD Checklist-Civilian Version, a screening tool for PTSD. Information about their history of substance use was also collected.Eighty clients (43 female, 37 male), aged 35 ± 8.0 years (mean ± SD), participated in the study, of which 52.7% screened positive for PTSD. Severity of marijuana use was significantly associated with a number of reexperiencing and hyperarousal symptoms and with overall severity of PTSD symptoms. Opiate, amphetamine, and benzodiazepine use did not appear to be related to PTSD symptoms.In this sample, marijuana may be used to self-treat certain PTSD symptoms, supporting the self-medication hypothesis. Further research is required to confirm the association between a diagnosis of PTSD and substance use. Given the high prevalence of PTSD in the substance-using population, routine PTSD screening in the substance abuse treatment setting may be justified.",0 +https://doi.org/10.1007/s00127-010-0281-4,Evidence for a psychotic posttraumatic stress disorder subtype based on the National Comorbidity Survey,"Purpose This study assessed the distribution of posttraumatic stress disorder (PTSD) symptoms and psychosis indicators among a large sample of individuals with a lifetime diagnosis of PTSD. The identification of a psychotic PTSD subtype was also predicted. Method Using data from the National Comorbidity Survey a latent class analysis was conducted on the PTSD symptoms of intrusion, avoidance, and hyperarousal and the psychosis hallucination and delusion indicators. Results Results indicated four latent classes, two of which had relatively high probabilities of endorsing the hallucination and delusion indicators. These classes were associated with a broad range of traumatic experiences. One particular class had high probabilities of endorsing both the psychosis indicators and the PTSD symptoms and was associated with a broad range of comorbid psychiatric disorders. Conclusion There was a candidate class that met the characteristics expected to be evident in a psychotic PTSD subtype. © Springer-Verlag 2010.",0 +https://doi.org/10.1176/ajp.148.12.1730,L'automatisme psychologique,,0 +https://doi.org/10.1016/j.neuroscience.2011.06.041,"Prenatal stress induces long term stress vulnerability, compromising stress response systems in the brain and impairing extinction of conditioned fear after adult stress","Stress is a risk factor for the development of affective disorders, including depression, post-traumatic stress disorder, and other anxiety disorders. However, not all individuals who experience either chronic stress or traumatic acute stress develop such disorders. Thus, other factors must confer a vulnerability to stress, and exposure to early-life stress may be one such factor. In this study we examined prenatal stress (PNS) as a potential vulnerability factor that may produce stable changes in central stress response systems and susceptibility to develop fear- and anxiety-like behaviors after adult stress exposure. Pregnant Sprague-Dawley rats were immobilized for 1 h daily during the last week of pregnancy. Controls were unstressed. The male offspring were then studied as adults. As adults, PNS or control rats were first tested for shock-probe defensive burying behavior, then half from each group were exposed to a combined chronic plus acute prolonged stress (CAPS) treatment, consisting of chronic intermittent cold stress (4 °C, 6 h/d, 14 days) followed on day 15 by a single session of sequential acute stressors (social defeat, immobilization, cold swim). After CAPS or control treatment, different groups were tested for open field exploration, social interaction, or cued fear conditioning and extinction. Rats were sacrificed at least 5 days after behavioral testing for measurement of tyrosine hydroxylase (TH) and glucocorticoid receptor (GR) expression in specific brain regions, and plasma adrenocorticotropic hormone (ACTH) and corticosterone. Shock-probe burying, open field exploration and social interaction were unaffected by any treatment. However, PNS elevated basal corticosterone, decreased GR protein levels in hippocampus and prefrontal cortex, and decreased TH mRNA expression in noradrenergic neurons in the dorsal pons. Further, rats exposed to PNS plus CAPS showed attenuated extinction of cue-conditioned fear. These results suggest that PNS induces vulnerability to subsequent adult stress, resulting in an enhanced fear-like behavioral profile, and dysregulation of brain noradrenergic and hypothalamic-pituitary-adrenal axis (HPA) activity.",0 +,Flying therapy for flying phobia.,"Optimum treatment for aircrew who have developed anxiety associated with flight includes a flying phase for desensitization. However, standardized flight profiles are not found in the literature. In this study, a method of desensitization flying, which may increase the probability of a return to productive flying, was devised and assessed.Seven aircrew were referred for flying desensitization. Behavioral therapy (relaxation training, imaginary flying, and thought switching) was usually continued by the Medical Officer (Pilot) (MOP). These aircrewmen flew 2-16 sorties in the RAF IAM Hawk or Hunter aircraft with the MOP. Each flight was structured with three purposes: to approach by increments the flight conditions in each victim's anxiety hierarchy, to regulate the amount of low workload, anxiety-vulnerable time during each sortie, and to practice relaxation techniques in the air.In all referred aircrewmen, anxiety was controllable in flight at IAM. Somatic signs diminished and no sortie was terminated early. All returned to operational flying. Anxiety recurred in one fast jet pilot while flying solo, and in one navigator, both of whom requested a change to transports. A transport pilot had recurrent uncontrollable anxiety at high altitude and is grounded. At 9-24 months follow-up, 5/7 were flying comfortably with rare, controllable anxiety. We conclude that actual exposure to flying is usually necessary for aircrew to recover from anxiety associated with flight.",0 +https://doi.org/10.1176/appi.ajp.159.4.660,Comparative Study of Trauma-Related Phenomena in Subjects With Pseudoseizures and Subjects With Epilepsy,"The purpose of this study was to examine potential differences in measures of trauma-related phenomena between subjects with pseudoseizures and subjects with intractable epilepsy.Thirty-one adult subjects with pseudoseizures and 32 subjects with intractable epilepsy (confirmed by video-EEG) were recruited from the epilepsy unit of a tertiary care hospital. Each participant completed the Impact of Event Scale, the Davidson Trauma Scale, the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (PTSD), the Dissociative Experience Scale, and the Pittsburgh Sleep Quality Index, as well as demographic, seizure history, and family functioning measures.Subjects with pseudoseizures had significantly higher mean scores on the Davidson Trauma Scale, Mississippi Scale for Combat-Related PTSD, Impact of Event Scale, and Pittsburgh Sleep Quality Index than subjects with epilepsy. In addition, a significantly higher percentage of subjects with pseudoseizures had scores above the clinical cutoff level of 30 on the Dissociative Experience Scale.Subjects with pseudoseizures exhibited trauma-related profiles that differed significantly from those of epileptic comparison subjects and closely resembled those of individuals with a history of traumatic experiences. Interventions aimed at trauma-related issues may be beneficial for patients with pseudoseizures.",0 +https://doi.org/10.1016/j.mehy.2004.08.032,Non-termination of sickness behavior as precipitating factor for mental disorders,"Sickness behavior can be defined as a combination of coordinated behavioral and physiological changes that develop in response to any condition that elicits pro-inflammatory activity. It is an adaptational homeostasis initiated by the influence of pro-inflammatory cytokines on central nervous system neurohormonal functioning. This paper introduces the concept of non-termination of sickness behavior as a potential threat to mental health. In view of the similarities between the behavioral symptoms, the neuroendocrine and the cytokine profiles of sickness behavior and that of a number of mental disorders it is hypothesized that the inappropriate continuation of sickness behavior, (i.e., non-termination), after recovery from the initial disease, could form the basis for mental disturbances. This would be particularly relevant in individuals with alterations in stress vulnerability (altered activation threshold and impaired negative feedback), which may occur due to the combination of genetic disposition and priming by early life experiences.",0 +https://doi.org/10.1080/10509670802143680,"Prison Therapeutic Community Treatment for Female Offenders: Profiles and Preliminary Findings for Mental Health and Other Variables (Crime, Substance Use and HIV Risk)","ABSTRACT This random assignment study compared women in a prison Therapeutic Community (TC) program with those in a cognitive-behavioral intervention. Over two thirds of study subjects received a lifetime diagnosis of severe mental disorder, nearly one-half received a diagnosis of PTSD, and virtually all reported exposure to trauma. Preliminary analysis (n = 314) found significantly better six-month post-prison outcomes for the TC group on measures of mental health, criminal behavior and HIV-risk behavior. These findings suggest the short-term effectiveness of prison TC treatment for female offenders with substance use disorders, and underscore the importance of adapting treatment to address mental health.",0 +,Psychiatric disorders following return from combat duty during the twenty-first century,"Knowledge of the psychiatric consequences of combat deployment expanded rapidly during the late 20th century as large numbers of Vietnam veterans experienced substantial difficulties with readjustment upon return from deployment. Current warfare in Afghanistan and Iraq has resulted in the longest period of sustained combat exposure for United States forces since Vietnam. This article compares the nature of conflict, composition of deployed forces, combat exposures, and injuries in these deployment settings compared to late 20th century conflicts. It also reviews early findings on rates of psychiatric disorders among returning troops and compares these findings with those of studies of troops returning from prior conflicts. Evaluation and treatment approaches to posttraumatic stress disorder in combat veterans are then provided. Preliminary findings suggest that early assessment of veterans may not represent the long-term psychiatric needs of returning veterans and that ongoing surveillance and availability of psychiatric care will be needed for this population.",0 +https://doi.org/10.1080/16506070801969005,Associations Between Dimensions of Anxiety Sensitivity and PTSD Symptom Clusters in Active‐Duty Police Officers,"Prior studies have shown that anxiety sensitivity (AS) plays an important role in posttraumatic stress disorder (PTSD) symptom severity. The purpose of this study was to evaluate associations between empirically supported PTSD symptom clusters (i.e. reexperiencing, avoidance, numbing, hyperarousal) and AS dimensions (i.e. psychological concerns, social concerns, somatic concerns). Participants were 138 active-duty police officers (70.7% female; mean age = 38.9 years; mean time policing = 173.8 months) who, as a part of a larger study, completed measures of trauma exposure, PTSD symptoms, AS, and depressive symptoms. All participants reported experiencing at least one event that they perceived as traumatic, and 44 (31.9%) screened positive for PTSD. Officers with probable PTSD scored significantly higher on AS total as well as the somatic and psychological concerns dimensional scores than did those without PTSD. As well, a higher percentage of officers with probable PTSD scored positively on the AS-derived Brief Screen for Panic Disorder (Apfeldorf et al., 1994) compared with those without PTSD. A series of regression analyses revealed that depressive symptoms, number of reported traumas, and AS somatic concerns were significant predictors of PTSD total symptom severity as well as severity of reexperiencing. Avoidance was predicted by depressive symptoms and AS somatic concerns. Only depressive symptoms were significantly predictive of numbing and hyperarousal cluster scores. These findings contribute to understanding the nature of association between AS and PTSD symptom clusters. Implications for the treatment of individuals having PTSD with and without panic-related symptomatology are discussed.",0 +https://doi.org/10.1016/j.comppsych.2010.12.005,"Current visual scanpath research: a review of investigations into the psychotic, anxiety, and mood disorders","The human visual system is comprised of an array of complex organs, which jointly decode information from visible light to construct a meaningful representation of the surrounding environment. The study of visual scanpaths transpired in a bid to enhance our understanding of the role of eye movements underpinning adaptive functioning as well as psychopathology and was further aided by the advent of modern eye-tracking techniques. This review provides a background to the nature of visual scanpaths, followed by an overview and critique of eye movement studies in specific clinical populations involving the psychotic, anxiety, and mood disorders, and concludes with suggested directions for future research. We performed a Medline and PsycInfo literature search, based on variations of the terms ""visual scanpath,"" ""eye-tracking,"" and ""eye movements,"" in relation to articles published from 1986 to the present. Eye-tracking studies in schizophrenia mostly concurred with the existence of a ""restricted"" scanning strategy, characterized by fewer number of fixations of increased durations, with shorter scanpath lengths, and a marked avoidance of salient features, especially in relation to facial emotion perception. This has been interpreted as likely reflecting dual impairments in configural processing as well as gestalt perception. Findings from the anxiety and mood disorders have conversely failed to yield coherent results, with further research warranted to provide corroborating evidence and overcome identified methodological limitations. Future studies should also look toward applying similar techniques to related disorders as well as conducting parallel neuroimaging investigations to elucidate potential neurobiological correlates.",0 +https://doi.org/10.1097/nmd.0000000000000428,The Role of Generalized Explicit and Implicit Guilt and Shame in Interpersonal Traumatization and Posttraumatic Stress Disorder,"Posttraumatic stress disorder (PTSD) and interpersonal traumatization are frequently associated with trauma-related guilt and shame. However, research on generalized guilt and shame in PTSD is lacking. The aim of this study was to investigate generalized explicit and implicit guilt and shame in interpersonal traumatization and PTSD. Interpersonally traumatized women either with PTSD (n = 28) or without PTSD (n = 32) and 32 nontraumatized women completed the Test of Self-Conscious Affect-3 and the Implicit Association Test to measure explicit and implicit guilt and shame. Explicit guilt and shame were significantly higher in women with PTSD than in traumatized women without PTSD. Traumatized women without PTSD showed significantly higher levels of explicit guilt and shame than nontraumatized women did. PTSD was associated with implicit guilt but not implicit shame. In addition to trauma-related guilt and shame, generalized explicit guilt and shame and implicit guilt seem to play a crucial role in PTSD.",0 +,Life events (Loss and traumatic) and emotional responses to them in acute catastrophe survivors and long-lasting heroin use disorder patients never exposed to catastrophic events,"Background. Symptoms of PTSD denote alterations in several neurobiological systems, including the opioid system. In a previous study on methadone-treated heroin use disorder (HUD) patients, we demonstrated strong correlations between the severity and progression of HUD and the subsequently greater severity of PTSD spectrum symptoms, so suggesting a unitary perspective. Methods. A comparative cross-sectional study was carried out to evaluate post-traumatic spectrum reactivity to loss and traumatic events in three groups: acute catastrophic event survivors experiencing (N=77) and the same number not experiencing PTSD (N=77), and a third group, of long-lasting HUD subjects who had never been exposed to catastrophic events (N=77). Results. To obtain an index of the magnitude of emotional response to losses and traumatic events, we conducted a preliminary ROC analysis on the TALS-SR total scores observed in our L’Aquila 2009 earthquake database, after having classified subjects as PTSD and No-PTSD (according to the SCID-questionnaire). That analysis determined the cut-off value required to ensure the best balance between sensitivity and specificity. The percentage of subjects who were over the threshold in the HUD group proved to be very similar to that observed in the PTSD earthquake survivors group [51 (66.2%) vs 56 (72.7%), Chi-square=0.49, p=.484], whereas it turned out to be significantly higher than that observed in the No-PTSD earthquake survivors group [51 (66.2%) vs 11 (14.3%), Chisquare= 41.07, p<.001]. Furthermore, the discriminant analysis utilizing TALS-SR domain scores as predictive variables failed to discriminate between the HUD group and the PTSD earthquake group, whereas it appears to clearly differentiate the No-PTSD earthquake group from the other two. Conclusions. This study, besides providing evidence of similarities in the type of reaction shown to loss and to traumatic events between HUD patients and earthquake survivors with PTSD, also supports the probable implication of the opioid system in the aetio(patho)logy of PTSD.",0 +https://doi.org/10.1037/0033-2909.86.2.420,Intraclass correlations: Uses in assessing rater reliability.,"Reliability coefficients often take the form of intraclass correlation coefficients. In this article, guidelines are given for choosing among six different forms of the intraclass correlation for reliability studies in which n target are rated by k judges. Relevant to the choice of the coefficient are the appropriate statistical model for the reliability and the application to be made of the reliability results. Confidence intervals for each of the forms are reviewed.",0 +https://doi.org/10.1023/a:1007806132319,"Predictors of emotional numbing, revisited: A replication and extension","Litz et al. (1997), theorizing that emotional numbing (EN) is the result of emotional depletion caused by chronic hyperarousal, demonstrated that a cluster of hyperarousal symptoms was a robust predictor of EN symptoms. In the present study, these findings were replicated and extended in two multiple regression analyses of data from a large, multisite investigation (T. M. Keane et al., 1998) of psychophysiological responding by male combat veterans. The arousal (D) cluster of symptoms was again the most robust predictor of EN symptoms, whereas physiological indices of arousal and reactivity accounted for negligible amounts of variance in both regression equations. These findings underscore the possible link between disturbances related to arousal and the capacity of traumatized individuals to express and experience pleasant feelings.",0 +https://doi.org/10.1002/9781119941101.ch13,Psycho-oncology in Underserved and Minority Populations,,0 +https://doi.org/10.1136/adc.2006.100305,Post-traumatic stress disorder in childhood,"In the past two decades, post-traumatic stress disorder (PTSD) after exposure to a variety of traumatic or particularly threatening experiences has gained recognition as a significant contributor to morbidity in children. The basic features involve the development of impairing stress symptoms, including re-experiencing of the event in the form of “flashbacks” (distressing images, thoughts or perceptions) or nightmares, avoidance of thinking or talking about the event, of places or people associated with the event and of things that remind one of the event. Hyperarousal, or feeling on edge, irritability and exaggerated “startle” responses to stimuli, and emotional numbing (sufferers feeling cut off and detached) have also been described. PTSD in children was originally described after particularly traumatic events such as physical and sexual abuse1–3 and the witnessing of violence.4 It has been recognised following both natural5,6 and man-made7,8 disasters, and extensively documented in refugees,9,10 war situations11 and in response to terrorism-induced trauma.12 More recently, attention has focused on PTSD occurring as a consequence of a variety of paediatric conditions, some life threatening, including cancer,13 head injury14 and motor vehicle accidents15,16 as well as mild to moderate paediatric trauma,17 acute illnesses resulting in admission to paediatric intensive care units,18 children who undergo organ transplantation19 and after diagnosis of diabetes mellitus type 1.20 Stressful experiences related to serious paediatric illness in children may be expected to affect parents psychologically. Accordingly, high levels of symptoms of PTSD have been reported in parents of children with a variety of problems such as meningococcal infections requiring admission to paediatric intensive care units,21 in family members of adolescent cancer survivors22 and of children with newly diagnosed type 1 diabetes.23 Early identification and appropriate referral …",0 +https://doi.org/10.1093/oxfordhb/9780195399066.013.0022,Risk and Protective Factors for Traumatic Stress Disorders,"Abstract This chapter provides an overview of risk and protective factors that may account for posttraumatic responses. In addition to risk and protective factors specifically for posttraumatic stress disorder (PTSD), the outcomes of resilience and posttraumatic growth are considered. Emphasis is placed on the importance of a longitudinal and especially a lifespan developmental framework to understand both the short- and long-term implications of trauma exposure and the factors that influence its consequences. A brief introduction to methodological approaches for documenting longitudinal change is presented, followed by suggestions for future research.",0 +https://doi.org/10.4088/jcp.14com09408,Trajectories of PTSD Symptoms and Predictive Factors of Trajectory Membership: A Step Toward Identifying Veterans at Risk,,0 +https://doi.org/10.1017/s0033291707002589,The latent structure of post-traumatic stress disorder: tests of invariance by gender and trauma type,"Background Measurement invariance of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) post-traumatic stress disorder (PTSD) criterion symptoms was tested by gender and trauma type, assaultive and non-assaultive. Method Analysis was conducted using latent class analysis (LCA), based on findings that the three-class LCA model from Breslau et al . ( Archives of General Psychiatry 2005, 62 , 1343–1351) fits the data across the four groups best. The classes represent three levels of PTSD-related disturbance: no disturbance, intermediate disturbance and pervasive disturbance, with the last one approximating the DSM-IV PTSD diagnosis. Results Analysis of measurement invariance showed that, with respect to gender, there was no evidence of differential symptom reporting within the same disturbance class. DSM-IV symptom indicators represent the latent structure of PTSD equally in males and females. We found that more female than male victims of assaultive violence experienced pervasive disturbance. In the absence of measurement variability associated with gender, the finding is likely to reflect a gender difference in susceptibility. The analysis of measurement invariance detected evidence of variability associated with trauma type. Victims of assaultive violence in the pervasive disturbance class report more severe distress (especially emotional numbing) than do victims of non-assaultive violence in the same class. Conclusions The finding of measurement bias associated with type of trauma raises questions about the applicability of a single definition for PTSD associated with assaultive violence and PTSD associated with traumatic events of lesser magnitude.",0 +https://doi.org/10.1371/journal.pbio.1002047,Illegal Drugs Laws: Clearing a 50-Year-Old Obstacle to Research,"The United Nations drug control conventions of 1960 and 1971 and later additions have inadvertently resulted in perhaps the greatest restrictions of medical and life sciences research. These conventions now need to be revised to allow neuroscience to progress unimpeded and to assist in the innovation of treatments for brain disorders. In the meantime, local changes, such as the United Kingdom moving cannabis from Schedule 1 to Schedule 2, should be implemented to allow medical research to develop appropriately.",0 +https://doi.org/10.3109/13651501.2014.961930,Post-traumatic stress disorder among Syrian refugees in Turkey: A cross-sectional study,"Refugees have had major challenges to meet their health care needs throughout history especially in war zones and natural disaster times. The health care needs of Syrian refugees have been becoming an increasingly important issue. We aimed to examine the prevalence of post-traumatic stress disorder (PTSD) and explore its relation with various socioeconomic variables among Syrian refugees, who sought asylum in Turkey.This cross-sectional study was conducted in a tent city. Sample size calculation yielded 352 and the participants of the study were determined randomly. Experienced and native Arabic speaking, psychiatrist evaluated the participants.The frequency of PTSD was 33.5%. Through the binary logistic regression analysis, we calculated that the probability of having PTSD among Syrian refugees in our sample was 71%, if they had the following features: with female gender; being diagnosed with psychiatric disorder in the past; having a family history of psychiatric disorder; and experiencing 2 or more traumas.The findings of our study suggest that PTSD among Syrian refugees in Turkey might be an important mental health issue in refugee camps especially among female refugees, who were exposed to 2 or more traumatic events and had a personal or family history of psychiatric disorder.",0 +https://doi.org/10.1097/00004583-199610000-00026,"Relationship between Early Abuse, Posttraumatic Stress Disorder, and Activity Levels in Prepubertal Children","To examine the relationship between early physical and sexual abuse, posttraumatic stress disorder (PTSD), major depression, and activity levels in prepubertal children.Nineteen unmedicated children with documented abuse (9.4 +/- 2.3 years; 6 girls, 13 boys) were compared with 15 healthy controls (8.3 +/- 1.9 years; 6 girls, 9 boys). Diagnoses were derived from structured interviews (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version). Motionlogger actigraphs collected activity data for 72 continuous hours in 1-minute epochs.Overall, abused children were 10% more active than normal children (p < .05) and displayed a paucity of periods of low-level daytime activity (p < .01). Abused children with PTSD were largely responsible for the increase in activity. Abused children with PTSD had a robust and normal circadian activity rhythm. Abused children in whom PTSD failed to develop had an attenuated circadian amplitude compared with subjects with PTSD (101% versus 93%, p < .01) and were phase-delayed by 61 minutes versus controls (p = .01). Early onset of abuse was significantly associated with greater likelihood of the development of PTSD and hyperactivity. Later age of abuse was associated with circadian dysregulation.These preliminary observations indicate that abused children with PTSD have activity profiles similar to those of children with attention-deficit hyperactivity disorder, while abused children without PTSD have activity profiles more similar to those of depressed children.",0 +https://doi.org/10.1023/a:1024789723779,Childhood abuse and sexual revictimization in a female Navy recruit sample,"To examine effects of childhood abuse on adult rape, 1,887 female Navy recruits were surveyed. Overall 35% of recruits had been raped and 57% had experienced childhood physical abuse (CPA) and/or childhood sexual abuse (CSA). Controlling for CPA, rape was significantly (4.8 times) more likely among women who had experienced CSA than among women who had not. In contrast, CPA (controlling for CSA) was unrelated to likelihood of adult rape. Alcohol problems and number of sex partners were examined as mediators. Although both variabies predicted rape, their effects were independent of the effects of CSA. Finally, despite ethnic group differences in the prevalence of victimization, the predictors of rape did not differ significantly across ethnic groups.",0 +https://doi.org/10.1002/jts.20427,The impact of sudden gains in cognitive behavioral therapy for posttraumatic stress disorder,"This study investigated sudden gains, i.e., rapid and stable improvements, in posttraumatic stress disorder (PTSD) symptoms that may occur in cognitive-behavioral therapy. Twenty-nine of 72 participants (39.2%) experienced a sudden gain during treatment. Mixed model ANOVAs analyzed sudden gains impact on clinician-rated PTSD symptom severity, patient-rated PTSD symptom severity, and patient-rated depressive symptom severity. Sudden gains in PTSD symptomology were associated with greater reductions in PTSD symptom severity for the avoidance/numbing and hyperarousal symptom clusters at posttreatment. By 6-month follow-up, the sudden gains group had maintained those reductions in symptoms, but the nonsudden gains group had achieved equal reductions in symptom severity. Participants experiencing sudden gains on PTSD measures had lower depression severity at posttreatment and follow-up.",0 +https://doi.org/10.1016/j.psychres.2010.04.039,Structure of posttraumatic stress disorder symptoms and psychosocial functioning in Veterans of Operations Enduring Freedom and Iraqi Freedom,"Posttraumatic stress disorder (PTSD) is one of the most prevalent psychiatric conditions in Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF-OIF), but little is known about the structure of PTSD symptoms, and associations between PTSD symptom clusters and psychosocial functioning in this population. A total of 272 OEF-OIF Veterans in Connecticut completed a mail survey containing measures of psychopathology, resilience, and psychosocial functioning. Confirmatory factor analyses revealed that the 4-factor dysphoria model, which is comprised of separate re-experiencing, avoidance, dysphoria, and hyperarousal symptom clusters, provided the best representation of PTSD symptom structure in this sample. Dysphoria symptoms were independently associated with a broad range of psychosocial measures, even after controlling for age, combat exposure, and other PTSD symptom clusters. Re-experiencing symptoms were associated with alcohol use problems, and avoidance symptoms were associated with increased psychosocial difficulties and decreased perceptions of postdeployment social support. These results suggest that dysphoria symptoms were strongly related to a broad range of psychosocial measures in this sample of OEF-OIF Veterans. Dysphoria symptoms may deserve special attention in the assessment and treatment of symptomatic OEF-OIF Veterans.",0 +https://doi.org/10.1111/j.1601-5215.2009.00442.x,Finding patterns and groupings: II. Introduction to latent profile analysis and finite mixture models,"An latent class analysis (LCA) is a particular kind of mixture analysis. If we take the LCA concept and change it so that the dataset now comprises observed continuous variables; and the classes differ in their means on one or more variables; then the resulting model is called latent profile analysis (LPA). As with LCA, the model assumes that classes explain associations so that within classes the observed variables are now modeled as uncorrelated. A similar looking model to LPA, one which does not make the assumption of zero within-class correlations, is the finite mixture model (FMM) model, which tries to find underlying clusters of distributed data-univariate if there is only one variable, multivariate if there are two or more. The FMM typically assumes the data have a normal distribution. Depending on which assumptions you include it is easy to move between an LPA and an FMM and indeed obtain quite similar looking answers, but keep in mind that the conceptual models behind these are quite different. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0 +https://doi.org/10.1111/j.1751-9004.2011.00379.x,Resilience in the Context of Chronic Stress and Health in Adults,"Over the past several decades, stress research has experienced a broadening of its pathologic focus to encompass the concept of resilience. There is a wealth of research on resilience but no general consensus regarding its conceptualization. Some define resilience as attaining eventual favorable outcomes following exposure to adversity. Others define it as specific relatively short-term responses characterized by a return to homeostasis after initial disruption due to a stressor, and still others refer to resilience as resources that enable the individual to withstand or recover from major stressors. Many of the existing conceptualizations of resilience are not applicable in the context of chronic stress which is particularly harmful to health. How do adults who experience chronic stress survive, manage, and thrive, and what resources enable them to do so? In this paper, we consider these questions by reviewing traditions of research and definitions of resilience in order to inform an understanding of resilience in general, and for the study of chronic stress in adults. Based on a review of the literature, we developed a taxonomy of resilience resources that can be applied broadly, and guide future research.",0 +https://doi.org/10.1542/peds.2004-0118,Traumatic Stress Symptoms in Adolescent Organ Transplant Recipients,"Symptoms of posttraumatic stress disorder (PTSD) after life-threatening medical illness have been found to predict poor outcome in preliminary studies of adults and children. However, these symptoms are rarely recognized in general medical or pediatric settings. Here we report on the first large investigation to assess prevalence and correlates of self-reported symptoms of posttraumatic stress in a nonreferred sample of adolescent liver, heart, and kidney transplant recipients.One hundred four adolescents, ages 12 to 20 years (mean: 15.7; SD: 2.1), completed and returned the University of California, Los Angeles, PTSD Index for the Diagnostic and Statistical Manual of Mental Disorders. All participants were at least 1 year post-initial transplant and were fluent speakers of English and/or Spanish.More than 16% of the adolescents met all symptom criteria for PTSD, and an additional 14.4% met 2 of 3 symptom-cluster criteria. Regression analysis indicated no effect of gender, ethnicity, age at interview, organ type, time since transplant, or age at transplant.As has been found with other life-threatening pediatric conditions, solid organ transplantation can precipitate symptoms of posttraumatic stress. Symptoms are not predicted by what would be considered objective factors increasing life threat, suggesting a greater salience of subjective appraisal of threat, as has been seen in studies of childhood cancer survivors.",0 +https://doi.org/10.1007/s11136-012-0328-y,"The impact of HIV status, HIV disease progression, and post-traumatic stress symptoms on the health-related quality of life of Rwandan women genocide survivors","We examined whether established associations between HIV disease and HIV disease progression on worse health-related quality of life (HQOL) were applicable to women with severe trauma histories, in this case Rwandan women genocide survivors, the majority of whom were HIV-infected. Additionally, this study attempted to clarify whether post-traumatic stress symptoms were uniquely associated with HQOL or confounded with depression.The Rwandan Women's Interassociation Study and Assessment was a longitudinal prospective study of HIV-infected and uninfected women. At study entry, 922 women (705 HIV+ and 217 HIV-) completed measures of symptoms of post-traumatic stress and HQOL as well as other demographic, clinical, and behavioral characteristics.Even after controlling for potential confounders and mediators, HIV+ women, in particular those with the lowest CD4 counts, scored significantly worse on HQOL and overall quality of life (QOL) than did HIV- women. Even after controlling for depression and HIV disease progression, women with more post-traumatic stress symptoms scored worse on HQOL and overall QOL than women with fewer post-traumatic stress symptoms.This study demonstrated that post-traumatic stress symptoms were independently associated with HQOL and overall QOL, independent of depression and other confounders or potential mediators. Future research should examine whether the long-term impact of treatment on physical and psychological symptoms of HIV and post-traumatic stress symptoms would generate improvement in HQOL.",0 +https://doi.org/10.3109/00048679309075799,Variations in Therapeutic Interventions for Cambodian and Chilean Refugee Survivors of Torture and Trauma: A Pilot Study,"The treatment of refugee survivors of torture and trauma has attracted increasing clinical attention. The present study surveyed therapists concerning the emphasis that was placed on disclosure of previous traumatic experiences in therapy with refugees from Chile and Cambodia. Significant differences were found between the two groups with trauma story discussion being judged by therapists to be more important to treatment outcome in Chilean patients. The problem of potential therapist bias limits definitive conclusions, however we suggest that differences in cultural preparedness for psychotherapy aimed at uncovering previous traumatic experiences may be the main reason for variations in styles of therapy offered to these distinctive ethnic groups. Other possible explanations are differences in diagnostic profiles and types of previous traumatic experiences.",0 +https://doi.org/10.1016/s0140-6736(12)60600-x,Shaping the renaissance of psychedelic research,"Psychedelic drugs have a rich and vibrant history as clinical aids for psychiatry. For two decades after the discovery of lysergide (LSD) in the 1940s, psychedelics were extensively studied and clinical progress was good.1 But research collapsed rapidly in 1966 when LSD was made illegal, and there was a subsequent hiatus of psychedelic research. After 40 years, this pause is now coming to an end, with many new studies and a refreshing approach to the research of psychedelic drugs.2",0 +https://doi.org/10.1097/brs.0b013e3181643eb8,Course and Prognostic Factors for Neck Pain in Whiplash-Associated Disorders (WAD),"Best evidence synthesis.To perform a best evidence synthesis on the course and prognostic factors for neck pain and its associated disorders in Grades I-III whiplash-associated disorders (WAD).Knowledge of the course of recovery of WAD guides expectations for recovery. Identifying prognostic factors assists in planning management and intervention strategies and effective compensation policies to decrease the burden of WAD.The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders (Neck Pain Task Force) conducted a critical review of the literature published between 1980 and 2006 to assemble the best evidence on neck pain and its associated disorders. Studies meeting criteria for scientific validity were included in a best evidence synthesis.We found 226 articles related to course and prognostic factors in neck pain and its associated disorders. After a critical review, 70 (31%) were accepted on scientific merit; 47 of these studies related to course and prognostic factors in WAD. The evidence suggests that approximately 50% of those with WAD will report neck pain symptoms 1 year after their injuries. Greater initial pain, more symptoms, and greater initial disability predicted slower recovery. Few factors related to the collision itself (for example, direction of the collision, headrest type) were prognostic; however, postinjury psychological factors such as passive coping style, depressed mood, and fear of movement were prognostic for slower or less complete recovery. There is also preliminary evidence that the prevailing compensation system is prognostic for recovery in WAD.The Neck Pain Task Force undertook a best evidence synthesis to establish a baseline of the current best evidence on the course and prognosis for WAD. Recovery of WAD seems to be multifactorial.",0 +https://doi.org/10.1007/978-3-642-54816-1_24,Virtual Natural Environments for Restoration and Rehabilitation in Healthcare,"AbstractFor over two decades, research and clinical projects have exploited Virtual Reality technologies in the treatment of numerous human conditions, from desensitisation régimes combating phobias to the use of distraction and exposure therapies for burns victims and those suffering from post-traumatic stress disorders. In contrast to previous “high-tech” interface and combat-oriented approaches to using VR in the psychological rehabilitation process, the present chapter advocates the use of virtual restorative environments (VREs)—the recreation of locations and scenes that, by virtue of their natural beauty and peacefulness, can significantly help to reduce the body’s reactivity to stress and restore cognitive or attentional capacities. The chapter also argues that VREs, suitably enhanced with more interactive and dynamic features, could offer significant benefits to patients in physical rehabilitation programmes. This is especially the case for amputees, for example, who, whilst awaiting the fitting of prosthetic limbs, could undertake competitive and motivational “virtual exercises”, thereby avoiding muscle atrophy and related reductions in residual limb capabilities. The report concludes that the exploitation of simulation technologies in psychological therapies is worthy of continued investigation, especially in the pursuit of enhancing patients’ recovery profiles following surgical procedures, from intensive care to the hospital recovery ward. VREs possess a range of important qualities, not least significant of which is real-time interaction and ease-of-editing, supporting the cost-effective generation of engaging and distributable scenarios that can be tailored relatively easily to meet the needs of individual patients.KeywordsVirtual realityRehabilitationRestorationHealthcareHuman factors",0 +https://doi.org/10.1017/s0033291713002651,"Childhood maltreatment, juvenile disorders and adult post-traumatic stress disorder: a prospective investigation","Background We examine prospectively the influence of two separate but potentially inter-related factors in the etiology of post-traumatic stress disorder (PTSD): childhood maltreatment as conferring a susceptibility to the PTSD response to adult trauma and juvenile disorders as precursors of adult PTSD. Method The Dunedin Multidisciplinary Health and Development Study (DMHDS) is a birth cohort ( n = 1037) from the general population of New Zealand's South Island, with multiple assessments up to age 38 years. DSM-IV PTSD was assessed among participants exposed to trauma at ages 26–38. Complete data were available on 928 participants. Results Severe maltreatment in the first decade of life, experienced by 8.5% of the sample, was associated significantly with the risk of PTSD among those exposed to adult trauma [odds ratio (OR) 2.64, 95% confidence interval (CI) 1.16–6.01], compared to no maltreatment. Moderate maltreatment, experienced by 27.2%, was not associated significantly with that risk (OR 1.55, 95% CI 0.85–2.85). However, the two estimates did not differ significantly from one another. Juvenile disorders (ages 11–15), experienced by 35% of the sample, independent of childhood maltreatment, were associated significantly with the risk of PTSD response to adult trauma (OR 2.35, 95% CI 1.32–4.18). Conclusions Severe maltreatment is associated with risk of PTSD response to adult trauma, compared to no maltreatment, and juvenile disorders, independent of earlier maltreatment, are associated with that risk. The role of moderate maltreatment remains unresolved. Larger longitudinal studies are needed to assess the impact of moderate maltreatment, experienced by the majority of adult trauma victims with a history of maltreatment.",0 +https://doi.org/10.15288/jsad.2012.73.549,Posttraumatic Stress Disorder Symptoms Mediate the Relationship Between Traumatic Experiences and Drinking Behavior Among Women Attending Alcohol Serving Venues in a South African Township,"South Africa has high rates of traumatic experiences and alcohol abuse or dependence, especially among women. Traumatic experiences often result in symptoms of posttraumatic stress disorder (PTSD), and PTSD has been associated with hazardous drinking. This article examines the relationship between traumatic events and hazardous drinking among women who patronized alcohol-serving venues in South Africa and examines PTSD as a mediator of this relationship.A total of 560 women were recruited from a Cape Town township. They completed a computerized assessment that included alcohol consumption, history of traumatic events, and PTSD symptoms. Mediation analysis examined whether PTSD symptoms mediated the relationship between the number of traumatic event categories experienced (range: 0-7) and drinking behavior.The mean Alcohol Use Disorders Identification Test score in the sample was 12.15 (range: 0-34, SD = 7.3), with 70.9% reaching criteria for hazardous drinking (AUDIT > 8). The mean PTSD score was 36.32 (range: 17-85, SD = 16.3),with 20.9% meeting symptom criteria for PTSD (PTSD Checklist with 20.9% meeting symptom criteria for PTSD (PTSD Checklist-Civilian Version ≥ 50). Endorsement of traumatic experiences was high, including adult emotional (51.8%), physical (49.6%), and sexual (26.3%) abuse; childhood physical (35.0%) and sexual (25.9%) abuse; and other types of trauma (83%). All categories of traumatic experiences, except the ""other"" category, were associated with hazardous drinking. PTSD symptoms mediated 46% of the relationship between the number of traumatic categories experienced and drinking behavior.Women reported high rates of hazardous drinking and high levels of PTSD symptoms, and most had some history of traumatic events. There was a strong relationship between traumatic exposure and drinking levels, which was largely mediated by PTSD symptoms. Substance use interventions should address histories of trauma in this population, where alcohol may be used in part to cope with past traumas.",0 +https://doi.org/10.1111/j.1399-5618.2008.00606.x,Missed bipolarity and psychiatric comorbidity in women with postpartum depression,"To investigate the diagnostic profile of women referred for postpartum depression.Fifty-six women seen consecutively with the referral diagnosis of postpartum depression were administered structured instruments to gather information about their DSM-IV Axis I diagnoses.In terms of frequency of occurrence, the primary diagnoses in this sample were: major depressive disorder (46%), bipolar disorder not otherwise specified (29%), bipolar II disorder (23%), and bipolar I disorder (2%). A current comorbid disorder, with no lifetime comorbidity, occurred among 32% of the sample; by contrast, lifetime comorbidity alone (i.e., with no currently comorbid disorder) was found among 27%. Both a lifetime and a current comorbidity were found among 18% of the women, and 23% had no comorbid disorder. The most frequently occurring current comorbid disorder was an anxiety disorder (46%), with obsessive-compulsive disorder (62%) being the most common type of anxiety disorder. For lifetime comorbidity, substance use (20%) and anxiety disorders (12%) were the two most common. Over 80% of patients who scored positive on either the Highs Scale or the Mood Disorder Questionnaire met the diagnostic criteria for a bipolar disorder.The results suggest that postpartum depression is a heterogeneous entity and that misdiagnosis of bipolar disorder in the postpartum period may be quite common. The findings have important clinical implications, which include the need for early detection of bipolarity through the use of reliable and valid assessment instruments, and implementation of appropriate prevention and treatment strategies.",0 +,Alcohol and stress in the military.,"Although research has independently linked stress experienced by military personnel to both alcohol use and posttraumatic stress disorder, more recently researchers have noted that there also is a significant overlap between stress reactions and alcohol use in veterans and active-duty service members. This overlap seems to be most understood in individuals who have experienced combat or military sexual trauma. This article will provide a brief review of some potential causal mechanisms underlying this relationship, including self-medication and genetic vulnerability models. It also addresses the possible implications for assessment and treatment of military personnel with co-occurring disorders.",0 +https://doi.org/10.1371/journal.pone.0102786,The Challenge of Living On: Psychopathology and Its Mediating Influence on the Readjustment of Former Child Soldiers,"Current civil wars are characterized by the increasing involvement of civilian populations and the systematic employment of child soldiers. An example of such wars was the conflict in Northern Uganda, where the war-affected population is still challenged by the reintegration of formerly abducted children and youths. A cross-sectional, population-based survey, using a multistage cluster sampling approach of 1,113 Northern Ugandans aged between 12 and 25 in camps for internally displaced persons and locally validated instruments was conducted to assess symptoms and diagnoses of Posttraumatic Stress Disorder (PTSD) and probable Depression in war-affected, as well as formerly abducted individuals. Further objectives were to determine predictors of psychopathology and to relate indicators of maladjustment (i.e., impairments in daily and community functioning, somatic complaints, suicidality, aggressiveness and discrimination) to abduction, level of exposure to violence and psychopathology. 43% of the sample reported abduction by the rebel army. Exposure to violence among this group was higher than for non-abducted youths (t = 28.05; p<.001). PTSD point prevalence rates were 25% among former child soldiers and 7% among the comparison group. High suicidal ideation was present in 16% and 6% respectively. A higher amount of experienced and witnessed event-types (β = . 32. p<.001), loss of first-degree relatives (β = .13. p<.001) and the number of event-types involving forced perpetration (β = .23. p<.001) were identified as risk factors of PTSD symptoms in former child soldiers. The associations between abductee-status and indicators of maladjustment were fully mediated by level of trauma exposure and psychopathology. Results show that child soldiering and its psychological sequelae affect a substantial proportion of children and youths. After release or flight, their readjustment depends at least partly on their level of mental traumatization.",0 +https://doi.org/10.1002/pon.3567,Patterns of psychological responses in parents of children that underwent stem cell transplantation,"Hematopoietic stem cell transplantation (HSCT) is curative in several life-threatening pediatric diseases but may affect children and their families inducing depression, anxiety, burnout symptoms, and post-traumatic stress symptoms, as well as post-traumatic growth (PTG). The aim of this study was to investigate the co-occurrence of different aspects of such responses in parents of children that had undergone HSCT.Questionnaires were completed by 260 parents (146 mothers and 114 fathers) 11-198 months after HSCT: the Hospital Anxiety and Depression Scale, the Shirom-Melamed Burnout Questionnaire, the post-traumatic stress disorders checklist, civilian version, and the PTG inventory. Additional variables were also investigated: perceived support, time elapsed since HSCT, job stress, partner-relationship satisfaction, trauma appraisal, and the child's health problems. A hierarchical cluster analysis and a k-means cluster analysis were used to identify patterns of psychological responses.Four clusters of parents with different psychological responses were identified. One cluster (n = 40) significantly differed from the other groups and reported levels of depression, anxiety, burnout symptoms, and post-traumatic stress symptoms above the cut-off. In contrast, another cluster (n = 66) reported higher levels of PTG than the other groups did.This study shows a subgroup of parents maintaining high levels of several aspects of distress years after HSCT. Differences between clusters might be explained by differences in perceived support, the child's health problems, job stress, and partner-relationship satisfaction.",0 +https://doi.org/10.1016/s0145-2134(99)00127-1,Post traumatic stress disorder reactions in children of war: a longitudinal study,"To establish rates of posttraumatic stress disorder (PTSD) reactions and general mental health problems in children who had experienced war trauma.A longitudinal study in the Gaza strip with 234 children aged 7 to 12 years, who had experienced war conflict, at 1 year after the initial assessment, that is, during the peace process. Children completed the Child Post Traumatic Stress Reaction Index (CPTS-RI), while the Rutter A2 and B2 Scales were completed by parents and teachers.The rate of children who reported moderate to severe PTSD reactions at follow-up had decreased from 40.6% (N = 102) to 10.0% (N = 74). 49 children (20.9%) were rated above the cut-off for mental health problems on the Rutter A2 (parent) Scales, and 74 children (31.8%) were above the cut-off on the Rutter B2 (teacher) Scales. The total scores on all three measures had significantly decreased during the 1-year period. The total CPTS-RI score at follow-up was best predicted by the number of traumatic experiences recalled at the first assessment.PTSD reactions tend to decrease in the absence of further stressors, although a substantial proportion of children still present with a range of emotional and behavioral problems. Cumulative previous experience of war trauma constitutes a risk factor for continuing PTSD symptoms.",0 +https://doi.org/10.1002/jts.20041,Patterns of treatment response in chronic posttraumatic stress disorder: An application of latent growth mixture modeling,"This study attempts to differentiate groups of individuals who exhibit different patterns of recovery following treatment for chronic posttraumatic stress disorder (PTSD) and describes these groups in terms of relevant characteristics at program intake. A sample of 2,219 Vietnam veterans who had completed a 12-week treatment program was followed up at 6, 12, and 24 months post admission using self-report measures. With change in PTSD symptoms over time as the focus, latent growth mixture modeling was used to assign individual veterans to subgroups. A three-group solution provided the best account of the data. Two groups showed moderate and consistent improvement over time although the larger group (n = 1,380) began treatment with more PTSD symptoms and improved more quickly over time. The smallest group (n = 87) showed a substantially different trajectory, with almost no net change in symptom levels over the 24-month period. The groups also varied significantly in terms of their characteristics, with symptom severity and improvements over time reflecting greater comorbidity and younger age. The results have both research and clinical implications.",0 +https://doi.org/10.2105/ajph.2008.150284,"Trends and Risk Factors for Mental Health Diagnoses Among Iraq and Afghanistan Veterans Using Department of Veterans Affairs Health Care, 2002–2008","We sought to investigate longitudinal trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans.We determined the prevalence and predictors of mental health diagnoses among 289,328 Iraq and Afghanistan veterans entering Veterans Affairs (VA) health care from 2002 to 2008 using national VA data.Of 289,328 Iraq and Afghanistan veterans, 106,726 (36.9%) received mental health diagnoses; 62,929 (21.8%) were diagnosed with posttraumatic stress disorder (PTSD) and 50 432 (17.4%) with depression. Adjusted 2-year prevalence rates of PTSD increased 4 to 7 times after the invasion of Iraq. Active duty veterans younger than 25 years had higher rates of PTSD and alcohol and drug use disorder diagnoses compared with active duty veterans older than 40 years (adjusted relative risk = 2.0 and 4.9, respectively). Women were at higher risk for depression than were men, but men had over twice the risk for drug use disorders. Greater combat exposure was associated with higher risk for PTSD.Mental health diagnoses increased substantially after the start of the Iraq War among specific subgroups of returned veterans entering VA health care. Early targeted interventions may prevent chronic mental illness.",0 +https://doi.org/10.1080/10509674.2014.887607,Mental Health Screening Outcomes Among Justice-Involved Youths Under Community Supervision,"The DISC Predictive Scales was administered to 812 New York City youths aged 10–19 placed under community supervision. Approximately half were indicated for possible mental health problems, most frequently mania and posttraumatic stress disorder. Girls were more likely than boys to flag on most disorders. Hierarchical Classes analysis produced five clusters: disruptive behavior, relational distress, marijuana, emotional dysregulation, and specific phobia. Posttraumatic stress disorder and mania were comorbid with all clusters except marijuana. Emotional dysregulation predicted higher, but relational distress predicted lower, risk for rearrest. Marijuana predicted failure to appear in court and receiving a final disposition of placement.",0 +https://doi.org/10.1111/j.1469-7610.2008.01995.x,Development and validation of the Child Post-Traumatic Cognitions Inventory (CPTCI),"Negative trauma-related cognitions have been found to be a significant factor in the maintenance of post-traumatic stress disorder (PTSD) in adults. Initial studies of such appraisals in trauma-exposed children and adolescents suggest that this is an important line of research in youth, yet empirically validated measures for use with younger populations are lacking. A measure of negative trauma-related cognitions for use with children and adolescents, the Child Post-Traumatic Cognitions Inventory (CPTCI), is presented. The measure was devised as an age-appropriate version of the adult Post-Traumatic Cognitions Inventory (Foa et al., 1999).The CPTCI was developed and validated within a large (n = 570) sample, comprising community and trauma-exposed samples of children and adolescents aged 6-18 years.Principal components analysis suggested a two-component structure. These components were labelled 'permanent and disturbing change' and 'fragile person in a scary world', and were each found to possess good internal consistency, test-retest reliability, convergent validity, and discriminative validity. The reliability and validity of these sub-scales was present regardless of whether the measure was completed in the acute phase or several months after a trauma. Scores on these sub-scales did not vary with age.The CPTCI is a reliable and valid measure that is not specific to the type of trauma exposure, and shows considerable promise as a research and clinical tool. The structure of this measure suggests that appraisals concerning the more abstract consequences of a trauma, as well as physical threat and vulnerability, are pertinent factors in trauma-exposed children and adolescents, even prepubescent children.",0 +https://doi.org/10.1542/peds.2010-2877,Self-Embedding Behavior: A New Primary Care Challenge,"OBJECTIVE: The goal of this study was to define self-embedding behavior (SEB), develop a clinical profile of adolescents who engage in SEB, and emphasize the importance of rapid, targeted, and effective identification and intervention. METHODS: As part of a retrospective study with a database evaluating 600 patients percutaneously treated for soft-tissue foreign body removal, adolescents were identified with self-embedded soft-tissue foreign bodies. We describe patients' gender, age, and psychiatric diagnoses; SEB age of onset, frequency, and self-reported reasons; and the number, type, location of, and removal technique for objects. RESULTS: Eleven patients (9 females) who engaged in SEB were identified. Ten of the 11 patients were members of a group home or psychiatric facility at the time they engaged in SEB. All patients had previous and multiple psychiatric diagnoses. SEB mean age-of-onset was 16 years, and mean number of SEB episodes per patient was 1.9. The most common self-reported purpose for SEB was suicidal ideation (6 of 8 [75%]) versus nonsuicidal ideation (2 of 8 [25%]), with 3 cases lacking this documentation. The mean number of objects embedded in a single episode was 2.4, usually composed of metal and embedded in the arm. Seventy-six foreign bodies were percutaneously removed (using ultrasound or fluoroscopic guidance), including metal, glass, wood, plastic, graphite, and crayon. CONCLUSIONS: SEB is an extreme form of self-injury requiring aggressive and timely interdisciplinary assessment and treatment. An understanding of SEB allows medical professionals to pursue rapid, targeted, and effective intervention to interrupt the cycle of self-harm and institute appropriate long-term therapy.",0 +,The comparative effectiveness of levels of training and years of work experience in firefighters as determining factors in the development of posttraumatic stress disorder,"Posttraumatic Stress Disorder (PTSD) has been known by other names and not well studied prior to returning Vietnam veterans who suffered psychological dysfunction. However, the term PTSD became part of the Diagnostic and Statistical Manual for Mental Disorders in 1981. Since that time PTSD has been researched extensively in veterans. However, little attention has been given to firefighters who encounter trauma on a daily basis compared to veterans who may have experienced traumatic events during war or intermittently. Since firefighters are vital to society for rescue and recovery, it is salient that they remain mentally as well as physically fit for duty. PTSD can be debilitating and even result in early retirement or the change of occupation. Hence, determining the risk and resilience factors against the development of PTSD in firefighters may prevent premature retirement or job change. Although some form of brief intervention may be offered to firefighters after a traumatic event, more extensive counseling may be necessary. Knowing the risk factors prior to facing a distressful event may prompt additional counseling subsequent to trauma and ultimately prevent severe or chronic PTSD that may interfere with the duties of these emergency workers. This research compared levels of training and work experience in 127 male firefighters who ranged in age from 21 to 57 who were primarily Caucasian (63.8%). African-Americans comprised 26.8%, Asians 1.6%, Hispanics 1.6%, and Puerto Rican 0.8%. The researcher investigated the relationship between levels of training and work experience on self-efficacy and ultimately the effect self-efficacy has on the manifestation of PTSD symptoms. This study extends previous research that shows when self-efficacy increases, psychological dysfunctioning decreases (Heinrichs, Wagner, Schoch, Soravia, Hellhammer, & Ehlert, 2005). A retrospective causal-comparative design also referred to as an ex post facto design was employed to examine years of training and work experience and their association to self-efficacy. Next, self-efficacy was investigated to look at its effects on symptoms of PTSD. Findings from the study found no significant difference in the relationships between levels of training and self-efficacy or between years of work experience and self-efficacy. However, the study did support prior research that showed a statistical negative correlation between self-efficacy and symptoms of PTSD. Hence, when self-efficacy increased, symptoms of PTSD decreased. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1186/s12888-015-0528-4,The clinical and cost effectiveness of group art therapy for people with non-psychotic mental health disorders: a systematic review and cost-effectiveness analysis,"The majority of mental health problems are non-psychotic (e.g., depression, anxiety, and phobias). For some people, art therapy may be a more acceptable alternative form of psychological therapy than standard forms of treatment, such as talking therapies. This study was part of a health technology assessment commissioned by the National Institute for Health Research, UK and aimed to systematically appraise the clinical and cost-effective evidence for art therapy for people with non-psychotic mental health disorders. Comprehensive literature searches for studies examining art therapy in populations with non-psychotic mental health disorders were performed in May 2013. A quantitative systematic review of clinical effectiveness and a systematic review of studies evaluating the cost-effectiveness of group art therapy were conducted. Eleven randomised controlled trials were included (533 patients). Meta-analysis was not possible due to clinical heterogeneity and insufficient comparable data on outcome measures across studies. The control groups varied between studies but included: no treatment/wait-list, attention placebo controls and psychological therapy comparators. Art therapy was associated with significant positive changes relative to the control group in mental health symptoms in 7 of the 11 studies. A de novo model was constructed and populated with data identified from the clinical review. Scenario analyses were conducted allowing comparisons of group art therapy with wait-list control and group art therapy with group verbal therapy. Group art-therapy appeared cost-effective compared with wait-list control with high certainty although generalisability to the target population was unclear; group verbal therapy appeared more cost-effective than art therapy but there was considerable uncertainty and a sizeable probability that art therapy was more cost effective. From the limited available evidence art therapy was associated with positive effects compared with control in a number of studies in patients with different clinical profiles. The included trials were generally of poor quality and are therefore likely to be at high risk of bias. Art therapy appeared to be cost-effective versus wait-list but further studies are needed to confirm this finding in the target population. There was insufficient evidence to make an informed comparison of the cost-effectiveness of group art therapy with group verbal therapy. HTA project no. 12/27/16; PROSPERO registration no. CRD42013003957 .",0 +https://doi.org/10.2196/jmir.2460,Internet-Based Early Intervention to Prevent Posttraumatic Stress Disorder in Injury Patients: Randomized Controlled Trial,"Posttraumatic stress disorder (PTSD) develops in 10-20% of injury patients. We developed a novel, self-guided Internet-based intervention (called Trauma TIPS) based on techniques from cognitive behavioral therapy (CBT) to prevent the onset of PTSD symptoms.To determine whether Trauma TIPS is effective in preventing the onset of PTSD symptoms in injury patients.Adult, level 1 trauma center patients were randomly assigned to receive the fully automated Trauma TIPS Internet intervention (n=151) or to receive no early intervention (n=149). Trauma TIPS consisted of psychoeducation, in vivo exposure, and stress management techniques. Both groups were free to use care as usual (nonprotocolized talks with hospital staff). PTSD symptom severity was assessed at 1, 3, 6, and 12 months post injury with a clinical interview (Clinician-Administered PTSD Scale) by blinded trained interviewers and self-report instrument (Impact of Event Scale-Revised). Secondary outcomes were acute anxiety and arousal (assessed online), self-reported depressive and anxiety symptoms (Hospital Anxiety and Depression Scale), and mental health care utilization. Intervention usage was documented.The mean number of intervention logins was 1.7, SD 2.5, median 1, interquartile range (IQR) 1-2. Thirty-four patients in the intervention group did not log in (22.5%), 63 (41.7%) logged in once, and 54 (35.8%) logged in multiple times (mean 3.6, SD 3.5, median 3, IQR 2-4). On clinician-assessed and self-reported PTSD symptoms, both the intervention and control group showed a significant decrease over time (P<.001) without significant differences in trend. PTSD at 12 months was diagnosed in 4.7% of controls and 4.4% of intervention group patients. There were no group differences on anxiety or depressive symptoms over time. Post hoc analyses using latent growth mixture modeling showed a significant decrease in PTSD symptoms in a subgroup of patients with severe initial symptoms (n=20) (P<.001).Our results do not support the efficacy of the Trauma TIPS Internet-based early intervention in the prevention of PTSD symptoms for an unselected population of injury patients. Moreover, uptake was relatively low since one-fifth of individuals did not log in to the intervention. Future research should therefore focus on innovative strategies to increase intervention usage, for example, adding gameplay, embedding it in a blended care context, and targeting high-risk individuals who are more likely to benefit from the intervention.International Standard Randomized Controlled Trial Number (ISRCTN): 57754429; http://www.controlled-trials.com/ISRCTN57754429 (Archived by WebCite at http://webcitation.org/6FeJtJJyD).",0 +https://doi.org/10.1177/0145445512450908,Latent Classes of PTSD Symptoms in Vietnam Veterans,"The authors examined heterogeneity in posttraumatic stress disorder (PTSD) symptom presentation among veterans ( n = 335) participating in the clinical interview subsample of the National Vietnam Veterans Readjustment Study. Latent class analysis was used to identify clinically homogeneous subgroups of Vietnam War combat veterans. Consistent with previous research, three classes emerged from the analysis, namely, veterans with no disturbance (61.4% of the cohort), intermediate disturbance (25.6%), and pervasive disturbance (12.5%). The authors also examined physical injury, war-zone stressor exposure, peritraumatic dissociation, and general dissociation as predictors of class membership. The findings are discussed in the context of recent conceptual frameworks that posit a range of posttraumatic outcomes and highlight the sizable segment of military veterans who suffer from intermediate (subclinical) PTSD symptoms.",0 +https://doi.org/10.1017/s1355617710000743,Postconcussive Symptoms After Blast and Nonblast-Related Mild Traumatic Brain Injuries in Afghanistan and Iraq War Veterans,"Blast injury is common in current warfare, but little is known about the effects of blast-related mild traumatic brain injury (mTBI). Profile analyses were conducted investigating differences in self-reported postconcussive (PC) symptoms in 339 veteran outpatients with mTBI histories reporting current symptoms based on mechanism of injury (blast only, nonblast only, or both blast and nonblast), number of blast injuries, and distance from the blast. Veterans with any blast-related mTBI history were younger and reported higher posttraumatic stress symptoms than veterans with nonblast-related mTBI histories, with a marginally significant difference in posttraumatic stress symptom report between veterans reporting blast-related mTBI only and those reporting nonblast-related mTBI. The groups did not differ in terms of PC symptom severity or PC symptom cluster profiles. Among veterans with blast-related mTBI histories, PC symptom report did not vary by number of blast-related mTBIs or proximity to blast. Overall, posttraumatic stress symptoms accounted for a substantial portion of variance in PC symptom report. In veteran outpatients with remote mTBI histories who have enduring symptom complaints related to the mTBI, mechanism of injury did not clearly contribute to differential PC symptom severity or PC symptom cluster profile. Proximal rather than distal factors may be important intervention targets in returning symptomatic veterans with mTBI histories.",0 +https://doi.org/10.1016/j.molbrainres.2004.06.017,Expression profile of mRNAs from rat hippocampus and its application to microarray,"Stress refers to physiological or psychological stimuli that disrupt homeostasis and induce pathophysiological conditions due to maladaptive response, sometimes resulting in mental disorders including depression and post-traumatic stress disorder. Severe stress has been shown to induce neuronal atrophy and apoptosis, especially in the hippocampus, which is thought to be a region of the brain important in stress-related disorders. We have analyzed gene expression in rat hippocampus comprehensively to clarify the molecular mechanism of stress-related disorders. In the present study, we identified and catalogued 13,660 partial complementary DNA sequences (expressed sequence tags (ESTs)) of randomly selected clones from a cDNA library of rat hippocampus. Sequence analysis showed that these clones cluster into 7173 non-redundant sequences comprising 1794 clusters and 5379 singletons. As a result of nucleotide and peptide database search, 2594 were found to represent known rat sequences. Of the remaining 4579 genes, 599 non-redundant ESTs represent rat homologs of genes identified in other species or new members of structurally related families. In addition, we illustrate the use of these clone sets by constructing a cDNA microarray focused on genes categorized into ""cell/organism defense"". These ESTs and our own microarray thus provide an improved genomic source for molecular studies of animal models of stress-related disorders.",0 +https://doi.org/10.1016/j.jesp.2015.05.003,The way I make you feel: Social exclusion enhances the ability to manage others' emotions,"Abstract Original conceptions of social exclusion focused upon the negative impact of exclusion on intelligent thought (Baumeister, Twenge, & Nuss, 2002). We propose that although exclusion may impair cognitive forms of intelligence, exclusion should enhance more socially relevant forms of intelligence, such as emotional intelligence. Specifically, we examined whether exclusion would enhance performance in one branch of emotional intelligence: the ability to manage others' emotions. Social exclusion heightened the number and breadth of strategies that participants used for managing others' emotions when responding to hypothetical scenarios (Study 1) and when responding to online pen pals (Studies 3 and 4). Furthermore, excluded participants were more effective at energizing an interaction partner in a face-to-face coaching interaction (Study 2) and were rated as more effective at managing their pen pal's emotions in an online pen pal exchange (Studies 3 and 4). Although exclusion heightened the number and breadth of emotion management strategies generated in a social task, exclusion did not heighten the number or breadth of nonsocial strategies (creative uses for common household items) generated in a comparison task (Study 4). Lastly, we found preliminary evidence suggesting that this enhanced emotion management after exclusion may serve to facilitate reconnection; excluded participants were liked more by their interaction partners (Study 2) and were rated to be more likable by objective coders (Studies 3 and 4). Altogether, these findings suggest that individuals may be more effective at managing others' emotions following social exclusion, and this greater effectiveness may promote reconnection.",0 +https://doi.org/10.1016/s0272-7358(03)00033-3,Psychological theories of posttraumatic stress disorder,"We summarize recent research on the psychological processes implicated in posttraumatic stress disorder (PTSD) as an aid to evaluating theoretical models of the disorder. After describing a number of early approaches, including social-cognitive, conditioning, information-processing, and anxious apprehension models of PTSD, the article provides a comparative analysis and evaluation of three recent theories: Foa and Rothbaum's [Foa, E. B. & Rothbaum, B. O. (1998). Treating the trauma of rape: cognitive behavioral therapy for PTSD. New York: Guilford Press] emotional processing theory; Brewin, Dalgleish, and Joseph's [Psychological Review 103 (1996) 670] dual representation theory; Ehlers and Clark's [Behaviour Research and Therapy 38 (2000) 319] cognitive theory. We review empirical evidence relevant to each model and identify promising areas for further research.",0 +https://doi.org/10.1023/a:1007710828777,PTSD scale of the child behavior checklist: Concurrent and discriminant validity with non-clinic-referred sexually abused children,"Several assessment instruments include measures that are purported to assess characteristics of posttraumatic stress disorder (PTSD). Although these measures are used often by researchers and clinicians, few are supported by extensive validity data. The PTSD scale of the Child Behavior Checklist (CBCL) is one that has not yet encountered significant challenges to its validity. We examine the concurrent and discriminant validity of the CBCL-PTSD scale. Participants included 63 non-clinic-referred sexually abused (SA) children, 60 non-SA psychiatric outpatient children, and 61 non-SA, non-clinic-referred schoolchildren. Results revealed questionable concurrent validity for this scale, and suggest poor discriminant validity between SA children and non-SA psychiatric outpatients.",0 +https://doi.org/10.1016/j.schres.2010.02.183,THE METHAMPHETAMINE AND PSYCHOSIS STUDY (MAPS) – INDIVIDUAL PROFILES AND TREATMENT NEEDS,"Background: Multiple studies are investigating the impact of substance abuse on early psychosis. Stimulants such as methamphetamines (MA), while known to precipitate psychosis, are understudied. The prevalence of MA abuse in young individuals showing signs of early psychosis is dramatically high in Western North America, as is the prevalence of psychosis in young MA abusers. MA lifetime use by youth diagnosed with psychosis ranges from 21-33%. Common reasons for drug misuse in first episode clients range from increased pleasure, reduced depression and anxiety, and enhanced social facilitation. Individuals who abuse drugs, particularly stimulants such as MA, tend to have their first hospitalization earlier than non-misusing peers with schizophrenia, present with more severe symptoms, and have more problems in areas of interpersonal relationships, motivation, role functioning and activities. For many people, the substance abuse may precede the onset of the illness, whereas for others MA abuse may coincide with the onset, or even follow the onset of psychosis. Sixty-90% of first episode psychosis youth have abused drugs prior to their first psychiatric contact, suggesting a strong connection between psychosis and substances. Recent studies suggest that MA users with psychosis are much more likely to experience psychotic symptoms again if they use MA, and are also more likely to have a psychotic relapse when confronted with stressful situations, even years after cessation of MA use. MA users with persistent or recurrent psychotic symptoms become vulnerable to stress and may benefit from antipsychotic medication the same way individuals with schizophrenia do. Method: Our study aimed at describing the profiles of individuals with MA abuse and psychotic symptoms. We also wished to determine patterns of abuse and psychotic symptoms over time. 295 participants were interviewed following at least one episode of acute psychotic symptoms linked to MA abuse, and followed with monthly measures of substance abuse and psychiatric symptoms for six months. Results: Most participants lived in transitional housing or were homeless. Only 13% had no family history of mental illness or substance abuse. Close to 70% had a previous diagnosis of a mental illness. Antisocial personality disorder (68%), depression (67%), and post-traumatic stress disorder (49%) were highly prevalent. Risk factors and trajectories of substance abuse and psychotic symptoms will also be presented. Treatment: Integrated dual-disorder treatment, where the mental health team works in collaboration with the substance abuse counsellors, is considered the evidenced-based treatment for individuals presenting with co-occurring substance abuse and severe mental illness. Such treatments include step-wise interventions, often using CBT and motivational interviewing components, and can be found in various settings, including assertive community treatments. However, only some of the difficulties presented by participants in our study are addressed in these programs. Our team is currently working on developing modular programs for people with early psychosis and various concurrent disorders. Some examples of these treatment modules will be presented.",0 +https://doi.org/10.3389/fnins.2012.00195,Social cognition in borderline personality disorder,"Many typical symptoms of borderline personality disorder (BPD) occur within interpersonal contexts, suggesting that BPD is characterized by aberrant social cognition. While research consistently shows that BPD patients have biases in mental state attribution (e.g., evaluate others as malevolent), the research focusing on accuracy in inferring mental states (i.e., cognitive empathy) is less consistent. For complex and ecologically valid tasks in particular, emerging evidence suggests that individuals with BPD have impairments in the attribution of emotions, thoughts, and intentions of others (e.g., Preißler et al., 2010). A history of childhood trauma and co-morbid PTSD seem to be strong additional predictors for cognitive empathy deficits. Together with reduced emotional empathy and aberrant sending of social signals (e.g., expression of mixed and hard-to-read emotions), the deficits in attribution might contribute to behavioral problems in BPD. Given the importance of social cognition on the part of both the sender and the recipient in maintaining interpersonal relationships and therapeutic alliance, these impairments deserve more attention.",0 +https://doi.org/10.5014/ajot.2012.001230,Effects of Sensory-Enhanced Yoga on Symptoms of Combat Stress in Deployed Military Personnel,"Abstract OBJECTIVE. We examined the effects of sensory-enhanced hatha yoga on symptoms of combat stress in deployed military personnel, compared their anxiety and sensory processing with that of stateside civilians, and identified any correlations between the State–Trait Anxiety Inventory scales and the Adolescent/Adult Sensory Profile quadrants. METHOD. Seventy military personnel who were deployed to Iraq participated in a randomized controlled trial. Thirty-five received 3 wk (≥9 sessions) of sensory-enhanced hatha yoga, and 35 did not receive any form of yoga. RESULTS. Sensory-enhanced hatha yoga was effective in reducing state and trait anxiety, despite normal pretest scores. Treatment participants showed significantly greater improvement than control participants on 16 of 18 mental health and quality-of-life factors. We found positive correlations between all test measures except sensory seeking. Sensory seeking was negatively correlated with all measures except low registration, which was insignificant. CONCLUSION. The results support using sensory-enhanced hatha yoga for proactive combat stress management.",0 +https://doi.org/10.1177/1476718x13498336,The role of environmental hazard in mothers’ beliefs about appropriate supervision,"Understanding factors that influence mothers’ beliefs about appropriate levels of supervision for their children may assist in efforts to reduce child injury rates. This study examined the interaction of child (i.e. age, gender, and injury risk behavior) and maternal perception of environmental hazard (i.e. hazard level, injury likelihood, and potential injury severity) variables in predicting mothers’ beliefs about appropriate levels of supervision for their children. Participants were 58 mothers of 2- to 8-year-old community children who were interviewed about their beliefs regarding child injury risk and appropriate supervision. Results indicated that perceived environmental hazard level interacted with child age, gender, and injury risk behavior to predict mothers’ beliefs about supervision. Perceived injury likelihood also interacted with child injury risk behavior to predict beliefs about supervision. Findings underscore the complexity of factors influencing mothers’ beliefs about appropriate supervision and indicate the importance of environmental hazard level in such beliefs.",0 +https://doi.org/10.1111/j.1600-0447.2009.01397.x,Outcome management in in-patient psychiatric care,"To delineate methods and to describe patient appraisal as well as effect of outcome management in in-patient psychiatric care.Two hundred and ninety-four adults with mental illness receiving in-patient treatment at a psychiatric hospital in rural Bavaria gave informed consent to participate in this cluster-randomised trial. Participants were asked to provide information on treatment outcome via weekly computerised standardised assessments. Patients and clinicians in the intervention group received continuous feedback of outcome.Patients were willing and able to regularly provide outcome data and valued feedback. However, use of feedback in conversations between patient and clinician was rare. Outcome management failed to impact on patient-rated outcome during in-patient treatment.Outcome management is feasible in people receiving in-patient psychiatric care, but failed to show an overall short-term effect. Strategies need to be developed to improve active use of routinely collected treatment outcome data in mental health care.",0 +https://doi.org/10.1002/jts.20618,Considering PTSD from the perspective of brain processes: A psychological construction approach,"Posttraumatic stress disorder (PTSD) is a complex psychiatric disorder that involves symptoms from various domains that appear to be produced by the combination of several mechanisms. The authors contend that existing neural accounts fail to provide a viable model that explains the emergence and maintenance of PTSD and the associated heterogeneity in the expression of this disorder (cf. Garfinkel & Liberzon, 2009). They introduce a psychological construction approach as a novel framework to probe the brain basis of PTSD, where distributed networks within the human brain are thought to correspond to the basic psychological ingredients of the mind. The authors posit that it is the combination of these ingredients that produces the heterogeneous symptom clusters in PTSD. Their goal is show that a constructionist approach has significant heuristic value in understanding the emergence and maintenance of PTSD symptoms, and leads to different and perhaps more useful conjectures about the origins and maintenance of the syndrome than the traditional hyperreactive fear account.",0 +https://doi.org/10.1016/j.cpr.2007.01.017,The development and maintenance of post-traumatic stress disorder (PTSD) in civilian adult survivors of war trauma and torture: A review,"This review provides a comprehensive and critical summary of the literature as to the development and maintenance of post-traumatic stress disorder (PTSD) following civilian war trauma and torture. Prevalence rates are reviewed and predictors are discussed in terms of risk factors, protective factors, and factors that maintain PTSD. Most epidemiologically sound studies found relatively low rates of PTSD. There is good evidence of a dose-response relationship between cumulative war trauma and torture and development and maintenance of PTSD. There is also some evidence that female gender and older age are risk factors in development of PTSD. Some refugee variables may exacerbate symptoms of PTSD and contribute to their maintenance. Preparedness for torture, social and family support, and religious beliefs may all be protective against PTSD following war trauma and torture. Applicability of the concept of PTSD to non-western populations and areas for much needed further study are discussed.",0 +https://doi.org/10.1002/jts.21718,Trajectories of PTSD symptoms following sexual assault: Is resilience the modal outcome?,"Theoretical frameworks positing qualitatively distinct trajectories of posttrauma outcome have received initial empirical support, but have not been investigated in cases of severe interpersonal trauma. To address this limitation, we conducted latent class growth analysis with longitudinal data collected from 119 female sexual assault survivors at 1-, 2-, 3-, and 4-months postassault. Participants' mean age was 33 years; 63% were White. We hypothesized that given the severity of exposure associated with sexual assault, resilience would not be the modal course of adaptation. Four distinct PTSD growth trajectories, representing unique latent classes of participants, best fit the data: a high chronic trajectory, a moderate chronic trajectory, a moderate recovery trajectory, and a marked recovery trajectory. Contrary to previous studies and recent theoretical models, resilience and resistance trajectories were not observed, as high levels of distress were evident in nearly all participants at 1-month postassault. These results suggest that theoretical models of posttrauma response positing resilience as the modal outcome may not generalize to cases of sexual assault.",1 +,Diseases among men 20 years after exposure to severe stress: Implications for clinical research and medical care,"OBJECTIVE Epidemiologic studies have linked exposure to severe environmental stress, such as natural disasters and combat operations, to the onset of specific psychiatric disorders. Some research also suggests that these exposures may be associated with the onset of chronic diseases as well. However, these chronic disease outcome studies often have been obscured by bias and confounding. METHOD The medical histories of 1399 male Vietnam veterans approximately 20 years after combat exposure (mean years = 17) were analyzed by lifetime posttraumatic stress disorder (PTSD) status (lifetime PTSD = 332 cases). These men were included in a national, random in-person study of United States Army veterans of the Vietnam War (study completion rate = 65%). RESULTS After controlling for preservice, in-service, and postservice factors (including intelligence, race, region of birth, enlistment status, volunteer status, Army marital status, Army medical profile, hypochondriasis, age, smoking history, substance abuse, education, and income), associations were found for reported circulatory [odds ratio (OR) = 1.62, p = .007], digestive (OR = 1.47, p = .036), musculoskeletal (OR = 1.78, p = .008), endocrine-nutritional-metabolic (OR = 1.58, p = .10), nervous system (OR = 2.47, p < .001), respiratory (OR = 1.54, p = .042), and nonsexually transmitted infectious diseases (OR = 2.14, p < .004) after military service. CONCLUSION Although this study has some limitations, it suggests that there is a direct link between severe stress exposures and a broad spectrum of human diseases. In the future, medical researchers and clinicians should focus more on the medical consequences of exposure to severe environmental stress and seek to better integrate psychobiologic models of disease pathogenesis.",0 +https://doi.org/10.1016/j.jpsychires.2010.11.016,Pretraumatic prolonged elevation of salivary MHPG predicts peritraumatic distress and symptoms of post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) is associated with elevated catecholamines and increased sympathetic arousal. However, it is unknown whether this condition is a pre-existing vulnerability factor for PTSD or an acquired result of either trauma exposure or the development of PTSD symptoms. We sought to examine if salivary 3-methoxy-4-hydroxy-phenylglycol (MHPG) in response to a laboratory stressor prior to critical incident exposure predicts the development of PTSD symptoms and if early childhood trauma influences this relationship. In a prospective cohort study, 349 urban police officers were assessed during academy training (baseline) and 243 were reassessed 12 months after the start of active duty (follow-up). At baseline, participants observed a video consisting of police critical incidents. Salivary MHPG was measured before and immediately after the challenge, and after 20min recovery. At follow-up, peritraumatic distress and PTSD symptoms were assessed in relationship to the worst critical incident during the past year. Participants with childhood trauma showed a trend towards higher MHPG increase to the challenge. Higher MHPG levels after 20min recovery were associated with both higher levels of peritraumatic distress and PTSD symptoms at follow-up. In a path analysis, elevated MHPG levels predicted higher peritraumatic distress which in turn predicted higher levels of PTSD symptoms while the direct effect of elevated MHPG levels on PTSD symptoms was no longer significant. Prolonged elevation of salivary MHPG in response to a laboratory stressor marks a predisposition to experience higher levels of peritraumatic distress and subsequently more PTSD symptoms following critical incident exposure.",0 +https://doi.org/10.1017/s0790966700007333,What is the profile of post-traumatic reactions within medical literature? A survey of eight journals,"Abstract Objectives: The importance of traumatic events is recognised by the public but the profile of psychological sequelae such as Post-traumatic Stress Disorder (PTSD) within psychiatry and medicine is unclear. We aimed to establish the profile of PTSD within high impact medical journals and within psychiatric journals based in America and the United Kingdom, since the initial classification of PTSD in DSM-III in 1980 and, before and after classification of PTSD in ICD-10 in 1992. Method: A survey of all articles on post-traumatic reactions published in eight journals between 1980 and 2000. Results: The proportion of articles on PTSD was less in UK based psychiatric journals than their counterparts based in America. The proportion of articles published after the classification of PTSD in ICD-10 has increased in both psychiatric and medical journals. Conclusions: In UK based journals, there is an under-representation of articles on PTSD compared with disorders of similar prevalence.",0 +https://doi.org/10.1111/j.1939-0025.2012.01171.x,Potential treatment mechanisms of counseling for children in Burundi: A series of n = 1 studies.,"Little is known about the impact and treatment processes of psychosocial counseling in low-income countries. This study aimed to generate hypotheses on key working mechanisms of counseling in Burundi. The authors carried out 11 empirically grounded n=1 studies with children (11-14years) screened for depression and anxiety who received counseling. The authors used quantitative (symptom scales) and qualitative instruments (treatment content and perceptions). Weekly measurements were taken preintervention (4 time points), during the intervention period (8-10 time points), and postintervention (4 time points). Five treatment mechanisms continua appeared associated with outcome trajectories: client centeredness, therapeutic alliance, active problem solving, trauma-focused exposure, and family involvement. Higher levels appeared associated with better outcomes. Contrarily, cases that demonstrated no change were characterized by a heavy focus on counselors' norms, containment and self-control, unstructured retelling and explicit avoidance, advice-oriented problem solving, and noninclusion of family members, respectively. The authors found a distinct clustering of outcome trends per therapist. The findings suggest that integrative counseling, which combines universal therapist variables with active use of specific therapeutic techniques and a systemic perspective, may be an adequate strategy to treat mental health symptoms of children in Burundi.",0 +https://doi.org/10.1176/appi.ajp.160.3.580,Association of Comorbid Posttraumatic Stress Disorder and Major Depression With Greater Risk for Suicidal Behavior,"Posttraumatic stress disorder (PTSD) increases the risk of suicidal behavior; a major depressive episode also increases the risk for suicidal behavior. The authors' goal was to examine the effect of comorbid PTSD and major depressive episode on suicidal behavior.Inpatients with a diagnosis of major depressive episode (N=156) were assessed for PTSD, suicidal behavior, and clinical risk factors for suicidal acts.Patients with comorbid major depressive episode and PTSD were more likely to have attempted suicide, and women with both disorders were more likely to have attempted suicide than men with both disorders. Cluster B personality disorder and PTSD were independently related to history of suicide attempts.The greater rate of suicide attempts among patients with comorbid PTSD and major depressive episode was not due to differences in substance use, childhood abuse, or cluster B personality disorders.",0 +https://doi.org/10.3168/jds.s0022-0302(01)74536-5,An Alternative AI Breeding Protocol for Dairy Cows Exposed to Elevated Ambient Temperatures before or after Calving or Both,"Our objective was to determine if a timed artificial insemination (AI) protocol (Ovsynch) might produce greater pregnancy rates than AI after a synchronized, detected estrus during summer. Lactating Holstein cows (n = 425) were grouped into breeding clusters and then assigned randomly to each of two protocols for AI between 50 and 70 days in milk. All cows were treated with GnRH followed 7 d later by PGF2alpha. Ovsynch cows then were treated with a second injection of GnRH 48 h after PGF2alpha and inseminated 16 to 19 h later. Controls received no further treatment after PGF2alpha and were inseminated after detected estrus. Pregnancy was diagnosed once by transrectal ultrasonography (27 to 30 d after AI) and again by palpation (40 to 50 d). Based on concentrations of progesterone in blood collected before each hormonal injection, only 85.4% of 425 cows were considered to be cycling. Although conception rates were not different between protocols at d 27 to 30, AI submission rates and pregnancy rates were greater after Ovsynch (timed AI) than after detected estrus. A temperature-humidity index > or = 72 was associated with fewer controls detected in estrus with lower conception than for controls detected in estrus when index values were < 72, whereas the reverse was true for cows after the Ovsynch protocol. We concluded that a timed AI protocol increased pregnancy rates at d 27 to 30 because its success was independent of either expression or detection of estrus. However, because of poorer embryonic survival in Ovsynch cows during heat stress only (39.5 vs. 69.2% survival for Ovsynch and control, respectively), pregnancy rates were not different by d 40 to 50 after timed AI.",0 +https://doi.org/10.1097/yco.0b013e32835b57a9,Neurocognitive profiles of people with borderline personality disorder,"This review summarizes recent neurocognitive research to better delineate the nosology, prognostication and cause underlying borderline personality disorder (BPD).BPD had marked clinical heterogeneity with high comorbidity. Executive dysfunction in this disorder was linked to suicidality and treatment adherence, and may serve as an endophenotype. BPD was also characterized by cognitive distortions such as risky decision-making, deficient feedback processing, dichotomous thinking, jumping to conclusion, monocausal attribution and paranoid cognitive style. Social cognition deficits recently described in BPD include altered social inference and emotional empathy, hypermentalization, poorer facial emotional recognition and facial expressions. In electrophysiological studies, BPD was found to have predominantly right hemispheric deficit in high-order cortical inhibition. Reduced left orbitofrontal activity by visual evoked potential and magnetoencephalography correlated with depressive symptoms and functional deterioration. Brain structures implicated in BPD include the hippocampus, dorsolateral prefrontal cortex and anterior cingulate cortex. Abnormal anatomy and functioning of frontolimbic circuitry appear to correlate with cognitive deficits.Frontolimbic structural and functional abnormalities underlie the broad array of cognitive abnormalities in BPD. Further research should espouse broader considerations of effects of comorbidity and clinical heterogeneity, and include community samples and, possibly, longitudinal designs.",0 +https://doi.org/10.4324/9780203846155,"Beginnings, Second Edition","Utilizing a decade’s worth of clinical experience gained since its original publication, Mary Jo Peebles builds and expands upon exquisitely demonstrated therapeutic approaches and strategies in this second edition of Beginnings. The essential question remains the same, however: How does a therapist begin psychotherapy? To address this delicate issue, she takes a thoughtful, step-by-step approach to the substance of those crucial first sessions, delineating both processes and potential pitfalls in such topics as establishing a therapeutic alliance, issues of trust, and history taking. Each chapter is revised and expanded to include the latest treatment research and modalities, liberally illustrated with rich case material, and espouse a commitment to the value of multiple theoretical perspectives. Frank and sophisticated, yet eminently accessible, this second edition will be an invaluable resource for educators, students, and seasoned practitioners of any therapeutic persuasion. © 2012 by Taylor & Francis Group, LLC.",0 +https://doi.org/10.1097/01.pra.0000348366.34419.28,Interpersonal Factors in Understanding and Treating Posttraumatic Stress Disorder,"Exposure to reminders of trauma underlies the theory and practice of most treatments for post-traumatic stress disorder (PTSD), yet exposure may not be the sole important treatment mechanism. Interpersonal features of PTSD influence its onset, chronicity, and possibly its treatment. The authors review interpersonal factors in PTSD, including the critical but underrecognized role of social support as both protective posttrauma and as a mechanism of recovery. They discuss interpersonal psychotherapy (IPT) as an alternative treatment for PTSD and present encouraging findings from two initial studies. Highlighting the potential importance of attachment and interpersonal relationships, the authors propose a mechanism to explain why improving relationships may ameliorate PTSD symptoms.",0 +https://doi.org/10.1207/s15327752jpa5201_2,The Multidimensional Scale of Perceived Social Support,"The development of a self-report measure of subjectively assessed social support, the Multidimensional Scale of Perceived Social Support (MSPSS), is described. Subjects included 136 female and 139 male university undergraduates. Three subscales, each addressing a different source of support, were identified and found to have strong factorial validity: (a) Family, (b) Friends, and (c) Significant Other. In addition, the research demonstrated that the MSPSS has good internal and test-retest reliability as well as moderate construct validity. As predicted, high levels of perceived social support were associated with low levels of depression and anxiety symptomatology as measured by the Hopkins Symptom Checklist. Gender differences with respect to the MSPSS are also presented. The value of the MSPSS as a research instrument is discussed, along with implications for future research.",0 +https://doi.org/10.1007/s10862-014-9477-3,Emotion Regulation Strategy Use and Posttraumatic Stress Disorder: Associations Between Multiple Strategies and Specific Symptom Clusters,"A growing literature suggests that emotion regulation (ER) is associated with posttraumatic stress disorder (PTSD). However, most of the studies in this literature have one or more important limitations, including examining only a single ER strategy (e.g., thought suppression) rather than multiple strategies simultaneously, examining PTSD at the syndrome level rather than by symptom cluster, and failing to control for negative affect. The present study sought to address these limitations by using latent variable modeling to examine the associations between multiple ER strategies and individual PTSD symptom clusters while controlling for negative affect. Of the four measurement models of ER strategy use examined, the best-fitting model allowed items corresponding to each included strategy to load onto their independent factors. Of the four measurement models of PTSD symptoms examined, the best-fitting model was the five-factor dysphoric arousal model. Results of structural models indicated that thought suppression and experiential avoidance were associated with most PTSD symptom clusters, even after controlling for negative affect. However, most other included ER strategies were not associated with any symptom clusters. A number of issues regarding measurement of ER and PTSD are discussed, and several suggestions for future research are provided.",0 +https://doi.org/10.1016/j.beth.2011.09.002,Relationship Distress in Partners of Combat Veterans: The Role of Partners’ Perceptions of Posttraumatic Stress Symptoms,"Partners of combat veterans with posttraumatic stress disorder report elevated relationship and psychological distress, but little is known about the mechanisms by which such distress develops. In two separate samples, we examined partners' perceptions of veterans' PTSD symptoms, with a specific focus on the simultaneous associations of partners' distress with their perceptions of veterans' reexperiencing, withdrawal/numbing, and hyperarousal symptom clusters. The first sample consisted of 258 partners of Operation Enduring- and Iraqi Freedom-era veterans who completed questionnaires. The second sample consisted of 465 partners of Vietnam-era veterans who completed interviews as part of the National Vietnam Veterans Readjustment Study. In both samples, path analyses revealed that, when examined simultaneously, partners' perceptions of withdrawal/numbing symptoms were associated with greater distress, but perceptions of reexperiencing symptoms were unrelated to psychological distress and significantly associated with lower levels of relationship distress. Given the cross-sectional nature of the data in both samples, there are multiple plausible interpretations of the results. However, the pattern is consistent with an attributional model of partner distress, whereby partners are less distressed when symptoms are more overtly related to an uncontrollable mental illness. Potential clinical implications are discussed.",0 +https://doi.org/10.1016/j.janxdis.2010.06.020,Posttraumatic stress symptom clusters associations with psychopathology and functional impairment,"We examined posttraumatic stress symptom clusters associations with psychopathology and functional impairment in 899 Norwegian survivors of the 2004 South-East Asia tsunami six months post-disaster. Posttraumatic stress symptoms were assessed with the Impact of Event Scale-Revised (IES-R) with intrusion, avoidance, and hyper-arousal subscales. For criterion variables, we used 10 indicators of psychopathology and functional impairment, e.g. having mental health problems, seeing mental health professionals, and use of medication or sick leave. Hyper-arousal had stronger correlations than avoidance with all criterion variables (p values<0.001) and stronger correlations than intrusion with seven of the 10 criterion variables (p values<0.01). Also, intrusion had stronger correlations than avoidance with seven of 10 criterion variables (p values<0.05). Thus, our findings indicate that symptoms of hyper-arousal may be more closely linked to psychopathology and functional impairment than other symptoms of posttraumatic stress following a sudden onset, short duration, natural disaster event.",0 +https://doi.org/10.1017/s1461145700001899,Open trial of citalopram in adults with post-traumatic stress disorder,"The selective serotonin reuptake inhibitors (SSRIs) are rapidly emerging as preferred first-line drugs in the pharmacological management of post-traumatic stress disorder (PTSD). Citalopram, an SSRI with highly potent and selective serotonin reuptake inhibition, may be a useful agent for treating the intrusive, avoidance, and arousal symptoms that characterize PTSD. Fourteen adult subjects (12 with civilian-related post-traumatic stress disorder, and 2 with combat-related post-traumatic stress disorder) were entered into an 8 wk, open- label, fixed-dose trial of citalopram, commencing with 20 mg/d, and increasing to 40 mg/d after 2 wk. Eleven subjects completed 8 wk treatment and were included in the data analysis. Based on the Clinician-Administered Post-traumatic Stress Disorder Scale (CAPS-2), there was significant reduction in all core PTSD symptoms (re-experiencing, hyperarousal, and avoidance) by week 8. Nine of the 11 completers were classified as 'responders' on Clinical Global Impression Improvement scores. Secondary measures of depression (Montgomery-Asberg Depression Rating Scale) and anxiety (Hamilton Anxiety Scale) also improved significantly by week 8. Citalopram was tolerated well, and there were no dropouts due to adverse effects. Data from this preliminary open trial suggests that citalopram, an SSRI, may be effective for reducing the key symptoms of PTSD, however, these findings need confirmation in double-blind, placebo-controlled trials.",0 +,No evidence of sleep disturbance in post-traumatic stress disorder: a polysomnographic study in injured victims of traffic accidents.,"Disturbed sleep is a common complaint among patients with PTSD. This complaint can be found in both the reexperiencing and hyperarousal symptom clusters in the DSM-IV. However, laboratory studies of sleep in PTSD have provided inconsistent evidence of objective sleep disturbances. Shortened REM latency, reduced sleep efficiency, restless sleep and increased prevalence of sleep apnea have been reported, but were not confirmed by all. A major shortcoming of most previous studies is the fact that they were done retrospectively in patients with chronic PTSD, often complicated by psychiatric comorbidity and drug abuse. Thus, little is known about the development of sleep disturbances in recently traumatized subjects.Eight injured victims of traffic accidents with PTSD and 6 injured victims without PTSD participated in a 3-night polysomnographic study one year after the accident.No significant differences between PTSD and non-PTSD patients were noted on any of the PSG measures. In addition, the two groups did not differ significantly from each other with respect to awakening thresholds during REM sleep.Considering that the present sample was free of active psychiatric comorbidity at the time of trauma and free of hypnotic medications, these results strengthen previous PSG studies suggesting that altered sleep perception, rather than sleep disturbance per se, may be the key problem in PTSD. More research is needed in order to examine whether this problem is specific to sleep or generalizes to other domains as well.",0 +https://doi.org/10.1007/bf02548422,Prosocial coping by youth exposed to violence,"Chronic exposure to violence encourages youth to cope with challenges via a mixture of asocial, depressive and antisocial, aggressive tactics rather than prosocially in ways that benefit self without harming others. Youth exposed to violence are, therefore, not only at high risk for posttraumatic stress disorder (PTSD) but also for externalizing and internalizing behavior problems, school dropout, teen pregnancy, substance abuse, and delinquency. Despite violence exposure, high-risk youth may cope prosocially with controllable and uncontrollable life challenges if supported at school by a prosocial coping-skills program (PCS) that takes place each week for 45 minutes in small groups (6-8, members) with equal numbers of members skilled (competent) and less skilled (high-risk) at prosocial coping. Each PCS session: begins with information exchange among members about feelings, thoughts, and experiences; is structured by group rules that promote prosocial coping during sessions; includes activities that assess and rehearse prosocial coping with real-life emotional, social, and achievement challenges; is data driven and tailored to members' diverse skill levels. PCS may enable school-based prevention of behavior problems and adverse life outcomes from first grade through high school. © 1994 Human Sciences Press, Inc.",0 +https://doi.org/10.1016/s0924-9338(09)70479-1,Psychiatric Comorbidity and PTSD in Addicted Prostitutes,"In the city of Rotterdam prostitution used to take place not only in sexclubs but also in and around a designated prostitution street-zone in the harbor area outside the city center. The group of sexworkers at this street-zone consisted primarily of severely addicted women. For a long period of time the harm reduction approach had been the major intervention for this socially marginalized group of women. From January 2003 to December 2004 184 of them could be interviewed and diagnosed according to DSM IV. Nearly all of them were addicted to heroin and cocaine and most of them also were dependent on alcohol and benzodiazepines. Psychiatric comorbidity was almost 100 %. Co-morbid conditions existed of cluster B and C personality disorders, psychotic disorders (26 %), affective disorders (31 %), acute PTSD (9 %) and adult-ADHD (8%). In 2006 the government had closed the prostitution street-zone and many of the women could be placed in therapeutic and protected homes. Now, 2 years later, we reinvestigate these women with respect to their actual social situation, their quality of life, psychiatric comorbidity and persisting (acute and chronic) PTSD. During the interviews we use the WHO Quality of life questionnaire and the KIP (clinical interview for PTSD). It is an ongoing study and the (preliminary) results will be presented during the symposium.",0 +https://doi.org/10.1192/pb.bp.105.008664,Treating post-traumatic stress disorder in the ‘real world’: evaluation of a specialist trauma service and adaptations to standard treatment approaches,"Aims and Method To evaluate the effectiveness of treatment at the Traumatic Stress Service (TSS) by comparing pre- and post-treatment scores on patient self-report measures. Through a questionnaire survey, to explore therapists' views of problems presenting in addition to post-traumatic stress disorder (PTSD) and how, as a result, they adapted their approach to trauma work. Results Therapists reported that their patients present with a range of complex problems, and self-report measures show that patients suffer particularly high levels of psychopathology. Therapists identified a number of adaptations to trauma-focused work to deal with these additional problems. Of the 112 patients who completed therapy, 43% filled in pre- and post-treatment questionnaire measures. Analysis showed clinically and statistically significant improvements in levels of PTSD, depression and social functioning. Clinical Implications The typical presentation of trauma survivors is often not ‘simple’ PTSD, but PTSD resulting from chronic and multiple traumas and complicated by additional psychological and social difficulties. Adaptations to trauma-focused work can successfully treat such ‘complex’ PTSD.",0 +https://doi.org/10.1016/j.comppsych.2012.12.010,Prevalence and risk factors of post-traumatic stress disorder among adult survivors six months after the Wenchuan earthquake,"Exposure to earthquake has been associated with psychological distress, in particular, the development of posttraumatic stress disorder (PTSD). The aims of this study were to estimate the prevalence of PTSD, explore the associated risk factors among adult survivors 6 months after the Wenchuan earthquake in China, and compare the findings in our study to other studies about the Wenchuan earthquake and other earthquakes that occurred in the past. Multistage stratified random sampling methods were conducted in three severely affected areas in the Wenchuan earthquake. In this study, 14,798 individuals were identified with simple random selection methods at the sampling sites, 14,207 individuals were screened with the 12-item General Health Questionnaire(GHQ-12), and 3692 individuals were administered a Chinese version of the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV axis I disorders (SCID-I/P) by 180 psychiatrists. The prevalence of PTSD was 15.57%. The risk factors for PTSD included old age, female gender, living alone, buried in the earthquake, injured in the earthquake, operated on after the earthquake, witnessing someone get injured in the earthquake, witnessing someone get buried in the earthquake, witnessing someone die in the earthquake (P < 0.05, 95% CI). PTSD is common after a major disaster. Risk factors help people to identify the potential victims after disasters in time. Post-disaster mental health recovery interventions include early identification, sustained psychosocial support, governmental programs that provide social and economic support.",0 +https://doi.org/10.1037/a0032607,Perceived military organizational support and peacekeeper distress: A longitudinal investigation.,"Many professions vital to the safety of society require workers to face high magnitude and potentially traumatizing events. Because this routine exposure can cause high levels of stress in workers, it is important to investigate factors that contribute to both risk of posttraumatic stress disorder (PTSD), and healthy responses to stress. Although some research has found social support to mitigate the effects of posttraumatic stress symptoms, scant research has investigated organizational support. The aim of the present study is to investigate the temporal relationship between stress symptoms and perceived organizational support in a sample of 1,039 service members deployed to the peacekeeping mission to Kosovo. Participants completed self-report measures of stress symptoms and perceived organizational support at 4 study time points. Bivariate latent difference score structural equation modeling was utilized to examine the temporal relationship among stress and perceived organizational support. In general, across the 4 time points, latent PCL scores evidenced a salient and negative relationship to subsequent POS latent difference scores. However, no significant relationship was found between latent POS variables and subsequent PCL latent difference scores. Findings suggest that prior stress symptoms are influencing service member's perceptions of the supportiveness of their organization such that increased prior stress is associated with worsening perceptions of support. These results illustrate that targeting stress directly may potentiate the positive influence of organizational support and that institutional support programs should be adapted to better account for the negative biases increased distress may encourage.",0 +https://doi.org/10.1016/j.amj.2011.04.005,Air Medical Evacuations from a Developing World Conflict Zone,"Somalia has been without effective government for close to two decades, with more than 1 million people internally displaced. The political unrest persists, with United Nations–backed African Union peacekeeping forces supporting the Transitional National government of Sharif Ahmed, struggling to maintain control of central Mogadishu from Islamist extremist groups, such as the reportedly Al-Qaeda–backed Al-Shabab. The African Union force of 5,000 troops is predominantly of Ugandan and Burundian origin, making up the African Mission in Somalia (AMISOM) effort. However, its mandate is limited to operations only in Mogadishu, and it is unauthorized to actively pursue insurgents. As with other ongoing high-profile conflicts, African Union troops face an enemy that blends into the civilian populace, fighting with a lethal mixture of improvised explosive devices and suicide bombers.",0 +https://doi.org/10.1093/jpepsy/jsq115,Predicting Posttraumatic Stress Following Pediatric Injury: A Systematic Review,"To review the recent empirical literature concerning development of posttraumatic stress symptoms following pediatric injury and summarize risk and predictive factors that will inform clinical practice and research.A systematic search of online databases such as PsycInfo, PILOTS, MedLine, and PubMed was performed. Further studies were identified through the reference lists of selected articles.Pre-injury psychological problems, the child's subjective experience of trauma severity/life threat, elevated heart rate immediately following the trauma, beliefs regarding initial symptoms, active thought suppression, and parental posttraumatic stress appear to be consistent predictors of persisting posttraumatic stress in children following injury.Specific variables may be useful in predicting posttraumatic stress following injury, which are discussed in terms of existing models of pediatric traumatic stress. Methodologies of included studies are also discussed.",0 +https://doi.org/10.1080/02699931.2013.879052,Overgeneral autobiographical memory predicts changes in depression in a community sample,"This study investigated whether overgeneral autobiographical memory (OGM) predicts the course of symptoms of depression and anxiety in a community sample, after 5, 6, 12 and 18 months. Participants (N=156) completed the Autobiographical Memory Test and the Depression Anxiety Stress Scales-21 (DASS-21) at baseline and were subsequently reassessed using the DASS-21 at four time points over a period of 18 months. Using latent growth curve modelling, we found that OGM was associated with a linear increase in depression. We were unable to detect changes over time in anxiety. OGM may be an important marker to identify people at risk for depression in the future, but more research is needed with anxiety.",0 +https://doi.org/10.1186/s12885-015-1815-7,Ambulatory Medical Assistance - After Cancer (AMA-AC): A model for an early trajectory survivorship survey of lymphoma patients treated with anthracycline-based chemotherapy,"Cancer survivorship has emerged as an important aspect of oncology due to the possibility of physical and psychosocial complications. The purpose of this study was to assess the feasibility of the Ambulatory Medical Assistance for After Cancer (AMA-AC) procedure for monitoring lymphoma survivorship during the first year after chemotherapy.AMA-AC is based on systematic general practitioner (GP) consultations and telephone interventions conducted by a nurse coordinator (NC) affiliated to the oncology unit, while an oncologist acts only on demand. Patients are regularly monitored for physical, psychological and social events, as well as their health-related quality of life (HRQoL). Inclusion criteria were patients newly diagnosed with non-Hodgkin or Hodgkin lymphomas, who had been treated with anthracycline-based chemotherapy and were in complete remission after treatment.All 115 patients and 113 collaborating GPs agreed to participate in the study. For patients who achieved one year of disease-free survival (n = 104) their assessments (438 in total) were fully completed. Eleven were excluded from analysis (9 relapses and 2 deaths). The most frequent complications when taking into account all grades were arthralgia (64.3%) and infections (41.7%). About one third of patients developed new diseases with cardiovascular complications as the most common. Psychological disorders such as anxiety, depression and post-traumatic stress disorder were diagnosed in 42.6% of patients. The data collected showed that Hodgkin lymphoma patients, females, and patients with lower HRQoL (mental component) at study entry were at greater risk for developing at least one psychological disorder.This study showed that AMA-AC is a feasible and efficient procedure for monitoring lymphoma survivorship in terms of GP and patient participation rates and adherence, and provides a high quality of operable data. Hence, the AMA-AC procedure may be transferable into clinical daily practice as an alternative to standard oncologist-based follow-up.",0 +https://doi.org/10.1007/s11136-013-0546-y,A cross-sectional study of psychological complaints and quality of life in severely injured patients,"PurposeThe purpose of this study was to examine the incidence of psychological complaints and the relationship of these complaints with the quality of life (QOL) and accident- and patient-related factors among severely injured patients after the rehabilitation phase.MethodsPatients of 18 years or older with an injury severity score above 15 were included 15–53 months after their accident. Accident and patient characteristics were obtained from questionnaires and the trauma registry. Several questionnaires (Hospital Anxiety and Depression Scale, Impact of Events Scale, and Cognitive Failure Questionnaire) were used to determine the symptoms of psychological problems (anxiety or depression, post-traumatic stress disorder, or subjective cognitive complaints, respectively). The World Health Organization Quality of Life-Bref was used to determine QOL. A reference group of the Dutch general population was used for comparison of QOL scores.ResultsThe participation rate was 62 % (n = 173). At the time of the study, 30.1 % (n = 52) of the investigated patients had psychological complaints. No relation between psychological complaints and somatic severity or type of injury was found. Patients who were employed before the accident or resumed working reported less psychological complaints. Use of any medication before the accident and treatment for pre-accidental psychological problems were positively related to psychological complaints afterwards. QOL of severely injured patients was impaired in comparison with the general Dutch population, but only for those with psychological complaints.ConclusionsPsychological complaints seem to be an important and underestimated factor for a decreased QOL among severely injured patients.",0 +https://doi.org/10.1037/0022-006x.72.2.155,Up Close and Personal: Temporal Variability in the Drinking of Individual College Students During Their First Year.,"Surveys have documented excessive drinking among college students and tracked annual changes in consumption over time. This study extended previous work by examining drinking changes during the freshman year, using latent growth curve (LGC) analysis to model individual change, and relating risk factors for heavy drinking to growth factors in the model. Retrospective monthly assessments of daily drinking were used to generate weekly estimates. Drinking varied considerably by week, apparently as a function of academic requirements and holidays. A 4-factor LGC model adequately fit the data. In univariate analyses, gender, race/ethnicity, alcohol expectancies, sensation seeking, residence, and data completeness predicted growth factors (ps <.05); gender, expectancies, residence, and data completeness remained significant when covariates were tested simultaneously. Substantive, methodological, and policy implications are discussed.",0 +https://doi.org/10.1016/j.jpsychires.2015.07.017,Trajectories of depression following spousal and child bereavement: A comparison of the heterogeneity in outcomes,"Our understanding of how individuals react to the loss of a close loved one comes largely from studies of spousal bereavement. The extent to which findings are relevant to other bereavements is uncertain. A major methodological limitation of current studies has been a reliance on retrospective reporting of functioning and use of samples of individuals who have self-selected for participant in grief research. To address these limitations, in the current study we applied Latent Growth Mixture Modelling (LGMM) in a prospective population-based sample to identify trajectories of depression following spousal and child bereavement in later life. The sample consisted of 2512 individual bereaved adults who were assessed once before and three times after their loss. Four discrete trajectories were identified: Resilience (little or no depression; 68.2%), Chronic Grief (an onset of depression following loss; 13.2%), Depressed-Improved (high pre-loss depression that decreased following loss; 11.2%), and Pre-existing Chronic Depression (high depression at all assessments; 7.4%). These trajectories were present for both child and spousal loss. There was some evidence that child loss in later life was associated more strongly with the Chronic Grief trajectory and less strongly with the Resilience trajectory. However these differences disappeared when covariates were included in the model. Limitations of the analyses are discussed. These findings increase our understanding of the variety of outcomes following bereavement and underscore the importance of using prospective designs to map heterogeneity of response outcomes.",0 +https://doi.org/10.2486/indhealth.2012-0108,Critical Body Temperature Profile as Indicator of Heat Stress Vulnerability,"Extreme climatic heat is a major health concern among workers in different occupational pursuits. People in the regions of western India confront frequent heat emergencies, with great risk of mortality and morbidity. Taking account of informal occupational groups (foundry and sheet metal, FSM, N=587; ceramic and pottery, CP, N=426; stone quarry, SQ, N=934) in different seasons, the study examined the body temperature profiling as indicator of vulnerability to environmental warmth. About 3/4th of 1947 workers had habitual exposure at 30.1-35.5°C WBGT and ~10% of them were exposed to 38.2-41.6°C WBGT. The responses of FSM, CP and SQ workers indicated prevailing high heat load during summer and post-monsoon months. Local skin temperatures (T(sk)) varied significantly in different seasons, with consistently high level in summer, followed by post-monsoon and winter months. The mean difference of T(cr) and T(sk) was ~5.2°C up to 26.7°C WBGT, and ~2.5°C beyond 30°C WBGT. Nearly 90% of the workers had T(cr) within 38°C, suggesting their self-adjustment strategy in pacing work and regulating T(cr). In extreme heat, the limit of peripheral adjustability (35-36°C T(sk)) and the narrowing down of the difference between T(cr) and T(sk) might indicate the limit of one's ability to withstand heat exposure.",0 +https://doi.org/10.1016/j.janxdis.2010.02.011,Evaluation of the Atypical Response scale of the Trauma Symptom Inventory-2 in detecting simulated posttraumatic stress disorder,"This investigation evaluated the Atypical Response (ATR) scale of the Trauma Symptom Inventory - 2nd edition (TSI-2) in terms of its ability to distinguish genuine symptoms of posttraumatic stress disorder (PTSD) from simulated PTSD. Seventy-five undergraduate students were trained to simulate PTSD and were given monetary incentives to do so. Their responses on the PTSD Checklist (PCL), TSI-2 ATR, and Personality Assessment Inventory (PAI) validity scales were compared to responses of 49 undergraduate students with genuine symptoms of PTSD instructed to respond honestly on testing. Results indicate that the revised version of the ATR is superior to the original version in detecting malingered PTSD. Discriminant Function Analyses revealed correct classification of 75% of genuinely distressed individuals and 74% of PTSD simulators.",0 +https://doi.org/10.1097/00008877-200509000-00005,A role for cannabinoid CB1 receptors in mood and anxiety disorders,"Mood and anxiety disorders, the most prevalent of the psychiatric disorders, cause immeasurable suffering worldwide. Despite impressive advances in pharmacological therapies, improvements in efficacy and side-effect profiles are needed. The present literature review examines the role that the endocannabinoid system may play in these disorders and the potential value of targeting this system in the search for novel and improved medications. Cannabis and its major psychoactive component (-)-trans-delta9-tetrahydrocannabinol, have profound effects on mood and can modulate anxiety and mood states. Cannabinoid receptors and other protein targets in the central nervous system (CNS) that modulate endocannabinoid function have been described. The discovery of selective modulators of some of these sites that increase or decrease endocannabinoid neurotransmission, primarily through the most prominent of the cannabinoid receptors in the CNS, the CB1 receptors, combined with transgenic mouse technology, has enabled detailed investigations into the role of these CNS sites in the regulation of mood and anxiety states. Although data point to the involvement of the endocannabinoid system in anxiety states, the pharmacological evidence seems contradictory: both anxiolytic- and anxiogenic-like effects have been reported with both endocannabinoid neurotransmission enhancers and blockers. Due to advances in the development of selective compounds directed at the CB1 receptors, significant progress has been made on this target. Recent biochemical and behavioural findings have demonstrated that blockade of CB1 receptors engenders antidepressant-like neurochemical changes (increases in extracellular levels of monoamines in cortical but not subcortical brain regions) and behavioural effects consistent with antidepressant/antistress activity in rodents.",0 +https://doi.org/10.1037/ort0000076,Differential accounts of refugee and resettlement experiences in youth with high and low levels of posttraumatic stress disorder (PTSD) symptomatology: A mixed-methods investigation.,"In recent years there has been increased debate and critique of the focus on psychopathology in general, and posttraumatic stress disorder (PTSD) in particular, as a predominant consequence of the refugee experience. This study was conducted to broaden the conceptualization and examination of the outcomes of the refugee experience by jointly examining how adaptive processes, psychosocial factors, and psychopathology are implicated. A mixed-methods approach was used to specifically examine whether adolescents' (N = 10) accounts of their refugee and resettlement experiences differed according to their level, ""high"" or ""low,"" of PTSD symptomatology. The superordinate themes of cultural belongingness and identification, psychological functioning, family unit functioning and relationships, and friendships and interpersonal processes, were identified as having particular relevance for the study's participants and in distinguishing between participants with high and low levels of PTSD symptomatology. Findings were characterized by marked differences between adolescents' accounts according to their symptomatology levels, and may thereby inform important avenues for future research as well as clinical prevention and intervention programs with refugee youth.",0 +https://doi.org/10.1007/s10862-012-9280-y,An Examination of the Latent Structure of the Difficulties in Emotion Regulation Scale,"The Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer, Journal of Psychopathology and Behavioral Assessment 26:41-54, 2004) is a popular multidimensional self-report measure of emotion regulation. The present study sought to examine the latent factor structure of the DERS. An examination of latent factor intercorrelations and a higher-order confirmatory factor analysis (CFA) suggested that the DERS-AWARENESS dimension may not represent the same higher-order emotion regulation construct as the other five DERS dimensions. Furthermore, findings supported the adequacy of a revised five-factor model of the DERS in which the AWARENESS dimension was removed. This revised DERS total scale did not diminish concurrent relations between the DERS and outcomes relevant to the emotion regulation domain (i.e., depression, anxiety, posttraumatic stress symptoms). Implications for the conceptualization and assessment of emotion regulation are discussed. © Springer Science+Business Media, LLC 2012.",0 +https://doi.org/10.1023/a:1024413918346,"Mental health, social functioning, and feelings of hatred and revenge of Kosovar Albanians one year after the war in Kosovo","A cross-sectional cluster sample survey was conducted in June 2000 in Kosovo to assess the prevalence of mental health problems associated with traumatic experiences, feelings of hatred and revenge, and the level of social functioning among Kosovar Albanians approximately 1 year after the end of the war. Findings of the second cross-sectional survey were compared with those from our 1999 mental health survey in Kosovo. Included in the survey were 1399 Kosovar Albanians aged 15 years or older living in 593 randomly selected households across Kosovo. Twenty-five percent of respondents reported PTSD symptoms, compared with 17.1% in 1999. The MOS-20 social functioning score improved to 69.8 from 29.5 in 1999. In the 2000 survey 54% of men felt hatred toward the Serbs, compared with 88.7% in 1999.",0 +,An examination of a two-factor model of rumination and its impact on the relationship between posttraumatic growth and Posttraumatic Stress Disorder (PTSD),"Research indicates that over half the US population will experience a trauma at some point during their lifetime (Kessler et al., 1995). Following traumatic events, individuals frequently experience a range of intrusion, avoidance, and arousal symptoms that fall on a continuum and can occur with such frequency and intensity that they meet the criteria for Posttraumatic Stress Disorder (PTSD; American Psychiatric Association, 2001). However, though many people experience traumas, only a small percentage develop PTSD. Research shows that many trauma survivors actually report benefit finding, or posttraumatic growth, after trauma. Currently, there is no clear understanding of the relationship between PTSD symptoms and posttraumatic growth. The current study hypothesized that two very different types of cognitive processing - reflection and brooding - would moderate the relationship between PTSD symptoms and posttraumatic growth, with reflection strengthening the relationship (making it more positive), and brooding weakening the relationship. 270 University undergraduate students completed self-report questionnaires asking about their trauma history, PTSD symptoms, their use of reflection and brooding, and their perceptions of posttraumatic growth. Although reflection and brooding both moderated the relationship between PTSD symptoms and posttraumatic growth, both had the same antagonistic effects, switching the relationship between PTSD symptoms and posttraumatic growth from positive to negative. The current study concludes that: (1) Future studies should investigate the role of third variables in attempting to understand the relationship between PTSD symptoms and posttraumatic growth; (2) Cognitive processing variables appear to be excellent sources of information in this relationship; (3) Brooding and reflection may represent one way to investigate distinctions between adaptive and maladaptive forms of cognitive processing after trauma, if measurement tools are improved. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1007/s11682-015-9402-8,Subgroups of US IRAQ and Afghanistan veterans: associations with traumatic brain injury and mental health conditions,"U. S. veterans of Iraq and Afghanistan are known to have a high prevalence of traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), and depression, which are often comorbid and share many symptoms. Attempts to describe this cohort by single diagnoses have limited our understanding of the complex nature of this population. The objective of this study was to identify subgroups of Iraq and Afghanistan veterans (IAVs) with distinct compositions of symptoms associated with TBI, PTSD, and depression. Our cross-sectional, observational study included 303,716 IAVs who received care in the Veterans Health Administration in 2010-2011. Symptoms and conditions were defined using International Classification of Diseases, Ninth Revision codes and symptom-clusters were identified using latent class analysis. We identified seven classes with distinct symptom compositions. One class had low probability of any condition and low health care utilization (HCU) (48 %). Other classes were characterized by high probabilities of mental health comorbidities (14 %); chronic pain and sleep disturbance (20 %); headaches and memory problems (6 %); and auditory problems (2.5 %). Another class had mental health comorbidities and chronic pain (7 %), and the last had high probabilities of most symptoms examined (3 %). These last two classes had the highest likelihood of TBI, PTSD, and depression and were identified as high healthcare utilizers. There are subgroups of IAVs with distinct clusters of symptom that are meaningfully associated with TBI, PTSD, depression, and HCU. Additional studies examining these veteran subgroups could improve our understanding of this complex comorbid patient population.",0 +https://doi.org/10.1016/s0735-1097(10)61657-9,POSTTRAUMATIC STRESS DISORDER IS ASSOCIATED WITH HIGHER C-REACTIVE PROTEIN LEVELS,"Background: Posttraumatic stress disorder (PTSD) has been linked to cardiovascular disease. Increased inflammation, through disruption of neuroendocrine systems, could be implicated, but limited data are available on the link between PTSD and inflammation. In a twin study of military veterans we tested the hypothesis that twins with PTSD had higher plasma levels of inflammatory biomarkers than their twin brothers without PTSD after adjusting for cardiovascular and behavioral factors. Methods: We examined 510 monozygotic and dizygotic middle-aged male twins (255 pairs), mean age 55 yr (range 47-61) from the Vietnam Era Twin Registry. PTSD and other psychiatric diagnoses were assessed with the Structured Clinical Interview for DSM-IV. Plasma levels of C-reactive protein (CRP) and interleukin-6 (IL-6), and cardiovascular risk factors were measured. Analyses were conducted on log-transformed biomarker data using mixed effects regression to account for pair cluster and to separate between- and within-pair effects. Results: Of 510 twins, 69 had a lifetime diagnosis of PTSD and 35 had current PTSD. PTSD was associated with increasing CRP levels. Mean CRP levels were lowest in twins with no diagnosis of PTSD (2.5 mg/L) and highest in those with current PTSD (5.1 mg/L); those with lifetime, but no current PTSD, had a intermediate mean CRP level (3.7 mg/L) (p=0.005). Differences were attenuated but remained significant (p=0.02) after adjustment for traditional CVD risk factors, BMI, previous CVD, major depression, and history of substance abuse. Within 29 pairs discordant for current PTSD, after adjusting for the same factors, the twins with current PTSD had 69% higher CRP than their brother without PTSD (p=0.02). Results did not differ significantly by zygosity. There were no differences in IL-6 levels based on PTSD status. Conclusion: PTSD, particularly a current episode, is associated with elevated CRP. Enhanced inflammation may be a mechanism for increased risk of somatic disorders, including CVD, in persons with PTSD.",0 +https://doi.org/10.1210/jc.2003-031373,Acute Stress Masking the Biochemical Phenotype of Partial Androgen Insensitivity Syndrome in a Patient with a Novel Mutation in the Androgen Receptor,"Hypogonadism has traditionally been classified as either hypogonadotropic or hypergonadotropic based on serum gonadotropin levels. However, when hypothalamic suppression of GnRH secretion occurs, it can mask an underlying hypergonadotropic state. In this report we document the unusual case of a 61-yr-old man with androgen insensitivity and coincidental functional hypogonadotropic hypogonadism (HH). Although functional HH is not a well-recognized entity in the male, major stress has been reported to cause transient suppression of the hypothalamic-pituitary-gonadal axis in men. The patient in question was noted to have undervirilization, minimal pubertal development, hypogonadal testosterone, and low gonadotropin levels consistent with congenital HH during a hospital admission for myocardial infarction. However, the patient had also had surgery for hypospadias, a clinical feature not typically part of the phenotypic spectrum of congenital HH. We therefore hypothesized that the combination of acute stress and chronic glucocorticoid administration for temporal arteritis induced transient HH in a patient with a disorder of sexual differentiation in whom gonadotropin levels would have otherwise been elevated. Using clinical, molecular, and genetic studies, the patient was found to have partial androgen insensitivity syndrome (PAIS) caused by a novel mutation (Ser(740)Cys) in the ligand-binding domain of the androgen receptor. Subsequent studies of the patient confirmed the characteristic gonadotropin and sex steroid abnormalities of PAIS. We describe for the first time a patient with PAIS presenting with a reversible hypogonadotropic biochemical profile triggered by an acute illness and corticosteroid therapy. This case highlights the necessity for caution when interpreting gonadotropin levels during acute stress.",0 +https://doi.org/10.1093/oxfordhb/9780195399066.013.0014,Information Processing in Posttraumatic Stress Disorder,"Abstract The chapter reviews the contribution of information processing models to understanding the development and maintenance of posttraumatic stress disorder. Individual differences in cognitive processing during the trauma and basic memory mechanism, such as priming and associative learning, may help explain why people with PTSD involuntarily re-experience parts of the trauma in a wide range of situations. Individual differences in how people remember traumatic events may influence the likelihood of developing PTSD. Attentional bias to trauma-related cues and threatening interpretations of the trauma or its aftermath help explain why people with PTSD have many symptoms of anxiety even though the trauma is over. Cognitive strategies people use to deal with memories of the trauma, such as effortful suppression of trauma memories and rumination, help explain why some develop chronic PTSD whereas many recover from trauma. Finally, there may be cognitive vulnerability factors that increase the probability of developing PTSD in response to trauma. Directions for future research are outlined.",0 +https://doi.org/10.1016/j.janxdis.2007.11.012,The structure of post-traumatic stress disorder symptoms in three female trauma samples: A comparison of interview and self-report measures,"Empirical research increasingly suggests that post-traumatic stress disorder (PTSD) is comprised of four factors: re-experiencing, avoidance, numbing, and hyperarousal. Nonetheless, there remains some inconsistency in the findings of factor analyses that form the bulk of this empirical literature. One source of such inconsistency may be assessment measure idiosyncrasies. To examine this issue, we conducted confirmatory factor analyses of interview and self-report data across three trauma samples. Analyses of the interview data indicated a good fit for a four-factor model across all samples; analyses of the self-report data indicated an adequate fit in two of three samples. Overall, findings suggest that measure idiosyncrasies may account for some of the inconsistency in previous factor analyses of PTSD symptoms.",0 +https://doi.org/10.1177/1073191104269954,Psychometric Properties of the Life Events Checklist,"The Life Events Checklist (LEC), a measure of exposure to potentially traumatic events, was developed at the National Center for Posttraumatic Stress Disorder (PTSD) concurrently with the Clinician Administered PTSD Scale (CAPS) to facilitate the diagnosis of PTSD. Although the CAPS is recognized as the gold standard in PTSD symptom assessment, the psychometric soundness of the LEC has never been formally evaluated. The studies reported here describe the performance of the LEC in two samples: college undergraduates and combat veterans. The LEC exhibited adequate temporal stability, good convergence with an established measure of trauma history—the Traumatic Life Events Questionnaire (TLEQ)— and was comparable to the TLEQ in associations with variables known to be correlated with traumatic exposure in a sample of undergraduates. In a clinical sample of combat veterans, the LEC was significantly correlated, in the predicted directions, with measures of psychological distress and was strongly associated with PTSD symptoms.",0 +https://doi.org/10.1016/j.drugalcdep.2012.06.003,Gender differences in the correlates of hazardous drinking among Iraq and Afghanistan veterans,"Despite increasing numbers of women veterans from the Iraq and Afghanistan conflicts, few studies have examined hazardous drinking in this group. The present study examined the prevalence of and risk and protective factors for hazardous drinking in a community-based sample of men and women veterans of Operations Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND).Veterans completed a structured survey that assessed hazardous drinking using the Alcohol Use Disorders Identification Test (AUDIT), and a broad range of demographic, life history, and psychopathology variables. Correlations and multivariate logistic regression analyses were conducted to examine risk and protective factors associated with hazardous drinking.A total 30.2% of male veterans and 16.3% of female veterans screened positive for hazardous drinking. In a multivariate analysis in male veterans, younger age, lifetime exposure to assaultive trauma, and conflict in interpersonal relationships were independently associated with hazardous drinking (p<.05). Among women veterans, younger age and posttraumatic stress disorder (PTSD) symptoms were independently associated with hazardous drinking in a multivariate analysis (p<.05). Secondary analyses of PTSD symptom clusters revealed that emotional numbing symptoms were independently related to hazardous drinking in women veterans (p<.05).Results of this study suggest that hazardous drinking is prevalent in both men and women OEF/OIF/OND veterans and is more likely to occur at younger ages. In addition, results indicate gender differences in the association between hazardous drinking and lifetime trauma history, PTSD symptoms, and interpersonal conflict, which may have important implications for the treatment of alcohol problems in men and women veterans.",0 +https://doi.org/10.1016/j.paid.2005.03.007,Pre-traumatic personality as a predictor of post-traumatic stress disorder among undergraduate students exposed to a terrorist attack: A prospective study in Israel,"The present study addresses the issue of the role played by the pre-traumatic personality, as evaluated by Cloninger’s Tridimensional Personality Theory (1987), in predicting post-traumatic stress disorder (PTSD) following traumatic exposure. The initial sample consisted of 185 undergraduate students evaluated for a different aim two weeks prior to a terrorist explosion on a bus heading to their university. One week after the explosion, the sample was assessed to determine actual exposure: 81 reported being exposed and thus constituted the final cohort, re-evaluated at six months after the exposure both in terms of personality profile and to determine formal diagnosis of PTSD. A logistic regression analysis showed that age and the harm-avoidance personality dimension (i.e., avoiding novel stimuli) were positively associated with the risk for developing PTSD, and that the novelty-seeking dimension (i.e., seeking novel stimuli of excitement) was negatively associated with this risk.",0 +https://doi.org/10.1007/s10615-015-0542-5,Caught in a Web of Multiple Jeopardy: Post-Traumatic Stress Disorder and HIV-Positive Asylum Seekers in Scotland,"Many HIV-positive asylum seekers have experienced multiple traumas and human rights violations—circumstances that engender posttraumatic stress disorder (PTSD). This qualitative study examines the impact of PTSD symptoms among HIV-positive asylum seekers in Scotland. Data were collected from 19 participants, using open-ended interviews, and narrative analysis was used to develop significant themes. All respondents had significant traumatic experiences, such as physical and sexual assault, witnessing the beating and death of a loved one, and being forced to participate in the sex trade. Many experienced multiple symptoms of PTSD, including re-experiencing of intrusive thoughts, flashbacks, avoidance, and arousal. These symptoms met the duration and impairment requirements for DSM-5 diagnosis of PTSD. Their symptoms impacted their ability to tell their stories convincingly when interviewed by immigration officials. Legal processes for asylum seeking require individuals to tell their stories but ignore the impact of trauma on their ability to do so, thus increasing the likelihood of their applications being rejected. The findings indicate the need for asylum seekers to have routine assessment and treatment for PTSD and the provision of appropriate therapeutic and advocacy services.",0 +https://doi.org/10.1016/j.addbeh.2010.03.023,PTSD symptom clusters in relationship to alcohol misuse among Iraq and Afghanistan war veterans seeking post-deployment VA health care,"Demographic factors, characteristics of military service, PTSD, and depression were examined as predictors of alcohol misuse in Iraq and Afghanistan War Veterans (N=287) presenting for post-deployment Veteran Affairs (VA) health care. Results indicated that alcohol misuse was more common among younger male Veterans who served in the Army or Marine Corps. Accounting for demographic factors and characteristics of service, Veterans who screened positive for PTSD or depression were two times more likely to report alcohol misuse relative to Veterans who did not screen positive for these disorders. The examination of specific PTSD symptom clusters suggested that emotional numbing symptoms were most strongly associated with alcohol misuse. The implications for interventions for alcohol misuse in returning Veterans are discussed.",0 +https://doi.org/10.1037/a0017203,Comparison of immediate-onset and delayed-onset posttraumatic stress disorder in military veterans.,"Differences in symptoms, trauma exposure, dissociative and emotional reactions to trauma, and subsequent life stress in war veterans reporting immediate-onset or delayed-onset posttraumatic stress disorder (PTSD) or no PTSD were investigated. The role of life stress in delayed-onset PTSD was also studied. Retrospective interviews were conducted with 142 United Kingdom veterans receiving a war pension for PTSD or physical disability. Immediate-onset and delayed-onset PTSD were similar in the number and type of symptoms reported at onset, but the delayed-onset group differed in showing a gradual accumulation of symptoms that began earlier and continued throughout their military career. They were more likely to report major depressive disorder and alcohol abuse prior to PTSD onset. Both groups described similar amounts of trauma exposure, but those in the delayed-onset group reported significantly less peritraumatic dissociation, anger, and shame. Veterans with delayed onsets were more likely than veterans with no PTSD to report the presence of a severe life stressor in the year before onset. In conclusion, the results suggest that delayed onsets involve a more general stress sensitivity and a progressive failure to adapt to continued stress exposure.",0 +https://doi.org/10.1037/a0035878,"Risk pathways among traumatic stress, posttraumatic stress disorder symptoms, and alcohol and drug problems: A test of four hypotheses.","The present study utilized longitudinal data from a community sample (n = 377; 166 trauma-exposed; 54% males; 73% non-Hispanic Caucasian; 22% Hispanic; 5% other ethnicity) to test whether pretrauma substance use problems increase risk for trauma exposure (high-risk hypothesis) or posttraumatic stress disorder (PTSD) symptoms (susceptibility hypothesis), whether PTSD symptoms increase risk for later alcohol/drug problems (self-medication hypothesis), and whether the association between PTSD symptoms and alcohol/drug problems is attributable to shared risk factors (shared vulnerability hypothesis). Logistic and negative binomial regressions were performed in a path analysis framework. Results provided the strongest support for the self-medication hypothesis, such that PTSD symptoms predicted higher levels of later alcohol and drug problems, over and above the influences of pretrauma family risk factors, pretrauma substance use problems, trauma exposure, and demographic variables. Results partially supported the high-risk hypothesis, such that adolescent substance use problems increased risk for assaultive violence exposure but did not influence overall risk for trauma exposure. There was no support for the susceptibility hypothesis. Finally, there was little support for the shared vulnerability hypothesis. Neither trauma exposure nor preexisting family adversity accounted for the link between PTSD symptoms and later substance use problems. Rather, PTSD symptoms mediated the effect of pretrauma family adversity on later alcohol and drug problems, thereby supporting the self-medication hypothesis. These findings make important contributions to better understanding the directions of influence among traumatic stress, PTSD symptoms, and substance use problems.",0 +https://doi.org/10.1080/09540260120074000,Post-traumatic stress disorder: diagnostic issues and epidemiology in adult survivors of traumatic events,This paper presents a review of the issues surrounding the diagnosis and epidemiology of post-traumatic stress disorder in adult survivors of traumatic events. The paper is presented in two section...,0 +https://doi.org/10.1007/bf00974317,Reliability and validity of a brief instrument for assessing post-traumatic stress disorder,"This study examines the psychometric properties of two versions of the PTSD Sympton Scale (PSS). The scale contains 17 items that diagnose PTSD according to DSM-III-R criteria and assess the severity of PTSD symptoms. An interview and self-report version of the PSS were administered to a sample of 118 recent rape and non-sexual assault victims. The results indicate that both versions of the PSS have satisfactory internal consistency, high test-retest reliability, and good concurrent validity. The interview version yielded high interrater agreement when administred separately by two interviewers and excellent convergent validity with the SCID. When used to diagnose PTSD, the self-report version of the PSS was somewhat more conservative than the interview version.",0 +https://doi.org/10.2466/16.02.pr0.115c11z7,Do Peritraumatic Emotions Differentially Predict PTSD Symptom Clusters? Initial Evidence for Emotion Specificity,"This study investigated whether specific peritraumatic emotions differentially predict PTSD symptom clusters in individuals who have experienced stressful life events. Hypotheses were developed based on the SPAARS model of PTSD. It was predicted that the peritraumatic emotions of anger, disgust, guilt, and fear would significantly predict re-experiencing and avoidance symptoms, while only fear would predict hyperarousal. Undergraduate students ( N = 144) participated in this study by completing a packet of self-report questionnaires. Multiple regression analyses were conducted with PCL-S symptom cluster scores as dependent variables and peritraumatic fear, guilt, anger, shame, and disgust as predictor variables. As hypothesized, peritraumatic anger, guilt, and fear all significantly predicted re-experiencing. However, only fear predicted avoidance, and anger significantly predicted hyperarousal. Results are discussed in relation to the theoretical role of emotions in the etiology of PTSD following the experience of a stressful life event.",0 +https://doi.org/10.1097/00005373-200005000-00007,"Outcome from Injury: General Health, Work Status, and Satisfaction 12 Months after Trauma","We evaluated outcomes 12 months after trauma in terms of general health, satisfaction, and work status.Two hundred forty-seven patients without severe neurotrauma were evaluated by interview during admission and by mailed self-report 6 and 12 months after trauma. Data were obtained from the Trauma Registry, interviews, and survey instruments. Baseline assessment was obtained with the Short Form 36 (SF36) and the Sickness Impact Profile (SIP) work scale. Outcome measures were the SF36, SIP work scale, Brief Symptom Inventory (BSI) depression scale, the Civilian Mississippi Scale for Posttraumatic Stress Disorder (PTSD), and a satisfaction questionnaire. Three regressions were determined for outcome. The dependent variables were general health and work status (linear) and satisfaction (logistic). Each regression controlled for baseline status and mental health, Injury Severity Score (ISS), and 12-month SF36 physical function before evaluating the effect of outcome mental health.Follow-up data were available for 75% of the patients at 6 months and 51% at 12 months. The mean age of patients was 37.2 +/- 0.9 years (+/-SEM), and 73% were male. Their average ISS was 13.9 +/- 0.6. Seventy percent of injuries were blunt force, 13.5 % were penetrating, and 16.5 % were burn injuries (mean total body surface area, 13.3 +/- 1.5%). Sixty-four percent of the patients had returned to work at 12 months. Follow-up SF36 mental health was associated with the dependent outcome in each regression. After controlling for baseline status and mental health, ISS, and outcome SF36 physical function, outcome mental health was associated with outcome SF36 general health (p < 0.001), SIP work status (p = 0.017), and satisfaction with recovery (p = 0.005). Outcome SF36 mental health was related to baseline mental health, 12-month PTSD and BSI depression scores, and increased drug and alcohol use.Twelve months after trauma, patients' work status, general health, and overall satisfaction with recovery are dependent on outcome mental health. This dependency persists despite measured baseline status, ISS, or physical recovery. The mental disease after trauma is attributable to poor mental health, the development of symptoms of PTSD and depression, and increased substance abuse. Trauma centers that fail to recognize, assess, and treat these injury-related mental health outcomes are not fully assisting their patients to return to optimal function.",0 +https://doi.org/10.1034/j.1600-0447.2000.102001058.x,Loss as a determinant of PTSD in a cohort of adult survivors of the 1988 earthquake in Armenia: implications for policy,"To study the relationship of post-traumatic stress disorder (PTSD) to severity of the disaster experience.A sample of 1785 adult participants of an epidemiological study initiated in the immediate aftermath of the 1988 earthquake in Armenia were interviewed about 2 years following the disaster based on the NIMH DIS-Disaster Supplement. All 154 cases of pure PTSD were compared with 583 controls without symptoms satisfying psychiatric diagnoses of interest.PTSD cases included more persons from areas with the worst destruction. Having the highest level of education compared to lowest (OR 0.6 [95% CI 0.4-0.9]), being accompanied at the moment of the earthquake (OR 0.6 [95% CI 0.4-0.9]) and making new friends after the earthquake (OR 0.6 [95% CI 0.5-0.8]) were protective for PTSD. PTSD risk increased with the total amount of loss to the family (OR for highest level of loss 4.1 [95% CI 2.3-7.5]).Based on this large population sample, we believe that early support to survivors with high levels of loss may reduce PTSD following earthquakes.",0 +https://doi.org/10.1016/j.psyneuen.2014.09.024,Blood-based gene-expression biomarkers of post-traumatic stress disorder among deployed marines: A pilot study,"The etiology of post-traumatic stress disorder (PTSD) likely involves the interaction of numerous genes and environmental factors. Similarly, gene-expression levels in peripheral blood are influenced by both genes and environment, and expression levels of many genes show good correspondence between peripheral blood and brain tissues. In that context, this pilot study sought to test the following hypotheses: (1) post-trauma expression levels of a gene subset in peripheral blood would differ between Marines with and without PTSD; (2) a diagnostic biomarker panel of PTSD among high-risk individuals could be developed based on gene-expression in readily assessable peripheral blood cells; and (3) a diagnostic panel based on expression of individual exons would surpass the accuracy of a model based on expression of full-length gene transcripts. Gene-expression levels in peripheral blood samples from 50 U.S. Marines (25 PTSD cases and 25 non-PTSD comparison subjects) were determined by microarray following their return from deployment to war-zones in Iraq or Afghanistan. The original sample was carved into training and test subsets for construction of support vector machine classifiers. The panel of peripheral blood biomarkers achieved 80% prediction accuracy in the test subset based on the expression of just two full-length transcripts (GSTM1 and GSTM2). A biomarker panel based on 20 exons attained an improved 90% accuracy in the test subset. Though further refinement and replication of these biomarker profiles are required, these preliminary results provide proof-of-principle for the diagnostic utility of blood-based mRNA-expression in PTSD among trauma-exposed individuals.",0 +,CINP 2000 - Collegium Internationale Neuro-Psychopharmacologicum 22nd Congress.,"At this large and varied meeting on neuropharmacotherapy, progress was reported on the newer more selective antipsychotics. The selective D(2) dopamine receptor partial agonist, aripiprazole (Otsuka Pharmaceutical Co Ltd) was recently proved effective over the medium term. The atypical antipsychotics generally, such as clozapine, have a good side effect profile and better patient compliance, even in Parkinson's disease (PD). Reboxetine (Pharmacia & Upjohn AB), having a far greater selectivity for norepinephrine reuptake inhibition than for serotonin or dopamine reuptake, is of particular value in treating depression. Paroxetine (Novo Nordisk A/S), a selective serotonin reuptake inhibitor (SSRI), has just completed a multicenter clinical trial, being effective in about 50% of cases of post-traumatic stress disorder. A meta-analysis of trials of other uptake inhibitors showed that ability to block serotonin (rather than norepinephrine) uptake correlated well with efficacy. Bipolar and other disorders were hoped to benefit from more selective agents in the future, the potential for which has been revealed through basic neurobiology, with, for example, only non-alpha7 nicotinic receptor subunits being expressed by those interneurons mediating nicotinic responses. An open label, 30-day study of a pyrrolopyrimidine, the corticotrophin releasing factor (CRF) type 1 receptor inhibitor, NBI-30775 (Neurocrine Biosciences Inc/Janssen Pharmaceutica NV) produced good antidepressant effects, but has had to be abandoned as a product due to indications of potential liver damage. Similarly, although glial-derived neurotrophic factor (GDNF) had proved ineffective in a 1999 trial for PD, due to failure to access the striatum, there was however much evidence to suggest that small molecule agonists of the TRK-B receptor should be effective. Of these, quinones such as L-783281 (Merck Research Laboratories) appear to activate all TRK subtypes by a common intracellular, rather than receptormediated action, which may limit their usefulness. Although such agents would have many potential applications, it is likely that highly selective receptor activation will be needed.",0 +https://doi.org/10.1007/s00134-009-1444-1,Post-traumatic growth in parents after a child’s admission to intensive care: maybe Nietzsche was right?,"OBJECTIVE: The aim of this prospective study was to establish the degree to which parents report post-traumatic growth after the intensive care treatment of their child. DESIGN: Prospective cross-sectional cohort study. SETTING: Paediatric Intensive Care Unit (PICU). SUBJECTS: A total of 50 parents of children, admitted to PICU for >12 h. MEASUREMENTS AND RESULTS: Parents provided stress ratings as their child was discharged from PICU and, 4 months later, completed postal questionnaires rating their anxiety, depression, post-traumatic stress and post-traumatic growth. As much as 44 parents (88%) indicated on the Posttraumatic Growth Inventory (PTGI) [1] that they had experienced a positive change to a great degree as a result of their experiences in PICU. Parents of children who were ventilated (P = 0.024) reported statistically higher post-traumatic growth as did parents of older children (P = 0.032). PTGI scores were positively correlated with post-traumatic stress scores at 4 months (P = 0.021), but on closer inspection this relationship was found to be curvilinear. CONCLUSIONS: Post-traumatic growth emerged as a salient concept for this population. It was more strongly associated with moderate levels of post-traumatic stress, than high or low levels.",0 +,Survey of domestic violence among young adolescents in Slovenia,"OBJECTIVE: It has been estimated that domestic violence is wide spread in Slovenia, but the lack of empirical data of domestic violence prevalence and its consequences, aggravate the precise knowledge on the extension of the phenomenon. The aim of the study was to assess the extensiveness and characteristics of domestic violence in the group of Slovenian adolescents. SUBJECTS: 1297 young adolescents (age 13-15 years) from 65 Slovenian primary schools participated in the study. METHODS: A questionnaire for domestic violence experience and help seeking screening, McMaster Family Functioning Scale, Buss/Perry Aggression Questionnaire and Trauma Symptom Checklist for Childrentrade mark (TSCCtrade mark) have been applied. RESULTS: 18.7% of participants experienced violence in their own family (38.3% males and 61.7% females). Different patterns of verbal violence, irritability and indirect violence predominated. In the most cases of domestic violence the adolescent's parents were involved as perpetrators and their close relatives (brothers, sisters). Victims displayed a significant profile that could be linked with their violence experience: dysfunctional family environmental, aggressiveness, anxiety, depression, anger and posttraumatic stress symptoms. CONCLUSIONS: Presented study confirmed that the phenomenon of domestic violence and abused adolescents is quite widespread in Slovenia and that in the future more attention on research and policy making level should be given to this phenomenon. Particularly the perceived gap between attitudes towards support and the actually given help could be the orientation for developing a better prevention strategies and screening procedures for domestic violence. A proper intervention and protection of the adolescent victims could effectively prevent the outburst of depression, suicide, behavioural problems and, spreading the aggressive behaviour patterns to the future generations. Language: en",0 +https://doi.org/10.2147/ndt.s10951,Tailoring therapeutic strategies for treating posttraumatic stress disorder symptom clusters,"According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, posttraumatic stress disorder (PTSD) is characterized by three major symptom clusters following an event that elicited fear, helplessness, or horror. This review will examine each symptom cluster of PTSD separately, giving case study examples of patients who exhibit a preponderance of a given symptom domain. We use a translational approach in describing the underlying neurobiology that is relevant to particular symptoms and treatment options, thus showing how clinical practice can benefit from current research. By focusing on symptom clusters, we provide a more specific view of individual patient's clinical presentations, in order to better address treatment needs. Finally, the review will also address potential genetic approaches to treatment as another form of individualized treatment.",0 +https://doi.org/10.1016/s0010-440x(96)90015-2,Unique patterns of comorbidity in posttraumatic stress disorder from different sources of trauma,"While there are many studies of comorbidity in combat veterans with posttraumatic stress disorder (PTSD), studies of PTSD from other sources of trauma (e.g., disasters, crimes, and civil violence) are just beginning to emerge. This is the first formal review comparing patterns of comorbidity in PTSD from different sources of trauma. Specific attention is given to the relative frequencies of substance abuse, depression, generalized anxiety, phobic, panic, somatization, psychotic, and personality disorders. The findings reveal that although similarities exist, the comorbidity profiles differ according to the type of trauma experienced and the population studied. Additionally, the evidence suggests that the associated psychiatric disorders are not truly comorbid, but are interwoven with the PTSD.",0 +https://doi.org/10.1108/ijph-02-2013-0004,Assessing post-traumatic stress symptoms in a Latino prison population,"Purpose – The purpose of this paper is to assess the reliability and validity of the Spanish version of the Davidson trauma scale (DTS-S) and to determine the prevalence and correlates of post-traumatic stress disorder (PTSD) symptoms in a non-clinical random sample of prison inmates. Design/methodology/approach – Probabilistic samples of 1,179 inmates from 26 penal institutions in Puerto Rico were selected using a multistage sampling design. Population estimates and correlations were obtained for PTSD, generalized anxiety and depression. The reliability, factor structure, and convergent validity of the DTS-S were assessed. Cross-validation was employed to confirm the results of the factor analyses. Findings – Using the cut-offs adopted by the scale's author, 136 (13.4 percent) of the inmates are likely to have current PTSD and 117 (11.6 percent) reach the cut-off for sub-threshold PTSD. Confirmatory factor analysis generated two factors explaining 53 percent of the variance. High reliabilities were obtained for the total scale (α=0.95) and for the frequency and severity scales (α=0.90 and 0.91). Significantly higher DTS-S scores were found for females ( t =2.26, p <0.025), for inmates diagnosed with depression or anxiety ( t =2.02, p <0.05), and those reporting suicide attempts ( t =4.47, p <0.0001). Originality/value – Findings support that the DTS-S is a reliable and valid measure to assess PTSD symptoms in Latino inmate populations and to identify individuals at risk for the disorder that require confirmatory diagnosis and clinical interventions.",0 +https://doi.org/10.1037/0022-006x.76.2.231,Reduced autobiographical memory specificity predicts depression and posttraumatic stress disorder after recent trauma.,"In this prospective longitudinal study, the authors examined the relationship between reduced specificity in autobiographical memory retrieval and the development of depression, posttraumatic stress disorder (PTSD), and specific phobia after injury in an assault. Assault survivors (N = 203) completed the Autobiographical Memory Test (J. M. G. Williams & K. Broadbent, 1986) at 2 weeks after the trauma as well as structured clinical interviews at 2 weeks and 6 months. Participants with acute stress disorder or major depression at 2 weeks, but not those with phobia, retrieved fewer specific autobiographical memories than those without the respective disorder. Reduced memory specificity at 2 weeks also predicted subsequent PTSD and major depression at 6 months over and above what could be predicted from initial diagnoses and symptom severity. Moderator analyses showed that low memory specificity predicted later depression in participants with prior episodes of major depression but not in those without prior depression. Mediation analyses suggested that rumination partly mediated and perceived permanent change fully mediated the effects of low memory specificity on posttrauma psychopathology at follow-up.",0 +https://doi.org/10.1002/j.1532-2149.2014.00459.x,An examination of the structural link between post-traumatic stress symptoms and chronic pain in the framework of fear-avoidance models,"The tendency to respond with fear and avoidance can be seen as a shared vulnerability contributing to the development of post-traumatic stress disorder (PTSD) and chronic pain. Although several studies have examined which specific symptoms of PTSD (re-experiencing, avoidance, emotional numbing and hyperarousal) are associated with chronic pain, none has considered this association within the framework of fear-avoidance models.Seven hundred fourteen patients with chronic musculoskeletal pain were assessed. Of these, 149 patients were selected for the study based upon the following inclusion criteria: exposure to a traumatic event before the onset of pain (with scores equal to or higher than 8 points on the fear and hopelessness scales of the Stressful Life Event Screening Questionnaire Revised) and scores equal to or higher than 30 on the Davidson Trauma Scale.Structural equation modelling was used to test the association between PTSD symptoms and pain outcomes (pain intensity and disability) using the mediating variables considered in the fear-avoidance models. The results show that emotional numbing and hyperarousal symptoms, but neither re-experiencing nor avoidance, affected pain outcome via anxiety sensitivity (AS), catastrophizing and fear of pain. PTSD symptoms increased the levels of AS, which predisposes to catastrophizing and, in turn, had an effect on the tendency of pain patients to respond with more fear and avoidance.This study provides empirical support for the potential role of PTSD symptoms in fear-avoidance models of chronic pain and suggests that AS is a relevant variable in the relationship between both disorders.",0 +,Mental and physical disability after sepsis.,"Sepsis remains a major cause of admissions to Intensive Care Units (ICU) and has a high mortality rates and significant morbidity in survivors. There are physical, cognitive and psychological sequelae from severe sepsis that have a negative effect on the patients' health related quality of life in the longer term and a social care and humanitarian impact. Although muscle mass loss during the septic period happens very quickly, recovery takes a considerable time and requires the patient to commit to exercising and eating well to rebuild. Where cognitive impairment has resulted from the septic illness the patients' ability to look after themselves may be affected and this has financial and family implications for future care. Patients may also develop psychological problems such as anxiety, depression or post traumatic stress disorder (PTSD), which can have a profound effect on their everyday functioning and the possibility of returning to work. As yet there are no published studies of rehabilitation with patients surviving severe sepsis, although there is one in progress at the moment. The use of techniques such as ICU diaries to help patients to understand their illness and deal with delusional memories they may have from their ICU stay has been shown to aid psychological recovery in general ICU patients, a percentage of whom will have suffered from sepsis. The use of a self-guided manualised 6 week rehabilitation program, the ICU Recovery Manual, has been shown to accelerate physical recovery in general ICU patients. Considerable amounts of money are spent treating patients with severe sepsis in ICU and not completing the job of returning them to as close as possible to their normal functioning does not make financial sense.",0 +https://doi.org/10.1016/j.biopsych.2003.09.014,"Stress doses of hydrocortisone, traumatic memories, and symptoms of posttraumatic stress disorder in patients after cardiac surgery: a randomized study","Traumatic experiences associated with cardiac surgery (CS) can result in traumatic memories and posttraumatic stress disorder (PTSD). Because it is known that subjects who develop PTSD often show sustained reductions in circulating cortisol concentrations, we performed a prospective, randomized study to examine whether exogenously administered stress doses of hydrocortisone during the perioperative period of CS reduces the long-term incidence of chronic stress and PTSD symptoms.Patients (n = 91) were prospectively randomized to receive either stress doses of hydrocortisone or standard treatment during the perioperative period of CS. Of 48 available patients at 6 months after CS, 26 had received stress doses of hydrocortisone and 22 standard treatment. Traumatic memories and PTSD symptoms were diagnosed with previously validated questionnaires.As compared with patients after standard therapy, patients from the hydrocortisone group had significantly lower chronic stress symptom scores (p <.05). There was no significant difference regarding the number or type of traumatic memories between the hydrocortisone and the standard treatment groups.Stress doses of hydrocortisone in patients undergoing CS are associated with a lower intensity of chronic stress and PTSD symptoms at 6 months after CS.",0 +https://doi.org/10.1080/08039480801984305,Traumatic experiences and post-traumatic stress disorder in Kurdistanian children and their parents in homeland and exile: An epidemiological approach,"The prevalence and correlates of post-traumatic stress disorder (PTSD) were assessed in random samples of school-aged Kurdistanian children and their parents in homeland and exile. Of the 376 eligible children at the two sites, 312 children and their parents (293 mothers and 248 fathers) completed the Harvard-Uppsala Trauma Questionnaire and Posttraumatic Stress Symptom interviews for children, and Harvard Trauma Questionnaire for parents. Unlike their children, fathers showed significantly higher PTSD frequencies in exile than in the homeland. The fathers' PTSD negatively correlated with the living standard and fathers' education, while child PTSD mostly correlated with maternal education and living in exile. Living in exile seems to have a negative impact on fathers' post-traumatic reactions, despite its positive influence on children. High drop-outs in exile limit the conclusions.",0 +https://doi.org/10.1097/brs.0b013e3182388739,Complexities in Understanding the Role of Compensation-Related Factors on Recovery From Whiplash-Associated Disorders,"Focused discussion.To present some of the complexities in conducting research on the role of compensation and compensation-related factors in recovery from whiplash-associated disorders (WAD) and to suggest directions for future research.There is divergence of opinion, primary research findings, and systematic reviews on the role of compensation and/or compensation-related factors in WAD recovery.The topic of research of compensation/compensation-related factors was discussed at an international summit meeting of 21 researchers from diverse fields of scientific enquiry. This article summarizes the main points raised in that discussion.Traffic injury compensation is a complex sociopolitical construct, which varies widely across jurisdictions. This leads to conceptual and methodological challenges in conducting and interpreting research in this area. It is important that researchers and their audiences be clear about what aspect of the compensation system is being addressed, what compensation-related variables are being studied, and what social/economic environment the compensation system exists in. In addition, summit participants also recommended that nontraditional, sophisticated study designs and analysis strategies be employed to clarify the complex causal pathways and mechanisms of effects.Care must be taken by both researchers and their audiences not to overgeneralize or confuse different aspects of WAD compensation. In considering the role of compensation/compensation-related factors on WAD and WAD recovery, it is important to retain a broad-based conceptualization of the range of biological, psychological, social, and economic factors that combine and interact to define and determine how people recover from WAD.",0 +https://doi.org/10.1080/15325024.2012.719351,"Longitudinal Relationships Between Neuroticism, Avoidant Coping, and Posttraumatic Stress Disorder Symptoms in Adolescents Following the 2008 Wenchuan Earthquake in China","The Wenchuan earthquake, which occurred in southwestern China in May 2008, was a source of severe psychological distress to adolescents. This study explored the developmental trajectory of posttraumatic stress disorder (PTSD) symptoms and the longitudinal relationships between neuroticism, avoidant coping, and PTSD symptoms measured at three time points: 1 year (T1), 1.5 years (T2), and 2 years (T3) after the earthquake. The participants included 636 adolescents from several high schools located in the areas that were most severely affected by the earthquake. Structural equation modeling results revealed bidirectional effects between neuroticism, avoidant coping, and PTSD symptoms. More severe PTSD symptoms predicted higher levels of avoidant coping at T1–T2 and T2–T3 but only predicted higher levels of neuroticism at T1–T2. Higher levels of neuroticism at T1 predicted more severe PTSD symptoms at T1–T2, while higher levels of avoidant coping at T1 predicted more severe PTSD symptoms at T2–T3.",0 +https://doi.org/10.1055/s-2008-1041061,Neurobehavioral Outcome of Children's Mild Traumatic Brain Injury,"Brain damage is underestimated as a public health and personal problem. The common belief in a good prognosis for childhood brain damage is unsubstantiated. It is based on lack of rigorous study and examiner satisfaction with a low response level. Occult brain trauma plagues victims into maturity. Above a rather low threshold of injury (even without focal neurologic findings), cognitive, personality, and adaptive dysfunctions are common and impairing. Child abuse signals were described. Brain lesions impair both matured functions and those expressed later. Dysfunctions were discussed for these neurobehavioral systems: consciousness, attention and tonic motor level; sensorimotor and body schema; neurophysiologic; cerebral personality; intelligence; memory; language; information processing; posttraumatic stress and mood; identity and insight; adaptivity in the community. Outcome evolves from complex pathologic, neurologic, anatomic, and personality parameters, the postinjury interval and child's age, the maturity and developmental trajectory of the function, social support, and emotional reaction to impairment. Assessment should study the entire range of functions, utilizing records, collaterals, observation, and qualitative and psychometric measurement. Complex, challenging, and ecologically relevant tasks are appropriate. There are several patterns of outcome: immediate permanent deficits; improvement through compensatory mechanisms, but with subclinical deficits; and initial progress with delayed expression (premature plateau of cognitive and personality maturity; physiologic developmental deficits). Confirmation of mild TBI may require several years of observation to determine late dysfunctions and deviation from preinjury or postinjury performance or expected level of development.",0 +https://doi.org/10.1080/1478994031000074289,Post-traumatic stress disorder caused in mentally disordered offenders by the committing of a serious violent or sexual offence,"The aim of the study was to measure in a sample of mentally disordered offenders the frequency of post-traumatic stress disorder (PTSD) symptoms related to the committing of an offence and to consider what factors might be contributory to the onset and maintenance of these symptoms. The study was the first to investigate the incidence of PTSD in a primarily mentally ill population. A sample of 37 mentally disordered offenders was assessed for PTSD according to the Diagnostic and Statistical Manual of Mental Disorders (DSM III-R; American Psychiatric Association, 1987) and the Impact of Events Scale (IES; Horowitz, Wilner and Alvarez, 1979). Of this sample, 33% met diagnostic criteria for PTSD and 54% had significant PTSD symptomatology as indexed by the IES. The IES scores were greater in those who had committed violent offences than in those who had committed sexual offences, and in those who had an affective diagnosis. Frequency of PTSD symptoms was greater in those offenders who now felt regret for their actions. The high frequency of PTSD symptoms in this population may serve as a significant stressor and may exacerbate co-morbid psychiatric illness and contribute to poor treatment response and relapse. Many mental illnesses are exacerbated by stress and the presence of untreated PTSD symptoms may serve to prevent treatment gains for the primary mental disorder. If risk of future dangerous-ness is associated with unstable mental state, as is often the case in a mentally disordered population, then the development of PTSD post-offence may serve to prolong or increase risk of harm to both self and others.",0 +,Lifetime trauma and associated mental health symptoms in homeless women: Impulsivity as a feature of posttraumatic stress disorder and addiction,"This study aimed to provide a comprehensive assessment of the lifetime traumatic experiences of homeless women, and to explore the linkage between trauma, posttraumatic stress disorder (PTSD), and substance use problems. One hundred adult homeless women were assessed. Descriptive data on trauma histories show that three-quarters of the sample experienced some form of childhood trauma, and 58% experienced childhood sexual trauma. Trauma in childhood was predictive of trauma in adulthood. As hypothesized, indirect evidence of the self-medication hypothesis was provided by a path analysis showing a linear relationship between trauma and substance use consequences that was mediated by PTSD symptoms. Measures of future time perspective, and self-report and behavioral measures of impulsivity did not converge to indicate a single shared common factor, though the self-report measure of trait impulsivity was predictive of both PTSD and substance use consequences. This study suggests that homeless women have extensive trauma histories that often begin in childhood, they likely use substances to cope, and that trait impulsivity may itself represent a common factor of both PTSD and SUD. Clinical implications are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1002/jts.20516,"Trauma, attempted suicide, and morning cortisol in a community sample of adolescents","Individuals exposed to trauma or who have attempted suicide may show abnormal cortisol profiles; those exposed to significant trauma show reduced, while those who attempt suicide show increased cortisol output, although the evidence is inconsistent. This study explores the associations between morning cortisol, trauma, and suicide attempts or ideation among young people. In a community-based sample of 501 15-year-olds, using data from a DSM-IV-compatible interview on suicidal-behavior/ideation, trauma, and morning cortisol, we found no association between these factors and morning cortisol. A significant gender interaction was found for those threatened with a weapon-men showing a negative and women a positive association, suggesting that any cortisol/trauma association may be partially explained by coexisting behavioral problems and gender.",0 +https://doi.org/10.1111/j.1468-2850.2006.00006.x,Developing and Implementing Randomized Effectiveness Trials in General Medical Settings.,"This article discusses the development of two mental health services research programs: one targeting depression treatment in primary care and the other early intervention for posttraumatic stress disorders in acute care. Both programs have used the randomized effectiveness trial to assess the delivery of empirically supported psychotherapeutic and psychopharmacologic interventions in these general medical settings. This article explores the fellowship training, clinical experiences, and conceptual frameworks that have informed the progression of the two research programs. Specific modifications to the traditional randomized clinical trial design employed in the effectiveness trials are discussed. This article concludes with reflection on intervention development trajectories and interdisciplinary team compositions that may facilitate the development of mental health interventions that both derive from the best scientific evidence and can be feasibly delivered in real-world treatment settings.",0 +,Effects of exogenous glucocorticoid on combat-related PTSD symptoms.,"Very few systematic human studies focus on changing the underlying traumatic memory after posttraumatic stress disorder (PTSD) has been established. Evidence from animal and human studies indicates that cortisol can be used to address traumatic memories. This translational pilot study is based on our previous rodent research in which extinction of fear memories was enhanced by glucocorticoids. The current study aims to assess the effectiveness of glucocorticoids in augmenting memory extinction and reducing clinical symptoms in veterans with combat-related PTSD.In a double-blind, placebo-controlled study, veterans with combat-related PTSD were exposed to a memory reactivation task using well established imagery and psychophysiology assessment technique followed by administration of either glucocorticoid or placebo.One week after glucocorticoid or placebo administration, participants who received the study medication showed significant PTSD-related symptom (cluster C) improvement compared with control participants who received placebo only. However, reduction of symptoms degraded at a 1-month postadministration assessment.These findings are consistent with a glucocorticoid-mediated enhancement of extinction to ameliorate PTSD symptoms. The use of traumatic memory reactivation temporally paired with glucocorticoid administration holds potential for developing a viable therapeutic option.",0 +https://doi.org/10.1037/rep0000075,The unfairness of it all: Exploring the role of injustice appraisals in rehabilitation outcomes.,"A fundamental principle of rehabilitation psychology is that individual appraisals of the social and physical environment-including injury itself-have profound consequences for coping and adjustment. When core assumptions of a just and predictable world are violated and accompanied by ostensibly undeserved suffering and loss, perceptions of injustice can arise. Given the role of appraisal processes in adjustment to disability, mounting empirical support, and absence of targeted interventions, the current article considers perceptions of injustice regarding personal injury/disability as a fundamental appraisal affecting rehabilitation outcomes.The authors review theory underpinning the relevance of injustice appraisals and critically examine existing literature regarding the impact of perceived injustice and related constructs (i.e., attribution of blame, anger, and belief in a just world) on adjustment following injury.The authors bring attention to perceptions of injustice regarding personal injury/disability as a fundamental appraisal affecting rehabilitation outcomes. Dimensions of the social environment that have not received substantial attention in current research on condition-related injustice appraisals are highlighted.Perceived injustice is a potentially central appraisal process to physical and psychological outcomes in the context of rehabilitation. Research regarding the role of perceived injustice, related constructs, and potential social/environmental modulators of injustice perception is still in its infancy. Guided buy its foundational principles, the field of rehabilitation psychology can broaden and shape inquiry regarding perceived injustice. This article aims to guide future research, offer concepts for key areas of discourse, and consider potential interventions in the rehabilitation psychology domain.",0 +https://doi.org/10.1002/jts.21735,Changes in Social Adjustment With Cognitive Processing Therapy: Effects of Treatment and Association With PTSD Symptom Change,"The current study sought to determine if different spheres of social adjustment, social and leisure, family, and work and income improved immediately following a course of cognitive processing therapy (CPT) when compared with those on a waiting list in a sample of 46 U.S. veterans diagnosed with posttraumatic stress disorder (PTSD). We also sought to determine whether changes in different PTSD symptom clusters were associated with changes in these spheres of social adjustment. Overall social adjustment, extended family relationships, and housework completion significantly improved in the CPT versus waiting-list condition, η(2) = .08 to .11. Hierarchical multiple regression analyses revealed that improvements in total clinician-rated PTSD symptoms were associated with improvements in overall social and housework adjustment. When changes in reexperiencing, avoidance, emotional numbing, and hyperarousal were all in the model accounting for changes in total social adjustment, improvements in emotional numbing symptoms were associated with improvements in overall social, extended family, and housework adjustment (β = .38 to .55). In addition, improvements in avoidance symptoms were associated with improvements in housework adjustment (β = .30), but associated with declines in extended family adjustment (β = -.34). Results suggest that it is important to consider the extent to which PTSD treatments effectively reduce specific types of symptoms, particularly emotional numbing and avoidance, to generally improve social adjustment.",0 +https://doi.org/10.4324/9780203714928,Female Students and Cultures of Violence in Cities,,0 +https://doi.org/10.1016/j.neuron.2015.05.036,Epigenetics of Stress-Related Psychiatric Disorders and Gene × Environment Interactions,"A deeper understanding of the pathomechanisms leading to stress-related psychiatric disorders is important for the development of more efficient preventive and therapeutic strategies. Epidemiological studies indicate a combined contribution of genetic and environmental factors in the risk for disease. The environment, particularly early life severe stress or trauma, can lead to lifelong molecular changes in the form of epigenetic modifications that can set the organism off on trajectories to health or disease. Epigenetic modifications are capable of shaping and storing the molecular response of a cell to its environment as a function of genetic predisposition. This provides a potential mechanism for gene-environment interactions. Here, we review epigenetic mechanisms associated with the response to stress and trauma exposure and the development of stress-related psychiatric disorders. We also look at how they may contribute to our understanding of the combined effects of genetic and environmental factors in shaping disease risk.",0 +https://doi.org/10.1093/milmed/160.10.493,"Compensation and Pension Evaluations: Psychotic, Neurotic, and Post-Traumatic Stress Disorder Millon Clinical Multiaxial Inventory II Profiles","The purpose of the present work was to provide an examination of the three major VA adjudication classifications (post-traumatic stress disorder [PTSD], psychotic, and neurotic) through objective psychological testing. During routine follow-up compensation and pension evaluations, 143 patients were given the Millon Clinical Multiaxial Inventory II (MCMI-II). Additionally, their current disability diagnoses as well as their current percentage of disability were coded. Discriminant function analysis revealed that the pivotal discriminatory variables were alcohol abuse for the PTSD patients, thought disorder for the psychotics, and anxiety for the neurotics. This is remarkably consistent with general clinical expectations. This should allow for more specific use of the MCMI-II in compensation and pension examinations by Department of Veterans' Affairs psychologists.",0 +https://doi.org/10.1093/alcalc/agn018,Childhood and Current Determinants of Heavy Drinking in Early Adulthood,"To explore the association of parental education, childhood living conditions and several adversities with heavy drinking in early adulthood, and to analyze the effect of the respondent's current circumstances on these associations.The analyses were conducted in a sample of 1234 adults aged 18-29 years participating in the Finnish Health 2000 Survey (65% of the original representative two-stage cluster sample, N = 1894). The outcome measure was heavy drinking measured by g/week for pure alcohol (for men >or=280 g/week and for women >or=140 g/week).8% of young adult men and 5% of women were heavy drinkers. In both genders, parental alcohol problems and other childhood adversities, poor own education, and unemployment status increased the risk of heavy drinking. The impact of childhood on heavy drinking was partly independent and partly mediated by adult characteristics, in particular, for both genders, low level of education.Childhood adversities are associated with heavy drinking in early adulthood among both genders. Childhood social circumstances as well as low educational level and unemployment should be taken into account in planning preventive policies to tackle the harms caused by excessive alcohol use at the individual and population level.",0 +https://doi.org/10.1016/j.psyneuen.2014.07.010,Cytokine production as a putative biological mechanism underlying stress sensitization in high combat exposed soldiers,"Combat stress exposed soldiers may respond to post-deployment stressful life events (SLE) with increases in symptoms of posttraumatic stress disorder (PTSD), consistent with a model of stress sensitization. Several lines of research point to sensitization as a model to describe the relations between exposure to traumatic events, subsequent SLE, and symptoms of PTSD. Based on previous findings we hypothesized that immune activation, measured as a high in vitro capacity of leukocytes to produce cytokines upon stimulation, underlies stress sensitization.We assessed mitogen-induced cytokine production at 1 month, SLE at 1 year, and PTSD symptoms from 1 month up to 2 years post-deployment in soldiers returned from deployment to Afghanistan (N=693). Exploratory structural equation modeling as well as latent growth models were applied.The data demonstrated significant three-way interaction effects of combat stress exposure, cytokine production, and post-deployment SLE on linear change in PTSD symptoms over the first 2 years following return from deployment. In soldiers reporting high combat stress exposure, both high mitogen-stimulated T-cell cytokine production and high innate cytokine production were associated with increases in PTSD symptoms in response to post-deployment SLE. In low combat stress exposed soldiers as well as those with low cytokine production, post-deployment SLE were not associated with increases in PTSD symptoms.High stimulated T-cell and innate cytokine production may contribute to stress sensitization in recently deployed, high combat stress exposed soldiers. These findings suggest that detecting and eventually normalizing immune activation may potentially complement future strategies to prevent progression of PTSD symptoms following return from deployment.",0 +https://doi.org/10.1002/mpr.1446,The Millennium Cohort Family Study: a prospective evaluation of the health and well-being of military service members and their families,"The need to understand the impact of war on military families has never been greater than during the past decade, with more than three million military spouses and children affected by deployments to Operations Iraqi Freedom and Enduring Freedom. Understanding the impact of the recent conflicts on families is a national priority, however, most studies have examined spouses and children individually, rather than concurrently as families. The Department of Defense (DoD) has recently initiated the largest study of military families in US military history (the Millennium Cohort Family Study), which includes dyads of military service members and their spouses (n > 10,000). This study includes US military families across the globe with planned follow-up for 21+ years to evaluate the impact of military experiences on families, including both during and after military service time. This review provides a comprehensive description of this landmark study including details on the research objectives, methodology, survey instrument, ancillary data sets, and analytic plans. The Millennium Cohort Family Study offers a unique opportunity to define the challenges that military families experience, and to advance the understanding of protective and vulnerability factors for designing training and treatment programs that will benefit military families today and into the future.",0 +https://doi.org/10.1016/j.janxdis.2015.02.005,Assessing possible DSM-5 ASD subtypes in a sample of victims meeting caseness for DSM-5 ASD based on self-report following multiple forms of traumatic exposure,"Acute stress disorder (ASD) was introduced into the DSM-IV to recognize early traumatic responses and as a precursor of PTSD. Although the diagnostic criteria for ASD were altered and structured more similarly to the PTSD definition in DSM-5, only the PTSD diagnosis includes a dissociative subtype. Emerging research has indicated that there also appears to be a highly symptomatic subtype for ASD. However, the specific nature of the subtype is currently unclear. The present study investigates the possible presence of ASD subtypes in a mixed sample of victims meeting caseness for DSM-5 ASD based on self-report following four different types of traumatic exposure (N=472). The results of latent profile analysis revealed a 5-class solution. The highly symptomatic class was marked by high endorsement on avoidance and dissociation compared to the other classes. Findings are discussed in regard to its clinical implications including the implications for the pending the ICD-11 and the recently released DSM-5.",0 +https://doi.org/10.1111/j.1475-3588.2007.00469.x,Post-Traumatic Stress Disorder in Turkish Child and Adolescent Survivors Three Years after the Marmara Earthquake,"The study investigated the emergence of post-traumatic stress disorder (PTSD) symptoms in child and adolescent survivors in Turkey three years after the 1999 Marmara Earthquake, with consideration of the severity of exposure and the survivors' gender and age. A representative sample of 293 young earthquake survivors (152 female and 141 male between the ages of 8 and 15) participated in the study. Participants' scores on the Post-Traumatic Stress Disorder Reaction Index for Children indicated that 31.4% reported moderate, 24.2% reported severe, and 3.8% reported very severe traumatic stress reactions. Analysis of the Revised Impact of Events Scale for Children scores revealed that 56% reported severe PTSD symptoms. While severity of exposure and gender were significantly associated with severity of PTSD symptoms, age was not related to PTSD symptoms. The results indicated a high need for addressing the mental health problems of the child and adolescent trauma survivors in Turkey.",0 +https://doi.org/10.1186/s12889-015-2647-8,"Five years after the accident, whiplash casualties still have poorer quality of life in the physical domain than other mildly injured casualties: analysis of the ESPARR cohort","This study aims to compare health status and quality of life five years after a road accident between casualties with whiplash versus other mild injuries, to compare evolution of quality of life at 1 and 5 years after the accident, and to explore the relation between initial injury (whiplash vs. other) and quality of life.The study used data from the ESPARR cohort (a representative cohort of road accident casualties) and included 167 casualties with ""pure"" whiplash and a population of 185 casualties with other mild injuries (MAIS-1). All subjects with lesions classified as cervical contusion (AIS code 310402) or neck sprain (AIS code 640278) were considered as whiplash casualties. Diagnosis was made by physicians, at the outset of hospital care, based on interview, clinical findings and X-ray. Whiplash injuries were then classified following the Quebec classification (grades 1 and 2). Quality of life was assessed on the WHOQoL-Bref questionnaire. Correlations between explanatory variables and quality of life were explored by Poisson regression and variance analysis.Between 1 and 5 years, global QoL improved for both whiplash and non-whiplash casualties; but, considering the two whiplash groups separately, improvement in grade 2 was much less than in grade 1. At 5 years, grade-2 whiplash casualties were more dissatisfied with their health (39.4%; p < 0.05) than non-whiplash (24.3%) or grade-1 whiplash casualties (27.0%). Deteriorated quality of life in the mental, social and environmental domains was mainly related to psychological and socioeconomic factors for both whiplash and other mildly injured road-accident casualties. While PTSD was a major factor for the physical domain, whiplash remained a predictive factor after adjustment on PTSD; unsatisfactory health at 5 years, with deteriorated quality of life in the physical domain, was observed specifically in the whiplash group, pain playing a predominant intermediate role.Deteriorated quality of life in the physical domain remained 5 years after the accident, specifically in the grade-2 whiplash group, pain playing a predominant intermediate role, which may be in line with the hypothesis of neuropathic pain.",0 +https://doi.org/10.1017/s0140525x12000374,Towards a multifaceted understanding of revenge and forgiveness,"Abstract We focus on two aspects: First, we argue that it is necessary to include implicit forgiveness as an additional adaptive behavioral option to the perception of interpersonal transgressions. Second, we present one possible way to investigate the cognitive-affective underpinnings of revenge and forgiveness: a functional MRI (fMRI) approach aiming at integrating forgiveness and revenge mechanisms into a single paradigm.",0 +https://doi.org/10.3402/ejpt.v5.24620,Assessing the co-occurrence of intimate partner violence domains across the life-course: relating typologies to mental health,"The inter-generational transmission of violence (ITV) hypothesis and polyvictimisation have been studied extensively. The extant evidence suggests that individuals from violent families are at increased risk of subsequent intimate partner violence (IPV) and that a proportion of individuals experience victimisation across multiple rather than single IPV domains. Both ITV and polyvictimisation are shown to increase the risk of psychiatric morbidity, alcohol use, and anger expression.The current study aimed to 1) ascertain if underlying typologies of victimisation across the life-course and over multiple victimisation domains were present and 2) ascertain if groupings differed on mean scores of posttraumatic stress disorder (PTSD), depression, alcohol use, and anger expression.University students (N=318) were queried in relation to victimisation experiences and psychological well-being. Responses across multiple domains of IPV spanning the life-course were used in a latent profile analysis. ANOVA was subsequently used to determine if profiles differed in their mean scores on PTSD, depression, alcohol use, and anger expression.Three distinct profiles were identified; one of which comprised individuals who experienced ""life-course polyvictimisation,"" another showing individuals who experienced ""witnessing parental victimisation,"" and one which experienced ""psychological victimisation only."" Life-course polyvictims scored the highest across most assessed measures.Witnessing severe physical aggression and injury in parental relationships as a child has an interesting impact on the ITV into adolescence and adulthood. Life-course polyvictims are shown to experience increased levels of psychiatric morbidity and issues with alcohol misuse and anger expression.",0 +https://doi.org/10.1007/s00391-014-0624-y,Traumatische Erfahrungen in der älteren deutschen Bevölkerung,"Background: World War II (WWII) is probably the most distressing and fatal historical event in Europe's recent past. Research on mental and physical health sequelae of these traumatic experiences from WWII has only started recently. Objectives: An overview on the findings from several population-based studies investigating the mental and physical health outcomes of traumatic experiences in the German elderly (born prior to 1946), especially from WWII, is given. Material and methods: The results presented here are based on several population-based representative studies regarding several aspects of mental and physical health in the elderly. Results: About 40-50 % of the elderly German population report at least one traumatic event, mostly from WWII. Traumatic experiences are related to higher rates of depressive and somatoform disorders, posttraumatic stress disorder, and physical morbidity, which are associated with increased health care utilization. Conclusion: The findings underline that the negative effects on health are long-term, manifold, and serious. Some of the elderly need psychotherapeutic interventions. Thus, a specific internet-based psychotherapeutic approach (ITT) is briefly presented. However, the majority of the elderly generally use other kinds of medical care, such as primary care, inpatient care, and geriatric care. It seems useful and necessary to pay more attention to the historical and biographical backgrounds of the patients to see and understand the current symptoms from this aspect. © 2014 Springer-Verlag Berlin Heidelberg.",0 +https://doi.org/10.1089/cap.2006.0121,Risperidone Treatment of Preschool Children with Thermal Burns and Acute Stress Disorder,"Pharmacologic treatment of acute stress disorder (ASD) is a novel area of investigation across all age groups. Very few clinical drug trials have been reported in children and adolescents diagnosed with ASD. Most of the available, potentially relevant, data are from studies of adults with posttraumatic stress disorder (PTSD). The atypical antipsychotic agents have been reported to be effective as an adjunctive treatment for adults with PTSD. There have been a limited number of studies published regarding atypical antipsychotic treatment of PTSD in children and adolescents, and there is no current literature available on the use of these agents for children with ASD. This report describes the successful treatment of three preschool-aged children with serious thermal burns as a result of physical abuse or neglect. Each of these children was hospitalized in a tertiary-care children's hospital and was diagnosed with ASD. In all cases, risperidone provided rapid and sustained improvement across all symptom clusters of ASD at moderate dosages. Minimal to no adverse effects were reported. These cases present preliminary evidence for the potential use of risperidone in the treatment of ASD in childhood.",0 +https://doi.org/10.1016/j.jad.2014.11.059,Specificity of abnormal brain volume in major depressive disorder: A comparison with borderline personality disorder,"Abnormal brain volume has been frequently demonstrated in major depressive disorder (MDD). It is unclear if these findings are specific for MDD since aberrant brain structure is also present in disorders with depressive comorbidity and affective dysregulation, such as borderline personality disorder (BPD). In this transdiagnostic study, we aimed to investigate if regional brain volume loss differentiates between MDD and BPD. Further, we tested for associations between brain volume and clinical variables within and between diagnostic groups.22 Females with a DSM-IV diagnosis of MDD, 17 females with a DSM-IV diagnosis of BPD and without comorbid posttraumatic stress disorder, and 22 age-matched female healthy controls (HC) were investigated using magnetic resonance imaging. High-resolution structural data were analyzed using voxel-based morphometry.A significant (p<0.05, cluster-corrected) volume decrease of the anterior cingulate cortex (ACC) was found in MDD compared to HC, as opposed to volume decreases of the amygdala in BPD compared to both HC and MDD. Sensitivity and specificity of regional gray matter volume for a diagnosis of MDD were modest to fair. Amygdala volume was related to depressive symptoms across the entire patient sample.Potential limitations of this study include the modest sample size and the heterogeneous psychotropic drug treatment.ACC volume reduction is more pronounced in MDD with an intermediate degree of volume loss in BPD compared to HC. In contrast, amygdala volume loss is more pronounced in BPD compared to MDD, yet amygdala volume is associated with affective symptom expression in both disorders.",0 +https://doi.org/10.1089/neu.2014.3844,Modeling of Community Integration Trajectories in the First Five Years after Traumatic Brain Injury,"The aims of this study were to assess the trajectories of community integration in individuals with traumatic brain injury (TBI) through one, two, and five years post-injury and to examine whether those trajectories could be predicted by demographic and injury characteristics. A longitudinal cohort study was conducted with 105 individuals with moderate-to-severe TBI admitted to a trauma referral center in 2005-2007. Demographics and injury-related factors were extracted from medical records. At the one-, two- and five-year follow-ups, community integration was measured by the Community Integration Questionnaire (CIQ). A hierarchical linear model (HLM) examined whether longitudinal trajectories of community integration could be predicted by: time, sex, age, relationship status, education, employment status, occupation, acute Glasgow Coma Scale score, cause of injury, days in post-traumatic amnesia (PTA), computed tomography Marshall Score, and Injury Severity Score. CIQ scores improved across the three time-points (p<0.001). Additionally, higher trajectories of community integration were predicted by being single at the time of injury (p<.001), higher level of education (p=0.006), employment (p<0.001), and a shorter length of PTA (p<0.001). In a follow-up HLM with interaction terms, time*PTA was statistically significant (p<0.001), suggesting that participants with longer PTA increased in community integration more rapidly than those with shorter PTA. The longitudinal course of community integration described in this study may help rehabilitation professionals to plan more extensive follow-ups and targeted rehabilitation programs in the early stage of recovery for patients with specific demographic and injury characteristics.",0 +https://doi.org/10.1002/icd.484,Latent growth mixture models: an important new tool for developmental researchers,"This manuscript by Connell and Frye (Infant Child Dev 2006; 15(6): 609–621) provides a clear example of the application of latent growth mixture models (LGMM) to the development of antisocial behaviour in adolescence. The LGMM approach is discussed in the context of this example, and factors influencing the results achieved with these methods are highlighted. Overall, developmental psychologists have much to gain from the use of these new approaches. Copyright © 2006 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1177/0004867414565478,The role of anger and ongoing stressors in mental health following a natural disaster,"Objective: Research has established the mental health sequelae following disaster, with studies now focused on understanding factors that mediate these outcomes. This study focused on anger, alcohol, subsequent life stressors and traumatic events as mediators in the development of mental health disorders following the 2009 Black Saturday Bushfires, Australia’s worst natural disaster in over 100 years. Method: This study examined data from 1017 (M = 404, F = 613) adult residents across 25 communities differentially affected by the fires and participating in the Beyond Bushfires research study. Data included measures of fire exposure, posttraumatic stress disorder, depression, alcohol abuse, anger and subsequent major life stressors and traumatic events. Structural equation modeling assessed the influence of factors mediating the effects of fire exposure on mental health outcomes. Results: Three mediation models were tested. The final model recorded excellent fit and observed a direct relationship between disaster exposure and mental health outcomes (b = .192, p < .001) and mediating relationships via Anger (b = .102, p < .001) and Major Life Stressors (b = .128, p < .001). Each gender was compared with multiple group analyses and while the mediation relationships were still significant for both genders, the direct relationship between exposure and outcome was no longer significant for men ( p = .069), but remained significant (b = .234, p < .001) for women. Conclusions: Importantly, anger and major life stressors mediate the relationship between disaster exposure and development of mental health problems. The findings have significant implications for the assessment of anger post disaster, the provision of targeted anger-focused interventions and delivery of government and community assistance and support in addressing ongoing stressors in the post-disaster context to minimize subsequent mental health consequences.",0 +https://doi.org/10.1017/s0954579400006131,Resilience as process,"Abstract Resilience, the development of competence despite severe or pervasive adversity, is examined using data from a longitudinal study of high-risk children and families. The study is guided by an organizationaldevelopmental perspective. Resilience is conceived not as a childhood given, but as a capacity that develops over time in the context of person-environment interactions. Factors related to resilience in our study are examined in terms of this transactional process. From our studies, we have found emotionally responsive caregiving to mediate the effects of high-risk environments and to promote positive change for children who have experienced poverty, family stress, and maltreatment. The implications of these findings are discussed.",0 +https://doi.org/10.1056/nejmoa1203366,Family Presence during Cardiopulmonary Resuscitation,"The effect of family presence during cardiopulmonary resuscitation (CPR) on the family members themselves and the medical team remains controversial.We enrolled 570 relatives of patients who were in cardiac arrest and were given CPR by 15 prehospital emergency medical service units. The units were randomly assigned either to systematically offer the family member the opportunity to observe CPR (intervention group) or to follow standard practice regarding family presence (control group). The primary end point was the proportion of relatives with post-traumatic stress disorder (PTSD)-related symptoms on day 90. Secondary end points included the presence of anxiety and depression symptoms and the effect of family presence on medical efforts at resuscitation, the well-being of the health care team, and the occurrence of medicolegal claims.In the intervention group, 211 of 266 relatives (79%) witnessed CPR, as compared with 131 of 304 relatives (43%) in the control group. In the intention-to-treat analysis, the frequency of PTSD-related symptoms was significantly higher in the control group than in the intervention group (adjusted odds ratio, 1.7; 95% confidence interval [CI], 1.2 to 2.5; P=0.004) and among family members who did not witness CPR than among those who did (adjusted odds ratio, 1.6; 95% CI, 1.1 to 2.5; P=0.02). Relatives who did not witness CPR had symptoms of anxiety and depression more frequently than those who did witness CPR. Family-witnessed CPR did not affect resuscitation characteristics, patient survival, or the level of emotional stress in the medical team and did not result in medicolegal claims.Family presence during CPR was associated with positive results on psychological variables and did not interfere with medical efforts, increase stress in the health care team, or result in medicolegal conflicts. (Funded by Programme Hospitalier de Recherche Clinique 2008 of the French Ministry of Health; ClinicalTrials.gov number, NCT01009606.).",0 +https://doi.org/10.1017/cbo9780511730030.034,Methodological Challenges in Studying the Mental Health Consequences of Disasters,,0 +https://doi.org/10.1002/1097-4679(198701)43:1<44::aid-jclp2270430107>3.0.co;2-n,Theoretical and empirical issues in the treatment of post-traumatic stress disorder in Vietnam veterans,"This article reviews the current status of research on the treatment of combat-related post-traumatic stress disorder (PTSD) in Vietnam veterans. Dynamic, behavioral, and biochemical models of treatment are presented, along with the findings of relevant treatment outcome studies. Examination of the treatment procedures employed in available studies revealed that direct therapeutic exposure to the memories of trauma emerged as the PTSD treatment technique common to all three theoretical models. The need for controlled investigations of the clinical efficacy of exposure-based interventions for combat-related PTSD is discussed. In addition, several other issues relevant to PTSD treatment research are presented and discussed, including the potential utility of studying untrained coping behavior in combat veterans; the effects of using heterogeneous subject samples in PTSD treatment research; and issues related to the measurement of treatment outcome.",0 +https://doi.org/10.1027/1016-9040/a000158,Exposure to Political Violence and Political Extremism,"Exposure to political violence can lead to various political and psychological outcomes. Using the protracted Israeli-Palestinian conflict as a natural laboratory, we explore the way in which exposure to conflict violence leads to changes in citizens’ political attitudes and behavior, offering a model for a stress-based process of political extremism. This model encapsulates three basic components in a causal chain leading to political extremism: exposure to political violence, psychological distress, and enhanced perceptions of threat. We find that prolonged exposure to political violence increases psychological distress, which in turn evokes stronger perceptions of threat that foment political attitudes eschewing compromise and favoring militarism. This causal chain fuels a destructive cycle of violence that is hard to break. Understanding these psychological and political consequences of exposure to political violence can help to shed light on the barriers that too often stymie peacemaking efforts and contribute to the deterioration of intractable conflicts around the globe. Thus, this review offers insights applicable to conflict zones around the world and suggests policy implications for therapeutic intervention and potential pathways to conflict resolution.",0 +https://doi.org/10.1007/s10880-012-9348-6,The Role of Injury and Trauma-Related Variables in the Onset and Course of Symptoms of Posttraumatic Stress Disorder,"Posttraumatic stress disorder (PTSD) affects a minority of trauma-exposed persons and is associated with significant impairment. This longitudinal study examined risk factors for PTSD. We tested whether the presence of injuries resulting from trauma exposure predicted the course of PTSD symptoms. In addition, we tested whether gender, trauma type, perceived life threat, and peritraumatic dissociation predicted the onset of PTSD symptoms. 236 trauma-exposed civilians were assessed for PTSD symptoms with a structured interview at four occasions during 6 months posttrauma. Path analysis showed that a model in which the female gender, assault, perceived life threat, and peritraumatic dissociation predicted PTSD severity at 1 week, and injury predicted PTSD severity 8 weeks after the traumatic event showed the best fit. However, a similar model without injury showed comparable fit. It is concluded that injuries have a negligible effect on the course of PTSD. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1007/s10803-014-2343-z,Variation in the Profile of Anxiety Disorders in Boys with an ASD According to Method and Source of Assessment,"To determine any variation that might occur due to the type of assessment and source used to assess them, the prevalence of 7 anxiety disorders were investigated in a sample of 140 boys with an Autism spectrum disorder (ASD) and 50 non-ASD (NASD) boys via the Child and Adolescent Symptom Inventory and the KIDSCID Clinical Interview. Boys with an ASD were significantly more anxious than their NASD peers. Data collected from the boys with an ASD themselves showed differences in the severity and diagnostic criterion of anxiety disorders to data collected from the boys’ parents. There were age-related variations to the pattern of anxiety disorder differences across reports from the boys with an ASD and reports from their parents.",0 +https://doi.org/10.1177/0886260514527172,"On the Pervasiveness of Event-Specific Alcohol Use, General Substance Use, and Mental Health Problems as Risk Factors for Intimate Partner Violence","The aim of this study was to evaluate the role of demographic, mental health, and substance use as risk factors for intimate partner violence (IPV). Data were derived from Wave II of the National Epidemiological Survey on Alcohol and Related Conditions (2004-2005). Eligible participants ( N = 25,778) reported having an intimate partner 1 year before the survey. Clustered survey multivariate multinomial regression methods were used to assess risk factors for episodes of IPV. IPV victimization, perpetration, and both victims/perpetrators were assessed. Bivariate analyses indicated that African Americans, Hispanics, and women were more likely to be victims, perpetrators, or victim/perpetrators as compared with men and Whites. Multivariate analyses suggested that having a marijuana use disorder was strongly associated with IPV victimization (odds ratio [OR] = 2.61) and victim/perpetration (OR = 2.65). Post-traumatic stress disorder was consistently associated with all IPV typologies. Depression was associated with victimization (OR = 2.00) and IPV victim/perpetration (OR = 1.74). Antisocial Personality Disorder and Mania were both related to IPV perpetration (ORs = 2.53 and 2.32) and victim/perpetration (ORs = 3.15 and 2.31). Results also indicated that alcohol use during episodes of IPV is common (i.e., 35% of those who reported IPV also reported that alcohol was involved). Results indicate several substance- and mental health–related correlates of IPV. In addition, findings indicate that alcohol use by the victim and/or perpetrator is common during IPV events. Policy implications and directions for future research are discussed.",0 +https://doi.org/10.1007/978-1-4615-1295-0_5,Neurobiological Models of Posttraumatic Stress Disorder,"(from the chapter) Focuses on two neurobiological systems that are critical for survival-the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis (HPA). Though most neurobiological research in posttraumatic stress disorder (PTSD) concentrates on these two systems, it is asserted that numerous other neurobiological systems are also involved in acute and chronic responses to stress, although far less is known about them as they relate to PTSD. Several new neurobiological models of PTSD are presented in an attempt to understand the current body of trauma-related neurobiological research. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.3109/10253890.2011.604751,"Stress risk factors and stress-related pathology: Neuroplasticity, epigenetics and endophenotypes","This paper highlights a symposium on stress risk factors and stress susceptibility, presented at the Neurobiology of Stress workshop in Boulder, CO, in June 2010. This symposium addressed factors linking stress plasticity and reactivity to stress pathology in animal models and in humans. Dr. J. Radley discussed studies demonstrating prefrontal cortical neuroplasticity and prefrontal control of hypothalamo-pituitary-adrenocortical axis function in rats, highlighting the emerging evidence of the critical role that this region plays in normal and pathological stress integration. Dr. M. Kabbaj summarized his studies of possible epigenetic mechanisms underlying behavioral differences in rat populations bred for differential stress reactivity. Dr. L. Jacobson described studies using a mouse model to explore the diverse actions of antidepressants in brain, suggesting mechanisms whereby antidepressants may be differentially effective in treating specific depression endophenotypes. Dr. R. Yehuda discussed the role of glucocorticoids in post-traumatic stress disorder (PTSD), indicating that low cortisol level may be a trait that predisposes the individual to development of the disorder. Furthermore, she presented evidence indicating that traumatic events can have transgenerational impact on cortisol reactivity and development of PTSD symptoms. Together, the symposium highlighted emerging themes regarding the role of brain reorganization, individual differences, and epigenetics in determining stress plasticity and pathology.",0 +https://doi.org/10.1016/s0924-9338(98)80045-x,Predictive factors of chronic Post-Traumatic Stress Disorder in rape victims,"This study aimed to investigate the psychological disorders following rape as well as the course of Post-Traumatic Stress Disorder (PTSD), and to determine clinical factors predictive of chronic PTSD. Seventy-three rape victims were observed in a systematic follow-up study over 1 year following rape using structured interview schedules. The frequency of PTSD was massive. The early disorders predicting PTSD 1 year after rape included somatoform and dissociative disorders, agoraphobia and specific phobias as well as depressive and gender identity disorders and alcohol abuse. Through stepwise logistic regressions, the following were found to be good models of prediction of chronic PTSD 1 year after rape: for the characteristics of the traumas, intrafamily rape, being physically assaulted outside rape, and added physical violence during rape; for the early psychological and behavioural attitudes, low self-esteem, permanent feelings of emptiness and running away; and for early mental disorders, agoraphobia and depressive disorders. Finally, among all these predictive factors, added physical violence during rape, low self-esteem, permanent feelings of emptiness and agoraphobia were shown to constitute a strong model of predictors. People presenting features such as the predictive factors of chronic PTSD found in the study should be asked about a history of rape and symptoms of PTSD.",0 +https://doi.org/10.1002/jts.20166,The impact of resource loss and traumatic growth on probable PTSD and depression following terrorist attacks,"The authors interviewed by phone 2,752 randomly selected individuals in New York City within 6 to 9 months after the attacks of September 11, 2001 on the World Trade Center, and 1,939 of these were reinterviewed at a 12- to 16-month follow-up. It was hypothesized that resource loss would significantly predict probable posttraumatic stress disorder (PTSD) and probable depression since September 11, and that resource loss's impact would be independent of previously identified predictors relating to individuals' demographic characteristics, history of stressful event exposure, prior trauma history, peritraumatic experience, and social support. Second, it was predicted that reported traumatic growth would be related to greater, not lesser, psychological distress. The authors' findings supported their hypotheses for resource loss, but traumatic growth was unrelated to psychological outcomes when other predictors were controlled.",0 +https://doi.org/10.1016/j.jad.2015.06.058,Patterns of DSM-5 posttraumatic stress disorder and depression symptoms in an epidemiological sample of Chinese earthquake survivors: A latent profile analysis,"Posttraumatic stress disorder (PTSD) and depression are highly comorbid in association with serious clinical consequences. Nevertheless, to date, no study using latent class or latent profile analysis (LCA/LPA) has examined patterns of co-occurring PTSD and depression symptoms among natural disaster survivors, nor has the distinctiveness of DSM-5 PTSD and depression symptoms been clarified in the aftermath of trauma. This study was primarily aimed at filling these gaps.LPA was used to examine self-reported PTSD and depression symptoms in an epidemiological sample of 1196 Chinese earthquake survivors.A 4-class solution characterized by low symptoms (53.9%), predominantly depression (18.2%), predominantly PTSD (18.9%) and combined PTSD-depression (9.0%) patterns fit the data best. Demographic characteristics and earthquake-related exposures were specifically or consistently associated with the non-parallel profiles varying in physical health impairment.A sample exposed to specific traumatic events was assessed by self-report measures.The distinctiveness of DSM-5 PTSD and depression symptoms following an earthquake suggests that PTSD and depression may be independent sequelae of psychological trauma rather than a manifestation of a single form of psychopathology. The current findings support the distinction between PTSD and depression constructs, and highlight the need for identifications of natural disaster survivors at high risk for PTSD and/or depression, and interventions individually tailored to one's symptom presentations.",0 +https://doi.org/10.1016/j.neurobiolaging.2014.12.015,"Trajectories of memory decline in preclinical Alzheimer's disease: results from the Australian Imaging, Biomarkers and Lifestyle Flagship Study of Ageing","Memory changes in preclinical Alzheimer's disease (AD) are often characterized by heterogenous trajectories. However, data regarding the nature and determinants of predominant trajectories of memory changes in preclinical AD are lacking. We analyzed data from 333 cognitively healthy older adults who participated in a multicenter prospective cohort study with baseline and 18-, 36-, and 54-month follow-up assessments. Latent growth mixture modeling revealed 3 predominant trajectories of memory change: a below average, subtly declining memory trajectory (30.9%); a below average, rapidly declining memory trajectory (3.6%); and an above average, stable memory trajectory (65.5%). Compared with the stable memory trajectory, high Αβ (relative risk ratio [RRR] = 2.1), and lower Mini-Mental State Examination (RRR = 0.6) and full-scale IQ (RRR = 0.9) scores were independently associated with the subtly declining memory trajectory; and high Αβ (RRR = 8.3), APOE ε4 carriage (RRR = 6.1), and greater subjective memory impairment (RRR = 1.2) were independently associated with the rapidly declining memory trajectory. Compared with the subtly declining memory trajectory group, APOE ε4 carriage (RRR = 8.4), and subjective memory complaints (RRR = 1.2) were associated with a rapidly declining memory trajectory. These results suggest that the preclinical phase of AD may be characterized by 2 predominant trajectories of memory decline that have common (e.g., high Αβ) and unique (e.g., APOE ε4 genotype) determinants.",0 +https://doi.org/10.1017/s0954579404044463,Gender differences in childhood onset conduct disorder,"The present study tested several predictions related to the theory that girls with conduct disorder (CD) follow a single delayed onset pathway. The following hypotheses were tested among a high-risk, stratified random sample of youth who used public services during a 6-month period: boys will be more likely to have childhood onset CD (COCD) than girls; girls with COCD will be less common than girls with adolescent onset CD (AOCD); COCD girls. AOCD girls, and COCD boys will be similar in terms of risk profiles and AOCD boys will have a less severe risk profile than COCD girls; and risk factors that differentiate between COCD and AOCD among males will not differentiate between COCD and AOCD among females. Among those youth who met the criteria for CD, males were significantly more likely to have COCD than females. However, close to half of females with CD met the criteria for the COCD subtype. Of the seven risk factors that were examined, girls with COCD scored higher than COCD boys on three factors and higher than AOCD girls on four factors; however, only one significant difference was found between AOCD girls and COCD boys. Finally, risk factors appeared to differentiate between COCD and AOCD groups in a similar way among males and females. These findings suggest that COCD is not rare among females in public service sectors, COCD girls can be distinguished from AOCD girls in terms of risk factors, and risk factors for COCD among males are also relevant to females.",0 +https://doi.org/10.1016/s0010-440x(99)90147-5,Expert opinions about the ICD-10 category of enduring personality change after catastrophic experience,"The inclusion of enduring personality change after catastrophic experience (EPCACE) as a diagnostic category in the ICD-10 represents a turning point in the evolution of the nosology of traumatic stress syndromes, yet many aspects of the diagnosis remain contentious. Given the absence of published research concerning this category, an exploratory survey of international experts was conducted using a questionnaire focusing on key aspects of the category, namely whether respondents used the diagnosis of EPCACE in their practice; which features were most salient in making a diagnosis of posttraumatic personality change; the types and characteristics of traumatic events that were judged to be most likely to cause EPCACE; and the possible limitations of the ICD-10 diagnosis. A response rate of 56.3% was obtained. A substantial portion of trauma experts working in the field of human-engendered violence recognize the possibility that certain traumas can result in personality change. However, questions were raised about the specificity of the criteria proposed for the category of EPCACE in ICD-10. A composite profile of proposed additional features suggests that a more comprehensive array of adaptational changes are recognized than are encompassed by EPCACE.",0 +https://doi.org/10.1176/appi.ajp.158.11.1923,Gender differences in patients with posttraumatic stress disorder in a general psychiatric practice.,"This report examined gender differences in the clinical manifestations of current posttraumatic stress disorder (PTSD) in treatment-seeking patients.Outpatients with PTSD (N=138) were interviewed with the Structured Clinical Interview for DSM-IV.Compared with male patients, female patients experienced more reexperiencing symptoms and were more likely to meet criteria for current PTSD and to report sexual trauma as their index trauma. Men with PTSD were more likely than women with PTSD to meet criteria for a substance use disorder and for antisocial personality disorder. No gender differences were found in the frequency of other types of comorbid disorders, the number of comorbid disorders, or the presence of PTSD as a primary disorder.Overall, male and female patients with current PTSD present with fairly comparable clinical profiles.",0 +https://doi.org/10.1176/ajp.147.6.729,Risk factors for PTSD and other diagnoses in a general sample of Vietnam veterans,"This study examined the contribution of premilitary, military, and postmilitary risk factors to posttraumatic stress disorder (PTSD) and other postwar diagnoses in a sample of Vietnam veterans. PTSD was explained primarily by war stressors, including threat to life and exposure to grotesque death, but premilitary and postmilitary factors also contributed to the likelihood of a current diagnosis of PTSD. Panic disorder was also highly predicted by war experiences, whereas prewar functioning played a stronger role in several non-PTSD diagnoses. The study supported the notion that PTSD is specifically linked to intense stressors. Mechanisms for interactions among risk factors are discussed.",0 +https://doi.org/10.1016/j.psychres.2015.08.028,Minimally adequate mental health care and latent classes of PTSD symptoms in female Iraq and Afghanistan veterans,"Female veterans of Operations Enduring and Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND) represent a growing segment of Department of Veterans Affairs (VA) health care users. A retrospective analysis used national VA medical records to identify factors associated with female OEF/OIF/OND veterans' completion of minimally adequate care (MAC) for PTSD, defined as the completion of at least nine mental health outpatient visits within a 15-week period or at least twelve consecutive weeks of medication use. The sample included female OEF/OIF/OND veterans with PTSD who initiated VA health care between 2007-2013, and were seen in outpatient mental health (N=2183). Multivariable logistic regression models examined factors associated with completing MAC for PTSD, including PTSD symptom expression (represented by latent class analysis), sociodemographic, military, clinical, and VA access factors. Within one year of initiating mental health care, 48.3% of female veterans completed MAC. Race/ethnicity, age, PTSD symptom class, additional psychiatric diagnoses, and VA primary care use were significantly associated with completion of MAC for PTSD. Results suggest that veterans presenting for PTSD treatment should be comprehensively evaluated to identify factors associated with inadequate completion of care. Treatments that are tailored to PTSD symptom class may help to address potential barriers.",0 +https://doi.org/10.1207/s15327752jpa8603_08,Risk of False Positives When Identifying Malingered Profiles Using the Trauma Symptom Inventory,"The Trauma Symptom Inventory (TSI; Briere, 1995) is a 100-item self-report measure of posttraumatic symptomatology that includes an Atypical Response (ATR) validity scale designed to differentiate honest from malingered profiles. In this study, using an analogue design to experimentally manipulate honest and malingered responses on the TSI, we found that proposed ATR cut scores produce a significant risk of false positives. Furthermore, the functioning of proposed cut scores worsened when we used posttraumatic stress disorder relevant samples and low estimates of malingering base rates. In light of these findings, the TSI should be used with caution when assessing claims of posttraumatic stress in forensic or disability settings.",0 +https://doi.org/10.1111/j.1471-6712.2007.00532.x,"Trauma, PTSD and personality: the relationship between prolonged traumatization and personality impairments","Chronic post-traumatic stress disorder (PTSD) has been associated with personality impairments involving externalized and internalized psychopathology. This study has explored the association between PTSD symptoms as consequences of prolonged torture experiences or early childhood trauma exposure and personality traits.One hundred and sixty-one men were included: 36 Iraqi men refugees (mean age = 43.9, SD = 8.7) who had longstanding torture experiences as adults; 42 Swedish prisoners (mean age = 33.8, SD = 7), with early childhood trauma exposure; 31 Arab men refugees (mean age = 41.8, SD = 8.9) without self-reported torture or violence experiences; 52 non-traumatized Swedish males (mean age = 39.3, SD = 5.5). They were assessed for symptoms of PTSD or PTSD hypothetical clusters. Personality profile was assessed by the Karolinska Scales of Personality (KSP). Factor analysis with varimax rotation was conducted and yielded three factors: externalized, internalized and avoidance domains.Individuals who suffered prolonged torture experiences or had early childhood trauma exposure showed impaired personality profiles in internalized and externalized domains. Individuals with or without PTSD showed significant differences p < 0.05 concerning: internalized, externalized and avoidance. ANOVA and post-hoc analysis according to Scheffé showed that the prolonged torture group > early childhood trauma exposure > nontraumatized group.Prolonged torture experiences or early trauma exposure may impair personality formation by enhancing the effects of cognitive, affective and behavioural vulnerabilities.",0 +https://doi.org/10.1016/j.comppsych.2008.02.004,Comorbidity in posttraumatic stress disorder: a structural equation modelling approach,"Posttraumatic stress disorder (PTSD) is associated with high rates of psychiatric comorbidity. Existing theories consider comorbidity as a consequence of PTSD (model 1), PTSD and comorbidity as a consequence of shared factors of vulnerability (model 2), and comorbidity as a consequence of trauma-type specific mechanisms (model 3).To compare the explanatory value of these models, we assessed PTSD (model 1), sense of coherence (model 2) and satisfaction with health (model 3) and symptoms of anxiety and depression as indicators of comorbidity 5 days (t1) and 6 months (t2) postaccident in 225 injured accident survivors. Structural equation models representing models 1 to 3 were tested separately and combined.Combined, models 1 and 3 explained 82% of the variance of comorbid symptoms at t2. Posttraumatic stress disorder and satisfaction with health (t2) exerted strong influences on comorbid symptoms.Comorbidity besides PTSD is best described by an integration of competing explanatory models.",0 +https://doi.org/10.1037/0021-843x.116.3.498,"Posttraumatic stress disorder symptoms, physiological reactivity, alcohol problems, and aggression among military veterans.","This study examined the association between posttraumatic stress disorder (PTSD) symptomatology and aggressive behavior among a sample of male Vietnam veterans (N = 1,328). Results indicated that the hyperarousal PTSD symptom cluster evidenced the strongest positive association with aggression at the bivariate level when compared with the other PTSD symptom clusters. When the PTSD symptom clusters were examined together as predictors, hyperarousal symptoms evidenced a significant positive relationship with aggression, and avoidance/numbing symptoms were negatively associated with aggression. Examination of potential mediators indicated that hyperarousal symptoms were directly associated with aggression and indirectly related to aggression via alcohol problems. Reexperiencing symptoms were associated with aggression only indirectly and through their positive association with physiological reactivity and negative association with alcohol problems. Study results highlight the complexity of the relationship between PTSD symptoms and aggression, and suggest possible mechanisms explaining this association.",0 +https://doi.org/10.1002/sim.1266,Binary partitioning for continuous longitudinal data: categorizing a prognostic variable,"We investigate a binary partitioning algorithm in the case of a continuous repeated measures outcome. The procedure is based on the use of the likelihood ratio statistic to evaluate the performance of individual splits. The procedure partitions a set of longitudinal data into two mutually exclusive groups based on an optimal split of a continuous prognostic variable. A permutation test is used to assess the level of significance associated with the optimal split, and a bootstrap confidence interval is obtained for the optimal split.",0 +https://doi.org/10.1007/s10072-011-0597-1,Expression of locus coeruleus mineralocorticoid receptor and glucocorticoid receptor in rats under single-prolonged stress,"The pathogenesis of the post-traumatic stress disorder (PTSD) may involve dysfunction of several brain structures, such as the amygdala, locus coeruleus, hippocampus, noradrenergic system as well as the hypothalamic- pituitary-adrenal (HPA) axis. The cortisol and locus coeruleus dysfunction may affect the secretion of corticosterone. The present study was designed to examine the expression of mineralocorticoid receptor (MR) and glucocorticoid receptor (GR) in the locus coeruleus in the rats treated with single-prolonged stress (SPS). The results showed that the expression of MR had a sharp decline on day 1, but gradually increased on days 4, 7, 14, and 28. The expression of GR gradually increased on days 1, 4, and 7, but decreased on days 14 and 28, respectively.MR and GR in the locus coeruleus may have a role in the development of long-term persistent neuropsychological sequelae in PTSD. © 2011 Springer-Verlag.",0 +https://doi.org/10.1037//0022-3514.83.5.1150,Resilience to loss and chronic grief: A prospective study from preloss to 18-months postloss.,"The vast majority of bereavement research is conducted after a loss has occurred. Thus, knowledge of the divergent trajectories of grieving or their antecedent predictors is lacking. This study gathered prospective data on 205 individuals several years prior to the death of their spouse and at 6- and 18-months postloss. Five core bereavement patterns were identified: common grief, chronic grief, chronic depression, improvement during bereavement, and resilience. Common grief was relatively infrequent, and the resilient pattern most frequent. The authors tested key hypotheses in the literature pertaining to chronic grief and resilience by identifying the preloss predictors of each pattern. Chronic grief was associated with preloss dependency and resilience with preloss acceptance of death and belief in a just world.",0 +https://doi.org/10.1016/j.mhpa.2012.12.001,Smoking status and exercise in relation to PTSD symptoms: A test among trauma-exposed adults,"The present investigation examined the interactive effect of cigarette smoking status (i.e., regular smoking versus non-smoking) and weekly exercise (i.e., weekly metabolic equivalent) in terms of posttraumatic stress (PTSD) symptom severity among a community sample of trauma-exposed adults. Participants included 86 trauma-exposed adults (58.1% female; Mage = 24.3). Approximately 59.7% of participants reported regular (≥ 10 cigarettes per day) daily smoking over the past year. The interactive effect of smoking status by weekly exercise was significantly associated with hyperarousal and avoidance symptom cluster severity (p ≤ .05). These effects were evident above and beyond number of trauma types and gender, as well as the respective main effects of smoking status and weekly exercise. Follow-up tests indicated support for the moderating role of exercise on the association between smoking and PTSD symptoms, such that the highest levels of PTSD symptoms were observed among regular smokers reporting low weekly exercise levels. Theoretical and clinical implications of the findings are discussed.",0 +https://doi.org/10.1016/j.janxdis.2015.10.005,Latent profiles of DSM-5 PTSD symptoms and the “Big Five” personality traits,"Typologies of DSM-5 PTSD symptoms and personality traits were evaluated in regard to coping styles and treatment preferences using data from 1266 trauma-exposed military veterans of which the majority were male (n=1097; weighted 89.6%). Latent profile analyses indicated a best-fitting 5-class solution; PTSD asymptomatic and emotionally stable (C1); predominant re-experiencing and avoidance symptoms and less emotionally stable (C2); subsyndromal PTSD (C3); predominant negative alterations in mood/cognitions and combined internalizing-externalizing traits (C4); and high PTSD severity and combined internalizing-externalizing traits (C5). Compared to C5, C1 members were less likely to use self-distraction, denial, and substance use and more likely to use active coping; C2 and C4 members were less likely to use denial and more likely to use behavioral disengagement; C3 members were less likely to use denial and instrumental coping and more likely to use active coping; most classes were less likely to seek mental health treatment. Compared to C1, C2 members were more likely to use self-distraction, substance use, behavioral disengagement and less likely to use active coping; C3 members were more likely to use self-distraction, and substance use, and less likely to use positive reframing, and acceptance; and C4 members were more likely to use denial, substance use, emotional support, and behavioral disengagement, and less likely to use active coping, positive reframing, and acceptance; all classes were more likely to seek mental health treatment. Emotional stability was most distinguishing of the typologies. Other implications are discussed.",0 +https://doi.org/10.1016/j.jsat.2015.06.001,The characteristics of a cohort who tamper with prescribed and diverted opioid medications,"To describe the methods and baseline characteristics of a cohort of people who tamper with pharmaceutical opioids, formed to examine changes in opioid use following introduction of Reformulated OxyContin®.Participants were 606 people from three Australian jurisdictions who reported past month injecting, snorting, chewing or smoking of a pharmaceutical opioid and had engaged in these practices at least monthly in the past 6 months. Baseline interviews were conducted prior to introduction of Reformulated OxyContin® in April 2014. Patterns of opioid use and cohort characteristics were examined according to whether participants were prescribed opioid medications, or exclusively used diverted medication.The cohort reported high levels of moderate/severe depression (61%), moderate/severe anxiety (43%), post-traumatic stress disorder (42%), chronic pain or disability (past 6 months, 54%) and pain (past month, 47%). Lifetime use of oxycodone, morphine, opioid substitution medications and codeine were common. Three-quarters (77%) reported ICD-10 lifetime pharmaceutical opioid dependence and 40% current heroin dependence. Thirteen percent reported past year overdose, and 70% reported at least one past month opioid injection-related injury or disease. The cohort displayed complex clinical profiles, but participants currently receiving opioid substitution therapy who were also prescribed other opioids particularly reported a wide range of risk behaviors, despite their health service engagement.Findings highlight the heterogeneity in the patterns and clinical correlates of opioid use among people who tamper with pharmaceutical opioids. Targeted health interventions are essential to reduce the associated harms.",0 +https://doi.org/10.1093/milmed/162.10.661,Post-Traumatic Stress Disorder and Functioning and Quality of Life Outcomes in Female Vietnam Veterans,"This investigation assessed whether current post-traumatic stress disorder (PTSD) was associated with impaired functioning in a nationally representative sample of female Vietnam veterans.Logistic models were used to determine the association between PTSD and outcome while adjusting for demographic characteristics and medical and psychiatric co-morbidities.PTSD was associated with significantly elevated odds of poorer functioning in five of the six outcome domains; only the association between perpetration of violence in the past year and PTSD did not achieve statistical significance. After adjusting for demographics and medical and psychiatric co-morbidities, PTSD remained associated with significantly elevated odds of bed days, poorer physical health, and currently not working.Among female Vietnam veterans PTSD is associated with a broad profile of functional impairment. The significantly increased odds of impaired functioning and diminished quality of life suggest that PTSD may be the core problem of the set of problems afflicting female Vietnam veterans.",0 +https://doi.org/10.1016/j.janxdis.2011.09.004,The structure of posttraumatic psychopathology in veterans attending primary care,"This study attempted to extend research indicating that posttraumatic stress disorder (PTSD) factors of Re-experiencing, Avoidance and Hyperarousal are more related to Fear/phobic disorders, while PTSD Dysphoria is more related to Anxious-Misery disorders. Trauma exposure, PTSD and comorbidity data for 668 veteran patients were analysed using confirmatory factor analyses and relative strengths of the relationships between PTSD factors and the Fear and Anxious-Misery factors were assessed. Combining Simms, Watson, and Doebbeling's (2002) model of PTSD symptoms and Krueger's (1999) Fear/Anxious Misery model of mood and anxiety disorders fit the data well. Contrary to previous research, PTSD Re-experiencing, Avoidance and Hyperarousal did not correlate more with the Fear factor; nor did PTSD Dysphoria correlate more with Anxious-Misery. Hyperarousal was more closely related to Fear than was Re-experiencing; however, Avoidance was not. Dysphoria was more closely related to the Anxious-Misery factor than all other PTSD factors.",0 +https://doi.org/10.1089/neu.2014.3401,Influence of the Severity and Location of Bodily Injuries on Post-Concussive and Combat Stress Symptom Reporting after Military-Related Concurrent Mild Traumatic Brain Injuries and Polytrauma,"Traumatic brain injuries (TBI) sustained in combat frequently co-occur with significant bodily injuries. Intuitively, more extensive bodily injuries might be associated with increased symptom reporting. In 2012, however, French et al. demonstrated an inverse relation between bodily injury severity and symptom reporting. This study expands on that work by examining the influence of location and severity of bodily injuries on symptom reporting after mild TBI. Participants were 579 US military service members who sustained an uncomplicated mild TBI with concurrent bodily injuries and who were evaluated at two military medical centers. Bodily injury severity was quantified using a modified Injury Severity Score (ISSmod). Participants completed the Neurobehavioral Symptom Inventory (NSI) and the Posttraumatic Stress Disorder Checklist (PCL-C), on average, 2.5 months post-injury. There was a significant negative association between ISSmod scores and NSI (r=-0.267, p<0.001) and PCL-C (r=-0.273, p<0.001) total scores. Using linear regression to examine the relation between symptom reporting and injury severity across the six ISS body regions, three body regions were significant predictors of the NSI total score (face; p<0.001; abdomen; p=0.003; extremities; p<0.001) and accounted for 9.3% of the variance (p<0.001). For the PCL-C, two body regions were significant predictors of the PCL-C total score (face; p<0.001; extremities; p<0.001) and accounted for 10.5% of the variance. There was an inverse relation between bodily injury severity and symptom reporting in this sample. Hypothesized explanations include underreporting of symptoms, increased peer support, disruption of fear conditioning because of acute morphine use, or delayed expression of symptoms.",0 +https://doi.org/10.1016/j.chc.2005.05.006,Childhood Post-Traumatic Stress Disorder: An Overview,"This article presents an overview of post-traumatic stress disorder (PTSD) as it relates to children and adolescents. The authors provide a critical review of the pediatric PTSD literature regarding the definition, epidemiology, clinical presentation, assessment, neurobiologic foundation, and treatment of PTSD. The importance of developmental and neurobiologic factors and the uniqueness of these factors to children are emphasized.",0 +,Female combat amputees have higher rates of posttraumatic stress disorder disability.,"The civilian trauma literature suggests that the sexes differ in physical and mental health outcomes following traumatic injury. In order to determine if the reaction to combat injury is different between the sexes in a specific war wounded population, service members with amputations, we examined the disability profiles of male and female amputees.All US combatants who sustained a major extremity amputation between October 2001 and July 2011 were examined for demographic and injury information from the Department of Defense Trauma Registry and for disability outcomes in the service specific Physical Evaluation Boards. The proportions of women versus men with various disabling conditions were compared using Fisher's Exact Test and the mean disability ratings for each condition were compared using student's t tests.Among 1,107 amputees, 21 were female. There was no difference in the average age, military rank, or Injury Severity Score between the sexes. While the most common military occupation of male amputees was infantry service, the most common occupation for the female amputee was military police. The overall disability ratings between females and males were not different (82% for females, 75% for males). Female amputees had more frequent disability from posttraumatic stress disorder (PTSD, 8/21 [38%] vs 168/818 [17%]). Disability ratings from PTSD tended to also be higher in women.Outside of variable occupational descriptions, both male and female amputees were exposed to explosions resulting in their injuries. Consistent with many civilian trauma and veterans' population studies, female amputees have higher frequencies of disability from PTSD. These results support the need for additional effort and attention directed towards optimizing physical and mental fitness following deployment in order to reduce disability and promote return to duty. Because certain conditions, such as PTSD, may be more or less common in men versus women veterans, postdeployment fitness may need to be tailored in a gender specific way.",0 +https://doi.org/10.1007/s11920-014-0469-5,Multiple Vantage Points on the Mental Health Effects of Mass Shootings,"The phenomenon of mass shootings has emerged over the past 50 years. A high proportion of rampage shootings have occurred in the United States, and secondarily, in European nations with otherwise low firearm homicide rates; yet, paradoxically, shooting massacres are not prominent in the Latin American nations with the highest firearm homicide rates in the world. A review of the scientific literature from 2010 to early 2014 reveals that, at the individual level, mental health effects include psychological distress and clinically significant elevations in posttraumatic stress, depression, and anxiety symptoms in relation to the degree of physical exposure and social proximity to the shooting incident. Psychological repercussions extend to the surrounding affected community. In the aftermath of the deadliest mass shooting on record, Norway has been in the vanguard of intervention research focusing on rapid delivery of psychological support and services to survivors of the “Oslo Terror.” Grounded on a detailed review of the clinical literature on the mental health effects of mass shootings, this paper also incorporates wide-ranging co-author expertise to delineate: 1) the patterning of mass shootings within the international context of firearm homicides, 2) the effects of shooting rampages on children and adolescents, 3) the psychological effects for wounded victims and the emergency healthcare personnel who care for them, 4) the disaster behavioral health considerations for preparedness and response, and 5) the media “framing” of mass shooting incidents in relation to the portrayal of mental health themes. © 2014, Springer Science+Business Media New York.",0 +https://doi.org/10.1186/1471-2458-10-573,Social support and Quality of Life: a cross-sectional study on survivors eight months after the 2008 Wenchuan earthquake,"Abstract Background The 2008 Wenchuan earthquake resulted in extensive loss of life and physical and psychological injuries for survivors. This research examines the relationship between social support and health-related quality of life for the earthquake survivors. Methods A multistage cluster sampling strategy was employed to select participants from 11 shelters in nine counties exposed to different degrees of earthquake damage, for a questionnaire survey. The participants were asked to complete the Short Form 36 and the Social Support Rating Scale eight months after the earthquake struck. A total of 1617 participants returned the questionnaires. The quality of life of the survivors (in the four weeks preceding the survey) was compared with that of the general population in the region. Multivariate logistic regression analysis and canonical correlation analysis were performed to determine the association between social support and quality of life. Results The earthquake survivors reported poorer quality of life than the general population, with an average of 4.8% to 19.62% reduction in scores of the SF-36 (p < 0.001). The multivariate logistic regression analysis showed that those with stronger social support were more likely to have better quality of life. The canonical correlation analysis found that there was a discrepancy between actual social support received and perceived social support available, and the magnitude of this discrepancy was inversely related to perceived general health (rs = 0.467), and positively related to mental health (rs = 0.395). Conclusion Social support is associated with quality of life in the survivors of the earthquake. More attention needs to be paid to increasing social support for those with poorer mental health.",0 +https://doi.org/10.1080/08964280209596399,Childhood Posttraumatic Stress Disorder and Efforts to Cope After Hurricane Floyd,"The authors report on the level of posttraumatic stress disorder (PTSD) experienced by fourth-grade children 6 months after Hurricane Floyd and describe the children's efforts to cope with their stress. All of the children they studied were directly affected by the hurricane, secondary to the destruction of their school by floodwaters. The homes of 37% of these children were also flooded. Ninety-five percent of the children experienced at least mild symptoms of PTSD, and 71% had symptoms that were moderate to very severe. Children who reported that their homes were flooded were 3 times more likely to report symptoms than those whose homes were not flooded, and the girls were twice as likely as the boys to report symptoms. The high PTSD prevalence rates are comparable to findings from other studies involving violence in which 94% of the victims reported experiencing symptoms. For further analyses, the authors used symptom clusters of hyperarousal, numbing/avoidance, and reexperiencing symptoms.",0 +https://doi.org/10.1037/a0026291,Efficacy of group treatment for posttraumatic stress disorder symptoms: A meta-analysis.,"This study conducted a meta-analysis of published randomized clinical group trials for adult survivors of trauma to examine the efficacy of the group format. Effect sizes for posttraumatic stress disorder (PTSD) severity outcome were examined. Sixteen studies were included, with a total of 1686 participants. Results of a random effects model meta-analysis indicated that group treatments are associated with significant preto posttreatment reduction in PTSD symptom severity (within treatment d .71, 95% CI [.51, .91]), and result in superior treatment effects relative to a wait list comparison condition (d .56, 95% CI [.31, .82]). However, no significant findings were obtained for group interventions relative to active treatment comparison conditions (d .09, 95% CI [ .03, .22]). Moderator analyses also indicated that gender and type of trauma moderated treatment effects for PTSD outcome, with smaller effect sizes associated with males relative to females and combined gender samples, and smaller effect sizes for combat and child sexual assault trauma samples relative to mixed-trauma sample studies. Taken together, group treatment for trauma symptoms is better than no treatment but not better relative to comparison conditions that control for nonspecific benefits of therapy. Additional work is needed to identify effective group treatments for PTSD, especially for patients with repeated or chronic traumatization.",0 +https://doi.org/10.1007/s11126-013-9272-4,Race and Incarceration in an Aging Cohort of Vietnam Veterans in Treatment for Post-Traumatic Stress Disorder (PTSD),"Cross sectional studies have addressed the incarceration of Vietnam veterans with post-traumatic stress disorder (PTSD), but no studies have examined changes in incarceration as they age. This study examines patterns of incarceration among Vietnam veterans treated in specialized veterans affairs (VA) intensive PTSD programs over time. Data was drawn from admission data from the initial episode of treatment of Caucasian and African American Vietnam veterans entering VA specialized intensive PTSD programs between 1993 and 2011 (N = 31,707). Bivariate correlations and logistic regression were used to examine associations among race and incarceration over time and the potentially confounding influence of demographic and clinical covariates on this relationship. Rates of reported incarceration declined from 63 to 43 %. Over time, African American veterans were 34 % more likely than Caucasian veterans to have a lifetime history of incarceration while interaction analysis showed steeper declines for Caucasians than African Americans. Rates of incarceration among these Vietnam veterans declined as they aged. Furthermore, African American veterans were substantially more likely than Caucasian veterans to have been incarcerated and showed less decline as the cohort aged. While reduced, needs for clinical PTSD services remain among aging combat veterans. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1007/s10862-014-9413-6,Tolerating Distress After Trauma: Differential Associations Between Distress Tolerance and Posttraumatic Stress Symptoms,"Distress tolerance has been implicated in disorders of emotional regulation, such as eating disorders and borderline personality disorder; however, much less attention has been given to distress tolerance in the context of posttraumatic stress (PTS). Several conceptual linkages between distress tolerance and PTS exist. Low distress tolerance may increase negative appraisals, reducing an individual's propensity to deal with distressing mental symptoms immediately after a trauma. Relatedly, a perceived inability to cope with the distress brought on by trauma-related memories and cues may engender maladaptive coping strategies. The few published studies examining the relationship between distress tolerance and PTS have demonstrated that lower distress tolerance was associated with increased PTS symptomatology, including increased avoidance, hyperarousal, and re-experiencing. The current study sought to replicate and extend the emerging empirical base by examining the relationship between distress tolerance and the four distinct PTS symptom clusters, while controlling for time since the index trauma and depressive symptoms. Results indicated that distress tolerance accounted for significant unique variance in re-experiencing and avoidance but not negative emotionality and hyperarousal symptoms. There was also a strong positive association between the number of traumas endorsed by participants, depression, and PTS symptoms. Findings suggest that distress tolerance is associated with PTS, lending further support to the putative relationship between PTS and distress tolerance. Accordingly, developing treatment protocols designed to increase distress tolerance in individuals affected by PTS may reduce symptom severity and increase coping abilities. © 2014 Springer Science+Business Media.",0 +https://doi.org/10.1037/0022-3514.92.4.745,Does repressive coping promote resilience? Affective-autonomic response discrepancy during bereavement.,"Traditional theories of coping emphasize the value of attending to and expressing negative emotion while recovering from traumatic life events. However, recent evidence suggests that the tendency to direct attention away from negative affective experience (i.e., repressive coping) may promote resilience following extremely aversive events (e.g., the death of a spouse). The current study extends this line of investigation by showing that both bereaved and nonbereaved individuals who exhibited repressive coping behavior--as measured by the discrepancy between affective experience and sympathetic nervous system response--had fewer symptoms of psychopathology, experienced fewer health problems and somatic complaints, and were rated as better adjusted by close friends than those who did not exhibit repressive coping. Results are discussed in terms of recent developments in cognitive and neuroimaging research suggesting that repressive coping may serve a protective function.",0 +https://doi.org/10.4018/978-1-4666-6563-7.ch015,Best Practice in Responding to Critical Incidents and Potentially Traumatic Experience within an Organisational Setting,"This chapter addresses best practice for organisational support after critical incidents and traumatic events within social work. Critical incidents are situations and incidents within workplace settings or roles, which, whilst able to be anticipated and planned for, have the potential to create a sense of emergency, crisis, and extreme stress, or have a traumatic impact on those directly or indirectly affected. Alongside the notion of critical incidents are concepts of debriefing, psychological debriefing, Critical Incident Stress Debriefing (CISD), and Critical Incident Stress Management (CISM). Debate about debriefing models has concerned their effectiveness and safety; the terms being loaded with meaning and tensions between scientific and holistic paradigms and between academic and practitioner perspectives. The chapter suggests areas of research and exploration for agency managers and senior practitioners wishing to make sense of the debates and enables the reader to consider best practice for critical incident response within organisational settings.",0 +https://doi.org/10.1002/pri.1598,"Physiotherapists' Beliefs About Whiplash‐associated Disorder: A Comparison Between Singapore and Queensland, Australia","Healthcare providers' beliefs may play a role in the outcome of whiplash-associated disorders (WAD), a condition which is proposed to be culturally dependent. Clinical practice guidelines recommend an active approach for the management of WAD, which is often delivered by physiotherapists. However, there is no data on physiotherapists' whiplash beliefs. Our primary objective was to determine physiotherapists' beliefs from Queensland (Australia) and Singapore, two cultures with differing prevalence of chronic musculoskeletal pain and chronic WAD.A pen and paper survey of musculoskeletal physiotherapists practicing in Queensland and Singapore was conducted. Participants completed questionnaires consisting of patient vignettes and statements inquiring knowledge and attitudes towards WAD. Chi-square tests of significance were used to compare the responses of physiotherapists from both samples.Ninety-one (response rate 45%) Queensland-based and 94 (response rate 98%) Singapore-based physiotherapists participated in the study. The beliefs in the management strategies for the patient vignettes were generally consistent with practice guidelines. A higher proportion of Queensland-based physiotherapists expected permanent disabilities for the patient vignette depicting chronic WAD (Queensland: 55% Singapore: 28% Pearson chi-sq 18.76, p < 0.005).Up to 99% of the physiotherapists from both samples believed in encouragement of physical activity, the effectiveness of exercise and multimodal physiotherapy for WAD. Significantly higher proportions of Singapore-based physiotherapists believed in ordering radiographs for acute WAD (Pearson chi-sq 41.98, p < 0.001) and also believed in a psychogenic origin of chronic WAD (Pearson chi-sq 22.57, p 0.001).The majority of beliefs between physiotherapists in Queensland and Singapore were similar but there were specific differences. Physiotherapists' whiplash beliefs in Queensland and Singapore did not clearly reflect the difference in prevalence of chronic musculoskeletal pain or chronic WAD in Queensland and Singapore.",0 +https://doi.org/10.1037/0022-0167.54.2.189,Anger problem profiles among partner violent men: Differences in clinical presentation and treatment outcome.,"Cluster analysis of 139 partner violent men's self-reports on the State-Trait Anger Expression Inventory identified profiles reflecting pathological anger (PA), low anger control (LAC), and normal anger (NA). The PA group self-reported higher pretreatment partner abuse, interpersonal dysfunction, distress, and substance abuse and had lower treatment attendance than the NA and LAC groups. Collateral (victim) partners reported higher pretreatment abuse by the PA and LAC groups than the NA group. At posttreatment and 6-month follow-up, the PA group had the highest levels of physical assault and injury. The LAC group exceeded the NA group in physical assault at posttreatment and psychological aggression at posttreatment and follow-up. The recognition of distinct anger problem profiles may lead to new strategies for research and practice.",0 +https://doi.org/10.1016/j.psym.2011.08.007,"The Comorbidity of Self-Reported Chronic Fatigue Syndrome, Post-Traumatic Stress Disorder, and Traumatic Symptoms","Background Data from primary care and community samples suggest higher rates of post-traumatic stress disorder (PTSD) among individuals with chronic fatigue syndrome (CFS). Objective This study investigated the co-occurrence of CFS, PTSD, and trauma symptoms and assessed the contribution of familial factors to the association of CFS with lifetime PTSD and current traumatic symptoms. Method Data on lifetime CFS and PTSD, as measured by self-report of a doctor's diagnosis of the disorder, and standardized questionnaire data on traumatic symptoms, using the Impact of Events Scale (IES), were obtained from 8544 female and male twins from the community-based University of Washington Twin Registry. Results Lifetime prevalence of CFS was 2% and lifetime prevalence of PTSD was 4%. Participants who reported a history of PTSD were over eight times more likely to report a history of CFS. Participants with scores ≥ 26 on the IES were over four times more likely to report CFS than those who had scores ≤ 25. These associations were attenuated but remained significant after adjusting for familial factors through within-twin pair analyses. Conclusion These results support similar findings that a lifetime diagnosis of CFS is strongly associated with both lifetime PTSD and current traumatic symptoms, although familial factors, such as shared genetic and environmental contributions, played a limited role in the relationship between CFS, PTSD, and traumatic symptoms. These findings suggest that future research should investigate both the familial and the unique environmental factors that may give rise to both CFS and PTSD.",0 +https://doi.org/10.1093/jpepsy/jsv074,Systematic Review: A Reevaluation and Update of the Integrative (Trajectory) Model of Pediatric Medical Traumatic Stress,"The objective of this systematic review is to reevaluate and update the Integrative Model of Pediatric Medical Traumatic Stress (PMTS; Kazak et al., 2006), which provides a conceptual framework for traumatic stress responses across pediatric illnesses and injuries.Using established systematic review guidelines, we searched PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and PubMed (producing 216 PMTS papers published since 2005), extracted findings for review, and organized and interpreted findings within the Integrative Model framework.Recent PMTS research has included additional pediatric populations, used advanced longitudinal modeling techniques, clarified relations between parent and child PMTS, and considered effects of PMTS on health outcomes. Results support and extend the model's five assumptions, and suggest a sixth assumption related to health outcomes and PMTS.Based on new evidence, the renamed Integrative Trajectory Model includes phases corresponding with medical events, adds family-centered trajectories, reaffirms a competency-based framework, and suggests updated assessment and intervention implications.",0 +https://doi.org/10.1016/j.janxdis.2010.03.009,Factor structure of posttraumatic stress disorder symptoms in the Australian general population,"The tripartite model of posttraumatic stress disorder (PTSD) articulated in DSM-IV has received limited empirical support. Over the past decade, a burgeoning literature on PTSD symptom structure has accumulated suggesting several alternative models. Elucidating the latent structure of PTSD has important clinical and theoretical implications. This paper presents the first confirmatory factor analytic investigation of PTSD symptoms in an epidemiologically based trauma-exposed sample from Australia. Data from a subsample of respondents from the 2007 National Survey of Mental Health and Wellbeing (NSMHWB; n=2677) were submitted to confirmatory factor analysis and several alternative conceptual models were tested. Empirical support was found for an intercorrelated four-factor model reflecting re-experiencing, avoidance, dysphoria, and hyperarousal symptoms. Given that the DSM is currently under revision, research addressing structural validity concerns is especially timely. The present findings renew calls in the structural literature suggesting that the structure of PTSD should be revised in DSM-V.",0 +https://doi.org/10.1196/annals.1364.051,Posttraumatic Stress Disorder and Other Psychological Sequelae Among World Trade Center Clean Up and Recovery Workers,"We assessed the health of workers exposed to the World Trade Center (WTC) site and of a comparison group of unexposed workers, by means of a mail survey. Exposed workers reported higher frequency of symptoms consistent with posttraumatic stress disorder (PTSD), depression, anxiety, and other psychological problems, approximately 20 months after the disaster. PTSD was positively associated with traumatic on-site experiences and with respiratory problems. These findings may have important clinical and public health implications.",0 +https://doi.org/10.1037/a0029609,"Beyond fear, helplessness, and horror: Peritraumatic reactions associated with posttraumatic stress symptoms among traumatized delinquent youth.","This study investigated associations among peritraumatic reactions, including the triad of fear, helplessness, and horror specified in Criterion A2 of the DSM-IV-R, and posttraumatic stress disorder (PTSD) diagnostic status and symptom severity among a sample of 555 juvenile justice-involved adolescents (188 girls and 367 boys). Results of hierarchical and logistic regression analyses indicated that, with the exception of helplessness, peritraumatic reactions beyond the DSM-IV-R triad, particularly disorganized behavior and confusion, were more strongly associated with PTSD diagnosis and symptoms among these youth than were the A2 criteria. Gender differences also emerged in the pattern of results, with disorganized behavior and dissociation associated more strongly with PTSD symptom levels among girls than boys. In addition, investigation of the relations between peritraumatic reactions and the recently proposed 5-factor model of PTSD symptom clusters showed that peritraumatic disorganization was the most consistently associated with PTSD symptoms, whereas peritraumatic helplessness was uniquely associated with Numbing among boys and Dissociation among girls. These results have implications for informing the DSM-5 as well as adding to the evidence base for deriving developmentally sensitive criteria for the diagnosis of PTSD among youth exposed to trauma.",0 +https://doi.org/10.1080/13803395.2013.798398,Neuropsychological functioning of combat veterans with posttraumatic stress disorder and mild traumatic brain injury,"This study examined the neuropsychological performance of 125 outpatient Operation Enduring Freedom/Operation Iraqi Freedom combat veterans with posttraumatic stress disorder (PTSD) and nonacute mild traumatic brain injury (TBI) (n = 66) and PTSD (n = 59) across multiple cognitive domains to determine whether mild TBI results in greater impairment among those with PTSD. Profile analyses revealed that veterans with PTSD and mild TBI did not differ significantly from those with just PTSD across domains, suggesting that comorbid mild TBI does not result in an additive effect. A norms-based comparison also revealed that neither group demonstrated impaired performance on any of the objective neuropsychological measures examined. However, both groups endorsed moderately elevated symptoms of depression and anxiety, indicating that comorbid psychopathology may contribute to subjective cognitive complaints.",0 +https://doi.org/10.1037/10409-010,Second-generation structural equation modeling with a combination of categorical and continuous latent variables: New opportunities for latent class–latent growth modeling.,,0 +https://doi.org/10.1097/00005053-200102000-00006,Posttraumatic Stress Disorder and Psychosocial Functioning after Severe Traumatic Brain Injury,"The aim of this study was to investigate the influence of posttraumatic stress disorder (PTSD) on rehabilitation after severe traumatic brain injury (TBI). Ninety-six patients with severe TBI patients were assessed 6 months after hospital discharge with the Posttraumatic Stress Disorder Interview, the Functional Assessment Measure (FAM), the Community Integration Questionnaire (CIQ), the Overt Aggression Scale (OAS), the General Health Questionnaire (GHQ), the Beck Depression Inventory (BDI), and the Satisfaction with Life Scale (SWL). PTSD was diagnosed in 27% of patients. Patients with PTSD reported higher scores on the GHQ and BDI, and lower scores on the FAM, CIQ, OAS, and SWLS than those without PTSD. Effective rehabilitation after severe TBI may be enhanced by management of PTSD.",0 +https://doi.org/10.2466/pr0.94.2.408-410,Responsivity to Stress in Chronic Posttraumatic Stress Disorder Due to Childhood Sexual Abuse,"The purpose of this study was to investigate psychological, cardiovascular, and neuroendocrine reactivity to standardized stress tests (orthostatic challenge, Stroop Color Word Test) in drug-free adult women with chronic PTSD due to repetitive childhood sexual abuse. At baseline, the 11 patients showed significantly higher mean scores on the Symptom Check List-90 and the Profile of Mood States than 13 healthy female controls, whereas baseline cardiovascular or hormonal parameters showed no differences between the groups. Also, no significant differences were found between the two groups in cardiovascular and hormonal responsivity to the stress tests. Thus, in the presence of robust psychological differences, the patients with chronic PTSD due to childhood sexual abuse did not show alterations in baseline values of neurobiological parameters, nor did they react differently to a physical and mental stress test when compared to healthy controls.",0 +https://doi.org/10.1016/j.cpr.2007.07.008,Mental health following traumatic injury: Toward a health system model of early psychological intervention,"In 2005, over 2 million people in the United States of America were hospitalised following non-fatal injuries. The frequency with which severe injury occurs renders it a leading cause of posttraumatic stress disorder and other trauma-related psychopathology. In order to develop a health system model of early psychological intervention for this population, we review the literature that pertains to mental health early intervention. The relevant domains include prevalence of psychopathology following traumatic injury, the course of symptoms, screening, and early intervention strategies. On the basis of available evidence, we propose a health system model of early psychological intervention following traumatic injury. The model involves screening for vulnerability within the hospital setting, follow-up screening for persistent symptoms at one month posttrauma, and early psychological intervention for those who are experiencing clinical impairment. Recommendations are made to facilitate tailoring early intervention psychological therapies to the special needs of the injury population.",0 +https://doi.org/10.1016/j.janxdis.2014.09.015,Evaluation of the Dimensions of Anger Reactions-5 (DAR-5) Scale in combat veterans with posttraumatic stress disorder,"After a traumatic event many people experience problems with anger which not only results in significant distress, but can also impede recovery. As such, there is value to include the assessment of anger in routine post-trauma screening procedures. The Dimensions of Anger Reactions-5 (DAR-5), as a concise measure of anger, was designed to meet such a need, its brevity minimizing the burden on client and practitioner. This study examined the psychometric properties of the DAR-5 with a sample of 163 male veterans diagnosed with Posttraumatic Stress Disorder. The DAR-5 demonstrated internal reliability (α=.86), along with convergent, concurrent and discriminant validity against a variety of established measures (e.g., HADS, PCL, STAXI). Support for the clinical cut-point score of 12 suggested by Forbes et al. (2014, Utility of the dimensions of anger reactions-5 (DAR-5) scale as a brief anger measure. Depression and Anxiety, 31, 166-173) was observed. The results support considering the DAR-5 as a preferred screening and assessment measure of problematic anger.",0 +https://doi.org/10.1186/1471-2458-9-159,MOSAIC (MOthers' Advocates In the Community): protocol and sample description of a cluster randomised trial of mentor mother support to reduce intimate partner violence among pregnant or recent mothers,"Intimate partner violence (IPV) is prevalent globally, experienced by a significant minority of women in the early childbearing years and is harmful to the mental and physical health of women and children. There are very few studies with rigorous designs which have tested the effectiveness of IPV interventions to improve the health and wellbeing of abused women. Evidence for the separate benefit to victims of social support, advocacy and non-professional mentoring suggested that a combined model may reduce the levels of violence, the associated mental health damage and may increase a woman's health, safety and connection with her children. This paper describes the development, design and implementation of a trial of mentor mother support set in primary care, including baseline characteristics of participating women.MOSAIC (MOtherS' Advocates In the Community) was a cluster randomised trial embedded in general practice and maternal and child health (MCH) nursing services in disadvantaged suburbs of Melbourne, Australia. Women who were pregnant or with infants, identified as abused or symptomatic of abuse, were referred by IPV-trained GPs and MCH nurses from 24 general practices and eight nurse teams from January 2006 to December 2007. Women in the intervention arm received up to 12 months support from trained and supported non-professional mentor mothers. Vietnamese health professionals also referred Vietnamese women to bilingual mentors in a sub-study. Baseline and follow-up surveys at 12 months measured IPV (CAS), depression (EPDS), general health (SF-36), social support (MOS-SF) and attachment to children (PSI-SF). Significant development and piloting occurred prior to trial commencement. Implementation interviews with MCH nurses, GPs and mentors assisted further refinement of the intervention. In-depth interviews with participants and mentors, and follow-up surveys of MCH nurses and GPs at trial conclusion will shed further light on MOSAIC's impact.Despite significant challenges, MOSAIC will make an important contribution to the need for evidence of effective partner violence interventions, the role of non-professional mentors in partner violence support services and the need for more evaluation of effective health professional training and support in caring for abused women and children among their populations.ACTRN12607000010493.",0 +https://doi.org/10.1111/j.1552-6909.2011.01261.x,"Abuse‐Related Post‐Traumatic Stress, Coping, and Tobacco Use in Pregnancy","pregnancy cessation PTSD abuse coping ABSTRACT Objective: To examine the relationship between trauma history, posttraumatic stress disorder (PTSD), coping, and smoking in a diverse sample of pregnant women, some of whom are active smokers. Design: Secondary analysis from a prospective study on PTSD and pregnancy outcomes. Setting: Maternity clinics at three health systems in the midwestern United States. Participants: Women age 18 or older (1,547) interviewed at gestational age fewer than 28 weeks. Methods: Participants were classified at nonsmokers, quitters (stopped smoking during pregnancy), and pregnancy smokers. Demographic, trauma, and pregnancy factors, substance use, and use of tobacco to cope were compared across groups. Logistic regression assessed the influence of these factors on being a smoker versus a nonsmoker and a quitter versus a pregnancy smoker. Results: Smokers differed from nonsmokers on all demographic risk factors (being African American, being preg- nant as a teen, having lower income and less education, and living in high-crime areas), had higher rates of current and lifetime PTSD, and were more likely to report abuse as their worst trauma. Pregnancy smokers had lower levels of education, were more likely to classify their worst trauma as ''extremely troubling,'' and were more likely to exhibit PTSD hyperarousal symptoms. In regression models, smoking ''to cope with emotions and problems'' doubled the odds of continuing to smoke while pregnant even after accounting for several relevant risk factors.",0 +https://doi.org/10.1080/10509674.2011.650349,Personality Profiles of Intimate Partner Violence Offenders With and Without PTSD,"Intimate partner violence (IPV) is a serious forensic and clinical problem throughout the United States. Research aimed at defining and differentiating subgroups of IPV offenders using standardized personality instruments may eventually help with matching treatments to specific individuals to reduce recidivism. The current study used a convenience sample of court-ordered IPV offenders to explore whether the presence of posttraumatic stress disorder (PTSD) can reliably differentiate this population in terms of personality characteristics and clinical symptoms. Profile analysis showed meaningful differences between PTSD (n = 22), non-PTSD (n = 43), and nontrauma (n = 13) groups on a variety of Millon Clinical Multiaxial Inventory and Personality Assessment Inventory personality and clinical scales. The PTSD group reported significantly less IPV than the non-PTSD and nontrauma groups, as well as endorsing greater overall distress, greater symptoms of anxiety, and greater symptoms of depression across instrum...",0 +https://doi.org/10.1007/s10865-011-9369-x,Symptom experience during acute coronary syndrome and the development of posttraumatic stress symptoms,"There is growing evidence for the development of posttraumatic stress symptoms as a consequence of acute cardiac events. Acute coronary syndrome (ACS) patients experience a range of acute cardiac symptoms, and these may cluster together in specific patterns. The objectives of this study were to establish distinct symptom clusters in ACS patients, and to investigate whether the experience of different types of symptom clusters are associated with posttraumatic symptom intensity at six months. ACS patients were interviewed in hospital within 48 h of admission, 294 patients provided information on symptoms before hospitalisation, and cluster analysis was used to identify patterns. Posttraumatic stress symptoms were assessed in 156 patients at six months. Three symptom clusters were identified; pain symptoms, diffuse symptoms and symptoms of dyspnea. In multiple regression analyses, adjusting for sociodemographic, clinical and psychological factors, the pain symptoms cluster (β = .153, P = .044) emerged as a significant predictor of posttraumatic symptom severity at six months. A marginally significant association was observed between symptoms of dyspnea and reduced intrusive symptoms at six months (β = -.156, P = .061). Findings suggest acute ACS symptoms occur in distinct clusters, which may have distinctive effects on intensity of subsequent posttraumatic symptoms. Since posttraumatic stress is associated with adverse outcomes, identifying patients at risk based on their symptom experience during ACS may be useful in targeting interventions.",0 +https://doi.org/10.1002/(sici)1520-6572(199724)3:4<27::aid-sess4>3.0.co;2-5,Psychosocial treatment of posttraumatic stress disorder,"A review of the psychosocial treatment research literature indicates that several forms of therapy appear to be useful in reducing the symptoms of posttraumatic stress disorder (PTSD). Strongest support is found for the treatments that combine cognitive and behavioral techniques. Hypnosis, psychodynamic, anxiety management, and group therapies may also produce short-term symptom reduction. Still unknown is whether any approach produces lasting effects. Imaginal exposure to trauma memories and hypnosis are techniques most likely to affect the intrusive symptoms of PTSD, whereas cognitive and psychodynamic approaches may better address the numbing and avoidance symptom cluster. Treatment should be tailored to the severity and type of presenting PTSD symptoms, to the type of trauma experience, and to the many likely comorbid diagnoses and adjustment problems. © 1997 John Wiley & Sons, Inc.",0 +https://doi.org/10.1002/jts.21933,Dissociation and Posttraumatic Stress Disorder: A Latent Profile Analysis,"The fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, ) contains a dissociative subtype for posttraumatic stress disorder (PTSD) characterized by significant depersonalization and derealization. In this study the PTSD dissociative subtype was examined using latent profile analysis in a sample of 541 trauma-exposed college students. Items from the PTSD Checklist and Multiscale Dissociation Inventory were used as latent class indicators. Results supported a 3-class solution including a well-adjusted class, a PTSD class, and a PTSD/dissociative class characterized by elevated symptoms of PTSD, depersonalization, and derealization. Significant class differences were found on a number of measures of related psychopathology with Cohen's d effect size estimates ranging from 0.04 to 1.86. Diagnostic and treatment implications regarding the dissociative subtype are discussed.",0 +https://doi.org/10.1080/19485565.2013.774627,Epigenetic Signatures May Explain the Relationship between Socioeconomic Position and Risk of Mental Illness: Preliminary Findings from an Urban Community-Based Sample,"Low socioeconomic position (SEP) has previously been linked to a number of negative health indicators, including poor mental health. The biologic mechanisms linking SEP and mental health remain poorly understood. Recent work suggests that social exposures influence DNA methylation in a manner salient to mental health. We conducted a pilot investigation to assess whether SEP, measured as educational attainment, modifies the association between genomic methylation profiles and traumatic stress in a trauma-exposed sample. Results show that methylation × SEP interactions occur preferentially in genes pertaining to nervous system function, suggesting a plausible biological pathway by which SEP may enhance sensitivity to stress and, in turn, risk of posttraumatic stress disorder.[Supplementary materials are available for this article. Go to the publisher's online edition of Biodemography and Social Biology for the following free supplemental resource: Supplementary tables of full model and functional annotation clustering results.].",0 +https://doi.org/10.1017/cbo9780511711879.028,Ontogenetic Perspectives on the Neurobiological Basis of Psychopathology Following Abuse and Neglect,"Introduction The US Federal Child Abuse Prevention and Treatment Act defines child abuse and neglect as the recent act or failure of parents and caretakers resulting in physical or emotional injury, sexual exploitation, and/or death. According to national statistics on the prevalence of childhood abuse and neglect in the United States, 905,000 people under 18 years of age were victimized during 2006. Of these, 64.1% were neglected; 16.0% were physically abused; and 15.1% suffered abandonment, threats of harm, congenital drug addiction, or other forms of maltreatment. Furthermore, 8.8% were sexually abused; 6.6% were either emotionally or psychologically maltreated; and 2.2% were medically neglected. Childhood maltreatment is a major risk factor for the development of depression, drug and alcohol abuse, posttraumatic stress disorder (PTSD), bipolar disorder (BPD), personality disorders, and aggression. Depending on an individual's sex, genetic makeup, and age at insult, chronic childhood traumatic stress (CTS) alters the endocrine profile and gene-expression pattern, as well as the functional activity, hemispheric integration, and morphology of the brain. In this chapter, we offer a holistic portrayal of the pathways between maltreatment and adverse psychiatric outcomes, arguing that the impact of abuse and neglect is best understood in the context of normal ontogenetic processes relating to trajectories of brain development. Neuropsychiatric Effects Of Trauma Several studies have documented the consequences of exposure to CTS. One of the most compelling is the Adverse Childhood Experience (ACE) Study, led by Vincent Felitti and Robert Anda (Felitti et al., 1998). © Cambridge University Press 2010.",0 +https://doi.org/10.1016/s0005-7967(01)00025-0,Long term course of chronic posttraumatic stress disorder in traffic accident victims: a three-year prospective follow-up study,"The purpose of the present study was to gather prospective longitudinal data on the long-term course and outcome of chronic posttraumatic stress disorder (PTSD). The target population for this study was 74 injured traffic accident victims who had been previously followed-up for one year after the trauma. Nineteen of the original 24 PTSD subjects (79%) and 39 of the original 50 Non-PTSD subjects (78%) were available for this study, which took place during the fourth year after the accident. Our results show that 10 (53%) of the 19 patients with PTSD at one-year still suffered from PTSD after another two-year follow-up interval, while 9 recovered from PTSD during this follow-up period. Only 2 of the 39 without PTSD at one year developed delayed onset PTSD. The best predictor of recovery from chronic PTSD was the initial level of posttraumatic reaction immediately after the accident. These results demonstrate that spontaneous recovery from PTSD can occur even among patients who are currently considered chronic. Severity of initial reaction to the trauma appears to be a major risk factor for non-remitting chronic PTSD.",0 +,A comparison of posttraumatic stress disorder and posttraumatic growth in *American and Israeli war veterans,"Over 50% of people experience a traumatic event during their lifetimes (Del, Kevin, Scotti, & Chen, 2006). These traumas may include, rape, a car accident, diagnosis of a chronic illness or military combat (Tedeschi & Calhoun, 2004). The trauma may have no impact on the individual, a negative effect, known as posttraumatic stress disorder (PTSD) or a positive effect, known as posttraumatic growth (PTG). The research has shown that positive and negative responses to a trauma may co-exist (Tedeschi & Calhoun 1995). Extensive research has been conducted examining the negative impact war has on veterans (Elder & Clipp, 1989; Erbes, Dikel, & Eberly, 2006; Solomon & Mikulincer, 1987). However, little research has focused on the positive outcomes veterans may exhibit due to their war experience. The purpose of the current study was to determine if there were significant differences in PTSD and PTG between war veterans in the United States of America and Israel. The current study focused on differences between the value systems of the two cultures and the amount of perceived social support within the two cultures as possible variables contributing to the differences in PTSD and PTG. Additionally, the current study examined veteran type, age, sex, marital status, branch of military served, years of military experience and employment status as possible predictor variables in the experience of PTSD and PTG. A total of 137 war veterans (70 America and 67 Israeli) participated in this study. Each participant completed several self-report questionnaires. The following measures were included: a demographics questionnaire, the Posttraumatic Stress Disorder Checklist-Military (PCL-M; Weathers, Litz, Herman, Huska & Keane, 1993), the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996), the Multidimensional Scale of Perceived Social Support (MSPSS; Zimet, Dahlem, Zimet, & Farley, 1988), and the Schwartz Value Scale (SVS; Schwartz, 1992). It was hypothesized that there would be a significant difference in the cultural values exhibited between American war veterans and Israeli war veterans. Results supported this hypothesis. However, further analyses demonstrated that veteran type (American or Israeli) was not a significant predictor in the experience of PTSD or PTG. In addition, perceived social support did not mediate the relationships between veteran type and PTSD and veteran type and PTG. Additional findings provided evidence for the experience of PTG in Israel in the same five-factor model found in the United States. Results indicated that within this study younger veterans were more likely to report higher levels of PTSD than older veteran and veterans with more years of military service were more likely to report higher levels of PTSD than veterans with less years of military service. Further, results demonstrated that female veterans were more likely to report higher levels of PTG than male veterans and that married veterans were more likely to report higher levels of PTG than single veterans. Results indicated veterans from the Air Force were less likely to experience PTSD and PTG than veterans from the other branches of military. Implications, limitations and directions for future research were presented. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1037//0033-2909.129.1.52,Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis.,,0 +https://doi.org/10.1111/ajop.12048,"Political violence, health, and coping among Palestinian women in the West Bank.","Political violence poses a considerable threat to the health of individuals. Protective factors, however, may help people to build resilience in the face of political violence. This study examined the influence of lifetime and past 30-day experiences of political violence on the mental and physical health of adult Palestinian women from the West Bank (N = 122). Two hypotheses were examined: (a) Reports of political violence exposure would be related to reports of poorer physical and mental health and (b) several coping variables (proactive coping; self-reliance; reliance on political, family, and religious support; and political or civic engagement) would function as moderators of the effects of political violence, buffering or weakening its effects on physical and mental health outcomes. Both lifetime and past 30-day measures of political violence were positively correlated with posttraumatic stress disorder symptoms. Proactive coping, reliance on self, and political or civic engagement significantly interacted with political violence to affect health in a counterintuitive direction; those with higher scores on these more internalized and individualistic coping strategies demonstrated worse health as political violence increased. Reliance on religious support, and, in particular, support from and participation in activities of religious institutions, emerged as a significant protective factor. Results underscore the importance of looking not only at whether political violence affects health, but also at how the relationships between political violence and health might occur, including the potential protective influence of resources within people's social environments.",0 +https://doi.org/10.1117/12.2176345,Red/near-infrared light-emitting diode therapy for traumatic brain injury,"This invited paper reviews our research with scalp application of red/near-infrared (NIR) light-emitting diodes (LED) to improve cognition in chronic, traumatic brain injury 1. Application of red/NIR light improves mitochondrial function (especially hypoxic/compromised cells) promoting increased ATP, important for cellular metabolism. Nitric oxide is released locally, increasing regional cerebral blood flow. Eleven chronic, mTBI participants with closed-head injury and cognitive dysfunction received 18 outpatient treatments (MWF, 6 Wks) starting at 10 Mo. to 8 Yr. post-mTBI (MVA, sports-related, IED blast injury). LED therapy is non-invasive, painless, non-thermal (FDA-cleared, non-significant risk device). Each LED cluster head (2.1 diameter, 500mW, 22.2mW/cm2) was applied 10 min (13J/cm2) to 11 scalp placements: midline, from front-to-back hairline; and bilaterally on dorsolateral prefrontal cortex, temporal, and parietal areas. Testing performed pre- and post-LED (+1 Wk, 1 and 2 Mo post- 18th treatment) showed significant linear trend for LED effect over time, on improved executive function and verbal memory. Fewer PTSD symptoms were reported. New studies at VA Boston include TBI patients treated with transcranial LED (26J/cm2); or treated with only intranasal red, 633nm and NIR, 810nm diodes placed into the nostrils (25 min, 6.5mW, 11.4J/cm2). Intranasal LEDs are hypothesized to deliver photons to hippocampus. Results are similar to Naeser et al. (2014). Actigraphy sleep data show increased sleep time (average, +1 Hr/night) post-18th transcranial or intranasal LED treatment. LED treatments may be self-administered at home (Naeser et al., 2011). A shamcontrolled study with Gulf War Illness Veterans is underway.",0 +https://doi.org/10.1037/a0021263,A different kind of comorbidity: Understanding posttraumatic stress disorder and chronic pain.,"Many traumatic events leave lingering physical injuries and chronic pain in their wake, in addition to trauma-related psychopathology. In this review, we provide an overview of developments in the recent literature on co-morbid posttraumatic stress disorder (PTSD) and chronic pain. Starting with the conceptual models presented by Sharp and Harvey (2001) and Asmundson, Coons, Taylor, and Klatz (2002), this review summarizes newer studies that examine prevalence of these co-morbid conditions. Additionally, we present an updated synthesis of research on factors that may maintain both chronic physical pain and PTSD in trauma survivors. Consideration of the impact of this co-morbidity on psychosocial assessment and treatment also is discussed, with particular attention to issues that warrant additional research.",0 +https://doi.org/10.1002/0471264385.wei0218,Growth Curve Analysis in Contemporary Psychological Research,"The term “growth curve” is used to describe data where: (1) the same entities are repeatedly observed, (2) the same procedures of measurement and scaling of observations are used, and (3) the timing of the observations is known. Growth curves are now common in many areas of psychological research, and some of these are presented here. The term “growth curve analysis” denotes the processes of describing, testing hypotheses, and making scientific inferences about the growth and change patterns in a wide range of time-related phenomena. In this sense, growth curve analyses are a specific form of the larger set of developmental and longitudinal research methods, but the unique features of growth data permit unique kinds of analyses. Formal models for the analysis of growth curves which have been developed in many different substantive domains are described here in five sections: (1) An introduction to growth curves, (2) linear models of growth, (3) multiple groups in growth curve models, (4) aspects of dynamic theory for growth models, and (5) multiple variables in growth curve analyses. We conclude with a discussion of future issues raised by the current growth models.",0 +https://doi.org/10.1016/j.addbeh.2014.10.034,Tobacco use trajectories among a large cohort of treated smokers with posttraumatic stress disorder,"This study identified distinct tobacco use trajectories across 18months in 943 veteran smokers with posttraumatic stress disorder (PTSD) in order to describe quit and relapse patterns, examine associations between trajectory groups on baseline characteristics and cessation service utilization, and explore group differences in mental health outcomes.Veterans who participated in a multisite, randomized trial of integrated smoking cessation care were grouped using k-means clustering based on reported daily tobacco use between baseline and 18months. Four trajectory clusters were identified: no reduction (62%), temporary reduction (11%), late sustained reduction (9%) and early sustained reduction (18%).Median quit times in the early, late, temporary, and no reduction groups were 451, 141.5, 97, and 2days, respectively. Compared to the early reduction group, the temporary reduction group exhibited higher baseline depression (p<0.01) and anxiety (p<0.01), but did not differ in treatment received, with both groups attending significantly more cessation visits (p<0.001) and more likely to receive recommended pharmacotherapy (p<0.001) than the no reduction group between baseline and 6months. The early reduction group exhibited lower depression relative to the no reduction (p<0.01) and temporary reduction (p<0.01) groups across all assessments between baseline and 18months. Differences were not observed between groups in depressive or PTSD symptom change over time between baseline and 18months.Tobacco use trajectories among treated smokers with PTSD vary distinctly. Characteristics of identified subgroups may lead to targeted interventions among smokers with PTSD and potentially other psychiatric disorders.",0 +https://doi.org/10.1089/jwh.2014.5096,Psychosocial Functioning and Health-Related Quality of Life Associated with Posttraumatic Stress Disorder in Male and Female Iraq and Afghanistan War Veterans: The VALOR Registry,"Iraq and Afghanistan war veterans suffer from high rates of posttraumatic stress disorder (PTSD). Given the growing number of women in the military, there is a critical need to understand the nature and extent of potential gender differences in PTSD-associated psychosocial functioning and health-related quality of life (HRQOL) in Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) veterans, which has not been studied to date.We used data from a gender-balanced national patient registry of warzone-deployed OEF/OIF veterans (Project VALOR: Veterans After-Discharge Longitudinal Registry) to determine the impact of gender on PTSD-related psychosocial functioning and HRQOL in 1,530 United States Iraq and Afghanistan war veterans (50% female) with and without PTSD. Overall psychosocial functioning was assessed with the Inventory of Psychosocial Functioning (IPF) and mental and physical HRQOL with the Veterans RAND 12-item Health Survey (VR-12) Mental and Physical Component Summary scores, respectively. Stratified linear regression models estimated gender-specific associations, controlling for demographic, deployment, and postdeployment factors. Interaction models tested for significant effect moderation by gender.In gender-stratified models, PTSD was strongly associated with higher IPF scores (greater functional impairment), with similar associations by gender. PTSD was also associated with lower Mental Component Summary scores (lower mental HRQOL) in both men and women, with no evidence of effect moderation by gender. PTSD was associated with lower Physical Component Summery scores in women but not men in adjusted models; however, interactions were not significant.PTSD among warzone-deployed OEF/OIF veterans is associated with significant impairments in both overall psychosocial functioning and HRQOL, with associations that are largely similar by gender. Findings support the need for thorough and continuous assessment of functional impairment and HRQOL during treatment of PTSD for both male and female OEF/OIF veterans.",0 +https://doi.org/10.1001/jama.294.5.580,Psychiatric and Cognitive Effects of War in Former Yugoslavia,"Although impunity for those responsible for trauma is widely thought to be associated with psychological problems in survivors of political violence, no study has yet investigated this issue.To examine the mental health and cognitive effects of war trauma and how appraisal of redress for trauma and beliefs about justice, safety, other people, war cause, and religion relate to posttraumatic stress responses in war survivors.A cross-sectional survey conducted between March 2000 and July 2002 with a population-based sample of 1358 war survivors who had experienced at least 1 war-related stressor (combat, torture, internal displacement, refugee experience, siege, and/or aerial bombardment) from 4 sites in former Yugoslavia, accessed through linkage sampling. Control groups at 2 study sites were matched with survivors on sex, age, and education.Semi-structured Interview for Survivors of War, Redress for Trauma Survivors Questionnaire, Emotions and Beliefs After War questionnaire, Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).The mean (SD) age was 39 (12) years, 806 (59%) were men, and 339 (25%) had high school or higher level of education. Participants reported experiencing a mean of 12.6 war-related events, with 292 (22%) and 451 (33%) having current and lifetime posttraumatic stress disorder (PTSD), respectively, and 129 (10%) with current major depression. A total of 1074 (79%) of the survivors reported a sense of injustice in relation to perceived lack of redress for trauma. Perceived impunity for those held responsible for trauma was only one of the factors associated with sense of injustice. Relative to controls, survivors had stronger emotional responses to impunity, greater fear and loss of control over life, less belief in benevolence of people, greater loss of meaning in war cause, stronger faith in God, and higher rates of PTSD and depression. Fear and loss of control over life were associated with PTSD and depression (odds ratio [OR], 2.91; 95% CI, 2.27-3.74 and OR, 2.30; 95% CI, 1.75-3.03, respectively), and emotional responses to impunity showed a relatively weaker association with PTSD (OR, 1.53; 95% CI, 1.16-2.02) and depression (OR, 1.39; 95% CI, 1.02-1.91). Appraisal of redress for trauma was not associated with PTSD or depression.PTSD and depression in war survivors appear to be independent of sense of injustice arising from perceived lack of redress for trauma. Fear of threat to safety and loss of control over life appeared to be the most important mediating factors in PTSD and depression. These findings may have important implications for reconciliation efforts in postwar countries and effective interventions for traumatized war survivors.",0 +https://doi.org/10.1016/j.jpsychires.2012.03.011,The burden of full and subsyndromal posttraumatic stress disorder among police involved in the World Trade Center rescue and recovery effort,"This study examined the prevalence, correlates, and perceived mental healthcare needs associated with subsyndromal PTSD in police involved in the World Trade Center (WTC) rescue and recovery effort.A total of 8466 police completed an interview/survey as part of the WTC Medical monitoring and Treatment Program an average of four years after 9/11/2001.The past month prevalence of full and subsyndromal WTC-related PTSD was 5.4% and 15.4%, respectively. Loss of someone or knowing someone injured on 9/11 (odds ratios [ORs]=1.56-1.86), pre-9/11 stressors (ORs=1.30-1.50), family support (ORs=0.83-0.94), and union membership (ORs=0.50-0.52) were associated with both full and subsyndromal PTSD. Exposure to the dust cloud (OR=1.36), performing search and rescue work (OR=1.29), and work support (OR=0.89) were additionally associated with subsyndromal PTSD. Rates of comorbid depression, panic disorder, and alcohol use problems (ORs=3.82-41.74), and somatic symptoms and functional difficulties (ORs=1.30-1.95) were highest among police with full PTSD, with intermediate rates among police with subsyndromal PTSD (ORs=2.93-7.02; and ORs=1.18-1.60, respectively). Police with full and subsyndromal PTSD were significantly more likely than controls to report needing mental healthcare (41.1% and 19.8%, respectively, versus 6.8% in trauma controls).These results underscore the importance of a more inclusive and dimensional conceptualization of PTSD, particularly in professions such as police, as operational definitions and conventional screening cut-points may underestimate the psychological burden for this population. Accordingly, psychiatric clinicians should assess for disaster-related subsyndromal PTSD symptoms in disaster response personnel.",0 +https://doi.org/10.1007/s11920-015-0598-5,Children’s Disaster Reactions: the Influence of Exposure and Personal Characteristics,"This paper reviews children's reactions to disasters and the personal and situational factors that influence their reactions. Posttraumatic stress disorder (PTSD) and posttraumatic stress reactions are the most commonly studied outcomes, though other conditions also occur including anxiety, depression, behavior problems, and substance use. More recently, traumatic grief and posttraumatic growth have been explored. New research has delineated trajectories of children's posttraumatic stress reactions and offered insight into the long-term consequences of their disaster experiences. Risk factors for adverse outcomes include pre-disaster vulnerabilities, perception of threat, and loss and life disruptions post-disaster. Areas in need of additional research include studies on the timing and course of depression and anxiety post-event and their interactions with other disorders, disaster-related functional and cognitive impairment, positive outcomes, and coping.",0 +https://doi.org/10.1016/j.ijnurstu.2011.09.015,The presence of resilience is associated with a healthier psychological profile in intensive care unit (ICU) nurses: Results of a national survey,"ICU nurses are repeatedly exposed to work related stresses resulting in the development of psychological disorders including posttraumatic stress disorder and burnout syndrome. Resilience is a learnable multidimensional characteristic enabling one to thrive in the face of adversity. In a national survey, we sought to determine whether resilience was associated with healthier psychological profiles in intensive care unit nurses.Surveys were mailed to 3500 randomly selected ICU nurses across the United States and included: demographic questions, the Posttraumatic Diagnostic Scale, Hospital Anxiety and Depression Scale, Maslach Burnout Inventory and the Connor-Davidson Resilience Scale.Overall, 1239 of the mailed surveys were returned for a response rate of 35%, and complete data was available on a total of 744 nurses. Twenty-two percent of the intensive care unit nurses were categorized as being highly resilient. The presence of high resilience in these nurses was significantly associated with a lower prevalence of posttraumatic stress disorder, symptoms of anxiety or depression, and burnout syndrome (<0.001 for all comparisons). In independent multivariable analyses adjusting for five potential confounding variables, the presence of resilience was independently associated with a lower prevalence of posttraumatic stress disorder (p<0.001), and a lower prevalence of burnout syndrome (p<0.001).The presence of psychological resilience was independently associated with a lower prevalence of posttraumatic stress disorder and burnout syndrome in intensive care unit nurses. Future research is needed to better understand coping mechanisms employed by highly resilient nurses and how they maintain a healthier psychological profile.",0 +https://doi.org/10.1017/s1355617712000367,Mild Traumatic Brain Injury and Posttraumatic Stress Disorder: Clinical and Conceptual Complexities,"The wars in Iraq and Afghanistan have raised public con-sciousness of traumatic brain injury (TBI) and posttraumaticstress disorder (PTSD), two of the most common healthconsequences of contemporary military deployment. TBI andPTSD may each in their own right exert a toll on affectedindividuals. Within the war zone, however, brain injury oftenoccurs within a broader context of extreme psychologicalstress (i.e., traumatic stress). Th e same dangerous circumstances(e.g., combat, encounters with improvised explosive devices)that lead to increased risk of TBI also place service membersat increased risk for PTSD. Therefore, the prevalence ofPTSD in returning war-zone veterans who have a history ofdeployment-related TBI are elevated, especially when thebrain injury falls at the milder end of the severity range,as is the case with the majority of deployment-relatedTBIs. For example, a RAND study estimated that almost20% of a representative sample of Operation EnduringFreedom/Operation Iraqi Freedom veterans screened positivefor history of mild TBI (mTBI), and that of those reportinga deployment mTBI, approximately 34% also screenedpositive for PTSD (Tanielian & Jaycox, 2008).The comorbidity of mTBI and PTSD is not limited, however,to war-zone veterans. Civilian events such as motor vehicleaccidents and interpersonal ass ault may also be associated withboth TBI and psychological traum a sufficiently severe to lead toPTSD. The prevalence of comorbid mTBI and PTSD is notwell-documented in civilians, but mTBI and/or PTSD eachaffect many civilians. The Centers for Disease Control andPrevention (2010) estimate that over 1.7 million people sustaina TBI each year, and that over 75% of these injuries are mild.A U.S. population-based survey estimated the prevalenceof PTSD in the general population to be at 7–8% (Kessler,Sonnega, Bromet, Hughes, & Nelson, 1995).Despite the relatively high rates of mTBI and PTSD inat-risk populations, much remains unknown about the clinicalconsequences in individuals who have both incurred anmTBI and experience PTSD. The sequelae of mTBI are oftenreferred to as post traumatic or post concussive symptoms.Some post traumatic symptoms (e.g., irritability, neurocog-nitive complaints) overlap with PTSD symptoms, makingdifferential diagnosis difficult. Other conditions commonlyco-occurring with TBI history and PTSD, such as chronicpain, depression, and substance abuse, may further complicatethe clinical presentation of patients with both history of mTBIand PTSD. As a result, considerablechallengesarise inregardsto both the assessment and clinical management of patientswith co-morbid mTBI and PTSD.The field of neuropsychology is well-positioned to tacklemany of the clinical and conceptual challenges posed bycomorbid mTBI and PTSD. This virtual special issue of theJournal of the International Neuropsychological Society (JINS)compiles eight papers on the topic of TBI and/or PTSD thatwere previously published in regular issues of JINS. The papersare for the first time grouped together with the goal of collec-tively addressing the issues con fronting clinicians who assessand care for patients with history of mTBI and PTSD.",0 +https://doi.org/10.1111/cdev.12205,Global Perspectives on Resilience in Children and Youth,"Global concerns about the consequences of disasters, political violence, disease, malnutrition, maltreatment, and other threats to human development and well-being have sparked a surge of international interest in resilience science. This article highlights progress and issues in research that aims to understand variations in human adaptation to adverse experiences. Two key questions are considered: Why is a new wave of global research on resilience important for developmental science? and Why is developmental science important for global resilience? The conclusion calls for developmental scientists to engage in international efforts to promote resilience.",0 +https://doi.org/10.1097/mlr.0000000000000059,Complex Comorbidity Clusters in OEF/OIF Veterans,"A growing body of research on US Veterans from Afghanistan and Iraq [Operations Enduring and Iraqi Freedom, and Operation New Dawn (OEF/OIF)] has described the polytrauma clinical triad (PCT): traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), and pain. Extant research has not explored comorbidity clusters in this population more broadly, particularly co-occurring chronic diseases.The aim of the study was to identify comorbidity clusters among diagnoses of deployment-specific (TBI, PTSD, pain) and chronic (eg, hypertension, diabetes) conditions, and to examine the association of these clusters with health care utilization and adverse outcomes.This was a retrospective cohort study.The cohort comprised OEF/OIF Veterans who received care in the Veterans Health Administration in fiscal years (FY) 2008-2010.We identified comorbidity using validated ICD-9-CM code-based algorithms and FY08-09 data, followed by which we applied latent class analysis to identify the most statistically distinct and clinically meaningful patterns of comorbidity. We examined the association of these clusters with process measures/outcomes using logistic regression to correlate medication use, acute health care utilization, and adverse outcomes in FY10.In this cohort (N=191,797), we found 6 comorbidity clusters. Cluster 1: PCT+Chronic Disease (5%); Cluster 2: PCT (9%); Cluster 3: Mental Health+Substance Abuse (24%); Cluster 4: Sleep, Amputation, Chronic Disease (4%); Cluster 5: Pain, Moderate PTSD (6%); and Cluster 6: Relatively Healthy (53%). Subsequent health care utilization patterns and adverse events were consistent with disease patterns.These comorbidity clusters extend beyond the PCT and may be used as a foundation to examine coordination/quality of care and outcomes for OEF/OIF Veterans with different patterns of comorbidity.",0 +https://doi.org/10.1037/e592682013-001,Sleep Problems Among Adolescent Survivors Following the 2008 Wenchuan Earthquake in China: A Cohort Study,"Objective: To examine sleep problems and associated risk factors among adolescent survivors following the 2008 Wenchuan earthquake, the deadliest earthquake to strike China in 30 years. Method: A cohort of students (N = 1,573) in the 7th and 10th grades from Dujiangyan City, 21 kilometers from the epicenter, was followed up periodically for 2 years. Participants were assessed at 12 months (n = 1,398; May 18-22, 2009), 18 months (n = 1,288; November 23-27, 2009), 24 months (n = 1,313; May 17-21, 2010), and 30 months (n = 1,038; November 22-26, 2010) after the earthquake. Adolescents were asked to complete the Pittsburgh Sleep Quality Index (PSQI; cutoff for sleep problems: total score of ≥ 8), Post-Traumatic Stress Disorder Self-Rating Scale (cutoff for probable posttraumatic stress disorder: ≥ 50), Depression Self- Rating Scale for Children (cutoff for depressive disorder: ≥ 15), Screen for Child Anxiety Related Emotional Disorders (cutoff for clinical anxiety: ≥ 25), Social Support Rate Scale, and Adolescent Self-Rating Life Events Checklist and provide demographic information. Trajectory analysis was used to examine sleep disturbance changes and associated risk factors. Results: Twelve months after the earthquake, 48.90% of participants reported sleeping less than 7 hours per night, 27.68% disclosed difficulties initiating sleep, 8.82% experienced problems staying sleep, 22.60% felt their sleep quality was poor, and 40.01% had difficulties functioning during daytime hours. Overall sleep problems, as assessed by the PSQI global scale, were stable from 18 months to 30 months following the earthquake, and the prevalence rates were between 28.79% and 30.18%. The risk of sleep issues was significantly increased in senior high school students (OR = 2.29) and in those who witnessed the tragic events directly (OR = 1.21). Depression (OR = 1.69), anxiety (OR = 1.57), poor social support (OR = 1.83), and negative life events (OR = 2.62) were also associated with increased risk and persistence of sleep problems. Conclusions: Sleep disturbances are common and persistent in adolescent earthquake survivors. Multiple demographic, psychosocial, and earthquake-related factors are associated with the increased risk of sleep difficulties. © 2012",0 +https://doi.org/10.1016/s0165-1781(02)00003-3,Event-related potential dysfunction in posttraumatic stress disorder: the role of numbing,"The purpose of this study was to examine the relationship between disturbance in event-related potentials (ERPs) and symptom clusters in posttraumatic stress disorder (PTSD). ERPs were recorded in 17 unmedicated civilian PTSD patients and 17 age- and sex-matched controls during a conventional auditory oddball task. PTSD symptom clusters (re-experiencing, active avoidance, numbing, hyperarousal) were correlated with ERP measures. The PTSD group showed ERP disturbances to target stimuli (reduced P200 and P300 and increased N200 amplitude, increased N200 and P300 latency) and reduced P200 amplitude to common stimuli compared to the control group. A significant negative correlation was found between the intensity of numbing symptoms and parietal P300 amplitude. This study replicates findings of disturbed N200 and P300 components in PTSD, reflecting impairments in stimulus discrimination and attention. The finding that numbing was associated with reduced attention processing (P300) is consistent with models positing a relationship between disordered arousal and attention in PTSD.",0 +https://doi.org/10.12688/f1000research.2-289.v1,Altered functional connectivity in posttraumatic stress disorder with versus without comorbid major depressive disorder: a resting state fMRI study.,"Posttraumatic stress disorder (PTSD) is an anxiety disorder that is often diagnosed with comorbid depressive disorder. Therefore, neuroimaging studies investigating PTSD typically include both patients with and without comorbid depression. Differences in activity of the anterior cingulate cortex (ACC) and insula have been shown to differentiate PTSD patients with and without major depressive disorder (MDD). Whether or not comorbid MDD affects resting state functional connectivity of PTSD patients has not been investigated to our knowledge. Here, resting state functional connectivity of PTSD patients with (PTSD+MDD; n=27) and without (PTSD-MDD; n=23) comorbid MDD was investigated. The subgenual ACC and insula were investigated as seed regions. Connectivity between the subgenual ACC and perigenual parts of the ACC was increased in PTSD+MDD versus PTSD-MDD. Reduced functional connectivity of the subgenual ACC with the thalamus was found in the PTSD+MDD group versus the PTSD-MDD group. These results remained significant after controlling for PTSD severity. In addition, the PTSD+MDD group showed reduced functional connectivity of the insula with the hippocampus compared to the PTSD-MDD group. However, this cluster was no longer significantly different when controlling for PTSD severity. Thus, resting state functional connectivity of the subgenual ACC may distinguish PTSD+MDD from PTSD-MDD. As PTSD patients with comorbid MDD are more treatment resistant, this result may be important for treatment development.",0 +https://doi.org/10.1089/neu.2015.3918,Evaluation of Cortical Thickness after Traumatic Brain Injury in Military Veterans,"Military service members frequently sustain traumatic brain injuries (TBI) while on active duty, a majority of which are related to explosive blasts and are mild in severity. Studies evaluating the cortical gray matter in persons with injuries of this nature remain scarce. The purpose of this study was to assess cortical thickness in a sample of military veterans with chronic blast-related TBI. Thirty-eight veterans with mild TBI and 17 veterans with moderate TBI were compared with 58 demographically matched healthy civilians. All veterans with TBI sustained injuries related to a blast and were between 5 and 120 months post-injury (M = 62.08). Measures of post-traumatic stress disorder (PTSD) and depression were administered, along with a battery of neuropsychological tests to assess cognition. The Freesurfer software package was used to calculate cortical thickness of the participants. Results demonstrated significant clusters of cortical thinning in the right hemispheric insula and inferior portions of the temporal and frontal lobe in both mild and moderate TBI participants. The TBI sample from this study demonstrated a high incidence of comorbid PTSD and depression symptoms, which is consistent with the previous literature. Cortical thickness values correlated with measures of PTSD, depression, and post-concussive symptoms. This study provides evidence of cortical thinning in the context of chronic blast-related mild and moderate TBI in military veterans who have comorbid psychiatric symptoms. Our findings provide important insight into the natural progression of long-term cortical change in this population and may have implications for future clinical evaluation and treatment.",0 +https://doi.org/10.1016/j.comppsych.2015.07.013,Discrepancies between clinical needs and helpseeking behaviors in co-occurring posttraumatic stress and alcohol use disorders,"The aim of the study was to compare subjects dually diagnosed with posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) to those with only one or none of these conditions regarding helpseeking needs and behaviors.Data from a large community sample (N=3694) were used to assess the associations among lifetime PTSD and AUD, other psychiatric disorders, clinical characteristics and lifetime helpseeking behaviors derived from a semi-structured interview.Comorbid individuals had more severe clinical profiles and were more impaired than individuals with either PTSD or AUD alone or those with no/other psychiatric conditions. However, they did not differ in overall helpseeking behavior from any other group. Those with comorbid PTSD/AUD were even less likely than the other groups to seek help for depression and anxiety disorders through specific treatment facilities or the use of prescribed psychotropic drugs.Despite a greater need for treatment the comorbid group did not seek more help than the others. Their lower use of prescribed drugs supports the self-medication hypothesis, suggesting that those individuals relieve their symptoms through higher alcohol use instead. Our findings underline the need for health care facilities to encourage helpseeking behavior in the aftermath of stressful life events.",0 +https://doi.org/10.1111/j.1460-9568.2010.07596.x,Consensus Document on European Brain Research,"Psychiatric and neurological diseases combined represent a considerable social and economic burden in Europe. A recent study conducted by the European Brain Council (EBC) quantified the 'cost and burden' of major brain diseases in Europe, amounting to €386bn per year. Considering that these costs will increase exponentially in the years to come due to ageing of the European population, it is necessary to act now in order to curb this increase and possibly reverse the trend. Thus, establishing a strong European platform supporting basic and clinical research in neuroscience is needed to confront the economic and social challenge posed by management of brain diseases in European countries. To setup a platform for discussion, EBC published in 2006 a Consensus Document on European Brain Research, describing needs and achievements of research in Europe and presenting proposals for future research programs. Since 2006, European research in neuroscience has advanced tremendously. The present document represents an update elaborated to reflect changes in research priorities and advances in brain research that have taken place since 2006. The same approach and format have been used here as in the previous version. Multinational and multidisciplinary teams have once again come together to express their views, not only on the current strengths in European research, but also on what needs to be done in priority, hoping that this update will inspire policy makers and stakeholders in directing funding for research in Europe.",0 +https://doi.org/10.1037/a0039146,Dream Dome: Do dreams shield the psyche in times of continuous stress?,"Results of analysis of 531 dreams, collected from 44 women living near the Gaza Strip in Israel under continuous rocket attacks, are presented. The most frequent themes found are 'Togetherness,' 'Being active,' 'Stress-related situation,' 'Fear and anxiety,' 'Helplessness,' and 'Masochism.' The participants were divided into 3 age groups-Young, Intermediate, and Old-and differences between the occurrence of dream themes in each group were examined. Results indicated high incidence of 'Togetherness' and 'Stress-related situation' themes in the young age group, whereas 'Symbolic' and 'No escape' themes were found to be significantly low in the same age group. On an unconscious level, the young age group seems to be the most vulnerable to the stress-related situation, the old age group is the least influenced by it, and the intermediate group makes the most psychological efforts at coping with it. © 2015 American Psychological Association.",0 +https://doi.org/10.1007/s10995-014-1508-x,Clinical Needs of In-treatment Pregnant Women with Co-occurring Disorders: Implications for Primary Care,"We investigated social vulnerability and behavioral health clinical profiles (symptom severity) of pregnant women with co-occurring disorders, defined as substance abuse, mental illness, and trauma at treatment entry compared to their nonpregnant counterparts and the role of interpersonal abuse in clinical presentation among pregnant women. Our objective was to provide primary health care providers with insight into the needs of pregnant patients with high behavioral health risks to serve them better during the critical window of opportunity for long-term impact. We conducted cross-sectional secondary analysis of baseline data from women enrolled in treatment programs in the Women, Co-occurring Disorders and Violence Study from nine sites across the United States. We used analysis of variance and Cochran-Mantel-Haenszel statistical analyses to compare means and frequencies of social vulnerability indicators and baseline Addiction Severity Index, Brief Symptom Inventory of mental health, and Posttraumatic Stress Diagnostic Scale scores between 152 pregnant and 2,577 nonpregnant women, and between pregnant women with and without current interpersonal abuse. Compared to nonpregnant women, pregnant women evidenced more social vulnerability but better behavioral health clinical profiles at treatment entry. Current interpersonal abuse was associated with increased mental health and trauma symptomatology but not with alcohol or drug abuse severity among pregnant women. The prenatal period is an important time for screening and intervention for factors such as social vulnerability and co-occurring disorders, known to affect pregnancy and infant outcomes; social and behavioral health services are particularly essential among pregnant women with co-occurring disorders. © 2014 Springer Science+Business Media New York.",0 +https://doi.org/10.1037/a0028455,Protective factors for intergenerational transmission of trauma among second and third generation Holocaust survivors.,"The current study explored whether differentiation of self and family communication styles were protective factors of secondary traumatic stress (STS). A sample of 215 Jewish Americans/Canadians whose families emigrated from Europe prior to or after World War II completed an online survey consisting of self-report measures. Four groups were created based on the participants’ Holocaust background and demographics: Second generation (2G; n 77) and third generation (3G; n 52), who self identified as having at least one parent or grandparent, respectively, who is/was a Holocaust survivor, and a matched control group for each generation (n 50; n 36, respectively) consisting of Jewish Americans/Canadians of European descent with no direct relatives who were Holocaust survivors. 2G and 3G referenced the Holocaust as the traumatic event on the STS measure, while the control group referenced non-Holocaust events. Results showed that levels of STS were generally within the normal range for all groups; however, 2G and 3G reported significantly higher levels of STS, lower levels of differentiation of self, and poorer family communication compared to their control groups. Greater differentiation of self and better family communication were associated with lower levels of STS. Differences between groups were consistent with other studies suggesting a mixture of resilience and vulnerability factors among 2G and 3G.",0 +https://doi.org/10.1002/da.20845,Classification of trauma and stressor-related disorders in DSM-5,"This review examines the question of whether there should be a cluster of disorders, including the adjustment disorders (ADs), acute stress disorder (ASD), posttraumatic stress disorder (PTSD), and the dissociative disorders (DDs), in a section devoted to abnormal responses to stress and trauma in the DSM-5. Environmental risk factors, including the individual's developmental experience, would thus become a major diagnostic consideration. The relationship of these disorders to one another is examined and also their relationship to other anxiety disorders to determine whether they are better grouped with anxiety disorders or a new specific grouping of trauma and stressor-related disorders. First how stress responses have been classified since DSM-III is reviewed. The major focus is on PTSD because it has received the most attention, regarding its proper placement among the psychiatric diagnoses. It is discussed whether PTSD should be considered an anxiety disorder, a stress-induced fear circuitry disorder, an internalizing disorder, or a trauma and stressor-related disorder. Then, ASD, AD, and DD are considered from a similar perspective. Evidence is examined pro and con, and a conclsion is offered recommending inclusion of this cluster of disorders in a section entitled ""Trauma and Stressor-Related Disorders."" The recommendation to shift ASD and PTSD out of the anxiety disorders section reflects increased recognition of trauma as a precipitant, emphasizing common etiology over common phenomenology. Similar considerations are addressed with regard to AD and DD.",0 +https://doi.org/10.1016/j.jpsychires.2010.10.011,Functional neuroimaging of emotionally intense autobiographical memories in post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) affects regions that support autobiographical memory (AM) retrieval, such as the hippocampus, amygdala and ventral medial prefrontal cortex (PFC). However, it is not well understood how PTSD may impact the neural mechanisms of memory retrieval for the personal past. We used a generic cue method combined with parametric modulation analysis and functional MRI (fMRI) to investigate the neural mechanisms affected by PTSD symptoms during the retrieval of a large sample of emotionally intense AMs. There were three main results. First, the PTSD group showed greater recruitment of the amygdala/hippocampus during the construction of negative versus positive emotionally intense AMs, when compared to controls. Second, across both the construction and elaboration phases of retrieval the PTSD group showed greater recruitment of the ventral medial PFC for negatively intense memories, but less recruitment for positively intense memories. Third, the PTSD group showed greater functional coupling between the ventral medial PFC and the amygdala for negatively intense memories, but less coupling for positively intense memories. In sum, the fMRI data suggest that there was greater recruitment and coupling of emotional brain regions during the retrieval of negatively intense AMs in the PTSD group when compared to controls.",0 +https://doi.org/10.1037/a0031467,Complex mental health sequelae of psychological trauma among women in prenatal care.,"Pregnancy is a critical time to identify and address maternal mental health problems, for the health of both mother and child. Pregnant women with histories of exposure to interpersonal psychological trauma may experience a range of mental health problems including but not limited to posttraumatic stress disorder (PTSD). In a community sample of 1,581 pregnant women, 25% reported symptoms consistent with at least one of six syndromes, including PTSD, major depressive disorder (MDD), generalized anxiety disorder (GAD), or clinically significant dissociation, somatization, or affect dysregulation. Six sub-groups with distinct mental health problem profiles were identified by cluster analysis. Controlling for sociodemographic risk factors, women with histories of interpersonal trauma were over-represented in four sub-groups characterized by: (1) PTSD comorbid with depression (childhood sexual abuse), (2) PTSD comorbid with affect/interpersonal dysregulation (childhood physical or emotional abuse), (3) somatization (adult abuse), and (4) GAD (foster/adoptive placement). Findings suggest risk relationships warranting further study between different types of interpersonal trauma exposure and psychiatric outcomes in pregnant women, including PTSD with two types of comorbidity.",0 +https://doi.org/10.1080/10926771.2011.588153,"Posttraumatic Stress Symptom Clusters, Trauma History, and Substance Use among College Students","Previous research found associations between experiencing specific posttraumatic stress disorder (PTSD) symptom clusters and use of specific substances among combat veterans, women exposed to domestic violence, and an inpatient sample; however, research has not utilized a college sample when considering this association. This study assessed trauma history, PTSD symptoms, alcohol use, and nonexperimental use of depressants, stimulants, opioids, cannabinoids, hallucinogens, inhalants, and steroids in college students. Results indicate unique associations between the PTSD symptom cluster of reexperiencing and use of depressants, avoidance/numbing with use of depressants and opiates, and hyperarousal with use of opiates. Further, the individual subclusters of behavioral avoidance and emotional numbing were associated with use of depressants and avoidance was associated with hallucinogen use. Implications are discussed.",0 +https://doi.org/10.1016/j.janxdis.2010.03.021,Validation of a Swedish version of the Impact of Event Scale-Revised (IES-R) in patients with burns,"The Impact of Event Scale (IES) and the Impact of Event Scale-Revised (IES-R) are often used as self-report instruments for symptoms of post-traumatic stress disorder (PTSD). However, there are few validations of the IES and the IES-R against structured clinical interviews. In this study the two scales, together with the three subscales of the IES-R, were assessed for their agreement with a diagnosis of PTSD in patients with burns 1 year after injury. Sixty patients with burns were evaluated 1 year after injury using the Structured Clinical Interview for the DSM-IV Axis I (SCID-I) psychiatric disorders and a Swedish version of the IES-R. The total score of the IES-R had the best discriminant ability (0.89) with a sensitivity of 1.0 and a specificity of 0.78. In conclusion, the total IES-R had good properties as a screening tool for PTSD and subsyndromal PTSD 1 year after burn injury.",0 +https://doi.org/10.1017/cbo9780511543647.007,Posttraumatic stress disorder in women,"This chapter discusses posttraumatic stress disorder (PTSD) in women. The clinical presentation in both men and women is often complex, with high levels of depression, anxiety, and substance use. Several epidemiological studies have indicated that, while men are more likely than women to be exposed to traumatic events, the prevalence of PTSD within the community is approximately twice as high for women. Few studies have investigated psycho physiological differences between men and women in acute reactions to threat that may serve as potential mediators for PTSD vulnerability. A mounting body of empirical research has supported the efficacy of certain types of psychotropic medication in the treatment of PTSD. Finally, while women may be at greater risk for the development of psychiatric sequelae following trauma, preliminary findings from treatment outcome studies indicate that they may benefit from PTSD interventions to a greater extent than men.",0 +https://doi.org/10.1002/da.20776,"Prevalence and predictors of posttraumatic stress symptoms in utility workers deployed to the World Trade Center following the attacks of September 11, 2001","Recent attention has begun to be focused on the effects of disaster recovery work on nonrescue workers. The goal of this study was to assess the prevalence and predictors of posttraumatic stress disorder (PTSD) and related symptoms in a population of utility workers deployed to the World Trade Center (WTC) site in the aftermath of 9/11.Utility workers deployed to the WTC site were screened at their place of employment between 10 and 34 months following the WTC attacks, utilizing both structured interviews and self-report measures. PTSD symptoms were assessed by the CAPS and the PCL; co-morbid disorders were also assessed. 2,960 individuals with complete CAPS and PCL data were included in the analyses.Eight percent of participants had symptoms consistent with full PTSD, 9.3% with subthreshold PTSD, 6% with MDD, 3.5% with GAD, and 2.5% with panic disorder. Although risk factors included psychiatric and trauma history, 51% of individuals with probable PTSD had neither; subjective perception of threat to one's life was the best predictor of probable PTSD. Extent of exposure predicted 89% of PTSD cases in those without a psychiatric or trauma history, but only 67% of cases among those with both.Nonrescue workers deployed to a disaster site are at risk for PTSD and depression. Extent of exposure affected the most vulnerable workers differently than the least vulnerable ones. These results suggest that the relationship among predictors of PTSD may be different for different vulnerability groups, and underscore the importance of screening, education, and prevention programs for disaster workers.",0 +https://doi.org/10.1016/j.pnpbp.2009.04.018,Brain-derived neurotrophic factor plasma levels in patients suffering from post-traumatic stress disorder,"In both animals and humans, stress has been demonstrated to reduce the expression of the Brain-Derived Neurotrophic Factor (BDNF), a neurotrophin (NT) which promotes the proliferation, survival and differentiation of neurons. Although traumatic events have been found to be associated with lower BDNF plasma levels in affective disorders, no study has explored this parameter in patients with post-traumatic stress disorder (PTSD). We, therefore, measured BDNF plasma level in 18 patients with PTSD and in 18 healthy control subjects. Diagnoses were assessed by the Structured Clinical Interview for DSM-IV, while the specific symptoms were examined in the patients by means of the Impact of Event Scale for PTSD and the traumas experienced were assessed by using the Life Events Checklist. BDNF plasma levels were evaluated by means of a standardized Elisa method. The results, while showing significantly lower BDNF levels in PTSD patients, as compared with those of healthy subjects (p=0.001), although obtained in a small sample size, would suggest that this NT may be involved in the pathophysiology of PTSD.",0 +,Personality disorder symptomatology among Vietnam veterans with combat-related PTSD.,"This research examined self-report personality profiles of 42 Vietnam veterans with combat-related posttraumatic stress disorder (PTSD) evaluated at an outpatient Veteran's Administration hospital PTSD clinic. Assessment was via the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev; DSM-III-R) Personality Disorders-II (SCID-II) self-report. Self-reported personality disorder symptomatology of PTSD patients was contrasted with that of 51 outpatients with a primary diagnosis of an anxiety disorder other than PTSD and with 16 patients with a primary diagnosis of major depressive disorder (MDD). Symptomatology from each of the 11 DSM-III-R categories and from the three personality disorder ""clusters"" was calculated in terms of percentage of possible traits endorsed, thus creating personality ""profiles"" for the three groups. PTSD veterans endorsed more traits overall than did both the mixed anxiety and MDD groups, particularly on the Cluster A, avoidant, and borderline scales. Results suggest a PTSD-related personality profile characterized by emotional lability/poor anger control, paranoia/suspiciousness, identity disturbance/confusion, social withdrawal/avoidance, and feelings of emptiness and boredom.",0 +https://doi.org/10.1007/s11126-010-9140-4,Factor Structure and Risk Factors for the Health Status of Homeless Veterans,"Homeless veterans have numerous health problems that have been previously characterized as falling into four major subgroups; addiction, psychosis, vascular disorders, and generalized medical and psychiatric illness. Comorbid conditions are common, often involving a combination of psychiatric and medical disorders. Using data from the same survey of homeless veterans that was used to establish these subgroups with cluster analysis, the present study examined the structure of these subgroup patterns through the use of factor analysis. This analysis yielded a five factor solution. They were named ""Cardiac"", Mood, Stress, Addiction, and Psychosis factors. Factor scores were computed and an odds ratio analysis was accomplished to determine the association between obtaining a high score on a given factor with a number of sociodemographic and homelessness related variables. It was concluded that health status of homeless veterans is a complex condition, but has a clear latent structure demonstrated by factor analysis. Scoring high or low on a particular factor is associated with numerous historical and sociodemographic considerations, notably age, ethnicity, and employment status. (",0 +,[Post-traumatic condition and psychological distress/well-being in a sample of inmates: a cluster analytic approach].,"AIM Researchers addressing the mental health needs of inmates reported that post-traumatic stress disorder (PTSD) was one of the most common disorders. This study examined the patterns of PTSD symptoms and their relation to the self-reported level of distress and psychological wellbeing in a sample of Italian inmates. METHODS Fifty inmates, 90% male, 54% aged 31-50 years, 70% awaiting trial, completed a battery of tests including the Davidson Trauma Scale (DTS), the Symptom Questionnaire (SQ), and the Psychological Well-Being Scales (PWBS). RESULTS Cluster analysis revealed three distinct clusters of respondents, which presents varying combination of PTSD symptoms, as measured with the three subscales of the DTS. Accordingly, these clusters were labeled Cluster 1--Traumatized (n = 18), Cluster 2--Non-traumatized (n = 18), and Cluster 3--Seriously traumatized (n = 14). Findings indicated that the three groups differed consistently across all the domains of the SQ and on the environmental mastery scale of the PWBS. Those in the Traumatized clusters, as compared to the Nontraumatized, demonstrated higher overall psychological distress and lower perceived environmental mastery. Moreover, independent of posttraumatic level, inmates showed poorer psychological wellbeing and higher distress than the normative population. DISCUSSION The patterns manifested in clusters 1 and 3 could become the focus of attention to deliver specific intervention aimed at reducing inmates' distress and encouraging their adjustment to prison life.",0 +https://doi.org/10.1037/a0029844,Multi-tier mental health program for refugee youth.,"We sought to establish that refugee youths who receive a multi-tiered approach to services, Project SHIFA, would show high levels of engagement in treatment appropriate to their level of mental health distress, improvements in mental health symptoms, and a decrease in resource hardships.Study participants were 30 Somali and Somali Bantu refugee youths in the English language learner classroom in a middle school in New England. Project SHIFA is a multi-tiered program including prevention and community resilience building for the community at large, school-based early intervention groups for at-risk students, and direct intervention using an established trauma model (trauma systems therapy) for those with significant psychological distress. Data were collected from students at time of enrollment, 6-month follow-up, and 12-month follow-up. Measures used were the War Trauma Screening Scale, Adolescent Post-War Adversities Scale-Somali version, UCLA PTSD Reaction Index for DSM-IV (Revision 1), and the Depression Self-Rating Scale.Students across all tiers of the program demonstrated improvements in mental health and resources. Resource hardships were significantly associated with symptoms of posttraumatic stress disorder over time, and the stabilization of resource hardships coincided with significant improvements in symptoms of depression and posttraumatic stress disorder for the top tier of participants.Project SHIFA is a promising model of treatment for young refugees.",0 +https://doi.org/10.1517/14656566.2011.604030,New approaches to combining pharmacotherapy and psychotherapy for posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) is a complex disorder associated with an intricate biological and psychological symptom profile and various common comorbidities. Despite an existing myriad of evidence-based and experimental treatments, PTSD is often difficult to treat. This reality necessitates a discussion of the potential of emerging treatments.A literature search using PubMed and PsychInfo was done using the following keywords: randomized clinical trials, treatment guidelines, pharmacotherapy and psychotherapy, all in addition to PTSD. A comprehensive treatment review establishes that early intervention approaches have not yet been found to prevent PTSD in trauma survivors. However, psychotherapy research provides substantial support for cognitive behavioral therapies and eye movement desensitization and reprocessing for chronic PTSD, and psychopharmacological approaches are myriad - although at present there is FDA approval only for sertraline and paroxetine. However, the efficacy of these treatments varies and, unfortunately, not everyone will achieve remission.So far, the mental health field has tended to focus on either biological or psychological targets. We propose that maximizing treatment success may require an integrated approach that does not dichotomize biological and psychological aspects. Exciting new developments reflecting this perspective include psychopharmacologic augmentation strategies that enhance the mechanisms of psychotherapy.",0 +https://doi.org/10.1055/s-2007-1014370,Preclinical Evidence on the Psychotropic Profile of Fluvoxamine,"Serotonin (5-HT) reuptake inhibitors (SSRIs) such as fluvoxamine are interesting compounds. Initially launched as antidepressants, they have been found to be active in various psychiatric disorders besides depression, including obsessive-compulsive disorder, panic disorder, and eating disturbances. Preliminary data suggest their efficacy in alcohol and drug abuse, aggression, and posttraumatic stress disorder as well. Along with those clinical findings, new preclinical data have emerged. For example, fluvoxamine has demonstrated activity in various models of anxiety in rodents. Its anxiolytic activity can be clearly discriminated from that of the benzodiazepines. In the DRL 72-sec paradigm, fluvoxamine exhibits a good antidepressant profile, similar to those of imipramine and flesinoxan. Studies have shown that fluvoxamine does not down-regulate beta-adrenoceptors; apparently, that property is not a conditio sine qua non for antidepressant activity. Results of studies of the mechanism of action of fluvoxamine in which drug discrimination tests were performed with rats and pigeons suggest that the fluvoxamine stimulus is not (or is only to a very limited degree) dependent on activation of 5-HT1A receptors or 5-HT1B/1D receptors, or both. Experimentation is ongoing in those animal models.",0 +https://doi.org/10.1007/978-1-60327-329-9_6,Toward Animal Models of Post-Traumatic Stress Disorder,"(from the chapter) The development of animal models for PTSD and other traumatic stress related brain changes is an important part of advancing our neurobiological understanding of the disease process as well as recovery, resilience, and possible therapeutic targets. Although animal models for PTSD are limited to the assessment of measurable and observable behavioral parameters and cannot assess complex psychological symptoms such as intrusive thoughts, meaning and dreams, valid and reliable animal models offer a means for researching biomolecular, pathophysiological, and pharmacological features of the disorder in ways that are not feasible in human studies. Trauma/stress-based Models were developed in an attempt to induce in the animal a state similar to PTSD by exposing animals to an equivalent of a traumatic experience. Mechanism-based models were developed considering potential brain mechanisms that may underlay the disorder. The most studied are enhanced fear conditioning, impaired extinction and more recently, impaired contextualization. Another important line of research addresses the question of additional factors that contribute to the susceptibility to develop PTSD. Genetic background and environmental factors have been studied and have led to the recognition of the importance of individual differences in susceptibility to develop the disorder. This chapter presents and discusses findings from various animal models, with the understanding that no single model encompasses in full the complexity of the disorder but that each of these models contributes to our understanding of PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1080/01612840600781121,PSYCHIATRIC AND PHYSICAL HEALTH RAMIFICATIONS OF TRAUMATIC EVENTS IN WOMEN,"All individuals are at some risk of experiencing a traumatic event and developing posttraumatic stress disorder (PTSD); however some individuals are at higher risk due to individual and environmental factors. This critical literature review focuses on women, as they are twice as likely as men to develop PTSD in their lifetimes. Should a woman develop PTSD, she is then at risk of developing psychiatric and physical health comorbidities that can further impact her quality of life. The strengths and limitations of current studies regarding this topic are discussed as are directions for future research and issues for nurses treating traumatized individuals.",0 +,Psychophysiological investigations of posttraumatic stress disorder imagery.,"Physiological responses to self-generated imagery of past traumatic combat experiences were assessed in medication-free Vietnam combat veterans, classified on the basis of DSM-III-R (American Psychiatric Association 1987) criteria into posttraumatic stress disorder (PTSD, n = 25), non-PTSD anxiety disorder (Anxious, n = 7), or no-mental-disorder (Healthy, n = 15) groups. ""Scripts"" describing each subject's combat experiences were read to him in the laboratory, and he was instructed to imagine the events the scripts portrayed, while heart rate, skin conductance, and frontalis electromyogram (EMG) were recorded. PTSD subjects' responses to their combat imagery were significantly higher than those of both control groups. A discriminant analysis identified 64 percent of PTSD subjects as physiological responders, and 100 percent of Anxious and 94 percent of Healthy subjects as nonresponders. A pilot study of imaginal flooding in three PTSD and two Healthy pilot subjects suggested that more prolonged, therapist-assisted imagery might increase the sensitivity of psychophysiological measures to PTSD, and that motor and endocrinological measures might also be of value in characterizing the disorder.",0 +,"Disentangling the Directions of Influence among Trauma Exposure, Posttraumatic Stress Disorder Symptoms, and Alcohol and Drug Problems","The present study utilized longitudinal data from a high-risk community sample (n= 377; 166 trauma-exposed; 54% males; 52% children of alcoholics; 73% non-Hispanic/Latino Caucasian; 22% Hispanic/Latino; 5% other ethnicity) to test a series of hypotheses that may help explain the risk pathways that link traumatic stress, posttraumatic stress disorder (PTSD) symptomatology, and problematic alcohol and drug use. Specifically, this study examined whether pre-trauma substance use problems increase risk for trauma exposure (the high-risk hypothesis) or PTSD symptoms (the susceptibility hypothesis), whether PTSD symptoms increase risk for later alcohol/drug problems (the self-medication hypothesis), and whether the association between PTSD symptoms and alcohol/drug problems is due to shared risk factors (the shared vulnerability hypothesis). This study also examined the roles of gender and ethnicity in these pathways. A series of logistic and negative binomial regressions were performed in a path analysis framework. A composite pre-trauma family adversity variable was formed from measures of family conflict, family life stress, parental alcoholism, and other parent psychopathology. Results provided the strongest support for the self-medication hypothesis, such that PTSD symptoms predicted higher levels of later alcohol and drug problems among non-Hispanic/Latino Caucasian participants, over and above the influences of pre-trauma family adversity, pre-trauma substance use problems, trauma exposure, and demographic variables. Results partially supported the high-risk hypothesis, such that adolescent substance use problems had a marginally significant unique effect on risk for assaultive violence exposure but not on overall risk for trauma exposure. There was no support for the susceptibility hypothesis, as pre-trauma adolescent substance use problems did not significantly influence risk for PTSD diagnosis/symptoms over and above the influence of pre-trauma family adversity. Finally, there was little support for the shared vulnerability hypothesis. Neither trauma exposure nor preexisting family adversity accounted for the link between PTSD symptoms and later substance use problems. These results add to a growing body of literature in support of the self-medication hypothesis. Findings extend previous research by showing that PTSD symptoms may influence the development of alcohol and drug problems over and above the influence of trauma exposure itself, preexisting family risk factors, and baseline levels of substance use. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0 +https://doi.org/10.1017/s0033291712002681,Course of post-traumatic stress disorder following war in the Balkans: 1-year follow-up study,"Prevalence rates of post-traumatic stress disorder (PTSD) following the experience of war have been shown to be high. However, little is known about the course of the disorder in people who remained in the area of conflict and in refugees. Method We studied a representative sample of 522 adults with war-related PTSD in five Balkan countries and 215 compatriot refugees in three Western European countries. They were assessed on average 8 years after the war and reinterviewed 1 year later. We established change in PTSD symptoms, measured on the Impact of Events Scale - Revised (IES-R), and factors associated with more or less favourable outcomes.During the 1-year period, symptoms decreased substantially in both Balkan residents and in refugees. The differences were significant for IES-R total scores and for the three subscales of intrusions, avoidance and hyperarousal. In multivariable regressions adjusting for the level of baseline symptoms, co-morbidity with depression predicted less favourable symptom change in Balkan residents. More pre-war traumatic events and the use of mental health services within the follow-up period were associated with less improvement in refugees.Several years after the war, people with PTSD reported significant symptom improvement that might indicate a fluctuating course over time. Co-morbid depression may have to be targeted in the treatment of people who remained in the post-conflict regions whereas the use of mental health services seems to be linked to the persistence of symptoms among refugees.",0 +https://doi.org/10.1002/pon.1827,"Rumination, post-traumatic growth, and distress: structural equation modelling with cancer survivors","Objective: Theoretical models of post-traumatic growth (PTG) have been derived in the general trauma literature to describe the post-trauma experience that facilitates the perception of positive life changes. To develop a statistical model identifying factors that are associated with PTG, structural equation modelling (SEM) was used in the current study to assess the relationships between perception of diagnosis severity, rumination, social support, distress, and PTG. Method: A statistical model of PTG was tested in a sample of participants diagnosed with a variety of cancers (N=313). Results: An initial principal components analysis of the measure used to assess rumination revealed three components: intrusive rumination, deliberate rumination of benefits, and life purpose rumination. SEM results indicated that the model fit the data well and that 30% of the variance in PTG was explained by the variables. Trauma severity was directly related to distress, but not to PTG. Deliberately ruminating on benefits and social support were directly related to PTG. Life purpose rumination and intrusive rumination were associated with distress. Conclusions: The model showed that in addition to having unique correlating factors, distress was not related to PTG, thereby providing support for the notion that these are discrete constructs in the post-diagnosis experience. The statistical model provides support that post-diagnosis experience is simultaneously shaped by positive and negative life changes and that one or the other outcome may be prevalent or may occur concurrently. As such, an implication for practice is the need for supportive care that is holistic in nature. Copyright © 2010 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1080/13854046.2013.774438,Postconcussive Symptom Complaints and Potentially Malleable Positive Predictors,"The purpose of this study was to examine the relationship between postconcussion symptom complaint (PCS) severity and positive coping factors (knowledge, self-efficacy, and attributions) in a sample of individuals who have sustained a mild TBI, above and beyond the demographic and psychiatric predictors that have been most commonly examined. Ninety-one people with a history of reported mild TBI were surveyed. Hierarchical regression analyses revealed that demographic variables and psychiatric symptom severity predicted PCS severity. Consistent with our hypotheses, knowledge, self-efficacy, and attributions, when taken together, made an independent and significant contribution to prediction of PCS severity (21% of additional variance). The most potent factor was attribution, or the extent to which one attributes symptoms to mild TBI versus other causes. Those who attribute their symptoms to TBI are more likely to report greater symptom severity overall. Taken together, knowledge, self-efficacy, and attributions contribute independently to PCS severity. Additional research is needed to determine if these factors are amenable to intervention.",0 +https://doi.org/10.1017/s1461145714000479,"Anxiolytic-like effects of YL-IPA08, a potent ligand for the translocator protein (18 kDa) in animal models of post-traumatic stress disorder","Recently, the translocator protein (18 kDa) (TSPO), previously called peripheral benzodiazepine receptor (PBR) and both the starting point and an important rate-limiting step in neurosteroidogenesis, has received increased attention in the pathophysiology of post-traumatic stress disorder (PTSD) because it affects the production of neurosteroids, reinforcing the hypothesis that selective TSPO ligands could potentially be used as anti-PTSD drugs. As expected, we showed that chronic treatment with YL-IPA08 [N-ethyl-N-(2-pyridinylmethyl)-2-(3,4-ichlorophenyl)-7-methylimidazo [1,2-a] pyridine-3-acetamide hydrochloride], a potent and selective TSPO ligand synthesized by our institute, caused significant suppression of enhanced anxiety and contextual fear induced in the inescapable electric foot-shock-induced mouse model of PTSD and the time-dependent sensitization (TDS) procedure. These effects were completely blocked by the TSPO antagonist PK11195. Furthermore, YL-IPA08 could increase the level of allopregnanolone in the prefrontal cortex and serum of post-TDS rats, and these effects were antagonized by PK11195. In summary, the findings from the current study showed that YL-IPA08, a potent and selective TSPO ligand, had a clear anti-PTSD-like effect, which might be partially mediated by binding to TSPO and the subsequent synthesis of allopregnanolone.",0 +https://doi.org/10.7205/milmed-d-10-00038,The Association Between Childhood Physical and Sexual Abuse and Functioning and Psychiatric Symptoms in a Sample of U.S. Army Soldiers,"We examined associations between abusive childhood experiences and functioning and psychiatric symptoms in an active duty sample of U.S. Army soldiers.Cross-sectional survey of 204 soldiers stationed at a southern U.S. Army facility.Forty-six percent of individuals reported childhood physical abuse alone, whereas 25% reported both childhood physical and sexual abuse. Soldiers' work, role, and social functioning; physical functioning; depression severity; and severity of alcohol misuse did not differ significantly with childhood abuse status (p > 0.22 for all). However, individuals who reported both childhood physical and sexual abuse reported severer posttraumatic stress disorder symptoms than did soldiers who reported no childhood abuse or childhood physical abuse only (p = 0.007).Although abusive childhood experiences were common, soldiers with such experiences reported functioning as well as those soldiers without such experiences. Posttraumatic stress disorder symptoms were significantly elevated only in those who reported both childhood physical and sexual abuse.",0 +https://doi.org/10.1111/j.1755-5949.2010.00158.x,Role of Zolpidem in the Management of Insomnia,"Insomnia is a common condition that affects one's ability to sleep comfortably and consequently to work effectively. Its etiology is multifactorial and involves plethora of risk factors. Consequences can vary from mild sleepiness to more sever psychiatric disturbances and ischemic stroke. Despite several diagnostic criteria it is poorly diagnosed and less often treated. Benzodiazepines formed the mainline therapy for many years till the advent of newer nonbenzodiazepine group of drugs including zolpidem. Zolpidem is an imidazo-pyridine compound that enhances the GABA(A) receptor function by interaction with Omega-1 receptor subtype. Its pharmacokinetic profile allows the patients to use it later in the night when having trouble falling asleep without any residual cognitive impairment the next morning. It has rapid onset of action, improves total sleep duration, and reduces night-time awakenings. Its adverse effect profile is satisfactory as it appears to have low addiction potential. This review will focus on the current role of zolpidem in the management of insomnia.",0 +https://doi.org/10.1097/nmd.0b013e318093ed2c,"Longitudinal Study of Posttraumatic Stress Disorder, Depression, and Changes in Traumatic Memories Over Time in Bosnian Refugees","This longitudinal study examined traumatic memory consistency over a 3-year period among a sample of highly traumatized Bosnian refugees, focusing on demographic factors, types of trauma, and posttraumatic stress disorder (PTSD) and depression. In 1996 and 1999, 376 Bosnian refugees were interviewed about 54 wartime trauma and torture events, and symptoms of PTSD and depression. Reports were compared for both time periods, and changed responses were analyzed for significance. Overall, there was consistency in reporting over time; when change occurred it was in the direction of decreased reports at follow-up. This downward trend was not associated with any particular diagnosis. However, PTSD alone, without comorbid symptoms of depression, was uniquely associated with the group that exhibited an upward trend. This implies that increased reporting is related specifically to the presence of PTSD symptoms, and that PTSD may be distinctly associated with the failed extinction of traumatic memories.",0 +https://doi.org/10.1111/j.1468-2982.2004.00698.x,Psychological and Sleep Quality Differences between Chronic Daily Headache and Temporomandibular Disorders Patients,"The aim of this study was to investigate whether chronic daily headache (CDH) and temporomandibular disorders (TMD) patients present with different psychological and sleep quality characteristics. Sixty-seven patients diagnosed with CDH, according to classification criteria from Silberstein et al., were matched by age and sex with 67 patients who had a primary diagnosis of myofascial pain (MP) and 67 patients with a primary diagnosis of TMJ intracapsular pain (IC) according to the Research Diagnostic Criteria for TMD. The CDH group was comprised of three mutually exclusive diagnostic groups: chronic migraine ( n = 35); chronic tension-type headache ( n = 26); ‘other CDH’ ( n = 6). All patients completed a battery of psychological and sleep quality questionnaires. All CDH subgroups showed similar psychological and sleep quality profiles. Pain intensity and duration were controlled in the multivariate analyses (MANCOVA) by treating them as covariates. The CDH and MP groups revealed higher levels of psychological distress than the IC group on most psychological domains. The MP group also revealed numerically higher levels of psychological distress in most psychological domains than the CDH group, although these differences were generally not significant. We did not find significant differences between the three groups on post traumatic stress symptoms either. Sleep quality was significantly worse in the MP group than in the CDH and IC groups. These results are discussed in the context of multimodal patient evaluation and treatments that are often necessary for successful clinical management.",0 +https://doi.org/10.1007/s10802-012-9677-9,Prospective Risk Factors for Adolescent PTSD: Sources of Differential Exposure and Differential Vulnerability,"There are two types of risk factors for developing PTSD: factors that increase the likelihood of experiencing a potentially traumatizing event and factors that increase the likelihood of developing symptoms following such events. Using prospective data over a two-year period from a large, diverse sample of urban adolescents (n = 1242, Mean age = 13.5), the current study differentiates these two sources of risk for developing PTSD in response to violence exposure. Five domains of potential risk and protective factors were examined: community context (e.g.; neighborhood poverty), family risk (e.g.; family conflict), behavioral maladjustment (e.g.; internalizing symptoms), cognitive vulnerabilities (e.g.; low IQ), and interpersonal problems (e.g.; low social support). Time 1 interpersonal violence history, externalizing behaviors, and association with deviant peers were the best predictors of subsequent violence, but did not further increase the likelihood of PTSD in response to violence. Race/ethnicity, thought disorder symptoms, and social problems were distinctly predictive of the development of PTSD following violence exposure. Among youth exposed to violence, Time 1 risk factors did not predict specific event features associated with elevated PTSD rates (e.g.; parent as perpetrator), nor did interactions between Time 1 factors and event features add significantly to the prediction of PTSD diagnosis. Findings highlight areas for refinement in adolescent PTSD symptom measures and conceptualization, and provide direction for more targeted prevention and intervention efforts. © 2012 Springer Science+Business Media, LLC.",0 +https://doi.org/10.1176/appi.ajp.159.5.855,Sleep Complaints as Early Predictors of Posttraumatic Stress Disorder: A 1-Year Prospective Study of Injured Survivors of Motor Vehicle Accidents,"Disturbed sleep is a common complaint among patients with posttraumatic stress disorder (PTSD) that appears in the reexperiencing and hyperarousal symptom clusters in DSM-IV. The causal relationship between sleep complaints and PTSD is unclear.Self-reported insomnia and excessive daytime sleepiness were assessed in 102 victims of motor vehicle accidents and 19 comparison subjects 1 week and 1, 3, 6, and 12 months after the trauma. At 12 months the Structured Clinical Interview for DSM-III-R was administered to determine diagnoses of PTSD.Twenty-six of the accident victims but none of the comparison subjects met the criteria for PTSD. Logistic regression models indicated that sleep complaints from 1 month on were significant in predicting PTSD at 1 year.These results suggest that on the basis of sleep complaints as early as 1 month after the trauma, it is possible to detect subjects who will later develop chronic PTSD.",0 +https://doi.org/10.4172/1522-4821.1000243,Mental Preparedness as a Pathway to Police Resilience and Optimal Functioning in the Line of Duty,"The idea of fostering ‘resilience’ among police and military personnel is a topic of growing interest (Andersen et al., 2015a; Cornum, Matthews, & Seligman, 2011; Reivich, Seligman, & McBride, 2011). This topic is particularly timely in light of recent media depictions of questionable use-of-force actions by police and the subsequent public retaliations against the police",0 +https://doi.org/10.1152/japplphysiol.00850.2005,Acclimatory-phase specificity of gene expression during the course of heat acclimation and superimposed hypohydration in the rat hypothalamus,"The induction of the heat-acclimated phenotype involves reprogramming the expression of genes encoding both constitutive and inducible proteins. In this investigation, we studied the global genomic response in the hypothalamus during heat acclimation, with and without combined hypohydration stress. Rats were acclimated for 2 days (STHA) or for 30 days (LTHA) at 34°C. Hypohydration (10% decrease in body weight) was attained by water deprivation. 32 P-labeled RNA samples from the hypothalamus were hybridized onto cDNA Atlas array (Clontech no. 1.2) membranes. Clustering and functional analyses of the expression profile of a battery of genes representing various central regulatory functions of body homeostasis demonstrated a biphasic acclimation profile with a transient upregulation of genes encoding ion channels, transporters, and transmitter signaling upon STHA. After LTHA, most genes returned to their preacclimation expression levels. In both STHA and LTHA, genes encoding hormones and neuropeptides, linked with metabolic rate and food intake, were downregulated. This genomic profile, demonstrating an enhanced transcription of genes linked with neuronal excitability during STHA and enhanced metabolic efficiency upon LTHA, is consistent with our previously established integrative acclimation model. The response to hypohydration was characterized by an upregulation of a large number of genes primarily associated with the regulation of ion channels, cell volume, and neuronal excitability. During STHA, the response was transiently desensitized, recovering upon LTHA. We conclude that hypohydration overrides the heat acclimatory status. It is notable that STHA and hypohydration gene profiles are analogous with the physiological profile described in the response to various types of brain injury.",0 +https://doi.org/10.2174/138920112799857576,Genomics and Pharmacogenomics of Brain Disorders,"CNS disorders are the third major problem of health in developed countries, with approximately 10% of direct costs associated with a pharmacological treatment of doubtful cost-effectiveness. There is an alarming abuse of psychotropic drugs worldwide and only 20-30% of patients with CNS disorders appropriately respond to conventional drugs. The pathogenesis of most CNS disorders is the result of the interplay of genetic and epigenetic factors with environmental factors leading to post-transcriptional changes and proteomic and metabolomic dysfunctions. It is estimated that genetics accounts for 20% to 95% of variability in drug disposition and pharmacodynamics, and about 25-60% of the Western population is defective in genes responsible for drug metabolism. In the European population only 25% of subjects are pure extensive metabolizers for the trigenic cluster integrated by the CYP2D6, CYP2C19 and CYP2C9 genes. About 50% of adverse drug events in CNS disorders might be attributed to pharmacogenomic factors. The rationale for practical pharmacogenomics and personalized therapeutics based on individual genomic profiles implies the management of different types of genes and their products including (i) genes associated with the mechanism of action of psychotropic drugs (neurotransmitters, receptors, transporters), (ii) genes encoding enzymes responsible for drug metabolism (phase I, phase II reactions), (iii) disease-specific genes associated with a particular pathogenic cascade, and (iv) pleiotropic genes with multilocative effects in metabolomic networks. The incorporation of genomic medicine procedures and pharmacogenomics into clinical practice, together with educational programs for the correct use of medication, must help to optimize therapeutics in CNS disorders.",0 +https://doi.org/10.1038/npp.2012.146,White Matter Integrity in Highly Traumatized Adults With and Without Post-Traumatic Stress Disorder,"Prior structural imaging studies of post-traumatic stress disorder (PTSD) have observed smaller volumes of the hippocampus and cingulate cortex, yet little is known about the integrity of white matter connections between these structures in PTSD samples. The few published studies using diffusion tensor imaging (DTI) to measure white matter integrity in PTSD have described individuals with focal trauma rather than chronically stressed individuals, which limits generalization of findings to this population; in addition, these studies have lacked traumatized comparison groups without PTSD. The present DTI study examined microstructural integrity of white matter tracts in a sample of highly traumatized African-American women with (n=25) and without (n=26) PTSD using a tract-based spatial statistical approach, with threshold-free cluster enhancement. Our findings indicated that, relative to comparably traumatized controls, decreased integrity (measured by fractional anisotropy) of the posterior cingulum was observed in participants with PTSD (p<0.05). These findings indicate that reduced microarchitectural integrity of the cingulum, a white matter fiber that connects the entorhinal and cingulate cortices, appears to be associated with PTSD symptomatology. The role of this pathway in problems that characterize PTSD, such as inadequate extinction of learned fear, as well as attention and explicit memory functions, are discussed.",0 +https://doi.org/10.1097/psy.0b013e3182303775,Medical Comorbidity of Full and Partial Posttraumatic Stress Disorder in US Adults,"This study examined associations between lifetime trauma exposures, PTSD and partial PTSD, and past-year medical conditions in a nationally representative sample of US adults.Face-to-face interviews were conducted with 34,653 participants in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression analyses evaluated associations of trauma exposure, PTSD, and partial PTSD with respondent-reported medical diagnoses.After adjustment for sociodemographic characteristics and comorbid Axis I and II disorders, respondents with full PTSD were more likely than traumatized respondents without full or partial PTSD (comparison group) to report diagnoses of diabetes mellitus, noncirrhotic liver disease, angina pectoris, tachycardia, hypercholesterolemia, other heart disease, stomach ulcer, human immunodeficiency virus seropositivity, gastritis, and arthritis (odds ratios [ORs] = 1.2-2.5). Respondents with partial PTSD were more likely than the comparison group to report past-year diagnoses of stomach ulcer, angina pectoris, tachycardia, and arthritis (ORs = 1.3-1.6). Men with full and partial PTSD were more likely than controls to report diagnoses of hypertension (both ORs = 1.6), and both men and women with PTSD (OR = 1.8 and OR = 1.6, respectively) and men with partial PTSD (OR = 2.0) were more likely to report gastritis. The total number of lifetime traumatic event types was associated with many assessed medical conditions (ORs = 1.04-1.16), reducing the magnitudes and rendering some of the associations between PTSD status and medical conditions nonsignificant.Greater lifetime trauma exposure and PTSD are associated with numerous medical conditions, many of which are stress-related and chronic, in US adults. Partial PTSD is associated with intermediate odds of some of these conditions.",0 +https://doi.org/10.1111/j.1467-9280.2006.01682.x,Psychological Resilience After Disaster,"Research on adult reactions to potentially traumatic events has focused almost exclusively on post-traumatic stress disorder (PTSD). Although there has been relatively little research on the absence of trauma symptoms, the available evidence suggests that resilience following such events may be more prevalent than previously believed. This study examined the prevalence of resilience, defined as having either no PTSD symptoms or one symptom, among a large (n = 2,752) probability sample of New York area residents during the 6 months following the September 11th terrorist attack. Although many respondents met criteria for PTSD, particularly when exposure was high, resilience was observed in 65.1% of the sample. Resilience was less prevalent among more highly exposed individuals, but the frequency of resilience never fell below one third even among the exposure groups with the most dramatic elevations in PTSD.",0 +https://doi.org/10.1016/s0006-3223(98)00210-8,Clinical utility of the selective serotonin reuptake inhibitors in the spectrum of anxiety,"The selective serotonin reuptake inhibitors (SSRIs) are now being employed in the treatment of the full spectrum of anxiety disorders. In comparative trials, the SSRIs are proving to be equal or superior in efficacy to traditional antianxiety medications. Due to their favorable side effect profile, safety, and tolerability, they are rapidly replacing older agents in the treatment of anxiety. Neuroanatomical pathways that may be important in the antianxiety effect of the SSRIs are outline and discussed, followed by a review of the clinical evidence supporting the efficacy of this class of medications in the treatment of anxiety disorders.",0 +https://doi.org/10.1037/tra0000005,Trajectories of posttraumatic growth and depreciation after two major earthquakes.,"This study examined trajectories of posttraumatic growth or depreciation (i.e., positive or negative life change) in personal strength and relationships after 2 major earthquakes in Canterbury, New Zealand using group-based trajectory modeling. Participants completed questionnaires regarding posttraumatic growth or depreciation in personal strength and relationship domains 1 month after the first earthquake in September 2010 (N = 185) and 3 months (n = 156) and 12 months (n = 144) after the more severe February 2011 earthquake. Three classes of growth or depreciation patterns were found for both domains. For personal strength, most of the participants were grouped into a ""no growth or depreciation"" class and smaller proportions were grouped into either a ""posttraumatic depreciation"" or ""posttraumatic growth"" class. The 3 classes for relationships all reported posttraumatic growth, differing only in degree. None of the slopes were significant for any of the classes, indicating that levels of growth or depreciation reported after the first earthquake remained stable when assessed at 2 time points after the second earthquake. Multinomial logistic regression analyses examining pre- and postearthquake predictors of trajectory class membership revealed that those in the ""posttraumatic growth"" personal strength class were significantly younger and had significantly higher pre-earthquake mental health than those in the ""posttraumatic depreciation"" class. Sex was the only predictor of the relationship classes: No men were assigned to the ""high posttraumatic growth"" class. Implications and future directions are discussed.",0 +,A longitudinal study of changes in psychological responses to continuous terrorism.,"The impact of ongoing terror over time has received little attention. This study assesses longitudinally prevalence and predictors of posttraumatic stress symptoms' trajectories, namely resistance, resilience, late-onset and chronicity in the course of intensive and ongoing terror.Two surveys were performed at a two-year interval among 153 Jewish Israeli adults.Results show probable PTSD prevalence, number of traumatic stress related symptoms (TSRS), and rate of severe posttraumatic symptomatology (PTSS) to increase over time (from 18.2% to 31.2%). With this, many (66.7% of those with PTSD and 39.3% of those with PTSS at wave 1) recovered. Late-onset of severe PTSS (19.6% of the sample) was predicted by income reduction, a major lifetime traumatic event, sense of threat, dissociation, coping via disengagement and low mood. Chronicity was predicted by sense of threat, pessimism, dissociation and disengagement.Continuous exposure to terror has a strong negative impact on mental health. Secondly, even within a chronic situation of terror, a large proportion of individuals with elevated levels of posttraumatic symptomatology recover over time; third, prolonged exposure to terror may also exacerbate symptomatology, but not per-se trigger new PTSD cases.",0 +https://doi.org/10.1017/s1041610213000987,The significance of experiences of war and migration in older age: long-term consequences in child survivors from the Dutch East Indies,"ABSTRACT Background: This study examines late consequences of war and migration in both non-clinical and clinical samples of child survivors of World War II. This is one of the very few studies on the mental health of children who were subjected to internment in camps, hiding, and violence under Japanese occupation in the Far East. It provides a unique case to learn about the significance of experiences of war and migration in later life. Methods: Long-term sequelae of the Japanese persecution in the Dutch East Indies (DEI) in child survivors were studied by analyzing sets of standardized questionnaires of 939 persons. Instruments dealt with post-traumatic responses, general health, and dissociation. Participants were recruited through community services and registers of clinical services. Discriminant analyses were conducted to evaluate the significance of early experiences in determining group belonging. Results: Compared with age-matched controls that lived through the German occupation in the Netherlands during World War II, the child survivors from the DEI reported both more trauma-related experiences and mental health disturbances in later life. In particular, the number of violent events during the war, among which especially internment in a camp, contributed to the variation among groups, in support of the significance of these disruptive experiences at older age. Conclusion: The results underline the long-term significance of World War II-related traumatic experiences in the population of elderly child survivors who spent their childhood in the former DEI.",0 +https://doi.org/10.1016/s0028-3908(00)00043-5,"Effects of the CRF1 receptor antagonist, CP 154,526, in the separation-induced vocalization anxiolytic test in rat pups","CRF(1) receptor antagonists have been proposed as novel pharmacological treatments for depression, anxiety and stress disorders. The primary goal of the present study was to evaluate the effects of the CRF(1) receptor antagonist, CP 154,526, in the separation-induced vocalization (SIV) model of anxiety. Nine- to 11-day-old rat pups were separated from their litter and the effects of intraperitoneally administered test compounds on the elicited ultrasonic vocalizations were measured. Side-effect potential was assessed using a modified inclined plane test ('time on an inclined plane', or TIP), and using negative geotaxis. SIV was reduced by CP 154,526 at doses that did not affect TIP or negative geotaxis, a profile like that of the 5-HT(1A) partial agonist buspirone. The benzodiazepine anxiolytic, diazepam, decreased SIV but also produced significant side effects at one to three-fold higher doses. Additional pharmacological characterization of SIV demonstrated anxiolytic-like effects of the atypical antipsychotic, clozapine, but not the typical antipsychotic, haloperidol, and of the serotonin reuptake inhibitor, zimelidine, but not the norepinephrine reuptake inhibitor, desipramine. In summary, the data support the conclusion that selective CRF(1) receptor antagonists may have utility in anxiety and stress disorders. The data further support the use of separation-induced vocalizations for identifying mechanistically diverse compounds with anxiolytic actions in man.",0 +https://doi.org/10.1016/j.jpsychires.2010.04.009,Association between age of onset and mood in bipolar disorder: Comparison of subgroups identified by cluster analysis and clinical observation,"This study compared subgroups identified by cluster analysis and clinical observation by evaluating the association between the age of onset of bipolar disorder and self-reported daily mood ratings.Two hundred and seventy patients with bipolar disorder provided daily self-reported mood ratings for about 6 months returning 55,188 days of data. The age of onset subgroups were determined both using previously defined cutoff values based upon clinical observation (≤12 years, 13-19 years, 20-29 years, >29 years), and model-based cluster analysis. Demographic characteristics were compared in the age of onset subgroups. Univariate general linear models with age of onset subgroups and other demographic variables as fixed factors and covariates were used to analyze the percent of days depressed, euthymic and hypomanic/manic.Using the predetermined subgroups, demographic differences were found between the four subgroups in the diagnosis of bipolar I/II, years of illness, age and use of lamotrigine. Post-hoc pairwise comparison found that patients with an age of onset less ≤ 12 years spent more days hypomanic/manic: 16.4 percent versus 8.0 for patients with an age of onset between 13 and 19 years (p=0.006) and 8.2 percent for patients with an age of onset between 20 and 29 years (p = 0.031). The majority of the additional days of hypomania/mania occurred outside of an episode. Model-based cluster analysis found a mixture of 2 distributions of onset with peaks at age 15.1 years (SD = 4.7) and 27.5 years (SD = 10.2). Analysis of these two subgroups detected no significant differences in demographic characteristics or mood ratings.Age of onset subgroups arising from clinical observation may be more useful than those determined by cluster analysis.",0 +https://doi.org/10.1016/j.neubiorev.2013.03.024,Current status on behavioral and biological markers of PTSD: A search for clarity in a conflicting literature,"Extensive research has identified stereotypic behavioral and biological abnormalities in post-traumatic stress disorder (PTSD), such as heightened autonomic activity, an exaggerated startle response, reduced basal cortisol levels and cognitive impairments. We have reviewed primary research in this area, noting that factors involved in the susceptibility and expression of PTSD symptoms are more complex and heterogeneous than is commonly stated, with extensive findings which are inconsistent with the stereotypic behavioral and biological profile of the PTSD patient. A thorough assessment of the literature indicates that interactions among myriad susceptibility factors, including social support, early life stress, sex, age, peri- and post-traumatic dissociation, cognitive appraisal of trauma, neuroendocrine abnormalities and gene polymorphisms, in conjunction with the inconsistent expression of the disorder across studies, confounds attempts to characterize PTSD as a monolithic disorder. Overall, our assessment of the literature addresses the great challenge in developing a behavioral and biomarker-based diagnosis of PTSD.",0 +https://doi.org/10.1038/tp.2013.70,Traumatic stress reactivity promotes excessive alcohol drinking and alters the balance of prefrontal cortex-amygdala activity,"Post-traumatic stress disorder (PTSD) and alcoholism are highly comorbid in humans and have partially overlapping symptomatic profiles. The aim of these studies was to examine the effects of traumatic stress (and stress reactivity) on alcohol-related behaviors and neuronal activation patterns. Male Wistar rats were trained to respond for alcohol, were exposed to predator odor (bobcat urine) paired with context and were tested for short- and long-term avoidance of the predator odor-paired context, alcohol self-administration and compulsivity of alcohol responding. Rats were re-exposed to the odor-paired context for western blot analysis of ERK phosphorylation in subregions of the medial prefrontal cortex (mPFC) and the amygdala. Rats that avoided the predator-paired chamber (Avoiders) exhibited persistent avoidance up to 6 weeks post conditioning. Avoiders exhibited increases in operant alcohol responding over weeks, as well as more compulsive-like responding for alcohol adulterated with quinine. Following re-exposure to the predator odor-paired context, Avoiders and Non-Avoiders exhibited unique patterns of neuronal activation in subregions of the mPFC and the amygdala, which were correlated with changes in avoidance and alcohol drinking. Furthermore, activity of upstream regions was differentially predictive of downstream regional activity in the Avoiders versus Non-Avoiders. An animal model for assessing the effect of traumatic stress on alcohol drinking reveals individual differences in neuronal activation patterns associated with re-exposure to traumatic stress-related stimuli, and may provide insight into the neural mechanisms underlying excessive alcohol consumption in humans with PTSD.",0 +https://doi.org/10.1080/10926771.2014.941083,"Relationships among Dispositional Attributional Style, Trauma-Specific Attributions, and PTSD Symptoms","The learned helplessness model and its various revisions suggest that causal attributions influence responses to events. This study examined relationships among the 3-factor symptom clusters of posttraumatic stress disorder (PTSD) represented in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–IV; American Psychiatric Association, 1994) and the individual dimensions of dispositional attributional style and trauma-specific attributions (i.e., internal–external, stable–unstable, global–specific). Relationships among attributions and clusters of PTSD symptoms represented by the 4-factor dysphoria model were also examined. Trauma-specific attributions were most predictive of PTSD symptoms, with higher associations for avoidance and numbing symptoms compared to arousal symptoms in the three-factor model and higher associations for dysphoria symptoms compared to arousal and avoidance symptoms in the four-factor dysphoria model. Results suggest that cognitive vulnerabilities coul...",0 +https://doi.org/10.1016/j.ridd.2016.01.007,Brief Symptom Inventory symptom profiles of outpatients with borderline intellectual functioning and major depressive disorder or posttraumatic stress disorder: Comparison with patients from regular mental health care and patients with Mild Intellectual Disabilities,"In most countries, people with borderline intellectual functioning (BIF) are not considered a separate group in mental health care. There is little to no research on the impact of BIF on the presentation, nature and severity of mental health problems. The aim of the present exploratory study was to compare, in a naturalistic setting of patients referred to secondary care, symptom profiles of patients with BIF diagnosed with either major depressive disorder (MDD) or posttraumatic stress disorder (PTSD) to patients from regular mental health care (RMHC) and patients with Mild ID diagnosed with the same disorders.We used a cohort of adolescent and adult outpatients (aged 16-88) with or without BIF diagnosed with a primary diagnosis MDD or PTSD. Primary outcome was the nature and severity of psychopathological symptoms assessed at baseline using the Brief Symptom Inventory. All outcomes were adjusted for gender and age.Results showed that BIF patients with a primary diagnosis MDD reported less severe symptoms on BSI Total and the subscales Depression, Obsession-Compulsion and Psychoticism than patients from regular mental health care (RMHC). There were no statistically significant differences in reported symptom severity on BSI Total and the different BSI subscales between BIF patients with PTSD and either patients from RMHC or patients with Mild ID. Patients Mild ID, did report significantly less severe symptoms on the subscale Depression and on the subscale Psychoticism than patients from RMHC.Since there were no other published studies into symptom profiles in patients with BIF compared to either patients with higher or lower levels of cognitive functioning, the study was mainly exploratory in nature, providing direction for future research. Results indicate that symptom profiles did not widely differ, but that there might be some characteristics unique to patients BIF separating them as a group from both patients from RMHC and patients with Mild ID.",0 +https://doi.org/10.1016/j.janxdis.2013.10.005,A meta-analytic clarification of the relationship between posttraumatic growth and symptoms of posttraumatic distress disorder,"Traumatic experiences can have a powerful impact on individuals and communities but the relationship between perceptions of beneficial and pathological outcomes are not known. Therefore, this meta-analysis examined both the strength and the linearity of the relationship between symptoms of posttraumatic stress disorder (PTSD) and perceptions of posttraumatic growth (PTG) as well as identifying the potential moderating roles of trauma type and age. Literature searches of all languages were conducted using the ProQuest, Wiley Interscience, ScienceDirect, Informaworld and Web of Science databases. Linear and quadratic (curvilinear) rs as well as βs were analysed. Forty-two studies (N = 11,469) that examined both PTG and symptoms of PTSD were included in meta-analytic calculations. The combined studies yielded a significant linear relationship between PTG and PTSD symptoms (r = 0.315, CI = 0.299, 0.331), but also a significantly stronger (as tested by Fisher's transformation) curvilinear relationship (r =0.372, CI = 0.353, 0.391). The strength and linearity of these relationships differed according to trauma type and age. The results remind those working with traumatised people that positive and negative post-trauma outcomes can co-occur. A focus only on PTSD symptoms may limit or slow recovery and mask the potential for growth.",0 +https://doi.org/10.1016/j.psychres.2015.10.002,A prospective study of leukocyte telomere length and risk of phobic anxiety among women,"We prospectively examined the relation of relative telomere lengths (RTLs), a marker of biological aging, to phobic anxiety in later-life. RTLs in peripheral blood leukocytes were measured among 3194 women in the Nurses' Health Study who provided blood samples in 1989/90. The Crown-Crisp Phobic Index (CCI, range=0–16) was assessed in 1988 and 2004. Only participants with CCI≤3 (consistent with no meaningful anxiety symptoms) in 1988 were included. We related baseline RTLs to odds ratios (ORs) of incident high phobic anxiety symptoms (CCI≥6). To enhance clinical relevance, we used finite mixture modeling (FMM) to relate baseline RTLs to latent classes of CCI in 2004. RTLs were not significantly associated with high phobic anxiety symptoms after 16 years of follow-up. However, FMM identified 3 groups of phobic symptoms in later-life: severe, minimal/intermediate, and non-anxious. The severe group had non-significantly shorter multivariable-adjusted mean RTLs than the minimal/intermediate and non-anxious groups. Women with shorter telomeres vs. longest telomeres had non-significantly higher likelihood of being in the severe vs. non-anxious group. Overall, there was no significant association between RTLs and incident phobic anxiety symptoms. Further work is required to explore potential connections of telomere length and emergence of severe phobic anxiety symptoms during later-life.",0 +https://doi.org/10.1037/a0024806,Postdisaster psychological intervention since 9/11.,"A wealth of research and experience after 9/11 has led to the development of evidence-based and evidence-informed guidelines and strategies to support the design and implementation of public mental health programs after terrorism and disaster. This article reviews advances that have been made in a variety of areas, including development of improved metrics and methodologies for conducting needs assessment, screening, surveillance, and program evaluation; clarification of risk and resilience factors as these relate to varying outcome trajectories for survivors and inform interventions; development and implementation of evidence-based and evidence-informed early, midterm, and late interventions for children, adults, and families; adaptation of interventions for cultural, ethnic, and minority groups; improvement in strategies to expand access to postdisaster mental health services; and enhancement of training methods and platforms for workforce development among psychologists, paraprofessionals, and other disaster responders. Continuing improvement of psychologists' national capacity to respond to catastrophic events will require more systematic research to strengthen the evidence base for postdisaster screening and interventions and effective methods and platforms for training. Policy decisions are clearly needed that enhance federal funding to increase availability and access to services, especially for longer term care. Traumatic bereavement represents a critical area for future research, as much needs to be done to clarify issues related to reactions and adaptation to a traumatic death.",0 +https://doi.org/10.1111/j.1439-0531.2007.00945.x,Different Types of Postpartum Luteal Activity Affected by the Exposure of Heat Stress and Subsequent Reproductive Performance in Holstein Lactating Cows,"The aim of the present study was to determine the effect of heat stress on postpartum (PP) luteal activity and subsequent reproductive performance in lactating cows. Thirty Holstein-Friesian (HF, >or=75%) cows (hot season, n = 15 and cool season, n = 15) were studied over 60 days after calving. The changes of temperature-humidity index (THI) were monitored within both seasons. Body condition scores (BCS), uterine involution and the ovarian structures were recorded. Plasma samples were obtained three times a week for the analysis of progesterone (P4) and prostaglandin F(2 alpha) metabolite (PG metabolite). Subsequent reproductive performance of the cows, calved within the same period was also evaluated. The means of THI for hot and cool seasons varied between 84-87 and 78-83 respectively. A drop of the mean BCS was recorded at 5 weeks PP in the cows during hot season (p < 0.01), however a delay of uterine involution during early PP period in hot season was not clearly seen. The cows with normal PP ovarian cyclicity during hot and cool seasons were 4/15 (26.7%) and 9/15 (60.0%) respectively. A higher percentage of abnormal luteal activity was found in the cows during hot season (p = 0.07) and delayed luteal cyclicity/anovulation was the most pronounced atypical P4 profile. The levels of PG metabolite were not different between groups and the relationship between the levels of PG metabolite and the time of uterine involution was not evident (p > 0.05). The heat detection rates and the pregnancy rates were higher in the cows during cool season (p < 0.05). Additionally, the higher first AI conception rates during cool season were recorded (p = 0.06). In conclusion, heat stress conditions had negative effects on BCS and altered a normal process of ovarian resumption PP, consequently resulted in lower reproductive performance in a tropical dairy herd.",0 +https://doi.org/10.1016/j.comppsych.2004.03.015,Does comorbid anxiety or depression affect clinical outcomes in patients with post-traumatic stress disorder and alcohol use disorders?,"Post-traumatic stress disorder (PTSD) is commonly comorbid with other psychiatric disorders, including substance use disorders. In spite of this, pharmacologic treatment trials for PTSD often exclude individuals with significant psychiatric comorbidity. This study is a post hoc analysis of a 12-week double-blind placebo-controlled trial investigating sertraline in the treatment of patients with comorbid PTSD and an alcohol use disorder. Individuals with additional anxiety and affective disorders were included. Patients (N = 93) were stratified into four groups depending on presence or absence of additional anxiety or depressive disorders and evaluated for the effects of comorbidity on PTSD symptoms, depressive symptoms, and drinking behaviors. We hypothesized that additional comorbidity would be associated with poorer outcomes. Patients in all four subgroups showed marked and clinically significant improvement in alcohol drinking behaviors over the course of the study. For the entire sample, over the course of the 12 weeks, mean drinks per drinking day fell from 13.0 +/- 8.4 (SD) to 3.0 +/- 5.0 (SD); t = 10.2, df = 92, P <.000. There were, however, no significant differences among groups. Patients in all four groups showed moderate improvement in Hamilton Depression Rating Scale (HAMD) scores and Clinician-Administered PTSD scale (CAPS) scores at endpoint. For the entire sample, mean CAPS scores fell from 59.3 +/- 19.4 (SD) to 40.8 +/- 26.0, t = 8.9, df = 92, P <.000. Mean HAMD scores fell from 17. 9 +/- 6.7 (SD) at baseline to 11.8 +/- 9.4 (SD) at endpoint; t = 6.7, df = 92, P <.000. There were, however, no significant differences among groups for change in HAM-D or CAPS scores. Hence, contrary to our hypothesis, having additional anxiety or mood disorder comorbidity did not decrease treatment response in individuals with comorbid PTSD and an alcohol use disorder.",0 +https://doi.org/10.1111/j.1601-5215.2011.00590.x,Treatment of psychosis during pregnancy – a case report and a mini-review,"Nielsen RE. Treatment of psychosis during pregnancy – a case report and a mini-review. Objective: Describe clinical problems in treating a patient with psychotic symptoms during pregnancy by presenting a case report, and review the current evidence on antipsychotic drugs during pregnancy. Methods: The review consists of a non-systematic clinical review of current data on treatment with antipsychotics during pregnancy. The case, a 27 year old female initially diagnosed with posttraumatic stress disorder (PTSD) after a rape and emotionally unstable personality disorder, illustrates some of the common challenges a clinician meets. The patient initially discontinues all treatment as she is unsure if the drugs could have a teratogenic effect and is changed to a treatment that is regarded as safe during pregnancy. Results: The current data supports treatment with chlorpromazine although there is a risk of side effects, e.g. extrapyramidal symptoms and hypotension, but also treatment with olanzapine and risperidone. If the patient is currently treated with clozapine, this treatment should be continued, due to clozapines unique efficacy profile. Blood monitoring for six months after birth is recommended when the newborn has been exposed to clozapine treatment. Conclusion: Current evidence on treatment with antipsychotics during pregnancy is sparse, but not treating is associated with increased risks compared to treatment.",0 +https://doi.org/10.1038/sc.2013.25,Examining factors that contribute to the process of resilience following spinal cord injury,"Cross-sectional survey.To examine factors that contribute to the process of positive adjustment, or resilience, in an adult community sample with spinal cord injury (SCI).South Australian Spinal Cord Injury Service, Hampstead Rehabilitation Centre, South Australia, AustraliaA postal survey comprising standardised measures of resilience (Connor-Davidson Resilience Scale-10 item), self-efficacy (Moorong Self-Efficacy Scale), locus of control (Locus of Control of Behaviour Scale) and psychological distress (Depression Anxiety Stress Scale--21 item).Of 60 respondents, 58% reported moderate to high levels of resilience. Resilience correlated significantly with high self-efficacy (r=0.68, P<0.01), internal locus of control (r=-0.52, P<0.01) and low psychological distress (depression r=-0.68, P<0.01; anxiety r=-0.55, P<0.01; stress r=-0.67, P<0.01). In comparison, resilience was not significantly influenced by degree of neuropathic pain (r=-0.23, P>0.05), time since injury (r=-0.14, P>0.05), gender (t(58)=-0.92, P>0.05), lesion completeness (t(57)=-0.86, P>0.05), or SCI diagnosis (t(58)=-1.21, P>0.05). A multiple regression indicated that psychological distress and self-efficacy were the only two variables that uniquely contributed to resilient behaviour.Resilience is an important psychological process in the longer-term management of SCI which can be promoted by targeting rehabilitation interventions towards mood management in addition to self efficacy beliefs. Larger-scale research will help to validate these results.",0 +https://doi.org/10.1371/journal.pone.0101741,Residential Treatment for Combat-Related Posttraumatic Stress Disorder: Identifying Trajectories of Change and Predictors of Treatment Response,"Combat-related posttraumatic stress disorder (PTSD) can be a difficult condition to treat and has been associated with serious medical and economic issues among U.S. military veterans. Distinguishing between treatment responders vs. non-responders in this population has become an important public health priority. This study was conducted to identify pre-treatment characteristics of U.S. veterans with combat-related PTSD that might contribute to favorable and unfavorable responses to high value treatments for this condition.This study focused on 805 patients who completed a VHA PTSD residential program between 2000 and 2007. These patients completed the PTSD Clinical Checklist at pre-treatment, post-treatment, and a four-month follow-up assessment. Latent growth curve analysis (LCGA) was incorporated to determine trajectories of changes in PTSD across these assessments and whether several key clinical concerns for this population were associated with their treatment responses.LCGA indicated three distinct trajectories in PTSD outcomes and identified several clinical factors that were prospectively linked with changes in veterans' posttraumatic symptomatology. When compared to a group with high PTSD symptom severity that decreased over the program but relapsed at follow-up (41%), the near half (48.8%) of the sample with an improving trajectory had less combat exposure and superior physical/mental health. However, when compared to a minority (10.2%) with relatively low symptomatology that also remained somewhat stable, patients in the improving group were younger and also reported greater combat exposure, poorer physical/mental health status, and more problems with substance abuse before the start of treatment.Findings suggest that veterans are most likely to benefit from residential treatment in an intermediate range of symptoms and risk factors, including PTSD symptom severity, history of combat exposure, and comorbid issues with physical/mental health. Addressing these factors in an integrative manner could help to optimize the effectiveness of treatments of combat-related PTSD in many cases.",0 +https://doi.org/10.1300/j229v06n02_02,Predicting Posttraumatic Stress Disorder from Acute Reactions,"There is much interest in identifying people shortly after trauma exposure who will subsequently develop posttraumatic stress disorder (PTSD). This review outlines recent developments in early identification of trauma-exposed people who are at high risk for PTSD development, including the rationale, evidence, and limitations of the acute stress diagnosis as a predictor of chronic PTSD. The potential role of acute dissociative responses mediating development of PTSD is also reviewed. The available evidence suggests that whereas acute dissociation is an important factor in the acute stress response, many people develop PTSD in the absence of dissociative symptoms. The evidence suggests that dissociation needs to be considered in the context of other factors in the aftermath of trauma if optimal identification of high-risk individuals is to be achieved.",0 +https://doi.org/10.3402/ejpt.v5.26516,Psychosocial recovery after serious injury,"The 2010 iteration of the Global Burden of Disease statistics (Murray et al., 2012) points to the growing impact of injury and highlights the mounting burden of psychiatric disorder. It is essential to examine the intersection between these two contributors to disease burden.The Australian Injury Vulnerability Study collected data of over 1,000 injury patients from their initial hospitalization to 6 years post-injury. Structured clinical interviews were used to diagnose psychiatric disorder and self-report measures for disability and symptom severity.A wide range of psychiatric disorders developed following injury, which included posttraumatic stress disorder, agoraphobia, depression, and substance use disorders (Bryant, O'Donnell, Creamer, Silove, & McFarlane, 2010). Although prevalence rates for these disorders were generally consistent over time, examination of trajectory data showed that different people had the disorders at different times. Importantly, the data showed that early anxiety, depression, and PTSD symptoms played a significant role in the development of long term disability after injury (Carty, O'Donnell, Evans, Kazantzis, & Creamer, 2011; O'Donnell et al., 2013).These data support the view that transdiagnostic models for early intervention may be required to address the complex psychiatric disorder trajectories that develop after injury.",0 +https://doi.org/10.1002/pon.3654,A meta‐analysis of prevalence rates and moderating factors for cancer‐related post‐traumatic stress disorder,"Objective Systematic reviews highlight a broad range of cancer-related post-traumatic stress disorder (CR-PTSD) prevalence estimates in cancer survivors. This meta-analysis was conducted to provide a prevalence estimate of significant CR-PTSD symptoms and full diagnoses to facilitate the psychological aftercare of cancer survivors. Methods A systematic literature search was conducted for studies using samples of cancer survivors by using validated clinical interviews and questionnaires to assess the prevalence of CR-PTSD (k = 25, n = 4189). Prevalence estimates were calculated for each assessment method using random-effects meta-analysis. Mixed-effects meta-regression and categorical analyses were used to investigate study-level moderator effects. Results Studies using the PTSD Checklist—Civilian Version yielded lower event rates using cut-off [7.3%, 95% confidence intervals (CI) = 4.5–11.7, k = 10] than symptom cluster (11.2%, 95% CI = 8.7–14.4, k = 9). Studies using the Structured Clinical Interview for Diagnostic and Statistical Manual, Fourth Edition (SCID), yielded low rates for lifetime (15.3%, 95% CI = 9.1–25, k = 5) and current CR-PTSD (5.1%, 95% CI = 2.8–8.9, k = 9). Between-study heterogeneity was substantial (I2 = 54–87%). Studies with advanced-stage samples yielded significantly higher rates with PTSD Checklist—Civilian Version cluster scoring (p = 0.05), and when assessing current CR-PTSD on the SCID (p = 0.05). The effect of mean age on current PTSD prevalence met significance on the SCID (p = 0.05). SCID lifetime prevalence rates decreased with time post-treatment (R2 = 0.56, p < 0.05). Discussion The cancer experience is sufficiently traumatic to induce PTSD in a minority of cancer survivors. Post-hoc analyses suggest that those who are younger, are diagnosed with more advanced disease and recently completed treatment may be at greater risk of PTSD. More research is needed to investigate vulnerability factors for PTSD in cancer survivors. © 2014 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.",0 +https://doi.org/10.1159/000365283,"Screening of Current Post-Traumatic Stress Disorder in Patients with Substance Use Disorder Using the Depression, Anxiety and Stress Scale (DASS-21): A Reliable and Convenient Measure","<b><i>Background:</i></b> Several instruments have been developed and validated as screens for post-traumatic stress disorder (PTSD) in substance use disorder (SUD) patients. Unfortunately, many of these instruments have one or several disadvantages (e.g. low specificity, low sensitivity or high costs). No research has been conducted on instruments that screen simultaneously for other psychiatric disorders, which would be a potentially time-saving and cost-effective approach. In the current study we tested the psychometric properties of the Depression, Anxiety and Stress Scale (DASS) as a screen for PTSD. <b><i>Methods:</i></b> The DASS was assessed in an inpatient facility during intake with 58 patients and again 4 weeks after admission. Another 138 patients were assessed 4 weeks after admission only. The results were compared to the Clinician-Administered PTSD Scale (CAPS) that was also administered after 4 weeks of abstinence. <b><i>Results:</i></b> ROC curve analyses showed an area under the curve of 0.84 for the DASS at intake and 0.78 for the DASS after 4 weeks' abstinence. <b><i>Conclusion:</i></b> The DASS is therefore a reliable and convenient measure to use as a screen for PTSD in SUD patients.",0 +https://doi.org/10.1016/j.janxdis.2013.12.005,Which symptoms of post-traumatic stress disorder are associated with suicide attempts?,"Individuals with post-traumatic stress disorder are at increased risk for suicide attempts. The present study aimed to determine which of the specific DSM-IV symptoms of post-traumatic stress disorder (PTSD) are independently associated with suicide attempts. Data came from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The NESARC has a sample size of N = 34653. The full sample size included in analyses was 2322 individuals with PTSD. Among individuals with lifetime PTSD, after adjusting for sociodemographic factors, as well as any mood, substance, personality, or anxiety disorder (excluding PTSD), increasing numbers of re-experiencing and avoidance symptoms were significantly correlated with suicide attempts. Of the specific symptoms, having physical reactions by reminders of the trauma, being unable to recall some part of it, and having the sense of a foreshortened future, were all associated with suicide attempts. These findings will help extend our understanding of the elevated risk for suicide attempts in individuals with PTSD.",0 +https://doi.org/10.1037/a0021348,Mediators and moderators of a psychosocial intervention for children affected by political violence.,"The authors examined moderators and mediators of a school-based psychosocial intervention for children affected by political violence, according to an ecological resilience theoretical framework.The authors examined data from a cluster randomized trial, involving children aged 8-13 in Central Sulawesi, Indonesia (treatment condition n = 182, waitlist control condition n = 221). Mediators (hope, coping, peer/emotional/play social support) and moderators (gender, age, family connectedness, household size, other forms of social support, exposure to political violence, and displacement) of treatment outcome on posttraumatic stress symptoms and function impairment were examined in parallel process latent growth curve models.Compared with the waitlist group, those receiving treatment showed maintained hope, increased positive coping, maintained peer social support, and increased play social support. Of these putative mediators, only play social support was found to mediate treatment effects, such that increases in play social support were associated with smaller reductions in posttraumatic stress disorder (PTSD) symptoms. Furthermore, the authors identified a number of moderators: Girls showed larger treatment benefits on PTSD symptoms; girls, children in smaller households, and children receiving social support from adults outside the household showed larger treatment benefits on function impairment.Findings provide limited evidence for an ecological resilience theoretical framework. On the basis of these findings, the authors recommend a stronger separation between universal prevention (e.g., resilience promotion through play) and selective/indicated prevention (e.g., interventions aimed at decreasing posttraumatic stress symptoms). Play-based interventions should be careful to exclude children with psychological distress. In addition, treatment effects may be augmented by selecting girls and socially vulnerable children.",0 +https://doi.org/10.4088/jcp.10m06419,Early and Delayed Onset of Response to Antidepressants in Individual Trajectories of Change During Treatment of Major Depression,"The timing and rate of improvement after the initiation of an antidepressant has implications for establishing the mechanism of antidepressant action and for answering the clinically relevant question of how long an appropriate trial of antidepressant medication should be. We explore the individual trajectories of relative change in depression severity to establish what proportion of individuals experience early and late onset of improvement.Longitudinal latent class analysis was applied in a secondary analysis of data obtained from the Genome-Based Therapeutic Drugs for Depression (GENDEP) study. In the GENDEP trial, conducted in 9 European academic psychiatry centers from July 2004 to June 2008, 811 treatment-seeking adult subjects with DSM-IV major depression received escitalopram or nortriptyline for 12 weeks. Montgomery-Asberg Depression Rating Scale measurements were taken weekly. The secondary analysis reported in this article was conducted in 2010.A model with 9 latent classes provided a good description of the individual trajectories of symptom change over time. These classes included 3 nonresponder classes, 3 classes with varying degrees of improvement concentrated in the first 3 weeks (early improvement), and 3 classes with varying degrees of improvement that was more prominent in the second 3 weeks than in the first 3 weeks (delayed improvement). More than half of the subjects who eventually reached remission showed a pattern of delayed improvement, and their eventual outcome could not be predicted from early time points. Early marked response occurred more frequently in subjects treated with nortriptyline than in those treated with escitalopram (12.9% vs 7.5%, χ² = 6.29, P = .01). Delayed complete remission occurred more frequently in subjects treated with escitalopram than in those treated with nortriptyline (13.6% vs 6.1%, χ² = 11.52, P = .0007).Both early and delayed improvement are common. Although early changes are maintained, the eventual outcome of 12-week antidepressant treatment can be accurately predicted only after 8 weeks.http://www.controlled-trials.com Identifier: ISRCTN03693000.",0 +https://doi.org/10.1002/jts.22011,"Trajectories of Scores on a Screening Instrument for PTSD Among World Trade Center Rescue, Recovery, and Clean-Up Workers","The longitudinal course of posttraumatic stress disorder (PTSD) over 8-9 years was examined among 16,488 rescue and recovery workers who responded to the events of September 11, 2001 (9/11) at the World Trade Center (WTC; New York, NY), and were enrolled in the World Trade Center Health Registry. Latent class growth analysis identified 5 groups of rescue and recovery workers with similar score trajectories at 3 administrations of the PTSD Checklist (PCL): low-stable (53.3%), moderate- stable (28.7%), moderate-increasing (6.4%), high-decreasing (7.7%), and high-stable (4.0%). Relative to the low-stable group, membership in higher risk groups was associated with 9/11-related exposures including duration of WTC work, with adjusted odds ratios ranging from 1.3 to 2.0, witnessing of horrific events (range = 1.3 to 2.1), being injured (range = 1.4 to 2.3), perceiving threat to life or safety (range = 2.2 to 5.2), bereavement (range = 1.6 to 4.8), and job loss due to 9/11 (range = 2.4 to 15.8). Within groups, higher PCL scores were associated with adverse social circumstances including lower social support, with B coefficients ranging from 0.2 to 0.6, divorce, separation, or widowhood (range = 0.4-0.7), and unemployment (range = 0.4-0.5). Given baseline, exposure-related, and contextual influences that affect divergent PTSD trajectories, screening for both PTSD and adverse circumstances should occur immediately, and at regular intervals postdisaster.",1 +https://doi.org/10.1192/bjp.bp.113.131227,Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis,"Background It is unclear how many children and adolescents develop post-traumatic stress disorder (PTSD) after trauma. Aims To determine the incidence of PTSD in trauma-exposed children and adolescents as assessed with well-established diagnostic interviews and to examine potential moderators of the estimate. Method A systematic literature search identified 72 peer-reviewed articles on 43 independent samples ( n = 3563). Samples consisting only of participants seeking or receiving mental health treatment were excluded. Main analyses involved pooled incidence estimates and meta-analyses of variance. Results The overall rate of PTSD was 15.9% (95% CI 11.5–21.5), which varied according to the type of trauma and gender. Least at risk were boys exposed to non-interpersonal trauma (8.4%, 95% CI 4.7–14.5), whereas girls exposed to interpersonal trauma showed the highest rate (32.9%, 95% CI 19.8–49.3). No significant difference was found for the choice of assessment interview or the informant of the assessment. Conclusions Research conducted with the best available assessment instruments shows that a significant minority of children and adolescents develop PTSD after trauma exposure, with those exposed to interpersonal trauma and girls at particular risk. The estimates provide a benchmark for DSM-5 and ICD-11.",0 +https://doi.org/10.31887/dcns.2011.13.2/jzohar,New insights into secondary prevention in post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) is unique amongst psychiatric disorders in two ways. Firstly, there is usually a very clear point of onset- the traumatic event The second unique feature of PTSD is that it is characterized by a failure of the normal response to resolve. Given these two characteristics, PTSD appears a good candidate for secondary prevention, ie, interventions immediately after the trauma. Evidence available starting from current concepts and contemporary research of potential secondary prevention interventions are presented. Common practices in the aftermath of trauma such as debriefing and benzodiazepines need to be carefully considered, taking into account their potential harm to the spontaneous recovery process, and the trajectory of PTSD, and not only judging them according to their immediate (comforting) effects. A discussion of the balance required between aiding recovery but not interfering with the potent natural resolution of symptoms (that is expected in most cases), along with potential avenues of future research, are presented. Results of a small pilot study with a single intervention of hydrocortisone immediately after trauma appear to be promising, and clearly indicate the need for further studies.",0 +https://doi.org/10.1037/a0018954,Are traumatic events necessary to elicit symptoms of posttraumatic stress?,"A diagnosis of posttraumatic stress disorder (PTSD) has been conceptualized as being precipitated by a particularly traumatic (e.g., combat exposure, rape, and violent assault). Recent research suggests that common stressful events (e.g., relational problems, divorce, and expected death of a loved one) may also be capable of eliciting posttraumatic symptomatology. The current study replicated and extended these previous findings, examining three groups of exposure: those who reported experiencing only traumatic events in the past year, those who reported experiencing only significant stressful life events in the last year, and those who experienced both types of events. Consistent with previous findings, we found that all three groups of exposure, including those experiencing only stressful life events, experienced similar amounts of PTSD symptomatology across symptom clusters. These data add to the growing literature that suggests that the type of events that cause symptoms of PTSD may be broader than the current diagnostic criteria indicate, and as such calls for more rigorous research in this area to better understand the diagnostic implications of these findings. Since the formal inclusion of posttraumatic stress disorder (PTSD) into the Diagnostic and Statistical Manual of Mental Disorders (3rd ed.; DSM-III; American Psychiatric Association (APA), 1980), controversy has arisen with the diagnosis, much of it centered on Criterion A1 (the stressor criterion). In DSM-III, this criterion held that an individual had to experience an event that is outside the range of usual human experience and that would be markedly distressing to almost anyone (APA, 1980). One of the first critiques of PTSD came from Breslau and Davis (1987), who claimed that the connection between this criterion and the symptom constellation of the PTSD diagnosis had not been adequately tested in an empirical manner. An additional criticism of this early criterion concerned the definition of a traumatic as one that occurred rarely in the population. Epidemiological studies have shown that traumatic stressors are relatively common, with most people experiencing at least one traumatic within their lifetime (Breslau, Davis, Andreski, & Peterson, 1991). In addition to these early criticisms of PTSD as a construct, several research studies have documented that events not necessarily considered traumatic elicit the symptom constella- tion thought to be associated with PTSD, raising questions con- cerning the disorder's symptom specificity. A study conducted by Joseph, Mynard, and Mayall (2000) on English adolescents found a relationship between high scores on measures of posttraumatic stress symptoms and stressful life events that normally would not be classified as traumatic by the current PTSD inclusion criteria (e.g., parental separation, trouble with the police, and family member with a drug or alcohol prob- lem). Additionally, Mol and colleagues (2005) used a general population sample to examine whether stressful events could gen- erate symptoms of PTSD and found that those who identified a stressful life as their worst subjective experience endorsed higher levels of PTSD symptoms than did those whose worst experience was a traumatic event. Similarly, Gold, Marx, Soler- Baillo, and Sloan (2005) divided college undergraduate partici- pants into two groups: those who endorsed a traumatic consistent with the A1 criterion of PTSD and those who experi- enced a negative life not consistent with that criterion. Consistent with previous research, individuals who reported expe- riencing negative life events not consistent with the traumatic nature of the A1 criterion showed equal, if not more, posttraumatic symptomatology than did those who indicated the experience of a traumatic in their life. A more recent study using structured clinical interviews found similar results in a sample of people seeking treatment for major depression (Bodkin, Pope, Detke, & Hudson, 2007). These recent findings underscore a perceived problem with the construct of PTSD and the criterion that has received increased attention as we move closer to the release of DSM (5th ed.). These studies also highlight the importance of additional research in this area to further explore the A1 criterion of PTSD and the stressors that can lead to a posttraumatic stress symptom constellation.",0 +https://doi.org/10.2174/138161209788168074,Tachykinin Receptors as Therapeutic Targets in Stress-Related Disorders,"The first report demonstrating the therapeutic efficacy of an orally applied neurokinin-1 (NK1) receptor antagonist in depression was published 10 years ago. Although there were difficulties to reproduce this particular finding, a huge amount of data has been published since this time, supporting the potential therapeutic value of various tachykinin ligands as promising novel tools for the management of stress-related disorders including anxiety disorders, schizophrenia and depression. The present review summarizes evidence derived from anatomical, neurochemical, pharmacological and behavioral studies demonstrating the localization of tachykinin neuropeptides including substance P (SP), neurokinin A, neurokinin B and their receptors (NK1, NK2, NK3) in brain areas known to be implicated in stress-mechanisms, mood/anxiety regulation and emotion-processing; their role as neurotransmitters and/or neuromodulators within these structures and their interactions with other neurotransmitter systems including dopamine, noradrenaline and serotonin (5-hydroxytryptamine, 5-HT). Finally, there is clear functional evidence from animal and human studies that interference with tachykinin transmission can modulate emotional behavior. Based on these findings and on evidence of upregulated tachykinin transmission in individuals suffering from stress-related disorders, several diverse tachykinin receptor antagonists, as well as compounds with combined antagonist profile have been developed and are currently under clinical investigation revealing evidence for anxiolytic, antidepressant and antipsychotic efficacy, seemingly characterized by a low side effect profile. However, substantial work remains to be done to clarify the precise mechanism of action of these compounds, as well as the potential of combining them with established and experimental therapies in order to boost efficacy.",0 +https://doi.org/10.1016/j.socscimed.2008.06.030,The psychological impact of the Israel–Hezbollah War on Jews and Arabs in Israel: The impact of risk and resilience factors,"Although there is abundant evidence that mass traumas are associated with adverse mental health consequences, few studies have used nationally representative samples to examine the impact of war on civilians, and none have examined the impact of the Israel-Hezbollah War, which involved unprecedented levels of civilian trauma exposure from July 12 to August 14, 2006. The aims of this study were to document probable post-traumatic stress disorder (PTSD), determined by the PTSD Symptom Scale and self-reported functional impairment, in Jewish and Arab residents of Israel immediately after the Israel-Hezbollah War and to assess potential risk and resilience factors. A telephone survey was conducted August 15-October 5, 2006, following the cessation of rocket attacks. Stratified random sampling methods yielded a nationally representative population sample of 1200 adult Israeli residents. The rate of probable PTSD was 7.2%. Higher risk of probable PTSD was associated with being a woman, recent trauma exposure, economic loss, and higher psychosocial resource loss. Lower risk of probable PTSD was associated with higher education. The results suggest that economic and psychosocial resource loss, in addition to trauma exposure, have an impact on post-trauma functioning. Thus, interventions that bolster these resources might prove effective in alleviating civilian psychopathology during war.",0 +https://doi.org/10.1023/a:1025774915005,Follow-up of young road accident victims,The aim of this study was to follow-up a group of children and young people previously examined for psychological sequelae following road traffic accidents. The group was assessed 18-month postaccident to assess the severity of continuing symptoms and examine any emergence of delayed onset of posttraumatic stress reactions. Participants (N = 31) completed the Revised Impact of Event Scale and the Child Posttraumatic Stress Reaction Index. Parents completed the Child Behavior Check-List and participated in a semistructured interview. Symptoms of PTSD were noted in a quarter of participants as was delayed onset of symptoms. The role of avoidance in symptom reporting and continuing disorder is discussed.,0 +https://doi.org/10.1097/00006199-199001000-00006,Parental Stress Response to Sexual Abuse and Ritualistic Abuse Of Children in Day-Care Centers,"The purpose of this study was to examine the stress responses of parents to the sexual and ritualistic abuse of their children in day-care centers. Sixty-five mothers and 46 fathers of children sexually abused in day-care centers completed the Symptom Checklist-90-Revised (SCL-90-R), a measure of psychological distress. These scores were compared with a carefully matched comparison group of parents of 67 nonabused children. Parents of abused children also completed the Impact of Event Scale (IES), a measure which indexes symptoms that characterize posttraumatic stress disorder. Parents of sexually abused children reported significantly more psychological distress than parents of nonabused children, with parents of ritually abused children displaying the most severe psychological distress. Parents of abused children reported symptom profiles on the SCL-90-R and IES consistent with posttraumatic stress disorder.",0 +https://doi.org/10.4314/ajpsy.v9i2.30213,Traumatic stress and psychopathology: experiences of a trauma clinic,"Objective: The study was undertaken to investigate the profile of individuals referred to the psychiatrist for assessment in terms of their demographic features, trauma experienced, diagnosis according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV), and recommendations made by the psychiatrist. Method: The trauma clinic, a key component of the Victim Empowerment Programme (VEP) of the Centre for the Study of Violence and Reconciliation (CSVR) in Johannesburg, South Africa is a multidisciplinary unit offering counselling and debriefing services to victims/survivors of violence. The staff consists of trained therapists (clinical, research and educational psychologists), social workers and a psychiatric nurse. Since 1998, a psychiatrist has been consulting at the clinic as well. A retrospective case review of all intake notes and progress notes of the clients was undertaken. The period of the survey was 1999-2002. Results: Of 3668 individuals presenting to the centre, 127 were referred to the resident psychiatrist for assessment. 119 were assessed. The majority were in the age range 15-45, unmarried and unemployed. Children under the age of 15 and refugees constituted 9.9% and 30% respectively. Major Depression was the most commonly diagnosed psychiatric condition (17.6%), with Post Traumatic Stress Disorder (PTSD), diagnosed less than expected (5.9%). Co- morbidity was common. Medication was prescribed for 66.4% of the sample, with a further 5.9% hospitalised. Conclusion: Not all individuals exposed to trauma develop PTSD, with mood disorders possibly being more common.",0 +,Quality of Life and Its Predictors in Adolescents after General Traumatic Injury,"Background: Injury is a leading cause of morbidity in adolescents in the United States, with almost 4 million 12- to 18-year olds experiencing non-fatal injury in 2009 alone. As survival rates improved, negative psychosocial outcomes were noted, including reduced health-related quality of life (HRQOL). Several variables have been investigated for association with worse HRQOL outcomes. However, no study has reported on the broader construct of quality of life (QOL) in this setting. The current project studied QOL in adolescents after general traumatic injury, specifically investigating whether it differed from a comparison group or changed over the year after injury. Factors potentially associated with poorer QOL outcomes were also evaluated, as they might serve as potential targets for intervention. Method: One-hundred eight 12- to 18-year-olds admitted to a level 1 trauma center after injury participated in this prospective cohort study with a population-based sampling frame. Data were collected within 30 days of injury and 2, 5, and 12 months after injury. The comparison sample was 116 12- to 18-year-olds without disability, mental health diagnosis or chronic illness. Adolescent posttraumatic stress disorder symptoms (PTSS), depressive symptoms, traumatic or stressful life events and parental PTSS were all considered for potential relationship to adolescent QOL. Analyses included descriptive statistics, paired comparisons, ANOVAs, mixed-model and linear regression and mediation analysis. Results: In general, injured adolescents reported normative QOL at injury and 2 months later and significantly better QOL at 5 and 12 months after injury. However, posttraumatic stress disorder was associated with significantly poorer QOL, and those with a higher number of postinjury traumatic or stressful life events had poorer QOL 1 year after injury. Depressive symptoms were also significantly correlated with lower QOL. Parental PTSS did not mediate the relationship between adolescent PTSS and QOL. Conclusions: Findings suggest points of intervention to improve QOL after adolescent injury. They further highlight a need for close communication between trauma center staff and primary care practitioners as well as education for primary providers. Future directions include attention to preinjury mental health and family functioning, investigations with younger children, and longer follow-up. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +,"Relationship between anger, alcoholism and symptoms of posttraumatic stress disorders in war veterans","Purpose: Studies among veterans indicate that veterans with posttraumatic stress disorder (PTSD) express anger, hostility and aggression as well as alcohol and substance abuse more then veterans without PTSD. The aim of this study was to analyze the relationship between anger, use of alcohol and symptoms of PTSD in war veterans in Bosnia and Herzegovina (B&H). Method: Comparing a group of veterans (n=54) with PTSD who use alcohol and a group of veterans (n=46) who do not use alcohol, the analyzed were dimensions of anger related to PTSD symptoms and alcohol usage. Medical records of patients treated at the Department for Psychiatry in Tuzla, B&H, Harvard Trauma Questionnaire (HTQ) – version for Bosnia and Herzegovina, State-Trait Anger Expression Inventory (STAXI), Structured Clinical Diagnostic Interview (SCID-I) were used in this study. The basic socio-demographic data were also collected. Results: A significant correlation is found between alcohol usage, and state and trait of anger (P",0 +https://doi.org/10.1159/000331345,Prenatal Excess Glucocorticoid Exposure and Adult Affective Disorders: A Role for Serotonergic and Catecholamine Pathways,"Fetal glucocorticoid exposure is a key mechanism proposed to underlie prenatal ‘programming’ of adult affective behaviours such as depression and anxiety. Indeed, the glucocorticoid metabolising enzyme 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2), which is highly expressed in the placenta and the developing fetus, acts as a protective barrier from the high maternal glucocorticoids which may alter developmental trajectories. The programmed changes resulting from maternal stress or bypass or from the inhibition of 11β-HSD2 are frequently associated with alterations in the hypothalamic-pituitary-adrenal (HPA) axis. Hence, circulating glucocorticoid levels are increased either basally or in response to stress accompanied by CNS region-specific modulations in the expression of both corticosteroid receptors (mineralocorticoid and glucocorticoid receptors). Furthermore, early-life glucocorticoid exposure also affects serotonergic and catecholamine pathways within the brain, with changes in both associated neurotransmitters and receptors. Indeed, global removal of 11β-HSD2, an enzyme that inactivates glucocorticoids, increases anxiety- and depressive-like behaviour in mice; however, in this case the phenotype is not accompanied by overt perturbation in the HPA axis but, intriguingly, alterations in serotonergic and catecholamine pathways are maintained in this programming model. This review addresses one of the potential adverse effects of glucocorticoid overexposure in utero, i.e. increased incidence of affective behaviours, and the mechanisms underlying these behaviours including alteration of the HPA axis and serotonergic and catecholamine pathways.",0 +https://doi.org/10.1186/1471-2199-8-46,Dynamic resolution of functionally related gene sets in response to acute heat stress,"Using a gene clustering strategy we determined intracellular pathway relationships within skeletal myotubes in response to an acute heat stress stimuli. Following heat shock, the transcriptome was analyzed by microarray in a temporal fashion to characterize the dynamic relationship of signaling pathways.Bioinformatics analyses exposed coordination of functionally-related gene sets, depicting mechanism-based responses to heat shock. Protein turnover-related pathways were significantly affected including protein folding, pre-mRNA processing, mRNA splicing, proteolysis and proteasome-related pathways. Many responses were transient, tending to normalize within 24 hours.In summary, we show that the transcriptional response to acute cell stress is largely transient and proteosome-centric.",0 +https://doi.org/10.1037/1040-3590.10.3.215,Assessing acute stress disorder: Psychometric properties of a structured clinical interview.,"This study presents the development ofa structured clinical interview to diagnose acute stress disorder (ASD). The Acute Stress Disorder Interview (ASDI) is a 19-item, dichotomously scored interview schedule that is based on criteria from the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). It was validated against clinician-based diagnoses of ASD on 65 trauma survivors assessed between 1 and 3 weeks posttrauma. It possessed good internal consistency (r = .90), sensitivity (91%), and specificity (93%). Test-retest reliability was evaluated on 60 trauma survivors between 1 and 3 weeks posttrauma, with a readministration interval of 2 to 7 days. Test-retest reliability of ASDI severity scores was strong (r = .88), and diagnostic agreement for presence (88%) and absence (94%) of ASD diagnosis was high. The ASDI appears to be a useful tool to identify those individuals who suffer ASD and are at risk of long-term posttraumatic stress disorder.",0 +https://doi.org/10.1089/neu.2012.2578,Group-Based Trajectory Analysis Applications for Prognostic Biomarker Model Development in Severe TBI: A Practical Example,"Over the last decade, biomarker research has identified potential biomarkers for the diagnosis, prognosis, and management of traumatic brain injury (TBI). Several cerebrospinal fluid (CSF) and serum biomarkers have shown promise in predicting long-term outcome after severe TBI. Despite this increased focus on identifying biomarkers for outcome prognostication after a severe TBI, several challenges still exist in effectively modeling the significant heterogeneity observed in TBI-related pathology, as well as the biomarker-outcome relationships. Biomarker data collected over time are usually summarized into single-point estimates (e.g., average or peak biomarker levels), which are, in turn, used to examine the relationships between biomarker levels and outcomes. Further, many biomarker studies to date have focused on the prediction power of biomarkers without controlling for potential clinical and demographic confounders that have been previously shown to affect long-term outcome. In this article, we demonstrate the application of a practical approach to delineate and describe distinct subpopulations having similar longitudinal biomarker profiles and to model the relationships between these biomarker profiles and outcomes while taking into account potential confounding factors. As an example, we demonstrate a group-based modeling technique to identify temporal S100 calcium-binding protein B (S100b) profiles, measured from CSF over the first week post-injury, in a sample of adult subjects with TBI, and we use multivariate logistic regression to show that the prediction power of S100b biomarker profiles can be superior to the prediction power of single-point estimates.",0 +https://doi.org/10.1097/htr.0000000000000030,White Matter Compromise in Veterans Exposed to Primary Blast Forces,"OBJECTIVE:: Use diffusion tensor imaging to investigate white matter alterations associated with blast exposure with or without acute symptoms of traumatic brain injury (TBI). PARTICIPANTS:: Forty-five veterans of the recent military conflicts included 23 exposed to primary blast without TBI symptoms, 6 having primary blast with mild TBI, and 16 unexposed to blast. DESIGN:: Cross-sectional case-control study. MAIN MEASURES:: Neuropsychological testing and diffusion tensor imaging metrics that quantified the number of voxel clusters with altered fractional anisotropy (FA) radial diffusivity, and axial diffusivity, regardless of their spatial location. RESULTS:: Significantly lower FA and higher radial diffusivity were observed in veterans exposed to primary blast with and without mild TBI relative to blast-unexposed veterans. Voxel clusters of lower FA were spatially dispersed and heterogeneous across affected individuals. CONCLUSION:: These results suggest that lack of clear TBI symptoms following primary blast exposure may not accurately reflect the extent of brain injury. If confirmed, our findings would argue for supplementing the established approach of making diagnoses based purely on clinical history and observable acute symptoms with novel neuroimaging-based diagnostic criteria that look below the surface for pathology. Language: en",0 +https://doi.org/10.1176/appi.psy.45.1.7,Identification of Traumatic Stress Reactions in Women at Increased Risk for Breast Cancer,"It has been shown that the diagnosis and treatment of cancer may constitute a traumatic event that generates in patients and some of their family members traumatic reactions that are consistent with the symptom profile of posttraumatic stress disorder (PTSD). The present study was conducted to establish the degree to which women at increased familial risk for breast cancer showed such traumatic reactions and to establish which demographic or psychological variables may contribute to the experience of such traumatic reactions in at-risk individuals. Seventy-three women from the Revlon UCLA Breast Center High Risk Clinic were assessed for traumatic reactions that might be consistent with the DSM-IV criteria for PTSD. The results showed that women at increased risk for breast cancer exhibited traumatic responses similar to those reported by cancer patients. When the authors used a self-report instrument that maps onto DSM-IV criteria, 4% of the study subjects reported symptoms consistent with criteria for a potential diagnosis of PTSD, and an additional 7% of the subjects reported symptoms consistent with potentially subclinical levels of PTSD, according to DSM-IV criteria.",0 +,A voice-based automated system for PTSD screening and monitoring.,"Comprehensive evaluation of PTSD includes diagnostic interviews, self-report testing, and physiological reactivity measures. It is often difficult and costly to diagnose PTSD due to patient access and the variability in symptoms presented. Additionally, potential patients are often reluctant to seek help due to the stigma associated with the disorder. A voice-based automated system that is able to remotely screen individuals at high risk for PTSD and monitor their symptoms during treatment has the potential to make great strides in alleviating the barriers to cost effective PTSD assessment and progress monitoring. In this paper we present a voice-based automated Tele-PTSD Monitor (TPM) system currently in development, designed to remotely screen, and provide assistance to clinicians in diagnosing PTSD. The TPM system can be accessed via a Public Switched Telephone Network (PSTN) or the Internet. The acquired voice data is then sent to a secure server to invoke the PTSD Scoring Engine (PTSD-SE) where a PTSD mental health score is computed. If the score exceeds a predefined threshold, the system will notify clinicians (via email or short message service) for confirmation and/or an appropriate follow-up assessment and intervention. The TPM system requires only voice input and performs computer-based automated PTSD scoring, resulting in low cost and easy field-deployment. The concept of the TPM system was supported using a limited dataset with an average detection accuracy of up to 95.88%.",0 +https://doi.org/10.1001/jama.2010.1507,Effect of DHA Supplementation During Pregnancy on Maternal Depression and Neurodevelopment of Young Children,"Uncertainty about the benefits of dietary docosahexaenoic acid (DHA) for pregnant women and their children exists, despite international recommendations that pregnant women increase their DHA intakes.To determine whether increasing DHA during the last half of pregnancy will result in fewer women with high levels of depressive symptoms and enhance the neurodevelopmental outcome of their children.A double-blind, multicenter, randomized controlled trial (DHA to Optimize Mother Infant Outcome [DOMInO] trial) in 5 Australian maternity hospitals of 2399 women who were less than 21 weeks' gestation with singleton pregnancies and who were recruited between October 31, 2005, and January 11, 2008. Follow-up of children (n = 726) was completed December 16, 2009.Docosahexaenoic acid-rich fish oil capsules (providing 800 mg/d of DHA) or matched vegetable oil capsules without DHA from study entry to birth.High levels of depressive symptoms in mothers as indicated by a score of more than 12 on the Edinburgh Postnatal Depression Scale at 6 weeks or 6 months postpartum. Cognitive and language development in children as assessed by the Bayley Scales of Infant and Toddler Development, Third Edition, at 18 months.Of 2399 women enrolled, 96.7% completed the trial. The percentage of women with high levels of depressive symptoms during the first 6 months postpartum did not differ between the DHA and control groups (9.67% vs 11.19%; adjusted relative risk, 0.85; 95% confidence interval [CI], 0.70-1.02; P = .09). Mean cognitive composite scores (adjusted mean difference, 0.01; 95% CI, -1.36 to 1.37; P = .99) and mean language composite scores (adjusted mean difference, -1.42; 95% CI, -3.07 to 0.22; P = .09) of children in the DHA group did not differ from children in the control group.The use of DHA-rich fish oil capsules compared with vegetable oil capsules during pregnancy did not result in lower levels of postpartum depression in mothers or improved cognitive and language development in their offspring during early childhood.anzctr.org.au Identifier: ACTRN12605000569606.",0 +https://doi.org/10.1080/15294145.2009.10773613,Posttraumatic Stress Disorder after Traumatic Brain Injury and Interpersonal Relationships: Contributions from Object-Relations Perspectives,"Posttraumatic stress disorder (PTSD) has been identified in survivors of traumatic brain injury (TBI), sustained from road traffic accidents, assaults, or industrial accidents. This article reviews the small literature on this population, which is predominantly characterized by integrations of cognitive neuropsychology and cognitive behavior therapy. While these perspectives have been applied to identify etiological processes and treatment options, one insufficiently specified domain in this literature is the role of interpersonal relationships. This includes interpersonal etiological mechanisms and social outcomes, but also therapeutic process for PTSD after TBI. In response, object-relations psychoanalytic concepts of symbolizing (Segal, 1957) and containing–contained (Bion, 1962) mechanisms are applied. These concepts are used to consider the aforementioned factors while permitting close conceptual links to neurological and cognitive vulnerabilities for this clinical group. This article finishes with a...",0 +https://doi.org/10.1002/acp.3160,The Influences of Event Centrality in Memory Models of PTSD,"Summary The consequences of events for well-being are influenced by individual and situational factors that are often studied in isolation. In the research reported here, a large (N = 489) nonclinical sample of college students reported their most traumatic event, posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, personality traits, and characteristics of their event memory. This study achieved three major goals. First, we identified the highest types of stress event types in this population as disruptions of interpersonal relationships, homicides/assaults on others, and assaults/accidents involving themselves. Second, we established that the effects of memory characteristics such as vividness, belief, and impact on PTSD symptoms are mediated by the centrality of the event to identity. Third, we affirmed the hypothesis that a structural model of the influence of personality factors on PTSD symptoms has a higher level of concurrent validity if event centrality is included as a mediator of those influences. Copyright © 2015 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1002/jcop.21671,THE ROLE OF SOCIAL SUPPORT ON MENTAL HEALTH AFTER MULTIPLE WILDFIRE DISASTERS,"Disasters can erode mental health (MH), even if it does not reach mental illness. This study explored the direct or moderating role of social support on MH after multiple wildfires, with attention to evacuation status and participant sex. Participants (N = 402) responded to a random digit dial telephone survey about their disaster exposure, current MH, MH at the time of the fire, social support, and life stressors since the disaster. For the evacuated, social support moderated the relation of fire stress to MH at the time of the fire, with those with high social support having better MH. For current MH, social support had a direct relation to MH, and moderated the influence of life stressors since the disaster for the evacuated and women. For those with a life stressor, current MH was better with high social support, but worse under average or low social support. Social support had a relation to current MH for women, but not men.",0 +https://doi.org/10.1097/01.pcc.0000137354.19807.44,Traumatic stress in parents of children admitted to the pediatric intensive care unit,"To measure the prevalence of parental acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) and to examine the relationship between ASD symptoms and PTSD symptoms in parents of infants and children admitted to the pediatric intensive care unit (PICU). To examine the correlation between parental perceptions of illness severity and objective measures. To assess the association among demographic, situational, and illness factors and the severity of ASD and PTSD.Prospective cohort study.Thirty-eight bed PICU at an urban children's hospital.The parents of 272 children admitted to the PICU for >48 hrs.ASD symptoms were assessed using the Acute Stress Disorder Scale during the child's admission. PTSD symptoms were assessed using the PTSD Checklist at least 2 months after discharge. The severity of illness was measured using the Pediatric Risk of Mortality (PRISM III) score.Of the 272 parents completing the initial assessment, 87 (32%) met symptom criteria for ASD. Of the 161 parents completing follow-up, 33 (21%) met symptom criteria for PTSD. PTSD symptoms at follow-up were associated with ASD symptoms assessed in the PICU, unexpected admission, parent's degree of worry that the child might die, and the occurrence of another hospital admission or other traumatic event subsequent to the index admission. Neither ASD nor PTSD responses were associated with objective measures of a child's severity of illness (PRISM III score).Traumatic stress symptoms are common among parents in the PICU and may persist long after discharge. There is strong support from these data for continued attention to supporting parents both during and after a child's PICU admission.",0 +https://doi.org/10.1891/0886-6708.25.1.116,"Prevalence and Determinants of Intimate Partner Violence Against Women in Kazeroon, Islamic Republic of Iran","The aim of this study was to screen for and estimate the prevalence of intimate partner violence (IPV) among women in Kazeroon, Iran. In November 2007, multistage cluster sampling was employed to recruit 702 women to participate in the study. A descriptive, cross-sectional design was employed. The prevalence of physical, psychological, and sexual abuse against women was 43.7%, 82.6%, and 30.9%, respectively, and there was a significant relationship between IPV and family income, education level, and level of religious commitment in both women and husbands. The study suggests that major strategies for prevention of IPV are empowering women and improving their status in the society by promoting of sexual equality in all rights, especially in employment and education.",0 +https://doi.org/10.1586/14737175.2.5.617,Nefazodone in the treatment of patients with post-traumatic stress disorder,"Post-traumatic stress disorder occurs in patients who have undergone a traumatic experience and manifests itself through a cluster of symptoms, including re-experiencing, avoidance and hyperarousal. Post-traumatic stress disorder is commonly found among veterans of war and victims of sexual trauma, natural disasters and accidents. Nefazodone is a medication that has an FDA-approved indication for treating depression. Nefazodone has also been reported to be efficacious in treating post-traumatic stress disorder. Despite recent reports of hepatotoxicity, when used appropriately, nefazodone is generally as well-tolerated as the medications currently FDA-indicated for post-traumatic stress disorder, the selective serotonin reuptake inhibitors. Through its mechanism inhibiting neuronal uptake of serotonin and norepinephrine and as a potent postsynaptic serotonergic antagonist, nefazodone has proven to be effective in treating post-traumatic stress disorder in several open-label trials. The results of such trials warrant its study in larger, double-blind, placebo-controlled clinical trials.",0 +https://doi.org/10.1016/s0084-3970(09)79253-9,"The Impact of Repression, Hostility, and Post-Traumatic Stress Disorder on All-Cause Mortality: A Prospective 16-Year Follow-up Study","A common assumption is that repression of traumatic memories is harmful to health. To assess this, we examined all-cause mortality among a national random sample of 4462 male US Army veterans evaluated in 1985 and followed up in 2000. Our hypothesis was that repression on the Welsh R scale would be associated with increased future mortality. We also expected to find a repression x post-traumatic stress disorder (PTSD) interaction effect. Multivariate Cox regression results for all veterans and for theater veterans (Vietnam service) and era veterans (no Vietnam service) separately, revealed that while PTSD was significant in all models, no main or interaction effect was found for repression. In addition, for era veterans, higher repression symptoms were protective for future mortality (HR = 0.95, p = 0.03). For hostility symptoms, although no interaction effect was found by PTSD, a positive main effect was detected for hostility, but only for theater veterans (HR = 1.04, p = 0.034). Disease-specific results were nonsignificant. Similar to a recent study, we also found that repression symptoms were negatively correlated with PTSD symptoms (r = -0.109, p < 0.001), suggesting repression might be protective. Our study found no evidence that repression had an adverse health impact on men exposed to psychological trauma. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1200/jco.2011.37.2631,Post-Traumatic Stress Symptoms in Long-Term Non-Hodgkin's Lymphoma Survivors: Does Time Heal?,"Little is known about the trajectory of post-traumatic stress disorder (PTSD) symptoms in cancer survivors, despite the fact that such knowledge can guide treatment. Therefore, this study examined changes in PTSD symptoms among long-term survivors of non-Hodgkin's lymphoma (NHL) and identified demographic, clinical, and psychosocial predictors and correlates of PTSD symptomatology.Surveys were mailed to 682 NHL survivors who participated in an earlier survey and now were at least 7 years postdiagnosis. Information was obtained regarding PTSD symptoms, positive and negative perceptions of the cancer experience (ie, impact of cancer), and other potential correlates of PTSD.A total of 566 individuals participated (83% response rate) with a median of 12.9 years since diagnosis; respondents were 52% female and 87% white. Although half (51%) of the respondents reported no PTSD symptoms and 12% reported a resolution of symptoms, more than one-third (37%) reported persistence or worsening of symptoms over 5 years. Survivors who reported a low income, stage ≥ 2 at diagnosis, aggressive lymphoma, having received chemotherapy, and greater impact of cancer (both positive and negative) at the initial survey had more PTSD symptoms at follow-up. In multivariable analysis, income and negative impacts of cancer were independent predictors of PTSD symptoms.More than one-third of long-term NHL survivors experience persisting or worsening PTSD symptoms. Providers should be aware of enduring risk; early identification of those at prolonged risk with standardized measures and treatments that target perceptions of the cancer experience might improve long-term outcomes.",0 +https://doi.org/10.1111/sode.12052,Can Psychosocial Intervention Improve Peer and Sibling Relations Among War-affected Children? Impact and Mediating Analyses in a Randomized Controlled Trial,"Social resources are considered important protectors in traumatic conditions, but few studies have analyzed their role in psychosocial interventions among war-affected children. We examined (1) whether a psychosocial intervention (teaching recovery techniques, TRT) is effective in improving peer and sibling relations, and (2) whether these potentially improved relations mediate the intervention's impacts on children's mental health. Participants were 428 Palestinian children [10–13 (mean = 11.29, standard deviation SD = .68)-year-old girls (49.4 percent) and boys (50.6 percent)], who were cluster-randomized into the TRT and wait-list control groups. They reported the quality of peer (friendship and loneliness) and sibling (intimacy, warmth, conflict, and rivalry) relations, and posttraumatic stress, depressive and psychological distress symptoms, as well as psychosocial well-being at baseline (T1), postintervention (T2), and six month follow-up (T3). Results showed gender-specific TRT intervention effects: Loneliness in peer relations reduced among boys and sibling rivalry reduced among girls. The TRT prevented the increase in sibling conflict that happened in the control group. The mediating hypothesis was partially substantiated for improved peer relations, and beneficial changes in sibling relations were generally associated with improved mental health.",0 +https://doi.org/10.1186/s12888-015-0424-y,Changes in mental disorder prevalence among conflict-affected populations: a prospective study in Sri Lanka (COMRAID-R),"BackgroundLongitudinal data are lacking on mental health trajectories following conflict resolution and return migration. COMRAID-R is a follow-up study of Muslims displaced by conflict from Northern Sri Lanka 20 years ago who are now beginning to return.MethodsOf 450 participants in displacement interviewed in 2011, 338 (75.1%) were re-interviewed a year later, and a supplementary random sample (n = 228) was drawn from return migrants with a comparable displacement history. Common mental disorder (CMD; Patient Health Questionnaire) and post-traumatic stress disorder (CIDI-subscale) were measured.ResultsA CMD prevalence of 18.8% (95%CI 15.2–22.5) at baseline had reduced to 8.6% (5.6–11.7) at follow-up in those remaining in displacement, and was 10.3% (6.5–14.1) in return migrants. PTSD prevalences were 2.4%, 0.3% and 1.6% respectively.ConclusionsWe observed a substantial decrease in CMD prevalence in this population over a short period, which may reflect the prospect of return migration and associated optimism following conflict resolution.",0 +https://doi.org/10.1080/17542863.2015.1019899,Military trauma and its sequel in families of Bedouin servicemen,"Posttraumatic responses of veterans have an adverse impact on the family unit. These impacts include a variety of psychiatric, emotional, and behavioral problems in the veteran's partner and children. Despite the increased attention given today to the central role of the family in the aftermath of trauma, studies in families of non-Western minority servicemen almost do not exist. The current study examined the associations between veterans’ posttraumatic symptoms and familial distress in an ethnic minority sample of 112 families of Bedouin members of the Israeli Defense Forces. Specifically, we have studied the relationship between the men's posttraumatic symptoms, wife's psychological symptoms, and maternal reports about children's wellbeing. Results showed that while fathers’ posttraumatic symptoms were related to their wives’ psychological distress, they were not related to maternal reports about children's problems. However, mothers with higher levels of depression and anxiety tended to report more em...",0 +https://doi.org/10.1016/j.psychres.2014.05.027,"Efficacy and acceptability of atypical antipsychotics for the treatment of post-traumatic stress disorder: A meta-analysis of randomized, double-blind, placebo-controlled clinical trials","As some evidences demonstrated that atypical antipsychotics (AA) may be efficacious in treating post-traumatic stress disorder (PTSD), we preformed a meta-analysis of randomized, double-blind, placebo-controlled clinical trials (RCTs) of AAs for the treatment of PTSD. Two hundred and fifty one papers were searched and screened. Eight RCTs met the inclusion criteria. AAs may be superior to placebo in the treatment of PTSD, as indicated by the changes in Clinician Administered PTSD Scale (CAPS) total scores (weighted mean differences (WMD)=−5.89, 95% confidence interval (CI) [−9.21, −2.56], P =0.0005) and also in CAPS subscale intrusion (WMD=−2.58, 95% CI[−3.83, −1.33], P <0.0001 ) and subscale hyperarousal (WMD=−2.94, 95% CI[−5.45, −0.43], P =0.02). The acceptability measured by dropout rates between AAs and placebo showed no statistical difference (OR=1.24, 95%CI [0.78, 1.97], P =0.36). PTSD symptom cluster, especially in intrusion and hyperarousal. However, we should be careful to generalize the conclusion because of the small number of included trails. We expect more RCTs will be done in the future so as to clarify the specific value of AAs for PTSD.",0 +https://doi.org/10.1037/a0036767,Collective efficacy and the contingent consequences of exposure to life-threatening violence.,"Neighborhood research has increasingly emphasized the potential for contextual characteristics to moderate the effects of youths' experiences on their outcomes. Drawing on collective efficacy theory, we examine the variable consequences of youths' exposures to life-threatening violence across neighborhoods. We argue that strong community normative orientations supporting the control of violence diminish the negative effect of exposure to severe violence on subsequent mental health among urban youth. We also consider the extent to which the consequences of exposure to violence vary by gender. Employing data from the Project on Human Development in Chicago Neighborhoods, we estimate a series of multivariate, multilevel linear models of internalizing and externalizing symptoms. Results indicate that, for girls, exposure to life-threatening violence (witnessing someone being attacked with a weapon or shot) increases both internalizing and externalizing symptoms. However, this effect achieves statistical significance only for girls who reside in neighborhoods with lower collective efficacy. For boys, our analyses offered weaker evidence of violence exposure effects on mental health. Implications for research on the social context of mental health are discussed.",0 +https://doi.org/10.1017/cbo9781139344456.022,Post-traumatic stress disorders,"When … you Think of Things, you find sometimes that a Thing which seemed very Thingish inside you is quite different when it gets out into the open and has other people looking at it. ([Winnie the Pooh] Milne, 2004; p. 99) Introduction Adjusting to a significant life event can be difficult for children and adults alike. A sudden bereavement, or bearing witness to violence or a tragic accident are experiences likely to be accompanied by complex, even debilitating feelings of fear or sadness. For the young child, making sense of traumatic events is complicated by limited life experiences, naïve understandings of the world and reliance on those around them. Their interpretation of events may be hindered by child-like language and reasoning. This chapter seeks to describe the impact of such events on children and portray the application of a model that can be used both to understand such reactions and guide interventions intended to help children by enabling them to confront their experiences, formulate a narrative and develop a helpful meaning of the event. Diagnosis Traumatic events can lead to a variety of psychological problems such as anxiety, depression, behavioural problems, substance abuse, self-harm and post-traumatic stress disorder (PTSD) (Perrin et al., 2000). In clinical practice, children’s reactions to traumatic events may be complex; those with symptoms of PTSD, who fail to meet the strict criteria for a diagnosis according to the current Diagnostic and Statistical Manual of Mental Disorders (DSM–IV–TR; American Psychiatric Association, 2000), may still be suffering from substantial distress and impairment (Carrion et al., 2002), which may respond to intervention. At the time of writing, the fifth edition of the DSM is in preparation and new criteria are likely to be introduced. © Cambridge University Press 1998, 2005, 2013.",0 +https://doi.org/10.3233/nre-2010-0558,Posttraumatic stress symptoms in OIF/OEF service members with blast-related and non-blast-related mild TBI,"To examine the proportion and severity of stress-related symptoms in U.S. service members with mild traumatic brain injuries (mTBI) received during deployment to Operation Iraqi Freedom (OIF) or Operation Enduring Freedom (OEF). Stress-related symptoms reported by service members with mTBI from explosive munitions are compared to symptoms reported by those with mTBI received from other mechanisms (i.e. falls, motor vehicle accidents).Posttraumatic stress, as measured by scores on the Posttraumatic Stress Disorder Checklist (PCL-C), for a sample of 586 OIF/OEF service members with blast-related mTBI was compared to a sample of 138 OIF/OEF service members with non-blast mTBI selected from retrospective review of research records.Re-experiencing symptoms such as flashbacks and nightmares were higher for the blast mTBI group than for the non-blast mTBI group. Symptoms on other PTSD clusters and total score did not significantly differ between groups. Equivalent proportions of the blast and non-blast groups endorsed severe PTSD symptoms, with total PCL-C scores greater than or equal to 50.Consistent with prior reports, high levels of posttraumatic stress symptoms occur in a substantial proportion of service members who experienced deployment-related blast and non-blast mTBI. Results suggest that the psychological rehabilitation of OIF/OEF service members with mTBI from explosive blast should include particular attention to addressing re-experiencing symptoms.",0 +https://doi.org/10.1016/j.janxdis.2015.08.001,Acute posttraumatic stress symptoms but not generalized anxiety symptoms are associated with severity of exposure to war trauma: A study of civilians under fire,"Posttraumatic stress (PTSS) and generalized anxiety symptoms (GAS) may ensue following trauma. While they are now thought to represent different psychopathological entities, it is not clear whether both GAS and PTSS show a dose-response to trauma exposure. The current study aimed to address this gap in knowledge and to investigate the moderating role of subjects' demographics in the exposure-outcome associations. The sample included 249 civilian adults, assessed during the 2014 Israel-Gaza military conflict. The survey probed demographic information, trauma exposure, and symptoms. PTSS but not GAS was associated with exposure severity. Women were at higher risk for both PTSS and GAS than men. In addition, several demographic variables were only associated with PTSS levels. PTSS dose-response effect was moderated by education. These findings are in line with emerging neurobiological and cognitive research, suggesting that although PTSS and GAS have shared risk factors they represent two different psychopathological entities. Clinical and theoretical implications are discussed.",0 +https://doi.org/10.1093/milmed/166.suppl_2.74,An Animal Model for Studying Therapeutic Drugs against Post-Traumatic Stress Disorder,"An animal model for the evolvement of post-traumatic stress disorder (PTSD) was developed by simulating the hormonal consequences of prolonged stress via the continuous administration of corticosterone by subcutaneously implanted sustained-release pellets. Behavioral, morphological, and biochemical effects were recorded and analyzed. This model has shown cognitive deficits as well as hippocampal damage in the rat similar to those found in PTSD patients. The model was also used to test a therapeutic treatment against stress-induced brain damages. Concomitant treatment with the L-type calcium channel blocker, nimodipine, protected young rats from corticosterone-induced morphological brain changes but not cognitive impairments. The proposed animal model may be useful for testing the efficacy of various neuroprotective drugs. Development of an effective drug treatment for use after a traumatic event and through the trauma period might prevent permanent brain damage and the development of PTSD.",0 +https://doi.org/10.1016/j.janxdis.2013.12.008,"The DSM-5 dissociative-PTSD subtype: Can levels of depression, anxiety, hostility, and sleeping difficulties differentiate between dissociative-PTSD and PTSD in rape and sexual assault victims?","The DSM-5 currently includes a dissociative-PTSD subtype within its nomenclature. Several studies have confirmed the dissociative-PTSD subtype in both American Veteran and American civilian samples. Studies have begun to assess specific factors which differentiate between dissociative vs. non-dissociative PTSD. The current study takes a novel approach to investigating the presence of a dissociative-PTSD subtype in its use of European victims of sexual assault and rape (N=351). Utilizing Latent Profile Analyses, we hypothesized that a discrete group of individuals would represent a dissociative-PTSD subtype. We additionally hypothesized that levels of depression, anger, hostility, and sleeping difficulties would differentiate dissociative-PTSD from a similarly severe form of PTSD in the absence of dissociation. Results concluded that there were four discrete groups termed baseline, moderate PTSD, high PTSD, and dissociative-PTSD. The dissociative-PTSD group encompassed 13.1% of the sample and evidenced significantly higher mean scores on measures of depression, anxiety, hostility, and sleeping difficulties. Implications are discussed in relation to both treatment planning and the newly published DSM-5.",0 +https://doi.org/10.1521/jscp.2012.31.6.542,"Coping Flexibility, Potentially Traumatic Life Events, and Resilience: A Prospective Study of College Student Adjustment","College has been shown to be a particularly stressful time both due to unique emergent stressors and because of increased vulnerability for exposure to potentially traumatic events (PTEs). Both of these conditions are associated with heightened risk for the development of stress-related pathology. However, while this period may be particularly challenging, previous work shows most students adapt in a number of heterogeneous ways that result in little or no stress-related symptomatology over the four years of college. There is indication from the coping literature that the ability to flexibly move between multiple coping behaviors may foster resilient outcomes. In this study, we examined trajectories of distress, using Latent Growth Mixture Modeling, and whether flexible coping aids in adaption. Results showed that trajectories were not influenced by exposure to a PTE and that the common outcome was little or no distress over the four years of college. Flexible coping was strongly associated with a resilie...",0 +https://doi.org/10.1017/s1355617700655066,Factors influencing outcome following mild traumatic brain injury in adults,"This study aimed to investigate outcome in adults with mild traumatic brain injury (TBI) at 1 week and 3 months postinjury and to identify factors associated with persisting problems. A total of 84 adults with mild TBI were compared with 53 adults with other minor injuries as controls in terms of postconcussional symptomatology, behavior, and cognitive performance at 1 week and 3 months postinjury. At 1 week postinjury, adults with mild TBI were reporting symptoms, particularly headaches, dizziness, fatigue, visual disturbance, and memory difficulties. They exhibited slowing of information processing on neuropsychological measures, namely the WAIS-R Digit Symbol subtest and the Speed of Comprehension Test. By 3 months postinjury, the symptoms reported at 1 week had largely resolved, and no impairments were evident on neuropsychological measures. However, there was a subgroup of 24% of participants who were still suffering many symptoms, who were highly distressed, and whose lives were still significantly disrupted. These individuals did not have longer posttraumatic amnesia (PTA) duration. They were more likely to have a history of previous head injury, neurological or psychiatric problems, to be students, females, and to have been injured in a motor vehicle accident. The majority were showing significant levels of psychopathology. A range of factors, other than those directly reflecting the severity of injury, appear to be associated with outcome following mild TBI.",0 +https://doi.org/10.1037/1082-989x.8.3.338,Distributional Assumptions of Growth Mixture Models: Implications for Overextraction of Latent Trajectory Classes.,"Growth mixture models are often used to determine if subgroups exist within the population that follow qualitatively distinct developmental trajectories. However, statistical theory developed for finite normal mixture models suggests that latent trajectory classes can be estimated even in the absence of population heterogeneity if the distribution of the repeated measures is nonnormal. By drawing on this theory, this article demonstrates that multiple trajectory classes can be estimated and appear optimal for nonnormal data even when only 1 group exists in the population. Further, the within-class parameter estimates obtained from these models are largely uninterpretable. Significant predictive relationships may be obscured or spurious relationships identified. The implications of these results for applied research are highlighted, and future directions for quantitative developments are suggested.",0 +https://doi.org/10.3928/00485713-20090728-05,The Historic Origins of Military and Veteran Mental Health Stigma and the Stress Injury Model as a Means to Reduce It,,0 +https://doi.org/10.1017/s135561770999049x,Cognitive impairment and functioning in PTSD related to intimate partner violence,"Abstract Posttraumatic stress disorder (PTSD) has been associated with neuropsychological impairments across multiple domains, but consensus regarding the cognitive profile of PTSD has not been reached. In this study of women with PTSD related to intimate partner violence ( n = 55) and healthy, demographically similar comparison participants (NCs; n = 20), we attempted to control for many potential confounds in PTSD samples. All participants were assessed with a comprehensive neuropsychological battery emphasizing executive functioning, including inhibition, switching, and abstraction. NCs outperformed PTSD participants on most neuropsychological measures, but the differences were significant only on speeded tasks (with and without executive functioning components). The PTSD group’s mean performance was within the average range on all neuropsychological tests. Within the PTSD group, more severe PTSD symptoms were associated with slower processing speed, and more severe dissociative symptoms were associated with poorer reasoning performance. These results suggest that women with PTSD related to intimate partner violence demonstrate slower than normal processing speed, which is associated with the severity of psychiatric symptoms. We speculate that the cognitive slowing seen in PTSD may be attributable to reduced attention due to a need to allocate resources to cope with psychological distress or unpleasant internal experiences. ( JINS , 2009, 15 , 879–887.)",0 +https://doi.org/10.1016/j.biopsych.2015.03.018,Germ Cell Origins of Posttraumatic Stress Disorder Risk: The Transgenerational Impact of Parental Stress Experience,"Altered stress reactivity is a predominant feature of posttraumatic stress disorder (PTSD) and may reflect disease vulnerability, increasing the probability that an individual will develop PTSD following trauma exposure. Environmental factors, particularly prior stress history, contribute to the developmental programming of the hypothalamic-pituitary-adrenal stress axis. Critically, the consequences of stress experiences are transgenerational, with parental stress exposure impacting stress reactivity and PTSD risk in subsequent generations. Potential molecular mechanisms underlying this transmission have been explored in rodent models that specifically examine the paternal lineage, identifying epigenetic signatures in male germ cells as possible substrates of transgenerational programming. Here, we review the role of these germ cell epigenetic marks, including posttranslational histone modifications, DNA methylation, and populations of small noncoding RNAs, in the development of offspring stress axis sensitivity and disease risk.",0 +https://doi.org/10.3205/psm000093,Emotional ambivalence and post-traumatic stress disorder (PTSD) in soldiers during military operations.,"This pilot study examined the extent to which a specific mechanism of emotion regulation - namely, ambivalence concerning the expressiveness of German soldiers' emotions - affects the severity of PTSD symptoms after a military operation.A survey was conducted at three points in time among 66 soldiers deployed on military crisis operations. The Harvard Trauma Questionaire (HTQ), the Ambivalence over Emotional Expressiveness Questionnaire (AEQ-G18), and a questionnaire on the particular stress of German soldiers during military operations were used.The study showed a significant correlation between emotional ambivalence and traumatization. Furthermore, it was shown that the subjective stress of soldiers leading up to deployment is more pronounced when emotional ambivalence is stronger in the context of military operations. This particular stress is greater before and during the military operation than after. Compared to a male control sample, the average AEQ-G18 scores of the soldier sample examined here are considerably lower.This pilot study clearly indicates that the AEQ-G18 could be a suitable predictor of the psychological burden on soldiers. The correlations between emotional ambivalence on the one hand and the particular and post-traumatic stressors on the other hand are not only statistically significant in the present pilot study, but may also be relevant as risk factors. It is, therefore, necessary to conduct more extensive studies on soldiers participating in military operations to verify the results of this pilot study.Zielsetzung: In dieser Pilotstudie wurde untersucht, inwiefern sich ein spezifischer Mechanismus der Emotionsregulation, nämlich die Ambivalenz gegenüber der Expressivität eigener Emotionen bei deutschen Soldaten auf die Ausprägung der Symptome einer PTBS nach dem Einsatz auswirkt.Methodik: Es wurde eine Befragung mit 66 Soldaten im Kriseneinsatz an drei Zeitpunkten durchgeführt. Dabei kamen neben dem Harvard Trauma Questionaire (HTQ), der Ambivalence over Emotional Expressiveness Questionnaire (AEQ-G18) sowie ein Fragebogen zur speziellen Belastung von Bundeswehrangehörigen in Kriseneinsätzen zum Einsatz.Ergebnisse: In der Studie zeigte sich ein signifikanter Zusammenhang zwischen emotionaler Ambivalenz und Traumatisierung. Des Weiteren konnte gezeigt werden, dass bei stärkerem Auftreten emotionaler Ambivalenz im Kontext von militärischen Einsätzen die subjektiven Belastungen von Soldaten zum militärischen Einsatz hin ausgeprägter sind. Diese speziellen Belastungen sind vor und während des Kriseneinsatzes höher als nach dem Kriseneinsatz, Im Vergleich zu einer männlichen Vergleichsstichprobe liegen die Mittelwerte bei dem AEQ-G18 der vorliegenden Soldatenstichprobe erheblich niedriger.Fazit: Die Pilotstudie weist deutlich darauf hin, dass die Diagnostik mit dem AEQ-G18 geeignet sein könnte, die psychischen Belastungen bei Soldaten vorherzusagen. Die Zusammenhänge zwischen emotionaler Ambivalenz einerseits und den speziellen sowie posttraumatischen Belastungen andererseits sind in der vorgelegten Pilotstudie nicht nur statistisch signifikant, sondern können als Risikofaktoren relevant sein. Daher ist es erforderlich weitere umfangreiche Studien bei Soldaten in Kriseneinsätzen durchzuführen, um die Ergebnisse der Pilotstudie zu überprüfen.",0 +https://doi.org/10.1016/j.chiabu.2008.12.006,The contribution of childhood emotional abuse to teen dating violence among child protective services-involved youth,"For child protective services (CPS) youth who may have experienced more than one form of maltreatment, the unique contribution of emotional abuse may be over-looked when other forms are more salient and more clearly outside of accepted social norms for parenting. This study considers the unique predictive value of childhood emotional abuse for understanding adolescent post-traumatic stress disorder (PTSD) symptomatology and dating violence. Further, PTSD symptomatology is assessed as an explanatory bridge in the emotional abuse-teen dating violence link.A random sample of 402 youth from the active caseload of a large urban CPS catchment area participated as part of a larger longitudinal study on adolescent health behaviors. Mid-adolescent youth across types of CPS status were targeted. CPS youth reported on lifetime maltreatment experiences, PTSD symptomatology, and past year dating experiences, using published scales.Over 85% of CPS youth had begun dating. For dating youth, some level of dating violence was common: over half of females (63-67%) and nearly half of males (44-49%). Taking into account other forms of maltreatment, emotional abuse emerged as a significant predictor of both PTSD symptomatology and dating violence among males and females. PTSD symptomatology was a significant mediator of the male emotional abuse-perpetration and the female emotional/physical abuse-victimization links, indicating a gendered patterning to findings.These results indicate that: (1) CPS youth are a high priority group for dating violence and PTSD-linked intervention; and (2) CPS youth continue to experience the unique negative impact of childhood emotional abuse in their adolescent adjustment. All CPS children should be evaluated for emotional abuse incurred, and appropriate intervention attention be given as to how it specifically impacts on the child's approach to relating to themselves and to others.The present study directs practice implications in regards to: (1) the problem of teen dating violence, (2) the salience of childhood emotional abuse; and (3) the importance of targeting PTSD symptomatolgy among CPS youth. A substantial number of CPS youth report early engagement in violent romantic relationships and require support towards attaining the non-coercive relationship experiences of their non-CPS-involved age mates. The topic of dating, healthy dating relationships, and dating violence may need to be part of the regular casework, with a view towards supporting youths' conceptualization of and skill set for healthy, close relationships. Further, this knowledge needs to be translated to foster parents and group home staff. With regard to the impact of childhood emotional abuse, CPS workers need to be sensitive to its potential for long-term, unique impact impairing relationship development. Emotional abuse is (a) unique among genders (i.e., for females, it clusters with physical abuse) and (b) uniquely predictive of PTSD symptoms and dating violence. Finally, as is consistent with theory and biopsychosocial evidence, PTSD symptomatology is a key causal candidate for understanding maltreatment-related impairment. Attention to targeting PTSD symptoms may be preventative for dating violence; attention to targeting emotional abuse experiences may be preventative for PTSD symptoms. CPS youth are an important population to involve in research, as their inclusion adds to the evidence-base to achieve evidence-informed practice and policy within child welfare.",0 +https://doi.org/10.1080/15374410802148152,Reactive Aggression and Posttraumatic Stress in Adolescents Affected by Hurricane Katrina,"The current study tests a theoretical model illustrating a potential pathway to reactive aggression through exposure to a traumatic event (Hurricane Katrina) in 166 adolescents (61% female, 63% Caucasian) recruited from high schools on the Gulf Coast of Mississippi. Results support an association between exposure to Hurricane Katrina and reactive aggression via posttraumatic stress disorder (PTSD) symptoms and poorly regulated emotion. The proposed model fits well for both boys and girls; however, results suggest that minority youth in this sample were more likely to experience emotional dysregulation in relation to posttraumatic stress than Caucasian youth. Further, results indicate that hurricane exposure, PTSD symptoms, and poorly regulated emotion are associated with reactive aggression even after controlling for proactive aggression. These findings have implications for postdisaster mental health services. Researchers examining mental health problems in youth after a significant disaster have traditionally focused on the presence of internalizing problems such as anxiety, depression, and posttraumatic stress disorder (PTSD) symptoms, with very little empirical attention paid to the incidence of post-disaster externalizing problems such as aggression. Specific types of aggressive responses, particularly those that involve poorly regulated emotion (i.e., reactive aggression), have been shown to be associated with a history of trauma and thus may be especially common following a traumatic event such as a hurricane.",0 +https://doi.org/10.1097/00004583-199403000-00004,Urinary Catecholamine Excretion in Sexually Abused Girls,"The objective of this study was to examine urinary catecholamine excretion in a self-selected sample of sexually abused and demographically matched control girls recruited from a prospective, longitudinal study.Twenty-four--hour urinary catecholamine and metabolite concentrations of epinephrine, norepinephrine, dopamine, 3-methoxy-4-hydroxyphenylglycol, metanephrine, normetanephrine, vanillylmandelic acid, 3,4-dihydroxyphenylacetic acid, and homovanillic acid were measured in 12 sexually abused and 9 control girls, aged 8 to 15 years. Psychiatric profiles also were obtained.The abused subjects excreted significantly greater amounts of metanephrine, vanillylmandelic acid, homovanillic acid, and total catecholamine synthesis as measured by the sum of epinephrine, norepinephrine, dopamine, and their metabolites compared to values from control subjects. When the means of all significant biochemical measures were adjusted by the covariate effect of height, only homovanillic acid and group interaction remained significant. There were positive trends toward significantly higher urinary excretion of metanephrine, vanillylmandelic acid, and total catecholamine synthesis. Sexually abused girls also had a greater incidence of suicidal ideation, suicide attempts, and dysthymia than control girls.These findings support the idea that sexually abused girls show evidence of higher catecholamine functional activity compared with controls. The clinical significance of these findings in their similarity to the psychobiology of both post-traumatic stress disorder and major depressive disorder. Results from this pilot study may be of value in understanding the mechanisms of depressive and anxiety disorders and in the clinical treatment of maltreated children.",0 +https://doi.org/10.2165/00002018-200427130-00003,Safety of a New Oral Contraceptive Containing Drospirenone,"New chemical entities must undergo rigorous, and preferably independent, safety and efficacy assessments before entry into the market. This is also true for oral contraceptives (OCs) given their extensive usage by healthy women and the safety concerns highlighted by the so-called 'third generation pill scare' in Europe a decade ago. This scare heightened patient and physician awareness of the increased risk of thromboembolic complications (mainly venous thromboembolism [VTE]) associated with OC use. Yasmin(registered trademark) (ethinylestradiol 30(mu)g/drospirenone 3mg [EE/DRSP]) is a novel OC that was demonstrated in clinical phase I-III studies to be highly effective in preventing pregnancy and to have a good safety profile. Nonetheless, clinical trials are not usually sufficiently powered to detect rare adverse events such as VTE to enable comparison with other OCs, which could allay fears and concerns about their inherent risks. Therefore, an extensive assessment of the VTE risk associated with EE/DRSP has been undertaken by reviewing data from the clinical development programme, postmarketing surveillance and spontaneous worldwide reporting, as well as information from other sources. Spontaneous worldwide reporting has revealed a VTE reporting rate of 5.1/100 000 women-years with EE/DRSP use. In contrast, 3-year interim results from a large, controlled, prospective postmarketing surveillance study suggest a VTE rate of 61/100 000 women-years for EE/DRSP, which is similar to the rates of 60/100 000 and 73/100 000 women-years for levonorgestrel-containing OCs and other OCs, respectively. When placed in context with potential biases and confounding factors that would inflate the perceived risk of VTEs with a novel OC, the VTE rate with EE/DRSP does not highlight any safety concerns. Furthermore, the risk of VTE with EE/DRSP or other OCs is far less than that associated with pregnancy and delivery (up to 800/100 000 women-years) or than other risks of daily living. Available data indicate that EE/DRSP is not associated with any increased risk of other serious adverse events such as hyperkalaemia, cardiac arrhythmia or birth defects. Nonetheless, caution should be exerted in prescribing EE/DRSP to women with conditions that predispose to hyperkalaemia. Overall, the safety data with EE/DRSP and other OCs indicate that these products have no negative impact on the risk of VTE (and other adverse events) in women who receive OCs for contraception.",0 +https://doi.org/10.1093/arclin/acv014,Profile Analyses of the Personality Assessment Inventory Following Military-Related Traumatic Brain Injury,"Personality Assessment Inventory (PAI) profiles were examined in 160 U.S. service members (SMs) following mild-severe traumatic brain injury (TBI). Participants who sustained a mild TBI had significantly higher PAI scores than those with moderate-severe TBI on eight of the nine clinical scales examined. A two-step cluster analysis identified four PAI profiles, heuristically labeled ""High Distress"", ""Moderate Distress"", ""Somatic Distress,"" and ""No Distress"". Postconcussive and posttraumatic stress symptom severity was highest for the High Distress group, followed by the Somatic and Moderate Distress groups, and the No Distress group. Profile groups differed in age, ethnicity, rank, and TBI severity. Findings indicate that meaningful patterns of behavioral and personality characteristics can be detected in active duty military SMs following TBI, which may prove useful in selecting the most efficacious rehabilitation strategies.",0 +https://doi.org/10.1348/147608310x520157,Post-traumatic growth as outcome of a cognitive-behavioural therapy trial for motor vehicle accident survivors with PTSD,"Treatment effects on post-traumatic growth (PTG) and its subdomains were investigated together with predictors of the Janus-face model of PTG.Effects were investigated within a randomized controlled trial of cognitive-behavioural therapy (CBT) for post-traumatic stress disorder (PTSD).Forty motor vehicle accident survivors were randomly assigned to a treatment or waiting condition. PTG was measured by the Post-traumatic Growth Inventory and complemented by its possible predictors (optimism, openness).The CBT treatment proved to be highly effective in terms of PTSD symptom reduction. In contrast to previous findings, however, there was no treatment effect on PTG in general. The CBT group showed, however, increases in PTG subdomains 'new possibilities' and 'personal strength'.The results of this study caution researchers to naively expect PTG as a uniformly positive outcome to evaluate treatment effectiveness.",0 +https://doi.org/10.1186/1752-1505-8-2,A national population-based assessment of 2007–2008 election-related violence in Kenya,"Abstract Background Following the contested national elections in 2007, violence occurred throughout Kenya. The objective of this study was to assess the prevalence, characteristics, and health consequences of the 2007–2008 election-related violence. Methods A cross-sectional, national, population-based cluster survey of 956 Kenyan adults aged ≥ 18 years was conducted in Kenya in September 2011 utilizing a two-stage 90 x 10 cluster sample design and structured interviews and questionnaires. Prevalence of all forms of violence surrounding the 2007 election period, symptoms of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), and morbidity related to sexual and physical violence were assessed. Results Of 956 households surveyed, 916 households participated (response rate 95.8%). Compared to pre-election, election-related sexual violence incidents/1000 persons/year increased over 60-fold (39.1-2370.1; p < .001) with a concurrent 37-fold increase in opportunistic sexual violence (5.2-183.1; p < .001). Physical and other human rights violations increased 80-fold (25.0-1987.1; p < .001) compared to pre-election. Overall, 50% of households reported at least one physical or sexual violation. Households reporting violence were more likely to report violence among female household members (66.6% vs. 58.1%; p = .04) or among the Luhya ethnic group (17.0% vs. 13.8%; p = 0.03). The most common perpetrators of election-related sexual violence were reported to be affiliated with government or political groups (1670.5 incidents/1000 persons per year); the Kalenjin ethnic group for physical violations (54.6%). Over thirty percent of respondents met MDD and PTSD symptom criteria; however, symptoms of MDD (females, 63.3%; males, 36.7%; p = .01) and suicidal ideation (females, 68.5%; males, 31.5%; p = .04) were more common among females. Substance abuse was more common among males (males, 71.2%; females, 28.8%; p < .001). Conclusion On a national level in Kenya, politically-motivated and opportunistic sexual and physical violations were commonly reported among sampled adults with associated health and mental health outcomes.",0 +https://doi.org/10.1002/1097-4679(200009)56:9<1109::aid-jclp2>3.0.co;2-c,An evidence-based approach to evaluating and managing suicidal emergencies,"This article presents a framework for making suicide risk estimations, as well as recommendations for the management of suicidal emergencies, that are useful to the practitioner. It provides a review of existing empirical data concerning factors significantly related to acute suicidal behaviors within high-risk diagnoses. Findings across studies are categorized into risk profiles (as proposed by Clark & Fawcett, 1992) that are meant to aid the clinician in the application of recent research. The profiles are intended as templates in development and clearly require continual updating and clarification as new studies are completed. The article then addresses related management issues such as the importance of viewing risk factors within a comprehensive suicide assessment and the impact of possible negative therapist reactions when working with high-risk patients.",0 +https://doi.org/10.1016/j.comppsych.2008.11.004,"Suicidality, aggression, and other treatment considerations among pregnant, substance-dependent women with posttraumatic stress disorder","Posttraumatic stress disorder (PTSD) and other Axis I comorbidity among women with substance use disorders (SUDs) appear similarly prevalent and are associated with comparable negative clinical profiles and treatment outcomes. The relative contribution of comorbid PTSD vs other Axis I psychiatric disorders to clinical characteristics is largely unexamined, however, despite theory and empirical data indicating that PTSD and SUDs may have a unique relationship that confers specific risk for clinical severity and poor treatment outcome. In a sample of pregnant, opioid- and/or cocaine-dependent women entering substance abuse treatment, women with PTSD (SUD-PTSD; n = 23) were compared to those with other Axis I comorbidity (SUD-PSY; n = 45) and those without Axis I comorbidity (SUD-only; n = 37). Data were collected via face-to-face interviews and urinalysis drug assays. Although the study groups had similar substance use severity, the SUD-PTSD group was more likely to report suicidality, aggression, and psychosocial impairment than both the SUD-PSY and SUD-only groups. Findings indicate treatment considerations for substance-dependent women with PTSD are broader and more severe than those with other Axis I conditions or substance dependence alone.",0 +https://doi.org/10.1053/comp.2002.35900,Does “subthreshold” posttraumatic stress disorder have any clinical relevance?,"The present report examined the extent to which subthreshold posttraumatic stress disorder (PTSD) (without lifetime PTSD) and full PTSD are associated with impairment or distress, controlling for comorbidity (i.e., major depression and panic disorder) in a sample of treatment-seeking psychiatric patients. Patients were administered diagnostic interviews and assessed for psychosocial impairment and whether or not they desired treatment for their PTSD symptoms. No significant differences were found between patients with full PTSD (N = 156) and those with subthreshold PTSD (N = 56) in degree of impairment (i.e., social and work functioning, as well as number of suicide attempts). In contrast, those with full PTSD had significantly more psychiatric hospitalizations and worse global functioning and were more likely to want treatment for their PTSD symptoms compared to those with subthreshold PTSD, albeit the majority of patients with subthreshold PTSD wanted treatment for their PTSD symptoms. These findings, like past research, suggest that subthreshold PTSD is associated with levels of social and work morbidity comparable to full PTSD. However, the report also underscores the difficulties in identifying a set of clinical criteria that clearly delineates between full PTSD and subthreshold PTSD.",0 +https://doi.org/10.1097/00005053-199902000-00004,Comparison of Outcome between Homogeneous and Heterogeneous Treatment Environments in Combat-Related Posttraumatic Stress Disorder,"This study compared treatment outcome at discharge, and 4, 8, and 12 month follow-up between an inpatient program consisting of a mixture of Vietnam combat veterans with posttraumatic stress disorder (PTSD) and general psychiatric patients (N = 42), and the same program at a later period, consisting of only Vietnam combat veterans with PTSD (N = 33). Veterans rated the homogeneous environment higher in satisfaction, support, order, clarity, and amount of discussion of combat, and lower in hostility, than the heterogeneous condition. However, veterans showed no improvement in condition at 12 month follow-up, with the exception of decreased violence, replicating earlier studies. No differences in outcome were found between homogeneous or heterogeneous treatment environments. This study underscores the enduring nature of chronic posttraumatic stress disorder in the veteran population.",0 +https://doi.org/10.1016/j.janxdis.2014.11.009,Associations between lifetime PTSD symptoms and current substance use disorders using a five-factor model of PTSD,"This paper aimed to extend the existing knowledge on the association between PTSD symptoms, alcohol use disorders (AUD) and nicotine dependence (ND) by distinguishing between anxious and dysphoric arousal PTSD symptoms and by considering the putative contribution of additional comorbidity. Data stem from a cross-sectional study in a stratified, representative sample of 1483 recently deployed soldiers using standardized diagnostic interviews. All lifetime PTSD symptom clusters (occurrence of any symptom and number of symptoms) were associated with current AUD and ND in crude models except that anxious arousal was not related to AUD. Associations were reduced in magnitude when controlling for comorbidity. Current ND was related to the occurrence of any emotional numbing and to the number of re-experiencing symptoms above the contribution of other symptom clusters and comorbidity. In conclusion, associations between PTSD symptoms, AUD and ND may be partially attributable to additional comorbidity. Findings also yield further evidence for a role of emotional numbing and re-experiencing symptoms in the comorbidity between PTSD and ND and for a distinction between dysphoric and anxious arousal PTSD symptoms.",0 +https://doi.org/10.1513/annalsats.201311-388oc,"Cognitive Function, Mental Health, and Health-related Quality of Life after Lung Transplantation","Cognitive and psychiatric impairments are threats to functional independence, general health, and quality of life. Evidence regarding these outcomes after lung transplantation is limited.Determine the frequency of cognitive and psychiatric impairment after lung transplantation and identify potential factors associated with cognitive impairment after lung transplantation.In a retrospective cohort study, we assessed cognitive function, mental health, and health-related quality of life using a validated battery of standardized tests in 42 subjects post-transplantation. The battery assessed cognition, depression, anxiety, resilience, and post-traumatic stress disorder (PTSD). Cognitive function was assessed using the Montreal Cognitive Assessment, a validated screening test with a range of 0 to 30. We hypothesized that cognitive function post-transplantation would be associated with type of transplant, cardiopulmonary bypass, primary graft dysfunction, allograft ischemic time, and physical therapy post-transplantation. We used multivariable linear regression to examine the relationship between candidate risk factors and cognitive function post-transplantation.Mild cognitive impairment (score, 18-25) was observed in 67% of post-transplant subjects (95% confidence interval [CI]: 50-80%) and moderate cognitive impairment (score, 10-17) was observed in 5% (95% CI, 1-16%) of post-transplant subjects. Symptoms of moderate to severe anxiety and depression were observed in 21 and 3% of post-transplant subjects, respectively. No transplant recipients reported symptoms of PTSD. Higher resilience correlated with less psychological distress in the domains of depression (P < 0.001) and PTSD (P = 0.02). Prolonged graft ischemic time was independently associated with worse cognitive performance after lung transplantation (P = 0.001). The functional gain in 6-minute-walk distance achieved at the end of post-transplant physical rehabilitation (P = 0.04) was independently associated with improved cognitive performance post-transplantation.Mild cognitive impairment was present in the majority of patients after lung transplantation. Prolonged allograft ischemic time may be associated with cognitive impairment. Poor physical performance and cognitive impairment are linked, and physical rehabilitation post-transplant and psychological resilience may be protective against the development of long-term impairment. Further study is warranted to confirm these potential associations and to examine the trajectory of cognitive function after lung transplantation.",0 +https://doi.org/10.1016/j.neuropsychologia.2013.01.007,Relationship between emotional experience and resilience: An fMRI study in fire-fighters,"Resilience refers to the capacity to cope effectively in stressful situations or adversity. It may involve the ability to experience emotions matching the demands of environmental circumstances. The brain mechanisms underlying resilience remain unclear. In this study, we aim to investigate the relationship between the neural basis of emotional experience and resilience. Thirty-six fire-fighters were included. They performed an fMRI script-driven paradigm comprising relaxing and trauma-related scripts to evaluate the cerebral substrate of emotional experience (p<0.05, FDR-corrected). Correlations were examined between fMRI activations and the resilience DRS15 scale (p<0.05). Resilience was positively correlated with the right amygdala and left orbitofrontal activations when performing the contrast of trauma vs. relaxing script. The present study provides neural data on the mechanisms underlying resilience and their relationship with emotional reactivity, suggesting that appropriate emotional response in stressful situations is essential for coping with aversive events in daily life.",0 +https://doi.org/10.1186/1744-859x-9-32,The combined effect of gender and age on post traumatic stress disorder: do men and women show differences in the lifespan distribution of the disorder?,"The aim of the study was to examine the combined effect of gender and age on post traumatic stress disorder (PTSD) in order to describe a possible gender difference in the lifespan distribution of PTSD.Data were collected from previous Danish and Nordic studies of PTSD or trauma. The final sample was composed of 6,548 participants, 2,768 (42.3%) men and 3,780 (57.7%) women. PTSD was measured based on the Harvard Trauma Questionnaire, part IV (HTQ-IV).Men and women differed in lifespan distribution of PTSD. The highest prevalence of PTSD was seen in the early 40s for men and in the early 50s for women, while the lowest prevalence for both genders was in the early 70s. Women had an overall twofold higher PTSD prevalence than men. However, at some ages the female to male ratio was nearly 3:1. The highest female to male ratio was found for the 21 to 25 year-olds.The lifespan gender differences indicate the importance of including reproductive factors and social responsibilities in the understanding of the development of PTSD.",0 +https://doi.org/10.1037/h0092349,Review of A clinical handbook/practical therapist manual for assessing and treating adults with post-traumatic stress disorder (PTSD).,"Reviews the book, A clinical handbook/practical therapist manual for assessing and treating adults with post-traumatic stress disorder (PTSD) by Donald Meichenbaum (see record 1995-97286-000). This text is a much needed addition in the burgeoning field that is coming to be called ""psychotraumatology,"" including critical incident debriefing and related phenomena. Few fields of psychopathology have been fortunate enough to attract the attention of practitioners with the level of skill that Don Meichenbaum shows in this Manual, and his sobering, careful analysis of the traumatology literature in several very controversial areas deserves kudos. The reality is that this Handbook/Manual is in fact both a relatively comprehensive overview of the Post-Traumatic Stress Disorder literature, as well as a guidebook for treatment intervention strategies. Moreover, it is replete with appropriate cautions about variables that can interfere with treatment progress, together with strategic suggestions for overcoming that interference. The Manual is not only tremendously diverse, but is exceptional in its standards of scholarship and its careful application of those scholarly standards even to the most controversial topics. The author is also extremely credible in his treatment of potential harm from clinical techniques, and the Manual is replete with several examples of documented pitfalls, whether from comorbidity, relapse with substance-abusing populations, or the potential for harm to some individuals from simple repetitions of traumatic experiences. All in all, the reviewer strongly encourages Psychotherapy readers to avail themselves of this extremely well-written and thoughtful text. Both the book itself and the topic of PTSD deserve the excellent coverage devoted to them by this outstanding psychotherapy clinician and researcher. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1007/s00787-010-0101-0,Correlates of comorbid anxiety and externalizing disorders in childhood obsessive compulsive disorder,"The present study examines the influence of diagnostic comorbidity on the demographic, psychiatric, and functional status of youth with a primary diagnosis of obsessive compulsive disorder (OCD). Two hundred and fifteen children (ages 5-17) referred to a university-based OCD specialty clinic were compared based on DSM-IV diagnostic profile: OCD without comorbid anxiety or externalizing disorder, OCD plus anxiety disorder, and OCD plus externalizing disorder. No age or gender differences were found across groups. Higher OCD severity was found for the OCD + ANX group, while the OCD + EXT group reported greater functional impairment than the other two groups. Lower family cohesion was reported by the OCD + EXT group compared to the OCD group and the OCD + ANX group reported higher family conflict compared to the OCD + EXT group. The OCD + ANX group had significantly lower rates of tic disorders while rates of depressive disorders did not differ among the three groups. The presence of comorbid anxiety and externalizing psychopathology are associated with greater symptom severity and functional and family impairment and underscores the importance of a better understanding of the relationship of OCD characteristics and associated disorders. Results and clinical implications are further discussed.",0 +https://doi.org/10.1176/appi.psychotherapy.2006.60.1.23,Working with Dreams in a Clinical Setting,"A disturbed sleep pattern, nightmares, and anxiety-filled dreams form a cluster of symptoms belonging to the DSM- IV diagnosis of Post-traumatic Stress Disorder. A psychotherapeutic group approach aimed at reducing these symptoms was undertaken in the form of a workshop. The workshop was not a regular part of the treatment program, but an experimental endeavor, offered to the patients during special occasions in the year (around holidays). The therapist was primarily interested in investigating possibilities for improving the quality of sleep and influencing the patterns of recurring anxiety-filled dreams and nightmares. The method has both structured and psychodynamic elements. The work carried out during the dream group was embedded in the total treatment program. This was crucial to allow personal themes to be continued in the regular treatment program.",0 +https://doi.org/10.1046/j.1440-172x.2001.00257.x,"Predictors of coping efficacy, negative moods and post-traumatic stress syndrome following major trauma","The purpose of the study was to test relationships among injury appraisals, coping, social support and outcomes of coping efficacy, mood states and post-traumatic stress syndrome. A purposive sample of 152 hospitalized patients a week following major trauma was recruited from two trauma centres. The measures included the modified Ways of Coping Scale; the brief Social Support Questionnaire; the brief Profile of Mood State; the Impact of Event Scale; and selected demographic and injury related variables. Data were analyzed by multivariate statistics. The results indicated that perceived controllability, satisfaction with social support, wishful-thinking coping and problem-focused coping were the significant predictors for coping efficacy; perceived stressfulness, problem-focused coping and wishful thinking explained a significant amount of variance in mood states; avoidance coping and wishful-thinking coping were predictors for post-traumatic stress syndrome. The moderating effects of emotion-focused coping at high and medium levels were identified.",0 +https://doi.org/10.1017/s0033291709990791,"PTSD after deployment to Iraq: conflicting rates, conflicting claims.","Post-traumatic stress disorder (PTSD) has been called one of the signature injuries of the Iraq War. In this review prevalence estimates of PTSD are summarized and discrepancies are discussed in relation to methodological differences between studies.We searched for population-based studies with a minimum sample size of 300. Studies based on help-seeking samples were excluded. We identified 60 possible papers, of which 19 fulfilled the inclusion criteria. Prevalence estimates and study characteristics were examined graphically with forest plots, but because of high levels of heterogeneity between studies, overall estimates of PTSD prevalence were not discussed.The prevalence of PTSD in personnel deployed to Iraq varied between 1.4% and 31%. Stratifying studies by PTSD measure only slightly reduced the variability in prevalence. Anonymous surveys of line infantry units reported higher levels of PTSD compared to studies that are representative of the entire deployed population. UK studies tend to report lower prevalence of PTSD compared with many US studies; however, when comparisons are restricted to studies with random samples, prevalences are similar. US studies that have assessed personnel more than once since return from deployment have shown that PTSD prevalence increases over the 12 months following deployment.Differences in methodologies and samples used should be considered when making comparisons of PTSD prevalence between studies. Further studies based on longitudinal samples are needed to understand how the prevalence of PTSD changes over time.",0 +https://doi.org/10.4067/s0718-48082012000200005,The Effects of Stress Coping Strategies in Post-Traumatic Stress Symptoms Among Earthquake Survivors: An Explanatory Model of Post-Traumatic Stress,"event common to a sample of 304 people (Chile, earthquake February, 27 2010) was determined through the application of the Ways of Coping Questionnaire and the Davidson Scale of Trauma. The results show 4 significant Regression Multiple Linear models explaining the total and the 3 types of PTSD symptoms through WOC such as avoidance and problem solution. However, a first integrated model through structural equations did not attain good fit indexes. The study has been concluded with an alternative integrated model presenting very good adjustment indexes (CMIN/DF=.058, RMSEA=.000, NFI=.999, CFI=.999 and PNFI=.100). Finally, explanations based on neuroimages and covert conditioning are provided along with reflections on the prevention and prevalence of the PTSD.",0 +https://doi.org/10.1038/tp.2015.65,Mitochondria-focused gene expression profile reveals common pathways and CPT1B dysregulation in both rodent stress model and human subjects with PTSD,"Posttraumatic stress disorder (PTSD), a trauma-related mental disorder, is associated with mitochondrial dysfunction in the brain. However, the biologic approach to identifying the mitochondria-focused genes underlying the pathogenesis of PTSD is still in its infancy. Previous research, using a human mitochondria-focused cDNA microarray (hMitChip3) found dysregulated mitochondria-focused genes present in postmortem brains of PTSD patients, indicating that those genes might be PTSD-related biomarkers. To further test this idea, this research examines profiles of mitochondria-focused gene expression in the stressed-rodent model (inescapable tail shock in rats), which shows characteristics of PTSD-like behaviors and also in the blood of subjects with PTSD. This study found that 34 mitochondria-focused genes being upregulated in stressed-rat amygdala. Ten common pathways, including fatty acid metabolism and peroxisome proliferator-activated receptors (PPAR) pathways were dysregulated in the amygdala of the stressed rats. Carnitine palmitoyltransferase 1B (CPT1B), an enzyme in the fatty acid metabolism and PPAR pathways, was significantly over-expressed in the amygdala (P < 0.007) and in the blood (P < 0.01) of stressed rats compared with non-stressed controls. In human subjects with (n = 28) or without PTSD (n = 31), significant over-expression of CPT1B in PTSD was also observed in the two common dysregulated pathways: fatty acid metabolism (P = 0.0027, false discovery rate (FDR) = 0.043) and PPAR (P = 0.006, FDR = 0.08). Quantitative real-time polymerase chain reaction validated the microarray findings and the CPT1B result. These findings indicate that blood can be used as a specimen in the search for PTSD biomarkers in fatty acid metabolism and PPAR pathways, and, in addition, that CPT1B may contribute to the pathology of PTSD.",0 +https://doi.org/10.4088/jcp.14com09488,Improving Our Understanding of Posttraumatic Trajectories,,0 +https://doi.org/10.1002/jclp.10113,Introduction: Psychosocial consequences of the war in the region of former Yugoslavia,"Editorials usually reflect research topics addressed in the articles which follow them as well as highlight central issues, providing an overview of the topic and sometimes outlining its historical development. Most of this is true for this editorial, but there is--unfortunately--an immediate connection to the current political situation as well: I am writing this two weeks after the attacks on the World Trade Center, and many people all over the world are afraid that war may now threaten countries not affected by war for many years. The threat of war makes us think more about the multiple medical and psychosocial consequences which follow it. Yet, there is no such thing as ""war."" Each war has its own profile of events which interact with the particular societies involved and with the people in the war region.",0 +https://doi.org/10.1093/jpepsy/jsj087,Psychological Distress and the Impact of Social Support on Fathers and Mothers of Pediatric Cancer Patients: Long-Term Prospective Results,"To explore the effects of social support on psychological distress of parents of pediatric cancer patients using a prospective design over a 5-year period.Parents of children diagnosed with cancer participated at diagnosis (T1), 6 months (T2), 12 months (T3), and 5 years later (T4). Instruments The General Health Questionnaire and the Social Support List (SSL) measuring amount of support, (dis)satisfaction with support, and negative interactions were administered.Psychological distress and amount of support received decreased significantly from diagnosis to T4. No significant change in (dis)satisfaction with support and negative interactions was found. Social support variables did not show any concurrent or prospective significant effect on mothers' distress at T4. Dissatisfaction with support showed a significant unique concurrent effect on fathers' distress at T4 and negative interactions had a prospective unique effect.Dissatisfaction with support and negative interactions that fathers experienced significantly affected their levels of psychological distress. No such effect was found for mothers.",0 +https://doi.org/10.1378/chest.13-1691,"Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition , and the Impact of Events Scale-Revised","We read with great interest the article by Bienvenu et al1 in a recent issue of CHEST (July 2013) and would like to compliment them on the development and validation of the Impact of Events Scale-Revised (IES-R) for patients with posttraumatic stress disorder (PTSD) after acute lung injury. Psychiatric nosology and diagnostic classification systems are always dynamic and in a state of flux. The authors developed the screening questionnaire and validated it against the Clinician-Administered PTSD Scale (CAPS), which is based on Diagnostic and Statistical Manual of Mental Disorders (DSM), fourth edition, diagnostic criteria.",0 +https://doi.org/10.1016/j.socscimed.2012.02.022,Beyond normality in the study of bereavement: Heterogeneity in depression outcomes following loss in older adults,"Studies of individual differences in bereavement have revealed prototypical patterns of outcome. However, many of these studies were conducted prior to the advent of sophisticated contemporary data analytic techniques. For example, Bonanno et al. (2002) used rudimentary categorization procedures to identify unique trajectories of depression symptomatology from approximately 3 years prior to 4 years following conjugal loss in a representative sample of older American adults. In the current study, we revisited these same data using Latent Class Growth Analysis (LCGA) to derive trajectories and test predictors. LCGA is a technique well-suited for modeling empirically- and conceptually-derived heterogeneous longitudinal patterns while simultaneously modeling predictors of those longitudinal patterns. We uncovered four discrete trajectories similar in shape and proportion to the previous analyses: Resilience (characterized by little or no depression; 66.3%), Chronic Grief (characterized by depression following loss, alleviated by 4 years post-loss; 9.1%), _Pre-existing Chronic Depression (ongoing high pre- through post-loss depression; 14.5%), and Depressed-Improved (characterized by high pre-loss depression that decreases following loss; 10.1%). Using this analytic strategy, we were able to examine multiple hypotheses about bereavement simultaneously. Health, financial stress, and emotional stability emerged as strong predictors of variability in depression only for some trajectories, indicating that depression levels do not have a common etiology across all the bereaved. As such, we find that identifying distinct patterns informs both the course and etiology of depression in response to bereavement.",0 +,Post traumatic stress disorder in children after tsunami disaster in Thailand: 2 years follow-up.,"On December 26, 2004, the tsunami destroyed many families, communities, and residential areas. Adverse psychological impact on children and adolescents due to a natural disaster of this magnitude has never been reported in Thailand's history particularly as Post-Traumatic Stress Disorder (PTSD).Investigate clinical symptoms and develop a 2-year monitoring and intervention program for PTSD in children affected by the December 26, 2004 tsunami natural disaster The study period started six weeks after the event and was completed after two years.One thousand six hundred and twenty five surviving students from two schools in Takuapa district, Phang-nga Province, were enrolled. Screening tests using Pediatric symptom checklists, Childhood depressive intervention (CDI), and Revised child impact of events scales (CRIES) were done. Psychiatric evaluations were done by child and adolescent psychiatrists. Post Traumatic Stress Disorder (PTSD) was diagnosed using criteria from Diagnostic and Statistical Manual of Mental Disorders, 4th edition.The prevalence of PSTD in the affected students were 57.3, 46.1, 31.6, 10.4, and 7.6% at 6 weeks, 6 months, 1 year, 1 1/2 years, and 2 years, respectively. The female: male ratio was 1.7:1. The peak age was 9-10 years old. Threatened situations were studied. Of the 176 students who risked their lives in the waves, 48 (27.3%) suffered from PTSD. Meanwhile, of the 1314 students who were not hit by the waves but were among affected friends and relatives, 42 students (3.1%) suffered from PTSD. The prevalence of PTSD in those hit by the waves were significantly higher than those who were not [p-value < 0.01, RR = 5.16 (4.04-.6.6)].The prevalence of PSTD in children who suffered from the tsunami disaster was as high as 57.3% at six weeks after the incident. It declined sharply at two years (7.6%) with the help of integrated welfare. The children continue to get financial, rehabilitation, and mental health support to prevent long-term adverse outcomes.",0 +https://doi.org/10.1017/s0033291706009019,Early childhood factors associated with the development of post-traumatic stress disorder: results from a longitudinal birth cohort,"Background. Childhood factors have been associated with increased risk of developing post-traumatic stress disorder (PTSD). Previous studies assessed only a limited number of childhood factors retrospectively. We examined the association between childhood neurodevelopmental, temperamental, behavioral and family environmental characteristics assessed before age 11 years and the development of PTSD up to age 32 years in a birth cohort. Method. Members of a 1972–73 New Zealand birth cohort ( n =1037) who were assessed at ages 26 and 32 years for PTSD as defined by DSM-IV. Results. We identified two sets of childhood risk factors. The first set of risk factors was associated both with increased risk of trauma exposure and with PTSD assessed at age 26. These included childhood externalizing characteristics and family environmental stressors, specifically maternal distress and loss of a parent. The second set of risk factors affected risk for PTSD only and included low IQ and chronic environmental adversity. The effect of cumulative childhood factors on risk of PTSD at age 26 was substantial; over 58% of cohort members in the highest risk quartile for three developmental factors had PTSD as compared to only 25% of those not at high risk on any factors. Low IQ at age 5, antisocial behavior, and poverty before age 11 continued to predict PTSD related to traumatic events that occurred between the ages of 26 and 32. Conclusions. Developmental capacities and conditions of early childhood may increase both risk of trauma exposure and the risk that individuals will respond adversely to traumatic exposures. Rather than being solely a response to trauma, PTSD may have developmental origins.",0 +https://doi.org/10.1037/a0022121,"The effects of trauma types, cumulative trauma, and PTSD on IQ in two highly traumatized adolescent groups.","We investigated the relationship between trauma type, posttraumatic stress disorder (PTSD), and intelligence quotient (IQ) utilizing a development-based taxonomy of trauma in a sample of 390 African-American adolescents and Iraqi refugee adolescents. Utilizing structural equation modeling, we compared different “good-fitting” models that describe the specific relationships between different trauma types, PTSD cluster symptoms (i.e., re-experiencing, arousal, avoidance, and emotional numbness/dissociation), and IQ factors (i.e., perceptual reasoning, verbal comprehension, working memory, and processing speed). Our findings support the hypothesis that different trauma types have different influences, some positive and some negative. Whereas abandonment and personal identity trauma (e.g., sexual abuse) have direct negative effects, secondary trauma (e.g., parents’ involvement in war or combat) has a positive effect on IQ. Collective identity trauma (e.g., oppression) did not have either negative or positive effects on IQ. The PTSD components reexperiencing and arousal generally mediated some of the negative effects of traumas on IQ; avoidance and emotional detachment/dissociation generally mediated positive effects. In conclusion, trauma type differentially impacts IQ. However, cumulative trauma dynamics have total negative significant effects on all of the four IQ components: perceptual reasoning, working memory, processing speed, and verbal comprehension.",0 +https://doi.org/10.1016/j.chiabu.2013.08.015,PTSD symptom cluster profiles of youth who have experienced sexual or physical abuse,"The research examined whether youth (6-17 years old) who were referred for treatment due to sexual, physical, or both types of abuse presented with distinct profiles of PTSD DSM-IV-TR symptom clusters. When examining data for the 749 youth participants, five PTSD symptom cluster profiles were identified with each profile representing approximately 20% of the youth. The five profiles were also differentiated with respect to being referred for physical or sexual abuse, age, parental ratings of internalizing symptoms, and self-reported depression. The youth referred for treatment in the aftermath of child sexual, physical, or both sexual and physical abuse presented with different profiles of PTSD symptom clusters thereby suggesting a need for individualized tailoring of evidenced-based treatments. Two cognitive behavioral approaches, designed for traumatized children and either their nonoffending or offending parents, were described for treating youth with the distinct PTSD profiles.",0 +https://doi.org/10.1111/j.1467-8624.2012.01861.x,Trajectories of Internalizing Problems in War-Affected Sierra Leonean Youth: Examining Conflict and Postconflict Factors,"Three waves of data from a prospective longitudinal study in Sierra Leone were used to examine internalizing trajectories in 529 war-affected youth (ages 10-17 at baseline; 25% female). Latent class growth analyses identified 4 trajectories: A large majority of youth maintained lower levels of internalizing problems (41.4%) or significantly improved over time (47.6%) despite very limited access to care, but smaller proportions continued to report severe difficulties 6 years postwar (4.5%) or their symptoms worsened (6.4%). Continued internalizing problems were associated with loss of a caregiver, family abuse and neglect, and community stigma. Despite the comparative resilience of most war-affected youth in the face of extreme adversity, there remains a compelling need for interventions that address family- and community-level stressors.",0 +https://doi.org/10.1097/00005053-200112000-00006,The Longitudinal Course of Posttraumatic Stress Disorder Symptoms among Aging Military Veterans,"This study examined the longitudinal course of posttraumatic stress disorder (PTSD) among two samples of Dutch aging military veterans: 576 veterans with a military disability pension and 198 community sample veterans, who fought in World War II, the former Dutch East Indies, and Korea. Both samples were investigated in 1992 and in 1998 with a standardized and validated instrument measuring PTSD symptoms. In 1992, 27% of the veterans with a military disability pension met the criteria for a PTSD diagnosis; in 1998, this was 29%. Of the community sample veterans, 9% reported a PTSD diagnosis in 1992, in 1998 this was 8%. The results provide strong support for the long-term persistence of PTSD symptoms. In addition, PTSD caseness at one time point was associated with significantly elevated PTSD symptom severity at the time of no PTSD diagnosis. No evidence was found for an aggravation of PTSD due to stressors associated with aging.",0 +https://doi.org/10.17615/j04r-w151,Hypothalamic-Pituitary-Thyroid Axis Function in Women With a Menstrually Related Mood Disorder: Association With Histories of Sexual Abuse,"INTRODUCTION: We previously reported a unique hypothalamic-pituitary- thyroid (HPT) axis profile in women with a menstrually related mood disorder (MRMD) who also had a history of sexual abuse (SA). In the present study, we sought to extend that work by examining the association of an SA history with HPT-axis disturbance in both women with MRMD and women without MRMD. METHODS: Fifty-seven women met the prospective criteria for MRMD (23 with an SA history), and 52 women were non-MRMD (18 with an SA history). Thyroid-stimulating hormone, thyroxin (T4; total and free), and triiodothyronine (T3; total and free) were evaluated in serum, together with thyroid hormone ratios reflecting T4 to T3 conversion. RESULTS: Women with MRMD, compared with women without MRMD, had elevated T3/T4 ratios (p values ≤ .01; reflecting increased conversion of T4 to T3) and lower free and total T4 concentrations (p values = .01). Higher T3/T4 ratios and lower T4 concentrations predicted more severe premenstrual symptoms in all women. An SA history, irrespective of MRMD status, was associated with elevated thyroid-stimulating hormone concentrations (p = .03). However, in women with MRMD, an SA history was associated with elevated T3 concentrations (p = .049), whereas in women without MRMD, an SA history was associated with decreased T3 concentrations (p = .02). CONCLUSIONS: An MRMD and an SA history are associated with independent and interactive effects on the HPT axis. The evidence that an MRMD moderates the influence of SA on T3 concentrations contributes to a growing body of work suggesting that an SA history may identify a distinct subgroup of women with MRMD.",0 +https://doi.org/10.1017/dmp.2015.64,Prevalence and Determinants of Chronic Post-Traumatic Stress Disorder After Floods,"To explore the prevalence and determinants of chronic post-traumatic stress disorder (PTSD) among flood victims.A cross-sectional survey was carried out in 2014 among individuals who had experienced the 1998 floods and had been diagnosed with PTSD in 1999 in Hunan, China. Cluster sampling was used to select subjects from the areas that had been surveyed in 1999. PTSD was diagnosed according to DSM-IV criteria, social support was measured according to a Social Support Rating Scale, coping style was measured according to a Simplified Coping Style Questionnaire, and personality was measured by use of the revised Eysenck Personality Questionnaire Short Scale for Chinese. Data were collected through face-to-face interviews by use of a structured questionnaire. Multivariate logistic regression analysis was used to reveal the determinants of chronic PTSD.A total of 123 subjects were interviewed, 17 of whom (14.4%) were diagnosed with chronic PTSD. Chronic PTSD was significantly associated with disaster stressors (odds ratio [OR]: 1.74; 95% confidence interval [CI]: 1.22-2.47), nervousness (OR: 1.09; 95% CI: 1.01-1.17), and social support (OR: 0.85; 95 CI%: 0.74-0.98).Chronic PTSD in flood victims is significantly associated with disaster stressors, nervousness, and social support. These factors may play important roles in identifying persons at high risk of chronic PTSD.",0 +https://doi.org/10.1037/0735-7028.32.2.151,"The Minnesota Multiphasic Personality Inventory-2, posttraumatic stress disorder, and women domestic violence survivors.","Empirical evidence and diagnostic decision rules for diagnosing Post-Traumatic Stress Disorder (PTSD) with Minnesota Multiphasic Personality Inventory - 2 were originally developed with a narrow and heterogeneous sample of trauma victims, Vietnam veterans. Relatively little empirical study has been given to the use of the MMPI-2 among domestic violence survivors, especially as it pertains to the issue of Post-Traumatic Stress Disorder. The utility and validity of prior empirical findings, based primarily on Vietnam veterans, cannot be extrapolated to other trauma victims without further empirical evidence supporting such application. In this study the MMPI-2 was administered to 93 women domestic violence survivors from domestic violence (a) shelters, (b) support groups, (c) outreach centers, and (d) other social service agencies. The Post-Traumatic Stress Diagnostic Scale (Foa, 1995) was used to identify which of 93 women survivors met diagnostic criteria for Post-Traumatic Stress Disorder. Multivariate analysis of variance, using nine MMPI-2 scales, found significant differences between women domestic violence survivors with and without PTSD on the F, K, 1(Hs), 2(D), 6(Pa), B(Sc), and PK-PTSD scales. Stepwise discriminant function analysis produced one significant discriminant function, including the K validity and the 1(Hs) scales, a 78% correct classification rate, and a sensitivity and specificity of 88% and 60%, respectively. The PK-PTSD scale correctly classified 68% of all cases, and a sensitivity and specificity of 81% and 45%, respectively, were found. Canonical correlation of MMPI-2 scales with sub-scales from Foa's (1995) Post-Traumatic Stress Diagnostic Scale revealed significant multiple correlations. Major findings suggest the MMPI-2 is sensitive to PTSD symptomatology and capable of discriminating between domestic violence survivors with and without PTSD. The MMPI-2 is as diagnostically efficient for assessing PTSD in domestic violence survivors as it is been found to be for Vietnam veterans. Implications for theory, research, practice, and limitations of this research are discussed.",0 +https://doi.org/10.1111/j.1758-5872.2011.00152.x,Course-dependent response of brain functional alterations in men with acute and chronic post-traumatic stress disorder: A follow-up functional magnetic imaging study,"Introduction The aim of this study was to investigate the neurofunctional alterations in both acute and chronic post-traumatic stress disorder (PTSD) resulting from the same stress experience. Methods Brain responses to emotional trauma-related and neutral pictures with a symptom provocation task were measured using functional magnetic resonance imaging (fMRI). Twenty-four PTSD patients resulting from a mining accident and 14 controls exposed to the same accident without PTSD two months post-trauma were recruited. In the follow-up study 20 PTSD patients and 14 controls were also recruited after 24 months post-trauma. Correlations were conducted in PTSD between altered fMRI blood oxygenation level-dependent (BOLD) signals of areas extracted as regions of interest and three Clinician-Administered PTSD Scale (CAPS) subscores respectively. Results In response to picture stimulus (traumatic negative pictures versus neutral pictures), the acute PTSD group showed greater activation in the bilateral posterior cingulate gyri, left precuneus, right fusiform and left parahippocampal gyrus than the chronic PTSD group (P   20 voxels). In the acute PTSD group, BOLD signals of either posterior cingulate gyrus correlated positively with CAPS intrusion subscores. There was also no significant correlation between BOLD signals of five regions mentioned above in the chronic PTSD group and three CAPS subscores. Discussion These findings suggested that brain circuits affected in acute PTSD may be more extended than chronic PTSD. The reason may due to the formation of traumatic memory in the acute phase of PTSD.",0 +https://doi.org/10.1080/19361521.2012.671796,"Deconstructing PTSD: Traumatic Experiences, Posttraumatic Symptom Clusters, and Mental Health Problems among Delinquent Youth","This study investigated interrelations among trauma exposure, posttraumatic stress disorder (PTSD) symptom clusters, and mental health problems among adjudicated adolescents. Girls scored higher than boys on measures of exposure to interpersonal trauma, PTSD symptom clusters, and mental health problems. Results of path analyses were consistent with the hypothesis that PTSD symptom clusters differentially mediate the relations between trauma exposure and mental health problems, with unique patterns of results for boys and girls. For all youth, avoidance mediated the association between trauma and internalizing symptoms whereas reexperiencing and arousal acted as mediators of externalizing. However, for boys only, noninterpersonal traumas also were related to PTSD symptoms, which in turn acted as mediators of internalizing. For girls only, reexperiencing and arousal acted as mediators of internalizing and associated symptoms of PTSD acted as a mediator of externalizing. © 2012",0 +https://doi.org/10.1111/bjhp.12064,Post-traumatic growth in stroke carers: A comparison of theories,"This study examined variables associated with post-traumatic growth (PTG) in stroke carers and compared predictions of two models of PTG within this population: the model of Schaefer and Moos was compared to that of Tedeschi and Calhoun (1992, Personal coping: Theory, research, and application. Westport, CT: Praeger, 149; 1998, Posttraumatic growth: Positive changes in the aftermath of crisis. Mahwah, NJ: Lawrence Erlbaum, 99; 2004, Psychol. Inq., 15, 1, respectively).A cross-sectional survey design was employed.Carers of stroke survivors (N = 71) completed questionnaires measuring PTG, coping style, social support, survivor functioning, age, and carer quality of life. Correlation, multiple regression, and mediation analyses were used to test hypotheses.All carers completing the PTG measure (N = 70) reported growth, but average scores differed from cancer carers (Chambers et al., 2012, Eur. J. Cancer Care, 21, 213; Thombre et al., 2010, J. Psychosocial Oncol., 28, 173). PTG was positively correlated with deliberate and intrusive rumination, avoidance coping, social support, and quality of life. Regression analysis showed that factors identified by Tedeschi and Calhoun (deliberate rumination, intrusive rumination, social support, acceptance coping, survivor functioning) accounted for 49% of variance in PTG, whereas those identified by Schaefer and Moos (active coping, avoidance coping, social support, survivor functioning, and age) accounted for only 21%. Rumination, especially deliberate rumination, explained most variance in PTG and mediated the effect of social support on PTG.The findings add to the limited body of evidence suggesting that stroke carers experience growth. Deliberate rumination and social support are important in explaining growth, and the findings support the model proposed by Tedeschi and Calhoun over that of Schaefer and Moos.What is already known on this subject? Literature on caring for stroke survivors focuses on negative outcomes (Ilse, Feys, de Wit, Putman, & de Weerdt, 2008) to the exclusion of positive outcomes such as post-traumatic growth (PTG; Calhoun & Tedeschi, 1999). Studies of a variety of health conditions have demonstrated that PTG occurs in patients and carers after illness events and is associated with well-being (Gangstad, Norman, & Barton, 2006; Helgeson, Reynolds, & Tomich, 2006; Kim, Schulz, & Carver, 2007). Exploratory studies and studies of benefit finding have shown that PTG occurs in stroke carers (Bacon, Milne, Sheikh, & Freeston, 2009; Buschenfeld, Morris, & Lockwood, 2009; Haley et al., 2009; Thompson, 1991), but there are no studies using standard instruments to assess PTG in this population. Moreover, current theories posit different explanations for PTG (Schaefer & Moos, 1992, 1998; Tedeschi & Calhoun, 2004), and there is a need for empirical tests (Park, 2010). What does this study add? This study extends knowledge by measuring PTG with a standard instrument in a sample of UK stroke carers and investigating associated variables. The study also compared the predictive power of the models of PTG proposed by Tedeschi and Calhoun (2004) and Schaefer and Moos (1992, 1998). PTG was found in UK stroke carers, but levels differed from cancer carers in other countries. Factors associated with PTG were identified; Tedeschi and Calhoun's model best predicted PTG. Deliberate rumination had a direct effect on PTG and also mediated the effect of social support. Deliberate rumination is a possible target for therapeutic interventions to enhance PTG.",0 +https://doi.org/10.1016/j.psychres.2014.11.063,Assessing DSM-5 latent subtypes of acute stress disorder dissociative or intrusive?,"Acute Stress Disorder (ASD) was first included in the DSM-IV in 1994. It was proposed to account for traumatic responding in the early post trauma phase and to act as an identifier for later Posttraumatic Stress Disorder (PTSD). Unlike PTSD it included a number of dissociative indicators. The revised DSM-5 PTSD criterion included a dissociative-PTSD subtype. The current study assessed if a dissociative-ASD subtype may be present for DSM-5 ASD. Moreover, we assessed if a number of risk factors resulted in an increased probability of membership in symptomatic compared to a baseline ASD profile. We used data from 450 bank robbery victims. Latent profile analysis (LPA) was used to uncover latent profiles of ASD. Multinomial logistic regression was used to determine if female gender, age, social support, peritraumatic panic, somatization, and number of trauma exposures increased or decreased the probability of profile membership. Four latent profiles were uncovered and included an intrusion rather than dissociative subtype. Increased age and social support decreased the probability of individuals being grouped into the intrusion subtype whereas increased peritraumatic panic and somatization increased the probability of individuals being grouped into the intrusion subtype. Findings are discussed in regard to the ICD-11 and the DSM-5.",0 +https://doi.org/10.1016/0005-7967(96)00038-1,One-year prospective follow-up of motor vehicle accident victims,"One-hundred and thirty-two victims of motor vehicle accidents (MVAs), who sought medical attention as a result of the MVA, were assessed at three points in time: 1-4 months post-MVA, 6 months later, and 12 months later. Of the 48 who met the full criteria for Post-Traumatic Stress Disorder (PTSD) initially, half had remitted at least in part by the 6-month follow-up point and two-thirds had remitted by the 1-yr follow-up. Using logistic regression, 3 variables combined to correctly identify 79% of remitters and non-remitters at the 12-month follow-up point: initial scores on the irritability and foreshortened future symptoms of PTSD and the initial degree of vulnerability the subject felt in a motor vehicle after the MVA. Four variables combined to predict 64% of the variance in the degree of post-traumatic stress symptoms at 12 months: presence of alcohol abuse and/or an Axis-II disorder at the time of the initial assessment as well as the total scores on the hyperarousal and on avoidance symptoms of PTSD present at the initial post-MVA assessment.",0 +https://doi.org/10.1521/psyc.2007.70.4.283,Five Essential Elements of Immediate and Mid–Term Mass Trauma Intervention: Empirical Evidence,"Given the devastation caused by disasters and mass violence, it is critical that intervention policy be based on the most updated research findings. However, to date, no evidence-based consensus has been reached supporting a clear set of recommendations for intervention during the immediate and the mid-term post mass trauma phases. Because it is unlikely that there will be evidence in the near or mid-term future from clinical trials that cover the diversity of disaster and mass violence circumstances, we assembled a worldwide panel of experts on the study and treatment of those exposed to disaster and mass violence to extrapolate from related fields of research, and to gain consensus on intervention principles. We identified five empirically supported intervention principles that should be used to guide and inform intervention and prevention efforts at the early to mid-term stages. These are promoting: 1) a sense of safety, 2) calming, 3) a sense of self- and community efficacy, 4) connectedness, and 5) hope.",0 +https://doi.org/10.7205/milmed-d-12-00367,"Mental Health, Help Seeking, and Stigma and Barriers to Care Among 3- and 12-Month Postdeployed and Never Deployed U.S. Army Combat Medics","U.S. Army Combat Medic serves as both Soldier and provider of combat casualty care, often in the heat of battle and with limited resources. Yet little is known about their help-seeking behavior and perceived stigma and barriers to care. Participants were three groups of U.S. Army Combat Medics surveyed at 3- and 12-months postdeployment from assignment with line units vs. those Medics who had never deployed to combat. The primary data source was surveys of mental health service utilization, perceived stigma and barriers to care, and depression and post-traumatic stress disorder screens. Medics who received help in the past year from a mental health professional ranged from 18% to 30%, with 18% to 30% seeking mental health assistance from other sources. Previously deployed Medics were more likely to obtain assistance than those who never deployed. Those meeting a mental health screening criteria were more likely to report associated stigma and barriers to care. Findings indicate that Medics in need of assistance report greater perceived barriers to mental health care, as well as stigma from seeking treatment, and that depression may be a salient issue for Medics. The longitudinal nature of the ongoing study will help determine the actual trajectory and onset of depression and post-traumatic stress disorder.",0 +https://doi.org/10.1017/cbo9780511730030.004,Anxiety Disorders and PTSD,"INTRODUCTION This chapter reviews the literature on the prevalence and etiology of anxiety disorders, including posttraumatic stress disorder (PTSD), following disasters. We highlight that there is relatively little information about anxiety disorders other than PTSD; the paucity of data is due to the challenge of the shared phenomenology of these disorders and the difficulty of defining their boundaries. A further challenge is explored, namely, how disasters interact with background morbidity in a community. In considering the etiology of anxiety disorders, the differential role of threat is hypothesized to be differentiated from the more enduring effect of the losses sustained in disasters. Anxiety disorders have an enduring effect in the aftermath of disasters, and many issues remain to be examined in future research, especially in expanding beyond PTSD. To begin, however, it is important to understand the settings in which disasters occur and the anticipations that abound following these events, as these have the potential to bias a rational appraisal of the challenges that will impact the affected community. Managing the psychological impact of disasters is a critical public-health challenge in the aftermath of these events. Informed prevalence and incidence estimates are critical to effective service planning. Unfortunately, there is often dramatization of disaster impact immediately afterward, with fears expressed about the capacity of the population to function and manage effectively (de Ville de Goyet, 2007). © Cambridge University Press 2009.",0 +https://doi.org/10.1016/j.addbeh.2011.07.022,The role of smoking expectancies in the relationship between PTSD symptoms and smoking behavior among women exposed to intimate partner violence,"Intimate partner violence (IPV) is a public health problem associated with negative health consequences, including higher rates of tobacco smoking. Smoking expectancies are related to motivation to quit and relapse. IPV-exposed women endorse higher rates of PTSD symptoms, which are related to smoking and smoking expectancies. The present study sought to examine the relationship among smoking behavior, smoking expectancies, and PTSD symptoms among IPV-exposed women. Participants were 83 women who reported experiencing IPV within the last month, smoked an average of 12 cigarettes per day, and reported moderate levels of nicotine dependence (FTND mean=4.4). Participants completed baseline and follow-up interviews. Multiple regression analyses assessed the relationships among smoking expectancies and PTSD symptoms to cigarettes smoked per day and nicotine dependence. Findings demonstrated that Stimulation/State Enhancement expectancies were positively related to cigarettes per day, whereas PTSD arousal symptoms were negatively related to cigarettes per day, p's<.05. Neither smoking expectancies nor PTSD symptoms were significantly related to nicotine dependence. Supplemental analyses revealed that PTSD re-experiencing symptoms were negatively related and PTSD avoidance/numbing symptoms were positively related to Stimulation/State Enhancement expectancies, p's<.05. This study extends findings regarding the association between PTSD symptoms and smoking among an understudied population - IPV-exposed women. The relationship between PTSD symptoms and smoking differed across PTSD symptom clusters and expectancy scales, which may have implications for treatment development. The fact that expectancies and PTSD symptoms are related to smoking behavior among IPV-exposed women may be important for enhancing prevention and intervention efforts.",0 +https://doi.org/10.1002/jts.20424,Acute stress disorder and posttraumatic stress disorder in parents of injured children,"Acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) were examined in 334 parents of children with traffic-related injuries. In the first month after their child's injury, 12% of parents had ASD and another 25% had partial ASD. Among 251 parents assessed again approximately 6 months postinjury, 8% had PTSD and another 7% had partial PTSD. The ASD and PTSD severity were associated (r = .54), but ASD status was not a sensitive predictor of later PTSD. Independent predictors of ASD severity included prior trauma exposure, peritrauma exposure and perceptions of the child's pain and life threat, and child ASD severity. Independent predictors of PTSD severity included prior trauma exposure, parent ASD severity, and parent-rated child physical health at follow-up.",0 +https://doi.org/10.1038/nrd4075,50 years of hurdles and hope in anxiolytic drug discovery,"Anxiety disorders are the most prevalent group of psychiatric diseases, and have high personal and societal costs. The search for novel pharmacological treatments for these conditions is driven by the growing medical need to improve on the effectiveness and the side effect profile of existing drugs. A huge volume of data has been generated by anxiolytic drug discovery studies, which has led to the progression of numerous new molecules into clinical trials. However, the clinical outcome of these efforts has been disappointing, as promising results with novel agents in rodent studies have very rarely translated into effectiveness in humans. Here, we analyse the major trends from preclinical studies over the past 50 years conducted in the search for new drugs beyond those that target the prototypical anxiety-associated GABA (γ-aminobutyric acid)-benzodiazepine system, which have focused most intensively on the serotonin, neuropeptide, glutamate and endocannabinoid systems. We highlight various key issues that may have hampered progress in the field, and offer recommendations for how anxiolytic drug discovery can be more effective in the future.",0 +https://doi.org/10.1108/jcp-09-2013-0023,Faking it: incentives and malingered PTSD,"Purpose – The purpose of this paper is to address how context for malingering and the provision of incentives influence malingered symptom profiles of post-traumatic stress disorder (PTSD). Design/methodology/approach – A 2 (case context)×3 (incentive) factorial design was utilized. Participants ( n =298) were given an incentive (positive, negative, or no incentive), randomly assigned to a criminal or civil context, and asked to provide a fake claim of child abuse with corresponding malingered symptoms of PTSD. Under these conditions, participants completed several questionnaires pertaining to symptoms of trauma and PTSD. Findings – Results indicated that negative incentives were primarily associated with lower symptom scores. Therefore, “having something to lose” may result in more constrained (and realistic) symptom reports relative to exaggeration evidenced with positive incentives. Originality/value – These results have implications for forensic settings where malingered claims of PTSD are common and incentives for such claims (e.g. having something to gain or lose) frequently exist. Previous studies have failed to address incentives (positive and negative) in relation to a crime (i.e. abuse) that can span both criminal and civil contexts.",0 +https://doi.org/10.2188/jea.je20130138,Mental Health Distress and Related Factors Among Prefectural Public Servants Seven Months After the Great East Japan Earthquake,"To develop an empirically informed support measure for workers, we examined mental health distress and its risk factors among prefectural public servants who were affected by the Great East Japan Earthquake and faced a demanding workload in the midterm of the disaster.We conducted a self-administered health survey of all public servants in the Miyagi prefectural government two and seven months after the Great East Japan Earthquake (3743 workers, 70.6% of all employees). We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for mental distress (defined as K6 score ≥10) in the domain of disaster-work-related stressors, work-related stressors, and disaster-related stressors.Among those with better levels of workplace communication, the only factor that increased the risk of mental distress was not taking a non-work day each week (adjusted OR 2.55, 95% CI 1.27-5.14). Among those with poorer levels of workplace communication, in addition to not taking a non-work day each week (adjusted OR 3.93, 95% CI 3.00-5.15), handling residents' complaints (adjusted OR 1.55, 95% CI 1.00-2.42), having dead or missing family members (adjusted OR 2.87, 95% CI 1.53-5.38), and living in a shelter more than two months after the disaster (adjusted OR 2.80, 95% CI 1.32-5.95) increased the risk of mental distress.All workers should be encouraged to take a non-work day each week. Among workers with poor workplace communication, special attention should be given to those who handle residents' complaints, have lost a family member(s), and are living in a shelter for a prolonged period of time.",0 +https://doi.org/10.1523/jneurosci.4012-11.2012,Susceptibility to PTSD-like behavior is mediated by corticotropin-releasing factor receptor type 2 levels in the bed nucleus of the stria terminalis.,"Posttraumatic stress disorder (PTSD) is a debilitating disease, which affects 8-10% of the population exposed to traumatic events. The factors that make certain individuals susceptible to PTSD and others resilient are currently unknown. Corticotropin-releasing factor receptor type 2 (CRFR2) has been implicated in mediating stress coping mechanisms. Here, we use a physiological PTSD-like animal model and an in-depth battery of tests that reflect the symptomology of PTSD to separate mice into subpopulations of ""PTSD-like"" and ""Resilient"" phenotypes. PTSD-like mice are hypervigilant, hyperalert, insomniac, have impaired attention and risk assessment, as well as accompanying attenuated corticosterone levels. Intriguingly, PTSD-like mice show long-term robust upregulation of BNST-CRFR2 mRNA levels, and BNST-CRFR2-specific lentiviral knockdown reduces susceptibility to PTSD-like behavior. Additionally, using a BNST mRNA expression array, PTSD-like mice exhibit a general transcriptional attenuation profile, which was associated with upregulation of the BNST-deacetylation enzyme, HDAC5. We suggest PTSD to be a disease of maladaptive coping.",0 +https://doi.org/10.1097/psy.0000000000000110,"Posttraumatic Stress, Heart Rate Variability, and the Mediating Role of Behavioral Health Risks","Posttraumatic stress disorder (PTSD) has been linked to reduced heart rate variability (HRV), which is in turn a risk factor for cardiovascular disease and death. Although hyperarousal and anxiety are thought to underlie this association, behavioral health risks, including smoking, alcohol dependence, obesity, and sleep disturbance, represent potential mechanisms linking PTSD and HRV.To test this hypothesis, short-term laboratory-based and 24-hour ambulatory measures of HRV were collected from 227 young adults (18-39 years), 107 of whom were diagnosed as having PTSD. Latent variable modeling was used to assess the relationship of PTSD symptoms with HRV along with potential behavioral health mediators.PTSD symptoms were associated with reduced HRV (β = -0.21, p = .002). However, this association was reduced in models that adjusted for cigarette consumption and history of alcohol dependence and was rendered nonsignificant in a model adjusting for sleep disturbance. Independent mediation effects were deemed significant via bootstrapping analysis. Together, the three behavioral health factors (cigarette consumption, history of alcohol dependence, and sleep disturbance) accounted for 94% of the shared variance between PTSD symptoms and HRV. Abdominal obesity was not a significant mediator.These results indicate that behavioral factors-specifically smoking, alcohol overuse, and sleep disturbance-mediate the association between PTSD and HRV-based indices of autonomic nervous system dysregulation. Benefits from psychiatric and psychological interventions in PTSD may therefore be enhanced by including modification of health behaviors.",0 +https://doi.org/10.1002/da.20137,Epidemiology of major depression in four cities in Mexico,"Analyses were conducted to estimate lifetime and current prevalence of major depressive disorder (MDD) for four representative cities of Mexico, to identify variables that influence the probability of MDD, and to further describe depression in Mexican culture. A multistage probability sampling design was used to draw a sample of 2,509 adults in four different regions of Mexico. MDD was assessed according to DSM-IV criteria by using the Composite International Diagnostic Interview collected by trained lay interviewers. The prevalence of MDD in these four cities averaged 12.8% for lifetime and 6.1% for the previous 12 months. MDD was highly comorbid with other mental disorders. Women were more likely to have lifetime MDD than were men. Being divorced, separated, or widowed (compared to married or never married) and having experienced childhood trauma were related to higher lifetime prevalence but not to current prevalence. In addition, age and education level were related to current 12-month MDD. Data on the profile of MDD in urban Mexico are provided. This research expands our understanding of MDD across cultures.",0 +https://doi.org/10.1097/ede.0b013e31816a9dff,Prior Assault and Posttraumatic Stress Disorder After Combat Deployment,"Factors that make people vulnerable to or resilient against posttraumatic stress disorder (PTSD) following overwhelming stress are not well understood. The objective of this study was to prospectively examine the relation between prior assault and new-onset PTSD symptoms in a large US military cohort deployed in the wars in Iraq and Afghanistan.Data on exposures and health outcomes were collected in the Millennium Cohort study at enrollment (July 2001 to June 2003) and follow-up (June 2004 to February 2006) from over 55,000 participants. Of these, 5324 were deployed in Iraq and Afghanistan, reported combat exposures, and were free of PTSD at baseline (881 women and 4443 men). We used multivariable logistic regression analysis to model the odds of new-onset PTSD in relation to prior assault.New-onset PTSD symptoms or diagnosis among deployers reporting combat exposures occurred in 22% of women who reported prior assault and 10% not reporting prior assault. Among men reporting prior assault, rates were 12% and 6%, respectively. Adjusting for baseline factors, the odds of new-onset PTSD symptoms was more than 2-fold higher in both women and men who reported assault prior to deployment.Prior assault appears to confer increased vulnerability for, rather than resilience against, PTSD symptoms among military professionals deployed to recent combat operations.",0 +https://doi.org/10.1093/ntr/ntt167,Ecological Momentary Assessment of Posttraumatic Stress Disorder Symptoms During a Smoking Quit Attempt,"Smokers with posttraumatic stress disorder (PTSD) tend to lapse more quickly following a quit attempt, which might be explained by changes in PTSD symptoms during a quit attempt. The present study examines changes in PTSD symptoms, negative affect, and craving before and during a quit attempt.Participants in this study were 52 smokers with PTSD who completed random-alarm ecological momentary assessments of PTSD symptoms, negative affect, cigarette craving, and smoking behavior throughout a prequit phase of ad hoc smoking, a phase of abstinence from smoking, and a postlapse phase.Relative to the prequit phase, the abstinent phase was marked by decreases in PTSD reexperiencing, avoidance, and numbing clusters (ps ≤ .01). The odds of PTSD symptom or negative affect variability from one reading in the ecological momentary assessment (EMA)to the next reading was decreased in PTSD reexperiencing, avoidance, and numbing clusters (ps ≤ .02). Smoking cravings were also mildly decreased in the abstinent and postlapse phases (ps < .01), although some cravings in both phases were rated at the maximum intensity. Increased craving was predicted by the previous EMA reading of PTSD symptoms.Results suggested that smoking abstinence is not associated with exacerbation of PTSD symptoms, but PTSD symptoms during abstinence were related to craving levels during the quit attempt.",0 +https://doi.org/10.1016/j.psyneuen.2012.06.015,Salivary cortisol and dehydroepiandrosterone sulfate in adolescent rape victims with post traumatic stress disorder,"In chronic sexual abuse victims with post traumatic stress disorder (PTSD), the hypothalamic pituitary adrenal (HPA) axis can be dysregulated. In single rape victims, PTSD symptoms are hypothesized to function as a chronic stressor leading to similar HPA-axis dysregulation. The objective of the current study was to assess HPA-axis functioning in female adolescents with rape-related PTSD, but no prior sexual trauma, in comparison to non-victimized controls.Salivary cortisol and dehydroepiandrosterone sulfate (DHEAS) were measured in 52 female adolescent rape victims with PTSD and 37 healthy adolescents at 0, 15, 30, 45 and 60 min after awakening, both under basal conditions and after 0.5 mg dexamethasone administration.Compared to age-matched controls, adolescent rape victims with PTSD showed significantly reduced cortisol and DHEAS levels. No group differences for the effect of dexamethasone suppression were found. Both the event of rape and PTSD diagnosis, and not factors such as sleep duration, smoking, education or oral contraceptives, accounted for the neuroendocrine differences between rape victims and controls.The results show evidence for a dysregulated HPA-axis in female adolescent victims of single sexual trauma with PTSD. The finding of hypocortisolism is consistent with endocrine dysfunctioning in chronic sexual abuse victims and may have clinical implications with regard to treatment possibilities.",0 +https://doi.org/10.1037/mil0000100,Examination of the Relationship Between PTSD and Distress Tolerance in a Sample of Male Veterans With Comorbid Substance Use Disorders,"Distress tolerance (DT), the perceived or actual ability to tolerate negative emotional or physical states, is inversely related to posttraumatic stress disorder (PTSD) symptoms in civilian, community samples. No studies to date have examined the relationship between DT and PTSD in clinical samples of veterans with a comorbid diagnosis of PTSD and a substance use disorder (SUD). Thus, the present study examined the relationship between DT and PTSD in a sample of predominately African American, male veterans (n = 75) diagnosed with comorbid PTSD and SUD (according to a structured clinical interview). Results of hierarchical linear regression models indicated that DT was inversely related to total PTSD symptom severity score, above and beyond depressive symptoms and SUD severity. Of the 4 symptom clusters, DT was inversely associated with intrusions and hyperarousal. These findings are discussed in light of previous work with civilian samples. Determining whether treatment incorporating DT skills would be useful for veterans undergoing PTSD treatment should be evaluated.",0 +https://doi.org/10.1002/jts.2490100410,Replication and extension of a risk profile for Amerasian youth,"The relationship between number of risk factors and symptoms of anxiety and depression was examined in a cohort of Vietnamese Amerasians, replicating a study done with a previous cohort. One hundred forty seven subjects awaiting U.S. placement completed the Hopkins Symptom Checklist, the Vietnamese Depression Scale, and a questionnaire which included items found to be risk factors for psychological distress among Amerasians. Number of risk factors was linearly related to symptoms of both depression and anxiety. Results are consistent with previous findings of the relationship between risk factors and symptoms of psychological distress. The profile may be helpful in anticipating which refugees may be at risk for future psychological distress, and thus be useful in preventively allocating scarce treatment resources.",0 +https://doi.org/10.1016/j.biopsych.2003.09.009,Salivary cortisol and posttraumatic stress disorder in a low-income community sample of women,"Studies of male combat veterans with posttraumatic stress disorder have demonstrated a profile of low cortisol. Studies with women with posttraumatic stress disorder (PTSD) have focused on childhood sexual abuse and holocaust survivors, both of whom experienced trauma during development, which could be different than adult trauma exposure.Using an epidemiologic sample of low-income women from an urban area in Michigan, we conducted structured psychiatric interviews and saliva cortisol collection on a subsample of women with exposure to trauma but never PTSD (n = 72), recent PTSD (n = 29), and past PTSD (n = 70). Saliva cortisol was collected at awakening, 30 minutes later, at bedtime, and during a clinic visit.Recent trauma exposure but not past trauma exposure led to an increase in saliva cortisol. Neither recent PTSD nor past PTSD resulted in any saliva cortisol changes compared with the trauma exposed, never PTSD group. Recent major depression (past 12 months) demonstrated a weak effect (p =.08) on bedtime saliva cortisol.While recent trauma exposure can increase saliva cortisol, neither recent nor past PTSD affected saliva cortisol in our community sample of women. Our data do not support saliva cortisol changes associated with PTSD.",0 +https://doi.org/10.5055/jem.2014.0209,Volunteers and professional rescue workers: Traumatization and adaptation after an avalanche disaster,"Objective: To compare the degree of traumatization and adaptation in professional and volunteer rescue workers after two snow avalanches. Method: Questionnaires including demographic questions, the Social Readjustment Rating Scale, the Rescue Workers Questionnaire, the General Health Questionnaire, the Impact of Event Scale, and the Coping Styles Questionnaire were answered by rescue workers (n = 168).Results: In several areas, professional rescuers had stronger fears than volunteers, all the same, volunteers were significantly more anxious and met criteria for PTSD caseness more often than professionals.Conclusion: The findings suggest that voluntary rescue workers suffer from post-traumatic stress disorder symptoms more often than professionals following demanding rescue missions.",0 +https://doi.org/10.1002/da.22149,TRAJECTORIES OF CHANGE IN ANXIETY SEVERITY AND IMPAIRMENT DURING AND AFTER TREATMENT WITH EVIDENCE-BASED TREATMENT FOR MULTIPLE ANXIETY DISORDERS IN PRIMARY CARE,"Coordinated Anxiety Learning and Management (CALM) is a model for delivering evidence-based treatment for anxiety disorders in primary care. Compared to usual care, CALM produced greater improvement in anxiety symptoms. However, mean estimates can obscure heterogeneity in treatment response. This study aimed to identify (1) clusters of participants with similar patterns of change in anxiety severity and impairment (trajectory groups); and (2) characteristics that predict trajectory group membership.The CALM randomized controlled effectiveness trial was conducted in 17 primary care clinics in four US cities in 2006-2009. 1,004 English- or Spanish-speaking patients age 18-75 with panic, generalized anxiety, social anxiety, and/or posttraumatic stress disorder participated. The Overall Anxiety Severity and Impairment Scale was administered repeatedly to 482 participants randomized to CALM treatment. Group-based trajectory modeling was applied to identify trajectory groups and multinomial logit to predict trajectory group membership.Two predicted trajectories, representing about two-thirds of participants, were below the cut-off for clinically significant anxiety a couple of months after treatment initiation. The predicted trajectory for the majority of remaining participants was below the cut-off by 9 months. A small group of participants did not show consistent improvement. Being sicker at baseline, not working, and reporting less social support were associated with less favorable trajectories.There is heterogeneity in patient response to anxiety treatment. Adverse circumstances appear to hamper treatment response. To what extent anxiety symptoms improve insufficiently because adverse patient circumstances contribute to suboptimal treatment delivery, suboptimal treatment adherence, or suboptimal treatment response requires further investigation.",0 +https://doi.org/10.1097/00004583-199401000-00013,Children Exposed to Disaster: II. Risk Factors for the Development of Post-Traumatic Symptomatology,"

ABSTRACT

Objective

To examine the influence of subject and exposure variables on the development of post-traumatic stress disorder (PTSD) symptoms and syndrome in children exposed to disaster.

Method

Three months after Hurricane Hugo, 5,687 school-aged children were surveyed about their experiences and reactions to the hurricane. Self-reports of PTSD symptoms were obtained by use of a PTSD Reaction Index.

Results

The presence of PTSD symptoms was strongly related to children's reported severity of the hurricane, degree of home damage sustained, and continued displacement; however, children's level of trait anxiety and their reported emotional reactivity during the hurricane were more strongly related to the presence of PTSD symptoms than were the exposure factors. Different sets of risk factors appeared to differentially influence the development of the three DSM-III-R PTSD symptom clusters. Little evidence for a differential effect of the risk factors between females and males and younger and older children was found.

Conclusions

Level of trait anxiety appears to be the single strongest risk for the development of severe post-traumatic reactions. The higher rate of post-traumatic symptoms in females and younger children in combination with the absence of differential reaction to the risk factors suggests that females and younger children are more likely to develop posttraumatic reactions following a disaster.",0 +https://doi.org/10.1037/a0033059,Longitudinal analysis of psychological resilience and mental health in Canadian military personnel returning from overseas deployment.,"The relationship between exposure to combat stressors and poorer postdeployment health is well documented. Still, some individuals are more psychologically resilient to such outcomes than others. Researchers have sought to identify the factors that contribute to resilience in order to inform resilience-building interventions. The present study assessed the criterion validity of a model of psychological resilience composed of various intrapersonal and interpersonal variables for predicting mental health among Canadian Forces (CF) members returning from overseas deployment. Participants included 1,584 male CF members who were deployed in support of the mission in Afghanistan between 2008 and 2010. Data on combat experiences and mental health collected through routine postdeployment screening were linked with historical data on the intrapersonal and interpersonal variables from the model. The direct and moderating effects of these variables were assessed using multiple linear regression analyses. Analyses revealed direct effects of only some intrapersonal and interpersonal resilience variables, and provided limited support for moderating effects. Specifically, results emphasized the protective nature of conscientiousness, emotional stability, and positive social interactions. However, other variables demonstrated unexpected negative associations with postdeployment mental health (e.g., positive affect and affectionate social support). Ultimately, results highlight the complexities of resilience, the limitations of previous cross-sectional research on resilience, and potential targets for resilience-building interventions. Additional longitudinal research on the stability of resilience is recommended to build a better understanding of how resilience processes may change over time and contribute to mental health after adverse experiences.",0 +https://doi.org/10.7205/milmed-d-14-00581,Simultaneous Treatment of Neurocognitive and Psychiatric Symptoms in Veterans with Post-Traumatic Stress Disorder and History of Mild Traumatic Brain Injury: A Pilot Study of Mindfulness-Based Stress Reduction,"Treating patient populations with significant psychiatric and neurocognitive symptomatology can present a unique clinical dilemma: progress in psychotherapy can be significantly fettered by cognitive deficits, whereas neurocognitive rehabilitation efforts can be ineffective because of psychiatric overlay. Application of mindfulness-based interventions to address either cognitive or psychiatric symptoms in isolation appears efficacious in many contexts; however, it remains unclear whether this type of intervention might help address simultaneous neurocognitive and psychiatric symptomatology. In a pre-post mixed methods design pilot study, nine Veterans with post-traumatic stress disorder (PTSD) and a history of mild traumatic brain injury with chronic cognitive complaints participated in Mindfulness-Based Stress Reduction (MBSR). Clinical interview, questionnaires, and attention and PTSD measures were administered immediately before, immediately after, and 3 months after MBSR completion. Qualitative and quantitative findings suggest high levels of safety, feasibility, and acceptability. Measurement of attention revealed significant improvement immediately following MBSR (p < 0.05, d = 0.57) and largely sustained improvement 3 months after completion of MBSR (p < 0.10, d = 0.48). Significant reduction in PTSD symptoms was found immediately after MBSR (p < 0.05, d = -1.56), and was sustained 3 months following MBSR completion (p < 0.05, d = -0.93). These results warrant a randomized controlled trial follow-up. Potential mechanisms for the broad effects observed will be explored.",0 +https://doi.org/10.1037/0090-5550.53.1.9,Considering resilience in the rehabilitation of people with traumatic disabilities.,"Objectives: To provide discussion on (a) the construct of resilience in relation to people with traumaticinjuries, (b) potential research directions, and (c) reliable and valid measures of resilience. Conclusions:Resilience as a construct is part of the “positive psychology” movement that focuses on identifying thestrengths of an individual when faced with adversity rather than on his or her weaknesses (e.g.,depression, anxiety). Although a universal denition does not exist, resilience is generally considered amultidimensional construct consisting of behaviors, thoughts, and actions, which can be learned over-time. Consequently, there is a growing body of literature examining resilience in different populations(e.g., children, older adults). However, there is a paucity of literature examining the resilience ofindividuals who have experienced a traumatic injury. Potentially, resilience and rehabilitation is a veryfruitful line of research due to the extreme adversity individuals are faced with postinjury when dealingwith the trauma of the injury and resultant impairments.Keywords: resilience, rehabilitation, traumatic, injury",0 +https://doi.org/10.1111/j.1741-3737.2008.00557.x,Is Partner Violence Worse in the Context of Control?,"M. P. Johnson’s (1995) proposal that there are two qualitatively distinct types of intimate partner violence—intimate terrorism and situational couple violence—has been an influential explanation for disparate findings on sex symmetry in domestic violence. This study examines whether this typology increases our ability to explain variations in the negative outcomes of partner violence as compared with the use of a continuous measure of violence. This study also considers whether the use of control to differentiate between types of violence helps to explain the negative consequences of partner violence. The results, based on analyses of data on 4,575 married women from National Violence Against Women survey, indicate mixed support for Johnson’s argument for a qualitative distinction between IT and SCV.",0 +https://doi.org/10.1186/1471-244x-14-106,Posttraumatic stress disorder and prolonged grief in refugees exposed to trauma and loss,"BackgroundWhile a large proportion of conflict-affected populations have been dually exposed to trauma and loss, there is inadequate research identifying differential symptom profiles related to bereavement and trauma exposure in these groups. The objective of this study were to (1) determine whether there are distinct classes of posttraumatic stress disorder (PTSD) and prolonged grief disorder (PGD) symptoms in bereaved trauma survivors exposed to conflict and persecution, and (2) examine whether particular types of refugee experiences and stressors differentially predict symptom profiles.MethodsParticipants were 248 Mandaean adult refugees who were assessed at an average of 4.3 years since entering Australia following persecution in Iraq. PTSD, PGD, trauma exposure, adjustment difficulties since relocation, and English proficiency were measured. Latent class analysis was used to elucidate symptom profiles of PTSD and PGD in this sample.ResultsLatent class analysis revealed four classes of participants: a combined PTSD/PGD class (16%), a predominantly PTSD class (25%), a predominantly PGD class (16%), and a resilient class (43%). Whereas membership in the PTSD/PGD class was predicted by exposure to traumatic loss, those in the PGD class were more likely to have experienced adaptation difficulties since relocation, and individuals in the PTSD class were more likely to have experienced difficulties related to loss of culture and support.ConclusionsThis study provides evidence that specific symptom patterns emerge following exposure to mass trauma and loss. These profiles are associated with distinct types of traumatic experiences and post-migration living difficulties. These results have substantial public health implications for assessment and intervention following mass trauma.",0 +https://doi.org/10.1186/1471-244x-10-21,The prevalence and correlates of adult separation anxiety disorder in an anxiety clinic,"Adult separation anxiety disorder (ASAD) has been identified recently, but there is a paucity of data about its prevalence and associated characteristics amongst anxiety patients. This study assessed the prevalence and risk factor profile associated with ASAD in an anxiety clinic.Clinical psychologists assigned 520 consecutive patients to DSM-IV adult anxiety subcategories using the SCID. We also measured demographic factors and reports of early separation anxiety (the Separation Anxiety Symptom Inventory and a retrospective diagnosis of childhood separation anxiety disorder). Other self-report measures included the Adult Separation Anxiety Symptom Questionnaire (ASA-27), the Depression, Anxiety, Stress Scales (DASS-21), personality traits measured by the NEO PI-R and the Work and Social Adjustment Scale. These measures were included in three models examining for overall differences and then by gender: Model 1 compared the conventional SCID anxiety subtypes (excluding PTSD and OCD because of insufficient numbers); Model 2 divided the sample into those with and without ASAD; Model 3 compared those with ASAD with the individual anxiety subtypes in the residual group.Patients with ASAD had elevated early separation anxiety scores but this association was unique in females only. Except for social phobia in relation to some comparisons, those with ASAD recorded more severe symptoms of depression, anxiety and stress, higher neuroticism scores, and greater levels of disability.Patients with ASAD attending an anxiety clinic are highly symptomatic and disabled. The findings have implications for the classification, clinical identification and treatment of adult anxiety disorders.",0 +https://doi.org/10.1093/jpepsy/jsj016,Posttraumatic Stress Symptoms in Parents of Children with Acute Burns,"To develop a model of risk factors for posttraumatic stress disorder (PTSD) symptoms in parents of children with burns.Immediately following the burn and 3 months later, parents reported on their children's and their own psychological functioning and traumatic stress responses.Approximately 47% of the parents reported experiencing significant posttraumatic stress symptoms 3 months after the burn. Our model indicates three independent pathways to PTSD symptoms (i.e., parent-child conflict, parents' dissociation, and children's PTSD symptoms). Additionally, parents' anxiety predicted increased parent-child conflict, conflict with extended family and size of the burn predicted parents' dissociation, and size of the burn and children's dissociation predicted children's PTSD symptoms.This study suggests that many parents of children with burns suffer from posttraumatic stress symptoms. Interventions that target factors such as family conflict, children's symptoms, and parents' acute anxiety and dissociation may diminish the risk for PTSD.",0 +https://doi.org/10.1080/00332747.2015.1051448,"Comorbidity of PTSD, Major Depression, and Substance Use Disorder Among Adolescent Victims of the Spring 2011 Tornadoes in Alabama and Joplin, Missouri.","The purpose of this study was twofold: (1) to estimate the prevalence of comorbid posttraumatic stress disorder (PTSD), major depressive episode (MDE), and substance use disorder (SUD); and (2) to identify risk factors for patterns of comorbidity among adolescents affected by disasters.A population-based sample of 2,000 adolescents (51% female; 71% Caucasian, 26% African American) aged 12 to 17 years (M = 14.5, SD = 1.7) and their parents was recruited from communities affected by the spring 2011 tornadoes in Alabama and Joplin, Missouri. Participants completed structured telephone interviews assessing demographic characteristics, impact of disaster, prior trauma history, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), symptoms of posttraumatic stress disorder (PTSD) and major depressive episode (MDE), and substance use disorder (SUD) symptoms. Prevalence estimates were calculated for PTSD + MDE, PTSD + SUD, MDE + SUD, and PTSD + MDE + SUD. Hierarchical logistic regression was used to identify risk factors for each comorbidity profile.Overall prevalence since the tornado was 3.7% for PTSD + MDE, 1.1% for PTSD + SUD, 1.0% for MDE + SUD, and 0.7% for PTSD + MDE + SUD. Girls were significantly more likely than boys to meet criteria for PTSD + MDE and MDE + SUD (ps < .05). Female gender, exposure to prior traumatic events, and persistent loss of services were significant risk factors for patterns of comorbidity. Parental injury was associated with elevated risk for PTSD + MDE. Adolescents should be evaluated for comorbid problems, including SUD, following disasters so that appropriate referrals to evidence-based treatments can be made.Results suggest that screening procedures to identify adolescents at risk for comorbid disorders should assess demographic characteristics (gender), impact of the disaster on the family, and adolescents' prior history of stressful events.",0 +https://doi.org/10.1517/14740330802423168,Paroxetine: safety and tolerability issues,"Paroxetine is a selective serotonin re-uptake inhibitor (SSRI) available in immediate release and controlled release (CR) formulations. Paroxetine is the most potent inhibitor of serotonin re-uptake among the now available SSRIs. Paroxetine has been approved for the treatment of major depressive disorder (MDD), obsessive-compulsive disorder, panic disorder (PD), generalised anxiety disorder, post traumatic stress disorder (PTSD), and social anxiety disorder (SAD) in adults, whereas paroxetine CR is approved for the treatment of MDD, SAD, PD and premenstrual dysphoric disorder in adults. The overall efficacy of paroxetine seems to be comparable to other SSRIs in the treatment of approved indications, although paroxetine treatment induces more sedation, constipation, sexual dysfunction, discontinuation syndrome and weight gain than other SSRIs. Recent data suggest that paroxetine treatment leads to increased rates of congenital malformations, although this evidence is not conclusive. Paroxetine and paroxetine CR are not indicated for use in the paediatric population and are categorised as Pregnancy Class D. In conclusion, whether the tolerability profile of paroxetine differs substantially from other new antidepressants (including other SSRIs) needs to be determined in adequately powered well-designed randomised controlled comparative clinical trials.",0 +https://doi.org/10.1097/00004714-199608000-00004,Trial of Trazodone for Posttraumatic Stress Disorder Using a Multiple Baseline Group Design,"Six patients with combat-related posttraumatic stress disorder (PTSD) entered a multiple-baseline trial of trazodone, beginning with 50 mg/day and increasing to 400 mg/day until response was maximal. Total Clinician-Administered PTSD Scale scores decreased from a mean of 92 at baseline to 79 at end point, and self-reported PTSD symptoms as measured by the Davidson Trauma Scale paralleled these results (mean of 102 at baseline to 88 at end point). Based on clinician global improvement scores, four patients were rated as much improved and two were rated to be minimally improved. Improvement in social and occupational functioning, and depression was minimal. Available follow-up scores for PTSD symptoms indicated that gains were maintained. Sleep was the first symptom to improve at 2 to 3 months. No dropouts during the treatment period occurred, and reported side effects were quite low. These preliminary data suggest that trazodone may be effective in reducing the three primary clusters of symptoms of PTSD. These findings should be confirmed by using a larger sample in a double-blind, placebo-controlled study.",0 +https://doi.org/10.1097/01.chi.0000046822.95464.14,New Findings on Alternative Criteria for PTSD in Preschool Children,"An alternative set of criteria for posttraumatic stress disorder (PTSD) for preschool children was analyzed for validity.Sixty-two traumatized children and 63 healthy controls, aged 20 months through 6 years, were assessed. The traumatic experiences included motor vehicle collisions, accidental injuries, abuse, and witnessing violence. The number of symptoms required for clusters C and D and the utility of proposed symptoms were systematically analyzed.No cases met the DSM-IV algorithm for PTSD. Cluster B was endorsed 67.9% of the time. The proportion of cases meeting the cluster C threshold was 2% when three symptoms were required, 11% when two symptoms were required, and 39% when one symptom was required. The rate of cluster D was 45% when two symptoms were required and 73% when one symptom was required. Four novel symptoms did not substantially add to the diagnostic validity of the criteria. The optimal algorithm (one cluster B symptom, one cluster C symptom, and two cluster D symptoms) diagnosed PTSD at a rate of 26%. Measures of comorbid symptoms concurrently provided convergent validation to support this revised algorithm.Revisions to the DSM-IV PTSD criteria continue to be supported so that highly symptomatic young children can be diagnosed.",0 +https://doi.org/10.1053/comp.2002.29843,The impact of torture on post-traumatic stress symptoms in war-affected Tamil refugees and immigrants,"The present study examines the effect of torture in generating post-traumatic stress disorder (PTSD) symptoms by comparing its impact with that of other traumas suffered by a war-affected sample of Tamils living in Australia. Traumatic predictors of PTSD were examined among a subsample of 107 Tamils (refugees, asylum seekers, and voluntary immigrants) who had endorsed at least one trauma category on the Harvard Trauma Questionnaire. Principal components analysis (PCA) yielded five trauma factors that were applied to predicting PTSD scores. Tamils exposed to torture returned statistically higher PTSD scores than other war trauma survivors after controlling for overall levels of trauma exposure. The torture factor identified by the PCA was found to be the main predictor of PTSD in a multiple regression analysis. Although limited by sampling constraints and retrospective measurement, the present study provides support for the identification of torture as a particularly traumatic event, even when the impact of other war-related trauma is taken into account.",0 +https://doi.org/10.1007/s00127-015-1135-x,Latent dimensions of posttraumatic stress disorder and their relations with alcohol use disorder,"Purpose: The objective of this study was to evaluate the relationship between factors of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) using confirmatory factor analysis (CFA) in order to further our understanding of the substantial comorbidity between these two disorders.Methods: CFA was used to examine which factors of PTSD's dysphoria model were most related to AUD in a military sample. Ohio National Guard soldiers with a history of overseas deployment participated in the survey (n = 1215). Participants completed the PTSD Checklist and a 12-item survey from the National Survey on Drug Use used to diagnosis AUD.Results: The results of the CFA indicated that a combined model of PTSD's four factors and a single AUD factor fit the data very well. Correlations between PTSD's factors and a latent AUD factor ranged from correlation coefficients of 0.258-0.285, with PTSD's dysphoria factor demonstrating the strongest correlation. However, Wald tests of parameter constraints revealed that AUD was not more correlated with PTSD's dysphoria than other PTSD factors.Conclusions: All four factors of PTSD's dysphoria model demonstrate comparable correlations with AUD. The role of dysphoria to the construct of PTSD is discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1080/00049530500125207,Characteristics of the first 1000 clients attending an anxiety clinic in South West Sydney,"This paper reports on the clinical and demographic characteristics of the first 1000 consecutive patients attending an anxiety disorders clinic at a district hospital in Sydney, Australia. Data from a large epidemiological study of the Australian population were used as a yardstick for broad comparison. Contrary to past research, a lower prevalence of comorbid anxiety and depression was found in the clinic, possibly because a portion of those patients were filtered out and referred elsewhere for treatment for depression. More female patients attended the clinic than the epidemiological study would predict. Greater numbers of patients with panic disorder, and fewer with posttraumatic stress disorder and social phobia were seen in the clinic than would be predicted by the epidemiological data. Although inferences are tentative because of the differing methods of diagnosis used, the findings indicate the value of comparing epidemiological and clinic profiles to identify those categories of anxiety patients that underutilise services.",0 +https://doi.org/10.1097/00006842-200111000-00014,Endocrine Levels at the Start of Treatment Are Associated With Subsequent Psychological Adjustment in Cancer Patients With Metastatic Disease,"This study examined the association between hormonal profiles at the start of cancer treatment and subsequent psychological symptomatology.Twenty-seven patients with metastatic renal cell carcinoma and 18 patients with metastatic melanoma completed three assessments during the course of treatment: at the start of treatment (baseline), at the end of treatment (3 weeks after baseline), and at a follow-up appointment 1 month later. Cortisol, norepinephrine, and epinephrine levels were measured at baseline using 15-hour urine samples. At each assessment, patients completed the Impact of Event Scale (IES) and the Brief Symptom Inventory (BSI).Patients reported moderate levels of distress throughout treatment as measured by the IES and BSI. Norepinephrine levels at the start of treatment were positively associated with IES total scores at the end of treatment and at follow-up, and cortisol levels were positively associated with IES total scores at follow-up after adjusting for baseline IES and overall distress scores. Norepinephrine levels were also positively associated with depression scores at follow-up, and cortisol levels were positively associated with depression scores at the end of treatment and at follow-up after adjusting for baseline depression and overall distress scores.Hormonal profiles at the start of cancer treatment are associated with subsequent psychological adjustment.",0 +https://doi.org/10.1016/j.brat.2004.05.002,"Developing new treatments: on the interplay between theories, experimental science and clinical innovation","It is often argued that behaviour therapy and cognitive-behaviour therapy have a sound theoretical and experimental basis. In the early days of behaviour therapy, the learning theory accounts that were the basis of treatment made clear suggestions about the procedures that were likely to be effective in treatment. In contrast, more recent cognitive-behavioural models tend to specify targets for therapy, but not the procedures that might be optimal for changing the targets. As a consequence, a considerable amount of work has to be done in order to create an effective cognitive-behavioural treatment from a promising cognitive-behavioural model. The process by which cognitive-behavioural treatments are developed is rarely discussed in the literature. For this reason, the way in which one group has used a mixture of phenomenological, experimental and treatment development studies to create effective cognitive therapy programmes for anxiety disorders is described.",0 +https://doi.org/10.1007/s00213-009-1722-1,Effects of acute tryptophan depletion in serotonin reuptake inhibitor-remitted patients with generalized anxiety disorder,"BACKGROUND: Serotonergic antidepressants [selective serotonin reuptake inhibitor (SSRI)] are first-line treatments for generalised anxiety disorder (GAD); however, it is not known if synaptic serotonin (5-HT) availability is important for SSRI efficacy. The present study tested the hypothesis that temporary reduction in central 5-HT transmission, through acute tryptophan depletion (ATD), would reverse the therapeutic effect of the SSRIs in GAD patients. METHODS: Twelve patients (six males) with GAD, who showed sustained clinical improvement with SSRI treatment, underwent ATD in a double-blind, placebo-controlled, within-subjects design over 2 days, 1 week apart. At the peak time of depletion, the participants inhaled 7.5% CO2 and air in random order for at least 12 min each. Psychological responses were measured using the Spielberger State Anxiety Inventory (STAI-S) and GAD-symptom visual analogue scales (VASs; e.g., worry and tense) and Profile of Mood States. RESULTS: Free plasma tryptophan to large neutral amino acid (LNAA) ratio decreased by 92% on the depletion day and decreased by 2% on the control day. Irrespective of depletion condition, 7.5% CO(2) inhalation significantly increased STAI-S and GAD-related VAS scores (all p < 0.05) compared with air inhalation. ATD had no effect on any of these measures despite the substantial reduction in free tryptophan/LNAA ratio. CONCLUSIONS: Although SSRIs treat GAD effectively, the present results suggest that the mechanism of action is different to that seen in panic, social anxiety, and post-traumatic stress disorders. Successful SSRI treatment of GAD may involve long-term receptor changes or alterations in other neurotransmitter systems downstream of serotonin.",0 +https://doi.org/10.1111/bph.12720,Agomelatine: mechanism of action and pharmacological profile in relation to antidepressant properties,"Agomelatine behaves both as a potent agonist at melatonin MT1 and MT2 receptors and as a neutral antagonist at 5-HT2C receptors. Accumulating evidence in a broad range of experimental procedures supports the notion that the psychotropic effects of agomelatine are due to the synergy between its melatonergic and 5-hydroxytryptaminergic effects. The recent demonstration of the existence of heteromeric complexes of MT1 and MT2 with 5-HT2C receptors at the cellular level may explain how these two properties of agomelatine translate into a synergistic action that, for example, leads to increases in hippocampal proliferation, maturation and survival through modulation of multiple cellular pathways (increase in trophic factors, synaptic remodelling, glutamate signalling) and key targets (early genes, kinases). The present review focuses on the pharmacological properties of this novel antidepressant. Its mechanism of action, strikingly different from that of conventional classes of antidepressants, opens perspectives towards a better understanding of the physiopathological bases underlying depression.",0 +https://doi.org/10.1136/bmjopen-2013-004070,Behavioural sleep problems in children with attention-deficit/hyperactivity disorder (ADHD): protocol for a prospective cohort study,"Children with attention-deficit/hyperactivity disorder (ADHD) commonly experience behavioural sleep problems, yet these difficulties are not routinely assessed and managed in this group. Presenting with similar symptoms to ADHD itself, sleep problems are complex in children with ADHD and their aetiology is likely to be multifactorial. Common internalising and externalising comorbidities have been associated with sleep problems in children with ADHD; however, this relationship is yet to be fully elucidated. Furthermore, limited longitudinal data exist on sleep problems in children with ADHD, thus their persistence and impact remain unknown. In a diverse sample of children with ADHD, this study aims to: (1) quantify the relationship between sleep problems and internalising and externalising comorbidities; (2) examine sleep problem trajectories and risk factors; and (3) examine the longitudinal associations between sleep problems and child and family functioning over a 12-month period.A prospective cohort study of 400 children with ADHD (150 with no/mild sleep problems, 250 with moderate/severe sleep problems) recruited from paediatric practices across Victoria, Australia. The children's parents and teacher provide data at baseline and 6-month and 12-month post enrolment.Parent report of child's sleep problem severity (no, mild, moderate, severe); specific sleep domain scores assessed using the Child Sleep Habits Questionnaire; internalising and externalising comorbidities assessed by the Anxiety Disorders Interview Schedule for Children IV/Parent version.Multiple variable logistic and linear regression models examining the associations between key measures, adjusted for confounders identified a priori.Ethics approval has been granted. Findings will contribute to our understanding of behavioural sleep problems in children with ADHD. Clinically, they could improve the assessment and management of sleep problems in this group. We will seek to publish in leading paediatric journals, present at conferences and inform Australian paediatricians through the Australian Paediatric Research Network.",0 +https://doi.org/10.1016/j.ajog.2011.05.003,The use of psychosocial stress scales in preterm birth research,"Psychosocial stress has been identified as a potential risk factor for preterm birth. However, an association has not been found consistently, and a consensus on the extent to which stress and preterm birth are linked is still lacking. A literature search was performed with a combination of keywords and MeSH terms to detect studies of psychosocial stress and preterm birth. Studies were included in the review if psychosocial stress was measured with a standardized, validated instrument and if the outcomes included either preterm birth or low birthweight. Within the 138 studies that met inclusion criteria, 85 different instruments were used. Measures that had been designed specifically for pregnancy were used infrequently, although scales were sometimes modified for the pregnant population. The many different measures that have been used may be a factor that accounts for the inconsistent associations that have been observed.",0 +https://doi.org/10.1111/acps.12358,Brain-derived neurotrophic factor and inflammatory markers in school-aged children with early trauma,"Objective The impact of childhood trauma (CT) on brain-derived neurotrophic factor (BDNF) and cytokines levels remains unclear. We investigated the association between CT and changes in BDNF and cytokines plasma levels in children. Method We recruited 36 children with trauma (CT+) and 26 children without trauma (CT-). The presence of CT was based on a clinical interview and by Criteria A of DSM-IV criteria for PTSD. Blood samples were drawn from all children to assess BDNF and cytokines. ancova was performed with psychiatric symptoms and BMI as covariates to evaluate group differences in plasma levels. Results CT+ showed increased levels of BDNF and TNF-α after excluding children with history of inflammatory disease (P < 0.05) when compared with those CT-. IL-12p70, IL-6, IL-8, IL-10, and IL-1β levels were not statistically different between groups. Conclusion CT+ showed increased BDNF and proinflammatory cytokines levels. The increase in BDNF levels may be an attempt to neutralize the negative effects of CT, while an increase in TNF-a levels be associated with a proinflammatory state after CT. How these changes associated with trauma relate to other biological changes and illness trajectory later in life remain to be further studied.",0 +https://doi.org/10.1016/j.jad.2010.10.021,Factors associated with suicidal ideation in OEF/OIF veterans,"The purpose of this project was to examine factors associated with suicidal ideation in returning Iraq and Afghanistan war veterans.A cross-sectional review of 1740 veterans' initial mental health screening evaluations. One-hundred and thirteen (6.5%) OEF/OIF veterans reported active suicidal ideation at the time of the interview.Prior exposures of physical or sexual abuse and having a history of a prior suicide attempt(s) were associated with the presence of current suicidal ideation, as were having a diagnosis of a psychotic disorder, a depressive disorder, or posttraumatic stress disorder (PTSD). Deployment concerns related to training (protective), the deployment environment, family concerns, deployment concerns, post-deployment support (protective), and post-deployment stressors were also associated with current suicidal ideation. Logistic regression analysis revealed the major risk factors were having a prior suicide attempt, female gender, and a depressive disorder diagnosis; while more perceived current social support was a protective factor. Logistic regression analysis also revealed having comorbid PTSD and depression carried a higher odds ratio for risk than did having either PTSD or depression alone; and that the PTSD avoidance symptom-cluster was associated with more risk than either the re-experiencing or hyper-arousal symptom clusters for current suicidal ideation.As a cross-sectional retrospective medical chart review, limitations include limited generalizability and causal relationships cannot be evaluated.Further investigation of these risk factors is warranted to aid in suicide risk assessment and in the development of targeted interventions to mitigate the identified risk factors and bolster the identified protective factor.",0 +https://doi.org/10.1016/j.jacc.2013.06.005,Post-Traumatic Stress Disorder and Coronary Heart Disease,"Post-traumatic stress disorder (PTSD) is a mental health condition that occurs relatively commonly in people exposed to situations that cause severe psychological stress, such as natural disasters, combat, or physical attack. In this issue of the Journal , Vaccarino et al. [(1)][1] report that the",0 +https://doi.org/10.1016/j.socscimed.2014.11.032,Mental health and general wellness in the aftermath of Hurricane Ike,"Exposure to natural disasters has been linked to a range of adverse outcomes, including mental health problems (e.g., posttraumatic stress symptoms [PTSS], depression), declines in role functioning (e.g., occupational difficulties), and physical health problems (e.g., somatic complaints). However, prior research and theory suggest that the modal postdisaster response in each of these domains is resilience, defined as low levels of symptoms or problems in a given outcome over time, with minimal elevations that are limited to the time period during the disaster and its immediate aftermath. However, the extent to which disaster survivors exhibit mental health wellness (resilience across multiple mental health conditions) or general wellness (resilience across mental health, physical health, and role functioning domains) remains unexplored. The purpose of this study was to quantify mental health and general wellness, and to examine predictors of each form of wellness, in a three-wave population-based study of Hurricane Ike survivors (N = 658). Latent class growth analysis was used to determine the frequency of resilience on four outcomes (PTSS: 74.9%; depression: 57.9%; functional impairment: 45.1%; days of poor health: 52.6%), and cross-tabulations were used to determine the frequency of mental health wellness (51.2%) and general wellness (26.1%). Significant predictors of both mental health and general wellness included lower peri-event emotional reactions and higher community-level collective efficacy; loss of sentimental possessions or pets and disaster-related financial loss were negative predictors of mental health wellness, and loss of personal property was a negative predictor of general wellness. The results suggest that studies focusing on a single postdisaster outcome may have overestimated the prevalence of mental health and general wellness, and that peri-event responses, personal property loss and collective efficacy have a cross-cutting influence across multiple domains of postdisaster functioning.",1 +https://doi.org/10.1007/s10597-013-9591-9,Treatment Processes of Counseling for Children in South Sudan: A Multiple n = 1 Design,"Studies into treatment processes in low-income settings are grossly lacking, which contributes to the scarcity of evidence-based psychosocial treatment. We conducted multiple n = 1 studies, with quantitative outcome indicators (depression-, PTSD- and anxiety- symptoms, hope) and qualitative process indicators (treatment- perceptions, content and progress) measured before, during and after counseling. We aimed to explore commonalities in treatment processes associated with change profiles within and between cases. The study was conducted in South Sudan with children aged between 10 and 15 years. Change profiles were associated with the quality of the counselor-client relationship (instilling trust and hope through self-disclosure, supportive listening and advice giving), level of client activation, and the ability of the counselor to match treatment strategies to the client's problem presentation (trauma- and emotional processing, problem solving, cognitive strategies). With limited time, due to restricted resources in low-income settings, training courses can now be better focused on key treatment processes. © 2013 Springer Science+Business Media New York.",0 +,"Anti- Diabetic effects of Crataegus's SPP Branchlet on Blood Lipids, Glucose and Anti-Oxidant Factors in Streptozotocin- Induced Diabetic Rats","Background and purpose: The epidemic of diabetes mellitus is one of the main concerns of the global health arena. This study investigated the effect of oral shoot Crateagus's SPP Branchlet on blood glucose, lipid profile, the level of oxidative stress in diabetic rats. Materials and methods: In this experimental study, we compared four groups of 15 teeth matched male rats: control, control treated with Crataegus's SPP Branchlet powder shoot, diabetic and diabetic treated with powder shoot. High blood glucose of 300 mg/dl and more was considered as an indicator of diabetes. Indicators of oxidative stress, including catalase, malonaldehyde, Superoxide Dismutase, glutathione peroxides and lipid parameters including triglycerides, total cholesterol, LDL, HDL, VLDL and also blood sugar and weight of rats were measured and reported using the mean and SD. Results: The statistical analysis of repeated measures analysis of variance showed that serum glucose, lipid profile (P<0.001) and the indicators of oxidative stress (PGPX, SOD, CAT, MDA< 0.001) were significantly affected with hawthorn. At significant level of 0.05, there is no difference between the treatment groups with control and diabetic groups for catalase. In diabetic rates, significant weight loss was achieved over time and compared with the control group (P<0.001). Conclusion: Based on our study, oral administration of Crataegus's SPP Branchlet in experimental diabetic male rats can improve blood sugar, lipids profile and oxidative stress disorders.",0 +https://doi.org/10.1093/milmed/163.5.331,Psychological Characteristics of Wounded and Disabled Croatian War Veterans,"Abstract Objective: Evaluation of the psychological state of a group of 119 Croatian disabled war veterans who suffered grave traumatic war experiences during the war in Croatia (1991–1992). Methods: Semistructured Clinical Interview, Profile Index Emotions test, and Zung's Self-Rating Depression Scale were used to assess disabled war veterans accommodated in special institutions for rehabilitation. Results: Changes in psychological functioning were established in 63.8% of disabled war veterans, the most frequent among them being indisposition, irritability, anxiety, and fear. In nearly half of the veterans there were changes in their relationships with close persons, difficulties in accepting the reality of their situations, and increased aggressiveness. Higher average values on the depression index (0.52) were also established. Conclusion: The established change in the psychological profile of disabled Croatian war veterans was lower than expected. However, because of their great vulnerability, it is necessary to increase efforts to secure their complete psychosocial recovery.",0 +https://doi.org/10.1017/s1461145707008152,β2 Nicotinic acetylcholine receptor availability in post-traumatic stress disorder,"Availability of nicotinic acetylcholine receptors containing beta2 subunits (beta2-nAChRs) was studied in unmedicated, symptomatic patients with post-traumatic stress disorder (PTSD) and healthy control subjects, all current non-smokers. A subgroup of participants had a history of smoking. Availability of beta2-nAChRs in the mesiotemporal cortex, prefrontal cortex, thalamus and striatum was determined using the radiotracer [123I]5-IA-85380 ([123I]5-IA) and single-photon emission computed tomography (SPECT). PTSD symptoms were assessed using the Clinician-Administered PTSD Scale (CAPS). Never-smoking PTSD patients compared to never-smoking healthy controls showed significantly higher [123I]5-IA binding in the mesiotemporal cortex (ANOVA: F=6.21, d.f.=1, 11, p=0.030). Among all PTSD patients, there was a significant correlation between the re-experiencing symptom cluster and thalamic [123I]5-IA binding (R2=0.66, p=0.019, Bonferroni corrected). These findings not only suggest an involvement of beta2-nAChRs in the pathophysiology of PTSD but also raise the possibility that this receptor may be a novel molecular target for drug development.",0 +https://doi.org/10.1016/s0920-9964(12)70238-4,CHILDHOOD TRAUMA AND SUBCLINICAL PSYCHOTIC EXPERIENCES IN YOUNG ADULTHOOD: 20-YEAR LONGITUDINAL ANALYSES OF TWO COHORT STUDIES,"Subclinical psychotic experiences (SPE) can progress to serious psychotic disorder (most commonly schizophrenia). There is increasing recognition that people who have experienced childhood trauma have a higher rate of SPE, but these studies are generally retrospective. We report 20-year follow up data on two South Australian cohorts, involving 1339 participants, assessed as children then again as young adults. The first cohort consists of 529 participants exposed to bushfires as children and 464 matched controls. The second cohort consists of 346 participants who grew up in the lead-affected community of Port Pirie. Data collected during childhood for both cohorts included emotional, behavioural and developmental measures. In addition, maternal IQ, children's IQ and lead levels during childhood were assessed in the Port Pirie cohort. The adult evaluations included SPE, total lifetime traumas, and alcohol and cannabis use, collected using questionnaires and structured diagnostic interviews. Analysis of cohort 1 data showed an association between SPE and the total number of traumas experienced by participants. In addition, emotional disturbances and dysfunctional parenting, assessed during childhood, were more common in those with adult SPE. Participants with higher levels of SPE were 4 times more likely to be alcohol dependant and 1.4 times more likely to have symptoms of cannabis dependence. The Port Pirie cohort contained 149 males and 197 females. We looked specifically at gender differences in this cohort and found that trauma exposure during childhood and adolescence was associated with the frequency and distress of both positive and depressive SPE in females only. For male participants, the total number of traumas correlated with only with the level of distress about negative symptoms. Again, alcohol was a stronger predictor of SPE than the use of other drugs including cannabis. In the female Port Pirie participants only, higher cumulative lead levels were associated with greater frequency and distress related to positive SPE. In the male Port Pirie participants, there were relationships between poorer motor and social development at age 3 years and adult SPE. There was a significant negative correlation between maternal IQ and the frequency of SPE reported by the participant 20 years later. In the total Port Pirie sample, greater hyperactivity measured at 7 years was associated with lower frequency and less distress related to negative symptoms in adulthood. There were also associations between aggression and social withdrawal at ages 3-4 years and later SPE. Young people who have experienced a greater number of traumas are more likely to develop SPE. A dysfunctional family environment and childhood behavioural disturbances are also associated with later SPE. We found that alcohol was a stronger predictor of SPE than cannabis. The Port Pirie data shows that there may be gender differences in the pathways to SPE. These findings contribute to our understanding of the contributions of traumatic experiences, lead exposure, family environment and differing developmental trajectories to adult SPE.",0 +https://doi.org/10.1016/j.jalz.2014.04.011,"Alzheimer's Disease prevalence, costs, and prevention for military personnel and veterans","By 2050, more than 13 million Americans of all ages are estimated to be living with Alzheimer's disease (AD), and the aggregate costs of care will swell to approximately $1.2 trillion. The rapidly climbing number of those affected with AD includes a growing population of aging military veterans affected who may have an added risk for the disease as a consequence of traumatic brain injury, posttraumatic stress disorder, and/or service-related injuries. The increasing number of individuals, the long duration of disability, and the rising cost of care for AD and other dementia to our society are important public health challenges facing many older adults. These challenges are further compounded by a burgeoning military veteran population that is much younger, with an increased risk of AD and other dementia, and who may experience decades-long periods of disability and care. This outlook underscores the critical need for investments in research at the federal and international levels to accelerate the pace of progress in developing breakthrough discoveries that will change the trajectory of AD and related dementia.",0 +https://doi.org/10.1007/s10608-012-9506-z,Influence of Depression on State and Trait Anger in Veterans with Posttraumatic Stress Disorder,"Anger is one of the most important symptoms of posttraumatic stress disorder (PTSD), and is associated with many of the adverse correlates of PTSD. Researchers have proposed theories to explain the relationship between anger and PTSD, but no study to date has examined the mediating role of depression. The purpose of this study was to explore the mediating effects of current major depression disorder (MDD), as well as PTSD numbing and dysphoria symptom clusters (King et al. 1998; Simms et al. 2002) on the relationship between PTSD and anger. There were 98 participants in the study, and all were male veterans with combat-related PTSD taking part in a clinical trial. Results indicated that MDD partially mediated the relationship between PTSD and state anger, while numbing and dysphoria clusters partially mediated the relationships between other PTSD symptom clusters and trait anger. Implications for the treatment of anger in veterans with PTSD are discussed. © 2012 Springer Science+Business Media New York (outside the USA).",0 +https://doi.org/10.1177/1077801215583622,Responses of International Migrant Women to Abuse Associated With Pregnancy,"The current study aims to identify what newly arrived migrant women do, in the early months post-birth, to respond to abuse associated with pregnancy. Textual data from 59 migrant women were analyzed thematically to identify common responses to abuses. The most common response was to physically leave their countries of origin and move to Canada, or to move out of the shared dwelling. Other responses included taking legal action, remaining silent, reporting the abuse, seeking counseling, isolating themselves, and supporting anger management for the abuser. These results enhance our understanding of the decisions, including inaction, made by migrant women.",0 +https://doi.org/10.1016/j.psychres.2015.06.038,Plasma brain-derived neurotrophic factor levels in patients suffering from post-traumatic stress disorder,"A number of studies have been done to investigate the role of brain-derived neurotrophic factor (BDNF) in patients with post-traumatic stress disorder (PTSD). In this study we aimed to test the relationship between plasma BDNF levels and PTSD. We solicited 65 subjects having recently experienced road traffic accidents (RTA) conforming to screening criteria. They were given follow-up examinations after one month, three months, and six months. PTSD was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-R-TR, American Psychiatric Association, 2000) using the Mini International Neuropsychiatric Interview (MINI). All participants were divided into two groups: a group with PTSD and a group without PTSD. There were no significant differences in plasma BDNF levels between the two groups at either the 48h or six-month examination. Within the PTSD group, no significant differences were found in plasma BDNF levels between the two examinations. BDNF levels in those without PTSD showed a higher trend over time after trauma. Higher BDNF levels may be an important protective factor for the prevention of traumatized subjects from developing PTSD.",0 +https://doi.org/10.1016/j.trf.2015.09.002,"Motor vehicle accidents and adolescents: An empirical study on their emotional and behavioral profiles, defense strategies and parental support","BACKGROUND: Research has limitedly focused on adolescents' emotional-behavioral functioning preceding road collisions and on the role of family support. OBJECTIVE: To verify whether the rates of motorbikes collisions among adolescents are associated with their emotional-behavioral functioning, their use of specific defense strategies and family support. METHOD: N = 150 adolescents who visited an emergency department for road accidents were selected and completed self-report questionnaires assessing emotional-behavioral functioning, difficulty in identifying and describing emotions, use of defense strategies and perceived family support. RESULTS: Higher rates of motorbike collisions are associated with more maladaptive emotional-behavioral functioning. Higher perceived family support is associated with lower rates of collisions. CONCLUSIONS: Recidivism of motor vehicle collision among adolescents can be considered as a form of acting-out caused by their psychological difficulties.",0 +https://doi.org/10.1108/09653561211278707,Research to practice: a disaster behavioral health framework,"Purpose – Research and experience following a variety of recent disasters has fostered the development of a range of disaster behavioral health interventions that can be used post‐disaster. Consensus documents recommend that five guiding principles be used to inform intervention efforts. These five essential elements, a sense of safety, calming, efficacy, connectedness, and hope, appear critical to the fostering of adaptation and resilience in affected communities. This paper aims to examine the use of these principles in practice.Design/methodology/approach – Translating these five evidence‐informed principles into practice requires dissemination, delivery and prioritizing and validation of the elements. Scholars identify actions for dissemination, delivery, and prioritization and validation, and this paper expands on the literature to identify processes that actualize the research into a framework for practice.Findings – This article describes how disaster behavioral health professionals in Colorado hav...",0 +https://doi.org/10.1007/s00115-013-3735-6,[Prophylaxis and therapy of post-traumatic stress disorder with propranolol: evidence and ethical analysis].,"The beta-antagonistic agent propranolol is increasingly being used in clinical trials for the prophylaxis and treatment of post-traumatic stress disorder (PTSD). This article discusses the evidence for the effectiveness of propranolol in the prophylaxis and treatment of PTSD and the ethical implications of research on these treatment approaches. The efficacy of a prophylactic or therapeutic use could not be shown during the last decade. Both treatment approaches raise ethical questions that should already be addressed during the clinical trials. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1016/j.neubiorev.2015.07.007,"Post-traumatic stress influences the brain even in the absence of symptoms: A systematic, quantitative meta-analysis of neuroimaging studies","Stress affects brain function, and may lead to post-traumatic stress disorder (PTSD). Considerable empirical data for the neurobiology of PTSD has been derived from neuroimaging studies, although findings have proven inconsistent. We used an activation likelihood estimation analysis to explore differences in brain activity between adults with and without PTSD in response to affective stimuli. We separated studies by type of control group: trauma-exposed and trauma-naive. This revealed distinct patterns of differences in functional activity. Compared to trauma-exposed controls, regions of the basal ganglia were differentially active in PTSD; whereas the comparison with trauma-naive controls revealed differential involvement in the right anterior insula, precuneus, cingulate and orbitofrontal cortices known to be involved in emotional regulation. Changes in activity in the amygdala and parahippocampal cortex distinguished PTSD from both control groups. Results suggest that trauma has a measurable, enduring effect upon the functional dynamics of the brain, even in individuals who experience trauma but do not develop PTSD. These findings contribute to the understanding of whole-brain network activity following trauma, and its transition to clinical PTSD.",0 +https://doi.org/10.1176/ajp.152.1.116,"Arousal, numbing, and intrusion: symptom structure of PTSD following assault","This study investigated hypotheses concerning the importance of symptoms of numbing in posttraumatic stress disorder (PTSD).Symptoms of PTSD were assessed in 72 female rape victims and 86 female victims of nonsexual assault approximately 3 months after the crimes occurred. A principal-components factor analysis of subjects' symptoms was then undertaken.The analysis yielded three factors: arousal/avoidance, numbing, and intrusion. These were somewhat different from the symptom clusters in DSM-III-R, since effortful avoidance and numbing symptoms did not load on the same factor. Numbing symptoms appeared to be particularly important in identifying individuals with PTSD.The results imply that there are two patterns of posttrauma symptoms, one characterizing PTSD and the second characterizing a phobic reaction.",0 +,Manual for ASEBA School-Age Forms & Profiles,,0 +https://doi.org/10.1016/j.chiabu.2013.01.005,Poly-victimization among juvenile justice-involved youths,"This study replicates and extends the research literature on poly-victimization with a vulnerable and under-served population, juvenile justice-involved youths.N=1959, 10-16 year old youths (76% male; 74% youth of color) consecutively newly admitted to juvenile detention facilities completed psychometric measures of trauma history, posttraumatic stress, affect regulation, alcohol/drug use, suicide risk, and somatic complaints.Using latent class analysis derived from 19 types of adversity, three unique classes best fit the data. A poly-victim class (49% female, 51% youth of color) accounted for 5% of the sample and reported a mean of 11.4 (SD=1.1) types. A relatively moderate adversity class (31% female, 70% youth of color) accounted for 36% of the sample and reported a mean of 8.9 (SD=0.3) types of adversity and 2.65 (SD=1.1) types of traumatic adversity. A low adversity class (59% of the sample; 17% female, 78% youth of color) reported a mean of 7.4 (SD=0.4) adversity types but only 0.3 (SD=0.45) types of traumatic adversity. The relatively moderate adversity class was comparable to poly-victims in endorsing extensive non-victimization traumatic adversity (e.g., accidental and loss trauma), but poly-victims were distinct from both moderate and low adversity class members in the likelihood of reporting all but one type of traumatic victimization, multiple types of traumatic victimization, and severe emotional and behavioral problems. Girls were at particularly high risk of poly-victimization, and African American and White youths also were at risk for poly-victimization.Although youth involved in the juvenile justice system typically have experienced substantial victimization, a poly-victimized sub-group, especially (but not exclusively) girls, warrants particular scientific, clinical, and rehabilitative attention in order to address the most severe behavioral and mental health problems and risks faced by this vulnerable population.",0 +https://doi.org/10.1194/jlr.m002196,Chronic social defeat stress disrupts regulation of lipid synthesis,"Several psychiatric disorders increase the risk of cardiovascular disease, including posttraumatic stress disorder and major depression. While the precise mechanism for this association has not yet been established, it has been shown that certain disorders promote an unfavorable lipid profile. To study the interaction of stress and lipid dysregulation, we utilized chronic social defeat stress (CSDS), a mouse model of chronic stress with features of posttraumatic stress disorder and major depression. Following exposure to CSDS, mice were given access to either regular chow or a Western-style diet high in fat and cholesterol (HFD). The combination of social stress and HFD resulted in significant perturbations in lipid regulation, including two key features of the metabolic syndrome: increased plasma levels of non-HDL cholesterol and intrahepatic accumulation of triglycerides. These effects were accompanied by a number of changes in the expression of hepatic genes involved in lipid regulation. Transcriptional activity of LXR, SREBP1c, and ChREBP were significantly affected by exposure to HFD and CSDS. We present CSDS as a model of social stress induced lipid dysregulation and propose that social stress alters lipid metabolism by increasing transcriptional activity of genes involved in lipid synthesis.",0 +https://doi.org/10.1016/j.jpsychires.2014.08.014,DSM-5 posttraumatic stress disorder: Factor structure and rates of diagnosis,"Posttraumatic stress disorder (PTSD) is a significant problem among Iraq/Afghanistan-era veterans. To date, however, there has been only limited research on how the recent changes in DSM-5 influence the prevalence and factor structure of PTSD. To address this key issue, the present research used a modified version of a gold-standard clinical interview to assess PTSD among a large sample of Iraq/Afghanistan-era veterans ( N = 414). Thirty-seven percent of the sample met DSM-5 criteria for PTSD compared to a rate of 38% when DSM-IV diagnostic criteria were used. Differences in rates of diagnosis between DSM-IV and DSM-5 were primarily attributable to changes to Criterion A and the separation of the “avoidance” and “numbing” symptoms into separate clusters. Confirmatory factor analysis (CFA) was used to compare the fit of the previous 3-factor DSM-IV model of PTSD to the 4-factor model specified in DSM-5 , a 4-factor “dysphoria” model, and a 5-factor model. CFA demonstrated that the 5-factor model (re-experiencing, active avoidance, emotional numbing, dysphoric arousal, anxious arousal) provided the best overall fit to the data, although substantial support was also found for the 4-factor DSM-5 model. Low factor loadings were noted for two of the symptoms in the DSM-5 model (psychogenic amnesia and reckless/self-destructive behavior), raising questions regarding the adequacy of fit between these symptoms and the other core features of PTSD. Overall, findings suggest the DSM-5 model of PTSD is an improvement over the previous DSM-IV model of PTSD, but still may not represent the true underlying factor structure of PTSD. • We tested the prevalence and factor structure of DSM-5 posttraumatic stress disorder. • 37% of veteran sample met DSM-5 PTSD. • 38% of veteran sample met DSM-IV PTSD. • Confirmatory factor analysis supported DSM-5 symptom structure.",0 +https://doi.org/10.1016/j.jad.2010.01.076,"Prolonged Grief Disorder, depression, and posttraumatic stress disorder are distinguishable syndromes","This study examined the distinctiveness of symptoms of Prolonged Grief Disorder (PGD), depression, and posttraumatic stress disorder (PTSD). We compared the fit of a one-factor model with the fit of four hierarchical models in which symptoms formed three distinct correlated higher-order dimensions, and PTSD-items were modeled in different ways.Self-reported data were available from two samples; 572 mourners recruited via the internet and 408 mourners recruited via healthcare workers.In Sample 1, the unitary model did not fit the data. The four hierarchical models all fit better. The model in which PTSD-items constituted four lower-order factors of reexperiencing, avoidance, dysphoria, and hyperarousal fit the data best. The fit was further improved, when one weak PGD-item and one weak PTSD-item were removed, and error-terms of similar items were allowed to correlate. Findings from Sample 1 were replicated in Sample 2.This study relied on self-reported data. Not all PGD-criteria and depression-criteria were assessed.This is the first confirmatory factor analysis study showing that symptoms of PGD, depression, and PTSD represent distinguishable syndromes. PGD-symptoms should be addressed in the assessment and treatment of bereaved people seeking treatment.",0 +https://doi.org/10.1521/pedi.2005.19.4.386,High-Lethality Status in Patients with Borderline Personality Disorder,"Recurrent suicidal behaviors in patients with Borderline Personality Disorder (BPD) are often considered communicative gestures; however, 10% complete suicide. This study seeks to identify risk factors for suicide within a BPD sample by comparing patients with High- and Low-Lethality attempts. BPD attempters (n = 113) were assessed on demographic, diagnostic, and personality variables: clinical symptoms, suicidal behaviors; childhood, family, and treatment histories; social adjustment; and recent life events. Forty-four High-Lethality attempters, defined by a score of 4 or more on Beck's Medical Lethality Scale, were compared to 69 Low-Lethality attempters. Discriminating variables were entered in a multivariate logistic regression model to define predictors of High-Lethality status. High-Lethality attempters were older, with children, less education, and lower socioeconomic class (SES) than Low-Lethality attempters. They were more likely to have Major Depressive Disorder (MDD), co-morbid Antisocial Personality Disorder (ASPD), and family histories of substance abuse. They reported greater intent to die, more lifetime attempts, hospitalizations, and time in the hospital. High-Lethality status was best predicted by low SES, co-morbid ASPD, extensive treatment histories, and greater intent to die. These characteristics resemble profiles of patients who complete suicide, are not specific for BPD, and do not include impulsivity, aggression, or severity of BPD criteria.",0 +https://doi.org/10.1159/000067068,Stalking Behavior – An Overview of the Problem and a Case Report of Male-to-Male Stalking during Delusional Disorder,"Stalking is a widespread phenomenon describing a pattern of intrusive and threatening behavior leading to the victim's perception of being harassed and rendered fearful. This paper outlines relevant aspects of the stalking concept and reviews the historical development of this categorization, different typologies of stalking behavior, associated psychiatric diagnoses, frequency and demographic data, psychomedical impact on the victims and therapeutic approaches. Special gender aspects are discussed by presenting a case history of male-to-male stalking.",0 +https://doi.org/10.1037/a0031290,Cognitive change predicts symptom reduction with cognitive therapy for posttraumatic stress disorder.,"There is a growing body of evidence for the effectiveness of trauma-focused cognitive behavior therapy (TF-CBT) for posttraumatic stress disorder (PTSD), but few studies to date have investigated the mechanisms by which TF-CBT leads to therapeutic change. Models of PTSD suggest that a core treatment mechanism is the change in dysfunctional appraisals of the trauma and its aftermath. If this is the case, then changes in appraisals should predict a change in symptoms. The present study investigated whether cognitive change precedes symptom change in Cognitive Therapy for PTSD, a version of TF-CBT.The study analyzed weekly cognitive and symptom measures from 268 PTSD patients who received a course of Cognitive Therapy for PTSD, using bivariate latent growth modeling.Results showed that (a) dysfunctional trauma-related appraisals and PTSD symptoms both decreased significantly over the course of treatment, (b) changes in appraisals and symptoms were correlated, and (c) weekly change in appraisals significantly predicted subsequent reduction in symptom scores (both corrected for the general decrease over the course of therapy). Changes in PTSD symptom severity did not predict subsequent changes in appraisals.The study provided preliminary evidence for the temporal precedence of a reduction in negative trauma-related appraisals in symptom reduction during trauma-focused CBT for PTSD. This supports the role of change in appraisals as an active therapeutic mechanism.",0 +,"Mothers of adolescent and young adult survivors of childhood cancer: Health beliefs, post-traumatic stress, growth and caregiving practices","Mothers of adolescent and young adult (AYA) childhood cancer survivors often continue to experience psychosocial challenges related to their child's illness and treatment long after the successful treatment of cancer. Such challenges may affect mothers' personal wellbeing and caregiving practices. Three studies were conducted to explore mothers' beliefs regarding their current and future health concerns, how they manage medical issues, relationships, and health-promoting behaviors. A new self-report scale, the Parental Health Competence Beliefs Inventory (pHCBI), was developed (Study 1) to examine the relationship between these beliefs and mothers' psychological well-being (Study 2) and caregiving behavior (Study 3). Eighty-six mothers of AYA childhood cancer survivors were recruited during their child's regularly scheduled clinic visits. Mothers completed the pHCBI and measures of psychosocial wellbeing, including the Perception of Changes in Self questionnaire (PCS) and Posttraumatic Stress Checklist (PCL-C). Exploratory factor analyses (EFA) identified pHCBI scale factors (Study 1) and domains of posttraumatic growth (PTG) (Study 2). Correlational and regression analyses examined the relationships between beliefs, PTG, and posttraumatic stress (PTS). In Study 3, mixed method analyses were used to identify reasons for attending clinic with their child and to explore relationships between these reasons, mothers' beliefs, and demographic and medical variables. The Study 1 EFA revealed a 23-item four-factor solution for the pHCBI: (a) Social Competence, (b) Health Perceptions, (c) Satisfaction with Healthcare, and (d) Health Apprehension. In Study 2, EFA identified three domains of PTG: (a) Interpersonal Relationships, (b) Life Satisfaction, and (c) Life Outlook. Social Competence was correlated with PTG with respect to Interpersonal Relationships and Life Satisfaction. Health Apprehension moderated the linear relationship between PTS and PTG-Life Satisfaction. Qualitative data revealed 10 reasons mothers give for accompanying their child to their follow-up clinic visit (Study 3). Mothers who report lower Satisfaction with Healthcare continued to attend the survivorship clinic out of Concern for Their Child's Health and Wellbeing. The better understanding of mothers' health-related beliefs and caregiving provided by the results of these studies may be useful in promoting mothers' wellbeing and in helping them to adjust to their AYA survivors' growing independence. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0 +https://doi.org/10.1207/s15328007sem1001_4,Adding Missing-Data-Relevant Variables to FIML-Based Structural Equation Models,"Conventional wisdom in missing data research dictates adding variables to the missing data model when those variables are predictive of (a) missingness and (b) the variables containing missingness. However, it has recently been shown that adding variables that are correlated with variables containing missingness, whether or not they are related to missingness, can substantially improve estimation (bias and efficiency). Including large numbers of these auxiliary variables is straightforward for researchers who use multiple imputation. However, what is the researcher to do if 1 of the FIML/SEM procedures is the analysis of choice? This article suggests 2 models for SEM analysis with missing data, and presents simulation results to show that both models provide estimation that is clearly as good as analysis with the EM algorithm, and by extension, multiple imputation. One of these models, the saturated correlates model, also provides good estimates of model fit.",0 +https://doi.org/10.1017/s0033291715001300,Latent classes of childhood trauma exposure predict the development of behavioral health outcomes in adolescence and young adulthood,"Background To develop latent classes of exposure to traumatic experiences before the age of 13 years in an urban community sample and to use these latent classes to predict the development of negative behavioral outcomes in adolescence and young adulthood. Method A total of 1815 participants in an epidemiologically based, randomized field trial as children completed comprehensive psychiatric assessments as young adults. Reported experiences of nine traumatic experiences before age 13 years were used in a latent class analysis to create latent profiles of traumatic experiences. Latent classes were used to predict psychiatric outcomes at age ⩾13 years, criminal convictions, physical health problems and traumatic experiences reported in young adulthood. Results Three latent classes of childhood traumatic experiences were supported by the data. One class (8% of sample), primarily female, was characterized by experiences of sexual assault and reported significantly higher rates of a range of psychiatric outcomes by young adulthood. Another class (8%), primarily male, was characterized by experiences of violence exposure and reported higher levels of antisocial personality disorder and post-traumatic stress. The final class (84%) reported low levels of childhood traumatic experiences. Parental psychopathology was related to membership in the sexual assault group. Conclusions Classes of childhood traumatic experiences predict specific psychiatric and behavioral outcomes in adolescence and young adulthood. The long-term adverse effects of childhood traumas are primarily concentrated in victims of sexual and non-sexual violence. Gender emerged as a key covariate in the classes of trauma exposure and outcomes.",0 +https://doi.org/10.1080/15299730802223362,Relations Among Peritraumatic Dissociation and Posttraumatic Stress: A Critical Review,"This paper critically reviews the empirical literature addressing the relationship of peritraumatic dissociation to posttraumatic stress. PSYCHLIT and MEDLINE literature searches were conducted to identify relevant studies. The list of articles generated was supplemented by a review of their bibliographies, which resulted in a total of 53 empirical studies. These studies were classified according to the type of potentially traumatizing event investigated and discussed. In the majority of studies, evidence was found for a positive association between peritraumatic dissociation and posttraumatic stress. However, research in this area is limited by several methodological differences and shortcomings with respect to study design, sample characteristics, measurement instruments, and control for moderating or mediating variables. In addition, research is also limited by conceptual problems and the lack of specific time parameters for the occurrence of peritraumatic dissociation. The literature is evaluated according to these methodological differences or shortcomings, and directions for future research are provided.",0 +https://doi.org/10.1002/14651858.cd000560,Psychological debriefing for preventing post traumatic stress disorder (PTSD),"Over approximately the last last fifteen years early psychological interventions such as psychological 'debriefing' have been increasingly used to treat psychological trauma. While these intervention have become popular and their use spread to several settings - efficacy had largely not been tested emprically. In 1997 a systmatic review of single session psychological ""debriefing"" was undertaken and this subsequently became a protocol and Cochrane Review published in 1998 (Issue2). This update forms the first substantive update of the original review.To assess the effectiveness of brief psychological debriefing for the management of psychological distress after trauma, and the prevention of post traumatic stress disorder.Electronic searching of MEDLINE, EMBASE, PsychLit, PILOTS, Biosis, Pascal, Occ. Safety and Health,SOCIOFILE, CINAHL, PSYCINFO, PSYNDEX, SIGLE, LILACS, CCTR, CINAHL, NRR, Hand search of Journal of Traumatic Stress. Contact with leading researchers.The inclusion criteria for all randomized studies was that they should focus on persons recently (one month or less) exposed to a traumatic event, should consist of a single session only, and that the intervention involve some form of emotional processing/ventilation by encouraging recollection/reworking of the traumatic event accompanied by normalisation of emotional reaction to the event.11 trials fulfilled the inclusion criteria. Quality was generally poor. Data from two trials could not be synthesised. Two trials involved the use of the intervention in an obstetric setting.Single session individual debriefing did not reduce psychological distress nor prevent the onset of post traumatic stress disorder (PTSD). Those who received the intervention showed no significant short term (3-5 months) in the risk of PTSD (odds ratio 1.22 (95% ci 0.60 to 2.46 )). At one year one trial reported that there was a significantly increased risk of PTSD in those receiving debriefing (odds ratio 2.88 (1.11 to 7.53))odds ratio 95%). There was also no evidence that debriefing reduced general psychological morbidity, depression or anxiety.There is no current evidence that psychological debriefing is a useful treatment for the prevention of post traumatic stress disorder after traumatic incidents. Compulsory debriefing of victims of trauma should cease.",0 +https://doi.org/10.1136/bmjopen-2013-003442,"Trajectories of recovery among homeless adults with mental illness who participated in a randomised controlled trial of Housing First: a longitudinal, narrative analysis","This study used longitudinal, narrative data to identify trajectories of recovery among homeless adults with mental illness alongside the factors that contribute to positive, negative, mixed or neutral trajectories over time. We expected that participants who received Housing First (HF) would describe more positive trajectories of recovery than those who were assigned to Treatment as Usual (TAU; no housing or support provided through the study).Narrative interview data were collected from participants at baseline and 18 months after random assignment to HF or TAU.Participants were sampled from the community in Vancouver, British Columbia.Fifty-four participants were randomly and purposively selected from the larger trial; 52 were interviewed at baseline and 43 were reinterviewed 18 months after randomisation.Semistructured interviews were conducted at both time points. For each participant, paired baseline and follow-up narratives were classified as positive, negative, mixed or neutral trajectories of recovery, and thematic analysis was used to identify the factors underlying different trajectories.Participants assigned to HF (n=28) were generally classified as positive or mixed trajectories; those assigned to TAU (n=15) were generally classified as neutral or negative trajectories. Positive trajectories were characterised by a range of benefits associated with good-quality, stable housing (eg, reduced substance use, greater social support), positive expressions of identity and the willingness to self-reflect. Negative, neutral and mixed trajectories were characterised by hopelessness ('things will never get better') related to continued hardship (eg, eviction, substance use problems), perceived failures and loss.HF is associated with positive trajectories of recovery among homeless adults with mental illness. Those who did not receive housing or support continued to struggle across a wide range of life domains. Findings are discussed with implications for addressing services and broader social change in order to benefit this marginalised population.",0 +https://doi.org/10.1080/13607863.2011.615740,Posttraumatic stress disorder and its comorbidity with depression and somatisation in the elderly – A German community-based study,"Even 60 years after World War II, the German elderly population is significantly more often affected by posttraumatic symptomatology compared to the younger cohorts. This study is addressing prevalence rates of posttraumatic symptomatology and its comorbidity with depression and somatisation.This study examines posttraumatic stress disorder (PTSD) according to DSM-IV, partial PTSD, depression and somatisation in a randomly selected sample of the German general population aged 60-85 years (N = 1.659) using self-rating instruments (Patient Health Questionnaire, PHQ; Post Traumatic Diagnostic Scale, PTDS).One-month prevalence rate was 4.0% for DSM-IV PTSD; another 12.2% fulfilled the criteria of partial PTSD. A significant increase across the age groups was found for partial PTSD. 11.5% of the persons affected by posttraumatic symptomatology fulfil the criteria of a somatoform syndrome, 8.6% fulfil the criteria of major depression and 10.4% fulfil the criteria of other depressive syndromes according to the PHQ. A current posttraumatic symptomatology is associated with increased prevalence rates of somatoform and depressive disorders. Moreover, traumatic experiences without a current PTSD are associated with increased rates of somatoform disorders.Posttraumatic symptomatology is a common phenomenon in the German elderly population. Especially, subsyndromal disorders are very common and increasing across the age groups. Posttraumatic symptomatology is associated with an increased risk of depressive and somatoform disorders. As posttraumatic symptoms are often neglected in geriatric health care, future effort should address the recognition and treatment of posttraumatic symptoms in elderly patients.",0 +https://doi.org/10.1097/00004714-199802000-00003,"An Open Trial of Paroxetine in Patients With Noncombat-Related, Chronic Posttraumatic Stress Disorder","The symptom overlap between posttraumatic stress disorder (PTSD) and other pharmacotherapy-responsive disorders suggests that pharmacotherapy might be effective. Nevertheless, of the eight published placebo-controlled trials investigating the pharmacotherapy of PTSD, only four found statistically significant efficacy for the treatment being studied. This literature possesses a number of methodologic limitations, including the fact that most studies have been conducted with war veterans, who may constitute a more treatment-refractory population. Several open trials and one controlled trial with selective serotonin reuptake inhibitors have reported improvement in some or all core PTSD symptoms (reexperiencing, avoidance, numbing, and hyperarousal). The authors hypothesized that paroxetine might be effective in PTSD, based on findings of its particular efficacy for anxiety and agitation in studies of depressed patients. The study presented here summarizes a 12-week, open-label trial of paroxetine among patients with noncombat-related, chronic PTSD. Outcome was assessed by an independent evaluator, the treating physician, and the patient, with the use of established rating scales for depression, anxiety, general symptoms, and PTSD core symptoms. A repeated-measures analysis of variance revealed highly significant improvement in all three symptom clusters, as well as in associated anxiety, depressive, and dissociative symptoms, with 11 of 17 (65%) patients rated as much or very much improved. The mean reduction in PTSD symptom scores was 48%. Exploratory analyses revealed that cumulative childhood trauma was negatively correlated with pharmacotherapy response (r = -0.52, p = 0.03). There was also significant variation in the time course of response across symptom clusters, which is suggestive of multiple mechanisms of response. Because paroxetine seems a highly promising treatment for all three symptom clusters of PTSD, a placebo-controlled clinical trial is warranted.",0 +https://doi.org/10.2989/17280580609486614,The management of traumatic stress disorder in infants,"The number of very young children exposed to trauma is under-represented. Trauma interferes with the organisation and development of brain structures and thus may have lasting effects on the individual's life. Traumatic stress disorder (TSD), which is the Axis I diagnosis used in the under-three patient population, encompasses four symptom clusters. Of note is the integral part of the Relationship Disorder Classification (Axis II) during this phase of life. The capacities needed to experience and recall early trauma are largely present from the beginning of life and rapidly develop during the first six months. The treatment of traumatic stress disorder rests on establishing a sense of safety, reducing the overwhelming affects evoked, helping the child to form a coherent narrative and thereby aiding the integration and psychological mastery of the traumatic event. The support of the attachment relationship with an adequate caregiver is pivotal.",0 +https://doi.org/10.1177/1087054714522512,The Neuropsychological Profile of Comorbid Post-Traumatic Stress Disorder in Adult ADHD,"Objective: ADHD and post-traumatic stress disorder (PTSD) are often comorbid yet despite the increased comorbidity between the two disorders, to our knowledge, no data have been published regarding the neuropsychological profile of adults with comorbid ADHD and PTSD. Likewise, previous empirical studies of the neuropsychology of PTSD did not control for ADHD status. We sought to fill this gap in the literature and to assess the extent to which neuropsychological test performance predicted psychosocial functioning, and perceived quality of life. Method: Participants were 201 adults with ADHD attending an outpatient mental health clinic between 1998 and 2003 and 123 controls without ADHD. Participants completed a large battery of self-report measures and psychological tests. Diagnoses were made using data obtained from structured psychiatric interviews (i.e., Structured Clinical Interview for DSM-IV, Schedule for Affective Disorders and Schizophrenia for School-Age Children Epidemiologic Version). Results: Differences emerged between control participants and participants with ADHD on multiple neuropsychological tests. Across all tests, control participants outperformed participants with ADHD. Differences between the two ADHD groups emerged on seven psychological subtests including multiple Wechsler Adult Intelligence Scale—Third edition and Rey-Osterrieth Complex Figure Test measures. These test differences did not account for self-reported quality of life differences between groups. Conclusion: The comorbidity with PTSD in adults with ADHD is associated with weaker cognitive performance on several tasks that appear related to spatial/perceptual abilities and fluency. Neuropsychological test performances may share variance with the quality of life variables yet are not mediators of the quality of life ratings.",0 +https://doi.org/10.1076/jcen.23.6.754.1021,Depression and Posttraumatic Stress Disorder at Three Months After Mild to Moderate Traumatic Brain Injury,"To investigate the frequency and risk factors of major depressive disorder (MDD) after mild to moderate traumatic brain injury (TBI), 69 TBI and 52 general trauma (GT) patients were prospectively recruited and studied at 3-months postinjury. There was a nonsignificant difference in the proportion of MDD patients in the TBI and GT groups. Therefore, a composite MDD group (TBI and GT patients) was compared to patients who were nondepressed. Female gender was related to MDD, but no other risk factors were identified. MDD was associated with disability (Glasgow Outcome Scale, Community Integration Questionnaire) and cognitive impairment. MDD was comorbid with posttraumatic stress disorder. Implications for postacute management of mild to moderate TBI are discussed.",0 +https://doi.org/10.1016/j.nlm.2014.01.003,Executive function in posttraumatic stress disorder (PTSD) and the influence of comorbid depression,"Posttraumatic stress disorder (PTSD) has been associated with neurocognitive deficits, such as impaired verbal memory and executive functioning. Less is known about executive function and the role of comorbid depression in PTSD. Recently, studies have shown that verbal memory impairments may be associated with comorbid depressive symptoms, but their role in executive function impairments is still unclear. To examine several domains of executive functioning in PTSD and the potentially mediating role of comorbid depressive symptoms in the relationship between executive function and PTSD. Executive functioning was assessed in 28 PTSD patients and 28 matched trauma-exposed controls. The Cambridge Neuropsychological Test Automated Battery (CANTAB) with subtests measuring response inhibition (SST), flexibility/set shifting (IED), planning/working memory (OTS) and spatial working memory (SWM) was administered in PTSD patients and trauma-exposed controls. Regression analyses were used to assess the predictive factor of PTSD symptoms (CAPS) and depressive symptoms (HADS-D) in relation to executive function when taking into account the type of trauma. Pearson’s correlations were used to examine the association between PTSD symptom clusters (CAPS) and executive function. The mediating effects of depression and PTSD were assessed using regression coefficients and the Sobel’s test for mediation. Our findings indicate that PTSD patients performed significantly worse on executive function than trauma-exposed controls in all domains assessed. PTSD symptoms contributed to executive functioning impairments (SST median correct, IED total errors, OTS latency to correct, SWM total errors and SWM strategy). Adding depressive symptoms to the model attenuated these effects. PTSD symptom clusters ‘numbing’ and to a lesser extent ‘avoidance’ were more frequently associated with worse executive function (i.e., IED total errors, OTS latency to correct and SWM total errors) than ‘reexperiencing’ and ‘hyperarousal’. Depressive symptoms mediated the relation between PTSD and executive function on some executive function measures (IED total errors and OTS latency to correct), whereas PTSD did not mediate the relation between depression and executive function. PTSD patients perform worse on executive function. The impairments seem to be mostly associated with the less specific PTSD symptom cluster of ‘numbing’. Depressive symptoms seem to mediate the relationship between PTSD and executive function. These findings may have clinical implications with regard to treatment indication and prognosis.",0 +https://doi.org/10.1016/j.neuroscience.2014.08.037,Stress-induced neuroplasticity: (Mal)adaptation to adverse life events in patients with PTSD – A critical overview,"Stress is an adaptive response to demands of the environment and thus essential for survival. Exposure to stress triggers hypothalamic-pituitary-adrenocortical (HPA) axis activation and associated neurochemical reactions, following glucocorticoid release from the adrenal glands, accompanied by rapid physiological responses. Stimulation of this pathway results in the activation of specific brain regions, including the hippocampus, amygdala and prefrontal cortex which are enriched with glucocorticoid receptors (GRs). Recent findings indicate that the activation of GRs mediates the regulation of the brain-derived neurotrophic factor (BDNF). BDNF is crucial for neural plasticity, as it promotes cellular growth and synaptic changes. Hence stress-induced activation of these pathways leads to neuroplastic changes, including the formation of long-lasting memories of the experiences. As a consequence, organisms can learn from stressful events and respond in an adaptive manner to similar demands in the future. Whereas an optimal stress level leads to enhancement of memory performance, the exposure to extreme, traumatic or chronic stressors is a risk factor for psychopathologies which are associated with memory impairment and cognitive deficits such as posttraumatic stress disorder (PTSD). In this review article, we will outline the implications of stress exposure on memory formation involving the role of glucocorticoids and BDNF. Within this context, potential adverse effects of neuroplastic alterations will be discussed using the example of PTSD.",0 +https://doi.org/10.1017/s0033291707001432,Effects of psychotherapy on regional cerebral blood flow during trauma imagery in patients with post-traumatic stress disorder: a randomized clinical trial,"Background Functional brain-imaging studies in post-traumatic stress disorder (PTSD) have suggested functional alterations in temporal and prefrontal cortical regions. Effects of psychotherapy on these brain regions have not yet been examined. Method Twenty civilian PTSD out-patients and 15 traumatized control subjects were assessed at baseline using psychometric ratings. Cerebral blood flow was measured using trauma script-driven imagery during 99m technetium hexamethyl-propylene-amine-oxime single-photon emission computed tomography scanning. All 20 out-patients were randomly assigned to treatment or wait-list conditions. Treatment was brief eclectic psychotherapy (BEP) in 16 weekly individual sessions. Results At baseline, greater activation was found in the right insula and right superior/middle frontal gyrus in the PTSD group than in the control group. PTSD patients treated with BEP significantly improved on all PTSD symptom clusters compared to those on the waiting list. After effective psychotherapy, lower activation was measured in the right middle frontal gyrus, compared to the PTSD patients on the waiting list. Treatment effects on PTSD symptoms correlated positively with activation in the left superior temporal gyrus, and superior/middle frontal gyrus. Conclusions BEP induced clinical recovery in PTSD patients, and appeared to modulate the functioning of specific PTSD-related sites in the prefrontal cortical regions.",0 +https://doi.org/10.1016/j.socscimed.2014.03.015,Posttraumatic stress in emergency settings outside North America and Europe: A review of the emic literature,"Mental health professionals from North America and Europe have become common participants in postconflict and disaster relief efforts outside of North America and Europe. Consistent with their training, these practitioners focus primarily on posttraumatic stress disorder (PTSD) as their primary diagnostic concern. Most research that has accompanied humanitarian aid efforts has likewise originated in North America and Europe, has focused on PTSD, and in turn has reinforced practitioners' assumptions about the universality of the diagnosis. In contrast, studies that have attempted to identify how local populations conceptualize posttrauma reactions portray a wide range of psychological states. We review this emic literature in order to examine differences and commonalities across local posttraumatic cultural concepts of distress (CCDs). We focus on symptoms to describe these constructs - i.e., using the dominant neo-Kraepelinian approach used in North American and European psychiatry - as opposed to focusing on explanatory models in order to examine whether positive comparisons of PTSD to CCDs meet criteria for face validity. Hierarchical clustering (Ward's method) of symptoms within CCDs provides a portrait of the emic literature characterized by traumatic multifinality with several common themes. Global variety within the literature suggests that few disaster-affected populations have mental health nosologies that include PTSD-like syndromes. One reason for this seems to be the almost complete absence of avoidance as pathology. Many nosologies contain depression-like disorders. Relief efforts would benefit from mental health practitioners getting specific training in culture-bound posttrauma constructs when entering settings beyond the boundaries of the culture of their training and practice.",0 +https://doi.org/10.1097/01.nmd.0000252135.25114.02,Profiling Posttraumatic Functional Impairment,"Many individuals who have been exposed to psychological trauma suffer from impaired functioning, regardless of whether they have PTSD. Our purpose was to identify a subset of PTSD symptoms linked to functional impairment to a) improve the likelihood that individuals with posttraumatic impairment receive treatment, and b) offer a method to assess cost-burden of trauma history in epidemiological studies. We examined patterns of trauma-related symptoms in two independent community surveys (N=1002 and 630). Rank ordering of symptoms and their associations with impairment guided construction of an impairment-related profile in the first data set. The profile was then tested in the second data set. The derived symptom profile, consisting of intense recollections and/or emotional symptoms upon exposure to reminders, plus one or more of numbing/detachment, avoidance, sleep problems, concentration problems, or hypervigilance, detected the majority (88% and 74%) of persons with posttraumatic functional impairment. The symptom profile can help identify traumatized individuals who may benefit from treatment but do not necessarily meet criteria for PTSD.",0 +https://doi.org/10.1023/b:joba.0000007455.08539.94,"Multidimensional Assessment of Emotion Regulation and Dysregulation: Development, Factor Structure, and Initial Validation of the Difficulties in Emotion Regulation Scale","Given recent attention to emotion regulation as a potentially unifying function of diverse symptom presentations, there is a need for comprehensive measures that adequately assess difficulties in emotion regulation among adults. This paper (a) proposes an integrative conceptualization of emotion regulation as involving not just the modulation of emotional arousal, but also the awareness, understanding, and acceptance of emotions, and the ability to act in desired ways regardless of emotional state; and (b) begins to explore the factor structure and psychometric properties of a new measure, the Difficulties in Emotion Regulation Scale (DERS). Two samples of undergraduate students completed questionnaire packets. Preliminary findings suggest that the DERS has high internal consistency, good test-retest reliability, and adequate construct and predictive validity.",0 +https://doi.org/10.1111/maq.12204,The “Thinking a Lot” Idiom of Distress and PTSD: An Examination of Their Relationship among Traumatized Cambodian Refugees Using the “Thinking a Lot” Questionnaire,"“Thinking a lot” (TAL)—also referred to as “thinking too much”—is a key complaint in many cultural contexts, and the current article profiles this idiom of distress among Cambodian refugees. The article also proposes a general model of how TAL generates various types of distress that then cause PTSD-type psychopathology, a model we refer to as the TAL–PTSD model. As tested in this Cambodian refugee sample, the model is supported by the following: (1) the close connection of TAL to PTSD as shown by odds ratio (OR = 19.6), correlation (r = .86), and factor loading; and (2) the mediation of most of the effect of TAL on PTSD by TAL-caused somatic symptoms, catastrophic cognitions, trauma recall, insomnia, and irritability. The questionnaire used in the present study is provided and can be used to examine TAL in other cultural and global contexts to advance the study of this commonly encountered distress form. [idioms of distress, “thinking a lot,” “thinking too much,” Cambodian refugees, PTSD]",0 +https://doi.org/10.1001/archpediatrics.2007.36,Impact of Conjoined Exposure to the World Trade Center Attacks and to Other Traumatic Events on the Behavioral Problems of Preschool Children,"To examine the long-term behavioral consequences of exposure to the World Trade Center (WTC) attacks in preschool children and to evaluate whether conjoined exposure to disaster and to other traumatic events has additive effects.Retrospective cohort study.Lower Manhattan, New York.A total of 116 preschool children directly exposed to the WTC attacks. Main Exposures High-intensity WTC attack-related trauma exposure indexed by the child experiencing 1 or more of the following: seeing people jumping out of the towers, seeing dead bodies, seeing injured people, witnessing the towers collapsing, and lifetime history of other trauma exposure. Main Outcome Measure Clinically significant behavioral problems as measured using the Child Behavioral Checklist.Preschool children exposed to high-intensity WTC attack-related events were at increased risk for the sleep problems and anxious/depressed behavioral symptom clusters. Conjoined exposure to high-intensity WTC attack-related events and to other trauma was associated with clinically significant emotionally reactive, anxious/depressed, and sleep-related behavioral problems. Children without a conjoined lifetime history of other trauma did not differ from nonexposed children. Risk of emotionally reactive, anxious/depressed, and attention problems in preschool children exposed to conjoined high-intensity WTC attack-related events and other trauma increased synergistically.Conjoined other trauma exposure seems to amplify the impact of high-intensity WTC attack-related events on behavioral problems. Preschool children exposed to high-intensity events who had no other trauma exposure did not have increased clinically significant behavioral problems. The additive effects of trauma exposure are consistent with an allostatic load hypothesis of stress. More vigorous outreach to trauma-exposed preschool children should become a postdisaster public health priority.",0 +,Sertraline treatment of comorbid posttraumatic stress disorder and alcohol dependence.,"Posttraumatic stress disorder (PTSD) often co-occurs with alcohol dependence, yet little is known about treatment of this comorbidity. The serotonin selective reuptake inhibitors have been shown preliminarily to be effective in decreasing symptoms of PTSD but have not been studied in individuals with comorbid alcohol dependence. This is of particular interest as the SSRIs also have a modest effect in decreasing alcohol consumption.In this preliminary trial, nine subjects with comorbid PTSD and alcohol dependence were treated in an open-label trial with sertraline for a 12-week period. Symptoms of PTSD and depression were monitored monthly with the Impact of Event Scale and the Hamilton Rating Scale for Depression (HAM-D). Alcohol consumption was monitored by a self-report instrument (Time-Line Follow-Back).There were significant decreases in all three symptom clusters of PTSD measured by overall PTSD symptom scores (p < or = .001) and in HAM-D scores (p < or = .001) during the follow-up period. Days of abstinence increased and average number of drinks decreased during the follow-up period. Four subjects claimed total abstinence during the follow-up period.While limited by small sample size and the open-label, nonblinded study design, this study suggests that sertraline may be useful in the treatment of PTSD complicated by alcoholism. The medication was well tolerated and subjects showed improvement in PTSD symptoms as well as decreased alcohol consumption. A controlled trial of sertraline in this population would be of interest.",0 +https://doi.org/10.1002/jts.20342,A group randomized trial of critical incident stress debriefing provided to U.S. peacekeepers,"In a group randomized trial of critical incident stress debriefing (CISD) with platoons of 952 peacekeepers, CISD was compared with a stress management class (SMC) and survey-only (SO) condition. Multilevel growth curve modeling found that CISD did not differentially hasten recovery compared to the other two conditions. For those soldiers reporting the highest degree of exposure to mission stressors, CISD was minimally associated with lower reports of posttraumatic stress and aggression (vs. SMC), higher perceived organizational support (vs. SO), and more alcohol problems than SMC and SO. Soldiers reported that they liked CISD more than the SMC, and CISD did not cause undue distress.",0 +https://doi.org/10.1007/978-1-4614-9354-9_14,Disaster Aid Distribution and Social Conflicts,"Mainstream psychological coping theories that are predominantly individualistic and apolitical tend to neglect diverging interests and social conflicts. Sociological approaches to social conflicts and their resolution and social capital approaches are able to capture these universal features of post-disaster contexts. However, socioculturally distinctive features, specific imbalances of power, and diverging personal and shared ways of dealing with disasters and related aid probably contribute to a locally specific way of coping with disaster aid goods and associated social conflicts. For instance, does the social standard for maintaining harmony (rukun) counter the development of social bitterness? In what way may it hinder resolutions of social conflicts? This chapter explores contributing elements of conflict dynamics and subsequently demonstrates the variety of ways of coping with conflicts. Identified coping styles ranged on a continuum with confrontational, clarifying, and direct (assimilative) strategies on one pole, subversive strategies in the middle, and indirect, accommodative, accepting strategies on the other pole. Several situational elements, such as sense of entitlement, social standing within the community as well as timing issues, that is, the probability of whether justice may still be achieved or not in the short or long term, seemed to moderate which strategy is enacted. © 2014 Springer Science+Business Media, LLC. All rights are reserved.",0 +https://doi.org/10.1016/j.cpr.2011.03.001,Building child trauma theory from longitudinal studies: A meta-analysis,"Many children are exposed to traumatic events, with potentially serious psychological and developmental consequences. Therefore, understanding development of long-term posttraumatic stress in children is essential. We aimed to contribute to child trauma theory by focusing on theory use and theory validation in longitudinal studies. Forty studies measuring short-term predictors and long-term posttraumatic stress symptoms were identified and coded for theoretical grounding, sample characteristics, and correlational effect sizes. Explicit theoretical frameworks were present in a minority of the studies. Important predictors of long-term posttraumatic stress were symptoms of acute and short-term posttraumatic stress, depression, anxiety, and parental posttraumatic stress. Female gender, injury severity, duration of hospitalization, and elevated heart rate shortly after hospitalization yielded small effect sizes. Age, minority status, and socioeconomic status were not significantly related to long-term posttraumatic stress reactions. Since many other variables were not studied frequently enough to compute effect sizes, existing theoretical frameworks could only be partially confirmed or falsified. Child trauma theory-building can be facilitated by development of encouraging journal policies, the use of comparable methods, and more intense collaboration.",0 +https://doi.org/10.1111/cp.12043,Development of the Arabic versions of the Impact of Events Scale‐Revised and the Posttraumatic Growth Inventory to assess trauma and growth in Middle Eastern refugees in Australia,The current study reports on the development of an Arabic version of the Revised version of the Impact of Events Scale (IES‐R). The IES‐R was developed to assist in exploring the relationship betwe...,0 +https://doi.org/10.1177/0193945910371215,Personal Growth After Severe Fetal Diagnosis,"The traumatic aspects of positive diagnosis of a severe fetal anomaly have garnered the most attention, but the personal growth in the aftermath of this event remains relatively unexplored. We used the five dimensions of growth and change from Posttraumatic Growth Inventory (PTGI) to analyze data generated from ethnographic interviews conducted with 15 women and 10 of their male partners in the aftermath of a severe fetal diagnosis. Eighteen (12 women and 6 men) of these 25 participants experienced positive change across these dimensions. Relating to others was the dimension that showed the most consistent early and prolonged change. Six of the 10 couples had congruent profiles of change. Negative change was evident in 2 women and 2 men. Recognizing the potential for growth allows nurses opportunities to promote it in the aftermath of severe fetal diagnosis.",0 +https://doi.org/10.1046/j.1440-1614.2002.00996.x,Dysregulation of the Right Brain: A Fundamental Mechanism of Traumatic Attachment and the Psychopathogenesis of Posttraumatic Stress Disorder,"This review integrates recent advances in attachment theory, affective neuroscience, developmental stress research, and infant psychiatry in order to delineate the developmental precursors of posttraumatic stress disorder.Existing attachment, stress physiology, trauma, and neuroscience literatures were collected using Index Medicus/Medline and Psychological Abstracts. This converging interdisciplinary data was used as a theoretical base for modelling the effects of early relational trauma on the developing central and autonomic nervous system activities that drive attachment functions.Current trends that integrate neuropsychiatry, infant psychiatry, and clinical psychiatry are generating more powerful models of the early genesis of a predisposition to psychiatric disorders, including PTSD. Data are presented which suggest that traumatic attachments, expressed in episodes of hyperarousal and dissociation, are imprinted into the developing limbic and autonomic nervous systems of the early maturing right brain. These enduring structural changes lead to the inefficient stress coping mechanisms that lie at the core of infant, child, and adult posttraumatic stress disorders.Disorganised-disoriented insecure attachment, a pattern common in infants abused in the first 2 years of life, is psychologically manifest as an inability to generate a coherent strategy for coping with relational stress. Early abuse negatively impacts the developmental trajectory of the right brain, dominant for attachment, affect regulation, and stress modulation, thereby setting a template for the coping deficits of both mind and body that characterise PTSD symptomatology. These data suggest that early intervention programs can significantly alter the intergenerational transmission of posttraumatic stress disorders.",0 +,Analysis of neuropsychiatric adverse events during clinical trials of efavirenz in antiretroviral-naive patients: a systematic review.,"People with HIV infection have several risk factors for developing neuropsychiatric adverse events: preexisting conditions, HIV disease stage, and antiretroviral treatment. The most widely used system for assessing neuropsychiatric adverse events in clinical trials is the US Division of AIDS severity grading scale, from Grade 1 (mild) to Grade 4 (life-threatening). First-line treatment with efavirenz has been associated with higher rates of neuropsychiatric adverse events than several other antiretrovirals. A MEDLINE search identified 17 randomized clinical trials of first-line HAART with two nucleoside analogs plus efavirenz, of which 13 reported neuropsychiatric adverse events using the Grade 1-4 system. The percentage of patients with graded neuropsychiatric adverse events, and the system used for analysis, was compared across the trials. Of the 13 trials identified, there were five different methods used to report neuropsychiatric adverse events: Grade 1-4 all, Grade 1-4 drug related, Grade 2-4 all, Grade 2-4 drug related, Grade 3-4 all, Grade 3-4 drug related, and adverse events leading to discontinuation. In addition, three trials used questionnaire-based methods instead of the Division of AIDS grading system. There were a significantly higher percentage of patients with Grade 1-4 neurological or psychiatric adverse events in the efavirenz versus comparator arms in the DMP-006, TMC278-C204, and STARTMRK trials. There were generally too few patients with each individual neuropsychiatric adverse event to allow meaningful comparisons of treatment arms. There were no significant differences in Grade 3 or 4 neuropsychiatric adverse events between the treatment arms in the ACTG 5142 or 2NN trials. In summary, there is a wide range of different systems used to report neuropsychiatric adverse events in HIV clinical trials. Use of a standardized endpoint would improve the interpretability of results across clinical trials.",0 +https://doi.org/10.1001/archpsyc.55.4.317,Treatment of Posttraumatic Stress Disorder by Exposure and/or Cognitive Restructuring,"Unanswered questions from controlled studies of posttraumatic stress disorder concern the value of cognitive restructuring alone without prolonged exposure therapy and whether its combination with prolonged exposure is enhancing.In a controlled study, 87 patients with posttraumatic stress disorder of at least 6 months' duration were randomly assigned to have 10 sessions of 1 of 4 treatments: prolonged exposure (imaginal and live) alone; cognitive restructuring alone; combined prolonged exposure and cognitive restructuring; or relaxation without prolonged exposure or cognitive restructuring.Integrity of audiotaped treatment sessions was satisfactory when rated by an assessor unaware of the treatment assignment. Seventy-seven patients completed treatment. The pattern of results was similar regardless of rater, statistical method, measure, occasion, and therapist. Exposure and cognitive restructuring, singly or combined, improved posttraumatic stress disorder markedly on a broad front. Gains continued to 6-month follow-up and were significantly greater than the moderate improvement from relaxation.Both prolonged exposure and cognitive restructuring were each therapeutic on their own, were not mutually enhancing when combined, and were each superior to relaxation.",0 +https://doi.org/10.1016/j.socscimed.2014.05.042,Understanding resilience in armed conflict: Social resources and mental health of children in Burundi,"Little is known about the role of cognitive social capital among war-affected youth in low- and middle-income countries. We examined the longitudinal association between cognitive social capital and mental health (depression and posttraumatic stress disorder (PTSD) symptoms), functioning, and received social support of children in Burundi. Data were obtained from face-to-face interviews with 176 children over three measurement occasions over the span of 4-months. Cognitive social capital measured the degree to which children believed their community was trustworthy and cohesive. Mental health measures included the Depression Self-Rating Scale (DSRS) (Birleson, 1981), the Child Posttraumatic Symptom Scale (Foa et al., 2001), and a locally constructed scale of functional impairment. Children reported received social support by listing whether they received different types of social support from self-selected key individuals. Cross-lagged path analytic modeling evaluated relationships between cognitive social capital, symptoms and received support separately over baseline (T1), 6-week follow-up (T2), and 4-month follow-up (T3). Each concept was treated and analyzed as a continuous score using manifest indicators. Significant associations between study variables were unidirectional. Cognitive social capital was associated with decreased depression between T1 and T2 ( B = −.22, p < .001) and T2 and T3 ( β = −.25, p < .001), and with functional impairment between T1 and T2 ( β = −.15, p = .005) and T2 and T3 ( β = −.14, p = .005); no association was found for PTSD symptoms at either time point. Cognitive social capital was associated with increased social support between T1 and T2 ( β = .16, p = .002) and T2 and T3 ( β = .16, p = .002). In this longitudinal study, cognitive social capital was related to a declining trajectory of children's mental health problems and increases in social support. Interventions that improve community relations in war-affected communities may alter the trajectories of resource loss and gain with conflict-affected children. • Cognitive social capital was associated with less depression. • Cognitive social capital was associated with greater social support. • Change in cognitive social capital was unrelated to social support and depression. • Cognitive social capital is promising for mental health prevention and promotion.",0 +https://doi.org/10.1177/0095327x12466828,What Does National Resilience Mean in a Democracy? Evidence from the United States and Israel,"Given various challenges to national security in democracies, such as terrorism and political violence, a growing need for reconceptualization of the term “resilience” emerges. The interface between national security and resilience is rooted in individuals’ perceptions and attitudes toward institutions and leadership. Therefore, in this article, we suggest that political–psychological features form the basis of citizens’ perceived definitions of national resilience. By comparing national resilience definitions composed by citizens of two democratic countries facing national threats of war and terrorism, the United States and Israel, we found that perceived threats, optimism, and public attitudes such as patriotism and trust in governmental institutions, are the most frequent components of the perceived national resilience. On the basis of these results, a reconceptualization of the term “national resilience” is presented. This can lead to validation of how resilience is measured and provide grounds for further examination of this concept in other democratic countries.",0 +https://doi.org/10.1348/014466510x527676,Psychological adjustment one year after the diagnosis of breast cancer: A prototype study of delayed post-traumatic stress disorder,"Objective. The utilization of a post-traumatic stress disorder (PTSD) diagnostic framework for categorizing the psychological adjustment of breast cancer (BC) patients has been debated. We wanted to study the prevalence of PTSD and predictors for PTSD. Design. The current study is a one-year follow-up of 64 early BC patients. Methods. PTSD, subclinical PTSD, delayed onset PTSD and several theory-driven predictive variables were examined. Results. Thirteen per cent of the patients showed full symptoms of disease-related PTSD compared with 7% at the initial study (6 weeks after diagnosis). Considerable changes were observed in all PTSD clusters (intrusion, avoidance, and arousal), in most cases representing a decrease in symptom level. Immature defence style, emotional coping, avoidant behaviour, and negative affectivity were all implicated as predicting variables in a hierarchical multiple regression analysis which explained 65% of the variability of PTSD severity one year after diagnosis. Conclusions. This study highlights the PTSD diagnosis as being highly relevant in oncology settings. Early screening for the above-mentioned four variables may help early identification of the patients most at risk of developing PTSD.",0 +https://doi.org/10.3389/fnhum.2013.00672,Avoidant symptoms in PTSD predict fear circuit activation during multimodal fear extinction,"Convergent evidence suggests that individuals with posttraumatic stress disorder (PTSD) exhibit exaggerated avoidance behaviors as well as abnormalities in Pavlonian fear conditioning. However, the link between the two features of this disorder is not well understood. In order to probe the brain basis of aberrant extinction learning in PTSD, we administered a multimodal classical fear conditioning/extinction paradigm that incorporated affectively relevant information from two sensory channels (visual and tactile) while participants underwent fMRI scanning. The sample consisted of fifteen OEF/OIF veterans with PTSD. In response to conditioned cues and contextual information, greater avoidance symptomatology was associated with greater activation in amygdala, hippocampus, vmPFC, dmPFC, and insula, during both fear acquisition and fear extinction. Heightened responses to previously conditioned stimuli in individuals with more severe PTSD could indicate a deficiency in safety learning, consistent with PTSD symptomatology. The close link between avoidance symptoms and fear circuit activation suggests that this symptom cluster may be a key component of fear extinction deficits in PTSD and/or may be particularly amenable to change through extinction-based therapies.",0 +https://doi.org/10.1300/j146v03n01_05,Witnessing Parental Violence as a Traumatic Experience Shaping the Abusive Personality,"Summary Previous work by Dutton and his colleagues has established a clinical profile on intimately abusive adult men that is quite similar to profiles of trauma victims in many essential clinical respects. Dutton (in press) showed that arousal modulation problems, affective monitoring, cognitive problem solving deficits, externalizing attributional styles, aggression and dissociative states are common to both groups. Furthermore, intimately abusive men demonstrate similar profiles as men diagnosed independently with PTSD on the MCMI-II. Dutton (1995a, 1995b) attributed the trauma to early assaults on the self through parental shaming, accompanied by insecure attachment and physical abuse victimization. Bowlby (1973) considered insecure attachment itself both a source and consequence of trauma. Since the infant turns to the attachment-object during periods of distress seeking soothing, a failure to obtain soothing maintains high arousal and endocrine secretion. Van der Kolk (1987) considered child abuse a...",0 +https://doi.org/10.1016/j.trf.2013.08.004,The impact of motor vehicle injury on distress: Moderators and trajectories over time,"• Post-motor vehicle injury (MVI) distress increased over time, particularly for men. • Pre-MVI distress predicted post-MVI distress. • The link between pre-MVI alcohol and post-MVI distress varied with pre-MVI distress. • Those with partners experienced less distress than the unpartnered. Research reveals that motor vehicle injuries (MVIs) can result in severe and debilitating psychological distress. Yet, not every person who has sustained a MVI suffers psychologically. It appears that risk of distress varies by demographic and psychosocial characteristics. The present study aimed to explore the trajectories of post-MVI distress and the effect of pre-MVI psychological functioning on post-MVI distress. Hierarchical linear modeling was used to explore the longitudinal dataset from the Canadian National Population Health Survey. Participants were assessed up to nine years post-MVI. Post-MVI distress increased over time. Men experienced greater overall distress than women and a greater increase in distress over time. Pre-MVI distress predicted post-MVI distress. This relationship was strongest for those with greater pre-MVI alcohol consumption. At low levels of pre-MVI distress, greater pre-MVI alcohol consumption was related to lower post-MVI distress, but at high levels of pre-MVI distress, greater pre-MVI alcohol consumption predicted increased post-MVI distress. Those with partners experienced less distress than the unpartnered. This study supports the general findings of other post-MVI and post-trauma studies, although the current study’s main and interaction effects reveal more complex and nuanced relationships among variables in their prediction of post-MVI psychological distress.",0 +https://doi.org/10.1016/j.jpain.2015.06.010,Paradoxical Pain Perception in Posttraumatic Stress Disorder: The Unique Role of Anxiety and Dissociation,"Posttraumatic stress disorder (PTSD) and chronic pain often co-occur and exacerbate each other. Elucidating the mechanism of this co-occurrence therefore has clinical importance. Previously, patients with PTSD with chronic pain were found to demonstrate a unique paradoxical pain profile: hyperresponsiveness together with hyposensitivity to pain. Our aim was to examine whether 2 seemingly paradoxical facets of PTSD (anxiety and dissociation) underlie this paradoxical profile. Patients with PTSD (n = 32) and healthy control individuals (n = 43) underwent psychophysical testing and completed questionnaires. Patients with PTSD had higher pain thresholds and higher pain ratings to suprathreshold stimuli than control individuals. Pain thresholds were positively associated with dissociation levels and negatively associated with anxiety sensitivity levels. Experimental pain ratings were positively associated with anxiety sensitivity and negatively related to dissociation levels. Chronic pain intensity was associated with anxiety, anxiety sensitivity, and pain catastrophizing. It appears that reduced conscious attention toward incoming stimuli, resulting from dissociation, causes delayed response in pain threshold measurement, whereas biases toward threatening stimuli and decreased inhibition, possibly caused by increased anxiety, are responsible for the intensification of experimental and chronic pain. The paradoxical facets of PTSD and their particular influences over pain perception seem to reinforce the coexistence of PTSD and chronic pain, and should be considered when treating traumatized individuals.This article provides new information regarding the underlying mechanism of the coexistence of PTSD and chronic pain. This knowledge could help to provide better management of PTSD and chronic pain among individuals in the aftermath of trauma.",0 +https://doi.org/10.14718/acp.2014.17.1.9,Afectaciones psicológicas de niños y adolescentes expuestos al conflicto armado en una zona rural de Colombia.,"Se determinaron las afectaciones psicológicas de 284 niños y adolescentes expuestos al conflicto armado en una zona rural colombiana, seleccionados mediante un muestreo aleatorio por afijación proporcional. Los instrumentos aplicados fueron: la Lista de chequeo de comportamiento infantil, el Auto-reporte de comportamientos de jóvenes, la Lista de síntomas postraumáticos, la Escala de estrategias de afrontamiento para adolescentes y la Escala de resiliencia para escolares. El 72% de la población presentó afectaciones psicológicas: el 64.4%, conductas internalizadas, el 47%, conductas externalizadas en rango clínico. El 32%, problemas somáticos; el 56%, se encontraba en riesgo de estrés postraumático, y el 93% consumía alcohol en grado moderado. La estrategia de afrontamiento más utilizada era dejar que las cosas se arreglaran solas. Se encontró una alta necesidad de atención en salud. Ser hombre constituyó un factor de riesgo de depresión, agresión y problemas sociales en los niños. A su vez, tener hasta doce años y estar cursando un grado escolar bajo, lo fue para los síntomas somáticos en adolescentes. Los resultados evidenciaron la afectación en la salud mental de los participantes.",0 +https://doi.org/10.1080/15374416.2015.1012722,Changes in PTSD and Depression During Prolonged Exposure and Client-Centered Therapy for PTSD in Adolescents,"Depressive symptoms are common among individuals with posttraumatic stress disorder (PTSD). Prolonged exposure therapy (PE) for PTSD has been found to alleviate both PTSD and depressive symptoms, but relatively little is known about the pattern of PTSD and depressive symptom change during treatment. This study aimed to investigate the relationship between changes in PTSD and depression during PE for adolescent (PE-A) and client-centered therapy (CCT). The moderating role of PE-A versus CCT and the possible differences across symptom clusters of PTSD were also examined. Participants were 61 female adolescents with sexual-assault-related PTSD randomized to PE-A (n = 31) or CCT (n = 30). Participants completed the Beck Depression Inventory and the Child PTSD Symptom Scale at pre-, mid-, and posttreatment and before each treatment session. Multilevel mediation analysis indicated a reciprocal but asymmetrical relationship between changes in PTSD and depression during treatment in the overall sample. Moderated mediation analysis showed that the reciprocal relation was observed only during PE-A. Reductions in PTSD led to reductions in depression to a greater extent (48.7%), 95% confidence interval [30.2, 67.2], than vice versa (22.0%), [10.6, 33.4]. For participants receiving CCT, reduction in PTSD led to reductions in depression (31.6%), [11.8, 51.4], but not vice versa (7.4%), [-7.1, 21.9]. The reciprocal relationship between PTSD and depression was also observed across different symptoms clusters of PTSD. Our findings suggest that changes in PTSD led to changes in depressive symptoms to a greater extent than vice versa across PE-A and CCT.",0 +https://doi.org/10.1080/08039480701773329,"Traumatic impact of a fire disaster on survivors—A 25-year follow-up of the 1978 hotel fire in Borås, Sweden","The objective of this study was to investigate the long-term psychological and mental health outcomes among survivors of a disastrous hotel fire. A 25-year follow-up investigation among adolescent and young adult survivors of a fire disaster was conducted in Borås, Sweden. A self-evaluation questionnaire and four self-rating scales - the IES-22, PTSS-10, GHQ-28 and SoC - were sent by mail to the participants. The results from the self-reported data showed low levels of psychiatric illness. Moreover, the respondents reported a low level of traumatic stress symptoms. More than 50% of the participants stated that the fire had a determining effect on their lives. Sixteen (21.3%) respondents indicated that the fire still had an impact on their daily lives. Differences between men and women were reported in most of the self-rating scales. The results indicate that a traumatizing experience (such as a fire disaster) still had a small effect on psychological health in a long-term perspective.",0 +https://doi.org/10.1097/yic.0b013e3282f4b616,An evidence-based review of the clinical use of sertraline in mood and anxiety disorders,"Sertraline is a selective serotonin reuptake inhibitor that has been used and studied extensively throughout the world and found to be safe and well tolerated in numerous patient populations, including those with either psychiatric and/or medical comorbidities. Randomized clinical trials have shown that it is an effective treatment for depressive and anxiety disorders and its efficacy is unaffected by psychiatric comorbidity. In non-comorbid patients, sertraline is effective for the acute treatment of major depressive disorders and prevention of relapse or recurrence. It is effective for acute treatment and longer-term management of social anxiety disorder, posttraumatic stress disorder,panic disorder, and generalized anxiety disorder. In adults and in pediatric patients, it is an effective short-term and long-term treatment for obsessive compulsive disorder.Sertraline has a good tolerability profile and has low fatal toxicity. In summary, sertraline is as effective as other antidepressants over a wide range of indications but may offer tolerability benefits as well as efficacy in patients with psychiatric and/or medical comorbidities and certain subtypes of depression.",0 +https://doi.org/10.1016/j.janxdis.2015.03.001,The factor structure of posttraumatic stress disorder symptoms among Rwandans exposed to the 1994 genocide: A confirmatory factor analytic study using the PCL-C,"The factor structure of posttraumatic stress disorder (PTSD) symptoms in Euro-American populations has been extensively studied, but confirmatory factor analytic studies from non-Western societies are lacking. Alternative models of DSM-IV symptoms were tested among Rwandan adults (N=465) who experienced trauma during the 1994 genocide. A cluster random survey was conducted with interviews held in Rwandan households. PTSD was assessed with the Posttraumatic Stress Disorder Checklist-Civilian version. Competing models were the DSM-IV, emotional numbing, dysphoria, aroused intrusion, and dysphoric arousal models. Results showed that the emotional numbing, dysphoria, and dysphoric arousal models had almost identical, good fit indices and fit the data significantly better than the other models. The emotional numbing and dysphoric arousal models also exhibited good construct validity. Results suggest that the latent structure of PTSD symptoms in Rwanda are comparable to that found in Euro-American samples, thereby lending further support to the cross-cultural validity of the construct.",0 +https://doi.org/10.1017/dmp.2015.172,The Geography of Mental Health and General Wellness in Galveston Bay After Hurricane Ike: A Spatial Epidemiologic Study With Longitudinal Data,"To demonstrate a spatial epidemiologic approach that could be used in the aftermath of disasters to (1) detect spatial clusters and (2) explore geographic heterogeneity in predictors for mental health and general wellness.We used a cohort study of Hurricane Ike survivors (n=508) to assess the spatial distribution of postdisaster mental health wellness (most likely resilience trajectory for posttraumatic stress symptoms [PTSS] and depression) and general wellness (most likely resilience trajectory for PTSS, depression, functional impairment, and days of poor health) in Galveston, Texas. We applied the spatial scan statistic (SaTScan) and geographically weighted regression.We found spatial clusters of high likelihood wellness in areas north of Texas City and spatial concentrations of low likelihood wellness in Galveston Island. Geographic variation was found in predictors of wellness, showing increasing associations with both forms of wellness the closer respondents were located to Galveston City in Galveston Island.Predictors for postdisaster wellness may manifest differently across geographic space with concentrations of lower likelihood wellness and increased associations with predictors in areas of higher exposure. Our approach could be used to inform geographically targeted interventions to promote mental health and general wellness in disaster-affected communities.",0 +https://doi.org/10.1016/j.comppsych.2014.06.003,"Predictors of decline in overall mental health, PTSD and alcohol use in OEF/OIF veterans","This study identified predictors of worsening mental health (including PTSD and alcohol use) over a 6-month period following return from deployment to Iraq (OIF) or Afghanistan (OIF). Using a national sample of 512 OEF/OIF veterans surveyed within 12 months of return from deployment (T1), and 6 months later (T2), we obtained demographic and deployment characteristics, risk and resilience factors, mental health status, PTSD and alcohol abuse. We performed logistic regression analyses to identify predictors of worse mental health, PTSD or alcohol use between T1 and T2, controlling for initial levels. Of the sample, 14-25% showed clinically worse mental health, PTSD or alcohol use. Each outcome was associated with some shared and some unique predictors. For example, younger age and recent medical care were both associated with worse alcohol use. Lack of adequate deployment training was uniquely associated with worse PTSD symptoms.",0 +https://doi.org/10.1111/jonm.12122,Exposure to workplace bullying and post-traumatic stress disorder symptomology: the role of protective psychological resources,"To examine the relationship between nurses' exposure to workplace bullying and Post-Traumatic Stress Disorder symptomology and the protective role of psychological capital (PsyCap).Workplace bullying has serious organisational and health effects in nursing. Few studies have examined the relation of workplace bullying to serious mental health outcomes, such as Post-Traumatic Stress Disorder. Even fewer have examined the effect of intrapersonal strengths on the health impact of workplace bullying.A survey of 1205 hospital nurses was conducted to test the hypothesized model. Nurses completed standardized measures of bullying, Post-Traumatic Stress Disorder and PsyCap.A moderated regression analysis revealed that more frequent exposure to workplace bullying was significantly related to Post-Traumatic Stress Disorder symptomology regardless of the PsyCap level. That is, PsyCap did not moderate the bullying/PTSD relationship in either group. Bullying exposure and PsyCap were significant independent predictors of Post-Traumatic Stress Disorder symptoms in both groups. Efficacy, a subdimension of PsyCap, moderated the bullying/Post-Traumatic Stress Disorder relationship only among experienced nurses.Workplace bullying appears to be predictive of Post-Traumatic Stress Disorder symptomology, a serious mental health outcome.Workplace bullying is a serious threat to nurses' health and calls for programmes that eliminate bullying and encourage greater levels of positive resources among nurses.",0 +https://doi.org/10.1080/00223891.2013.819512,"Accuracy of MMPI–2–RF Validity Scales for Identifying Feigned PTSD Symptoms, Random Responding, and Genuine PTSD","The Minnesota Multiphasic Personality Inventory-2-RF (MMPI-2-RF) validity scales were evaluated to determine accuracy when differentiating honest responding, random responding, genuine posttraumatic stress disorder (PTSD), and feigned PTSD. Undergraduate students (n = 109), screened for PTSD, were randomly assigned to 1 of 4 instructional groups: honest, feign PTSD, half random, and full random. Archival data provided clinical MMPI-2-RF profiles consisting of 31 veterans diagnosed with PTSD. Veterans were diagnosed with PTSD using a structured interview and had passed a structured interview for malingering. Validity scales working as a group had correct classification rates of honest (96.6%), full random (88.9%), genuine PTSD (80.7%), fake PTSD (73.1%), and half random (44.4%). Results were fairly supportive of the scales' ability to discriminate feigning and full random responding from honest responding of normal students as well as veterans with PTSD. However, the RF validity scales do not appear to be as effective in detecting partially random responding.",0 +https://doi.org/10.1017/s0954579410000180,Trauma and resilience in young refugees: A 9-year follow-up study,"The aim of the present study was to assess and understand the long-term trajectory of psychological problems among young Middle Eastern refugees in Denmark. Participants were 131 young refugees from the Middle East (76 girls, 55 boys; mean age = 15.3 years) from 67 families. They were assessed first on arrival in Denmark in 1992-1993 and again 8-9 years later. The high prevalence of psychological problems at arrival was considerably reduced by the time of follow-up, but it was still somewhat higher than what has been found in most community studies using the same assessment tools. Groups of children differed in showing low levels of symptoms at arrival that were stable (spared) or increased (reacting) and high levels at arrival that persisted (traumatized) or decreased (adapted). The number of types of traumatic experiences before arrival distinguished the spared and the traumatized young refugees and the number of types of stressful events after arrival the adapted and the traumatized, also after corrections for age, sex, specific traumatic events, parents' education and health, and the social situation of the young refugees. The study emphasizes the importance of environmental factors for healthy long-term adaptation after traumatic experiences related to war and other organized violence.",0 +https://doi.org/10.1037/a0026361,Attendance and substance use outcomes for the Seeking Safety program: Sometimes less is more.,"This study uses data from the largest effectiveness trial to date on treatment of co-occurring posttraumatic stress and substance use disorders, using advances in statistical methodology for modeling treatment attendance and membership turnover in rolling groups.Women receiving outpatient substance abuse treatment (N = 353) were randomized to 12 sessions of Seeking Safety or a health education control condition. Assessments were completed at baseline and at 1 week, 3, 6, and 12 months posttreatment. Outcome measures were alcohol and cocaine use in the prior 30 days captured using the Addiction Severity Index. Latent class pattern mixture modeling (LCPMM) was used to estimate attendance patterns and to test for treatment effects within and across latent attendance patterns and group membership turnover.Across LCPMM analyses for alcohol and cocaine use, similar treatment attendance patterns emerged: Completers never decreased below an 80% probability of attendance, droppers never exceeded a 41% probability of attendance, and titrators demonstrated a 50% to 80% probability of attendance. Among completers, there were significant decreases in alcohol use from baseline to 1-week posttreatment, followed by nonsignificant increases in alcohol during follow-up. No differences between treatment conditions were detected. Titrators in Seeking Safety had lower rates of alcohol use from 1-week through 12-month follow-up compared with control participants. Droppers had nonsignificant increases in alcohol during both study phases. Cocaine use findings were similar but did not reach significance levels.The impact of client self-modulation of treatment dosage and group membership composition may influence behavioral treatment outcomes among this population.",0 +https://doi.org/10.1016/j.socscimed.2008.03.030,Debating war-trauma and post-traumatic stress disorder (PTSD) in an interdisciplinary arena,"Researchers have tried to determine and verify the effects of violent conflicts on the mental health of those affected by focusing on war trauma, posttraumatic stress disorder (PTSD), and other trauma-related disorders. This, in turn, led to the development of different kinds of theories and aid programs that aim at preventing and treating the consequences of violence and mental health. Until now, there is no agreement on the public health value of the concept of PTSD and no agreement on the appropriate type of mental-health care. Instead, psychiatrists have engaged in sometimes fierce discussions over the universality of war trauma, PTSD, and other trauma-related disorders. The two most polar positions are those who try to validate PTSD as a universal and cross-culturally valid psychopathological response to traumatic distress which may be cured or ameliorated with (Western) clinical and psychosocial therapeutic measures, and those who argue that the Western discourse on trauma only makes sense in the context of a particular cultural and moral framework and, therefore, becomes problematic in the context of other cultural and social settings. Although these positions seem mutually exclusive, their debates have led to the development of less radical approaches toward war-trauma and PTSD. The purpose of this literature review is to analyse the discourses on and debates over war-trauma and PTSD in the psychiatric literature in order to establish a better understanding for the diverse conceptualizations, interpretations and proposed healing strategies. Moreover, I discuss the cultural construction and conceptualization of war-trauma and PTSD from an anthropological perspective and show how anthropologists contribute to psychiatric debates so as to ensure more sophisticated diagnoses and healing strategies in culturally diverse contexts.",0 +https://doi.org/10.1007/s40653-014-0035-7,"Adolescent Adjustment, Caregiver-Adolescent Relationships, and Outlook Towards the Future in the Long-Term Aftermath of the Bosnian War","Using a mixed-method design with Bosnian students (n = 63, ages 16–19) and their primary caregivers (n = 50), we explored the impact of post-war adversities on adolescent adjustment, adolescent-caregiver relationships, and future outlook 8 years after the 1992–1995 Bosnian civil war. Adolescents and caregivers identified themes linking the war and its aftermath to ongoing emotional adjustment difficulties, relationships challenges, and negative future outlook. Adolescents’ posttraumatic stress symptoms were positively correlated with self-report measures of interpersonal stressors, existential stressors, parental psychological control, and anxious/withdrawn symptoms. Parental psychological control partially mediated the association between interpersonal post-war adversities and posttraumatic stress symptoms. © 2015, Springer International Publishing.",0 +,Elaboration on posttraumatic stress disorder diagnostic criteria: a factor analytic study of PTSD exposure to war or terror.,"In societies facing prolonged exposure to war and terror, empirical research provides mixed support for the posttraumatic stress disorder (PTSD) symptom clusters groupings identified by the Diagnostic and Statistical Manual (DSM-IV-TR) as re-experiencing the event, avoidance and emotional numbing, and hyperarousal.This study examines the validity of the PTSD symptom clusters in elements of Israeli society exposed to man-made trauma. Survivors (N=2,198) of seven different war and terror-related traumas were assessed using a DSM-IV-TR based PTSD inventory. Four confirmatory factor analytic models were compared.The most acceptable model was a correlated model consisting of four factors of re-experiencing, avoidance, emotional numbing, and hyperarousal. DSM-IV-TR avoidance empirically split into active avoidance and emotional numbing. These results corroborate knowledge and suggest that in Israel, where stressors are ongoing, the PTSD symptom clusters may be reformulated in DSM-5 to consist of re-experiencing, active avoidance, emotional numbing and hyperarousal.",0 +https://doi.org/10.1016/j.janxdis.2013.09.004,Diagnostic accuracy of three scoring methods for the Davidson Trauma Scale among U.S. military Veterans,"• Three scoring methods for the Davidson Trauma Scale were compared. • Subjects were 804 Afghanistan and Iraq war-era military Service Members and Veterans. • Adding a cut score to the symptom cluster method generally improved specificity. • Cut score in the range of 68–72 provided optimal diagnostic accuracy. Self-report questionnaires are frequently used to identify PTSD among U.S. military personnel and Veterans. Two common scoring methods used to classify PTSD include: (1) a cut score threshold and (2) endorsement of PTSD symptoms meeting DSM-IV-TR symptom cluster criteria (SCM). A third method requiring a cut score in addition to SCM has been proposed, but has received little study. The current study examined the diagnostic accuracy of three scoring methods for the Davidson Trauma Scale (DTS) among 804 Afghanistan and Iraq war-era military Service Members and Veterans. Data were weighted to approximate the prevalence of PTSD and other Axis I disorders in VA primary care. As expected, adding a cut score criterion to SCM improved specificity and positive predictive power. However, a cut score of 68–72 provided optimal diagnostic accuracy. The utility of the DTS, the role of baseline prevalence, and recommendations for future research are discussed.",0 +https://doi.org/10.1037/0022-006x.53.1.95,Social support in Vietnam veterans with posttraumatic stress disorder: A comparative analysis.,,0 +https://doi.org/10.1590/s2237-60892012000400007,"Factor structure, internal consistency and reliability of the Posttraumatic Stress Disorder Checklist (PCL): an exploratory study","Posttraumatic stress disorder (PTSD) is an anxiety disorder resulting from exposure to traumatic events. The Posttraumatic Stress Disorder Checklist (PCL) is a self-report measure largely used to evaluate the presence of PTSD.To investigate the internal consistency, temporal reliability and factor validity of the Portuguese language version of the PCL used in Brazil.A total of 186 participants were recruited. The sample was heterogeneous with regard to occupation, sociodemographic data, mental health history, and exposure to traumatic events. Subjects answered the PCL at two occasions within a 15 days' interval (range: 5-15 days).Cronbach's alpha coefficients indicated high internal consistency for the total scale (0.91) and for the theoretical dimensions of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) (0.83, 0.81, and 0.80). Temporal reliability (test-retest) was high and consistent for different cutoffs. Maximum likelihood exploratory factor analysis (EFA) was conducted and oblique rotation (Promax) was applied. The Kaiser-Meyer-Olkin (KMO) index (0.911) and Bartlett's test of sphericity (χ² = 1,381.34, p < 0.001) indicated that correlation matrices were suitable for factor analysis. The analysis yielded three symptom clusters which accounted for 48.9% of the variance, namely, intrusions, avoidance, and numbing-hyperarousal.Our findings provide additional data regarding the psychometric properties of the PCL, including internal consistency, test-retest reliability, and factor validity. Results are discussed in relation to PTSD theoretical models.",0 +https://doi.org/10.1002/da.22128,DEVELOPMENT OF A GUIDED SELF-HELP (GSH) PROGRAM FOR THE TREATMENT OF MILD-TO-MODERATE POSTTRAUMATIC STRESS DISORDER (PTSD),"There is a shortage of suitably qualified therapists able to deliver evidence-based treatment for posttraumatic stress disorder (PTSD), precluding timely access to intervention. This work aimed to develop an optimally effective, feasible, and acceptable guided self-help (GSH) program for treatment of the disorder.The study followed Medical Research Council (MRC) guidance for the development of a complex intervention. A prototype GSH program was developed through an initial modeling phase. Systematic reviews of the literature informed a portfolio of up-to-date information for key stakeholders to consider and discuss in a series of focus groups and semistructured interviews, which included 10 mental health professionals with expertise in the fields of GSH and/or PTSD, and seven former PTSD sufferers. Data were analyzed through a process of Inductive Thematic Analysis and used to inform the content, delivery, and guidance of a GSH program for PTSD. The prototype was piloted with 19 PTSD sufferers in two pilot studies, and refined on the basis of their quantitative results and qualitative feedback.The final version was available online and in hardcopy. It included 11 modules, some being mandatory and others optional, allowing tailoring of the intervention to meet an individual's specific needs. Qualitative and quantitative results of the pilot studies supported its efficacy in terms of reducing traumatic stress symptoms and its acceptability to PTSD sufferers.Delivering psychological treatment in a GSH format shows promise as an effective and acceptable way of treating mild-to-moderate PTSD.",0 +https://doi.org/10.1207/s15327876mp1602_2,"Prewar, war-zone, and postwar predictors of posttraumatic stress in female Vietnam Veteran health care providers.","Using the National Vietnam Veterans Readjustment Study database, we explored predictors of current posttraumatic stress disorder (PTSD) symptom severity in 373 female Vietnam veteran health care pr...",0 +https://doi.org/10.1093/fampra/cmq049,Post-traumatic stress disorder screening test performance in civilian primary care,"we determined the test performance characteristics of four brief post-traumatic stress disorder (PTSD) screening tests in a civilian primary care setting.this was a cross-sectional cohort study of adults attending a family medicine residency training clinic in the southeastern USA. Four hundred and eleven participants completed a structured telephone interview that followed an index clinic visit. Screening tests included: PTSD Symptom Checklist-Civilian Version (17 items), SPAN (four items), Breslau's scale (seven items) and Primary Care PTSD screen (PC-PTSD) (four items). A modified Clinician-Administered PTSD Scale was used to determine past month PTSD for comparison. Receiver operating characteristic analysis based on area under the curve (AUC) was used to assess diagnostic efficiency (>0.80 desired). Cut-off scores were selected to yield optimal sensitivity and specificity (>80%).past month PTSD was substantial (women = 35.8% and men = 20.0%; P < 0.01). AUC values were PTSD Symptom Checklist (PCL) (0.897), SPAN (0.806), Breslau's scale (0.886) and PC-PTSD (0.885). Optimal cut-scores yielded the following sensitivities and specificities: PCL (80.0% and 80.7%; cut-off = 43), SPAN (75.9% and 71.6%; cut-off = 3), Breslau's scale (84.5% and 76.4%; cut-off = 4) and PC-PTSD (85.1% and 82.0%; cut-off = 3). Overall and gender-specific screening test performances were explored.results confirm: (i) PTSD was common, especially among women; (ii) all four PTSD screening tests were diagnostically adequate; (iii) Two of four PTSD screening tests showed adequate sensitivity and specificity (>80%) and (iv) The PC-PTSD screening test (four items) appeared to be the best single screening test. There are few studies to establish the utility of PTSD screening tests within civilian primary care.",0 +https://doi.org/10.1037/a0020981,A meta-analytic investigation of the structure of posttraumatic stress disorder symptoms.,"Converging lines of evidence have called into question the validity of conceptualizations of posttraumatic stress disorder (PTSD) based on the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association, 2000) and suggested alternative structural models of PTSD symptomatology. We conducted a meta-analysis of 40 PTSD studies (N = 14,827 participants across studies) that used a DSM-based measure to assess PTSD severity. We aggregated correlation matrices across studies and then applied confirmatory factor analysis to the aggregated matrices to test the fit of competing models of PTSD symptomatology that have gained support in the literature. Results indicated that both prominent 4-factor models of PTSD symptomatology yielded good model fit across subsamples of studies; however, the model comprising Intrusions, Avoidance, Hyperarousal, and Dysphoria factors appeared to fit better across studies. Results also indicated that the best fitting models were not moderated by measure or sample type. Results are discussed in the context of structural models of PTSD and implications for the diagnostic nosology.",0 +https://doi.org/10.1186/s13063-015-0982-9,"Modular Approach to Therapy for Anxiety, Depression, Trauma, or Conduct Problems in outpatient child and adolescent mental health services in New Zealand: study protocol for a randomized controlled trial","Mental health disorders are common and disabling for young people because of the potential to disrupt key developmental tasks. Implementation of evidence-based psychosocial therapies in New Zealand is limited, owing to the inaccessibility, length, and cost of training in these therapies. Furthermore, most therapies address one problem area at a time, although comorbidity and changing clinical needs commonly occur in practice. A more flexible approach is needed. The Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems (MATCH-ADTC) is designed to overcome these challenges; it provides a range of treatment modules addressing different problems, within a single training program. A clinical trial of MATCH-ADTC in the USA showed that MATCH-ADTC outperformed usual care and standard evidence-based treatment on several clinical measures. We aim to replicate these findings and evaluate the impact of providing training and supervision in MATCH-ADTC to: (1) improve clinical outcomes for youth attending mental health services; (2) increase the amount of evidence-based therapy content; (3) increase the efficiency of service delivery.This is an assessor-blinded multi-site effectiveness randomized controlled trial. Randomization occurs at two levels: (1) clinicians (≥60) are randomized to intervention or usual care; (2) youth participants (7-14 years old) accepted for treatment in child and adolescent mental health services (with a primary disorder that includes anxiety, depression, trauma-related symptoms, or disruptive behavior) are randomly allocated to receive MATCH-ADTC or usual care. Youth participants are recruited from 'mainstream', Māori-specific, and Pacific-specific child and adolescent mental health services. We originally planned to recruit 400 youth participants, but this has been revised to 200 participants. Centralized computer randomization ensures allocation concealment. The primary outcome measures are: (i) the difference in trajectory of change of clinical severity between groups (using the parent-rated Brief Problem Monitor); (ii) clinicians' use of evidence-based treatment procedures during therapy sessions; (iii) total time spent by clinicians delivering therapy.If MATCH-ADTC demonstrates effectiveness it could offer a practical efficient method to increase access to evidence-based therapies, and improve outcomes for youth attending secondary care services.Australian and New Zealand Clinical Trials Registry ACTRN12614000297628 .",0 +https://doi.org/10.1080/08039480310002660,Parent-child discrepancy in reporting children's post-traumatic stress reactions after a traffic accident,"This study examines possible parent-child discrepancies in the reporting of post-traumatic stress reactions in children after a traffic accident. Sixteen children exposed to the same traffic accident were interviewed about post-traumatic stress reactions at 5 weeks and at 6 months after the event, utilizing the Child Posttraumatic Stress Reaction Index (CPTS-RI). Independently, the parents' reported their child's degree of post-traumatic stress reactions on the CPTS-RI: Parent questionnaire, at the same two times. Clinicians also assessed the children's level of general functioning on the Children's Global Assessment Scale. The children reported significantly more post-traumatic stress reactions than observed by their parents 4 weeks after the accident. The parent-child discrepancy was more pronounced among younger children. The level of children's self-reported post-traumatic stress reactions decreased significantly from the first to the second assessment. At the second assessment, 6 months after the accident, there was no significant parent-child discrepancy observed. The children showed a normal level of functioning despite their post-traumatic stress reactions. The reported parent-child discrepancy indicates that information about children's post-traumatic stress reactions after an accident is best obtained directly from the children.",0 +https://doi.org/10.1521/psyc.2008.71.3.234,Ethnic/Racial Diversity and Posttraumatic Distress in the Acute Care Medical Setting,"Recent commentary has advocated for epidemiological investigation as a foundational science for understanding disparities in the delivery of mental health care and for the development of early trauma–focused interventions. Few acute care investigations have examined the diversity of ethnic/racial heritages or compared variations in early posttraumatic distress in representative samples of injured trauma survivors. Hospitalized injury survivors at two United States level I trauma centers were randomly approached in order to document linguistic and ethnic/racial diversity. Approximately 12% of patients approached were non–English speaking with 16 languages represented. English speaking, inpatients were screened for posttraumatic stress disorder, peritraumatic dissociative, and depressive symptoms. For 269 English speaking study participants, ethnic/racial group status was clearly categorized into one group for 72%, two groups for 25%, and three groups for 3% of participants. Regression analyses that adjusted for relevant clinical and demographic characteristics revealed that relative to whites, patients from American Indian, African American, Hispanic, and Asian heritages demonstrated significant elevations in one or more posttraumatic symptom clusters. A remarkable diversity of heritages was identified, and posttraumatic distress was elevated in ethnic/racial minority patients. Policy–relevant clinical investigations that combine evidence–based treatments, bilingual/bicultural care–management strategies, and support for trauma center organizational capacity building may be required in order to enhance the quality of mental health care for diverse injured trauma survivors.",0 +https://doi.org/10.4330/wjc.v6.i6.455,"Metabolic, autonomic and immune markers for cardiovascular disease in posttraumatic stress disorder","Posttraumatic stress disorder (PTSD) has been associated with significantly greater incidence of heart disease. Numerous studies have indicated that health problems for individuals with PTSD occur earlier in life than in the general population. Multiple mechanistic pathways have been suggested to explain cardiovascular disese (CVD) risk in PTSD, including neurochemical, behavioral, and immunological changes. The present paper is a review of recent research that examines cardiovascular and immune risk profiles of individuals with PTSD. First, we address the relatively new evidence that the constellation of risk factors commonly experienced in PTSD fits the profile of metabolic syndrome. Next we examine the findings concerning hypertension/blood pressure in particular. The literature on sympathetic and parasympathetic responsivity in PTSD is reviewed. Last, we discuss recent findings concerning immune functioning in PTSD that may have a bearing on the high rates of CVD and other illnesses. Our primary goal is to synthesize the existing literature by examining factors that overlap mechanistically to increase the risk of developing CVD in PTSD.",0 +https://doi.org/10.1080/17523281.2010.504645,Profiles of individuals seeking psychiatric help for psychotic symptoms linked to methamphetamine abuse – baseline results from the MAPS (methamphetamine and psychosis study),"Background: Methamphetamine psychosis (MAP) is commonly encountered in psychiatric emergency rooms (ERs) in North America, and little is known regarding the specific needs of this clientele. Aims: This study aimed at describing the psychiatric and socioeconomic profiles of individuals with co-occurring methamphetamine abuse and psychosis profiles. Method: Two hundred and ninety-five (295) individuals needing psychiatric help for MAP were assessed regarding their socioeconomic situation, their substance abuse patterns, family histories, past psychiatric diagnoses, childhood trauma, and co-occurring disorders of depression, PTSD and antisocial personality disorder. Results: Eighty-seven percent had a family history of mental illness or substance abuse and close to 70% had a previous diagnosis of a mental illness, although only 21% of a psychotic disorder. Antisocial personality disorder, depression, and post-traumatic stress disorder were highly prevalent in our sample. Cluster analyses on methamphetamine (...",0 +https://doi.org/10.1080/08039480801983992,A latent class analysis of adolescent adverse life events based on a Danish national youth probability sample.,"The aim of this study was to determine if there are meaningful clusters of individuals with similar experiences of adverse life events in a nationally representative sample of Danish adolescents. Latent class analysis (LCA) was used to identify such clusters or latent classes. In addition, the relationships between the latent classes and living arrangements and diagnosis of post-traumatic stress disorder (PTSD) were estimated. A four-class solution was found to be the best description of multiple adverse life events, and the classes were labelled ""Low Risk"", ""Intermediate Risk"", ""Pregnancy"" and ""High Risk"". Compared with the Low Risk class, the other classes were found to be significantly more likely to have a diagnosis PTSD and live with only one parent. This paper demonstrated how trauma research can focus on the individual as the unit of analysis rather than traumatic events.",0 +https://doi.org/10.1001/jama.300.6.676,Association of Combatant Status and Sexual Violence With Health and Mental Health Outcomes in Postconflict Liberia,"Liberia's wars since 1989 have cost tens of thousands of lives and left many people mentally and physically traumatized.To assess the prevalence and impact of war-related psychosocial trauma, including information on participation in the Liberian civil wars, exposure to sexual violence, social functioning, and mental health.A cross-sectional, population-based, multistage random cluster survey of 1666 adults aged 18 years or older using structured interviews and questionnaires, conducted during a 3-week period in May 2008 in Liberia.Symptoms of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), social functioning, exposure to sexual violence, and health and mental health needs among Liberian adults who witnessed or participated in the conflicts during the last 2 decades.In the Liberian adult household-based population, 40% (95% confidence interval [CI], 36%-45%; n = 672/1659) met symptom criteria for MDD, 44% (95% CI, 38%-49%; n = 718/1661) met symptom criteria for PTSD, and 8% (95% CI, 5%-10%; n = 133/1666) met criteria for social dysfunction. Thirty-three percent of respondents (549/1666) reported having served time with fighting forces, and 33.2% of former combatant respondents (182/549) were female. Former combatants experienced higher rates of exposure to sexual violence than noncombatants: among females, 42.3% (95% CI, 35.4%-49.1%) vs 9.2% (95% CI, 6.7%-11.7%), respectively; among males, 32.6% (95% CI, 27.6%-37.6%) vs 7.4% (95% CI, 4.5%-10.4%). The rates of symptoms of PTSD, MDD, and suicidal ideation were higher among former combatants than noncombatants and among those who experienced sexual violence vs those who did not. The prevalence of PTSD symptoms among female former combatants who experienced sexual violence (74%; 95% CI, 63%-84%) was higher than among those who did not experience sexual violence (44%; 95% CI, 33%-53%). The prevalence of PTSD symptoms among male former combatants who experienced sexual violence was higher (81%; 95% CI, 74%-87%) than among male former combatants who did not experience sexual violence (46%; 95% CI, 39%-52%). Male former combatants who experienced sexual violence also reported higher rates of symptoms of depression and suicidal ideation. Both former combatants and noncombatants experienced inadequate access to health care (33.0% [95% CI, 22.6%-43.4%] and 30.1% [95% CI, 18.7%-41.6%], respectively).Former combatants in Liberia were not exclusively male. Both female and male former combatants who experienced sexual violence had worse mental health outcomes than noncombatants and other former combatants who did not experience exposure to sexual violence.",0 +https://doi.org/10.4161/hv.4.2.5217,Self-reported adverse health events following smallpox vaccination in a large prospective study of US military service members,"In December 2002, the Department of Defense re-instituted smallpox vaccination for US military forces following growing concerns that smallpox might be employed as a bioterrorist weapon. More than one million service members have been given the smallpox vaccine since 2002, although there have been concerns about the safety of the vaccine. Using a large self-reported prospective database, this analysis investigated a wide variety of self-reported health outcomes and possible association with smallpox vaccination. After confirming self-reported vaccination history with electronic vaccine data, 40,472 individuals were included in the analyses, 8,793 of whom received the smallpox vaccine and 31,679 who did not. No significant adverse associations between smallpox vaccination and self-reported health outcomes, including mental and physical functioning, cardiovascular diseases, and autoimmune disorders, were found. These findings complement studies that utilize other data sources, such as electronic hospitalization records, and may be reassuring to health care providers and those who receive the smallpox vaccination.",0 +https://doi.org/10.1080/15299732.2010.514846,Predicting Stabilizing Treatment Outcomes for Complex Posttraumatic Stress Disorder and Dissociative Identity Disorder: An Expertise-Based Prognostic Model,"The purpose of this study was to develop an expertise-based prognostic model for the treatment of complex posttraumatic stress disorder (PTSD) and dissociative identity disorder (DID). We developed a survey in 2 rounds: In the first round we surveyed 42 experienced therapists (22 DID and 20 complex PTSD therapists), and in the second round we surveyed a subset of 22 of the 42 therapists (13 DID and 9 complex PTSD therapists). First, we drew on therapists' knowledge of prognostic factors for stabilization-oriented treatment of complex PTSD and DID. Second, therapists prioritized a list of prognostic factors by estimating the size of each variable's prognostic effect; we clustered these factors according to content and named the clusters. Next, concept mapping methodology and statistical analyses (including principal components analyses) were used to transform individual judgments into weighted group judgments for clusters of items. A prognostic model, based on consensually determined estimates of effect sizes, of 8 clusters containing 51 factors for both complex PTSD and DID was formed. It includes the clusters lack of motivation, lack of healthy relationships, lack of healthy therapeutic relationships, lack of other internal and external resources, serious Axis I comorbidity, serious Axis II comorbidity, poor attachment, and self-destruction. In addition, a set of 5 DID-specific items was constructed. The model is supportive of the current phase-oriented treatment model, emphasizing the strengthening of the therapeutic relationship and the patient's resources in the initial stabilization phase. Further research is needed to test the model's statistical and clinical validity.",0 +https://doi.org/10.1093/milmed/159.12.739,Preventing Post-Traumatic Stress Disorder Resulting from Military Operations,"Military personnel are at high risk for developing post-traumatic stress disorder (PTSD), historically 10 to 50% of all casualties. The best treatment is to provide an opportunity for rest and ventilation of feelings and then to return the person to duty and to his or her peer group. Preventing the cycle of PTSD from starting and thus decreasing psychiatric casualties is feasible. This can be done by promoting unit cohesion and morale, ensuring that individuals know their jobs, inducing stress during training so individuals will be better prepared to cope, providing realistic information about what to expect in combat, and holding group debriefings immediately after any traumatic event. This paper discusses various models for preventing PTSD and examines future directions for the prevention of PTSD.",0 +https://doi.org/10.1111/nhs.12152,Post-traumatic stress disorder among survivors two years after the 2010 Mount Merapi volcano eruption: A survey study,"The Mount Merapi volcanic eruption in October 2010 was one of Indonesia's largest and most recent natural disasters. A cross-sectional study was undertaken to measure the psychosocial impact of the eruption on survivors in two locations in Yogyakarta, Java, Indonesia. The Impact of Event Scale Revised was used to assess participants' symptoms of post-traumatic stress disorder. Post-Traumatic Stress Disorder responses and demographic characteristics were compared in both locations by conducting bivariate analysis using Mann-Whitney and t tests. The relative contributions of demographic variables and psychosocial impact were examined using multiple linear regression analyses. Two years after the eruption, survivors from the area closest to the eruption had significantly higher Impact of Event Scale Revised scores than those in the comparison area. In particular, females, adults between the ages of 18 and 59, and people who owned their own home experienced the highest levels of psychosocial impact. Nurses and other health professionals need to be aware of the impact of natural disasters on survivors and develop interventions to help people adjust to the psychosocial impact of these events.",0 +https://doi.org/10.1097/00004583-199906000-00013,Suicide‐Bereaved Children and Adolescents: A Controlled Longitudinal Examination,"The current study examined emotional and behavioral sequelae in children who have experienced parental suicide by completing a secondary analysis of data from the Grief Research Study, a longitudinal study of childhood bereavement.Twenty-six suicide-bereaved (SB) children, aged 5 to 17 years, were compared with 332 children bereaved from parental death not caused by suicide (NSB) in interviews 1, 6, 13, and 25 months after the death. Children's emotional reactions to the death, psychiatric symptomatology, and psychosocial functioning after the parent's death were determined.Grief emotions were common in both groups. SB children were more likely to experience anxiety, anger, and shame than NSB children. SB children were more likely to have preexisting behavioral problems and more behavioral and anxiety symptoms throughout the first 2 years compared with NSB children. Indices of depression, suicidality, and psychosocial functioning differed minimally between groups.SB children experience some ""common"" elements of bereavement. In addition, they demonstrate some lifetime risk factors as well as subsequent pathology that suggests a negative behavioral trajectory. As these cohorts have not yet passed through the age of risk, long-term follow-up is critical.",0 +https://doi.org/10.1038/npp.2010.10,Amygdala Transcriptome and Cellular Mechanisms Underlying Stress-Enhanced Fear Learning in a Rat Model of Posttraumatic Stress Disorder,"Severe stress or trauma can cause permanent changes in brain circuitry, leading to dysregulation of fear responses and the development of posttraumatic stress disorder (PTSD). To date, little is known about the molecular mechanisms underlying stress-induced long-term plasticity in fear circuits. We addressed this question by using global gene expression profiling in an animal model of PTSD, stress-enhanced fear learning (SEFL). A total of 15 footshocks were used to induce SEFL and the volatile anesthetic isoflurane was used to suppress the behavioral effects of stress. Gene expression in lateral/basolateral amygdala was measured using microarrays at 3 weeks after the exposure to different combinations of shock and isoflurane. Shock produced robust effects on amygdalar transcriptome and isoflurane blocked or reversed many of the stress-induced changes. We used a modular approach to molecular profiles of shock and isoflurane and built a network of regulated genes, functional categories, and cell types that represent a mechanistic foundation of perturbation-induced plasticity in the amygdala. This analysis partitioned perturbation-induced changes in gene expression into neuron- and astrocyte-specific changes, highlighting a previously underappreciated role of astroglia in amygdalar plasticity. Many neuron-enriched genes were highly correlated with astrocyte-enriched genes, suggesting coordinated transcriptional responses to environmental challenges in these cell types. Several individual genes were validated using RT-PCR and behavioral pharmacology. This study is the first to propose specific cellular and molecular mechanisms underlying SEFL, an animal model of PTSD, and to nominate novel molecular and cellular targets with potential for therapeutic intervention in PTSD, including glycine and neuropeptide systems, chromatin remodeling, and gliotransmission.",0 +https://doi.org/10.1002/(sici)1097-4679(199712)53:8<809::aid-jclp4>3.0.co;2-a,Assessment of PTSD symptoms in a community exposed to serial murder,"This study examined the presence of PTSD symptoms across time in a community exposed to serial murder. One hundred eighty four subjects (48% response rate) responded to the initial survey while 64 and 30 subjects, respectively, participated in the 9- and 18-month follow-up studies. Results indicated widespread endorsement of PTSD symptoms following the murders. The most severe reactions were found among residents demographically similar to the victims. PTSD symptoms, while not transient, appeared to decrease over time with few subjects still reporting symptoms at 18 months. These data suggest that violent acts such as serial murder can have far reaching psychological consequences for the community and result in vicarious victimization. © 1997 John Wiley & Sons, Inc. J Clin Psychol 53: 809–815, 1997",0 +https://doi.org/10.1176/appi.neuropsych.13010006,Prazosin for Military Combat-Related PTSD Nightmares: A Critical Review,"Military combat is a common trauma experience associated with posttraumatic stress disorder (PTSD). Trauma-related nightmares are a hallmark symptom of PTSD. They can be resistant to label-pharmacological PTSD treatment, and they are associated with a variety of adverse health outcomes. The purpose of this article is to review and evaluate prazosin therapy for combat-related PTSD nightmares. Consistent with available literature for all-causes PTSD nightmares, prazosin is an effective off-label option for combat-related PTSD nightmares. Future trials may further instruct use in specific combat-exposure profiles.",0 +https://doi.org/10.1136/bmjopen-2015-009698,Does abortion increase women's risk for post-traumatic stress? Findings from a prospective longitudinal cohort study,"To prospectively assess women's risk for post-traumatic stress disorder (PTSD) and of experiencing post-traumatic stress symptoms (PTSS) over 4 ears after seeking an abortion, and to assess whether symptoms are attributed to the pregnancy, abortion or birth, or other events in women's lives.Prospective longitudinal cohort study which followed women from approximately 1 week after receiving or being denied an abortion (baseline), then every 6 months for 4 years (9 interview waves).30 abortion facilities located throughout the USA.Among 956 women presenting for abortion care, some of whom received an abortion and some of whom were denied due to advanced gestational age; 863 women are included in the longitudinal analyses.PTSS and PTSD risk were measured using the Primary Care PTSD Screen (PC-PTSD). Index pregnancy-related PTSS was measured by coding the event(s) described by women as the cause of their symptoms.We used unadjusted and adjusted logistic mixed-effects regression analyses to assess whether PTSS, PTSD risk and pregnancy-related PTSS trajectories of women obtaining abortions differed from those who were denied one.At baseline, 39% of participants reported any PTSS and 16% reported three or more symptoms. Among women with symptoms 1-week post-abortion seeking (n=338), 30% said their symptoms were due to experiences of sexual, physical or emotional abuse or violence; 20% attributed their symptoms to non-violent relationship issues; and 19% said they were due to the index pregnancy. Baseline levels of PTSS, PTSD risk and pregnancy-related PTSS outcomes did not differ significantly between women who received and women who were denied an abortion. PTSS, PTSD risk and pregnancy-related PTSS declined over time for all study groups.Women who received an abortion were at no higher risk of PTSD than women denied an abortion.",0 +https://doi.org/10.1289/ehp.6702,Health and environmental consequences of the world trade center disaster.,"The attack on the World Trade Center (WTC) created an acute environmental disaster of enormous magnitude. This study characterizes the environmental exposures resulting from destruction of the WTC and assesses their effects on health. Methods include ambient air sampling; analyses of outdoor and indoor settled dust; high-altitude imaging and modeling of the atmospheric plume; inhalation studies of WTC dust in mice; and clinical examinations, community surveys, and prospective epidemiologic studies of exposed populations. WTC dust was found to consist predominantly (95%) of coarse particles and contained pulverized cement, glass fibers, asbestos, lead, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and polychlorinated furans and dioxins. Airborne particulate levels were highest immediately after the attack and declined thereafter. Particulate levels decreased sharply with distance from the WTC. Dust pH was highly alkaline (pH 9.0-11.0). Mice exposed to WTC dust showed only moderate pulmonary inflammation but marked bronchial hyperreactivity. Evaluation of 10,116 firefighters showed exposure-related increases in cough and bronchial hyperreactivity. Evaluation of 183 cleanup workers showed new-onset cough (33%), wheeze (18%), and phlegm production (24%). Increased frequency of new-onset cough, wheeze, and shortness of breath were also observed in community residents. Follow-up of 182 pregnant women who were either inside or near the WTC on 11 September showed a 2-fold increase in small-for-gestational-age (SGA) infants. In summary, environmental exposures after the WTC disaster were associated with significant adverse effects on health. The high alkalinity of WTC dust produced bronchial hyperreactivity, persistent cough, and increased risk of asthma. Plausible causes of the observed increase in SGA infants include maternal exposures to PAH and particulates. Future risk of mesothelioma may be increased, particularly among workers and volunteers exposed occupationally to asbestos. Continuing follow-up of all exposed populations is required to document the long-term consequences of the disaster.",0 +https://doi.org/10.1111/acer.12422,Psychiatric Comorbidity and Perceived Alcohol Stigma in a Nationally Representative Sample of Individuals with DSM-5 Alcohol Use Disorder,"Background Alcohol use disorder (AUD) is among the most stigmatized health conditions and is frequently comorbid with mood, anxiety, and drug use disorders. Theoretical frameworks have conceptualized stigma-related stress as a predictor of psychiatric disorders. We described profiles of psychiatric comorbidity among people with AUD and compared levels of perceived alcohol stigma across profiles. Methods Cross-sectional data were analyzed from a general population sample of U.S. adults with past-year DSM-5 AUD (n = 3,368) from the National Epidemiologic Survey on Alcohol and Related Conditions, which was collected from 2001 to 2005. Empirically derived psychiatric comorbidity profiles were established with latent class analysis, and mean levels of perceived alcohol stigma were compared across the latent classes while adjusting for sociodemographic characteristics and AUD severity. Results Four classes of psychiatric comorbidity emerged within this AUD sample, including those with: (i) high comorbidity, reflecting internalizing (i.e., mood and anxiety disorders) and externalizing (i.e., antisocial personality and drug use disorders) disorders; (ii) externalizing comorbidity; (iii) internalizing comorbidity; and (iv) no comorbidity. Perceived alcohol stigma was significantly higher in those with internalizing comorbidity (but not those with high comorbidity) as compared to those with no comorbidity or externalizing comorbidity. Conclusions Perceived stigma, as manifested by anticipations of social rejection and discrimination, may increase risk of internalizing psychiatric comorbidity. Alternatively, internalizing psychiatric comorbidity could sensitize affected individuals to perceive more negative attitudes toward them. Future research is needed to understand causal and bidirectional associations between alcohol stigma and psychiatric comorbidity.",0 +https://doi.org/10.1016/j.addbeh.2010.01.010,An investigation of relations between crystal methamphetamine use and posttraumatic stress disorder,"Evidence documents elevated rates of various types of drug use among people with posttraumatic stress disorder (PTSD). However, relatively little research has specifically examined crystal methamphetamine (CM) use among individuals with PTSD. The present study examined the relation between PTSD diagnostic status, PTSD symptom severity within symptom type clusters, and CM use histories among traumatic event-exposed individuals with versus without PTSD. Consistent with expectations, individuals with PTSD were significantly more likely to report CM use than trauma-exposed individuals without PTSD. Additionally, CM users with PTSD reported a longer duration of CM use than trauma-exposed CM users without PTSD. Finally, PTSD avoidance and hyperarousal symptoms, but not re-experiencing, were related to CM use. The potential clinical and research implications of the findings are discussed.",0 +https://doi.org/10.1016/j.psychres.2011.11.015,Behavioral inhibition and PTSD symptoms in veterans,"Behavioral inhibition (BI), a temperamental bias to respond to novel stimuli with avoidance behaviors, is a risk factor for posttraumatic stress disorder (PTSD). It is unclear whether BI accounts for additional variance in PTSD symptom severity beyond that accounted for by general anxiety. Here, 109 veterans (mean age 50.4 years, 9.2% female) provided self-assessment of PTSD symptoms, state and trait anxiety, combat exposure, and current (adult) and retrospective (childhood) BI. Adult BI was correlated with anxiety and PTSD symptom severity, especially cluster C (avoidance) symptoms, but not with combat exposure. A regression model including adult BI, state and trait anxiety, and combat exposure was able to correctly classify over 80% of participants according to presence or absence of severe PTSD symptoms. Because avoidance behaviors are a core component of PTSD, self-assessments of BI may be an important tool in understanding PTSD and potentially assessing vulnerability to the disorder.",0 +https://doi.org/10.1111/cch.12168,Diagnosing attention-deficit hyperactivity disorder (ADHD) in children involved with child protection services: are current diagnostic guidelines acceptable for vulnerable populations?,"Children involved with child protection services (CPS) are diagnosed and treated for attention-deficit hyperactivity disorder (ADHD) at higher rates than the general population. Children with maltreatment histories are much more likely to have other factors contributing to behavioural and attentional regulation difficulties that may overlap with or mimic ADHD-like symptoms, including language and learning problems, post-traumatic stress disorder, attachment difficulties, mood disorders and anxiety disorders. A higher number of children in the child welfare system are diagnosed with ADHD and provided with psychotropic medications under a group care setting compared with family-based, foster care and kinship care settings. However, children's behavioural trajectories change over time while in care. A reassessment in the approach to ADHD-like symptoms in children exposed to confirmed (or suspected) maltreatment (e.g. neglect, abuse) is required. Diagnosis should be conducted within a multidisciplinary team and practice guidelines regarding ADHD diagnostic and management practices for children in CPS care are warranted both in the USA and in Canada. Increased education for caregivers, teachers and child welfare staff on the effects of maltreatment and often perplexing relationship with ADHD-like symptoms and co-morbid disorders is also necessary. Increased partnerships are needed to ensure the mental well-being of children with child protection involvement.",0 +https://doi.org/10.1016/j.injury.2015.08.038,Course of recovery for whiplash associated disorders in a compensation setting,"The detailed course of recovery following compensable whiplash associated disorders (WAD) is not well understood. Some people recover within months and others report symptoms for extended periods. Recent research identified distinct recovery pathways. Identifying recovery pathways for people with this condition in compensable settings could assist clinical and claim management.This study aimed to identify recovery trajectories based on disability, pain catastrophising and mental health and, secondly, to examine developmental linkages between the trajectories.A cohort of 246 people with compensable WAD were followed for 24 months after a motor vehicle related injury.Functional Rating Index (FRI), Pain Catastrophising Scale (PCS) and the SF36 Mental Component Score (SF 36 MCS).Group-based trajectory analytical techniques were used to identify distinct post-injury profiles. Multinominal logistic regression modelling identified factors associated with membership of different trajectories.246 people were enrolled a median of 72 days after injury. Three trajectories were identified for the measures used and their prevalences, respectively, were: for disability (FRI) they were mild (47%), moderate (31%), and severe (22%); for pain catastrophising (PCS) they were non-catastrophisers (55%), moderate-low catastrophisers (32%) and clinically significant catastrophisers (13%); and, for mental health (SF36 MCS) they were good mental health (40%), moderately low mental health (42%) and severely low mental health (18%). All groups showed no further recovery beyond 12 months after injury. The significant baseline predictors of the severe disability trajectory were: lower (that means worse) bodily pain scores (SF 36 BPS) (p≤0.01); high pain catastrophising (p≤0.01); and, self-reported fair or poor general health (p=0.03). Conditional probabilities for group membership showed that the three trajectories for both PCS and FRI were linked. Dual membership was high for the mild disability and mild pain catastrophising trajectories and, for the severe disability and clinically significant pain catastrophising trajectories.There is a strong and plausible association between severe disability, clinical levels of pain catastrophising and low mental health. Claimants can be identified at claim notification based on three estimated recovery trajectories. Claim and clinical interventions can be targeted to the profile within each recovery trajectory.",0 +https://doi.org/10.2340/16501977-0870,Coping with spinal cord injury: Tenacious goal pursuit and flexible goal adjustment,"To investigate the correlation of higher-order coping strategies of tenacious goal pursuit and flexible goal adjustment with adjustment after rehabilitation in spinal cord injury.Cross-sectional correlational study.All 397 eligible patients entered for spinal cord rehabilitation between 1999 and 2009 were contacted and 130 (33%) agreed to complete a self-report questionnaire.Partial correlations were computed between tenacious goal pursuit and flexible goal adjustment and affective and cognitive psychological adjustment. Demographics, spinal cord injury related variables, social support and coping were used as control variables.After controlling for relevant demographic, medical and social support indices, partial correlations between tenacious goal pursuit and indices of adaptation were not significant. Significant partial correlations were observed between flexible goal adjustment and each of the indices of adjustment (r = -0.33, -0.42, 0.51, -0.38, respectively, for depression, anxiety, acceptance, and helplessness) after controlling for all relevant variables in the model. Flexible goal adjustment explained significant additional proportions of variance for each of the adjustment indices (7%, 11%, 18%, and 7%, respectively).Flexible goal adjustment, but not tenacious goal pursuit, is associated with psychological adjustment in spinal cord injury. Further research is needed to understand the mechanisms of flexible goal adjustment. Interventions targeting flexible goal adjustment might be of benefit for the patient.",0 +https://doi.org/10.1371/journal.pone.0077903,The Course of Serum Inflammatory Biomarkers Following Whiplash Injury and Their Relationship to Sensory and Muscle Measures: a Longitudinal Cohort Study,"Tissue damage or pathological alterations are not detectable in the majority of people with whiplash associated disorders (WAD). Widespread hyperalgisa, morphological muscle changes and psychological distress are common features of WAD. However little is known about the presence of inflammation and its association with symptom persistence or the clinical presentation of WAD. This study aimed to prospectively investigate changes in serum inflammatory biomarker levels from the acute (<3 weeks) to chronic (>3 months) stages of whiplash injury. It also aimed to determine relationships between biomarker levels and hyperalgesia, fatty muscle infiltrates of the cervical extensors identified on MRI and psychological factors. 40 volunteers with acute WAD and 18 healthy controls participated. Participants with WAD were classified at 3 months as recovered/mild disability or having moderate/severe disability using the Neck Disability Index. At baseline both WAD groups showed elevated serum levels of CRP but by 3 months levels remained elevated only in the moderate/severe group. The recovered/mild disability WAD group had higher levels of TNF-α at both time points than both the moderate/severe WAD group and healthy controls. There were no differences found in serum IL-1β. Moderate relationships were found between hyperalgesia and CRP at both time points and between hyperalgesia and IL-1β 3 months post injury. There was a moderate negative correlation between TNF-α and amount of fatty muscle infiltrate and pain intensity at 3 months. Only a weak relationship was found between CRP and pain catastrophising and no relationship between biomarker levels and posttraumatic stress symptoms. The results of the study indicate that inflammatory biomarkers may play a role in outcomes following whiplash injury as well as being associated with hyperalgesia and fatty muscle infiltrate in the cervical extensors.",0 +https://doi.org/10.1097/00004583-199912000-00014,Risk Factors for Psychological Maladjustment of Parents of Children With Cancer,"Objective To examine risk variables for future, more immediate, and persistent psychological distress of parents of pediatric cancer patients. Method Parents (n = 128) completed questionnaires at the time of diagnosis (T1) and 12 months later (T2). Multiple regression analyses were performed using the following as predictors: demographics, illness-related variables, other life events, personality, coping styles, and social support. Results Trait anxiety was the strongest predictor of both fathers' and mothers' future distress. Changes in trait anxiety during the year also accompanied changes in both parents' levels of distress. Additional prospective predictors for fathers were the coping style “social support-seeking” and dissatisfaction with support. Dissatisfaction with support also had short-term effects for fathers. An additional prospective predictor for mothers was the number of pleasant events they had experienced prior to diagnosis, while a short-term effect was found for performance in assertiveness. No predictors for the persistence of distress were found. Conclusions These results underscore the importance of personality anxiety in predicting parents' risk for adjustment difficulties associated with the experience of cancer in one's child. An additional risk factor for fathers was social support. For mothers, previously experienced life events and the frequency of assertive behavior were additional risk factors.",0 +https://doi.org/10.1016/s0140-6736(09)60660-7,"Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001–05: an epidemiological survey","In China and other middle-income countries, neuropsychiatric conditions are the most important cause of ill health in men and women, but efforts to scale up mental health services have been hampered by the absence of high-quality, country-specific data for the prevalence, treatment, and associated disability of different types of mental disorders. We therefore estimated these variables from a series of epidemiological studies that were done in four provinces in China.We used multistage stratified random sampling methods to identify 96 urban and 267 rural primary sampling sites in four provinces of China; the sampling frame of 113 million individuals aged 18 years or older included 12% of the adult population in China. 63 004 individuals, identified with simple random selection methods at the sampling sites, were screened with an expanded version of the General Health Questionnaire and 16,577 were administered a Chinese version of the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV axis I disorders by a psychiatrist.The adjusted 1-month prevalence of any mental disorder was 17.5% (95% CI 16.6-18.5). The prevalence of mood disorders was 6.1% (5.7-6.6), anxiety disorders was 5.6% (5.0-6.3), substance abuse disorders was 5.9% (5.3-6.5), and psychotic disorders was 1.0% (0.8-1.1). Mood disorders and anxiety disorders were more prevalent in women than in men, and in individuals 40 years and older than in those younger than 40 years. Alcohol use disorders were 48 times more prevalent in men than in women. Rural residents were more likely to have depressive disorders and alcohol dependence than were urban residents. Among individuals with a diagnosable mental illness, 24% were moderately or severely disabled by their illness, 8% had ever sought professional help, and 5% had ever seen a mental health professional.Substantial differences between our results and prevalence, disability, and treatment rate estimates used in the analysis of global burden of disease for China draw attention to the need for low-income and middle-income countries to do detailed, country-specific situation analyses before they scale up mental health services.China Medical Board of New York, WHO, and Shandong Provincial Bureau of Health.",0 +https://doi.org/10.1016/j.neuropsychologia.2006.03.024,Retrieval and emotional processing of traumatic memories in posttraumatic stress disorder: Peripheral and central correlates,"Posttraumatic stress disorder (PTSD) is thought to be characterized by dysfunctional memory processes, i.e., the automatic re-experiencing of the traumatic event and the inability to consciously recall facts about the traumatic event, as well as altered emotional processing of trauma-relevant cues. The present study examined the cerebral mechanisms underlying the cued recall of trauma-specific memories and the emotional processing of the presented cues in 16 PTSD patients, 15 trauma-exposed subjects without PTSD and 16 healthy controls. Subjects received questions about their specific trauma as well as other disastrous and neutral events while the electroencephalogram and heart rate were measured. The PTSD patients showed no impairment in trauma-specific declarative memory compared to non-PTSD subjects but had some deficits in general declarative memory as assessed by the Wechsler Memory Scale-Revised. Compared to healthy control subjects, PTSD patients displayed increased P300 and late positive complex amplitudes to trauma-specific questions, indicating enhanced emotional processing of these cues. In line with their behavioral performance, both trauma-exposed groups showed decreased terminal contingent negative variation amplitudes to trauma-specific questions over frontal electrodes reflecting altered memory retrieval. Within-group comparisons revealed that only the PTSD group but not the other groups showed a differentiation between trauma-specific and neutral questions with respect to the LPC, tCNV and P300. Concordantly with previous studies, PTSD patients showed elevated resting heart rate compared to the healthy controls. These findings are discussed in the context of current models of the role of declarative memory in the development and maintenance of PTSD.",0 +,Characteristics of difficult-to-place youth in state custody: a profile of the Exceptional Care Pilot Project population.,"This study examines the characteristics of Texas youth designated as 'most difficult to place' recipients of service under the Exceptional Care Pilot Project (N = 46). Findings include, among others, high levels of comorbid psychiatric disturbance (> 3 diagnostic groupings), physical (78.3%) and sexual (88%) maltreatment, and placement breakdowns (m = 4.8 therapeutic placements). This initial profile of the population provides a base for helping other states identify and plan for the needs of their most troubled youth.",0 +https://doi.org/10.1002/cpp.636,The role of shame and self-critical thinking in the development and maintenance of current threat in post-traumatic stress disorder,"There is increasing recognition of emotions other than fear in post-traumatic stress disorder (PTSD), and recent research has looked at the role of shame. Cognitive theory suggests that PTSD is caused by traumatic experiences being processed in a way that causes ongoing current threat. In this paper we suggest that shame might contribute to the creation/maintenance of ongoing current threat as it attacks an individual's psychological integrity. A correlational design was used to investigate some of the factors that might contribute to a shame response within a PTSD sample. It was hypothesized that individuals with PTSD who report higher levels of shame would be more prone to engage in self-critical thinking and less prone to engage in self-reassuring thinking than individuals with PTSD who report lower levels of shame. Data were gathered using self-report questionnaires, and results supported the hypotheses. It is suggested therapy for shame-based PTSD needs to incorporate strategies to help individuals develop inner caring, compassion and self-reassurance.",0 +https://doi.org/10.1007/s12207-010-9072-1,Toward a Typology of High-Risk Major Stressful Events and Situations in Posttraumatic Stress Disorder and Related Psychopathology,"The diagnosis of posttraumatic stress disorder (PTSD) was introduced in 1980 with the publication of the Diagnostic and Statistical Manual of the American Psychiatric Association, Third Edition (DSM-III). DSM-III put forward a novel syndrome consisting of intrusive, avoidance/numbing, and arousal symptoms as distinctive psychopathology following exposure to traumatic events. The traumatic stressors, although expanded in later editions published in 1987 (DSM-III-R) and 1994 (DSM-IV), focus on life-threatening events and situations. However, at least 12 studies, most of them recent, have found associations between the PTSD symptoms and the PTSD symptom syndrome with stressors, such as unemployment and divorce that would not qualify, even in the broadened DSM-IV diagnosis, as traumatic stressors. These findings challenge the basic assumption on which the PTSD diagnosis is based, the assumption that exposure to life-threatening stressors is the primary cause of a unique set of stress response symptoms. The purpose of this paper is to show how to confront this challenge by developing a typology of stressful situations and events that can be tested systematically for their relation to the PTSD symptom syndrome and other relevant variables. The typology includes but is not limited to the types of situations and events defined as “traumatic” in the DSMs.",0 +https://doi.org/10.1016/j.psyneuen.2004.05.001,No morning cortisol response in patients with severe global amnesia,"Activity of the hypothalamus pituitary adrenal (HPA) axis is characterized by a pronounced circadian rhythm. An acute increase in cortisol levels occurs after awakening in the morning with continuously declining levels over the course of the remaining day. The morning cortisol increase probably reflects an activational response of the HPA axis aimed at preparing the body for the day. Some studies found patterns of enhanced or blunted waking cortisol responses observed under chronic stress, burnout, or post traumatic stress disorder. The present study wanted to characterize the morning cortisol response and the circadian cortisol day profile in a sample of six male patients with severe amnesia due to hypoxia, herpes simplex encephalitis or closed head injury. Age and gender matched relatives or friends served as controls. Cortisol was measured from saliva samples collected at home on two consecutive days. The patients were woken up in the morning by their partners or caregivers. The morning cortisol increase typically observed in healthy subjects and also observed in the control group was absent in the amnesic patients. In contrast, a normal circadian day profile was found in the amnesic patients, with a pronounced circadian cortisol decrease. Further studies are needed to understand the neurological or psychological mechanisms leading to a missing morning cortisol response in amnesic patients.",0 +https://doi.org/10.1016/j.chiabu.2014.03.004,Impact of childhood maltreatment on physical health-related quality of life in U.S. active duty military personnel and combat veterans,"Previous studies have found an association between childhood maltreatment (CM) and health-related quality of life (HRQoL), and to a lesser extent have considered whether psychiatric symptoms may explain the relationship. This study aimed to further our understanding of the link between CM and HRQoL by testing whether posttraumatic stress disorder (PTSD) or depressive symptoms mediate the relationship between childhood maltreatment and physical HRQoL. Mediation models were examined in a sample of male Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) active duty and combat veterans (n=249). PTSD and depressive symptoms mediated the relationship between CM and overall physical HRQoL, as well as participation in daily activities due to physical health, bodily pain, and social functioning. Mediation of the relationship between childhood maltreatment and physical and social functioning by depression and PTSD symptoms may lend support to neurobiological hypotheses that childhood maltreatment sensitizes the nervous system and after repeated trauma may lead to the development of psychiatric symptoms, which have a major impact on morbidity and mortality.",0 +https://doi.org/10.3402/ejpt.v7.29700,"PTSD in ICD-10 and proposed ICD-11 in elderly with childhood trauma: prevalence, factor structure, and symptom profiles","Background : The proposal for ICD-11 postulates major changes for posttraumatic stress disorder (PTSD) diagnosis, which needs investigation in different samples. Aims : To investigate differences of PTSD prevalence and diagnostic agreement between ICD-10 and ICD-11, factor structure of proposed ICD-11 PTSD, and diagnostic value of PTSD symptom severity classes. Method : Confirmatory factor analysis and latent profile analysis were used on data of elderly survivors of childhood trauma (>60 years, N =399). Results : PTSD rates differed significantly between ICD-10 (15.0%) and ICD-11 (10.3%, z =2.02, p= 0.04). Unlike previous research, a one-factor solution of ICD-11 PTSD had the best fit in this sample. High symptom profiles were associated with PTSD in ICD-11. Conclusions : ICD-11 concentrates on PTSD’s core symptoms and furthers clinical utility. Questions remain regarding the tendency of ICD-11 to diagnose mainly cases with severe symptoms and the influence of trauma type and participant age on the factor structure. Keywords: Latent class analysis; childhood abuse; World War II; institutional abuse; long term consequences; trauma severity (Published: 21 January 2016) Responsible Editor: Anke Ehlers, University of Oxford, United Kingdom. For the abstract or full text in other languages, please see Supplementary files in the column to the right (under ‘Article Tools’). Citation: European Journal of Psychotraumatology 2016, 7 : 29700 - http://dx.doi.org/10.3402/ejpt.v7.29700",0 +,Post-traumatic stress disorder in children exposed to violence.,"To investigate to what extent local children exposed to community violence develop post-traumatic stress disorder (PTSD), whether the symptom profile is typical or atypical, and how detection can be improved.A cross-sectional study of two samples of children with a high risk of past exposure to violence.Sixty Xhosa-speaking children aged 10-16 years; 30 from the Children's Home which serves Khayelitsha, and 30 from a school in a violent area of Khayelitsha.A shortened version of the Survey of Exposure to Community Violence (SECV) was administered to determine exposure to violence. Structured questionnaires and a clinical assessment were used to elicit symptoms and make psychiatric diagnoses.All 60 children reported exposure to indirect violence, 57 (95%) had witnessed violence, and 34 (56%) had experienced violence themselves. Twenty-four (40%) met the criteria for on or more DSM-III-R diagnoses and 13 (21.7%) met the criteria for PTSD.Community violence places children at a high risk of developing serious psychiatric disorders and many children develop PTSD. None of the children in the school sample had received intervention prior to the study, pointing towards an urgent need for increased community and professional awareness of children at risk.",0 +https://doi.org/10.1016/s0006-3223(02)01895-4,Early predictors of posttraumatic stress disorder,The benefits of providing early intervention for people recently exposed to trauma have highlighted the need to develop means to identify people who will develop chronic posttraumatic stress disorder (PTSD). This review provides an overview of prospective studies that have indexed the acute reactions to trauma that are predictive of chronic posttraumatic stress disorder. Ten studies of the predictive power of the acute stress disorder diagnosis indicate that this diagnosis does not have adequate predictive power. There is no convergence across studies on any constellation of acute symptoms that predict posttraumatic stress disorder. A review of biological and cognitive mechanisms occurring in the acute posttraumatic phase suggests that these factors may provide more accurate means of predicting chronic posttraumatic stress disorder. Recommendations for future research to facilitate identification of key markers of acutely traumatized people who will develop posttraumatic stress disorder are discussed.,0 +https://doi.org/10.1176/ajp.153.2.219,Predictors of PTSD in injured trauma survivors: a prospective study,"The aim of this study was to prospectively examine the relationship between immediate and short-term responses to a trauma and the subsequent development of posttraumatic stress disorder (PTSD).All patients consecutively admitted to a general hospital were screened for the presence of physical injury due to a traumatic event. Fifty-one eligible subjects were assessed 1 week and 6 months after the trauma. The initial assessment included measures of event severity, peritraumatic dissociation, and symptoms of intrusion, avoidance, depression, and anxiety. The follow-up assessments added the PTSD module of the Structured Clinical Interview for DSM-III-R--Non-Patient Version and the civilian trauma version of the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder.Thirteen subjects (25.5%) met PTSD diagnostic criteria at follow-up. Subjects who developed PTSD had higher levels of peritraumatic dissociation and more severe depression, anxiety, and intrusive symptoms at the 1-week assessment. Peritraumatic dissociation predicted a diagnosis of PTSD after 6 months over and above the contribution of other variables and explained 29.4% of the variance of PTSD symptom intensity. Initial scores on the Impact of Event Scale predicted PTSD status with 92.3% sensitivity and 34.2% specificity. Symptoms of avoidance that were initially very mild intensified in the subjects who developed PTSD.Peritraumatic dissociation is strongly associated with the later development of PTSD. Early dissociation and PTSD symptoms can help the clinician identify subjects at higher risk for developing PTSD.",0 +,Outcome of Head and Other Injuries among Israeli Children: Physical Limitations and Stress Symptoms,"BACKGROUND: Head injuries, especially in young children, are frequent and may cause long-lasting impairments. OBJECTIVES: To investigate the outcome of head and other injuries caused by diverse mechanisms and of varied severity. METHODS: The study population consisted of Jews and Arabs (n=792), aged 0-17 years old, hospitalized for injuries in six hospitals in Israel. Caregivers were interviewed during hospitalization regarding circumstances of the injury and sociodemographic variables. Information on injury mechanism, profile and severity, and length of hospitalization was gathered from the medical files. Five months post-injury the caregivers were interviewed by phone regarding physical limitations and stress symptoms. RESULTS: Head injuries occurred in 60% of the children, and of these, 22.2% suffered traumatic brain injury with loss of consciousness (type 1). Among the rest, 22% of Jewish children and 28% of Arab children remained with at least one activity limitation, and no statistically significant differences were found among those with head or other injuries. The odds ratio for at least two stress symptoms was higher for children involved in transport-related injuries (OR 2.70, 95% confidence interval 1.38-5.28) than for other mechanisms, controlling for injury profile. No association was found between stress symptoms and injury severity. CONCLUSIONS: Most children had recovered by 5 months after the injury. Residual activity limitations were no different between those with head or with other injuries. Stress symptoms were related to transport-related injuries, but not to the presence of TBI or injury severity. Language: en",0 +https://doi.org/10.1016/j.physbeh.2011.03.001,Stress-induced alterations in anxiety-like behavior and adaptations in plasticity in the bed nucleus of the stria terminalis,"In vulnerable individuals, exposure to stressors can result in chronic disorders such as generalized anxiety disorder (GAD), major depressive disorder (MDD), and post-traumatic stress disorder (PTSD). The extended amygdala is critically implicated in mediating acute and chronic stress responsivity and anxiety-like behaviors. The bed nucleus of the stria terminalis (BNST), a subregion of the extended amygdala, serves as a relay of corticolimbic information to the paraventricular nucleus of the hypothalamus (PVN) to directly influence the stress response. To investigate the influence of the corticosteroid milieu and housing conditions on BNST function, adult C57Bl/6J were either acutely or chronically administered corticosterone (CORT, 25mg/kg in sesame oil) or vehicle (sesame oil) or were group housed or socially isolated for 1 day (acute) or 6-8 weeks (chronic). To ascertain whether these stressors could influence anxiety-like behavior, studies were performed using the novel open-field (NOF) and the elevated zero maze (EZM) tests. To investigate potential associated changes in plasticity, alterations in BNST function were assessed using ex vivo extracellular field potential recordings in the (dorsal-lateral) dlBNST and a high frequency stimulus protocol to induce long-term potentiation (LTP). Our results suggest that chronic CORT injections and chronic social isolation housing conditions lead to an increase in anxiety-like behavior on the EZM and NOF. Chronically stressed mice also displayed a parallel blunting of LTP in the dlBNST. Conversely, acute social isolation housing had no effect on anxiety-like behavior but still resulted in a blunting of LTP in the dlBNST. Collectively, our results suggest acute and chronic stressors can have a distinct profile on plasticity in the BNST that is not uniformly associated with an increase in anxiety-like behavior.",0 +https://doi.org/10.1007/978-1-4614-9354-9_5,Methodological Basis of a Culture-Specific Coping Approach,"In mainstream psychology, rather specific (and therefore restrictive) research perspectives on coping with disaster dominate. Research uses quantitative methods to build knowledge about the mechanisms and conditions by which disasters affect mental health. The focus of analysis is on measures of individual differences with regard to experiences, coping strategies, and mental health outcomes. Developing generalizable and, potentially, universally applicable models is a major research interest. We argue that methodologies used in mainstream psychologies are not compatible with the purposes of our approach-that is, to describe sociocultural-specific personal and communal long-term coping dynamics after a disaster. We argue that a cultural-psychological approach implies specific propositions about human subjectivity, human agency, and research methods. Previously prominent, restrictive epistemological approaches to coping with disasters need to be broadened by rethinking research units, allowing for complex interrelations instead of assuming a linear causal process, being process-oriented, and including power-critical investigations. This chapter ends with a presentation of the methodological approach used in our case study, which we believe exemplifies alternatives to mainstream psychological research in disaster contexts. © 2014 Springer Science+Business Media, LLC. All rights are reserved.",0 +https://doi.org/10.1037/0033-3204.33.3.449,African Americans and anxiety disorders research: Development of a testable theoretical framework.,"The past decade has witnessed a tremendous growth in the population of minorities in this country. As this segment of the population has grown, psychology has slowly begun to realize the need to examine the presentation of psychological symptoms among minorities as well as the response of minorities to traditional psychological treatment. While several investigations have been conducted to date, the results are far from consistent. Some studies have demonstrated marked differences in the symptom profiles and treatment responses of minorities as compared with Whites, while others have found little, if any, differences. A major contributing factor to such inconsistent results may be that research in this area has typically proceeded in the absence of a testable theoretical framework. This review examines research conducted with a specific minority population, African Americans, suffering with a DSM anxiety disorder. We first examine the epidemiological and treatment outcome studies in an effort to ascertain the consistencies and inconsistencies that exist within the literature. More importantly, we then provide a preliminary theoretical framework that not only accounts for the discrepant findings, but also allows investigators to generate testable hypotheses regarding the manifestation and presentation of anxious symptoms, and to evaluate the efficacy of psychological interventions among African Americans. We conclude with suggestions for future investigations in this area.",0 +https://doi.org/10.1111/jcpp.12056,Annual Research Review: The experience of youth with political conflict - challenging notions of resilience and encouraging research refinement,"Drawing on empirical studies and literature reviews, this paper aims to clarify and qualify the relevance of resilience to youth experiencing political conflict. It focuses on the discordance between expectations of widespread dysfunction among conflict-affected youth and a body of empirical evidence that does not confirm these expectations.The expectation for widespread dysfunction appears exaggerated, relying as it does on low correlations and on presumptions of universal response to adversity. Such a position ignores cultural differences in understanding and responding to adversity, and in the specific case of political conflict, it does not account for the critical role of ideologies and meaning systems that underlie the political conflict and shape a young people's interpretation of the conflict, and their exposure, participation, and processing of experiences. With respect to empirical evidence, the findings must be viewed as tentative given the primitive nature of research designs: namely, concentration on violence exposure as the primary risk factor, at the expense of recognizing war's impact on the broader ecology of youth's lives, including disruptions to key economic, social, and political resources; priority given to psychopathology in the assessment of youth functioning, rather than holistic assessments that would include social and institutional functioning and fit with cultural and normative expectations and transitions; and heavy reliance on cross-sectional, rather than longitudinal, studies.Researchers and practitioners interested in employing resilience as a guiding construct will face such questions: Is resilience predicated on evidence of competent functioning across the breadth of risks associated with political conflict, across most or all domains of functioning, and/or across time? In reality, youth resilience amidst political conflict is likely a complex package of better and poorer functioning that varies over time and in direct relationship to social, economic, and political opportunities. Addressing this complexity will complicate the definition of resilience, but it confronts the ambiguities and limitations of work in cross-cultural contexts.",0 +https://doi.org/10.1007/978-1-60327-329-9_10,The Locus Coeruleus-Noradrenergic System and Stress: Implications for Post-Traumatic Stress Disorder,"Stress is associated with the activation of a number of central physiological systems, which act to enhance arousal and modulate attentional, memory, and other behavioral processes. The net consequence of these actions better permits the organism to contend with a challenging situation and react promptly and effectively when similar conditions are reencountered. It has long been known that stress is associated with a robust activation of the locus coeruleus and other noradrenergic systems. Moreover, evidence indicates a prominent involvement of central noradrenergic systems in a variety of behavioral and cognitive processes associated with stress, including arousal, memory, and attention. Under normal conditions, these actions are likely beneficial to the individual. However, under conditions of extreme stress/trauma, stressor-induced sensitization of noradrenergic systems and long-term actions of norepinephrine may well prove maladaptive. Consistent with this hypothesis, available evidence indicates a prominent involvement of noradrenergic systems in the behavioral pathology associated with various stress-related disorders, particularly post-traumatic stress disorder (PTSD). In particular, there is strong evidence for an involvement of noradrenergic systems in PTSD-related hyperarousal, intrusive memories, and sleep disturbances. Consistent with this, recent studies suggest that pharmacological disruption of noradrenergic neurotransmission may well be efficacious in treating these symptoms of PTSD. Combined, available information indicates that the central noradrenergic systems likely contribute to a broad spectrum of behavioral symptoms of PTSD and that pharmacological treatments targeting noradrenergic neurotransmission will prove clinically beneficial.",0 +https://doi.org/10.7205/milmed-d-13-00271,"Preliminary Evaluation of PTSD Coach, a Smartphone App for Post-Traumatic Stress Symptoms","PTSD Coach is a mobile application (app) designed to help individuals who have post-traumatic stress disorder (PTSD) symptoms better understand and self-manage their symptoms. It has wide-scale use (over 130,000 downloads in 78 countries) and very favorable reviews but has yet to be evaluated. Therefore, this study examines user satisfaction, perceived helpfulness, and usage patterns of PTSD Coach in a sample of 45 veterans receiving PTSD treatment. After using PTSD Coach for several days, participants completed a survey of satisfaction and perceived helpfulness and focus groups exploring app use and benefit from use. Data indicate that participants were very satisfied with PTSD Coach and perceived it as being moderately to very helpful with their PTSD symptoms. Analysis of focus group data resulted in several categories of app use: to manage acute distress and PTSD symptoms, at scheduled times, and to help with sleep. These findings offer preliminary support for the acceptability and perceived helpfulness of PTSD Coach and suggest that it has potential to be an effective self-management tool for PTSD. Although promising, future research is required to validate this, given study limitations.",0 +https://doi.org/10.1007/s11469-009-9228-y,Resilience Moderates the Relationship Between Exposure to Violence and Posttraumatic Reexperiencing in Mi’kmaq Youth,"This study is part of a school-based collaborative research project with a Nova Scotian Mi'kmaq community that hopes to shed light on the relationship between exposure to violence and mental health in First Nations youth. This particular study sought to examine how the multifaceted construct of resilience might act as a protective factor, buffering some students from the negative mental health consequences of exposure to violence. The present paper focuses on whether the construct of resilience, measured by the Child and Youth Resiliency Measure (CYRM; Ungar et al. 2008), has a moderating impact on the relationship between exposure to violence (emotional, physical, and sexual), measured by the Childhood Experience of Violence Questionnaire (CEVQ; Walsh, MacMillan, Trocmé, Jamieson, & Boyle, in press), and posttraumatic stress symptoms, measured by the Child PTSD Symptom Scale (CPSS, Foa et al. 2001). Results showed that the positive relationship between exposure to violence-measured as emotional, physical, and sexual abuse, and witnessing domestic violence-and the reexperiencing symptom cluster of PTSD was moderated by resilience, such that exposure to violence was only predictive of reexperiencing at lower levels of resilience. These findings not only help provide further cross-cultural validation for the CYRM as a measure, but provide support for an ecological conceptualization of resilience. © Springer Science + Business Media, LLC 2009.",0 +https://doi.org/10.1007/s00213-010-2009-2,Effects of early life stress on cognitive and affective function: an integrated review of human literature,"The investigation of putative effects of early life stress (ELS) in humans on later behavior and neurobiology is a fast developing field. While epidemiological and neurobiological studies paint a somber picture of negative outcomes, relatively little attention has been devoted to integrating the breadth of findings concerning possible cognitive and emotional deficits associated with ELS. Emerging findings from longitudinal studies examining developmental trajectories of the brain in healthy samples may provide a new framework to understand mechanisms underlying ELS sequelae.The goal of this review was twofold. The first was to summarize findings from longitudinal data on normative brain development. The second was to utilize this framework of normative brain development to interpret changes in developmental trajectories associated with deficits in cognitive and affective function following ELS.Five principles of normative brain development were identified and used to discuss behavioral and neural sequelae of ELS. Early adversity was found to be associated with deficits in a range of cognitive (cognitive performance, memory, and executive functioning) and affective (reward processing, processing of social and affective stimuli, and emotion regulation) functions.Three general conclusions emerge: (1) higher-order, complex cognitive and affective functions associated with brain regions undergoing protracted postnatal development are particularly vulnerable to the deleterious effects of ELS; (2) the amygdala is particularly sensitive to early ELS; and (3) several deficits, particularly those in the affective domain, appear to persist years after ELS has ceased and may increase risk for later psychopathology.",0 +https://doi.org/10.1016/j.janxdis.2014.07.001,Peeking into the black box: Mechanisms of action for anger management treatment,"We investigated potential mechanisms of action for anger symptom reductions, specifically, the roles of anger regulation skills and therapeutic alliance on changes in anger symptoms, following group anger management treatment (AMT) among combat veterans with posttraumatic stress disorder (PTSD). Data were drawn from a published randomized controlled trial of AMT conducted with a racially diverse group of 109 veterans with PTSD and anger symptoms residing in Hawaii. Results of latent growth curve models indicated that gains in calming skills predicted significantly larger reductions in anger symptoms at post-treatment, while the development of cognitive coping and behavioral control skills did not predict greater symptom reductions. Therapeutic alliance had indirect effects on all outcomes mostly via arousal calming skills. Results suggest that generalized symptom reduction may be mediated by development of skills in calming physiological arousal. In addition, arousal reduction skills appeared to enhance one's ability to employ other anger regulation skills.",0 +https://doi.org/10.1111/j.0006-341x.1999.00463.x,Finite Mixture Modeling with Mixture Outcomes Using the EM Algorithm,"This paper discusses the analysis of an extended finite mixture model where the latent classes corresponding to the mixture components for one set of observed variables influence a second set of observed variables. The research is motivated by a repeated measurement study using a random coefficient model to assess the influence of latent growth trajectory class membership on the probability of a binary disease outcome. More generally, this model can be seen as a combination of latent class modeling and conventional mixture modeling. The EM algorithm is used for estimation. As an illustration, a random-coefficient growth model for the prediction of alcohol dependence from three latent classes of heavy alcohol use trajectories among young adults is analyzed.",0 +https://doi.org/10.1016/j.jpsychires.2013.08.013,Predicting post-traumatic stress disorder in veterans: Interaction of traumatic load with COMT gene variation,"Because post-traumatic stress disorder (PTSD) by definition can occur only after exposure to a traumatic event, military veterans who are at high risk for trauma exposure are a particularly relevant population for studying the interaction of trauma with genetic factors that may predispose for the disorder. A number of studies have implicated specific genes as possible risk factors in developing PTSD, including the catechol-O-methyltransferase gene (COMT).Data from Iraq War veterans (n = 236) were used to examine the interaction between COMT and traumatic experiences in predicting later development of PTSD symptoms. Subjects were assessed for exposure to traumatic events both before and during deployment.The interaction between trauma load and COMT was a significant predictor of PTSD symptoms. Those with the heterozygous genotype (Val/Met) showed fewer symptoms associated with trauma exposure compared to those with either homozygous genotype. This interaction remained significant after controlling for other risk factors for PTSD, including personality dimensions of Internalizing and Externalizing.COMT genotype affects risk for development of PTSD symptoms following exposure to trauma.",0 +https://doi.org/10.1016/j.psychres.2013.05.005,Using a hybrid model to investigate the comorbidity and symptom overlap between social phobia and the other anxiety disorders and unipolar mood disorders,New hybrid models of psychopathology have been proposed that combine the current categorical approach with symptom dimensions that are common across various disorders. The present study investigated the new hybrid model of social anxiety in a large sample of participants with anxiety disorders and unipolar mood disorders to improve understanding of the comorbidity and symptom overlap between social phobia (SOC) and the other anxiety disorders and unipolar mood disorders. Six hundred and eighty two participants from a specialized outpatient clinic for anxiety treatment completed a semi-structured diagnostic interview and the Multidimensional Assessment of Social Anxiety (MASA). A hybrid model symptom profile was identified for SOC and compared with each of the other principal diagnoses. Significant group differences were identified on each of the MASA scales. Differences also were identified when common sets of comorbidities were compared within participants diagnosed with SOC. The findings demonstrated the influence of both the principal diagnosis of SOC and other anxiety disorders and unipolar mood disorders as well as the influence of comorbid diagnoses with SOC on the six symptom dimensions. These findings highlight the need to shift to transdiagnostic assessment and treatment practices that go beyond the disorder-specific focus of the current categorical diagnostic systems.,0 +https://doi.org/10.1007/bf00977239,A prospective examination of post-traumatic stress disorder in rape victims,,0 +https://doi.org/10.2174/157340011797183193,Translational Fear Inhibition Models as Indices of Trauma-related Psychopathology,"Posttraumatic stress disorder (PTSD) is a debilitating psychiatric condition that arises from exposure to a traumatic event such as combat exposure, a vehicular accident, or an act of violence. The symptom clusters of PTSD include hyperarousal and re-experiencing of the traumatic event when exposed to trauma reminders, as well as avoidance of such reminders. The fear-and anxiety-related symptoms of PTSD can be conceptualized, and subsequently modeled, as the result of fear conditioning such that the traumatic event serves as an unconditioned stimulus and the environmental cues present at the time of the trauma serve as conditioned stimuli that can ultimately elicit conditioned fear responses (i.e., clinical symptoms) long after the trauma has occurred. Many of the most successful treatments for anxiety disorders such as PTSD are based on the principles of fear extinction in which the repeated presentation of a conditioned stimulus, without noxious consequences, reduces the frequency and intensity of a conditioned response. In the current review, we discuss the most widely employed psychophysiological protocols that have been used to study fear processing in human populations, both psychiatrically healthy and with PTSD. Special emphasis is placed on how translational clinical research can inform clinical practices and vice versa. © 2011 Bentham Science Publishers.",0 +https://doi.org/10.1007/s00484-012-0608-9,Climate change and thermal comfort in Hong Kong,"Thermal comfort is a major issue in cities and it is expected to change in the future due to the changing climate. The objective of this paper is to use the universal thermal comfort index (UTCI) to compare the outdoor thermal comfort in Hong Kong in the past (1971-2000) and the future (2046-2065 and 2081-2100). The future climate of Hong Kong was determined by the general circulation model (GCM) simulations of future climate scenarios (A1B and B1) established by the Intergovernmental Panel on Climate Change (IPCC). Three GCMs were chosen, GISS-ER, GFDL-CM2.1 and MRI-CGCM2.3.2, based on their performance in simulating past climate. Through a statistical downscaling procedure, the future climatic variables were transferred to the local scale. The UTCI is calculated by four predicted climate variables: air temperature, wind speed, relative humidity and solar radiation. After a normalisation procedure, future UTCI profiles for the urban area of Hong Kong were created. Comparing the past UTCI (calculated by observation data) and future UTCI, all three GCMs predicted that the future climate scenarios have a higher mode and a higher maximum value. There is a shift from 'No Thermal Stress' toward 'Moderate Heat Stress' and 'Strong Heat Stress' during the period 2046-2065, becoming more severe for the later period (2081-2100). Comparing the two scenarios, B1 exhibited similar projections in the two time periods whereas for A1B there was a significant difference, with both the mode and maximum increasing by 2 °C from 2046-2065 to 2081-2100. © 2012 ISB.",0 +https://doi.org/10.1007/0-387-25610-5_13,PTSD and Chronic Pain: Cognitive-Behavioral Perspectives and Practical Implications,"GH, a 40-year-old software engineer, was referred to the second author by his primary care physician for treatment of Posttraumatic Stress Disorder (PTSD) that developed subsequent to a road traffic collision 9 months earlier. A vehicle struck GH at moderate speed while he was cycling to work during rush-hour traffic and, as a result, he was flipped over the handlebars and thrown against a building wall. He hit his head, cracking the helmet he was wearing, and sustained multiple soft tissue injuries to his neck, upper back, and shoulders that were considered mild in nature. GH was deemed to be not at fault for the accident, and his insurance company replaced his bicycle and helmet and covered his hospital expenses and wage loss. He took 6 weeks off work and resumed fulltime employment after receiving a transfer 6 months after the accident. During his intake interview, GH reported having difficulty performing his job and being easily irritated by colleagues. On examination, he was found to meet diagnostic criteria for PTSD, with scores on various assessment instruments indicating his symptoms to be severe. He was also moderately depressed and was experiencing daily pain in his neck and back, which, although fluctuating in severity from mild to moderate, had persisted over the past 9 months.",0 +https://doi.org/10.1016/j.euroneuro.2005.10.007,"Fluoxetine in the acute treatment and relapse prevention of combat-related post-traumatic stress disorder: Analysis of the veteran group of a placebo-controlled, randomized clinical trial","The efficacy and safety of fluoxetine (20-80 mg) was compared with placebo in 144 veterans [36.2 years], diagnosed with combat-related post-traumatic stress disorder (PTSD) selected from a 12-week acute and 24-week relapse prevention PTSD trial. In the acute phase, improvements were greater with fluoxetine than placebo in the disease-specific outcome measures: Treatment Outcome PTSD (TOP-8) total scores (SE):-9.05 (0.90) and -5.20 (1.23), p = 0.001; Clinician Administered PTSD Scale (CAPS) total scores:-31.12 (2.72) and -16.07 (4.24), p < 0.001; all CAPS subscores; Davidson Trauma Scale (DTS) total scores; and other general outcome measures. In the maintenance phase, fluoxetine was superior to placebo in sustaining improvement in TOP-8 [-1.01 (0.91) and 1.56 (0.95)] and CAPS [-4.93 (3.54) and 5.48 (3.66)]. The risk of relapse in the placebo arm was significantly greater than in the fluoxetine arm (log-rank test chi 2 = 4.090, df = 1, p = 0.048). Fluoxetine was well tolerated at a mean daily dose of 65 mg.",0 +https://doi.org/10.1016/j.brat.2008.09.004,Anxiety and post-traumatic stress symptoms following wisdom tooth removal,"The purpose of the present study was to determine the psychological impact of wisdom teeth removal and to identify the psychological risk factors for the development of dental anxiety and post-traumatic stress symptoms. Participants were 34 consecutive elective patients referred for surgical removal of a wisdom tooth under local anesthesia. Frequency of previous distressing dental events and general traumatic life events were assessed at baseline (t1), and emotional distress (pain, state anxiety and disturbance) immediately after treatment (t2). Post-traumatic stress responses were determined three days after treatment (t3), and at four weeks follow-up (t4), while severity of dental trait anxiety was assessed at t1 and at t4. Two patients (8%) met screening criteria for Post-Traumatic Stress Disorder (PTSD) at t4. Multivariate analysis revealed that previous exposure to distressing dental events and pre-operative anxiety level predicted anxiety level at t4, accounting for 71% of the variance. Severity of pain during treatment was a significant predictor variable of PTSD symptom severity at t4 (25% explained variance). The findings underline the importance of pain-free treatments and awareness of patients' individual predisposition to anxiety or trauma-related symptoms to reduce the risk of iatrogenic psychological harm.",0 +https://doi.org/10.1007/s00134-013-3037-2,The PRESERVE mortality risk score and analysis of long-term outcomes after extracorporeal membrane oxygenation for severe acute respiratory distress syndrome,"PurposeThis study was designed to identify factors associated with death by 6 months post-intensive care unit (ICU) discharge and to develop a practical mortality risk score for extracorporeal membrane oxygenation (ECMO)-treated acute respiratory distress syndrome (ARDS) patients. We also assessed long-term survivors’ health-related quality of life (HRQL), respiratory symptoms, and anxiety, depression and post-traumatic stress disorder (PTSD) frequencies.MethodsData from 140 ECMO-treated ARDS patients admitted to three French ICUs (2008–2012) were analyzed. ICU survivors contacted >6 months post-ICU discharge were assessed for HRQL, psychological and PTSD status.ResultsMain ARDS etiologies were bacterial (45 %), influenza A[H1N1] (26 %) and post-operative (17 %) pneumonias. Six months post-ICU discharge, 84 (60 %) patients were still alive. Based on multivariable logistic regression analysis, the PRESERVE (PRedicting dEath for SEvere ARDS on VV-ECMO) score (0–14 points) was constructed with eight pre-ECMO parameters, i.e. age, body mass index, immunocompromised status, prone positioning, days of mechanical ventilation, sepsis-related organ failure assessment, plateau pressure andpositive end-expiratory pressure. Six-month post-ECMO initiation cumulative probabilities of survival were 97, 79, 54 and 16 % for PRESERVE classes 0–2, 3–4, 5–6 and ≥7 (p < 0.001), respectively. HRQL evaluation in 80 % of the 6-month survivors revealed satisfactory mental health but persistent physical and emotional-related difficulties, with anxiety, depression or PTSD symptoms reported, by 34, 25 or 16 %, respectively.ConclusionsThe PRESERVE score might help ICU physicians select appropriate candidates for ECMO among severe ARDS patients. Future studies should also focus on physical and psychosocial rehabilitation that could lead to improved HRQL in this population.",0 +https://doi.org/10.1007/s10461-011-0095-8,OPRM1 and Diagnosis-Related Posttraumatic Stress Disorder in Binge-Drinking Patients Living with HIV,"Posttraumatic stress disorder (PTSD) has been linked to numerous negative outcomes in persons living with HIV (PLH) and there is evidence that PTSD symptoms may play a role in maintaining alcohol use problems. The opioid receptor mu-1 (OPRM1) gene may play a role in both PTSD and alcohol use. We examined the association between PTSD and drinking motives as well as variation in the OPRM1 as a predictor of both PTSD and drinking motives in a sample of 201 PLH reporting recent binge drinking. Self-reported PTSD symptom severity was significantly associated with drinking motives for coping, enhancement, and socialization. OPRM1 variation was associated with decreased PTSD symptom severity as well as enhancement motives for drinking.",0 +https://doi.org/10.1017/s0033291711000948,Heart rate after trauma and the specificity of fear circuitry disorders,"Fear circuitry disorders purportedly include post-traumatic stress disorder (PTSD), panic disorder, agoraphobia, social phobia and specific phobia. It is proposed that these disorders represent a cluster of anxiety disorders triggered by stressful events and lead to fear conditioning. Elevated heart rate (HR) at the time of an aversive event may reflect strength of the unconditioned response, which may contribute to fear circuitry disorders.This prospective cohort study assessed HR within 48 h of hospital admission in 602 traumatically injured patients, who were assessed during hospital admission and within 1 month of trauma exposure for lifetime psychiatric diagnosis. At 3 months after the initial assessment, 526 patients (87%) were reassessed for PTSD, major depressive disorder, panic disorder, agoraphobia, social phobia, obsessive compulsive disorder and generalized anxiety disorder.At the 3-month assessment there were 77 (15%) new cases of fear circuitry disorder and 87 new cases of non-fear circuitry disorder (17%). After controlling for gender, age, type of injury and injury severity, patients with elevated HR (defined as ≥96 beats per min) at the time of injury were more likely to develop PTSD [odds ratio (OR) 5.78, 95% confidence interval (CI) 2.32-14.43], panic disorder (OR 3.46, 95% CI 1.16-10.34), agoraphobia (OR 3.90, 95% CI 1.76-8.61) and social phobia (OR 3.98, 95% CI 1.42-11.14). Elevated HR also predicted new fear circuitry disorders that were not co-morbid with a non-fear circuitry disorder (OR 7.28, 95% CI 2.14-24.79).These data provide tentative evidence of a common mechanism underpinning the onset of fear circuitry disorders.",0 +https://doi.org/10.1176/appi.neuropsych.12090223,Post-Treatment Lyme Syndrome and Central Sensitization,"Central sensitization is a process that links a variety of chronic pain disorders that are characterized by hypersensitivity to noxious stimuli and pain in response to non-noxious stimuli. Among these disorders, treatments that act centrally may have greater efficacy than treatments acting peripherally. Because many individuals with post-treatment Lyme syndrome (PTLS) have a similar symptom cluster, central sensitization may be a process mediating or exacerbating their sensory processing. This article reviews central sensitization, reports new data on sensory hyperarousal in PTLS, explores the potential role of central sensitization in symptom chronicity, and suggests new directions for neurophysiologic and treatment research.",0 +https://doi.org/10.1007/s10865-008-9176-1,The covariation of multiple risk factors in primary care: a latent class analysis,"There is a need to advance the quality of healthcare by increasing knowledge about multiple risk factors and how to intervene to improve health outcomes. In an effort to better describe the presentation of multiple risks, this study involved a database review to describe the prevalence and covariation of multiple risk factors in individuals presenting to primary care. Patients with a primary care encounter from January 1, 2005 to June 30, 2005 (N = 10,043) were identified from the Department of Veteran's Affair's medical database and information about the following risk factors was extracted: alcohol use, psychiatric distress, body mass, smoking status, blood pressure, and posttraumatic stress. Exploratory and confirmatory latent class analyses identified three classes of individuals. Class 1 consisted of individuals with an overall lower level of risk for health problems, but a moderately high likelihood of elevated blood pressure. Individuals in Class 2 appeared to have the greatest need for intervention because they had a moderate to high likelihood of reporting at risk alcohol use, smoking, depression, and posttraumatic stress. Class 3 consisted of individuals reporting the co-occurrence of at risk alcohol use, smoking, and elevated blood pressure. Similar to past research, the findings highlight the need for addressing multiple risk factors in primary care. In addition, this study expands on the literature by identifying specific patterns of covariation among different risk factors that suggest avenues for research and program development. (",0 +https://doi.org/10.1038/npp.2013.301,Influence of RGS2 on Sertraline Treatment for Social Anxiety Disorder,"Only a minority of patients with social anxiety disorder (SAD) has a robust therapeutic response to evidence-based serotonin reuptake inhibitor (SSRI) treatment. To help improve the personalized medicine approach to psychiatric care, we evaluated several candidate genetic predictors of SSRI response in SAD. At the start of a randomized controlled trial (NCT00282828), 346 patients with SAD at three sites received protocol-driven, open-label treatment with sertraline, up to 200. mg/d over 10 weeks. Efficacy was determined using a continuous measure of outcome (Liebowitz Social Anxiety Scale (LSAS)) and dichotomous indicators of response (LSAS ≤ 50) and remission (LSAS ≤ 30). Predictors of efficacy were examined in multivariate regression models that included eight polymorphic variants in four candidate genes (four in RGS2, two in HTR2A, one in SLC6A2, and one in SLC6A4). Adjusting for genetic ancestral cluster and non-genetic predictors of response, all four single-nucleotide polymorphisms (SNPs) in RGS2 predicted change in LSAS over time, at study-wise significance (p=0.00833), with the minor allele associated with less improvement over time. After adjusting for genetic ancestral cluster and non-genetic predictors of remission, two of the four RGS2 SNPs predicted likelihood of remission at or just below study-wise significance (p=0.025): rs4606 (AOR=0.49 (95% CI=0.27-0.90), p=0.022) and rs1819741 (AOR=0.50 (95% CI=0.28-0.92), p=0.027). Variation in RGS2, a gene previously shown to be associated with social anxiety phenotypes and serotonergic neurotransmission, may be a biomarker of the likelihood of substantially benefiting from sertraline among patients with SAD.",0 +https://doi.org/10.1016/j.newideapsych.2015.06.001,Trajectory-based methods in clinical psychology: A person centred narrative approach,Abstract Life trajectories in clinical psychology research are often not treated as interactive trajectories but rather as static transversal variables. But developmental pathways are often cumulative and conditional and currently require sophisticated group-based modeling to tease out individual differences in trajectories. Clinical psychologists often require personal information on transitions and turning points in life which require eliciting information through qualitative life history approaches. A method is proposed for identifying life events within the person's narrative and describing trajectories as event spaces likely to reflect end-point psychopathology.,0 +https://doi.org/10.1001/jama.277.3.215,Is there a Gulf War Syndrome? Searching for syndromes by factor analysis of symptoms,"Objective. - To search for syndromes in Persian Gulf War veterans. Participants. - Two hundred forty-nine (41%) of the 606 Gulf War veterans of the Twenty-fourth Reserve Naval Mobile Construction Battalion living in 5 southeastern states participated; 145 (58%) had retired from service, and the rest were still serving in the battalion. Design. - Participants completed a standardized survey booklet measuring the anatomical distributions or characteristics of each symptom, a booklet measuring wartime exposures, and a standard psychological personality assessment inventory. Two-stage factor analysis was used to disentangle ambiguous symptoms and identity syndromes. Main Outcome Measures. - Factor analysis-derived syndromes. Results. - Of 249 participants, 175 (70%) reported having had serious health problems that most attributed to the war, and 74 (30%) reported no serious health problems. Principal factor analysis yielded 6 syndrome factors, explaining 71% of the variance. Dichotomized syndrome indicators identified the syndromes in 63 veterans (25%). Syndromes 1 ('impaired cognition,' characterized by problems with attention, memory, and reasoning, as well as insomnia, depression, daytime sleepiness, and headaches), 2 ('confusion-ataxia,' characterized by problems with thinking, disorientation, balance disturbances, vertigo, and impotence), and 3 ('arthro-myo-neuropathy,' characterized by joint and muscle pains, muscle fatigue, difficulty lifting, and extremity paresthesias) represented strongly clustered symptoms; whereas, syndromes 4 ('phobia- apraxia'), 5 ('fever-adenopathy'), and 6 ('weakness-incontinence') involved weaker clustering and mostly overlapped syndromes 2 and 3. Veterans with syndrome 2 were 12.5 times (95% confidence interval, 3.5-44.8) more likely to be unemployed than those with no health problems. A psychological profile, found in 48.4% of those with the syndromes, differed from posttraumatic stress disorder, depression, somatoform disorder, and malingering. Conclusion. - These findings support the hypothesis that clusters of symptoms of many Gulf War veterans represent discrete factor analysis-derived syndromes that appear to reflect a spectrum of neurologic injury involving the central, peripheral, and autonomic nervous systems.",0 +https://doi.org/10.2165/00023210-200620060-00003,Long-Term Pharmacotherapy for Post-Traumatic Stress Disorder,"This article reviews the literature on the long-term pharmacological treatment of post-traumatic stress disorder (PTSD). A PUBMED search was conducted; only studies on the effects of long-term (> 14-weeks) pharmacological treatment for PTSD in adults or children were considered. Our search identified three randomised, double-blind, placebo-controlled studies (one each for sertraline, fluoxetine and risperidone), four open-label studies (one each for sertraline, paroxetine, nefazodone and valproate), one retrospective case series (clozapine) and one pooled analysis (sertraline). All studies involved adult populations, with the exception of the study of clozapine. The studies demonstrate that long-term treatment of PTSD with SSRIs effectively maintains the previous treatment response and improvement in quality of life, converts more patients to responder status and accounts for one-third of overall treatment gains. Greater PTSD severity predicts a longer time to response to these drugs. Discontinuation of SSRI treatment after 12 weeks results in a greater risk of relapse and symptom exacerbation compared with extended treatment. In addition to improved PTSD symptoms, extended treatment with paroxetine improves verbal declarative memory and increases hippocampal volume. Long-term treatment of PTSD with atypical antipsychotics (risperidone and clozapine), non-SSRI antidepressants (nefazodone) and antiepileptic drugs (AEDs; valproate) also appears to result in significant improvements in PTSD symptoms. In conclusion, long-term treatment of PTSD with SSRIs improves the psychiatric and clinical outcome of patients with the disorder and prevents relapse and symptom exacerbation. The effect of other agents (atypical antipsychotics, AEDs and other psychotropic medications) requires further controlled study. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1016/j.jad.2013.12.013,Family history of a mood disorder indicates a more severe bipolar disorder,"In the clinical setting, patients with bipolar disorder (BD) are often asked about potential family history (FH) of mood disorders. The aim of the present study was to examine differences between BD patients with FH of a mood disorder, and those without, on clinical, personality and social functioning characteristics, as well as on the symptomatic course of the disorder.Data was collected from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). For this report, we included 2600 patients, 1963 of those reported having a first-degree family member with a mood disorder, and 637 reported of no such FH. We investigated the impact of FH on socio-demographic, clinical, personality and quality of life variables, as well as on symptomatology during the first year of treatment.Patients reporting FH of a mood disorder had an earlier age at onset of depression/mania, more phases, rapid cycling and more suicide attempts. Across different assessments, patients with FH showed consistently elevated depressive symptoms, such as lower concentration and energy, higher suicidal ideation, as well as increased racing thoughts and distractibility within the manic spectrum of symptoms. Further, the FH group had lower quality of life, higher neuroticism and higher personality disorder scores compared to patients without FH.Information on FH was obtained through the proband.Overall, BD patients reporting FH of a mood disorder showed a worse clinical profile upon presentation for treatment and a more symptomatic course of the disorder.",0 +https://doi.org/10.1348/135910707x250866,"Expressive writing and post-traumatic stress disorder: Effects on trauma symptoms, mood states, and cortisol reactivity","This study investigates the boundary conditions (feasibility, safety, and efficacy) of an expressive writing intervention for individuals with post-traumatic stress disorder [PTSD].Randomized trial with baseline and 3-month follow-up measures of PTSD severity and symptoms, mood states, post-traumatic growth, and (post-only) cortisol reactivity to trauma-related stress.Volunteers with a verified diagnosis of PTSD (N=25) were randomly assigned to an experimental group (writing about their traumatic experience) or control group (writing about time management).Expressive writing was acceptable to patients with PTSD and appeared safe to utilize. No changes in PTSD diagnosis or symptoms were observed, but significant improvements in mood and post-traumatic growth were observed in the expressive writing group. Finally, expressive writing greatly attenuated neuroendocrine (cortisol) responses to trauma-related memories.The present study provides insight into several boundary conditions of expressive writing. Writing did not decrease PTSD-related symptom severity. Although patients continue to exhibit the core features of PTSD, their capacity to regulate those responses appears improved following expressive writing. Dysphoric mood decreased after writing and when exposed to traumatic memories, participants' physiological response is reduced and their recovery enhanced.",0 +https://doi.org/10.1007/bf00963574,Psychopathology subtypes and symptom correlates among former prisoners of war,"Psychopathology and symptom patterns were studied in 60 former prisoners-of-war (POWs) by administering standardized tests including the Minnesota Multiphasic Personality Inventory (MMPI), an adjustment problem checklist, and a structured clinical interview. Most POWs showed marked psychological impairment, but modal profile analysis identified two prototypic MMPI patterns, which differed in pervasiveness and type of psychopathology. Profile subtypes were defined by unique clusters of clinical symptoms and differed in confinement stress severity. The typology of symptoms argues against a homogeneous conceptualization of stress-induced disorders and suggests the need for definition of the severity and subtype of stress phenomena and individual difference factors in responding to trauma. © 1986 Plenum Publishing Corporation.",0 +https://doi.org/10.1001/archderm.1987.01660290115028,Antidepressant Drugs in Dermatology,"Recent studies indicate that antidepressant medications may be effective treatments for dermatologic disorders such as chronic urticaria and angioedema, nocturnal pruritus in atopic eczema, and postherpetic neuralgia, even in the absence of coexisting psychopathologic conditions. Their efficacy may be related to their antihistaminic, anticholinergic, and centrally mediated analgesic effects and appears to be independent of their antidepressant effect. It is likely, therefore, that more dermatologists will be prescribing these drugs without a psychiatric consultation.",0 +https://doi.org/10.1037/cp2006003,Are gender differences in post-traumatic stress disorder rates attenuated in substance use disorder patients?,"Abstract We review 15 studies that examined rates of post-traumatic stress disorder (PTSD) in substance use disorder (SUD) patients to determine whether the typical female-greaterthan-male gender difference in PTSD rates is attenuated in SUD samples. Since the majority of studies reviewed did not find a gender difference in PTSD rates, we critically examined methodological factors that might account for this attenuation, but none appeared to completely account for the variability in detection of gender differences across studies. Several factors may contribute to making rates of PTSD among SUD males equivalent to the high rates observed in SUD females: 1) the risky lifestyle associated with men's substance abuse may increase their exposure to traumatic events, 2) a history of more severe trauma characteristics may be apparent among men with SUDs, or 3) attenuated gender differences in rates of other comorbidities that increase PTSD risk (e.g., depression) may exist. Clinical implications are discussed. According to epidemiological studies, post-traumatic stress disorder (PTSD) is a highly comorbid condition among those with substance use disorders (SUDs; see review by Stewart, 1996). In the National Comorbidity Survey, a large-scale epidemiologic survey conducted in the U.S., Kessler and colleagues (1997) found that those with alcohol dependence were at 3-4 times increased risk of lifetime PTSD as compared to those without alcohol dependence. Moreover, the presence of comorbid PTSD among individuals being treated for SUDs is related to poorer treatment adherence (Hien, Nunes, Rudnick Levin, & Fraser, 2000) and outcomes, including higher relapse rates (e.g., Ouimette, Brown, & Najavits, 1998; Ouimette, Finney, & Moos, 1999). It has been suggested that if patients with comorbid SUD-PTSD were to receive trauma-specific treatment, they might avoid overutilizing or misusing expensive inpatient SUD treatments, thereby reducing the cost of clinical care (e.g., Brown, Recupero, & Stout, 1995). The delineation of gender variations in the presentation of this comorbidity may identify factors that will improve treatment outcomes (Sonne et al., 2003). A fairly consistent finding across epidemiologic studies on PTSD rates in the general adult population is that women are about twice as likely to have PTSD as men (e.g., Breslau, Chilcoat, Kessler, Peterson, & Lucia, 1999; Breslau, Davis, Andreski, & Peterson, 1991; Breslau, Davis, Andreski, Peterson, & Schultz, 1997; Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995). Moreover, women experience qualitatively different traumatic life experiences than do men. These findings have led to an interest in understanding gender differences in PTSD and their implications for etiology and treatment of the disorder (e.g., Kimerling, Ouimette, & Weitlauf, in press). Early research on comorbid PTSD-SUDs focused almost exclusively on male veterans whose pathology arose in the context of combat trauma; more recently, a focus has emerged on women with comorbid PTSD-SUDs (Najavits, Weiss, & Shaw, 1997). The major purpose of this article is to examine gender as an important individual difference variable with respect to trauma and PTSD among patients with SUDs. This brief review focuses on rates of trauma and PTSD among clinical samples of male and female SUD patients. Summaries of the methods and findings of the studies reviewed in this article are provided in Tables 1 and 2, for trauma exposure rates and PTSD rates, respectively. Gender Differences in Adult Samples Brown et al. (1995) studied the prevalence of trauma histories and comorbid PTSD among 84 adults (48 male; 36 female) seeking treatment at a private hospital inpatient substance-abuse treatment program. Participants completed self-report measures of lifetime trauma exposure and PTSD symptoms. Women were more likely than men to have been physically abused/assaulted (31% vs. …",0 +https://doi.org/10.1097/01.nmd.0000249060.48248.ba,Reactions to Combat Stress in Israeli Veterans Twenty Years After the 1982 Lebanon War,"During the war or shortly thereafter, the most common manifestation of combat induced psychopathology is combat stress reaction (CSR). The long-term consequences of CSR have so far received little scientific attention. The aim of this study was to examine whether CSR is a marker for long-term PTSD and other psychiatric comorbidities. Two groups of veterans from the 1982 Lebanon war were assessed 20 years after the war: one comprised 286 CSR casualties and the other comprised 218 matched non-CSR soldiers. Participants were assessed for PTSD, psychiatric symptomatology, social functioning, physical health, and postwar life events. Twenty years after the war, veterans with antecedent CSR reported more PTSD, psychiatric symptomatology and distress, social dysfunction, and health problems than did non-CSR veterans. We conclude that CSR should be seen as a marker for long-term psychiatric distress and impairment. In addition, the implications of combat-related trauma are broad and varied, and go beyond the narrow scope of PTSD.",0 +https://doi.org/10.1176/appi.ajp.162.12.2276,Predicting Posttraumatic Stress Symptoms From Pretraumatic Risk Factors: A 2-Year Prospective Follow-Up Study in Firefighters,"Most studies focusing on risk factors for posttraumatic stress disorder (PTSD) have used retrospective study designs. Only a small number of studies have prospectively examined risk factors in the immediate aftermath of trauma exposure in predicting PTSD symptoms. The purpose of this study was to identify predictive risk factors for posttraumatic stress symptoms and comorbid psychopathological symptoms present during the time before exposure to traumatic stress in a high-risk population.Forty-three professional firefighters were assessed immediately after basic training (baseline) and at 6, 9, 12, and 24 months after entry into firefighter service. Subjects were screened for psychopathological symptoms, including symptoms of PTSD, depression, and anxiety. Subjects were also characterized with regard to personality traits such as self-efficacy, hostility, and alexithymia. Neuroendocrine activity was assessed by examination of awakening and diurnal salivary cortisol profiles and 24-hour urinary catecholamine excretion. Multiple linear regression analysis was used to analyze posttraumatic stress symptoms at 24-month follow-up as a function of pretraumatic characteristics.A high level of hostility and a low level of self-efficacy at baseline accounted for 42% of the variance in posttraumatic stress symptoms after 2 years. Subjects who had both risk factors at baseline showed a significant increase in measures of PTSD symptoms, depression, anxiety, general psychological morbidity, global symptom severity, and alexithymia during the 2-year period. Biological characteristics were not predictive of the development of psychopathological symptoms.These results suggest that specific personality traits may constitute markers of vulnerability to the development of psychopathological symptoms after trauma exposure. Early identification of preexisting risk factors is needed to provide effective prevention and intervention for individuals who are at risk of developing trauma-related disorders.",0 +https://doi.org/10.2174/1573400511666150629104748,"Adaptation to Traumatic Stress: Resilient Traits, Resources, and Trajectories of Outcomes","The term resilience is too often poorly operationalized and loosely conceptualized. Historically, it has beendefined as a trait, characteristic, or collection of resources that facilitates healthy adjustment to a potentially traumaticevent (PTE) and has typically been measured at one point in time. More recently, it has been defined as an outcome, or asuccessful course of adaptation following exposure to a severe and overwhelming experience. Inherent in this definition isthe expectation that a cross-sectional evaluation will fall short; if resilience is an adaptation to an experience, it must thenunfold over time. Unfortunately, the absence of a single unifying paradigm of resilience has hindered progress in the field.In this review, we discuss the handful of characteristics that are most consistently linked to low levels of distressfollowing exposure to a PTE and describe several prototypic trait resilience measures for adults. We also describe andcritically evaluate research that has generated distinct typologies or groups with similar trajectories of adjustmentfollowing exposure to PTEs. Finally, we provide examples of several studies of interventions to promote resilience.Ultimately, for the field to advance, clinicians, researchers, and policy-makers need to isolate the factors that reliablypromote a successful adjustment across a broad range of domains, including emotional, physical, and occupationalfunctioning. Once known, prevention and intervention strategies need to be refined and tested so that suffering anddysfunction can be mitigated before chronic and debilitating distress become entrenched in those who do not recover ontheir own.",0 +https://doi.org/10.1093/milmed/161.7.407,Post-Traumatic Stress Disorder Symptoms among Gulf War Veterans,"This study assessed the prevalence of risk for development of post-traumatic stress disorder (PTSD) symptoms among active duty and reserve veterans from Pennsylvania and Hawaii who either deployed (N = 1,524) or did not deploy (N = 2,727) to the Persian Gulf as a result of Operation Desert Storm. All participants anonymously completed a survey questionnaire that included the Impact of Event Scale and the Brief Symptom Inventory. Results indicate the likelihood of PTSD symptoms in approximately 8.0% of active duty veterans and 9.3% of reserve veterans who deployed to the Persian Gulf. PTSD risk comparisons are made with other active duty Army veterans assessed 1 year earlier. Sources of trauma are presented and implications for future military deployments on potential risks for developing PTSD are discussed.",0 +https://doi.org/10.1007/7854_2009_33,Challenging Anxiety: A Focus on the Specificity of Respiratory Symptoms,"Physiological symptoms are characteristic features of anxiety states. Presumably, specific psychophysiological profiles differentiate between anxiety disorders, which would offer potential for diagnostic purposes. Abundant evidence points to a causal relationship between panic disorder and instability of respiratory regulation. However, the specificity of most measures that indicate aberrant functioning of the respiratory system in PD can be questioned. Possibly, the traditional measures of respiratory functioning are too restricted. The underlying respiratory vulnerability in PD seems to constitute a subtle, unstable trait, which calls for more sensitive and sophisticated measures of respiratory variability and chaos. To increase the probability of finding parameters with diagnostic specificity, the application of disorder specific challenge paradigms is recommended.",0 +https://doi.org/10.4088/jcp.14com09379,Viewing Suicide Risk Through a New Lens: The Benefits of Examining Symptom Trajectories,,0 +https://doi.org/10.1023/a:1007580616096,,"The present study provided psychometric data on the KID-SAVE, an empirically based measure of children's exposure to community violence. The KID-SAVE was administered to 470 inner-city children in the third through seventh grades and demonstrated excellent reliability. Factor analysis yielded three subscales: Traumatic Violence, Indirect Violence, and Physical/Verbal Abuse. Initial investigation of construct validity suggested that the KID-SAVE successfully discriminated between groups of children reporting high and low levels of traumatic symptoms. The KID-SAVE appears to be a promising assessment tool and allows for quantification of the severity of violence exposure.",0 +https://doi.org/10.1017/s0033291715002184,DSM-IV post-traumatic stress disorder among World Trade Center responders 11–13 years after the disaster of 11 September 2001 (9/11),"Background Post-traumatic symptomatology is one of the signature effects of the pernicious exposures endured by responders to the World Trade Center (WTC) disaster of 11 September 2001 (9/11), but the long-term extent of diagnosed Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) post-traumatic stress disorder (PTSD) and its impact on quality of life are unknown. This study examines the extent of DSM-IV PTSD 11–13 years after the disaster in WTC responders, its symptom profiles and trajectories, and associations of active, remitted and partial PTSD with exposures, physical health and psychosocial well-being. Method Master's-level psychologists administered sections of the Structured Clinical Interview for DSM-IV and the Range of Impaired Functioning Tool to 3231 responders monitored at the Stony Brook University World Trade Center Health Program. The PTSD Checklist (PCL) and current medical symptoms were obtained at each visit. Results In all, 9.7% had current, 7.9% remitted, and 5.9% partial WTC-PTSD. Among those with active PTSD, avoidance and hyperarousal symptoms were most commonly, and flashbacks least commonly, reported. Trajectories of symptom severity across monitoring visits showed a modestly increasing slope for active and decelerating slope for remitted PTSD. WTC exposures, especially death and human remains, were strongly associated with PTSD. After adjusting for exposure and critical risk factors, including hazardous drinking and co-morbid depression, PTSD was strongly associated with health and well-being, especially dissatisfaction with life. Conclusions This is the first study to demonstrate the extent and correlates of long-term DSM-IV PTSD among responders. Although most proved resilient, there remains a sizable subgroup in need of continued treatment in the second decade after 9/11.",0 +https://doi.org/10.1111/j.1744-6163.2011.00324.x,Biological Perspectives: Detecting Malingering of Post-Traumatic Stress Disorder (PTSD) in Adults,"The issue of detecting malingering post-traumatic stress disorder (PTSD) is a difficult one. Given the complexity of PTSD and the current state of the art in making accurate diagnosis of various mental health conditions, it should be no surprise that detecting malingering in patients complaining of symptoms of possible PTSD is a difficult process. This article is intended to shed more light than darkness on this process. Clearly, the ideas and approaches that are suggested are meant as an introduction to developing a deeper understanding of the processes associated with detecting malingering of PTSD. In doing this, it is intended to make the process of attempting to detect the possible malingering of PTSD a clearer,more thoughtful, and more clinically useful endeavor. Certainly, such an effort is not free from controversy nor is it perfect. Also, the approaches that are described here are not unique and can be found elsewhere in the literature. Assessing PTSD and detecting possible malingering of PTSD is a difficult task. However, if a clinician takes a multimodal approach to the assessment of PTSD, then the process of detecting possible attempts to malinger this disorder is far less daunting. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0 +https://doi.org/10.1016/j.psyneuen.2009.04.004,"Pituitary response to metyrapone in Gulf War veterans: Relationship to deployment, PTSD and unexplained health symptoms","Gulf War deployment has been associated with a distinct neuroendocrine profile characterized by low 24h basal ACTH levels and enhanced cortisol and ACTH suppression to low-dose dexamethasone. The metyrapone stimulation test was performed to further characterize hypothalamic-pituitary activity in Gulf War veterans (GWV) and its relationship to unexplained medical symptoms and post-traumatic stress disorder (PTSD).Eleven GWV without PTSD, 18 GWV with PTSD and 15 healthy subjects not exposed to the Gulf War theater (non-exposed) underwent the metyrapone stimulation test, which inhibits cortisol synthesis, impairs cortisol-mediated negative feedback inhibition and in turn increases levels of ACTH and 11-deoxycortisol, a cortisol precursor. These hormones were measured at baseline (7:00 a.m.) and at intervals (from 8:00 a.m. to 4:00 p.m.) following the administration of metyrapone 750mg orally at 7:05 a.m. and at 10:05 a.m.There were group differences in the ACTH response despite similar cortisol and 11-deoxycortisol responses to metyrapone. GWV without PTSD had a significantly attenuated ACTH response compared to non-exposed subjects; GWV with PTSD had a significantly higher ACTH response than GWV without PTSD but did not differ from non-exposed subjects. Among GWV, unexplained medical health symptoms (e.g., neurological, musculoskeletal, cardiac, and pulmonary symptoms) and PTSD symptoms were significantly positively associated with the ACTH response to metyrapone.Gulf War deployment is associated with a substantially lower ACTH response to metyrapone. In contrast, unexplained health symptoms and PTSD in Gulf War veterans are associated with relatively greater hypothalamic-pituitary activity which may reflect increased CRF activity and is evident only in consideration of deployment effects. This pattern of differences suggests either that Gulf War deployment and its associated exposures results in enduring changes in pituitary function or that reduced hypothalamic-pituitary activity protects against the development of PTSD and other deployment-related health problems.",0 +https://doi.org/10.1007/s11682-015-9379-3,Sex differences in orbitofrontal connectivity in male and female veterans with TBI,"More female soldiers are now serving in combat theaters than at any other time. However, little is known about possible sex differences underlying the neuropathology and manifestation of one of modern war's signature injuries, traumatic brain injury (TBI). The paucity of information regarding sex differences in TBI is particularly evident when examining changes in executive function and emotion regulation associated with post concussive events. The current study objective was to observe whether patterns of orbitofrontal (OFC) functional connectivity would differ between female veterans with TBI and their male counterparts. The study further sought to determine whether OFC connectivity might be differentially associated with clinical measures of aggression and hostility. Seventeen female veterans and 24 male veterans, age 18 to 25, who met criteria for TBI completed resting state magnetic resonance imaging (MRI) and clinical assessment measures. Imaging data were analyzed using left and right seed regions of the OFC, and regression analyses were conducted to observe the relationship between resting state connectivity and self-reported aggression. Females and males in this study differed in OFC connectivity, with females demonstrating greater connectivity between left and right OFC and parietal and occipital regions and males demonstrating greater connectivity between left and right OFC and frontal and temporal regions. Significant associations between resting state connectivity and clinical measures were found only in male veterans. These findings suggest that TBI may interact with sex-specific patterns of brain connectivity in male and female veterans and exert divergent effects on clinical profiles of aggression post-injury.",0 +https://doi.org/10.1056/nejmra012941,Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) is an increasingly recognized and potentially preventable condition. Certain factors, especially the severity of the trauma, perceived lack of social support and peri-traumatic dissociation have been associated with its development. In recent years, a more robust evidence base regarding the management of individuals involved in traumatic events has emerged. Immediately after a traumatic event, simple practical, pragmatic support provided in a sympathetic manner by non-mental health professionals seems most likely to help. For individuals who develop persisting PTSD, trauma-focused cognitive behavioural therapy (TFCBT) may be beneficial within a few months of the trauma. For those who develop chronic PTSD, TFCBT and eye movement desensitization and reprocessing are best supported by the current evidence. Some anti-depressants appear to have a modest beneficial effect and are recommended as a second-line treatment. The current evidence base has allowed the development of guidelines that now require implementation. This has major implications in terms of planning and developing services that allow appropriately qualified and trained individuals to be available to cater adequately for the needs of survivors of traumatic events. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1023/a:1024442802113,Posttraumatic stress disorder and family functioning in adolescent cancer,"Twenty three adolescents with a history of cancer, 27 physically abused adolescents, and 23 healthy, nonabused adolescents were administered structured posttraumatic stress disorder (PTSD) interviews and self-report questionnaires regarding family functioning. Thirty five percent of adolescent cancer subjects met criteria for lifetime PTSD as compared to only 7% of the abused adolescents: 17% of the cancer subjects and 11% of the abuse subjects met criteria for current PTSD. Adolescents with cancer viewed their mothers and fathers as significantly more caring and more protective than the comparison and abused adolescents. Cancer subjects who met criteria for lifetime PTSD saw their families as significantly more chaotic than those who did not have PTSD. Eighty three percent of cancer subjects who had lifetime PTSD also had mothers who had PTSD.",0 +https://doi.org/10.3389/fpsyg.2015.01071,"Auditory verbal hallucinations in schizophrenia and post-traumatic stress disorder: common phenomenology, common cause, common interventions?","Auditory verbal hallucinations (AVH: 'hearing voices') are found in both schizophrenia and post-traumatic stress disorder (PTSD). In this paper we first demonstrate that AVH in these two diagnoses share a qualitatively similar phenomenology. We then show that the presence of AVH in schizophrenia is often associated with earlier exposure to traumatic/emotionally overwhelming events, as it is by definition in PTSD. We next argue that the content of AVH relates to earlier traumatic events in a similar way in both PTSD and schizophrenia, most commonly having direct or indirect thematic links to emotionally overwhelming events, rather than being direct re-experiencing. We then propose, following cognitive models of PTSD, that the reconstructive nature of memory may be able to account for the nature of these associations between trauma and AVH content, as may threat-hypervigilance and the individual's personal goals. We conclude that a notable subset of people diagnosed with schizophrenia with AVH are having phenomenologically and aetiologically identical experiences to PTSD patients who hear voices. As such we propose that the iron curtain between AVH in PTSD (often termed 'dissociative AVH') and AVH in schizophrenia (so-called 'psychotic AVH') needs to be torn down, as these are often the same experience. One implication of this is that these trauma-related AVH require a common trans-diagnostic treatment strategy. Whilst antipsychotics are already increasingly being used to treat AVH in PTSD, we argue for the centrality of trauma-based interventions for trauma-based AVH in both PTSD and in people diagnosed with schizophrenia.",0 +https://doi.org/10.1016/j.brat.2005.03.001,Anhedonia and emotional numbing in combat veterans with PTSD,"We explored relationships between anhedonia and posttraumatic stress disorder (PTSD) symptom clusters, including their role in predicting psychiatric comorbidity. Our measure of anhedonia was derived from an examination of the latent structure of the Beck Depression Inventory. We found evidence for a two-factor solution, leading to anhedonia and undifferentiated, global depressive symptoms scales. In primary analyses, anhedonia had a unique positive relationship with PTSD's emotional numbing symptoms and minimal relationships with other PTSD symptoms. Upon examining the incremental validity of appetitive functioning (i.e., anhedonia, emotional numbing) over and above aversive functioning (i.e., re-experiencing, avoidance, and hyper-arousal PTSD symptoms) variables, greater emotional numbing increased the likelihood of being diagnosed with a major depressive disorder, and greater anhedonia increased the likelihood of being diagnosed with additional anxiety disorders and to a lesser extent, psychotic disorders. Results were consistent with research on the distinction of appetitive and aversive functioning, providing insight into the nature of PTSD.",0 +https://doi.org/10.1002/jts.20559,An evaluation of competing models for the structure of PTSD symptoms using external measures of comorbidity,"Research on the structure of posttraumatic stress disorder (PTSD) symptoms has yielded support for two 4-factor models: the King (King, Leskin, King, & Weathers, 1998) and Simms/Watson models (Simms, Watson, & Doebbeling, 2002). This study evaluated them using data drawn from 1,128 Vietnam veterans by comparing associations with a latent internalizing comorbidity variable and five scales from the MMPI-2 Restructured Clinical (RC) Scales (Tellegen et al., 2003). The Simms/Watson dysphoria factor failed to show evidence of superior convergent or discriminant validity in association with external measures relative to the numbing or hyperarousal factors of the King model. Findings raise questions about proposals to abandon the distinction between numbing and hyperarousal symptoms in favor of a dysphoria-based model.",0 +https://doi.org/10.1002/jts.20017,Correlation between traumatic events and posttraumatic stress disorder among North Korean defectors in South Korea,"The number of North Korean defectors entering South Korea has been increasing rapidly since 1994. Two hundred North Korean defectors in South Korea were studied to identify their experiences of traumatic events in North Korea and during defection, and the correlation with Posttraumatic Stress Disorder (PTSD). Researchers conducted face-to-face interviews and assisted defectors in performing a self-report assessment of this survey. The study questionnaire consisted of demographic characteristics, the Traumatic Experiences Scale for North Korean Defectors, and the PTSD part of the Structured Clinical Interview for DSM-III-R Korean version. Prevalence rate of PTSD in defectors was 29.5%, with a higher rate for women. In factor analysis, the 25 items of traumatic events experienced in North Korea were divided into three factors: Physical Trauma, Political-Ideological Trauma, and Family-Related Trauma. In addition, the 19 items of traumatic events during defection were grouped into four factors: Physical Trauma, Detection and Capture-Related Trauma, Family-Related Trauma, and Betrayal-Related Trauma. In multifactorial logistic regression analysis, Family-Related Trauma in North Korea had a significant odds ratio.",0 +https://doi.org/10.1002/jts.20220,PTSD symptoms in children and adolescents 28 months after a flood: Age and gender differences,"The present study examined the prevalence and predictors of posttraumatic stress disorder symptoms (PTSD) in a sample of 533 students (aged 11 to 21), 28 months after the 1997 Flood in southwestern Poland. The results show that 18% of the participants met all diagnostic criteria for PTSD. Based on hierarchical multiple regression analyses, PTSD criteria symptoms were positively correlated with the degree of exposure to trauma experienced during the disaster. A three-way interaction of trauma, age, and gender showed that more PTSD symptoms were observed among the younger participants and girls than among the older boys. The results confirm the need of research testing culturally sensitive implementation of mental health programs for young victims of disasters, taking into account their age and gender.",0 +https://doi.org/10.1002/jts.20523,Heterogeneity in the course of posttraumatic stress disorder: Trajectories of symptomatology,"Unconditional and conditional trajectories of posttraumatic stress disorder (PTSD) symptomatology were examined using a sample of U.S. soldiers deployed on a NATO-led peacekeeping mission to Kosovo. Data were collected at 4 time points, ranging from the weeks leading up to deployment to 9-months postdeployment. Latent class growth analysis revealed 4 unique symptom trajectories: resilience, recovery, delayed, and unrealized anxiety. Variables identified as significant predictors of trajectory class included previous traumatic events, combat exposure, peacekeeping daily hassles, depression, alcohol use, aggressive behavior, stress reactivity, and military rank. Results from this study add to the literature detailing the variability in PTSD course, as well as to the literature pertaining to predictors of PTSD onset and course.",1 +https://doi.org/10.1016/j.paid.2014.10.021,Support for the location of negative posttraumatic cognitions in the diagnosis of posttraumatic stress disorder,"Abstract Objective To investigate the extent to which negative posttraumatic cognitions predict, and so can be best located within, the DSM-5 (APA, 2013) individual symptom clusters of posttraumatic stress disorder (PTSD). Method An online survey of traumatic experiences, featuring 528 adults. Results Negative posttraumatic cognitions seem best placed within the Numbing/Detachment symptom cluster. Negative posttraumatic cognitions relating to the self predict higher levels of symptoms across the clusters. While negative cognitions relating to the world contributed to most symptom groups, self-blame cognitions did not. Conclusions Our findings support the placement of posttraumatic cognitions as part of the Numbing/Detachment symptom cluster within the DSM-5rather than the Intrusion, Avoidance and Hyperarousal clusters.",0 +https://doi.org/10.1037/a0027159,The relationship between posttraumatic stress disorder symptoms and paternal parenting of adult children among ex-prisoners of war: A longitudinal study.,"The aversive impact of combat and combat-induced posttraumatic stress disorder (PTSD) on parenting of young children has been examined in a few studies. Nevertheless, the toll of war captivity on parenting and the long-term relations between posttraumatic symptoms and paternal parenting of adult children remains unknown. This longitudinal study examined paternal parenting of adult children among war veterans, some of whom were held in captivity. Furthermore, we examined the mediating role of PTSD symptoms in the association between captivity and parenting. The sample included two groups of male Israeli veterans from the 1973 Yom Kippur War: ex-prisoners of war (ex-POWs) and comparable veterans who had not been held captive. Both groups were assessed via self-report measures of PTSD at three time points: Time 1 (18 after the war), Time 2 (30 after the war), and Time 3 (35 after the war) years after the war. Results shows that ex-POWs reported lower levels of positive parenting compared to comparison group veterans at Time 3. Furthermore, PTSD symptoms at Time 1, Time 2, and Time 3 mediated the association between captivity experience and parenting at Time 3. In addition, it was found that increases in the levels of PTSD symptom clusters over time were associated with lower levels of positive parenting at Time 3.",0 +https://doi.org/10.1080/00048670701449161,Australian Guidelines for the Treatment of Adults with Acute Stress Disorder and Post-Traumatic Stress Disorder,"Over the past 2–3 years, clinical practice guidelines (CPGs) for post-traumatic stress disorder (PTSD) and acute stress disorder (ASD) have been developed in the USA and UK. There remained a need, however, for the development of Australian CPGs for the treatment of ASD and PTSD tailored to the national health-care context. Therefore, the Australian Centre for Posttraumatic Mental Health in collaboration with national trauma experts, has recently developed Australian CPGs for adults with ASD and PTSD, which have been endorsed by the National Health and Medical Research Council (NHMRC). In consultation with a multidisciplinary reference panel (MDP), research questions were determined and a systematic review of the evidence was then conducted to answer these questions (consistent with NHMRC procedures). On the basis of the evidence reviewed and in consultation with the MDP, a series of practice recommendations were developed. The practice recommendations that have been developed address a broad range of clinical questions. Key recommendations indicate the use of trauma-focused psychological therapy (cognitive behavioural therapy or eye movement desensitization and reprocessing in addition to in vivo exposure) as the most effective treatment for ASD and PTSD. Where medication is required for the treatment of PTSD in adults, selective serotonin re-uptake inhibitor antidepressants should be the first choice. Medication should not be used in preference to trauma-focused psychological therapy. In the immediate aftermath of trauma, practitioners should adopt a position of watchful waiting and provide psychological first aid. Structured interventions such as psychological debriefing, with a focus on recounting the traumatic event and ventilation of feelings, should not be offered on a routine basis.",0 +https://doi.org/10.1016/0306-4603(95)00024-7,Understanding comorbidity between ptsd and substance use disorders: Two preliminary investigations,"While there is high level of comorbidity of PTSD and substance use disorders (SUDs), little research has focused on the overlapping symptom constellation characteristic of both PTSD and substance use/withdrawal. This report describes two preliminary investigations that address this area. In the first study, the pattern of PTSD symptoms in a sample of women (n = 28) seeking treatment for a SUD and comorbid with PTSD was compared with the symptom pattern of a sample of women (n = 28) with PTSD only. The PTSD + SUD group evidenced significantly more symptoms in the avoidance and arousal symptom clusters than the PTSD-only group. At the individual symptom level, the PTSD + SUD group reported significantly more sleep disturbance than the PTSD-only group. It was also determined that the PTSD + SUD group reported greater traumatic-event exposure than the PTSD-only group. In the second study, PTSD symptoms were compared in a sample of alcohol- dependent and a sample of cocaine-dependent individuals with PTSD. The alcohol- dependent group exhibited significantly more arousal symptoms than the cocaine-dependent group. Implications of the results for the assessment of individuals with comorbid PTSD and SUDs are discussed.",0 +https://doi.org/10.1080/09503153.2011.597200,Associations Between Post-Traumatic Stress Disorder Symptoms and Alcohol and Other Drug Problems: Implications for Social Work Practice,"This study examines the associations between alcohol and other drug problems (AOD) and post-traumatic stress disorder (PTSD) symptoms in 499 women recruited from outpatient treatment programmes for AOD problems and the general community in western New York. The women were divided into three groups: no-AOD, past-AOD, and current-AOD. The current-AOD group was further subdivided into groups based on alcohol, marijuana, and cocaine misuse. Group comparisons on PTSD symptoms revealed that the current-AOD group experienced more PTSD symptoms than the no-AOD and past-AOD groups. The alcohol and cocaine misuse groups experienced more PTSD symptoms overall and for each symptom cluster than the no-AOD and past-AOD groups, but did not differ from each other or the marijuana group on PTSD symptoms. These findings suggest that individuals who have AOD problems should be assessed for PTSD symptoms and provided with trauma-specific interventions when warranted. Trauma-informed care may benefit those in AOD treatment. Individuals who have PTSD symptoms should be assessed for AOD problems as well.",0 +https://doi.org/10.1080/15299732.2014.970265,"Cumulative Trauma, Hyperarousal, and Suicidality in the General Population: A Path Analysis","Although trauma exposure and posttraumatic stress disorder (PTSD) both have been linked to suicidal thoughts and behavior, the underlying basis for this relationship is not clear. In a sample of 357 trauma-exposed individuals from the general population, younger participant age, cumulative trauma exposure, and all three Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, PTSD clusters (reexperiencing, avoidance, and hyperarousal) were correlated with clinical levels of suicidality. However, logistic regression analysis indicated that when all PTSD clusters were considered simultaneously, only hyperarousal continued to be predictive. A path analysis confirmed that posttraumatic hyperarousal (but not other components of PTSD) fully mediated the relationship between extent of trauma exposure and degree of suicidal thoughts and behaviors.",0 +https://doi.org/10.1007/s001270050006,"Trauma exposure, resilience, social support, and PTSD construct validity among former prisoners of war","Background: The aim of this study was to investigate predictors of persistent symptoms of posttraumatic stress disorder (PTSD) and to examine the construct validity of PTSD in a national sample of 270 World War II and Korean Conflict prisoners of war (POWs). Method: POWs were interviewed at two points in time (1965 and 1990). Predictors included PTSD symptomatology measured in 1965 by items from the Cornell Medical Index (CMI), severity of captivity trauma, resilience factors, and post-trauma social support. The criterion, symptomatology in the early 1990s, was evaluated with the PTSD module of the Structured Clinical Interview for DSM (SCID). Results: The CMI provided only partial coverage of PTSD criteria and appeared to provide only a general index of distress. Clustering of SCID items in two-dimensional space via multidimensional scaling analysis offers some construct validation for the DSM's differentiation of PTSD symptoms into criterion groups, although there was not a perfect match. Trauma severity is best related to PTSD symptomatology experienced in 1990, mitigated in part by greater education level and age at the time of trauma exposure. Surprisingly, 1965 distress added only a modest amount to the prediction of current distress, while post-trauma social support added none. Conclusions: These findings support previous work showing the severe psychological sequelae of POW status 40-50 years after captivity, and indicate that trauma severity during captivity is the best predictor of current PTSD symptomatology. Results also add to our understanding of the conceptual differentiation of PTSD symptoms into separate and distinct symptom clusters.",0 +https://doi.org/10.1080/10926771.2012.665429,Confirmatory Factor Analysis of the Posttraumatic Stress Disorder Checklist,"Several studies have employed confirmatory factor analysis (CFA) to examine the latent structure of the Posttraumatic Stress Disorder (PTSD) Checklist (PCL; Weathers, Litz, Herman, Huska, & Keane, 1993), a measure that assesses PTSD symptomatology. Findings have failed to support the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision [DSM–IV–TR]; American Psychiatric Association, 2000) PTSD model, consisting of reexperiencing, avoidance/numbing, and arousal factors, and no consensus has emerged regarding the best fitting alternative model. Additionally, most studies have utilized homogeneous trauma samples. This study used CFA to examine the PCL factor structure in a sample with exposure to various traumatic events. Superior fit was demonstrated by a model specifying reexperiencing, avoidance, dysphoria, and arousal factors.",0 +,Using therapeutic writing to deconstruct recovery from posttraumatic stress disorder (PTSD),"Exposure to physical and psychological trauma has produced a post-millennial epoch of posttraumatic stress disorder (PTSD), a debilitating anxiety disorder that occurs after exposure to an extreme stressor or prolonged victimization. After an extensive review of treatment protocols in 2008, the Institute of Medicine (IOM) exhorted clinicians to focus on defining the concept of recovery, concentrating on symptom reduction, removal of the PTSD diagnosis, and end-state function. Although the IOM report mobilized large-scale efforts to quantify treatments and standardize delivery of treatment protocols, PTSD recovery remains a concept that has been largely unexplored. The primary aim of this study was to answer the following question: What is the basic psychosocial process that men and women undergo in recovering from PTSD? The study also fulfilled some secondary aims: (a) identifying which, if any, elements of traditional therapy contributed to recovery and (b) establishing a realistic timeline for recovery. Charmaz's method of narrative analysis and grounded theory construction was used to generate the PTSD Recovery Model. The model was nonlinear and included six universal stages that occurred during PTSD recovery: Experiencing Trauma, Dominating Diagnosis, Seeking Solace, Surviving Symptoms, Marking Time, and Navigating Recovery. Support for the model came from research participants and experts. Participants (N=41) were predominantly white, female, and had earned college or graduate degrees. Almost half of the participants (47.5%) reported that it required five years or more for them to feel better or attain some degree of recovery after exposure to trauma. Intimate partner violence and child sexual and/or physical abuse were the most commonly reported traumatic events that had caused PTSD. Although participants stated that experienced mental health clinicians were the most helpful persons or treatment in seeking recovery, they also reported that recovery typically involved a combination of traditional and alternative therapies, often used simultaneously. Most participants who reported recovery were actively engaged in seeking beneficial therapies and saw themselves as architects of the healing process. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0 +https://doi.org/10.1007/s10608-013-9587-3,Perceived Control is a Transdiagnostic Predictor of Cognitive–Behavior Therapy Outcome for Anxiety Disorders,"Perceived control has been proposed to be a general psychological vulnerability factor that confers an elevated risk for developing anxiety disorders, but there is limited research examining perceived control during cognitive-behavioral therapies (CBT). The present study examined whether treatment resulted in improvements in perceived control, and the indirect effects of CBT on changes in symptoms of obsessive-compulsive disorder, social phobia, generalized anxiety disorder, and panic disorder via changes in perceived control. Participants (n = 606) were a large clinical sample presenting for treatment at an outpatient anxiety disorders clinic. Participants completed a series of self-report questionnaires and a structured clinical interview at an intake evaluation and at two follow-up assessments 12 and 24 months later, with the majority of participants initiating CBT between the first two assessments. Results of latent growth curve models indicated that individuals initiating CBT subsequently reported large increases in perceived control and significant indirect effects of treatment on intraindividual changes in each of the four anxiety disorders examined via intraindividual changes in perceived control. These results suggest that the promotion of more adaptive perceptions of control is associated with recovery from anxiety disorders. Furthermore, the consistent finding of indirect effects across the four anxiety disorders examined underscores the transdiagnostic importance of perceived control in predicting CBT outcomes.",0 +,Influencing factors of posttraumatic stress disorder in the shipwreck related military rescuers in Yantai.,"Studied the influential factors of posttraumatic stress disorder (PTSD) and the impact on the shipwreck related military rescuers. Ss were 39 military rescuers (aged 17-49 yrs) (38 males and 1 female) who participated in rescue work after a shipwreck in Yantai, China, December 24th, 1999. One mo later, Ss were assessed with the Self-Rating PTSD Scale (X. Liu, et al, 1998), the Chinese revised version of the SCL-90 (W. Wu), the revised Life Event Scale (M. Zhang), the Eysenck Personality Questionnaire (EPQ), and a self-developed questionnaire referring to demographic information, stress of life events, and social supports. The prevalence of PTSD was 17.95% (7 Ss with PTSD). Correlation analysis revealed the significant factors related to PTSD: economic support when disadvantaged, satisfaction with leaders' attitudes and methods in rescue work, satisfaction in dealing with problems and affairs after the accident, stress in the rescue process, the score of the LES, and the N score of the EPQ. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1016/j.schres.2014.04.005,Treatment response heterogeneity in the predominant negative symptoms of schizophrenia: Analysis of amisulpride vs placebo in three clinical trials,"The extent of heterogeneity in response to the psychopharmacological treatment of negative symptoms is unknown.To examine the extent of heterogeneity in response to the treatment of predominantly negative symptoms of schizophrenia.Data were analyzed from three clinical trials that compared placebo or amisulpride for up to 60days. Trial participants had predominantly negative symptoms of schizophrenia (n=485). Heterogeneity of percentage reduction on the Scale for the Assessment of Negative Symptoms (SANS) was examined with trajectory-group based modeling followed by descriptive statistics and the prediction of trajectory group membership with logistic regression modeling. Analyses were repeated separately for the placebo and amisulpride groups.Trajectory group-based modeling identified groups of non- (n=297, 61.2%), gradual-moderate (n=135, 27.8%) and rapid- (n=53, 10.9%) responders. At baseline compared to non-responders, rapid-responders had consistently significantly (p<.05) higher SANS total and subscale scores. Percent SANS improvement at endpoint was greatest for the rapid-responders group, a finding that replicated stratifying by placebo and amisulpride treatment groups. Similarly, in the total sample and stratifying by placebo and amisulpride groups, dropout was not significantly associated with trajectory group membership.Trajectories of treatment response to the psychopharmacological medication of the negative symptoms of schizophrenia demonstrate substantial heterogeneity. Approximately half of the patients included in our analysis showed little improvement, and the most severely ill at baseline responded the most.",0 +https://doi.org/10.1176/ajp.147.8.1057,Failure to detect fabricated posttraumatic stress disorder with the use of the MMPI in a clinical population,"The authors attempted to replicate previous studies that used the Frequency (F) scale and the posttraumatic stress disorder (PTSD) subscale of the MMPI to discriminate Vietnam veterans with PTSD from well-adjusted veterans and mental health professionals who feigned symptoms of PTSD. Profiles of veterans with PTSD were compared to those of veterans with non-PTSD psychiatric disorders and veterans with fabricated PTSD symptoms who sought treatment. Discriminant analysis of F scale and PTSD subscale scores correctly identified only 43.59% of the subjects, thus failing to support use of the MMPI in detecting fabricated symptoms of PTSD in a clinical population.",0 +https://doi.org/10.1002/brb3.322,Determinants of psychological resistance and recovery among women exposed to assaultive trauma,"Women exposed to potentially traumatic events (PTEs) are at high risk for developing psychiatric disorders, including posttraumatic stress disorder (PTSD), general anxiety disorder (GAD), major depressive disorder (MDD), and substance-related disorders. However, this risk is not universal. Most women are resistant (i.e., remain asymptomatic), or recover following a brief symptomatic period. This study examined the psychological factors associated with resistant and recovered outcomes in a sample of high-risk women exposed to assault-related PTEs.One hundred and fifty-nine women completed the Life Events Checklist and were administered the Structured Clinical Interview for DSM-IV Axis I Disorders. This resulted in three groups: (1) no diagnosis (no past or current psychiatric disorder diagnosis; n = 56), (2) past diagnosis (a past psychiatric disorder diagnosis, but none currently; n = 31), and (3) current diagnosis (a current diagnosis of one or more psychiatric disorders; n = 72). Groups were compared on sociodemographics, PTE exposure, psychopathology, health-related quality of life (HRQOL), and psychological resilience-related factors.The majority of respondents (79%) did not develop chronic PTSD following assault exposure, and the most common psychiatric outcome was MDD (30%). High endorsement of mastery and social support were associated with the no diagnosis group; and greater reports of mastery and posttraumatic growth were associated with recovery from a past psychiatric disorder. Furthermore, both resilient groups (i.e., no diagnosis and past diagnosis) scored higher on HRQOL measures compared with the current diagnosis group (P < 0.001).Psychological resilience has ramifications to health and well-being, and identifying these factors has potential to inform preventive strategies and treatment interventions for assault exposed women.",0 +https://doi.org/10.1002/1097-4679(198701)43:1<28::aid-jclp2270430105>3.0.co;2-j,Combat-related post-traumatic stress disorder etiology: Replicated findings in a national sample of Vietnam-era men,"To examine the generality of recent findings on PTSD etiology in help-seeking Vietnam combat veterans, replication was attempted with data from a national study of Vietnam-era men that included combat veterans. Use of a Guttman scaling technique for assessing combat exposure was found to be robust for use with a national nonclinical sample as well. In addition, multiple regression analysis was used to examine predictive relationships between premilitary adjustment, military adjustment, combat exposure, and post-traumatic stress disorder (PTSD). Results obtained from the national sample showed the same patterning as that reported from the smaller clinical sample. Combat exposure was related significantly to PTSD symptomatology, while premilitary adjustment was not. A previously identified discriminant function, composed of psychological symptoms not found in the DSM III criteria for PTSD, also was cross-validated.",0 +https://doi.org/10.1093/jpepsy/jss091,The Association Between Parent PTSD/Depression Symptoms and Child PTSD Symptoms: A Meta-Analysis,"The present article presents a meta-analysis of studies examining the association between parent posttraumatic stress disorder (PTSD)/depression symptoms and child PTSD symptoms (PTSS) after a child's exposure to a traumatic event while considering multiple moderating factors to explain heterogeneity of effect sizes.35 studies were included: 32 involving the association between parent and child PTSS and 9 involving the association between parent depression and child PTSS.Across existing studies, both parent and child PTSS (r = 0.31) and parent depression and child PTSS (r = 0.32) yielded significant effect sizes. Parent gender, assessment type (interview vs. questionnaire), differences in assessment type for parents and children, and study design (cross-sectional vs. longitudinal) moderated the relationship between parent and child PTSS.The current findings confirm the associations between parental posttraumatic responses and child PTSS and highlight important moderating factors to include in future studies of child PTSS.",0 +https://doi.org/10.1097/brs.0b013e31823881bc,Does Knowledge of Predictors of Recovery and Nonrecovery Assist Outcomes After Whiplash Injury?,"Nonsystematic review.Review of prognostic indicators for outcome after whiplash injury and the implications for clinical practice and future research.The capacity to predict outcome after whiplash injury is important to guide the management of the condition. There have now been numerous cohort studies and several systematic reviews of prognosis. It is not clear if the current knowledge of prognostic indicators is useful for clinical practice and to improve outcomes after injury.Nonsystematic review of research investigating the prediction of chronic pain/disability and psychological outcomes after whiplash injury.There remains considerable uncertainty surrounding the identification of clear prognostic indicators after whiplash injury. All systematic reviews note the moderate or lower quality if primary cohort studies and only one systematic review performed meta-analysis. There have been no studies attempting validation of predictive models. At the present time, the knowledge base stands that higher initial pain levels are the most consistent predictor of poor functional recovery. Additional promising factors include physical factors of cold hyperalgesia and loss of neck range of movement, although the latter is inconsistent. Psychological factors of pain catastrophizing, symptoms of post-traumatic stress and recovery perceptions are also prognostic of poor recovery and the presence of depressed mood is inconsistent. Further research is needed to validate predictive models, investigate interactions between factors, and to determine whether modification of predictors is possible and leads to improved outcomes.The understanding of factors predictive of poor recovery after whiplash injury is evolving. Although more research is required to validate predictive models, some factors show consistent predictive capacity and could be used in clinical practice as potential indicators of poor recovery. It is not known if the specific targeting of modifiable prognostic indicators can be achieved or will lead to improved outcomes.",0 +https://doi.org/10.1016/j.brat.2009.12.009,The efficacy of a brief internet-based self-help intervention for the bereaved,"Research so far has shown little evidence that written disclosure facilitates recovery from bereavement. There are good reasons to assume that written disclosure may only benefit those bereaved who are at risk for developing problems or who are experiencing significant psychological problems as a result of their loss, and only when appropriate writing instructions are used. Drawing on previous work in the area of post-traumatic stress, a writing intervention was designed to test these assumptions. Bereaved individuals, who were still significantly distressed by their loss, were randomly assigned to the intervention condition (N = 460) or a waiting-list control condition (N = 297). Both groups filled in questionnaires online at baseline, and 3 and 6 months later. The intervention was administered via e-mail immediately after baseline measurement. Results showed that writing decreased feelings of emotional loneliness and increased positive mood, in part through its effect on rumination. However, writing did not affect grief or depressive symptoms. Contrary to expectations, effects did not depend on participants' risk profile or baseline distress level. Implications of these findings are discussed.",0 +https://doi.org/10.1176/appi.ajp.158.4.594,Incidence and Prediction of Posttraumatic Stress Disorder Symptoms in Severely Injured Accident Victims,"This study was designed to assess the incidence of posttraumatic stress disorder (PTSD) in severely injured accident victims and to predict the presence of PTSD symptoms at a 12-month follow-up.A longitudinal, 1-year follow-up study was carried out with 106 consecutive patients with severe accidental injuries who were admitted to the trauma surgeons' intensive care unit at a university hospital. Patients were interviewed within 1 month and 12 months after the accident. Assessments included an extensive clinical interview, the Impact of Event Scale, the Clinician-Administered PTSD Scale, the Sense of Coherence questionnaire, and the Freiburg Questionnaire of Coping With Illness.A total of 13.4 days (SD=6.6) after the accident, five patients (4.7%) met all criteria for PTSD with the exception of the time criterion. A total of 22 other patients (20.8%) had subsyndromal PTSD. At the 1-year follow-up, two patients (1.9%) had PTSD, and 13 (12.3%) had subsyndromal PTSD. Multiple regression analysis explained 34% of the variance of PTSD symptoms 12 months after the accident. Biographical risk factors, the sense of a death threat, symptoms of intrusion, and problem-oriented coping each contributed significantly to the predictive model.In severely injured accident victims who were healthy before experiencing trauma, the incidence of PTSD was low. One-third of the variance of PTSD symptoms at 1-year follow-up could be predicted by mainly psychosocial variables.",0 +https://doi.org/10.1016/j.genhosppsych.2004.06.005,Holocaust survivors coping with open heart surgery decades later: posttraumatic symptoms and quality of life,"History of prolonged traumatization has been associated with reduced quality of life (QoL) and difficulties in coping with major life-threatening conditions. We assessed the association between the impact of Holocaust experience (posttraumatic symptoms) and QoL of patients before and after an open heart surgery.Sixty-three Holocaust survivors were interviewed before open heart surgery (at admission), 52 at follow-up at 1 week, and 58 at follow-up at 6 months. The interview included background data, Impact of Event Scale (IES), Mastery scale, and QoL measured by the Nottingham Health Profile. Medical data were retrieved from the patients' charts.The total IES score indicate a high level of posttraumatic symptoms at all the time points (close to a mean of 18), but there was a clear trend of changes in the avoidance subscale: At admission, the patients manifested lower avoidance compared with the levels after the surgery and at the follow-up. No significant differences in IES were found by Holocaust experiences. Significant improvements in most components of QoL were found at the follow-up. In multivariate analyses at each time point, the findings show that those with higher levels of posttraumatic symptoms are more at risk for problems in pain and mobility domains of QoL at admission, for emotional reaction after the surgery, and at the follow-up, these associations are only at trend level, while lower sense of mastery became significant.The improvement in QoL despite persistence of the impact of the Holocaust may indicate that past severe prolonged traumatization does not necessarily reduce the survivors' ability to cope with and regain physical and psychosocial functioning after a severe life-threatening medical condition. This may be further generalized to other significant crisis situations in life, such as prolonged periods of stress, suffered by many populations throughout the world.",0 +https://doi.org/10.1080/02699931.2015.1126555,Profiles of emotion regulation: Understanding regulatory patterns and the implications for posttraumatic stress,"Trauma survivors often experience posttraumatic stress (PTS) and report concurrent difficulties with emotion regulation (ER). Although individuals typically use multiple regulatory strategies to manage emotion, no studies yet examine the influence of a constellation of strategies on PTS in a community sample. We assessed six ER strategies and investigated whether specific profiles of ER (i.e. the typical pattern of regulation, determined by how often each strategy is used) were related to PTS. A hierarchical cluster analysis indicated that four distinct profiles were present: Adaptive Regulation, Active Regulation, Detached Regulation, and Maladaptive Regulation. Further analyses revealed that an individual's profile was not related to frequency of past trauma, but had the power to differentiate symptom severity for overall PTS and each symptom cluster of posttraumatic stress disorder. These findings highlight how profiles characterising multiple regulatory strategies offer a more complete understanding of the ways ER can account for PTS.",0 +https://doi.org/10.1017/s2040174414000130,Challenges in modelling the random structure correctly in growth mixture models and the impact this has on model mixtures,"Lifecourse trajectories of clinical or anthropological attributes are useful for identifying how our early-life experiences influence later-life morbidity and mortality. Researchers often use growth mixture models (GMMs) to estimate such phenomena. It is common to place constrains on the random part of the GMM to improve parsimony or to aid convergence, but this can lead to an autoregressive structure that distorts the nature of the mixtures and subsequent model interpretation. This is especially true if changes in the outcome within individuals are gradual compared with the magnitude of differences between individuals. This is not widely appreciated, nor is its impact well understood. Using repeat measures of body mass index (BMI) for 1528 US adolescents, we estimated GMMs that required variance–covariance constraints to attain convergence. We contrasted constrained models with and without an autocorrelation structure to assess the impact this had on the ideal number of latent classes, their size and composition. We also contrasted model options using simulations. When the GMM variance–covariance structure was constrained, a within-class autocorrelation structure emerged. When not modelled explicitly, this led to poorer model fit and models that differed substantially in the ideal number of latent classes, as well as class size and composition. Failure to carefully consider the random structure of data within a GMM framework may lead to erroneous model inferences, especially for outcomes with greater within-person than between-person homogeneity, such as BMI. It is crucial to reflect on the underlying data generation processes when building such models.",0 +https://doi.org/10.1097/htr.0000000000000142,Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes.,"To explore the taxonomy of combat-related mild traumatic brain injury (mTBI) based on symptom patterns.Up to 1341 military personnel who experienced a combat-related mTBI within 2 years of evaluation.Neurobehavioral Symptom Inventory and PTSD Checklist-Civilian Version (PCL-C).Cluster analysis revealed the following 4 subtypes: primarily psychiatric (posttraumatic stress disorder) group, a cognitive group, a mixed symptom group, and a good recovery group. The posttraumatic stress disorder cluster (21.9% of the sample) reported symptoms related to hyperarousal and dissociation/depression with few complaints related to cognition or headaches. The cognitive group (21.5% of the sample) had primarily cognitive and headache complaints with few mood symptoms. The mixed profile cluster included 18.6% of the sample and was characterized by a combination of mood complaints (hyperarousal and dissociation/depression), cognitive complaints, and headaches. The largest cluster (37.8% of the sample) had an overall low symptom profile and was labeled the ""good recovery"" group.The results support a unique taxonomy for combat-related mTBI. The clinical differences among these subtypes indicate a need for unique treatment resources and programs.",0 +https://doi.org/10.1521/pedi.2009.23.4.357,Family history study of the familial coaggregation of borderline personality disorder with axis I and nonborderline dramatic cluster axis II disorders.,"The purpose of this study was to assess the familial coaggregation of borderline personality disorder (BPD) with a full array of axis I disorders and four axis II disorders (antisocial personality disorder, histrionic personality disorder, narcissistic personality disorder, and sadistic personality disorder) in the first-degree relatives of borderline probands and axis II comparison subjects. Four hundred and forty-five inpatients were interviewed about familial psychopathology using the Revised Family History Questionnaire-a semistructured interview of demonstrated reliability. Of these 445 subjects, 341 met both DIB-R and DSM-III-R criteria for BPD and 104 met DSM-III-R criteria for another type of personality disorder (and neither criteria set for BPD). The psychopathology of 1,580 first-degree relatives of borderline probands and 472 relatives of axis II comparison subjects was assessed. Using structural models for familial coaggregation, it was found that BPD coaggregates with major depression, dysthymic disorder, bipolar I disorder, alcohol abuse/dependence, drug abuse/dependence, panic disorder, social phobia, obsessive-compulsive disorder, generalized anxiety disorder, posttraumatic stress disorder, somatoform pain disorder, and all four axis II disorders studied. Taken together, the results of this study suggest that common familial factors, particularly in the areas of affective disturbance and impulsivity, contribute to borderline personality disorder.",0 +https://doi.org/10.1007/978-1-4899-7522-5_2,Neurobiological Risk Factors and Predictors of Vulnerability and Resilience to PTSD,"The risk of developing PTSD following a traumatic experience depends on several vulnerability factors that may be classified into three distinct categories: Pre-traumatic, peri-traumatic, and posttraumatic vulnerability factors. Accordingly, while we attempted to create a profile of the high-risk PTSD patient, the following factors should be included, among others: Small hippocampus, previously altered HPA axis, vulnerable genetic profile, associated body injury, increased post-trauma noradrenergic activity. Some protective factors have been identified and included, but are not limited to coping, resources (e.g., social support, self-esteem, optimism), and finding meaning. Finally, human beings are resilient and in general are able to cope with adverse situations. Therefore, discovering possible resilience factors may assist in identifying the patients at risk and may contribute to developing the strategies to prevent the development of PTSD. © Springer Science+Business Media New York 2015.",0 +https://doi.org/10.1007/s11892-015-0618-1,Diabetes Among Refugee Populations: What Newly Arriving Refugees Can Learn From Resettled Cambodians,"A growing body of literature suggests that cardiometabolic disease generally and type 2 diabetes specifically are problems among refugee groups. This paper reviews rates of cardiometabolic disease and type 2 diabetes among refugees and highlights their unique risk factors including history of malnutrition, psychiatric disorders, psychiatric medications, lifestyle changes toward urbanization and industrialization, social isolation, and a poor profile on the social determinants of health. Promising interventions are presented for preventing and treating diabetes in these groups. Such interventions emphasize well-coordinated medical and mental health care delivered by cross-cultural and multidisciplinary teams including community health workers that are well integrated into the community. Finally, recommendations for service, policy, and research are made. The authors draw on local data and clinical experience of our collective work with Cambodian American refugees whose 30-year trajectory illustrates the consequences of ignoring diabetes and its risk factors in more recent, and soon to be arriving, refugee cohorts.",0 +https://doi.org/10.1016/j.pscychresns.2006.01.004,Voxel-based diffusion tensor analysis reveals aberrant anterior cingulum integrity in posttraumatic stress disorder due to terrorism,"Recent functional neuroimaging work has suggested that interregional functional connectivity between the anterior cingulate cortex (ACC), other limbic, and prefrontal regions may be involved in the pathophysiology of posttraumatic stress disorder (PTSD). However, less attention has been paid to the white matter network. Voxel-based analysis enables an exploration of morphological or functional changes throughout the entire brain. Here we undertook the first application of this technology to diffusion tensor data in patients with PTSD. Participants were 9 victims of the Tokyo subway sarin attack with PTSD and 16 matched victims of the same traumatic event without PTSD. The voxel-based analysis showed a significant fractional anisotropy increase in the left anterior cingulum, subjacent to the left ACC gray matter where we previously found a volume decrement, in PTSD subjects. Moreover, the severity was positively, but not significantly associated with the fractional anisotropy of the left anterior cingulum in the victims with PTSD, using the region of interest defined in the native space with the inverse normalization technique. The present study demonstrated further evidence of abnormalities of both the ACC, a structure that is pivotally involved in attention, emotional regulation, and fear conditioning, and of subjacent white matter in the pathology of PTSD.",0 +https://doi.org/10.1097/00005373-199911000-00009,Posttraumatic Stress Disorder in Injured Adults: Etiology by Path Analysis,"Posttraumatic Stress Disorder (PTSD) impairs outcome from injury. We present a path analysis of factors related to the development of PTSD in injured adults.A prospective cohort of 250 patients without severe neurotrauma was evaluated by interview during admission and by mailed self-report 6 months later. Data were gathered from the trauma registry (age, injury mechanism, and Injury Severity Score), social history (gender, income, education, and social support), and survey instruments. Baseline assessment used the Michigan Critical Events Perception Scale (peritraumatic dissociation and subjective threat to life), the Life Experience Survey (stressful exposure history), and the SF36 (general and mental health). PTSD at 6 months was identified with the civilian Mississippi Scale for PTSD. Data are listed as mean +/- SEM or percent (%). Path analysis was conducted by linear regression and significant (p<0.05) variables are shown. Factors are listed with the standardized beta. A negative beta suggests a protective effect.The 176 patients (72%) who completed the 6-month follow-up were 37.7+/-0.88 years old; 75% were men; and blunt (70%), penetrating (13.5%), and burn (16.4%) mechanisms caused the injuries. Assault was involved in 14.5% of the cases. Average income was $44,300+/-2,700/yr, education was 13.0+/-0.15 years, and Injury Severity Score was 13.9+/-0.50. A total of 42.3% of the patients developed PTSD. The 39.7% of the variance in PTSD explained by the model was due to intentional injury (beta = 0.27), male gender (beta = -0.21), age (beta = -0.20), peritraumatic dissociation (beta = 0.174), baseline mental health (beta = -0.21), and prior life-threatening illness (beta = -0.29). Peritraumatic dissociation was due to the patient's sense of threat to life (beta = -0.47), and threat was related to Injury Severity Score (beta = 0.2), assault(beta = 0.14), education (beta = -0.15), and age (beta = -0.19). Baseline SF36 mental health was related to social support (beta = 0.27) and income (beta = 0.21). Income was contingent on education (beta = 0.21).PTSD occurred in 42.3% of injured adults 6 months after trauma and was related to assault, dissociation, female gender, youth, poor mental health, and prior illness. By modeling PTSD, we may learn more of the etiology, risk stratification, and potentials for the treatment of this common and important morbidity of injury.",0 +https://doi.org/10.1016/j.paid.2005.11.034,Confirmatory factor analysis of posttraumatic stress symptoms in emergency personnel: An examination of seven alternative models,"Recent studies into the underlying factor structure of posttraumatic stress symptoms often report factor structures that do not replicate the three symptom cluster of re-experiencing, avoidance and arousal symptoms as classified within the Diagnostic and Statistical Manual of Mental disorders (American Psychiatric Association, 1994, 2000). Data from 485 emergency service personnel who had experienced an occupational trauma were submitted to confirmatory factor analysis to test seven alternative factor models of posttraumatic stress symptoms. This study is one of the most comprehensive structural analyses of posttrauma symptoms to date. The model of best fit comprised four first-order factors including intrusion, avoidance, numbing and arousal alongside a general PTSD factor. This study highlighted the difference between the current DSM symptom groupings and those derived empirically.",0 +https://doi.org/10.1176/appi.ajp.159.11.1940,Is Comorbidity of Posttraumatic Stress Disorder and Borderline Personality Disorder Related to Greater Pathology and Impairment?,"The authors examined whether patients with comorbid borderline personality disorder and posttraumatic stress disorder (PTSD) have a more severe clinical profile than patients with either disorder without the other.Outpatients with borderline personality disorder without PTSD (N=101), PTSD without borderline personality disorder (N=121), comorbid borderline personality disorder and PTSD (N=48), and major depression without PTSD or borderline personality disorder (N=469) were assessed with structured interviews for psychiatric disorders and for degree of impairment.Outpatients with diagnoses of comorbid borderline personality disorder and PTSD were not significantly different from outpatients with borderline personality disorder without PTSD, PTSD without borderline personality disorder, or major depression without PTSD or borderline personality disorder in severity of PTSD-related symptoms, borderline-related traits, or impairment.The additional diagnosis of PTSD or borderline personality disorder does little to augment the pathology or dysfunction of patients who have either disorder without the other.",0 +https://doi.org/10.1037/a0014565,Mapping evidence-based treatments for children and adolescents: Application of the distillation and matching model to 615 treatments from 322 randomized trials.,"This study applied the distillation and matching model to 322 randomized clinical trials for child mental health treatments. The model involved initial data reduction of 615 treatment protocol descriptions by means of a set of codes describing discrete clinical strategies, referred to as practice elements. Practice elements were then summarized in profiles, which were empirically matched to client factors (i.e., observed problem, age, gender, and ethnicity). Results of a profile similarity analysis demonstrated a branching of the literature into multiple problem areas, within which some age and ethnicity special cases emerged as higher order splits. This is the 1st study to aggregate evidence-based treatment protocols empirically according to their constituent treatment procedures, and the results point both to the overall organization of therapy procedures according to matching factors and to gaps in the current child and adolescent treatment literature.",0 +https://doi.org/10.1016/0887-6185(90)90022-2,War stressors and symptom persistence in posttraumatic stress disorder,"Abstract This study focused on delineating aspects of war stressors associated with risk for posttraumatic stress disorder in Vietnam veterans. Findings from 191 Vietnam war veterans are presented, addressing which elements of the war experience predicted PTSD in remission or persistent PTSD. Some experiences, like loss and injury, predicted having had PTSD symptoms in the past, while other experiences, such as exposure to grotesque death, predicted current (persistent) PTSD. Discriminant analysis showed that the more extreme/intense the stressor experiences, the higher the risk for developing PTSD and for persistent symptoms. These findings provide empirical support for the PTSD diagnosis and additional data for refining the PTSD stressor criterion.",0 +https://doi.org/10.1016/j.psym.2014.05.006,"Somatoform Disorders and Trauma in Medically-Admitted Children, Adolescents, and Young Adults: Prevalence Rates and Psychosocial Characteristics","The purpose of this study is to describe past traumatic experiences in medically-admitted pediatric and young adult patients diagnosed with somatoform disorders and to explore the demographic, diagnostic, and psychosocial differences between those with and without trauma histories.Retrospective medical record reviews were performed for patients (aged 3-29 years) seen by the Psychiatry Consultation Service (2010-2011) at a pediatric medical hospital and diagnosed with a somatoform disorder. Clinical data collected included demographics, medical history, current physical symptoms, psychiatric diagnoses and history, trauma history, coping styles, family psychiatric and medical history, peer and family factors, psychiatric disposition after discharge, and service utilization.The mean age of the 180 identified patients was 15.1 years. Most patients were girls (75.0%) and White (71.7%). Somatoform diagnoses were primarily pain (51.4%) and conversion disorders (28.9%). Rates of trauma were similar to national norms (29.7%). Trauma history did not correlate with age, sex, race, income, length of hospitalization, or type of somatoform disorders. However, patients with trauma histories had significantly higher rates of psychiatric comorbidities (76.0% vs. 50.8%), past psychiatric treatment (81.1% vs. 59.1%), parent mental illness (69.8% vs. 38.6%), and family conflict (52.8% vs. 37.0%) and were more likely to require inpatient psychiatric hospitalization on discharge (18.9% vs. 6.3%).Prevalence of trauma in a sample of medically-admitted pediatric and young adult patients with somatoform diagnoses was similar to national norms. However, patients with a history of trauma had unique psychiatric and psychosocial profiles compared to those without a history of trauma.",0 +https://doi.org/10.1097/00005053-199104000-00001,Comorbidity of Psychiatric Disorders and Personality Profiles of American World War II Prisoners of War,"To characterize the effects of trauma sustained more than 40 years ago, prevalence of psychiatric disorders and personality dimensions were examined in a sample of 62 former World War II POWs. The negative effects of their experiences are reflected in their multiple lifetime diagnoses and in their current personality profiles. Fifty percent met DSM-III posttraumatic stress disorder (PTSD) criteria within 1 year of release; 18 (29%) continued to meet the criteria 40 years later at examination (chronic PTSD). A lifetime diagnosis of generalized anxiety disorder was found for over half the entire sample; in 42% of those who never had PTSD, 38% of those with recovery from PTSD, and 94% of those with chronic PTSD. Ten percent of those without a PTSD diagnosis had experienced a depressive disorder, as had 23% of those with recovery from PTSD and 61% of the POWs with chronic PTSD. The combination of depressive and anxiety disorders also was frequent in the total sample (61%). Current MMPIs of three groups with psychiatric diagnosis were compared with those of POWs who had no diagnoses and with a group of Minnesota normal men. Profile elevations for the groups, from highest to lowest, were: POWs with chronic PTSD, POWs with recovery from PTSD, POWs with other psychiatric diagnoses, POWs with no disorders, and Minnesota normal men. Symptoms of anxiety, depression, and somatic concerns combined with the personality styles of suppression and denial characterize the current adjustment of negatively affected POWs.",0 +https://doi.org/10.1096/fj.11-198416,Release of gliotransmitters through astroglial connexin 43 hemichannels is necessary for fear memory consolidation in the basolateral amygdala,"Recent in vitro evidence indicates that astrocytes can modulate synaptic plasticity by releasing neuroactive substances (gliotransmitters). However, whether gliotransmitter release from astrocytes is necessary for higher brain function in vivo, particularly for memory, as well as the contribution of connexin (Cx) hemichannels to gliotransmitter release, remain elusive. Here, we microinfused into the rat basolateral amygdala (BLA) TAT-Cx43L2, a peptide that selectively inhibits Cx43-hemichannel opening while maintaining synaptic transmission or interastrocyte gap junctional communication. In vivo blockade of Cx43 hemichannels during memory consolidation induced amnesia for auditory fear conditioning, as assessed 24 h after training, without affecting short-term memory, locomotion, or shock reactivity. The amnesic effect was transitory, specific for memory consolidation, and was confirmed after microinfusion of Gap27, another Cx43-hemichannel blocker. Learning capacity was recovered after coinfusion of TAT-Cx43L2 and a mixture of putative gliotransmitters (glutamate, glutamine, lactate, d-serine, glycine, and ATP). We propose that gliotransmitter release from astrocytes through Cx43 hemichannels is necessary for fear memory consolidation at the BLA. Thus, the present study is the first to demonstrate a physiological role for astroglial Cx43 hemichannels in brain function, making these channels a novel pharmacological target for the treatment of psychiatric disorders, including post-traumatic stress disorder.",0 +https://doi.org/10.1080/17523281.2013.865663,"Posttraumatic stress disorder, alcohol use, and life stress among African-American women","Robust data document the strong association between posttraumatic stress disorder (PTSD) symptoms and problematic alcohol use in female psychiatric patients. Reasons for this frequent co-morbidity remain unclear, highlighting the value of investigating factors common to both disorders to gain additional clarity. The current study examined whether the psychosocial factor, life stress, mediated the link between PTSD symptomatology and alcohol use in a sample of African-American women from low-income backgrounds with a history of intimate partner violence and suicidality (n = 143). Bootstrapping analysis demonstrated that life stress fully mediated the effect of PTSD symptoms on alcohol use. Consistent with the self-medication hypothesis of addiction, our findings indicate that life stress may be a causal mechanism in the development of subsequent alcohol problems among women with existing PTSD symptomatology. Prevention and treatment implications concerning the target population are discussed.",0 +https://doi.org/10.1037/ort0000006,Family and peer social support and their links to psychological distress among hurricane-exposed minority youth.,"Experiencing a disaster such as a hurricane places youth at a heightened risk for psychological distress such as symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression. Social support may contribute to resilience following disasters, but the interrelations of different types of support, level of exposure, and different symptoms among youth is not well understood. This study examined associations among family and peer social support, level of hurricane exposure, and their links to psychological distress using both a large single-time assessment sample (N = 1,098) as well as a longitudinal sample followed over a 6-month period (n = 192). Higher levels of hurricane exposure were related to lower levels of social support from family and peers. Higher levels of family and peer social support demonstrated both concurrent and longitudinal associations with lower levels of psychological distress, with associations varying by social support source and psychological distress outcome. Findings also suggested that the protective effects of high peer social support may be diminished by high hurricane exposure. The results of this study further our understanding of the role of social support in hurricane-exposed youths' emotional functioning and point to the potential importance of efforts to bolster social support following disasters.",0 +https://doi.org/10.1097/01.nmd.0000117590.81374.7c,Surviving the Vajont Disaster,"The aim of the present study was to assess the chronic psychiatric consequences of the Vajont disaster in a group of survivors still living in the valley 36 years after the event. Thirty-nine subjects were assessed by means of a semistructured interview to investigate the extent of the traumatic experience and a structured diagnostic interview for the diagnoses of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). The degree of traumatic exposure significantly predicts the presence of PTSD. The lifetime frequency of full PTSD was 26%, and a further 33% of the sample displayed partial PTSD. Lifetime MDD was present in 28% of the subjects, and its prediction factors were female gender and number of losses of first-degree relatives in the disaster. Trauma-related fears are very common in the sample. A large-scale disaster, such as that of the Vajont valley, affects the psychological health of survivors for decades.",0 +https://doi.org/10.4103/0019-5545.174365,Resilience: A psychobiological construct for psychiatric disorders,"Understanding of psychopathology of mental disorder is evolving, particularly with availability of newer insight from the field of genetics, epigenetics, social, and environmental pathology. It is now becoming clear how biological factors are contributing to development of an illness in the face of a number of psychosocial factors. Resilience is a psychobiological factor which determines individual's response to adverse life events. Resilience is a human capacity to adapt swiftly and successfully to stressful/traumatic events and manage to revert to a positive state. It is fundamental for growth of positive psychology which deals with satisfaction, adaptability, contentment, and optimism in people's life. Of late, there has been a paradigm shift in the understanding of resilience in context of stress risk vulnerability dimension. It is a neurobiological construct with significant neurobehavioral and emotional features which plays important role in deconstructing mechanism of biopsychosocial model of mental disorders. Resilience is a protective factor against development of mental disorder and a risk factor for a number of clinical conditions, e.g. suicide. Available information from scientific studies points out that resilience is modifiable factor which opens up avenues for a number of newer psychosocial as well as biological therapies. Early identification of vulnerable candidates and effectiveness of resilience-based intervention may offer more clarity in possibility of prevention. Future research may be crucial for preventive psychiatry. In this study, we aim to examine whether resilience is a psychopathological construct for mental disorder.",0 +https://doi.org/10.1097/psm.0b013e3182761e8b,Exploration of Delayed-Onset Posttraumatic Stress Disorder After Severe Injury,"The first aim of this work was to conduct a rigorous longitudinal study to identify rates of delayed-onset posttraumatic stress disorder (PTSD) in a sample of patients with severe injury. The second aim was to determine what variables differentiated delayed-onset PTSD from chronic PTSD.Randomly selected patients with injury who were admitted to four hospitals around Australia were recruited to the study (N = 834) and assessed in the acute care hospital, at 3 months, and at 12 months. A structured clinical interview was used to assess PTSD at each time point.Seventy-three patients (9%; n = 73) had PTSD at 12 months. Of these, 39 (53%) were classified as having delayed-onset PTSD. Furthermore, 22 (56%) patients with delayed-onset PTSD had minimal PTSD symptoms at 3 months (i.e., they did not have partial/subsyndromal PTSD at 3 months). The variables that differentiated delayed-onset PTSD from chronic PTSD were greater injury severity (odds ratio [OR] = 1.13; 95% confidence interval [CI] = 1.02-1.26), lower anxiety severity at 3 months (OR = 0.73; 95% CI = 0.61-0.87), and greater pain severity at 3 months (OR = 1.39; 95% CI = 1.06-1.84).Delayed-onset PTSD occurred frequently in this sample. Approximately half of the patients with delayed-onset PTSD had minimal PTSD symptoms at 3 months; therefore, their delayed-onset PTSD could not be accounted for by a small number of fluctuating symptoms. As we move toward DSM-V, it is important that research continues to explore the factors that underpin the development of delayed-onset PTSD.",0 +https://doi.org/10.1080/00048670802512024,Naturalistic Comparison of Models of Programmatic Interventions for Combat-Related Post-Traumatic Stress Disorder,"Objectives: Post-traumatic stress disorder (PTSD) is a difficult-to-treat sequel of combat. Data on effectiveness of alternate treatment structures are important for planning veterans’ psychiatric services. The present study compared clinical presentations and treatment outcomes for Australian veterans with PTSD who participated in a range of models of group-based treatment. Method: Participants consisted of 4339 veterans with combat-related PTSD who participated in one of five types of group-based cognitive behavioural programmes of different intensities and settings. Data were gathered at baseline (intake), as well as at 3 and 9 month follow up, on measures of PTSD, anxiety, depression and alcohol misuse. Analyses of variance and effect size analyses were used to investigate differences at intake and over time by programme type. Results: Small baseline differences by programme intensity were identified. Although significant improvements in symptoms were evident over time for each programme type, no significant differences in outcome were evident between programmes. When PTSD severity was considered, veterans with severe PTSD performed less well in the low-intensity programmes than in the moderate- or high-intensity programmes. Veterans with mild PTSD improved less in high-intensity programmes than in moderate- or low-intensity programmes. Conclusion: Comparable outcomes are evident across programme types. Outcomes may be maximized when veterans participate in programme intensity types that match their level of PTSD severity. When such matching is not feasible, moderate-intensity programmes appear to offer the most consistent outcomes. For regionally based veterans, delivering treatment in their local environment does not detract from, and may even enhance, outcomes. These findings have implications for the planning and purchasing of mental health services for sufferers of PTSD, particularly for veterans of more recent combat or peacekeeping deployments.",0 +https://doi.org/10.3109/13651501.2013.855793,Increased co-morbidity of depression and post-traumatic stress disorder symptoms and common risk factors in intensive care unit survivors: A two-year follow-up study,"To investigate the long-term psychological impact of intensive care unit (ICU) hospitalization, as well as to establish risk factors which successfully discriminate patients at higher risk.The Medical Outcomes Study Short Form Survey (SF-36), the Center for Epidemiologic Studies for Depression (CES-D), and the Davidson Trauma Scale (DTS) questionnaires were obtained from 48 ICU survivors who were also interviewed and self-reported on several acknowledged risk factors.A high co-morbidity between depression and post-traumatic stress disorder (PTSD) cases was observed. Both CES-D and DTS scores correlated negatively with the SF-36 mental health subscale scores; although a causative relation cannot be attributed to this finding, it indicates a potential negative impact of depression and PTSD symptoms on the patients' quality of life even at 18- to 24-month post-ICU. The most important risk factor associated with a long-term impact on quality of life, depression and PTSD was lifetime history of any psychiatric disorder.During ICU admissions efforts should be made towards identifying and psychologically supporting those patients with a previous history of a psychiatric disease, as they are at considerably higher risk of suffering from the long-term psychological sequelae of ICU admission.",0 +https://doi.org/10.1159/000313981,Validity and Reliability of the Persian Language Version of the Neuropsychiatry Unit Cognitive Assessment Tool,"<i>Background/Aims:</i> Only a limited number of cognitive screening tools are available for the Persian-speaking population, and we sought to translate and validate the Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG), a multidimensional cognitive screening tool. <i>Methods:</i> We used multiple language specialists to translate and then back-translate the NUCOG, and administered the Persian language NUCOG and Mini-Mental State Examination (MMSE) to 184 individuals: 60 controls and 124 patients, 33 of whom had dementia, 30 non-dementing neurological disorders and 61 a psychiatric illness. <i>Results:</i> The NUCOG outperformed the MMSE in differentiating the patient groups and controls. The ‘profile’ across the 5 NUCOG domains differentiated dementia subgroups such as senile dementia of the Alzheimer type (SDAT), frontotemporal dementia and mild cognitive impairment (MCI). Psychiatric patients with psychosis and posttraumatic stress disorder were more impaired than patients with affective disorders. The NUCOG reliably differentiated controls from patients with MCI (at 86.5/100, sensitivity of 83.3% and specificity of 87.5%) and SDAT (at 75/100, sensitivity and specificity of 100%) patients from controls. <i>Conclusions:</i> The Persian language NUCOG appears to perform strongly in an unselected population, reliably differentiating patients with dementia from controls, and detecting cognitive impairment in a range of clinical disorders.",0 +https://doi.org/10.1111/j.1741-6612.2004.00017.x,"Post-traumatic stress disorder, social support and cognitive status in community-based older veterans","Objective: The present study investigated the relationships between structural and qualitative aspects of social support, combat-related post-traumatic stress disorder (PTSD) and cognitive status in a New Zealand veterans sample. Methods: A random sample of 232 New Zealand veterans completed a self-report questionnaire and participated in a face-to-face interview. Results: Regression analysis showed that when controlling for age, income, education, depression and general health, PTSD scores had a negative relationship with cognitive status. Those who reported having private, restricted social networks had poorer cognitive functioning. These relationships were independent of each other. Conclusions: The findings suggest that while social support might be a potential target for interventions in at-risk older adults, health professionals need to be aware of the concomitant possible influence of past trauma when dealing with this specific population.",0 +https://doi.org/10.1016/s0193-953x(01)00005-3,Psychobiology of the acute stress response and its relationship to the psychobiology of post-traumatic stress disorder,"The literature to date that examines the biology of the acute stress reactions suggests that relatively lower baseline cortisol is associated with the development of PTSD. This is particularly informative because of the ongoing controversy surrounding baseline cortisol in PTSD. Studies have found low baseline cortisol, normal range, and elevated baseline cortisol in chronic PTSD, and it has been unclear whether this reflects methodologic differences across studies or true heterogeneity within the disorder. Thus, the few studies to date support the finding of low-normal baseline cortisol in chronic PTSD and suggest that it is a pre-existing functional trait. Whether it plays an etiologic role or is an epiphenomenon of some other process is unclear. What does seem clear, however, is that this characteristic is relatively nonspecific to PTSD, given the fact that low cortisol has been observed in multiple subject populations, including normal individuals under chronic stress as well as chronic medical conditions (for review see [23]). For example, it is possible that reduced baseline cortisol reflects the net result of input to the hypothalamus from cortical and subcortical regions of the brain linked to increased vigilance, sensitization to trauma because of prior traumatic experiences, or genetic factors. For example, primate studies have demonstrated persistent alterations in HPA axis functioning in animals reared by mothers living in moderately stressful conditions [24]. The development of PTSD is associated with sensitization of the startle response. Because the neurobiology of startle is well characterized, this finding implicates a role for specific neurocircuitry in PTSD [25]. Non-habituation of the startle response in PTSD appears related to sensitization specifically to contextual cues (i.e., the environment) that signal the presence of potential threat of danger-related fears [26]. This may be the neurobiological correlate to the over-generalization seen in PTSD that distinguishes the disorder from a simple trauma-induced phobia. The bed nucleus of the stria terminalis (BNST) is specifically implicated from preclinical research in the mediation of context-dependent cues [1]. Treatments that result in down-regulation of the BNST are therefore of particular interest in therapeutic models of prevention after trauma. The fact that a number of vulnerability factors associated with increased risk for developing PTSD are also likely to be biologically based (e.g., a genetic component, prior psychiatric history, prior family of history of psychiatric disorder), provides further evidence in support of a role for psychobiological factors in producing PTSD. Nevertheless, the considerable overlap on these measures between those who will develop PTSD, and those who eventually recover spontaneously, belies any attempt to identify any single or pathognomonic biological marker for risk. For now, the standard of care in predicting level of symptomatology and prognosis in the acute setting continues to be based on careful, informed, serial assessments of symptoms and functioning. Because the capacity to learn from and adapt to adverse conditions are essential to the survival of any species, understanding the neurobiological pathways that mediate learning from traumatic experiences in an adaptive way is as important as understanding the etiology of PTSD and other trauma-related maladaptive consequences. Biological models that trace the causal cascade of post-traumatic events in the brain and neuroendocrine systems may offer a multiplicity of possibilities for intervention. It is well established that conditioned responses are robust and persistent. Moreover, the primary mechanism of habituation is overlearning rather than extinction. Interventions that promote overlearning may therefore prove to be the most powerful and efficient preventative treatments. The therapeutics literature supports this hypothesis, in that brief psychosocial interventions based on sophisticated cognitive-behavioral models have proven effective in reducing suffering, symptom severity, and chronicity in individuals presenting with acute PTSD symptoms [27-29]. No acutely administered pharmacologic treatment to date has been shown effective in accelerating the process of recovery or in preventing the development of chronic PTSD. However, pharmacologic interventions that would prevent sensitization of circuits related to context-dependent threat perception, dysregulation of affect, and/or dysregulation of normal circadian rhythms are of theoretical interest and deserve further study.",0 +https://doi.org/10.1503/cmaj.110676,Predictors of long-term prognosis of depression,"Many people with depression experience repeated episodes. Previous research into the predictors of chronic depression has focused primarily on the clinical features of the disease; however, little is known about the broader spectrum of sociodemographic and health factors inherent in its development. Our aim was to identify factors associated with a long-term negative prognosis of depression.We included 585 people aged 16 years and older who participated in the 2000/01 cycle of the National Population Health Survey and who reported experiencing a major depressive episode in 2000/01. The primary outcome was the course of depression until 2006/07. We grouped individuals into trajectories of depression using growth trajectory models. We included demographic, mental and physical health factors as predictors in the multivariable regression model to compare people with different trajectories.Participants fell into two main depression trajectories: those whose depression resolved and did not recur (44.7%) and those who experienced repeated episodes (55.3%). In the multivariable model, daily smoking (OR 2.68, 95% CI 1.54-4.67), low mastery (i.e., feeling that life circumstances are beyond one's control) (OR 1.10, 95% CI 1.03-1.18) and history of depression (OR 3.5, 95% CI 1.95-6.27) were significant predictors (p < 0.05) of repeated episodes of depression.People with major depression who were current smokers or had low levels of mastery were at an increased risk of repeated episodes of depression. Future studies are needed to confirm the predictive value of these variables and to evaluate their accuracy for diagnosis and as a guide to treatment.",0 +https://doi.org/10.1080/21622965.2013.789964,A Neuropsychological Profile of Childhood Maltreatment Within an Adolescent Inpatient Sample,"Recent research has begun to identify the neurocognitive and psychological effects of childhood maltreatment, although information is limited on the neuropsychological presentation of maltreatment in psychiatrically hospitalized adolescents. This study examined the executive-functioning and language abilities as well as psychopathological presentation of childhood maltreatment victims in an adolescent psychiatric inpatient setting. The sample consisted of adolescent inpatients (ages 13-19 years old) who completed a neuropsychological/psychological assessment during hospitalization (n = 122). The sample was grouped based on childhood maltreatment history, with one group categorized by maltreatment history (n = 49) and the other group characterized by no maltreatment history (n = 73). Analyses revealed statistically significant differences (p < .01) between maltreatment groups on executive functioning, as well as on measures of self-reported depression and anxiety symptoms. No group differences remained after controlling for posttraumatic stress disorder. Further, distinct neuropsychological profiles were identified for specific types of maltreatment experienced. These findings suggest that while childhood maltreatment is associated with a range of neuropsychological impairments, the specific type of maltreatment experienced may have a significant influence on the type and severity of impairments. These findings contribute to the growing body of research on the significant consequences of childhood maltreatment.",0 +https://doi.org/10.1101/lm.393906,Conditioned fear extinction and reinstatement in a human fear-potentiated startle paradigm,"The purpose of this study was to analyze fear extinction and reinstatement in humans using fear-potentiated startle. Participants were fear conditioned using a simple discrimination procedure with colored lights as the conditioned stimuli (CSs) and an airblast to the throat as the unconditioned stimulus (US). Participants were extinguished 24 h after fear conditioning. Upon presentation of unsignaled USs after extinction, participants displayed significant fear reinstatement. In summary, these procedures produced robust fear-potentiated startle, significant CS+/CS− discrimination, within-session extinction, and significant reinstatement. This is the first demonstration of fear extinction and reinstatement in humans using startle measures.",0 +https://doi.org/10.1016/j.janxdis.2010.04.009,A confirmatory factor analysis of combined models of the Harvard Trauma Questionnaire and the Inventory of Complicated Grief-Revised: Are we measuring complicated grief or posttraumatic stress?,"The aim of this study was to assess the factorial structure of complicated grief (CG) and investigate the relationship between CG and posttraumatic stress disorder (PTSD) through the assessment of models combining both constructs. The questionnaire was completed by elderly, married respondents with a history of at least one significant, interpersonal loss (145 males and 147 females, 60–81 years). Confirmatory factor analysis (CFA) supported a two-factor model of separation and traumatic distress in CG. To investigate the relationship between CG and PTSD three combined models were specified and estimated using CFA. A model where all five factors, the two factors of CG and the three factors of PTSD, as defined by the DSM-IV, were allowed to correlate provided the best fit. The results indicated a considerable overlap between the dimensions of CG and PTSD, and complicated grief is construct that appears to be largely accounted for by especially the intrusive component of PTSD.",0 +https://doi.org/10.1007/s12207-013-9175-6,The Evolving Construct of Posttraumatic Stress Disorder (PTSD): DSM-5 Criteria Changes and Legal Implications,"In the DSM-5, the diagnosis of posttraumatic stress disorder (PTSD) has undergone multiple, albeit minor, changes. These changes include shifting PTSD placement from within the anxiety disorders into a new category of traumatic and stressor-related disorders, alterations in the definition of a traumatic event, shifting of the symptom cluster structure from three to four clusters, the addition of new symptoms including persistent negative beliefs and expectations about oneself or the world, persistent distorted blame of self or others, persistent negative trauma-related emotions, and risky or reckless behaviors, and the addition of a dissociative specifier. The evidence or lack thereof behind each of these changes is briefly reviewed. These changes, although not likely to change overall prevalence, have the potential to increase the heterogeneity of individuals receiving a PTSD diagnosis both by altering what qualifies as a traumatic event and by adding symptoms commonly occurring in other disorders such as depression, borderline personality disorder, and dissociative disorders. Legal implications of these changes include continued confusion regarding what constitutes a traumatic stressor, difficulties with differential diagnosis, increased ease in malingering, and improper linking of symptoms to causes of behavior. These PTSD changes are discussed within the broader context of DSM reliability and validity concerns.",0 +https://doi.org/10.1016/j.bbr.2012.05.016,Generalization of contextual fear depends on associative rather than non-associative memory components,"Posttraumatic stress disorder (PTSD) is characterized by the presence of three major symptom clusters: persistent fear memories, hyperarousal, and avoidance. With a passage of time after the trauma, PTSD patients show an increase in unspecific fear and avoidance, a phenomenon termed “fear generalization”. It is not clear whether fear generalization arises from the time-dependent growth of hyperarousal or changes in associative fear. The present study investigated behavioral and neuroanatomical correlates of non-associative and associative fear memory one week vs. one month after a trauma in a mouse model of PTSD with immediate vs. delayed foot shock application. The immediate shock procedure led to a lower contextual fear, but did not influence the hyperarousal (i.e. increased acoustic startle responses) assessed within the first week after the trauma. Only delayed shocked mice demonstrated generalization of contextual fear and an increase in generalized avoidance behavior, with no changes in hyperarousal one month after trauma. We observed the same increase in c-Fos expression following delayed and immediate shock presentation within the lateral, basolateral, central amygdala and CA1, CA3 and dentate gyrus of hippocampus, suggesting that all of these structures contribute to the development of hyperarousal. Only basolateral amygdala and dentate gyrus appeared to be additionally involved in encoding of contextual information. In summary, our results demonstrate the independence of associative and non-associative trauma-related fear. They support the hypothesis that generalized fear emerges in consequence of forgetting specific stimulus attributes associated with the shock context.",0 +https://doi.org/10.1371/currents.dis.cfcbaf509711641ab5951535851e572e,Developing a Consensus-based Definition of “Kokoro-no Care” or Mental Health Services and Psychosocial Support: Drawing from Experiences of Mental Health Professionals Who Responded to the Great East Japan Earthquake,"In this survey, we aimed to build consensus and gather opinions on 'Kokoro-no care' or mental health services and psychosocial support (MHSPSS) after a disaster, among mental health professionals who engaged in care after the Great East Japan Earthquake.We recruited mental health professionals who engaged in support activities after the Great East Japan Earthquake, which included local health professionals in the affected areas and members of mental health care teams dispatched from outside (n = 131). Adopting the Delphi process, we proposed a definition of 'Kokoro-no care', and asked the participants to rate the appropriateness on a 5-point Likert scale. We also solicited free comments based on the participants' experiences during the disaster. After Round 1, we presented the summary statistics and comments, and asked the participants to re-rate the definition that had been modified based on their comments. This process was repeated twice, until the consensus criterion of ≥ 80% of the participants scoring ≥ 4 on the statement was fulfilled.In Round 1, 68.7% of the respondents rated the proposed definition ≥ 4 for its appropriateness, and 88.4% did so in Round 2. The comments were grouped into categories (and subcategories) based on those related to the definition in general (Appropriate, Continuum of MHSPSS, Cautions in operation, Alternative categorisation of care components, Whether the care component should be categorised according to the professional involved, Ambiguous use of psychology, and Others), to mental health services (Appropriate, More specification within mental health services, More explicit remarks on mental health services, and Others), and to psychosocial support (Whether the care component should be categorised according to the professional involved, Raising concerns about the terms, and Others), and others.We achieved a consensus on the definition of 'Kokoro-no care', and systematically obtained suggestions on the concept, and practical advice on operation, based on the participants' experiences from the Great East Japan Earthquake. This collective knowledge will serve as reference to prepare and respond to future disasters.",0 +https://doi.org/10.2224/sbp.2008.36.8.1063,"CRITICAL INCIDENT, ADULT ATTACHMENT STYLE, AND POSTTRAUMATIC STRESS DISORDER: A COMPARISON OF THREE GROUPS OF SECURITY WORKERS","In this paper the authors render the results of research investigating adult attachment and posttraumatic stress disorder (PTSD) in a sample of Belgian security workers. The sample contained 3 subsamples: 68 individuals who had directly experienced a critical incident, 67 individuals who indirectly went through a critical incident, and 77 individuals who had not experienced a critical incident in the last six months. The analysis of the research results shows that the secure attachment style and the three PTSD trauma symptom clusters in DSM-IV - intrusion, avoidance/numbing, and hyperarousal - discriminate between the three subsamples. In other words, security workers who were directly and actively confronted with a critical incident were significantly more insecurely attached and suffered significantly more from PTSD symptoms than the groups who had no or indirect experience of a critical incident. Furthermore, trauma-focused cognitive-behavioral therapy is widely and quite efficiently used in the treatment of PTSD. Interest has been expressed in medical approaches.",0 +https://doi.org/10.3402/ejpt.v6.25290,Update to an evaluation of ICD-11 PTSD and complex PTSD criteria in a sample of adult survivors of childhood institutional abuse by Knefel & Lueger-Schuster (2013): a latent profile analysis,"The World Health Organization (WHO) International Classification of Diseases, 11th version (ICD-11), has proposed a trauma-related diagnosis of complex posttraumatic stress disorder (CPTSD) separate and distinct from posttraumatic stress disorder (PTSD).To determine whether the symptoms endorsed by individuals who had experienced childhood institutional abuse form classes that are consistent with diagnostic criteria for ICD-11 CPTSD as distinct from PTSD.A latent profile analysis (LPA) was conducted on 229 adult survivors of institutional abuse using the Brief Symptom Inventory and the PTSD Checklist-Civilian Version to assess current psychopathological symptoms.The LPA revealed four classes of individuals: (1) a class with elevated symptoms of CPTSD (PTSD symptoms and disturbances in self-organization); (2) a class with elevated symptoms of PTSD and low disturbances in self-organization; (3) a class with elevated disturbances in self-organization symptoms and some elevated PTSD symptoms; and (4) a class with low symptoms.The results support the existence of a distinct group in our sample, that could be described by the proposed diagnostic category termed CPTSD more precisely than by normal PTSD. In addition, there seems to be a group of persons that do not fulfill the criteria for a trauma-related disorder but yet suffer from psychopathological symptoms.",0 +https://doi.org/10.1111/papt.12069,Predictors of outcome of an Internet-based cognitive-behavioural therapy for post-traumatic stress disorder in older adults,"The aim of this study was to evaluate the role of resource-oriented variables such as self-efficacy, locus of control (LOC) and post-traumatic growth (PTG) in predicting treatment response in older adults with post-traumatic stress.Fifty-eight older adults with subsyndromal or greater severity of war-associated post-traumatic stress disorder (PTSD) symptoms completed a randomized controlled Internet-based cognitive-behavioural therapy (CBT) with immediate and delayed treatment groups. Assessments of PTSD severity and resource-oriented variables of self-efficacy, LOC and PTG were conducted at baseline, post-treatment and at a 6-month follow-up.Results revealed that pre-treatment scores on measures of internal LOC and PTG predicted PTSD symptom severity at post-treatment, even after controlling for initial PTSD. At a 6-month follow-up, internal LOC continued to predict PTSD symptom severity. In addition, repeated-measures analyses of variance revealed that, relative to older adults with low internal LOC and PTG, older adults with high internal LOC and PTG, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment.These findings suggest that greater locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Assessment of these constructs may be useful in identifying trauma survivors who are most likely to respond to CBT.Greater internal locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Older adults with initial high internal locus of control and post-traumatic growth, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. It could be assumed that patients with initial functional appraisals could benefit easier and faster from a trauma-focused cognitive-behavioural therapy compared to individuals with lower internal locus of control and post-traumatic growth.",0 +https://doi.org/10.1177/1073191106295914,"The Utility of the PAI and the MMPI-2 for Discriminating PTSD, Depression, and Social Phobia in Trauma-Exposed College Students","This study investigated the Minnesota Multiphasic Personality Inventory—Revised (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) and the Personality Assessment Inventory (PAI; Morey, 1991) with regard to each instrument's utility for discriminating post-traumatic stress disorder (PTSD) from depression and social phobia in a sample of college students with mixed civilian trauma exposure. Participants were 90 trauma-exposed undergraduates (16 male, 74 female) classified into one of four groups: PTSD, depressive disorders, social phobia, and well-adjusted. For both the PAI and the MMPI-2, profile analysis revealed that the groups differed in the elevation and shape of their profiles. The PAI Traumatic Stress subscale demonstrated good discriminant validity.",0 +https://doi.org/10.1016/j.bbr.2015.10.023,cis-3-Hexenol and trans-2-hexenal mixture prevents development of PTSD-like phenotype in rats,"Several green leaf volatiles have anxiolytic/antidepressant properties and attenuate adrenocortical stress response in rodents. However, it remains unknown whether a mixture of cis-3-hexenol and trans-2-hexenal so-called 'green odor (GO)' affects fear-associated post-traumatic stress disorder (PTSD)-like behavior. In the present study, fear memory of the initial conditioning stimulus was stably maintained by weekly presentation of conditioned tone. Examination of open field behavior, acoustic startle response, prepulse inhibition, and immobility in the forced swim test for 2 weeks after initial conditioning revealed that conditioned rats sustained anxiety, enhanced startle response, hypervigilance, depression-like behavior, and hypocortisolism, which is consistent with PTSD symptoms. Daily, not acute, GO presentation facilitated fear extinction and reduced PTSD-like behavioral and endocrinal responses. To further investigate the mechanism of effect of GO, we examined the effect of paroxetine (a selective serotonin reuptake inhibitor), p-chlorophenylalanine (PCPA, an irreversible serotonin synthesis inhibitor), alone or in combination of GO on PTSD-like phenotype. The alleviative effects of GO were masked by simultaneous paroxetine administration. PCPA-induced serotonin depletion abolished the effects of GO. Our results suggest that daily GO presentation facilitates fear extinction and prevents development of PTSD-like symptoms.",0 +https://doi.org/10.1177/00220345980770101201,Psychophysiological Assessment of Stress in Chronic Pain: Comparisons of Stressful Stimuli and of Response Systems,"Due to disparate findings across the published studies, the stress-hyperactivity hypothesis has never been fully accepted as a causal mechanism for chronic muscle pain. Two recent comprehensive reviews of the psychophysiological studies of chronic pain came to opposite conclusions about the viability of the hypothesis, which stemmed from differing importance placed on the experimental methodology: the adequacy of stress manipulation. The present study tested the hypotheses that the adequacy of stress manipulation is influenced by stress stimuli type, degree of personal relevance, and selection of criterion for verification of stress experience, and that these factors have a measurable impact on the related physiological responses in a manner that is consistent with a theory of stress applicable to clinical stress disorders. The three factors investigated were: task (imagery, reaction time), relevance (high, low), and manipulation criterion (autonomic, self-report). The tasks were presented to 16 chronic pain patients while muscle, electrodermal, and self-report responses were recorded. Reaction-time tasks and high-relevance conditions led to high muscle and electrodermal responses. Only the high-relevance imagery, however, produced high self-reported distress. Consistent with other research, the present overall data demonstrated differing physiological profiles for different stimuli types. More importantly, these data suggest that the manipulation type and the manipulation criterion influence outcomes of experimental tests of stress on physiological systems, which may directly lead to contrasting conclusions about causal relations between stress and chronic pain conditions.",0 +https://doi.org/10.1080/13284200802356820,Implications of neuroscientific evidence for the cognitive models of post-traumatic stress disorder,"Brewin's dual representation theory, Ehlers and Clark's cognitive appraisal model, and Dalgleish's schematic, propositional, analogue and associative representational systems model are considered in the light of recent evidence on the neural substrates of post-traumatic stress disorder (PTSD). The models' proposals about the cognitive mechanism of memory dysfunction in PTSD are described and evaluated against current knowledge about the neural pathways and functions disrupted in PTSD. A dual pathway model of memory is consistent with neuroscience of memory. The appraisal model also provides an account of the top-down modulation of memory and arousal problems consistent with current neuroscientific evidence of PTSD. Dalgleish's model is less consistent with the evidence because it relies upon assumptions that cannot yet be tested neuroscientifically. All three models under-specify the causal and maintaining influence of hyperarousal relative to the role it plays in current neuroscientific models of PTSD. Implications of the evidence for improving treatment and prevention are discussed.",0 +https://doi.org/10.1097/jgp.0b013e31820d92e7,Psychiatric Comorbidity of Full and Partial Posttraumatic Stress Disorder Among Older Adults in the United States: Results From Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions,"

Objectives

To present findings on the prevalence, correlates, and psychiatric comorbidity of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition posttraumatic stress disorder (PTSD) and partial PTSD in a nationally representative sample of U.S. older adults.

Design, Setting, and Participants

Face-to-face interviews with 9,463 adults age 60 years and older in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions.

Measurements

Sociodemographic correlates; worst stressful experiences; comorbid lifetime mood, anxiety, substance use, and personality disorders; psychosocial functioning; and suicide attempts.

Results

Lifetime prevalences ± standard errors of PTSD and partial PTSD were 4.5% ± 0.25 and 5.5% ± 0.27, respectively. Rates were higher in women (5.7% ± 0.37 and 6.5% ± 0.39) than in men (3.1% ± 0.31 and 4.3% ± 0.37). Older adults with PTSD most frequently identified unexpected death of someone close, serious illness or injury to someone close, and their own serious or life-threatening illness as their worst stressful events. Older adults exposed to trauma but without full or partial PTSD and respondents with partial PTSD most often identified unexpected death of someone close, serious illness or injury to someone close, and indirect experience of 9/11 as their worst events. PTSD was associated with elevated odds of lifetime mood, anxiety, drug use, and borderline and narcissistic personality disorders and decreased psychosocial functioning. Partial PTSD was associated with elevated odds of mood, anxiety, and narcissistic and schizotypal personality disorders and poorer psychosocial functioning relative to older adults exposed to trauma but without full or partial PTSD.

Conclusions

PTSD among older adults in the United States is slightly more prevalent than previously reported and is associated with considerable psychiatric comorbidity and psychosocial dysfunction. Partial PTSD is associated with significant psychiatric comorbidity, particularly with mood and other anxiety disorders.",0 +https://doi.org/10.1348/014466507x206883,"Low specificity of symptoms on the post-traumatic stress disorder (PTSD) symptom scale: A comparison of individuals with PTSD, individuals with other anxiety disorders and individuals without psychopathology","Objectives Screening for post-traumatic stress disorder (PTSD) takes place in clinical and research settings where diagnostic interviews are not feasible, and typically relies on self-report instruments like the PTSD symptom scale (PSS). Concerns have been raised about the specificity of PTSD symptoms assessed by questionnaires. This study examined whether the PSS distinguishes between patients with PTSD and those with other anxiety disorders or healthy controls. Design A between-participants design was employed. Methods The participants were 65 individuals with PTSD, 40 individuals with other anxiety disorders and 40 healthy controls. They completed the PSS with respect to a range of stressful life-events. Results Using this instrument, 86% of individuals with PTSD and 5% of healthy controls endorsed sufficient symptoms to meet the PTSD diagnosis. This was also the case for 43% of individuals with other anxiety disorders, and self-reported symptoms related to traumatic events and aversive events that are generally not considered traumatic. Conclusions The findings suggest that many people screened positive for PTSD may actually be suffering from another anxiety disorder.",0 +https://doi.org/10.1016/j.bbi.2013.07.005,Differential neuroendocrine and immune responses to acute psychosocial stress in women with type 1 bipolar disorder,"Bipolar disorder (BD) has been associated with immune imbalance, including lymphocyte activation and increased pro-inflammatory cytokines. Immune activation is part of stress response, and psychosocial stress has been implicated in the pathogenesis of psychiatric disorders. Here, we investigated the neuroendocrine and immune responses to acute psychosocial stress challenge in BD. Thirteen euthymic participants with type 1 BD and 15 healthy controls underwent the Trier Social Stress Test protocol (TSST). Blood samples were collected before and after TSST. Lymphocytes were isolated and stimulated in vitro to assess lymphocyte activation profile, lymphocyte sensitivity to dexamethasone, mitogen-activated protein kinase (MAPK) and nuclear factor kappa B (NF-κB) signaling by flow cytometry. Heart rate and salivary cortisol levels were monitored across the task. BD participants exhibited blunted stress responses as shown by reduced heart rate and salivary cortisol levels in comparison to healthy controls. BD was also associated with reduction in the percentage of regulatory T cells, but with expansion of activated T cells. When compared to controls, patients showed increased lymphocyte MAPK p-ERK and p-NF-κB signaling after the stress challenge, but exhibited a relative lymphocyte resistance to dexamethasone. In conclusion, stress-related neuroendocrine responses are blunted, associated with increased immune activation and lower sensitivity to glucocorticoids in BD. An inability in reducing NF-κB and MAPK signaling following TSST could be underlying the immune imbalance observed in BD.",0 +https://doi.org/10.1007/s00737-014-0467-y,Psychophysiology and posttraumatic stress disorder symptom profile in pregnant African-American women with trauma exposure,"While female sex is a robust risk factor for posttraumatic stress disorder (PTSD), pregnant women are an understudied population in regards to PTSD symptom expression profiles. Because circulating hormones during pregnancy affect emotionality, we assessed whether pregnant women would have increased expression of the intermediate phenotypes of hyperarousal and fear-potentiated startle (FPS) compared to non-pregnant women. We examined PTSD symptom profiles in pregnant (n = 207) and non-pregnant women (n = 370). In a second study, FPS responses were assessed in 15 pregnant and 24 non-pregnant women. All participants were recruited from the obstetrics and gynecology clinic at a public hospital serving a primarily African-American, low socioeconomic status, inner-city population. Our results indicate that overall PTSD symptoms were not different between the groups of women. However, pregnant women reported being more hypervigilant (p = 0.036) than non-pregnant women. In addition, pregnant women showed increased FPS to a safety signal compared to non-pregnant women (p = 0.024). FPS to a safety signal in pregnant women was significantly correlated with PTSD hyperarousal symptoms (r = 0.731, p < 0.001). Furthermore, discrimination between danger and safety signals was present in non-pregnant women (p = 0.008), but not in pregnant women (p = 0.895). Together, these data suggest that pregnant women show clinical and psychophysiological hyperarousal compared to non-pregnant women, and support screening for PTSD and assessment of PTSD risk in pregnant women.",0 +https://doi.org/10.1007/s00127-014-0890-4,"Patterns of victimization, suicide attempt, and posttraumatic stress disorder in Greenlandic adolescents: a latent class analysis","Aim The current study had two main aims. The first was to identify groups of adolescents based on their similarity of responding across a number of victimizing and potentially traumatic events (PTEs). In doing so, we employed the statistical technique of Latent Class Analysis (LCA). The second aim was to assess the relationship between our resultant classes and the covariates of gender, suicide attempt, and PTSD. Methods Two hundred and sixty-nine Greenlandic school students, aged 12-18 (M = 15.4, SD = 1.84) were assessed for their level of exposure to PTEs. In addition, adolescents were assessed for the psychological impact of these events. A LCA was performed on seven binary indicators representing PTEs. Logistic regression was subsequently implemented to ascertain the relationships between latent classes and covariates. Results Three distinct classes were uncovered: a violence, neglect, and bullying class (class 1), a wide-ranging multiple PTE class (class 2), and a normative/baseline class (class 3). Notably, classes 1 and 2 were largely separated by the presence or absence of sexual PTEs. Individuals who reported having previously attempted suicide were almost six times more likely to be members of class 1 (OR = 5.97) and almost four times more likely to be members of class 2 (OR = 3.87) compared to the baseline class (class 3). Individuals who met the diagnostic criteria for PTSD were five times as likely to be members of class 1 and class 2 (OR = 5.09) compared to the baseline class. No significant associations were found between classes and gender. Conclusion The results underline the complexity of the interplay between multiple victimization experiences, traumatization, and suicide attempts. © 2014 Springer-Verlag Berlin Heidelberg.",0 +https://doi.org/10.1080/13607863.2014.920299,Post-traumatic stress disorder in older adults: a systematic review of the psychotherapy treatment literature,"Older adults represent the fastest growing segment of the US and industrialized populations. However, older adults have generally not been included in randomized clinical trials of psychotherapy for post-traumatic stress disorder (PTSD). This review examined reports of psychological treatment for trauma-related problems, primarily PTSD, in studies with samples of at least 50% adults aged 55 and older using standardized measures.A systematic review of the literature was conducted on psychotherapy for PTSD with older adults using PubMed, Medline, PsychInfo, CINAHL, PILOTS, and Google Scholar.A total of 42 studies were retrieved for full review; 22 were excluded because they did not provide at least one outcome measure or results were not reported by age in the case of mixed-age samples. Of the 20 studies that met review criteria, there were: 13 case studies or series, three uncontrolled pilot studies, two randomized clinical trials, one non-randomized concurrent control study and one post hoc effectiveness study. Significant methodological limitations in the current older adult PTSD treatment outcome literature were found reducing its internal validity and generalizability, including non-randomized research designs, lack of comparison conditions and small sample sizes.Select evidence-based interventions validated in younger and middle-aged populations appear acceptable and efficacious with older adults. There are few treatment studies on subsets of the older adult population including cultural and ethnic minorities, women, the oldest old (over 85), and those who are cognitively impaired. Implications for clinical practice and future research directions are discussed.",0 +https://doi.org/10.1016/j.genhosppsych.2015.05.005,Posttraumatic stress disorder in organ transplant recipients: a systematic review,"To summarize and critically review the existing literature on the prevalence of posttraumatic stress disorder (PTSD) following organ transplantation, risk factors for posttransplantation PTSD and the relationship of posttransplant PTSD to other clinical outcomes including health-related quality of life (HRQOL) and mortality.We conducted a systematic literature review using PubMed, CINAHL Plus, the Cochrane Library and PsycInfo and a search of the online contents of 18 journals.Twenty-three studies were included. Posttransplant, the point prevalence of clinician-ascertained PTSD ranged from 1% to 16% (n=738), the point prevalence of questionnaire-assessed substantial PTSD symptoms ranged from 0% to 46% (n=1024) and the cumulative incidence of clinician-ascertained transplant-specific PTSD ranged from 10% to 17% (n=482). Consistent predictors of posttransplant PTSD included history of psychiatric illness prior to transplantation and poor social support posttransplantation. Posttransplant PTSD was consistently associated with worse mental HRQOL and potentially associated with worse physical HRQOL.PTSD may impact a substantial proportion of organ transplant recipients. Future studies should focus on transplant-specific PTSD and clarify potential risk factors for, and adverse outcomes related to, posttransplant PTSD.",0 +https://doi.org/10.1186/1741-7015-12-56,School-based mental health intervention for children in war-affected Burundi: a cluster randomized trial,"BackgroundArmed conflicts are associated with a wide range of impacts on the mental health of children and adolescents. We evaluated the effectiveness of a school-based intervention aimed at reducing symptoms of posttraumatic stress disorder, depression, and anxiety (treatment aim); and improving a sense of hope and functioning (preventive aim).MethodsWe conducted a cluster randomized trial with 329 children in war-affected Burundi (aged 8 to 17 (mean 12.29 years, standard deviation 1.61); 48% girls). One group of children (n = 153) participated in a 15-session school-based intervention implemented by para-professionals, and the remaining 176 children formed a waitlist control condition. Outcomes were measured before, one week after, and three months after the intervention.ResultsNo main effects of the intervention were identified. However, longitudinal growth curve analyses showed six favorable and two unfavorable differences in trajectories between study conditions in interaction with several moderators. Children in the intervention condition living in larger households showed decreases on depressive symptoms and function impairment, and those living with both parents showed decreases on posttraumatic stress disorder and depressive symptoms. The groups of children in the waitlist condition showed increases in depressive symptoms. In addition, younger children and those with low levels of exposure to traumatic events in the intervention condition showed improvements on hope. Children in the waitlist condition who lived on their original or newly bought land showed improvements in hope and function impairment, whereas children in the intervention condition showed deterioration on these outcomes.ConclusionsGiven inconsistent effects across studies, findings do not support this school-based intervention as a treatment for posttraumatic stress disorder and depressive symptoms in conflict-affected children. The intervention appears to have more consistent preventive benefits, but these effects are contingent upon individual (for example, age, gender) and contextual (for example, family functioning, state of conflict, displacement) variables. Results suggest the potential benefit of school-based preventive interventions particularly in post-conflict settings.Trial registrationThe study was registered as ISRCTN42284825",0 +https://doi.org/10.1186/1471-244x-14-193,Rapid emotional processing in relation to trauma-related symptoms as revealed by magnetic source imaging,"Traumatic stress leads to functional reorganization in the brain and may trigger an alarm response. However, when the traumatic event produces severe helplessness, the predominant peri-traumatic response may instead be marked by a dissociative shutdown reaction. The neural correlates of this dissociative shutdown were investigated by presenting rapidly presented affective pictures to female participants with posttraumatic stress disorder (PTSD), and comparing responses to a Non-PTSD control group.Event-related-magnetic-fields were recorded during rapid visual serial presentation of emotionally arousing stimuli (unpleasant or pleasant), which alternated with pictures with low affective content (neutral). Neural sources, based on the L2-surface-minimum-norm, correlated with the severity of the symptom clusters: PTSD, depression and shutdown dissociation.For the early cortical response (60 to 110 ms), dissociation and PTSD symptom severity show similar spatial distributions of correlates for unpleasant stimuli. Cortical networks that could be involved in the relationships seem to be widespread.We conclude that shutdown dissociation, PTSD and depression all have distinct effects on early processing of emotional stimuli.",0 +https://doi.org/10.2105/ajph.2006.087007,Psychological Sequelae Resulting From the 2004 Florida Hurricanes: Implications for Postdisaster Intervention,"Objectives. Data are limited regarding mental health effects of disasters such as hurricanes. We sought to determine the prevalence of and major risk factors associated with posttraumatic stress disorder (PTSD), generalized anxiety disorder, and major depressive episode 6 to 9 months after the 2004 Florida hurricanes. Methods. Random-digit dialing was used to recruit a representative population sample of 1452 hurricane-affected adults. Results. Posthurricane prevalence for PTSD was 3.6%, for generalized anxiety disorder was 5.5%, and for major depressive episode was 6.1%. Risk factors varied somewhat across disorders, with the exception of previous exposure to traumatic events, which increased risk of all negative outcomes. Conclusions. Storm exposure variables and displacement were associated primarily with PTSD. Notably, high social support in the 6 months preceding the hurricanes protected against all types of disorders.",0 +https://doi.org/10.1002/jnr.23684,Dysfunctional or hyperfunctional? The amygdala in posttraumatic stress disorder is the bull in the evolutionary China shop,"Our motivation in writing this Review arose not only from the great value in contributing to this special issue of the Journal of Neuroscience Research but also from the desire to express our opinion that the description of the amygdala as ""dysfunctional"" in posttraumatic stress disorder (PTSD) might not be appropriate. We acknowledge that excessive activation of the amygdala contributes to the cluster of PTSD symptoms, including hypervigilance, intrusive memories, and impaired sleep, that underlies the devastating mental and physical outcomes in trauma victims. The issue that we address is whether the symptoms of PTSD represent an impaired (dysfunctional) or sensitized (hyperfunctional) amygdala status. We propose that the amygdala in PTSD is hyperfunctional rather than dysfunctional in recognition of the fact that the individual has already survived one life-threatening attack and that another may be forthcoming. We therefore consider PTSD to be a state in which the amygdala is functioning optimally if the goal is to ensure a person's survival. The misery caused by a hyperfunctional amygdala in PTSD is the cost of inheriting an evolutionarily primitive mechanism that considers survival more important than the quality of one's life.",0 +https://doi.org/10.1038/npp.2014.225,Interaction between the Cholecystokinin and Endogenous Cannabinoid Systems in Cued Fear Expression and Extinction Retention,"Post-traumatic stress disorder (PTSD) is thought to develop, in part, from improper inhibition of fear. Accordingly, one of the most effective treatment strategies for PTSD is exposure-based psychotherapy. Ideally, neuroscience would inform adjunct therapies that target the neurotransmitter systems involved in extinction processes. Separate studies have implicated the cholecystokinin (CCK) and endocannabinoid systems in fear; however, there is a high degree of anatomical colocalization between the cannabinoid 1 receptor (Cnr1) and CCK in the basolateral amygdala (BLA), a brain region critical for emotion regulation. Although most research has focused on GABA and GABAergic plasticity as the mechanism by which Cnr1 mediates fear inhibition, we hypothesize that a functional interaction between Cnr1 and CCKB receptor (CCKBR) is critical for fear extinction processes. In this study, systemic pharmacological manipulation of the cannabinoid system modulated cued fear expression in C57BL/6J mice after consolidation of auditory fear conditioning. Knockout of the CCKBR, however, had no effect on fear- or anxiety-like behaviors. Nonetheless, administration of a Cnr1 antagonist increased freezing behavior during a cued fear expression test in wild-type subjects, but had no effect on freezing behavior in CCKBR knockout littermates. In addition, we found that Cnr1-positive fibers form perisomatic clusters around CCKBR-positive cell bodies in the BLA. These CCKBR-positive cells comprise a molecularly heterogenous population of excitatory and inhibitory neurons. These findings provide novel evidence that Cnr1 contributes to cued fear expression via an interaction with the CCK system. Dysfunctional Cnr1-CCKBR interactions might contribute to the etiology of, or result from, fear-related psychiatric disease.",0 +https://doi.org/10.1016/j.janxdis.2015.07.007,Six years after the wave. Trajectories of posttraumatic stress following a natural disaster,"The characteristics of long-term trajectories of distress after disasters are unclear, since few studies include a comparison group. This study examines trajectories of recovery among survivors in comparison to individuals with indirect exposure.Postal surveys were sent to Swedish tourists, repatriated from the 2004 Indian Ocean tsunami (n=2268), at 1, 3, and 6 years after the tsunami to assess posttraumatic stress (PTS) and poor mental health. Items were used to ascertain high and moderate disaster exposure groups and an indirect exposure comparison group.Long-term PTS trajectories were best characterized by a resilient (72.3%), a severe chronic (4.6%), a moderate chronic (11.2%) and a recovering (11.9%) trajectory. Trajectories reported higher levels of PTS than the comparison group. Exposure severity and bereavement were highly influential risk factors.These findings have implications regarding anticipation of long-term psychological adjustment after natural disasters and need for interventions after a single traumatic event with few secondary stressors.",1 +https://doi.org/10.3109/13651501.2013.855792,Characterizing impulsivity profile in patients with obsessive–compulsive disorder,"Impulsivity represents a key dimension in obsessive-compulsive disorder (OCD), in relation to outcome and course. It can be assessed through the Barratt Impulsiveness Scale (BIS), which explores three main areas: attentional, motor, and nonplanning. Present study was aimed to assess level of impulsivity in a sample of OCD patients, in comparison with healthy controls, using the BIS.Seventy-five OCD outpatients, 48 of them having psychiatric comorbidities and 70 healthy controls, were assessed through the BIS, and their scores were analyzed using Student's t-test for independent samples, on the basis of demographic and clinical characteristics.BIS total scores were significantly higher (P: 0.01) in patients compared to controls, with no difference between pure and comorbid patients. Attentional impulsivity scores were significantly higher than controls in patients with pure (P < 0.001) and comorbid OCD (P < 0.001), without differences among them. Patients with multiple OC phenotypes showed higher, though statistically non significant, total and attentional scores, compared to single phenotype patients. In addition, patients with comorbid major depressive disorder had higher, though statistically non significant, total and attentional scores, compared to patients with comorbid bipolar disorder, generalized anxiety disorder, and other disorders.Present findings showed higher impulsivity levels in OCD patients versus controls, particularly in the attentional area, and ultimately suggest a potential cognitive implication.",0 +https://doi.org/10.1016/j.jpsychires.2014.04.020,Cortisol response to an experimental stress paradigm prospectively predicts long-term distress and resilience trajectories in response to active police service,"Heterogeneity in glucocorticoid response to experimental stress conditions has shown to differentiate individuals with healthy from maladaptive real-life stress responses in a number of distinct domains. However, it is not known if this heterogeneity influences the risk for developing stress related disorders or if it is a biological consequence of the stress response itself. Determining if glucocorticoid response to stress induction prospectively predicts psychological vulnerability to significant real life stressors can adjudicate this issue. To test this relationship, salivary cortisol as well as catecholamine responses to a laboratory stressor during academy training were examined as predictors of empirically identified distress trajectories through the subsequent 4 years of active duty among urban police officers routinely exposed to potentially traumatic events and routine life stressors (N = 234). During training, officers were exposed to a video vignette of police officers exposed to real-life trauma. Changes in salivary 3-methoxy-4-hydroxyphenylglycol (MHPG) and cortisol in response to this video challenge were examined as predictors of trajectory membership while controlling for age, gender, and baseline neuroendocrine levels. Officers who followed trajectories of resilience and recovery over 4 years mounted significant increases in cortisol in response to the experimental stressor, while those following a trajectory of chronic increasing distress had no significant cortisol change in response to the challenge. MHPG responses were not associated with distress trajectories. Cortisol response prospectively differentiated trajectories of distress response suggesting that a blunted cortisol response to a laboratory stressor is a risk factor for later vulnerability to distress following significant life stressors.",0 +https://doi.org/10.1023/a:1022055110238,Hazardous alcohol use and treatment outcome in male combat veterans with posttraumatic stress disorder,"The relationship between alcohol problems and posttraumatic stress disorder (PTSD) remains unclear. Six hundred and eight combat veterans diagnosed with PTSD were assessed for PTSD symptoms and alcohol problems prior to group cognitive-behavioral treatment. They were reassessed 3 and 9 months after treatment. Participants were classified into low-risk and hazardous drinkers at each time point. Drinking status at intake did not predict PTSD symptoms at intake or follow-up. However, drinking status was associated with PTSD symptoms when both were assessed at follow-up. PTSD arousal symptoms were the only symptom cluster to differentiate drinking groups.",0 +https://doi.org/10.1136/bmjopen-2014-007051,Mental health and functional impairment outcomes following a 6-week intensive treatment programme for UK military veterans with post-traumatic stress disorder (PTSD): a naturalistic study to explore dropout and health outcomes at follow-up,"Combat Stress, a UK national charity for veterans with mental health problems, has been funded by the National Health Service (NHS) to provide a national specialist service to deliver treatment for post-traumatic stress disorder (PTSD). This paper reports the efficacy of a PTSD treatment programme for UK veterans at 6 months follow-up.A within subject design.UK veterans with a diagnosis of PTSD who accessed Combat Stress.246 veterans who received treatment between late 2012 and early 2014.An intensive 6-week residential treatment programme, consisting of a mixture of individual and group sessions. Participants were offered a minimum of 15 individual trauma-focused cognitive behavioural therapy sessions. In addition, participants were offered 55 group sessions focusing on psychoeducational material and emotional regulation.Clinicians completed measures of PTSD and functional impairment and participants completed measures of PTSD, depression, anger and functional impairment.We observed significant reductions in PTSD scores following treatment on both clinician completed measures (PSS-I: -13.0, 95% CI -14.5 to -11.5) and self-reported measures (Revised Impact of Events Scale (IES-R): -16.5, 95% CI -19.0 to -14.0). Significant improvements in functional impairment were also observed (eg, Health of the Nation Outcome Scales (HONOS): -6.85, 95% CI -7.98 to -5.72). There were no differences in baseline outcomes between those who completed and those who did not complete the programme, or post-treatment outcomes between those we were able to follow-up at 6 months and those lost to follow-up.In a naturalistic study we observed a significant reduction in PTSD scores and functional impairment following treatment. These improvements were maintained at 6 month follow-up. Our findings suggest it may be helpful to take a closer look at combining individual trauma-focused cognitive behaviour therapy and group sessions when treating veterans with PTSD. This is the first UK study of its kind, but requires further evaluation.",0 +https://doi.org/10.4088/jcp.14com09372,Empirical Characterization of Heterogeneous Posttraumatic Stress Responses Is Necessary to Improve the Science of Posttraumatic Stress,"Article AbstractBecause this piece does not have an abstract, we have provided for your benefit the first 3 sentences of the full text.The concept of posttraumatic stress psychopathology is simple and intuitive: following a highly distressing event, some people develop sustained aversive responses that dominate their lives, causing overwhelming distress and havoc in their emotional, cognitive, behavioral, and interpersonal functioning. Despite the conceptual simplicity of posttraumatic stress, a decisive definition of the concept seems out of reach. The posttraumatic stress disorder (PTSD) diagnosis differs both between international standards (ie, International Classification of Diseases) and the US standards (Diagnostic and Statistical Manual of Mental Disorders ) and across iterations of these manuals.",0 +https://doi.org/10.1188/09.onf.395-400,Post-Traumatic Stress Disorder Related to the Cancer Experience,"Many healthcare professionals think about Post-Traumatic Stress Disorder (PTSD) in the context of soldiers returning from war zones, victims of abuse, or trauma survivors. Research literature supports a range of psychological stressors that are associated with a cancer diagnosis and subsequent treatment. Psychological responses of distress are most often reported at major transition points, such as diagnosis, treatment, conclusion of treatment, recurrence, and terminal disease, and include but are not limited to shock, denial, fear, anxiety, panic, sadness, depression, and appetite and sleep disturbances. A multimodal approach is needed to diagnose PTSD. This includes data that address social, cognitive, emotional, family, and occupational functioning. The human spirit is resilient. Many research studies have investigated positive life changes that individuals claim are a result of their cancer experiences. sources of posttraumatic growth will help all healthcare professionals foster the strength of the people they care for. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1037/a0016671,Masculine gender role stress and posttraumatic stress disorder symptom severity among inpatient male crack/cocaine users.,"This study examined the association between masculine gender role stress (MGRS) and posttraumatic stress disorder (PTSD) symptom severity, above and beyond other factors previously found to be associated with PTSD symptoms (e.g., anxiety sensitivity and thought suppression) among 33 crack/cocaine-dependent patients in residential substance abuse treatment. Participants completed a series of questionnaires and were interviewed to determine current PTSD symptom severity. MGRS accounted for a significant amount of additional variance in PTSD symptom severity above and beyond other identified risk factors for PTSD. Results are discussed in terms of their implications for reducing PTSD risk among men following exposure to a potentially traumatic event. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1080/15487768.2013.789688,"Intersection of Stress, Social Disadvantage, and Life Course Processes: Reframing Trauma and Mental Health","This paper describes the intersection of converging lines of research on the social structural, psychosocial, and physiological factors involved in the production of stress and implications for the field of mental health. Of particular interest are the stress sensitization consequences stemming from exposure to adversity over the life course. Contemporary stress sensitization theory provides important clinical utility in articulating mechanisms through which these multiple levels exert influence on mental health. Stress sensitization models (a) extend understanding of neurobiological and functional contexts within which extreme stressors operate and (b) make clear how these can influence psychologically traumatic outcomes. The value of interventions that are sensitive to current contexts as well as life course profiles of cumulative stress are illustrated through recent treatment innovations.",0 +https://doi.org/10.1002/jts.20121,Post-tsunami stress: A study of posttraumatic stress disorder in children living in three severely affected regions in Sri Lanka,"At 3 to 4 weeks after the December 2004 tsunami disaster we assessed symptoms of posttraumatic stress disorder (PTSD) in 264 children who lived in severely affected coastal communities in Manadkadu (northern coast), Kosgoda (western coast), and Galle (southern coast) in Sri Lanka. The prevalence rate of tsunami-related posttraumatic stress disorder (PTSD) (ignoring the time criterion) ranged between 14% and 39% and an additional 5% to 8% had PTSD unrelated to the tsunami. The PTSD symptoms were explained by the severity of the trauma exposure and family loss, as well as previous traumatic events. The results confirm the relevance of the individual history of traumatic events for the genesis of PTSD and indicate a high need of mental health assistance among the tsunami-affected children in Sri Lanka.",0 +https://doi.org/10.1007/s12310-010-9032-7,Test Anxiety Prevention and Intervention Programs in Schools: Program Development and Rationale,"This paper (a) discusses the need for anxiety-focused prevention and intervention efforts, (b) discusses test anxiety interventions as an avenue toward building school partnerships to conduct anxiety-focused prevention and intervention efforts, and (c) provides a brief description of the University of New Orleans test anxiety program model and previously published findings. This paper also presents new data in support of our rationale from one of our screening assessments to highlight the linkages between test anxiety and anxiety problems more broadly and presents a brief summary of initial acceptability data. Data indicate that test anxiety was related to symptoms of anxiety disorders and depression. Moreover, among an initial wave of (n = 59) participants in a new intervention study, acceptability data are promising. For example, 96% indicating they were glad they participated and 70% of students showed substantial knowledge (at least 80% correct) of intervention content. Results are discussed in terms of how the data provide evidence for the importance of targeting test anxiety, future research directions, and applied implications.",0 +https://doi.org/10.1111/j.2044-8260.1992.tb01018.x,Social support and stress: The role of social comparison and social exchange processes,"This paper first presents four different conceptualizations of social support: social integration, satisfying relationships, perceived helpfulness and enacted support. Then, classic and contemporary social comparison theory and social exchange theory are analysed as they are two theoretical perspectives that are particularly useful in understanding social support. These perspectives are employed to explain three seemingly paradoxical phenomena in the domain of social support: (1) the fact that support sometimes has negative effects; (2) the fact that the occurrence of stress itself can sometimes decrease the availability of support resources; and (3) the phenomenon that people believe that they give more support than they receive, and that there is more support available for them than for others.",0 +https://doi.org/10.1080/15374416.2012.717872,Longitudinal Examination of PTSD Symptoms and Problematic Alcohol Use as Risk Factors for Adolescent Victimization,"The current study examined associations between posttraumatic stress disorder (PTSD) symptoms and future interpersonal victimization among adolescents, after accounting for the impact of early victimization exposure, gender, ethnicity, and household income. In addition, problematic alcohol use was tested as a mediator of the relation between PTSD symptoms and subsequent victimization. Participants included a national longitudinal sample of adolescents (N = 3,604) who were ages 12 to 17 at the initial assessment: 50% were male, and 67% were White, 16% African American, and 12% Hispanic. Cohort-sequential latent growth curve modeling was used to examine associations among the study variables. Baseline PTSD symptoms significantly predicted age-related increases in interpersonal victimization, even after accounting for the effects of earlier victimization experiences. In addition, alcohol problems emerged as a partial mediator of this relation, such that one fourth to one third of the effect of PTSD symptoms on future victimization was attributable to the impact of PTSD symptoms on alcohol problems (which, in turn, predicted additional victimization risk). Collectively, the full model accounted for more than half of the variance in age-related increases in interpersonal victimization among youth. Results indicate that PTSD symptoms serve as a risk factor for subsequent victimization among adolescents, over and above the risk conferred by prior victimization. This increased risk occurred both independently and through the impact of PTSD symptoms on problematic alcohol use. Based on these findings, it is hypothesized that the likelihood of repeated victimization among youth might be reduced through early detection and treatment of these clinical problems.",0 +https://doi.org/10.1111/1469-7610.00201,Incidence and associations of parental and child posttraumatic stress symptoms in pediatric patients,"Previous studies consistently found remarkable prevalence rates of posttraumatic stress symptoms (PTSS) and posttraumatic stress disorders (PTSD) in pediatric patients and their parents. Findings suggest a significant association between child and parent PTSS. The present study examined, in a sample of pediatric patients with different conditions, incidence rates and determinants of PTSS and PTSD in the patients, and their mothers and fathers. Also, associations of maternal, paternal and child PTSS and PTSD were analyzed.Two hundred and nine children (aged 6.5-14.5 years) were interviewed 5-6 weeks after an accident or a new diagnosis of cancer or diabetes mellitus type 1 by means of the Child PTSD Reaction Index. Their mothers (n = 180) and fathers (n = 175) were assessed with the Posttraumatic Diagnostic Scale.Children reported PTSS levels in the mild range. Sixteen percent of the fathers and 23.9% of the mothers met full DSM-IV diagnostic criteria for current PTSD. Type of trauma impacted differently on parents and children. In children, accident-related injury was associated with higher PTSS scores. Conversely, in parents, diagnosis of cancer in their child was associated with more symptoms. Functional status of the child was also found to be an important predictor of PTSS in children and parents. PTSS scores of mothers and fathers were significantly correlated with each other. However, child PTSS were not significantly related to PTSS of mothers and fathers. This was true for total scores as well as for DSM-IV symptom clusters.There is a need for careful evaluation of PTSS and PTSD in pediatric patients with accidental injuries or sudden onset of severe chronic diseases and in their respective parents. Importantly, children, their mothers, and their fathers should be assessed separately, because a significant association between child and parental PTSS may not exist.",0 +https://doi.org/10.1111/j.1365-2788.2005.00705.x,Is Post-Traumatic Stress Disorder a helpful concept for adults with intellectual disability?,"Research using the concept of Post-Traumatic Stress Disorder (PTSD) with adults with intellectual disability (ID)assumes they perceive and react to traumatic events in a similar way to non-disabled adults. Reactions to trauma displayed by children may be relevant to adults with ID as well.Two focus groups were held with professionals and practitioners to explore the relevance of criteria from child as well as adult literature to adults with ID who experience trauma. Descriptive thematic analysis was carried out.Abuse, parental bereavement, and having children removed were considered common sources of trauma. Similarities identified between disabled and non-disabled adults were flashbacks and nightmares; distressed by reminders; avoidance; hypervigilance and increased arousal. Differences were the frequent occurrence of multiple rather than single events, which were considered significant in generating chronic problems similar to those described as PTSD; also the occurrence of physical health problems and behavioural re-enactments.Experienced professionals and practitioners considered most of the ideas from PTSD research with non-disabled adults to be relevant to adults with ID who experience trauma, but that some behaviour reported in research with children was also relevant. Topics and questions for use in clinical and research practice with individuals who have experienced trauma were proposed.",0 +,Assessing the impact of posttraumatic stress disorder (PTSD) among wives of veterans: A phenomenological study of life changing experiences of wives of war veterans diagnosed with PTSD,"Post Traumatic Stress Disorder is a chronic illness that not only destabilizes the victim, but also impacts the lives of family members and those close them by way of compassion fatigue or secondary traumatization. The purpose of this mixed-method, phenomenological study was to explore the lived experiences of a sample of 10 wives of Iraq and Afghanistan war veterans diagnosed with PTSD in order to assess the impact of the veterans' symptoms upon their wives, their marriage, and their family life. The setting was a local community close to Fort Jackson Military Cantonment in Columbia, South Carolina. Ten wives of war veterans diagnosed with PTSD were recruited on a voluntary basis from the local churches where they worshipped. A face-to-face semi-structured interview was conducted in order to explore the wives' lived experiences. Participant's mean score was 82.7 of a possible 85 as measured by the Secondary Traumatic Stress Scale. All participants experienced secondary trauma. African-American participants scored significantly higher than the White participants on the Avoidance and Arousal scales and on Total score. No significant differences were found for ethnicity on the Intrusion scale. Themes found in the interviews related to (1) fears and uncertainties about the future of their marriages; (2) determination to keep their marriage vows; (3) guilt and shame; (4) systemic change in lifestyle; (5) mental and emotional stress; (6) coping strategies, and (7) strength and empowerment. Further studies relating spouses' symptom severity with that of veterans, effectiveness of coping skills, and effects on children are called for. Including veterans' wives in conjoint therapy is recommended, as is the development of principles of marital therapy to help couples move beyond the diagnosis of PTSD and toward recovery. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1037/a0025591,A French adaptation of the Posttraumatic Diagnostic Scale.,"The factor structure of a French adaptation of the Posttraumatic Diagnostic Scale (PDS-F) based on the original scale by Foa, Cashman, Jaycox, and Perry (1997) was examined in 287 community members. Confirmatory factor analysis evaluated three models: the three symptom clusters of Posttraumatic Stress Disorder (PTSD) defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM–IV; American Psychiatric Association, 1994), the 4-factor King, Leskin, King, and Weathers (1998) model and the 4-factor Simms, Watson, and Doebbelling (2002) model. The data’s fit to the DSM–IV model was unacceptable. Both 4-factor models demonstrated a good fit; however, the Simms et al. (2002) model with intrusions, avoidance, dysphoria, and hyperarousal factors showed the best fit. Scores calculated for the Simms et al. (2002) factors showed good reliability and validity. The study also examined lifetime stressful event reporting and PTSD severity. “Stressful” events not traditionally defined as “traumatic” (e.g., death of a loved one) were frequently endorsed as the respondent’s most stressful event (i.e., index event) and corresponded to a possible PTSD diagnosis. Furthermore, PTSD severity was associated with negative emotional appraisals of the index event (DSM–IV criterion A2 for PTSD) and lifetime cumulative stressful event intensity whereas PTSD severity was not associated with the degree of physical harm of the index event (criterion A1). Lifetime stressful experiences are discussed in light of evidence supporting a dysphoria component in PTSD.",0 +https://doi.org/10.1016/j.psychres.2012.11.024,Attentional bias for affective visual stimuli in posttraumatic stress disorder and the role of depression,"An attentional bias for trauma-related verbal cues was frequently demonstrated in posttraumatic stress disorder (PTSD) using variants of the emotional Stroop task (EST). However, the mechanisms underlying the Stroop-effect are ill-defined and it is yet unclear how the findings apply to different paradigms and stimulus modalities. To address these open questions, for the first time a spatial-cuing task with pictorial cues of different emotional valence was administered to trauma-exposed individuals with and without PTSD, and non-trauma-exposed controls. Groups did not show different response profiles across affective conditions. However, a group effect was evident when comparing depressed with non-depressed individuals: Those with depression showed delayed attending towards trauma-related cues and faster attending away from negative cues. In correlational analyses, attentional avoidance was associated with both depression and PTSD symptom severity. These findings highlight the need for research on trauma populations and anxiety in general to pay closer attention to depression as an important confound in the study of emotional information processing.",0 +https://doi.org/10.1111/j.1469-7610.2010.02209.x,Evaluation of a classroom-based psychosocial intervention in conflict-affected Nepal: a cluster randomized controlled trial,"In situations of ongoing violence, childhood psychosocial and mental health problems require care. However, resources and evidence for adequate interventions are scarce for children in low- and middle-income countries. This study evaluated a school-based psychosocial intervention in conflict-affected, rural Nepal.A cluster randomized controlled trial was used to evaluate changes on a range of indicators, including psychiatric symptoms (depression, anxiety, posttraumatic stress disorder), psychological difficulties, resilience indicators (hope, prosocial behavior) and function impairment. Children (n = 325) (mean age = 12.7, SD = 1.04, range 11-14 years) with elevated psychosocial distress were allocated to a treatment or waitlist group.Comparisons of crude change scores showed significant between-group differences on several outcome indicators, with moderate effect sizes (Cohen d = .41 to .58). After correcting for nested variance within schools, no evidence for treatment effects was found on any outcome variable. Additional analyses showed gender effects for treatment on prosocial behavior (mean change difference: 2.70; 95% CI, .97 to 4.44), psychological difficulties (-2.19; 95% CI, -3.82 to -.56), and aggression (-4.42; 95% CI, -6.16 to -2.67). An age effect for treatment was found for hope (.90; 95% CI, -1.54 to -.26).A school-based psychosocial intervention demonstrated moderate short-term beneficial effects for improving social-behavioral and resilience indicators among subgroups of children exposed to armed conflict. The intervention reduced psychological difficulties and aggression among boys, increased prosocial behavior among girls, and increased hope for older children. The intervention did not result in reduction of psychiatric symptoms.",0 +https://doi.org/10.1080/15427600902911221,A Second-Order Growth Mixture Model for Developmental Research,"Growth mixture modeling, a combination of growth modeling and finite mixture modeling, is a flexible, exploratory method for identifying and describing between-person heterogeneity in change. In this article we introduce a second-order growth mixture model that combines a longitudinal common factor model, measurement invariance constraints, latent growth model, and mixture model. This approach capitalizes on the benefits of multivariate measurement and the flexibility of mixtures for representing heterogeneity. We describe the model and illustrate its use with multi-reporter longitudinal data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development tracking the development of children's externalizing behaviors through elementary school.",0 +https://doi.org/10.1080/15325024.2012.678779,Confirmatory Factor Analysis of the Posttraumatic Growth Inventory in a Veteran Sample with Posttraumatic Stress Disorder,"The objective of this study was to conduct a confirmatory factor analysis (CFA) of the Posttraumatic Growth Inventory (PTGI) to determine if the factor structure is the same for a veteran sample with posttraumatic stress disorder (PTSD; N = 221) as compared to previous studies that have used more heterogeneous samples of subjects. Analyses were conducted in order to examine the best model fit between three broad dimensional factors, a five-factor structure, or a factor structure consisting of one higher-order “general” factor with five “lower-order” factors. Results of the CFA revealed adequate fits for the five-factor and five-factor higher-order models. The findings of this study support the use of the PTGI total and factor scores when interpreting results in veteran samples with PTSD.",0 +https://doi.org/10.1007/978-1-4939-3014-2_10,Maternal Obesity in Pregnancy: Consequences for Brain Function in the Offspring,"It is perhaps not surprising that an inhospitable intrauterine environment can result in neurodevelopmental disorders, given the enormous changes in brain development that occur during gestation. Here we discuss: (1) Obesity is a state of low-grade inflammation and is thus a candidate for having an unfavorable impact on brain function in the offspring. (2) Maternal obesity has recently been associated with offspring attention deficit hyperactivity disorder and autism spectrum disorder. A recent study found differences in amniotic fluid mRNA for 20 genes in fetuses of obese versus lean women, and several of these genes impact on brain sculpting. (3) The balance between excitable and inhibitory neural function can be disturbed as a consequence of maternal obesity and can lead to hyperexcitability-linked cognitive decline later in life. (4) While most studies of brain development and function have focused on neurons, inflammation and oxidative stress have major effects on microglia and astrocytes, key cells in the sculpting of synapses, neural plasticity, and the formation of neural networks. (5) Animal models are, of necessity, widely used and the temporal trajectory of neurodevelopment to accommodate the requirements of the different species has recently been modeled. While detailed studies are essential for understanding mechanism, it is critical to test the outcomes of manipulating the system on behavior. In this regard considerable care is required to ensure that the most appropriate behavioral test and animal model are used. Thus, there is considerable scope for consolidating our understanding of the effects of maternal obesity on brain function in the offspring. © Springer Science+Business Media New York 2016.",0 +https://doi.org/10.1016/j.comppsych.2014.11.009,Examining the relationship between coping strategies and suicidal desire in a sample of United States military personnel,"Suicidal desire in the military has been previously examined through the lens of the Interpersonal-Psychological Theory of Suicide (IPTS). However, no research has examined the impact of specific coping strategies on perceived burdensomeness, thwarted belongingness, and suicidal ideation in a large population of individuals serving in the US military. Furthermore, the factor structure of previously utilized coping clusters did not apply to our sample of military personnel. Therefore, we found a three-factor solution to be tested in this sample. We hypothesized that specific types of coping behavior clusters (Adaptive and Maladaptive) would predict both IPTS constructs and suicidal ideation. Results indicated that Adaptive and Maladaptive coping clusters predicted the IPTS constructs in the hypothesized directions. However, only the Maladaptive cluster predicted suicidal ideation. These findings implicate the need for further research and suicide prevention efforts focusing on coping strategies, specifically those that are maladaptive in nature, in relation to suicidal ideation in military members.",0 +https://doi.org/10.1016/j.jad.2014.06.024,Neuropsychological impairments in panic disorder: A systematic review,"There is a growing body of literature investigating the neuropsychological profile of panic disorder (PD), some of which suggests potential cognitive dysfunction. This paper systematically reviews the existing literature on neuropsychological performance in PD.PsycINFO, EMBASE, MEDLINE and PsycARTICLES databases were searched to identify articles reporting on neuropsychological function in PD published in English during the time period 1980 to March 2012. 14 studies were identified.There was limited support for impairment in short term memory among individuals with PD, although this was not found across all studies. Overall, the reviewed studies did not support the presence of impairment in other areas of cognitive functioning, including executive function, long term memory, visuospatial or perceptual abilities and working memory.Studies with samples of fewer than 15 participants per group were excluded from this review. A limited amount of research has been published on this topic and small sample sizes (under 25 per group) have been used by many studies. Therefore, the current review is based on a small number of studies with limited power.There is limited evidence of specific neuropsychological impairments in participants with PD. Impairments in short term memory warrant further investigation to establish their relevance to clinical practice. Larger sample sizes and appropriate statistical adjustment for multiple comparisons in future studies is highly recommended.",0 +https://doi.org/10.1037/rep0000049,Psychiatric comorbidity effects on compensatory cognitive training outcomes for veterans with traumatic brain injuries.,"To investigate the influence of posttraumatic stress disorder (PTSD) diagnosis, and PTSD and depression severity, on the postconcussive symptom trajectory over the course of a 1-year study period.Secondary analysis of a randomized controlled trial comparing veterans who received supported employment combined with compensatory cognitive training to those who received supported employment only. Assessments were conducted at baseline, 3- (postintervention), 6-, and 12-months. Participants were 50 Operation Enduring and Iraqi Freedom (OEF/OIF) veterans with a history of mild to moderate traumatic brain injury (TBI) who were unemployed, seeking work, and who had neuropsychological impairment. Of all participants, 74% met diagnostic criteria for PTSD. All participants received supported employment and half of the sample also received Cognitive Symptom Management and Rehabilitation Therapy (CogSMART), a 12-session, manualized compensatory cognitive training intervention.Veterans with PTSD and greater depression severity endorsed significantly more severe postconcussive symptomatology at all assessment time points. However, the rate of CogSMART-associated improvement in postconcussive symptoms did not differ as a result of psychiatric symptomatology.Study results suggest that for veterans with a history of mild to moderate TBI, presence of comorbid PTSD or depressive symptoms should not preclude participation in cognitive rehabilitation interventions.",0 +https://doi.org/10.1002/1097-4679(198701)43:1<56::aid-jclp2270430108>3.0.co;2-d,Conducting applied research on Vietnam combat-related post-traumatic stress disorder,"A paradigmatic shift in post-traumatic stress disorder (PTSD) research is underway. Formistic and mechanistic research designs, characterized by single-category, single-cause, single-effect models, gradually are being replaced by contextual and organistic research designs that feature multi-category, multi-cause, and multi-effect interactional models. Such changes in diagnostic and treatment outcome research require solving many methodological issues in such areas as: measuring types of traumas and stressors; measuring PTSD symptoms and subtypes; measuring subject dispositional characteristics (such as ethnic differences); assessing concurrent and/or pre-existing psychiatric (Axis I) disorders; classifying personality styles and concurrent and/or pre-existing personality (Axis II) disorders; evaluating phase in the development of PTSD as a disorder; measuring current environmental stresses and interpersonal interactions; and assessing secondary gains and readiness for treatment. These and other methodological problems must be addressed as research on PTSD shifts to longitudinal measurement of subjects randomly assigned to treatment conditions.",0 +https://doi.org/10.1037/0021-843x.115.3.624,The role of hyperarousal in the manifestation of posttraumatic psychological distress following injury.,"The authors examined the temporal relation among posttraumatic stress disorder symptom clusters, using data derived from a longitudinal study of survivors of orofacial injury (N = 264). They conducted cross-lagged panel analyses, with self-reported symptom data collected at 1, 6, and 12 months postinjury. Results demonstrate that hyperarousal was a potent predictor of subsequent symptoms of reexperiencing and avoidance as well as hyperarousal. By contrast, neither reexperiencing nor avoidance was significantly related to other symptom clusters other than themselves over time. These findings underscore the distinctive nature of hyperarousal in the manifestation of posttraumatic psychological distress over time. Implications for theory, clinical intervention, and future research are discussed.",0 +https://doi.org/10.1093/jpepsy/jsm013,Trajectories of Adjustment in Mothers of Children with Newly Diagnosed Cancer: A Natural History Investigation,"The objectives of this study were (a) to assess negative affectivity and posttraumatic symptomatology in mothers following the diagnosis of cancer in their children; (b) to examine sociodemographic and psychosocial variables associated with change in distress over time; and (c) to identify distinct subgroups of mothers whose patterns and trajectories of adjustment can be distinguished according to available predictor data.Two hundred and twelve mothers at seven sites were assessed just following their child's diagnosis, and again 3 months and 6 months later. Primary outcomes included measures of mood disturbance, depressive symptoms, and symptoms of posttraumatic stress.Overall, mothers demonstrated a pattern of mildly elevated negative affectivity and posttraumatic symptomatology initially, with steady improvements evident at 3- and 6-month follow-up. Distinct adjustment trajectories were evident within the sample as a whole, indicating subgroups of mothers with high-declining, moderate-stable, and low-stable distress levels.These findings highlight considerable resilience among mothers facing the stress of childhood cancer. Intervention efforts aimed at reducing maternal distress might best be targeted towards the subgroup of mothers who may be predicted to exhibit the highest level of distress.",0 +https://doi.org/10.1093/ilar/ilu006,Maintaining the Clinical Relevance of Animal Models in Translational Studies of Post-Traumatic Stress Disorder,"The diagnosis of Post-Traumatic Stress Disorder (PTSD) is conditional on directly experiencing or witnessing a significantly threatening event and the presence of a certain minimal number of symptoms from each of four symptom clusters (re-experiencing, avoidance, negative cognition and mood, and hyperarousal) at least one month after the event (DSM 5) (American Psychiatric Association 2013). Only a proportion of the population exposed develops symptoms fulfilling the criteria. The individual heterogeneity in responses of stress-exposed animals suggested that adapting clearly defined and reliably reproducible ""diagnostic"", i.e. behavioral, criteria for animal responses would augment the clinical validity of the analysis of study data. We designed cut-off (inclusion/exclusion) behavioral criteria (CBC) which classify study subjects as being severely, minimally or partially affected by the stress paradigm, to be applied retrospectively in the analysis of behavioral data. Behavioral response classification enables the researcher to correlate (retrospectively) specific anatomic, bio-molecular and physiological parameters with the degree and pattern of the individual behavioral response, and also introduces ""prevalence rates"" as a valid study-parameter. The cumulative results of our studies indicate that, by classifying the data from individual subjects according to their response patterns, the animal study can more readily be translated into clinical ""follow-up"" studies and back again. This article will discuss the concept of the model and its background, and present a selection of studies employing and examining the model, alongside the underlying translational rationale of each.",0 +https://doi.org/10.1007/s00127-005-0005-3,"Mental health profiles among married, never-married, and separated/divorced mothers in a nationally representative sample","Background: Several studies have found that married mothers compared to single mothers had better mental health (Cairney et al. in Soc Psychiatry Psychiatr Epidemiol 38:442-449, 2003; Cairney et al. in Can J Public Health 90:320-324, 1999; Davies et al. in J Marriage Fam 59:294-308, 1997; Lipman et al. in Am J Psychiatry 158:73-77, 2001; Wang in Soc Psychiatry Psychiatr Epidemiol 39:26-32, 2004). Although a relationship between family structure (single vs married mothers) and psychiatric disorders is well established, several questions remain. The present study addressed the question ""Are there differences in the prevalence of psychiatric disorders between married, never-married, and separated/divorced mothers?"" Methods: The present report examined the lifetime prevalence of anxious misery, fear, and externalizing disorders among mothers in relation to family structure (married, never-married, and separated/divorced) in the US National Comorbidity Survey (N=1,534). Results: Results indicated that never-married mothers appeared to be generally similar to married mothers in their mental health profiles. Separated/divorced mothers compared to married mothers had increased odds of having any anxious-misery disorder, depression, dysthymia, generalized anxiety disorder (GAD), posttraumatic stress disorder, any externalizing disorder, and antisocial personality disorder. Differences were found between never-married and separated/divorced mothers, with separated/divorced mothers having increased odds ratios of having any anxious-misery disorder, depression, and GAD. Conclusions: Results are discussed in light of the unique life contexts of married, never-married, and separated/divorced mothers and as further evidence for the case against combining the separated/divorced and never-married marital status into one ""single motherhood"" classification in mental health research. © Springer-Verlag 2006.",0 +,A study on the long-term effects of child sexual abuse: An empirical investigation of the post-traumatic stress disorder and traumagenic dynamic models.,"Recently, child sexual abuse (CSA) has become an issue of increasing interest and concern in the social and scientific domains. To date, research on CSA has focused on documenting the incidence, prevalence, and impact of sexual abuse, and the literature is in need of theoretically-driven studies. Accordingly, this study assessed the Post-traumatic Stress Disorder (PTSD) and Traumagenic Dynamics (TD) models of CSA. Participants were 603 adult women recruited from two University settings and the Internet, 205 (34%) of whom reported a history of CSA. They completed a series of questionnaires inquiring about their socio-demographic characteristics, childhood experiences and present experiences. The PTSD and TD perspectives were tested using hierarchical multiple regression; the results provide partial support for both formulations of CSA, and suggest that including non-sexual child abuse and parental relationship variables improves prediction in both models. The implications of these findings and future directions for the CSA literature are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1097/01.yic.0000182116.49887.ae,Quetiapine as an adjunctive treatment for post-traumatic stress disorder: an 8-week open-label study,"This study evaluated the effectiveness of quetiapine for subjects with post-traumatic stress disorder (PTSD) who were already on a stable dose of a selective serotonin reuptake inhibitor (SSRI) but had significant PTSD symptoms. Fifteen subjects were enrolled in an 8-week open-label trial for PTSD in which quetiapine was added to an SSRI. Subjects were on a stable dose of the SSRI for at least 6 weeks before study entry and had a Clincian-Administered PTSD Scale (CAPS) score of greater than or equal to 50 at study baseline. The mean age of subjects was 49 years (eight men and seven women). The average duration of PTSD was 29 years, one-third of subjects had combat-related PTSD, and two-thirds had noncombat PTSD. The mean dose prescribed in the study was 216 mg per day. The initial median CAPS score was 80, indicating severe PTSD. The addition of a modest dose of quetiapine provided significant relief from PTSD symptoms with a 42% overall improvement in PTSD symptoms based on the CAPS and significant improvement along each dimension of symptoms: re-experiencing (Z=-3.24, P=0.0012), hyperarousal (Z=-3.30, P=0.001) and avoidance (Z=-2.13, P=0.03). Subjects rated themselves as 45% improved on average on the Davidson Trauma Scale and reported a 44% decrease in their level of disability and impairment as reflected by the Sheehan Disability Scale. Subjects with PTSD who had significant PTSD symptoms when on an SSRI benefited from the addition of quetiapine. Patients improved significantly on all three clusters of PTSD symptoms: re-experiencing, hyperarousal and avoidance.",0 +https://doi.org/10.1093/milmed/156.2.68,Combat Stress Reaction and Changes in Military Medical Profile,"This study examines changes in the military medical profile following participation in war. Two groups of Israeli soldiers who participated in the 1982 Lebanon War were studied: 360 soldiers who were treated for immediate combat stress disorder during the war, and a matched control group of 310 soldiers who participated in the same war and were not identified as combat stress reaction casualties. Significant lowering of the profile after the war was noted for both groups. These changes were much stronger for combat stress reaction casualties. The differences between the groups were especially pronounced with regard to the addition of the psychiatric impairment category to the military medical profile. No background characteristics differentiated between combat stress reaction casualties who lowered their profile and those who did not. The implications of the findings for further research and for military mental health policy are discussed.",0 +https://doi.org/10.1016/j.jpsychires.2015.05.014,"Latent profile analyses of posttraumatic stress disorder, depression and generalized anxiety disorder symptoms in trauma-exposed soldiers","Posttraumatic stress disorder (PTSD) is comorbid with major depressive disorder (MDD; Kessler et al., 1995) and generalized anxiety disorder (GAD; Brown et al., 2001). We aimed to (1) assess discrete patterns of post-trauma PTSD-depression-GAD symptoms using latent profile analyses (LPAs), and (2) assess covariates (gender, income, education, age) in defining the best fitting class solution. The PTSD Checklist (assessing PTSD symptoms), GAD-7 scale (assessing GAD symptoms), and Patient Health Questionnaire-9 (assessing depression) were administered to 1266 trauma-exposed Ohio National Guard soldiers. Results indicated three discrete subgroups based on symptom patterns with mild (class 1), moderate (class 2) and severe (class 3) levels of symptomatology. Classes differed in symptom severity rather than symptom type. Income and education significantly predicted class 1 versus class 3 membership, and class 2 versus class 3. In conclusion, there is heterogeneity regarding severity of PTSD-depression-GAD symptomatology among trauma-exposed soldiers, with income and education predictive of class membership.",0 +https://doi.org/10.1016/j.paid.2015.03.034,Personality and trauma-related risk factors for traumatic exposure and for posttraumatic stress symptoms (PTSS): A three-year prospective study,"Abstract The aim of this prospective study was twofold: (1) to examine the role of pre-traumatic personality variables in the risk for exposure to trauma, and (2) to explore the role of pre-traumatic personality variables and subjective trauma-related variables – namely proximity to the trauma and its subjective experience – in the risk for developing posttraumatic stress symptoms (PTSS). The study included 1210 Israeli B.A. students assessed twice: at the start of their first academic year (t1), and at the end of their third academic year (t2). Over a period of three academic years, 439 (36%) of the 1210 participants had been exposed to trauma, showing increased PTSS. The findings show that (a) males without a history of psychiatric disorder, who are high in extraversion and openness, are at an elevated risk for traumatic exposure; (b) the subjective trauma-related variables – close proximity to the traumatic event and greater experience of the traumatic event as a threat – are predominant risk factors for PTSS; and (c) females with a history of psychiatric disorder, along with low tendencies of extraversion and openness and high levels of neuroticism, are at a higher risk for PTSS following traumatic exposure.",0 +https://doi.org/10.1037/ort0000032,Personality disorders in previously detained adolescent females: A prospective study.,"This longitudinal study investigated the predictive value of trauma and mental health problems for the development of antisocial personality disorder (ASPD) and borderline personality disorder (BPD) in previously detained women. The participants were 229 detained adolescent females who were assessed for traumatic experiences and mental health problems (mean age = 15.5 years). Three to 6 years later (M = 4.5; SD = 0.6), ASPD and BPD were diagnosed with a semistructured interview. Forty percent of the women had a personality disorder (i.e., ASPD 15.8%, BPD 9.2%, or both ASPD and BPD 15.2%). Posttraumatic stress, depressive symptoms, and dissociation during detention increased the risk for BPD in adulthood. Surprisingly, neither conduct problems nor substance dependence predicted ASPD; these findings require further study because they add to the controversy surrounding ASPD in females. The high prevalence rates of personality disorders indicate the need for intervention programs that target these unwanted outcomes.",0 +https://doi.org/10.1016/j.ajp.2012.07.012,"Psychobiology of PTSD in the acute aftermath of trauma: Integrating research on coping, HPA function and sympathetic nervous system activity","Research on the psychobiological sequelae of trauma has typically focused on long-term alterations in individuals with chronic posttraumatic stress disorder (PTSD). Far less is known about the nature and course of psychobiological risk factors for PTSD during the acute aftermath of trauma. In this review, we summarize data from prospective studies focusing on the relationships among sympathetic nervous system activity, hypothalamic-pituitary-adrenal function, coping strategies and PTSD symptoms during the early recovery (or non-recovery) phase. Findings from pertinent studies are integrated to inform psychobiological profiles of PTSD-risk in children and adults in the context of existing models of PTSD-onset and maintenance. Data regarding bidirectional relations between coping strategies and stress hormones is reviewed. Limitations of existing literature and recommendations for future research are discussed.",0 +https://doi.org/10.1097/00004479-199804000-00006,The Indochinese Psychiatry Clinic: Trauma and Refugee Mental Health Treatment in the 1990s,"The Indochinese Psychiatry Clinic (IPC), located in Boston, was founded in 1981 to meet the special needs of traumatized Cambodian, Vietnamese, and Laotian refugees resettling in the Boston area. Over the past 16 years, IPC has pioneered the field of refugee mental health and the treatment of the psychological and social sequelae of mass violence and torture. IPC developed the bicultural model of psychiatric treatment of refugees suffering from trauma-related mental disorders, which utilizes a multidisciplinary, bicultural team approach that emphasizes understanding the patient's trauma history within the appropriate cultural, social, and political context. This article summarizes IPC's background, patient profile, clinical approach, service elements, and funding structure. Recent immigration and welfare reform legislation will have a harsh impact on the population of refugees who are disabled due to the psychosocial consequences of their traumatic experiences. This legislation and the restrictions on mental health care imposed by public managed care will also affect the providers of their mental health care.",0 +https://doi.org/10.3402/ejpt.v3i0.18201,Assessing a dysphoric arousal model of acute stress disorder symptoms in a clinical sample of rape and bank robbery victims,"Since the introduction of Acute Stress Disorder (ASD) into the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) research has focused on the ability of ASD to predict PTSD rather than focusing on addressing ASD's underlying latent structure. The few existing confirmatory factor analytic (CFA) studies of ASD have failed to reach a clear consensus regarding ASD's underlying dimensionality. Although, the discrepancy in the results may be due to varying ASD prevalence rates, it remains possible that the model capturing the latent structure of ASD has not yet been put forward. One such model may be a replication of a new five-factor model of PTSD, which separates the arousal symptom cluster into Dysphoric and Anxious Arousal. Given the pending DSM-5, uncovering ASD's latent structure is more pertinent than ever.USING CFA, FOUR DIFFERENT MODELS OF THE LATENT STRUCTURE OF ASD WERE SPECIFIED AND TESTED: the proposed DSM-5 model, the DSM-IV model, a three factor model, and a five factor model separating the arousal symptom cluster.The analyses were based on a combined sample of rape and bank robbery victims, who all met the diagnostic criteria for ASD (N = 404) using the Acute Stress Disorder Scale.The results showed that the five factor model provided the best fit to the data.The results of the present study suggest that the dimensionality of ASD may be best characterized as a five factor structure which separates dysphoric and anxious arousal items into two separate factors, akin to recent research on PTSD's latent structure. Thus, the current study adds to the debate about how ASD should be conceptualized in the pending DSM-5.",0 +https://doi.org/10.1002/jts.20354,Tonic immobility mediates the influence of peritraumatic fear and perceived inescapability on posttraumatic stress symptom severity among sexual assault survivors,"This study evaluated whether tonic immobility mediates the relations between perceived inescapability, peritraumatic fear, and posttraumatic stress disorder (PTSD) symptom severity among sexual assault survivors. Female undergraduates (N = 176) completed questionnaires assessing assault history, perceived inescapability, peritraumatic fear, tonic immobility, and PTSD symptoms. Results indicated that tonic immobility fully mediated relations between perceived inescapability and overall PTSD symptom severity, as well as reexperiencing and avoidance/numbing symptom clusters. Tonic immobility also fully mediated the relation between fear and reexperiencing symptoms, and partially mediated relations between fear and overall PTSD symptom severity, and avoidance/numbing symptoms. Results suggest that tonic immobility could be one path through which trauma survivors develop PTSD symptoms. Further study of tonic immobility may inform our ability to treat trauma victims.",0 +https://doi.org/10.1017/s0033291709992121,"Childhood adversity, adult stressful life events, and risk of past-year psychiatric disorder: a test of the stress sensitization hypothesis in a population-based sample of adults","Background Childhood adversity (CA) is associated with adult mental disorders, but the mechanisms underlying this association remain inadequately understood. Stress sensitization, whereby CA increases vulnerability to mental disorders following adult stressful life events, has been proposed as a potential mechanism. We provide a test of the stress sensitization hypothesis in a national sample. Method We investigated whether the association between past-year stressful life events and the 12-month prevalence of major depression, post-traumatic stress disorder (PTSD), other anxiety disorders, and perceived stress varies according to exposure to CA. We used data from the National Epidemiological Survey of Alcohol and Related Conditions (NESARC) ( n =34 653). Results Past-year stressful life events were associated with an increased risk of major depression, PTSD, anxiety disorders, and perceived stress. However, the magnitude of the increased risk varied according to respondents' history of CA. For example, past-year major stressors were associated with a 27.3% increase in the 12-month risk of depression among individuals with ⩾3 CAs and a 14.8% increased risk among individuals without CAs. Stress sensitization effects were present for depression, PTSD, and other anxiety disorders in women and men, although gender differences were found in the threshold of past-year stress needed to trigger such effects. Stress sensitization was most evident among individuals with ⩾3 CAs. Conclusions CA is associated with increased vulnerability to the deleterious mental health effects of adult stressors in both men and women. High levels of CA may represent a general diathesis for multiple types of psychopathology that persists throughout the life course.",0 +https://doi.org/10.1016/j.psyneuen.2011.09.013,Altered salivary alpha-amylase awakening response in Bosnian War refugees with posttraumatic stress disorder,"In posttraumatic stress disorder (PTSD), chronic activation of the sympathetic nervous system (SNS) has been suggested. No study so far has investigated diurnal secretion patterns of salivary alpha-amylase (sAA) in PTSD, a promising candidate for non-invasive assessment of SNS activity. We compared sAA diurnal profiles between a group of Bosnian War refugees with PTSD and a healthy control group, and further analyzed for associations with psychiatric symptoms and glucocorticoid (GC) sensitivity of inflammatory regulation. PTSD patients showed a sAA awakening response profile that was opposite to those seen in healthy controls, i.e. an increase instead of a sharp decrease. Patterns of sAA secretion were further positively associated with psychiatric symptoms of PTSD. Finally, higher sAA awakening responses were associated with higher GC sensitivity of inflammatory cytokine production. These findings are in line with altered SNS function in PTSD, and lend further support for employing assessment of diurnal sAA profiles as non-invasive biomarkers in stress-related disease.",0 +https://doi.org/10.1037/tra0000081,An investigation of PTSD's core dimensions and relations with anxiety and depression.,"Posttraumatic stress disorder (PTSD) is highly comorbid with anxiety and depressive disorders, which is suggestive of shared variance or common underlying dimensions. The purpose of the present study was to examine the relationship between the latent factors of PTSD with the constructs of anxiety and depression in order to increase understanding of the co-occurrence of these disorders.Data were collected from a nonclinical sample of 186 trauma-exposed participants using the PTSD Checklist and Hospital Anxiety and Depression Scale. Confirmatory factor analyses were conducted to determine model fit comparing 3 PTSD factor structure models, followed by Wald tests comparing the relationships between PTSD factors and the core dimensions of anxiety and depression.In model comparisons, the 5-factor dysphoric arousal model of PTSD provided the best fit for the data, compared to the emotional numbing and dysphoria models of PTSD. Compared to anxious arousal, the dysphoric arousal and numbing factors of PTSD were more related to depression severity. Numbing, anxious arousal, and dysphoric arousal were not differentially related to the latent anxiety factor.The underlying factors of PTSD contain aspects of the core dimensions of both anxiety and depression. The heterogeneity of PTSD's associations with anxiety and depressive constructs requires additional empirical exploration because clarification regarding these relationships will impact diagnostic classification as well as clinical practice.",0 +https://doi.org/10.1016/s0887-6185(01)00068-8,The structure of posttraumatic stress disorder symptoms in combat veterans: A confirmatory factor analysis of the impact of event scale,"There has been controversy over the most appropriate way to define symptom clusters for posttraumatic stress disorder (PTSD). We tested the factor structure of the Impact of Event Scale (IES) in a sample of 195 male combat veterans with chronic PTSD by using confirmatory factor analysis . The two-factor model including Intrusion (i.e., unwanted memories of the event) and Avoidance (i.e., attempts to avoid reminders and numbing of emotional responsiveness) deviated significantly from good fit. However, a four-factor model, including Intrusion and Effortful Avoidance subscales, as well as Sleep Disturbance and Emotional Numbing subscales, fit significantly better. Correlations with other PTSD measures are explored and implications for the conceptualization of PTSD are discussed.",0 +https://doi.org/10.1037/0735-7028.36.6.626,Key Elements in Couples Therapy With Veterans With Combat-Related Posttraumatic Stress Disorder.,"If a client dealing with combat-related posttraumatic stress disorder (PTSD) presents for psychotherapy, should you consider including his or her partner in treatment? How could couples therapy be beneficial? What framework do you have to conceptualize the relational issues and potential treatment? Although clinicians have long been encouraged to include families in the treatment of combat-related PTSD, few specific couple-family therapies exist, and outcome research is scarce. Because of the adverse effects of PTSD on relationships, couples therapy can be a powerful adjunct treatment; however, few receive this service. A new framework for conceptualizing couples therapy organizes treatment around the 3 PTSD symptom clusters (reexperiencing, avoidance, and arousal). Relationship consequences of each symptom cluster are summarized, followed by useful treatment interventions and a case study.",0 +https://doi.org/10.1016/j.jaac.2010.12.001,"Mental Health and Childhood Adversities: A Longitudinal Study in Kabul, Afghanistan","To identify prospective predictors of mental health in Kabul, Afghanistan.Using stratified random-sampling in schools, mental health and life events for 11-to 16-year-old students and their caregivers were assessed. In 2007, 1 year after baseline, the retention rate was 64% (n = 115 boys, 119 girls, 234 adults) with no evidence of selection bias. Self- and caregiver-rated child mental health (Strengths and Difficulties Questionnaire), depressive (Depression Self-Rating Scale), and posttraumatic stress (Child Revised Impact of Events Scale) symptoms and caregiver mental health (Self-Report Questionnaire) were assessed. Lifetime trauma and past-year traumatic, stressful, and protective experiences were assessed.With the exception of posttraumatic stress, one-year trajectories for all mental health outcomes showed significant improvement (p < .001). Family violence had a striking impact on the Strengths and Difficulties Questionnaire data, raising caregiver-rated scores by 3.14 points (confidence interval [CI] 2.21-4.08) or half a standard deviation, and self-rated scores by 1.26 points (CI 0.50-2.03); past-year traumatic beatings independently raised self-rated scores by 1.85 points (CI 0.03-3.66). A major family conflict raised depression scores by 2.75 points (CI 0.89-4.61), two thirds of a standard deviation, whereas improved family life had protective effects. Posttraumatic stress symptom scores, however, were solely contingent on lifetime trauma, with more than three events raising scores by 5.38 points (CI 1.76-9.00).Family violence predicted changes in mental health problems other than posttraumatic stress symptoms in a cohort that showed resilience to substantial socioeconomic and war-related stressors. The importance of prospectively identifying impacts of specific types of childhood adversities on mental health outcomes is highlighted to strengthen evidence on key modifiable factors for intervention in war-affected populations.",0 +https://doi.org/10.1007/s00520-013-2083-1,Parent perspectives on family-based psychosocial interventions in pediatric cancer: a mixed-methods approach,"Family-based interventions in pediatric cancer face challenges associated with integrating psychosocial care into a period of intensive treatment and escalating stress. Little research has sought input from parents on the role of interventions delivered shortly after diagnosis. This mixed-methods study obtained parents' perspectives on the potential role of family-based interventions. Twenty-five parents provided feedback on the structure and timing of psychosocial interventions via focus groups and a questionnaire. Qualitative analyses resulted in three themes that were illustrative of a traumatic stress framework: (1) tension between focusing on child with cancer and addressing other family needs, (2) factors influencing parents' perception of a shared experience with other parents, and (3) the importance of matching interventions to the trajectory of parent adjustment. Quantitative data indicated that parents preferred intervention within 6 months of diagnosis, with almost half favoring within 2 months of diagnosis, and the majority wanted interventions targeted to parents only. Qualitative themes highlight the importance of using a traumatic stress framework to inform the development of family-based interventions for those affected by pediatric cancer.",0 +https://doi.org/10.1038/sj.npp.1300153,Divalproex in the Treatment of Impulsive Aggression: Efficacy in Cluster B Personality Disorders,"Impulsive aggressive behavior is common in psychiatric disorders and accounts for significant morbidity and mortality. However, little systematic treatment data exist from placebo-controlled trials for this symptom domain. This was a multicenter, randomized, double-blind, placebo-controlled study in which outpatients with a score of > or =15 on the Aggression scale of the Overt Aggression Scale-Modified (OAS-M) and who fulfilled DSM-IV criteria for Cluster B personality disorder (n=96), intermittent explosive disorder (n=116), or post-traumatic stress disorder (n=34) were randomized to divalproex sodium or placebo for 12 weeks duration. Based on average OAS-M Aggression scores over the last 4 weeks of treatment, a treatment effect was not observed in the intent-to-treat data set (combined across the three psychiatric disorders), but was observed in both intent-to-treat and evaluable data sets for patients with Cluster B personality disorders. In the Cluster B evaluable data set, statistically significant treatment differences favoring divalproex were also observed for component items of the OAS-M Aggression score, including verbal assault and assault against objects, as well as OAS-M Irritability score, and Clinical Global Impression (CGI)-Severity at multiple time points throughout the study. No treatment group difference was noted for overall premature discontinuation rate; however, across psychiatric diagnoses, 21 (17%) patients in the divalproex group prematurely discontinued because of an adverse event, as compared to 4 (3%) patients in the placebo group (p <0.001). While a treatment effect was not observed when all diagnostic groups were combined, in a large subgroup of patients with Cluster B disorders, divalproex was superior to placebo in the treatment of impulsive aggression, irritability, and global severity.",0 +https://doi.org/10.1023/a:1014864225889,War-related trauma and symptoms of posttraumatic stress disorder among adult Kosovar refugees,"Since 1999, almost 16,000 Kosovar refugees have entered the United States. Few studies have investigated trauma and symptoms of posttraumatic stress disorder (PTSD) in this population. We conducted a caseworker-assisted survey of 129 Kosovar refugees (aged 18 to 79 years, 55% male). Of these individuals, 78 (60.5%) showed the likely presence of PTSD. The mean number of war-related traumatic events reported was 15 (SD = 4.5). Higher PTSD scores were associated with more traumatic events and female gender.",0 +https://doi.org/10.1016/j.yebeh.2007.02.008,The role of comorbid psychiatric conditions in health status in epilepsy,"Comorbid psychiatric conditions are highly prevalent in patients with epilepsy, yet the long-term implications across multiple mental health conditions are poorly understood. We examined the association between psychiatric diagnoses and self-reported health status in veterans with epilepsy. ANCOVA models were used to derive adjusted SF-36V scores for individuals with epilepsy alone (N=7379) or with additional psychiatric conditions (N=6320): depression, schizophrenia, bipolar disorder, anxiety disorder, substance abuse, and posttraumatic stress disorder (PTSD). Compared with patients with epilepsy alone, scores of veterans with comorbid psychiatric diagnoses averaged 21% lower across all domains. Role Limitation scales exhibited the greatest decrement across domains. A PTSD diagnosis consistently corresponded to lower scores, followed by depression. Schizophrenia contributed the least detriment to perceived health status. Comorbid psychiatric conditions impart significant emotional and physical burdens, requiring timely recognition and treatment of these disorders. Patients with epilepsy are uniquely at risk for high physical-psychiatric comorbidity profiles, with concomitant losses in perceived health status.",0 +https://doi.org/10.1521/pedi.1994.8.3.181,The Origin and Structure of the Abusive Personality,"Comparisons were made of 120 wife-assaultive men and 40 demographically matched controls. Discriminant functions correctly classified 90% (based on personality scores only) and 95% (personality and anger scores) of men into high and low categories for psychological abuse (as reported by a sample of their female partners). The measure correlated most highly with the discriminant function was borderline personality organization (BPO), but anger and other personality disorders also contributed to discriminatory power. Negativlstic (passive-aggressive + self-defeating) personality disorder was associated with the discriminant function for both emotional abuse and dominance/isolation, but narcissistic and aggressive-sadistic personality disorders were more associated with emotional abuse and avoidant personality disorder was more associated with dominance/isolation. The avoidant-negativistic profile (with associated borderline features) found for these men is also indicative of posttraumatic stress disorder. T...",0 +https://doi.org/10.1371/journal.pone.0117092,Acute and Chronic Plasma Metabolomic and Liver Transcriptomic Stress Effects in a Mouse Model with Features of Post-Traumatic Stress Disorder,"Acute responses to intense stressors can give rise to post-traumatic stress disorder (PTSD). PTSD diagnostic criteria include trauma exposure history and self-reported symptoms. Individuals who meet PTSD diagnostic criteria often meet criteria for additional psychiatric diagnoses. Biomarkers promise to contribute to reliable phenotypes of PTSD and comorbidities by linking biological system alterations to behavioral symptoms. Here we have analyzed unbiased plasma metabolomics and other stress effects in a mouse model with behavioral features of PTSD. In this model, C57BL/6 mice are repeatedly exposed to a trained aggressor mouse (albino SJL) using a modified, resident-intruder, social defeat paradigm. Our recent studies using this model found that aggressor-exposed mice exhibited acute stress effects including changed behaviors, body weight gain, increased body temperature, as well as inflammatory and fibrotic histopathologies and transcriptomic changes of heart tissue. Some of these acute stress effects persisted, reminiscent of PTSD. Here we report elevated proteins in plasma that function in inflammation and responses to oxidative stress and damaged tissue at 24 hrs post-stressor. Additionally at this acute time point, transcriptomic analysis indicated liver inflammation. The unbiased metabolomics analysis showed altered metabolites in plasma at 24 hrs that only partially normalized toward control levels after stress-withdrawal for 1.5 or 4 wks. In particular, gut-derived metabolites were altered at 24 hrs post-stressor and remained altered up to 4 wks after stress-withdrawal. Also at the 4 wk time point, hyperlipidemia and suppressed metabolites of amino acids and carbohydrates in plasma coincided with transcriptomic indicators of altered liver metabolism (activated xenobiotic and lipid metabolism). Collectively, these system-wide sequelae to repeated intense stress suggest that the simultaneous perturbed functioning of multiple organ systems (e.g., brain, heart, intestine and liver) can interact to produce injuries that lead to chronic metabolic changes and disorders that have been associated with PTSD.",0 +https://doi.org/10.1017/s0033291714001202,Post-traumatic growth among veterans in the USA: results from the National Health and Resilience in Veterans Study,"Background There is increasing recognition that, in addition to negative psychological consequences of trauma such as post-traumatic stress disorder (PTSD), some individuals may develop post-traumatic growth (PTG) following such experiences. To date, however, data regarding the prevalence, correlates and functional significance of PTG in population-based samples are lacking. Method Data were analysed from the National Health and Resilience in Veterans Study, a contemporary, nationally representative survey of 3157 US veterans. Veterans completed a survey containing measures of sociodemographic, military, health and psychosocial characteristics, and the Posttraumatic Growth Inventory-Short Form. Results We found that 50.1% of all veterans and 72.0% of veterans who screened positive for PTSD reported at least ‘moderate’ PTG in relation to their worst traumatic event. An inverted U-shaped relationship was found to best explain the relationship between PTSD symptoms and PTG. Among veterans with PTSD, those with PTSD reported better mental functioning and general health than those without PTG. Experiencing a life-threatening illness or injury and re-experiencing symptoms were most strongly associated with PTG. In multivariable analysis, greater social connectedness, intrinsic religiosity and purpose in life were independently associated with greater PTG. Conclusions PTG is prevalent among US veterans, particularly among those who screen positive for PTSD. These results suggest that there may be a ‘positive legacy’ of trauma that has functional significance for veterans. They further suggest that interventions geared toward helping trauma-exposed US veterans process their re-experiencing symptoms, and to develop greater social connections, sense of purpose and intrinsic religiosity may help promote PTG in this population.",0 +https://doi.org/10.1002/wps.20057,Diagnosis and classification of disorders specifically associated with stress: proposals for ICD-11,"The diagnostic concepts of post-traumatic stress disorder (PTSD) and other disorders specifically associated with stress have been intensively discussed among neuro- and social scientists, clinicians, epidemiologists, public health planners and humanitarian aid workers around the world. PTSD and adjustment disorder are among the most widely used diagnoses in mental health care worldwide. This paper describes proposals that aim to maximize clinical utility for the classification and grouping of disorders specifically associated with stress in the forthcoming 11th revision of the International Classification of Diseases (ICD-11). Proposals include a narrower concept for PTSD that does not allow the diagnosis to be made based entirely on non-specific symptoms; a new complex PTSD category that comprises three clusters of intra- and interpersonal symptoms in addition to core PTSD symptoms; a new diagnosis of prolonged grief disorder, used to describe patients that undergo an intensely painful, disabling, and abnormally persistent response to bereavement; a major revision of ""adjustment disorder"" involving increased specification of symptoms; and a conceptualization of ""acute stress reaction"" as a normal phenomenon that still may require clinical intervention. These proposals were developed with specific considerations given to clinical utility and global applicability in both low- and high-income countries.",0 +https://doi.org/10.1111/j.1469-7610.2012.02620.x,Research Review: Psychosocial adjustment and mental health in former child soldiers - a systematic review of the literature and recommendations for future research,"This article reviews the available quantitative research on psychosocial adjustment and mental health among children (age <18 years) associated with armed forces and armed groups (CAAFAG)--commonly referred to as child soldiers.PRISMA standards for systematic reviews were used to search PubMed, PsycInfo, JSTOR, and Sociological Abstracts in February 2012 for all articles on former child soldiers and CAAFAG. Twenty-one quantitative studies from 10 countries were analyzed for author, year of publication, journal, objectives, design, selection population, setting, instruments, prevalence estimates, and associations with war experiences. Opinion pieces, editorials, and qualitative studies were deemed beyond the scope of this study. Quality of evidence was rated according to the systematic assessment of quality in observational research (SAQOR).According to SAQOR criteria, among the available published studies, eight studies were of high quality, four were of moderate quality, and the remaining nine were of low quality. Common limitations were lack of validated mental health measures, unclear methodology including undefined sampling approaches, and failure to report missing data. Only five studies included a comparison group of youth not involved with armed forces/armed groups, and only five studies assessed mental health at more than one point in time. Across studies, a number of risk and protective factors were associated with postconflict psychosocial adjustment and social reintegration in CAAFAG. Abduction, age of conscription, exposure to violence, gender, and community stigma were associated with increased internalizing and externalizing mental health problems. Family acceptance, social support, and educational/economic opportunities were associated with improved psychosocial adjustment.Research on the social reintegration and psychosocial adjustment of former child soldiers is nascent. A number of gaps in the available literature warrant future study. Recommendations to bolster the evidence base on psychosocial adjustment in former child soldiers and other war-affected youth include more studies comprising longitudinal study designs, and validated cross-cultural instruments for assessing mental health, as well as more integrated community-based approaches to study design and research monitoring.",0 +https://doi.org/10.1037/ort0000057,Psychological distress among victimized women on probation and parole: A latent class analysis.,"Latent class analysis was used to identify subgroups of victimized women (N = 406) on probation and parole differentiated by levels of general psychological distress. The 9 primary symptom dimensions from the Brief Symptom Inventory (BSI) were used individually as latent class indicators (Derogatis, 1993). Results identified 3 classes of women characterized by increasing levels of psychological distress; classes were further differentiated by posttraumatic stress disorder symptoms, cumulative victimization, substance use and other domains of psychosocial functioning (i.e., sociodemographic characteristics; informal social support and formal service utilization; perceived life stress; and resource loss). The present research was effective in uncovering important heterogeneity in psychological distress using a highly reliable and easily accessible measure of general psychological distress. Differentiating levels of psychological distress and associated patterns of psychosocial risk can be used to develop intervention strategies targeting the needs of different subgroups of women. Implications for treatment and future research are presented.",0 +https://doi.org/10.1186/cc12781,Sleepless nights in the ICU: the awaken family,"Having a loved-one in the ICU is a traumatic experience for family members that can lead to a cluster of psychological complications, recently defined as post-intensive care family syndrome. In a previous issue of Critical Care, Day and colleagues stressed the severe sleep disturbance and fatigue experienced by a majority of ICU patient family members. However, despite this burden being well characterised, the best preventive coping strategy remains undetermined.",0 +https://doi.org/10.1017/cbo9781107446700.014,Defining victims: a proposed typology for victims of war crimes and their need for reparation,"Born in the ashes of the Second World War, the field of victimology has grown tremendously in recent years, where we have seen much excellent empirical research done on victims. Much of the research deals with specific types of victimization (e.g., domestic violence, rape), empirical aspects of victimization in general (e.g., victimization surveys) and the consequences of victimization (e.g., post-traumatic stress disorder (PTSD)). However, despite the many empirical studies, relatively little attention has been paid to theoretical aspects of victimology. As Landau and Freeman-Longo point out, the dearth of theoretical work in victimology is surprising given that in a relatively new field problems of definition and boundary-setting would be an important starting point for further studies therein. Victimologists have not always shied away from theoretical work. Early victimologists, such as Hans von Hentig, Benjamin Mendelsohn, Marvin Wolfgang and Ezzat Fattah, were very active in developing theoretical victimology. Each developed their own typology of victims in order to better understand, explain and hence prevent victimization. By the early 1980s, under the influence of the victims’ movement, these typologies lost much of their original popularity, as victimology moved away from criminology and stopped trying to explain crime. As Ezzat Fattah observes, there was a shift ‘from victimology of the act to victimology of action’ as victimology became increasingly associated with victim support. © Cambridge University Press 2014.",0 +https://doi.org/10.1185/135525704x20394,US female veterans in VA primary care: post traumatic stress disorder symptoms and functional status,"We sought to examine the relationship between post traumatic stress disorder (PTSD) symptomatology, demographic variables, and functional status in US female veterans. One hundred ninety-one female veterans were identified from primary care clinics in four VA Medical Centers for participation in this study. The relationship between demographic variables, physical and mental health functional status on the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and PTSD severity on the PTSD Checklist (PCL) was examined using ANOVAs and simple and multiple linear regression modeling. After adjusting for other demographic covariates, PTSD severity was related to age (older patients reported less symptoms), and employment status (veterans who were not working due to disability reported significantly more PTSD symptoms than those who were working). Additionally, after adjusting for relevant demographic covariates, greater PTSD symptomatology was related to worse functioning across both physical and mental health domains on the SF-36. PTSD symptom severity was easily assessed in this primary care sample of female veterans using the PCL. Screening female veterans through primary care clinics is likely to identify women with PTSD who are not functioning as well as their peers and who are in need of specialized services. These findings are similar to those using men identified through VA primary care clinics. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1097/nmd.0b013e3181fe73fa,Attachment Style in the Prediction of Recovery Following Group Treatment of Combat Veterans With Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) can be difficult to treat, with gains often particularly modest in combat veterans. Although group-based treatments are commonly delivered for veterans, little is known about factors influencing their outcomes. Attachment style is known to be associated with psychopathology after trauma and is critical to group-based interventions, but has not yet been investigated in relation to treatment outcome. A better understanding of factors that influence outcome is critical in optimizing the effectiveness of such interventions. This study investigated attachment style as a predictor of outcome for 103 veterans attending group-based treatment for combat-related PTSD. Measures included the Clinician Administered PTSD Scale, PTSD Checklist, and Relationship Styles Questionnaire. Path analyses indicated preoccupied attachment style strongly negatively predicted outcome following treatment. The preoccupied attachment style impedes recovery in group-based treatment for veterans with PTSD. Potential mechanisms underlying this finding are discussed. The results suggest that greater attention should be paid at initial assessment to attachment style of veterans before entering PTSD treatment, particularly group-based interventions.",0 +https://doi.org/10.1002/jts.21954,Associations Between Functioning and PTSD Symptom Clusters in a Dismantling Trial of Cognitive Processing Therapy in Female Interpersonal Violence Survivors,"This study conducted secondary analyses of a published trial and sought to determine if different domains of psychosocial functioning (e.g., daily living, work, nonfamily relationships) improved following trauma-focused treatment for posttraumatic stress disorder (PTSD). Cognitive processing therapy (CPT), an empirically supported treatment that involves evaluating trauma-related beliefs and written trauma accounts, was compared to its components: CPT without the written accounts or written accounts only in a sample of 78 women with PTSD secondary to interpersonal violence. Overall and individual domains of functioning significantly improved with treatment and results were similar across treatment groups, Fs (2, 150) ≥ 11.87, ps < .001. Additionally, we investigated whether changes in different PTSD symptom clusters were associated with outcomes in domains of psychosocial functioning, after collapsing across treatment condition. Multiple hierarchical linear regression analyses revealed that overall clinician-assessed PTSD symptom reduction was associated with outcomes in all domains of functioning, βs = .44 to .68, ps < .001. Additionally, improvements in the emotional numbing symptom cluster were associated with outcomes in the nonfamily relationships domain, β = .42, p < .001, and improvements in the hyperarousal symptom cluster were associated with outcomes in the overall, daily living, and household tasks domains, βs = .34 to .39, ps < .01. Results suggest that it may be important to monitor improvements in emotional numbing and hyperarousal symptoms throughout treatment to increase the likelihood of changes in psychosocial functioning. Spanish Abstracts by the Asociación Chilena de Estrés Traumático (ACET) Este estudio condujo un análisis secundario de un ensayo publicado y buscó determinar si diferentes dominios de funcionamiento psicosocial (ej., vida diaria, trabajo, relaciones no familiares) mejoraron después de un tratamiento enfocado en el trauma para trastorno por estrés post-traumático (TEPT). La terapia de procesamiento cognitivo (TPC), un tratamiento respaldado empíricamente que involucra la evaluación de las creencias relacionadas al trauma y los relatos escritos del trauma, fue comparado con sus componentes: TPC sin los relatos escritos o solamente relatos escritos en una muestra de 78 mujeres con TEPT secundario a violencia interpersonal. Los dominios de funcionamiento generales e individuales aumentaron significativamente con el tratamiento y los resultados fueron similares a través de los grupos de tratamiento, Fs (2, 150) ≥ 11.87, ps < .001. Adicionalmente, investigamos si los cambios en los diferentes grupos de síntomas de TEPT se asociaron con resultados en dominios de funcionamiento psicosocial, después de colapsar a través de las condiciones de tratamiento. Un análisis de regresión linear múltiple jerárquica reveló que la reducción general de síntomas de TEPT evaluada por clínicos se asoció con los resultados en todos los dominios de funcionamiento βs = .44 to .68, ps < .001. Adicionalmente, mejorías en el grupo de síntomas de entumecimiento emocional se asociaron con los resultados del dominio de relaciones no familiares, β = .42,p < .001, y mejorías en el grupo de síntomas de hiperexcitabilidad se asociaron con los resultados generales en los dominios, de vida diaria y tareas domésticas βs = .34 to .39, ps < .01.Los resultados sugieren que puede ser importante monitorear las mejorías en los síntomas de entumecimiento emocional e hiperexcitabilidad a lo largo del tratamiento para aumentar la probabilidad de cambios en el funcionamiento psicosocial. Traditional and Simplified Chinese Abstracts by AsianSTSS 標題：人際暴力女倖存者接受認知處理療法的拆解試驗中功能和PTSD症狀羣的關係 撮要：本研究為一已刊登研究的二次分析，驗証治療創傷後壓力症(PTSD)的聚焦創傷法後心理社會功能中不同領域(如日常生活、工作、家庭以外關係)的改進。認知處理療法(CPT)是實証支持的治療，包括評估創傷相連信念和創傷筆記。CPT在研究中對照其中成份：即CPT除去創傷筆記，或只有創傷筆記，而樣本是78名因人際暴力而患上PTSD的婦女。綜合和個別功能領域在治療後明顯改進，而不同治療組別中結果相類，FS (2, 150) 11.87, ps < .001。我們亦檢測不同PTSD症狀羣變化在除去治療狀況因素後會否與心理社會功能領域結果相連。多重階層綫性分析顯示綜合臨床評估PTSD症狀減退與功能的所有領域結果相關，βS= .44至 .68, ps< .001。情感麻木症狀羣的改進和非家庭關係領域結果相連，β= .42, p< .001., 而過激症狀羣改進則與綜合、日常生活和家居事務領域有關係，βS= .34至.39, ps< .01。結論是在治療中監察情感麻木和過激症狀的改進增加心理社會功能改善的機會。 标题：人际暴力女幸存者接受认知处理疗法的拆解试验中功能和PTSD症状羣的关系 撮要：本研究为一已刊登研究的二次分析，验证治疗创伤后压力症(PTSD)的聚焦创伤法后心理社会功能中不同领域(如日常生活、工作、家庭以外关系)的改进。认知处理疗法(CPT)是实证支持的治疗，包括评估创伤相连信念和创伤笔记。CPT在研究中对照其中成份：即CPT除去创伤笔记，或只有创伤笔记，而样本是78名因人际暴力而患上PTSD的妇女。综合和个别功能领域在治疗后明显改进，而不同治疗组别中结果相类，FS (2, 150) 11.87, ps < .001。我们亦检测不同PTSD症状羣变化在除去治疗状况因素后会否与心理社会功能领域结果相连。多重阶层线性分析显示综合临床评估PTSD症状减退与功能的所有领域结果相关，βS= .44至 .68, ps< .001。情感麻木症状羣的改进和非家庭关系领域结果相连，β= .42, p< .001., 而过激症状羣改进则与综合、日常生活和家居事务领域有关系，βS= .34至.39, ps< .01。结论是在治疗中监察情感麻木和过激症状的改进增加心理社会功能改善的机会。",0 +https://doi.org/10.1093/oxfordhb/9780195307030.013.0015,Personality Factors in the Anxiety Disorders,"This chapter describes a theoretical framework based on hierarchical models of personality and the anxiety disorders that is able to reflect both the DSM-IV organization of anxiety disorders as a distinct internalizing cluster (separate from mood disorders) as well as the diagnostic specificity within the category of anxiety disorders. The literature examining relationships between higher-order personality dimensions, such as Neuroticism and Extraversion, as well as lower-order facets of personality, such as self-criticism, perfectionism, and anxiety sensitivity, and the anxiety disorders is reviewed. Several mechanisms of interaction between personality factors and anxiety disorders are considered, specifically, vulnerability, scar, and pathoplasty models. Based on this literature, specific personality profiles associated with each anxiety disorder are proposed. © 2009 by Oxford University Press. All rights reserved.",0 +https://doi.org/10.1007/s11055-007-0142-0,Typology of post-traumatic stress disorder in children and adolescents,"Results obtained from clinical and psychopathological studies of 161 patients with post-traumatic stress disorder (PTSD) aged 3-18 years with symptom durations from one month to four years are presented. Four major clinical variants of the type of PTSD were identified in children and adolescents: insomniac (34.8%), phobic (23.6%), psychopathic-like (21.7%), and asthenic-depressive (19.9%). These variants, differing in terms of course and prognosis, occurred at different frequencies in different age and ethnic groups; there were no gender-related differences. © Springer Science+Business Media, Inc. 2007.",0 +https://doi.org/10.2466/pr0.1995.76.3.939,Posttraumatic Stress Disorder and the MCMI-II,"This study investigated the MCMI-II profile characteristics of 39 veterans diagnosed with Posttraumatic Stress Disorder. Characteristics of the mean group profile were similar to prior findings reported in the literature on the MCMI and Posttraumatic Stress Disorder with highest mean elevations found on the Avoidant, Passive-Aggressive, Schizoid, and Antisocial basic personality scales, the Borderline and Schizotypal pathological personality scales, and with elevations on the Anxiety, Dysthymia, Alcohol Dependence, Drug Dependence, and Major Depression clinical syndrome scales. A multivariate analysis of variance comparing the group with Posttraumatic Stress Disorder with a non-PTSD comparison group of 39 on the basic personality, pathological personality, and the clinical syndrome scales of the MCMI-II was not statistically significant. Nonetheless, univariate analyses of variance comparing the two groups on the individual modifier scales and the individual personality and clinical syndrome scales of the MCMI-II using a Bonferroni adjusted probability indicated significant differences on the Desirability and Histrionic scales. Response-style bias as a possible factor in MCMI-II profiles for the group with Posttraumatic Stress Disorder is also discussed.",0 +https://doi.org/10.1016/j.apnu.2015.01.002,"The Relations between Violence Exposure, Posttraumatic Stress Symptoms, Secondary Traumatization, Vicarious Post Traumatic Growth and Illness Attribution among Psychiatric Nurses","This study examined posttraumatic stress disorder symptoms (PTSD), secondary traumatization (ST) and vicarious posttraumatic growth (VG) among Israeli psychiatric nurses (PN) who were compared to community nurses (CN). Furthermore, we examined the contribution of PN perceptions of the etiology of their patients' mental illness to their PTSD, ST and VG. Results show that PN reported higher levels of both PTSD and ST symptoms, but lower levels of VG, as compare to CN. While ST symptoms were positively related to VG among CN, PTSD and ST symptoms were negatively associated among PN. Finally, exposure to patients' violence, PTSD or ST symptoms, and illness attribution dimensions of 'powerful others', predicted nurses' VG. PN are an at-risk population for work-related stress residues.",0 +https://doi.org/10.1002/jts.22041,Technology-Enhanced Stepped Collaborative Care Targeting Posttraumatic Stress Disorder and Comorbidity After Injury: A Randomized Controlled Trial,"Posttraumatic stress disorder (PTSD) and its comorbidities are endemic among injured trauma survivors. Previous collaborative care trials targeting PTSD after injury have been effective, but they have required intensive clinical resources. The present pragmatic clinical trial randomized acutely injured trauma survivors who screened positive on an automated electronic medical record PTSD assessment to collaborative care intervention (n = 60) and usual care control (n = 61) conditions. The stepped measurement-based intervention included care management, psychopharmacology, and psychotherapy elements. Embedded within the intervention were a series of information technology (IT) components. PTSD symptoms were assessed with the PTSD Checklist at baseline prerandomization and again, 1-, 3-, and 6-months postinjury. IT utilization was also assessed. The technology-assisted intervention required a median of 2.25 hours (interquartile range = 1.57 hours) per patient. The intervention was associated with modest symptom reductions, but beyond the margin of statistical significance in the unadjusted model: F(2, 204) = 2.95, p = .055. The covariate adjusted regression was significant: F(2, 204) = 3.06, p = .049. The PTSD intervention effect was greatest at the 3-month (Cohen's effect size d = 0.35, F(1, 204) = 4.11, p = .044) and 6-month (d = 0.38, F(1, 204) = 4.10, p = .044) time points. IT-enhanced collaborative care was associated with modest PTSD symptom reductions and reduced delivery times; the intervention model could potentially facilitate efficient PTSD treatment after injury.",0 +https://doi.org/10.1080/13623699.2012.678087,"Mental health survey among landmine survivors in Siem Reap province, Cambodia","Many survivors of the Khmer Rouge period in Cambodia and the subsequent war with Vietnam have now returned to Cambodia. In this two-stage household cluster survey in Siem Reap Province in Cambodia, we explored the mental health consequences on 166 landmine injury survivors selected from 1000 household in 50 clusters and an oversample of all landmine survivors. We found a prevalence of anxiety of 62% for all respondents, 74% for depression, and 34% for post-traumatic stress disorder (PTSD). These prevalences were statistically significantly higher than among the adult population who had not been injured by landmines. These data underscore the importance of providing mental health care services for the people in Siem Reap Province in Cambodia who have been injured by landmines.",0 +https://doi.org/10.1186/1471-244x-11-115,Exercise augmentation compared to usual care for Post Traumatic Stress Disorder: A Randomised Controlled Trial (The REAP study: Randomised Exercise Augmentation for PTSD),"BackgroundThe physical wellbeing of people with mental health conditions can often be overlooked in order to treat the primary mental health condition as a priority. Exercise however, can potentially improve both the primary psychiatric condition as well as physical measures that indicate risk of other conditions such as diabetes mellitus and cardiovascular disease. Evidence supports the role of exercise as an important component of treatment for depression and anxiety, yet no randomised controlled trials (RCT's) have been conducted to evaluate the use of exercise in the treatment of people with post traumatic stress disorder (PTSD).This RCT will investigate the effects of structured, progressive exercise on PTSD symptoms, functional ability, body composition, physical activity levels, sleep patterns and medication usage.Methods and designEighty participants with a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnosis of PTSD will be recruited. Participants will have no contraindications to exercise and will be cognitively able to provide consent to participate in the study.The primary outcome measures will be PTSD symptoms, measured through the PTSD Checklist Civilian (PCL-C) scale. Secondary outcome measures will assess depression and anxiety, mobility and strength, body composition, physical activity levels, sleep patterns and medication usage. All outcomes will be assessed by a health or exercise professional masked to group allocation at baseline and 12 weeks after randomisation.The intervention will be a 12 week individualised program, primarily involving resistance exercises with the use of exercise bands. A walking component will also be incorporated. Participants will complete one supervised session per week, and will be asked to perform at least two other non-supervised exercise sessions per week. Both intervention and control groups will receive all usual non-exercise interventions including psychotherapy, pharmaceutical interventions and group therapy.DiscussionThis study will determine the effect of an individualised and progressive exercise intervention on PTSD symptoms, depression and anxiety, mobility and strength, body composition, physical activity levels, sleep patterns and medication usage among people with a DSM-IV diagnosis of PTSD.Trial Registration ACTRN12610000579099",0 +https://doi.org/10.1007/s10464-015-9727-x,Rebuild or Relocate? Resilience and Postdisaster Decision-Making After Hurricane Sandy,"Hurricane Sandy struck the east coast of the United States on October 29, 2012, devastating communities in its path. In the aftermath, New York implemented a home buyout program designed to facilitate the permanent relocation of residents out of areas considered to be at risk for future hazards. While home buyout programs are becoming popular as policy tools for disaster mitigation, little is known about what factors influence homeowners to participate in or reject these programs. This study used mixed methods to assess the relationship between community resilience and the relocation decision in two heavily damaged communities in which the majority of residents made different decisions regarding whether or not to pursue a buyout. The sample was composed of residents from Oakwood Beach and Rockaway Park, both working-class communities in New York City, who participated via a community survey (N = 133) and/or in-depth interviews (N = 28). Results suggested that community resilience moderated the relationship between community of residence and the buyout decision, leading to opposite responses on the buyout decision. Contextual community factors, including the history of natural disasters, local cultural norms, and sense of place, were instrumental in explaining these different responses. Implications for disaster policy are discussed.",0 +https://doi.org/10.1001/jama.2014.13186,Climate Change,"Health is inextricably linked to climate change. It is important for clinicians to understand this relationship in order to discuss associated health risks with their patients and to inform public policy.To provide new US-based temperature projections from downscaled climate modeling and to review recent studies on health risks related to climate change and the cobenefits of efforts to mitigate greenhouse gas emissions.We searched PubMed and Google Scholar from 2009 to 2014 for articles related to climate change and health, focused on governmental reports, predictive models, and empirical epidemiological studies. Of the more than 250 abstracts reviewed, 56 articles were selected. In addition, we analyzed climate data averaged over 13 climate models and based future projections on downscaled probability distributions of the daily maximum temperature for 2046-2065. We also compared maximum daily 8-hour average ozone with air temperature data taken from the National Oceanic and Atmospheric Administration, National Climate Data Center.By 2050, many US cities may experience more frequent extreme heat days. For example, New York and Milwaukee may have 3 times their current average number of days hotter than 32°C (90°F). High temperatures are also strongly associated with ozone exceedance days, for example, in Chicago, Illinois. The adverse health aspects related to climate change may include heat-related disorders, such as heat stress and economic consequences of reduced work capacity; respiratory disorders, including those exacerbated by air pollution and aeroallergens, such as asthma; infectious diseases, including vectorborne diseases and waterborne diseases, such as childhood gastrointestinal diseases; food insecurity, including reduced crop yields and an increase in plant diseases; and mental health disorders, such as posttraumatic stress disorder and depression, that are associated with natural disasters. Substantial health and economic cobenefits could be associated with reductions in fossil fuel combustion. For example, greenhouse gas emission policies may yield net economic benefit, with health benefits from air quality improvements potentially offsetting the cost of US and international carbon policies.Evidence over the past 20 years indicates that climate change can be associated with adverse health outcomes. Health care professionals have an important role in understanding and communicating the related potential health concerns and the cobenefits from policies to reduce greenhouse gas emissions.",0 +https://doi.org/10.1007/s00441-013-1687-6,Translationally relevant modeling of PTSD in rodents,"Post-traumatic stress disorder (PTSD) is clinically defined in DSM-4 by exposure to a significantly threatening and/or horrifying event and the presence of a certain number of symptoms from each of three symptom clusters at least one month after the event. Since humans clearly do not respond homogeneously to a potentially traumatic experience, the heterogeneity in animal responses might be regarded as confirming the validity of animal studies, rather than as representing a problem. A model of diagnostic criteria for psychiatric disorders could therefore be applied to animal responses to augment the validity of study data, providing that the criteria for classification are clearly defined, reliably reproducible and yield results that conform to findings in human subjects. The method described herein was developed in an attempt to model diagnostic criteria in terms of individual patterns of response by using behavioral measures and determining cut-off scores to distinguish between extremes of response or non-response, leaving a sizeable proportion of subjects in a middle group, outside each set of cut-off criteria. The cumulative results of our studies indicate that the contribution of animal models can be further enhanced by classifying individual animal study subjects according to their response patterns. The animal model also enables the researcher to go one step further and correlate specific anatomic, bio-molecular and physiological parameters with the degree and pattern of the individual behavioral response and introduces prevalence rates as a parameter. The translational value of the classification method and future directions are discussed. © 2013 Springer-Verlag Berlin Heidelberg.",0 +https://doi.org/10.1080/1061580031000075814,Associations between self and other representations and posttraumatic adjustment among political prisoners,"The content and structure of self and other representations and their association with posttraumatic stress symptoms, somatic symptoms, and positive growth were studied among 117 Palestinian male political prisoners. Further, the associations between the representations and the severity of trauma and the post-detention conditions (such as education, place of residency and employment), and the role of representation patterns as a moderator between trauma exposure and symptoms was studied. Cluster analysis identified three representation patterns based on participants' descriptions of their spouse and themselves, and of childhood relationships with their mother and father. Representation patterns differed in negative vs. positive content and in the levels of differentiation and conceptual maturity: The Malevolent Others and Defeated Self representation pattern was characterized by very negative content, and poor differentiation and conceptual maturity in all descriptions; the Moderate Parents and Negative S...",0 +https://doi.org/10.1080/02699050600773276,Symptoms of post-traumatic stress: Intrusion and avoidance 6 and 12 months after TBI,"Primary objectives: (1) To examine survivors with traumatic brain injury (TBI) for symptoms of avoidance and intrusion, two dimensions of post-traumatic stress (PTS) at 6 and 12 months post-injury. (2) To identify risk factors associated with these symptoms.Research design: Prospective follow-up study.Methods and procedures: Georgia and North Carolina Model Brain Injury Systems participants (n = 198) with mild (19%), moderate (21%) and severe (60%) TBI were interviewed by telephone at 6 and 12 months post-injury. The Impact of Event Scale (IES) was used to identify intrusion and avoidance symptoms.Results: Symptoms consistent with severe PTS increased from 11% at 6 months to 16% 12 months post-injury (p < 0.003). African-Americans (p < 0.01) and women (p < 0.05) reported greater symptomatology at 12 months compared to their counterparts. TBI severity and memory of the event were not associated with PTS-like symptoms. Symptoms increased over time when examined by race, injury intent, gender and age (p < 0.05).Conclusions: Regardless of severity, survivors with TBI are at risk for developing symptoms consistent with PTS. Amnesia for the injury event was not protective against developing these symptoms. African-Americans appear to be at greatest risk.",0 +https://doi.org/10.2190/pm.39.4.b,Trajectory of Posttraumatic Stress Disorder Caused by Myocardial Infarction: A Two-Year Follow-up Study,"Objective: A substantial proportion of patients develop posttraumatic stress disorder (PTSD) following myocardial infarction (MI). Previous research on the trajectory over time of PTSD in post-MI patients is scant and refers to self-rated posttraumatic symptoms. The aim of this study was to investigate the longitudinal course of an interviewer-rated diagnosis of PTSD and PTSD symptom severity following MI. Methods: Study participants were 40 patients (78% men, mean age 54 α 8 years) who were diagnosed with PTSD using the Clinician-administered PTSD Scale (CAPS) after an average of 5 α 4 months (range 2–16 months) following an index MI. After a mean follow-up of 26 α 6 months (range 12–36 months), 24 patients underwent a second diagnostic interview. Results: Two-thirds of patients ( n = 16) still qualified for a diagnosis of PTSD at follow-up. In all 24 patients, total PTSD symptoms ( p = 0.001), re-experiencing symptoms ( p < 0.001), avoidance symptoms ( p = 0.015), and, with borderline significance, hyperarousal symptoms ( p < 0.06) had all decreased over time. However, in the subgroup of the 16 patients who had retained PTSD diagnostic status at follow-up, symptoms of avoidance ( p = 0.23) and of hyperarousal ( p = 0.48) showed no longitudinal decline. Longer duration of follow-up was associated with a greater decrease in avoidance symptoms ( p = 0.029) and, with borderline significance, in re-experiencing symptoms ( p < 0.07) across all patients. Conclusion: Although PTSD symptomatology waned over time and in relation to longer follow-up, two-thirds of patients still qualified for a diagnosis of PTSD 2 years after the initial diagnosis. In post-MI patients, clinical PTSD is a considerably persistent condition.",0 +,Rorschach indicators of chronic childhood sexual abuse in female borderline inpatients.,"Recent research indicates a high incidence of childhood sexual abuse and incest among female patients with a diagnosis of borderline personality disorder (BPD). The author investigated the detection and long-term aftereffects of this abuse using a constellation of Rorschach scores that were predicted to occur more frequently in borderline patients with extended sexual victimization before age 14. Sixty-two subjects were divided into two groups (33 with and 29 without such a history) and compared on the following features: color-dominated percepts, primary-process content, confabulation, activity versus passivity, and two new scores related to dissociative symptoms. Some subjects were also administered the Dissociative Experiences Scale and the DSM-III Structured Clinical Interview for posttraumatic stress disorder. The sexually abused group had significantly higher scores both on the Rorschach features and on the clinical measures. The author contends that the identified Rorschach constellation reflects symptoms associated with these trauma-related syndromes, which are more central to the profile of BPD, both on psychological tests and clinically, than is generally recognized.",0 +https://doi.org/10.1080/10926771.2014.892047,Childhood Abuse Types and Physical Health at the Age of 24: Testing Health Risk Behaviors and Psychological Distress as Mediators,"This study examines whether adult psychological distress and health risk behaviors mediate the relationship between childhood abuse and physical health in adulthood. A randomly selected population-based sample, with oversampling to include a one-third subgroup of former child protection cases, completed a structured interview. Questions pertained to childhood exposure to abuse, adult psychological distress, physical health, and health risk behaviors. Previous research using this sample had identified three abuse typologies: emotional abuse, sexual abuse, and polyvictimization (physical abuse, emotional abuse, and neglect). All three typologies were significantly associated with poorer self-reported physical health. Psychological distress and health risk behaviors partially mediated the relationship between nonabuse, sexual abuse, polyvictimization, and physical health, and fully mediated the relationship between emotional abuse and physical health. The results of this study indicate that health risk behav...",0 +https://doi.org/10.1007/s00127-014-0984-z,Loss of social resources predicts incident posttraumatic stress disorder during ongoing political violence within the Palestinian Authority,"Exposure to ongoing political violence and stressful conditions increases the risk of posttraumatic stress disorder (PTSD) in low-resource contexts. However, much of our understanding of the determinants of PTSD in these contexts comes from cross-sectional data. Longitudinal studies that examine factors associated with incident PTSD may be useful to the development of effective prevention interventions and the identification of those who may be most at-risk for the disorder.A 3-stage cluster random stratified sampling methodology was used to obtain a representative sample of 1,196 Palestinian adults living in Gaza, the West Bank and East Jerusalem. Face-to-face interviews were conducted at two time points 6-months apart. Logistic regression analyses were conducted on a restricted sample of 643 people who did not have PTSD at baseline and who completed both interviews.The incidence of PTSD was 15.0 % over a 6-month period. Results of adjusted logistic regression models demonstrated that talking to friends and family about political circumstances (aOR = 0.78, p = 0.01) was protective, and female sex (aOR = 1.76, p = 0.025), threat perception of future violence (aOR = 1.50, p = 0.002), poor general health (aOR = 1.39, p = 0.005), exposure to media (aOR = 1.37, p = 0.002), and loss of social resources (aOR = 1.71, p = 0.006) were predictive of incident cases of PTSD.A high incidence of PTSD was documented during a 6-month follow-up period among Palestinian residents of Gaza, the West Bank, and East Jerusalem. Interventions that promote health and increase and forestall loss to social resources could potentially reduce the onset of PTSD in communities affected by violence.",0 +https://doi.org/10.1097/00004850-200111000-00003,Olanzapine treatment for post-traumatic stress disorder: an open-label study,"Post-traumatic stress disorder (PTSD) is a common and increasingly diagnosed mental illness. Recent pharmacotherapeutic research on treatments for this condition has focused on antidepressant drugs with serotonergic actions. However, the presence of intrusive, psychotic-like symptoms in a substantial portion of PTSD patients raises the possibility that antipsychotics with serotonergic properties might also prove useful in treating PTSD. We conducted an open-label 8-week study of olanzapine treatment in veterans with combat-induced PTSD. Primary outcome measures in this study were the Clinician Administered PTSD Scale (CAPS) and the Clinical Global Impressions Improvement scale. Secondary outcome measures included the Hamilton Rating Scales for Depression (HRSD) and Anxiety (HRSA). Forty-eight patients enrolled in the study, and 30 completed the 8-week trial. Results of intent-to-treat and completer analyses demonstrated that all outcome measures improved significantly during treatment. Secondary analyses indicate that improvement in the intrusive symptom cluster of the CAPS was independent of improvement on the HRSD and HRSA. In conclusion, the study indicates that olanzapine treatment is useful in alleviating the symptoms of combat-induced PTSD.",0 +https://doi.org/10.1300/j229v07n02_02,Evidence for a Dissociative Subtype of Post-Traumatic Stress Disorder Among Help-Seeking Childhood Sexual Abuse Survivors,"This study examined evidence for a dissociative subtype of post-traumatic stress disorder (PTSD) among women seeking psychotherapy for childhood sexual abuse (CSA). One hundred and twenty-two women seeking treatment for CSA completed a battery of questionnaires assessing PTSD, dissociative symptoms, and child maltreatment. Using signal detection analysis, we identified high and low dissociation PTSD subgroups. A constellation of three PTSD symptoms-hypervigilance, sense of foreshortened future, and sleep difficulties-discriminated between these two subgroups (OR = 8.15). Further evidence was provided by the finding of a nonlinear relationship between severity of childhood maltreatment and dissociation in the women with PTSD. These results provide support for a dissociative subtype of PTSD that may stem from more severe childhood experiences of neglect and abuse.",0 +https://doi.org/10.1111/j.1469-7610.2005.01439.x,"The Goteborg discotheque fire: posttraumatic stress, and school adjustment as reported by the primary victims 18 months later","On October 29, 1998, around 400 young people were gathered in an old warehouse in Göteborg, Sweden, for a discotheque party. A fire erupted and spread explosively. Adolescents were exposed to dreadful scenes inside and outside the building. In all, 63 young people were killed and 213 physically injured. An 18-month follow-up with 275 adolescents (126 girls) who survived the fire, regarding the effects of the fire on symptoms of posttraumatic stress, school adjustment and performance, is reported.Impact of Events Scale (IES), Clinician Administered Posttraumatic Stress Scale (CAPS) and an interview concerning background factors and issues of public and personal support.The level of posttraumatic stress was generally high, and highest among adolescents with an immigrant background. In all, 25% of the participants met DSM-IV criteria for PTSD. Twenty-three percent of the participants reported having either dropped out of school or repeated a class because of the fire. Students' ratings of how their own school handled the situation, and school absenteeism, were related to ratings of their own performance in school as well as to the level of posttraumatic stress.Traditional talking cures were more sought out by girls than boys. Broad-scale interventions must be complemented with special treatment opportunities for the most severely afflicted. Victims who suffer from high levels of posttraumatic stress need special support for a long period of time to minimise the effects on scholastic achievement and adjustment. Studies of the effects of traumatic events on child and adolescent development should measure school-related effects better than has hitherto been the case.",0 +https://doi.org/10.1177/003435520104400404,Physical Impairments as Risk Factors for the Development of Posttraumatic Stress Disorder,"The case-control method, a retrospective design useful in studying the etiology of rare diseases, was utilized to examine the relative risk of posttraumatic stress disorder (PTSD) among individuals with six types of traumatic physical impairments. Odds ratios and associated confidence intervals were calculated for each impairment in a group of 45,320 veterans receiving medical services. Four of the six impairments were found to be risk factors for PTSD. Implications for rehabilitation counseling and research are discussed.",0 +https://doi.org/10.1111/j.1469-7610.2011.02431.x,"Prevalence, comorbidity and course of trauma reactions in young burn-injured children","Infants, toddlers and preschoolers are the highest risk group for burn injury. However, to date this population has been largely neglected. This study examined the prevalence, onset, comorbidity and recovery patterns of posttrauma reactions in young children with burns.Parents of 130 unintentionally burned children (1-6 years) participated in the study. The Diagnostic Infant Preschool Assessment was conducted with parents at 1 and 6 months postinjury.The majority of children were resilient. However, 35% were diagnosed with at least one psychological disorder, there was a high rate of comorbidity with posttraumatic stress disorder, and 8% of children did not experience recovery in distress levels over the course of 6 months.These outcomes are likely to have serious repercussions for a young child's medical and psychosocial recovery as well as their normal developmental trajectories. It is recommended that screening, prevention and early intervention resources are incorporated into paediatric health care settings to optimise children's psychological adjustment following burn injury.",0 +https://doi.org/10.1017/s0033291796004242,The validity of two versions of the GHQ in the WHO study of mental illness in general health care,"Background . In recent years the 12-item General Health Questionnaire (GHQ-12) has been extensively used as a short screening instrument, producing results that are comparable to longer versions of the GHQ. Methods . The validity of the GHQ-12 was compared with the GHQ-28 in a World Health Organization study of psychological disorders in general health care. Results are presented for 5438 patients interviewed in 15 centres using the primary care version of the Composite International Diagnostic Instrument, or CIDI-PC. Results . Results were uniformly good, with the average area under the ROC curve 88, range from 83 to 95. Minor variations in the criteria used for defining a case made little difference to the validity of the GHQ, and complex scoring methods offered no advantages over simpler ones. The GHQ was translated into 10 other languages for the purposes of this study, and validity coefficients were almost as high as in the original language. There was no tendency for the GHQ to work less efficiently in developing countries. Finally gender, age and educational level are shown to have no significant effect on the validity of the GHQ. Conclusions . If investigators wish to use a screening instrument as a case detector, the shorter GHQ is remarkably robust and works as well as the longer instrument. The latter should only be preferred if there is an interest in the scaled scores provided in addition to the total score.",0 +https://doi.org/10.1080/16513860701223060,"Coping, conversation tactics and marital interaction in persons with acquired profound hearing loss (APHL): Correlates of distress","This study investigated coping strategies, conversation tactics, and marital interaction in acquired profound hearing loss (APHL) and compared emotionally stable (n = 15) and emotionally distressed (n = 7) participants. Nominated family members were assessed on most measures. Comparisons were also made in the subgroup of married participants. A combined distress criterion was derived from scores on standardized measures of anxiety, depression, hearing handicap, and post-traumatic stress. Groups were compared on the Ways-of-Coping Checklist, a newly devised measure of conversation tactics, and on the Couple Behaviour Report. It was found that distressed APHL participants were more likely to cope through avoidance, self-blame, and wishful thinking, and they used more avoidant tactics in conversation. The coping profile of family members did not differentiate distress groups. However, there was some indication of greater employment of coercive tactics by family members of distressed participants. The results...",0 +https://doi.org/10.17918/etd-2838,The effect of posttraumatic stress disorder psychoeducation on the nature and severity of traumatic stress symptoms in a Burundian sample,"Post-Traumatic Stress Disorder (PTSD) was recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980 as a syndrome associated with the experience of a traumatic event (ARA, 1980). In recent years, the diagnosis of PTSD has been increasingly applied to diverse cultural settings, even as the validity of the construct sparks controversy and debate. Argument continues over whether the symptoms of PTSD are more driven by universal biological response or cultural factors. A review of the literature that documents recent efforts to identify and treat posttraumatic stress symptoms in diverse populations is provided. Given evidence for the suggestive and iatrogenic effects of some PTSD treatment methods and other interventions, as well as the theoretical support for the presence of social influences germane to cross-cultural research and treatment, it was proposed that PTSD-specific psychoeducation in pre-industrialized settings might diminish otherwise beneficial treatment effects. The present project drew on an indigent, rural Burundian sample and used an experimental design to examine the influence of PTSD psychoeducation on the nature and severity of traumatic stress symptoms reported. Participants were randomized to three conditions: A reconciliation workshop with psychoeducation, a reconciliation workshop without psychoeducation, and a waitlist control. Results showed that participants in the psychoeducation condition experienced a diminished reduction of PTSD symptoms relative to other conditions. There was no differential effect by condition on more general symptoms of anxiety, depression, and somatization symptoms. Secondary hypotheses predicting relationships at baseline between prior exposure to trauma models developed in industrialized societies and the nature and severity of posttraumatic stress symptoms were not supported. The findings are discussed in terms of how they might inform intervention development for traumatic stress in non-industrialized cultural settings. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1007/s10826-014-9936-1,Psychometric Properties of the Child’s Reaction to Traumatic Events Scale-Revised in English and Lugandan,"Brief and age-appropriate measures of trauma-related symptoms are useful for identifying children in need of clinical services. The current study examines the psychometric properties of the 23-item Child's Reaction to Traumatic Events Scale-Revised (CRTES-R). The CRTES-R includes subscales assessing hyperarousal, avoidance and intrusion. To date, no studies have examined the psychometric properties of this revised measure or cross-cultural differences in its factor structure. Two samples of (a) children (ages 6-21) who had experienced a hurricane in the USA or Grenada (N = 135), and (b) Ugandan children (ages 8-17) who had experienced a variety of traumatic events (N = 339) completed the CRTES-R in English or Lugandan. Confirmatory factor analysis supported an empirically adjusted model with three modified latent factors in both the English (χ2/df = 1.34, CFI = .90, RMSEA = .05) and Lugandan samples (χ2/df = 1.45, CFI = .93, RMSEA = .04). Although the analysis supported separate hyperarousal, avoidance and intrusion subscales, the items that loaded on each factor differed from the original CRTES-R subscales. The English version of the CRTES-R showed good concurrent validity with the Kauai Recovery Index measure of trauma symptoms. Those using the CRTES-R to assess children's experiences of the different symptom types should consider using the empirically-derived subscales described in this paper; however, those who wish to capture a broad spectrum of PTSD symptoms should consider using all the original CRTES-R items and calculating a total score.",0 +https://doi.org/10.1007/978-3-319-12096-6_12,Dividing Traffic Sub-areas Based on a Parallel K-Means Algorithm,"AbstractIn order to alleviate the traffic congestion and reduce the complexity of traffic control and management, it is necessary to exploit traffic sub-areas division which should be effective in planing traffic. Some researchers applied the K-Means algorithm to divide traffic sub-areas on the taxi trajectories. However, the traditional K-Means algorithms faced difficulties in processing large-scale Global Position System(GPS) trajectories of taxicabs with the restrictions of memory, I/O, computing performance. This paper proposes a Parallel Traffic Sub-Areas Division(PTSD) method which consists of two stages, on the basis of the Parallel K-Means(PKM) algorithm. During the first stage, we develop a process to cluster traffic sub-areas based on the PKM algorithm. Then, the second stage, we identify boundary of traffic sub-areas on the base of cluster result. According to this method, we divide traffic sub-areas of Beijing on the real-word (GPS) trajectories of taxicabs. The experiment and discussion show that the method is effective in dividing traffic sub-areas.KeywordsTraffic Sub-AreasGPS TrajectoriesK-MeansMapReduce",0 +https://doi.org/10.1080/17523281.2011.611118,Prolonged exposure to post-traumatic stress disorder (PTSD) in an active substance abuser,"Effective treatments for post-traumatic stress disorder (PTSD) have been the focus of research studies for many years, with exposure therapy consistently emerging as the leading treatment for this disorder. However, for a variety of reasons most studies exclude individuals suffering from concurrent substance use disorders. In recent years, this omission has been addressed, and the belief that substance dependent individuals cannot benefit from trauma treatment until they are free from substances is losing favor. Early studies have demonstrated that prolonged exposure therapy can be effective for persons suffering from both disorders. The current case study seeks to provide information on the length of time and type of symptom change in an individual suffering from comorbid PTSD-substance abuse (PTSD-SA). Therefore, prolonged exposure was utilized to treat PTSD in an active abuser of both alcohol and marijuana. Pre- and post-treatment assessments demonstrate dramatic reductions in PTSD symptoms, general an...",0 +https://doi.org/10.1093/biomet/88.3.767,Testing the number of components in a normal mixture,"We demonstrate that, under a theorem proposed by Vuong, the likelihood ratio statistic based on the Kullback-Leibler information criterion of the null hypothesis that a random sample is drawn from a k 0 -component normal mixture distribution against the alternative hypothesis that the sample is drawn from a k 1 -component normal mixture distribution is asymptotically distributed as a weighted sum of independent chi-squared random variables with one degree of freedom, under general regularity conditions. We report simulation studies of two cases where we are testing a single normal versus a two-component normal mixture and a two-component normal mixture versus a three-component normal mixture. An empirical adjustment to the likelihood ratio statistic is proposed that appears to improve the rate of convergence to the limiting distribution.",0 +https://doi.org/10.1016/j.jpsychires.2012.12.005,Trajectories of posttraumatic stress symptomatology in older persons affected by a large-magnitude disaster,"This study examined the nature and determinants of longitudinal trajectories of disaster-related posttraumatic stress disorder (PTSD) symptoms in older persons affected by a large-magnitude disaster. Two hundred six adults age 60 or older (mean = 69, range = 60-92) who resided in the Galveston Bay area when Hurricane Ike struck in September 2008 completed telephone interviews an average of 3-, 6-, and 15-months after this disaster. Latent growth mixture modeling was employed to identify predominant trajectories of disaster-related PTSD symptoms over time; and pre-, peri-, and post-disaster determinants of these trajectories were then examined. A 3-class solution optimally characterized PTSD symptom trajectories, with the majority (78.7%) of the sample having low/no PTSD symptoms over all assessments (i.e., resistant); 16.0% having chronically elevated symptoms (i.e., chronic); and 5.3% having a delayed onset course of symptoms (i.e., delayed-onset). Lower education, greater severity of Hurricane Ike exposure (i.e., Ike-related physical illness or injury and high level of community destruction), and greater number of traumatic and stressful life events after Hurricane Ike, particularly financial problems, were associated with a chronic PTSD trajectory. Greater number of traumatic and stressful life events, particularly financial problems after Hurricane Ike, was also associated with a delayed-onset trajectory. These findings suggest that there are heterogeneous trajectories of disaster-related PTSD symptoms in older adults and that these trajectories have common and unique determinants. They also underscore the importance of prevention efforts designed to mitigate the deleterious effects of post-disaster stressors, most notably financial distress, in older persons affected by disasters.",1 +https://doi.org/10.1002/jts.20150,"Heart rate of motor vehicle accident survivors in the emergency department, peritraumatic psychological reactions, ASD, and PTSD severity: A 6-month prospective study","This small-scale study investigates the relationships between the heart rate of motor vehicle accident survivors presenting in the emergency department (ED) and acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) symptom severity. It also examines the relationships between the survivor's heart rate in the ED and peritraumatic dissociation and peritraumatic distress reported 2 weeks posttrauma. Fifty motor vehicle accident (MVA) survivors were assessed 2 weeks, 1 (N = 42), 3 (N = 37), and 6 months (N = 37) post-MVA. The heart rate in the ED predicted self-reported ASD symptom severity and clinician-rated PTSD symptom severity at 6 months but not at 1 or 3 months. Survivors' heart rate in the ED was significantly correlated with peritraumatic dissociation but not peritraumatic distress. These findings support the role of elevated ED heart rate as a predictor of both ASD and chronic PTSD symptom severity and may help to clarify the discrepant findings of previous research.",0 +https://doi.org/10.1007/s00127-015-1035-0,Post-traumatic stress disorder and chronic disease: open questions and future directions,"A large body of research has now firmly established that traumatic events, such as natural disasters, combat, sexual assault, and child abuse, are frequent occurrences throughout the world and that there are substantial consequences of traumatic event experiences. In most countries, the majority of adults report exposure to at least one traumatic event in their lifetime [1]. PTSD, the paradigmatic stress-related mental disorder, emerges in some persons in response to an unpredictable and uncontrollable traumatic event. PTSD is common with lifetime estimates ranging from 1.7 % in South Korea to 8.8 % in Northern Ireland, and past-year prevalences from a high of 3.8 % in Northern Ireland to a low of 0.2 % in China [2]. Separately, evidence shows that persons who experience traumatic events are more likely to report cardiovascular disease, respiratory disease, and other physical illness [3]. Researchers and health professionals commonly treat the brain and the body as if they are distinct entities, and this approach informs most of the scholarship about the consequences of traumatic events. However, recent advances in our understanding of the relation between PTSD and chronic diseases such as cardiovascular disease and type-2 diabetes suggest this approach is misguided. For example, a recent meta-analysis showed that PTSD and PTSD symptoms are associated with worse self-reported health and health-related quality of life [4]. Rigorous prospective studies have provided evidence that PTSD increases risk of first-onset cardiovascular disease and type-2 diabetes [5, 6]. This evidence, and a comparable body of literature, suggests that PTSD may have profound adverse effects on physical health over the life course. This opens up an important new perspective on the study of the consequences of PTSD and an emerging literature is now informing our understanding of how PTSD may be linked to physical illness.",0 +https://doi.org/10.1080/09602011.2010.540920,Is it time to act? The potential of acceptance and commitment therapy for psychological problems following acquired brain injury,"Behaviour therapies have a well-established, useful tradition in psychological treatments and have undergone several major revisions. Acceptance and Commitment Therapy (ACT) and mindfulness-based approaches are considered a third wave of behavioural therapies. Emerging evidence for ACT has demonstrated that this paradigm has promising effectiveness in improving functionality and well-being in a variety of populations that have psychological disturbances and/or medical problems. In this review we first evaluate traditional cognitive behavioural therapy (CBT) interventions used to manage psychological problems in distressed individuals who have sustained an acquired brain injury (ABI). We provide an overview of the ACT paradigm and the existent evidence base for this intervention. A rationale is outlined for why ACT-based interventions may have potential utility in assisting distressed individuals who have sustained a mild to moderate ABI to move forward with their lives. We also review emerging evidence that lends preliminary support to the implementation of acceptance and mindfulness-based interventions in the rehabilitation of ABI patient groups. On the basis of existent literature, we recommend that it is an opportune time for forthcoming research to rigorously test the efficacy of ACT-based interventions in facilitating ABI patient groups to re-engage in living a valued and meaningful life, in spite of their neurocognitive and physical limitations. The promising utility of testing the efficacy of the ACT paradigm in the context of multimodal rehabilitation programmes for ABI populations is also addressed.",0 +https://doi.org/10.1016/j.jad.2013.04.038,Presentation and prevalence of PTSD in a bipolar disorder population: A STEP-BD examination,"Co-occurring psychiatric diagnoses have a negative impact on quality of life and change the presentation and prognosis of bipolar disorder (BD). To date, comorbidity research on patients with BD has primarily focused on co-occurring anxiety disorders and trauma history; only recently has there been a specific focus on co-occurring PTSD and BD. Although rates of trauma and PTSD are higher in those with bipolar disorder than in the general population, little is known about differences across bipolar subtypes.Using the NIMH STEP-BD dataset (N=3158), this study evaluated whether there were baseline differences in the prevalence of PTSD between participants with bipolar disorder I (BDI) and bipolar disorder II (BDII), using the MINI and the Davidson Trauma Scale. Differences in PTSD symptom clusters between patients with BDI and BDII were also evaluated.A significantly greater proportion of participants with BDI had co-occurring PTSD at time of study entry (Χ(2)(1)=12.6; p<.001). BDI and BDII subgroups did not significantly differ in re-experiencing, avoidance, or arousal symptoms.The analysis may suggest a correlational relationship between PTSD and BD, not a causal one. Further, it is possible this population seeks treatment more often than individuals with PTSD alone. Finally, due to the episodic nature of BD and symptom overlap between the two disorders, misdiagnosis is possible.PTSD may be more prevalent in patients with BDI. However, the symptom presentation of PTSD appears similar across BD subtypes. Individuals should be thoroughly assessed for co-occurring diagnoses in an effort to provide appropriate treatment.",0 +https://doi.org/10.1111/j.1469-7610.2005.00370.x,Examining minor and major depression in adolescents,"Research has shown that a large proportion of adolescents with symptoms of depression and substantial distress or impairment fail to meet the diagnostic criteria for a major depressive disorder (MDD). However, many of these undiagnosed adolescents may meet criteria for a residual category of the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revised (DSM-IV-TR), Depressive Disorder Not Otherwise Specified. Minor Depression (mDEP), an example of one of these categories, allows the inclusion of sub-threshold cases that fall below the diagnostic criteria of the five symptoms required for MDD. Minor depression in adolescence is important because it is significantly related to MDD in adulthood. The present study examines a number of risk factors, functional impairment, comorbidity and service utilization patterns associated with depression in community adolescents who met the DSM-IV criteria for mDEP and compares their profile to adolescents who met the criteria for MDD.Puerto Rican adolescents 11 to 17 years old were selected from an island-wide probability household sample of children ranging in age from 4 to 17. The Diagnostic Interview Schedule in Spanish (DISC IV), together with a structured protocol of risks and protective factors, and service utilization questionnaires were administered to primary caretakers and their children.Our findings indicate that youngsters with mDEP had significant impairment and used more mental health services than those with major depression. In addition, adolescents with mDEP had similar outcomes when compared to those meeting full criteria for MDD in terms of psychosocial correlates and comorbidity.The results, although not definitive, suggest a need for further research in order to determine the validity of the present DSM IV diagnostic criteria for mDEP in adolescents.",0 +https://doi.org/10.1080/10673220216206,Distinguishing Trauma-Associated Narcissistic Symptoms from Posttraumatic Stress Disorder: A Diagnostic Challenge,"Individuals with trauma-associated narcissistic symptoms (referred to in this paper by the acronym TANS for simplicity) display a discrete cluster of psychological symptoms that can closely mimic those of PTSD. In TANS, the underlying vulnerability to traumatic stress usually stems from a narcissistic personality disorder or narcissistic personality traits. However, narcissistic symptoms associated with an external traumatic event may be reflexively and erroneously attributed to PTSD, no matter how small or insignificant the traumatic stressor. Mistaking TANS for PTSD usually results in treatment failure. In litigation, distinguishing between TANS and PTSD assists the trier of fact in determining causation and assessing damages.",0 +https://doi.org/10.1037//0021-843x.108.1.164,"Posttraumatic stress disorder in a national sample of female and male Vietnam veterans: Risk factors, war-zone stressors, and resilience-recovery variables.","Relationships among pretrauma risk factors (e.g., family instability, childhood antisocial behavior), war-zone stressors (e.g., combat, perceived threat), posttrauma resilience-recovery variables (e.g., hardiness, social support), and posttraumatic stress disorder (PTSD) symptom severity were examined. Data from a national sample of 432 female and 1,200 male veterans were analyzed using structural equation modeling. For both genders, direct links to PTSD from pretrauma, war-zone, and posttrauma variable categories were found; several direct associations between pretrauma and posttrauma variables were documented. Although war-zone stressors appeared preeminent for PTSD in men, posttrauma resilience-recovery variables were more salient for women. Researchers, policymakers, and clinicians are urged to take a broad view on trauma and its sequelae, especially regarding possible multiple exposures over time and the depletion and availability of important resources.",0 +https://doi.org/10.1002/jts.21727,Association of life threat and betrayal with posttraumatic stress disorder symptom severity,"The Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association [APA], 2000) emphasizes life threat as the defining feature of psychological trauma. Recent theoretical and empirical work, however, indicates the need to identify and evaluate other key aspects of trauma. Betrayal has been proposed as a pertinent, distinct, and complementary factor that can explain effects of trauma not accounted for by life threat alone. This study examined the relationship between injury, perceived life threat (PLT), and betrayal with posttraumatic stress disorder (PTSD) symptom severity. Trauma-exposed college students (N = 185) completed self-report measures of trauma exposure and PTSD, as well as items regarding life threat, betrayal, and level of medical care received. In hierarchical regressions incorporating injury, PLT, and betrayal, betrayal was associated with all PTSD symptom clusters and PTSD total severity (f2 = .08), whereas PLT was associated with hyperarousal (f2 = .05) and PTSD total (f2 = .03), and injury had no association with PTSD symptoms. In a revised model with trauma type as an additional variable, betrayal was associated with avoidance (f2 = .03), numbing (f2 = .04), and PTSD total (f2 = .03), whereas PLT was associated with reexperiencing (f2 = .04), hyperarousal (f2 = .04), and PTSD total (f2 = .03), and injury was associated with avoidance (f2 = .03). These findings support the idea that betrayal is a core dimension of psychological trauma that may play an important role in the etiology of PTSD.",0 +https://doi.org/10.1093/fampra/cmg428,Post-traumatic stress disorder among family physicians in Bosnia and Herzegovina,"The traumatic events experienced by thousands of people in Bosnia and Herzegovina during the 1992-1995 conflict may have a lasting effect on the mental health of the country, characterized by high rates of post-traumatic stress disorder (PTSD). A diagnosis of PTSD among family physicians could affect their ability to diagnose and treat patients for depression, anxiety and PTSD.The aim of the present study was to determine the prevalence of PTSD among family medicine physicians in Bosnia and Herzegovina.A self-administered questionnaire, including the PTSD Checklist-Civilian Version (PCL-C) which is a validated scale for PTSD screening, was distributed to family medicine residents and specialists in Bosnia and Herzegovina. The prevalence of PTSD was determined, and factors related to PTSD were considered.One hundred and thirty-three (90.5%) of the 147 physicians who were available to be surveyed completed the questionnaire. Of the 88% who had a traumatic experience during the war, 18% met the criteria for PTSD. The likelihood of meeting the criteria for PTSD was not affected by age, sex or whether the physician had worked in a field hospital during the war. However, a positive response to the question ""Do you think the traumatic event you experienced during the war still affects you today?"" was highly associated with the diagnosis of PTSD (odds ratio 7.26, 95% confidence interval: 1.57-33.60). Also, this question was shown to have a high degree of sensitivity and negative predictive value, and may be of use as a screening tool for ruling out the presence of PTSD after a traumatic war experience.",0 +https://doi.org/10.1016/j.brat.2004.03.006,Cognitive therapy for post-traumatic stress disorder: development and evaluation,"The paper describes the development of a cognitive therapy (CT) program for post-traumatic stress disorder (PTSD) that is based on a recent cognitive model (Behav. Res. Therapy 38 (2000) 319). In a consecutive case series, 20 PTSD patients treated with CT showed highly significant improvement in symptoms of PTSD, depression and anxiety. A subsequent randomized controlled trial compared CT ( N = 14 ) and a 3-month waitlist condition (WL, N = 14 ). CT led to large reductions in PTSD symptoms, disability, depression and anxiety, whereas the waitlist group did not improve. In both studies, treatment gains were well maintained at 6-month follow-up. CT was highly acceptable, with an overall dropout rate of only 3%. The intent-to-treat effect sizes for the degree of change in PTSD symptoms from pre to post-treatment were 2.70–2.82 (self-report), and 2.07 (assessor-rated). The controlled effect sizes for CT versus WL post-treatment scores were 2.25 (self-report) and 2.18 (assessor-rated). As predicted by the cognitive model, good treatment outcome was related to greater changes in dysfunctional post-traumatic cognitions. Patient characteristics such as comorbidity, type of trauma, history of previous trauma, or time since the traumatic event did not predict treatment response, however, low educational attainment and low socioeconomic status were related to better outcome.",0 +https://doi.org/10.1016/j.psychres.2007.09.005,Assessing reliability and validity of the Arabic language version of the Post-traumatic Diagnostic Scale (PDS) symptom items,"Arab immigrant women are vulnerable to post-traumatic stress disorder (PTSD) because of gender, higher probability of being exposed to war-related violence, traditional cultural values, and immigration stressors. A valid and reliable screen is needed to assess PTSD incidence in this population. This study evaluated the reliability and validity of an Arabic language version of the symptom items in Foa et al.'s [Foa, E.B., Cashman, L., Jaycox, L., and Perry, K. 1997. The validation of a self report measure of posttraumatic stress disorder: the Posttraumatic Diagnostic Scale. Psychological Assessment 9(4), 445–451]. Post-traumatic Diagnostic Scale (PDS) in a sample of Arab immigrant women ( n = 453). Reliability was supported by Cronbach's alpha values for the Arabic language version (0.93) and its subscales (0.77–0.91). Results of group comparisons supported validity: Women who had lived in a refugee camp or emigrated from Iraq — a country where exposure to war and torture is common — were exhibiting depressive symptoms (Center for Epidemiological Studies-Depression Scale (CES-D) score above 18), or reported moderately to severely impaired functioning had significantly higher mean PDS total and symptom subscale scores than women who had not had these experiences or were not exhibiting depressive symptoms. Scores on the PDS and its subscales were also positively correlated with the Profile of Mood States (POMS) depression and anxiety subscales and negatively correlated with the POMS vigor subscale ( r = − .29 to− .39).",0 +https://doi.org/10.1016/j.jpsychores.2014.09.007,The association between alexithymia and posttraumatic stress symptoms following multiple exposures to traumatic events in North Korean refugees,"The present study aimed to investigate the effect of the interaction between the number of traumas experienced and alexithymia, on posttraumatic stress disorder (PTSD) symptoms.The sample comprised 199 North Korean refugees. Participants completed the Trauma Exposure Check List for North Korean Refugees, Impact of Event Scale-Revised (IES-R), Toronto Alexithymia Scale-20 (TAS-20), and Center for Epidemiological Studies-Depression Scale (CES-D).TAS-20 scores were positively correlated with IES-R scores (r=0.21, p<0.01), after controlling for gender, age, and CES-D scores. The number of traumas experienced was also positively correlated with IES-R scores (r=0.32, p<0.001), but not with TAS-20 scores, after controlling for gender, age, and CES-D scores. A hierarchical multiple regression analysis revealed a significant interaction between the number of traumas experienced and TAS-20 scores, for IES-R scores (t=2.10, p<0.05). Moderation analysis further revealed that TAS-20 scores moderate the relationship between the number of traumas experienced and IES-R scores (t=2.90, p<0.01). For refugees with higher TAS-20 scores, those who had experienced more traumas had higher IES-R scores. However, within refugees with lower TAS-20 scores, IES-R scores were not significantly different for those who had experienced a higher number of traumas compared with those who had experienced a lower, or average, number of traumas.The results of the current study suggest that, as individuals experience more traumatic events, clearly identifying and expressing emotions become more crucial for reducing PTSD symptoms.",0 +https://doi.org/10.1016/j.drugalcdep.2004.08.005,"Post-traumatic stress disorder, drug dependence, and suicidality among male Vietnam veterans with a history of heavy drug use","This study examines the roles of post-traumatic stress disorder (PTSD) and drug dependence in non-fatal suicidality, i.e., suicidal ideation and suicide attempt, among Vietnam veterans in their adult years. The sample includes male veterans deployed to Vietnam, including an oversample of those who tested positive for opiates at their return ( n = 642). PTSD, substance abuse, suicidality, and other psychopathology are analyzed using three waves of survey and military data covering the time period from early adolescence to middle adulthood. Measures include the onset and recency of each of the lifetime DSM-IV PTSD symptom criteria, and yearly symptom measures of DSM-IV dependence for alcohol and eight classes of psychoactive substances. Survival and hazard models are applied to assess the effects of drug dependence, PTSD, and other psychopathology on the duration of suicidality. Longitudinal models estimate the casual relationships among PTSD, drug dependence, and suicidality over a 25-year period. Results show evidence of strong continuity of PTSD, drug dependence, and suicidality over time. The causal role of drug dependence on PTSD and suicidality is limited to young adulthood. Evidence is stronger for self-medication in later adulthood. The results indicate that a life course perspective is needed for the combined treatment of PTSD and drug dependence for severely traumatized populations.",0 +https://doi.org/10.1080/13554794.2011.588181,A case of frontal neuropsychological and neuroimaging signs following multiple primary-blast exposure,"Blast-related traumatic brain injury (TBI) from the Afghanistan and Iraq wars represents a significant medical concern for troops and veterans. To better understand the consequences of primary-blast injury in humans, we present a case of a Marine exposed to multiple primary blasts during his 14-year military career. The neuropsychological profile of this formerly high-functioning veteran suggested primarily executive dysfunction. Diffusion-tensor imaging revealed white-matter pathology in long fiber tracks compared with a composite fractional-anisotropy template derived from a veteran reference control group without TBI. This study supports the existence of primary blast-induced neurotrauma in humans and introduces a neuroimaging technique with potential to discriminate multiple-blast TBI.",0 +https://doi.org/10.1080/10615800108248359,Motor vehicle accident trauma exposure: Personality profiles associated with posttraumatic diagnoses,"Abstract Personality profiles associated with diagnostically distinct posttraumatic responses were examined. Profiles were compared between three groups defined on the basis of posttraumatic diagnosis following motor vehicle accident (MVA) trauma exposure. The diagnostic groups were: Posttraumatic Stress Disorder (PTSD), Acute Stress Disorder (ASD) without progression to PTSD, and subclinical responses. Participants were male and female community volunteers aged 18 to 77 (N = 83) who had all been exposed to an MVA meeting the DSM-IV diagnostic criteria for a traumatic event. The Personality Assessment Inventory (Morey, 1991) was used to assess psychological variables in the framework of posttraumatic diagnostic groups. The PTSD group scored significantly higher than the ASD and subclinical groups on scales assessing somatic complaints, anxiety, anxiety related disorders, depression, non-psychotic symptoms of schizophrenia, and negative relationships. The profile of the ASD group was characterized by self ...",0 +https://doi.org/10.1016/j.jad.2013.06.014,"The relationship between worry, rumination, and comorbidity: Evidence for repetitive negative thinking as a transdiagnostic construct","Repetitive negative thinking (RNT) increases vulnerability to multiple anxiety and depressive disorders and, as a common risk factor, elevated RNT may account for the high levels of comorbidity observed between emotional disorders. The aims of this study were to (a) compare two common forms of RNT (worry and rumination) across individuals with non-comorbid anxiety or depressive disorders, and (b) to examine the relationship between RNT and comorbidity.A structured diagnostic interview and measures of rumination, worry, anxiety, and depression were completed by a large clinical sample with an anxiety disorder or depression (N=513) presenting at a community mental health clinic.Patients without (n=212) and with (n=301) comorbid diagnoses did not generally differ across the principal diagnosis groups (depression, generalised anxiety disorder, social anxiety disorder, panic disorder) on worry or rumination. As predicted, comorbidity was associated with a higher level of RNT.Cross-sectional design precluded causal conclusions and findings may not generalize to excluded anxiety disorders.Consistent with the transdiagnostic hypothesis, RNT was associated with a range of anxiety disorders and depression and with comorbidity for those with a principal depressive disorder, supporting recent evidence that RNT is a transdiagnostic process. The presence of RNT, specifically worry and rumination, should be assessed and treated regardless of diagnostic profile. Future research may show that both pure and comorbid depressed or anxious patients receive incremental benefit from transdiagnostic protocols developed to treat core pathological processes of RNT traditionally associated with separate disorders.",0 +https://doi.org/10.3389/fnbeh.2014.00209,Improvement of mood and sleep alterations in posttraumatic stress disorder patients by eye movement desensitization and reprocessing,"Posttraumatic stress disorder (PTSD) patients exhibit depressive and anxiety symptoms, in addition to nightmares, which interfere with sleep continuity. Pharmacologic treatment of these sleep problems improves PTSD symptoms, but very few studies have used psychotherapeutic interventions to treat PTSD and examined their effects on sleep quality. Therefore, in the present study, we sought to investigate the effects of Eye Movement Desensitization Reprocessing therapy on indices of mood, anxiety, subjective, and objective sleep. The sample was composed of 11 healthy controls and 13 PTSD patients that were victims of assault and/or kidnapping. All participants were assessed before, and 1 day after, the end of treatment for depressive and anxiety profile, general well-being and subjective sleep by filling out specific questionnaires. In addition, objective sleep patterns were evaluated by polysomnographic recording. Healthy volunteers were submitted to the therapy for three weekly sessions, whereas PTSD patients underwent five sessions, on average. Before treatment, PTSD patients exhibited high levels of anxiety and depression, poor quality of life and poor sleep, assessed both subjectively and objectively; the latter was reflected by increased time of waking after sleep onset. After completion of treatment, patients exhibited improvement in depression and anxiety symptoms, and in quality of life; with indices that were no longer different from control volunteers. Moreover, these patients showed more consolidated sleep, with reduction of time spent awake after sleep onset. In conclusion, Eye Movement Desensitization and Reprocessing was an effective treatment of PTSD patients and improved the associated sleep and psychological symptoms.",0 +https://doi.org/10.1097/jom.0b013e318270d709,Gulf War Illness,"To further elucidate the nature of illness in veterans of the 1990 to 1991 Gulf War (GW) by examining the GW Illness (GWI) definition advanced by the Centers for Disease Control and Prevention, which specified caseness as having at least one symptom from two of the three factors: fatigue, mood-cognition, and musculoskeletal.A total of 311 male and female GW veterans drawn from across the nation were assessed in a survey-based study approximately 10 years after deployment.A total of 33.8% of the probability-weighted sample met GWI criteria. Multiple symptom profiles were found, with more than half of GWI cases endorsing a symptom on all the three factors, and almost all cases endorsing at least one mood-cognition symptom.Although the Centers for Disease Control and Prevention definition has some limitations that should be considered, it remains a useful tool for assessing the presence of illness in GW veterans.",0 +https://doi.org/10.1155/2010/479364,Molecular and Therapeutic Potential and Toxicity of Valproic Acid,"Valproic acid (VPA), a branched short-chain fatty acid, is widely used as an antiepileptic drug and a mood stabilizer. Antiepileptic properties have been attributed to inhibition of Gamma Amino Butyrate (GABA) transaminobutyrate and of ion channels. VPA was recently classified among the Histone Deacetylase Inhibitors, acting directly at the level of gene transcription by inhibiting histone deacetylation and making transcription sites more accessible. VPA is a widely used drug, particularly for children suffering from epilepsy. Due to the increasing number of clinical trials involving VPA, and interesting results obtained, this molecule will be implicated in an increasing number of therapies. However side effects of VPA are substantially described in the literature whereas they are poorly discussed in articles focusing on its therapeutic use. This paper aims to give an overview of the different clinical-trials involving VPA and its side effects encountered during treatment as well as its molecular properties.",0 +https://doi.org/10.2989/17280583.2014.923433,Resilience and post-traumatic stress disorder in the acute aftermath of rape: a comparative analysis of adolescents versus adults,"Rape trauma contributes significantly to the mental burden of disease, affecting resilience and vulnerabilities at every developmental life stage. Appropriate resilience-promoting strategies could potentially buffer or protect trauma-exposed individuals from psychopathology.This study aimed to assess and compare (using validated measuring instruments) resilience, post-traumatic stress disorder (PTSD) and other variables in the acute aftermath of rape, between adolescent and adult females and to assess associations with these variables.We conducted a comparative analysis of resilience, PTSD, prior trauma, demographic variables and psychiatric morbidity in 41 adolescent and 47 adult female rape survivors six weeks post-rape. We assessed the relationship of resilience to PTSD, demographic variables and prior trauma and investigated if resilience levels predicted PTSD after adjusting for prior trauma.We found no significant differences in resilience levels between the groups, but the adolescent PTSD rate (40%) was double that in adults (20%). In adults, a significant negative correlation was evident between resilience and PTSD symptoms scores.More knowledge of resilience versus stress susceptibility for PTSD throughout the lifespan is needed and can inform the development of more effective clinical assessment and resilience-promoting strategies.",0 +https://doi.org/10.1007/978-1-59259-852-6_12,Glutamatergic Systems and Anxiety,"Anxiety is a normal emotion experienced by humans and other mammalian species. However, anxiety also exists in pathological forms, and anxiety disorders are the most prevalent of psychiatric disorders. Prevalence rates vary with the diagnostic tools used to estimate them, and with study design, but the most extensive studies suggest that within the United States, 15.7 million people are affected yearly and 30 million at some point in their lives (1). In a US study, 6% of men and 13% of women had suffered from an anxiety disorder in the previous 6 mo (2).KeywordsNMDA ReceptorAnxiety DisorderAMPA ReceptorFear ConditioningMetabotropic Glutamate ReceptorThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.",0 +https://doi.org/10.1186/1478-7954-8-28,"Psychosocial stress and strategies for managing adversity: measuring population resilience in New South Wales, Australia","Populations around the world are facing an increasing number of adversities such as the global financial crisis, terrorism, conflict, and climate change. The aim of this paper was to investigate self-reported strategies and sources of support used to get through ""tough times"" in an Australian context and to identify patterns of response in the general population and differences in potentially vulnerable subgroups.Data were collected through a cross-sectional survey of the New South Wales population in Australia. The final sample consisted of 3,995 New South Wales residents aged 16 years and above who responded to the question: ""What are the things that get you through tough times?""Respondents provided brief comments that were coded into 14 main subject-area categories. The most frequently reported responses were family and self (52%); friends and neighbors (21%); use of positive emotional and philosophical strategies (17%), such as sense of humor, determination, and the belief that things would get better; and religious beliefs (11%). The responses of four population subgroups were compared, based on gender, household income, level of psychological distress, and whether a language other than English was spoken at home. Women reported greater use of friends and neighbors and religious or spiritual beliefs for support, whereas men reported greater use of drinking/smoking and financial supports. Those with lower incomes reported greater reliance on positive emotional and philosophical strategies and on religious or spiritual beliefs. Those with high levels of psychological distress reported greater use of leisure interests and hobbies, drinking/smoking, and less use of positive lifestyle strategies, such as adequate sleep, relaxation, or work/life balance. Those who spoke a language other than English at home were less likely to report relying on self or others (family/friends) or positive emotional and philosophical strategies to get through tough times.Understanding strategies and sources of support used by the population to get through adversity is the first step toward identifying the best approaches to build and support strengths and reduce vulnerabilities. It is also possible to reflect on how large-scale threats such as pandemics, disasters, conflict, bereavement, and loss could impact individual and population resilience.",0 +https://doi.org/10.1017/s0033291710002047,Prospective risk factors for new-onset post-traumatic stress disorder in National Guard soldiers deployed to Iraq,"Background National Guard troops are at increased risk for post-traumatic stress disorder (PTSD); however, little is known about risk and resilience in this population. Method The Readiness and Resilience in National Guard Soldiers Study is a prospective, longitudinal investigation of 522 Army National Guard troops deployed to Iraq from March 2006 to July 2007. Participants completed measures of PTSD symptoms and potential risk/protective factors 1 month before deployment. Of these, 81% ( n =424) completed measures of PTSD, deployment stressor exposure and post-deployment outcomes 2–3 months after returning from Iraq. New onset of probable PTSD ‘diagnosis’ was measured by the PTSD Checklist – Military (PCL-M). Independent predictors of new-onset probable PTSD were identified using hierarchical logistic regression analyses. Results At baseline prior to deployment, 3.7% had probable PTSD. Among soldiers without PTSD symptoms at baseline, 13.8% reported post-deployment new-onset probable PTSD. Hierarchical logistic regression adjusted for gender, age, race/ethnicity and military rank showed that reporting more stressors prior to deployment predicted new-onset probable PTSD [odds ratio (OR) 2.20] as did feeling less prepared for deployment (OR 0.58). After accounting for pre-deployment factors, new-onset probable PTSD was predicted by exposure to combat (OR 2.19) and to combat's aftermath (OR 1.62). Reporting more stressful life events after deployment (OR 1.96) was associated with increased odds of new-onset probable PTSD, while post-deployment social support (OR 0.31) was a significant protective factor in the etiology of PTSD. Conclusions Combat exposure may be unavoidable in military service members, but other vulnerability and protective factors also predict PTSD and could be targets for prevention strategies.",0 +https://doi.org/10.1080/13607863.2013.833164,Randomised controlled trial of a cognitive narrative intervention for complicated grief in widowhood,"The implementation of bereavement interventions is frequently requested, and its effectiveness has been controversial. The aim of this study is to evaluate the effectiveness of a cognitive narrative intervention for complicated grief (CG) for controlling post-traumatic and depressive issues.The study is a randomised controlled trial and uses the Socio Demographic Questionnaire (SDQ), the Inventory of Complicated Grief (ICG), the Beck Depression Inventory (BDI) and the Impact of Events Scale-Revised (IES-R). There were three phases in the study: (1) The SDQ and CG evaluations were applied to bereaved elders (n = 82). The bereaved elders with the 40 highest ICG values (≥25) were randomly allocated into two groups: the intervention group (n = 20) and control group (n = 20); (2) participants were evaluated using the BDI and IES-R and the IG gave informed consent to participate in an intervention with four weekly 60-min sessions addressing recall, emotional and cognitive subjectivation, metaphorisation and projecting. (3) Two months later, the ICG, BDI and IES-R assessments were repeated.Outcome measures showed a statistically significant reduction of CG, depressive and traumatic symptoms compared to the controls. Very high effect sizes for the ICG, BDI and IES-R reflect the effectiveness of the intervention along the longitudinal profile.These results reinforce the importance of brief interventions that combine a reduced number of sessions with lower costs, which is reflected in an increased adherence to the programme along with high effectiveness.",0 +https://doi.org/10.1016/j.jpsychires.2012.07.012,"Heterogeneity of posttraumatic stress symptoms in a highly traumatized low income, urban, African American sample","Trauma is associated with a range of outcomes; identification of homogeneous profiles of posttrauma symptoms may inform theory, diagnostic refinement, and intervention. The present investigation applies a novel analytic technique to the identification of homogeneous subgroups of post-traumatic symptomatology in a large sample of African American adults reporting high levels of trauma. Latent profiles of posttraumatic stress disorder (PTSD) symptom severity were tested using latent profile analysis. Pseudo-class draws were used to characterize class differences across types of trauma, diagnostic comorbidities, and clinically-relevant features. Participants consisted of 2915 highly traumatized African Americans living in low income, urban setting and recruited from medical clinics in Atlanta, GA. Findings supported the presence of six distinct subgroups of posttraumatic stress symptom profiles described as resilient, moderate with amnesia, moderate with diminished interest, moderate without diminished interest and amnesia severe without amnesia, and severe overall. Observed subgroups differed across numerous historical and concurrent factors including childhood trauma, current and lifetime diagnoses of PTSD and major depression, lifetime substance use diagnosis, dissociation, depressive symptoms, emotional dysregulation, negative and positive affect, and history of hospitalization and suicidality. Posttraumatic stress disorder as currently defined is comprised of homogeneous subgroups with important differences in posttraumatic stress symptom endorsement as well as concomitant differentiation of associated diagnoses and clinically-relevant associated features.",0 +https://doi.org/10.1002/jclp.22142,Centrality of positive and negative deployment memories predicts posttraumatic growth in danish veterans.,"The purpose of the present study was to examine theoretically motivated predictors for the development of positive changes following potentially traumatic experiences (i.e., posttraumatic growth). Specifically, we wanted to examine the prediction that memories of highly negative and positive deployment events predict subsequent posttraumatic growth.A total of 251 Danish soldiers (7% female, mean age 26.4) deployed to forward operating bases in Afghanistan filled out questionnaires before, during, and after deployment. This allowed us to perform prospective as well as cross-sectional analyses of the data.The main findings were that the centrality of highly emotional memories from deployment predicted growth alongside openness to experience, combat exposure, and social support. Importantly, the centrality of both positive and negative memories predicted growth equally well.The perceived importance of both negative and positive events may play an important part in the development of posttraumatic growth.",0 +https://doi.org/10.1002/jts.21998,Meta-Analysis of Risk Factors for Secondary Traumatic Stress in Therapeutic Work With Trauma Victims,"Revisions to the posttraumatic stress disorder (PTSD) diagnostic criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) clarify that secondary exposure can lead to the development of impairing symptoms requiring treatment. Historically known as secondary traumatic stress (STS), this reaction occurs through repeatedly hearing the details of traumatic events experienced by others. Professionals who work therapeutically with trauma victims may be at particular risk for this exposure. This meta-analysis of 38 published studies examines 17 risk factors for STS among professionals indirectly exposed to trauma through their therapeutic work with trauma victims. Small significant effect sizes were found for trauma caseload volume (r = .16), caseload frequency (r = .12), caseload ratio (r = .19), and having a personal trauma history (r = .19). Small negative effect sizes were found for work support (r = -.17) and social support (r = -.26). Demographic variables appear to be less implicated although more work is needed that examines the role of gender in the context of particular personal traumas. Caseload frequency and personal trauma effect sizes were moderated by year of publication. Future work should examine the measurement of STS and associated impairment, understudied risk factors, and effective interventions.",0 +https://doi.org/10.1023/b:mebr.0000027423.34733.12,Single Photon Emission Computed Tomography (SPECT) in Obsessive–Compulsive Disorder Before and After Treatment with Inositol,"Inositol, a glucose isomer and second messenger precursor, regulates numerous cellular functions and has demonstrated efficacy in obsessive-compulsive disorder (OCD) through mechanisms that remain unclear. The effect of inositol treatment on brain function in OCD has not been studied to date. Fourteen OCD subjects underwent single photon emission computed tomography (SPECT) with Tc-99m HMPAO before and after 12 weeks of treatment with inositol. Whole brain voxel-wise SPM was used to assess differences in perfusion between responders and nonresponders before and after treatment as well as the effect of treatment for the group as a whole. There was 1) deactivation in OCD responders relative to nonresponders following treatment with inositol in the left superior temporal gyrus, middle frontal gyrus and precuneus, and the right paramedian post-central gyrus; 2) no significant regions of deactivation for the group as a whole posttreatment; and 3) a single cluster of higher perfusion in the left medial prefrontal region in responders compared to nonresponders at baseline. Significant reductions in the YBOCS and CGI-severity scores followed treatment. These data are only partly consistent with previous functional imaging work on OCD. They may support the idea that inositol effects a clinical response through alternate neuronal circuitry to the SSRIs and may complement animal work proposing an overlapping but distinct mechanism of action.",0 +https://doi.org/10.1002/da.20767,Considering PTSD for DSM-5,"This is a review of the relevant empirical literature concerning the DSM-IV-TR diagnostic criteria for PTSD. Most of this work has focused on Criteria A1 and A2, the two components of the A (Stressor) Criterion. With regard to A1, the review considers: (a) whether A1 is etiologically or temporally related to the PTSD symptoms; (b) whether it is possible to distinguish ""traumatic"" from ""non-traumatic"" stressors; and (c) whether A1 should be eliminated from DSM-5. Empirical literature regarding the utility of the A2 criterion indicates that there is little support for keeping the A2 criterion in DSM-5. The B (reexperiencing), C (avoidance/numbing) and D (hyperarousal) criteria are also reviewed. Confirmatory factor analyses suggest that the latent structure of PTSD appears to consist of four distinct symptom clusters rather than the three-cluster structure found in DSM-IV. It has also been shown that in addition to the fear-based symptoms emphasized in DSM-IV, traumatic exposure is also followed by dysphoric, anhedonic symptoms, aggressive/externalizing symptoms, guilt/shame symptoms, dissociative symptoms, and negative appraisals about oneself and the world. A new set of diagnostic criteria is proposed for DSM-5 that: (a) attempts to sharpen the A1 criterion; (b) eliminates the A2 criterion; (c) proposes four rather than three symptom clusters; and (d) expands the scope of the B-E criteria beyond a fear-based context. The final sections of this review consider: (a) partial/subsyndromal PTSD; (b) disorders of extreme stress not otherwise specified (DESNOS)/complex PTSD; (c) cross- cultural factors; (d) developmental factors; and (e) subtypes of PTSD.",0 +https://doi.org/10.1152/ajpheart.00857.2003,Senescence alters blood flow responses to acute heat stress,"Renal and splanchnic sympathetic nerve discharge (SND) responses to heating are significantly reduced in senescent compared with young Fischer-344 (F344) rats (Kenney MJ and Fels RJ. Am J Physiol Regul Integr Comp Physiol 283: R513–R520, 2002). However, the functional significance of this finding is not known. We tested the hypothesis that blood flow distribution profiles to heating are altered in senescent (24 mo old) compared with mature (12 mo old) and young (3 mo old) F344 rats. Visceral organ, skeletal muscle, and tail blood flows were determined with the radionuclide-tagged microsphere technique before (control, 38°C) and during heating that increased body temperature to 41°C in anesthetized F344 rats. Vascular conductance in the kidney, stomach, large intestine, pancreas, spleen, and tail was significantly reduced during control before heating in senescent compared with young F344 rats. Heating significantly decreased kidney, stomach, small and large intestine, and pancreas vascular conductance in young and mature but not senescent F344 rats. Vascular conductance at 41°C in the kidney and small intestine was significantly lower and in the stomach tended to be lower in young compared with senescent rats. Splenic conductance increased during heating in young and senescent rats but was highest in young rats. Tail conductance during heating was significantly increased in young rats but remained unchanged in mature and senescent rats. These results demonstrate a marked attenuation in heating-induced vascular conductance changes in senescent rats, suggesting an important functional consequence for the attenuated SND responses to heating in aged rats.",0 +https://doi.org/10.4102/sajpsychiatry.v21i1.641,Medical students’ experience and perceptions of their final rotation in psychiatry,"<p><strong>Background.</strong> Evaluation of specific courses, rotations or attachments in medical education is common practice.<strong> </strong></p><p><strong>Objective.</strong> To evaluate medical students’ perceptions of their final psychiatry rotation of 7 weeks. </p><p><strong>Methods.</strong> A questionnaire was developed for medical students to give feedback on their psychiatry rotation at Weskoppies Hospital in Tshwane, South Africa. Four scores were developed: (<em>i</em>) a clinical exposure score for psychiatric conditions encountered during the rotation; (<em>ii</em>) an ethics exposure score comprising confidentiality and informed consent; (<em>iii</em>) an admissions exposure score for different admission options; and (<em>iv</em>) a perception score related to students’ experience of the rotation. The evaluation took place over a period of 4 years, between 2006 and 2009.</p><p><strong>Results.</strong> Over the study period, 87% of 708 students completed the questionnaire. The higher number of female respondents (63%) was in accordance with the general student profile. The four resulting scores were: clinical exposure 67%; ethics exposure 78%; admissions exposure 86%; and perceptions 75%. The main strengths of the rotation were identified as the positive learning environment, exposure to patients, discussions and ward conferences, and approaches followed.</p><p><strong>Conclusions. </strong>The conceptualisation of the tool to elicit specific scores was useful for presenting the findings. The student feedback provided valuable information for the psychiatry curriculum planners and teachers, and led to further adaptations to the structure of the rotations and the learning opportunities provided.</p>",0 +https://doi.org/10.1002/jts.21952,Social Anxiety Disorder Is Associated With PTSD Symptom Presentation: An Exploratory Study Within A Nationally Representative Sample,"Posttraumatic stress disorder (PTSD) and social anxiety disorder (SAD) demonstrate a high degree of comorbidity (ranging from 14.8% to 46.0%); however, little is known about the nature of this association. Contemporary research has largely focused on treatment-seeking or veteran samples, and may not generalize to the population as a whole. Large-scale epidemiological studies are needed to fill existing gaps in the literature and to clarify this association for the general population. The current study examined whether the presence of comorbid SAD influenced PTSD symptom presentation. The rate of individual PTSD symptoms was investigated among individuals with PTSD and SAD in comparison to those with PTSD alone. Data were obtained from Wave 2 of the National Epidemiological Survey of Alcohol and Related Conditions, a large, nationally representative survey of American adults (n = 34,653). Analyses revealed elevated rates of PTSD symptoms among those with comorbid PTSD and SAD across all symptom clusters, with significant odds ratios ranging from 1.5 to 4.87. Adjusting for depression and other Axis I disorders did not substantially alter study findings. Results suggest that the presence of SAD is associated with differences in the expression of PTSD symptoms.",0 +https://doi.org/10.1016/j.pain.2013.05.005,Patients with chronic whiplash can be subgrouped on the basis of symptoms of sensory hypersensitivity and posttraumatic stress,"The lack of efficacy of rehabilitative approaches to the management of chronic whiplash-associated disorders (WAD) may be in part due to heterogeneity of the clinical presentation of this patient population. The aim of this study was to identify homogeneous subgroups of patients with chronic WAD on the basis of symptoms of PTSD and sensory hypersensitivity and to compare the clinical presentation of these subgroups. Successive k-means cluster analyses using 2, 3 and 4 cluster solutions were performed by using data for 331 (221 female) patients with chronic (>3 months) WAD. The 4 cluster solution was identified as the most clinically relevant, yielding 4 distinct clusters: no to mild posttraumatic stress symptoms and no sensory hypersensitivity (nPnH), no to mild posttraumatic stress symptoms and sensory hypersensitivity (nPH), moderate to severe posttraumatic stress and no sensory hypersensitivity (PnH) and moderate to severe posttraumatic stress and sensory hypersensitivity (PH). The nPnH cluster was the largest cluster, comprising 43.5% of the sample. The PH cluster had significantly worse disability, pain intensity, self-reported mental health status and cervical range of motion in comparison to the nPnH and nPH clusters. These data provide further evidence of the heterogeneity of the chronic WAD population and the association of a more complex clinical presentation with higher disability and pain in this patient group.",0 +https://doi.org/10.1177/1529100610387086,Weighing the Costs of Disaster,"Disasters typically strike quickly and cause great harm. Unfortunately, because of the spontaneous and chaotic nature of disasters, the psychological consequences have proved exceedingly difficult to assess. Published reports have often overestimated a disaster's psychological cost to survivors, suggesting, for example, that many if not most survivors will develop posttraumatic stress disorder (PTSD); at the same time, these reports have underestimated the scope of the disaster's broader impact in other domains. We argue that such ambiguities can be attributed to methodological limitations. When we focus on only the most scientifically sound research--studies that use prospective designs or include multivariate analyses of predictor and outcome measures--relatively clear conclusions about the psychological parameters of disasters emerge. We summarize the major aspects of these conclusions in five key points and close with a brief review of possible implications these points suggest for disaster intervention. 1. Disasters cause serious psychological harm in a minority of exposed individuals. People exposed to disaster show myriad psychological problems, including PTSD, grief, depression, anxiety, stress-related health costs, substance abuse, and suicidal ideation. However, severe levels of these problems are typically observed only in a relatively small minority of exposed individuals. In adults, the proportion rarely exceeds 30% of most samples, and in the vast majority of methodologically sound studies, the level is usually considerably lower. Among youth, elevated symptoms are common in the first few months following a high-impact disaster, but again, chronic symptom elevations rarely exceed 30% of the youth sampled. 2. Disasters produce multiple patterns of outcome, including psychological resilience. In addition to chronic dysfunction, other patterns of disaster outcome are typically observed. Some survivors recover their psychological equilibrium within a period ranging from several months to 1 or 2 years. A sizeable proportion, often more than half of those exposed, experience only transient distress and maintain a stable trajectory of healthy functioning or resilience. Resilient outcomes have been evidenced across different methodologies, including recent studies that identified patterns of outcome using relatively sophisticated data analytic approaches, such as latent growth mixture modeling. 3. Disaster outcome depends on a combination of risk and resilience factors. As is true for most highly aversive events, individual differences in disaster outcomes are informed by a number of unique risk and resilience factors, including variables related to the context in which the disaster occurs, variables related to proximal exposure during the disaster, and variables related to distal exposure in the disaster's aftermath. Multivariate studies indicate that there is no one single dominant predictor of disaster outcomes. Rather, as with traumatic life events more generally, most predictor variables exert small to moderate effects, and it is the combination or additive total of risk and resilience factors that informs disaster outcomes. 4. Disasters put families, neighborhoods, and communities at risk. Although methodologically complex research on this facet of disasters' impact is limited, the available literature suggests that disasters meaningfully influence relationships within and across broad social units. Survivors often receive immediate support from their families, relatives, and friends, and for this reason many survivors subsequently claim that the experience brought them closer together. On the whole, however, the empirical evidence suggests a mixed pattern of findings. There is evidence that social relationships can improve after disasters, especially within the immediate family. However, the bulk of evidence indicates that the stress of disasters can erode both interpersonal relationships and sense of community. Regardless of how they are affected, postdisaster social relations are important predictors of coping success and resilience. 5. The remote effects of a disaster in unexposed populations are generally limited and transient. Increased incidence of extreme distress and pathology are often reported in remote regions hundreds if not thousands of miles from a disaster's geographic locale. Careful review of these studies indicates, however, that people in regions remote to a disaster may experience transient distress, but increased incidence of psychopathology is likely only among populations with preexisting vulnerabilities (e.g., prior trauma or psychiatric illness) or actual remote exposure (e.g., loss of a loved one in the disaster). Finally, we review the implications for intervention. There is considerable interest in prophylactic psychological interventions, such as critical incident stress debriefing (CISD), that can be applied globally to all exposed survivors in the immediate aftermath of disaster. Multiple studies have shown, however, that CISD is not only ineffective but in some cases can actually be psychologically harmful. Other less invasive and more practical forms of immediate intervention have been developed for use with both children and adults. Although promising, controlled evaluations of these less invasive interventions are not yet available. The available research suggests that psychological interventions are more likely to be effective during the short- and long-term recovery periods (1 month to several years postdisaster), especially when used in combination with some form of screening for at-risk individuals. Such interventions should also target the maintenance and enhancement of tangible, informational, and social-emotional support resources throughout the affected community. Language: en",0 +https://doi.org/10.1111/j.0963-7214.2004.00300.x,Who Develops Posttraumatic Stress Disorder?,"Nearly half of U.S. adults experience at least one traumatic event in their lifetimes, yet only 10% of women and 5% of men develop posttraumatic stress disorder (PTSD). Why this is so is among the most central questions in current PTSD research. This article reviews the current status of knowledge about who develops PTSD, discussing the strengths and weaknesses of the evidence. We describe the major models used to understand responses to traumatic events, as well as future research directions. We also propose that an exclusive focus on individual differences and individual intervention overlooks opportunities to reduce the prevalence of PTSD by modifying factors at the neighborhood, community, or national level.",0 +https://doi.org/10.1037/1040-3590.7.1.66,Psychological assessment of aviators captured in World War II.,"Psychological assessments, including administration of the Minnesota Multiphasic Personality Inventory (MMPI) and structured interviews for Axis I mental disorders and posttraumatic stress disorder (PTSD) specifically, were used to describe 33 World War II (WWII) aviators who were held as prisoners of war (POWs) for an average of 14 months. Results showed more elevated MMPI profile patterns than expected given previous research with pilots (Butcher, 1994) and rates of current and lifetime PTSD at 33%, reasoned to derive from POW trauma. Despite this level of psychopathology, WWII aviator POW survivors were found to be more resilient to captivity effects than age-similar nonaviator WWII POW survivors characterized generally by less advantages in education, military rank, and other personal resources. Compared with aviator former POWs of the Vietnam War studied in their mid-life years (Ursano, Boydstun, & Wheatley, 1981), the present sample appeared to be less psychologically robust. Studies of former prisoners of war (POWs) have revealed that war captivity is associated with increased vulnerability to physical and psychological illnesses. Yet, some POW survivors do not exhibit psychological distress or mental disorders following trauma cessation (Kluznik, Speed, Van Valkenburg, & Magraw, 1986; Sutker, Allain, & Winstead, 1993; Ursano, Boydstun, & Wheatley, 1981). Of interest are studies of American servicemen, primarily aviators, held as prisoners in North Vietnam for periods extending up to 7 or 8 years. The Ursano et al. (1981) follow-up of 253 former POW aviators revealed that, in addition to the potent impact of stressor severity, such characteristics as rank at shoot down, college education, and status as pilots and navigators were associated with lessened risk for psychiatric morbidity, although 25% of these men were labeled with mental disorders. Ursano et al. (1981) described aviators as a well-educated, intelligent military subset, homogeneous in achievement needs and potentially resistant to mental disorders. Butcher (1994) published Minnesota Multiphasic Personality Inventory (MMPI) and MMPI-2 profile patterns of applicants for flight crew positions with a major airline. Results showed that airline pilots, many of whom had served military duty, minimized problems on psychological tests and presented themselves as psychologically robust. These studies shed light on the resilience of pilots generally and survivors of Vietnam POW captivity specifically, but little attention has been directed toward study of",0 +https://doi.org/10.1002/jts.20200,"Conduct disorder, war zone stress, and war-related posttraumatic stress disorder symptoms in American Indian Vietnam veterans",This study examined whether conduct disorder (CD) was associated with war zone stress and war-related post-traumatic stress disorder (PTSD) symptoms in American Indian (AI) Vietnam veterans. Cross-sectional lay-interview data was analyzed for 591 male participants from the American Indian Vietnam Veterans Project. Logistic regression evaluated the association of CD with odds of high war zone stress and linear regression evaluated the association of CD and PTSD symptom severity. Childhood CD was not associated with increased odds of high war zone stress. Conduct disorder was associated with elevated war-related PTSD symptoms among male AI Vietnam Veterans independent of war zone stress level and other mediators. Future efforts should examine reasons for this association and if the association exists in other AI populations.,0 +https://doi.org/10.1097/01.jtn.0000292119.73023.c2,Gender Comparison of Exposed Trauma and Posttraumatic Stress Disorder in a Community Sample of Adolescents,"This study surveys the prevalence of exposed traumatic events and posttraumatic stress disorder among the high school students. A total of 735 students were selected by stratified cluster sampling. The self-report trauma checklists and Mississippi Scale were used. The most common traumatic experiences were ""witnessing or being in a bad car accident,"" ""getting some really bad news unexpectedly,"" and witnessing violence. The last 2 experiences were more common among girls. The rate of the subjects who scored more than the cutoff point in the Mississippi Scale was 27.2%. There is an extremely high rate of exposed trauma rate, and approximately one third of them have posttraumatic stress disorder symptoms.",0 +https://doi.org/10.1001/archgenpsychiatry.2010.116,Pilot Study of Psilocybin Treatment for Anxiety in Patients With Advanced-Stage Cancer,"Researchers conducted extensive investigations of hallucinogens in the 1950s and 1960s. By the early 1970s, however, political and cultural pressures forced the cessation of all projects. This investigation reexamines a potentially promising clinical application of hallucinogens in the treatment of anxiety reactive to advanced-stage cancer.To explore the safety and efficacy of psilocybin in patients with advanced-stage cancer and reactive anxiety.A double-blind, placebo-controlled study of patients with advanced-stage cancer and anxiety, with subjects acting as their own control, using a moderate dose (0.2 mg/kg) of psilocybin.A clinical research unit within a large public sector academic medical center.Twelve adults with advanced-stage cancer and anxiety.In addition to monitoring safety and subjective experience before and during experimental treatment sessions, follow-up data including results from the Beck Depression Inventory, Profile of Mood States, and State-Trait Anxiety Inventory were collected unblinded for 6 months after treatment.Safe physiological and psychological responses were documented during treatment sessions. There were no clinically significant adverse events with psilocybin. The State-Trait Anxiety Inventory trait anxiety subscale demonstrated a significant reduction in anxiety at 1 and 3 months after treatment. The Beck Depression Inventory revealed an improvement of mood that reached significance at 6 months; the Profile of Mood States identified mood improvement after treatment with psilocybin that approached but did not reach significance.This study established the feasibility and safety of administering moderate doses of psilocybin to patients with advanced-stage cancer and anxiety. Some of the data revealed a positive trend toward improved mood and anxiety. These results support the need for more research in this long-neglected field.clinicaltrials.gov Identifier: NCT00302744.",0 +https://doi.org/10.1016/j.injury.2014.08.028,Quality of life two years after severe trauma: A single centre evaluation,"Trauma related injuries are a main cause for long-lasting morbidity and disability especially in younger patients with their productive years ahead. On a routine basis, we assessed health related quality of life two years after trauma of severely injured patients at our level-I trauma centre via posted survey.The posted survey included (1) POLO-Chart questionnaire with European Quality of Life (EuroQoL), Short Form Health Survey-36 (SF 36) and the recently developed and validated Trauma Outcome Profile (TOP) combined with (2) single centre data according to TraumaRegister DGU(®) data sets including trauma mechanism, injuries and initial treatment. Inclusion criteria were severely injured patients ≥ 18 years, treated between 2008 and 2010. Exclusion criteria were death, cognitive impairment, lack of German language and denial of participation.129 datasets were eligible for analysis reflecting a typical trauma collective with mean age 44 years, predominantly male (67%), mean ISS 22 and 98% blunt trauma. Two years after trauma, 62% of the patients reported of relevant remaining pain and 64% of severe functional deficit in at least one body region. Sixty-four percent of the patients suffered from decreased overall quality of life (EuroQoL≤0.8). Additionally, all domains of SF-36 were impaired compared to an age and gender adjusted cohort of healthy individuals, especially domains of pain and activity of daily living. These impairments were associated with decreased 'social functioning' and 'emotional role functioning'. TOP results confirmed these findings: Quality of life was decreased in almost every dimension. TOP additionally identified sequels especially in domains of ""Mental Functioning"" and impairments in psychological recovery including post-traumatic stress disorder, depression and anxiety. Socioeconomic impairments were frequent including further hospitalisations (62%), duration of inability to work ≥ 6 month (54%), financial disadvantages (45%) and work loss (26%).Our results demonstrate that multiple trauma patients two years after injury suffer from impairments including persisting pain, functional deficits, mental and socioeconomic deficits. The 'Trauma Outcome Profile' instrument seems a proper tool to discover impairments in trauma patients early on and guide proper rehabilitation resources to the best of the patient.",0 +https://doi.org/10.1177/1077801213517515,Mental Health Effects of Intimate Terrorism and Situational Couple Violence Among Black and Hispanic Women,"An important aspect of Johnson’s intimate terrorism (IT) and situational couple violence (SCV) typology is his assertion that victims experience different negative outcomes depending on which category of violence they endure. Anderson calls for reexamining this typology to highlight the importance of coercive control with or without physical violence present. Similar to most studies, Anderson’s research uses a sample that includes mostly White women. The current study employs Anderson’s methods and ordinary least squares (OLS) regression analyses, but uses a sample of predominately Black women and Latinas from the 1998 Chicago Women’s Health Risk Study.",0 +https://doi.org/10.1016/j.beth.2006.04.003,Internalizing and Externalizing Subtypes in Female Sexual Assault Survivors: Implications for the Understanding of Complex PTSD,"This study replicated and extended findings of internalizing and externalizing subtypes of posttraumatic psychopathology (Miller, M. W., Greif, J. L., & Smith, A. A. (2003). Multidimensional Personality Questionnaire profiles of veterans with traumatic combat exposure: Internalizing and externalizing subtypes. Psychological Assessment , 15, 205–215; Miller, M. W., Kaloupek, D. G., Dillon, A. L., & Keane, T.M. (2004). Externalizing and internalizing subtypes of combat-related PTSD: A replication and extension using the PSY-5 Scales. Journal of Abnormal Psychology, 113, 636–645) to a female sample of rape survivors with chronic PTSD. Cluster analyses of Schedule for Nonadaptive and Adaptive Personality (Clark, L. A. (1996). SNAP—Schedule for Nonadaptive and Adaptive Personality: Manual for administration, scoring, and interpretation . Minneapolis: University of Minnesota Press.) temperament scale profiles from 143 women with PTSD partitioned the sample into a simple PTSD cluster, defined by normal range personality scores and moderate symptomatology, and 2 more “complex” clusters distinguished by more severe tendencies towards externalizing or internalizing psychopathology. Externalizers were characterized by disinhibition, substance dependence, and Cluster B personality disorder features; internalizers by low positive temperament, high rates of major depressive disorder, and elevations on measures of schizoid and avoidant personality disorder.",0 +https://doi.org/10.1111/j.2044-8260.1994.tb01095.x,Post-traumatic stress disorder without the trauma,"Examples are reported of PTSD cases showing full symptomatology (intrusive imagery, avoidance behaviour, disordered arousal) in the absence of a single, acute, dramatic trauma of the kind required by the current DSM-III-R definition. Such trauma is thus not a necessary condition for PTSD, and other evidence shows it to be not a sufficient condition. It is suggested that the DSM-III-R Axis IV distinction between acute and enduring psychosocial stressors be incorporated into the definition to distinguish two pathways to stress disorder, post-traumatic (PTSD) and prolonged duress (PDSD). Differential treatment implications of the two routes are noted.",0 +https://doi.org/10.3928/01477447-20070201-16,Traumatic Below-elbow Amputations,"Prehension, intelligence, and erect posture distinguish humans from lower animals. Hands are instrumental for our survival and welfare. We use our hands when we work, recreate, and communicate. A handshake, a touch, a sign, or signal has significant social and communicative meanings. Hands play a major role in defining the skill level of our activities and our level of social expression and integration. Indeed, refined psychomotor precision of hand function may distinguish some individuals among us, gifting society with its more skilled craftsmen, surgeons, artisans, musicians, athletes, and the like in a highly digital world. For others, their hands are critical in providing and caring for their families. Injury severity scores may identify the majority of patients that require amputation; however, injury severity scoring system predictions in individual patients may be problematic and should be used with caution. Amputees require comprehensive multidisciplinary treatment and compassion so that they can successfully overcome their losses. Ultimately, the patients must change, adjust, and adapt to successfully reintegrate themselves into their families, peer groups, job settings, and society as a whole. Early amputation may decrease the incidence and severity of phantom pain compared to amputation after the failure of reconstruction. Early prosthetic fitting, training, and physical rehabilitation; early psychological and sociological support; and early return to work facilitate successful functional recovery. Psychological recovery may be a more arduous and extended process than physical recovery. We must teach our amputees from the outset to use their losses as an incentive for success, assist them to regain their quality of life, and encourage them to act as role models for and to educate others.",0 +https://doi.org/10.1097/nmd.0b013e3182532312,Posttraumatic Stress Disorder Associated With Combat Service in Iraq or Afghanistan,"Studies of posttraumatic stress disorder (PTSD) prevalence associated with deployment to Iraq or Afghanistan report wide variability, making interpretation and projection for research and public health purposes difficult. This article placed this literature within a military context. Studies were categorized according to deployment time-frame, screening case definition, and study group (operational infantry units exposed to direct combat versus population samples with a high proportion of support personnel). Precision weighted averages were calculated using a fixed-effects meta-analysis. Using a specific case definition, the weighted postdeployment PTSD prevalence was 5.5% (95% CI, 5.4-5.6) in population samples and 13.2% (12.8-13.7) in operational infantry units. Both population-level and unit-specific studies provided valuable and unique information for public health purposes; understanding the military context is essential for interpreting prevalence studies.",0 +https://doi.org/10.1016/j.drugalcdep.2014.04.014,Regular drinking may strengthen the beneficial influence of social support on depression: Findings from a representative Israeli sample during a period of war and terrorism,"Social support is consistently associated with reduced risk of depression. Few studies have investigated how this relationship may be modified by alcohol use, the effects of which may be particularly relevant in traumatized populations in which rates of alcohol use are known to be high.In 2008 a representative sample of 1622 Jewish and Palestinian citizens in Israel were interviewed by phone at two time points during a period of ongoing terrorism and war threat. Two multivariable mixed effects regression models were estimated to measure the longitudinal association of social support from family and friends on depression symptoms. Three-way interaction terms between social support, alcohol use and time were entered into the models to test for effect modification.Findings indicated that increased family social support was associated with less depression symptomatology (p=<.01); this relationship was modified by alcohol use and time (p=<.01). Social support from friends was also associated with fewer depression symptoms (p=<.01) and this relationship was modified by alcohol use and time as well (p=<.01). Stratified analyses in both models revealed that the effect of social support was stronger for those who drank alcohol regularly than those who did not drink or drank rarely.These findings suggest that social support is a more important protective factor for depression among regular drinkers than among those who do not drink or drink rarely in the context of political violence. Additional research is warranted to determine whether these findings are stable in other populations and settings.",0 +https://doi.org/10.1111/j.1600-0447.1995.tb05923.x,Reversible and selective inhibitors of monoamine oxidase A in mental and other disorders,"The clinically tested reversiblc inhibitors of monoamine oxidase A (RIMAs) include brofaromine, moclobemide and toloxatone. Moclobemide has shown unequivocal antidepressant activity against serious deprcssivc illness in 4 placebo-controlled double-blind trials. It has been compared with amitriptyline, imipramine, clomipramine, desipramine, maprotiline, fluoxetine, fluvoxamine, tranylcypromine. toloxatone, mianserin and amineptine in the treatment of depressive disorders. Meta-analysis showed convincing evidence of moclobemide efficacy, comparable with the most potent antidepressants available. The efficacy of moclobemide has been demonstrated in psychotic and non-psychotic depression, in depression with and without melancholia, in endogenous depression (both unipolar and bipolar), in retarded depression and in agitated depression. The efficacy of moelobemide, allied to the unusually benign side effect profile, has led to exploration of its use in other disorders. Two small studies have given encouraging results in the treatment of attention-deficit hyperactivity disorder. Large placebo-controlled studies have shown the activity of moclobemide in the depression that accompanies dementia (such as senile dementia of Alzheimer type). The results also suggested that, in this patient population, cognitive ability improved in parallel. Social phobia has also been shown to improve on treatment with either moclobemide or brofaromine. Clinical trials are in progress on the effect of moclobemide in chronic fatigue syndrome. Moreover, there are encouraging results with the use of brofaromine and moclobemide in panic disorder. Other disorders in which treatment with RIMA is of interest include agoraphobia, bulimia, borderline personality disorder, post-traumatic stress disorder, compulsive hair pulling (trichotillomania), dysmorphophobia, kleptomania as well as various anxiety syndromes.",0 +https://doi.org/10.1016/j.childyouth.2016.01.006,The interrelationships between trauma and internalizing symptom trajectories among adolescents in foster care,"Abstract This study examined the interrelationships between changes in trauma and internalizing symptoms among adolescents in foster care. Using three waves of data from the National Survey of Child and Adolescent Well-Being, growth-curve analyses were conducted with a sample of 155 adolescents aged 11–15 in out-of-home care. Findings indicated that the initial level of post-traumatic stress symptoms was significantly associated with the initial level of internalizing symptoms at Wave I and decreases in post-traumatic stress symptoms were significantly associated with decreases in internalizing symptoms from Wave I to Wave IV. Viewing trauma and internalizing symptoms as interrelated affords increased understanding of ways in which adolescents who have experienced high levels of stress express their needs. As such, it may be clinically beneficial to conduct an evaluation of trauma symptoms for adolescents in foster care, regardless of whether there has been a documented history of a traumatic event. Doing so may provide a more comprehensive view into the underlying influences of adolescent behaviors and help capture a broader clinical picture necessary for effective intervention.",0 +https://doi.org/10.1023/a:1007777032063,Psychometric evaluation of Horowitz's impact of event scale: A review,"Despite being developed before the formal introduction of posttraumatic stress disorder (PTSD) within the diagnostic literature, the Impact of Event Scale (Horowitz, Wilner, & Alvarez, 1979) remains one of the most widely used self-report measures of posttraumatic stress. This paper presents an overview of research using the IES in an attempt to assess its psychometric status. It is concluded that the psychometric properties of the IES are satisfactory (although not as a PTSD diagnostic measure) and that continued use of the IES as a measure of intrusive and avoidant processes is warranted.",0 +https://doi.org/10.1016/j.comppsych.2011.04.043,Social reactions as a predictor of PTSD symptom trajectories following sexual assault,"Introduction: Most research on the psychological impact of sexual assault has been cross-sectional. Using a longitudinal design, we examined the course of PTSD in a group of recent rape survivors. We found 4 distinct PTSD symptom trajectories that we labeled resilience, recovery, moderate chronicity, and high chronicity (Steenkamp et al, 2010). Studies have shown that negative social reactions to assault disclosure correlate with greater PTSD symptom severity (Borja, 2006; Ullman & Filipas, 2001) and can deter victims from seeking help (Ahrens, 2006). However, the extent to which social reactions to rape predict different symptom courses is unknown. Method: Sixty-nine sexual assault survivors completed online questionnaires monthly for the first 4 months following the assault. The Social Reactions Questionnaire (SRQ) assesses 7 types of positive and negative reactions to sexual assault disclosure (emotional support, treat differently, distraction, take control, informational support, victim blame, and egocentric; Ullman, 2000). PTSD symptom severity was assessed using the PTSD Checklist (PCL-C, Weathers et al, 1993). Results: An analysis of variance indicated that the moderate chronic group reported significantly more negative reactions than both the recovery (P = .008) and resilience (P = .04) groups. Specifically, negative reactions where the person treated the survivor differently or took control of the situation distinguished between the moderate chronic and the recovery/resilience groups. Blaming the victim or making the situation about the person instead of the survivor distinguished between the moderate chronic and the resilience groups. Discussion: Consistent with previous studies, negative social reactions to assault disclosure were associated with greater PTSD symptom severity. However, this is the first study demonstrating that social reactions after sexual assault predict distinct PTSD trajectories, with negative reactions predicting a chronic PTSD symptom course. This suggests that reactions of mental health providers, friends, and family may affect PTSD symptom trajectories in survivors and has implications for improving social reactions to sexual assault disclosure. Public Health Significance: In addition to interventions directly targeting survivors' distress and PTSD symptoms after sexual assault, it may be helpful to educate others on the impact of negative social reactions after sexual assault disclosure.",0 +https://doi.org/10.1007/s11055-008-0008-0,Post-traumatic stress disorder in different types of stress (clinical features and treatment),"Two types of stress situation were compared: involvement in combat actions and working in the post-Chernobyl atomic energy station clean-up. A total of 30 subjects involved in combat actions (combatants) and 33 clean-up workers were observed for 5-6 years and 15-17 years after involvement in stress situations. Mean ages in the two groups were 27.0 +/- 2.8 and 43.7 +/- 4.5 years respectively. Clinical features were analyzed in terms of the major criteria of post-traumatic stress disorder (PTSD)--""immersion"" in the experience, ""avoidance,"" ""hyperexcitability,"" and ""social functioning."" There were both common features in the two groups of subjects as well as individual characteristics dependent on the nature of the stress. Patients were treated with Coaxil at a dose of 37.5 mg/day for four weeks. In both groups of patients, Coaxil had the most favorable effects on immersion and hyperexcitability, which improved social adaptation. The ""avoidance"" symptom was more resistant. These studies lead to the conclusion that Coaxil is an effective agent for the treatment of different types of PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0 +,Clinical sleep disorder profiles in a large sample of trauma survivors: An interdisciplinary view of posttraumatic sleep disturbance,"Study Objectives: To examine the relationship between psychiatric symptoms and self-reported sleep, sleepiness, and nightmare complaints in a convenience sample of 437 trauma survivors. Method: Based on symptom severity reports, individuals were classified as having psychophysiological insomnia (PPI), chronic nightmare disorder (CND), and sleep-disordered breathing (SDB) profiles. Individuals with each symptom profile were compared to individuals without the respective profile on sleep indices, sleepiness-related impairment, and psychiatric distress (anxiety, depression, posttraumatic stress symptoms). Results: Individuals with PPI (76%), CND (79%), SDB (68%), or all three profiles (46%) had significantly worse sleep onset latency, sleep efficiency, total sleep time, sleep-related functional impairment, and psychiatric distress compared to those without each disorder profile. Conclusions: The majority of trauma survivors in this sample suffered from sleep complaints sufficiently severe to warrant independent clinical attention by sleep medicine specialists. Longitudinal studies are necessary to determine whether these disturbances are caused exclusively by PTSD or another sleep disorder comorbid with PTSD.",0 +https://doi.org/10.1097/nmd.0b013e318229cfba,"Effects of Chronic Posttraumatic Stress Disorder on Metabolic Risk, Quality of Life, and Stress Hormones in Aging Former Refugee Children","It is still unclear whether the association between traumatic stress and physical disease is mediated by posttraumatic stress disorder (PTSD). Therefore, we examined the long-term consequences of PTSD on cardiovascular risk, stress hormones, and quality of life in a sample of former refugee children who were severely traumatized more than six decades ago. In 25 subjects with chronic PTSD and 25 trauma-controlled subjects, we measured the variables of metabolic syndrome supplemented by the ankle-brachial index and highly sensitive C-reactive protein. Quality of life was assessed using the 36-item Short-Form Health Survey. Cortisol, adrenocorticotropin-releasing hormone (ACTH), and dehydroepiandrosterone (DHEA) were measured using the low-dose-dexamethasone suppression test. In addition, salivary cortisol was assessed at 8:00 a.m., 12:00 p.m., 4:00 p.m., and 8:00 p.m. We found a significant group effect between participants with and without PTSD regarding quality of life but not in any metabolic parameter including the ankle-brachial index or cortisol, ACTH, and DHEA in plasma before and after dexamethasone or salivary cortisol. The postulated association between traumatic stress and physical illness does not appear to be mediated by PTSD in this population. Nevertheless, the search for subgroups of PTSD patients with childhood traumatization leading to different metabolic and endocrine long-term consequences in aging PTSD patients is needed.",0 +https://doi.org/10.1016/j.beth.2014.07.005,Differential Predictors of Transient Stress Versus Posttraumatic Stress Disorder: Evaluating Risk Following Targeted Mass Violence,"Schools have become a common incident site for targeted mass violence, including mass shootings. Although exposure to mass violence can result in significant distress, most individuals are able to fully recover over time, while a minority develop more pervasive pathology, such as PTSD. The present study investigated how several pre- and posttrauma factors predict posttraumatic stress symptoms (PTSS) in both the acute and distal aftermath of a campus mass shooting using a sample with known levels of pretrauma functioning (N=573). Although the largest proportion of participants evidenced resilience following exposure to the event (46.1%), many reported high rates of PTSS shortly after the shooting (42.1%) and a smaller proportion (11.9%) met criteria for probable PTSD both in the acute and more distal aftermath of the event. While several preshooting factors predicted heightened PTSS after the shooting, prior trauma exposure was the only preshooting variable shown to significantly differentiate between those who experienced transient versus prolonged distress. Among postshooting predictors, individuals reporting greater emotion dysregulation and peritraumatic dissociative experiences were over four times more likely to have elevated PTSS 8months postshooting compared with those reporting less dysregulation and dissociative experiences. Individuals with less exposure to the shooting, fewer prior traumatic experiences, and greater satisfaction with social support were more likely to recover from acute distress. Overall, results suggest that, while pretrauma factors may differentiate between those who are resilient in the aftermath of a mass shooting and those who experience heightened distress, several event-level and posttrauma coping factors help distinguish between those who eventually recover and those whose PTSD symptoms persist over time.",0 +https://doi.org/10.1155/2014/256584,Lifetime Prevalence of Psychiatric Disorders among Parents of Children with Bipolar I Disorder: Parental Difference,"Background . Evaluation of family system is an important area in the context of child and adolescent mental health. This study aimed to estimate psychiatric disorders in parents of children and adolescents with bipolar I disorder (BID). Methods and Materials . In this cross-sectional study, during 2012-2013, all of the children and adolescents diagnosed with BID based on Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version were included. All of the parents (both mother and father) were evaluated by Structured Clinical Interview for DSM-IV-TR . Statistical Analysis . Prevalence rates are reported and independent-sample t -test and chi-square test were used when appropriate. Results . A total of 108 families were interviewed. 25% of mothers and 33% of fathers met the criteria for at least one psychiatric disorder, with major depressive disorder, BMD, and cluster B personality disorder being more prevalent. Fathers were more likely to receive a dual psychiatric diagnosis. Cluster B personality disorder and substance dependence were more prevalent among fathers while major depressive disorder was more prevalent among mothers. Conclusion . This study confirmed a higher prevalence of psychiatric disorders in parents of children with BID and emphasizes parental evolution.",0 +https://doi.org/10.1038/mp.2013.183,"Internalizing disorders and leukocyte telomere erosion: a prospective study of depression, generalized anxiety disorder and post-traumatic stress disorder","There is evidence that persistent psychiatric disorders lead to age-related disease and premature mortality. Telomere length has emerged as a promising biomarker in studies that test the hypothesis that internalizing psychiatric disorders are associated with accumulating cellular damage. We tested the association between the persistence of internalizing disorders (depression, generalized anxiety disorder and post-traumatic stress disorder) and leukocyte telomere length (LTL) in the prospective longitudinal Dunedin Study (n=1037). Analyses showed that the persistence of internalizing disorders across repeated assessments from ages 11 to 38 years predicted shorter LTL at age 38 years in a dose-response manner, specifically in men (β=-0.137, 95% confidence interval (CI): -0.232, -0.042, P=0.005). This association was not accounted for by alternative explanatory factors, including childhood maltreatment, tobacco smoking, substance dependence, psychiatric medication use, poor physical health or low socioeconomic status. Additional analyses using DNA from blood collected at two time points (ages 26 and 38 years) showed that LTL erosion was accelerated among men who were diagnosed with internalizing disorder in the interim (β=-0.111, 95% CI: -0.184, -0.037, P=0.003). No significant associations were found among women in any analysis, highlighting potential sex differences in internalizing-related telomere biology. These findings point to a potential mechanism linking internalizing disorders to accelerated biological aging in the first half of the life course, particularly in men. Because internalizing disorders are treatable, the findings suggest the hypothesis that treating psychiatric disorders in the first half of the life course may reduce the population burden of age-related disease and extend health expectancy.",0 +,Militærmedicinske erfaringer fra krigen mod terror,,0 +https://doi.org/10.1371/journal.pone.0115013,Psychological Sequelae of the Station Nightclub Fire: Comparing Survivors with and without Physical Injuries Using a Mixed-Methods Analysis,"Surveying survivors from a large fire provides an opportunity to explore the impact of emotional trauma on psychological outcomes.This is a cross-sectional survey of survivors of The Station Fire. Primary outcomes were post-traumatic stress (Impact of Event Scale - Revised) and depressive (Beck Depression Inventory) symptoms. Linear regression was used to examine differences in symptom profiles between those with and without physical injuries. The free-response section of the survey was analyzed qualitatively to compare psychological sequelae of survivors with and without physical injuries.104 participants completed the study survey; 47% experienced a burn injury. There was a 42% to 72% response rate range. The mean age of respondents was 32 years, 62% were male, and 47% experienced a physical injury. No significant relationships were found between physical injury and depressive or post-traumatic stress symptom profiles. In the qualitative analysis, the emotional trauma that survivors experienced was a major, common theme regardless of physical injury. Survivors without physical injuries were more likely to experience survivor guilt, helplessness, self-blame, and bitterness. Despite the post-fire challenges described, most survivors wrote about themes of recovery and renewal.All survivors of this large fire experienced significant psychological sequelae. These findings reinforce the importance of mental health care for all survivors and suggest a need to understand factors influencing positive outcomes.",0 +https://doi.org/10.3233/nre-1999-13202,Post-traumatic stress disorder: An overview and its relationship to closed head injuries,"While exposure to traumatic psychological and physical trauma can produce posttraumatic stress disorder (PTSD), multiple factors determine whether a person will develop PTSD following trauma exposure. PTSD has a high rate of comorbidity with psychiatric, substance abuse, and somatization disorders. Persons with PTSD experience profound and persistent alterations in their physiological reactivity to internal and external stimuli which prevents them from utilizing their emotions to process incoming information. These patients have chronically high levels of sympathetic nervous system activity and low levels of glucocorticoids to cope with stress and modulate their catecholamine levels. Neuropsychological assessment of patients with PTSD depends to a large degree on the sensitivity of the measures which are utilized and a pre-existing history of learning disabilities, head trauma, and/or neurological disorders. While closed head injuries (CHI) are unlikely to produce PTSD symptoms, persons with CHI are likely to develop PTSD symptoms if they are exposed to trauma prior to the onset of retrograde amnesia or after the resolution of post-traumatic amnesia. If the traumatic event occurs while the patient with CHI is amnestic or unconscious, they are unlikely to develop PTSD symptoms. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1038/npp.2015.257,Predicting Treatment Outcome in PTSD: A Longitudinal Functional MRI Study on Trauma-Unrelated Emotional Processing,"In about 30-50% of patients with posttraumatic stress disorder (PTSD), symptoms persist after treatment. Although neurobiological research has advanced our understanding of PTSD, little is known about the neurobiology underlying persistence of PTSD. Two functional MRI scans were collected from 72 war veterans with and without PTSD over a 6- to 8-month interval, during which PTSD patients received trauma-focused therapy. All participants performed a trauma-unrelated emotional processing task in the scanner. Based on post-treatment symptom severity, a distinction was made between remitted and persistent patients. Behavioral and imaging measures of trauma-unrelated emotional processing were compared between the three groups (remitted patients, N=21; persistent patients, N=22; and combat controls, N=25) with repeated-measures (pre- and post-treatment) analyses. Second, logistic regression was used to predict treatment outcome. Before and after treatment, persistent patients showed a higher dorsal anterior cingulate cortex (dACC) and insula response to negative pictures compared with remitted patients and combat controls. Before treatment, persistent patients showed increased amygdala activation in response to negative pictures compared with remitted patients. The remitted patients and combat controls did not differ on the behavioral or imaging measures. Finally, higher dACC, insula, and amygdala activation before treatment were significant predictors of symptom persistence. Our results highlight a pattern of brain activation that may predict poor response to PTSD treatment. These findings can contribute to the development of alternative or additional therapies. Further research is needed to elucidate the heterogeneity within PTSD and describe how differences in neural function are related to treatment outcome. Such approaches are critical for defining parameters to customize PTSD treatment and improve treatment response rates.",0 +https://doi.org/10.1097/00005053-200106000-00003,The Comprehensive Assessment of Defense Style: Measuring Defense Mechanisms in Children and Adolescents,"This study introduces the Comprehensive Assessment of Defense Style (CADS), a new method to assess descriptively the defensive behavior of children and adolescents. Parents of 124 children and adolescents referred to a mental health clinic, of 104 nontreated children, and of 15 children whose fathers were treated for posttraumatic stress disorder completed the CADS. Factor analysis of 28 defenses yielded one mature factor, one immature factor of defenses expressed in relations with the environment (other-oriented), and one of defenses expressed in relations with the self (self-oriented). The CADS significantly discriminated between patients and nonpatients. Psychiatric patients used more immature and fewer mature defenses than control subjects, and adolescents used more mature and fewer other-oriented defenses than children. Girls used more mature and fewer other-oriented defenses than boys. The reliability and validity data of the CADS are encouraging. The three defense factors may be implemented for diagnostic and clinical purposes as well as for screening for psychopathology risk in untreated populations.",0 +,Cortical hyperexcitability in post-traumatic stress disorder secondary to minor accidental head trauma: a neurophysiologic study.,"We applied paired transcranial magnetic stimulation (pTMS) to patients with post-traumatic stress disorder (PTSD) secondary to minor accidental head trauma. Our purpose was to determine the potential abnormality of motor cortex excitability in this pathologic condition.pTMS stimulation, according to the conditioning-test paradigm employing interstimulus intervals (ISIs) of 1-6 ms, was used to investigate intracortical inhibition in control subjects and patients with PTSD. The study population consisted of 14 patients who had developed PTSD following minor head trauma, 12 healthy volunteers without a clinical history of head trauma and 11 healthy subjects who had reported accidental minor head trauma 1-4 months before the study. This clinical electrophysiologic study was performed at the Department of Neuroscience, University of Rome ""Tor Vergata.""All patients with PTSD exhibited a significantly lower motor evoked potential (MEP) inhibition than controls at 2 ms, 3 ms and 4 ms ISI. The statistical analysis of the pTMS protocol showed a significant effect (F2,36 = 25.63, p < 0.001) of the factor ""group,"" because patients with PTSD showed a mean conditioned MEP amplitude higher than that observed in both control groups for all 6 ISIs analyzed. The ""ISI"" factor was also significant (F5,180 = 89.85, Greenhouse-Geisser epsilon = 0.35; p < 0.001), with the mean conditioned MEP amplitude increasing from 22.5% to 127.8% as the ISI increased from 1 ms to 6 ms. Finally, the interaction of group with ISI was also significant (F10,180 = 8.97, p < 0.001), showing that the condition of PTSD secondary to head trauma was able to affect the MEP amplitude at different ISIs.Our results demonstrate that PTSD can give rise to abnormalities in intracortical inhibition. Our results provide further evidence that alterations in cortical inhibitory circuits may underlie specific forms of neuroticism in humans.",0 +https://doi.org/10.1002/pon.3309,Low socioeconomic status and mental health outcomes in colorectal cancer survivors: disadvantage? advantage? … or both?,"The goal of this study is to examine the relationship between socioeconomic status (SES) and both positive and negative mental health (MH) outcomes in a population-based sample of colorectal cancer survivors. On the basis of theoretical conceptualizations of trauma and posttraumatic growth, low SES was hypothesized to be positively associated with both greater negative MH outcomes (e.g., distress) and greater positive MH outcomes (e.g., growth).Colorectal cancer survivors (n = 1300; 57% male; mean age 69.4 and 4.0 years post-diagnosis) were recruited using a regional, population-based cancer registry in the Netherlands and completed a questionnaire assessing current negative and positive MH outcomes. Low, medium, and high SES respondents were identified using an area-level indicator of SES based on aggregated individual fiscal data on monetary home value and household income.Analysis of covariance and logistic regression analyses indicated that low SES was a risk factor for greater negative MH outcomes. Relative to high SES survivors, low SES survivors reported poorer status on nine indices of MH, and high SES survivors were about 50% less likely to report clinically important levels of anxiety and depression. Results provided partial support for the hypothesis low SES was a 'risk' factor for greater positive MH outcomes. Relative to high SES survivors, low SES survivors reported greater positive MH outcomes on 2 of 5 positive MH indices examined (Positive Self-Evaluation, Meaning of Cancer).Study findings are the first to suggest that low SES might increase the likelihood of both greater negative as well as positive MH outcomes in cancer survivors.",0 +https://doi.org/10.1016/s0140-6736(14)61328-3,Improving mental health is key to reduce violence in Israel and Gaza,"The prolonged and complex Israeli–Palestinian conflict profoundly affects the health and wellbeing of both Palestinians and Israelis.1 The present escalation between Hamas and Israel follows a well-worn pattern of confrontation. Superior Israeli military force means that Palestinians have more physical casualties. On both sides, however, many civilians are exposed to conflict-related stressors, and neither Israelis nor Palestinians are immune to their mental or physical health consequences.",0 +https://doi.org/10.1016/j.jad.2010.06.018,Psychiatric disorders and functional impairment among disaster victims after exposure to a natural disaster: A population based study,"We aimed to examine psychiatric morbidity and functional impairment after a natural disaster.Norwegian tourists who survived the 2004 tsunami in Khao Lak (n = 63), a severely affected area in Thailand, were interviewed in person 2.5 years after the disaster. The examination included the Mini International Neuropsychiatric Interview, the PTSD module of the Structured Clinical Interview for DSM-IV Axis I disorders, the Work and Social Adjustment Scale (WSAS), the Global Assessment of Functioning function score (GAF-F), and questions covering background characteristics and disaster exposure.The most prevalent disorders were specific phobia (30.2%), agoraphobia (17.5%), social anxiety disorder (11.1%), PTSD (11.1%), major depressive disorder (MDD, 11.1%), and dysthymic disorder (DD, 11.1%). In 24 of the 40 respondents with a current psychiatric disorder, symptoms had originated after the tsunami. The post-tsunami 2.5 year incidence of PTSD and MDD was 36.5% and 28.6%, respectively. Multivariable regression analysis showed that the depressive disorders (MDD and DD) and PTSD were associated with self-reported functional impairment (WSAS), and the depressive disorders were associated with clinician assessed functional impairment (GAF-F).Small sample size and high education may limit the generalizability of the results.Depression and anxiety disorders were common among disaster victims 2.5 years after the 2004 tsunami. Psychiatric disorders other than PTSD, especially depressive disorders, are of clinical importance when considering long-term mental health effect of disasters.",0 +https://doi.org/10.1002/ajmg.b.32216,Comparing the utility of homogeneous subtypes of cocaine use and related behaviors with DSM-IV cocaine dependence as traits for genetic association analysis,"Because DSM-IV cocaine dependence (CD) is heterogeneous, it is not an optimal phenotype to identify genetic variation contributing to risk for cocaine use and related behaviors (CRBs). We used a cluster analytic method to differentiate homogeneous, highly heritable subtypes of CRBs and to compare their utility with that of the DSM-IV CD as traits for genetic association analysis. Clinical features of CRBs and co-occurring disorders were obtained via a poly-diagnostic interview administered to 9,965 participants in genetic studies of substance dependence. A subsample of subjects (N = 3,443) were genotyped for 1,350 single nucleotide polymorphisms (SNPs) selected from 130 candidate genes related to addiction. Cluster analysis of clinical features of the sample yielded five subgroups, two of which were characterized by heavy cocaine use and high heritability: a heavy cocaine use, infrequent intravenous injection group and an early-onset, heavy cocaine use, high comorbidity group. The utility of these traits was compared with the CD diagnosis through association testing of 2,320 affected subjects and 480 cocaine-exposed controls. Analyses examined both single SNP (main) and SNP–SNP interaction (epistatic) effects, separately for African-Americans and European-Americans. The two derived subtypes showed more significant P values for 6 of 8 main effects and 7 of 8 epistatic effects. Variants in the CLOCK gene were significantly associated with the heavy cocaine use, infrequent intravenous injection group, but not with the DSM-IV diagnosis of CD. These results support the utility of subtypes based on CRBs to detect risk variants for cocaine addiction. © 2013 Wiley Periodicals, Inc.",0 +https://doi.org/10.1007/s10548-014-0386-2,Characterization of Post-traumatic Stress Disorder Using Resting-State fMRI with a Multi-level Parametric Classification Approach,"Functional neuroimaging studies have found intra-regional activity and inter-regional connectivity alterations in patients with post-traumatic stress disorder (PTSD). However, the results of these studies are based on group-level statistics and therefore it is unclear whether PTSD can be discriminated at single-subject level, for instance using the machine learning approach. Here, we proposed a novel framework to identify PTSD using multi-level measures derived from resting-state functional MRI (fMRI). Specifically, three levels of measures were extracted as classification features: (1) regional amplitude of low-frequency fluctuations (univariate feature), which represents local spontaneous synchronous neural activity; (2) temporal functional connectivity (bivariate feature), which represents the extent of similarity of local activity between two regions, and (3) spatial functional connectivity (multivariate feature), which represents the extent of similarity of temporal correlation maps between two regions. Our method was evaluated on 20 PTSD patients and 20 demographically matched healthy controls. The experimental results showed that the features of each level could successfully discriminate PTSD patients from healthy controls. Furthermore, the combination of multi-level features using multi-kernel learning can further improve the classification performance. Specifically, the classification accuracy obtained by the proposed framework was 92.5 %, which was an increase of at least 5 and 17.5 % from the two-level and single-level feature based methods, respectively. Particularly, the limbic structure and prefrontal cortex provided the most discriminant features for classification, consistent with results reported in previous studies. Together, this study demonstrated for the first time that patients with PTSD can be identified at the individual level using resting-state fMRI data. The promising classification results indicated that this method may provide a complementary approach for improving the clinical diagnosis of PTSD. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1037/1040-3590.17.1.70,Assessing Positive and Negative Changes in the Aftermath of Adversity: Psychometric Evaluation of the Changes in Outlook Questionnaire.,"The Changes in Outlook Questionnaire (CiOQ; S. Joseph, R. Williams, & W. Yule, 1993) is a 26-item self-report measure that was designed to assess positive and negative changes in the aftermath of adversity. This article had 3 aims: 1st, to investigate the factor structure of the CiOQ; 2nd, to test for internal consistency reliability and convergent and discriminant validity; and, 3rd, to investigate the association between positive and negative changes in outlook, posttraumatic stress, and psychological distress. Three studies are reported. Study 1 provides evidence that positive and negative changes are statistically separable and that the 2-factor model is a better fit than the 1-factor model. Studies 2 and 3 provide evidence for internal consistency reliability, convergent and discriminant validity of the CiOQ, and its associations with posttraumatic stress and psychological distress. In conclusion, the CiOQ has much promise for research on responses to stressful and traumatic events.",0 +https://doi.org/10.3928/00989134-20141111-02,Nursing Home Disaster Planning and Response: A Policy Perspective,"Nursing home residents are among the most vulnerable members of a community threatened by disaster. In the past, insufficient planning has resulted in preventable morbidity and mortality for nursing home residents during disasters. State and federal policies have evolved over the past decade to improve oversight of nursing home disaster planning. However, continued political advocacy is critically necessary to promote the safety of nursing home residents during potential emergencies and, especially, naturally occurring disasters. Opportunities exist to improve nursing home disaster response, including better preparation and training and dedicated resources for data management and oversight.",0 +https://doi.org/10.1002/jts.20073,Testing the latent structure of posttraumatic stress disorder: A taxometric study of combat veterans,"Since the diagnosis of posttraumatic stress disorder (PTSD) first appeared in the psychiatric nomenclature in 1980, considerable debate has revolved around the nature of the condition. Specifically, is PTSD best conceptualized as one end of a continuum of human response to traumatic stress or does it represent a discontinuous latent category? Two taxometric procedures were used to investigate this issue in a random community sample of 692 Australian combat veterans, using structured interview and self-report instruments to assess PTSD symptomatology. Findings favored a dimensional model of PTSD, consistent with previous taxometric work on treatment-seeking samples (A. Ruscio, Ruscio, & Keane, 2002). Implications are drawn for the conceptualization, etiology, and assessment of PTSD.",0 +https://doi.org/10.1111/j.1360-0443.2011.03658.x,Seeking Safety treatment for male veterans with a substance use disorder and post-traumatic stress disorder symptomatology,"To determine whether substituting Seeking Safety (SS), a manualized therapy for comorbid substance use disorders (SUD) and post-traumatic stress disorder (PTSD) for part of treatment-as-usual (TAU) improves substance use outcomes.Randomized controlled effectiveness trial.Out-patient Veterans Administration Health Care System SUD clinic.Ninety-eight male military Veterans with a SUD and co-occurring PTSD symptomatology.Drug and alcohol use and PTSD severity, measured on the first day of treatment, and 3 (i.e. the planned end of SS sessions) and 6 months following the baseline assessment. Treatment attendance and patient satisfaction were measured following treatment (3-month follow-up). Active coping was measured at treatment intake and following treatment.SS compared to TAU was associated with better drug use outcomes (P < 0.05), but alcohol use and PTSD severity decreased equally under both treatments (P's < 0.01). SS versus TAU was associated with increased treatment attendance, client satisfaction and active coping (all P's < 0.01). However, neither these factors nor decreases in PTSD severity mediated the effect of treatment on drug use.The manualized treatment approach for substance use disorder, Seeking Safety, is well received and associated with better drug use outcomes than 'treatment as usual' in male veterans with post-traumatic stress disorder. However, the mechanism of its effect is unclear.",0 +https://doi.org/10.1192/bjp.bp.114.150078,Latent structure of the proposed ICD-11 post-traumatic stress disorder symptoms: Implications for the diagnostic algorithm,"Background The latent structure of the proposed ICD-11 post-traumatic stress disorder (PTSD) symptoms has not been explored. Aims To investigate the latent structure of the proposed ICD-11 PTSD symptoms. Method Confirmatory factor analyses using data from structured clinical interviews administered to injury patients ( n = 613) 6 years post-trauma. Measures of disability and psychological quality of life (QoL) were also administered. Results Although the three-factor model implied by the ICD-11 diagnostic criteria fit the data well, a two-factor model provided equivalent, if not superior, fit. Whereas diagnostic criteria based on this two-factor model resulted in an increase in PTSD point prevalence (5.1% v. 3.4%; z = 2.32, P <0.05), they identified individuals with similar levels of disability ( P = 0.933) and QoL ( P = 0.591) to those identified by the ICD-11 criteria. Conclusions Consistent with theorised reciprocal relationships between re-experiencing and avoidance in PTSD, these findings support an alternative diagnostic algorithm requiring at least two of any of the four re-experiencing/avoidance symptoms and at least one of the two hyperarousal symptoms.",0 +https://doi.org/10.1016/j.socscimed.2011.02.022,The limits of resilience: Distress following chronic political violence among Palestinians,"We examined posttraumatic stress disorder (PTSD) and depression symptom trajectories during ongoing exposure to political violence, seeking to identify psychologically resilient individuals and the factors that predict resilience. Face-to-face interviews were conducted with a random sample of 1196 Palestinian adult residents of the West Bank, Gaza, and East Jerusalem across three occasions, six months apart (September 2007-November 2008). Latent growth mixture modeling identified PTSD, and depression symptom trajectories. Results identified three PTSD trajectories: moderate-improving (73% moderate symptoms at baseline, improving over time), severe-chronic (23.2% severe and elevated symptoms over the entire year); and severe-improving (3.5% severe symptoms at baseline and marked improvement over time). Depression trajectories were moderate-improving (61.5%); severe-chronic (24.4%); severe-improving (14.4%). Predictors of relatively less severe initial symptom severity, and improvement over time for PTSD were less political violence exposure and less resource loss; and for depression were younger age, less political violence exposure, lower resource loss, and greater social support. Loss of psychosocial and material resources was associated with the level of distress experienced by participants at each time period, suggesting that resource-based interventions that target personal, social, and financial resources could benefit people exposed to chronic trauma.",1 +https://doi.org/10.1007/s12207-013-9177-4,Underlying Dimensions of DSM-5 Posttraumatic Stress Disorder and Major Depressive Disorder Symptoms,"This study examined the relationship between the underlying latent factors of major depression symptoms and DSM-5 posttraumatic stress disorder (PTSD) symptoms (American Psychiatric Association, 2013). A nonclinical sample of 266 participants with a trauma history participated in the study. Confirmatory factor analyses were conducted to evaluate the fit of the DSM-5 PTSD model and dysphoria model, as well as a depression model comprised of somatic and nonsomatic factors. The DSM-5 PTSD model demonstrated somewhat better fit over the dysphoria model. Wald tests indicated that PTSD’s negative alterations in cognitions and mood factor was more strongly related to depression’s nonsomatic factor than its somatic factor. This study furthers a nascent line of research examining the relationship between PTSD and depression factors in order to better understand the nature of the high comorbidity rates between the two disorders. Moreover, this study provides an initial analysis of the new DSM-5 diagnostic criteria for PTSD.",0 +https://doi.org/10.3389/fnhum.2013.00689,Toward a visuospatial developmental account of sequence-space synesthesia,"Sequence-space synesthetes experience some sequences (e.g., numbers, calendar units) as arranged in spatial forms, i.e., spatial patterns in their mind's eye or even outside their body. Various explanations have been offered for this phenomenon. Here we argue that these spatial forms are continuous with varieties of non-synesthetic visuospatial imagery and share their central characteristics. This includes their dynamic and elaborative nature, their involuntary feel, and consistency over time. Drawing from literatures on mental imagery and working memory, we suggest how the initial acquisition and subsequent elaboration of spatial forms could be accounted for in terms of the known developmental trajectory of visuospatial representations. This extends from the formation of image-based representations of verbal material in childhood to the later maturation of dynamic control of imagery. Individual differences in the development of visuospatial style also account for variation in the character of spatial forms, e.g., in terms of distinctions such as visual versus spatial imagery, or ego-centric versus object-based transformations.",0 +https://doi.org/10.1037/a0037075,Cognitive processing therapy for veterans with posttraumatic stress disorder: A comparison between outpatient and residential treatment.,"Across the Veterans Affairs (VA) Healthcare System, outpatient and residential posttraumatic stress disorder (PTSD) treatment programs are available to veterans of all ages and both genders; however, no research to date has compared these treatment options. This study compared veterans who received outpatient (n = 514) to those who received residential treatment (n = 478) within a VA specialty clinic on demographic and pretreatment symptom variables. Further, the study examined pre- to posttreatment symptom trajectories across the treatment programs.All 992 veterans met diagnostic criteria for PTSD and attended at least 1 session of cognitive processing therapy (CPT) in either the outpatient or residential program. Bivariate analyses were utilized to investigate differences between samples on demographic variables and severity of pretreatment symptoms. Multilevel modeling (MLM) was used to investigate the change in symptomatology between the 2 samples from pre- to posttreatment.Analyses indicated that the samples differed on all demographic and pretreatment symptom variables, with residential patients reporting higher scores on all assessment measures. MLM results demonstrated that symptom scores improved for all veterans across time, with outpatients consistently reporting fewer symptoms at both time points. The time by program interaction was significant for PTSD-related symptom trajectories, but not for the depression-related symptom trajectory.This is the 1st study to compare pretreatment characteristics and treatment outcome between veterans receiving outpatient and residential PTSD treatment. Findings may help clinicians select appropriate care for their patients by identifying relevant pretreatment characteristics and generally informing expectations of treatment outcome.",0 +https://doi.org/10.1016/j.janxdis.2015.12.004,"Altered gene expression of the innate immune, neuroendocrine, and nuclear factor-kappa B (NF-κB) systems is associated with posttraumatic stress disorder in military personnel","Whole transcriptome analysis provides an unbiased examination of biological activity, and likely, unique insight into the mechanisms underlying posttraumatic stress disorder (PTSD) and comorbid depression and traumatic brain injury. This study compared gene-expression profiles in military personnel with PTSD (n=28) and matched controls without PTSD (n=27) using HG-U133 Plus 2.0 microarrays (Affymetrix), which contain 54,675 probe sets representing more than 38,500 genes. Analysis of expression profiles revealed 203 differentially expressed genes in PTSD, of which 72% were upregulated. Using Partek Genomics Suite 6.6, differentially expressed transcription clusters were filtered based on a selection criterion of ≥1.5 relative fold change at a false discovery rate of ≤5%. Ingenuity Pathway Analysis (Qiagen) of the differentially expressed genes indicated a dysregulation of genes associated with the innate immune, neuroendocrine, and NF-κB systems. These findings provide novel insights that may lead to new pharmaceutical agents for PTSD treatments and help mitigate mental and physical comorbidity risk.",0 +https://doi.org/10.1016/j.jad.2014.03.024,Typologies of posttraumatic stress disorder in the U.S. adult population,"Posttraumatic stress disorder (PTSD) is characterized by heterogeneous clusters of re-experiencing, avoidance, numbing, and hyperarousal symptoms. However, data are lacking regarding the predominant, population-based typologies of this disorder, and how they are linked to trauma-related characteristics, psychiatric comorbidities, and health-related quality of life.We used latent class analyses (LCAs) to evaluate predominant typologies of PTSD in a nationally representative sample of 2463 U.S. adults with PTSD. Multinomial logistic regression analyses were then conducted to evaluate trauma-related characteristics, psychiatric comorbidities, and health-related quality of life variables associated with these typologies.LCAs revealed three predominant typologies of PTSD-Anxious-Re-experiencing (weighted prevalence=32.2%), Dysphoric (32.8%), and High Symptom (35.0%). Compared to the Dysphoric class, the Anxious-Re-experiencing and High Symptom classes were more likely to report sexual assault, physical assault, and military combat as their worst traumatic events; had an earlier age of onset and longer duration of PTSD; and were more likely to be diagnosed with nicotine dependence and borderline personality disorder, to have attempted suicide, and had poorer physical health-related quality of life (HRQoL). The High Symptom class had increased odds of all disorders, suicide attempts, and the poorest HRQoL.Diagnoses were based on DSM-IV criteria and cross-sectional analyses preclude examination of how PTSD typologies are temporally related to other variables.PTSD in the general U.S. adult population is characterized by three predominant typologies, which are differentially linked to trauma and clinical characteristics. These findings underscore the importance of personalized approaches to the assessment, monitoring, and treatment of PTSD that take into consideration the heterogeneous manifestations of this disorder.",0 +,Mental health outcomes at the Jersey Shore after Hurricane Sandy.,"On October 29, 2012, Hurricane Sandy made landfall in the most densely populated region in the US. In New Jersey, thousands of families were made homeless and entire communities were destroyed in the worst disaster in the history of the state. The economic impact of Sandy was huge, comparable to Hurricane Katrina. The areas that sustained the most damage were the small- to medium-sized beach communities along New Jersey's Atlantic coastline. Six months following the hurricane, we conducted a random telephone survey of 200 adults residing in 18 beach communities located in Monmouth County. We found that 14.5% (95% CI = 9.9-20.2) of these residents screened positive for PTSD and 6.0% (95% CI = 3.1-10.2) met criteria for major depression. Altogether 13.5% (95% CI = 9.1-19.0) received mental health counseling and 20.5% (95% CI = 15.1-26.8) sought some type of mental health support in person or online, rates similar to those reported in New York after the World Trade Center disaster In multivariate analyses, the best predictors of mental health status and service use were having high hurricane exposure levels, having physical health limitations, and having environmental health concerns. Research is needed to assess the mental health status and service use of Jersey Shore residents over time, to evaluate environmental health concerns, and to better understand the storm's impact among those with physical health limitations.",0 +,A family study of PTSD : occurrence and correlates of internalizing disorders in children of OIF/OEF soldiers with combat posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) is one of the most common psychiatric disorders among U.S. combatants who are deployed to Operation Iraqi Freedom and Operation Enduring Freedom conflicts (OIF/OEF). Combat PTSD has been shown to be associated with impaired social, occupational, and physical functioning. An understudied area of research is how PTSD from combat affects interpersonal functioning at the family level. Of particular vulnerability to disruption in relational systems is the parent-child dyad. The present study focused on parental PTSD, child environment, and child psychological symptoms in order to begin delineating pathways connecting parent trauma to child psychopathology. The sample consisted of 21 dyads : Adult participants with and without combat-related PTSD and biological child participants (aged 6 - 17). Parents and children were administered structured diagnostic interviews and dimensional measures of anxiety, depression, and PTSD and home environment. Simple linear regression was used to test a predictive model between fathers' level of PTSD symptoms and child clinical symptoms. Multiple regression was used to test the mediation model of child home environment on the relationship between parent and child symptomatology. Results from descriptive analyses showed that level of fathers' combat exposure was a significant predictor at the alpha = 0.05 level for child anxiety, PTSD symptoms, oppositional, and conduct problems. However, level of fathers' combat exposure did not predict child depression, somatization, or withdrawn symptoms. Results showed no interaction effects. This pilot study demonstrates that the experiences of OIF/OEF combatants such as the nature of their combat exposure during deployment may be important in impacting the psychological outcomes of their offspring. Furthermore, the warzone experiences of OIF/OEF combatants during deployment appear to predict child anxiety, PTSD, and externalizing symptoms, but not child depression, withdrawn symptoms, or somatization. Results of this pilot study should be considered preliminary and the design should be replicated with a larger sample of OIF/OEF combatants. The current findings may be relevant in advancing our knowledge of etiological models of psychiatric illness in youths, identifying at-risk individuals during early life stages, and advancing mental health interventions for military families",0 +https://doi.org/10.1037/tra0000012,Evaluating the dimensionality of PTSD in a sample of OIF/OEF veterans.,"Both categorical and dimensional models of mental disorders, including posttraumatic stress disorder (PTSD), are useful for diagnostic and heuristic purposes; however, few empirical studies have compared categorical and dimensional models of PTSD side-by-side or compared these models to a hybrid (dimensional and categorical) model. In the present study, the dimensionality of PTSD was examined by fitting latent profile analytic, confirmatory factor analytic, and factor mixture models in 271 Operation Iraqi Freedom/Operation Enduring Freedom veterans 6 months after return from deployment. Latent profile analysis was used to identify subgroups of individuals with similar PTSD symptom profiles and predictors of subgroup membership, confirmatory factor analysis was used to identify the underlying continuous structure of PTSD in this sample, and factor mixture modeling was used to test whether a hybrid categorical and continuous model of PTSD best fit our sample. A factor mixture model consisting of a 4-factor dysphoria model of PTSD with 2 classes characterized by low and moderate symptom severity was the best-fitting model. Dissociation and deployment concerns emerged as significant predictors of membership in the moderate symptoms class. Implications for PTSD diagnostic conceptualization and treatment planning are discussed.",0 +https://doi.org/10.1016/j.janxdis.2014.02.005,Properties of Swedish posttraumatic stress measures after a disaster,"• The construct of chronic PTSD generally shows temporal invariance. • The dysphoric-arousal model provided better fit than four- and three-factor models. • The Swedish IES-R and the PCL work well as measures of chronic posttraumatic stress. This study evaluated the properties of Swedish versions of self-report measures of posttraumatic stress disorder (PTSD), with emphasis on the Impact of Event Scale-Revised (IES-R). Survey data from adult survivors 1, 3, and 6 years after the 2004 Indian Ocean tsunami ( n = 1506) included the IES-R (from which the IES-6 was derived) and the 12-item General Health Questionnaire (GHQ-12). The PTSD Checklist (PCL) was included in one survey. A structured clinical interview was performed after 6 years ( n = 142). Factor analyses of the IES-R and PCL indicated that a dysphoric-arousal model provided good fit invariant across assessments. Both measures were accurate in excluding PTSD while all measures provided poorer positive predictive values. The IES-R, but not the IES-6 and GHQ-12, evidenced stability across assessments. In conclusion, the Swedish IES-R and PCL are sound measures of chronic PTSD, and the findings illustrate important temporal aspects of PTSD assessment.",0 +https://doi.org/10.1016/j.chc.2009.02.007,Giving Voice to the Unsayable: Repairing the Effects of Trauma in Infancy and Early Childhood,"The research on early trauma establishes conclusively that, although there are marked individual differences in how children in the first five years of life respond to and recover from trauma, they consistently show negative biological, emotional, social, and cognitive sequelae after enduring traumatic events. This evidence lends particular urgency to the development, evaluation and implementation of approaches to prevention and treatment that are both empirically supported and can be effectively adapted to mental health community programs and other service systems that serve traumatized children and their families. This article describes the clinical applications and community dissemination of child-parent psychotherapy (CPP), a relationship-based trauma treatment for young children and their families that has substantial empirical evidence of efficacy in decreasing symptoms of traumatic stress and restoring young children's normative developmental trajectories. Clinical illustrations are provided to demonstrate how this intervention is conducted and to consider how it might effect therapeutic change.",0 +https://doi.org/10.1007/s10566-014-9289-3,Mother and Child Reports of Hurricane Related Stressors: Data from a Sample of Families Exposed to Hurricane Katrina,"Families exposed to disasters such as Hurricane Katrina are at risk for numerous adverse outcomes. While previous literature suggests that the degree of disaster exposure corresponds with experiencing negative outcomes, it is unclear if parents and children report similar levels of disaster exposure.The purpose of this paper was to examine levels of disaster stressor agreement among mother-child dyads affected by Hurricane Katrina, and to examine whether discrepancies in disaster stressor reports are associated with higher levels of posttraumatic stress (PTS) symptoms.Participants in this study consisted of 353 dyads of mothers (age M = 38.79 years, SD = 7.52; 68% African American) and children (52% girls; age M = 11.61 years, SD = 1.57) exposed to Hurricane Katrina. Parents and children were assessed at two timepoints, 3 - 7 months and 14 - 17 months postdisaster. Parent and child responses to items regarding hurricane related stressor exposure and PTS symptoms were analyzed.Agreement on hurricane related exposures was predominately slight to moderate, with kappas ranging from κ = .19 to κ = .83. Polynomial regression analyses revealed that when mothers reported low levels of Immediate Loss/Disruption stressors and children reported high levels of these stressors, children reported higher levels of Time 2 PTS symptoms, b = -.72 (.33), p = .03.Overall, levels of mother-child response agreement were low. Discrepancies in mother and child reports predicted higher levels of child PTS symptoms. Clinicians may want to query both parents and children about their disaster experiences when working with families postdisaster.",0 +https://doi.org/10.1111/pme.12773,Pharmaceutical Opioid Use and Dependence among People Living with Chronic Pain: Associations Observed within the Pain and Opioids in Treatment (POINT) Cohort,"There is increasing concern about the appropriateness of prescribing pharmaceutical opioids for chronic non-cancer pain (CNCP), given the risks of problematic use and dependence. This article examines pharmaceutical opioid dose and dependence and examines the correlates of each.Baseline data were obtained from a national sample of 1,424 people across Australia (median 58 years, 55% female and experiencing pain for a median of 10 years), who had been prescribed opioids for CNCP. Current opioid consumption was estimated in oral morphine equivalent (OME; mg per day), and ICD-10 pharmaceutical opioid dependence was assessed using the Composite International Diagnostic Interview.Current opioid consumption varied widely: 8.8% were taking <20 mg OME per day, 52.1% were taking 21-90 mg OME, 24.3% were taking 91-199 mg OME, and 14.8% were taking >= 200 mg OME. Greater daily OME consumption was associated with higher odds of multiple physical and mental health issues, aberrant opioid use, problems associated with opioid medication and opioid dependence. A significant minority, 8.5%, met criteria for lifetime ICD-10 pharmaceutical opioid dependence and 4.7% met criteria for past year ICD-10 pharmaceutical opioid dependence. Multivariate analysis found past-year dependence was independently associated with being younger, exhibiting more aberrant behaviors and having a history of benzodiazepine dependence.In this population of people taking opioids for CNCP, consumption of higher doses was associated with increased risk of problematic behaviors, and was more likely among people with a complex profile of physical and mental health problems.",0 +https://doi.org/10.1111/j.1467-8624.2010.01453.x,"Disasters, Victimization, and Children’s Mental Health","In a representative sample of 2,030 U.S. children aged 2–17, 13.9% report lifetime exposure to disaster, and 4.1% report experiencing a disaster in the past year. Disaster exposure was associated with some forms of victimization and adversity. Victimization was associated with depression among 2- to 9-year-old disaster survivors, and with depression and aggression among 10- to 17-year-old disaster survivors. Children exposed to either victimization only or both disaster and victimization had worse mental health compared to those who experienced neither. More research into the prevalence and effects of disasters and other stressful events among children is needed to better understand the interactive risks for and effects of multiple forms of trauma.",0 +https://doi.org/10.1016/j.janxdis.2005.04.003,Simple versus complex PTSD: A cluster analytic investigation,"A cluster analytic investigation was conducted on measures of PTSD associated features (e.g., personality pathology, dissociative tendencies) to investigate whether empirically-defined clusters correspond to Herman's [1992, Complex PTSD: a syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress, 5, 377-391; 1997, Trauma and recovery (Rev. ed.). New York: Basic Books] distinction between simple and complex PTSD. Results from a sample of 60 PTSD patients were broadly consistent with this distinction, although some inconsistencies were observed. Treatment outcome generally did not differ between the two clusters. Implications for classifying and treating PTSD are discussed.",0 +https://doi.org/10.1016/j.psychres.2014.05.043,Clustering of symptoms of mental disorder in the medium-term following conflict: An epidemiological study in Timor-Leste,"It is important to define subpopulations with mental health and psychosocial reactions in the medium-term following conflict to ensure that an appropriate array of services are provided to meet the diversity of needs. We conducted a latent class analysis (LCA) on epidemiological data drawn from an urban and rural sample of 1221 adults (581 men and 640 women, response 82%) in post-conflict Timor Leste 4 years after the cessation of violence. The prevalence of PTSD was 4.9%; severe distress 4.8%; anger attacks 38.3%; and paranoid-like symptoms 10.9%. The best fitting LCA yielded three classes comprising those with no or minimal symptoms (86%), a class with anger-paranoia (13%) and a comorbid mental disorder class (1.5%) characterized by PTSD (100%) and severe distress (98%). The comorbid mental disorder class had an over-representation of men, the unemployed, residents in the urban area and persons with the greatest exposure to human rights trauma, murder and health stress. The anger-paranoia class experienced moderate levels of trauma and had an over-representation of urban dwellers, women, and those with higher levels of education. The analysis assists in clarifying the populations with mental disorder and adverse psychosocial reactions in need of intervention in the medium-term following conflict.",0 +https://doi.org/10.1016/j.seizure.2006.04.003,"Psychiatric disorders in patients with psychogenic non-epileptic seizures, with and without comorbid epilepsy","The aim of this study is to describe similarities and differences in epidemiological, psychiatric and semiologic variables between patients with psychogenic none epileptic seizures (PNES) and comorbid epilepsy (mixed PNES), and patients with PNES without comorbid epilepsy (pure PNES).Forty-three patients with PNES diagnosed by Video-EEG were included. Twenty-four had pure PNES, and ninteen mixed PNES. Female population, age, duration of PNES, psychiatric institutionalization, psychopharmacotherapy, dissociative disorders and posttraumatic stress disorder (PTSD), were significantly higher in the pure PNES patients. Suicide attempts, antiepileptic therapy, conversive, affective and personality disorders were frequent in both groups. In the analysis of seizure semiology, the total lack of responsiveness was significantly higher in the mixed PNES group.Pure PNES patients showed similarities and differences in the psychiatric profile, with a greater prevalence of dissociative disorders and PTSD, factors related to psychiatric severity.",0 +https://doi.org/10.1371/journal.pone.0027640,Post-Traumatic Stress Disorder (PTSD) Symptoms Predict Delay to Hospital in Patients with Acute Coronary Syndrome,"Increased delay to hospital presentation with acute coronary syndrome (ACS) is associated with poor outcomes. While demographic factors associated with this delay have been well described, scarce data are available on the role of modifiable factors, such as psychosocial disorders, on pre-hospital delay. Patients with symptoms of post-traumatic stress disorder (PTSD) often avoid stressful situations and may delay presenting for care when they experience cardiac symptoms. It is unknown, however, whether PTSD symptoms negatively impact the time to presentation during an ACS.We assessed the relationship between PTSD symptoms and pre-hospital delay in 241 adults with an ACS in the ongoing Prescription Use, Lifestyle, Stress Evaluation (PULSE) study.Overall, 66% of patients were male; 40% were Hispanic or Latino. The mean age was 61.9±11.6 years old. PTSD symptoms were present in 17.8% of patients. Pre-hospital delay was longer for patients with PTSD symptoms compared to those without [geometric mean: 25.8 hours (95% CI 13.8-44.8) vs. 10.7 hours (95% CI 8.3-13.8)]; P = 0.005. After multivariable adjustment for age, sex, ethnicity, depression, left ventricular ejection fraction and history of myocardial infarction, the mean pre-hospital delay was 173% (95% CI: 36%-450%) longer for patients with versus without PTSD symptoms.Among patients presenting with an ACS, PTSD symptoms were independently associated with longer pre-hospital delays. Future studies of pre-hospital delay should examine the mechanisms underlying this association.",0 +https://doi.org/10.1037/a0027338,Facets of pejorative self-processing in complicated grief.,"Complicated grief (CG) has been proposed as a psychiatric response to bereavement distinct from established mood and anxiety disorder diagnoses. Little is known about the nature of cognitive-affective processing in CG, nor any similarities or differences compared with the processing profiles associated with other emotional disorders. Three studies therefore investigated 3 broad facets of negative self-processing associated with either elevated symptoms of, or diagnosis of, CG--namely, self-related attributions or blame, self-devaluation, and cognitions about the future self.These self-processing domains were assessed using a variety of self-report and scenario-based measures either linked specifically to the bereavement or more general in their focus. Study 1 used a correlational design in a community bereaved sample. Study 2 employed an extreme-groups approach looking at individuals high versus low in CG symptoms, and Study 3 compared those with a CG diagnosis to healthy bereaved controls.The data revealed a profile of processing in CG characterized by significant relationships between CG symptoms or diagnosis and both self-devaluation and negative self-related cognitions about the future, but the data provided no support for a similar relationship with negative self-related attributions.These findings extend our understanding of self-related cognitive processing in CG. They also suggest that CG is characterized by a cognitive-affective processing profile that is distinct from that associated with other disorders, notably major depression, in the literature. This has potential implications for the psychological treatment of CG and for its nosological status as a post-loss syndrome distinct from depression.",0 +https://doi.org/10.1037/0022-006x.75.1.154,Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after Hurricane Katrina.,"On the basis of theory and previous research, it was hypothesized that predisaster child trait anxiety would predict disaster-related posttraumatic stress symptoms and generalized anxiety disorder symptoms, even after controlling for the number of hurricane exposure events. Results support this hypothesis and further indicate that predisaster negative affect predicted disaster-related posttraumatic stress symptoms and generalized anxiety disorder symptoms. Also, Katrina-related posttraumatic stress disorder symptoms were predicted by the number of hurricane exposure events and sex (being female). Predisaster generalized anxiety disorder symptoms predicted postdisaster generalized anxiety disorder symptoms, and predisaster trait anxiety predicted postdisaster depressive symptoms. Findings are discussed in terms of their relevance for developing interventions to mitigate the impact of disasters in youths.",0 +https://doi.org/10.1177/0013164413496812,Piecewise Linear–Linear Latent Growth Mixture Models With Unknown Knots,"Latent growth curve models with piecewise functions are flexible and useful analytic models for investigating individual behaviors that exhibit distinct phases of development in observed variables. As an extension of this framework, this study considers a piecewise linear–linear latent growth mixture model (LGMM) for describing segmented change of individual behavior over time where the data come from a mixture of two or more unobserved subpopulations (i.e., latent classes). Thus, the focus of this article is to illustrate the practical utility of piecewise linear–linear LGMM and then to demonstrate how this model could be fit as one of many alternatives—including the more conventional LGMMs with functions such as linear and quadratic. To carry out this study, data ( N = 214) obtained from a procedural learning task research were used to fit the three alternative LGMMs: (a) a two-class LGMM using a linear function, (b) a two-class LGMM using a quadratic function, and (c) a two-class LGMM using a piecewise linear–linear function, where the time of transition from one phase to another (i.e., knot) is not known a priori, and thus is a parameter to be estimated.",0 +https://doi.org/10.1080/17449200903343209,‘Traumatisers or traumatised’: Trauma experiences and personality characteristics of Australian prisoners,"Post-traumatic stress disorder (PTSD) is over represented in the prisoner population and is predictive of violence and suicide. This raises issues in relation to prisoner management, as well as theoretical issues such as why there is a range of vulnerability for PTSD. The current study examines the relationship between PTSD and personality profiles of prisoners.Data from 1305 participants in the NSW survey of health in prisoners are examined to identify relationships between personality profiles derived from the Temperament and Character Inventory (TCI) and PTSD. Participants are grouped as experiencing no trauma; with a trauma history but no PTSD; and being diagnosed with PTSD. A logistic regression modelled significant predictors of PTSD. These data indicated that women prisoners report PTSD at twice the rate of males. An increased risk for PTSD is associated with high Harm Avoidance, low Self-Directedness, high Persistence and high Self-Transcendence.A combination of both temperament and character traits influences the trajectory towards PTSD development. Targeted treatment of these traits is needed in addressing the problems of prisoners with PTSD and managing the associated risks of violence and suicide.",0 +https://doi.org/10.1001/jama.292.5.575,"Mental Health, Social Functioning, and Disability in Postwar Afghanistan","More than 2 decades of conflict have led to widespread human suffering and population displacement in Afghanistan. In 2002, the Centers for Disease Control and Prevention and other collaborating partners performed a national population-based mental health survey in Afghanistan.To provide national estimates of mental health status of the disabled (any restriction or lack of ability to perform an activity in the manner considered normal for a human being) and nondisabled Afghan population aged at least 15 years.A national multistage, cluster, population-based mental health survey of 799 adult household members (699 nondisabled and 100 disabled respondents) aged 15 years or older conducted from July to September 2002. Fifty district-level clusters were selected based on probability proportional to size sampling. One village was randomly selected in each cluster and 15 households were randomly selected in each village, yielding 750 households.Demographics, social functioning as measured by selected questions from the Medical Outcomes Study 36-Item Short-Form Health Survey, depressive symptoms measured by the Hopkins Symptoms Checklist-25, trauma events and symptoms of posttraumatic stress disorder (PTSD) measured by the Harvard Trauma Questionnaire, and culture-specific symptoms of mental illness and coping mechanisms.A total of 407 respondents (62.0%) reported experiencing at least 4 trauma events during the previous 10 years. The most common trauma events experienced by the respondents were lack of food and water (56.1%) for nondisabled persons and lack of shelter (69.7%) for disabled persons. The prevalence of respondents with symptoms of depression was 67.7% (95% confidence interval [CI], 54.6%-80.7%) and 71.7% (95% CI, 65.0%-78.4%), and symptoms of anxiety 72.2% (95% CI, 63.8%-80.7%) and 84.6% (95% CI, 74.1%-95.0%) for nondisabled and disabled respondents, respectively. The prevalence of symptoms of PTSD was similar for both groups (nondisabled, 42.1%; 95% CI, 34.2%-50.1%; and disabled, 42.2%; 95% CI, 29.2%-55.2%). Women had significantly poorer mental health status than men did. Respondents who were disabled had significantly lower social functioning and poorer mental health status than those who were nondisabled. Feelings of hatred were high (84% of nondisabled and 81% of disabled respondents). Coping mechanisms included religious and spiritual practices; focusing on basic needs, such as higher income, better housing, and more food; and seeking medical assistance.In this nationally representative survey of Afghans, prevalence rates of symptoms of depression, anxiety, and PTSD were high. These data underscore the need for donors and health care planners to address the current lack of mental health care resources, facilities, and trained mental health care professionals in Afghanistan.",0 +https://doi.org/10.1097/01.nmd.0000195307.28743.b2,Perceived Safety in Disaster Workers Following 9/11,"The perception of being safe, perceived safety, is an important component of health and the ability to work after exposure to traumatic events of all kinds. The relationship of perceived safety to posttraumatic stress disorder and depression has rarely been examined. This study examined symptoms of posttraumatic stress disorder, depression, and perceived safety in disaster workers 2 weeks after the 9/11 terrorist attacks. Perceived safety was lower in those with greater exposure (e.g., those who felt they were in physical danger, worked with dead bodies, or witnessed someone being killed or seriously injured). Lower perceived safety was associated with greater symptoms of intrusion and hyperarousal but not avoidance. Safety was negatively correlated with depression and peritraumatic dissociation. Lowered perceptions of safety following terrorist events have implications for social and work-related behaviors that can affect long-term health, morale, and productivity in disaster workers and other first responders.",0 +https://doi.org/10.1007/s00213-014-3446-0,Mefloquine and psychotomimetics share neurotransmitter receptor and transporter interactions in vitro,"RationaleMefloquine is used for the prevention and treatment of chloroquine-resistant malaria, but its use is associated with nightmares, hallucinations, and exacerbation of symptoms of post-traumatic stress disorder. We hypothesized that potential mechanisms of action for the adverse psychotropic effects of mefloquine resemble those of other known psychotomimetics.ObjectivesUsing in vitro radioligand binding and functional assays, we examined the interaction of (+)- and (−)-mefloquine enantiomers, the non-psychotomimetic anti-malarial agent, chloroquine, and several hallucinogens and psychostimulants with recombinant human neurotransmitter receptors and transporters.ResultsHallucinogens and mefloquine bound stereoselectively and with relatively high affinity (K i = 0.71–341 nM) to serotonin (5-HT) 2A but not 5-HT1A or 5-HT2C receptors. Mefloquine but not chloroquine was a partial 5-HT2A agonist and a full 5-HT2C agonist, stimulating inositol phosphate accumulation, with similar potency and efficacy as the hallucinogen dimethyltryptamine (DMT). 5-HT receptor antagonists blocked mefloquine’s effects. Mefloquine had low or no affinity for dopamine D1, D2, D3, and D4.4 receptors, or dopamine and norepinephrine transporters. However, mefloquine was a very low potency antagonist at the D3 receptor and mefloquine but not chloroquine or hallucinogens blocked [3H]5-HT uptake by the 5-HT transporter.ConclusionsMefloquine, but not chloroquine, shares an in vitro receptor interaction profile with some hallucinogens and this neurochemistry may be relevant to the adverse neuropsychiatric effects associated with mefloquine use by a small percentage of patients. Additionally, evaluating interactions with this panel of receptors and transporters may be useful for characterizing effects of other psychotropic drugs and for avoiding psychotomimetic effects for new pharmacotherapies, including antimalarial quinolines.",0 +,Late-life adaptation in the aftermath of extreme stress.,,0 +https://doi.org/10.1207/s15374424jccp2504_11,"Children's Coping Assistance: How Parents, Teachers, and Friends Help Children Cope After a Natural Disaster","Investigated the construct of coping assistance, defined as actions taken by significant others to help children cope with stressful events, in the aftermath of Hurricane Andrew. The Children's Coping Assistance Checklist (CCAC) was developed to assess three types of coping assistance (Emotional Processing, Roles and Routines, and Distraction) from three sources (Parents, Teachers, and Friends). The CCAC and measures of children's social support, coping, and posttraumatic stress disorder (PTSD) symptomatology were administered to 506 third through fifth graders 7 months after Hurricane Andrew. Roles and Routines coping assistance was reported most frequently, followed by Distraction and Emotional Processing. Coping assistance from parents and friends was reported more frequently than from teachers. Third graders reported significantly more Emotional Processing from parents and friends than fourth and fifth graders; no sex effects were found. As expected, children with more severe levels of PTSD symptomato...",0 +https://doi.org/10.3109/00048678709158924,The Post-Accident Syndrome: Variations in the Clinical Picture,"Three hundred and twenty-seven subjects involved in civil accident litigation and referred by solicitors for either plaintiff or defendant were examined. A precise psychiatric diagnosis was applicable in only a minority of subjects, although psychiatric symptoms, including pain, anxiety and depression, were prominent. Overall the clinical picture was an amorphous one. Cluster analysis was performed to examine a variety of clinical, demographic and historical variables. This showed four stable groups, which are here described as: stoic, depressive, phobic motor accident and prior claimants. It is suggested that the phenomenological approach taken here, paying particular attention to clinical sub-groups, may be a more useful route towards the understanding and treatment of post-accident psychiatric disturbance than is the existing but confused approach, in which motivation has been a prime focus of interest. The particular sub-groups demonstrated here, if replicated, could form the basis for such an approach.",0 +https://doi.org/10.1017/s0033291711000730,Decreased regional cerebral blood flow in medial prefrontal cortex during trauma-unrelated stressful imagery in Vietnam veterans with post-traumatic stress disorder.,"Neuroimaging research has demonstrated medial prefrontal cortex (mPFC) hyporesponsivity and amygdala hyperresponsivity to trauma-related or emotional stimuli in post-traumatic stress disorder (PTSD). Relatively few studies have examined brain responses to the recollection of stressful, but trauma-unrelated, personal events in PTSD. In the current study, we sought to determine whether regional cerebral blood flow (rCBF) abnormalities in mPFC and amygdala in PTSD could be observed during the recollection of trauma-unrelated stressful personal events.Participants were 35 right-handed male combat veterans (MCVs) and female nurse veterans (FNVs) who served in Vietnam: 17 (seven male, 10 female) with current military-related PTSD and 18 (nine male, nine female) with no current or lifetime PTSD. We used positron emission tomography (PET) and script-driven imagery to study rCBF during the recollection of trauma-unrelated stressful versus neutral and traumatic events.Voxelwise tests revealed significant between-group differences for the trauma-unrelated stressful versus neutral comparison in mPFC, specifically in the anterior cingulate cortex (ACC). Functional region of interest (ROI) analyses demonstrated that this interaction in mPFC represented greater rCBF decreases in the PTSD group during trauma-unrelated stressful imagery relative to neutral imagery compared to the non-PTSD group. No differential amygdala activation was observed between groups or in either group separately.Veterans with PTSD, compared to those without PTSD, exhibited decreased rCBF in mPFC during mental imagery of trauma-unrelated stressful personal experiences. Functional neuroanatomical models of PTSD must account for diminished mPFC responses that extend to emotional stimuli, including stressful personal experiences that are not directly related to PTSD.",0 +https://doi.org/10.1289/ehp.1104625,"Neighborhood Effects on Heat Deaths: Social and Environmental Predictors of Vulnerability in Maricopa County, Arizona","Background: Most heat-related deaths occur in cities, and future trends in global climate change and urbanization may amplify this trend. Understanding how neighborhoods affect heat mortality fills an important gap between studies of individual susceptibility to heat and broadly comparative studies of temperature–mortality relationships in cities.Objectives: We estimated neighborhood effects of population characteristics and built and natural environments on deaths due to heat exposure in Maricopa County, Arizona (2000–2008).Methods: We used 2000 U.S. Census data and remotely sensed vegetation and land surface temperature to construct indicators of neighborhood vulnerability and a geographic information system to map vulnerability and residential addresses of persons who died from heat exposure in 2,081 census block groups. Binary logistic regression and spatial analysis were used to associate deaths with neighborhoods.Results: Neighborhood scores on three factors—socioeconomic vulnerability, elderly/isolation, and unvegetated area—varied widely throughout the study area. The preferred model (based on fit and parsimony) for predicting the odds of one or more deaths from heat exposure within a census block group included the first two factors and surface temperature in residential neighborhoods, holding population size constant. Spatial analysis identified clusters of neighborhoods with the highest heat vulnerability scores. A large proportion of deaths occurred among people, including homeless persons, who lived in the inner cores of the largest cities and along an industrial corridor.Conclusions: Place-based indicators of vulnerability complement analyses of person-level heat risk factors. Surface temperature might be used in Maricopa County to identify the most heat-vulnerable neighborhoods, but more attention to the socioecological complexities of climate adaptation is needed.",0 +https://doi.org/10.1038/mp.2011.56,Accounting for comorbidity in assessing the burden of epilepsy among US adults: results from the National Comorbidity Survey Replication (NCS-R),"Although epilepsy is associated with substantial role impairment, it is also highly comorbid with other physical and mental disorders, making unclear the extent to which impairments associated with epilepsy are actually due to comorbidities. This issue was explored in the National Comorbidity Survey Replication (NCS-R), a nationally representative household survey of 5692 US adults. Medically recognized epilepsy was ascertained with self-report, comorbid physical disorders with a chronic conditions checklist, and comorbid DSM-IV mental disorders with the Composite International Diagnostic Interview. Lifetime epilepsy prevalence was estimated at 1.8%. Epilepsy was comorbid with numerous neurological and general medical conditions and with a sporadic cluster of mental comorbidities (panic, PTSD, conduct disorder and substance use disorders). Although comorbid disorders explain part of the significant gross associations of epilepsy with impairment, epilepsy remains significantly associated with work disability, cognitive impairment and days of role impairment after controlling comorbidities. The net association of epilepsy with days of role impairment after controlling for comorbidities is equivalent to an annualized 89.4 million excess role impairment days among US adults with epilepsy, arguing that role impairment is a major component of the societal costs of epilepsy per se rather than merely due to disorders comorbid with epilepsy. This estimated burden is likely conservative as some parts of the effects of epilepsy are presumably mediated by secondary comorbid disorders.",0 +https://doi.org/10.1111/pcn.12022,Persistent mental health disturbances during the 10 years after a disaster: Four-wave longitudinal comparative study,"Although some studies have examined the long-term effects of disasters, very little is known about severe persistent symptoms following disasters. The aim of the present study was to examine persistent mental health problems and to what extent disaster exposure predicts long-term persistent disturbances.Following a major disaster, a four-wave study was conducted (surveys 2-3 weeks, 18 months, 4 years and 10 years after the event) that examined severe post-traumatic stress disorder (PTSD) symptomatology (Impact of Event Scale), anxiety and depression symptoms and sleeping problems (Symptom Check List-90-R), and use of physician-prescribed tranquilizers. Participants were affected adult Dutch native residents (n = 1083). At wave 2 and 3, a control group participated (n = 694). At wave 1, severity of disaster exposure was examined. Multiple imputation was used to target the problem of missing data across surveys due to non-response such as in the fourth wave (61%).In total, 6.7% (95% confidence interval [CI]: 5.1-8.2) developed persistent PTSD symptoms during the 10 years after the event. For anxiety, depression, sleeping problems these prevalences were 3.8% (95%CI: 2.7-5.0), 6.2% (95%CI: 4.7-7.6) and 4.8% (95%CI: 3.5-6.1) respectively. In total 1.3% (95%CI: 0.6-2.0) used tranquilizers at all waves. Approximately one out of 10 with severe symptoms 2-3 weeks after the event, developed persistent symptoms. Even in the long term, affected residents compared to controls had more often chronic anxiety symptoms and sleeping problems. High disaster exposure independently predicted persistent PTSD symptoms (adjusted odds ratio [adj. OR], 4.20; 95%CI: 2.02-8.74, P < 0.001), anxiety (adj. OR, 3.43; 95%CI: 1.28-9.20, P < 0.01), depression symptoms (adj. OR, 2.95; 95%CI: 1.26-6.93, P < 0.01), and sleeping problems (adj. OR, 3.74; 95%CI: 1.56-8.95, P < 0.001).Post-disaster mental health care should (also) target persistent mental health disturbances in the long term, especially PTSD, anxiety, depression symptoms, and sleeping problems. High disaster exposure may be an early marker for risk of persistent symptoms.",0 +https://doi.org/10.1002/cbm.316,Borderline personality disorder as seen from an attachment perspective: a review,"There is increasing evidence that both borderline personality disorder and PTSD can be partly understood as damage to the attachment system. Research on primates has shown how severe are the effects of a damaged attachment system. Distress symptoms produced by separation are similar to those seen in narcotic withdrawal and involve aggressive behaviour. Chronic stress in children can cause dysregulation of the normal stress response and maladaptive brain activities. Secure, avoidant, anxious-ambivalent attachment in childhood can now be measured. Insecure children show needless aggression; avoidant children can become either abusers or victims. Disorganized attachment is a mixture of avoidant and anxious-ambivalent behaviour and may lead to adult borderline personality disorder. Patterns of attachment are self-perpetuating and may be transmitted across generations. PTSD is a syndrome resulting from a terrifying state of helplessness. Its manifestations are similar to those seen with disorganized attachment behaviours. Individuals can appear to cut themselves off from memories and feelings that are too painful to acknowledge. As a result trauma can become organized at a sensory and somatic level which is difficult to change. PTSD appears to alter neurophysiology and neuroanatomy. Traumatogenic stimuli may produce abnormal brain activity and, for example, an inability to speak. ‘Flips’ of mental state have been recorded both in patients who have been through childhood abuse and in borderline patients. The goal of treatment for borderline personality disorder should include the integration of dissociated self-states. Copyright © 1999 Whurr Publishers Ltd.",0 +https://doi.org/10.1111/j.1600-0447.2009.01407.x,Gender differences in bipolar disorder type I and II,"We investigated gender differences in bipolar disorder (BD) type I and II in a representative cohort of secondary care psychiatric in- and out-patients.In the prospective, naturalistic Jorvi Bipolar Study of 191 secondary care psychiatric in- and out-patients, 160 patients (85.1%) could be followed up for 18 months with a life chart.After adjusting for confounders, no marked differences in illness-related characteristics were found. However, female patients with BD had more lifetime comorbid eating disorders (P < 0.001, OR = 5.99, 95% CI 2.12-16.93) but less substance use disorders (P < 0.001, OR = 0.29, 95% CI 0.16-0.56) than males. Median time to recurrence after remission was 3.1 months longer among men than women, female gender carrying a higher hazard of recurrence (P = 0.006, HR = 2.00, 95% CI 1.22-3.27).Men and women with type I and II BD have fairly similar illness-related clinical characteristics, but their profile of comorbid disorders may differ significantly, particularly regarding substance use and eating disorders. In medium-term follow-up, females appear to have a higher hazard of recurrence than males.",0 +https://doi.org/10.1016/j.jpsychires.2012.02.006,Temporal analysis of heart rate variability as a predictor of post traumatic stress disorder in road traffic accidents survivors,"Road Traffic Accidents (RTA) are most probably the leading cause of post traumatic stress disorder (PTSD) in developed countries. The autonomic nervous system (ANS) disturbances, due to psychological trauma, are part of the pathophysiology of PTSD. The aim of the present study was to determine whether early heart rate variability (HRV) measurement, a biomarker of the ANS function, could act as a predictor of PTSD development after a RTA.We prospectively investigated 35 survivors of RTA with both physical injury and psychological trauma. HRV data were obtained from 24-h Holter ECG monitoring, which was performed on the second day after the accident. Time domain analysis was applied to the inter-beat (RR) interval time series to calculate the various parameters of HRV. PTSD status was assessed 2 and 6 months after RTA.There was a global diminution of HRV measurements in the PTSD group at both 2 and 6 months. The variability index was the best predictor of PTSD with the area under the receiveroperating curve for discriminating PTSD at 6 months at 0.92 (95% CI: 0.785; 1.046). A cut-off at 2.19% yielded a sensitivity of 85.7% and a specificity of 81.8% for PTSD. Positive and negative predictive values were respectively 75% and 90%. However, initial heart rate (HR) data were relevant at 2 months but not at 6 months.RTA survivors exhibiting lower parasympathetic modulation of HR, indexed by temporal analysis of HRV, are more susceptible to developing PTSD as a short and long-term outcome.",0 +,The Performance of Post-Traumatic Stress Disorder Subjects in Verbal and Visual False Memory Tasks,"Introduction: The current study investigated verbal and visual false memories among post-traumatic stress disorder sufferers. Methods: This causal-comparative study recruited 20 patients suffering from PTSD according to the DSMIV-TR criteria, and 20 non-PTSD subjects who involved in the same trauma of PTSD as well as 20 normal subjects who were matched for age, sex, and socio-economic status. The instruments included Beck Depression Inventory, Beck Anxiety Inventory, Impact of Event Scale, WIAS (short version), plus the Visual and Verbal False Memory Tasks prepared according to Deese-Roediger-McDermott's (DRM) paradigm. Obtained data were analyzed using the analysis of variance (ANOVA) and Tukey's post-hoc test. Results: Our findings indicated that PTSD patients produced more false memories (both verbal and visual) than non-PTSD and healthy control subjects in both tasks. Conclusion: Such findings are interpretable within the framework of the cognitive theories of PTSD and other memory deficits of PTSD patients. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1016/s0887-6185(02)00184-6,Trauma and bereavement:,"The intersection between trauma and bereavement has only recently been explored. Prior studies of bereavement have often neglected to measure posttraumatic stress disorder (PTSD) symptoms; the few that have offer equivocal findings concerning the role of PTSD symptomatology following loss. Few studies have explored the relationship between PTSD and the other psychological sequelae more commonly associated with loss. The current investigation assessed PTSD symptoms over time following the death of a spouse, using violence and the suddenness of the loss as potential outcome predictors. In addition, the relationship between PTSD and depression symptoms was assessed. Violent death predicted PTSD symptoms and the persistence of depression over time. The suddenness of the loss was not related to PTSD symptoms. This investigation suggests that violent death results in development of PTSD symptoms over and above the normal grief response and thus, may contribute to a more severe grief response.",0 +https://doi.org/10.1080/10926771.2015.1062451,Are Specific Emotion Regulation Strategies Differentially Associated with Posttraumatic Growth Versus Stress?,"Extremely few studies have examined emotion regulation strategies as predictors of posttraumatic growth (PTG). This study aimed to examine several specific emotion regulation strategies, along with meaning making, as predictors of PTG, as opposed to posttraumatic distress. Participants were 107 adult women who had experienced a very stressful or traumatic event within the past 3 years and completed questionnaires measuring emotion regulation, meaning making, distress, and PTG. Emotion suppression positively predicted distress, but not PTG. Meaning making positively predicted PTG and negatively predicted distress. Bootstrapped mediation models showed that emotional processing has a significant indirect effect on PTG and distress through its effect on meaning making. Results indicate that researchers should pay closer attention to emotional processes involved in etiological models of PTG. It might also be helpful to examine specific emotion regulation strategies, as these can point to ways to help people na...",0 +https://doi.org/10.1002/jts.20573,Predicting posttraumatic stress symptoms in children following Hurricane Katrina: A prospective analysis of the effect of parental distress and parenting practices,en,0 +,Post Traumatic Stress Disorder: Psychobiological mechanisms of traumatic remembrance.,"(from the chapter) synthesize the findings from preclinical investigations of learning and memory processes and the neurochemical effects of stress with clinical studies of posttraumatic stress disorder (PTSD) to develop a set of hypotheses related to the role of traumatic remembrance in the pathogenesis and treatment of PTSD / discuss the possible mechanisms underlying memory distortion that occurs in PTSD patients / adopted a cognitive neuroscience perspective that assumed that the features of traumatic memories and dissociative states in PTSD are properties of the underlying neural and psychodynamic networks mediating these functions neural mechanisms of learning and memory: relevance to the reexperiencing symptoms of PTSD [fear conditioning, a possible failure of extinction in PTSD, behavioral sensitization and stress sensitivity in PTSD] / altered memory functions in PTSD [dissociation, declarative memory, encoding of traumatic memories, factors related to traumatic memory recall] / assessment and treatment of PTSD-related memory disturbances (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1017/s003329171300250x,Abnormalities in whole-brain functional connectivity observed in treatment-naive post-traumatic stress disorder patients following an earthquake,"Background Convergent studies have highlighted the dysfunction of the amygdala, prefrontal cortex and hippocampus in post-traumatic stress disorder (PTSD). However, only a few studies have investigated the functional connectivity between brain regions in PTSD patients during the resting state, which may improve our understanding of the neuropathophysiology of PTSD. The aim of this study was to investigate patterns of whole-brain functional connectivity in treatment-naive PTSD patients without co-morbid conditions who experienced the 8.0-magnitude earthquake in the Sichuan province of China. Method A total of 72 PTSD patients and 86 trauma-exposed non-PTSD controls participated in the resting-state functional magnetic resonance imaging study. All these subjects were recruited from the disaster zone of the 2008 Sichuan earthquake. Functional connectivities between 90 paired brain regions in PTSD patients were compared with those in trauma-exposed non-PTSD controls. Furthermore, Pearson correlation analysis was performed between significantly abnormal connectivities in PTSD patients and their clinician-administered PTSD scale (CAPS) scores. Results Compared with non-PTSD controls, PTSD patients showed weaker positive connectivities between the middle prefrontal cortex (mPFC) and the amygdala, hippocampus, parahippocampal gyrus and rectus, as well as between the inferior orbitofrontal cortex and the hippocampus. In addition, PTSD patients showed stronger negative connectivity between the posterior cingulate cortex (PCC) and the insula. The CAPS scores in PTSD patients correlated negatively with the connectivity between the amygdala and the mPFC. Conclusions PTSD patients showed abnormalities in whole-brain functional connectivity, primarily affecting the connectivities between the mPFC and limbic system, and connectivity between the PCC and insula.",0 +https://doi.org/10.1017/s003329170700997x,Cerebral blood flow changes during retrieval of traumatic memories before and after psychotherapy: a SPECT study,"ABSTRACT Background Traumatic memory is a key symptom in psychological trauma victims and may remain vivid for several years. Psychotherapy has shown that neither the psychopathological signs of trauma nor the expression of traumatic memories are static over time. However, few studies have investigated the neural substrates of psychotherapy-related symptom changes. Method We studied 16 subthreshold post-traumatic stress disorder (PTSD) subjects by using a script-driven symptom provocation paradigm adapted for single photon emission computed tomography (SPECT) that was read aloud during traumatic memory retrieval both before and after exposure-based and cognitive restructuring therapy. Their neural activity levels were compared with a control group comprising 11 waiting-list subthreshold PTSD patients, who were age- and profile-matched with the psychotherapy group. Results Significantly higher activity was observed in the parietal lobes, left hippocampus, thalamus and left prefrontal cortex during memory retrieval after psychotherapy. Positive correlations were found between activity changes in the left prefrontal cortex and left thalamus, and also between the left prefrontal cortex and left parietal lobe. Conclusions Neural mechanisms involved in subthreshold PTSD may share neural similarities with those underlying the fragmented and non-verbal nature of traumatic memories in full PTSD. Moreover, psychotherapy may influence the development of a narrative pattern overlaying the declarative memory neural substrates.",0 +https://doi.org/10.1111/j.1749-6632.1996.tb32529.x,A Clinical Approach to the Pharmacotherapy of Aggression in Children and Adolescents,"Overt aggression in its various forms is the most prevalent symptom presenting to pediatric mental health providers, regardless of setting. It is a behavior with a heterogeneous etiology and requires a comprehensive approach to evaluation and treatment. Evaluation of the aggressive child must assess medical, neurologic, psychiatric, psychosocial, familial, and/or educational contributions to behavioral dyscontrol. Multimodal treatment is generally required. At present, there is no single medication to recommend for the treatment of aggressive behavior. Multiple medications have clinically been used in a nonspecific fashion to target excessive childhood aggression. Although successful for some, this approach increases risk for ineffective interventions accompanied by side effects. Until a scientific understanding of the developmental neurobiology of aggression leads to more specific treatment, this review suggests the use of a diagnostic-based approach to the pharmacology of aggression (FIG. 1). Descriptive diagnostic techniques should be used to define the presence of any primary or comorbid psychiatric disorder that presents with aggression as an associated symptom. Treating aggression in the context of these psychiatric syndromes appears to be the most direct approach. Aggression occurring in the context of a medication-responsive psychiatric diagnosis appears most sensitive to pharmacologic intervention. Presently, evidence for efficacy is strongest for aggression in the context of ADHD, psychotic disorder, adolescent-onset bipolar disorder, and ictal aggression It remains less clear that medication can help aggression when it occurs independently of a pharmacologically treatable comorbid psychiatric disorder. Aggression may respond to a target symptom approach where discrete behavioral symptoms that contribute to aggression, such as irritability, explosiveness, fear, or impulsivity, may be modified by medication intervention (FIG. 1). When treatment is approached in this fashion, it is standard practice to use the least toxic and safest intervention first. Behavioral treatment based on contingency management principles could be initially recommended. Medication trials should first use medications that have demonstrated empiric efficacy in reducing aggression (TABLE 1) and that have a favorable safety profile. Neuroleptics to treat aggression in nonpsychotic psychiatrically referred youth should be kept to a minimum, secondary to their significant adverse risk profile. Alternative medications, such as selective serotonin reuptake-inhibiting antidepressants, buspirone, lithium, anticonvulsants, opiate blocking agents, propranolol, nadolol, and clonidine, deserve more clinical research in pediatric aggression. These medications may offer effective and less toxic alternatives in the pharmacologic treatment of inappropriate excessive childhood aggression.",0 +https://doi.org/10.1017/s1092852900008889,Genetics of Posttraumatic Stress Disorder,"ABSTRACT Posttraumatic stress disorder (PTSD) is a prevalent anxiety disorder marked by behavioral, physiologic, and hormonal alterations. PTSD is disabling and commonly follows a chronic course. The etiology of PTSD is unknown, although exposure to a traumatic event constitutes a necessary, but not sufficient, factor. A twin study of Vietnam veterans has shown significant genetic contribution to PTSD. The fact that PTSD's underlying genotypic vulnerability is only expressed following trauma exposure limits the usefulness of family-based linkage approaches. In contrast to the other major psychiatric disorders, large studies for the search of underlying genes have not been described in PTSD to date. Complementary approaches for locating involved genes include association-based studies employing case-control or parental genotypes for transmission dysequilibrium analysis and quantitative trait loci studies in animal models. Identification of susceptibility genes will increase our understanding of traumatic stress disorders and help to elucidate their molecular basis. The current review provides an up-to-date outline of progress in the field of PTSD.",0 +https://doi.org/10.1007/s11606-013-2374-8,The Relationship between Body Mass Index and Mental Health Among Iraq and Afghanistan Veterans,"ABSTRACT BACKGROUND Obesity is a growing public health concern and is becoming an epidemic among veterans in the post-deployment period. OBJECTIVE To explore the relationship between body mass index (BMI) and posttraumatic stress disorder (PTSD) in a large cohort of Iraq and Afghanistan veterans, and to evaluate trajectories of change in BMI over 3 years. DESIGN Retrospective, longitudinal cohort analysis of veterans’ health records PARTICIPANTS A total of 496,722 veterans (59,790 female and 436,932 male veterans) whose height and weight were recorded at the Department of Veterans Affairs (VA) healthcare system at least once after the end of their last deployment and whose first post-deployment outpatient encounter at the VA was at least 1 year prior to the end of the study period (December 31, 2011). MAIN MEASURES BMI, mental health diagnoses. KEY RESULTS Seventy-five percent of Iraq and Afghanistan veterans were either overweight or obese at baseline. Four trajectories were observed: “stable overweight” represented the largest class; followed by “stable obese;” “overweight/obese gaining;” and “obese losing.” During the 3-year ascertainment period, those with PTSD and depression in particular were at the greatest risk of being either obese without weight loss or overweight or obese and continuing to gain weight. Adjustment for demographics and antipsychotic medication attenuated the relationship between BMI and certain mental health diagnoses. Although BMI trajectories were similar in men and women, some gender differences were observed. For example, the risk of being in the persistently obese class in men was highest for those with PTSD, whereas for women, the risk was highest among those with depression. CONCLUSIONS The growing number of overweight or obese returning veterans is a concerning problem for clinicians who work with these patients. Successful intervention to reduce the prevalence of obesity will require integrated efforts from primary care and mental health to treat underlying mental health causes and assist with engagement in weight loss programs.",0 +https://doi.org/10.2105/ajph.2008.155432,A Prospective Study of Depression Following Combat Deployment in Support of the Wars in Iraq and Afghanistan,"Objective. We investigated relations between deployment and new-onset depression among US service members recently deployed to the wars in Iraq and Afghanistan. Methods. We included 40 219 Millennium Cohort Study participants who completed baseline and follow-up questionnaires and met inclusion criteria. Participants were identified with depression if they met the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire criteria for depression at follow-up, but not at baseline. Results. Deployed men and women with combat exposures had the highest onset of depression, followed by those not deployed and those deployed without combat exposures. Combat-deployed men and women were at increased risk for new-onset depression compared with nondeployed men and women (men: adjusted odds ratio [AOR] = 1.32; 95% confidence interval [CI] = 1.13, 1.54; women: AOR = 2.13; 95% CI = 1.70, 2.65). Conversely, deployment without combat exposures led to decreased risk for new-onset depression compared with those who did not deploy (men: AOR = 0.66; 95% CI = 0.53, 0.83; women: AOR = 0.65; 95% CI = 0.47, 0.89). Conclusions. Deployment with combat exposures is a risk factor for new-onset depression among US service members. Post-deployment screening may be beneficial for US service members exposed to combat.",0 +https://doi.org/10.15288/jsa.2003.64.601,Rates and symptoms of PTSD among cocaine-dependent patients.,"This study evaluated lifetime traumatic events and current posttraumatic stress disorder (PTSD) symptoms in a substance abuse sample.Participants in the study consisted of 558 (75.1% male) cocaine-dependent individuals who completed self-report measures of trauma and PTSD symptoms prior to entry into treatment.Results showed a high number of lifetime traumatic events, even among those without PTSD. General disaster was the most prevalent. Current PTSD was found in 10.9% of the participants, with a significantly higher rate among women (21.6%) than among men (7.2%). For those with PTSD, the most prominent PTSD symptom cluster was arousal, and the most common symptoms were restricted affect, detachment and irritability. Participants with PTSD endorsed a large number of symptoms, almost double that needed to meet diagnostic criteria; however, neither number of traumas nor type of trauma was associated with their level of PTSD symptoms. Even among those not meeting PTSD criteria, subthreshold symptoms were found, with avoidance the most prominent cluster. Sociodemographic and recent cocaine use variables did not differentiate the PTSD from non-PTSD groups.PTSD is present in a sizeable percentage of cocaine-dependent treatment-seeking patients, particularly women. Clinicians might address arousal symptoms in particular, which were the most prominent symptom cluster, and which may be exacerbated by cocaine use. Even among those without PTSD, lifetime trauma is substantial and subthreshold PTSD symptoms are common. Vulnerability to PTSD needs further study, as sociodemographic and cocaine use variables did not distinguish between PTSD and non-PTSD groups.",0 +https://doi.org/10.1016/j.amepre.2013.01.013,Post-Traumatic Stress Disorder,"

Abstract

Since the start of the wars in Afghanistan and Iraq, the U.S. military has implemented several population-based initiatives to enhance psychological resilience and prevent psychological morbidity in troops. The largest of these initiatives is the Army's Comprehensive Soldier Fitness (CSF) program, which has been disseminated to more than 1 million soldiers. However, to date, CSF has not been independently and objectively reviewed, and the degree to which it successfully promotes adaptive outcomes and prevents the development of deployment-related mental health disorders such as post-traumatic stress disorder (PTSD) is uncertain. This paper critically evaluates the theoretic foundation for and evidence supporting the use of CSF.",0 +https://doi.org/10.1080/0887044022000004966,"Personality, Social Context and Cognitive Predictors of Post-Traumatic Stress Disorder in Myocardial Infarction Patients","The study investigated the relationship between two personality factors (alexithymia and negative affect), social support, the immediate cognitive and emotional response (importance, degree of emotional response, dissociation, fear) to a myocardial infarction and the frequency of post-traumatic stress disorder (PTSD) symptoms three months following a myocardial infarction (MI). Seventy five of eighty nine consecutive hospital admissions completed questionnaires both in hospital and three months subsequently. The study found a PTSD prevalence rate of sixteen percent three months following MI. There was a moderate reduction of intrusive memories of the MI and anxiety symptoms over time and a non-significant reduction in avoidance phenomena. Depressive symptoms did not reduce over time. Significant associations were found between PTSD symptoms at three months and initial intrusion and avoidance symptoms, negative affect, absence of confidant support, dissociation, fright and surprise. The percentage of the v...",0 +https://doi.org/10.1007/s00127-011-0439-8,"Relationships between impact on employment, working conditions, socio-occupational categories and symptoms of post-traumatic stress disorder after the industrial disaster in Toulouse, France","Objectives: The aims of this paper were (1) to analyze the prevalence of symptoms of post-traumatic stress disorder (S-PTSD) in a population of workers 1 year after an industrial disaster; and (2) to assess the role of factors of vulnerability such as the occupational impact of a disaster and economic conditions. Methods: A cross-sectional survey assessing the relationships between socio-occupational category, impact on employment and S-PTSD was conducted by the self-administered impact of event scale-revised. Results: The prevalence of S-PTSD in workers in the peripheral zone (<3 km around the explosion site) was 12% in men and 18% in women. Factors significantly associated with S-PTSD in men were non-managerial socio-occupational category: employees (ORa = 4.3; [2.3; 7.8]), factory workers/laborers (ORa = 3.7; [1.8; 7.6]), intermediate professions (ORa = 3.3; [1.9; 5.9]), and artisans (ORa = 3; [1.3; 7.7]); and layoff (ORa = 2.6; [1.5; 4.5]) or unusable workplace after the explosion (ORa = 1.8; [1.1; 2.8]). In women, factors significantly associated with S-PTSD were the socio-occupational categories of employees and factory workers (ORa = 2.2; [1.4; 3.5]), artisans (ORa = 2.7; [1.3; 5.7]) and intermediate professions, (ORa = 1.5; [1; 2.3]) and reporting of an occupational accident (ORa = 1.5; [1.1; 2.2]). Conclusion: Impact on the workplace and socioeconomic conditions were associated with S-PTSD. The epidemiological approach in disaster situations needs to be improved, particularly in the social and occupational dimension when economically active populations are involved. Vulnerable subgroups, defined by occupational impact and low socioeconomic category, should be taken into account. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1016/s0006-3223(97)00511-8,"Hypnotizability, pain threshold, and dissociative experiences","There may be an association between pain threshold, hypnotizability, and dissociative experiences. The purpose of the present study was to examine this association.Forty-one healthy subjects were included in the study. Pain thresholds were determined using a manual algometer. The Dissociative Experiences Scale was administered to all subjects. Hypnotizability of the subjects was assessed by the eye roll sign of the Hypnotic Induction Profile. There were 14, 15, and 12 subjects in the Grade 1, 2, and 3 groups, respectively.Highly hypnotizable subjects had lower pain thresholds and were more likely to report dissociative experiences than the less hypnotizable subjects.There is an association between pain threshold, hypnotizability, and dissociative experiences. It may be suggested that dissociative and somatic symptoms may be integrally linked and related to hypnotic suggestibility.",0 +https://doi.org/10.1126/science.1222069,Are We Winning the War Against Posttraumatic Stress Disorder?,"The most methodologically rigorous epidemiological study on American military personnel deployed to Iraq and Afghanistan found that 4.3% of troops developed posttraumatic stress disorder (PTSD). Among deployed combatants, 7.6% developed PTSD, whereas 1.4% of deployed noncombatants did so. The U.S. Department of Veterans Affairs has launched a program ensuring that all veterans with PTSD will receive evidence-based cognitive-behavioral therapy, and the Army has developed Battlemind postdeployment early interventions that reduce risk for the disorder.",0 +https://doi.org/10.1037/pas0000254,Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders–Fifth Edition (PCL-5) in veterans.,"This study examined the psychometric properties of the posttraumatic stress disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5; Weathers, Litz, et al., 2013b) in 2 independent samples of veterans receiving care at a Veterans Affairs Medical Center (N = 468). A subsample of these participants (n = 140) was used to define a valid diagnostic cutoff score for the instrument using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5; Weathers, Blake, et al., 2013) as the reference standard. The PCL-5 test scores demonstrated good internal consistency (α = .96), test-retest reliability (r = .84), and convergent and discriminant validity. Consistent with previous studies (Armour et al., 2015; Liu et al., 2014), confirmatory factor analysis revealed that the data were best explained by a 6-factor anhedonia model and a 7-factor hybrid model. Signal detection analyses using the CAPS-5 revealed that PCL-5 scores of 31 to 33 were optimally efficient for diagnosing PTSD (κ(.5) = .58). Overall, the findings suggest that the PCL-5 is a psychometrically sound instrument that can be used effectively with veterans. Further, by determining a valid cutoff score using the CAPS-5, the PCL-5 can now be used to identify veterans with probable PTSD. However, findings also suggest the need for research to evaluate cluster structure of DSM-5. (PsycINFO Database Record",0 +https://doi.org/10.1093/geronj/44.6.s207,"Psychological Symptoms in Older Adults Following Natural Disaster: Nature, Timing, Duration, and Course","Using a prospective design with five follow-up intervals, the study addressed questions regarding the timing of onset, duration, course, and nature of psychological reaction to natural disaster. As participants in a statewide panel study, more than 200 older adults were interviewed both before and after two distinct floods occurred in southeastern Kentucky in 1981 and 1984. Exposure to these incidents, which differed in overall intensity, was assessed at both the individual and community levels. Personal loss was associated with short-term increases in negative affect, limited to one year postflood. Longer-term effects were more dependent on the level of community destruction. Exposure to high levels of community destruction was related to decreased positive affect up to two years postdisaster, whereas exposure to high levels of both community destruction and personal loss was predictive of increased negative affect for two years.",0 +https://doi.org/10.1002/1097-4679(199301)49:1<33::aid-jclp2270490106>3.0.co;2-h,Complex partial epileptic signs as a continuum from normals to epileptics: Normative data and clinical populations,"Over a 10-year period, a total of 447 men and 624 women between 18 and 61 years of age were administered an inventory whose items describe experiences that are similar to those evoked by electrical stimulation of the temporal lobes. Empirically determined factors contained experiences of sensory enhancement, affective-dissociation, ego alien intrusions, and literary emphasis. Using this population as a reference, T scores for these clusters were calculated for special normal populations (poets, drama students, false pregnancies) and for clinical groups (post-traumatic stress, anxiety-depersonalization, exotic dissociations, and complex partial epilepsy). Whereas only mild elevations (50 < T < 65) in indicators of temporal lobe signs and symptoms were noted in the special groups, moderate (65 < T < 75) and severe (T > 79) elevations were noted in the clinical populations.",0 +https://doi.org/10.1176/ajp.153.3.369,Chronic PTSD in Vietnam combat veterans: course of illness and substance abuse,"The purpose of this study was to measure the longitudinal course of specific symptoms of posttraumatic stress disorder (PTSD) and related symptoms of alcohol and substance abuse and the effects of alcohol and substances on the symptoms of PTSD.A structured interview for the assessment of PTSD and alcohol and substance abuse, as well as other factors such as life stressors and treatment, was administered to 61 Vietnam combat veterans with PTSD.Onset of symptoms typically occurred at the time of exposure to combat trauma in Vietnam and increased rapidly during the first few years after the war. Symptoms plateaued within a few years after the war, following which the disorder became chronic and unremitting. Hyperarousal symptoms such as feeling on guard and feeling easily startled developed first, followed by avoidant symptoms and finally by symptoms from the intrusive cluster. The onset of alcohol and substance abuse typically was associated with the onset of symptoms of PTSD, and the increase in use paralleled the increase of symptoms. Patients reported a tendency for alcohol, marijuana, heroin, and benzodiazepines to make PTSD symptoms better, while cocaine made symptoms in the hyperarousal category worse. There was no relationship between treatment interventions and the natural course of PTSD.These findings suggest that symptoms of PTSD begin soon after exposure to trauma, that hyperarousal symptoms are the first symptoms to occur, that the natural course of alcohol and substance abuse parallels that of PTSD, and that specific substances have specific effects on PTSD symptoms.",0 +https://doi.org/10.1097/00004583-199303000-00027,A 6-Year Follow-up Study of Cambodian Refugee Adolescents Traumatized as Children,"Seventy-three percent of a sample of 46 Cambodian youth interviewed in 1984 and 1987 were reinterviewed in 1990 as part of a pretest for a multisite study of Cambodian refugee trauma now under way. An additional sample of convenience of 38 youth were also interviewed to determine reliability and validity of the diagnostic instruments chosen for the larger study. The DSM-III-R diagnosis of post-traumatic stress disorder (PTSD) was found to persist, but the symptoms appeared less intense over time. In contrast, the prevalence of depression dropped markedly since 1987. Subjects remained largely free of comorbid conditions. Diagnostic reliability and validity were satisfactory. The follow-up sample appeared to be functioning well despite their PTSD profiles. The findings are discussed in light of several current controversies surrounding the concept and measurement of PTSD.",0 +https://doi.org/10.1016/j.brat.2013.02.002,Sex differences in recovery from PTSD in male and female interpersonal assault survivors,"Men and women differ in exposure to trauma and the development of posttraumatic stress disorder (PTSD); however, research regarding sex differences in recovery from PTSD has been sparse. This study evaluated the treatment response trajectory for 69 male and female interpersonal assault survivors, using a modified Cognitive Processing Therapy (CPT) protocol that allowed survivors to receive up to18 sessions of CPT, with treatment end determined by therapy progress. Few sex differences were observed in trauma history, baseline PTSD and depressive severity, Axis I comorbidity, anger, guilt and dissociation. Women did report more sexual assault in adulthood and elevated baseline guilt cognitions, whereas men reported more baseline anger directed inward. Attrition and total number of sessions did not differ by sex. Over the course of treatment and follow-up, men and women demonstrated similar rates of change in PTSD and depressive symptoms. However, medium effect sizes on both of these primary outcomes at the 3-month follow-up assessment favored women. Several differences in the slope of change emerged on secondary outcomes such that women evidenced more rapid gains on global guilt, guilt cognitions, anger/irritability, and dissociation. Results suggest that male survivors may warrant additional attention to address these important clinical correlates.",0 +https://doi.org/10.1177/003335491012500411,Trends of Elevated PTSD Risk in Firefighters Exposed to the World Trade Center Disaster: 2001–2005,"Objectives. We identified trends in the prevalence of elevated posttraumatic stress disorder (PTSD) risk as determined by the Fire Department of the City of New York (FDNY)-modified PTSD Checklist in World Trade Center (WTC)-exposed firefighters. We also examined trends in relation to WTC exposure, social support, change in recreational activities, and functional health. Methods. We analyzed 16,826 questionnaires from 10,074 firefighters in yearly intervals, from September 12, 2001, to September 11, 2005. Results. The prevalence of elevated PTSD risk increased over time, from 9.8% in year 1 to 10.6% in year 4 ( p<0.0001). Earliest arrival at the WTC site (odds ratio [OR] = 6.0; 95% confidence interval [CI] 4.4, 8.3), prolonged work at the site (OR=2.0; 95% CI 1.8, 2.3), providing supervision without previous supervisory experience (OR=4.1; 95% CI 2.8, 6.1), and retirement due to a WTC-related disability (OR=1.3; 95% CI 1.1, 1.5) were associated with ever having elevated PTSD risk. Difficulty functioning at home was strongly associated with elevated PTSD risk (ORs ranged from 17.0 [95% CI 14.5, 20.0] in year 1 to 26.7 [95% CI 20.3, 35.2] in year 3), as was difficulty functioning at work (ORs ranged from 12.1 [95% CI 10.2, 14.2] in year 1 to 23.0 [95% CI 14.6, 36.3] in year 2). Conclusions. Elevated PTSD risk was associated with exposure to the WTC site as well as functional impairment, and remained largely unabated during the first four years of the study. Screening for elevated PTSD risk may be useful in identifying those who could benefit from interventions during long-term follow-up, as well as in the immediate aftermath of disasters.",0 +https://doi.org/10.1016/j.genhosppsych.2004.04.003,"Psychiatric disorders, trauma, and MMPI profile in a Spanish sample of nonepileptic seizure patients","The aim of this study was to examine clinical characteristics in patients with psychogenic nonepileptic seizures and to analyze the Minnesota Multiphasic Personality Inventory (MMPI) profiles and their relation to psychopathology. Thirty patients with nonepileptic seizures confirmed through video-electroencephalography were included. A structured clinical interview (Structured Clinical Interview for DSM-III-R), a measure of personality variables (MMPI), and several structured interviews designed for collecting data on clinical and personal history were administered. Descriptive and comparative statistical methods were used. Of the sample, 67.7% met criteria for two or more simultaneous Axis I diagnoses, and 60% for an Axis II personality disorder. The most frequently elevated scales of the MMPI were Schizophrenia and Depression. There were multiple scale elevations in 12 profiles, the 91.7% of which had elevated ""neurotic"" and ""psychotic"" scales. The subgroup with personality disorders showed higher scores on the MMPI Paranoia and Hypomania scales, and the subgroup with traumatic experiences showed higher scores on the MMPI Hypomania scale. Our sample comprising patients with nonepileptic seizures showed a significant degree of psychopathology and absence of a unique character substrate. According to grades of clinical severity of pseudoseizures, several subgroups and different therapeutic implications may be defined.",0 +https://doi.org/10.2165/00023210-199402030-00007,Serotonin 5-HT1A Agonists,"In 1980, buspirone was found to have anxiolytic potential. This finding initiated the development of the azapirones — highly serotonin 5-HT1A agonists. The balance of evidence suggests that the azapirones act as partial agonists postsynaptically, but as full agonists presynaptically in the dorsal raphé. This review focuses mainly on agents for which there are published clinical trial data. Numerous studies have shown that buspirone, gepirone and ipsapirone are as effective as the benzodiazepines in the treatment of generalised anxiety. However, they have a slower onset of action. The azapirones have a completely different adverse reaction profile (dizziness and gastric complaints) compared with the benzodiazepines (sedation, memory loss and withdrawal dependency). Several controlled studies have shown that the azapirones are effective in depression, particularly of the melancholic type. They have an adverse effects profile similar to, but less severe than, the selective serotonin reuptake inhibitors and different to that of the tricyclic antidepressants. Buspirone has not yet proven to be effective in panic disorder. However, gepirone, ipsapirone and other azapirones may be more effective in this disorder. Early studies indicate promising results for buspirone in the treatment of obsessive-compulsive disorder. Clinical trials in alcoholism are equivocal. Further studies of this class of drugs in the treatment of social phobia, post-traumatic stress disorder, premenstrual syndrome, and compulsive and aggressive disorders are in progress. A principle drawback with this class of drug is their short half-life. However, sustained release preparations are being developed. © 1994, Adis International Limited. All rights reserved.",0 +https://doi.org/10.1016/s0887-6185(97)00041-8,Posttraumatic stress disorder after childbirth: A cross sectional study,"The prevalence of having a posttraumatic stress disorder (PTSD) profile after childbirth and women's cognitive appraisal of the childbirth were studied cross sectionally in an unselected sample of all women who had given birth over a 1-year period in Linköping, Sweden. The PTSD profile was assessed by means of Traumatic Event Scale (TES), which is based on diagnostic criteria from Diagnostic and Statistical Manual of Mental Disorders , fourth edition ( DSM-IV ; American Psychiatric Association, 1994). The women's cognitive appraisal of the childbirth was measured by means of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ). Twenty-eight women (1.7%) of 1640 met criteria for a PTSD profile related to the recent delivery. A PTSD profile was related to a history of having received psychiatric/psychological counseling, a negative cognitive appraisal of the past delivery, mulliparity, and rating the contact with delivery staff in negative terms.",0 +https://doi.org/10.1016/j.smrv.2014.02.001,Ontogeny of dreaming: A review of empirical studies,"The examination of children's sleep-related mental experiences presents many significant challenges for researchers investigating the developmental trajectories of human dreaming. In contrast to the well-explored developmental patterns of human sleep, data from dream research are strikingly divergent with highly ambiguous results and conclusions, even though there is plenty of indirect evidence suggesting parallel patterns of development between neural maturation and dreaming. Thus results from studies of children's dreaming are of essential importance not only to enlighten us on the nature and role of dreaming but to also add to our knowledge of consciousness and cognitive and emotional development. This review summarizes research results related to the ontogeny of dreaming: we critically reconsider the field, systematically compare the findings based on different methodologies, and highlight the advantages and disadvantages of methods, arguing in favor of methodological pluralism. Since most contradictory results emerge in connection with descriptive as well as content related characteristics of young children's dreams, we emphasize the importance of carefully selected dream collection methods. In contrast nightmare-related studies yield surprisingly convergent results, thus providing strong basis for inferences about the connections between dreaming and cognitive emotional functioning. Potential directions for dream research are discussed, aiming to explore the as yet unraveled correlations between the maturation of neural organization, sleep architecture and dreaming patterns.",0 +https://doi.org/10.3109/08039488.2012.655308,The Norwegian version of the PTSD Checklist (PCL): Construct validity in a community sample of 2004 tsunami survivors,"The PTSD Checklist (PCL) is a widely used self-administered measure of post-traumatic stress disorder (PTSD) and it has been validated in a variety of languages and cultures.Evaluate the diagnostic validity of the Norwegian version of a specific PCL (PCL-S) for detecting PTSD in epidemiological research.Participants were severely exposed Norwegian survivors from the 2004 South-East Asian tsunami. Of 75 individuals asked to participate, 63 responded (84%). PTSD was assessed by PCL-S and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). These instruments were compared to evaluate the diagnostic validity of the PCL. We used two different scoring methods to diagnose PTSD based on PCL. The first method was based on the dichotomized sum score (cut-off ≥ 50) and the second was based on the flowchart method following DSM-IV symptom criteria. Area under the curve (AUC), Cohen's kappa, sensitivity and specificity were used to evaluate the agreement between the PCL and SCID-I.According to the clinical interview, 11.3% of the participants met the diagnostic criteria for PTSD. The two scoring methods of PCL-S revealed similar results: according to both methods, 14.5% were categorized with PTSD. AUC was 0.98 (95% CI 0.93-1.00). For Cohen's kappa, the agreement was 0.71. Sensitivity was 0.86 and specificity 0.95. Agreement between PCL and SCID-I investigated for each of the three symptom clusters of PTSD and for the 17 individual items showed mostly a moderate to substantial agreement.The Norwegian version of the PCL-S performed well as a diagnostic instrument for detecting PTSD in epidemiological research.",0 +https://doi.org/10.1080/10437797.2015.1001274,Military Social Work: Opportunities and Challenges for Social Work Education,"Military social work is a specialized field of practice spanning the micro-macro continuum and requiring advanced social work knowledge and skills. The complex behavioral health problems and service needs of Iraq and Afghanistan veterans highlight the need for highly trained social work professionals who can provide militarily-relevant and culturally-responsive evidence-informed services. Responding to the military behavioral health workforce and service needs of recently returned veterans presents both opportunities and challenges for military social work education. This article discusses the rationale for a military social work specialization, the need for military social work education, and opportunities and challenges for social work education. An integrated model of intellectual capital is proposed to guide strategic planning for future military social work education.",0 +https://doi.org/10.1523/jneurosci.1526-14.2014,Epigenetic Modification of the Glucocorticoid Receptor Gene Is Linked to Traumatic Memory and Post-Traumatic Stress Disorder Risk in Genocide Survivors,"Recent evidence suggests that altered expression and epigenetic modification of the glucocorticoid receptor gene (NR3C1) are related to the risk of post-traumatic stress disorder (PTSD). The underlying mechanisms, however, remain unknown. Because glucocorticoid receptor signaling is known to regulate emotional memory processes, particularly in men, epigenetic modifications of NR3C1 might affect the strength of traumatic memories. Here, we found that increased DNA methylation at the NGFI-A (nerve growth factor-induced protein A) binding site of the NR3C1 promoter was associated with less intrusive memory of the traumatic event and reduced PTSD risk in male, but not female survivors of the Rwandan genocide. NR3C1 methylation was not significantly related to hyperarousal or avoidance symptoms. We further investigated the relationship between NR3C1 methylation and memory functions in a neuroimaging study in healthy subjects. Increased NR3C1 methylation-which was associated with lower NR3C1 expression-was related to reduced picture recognition in male, but not female subjects. Furthermore, we found methylation-dependent differences in recognition memory-related brain activity in men. Together, these findings indicate that an epigenetic modification of the glucocorticoid receptor gene promoter is linked to interindividual and gender-specific differences in memory functions and PTSD risk.",0 +https://doi.org/10.1007/s00737-011-0244-0,The role of psychosocial factors in the course of pain—a 1-year follow-up study among women living in Sweden,"The understanding of the associations between psychosocial factors and persistent pain and their impact on the course of pain among women is crucial to identify risk populations and prevent long-term pain from developing. The aim of the study was to investigate the course of pain among women and the psychosocial factors associated with it. The study was a 1-year follow-up (FU) among 2,300 women in the general population of Sweden. Sociodemographic and psychosocial factors were analyzed in relation to the course of pain, assessed as the presence of pain during the last 3 months at baseline (BL) and at FU. Thirty-three percent of the women with no pain at BL and 77% of those with pain at BL reported pain at FU. Compared to the pain-free women, those who developed pain at FU reported lower social support and physical quality of life (QoL) and worse mental health. Women with sustained pain were older and reported worse mental health, lack of social support, and lower levels of QoL compared to those who recovered from pain. In the multiple logistic regression analyses, only post-traumatic stress symptoms were associated with the development of pain at FU. Number of pain locations and pain duration at BL and physical QoL were associated with sustained pain. Moreover, social support was identified as a protective factor against sustained pain. Pain is persistent or recurrent in a general female population. The results indicate that psychosocial factors do not work as primary predictors in the course of pain and might be better understood through indirect processes by limiting the individual's resources for handling pain in a functional manner.",0 +https://doi.org/10.2174/1567205012666150701102947,Stability in Cognitive Function Over 18 Years: Prevalence and Predictors among Older Mexican Americans,"Numerous studies have examined the association of physical, behavioral and social factors with cognitive decline in older adults. Less attention has been placed on factors associated with long-term maintenance of intact cognition even into very old age. A greater understanding of those factors can inform the development of activities for maintaining cognitive strength.Using a sample from the Hispanic Established Populations for Epidemiologic Study of the Elderly, a population-based study of non-institutionalized Mexican Americans aged 65 and older from five Southwestern states (N = 2767), latent class mixture models were developed to identify subgroups of cognitive change over time.Three distinct trajectories of cognitive change were identified and characterized as stable, slow decline and rapid decline. Compared to the rapid decline group, a higher proportion of the stable cognition group were women, had high school education, were married and attended church one or more times per week. Regular church attendance had a significant positive impact in the stable group (β = 0.64, p <0.01), the slow decline group (β = 0.84, p <0.001) and the rapid decline group (β = 2.50, p <0.001). Activity limitations had a consistently negative association with cognition in the stable, slow decline and rapid decline groups (β = -0.37, p <0.001; β = -0.85, p <0.001; and β = -1.58, p <0.001 respectively).Substantial heterogeneity exists in rates of cognitive decline among older Mexican Americans. Interventions targeting cognitive maintenance may benefit from increased focus on factors associated with continued social engagement.",0 +https://doi.org/10.1056/nejmoa0903326,Morphine Use after Combat Injury in Iraq and Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) is a common adverse mental health outcome among seriously injured civilians and military personnel who are survivors of trauma. Pharmacotherapy in the aftermath of serious physical injury or exposure to traumatic events may be effective for the secondary prevention of PTSD.We identified 696 injured U.S. military personnel without serious traumatic brain injury from the Navy-Marine Corps Combat Trauma Registry Expeditionary Medical Encounter Database. Complete data on medications administered were available for all personnel selected. The diagnosis of PTSD was obtained from the Career History Archival Medical and Personnel System and verified in a review of medical records.Among the 696 patients studied, 243 received a diagnosis of PTSD and 453 did not. The use of morphine during early resuscitation and trauma care was significantly associated with a lower risk of PTSD after injury. Among the patients in whom PTSD developed, 61% received morphine; among those in whom PTSD did not develop, 76% received morphine (odds ratio, 0.47; P<0.001). This association remained significant after adjustment for injury severity, age, mechanism of injury, status with respect to amputation, and selected injury-related clinical factors.Our findings suggest that the use of morphine during trauma care may reduce the risk of subsequent development of PTSD after serious injury.",0 +https://doi.org/10.1055/s-2007-965067,Blood Lactate and Heat Stress during Training in Rowers,"The purpose of the present study was to test the hypothesis that large increases in blood lactate concentration ([La] (b)) and/or body temperature may occur during an endurance training on a rowing ergometer and disrupt training. The influence of an increase in air convection on the capacity to perform a prolonged exercise was also explored. Ten trained oarsmen were asked to undergo twice, in control (C) and increased air ventilation (AV) conditions, two 30-min trainings on a rowing ergometer at a work rate corresponding to 2.5 mmol . L (-1) of [La] (b) determined during a previous incremental exercise (P (2.5)). Four subjects did not complete the training session in C despite a steady state in [La] (b) in two of them. In these four subjects, the end of the exercise was associated with the highest measured rectal temperatures (T (re), 39.4 +/- 0.1 degrees C) and rate of perceived exertion (RPE, 17.8 +/- 0.3). Regarding the six other subjects, their heart rate, oxygen uptake, RPE, T (re) and water loss values were lower (p < 0.05) in AV than in C. [La] (b) displayed the same profile in C and AV. This study suggests that i) high body temperature may constitute a significant factor of perceived exertion and disrupt indoor training session, and ii) capacity to perform an endurance training on a rowing ergometer was improved by increasing air convection.",0 +https://doi.org/10.1080/10615806.2013.853049,The effect of persistent posttraumatic stress disorder symptoms on executive functions in preadolescent children witnessing a single incident of death,"We compared executive functions (EFs) of traumatized preadolescent children with and without marked posttraumatic stress disorder (PTSD) symptoms to the performance of a nontraumatized control group, and examined the relationships between EF deficits and functional status in traumatized preadolescent children. Fifty-one preadolescent children who had witnessed a death at school 30 months prior (26 with marked PTSD symptoms and 25 without) and 30 healthy controls who had not been traumatized participated. EFs were examined using the Comprehensive Attention Test (CAT). The functional state of traumatized children was measured by the Parent Report Form-Children's Health and Illness Profile-Children's Edition (PRF-CHIP-CE). The traumatized children, regardless of status of PTSD symptomatology, showed poorer working memory performance than nontraumatized healthy controls. The traumatized children with marked PTSD symptoms performed more poorly on measures of interference control compared to those children without marked PTSD symptoms. Lower levels of EFs were associated with lower risk avoidance and diminished academic achievement in traumatized children. These results indicate that an inhibitory control deficit is specifically associated with the current PTSD symptoms but not with trauma exposure per se.",0 +https://doi.org/10.1016/j.comppsych.2005.04.006,Trauma and posttraumatic stress in users of the Anxiety Disorders Association of America Web site,"The Web site for the Anxiety Disorders Association of America (ADAA) receives more than 5 million visits per month and thus represents a unique medium for the study of anxiety disorders. ADAA Web site users from October 2002 to January 2003 were invited to complete a survey oriented toward trauma history and psychiatric sequelae. A diagnostic approximation of posttraumatic stress disorder (PTSD) was based on responses to the Trauma Questionnaire, the Davidson Trauma Scale, and questions about impairment. The Connor-Davidson Resilience Scale was also used. Variables were tested for their association with PTSD. Among 1558 participants, 87% had a history of trauma, and 38% had current PTSD. The population was comprised predominantly of white middle-class women, half of whom were married. More than 90% were first-time users of the site. Factors associated with PTSD included death of, or harm to, a loved one; personal history of incest, rape, or physical abuse; lower age; lower income; unemployment; missed work; increased medical care; dissatisfaction with psychotropic medication; depressive symptoms; and lower resilience. In this selective convenience sample, there were high rates of traumatization and PTSD. The demographics of this group are similar to those seen in previously studied populations that had contacted the ADAA. Furthermore, the factors associated with PTSD were like those in many community surveys. The ADAA Web site has the opportunity to benefit large numbers of highly distressed individuals.",0 +https://doi.org/10.1002/mpr.133,Assessing the longitudinal course of depression and economic integration of south-east Asian refugees: an application of latent growth curve analysis,"This paper has both methodological and substantive application for mental-health researchers. Methodologically, it presents the latent growth curve (LGC) technique within a structural equation modelling (SEM) framework as a powerful tool to analyse change in depressive symptoms and potential correlates of such changes. The rationale for LGC analysis and subsequent elaboration of this statistical approach are presented. The limitations of traditional analytical methods are also addressed. Substantively, the paper considers socio-contextual factors as correlates of change in symptoms, and examines the dynamic systematic relationship with the degree of economic integration of south-east Asian immigrants in Canada over time. Using the LGC technique, this study also investigated how the longitudinal course of subclinical depression places individuals at risk for developing full-blown major depression. The LGC results provided strong evidence for the reciprocal influence between economic integration and subclinical depression of immigrants. The initial level of economic integration negatively influenced the rate of change in subclinical depression whereas the initial level of subclinical depression negatively influenced the rate of change in economic integration. Both initial level and the rate of change in subclinical depression placed individuals at risk for full-blown major depression. However, traditional auto-regressive models were not capable of revealing these dynamic associations. Thus, an investigation of within-individual change in symptoms and potential correlates of such changes is necessary to understand the process that results in full-blown mental disorder.",0 +,The economic consequences of post-traumatic stress disorder in clients of Veterans Affairs Canada,"Historically, post-traumatic stress disorder (PTSD) was questioned in regard to the ""reality"" of the clinical disorder. Largely during the post-Vietnam era, medical legitimacy pushed an agenda to study the condition, and contemporary interests shifted to cost-effective and effacious treatment identification. Although a priority for mental health, clinical approaches to care are not the only need for individuals who face diagnosis. I explore financial consequences of post-traumatic stress disorder in clients of Veterans Affairs Canada (VAC) to more specifically identify the economic vulnerabilities of veterans in an attempt to inform policy development. As a chronic condition, PTSD requires management over broad periods of time, often outside of the medical complex. Furthermore, a growing number of veterans are young and in search of gainful civilian employment, yet at risk of disrupted work lives as a result of their mental health status. This certainly carries implications for economic well-being. To better understand the relationship between PTSD and economic standing, I build upon current literature to develop two statistical analyses. The first project focuses on describing the relationship between PTSD and income and perceptions of financial security. This sample is marked with health disadvantage at the outset, through connection with VAC services. However, findings illustrate that PTSD holds significant association with economic well-being when other risk factors (including comorbidities) are controlled. This analysis informs caregivers (both medical and non-medical) about the importance of PTSD as a unique health problem with socioeconomic risk among veterans. The second analytic design assesses the specific symptom clusters of post-traumatic stress disorder as they relate to financial outcomes. Specifically, veterans experience symptoms of PTSD without meeting the clinical requirements for diagnosis, thus being left untreated. However, the findings illustrate that symptom clusters of PTSD maintain significant (and distinctive) relationships with various economic outcomes. This supports contemporary psychometric assessments that suggest the diagnostic criteria for PTSD require conceptual revisions. A reconfiguration of diagnostic criteria is supported in confirmatory factor analysis of my sample. I link these findings to targeted policy suggestions for VAC in regard to outreach for veterans with subclinical, yet meaningful, symptoms of post-traumatic stress. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0 +https://doi.org/10.1080/15299732.2013.834862,Main and Interactive Effects of Anxiety Sensitivity and Physical Distress Intolerance with Regard to PTSD Symptoms Among Trauma-Exposed Smokers,"The present study examined the roles of anxiety sensitivity (AS; the tendency to misinterpret physical internal sensations of harmful) and distress tolerance (the capacity to tolerate aversive stimuli) in terms of the expression of posttraumatic stress disorder (PTSD) symptoms among a sample of trauma-exposed, treatment-seeking tobacco smokers (n = 137; Mage = 37.7 years, 48.2% female). It was hypothesized that higher AS and lower physical distress tolerance would interact to predict greater PTSD avoidance and hyperarousal symptoms. Results were partially consistent with this prediction. Specifically, there was a significant interactive effect of AS by physical distress tolerance in terms of PTSD hyperarousal symptom cluster severity. The form of the interaction was in the expected direction, with the highest levels of PTSD hyperarousal symptoms reported among smokers with higher levels of AS and a lower capacity to tolerate physical distress. Findings underscore the importance of considering AS and physical distress tolerance in terms of better understanding mechanisms underlying the expression of PTSD symptoms among trauma-exposed smokers.",0 +https://doi.org/10.1016/j.injury.2008.11.006,Severity of injury does not have any impact on posttraumatic stress symptoms in severely injured patients,"Due to improved surgical techniques and more efficient decision making in treating severely injured patients, survival rates have increased over the years. This study was initiated to evaluate the incidence and identify risk factors for developing posttraumatic stress symptoms, using both extensive trauma-related data and data assessing the psychological trauma, in a population of severely injured patients.79 patients admitted to the Department of Multitrauma and Spinal Cord Injury at Sunnaas Rehabilitation Hospital from 2003 to 2005, prospectively completed semistructured psychological interviews and questionnaires, such as Impact of Event Scale-Revised. In addition, extensive injury-related data, such as injury severity score (ISS), new injury severity score (NISS), and probability of survival (PS) were collected.39% had multiple trauma, 34% had multiple injuries including spinal cord injuries, and 27% had isolated spinal cord injuries. Mean NISS was 31.5 (S.D. 13.7). 6% met diagnostic criteria for posttraumatic stress disorder (PTSD) and 9% met the criteria for subsyndromal PTSD. Injury-related data did not influence the prevalence of posttraumatic stress symptoms, however, some psychosocial variables did have a significant impact.We found a low incidence of PTSD and subsyndromal PTSD. No significant differences were found between the patients suffering from posttraumatic stress symptoms and the non-symptoms group in relation to injury-related data such as ISS/NISS, PS, or multiple trauma versus spinal cord injury. The most evident risk factors for developing posttraumatic stress symptoms were symptoms of anxiety, female gender and negative attitudes toward emotional expression.",0 +https://doi.org/10.1192/bjp.181.5.433,Survivors of the Piper Alpha oil platform disaster: long-term follow-up study,"The long-term psychological effects of surviving a major disaster are poorly understood. We undertook a survey of survivors of the Piper Alpha oil platform disaster (1988).To examine the role of factors relating to the trauma, the survivors and the survivors' circumstances.Ten years after the disaster, 78% (46/59) of the survivors were located, of whom 72% (33/46) agreed to be interviewed. A further three individuals completed postal measures.The most stringent diagnostic criteria for post-traumatic stress disorder (PTSD) were met by 21% (7/33) of the survivors over 10 years after the disaster. Features such as physical injury, personal experience and survivor guilt were associated with significantly higher levels of post-traumatic symptoms.A narrow definition of factors affecting outcome will limit the potential for improving survivor well-being in the long-term after major disasters. Specific symptoms that are not included in the criteria for the diagnosis of PTSD, together with issues such as re-employment, need to be addressed.",0 +https://doi.org/10.1007/s10964-014-0160-5,"The Effects of Age, Gender, Hopelessness, and Exposure to Violence on Sleep Disorder Symptoms and Daytime Sleepiness Among Adolescents in Impoverished Neighborhoods","Although sleep problems are associated with negative outcomes among adolescents, studies have not focused on sleep disorder symptoms among adolescents living in impoverished neighborhoods and how sleep problems may be related to two factors common in those environments: hopelessness and exposure to violence. This study used data from the longitudinal Mobile Youth Survey (MYS; N = 11,838, 49 % female, 93 % African-American) to examine trajectories of sleep problems by age (10-18 years) among impoverished adolescents as a function of gender, feelings of hopelessness, and exposure to violence. The results indicate that sleep problems associated with traumatic stress decline with age, with four notable distinctions. First, the steepest decline occurs during the early adolescent years. Second, the rate of decline is steeper for males than for females. Third, exposure to violence impedes the rate of decline for all adolescents, but more dramatically for females than for males. Fourth, the rate of decline is smallest for adolescents with feelings of hopelessness who also had been exposed to violence. To explore the generalizability of these results to other types of sleep disorders, we analyzed cross-sectional data collected from a subsample of 14- and 15-year-old MYS participants (N = 263, 49 % female, 100 % African-American) who completed a sleep symptoms questionnaire. Four results from the cross-sectional analysis extend the findings of the longitudinal analysis. First, the cross-sectional results showed that symptoms of apnea, insomnia, nightmares, and restless legs syndrome or periodic limb movement disorder (RLS/PLMD), as well as daytime sleepiness, increase as a function of hopelessness. Second, symptoms of insomnia, RLS, and nightmares, as well as daytime sleepiness, increase as function of exposure to violence. Third, symptoms of insomnia and RLS/PLMD are greater under conditions of combined hopelessness and exposure to violence than for either condition alone. Fourth, symptoms of RLS/PLMD are worst for females who have been exposed to violence and experience hopelessness. Overall, the findings suggest that hopelessness and exposure to violence have negative independent and multiplicative effects on adolescent sleep, particularly for females. Understanding the causal factors associated with inadequate sleep in impoverished adolescents is important for three reasons. First, sleep is an important aspect of adolescent development. Second, inadequate sleep has severe consequences for adolescent morbidity, mortality, and overall quality of life. Third, impoverished adolescents are at the most severe risk for poor outcomes, and improvement in their sleep may produce large gains. © 2014 Springer Science+Business Media New York.",0 +https://doi.org/10.1002/j.2051-5545.2010.tb00254.x,The long-term costs of traumatic stress: intertwined physical and psychological consequences,"The gradual emergence of symptoms following exposure to traumatic events has presented a major conceptual challenge to psychiatry. The mechanism that causes the progressive escalation of symptoms with the passage of time leading to delayed onset post-traumatic stress disorder (PTSD) involves the process of sensitization and kindling. The development of traumatic memories at the time of stress exposure represents a major vulnerability through repeated environmental triggering of the increasing dysregulation of an individual's neurobiology. An increasing body of evidence demonstrates how the increased allostatic load associated with PTSD is associated with a significant body of physical morbidity in the form of chronic musculoskeletal pain, hypertension, hyperlipidaemia, obesity and cardiovascular disease. This increasing body of literature suggests that the effects of traumatic stress need to be considered as a major environmental challenge that places individual's physical and psychological health equally at risk. This broader perspective has important implications for developing treatments that address the underlying dysregulation of cortical arousal and neurohormonal abnormalities following exposure to traumatic stress.",0 +https://doi.org/10.1016/j.jaac.2012.05.013,Acute Stress Symptoms in Children: Results From an International Data Archive,"

Objective

To describe the prevalence of acute stress disorder (ASD) symptoms and to examine proposed DSM-5 symptom criteria in relation to concurrent functional impairment in children and adolescents.

Method

From an international archive, datasets were identified that included assessment of acute traumatic stress reactions and concurrent impairment in children and adolescents 5 to 17 years of age. Data came from 15 studies conducted in the United States, United Kingdom, Australia, and Switzerland and included 1,645 children and adolescents. Dichotomized items were created to indicate the presence or absence of each of the 14 proposed ASD symptoms and functional impairment. The performance of a proposed diagnostic criterion (number of ASD symptoms required) was examined as a predictor of concurrent impairment.

Results

Each ASD symptom was endorsed by 14% to 51% of children and adolescents; 41% reported clinically relevant impairment. Children and adolescents reported from 0 to 13 symptoms (mean = 3.6). Individual ASD symptoms were associated with greater likelihood of functional impairment. The DSM-5 proposed eight-symptom requirement was met by 202 individuals (12.3%) and had low sensitivity (0.25) in predicting concurrent clinically relevant impairment. Requiring fewer symptoms (three to four) greatly improved sensitivity while maintaining moderate specificity.

Conclusions

This group of symptoms appears to capture aspects of traumatic stress reactions that can create distress and interfere with children's and adolescents' ability to function in the acute post-trauma phase. Results provide a benchmark for comparison with adult samples; a smaller proportion of children and adolescents met the eight-symptom criterion than reported for adults. Symptom requirements for the ASD diagnosis may need to be lowered to optimally identify children and adolescents whose acute distress warrants clinical attention.",0 +https://doi.org/10.1016/j.janxdis.2011.08.003,Understanding the relationship between co-occurring PTSD and MDD: Symptom severity and affect,"How to best understand theoretically the nature of the relationship between co-occurring PTSD and MDD (PTSD+MDD) is unclear. In a sample of 173 individuals with chronic PTSD, we examined whether the data were more consistent with current co-occurring MDD as a separate construct or as a marker of posttraumatic stress severity, and whether the relationship between PTSD and MDD is a function of shared symptom clusters and affect components. Results showed that the more severe depressive symptoms found in PTSD+MDD as compared to PTSD remained after controlling for PTSD symptom severity. Additionally, depressive symptom severity significantly predicted co-occurring MDD even when controlling for PTSD severity. In comparison to PTSD, PTSD+MDD had elevated dysphoria and re-experiencing - but not avoidance and hyperarousal - PTSD symptom cluster scores, higher levels of negative affect, and lower levels of positive affect. These findings provide support for PTSD and MDD as two distinct constructs with overlapping distress components.",0 +https://doi.org/10.1037/a0020462,Reporting results of latent growth modeling and multilevel modeling analyses: Some recommendations for rehabilitation psychology.,"There has been a general increase in interest and use of modeling techniques that treat data as nested, whether it is people nested within larger units, such as families or treatment centers, or observations nested under people. The popularity can be witnessed by noting the number of new textbooks and articles related to latent growth curve modeling and multilevel modeling. This paper discusses both of these techniques in the context of longitudinal research designs, with the main purposes of highlighting some benefits and issues related to the use of these models and outlining guidelines for reporting results from studies using multilevel modeling or latent growth modeling.These longitudinal analytic techniques can be greatly beneficial to researchers conducting rehabilitation studies, but there are several issues related to their use and reporting that need to be taken into consideration.",0 +https://doi.org/10.1111/ajo.12064,"Clinical and psychological impact after surgical, medical or expectant management of first-trimester miscarriage - a randomised controlled trial","The management of first-trimester miscarriage has been studied extensively in recent years. However, relatively little attention has been focussed on woman's satisfaction and psychological impact from different treatment modalities.To investigate the clinical and psychological outcomes of surgical, medical and expectant management of first-trimester miscarriage.A prospective randomised controlled trial of 180 women suffering miscarriage managed by either surgical evacuation, medical evacuation or expectant management was conducted in a university-affiliated, tertiary referral hospital. The complete miscarriage rate, clinical symptomatology, complications, women's satisfaction and the psychological impact were evaluated.Women in surgical evacuation (98.1%) had a significantly higher complete miscarriage rate when compared with medical evacuation (70%) and expectant management (79.3%). Women who had surgical evacuation had significantly shorter duration of vaginal bleeding, but higher rate of infection. Women who had medical evacuation had significantly more gastrointestinal symptoms. Despite differences in efficacy and complication profile, there was no significant difference in satisfaction among groups. There were no significant differences in terms of psychological well-being, depression scores, anxiety level, fatigue symptoms as measured in General Health Questionnaire-12, Beck Depression Inventory, Spielberger's State Anxiety Inventory and fatigue scale at treatment and four weeks after treatment. However, women with active intervention had greater post-traumatic stress symptoms as measured in Chinese version of Impact of Event Scale-Revised at the time of treatment when compared with women in expectant management.Without substantial differences in the clinical and psychological impact between different treatment modalities, a more conservative approach with expectant management for miscarriage may be an option for women.",0 +https://doi.org/10.1037/0022-006x.72.1.121,Preliminary Reliability and Validity of the Clinician-Administered PTSD Scale for Schizophrenia.,"This study provides preliminary psychometric support for a version of the Clinician-Administered Posttraumatic Stress Disorder (PTSD) Scale (CAPS; D. D. Blake et al., 1990) adapted for use with patients with schizophrenia (CAPS-S; J. S. Gearon. S. Thomas-Lohrman, & A. S. Bellack, 2001). Nineteen women with schizophrenia and co-occurring illicit drug use disorders were administered the CAPS-S, the Structured Clinical Interview for DSM-IV diagnoses (SCID). and scales measuring trauma-related psychopathology. The results indicate that the CAPS-S can distinguish between those with and without PTSD and that the symptom clusters measure unified constructs. Interrater and test-retest reliability were high for PTSD diagnosis and symptom clusters. Solid convergent validity was demonstrated between the CAPS-S and SCID-based PTSD diagnoses and the Impact of Event Scale. There is also preliminary evidence of discriminant validity. These results support the use of the CAPS-S in women with schizophrenia.",0 +https://doi.org/10.1097/00001504-200211000-00011,Violent behaviour and post-traumatic stress disorder,"Future research into violent behaviour and post-traumatic stress disorder will reveal the risk factors for this disorder, and try to explain what it is that, afterexposing an individual to psychological trauma, leads to post-traumatic stress disorder. Possible protective factors and mechanisms to prevent the occurence of post-traumatic stress disorder will be described.",0 +https://doi.org/10.1037/a0018082,Best practices for missing data management in counseling psychology.,"This article urges counseling psychology researchers to recognize and report how missing data are handled, because consumers of research cannot accurately interpret findings without knowing the amount and pattern of missing data or the strategies that were used to handle those data. Patterns of missing data are reviewed, and some of the common strategies for dealing with them are described. The authors provide an illustration in which data were simulated and evaluate 3 methods of handling missing data: mean substitution, multiple imputation, and full information maximum likelihood. Results suggest that mean substitution is a poor method for handling missing data, whereas both multiple imputation and full information maximum likelihood are recommended alternatives to this approach. The authors suggest that researchers fully consider and report the amount and pattern of missing data and the strategy for handling those data in counseling psychology research and that editors advise researchers of this expectation.",0 +https://doi.org/10.1023/b:joyo.0000037635.06937.13,Assessing Covariates of Adolescent Delinquency Trajectories: A Latent Growth Mixture Modeling Approach,"Using data from a community sample of 1218 boys and girls (mean age at the first wave was 15.5 years), this longitudinal study examined several covariates--adjustment problems, poor academic achievement, negative life events, and unsupportive family environments--of distinctive trajectories of juvenile delinquency. Latent growth mixture modeling analysis revealed 6 trajectory groups: rare offenders, moderate late peakers, high late peakers, decreasers, moderate-level chronics, and high-level chronics. Several factors discriminated between more normative groups and high-level chronic offenders, including poor academic achievement, unsupportive family environments, life events, and substance use, whereas almost no differences were found between groups with more serious offending trajectories. Overall, there was more specificity in correlates of distinctive offending trajectories than expected by general theories of crime (e.g., Gottfredson, M. R., and Hirschi, T., 1990, A General Theory of Crime. Stanford University Press, Stanford, CA). (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0 +,Posttraumatic Stress Disorder Symptoms Might be Destroying your Intimacy: A Test of Mediational Models in a Community Sample of Couples,"The present research focused on the pathways through which the symptoms of posttraumatic stress disorder (PTSD) may negatively impact intimacy. Previous research has confirmed a link between self-reported PTSD symptoms and intimacy; however, a thorough examination of mediating paths, partner effects, and secondary traumatization has not yet been realized. With a sample of 297 heterosexual couples, intraindividual and dyadic models were developed to explain the relationships between PTSD symptoms and intimacy in the context of interdependence theory, attachment theory, and models of self-preservation (e.g., fight-or-flight). The current study replicated the findings of others and has supported a process in which affective (alexithymia, negative affect, positive affect) and communication (demand-withdraw behaviour, self-concealment, and constructive communication) pathways mediate the intraindividual and dyadic relationships between PTSD symptoms and intimacy; Moreover, it also found that the PTSD symptoms of each partner were significantly related; however, this was only the case for those dyads in which the partners had disclosed most everything about their traumatic experiences. As such, secondary traumatization was supported. Finally, although the overall pattern of results suggest a total negative effect of PTSD symptoms on intimacy, a sex difference was evident such that the direct effect of the woman's PTSD symptoms were positively associated with both her and her partner's intimacy. It is possible that the Tend-and-Befriend model of threat response, wherein women are said to foster social bonds in the face of distress, may account for this sex difference. Overall, however, it is clear that PTSD symptoms were negatively associated with relationship quality and attention to this impact in the development of diagnostic criteria and treatment protocols is necessary. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1016/j.drugalcdep.2014.09.418,Pathways to change: Trajectories following treatment in women with co-occurring PTSD and substance use disorders,"s / Drug and Alcohol Dependence 146 (2015) e118–e201 e185 Chi-squares & ANOVAs were used to compare dichotomous & continuous variables, respectively. Results: Incentives increased abstinence above control levels antepartum & postpartum: (late-pregnancy: 37% vs 11%; 2wk: 33% vs 15%; 4wk: 31% vs 12%; 8wk: 25% vs 10%; 12wk: 22% vs 7%; 24wk: 15% vs 3%; all p 16) at weeks 4–12 postpartum (all p< .05). Conclusions: In addition to increasing smoking abstinence, voucher-based incentives for smoking cessation decrease postpartum depression. This effect compliments the significant improvements in birth outcomes & breastfeeding duration reported previously with this intervention. Financial support: R01DA14028, R01HD075669, P20GM103644, T32DA07242. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.417 Pathways to change: Trajectories following treatment in women with co-occurring PTSD and substance use disorders Teresa Lopez-Castro1, M. Hu2, D.A. Hien1 1 The City College of New York, New York, NY, United States 2 NY State Psychiatric Institute, New York, NY, United",0 +https://doi.org/10.1007/978-1-4899-7522-5_3,The Early Adolescent or “Juvenile Stress” Translational Animal Model of Posttraumatic Stress Disorder,"The diagnosis of posttraumatic stress disorder (PTSD) requires exposure to a major traumatic event. This criterion has influenced the thinking about causes of the disorder, approaches to treatment, and also how to establish an effective animal model of the disorder. Accordingly, the focus in animal models of PTSD is on what would establish an effective traumatic exposure that would lead to PTSD-related symptoms in the studied animal. However, the prevalence of PTSD among individuals exposed to a traumatic event suggests that the exposure to the trauma is not sufficient to induce PTSD, since most exposed individuals will not develop the disorder. The emphasis in translational animal models of PTSD should thus be on inclusion of relevant risk factors, that together with the exposure to a traumatic event will lead to the development of PTSD. Epidemiological studies indicate that childhood trauma predisposes individuals to develop stress-related disorders later in life. As a result of this finding, we developed an animal model in which exposing rats to early adolescence (postweaning, prepubertal, juvenile) stress was also found to induce a predisposition to develop PTSD following an exposure to an additional stress in adulthood. Within these pre-exposed animals, dissociation could be caused among individuals that exhibited more anxious or more depressive symptoms. This dissociation, which has been recognized also in human patients, required the development of a behavioral profiling approach that enabled grouping animals according to their clusters of symptoms. Interestingly, this approach also enabled the identification of new data on the influence of sex on long-term consequences of “Juvenile Stress.” These data reveal that whilst both male and female rats showed behavioral changes following exposure to a stressor at juvenility, the profile of effects differed between the sexes. Collectively, these findings indicate that the model presented here is an effective translational model for understanding of the etiology of trauma-related disorders and of relevant predisposing factors. © Springer Science+Business Media New York 2015.",0 +https://doi.org/10.1002/1097-4679(198907)45:4<542::aid-jclp2270450407>3.0.co;2-d,Clinical meaning of the Keane PTSD scale,"A correlational study that included 82 male inpatient alcoholics was conducted to determine the clinical meaning of the Keane PTSD Scale of the MMPI. The PTSD Scale was correlated with the variables of the Shipley Institute of Living Scale, the Life Purpose Questionnaire, the Existential Depression Test, and the standard MMPI measures, plus the A, R, Es and MacAndrew Scales. The pattern of correlations suggested that the PTSD scale measures general psychological maladjustment and dysphoric feelings rather than any specifiable syndrome. The strong correlation with the Welch A, which measures a general level of maladjustment, suggests that the PTSD and Welch A scales are measuring the same factor. The PTSD scale, therefore, appears to provide very little information about this population beyond that available from the overall clinical profile and the Welch A scale.",0 +https://doi.org/10.1002/jts.20677,Posttraumatic stress hyperarousal symptoms mediate the relationship between childhood exposure to violence and subsequent alcohol misuse in Mi'kmaq youth,"This study was part of a school-based collaborative research project with a Canadian Mi'kmaq community that examined the potential role of posttraumatic stress (PTS) symptom clusters in mediating the relationship between childhood exposure to violence (EV) and alcohol misuse in a sample of Mi'kmaq adolescents (N = 166). The study employed a cross-sectional design and used several well-validated self-report questionnaires. Path analytic results showed that when each PTS symptom cluster was independently investigated for mediating effects while controlling for depressive symptoms, age, and gender, only the PTS hyperarousal symptom cluster fully mediated the EV-alcohol misuse relationship. Results are discussed within the context of previous theory and research on the topic of PTS as a mediator between EV and alcohol misuse.",0 +https://doi.org/10.1016/j.psychres.2011.07.019,Cognitive-behavioral coping strategies associated with combat-related PTSD in treatment-seeking OEF–OIF Veterans,"Posttraumatic stress disorder (PTSD) is associated with intrusive trauma-related thoughts and avoidance behaviors that contribute to its severity and chronicity. This study examined thought control and avoidance coping strategies associated with both a probable diagnosis and symptom severity of combat-related PTSD in a sample of 167 treatment-seeking Operations Enduring Freedom and Iraqi Freedom (OEF-OIF) Veterans. Within one year of returning from deployment, Veterans completed a survey containing measures of combat exposure, coping strategies, psychopathology, and postdeployment social support. Veterans with a positive screen for PTSD scored higher than Veterans without a positive screen for PTSD on measures of worry, self-punishment, social control, behavioral distraction, and avoidance coping strategies. Worry and social avoidance coping were positively related to PTSD symptoms, and greater perceptions of understanding from others were negatively related to these symptoms. A structural equation model revealed that scores on a measure of postdeployment social support were negatively associated with scores on measures of maladaptive cognitive coping (i.e., worry, self-punishment) and avoidance coping (social and non-social avoidance coping) strategies, which were positively associated with combat-related PTSD symptoms. These results suggest that maladaptive thought control and avoidance coping may partially mediate the relation between postdeployment social support and combat-related PTSD symptoms in treatment-seeking OEF-OIF Veterans. Consistent with cognitive therapy models, these findings suggest that interventions that target maladaptive coping strategies such as worry, self-punishment, and social avoidance, and that bolster social support, most notably understanding from others, may help reduce combat-related PTSD symptoms in this population.",0 +https://doi.org/10.1177/1359105313510339,Utilizing correspondence analysis to characterize the mental health of cardiac patients with diabetes,"The aim of this study was to examine the mental health of cardiac patients with diabetes and whether symptoms varied by gender and/or age. Screening for depression and posttraumatic stress symptoms was conducted on 1003 patients with cardiovascular disease. Correspondence analysis was utilized to identify clinical core profiles. Results suggested that cardiovascular disease patients with diabetes, particularly males, experience high rates of depression, suicide ideation, and posttraumatic stress symptoms. Clinical implications of these findings include targeted mental health screening options as well as offering a closer look at the specific concerns of cardiovascular disease patients with diabetes.",0 +https://doi.org/10.1016/j.paid.2008.11.004,Anxiety and prepulse inhibition of acoustic startle in a normative sample: The importance of signal-to-noise ratio,"Abstract Previous studies have used prepulse inhibition of the startle response (PPI) to investigate the anxiety spectrum, primarily in patient samples, with mixed results. The inconsistency in findings may be due, in part, to the use of non-optimal signal-to-noise ratios (SnRs: the difference between background noise intensity and prepulse intensity) in some studies. We proposed that, as SnR approaches +15 dB, anxiety spectrum variables will be negatively correlated with PPI, even in a normative sample. Thus, we used the MCMI-III to measure levels of trait anxiety, posttraumatic stress disorder (PTSD), and the three Cluster C personality disorders in a sample of 53 undergraduate females, and then correlated their scores with their PPI levels at SnRs of +5, +10, and +15 dB. All of the anxiety constructs except obsessive-compulsive personality disorder (OCPD) were correlated with PPI, but only in the +15 dB condition. Although OCPD symptomatology was not correlated with PPI, it was negatively correlated with PTSD and may have been indicative of adaptive functioning in this normative sample. The present study demonstrates that PPI is a sensitive index of anxiety symptomatology even in the normative range, and that a SnR near +15 dB may be necessary to reliably detect associations between PPI and these psychological variables.",0 +https://doi.org/10.1371/journal.pone.0042684,Lasting Consequences of Traumatic Events on Behavioral and Skeletal Parameters in a Mouse Model for Post-Traumatic Stress Disorder (PTSD),"Post-traumatic stress disorder (PTSD) is an anxiety disorder that not only affects mental health, but may also affect bone health. However, there have been no studies to examine the direct relationship between PTSD and bone.We employed electric shocks in mice to simulate traumatic events that cause PTSD. We also injected the anxiogenic drug FG-7142 prior to electric shocks. Electric shocks created lasting conditioned fear memory in all mice. In young mice, electric shocks elicited not only behavioral response but also skeletal response, and injection of FG-7142 appeared to increase both types of response. For example in behavioral response within the first week, mice shocked alone froze an average of 6.2 sec in 10 sec tests, and mice injected with FG-7142 froze 7.6 sec, both significantly different (P<0.05) from control mice, which only froze 1.3 sec. In skeletal response at week 2, shocks alone reduced 6% bone mineral content (BMC) in total body (P = 0.06), while shocks with FG-7142 injection reduced not only 11% BMC (P<0.05) but also 6% bone mineral density (BMD) (P<0.05). In addition, FG-7142 injection also caused significant reductions of BMC in specific bones such as femur, lumbar vertebra, and tibia at week 3. Strong negative correlations (R(2) = -0.56, P<0.05) and regression (y = 0.2527-0.0037 * x, P<0.01) between freezing behavior and total body BMC in young mice indicated that increased contextual PTSD-like behavior was associated with reduced bone mass acquisition.This is the first study to document evidence that traumatic events induce lasting consequences on both behavior and skeletal growth, and electric shocks coupled with injection of anxiogenic FG-7142 in young mice can be used as a model to study the effect of PTSD-like symptoms on bone development.",0 +https://doi.org/10.1089/pho.2010.2814,"Improved Cognitive Function After Transcranial, Light-Emitting Diode Treatments in Chronic, Traumatic Brain Injury: Two Case Reports","Objective: Two chronic, traumatic brain injury (TBI) cases, where cognition improved following treatment with red and near-infrared light-emitting diodes (LEDs), applied transcranially to forehead and scalp areas, are presented. Background: Significant benefits have been reported following application of transcranial, low-level laser therapy (LLLT) to humans with acute stroke and mice with acute TBI. These are the first case reports documenting improved cognitive function in chronic, TBI patients treated with transcranial LED. Methods: Treatments were applied bilaterally and to midline sagittal areas using LED cluster heads [2.1″ diameter, 61 diodes (9 × 633 nm, 52 × 870 nm); 12–15 mW per diode; total power: 500 mW; 22.2 mW/cm2; 13.3 J/cm2 at scalp (estimated 0.4 J/cm2 to cortex)]. Results: Seven years after closed-head TBI from a motor vehicle accident, Patient 1 began transcranial LED treatments. Pre-LED, her ability for sustained attention (computer work) lasted 20 min. After eight weekly LED treatments, her sustained attention time increased to 3 h. The patient performs nightly home treatments (5 years); if she stops treating for more than 2 weeks, she regresses. Patient 2 had a history of closed-head trauma (sports/military, and recent fall), and magnetic resonance imaging showed frontoparietal atrophy. Pre-LED, she was on medical disability for 5 months. After 4 months of nightly LED treatments at home, medical disability discontinued; she returned to working full-time as an executive consultant with an international technology consulting firm. Neuropsychological testing after 9 months of transcranial LED indicated significant improvement (+1, +2SD) in executive function (inhibition, inhibition accuracy) and memory, as well as reduction in post-traumatic stress disorder. If she stops treating for more than 1 week, she regresses. At the time of this report, both patients are continuing treatment. Conclusions: Transcranial LED may improve cognition, reduce costs in TBI treatment, and be applied at home. Controlled studies are warranted.",0 +https://doi.org/10.1002/da.20867,Risk factors and posttraumatic stress disorder: are they especially predictive following exposure to less severe stressors?,"The diagnosis of posttraumatic stress disorder (PTSD) requires exposure to a traumatic stressor, as defined by Criterion A in the DSM criteria for PTSD. Yet, over the course of successive revisions of the diagnostic manual, the range of qualifying stressors has expanded considerably (e.g., watching terrorist attacks on television). Moreover, stressors that fall short of qualifying for even an expanded Criterion A can produce apparent PTSD. Taken together, these findings imply that people who do satisfy symptomatic criteria for PTSD following exposure to less severe stressors carry a heavy burden of risk factors.To test this hypothesis, we examined whether the association between the risk factor of lower intelligence and more severe PTSD and depression symptoms would be greater among women reporting less severe CSA (n = 15) relative to women who reported moderate (n = 54) or high (n = 31) severity CSA.The evidence was consistent with this hypothesis for subjects in the low and moderate severity groups, but less so for those in the high severity group.Lower intelligence was a more potent risk factor for posttraumatic distress among people exposed to less severe relative to moderately severe stressors.",0 +https://doi.org/10.1016/j.janxdis.2010.09.001,Main and interactive effects of a nonclinical panic attack history and distress tolerance in relation to PTSD symptom severity,"The current study investigated the main and interactive effects of a nonclinical panic attack history and distress tolerance in relation to PTSD symptoms. The sample consisted of 91 adults (62.6% women; M(age)=23.45, SD=9.56) who met DSM-IV criteria for trauma exposure, 53.8% of whom met criteria for a recent (past 2 years) history of nonclinical panic attacks. Results indicated that distress tolerance, as measured by the Distress Tolerance Scale (Simons & Gaher, 2005), was significantly related to all PTSD symptom clusters, and a nonclinical panic attack history was significantly related to PTSD re-experiencing and hyperarousal symptoms. The interaction of a nonclinical panic attack history and distress tolerance significantly predicted unique variance in only PTSD hyperarousal symptoms. Implications and future directions are discussed for the role of nonclinical panic attacks and distress tolerance in PTSD symptom expression.",0 +https://doi.org/10.1097/00004583-199904000-00010,Posttraumatic Stress Disorder in Hospitalized Adolescents: Psychiatric Comorbidity and Clinical Correlates,"

ABSTRACT

Objective

To describe the diagnostic comorbidity and clinical correlates of posttraumatic stress disorder (PTSD) in adolescent psychiatric inpatients.

Method

Seventy-four adolescent inpatients were given a structured diagnostic interview, the revised version of the Diagnostic Interview for Children and Adolescents, and a battery of standard self-report measures to assess general trauma exposure, posttraumatic stress symptoms, suicidal behavior, dissociation, and depression.

Results

Ninety-three percent of subjects reported exposure to at least one traumatic event such as being a witness/victim of community violence, witnessing family violence, or being the victim of physical/sexual abuse. Thirty-two percent of subjects met diagnostic criteria for current PTSD, with sexual abuse cited as the most common traumatic stressor in 69% of PTSD cases. Girls were significantly more likely to develop PTSD than boys, although the total number of types of trauma did not differ by gender. Compared with psychiatric controls, male youngsters with PTSD were significantly more likely to have comorbid diagnoses of eating disorders, other anxiety disorders, and somatization disorder. Furthermore, male and female youngsters with PTSD were significantly more likely to have attempted suicide and report greater depressive and dissociative symptoms.

Conclusion

In clinical populations of hospitalized adolescents exposed to multiple forms of trauma, PTSD is a common, but highly comorbid disorder. Specific multimodal assessments and treatments targeted to both PTSD and its comorbidity profile are warranted. J. Am. Acad. Child Adolesc. Psychiatry, 1999, 38(4):385–392.",0 +https://doi.org/10.1111/sipr.12001,Reintegration Challenges in U.S. Service Members and Veterans Following Combat Deployment,"Although the majority of combat veterans reintegrate into civilian life without long-lasting problems, a sizable minority return from deployment with psychiatric or physical injuries that warrant medical attention. Even in the absence of diagnosable disorders, many experience functional problems that impede full reintegration into civilian life. Considerable resources have been allocated to studying, diagnosing, treating, and compensating combat-related disorders. This important work has resulted in significant improvements in healthcare for those with deployment-related difficulties. Nevertheless, many service members and veterans with reintegration difficulty may not receive needed help. Based on our review, we argue that in addition to treatment and compensation for diagnosable postdeployment problems, a comprehensive approach to reintegration is needed that includes partnership between the government, private sector, and the public.",0 +https://doi.org/10.1176/appi.ps.62.7.765,Barriers to Receiving Early Care for PTSD: Results From the Jerusalem Trauma Outreach and Prevention Study,,0 +https://doi.org/10.1371/journal.pone.0080952,White Matter Microstructure Alterations: A Study of Alcoholics with and without Post-Traumatic Stress Disorder,"Many brain imaging studies have demonstrated reductions in gray and white matter volumes in alcoholism, with fewer investigators using diffusion tensor imaging (DTI) to examine the integrity of white matter pathways. Among various medical conditions, alcoholism and post-traumatic stress disorder (PTSD) are two comorbid diseases that have similar degenerative effects on the white matter integrity. Therefore, understanding and differentiating these effects would be very important in characterizing alcoholism and PTSD. Alcoholics are known to have neurocognitive deficits in decision-making, particularly in decisions related to emotionally-motivated behavior, while individuals with PTSD have deficits in emotional regulation and enhanced fear response. It is widely believed that these types of abnormalities in both alcoholism and PTSD are related to fronto-limbic dysfunction. In addition, previous studies have shown cortico-limbic fiber degradation through fiber tracking in alcoholism. DTI was used to measure white matter fractional anisotropy (FA), which provides information about tissue microstructure, possibly indicating white matter integrity. We quantitatively investigated the microstructure of white matter through whole brain DTI analysis in healthy volunteers (HV) and alcohol dependent subjects without PTSD (ALC) and with PTSD (ALC+PTSD). These data show significant differences in FA between alcoholics and non-alcoholic HVs, with no significant differences in FA between ALC and ALC+PTSD in any white matter structure. We performed a post-hoc region of interest analysis that allowed us to incorporate multiple covariates into the analysis and found similar results. HV had higher FA in several areas implicated in the reward circuit, emotion, and executive functioning, suggesting that there may be microstructural abnormalities in white matter pathways that contribute to neurocognitive and executive functioning deficits observed in alcoholics. Furthermore, our data do not reveal any differences between ALC and ALC+PTSD, suggesting that the effect of alcohol on white matter microstructure may be more significant than any effect caused by PTSD.",0 +,Examining the role of grief in the etiology of Posttraumatic Stress Disorder (PTSD) symptoms in American Indian adolescents,"The prevalence of Posttraumatic Stress Disorder (PTSD) is reported to be comparatively high in child and adolescent populations (Reinherz, Gaiconia, Leftkowitz, Pakiz, & Frost,1993). However, recent research has suggested that there may be differing etiological factors, specifically, Child Traumatic Grief (CTG), that contributes to the development of PTSD symptoms in American Indian adolescents (Morsette, at al., 2007). First this study demonstrated that CTG symptoms predicted PTSD symptoms above and beyond that which was predicted by violence exposure. Second, it was found that CTG predicted depression above and that which was predicted by PTSD symptoms. Third, it found that grief was significantly correlated with PTSD symptoms. Similarly, grief was also significantly correlated with the depressive symptoms. Finally, using a two-tailed Pearson's Product mom$$ent correlation this study found there was no correlation between PTSD symptoms, grief symptoms, depressive symptoms, and American Indian student's Grade Point Average and absenteeism. However, a post-hoc analysis using a one-tailed Pearson's Product moment correlation indicated a statistical significant correlation between GPA and depression. Additional etiological models are explored. This study is the first to examine etiological factors of PTSD in American Indian adolescents. Additional qualitative research is necessary to better understand the contribution of grief in the development of PTSD symptoms.",0 +https://doi.org/10.4135/9781483369532.n385,Posttraumatic Stress Disorder in Children,"Children and psychic trauma: a brief review of contemporary thinking. Children traumatized by witnessing acts of personal violence: homicide, rape, or suicide behavior. Children traumatized in small groups. Children traumatized by catastrophic situations. Children traumatized by Central American warfare. Post-traumatic stress disorder in children with cancer. Children traumatized by physical abuse. Post-traumatic symptoms in incest victims. Interaction of trauma and grief in childhood.",0 +https://doi.org/10.1111/jsr.12064,Sex differences in objective measures of sleep in post-traumatic stress disorder and healthy control subjects,"A growing literature shows prominent sex effects for risk for post-traumatic stress disorder and associated medical comorbid burden. Previous research indicates that post-traumatic stress disorder is associated with reduced slow wave sleep, which may have implications for overall health, and abnormalities in rapid eye movement sleep, which have been implicated in specific post-traumatic stress disorder symptoms, but most research has been conducted in male subjects. We therefore sought to compare objective measures of sleep in male and female post-traumatic stress disorder subjects with age- and sex-matched control subjects. We used a cross-sectional, 2 × 2 design (post-traumatic stress disorder/control × female/male) involving83 medically healthy, non-medicated adults aged 19-39 years in the inpatient sleep laboratory. Visual electroencephalographic analysis demonstrated that post-traumatic stress disorder was associated with lower slow wave sleep duration (F(3,82) = 7.63, P = 0.007) and slow wave sleep percentage (F(3,82) = 6.11, P = 0.016). There was also a group × sex interaction effect for rapid eye movement sleep duration (F(3,82) = 4.08, P = 0.047) and rapid eye movement sleep percentage (F(3,82) = 4.30, P = 0.041), explained by greater rapid eye movement sleep in post-traumatic stress disorder females compared to control females, a difference not seen in male subjects. Quantitative electroencephalography analysis demonstrated that post-traumatic stress disorder was associated with lower energy in the delta spectrum (F(3,82) = 6.79, P = 0.011) in non-rapid eye movement sleep. Slow wave sleep and delta findings were more pronounced in males. Removal of post-traumatic stress disorder subjects with comorbid major depressive disorder, who had greater post-traumatic stress disorder severity, strengthened delta effects but reduced rapid eye movement effects to non-significance. These findings support previous evidence that post-traumatic stress disorder is associated with impairment in the homeostatic function of sleep, especially in men with the disorder. These findings suggest that group × sex interaction effects on rapid eye movement may occur with more severe post-traumatic stress disorder or with post-traumatic stress disorder comorbid with major depressive disorder.",0 +https://doi.org/10.1016/j.pnpbp.2013.01.001,"Differential effectiveness of tianeptine, clonidine and amitriptyline in blocking traumatic memory expression, anxiety and hypertension in an animal model of PTSD","Individuals exposed to life-threatening trauma are at risk for developing post-traumatic stress disorder (PTSD), a debilitating condition that involves persistent anxiety, intrusive memories and several physiological disturbances. Current pharmacotherapies for PTSD manage only a subset of these symptoms and typically have adverse side effects which limit their overall effectiveness. We evaluated the effectiveness of three different pharmacological agents to ameliorate a broad range of PTSD-like symptoms in our established predator-based animal model of PTSD. Adult male Sprague-Dawley rats were given 1-h cat exposures on two occasions that were separated by 10 days, in conjunction with chronic social instability. Beginning 24 h after the first cat exposure, rats received daily injections of amitriptyline, clonidine, tianeptine or vehicle. Three weeks after the second cat exposure, all rats underwent a battery of behavioral and physiological tests. The vehicle-treated, psychosocially stressed rats demonstrated a robust fear memory for the two cat exposures, as well as increased anxiety expressed on the elevated plus maze, an exaggerated startle response, elevated heart rate and blood pressure, reduced growth rate and increased adrenal gland weight, relative to the vehicle-treated, non-stressed (control) rats. Neither amitriptyline nor clonidine was effective at blocking the entire cluster of stress-induced sequelae, and each agent produced adverse side effects in control subjects. Only the antidepressant tianeptine completely blocked the effects of psychosocial stress on all of the physiological and behavioral measures that were examined. These findings illustrate the differential effectiveness of these three treatments to block components of PTSD-like symptoms in rats, and in particular, reveal the profile of tianeptine as the most effective of all three agents.",0 +https://doi.org/10.1097/psy.0b013e3181646765,Suicide Attempts in Anorexia Nervosa,"To explore prevalence and patterns of suicidal attempts in persons with anorexia nervosa (AN).Participants were the first 432 persons (22 male, 410 female) enrolled in the NIH funded Genetics of Anorexia Nervosa Collaborative Study. All participants had current or lifetime AN. The participants ranged in age from 16 to 76 (mean = 30.4, SD = 11.3). Suicidal behavior and intent was assessed via the Diagnostic Interview for Genetic Studies. We compared frequency and severity of attempts across diagnostic subtypes and comorbidity, and personality features associated with the presence of suicide attempts in persons with AN.About 16.9% of those with AN attempted suicide. Significantly fewer persons with the restricting subtype (7.4%) reported at least one attempt than those with purging AN (26.1%), AN with binge eating (29.3%), and a mixed picture of AN and bulimia nervosa (21.2%). After controlling for major depression, suicide attempts were associated with substance abuse, impulsive behaviors and traits, Cluster B personality disorders, panic disorder, and post-traumatic stress disorder as well as low self-directedness and eating disorder severity.Suicide attempts in AN are not uncommon, are frequently associated with the intention to die, occur less frequently in persons with the restricting subtype of the illness, and after controlling for depression are associated with a constellation of behaviors and traits associated with behavioral and affective dyscontrol.",0 +https://doi.org/10.1016/0965-2302(93)90054-4,Can post-traumatic stress disorder be prevented?,"Abstract In the 20-odd years since the cluster of symptoms known as Post Traumatic Stress Disorder (PTSD) has been studied, we have learned a great deal about treating the distress that accompanies trauma in its many forms. We will only know whether or not we have succeeded in preventing the disorder when we have access to long-term studies of people who received intervention immediately following a traumatic event. We do know, however, much more about the impact of trauma on victims and witnesses of traumatic events, sometimes long past the event itself. We know, for example, that ‘triggers'-events reminiscent of the original event-play an extraordinarily important role in the development of symptoms. Removing those triggers is one method for alleviating distress. But a growing interest in the relationship between body, mind, and spirit points toward another possibility: counteracting the stressful triggers with equally powerful images that contain the seeds of recovery. Nurses are continually exposed to pain and suffering, stress and trauma, are themselves vulnerable to PTSD, and perhaps as much as the patients they care for, need hope and healing. We may not be able to prevent stress or distress. But we can alter the intensity and duration of stress related to trauma by naming our demons, daring to struggle with them, and by creating healing communities for ourselves as well as our patients.",0 +https://doi.org/10.1002/jts.20647,Comparing the diagnosis of PTSD when assessing worst versus multiple traumatic events in a chronically mentally ill sample,"Despite interest in the nature of the traumatic event required to meet Criterion A for posttraumatic stress disorder (PTSD) as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994), little attention has been paid to the diagnostic ramifications of linking PTSD symptoms to a single traumatic event in the context of multiple trauma exposures. In this study, 67 dually diagnosed clients with at least 2 potential Criterion A traumatic events completed the Posttraumatic Stress Diagnostic Scale twice, in counterbalanced order: once regarding their worst event and once regarding all events. When responding regarding their worst trauma, 53.7% met probable PTSD criteria. This rose to 67.2% when considering all traumas. Although preliminary, these results suggest that linking PTSD symptoms to a single traumatic event excludes a meaningful number of cases who are otherwise indistinguishable based on symptom profile.",0 +https://doi.org/10.1007/s12144-015-9348-4,Perceptions of Trauma and Loss among Children and Adolescents Exposed to Disasters a Mixed-Methods Study,"The purpose of the current study was to extend knowledge of youth exposed to multiple disasters and the experience of cumulative childhood adversity by analyzing perceptions of trauma and loss in children and adolescents. A concurrent mixed-methods design was utilized to explore an ethnically diverse, predominantly low-income sample of youth (N = 4,154) aged 8–18 years from three parishes (counties) in Louisiana impacted by Hurricane Katrina and the Gulf Oil Spill. Youth completed assessments of posttraumatic stress symptoms (PTSS), hurricane exposure and oil spill stress, and responded to an open-ended question regarding lifetime trauma and loss. Independent coders assigned responses to 30 categories using a qualitative codebook based on both predetermined and emerging information. Codes were compared and contrasted for meaning and grouped into broader, organizing themes. Themes of trauma and loss included: death and loss of others, threats to life, family disruption, interpersonal trauma, and life transitions. Trauma and loss predicted PTSS when controlling for hurricane exposure and oil spill stress. Most trauma and loss conferred generalized risk regardless of event typology, although interpersonal trauma had unique effects. Findings improve understanding of the nature and extent of trauma and loss among youth exposed to multiple disasters. The use of a mixed-methods design clarifies prior findings in the broader trauma literature and child disaster studies. Through identification of vulnerable subgroups and patterns in perceptions of trauma and loss, findings have important implications for prevention and intervention strategies that promote long-term recovery. © 2015, Springer Science+Business Media New York.",0 +https://doi.org/10.1055/s-2002-23173,Naive and Memory T Cell Subsets are Differentially Mobilized During Physical Stress,"This study examined the naive and memory phenotypic profiles of CD4+ and CD8hi T cells that were mobilized to the peripheral circulation during a combination of aerobic exercise and heat stress, determining expression of the adhesion molecules CD62L and CD11a on the recruited cells. Twelve recreationally active males (age 27.1 +/- 5.3 yr, height 1.77 +/- 0.08 m, mass 76.9 +/- 12.0 kg, VO2peak 43.9 +/- 6.7 mL x kg(-1) x min(-1)) completed a 40 min bout of cycle ergometry at 65 % of VO2peak while immersed to mid-chest in a water bath at 39 degrees C. Venous blood samples were collected before (T0), during (T40) and 30 min after (T70) exposure to combined exercise and heat stress. Specimens were analyzed by three-colour flow cytometry for CD4+ and CD8hi T cell expression of CD45RO, CD11a and CD62L. Some 80 % of the CD4+ T cells that were mobilized were of the CD45RO memory phenotype, with the numbers of CD11alo and CD62L+ cells increasing more than those of CD11ahi and CD62L- cells. For the CD8hi cells, there was a more equal recruitment of CD45RO- naive (43 %) and CD45RO+ memory (57 %) cells. The majority (84 %) of recruited CD8+ cells were CD11ahi; there was a trend to predominance of CD62L- cells (57 %) for the memory subset, but with almost equal recruitment of CD62L+/- for the naive subset. We conclude that the exercise + heat stress induced trend to an increase in CD4+ T cells is linked in some way to memory phenotype; it cannot be explained simply by a high density expression of CD11a and lack of the lymph node homing receptor (CD62L). Furthermore, although mobilization of CD8hi T cells is not linked to memory phenotype, a high density expression of CD11a and a lack of the lymph node homing receptor are important determinants of CD8hi T cell mobilization.",0 +https://doi.org/10.1016/j.jpsychires.2009.10.001,"Psychopathological, biological, and neuroimaging characterization of posttraumatic stress disorder in survivors of a severe coalmining disaster in China","On July 29, 2007, a severe coalmine-flooded disaster occurred in central China and 69 miners were trapped in an about 1400 m underground coal pit. Fortunately, all of them were rescued after 75 h of the ordeal. At 3 and 6 months after the disaster, psychopathological profiles, plasma levels of cortisol and adrenocorticotropic hormone (ACTH) were evaluated in 48 survivors for posttraumatic stress disorder (PTSD) and comorbid symptoms. Magnetic resonance imaging (MRI) study was performed at 6 months. The prevalence of PTSD was 35.4% (17/48) at 3 months and 31.3% (15/48) at 6 months post-disaster, with high rates of comorbid symptoms. Risk factors for PTSD included previous traumatic experience, less than 5 years of being a miner, in an extremely exhausted or sick during the disaster, poor interpersonal relationship and poor sleep quality experienced before the disaster. Mean plasma cortisol levels at 6 months, but not at 3 months, were significantly higher in PTSD-positive subjects than the negative, and positively correlated with the severity of several comorbid symptoms. Either whole or regional brain volumes of PTSD-positive subjects were not significantly different from PTSD-negative subjects, but PTSD subjects had significantly reduced fractional anisotropy values in the right posterior cingulum and bilateral hippocampal body compared to subjects without PTSD. These results suggest that traumatic exposure in severe coalmining disasters results in considerable psychological consequences, with highly prevalent PTSD and comorbid symptoms, which are associated with previous traumatic experience, shorter-length underground services, and poor interpersonal relationships and sleep quality experienced before the disaster. Baseline cortisol level may be a useful biological predictor for different phases of the development of PTSD. The aberrant connectivity of the hippocampus and the cingulum may represent an early pathological response to trauma exposure.",0 +https://doi.org/10.1192/bjp.186.6.467,Documented combat exposure of US veterans seeking treatment for combat-related post-traumatic stress disorder,"Background There are concerns regarding the validity of combat exposure reports of veterans seeking treatment for combat-related post-traumatic stress disorder (PTSD) within US Veterans Affairs Medical Centers. Aims To verify combat exposure history for a relevant sample through objective historical data. Method Archival records were reviewed from the US National Military Personnel Records Center for 100 consecutive veterans reporting Vietnam combat in a Veterans Affairs PTSD clinic. Cross-sectional clinical assessment and 12-month service use data were also examined. Results Although 93% had documentation of Vietnam war-zone service, only 41% of the total sample had objective evidence of combat exposure documented in their military record. There was virtually no difference between the Vietnam ‘combat’ and ‘no combat’ groups on relevant clinical variables. Conclusions A significant number of treatment-seeking Veterans Affairs patients may misrepresent their combat involvement in Vietnam. There are implications for the integrity of the PTSD database and the Veterans Affairs healthcare system.",0 +https://doi.org/10.1016/j.physbeh.2006.01.033,"Cortical/hippocampal monoamines, HPA-axis changes and aversive behavior following stress and restress in an animal model of post-traumatic stress disorder","Post-traumatic stress disorder (PTSD) is characterized by monoaminergic and hypothalamic–pituitary–adrenal (HPA)-axis abnormalities. Understanding monoamine-HPA-axis responses following stress and restress may provide a greater understanding of the neurobiology of PTSD and of its treatment. Hippocampal and frontal cortex serotonin, noradrenaline and dopamine, plasma corticosterone and aversive behavior were studied in rats on day 1 and day 7 post acute stress (AS = sequential restraint stress, swim stress and halothane exposure), and on day 1 and day 7 post restress (RS = swim stress). After AS, there was an early increase in both avoidant behavior and corticosterone (1 h after stress), with subsequent normalisation (day 7), suggesting an adequate adaptive response to the stressor. However, restress (RS) evoked a significant early HPA-axis hyporesponsiveness (1 h after RS) and a later significant increase in avoidant behavior on day 7 post RS. Hippocampal serotonin, noradrenaline and dopamine concentrations were unchanged 1 h post AS, but were significantly raised on day 7 post AS. Restress, however, reduced serotonin and noradrenaline levels 1 h after and on day 7 post RS, respectively, while dopamine was unchanged. In the frontal cortex only dopamine levels were altered, being significantly elevated 1 h after AS, and reduced on day 7 post RS. AS and RS thus differently effect the HPA-axis, evoking regional-specific brain monoamine changes that underlie maladaptive behavior and other post stress-related sequelae.",0 +https://doi.org/10.37757/mr2014.v16.n2.11,Chronic Kidney Disease in Central American Agricultural Communities: Challenges for Epidemiology and Public Health,"This paper contextualizes the chronic kidney disease epidemic and related burden of disease affecting Central American farming communities. It summarizes the two main causal hypotheses (heat stress and agrochemicals), draws attention to the consequences of dichotomous reasoning concerning causality, and warns of potential conflicts of interest and their role in manufacturing doubt. It describes some methodological errors that compromise past study findings and cautions against delaying public health actions until a conclusive understanding is reached about the epidemic's causes and underlying mechanisms. It makes the case for a comprehensive approach to the historical, social and epidemiological facts of the epidemic, for critically assessing existing studies and for enhanced rigor in new research.",0 +https://doi.org/10.1207/s15327876mp0801_1,Combat exposure and posttraumatic stress symptomatology among U.S. soldiers deployed to the Gulf War.,"Among the most stressful experiences soldiers encounter during combat is exposure to dead and wounded soldiers and civilians. This article examines the early (9 months postcombat) psychological reactions of U.S. Army soldiers deployed from Germany who served in frontline combat units during the Persian Gulf War. In particular, the article focuses on stress symptoms associated with soldiers' exposure to death and wounding during Operations Desert Shield and Desert Storm. Those soldiers exposed to casualties, especially U.S. casualties, had greater distress scores as measured by the Impact of Event Scale (IES) and a tripartite measure of posttraumatic stress (PTS) symptomatology modeled on the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1987) than did those without such exposure. Rank, type of casualty exposure, and current problems with coworkers and chain of command were additively related to explained variance in IES and PTS symptoma...",0 +https://doi.org/10.1007/s00737-011-0224-4,Bio-socio-demographic factors associated with post-traumatic stress disorder in a sample of postpartum Brazilian women,"Post-traumatic stress disorder (PTSD) is common among women. In the postpartum period, the prevalence is between 1% and 6%. The present study investigated PTSD in a sample of 400 Brazilian women between 2 and 26 weeks postpartum using the Mini-International Neuropsychiatric Interview and found a frequency of 5.3%. The factors associated with the occurrence of PTSD were low purchasing power, a history of psychiatric disorders, clinical disease, and the infant having experienced some complication (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1080/10926771.2013.845278,"Ethnic Identity, Family Cohesion, and Symptoms of Post-traumatic Stress Disorder in Maltreated Youth","Post-traumatic stress disorder (PTSD) is prevalent among maltreated youth, but little empirical work exists regarding the role of ethnic identity and family cohesion as influential factors among different ethnic groups. This study included an ethnically diverse sample of adolescents affiliated with a state-administered residential facility for maltreated youth. Variables included ethnic identity and family cohesion, as well as symptoms of PTSD, depression, dissociation, and post-traumatic cognitions. The most prominent finding was that low family cohesion predicted greater PTSD symptoms, depression, dissociation, and post-traumatic cognitions. This finding was especially pronounced for multiracial youth. Results are discussed within the context of developmental pathways regarding ethnic identity development in multiracial youth.",0 +https://doi.org/10.1007/s10461-011-9980-4,The Effects of Traumatic Stressors and HIV-Related Trauma Symptoms on Health and Health Related Quality of Life,"The study identified relations among traumatic stressors, HIV-related trauma symptoms, comorbid medical conditions, and health related quality of life (HRQL) in individuals with HIV. Participants (N = 118) completed a structured clinical interview on HIV as a traumatic stressor and other severe traumatic stressors and completed the Impact of Event Scale to assess HIV-related trauma symptoms and the Medical Outcomes Study 36-item Short Form (SF-36) to assess HRQL. Medical chart reviews determined comorbid conditions. Path analysis findings indicated participants with prior severe traumatic stressors experienced their HIV diagnosis as traumatic and in turn were more likely to have current HIV-related trauma symptoms which were negatively related to HRQL. HIV as a traumatic stressor was related to coronary artery diseases and HRQL. Traumatic stressors and HIV-related trauma symptoms impact health in individuals with HIV and highlight the need for psychological interventions prior to diagnosis and throughout treatment.",0 +https://doi.org/10.3109/09540261.2011.559456,PTSD among military personnel,"Although symptoms characteristic of post-traumatic stress disorder (PTSD) have been noted in military personnel for many centuries, it was not until 1980 that the disorder was formally recognized and became the focus of legitimate study. This paper reviews our current state of knowledge regarding the prevalence and course of this complex condition in past and present members of the defence forces. Although rates vary across conflicts and countries, there is no doubt that PTSD affects substantial numbers of personnel and results in considerable impairment in functioning and quality of life. The paper goes on to discuss recent attempts to build resilience and to promote adjustment following deployment, noting that there is little evidence at this stage upon which to draw firm conclusions. Finally, effective treatment for PTSD is reviewed, with particular reference to the challenges posed by this population in a treatment setting.",0 +https://doi.org/10.1016/j.psc.2004.03.007,International disaster mental health,"This article distills key issues and controversies in the field of international disaster mental health. It offers perspectives from cross-cultural research and describes current controversies, including the appropriateness of bringing to bear Western structures of mental health and psychiatric diagnosis to non-Western settings. It reports early lessons learned from the field regarding what might best constitute assistance within a foreign culture and where to place emphasis. It recommends becoming involved within the relief establishment.",0 +https://doi.org/10.1002/pmh.1177,The effect of trauma on expressive language impairment in borderline personality disorder,"Borderline personality disorder (BPD) is a disorder with known expressive language impairments that may be activated in treatment through interpersonal cues to the trauma memory system of these patients. However, there are few BPD studies investigating this phenomenon empirically. Our previous research is the first known investigation revealing expressive language deficits using clinically relevant trauma-salient stimuli; the current study extends this to compare specific expressive language deficits on a neutral and emotive stimulus and relationships with trauma history. BPD and matched control (N = 24) verbalizations were analysed by computerized measures of language impairment and pause profiles. BPD subjects evidenced greater overall language impairment and reduced syntactic complexity, but not semantic complexity compared with controls. No such differences were found between the two groups on the neutral condition. BPD subjects utilized significantly higher proportions of pauses for both the emotive and neutral condition. BPD subjects used significantly greater proportions of pauses when generating adjectives related to early relationship with mother, not father. Presence of physical abuse history and PTSD related to some expressive language deficits. These results support neuroimaging findings demonstrating reduced activation of the pre-frontal cortex or anterior cingulate, alongside increased bilateral activation of the amygdala, during exposure to trauma-salient stimuli. Copyright © 2012 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1016/j.childyouth.2010.03.028,Mental health needs of children exposed to intimate partner violence seeking help from mental health services,"The aim of this study is to examine whether children and adolescents exposed to interparental physical and environmental violence have specific needs when seeking public mental health services compared to non-exposed outpatients. The witnessing of intimate partner violence (IPV), psychopathology, functional impairment, and several individual and family variables were assessed in 520 children aged 8 to 17 years. Results showed that living with violent parents at home increased the child's risk of posttraumatic stress disorder, dysthymia, self-harming behavior, and functional impairment. Exposed children's mothers were more likely to overprotect their sons, punish their daughters and report greater psychopathology, whereas fathers who engaged in marital violence displayed greater emotional distress and were more likely to punish and reject their children. The child's sex moderated the IPV effects on parenting, parental discipline, child's life events and health appraisal. Given the specific clinical profile of exposed children, mental health services should develop schedules to detect, assess, and treat these cases.",0 +https://doi.org/10.1111/j.1471-4159.2011.07545.x,"Cells, biomarkers, and post-traumatic stress disorder: evidence for peripheral involvement in a central disease","Post-traumatic stress disorder (PTSD) is a complicated CNS syndrome. Looking beyond the CNS, recent studies suggest that peripheral blood mononuclear cells could cause and/or exacerbate PTSD. This review summarizes the literature, describes associations between circulating peripheral blood cells and PTSD, proposes a novel mechanism, and analyzes several biomarkers that appear to associate with PTSD symptoms. Several experimental animal models have shown that peripheral blood mononuclear cell activity can cause hippocampal volume loss and PTSD-like symptoms. Data from these models suggest that a traumatic event and/or traumatic events can trigger peripheral cells to migrate, mediate inflammation, and decrease neurogenesis, potentially leading to CNS volume loss. Biomarkers that associate with PTSD symptoms have the potential to differentiate PTSD from traumatic brain injury, but more work needs to be done. Research examining the mechanism of how traumatic events are linked to peripheral blood mononuclear cell functions and biomarkers may offer improved diagnoses and treatments for PTSD patients.",0 +https://doi.org/10.1037/neu0000228,A meta-analysis on the impact of psychiatric disorders and maltreatment on cognition.,"Few studies have attempted to describe the range of cognitive impairments in individuals with psychiatric disorders who experienced maltreatment as children. The aims of this meta-analysis were to establish the impact of maltreatment and psychiatric disorders on cognition, and to examine the change in impact from childhood to adulthood.Twelve publications from 1970 to 2013 were included, with the following inclusion criteria: (a) individuals with a psychiatric disorder who experienced maltreatment, (b) use of at least 1 standardized neuropsychological measure, and (c) use of a control group without any psychiatric disorder or mistreatment. The majority of studies (10/12) were about posttraumatic stress disorder. Several effect sizes were calculated (Hedge's g) according to the cognitive domains.The results of the meta-analysis demonstrate that the combination of psychiatric disorders and childhood maltreatment has a negative impact on global cognitive performance, with a moderate effect size (g = -0.59). The most affected cognitive domains for individuals aged 7- to 18-years-old were visual episodic memory (g = -0.97), executive functioning (g = -0.90), and intelligence (g = -0.68). For individuals over the age of 18-years-old, the most affected cognitive domains were verbal episodic memory (g = -0.77), visuospatial/problem solving (g = -0.73), and attention (g = -0.72). The impact of maltreatment and psychiatric disorders was greater in children than in adults (slope = 0.008, p < .002).The results suggest that exposure to maltreatment and the presence of psychiatric disorders have a broad impact on cognition, with specific neuropsychological profile.",0 +https://doi.org/10.1016/j.comppsych.2013.11.017,Panic Disorder and Agoraphobia in OCD patients: Clinical profile and possible treatment implications,"Panic Disorder (PD) and agoraphobia (AG) are frequently comorbid with obsessive-compulsive disorder (OCD), but the correlates of these comorbidities in OCD are fairly unknown. The study aims were to: 1) estimate the prevalence of PD with or without AG (PD), AG without panic (AG) and PD and/or AG (PD/AG) in a large clinical sample of OCD patients and 2) compare the characteristics of individuals with and without these comorbid conditions.A cross-sectional study with 1001 patients of the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders using several assessment instruments, including the Dimensional Yale-Brown Obsessive-Compulsive Scale and the Structured Clinical Interview for DSM-IV-TR Axis I Disorders. Bivariate analyses were followed by logistic regression models.The lifetime prevalence of PD was 15.3% (N=153), of AG 4.9% (N=49), and of PD/AG 20.2% (N=202). After logistic regression, hypochondriasis and specific phobia were common correlates of the three study groups. PD comorbidity was also associated with higher levels of anxiety, having children, major depression, bipolar I, generalized anxiety and posttraumatic stress disorders. Other independent correlates of AG were: dysthymia, bipolar II disorder, social phobia, impulsive-compulsive internet use, bulimia nervosa and binge eating disorder. Patients with PD/AG were also more likely to be married and to present high anxiety, separation anxiety disorder, major depression, impulsive-compulsive internet use, generalized anxiety, posttraumatic stress and binge eating disorders.Some distinct correlates were obtained for PD and AG in OCD patients, indicating the need for more specific and tailored treatment strategies for individuals with each of these clinical profiles.",0 +https://doi.org/10.3928/00485713-20090514-01,The Epidemiology of Posttraumatic Stress Disorder,,0 +https://doi.org/10.1186/s13041-015-0104-3,Brain transcriptome profiles in mouse model simulating features of post-traumatic stress disorder,"Social-stress mouse model, based on the resident-intruder paradigm was used to simulate features of human post-traumatic stress disorder (PTSD). The model involved exposure of an intruder (subject) mouse to a resident aggressor mouse followed by exposure to trauma reminders with rest periods. C57BL/6 mice exposed to SJL aggressor mice exhibited behaviors suggested as PTSD-in-mouse phenotypes: intermittent freezing, reduced locomotion, avoidance of the aggressor-associated cue and apparent startled jumping. Brain tissues (amygdala, hippocampus, medial prefrontal cortex, septal region, corpus striatum and ventral striatum) from subject (aggressor exposed: Agg-E) and control C57BL/6 mice were collected at one, 10 and 42 days post aggressor exposure sessions. Transcripts in these brain regions were assayed using Agilent's mouse genome-wide arrays.Pathways and biological processes associated with differentially regulated genes were mainly those thought to be involved in fear-related behavioral responses and neuronal signaling. Expression-based assessments of activation patterns showed increased activations of pathways related to anxiety disorders (hyperactivity and fear responses), impaired cognition, mood disorders, circadian rhythm disruption, and impaired territorial and aggressive behaviors. In amygdala, activations of these pathways were more pronounced at earlier time-points, with some attenuation after longer rest periods. In hippocampus and medial prefrontal cortex, activation patterns were observed at later time points. Signaling pathways associated with PTSD-comorbid conditions, such as diabetes, metabolic disorder, inflammation and cardiac infarction, were also significantly enriched. In contrast, signaling processes related to neurogenesis and synaptic plasticity were inhibited.Our data suggests activations of behavioral responses associated with anxiety disorders as well as inhibition of neuronal signaling pathways important for neurogenesis, cognition and extinction of fear memory. These pathways along with comorbid-related signaling pathways indicate the pervasive and multisystem effects of aggressor exposure in mice, potentially mirroring the pathologic conditions of PTSD patients.",0 +https://doi.org/10.1002/jts.21708,What can multiwave studies teach us about disaster research: An analysis of low-income Hurricane Katrina survivors,"Previous research on natural disasters has been limited by a lack of predisaster data and statistical analyses that do not adequately predict change in psychological symptoms. In the current study, we addressed these limitations through analysis of 3 waves of data from a longitudinal investigation of 313 low-income, African American mothers who were exposed to Hurricane Katrina. Although postdisaster cross-sectional estimates of the impact of traumatic stress exposure and postdisaster social support on postdisaster psychological distress were somewhat inflated, the general trends persisted when controlling for predisaster data (B = 0.88 and -0.33, vs. B = 0.81 and -0.27, respectively). Hierarchical linear modeling of the 3 waves of data revealed that lower predisaster social support was associated with higher psychological distress at the time of the disaster (β = -.16), and that higher traumatic stress exposure was associated with greater increases in psychological distress after the storm (β = .86). Based on the results, we suggest that the impact of traumatic stress on psychological trajectories cannot be accounted for solely by preexisting risk, and recommend more complex research designs to further illuminate the complex, dynamic relationships between psychological distress, traumatic stress exposure, and social support.",0 +https://doi.org/10.1371/journal.pone.0022371,Risk Factors of Posttraumatic Stress Disorder among Survivors after the 512 Wenchuan Earthquake in China,"This study investigated the psychological reactions of survivors of the 512 Wenchuan earthquake in China and the risk factors associated with those reactions. The Impact of Event Scale-Revised (IES-R), Type D Scale-14 (DS14), a self-developed trauma experience questionniare, and a demographic questionnaire were administered to 956 earthquake survivors (389 males and 567 females) in Mianzhu, one of the cities most affected by the earthquake. The results showed that postraumatic stress disorder (PTSD) symptoms affected 84.8% of survivors one to two months after the earthquake. Significant risk factors associated with PTSD symptoms included: (1) being female; (2) older age; (3) higher exposure to traumatic events during the earthquake; and (4) negative affect in Type-D personality.",0 +https://doi.org/10.1358/dot.2012.48.4.1745225,Utilizing pharmacodynamic properties of second-generation antipsychotics to guide treatment,"Second-generation antipsychotics (SGAs) are used for the treatment of multiple psychiatric disorders including schizophrenia, bipolar depression, bipolar mania, autism and major depressive disorder. Additionally, their off-label use has been expanding to include other disorders as well, including post-traumatic stress disorder, obsessive compulsive disorder, generalized anxiety disorder, eating disorders and personality disorders. All SGAs share common properties; however, each individual SGA has a unique pharmacodynamic profile that may be utilized to guide and individualize treatment.",0 +https://doi.org/10.1016/j.socscimed.2014.09.054,"In search of links between social capital, mental health and sociotherapy: A longitudinal study in Rwanda","To date, reviews show inconclusive results on the association between social capital and mental health. Evidence that social capital can intentionally be promoted is also scarce. Promotion of social capital may impact post-conflict recovery through both increased social cohesion and better mental health. However, studies on community interventions and social capital have mostly relied on cross-sectional study designs. We present a longitudinal study in Rwanda on the effect on social capital and mental health of sociotherapy, a community-based psychosocial group intervention consisting of fifteen weekly group sessions. We hypothesized that the intervention would impact social capital and, as a result of that, mental health. We used a quasi-experimental study design with measurement points pre- and post-intervention and at eight months follow-up (2007-2008). Considering sex and living situation, we selected 100 adults for our experimental group. We formed a control group of 100 respondents with similar symptom score distribution, age, and sex from a random community sample in the same region. Mental health was assessed by use of the Self Reporting Questionnaire, and social capital through a locally adapted version of the short Adapted Social Capital Assessment Tool. It measures three elements of social capital: cognitive social capital, support, and civic participation. Latent growth models were used to examine whether effects of sociotherapy on mental health and social capital were related. Civic participation increased with 7% in the intervention group versus 2% in controls; mental health improved with 10% versus 5% (both: p < 0.001). Linear changes over time were not significantly correlated. Support and cognitive social capital did not show consistent changes. These findings hint at the possibility to foster social capital and simultaneously impact mental health. Further identification of pathways of influence may contribute to the designing of psychosocial interventions that effectively promote recovery in war-affected populations.Nederlands Trial Register 1120.",0 +https://doi.org/10.1016/j.jpsychires.2010.10.014,Reduced hippocampus volume in the mouse model of Posttraumatic Stress Disorder,"Some, but not all studies in patients with posttraumatic stress disorder (PTSD), report reduced hippocampus (HPC) volume. In particular it is unclear, whether smaller hippocampal volume represents a susceptibility factor for PTSD rather than a consequence of the trauma. To gain insight into the relationship of brain morphology and trauma exposure, we investigated volumetric and molecular changes of the HPC in a mouse model of PTSD by means of in vivo Manganese Enhanced Magnetic Resonance Imaging (MEMRI) and ex vivo ultramicroscopic measurements. Exposure to a brief inescapable foot shock led to a volume reduction in both left HPC and right central amygdala two months later. This volume loss was mirrored by a down-regulation of growth-associated protein-43 (GAP43) in the HPC. Enriched housing decreased the intensity of trauma-associated contextual fear, independently of whether it was provided before or after the shock. Beyond that, enriched housing led to an increase in intracranial volume, including the lateral ventricles and the hippocampus, and to an up-regulation of GAP43 as revealed by MEMRI and Western blot analysis, thus partially compensating for trauma-related HPC volume loss and down-regulation of GAP43 expression. Together these data demonstrate that traumatic experience in mice causes a reduction in HPC and central amygdala volume possibly due to a shrinkage of axonal protrusions. Enriched housing might induce trophic changes, which may contribute to the amelioration of trauma-associated PTSD-like symptoms at behavioural, morphological and molecular levels.",0 +https://doi.org/10.1016/s0191-8869(99)00032-x,The association between adult attachment style and mental health in extreme life-endangering conditions,"Abstract This study examines the association between adult attachment style and psychopathology in extreme life-endangering conditions. A group of 40 Israeli Jewish settlers who lived within the Palestinian Authority territory (high-threat group) were asked to fill out an attachment style scale and psychiatric symptomatology measures. They were compared to a control group of Israeli Jewish persons who lived within the State of Israel. Findings showed higher symptomatology in the high-threat than control group. Secure attachment style was inversely related to symptomatology measures. In contrast, anxious–ambivalent and avoidant attachment styles were positively related to symptomatology measures. However, whereas the anxious–ambivalent attachment style was related to psychopathology in the two threat conditions, the avoidant style was related to psychopathology only in the high-threat group. Results were discussed in terms of attachment theory.",0 +https://doi.org/10.1016/j.addbeh.2011.09.010,Treatment of substance abusing patients with comorbid psychiatric disorders,"To update clinicians on the latest in evidence-based treatments for substance use disorders (SUD) and non-substance use disorders among adults and suggest how these treatments can be combined into an evidence-based process that enhances treatment effectiveness in comorbid patients.Articles were extracted from Pubmed using the search terms ""dual diagnosis,"" ""comorbidity"" and ""co-occurring"" and were reviewed for evidence of effectiveness for pharmacologic and psychotherapeutic treatments of comorbidity.Twenty-four research reviews and 43 research trials were reviewed. The preponderance of the evidence suggests that antidepressants prescribed to improve substance-related symptoms among patients with mood and anxiety disorders are either not highly effective or involve risk due to high side-effect profiles or toxicity. Second generation antipsychotics are more effective for treatment of schizophrenia and comorbid substance abuse and current evidence suggests clozapine, olanzapine and risperidone are among the best. Clozapine appears to be the most effective of the antipsychotics for reducing alcohol, cocaine and cannabis abuse among patients with schizophrenia. Motivational interviewing has robust support as a highly effective psychotherapy for establishing a therapeutic alliance. This finding is critical since retention in treatment is essential for maintaining effectiveness. Highly structured therapy programs that integrate intensive outpatient treatments, case management services and behavioral therapies such as Contingency Management (CM) are most effective for treatment of severe comorbid conditions.Creative combinations of psychotherapies, behavioral and pharmacological interventions offer the most effective treatment for comorbidity. Intensity of treatment must be increased for severe comorbid conditions such as the schizophrenia/cannabis dependence comorbidity due to the limitations of pharmacological treatments.",0 +https://doi.org/10.1002/1097-4679(199407)50:4<529::aid-jclp2270500408>3.0.co;2-l,MMPI profiles in PTSD as a function of comorbidity,"A sample of 135 Vietnam veteran inpatients with combat-related PTSD was sorted into three groups, depending upon the presence of concurrent psychiatric disorders: Depression (n = 68), Psychosis (n = 31), and Other (n = 36). Pairwise comparisons were made on the MMPI with respect to the validity indicators, clinical scales, four relevant Harris-Lingoes subscales, the Psychoticism content scale, and the MMPI-PTSD subscale. Results indicate variations in scale elevations as a function of comorbid diagnosis. Various items and scales appear to differentiate the Psychosis group due to greater psychopathology. In general, the results spotlight the heterogeneous aspects that comorbidity brings to PTSD assessment.",0 +https://doi.org/10.1080/07448481.2015.1068173,Readjustment of Urban Veterans: A Mental Health and Substance Use Profile of Iraq and Afghanistan Veterans in Higher Education,"To identify the prevalence of substance use and mental health problems among veterans and student service members/veterans (SSM/V) returning from Iraq and Afghanistan to New York City's low-income neighborhoods.A sample of 122 veterans attending college and 116 veterans not enrolled recruited using respondent-driven sampling.Logistic regression analysis of variation in characteristics of those veterans attending college; linear regression examining effects of college attendance on life satisfaction.Having a traumatic brain injury or disability was positively associated with college attendance. Being married, employed, or in college was predictive of overall life satisfaction. SSM/V were significantly less likely to screen positive for depression or drug use disorder. African American veterans were significantly less likely to attend college than white or Hispanic veterans.Substance use and some mental health disorders do not preclude inner-city veterans from entering higher education. This study contributes to the sparse literature on African American veterans and SSM/V.",0 +,Profiles of referrals to a psychiatric service: a descriptive study of survivors of the Nairobi US Embassy terrorist bomb blast.,"OBJECTIVE: To document the socio-demographic characteristics and psychiatric profiles of the survivors of the Nairobi United States Embassy terrorist bomb blast referred to a psychiatric and psychotherapy (counselling) service. METHOD: This was a descriptive cross-sectional study. Clinical interviews and structured questionnaires for post-traumatic stress disorder (PTSD) and stress were administered. Survivors of the bomb blast referred to a psychiatric and psychotherapy service one year or more after the bombing were included in the study. These survivors had been treated using psychopharmacotherapy and individualised (not group) therapy/counselling. RESULTS: Eighty-three consecutive referrals to a psychiatric service participated in this study. There were more males and the sample was generally well educated. The referrals made contact with the referring agency for a number of reasons including seeking psychological, financial and medical assistance. All the patients reported varying degrees of psychiatric symptoms and functional impairment on various aspects of social occupational functioning. High scores for PTSD and other related stress were recorded one or more years after the bombing. CONCLUSION: Although the survivors indicated that initial counselling following the blast had helped them, they still scored high on PTSD suggesting that clinically, the initial counselling had little, if any impact on the development of PTSD. There is need for a holistic approach to the management of psychotrauma in individuals. Language: en",0 +https://doi.org/10.1037/trm0000020,Exploring the fit of Western PTSD models across three non-Western low- and middle-income countries.,"The purpose of this study was to examine the fit of existing Western posttraumatic stress disorder (PTSD) models across 3 non-Western low and middle income countries (LMIC). Secondary data analysis was conducted from studies among torture survivors in Northern Iraq, sexual violence survivors in the Democratic Republic of Congo (DRC), and Burmese refugees in Thailand. Confirmatory factor analyses were conducted on Harvard Trauma Questionnaire (HTQ) data to compare established Western PTSD models using (a) the 3-factor Diagnostic and Statistical Manual (DSM) 4th edition model, (b) the 4-factor “numbing” model, (c) the 4-factor “dysphoria” model, and (d) the 4- factor DSM-5 model. For both the DRC and Burma all models had adequate fit. Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) determined that the 4-factor “numbing” model was the best fit for the DRC and the 4-factor “dysphoria” model was the best fit for Burma. For Iraq, none of the models had adequate fit. Results support previous research which indicates inconsistency among Western models of PTSD among populations from LMIC. Further research should explore whether this is indicative of the context or potentially other factors.",0 +https://doi.org/10.1017/s1352465803001115,A PSYCHO-PHYSIOLOGICAL COMPARISON OF POST-TRAUMATIC AND PROLONGED DURESS STRESS DISORDERS,"It has been proposed that post-traumatic stress disorder (PTSD) and so-called “prolonged duress stress disorder” (PDSD) have similar symptom profiles and differ only with regard to the presence or absence of a “traumatic event”. This single case experiment investigated whether PTSD can be distinguished from PDSD at the level of patho-physiology. The results indicate that both PTSD and PDSD imagery elicit physiological responses, but these are more readily and more strongly evoked by the former than the latter. These findings suggest that physiological response differences between PTSD and PDSD may be only a matter of degree. Implications are drawn for the psycho-physiological assessment of PDSD and recommendations for further research are made.",0 +https://doi.org/10.1007/s00213-004-1849-z,Olanzapine versus fluphenazine in an open trial in patients with psychotic combat-related post-traumatic stress disorder,"Rationale: Combat-related post-traumatic stress disorder (PTSD) is often complicated with other psychiatric comorbidities, and is refractory to treatment. Objective: The aim of an open, comparative 6-week study was to compare olanzapine and fluphenazine, as a monotherapy, for treating psychotic combat-related PTSD. Method: Fifty-five male war veterans with psychotic PTSD (DSM-IV criteria) were treated for 6 weeks with olanzapine (n=28) or fluphenazine (n=27) in a 5-10 mg/day dose range, once or twice daily. Patients were evaluated at baseline, and after 3 and 6 weeks of treatment, using Watson's PTSD scale, Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression Severity Scale (CGI-S), Clinical Global Impression Improvement Scale (CGI-I), Patient Global Impression Improvement Scale (PGI-I) and Drug Induced Extra-Pyramidal Symptoms Scale (DIEPSS). Results: At baseline, patient's data (age, duration of combat experience and scores in all measurement instruments) did not differ. After 3 and 6 weeks of treatment, olanzapine was significantly more efficacious than fluphenazine in reducing symptoms in PANSS (negative, general psychopathology subscale, supplementary items), Watson's PTSD (avoidance, increased arousal) subscales, CGI-S, CGI-I, and PGI-I scale. Both treatments affected similarly the symptoms listed in PANSS positive and Watson's trauma re-experiencing subscales. Fluphenazine induced more extrapyramidal symptoms. Prolongation of the treatment for 3 additional weeks did not affect the efficacy of either drug. Conclusions: Our data indicate that both fluphenazine and olanzapine were effective for particular symptom profile in psychotic combat-related PTSD. Olanzapine was better than fluphenazine in reducing most of the psychotic and PTSD symptoms, and was better tolerated in psychotic PTSD patients.",0 +https://doi.org/10.1002/jts.20530,Long-term perspectives on posttraumatic growth in disaster survivors,"Findings on posttraumatic growth (PTG) and distress have not been consistent. This study examines the relationship in a very long-term perspective. The Posttraumatic Growth Inventory was completed by 46 survivors from a single disaster 27 years posttrauma. Posttraumatic stress was measured by the Impact of Event Scale (IES) immediately after the event, and after 1, 5, and 27 years. In the final follow-up, general mental health was also assessed. Strong positive associations were found between PTG and concurrent posttraumatic stress. Although weaker associations were found for the past, concurrent problems in general mental health clearly coexisted with PTG decades after a disaster, yet mediated by IES.",0 +https://doi.org/10.1037/0022-006x.74.4.698,"Anger, hostility, and posttraumatic stress disorder in trauma-exposed adults: A meta-analysis.","This meta-analysis synthesizes the available data on the strength of association between anger and posttraumatic stress disorder (PTSD) and between hostility and PTSD, covering 39 studies with trauma-exposed adults. Effect sizes did not differ for anger and hostility, which could therefore be combined; effect sizes for anger expression variables were analyzed separately. The analyses revealed large effects. The weighted mean effect size (r) was .48 for anger-hostility, .29 for anger out, .53 for anger in, and -.44 for anger control. Moderator analyses were conducted for anger-hostility, showing that effect sizes were substantially larger with increasing time since the event and that effect sizes were larger in samples with military war experience than in samples that had experienced other types of traumatic events.",0 +https://doi.org/10.1177/0269881114565142,The adverse health effects of synthetic cannabinoids with emphasis on psychosis-like effects,"Cannabis use is associated with an increased risk of psychosis in vulnerable individuals. Cannabis containing high levels of the partial cannabinoid receptor subtype 1 (CB 1 ) agonist tetrahydrocannabinol (THC) is associated with the induction of psychosis in susceptible subjects and with the development of schizophrenia, whereas the use of cannabis variants with relatively high levels of cannabidiol (CBD) is associated with fewer psychotic experiences. Synthetic cannabinoid receptor agonists (SCRAs) are full agonists and often more potent than THC. Moreover, in contrast to natural cannabis, SCRAs preparations contain no CBD so that these drugs may have a higher psychosis-inducing potential than cannabis. This paper reviews the general toxicity profile and the adverse effects of SCRAs with special emphasis on their psychosis-inducing risk. The review shows that, compared with the use of natural cannabis, the use of SCRAs may cause more frequent and more severe unwanted negative effects, especially in younger, inexperienced users. Psychosis and psychosis-like conditions seem to occur relatively often following the use of SCRAs, presumably due to their high potency and the absence of CBD in the preparations. Studies on the relative risk of SCRAs compared with natural cannabis to induce or evoke psychosis are urgently needed.",0 +https://doi.org/10.1016/j.apmr.2013.09.004,Exploring the Clinical Course of Neck Pain in Physical Therapy: A Longitudinal Study,"To investigate the short-term trajectory of recovery from mechanical neck pain, and predictors of trajectory.Prospective, longitudinal cohort study with 5 repeated measurements over 4 weeks.Community-based physical therapy clinics.Convenience sample of community-dwelling adults (N=50) with uncomplicated mechanical neck disorders of any duration.Usual physical therapy care.Neck Disability Index (NDI), numeric rating scale (NRS) of pain intensity.A total of 50 consecutive subjects provided 5 data points over 4 weeks. Exploratory modeling using latent class growth analysis revealed a linear trend in improvement, at a mean of 1.5 NDI points and 0.5 NRS points per week. Within the NDI trajectory, 3 latent classes were identified, each with a unique trend: worsening (14.5%), rapid improvement (19.6%), and slow improvement (65.8%). Within the NRS trajectory, 2 unique trends were identified: stable (48.0%) and improving (52.0%). Predictors of trajectory class suggest that it may be possible to predict the trajectory. Results are described in view of the sample size.The mean trajectory of improvement in neck pain adequately fits a linear model and suggests slow but stable improvement over the short term. However, up to 3 different trajectories have been identified that suggest neck pain, and recovery thereof, is not homogenous. This may hold value for the design of clinical trials.",0 +https://doi.org/10.1002/hipo.20102,Bilateral hippocampal volume reduction in adults with post-traumatic stress disorder: A meta-analysis of structural MRI studies,"Over the last decade a significant number of studies have reported smaller hippocampal volume in individuals with symptoms of post-traumatic stress disorder (PTSD) relative to control groups, and in some cases hemispheric asymmetries in this effect have been noted. However these reported asymmetries have not been in a consistent direction, and other well-controlled studies have failed to observe any hippocampal volume difference. This paper reports a systematic review and meta-analysis of studies in which hippocampal volume was estimated from magnetic resonance images in adult patients with PTSD. After applying a variety of selection criteria intended to minimize potential confounds in pooled effect-size estimates, the meta-analysis included 13 studies of adult patients with PTSD that compared the patients to well-matched control groups, for a total of 215 patients and 325 control subjects. The studies varied with respect to participant age, gender distribution, source of trauma, severity of symptoms, duration of disorder, the nature of the control groups, and the methods employed for volumetric quantification. Despite these differences, pooled effect size calculations across the studies indicated significant volume differences in both hemispheres. On average PTSD patients had a 6.9% smaller left hippocampal volume and a 6.6% smaller right hippocampal volume compared with control subjects. These volume differences were smaller when comparing PTSD patients with control subjects exposed to similar levels of trauma, and larger when comparing PTSD patients to control subjects without significant trauma exposure. Such differences are consistent with the notion that exposure to stressful experiences can lead to hippocampal atrophy, although prospective studies would be necessary to unambiguously establish such a relationship. © 2005 Wiley-Liss, Inc.",0 +https://doi.org/10.1080/14789949.2014.981563,Interventions with women offenders: a systematic review and meta-analysis of mental health gain,"Currently, a conjunction of policy, legislative change in health and social care and the criminal justice system, combined with funding for innovative services make it opportune to assess the evidence base for interventions with women offenders. Women offenders have a distinctive criminological, health and social profile and a gender specific approach to their difficulties is advocated. This systematic review and meta-analysis focus on mental health gain in adult women offenders in forensic health settings, criminal justice institutions and in the community, following therapeutic interventions. Interventions were assessed in terms of specific outcome measures of depression, trauma symptomatology and global mental health status. Comprehensive search strategies yielded 3018 articles, from which we obtained 199 full text articles. Seventeen articles were included in the final review, of which six were excluded from the meta-analysis as there was no comparator group. There is a modest, but increasing, body of...",0 +https://doi.org/10.1111/acps.12387,Distinct intrinsic network connectivity patterns of post-traumatic stress disorder symptom clusters,"Objective Post-traumatic stress disorder (PTSD) is considered a multidimensional disorder, with distinct symptom clusters including re-experiencing, avoidance/numbing, hyperarousal, and most recently depersonalization/derealization. However, the extent of differing intrinsic network connectivity underlying these symptoms has not been fully investigated. We therefore investigated the degree of association between resting connectivity of the salience (SN), default mode (DMN), and central executive (CEN) networks and PTSD symptom severity. Method Using resting-state functional MRI data from PTSD participants (n = 21), we conducted multivariate analyses to test whether connectivity of extracted independent components varied as a function of re-experiencing, avoidance/numbing, hyperarousal, and depersonalization/derealization. Results Hyperarousal symptoms were associated with reduced connectivity of posterior insula/superior temporal gyrus within SN [peak Montréal Neurological Institute (MNI): −44, −8, 0, t = −4.2512, k = 40]. Depersonalization/derealization severity was associated with decreased connectivity of perigenual anterior cingulate/ventromedial prefrontal cortex within ventral anterior DMN (peak MNI: 8, 40, −4; t = −3.8501; k = 15) and altered synchrony between two DMN components and between DMN and CEN. Conclusion Our results are consistent with prior research showing intrinsic network disruptions in PTSD and imply heterogeneous connectivity patterns underlying PTSD symptom dimensions. These findings suggest possible biomarkers for PTSD and its dissociative subtype.",0 +https://doi.org/10.1038/nn.2499,Synaptic correlates of fear extinction in the amygdala,"Anxiety disorders such as post-traumatic stress are characterized by an impaired ability to learn that cues previously associated with danger no longer represent a threat. However, the mechanisms underlying fear extinction remain unclear. We found that fear extinction in rats was associated with increased levels of synaptic inhibition in fear output neurons of the central amygdala (CEA). This increased inhibition resulted from a potentiation of fear input synapses to GABAergic intercalated amygdala neurons that project to the CEA. Enhancement of inputs to intercalated cells required prefrontal activity during extinction training and involved an increased transmitter release probability coupled to an altered expression profile of ionotropic glutamate receptors. Overall, our results suggest that intercalated cells constitute a promising target for pharmacological treatment of anxiety disorders.",0 +https://doi.org/10.1093/jpepsy/jsv091,Profiles of Resilience and Growth in Youth With Cancer and Healthy Comparisons,"Inconsistent links between posttraumatic stress symptoms (PTS) and posttraumatic growth (PTG) in youth following a stressful life event have been observed in previous literature. Latent profile analysis (LPA) provides a novel approach to examine the heterogeneity of relations between these constructs.Participants were 435 youth (cancer group=253; healthy comparisons = 182) and one parent. Children completed measures of PTS, PTG, and a life-events checklist. Parents reported on their own PTS and PTG. LPA was conducted to identify distinct adjustment classes.LPA revealed three profiles. The majority of youth (83%) fell into two resilient groups differing by levels of PTG. Several factors predicted youth's profile membership.PTS and PTG appear to be relatively independent constructs, and their relation is dependent on contextual factors. The majority of youth appear to be resilient, and even those who experience significant distress were able to find benefit.",0 +https://doi.org/10.1207/s15324796abm3201_9,Body change stress for women with breast cancer: The breast-impact of treatment scale,"Body change stress refers to subjective psychological stress that accompanies women's negative and distressing thoughts, emotions, and behaviors resultant from breast cancer and breast surgeries. Body change stress is manifest with traumatic stress-like symptoms.The development of the Breast-Impact of Treatment Scale (BITS) is described. The construct is assessed with 13 items that comprise a one-factor solution.Tests of convergent validity demonstrate the relationship, but not overlap, of the BITS with measures of stress, emotional distress, and sexuality. The BITS distinguishes between women receiving segmental mastectomy (lumpectomy) versus mastectomy. Incremental validity is shown with comparison to ratings of body satisfaction.An early psychometric foundation enables use of the BITS to assess a common and distressing quality of life outcome for women with breast cancer.",0 +https://doi.org/10.1080/15374416.2014.883928,Posttraumatic Symptom Structure Across Age Groups,"The applicability of diagnostic criteria of Posttraumatic Stress Disorder to the pediatric population has been a focus of much debate (e.g., Carrion, Weems, Ray, & Reiss, 2002 ), informing changes in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5). The current study examined the factor structure of posttraumatic distress among adult versus pediatric samples using confirmatory factor analysis. The analysis was performed on the DSM-IV-adherent Posttraumatic Diagnostic Scale (Foa, Cashman, Jaycox, & Perry, 1997 ) and Child Posttraumatic Symptom Scale (Foa, Johnson, Feeny, & Treadwell, 2001 ). The sample included 378 adult and 204 child and adolescent victims of diverse single-event traumas. A series of models based on previous findings and DSM-IV specification were evaluated. A 4-factor model (Intrusions, Avoidance, Dysphoria, and Hyperarousal), similar to the DSM-5 model, best fit the data among adults, and a different 4-factor model (Intrusion, Avodiance, Numbing, and Hyperarousal) best fit the data among children and adolescents. Despite some similarity, the posttraumatic symptom profiles of pediatric and adult samples may differ. These differences are not fully incorporated into the DSM-5, and warrant further examination.",0 +https://doi.org/10.4135/9781446247648.n17,Crisis Intervention,,0 +https://doi.org/10.1016/j.brat.2004.04.004,Peritraumatic dissociation and experiential avoidance as predictors of posttraumatic stress symptomatology,"This study examined whether peritraumatic dissociation serves as a proxy risk factor for experiential avoidance in its relationship with posttraumatic stress disorder (PTSD) symptomatology. One hundred eighty-five trauma survivors completed measures that assessed for peritraumatic dissociation, experiential avoidance, and PTSD symptom severity. The results indicated that peritraumatic dissociation and experiential avoidance were significantly related to PTSD symptomatology at baseline. However, after initial levels of PTSD symptomatology were taken into account, only experiential avoidance was related to PTSD symptoms both 4- and 8-weeks later. These results indicate that peritraumatic dissociation is not a proxy risk factor for experiential avoidance and contributes to the growing body of literature indicating that experiential avoidance is an important factor related to the psychological symptoms experienced by trauma survivors.",0 +https://doi.org/10.17305/bjbms.2008.3002,Paroxetine in the Treatment of Post Traumatic Stress Disorder: Our Experiences,"Posttraumatic stress disorder can develop after individual’s exposure or witnessing of life threatening events. It is characterized by three clusters of symptoms. The course of PTSD is often chronic and impedes individual’s functioning. Studies of PTSD treatment with paroxetine provide evidence for its efficacy in reducing symptoms and its favorable profile of side-effects. The objective of this work was to determine the efficacy of paroxetine in the treatment of PTSD.The sample consisted of 30 subjects with chronic PTSD. All subjects received treatment with paroxetine in therapeutic dose range for six months. Subjects were assessed prior to therapy and following six months of treatment with paroxetine with the use of following instruments: SCL 90-R, Mississippi Questionnaire, and CGI.The results indicate statistically significant reduction on all subscales of SCL 90-R following six months of treatment, P<0,05. The difference between two assessments with Mississippi Questionnaire was statistically significant, P< 0,05. PTSD rate in our sample was reduced from 100% before treatment to 64% after treatment. Paroxetine was administered in daily dose of 20 mg in 88% of the subjects, and 40 mg in the remaining 12%. Unwanted effects were registered in 16,7% of the subjects and they were mild. Objective improvement was registered in 84% of the sample, and subjective improvement was registered in 80%. Reduction of relapse symptoms was registered in 24% of the subjects.Paroxetine proved to be efficient and safe in treatment of symptoms of PTSD in this study.",0 +https://doi.org/10.1177/070674370004501005,"Living Conditions and Emotional Profiles of Cambodian, Central American, and Québécois Youth","To compare Cambodian and Central American adolescent refugees to Quebec with their Quebec-born peers in regard to emotional and behavioural problems, feelings of competence, and risk-behaviour profiles, and to examine relations between emotional variables and living conditions in the 3 groups.The sample consisted of 76 Cambodian, 82 Central American and 67 Québécois youth living in the Montreal area. The teenagers' internalization and externalization symptoms were assessed using the Child Behaviour Checklist (CBCL) and the Youth Self-Report (YSR); the YSR also provided a measure of their feelings of competence. Risk behaviour was reported by the teenagers. The socioeconomic status of the teenagers' households was taken into account in multiple regression analyses conducted for each group.The level of emotional and behavioural problems reported by teenagers was lowest in Central Americans and highest in Québécois; the latter group also reported more risk behaviours than did either refugee group. The socioeconomic status of the Cambodian and Central American refugee households was lower than that of the Québécois. Living conditions were not a major determinant of emotional distress in young Cambodians, but low annual income was associated with internalizing symptoms among Central American youth. The most powerful predictor of externalizing symptoms among the Québécois youth was having a single-parent household.This study underscores the contrast between the living conditions of young Cambodian and Central American refugees to Quebec and those of Quebec-born youth. These refugees' precarious socioeconomic status is not accompanied by an increase in adolescents' emotional and behavioural problems.",0 +,Elaboration and Content Analysis of Conceptual Structure in Posttraumatic Stress Disorder,"Three recent studies attempted to substantiate Sewell and Cromwell's (1990) theory of Posttraumatic Stress Disorder (PTSD; American Psychiatric Association, 1994) based on personal construct theory (Kelly, 1955). One crucial aspect of the model that was tested in each of the studies is elaboration, which is the process of bringing more of a person's repertoire of understanding (constructions) to a certain experience to give it meaning. Elaboration is representative of whether or not the individual is using an integrated set of constructs to deal with a traumatic event. A two-part study (1) reanalyzed existing data to assist in understanding discrepancies in past findings, and (2) content analyzed constructs given by subjects in all three studies. Findings concerning elaboration remained somewhat discrepant but suggested possible differences when investigating the emergent versus submerged poles of constructs.",0 +https://doi.org/10.1016/j.adolescence.2013.05.008,Latent structure of posttraumatic stress disorder symptoms in an adolescent sample one month after an earthquake,"Increasing empirical studies suggest that the tripartite posttraumatic stress disorder (PTSD) model described in the DSM-IV does not accurately account for the underlying PTSD factor structure, and several alternative models have been proposed. The present study investigated a newly refined, five-factor model of PTSD symptoms in a sample of Chinese adolescent survivors of an earthquake. A total of 1198 middle school students (653 females, 526 males) with a mean age of 14.4 years (SD = 1.1, range: 11-18) participated in this study one month after an earthquake. The novel five-factor model comprised of intrusion, avoidance, numbing, dysphoric arousal, and anxious arousal demonstrated significantly better fit than two alternative four-factor models. Further analyses revealed differentiable relations between the PTSD factors and external measures of anxiety and depression. These findings provide empirical support for the robustness of five-factor model, and carry implications for further reorganization of PTSD criteria.",0 +https://doi.org/10.1177/1073191105275456,Utility of the Trauma Symptom Inventory’s Atypical Response Scale in Detecting Malingered Post-Traumatic Stress Disorder,"The authors examined the Trauma Symptom Inventory's (TSI) ability to discriminate 88 student post-traumatic stress disorder (PTSD) simulators screened for genuine PTSD from 48 clinical PTSD-diagnosed outpatients. Results demonstrated between-group differences on several TSI clinical scales and the Atypical Response (ATR) validity scale. Discriminant function analysis using ATR revealed 75% correct patient classification but only 48% correct simulator classification, with an overall correct classification rate of 59% (positive predictive power [PPP] = .71; negative predictive power [NPP] = .51). Individual ATR cutoff scores did not yield impressive classification results, with the optimal cutoff (T score = 61) correctly classifying only 61% of simulators and patients (PPP = .66, NPP = .54). Although ATR was not developed as a malingered PTSD screen, instead serving as a general validity screen, caution is recommended in its current clinical use for detecting malingered PTSD.",0 +https://doi.org/10.1097/00005053-199307000-00003,Emotional and Coping Responses to Serial Killings The Gainesville Murders,"Forensic experts have focused more on the psychological profile of a serial killer rather than on the pronounced effects on the community at large. Coping with a stressful event is thought to influence emotional states. However, little empirical understanding of this process exists. The present study examined changes in psychological factors 9 days after the occurrence of serial killings in a college community. Multivariate analyses of variance conducted on the variables of stress, anxiety, physical symptoms, and depression revealed a significant difference between the group tested after the murders and a cross-sectional cohort group. Univariate analyses revealed that the study class was significantly more depressed compared with the cohort group. The study class was also significantly more depressed compared with their own responses 1 year before the killings. For both classes, depression was significantly correlated with certain coping styles, including escape-avoidance and accept responsibility. Results have implications for certain coping behaviors (i.e., avoidant behaviors), such as that leaving the community may have been maladaptive and perhaps diverted attention from the more necessary active problem-solving behaviors (e.g., increasing security) in addition to increasing depression.",0 +https://doi.org/10.1176/ajp.146.12.1530,Pierre Janet and the breakdown of adaptation in psychological trauma,"In this reappraisal of the work of Pierre Janet at the centenary of the publication of L'automatisme psychologique, the authors review his investigations into the mental processes that transform traumatic experiences into psychopathology. Janet was the first to systematically study dissociation as the crucial psychological process with which the organism reacts to overwhelming experiences and show that traumatic memories may be expressed as sensory perceptions, affect states, and behavioral reenactments. Janet provided a broad framework that unifies into a larger perspective the various approaches to psychological functioning which have developed along independent lines in this century. Today his integrated approach may help clarify the interrelationships among such diverse topics as memory processes, state-dependent learning, dissociative reactions, and posttraumatic psychopathology.",0 +https://doi.org/10.1037/tep0000083,Provision of evidence-based therapies to rural survivors of domestic violence and sexual assault via telehealth: Treatment outcomes and clinical training benefits.,"Rural survivors of sexual assault and domestic violence experience considerable difficulties accessing mental health services. Similarly, graduate psychology training programs located in rural locations have historically been limited in their ability to provide trainees with extensive exposure to specific client populations. With the advent of distal technologies–especially secure, encrypted videoconferencing capabilities—it is now possible to connect rural clients with specialized, mental health services provided by university-based training clinics. This article reviews mental health care needs and treatment barriers experienced by rural populations, and describes an innovative solution to begin to address these problems. Specifically, a partnership between a university-based mental health care clinic and 3 rural domestic violence/rape crisis centers is described, and preliminary treatment outcome data are presented. Training benefits reported by graduate student therapists and satisfaction ratings provided by crisis center staff and advocates are also presented and discussed.",0 +https://doi.org/10.1097/yco.0b013e32835b2c01,Treatment of posttraumatic stress disorder in children and adolescents,"We review recent evidence regarding risk factors for childhood posttraumatic stress disorder (PTSD) and treatment outcome studies from 2010 to 2012 including dissemination studies, early intervention studies and studies involving preschool children.Recent large-scale epidemiological surveys confirm that PTSD occurs in a minority of children and young people exposed to trauma. Detailed follow-up studies of trauma-exposed young people have investigated factors that distinguish those who develop a chronic PTSD from those who do not, with recent studies highlighting the importance of cognitive (thoughts, beliefs and memories) and social factors. Such findings are informative in developing treatments for young people with PTSD. Recent randomized controlled trials (RCTs) confirm that trauma-focused cognitive behaviour therapy (TF-CBT) is a highly efficacious treatment for PTSD, although questions remain about effective treatment components. A small number of dissemination studies indicate that TF-CBT can be effective when delivered in school and community settings. One recent RCT shows that TF-CBT is feasible and highly beneficial for very young preschool children. Studies of early intervention show mixed findings.Various forms of theory-based TF-CBT are highly effective in the treatment of children and adolescents with PTSD. Further work is needed to replicate and extend initial promising outcomes of TF-CBT for very young children. Dissemination studies and early intervention studies show mixed findings and further work is needed.",0 +https://doi.org/10.1016/j.jaac.2015.10.009,Evaluation of a Family-Centered Preventive Intervention for Military Families: Parent and Child Longitudinal Outcomes,"This study evaluates the longitudinal outcomes of Families OverComing Under Stress (FOCUS), a family-centered preventive intervention implemented to enhance resilience and to reduce psychological health risk in military families and children who have high levels of stress related to parental wartime military service.We performed a secondary analysis of evaluation data from a large-scale service implementation of the FOCUS intervention collected between July 2008 and December 2013 at 15 military installations in the United States and Japan. We present data for 2,615 unique families (3,499 parents and 3,810 children) with completed intake and at least 1 postintervention assessment. Longitudinal regression models with family-level random effects were used to assess the patterns of change in child and parent (civilian and military) psychological health outcomes over time.Improvement in psychological health outcomes occurred in both service member and civilian parents. Relative to intake, parental anxiety and depression symptoms were significantly reduced postintervention, and these reductions were maintained at 2 subsequent follow-up assessments. In addition, we identified an improvement over time in emotional and behavioral symptoms and in prosocial behaviors for both boys and girls. We observed reductions in the prevalence of unhealthy family functioning and child anxiety symptoms, as well as parental depression, anxiety, and posttraumatic stress symptoms from intake to follow-up.Longitudinal program evaluation data show sustained trajectories of reduced psychological health risk symptoms and improved indices of resilience in children, civilian, and active duty military parents participating in a strength-based, family-centered preventive intervention.",0 +https://doi.org/10.1097/01.j.pain.0000460350.30707.8d,Distinct quantitative sensory testing profiles in nonspecific chronic back pain subjects with and without psychological trauma,"Psychological trauma is associated with an increased risk for chronification of nonspecific chronic back pain (nsCLBP) independent of posttraumatic stress disorder (PTSD). However, the mechanisms underlying the role of psychological trauma in nsCLBP are less clear than in PTSD. Therefore, this study considered whether psychological trauma exposure (TE) is accompanied by specific alterations in pain perception. The study included 56 participants with nsCLBP and TE (nsCLBP-TE), 93 participants with nsCLBP without TE (nsCLBP-W-TE), and 31 pain-free controls. All participants underwent a thorough clinical evaluation. The standardized quantitative sensory testing protocol of the German Research Network on Neuropathic Pain was used to obtain comprehensive profiles on somatosensory functions in painful (back) and non-painful areas (hand). The protocol consisted of thermal and mechanical detection as well as pain thresholds, vibration thresholds, and pain sensitivity to sharp and blunt mechanical stimuli. Psychological trauma was validated by structured clinical interview. Trauma-associated symptom severity, anxiety, and depressive symptomatology were assessed by self-report questionnaires. Differences in somatosensory function were seen only for pressure pain thresholds. Compared with controls, nsCLBP-TE revealed hyperalgesia generalized in space with lower thresholds in painful and non-painful areas, whereas nsCLBP-W-TE demonstrated localized alterations with decreased thresholds only in the pain-affected area of the back (P ≤ 0.006). Our findings suggest an augmented central pain processing in nsCLBP-TE (alterations in painful and non-painful areas), whereas nsCLBP-W-TE show only local changes (alterations only in the painful area) suggesting regional sensitization processes. This finding might explain why TE without PTSD is associated with an increased prevalence of chronic pain.",0 +https://doi.org/10.1016/s0165-1781(01)00325-0,Pre- and post-disaster negative life events in relation to the incidence and severity of post-traumatic stress disorder,"There is evidence suggesting that stressful life events may precede major psychiatric illness, such as major depression, and that the severity of a traumatic event outside the range of usual human experience may provoke post-traumatic stress disorder (PTSD). The present study was carried out to examine the effects of pre- and post-disaster stressful life events on the incidence rate of PTSD following two man-made traumatic events. An epidemiological study examining 127 victims of a flash fire in a ballroom and 55 motor vehicle accident (MVA) victims was undertaken. PTSD symptoms were assessed by means of the Composite International Diagnostic Interview and the pre- and post-disaster stressful life events by means of the Diagnostic Interview Schedule, Disaster Supplement. Binary logistic and multiple linear regression analyses were employed to examine the relationships between PTSD and pre- and post-disaster life events. There were no significant relationships between stressful life events the year prior to the traumatic event and the incidence or severity of PTSD. There were highly significant relationships between the cumulative number and event severity of post-disaster negative life events and the incidence rate and severity of PTSD. The post-disaster life events were significantly more related to the avoidance-depression dimension than to the anxiety-arousal dimension of PTSD. The most significant life events were: loss of job or income, broken relationships, serious illnesses or injuries in the victims and death or illness in close acquaintances. The results of this study show that the number and severity of additional stressful life events signal a higher risk to develop PTSD and a higher severity of the avoidance-depression dimension of PTSD symptomatology.",0 +https://doi.org/10.1016/s1499-3872(11)60122-7,Posttraumatic stress disorder after liver transplantation,"Liver transplantation can lead to the development of posttraumatic stress disorder (PTSD), but the risk factors associated with this progression are not well understood. To study this syndrome in adult liver transplant recipients, a cross-sectional investigation of 296 recipients at our hospital was carried out between January and June 2010.Study participants completed two questionnaires [a PTSD self-rating scale (PTSD-SS) and a validated Chinese version of the Medical Outcomes Study Short Form-36 (SF-36)]. Clinical and demographic data were collected from the records of the Chinese Liver Transplant Registry and via questionnaires.The prevalence of full PTSD and partial PTSD (that met the criteria for 2 of the 3 symptom clusters) was 3.7% and 5.4%, respectively, for all transplant recipients. Significant differences between the recipients with no PTSD, partial PTSD, and full PTSD were found in all SF-36 domains except for physical functioning (P=0.466). In general, domain scores were the highest in the recipients who did not meet the criteria for PTSD and the lowest in the recipients who met the criteria for full PTSD. Greater severity of posttraumatic stress symptoms was correlated with poorer quality of life, especially in the bodily pain (P=0.004), social functioning (P=0.001), role-emotional (P=0.048), and mental health (P<0.001) domains. The model for end-stage liver disease (MELD) scores, complications, and educational status were identified by multiple regression analysis as risk factors for developing PTSD.PTSD occurred after liver transplantation and was significantly associated with decreased quality of life. Higher MELD scores and complications after transplantation were risk factors that contributed to PTSD, and higher education was a protective factor.",0 +https://doi.org/10.4088/jcp.13m08731,A Comparison of the Capacity of <em>DSM-IV]</em> and <em>DSM-5]</em> Acute Stress Disorder Definitions to Predict Posttraumatic Stress Disorder and Related Disorders,"This study addresses the extent to which DSM-IV and DSM-5 definitions of acute stress disorder (ASD) predict subsequent posttraumatic stress disorder (PTSD) and related psychiatric disorders following trauma.Patients with randomized admissions to 5 hospitals across Australia (N = 596) were assessed in hospital and reassessed for PTSD at 3 (n = 508), 12 (n = 426), 24 (n = 439), and 72 (n = 314) months using the Clinician-Administered PTSD Scale; DSM-IV definition of PTSD was used at each assessment, and DSM-5 definition was used at 72 months. The Mini-International Neuropsychiatric Interview (MINI) was used at each assessment to assess anxiety, mood, and substance use disorders.Forty-five patients (8%) met DSM-IV criteria, and 80 patients (14%) met DSM-5 criteria for ASD. PTSD was diagnosed in 93 patients (9%) at 3, 82 patients (10%) at 12, 100 patients (12%) at 24, and 26 patients (8%) at 72 months; 19 patients (6%) met DSM-5 criteria for PTSD at 72 months. Comparable proportions of those diagnosed with ASD developed PTSD using DSM-IV (3 months = 46%, 12 months = 39%, 24 months = 32%, and 72 months = 25%) and DSM-5 (43%, 42%, 33%, and 24%) ASD definitions. Sensitivity was improved for DSM-5 relative to DSM-IV for depression (0.18 vs 0.30), panic disorder (0.19 vs 0.41), agoraphobia (0.14 vs 0.40), social phobia (0.12 vs 0.44), specific phobia (0.24 vs 0.58), obsessive-compulsive disorder (0.17 vs 0.47), and generalized anxiety disorder (0.20 vs 0.47). More than half of participants with DSM-5-defined ASD had a subsequent disorder.The DSM-5 criteria for ASD results in better identification of people who will subsequently develop PTSD or another psychiatric disorder relative to the DSM-IV criteria. Although prediction is modest, it suggests that the new ASD diagnosis can serve a useful function in acute trauma settings for triaging those who can benefit from either early intervention or subsequent monitoring.",0 +https://doi.org/10.1037/a0021482,Disasters and youth: A meta-analytic examination of posttraumatic stress.,"Meta-analyze the literature on posttraumatic stress (PTS) symptoms in youths post-disaster.Meta-analytic synthesis of the literature (k = 96 studies; Ntotal = 74,154) summarizing the magnitude of associations between disasters and youth PTS, and key factors associated with variations in the magnitude of these associations. We included peer-reviewed studies published prior to 1/1/2009 that quantitatively examined youth PTS (≤ 18 years at event) after a distinct and identifiable disaster.Despite variability across studies, disasters had a significant effect on youth PTS (small-to-medium magnitude; rpooled = .19, SEr = .03; d = 0.4). Female gender (rpooled = .14), higher death toll (disasters of death toll ≤ 25: rpooled = .09; vs. disasters with ≥ 1,000 deaths: rpooled = .22), child proximity (rpooled = .33), personal loss (rpooled = .16), perceived threat (rpooled = .34), and distress (rpooled = .38) at time of event were each associated with increased PTS. Studies conducted within 1 year post-disaster, studies that used established measures, and studies that relied on child-report data identified a significant effect.Youths are vulnerable to appreciable PTS after disaster, with pre-existing child characteristics, aspects of the disaster experience, and study methodology each associated with variations in the effect magnitude. Findings underscore the importance of measurement considerations in post-disaster research. Areas in need of research include the long-term impact of disasters, disaster-related media exposure, prior trauma and psychopathology, social support, ethnicity/race, prejudice, parental psychopathology, and the effects of disasters in developing regions of the world. Policy and clinical implications are discussed.",0 +https://doi.org/10.2217/fon.10.31,Link between personality and cancer,"Personality refers to an individual’s enduring and pervasive personal motivation, emotion, interpersonal style, attitudes and behavior that are stable over a long time after young adulthood. In relation to the cancer trajectory, three basic and one other personality traits have been studied with some frequency, namely neuroticism, extraversion, conscientiousness and optimism. The considerable stability of personality over time makes it a potential long-acting etiological factor for the development of cancer. However, the studies performed so far do not give much support to personality as a causative factor for cancer. Some studies of cancer survival have found significant associations between lower optimism and higher neuroticism with shorter survival. More mental distress and fatigue and poorer quality of life is significantly associated with higher neuroticism and lower optimism at cancer screening, diagnosis and primary treatment, short- and long-term follow-up and towards the end of life. Neuroticism is a strong predictor of post-traumatic stress disorder triggered by cancer as a life-threatening experience eventually leading to negative personality changes. To what extent cancer leads to positive personality changes (post-traumatic growth) is currently unsettled. Basic personality traits are strongly associated with lifestyle, which is considered an important etiological factor for the development of cancer. The methodological problems in the study of personality and cancer are considerable, and many research designs used so far may have been too simplistic. Studies of potential biomarkers for personality traits combined with inflammation markers of cellular carcinogenesis in longitudinal designs could be promising for the future. High neuroticism is important for the clinical management of cancer patients and should gain more attention from oncologists in the future.",0 +https://doi.org/10.1186/1476-069x-10-48,Respiratory and mental health effects of wildfires: an ecological study in Galician municipalities (north-west Spain),"BackgroundDuring the summer of 2006, a wave of wildfires struck Galicia (north-west Spain), giving rise to a disaster situation in which a great deal of the territory was destroyed. Unlike other occasions, the wildfires in this case also threatened farms, houses and even human lives, with the result that the perception of disaster and helplessness was the most acute experienced in recent years. This study sought to analyse the respiratory and mental health effects of the August-2006 fires, using consumption of anxiolytics-hypnotics and drugs for obstructive airway diseases as indicators.MethodsWe conducted an analytical, ecological geographical- and temporal-cluster study, using municipality-month as the study unit. The independent variable was exposure to wildfires in August 2006, with municipalities thus being classified into the following three categories: no exposure; medium exposure; and high exposure. Dependent variables were: (1) anxiolytics-hypnotics; and (2) drugs for obstructive airway diseases consumption. These variables were calculated for the two 12-month periods before and after August 2006. Additive models for time series were used for statistical analysis purposes.ResultsThe results revealed a higher consumption of drugs for obstructive airway diseases among pensioners during the months following the wildfires, in municipalities affected versus those unaffected by fire. In terms of consumption of anxiolytics-hypnotics, the results showed a significant increase among men among men overall -pensioners and non-pensioners- in fire-affected municipalities.ConclusionsOur study indicates that wildfires have a significant effect on population health. The coherence of these results suggests that drug utilisation research is a useful tool for studying morbidity associated with environmental incidents.",0 +,Pilot study to assess the viability of a rape trauma syndrome questionnaire.,"Studies have revealed that rape victims undergo a number of psychological symptoms following the attack, which constitute a specific syndrome termed the rape trauma syndrome (RTS). Evidence of the RTS has been admitted as scientific testimony in the prosecution of sexual offences and has been integral in their successful conviction. The present study aims to assess the viability of a questionnaire designed to identify the RTS in victims of alleged rape.A 77-item rape trauma syndrome questionnaire (RTSQ) was developed and administered to 30 women who reported rape and 57 nurses who formed the control group. The data were analysed using the Statistical Package for the Social Sciences (Windows Version 6.0).Statistical analysis suggested that the questionnaire was internally consistent and effective in uncovering significant differences between rape victims and controls in their experience of rape trauma symptoms. Rape victims scored significantly higher than controls on the RTS scale. Those who faked rape were also found to endorse a greater number of the rape trauma symptoms than actual rape victims, as well as a greater number of fictitious and unlikely symptoms.This pilot study confirmed the viability of the RTSQ and paves the way for a more rigorous examination of its reliability and validity. In the future, the questionnaire may be of use in ascertaining the veracity of victims' claims of rape in the conviction of sexual offences where circumstances are equivocal.",0 +https://doi.org/10.1111/j.1460-9568.2008.06511.x,Impaired extinction of learned fear in rats selectively bred for high anxiety - evidence of altered neuronal processing in prefrontal-amygdala pathways,"The impaired extinction of acquired fear is a core symptom of anxiety disorders, such as post-traumatic stress disorder, phobias or panic disorder, and is known to be particularly resistant to existing pharmacotherapy. We provide here evidence that a similar relationship between trait anxiety and resistance to extinction of fear memory can be mimicked in a psychopathologic animal model. Wistar rat lines selectively bred for high (HAB) or low (LAB) anxiety-related behaviour were tested in a classical cued fear conditioning task utilizing freezing responses as a measure of fear. Fear acquisition was similar in both lines. In the extinction trial, however, HAB rats showed a marked deficit in the attenuation of freezing responses to repeated auditory conditioned stimulus presentations as compared with LAB rats, which exhibited rapid extinction. To gain information concerning the putatively altered neuronal processing associated with the differential behavioural response between HAB and LAB rats, c-Fos expression was investigated in the main prefrontal-amygdala pathways important for cued fear extinction. HAB compared to LAB rats showed an attenuated c-Fos response to repeated conditioned stimulus presentations in infralimbic and cingulate cortices, as well as in the lateral amygdala, but facilitated the c-Fos response in the medial part of the central amygdala. In conclusion, the present results support the notion that impaired extinction in high anxiety rats is accompanied by an aberrant activation profile in extinction-relevant prefrontal-amygdala circuits. Thus, HAB rats may represent a clinically relevant model to study the mechanisms and potential targets to accelerate delayed extinction processes in subjects with enhanced trait anxiety.",0 +https://doi.org/10.1037/h0099863,Posttraumatic stress disorder among three-generation families in times of war: A comparison between Israeli Jewish and Arabs after the Second Lebanon War (2006) and Cast Lead Operation (2009).,"There is little mention in the existing literature regarding the differential effects of wars or military operations on 3-generation families. Participants (n = 509; 167 elderly parents, 171 adult offspring, and 171 adult grandchildren) living in the northern and southern regions of Israel were interview after the Second Lebanon War (2006) and the Cast Lead Operation (2009). The participants were sampled by using a cluster sampling. Elderly parents experience higher levels of PTSD symptoms than their adult children or their adult grandchildren do. Women experience higher levels of PTSD symptoms than men and Israeli Arabs and Druze higher levels than Israeli Jews in all 3 generations. A policy should be enacted among the local authorities and the governmental offices that would ensure accessibility to and the ability to provide proper care especially for the elderly population during times of war, military operations, or terror events. In addition, it is important to set up local teams in every local community to deal with the level of mental and emotional preparedness of the homefront and its inhabitants, in case the latter should again become part of the human casualties of the wars and terrorist events that occur in Israel.",0 +https://doi.org/10.1186/s12888-014-0330-8,Comparison of psychiatric disability on the health of nation outcome scales (HoNOS) in resettled traumatized refugee outpatients and Danish inpatients,"Currently, the mental health issues of traumatized refugees are mainly documented in terms of posttraumatic stress disorder, depression, and anxiety. Importantly, there are no reports of the level of psychiatric disability in treatment seeking traumatized refugees resettled in the West. Insufficient acknowledgment of the collective load of bio-psycho-social problems in this patient group hinders effective psychiatric and social service utilization outside the specialized clinics for traumatized refugees.The level of psychiatric disability in traumatized refugees from Danish specialized clinics (N = 448) is documented using routine monitoring data from pre- and post-treatment on the Health of Nation Outcome Scales (HoNOS). Furthermore, the HoNOS ratings are compared with routine monitoring data from Danish inpatients with different diagnoses (N = 10.911).The routinely collected data indicated that despite their outpatient status, traumatized refugees had higher levels of psychiatric disability at pre-treatment compared to most inpatients. Moreover, the traumatized refugees had a HoNOS profile characterized by an overall high problem level in various psychiatric and social domains. The rate of pre- to post-treatment improvement on the HoNOS was smaller for the traumatized refugees than it was for the psychiatric inpatients.The level, and the versatile profile, of psychiatric disability on the HoNOS point to complex bio-psycho-social problems in resettled treatment seeking traumatized refugees. Thus, a broader assessment of symptoms and better cooperation between psychiatric, health care, and social systems is necessary in order to meet the treatment needs of this group.",0 +,Overview of post-traumatic stress.,"The purpose of this article is to provide an overview of the acute stress response with additional information on post-traumatic stress. There is an emphasis on the theoretical foundations and post-traumatic stress disorder symptoms. Risk factors, symptom clusters, and the diagnostic criteria for post-traumatic stress disorder are described as a foundation for clinical implications and a focused nursing assessment.",0 +https://doi.org/10.1016/j.chiabu.2015.03.006,Posttraumatic stress avoidance symptoms as mediators in the development of alcohol use disorders after exposure to childhood sexual abuse in a Swiss community sample,"This study examined the role of posttraumatic stress disorder (PTSD) symptoms of re-experience, avoidance, and hyperarousal in the relationship between different types of trauma and alcohol use disorders (AUD). We used data from 731 trauma-exposed individuals who participated in the first wave of the PsyCoLaus-study. Trauma characteristics were assessed relatively to the occurrence of lifetime PTSD symptoms and AUD. The results suggest that lifetime and childhood sexual abuse as well as overall childhood trauma were directly linked to AUD and PTSD symptoms, in particular to avoidance symptoms. From single symptom clusters PTSD avoidance was found to specifically mediate the trauma-AUD pathway. Both childhood and sexual trauma strongly contribute to the comorbidity of PTSD and AUD and avoidance-type symptoms appear to play a central role in maintaining this association. Hence, the alleviation of avoidance symptoms might be an important target for therapeutic intervention among victims of sexual abuse before specific addiction treatment is initiated.",0 +https://doi.org/10.9758/cpn.2014.12.1.41,Comparison of Memory Function and MMPI-2 Profile between Post-traumatic Stress Disorder and Adjustment Disorder after a Traffic Accident,"Differential diagnosis between post-traumatic stress disorder (PTSD) and adjustment disorder (AD) is rather difficult, but very important to the assignment of appropriate treatment and prognosis. This study investigated methods to differentiate PTSD and AD.Twenty-five people with PTSD and 24 people with AD were recruited. Memory tests, the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and Beck's Depression Inventory were administered.There were significant decreases in immediate verbal recall and delayed verbal recognition in the participants with PTSD. The reduced memory functions of participants with PTSD were significantly influenced by depressive symptoms. Hypochondriasis, hysteria, psychopathic deviate, paranoia, schizophrenia, post-traumatic stress disorder scale of MMPI-2 classified significantly PTSD and AD group.Our results suggest that verbal memory assessments and the MMPI-2 could be useful for discriminating between PTSD and AD.",0 +https://doi.org/10.1097/htr.0b013e3182248344,Influence of Bodily Injuries on Symptom Reporting Following Uncomplicated Mild Traumatic Brain Injury in US Military Service Members,": To examine the relations among bodily injuries, traumatic stress, and postconcussion symptoms in a sample of combat-injured US service members who sustained a mild traumatic brain injury.: One hundred and thirty-seven service members evaluated and treated at Walter Reed Army Medical Center following medical evacuation from the combat theater of Operation Enduring Freedom and Operation Iraqi Freedom. All had sustained an uncomplicated mild traumatic brain injury and concurrent bodily injuries.: Participants completed 2 symptom checklists within 3 months of injury. Severity of bodily injuries was quantified with a modified version of the Injury Severity Score that excluded intracranial injuries (ISSmod). Participants were classified into 4 ISSmod groups: minor (n = 17), moderate (n = 48), serious (n = 40), severe/critical (n = 32).: Neurobehavioral Symptom Inventory (NBSI) and the Posttraumatic Stress Disorder Checklist-Civilian version (PCLC).: There was a significant negative association between ISSmod scores and the NBSI and PCLC total scores. There were significant main effects across the 4 groups for the NBSI and PCLC total scores. The highest NBSI and PCLC scores were consistently found in the ISSmod minor group, followed by the moderate, serious, and severe/critical groups.: While it might be expected that greater comorbid physical injuries would be associated with greater symptom burden, in this study as the severity of bodily injuries increased, symptom burden decreased. Hypothesized explanations include: underreporting of symptoms; increased peer support; disruption of fear conditioning due to acute morphine use; or delayed expression of symptoms.",0 +https://doi.org/10.1017/s0033291711000249,Latent class analysis of co-morbidity in the Adult Psychiatric Morbidity Survey in England 2007: implications for DSM-5 and ICD-11,"Psychiatric co-morbidity is complex and ubiquitous. Our aim was to describe the extent, nature and patterning of psychiatric co-morbidity within a representative sample of the adult population of England, using latent class analysis.Data were used from the 2007 Adult Psychiatric Morbidity Survey, a two-phase national household survey undertaken in 2007 comprising 7325 participants aged 16 years and older living in private households in England. The presence of 15 common mental health and behavioural problems was ascertained using standardized clinical and validated self-report measures, including three anxiety disorders, depressive episode, mixed anxiety depressive disorder, psychosis, antisocial and borderline personality disorders, eating disorders, post-traumatic stress disorder, attention deficit disorder, alcohol and drug dependencies, problem gambling and attempted suicide.A four-class model provided the most parsimonious and informative explanation of the data. Most participants (81.6%) were assigned to a non-symptomatic or 'Unaffected' class. The remainder were classified into three qualitatively different symptomatic classes: 'Co-thymia' (12.4%), 'Highly Co-morbid' (5.0%) and 'Addictions' (1.0%). Classes differed in mean numbers of conditions and impairments in social functioning, and these dimensions were correlated.Our findings confirm that mental disorders typically co-occur and are concentrated in a relatively small number of individuals. Conditions associated with the highest levels of disability, mortality and cost--psychosis, suicidality and personality disorders--are often co-morbid with more common conditions. This needs to be recognized when planning services and when considering aetiology.",0 +https://doi.org/10.1111/sltb.12098,PTSD Symptom Clusters Are Differentially Associated with Components of the Acquired Capability for Suicide,"Previous research has established the link between posttraumatic stress disorder (PTSD) and suicidal behavior. In the current study, constructs proposed to explain this relationship were examined, applying the framework of the interpersonal-psychological theory of suicide (IPTS). Relationships between acquired capability for suicide (ACS; i.e., fearlessness about death [FAD] and pain tolerance) and specific PTSD symptom clusters were explored. In a sample of 334 trauma-exposed undergraduates, anxious arousal and FAD were negatively associated, and numbing and pain tolerance were positively associated. Results establish a foundation for investigating the role of ACS in understanding observed relationships between suicidal behavior and PTSD symptoms.",0 +https://doi.org/10.1002/jts.21821,Mental Disorders Associated With Subpopulations of Women Affected by Violence and Abuse,"Violence against women is a major public health problem associated with mental disorders. Few studies have examined the heterogeneity of interpersonal violence and abuse (IVA) among women and associated mental health problems. Latent class analysis was used to identify subpopulations of women with similar lifetime histories of IVA victimization and to examine 10 associated past-year mental disorders. Participants were 19,816 adult women who participated in Wave 2 of the National Epidemiologic Study on Alcohol and Related Conditions (NESARC). The 3-class model was best supported by the data. Class 1 (6.7%) had a high probability of witnessing domestic violence as a child. Class 2 (21.8%) had a low probability of all events except lifetime sexual assault. Class 3 (71.5%) had a low probability for all events. Mental disorders were more common among members of Classes 1 and 2 than Class 3. For example, members in Class 1 were approximately 8 and 9 times more likely than members in Class 3 to have had posttraumatic stress disorder or a drug use disorder, respectively, during the past year. Of the 10 mental disorders, 5 were more common among members of Class 1 than of Class 2. Findings suggest the mental health consequences of IVA among women are extensive and interventions should be tailored for distinct subpopulations affected by IVA.",0 +https://doi.org/10.3109/09638289809166101,Whiplash and post-traumatic stress disorder,This study examined the comorbidity of whiplash and post-traumatic stress disorder (PTSD) following motor vehicle accidents. A treatment strategy in cases with both disorders is proposed.A review of the literature on psychological consequences of motor vehicle accidents and on risk factors associated with developing chronic whiplash complaints is given. A case report is presented to illustrate the treatment strategy.Traffic accidents lead to psychological complaints more often than is realized in clinical practice. It is estimated that PTSD occurs in at least 25% of traffic accident victims who sustain physical injuries. This number is probably higher in patients with chronic whiplash complaints. The case report shows that improvement in relation with the post-traumatic stress symptoms can have a beneficial effect on coping with the chronic whiplash complaints.The psychotherapeutic treatment of patients with chronic whiplash complaints and PTSD should be aimed primarily at coping with the trauma and not at the chronic pain complaints.,0 +https://doi.org/10.1037/a0030251,How does the posttraumatic cognitions inventory fit in a four-factor posttraumatic stress disorder world? An initial analysis.,"The posttraumatic cognitions inventory (PTCI) has emerged as a well-supported measure of trauma-related cognitions and has been associated with overall posttraumatic stress disorder (PTSD) severity. The present study sought to contribute to the literature regarding the utility of this measure and importance of considering the role of trauma-related cognitions in relation to an emerging four-factor model of PTSD symptomatology. To address discrepancies in the previous literature, we first replicated prior research by investigating the relationship between the PTCI cognitions (self, world/other, and self-blame) and overall PTSD symptoms. Next, we used structural equation modeling to examine a model of the relationships between posttraumatic cognitions and a well-supported four-factor model of PTSD (including separate avoidance and numbing clusters). We assessed PTSD symptomatology using both clinician-administered and self-report instruments in a treatment-seeking sample of sexual assault survivors. Results largely supported the theorized model of relationships between posttraumatic cognitions and PTSD symptom clusters. Discrepancies were observed between the two PTSD measures, which may help to clarify previous conflicting reports. Clinical and theoretical implications are considered. © 2012 American Psychological Association.",0 +https://doi.org/10.1007/s10862-012-9325-2,Main and Interactive Effects of Distress Tolerance and Negative Affect Intensity in Relation to PTSD Symptoms among Trauma-Exposed Adults,"The present investigation evaluated the main and interactive effects of distress tolerance and negative affect intensity in relation to posttraumatic stress disorder (PTSD) symptom severity and symptom cluster severity. Participants were 190 trauma-exposed adults (52.6 % women; Mage=25.3 years, SD=11.4) recruited from the community. Distress tolerance (i.e., perceived ability to withstand distressing emotional states) demonstrated significant incremental associations with global PTSD symptom severity as well as Re-Experiencing, Emotional Numbing, and Hyperarousal symptom cluster severity. Negative affect intensity (i.e., perceived intensity of negative emotional responses) demonstrated significant incremental associations with each of the PTSD symptom outcomes. Moreover, the incremental interactive effect of distress tolerance and negative affect intensity was significantly associated with PTSD symptom severity as well as PTSD-Emotional Numbing symptom cluster severity. These incremental effects were evident after accounting for the variance explained by anxiety sensitivity (i.e., fear of anxiety-related sensations). Post hoc probing analyses supported the moderating role of negative affect intensity in the association between distress tolerance and PTSD symptom severity, such that low levels of distress tolerance, in the context of elevated levels of negative affect intensity, were associated with the greatest levels of PTSD symptoms.",0 +https://doi.org/10.1017/s135246580001835x,Cognitive Factors in Persistent versus Recovered Post-Traumatic Stress Disorder after Physical or Sexual Assault: A Pilot Study,"Cognitive models have linked individual differences in the appraisal of traumatic events and their sequelae to the persistence of post-traumatic stress disorder (PTSD). A pilot study investigated this proposal with victims of assault. Eleven assault victims suffering from persistent PTSD and 9 victims who had recovered from PTSD were interviewed retrospectively and compared on potentially relevant cognitive factors. Groups were comparable in terms of characteristics of the assault, gender, age, and initial PTSD severity. Participants with persistent PTSD were less likely than those who had recovered to have engaged in mental planning during the assault and more likely to have experienced mental defeat, and to indicate negative appraisals of their actions during the assault, of others' reactions after the assault, and of their initial PTSD symptoms. They were also more likely to indicate global negative beliefs concerning their perception of themselves, their world or their future. These cognitive factors may maintain PTSD symptoms either directly or by motivating the individual to engage in behaviour that prevents change.",0 +https://doi.org/10.1016/j.jad.2015.03.063,Posttraumatic and depressive symptoms in β-endorphin dynamics,"A disturbed beta-endorphin system can be a part of the post-traumatic stress disorder (PTSD) and depression allostasis. Study subjects (N=392) included those with PTSD and/or (stress-induced) depression, and healthy controls with and without traumas. The aim of the study was to examine the network of relations centered around plasma beta-endorphin. The network included anxiety (as a personality trait), traumatic events, pain, aggressiveness, depressive symptoms, and three clusters of PTSD symptoms: intrusions, avoidance, and hyperarousal. Beta-endorphin was represented by individual mean from 13 time points (BEmean), reflecting the total amount of the peripherally secreted hormone, and the coefficient of variation (BEvar), calculated as the ratio of standard deviation to the mean, reflecting the hormone׳s dynamics. BEvar correlated with all other variables, BEmean had no correlations. Structural equation modeling (SEM) was used to examine all interrelations (including their directions) of BEvar and the state/trait variables in the context of their entirety. The model revealed that hyperarousal and anxiety were the only direct agents of peripheral beta-endorphin fluctuations, mediating the effects of other variables. Traumatic events and intrusions act on BEvar via hyperarousal, while depressive symptoms, avoidance, and pain act via anxiety. Hyperarousal should be emphasized as the main agent not only because its effect on BEvar is larger than that of anxiety, but also because it increases anxiety itself (via avoidance and pain). All influences on BEvar are positive and they indicate long-term (sensitizing) effects (as opposed to direct stimulation, for example, by acute pain, anger, etc.). Relations apart from beta-endorphin are also discussed.",0 +https://doi.org/10.1111/j.2044-8341.2011.02026.x,Group music therapy for patients with persistent post-traumatic stress disorder - an exploratory randomized controlled trial with mixed methods evaluation,"Objectives. Not all patients with post-traumatic stress disorder (PTSD) respond to cognitive behavioural therapy (CBT). Literature suggests group music therapy might be beneficial in treating PTSD. However, feasibility and effectiveness have not been assessed. The study objectives were to assess whether group music therapy was feasible for patients who did not respond to CBT, and whether it has an effect on PTSD symptoms and depression. Design. The study employed mixed methods comprising of an exploratory randomized controlled trial, qualitative content analysis of therapy, and patient interviews. Method. Patients with significant PTSD symptoms (n= 17) following completion of CBT were randomly assigned to treatment (n= 9) or control groups (n= 8). The treatment group received 10 weeks of group music therapy after which exit interviews were conducted. Control group patients were offered the intervention at the end of the study. Symptoms were assessed on the Impact of Events Scale-Revised and Beck Depression Inventory II at the beginning and end of treatment. Results. Treatment-group patients experienced a significant reduction in severity of PTSD symptoms (−20.18; 95% confidence interval [CI]: [−31.23, −9.12]) and a marginally significant reduction in depression (−11.92; 95%CI: [−24.05, 0.21]) at 10 weeks from baseline compared to the control. Patients viewed music therapy as helpful and reported experiences concur with current literature. Conclusions. Group music therapy appears feasible and effective for PTSD patients who have not sufficiently responded to CBT. Limitations include the small sample size and lack of blinding. Further research should address these limitations, test sustainability, and identify specific factors that address symptoms in treatment.",0 +https://doi.org/10.1037/0022-006x.74.4.707,Longitudinal analysis of the relationship between symptoms and quality of life in veterans treated for posttraumatic stress disorder.,This study examined how change in posttraumatic stress disorder (PTSD) symptoms relates to change in quality of life. The sample consisted of 325 male Vietnam veterans with chronic PTSD who participated in a randomized trial of group psychotherapy. Latent growth modeling was used to test for synchronous effects of PTSD symptom change on psychosocial and physical health-related quality of life within the same time period and lagged effects of initial PTSD symptom change on later change in quality of life. PTSD symptoms were associated with reduced quality of life before treatment. There were synchronous effects of symptom change on change in quality of life but no significant lagged effects. Results indicate the importance of measuring quality of life in future investigations of PTSD treatment.,0 +https://doi.org/10.1080/15325024.2010.519288,Cumulative Tertiary Appraisals of Traumatic Events Across Cultures: Two Studies,"Two studies compared the effects of cumulative trauma (CT) with those of cumulative negative (CNTA) and cumulative positive tertiary appraisals (CPTA). The first study was conducted with an adult clinical population in the U.S. (N = 399), while the second study was conducted with adolescent students in Gaza (N = 422). Among the effects found were that path analysis with comulative trauma, positive tertiary appraisal, and cumulative negative tertiary appraisals as independent variables and mental health measures as dependent variables, in both samples, found that CNTA and CPTA had direct positive and direct negative effects, respectively, on PTSD, depression, and anxiety. However, CT, independent from appraisals, had direct effects in producing the more complicated symptom clusters of cumulative trauma disorders.",0 +https://doi.org/10.1089/jwh.2011.2788,Markers of Inflammation in Midlife Women with Intimate Partner Violence Histories,"Lifetime occurrence of intimate partner violence (IPV) in women has been associated with increased prevalence of aging-related chronic diseases, including those with a pathophysiology involving inflammation. To begin to identify potential biologic mediators of this relationship, this cross-sectional study examined associations between past IPV and circulating levels of C-reactive protein (CRP) and interleukin-6 (IL-6)-measures linked with emergence of aging-related diseases-along with in vitro IL-6 production by peripheral blood mononuclear cells (PBMC) stimulated with either phytohemagglutinin A (PHA) or lipopolysaccharide (LPS).Apparently healthy, midlife women with divorce histories were recruited from the community. Histories of intimate partner psychological aggression, physical assault, sexual coercion, and stalking were assessed, along with current depression, posttraumatic stress symptoms, and health-related characteristics. At two visits, blood was drawn for assessment of biologic measures; measures were averaged across visits.In this sample (n=68), a history of being stalked was significantly positively correlated with CRP levels; in a multiple regression analysis that included body mass index (BMI) and current symptoms, this association was attenuated by adjusting for BMI. Physical assault history was significantly negatively correlated with PHA-stimulated IL-6 production. This was most apparent for severe assault and was not accounted for by BMI or symptoms.IPV histories remitted for an average of 10 years were associated with biologic mediators of inflammation. The profile was not uniformly proinflammatory, suggesting that in situations of traumatic or chronic stress, different aspects of the inflammatory response are differentially regulated and subjected to diverse compensatory mechanisms.",0 +https://doi.org/10.1016/s0191-8869(02)00066-1,Battlefield functioning and chronic PTSD: associations with perceived self efficacy and causal attribution,"This study has two aims: (1) to examine the associations between battlefield functioning and perceived self efficacy (PSE) and attributional style; (2) to examine the unique and cumulative contributions of battlefield functioning, PSE, and attributional style to long term PTSD . The subjects were three groups of Israeli veterans of the 1973 Yom Kippur, who differed in their battlefield functioning: 112 combat stress reaction (CSR) casualties, 98 veterans who received medals for bravery, and 189 controls. The subjects filled out a series of questionnaires that assessed PTSD, PCE, attributional style and PTSD, two decades after the war. CSR casualties exhibited the lowest level of PSE, decorated veterans the highest. The three groups also differed in locus of control , with different attribution for failure. Discriminant analysis of PTSD and non-PTSD veterans showed that sociodemographic background, battlefield performance, PSE and attributional style classified 81% of all veterans correctly. The implications of these findings are discussed.",0 +https://doi.org/10.1016/s0005-7967(99)00101-1,Evidence of a disposition toward fearfulness and vulnerability to posttraumatic stress in dysfunctional pain patients,"Few investigations have addressed whether patient subgroups derived using the Multiaxial Assessment of Pain (MAP) [Turk, D. C., & Rudy, T. E. (1987). Towards a comprehensive assessment of chronic pain patients. Behaviour Research and Therapy, 25, 237-249; Turk, D. C., & Rudy, T. E. (1988). Toward an empirically derived taxonomy of chronic pain patients: integration of psychological assessment data. Journal of Consulting and Clinical Psychology, 56, 233-238.] differ with regard to fear and avoidance. It has, however, been reported that dysfunctional patients exhibit more pain-specific fear and avoidance than patients classified as interpersonally distressed or minimizers/adaptive copers [Asmundson, G. J. G., Norton, G. R., & Allerdings, M. D. (1997). Fear and avoidance in dysfunctional chronic back pain patients. Pain, 69, 231-236.]. We attempted to extend these findings by examining two fear constructs that are receiving increased attention in the chronic pain literature-anxiety sensitivity and PTSD. The sample comprised 115 patients with chronic pain. Of these, 14 (12.2%) were classified as dysfunctional, 21 (18.3%) as interpersonally distressed and 47 (40.8%) as minimizers/adaptive copers. Between-group differences were observed on the fear of cognitive and emotional dyscontrol dimension of anxiety sensitivity, total and symptom cluster scores on the PTSD measure, and depression. No differences were observed for the fear of somatic sensations dimension of anxiety sensitivity or agoraphobia, social phobia, and blood/injury fears. Dysfunctional patients generally exhibited elevated scores relative to one or both of the other MAP subgroups on fear of cognitive and emotional dyscontrol, depressed affect, PTSD symptom total score and PTSD symptom cluster scores. As well, a substantial proportion of dysfunctional and interpersonally distressed patients were classified as having PTSD (71.4 and 42.9%, respectively) when compared to minimizers/adaptive copers (21.3%). These results suggest that MAP subgroups differ with regard to their propensity to be(come) fearful and in their likelihood of having PTSD. Theoretical and clinical implications are discussed.",0 +https://doi.org/10.1017/s1355617709990282,Longitudinal effects of PTSD on memory functioning,"Abstract Numerous studies have demonstrated explicit and working memory deficits related to posttraumatic stress disorder (PTSD), but few have addressed longitudinal changes in memory functioning. There is some evidence to suggest an interactive effect of PTSD and aging on verbal memory decline in Holocaust survivors (Yehuda et al., 2006). However, the longitudinal trajectory of neuropsychological functioning has not been investigated in Vietnam veterans, a younger but substantial population of aging trauma survivors. We administered tests of visual and verbal memory, and working memory to derive different dependent measures in veterans between the ages of 41 and 63, the majority of whom served in the Vietnam War. Twenty-five veterans with PTSD and 22 veterans without PTSD were assessed over two time points (mean age at follow-up = 54.0; mean inter-test interval = 34 months). The PTSD+ group, consisting of veterans with chronic, primarily combat-related PTSD, did not show a significant change in PTSD symptoms over time. Compared to veterans without PTSD, veterans with PTSD showed a greater decline in delayed facial recognition only, and this decline was extremely subtle. ( JINS , 2009, 15 , 853–861.)",0 +https://doi.org/10.1017/s0033291713001347,Transdiagnostic and disorder-specific models of intergenerational transmission of internalizing pathology – ERRATUM,"Reports an error in ""Transdiagnostic and disorder-specific models of intergenerational transmission of internalizing pathology"" by L. R. Starr, C. C. Conway, C. L. Hammen and P. A. Brennan (Psychological Medicine, 2014[Jan], Vol 44[1], 161-172). In the original article, there were errors in Figure 1. The correct Figure 1 is present in the erratum. (The following abstract of the original article appeared in record 2013-44252-015). Background: Numerous studies have supported an association between maternal depression and child psychiatric outcomes, but few have controlled for the confounding effects of both maternal and offspring co-morbidity. Thus, it remains unclear whether the correspondence between maternal and offspring depressive and anxiety disorders is better explained by associations between shared features of maternal and offspring internalizing disorders or by specific effects exerted by unique aspects of individual disorders. Method: Pairs of mothers and offspring overselected for maternal depression (n = 815) were assessed at offspring age 15 years for anxiety and depressive disorders; 705 completed a follow-up at offspring age 20 years. For both mothers and offspring, structural equation modeling was used to distinguish transdiagnostic internalizing pathology - representing the overlap among all depressive and anxiety disorders - from diagnosis-specific forms of pathology. To discriminate between general versus specific pathways of intergenerational transmission of psychopathology, we examined (a) the general association between the maternal and offspring internalizing factors and (b) the correlations between maternal and offspring diagnosis-specific pathology for each disorder. Results: For mothers and offspring, a unidimensional latent variable model provided the best fit to the correlations among depressive and anxiety disorders. The maternal transdiagnostic internalizing factor strongly predicted the corresponding factor among offspring. In addition, the unique component of post-traumatic stress disorder among offspring was significantly related to the analogous unique component among mothers, but specific components of other maternal disorders, including depression, did not predict corresponding offspring pathology. Conclusions: Results suggest that intergenerational transmission of internalizing disorders is largely non-specific. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0 +https://doi.org/10.1002/jts.20048,Phenomenology and psychological assessment of complex posttraumatic states,"The authors offer a framework for the assessment of psychological responses associated with exposure to early onset, multiple, or extended traumatic stressors. Six prominent and overlapping symptoms clusters are described: altered self-capacities, cognitive symptoms, mood disturbance, overdeveloped avoidance responses, somatoform distress, and posttraumatic stress. A strategy for the structured, psychometrically valid assessment of these outcomes is introduced, and specific recommendations for use of various generic and trauma-specific child and adult measures are provided. Implications of trauma assessment for treatment planning are discussed.",0 +https://doi.org/10.1002/acp.3081,Longitudinal Analysis of Children's Internal States Language and Posttraumatic Stress Symptoms Following a Natural Disaster,"Summary Disclosure of internal states terms (e.g., emotions, cognitions, and perceptions) in traumatic event descriptions is thought to be associated with physical and mental health in adults, but studies with children have been mixed, and the interpretation of many findings is complicated by the lack of longitudinal data. Using data collected from 568 students (ages 7–12 years) attending schools in Miami-Dade County, Florida, this study examined the internal states language in participant's written descriptions of the ‘worst things that happened during the hurricane’ collected 3 and 7 months after Hurricane Andrew. Associations between these internal states and their posttraumatic stress symptoms (PTSS) 3, 7, and 10 months post-hurricane were evaluated using structural equation modeling. Patterns of association suggest that PTSS were not affected by internal states disclosure; rather, internal states language seemed to be a manifestation of PTSS. Implications for risk assessment, theory building, and treatment of PTSS in children are discussed. Copyright © 2014 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1097/psy.0b013e3181835c07,Persistence of Posttraumatic Stress Symptoms 12 and 36 Months After Acute Coronary Syndrome,"To assess the prevalence and predictors of posttraumatic stress symptoms in patients at 12 and 36 months post hospital admission for an acute coronary syndrome (ACS). There is increasing recognition that posttraumatic stress may develop in the aftermath of an acute cardiac event. However, there has been little research on the longer-term prevalence of posttraumatic stress disorder (PTSD).Posttraumatic stress symptoms were assessed at 12 months in 213 patients with ACS and in 179 patients at 36 months. Predictor variables included clinical, demographic, and emotional factors measured during hospital admission.At 12 months post ACS, 26 (12.2%) patients qualified for a diagnosis of PTSD; 23 (12.8%) patients were identified with PTSD at 36 months. Posttraumatic symptoms at 12 months were associated with younger age, ethnic minority status, social deprivation, cardiac symptom recurrence, history of depression, depressed mood during admission, hostility, and Type D personality. In multiple regression, depressed mood during admission and recurrent cardiac symptoms were independent predictors of posttraumatic symptoms (R(2) = 0.507, p < .001). At 36 months, posttraumatic stress symptoms were independently predicted by posttraumatic symptom levels at 12 months and depressed mood during admission (R(2) = 0.635, p < .001).Posttraumatic stress symptoms persist for at least 3 years after an acute cardiac event. Early emotional responses are important in predicting longer-term posttraumatic stress. It is important to identify patients at risk for posttraumatic stress as they are more likely to experience reduced quality of life.",0 +,"Resilience, Vulnerability and the Course of Posttraumatic Reactions",,0 +https://doi.org/10.1002/hbm.23051,Anatomical and functional connectivity in the default mode network of post-traumatic stress disorder patients after civilian and military-related trauma,"Posttraumatic stress disorder (PTSD) is characterized by unwanted intrusive thoughts and hyperarousal at rest. As these core symptoms reflect disturbance in resting-state mechanisms, we investigated the functional and anatomical involvement of the default mode network (DMN) in this disorder. The relation between symptomatology and trauma characteristics was considered. Twenty PTSD patients and 20 matched trauma-exposed controls that were exposed to a similar traumatic event were recruited for this study. In each group, 10 patients were exposed to military trauma, and 10 to civilian trauma. PTSD, anxiety, and depression symptom severity were assessed. DMN maps were identified in resting-state scans using independent component analysis. Regions of interest (medial prefrontal, precuneus, and bilateral inferior parietal) were defined and average z-scores were extracted for use in the statistical analysis. The medial prefrontal and the precuneus regions were used for cingulum tractography whose integrity was measured and compared between groups. Similar functional and anatomical connectivity patterns were identified in the DMN of PTSD patients and trauma-exposed controls. In the PTSD group, functional and anatomical connectivity parameters were strongly correlated with clinical measures, and there was evidence of coupling between the anatomical and functional properties. Type of trauma and time from trauma were found to modulate connectivity patterns. To conclude, anatomical and functional connectivity patterns are related to PTSD symptoms and trauma characteristics influence connectivity beyond clinical symptoms. Hum Brain Mapp 37:589-599, 2016. © 2015 Wiley Periodicals, Inc.",0 +https://doi.org/10.4321/s0213-61632014000300001,Complex posttraumatic stress disorder in traumatised asylum seekers: a pilot study,"Complex posttraumatic stress disorder (cPTSD), a construct associated with early onset and repeated interpersonal trauma, has not previously been assessed in asylum seekers who have experienced major human rights violations. The aim of this pilot study was to describe the cPTSD symptom profile in asylum seekers, and to compare this profile between three groups of people who have experienced: human trafficking, domestic violence and/or torture. Methods: Over a period of eight weeks, clinicians working at the Helen Bamber Foundation charity invited 48 patients currently receiving psychotherapy to take part in the study, of whom 30 (62.5%) agreed. The structured interview for disorders of extreme stress (SIDES) was used to assess cPTSD in 29 asylum seekers, as one patient withdrew during the interview. Results: Participants originated from 18 countries, 72.4% were female, the median age at trauma onset was 17 years and the duration of trauma was ten years. Eight (27.6%) participants were found to have cPTSD, defined as having all six symptom clusters, and 15 (51.7%) had five or more cPTSD symptom clusters. Age at trauma onset, duration of trauma, last trauma experience, gender and trauma type were not found to be associated with cPTSD presence. Conclusions: Extensive cPTSD symptoms were common in all participants, regardless of the nature of the trauma experienced. Future research is needed to enable generalisability of cPTSD symptom profile in asylum seekers.",0 +https://doi.org/10.1016/j.puhe.2009.04.002,Women in prison: The central issues of gender characteristics and trauma history,"Insufficient attention is being paid to two key issues which are critical to a better understanding of what can be done to improve present services for women in prison. Firstly, the demographics, determinants and profiles of imprisoned women clearly show factors that should be central to any prison policy for women. Secondly, an analysis of the role of trauma history shows its strong influence on offending behaviour. Any modern approach to providing a more acceptable criminal justice policy for women must pay much greater attention to these two important issues.",0 +https://doi.org/10.1037/a0019891,Cognitive and emotional processing through writing among adolescents who experienced the death of a classmate.,"This study investigated how written emotional disclosure reflects the processes by which adolescents cope with a traumatic event they experienced collectively - the sudden death of a classmate. Twenty high school students wrote about their emotional reactions to the death on 3 consecutive days. The writings were coded using the Linguistic Inquiry and Word Count (LIWC) and analyzed using a mixed-methods software (T-LAB). A measure of posttraumatic stress symptoms (Impact of Events Scale-Revised) obtained at baseline (14 days after the death) and 1 week and 4 months' postwriting was used to classify the students into four adjustment trajectories: Delayed Distress, Recovery, Stable-Negative, and Stable-Positive. Textual analysis revealed a progressive elaboration of the traumatic event across the 3 writing days, moving from a factual perspective to the processing of emotions to an integrated emotional and cognitive restructuring of the event. The nature of the writing differed across adjustment trajectories. Specifically, students in the Stable-Positive and Recovery trajectories made greater mention of the deceased classmate and reflected greater cognitive processing of the trauma. Students in the Stable-Negative and Delayed Distress trajectories used more self-references and negative emotion words and showed a greater degree of inhibition. The results provide preliminary clues to adjustment processes in adolescent bereavement. © 2010 American Psychological Association.",0 +https://doi.org/10.1186/1471-244x-14-s1-s1,"Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders","Anxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated.These guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology, diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980-2012). Treatment strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines.These guidelines are presented in 10 sections, including an introduction, principles of diagnosis and management, six sections (Sections 3 through 8) on the specific anxiety-related disorders (panic disorder, agoraphobia, specific phobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder), and two additional sections on special populations (children/adolescents, pregnant/lactating women, and the elderly) and clinical issues in patients with comorbid conditions.Anxiety and related disorders are very common in clinical practice, and frequently comorbid with other psychiatric and medical conditions. Optimal management requires a good understanding of the efficacy and side effect profiles of pharmacological and psychological treatments.",0 +https://doi.org/10.1016/j.jad.2014.05.040,"Caregiver distress, shared traumatic exposure, and child adjustment among area youth following the 2013 Boston Marathon bombing","Disasters are associated with myriad negative outcomes in youth, including posttraumatic stress disorder and related psychopathology. Prior work suggests links between caregiver distress and child mental health outcomes following community traumas, but the extent to which caregiver distress is directly linked to post-disaster child functioning, or whether such associations may simply be due to shared traumatic exposure, remains unclear.The current study examined relationships among caregiver distress, caregiver-child shared traumatic exposure, and child outcomes in Boston-area families (N=460) during the six months following the 2013 Boston Marathon bombing. Parents completed surveys about their and their child׳s potentially traumatic experiences during the bombing and subsequent manhunt. Post-attack caregiver distress and child psychological functioning were also assessed.After accounting for caregiver-child shared traumatic exposure, significant associations were retained between caregiver distress and child functioning across several domains. Furthermore, after accounting for caregiver traumatic exposure, caregiver distress moderated relationships between child traumatic exposure and child posttraumatic stress and conduct problems, such that associations between child traumatic exposure and child posttraumatic stress and conduct problems were particularly strong among children of highly distressed caregivers.The cross-sectional design did not permit evaluations across time, and population-based methods were not applied.Findings clarify links between caregiver distress and child psychopathology in the aftermath of disaster and can inform optimal allocation of clinical resources targeting disaster-affected youth and their families.",0 +https://doi.org/10.1007/s10072-013-1623-2,Head and facial injuries due to cluster munitions,"Cluster munitions are weapons that scatter smaller sub-munitions intended to kill or mutilate on impact. They have been used by the Israeli army in the south of Lebanon and are now scattered over wide rural areas affecting its inhabitants. Because of their easily ""pickable"" nature, sub-munitions can inflict injuries to the head and face regions. In this study, we aimed to explore the head and face injuries along with their clinical features in a group of Lebanese patients who suffered from such injuries due to a sub-munition's detonation. The study included all the cases reported between 14 August 2006 and 15 February 2013, with head and face injuries related to cluster bombs. Injuries were classified into brain, eye, otologic and auditory impairments, oral and maxillofacial, and skin and soft-tissue injuries. Psychological effects of these patients were also examined as for post-traumatic stress disorder, major depressive disorder, generalized anxiety disorder and acute stress syndrome. During the study period, there were 417 casualties as a result of cluster munitions' blasts. Out of the total number of victims, 29 (7 %) were injured in the head and the face region. The convention on cluster munitions of 2008 should be adhered to, as these inhumane weapons indiscriminately and disproportionately harm innocent civilians, thereby violating the well-established international principles governing conflict and war today. © 2014 Springer-Verlag.",0 +https://doi.org/10.1111/pcn.12126,Psychiatric symptoms of noradrenergic dysfunction: A pathophysiological view,"What psychiatric symptoms are caused by central noradrenergic dysfunction? The hypothesis considered in this review is that noradrenergic dysfunction causes the abnormalities in arousal level observed in functional psychoses. In this review, the psychiatric symptoms of noradrenergic dysfunction were inferred pathophysiologically from the neuroscience literature. This inference was examined based on the literature on the biology of psychiatric disorders and psychotropics. Additionally, hypotheses were generated as to the cause of the noradrenergic dysfunction. The central noradrenaline system, like the peripheral system, mediates the alarm reaction during stress. Overactivity of the system increases the arousal level and amplifies the emotional reaction to stress, which could manifest as a cluster of symptoms, such as insomnia, anxiety, irritability, emotional instability and exaggerated fear or aggressiveness (hyperarousal symptoms). Underactivity of the system lowers the arousal level and attenuates the alarm reaction, which could result in hypersomnia and insensitivity to stress (hypoarousal symptoms). Clinical data support the hypothesis that, in functional psychoses, the noradrenergic dysfunction is in fact associated with the arousal symptoms described above. The anti-noradrenergic action of anxiolytics and antipsychotics can explain their sedative effects on the hyperarousal symptoms of these disorders. The results of animal experiments suggest that excessive stress can be a cause of long-term noradrenergic dysfunction.",0 +https://doi.org/10.1002/(sici)1520-6394(1997)5:1<34::aid-da6>3.0.co;2-5,Psychotic features and combat-associated PTSD,"Psychotic symptoms and psychotic disorder diagnoses have occasionally been reported in association with chronic posttraumatic stress disorder (PTSD). Although psychotic features may be related to core PTSD symptoms, i.e., part of the reexperiencing phenomena, it is possible that they are secondary to certain comorbid disorders which are also prevalent in this patient population, e.g. major depression or substance abuse. In a prospective study, combat associated PTSD patients (n = 25) were administered clinical ratings, including the Structured Clinical Interview for DSM-III-R with psychotic screen (SCID-P), Clinician Administered PTSD Scale (CAPS) and the Impact of Events Scale (IES). Thirty-six percent (n = 9) endorsed psychotic symptoms with associated comorbidity including: major depressive episode, bipolar disorder, alcohol or polysubstance abuse panic disorder, and phobias. All but one of the patients with psychotic features also met criteria for major depressive episode. None had a primary psychotic disorder diagnosis. There were no significant differences in total CAPS scores between patients with or without psychotic features (82.6 +/-0 17.6 versus 75.3 +/- 22.4, p ns), nor for the different symptom cluster subscales. There were also no differences in the IES scores between groups (34.8 +/- 10 versus 32.6 +/- 10 p ns). This suggests that these psychotic features may not necessarily reflect severity of PTSD symptoms. PTSD may share a common diathesis with mood disorders including psychotic depression. Further study is needed of these phenomena.",0 +https://doi.org/10.1037//1040-3590.12.2.197,Validation of a brief measure of posttraumatic stress disorder: The Distressing Event Questionnaire (DEQ).,"The Distressing Event Questionnaire (DEQ) is a brief instrument for assessing posttraumatic stress disorder (PTSD) according to criteria provided in Diagnostic and Statistical Manual of Mental Disorders (4th ed.). The DEQ possesses high internal consistency and exhibited satisfactory short-term temporal stability in studies with Vietnam War combat veterans and battered women. In a sample of Vietnam War veterans and 4 separate samples of abused women (with histories of incest, rape, intimate partner abuse, or prostitution and abuse), the DEQ exhibited very good discriminative validity when judged against structured interview assessment of PTSD. The DEQ exhibited strong convergent validity with other PTSD measures and other indexes of adjustment and also exhibited strong convergent validity as a measure of PTSD across ethnic groups in both the veteran sample and the combined women's sample.",0 +https://doi.org/10.1185/135525701750167438,Current status of anxiolytic drugs,"Anxiety disorders commonly seen in primary care are characterized by psychological and physical symptoms of disabling anxiety. However, they are often unrecognized and under-diagnosed. Because of the dearth of trained therapists, pharmacotherapy remains the most widespread form of treatment. Newer anti-anxiety drugs have been developed that are more effective with a better side-effect profile. In this article, the various anxiety disorders are described together with their appropriate pharmacotherapy.",0 +https://doi.org/10.1016/j.biopsych.2012.06.029,Gray Matter Correlates of Posttraumatic Stress Disorder: A Quantitative Meta-Analysis,"

Background

Since the inception of the diagnosis posttraumatic stress disorder (PTSD), attempts have been undertaken to understand why only a subpopulation of individuals exposed to trauma develops PTSD. Cerebral gray matter reductions have been suggested to be a crucial pathobiological marker of PTSD. However, a quantitative meta-analysis of whole-brain voxel-based morphometry studies is lacking.

Methods

Here, we investigated concurrence across voxel-based morphometry studies in PTSD compared with trauma-exposed individuals without PTSD (all together nine studies with 319 subjects) by means of activation likelihood estimation.

Results

We identified brain regions of consistent gray matter reduction in anterior cingulate cortex, ventromedial prefrontal cortex, left temporal pole/middle temporal gyrus, and left hippocampus in PTSD patients compared with individuals exposed to trauma without PTSD.

Conclusions

This is the first quantitative whole-brain meta-analysis showing brain structure deficits in traumatized subjects with PTSD compared with trauma-exposed healthy control subjects. The gray matter deficit profile overlaps with brain networks of emotion processing, fear extinction, and emotion regulation known to be affected in PTSD. Although the data cannot clarify if this is a predisposition or a consequence of the disease, the results may facilitate the need to control for structural characteristics in future functional brain studies.",0 +https://doi.org/10.1002/jts.20092,Differential relationships of childhood abuse and neglect subtypes to PTSD symptom clusters among adolescent inpatients,"This article investigates whether childhood abuse and neglect subtypes (i.e., physical, sexual, and emotional abuse, and physical and emotional neglect) differentially predict the severity of individual posttraumatic stress disorder (PTSD) symptom clusters and overall posttraumatic stress. Eighty-nine patients admitted to the short-term adolescent treatment unit of a psychiatric hospital completed a battery of psychological assessments. Findings of multiple regression analyses showed that emotional and sexual abuse rather than physical abuse, emotional neglect, or physical neglect is related to individual symptom cluster severity and overall posttraumatic stress. Results suggested that a greater level of specificity is necessary when assessing child abuse and posttraumatic stress because each level provides more specific information about how to intervene to reduce the risk of negative outcomes.",0 +https://doi.org/10.1289/ehp.11164,"Enduring Mental Health Morbidity and Social Function Impairment in World Trade Center Rescue, Recovery, and Cleanup Workers: The Psychological Dimension of an Environmental Health Disaster","The World Trade Center (WTC) attacks exposed thousands of workers to hazardous environmental conditions and psychological trauma. In 2002, to assess the health of these workers, Congress directed the National Institute for Occupational Safety and Health to establish the WTC Medical Monitoring and Treatment Program. This program has established a large cohort of WTC rescue, recovery, and cleanup workers. We previously documented extensive pulmonary dysfunction in this cohort related to toxic environmental exposures.Our objective in this study was to describe mental health outcomes, social function impairment, and psychiatric comorbidity in the WTC worker cohort, as well as perceived symptomatology in workers' children.Ten to 61 months after the WTC attack, 10,132 WTC workers completed a self-administered mental health questionnaire.Of the workers who completd the questionnaire, 11.1% met criteria for probable post-traumatic stress disorder (PTSD), 8.8% met criteria for probable depression, 5.0% met criteria for probable panic disorder, and 62% met criteria for substantial stress reaction. PTSD prevalence was comparable to that seen in returning Afghanistan war veterans and was much higher than in the U.S. general population. Point prevalence declined from 13.5% to 9.7% over the 5 years of observation. Comorbidity was extensive and included extremely high risks for impairment of social function. PTSD was significantly associated with loss of family members and friends, disruption of family, work, and social life, and higher rates of behavioral symptoms in children of workers.Working in 9/11 recovery operations is associated with chronic impairment of mental health and social functioning. Psychological distress and psychopathology in WTC workers greatly exceed population norms. Surveillance and treatment programs continue to be needed.",0 +https://doi.org/10.1191/0269215505cr867oa,A prospective study on paediatric traffic injuries: health-related quality of life and post-traumatic stress,"Objectives: To examine children's reports of their health-related quality of life (HRQoL) following paediatric traffic injury, to explore child and parental post-traumatic stress, and to identify children and parents with adverse outcomes. Design: Prospective cohort study. Assessments: shortly after the injury, three months and six months post injury. Setting: Department of Traumatology, University Hospital. Subjects: Fifty-one young traffic injury victims aged 8-15 years. Main measures: TNO-AZL Children's Quality of Life questionnaire and the Impact of Event Scale. Results: Short-term adverse changes in the child's HRQoL were observed for the child's motor functioning and autonomy. At three months, 12% of the children and 16% of the parents reported serious post-traumatic stress symptoms. Increased stress at three months, or across follow-up, was observed among hospitalized children, children with head injuries, and children injured in a motor vehicle accident. Parental stress was related to low socioeconomic status and the seriousness of the child's injury and accident (hospitalization, head injury, serious injury, motor vehicle involved, others injured). Conclusions: The children reported only temporary effects in their motor functioning and autonomy. Post-traumatic stress symptoms following paediatric traffic injury were not only experienced by the children, but also by their parents.",0 +,Applying suppression subtractive hybridization technique to investigate gene differential expression profiles in rats liver during the course of heat stress,"Aim: To explore the molecular mechanism of heat stress by isolating diff erentially expressed genes occurred during the course of heat stress and filtrat ing functional gene segments concerned with heat stress with Suppression Subtrac tive Hybridization technique. Methods: There were 2 groups in th e experiment: heat stress group and normal temperature control group. mRNAs were isolated from the liver tissue individually and then transcripted into cDNAs. A fter cut with endonuclease and ligation with adaptors, SSH was carried out with cDNAs of heat stress group as tester while cDNAs of control group as driver. Pro ducts were cloned into T/A vector to form recombined plasmids to transfect compe tence cells for filtration and appraisal. Results: mRNAs were ab undant and of high quality, cDNAs were reverse-transcripted and then cut into s egments about 500 bp successfully. Ligation efficiency was satisfied. The subtr active hybridization library was constructed successfully after effective hybrid ization and 180 segments were primarily isolated from it. Conclusion: Construction of heat stress differentially expressed genes subtractive lib rary has established the foundation of filtrating heat stress concerned genes, i t is of active significance for exploring functional genes that controlled heat stress.",0 +https://doi.org/10.1037/1541-1559.5.1.36,A preliminary classification system for homeless veterans with mental illness.,"The purpose of this study was that of defining psychiatric profiles among veterans based on a structured interview of 3,595 individuals administered by outreach mental health clinicians to individuals who were presently or recently homeless. The interview included ratings of presence or absence of current psychiatric disorders; alcoholism, drug abuse, psychosis, mood disorders, personality disorders, PTSD, and adjustment disorders. We identified three subgroups using cluster analysis each showing different diagnostic profiles that were characterized as “addiction” (n 3,061), “psychosis” (n 218), and “personality” disorders (n 54). Cluster membership was related to demographic characteristics, living situation, length of homelessness, and symptoms and complaints including cognitive difficulties, suicidality, violence, and depression. Group comparison statistics were used to compare intercluster differences in demographics, homeless situation, symptoms, and subjective complaints. There were no major intercluster differences in socioethnic, demographic, and homeless situation variables. Differences occurred in complaints of depression, positive symptoms of psychosis, and suicidality. It was concluded that despite the disproportionate sizes of the clusters homeless veterans with mental illness are nevertheless heterogeneous with regard to their psychiatric profiles.",0 +https://doi.org/10.1037//1040-3590.12.1.61,Acute stress disorder scale: A self-report measure of acute stress disorder.,,0 +https://doi.org/10.1159/000152377,DSM-IV Personality Disorders and Their Axis I Correlates in the South African Population,"The prevalence of personality disorders (PD) in the South African population is largely unknown. Thus, we undertook to estimate prevalence, demographic correlates, co-morbidity and treatment rates of DSM-IV PD among South Africans.A three-stage probability sample design was used. Of the 4,433 interviews obtained, based on quality control criteria, 4,315 interviews were retained for analysis. All participants were screened for PD and axis I disorders with the World Health Organisation Composite International Diagnostic Interview. The multiple imputation method was then used to estimate prevalence.The multiple imputation prevalence estimate in the total sample was 6.8%. All three PD clusters were significantly co-morbid with each other and with other axis I disorders. Male gender was the only significant predictor of PD. Of note was the finding that less than one fifth of participants with a possible PD diagnosis had received treatment for a mental health or substance abuse problem in the previous 12 months.The high co-morbidity of PD with axis I disorders in South Africa is consistent with previous reports elsewhere. However, more research is indicated to determine the reasons for the higher prevalence of cluster A disorders than of cluster B and C disorders in this population.",0 +https://doi.org/10.1080/15299732.2014.985864,The Role of Personality Traits and Profiles in Posttrauma Comorbidity,"Many service members experience symptoms of posttraumatic stress disorder (PTSD) after deployment. PTSD can vary widely in its presentation and associated features, such as comorbid conditions. Research has shown that veterans with PTSD and an internalizing personality profile are more likely to experience internalizing comorbidity (e.g., anxiety, depression), whereas veterans with PTSD and an externalizing personality profile are more likely to experience externalizing comorbidity (e.g., substance abuse, aggression). To date, however, this research has been limited by a focus on diagnosable disorders and personality categories. In a nonclinical sample of 224 National Guard/Reserve service members who had served since 2001, we explored whether personality traits (measured continuously) moderated associations of PTSD symptom severity with the severity of internalizing (depression, anxiety) and externalizing (alcohol abuse, aggression) symptoms. Results showed that the association of PTSD with anxiety was stronger when extraversion was lower (corresponding to an internalizing personality profile). Moreover, the association of PTSD with alcohol abuse was stronger when extraversion was high and conscientiousness was low (corresponding to an externalizing personality profile). Surprisingly, this association was also stronger when extraversion was low and conscientiousness was high. Results offer additional insights into prior research on personality and comorbidity.",0 +https://doi.org/10.1080/00039899809605705,Chronic Neurobehavioral Effects of Tokyo Subway Sarin Poisoning in Relation to Posttraumatic Stress Disorder,"Chronic neurobehavioral effects of acute sarin poisoning were evaluated in 9 male and 9 female patients who were exposed to sarin poisoning in the Tokyo subway incident in Japan. The investigators used nine neurobehavioral tests, as well as a posttraumatic stress disorder checklist, 6-8 mo after the poisoning occurred. Serum cholinesterase activity in patients on the day of poisoning (i.e., March 20, 1995) ranged from 13 to 131 IU/l (mean=72.1 IU/l). The results of analysis covariance, in which age, education level, alcohol consumption, and smoking status (covariates) were controlled in 18 sarin cases and in 18 controls, showed that the score on the digit symbol (psychomotor performance) test was significantly lower in the sarin cases than in controls. Nonetheless, the scores for the General Health Questionnaires, fatigue of Profile of Mood States, and posttraumatic stress disorder checklist were significantly higher in the sarin cases than controls. The investigators added posttraumatic stress disorder to the covariates, and only the score on the digit symbol test was significantly lower in sarin cases. In addition, the results of stepwise multiple regression analysis in 18 sarin cases revealed that scores for the General Health Questionnaires, fatigue of Profile of Mood States (i.e., fatigue, tension-anxiety, depression, and anger-hostility)-together with the paired-associate learning test-were associated significantly with posttraumatic stress disorder. The association did not remain significant for the digit symbol test score. Perhaps a chronic effect on psychomotor performance was caused directly by acute sarin poisoning; on the other hand, the effects on psychiatric symptoms (General Health Questionnaire) and fatigue (Profile of Mood States) appeared to result from posttraumatic stress disorder induced by exposure to sarin.",0 +https://doi.org/10.1080/09540120902732027,The effect of post-traumatic stress disorder on HIV disease progression following hurricane Katrina,"Post-traumatic stress disorder (PTSD) is a common psychological outcome of any disaster. The purpose of this study was to examine the effects of PTSD on disease progression among HIV-infected persons in metropolitan New Orleans post-hurricane Katrina. One-year post-storm, a convenience sample of 145 HIV-infected patients who returned to care at the HIV Outpatient Program clinic in New Orleans were interviewed. Clinical factors pre and one and two years post-disaster were abstracted from medical records and compared by PTSD status. Of the 145 participants, 37.2% had PTSD. Those with PTSD were more likely than those without PTSD to have detectable plasma viral loads at both follow-up time points post-disaster and more likely to have CD4 cell counts <200/mm(3) two years post-disaster. They were also more likely to have had medication interruptions immediately post-disaster. Our findings corroborate the findings of others that PTSD accelerates HIV disease progression. Disaster planners should consider the special counseling and medication safeguards needs of HIV-infected persons.",0 +https://doi.org/10.1016/s0306-4530(03)00027-1,Blunted growth hormone response to clonidine in post-traumatic stress disorder,"Hyperactivity of the sympathetic and noradrenergic systems is thought to be a feature of post-traumatic stress disorder (PTSD). Assessment of noradrenergic receptor function can be undertaken by measuring the growth hormone (GH) response to the α 2 -agonist clonidine. The aim of this study was to examine whether subjects with combat-related PTSD (with or without co-morbid depression) have a blunted growth hormone response to clonidine, compared to a combat-exposed control group. Twenty-three Vietnam veterans suffering from PTSD alone, 27 suffering from PTSD and co-morbid depression, and 32 veteran controls with no psychiatric illness were administered 1.5 μg/kg clonidine i.v. Plasma growth hormone was measured every 20 min for 120 min. The growth hormone response to clonidine was significantly blunted in the non-depressed PTSD group compared to both the depressed PTSD group and the control group as measured by peak growth hormone, delta growth hormone and AUC growth hormone. Subjects with PTSD and no co-morbid depressive illness show a blunted growth hormone response to clonidine. This suggests that post-synaptic α 2 -receptors are subsensitive. This finding is consistent with other studies showing increased noradrenergic activity in PTSD.",0 +https://doi.org/10.1016/j.canep.2010.03.014,Multi-chaperone-peptide-rich mixture from colo-carcinoma cells elicits potent anticancer immunity,"Chaperones play an important role in inducing anti-cancer immunity. To explore the probability of using chaperone-peptide-rich complexes extracted from colo-carcinoma cells as anti-cancer vaccine, we extracted and prepared chaperone-peptide-rich complexes from CT26 cells, which were subsequently investigated on anti-cancer efficacy.The crude extracts of the CT26 cells treated with heat and Trichosanthin were precipitated with salt and dialyzed to remove proteins below 50kDa and above 300kDa in molecular weight; the proteins with the molecular weights in 70kDa, 90kDa, 95kDa, 110kDa and 170kDa were collected through gel filtration and SDS-PAGE. After confirmation, the purified proteins were used to determine their effects on lymphocyte proliferation, the activities of NK and CTL, tumor suppression and the tumor-bearing mouse survival.The majority of the chaperone-peptides of anti-cancer immunity in CT26 cells, including HSP70-antigen peptide, HSP90-antigen peptide, gp96-antigen peptide, HSP-110 antigen peptide, HSP170-antigen peptide, was satisfactorily extracted that the multi-chaperone-peptide-rich mixtures were obtained. All the mixtures prepared could elicit lymphocyte proliferation, enhance the activities of CTL and NK, reinforce the tumor suppression and prolong the mouse survival.The multi-chaperone-peptide-rich mixtures could be prepared via dialysis and gel filtration combining with SDS-PAGE. Both the heat stress and Trichosanthin could induce and increase the mixtures, of which that treated by 42 degrees C heat and Trichosanthin was found to possess the strongest anti-cancer efficacy.",0 +https://doi.org/10.1136/oemed-2011-100382.156,Post-deployment BATTLEMIND training for the UK Armed Forces: a cluster-randomised controlled trial,"Objectives Combat exposure can increase the risk of subsequent psychological ill-health in Armed Forces (AF) personnel. A US post-deployment psycho-educational intervention, Battlemind, has shown a beneficial effect on mental health in US military personnel exposed to high levels of potentially traumatic combat events. Our aim was to evaluate the efficacy of Battlemind in UK AF personnel. Methods Battlemind was compared with the UK standard post-deployment stress and homecoming brief in a cluster randomised controlled trial. 2443 UK AF personnel returning from Afghanistan via Cyprus completed a questionnaire about combat experiences and current mental health status before receiving their randomly allocated intervention, of these, 1616 (66%) completed follow-up approximately 6 months later. Primary outcomes were the General Health Questionnaire (GHQ-12) to measure common mental disorders, and the post traumatic stress disorder checklist (PCL-C) to measure probable PTSD. Secondary outcomes included alcohol misuse, assessed with the AUDIT. The two study arms were compared using mixed-effect models to take account of possible cluster effects. Results We did not find a difference in mental health or overall AUDIT score between Battlemind and the standard brief. Those who received Battlemind were less likely to be classified as binge drinkers than those receiving the standard brief (adjusted OR 0.73 (95% CI 0.58 to 0.92)). Conclusions UK post-deployment Battlemind did not improve mental health compared with the standard post-deployment brief. However, it had a modest impact on reported binge drinking. Alcohol misuse is problematic in the UK AF so an intervention that reduces binge drinking may be helpful.",0 +https://doi.org/10.1016/j.jcrimjus.2015.09.001,Socially disorganized yet safe: Understanding resilience to crime in neighborhoods in New Zealand,"Abstract Purpose Drawing on theories from environmental criminology, this article identifies neighborhood-level characteristics that promote resiliency in neighborhoods in New Zealand with disadvantageous socioeconomic settings. Methods We used neighborhood-level crime (2008–2010) and socio-economic data to develop a Crime Resilience Index for New Zealand (CRINZ) to quantify neighborhood level resilience to crime across the country. We then examined relationships between the index and a suite of built and social neighborhood-level characteristics. Results Access to built environment factors generally decreased across neighborhoods stratified by resiliency. That is, resilient neighborhoods had decreased access to a range of healthcare, education, and living infrastructures. Very little difference was found in the social environment of high resilient and low resilient neighborhoods in New Zealand. Conclusions Understanding why communities respond differently in similar environments can enable communities to respond better or more effectively to such stressful environments and consequently build resilience. Identifying ‘place-specific’ resilience factors can be effective in reducing crime in neighborhoods.",0 +https://doi.org/10.1007/s12144-015-9338-6,Hurricane Katrina: Maternal Depression Trajectories and Child Outcomes,"The authors examined depression trajectories over two years among mothers exposed to Hurricane Katrina. Risk and protective factors for depression trajectories, as well as associations with child outcomes were analyzed.This study included 283 mothers (age at time 1, M = 39.20 years, SD = 7.21; 62% African American). Mothers were assessed at four time points over two years following Hurricane Katrina. Mothers reported posttraumatic stress symptoms, hurricane exposure, traumatic life events, and social support at time 1. Depressive symptoms were modeled at times 2, 3, and 4. Youth reported their distress symptoms (posttraumatic stress, depression, and anxiety) at time 4.Latent class growth analyses identified three maternal depression trajectories among mothers exposed to Hurricane Katrina: low (61%), resilient (29%), and chronic (10%). Social support was identified as a protective factor among mothers.Three main trajectories of maternal depression following Hurricane Katrina were identified. Social support was protective for mothers. Identified trajectories were not associated with children's distress outcomes. These results have implications for disaster responses, screening efforts, and interventions targeted towards families. Future studies warrant the investigation of additional risk and protective factors that can affect maternal and child outcomes.",0 +https://doi.org/10.1352/0895-8017(2008)113[133:powwhm]2.0.co;2,Profiles of Women Who Have Mental Retardation With and Without a Documented History of Abuse,"Thirty-six women with mental retardation were divided into two groups on the basis of whether they had a documented history of abuse during the preceding 5 years. The women with this history were more likely than the women with no documented history of abuse to be employing passive/avoidant decision-making strategies, reporting higher levels of stress, having dual diagnoses, be receiving counseling, and relying on others to go out into the community. We recommend that special attention be paid to designing interventions that are tailored to the specific needs of these women.",0 +https://doi.org/10.7205/milmed.173.12.1158,"Post-Traumatic Stress Reactions before the Advent of Post-Traumatic Stress Disorder: Potential Effects on the Lives and Legacies of Alexander the Great, Captain James Cook, Emily Dickinson, and Florence Nightingale","Evidence is presented that Alexander the Great, Captain James Cook, Emily Dickinson, and Florence Nightingale each developed symptoms consistent with post-traumatic stress disorder in the aftermath of repeated potentially traumatizing events of differing character. Their case histories also varied with respect to background, premorbid personality style, risk factors, clinical presentation, and course of the illness, illustrating the pleomorphic character of the disorder, as well as the special problems in diagnosing it in historical figures.",0 +https://doi.org/10.1097/00004583-199908000-00018,When the Earth Stops Shaking: Earthquake Sequelae Among Children Diagnosed for Pre-Earthquake Psychopathology,"To examine risk and protective processes for posttraumatic stress reactions and negative sequelae following the Northridge earthquake (EQ) among youths diagnosed for pre-EQ psychopathology.Symptoms of posttraumatic stress disorder (PTSD), depression, general anxiety, and social impairment were evaluated using telephone interviews among 66 children participating in a family-genetic study of childhood-onset depression at the time of the EQ.Significant predictors of PTSD symptoms 1 year after the EQ included perceived stress and resource loss associated with the EQ, a pre-EQ anxiety disorder, and more frequent use of cognitive and avoidance coping strategies. PTSD symptoms were associated with high rates of concurrent general anxiety symptoms, depressive symptoms, and social adjustment problems with friends. The only significant correlation between sibling scores was on measures of sibling reports of objective exposure.Preexisting anxiety disorders represent a risk factor for postdisaster PTSD reactions. Postdisaster services need to attend to the needs of these youths as well as those of youths experiencing high levels of subjective stress, resource loss, and/or high exposure. That children within families show significant variation in postdisaster reactions underscores the need for attention to individual child characteristics and unshared environmental attributes.",0 +https://doi.org/10.1186/1471-2458-12-554,Different Points of a Continuum? Cross Sectional Comparison of the Current and Pre-contact Psychosocial Problems among the Different Categories of Adolescents in Institutional Care in Nigeria,"The combination of adverse social indicators and a predominantly youthful population puts Nigeria, and indeed many countries of sub-Sahara Africa, at the risk of explosion in the number of youth coming in contact with the juvenile justice system. Despite this risk, custodial childcare systems in the region are still poorly developed with both juvenile offenders and neglected adolescents coming in contact with the systems being kept in the same incarcerating facility. The needs of these different groups of adolescents may be different. Knowing their common and unique needs can inform common prevention strategies and ensure that specific service-needs of different categories of adolescents in institutional custody are met.Data on the family background, pre-contact social circumstance, neurological and anthropometric profiles, and certain aspects of mental health of adolescents drawn from two juvenile justice institutions in Nigeria were obtained. The results for the adolescents on 'criminal code' and those admitted as a case of child neglect were compared using chi-square and odd ratios.Participants were 211 adolescents comprising of 158 on 'criminal code' and 53 declared as 'neglected'. A lot of similarities were found. For instance, the prevalence of parental separation, family transition, experience of street-life and lifetime exposure to traumatic events and posttraumatic stress was equally high among the two groups of adolescents. The adolescents on 'criminal code' however had significantly higher prevalence of conduct and alcohol/substance use disorders while the child neglect group had poorer anthropometric profiles and higher prevalence of neurological disorders.Child neglect and juvenile delinquency in Nigeria may truly be different points of a continuum. There are however fundamental differences that can warrant specific prevention strategies and tailor-made service provision while in custodial care.",0 +https://doi.org/10.1016/j.injury.2009.06.309,The effect of compensation claims on outcomes after injury,,0 +https://doi.org/10.2458/v22i1.21077,Notes on the practice of food justice in the U.S.: understanding and confronting trauma and inequity,"The lexicon of the U.S. food movement has expanded to include the term 'food justice.' Emerging after approximately two decades of food advocacy, this term frames structural critiques of agri-food systems and calls for radical change. Over those twenty years, practitioners and scholars have argued that the food movement was in danger of creating an 'alternative' food system for the white middle class. Alternative food networks drew on white imaginaries of an idyllic communal past, promoted consumer-oriented, market-driven change, and left yawning silences in the areas of gendered work, migrant labor, and racial inequality. Justice was often beside the point. Now, among practitioners and scholars we see an enthusiastic surge in the use of the term food justice but a vagueness on the particulars. In scholarship and practice, that vagueness manifests in overly general statements about ending oppression, or morphs into outright conflation of the dominant food movement's work with food justice (see What does it mean to do food justice? Cadieux and Slocum (2015), in this Issue). In this article, we focus on one of the four nodes (trauma/inequity, exchange, land and labor) around which food justice organizing appears to occur: acknowledging and confronting historical, collective trauma and persistent race, gender, and class inequality. We apply what we have learned from our research in U.S. and Canadian agri-food systems to suggest working methods that might guide practitioners as they work toward food justice, and scholars as they seek to study it. In the interests of ensuring accountability to socially just research and action, we suggest that scholars and practitioners need to be more clear on what it means to practice food justice. Towards such clarity and accountability, we urge scholars and practitioners to collaboratively document how groups move toward food justice, what thwarts and what enables them.",0 +https://doi.org/10.1093/biostatistics/3.4.459,General growth mixture modeling for randomized preventive interventions,"This paper proposes growth mixture modeling to assess intervention effects in longitudinal randomized trials. Growth mixture modeling represents unobserved heterogeneity among the subjects using a finite-mixture random effects model. The methodology allows one to examine the impact of an intervention on subgroups characterized by different types of growth trajectories. Such modeling is informative when examining effects on populations that contain individuals who have normative growth as well as non-normative growth. The analysis identifies subgroup membership and allows theory-based modeling of intervention effects in the different subgroups. An example is presented concerning a randomized intervention in Baltimore public schools aimed at reducing aggressive classroom behavior, where only students who were initially more aggressive showed benefits from the intervention.",0 +https://doi.org/10.1002/da.20775,Informing the symptom profile of complicated grief,"Background: Complicated Grief (CG) is under consideration as a new diagnosis in DSM5. We sought to add empirical support to the current dialogue by examining the commonly used Inventory of Complicated Grief (ICG) scale completed by 782 bereaved individuals. Methods: We employed IRT analyses, factor analyses, and sensitivity and specificity analyses utilizing our full sample (n = 782), and also compared confirmed CG cases (n = 288) to noncases (n = 377). Confirmed CG cases were defined as individuals bereaved at least 6 months who were seeking care for CG, had an ICG≥30, and received a structured clinical interview for CG by a certified clinician confirming CG as their primary illness. Noncases were bereaved individuals who did not present with CG as a primary complaint (including those with depression, bipolar disorder, anxiety disorders, and controls) and had an ICG<25. Results: IRT analyses provided guidance about the most informative individual items and their association with CG severity. Factor analyses demonstrated a single factor solution when the full sample was considered, but within CG cases, six symptom clusters emerged: (1) yearning and preoccupation with the deceased, (2) anger and bitterness, (3) shock and disbelief, (4) estrangement from others, (5) hallucinations of the deceased, and (6) behavior change, including avoidance and proximity seeking. The presence of at least one symptom from three different symptom clusters optimized sensitivity (94.8%) and specificity (98.1%). Conclusions: These data, derived from a diverse and predominantly clinical help seeking population, add an important perspective to existing suggestions for DSM5 criteria for CG. Depression and Anxiety, 2011. © 2010 Wiley-Liss, Inc.",0 +https://doi.org/10.1037/a0027664,Postdeployment Battlemind training for the U.K. armed forces: A cluster randomized controlled trial.,"Combat exposure can increase the risk of subsequent psychological ill-health in armed forces (AF) personnel. A U.S. postdeployment psycho-educational intervention, Battlemind, showed a beneficial effect on mental health in U.S. military personnel exposed to high combat levels. We evaluated the effectiveness of an anglicized version of postdeployment Battlemind.Battlemind was adapted for the United Kingdom. The main amendments were to sections about carrying weapons, driving, and alcohol misuse. The anglicized Battlemind was compared with the U.K. standard postdeployment brief in a cluster randomized controlled trial. At baseline, 2,443 U.K. AF personnel returning from Afghanistan via Cyprus completed questionnaires about their combat experiences and mental health. Of these, 1,616 (66%) completed 6-month follow-up questionnaires. We used the Posttraumatic Stress Disorder Checklist (PCL-C) to measure probable posttraumatic stress disorder and the General Health Questionnaire (GHQ-12) to measure common mental disorders. Secondary outcomes included alcohol misuse, assessed with the Alcohol Use Disorders Identification Test (AUDIT), and binge drinking. Mixed-effects models were used to account for possible cluster effects.We did not find a difference in mental health or overall AUDIT score. Those who received Battlemind versus the standard brief were less likely to report binge drinking, although the effect size was small (adjusted odds ratio = 0.73, 95% CI [0.58, 0.92]).The anglicized Battlemind did not improve mental health but had a modest impact on the reporting of binge drinking. Alcohol misuse is problematic in military populations; therefore, an intervention that reduces binge drinking may be helpful.",0 +https://doi.org/10.1371/journal.pone.0083967,White Matter Microstructural Changes as Vulnerability Factors and Acquired Signs of Post-Earthquake Distress,"Many survivors of severe disasters need psychological support, even those not suffering post-traumatic stress disorder (PTSD). The critical issue in understanding the psychological response after experiencing severe disasters is to distinguish neurological microstructural underpinnings as vulnerability factors from signs of emotional distress acquired soon after the stressful life event. We collected diffusion-tensor magnetic resonance imaging (DTI) data from a group of healthy adolescents before the Great East Japan Earthquake and re-examined the DTIs and anxiety levels of 30 non-PTSD subjects from this group 3-4 months after the earthquake using voxel-based analyses in a longitudinal DTI study before and after the earthquake. We found that the state anxiety level after the earthquake was negatively associated with fractional anisotropy (FA) in the right anterior cingulum (Cg) before the earthquake (r = -0.61, voxel level p<0.0025, cluster level p<0.05 corrected), and positively associated with increased FA changes from before to after the earthquake in the left anterior Cg (r = 0.70, voxel level p<0.0025, cluster level p<0.05 corrected) and uncinate fasciculus (Uf) (r = 0.65, voxel level p<0.0025, cluster level p<0.05 corrected). The results demonstrated that lower FA in the right anterior Cg was a vulnerability factor and increased FA in the left anterior Cg and Uf was an acquired sign of state anxiety after the earthquake. We postulate that subjects with dysfunctions in processing fear and anxiety before the disaster were likely to have higher anxiety levels requiring frequent emotional regulation after the disaster. These findings provide new evidence of psychophysiological responses at the neural network level soon after a stressful life event and might contribute to the development of effective methods to prevent PTSD.",0 +https://doi.org/10.1080/13623690108409553,"Stories of pre‐war, war and exile: Bosnian refugee children in Sweden","While standardized questionnaires produce counts of isolated events, a semi-structured interview derives a story, a complex narrative in time and place. Ninety Bosnian refugee children and adolescents (ages 1-20), resettled in Sweden, were assessed in a semi-structured clinical interview designed to identify and offer support to children at risk. A family-child account of traumatic exposure was analysed quantitatively and qualitatively. Type-stories or clusters of experience were identified for three distinct periods: prior to war, during war, and after war in exile. The extent of trauma-stress exposure during each of these periods proved unrelated. Pre-war experience presented as preponderantly good and safe. Differences in child exposure during war and exile could be understood in relation to identifiable socio-demographic factors; particularly ethnic background, social class, child age and family size. Further, the stories derived cast light on the equity of Swedish refugee reception, exposing both egalitarian and discriminatory tendencies.",0 +https://doi.org/10.4314/ajpsy.v11i1.30255,Post traumatic stress disorder symptoms in a psychiatric population not presenting with trauma: a preliminary study,"Post Traumatic Stress Disorder (PTSD) is a diagnostic category used to describe symptoms arising from emotionally traumatic experience(s). Research suggests that PTSD may be under- diagnosed when trauma is not the presenting problem or when not the focus of clinical intervention. There is a dearth of South African information on the prevalence of PTSD in a psychiatric population. The aim of this study was to determine the prevalence and comorbidity of PTSD in a psychiatric population, not presenting on the basis of trauma.The study was cross sectional and conducted at a psychiatric outpatient clinic in the Durban Metropolitan area. The sample was obtained from patients seen at follow up over a period of twelve weeks. The researcher randomly selected prospective participants and at the end of their consultation the purpose of the study was explained and they were invited to participate. Demographic characteristics and diagnosis were recorded. Thereafter, the Zulu version of the Modified Posttraumatic Diagnostic Scale (MPDS) was administered and data collected.The study demonstrated that 22% of subjects reported symptoms of PTSD where the primary presentation was not trauma related.A significant number of psychiatric patients presenting for non-trauma related psychopathology report symptoms of PTSD when specifically questioned. The findings suggest that such questioning may be overlooked when dealing with psychiatric patients who do not specifically present on the basis of trauma.",0 +https://doi.org/10.1007/s00127-012-0537-2,"Potentially traumatic event exposure, posttraumatic stress disorder, and Axis I and II comorbidity in a population-based study of Norwegian young adults","Epidemiologic research on traumatic stress is limited in Norway. Prevalence and correlates of exposure to potentially traumatic events (PTEs) and posttraumatic stress disorder (PTSD), and patterns of comorbidity with DSM-IV Axis I and II disorders were examined in an epidemiologic sample.Demographics, PTEs and resulting PTSD, and comorbid DSM-IV diagnoses were assessed in 2,794 members of the Norwegian Institute of Public Health Twin Panel. The sample comprised 37% male, with an average age of 28.2 years (SD = 3.9).Approximately, one-quarter of participants had lifetime PTE exposure; most PTEs were more common in men than in women. Lifetime prevalence of PTSD was 2.6%, and was significantly more common in women than men. Being female and type of PTE (both interpersonal and accidental traumatic events) were associated with increased PTSD symptoms, whereas higher education was associated with lower symptoms. PTSD was related to increased odds of most Axis I and II conditions.PTE exposure and PTSD prevalence were lower than in the USA, but comparable to other European countries. Sex differences replicated previous research. The relationship between PTSD and borderline personality disorder was significantly stronger than the relationship between PTSD and any other Axis II conditions.",0 +https://doi.org/10.1016/j.jad.2015.09.072,The role of fathers' psychopathology in the intergenerational transmission of captivity trauma: A twenty three-year longitudinal study,"The aversive impact of combat and parents' combat-induced posttraumatic stress disorder (PTSD) on young children has been examined in a few studies. However, the long-term toll of war captivity on the secondary traumatization (ST) of adult offspring remains unknown. This study aimed to assess the longitudinal associations between former prisoners of war (ex-POWs), PTSD, depressive symptoms and their adult offsprings ST.A sample of 134 Israeli father-child dyads (80 ex-POWs dyads and a comparison group of 44 veterans'dyads) completed self-report measures. The fathers participated in three waves of measurements following the Yom Kippur War (T1: 1991, T2: 2003, and T3: 2008), while the offspring took part in T4 (2013).Offspring of ex-POWs with PTSD at T3 reported more ST symptoms than offspring of ex-POWs without PTSD and controls. Ex-POWs' PTSD hyper-arousal symptom cluster at T3 was positively related to offsprings ST avoidance symptom cluster. Offspring of ex-POWs with chronic and delayed PTSD trajectories reported more ST symptoms than offspring of ex-POWS and controls with resilient trajectories. Ex-POWs' PTSD and depression symptoms at T1, T2 and T3 mediated the link between war captivity (groups) and offsprings ST in T4.The use of self-report measures that did not cover the entire span of 40 years since the war, might may bias the results.The intergenerational transmission of captivity related trauma following the Yom Kippur War was exemplified. ST symptoms among ex-POWs' adult offspring are closely related to their father' PTSD and related depressive symptom comorbidity.",0 +https://doi.org/10.1016/j.psychres.2013.07.041,"The impact of self-efficacy, alexithymia and multiple traumas on posttraumatic stress disorder and psychiatric co-morbidity following epileptic seizures: A moderated mediation analysis","This study investigated the incidence of posttraumatic stress disorder (PTSD) and psychiatric co-morbidity following epileptic seizure, whether alexithymia mediated the relationship between self-efficacy and psychiatric outcomes, and whether the mediational effect was moderated by the severity of PTSD from other traumas. Seventy-one (M=31, F=40) people with a diagnosis of epilepsy recruited from support groups in the United Kingdom completed the Posttraumatic Stress Diagnostic Scale, the Hospital Anxiety and Depression Scale, the Toronto Alexithymia Scale-20 and the Generalized Self-Efficacy Scale. They were compared with 71 people (M=29, F=42) without epilepsy. For people with epilepsy, 51% and 22% met the diagnostic criteria for post-epileptic seizure PTSD and for PTSD following one other traumatic life event respectively. For the control group, 24% met the diagnostic criteria for PTSD following other traumatic life events. The epilepsy group reported significantly more anxiety and depression than the control. Partial least squares (PLS) analysis showed that self-efficacy was significantly correlated with alexithymia, post-epileptic seizure PTSD and psychiatric co-morbidity. Alexithymia was also significantly correlated with post-epileptic seizure PTSD and psychiatric co-morbidity. Mediation analyses confirmed that alexithymia mediated the path between self-efficacy and post-epileptic seizure PTSD and psychiatric co-morbidity. Moderated mediation also confirmed that self-efficacy and PTSD from one other trauma moderated the effect of alexithymia on outcomes. To conclude, people can develop posttraumatic stress disorder symptoms and psychiatric co-morbidity following epileptic seizure. These psychiatric outcomes are closely linked with their belief in personal competence to deal with stressful situations and regulate their own functioning, to process rather than defend against distressing emotions, and with the degree of PTSD from other traumas.",0 +https://doi.org/10.1097/00043764-198909000-00011,A Distinct Pattern of Personality Disturbance following Exposure to Mixtures of Organic Solvents,"To assess systematically the pattern of psychologic distress in chemically exposed workers complaining of personality changes, we administered the Minnesota Multiphasic Personality Inventory to 22 men with a history of exposure to mixtures of organic solvents. Results indicated clinically significant profile elevations in more than 90% of the exposed workers. Moreover, a consistent response profile was noted, indicating a high rate of somatic disturbances, anxiety, depression, social isolation, and fear of losing control. In addition, those workers with the longest exposure duration had the highest elevations on the scale measuring disturbances of thinking, social alienation, poor concentration, and anxiety. Comparisons between these subjects and a group of former prisoners of war with posttraumatic stress disorder revealed strikingly similar clinical profiles. We present a case history that illustrates the nature of this psychologic disturbance.",0 +https://doi.org/10.1007/s001320170008,Post-traumatic kyphosis of the thoracic and lumbar spine,"Assessing the initial post-traumatic situation is of imminent importance in choosing the most suitable approach for primary treatment of thoracic and lumbar spine fractures. Misjudging the static situation of the injured spine is a common reason for selecting an inadequate therapeutic procedure. The consequence is a defective spinal position with the corresponding symptoms, which usually requires a complicated surgical procedure. Our experience is based on 34 patients with a post-traumatic defective position of the thoracic and lumbar spine: 12 patients underwent primary surgical and 22 primary conservative treatment. The aim of our study was to demonstrate the initial situation and primary management as well as subsequent problems and the respective surgical procedure applied in our department for correcting and stabilizing the areas involved and to present intermediate results.",0 +https://doi.org/10.1002/jts.21670,Smoking intensity and severity of specific symptom clusters in posttraumatic stress disorder,"Smoking prevalence among patients with posttraumatic stress disorder (PTSD) is over 40%. Baseline data from the VA Cooperative Studies Program trial of integrated versus usual care for smoking cessation in veterans with PTSD (N = 863) were used in multivariate analyses of PTSD and depression severity, and 4 measures of smoking intensity: cigarettes per day (CPD), Fagerström Test for Nicotine Dependence (FTND), time to first cigarette, and expired carbon monoxide. Multivariate regression analysis showed the following significant associations: CPD with race (B = -7.16), age (B = 0.11), and emotional numbing (B =0 .16); FTND with race (B = -0.94), education (B = -0.34), emotional numbing (B = 0.04), significant distress (B = -0.12), and PHQ-9 (B = 0.04); time to first cigarette with education (B = 0.41), emotional numbing (B = -0.03), significant distress (B = 0.09), and PHQ-9 (B = -0.03); and expired carbon monoxide with race (B = -9.40). Findings suggest that among veterans with PTSD, White race and emotional numbing were most consistently related to increased smoking intensity and had more explanatory power than total PTSD symptom score. Results suggest specific PTSD symptom clusters are important to understanding smoking behavior in patients with PTSD.",0 +https://doi.org/10.1023/a:1024776509667,Coping responses and posttraumatic stress symptomatology in urban fire service personnel,"Emergency workers, including urban fire fighters and paramedics, must cope with a variety of duty-related stressors including traumatic incident exposures. Little is known about coping responses of emergency workers or whether their coping responses predict future mental health outcomes. The previously formulated Coping Responses of Rescue Workers Inventory (CRRWI) underwent a principal components analysis employing a sample (N = 220) of urban fire fighters and paramedics. Six empirically and theoretically distinct CRRWI components were identified which were relatively stable over a 6-month period. Scores on one of the CRRWI scales, but neither years of service nor their past half year's traumatic incident exposures, predicted future changes in self-reports of posttraumatic stress symptomatology.",0 +https://doi.org/10.1016/j.annepidem.2006.12.002,"Reliability of Standard Health Assessment Instruments in a Large, Population-Based Cohort Study","The Millennium Cohort Study began in 2001 using mail and Internet questionnaires to gather occupational and environmental exposure, behavioral risk factor, and health outcome data from a large, population-based US military cohort. Standardized instruments, including the Patient Health Questionnaire, the Medical Outcomes Study Short Form-36 for Veterans, and the Posttraumatic Stress Disorder (PTSD) Checklist–Civilian Version, have been validated in various populations. The purpose of this study was to investigate internal consistency of standardized instruments and concordance of responses in a test-retest setting. Cronbach alpha coefficients were used to investigate the internal consistency of standardized instruments among 76,742 participants. Kappa statistics were calculated to measure stability of aggregated responses in a subgroup of 470 participants who voluntarily submitted an additional survey within 6 months of their original submission. High internal consistency was found for 14 of 16 health components, with lower internal consistency found among two alcohol components. Substantial test-retest stability was observed for stationary variables, while moderate stability was found for more dynamic variables that measured conditions with low prevalence. These results substantiate internal consistency and stability of several standard health instruments applied to this large cohort. Such reliability analyses are vital to the integrity of long-term outcome studies.",0 +https://doi.org/10.1016/s0163-8343(98)00042-5,Posttraumatic stress disorder in response to HIV infection,"This study investigated the psychological impact of HIV infection through assessment of posttraumatic stress disorder in response to HIV infection. Sixty-one HIV-positive homosexual/bisexual men were assessed for posttraumatic stress disorder in response to HIV infection (PTSD-HIV) using a modified PTSD module of the DIS-III-R. Thirty percent met criteria for a syndrome of posttraumatic stress disorder in response to HIV diagnosis (PTSD-HIV). In over one-third of the PTSD cases, the disorder had an onset greater than 6 months after initial HIV infection diagnosis. PTSD-HIV was associated with other psychiatric diagnoses, particularly the development of first episodes of major depression after HIV infection diagnosis. PTSD-HIV was significantly associated with a pre-HIV history of PTSD from other causes, and other pre-HIV psychiatric disorders and neuroticism scores, indicating a similarity with findings in studies of PTSD from other causes. The findings from this preliminary study suggest that a PTSD response to HIV diagnosis has clinical validity and requires further investigation in this population and other medically ill groups. The results support the inclusion of the diagnosis of life-threatening illness as a traumatic incident that may lead to a posttraumatic stress disorder, which is consistent with the DSM-IV criteria.",0 +https://doi.org/10.1097/ta.0b013e318160ba42,Incidence of Posttraumatic Stress Disorder and Mild Traumatic Brain Injury in Burned Service Members: Preliminary Report,"Although sustaining physical injury in theater increases service members' risk for posttraumatic stress disorder (PTSD), exposure to explosive munitions may increase the risk of mild traumatic brain injury (mTBI). We hypothesized a higher incidence of PTSD and mTBI in service members who sustained both burn and explosion injuries than in nonexplosion exposed service members.A retrospective review of PTSD and mTBI assessments was completed on burned service members between September 2005 and August 2006. Subjects were divided into cohort groups: (1) PTSD and mTBI, (2) PTSD and no mTBI, (3) mTBI and no PTSD, (4) no mTBI and no PTSD. Specific criteria used for group classification were based on subjects' total score on Posttraumatic Stress Disorder Checklist, Military version (PCL-M), clinical interview, and record review to meet American Congress of Rehabilitation Medicine criteria for mTBI. Descriptive analyses were used.Seventy-six service members met the inclusion criteria. The incidence rate of PTSD was 32% and mTBI was 41%. Eighteen percent screened positive for PTSD and mTBI; 13% screened positive for PTSD, but not mTBI; 23% screened positive for mTBI but not PTSD; 46% did not screen positive for either PTSD or mTBI.Given the high incidence of these disorders in burned service members, further screening of PTSD and TBI appears warranted. Because symptom presentation in PTSD and mTBI is clinically similar in acute and subacute stages, and treatments can vary widely, further research investigating symptom profiles of PTSD and mTBI is warranted.",0 +https://doi.org/10.1016/j.psychres.2012.02.003,Differentiating PTSD symptomatology with the MMPI-2-RF (Restructured Form) in a forensic disability sample,"The current study was designed to explore models of assessing various forms of Post-Traumatic Stress Disorder (PTSD) symptomatology that incorporate both broad and more narrowly focused affective markers. We used broader markers of demoralization, negative activation, positive activation, and aberrant experiences to predict global PTSD scores, whereas more narrowly focused markers of positive and negative affect were used to differentiate between PTSD symptom clusters. A disability sample consisting of 347 individuals undergoing medico-legal psychological evaluations was used for this study. All participants completed symptom measures of PTSD and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) (from which MMPI-2-RF scores were derived). The results indicated that demoralization was the best individual predictor of PTSD globally, and that more narrowly focused MMPI-2-RF Specific Problems scales provided a differential prediction of PTSD symptom clusters. Theoretical and practical implications of these findings are discussed within contemporary frameworks of internalizing personality and psychopathology.",0 +https://doi.org/10.1016/j.janxdis.2011.07.004,Understanding the relationship of perceived social support to post-trauma cognitions and posttraumatic stress disorder,"Poor social support in the aftermath of a traumatic event is a well-established risk factor for posttraumatic stress disorder (PTSD) among adult trauma survivors. Yet, a great deal about the relationship between social support and PTSD remains poorly understood. In this study, we analyzed data from 102 survivors of a serious motor vehicle accident (MVA) at 4 weeks (Time 1) and 16 weeks (Time 2) post-MVA. We assessed the role of perceived dyadic social support, positive dyadic interaction, and negative dyadic interaction in the development and maintenance of PTSD. In addition, we examined how these social support constructs work together with negative post-trauma cognitions to affect the maintenance of PTSD. Neither perceived social support nor the quality of social interaction (i.e., positive or negative) was associated with PTSD symptom severity at Time 1. However, among those with elevated PTSD symptom severity at Time 1, greater social support and positive social interaction and lower negative social interaction were each associated with reductions in PTSD symptom severity from Time 1 to Time 2. For social support and negative social interaction, this association ceased to be significant when jointly assessed with negative post-trauma cognitions, suggesting that perceived social support and negative dyadic interaction were associated with maintenance of PTSD symptom severity because of their association with negative post-trauma cognitions. These results provide support to models and treatments of PTSD that emphasize the role of negative post-trauma cognitions in maintenance of PTSD.",0 +https://doi.org/10.1016/0163-8343(95)00060-7,Psychiatric evaluation of physical rehabilitation patients,"We conducted a study to demonstrate the frequency and types of psychiatric/psychological symptoms. A Structured Interview according to the DSM-III-R was conducted which demonstrated that 46 (41.4%) of 111 rehabilitation inpatients met the criteria for some forms of psychiatric disorders: 34 patients for major depression, 10 for adjustment disorder with anxious mood, and 2 for posttraumatic stress disorder. The remaining 65 patients (58.6%) showed normal reactions to their diseases. Average length of hospital stay for patients with major depression was significantly longer than those with no or the other types of psychiatric disease. They were also tested with Zung's Self-Rating Anxiety Scale (SAS), Zung's Self-Rating Depression Scale (SDS), and Profile of Mood States (POMS). Three psychological tests were useful in detecting depression or adjustment disorder among rehabilitation patients; however, these tests are not always specific to the type of psychiatric disorders. Patients with higher scores in those three tests should be referred to a psychiatric consultant for detailed examinations and proper treatments, if necessary.",0 +https://doi.org/10.1023/b:jots.0000004077.22408.cf,A descriptive analysis of PTSD chronicity in Vietnam veterans,"This study examined the chronicity of PTSD in 530 male and female Vietnam veterans who were drawn from 2 large, ethnically diverse samples. Delayed onset was common, as was a failure to fully remit: 78% of the 239 veterans with full or partial lifetime PTSD were symptomatic in the 3 months prior to assessment. Cluster analysis identified 4 subtypes of posttraumatic response, with women most likely to be in a delayed onset cluster, and minority men most likely to be in a severe chronic cluster. The extent of chronicity observed in this sample underscores the need for treatments that address the persistence of posttraumatic symptoms.",0 +https://doi.org/10.2174/1568007033482850,The Vasopressin V1b Receptor as a Therapeutic Target in Stress-related Disorders,"The complexity of the stress response would appear to provide multiple opportunities for intervention, but treatment strategies are often centered on the improvement of symptoms rather than attempting to “treat” the stress response. However, recent efforts have begun to focus on the development of pharmacological agents that can attenuate the stress response itself, rather than the symptoms associated with stress. Although CRF, which is the main regulator of the stress system, is the focus of current interest, there is an accumulating body of evidence suggesting that the vasopressinergic system may play an equal role in the regulation of the stress response, and that V1b receptor antagonists may be of potential therapeutic benefit. The availability of SSR149415, the first selective antagonist for the V1b receptor has allowed us to evaluate this hypothesis. SSR149415 is able to attenuate some but not all stress-related behaviors in rodents. While the antidepressant-like activity of the compound was comparable to that of reference antidepressants, the overall profile displayed in anxiety tests was different from that of classical anxiolytics, such as benzodiazepines. The latter were active in a wide range of anxiety models, whereas the V1b receptor antagonist showed clear-cut effects only in particularly stressful situations. It is important to note that SSR149415 is devoid of central depressant effects, even at high doses, and does not affect cognitive processes, suggesting a large therapeutic window. Altogether, these findings suggest that V1b receptor antagonists might be useful as a treatment for major depression and stress disorders that result from traumatic events.",0 +https://doi.org/10.12740/pp/22256,Research and treatment of war neuroses at the Clinic for Nervous and Mental Diseases at the Jagiellonian University in Krakow before World War II in the context of psychiatry in Europe,"Celem artykułu jest przegląd badań dotyczących diagnostyki i leczenia nerwic wojennych w Klinice Neurologiczno-Psychiatrycznej Uniwersytetu Jagiellońskiego przed wybuchem II wojny światowej. Zaprezentowano również działalność profesora Jana Piltza ówczesnego kierownika Kliniki i jego najważniejsze dokonania naukowe. Opisywane w artykule publikacje pochodzą głównie z okresu I wojny światowej i obejmują analizy kliniczne następstw stresu doświadczanego na froncie, a także opis sposobów ich leczenia. Przedstawiono również inne najważniejsze doniesienia z obszaru nerwic wojennych, jakie ukazały się w Europie w tym samym czasie. W artykule zwrócono uwagę na bardzo współczesny i wybiegający ponad ówczesną przeciętność sposób myślenia o leczeniu nerwic wojennych prezentowany przez prof. Piltza i jego zespół. Nowatorskie spojrzenie na ich leczenie związane było przede wszystkim z dostrzeganiem przyczyny nerwicy we wcześniejszych zaburzeniach osobowości pacjentów, zaleceniem psychoterapii jako podstawowej metody leczenia, a także podkreślaniem konieczności dalszej rehabilitacji po zakończeniu leczenia szpitalnego. Przywiązywano także dużą wagę do konieczności indywidualnego opracowywania planów terapii dla każdego z pacjentów.",0 +,Psychopathology in children of Holocaust survivors: a review of the research literature.,"The literature on transgenerational transmission of Holocaust trauma has grown into a rich body of unique psychological knowledge with almost 400 publications. For the time being, however, the transgenerational effect of the Holocaust on the offspring remains a subject of considerable controversy. The main question involves the presence or absence of specific psychopathology in this population. Psychotherapists kept reporting various characteristic signs of distress while research failed to find significant differences between offspring and comparative groups. In an effort to settle this question, the present review of the research literature provides a summary of the findings of 35 comparative studies on the mental state of offspring of Holocaust survivors, published between 1973-1999. This extensive research indicates rather conclusively that the non-clinical population of children of Holocaust survivors does not show signs of more psychopathology than others do. Children of Holocaust survivors tend to function rather well in terms of manifest psychopathology and differences in the mental state of offspring and people in general are small according to most research. The clinical population of offspring, however, tend to present a specific ""psychological profile"" that includes a predisposition to PTSD, various difficulties in separation-individuation and a contradictory mix of resilience and vulnerability when coping with stress.",0 +https://doi.org/10.1016/s0278-5846(02)00338-x,Role of selective serotonin reuptake inhibitors in psychiatric disorders: a comprehensive review,"The selective serotonin reuptake inhibitors (SSRIs) have emerged as a major therapeutic advance in psychopharmacology. As a result, the discovery of these agents marks a milestone in neuropsychopharmacology and rational drug design, and has launched a new era in psychotropic drug development. Prior to the SSRIs, all psychotropic medications were the result of chance observation. In an attempt to develop a SSRI, researchers discovered a number of nontricyclic agents with amine-uptake inhibitory properties, acting on both noradrenergic and serotonergic neurons with considerable differences in potency. A given drug may affect one or more sites over its clinically relevant dosing range and may produce multiple and different clinical effects. The enhanced safety profile includes a reduced likelihood of pharmacodynamically mediated adverse drug-drug interactions by avoiding affects on sites that are not essential to the intended outcome. SSRIs were developed for inhibition of the neuronal uptake pump for serotonin (5-HT), a property shared with the TCAs, but without affecting the other various neuroreceptors or fast sodium channels. The therapeutic mechanism of action of SSRIs involves alteration in the 5-HT system. The plethora of biological substrates, receptors and pathways for 5-HT are candidates to mediate not only the therapeutic actions of SSRIs, but also their side effects. A hypothesis to explain these immediate side effects is that 5-HT is increased at specific 5-HT receptor subtypes in discrete regions of the body where the relevant physiologic processes are regulated. Marked differences exist between the SSRIs with regard to effects on specific cytochrome P450 (CYP) enzymes, and thus the likelihood of clinically important pharmacokinetic drug-drug interactions. Although no clear relationship exists between the clinical efficacy, plasma concentration of SSRIs, nor any threshold that defines toxic concentrations, but therapeutic drug monitoring (TDM) may be useful in special populations, such as in elderly patients, poor metabolizers (PM) of sparteine (CYP2D6) or mephenytoin (CYP2C19), and patients with liver and kidney impairment. Several meta-analyses have reviewed the comparative efficacy of TCAs and SSRIs, and concluded that both TCAs and SSRIs have similar efficacy in the treatment of depression. SSRIs have demonstrated better efficacy and tolerability in the treatment of obsessive compulsive disorder (OCD). They have also been found to be effective in the treatment for social anxiety disorder both in reducing total levels of social anxiety and in improving overall clinical condition. The benefit of SSRIs in anorexia nervosa (AN) is apparently short-term unless medication is given in the context of nutritional or behavioral therapy. No single antidepressant can ever be recommended for every patient, but in a vast majority of patients, SSRIs should be considered as one of the first-line drugs in the treatment of depression.",0 +https://doi.org/10.1080/02646830600643874,"Postnatal depression and post‐traumatic stress after childbirth: Prevalence, course and co‐occurrence","Research relating to the postnatal mental health of women has tended to focus on postnatal depression. There have been increasing calls to consider the issue of post-partum anxiety disorders, including post-traumatic stress disorder (PTSD). This study sought to provide further evidence regarding the prevalence and longitudinal course of post-traumatic stress symptoms resulting from traumatic birth experiences. The study also investigated the extent to which symptoms of trauma and depression occur together in the postnatal period. Four hundred women were recruited from the maternity ward of a public hospital in South West Sydney. Symptoms of birth trauma and postnatal depression were assessed via questionnaires given at birth, 6 weeks, 6 months and 12 months post-partum. The prevalence of having a PTSD profile at 6 weeks post-partum was 2%. A further 10.5% of women reported experiencing significant distress related to childbirth and several symptoms of post-traumatic stress without meeting full diagnostic criteria. The prevalence of a PTSD profile remained relatively stable across the first 12 months post-partum, with estimates being 2.6% at 6 months and 2.4% at 12 months. The co-morbidity between post-traumatic stress and postnatal depression was high at all three time points. The study highlights the potentially chronic nature of PTSD after childbirth and the importance of viewing post-partum emotional distress in a broader context than simply postnatal depression.",0 +https://doi.org/10.1177/1363461510364573,"Communal Violence and Child Psychosocial Well-being: Qualitative Findings from Poso, Indonesia","This exploratory study examined the health care system in relation to communal violence-related psychosocial wellbeing in Poso, Indonesia, as preparation for conducting a cluster randomized trial of a psychosocial intervention. We employed focus groups with children ( N = 9), parents ( N = 11), and teachers ( N = 8), as well as semi-structured interviews with families affected by communal violence ( N = 42), and key informants ( N = 33). An interrelated set of problems was found that included poverty, an indigenized trauma construct, morally inappropriate behavior, inter-religious tensions, and somatic problems. Participants emphasized social-ecological interactions between concerns at different systemic levels, although problems were mainly addressed through informal care by families. The programmatic and research implications of these findings are discussed.",0 +https://doi.org/10.1016/j.pscychresns.2008.07.014,Functional connectivity reveals inefficient working memory systems in post-traumatic stress disorder,"We applied a covariance-based multivariate analysis to functional magnetic resonance imaging (fMRI) data to investigate abnormalities in working memory (WM) systems in patients with post-traumatic stress disorder (PTSD). Patients (n=13) and matched controls (n=12) were scanned with fMRI while updating or maintaining trauma-neutral verbal stimuli in WM. A multivariate statistical analysis was used to investigate large-scale brain networks associated with these experimental tasks. For the control group, the first network reflected brain activity associated with WM updating and principally involved bilateral prefrontal and bilateral parietal cortex. Controls' second network was associated with WM maintenance and involved regions typically activated during storage and rehearsal of verbal material, including lateral premotor and inferior parietal cortex. In contrast, PTSD patients appeared to activate a single fronto-parietal network for both updating and maintenance tasks. This is indicative of abnormally elevated activity during WM maintenance and suggests inefficient allocation of resources for differential task demands. A second network in PTSD, which was not activated in controls, showed regions differentially activated between WM tasks, including the anterior cingulate, medial prefrontal cortex, fusiform and supplementary motor area. These activations may be linked to hyperarousal and abnormal reactivity, which are characteristic of PTSD.",0 +https://doi.org/10.1136/bmj.39430.638241.ae,New onset and persistent symptoms of post-traumatic stress disorder self reported after deployment and combat exposures: prospective population based US military cohort study,"To describe new onset and persistence of self reported post-traumatic stress disorder symptoms in a large population based military cohort, many of whom were deployed in support of the wars in Iraq and Afghanistan.Prospective cohort analysis.Survey enrolment data from the millennium cohort (July 2001 to June 2003) obtained before the wars in Iraq and Afghanistan. Follow-up (June 2004 to February 2006) data on health outcomes collected from 50 184 participants.Self reported post-traumatic stress disorder as measured by the posttraumatic stress disorder checklist-civilian version using Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria.More than 40% of the cohort were deployed between 2001 and 2006; between baseline and follow-up, 24% deployed for the first time in support of the wars in Iraq and Afghanistan. New incidence rates of 10-13 cases of post-traumatic stress disorder per 1000 person years occurred in the millennium cohort. New onset self reported post-traumatic stress disorder symptoms or diagnosis were identified in 7.6-8.7% of deployers who reported combat exposures, 1.4-2.1% of deployers who did not report combat exposures, and 2.3-3.0% of non-deployers. Among those with self reported symptoms of post-traumatic stress disorder at baseline, deployment did not affect persistence of symptoms.After adjustment for baseline characteristics, these prospective data indicate a threefold increase in new onset self reported post-traumatic stress disorder symptoms or diagnosis among deployed military personnel who reported combat exposures. The findings define the importance of post-traumatic stress disorder in this population and emphasise that specific combat exposures, rather than deployment itself, significantly affect the onset of symptoms of post-traumatic stress disorder after deployment.",0 +https://doi.org/10.1097/yco.0b013e32833f5585,Current research on cognitive aspects of anxiety disorders,"Cognitive dysfunction is frequently reported in anxiety disorders. Our aim is to describe recent advances concerning these cognitive aspects.Cognitive dysfunction in anxiety disorders can be classified into four domains. The first concerns executive functions, mainly attentional processes. The second concerns memory, including deficits in working, episodic, and autobiographical memory. The third encompasses maladaptive cognitions, or thoughts and beliefs. Finally, a burgeoning area of research (mainly in obsessive-compulsive disorder and posttraumatic stress disorder) concerns metacognitions, or thoughts and beliefs about one's own thoughts and beliefs. All of these dysfunctions may contribute to maintain or aggravate anxiety disorders. When developing and implementing interventions, researchers and clinicians alike must consider these cognitive aspects, and may need to tailor their approaches accordingly.Advances have clearly been made in the elucidation of the cognitive functioning associated with anxiety disorders. It remains unclear if particular cognitive profiles can help to distinguish anxiety disorders from one another, although emerging evidence suggests this may be the case. Further clarification will add to our understanding of the development and maintenance of these disorders, and may provide targets for future therapy and endophenotypes.",0 +https://doi.org/10.1016/j.pmrj.2015.03.007,Psychological Distress After Orthopedic Trauma: Prevalence in Patients and Implications for Rehabilitation,"Orthopedic trauma is an unforeseen life-changing event. Serious injuries include multiple fractures and amputation. Physical rehabilitation has traditionally focused on addressing functional deficits after traumatic injury, but important psychological factors also can dramatically affect acute and long-term recovery. This review presents the effects of orthopedic trauma on psychological distress, potential interventions for distress reduction after trauma, and implications for participation in rehabilitation. Survivors commonly experience post-traumatic stress syndrome, depression, and anxiety, all of which interfere with functional gains and quality of life. More than 50% of survivors have psychological distress that can last decades after the physical injury has been treated. Early identification of patients with distress can help care teams provide the resources and support to offset the distress. Several options that help trauma patients navigate their short-term recovery include holistic approaches, pastoral care, coping skills, mindfulness, peer visitation, and educational resources. The long-term physical and mental health of the trauma survivor can be enhanced by strategies that connect the survivor to a network of people with similar experiences or injuries, facilitate support groups, and social support networking (The Trauma Survivors Network). Rehabilitation specialists can help optimize patient outcomes and quality of life by participating in and advocating these strategies.",0 +https://doi.org/10.1111/psyp.12148,"Cardiac stability at differing levels of temporal analysis in panic disorder, post-traumatic stress disorder, and healthy controls","The panic disorder (PD) literature provides evidence for both physiologic rigidity and instability as pathognomonic features of this disorder. This ambiguity may be a result of viewing PD at differential levels of temporal analysis. We assessed cardiac variability across three levels of temporal scale in PD patients, post-traumatic stress disorder (PTSD) patients, and healthy controls. Sixteen healthy controls, 14 PD patients, 23 PTSD patients, and 16 PTSD + PD patients presented for a polysomnogram. Differences were assessed in respiratory sinus arrhythmia (RSA), autoregressive stability of heart rate (HR), and the number of nonspecific accelerations in HR over the night. No differences in RSA were found between groups; however, PD patients exhibited significantly lower autoregressive HR stability, and all patients had significantly more HR accelerations than controls. These data reinforce prior findings demonstrating physiologic instability in PD and indicate that prior equivocalities regarding physiologic variability in PD may be due to limited temporal scaling of measurements.",0 +https://doi.org/10.1177/008124631104100403,PTSD Symptoms in Intellectually Disabled Victims of Sexual Assault,"The high rates of sexual violence in the country suggest that people with intellectual disabilities (ID) are likely to be sexually victimised. Rape and sexual assault have negative consequences for survivors, with Post Traumatic Stress Disorder (PTSD) being the most common psychiatric diagnosis used to capture the reaction to this trauma. This study sought to investigate the presence of PTSD symptoms in a group of people with ID who had been sexually abused. The Child PTSD Checklist was administered to 54 individuals with ID — 27 with and 27 without a known history of sexual abuse. The Checklist was also administered to the care-givers of those who had been sexually abused. Higher rates of a PTSD diagnosis and a higher intensity of PTSD symptoms were found in the group with than in the group without a history of sexual abuse. There were no significant differences between self and care-giver reports with respect to the prevalence of a PTSD diagnosis, but there were differences on the different symptom clusters. The results indicate that survivors with ID should be asked directly about their internal subjective experiences, with care-giver reports being used as collateral information, and that therapeutic interventions following sexual abuse should be offered.",0 +https://doi.org/10.1177/2158244014554386,Using the Brief Resilience Scale to Assess Chinese People’s Ability to Bounce Back From Stress,"This study examined the utility of an adapted version of the Brief Resilience Scale (BRS) to measure Chinese undergraduates’ ability to bounce back from stress. The BRS together with measures tapping optimism, self-esteem, pessimism, and physical health were administered to 547 Hong Kong and 268 mainland Chinese undergraduates. The BRS was found to measure one single construct and exhibited convergent validity in both samples. Further analyses using a path analytic model showed that the BRS scores substantially mediated the link between the two positive traits (optimism and self-esteem) and physical health in the two samples. The results suggested that the BRS is a reliable and valid instrument for measuring Chinese undergraduates’ ability to bounce back from stress. The implications for further research related to resilience in Chinese people are discussed.",0 +https://doi.org/10.1126/science.1128944,The Psychological Risks of Vietnam for U.S. Veterans: A Revisit with New Data and Methods,"In 1988, the National Vietnam Veterans Readjustment Study (NVVRS) of a representative sample of 1200 veterans estimated that 30.9% had developed posttraumatic stress disorder (PTSD) during their lifetimes and that 15.2% were currently suffering from PTSD. The study also found a strong dose-response relationship: As retrospective reports of combat exposure increased, PTSD occurrence increased. Skeptics have argued that these results are inflated by recall bias and other flaws. We used military records to construct a new exposure measure and to cross-check exposure reports in diagnoses of 260 NVVRS veterans. We found little evidence of falsification, an even stronger dose-response relationship, and psychological costs that were lower than previously estimated but still substantial. According to our fully adjusted PTSD rates, 18.7% of the veterans had developed war-related PTSD during their lifetimes and 9.1% were currently suffering from PTSD 11 to 12 years after the war; current PTSD was typically associated with moderate impairment.",0 +https://doi.org/10.1037/a0018745,Comparison of posttraumatic stress disorder symptom structure models in Hispanic and White college students.,"This study tested measurement invariance between Hispanic (n = 226) and White (n = 278) college students' responses to a well-validated measure of posttraumatic stress disorder (PTSD) symptoms. Participants completed the PTSD Checklist-Civilian Version (PCL-C; Weathers, Litz, Herman, Juska, & Keane, 1993); however, trauma histories were not assessed, nor were responses to the PCL-C indexed to a specific traumatic event. Eight models were tested using within-groups confirmatory factor analysis (CFA); 3 models (D. King, Leskin, King, & Weathers, 1998; Simms, Watson, & Doebbeling, 2002; Smith, Redd, DuHamel, Vickberg, & Ricketts, 1999) showed good fit for both ethnic groups, although differences in the degree of fit were observed between the 2 ethnic groups. Models that demonstrated good fit were then compared for equivalence using multiple group CFA. Factor loadings were equivalent between groups, but intercepts differed between groups in all 3 models. Mean item score differences between Hispanic and White groups were observed on items assessing emotional upset with reminders (Item B4) and emotional distancing (Item C5). D. King and colleagues (1998) model resulted in the best measurement invariance. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1177/1534765610396726,Lost in trans-lation: Interpreting systems of trauma for transgender clients.,"Transgender clients frequently experience multiple types of violence (Mizock & Lewis, 2008), including interpersonal (violence that occurs between, at least, two people), self-directed (violence that is self-inflicted), and collective (violence that is inflicted by larger groups of people/institutions; Krug et al., 2002). Transgender clients who experience any of these types of violence are at a higher risk for developing psychiatric symptoms that may require the attention of a mental health care provider (Mizock & Lewis, 2008). Thus, it is crucial that clinicians understand how transgender clients respond to such violence and how these reactions relate to the clinical needs of transgender clients (Lev, 2004). In this article, we will summarize and cluster the types of violence that have been documented in the transgender literature. We will then highlight PTSD and complex PTSD as conceptual frameworks for working with transgender clients. Furthermore, we will examine how the binary notion of gender ignor...",0 +https://doi.org/10.1002/j.1556-6678.2011.tb00063.x,Posttraumatic Stress in U.S. Marines: The Role of Unit Cohesion and Combat Exposure,"Combat exposure is a consistent predictor of posttraumatic stress (PTS). Understanding factors that might buffer the effects of combat exposure is crucial for helping service members weather the stress of war. In a study of U.S. Marines returning from Iraq, hierarchical multiple regression analyses revealed that unit cohesion and combat exposure predicted PTS, depression, and anger. Furthermore, results indicated that unit cohesion may be an important buffer, possibly limiting the development of PTS and depression following combat exposure.",0 +https://doi.org/10.1002/9781119998471.ch1a,Commentaries,,0 +https://doi.org/10.1186/1471-2288-12-185,"From concepts, theory, and evidence of heterogeneity of treatment effects to methodological approaches: a primer","Implicit in the growing interest in patient-centered outcomes research is a growing need for better evidence regarding how responses to a given intervention or treatment may vary across patients, referred to as heterogeneity of treatment effect (HTE). A variety of methods are available for exploring HTE, each associated with unique strengths and limitations. This paper reviews a selected set of methodological approaches to understanding HTE, focusing largely but not exclusively on their uses with randomized trial data. It is oriented for the ""intermediate"" outcomes researcher, who may already be familiar with some methods, but would value a systematic overview of both more and less familiar methods with attention to when and why they may be used. Drawing from the biomedical, statistical, epidemiological and econometrics literature, we describe the steps involved in choosing an HTE approach, focusing on whether the intent of the analysis is for exploratory, initial testing, or confirmatory testing purposes. We also map HTE methodological approaches to data considerations as well as the strengths and limitations of each approach. Methods reviewed include formal subgroup analysis, meta-analysis and meta-regression, various types of predictive risk modeling including classification and regression tree analysis, series of n-of-1 trials, latent growth and growth mixture models, quantile regression, and selected non-parametric methods. In addition to an overview of each HTE method, examples and references are provided for further reading.By guiding the selection of the methods and analysis, this review is meant to better enable outcomes researchers to understand and explore aspects of HTE in the context of patient-centered outcomes research.",0 +https://doi.org/10.2174/138161210791516404,Topiramate in the New Generation of Drugs: Efficacy in the Treatment of Alcoholic Patients,"Predicated upon a neuropharmacological conceptual model, there is now solid clinical evidence to support the efficacy of topiramate for the treatment of alcohol dependence. Topiramate treatment can be initiated whilst the alcohol-dependent individual is still drinking - just when crisis intervention is most likely to be needed by a patient with or without his or her family asking the health practitioner for assistance. Because topiramate can be paired with a brief intervention, there is now the exciting possibility of treating most alcohol- dependent individuals in office-based practice or generic treatment settings. Topiramate's additional effects on other impulsedyscontrol disorders make it a particularly interesting compound for the treatment of other comorbid drug or psychiatric disorders. Additionally, future studies should explore whether topiramate can be combined with other putative therapeutic agents to increase its efficacy. One notable clinical challenge in the development of topiramate as a pharmacotherapy to treat alcohol dependence is the determination of the smallest dose that can result in efficacy, thereby achieving the optimum balance between therapeutic benefit and adverse event profile. Animal data do provide support for topiramate's general anti-drinking effects but also indicate that its mechanisms of action might rely on several complex pharmacobehavioral changes. Additional preclinical studies are needed to elucidate more clearly the basic mechanistic processes that underlie topiramate's efficacy as a treatment for alcohol dependence. Preclinical information that topiramate may have differential effects based on genetic vulnerability opens up the possibility of future methods to optimize treatment.",0 +https://doi.org/10.1146/annurev-med-061610-154046,Traumatic Brain Injury and Its Neuropsychiatric Sequelae in War Veterans,"The post–September 11, 2001 wars in and around Afghanistan and Iraq have increased awareness of traumatic brain injury (TBI), particularly blast-induced mild TBI. This article provides an overview of TBI and its neuropsychiatric sequelae in U.S. war veterans who participated in the current operations in and around Afghanistan and Iraq, with particular emphasis on blast-related mild TBI. Psychiatric disorders, particularly posttraumatic stress disorder, pain, and sensory impairments are prevalent in war veterans with TBI. Research is needed to more definitively characterize the epidemiology of TBI-related functional difficulties, the effects of blasts compared with other mechanisms of injury, recovery trajectories, and treatment outcomes in this population.",0 +https://doi.org/10.1017/s1461145708008961,Onset of activity and time to response on individual CAPS-SX17 items in patients treated for post-traumatic stress disorder with venlafaxine ER: a pooled analysis,"This pooled analysis of data from two randomized, placebo-controlled trials of venlafaxine extended release (ER) assessed onset of activity and time to response on the 17 symptoms of post-traumatic stress disorder (PTSD) listed in DSM-IV and measured by the 17-item Clinician-Administered PTSD Scale (CAPS-SX17). The intent-to-treat (ITT) population comprised 687 patients (placebo, n=347; venlafaxine ER, n=340). Significant (p<0.05) separation between venlafaxine ER and placebo was observed on most CAPS-SX17 items, with earliest onset of activity and response (week 2) on items 5 (physiological reactivity on exposure to cues) and 14 (irritability or anger outbursts), and (week 4) items 1 (intrusive recollections) and 4 (psychological distress at exposure to cues). Onset of activity and response occurred later (generally, weeks 6-8) on items 9 (diminished interest/participation in activities), 10 (detachment or estrangement), 11 (restricted range of affect), 12 (sense of foreshortened future), all associated with numbing, 15 (difficulty concentrating), 16 (hypervigilance), 17 (exaggerated startle response), associated with hyperarousal, and 6 (avoidance of thoughts/feelings or conversations). Significant differences between venlafaxine ER and placebo were largely absent throughout the treatment period and at the primary week-12 end-point for items 2 (distressing dreams), 7 (avoidance of activities, places or people), 8 (inability to recall important aspect of trauma) and 13 (difficulty falling/staying asleep). These results indicate that symptoms of physiological reactivity and psychological distress in response to cues, and irritability/anger outbursts show early and robust improvement with venlafaxine ER treatment, while symptoms of numbing and hyperarousal take longer. The early and persistent effect of venlafaxine ER over placebo on anger/irritability is noteworthy in view of the clinical significance of these symptoms in PTSD.",0 +https://doi.org/10.1002/1097-4679(198909)45:5<709::aid-jclp2270450505>3.0.co;2-p,Co-morbidity: Lessons learned about Post-Traumatic Stress Disorder (PTSD) from developing ptsd scales for the MMPI,"Results from efforts to develop and validate PTSD measures are promising, but a ""gold standard"" has not been achieved. Keane, Malloy, and Fairbank (1984) have developed an MMPI PTSD subscale that has been cross-validated with clinicians' classification of PTSD at acceptable levels of agreement, specificity, and sensitivity. There is, however, room for improvement. Empirical evidence is presented that indicates that the next round of efforts to increase reliability and validity of PTSD measures must account for the presence/absence of co-morbidity (i.e., the simultaneous occurrence of other psychiatric disorders). For example, differences are noted in MMPI group profiles and PTSD scales between psychiatric patients and substance abusers. Second, different MMPI items emerge as indicative of PTSD; these vary as a function of the presence of other Axis I disorders among groups of Vietnam combat veterans who seek treatment for substance abuse. Results substantiate that different MMPI items for classifying PTSD occur with groups that differ in co-morbidity. Improvements in PTSD scale development are more likely when the contributions of pre-existing or subsequently co-occurring psychiatric disorders are taken in account, as well as variations in level of personality maturity. The evidence suggests that a ""family"" of PTSD scales need to be developed that take into account co-morbidity differences.",0 +https://doi.org/10.1016/j.jagp.2012.11.018,Successful Aging Among Older Veterans in the United States,"

Objective

To develop a unidimensional latent model of successful aging and to evaluate sociodemographic, medical, psychiatric, and psychosocial correlates of this construct in a nationally representative sample of older veterans in the United States.

Methods

Data were analyzed from a cross-sectional web survey of 2,025 U.S. veterans aged 60 to 96 years who participated in the National Health and Resilience in Veterans Study. Self-report measures of sociodemographics; subjective physical, mental, and cognitive functioning; and psychosocial characteristics were used. Confirmatory factor analysis was used to construct a unidimensional latent factor of successful aging. Correlates of scores on this factor were then evaluated.

Results

Most older veterans (82.1%) rated themselves as aging successfully. A unidimensional latent factor composed of seven measures of self-rated successful aging, quality of life, and physical, mental, cognitive, and social functioning provided a good fit to the data. Physical health difficulties (β = −0.39) and current psychological distress (β = −0.33) were most strongly negatively related to scores on this latent factor of successful aging, while protective psychosocial characteristics (β = 0.22), most notably resilience, gratitude, and purpose in life, were most strongly positively related to these scores. Additional positive predictors of successful aging included White, non-Hispanic race, being married or living with partner, perceiving a positive effect of the military on one's life, active lifestyle, positive expectations regarding aging, and conscientiousness; additional negative predictors included substance abuse history.

Conclusion

Results of this study provide a dimensional approach to characterizing components and correlates of successful aging in older veterans. Interventions and policy initiatives designed to mitigate physical health difficulties and psychological distress and to enhance protective psychosocial characteristics such as resilience, gratitude, and purpose in life may help promote successful aging in this population.",0 +https://doi.org/10.3402/ejpt.v5.25338,"Resilience definitions, theory, and challenges: interdisciplinary perspectives","In this paper, inspired by the plenary panel at the 2013 meeting of the International Society for Traumatic Stress Studies, Dr. Steven Southwick (chair) and multidisciplinary panelists Drs. George Bonanno, Ann Masten, Catherine Panter-Brick, and Rachel Yehuda tackle some of the most pressing current questions in the field of resilience research including: (1) how do we define resilience, (2) what are the most important determinants of resilience, (3) how are new technologies informing the science of resilience, and (4) what are the most effective ways to enhance resilience? These multidisciplinary experts provide insight into these difficult questions, and although each of the panelists had a slightly different definition of resilience, most of the proposed definitions included a concept of healthy, adaptive, or integrated positive functioning over the passage of time in the aftermath of adversity. The panelists agreed that resilience is a complex construct and it may be defined differently in the context of individuals, families, organizations, societies, and cultures. With regard to the determinants of resilience, there was a consensus that the empirical study of this construct needs to be approached from a multiple level of analysis perspective that includes genetic, epigenetic, developmental, demographic, cultural, economic, and social variables. The empirical study of determinates of resilience will inform efforts made at fostering resilience, with the recognition that resilience may be enhanced on numerous levels (e.g., individual, family, community, culture).",0 +https://doi.org/10.1213/ane.0000000000000265,Psychological Trajectories after Intraoperative Awareness with Explicit Recall,,0 +https://doi.org/10.1016/s0145-2134(96)00134-2,Discriminant validity of the TSC-40 in an outpatient setting,"This study examines the discriminant validity of the Trauma Symptom Checklist (TSC-40) in a clinical sample. The TSC-40 was developed as a research instrument for assessing the impact of a history of sexual victimization. Previous validity studies used nonclinical samples of women (Elliott & Briere, 1992; Gold, Milan, Myall, & Johnson, 1994). In the present study, the TSC-40 was administered to 103 men and 79 women requesting services at two outpatient clinics. Information about sexual victimization was collected from the client during intake and from the therapist after the client had received 6 months of therapy. A history of CSA was associated both with high symptom levels across symptom dimensions, and, specifically, with elevation on the trauma subscale of the TSC-40. The findings support the view that, in a clinical setting, CSA is associated both with generalized distress and with PTSD symptoms.",0 +https://doi.org/10.1111/j.1749-6632.2009.04979.x,Status of Glucocorticoid Alterations in Post-traumatic Stress Disorder,"The current status of glucocorticoid alterations in post-traumatic stress disorder (PTSD) will be described in this chapter. Emphasis will be placed on data that suggest that at least some glucocorticoid-related observations in PTSD reflect pretraumatic glucocorticoid status. Recent observations have provided some evidence that pretraumatic glucocorticoid alterations may arise from genetic, epigenetic, and possibly other environmental influences that serve to increase the likelihood of developing PTSD following trauma exposure, as well as modulate attendant biological alterations associated with its pathophysiology. Current studies in the field of PTSD employ glucocorticoid challenge strategies to delineate effects of exogenously administered glucocorticoids on neuroendocrine, cognitive, and brain function. Results of these studies have provided an important rationale for using glucocorticoid strategies in the treatment of PTSD.",0 +https://doi.org/10.1016/j.pain.2004.12.005,Physical and psychological factors predict outcome following whiplash injury,"Predictors of outcome following whiplash injury are limited to socio-demographic and symptomatic factors, which are not readily amenable to secondary and tertiary intervention. This prospective study investigated the predictive capacity of early measures of physical and psychological impairment on pain and disability 6 months following whiplash injury. Motor function (ROM; kinaesthetic sense; activity of the superficial neck flexors (EMG) during cranio-cervical flexion), quantitative sensory testing (pressure, thermal pain thresholds, brachial plexus provocation test), sympathetic vasoconstrictor responses and psychological distress (GHQ-28, TSK, IES) were measured in 76 acute whiplash participants. The outcome measure was Neck Disability Index scores at 6 months. Stepwise regression analysis was used to predict the final NDI score. Logistic regression analyses predicted membership to one of the three groups based on final NDI scores (<8 recovered, 10-28 mild pain and disability, >30 moderate/severe pain and disability). Higher initial NDI score (1.007-1.12), older age (1.03-1.23), cold hyperalgesia (1.05-1.58), and acute post-traumatic stress (1.03-1.2) predicted membership to the moderate/severe group. Additional variables associated with higher NDI scores at 6 months on stepwise regression analysis were: ROM loss and diminished sympathetic reactivity. Higher initial NDI score (1.03-1.28), greater psychological distress (GHQ-28) (1.04-1.28) and decreased ROM (1.03-1.25) predicted subjects with persistent milder symptoms from those who fully recovered. These results demonstrate that both physical and psychological factors play a role in recovery or non-recovery from whiplash injury. This may assist in the development of more relevant treatment methods for acute whiplash.",0 +https://doi.org/10.1081/ada-120018845,Comparative Profiles Of Women With Ptsd And Comorbid Cocaine Or Alcohol Dependence,"This study examined differences in substance abuse severity, trauma history, posttraumatic stress disorder (PTSD) symptomatology and psychiatric comorbidity among treatment-seeking women (N= 74) with PTSD and either comorbid cocaine or alcohol dependence. Women in the cocaine/PTSD group, compared with the alcohol/PTSD group, demonstrated greater occupational impairment (e.g., greater severity on the employment subscale of the Addiction Severity Index, less monthly income, fewer days worked in past month), more legal problems (e.g., greater number of months incarcerated and arrests for prostitution), and greater social impairment (e.g., fewer number of close friends, less likely to be married). Women in the alcohol/PTSD group evidenced higher rates of exposure to serious accidents, other situations involving serious injury, and other extraordinarily stressful life events. Rates of major depression and social phobia were higher among the alcohol/PTSD group than the cocaine/PTSD group. Women in the alcohol/PTSD group scored higher on the CAPS avoidance, hyperarousal, and total subscale scores. The current findings enhance our understanding of the substance-specific profiles of women with PTSD and comorbid substance use disorders and may have important implications for the design of dual-diagnosis interventions.",0 +https://doi.org/10.1016/j.jad.2007.06.006,A review on cognitive impairments in depressive and anxiety disorders with a focus on young adults,"There is growing evidence for cognitive dysfunction in depressive and anxiety disorders. Nevertheless, the neuropsychological profile of young adult patients has not received much systematic investigation. The following paper reviews the existing literature on cognitive impairments in depressive and anxiety disorders particularly among young adults. Additionally, the focus of young adult age group and the effect of confounding variables on study results are discussed.Electronic database searches were conducted to identify research articles focusing on cognitive impairments in depressive or anxiety disorders among young adults published in English during years 1990-2006.Cognitive impairments are common in young adults with major depression and anxiety disorders, although their nature remains partly unclear. Accordingly, executive dysfunction is evident in major depression, but other more specific deficits appear to depend essentially on disorder characteristics. The profile of cognitive dysfunction seems to depend on anxiety disorder subtype, but at least obsessive-compulsive disorder is associated with deficits in executive functioning and visual memory. The conflicting results may be explained by heterogeneity within study participants, such as illness status, comorbid mental disorders, and medication, and other methodological issues, including inadequate matching of study groups and varying testing procedures.The study is a comprehensive review, but not a formal meta-analysis, due to methodological heterogeneity.Cognitive impairments are common in major depression and anxiety disorders. However, more research is needed to confirm and widen these findings, and to expand the knowledge into clinical practice. Controlling of confounding variables in future studies is highly recommended.",0 +https://doi.org/10.1016/j.pnpbp.2011.03.006,Comorbid obsessive–compulsive personality disorder in obsessive–compulsive disorder (OCD): A marker of severity,"Comorbid obsessive-compulsive personality disorder (OCPD) is well-described in obsessive-compulsive disorder (OCD). It remains unclear, however, whether OCPD in OCD represents a distinct subtype of OCD or whether it is simply a marker of severity in OCD.The aim of this study was to compare a large sample of OCD subjects (n=403) with and without OCPD on a range of demographic, clinical and genetic characteristics to evaluate whether comorbid OCPD in OCD represents a distinct subtype of OCD, or is a marker of severity.Our findings suggest that OCD with and without OCPD are similar in terms of gender distribution and age at onset of OC symptoms. Compared to OCD-OCPD (n=267, 66%), those with OCD+OCPD (n=136, 34%) are more likely to present with the OC symptom dimensions which reflect the diagnostic criteria for OCPD (e.g., hoarding), and have significantly greater OCD severity, comorbidity, functional impairment, and poorer insight. Furthermore there are no differences in distribution of gene variants, or response to treatment in the two groups.The majority of our findings suggest that in OCD, patients with OCPD do not have a highly distinctive phenomenological or genetic profile, but rather that OCPD represents a marker of severity.",0 +https://doi.org/10.1186/s13032-015-0029-y,A comparison between survival from cancer before and after a physical traumatic injury: physical trauma before cancer is associated with decreased survival,"Prior traumatic experiences have been associated with poorer coping strategies, greater distress, and more posttraumatic stress disorder (PTSD) symptoms following a subsequent cancer diagnosis affecting their survival. However, the impact of prior physical traumatic injury on cancer survival has not been examined.The present study matched patients from the same Level 1 Trauma center who appeared in both the trauma and cancer registries. A total of 498 patients met the criteria between 1998 and 2014 who have experienced both a diagnosis of cancer and a physical traumatic injury. The survival between the patients who had physical trauma before cancer (TBC) versus those that had physical trauma after the cancer diagnosis (TAC) were compared.The TBC group had a higher percentage of males (48 % vs 33 % p = 0.001) and motor vehicle collisions (18 % vs 7 %, p < 0.001), than the TAC group. TBC patients were also significantly younger than TAC patients at the time of the physical traumatic event (68.7 ± 14.6 vs 76.2 ± 12.0 years, p < 0.001), and longer length of time between the cancer diagnosis and physical traumatic injury (2.9 ± 2.9 vs 1.7 ± 2.6 years, p < 0.001). The overall probability of survival for the entire sample was 68 %. Percent survival for the TBC (n = 251) and TAC (n = 247) groups was 56 and 80 % respectively (p < 0.001). Results were consistent regardless of stage of cancer at diagnosis (hazard ratio (HR (Standard Error)). After adjusting for comorbidities Charlson comorbidity index (CCI) (HR = 1.2 (0.06), p = 0.009)), cancer stage (HR = 2.8 (0.12), p < 0.001)), lung cancer (HR = 1.7 (0.25), p < 0.001) and bladder cancer (HR = 3.5 (0.55), p = 0.02), experiencing a prior physical traumatic injury was associated with an increased HR for mortality of 4.6 (0.93), p < 0.001).A physical traumatic episode before cancer diagnosis (TBC) increased the risk of death 4.6 fold compared to the TAC group even after adjusting for CCI, stage of cancer at diagnosis, lung cancer, and bladder cancer. These findings suggest considering a history of physical traumatic injury in cancer patients as a possible risk factor for faster cancer progression and mortality.",0 +https://doi.org/10.1891/0886-6708.24.1.52,"Relationships Between Mobbing at Work and MMPI-2 Personality Profile, Posttraumatic Stress Symptoms, and Suicidal Ideation and Behavior","This study investigates the relationships between the experience of mobbing at work and personality traits and symptom patterns as assessed by means of the revised version of the Minnesota Multiphasic Personality Inventory (MMPI-2). Participants were 107 workers who had contacted mental health services because they perceived themselves as victims of mobbing. In line with previous research, the results showed that the MMPI-2 mean profile was characterized by a neurotic component as evidenced by elevations of Scales 1, 2, and 3 and a paranoid component as indicated by elevation of Scale 6. Contrary to previous research, a pattern of positive and significant correlations was found between the frequency of exposure to mobbing behaviors and the MMPI-2 clinical, supplementary, and content scales, including the posttraumatic stress scale. Only about half the participants showed a severity of posttraumatic stress symptoms indicative of a posttraumatic stress disorder. The frequency of exposure to mobbing predicted suicidal ideation and behavior, with depression only partially mediating this relationship. (",0 +https://doi.org/10.1007/s00115-014-4205-5,Neonatizid,"Background: The term neonaticide describes the act of killing a newborn child by a parent (mostly by the mother) within 24 h after birth. The aim of this study was to establish a classification of female perpetrators using psychopathological, mental, social and biographical characteristics and to make a comparison of the frequency between the old and new federal states in Germany. Material and methods: In this study a total of 63 female German perpetrators who killed at least one newborn between 1986 and 2009 are portrayed and classified by epidemiological and psychopathological characteristics and personality profiles. After obtaining consent from the public prosecutors responsible, data were collected from forensic psychiatric expert opinions and legally valid court verdicts. A questionnaire was established to answer the questions on the psychopathological, e.g. do the women suffer from a mental disease when killing their newborn(s), mental, e.g. can personality accentuations be elicited, social, e.g. are the women unemployed and biographical characteristics of the women, e.g. how old are the women? Finally, an investigation was carried out using significance tests to find out if there was a significant statistical difference in the frequency of neonaticide between the eastern and western federal states. Results: A cluster analysis based on the descriptive analysis was developed. The cluster analysis provided a foundation for a dichotomous classification of the perpetrators depending on five criteria. The first category contained 32 perpetrators who were on average 21 years old, who were primiparous and who hid, ignored or did not perceive their pregnancy. Most of them still lived with their parents. The perpetrators either did not have a mental disease or suffered from an acute stress disorder. The second category contained 31 perpetrators who were on average 25 years old, who were pluriparous, who hid their pregnancy and who lived with their partner. These women either did not have a mental disease or suffer from a personality disorder. A statistically significant higher incidence was found in the eastern federal states of Germany. Conclusion: The presented categorization of female perpetrators into two groups, where the features only show a small degree of overlap, should be taken into consideration in the assessment of the reasons for neonaticide. The typology of female perpetrators is more heterogeneous than previously assumed. The presented typologies and knowledge of conditional constellations involved in neonaticide achieve better prerequisites to be able to recognize persons at risk earlier and to instigate preventive measures. © 2015, Springer-Verlag Berlin Heidelberg.",0 +https://doi.org/10.1186/1477-7525-12-38,Properties of patient-reported outcome measures in individuals following acute whiplash injury,"The aim of this study was to assess the acceptability, reliability, validity and responsiveness of the Short-Form Health Survey (SF-12) and its preference-based derivative (SF-6D), the EQ-5D and the Neck Disability Index (NDI) in patients recovering from acute whiplash injury.Data from the Managing Injuries of the Neck Trial of 3,851 patients with acute whiplash injury formed the basis of this empirical investigation. The EQ-5D and SF-12 were collected at baseline, and all three outcome measures were then collected at 4 months, 8 months and 12 months post-randomisation. The measures were assessed for their acceptability (response rates), internal consistency, validity (known groups validity and discriminant validity) and their internal and external responsiveness.Response rates were broadly similar across the measures, with evidence of a floor effect for the NDI and a ceiling effect for the EQ-5D utility measure. All measures had Cronbach's α statistics of greater than 0.7, indicating acceptable internal consistency. The NDI and EQ-5D utility score correlated more strongly with the physical component scale of the SF-12 than the mental component scale, whilst this was reversed for the SF-6D utility score. The smaller standard deviations in SF-6D utility scores meant there were larger effect sizes for differences in utility score between patients with different injury severity at baseline than for the EQ-5D utility measure. However, the EQ-5D utility measure and NDI were both more responsive to longitudinal changes in health status than the SF-6D.There was no evidence of differences between the EQ-5D utility measure and NDI in terms of their construct validity, discriminant validity or responsiveness in patients with acute whiplash injury. However, both demonstrated superior responsiveness to longitudinal health changes than the SF-6D.",0 +https://doi.org/10.3109/00048670903393597,Prevalence Estimates of Combat-Related Post-Traumatic Stress Disorder: Critical Review,"The aim of the present study was to provide a critical review of prevalence estimates of combat-related post-traumatic stress disorder (PTSD) among military personnel and veterans, and of the relevant factors that may account for the variability of estimates within and across cohorts, including methodological and conceptual factors accounting for differences in prevalence rates across nations, conflicts/wars, and studies. MEDLINE and PsycINFO databases were examined for literature on combat-related PTSD. The following terms were used independently and in combinations in this search: PTSD, combat, veterans, military, epidemiology, prevalence. The point prevalence of combat-related PTSD in US military veterans since the Vietnam War ranged from approximately 2% to 17%. Studies of recent conflicts suggest that combat-related PTSD afflicts between 4% and 17% of US Iraq War veterans, but only 3-6% of returning UK Iraq War veterans. Thus, the prevalence range is narrower and tends to have a lower ceiling among combat veterans of non-US Western nations. Variability in prevalence is likely due to differences in sampling strategies; measurement strategies; inclusion and measurement of the DSM-IV clinically significant impairment criterion; timing and latency of assessment and potential for recall bias; and combat experiences. Prevalence rates are also likely affected by issues related to PTSD course, chronicity, and comorbidity; symptom overlap with other psychiatric disorders; and sociopolitical and cultural factors that may vary over time and by nation. The disorder represents a significant and costly illness to veterans, their families, and society as a whole. Further carefully conceptualized research, however, is needed to advance our understanding of disorder prevalence, as well as associated information on course, phenomenology, protective factors, treatment, and economic costs.",0 +https://doi.org/10.1017/s1461145711001209,Evidence-based pharmacotherapy of post-traumatic stress disorder (PTSD),"Post-traumatic stress disorder (PTSD) is a prevalent and disabling disorder. Recognition of neurobiological abnormalities associated with this condition suggests the potential efficacy of medication in its treatment. Nevertheless, questions regarding the efficacy of medications remain, despite general endorsement by clinical practice guidelines of selective serotonin reuptake inhibitors (SSRIs) as first-line agents in treating PTSD. This paper reviews evidence from randomized controlled trials (RCTs) for the efficacy of acute and long-term pharmacotherapy for PTSD, including the treatment of refractory PTSD. In addition, we conducted a systematic meta-analysis to compare the efficacy of different medications in treating PTSD. The effects of methodological study features (including year of publication, duration, number of centres) and sample characteristics (proportion of combat veterans, gender composition) were also tested. The largest body of evidence for short- and long-term efficacy of medication currently exists for SSRIs, with promising initial findings for the selective noradrenergic reuptake inhibitor venlafaxine and the atypical antipsychotic risperidone. Treatment effect was predicted by number of centres and recency of the study, with little evidence that sample characteristics predicted response. Evidence for the effectiveness of benzodiazepines is lacking, despite their continued use in clinical practice. Finally, the α1 antagonist prazosin and the atypical antipsychotics show some efficacy in treatment-resistant PTSD. Adequately powered trials that are designed in accordance with best-practice guidelines are required to provide conclusive evidence of clinically relevant differences in efficacy between agents in treating PTSD, and to help estimate clinical and methodological predictors of treatment response.",0 +https://doi.org/10.1053/apmr.2002.28802,Early cognitive status and productivity outcome after traumatic brain injury: findings from the TBI model systems.,"To evaluate the contribution of early cognitive assessment to the prediction of productivity outcome after traumatic brain injury (TBI) adjusted for severity of injury, demographic factors, and preinjury employment status.Inception cohort.Six inpatient brain injury rehabilitation programs.A total of 388 adults with TBI whose posttraumatic amnesia (PTA) resolved before discharge from inpatient rehabilitation.Administered neuropsychologic tests during inpatient stay on emergence from PTA. Follow-up interview and evaluation. Predictor measures also determined.Productivity status at follow-up 12 months postinjury.Multiple logistic regression analysis revealed that preinjury productivity status, duration of PTA, education level, and early cognitive status each made significant, independent contributions to the prediction of productivity status at follow-up. When adjusted for all other predictors, persons scoring at the 75th percentile on early cognitive status (less impaired) had 1.61 times greater odds (95% confidence interval [CI], 1.07-2.41) of being productive follow-up than those scoring at the 25th percentile (more impaired). Without adjustment, persons scoring at the 75th percentile had 2.46 times greater odds (95% CI, 1.77-3.43) of being productive at follow-up.Findings support the utility of early cognitive assessment by using neuropsychologic tests. In addition to other benefits, early cognitive assessment makes an independent contribution to prediction of late outcome. Findings support the clinical practice of performing initial neuropsychologic evaluations after resolution of PTA.",0 +https://doi.org/10.1016/j.puhe.2013.04.018,"What are the determinants of post-traumatic stress disorder: age, gender, ethnicity or other? Evidence from 2008 Wenchuan earthquake","To estimate the prevalence of post-traumatic stress disorder (PTSD) and assess determinants related to PTSD symptoms among adult earthquake survivors after the 2008 Wenchuan earthquake in China.Cross-sectional multicluster sample surveys with data collected from four counties.Surveys were conducted separately in four counties in Sichuan Province, with a total of 2004 respondents. Beichuan County and Dujiangyan City were damaged more severely than Yaan County and Langzhong County during the earthquake. In total, 1890 households were represented, with a mean of 2.2 respondents per household. Data were collected using structured interviews, and the Harvard Trauma Questionnaire and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria were used to diagnose PTSD.The prevalence rates of suspected PTSD were 47.3% (n = 436) in heavily damaged areas and 10.4% (n = 93) in moderately damaged areas. The prevalence rates of PTSD symptoms among elderly, middle aged and young adults were 55.8%, 50.2% and 28.6% (P = 0.001), respectively, in heavily damaged areas. Older age, female gender, unmarried/divorced/widowed, ethnic minority, death of family member, no household income and damaged household were independent risk factors for PTSD symptoms in heavily damaged areas.Interventions designed to reduce PTSD among populations affected by the 2008 earthquake should focus on people without household incomes, those with damaged households and those who experienced the death of a family member. Effective, sustainable and culturally sensitive psychosocial interventions and mental health services are required, and attention should be directed to survivors who experienced the death of a family member, women and older adults following the devastating natural disaster. Governments should support income-generating activities and improve living conditions. Trained field personnel can assist with PTSD assessments and referrals, and existing rural healthcare services can be used to provide treatment for common psychiatric disorders.",0 +https://doi.org/10.1007/s10578-005-0002-5,IQ and Posttraumatic Stress Symptoms in Children Exposed to Interpersonal Violence,"Background: The literature is mixed as to the relationship between intelligence quotient (IQ) and Posttraumatic Stress Disorder (PTSD) symptomatology in adult populations. Even less is known about the relationship in children who have been traumatized. Methods: Fifty-nine children and adolescents (mean age = 10.6) with a history of interpersonal violence were evaluated with respect to PTSD symptomatology, number of traumas, and estimated Verbal, Performance and Full scale IQ scores. PTSD symptomatology included symptom levels for cluster B (re-experiencing), cluster C (avoidance and numbing), and cluster D (Hypervigilance) and criterion F, functional impairment. Results: Results indicated that Full scale and Verbal IQ were significantly associated with the number of traumas, re-experiencing symptoms, and impairment. Performance IQ was only associated with impairment. Regression analyses suggested that together PTSD symptomatology predicted Full scale and Verbal IQ but nor Performance IQ and impairment was the single best predictor of IQ generally. Conclusions: Findings provide support for an association between PTSD symptoms and IQ, particularly verbal IQ. Two possible reasons for this relationship are that higher levels of Verbal IQ may serve as a premorbid protective factor against the development of re-experiencing symptoms, or performance on post-trauma Verbal IQ measures may be negatively impacted by expression of PTSD symptoms. Longitudinal studies are needed to clarify which of these two possibilities explains the association. (",0 +https://doi.org/10.3168/jds.2010-3722,Short communication: Alterations in expression of gluconeogenic genes during heat stress and exogenous bovine somatotropin administration,"Study objectives were to evaluate hepatic gluconeogenic enzyme gene expression in recombinant bovine somatotropin (rbST)-treated lactating dairy cattle during heat stress (HS) or in thermal-neutral, pair-fed (PF) animals. Twenty-two multiparous (99 d in milk, 656 kg of BW) Holstein cows were subjected to 3 consecutive experimental periods (7 d each): (1) thermal neutral, (2) HS or PF, and (3) HS or PF with rbST (Posilac, administered on d 1 of period 3). Liver biopsies were obtained on the final day of each period. Heat stress conditions progressively decreased dry matter intake for the first 5 to 6 d during period 2 before stabilizing (a decrease of 6.15 kg; 30%) on d 6 and 7, and feed intake remained stable and not different from period 2 during period 3. Cytosolic phosphoenolpyruvate carboxykinase mRNA abundance increased during PF, but was unaffected by HS or bST. Pyruvate carboxylase gene expression increased during HS and PF, and administering bST decreased pyruvate carboxylase mRNA abundance during both HS and PF. Insulin-like growth factor-I gene expression increased following bST administration during HS and PF, confirming hepatic bST responsiveness. Exposure to HS leads to a change in hepatic gluconeogenic enzyme profile that appears to be dependent on plane of nutrition.",0 +https://doi.org/10.1016/j.phrs.2015.05.003,Ketamine and suicidal ideation in depression: Jumping the gun?,"Depression and suicide are known to be intricately entwined but the neurobiological basis underlying this association is yet to be understood. Ketamine is an N-methyl d-aspartate (NMDA) receptor antagonist used for induction and maintenance of general anaesthesia but paradoxically its euphoric effects lead to its classification under drugs of abuse. The serendipitous finding of rapid-onset antidepressant action of subanaesthetic dosing with ketamine by intravenous infusion has sparked many preclinical and clinical investigations. A remarkable suppression of suicidal ideation was also reported in depressed patients. This review focuses on the clinical trials on ketamine that reported remedial effects in suicidal ideation in depression and addresses also the molecular mechanisms underlying the antidepressant and psychotomimetic actions of ketamine. The neuropsychiatric profile of subanaesthetic doses of ketamine encourages its use in the management of suicidal ideation that could avert emergent self-harm or suicide. Finally, the need for neuroimaging studies in suicidal patients to identify the brain region specific and temporal effects of ketamine, and the possibility of employing ketamine as an experimental tool in rodent-based studies to study the mechanisms underlying suicidal behaviour are highlighted.",0 +https://doi.org/10.1371/journal.pone.0039025,Cortical Thinning in Patients with Recent Onset Post-Traumatic Stress Disorder after a Single Prolonged Trauma Exposure,"Most of magnetic resonance imaging (MRI) studies about post-traumatic stress disorder (PTSD) focused primarily on measuring of small brain structure volume or regional brain volume changes. There were rare reports investigating cortical thickness alterations in recent onset PTSD. Recent advances in computational analysis made it possible to measure cortical thickness in a fully automatic way, along with voxel-based morphometry (VBM) that enables an exploration of global structural changes throughout the brain by applying statistical parametric mapping (SPM) to high-resolution MRI. In this paper, Laplacian method was utilized to estimate cortical thickness after automatic segmentation of gray matter from MR images under SPM. Then thickness maps were analyzed by SPM8. Comparison between 10 survivors from a mining disaster with recent onset PTSD and 10 survivors without PTSD from the same trauma indicates cortical thinning in the left parietal lobe, right inferior frontal gyrus, and right parahippocampal gyrus. The regional cortical thickness of the right inferior frontal gyrus showed a significant negative correlation with the CAPS score in the patients with PTSD. Our study suggests that shape-related cortical thickness analysis may be more sensitive than volumetric analysis to subtle alteration at early stage of PTSD.",0 +https://doi.org/10.1002/imhj.21506,PRENATAL REFLECTIVE FUNCTIONING IN PRIMIPAROUS WOMEN WITH A HIGH-RISK PROFILE,ar,0 +https://doi.org/10.1017/s0033291712002309,"Subsyndromal depression in the United States: prevalence, course, and risk for incident psychiatric outcomes","Background Subsyndromal depression (SD) may increase risk for incident major depressive and other disorders, as well as suicidality. However, little is known about the prevalence, course, and correlates of SD in the US general adult population. Method Structured diagnostic interviews were conducted to assess DSM-IV Axis I and II disorders in a nationally representative sample of 34 653 US adults who were interviewed at two time-points 3 years apart. Results A total of 11.6% of US adults met study criteria for lifetime SD at Wave 1. The majority (9.3%) had <5 total symptoms required for a diagnosis of major depression; the remainder (2.3%) reported ⩾5 symptoms required for a diagnosis of major depression, but denied clinically significant distress or functional impairment. SD at Wave 1 was associated with increased likelihood of developing incident major depression [odds ratios (ORs) 1.72–2.05], as well as dysthymia, social phobia, and generalized anxiety disorder (GAD) at Wave 2 (ORs 1.41–2.92). Among respondents with SD at Wave 1, Cluster A and B personality disorders, and worse mental health status were associated with increased likelihood of developing incident major depression at Wave 2. Conclusions SD is prevalent in the US population, and associated with elevated rates of Axis I and II psychopathology, increased psychosocial disability, and risk for incident major depression, dysthymia, social phobia, and GAD. These results underscore the importance of a dimensional conceptualization of depressive symptoms, as SD may serve as an early prognostic indicator of incident major depression and related disorders, and could help identify individuals who may benefit from preventive interventions.",0 +https://doi.org/10.1002/da.1029,Clinician-administered PTSD scale: A review of the first ten years of research,"The Clinician-Administered PTSD Scale (CAPS) is a structured interview for assessing posttraumatic stress disorder (PTSD) diagnostic status and symptom severity. In the 10 years since it was developed, the CAPS has become a standard criterion measure in the field of traumatic stress and has now been used in more than 200 studies. In this paper, we first trace the history of the CAPS and provide an update on recent developments. Then we review the empirical literature, summarizing and evaluating the findings regarding the psychometric properties of the CAPS. The research evidence indicates that the CAPS has excellent reliability, yielding consistent scores across items, raters, and testing occasions. There is also strong evidence of validity: The CAPS has excellent convergent and discriminant validity, diagnostic utility, and sensitivity to clinical change. Finally, we address several concerns about the CAPS and offer recommendations for optimizing the CAPS for various clinical research applications.",0 +https://doi.org/10.1177/0886260507313975,"Posttraumatic Stress Disorder Following Ethnoreligious Conflict in Jos, Nigeria","In September 2001, ethnoreligious rioting occurred in Jos, Nigeria. Using a multistage cluster sampling technique, 290 respondents were recruited in Jos 7 to 9 months after the riots. Data were collected regarding demographics, exposure to traumatic events, and psychological symptoms. Resting pulse and blood pressure were recorded. A total of 145 (52.5%) witnessed or were victims of personal attacks, 165 (59.6%) lost their possessions, 56 (20.7%) had their homes burned, 44 (16.2%) witnessed relatives' deaths, and 8 (2.9%) were robbed. A total of 252 (89.7%) of the respondents met reexperiencing criteria, 138 (49.1%) met avoidance criteria, and 236 (84.0%) met arousal criteria for posttraumatic stress disorder (PTSD). A total of 116 (41%, 95% confidence interval [CI] = 36% to 47%) met all three categories for PTSD. Only personal attacks (adjusted odds ratio = 2.8, 95% CI = 1.7 to 4.7) and a heart rate of 90 beats/min or more (adjusted odds ratio = 2.8, 95% CI = 1.4 to 5.8) were significantly related to PTSD in a multivariate model.",0 +https://doi.org/10.1093/jpepsy/jsj052,Introduction to the Special Issue: Posttraumatic Stress Related to Pediatric Illness and Injury,"doi:10.1093/jpepsy/jsj052 Advance Access publication August 3, 2005 Journal of Pediatric Psychology vol. 31 no. 4 © The Author 2005. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oupjournals.org Introduction to the Special Issue: Posttraumatic Stress Related to Pediatric Illness and Injury",0 +https://doi.org/10.1097/01.nmd.0000142030.44203.63,"Personality Characterizations of Outpatients With Schizophrenia, Schizophrenia With Substance Abuse, and Primary Substance Abuse","The study extended previous research on the relationship between personality traits and Axis I disorders. It examined personality differences between individuals diagnosed with schizophrenia and substance abuse and also included individuals dually diagnosed with both schizophrenia and substance abuse. Comparisons were made with respect to characteristics of both normal personality, as measured by the NEO Five-Factor Inventory (NEO-FFI), and disordered personality, as measured by the Millon Multiaxial Personality Inventory. On the NEO-FFI, all groups differed significantly from the NEO-FFI normative sample on at least three personality domains. As predicted, the dual diagnosis group showed the most personality deviance and pathology. The schizophrenia group was primarily distinguished by higher levels of agreeableness, whereas the substance abuse group was more extroverted and showed a prominence of Cluster B personality patterns. An unexpected finding was an interaction between diagnostic group and age, such that older relative to younger individuals in the single diagnosis groups showed greater personality adaptivity and moderation, whereas older individuals in the dual diagnosis group showed less.",0 +https://doi.org/10.1111/j.1750-8606.2008.00069.x,Treatment and Prevention of Posttraumatic Stress Reactions in Children and Adolescents Exposed to Disasters and Terrorism: What Is the Evidence?,"Youth who are exposed to devastating natural disasters or terrorist attacks report high levels of posttraumatic stress (PTS) and may develop posttraumatic stress disorder (PTSD). This article summarizes evidence on the treatment of PTS reactions in these youth and describes interventions developed for the immediate aftermath of the event, the short-term recovery and rebuilding phase, or the long-term recovery phase. Psychological first aid and evidence-based psychoeducational materials show promise for the early phases of postdisaster recovery. For youth with persistent PTSD, cognitive-behavioral interventions appear promising but require further study. Children and adolescents exposed to disasters and acts of terrorism may need multicomponent interventions because their reactions are often multifaceted and often include other psychological problems.",0 +https://doi.org/10.1152/japplphysiol.00306.2004,Stress-related genomic responses during the course of heat acclimation and its association with ischemic-reperfusion cross-tolerance,"Acclimation to heat is a biphasic process involving a transient perturbed phase followed by a long lasting period during which acclimatory homeostasis is developed. In this investigation, we used cDNA stress microarray (Clontech Laboratory) to characterize the stress-related genomic response during the course of heat acclimation and to test the hypotheses that 1) heat acclimation influences the threshold of activation of protective molecular signaling, and 2) heat-acclimation-mediated ischemic-reperfusion (I/R) protection is coupled with reprogrammed gene expression leading to altered capacity or responsiveness of protective-signaling pathways shared by heat and I/R cytoprotective systems. Rats were acclimated at 34°C for 0, 2, and 30 days. 32 P-labeled RNA samples prepared from the left ventricles of rats before and after subjection to heat stress (HS; 2 h, 41°C) or after I/R insult (ischemia: 75%, 45 min; reperfusion: 30 min) were hybridized onto the array membranes. Confirmatory RT-PCR of selected genes conducted on samples taken at 0, 30, and 60 min after HS or total ischemia was used to assess the promptness of the transcriptional response. Cluster analysis of the expressed genes indicated that acclimation involves a “two-tier” defense strategy: an immediate transient response peaking at the initial acclimating phase to maintain DNA and cellular integrity, and a sustained response, correlated with slowly developed adaptive, long-lasting cytoprotective signaling networks involving genes encoding proteins that are essential for the heat-shock response, antiapoptosis, and antioxidation. Gene activation was stress specific. Faster activation and suppression of signaling pathways shared by HS and I/R stressors probably contribute to heat-acclimation I/R cross-tolerance.",0 +https://doi.org/10.1016/s0006-3223(98)00231-5,Low platelet-poor plasma concentrations of serotonin in patients with combat-related posttraumatic stress disorder,"

Abstract

Background: Combat-related posttraumatic stress disorder (CR-PTSD) is associated with a dysregulation of various neurotransmitter systems. Methods: We assessed levels of platelet-poor plasma (PPP) norepinephrine (NE), and serotonin (5-HT), and 24-hour urinary excretion of NE, dopamine (DA), and homovanillic acid (HVA) in 17 male outpatients with untreated chronic CR-PTSD (age, 33.1 ± 7.4 years) and 10 normal control subjects (age, 35.8 ± 2.7 years). Results: Compared with the control subjects, the PTSD patients showed significantly lower PPP 5-HT levels, elevated PPP NE levels, and significantly higher mean 24-hour urinary excretion of all three catecholamines (NE, DA, and HVA). The 24-hour urinary HVA values of the CR-PTSD patients correlated significantly and positively with the total Impact of Event Scale scores and the avoidance symptoms cluster scores, and the PPP 5-HT levels correlated negatively with the Hamilton Anxiety Rating Scale scores. The PPP NE/5-HT ratio was significantly higher in the study group than in the control subjects. Conclusions: We believe this combined enhanced noradrenergic activity and diminished 5-HT activity may be relevant to the neurobiology of CR-PTSD.",0 +https://doi.org/10.1002/pbc.25325,A controlled study of internalizing symptoms in older adolescents with sickle cell disease,"Due to the ongoing medical challenges we hypothesized that older adolescents with sickle cell disease (SCD) would report greater rates of internalizing symptoms and diagnoses. This study is a follow-up to a previous study [1] that found few differences between the emotional well-being of children ages 8-15 with SCD and comparison peers. Our aim is to re-assess internalizing symptoms of youth with SCD and comparison peers at age 18.At follow-up, trained staff members administered semi-structured psychiatric interviews and widely use behavioral health questionnaires to adolescents with SCD (n = 48), their comparison peers (COMP; n = 51) and a caregiver. Mood, internalizing symptoms and diagnoses, were evaluated cross-sectionally at the follow-up (age 18).Psychiatric interview data showed that COMP reported more phobias relative to adolescents with SCD; no significant differences were reported for any other current symptoms (depression, anxiety, or mania). Questionnaire data showed all scores in the normal range with two significant differences: older adolescents with SCD reported more symptoms of tension-anxiety and fatigue-inertia. Both groups reported significant rates of internalizing disorders with 31% of youth with SCD and 35% of COMP having a DSM-IV diagnosis.Psychiatric interview data for both groups of older adolescents suggested considerable psychopathology; questionnaire data for both groups were in the normal range. We report few significant differences-more phobias in comparisons peers; more tension-anxiety and fatigue-inertia reported by youth with SCD. The overall findings suggest considerable resilience for youth with SCD, but both groups of adolescents report significant rates of psychopathology similar to national rates.",0 +https://doi.org/10.1037/a0017829,Beyond resilience and PTSD: Mapping the heterogeneity of responses to potential trauma.,"The formal acceptance of posttraumatic stress disorder (PTSD) as a legitimate diagnostic category in the1980 Diagnostic and Statistical Manual of Mental Disorders stimulated a torrent of research onpsychological trauma. Not surprisingly, PTSD and its treatment had dominated that research. Anothercommon approach has been to measure the average impact of different potentially traumatic events, aswell as the factors that inform that impact. In this article, we consider the limitations of these perspectivesand argue for a broader theoretical approach that takes into account the natural heterogeneity of traumareactions over time. To that end, we review recent attempts to identify prototypical patterns or trajectoriesof trauma reaction that include chronic dysfunction, but also delayed reactions, recovery, and psycho-logical resilience. We consider the advantages but also the limitations and ongoing controversiesassociated with this approach. Finally, we introduce promising new research that uses relative sophis-ticated advances in latent growth mixture modeling as a means of empirically mapping the heterogeneityof trauma responses and consider some of the implications of this approach for existing trauma theories.Keywords: resilience, PTSD, trauma trajections, grief",0 +https://doi.org/10.1196/annals.1314.016,Neurobiology of Memory and Dissociation in Trauma Survivors,Abstract: This symposium examines the neurobiology of memory and dissociation in traumatized individuals. Several paradigms are presented that investigate the specific nature of differences in “remembering” in relation to neuroendocrine profiles among those with and without posttraumatic stress disorder (PTSD). These lines of research may help to clarify the paradox of distortion or absence of some memories and enhancement of others in PTSD.,0 +https://doi.org/10.1016/s0006-3223(97)00475-7,Analysis of heart rate variability in posttraumatic stress disorder patients in response to a trauma-related reminder,"

Abstract

Background: Spectral analysis of heart rate variability has recently been shown to be a reliable noninvasive test for quantitative assessment of cardiovascular autonomic regulatory responses, providing a dynamic map of sympathetic and parasympathetic interaction. In a prior study exploring the state of hyperarousal characterizing the posttraumatic stress disorder (PTSD) syndrome, the authors described standardized heart rate analysis carried out in 9 PTSD patients at rest, which demonstrated clear-cut evidence of a baseline autonomic hyperarousal state. Methods: To examine the dynamics of this hyperarousal state, standardized heart rate analysis was carried out in 9 PTSD patients compared to a matched control group of 9 healthy volunteers. Twenty-minute recordings of electrocardiogram in response to a trauma-related cue as opposed to a resting state were performed and analyzed. The PTSD patients were asked to recount the presumed triggering traumatic event, and the control subjects recounted a significant stressful negative life event. Results: Our results show that, whereas the control subjects demonstrated significant autonomic responses to the stressogenic stimulus supplied by the recounting of a major stressful experience, the PTSD patients demonstrated almost no autonomic response to the recounting of the triggering stressful event. The PTSD patients demonstrated a degree of autonomic dysregulation at rest which was comparable to that seen in the control subjects' reaction to the stress model. Conclusions: The lack of response to the stress model applied in the study appears to imply that PTSD patients experience so great a degree of autonomic hyperactivation at rest, that they are unable to marshal a further stress response to the recounting of the triggering trauma, as compared to control subjects.",0 +https://doi.org/10.1002/jts.20221,Adult sexual abuse is associated with elevated neurohormone levels among women with PTSD due to childhood sexual abuse,"Posttraumatic stress disorder (PTSD) has been associated with reduced, similar, or increased urinary cortisol levels. The authors identified a factor that might contribute to such variability when they obtained 24-hour urinary neurohormone profiles on 69 women with PTSD due to childhood sexual abuse. Half (n = 35) had subsequently experienced adult sexual abuse (ASA) while the other half (n = 34) had not. The ASA group had significantly elevated urinary cortisol, norepinephrine and dopamine levels in comparison to the non-ASA group. Neither a history of childhood or adult physical abuse nor other variables contributed to this finding. The results suggest that the psychobiological consequences of exposure to the same traumatic event may differ as a result of an interaction between age and the composite history of trauma exposure.",0 +https://doi.org/10.1002/da.20262,Role of GABA in anxiety and depression,"This review assesses the parallel data on the role of gamma-aminobutyric acid (GABA) in depression and anxiety. We review historical and new data from both animal and human experimentation which have helped define the key role for this transmitter in both these mental pathologies. By exploring the overlap in these conditions in terms of GABAergic neurochemistry, neurogenetics, brain circuitry, and pharmacology, we develop a theory that the two conditions are intrinsically interrelated. The role of GABAergic agents in demonstrating this interrelationship and in pointing the way to future research is discussed.",0 +https://doi.org/10.1371/journal.pone.0041532,Posttraumatic Stress Symptoms after Exposure to Two Fire Disasters: Comparative Study,"This study investigated traumatic stress symptoms in severely burned survivors of two fire disasters and two comparison groups of patients with ""non-disaster"" burn injuries, as well as risk factors associated with acute and chronic stress symptoms. Patients were admitted to one out of eight burn centers in The Netherlands or Belgium. The Impact of Event Scale (IES) was administered to 61 and 33 survivors respectively of two fire disasters and 54 and 57 patients with ""non-disaster"" burn etiologies at 2 weeks, 3, 6, 12 and 24 months after the event. We used latent growth modeling (LGM) analyses to investigate the stress trajectories and predictors in the two disaster and two comparison groups. The results showed that initial traumatic stress reactions in disaster survivors with severe burns are more intense and prolonged during several months relative to survivors of ""non-disaster"" burn injuries. Excluding the industrial fire group, all participants' symptoms on average decreased over the two year period. Burn severity, peritraumatic anxiety and dissociation predicted the long-term negative outcomes only in the industrial fire group. In conclusion, fire disaster survivors appear to experience higher levels of traumatic stress symptoms on the short term, but the long-term outcome appears dependent on factors different from the first response. Likely, the younger age, and several beneficial post-disaster factors such as psychosocial aftercare and social support, along with swift judicial procedures, contributed to the positive outcome in one disaster cohort.",1 +https://doi.org/10.1002/mpr.1417,Assessing impact of differential symptom functioning on post-traumatic stress disorder (PTSD) diagnosis,"This article explores the generalizability of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic criteria for post-traumatic stress disorder (PTSD) to various subpopulations. Besides identifying the differential symptom functioning (also referred to as differential item functioning [DIF]) related to various background variables such as gender, marital status and educational level, this study emphasizes the importance of evaluating the impact of DIF on population inferences as made in health surveys and clinical trials, and on the diagnosis of individual patients. Using a sample from the National Comorbidity Study-Replication (NCS-R), four symptoms for gender, one symptom for marital status, and three symptoms for educational level were significantly flagged as DIF, but their impact on diagnosis was fairly small. We conclude that the DSM-IV diagnostic criteria for PTSD do not produce substantially biased results in the investigated subpopulations, and there should be few reservations regarding their use. Further, although the impact of DIF (i.e. the influence of differential symptom functioning on diagnostic results) was found to be quite small in the current study, we recommend that diagnosticians always perform a DIF analysis of various subpopulations using the methodology presented here to ensure the diagnostic criteria is valid in their own studies.",0 +https://doi.org/10.1007/s10567-013-0145-z,Long-Term Trajectories and Service Needs for Military Families,"The deployment of US military personnel to recent conflicts has been a significant stressor for their families; yet, we know relatively little about the long-term family effects of these deployments. Using data from prior military service eras, we review our current understanding of the long-term functioning and needs of military families. These data suggest that overseas deployment, exposure to combat, experiencing or participating in violence during war deployment, service member injury or disability, and combat-related post-traumatic stress disorder (PTSD) all have profound impacts on the functioning of military families. We offer several recommendations to address these impacts such as the provision of family-centered, trauma-informed resources to families of veterans with PTSD and veterans who experienced high levels of combat and war violence. Recent efforts to address the needs of caregivers of veterans should be evaluated and expanded, as necessary. We should also help military families plan for predictable life events likely to challenge their resilience and coping capacities. Future research should focus on the following: factors that mediate the relationship between PTSD, war atrocities, caregiver burden, and family dysfunction; effective family-centered interventions that can be scaled-up to meet the needs of a dispersed population; and system-level innovations necessary to ensure adequate access to these interventions. © 2013 Springer Science+Business Media New York.",0 +https://doi.org/10.1037/a0029157,Posttraumatic stress symptom severity and inflammatory processes in midlife women.,"This cross-sectional study examined associations between current (last 30 days) and past (worst lifetime episode) posttraumatic stress (PTS) symptom severity and two markers of inflammation - circulating C-reactive protein and interleukin-6 (IL-6) - along with in vitro IL-6 production by stimulated peripheral blood mononuclear cells. Healthy, midlife women attended two research visits where a blood draw was followed by either benign questionnaires (visit 1, baseline), or questionnaires and an interview to assess traumatic events and PTS symptoms (visit 2, trauma assessment). All women, but one, were negative for current syndromal posttraumatic stress disorder (PTSD); 13 women (20%) met criteria for past syndromal PTSD. There were no statistically significant associations between current PTS symptoms and biological measures. In contrast, there was a statistically significant past PTS symptom severity × Visit interaction for circulating IL-6 levels. At visit 1 only (baseline), past symptom severity was significantly, negatively associated with IL-6 levels. Further, when past symptom severity reached syndromal levels, IL-6 levels were significantly higher at visit 2 (trauma assessment) than visit 1 (baseline). These results contribute to an emerging literature showing that PTSD and its symptoms are not always associated with a proinflammatory profile. They also raise the possibility that, in the context of severe past PTS symptoms, circulating IL-6 levels may be sensitive to confronting trauma reminders. © 2012 American Psychological Association.",0 +https://doi.org/10.1177/0886260512448848,Does Acute Stress Disorder Predict Posttraumatic Stress Disorder Following Bank Robbery?,"Unfortunately, the number of bank robberies is increasing and little is known about the subsequent risk of posttraumatic stress disorder (PTSD). Several studies have investigated the prediction of PTSD through the presence of acute stress disorder (ASD). However, there have only been a few studies following nonsexual assault. The present study investigated the predictive power of different aspects of the ASD diagnosis and symptom severity on PTSD prevalence and symptom severity in 132 bank employees. The PTSD diagnosis, based on the three core symptom clusters, was best identified using cutoff scores on the Acute Stress Disorder scale. ASD severity accounted for 40% and the inclusion of other risk factors accounted for 50% of the PTSD severity variance. In conclusion, results indicated that ASD appears to predict PTSD differently following nonsexual assault than other trauma types. ASD severity was a stronger predictor of PTSD than ASD diagnosis.",0 +https://doi.org/10.1080/00332747.1993.11024627,Children in Poverty: Resilience Despite Risk,"Two objectives provided the focus for the Conference on Community Violence and Children's Development that was jointly sponsored by the National Institute of Mental Health and the John D. and Catherine T. MacArthur Foundation. One was to examine the evidence for deficit behaviors that characterized children reared in poverty; the second was to identify the characteristics of children who sustained their competencies despite being reared in comparable environments. These dual objectives took this form: ""What can we conclude from studies of children, their families, and environments about characteristics that predispose children to maladjustment following exposure to violence, and about characteristics that protect children from such adjustment problems following, or in the midst of, violence exposure?""",0 +https://doi.org/10.1002/pon.1601,Posttraumatic stress disorder symptoms in cancer: psychometric analysis of the Spanish Posttraumatic Stress Disorder Checklist-Civilian version,"The PTSD Checklist-Civilian version (PCL-C) was used as a screening tool to assess the presence of PTSD symptoms. The aim of this study was to explore the factorial structure of the Spanish version of the PCL-C and calculate the correlation of PTSD symptoms with distress and health-related quality of life.The sample included 494 cancer outpatients. In order to validate the PCL-C, a principal component analysis was applied. The association between variable was measured by Pearson correlation.Findings evidenced three symptoms clusters on the PCL-C version, defined as Hyperarousal/Re-experiencing, Numbing and Avoidance. About 10% of the total sample met clinical PTSD symptoms. In addition, PTSD symptoms were related negatively to health-related quality of life and positively related with distress.The conceptualization of PTSD symptoms for cancer patients is supported by the specific symptom clusters identified on PCL-C.",0 +https://doi.org/10.1016/j.brat.2003.09.005,Understanding the pattern of PTSD symptomatology: a comparison of between versus within-group approaches,"This report examines the influence of statistical approach on patterns of Posttraumatic Stress Disorder (PTSD). In this report, 114 women and 51 men were assessed using both the Clinician Administered PTSD Scale (CAPS) and the Posttraumatic Symptom Scale-Self Report measure (PSS-SR). Data were examined using both a between-group and a within-group design. In the between-group approach, three subsamples were formed, representing full syndrome PTSD (fPTSD), partial PTSD (pPTSD), and no PTSD. The fPTSD and pPTSD groups differed on total scores on both PTSD measures, although differences were noted between clinician and self-report measures in specific symptom clusters. In the within-group approach, curve estimation techniques were used to examine linear versus quadratic fit of the data, utilizing the sample as a whole, ranked according to a separate scale of clinical severity. A linear approach was noted for each measure. Results are discussed in light of current design choices in the literature and its impact on the understanding of post-trauma problems.",0 +https://doi.org/10.1017/s0033291712002619,What explains post-traumatic stress disorder (PTSD) in UK service personnel: deployment or something else?,"Background In previous studies an association between deployment to Iraq or Afghanistan and an overall increased risk for post-traumatic stress disorder (PTSD) in UK armed forces has not been found. The lack of a deployment effect might be explained by including, in the comparison group, personnel deployed on other operations or who have experienced traumatic stressors unrelated to deployment. Methods The sample comprised 8261 regular UK armed forces personnel who deployed to Iraq, Afghanistan or other operational areas or were not deployed. Participants completed the PTSD CheckList – Civilian Version (PCL-C) and provided information about deployment history, demographic and service factors, serious accidents and childhood experiences. Results Deployment to Iraq or Afghanistan [odds ratio (OR) 1.2, 95% confidence interval (CI) 0.6–2.2] or elsewhere (OR 1.1, 95% CI 0.6–2.0) was unrelated to PTSD although holding a combat role was associated with PTSD if deployed to Iraq or Afghanistan (OR 2.7, 95% CI 1.9–3.9). Childhood adversity (OR 3.3, 95% CI 2.1–5.0), having left service (OR 2.7, 95% CI 1.9–4.0) and serious accident (OR 2.1, 95% CI 1.4–3.0) were associated with PTSD whereas higher rank was protective (OR 0.3, 95% CI 0.12–0.76). Conclusions For the majority of UK armed forces personnel, deployment whether to Iraq, Afghanistan or elsewhere confers no greater risk for PTSD than service in the armed forces per se but holding a combat role in those deployed to Iraq or Afghanistan is associated with PTSD. Vulnerability factors such as lower rank, childhood adversity and leaving service, and having had a serious accident, may be at least as important as holding a combat role in predicting PTSD in UK armed forces personnel.",0 +https://doi.org/10.3109/15622975.2011.577189,Cyclic adenosine monophosphate responsive element binding protein in post-traumatic stress disorder,"The cyclic adenosine monophosphate responsive element binding (CREB) protein is a transcription factor involved in different neural processes, such as learning, neuroplasticity and the modulation of stress response. Alterations in the CREB pathway have been observed in the brains and lymphocytes of patients affected by depression and alcohol abuse. Given the lack of information, our study aimed at investigating the levels of total and activated CREB protein in lympho-monocytes of 20 drug-free patients suffering from post-traumatic stress disorders (PTSD), as compared with 20 healthy control subjects.Blood samples were collected from patients and healthy control subjects on the same time and lympho-monocytes were isolated according to standardized methods. CREB protein levels and activation were measured by means of immunoenzymatic techniques.The results showed that PTSD patients had statistically lower levels of total CREB protein in lympho-monocytes than healthy control subjects. On the contrary, no difference in the activated CREB protein was detected.These findings, albeit preliminary, would suggest that the CREB pathway might be involved in the pathophysiology of PTSD. Future studies should clarify if specific PTSD symptom clusters might be related to the CREB pathway.",0 +https://doi.org/10.1037/a0026621,Prospective investigation of the impact of cannabis use disorders on posttraumatic stress disorder symptoms among veterans in residential treatment.,"This investigation sought to provide the first prospective examination of the association between the presence of a current cannabis use disorder (CUD) diagnosis and changes in posttraumatic stress disorder (PTSD) symptoms over time after discontinuation, after accounting for the theoretically relevant effects of age, trauma severity, psychological distress, and co-occurring substance use disorders. The study was longitudinal and assessed clinical patients at two time points: residential PTSD treatment intake and discharge. The sample consisted of 260 male combat-exposed military veteran patients (Mage-52.57 years, SD-5.47) admitted to a Veterans Affairs residential rehabilitation program for PTSD between 2000 and 2008. Diagnoses were obtained using the Structured Clinical Interview for DSM-IV, and PTSD outcomes were determined by the PTSD Checklist-Military Version. Results indicate that the presence of a CUD diagnosis was significantly predictive of lower levels of change (between treatment intake and discharge) in PTSD symptom severity as well as PTSD avoidance-numbing and hyperarousal symptom cluster severity (all ps-.05). This study presents the first evidence of a prospective relation between problematic cannabis use and PTSD symptoms, indicating that individuals with a CUD are likely to experience lower levels of change in PTSD symptoms over time, within the context of discontinuation owing to residential PTSD treatment. © 2011 American Psychological Association.",0 +https://doi.org/10.1002/jclp.22017,Loving-Kindness in the Treatment of Traumatized Refugees and Minority Groups: A Typology of Mindfulness and the Nodal Network Model of Affect and Affect Regulation,"This article discusses how loving-kindness can be used to treat traumatized refugees and minority groups, focusing on examples from our treatment, culturally adapted cognitive-behavioral therapy (CA-CBT). To show how we integrate loving-kindness with other mindfulness interventions and why loving-kindness should be an effective therapeutic technique, we present a typology of mindfulness states and the Nodal Network Model (NNM) of Affect and Affect Regulation. We argue that mindfulness techniques such as loving-kindness are therapeutic for refugees and minority populations because of their potential for increasing emotional flexibility, decreasing rumination, serving as emotional regulation techniques, and forming part of a new adaptive processing mode centered on psychological flexibility. We present a case to illustrate the clinical use of loving-kindness within the context of CA-CBT.",0 +https://doi.org/10.1002/da.1051,"Anxiety disorders and major depression, together or apart","This paper will discuss the relationship between anxiety and depression. We will begin with a brief historical perspective. We will then move into the twentieth century, with a focus on the 1950s, at which time the introduction of pharmacological treatment options revolutionized the field of psychiatry. The use of psychiatric medications and the observation of treatment response provided an additional means of understanding the relationship between anxiety and depression. From the late 1970s to the 1990s, it became apparent that various medications possessed wider therapeutic profiles than were previously recognized. For example, many medications were found to be efficacious in both anxiety and depressive disorders. These expanded therapeutic profiles provided additional clues to fuel our thinking about the relationship between anxiety and depression. The two major objectives of this paper are, first, to describe and formalize a process of pharmacological dissection and, second, to consider how this process might contribute to our search for a better understanding of the relationship between anxiety and depression.",0 +https://doi.org/10.1080/07347332.2011.633979,Posttraumatic Stress Symptoms in Children of Mothers Diagnosed with Breast Cancer,"There are inconsistent findings regarding whether a mother's diagnosis of cancer affects her child's psychological health. The aim of this study was to compare maternally perceived symptoms of posttraumatic stress disorder (PTSD) in children of women with and without breast cancer. Forty mothers with breast cancer (assessed within 8 weeks of diagnosis) and 39 mothers without breast cancer were administered the Child Behavior Checklist (CBCL/6-18), UCLA Post Traumatic Stress Disorder (PTSD) Index, and Patient Health Questionnaire (PHQ-9). Descriptive discriminant analysis revealed that mothers with cancer perceived their children to have significantly greater symptoms of PTSD and internalizing distress than the mothers without cancer. No significant difference was found in maternal perception of externalizing symptoms in their children. Results revealed the importance of the assessment of PTSD in children whose mothers have cancer and the discussion includes implications for future research and clinical interventions.",0 +https://doi.org/10.1111/cpsp.12003,Allostasis: The emperor of all (trauma‐related) maladies.,"The construct of allostasis is defined as change in the functioning of biological systems as a result of prolonged exposure to stress. In this article, the construct of bio-behavioral allostasis is proposed to describe peri-traumatic, shorter-term, and chronic changes in neurobiological systems and behaviors that account for the development and long-term maintenance of posttraumatic stress disorder (PTSD) symptoms and associated clinical features. The conceptual framework of bio-behavioral allostasis is applied to generate hypotheses about how premorbid vulnerabilities in different neurobiological systems interact with allostasis to predict heterogeneity in PTSD clinical profiles and patterns of comorbidity likely to develop after trauma exposure. The model offers a means by which to integrate independent theories of PTSD etiology to more fully account for unique features of PTSD, thereby improving its diagnostic discriminant validity. It also enables the identification of symptoms common across disorders that develop during exposure to adverse environments. Conceptualizing PTSD as a process of dynamic allostasis can advance our understanding of trauma-related diagnostic syndromes and inform the development of comprehensive treatments.",0 +https://doi.org/10.1001/archsurg.137.2.200,"Posttraumatic Stress, Problem Drinking, and Functional Outcomes After Injury","Patients undergoing trauma surgery for injury who have subsequent posttraumatic stress disorder (PTSD) or problem drinking will demonstrate significant impairments in functional outcomes compared with patients without these disorders.Prospective cohort study.Level I academic trauma center.One hundred one randomly selected survivors of intentional and unintentional injuries were interviewed while hospitalized and again 1 year later. The investigation achieved a 73% 1-year follow-up rate.Posttraumatic stress disorder was assessed with the Post-traumatic Stress Disorder Checklist and problem drinking was assessed with the Alcohol Use Disorder Identification Test. Functional status was assessed with the Medical Outcomes Study 36-Item Short-Form Health Survey.One year after injury, 30% of patients (n = 22) met symptomatic criteria for PTSD and 25% (n = 18) had Alcohol Use Disorder Identification Test scores indicative of problem drinking. Patients with PTSD demonstrated significant adverse outcomes in 7 of the 8 domains of the Medical Outcomes Study 36-Item Short-Form Health Survey compared with patients without PTSD. In multivariate models that adjusted for injury severity, chronic medical conditions, age, sex, preinjury physical function, and alcohol use, PTSD remained the strongest predictor of an adverse outcome. Patients with problem drinking did not demonstrate clinically or statistically significant functional impairment compared with patients without problem drinking.Posttraumatic stress disorder persisted in 30% of patients 1 year after traumatic injury and was independently associated with a broad profile of functional impairment. The development of treatment intervention protocols for trauma patients with PTSD is warranted.",0 +https://doi.org/10.1016/j.pain.2008.01.001,An examination of the synergy of pain and PTSD on quality of life: Additive or multiplicative effects?,"Although models have been proposed to explain common factors that maintain comorbid pain and PTSD [Sharp TJ, Harvey AG. Chronic pain and posttraumatic stress disorder: mutual maintenance? Clin Psychol Rev 2001; 21: 857-77], the exact nature of the relationship between these two conditions and their impact on quality of life (QOL) is unknown. The aim of the present investigation was to examine the unique and interactive effects of PTSD and pain on role functioning and life satisfaction--two important domains of QOL. The study utilized a help-seeking sample of motor vehicle accident (MVA) survivors whose accidents resulted in symptoms of comorbid PTSD and pain (N=192). Hierarchical regression models were used to examine the relationship between four PTSD symptom clusters, pain, and the interaction of each cluster and pain on role functioning and life satisfaction separately. Results of these analyses revealed a significant interaction of pain and emotional numbing on role functioning, suggesting a multiplicative effect on this domain of QOL. Decomposition of this interaction revealed a negative association between numbing and functioning at low levels of pain but no relationship at higher levels. A marginal interaction of pain and hyperarousal also was noted for life satisfaction. Decomposition of the interaction effect revealed a marginal association between hyperarousal and decreased satisfaction only at high levels of pain. A main effect of emotional numbing on decreased life satisfaction also was observed in this model, suggesting a unique influence of numbing. The results of the current research indicate that the synergistic relationship of pain and PTSD may vary across domains of QOL.",0 +https://doi.org/10.1001/archinte.165.19.2257,Initial Patterns of Clinical Care and Recovery From Whiplash Injuries,"Little is known about the most effective pattern of clinical care for acute whiplash. We designed a cohort study to determine whether patterns of early clinical care (involving visits to general practitioners, chiropractors, or specialists) were associated with different rates of recovery.We studied 2486 Saskatchewan adults with whiplash injuries. We defined 8 initial patterns of care that integrated type of provider and number of visits. We used multivariable Cox models to estimate the association between patterns of care and time to recovery while controlling for injury severity and other confounders.There was an independent association between the type and intensity of initial clinical care and time to recovery. We found that patients in the low-utilization general practitioner group had the fastest recovery, even after controlling for injury severity and other confounders. Compared with this group, the high-utilization general practitioner group experienced a 1-year rate of recovery that was 27% slower (adjusted hazard rate ratio [HRR], 0.73; 95% confidence interval [CI], 0.61-0.87); for the high-utilization chiropractic group it was 39% slower (HRR, 0.61; 95% CI, 0.46-0.81); for the high-utilization general practitioner plus chiropractic combined group it was 28% slower (HRR, 0.72; 95% CI, 0.57-0.91); and for those who consulted general practitioners and specialists, it was 31% slower (HRR, 0.69; 95% CI, 0.55-0.87).The type and intensity of clinical care initiated within the first month after the injury is associated with the rate of recovery from whiplash injuries. Our study does not support the hypothesis that early aggressive care promotes faster recovery.",0 +https://doi.org/10.1002/da.21947,EPIDEMIOLOGIC RESEARCH ON INTERPERSONAL VIOLENCE AND COMMON PSYCHIATRIC DISORDERS: WHERE DO WE GO FROM HERE?,"BACKGROUND Interpersonal violence is one of the major causes of death and disability worldwide.[1] For every death, many more people are exposed to nonfatal violence: for example, in national, population-based surveys, estimates of violence exposure before age 18 range from 14.0% for family violence,[2,3] 49.6–53.1% for physical assault, 6.7–8% for sexual victimization, and 24.8–29.7% for community violence.[4] Several major studies and reviews have identified interpersonal violence as a leading contributor to common forms of psychopathology, including depression, anxiety, and substance abuse.[5–7] In the past 20 years, longitudinal studies on violence and psychopathology have proliferated.However, important methodological issues remain that may affect the validity of inferences that may be drawn from the existing data, including confounding by previolence psychiatric disorders, selection bias, limitations to causal inference inherent to observational studies, and a need to consider the evolution of violence exposures and violence across key life stages. As we consolidate current evidence and consider how to move forward in research on the mental health implications of violence, it is worthwhile to examine how these methodological issues affect interpretations of the current literature. In this review, we examine current research on the relationship between interpersonal violence and three of the most common psychiatric disorders: depression, anxiety, and substance abuse. We focus on these disorders due to the important public health burden they place on the population: according",0 +https://doi.org/10.1037/a0027584,Application of the stressor vulnerability model to understanding posttraumatic stress disorder (PTSD) and alcohol-related problems in an undergraduate population.,"Research examining the comorbidity of posttraumatic stress disorder (PTSD) and alcohol-use disorder (AUD) suggests that individuals experiencing PTSD symptoms (PTSS) often drink alcohol as a means to self-medicate their trauma symptoms; however, little attention has been given to moderating variables that may make this association more likely. The stressor vulnerability model proposes that being male, relying on maladaptive forms of coping, and holding positive alcohol-outcome expectancies predispose individuals to engage in alcohol use when experiencing psychological distress. In the current study, sex, avoidance coping (AVC), tension-reduction expectancies (TRE), and emotional-relief drinking-refusal self-efficacy (ERDRSE) were examined as moderators of the relationship between PTSS and alcohol-related problems in a sample of 144 undergraduates. Results indicated that males reporting high levels of TRE exhibited a stronger positive relationship between PTSS and alcohol-related problems than was present for males reporting low levels of TRE and for females reporting either high or low levels of TRE. In addition, a significant positive relationship between PTSS and alcohol-related problems was observed for individuals reporting high levels of TRE and low levels of ERDRSE, but not for individuals reporting high levels of TRE and high levels of ERDRSE, low TRE-low ERDRSE, or low TRE-high ERDRSE. Assessment of these vulnerability factors in traumatized youth and young adults may serve as a useful means of identifying individuals at risk for the development of alcohol-related problems.",0 +https://doi.org/10.1007/s00520-010-0880-3,Racial disparities in traumatic stress in prostate cancer patients: secondary analysis of a National URCC CCOP Study of 317 men,"IntroductionAfrican American men have the highest rates of prostate cancer of any racial group, but very little is known about the psychological functioning of African American men in response to prostate cancer diagnosis and treatment.PurposeIn this secondary analysis of a national trial testing a psychological intervention for prostate cancer patients, we report on the traumatic stress symptoms of African American and non-African American men.MethodsThis analysis includes 317 men (African American: n = 30, 9%; non-African American: n = 287, 91%) who were enrolled in the intervention trial, which included 12 weeks of group psychotherapy and 24 months of follow-up. Using mixed model analysis, total score on the Impact of Events Scale (IES) and its Intrusion and Avoidance subscales were examined to determine mean differences in traumatic stress across all time points (0, 3, 6, 12, 18, and 24 months). In an additional analysis, relevant psychosocial, demographic, and clinical variables were added to the model.ResultsResults showed significantly higher levels of traumatic stress for African American men compared to non-African American men in all models independently of the intervention arm, demographics, and relevant clinical variables. African Americans also had a consistently higher prevalence of clinically significant traumatic stress symptoms (defined as IES total score ≥27). These elevations remained across all time points over 24 months.ConclusionsThis is the first study to show a racial disparity in traumatic stress specifically as an aspect of overall psychological adjustment to prostate cancer. Recommendations are made for appropriate assessment, referral, and treatment of psychological distress in this vulnerable population.",0 +https://doi.org/10.3109/02699052.2013.851416,Psychosocial and psychological factors associated with post-traumatic stress disorder following traumatic brain injury in adult civilian populations: A systematic review,"Increasing support exists for the development of post-traumatic stress disorder (PTSD) after traumatic brain injury (TBI). Despite the psychological nature of PTSD, previous reviews have mainly focused on the injury-related and neurological characteristics of its presentation in TBI. Consequently, this review systematically examined the psychological and psychosocial variables associated with PTSD symptoms after TBI in civilian adults.Detailed searching retrieved 28 relevant articles which met the inclusion criteria. Each article underwent a thorough quality assessment procedure and data were extracted relevant to the review's aims.Results highlighted several psychological and psychosocial variables associated with PTSD after TBI, including historical factors and those which become relevant after the traumatic event. Furthermore, the results indicated that some factors were not associated with PTSD after TBI, despite a relationship existing with PTSD in the general population. The findings of the quality assessment were utilized throughout the formation of results.The review highlights the importance of addressing psychological and psychosocial factors within the assessment and treatment of PTSD after TBI. The limitations of the research are highlighted and the clinical and research implications discussed.",0 +https://doi.org/10.1186/1471-244x-4-34,Psychological trauma and evidence for enhanced vulnerability for posttraumatic stress disorder through previous trauma among West Nile refugees,"BackgroundPolitical instability and the civil war in Southern Sudan have resulted in numerous atrocities, mass violence, and forced migration for vast parts of the civilian population in the West Nile region. High exposure to traumatic experiences has been particularly prominent in the Ugandan and Sudanese of the West Nile Region, representing an indication of the psychological strain posed by years of armed conflict.MethodsIn this study the impact of traumatic events on the prevalence and severity of posttraumatic stress disorder (PTSD) in a random sample of 3.339 Ugandan nationals, Sudanese nationals, and Sudanese refugees (1.831 households) of the West Nile region is assessed.ResultsResults show a positive correlation between the number of traumatic events and the number of endorsed PTSD symptoms. Of the 58 respondents who experienced the greatest number of traumatizing experiences, all reported symptoms which met the DSM-IV criteria for PTSD.ConclusionsThere is a clear dose-effect relationship between traumatic exposure and PTSD in the studied populations with high levels of traumatic events. In this context, it is probable that any individual could develop PTSD regardless of other risk-factors once the trauma load reaches a certain threshold.",0 +https://doi.org/10.1001/archgenpsychiatry.2009.153,Interactive Effect of Stressful Life Events and the Serotonin Transporter 5-HTTLPR Genotype on Posttraumatic Stress Disorder Diagnosis in 2 Independent Populations,"The 5-HTTLPR polymorphism in the promoter region of the serotonin transporter gene (SLC6A4) has been found to moderate several categories of emotional response after stressful life events. Previous studies generally focused on its effect on depressive symptoms; little is known about its moderation of the development of posttraumatic stress disorder (PTSD).To examine the effects of childhood adversity, adult traumatic events, 5-HTTLPR genotypes, and gene x environment interactions on the etiology of PTSD.A cross-sectional study in which participants in several studies investigating the genetics of substance dependence were also screened for lifetime PTSD. The triallelic system of 5-HTTLPR was genotyped. Logistic regression modeling was used in the analyses.General community.Five hundred eighty-two European American and 670 African American individuals who reported experiences of childhood adversity, adult traumatic events, or both. Main Outcome Measure Diagnosis of PTSD, defined by DSM-IV diagnostic criteria and assessed through the Semi-Structured Assessment for Drug Dependence and Alcoholism interview.Childhood adversity and adult traumatic events both predicted PTSD. Although the 5-HTTLPR genotype alone did not predict the onset of PTSD, it interacted with adult traumatic events and childhood adversity to increase the risk for PTSD, especially for those with high rates of both types of trauma exposure (European American: odds ratio [OR], 2.86; 95% confidence interval [CI], 1.50-5.45; P = .002; African American: OR, 1.88; 95% CI, 1.04-3.40; P = .04; pooled: OR, 2.31; 95% CI, 1.50-3.56; P < .001).Participants who had both childhood adversity and adult traumatic events were more likely to develop lifetime PTSD compared with those who experienced either type of adverse event. The risk was increased in individuals with 1 or 2 copies of the S' (S) allele compared with the L' (L) homozygotes. Our study provides additional direct evidence that PTSD is influenced by the interactive effect of environmental and genetic factors.",0 +,Managing the psychiatric morbidity of disasters.,"Predicting the morbidity from disasters requires clear conceptual frameworks about the different categories of victims and also the manner in which the consequences emerge over the passage of time. Disasters by their nature are events that create confusion and challenge the ordinary structures within a society to manage the basic needs of that social group. A clear conceptual map is of considerable help in minimising the sense of chaos and restoring the provision of needs. There is now a sufficient body of data about the psychological impacts of disasters to begin to think about these events from a broad conceptual framework. In essence, these are events where an environmental stressor can be conceived of in a similar way to a physical environmental toxin that creates a risk in those with differing degrees of exposure. The management response can be informed by using public health models for minimising the consequences of exposure and ensuring broad based approaches are applied.",0 +https://doi.org/10.1002/jts.21989,Posttraumatic Stress Symptom Trajectories Among Children Exposed to Violence,"Little research has examined the developmental course of posttraumatic stress symptoms (PTSS) in children. The current study aimed to identify developmental trajectories of PTSS in childhood and to examine predictors of symptom presentation in 1,178 children from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) studies, a consortium of studies focusing on the causes and effects of child maltreatment. Most children had a history of documented reports with Child Protective Services (CPS) and all were identified as living in high-risk environments. Using group-based trajectory modeling, 3 unique developmental trajectories were identified: Resilient, Clinical-Improving (PTSS in the clinical range at baseline then declining over time), and Borderline-Stable (chronically subclinical PTSS). Children in the Clinical-Improving group were more likely than children in the Resilient group to have reports of physical abuse (RRR = 1.76), emotional abuse (RRR = 2.55), neglect (RRR = 1.57), and exposure to violence at home and in the community (RRR = 1.04). Children in the Borderline-Stable group were more likely than children in the Resilient group to have a CPS history of neglect (RRR = 2.44) and exposure to violence at home and in the community (RRR = 1.04). Many children living in high-risk environments exhibit resilience to PTSS, but exposure to witnessed violence and neglect appear to put children at chronic risk for poor adjustment. These children may require more intensive, integrated clinical services that attend to multiple adverse experiences.",0 +https://doi.org/10.1097/nmd.0b013e31818ec95d,Trait Dissociation Predicts Posttraumatic Stress Disorder Symptoms in a Prospective Study of Urban Police Officers,"The current study prospectively examines the predictive relationship of trait dissociation, assessed during academy training, to PTSD symptoms assessed at 12 months of active police duty in relatively young and healthy police academy recruits (N = 180). The roles of pre-academy trauma exposure, exposure to life-threatening critical incidents during police duty, and peritraumatic dissociation at the time of the officer's worst critical incident were also examined. Utilizing path analytic techniques, greater trait dissociation, assessed during academy training, was predictive of both peritraumatic dissociation, and PTSD symptoms assessed at 12 months of police service. Moreover, after accounting for trait dissociation and peritraumatic dissociation, the relationship of previous trauma to later PTSD symptoms was no longer significant, demonstrating that the effect of previous trauma on later vulnerability to PTSD symptoms in this sample may be mediated by both trait and peritraumatic dissociation.",0 +https://doi.org/10.1093/oxfordhb/9780195307030.013.0019,Psychological Models of Posttraumatic Stress Disorder and Acute Stress Disorder,"This chapter first reviews early learning theories of posttraumatic stress disorder (PTSD). This section highlights the role of classical and operant conditioning, as these forms of conditioning are the basis for many of the contemporary theories of PTSD and still shape a preponderance of thought on the nature of the disorder. Yet, as is pointed out, these conditioning models fail to account for some of the complexities seen in PTSD. The next section reviews alternative conceptualizations regarding new learning theory models, information-processing models, and emotional processing models, forming the basis for more contemporary thought. The chapter concludes with a brief discussion of challenges in the conceptualization of trauma exposure and PTSD symptoms.",0 +https://doi.org/10.1017/cbo9780511500008.015,PTSD: A Disorder of Recovery?,"INTRODUCTION: A VIEW OF THE ETIOLOGY OF PTSD Posttraumatic stress disorder is the better researched consequence of traumatic events. In its current formulation (APA, 1994) the disorder is essentially linked to the triggering event: It cannot be diagnosed in the absence of a traumatic event, and its core symptoms of reexperiencing and avoidance must refer to the traumatic event. This perspective implies a causal link between the event and subsequent PTSD. Such a link is also intuitively appealing and frequently appears in survivors' narratives. For an external observer as well, the association between a traumatic event and PTSD appears to have some truth to it because many survivors' lives are dramatically changed by an encounter with extreme adversity or evil. Thus, from both the survivor's perspective and that of involved observers, the traumatic event is the cause of PTSD. From a scientific point of view, however, this is only half true because many trauma survivors do not develop PTSD. A traumatic event, accordingly, is a necessary , but certainly not a sufficient cause of PTSD. If so, then what are the alternatives? The oldest alternative to simple causation refers to individual differences in vulnerability. Historically, this mainly concerned predisposing factors, an attribution that often carried value judgments. The latter could extend from assuming a personality defect in those who broke down under stress to more understandingly relegating the causality to the wear and tear of the central nervous system by adverse living circumstances (e.g., McEwen, 2000) or birth circumstances (e.g., Meaney et al., 1991; see also Bagot et al., this volume).",0 +https://doi.org/10.1037/a0021778,Outcome following inpatient trauma treatment: Differential response based on pre-treatment symptom severity.,"The purpose of the current study was to examine the extent to which clients of a Stage 1 inpatient program for adult survivors of childhood trauma experienced improvements in their trauma-related symptoms during and following treatment. In addition, the study aimed to enhance our understanding of who benefited by examining trajectories of symptom change, and the extent to which pretreatment symptom severity differentiated the trajectory groups. We used a waitlist comparison methodology and a 6-month follow-up period to examine treatment outcome. We analyzed the data using linear mixed models and latent class growth modeling. Results indicated that the treatment group experienced significantly greater reduction in their trauma-related symptoms than the waitlist group, and this reduction was largely maintained 6-months following discharge. Examinations of group change trajectories indicated that there were 3 groups with distinct change patterns. Analyses examining pretreatment symptom severity in relation to change trajectories indicated that clients with a range of severities of trauma-related symptoms benefited from the program. Clients for whom the program was less effective in reducing trauma-related symptoms were those with severe anxiety and arousal symptoms at admission. The results support the efficacy of inpatient trauma treatment programs for adult survivors of childhood maltreatment, and suggest that modifications during and following treatment may assist a subset of clients in achieving similar gains. © 2011 American Psychological Association.",0 +https://doi.org/10.1037//0022-006x.68.2.290,Similarity of prior trauma exposure as a determinant of chronic stress responding to an airline disaster.,"The cumulative effects of trauma were examined in 108 workers at the site of a major air disaster at 4 time points over a year following the crash. The influence of trauma history on chronic distress and physiological arousal associated with the crash were examined. Stress levels were expected to differ on the basis of the similarity of prior trauma exposure to work at the crash site. Prior traumatic exposure that was ""dissimilar"" to this type of work was associated with greater vulnerability to crash-related stress, that is, more distress and crash-related intrusions during the year following the crash. Accumulation of a variety of different traumatic experiences appeared to sensitize workers to the new stressor and to perpetuate chronic stress. Understanding the role of trauma history is important for improving intervention efforts aimed at alleviating stress following a trauma.",0 +https://doi.org/10.1037//0022-006x.64.4.712,Symptoms of posttraumatic stress in children after Hurricane Andrew: A prospective study.,"The authors examined symptoms of posttraumatic stress in 3rd-5th grade children during the school year after Hurricane Andrew. From a conceptual model of the effects of traumatic events, 442 children were evaluated 3, 7, and 10 months postdisaster with respect to (a) their exposure to traumatic events during and after the disaster, (b) their preexisting demographic characteristics, (c) the occurrence of major life stressors, (d) the availability of social support, and (e) the type of coping strategies used to cope with disaster-related distress. Although symptoms of posttraumatic stress disorder (PTSD) declined over time, a substantial level of symptomatology was observed up to 10 months after the disaster. All 5 factors in the conceptual model were predictive of children's PTSD symptoms 7 and 10 months postdisaster. Findings are discussed in terms of the potential utility of the model for organizing thinking about factors that predict the emergence and persistence of PTSD symptoms in children.",0 +https://doi.org/10.1111/pme.12866,Concurrent Validity of the Defense and Veterans Pain Rating Scale in VA Outpatients,"The purpose of this report is to investigate the concurrent validity of the Defense and Veterans Pain Rating Scale (DVPRS) with other validated self-report measures in U.S. veterans.This correlational study was conducted using two samples of outpatients at the Washington, DC Veterans Affairs Medical Center who completed self-report measures relevant to pain conditions, including pain disability, quality of life, and mental health. Study 1 and 2 consisted of n = 204 and n = 13 participants, respectively.Bivariate Spearman correlations were calculated to examine the correlation among total scores and subscale scores for each scale of interest. Multiple linear regressions were also computed in Study 1.In Study 1, the DVPRS interference scale (DVPRS-II) was significantly correlated with the Pain Disability Questionnaire (PDQ) (ρ = 0.69, P < 0.001) and the Veterans RAND 36-item Health Survey physical and mental component scales (ρ = -0.37, P < 0.001; ρ = -0.46, P < 0.001, respectively). When controlling for sex, age, and other self-report measures, the relationship between the DVPRS-II and PDQ remained significant. In Study 2, pain interference on the DVPRS and Brief Pain Inventory were highly correlated (ρ = 0.90, P < 0.001); however, the intensity scale of each measure was also highly associated with the interference summary scores.These findings provide preliminary evidence for the concurrent validity of the DVPRS as a brief, multidimensional measure of pain interference that make it a practical tool for use in primary care settings to assess the impact of pain on daily functioning and monitor chronic pain over time.",0 +https://doi.org/10.1037/a0019019,"Personality patterns among Black, White, and Hispanic combat veterans.","Little is known about racial and ethnic differences in personality pathology in combat veterans. Thisinvestigation explored the relationship between race, ethnicity, and personality disorders (PDs) in asample of 96 combat veterans. Ethnoracial group status was based on self-identification, and the groupswere mutually exclusive. PDs were assessed with the MCMI-III , posttraumatic stress disorder (PTSD)was assessed with the Clinician Administered PTSD scale, and combat exposure was assessed with theCombat Exposure Scale. The findings suggest that Hispanic veterans were more likely to have cluster APDs compared to non-Hispanic veterans, even after controlling for demographics, level of combatexposure, and current PTSD. Implications of the results for the research and treatment of culturallydiverse individuals with PDs are discussed.Keywords: personality disorder, combat veteran, race, ethnicity",0 +https://doi.org/10.1016/s1056-4993(18)30375-4,Post-Traumatic Stress Disorder in Children and Adolescents,The past decade has seen a significant increase in our understanding of the unique impact that trauma may have on the developmental trajectory of children and adolescents. We examine the recent clinical and research literature regarding risk factors for post-traumatic stress disorder (PTSD) in childhood and the various manifestations in which PTSD may present in childhood and adolescence. Case vignettes are presented to elucidate issues that often emerge in the diagnosis and treatment of PTSD in childhood and adolescence.,0 +https://doi.org/10.1186/1471-244x-11-67,Typology of adults diagnosed with mental disorders based on socio-demographics and clinical and service use characteristics,"Mental disorder is a leading cause of morbidity worldwide. Its cost and negative impact on productivity are substantial. Consequently, improving mental health-care system efficiency - especially service utilisation - is a priority. Few studies have explored the use of services by specific subgroups of persons with mental disorder; a better understanding of these individuals is key to improving service planning. This study develops a typology of individuals, diagnosed with mental disorder in a 12-month period, based on their individual characteristics and use of services within a Canadian urban catchment area of 258,000 persons served by a psychiatric hospital.From among the 2,443 people who took part in the survey, 406 (17%) experienced at least one episode of mental disorder (as per the Composite International Diagnostic Interview (CIDI)) in the 12 months pre-interview. These individuals were selected for cluster analysis.Analysis yielded four user clusters: people who experienced mainly anxiety disorder; depressive disorder; alcohol and/or drug disorder; and multiple mental and dependence disorder. Two clusters were more closely associated with females and anxiety or depressive disorders. In the two other clusters, males were over-represented compared with the sample as a whole, namely, substance abuses with or without concomitant mental disorder. Clusters with the greatest number of mental disorders per subject used a greater number of mental health-care services. Conversely, clusters associated exclusively with dependence disorders used few services.The study found considerable heterogeneity among socio-demographic characteristics, number of disorders, and number of health-care services used by individuals with mental or dependence disorders. Cluster analysis revealed important differences in service use with regard to gender and age. It reinforces the relevance of developing targeted programs for subgroups of individuals with mental and/or dependence disorders. Strategies aimed at changing low service users' attitude (youths and males) or instituting specialised programs for that particular clientele should be promoted. Finally, as concomitant disorders are frequent among individuals with mental disorder, psychological services and/or addiction programs must be prioritised as components of integrated services when planning treatment.",0 +,Lay mental health in the aftermath of disaster: preliminary evaluation of an intervention for Haiti earthquake survivors.,"In the year following the 2010 Haiti earthquake, local earthquake survivors trained as lay mental health workers implemented a culturally-adapted, psychosocial and trauma-focused group intervention for residents of camps for internally displaced peoples (IDPs). Analysis of evaluation data collected at three Port-au-Prince IDP camps revealed decreased self-reported posttraumatic distress (measured using the Harvard Trauma Questionnaire) associated with participation in this intervention. Improvement occurred across all three PTSD symptom clusters (re-experiencing, avoidance, and hyperarousal). Female participants reported higher baseline distress, were more likely to participate in the intervention, and benefitted more than did men. Results provide initial support for the effectiveness of train-the-trainer interventions utilizing local lay disaster survivors.",0 +https://doi.org/10.1093/eurpub/ckr138,Relationship between post-traumatic stress disorder and diabetes among 105 180 asylum seekers in the Netherlands,"Several reports have demonstrated a relationship between post-traumatic stress disorder (PTSD) and type 2 diabetes (T2DM) mainly in combat veterans. The relationship between PTSD and T2DM has not been evaluated among vulnerable migrant populations. The main objective of this study was therefore to assess the relationship between PTSD and T2DM among asylum seekers in the Netherlands.Analysis of a national electronic database of the Dutch Community Health Services for Asylum seekers aged≥18 years (N=105,180).Asylum seekers with PTSD had a higher prevalence of T2DM compared with those without PTSD. The age-adjusted prevalence ratios (APR) were 1.40 (95% CI, 1.12-1.76) in men and 1.22 (95% CI, 0.95-1.56) in women compared with individuals without PTSD, respectively. There was an interaction between PTSD and comorbid depression (P<0.05) in men and women, indicating that the effect of PTSD and comorbid depression on T2DM differed. When the analyses were stratified by depression status, among non-depressed group, individuals with PTSD had a higher prevalence of T2DM compared with those without PTSD [APR=1.47 (95% CI, 1.15-1.87) in men and APR=1.27 (95% CI, 0.97-1.66) in women]. Among the depressed individuals, however, there was no association between PTSD and T2DM [APR=0.87 (95% CI, 0.43-1.76) in men, and APR=1.00, (95% CI, 0.54-1.83) in women].The findings suggest that history of PTSD is related to high levels of T2DM among asylum seekers independent of comorbid depression. Clinicians and policy makers need to take PTSD into account when assessing and treating diabetes among vulnerable migrant populations.",0 +https://doi.org/10.1016/j.beth.2011.03.007,Preliminary Psychometric Properties of the Acceptance and Action Questionnaire–II: A Revised Measure of Psychological Inflexibility and Experiential Avoidance,"The present research describes the development and psychometric evaluation of a second version of the Acceptance and Action Questionnaire (AAQ-II), which assesses the construct referred to as, variously, acceptance, experiential avoidance, and psychological inflexibility. Results from 2,816 participants across six samples indicate the satisfactory structure, reliability, and validity of this measure. For example, the mean alpha coefficient is .84 (.78–.88), and the 3- and 12-month test–retest reliability is .81 and .79, respectively. Results indicate that AAQ-II scores concurrently, longitudinally, and incrementally predict a range of outcomes, from mental health to work absence rates, that are consistent with its underlying theory. The AAQ-II also demonstrates appropriate discriminant validity. The AAQ-II appears to measure the same concept as the AAQ-I ( r = .97) but with better psychometric consistency.",0 +,Neurobiology of Post-Traumatic Stress Disorder,"Post-Traumatic Stress Disorder (PTSD) is a common and severe psychiatric disorder precipitated by exposure to a psychologically distressing event. PTSD is associated with significant morbidity and mortality and is characterized by the presence of three distinct, but co-occurring, symptom clusters. Research evidence suggests that PTSD has a neurobiological basis. Current research on the neurobiology of PTSD include the utilization of functional brain imaging molecular genetic research; the incorporation of cross-system research including neuroendocrine, neurochemical, and neuroimmunological systems. This book examines the neurobiological basis of PTSD and the future research goals in regards to these findings. © 2010 by Nova Science Publishers, Inc. All rights reserved.",0 +https://doi.org/10.1016/s0193-953x(05)70255-0,SYMPTOMATIC AND FUNCTIONAL ASSESSMENT OF SOCIAL ANXIETY DISORDER IN ADULTS,"There are several old and new tools for assessment of generalized SAD but few for nongeneralized SAD. Scales are available in both self-rated and interviewer-rated formats. Self-rated scales vary in appearance in length and specificity for SAD and psychometric properties. The best-studied self-rated scales are the FQ, FNE, SAAD, SPAI, and SPIN. The FQ is an early scale, with a subscale of social phobia with reasonable psychometric properties and has withstood the test of time. The FNE and SAAD are based on cognitive models of SAD but lack assessment of physiologic arousal symptoms--an important symptom cluster of SAD. The SPIN is a relatively new scale and shows potential especially with its three-item screener for generalized SAD. The two interviewer-rated scales, the LSAS and BSPS, are both widely used and demonstrate sound psychometric properties. Either one can be regarded as a satisfactory scale in the assessment of symptom severity and treatment response. The BSPS also measures several physical symptoms common in SAD. There are fewer validated tools available for nongeneralized SAD. It is a prevalent condition that may account for 25% or more of patients with SAD. More research is required on the epidemiology, recognition, assessment, and treatment of nongeneralized SAD. Education of patients and clinicians, and the use of improved and briefer tools in these settings, may help SAD patients to obtain appropriate help and improve their functioning and productivity. Few tools are available that can reliably assess disability due to SAD, and more research in this area is important and required.",0 +https://doi.org/10.1016/j.socscimed.2005.05.007,Pathways to youth homelessness,"Research documents high levels of psychopathology among homeless youth. Most research, however, has not distinguished between disorders that are present prior to homelessness and those that develop following homelessness. Hence whether psychological disorders are the cause or consequence of homelessness has not been established. The aim of this study is to investigate causal pathways to homelessness amongst currently homeless youth in Australia. The study uses a quasi-qualitative methodology to generate hypotheses for larger-scale research. High rates of psychological disorders were confirmed in the sample 35 homeless youth aged 14-25. The rates of psychological disorders at the point of homelessness were greater than in normative samples, but the rates of clinical disorder increased further once homeless. Further in-depth analyses were conducted to identify the temporal sequence for each individual with a view to establishing a set of causal pathways to homelessness and trajectories following homelessness that characterised the people in the sample. Five pathways to homelessness and five trajectories following homelessness were identified that accounted for the entire sample. Each pathway constituted a series of interactions between different factors similar to that described by Craig and Hodson (1998. Psychological Medicine, 28, 1379-1388) as ""complex subsidiary pathways"". The major findings were that (1) trauma is a common experience amongst homeless youth prior to homelessness and figured in the causal pathways to homelessness for over half of the sample; (2) once homeless, for the majority of youth there is an increase in the number of psychological diagnoses including drug and alcohol diagnoses; and (3) crime did not precede homelessness for all but one youth; however, following homelessness, involvement in criminal activity was common and became a distinguishing factor amongst youth. The implications of these findings for future research and service development are discussed.",0 +https://doi.org/10.1109/acii.2013.92,Stress Detection for PTSD via the StartleMart Game,"Computer games have recently shown promise as a diagnostic and treatment tool for psychiatric rehabilitation. This paper examines the positive impact of affect detection and advanced game technology on the treatment of mental diagnoses such as Post Traumatic Stress Disorder (PTSD). For that purpose, we couple game design and game technology with stress detection for the automatic profiling and the personalized treatment of PTSD via game-based exposure therapy and stress inoculation training. The PTSD treatment game we designed forces the player to go through various stressful experiences while a stress detection mechanism profiles the severity and type of PTSD via skin conductance responses to those in-game stress elicitors. The initial study and analysis of 14 PTSD-diagnosed veteran soldiers presented in this paper reveals clear correspondence between diagnostic standard measures of PTSD severity and skin conductance responses. Significant correlations between physiological responses and subjective evaluations of the stressfulness of experiences, represented as pair wise preferences, are also found. We conclude that this supports the use of the simulation as a relevant treatment tool for stress inoculation training. This points to future avenues of research toward discerning between degrees and types of PTSD using game-based diagnostic and treatment tools.",0 +https://doi.org/10.1007/s10508-015-0546-9,"Complexity of Childhood Sexual Abuse: Predictors of Current Post-Traumatic Stress Disorder, Mood Disorders, Substance Use, and Sexual Risk Behavior Among Adult Men Who Have Sex with Men","Men who have sex with men (MSM) are the group most at risk for HIV and represent the majority of new infections in the United States. Rates of childhood sexual abuse (CSA) among MSM have been estimated as high as 46 %. CSA is associated with increased risk of HIV and greater likelihood of HIV sexual risk behavior. The purpose of this study was to identify the relationships between CSA complexity indicators and mental health, substance use, sexually transmitted infections, and HIV sexual risk among MSM. MSM with CSA histories (n = 162) who were screened for an HIV prevention efficacy trial completed comprehensive psychosocial assessments. Five indicators of complex CSA experiences were created: CSA by family member, CSA with penetration, CSA with physical injury, CSA with intense fear, and first CSA in adolescence. Adjusted regression models were used to identify relationships between CSA complexity and outcomes. Participants reporting CSA by family member were at 2.6 odds of current alcohol use disorder (OR 2.64: CI 1.24-5.63), two times higher odds of substance use disorder (OR 2.1: CI 1.02-2.36), and 2.7 times higher odds of reporting an STI in the past year (OR 2.7: CI 1.04-7.1). CSA with penetration was associated with increased likelihood of current PTSD (OR 3.17: CI 1.56-6.43), recent HIV sexual risk behavior (OR 2.7: CI 1.16-6.36), and a greater number of casual sexual partners (p = 0.02). Both CSA with Physical Injury (OR 4.05: CI 1.9-8.7) and CSA with Intense Fear (OR 5.16: CI 2.5-10.7) were related to increased odds for current PTSD. First CSA in adolescence was related to increased odds of major depressive disorder. These findings suggest that CSA, with one or more complexities, creates patterns of vulnerabilities for MSM, including post-traumatic stress disorder, substance use, and sexual risk taking, and suggests the need for detailed assessment of CSA and the development of integrated HIV prevention programs that address mental health and substance use comorbidities.",0 +https://doi.org/10.1002/mpr.355,Project VALOR: design and methods of a longitudinal registry of post-traumatic stress disorder (PTSD) in combat-exposed Veterans in the Afghanistan and Iraqi military theaters of operations,"Few studies have investigated the natural history of post-traumatic stress disorder (PTSD). Project VALOR (Veterans' After-discharge Longitudinal Registry) was designed as a longitudinal patient registry assessing the course of combat-related PTSD among 1600 male and female Veterans who served in Operation Enduring Freedom (OEF) in Afghanistan or Operation Iraqi Freedom (OIF). Aims of the study include investigating patterns and predictors of progression or remission of PTSD and treatment utilization. The study design was based on recommendations from the Agency for Healthcare Quality and Research for longitudinal disease registries and used a pre-specified theoretical model to select the measurement domains for data collection and interpretation of forthcoming results. The registry will include 1200 male and female Veterans with a recent diagnosis of PTSD in the Department of Veteran Affairs (VA) electronic medical record and a comparison group of 400 Veterans without a medical record-based PTSD diagnosis, to also allow for case-control analyses. Data are collected from administrative databases, electronic medical records, a self-administered questionnaire, and a semi-structured diagnostic telephone interview. Project VALOR is a unique and timely registry study that will evaluate the clinical course of PTSD, psychosocial correlates, and health outcomes in a carefully selected cohort of returning OEF/OIF Veterans.",0 +https://doi.org/10.1097/brs.0b013e31816244ed,Legislative Change Is Associated With Improved Health Status in People With Whiplash,"Interrupted time series.To assess whether a change in legislation improved health status and quality of life for people with whiplash.Whiplash was the most prevalent injury in a compulsory, fault based, third party motor vehicle insurance scheme in New South Wales, Australia. Legislative change removed financial compensation for ""pain and suffering"" for whiplash, introduced clinical practice guidelines for its treatment; and changed regulations to permit earlier acceptance of compensation claims, and earlier access to treatment, for all types of injury.Three independent groups of people with whiplash were identified from insurance data (before legislative change--the 1999 group and, after legislative change--the 2001 and 2003 groups). Health status was assessed 2 years after injury by a telephone interviewer blinded to the study hypotheses. The main outcome measure was disability, as assessed by the Functional Rating Index (FRI). Pain and health-related quality of life was also assessed.The mean FRI at 2 years after injury was 38.0% (SE, 1.9) for the 1999 group, 31.8% (SE, 2.1) for the 2001 group, and 30.1% (SE, 1.8) for the 2003 group (F = 5.0, P = 0.007). Improvement in secondary outcomes, including pain, also occurred.Health status of people with whiplash improved after legislative change. Design of compensation schemes should be undertaken with the understanding that the scheme structure may have substantial effects on the long-term health of injured people.",0 +https://doi.org/10.1002/jts.20492,Measurement invariance of posttraumatic stress disorder symptoms among U.S. military personnel,"Studies have not examined the factor structure or measurement invariance of posttraumatic stress disorder (PTSD) symptomatology using population-based data. Confirmatory factor analysis of the PTSD Checklist-Civilian Version (PCL-C) was conducted in a representative sample of U.S. active duty military personnel (N = 15,593). Consistent with prior research, a 4-factor model consisting of reexperiencing, avoidance, emotional numbing, and arousal factors was superior to four alternative models. Measurement invariance was found for factor loadings, but not observed item intercepts when comparing personnel with and without a recent deployment (≤12 months). Findings indicate differences in the level of observed responses across deployment subgroups that exceed what would be expected for individuals with similar PCL latent factors scores. Implications of results are discussed.",0 +https://doi.org/10.1002/jts.21988,The Relationship Between Course of PTSD Symptoms in Deployed U.S. Marines and Degree of Combat Exposure,"Large cohort studies suggest that most military personnel experience minimal posttraumatic stress disorder (PTSD) symptoms following warzone deployment, an outcome often labeled resilience. Very low symptom levels, however, may be a marker for low exposure, not resilience, which requires relatively high-magnitude or high-frequency stress exposure as a precondition. We used growth mixture modeling (GMM) to examine the longitudinal course of lifetime PTSD symptoms following combat exposure by disaggregating deployed U.S. Marines into upper, middle, and lower tertiles of combat exposure. All factor models fit the data well; Tucker-Lewis Index (TLI) and comparative fit index (CFI) values ranged from .91 to .97. Three distinct trajectories best explained the data within each tertile. The upper tertile comprised True Resilience (73.2%), New-Onset Symptoms (18.3%), and Pre-existing Symptoms (8.5%) trajectories. The middle tertile also comprised True Resilience (74.5%), New-Onset Symptoms (16.1%), and Pre-existing Symptoms (9.4%) trajectories. The lower tertile comprised Artifactual Resilience (86.3%), Pre-existing Symptoms (7.6%), and New-Onset Symptoms (6.1%) trajectories. True Resilience involved a clinically significant symptom increase followed by a return to baseline, whereas Artifactual Resilience involved consistently low symptoms. Conflating artifactual and true resilience may inaccurately create the expectation of persistently low symptoms regardless of warzone exposure.",1 +https://doi.org/10.1007/bf02294360,Application of model-selection criteria to some problems in multivariate analysis,"A review of model-selection criteria is presented, with a view toward showing their similarities. It is suggested that some problems treated by sequences of hypothesis tests may be more expeditiously treated by the application of model-selection criteria. Consideration is given to application of model-selection criteria to some problems of multivariate analysis, especially the clustering of variables, factor analysis and, more generally, describing a complex of variables.",0 +https://doi.org/10.1016/j.jad.2010.07.022,An integrated model of risk and protective factors for post-deployment PTSD symptoms in OEF/OIF era combat veterans,"Few attempts have been made to integrate the known risk factors for combat-related posttraumatic stress disorder (PTSD) into a comprehensive model. This study investigated relative contributions of combat experiences, post-battle experiences, and perceptions of threat to post-deployment PTSD symptoms, and also examined whether pre-deployment preparedness moderated associations among these variables.Two hundred seven troops deployed to the Middle East between 2001 and 2008 completed self-report measures. Data were analyzed using path analysis and regressions. A comprehensive model including additive effects, mediation, and moderation was examined.Perceptions of threat mediated the association of combat experiences with PTSD, but not that of post-battle experiences with PTSD. Sense of preparedness for deployment moderated the association of combat experiences with perceived threat, such that troops with low preparedness perceived high levels of threat regardless of combat exposure, whereas troops with high preparedness perceived levels of threat that were correlated with levels of combat.Data were cross-sectional, all assessment was retrospective self-report, and the sample was primarily White, male, and married.Combat and post-battle experiences appear linked to PTSD via separate pathways. Thus, PTSD prevention efforts may need to vary based on types of events experienced. Pre-deployment preparation mitigated perceived threat in the context of low combat exposure, but it did not moderate direct associations of risk factors with PTSD symptoms. Thus, pre-deployment training and preparation do not appear sufficient to protect against PTSD.",0 +,First steps towards the validation of the relations to others french scale (ERA: Echelle de relations avec les autres),"The aim of the paper is to describe the process of constructing and validating a new scale (called ERA) assessing relations to others. The ERA scale is designed to be all at once time-saving (only 16 items) and widely informative (covering 4 major domains of relations to others: Openness to others - relational distance - personal and relational insight - pleasure through and within the relationship), and can be administered to clinical and non clinical populations. The ERA scale has a good internal coherence, a good external validity, an excellent discriminant validity and a good test-retest reliability. The study of sensitivity to change is still in progress.",0 +https://doi.org/10.1159/000065127,The Classification of Anxiety Disorders in ICD-10 and DSM-IV: A Concordance Analysis,"On the surface, the classifications of anxiety disorders in DSM-IV and ICD-10 appear quite similar. However, differences exist and are evident in four aspects of the diagnostic criteria: typology, identifying criteria, inclusion and exclusion criteria. The current study uses data from the Australian National Mental Health Survey to model the impact of these differences on the diagnosis of generalized anxiety disorder. The results show that the concordance between the current classifications would be improved with the removal of the criterion for uncontrollability from DSM-IV, a closer focus on the symptoms of hypervigilance and scanning as in DSM-IV and the removal of the clinical significance criterion from DSM-IV. Equivalency of the exclusion criteria between the two classification systems reduces the concordance, demonstrating that each classification systems is a set of <i>inter</i>dependent diagnoses, and to ultimately achieve concordance, all diagnoses must be considered together.",0 +,Empirical identification of Axis I and Axis II symptom subtypes of sex addiction using Latent Profile Analysis,"Sexual addiction is a disorder characterized by lack of control over sexual urges, pathological relationships and lack of intimacy, mood-altering experiences, and adverse consequences that tend to be disregarded by the person affected. Although not classified as a mental disorder in the Diagnostic Statistical Manual-IV-TR (DSM-IV-TR, APA, 2000) this distressful sexual manifestation is increasingly recognized as a clinical and public health problem. Previous studies suggest commonalities with addictive disorders and maladaptive personality traits. The purpose of the current study was to analyze personality configurations of individuals diagnosed as sex addicts and uncover specific subtypes or profiles associated to sexually addictive behaviors. The study used archival data from 222 individuals, mostly males, treated at a residential program for sex addiction. Latent Profile Analysis (LPA) was utilized to uncover latent classes by using scale scores from the Millon Clinical Multiaxial Inventory-III (MCMI-III) and the Personality Assessment Inventory (PAI). The statistical analyses identified four latent classes for Axis I and five classes for Axis II corresponding to homogeneous subgroups of participants, and determined class membership. Findings were followed up with multivariate and univariate analyses of variances and discriminant analysis to better understand qualitative and quantitative differences among groups. Results revealed significant relationships between class membership and symptoms of Axis I and Axis II disorders measured by other screening tests: the Sexual Addiction Screening Test-Revised (SAST- R), the Eating Disorder Inventory (EDI), Post Traumatic Stress Inventory (PTSI), and the Brief Symptom Inventory (BSI), as well as severity of sexually addictive behaviors, and specific types of behavioral manifestations of sexual addiction as measured by the Sexual Dependency Inventory (SDI-R). No relations were found with legal consequences of addictive behavior. Some implications for treatment of sexual addiction were also addressed. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0 +https://doi.org/10.1016/j.ejphar.2004.02.053,"Cerebral dysfunction in type 1 diabetes: effects of insulin, vascular risk factors and blood-glucose levels","Type 1 diabetes can lead to several well-described complications such as retinopathy, nephropathy and peripheral neuropathy. Evidence is accumulating that it is also associated with gradually developing end-organ damage in the central nervous system. This relatively unknown complication can be referred to as ""diabetic encephalopathy"" and is characterised by electrophysiological and neuroradiological changes, such as delayed latencies of evoked potentials, modest cerebral atrophy and (periventricular) white matter lesions. Furthermore, individuals with type 1 diabetes may show performance deficits in a wide range of cognitive domains. The exact mechanisms underlying this diabetic encephalopathy are only partially known. Chronic metabolic and vascular changes appear to play an important role. Interestingly, the differences in the ""cognitive profile"" between type 1 and type 2 diabetes also suggest a critical role for disturbances of insulin action in the central nervous system.",0 +https://doi.org/10.1002/da.22083,PSYCHOLOGICAL RESILIENCE IN OLDER U.S. VETERANS: RESULTS FROM THE NATIONAL HEALTH AND RESILIENCE IN VETERANS STUDY,"Although a large body of empirical research has examined negative psychological outcomes in older veterans, relatively little is known about the prevalence and determinants of psychological resilience in this population.A nationally representative sample of 2,025 U.S. veterans aged 60 and older (mean = 71.0, standard deviation = 7.1, range = 60-96) completed a web-based survey as part of the National Health and Resilience in Veterans Study (NHRVS). Cluster analysis of measures of lifetime potentially traumatic events, and current PTSD, major depression, and generalized anxiety symptoms was used to classify psychological outcomes.A three-group solution best fit the data: Control (low number of lifetime traumas, low current psychological distress; 60.4%); Resilient (high number of lifetime traumas, low current psychological distress; 27.5%); and distressed (high number of lifetime traumas, high current psychological distress; 12.1%). Among older veterans with a high number of traumas, 69.5% were in the Resilient group. Compared to the Distressed group, the Resilient group was more likely to have college or higher level of education, and to be married or living with a partner. They also scored higher on measures of emotional stability, social connectedness (i.e., secure attachment style, social support), protective psychosocial characteristics (e.g., community integration, purpose in life), and positive perceptions of the military's effect on one's life; and lower on measures of physical health difficulties and psychiatric problems, and openness to experiences.Among older U.S. veterans who have endured a high number of traumas in their lifetimes, nearly 70% are psychologically resilient in later life. Prevention efforts targeted toward bolstering social connectedness, community integration, and purpose in life may help promote psychological resilience in older veterans who endured a significant number of traumas in their lives.",0 +https://doi.org/10.1007/s10862-008-9101-5,Influences of Comorbid Disorders on Personality Assessment Inventory Profiles in Women with Posttraumatic Stress Disorder,"The present study describes Personality Assessment Inventory (PAI) profiles for women with posttraumatic stress disorder (PTSD). Four groups of women were sampled: single Axis I diagnosis of PTSD; PTSD and major depressive disorder (MDD); PTSD, MDD, at least one other Axis I disorder; and controls with no Axis I disorder. Higher comorbidity rates were associated with higher mean profile elevations and broader range of endorsed symptoms. The group with the highest rate of comorbidity produced profiles most similar to previously published reports of patients with PTSD. This is in contrast to women with a single diagnosis of PTSD, who produced relative mean elevations only on subscales measuring distress caused by trauma and physiological symptoms of depression. Thus, published profiles may be more reflective of PTSD with comorbidity than a single diagnosis of PTSD.",0 +https://doi.org/10.1016/j.jad.2010.03.021,Posttraumatic growth in Veterans of Operations Enduring Freedom and Iraqi Freedom,"A growing body of research has examined the prevalence and correlates of psychopathology, mild traumatic brain injury, and related problems in Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF-OIF). While these studies help characterize the deleterious effects of combat, no known study has examined factors that may enhance posttraumatic growth or positive changes experienced as a result of combat in this population. A total of 272 predominantly older Reservist/National Guard OEF-OIF Veterans completed an anonymous mail survey that assessed combat exposure, psychopathology, psychosocial functioning, social support, and posttraumatic growth. Seventy-two percent of the sample endorsed a significant degree of posttraumatic growth in at least one of the areas assessed, the most common of which were changing priorities about what is important in life (52.2%), being able to better appreciate each day (51.1%), and being better able to handle difficulties (48.5%). Hierarchical regression analysis revealed that younger age, greater posttraumatic stress disorder (PTSD) symptoms, and increased perceptions of unit member support and effort/perseverance were significantly associated with posttraumatic growth. Respondents with PTSD scored higher on an overall measure of posttraumatic growth and on items reflecting appreciation of life and personal strength. This study is limited by a relatively low survey return rate and employment of an abbreviated measure of posttraumatic growth. Results of this study suggest that interventions to bolster unit member support and to enhance perceptions of effort and perseverance may help promote posttraumatic growth in OEF-OIF Veterans.",0 +https://doi.org/10.1016/j.injury.2013.03.006,Patterns of healthcare service utilisation following severe traumatic brain injury: An idiographic analysis of injury compensation claims data,"The rate and extent of recovery after severe traumatic brain injury (TBI) is heterogeneous making prediction of likely healthcare service utilisation (HSU) difficult. Patterns of HSU derived from nomothetic samples do not represent the diverse range of outcomes possible within this patient group. Group-based trajectory model is a semi-parametric statistical technique that seeks to identify clusters of individuals whose outcome (however measured) follows a similar pattern of change over time.To identify and characterise patterns of HSU in the 5-year period following severe TBI.Detailed healthcare treatment payments data in 316 adults with severe TBI (Glasgow Coma Scale score 3-8) from the transport accident compensation system in the state of Victoria, Australia was accessed for this analysis. A semi-parametric group-based trajectory analytical technique for longitudinal data was applied to monthly observation counts of HSU data to identify distinct clusters of participants' trajectories. Comparison between trajectory groups on demographic, injury, disability and compensation relevant outcomes was undertaken.Four distinct patterns (trajectories) of HSU were identified in the sample. The first trajectory group comprised 27% of participants and displayed a rapid decrease in HSU in the first year post-injury. The second group comprised 24% of participants and showed a sharp peak in HSU during the first 12 months post-injury followed by a decline over time. The third group comprised 32% of participants and showed a slight peak in HSU in the first few months post-injury and then a slow decline over time. The fourth group comprised 17% of participants and displayed a steady rise in HSU up to 30 months post-injury, followed by a gradual decline to a level consistent with that received in the first months post-injury. Significant differences were observed between groups on factors such as age, injury severity, and use of disability services.There is substantial variation in patterns of HSU following severe TBI. Idiographic analysis can provide rich information for describing and understanding the resources required to help people with TBI.",0 +https://doi.org/10.7205/milmed-d-12-00386,Efficacy of Stellate Ganglion Block in the Treatment of Anxiety Symptoms From Combat-Related Post-Traumatic Stress Disorder: A Case Series,Report the efficacious use of stellate ganglion blocks (SGBs) in treating the anxiety symptoms of four patients diagnosed with combat-related post-traumatic stress disorder (PTSD) and discuss possible mechanisms of action to explain these findings.Successful treatment of PTSD with SGB has been demonstrated and reported previously at Walter Reed Army Medical Center. An identical protocol was used at Tripler Army Medical Center to treat four service members diagnosed with combat-related PTSD.All patients reported received an SGB on the right side at the level of C6. The patient's PTSD symptoms were evaluated using the Post-traumatic Stress Disorder Checklist (PCL). This checklist was distributed one day before treatment and again the day following treatment. The patients were also given the PCL at subsequent follow-up visits to quantify sustained benefit.SGB showed acute benefit for the symptoms of PTSD by markedly reduced PCL scores after the procedure. Benefits were also sustained during close outpatient follow-up.Selective blockade of the right stellate ganglion at C6 is a minimally invasive procedure with an excellent safety profile that may provide sustained relief of PTSD symptoms. The procedure may also provide benefit for those who are resistant to psychotropic intervention.,0 +https://doi.org/10.1016/j.resuscitation.2007.11.012,Public Access Defibrillation: Psychological consequences in responders,"Adverse psychological reactions are relatively frequent in professional ambulance crews who attend traumatic events, yet appear unusual in lay persons who attempt resuscitation of victims of out of hospital cardiac arrest.To investigate the psychological profile of first responders to gain insight into possible factors that might protect them against such reactions.Qualitative study of first responders in a community scheme in Barry, South Wales. In depth semi-structured interviews with six subjects were analysed using Interpretive Phenomenological Analysis (IPA).The study identified a resilience phenomenon in first responders accounted for by certain enabling core beliefs about their role, their capacity, and about the meaning of negative and positive outcomes for themselves. A realistic appreciation of their own limitations, confidence in their ability to perform as trained and being able to handle positive and negative outcomes were prominent features. The ability to act with emotional detachment appears a further protective mechanism. This mindset, loosely described as 'a philosophy', protects against the development of adverse reactions to stress or from becoming unduly concerned about negative outcomes. The responders had altruistic motives for undertaking the role yet were capable of operating with a high degree of naturally occurring resilience to stress or undermining anxiety. It is the combination of being motivated by altruism coupled with an inherent resilience that appears to be the crucial protective mechanism.The group demonstrated an apparently innate resilience to the adverse psychological effects of responding with an AED in a PAD scheme. This enables them to operate optimally in stressful situations without experiencing the negative psychological consequences that might otherwise arise. This information may be used to raise awareness about the psychological requirements for the role and to assist screening or selection processes.",0 +https://doi.org/10.1080/13803395.2015.1102203,Event-based prospective memory among veterans: The role of posttraumatic stress disorder symptom severity in executing intentions,"Posttraumatic stress disorder (PTSD) has been linked with neuropsychological deficits in several areas, including attention, learning and memory, and cognitive inhibition. Although memory dysfunction is among the most commonly documented deficits associated with PTSD, our existing knowledge pertains only to retrospective memory. The current study investigated the relationship between PTSD symptom severity and event-based prospective memory (PM).Forty veterans completed a computerized event-based PM task, a self-report measure of PTSD, and measures of retrospective memory.Hierarchical regression analysis results revealed that PTSD symptom severity accounted for 16% of the variance in PM performance, F(3, 36) = 3.47, p < .05, after controlling for age and retrospective memory. Additionally, each of the three PTSD symptom clusters was related, to varying degrees, with PM performance.Results suggest that elevated PTSD symptoms may be associated with more difficulties completing tasks requiring PM. Further examination of PM in PTSD is warranted, especially in regard to its impact on everyday functioning.",0 +https://doi.org/10.1111/j.1469-7610.2009.02089.x,Child Behavior Checklist Juvenile Bipolar Disorder (CBCL-JBD) and CBCL Posttraumatic Stress Problems (CBCL-PTSP) scales are measures of a single dysregulatory syndrome,"The Child Behavior Checklist Juvenile Bipolar Disorder (CBCL-JBD) profile and Posttraumatic Stress Problems (CBCL-PTSP) scale have been used to assess juvenile bipolar disorder (JBD) and posttraumatic stress disorder (PTSD), respectively. However, their validity is questionable according to previous research. Both measures are associated with severe psychopathology often encompassing multiple DSM-IV diagnoses. Further, children who score highly on one of these scales often have elevated scores on the other, independent of PTSD or JBD diagnoses. We hypothesized that the two scales may be indicators of a single syndrome related to dysregulated mood, attention, and behavior. We aimed to describe and identify the overlap between the CBCL-JBD profile and CBCL-PTSP scales.Two thousand and twenty-nine (2029) children from a nationally representative sample (1073 boys, 956 girls; mean age = 11.98; age range = 6-18) were rated on emotional and behavior problems by their parents using the CBCL. Comparative model testing via structural equation modeling was conducted to determine whether the CBCL-JBD profile and CBCL-PTSP scale are best described as measuring separate versus unitary constructs. Associations with suicidality and competency scores were also examined.The CBCL-JBD and CBCL-PTSP demonstrated a high degree of overlap (r = .89) at the latent variable level. The best fitting, most parsimonious model was one in which the CBCL-JBD and CBCL-PTSP items identified a single latent construct, which was associated with higher parental endorsement of child suicidal behavior, and lower functioning.The CBCL-JBD profile and CBCL-PTSP scale overlap to a remarkable degree, and may be best described as measures of a single syndrome. This syndrome appears to be related to severe psychopathology, but may not conform to traditional DSM-IV classification. These results contribute to the ongoing debate about the utility of the CBCL-JBD and CBCL-PTSP profiles, and offer promising methods of empirically based measurement of disordered self-regulation in youth.",0 +https://doi.org/10.1017/s1352465801002119,DETERMINING THE COGNITIVE PORTS OF ENTRY AMONGST THE POST-TRAUMATIC STATES: TREATMENT IMPLICATIONS,"Post-traumatic stress disorder (PTSD) is one of a range of trauma responses and has claimed the most therapeutic attention, but other post-traumatic states are probably, collectively, as common and produce a comparable level of functional impairment. It is suggested that in accordance with the cognitive theory of emotional disorders (Alford & Beck, 1997) the post-traumatic states are distinguished by differing cognitive content. Further, it is suggested that PTSD clients have particular information processing biases and those with a chronic form of the condition have a cognitive profile similar to those with a personality disorder. The differing cognitive architecture amongst the post-traumatic states suggests different treatment focii (Scott & Stradling, 2001).",0 +https://doi.org/10.1007/978-3-319-22985-0_25,Intimate Relationship Distress and Combat-related Posttraumatic Stress Disorder,"Combat-related posttraumatic stress disorder (ptsd) has a significant deleterious effect on interpersonal relationships. Intimate partner relationships can play a crucial role in the mediation, amelioration, maintenance, or aggravation of combat-related ptsd. This chapter presents a case of relationship distress in a 28-year-old female spouse of an Operation Iraqi Freedom (OIF) combat veteran with ptsd. The spouse presents with impaired functioning in behavioral, cognitive, and affective domains specifically reactive to the unique symptom clusters of her husband s ptsd. She also reports associated psychosocial problems to include divorce, occupational difficulty, financial problems, caregiver burden, and mental health stigma. Treatment includes a thorough safety assessment, psychiatric evaluation, individual and couple-based cognitive behavioral psychotherapy, and referral to supportive services. Developing a greater understanding of the impact and complex interplay of combat-related ptsd on intimate relationships can be of great benefit to the mental health providers, the veterans, their intimate partners, and the family system. © Springer International Publishing Switzerland 2015.",0 +https://doi.org/10.1111/jmft.12017,Military-Related Posttraumatic Stress Disorder and Intimate Relationship Behaviors: A Developing Dyadic Relationship Model,"The protracted conflict in Iraq and Afghanistan and an all-volunteer military has resulted in multiple war zone deployments for many service members. While quick redeployment turnaround has left little time for readjustment for either the service member or family, dealing with the long-term sequelae of combat exposure often leaves families and intimate partners ill-prepared for years after deployments. Using a modified grounded theory approach, digitally recorded couple interviews of 23 couples were purposefully selected from a larger sample of 441 couples to better understand the impact of war zone deployment on the couple. The veteran sample was recruited from a randomly selected cohort of men in treatment for posttraumatic stress disorder (PTSD). Overall, it was found when veterans experiencing deployment-related PTSD reenter or start new intimate relationships they may bring with them a unique cluster of interrelated issues which include PTSD symptoms, physical impairment, high rates of alcohol and/or drug abuse, and psychological and physical aggression. These factors contributed to a dynamic of exacerbating conflict. How these couples approached relationship qualities of mutuality, balanced locus of control and weakness tolerance across six axes of caregiving, disability, responsibility, trauma, communication, and community impacted the couple's capacity to communicate and resolve conflict. This dyadic relationship model is used to help inform implications for clinical practice.",0 +https://doi.org/10.3233/wor-2012-0954-5794,An epidemiological profile of cashiers holders carpal tunnel syndrome in a grocery store chain,"Occupational diseases are those acquired in the work. Statistics show an increase number of cases, victims like typists, telephone's operators, cashiers and many others with varied levels of involvement. It is composed of disorders affecting the upper limbs being recognized by the Ministry of Social Welfare. Among these diseases stands out for its high occurrence Carpal Tunnel Syndrome (CTS). It has been considered a disease of the century, because its incidence has increased in 40.8% of repetitive stress disorders, with prevalence in females, and predominant age ranging from 25 to 40 years. It is characterized by pain and paresthesia in the first four fingers and wrists, and arm pain, weakness, numbness in the territory of the median nerve, preserving or not the palmar sensation and numbness in the median sensory distribution. This study aims to assess functional capacity and severity of symptoms presented by cashiers diagnosed with CTS. It is a descriptive and quantitative in nature. The population consists of 13 grocery store cashiers of both sexes, with a workload of 42 hours. We will be used as an instrument called the Boston Carpal Tunnel Questionnaire. That purports to be an effective means of measuring the numbness and pain in hands and wrists. Exclusion criteria we consider the subjects who have other diseases associated with CTS. The collection is with the possibility of partial results to be entered in a spreadsheet in Microsoft Excel for data analysis and subsequent discussion and correlation with the current literature.",0 +https://doi.org/10.1177/0163278713494774,Association Between Exercise and Posttraumatic Stress Symptoms Among Trauma-Exposed Adults,"The present investigation examined associations between intensities of exercise involvement and posttraumatic stress (PTS) symptom cluster severity (reexperiencing, avoidance/numbing, and hyperarousal). The sample was comprised of 108 adults (54.6% women; M age = 23.9, SD = 10.22, range = 18–62), who endorsed exposure to a Diagnostic and Statistical Manual of Mental Disorders (Fourth edition, Text Revision) posttraumatic stress disorder Criterion A traumatic life event but did not meet criteria for any current Axis I psychopathology. After controlling for gender and lifetime number of trauma exposure types experienced, results indicated that vigorous-intensity exercise, but not light- or moderate-intensity exercise, was significantly inversely associated with hyperarousal symptom cluster severity. This study adds to the scarce, yet growing, body of exercise—PTS literature—by illuminating the inverse associations of vigorous-intensity exercise, specifically, and PTS hyperarousal symptom severity among trauma-exposed individuals.",0 +https://doi.org/10.1002/job.1974,Effects of initial resources on the development of strains during a stressful training situation: Some counterintuitive results,"Summary Resource theories of occupational stress argue that employees' personal and environmental resources protect them from too much distress or strain during stressful work experiences. We examined four resources (emotional stability, previous experience, low drain on pre-existing resources, and workgroup quality) available to soldiers at the beginning of a stressful 3-month training experience as predictors of the trajectories of their strains over that period of time. Based on conservation of resources theory and the job demands–resources model, we predicted that the trends of strains would be more favorable (would increase more slowly or decline more quickly) if participants started the training with greater resources. The resources, primarily emotional stability and lack of pre-existing resource drain, tended to be negatively related to strains, consistent with the idea that they can reduce strains. Significant interactions predicting trends were found predicting two of the three strains (post-traumatic stress symptoms and depression, but not reports of physical health). Contrary to expectations, however, the three resources that significantly predicted trends over time (emotional stability, previous experience, and low pre-existing resource drain) were associated with worsening rather than improving strains. Copyright © 2014 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1097/ccm.0000000000000865,Psychosocial Outcomes in Informal Caregivers of the Critically Ill,"The objective of the review was to evaluate and synthesize the prevalence, risk factors, and trajectory of psychosocial morbidity in informal caregivers of critical care survivors.A systematic search of MEDLINE, PsychInfo, PubMed, CINAHL, Cochrane Library, Scopus, PILOTS, EMBASE, and Physiotherapy Evidence Database was undertaken between January and February 2014.Citations were screened independently by two reviewers for studies that investigated psychosocial outcomes (depression, anxiety, stress, posttraumatic stress disorder, burden, activity restriction, and health-related quality of life) for informal caregivers of critical care survivors (mechanically ventilated for 48 hr or more).Data on study outcomes were extracted into a standardized form and quality assessed by two independent reviewers using the Newcastle-Ottawa Scale, the Physiotherapy Evidence Database, and the National Health and Medical Research Council Hierarchy of Evidence guide. Preferred Reporting Items for Systematic Reviews guidelines were followed.Fourteen studies of 1,491 caregivers were included. Depressive symptoms were the most commonly reported outcome with a prevalence of 75.5% during critical care and 22.8-29% at 1-year follow-up. Risk factors for depressive symptoms in caregivers included female gender and younger age. The greatest period of risk for all outcomes was during the patient's critical care admission although psychological symptoms improved over time. The overall quality of the studies was low.Depressive symptoms were the most prevalent in informal caregivers of survivors of intensive care who were ventilated for more than 48 hours and persist at 1 year with a prevalence of 22.8-29.0%, which is comparable with caregivers of patients with dementia. Screening for caregiver risks could be performed during the ICU admission where intervention can be implemented and then evaluated. Further high-quality studies are needed to quantify anxiety, stress, caregiver burden, and posttraumatic stress disorder outcomes in informal caregivers of long-stay patients surviving ICU.",0 +https://doi.org/10.1080/10926771.2012.698377,"Attachment Disruptions, IQ, and PTSD in African American Adolescents: A Traumatology Perspective","Attachment disruptions, other traumas, posttraumatic stress disorder (PTSD), and intelligence quotient (IQ) were measured in a sample of 181 African American adolescents. Path analysis was utilized to test the effects of different types of attachment disruptions on IQ and PTSD. Findings supported that mother and father abandonments and being in foster care are associated with decreased perceptual reasoning, processing speed, and working memory, and increased discrepancy between perceptual and verbal toward decreased perceptual reasoning. Such suppression and discrepancy contribute to poor academic achievement. Results validated the traumatology perspective on attachment disruptions as traumas that are associated with PTSD, suppression of most IQ potentials, and with potential brain hemispheric desynchronization. The ramifications of these results for helping African American adolescents are discussed.",0 +https://doi.org/10.1177/0165025408090973,Child development and family mental health in war and military violence: The Palestinian experience,"The article reviews developmental research among Palestinians living in Gaza. The aims are, first, to analyze how exposure to traumatic events associates with children's mental health and their cognitive, emotional and social development. Second, we aimed to model familial and symbolic processes that can either harm or protect the mental health of children. Third, we wanted to learn who the resilient children are in conditions of war and military violence. The reviewed research has been conducted in the context of a Palestinian non-governmental organization, the Gaza Community Mental Health Programme, during the political upheavals involving hopes for peace and intensive war and violence: the First Intifada (1987—1993), the Palestinian Authority rule (1994— ) and the Second Al Aqsa Intifada (2001— ). The results show that life threat, violence and losses form a risk for increased psychological distress. There are, however, a myriad of child, family and society related factors and psycho-socio-physiological processes that protect child development and mental health. They include, e.g. loving and wisely guiding parenting, children's flexible and high cognitive capacity, flexible and multiple coping strategies and narrative and symbolic nocturnal dreaming, as well as social support and good peer relations. Different models explain psychological distress and positive resources, including child resilience. Exposure to trauma is crucial in predicting distress, while familial and developmental issues are important in building resilience. Children's conscious and unconscious cognitive-emotional processes are crucial for underlying mental health and knowledge about them is important in tailoring evidence-based preventive interventions among war victims.",0 +https://doi.org/10.1016/j.encep.2010.08.009,Prise en charge médicamenteuse de l’anxiété chez le patient souffrant de schizophrénie,"Anxiety is a major and frequent symptom of schizophrenia, which is associated with an increased risk of relapse, impaired functioning, lower quality of life and increased incidence of suicide attempts. Despite its clinical relevance, anxiety in schizophrenia remains poorly understood. In the prodromic phase, anxiety indicates a progression towards psychotic decompensation. After a first episode, it is an indicator of relapse.Two approaches have been used to investigate anxiety in schizophrenia: (i) categorical approach (comorbidity of schizophrenia and anxiety disorders) and (ii) dimensional approach (anxiety as a major symptom of the ""dysphoric"" dimension). Clinical categorical studies reported an increased frequency of comorbidity between schizophrenia and obsessive-compulsive disorder, panic disorder, social phobia, post-traumatic stress disorder, generalized anxiety disorder, agoraphobia, and specific phobia. The dimensional approach proposes that five different factors contribute to the structure of the Positive and Negative Syndrome Scale (PANSS), with anxiety as a major symptom of the ""dysphoria"" dimension. Concerning diagnosis, it is unclear whether psychotic and neurotic anxiety differs in nature or intensity. Nevertheless, both are frequently opposed.Psychotic anxiety is intense, profound and hermetic. In contrast to neurotic anxiety, it is associated with psychomotor disturbances, such as agitation and sideration. There is no specific tool to evaluate anxiety in schizophrenia. The dimensional approach usually runs an evaluation using items or factors extracted from the most widely-used scales, i.e. PANSS or Brief Psychiatric Rating Scale (BPRS) or from anxiety scales developed in non-schizophrenic populations, such as the Hamilton Anxiety Scale (HAMA). Recently, we developed a specific scale for hetero-evaluation (Échelle Anxiété Schizophrénie [EAS scale]). The EAS scale was recently validated and the study of its sensitivity is ongoing. THERAPEUTICAL ISSUES: Several studies have examined the effects of antipsychotics on the anxious/depressive cluster extracted from the PANSS, and some other studies have specifically evaluated the effect of antipsychotics on depressive symptoms using the Montgomery and Asberg Depression Rating Scale (MADRS) and Calgary Depression Scale for Schizophrenia (CDSS), but to our knowledge, no study has reported the effect of antipsychotics or other treatment on anxiety when using a schizophrenia-specific scale. There are no specific guideline treatments for anxiety in schizophrenia. Among phenothiazines, cyamemazine is frequently prescribed in France, because of its potent anxiolytic activity and good neurological tolerance. Some authors have suggested a specific treatment with benzodiazepines. However, benzodiazepines should be used with caution, due to undesirable actions such as dependence, rebound and potentiation of certain lateral effects.",0 +https://doi.org/10.1098/rstb.2006.1821,Gulf War illness: a view from Australia,"Australia sent a small, mostly naval, deployment to the 1991 Gulf War. When papers and media concerns arose about unexplained Gulf War illnesses in Gulf War troops from other countries, Australia decided to undertake its own study of Australian veterans. Undertaking a later study, more than 10 years after the Gulf War, allowed us to incorporate some methodological improvements on previous research, such as the inclusion of a face-to-face health assessment where more objective health data could be collected in addition to using a postal questionnaire. Despite the different Gulf War experience for the mostly naval Australian group, there were remarkable consistencies in the patterns of multiple symptom reporting found in overseas studies, including the fact that no unique symptom clusters were identified. In general, this excess symptom reporting was not found to occur with excesses in more objective measures of physical health. These objective physical measures included a wide range of haematological, biochemical and serological markers, a physical examination, spirometry and a step test of fatigability. In contrast, several psychological disorders, including anxiety, post-traumatic stress disorder, depression and substance abuse, were found to occur in excess in the Australian Gulf War group and were associated with Gulf War psychological stressors. These findings have helped raise awareness in Australia of psychological health problems in deployed military personnel.",0 +https://doi.org/10.1016/j.psychres.2010.04.021,Latent profile analysis and comorbidity in a sample of individuals with compulsive buying disorder,"The aims of this study were to perform a latent profile analysis in a sample of individuals with compulsive buying, to explore the psychiatric comorbidity, and to examine whether or not more severe compulsive buying is associated with greater comorbidity. Compulsive buying measures and SCID data obtained from 171 patients with compulsive buying behavior who had participated in treatment trials at different clinical centers in the U.S. and Germany were analyzed. Latent profile analysis produced two clusters. Overall, cluster 2, included subjects with more severe compulsive buying, and was characterized by higher lifetime as well as current prevalence rates for Axis I and impulse control disorders. Nearly 90% of the total sample reported at least one lifetime Axis I diagnosis, particularly mood (74%) and anxiety (57%) disorders. Twenty-one percent had a comorbid impulse control disorder, most commonly intermittent explosive disorder (11%). Half of the sample presented with at least one current Axis I disorder, most commonly anxiety disorders (44%). Given the substantial psychiatric comorbidity, it is reasonable to question whether or not compulsive buying represents a distinct psychiatric entity vs. an epiphenomenon of other psychiatric disorders.",0 +https://doi.org/10.1371/journal.pone.0059236,A Systematic Review of PTSD Prevalence and Trajectories in DSM-5 Defined Trauma Exposed Populations: Intentional and Non-Intentional Traumatic Events,"We conducted a systematic review of the literature to explore the longitudinal course of PTSD in DSM-5-defined trauma exposed populations to identify the course of illness and recovery for individuals and populations experiencing PTSD.We reviewed the published literature from January 1, 1998 to December 31, 2010 for longitudinal studies of directly exposed trauma populations in order to: (1) review rates of PTSD in the first year after a traumatic event; (2) examine potential types of proposed DSM-5 direct trauma exposure (intentional and non-intentional); and (3) identify the clinical course of PTSD (early onset, later onset, chronicity, remission, and resilience). Of the 2537 identified articles, 58 articles representing 35 unique subject populations met the proposed DSM-5 criteria for experiencing a traumatic event, and assessed PTSD at two or more time points within 12 months of the traumatic event.The mean prevalence of PTSD across all studies decreases from 28.8% (range =3.1-87.5%) at 1 month to 17.0% (range =0.6-43.8%) at 12 months. However, when traumatic events are classified into intentional and non-intentional, the median prevalences trend down for the non-intentional trauma exposed populations, while the median prevalences in the intentional trauma category steadily increase from 11.8% to 23.3%. Across five studies with sufficient data, 37.1% of those exposed to intentional trauma develop PTSD. Among those with PTSD, about one third (34.8%) remit after 3 months. Nearly 40% of those with PTSD (39.1%) have a chronic course, and only a very small fraction (3.5%) of new PTSD cases appears after three months.Understanding the trajectories of PTSD over time, and how it may vary by type of traumatic event (intentional vs. non-intentional) will assist public health planning and treatment.",0 +https://doi.org/10.1111/j.1600-0447.1994.tb01580.x,Posttraumatic stress reactions after single and double trauma,"This study evaluated the severity and symptom profile of posttraumatic stress reactions of 202 adults exposed in 1988 to political violence in Azerbaijan and/or the earthquake in Armenia. High rates of severe posttraumatic stress reactions were found among the most highly exposed individuals, irrespective of the type of trauma. There was no difference in symptom profile for subjects exposed to earthquake versus violence. These similarities in severity and symptom profile may be attributable to common features of the exposures, which included experiencing life-threat and witnessing injury, multilation and death. Recent prior exposure to violence contributed to the severity of reaction to the earthquake. The high rates of chronic and severe posttraumatic stress reactions in Armenia constitute a major public mental health problem.",0 +https://doi.org/10.1177/0886260509354587,ASD and PTSD in Rape Victims,"In recent years, a number of studies have investigated the prediction of posttraumatic stress disorder (PTSD) through the presence of acute stress disorder (ASD). The predictive power of ASD on PTSD was examined in a population of 148 female rape victims who visited a center for rape victims shortly after the rape or attempted rape. The PTSD diagnosis based solely on the three core symptom clusters was best identified by a subclinical ASD diagnosis based on all ASD criteria except dissociation. However, a full PTSD diagnosis including the A 2 and F criteria was best identified by classifying victims according to a full ASD diagnosis. Regardless of whether cases were classified according to full PTSD status or according to meeting the criteria for the three PTSD core symptom clusters, the classification was correct only in approximately two thirds of the cases. A regression analysis based on ASD severity and sexual problems following the rape accounted for only 28% of the PTSD severity variance. In conclusion, the ASD diagnosis is not an optimal method for identifying those most at risk for PTSD. It remains to be seen whether a better way can be found.",0 +https://doi.org/10.2190/pm.42.2.e,A Comparison of the Acute Stress Reactions between the Han and Tibetan Ethnic Groups in Responding to Devastating Earthquakes,"Objective: The purpose of the present study was to investigate whether there were differences in the acute stress reaction (ASR) between the Tibetan and the Han ethnic groups after experiencing devastating earthquakes. Methods: One hundred twelve Han survivors of the Wenchuan earthquake and 112 Tibetan survivors of the Yushu earthquake were rated using the PTSD Checklist-Civilian (PCL-C) according to their trauma experiences, ages, genders, severity levels of injuries, and medical services received. Results: Injured Tibetans had lower scores across symptom clusters of avoidance, numbing, and the total score of PCL-C as compared to Hans. Among Tibetans, severe ASR was associated with a higher education level and earthquake experience, whereas only earthquake experience was associated with severe ASR among injured Hans. Conclusion: Cultural factors may play significant roles in the acute stress reaction of survivors with different cultural backgrounds following an earthquake.",0 +,Diagnosis and management of generalized anxiety disorder and panic disorder in adults.,"Generalized anxiety disorder (GAD) and panic disorder (PD) are among the most common mental disorders in the United States, and they can negatively impact a patient's quality of life and disrupt important activities of daily living. Evidence suggests that the rates of missed diagnoses and misdiagnosis of GAD and PD are high, with symptoms often ascribed to physical causes. Diagnosing GAD and PD requires a broad differential and caution to identify confounding variables and comorbid conditions. Screening and monitoring tools can be used to help make the diagnosis and monitor response to therapy. The GAD-7 and the Severity Measure for Panic Disorder are free diagnostic tools. Successful outcomes may require a combination of treatment modalities tailored to the individual patient. Treatment often includes medications such as selective serotonin reuptake inhibitors and/or psychotherapy, both of which are highly effective. Among psychotherapeutic treatments, cognitive behavior therapy has been studied widely and has an extensive evidence base. Benzodiazepines are effective in reducing anxiety symptoms, but their use is limited by risk of abuse and adverse effect profiles. Physical activity can reduce symptoms of GAD and PD. A number of complementary and alternative treatments are often used; however, evidence is limited for most. Several common botanicals and supplements can potentiate serotonin syndrome when used in combination with antidepressants. Medication should be continued for 12 months before tapering to prevent relapse.",0 +https://doi.org/10.1016/j.aucc.2013.10.060,The course of postraumatic stress in children: Examination of symptom trajectories following PICU admission,"Background and aims: Advances in modern medicine have increasingly improved survival rates of critically ill and injured children. Evidence suggests that there is a significant risk for posttraumatic stress symptoms (PTSS) for children following admission to the Paediatric Intensive Care (PICU), however few studies have explored individual recovery patterns, especially in children. Aims: This paper identifies patterns of PTSS in children aged from 1 year following PICU admission using group-based trajectory modelling. Methods: Following IRB approval, maternal reports of child distress from the acute stage and up to 2 years post-PICU admission (n = 272) were examined to: (1) assess the prevalence of distress in the child, (2) identify symptom trajectories, and (3) identify risk factors associated with poor child mental health outcomes following PICU admission. Results: Analysis identified three distinct symptom trajectories in the children. The majority were resilient (82%). A small group had very high symptoms in the acute phase but were below the clinical cut-off after 6 months (recovery 3%). A significant group of children had clinical level symptoms that did not appear to improve over time (chronic 15%). There was no evidence of delayed onset PTSS. Child age and gender do not predict trajectory patterns. Conclusions: There is growing evidence that significant distress in the peritrauma period is linked to continuing clinical level distress symptoms which have the potential to impact on child physical recovery and long term functioning. Research into early interventions for distressed children following critical illness is a matter of urgency.",0 +https://doi.org/10.1080/16501960410023877,Methodological issues and research recommendations for mild traumatic brain injury: the who collaborating centre task force on mild traumatic brain injury,"The WHO Collaborating Centre for Neurotrauma Task Force on Mild Traumatic Brain Injury performed a comprehensive search and critical review of the literature published between 1980 and 2002 to assemble the best evidence on the epidemiology, diagnosis, prognosis and treatment of mild traumatic brain injury. Of 743 relevant studies, 313 were accepted on scientific merit and comprise our best-evidence synthesis. The current literature on mild traumatic brain injury is of variable quality and we report the most common methodological flaws. We make recommendations for avoiding the shortcomings evident in much of the current literature and identify topic areas in urgent need of further research. This includes the need for large, well-designed studies to support evidence-based guidelines for emergency room triage of children with mild traumatic brain injury and to explore more fully the issue of prognosis after mild traumatic brain injury in the elderly population. We also advocate use of standard criteria for defining mild traumatic brain injury and propose a definition.",0 +https://doi.org/10.1097/ede.0b013e31815c1dbf,Longitudinal Determinants of Posttraumatic Stress in a Population-Based Cohort Study,"Posttraumatic stress disorder is a prevalent and disabling psychologic pathology. Longitudinal research on the predictors of posttraumatic stress symptomatology is limited.We recruited 2752 participants to a prospective, population-based cohort study by conducting a telephone survey of adult residents of the New York City metropolitan area in 2002; participants completed 3 follow-up interviews over a 30-month period. Censoring weights were estimated to account for potential bias. We used generalized estimating equation logistic regression models with bootstrapped confidence intervals to assess the predictors of posttraumatic stress over time in multivariable models.Predictors of posttraumatic stress over time included ongoing stressors (odds ratio [OR] = 1.91 per 1 unit increase in number of stressors, [95% confidence interval = 1.55-2.36]) and traumatic events (OR = 1.92 per 1 unit increase in number of traumatic events [CI = 1.71-2.22]), social support (compared with high levels, OR = 1.71 for medium [1.09-2.52]; OR = 1.57 for low [1.08-2.35]), low income (OR = 0.87 per $10,000 increase [0.81-0.92]), female sex (1.60 [1.11-2.23]), and Latino ethnicity (compared with white, OR = 1.74 [1.05-2.97]).These findings suggest that ongoing stressors play a central role in explaining the trajectory of posttraumatic stress over time, and that factors beyond the experience of stressors and traumas may account for sex and ethnic differences in posttraumatic stress risk. Interventions that focus on reducing ongoing adversity may help mitigate the consequences of traumatic events.",0 +https://doi.org/10.1093/aje/kwg187,Trends of Probable Post-Traumatic Stress Disorder in New York City after the September 11 Terrorist Attacks,"The authors investigated trends in probable post-traumatic stress disorder (PTSD) prevalence in the general population of New York City in the first 6 months after the September 11 terrorist attacks. Three random digit dialing telephone surveys of adults in progressively larger portions of the New York City metropolitan area were conducted 1 month, 4 months, and 6 months after September 11, 2001. A total of 1,008, 2,001, and 2,752 demographically representative adults were recruited in the three surveys, respectively. The current prevalence of probable PTSD related to the September 11 attacks in Manhattan declined from 7.5% (95% confidence interval: 5.7, 9.3) 1 month after September 11 to 0.6% (95% confidence interval: 0.3, 0.9) 6 months after September 11. Although the prevalence of PTSD symptoms was consistently higher among persons who were more directly affected by the attacks, a substantial number of persons who were not directly affected by the attacks also met criteria for probable PTSD. These data suggest a rapid resolution of most of the probable PTSD symptoms in the general population of New York City in the first 6 months after the attacks. The psychological consequences of a large-scale disaster in a densely populated urban area may extend beyond persons directly affected by the disaster to persons in the general population.",0 +https://doi.org/10.1016/j.chiabu.2005.09.006,"Post-traumatic stress disorder, depression, and anxiety among Gaza Strip adolescents in the wake of the second Uprising (Intifada)","Children and adolescents of the Gaza Strip have been subjected to continuous violence since the eruption of the second Intifada (Uprising). Little is known, however, about the psychological effects of this violence on children and adolescents of Gaza. Thus, the purpose of the present investigation was to evaluate and describe the psychological effects of exposure of war-like circumstances on this population.Participants for this study were 229 Palestinian adolescents living in the Gaza Strip who were administered measures of post-traumatic stress disorder (PTSD), depression, anxiety, and coping.Of the 229 participants, 68.9% were classified as having developed PTSD, 40.0% reported moderate or severe levels of depression, 94.9% were classified as having severe anxiety levels, and 69.9% demonstrated undesirable coping responses. A canonical discriminant analysis revealed that adolescents diagnosed with PTSD tended to be those who reported the highest levels of depression, anxiety, and positive reappraisal coping, and the lowest levels of seeking guidance and support coping.These results indicate that a significant proportion of Palestinian adolescents living in the Gaza Strip are experiencing serious psychological distress.",0 +https://doi.org/10.1001/archgenpsychiatry.2012.8,Emotional Reactivity to a Single Inhalation of 35% Carbon Dioxide and Its Association With Later Symptoms of Posttraumatic Stress Disorder and Anxiety in Soldiers Deployed to Iraq,"The identification of modifiable predeployment vulnerability factors that increase the risk of combat stress reactions among soldiers once deployed to a war zone offers significant potential for the prevention of posttraumatic stress disorder (PTSD) and other combat-related stress disorders. Adults with anxiety disorders display heightened emotional reactivity to a single inhalation of 35% carbon dioxide (CO(2)); however, data investigating prospective linkages between emotional reactivity to CO(2) and susceptibility to war-zone stress reactions are lacking.To investigate the association of soldiers' predeployment emotional reactivity to 35% CO(2) challenge with several indices of subsequent war-zone stress symptoms assessed monthly while deployed in Iraq.Prospective cohort study of 158 soldiers with no history of deployment to a war zone were recruited from the Texas Combat Stress Risk Study between April 2, 2007, and August 28, 2009.Multilevel regression models were used to investigate the association between emotional reactivity to 35% CO(2) challenge (assessed before deployment) and soldiers' reported symptoms of general anxiety/stress, PTSD, and depression while deployed to Iraq.Growth curves of PTSD, depression, and general anxiety/stress symptoms showed a significant curvilinear relationship during the 16-month deployment period. War-zone stressors reported in theater were associated with symptoms of general anxiety/stress, PTSD, and depression. Consistent with the prediction, soldiers' emotional reactivity to a single inhalation of 35% CO(2)-enriched air before deployment significantly potentiated the effects of war-zone stressors on the subsequent development of PTSD symptoms and general anxiety/stress symptoms but not on the development of depression, even after accounting for the effects of trait anxiety and the presence of past or current Axis I mental disorders.Soldiers' emotional reactivity to a 35% CO(2) challenge may serve as a vulnerability factor for increasing soldiers' risk for PTSD and general anxiety/stress symptoms in response to war-zone stressors.",0 +https://doi.org/10.1111/jmwh.12221,A Mixed-Methods Study of Secondary Traumatic Stress in Certified Nurse-Midwives: Shaken Belief in the Birth Process,"Secondary traumatic stress (STS) is an occupational hazard for clinicians who can experience symptoms of posttraumatic stress disorder (PTSD) from exposure to their traumatized patients. The purpose of this mixed-methods study was to determine the prevalence and severity of STS in certified nurse-midwives (CNMs) and to explore their experiences attending traumatic births.A convergent, parallel mixed-methods design was used. The American Midwifery Certification Board sent out e-mails to all their CNM members with a link to the SurveyMonkey study. The STS Scale was used to collect data for the quantitative strand. For the qualitative strand, participants were asked to describe their experiences of attending one or more traumatic births. IBM SPSS 21.0 (Version 21.0, Armonk, NY) was used to analyze the quantitative data, and Krippendorff content analysis was the method used to analyze the qualitative data.The sample consisted of 473 CNMs who completed the quantitative portion and 246 (52%) who completed the qualitative portion. In this sample, 29% of the CNMs reported high to severe STS, and 36% screened positive for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnostic criteria for PTSD due to attending traumatic births. The top 3 types of traumatic births described by the CNMs were fetal demise/neonatal death, shoulder dystocia, and infant resuscitation. Content analysis revealed 6 themes: 1) protecting my patients: agonizing sense of powerlessness and helplessness; 2) wreaking havoc: trio of posttraumatic stress symptoms; 3) circling the wagons: it takes a team to provide support … or not; 4) litigation: nowhere to go to unburden our souls; (5) shaken belief in the birth process: impacting midwifery practice; and 6 moving on: where do I go from here?The midwifery profession should acknowledge STS as a professional risk.",0 +https://doi.org/10.1016/s0010-440x(98)90069-4,Psychiatric morbidity following motor vehicle accidents: A review of methodological issues,"Motor vehicle accidents (MVAs), even those of a nonserious nature, appear to increase the risk of severe psychiatric morbidity in survivors. The present review examines the evidence indicating the levels of psychiatric morbidity in MVA survivors. Although no consistent profile has emerged, the most commonly reported symptoms are depression, anxiety, irritability, driving phobia, anger, sleep disturbances, and headache, with rates of posttraumatic stress disorder (PTSD) across studies of 0% to 100%. Variability in the type and severity of psychiatric outcomes may be due, in part, to methodological inadequacies in many studies, particularly the use of biased population samples, inclusion of subjects exposed to varied types of accidents, an absence of a clear definition of PTSD, a reliance on clinical judgment rather than the use of objective psychometric measures, the failure to include ratings of injury severity, and the absence of assessments for past exposure to traumatic events or preexisting posttraumatic reactions. The most important concern relates to the use of nonrepresentative samples, usually patients referred for medicolegal assessment in whom issues of compensation are of central importance. Gender and age differences distinguish the compensation group from the general population of MVA survivors, who therefore may also differ in the vulnerability to posttraumatic morbidity. It is argued that more systematic research on unselected subject samples is critical to establish epidemiological data on the true nature and extent of psychiatric morbidity following MVAs.",0 +https://doi.org/10.1186/1471-2458-9-231,A systematic review of post-deployment injury-related mortality among military personnel deployed to conflict zones,"This paper reports on a systematic review of the literature on the post-conflict injury-related mortality of service members who deployed to conflict zones.Literature databases, reference lists of articles, agencies, investigators, and other sources were examined to find studies comparing injury-related mortality of military veterans who had served in conflict zones with that of contemporary veterans who had not served in conflict zones. Injury-related mortality was defined as a cause of death indicated by International Classification of Diseases E-codes E800 to E999 (external causes) or subgroupings within this range of codes.Twenty studies met the review criteria; all involved veterans serving during either the Vietnam or Persian Gulf conflict. Meta-analysis indicated that, compared with non-conflict-zone veterans, injury-related mortality was elevated for veterans serving in Vietnam (summary mortality rate ratio (SMRR) = 1.26, 95% confidence interval (95%CI) = 1.08-1.46) during 9 to 18 years of follow-up. Similarly, injury-related mortality was elevated for veterans serving in the Persian Gulf War (SMRR = 1.26, 95%CI = 1.16-1.37) during 3 to 8 years of follow-up. Much of the excess mortality among conflict-zone veterans was associated with motor vehicle events. The excess mortality decreased over time. Hypotheses to account for the excess mortality in conflict-zone veterans included post-traumatic stress, coping behaviors such as substance abuse, ill-defined diseases and symptoms, lower survivability in injury events due to conflict-zone comorbidities, altered perceptions of risk, and/or selection processes leading to the deployment of individuals who were risk-takers.Further research on the etiology of the excess mortality in conflict-zone veterans is warranted to develop appropriate interventions.",0 +https://doi.org/10.1037/a0015370,A prospective examination of PTSD symptoms as risk factors for subsequent exposure to potentially traumatic events among women.,"Previous research has suggested that both exposure to potentially traumatic events (PTEs) and emotional reactions to such events act as risk factors for subsequent exposure. Although some studies have implicated posttraumatic stress disorder (PTSD) symptoms as risk factors, extant research suffers from a number of methodological limitations, including the use of cross-sectional designs and student populations. The present study sought to address these limitations using a 2-year, 3-wave national probability household sample of 2,863 adult women. After controlling for demographic characteristics, prior exposure to PTEs, and Wave 1 depression and substance abuse, PTSD reexperiencing symptoms at Wave 1 predicted subsequent exposure to interpersonal violence victimization (IPVV) perpetrated by a nonintimate perpetrator; however, PTSD symptoms did not predict intimate partner IPVV. In addition, PTSD hyperarousal symptoms were unique predictors of subsequent exposure to other traumatic stressors. Findings suggest that efforts to prevent PTEs should focus attention on both prior exposure and PTSD symptoms in response to such exposure.",0 +https://doi.org/10.1177/0165025406066743,Psychological distress and resources among siblings and parents exposed to traumatic events,"We examined symmetries and asymmetries within family members' psychological distress and resources in general and when exposed to traumatic events in particular. PTSD and depressive symptoms indicated distress and resilient attitudes, and satisfaction with quality of life indicated resources. We also analysed potential complementary dynamics between family members and identified family types according to their distress and resources. Concerning trauma impact, we hypothesized that exposure to family military violence (FMV) and recent personal trauma (RPT) predict family members' psychological distress and resources differently, indicating asymmetry in family responses. The participants were 65 Palestinian families each consisting of a mother, a father and their 15-, 17and 19-year-old children. The within-family MANOVA results showed asymmetric in psychological distress and resources in sibling and spousal subsystems, for example older siblings reported a higher level of depressive symptoms than both parents, and mothers reported PTSD more often than fathers. The cluster analysis identified four family types, two with symmetric responses: In the “resilient families” all members showed low distress and high resources, and in the “ordeal families” all showed distress and low resources. In the asymmetric families either the children or the parents showed low distress and high resources, named the “children's strength families” and the “parental strength families”, respectively. Partial correlation analysis revealed complementary dynamics between children and their parents: If mothers reported high levels of psychological distress, the 15and 17-year-olds reported low or vice versa. Spousal complementary dynamics were found in psychosocial resources: If the mother showed highly resilient attitudes, the father showed low or vice versa. As hypothesized, exposure to traumatic events was differently associated with family members’ psychological distress and resources. Family military trauma (FMT) predicted depressive symptoms only among the youngest siblings, and recent personal trauma (RPT) was associated with dissatisfaction with quality of life only among the oldest sibling and fathers.",0 +https://doi.org/10.1037/1082-989x.8.3.384,"Overextraction of Latent Trajectory Classes: Much Ado About Nothing? Reply to Rindskopf (2003), Muthén (2003), and Cudeck and Henly (2003).","The comments on D. J. Bauer and P. J. Curran (2003) share 2 common themes. The 1st theme is that model-checking procedures may be capable of distinguishing between mixtures of normal and homogeneous nonnormal distributions. Although useful for assessing model quality, it is argued here that currently available procedures may not always help discern between these 2 possibilities. The 2nd theme is that even if these 2 possibilities cannot be distinguished, a growth mixture model may still provide useful insights into the data. It is argued here that whereas this may be true for the scientific goals of description and prediction, the acceptance of a model that fundamentally misrepresents the underlying data structure may be less useful in pursuit of the goal of explanation.",0 +https://doi.org/10.1007/s11136-012-0210-y,Measurement of individualised quality of life amongst young people with indicated personality disorder during emerging adulthood using the SEIQoL-DW,"Purpose To examine both the feasibility of applying the Schedule for the Evaluation of Individual Quality of Life- Direct Weighting procedure (SEIQoL-DW) as a routine outcome measure within an early intervention service for young people with indicated personality disorder and the overall quality of life (QoL) in this population. Methods SEIQoL-DW was administered alongside the Standardised Assessment of Personality-Abbreviated Scale-Self-Report (SAPAS-SR), Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder Scale (GAD-7) and the Post-Traumatic Stress Disorder-Primary Care (PTSD-PC) as part of routine service evaluation over a 16-month period. Descriptive statistics were calculated for data reflecting use of the SEIQoL-DW alongside demographic and outcome variables. Results The SEIQoL-DW was administered to 52 young adults with indicated personality disorder, with 47 completing the measure, taking an average time of 27 min. Individual QoL was poor with a mean global index score of 55.07 (SD = 22.34). Individual QoL areas formed five main domains-'Aspects of Daily Living', 'Relationships', 'Social Life and Leisure', 'Family' and 'Emotional and Physical Wellbeing'. Conclusion This study further extends the application of the SEIQoL-DW for use as a routine outcome measure within a busy service setting, although ways to accommodate administration time need to be considered. Poor QoL highlights the need for continued development of services to meet the needs of young adults with indicated personality disorder. © Springer Science+Business Media B.V. 2012.",0 +https://doi.org/10.1016/j.janxdis.2013.05.005,Attention to threat images in individuals with clinical and subthreshold symptoms of post-traumatic stress disorder,"Attention to general and trauma-relevant threat was examined in individuals with clinical and subthreshold symptoms of post-traumatic stress disorder (PTSD). Participants' eye gaze was tracked and recorded while they viewed sets of four images over a 6-s presentation (one negative, positive, and neutral image, and either a general threat image or a trauma-relevant threat image). Two trauma-exposed groups (a clinical and a subthreshold PTSD symptom group) were compared to a non-trauma-exposed group. Both the clinical and subthreshold PTSD symptom groups attended to trauma-relevant threat images more than the no-trauma-exposure group, whereas there were no group differences for general threat images. A time course analysis of attention to trauma-relevant threat images revealed different attentional profiles for the trauma-exposed groups. Participants with clinical PTSD symptoms exhibited immediate heightened attention to the images relative to participants with no-trauma-exposure, whereas participants with subthreshold PTSD symptoms did not. In addition, participants with subthreshold PTSD symptoms attended to trauma-relevant threat images throughout the 6-s presentation, whereas participants with clinical symptoms of PTSD exhibited evidence of avoidance. The theoretical and clinical implications of these distinct attentional profiles are discussed.",0 +https://doi.org/10.1097/htr.0000000000000149,Clinical Utility and Psychometric Properties of the Traumatic Brain Injury Quality of Life Scale (TBI-QOL) in US Military Service Members,"To examine the clinical utility and psychometric properties of the Traumatic Brain Injury Quality of Life (TBI-QOL) scale in a US military population.One hundred fifty-two US military service members (age: M = 34.3, SD = 9.4; 89.5% men) prospectively enrolled from the Walter Reed National Military Medical Center and other nationwide community outreach initiatives. Participants included 99 service members who had sustained a mild traumatic brain injury (TBI) and 53 injured or noninjured controls without TBI (n = 29 and n = 24, respectively).Participants completed the TBI-QOL scale and 5 other behavioral measures, on average, 33.8 months postinjury (SD = 37.9).Fourteen TBI-QOL subscales; Neurobehavioral Symptom Inventory; Posttraumatic Stress Disorder Checklist-Civilian version; Alcohol Use Disorders Identification Test; Combat Exposure Scale.The internal consistency reliability of the TBI-QOL scales ranged from α = .91 to α = .98. The convergent and discriminant validity of the 14 TBI-QOL subscales was high. The mild TBI group had significantly worse scores on 10 of the 14 TBI-QOL subscales than the control group (range, P < .001 to P = .043). Effect sizes ranged from medium to very large (d = 0.35 to d = 1.13). The largest differences were found on the Cognition-General Concerns (d = 1.13), Executive Function (d = 0.94), Grief-Loss (d = 0.88), Pain Interference (d = 0.83), and Headache Pain (d = 0.83) subscales.These results support the use of the TBI-QOL scale as a measure of health-related quality of life in a mild TBI military sample. Additional research is recommended to further evaluate the clinical utility of the TBI-QOL scale in both military and civilian settings.",0 +https://doi.org/10.1097/psy.0b013e31819ccd10,Trajectories of Self-Rated Health Among Veterans: A Latent Growth Curve Analysis of the Impact of Posttraumatic Symptoms,"To examine the effects of combat stress reaction (CSR) and posttraumatic stress symptoms (PTS) on the level and trajectories of self-rated health (SRH) over 20 years after war exposure.A total of 675 veterans comprising two groups, a CSR group (n = 369) and a matched control group without CSR (n = 306), were assessed in a prospective longitudinal design, 1, 2, 3, and 20 years after their participation in the 1982 Lebanon War. SRH and PTS were assessed repeatedly, at each point of measurement.The CSR participants showed more impaired initial SRH than the controls. Although the CSR group showed an improvement in SRH over time, its SRH level remained lower than that of the control group in all 4 points in time. Initial levels of PTS were associated with more impaired SRH and lower improvement over time. In addition, increased levels of PTS in the first follow-up period were related to poorer SRH, in comparison to the predicted trajectory on the basis of CSR and initial PTS.Stress reaction to war trauma affected the trajectory of SRH over a 20-year period. Although the differences between veterans who had shown acute stress reaction and those who had not persisted over the entire period, there was slow improvement in SRH over time among the more impaired CSR group. PTS in the first years after the war slowed this improvement and thus played a key role in the relationship between war trauma and physical health.",0 +https://doi.org/10.1002/hbm.23093,Abnormal functional architecture of amygdala‐centered networks in adolescent posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) is a prevalent, debilitating, and difficult to treat psychiatric disorder. Very little is known of how PTSD affects neuroplasticity in the developing adolescent brain. Whereas multiple lines of research implicate amygdala-centered network dysfunction in the pathophysiology of adult PTSD, no study has yet examined the functional architecture of amygdala subregional networks in adolescent PTSD. Using intrinsic functional connectivity analysis, we investigated functional connectivity of the basolateral (BLA) and centromedial (CMA) amygdala in 19 sexually abused adolescents with PTSD relative to 23 matched controls. Additionally, we examined whether altered amygdala subregional connectivity coincides with abnormal grey matter volume of the amygdaloid complex. Our analysis revealed abnormal amygdalar connectivity and morphology in adolescent PTSD patients. More specifically, PTSD patients showed diminished right BLA connectivity with a cluster including dorsal and ventral portions of the anterior cingulate and medial prefrontal cortices (p < 0.05, corrected). In contrast, PTSD patients showed increased left CMA connectivity with a cluster including the orbitofrontal and subcallosal cortices (p < 0.05, corrected). Critically, these connectivity changes coincided with diminished grey matter volume within BLA and CMA subnuclei (p < 0.05, corrected), with CMA connectivity shifts additionally relating to more severe symptoms of PTSD. These findings provide unique insights into how perturbations in major amygdalar circuits could hamper fear regulation and drive excessive acquisition and expression of fear in PTSD. As such, they represent an important step toward characterizing the neurocircuitry of adolescent PTSD, thereby informing the development of reliable biomarkers and potential therapeutic targets.",0 +https://doi.org/10.1016/0005-7967(93)90048-y,Perceived controllability and the development of posttraumatic stress disorder (PTSD) in crime victims,"This study evaluated the association between perception of controllability and the development of posttraumatic stress disorder (PTSD) following criminal assault. Factor analysis of a perceived controllability scale revealed three factors; perceived controllability felt during the assault, expected controllability over future assaults, and perceived controllability over aversive events more generally. Only the latter factor was associated with PTSD symptom severity. The hypothesis that perceived controllability would be negatively associated with assault severity was partially supported. Further analyses showed that the association between controllability and PTSD was not mediated or moderated by assault severity measures. The role of perceived controllability in the development of PTSD is discussed.",0 +https://doi.org/10.1016/s0165-1781(00)00195-5,Autonomic dysregulation in panic disorder and in post-traumatic stress disorder: application of power spectrum analysis of heart rate variability at rest and in response to recollection of trauma or panic attacks,"Power spectral analysis (PSA) of heart rate variability (HRV) offers reliable assessment of cardiovascular autonomic responses, providing a 'window' onto the interaction of peripheral sympathetic and parasympathetic tone. Alterations in HRV are associated with various physiological and pathophysiological processes, and may contribute to morbidity and mortality. Previous studies of posttraumatic stress disorder (PTSD) found lower resting HRV in patients compared to controls, suggesting increased sympathetic and decreased parasympathetic tone. This article describes the analysis of HRV at rest and after psychological stress in panic disorder (PD) patients, in an enlarged sample of PTSD patients, and in healthy control subjects. Standardized heart rate (HR) analysis was carried out in 14 PTSD patients, 11 PD patients and 25 matched controls. ECG recordings were made while subjects were resting ('rest 1'), while recalling the trauma implicated in PTSD, or the circumstances of a severe panic attack, as appropriate ('recall'), and again while resting ('rest 2'). Controls were asked to recall a stressful life event during recall. While both patient groups had elevated HR and low frequency (LF) components of HRV at baseline (suggesting increased sympathetic activity), PTSD patients, unlike PD patients and controls, failed to respond to the recall stress with increases in HR and LF. HRV analysis demonstrates significant differences in autonomic regulation of PTSD and PD patients compared to each other and to control subjects. HRV analysis may augment biochemical studies of peripheral measures in these disorders.",0 +https://doi.org/10.1007/978-1-4614-5737-4,Community Disaster Vulnerability,"Disaster vulnerability is rapidly increasing on a global scale, particularly for those populations which are the historical clients of the social work profession. These populations include the very young and very old, the poor, ethnic and racial minorities, and those with physical or mental disabilities. Social workers are increasingly providing services in disasters during response and recovery periods, and are using community interventions to reduce disaster vulnerability. There is a need for a cogent theory of vulnerability and research that addresses improved community disaster practice and community resilience. Community Disaster Vulnerability and Resilience provides a unifying theoretical framework backed by research which can be translated into knowledge for effective practice in disasters. © Springer Science+Business Media New York 2013. All rights are reserved.",0 +,"Clinicians' Posttraumatic Growth following Hurricane Katrina: The Influence of Life Events, Professional Quality of Life, and Primary and Secondary Traumatic Stress","This study was a secondary data analysis of 244 clinicians living and working in a post-Katrina environment. Using structural equation modeling, clinicians' trauma histories and primary and secondary traumatic stress were assessed in relationship to posttraumatic growth. It was expected that a greater number of traumatic life events would be related to higher levels of traumatic experience and growth. It was also expected that traumatic life experience would be associated with growth. Contrary to expectation, the initial evaluation of the path coefficients showed no significant paths between primary trauma and posttraumatic growth. A closer inspection of measures and model diagnostics revealed three distinct constructs pertaining to primary trauma, none of which were highly correlated. A revised model was then re-fit with the inclusion of two latent variables, primary trauma and posttraumatic growth, which yielded a better fit. The new model was statistically overidentified. The results showed that a greater number of traumatic life events were related to both primary and secondary traumatic stress but not growth. The latent variables revealed a statistically significant relationship between traumatic reexperiencing which related to greater posttraumatic growth in the domain, appreciation for life. Implications for theory development, clinical practice and policy, and future research are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1002/jts.20589,Efficacy of exposure therapy for Japanese patients with posttraumatic stress disorder due to mixed traumatic events: A randomized controlled study,en,0 +https://doi.org/10.1097/nmd.0000000000000060,Risk Factors of Posttraumatic Stress Disorder After an Earthquake Disaster,"This study sought to predict posttraumatic stress disorder (PTSD) from women's reproductive health events after an earthquake experience. Data on antenatal care, pregnancy outcomes, family planning, socioeconomic status, earthquake experiences, and mental health were collected from a random sample of 425 women of reproductive age using the Centers for Disease Control and Prevention Reproductive Health Assessment Toolkit and the Harvard Trauma Questionnaire. Data were analyzed using multivariate regression analysis to predict PTSD symptoms from posttrauma care variables and reproductive health events. Restricted social participation, use of temporary accommodation, pregnancy complications, and use of injectable contraceptives were significant risk factors of PTSD. These factors may be exacerbated by the social context of conservative societies, traditions about health care-seeking behavior, and access to health care. Antecedent reproductive health events influence women's reaction to major trauma including events such as an earthquake.",0 +,The concept of nomogenic disorders.,"The term 'nomogenic disorders' has been coined for psychopathological conditions created, enhanced, and perpetuated by the law and its application, and for the psychological and social consequences of the law and the way it affects the course of the disease process. Questions are raised regarding the diagnosis, prognosis and therapy of this cluster of disorders. Conditions paradigmatic of nomogenic disorder are presented. Emphasis is placed on the historical development of traumatic neuroses, as they are at present the most frequently encountered nomogenic condition. The clinical and theoretical importance of the concept of nomogenesis is discussed.",0 +https://doi.org/10.1016/s2215-0366(14)00121-7,Pharmacological prevention of post-traumatic stress disorder and acute stress disorder: a systematic review and meta-analysis,"An increasing number of studies have investigated the pharmacological prevention of post-traumatic stress disorder (PTSD) and acute stress disorder (ASD). This is the first systematic review to examine the effects of pharmacotherapies (eg, β blockers, hydrocortisone, and selective serotonin re-uptake inhibitors) given within the first month after a traumatic or aversive event to prevent PTSD or ASD compared with no pharmacotherapy or placebo control.A systematic literature search in PubMed, PsycINFO, Embase, and the Cochrane database of randomised trials was done. Studies included randomised controlled trials, controlled clinical trials, and cohort studies; their overall quality was low to moderate. We computed the pooled incidence risk ratio (IRR): the risk of incidence of PTSD or ASD in the pharmacotherapy groups relative to the incidence of PTSD or ASD in the control groups. Additionally, we computed Hedges'g effect sizes for PTSD or ASD continuous outcomes.15 studies met inclusion criteria (1765 individuals). Pharmacotherapy was more effective in preventing PTSD or ASD than placebo or no intervention (14 studies, 1705 individuals, IRR 0·65, 95% CI 0·55-0·78; number needed to treat 11·36), although no effect was found when only randomised controlled trials were included (ten studies, 300 individuals, IRR 0·69, 95% CI 0·40-1·21). Hydrocortisone showed a large effect in reducing the risk of PTSD (five studies, 164 individuals, IRR 0·38, 95% CI 0·16-0·92).No firm evidence was found for the efficacy of all early pharmacotherapies in the prevention of PTSD or ASD, but hydrocortisone reduced the risk of developing PTSD. The small number of studies and their limited methodological quality cast uncertainty about the effects.None.",0 +https://doi.org/10.1007/s12207-011-9101-8,"Erratum to: Trends in Psychological/Psychiatric Injury and Law: Continuing Education, Practice Comments, Recommendations","This literature review of the major topics in the field of psychological/psychiatric injury and law is aimed at developing practice in the area. The field is a fast-developing one, with over ten major topics that it needs to integrate. In particular, the present review focuses on current work on: law (evidence, tort); forensic psychology; assessment and testing; psychological injuries (posttraumatic stress disorder, chronic pain, traumatic brain injury, other); the APA DSM-5 draft (Diagnostic and statistical manual of mental disorders; American Psychiatric Association 2010); malingering; causality; multicultural considerations; disability; the American Medical Association (AMA) Guides to the evaluation of permanent impairment (Rondinelli et al. 2008); models; and treatment. At the end of each section of the article, practice comments introduce critical issues in applying the research to psychological work in the area. Whether undertaking tort evaluations, disability, and treatment plan assessments or treating individuals with psychological injuries, the professional needs state-of-the-art information in all the areas listed in order to remain scientifically informed, comprehensive, and impartial. The article concludes with recommendations for an integrated field in psychological/psychiatric injury and law, study in the field, research in its major areas, best practice policies, for example in assessment and treatment, and model building.",0 +https://doi.org/10.1586/14737175.8.8.1233,From efficacy to effectiveness: the trajectory of the treatment literature for children with PTSD,"This review summarizes efficacious treatments for preschoolers, children and adolescents with post-traumatic stress disorder, with a focus on the advances made within the last 5 years. There is considerable support for the use of trauma-specific cognitive-behavioral interventions, in both individual and group formats. The research on psychopharmacological treatments lags behind that of psychotherapy and is currently inconclusive. Limitations of the studies are discussed and treatments that warrant further consideration are reviewed. The authors also review current advances in effectiveness and suggest future directions that are important in generalizing the interventions to underserved and hard to reach populations. The article concludes with the authors' projections for the evolution of the field within the upcoming 5 years.",0 +https://doi.org/10.1111/j.1467-7717.2007.00337.x,The international humanitarian system and the 2004 Indian Ocean earthquake and tsunamis,"The December 2004 Indian Ocean earthquake and tsunamis were an exceptional event. So too was the scale of the response, particularly the level of international funding. Unprecedented donations meant that for once, an international emergency response was largely free of financial constraints. This removal of the funding constraint facilitated observation of the capacity and quality of international disaster aid. The Tsunami Evaluation Coalition conducted five independent thematic assessments in 2005—an impact study was planned, but never implemented. The five evaluations were supported by 44 sub-studies. Based on this work, this paper compares international disaster response objectives, principles and standards with actual performance. It reaches conclusions on four salient aspects: funding; capacity and quality; recovery; and ownership. It ends by proposing a fundamental reorientation of international disaster response approaches that would root them in concepts of sustainable disaster risk reduction and recovery, based on local and national ownership of these processes.",0 +https://doi.org/10.1016/j.comppsych.2011.12.001,Attention-deficit/hyperactivity disorder comorbidity in a sample of veterans with posttraumatic stress disorder,"This study examined attention-deficit/hyperactivity disorder (ADHD) comorbidity in military veterans with a high prevalence of posttraumatic stress disorder (PTSD) and evaluated the relationships between the 2 disorders and exposure to traumatic events. The sample included 222 male and female military veterans who were administered structured clinical interviews based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Results show that 54.5% met the criteria for current PTSD, 11.5% of whom also met the criteria for current adult ADHD. Level of trauma exposure and ADHD severity were significant predictors of current PTSD severity. Evaluation of the underlying structure of symptoms of PTSD and ADHD using confirmatory factor analysis yielded a best-fitting measurement model that comprised 4 PTSD factors and 3 ADHD factors. Standardized estimates of the correlations among PTSD and ADHD factors suggested that the largest proportion of shared variance underlying PTSD-ADHD comorbidity is related to problems with modulating arousal levels that are common to both disorders (ie, hyperarousal and hypoarousal).",0 +https://doi.org/10.1097/00004583-199603000-00018,Twenty-One—Month Follow-up Study of School-Age Children Exposed to Hurricane Andrew,"To explore the 21-month course of posttraumatic stress symptomatology (PTSS) and psychological morbidity in 30 school-age children (7 to 13 years) after exposure to Hurricane Andrew.Pynoos' Posttraumatic Stress Disorder Reaction Index and Achenbach's Teacher's Report Form were administered at 8 and 21 months after Hurricane Andrew.At 21 months 70% of the children endorsed moderate-severe PTSS. The reduction in PTSS was greater for boys than girls. Psychopathology as measured by the Teacher's Report Form increased over the 19-month period. Boys demonstrated significant increases in internalizing symptoms and in Withdrawn, Anxious/Depressed, Social Problems, and Attention Problems scales, and girls showed a significant increase in the Anxious/Depressed scale.Twenty-one months after exposure to Hurricane Andrew, there were continuing high levels of PTSS and evidence of increasing emotional and behavioral problems. While girls sustained higher levels of PTSS, boys demonstrated higher indices of other psychopathology. The enduring effects of disaster associated with secondary stressors and ""traumatic reminders"" continue to be etiologically important for continuing psychological morbidity.",0 +https://doi.org/10.1002/brb3.183,A factor analysis of posttraumatic stress disorder symptoms using data pooled from two venlafaxine extended‐release clinical trials,"Confirmatory factor analysis (CFA) of Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) three-factor posttraumatic stress disorder (PTSD) diagnostic criteria was conducted to determine fit for this patient population. An exploratory factor analysis (EFA) of alternate symptom structures was planned to identify symptoms that cluster in this population. The response of symptom factors to treatment with venlafaxine extended release (ER) was explored.Baseline 17-item Clinician-Administered PTSD Scale (CAPS-SX17) data were pooled from patients enrolled in two double-blind, randomized, placebo-controlled trials. The CFA was conducted using maximum likelihood and weighted, least-squares factor extraction methods. The EFA was performed using a polychoric correlation covariance matrix and Pearson correlation matrix.Data from a pooled population of 685 patients (venlafaxine ER: n = 339; placebo: n = 346) were analyzed. CFA rejected the DSM-IV three-factor structure. The EFA identified a different three-factor structure as the best fit: factor 1 included reexperiencing symptoms, factor 2 included symptoms of altered mood and cognition, whereas factor 3 comprised avoidance and arousal symptoms. All DSM-IV symptom factors and all factors in the identified three-factor model responded positively to venlafaxine ER treatment.Data are consistent with literature failing to confirm the three-factor structure of DSM-IV PTSD, and they support the DSM-5 inclusion of a symptom cluster addressing altered mood and cognition in PTSD. The efficacy of venlafaxine ER in reducing a range of symptom clusters in PTSD is consistent with its multiple mechanisms of action.",0 +https://doi.org/10.1016/0883-9417(93)90003-f,An exploration of the characteristics of post-traumatic stress disorder in reserve forces deployed during desert storm,"Post-traumatic stress disorder (PTSD), previously defined in Vietnam War veterans, was described in 251 Desert Storm reservists. The Mississippi Scale, Revised, was used with a brief demographic profile to survey Army, Marine, and Air Force personnel who had been deployed to Saudi Arabia. Age, sex, marital status, race, rank, duty, length of deployment, and branch of service were not found to be significantly related to PTSD symptoms. However, those surveyed within 3 to 6 months of homecoming reported significantly greater symptoms than those surveyed after 6 months. Five percent of subjects were found to have clinically diagnostic levels of PTSD symptoms 6 months after homecoming. Individuals who expressed difficulty discussing their experiences with more than one person also showed significantly higher PTSD scores. These findings indicate that readjustment reactions were prevalent during the first 6 months and that PTSD could be identified in 5% of the Desert Storm veterans.",0 +https://doi.org/10.1038/ajh.2008.296,"Blood Pressure in Firefighters, Police Officers, and Other Emergency Responders","Elevated blood pressure is a major risk factor for cardiovascular morbidity and mortality. Increased risk begins in the prehypertensive range and increases further with higher pressures. The strenuous duties of emergency responders (firefighters, police officers, and emergency medical services (EMS) personnel) can interact with their personal risk profiles, including elevated blood pressure, to precipitate acute cardiovascular events. Approximately three-quarters of emergency responders have prehypertension or hypertension, a proportion which is expected to increase, based on the obesity epidemic. Elevated blood pressure is also inadequately controlled in these professionals and strongly linked to cardiovascular disease morbidity and mortality. Notably, the majority of incident cardiovascular disease events occur in responders who are initially prehypertensive or only mildly hypertensive and whose average premorbid blood pressures are in the range in which many physicians would hesitate to prescribe medications (140-146/88-92). Laws mandating public benefits for emergency responders with cardiovascular disease provide an additional rationale for aggressively controlling their blood pressure. This review provides a background on emergency responders, summarizes occupational risk factors for hypertension and the metabolic syndrome, their prevalence of elevated blood pressure, and evidence linking hypertension with adverse outcomes in these professions. Next, discrepancies between relatively outdated medical standards for emergency responders and current, evidence-based guidelines for blood pressure management in the general public are highlighted. Finally, a workplace-oriented approach for blood pressure control among emergency responders is proposed, based on the seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.",0 +https://doi.org/10.1093/jpepsy/jsv047,Parents of Children With Cancer: At-Risk or Resilient?,"To examine adjustment in parents of children with cancer using a design that minimizes focusing effects and allows for direct comparison with parents of healthy children.Parents of 305 children with cancer and a demographically similar sample of 231 parents of healthy children were evaluated using diagnostic interviews for posttraumatic stress disorder (PTSD), and questionnaire measures of posttraumatic stress symptoms (PTSS) and psychological growth (PG), as well as measures of global psychological functioning.Rates of current and lifetime PTSD in parents of children with cancer were low, and did not differ from comparison parents. Likewise, levels of PTSS were not significantly different from comparison parents, but differed as a function of time since diagnosis, with parents of children who were ≥ 5 years from diagnosis reporting significantly lower PTSS than comparison parents. PG was higher in parents of children with cancer than in comparison parents regardless of time since diagnosis.Parents of children with cancer demonstrate resilience to this challenge.",0 +https://doi.org/10.1002/jts.20261,Individual differences in fear: Isolating fear reactivity and fear recovery phenotypes,"Although different people respond differently to threatening events, animal research on the neural basis of fear tends to focus on typical responses. Yet there are substantial individual differences between animals exposed to identical behavioral procedures. In an effort to begin to understand the nature and causes of fear variability and resilience, we separated outbred Sprague-Dawley rats into high and low reactivity, and fast and slow recovery phenotypes, based on freezing levels during fear conditioning and extinction, respectively. Subsequent tests revealed stable differences in both measures, indicating that fear responses reflect trait-like phenotypes in outbred animals. Because clinical disorders may reflect extreme phenotypes, identification of the biological basis for these differences could provide insights into human individual differences in fear.",0 +https://doi.org/10.1111/j.1552-6909.2011.01290.x,Emotional Responses of Mothers of Late‐Preterm and Term Infants,"ABSTRACT Objective To compare the emotional responses of mothers of late‐preterm infants (34 0/7 to 36 6/7 weeks gestation) with those of mothers of full‐term infants. Design A mixed method comparative study. Setting A southeastern tertiary academic medical center postpartum unit. Participants Sixty mothers: 29 mothers of late‐preterm infants and 31 mothers of full‐term infants. Methods Measures of maternal emotional distress (four standardized measures of anxiety, postpartum depression, posttraumatic stress symptoms, and worry about infant health) and open‐ended semistructured maternal interviews were conducted in the hospital following birth and by phone at one month postpartum. Results Mothers of late‐preterm infants experienced significantly greater emotional distress immediately following delivery, and their distress levels continued to be higher at one month postpartum on each of the standardized measures. Mothers of late‐preterm infants also discussed the altered trajectories in their birth and postpartum experiences and feeling unprepared for these unexpected events as a source of ongoing emotional distress. Conclusion Mothers of late‐preterm infants have greater emotional distress than mothers of term infants for at least one month after delivery. Our findings suggest that it may not be a single event that leads to different distress levels in mothers of late‐preterm and full‐term infants but rather the interaction of multiple alterations in the labor and delivery process and the poorer‐than‐expected infant health outcomes. In the future, researchers need to examine how and when mothers' emotional responses change over time and how their responses relate to parenting and infant health and development.",0 +https://doi.org/10.1037/abn0000020,Posttraumatic stress in deployed Marines: Prospective trajectories of early adaptation.,"We examined the course of PTSD symptoms in a cohort of U.S. Marines (N = 867) recruited for the Marine Resiliency Study (MRS) from a single infantry battalion that deployed as a unit for 7 months to Afghanistan during the peak of conflict there. Data were collected via structured interviews and self-report questionnaires 1 month prior to deployment and again at 1, 5, and 8 months postdeployment. Second-order growth mixture modeling was used to disaggregate symptom trajectories; multinomial logistic regression and relative weights analysis were used to assess the role of combat exposure, prior life span trauma, social support, peritraumatic dissociation, and avoidant coping as predictors of trajectory membership. Three trajectories best fit the data: a low-stable symptom course (79%), a new-onset PTSD symptoms course (13%), and a preexisting PTSD symptoms course (8%). Comparison in a separate MRS cohort with lower levels of combat exposure yielded similar results, except for the absence of a new-onset trajectory. In the main cohort, the modal trajectory was a low-stable symptoms course that included a small but clinically meaningful increase in symptoms from predeployment to 1 month postdeployment. We found no trajectory of recovery from more severe symptoms in either cohort, suggesting that the relative change in symptoms from predeployment to 1 month postdeployment might provide the best indicator of first-year course. The best predictors of trajectory membership were peritraumatic dissociation and avoidant coping, suggesting that changes in cognition, perception, and behavior following trauma might be particularly useful indicators of first-year outcomes.",1 +https://doi.org/10.1016/j.jpsychores.2015.06.001,Posttraumatic stress disorder and somatic symptoms among child and adolescent survivors following the Lushan earthquake in China: A six-month longitudinal study,"To explore somatic conditions in a sample of 2299 child and adolescent survivors of an earthquake and their relationship to posttraumatic stress disorder (PTSD) symptoms.The Children's Revised Impact of Event Scale, the Patient Health Questionnaire (PHQ)-13 scale, a short version of PHQ-15 scale that omits two items involving sexual pain/problems and menstrual problems, and a project-developed questionnaire were administered to participants three and six months after the earthquake.Among child and adolescent survivors, the prevalence rates of probable PTSD were 37.4 and 24.2% three and six months, respectively, after the earthquake. The most common somatic symptoms were trouble sleeping (58.4 and 48.4%), feeling tired or having low energy (52.0 and 46.1%), and stomach pain (45.8 and 45.4%) after three and six months, respectively. Several specific somatic symptoms evaluated three months after the earthquake including trouble sleeping, headache, and shortness of breath were predictors of the overall PTSD symptoms evaluated six months after the earthquake. Additionally, the symptom of hyperarousal evaluated after three months could predict the overall somatic symptoms evaluated after six months.PTSD and somatic symptoms were common after the earthquake, and a longitudinal association between PTSD and somatic symptoms was detected among child and adolescent survivors. These findings have implications in China and possibly elsewhere.",0 +https://doi.org/10.1007/s11920-015-0655-0,Prevention of Post-Traumatic Stress Disorder After Trauma: Current Evidence and Future Directions,"Post-traumatic stress disorder (PTSD) is a frequent, tenacious, and disabling consequence of traumatic events. The disorder's identifiable onset and early symptoms provide opportunities for early detection and prevention. Empirical findings and theoretical models have outlined specific risk factors and pathogenic processes leading to PTSD. Controlled studies have shown that theory-driven preventive interventions, such as cognitive behavioral therapy (CBT), or stress hormone-targeted pharmacological interventions, are efficacious in selected samples of survivors. However, the effectiveness of early clinical interventions remains unknown, and results obtained in aggregates (large groups) overlook individual heterogeneity in PTSD pathogenesis. We review current evidence of PTSD prevention and outline the need to improve the disorder's early detection and intervention in individual-specific paths to chronic PTSD.",0 +https://doi.org/10.1002/sim.2806,Measuring and maximizing coverage in the World Trade Center Health Registry,"The World Trade Center Health Registry (WTCHR) is a database for following people who were exposed to the disaster of 11 September 2001. Hundreds of thousands of people were exposed to the immense cloud of dust and debris, the indoor dust, the fumes from persistent fires, and the mental trauma of the terrorist attacks on the WTC on 9/11. The purpose of the WTCHR is to evaluate the potential short- and long-term physical and mental health effects of the disaster. The definitions of the exposed groups are broad and defined based on an understanding of which groups had the highest exposures to the WTC disaster and its aftermath. The four exposure groups include rescue and recovery workers, residents, students and school staff, and building occupants and passersby in Lower Manhattan. While one goal of the WTCHR was to maximize coverage overall and for each exposure group, another was to ensure equal representation within exposure groups. Because of the multiple sample types pursued, several approaches were required to determine eligibility. Estimates of the number of eligible persons in each of the exposed populations were based on the best available information including Census, entity-specific employment figures, and public and private school enrollment data, among other publicly available sources. To address issues of undercoverage and overcoverage a variety of methods were assessed or applied, including a capture-recapture analyses test of overlapping sample building list sources and automated deduplication of sample records. Estimates of the true eligible population indicate that over 400,000 unique individuals were eligible for the baseline health survey. Interviewer-administered surveys were completed with more than 71,000 persons, resulting in an overall enrollment rate of approximately 17 per cent. Coverage was highest among rescue and recovery workers, followed by residents, students and school staff, and building occupants. Both the accuracy of coverage estimates and the raw number and representativeness of enrollees were maximized by our approach to coverage. In designing a registry which relies on multiple pathways and sources of data to build the sample, it is important to develop a comprehensive approach that considers all sources of error and minimizes bias that may be introduced through the methodology.",0 +https://doi.org/10.2105/ajph.2009.168971,Pervasive Trauma Exposure Among US Sexual Orientation Minority Adults and Risk of Posttraumatic Stress Disorder,"We assessed sexual orientation disparities in exposure to violence and other potentially traumatic events and onset of posttraumatic stress disorder (PTSD) in a representative US sample.We used data from 34 653 noninstitutionalized adult US residents from the 2004 to 2005 wave of the National Epidemiologic Survey on Alcohol and Related Conditions.Lesbians and gay men, bisexuals, and heterosexuals who reported any same-sex sexual partners over their lifetime had greater risk of childhood maltreatment, interpersonal violence, trauma to a close friend or relative, and unexpected death of someone close than did heterosexuals with no same-sex attractions or partners. Risk of onset of PTSD was higher among lesbians and gays (adjusted odds ratio [AOR] = 2.03; 95% confidence interval [CI] = 1.34, 3.06), bisexuals (AOR = 2.13; 95% CI = 1.38, 3.29), and heterosexuals with any same-sex partners (AOR = 2.06; 95% CI = 1.54, 2.74) than it was among the heterosexual reference group. This higher risk was largely accounted for by sexual orientation minorities' greater exposure to violence, exposure to more potentially traumatic events, and earlier age of trauma exposure.Profound sexual orientation disparities exist in risk of PTSD and in violence exposure, beginning in childhood. Our findings suggest there is an urgent need for public health interventions aimed at preventing violence against individuals with minority sexual orientations and providing follow-up care to cope with the sequelae of violent victimization.",0 +https://doi.org/10.1080/15325024.2013.877774,"Posttraumatic Stress and Well-Being Following Relationship Dissolution: Coping, Posttraumatic Stress Disorder Symptoms From Past Trauma, and Traumatic Growth","This study investigated posttraumatic stress symptoms (PTSS) and psychological comorbidity following dating relationship dissolution. The roles of coping, posttraumatic growth, and posttraumatic stress disorder (PTSD) severity from past trauma were analyzed. Participants (n = 187) were recruited through an online survey. Emotion-focused coping and PTSD severity from past trauma were positively associated with higher levels of PTSS and psychological comorbidity. Posttraumatic growth was negatively associated with psychological comorbidity; problem-focused coping was negatively associated with PTSS. Emotion-focused coping and PTSD severity from past trauma appeared to be risk factors for psychological outcomes, while posttraumatic growth and problem-focused coping were found to be protective factors.",0 +https://doi.org/10.1176/appi.ajp.2009.09081168,Emotion Modulation in PTSD: Clinical and Neurobiological Evidence for a Dissociative Subtype,"In this article, the authors present evidence regarding a dissociative subtype of PTSD, with clinical and neurobiological features that can be distinguished from nondissociative PTSD. The dissociative subtype is characterized by overmodulation of affect, while the more common undermodulated type involves the predominance of reexperiencing and hyperarousal symptoms. This article focuses on the neural manifestations of the dissociative subtype in PTSD and compares it to those underlying the reexperiencing/hyperaroused subtype. A model that includes these two types of emotion dysregulation in PTSD is described. In this model, reexperiencing/hyperarousal reactivity is viewed as a form of emotion dysregulation that involves emotional undermodulation, mediated by failure of prefrontal inhibition of limbic regions. In contrast, the dissociative subtype of PTSD is described as a form of emotion dysregulation that involves emotional overmodulation mediated by midline prefrontal inhibition of the same limbic regions. Both types of modulation are involved in a dynamic interplay and lead to alternating symptom profiles in PTSD. These findings have important implications for treatment of PTSD, including the need to assess patients with PTSD for dissociative symptoms and to incorporate the treatment of dissociative symptoms into stage-oriented trauma treatment.",0 +https://doi.org/10.1111/j.1468-2850.2007.00080.x,Understanding the psychological impact of terrorism on youth: Moving beyond posttraumatic stress disorder.,"Comer and Kendall's (2007) comprehensive review of the impact of terrorism on youth organizes this important and burgeoning area of research. The present commentary focuses on youth outcomes associated with proximal contact with terrorist attacks, and highlights several important issues that merit attention. Specifically, the commentary emphasizes the importance of examining youths’ postattack outcomes broadly (in addition to posttraumatic stress disorder and its symptoms), assessing traumatic grief and bereavement when mass casualties occur, and evaluating issues of comorbidity and functional impairment. Future research on the impact of terrorism on youth would benefit from adopting a developmental psychopathology perspective in understanding variables that may influence and be influenced by youths’ reactions to terrorist events. Implications for research and clinical practice are discussed.",0 +https://doi.org/10.1002/mpr.1416,Validation of lay-administered mental health assessments in a large Army National Guard cohort,"To report the reliability and validity of key mental health assessments in an ongoing study of the Ohio Army National Guard (OHARNG). The 2616 OHARNG soldiers received hour-long structured telephone surveys including the post-traumatic stress disorder (PTSD) checklist (PCV-C) and Patient Health Questionnaire - 9 (PHQ-9). A subset (N = 500) participated in two hour clinical reappraisals, using the Clinician-Administered PTSD Scale (CAPS) and the Structured Clinical Interview for DSM (SCID). The telephone survey assessment for PTSD and for any depressive disorder were both highly specific [92% (standard error, SE 0.01), 83% (SE 0.02)] with moderate sensitivity [54% (SE 0.09), 51% (SE 0.05)]. Other psychopathologies assessed included alcohol abuse [sensitivity 40%, (SE 0.04) and specificity 80% (SE 0.02)] and alcohol dependence [sensitivity, 60% (SE 0.05) and specificity 81% (SE 0.02)].The baseline prevalence estimates from the telephone study suggest alcohol abuse and dependence may be higher in this sample than the general population. Validity and reliability statistics suggest specific, but moderately sensitive instruments.",0 +,"Relationships between sexual abuse in childhood, post-traumatic stress disorder (PTSD) and cognitive impairments","Current theoretical study shows relationships between sexual abuse during childhood, post-traumatic stress disorder (PTSD) and cognitive impairments. The cognitive perspective of sexual abuse effects and PTSD has been undertaken. Child sexual abuse against children is considered a risk factor in child development due to severe cognitive, emotional and behavioral sequences related to the event. The impact of sexual abuse involves short and long term effects and may be seen during adulthood. Review studies foreground the association between traumatic events (sexual abuse), PTSD, and alterations, structural and functional, in cerebral areas related to biological stress response systems. The necessity of future researches investigating the effects of stress and trauma in the child’s neurodevelopment will be discussed.",0 +https://doi.org/10.1016/j.jadohealth.2012.11.014,Challenges Faced by Former Child Soldiers in the Aftermath of War in Uganda,"

Abstract

Purpose

Warfare takes a profound toll of all layers of society, creating multiple and multilevel challenges that impinge on the psychosocial well-being of affected individuals. This study aims to assess the scope and salience of challenges confronting former child soldiers and at identifying additional challenges they face compared to non-recruited young people in war-affected northern Uganda.

Methods

The study was carried out with a stratified random sample of northern Ugandan adolescents (n = 1,008), of whom a third had formerly been recruited (n = 330). The mixed-method comparison design consisted of a constrained free listing task to determine the challenges; a free sorting task to categorize them into clusters; and statistical analysis of their prevalence among formerly recruited youth and of how they compare with those of nonrecruited youth.

Results

Altogether, 237 challenges were identified and clustered into 15 categories, showing that formerly recruited participants mainly identified ""emotional"" and ""training and skills""–related challenges. Compared with nonrecruited counterparts, they reported significantly more ""emotional"" and fewer ""social and relational"" challenges, with the exception of stigmatization. Overall, there was similarity between the challenges reported by both groups.

Conclusions

The challenges confronting formerly recruited youths reach well beyond the effects of direct war exposure and emerge mainly from multiple influence spheres surrounding them. These challenges are largely shared in common with nonrecruited youths. This multidimensional and collective character of challenges calls for comprehensive psychosocial interventions through which healing the psychological wounds of war is complemented by mending the war-affected surroundings at all levels and in all life areas.",0 +https://doi.org/10.1371/journal.pone.0127241,Post-Traumatic Stress Symptoms and Post-Traumatic Growth: Evidence from a Longitudinal Study following an Earthquake Disaster,"The current longitudinal study aims to examine the bidirectional relationship between post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG).One hundred twenty-two adults in the most severely affected area were investigated by self-report questionnaires at 12 months and 18 months after the Wenchuan Earthquake occurred in China.The autoregressive cross-lagged structure equation analysis revealed that PTG at 12 months post-earthquake could negatively predict PTSS at 18 months post-earthquake above and beyond PTSS stability, whereas PTSS at 12 months post-earthquake could not significantly predict subsequent PTG. Moreover, PTG at 12 months post-earthquake could predict fewer subsequent intrusions, numbing and hyper-arousal symptoms but not avoidance symptoms.Growth can play a role in reducing long-term post-traumatic stress symptoms, and the implication of a positive perspective in post-trauma circumstance is discussed.",0 +https://doi.org/10.2190/gcgw-86dc-a30r-286a,"Post-Homicide Reactions: Grief, Mourning and Post-Traumatic Stress Disorder following a Drunk Driving Fatality","This article examines the impact of gender, religious beliefs, subjective health status, individuals' past experience with death, social support, and time since the death on the extent of mourning, the extent of grieving, and Post-traumatic Stress Disorder (PTSD) symptomatology. It is proposed that the mode of death complicates the nature and course of bereavement after the death of a primary family member in a drunk driving collision. The unnecessary and violent nature of the death of drunk driving victims adds to the depth and extent of the psychological response to trauma. It is proposed that the models of grief utilized to conceptualize the grieving process are inadequate as a sole measure of the response of this type of death. Therefore, the inclusion of Post-traumatic Stress Disorder was provided for a more comprehensive understanding of this type of grief response. Survey data were collected on 171 primary family members of drunk driving victims (spouses, parents, siblings, or children) randomly selected from support groups and social service agencies throughout Texas. Results provide a greater understanding of the factor influencing the responses of the surviving family members after a drunk driving fatality and demonstrate that the grief and PTSD response share common predictors.",0 +https://doi.org/10.1080/10926771.2015.1079284,Guilt Among Ex-Prisoners of War,"The article explores guilt and its correlates among Israeli ex-prisoners of war (ex-POWs) of the 1973 Yom Kippur War (YKW; N = 119) and a matched group of veterans of the same war who were not held captive (N = 97). Results revealed that compared with controls, ex-POWs reported both more posttraumatic stress symptoms (PTSS) and more guilt, after adjusting for PTSS. Results also revealed a significant PTSS × Group interaction effect on guilt, wherein the association between PTSS and guilt was stronger among ex-POWs than among controls. Among ex-POWs, results showed that feelings of helplessness when falling captive, inwardly directed active coping, and a sense of loss of control during captivity contributed to the prediction of guilt. Support at homecoming made no contributions to variance, and circumstances of falling into captivity did not predict guilt. Results support the notion that guilt is a significant component of the psychological aftermath of war captivity, and highlight its correlates. Clinical...",0 +https://doi.org/10.1080/19361521.2011.609154,Genetic and Environmental Influences on Posttrauma Adjustment in Children and Adolescents: The Role of Personality Constructs,"The prevalence of exposure to traumatic events in childhood and adolescence is high and is associated with a host of mental health difficulties. However, not all trauma-exposed youth develop mental health difficulties in the wake of trauma, suggesting that other factors, such as personality and genetic influences, may play a role in posttrauma adjustment. In the present article, we provide an overview of how personality factors influence posttrauma trajectories and how both personality and posttrauma adjustment may be influenced by genetic factors. We first review major personality constructs, with a focus on developmental and assessment considerations in trauma-exposed youth. Next, we provide a discussion of genetic influences on personality, exposure to traumatic events, and the development of mental health disorders following traumatic event exposure. Lastly, recommendations for future research are provided. © 2011",0 +https://doi.org/10.1176/ajp.156.3.367,"Acute Stress Response and Posttraumatic Stress Disorder in Traffic Accident Victims: A One-Year Prospective, Follow-Up Study","OBJECTIVE: This study was designed to assess the natural course of posttraumatic symptoms formation, as well as the degree to which acute stress reactions predict later posttraumatic stress disorder (PTSD) in injured traffic accident victims. METHOD: A prospective, 1-year follow-up study was carried out on 74 injured traffic accident victims and a comparison group of 19 patients who were hospitalized for elective orthopedic surgery. Participants were interviewed within the first week following the accident, and follow-up interviews were performed 1, 3, 6, and 12 months after the accident. At 12 months, a structured clinical interview was administered to determine a formal DSM-III-R diagnosis of PTSD. RESULTS: Twenty-four (32%) of the 74 traffic accident victims, but none of the 19 comparison subjects, met DSM-III-R criteria for PTSD at 1 year. Traffic accident victims who developed PTSD had higher levels of premorbid and comorbid psychopathology. Levels of posttraumatic symptoms were significantly higher from the outset in the subjects who developed PTSD and worsened progressively over the first 3 months, in contrast to subjects without PTSD, who manifested gradual amelioration of symptoms during this time. Existence of posttraumatic symptoms immediately after the accident was a better predictor of later PTSD than was accident or injury severity. CONCLUSIONS: In this study, a significant portion of injured traffic accident victims manifested PTSD 1 year after the event. The development of PTSD at 1 year can be predicted as early as 1 week after the accident on the basis of the existence and severity of early PTSD-related symptoms. However, the first 3 months following the accident appear to be the critical period for the development of PTSD. (Am J Psychiatry 1999; 156:367–373)",0 +https://doi.org/10.1037/a0020045,Comparing posttraumatic stress disorder's symptom structure between deployed and nondeployed veterans.,"We tested two empirically validated 4-factor models of posttraumatic stress disorder (PTSD) symptoms using the PTSD Checklist: King, Leskin, King, and Weathers' (1998) model including reexperiencing, avoidance, emotional numbing, and hyperarousal factors, and Simms, Watson, and Doebbeling's (2002) model including reexperiencing, avoidance, dysphoria, and hyperarousal. Our aim was to determine which fit better in two groups of military veterans: peacekeepers previously deployed to a war zone (deployed group) and those trained for peacekeeping operations who were not deployed (nondeployed group). We compared the groups using multigroup confirmatory factor analysis. Adequate model fit was demonstrated among the nondeployed group, with no significant difference between King et al.'s (1998) model (separating avoidance and numbing) and Simms et al.'s (2002) similar model involving a dysphoria factor. A better fitting factor structure consistent with Simms et al.'s (2002) model was found in the deployed group. Comprehensive measurement invariance testing demonstrated significant differences between the deployed and nondeployed groups on all structural parameters, except observed variable intercepts (thus indicating similarities only in PTSD item severity). These findings add to researchers' understanding of PTSD's factor structure, given the revision of PTSD that will appear in the forthcoming 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2010)--namely, that the factor structure may be quite different between groups with and without exposure to major traumatic events.",0 +https://doi.org/10.1300/j070v06n03_07,Internal Verification and Corroboration of Traumatic Memories of Child Sexual Abuse,"ABSTRACT Based on clinical experience and review of the clinical and legal research literature, the author proposes that a cluster of several of six clinical findings is a potential indicator of internal corroboration that trauma occurred, especially that of child sexual abuse. These six clinical findings include: the presence of a high risk disorder or illness; post-traumatic stress disorder; age regression, flashbacks, abreactions or other re-experiencing of the trauma; repetitions, repetition compulsions or re-enactments; characteristics of the memories themselves; and other patterns, dynamics, and connections. The author welcomes the experience and feedback of clinicians who assist survivors of trauma, especially that of child sexual abuse.",0 +https://doi.org/10.1007/s00415-006-0156-5,Recovery from mild traumatic brain injury,"Fatigue is one of the most frequently reported symptoms after Mild Traumatic Brain Injury (MTBI). To date, systematic and comparative studies on fatigue after MTBI are scarce, and knowledge on causal mechanisms is lacking. To determine the severity of fatigue six months after MTBI and its relation to outcome. Furthermore, to test whether injury indices, such as Glasgow Coma Scale scores, are related to higher levels of fatigue. Postal questionnaires were sent to a consecutive group of patients with an MTBI and a minor-injury control group, aged 18–60, six months after injury. Fatigue severity was measured with the Checklist Individual Strength. Postconcussional symptoms and limitations in daily functioning were assessed using the Rivermead Post Concussion Questionnaire and the SF-36. A total of 299 out of 618 eligible (response rate 52%) MTBI patients and 287 out of 482 eligible (response rate 60%) minor-injury patients returned the questionnaire. Ninety-five MTBI patients (32%) and 35 control patients (12%) were severely fatigued. Severe fatigue was highly associated with the experience of other symptoms, limitations in physical and social functioning, and fatigue related problems like reduced activity. Of various trauma severity indices, nausea and headache experienced on the ED were significantly related to higher levels of fatigue at six months. In conclusion, one third of a large sample of MTBI patients experiences severe fatigue six months after injury, and this experience is associated with limitations in daily functioning. Our finding that acute symptoms and mechanism of injury rather than injury severity indices appear to be related to higher levels of fatigue warrants further investigation.",0 +https://doi.org/10.1016/s0163-8343(01)00163-3,Panic disorder among Vietnamese refugees attending a psychiatric clinic: prevalence and subtypes,"This study surveys Vietnamese refugees attending two psychiatric clinics to determine both the prevalence of panic disorder (PD) as well as panic attack subtypes in those suffering PD. A culturally valid adaptation of the SCID-panic module (the Vietnamese Panic Disorder Survey or VPDS) was administered to 100 Vietnamese refugees attending two psychiatric clinics. Utilizing culturally sensitive panic probes, the VPDS provides information regarding both the presence of PD and panic attack subtypes during the month prior to interview. Of 100 patients surveyed, 50 (50%) currently suffered PD. Among the 50 patients suffering PD, the most common panic attack subtypes during the previous month were the following: ""orthostatic dizziness"" (74% of the 50 panic disorder patients [PDPs]), headache (50% of PDPs), wind-induced/temperature-shift-induced (24% of PDPs), effort-induced (18% of PDPs), gastro-intestinal (16% of PDPs), micturition-induced (8% of PDPs), out-of-the-blue palpitations (24% of PDPs), and out-of-the-blue shortness of breath (16% of PDPs). Five mechanisms are adduced to account for this high PD prevalence as well as the specific profile of subtypes: 1) a trauma-caused panic attack diathesis; 2) trauma-event cues; 3) ethnic differences in physiology; 4) catastrophic cognitions generated by cultural syndromes; and 5) a modification of Clark's spiral of panic.",0 +https://doi.org/10.1037/a0016945,Maladaptive cognitive appraisals mediate the evolution of posttraumatic stress reactions: A 6-month follow-up of child and adolescent assault and motor vehicle accident survivors.,"A prospective longitudinal follow-up study (n = 59) of child and adolescent survivors of physical assaults and motor vehicle accidents assessed whether cognitive processes predicted posttraumatic stress symptomatology (PTSS) at 6 months posttrauma in this age group. In particular, the study assessed whether maladaptive posttraumatic appraisals mediated the relationship between initial and later posttraumatic stress. Self-report measures of PTSS, maladaptive appraisals, and other cognitive processes, as well as structured interviews assessing for acute stress disorder and posttraumatic stress disorder (PTSD), were completed at 2-4 weeks and 6 months posttrauma. PTSS and PTSD at 6 months were associated with maladaptive appraisals and other cognitive processes but not demographic or objective trauma severity variables. Only maladaptive appraisals were found to associate with PTSS/PTSD after partialing out initial symptoms/diagnosis and to mediate between initial and later PTSS. It was argued that, on this basis, maladaptive appraisals are involved in the development and maintenance of PTSS over time, whereas other cognitive processes (e.g., subjective threat, memory processes) may have an effect only in the acute phase. The implications of this study for the treatment of PTSS in youths are discussed.",0 +https://doi.org/10.1016/j.biopsycho.2004.12.003,Ambulatory cardiovascular functioning in healthy postmenopausal women with victimization histories,"Criminal victimization is a prevalent stressor among women, with potentially long-lasting emotional consequences. The present study examined associations among severity of lifetime victimization, current posttraumatic stress disorder (PTSD) symptoms, and ambulatory blood pressure (ABP) and heart rate (AHR) levels and variability. Thirty-nine healthy post-menopausal women who endorsed a history of criminal victimization completed a measure of PTSD symptom severity and participated in an average of 18 h of ambulatory cardiovascular monitoring. PTSD symptom clusters were associated with AHR. Symptom clusters and lifetime victimization severity jointly predicted ABP, with ABP the highest among severely victimized women with high levels of current intrusions. Given the prevalence of criminal victimization, biopsychosocial research on women's cardiovascular disease risk may benefit from increased attention to this stressor and its psychological sequelae.",0 +https://doi.org/10.1037/a0024007,Couple adjustment and posttraumatic stress disorder symptoms in National Guard veterans of the Iraq war.,"Relationship adjustment and posttraumatic stress disorder (PTSD) symptoms were assessed across two time points in a sample of 313 married or partnered National Guard soldiers recently returned from combat duty in Iraq. Structural equation modeling using a four-factor model for PTSD found the latent variable dysphoria (reflecting generalized distress including aspects of emotional numbing and arousal) had the strongest independent contribution to predicting relationship adjustment at Time 1 and indirectly predicted poorer relationship adjustment at Time 2. Exploratory analysis of gender differences (n = 33 women; n = 280 men) suggested a different pattern of relations between PTSD factors and relationship adjustment among female soldiers at Time 1, with a trend toward trauma specific avoidance being more highly related to relationship adjustment. Clinical and research implications are discussed.",0 +,Racial differences in the physical and psychosocial health among black and white women with chronic pain.,"Gender-based differences in pain epidemiology, pain threshold, attitudes toward pain management, coping styles and social roles are well described, yet little is known about the chronic pain experience in women or the role race plays. A retrospective analysis of self-reported data using a secondary clinical database was performed to elucidate the relationship between race and pain severity, depression, physical disability, posttraumatic stress disorder (PTSD) as well as affective distress in women with chronic pain. White (n=1,088) and black (n=104) adult women were compared based on their responses to the McGill Pain Questionnaire, Beck Depression Inventory, Pain Disability Index, Posttraumatic Chronic Pain Test and items from the West-Haven Yale Multidisciplinary Pain Inventory. After accounting for sociodemographic, medical, psychological and physical confounders, there was no significant race effect for pain severity or affective distress. However, black women with chronic pain experience more physical impairments than white women with chronic pain (beta = 4.622; p<0.005). Except for the family/home responsibilities, similar differences were found on all PDI subscales. We also found that disability mediates the race-depression relationship such that black women are comparatively more vulnerable to depression as a result of higher disability. Due to the economic, social and emotional impact that disability has on women with chronic pain and their families, these findings have significant implications for chronic pain research as well as its management in black women.",0 +https://doi.org/10.3171/jns.2002.97.4.0929,Temporal pattern of cochlear nerve degeneration following compression injury: a quantitative experimental observation,"It has been empirically recognized that the cochlear nerve is highly vulnerable to traumatic stress resulting from surgical procedures; therefore, careful manipulation of the cochlear nerve is mandatory in preventing trauma-induced hearing loss during cerebellopontine angle (CPA) surgery. There is, however, no precise knowledge about the temporal pattern of cochlear nerve degeneration following trauma. This study was performed to determine the temporal pattern of injury that occurs after cochlear nerve trauma, knowledge of which is indispensable not only to neurosurgeons but also to all those who manage lesions involving the cochlear nerve.Right suboccipital craniectomies were performed in groups of rats with the aid of a surgical microscope, and the seventh and eighth cranial nerve trunks were identified at the internal auditory meatus. The cochlear nerve was quantifiably compressed while compound action potentials of the cochlear nerve were monitored and recorded. Following injury, one group of rats was killed for histological examination at the end of each week for 4 weeks. Data from this study disclosed that the degeneration of the compressed cochlear nerve progressed in a relatively rapid manner and was complete within 1 week after the insult. The main pathophysiological mechanisms responsible for cochlear neuronal death in this experimental setting appeared to be necrosis, and an apoptotic mechanism seemed to play a subsidiary role.Accurate knowledge about the temporal profile of trauma-induced cochlear nerve degeneration is closely linked with the problem of the therapeutic time window. The results of the present study indicated that any measures to ameliorate cochlear nerve degeneration following trauma should be started as early as possible (within 1 week) after an injury.",0 +https://doi.org/10.1177/1359104506067876,Cognitive-behavioural Group Intervention for PTSD Symptoms in Children Following the Athens 1999 Earthquake: A Pilot Study,"This study examined the effects of a short-term group cognitive-behavioural intervention in children who were experiencing PTSD symptoms following the Athens 1999 earthquake. Twenty children, aged 8-12 years, referred for treatment to a local child mental health team were assigned, depending on timing of referral to two groups - Group 1 ( N = 10), which started treatment 2 months after the earthquake and Group 2 ( N = 10), which started treatment at 4 months postearthquake. A statistically significant reduction in overall PTSD (Posttraumatic Stress Disorder) symptoms across the three PTSD symptom clusters - intrusion, avoidance, and arousal - as well as in depressive symptoms was reported immediately after the intervention. The treatment also produced a statistically significant improvement in children’s psychosocial functioning. Further significant improvement was reported in children at an 18-month follow-up. Treatment gains were maintained at a 4-year follow-up. Despite several limitations to this study, short-term group CBT (cognitive-behavioural therapy) was found to be a useful treatment approach, which can be offered in clinical settings, particularly if resources are limited.",0 +https://doi.org/10.1097/nur.0000000000000030,Psychiatric Advanced Practice Nurses Contributions to Supporting Survivors and Caregivers Affected by the Boston Marathon Bombings,"The role of the psychiatric advanced practice nurse in promoting psychological health and resiliency for patients, their families and staff following the Boston Marathon bombings is reviewed.On April 15, 2013, 2 bombs exploded near the finish line at the Boston Marathon. Within minutes, 39 patients suffering from multiple injuries presented at a level I trauma center. The magnitude of this event and its effect on our hospital required a comprehensive response that would promote resiliency and healing.Lessons shared from responders to other tragedies were helpful in guiding our interprofessional efforts. The multiple layers of our response are reviewed to offer learnings that may inform others as they work to promote resiliency and healing following traumatic events.In response to this event, we utilized a trauma-informed care framework emphasizing physical, psychological, and emotional safety to assist staff, survivors, and families on their journey of healing.Emotional reactions were dramatic but were eased by the psychological care and education that our patients, their families, and staff received in the first days to weeks after the bombings.The psychiatric advanced practice nurse can influence positive outcomes by utilizing a trauma-informed care framework.",0 +https://doi.org/10.1016/s0145-2134(01)00305-2,Differential symptom pattern of post-traumatic stress disorder (PTSD) in maltreated children with and without concurrent depression,"The present study attempted to examine specific differences in the Post-Traumatic Stress Disorder (PTSD) symptomatology among abused children with and without concurrent depression.PTSD and depressive symptoms were identified that discriminate between 98 children divided into three groups: (1) abused children with PTSD, (2) nonabused children who meet criteria for Major Depressive Disorder (MDD), and (3) abused children with both PTSD and MDD.Analyses revealed that nine items reflecting depressive symptomatology, primarily vegetative symptoms, differentiated the diagnostic groups (PTSD-only, MDD-only, and the combined group). A discriminant analysis revealed that the sum of responses to the nine significant items adequately predicted diagnostic classification for those with PTSD and depression, but did not correctly diagnose any in the combined group. Analyses also revealed that three post-trauma symptoms, including psychological amnesia, flashbacks/reenactments, and sleep difficulties, discriminated between the groups. The PTSD-only group reported more episodes of psychological amnesia while the PTSD and MDD group experienced more flashbacks.For the sample of abused children examined, these results illuminate differences with respect to PTSD symptom presentation for those children with PTSD who have a concurrent depressive disorder and their nondepressed counterparts. Children with PTSD who have a concurrent depression report greater levels of intrusive PTSD-related symptoms.",0 +https://doi.org/10.1007/s11013-010-9170-2,"Nepali Concepts of Psychological Trauma: The Role of Idioms of Distress, Ethnopsychology and Ethnophysiology in Alleviating Suffering and Preventing Stigma","In the aftermath of a decade-long Maoist civil war in Nepal and the recent relocation of thousands of Bhutanese refugees from Nepal to Western countries, there has been rapid growth of mental health and psychosocial support programs, including posttraumatic stress disorder treatment, for Nepalis and ethnic Nepali Bhutanese. This medical anthropology study describes the process of identifying Nepali idioms of distress and local ethnopsychology and ethnophysiology models that promote effective communication about psychological trauma in a manner that minimizes stigma for service users. Psychological trauma is shown to be a multifaceted concept that has no single linguistic corollary in the Nepali study population. Respondents articulated different categories of psychological trauma idioms in relation to impact on the heart-mind, brain-mind, body, spirit, and social status, with differences in perceived types of traumatic events, symptom sets, emotion clusters and vulnerability. Trauma survivors felt blamed for experiencing negative events, which were seen as karma transmitting past life sins or family member sins into personal loss. Some families were reluctant to seek care for psychological trauma because of the stigma of revealing this bad karma. In addition, idioms related to brain-mind dysfunction contributed to stigma, while heart-mind distress was a socially acceptable reason for seeking treatment. Different categories of trauma idioms support the need for multidisciplinary treatment with multiple points of service entry.",0 +https://doi.org/10.1185/135525702125000930,Post-traumatic stress disorder and alcohol use disorder,"Our clinical observations along with data in the literature have shown an increased incidence of alcohol use disorder in persons who suffer from post-traumatic stress disorder. In this work we examined alcohol use disorder in war veterans who were suffering from post-traumatic stress disorder (group 1) (n=52) and compared them with veterans who were traumatized but who had not developed a clinical picture of post-traumatic stress disorder (group 2) (n=29) and a sample from the general population (group 3) (n=30). The objective of this work was to establish the cluster symptoms of post-traumatic stress disorder that are related to alcohol use disorder and connected with depression. All of the respondents were males. The methods used were structured clinical interviews for the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders axis I disorders for addiction and post-traumatic stress disorder and Beck's scale for depression. The results obtained showed that there were no statistically significant differences in the incidence of alcohol use disorders between traumatized patients who had and those who had not developed post-traumatic stress disorder, but there was a significant statistical differencefor both groups 1 and 2 in relation to the control group. The variables that correlated positively with alcohol use disorder were the cluster symptoms of re-experiencing and the arousal symptom of the traumatized group and there was also increased depression in both groups examined (groups 1 and 2).",0 +https://doi.org/10.1007/s00737-012-0312-0,Mother–infant bonding impairment across the first 6 months postpartum: the primacy of psychopathology in women with childhood abuse and neglect histories,"Our goal was to examine the trajectory of bonding impairment across the first 6 months postpartum in the context of maternal risk, including maternal history of childhood abuse and neglect and postpartum psychopathology, and to test the association between self-reported bonding impairment and observed positive parenting behaviors. In a sample of women with childhood abuse and neglect histories (CA+, n = 97) and a healthy control comparison group (CA-, n = 53), participants completed questionnaires related to bonding with their infants at 6 weeks, 4 months, and 6 months postpartum and psychopathology at 6 months postpartum. In addition, during a 6-month postpartum home visit, mothers and infants participated in a dyadic play interaction subsequently coded for positive parenting behaviors by blinded coders. We found that all women, independent of risk status, increased in bonding with their infant over the first 6 months postpartum; however, women with postpartum psychopathology (depression and posttraumatic stress disorder [PTSD]) showed consistently greater bonding impairment scores at all timepoints. Moreover, we found that, at the 6-month assessment, bonding impairment and observed parenting behaviors were significantly associated. These results highlight the adverse effects of maternal postpartum depression and PTSD on mother-infant bonding in early postpartum in women with child abuse and neglect histories. These findings also shed light on the critical need for early detection and effective treatment of postpartum mental illness in order to prevent problematic parenting and the development of disturbed mother-infant relationships. Results support the use of the Postpartum Bonding Questionnaire as a tool to assess parenting quality by its demonstrated association with observed parenting behaviors.",0 +https://doi.org/10.1037/a0018135,"Validating female psychopathy subtypes: Differences in personality, antisocial and violent behavior, substance abuse, trauma, and mental health.","Recent empirical investigations utilizing male prisoners have begun to validate clinical conceptualizations of primary and secondary psychopathy subtypes. We extended this literature by identifying similar psychopathic subtypes in female prisoners on the basis of personality structure using model-based cluster analysis. Secondary psychopaths (n = 39) were characterized by personality traits of negative emotionality and low behavioral constraint, an early onset of antisocial and criminal behavior, greater substance use and abuse, more violent behavior and institutional misconduct, and more mental health problems, including symptoms of posttraumatic stress disorder and suicide attempts. Primary psychopaths (n = 31) exhibited few distinguishing personality features but were prolific criminals especially in regards to nonviolent crime, and exhibited relatively few mental health problems despite substantial exposure to traumatic events. The results support alternative etiological pathways to antisocial and criminal behavior that are evident in personality structure as well as gender similarities and differences in the manifestation of psychopathic personalities.",0 +https://doi.org/10.3233/wor-2011-1101,A study in contrasts: Inscriptions of posttraumatic stress disorder (PTSD) in two works of fiction,"This study investigates the depiction of Posttraumatic Stress Disorder (PTSD) in two works of fiction, The Bluest Eye, by Toni Morrison, and Ordinary People, by Judith Guest.In each text, the character struggling to mount a defense against the symptoms of PTSD is a child who must confront not only a single, precipitous event but also deleterious, ancillary conditions that threaten to impede the recovery process.This is a study in contrast that utilizes a comparative case analysis of two fictional characters.One child reconstructs an integrated self while the other deteriorates mentally and emotionally.These results suggest factors such as social supports, economic status, race and aesthetic self-image may play critical roles in a child's resiliency to the symptoms of PTSD.",0 +https://doi.org/10.1002/jts.20486,Disparate prevalence estimates of PTSD among service members who served in Iraq and Afghanistan: Possible explanations,"The authors reviewed 29 studies that provide prevalence estimates of posttraumatic stress disorder (PTSD) among service members previously deployed to Operations Enduring and Iraqi Freedom and their non-U.S. military counterparts. Studies vary widely, particularly in their representativeness and the way PTSD is defined. Among previously deployed personnel not seeking treatment, most prevalence estimates range from 5 to 20%. Prevalence estimates are generally higher among those seeking treatment: As many as 50% of veterans seeking treatment screen positive for PTSD, though much fewer receive a PTSD diagnosis. Combat exposure is the only correlate consistently associated with PTSD. When evaluating PTSD prevalence estimates among this population, researchers and policymakers should carefully consider the method used to define PTSD and the population the study sample represents.",0 +https://doi.org/10.1097/00004356-200409000-00003,Do post-traumatic stress symptoms predict reactions of adaptation to disability after a sudden-onset spinal cord injury?,"Based on the perspective that post-traumatic stress disorder (PTSD) reflects a reaction of adaptation to trauma, the goal of this research was to examine the ability of PTSD symptom clusters (re-experiencing, avoidance, and hyperarousal) to predict eight reactions of adaptation to disability (shock, anxiety, denial, depression, internalized anger, externalized hostility, acknowledgment, and adjustment) among individuals with non-congenital spinal cord injuries. Individuals (all of whom attended either a specialized civilian or a veteran spinal cord injury clinic in Texas) completed two self-report questionnaires--the Reactions to Impairment and Disability Inventory (RIDI) and the Purdue Posttraumatic Stress Disorder Scale Revised (PPTSD-R). According to the statistical fit indices, five of the fit indices suggested that the revised model was a good fit to the data, whereas one fit index and the chi/df ratio indicated that the revised model fit the data poorly. The model provided information on the ability of PTSD clusters to predict reactions of adaptation, which suggested a specific pattern of vacillation of post-traumatic responses during the process of adaptation. These findings need replication before proposing interventions for post-traumatic stress responses after the onset of a spinal cord injury.",0 +https://doi.org/10.1038/mp.2013.61,Elevated brain cannabinoid CB1 receptor availability in post-traumatic stress disorder: a positron emission tomography study,"Endocannabinoids and their attending cannabinoid type 1 (CB1) receptor have been implicated in animal models of post-traumatic stress disorder (PTSD). However, their specific role has not been studied in people with PTSD. Herein, we present an in vivo imaging study using positron emission tomography (PET) and the CB1-selective radioligand [(11)C]OMAR in individuals with PTSD, and healthy controls with lifetime histories of trauma (trauma-exposed controls (TC)) and those without such histories (healthy controls (HC)). Untreated individuals with PTSD (N=25) with non-combat trauma histories, and TC (N=12) and HC (N=23) participated in a magnetic resonance imaging scan and a resting PET scan with the CB1 receptor antagonist radiotracer [(11)C]OMAR, which measures the volume of distribution (VT) linearly related to CB1 receptor availability. Peripheral levels of anandamide, 2-arachidonoylglycerol, oleoylethanolamide, palmitoylethanolamide and cortisol were also assessed. In the PTSD group, relative to the HC and TC groups, we found elevated brain-wide [(11)C]OMAR VT values (F(2,53)=7.96, P=0.001; 19.5% and 14.5% higher, respectively), which were most pronounced in women (F(1,53)=5.52, P=0.023). Anandamide concentrations were reduced in the PTSD relative to the TC (53.1% lower) and HC (58.2% lower) groups. Cortisol levels were lower in the PTSD and TC groups relative to the HC group. Three biomarkers examined collectively--OMAR VT, anandamide and cortisol--correctly classified nearly 85% of PTSD cases. These results suggest that abnormal CB1 receptor-mediated anandamide signaling is implicated in the etiology of PTSD, and provide a promising neurobiological model to develop novel, evidence-based pharmacotherapies for this disorder.",0 +https://doi.org/10.1177/0886260508329131,Duration of Exposure and the Dose-Response Model of PTSD,A dose-response model underlies posttraumatic stress disorder (PTSD) and posits a relationship between event magnitude and clinical outcome. The present study examines whether one index of event magnitude—duration of exposure—contributes to risk of PTSD among female victims of sexual assault. Findings support a small but significant contribution of event duration to clinical status in the immediate aftermath of trauma but not at 3-month follow-up. The opposite pattern is obtained for subjective appraisals of threat. These findings add to a growing literature that suggests that a simple application of the dose-response model to objective event characteristics may be insufficient to explain the risk of PTSD.,0 +https://doi.org/10.1016/j.jmwh.2005.04.024,Cortisol Level and Perinatal Outcome in Pregnant Women With Posttraumatic Stress Disorder: A Pilot Study,"Posttraumatic stress disorder (PTSD) affects 12% of women in the United States and could affect childbearing via behavioral and neuroendocrine mechanisms. This pilot study collected preliminary data about the extent to which the low cortisol profile found in patients with PTSD also occurs in the hormonal context of pregnancy, as well as the association between PTSD and less optimal processes and outcomes of pregnancy. Standardized psychiatric diagnostic telephone interviews, salivary cortisol assays, and medical records review were evaluated in a community sample of 25 women pregnant with their first child. Higher PTSD symptom counts correlated with worse overall perinatal outcomes summarized by an Optimality Index Score (n = 22; r = -.725; P < .001). The women whose symptoms met diagnostic criteria for PTSD or partial PTSD had lower peak basal salivary cortisol concentrations (n = 14; mean = .4584 versus .8123; P = .010). Further research on the effects of PTSD on pregnancy processes and outcomes is warranted. Differences in cortisol levels were consistent with the pattern seen in nonpregnant women with PTSD. This finding suggests that salivary cortisol would be a useful biological measure to include in perinatal research on PTSD and childbearing.",0 +https://doi.org/10.2174/157340007781369694,Problems in Statistical Analysis of Attrition in Randomized Controlled Clinical Trials of Antidepressant for Geriatric Depression,"Attrition from clinical trials is unavoidable in geriatric psychiatry and beyond. It results in incomplete data and consequently imposes three fundamental challenges: greater bias, reduced power, and less generalizability. In an effort to assess the extent of attrition and the relevance of statistical methods applied to analyze incomplete data in geriatric psychiatry, we reviewed 69 published antidepressant randomized clinical trials conducted since 1975. The median attrition rate estimated from these trials was 26.6%; nevertheless, we found that many trials lack data analytic strategies to address the problem of attrition. Most of the applied statistical analyses involved chi-square tests, t-tests, and analysis of variance (ANOVA), each of which assume that data are missing completely at random. Even when imputation for missing data due to attrition was attempted, only the last observation carried forward (LOCF) method was implemented. The LOCF imputation can actually increase bias of the results in the analysis of repeatedly measured outcomes. In addition, despite the longitudinal nature of repeatedly measured outcomes, the statistical methods used are for analysis of cross-sectional data. Thus, the data analytic strategies did not adequately meet the challenges arising from attrition. We encourage the use of mixed-effects models to reduce the impact of attrition on bias, power and generalizability in antidepressant RCTs for geriatric depression. For imputation, we recommend use of multiple imputation methods instead of LOCF.",0 +https://doi.org/10.1682/jrrd.2014.05.0130,Impact of comorbid depression on quality of life in male combat Veterans with posttraumatic stress disorder,"For Veterans with posttraumatic stress disorder (PTSD), depression is a highly comorbid condition. Both conditions have been associated with decreased quality of life, and research suggests that comorbid PTSD and depression may result in worse quality of life than PTSD alone. However, research is needed to elucidate the effect of comorbidity on a broader variety of quality of life domains. In this study, we used baseline data of 158 male combat Veterans taking part in a PTSD treatment trial and examined the unique relationships between quality of life domains and PTSD symptom clusters, major depressive disorder (MDD) diagnosis, and self-reported depressive symptoms. Veterans with comorbid PTSD-MDD reported significantly worse satisfaction-related quality of life than those with PTSD alone, although this finding was largely attributable to PTSD numbing symptoms. Subsequent analyses comparing the effect of numbing symptoms to depressive symptoms revealed that depression exerted a stronger influence, although numbing symptoms were still uniquely associated with quality of life. We discuss implications for treatment and research, as well as the need to address negative affect in Veterans with PTSD.",0 +https://doi.org/10.2217/17410541.4.2.201,Integrating genomics and neuromarkers for the era of brain-related personalized medicine,"The harsh reality is that many medical treatments do not work as expected in a significant percentage of patients, and occasionally there are serious side effects. A new paradigm of personalized medicine is emerging, which proactively tailors treatment to each individual’s biological and psychological profile. The first proof-of-concept phase of personalized medicine has now been achieved. However, it has thus far focused on the use of genomic markers and on disorders of the body. The complexity of the brain is likely to require a shift from a single genetic marker focus to a more integrated approach in which additional brain-related information (neuromarkers) is taken into account. Codevelopment of genomic neuromarkers with new compounds in a personalized medicine approach will lead to increased drug R&D and treatment benefits. The emerging genomic neuromarker potential has begun to be incorporated into the template for the next version of the Diagnostic and Statistical Manual (DSM-V). The statistical power of large subject numbers in databases in general (and standardized databases in particular) provides an ideal source for elucidating the best genomic–neuromarker profiles (explaining most of the main-effects variance), which will empower a brain-related personalized medicine into mainstream clinical practice.",0 +,Post-traumatic stress disorder: a biopsychological perspective.,"This paper provides a critical review of the current explanatory models of the post-traumatic stress disorder (PTSD). Most of these models are incomplete and lack empirical confirmation. It is argued that unidimensional treatment modalities, derived from such models, fail to address the complex nature of the disorder and are likely to generate partial results. A broad hypothesis-testing approach, combining biological, psychological and psychosocial interventions, should be preferred in clinical practice. Rehabilitation should replace curative techniques and unrealistic goals in many cases.",0 +https://doi.org/10.3760/cma.j.issn.0254-6450.2009.08.008,[Analysis on factors affecting the severity of post-traumatic stress disorder in transferred casualty after Earthquake].,"OBJECTIVE: To investigated the related factors which affecting the severity degrees of post-traumatic stress disorder (PTSD) in transferred casualty after Wenchuan Earthquake. METHODS: Taking PTSD symptoms self-assessment scale (PCL-C) to involve 386 wounded who suffered 40 days after the earthquake disaster, from 11 hospitals and were transferred to Chongqing city. Multi-stage cluster sampling method was used. 354 valid questionnaires were recovered to explore the relevant factors affecting the severity on the symptoms of PTSD. RESULTS: This survey contains 354 subjects, with male 154 (43.6%), female 200 (56.4%), age 43.76 +/- 21.22, nation alities: Han people 236 (66.7%), Qiang people 114 (32.2%), others 4 (1.1%), and marriage status as unmarried 92 (26.1%), married 253 (71.7%), others 9 (2.2%). The wounded women PTSD have more serious symptoms than men, and there were differences between them in repeated and disturbing dreams of this stressful experience (t = 2.46, P = 0.014), a strong sense of psychological suffering annoyance (t = 2.02, P = 0.044), having difficulty concentrating (t = 2.04, P = 0.042), being super-alert (t = 2.465, P = 0.014) etc, also in the total scores (t = 2.489, P = 0.013) (P Language: zh",0 +https://doi.org/10.1016/0022-4405(96)00003-9,Etiologic factors in the development of posttraumatic stress disorder in children and adolescents,"Abstract This article presents an overview of the literature on potential etiological factors in the development of PTSD in children. An etiological model for PTSD is offered which generates hypotheses for identifying links between exposure to traumatic events and consequent symptoms, as well as testing relationships between exposure variables and other possible mediating factors. Three possible kinds of interaction between etiologic and mediating variables, leading to different levels of symptoms, are presented. Findings from 25 recent studies examining etiologic factors are considered to form an empirical basis for current knowledge about PTSD in children. Severity of trauma exposure and parental trauma-related distress have consistently produced positive correlations with PTSD symptoms. Length of time since trauma exposure is consistently negatively correlated with PTSD severity. Findings regarding relationships between PTSD risk, age and gender are inconsistent at this time. Other gaps in our current knowledge and understanding are identified, and implications for future clinical and research efforts are discussed.",0 +https://doi.org/10.1007/s00127-014-0865-5,The relationship between post traumatic stress disorder and post traumatic growth: gender differences in PTG and PTSD subgroups,"Purpose: This study investigated the post traumatic stress disorder (PTSD) and post traumatic growth (PTG) in 2,300 earthquake survivors 1 year after the 2008 Wenchuan earthquake. This study aimed to investigate the relationship between PTSD and PTG and also tested for the gender differences in PTSD and PTG subgroups. Methods: A stratification random sampling strategy and questionnaires were used to collect the data. The PTSD was assessed using the PTSD Check list-Civilian and the PTG was assessed using the Post traumatic growth inventory. 2,300 individuals were involved in the initial survey with 2,080 completing the final questionnaire, a response rate of 90.4 %. One-way ANOVA analyses were performed to investigate the gender differences in the PTSD and PTG subgroups. Results: One year following the earthquake, 40.1 and 51.1 % of survivors reported PTSD and PTG, respectively. A bivariate correlation analysis indicated that there was a positive association between PTG and PTSD. The PTG and PTSD variance analysis conducted on female and male subgroups suggested that women were more affected than men. Conclusions: Given the relatively high PTG prevalence, it was concluded that researchers need to pay more attention to the positive outcomes of an earthquake rather than just focusing on the negative effects. The surveys and analyses indicated that psychological intervention and care for the earthquake disaster survivors should focus more on females and older people, who tend to be more adversely affected. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1177/0886260507301226,Multiple Traumatic Experiences and the Development of Posttraumatic Stress Disorder,"This study assesses the differential and combined impacts of multiple lifetime stressors in the development and severity of posttraumatic stress disorder (PTSD) symptoms. One hundred and four clinical and 64 nonclinical participants were assessed for their exposure to four types of interpersonal trauma: physical and sexual abuse in childhood, lifetime community violence, and domestic violence in adulthood. PTSD symptomatology was assessed using the Los Angeles Symptom Checklist (LASC). Results indicated that exposure to lifetime multiple traumatic experiences was positively correlated with severity of PTSD symptoms. Clinical participants had experienced significantly more multiple traumas and had a higher rate of PTSD than the nonclinical participants. Results also suggested that adults who had experienced childhood sexual abuse were at higher risk for the development of PTSD related to interpersonal violence than adults who were not sexually abused as children.",0 +https://doi.org/10.1016/j.socscimed.2015.08.043,Health in police officers: Role of risk factor clusters and police divisions,"Law enforcement is a stressful occupation associated with significant health problems. To date, most studies have focused on one specific factor or one domain of risk factors (e.g., organizational, personal). However, it is more likely that specific combinations of risk factors are differentially health relevant and further, depend on the area of police work.A self-selected group of officers from the criminal, community, and emergency division (N = 84) of a Swiss state police department answered questionnaires assessing personal and organizational risk factors as well as mental and physical health indicators.In general, few differences were observed across divisions in terms of risk factors or health indicators. Cluster analysis of all risk factors established a high-risk and a low-risk cluster with significant links to all mental health outcomes. Risk cluster-by-division interactions revealed that, in the high-risk cluster, Emergency officers reported fewer physical symptoms, while community officers reported more posttraumatic stress symptoms. Criminal officers in the high-risk cluster tended to perceived more stress. Finally, perceived stress did not mediate the relationship between risk clusters and posttraumatic stress symptoms.In summary, our results support the notion that police officers are a heterogeneous population in terms of processes linking risk factors and health indicators. This heterogeneity thereby appeared to be more dependent on personal factors and individuals' perception of their own work conditions than division-specific work environments. Our findings further suggest that stress-reduction interventions that do not target job-relevant sources of stress may only show limited effectiveness in reducing health risks associated with police work.",0 +https://doi.org/10.1037/0022-006x.76.2.219,"Do cognitive models help in predicting the severity of posttraumatic stress disorder, phobia, and depression after motor vehicle accidents? A prospective longitudinal study.","The study investigated the power of theoretically derived cognitive variables to predict posttraumatic stress disorder (PTSD), travel phobia, and depression following injury in a motor vehicle accident (MVA). MVA survivors (N = 147) were assessed at the emergency department on the day of their accident and 2 weeks, 1 month, 3 months, and 6 months later. Diagnoses were established with the Structured Clinical Interview for DSM-IV. Predictors included initial symptom severities; variables established as predictors of PTSD in E. J. Ozer, S. R. Best, T. L. Lipsey, and D. S. Weiss's (2003) meta-analysis; and variables derived from cognitive models of PTSD, phobia, and depression. Results of nonparametric multiple regression analyses showed that the cognitive variables predicted subsequent PTSD and depression severities over and above what could be predicted from initial symptom levels. They also showed greater predictive power than the established predictors, although the latter showed similar effect sizes as in the meta-analysis. In addition, the predictors derived from cognitive models of PTSD and depression were disorder-specific. The results support the role of cognitive factors in the maintenance of emotional disorders following trauma.",0 +https://doi.org/10.1016/j.jbtep.2009.02.003,Visual false memories in post-traumatic stress disorder (PTSD),"There is an ongoing debate whether or not patients with post-traumatic stress disorder (PTSD) are more prone to produce false memories. The present study investigated this question using a visual variant of the Deese-Roediger-McDermott (DRM) paradigm, additionally addressing underlying mechanisms of false memory production (e.g., depression, dissociation, emotional valence, arousal). The visual paradigm was administered to 48 traumatized individuals with (n=20) and without PTSD (n=28) and 28 non-traumatized controls. Groups did not differ with regard to memory performance and memory confidence. False memories were correlated with depression. We recommend that future studies employ trauma-related material to further explore memory aberrations in PTSD.",0 +https://doi.org/10.1016/j.cpr.2008.03.006,Relations among peritraumatic dissociation and posttraumatic stress: A meta-analysis,"A meta-analysis was performed on the empirical literature which addressed the relationship of peritraumatic dissociation to posttraumatic stress (PTS). Extensive literature searches were conducted to identify as many relevant studies as possible, and revealed 59 independent eligible studies. All studies were coded using a detailed code sheet that included effect measures, variables that indicated the methodological quality of the studies, and substantial variables that might theoretically affect the relationship between peritraumatic dissociation and PTS. A significant positive relation between peritraumatic dissociation and PTS was found. Differences in the methodological rigor between studies - time elapsed since peritraumatic dissociation, design, sample type, and study type - significantly and sufficiently explained the variability in effect sizes between studies. Theoretical variables did not explain such variability. Although results underline earlier findings, due to designs of the reviewed studies no conclusions could be drawn as to causal relations between peritraumatic dissociation and PTS.",0 +https://doi.org/10.1067/mhl.2001.118296,Predicting post-traumatic symptoms in cardiac patients,"The purpose of this study was to identify correlates and predictors of the symptoms of post-traumatic stress disorder (PTSD) in a cohort of patients with myocardial infarction, while the patients were in hospital and 3 months after infarction.Longitudinal, consecutive referrals were used.From a possible 68 consecutive patients with a first myocardial infarction who completed questionnaires in hospital and survived to 3-month follow-up, 39 completed follow-up questionnaires.PTSD measures were taken in hospital and 3 months after discharge. Predictor variables were measures of mood taken in hospital and measures of the immediate cognitive and emotional reactions at the time of the infarct.Associations between the independent variables and PTSD symptoms were stronger at 3-month follow-up than while in hospital. At this time, the frequency of intrusive thoughts was predicted by the degree of fright at the time of the event (adjusted R(2) = 0.262; beta =.57; t = 3.30; P <.01) and positive affect scores (additional adjusted R(2) = 0.112; beta = -.37 t = -2.18; P <.05). The degree of physiologic arousal at the time of such flashbacks was predicted by levels of negative affect in hospital (adjusted R(2) = 0.174; beta =.46; t = 2.46; P <.05), which also predicted avoidance scores (adjusted R(2) = 0.203; beta =.48; t = 2.62; P <.05).Because many of the symptoms of PTSD are self-remitting, and intervening too early in the course of the disorder may exacerbate the disorder, it is important not to intervene too early or over-treat this disorder. Formal treatment may be useful if provided some months after discharge from hospital. If either secondary or primary care services are to treat myocardial infarction-related PTSD effectively, it is important to identify patients who are at risk for it. These data contribute to the development of a profile of patients at risk.",0 +https://doi.org/10.1016/s0301-0511(01)00091-6,The somatic symptom paradox in DSM-IV anxiety disorders: suggestions for a clinical focus in psychophysiology,"Although DSM-IV criteria for anxiety disorders include physiological symptoms, these symptoms are evaluated exclusively by verbal report. The current review explores the background for this paradox and tries to demonstrate on theoretical and empirical grounds how it could be resolved, providing new insights about the role of psychophysiological measures in the clinic. The three-systems approach to evaluating anxiety argues that somatic measures as well as verbal and behavioral ones are indispensable. However, the low concordance between these domains of measurement impugns their reliability and validity. We argue that concordance can be improved by examining the relationship of variables less global than anxiety and by restriction to specific anxiety disorders. For example, recent evidence from our and other laboratories indicate a prominent role of self-reported and physiologically measured breathing irregularities in panic disorder. Nonetheless, even within a diagnosis, anxiety patients vary radically in which somatic variables are deviant. Thus, in clinical practice, individual profiles of psychological and physiological anxiety responses may be essential to indicate distinct therapeutic approaches and ways of tracking improvement. Laboratory provocations specific to certain anxiety disorders and advances in ambulatory monitoring vastly expand the scope of self-report and physiological measurement and will likely contribute to a refined assessment of anxiety disorders.",0 +https://doi.org/10.1159/000056243,Family and Past History of Mental Illness as Predisposing Factors in Post-Traumatic Stress Disorder,"Family studies of post-traumatic stress disorder (PTSD) have given inconsistent results to date. Identifying predisposing factors in PTSD compared to anxiety disorders may help to clarify the classification of PTSD as a diagnostic entity.Retrospective case note study of 87 PTSD patients who participated in an RCT, and 51 PTSD patients and 87 agoraphobics treated routinely in outpatients.Compared to agoraphobics, PTSD patients had significantly less family history of anxiety disorder but not mental illness in general. They also had significantly less personal history of mental illness prior to the index episode.Trauma precipitated PTSD in subjects who had significantly fewer premorbid predisposing factors than did agoraphobics. Such factors may predispose agoraphobics to become psychiatrically ill after more minor trauma. Research is needed to systematically compare the events which precipitate PTSD as opposed to agoraphobia and other anxiety disorders.",0 +https://doi.org/10.1016/j.psychres.2015.09.044,Posttraumatic stress disorder in eating disorder patients: The roles of psychological distress and timing of trauma,"Exposure to traumatic events may be a risk factor for subsequent development of an eating disorder (ED). In a previous study, we showed that trauma exposure impacted symptom load in ED patients. We also saw an effect of trauma on general psychological distress. The aim of the present study was to investigate the association between Posttraumatic stress disorder (PTSD) and ED severity, to focus on the mediating role of psychological distress for the association, and to assess the role of timing of trauma in relation to emergence of ED. Participants were Swedish adult ED patients with a history of traumatic exposure (N=843, Mean age 27.2, 97.3% female). One fourth (24.1%) of the participants had a lifetime diagnosis of PTSD. PTSD had an impact on ED severity, but the impact was mediated by psychological distress. When stratifying the sample based on timing of trauma a significant effect was present only in those with trauma within a year of emergence of ED. The results suggest emotion regulation as a possible underlying factor of interest in future research.",0 +https://doi.org/10.1016/j.annepidem.2009.06.005,Patterns and Predictors of Trajectories of Depression after an Urban Disaster,"To identify and understand the patterns and predictors of depressive symptom trajectories over time after mass traumatic events.Data were used from a prospective, representative sample of adult residents of the New York City metropolitan area (N=2,282) followed up across four survey waves between 2001 (after the September 11 attacks) and 2004. Semi-parametric group-based modeling was used to identify trajectories, as well as the time-fixed and time-varying predictors of distinct depressive trajectories.Five distinct trajectories of depression were characterized: minimal symptomatology at all time points (group 1, 39% of sample), mild delayed depression (group 2, 34% of sample), recovery (group 3, 6% of sample), severe delayed depression (group 4, 13% of sample), and chronic severe depression (group 5, 8% of sample). Among members of distinct trajectories, lower household income, exposure to ongoing stressors, and exposure to traumatic events were commonly associated with an increased number of depressive symptoms.Ongoing socioeconomic adversity appears to be centrally associated with a worse course of depression after exposure to traumatic events. Identifying distinct trajectories of depression and the preventable factors that are associated with them may facilitate the development of interventions that aim to promote better mental health.",0 +https://doi.org/10.2147/ppa.s29734,"Neuropsychophysical optimization by REAC technology in the treatment of: sense of stress and confusion. Psychometric evaluation in a randomized, single blind, sham-controlled naturalistic study","Neuropsychophysical optimization by REAC technology in the treatment of: sense of stress and confusion. Psychometric evaluation in a randomized, single blind, sham-controlled naturalistic study Vania Fontani1, Lucia Aravagli1, Matteo Lotti Margotti2, Alessandro Castagna1, Piero Mannu1, Salvatore Rinaldi11Department of Neuro Psycho Physio Pathology, 2Department of Information Technology and Statistical Analysis, Rinaldi Fontani Institute, Florence, ItalyPurpose: The aim of this study is to investigate the effects of neuropsychophysical optimization (NPPO) protocol treatment by radioelectric asymmetric conveyer (REAC) technology in the management of sense of stress and confusion (SSC); an analysis of a single cluster of the psychological stress measure (PSM) test.Patients and methods: The PSM, a self-administered questionnaire, was used to measure psychological stress and SSC for a group of 888 subjects. Data were collected immediately prior to and following the 4-week REAC-NPPO treatment cycle.Results: This study demonstrates a significant reduction in scores measuring subjective perceptions of stress for subjects treated with one cycle of REAC-NPPO. At the end-point of the study, the number of treated subjects reporting symptoms of stress-related SSC on the PSM test was significantly reduced, whereas there was no difference in sham-treated subjects.Conclusion: One cycle of REAC-NPPO appears to reduce subjective perceptions of SSC measured by the PSM.Trial registration: This trial has been registered in the Australian New Zealand Clinical Trials Registry as ACTRN12607000497404.Keywords: stress disorders, adaptation disorders, REAC, NPPO",0 +https://doi.org/10.1007/bf03040918,Increase of serum triiodothyronine concentration in soldiers with combat-related chronic post-traumatic stress disorder with or without alcohol dependence,"Background: Post-traumatic stress disorder (PTSD) is a relatively new psychiatric disorder with three clusters of symptoms: trauma re-experiencing, avoidance, and increased arousal. The condition develops after a person sees, is involved in, or hears of an extreme traumatic stressor such as war, torture, natural catastrophe, assault, rape, or serious accident. PTSD is also often comorbid with other psychiatric disorders, especially with alcohol dependence. Several hormonal alterations have been reported in veterans with combat-related PTSD, including elevations in certain thyroid hormones, e.g., total T3; however, previous studies have not controlled for alcohol dependence, a common comorbid psychiatric disorder in this population. Objective: The first aim of our study was to assess possible differences in basal serum levels of free triiodothyronine (FT3), total triiodothyronine (TT3), free thyroxine (FT4), total thyroxine (TT4), and thyroid stimulating hormone (TSH) in Croatian soldiers with combat-related chronic PTSD alone or comorbid with alcohol dependence and in healthy controls. The second purpose of the study was to determine any correlation between duration of combat activities, number of combat traumas, intensity and duration of PTSD symptoms, and serum levels of TT3, FT3, TT4, FT4, and TSH in this sample. Method: We analyzed basal serum FT3, TT3, FT4, TT4, and TSH concentrations in soldiers with combat-related chronic PTSD (N = 43), combat-related chronic PTSD comorbid with alcohol dependence (N = 41), and in healthy controls (N = 39) using a luminoimmunochemical assay. Results: Soldiers with chronic combat-related PTSD with or without comorbid alcohol addiction had significantly higher values of TT3 than the control group (F = 19.556, p < 0.01). There was a significant correlation between TT3 levels and number of traumatic events in both the PTSD group (r = 0.663, p < 0.01) and those with PTSD comorbid with alcohol dependence (r = 0.836, p < 0.01). There was also a significant correlation between TT3 levels and symptoms of increased arousal in both PTSD (r = 0.419, p < 0.01) and PTSD comorbid with alcohol dependence (r = 0.516, p < 0.01). Conclusion: Elevated concentrations of serum TT3 are associated with combat-related PTSD, regardless of its comorbidity with alcohol dependence, and also with the number of traumatic events and symptoms of increased arousal. Given that current pharmacotherapy for PTSD is inadequate, reduction of TT3 may be a new strategy for pharmacologic intervention that could contribute to more effective treatment of this disorder.",0 +https://doi.org/10.1080/14681990802641299,Complicated grief: implications for the treatment of post-traumatic stress disorder in couples,"Complicated grief has many interfaces with post-traumatic stress disorder (PTSD) including avoidance, flashbacks and shattered assumptions. Increasing use of cognitive behavioural therapy (CBT) models in grief work are drawing on lessons learned in PTSD treatment. However, models used in grief work, such as attachment, the Dual Process Model (Stroebe & Schut, 1999) and Psychosocial Transition Theory (Parkes, 1993), are less commonly applied to understanding and treating PTSD. This paper gives an overview of how these theories explain complicated grief and PTSD and considers implications they have on treatment of couples, based on literature review and clinical experience. Treatment implications include treating PTSD before traumatic grief, working with intra-couple coping style differences, promoting acceptance and forgiveness and taking a full attachment history.",0 +https://doi.org/10.1177/1534765610395627,A latent growth mixture modeling approach to PTSD symptoms in rape victims.,"The research literature has suggested that longitudinal changes in posttraumatic stress disorder (PTSD) could be adequately described in terms of one universal trajectory, with individual differences in baseline levels (intercept) and rate of change (slope) being negligible. However, not everyone who has experienced a trauma is diagnosed with PTSD, and symptom severity levels differ between individuals exposed to similar traumas. The current study employed the latent growth mixture modeling technique to test for multiple trajectories using data from a sample of Danish rape victims (N = 255). In addition, the analysis aimed to determine whether a number of explanatory variables could differentiate between the trajectories (age, acute stress disorder [ASD], and perceived social support). Results concluded the existence of two PTSD trajectories. ASD was found to be the only significant predictor of one trajectory characterized by high initial levels of PTSD symptomatology. The present findings confirmed the existence of multiple trajectories with regard to PTSD symptomatology in a way that may be useful to clinicians working with this population.",1 +https://doi.org/10.1007/978-1-4899-7522-5_1,Vulnerability to PTSD: Psychosocial and Demographic Risk and Resilience Factors,"The risk of developing PTSD after a traumatic experience depends on several vulnerability factors that may be classified into three distinct categories—pre-traumatic, peri-traumatic, and posttraumatic. Accordingly, while attempting to draw the profile of the high-risk patient for PTSD, the following factors should be included, among others: The history of previous trauma, the history of previous psychiatric disorder, female gender, ethnic minority, high severity of initial posttraumatic symptoms (ASR), associated body injury, “high-risk” traumatic event (man-made trauma), and peri-traumatic dissociation. In contrast, various resilience factors may be protective and act to prevent the development of PTSD. Although resilience factors were generally not discussed in this chapter, future research should be designed to uncover resilience factors, in order to differentiate between high-risk and low-risk patients in order to identifying the patients at risk and to attempt to develop the strategies to prevent the development of PTSD. © Springer Science+Business Media New York 2015.",0 +https://doi.org/10.1016/j.bbr.2012.07.022,Murine model of repeated exposures to conspecific trained aggressors simulates features of post-traumatic stress disorder,"We evaluated repeated exposures of mice to a trained aggressor mouse as a model (adapted from ""social stress"" models of traumatic stress) for aspects of post-traumatic stress disorder (PTSD). Using a ""cage-within-cage resident-intruder"" protocol, subject C57BL/6J mice were exposed to aggressors for 6 h daily for 5 or 10 days. At one to three random times during each 6-h session, subjects were exposed directly to aggressor for 1 min or 10 bites, whichever came first. Behavioral, physiological, and histological changes associated with aggressor-exposure were assessed for up to 6 weeks. During aggressor exposure, subjects displayed less territorial behavior, gained weight, and increased body temperature. One day after the last aggressor exposure, inflammatory cardiac histopathologies were prevalent; after 10 days, only mild myocardial degeneration with fibrosis or fibroplasias was evident, while controls showed almost no cardiac abnormalities at any time. After 4 weeks, the medial prefrontal cortex of control mice showed increased dendritic spine density, but aggressor-exposed mice showed no increase. Behaviors affected by aggressor exposure were evaluated in a partition test wherein the subject mouse is separated from the aggressor by a fenestrated partition that permits sensory cues to pass but prevents direct physical interaction. For up to 4-6 weeks after the last aggressor exposure, subjects showed prolonged grooming, freezing, retarded locomotion and no tail rattling. PTSD and its co-morbidities are often consequent to repeated aggravated ""social"" assaults (e.g., combat) and manifest socially over time, suggesting the relevance of this repeated aggressor-exposure model to clinical aspects of PTSD.",0 +https://doi.org/10.4088/jcp.14m09229,Factors Affecting Exits From Homelessness Among Persons With Serious Mental Illness and Substance Use Disorders,"We sought to understand the housing trajectories of homeless consumers with serious mental illness (SMI) and co-occurring substance use disorders (SUD) and to identify factors that best predicted achievement of independent housing.Using administrative data, we identified homeless persons with SMI and SUD admitted to a residential rehabilitation program from December 2008 to November 2011. Our primary outcome measure was independent housing status. On a random sample (N = 36), we assessed a range of potential predictors of housing outcomes, including symptoms, cognition, and social/community supports. We used the Residential Time-Line Follow-Back (TLFB) Inventory to gather housing histories since exiting rehabilitation and to identify housing outcomes. We used Recursive Partitioning (RP) to identify variables that best differentiated participants by these outcomes.We identified 3 housing trajectories: stable housing (n = 14), unstable housing (n = 15), and continuously engaged in housing services (n = 7). In RP analysis, 2 variables (Symbol Digit Modalities Test [SDMT], a neurocognitive speed of processing measure, and Behavior and Symptom Identification Scale [BASIS-24] Relationships subscale, which quantifies symptoms affecting relationships) were sufficient to capture information provided by 26 predictors to classify participants by housing outcome. Participants predicted to continuously engage in services had impaired processing speeds (SDMT score < 32.5). Among consumers with SDMT score ≥ 32.5, those predicted to achieve stable housing had fewer interpersonal symptoms (BASIS-24 Relationships subscale score < 0.81) than those predicted to have unstable housing. This model explains 57% of this sample's variability and 14% of this population's variability in housing outcomes.Because cognition and symptoms influencing relationships predicted housing outcomes for homeless adults with SMI and SUD, cognitive and social skills training may be useful for this population.",0 +https://doi.org/10.1001/jama.298.5.543,Exposure to War Crimes and Implications for Peace Building in Northern Uganda,"Since the late 1980s, the Lord's Resistance Army has waged war against the Ugandan People's Democratic Army and the people of northern Uganda. Ending the conflict and achieving peace have proven to be challenges. In this context, it is important to examine population-based data on exposure to war crimes to understand how survivors perceive mechanisms aimed at achieving a lasting peace.To assess the level of exposure to war-related violence and the prevalence of posttraumatic stress disorder (PTSD) and depression symptoms in northern Uganda and to determine how these variables are associated with respondents' views about peace.Multistage, stratified, random cluster survey of 2585 adults aged 18 years or older conducted in villages and camps for internally displaced persons in 4 districts of northern Uganda in April and May 2005.Rates and patterns of exposure to trauma; symptom criteria for PTSD, assessed via the PTSD Checklist-Civilian Version with a total severity score of 44; symptoms of depression, assessed via the Johns Hopkins Depression Symptom Checklist with a cutoff of 42; and opinions and attitudes about peace.Among the respondents, 1774 of 2389 (74.3%) met PTSD symptom criteria and 1151 of 2585 (44.5%) met depression symptom criteria. Four patterns of exposure to trauma were distinguished: those with low exposure (group 1; 21.4%), witnesses to war-related violence (group 2; 17.8%), those threatened with death and/or physically injured (group 3; 16.4%), and those abducted (group 4; 44.3%). Respondents in groups 3 and 4, who experienced the most traumatic exposures, were more likely to have PTSD symptoms compared with group 1 (group 3 vs group 1: odds ratio [OR], 7.04 [95% confidence interval {CI}, 5.02-9.87]; group 4 vs group 1: OR, 6.07 [95% CI, 4.77-7.71]). Groups 3 and 4 were also more likely to meet depression symptom criteria (group 3 vs group 1: OR, 5.76 [95% CI, 4.34-7.65]; group 4 vs group 1: OR, 4.00 [95% CI, 3.16-5.06]). Respondents who met the PTSD symptom criteria were more likely to identify violence as a means to achieve peace (OR, 1.31; 95% CI, 1.05-1.65). Respondents who met the depression symptom criteria were less likely to identify nonviolence as a means to achieve peace (OR, 0.77; 95% CI, 0.65-0.93).Our study found high prevalence rates for symptoms of PTSD and depression in a conflict zone. Respondents reporting symptoms of PTSD and depression were more likely to favor violent over nonviolent means to end the conflict.",0 +https://doi.org/10.1016/j.comppsych.2013.07.052,Dimensional structure and prospective evolution of posttraumatic stress symptomatology in World Trade Center responders,"Background: Posttraumatic stress disorder (PTSD) is an anxiety disorder characterized by heterogeneous clusters of re-experiencing, avoidance, numbing, and hyperarousal symptoms. A large body of confirmatory factor analytic (CFA) studies has demonstrated that four-factor dysphoria and emotional numbing models provide a better representation of PTSD symptom dimensionality compared to the three-factor DSM-IV model. Recently, CFA studies of various trauma-exposed samples have found that a novel five-factor model, which separates the DSM-IV hyperarousal symptom cluster into distinct dysphoric and anxious arousal clusters, provides a superior representation of PTSD symptom dimensionality. To date, however, no study of which we are aware has evaluated the best dimensional representation of PTSD symptoms in World Trade Center (WTC) responders, or how symptom clusters from this model are prospectively related. Methods: Confirmatory factor analyses (CFAs) were used to examine the factor structure of the PTSD Checklist in a cohort of 10,835 WTC responders, including 4,035 police responders and 6,800 non-traditional responders, who were evaluated an average of 3, 6, and 8 years after the WTC attacks. An autoregressive cross-lagged panel regression analysis was then conducted to evaluate interrelationships among PTSD symptom clusters over time. Results: CFAs revealed that a five-factor model comprised of intercorrelated clusters of re-experiencing, avoidance, emotional numbing, dysphoric arousal, and anxious arousal symptoms provided the best representation of PTSD symptoms in police and non-traditional WTC responders. In police responders, anxious arousal symptoms were most strongly prospectively linked to reexperiencing symptoms, and dysphoric arousal to numbing symptoms in the intermediate-term, while re-experiencing symptoms predominantly drove numbing symptoms in the long-term. In non-traditional responders, anxious arousal symptoms were most strongly prospectively linked to re-experiencing symptoms, while dysphoric arousal symptoms predominantly drove numbing symptoms over time. In both groups of responders, avoidance symptoms drove re-experiencing symptoms over time. Conclusions: A novel 5-factor model comprised of re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal symptoms best represented PTSD symptomatology in both traditional and non-traditional disaster responders. Prospective interrelationships among these symptom clusters suggest that targeting hyperarousal and avoidance symptoms early after disaster exposure may help reduce later symptoms of re-experiencing and numbing in disaster responders.",0 +,"It's all my fault: A mediational model of shame, guilt, posttraumatic stress disorder and depression in a sample of battered women","Feelings of shame and guilt have received increased attention in mental health research. Women who are victims of Intimate Partner Violence (IPV) experience a wide array of emotions and stigma associated with their status, which may impact their physical and mental health. A fairly common response to traumatic events such as IPV is for the victim to blame herself and experience feelings of responsibility, shame, and guilt. The current study examined the relationships between trauma-related factors, the social/emotional factors of shame and guilt, and symptoms of Posttraumatic Stress Disorder (PTSD), depression, and the comorbid condition in a sample of 137 battered women residing in domestic violence shelters. It was suggested that shame would be a predictor and mediator for depression, as both constructs are related to self-evaluation. Guilt was suggested as a predictor and mediator for PTSD, as both of these constructs are related to events or behaviors. Shame was found to be a significant mediator in the relationship between trauma-related factors and symptoms of depression. A combined shame and guilt score was found to significantly mediate comorbid symptoms. Guilt alone failed to demonstrate significant mediation of PTSD symptoms. Predictive models using trauma-related factors along with shame and guilt were found to account for a significant amount of variance in mental health symptoms. This research supports the importance shame and guilt, particularly in combination, and their contribution to mental health in female IPV victims. Future research on the interrelationships and distinction between shame and guilt as they impact psychopathology are needed, as well as refinements to these and other predictive models for use in early detection, treatment, and potentially prevention of mental health problems following IPV victimization. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1207/s15327752jpa7103_3,An Investigation of Malingering Posttraumatic Stress Disorder on the Personality Assessment Inventory,"Utilizing the Personality Assessment Inventory (PAI; Morey, 1991), this study aimed to isolate a pattern of responding that is indicative of an attempt to malinger posttraumatic stress disorder (PTSD). The PAI profiles of 116 male participants were examined. Profiles of a group of 29 alcohol-abusing veterans with a primary Axis I (American Psychiatric Association, 1994) diagnosis of PTSD and a group of 30 alcohol-abusing veterans with no other diagnoses were compared to those of 27 undergraduate men instructed to feign PTSD. Control data were obtained from another group of 30 undergraduates. The student malingerers produced PAI profiles that were significantly different from the veterans with PTSD. Seven scales distinguished the malingerers from the veterans with an actual diagnosis of PTSD. Malingerers tended to overexaggerate pathology, inflating their scores on many clinical scales greater than the mean of the PTSD sample. Malingerers also scored higher on Morey's (1993) 8-item Malingering Index than either group of veterans and the controls. Only 2 scales reliably differentiated alcohol-abusing veterans with PTSD from those without the disorder. The implications of these findings in the diagnosis of PTSD are discussed.",0 +https://doi.org/10.1152/ajpheart.00029.2005,Menstrual cycle and sex affect hemodynamic responses to combined orthostatic and heat stress,"Women have decreased orthostatic tolerance compared with men, and anecdotal evidence suggests women are more susceptible to orthostatic intolerance in warm environments. Because estrogen and progesterone affect numerous physiological variables that may alter orthostatic tolerance, the purpose of our study was to compare orthostatic tolerance across the menstrual cycle phases in women during combined orthostatic and heat stress and to compare these data with those of men. Eight normally menstruating women and eight males (22 +/- 4.0 and 23 +/- 3.5 yr, respectively) completed the protocol. Women were studied during their early follicular (EF), ovulatory (OV), and midluteal (ML) phases. Men were studied twice within 2-4 wk. Heart rate, cardiac output, blood pressure, core temperature (T(c)), and cutaneous vascular conductance (CVC) were measured during three head-up tilt tests, consisting of two tilts in the thermoneutral condition and one tilt after a 0.5 degrees C rise in T(c). There was no difference in orthostatic tolerance across the menstrual cycle phases, despite higher CVC in the ML phase after heating (EF, 42.3 +/- 4.8; OV, 40.1 +/- 3.7; ML, 57.5 +/- 4.5; P < 0.05). Orthostatic tolerance in the heat was greater in men than women (P < 0.05). These data suggest that although many physiological variables associated with blood pressure regulation fluctuate during the menstrual cycle, orthostatic tolerance in the heat remains unchanged. Additionally, our data support a clear sex difference in orthostatic tolerance and extend upon previous data to show that the sex difference in the heat is not attributable to fluctuating hormone profiles during the menstrual cycle.",0 +,Post-traumatic stress disorder among patients with orofacial pain.,"To examine the presence and impact of post-traumatic stress disorder (PTSD) in a sample of patients seeking treatment for orofacial pain.One hundred forty-one consecutive patients with an array of orofacial pain conditions were screened using a structured clinical interview for PTSD and the PTSD Symptom Checklist--Civilian Version (PCL), a brief PTSD self-report inventory. Additionally, participants received a clinical examination and self-report questionnaires to assess pain, coping styles, and presence of post-traumatic symptoms.Thirty-three (23%) patients received a full lifetime or current PTSD diagnosis, with an additional 11 patients receiving a partial PTSD diagnosis. Only 5 of these 44 patients had ever been previously diagnosed with PTSD. PTSD symptoms were associated with higher pain scores (P < .05) and affective distress (P < .01). Furthermore, discriminant function analyses suggested that the PCL accurately classified 89% of these cases (sensitivity = .85, specificity = .90, positive predictive power = 74%, negative predictive power = 95%).These results suggest that PTSD is prevalent in the orofacial pain setting and that PTSD symptomatology is associated with increased pain and affective distress that may complicate clinical presentation. Furthermore, PTSD can be accurately and efficiently assessed using a brief, self-report inventory.",0 +https://doi.org/10.1017/cbo9780511730030.003,The Experience of Disaster:,,0 +https://doi.org/10.1007/978-3-319-18866-9_6,Posttraumatic Stress in the Aftermath of Mass Shootings,"Recent mass shooting incidents in the USA include the 2007 shooting at Virginia Tech and the 2012 shootings at the Aurora, Colorado movie theatre and Sandy Hook elementary school in Newtown, Connecticut. Although these events generated much national attention, surprisingly, little research has evaluated mental health impacts of mass shootings, and no efforts to our knowledge have been made to synthesize the empirical findings. In this chapter, we review the extant literature on posttraumatic stress in the aftermath mass shootings. We identified 35 peer-reviewed articles, comprised of 19 independent samples in the aftermath of 14 mass shooting incidents. The prevalence of posttraumatic stress disorder in these studies ranged from 3 to 91 %. Several factors could underlie this wide variation, including differences in the assessment measures, criteria used to define cases, timing of assessment, and sample characteristics. Risk factors for more severe posttraumatic stress symptoms have been identified, including demographic and pre-incident characteristics (e.g., female gender, pre-incident psychological symptoms), event exposure (e.g., greater proximity to the attack, acquaintance with the deceased), and fewer psychosocial resources (e.g., emotion regulation difficulties, lower social support). Further research that draws on pre-incident and longitudinal data will yield important insights into the processes that exacerbate or sustain posttraumatic stress over time and provide important information for crisis preparedness and post-incident mental health interventions.",0 +https://doi.org/10.1007/s00421-012-2506-6,Hypohydration and acute thermal stress affect mood state but not cognition or dynamic postural balance,"Equivocal findings have been reported in the few studies that examined the impact of ambient temperature (T a) and hypohydration on cognition and dynamic balance. The purpose of this study was to determine the impact of acute exposure to a range of ambient temperatures (T a 10-40 C) in euhydration (EUH) and hypohydration (HYP) states on cognition, mood and dynamic balance. Thirty-two men (age 22 ± 4 years, height 1.80 ± 0.05 m, body mass 85.4 ± 10.8 kg) were grouped into four matched cohorts (n = 8), and tested in one of the four T a (10, 20, 30, 40 C) when EUH and HYP (-4 % body mass via exercise-heat exposure). Cognition was assessed using psychomotor vigilance, 4-choice reaction time, matching to sample, and grammatical reasoning. Mood was evaluated by profile of mood states and dynamic postural balance was tested using a Biodex Balance System. Thermal sensation (TS), core (T core) and skin temperature (T sk) were obtained throughout testing. Volunteers lost -4.1 ± 0.4 % body mass during HYP. T sk and TS increased with increasing T a, with no effect of hydration. Cognitive performance was not altered by HYP or thermal stress. Total mood disturbance (TMD), fatigue, confusion, anger, and depression increased during HYP at all T a. Dynamic balance was unaffected by HYP, but 10 C exposure impaired balance compared to all other T a. Despite an increase in TMD during HYP, cognitive function was maintained in all testing environments, demonstrating cognitive resiliency in response to body fluid deficits. Dynamic postural stability at 10 C appeared to be hampered by low-grade shivering, but was otherwise maintained during HYP and thermal stress. © 2012 Springer-Verlag Berlin Heidelberg (outside the USA).",0 +https://doi.org/10.1016/j.bbi.2016.01.011,Toll-like receptor expression and function in type I bipolar disorder,"Bipolar disorder (BD) has been associated with immune imbalance and low-grade inflammation. The underlying mechanisms remain largely obscure but may involve changes in cell signaling. Toll-like receptors (TLRs) are widely expressed by immune cells. Specific binding of TLRs to pathogen- or danger-associated signals leads to inflammatory responses. Here, we analyzed the frequencies of TLR-1, TLR-2, TLR-4, TLR-5 and TLR-6 in monocytes, regulatory T cells (Tregs) and activated T cells from type I BD euthymic patients and healthy controls (HCs). Monocytes were stimulated in vitro with specific TLR agonists (flagellin, LPS, LTA, BLP and PGN) and immunophenotyped. Cytokines (IL-8, IL-1beta, IL-6, IL-10, TNF-alpha and IL-12p70) were assessed with cytometric bead arrays. At baseline, increased percentages of TLR-1+ and TLR-2+ monocytes and reduced expression of TLR-5 were observed in BD. Following stimulation, the percentage of TLR-1+, TLR-2+, and TLR-6+ monocytes was higher in BD subjects than in HCs. Increased levels of IL-8, IL-12p70 and TNF were observed following stimulation with TLR-1, TLR-2 and TLR-6 agonists, suggesting increased signaling via these receptors in BD. In contrast to HCs, BD patients exhibited no changes in TLR-5 expression following stimulation. The percentage of TLR-2+ Treg cells as well as activated T cells expressing both TLR-2 and TLR-5 increased in BD patients. Given the importance of TLRs in triggering immune responses, our data indicate a role for these receptors in the low-grade inflammatory profile documented in BD.",0 +https://doi.org/10.1016/s0006-3223(99)00262-0,A developmental psychopathology model of childhood traumatic stress and intersection with anxiety disorders,"

Abstract

Empirical findings regarding childhood traumatic stress are placed within a developmental life-trajectory model that incorporates a tripartite etiology of posttrauma distress. This approach recognizes an intricate matrix of child-intrinsic factors, developmental maturation and experience, life events, and evolving family and social ecologies. Of central developmental importance in the field of traumatic stress is the ontogenesis of appraisal, emotional response, emotional and physiological regulation, and consideration of protective action with regard to danger. The complexity of traumatic situations and their aftermath suggests the relevance of multiple stress diatheses in understanding individual variability in proximal and distal effects. Neurobiological systems that subserve danger mature over childhood and adolescence. Neurophysiological and neurohormonal studies among traumatized children and adolescents suggest potential neurodevelopmental stage-related vulnerabilities within these systems. Advances in child development and traumatic stress provide tools for investigating proximal and distal interplay of psychopathology, disturbances in the acquisition and maintenance of developmental competencies, and life-trajectory outcomes. A developmental psychopathology model suggests different avenues by which dangerous circumstances, childhood traumatic experiences, and posttraumatic stress disorder (PTSD) can intersect with other anxiety disorders over the life span.",0 +https://doi.org/10.1093/pubmed/fdn025,"Prevalence and predictors of mental disorders among women in Sanliurfa, Southeastern Turkey","Mental health is one of the most important public health issues because of major contributor to the global burden of disease. In this study, we examined the prevalence and predictors of mental disorders among married women from 15 to 49 years of age and the need for mental health services in the primary health care settings.In this cross-sectional study, 270 women were selected using probability cluster sampling method at 95% confidence interval (91.5% response rate). The Structured Clinical Interview for DSM-IV (SCID-I) and women socio-demographic information form were used to collect data.Although the prevalence of mental disorder was 25.9% (8.5% with one diagnosis; 17.4% were two or more diagnoses), 4.7% of these women had contacted a carer in the last year for psychological reasons. According to the SCID-I assessment, the most prevalent diagnoses were major depressive disorder (7.3%), phobic disorder (4.8%) and posttraumatic stress disorder (3.6%). In this study, comorbid diagnoses were present in 67.2% of patients. Logistic regression analyses revealed that domestic violence, history of previous trauma, anemia and cutaneous leishmaniasis were significant predictors of any mental disorders (P < 0.05).These findings highlight the need for systematic development of community-based mental health services in conjunction with primary health care services for the screening, early identification and treatment of women suffering from mental disorders, and the improvement of anemia and cutaneous leishmaniasis control programme.",0 +https://doi.org/10.1186/s12888-015-0440-y,Post-traumatic stress disorder and depression prevalence and associated risk factors among local disaster relief and reconstruction workers fourteen months after the Great East Japan Earthquake: a cross-sectional study,"Many local workers have been involved in rescue and reconstruction duties since the Great East Japan Earthquake (GEJE) on March 11, 2011. These workers continuously confront diverse stressors as both survivors and relief and reconstruction workers. However, little is known about the psychological sequelae among these workers. Thus, we assessed the prevalence of and personal/workplace risk factors for probable post-traumatic stress disorder (PTSD), probable depression, and high general psychological distress in this population.Participants (N = 1294; overall response rate, 82.9%) were workers (firefighters, n = 327; local municipality workers, n = 610; hospital medical workers, n = 357) in coastal areas of Miyagi prefecture. The study was cross-sectional and conducted 14 months after the GEJE using a self-administered questionnaire which included the PTSD Checklist-Specific Version, the Patient Health Questionnaire-9, and the K6 scale. Significant risk factors from bivariate analysis, such as displacement, dead or missing family member(s), near-death experience, disaster related work, lack of communication, and lack of rest were considered potential factors in probable PTSD, probable depression, and high general psychological distress, and were entered into the multivariable logistic regression model.The prevalence of probable PTSD, probable depression, and high general psychological distress was higher among municipality (6.6%, 15.9%, and 14.9%, respectively) and medical (6.6%, 14.3%, and 14.5%, respectively) workers than among firefighters (1.6%, 3.8%, and 2.6%, respectively). Lack of rest was associated with increased risk of PTSD and depression in municipality and medical workers; lack of communication was linked to increased PTSD risk in medical workers and depression in municipality and medical workers; and involvement in disaster-related work was associated with increased PTSD and depression risk in municipality workers.The present results indicate that at 14 months after the GEJE, mental health consequences differed between occupations. High preparedness, early mental health interventions, and the return of ordinary working conditions might have contributed to the relative mental health resilience of the firefighters. Unlike the direct effects of disasters, workplace risk factors can be modified after disasters; thus, we should develop countermeasures to improve the working conditions of local disaster relief and reconstruction workers.",0 +https://doi.org/10.1017/s0033291709990298,Emotional disorders: Cluster 4 of the proposed meta-structure for DSM-V and ICD-11,"Background The extant major psychiatric classifications DSM-IV, and ICD-10, are atheoretical and largely descriptive. Although this achieves good reliability, the validity of a medical diagnosis would be greatly enhanced by an understanding of risk factors and clinical manifestations. In an effort to group mental disorders on the basis of aetiology, five clusters have been proposed. This paper considers the validity of the fourth cluster, emotional disorders, within that proposal. Method We reviewed the literature in relation to 11 validating criteria proposed by a Study Group of the DSM-V Task Force, as applied to the cluster of emotional disorders. Results An emotional cluster of disorders identified using the 11 validators is feasible. Negative affectivity is the defining feature of the emotional cluster. Although there are differences between disorders in the remaining validating criteria, there are similarities that support the feasibility of an emotional cluster. Strong intra-cluster co-morbidity may reflect the action of common risk factors and also shared higher-order symptom dimensions in these emotional disorders. Conclusion Emotional disorders meet many of the salient criteria proposed by the Study Group of the DSM-V Task Force to suggest a classification cluster.",0 +https://doi.org/10.1176/ajp.152.4.516,A 50-year prospective study of the psychological sequelae of World War II combat,"The authors took advantage of a 50-year prospective study of World War II veterans to examine the predictors and correlates of combat exposure, symptoms of posttraumatic stress disorder (PTSD), and trait neuroticism.The subjects were 107 veterans who had been extensively studied before and immediately after serving overseas in World War II. All served as members of the study until the present time, and 91 completed questionnaires of both PTSD symptoms and neuroticism.In this study group, variables associated with positive psychosocial health in adolescence and at age 65 predicted combat exposure. Combat exposure and number of physiological symptoms during combat stress--but not during civilian stress--predicted symptoms of PTSD in 1946 and 1988. Combat exposure also predicted early death and study attrition. Psychosocial vulnerability in adolescence and at age 65 and physiological symptoms during civilian stress--but not during combat stress--predicted trait neuroticism at age 65.Combat exposure predicted symptoms of PTSD but not nonspecific measures of psychopathology. Premorbid vulnerability predicted subsequent psychopathology but not symptoms of PTSD.",0 +https://doi.org/10.1017/s0033291709990663,Estimating post-traumatic stress disorder in the community: lifetime perspective and the impact of typical traumatic events – Corrigendum,"Reports an error in ""Estimating post-traumatic stress disorder in the community: Lifetime perspective and the impact of typical traumatic events"" by N. Breslau, E.L. Peterson, L.M. Poisson, L.R. Schultz and V.C. Lucia (Psychological Medicine, 2004[Jul], Vol 34[5], 889-898). There was an error in the first sentence of the 'Data analysis' section on page 891. The correct version of the sentence is present in the erratum. (The following abstract of the original article appeared in record 2004-17343-013). Community surveys have assessed post-traumatic stress disorder (PTSD) in relation to traumatic events designated by respondents as the worst they have ever experienced. An assessment of PTSD in relation to all reported traumas would impose too great a burden on respondents, a considerable proportion of whom report multiple traumas. The 'worst event' method is efficient for identifying persons with PTSD, but may overestimate the conditional probability of PTSD associated with the entire range of PTSD-level traumas. In this report, we evaluate this potential bias. The Detroit Area Survey of Trauma (n = 2181) estimated the PTSD risk from two samples of traumas: (1) a representative sample of traumas formed by selecting a random trauma from each respondent's list of traumas; and (2) traumas designated by respondents as the worst (the standard method). Results showed that both estimation methods converged on key findings, including identifying trauma types with the highest probability of PTSD and sex differences in the risk of PTSD. Compared to the random events, the 'worst event' method yielded a moderately higher conditional probability for PTSD (0.136 v. 0.092). The bias was due almost entirely to the deviation of the distribution of the worst events from expected values, if all event types had equal prior selection probabilities. Direct adjustment, setting the distribution equal to expected values and applying the observed probabilities of PTSD associated with individual event types brought the estimate close to the unbiased estimate, based on the randomly selected traumas. Only the 'worst event' method can be used as a short-cut to assessing all traumas. The bias in the estimated risk of PTSD is modest and is attenuated by direct adjustment. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0 +https://doi.org/10.1007/s10862-011-9251-8,A Comparison of Multidimensional Health Profiles across Three Trauma-Exposed Diagnostic Groups,"Posttraumatic stress disorder has been associated with adverse health outcomes. The extent to which the health effects of PTSD differ from other diagnoses has not been explored empirically. The current study investigated the Multidimensional Health Profile (including both Psychosocial and Health factors), across three diagnostic groups and one group of well-adjusted participants (N=92) in a contrastedgroups design. Participants were all trauma-exposed and were assessed using structured clinical interviews. The PTSD and depression groups tended to differ from the social phobia and well-adjusted groups. Both the PTSD and depression groups demonstrated elevated profiles on variables assessing psychological distress, negative social exchange, and hypochondriasis. Results are consistent with prior research suggesting PTSD is associated with worse psychological and health functioning relative to trauma-exposed individuals without PTSD, although these health outcomes seem to differ little between those with PTSD and those with depression. © Springer Science+Business Media, LLC 2011.",0 +https://doi.org/10.1111/dar.12230,Pathways to change: Use trajectories following trauma-informed treatment of women with co-occurring post-traumatic stress disorder and substance use disorders,"Introduction and Aims Despite advances towards integration of care for women with co-occurring substance use disorder (SUD) and post-traumatic stress disorder (PTSD), low abstinence rates following SUD/PTSD treatment remain the norm. The utility of investigating distinct substance use trajectories is a critical innovation in the detection and refining of effective interventions for this clinical population. Design and Methods The present study reanalysed data from the largest randomised clinical trial to date for co-occurring SUD and PTSD in women (National Drug Abuse Treatment Clinical Trials Network; Women and Trauma Study). Randomised participants (n = 353) received one of two interventions in addition to treatment as usual for SUD: (i) trauma-informed integrative treatment for PTSD/SUD; or (ii) an active control psychoeducation course on women's health. The present study utilised latent growth mixture models (LGMM) with multiple groups to estimate women's substance use patterns during the 12-month follow-up period. Results Findings provided support for three different trajectories of substance use in the post-treatment year: (i) consistently low likelihood and use frequency; (ii) consistently high likelihood and use frequency; and (iii) high likelihood and moderate use frequency. Covariate analyses revealed improvement in PTSD severity was associated with membership in a specific substance use trajectory, although receiving trauma-informed treatment was not. Additionally, SUD severity, age and after-care efforts were shown to be related to trajectory membership. Discussion and Conclusions Findings highlight the necessity of accounting for heterogeneity in post-treatment substance use, relevance of trauma-informed care in SUD recovery and benefits of incorporating methodologies like LGMM when evaluating SUD treatment outcomes. [López-Castro T, Hu M-C, Papini S, Ruglass LM, Hien DA. Pathways to change: Use trajectories following trauma-informed treatment of women with co-occurring post-traumatic stress disorder and substance use disorders. Drug Alcohol Rev 2015]",0 +https://doi.org/10.1097/brs.0b013e3182388449,Toward Optimal Early Management After Whiplash Injury to Lessen the Rate of Transition to Chronicity,"Expert debate and synthesis of research to inform future management approaches for acute whiplash disorders.To identify a research agenda toward improving outcomes for acute whiplash-injured individuals to lessen the incidence of transition to chronicity.International figures are concordant, estimating that 50% of individuals recover from pain and disability within 3 to 6 months of a whiplash injury. The remainder report continuing symptoms up to 1 to 2 years or longer postinjury. As no management approach to date has improved recovery rates, new clinical/research directions are required for early management of whiplash-injured patients.A group of multidisciplinary researchers critically debated evidence and current research concerning whiplash from biological, psychological, and social perspectives toward informing future research directions for management of acute whiplash.It was recognized that effective treatments for acute whiplash are constrained by a limited understanding of causes of whiplash-associated disorders. Acute whiplash presentations are heterogeneous leading to the proposal that a research priority was development of a triage system based on modifiable prognostic indicators and clinical features to better inform individualized early management decisions. Other priorities identified included researching effective early pain management for individuals presenting with moderate to high levels of pain; development of best education/information for acute whiplash; testing the efficacy of stratified and individualized rehabilitation, researching modes of delivery considering psychosocial modulators of pain and disability; and the timing, nature, and mode of delivery of cognitive-behavioral therapies. Directions were highlighted for future biomechanical research into injury prevention.The burden of whiplash injuries, the high rate of transition to chronicity, and evidence of limited effects of current management on transition rates demand new directions in evaluation and management. Several directions have been proposed for future research, which reflect the potential multifaceted dimensions of an acute whiplash disorder.",0 +https://doi.org/10.1016/j.ejpn.2007.11.002,PMTS and stress response sequences in parents of children with spina bifida,"To test the presence and progress of Pediatric Medical Traumatic Stress (PMTS) symptoms in parents of children with spina bifida (SB).Parents of 23 newborns with SB were interviewed prospectively and parents of 58 school-aged children with SB were interviewed retrospectively. PMTS symptoms were assessed with 17 DSM-IV criteria for the clusters Intrusion, Avoidance, and Increased Arousal.Within 3 months after the SB diagnosis, 75% of the parents met diagnostic criteria for symptoms of Intrusion and Increased Arousal, but not of Avoidance. In parents of school-aged children with SB, PMTS symptoms had declined in the first 4 years of the child's life and stabilized during the school years. Approximately 30% of the mothers and 20% of the fathers still met diagnostic criteria for Intrusion, Avoidance and Increased Arousal. In mothers of children with open SB, symptoms of Intrusion and Increased Arousal had decreased more slowly than in mothers of children with closed SB.An SB diagnosis initially provokes traumatic stress symptoms in three-quarters of the parents; however, in most of them, these symptoms diminish during the first 4 years of the child's life. In a minority of the parents, severe stress symptoms persist beyond middle childhood. Professional psychological help may need to be offered to this selective group of parents whose levels of stress do not decline after the child's preschool years. Longitudinal research is needed to further investigate and confirm the trends that were found in parents' psychological adjustment to SB.",0 +https://doi.org/10.1080/13548500600708409,The effects of childbirth-related post-traumatic stress disorder on women and their relationships: A qualitative study,"There is converging evidence that 1%-2% of women develop post-traumatic stress disorder (PTSD) as a result of childbirth. The current study aimed to explore the long-term effects of childbirth-related PTSD on women, their relationship with their partner and their relationship with their child. Semi-structured interviews were carried out with six women who reported clinically significant PTSD after birth, ranging from 7 months to 18 years beforehand. Interviews were transcribed and analysed using thematic analysis. Childbirth-related PTSD was found to have wide-ranging effects on women and their relationships. Women reported changes in physical well-being, mood and behaviour, social interaction, and fear of childbirth. Women reported negative effects on their relationship with their partner, including sexual dysfunction, disagreements and blame for events of birth. The mother-baby bond was also seriously affected. Nearly all women reported initial feelings of rejection towards the baby but this changed over time. Long-term, women seemed to have either avoidant or anxious attachments with their child. It is concluded that childbirth-related PTSD can have severe and lasting effects on women and their relationships with their partner and children. Further research is needed to compare this to normal difficulties experienced by women after having children.",0 +https://doi.org/10.1023/a:1024489231842,The function of image control in the psychophysiology of posttraumatic stress disorder,"The physiological response to trauma-related stimuli of up to one third of participants with posttraumatic stress disorder (PTSD) cannot be discriminated from that of controls. Psychophysiological measures (heart rate and blood pressure) of 22 PTSD and 23 control civilian participants, all exposed to missile attacks during the Gulf War, were recorded while listening to five scripts. The physiological response of PTSD subjects with high image control (IC) was lower than that of PTSD participants with low IC and similar to that of non-PTSD subjects. The physiological response poorly discriminated high IC PTSD participants from controls, but was successful in discriminating low IC PTSD subjects from controls with 91% specificity and 92% sensitivity. Image control is proposed as a function influencing physiological response in PTSD.",0 +https://doi.org/10.1007/4-431-29567-4_19,Functional Neuroimaging Research in Posttraumatic Stress Disorder,"Neuroimaging research in posttraumatic stress disorder (PTSD) is only two decadesold, but is rapidly expanding and evolving in methodological sophistication (Pitmanet al. 2001; Hull 2002; Liberzon and Phan 2003). Earlier structural and symptom-provocation studies are giving way to hypothesis-driven cognitive activationstudies, longitudinal and treatment studies, and translationally driven integrativestudies. The focused review of functional neuroimaging research in PTSD that followsdiscusses findings to better understand the functional neuroanatomy underlyingPTSD symptoms and pathophysiology. We begin with a selective review of theresearch on functional neuroanatomy of emotions that is specifically relevant toPTSD. The ensuing discussion links the two bodies of literature in order to providea better understanding of the processing of threat-related emotions and how this informsour understanding of the brain mechanisms that subserve PTSD.PTSD is characterized by exposure to life-threatening event/s associated withintense emotional reactions. Symptom clusters consist of reexperiencing the trauma(such as nightmares and intrusive memories), avoidance and numbing (avoidingtrauma-related cues, feeling emotionally distant from loved ones), and hyperarousal(hypervigilance, sleep disturbances) (American Psychiatric Association 2000). Becausethese criteria are descriptive, atheoretical, and not confined to a specific diagnosis,it is possible that patients with different neurobiological subtypes will sharethe same diagnosis or that patients with similar neurobiological abnormalities maycross descriptive categorical boundaries. Neurobiological evidence does offer thepotential to identify findings specific to trauma exposure and/or to PTSD's symptomsand pathophysiology, thereby helping to differentiate, define, and treat thesedisorders in a more meaningful way.One powerful, noninvasive means of investigating brain function in PTSD is theuse of relatively new neuroimaging methods such as magnetic resonance imaging(MRI) and positron emission tomography (PET). MRI methodology relies on spinproperties of protons in human brain tissue to outline brain structures and estimate their volume. Functional MRI (fMRI) uses the paramagnetic properties of oxy- anddeoxyhemoglobin in conjunction with rapid acquisition sequences to create maps ofblood-oxygen level dependent (BOLD) signal activity, i.e., blood flow reflective ofneuronal firing, thereby allowing the study of neural processing of specific tasks.Single photon emission computed tomography (SPECT) and PET use radio-emittingisotopes of biologically relevant molecules to estimate blood flow, metabolicrate, receptor binding, and quantification and the assessment of pharmacologicalactivity in vivo.",0 +https://doi.org/10.2307/351733,Measuring Intrafamily Conflict and Violence: The Conflict Tactics (CT) Scales,"Development of research on intrafamily and violence requires both conceptual clarity and measures of the concepts. The introduction to this paper therefore seeks to clarifj and distinguish the concepts of conflict, conflict of interest, hostility, and violence. The main part qf the paper describes the Conflict Tactics (CT) Scales. The CT Scales are designed to measure the use qf Reasoning, VerbalAggression, and Violence within the family. Information is presented on the following aspects of this instrument: theoretical rational, acceptability to respondents, scoring, factor structure, reliability, validity, and norms for a nationally representative sample of 2,143 couples.",0 +https://doi.org/10.1159/000120025,Incidence of Hospital-Treated Traumatic Brain Injury in the Oslo Population,"<i>Background:</i> The aim of this prospective, population-based study is to present the incidence of hospital-treated traumatic brain injury (TBI) in Oslo, Norway, and to describe the severity of brain injuries and outcome of the patients’ acute medical care. <i>Methods:</i> Data were obtained from hospital admission registers and medical records from May 2005 to May 2006. The initial severity of TBI was measured by the Glasgow Coma Scale. The region is urban with a population of 534,129. <i>Results:</i> The 445 patients identified represent an annual incidence of 83.3/100,000. The median age was 29 years. The male:female ratio was 1.8:1.0. The highest incidence of TBI hospitalizations was found in the elderly males and the youngest children. The most common causes of TBI were falls (51%) and transport accidents (29.7%). Intracranial lesions were found more often in the elderly. The case fatality rate was 2.0/100 hospitalized patients and was highest in the elderly. <i>Conclusions:</i> The incidence of hospital-treated TBI in this study is considerably lower than that found in previous studies from Norway and Scandinavia. Despite the apparent decline in TBI hospitalization rates, our findings should also draw attention to the need for more effective preventive programmes related to falls. Studies that assess long-term consequences of TBI in elderly patients are also needed.",0 +https://doi.org/10.1016/s0005-7967(98)00181-8,Cognitive factors involved in the onset and maintenance of posttraumatic stress disorder (PTSD) after physical or sexual assault,"Cognitive factors hypothesised to influence the development and maintenance of PTSD were investigated. 92 assault victims completed questionnaires assessing a range of cognitive variables. Factors relating to onset of PTSD were investigated by comparing victims who did and who did not suffer PTSD. Factors relating to maintenance of PTSD were investigated by comparing victims who had recovered from PTSD with victims who had persistent PTSD. Cognitive factors associated with both onset and maintenance of PTSD were: appraisal of aspects of the assault itself (mental defeat, mental confusion, appraisal of emotions); appraisal of the sequelae of the assault (appraisal of symptoms, perceived negative responses of others, permanent change); dysfunctional strategies (avoidance/safety seeking) and global beliefs impacted by assault. Cognitive factors that were associated only with the onset of PTSD were: detachment during assault; failure to perceive positive responses from others and mental undoing. Relationships between the cognitive variables and PTSD remained significant when variations in perceived and objective assault severity were statistically controlled. The cognitive factors identified in the study may contribute to PTSD directly, by generating a sense of ongoing threat, or indirectly, by motivating cognitive and behavioural strategies that prevent recovery, or by affecting the nature of the traumatic memory.",0 +https://doi.org/10.4172/1522-4821.1000261,Relationship between Persistent Post-traumatic Stress Disorder and Human Remains Exposure for Staten Island Barge and Landfill Recovery and Clean-up Workers After 9/11,"After the September 11, 2001 World Trade Center (WTC) disaster, recovery and clean-up efforts were concentrated at the WTC site and the Staten Island (SI) Fresh Kills landfill and barges. Research is limited regarding the long-term health effects of human remains exposure during clean-up and recovery work at the SI landfill and barges. We studied 1,592 WTC Health Registry enrollees who worked at the SI landfill, loading piers and barges after the 9/11/01 attacks to assess the relationship between remains exposure and persistent posttraumatic stress disorder (PTSD) 10-11 years later. A dose-response relationship was found between frequency of human remains exposure and persistent PTSD (adjusted odds ratio (AOR): every day (AOR) = 4.77; 95% confidence interval (CI): 2.00-11.52, almost every day (AOR) = 4.35; 95% CI: 1.75-10.80), and some days (AOR) = 2.98; 95% CI: 1.43-6.22). When exposed to human remains, sanitation workers had higher odds of persistent PTSD, compared to firefighters and police. In addition, respondents who scored lower on a social support scale had higher odds of persistent PTSD. The findings highlight the need for strategies to reduce the risk of PTSD associated with exposure to human remains in future disasters.",0 +https://doi.org/10.1093/oxfordjournals.rpd.a031874,Chernobyl Clean-up Workers' Perception of Radiation Threat,"The goals of this study were: (1) to compare the psychometric profiles of male Chernobyl liquidators who met DSM-III-R criteria for current PTSD with those who did not, and (2) to explore liquidators' perception and assessment of the 'invisible' stressor of the radioactive hazard. Results of t-test comparisons between the PTSD and non-PTSD groups for the various psychometric measures are shown. Both diagnostic groups were similar in regard to their mean ages and education levels. The PTSD group scored significantly higher than the non-PTSD group on all the measures of PTSD and general psychiatric symptomatology, state and trait anxiety, depression. On the whole, results of this study demonstrate the determining role of individual perception and assessment of radioactive hazard in the development of post-traumatic stress and place this problem among the most important in studying the psychological consequences of experiencing radioactive threat. The real working conditions and the level of information also affected workers' estimate of the severity of the radiation hazard in Chernobyl.",0 +https://doi.org/10.1002/pon.962,Differences in patterns of depression after treatment for breast cancer,"Depression is a significant problem for some breast cancer survivors after the end of treatment. This study assessed depression using the CES-D for 84 breast cancer patients at the conclusion of radiation treatment, and at 3 and 6 months post-treatment. Based on the pattern of CES-D scores, patients were divided into five groups: (1) Stay Depressed (scores above clinical cutoff for depression at all timepoints); (2) Recover (above threshold at baseline, but below at follow-up); (3) Become Depressed (below threshold at baseline, but above at follow-up); (4) Never Depressed (below threshold at all times); and (5) Vacillate (none of the above patterns). This study examined the relationships between depression groups and a variety of medical, demographic, and psychological measures, including anxiety and quality of life (QOL). Number of children at home significantly distinguished the groups, with the Become Depressed group having more children and the Vacillate group having fewer children. Anxiety levels were different among the groups, with Recover and Never Depressed groups having consistently lower anxiety scores. QOL scores also distinguished the groups in that Never Depressed patients demonstrated better QOL than all other groups. The findings have implications for understanding resilience in cancer patients.",0 +https://doi.org/10.1002/jts.20538,A cluster randomized controlled trial to determine the efficacy of Trauma Risk Management (TRiM) in a military population,"Trauma Risk Management is a peer-support program that aims to promote help-seeking in the aftermath of traumatic events. Prior to its implementation, the British military conducted a randomized controlled trial of Trauma Risk Management against standard care in 12 warships; 6 were randomized to use Trauma Risk Management after collecting baseline measurements. Follow up after 12–18 months found no significant change in psychological health or stigma scores in either group; however, the studied vessels only encountered low numbers of critical incidents. Additionally, measurements of organizational functioning were modestly better in the Trauma Risk Management ships. The authors conclude that within organizations using Trauma Risk Management may be beneficial and may, in time, lead to a valuable cultural shift.",0 +https://doi.org/10.15288/jsad.2010.71.629,Course of Alcohol Dependence Among Vietnam Combat Veterans and Nonveteran Controls*,"Identifying developmental trajectories of alcohol use is fundamental in building theories of alcoholism etiology and course. The purpose of this study was to replicate and generalize our previous finding that had been based on a twin sample drawn from the Vietnam Era Twin Registry. In this study, we made use of a nontwin sample of Vietnam veterans drawn from the Vietnam Era Study--a 25-year follow-up of the Vietnam Drug User Returns project that assessed the long-term medical and psychiatric consequences of substance abuse or dependence in Vietnam.Alcohol-related behaviors and psychiatric status were assessed in a sample of 839 individuals that comprised 323 veterans who tested positive for drugs (i.e., opiates, barbiturates, or amphetamines) on discharge from Vietnam, 319 veterans who tested negative for drugs at that time, and a nonveteran control sample (n = 197). Individuals with a lifetime diagnosis of alcohol dependence (n = 293) were selected for further analysis. Using detailed life history charts, in-person structured interviews were conducted, which entailed retrospective reports covering the 25 years since the 1972 survey. Measures of alcohol and drug use as well as psychiatric symptoms were obtained by assessing each year of the follow-up interval, beginning with 1972.Using latent growth mixture modeling, a four-class model was identified with trajectories that were parallel to those identified in our previous studies based on the Vietnam Era Twin Registry: severe chronic alcoholics, severe nonchronic alcoholics, late-onset alcoholics, and young-adult alcoholics.Present findings provide additional support for the replicability and generalizability of meaningful differences in the course of alcoholism from early adulthood to midlife.",0 +https://doi.org/10.1016/j.chiabu.2009.08.012,Identifying experiences of physical and psychological violence in childhood that jeopardize mental health in adulthood,"This study examined associations between profiles of physical and psychological violence in childhood from parents and two dimensions of mental health in adulthood (negative affect and psychological well-being). Profiles were distinguished by the types of violence retrospectively self-reported (only physical, only psychological, or both psychological and physical violence), as well as by the frequency at which each type of violence reportedly occurred (never, rarely, or frequently).Multivariate regression models were estimated using data from the National Survey of Midlife in the U.S. (MIDUS). An adapted version of the Conflict Tactics Scales (CTS) was used to collect respondents' reports of physical and psychological violence in childhood from each parent. Respondents also reported on current experiences of negative affect and psychological well-being.Regarding violence from mothers, reports of frequent psychological violence-even when coupled with never or rarely having experienced physical violence-were associated with more negative affect and less psychological well-being in adulthood. Nearly all profiles of violence in childhood from fathers-with the exception of reports of rare physical violence only-were associated with poorer adult mental health.Results provide evidence that frequent experiences of psychological violence from parents-even in the absence of physical violence and regardless of whether such violence is from mothers or fathers-can place individuals' long-term mental health at risk. Moreover, frequent physical violence from fathers-even in the absence of psychological violence-also serves as a risk factor for poorer adult mental health.Findings provide additional empirical support for the importance of prevention and intervention efforts directed toward children who experience physical and psychological violence from parents, as well as among adults who reportedly experienced in childhood only one type of violence and especially psychological violence at high levels of frequency.",0 +https://doi.org/10.1371/journal.pone.0124782,A Longitudinal Investigation of the Relationship between Posttraumatic Stress Symptoms and Posttraumatic Growth in a Cohort of Israeli Jews and Palestinians during Ongoing Violence,"OBJECTIVES: Meta-analytic evidence based on cross-sectional investigations between posttraumatic growth (PTG) and posttraumatic stress disorder (PTSD) demonstrates that the two concepts are positively related and that ethnic minorities report greater PTG. Few longitudinal studies have quantified this relationship so the evidence is limited regarding the potential benefit PTG may have on post-traumatic adjustment and whether differences between ethnic groups exist. METHODS: The current study attempts to fill a substantial gap in the literature by exploring the relationship between PTG and PTSD symptom clusters longitudinally using a nationally representative cohort of 1613 Israelis and Palestinian Citizens of Israel (PCI) interviewed via telephone on three measurement occasions during one year. Latent cross-lagged structural models estimated the relationship between PTG and each PTSD symptom cluster, derived from confirmatory factor analysis, representing latent and statistically invariant PTSD symptom factors, best representing PTSD for both ethnic groups. RESULTS: PTG was not associated with less PTSD symptom severity in any of the four PTSD clusters, for Jews and PCI. In contrast, PTSD symptom severity assessed earlier was related to later reported PTG in both groups. CONCLUSIONS: This study demonstrates that PTSD symptoms contribute to greater reported PTG, but that PTG does not provide a salutatory benefit by reducing symptoms of PTSD. Language: en",0 +https://doi.org/10.1016/j.jclinepi.2006.05.009,Millennium Cohort: enrollment begins a 21-year contribution to understanding the impact of military service,"

Abstract

Objective

In response to health concerns of military members about deployment and other service-related exposures, the Department of Defense (DoD) initiated the largest prospective study ever undertaken in the U.S. military.

Study Design and Setting

The Millennium Cohort uses a phased enrollment strategy to eventually include more than 100,000 U.S. service members who will be followed up through the year 2022, even after leaving military service. Subjects will be linked to DoD and Veterans Affairs databases and surveyed every 3 years to obtain objective and self-reported data on exposures and health outcomes.

Results

The first enrollment phase was completed in July 2003 and resulted in 77,047 consenting participants, well representative of both active-duty and Reserve/Guard forces. This report documents the baseline characteristics of these Cohort members, describes traditional, postal, and Web-based enrollment methods; and describes the unique challenges of enrolling, retaining, and following such a large Cohort.

Conclusion

The Millennium Cohort was successfully launched and is becoming especially relevant, given current deployment and exposure concerns. The Cohort is representative of the U.S. military and promises to provide new insight into the long-term effects of military occupations on health for years to come.",0 +https://doi.org/10.1080/16506073.2011.621971,Clarifying the Relationship Between AS Dimensions and PTSD Symptom Clusters: Are Negative and Positive Affectivity Theoretically Relevant Constructs?,"The association between anxiety sensitivity (AS) and posttraumatic stress disorder (PTSD) has been established in contemporary literature; however, research is divided over the nature of specific relationships between AS dimensions and PTSD symptoms clusters. Further, a paucity of research has examined the AS and PTSD relationship while accounting for theoretically relevant variables, such as negative (NA) and positive affect (PA). The purpose of the current study was twofold: first, to clarify divergent findings regarding the contribution of AS dimensions to PTSD symptom clusters, and, second, to further assess the relevance of NA and PA within the AS/PTSD relationship. Hierarchal regression analyses showed that, beyond shared variance attributable to NA and PA, AS somatic concerns were significantly associated with three of four PTSD symptom (i.e., reexperiencing, numbing, hyperarousal), AS cognitive concerns were only associated with hyperarousal, and AS socially observable symptoms were not significantly associated with any PTSD symptom clusters. These findings suggest that AS somatic concerns are the most robust predictor of variance within the AS/PTSD relationship and further clarify the theoretical importance of NA and PA within this relationship. Comprehensive results, implication, and directions for future research are discussed.",0 +https://doi.org/10.14310/horm.2002.1251,"Epigenetics, brain, behavior, and the environment","Early experiences can modify regulatory factors affecting gene expression in such a way that, although the DNA sequence itself is not changed, the individual's physiology and behavior is substantially influenced. In some instances these epigenetic effects are exerted upon exposure, while in other instances they are transmitted across generations via incorporation into the germline. Examples of both types of epigenetic effects are presented. First, experience with siblings (littermates) organizes behaviors and their underlying neural substrates in such a way that, as adults, rats and knockout mice behave differently. Second, exposure to the fungicide vinclozolin early in pregnancy imprints the male lineage in such a manner that rats exhibit distinct behavioral profiles as well as unique patterns of gene expression in relevant brain regions. Taken together, this work demonstrates that present and past environments alike modify both social and affiliative related behaviors and their related metabolic activity in specific brain nuclei as well as influencing the abundance of specific genes altering the epigenome in the target brain areas.",0 +https://doi.org/10.1097/aia.0b013e31828d5b2b,Sedation of Critically Ill Patients Undergoing Mechanical Ventilation,"Achieving and maintaining an optimal level of comfort and safety in the ICU plays an integral part in caring for critically ill patients. In general, the choice of sedative agent used in ICU patients should be driven by the specific indications and goals of sedation for each patient and the clinical pharmacology of the sedative agent in a particular patient, including its onset and offset of effect and its side-effect profile. Utilizing standard rating scales and unit-based guidelines facilitates the proper use of sedation and analgesia. The triad of factors that lead to agitation include pain, delirium, and anxiety. These factors should be addressed in a stepwise manner and treatment should be focused to a specific indication. Use of sedative hypnotics should be limited to those patients requiring a deeper level of sedation to provide maximal comfort and safety for the patient, or in those in whom agitation is not controlled even after addressing the factors of the triad. © 2013, Lippincott Williams & Wilkins.",0 +https://doi.org/10.3109/10253890.2011.578184,Behaviorally inhibited temperament is associated with severity of post-traumatic stress disorder symptoms and faster eyeblink conditioning in veterans,"Prior studies have sometimes demonstrated facilitated acquisition of classically conditioned responses and/or resistance to extinction in post-traumatic stress disorder (PTSD). However, it is unclear whether these behaviors are acquired as a result of PTSD or exposure to trauma, or reflect preexisting risk factors that confer vulnerability for PTSD. Here, we examined classical eyeblink conditioning and extinction in veterans self-assessed for current PTSD symptoms, exposure to combat, and the personality trait of behavioral inhibition (BI), a risk factor for PTSD. A total of 128 veterans were recruited (mean age 51.2 years; 13.3% female); 126 completed self-assessment, with 25.4% reporting a history of exposure to combat and 30.9% reporting current, severe PTSD symptoms (PTSS). The severity of PTSS was correlated with current BI (R(2) = 0.497) and PTSS status could be predicted based on current BI and combat history (80.2% correct classification). A subset of the veterans (n = 87) also completed the eyeblink conditioning study. Among veterans without PTSS, childhood BI was associated with faster acquisition; veterans with PTSS showed delayed extinction, under some conditions. These data demonstrate a relationship between current BI and PTSS, and indicate that the facilitated conditioning sometimes observed in patients with PTSD may partially reflect personality traits such as childhood BI that pre-date and contribute to vulnerability for PTSD.",0 +https://doi.org/10.1007/s10802-015-0078-8,"Traumatic Life Events and Psychopathology in a High Risk, Ethnically Diverse Sample of Young Children: A Person-Centered Approach","Studies of the association between traumatic experiences and psychopathology in early childhood have primarily focused on specific types of events (e.g., sexual abuse) or aggregated different types of events without differentiating among them. We extend this body of work by investigating patterns of traumatic event exposure in a high-risk, ethnically diverse sample of children ages 3-6 (N = 211; 51 % female) and relating these different patterns to parents' reports of child externalizing, internalizing, and post-traumatic stress symptomatology. Using latent class analysis, which divides a heterogeneous population into homogenous subpopulations, we identified three patterns of traumatic events based on parents' responses to an interview-based assessment of trauma exposure in young children: (1) severe exposure, characterized by a combination of family violence and victimization; (2) witnessing family violence without victimization; and (3) moderate exposure, characterized by an absence of family violence but a moderate probability of other events. The severe exposure class exhibited elevated internalizing and post-traumatic stress symptoms relative to the witness to violence and moderate exposure classes, controlling for average number of traumatic events. Results highlight the need for differentiation between profiles of traumatic life event exposure and the potential for person-centered methods to complement the cumulative risk perspective.",0 +https://doi.org/10.1017/s1355617709990488,The influence of pre-deployment neurocognitive functioning on post-deployment PTSD symptom outcomes among Iraq-deployed Army soldiers,"Abstract This study evaluated associations between pre-deployment neurocognitive performance and post-deployment posttraumatic stress disorder (PTSD) symptoms in a sample of deployed active duty Army soldiers. As part of a larger longitudinal study, each participant completed baseline measures of memory, executive attention, and response inhibition, and baseline and post-deployment self-report measures of PTSD symptom severity. Data were subjected to multiple regression analyses that examined associations between baseline neurocognitive performances and longitudinal PTSD symptom outcome. Results revealed that pre-trauma immediate recall of visual information was associated with post-deployment PTSD symptom severity, even after controlling for pre-deployment PTSD symptom levels, combat intensity, age, gender, and test-retest interval. There was also an interaction between pre-deployment PTSD symptom severity and pre-deployment immediate visual recall and verbal learning, indicating that neurocognitive performances were more strongly (and negatively) associated with residualized post-deployment PTSD symptoms at higher levels of pre-deployment PTSD symptoms. These findings highlight the potential role of pre-trauma neurocognitive functioning in moderating the effects of trauma exposure on PTSD symptoms.( JINS , 2009, 15 , 840–852.)",0 +https://doi.org/10.1097/ta.0b013e31824a4c75,The association between positive screen for future persistent posttraumatic stress symptoms and injury incident variables in the pediatric trauma care setting,"Posttraumatic stress (PTS) disorder after injury is a significant yet underaddressed issue in the trauma care setting. Parental anxiety may impact a child's risk of future, persistent PTS symptoms after injury. This study aimed to: (1) identify injury incident and demographic variables related to a positive screen for future, persistent PTS symptoms in children; and (2) examine the relationship between parental anxiety and a positive screen for future, persistent PTS symptoms in children.From November 2009 to August 2010, 124 patients were enrolled at a pediatric trauma center. Inclusion criteria were as follows: (1) age 7 years to 17 years; (2) hospitalized for at least 24 hours after physical trauma; and (3) English or Spanish speaking. State and trait anxiety were measured for both pediatric patients and their parents/guardians via the state trait anxiety inventory for children and state trait anxiety inventory, respectively. Risk for future, persistent PTS, among pediatric patients was assessed via the screening tool for early predictor of posttraumatic stress disorder (STEPP).Of 116 participants assessed via the STEPP, 32 (28%) screened positive for risk of future, persistent PTS symptoms. Motor vehicle collision and parental presence at injury were associated with a positive STEPP screen. The effect of parental presence on positive STEPP screen was modified by parental trait anxiety. Children of anxious parents present at injury were over 14 times as likely to screen positive for risk of future, persistent PTS, as those without a parent present.The risk of future, persistent PTS, after injury among the pediatric population is substantial. Parents with existing trait anxiety are shown to influence their child's risk for future, persistent PTS, particularly if present at the injury event. Further study of PTS prevention and control strategies are needed among this population within the trauma care setting.Epidemiological study, level II.",0 +https://doi.org/10.1002/jts.20196,Confirmatory factor analysis of posttraumatic stress symptoms in cambodian refugees,"This study used confirmatory factor analysis to examine the factor structure of the Cambodian version of the Harvard Trauma Questionnaire in 488 Cambodian refugees residing in the United States. Five alternative conceptual models were compared. A model with four correlated factors reflecting symptoms of re-experiencing, avoidance, emotional numbing, and hyperarousal provided the best fit to these data. The avoidance and emotional numbing clusters demonstrated distinct associations with depression symptoms, providing some evidence of the construct validity of the four-factor solution.",0 +https://doi.org/10.1176/appi.psychotherapy.1989.43.2.208,The Dynamics of Posttraumatic Stress Disorder in South African Political Ex-Detainees,This paper explores the dynamic factors involved in the generation of the classical posttraumatic stress disorder (PTSD) in a population of Black South African political ex-detainees. A model is proposed of the evolution of inner psychic events in response to the detention-related trauma which result in the typical symptom cluster.,0 +,[PTSD as result of the 1997 flood--occurrence and display of distemper].,"The occurrence and course of PTSD in the countryside environment as the result of flood in 1997 has been described. The research was experimented around four villages by Nysa Kłodzka river-basin; the area was affected by disaster unexpectedly and extremely hard.97 people have been tested as the straightforward witnesses of flood. They had never been treated by a psychiatrist before 1997 and they haven't experienced any other stressful event that might have been an independent reason of the occurrence PTSD. The extent of trauma, risk of shock and the length of time that those examined were in danger was identical. None of the studied had received psychological or psychiatric support after the disaster. The research was carried out by one investigator (psychiatrist) 60-63 months after the flood at the victims' houses (the psychiatrist's visit was preceded by the phone appointment). The research instrument--Composite International Diagnostic Interview CIDI: section A (referred to demographic dates) and section N (referred to PTSD).PTSD diagnosis was made in 30.9% of the examined group. The distempered people are mostly educated at the lowest level (49.9% with the ground education) or unemployed (39.2%). Older people were more susceptible to PTSD. PTSD diagnosis was made more often for men (39.5%) than for women (25.4), what is directly related to the lower education and a worse material status of the examined men. Full symptomatic PTSD, remaining up to 60-63 months after the flood, was confirmed in 15.5% of the studied group.The frequency and profile of PTSD occurrence (lower educated, older and the poor people) in the examined group is consistent with the other studies done. The fact that PTSD diagnosis was more frequent amongst men (39.5% vs. 25.4% in women) has been mentioned and explained above. No person in the group has confirmed the short (lasting only up to one month) term of persistence of the symptoms what is tantamount to no acute stress disorder right after the flood. It might be probably caused by the permanence of flood destruction and the prolonged exposure to the stress factor.",0 +https://doi.org/10.3168/jds.s0022-0302(07)72635-8,Fertility of Lactating Dairy Cows Administered Recombinant Bovine Somatotropin During Heat Stress,"Administration of recombinant bovine somatotropin (bST) to lactating dairy cows during heat stress increases milk yield, but it also can increase body temperature and may therefore compromise fertility. However, it is possible that bST treatment could increase fertility during heat stress because it has been reported to increase fertility in lactating cows. In addition, bST increases secretion of insulin-like growth factor-I (IGF-I) that promotes embryo survival. The purpose of this study was to determine effects of bST on reproductive function in lactating dairy cows during heat stress. The experiment was conducted in southern Georgia from July to November 2005 using lactating Holstein cows (n = 276 for reproductive traits). For first service timed artificial insemination (TAI), cows were presynchronized with 2 injections of PGF(2alpha) given 14 d apart followed by a modified Ovsynch protocol (GnRH and insemination at 72 h following PGF(2alpha) ). Pregnancy was diagnosed by using ultrasonography on d 29 and reconfirmed by palpation between d 45 and 80 post-TAI. Nonpregnant cows were resynchronized with the modified Ovsynch protocol and received a second TAI. Treatment with bST started 1 wk before the start of Ovsynch and continued at 2-wk intervals. Blood samples were collected from a subset of cows to determine IGF-I profiles immediately before the first bST injection, 1 wk later, and at d 35 of bST treatment. Rectal temperatures were assessed on d 29 of bST treatment. Pregnancy rates (d 45 to 80 post-TAI) did not differ between bST and control cows for first- (16.7 vs. 15.2%) or second-service TAI (14.8 vs. 17.2%). Plasma concentrations of IGF-I and milk yield were greater for bST-treated cows following the initiation of bST treatment and bST increased rectal and vaginal temperatures. Body condition score was less for bST-treated cows. In conclusion, treatment with bST during heat stress increased IGF-I concentrations, milk yield over time, and rectal and vaginal temperatures without affecting first- or second-service pregnancy rates. Thus, at least under certain housing conditions, bST can be used to improve milk yield during heat stress without compromising fertility.",0 +https://doi.org/10.1080/0886571x.2015.1046731,Multiple Traumatic Experiences and the Expression of Traumatic Stress Symptoms for Children and Adolescents,"In order to understand the differential presentation of trauma stress symptoms over the course of development from children to adolescents, a sample of more than 11,000 children and adolescents were studied who were identified as to whether they had experienced multiple trauma experiences prior to placement in child welfare custody. Six age groups were compared on their presentation of symptoms associated with traumatic experiences. Trauma stress symptoms were dramatically different for children and adolescents despite the similarity of trauma experiences. Implications for understanding and addressing multiple trauma experiences across a developmental trajectory are discussed.",0 +https://doi.org/10.1007/s00520-015-2960-x,Acute stress trajectories 1 year after a breast cancer diagnosis,"Purpose: The purpose of this study was to evaluate the longitudinal trajectories of acute stress reactions over the course of diagnosis, treatment, and follow-up assessments in a group of non-metastatic breast cancer patients during five different moments of the illness process, and to identify psychological predictors of the trajectories. Methods: The sample was formed by 102 non-metastatic breast cancer patients treated with adjuvant chemotherapy. Latent growth mixture models (LGMM) were used to identify latent classes, and we used multinomial logistic regression in a conditional model to examine predictors to differentiate between trajectories. Results: We identified four different groups according to their trajectories: (1) a resilient group, (44.5 %); (2) a mild acute stress group, (40.6 %); (3) a delayed–recovery group (11.9 %); and (4) a chronic acute stress group (2.9 %). Moreover, anxious preoccupation showed the strongest significant effects in predicting each class, whereas cognitive avoidance and type C personality had moderate effects for participants in the mild acute stress group. Conclusions: This study demonstrates that the majority of breast cancer patients in our study were resilient, with only a small percentage showing chronic acute stress. Because coping strategies, specifically anxious preoccupation, and not more stable variables played a main role in the prediction of acute stress trajectories, future preventive interventions should center in promoting more adaptive coping strategies in breast cancer patients. © 2015, Springer-Verlag Berlin Heidelberg.",1 +https://doi.org/10.1016/j.jrp.2010.03.004,The effects of insecure attachment orientations and perceived social support on posttraumatic stress and depressive symptoms among civilians exposed to the 2009 Israel–Gaza war: A follow-up Cross-Lagged panel design study,"A follow-up Cross-Lagged-design was used to test the effects of attachment orientations and perceived social support on posttraumatic stress disorder (PTSD) and major depressive disorder symptoms (MDD) in a sample of 135 Israeli students who were evacuated from a university campus located near the Israel–Gaza border in response to increased missile-fire in the area. An internet-based data collection procedure enabled the simultaneous survey of evacuees located up to 40 km from the border at war, both during the fighting and 4 months after the ceasefire. Proximity to the border did not affect levels of PTSD or MDD symptoms, attachment orientation, or levels of perceived social support. Analyses involving Cross-Lagged Panel Correlation (CLPC) path models revealed that Attachment–Anxiety had significant positive effects on PTSD, MDD, and perceived social support. Neither PTSD nor MDD nor perceived social support had any reciprocal follow-up effect on Attachment–Anxiety. These findings underscore the central role of individual trait personality differences in predicting changes in both mental health problems and interpersonal relations over time, following exposure to trauma.",0 +https://doi.org/10.1007/s00420-013-0861-1,Personality traits of the Five-Factor Model are associated with work-related stress in special force police officers,"Purpose: The police work is particularly stressful. The aim of this work was to clarify whether the personality factors are associated with perceived stress levels or reactivity to environmental stressors in a special body of police. Methods: The police officers in charge of guaranteeing public order at the L'Aquila G8 meeting were subjected to a control of their levels of work-related stress in anticipation of the event. Personality was assessed by the Italian version of the Five-Factor Model questionnaire, while stress was measured three times (during routine work in January 2009, preparation and imminence of the event, in April and July 2009, respectively) with the demand/control/support model of Karasek and the effort/reward imbalance model of Siegrist. A total of 289 of 294 officers took part in the survey. Results: Some personality traits of the Five-Factor Model were associated with stress levels and stress reactivity. Neuroticism (low emotional stability) showed the strongest associations with job strain (demand/control ratio) (β = 0.115, p < 0.05) and effort/reward imbalance (β = 0.270, p < 0.001) and was associated with most of the stress variables. High agreeableness was associated with low effort/reward imbalance (β = -0.157, p < 0.01). Conclusions: Personality factors may mitigate or increase the strain induced by environmental stressors. © 2013 Springer-Verlag Berlin Heidelberg.",0 +https://doi.org/10.1117/12.273793,"Temperature, stress, disorder, and crystallization effects in laser diodes: measurements and impacts","This paper reviews extensive Raman scattering, reflectance modulation and luminescence microprobe measurements made on GaInP/AlGaInP, GaAs/AlGaAs and InGaAs/AlGaAs ridge quantum well lasers to investigate (i) laser operating temperatures, (ii) built-in mechanical stress, (iii) atomic disorder in mirror facets, (iv) Si recrystallization effects in mirror coatings, and (v) correlations of these parameters with laser performance and reliability data. Mirror temperatures have been found to depend sensitively on mirror treatment, mirror structure design, the geometry of a deposited heat spreader, the type of coupling of the laser to a heat sink, the number of active quantum wells, the type of cladding layer, and the strength of lattice disorder at the mirror surfaces. Axial temperatures drop from the hot mirror side along the cavity to low constant values within typically 10 μm. Degradation processes have been observed in real time by continuously monitoring the mirror temperature. Dark line defects formed during laser operation exhibit a temperature gradually increasing with time. The mirrors suffer catastrophic optical damage within seconds after having reached a critical temperature. Temperature maps show a striking localized hot spot within the optical near-field pattern. Strong structural and compositional lattice disorder have been identified as potential root causes of strong mirror heating. Disorder strongly suppresses the catastrophic optical mirror damage power limit. Ridge waveguide lasers show a characteristic camel hump-like stress profile, i.e. high compressive strain levels of up to 5 kbar near the ridge slopes and reduced compressive stress or even low tensile stress fields towards the ridge center. The measured stress fields affect the formation of defects and the optical near-field pattern. Ion-beam deposited amorphous Si layers in mirror coating stacks rapidly recrystallize under high power exposure. This reduces the reflectivity of the coating and increases the transmitted power. Model experiments demonstrate that the recrystallization can modify the effective kink-free optical output power.",0 +https://doi.org/10.1177/0886260508317174,Resource Loss and Naturalistic Reduction of PTSD Among Inner-City Women,"Halting the process of psychosocial and material resource loss has been theorized as being associated with the reduction of posttraumatic stress disorder (PTSD). This study examines how the limiting of resource loss is related to alleviation of PTSD symptoms among 102 inner-city women, who originally met diagnostic criteria for PTSD after experiencing interpersonal traumatic events such as child abuse, rape, and sexual assault. Participants whose PTSD symptoms improve and become nondiagnostic for PTSD are compared with those who remain diagnostic. The two groups are not significantly different at pretest. However, at the 6-month time point, those who become nondiagnostic for PTSD report less resources loss in three of four domains. This pattern suggests that as PTSD symptoms decrease, women's material and psychosocial resource loss diminishes, which in turn, may aid their recovery process.",0 +https://doi.org/10.1016/j.cpr.2014.03.002,Remission from post-traumatic stress disorder in adults: A systematic review and meta-analysis of long term outcome studies,"Posttraumatic stress disorder (PTSD) is a frequent mental disorder associated with significant distress and high costs. We conducted the first systematic review and meta-analysis on spontaneous long-term remission rates, i. e., without specific treatment. Data sources were searches of databases, hand searches, and contact with authors. Remission estimates were obtained from observational prospective studies of PTSD without specific treatment. Remission was defined as the actual percentage of PTSD cases at baseline who are non-cases after a minimum of ten months. Forty-two studies with a total of 81,642 participants were included. The mean observation period was 40 months. Across all studies, an average of 44.0% of individuals with PTSD at baseline were non-cases at follow-up. Remission varied between 8 and 89%. In studies with the baseline within the first five months following trauma the remission rate was 51.7% as compared to 36.9% in studies with the baseline later than five months following trauma. Publications on PTSD related to natural disaster reported the highest mean of remission rate (60.0%), whereas those on PTSD related to physical disease reported the lowest mean of remission rate from PTSD (31.4%). When publications on natural disaster were used as a reference group, the only type of traumatic events to differ from natural disaster was physical disease. No other measured predictors were associated with remission from PTSD. Long-term remission from PTSD without specific treatment varies widely and is higher in studies with the baseline within five months following trauma.",0 +https://doi.org/10.1196/annals.1314.008,"Trauma, Genes, and the Neurobiology of Personality Disorders","A model for personality dysfunction posits an interaction between inherited susceptibility and environmental factors such as childhood trauma. Core biological vulnerabilities in personality include dimensions of affective instability, impulsive aggression, and cognition/perceptual domains. For the dimension of impulsive aggression, often seen in borderline personality disorder (BPD), the underlying neurobiology involves deficits in central serotonin function and alterations in specific brain regions in the cingulate and the medial and orbital prefrontal cortex. The role of trauma in the development of personality disorder and especially for BPD remains unclear. Although recent studies suggest that BPD is not a trauma-spectrum disorder and that it is biologically distinct from posttraumatic stress disorder, high rates of childhood abuse and neglect do exist for individuals with personality dysfunction. Personality symptom clusters seem to be unrelated to specific abuses, but they may relate to more enduring aspects of interpersonal and family environments in childhood. Whereas twin and family studies indicate a partially heritable basis for impulsive aggression, studies of serotonin-related genes to date suggest only modest contributions to behavior. Gene-environment interactions involving childhood maltreatment are demonstrated in recent studies on antisocial behaviors and aggressive rhesus monkeys and highlight the need for further research in this important area.",0 +https://doi.org/10.1515/ijamh-2013-0069,Buprenorphine in the treatment of non-suicidal self-injury: a case series and discussion of the literature,"Abstract A global public health problem, non-suicidal self-injury (NSSI) is highly prevalent in both males and females, and tends to first occur in adolescence. NSSI is correlated with a history of childhood trauma, and with a variety of developmental and psychiatric disorders. NSSI is associated with increased risk of morbidity and premature death from suicide, accidents, and natural causes. Current treatment approaches are inadequate for a substantial number of people. Converging evidence for opioid system dysregulation in individuals with NSSI make this a promising area of investigation for more effective treatments. The pharmacological profile of buprenorphine, a potent μ-opioid partial agonist and κ-opioid antagonist, suggests that it may be beneficial. In this paper, we describe the successful treatment of severe NSSI with buprenorphine in six individuals, followed by discussion and further recommendations.",0 +https://doi.org/10.1177/0004867414563187,Mental illness and housing outcomes among a sample of homeless men in an Australian urban centre,"Objective: The over-representation of mental illness among homeless people across the globe is well documented. However, there is a dearth of Australian literature on the mental health needs of homeless individuals. Furthermore, longitudinal research examining the factors that contribute to better housing outcomes among this population is sparse. The aim of this research is to describe the mental illness profile of a sample of homeless men in an Australian urban centre (in Sydney) and examine the factors associated with better housing outcomes at 12-month follow-up. Methods: A longitudinal survey was administered to 253 homeless men who were involved in the Michael Project: a 3-year initiative which combined existing accommodation support services with assertive case management and access to coordinated additional specialist allied health and support services. A total of 107 participants were followed up 12 months later. The survey examined the demographics of the sample and lifetime mental disorder diagnoses, and also included psychological screeners for current substance use and dependence, psychological distress, psychosis, and post-traumatic stress. Results: Consistent with existing literature, the prevalence of mental illness was significantly greater amongst this sample than the general Australian population. However, mental illness presentation was not associated with housing situation at 12-month follow-up. Instead, type of support service at baseline was the best predictor of housing outcome, wherein participants who received short to medium-term accommodation and support were significantly more likely to be housed in stable, long-term housing at the 12-month follow-up than participants who received outreach or emergency accommodation support. Conclusions: This study provides evidence to support an innovative support model for homeless people in Australia and contributes to the limited Australian research on mental illness in this population.",0 +https://doi.org/10.1016/j.biopsych.2013.11.029,Re-establishment of Anxiety in Stress-Sensitized Mice Is Caused by Monocyte Trafficking from the Spleen to the Brain,"Persistent anxiety-like symptoms may have an inflammatory-related pathophysiology. Our previous work using repeated social defeat (RSD) in mice showed that recruitment of peripheral myeloid cells to the brain is required for the development of anxiety. Here, we aimed to determine if 1) RSD promotes prolonged anxiety through redistribution of myeloid cells and 2) prior exposure to RSD sensitizes the neuroimmune axis to secondary subthreshold stress.Mice were subjected to RSD and several immune and behavioral parameters were determined .5, 8, or 24 days later. In follow-up studies, control and RSD mice were subjected to subthreshold stress at 24 days.Repeated social defeat-induced macrophage recruitment to the brain corresponded with development and maintenance of anxiety-like behavior 8 days after RSD, but neither remained at 24 days. Nonetheless, social avoidance and an elevated neuroinflammatory profile were maintained at 24 days. Subthreshold social defeat in RSD-sensitized mice increased peripheral macrophage trafficking to the brain that promoted re-establishment of anxiety. Moreover, subthreshold social defeat increased social avoidance in RSD-sensitized mice compared with naïve mice. Stress-induced monocyte trafficking was linked to redistribution of myeloid progenitor cells in the spleen. Splenectomy before subthreshold stress attenuated macrophage recruitment to the brain and prevented anxiety-like behavior in RSD-sensitized mice.These data indicate that monocyte trafficking from the spleen to the brain contributes re-establishment of anxiety in stress-sensitized mice. These findings show that neuroinflammatory mechanisms promote mood disturbances following stress-sensitization and outline novel neuroimmune interactions that underlie recurring anxiety disorders such as posttraumatic stress disorder.",0 +https://doi.org/10.1176/appi.ajp.162.3.538,Is Posttraumatic Stress in Youth a Culture-Bound Phenomenon? A Comparison of Symptom Trends in Selected U.S. and Russian Communities,"The cross-cultural applicability of the concept of posttraumatic stress was investigated by assessing symptom frequency and levels of comorbid psychopathology in adolescents from the United States and Russia.A self-report survey was conducted in representative samples of 2,157 adolescents 14 to 17 years old from urban communities of the United States (N=1,212) and Russia (N=945).In both countries, the levels of all three major clusters of posttraumatic symptoms (reexperiencing, avoidance, and arousal), as well as of internalizing psychopathology, increased along with the level of posttraumatic stress. Expectations about the future had a tendency to decrease with increasing posttraumatic stress. No differences between countries in significant interaction effects for symptom levels were found.The current findings suggest that posttraumatic symptoms and their associations with other adolescent mental health problems are not culture bound and that the psychological consequences of trauma follow similar dynamics cross-culturally.",0 +https://doi.org/10.1097/00131746-200505000-00010,Patients with Generalized Anxiety Disorder and a History of Trauma: Somatic Symptom Endorsement,"The authors investigated the types and rates of trauma exposure and differences in symptom endorsement in a clinical sample of patients diagnosed with generalized anxiety disorder (GAD). Fifty-eight patients with GAD were assessed using the Structured Clinical Interview (SCID) and Trauma Assessment for Adults. In order to explore the relationship between specific traumatic event(s) and clinical presentation, the presence of somatic symptoms associated with GAD, including muscle tension, autonomic hyperactivity, and vigilance/scanning clusters (using DSM-III-R criteria), were examined. Patients with a history of sexual assault before 18 years (25.9%) endorsed fewer somatic symptoms, specifically fewer motor tension and autonomic GAD symptoms, than patients with other types of trauma. These findings indicate that early exposure to serious trauma, specifically childhood sexual assault, may lead to a different clinical presentation in GAD patients.",0 +https://doi.org/10.1111/jonm.12160,"Compassion satisfaction, compassion fatigue, anxiety, depression and stress in registered nurses in Australia: study 1 results","Aim To explore compassion fatigue and compassion satisfaction with the potential contributing factors of anxiety, depression and stress. Background To date, no studies have connected the quality of work-life with other contributing and co-existing factors such as depression, anxiety and stress. Method A self-report exploratory cross sectional survey of 132 nurses working in a tertiary hospital. Result The reflective assessment risk profile model provides an excellent framework for examining the relationships between the professional quality of work factors and contributing factors within the established risk profiles. The results show a definite pattern of risk progression for the six factors examined for each risk profile. Additionally, burnout and secondary traumatic stress were significantly related to higher anxiety and depression levels. Higher anxiety levels were correlated with nurses who were younger, worked full-time and without a postgraduate qualification. Twenty percent had elevated levels of compassion fatigue: 7.6% having a very distressed profile. At-risk nurses' stress and depression scores were significantly higher than nurses with higher compassion satisfaction scores. Implications for nursing managers The employed nurse workforce would benefit from a psychosocial capacity building intervention that reduces a nurse's risk profile, thus enhancing retention.",0 +https://doi.org/10.1002/gps.1369,"Prevalence, risk factors and aging vulnerability for psychopathology following a natural disaster in a developing country","Objectives This study explored the psychopathological reactions to a natural disaster and their respective risk factors among the elderly in Honduras and their vulnerability as compared to other adults. Study subjects and sample Eight hundred respondents of both genders aged 15 years and above, of which 103 were 60 and over, were selected from high, middle and low residential status areas in Tegucigalpa that had suffered high and low exposure to the devastating effects of Hurricane Mitch. Research instruments CIDI was used to diagnose PTSD and the Impact of Events Scale was administered as a measure of severity of post-traumatic reaction. Depression and alcohol misuse were examined using screening instruments. The SRQ was used as both a measure of emotional distress and dichotomized to screen for probable psychiatric disorder. Results PTSD, depression and SRQ-case were found, respectively in 13.6%, 18.8%, and 21.4% of the elderly. Their reactions did not differ in frequency than of those of younger adults. Among the elderly, pre-hurricane psychological problems and the intensity of exposure were associated with increased risk for all outcomes measured except for alcohol misuse. Conclusion No evidence was found for a differential vulnerability on the part of the elderly as compared with younger adults. Among the elderly increasing age was not a factor. Copyright © 2005 John Wiley & Sons, Ltd.",0 +https://doi.org/10.7205/milmed.170.9.787,Lifetime Sexual and Physical Victimization among Male Veterans with Combat-Related Post-traumatic Stress Disorder,"Because of the high prevalence of post-traumatic stress disorder (PTSD) among veteran men and the limited research on victimization in this group, we recruited 133 male veterans with combat-related PTSD from a psychiatric inpatient unit and assessed them for lifetime physical and sexual trauma. Results indicated that 96% of the sample had experienced some form of victimization over their lifetimes; 60% reported childhood physical abuse, 41% childhood sexual abuse, 93% adulthood physical assault, and 20% adulthood sexual assault. In the preceding year alone, 46% experienced either physical or sexual assault. These findings support the need for routine inquiry into the histories of noncombat victimization in this cohort. Determining the lifetime history of trauma exposure may have implications for vulnerability to subsequent development of PTSD and the risk of future violence.",0 +https://doi.org/10.2466/pr0.1993.72.2.667,Personality Subgroups in an Inpatient Vietnam Veteran Treatment Program,"Millon Clinical Multiaxial Inventory personality profiles of 250 male inpatient Vietnam veterans were examined to locate subgroups within that population. Using a hierarchical cluster analysis to form relatively homogeneous groups, four clusters were identified which accounted for 98% of the population. Three clusters had Millon profiles suggestive of a stress reaction and one cluster had a profile indicative of an antisocial adjustment. As measured by a PTSD subscale of the Minnesota Multiphasic Personality Inventory two clusters are high stress groups and two clusters are lower stress groups. The two Millon personality profiles in the high stress category were an 8-2-1/6 group and a 2-8-1-3 group. The lower stress groups had profiles of /8-2 and 6/8-5. The high stress groups are considered Posttraumatic Stress Disorder groups and the lower stress groups are considered nonPosttraumatic Stress Disorder groups.",0 +https://doi.org/10.1037/0021-843x.113.4.636,Externalizing and Internalizing Subtypes of Combat-Related PTSD: A Replication and Extension Using the PSY-5 Scales.,"This study replicated and extended prior findings of internalizing and externalizing subtypes of posttraumatic response (M. W. Miller, J. L. Greif, & A. A. Smith, 2003). Cluster analyses of the Minnesota Multiphasic Personality Inventory--2 Personality Psychopathology--Five (MMPI-2 PSY-5; A. R. Harkness, J. L. McNulty, Y. S. Ben-Porath, 1995) profiles obtained from 736 veterans with posttraumatic stress disorder (PTSD) partitioned the sample into a low pathology cluster defined by personality scores in the normal range, an externalizing cluster characterized by low constraint and high negative emotionality, and an internalizing cluster with high negative emotionality and low positive emotionality. Externalizers showed the highest rates of alcohol-related and antisocial personality disorders; internalizers, the highest rates of panic and major depressive disorder. These findings support the development of a personality-based typology of posttraumatic response designed to account for heterogeneity in the expression of PTSD and associated psychopathology.",0 +https://doi.org/10.3109/09638237.2013.819422,PTSD in the armed forces: What have we learned from the recent cohort studies of Iraq/Afghanistan?,"Post-traumatic stress disorder (PTSD) was formally recognised as a psychiatric disorder in 1980, largely in response to America's attempts to make sense of the costs of the Vietnam war [Wessely, S., & Jones, E. (2004). Psychiatry and the 'lessons of Vietnam': What were they, and are they still relevant? War & Society, 22(1), 89-103.]. Interestingly, all of this occurred without much contribution from epidemiology, which came later (Wessely & Jones, 2004). This cannot be said of the current conflicts, where from the outset there has been a focus of attention on the epidemiology of PTSD in those who served in either Iraq or Afghanistan, even whilst the conflicts were ongoing. In this editorial, we focus on this recent epidemiological contribution to the understanding of PTSD in military personnel.",0 +https://doi.org/10.1002/jts.20267,Erratum for “Posttraumatic stress after a motor vehicle accident: A six-month follow-up study utilizing latent growth modeling”,"Reports an error in ""Posttraumatic stress after a motor vehicle accident: A six-month follow-up study utilizing latent growth modeling"" by Kitty K. Wu and Mike W. L. Cheung (Journal of Traumatic Stress, 2006[Dec], Vol 19[6], 923-936). Mike W. L. Chueng's affiliation was incorrectly listed in the print version. The correct affiliation is: Department of Psychology, National University of Singapore, Singapore. (The following abstract of the original article appeared in record 2007-00025-016.) Features of posttraumatic stress disorder (PTSD) for 596 survivors of motor vehicle accidents were examined by self-report measures at 1 week, 1 month, 3 months, and 6 months after the motor vehicle accident (MVA). Latent growth modeling was utilized to study the trend and predictors of the level of distress. Results indicated that 5-20% of the participants reported to have a significant level of posttraumatic stress in one, two, or three of the PTSD symptom clusters within the period studied. Survivors with significant acute stress 1 week after the MVA had a higher risk for developing chronic posttraumatic stress. Although the severity of intrusive and hyperarousal symptoms decreased over time, the severity of avoidance symptoms remained unchanged. Factors predicting the course of PTSD after an MVA are identified. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1016/j.neuro.2012.03.011,"Organophosphate-induced brain damage: Mechanisms, neuropsychiatric and neurological consequences, and potential therapeutic strategies","Organophosphate (OP)-induced brain damage is defined as progressive damage to the brain, resulting from the cholinergic neuronal excitotoxicity and dysfunction induced by OP-induced irreversible AChE inhibition. This delayed secondary neuronal damage that occurs mainly in the cholinergic regions of the brain that contain dense accumulations of cholinergic neurons and the majority of cholinergic projection, might be largely responsible for persistent profound neuropsychiatric and neurological impairments (memory, cognitive, mental, emotional, motor and sensory deficits) in the victims of OP poisoning. Neuroprotective strategies for attenuating OP-induced brain damage should target different development stages of OP-induced brain damage, and may include but not limited to: (1) Antidote therapies with atropine and related efficient anticholinergic drugs; (2) Anti-excitotoxic therapies targeting attenuation of cerebral edema and inflammatory reaction, blockage of calcium influx, inhibition of apoptosis program, and the control of seizures; (3) Neuroprotective strategies using cytokines, antioxidants and NMDAR antagonists (a single drug or a combination of drugs) to slow down the process of secondary neuronal damage; and (4) Therapies targeting individual symptoms or clusters of chronic neuropsychiatric and neurological symptoms. These neuroprotective strategies may help limit or prevent secondary neuronal damage at the early stage of OP poisoning and attenuate the subsequent neuropsychiatric and neurological impairments, thus reducing the long-term disability caused by exposure to OPs.",0 +https://doi.org/10.1016/s0022-3999(03)00614-7,Validity of the Type D personality construct in Danish post-MI patients and healthy controls,"Type D personality has been associated with increased risk of depression, vital exhaustion, social alienation, a higher number of reinfarctions, and higher mortality rates in patients with established coronary artery disease (CAD) independent of traditional biomedical risk factors. The construct was developed in Belgian cardiac patients, but little is known about its applicability in other nationalities. The objectives of the present article were to cross-validate the Type D Personality Scale-16 (DS16) in a Danish sample of patients with a first myocardial infarction and a random sample of healthy controls, and to investigate whether Type D is associated with posttraumatic stress disorder (PTSD). A questionnaire was given to 112 consecutive patients with a first myocardial infarction 4 to 6 weeks post infarction, and to 115 healthy controls selected randomly from the general population. The two-factor structure of the DS16 and the internal consistency of the Negative Affectivity ( α =.83) and Social Inhibition ( α =.76) subscales were confirmed. The construct validity of the DS16 was confirmed against scales that measure similar constructs, and the discriminant validity of the DS16 against measures of psychopathology . In a pooled sample of patients and healthy controls, comparison of both groups confirmed that Type D may be conceptualised as a marker of general emotional distress , with Type D persons scoring higher on depression, anxiety, and the PTSD symptom clusters arousal and avoidance compared with non-Type D persons. A regression analysis run in two steps showed that the inclusion of Type D in the model lead to an improvement in the level of prediction of PTSD above and beyond a model that included gender, age, MI, neuroticism , and extroversion. Type D (OR=4.46; 95% CI: 1.36 to 14.64), diagnosis of MI (OR=4.03; 95% CI: 1.43 to 11.35), and neuroticism (OR=1.32; 95% CI: 1.13 to 1.53) were independently associated with PTSD, adjusting for all other variables. These findings indicate that the Type D construct is equally applicable in Danish patients with CAD, and that Type D is associated with PTSD.",0 +https://doi.org/10.1097/00005053-200204000-00001,A TWIN REGISTRY STUDY OF FAMILIAL AND INDIVIDUAL RISK FACTORS FOR TRAUMA EXPOSURE AND POSTTRAUMATIC STRESS DISORDER,"This study examines the association of individual and familial risk factors with exposure to trauma and posttraumatic stress disorder (PTSD) in male twins (N = 6744) from the Vietnam Era Twin Registry. Independent reports of familial psychopathology from co-twins were used to avoid the potential biases of the family history method. Risk for exposure to traumatic events was increased by service in Southeast Asia, preexisting conduct disorder, preexisting substance dependence, and a family history of mood disorders whose effects appear to be partly genetic. Preexisting mood disorders in the individual were associated with decreased odds of traumatic exposure. Risk of developing PTSD following exposure was increased by an earlier age at first trauma, exposure to multiple traumas, paternal depression, less than high school education at entry into the military, service in Southeast Asia, and preexisting conduct disorder, panic disorder or generalized anxiety disorder, and major depression. Results suggest the association of familial psychopathology and PTSD may be mediated by increased risk of traumatic exposure and by preexisting psychopathology.",0 +https://doi.org/10.1200/jco.2006.06.8775,Psychosocial Concerns and Interventions for Cancer Survivors,"In light of the increasing population living with a history of cancer in the United States, it is important to attend to quality of life and health in this group, and to develop effective interventions to address psychosocial and physical concerns across the course of the cancer trajectory. The goals of this article are to document the need for attention to psychosocial domains; offer a brief overview of the current status of the empirical literature on effects of psychosocial interventions with cancer survivors, relying on systematic reviews and meta-analyses conducted in the last decade; highlight recent examples of randomized, controlled psychosocial intervention trials directed toward cancer survivors after the completion of primary medical treatments (ie, the re-entry phase and beyond); and identify directions for application and research.",0 +https://doi.org/10.2105/ajph.2008.151605,"A Computerized, Self-Administered Questionnaire to Evaluate Posttraumatic Stress Among Firefighters After the World Trade Center Collapse","We sought to determine the frequency of psychological symptoms and elevated posttraumatic stress disorder (PTSD) risk among New York City firefighters after the World Trade Center (WTC) attack and whether these measures were associated with Counseling Services Unit (CSU) use or mental health-related medical leave over the first 2.5 years after the attack.Shortly after the WTC attack, a computerized, binary-response screening questionnaire was administered. Exposure assessment included WTC arrival time and ""loss of a co-worker while working at the collapse."" We determined elevated PTSD risk using thresholds derived from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, and a sensitivity-specificity analysis.Of 8487 participants, 76% reported at least 1 symptom, 1016 (12%) met criteria for elevated PTSD risk, and 2389 (28%) self-referred to the CSU, a 5-fold increase from before the attack. Higher scores were associated with CSU use, functional job impairment, and mental health-related medical leave. Exposure-response gradients were significant for all outcomes.This screening tool effectively identified elevated PTSD risk, higher CSU use, and functional impairment among firefighters and therefore may be useful in allocating scarce postdisaster mental health resources.",0 +https://doi.org/10.1016/j.psychres.2010.12.016,Risk indicators for post-traumatic stress disorder in adolescents exposed to the 5.12 Wenchuan earthquake in China,"In Chinese adolescents exposed to the Wenchuan earthquake, we used the Children's Revised Impact of Event Scale (CRIES) as the screening tool, and Post-traumatic Cognitions Inventory (PTCI) and the Social Support Rating Scale (SSRS) were used to assess the cognitive status and their social supports, to evaluate the prevalence and the predictors variables of post-traumatic stress disorder (PTSD) after the Wenchuan earthquake in China, which occurred on 12 May 2008. Subjects with a CRIES score greater than 30 were interviewed and assessed using the DSM-IV criteria for PTSD diagnosis by a trained psychiatrist with the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Lifetime version (Kiddie-SADS-L). We found the overall prevalence of PTSD was 2.5% in 3208 adolescents from the surrounding areas of the epicentre 6months after the earthquake. Risk factors for post-traumatic stress symptoms are as follows: being female, being buried/injured during the earthquake, having parents who were severely injured, having classmate(s) who died, having a house destroyed, and witnessing someone buried/wounded/dying during the earthquake. Individuals with better social support had significantly lower scores on the CRIES. There were significant differences in cognitive style between individuals at low risk for PTSD (CRIES<30) and those at high risk for PTSD (CRIES≥30). Post-traumatic cognition emerged as an important factor that was associated with PTSD reactions in children. Social support can lessen the impact of a natural disaster by affecting post-traumatic cognition.",0 +https://doi.org/10.1176/ajp.152.4.529,Risk factors for PTSD-related traumatic events: a prospective analysis,"The authors previously identified suspected risk factors for traumatic events related to posttraumatic stress disorder (PTSD) on the basis of data gathered retrospectively. In this study, they tested that model prospectively.A random sample of 1,200 persons was drawn from all 21- to 30-year-old members of a large health maintenance organization. In 1989, 1,007 of these persons were interviewed, and suspected risk factors were measured. In 1992, 979 were reinterviewed, and the 3-year incidence of exposure to traumatic events was ascertained.Nineteen percent of the sample reported traumatic events during the 3-year follow-up. A history of past exposure to traumatic events signaled an increase in the liability to exposure during follow-up, independent of suspected risk factors. Two predictors of exposure, neuroticism and extroversion, identified retrospectively, also predicted exposure prospectively. The odds for exposure among males and persons with less than a college education were marginally significant. Early misconduct and a family history of psychiatric disorder-predictors of exposure in the retrospective data-were not significant predictors at 3-year follow-up. Blacks had a higher incidence of exposure during follow-up than whites. An exploratory reanalysis suggested that the discrepancy between the retrospective and prospective results may be explained by the inclusion of childhood exposure in the lifetime retrospective inquiry.The assumption that PTSD-related traumatic events are random phenomena was unsupported. Among young adults, those with less education, blacks, and those with high neuroticism and extroversion scores are more likely than others to be exposed to traumatic events and are thus at greater risk for PTSD.",0 +https://doi.org/10.1037/pro0000043,Broadening the focus in supporting reintegrating Iraq and Afghanistan veterans: Six key domains of functioning.,"As the major ground troop presence in the Middle East is reduced, it is time to reflect, maximize lessons learned, and look forward to what lies ahead for the nearly 2.6 million service members of the United States military who have deployed in support of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn. A systematic review of the literature on postdeployment functioning of Iraq and Afghanistan troops was conducted. Findings are described and contextualized in terms of service members' ongoing strengths, needs, and challenges. The corpus of research on deployed personnel indicates that service members demonstrate resilience in the face of war-related stressors. However, postdeployment impairment in 6 functional domains emerged in the literature review, including mental health, social and role functioning, relationship functioning and family life, spirituality, physical health, and financial well-being. Although risk factors and future trajectories vary across these domains, psychiatric difficulties are a consistent predictor of a worsened course. Implications for clinical practice are described based on the review findings. To promote wellbeing in the years ahead, it is important that service members are supported in their various roles (such as in the classroom, the workforce, and the family). In addition, routine assessment of functioning across domains is highly recommended for postdeployment service members. (PsycINFO Database Record © 2015 APA, all rights reserved).",0 +https://doi.org/10.1081/erc-200043945,Molecular Events Triggered by Heat Shock in Y1 Adrenocortical Cells,"Several stimuli, including stress conditions, promote the activation of MAP kinases family members (ERK1/2, JNK, p38). In turn, these enzymes regulate several cellular functions. Given that MAPK activation requires the phosphorylation of these proteins, their inactivation depends on the activity of specific phosphatases. MAPK phosphatase-1 (MKP-1), a phosphatase specifically involved in the inactivation of MAPK family members, is induced by mitogenic stimuli and stress conditions. Here we describe the effect of heat shock (HS), 10 min, 45 degrees C, on MAPKs activities and MKP-1 mRNA and protein levels in Y1 adrenocortical cells. Western blot analysis performed with antibodies against the phosphorylated forms of ERK1/2 and JNK revealed that HS produced the rapid activation of these kinases. Their inactivation was also a rapid event and occurred together with the increase of MKP-1 protein levels detected by Western blot analysis. In addition, the effect of HS on MKP-1 protein levels seems to be exerted at the transcriptional level, since the amount of its mRNA in heat shocked cells was higher than in nonheated cells. Comparison of the temporal profiles of MKP-1 protein induction and MAPKs phospho-dephosphorylation suggests that MKP-1 induction could contribute to ERK1/2 and JNK inactivation after HS.",0 +https://doi.org/10.1097/nmd.0000000000000213,Measuring Secondary Traumatic Stress Symptoms in Military Spouses With the Posttraumatic Stress Disorder Checklist Military Version,"Little research to date has examined secondary traumatic stress symptoms in spouses of military veterans. This study investigated the presence and severity of posttraumatic stress symptoms in a sample of 227 Army National Guard veterans and secondary traumatic stress symptoms among their spouses. The veterans completed the posttraumatic stress disorder (PTSD) Checklist Military Version (PCL-M) (Weathers et al., 1993) to determine the probable prevalence rate of posttraumatic stress symptoms. A modified version of the PCL-M was used to assess secondary traumatic stress symptoms in the spouses. A confirmatory factor analysis showed that the modified version of the PCL-M used to assess secondary traumatic stress symptoms in spouses fits using the same four-factor PTSD structure as the PCL-M for veterans. This study provides initial evidence on the underlying symptom structure of secondary traumatic stress symptoms among spouses of traumatic event victims.",0 +https://doi.org/10.1007/s10464-014-9634-6,Trajectories of Posttraumatic Stress Among Urban Residents,"Urban residents experience a wide range of traumatic events and are at increased risk of assaultive violence. Although previous research has examined trajectories of posttraumatic stress (PTS) through latent class growth analysis (LCGA) among persons exposed to the same index events (e.g., a natural disaster), PTS trajectories have not been documented among urban residents. The aims of this study were to conduct LGCA with a sample of trauma survivors from Detroit, Michigan (N = 981), and to explore predictors of trajectory membership. Participants completed three annual telephone surveys, each of which included the posttraumatic stress disorder (PTSD) Checklist-Civilian Version. Four PTS trajectories were detected. Although the majority evidenced a trajectory of consistently few symptoms (Low: 72.5%), 4.6% were in a trajectory of chronic severe PTSD (High), and the remainder were in trajectories of consistently elevated, but generally subclinical, levels of PTS (Decreasing: 12.3%; Increasing: 10.6%). Socioeconomic disadvantage (e.g., lower income), more extensive trauma history (e.g., childhood abuse), and fewer social resources (e.g., lower social support) were associated with membership in higher PTS trajectories, relative to the Low trajectory. The results suggest that efforts to reduce PTS in urban areas need to attend to socioeconomic vulnerabilities in addition to trauma history and risk for ongoing trauma exposure.",0 +https://doi.org/10.1002/hbm.22829,Neurobiological indicators of disinhibition in posttraumatic stress disorder,"Deficits in impulse control are increasingly recognized in association with posttraumatic stress disorder (PTSD). To our further understanding of the neurobiology of PTSD-related disinhibition, we examined alterations in brain morphology and network connectivity associated with response inhibition failures and PTSD severity. The sample consisted of 189 trauma-exposed Operation Enduring Freedom/Operation Iraqi Freedom veterans (89% male, ages 19-62) presenting with a range of current PTSD severity. Disinhibition was measured using commission errors on a Go/No-Go (GNG) task with emotional stimuli, and PTSD was assessed using a measure of current symptom severity. Whole-brain vertex-wise analyses of cortical thickness revealed two clusters associated with PTSD-related disinhibition (Monte Carlo cluster corrected P < 0.05). The first cluster included portions of right inferior and middle frontal gyri and frontal pole. The second cluster spanned portions of left medial orbital frontal, rostral anterior cingulate, and superior frontal gyrus. In both clusters, commission errors were associated with reduced cortical thickness at higher (but not lower) levels of PTSD symptoms. Resting-state functional magnetic resonance imaging analyses revealed alterations in the functional connectivity of the right frontal cluster. Together, study findings suggest that reductions in cortical thickness in regions involved in flexible decision-making, emotion regulation, and response inhibition contribute to impulse control deficits in PTSD. Furthermore, aberrant coupling between frontal regions and networks involved in selective attention, memory/learning, and response preparation suggest disruptions in functional connectivity may also play a role.",0 +https://doi.org/10.1016/j.biopsycho.2005.03.004,Meta-analytic review of event-related potential studies in post-traumatic stress disorder,"In recent years there has been an accumulation of studies that have utilized the measurement of event-related potentials (ERP) to examine the neuroelectric correlates of hypothesized alterations in information processing in persons with post-traumatic stress disorder (PTSD). The objective of this meta-analysis was to summarize the findings of ERP PTSD research, including studies that have examined P50 auditory sensory gating, augmenting-reducing P200, and P300 in target detection oddball tasks. The results suggest that persons with PTSD exhibit alterations in the amplitude and latency of ERP within these paradigms that support the hypothesis that changes in information processing can accompany PTSD. The results were also consistent with recent cognitive neuropsychological findings in PTSD research.",0 +https://doi.org/10.1037/a0019480,Family satisfaction predicts life satisfaction trajectories over the first 5 years after traumatic brain injury.,"Examined the influence of functional impairment, stable marital status, and family satisfaction on life satisfaction trajectories for 609 individuals (435 men, 174 women) over the first 5 years after traumatic brain injury (TBI).Participants completed the Family Satisfaction Scale (FSS), Functional Independence Measure (FIM), and the Life Satisfaction Index (LSI) at years 1, 2, 4, and 5 after sustaining a TBI.Trajectory modeling revealed that higher family satisfaction was associated with increases in life satisfaction for individuals with less functional impairment. Stable marital status was not significantly associated with life satisfaction trajectories.Family satisfaction appears to have pronounced beneficial effects on life satisfaction for persons with less functional impairment after TBI regardless of marital status. In contrast, a stable marriage appears to have no apparent benefits to self-reported life satisfaction over the first 5 years post-TBI. Theoretical and clinical implications of these results are discussed.",0 +https://doi.org/10.1093/jurban/jti074,PTSD and Depression Among Displaced Chinese Workers After the World Trade Center Attack: A Follow-up Study,"We conducted a follow-up assessment to assess the development of Posttraumatic Stress Disorder (PTSD) and depression among Chinese immigrants after the World Trade Center attack. Sixty-five Chinese displaced workers who were originally interviewed in May 2002 were re-interviewed in March 2003. Whereas depression scores decreased over time, average PTSD scores remained unchanged. The trajectory of posttraumatic stress symptoms was more complex, with an increasing number of individuals who show no or little emotional health problems and another increasing group of individuals with exacerbated posttraumatic stress symptoms. Although the mean values of the re-experiencing and hypervigilance cluster did not change over time, the mean value of the avoidance/numbing cluster increased significantly from time 1 (M= 4.60, SD = 4.98) to time 2 (M= 6.34, SD = 4.24), (F1.61=5.69,P= .02). A higher proportion of subjects met diagnostic criteria of PTSD at time 2 (27%) than at time 1 (21%). The study highlights the importance of ongoing mental health surveillance of diverse cultural and linguistic groups after a major traumatic event.",0 +https://doi.org/10.1093/med/9780198566854.003.0009,Responses to violence and trauma: the case of post-traumatic stress disorder,"Chapter 9 describes and evaluates the relatively recent mental health models of the impact of trauma, and discusses the ways that traumatic events affect people, the political and cultural effects of understanding these consequences as ‘disorder’, particularly as Post-traumatic Stress Disorder (PTSD), and concludes by looking at the relevance of the concept of PTSD to forensic populations.",0 +https://doi.org/10.1375/twin.13.1.57,Clustering of Trauma and Associations with Single and Co-Occurring Depression and Panic Attack over Twenty Years,"Individuals who experience one type of trauma often experience other types, yet few studies have examined the clustering of trauma. This study examines the clustering of traumatic events and associations of trauma with risk for single and co-occurring major depressive disorder (MDD) and panic attack for 20 years after first trauma. Lifetime histories of MDD, panic attack, and traumatic events were obtained from participants in an Australian twin sample. Latent class analysis was used to derive trauma classes based on each respondent's trauma history. Associations of the resulting classes and of parental alcohol problems and familial effects with risk for a first onset of single and co-occurring MDD and panic attack were examined from the year of first trauma to 20 years later. Traumatic events clustered into three distinct classes characterized by endorsement of little or no trauma, primarily nonassaultive, and primarily assaultive events. Individuals in the assaultive class were characterized by a younger age at first trauma, a greater number of traumatic events, and high rates of parental alcohol problems. Members of the assaultive trauma class had the strongest and most enduring risk for single and co-occurring lifetime MDD and panic attack. Assaultive trauma outweighed associations of familial effects and nonassaultive trauma with risk for 10 years following first trauma.",0 +https://doi.org/10.1037/a0023314,Patterns of violence against women: A latent class analysis.,"This study examined patterns of nine types of violence against women (VAW) and associated mental health problems. The following self-reported, lifetime violence victimization was examined among 1424 employed women: (1) childhood physical abuse, (2) childhood sexual abuse, (3) physical abuse between parents/guardians during childhood, (4) psychological intimate partner violence (IPV), (5) physical IPV, (6) sexual IPV, (7) adult physical or sexual assault by a non-intimate partner, (8) physical workplace violence, and (9) psychological workplace violence. Latent class analysis was used to identify homogenous patterns, called ""classes,"" of women's ""yes/no"" responses to experiencing these types of violence. The best model consisted of 4-classes characterized by the following probabilities: low violence (class 1: 63.1%), high psychological and physical IPV (class 2: 15.6%), high physical and psychological workplace violence (class 3: 12.4%), and moderate to high childhood abuse (class 4: 9.0%). When compared to class 1 (low violence), membership in classes 2 (IPV) and 4 (childhood abuse) was associated with screening positive for depression in the past week at baseline after controlling for the influence of demographic characteristics on class membership. Also, when compared to class 1 (low all), membership in class 2 (IPV) was associated with greater odds of screening positive for posttraumatic stress disorder in the past month at the six month follow-up assessment. Findings document distinct patterns of VAW and associated proximal and distal mental health outcomes. Implications for interventions aimed to improve employed women's health are discussed.",0 +https://doi.org/10.1016/j.yebeh.2004.04.011,Psychogenic status epilepticus in children,"Epilepsy features, psychiatric profile, psychosocial factors, and outcome are described for six children (three males) aged 5-15 years (mean 12.1) with psychogenic status epilepticus (PSE), i.e., prolonged or repetitive psychogenic seizures (PSs), >30 minutes, simulating status epilepticus. They had epilepsy, they were on chronic anticonvulsants (ACVs), and some had other neurological deficits. All received intravenous and/or rectal ACVs prior to suspicion of PSE. PSE was confirmed via video/EEG, demonstrating no epileptogenic activity during alleged seizures. Provocation and placebo therapy techniques were used in two. Psychiatric assessment identified comorbid disorders such as depression, anxiety disorder, obsessive-compulsive disorder, obsessive-compulsive symptoms, and posttraumatic stress disorder. Psychosocial stressors were almost ubiquitous. Psychiatric intervention included psychotherapy, family therapy, and medical treatment in one patient. Outcome was monitored for an average of 3.6 years (3-5 years). PSE did not recur. PSs recurred in three. Psychiatric comorbidity improved in four, who accepted psychiatric intervention and whose epilepsy also improved. In conclusion, the occurrence of PSE in children and adolescents with epilepsy is stressed. Prompt diagnosis was often missed in the acute care setting, and this carries important implications for iatrogenic complications. PSE diagnosis resulted in identification and management of comorbid psychiatric disorders. This was probably important in reducing the predominating anxiety and affective disorders in most patients as well as PSE recurrence. Epilepsy severity and associated deficits were most likely important factors in determining outcome.",0 +https://doi.org/10.1176/appi.ajp.161.8.1390,Posttraumatic Stress Disorder and Depression Following Trauma: Understanding Comorbidity,"Posttraumatic stress disorder (PTSD) and major depression occur frequently following traumatic exposure, both as separate disorders and concurrently. This raises the question of whether PTSD and depression are separate disorders in the aftermath of trauma or part of a single general traumatic stress construct. This study aimed to explore the relationships among PTSD, depression, and comorbid PTSD/depression following traumatic injury.A group of 363 injury survivors was assessed just prior to discharge from hospital and 3 and 12 months postinjury. Canonical correlations were used to examine the relationship between PTSD and depression symptom severity and a set of predictor variables. Multinomial logistic regression was used to identify whether the diagnostic categories of PTSD, depression, and comorbid PTSD/depression were associated with different groups of predictors.The majority of psychopathology in the aftermath of trauma was best conceptualized as a general traumatic stress factor, suggesting that when PTSD and depression occur together, they reflect a shared vulnerability with similar predictive variables. However, there was also evidence that in a minority of cases at 3 months, depression occurs independently from PTSD and was predicted by a different combination of variables.While PTSD and comorbid PTSD/depression are indistinguishable, the findings support the existence of depression as a separate construct in the acute, but not the chronic, aftermath of trauma.",0 +https://doi.org/10.1001/jamapediatrics.2013.2741,Posttraumatic Stress Following Pediatric Injury,"After pediatric injury, transient traumatic stress reactions are common, and about 1 in 6 children and their parents develop persistent posttraumatic stress (PTS) symptoms that are linked to poorer physical and functional recovery. Meta-analytic studies identify risk factors for persistent PTS, including preinjury psychological problems, peritrauma fear and perceived life threat, and posttrauma factors such as low social support, maladaptive coping strategies, and parent PTS symptoms. There is growing prospective data indicating that children's subjective appraisals of the injury and its aftermath influence PTS development. Secondary prevention of injury-related PTS often involves parents and focuses on promoting adaptive child appraisals and coping strategies. Web-based psychoeducation and targeted brief early intervention for injured children and their parents have shown a modest effect, but additional research is needed to refine preventive approaches. There is a strong evidence base for effective psychological treatment of severe and persistent PTS via trauma-focused cognitive behavioral therapy; evidence is lacking for psychopharmacological treatment. Pediatric clinicians play a key role in preventing injury-related PTS by providing ""trauma-informed"" pediatric care (ie, recognizing preexisting trauma, addressing acute traumatic stress reactions associated with the injury event, minimizing potentially traumatic aspects of treatment, and identifying children who need additional monitoring or referral).",0 +https://doi.org/10.1176/appi.ajp.157.4.629,Posttraumatic Stress Disorder After Severe Traumatic Brain Injury,"This study indexed the profile of posttraumatic stress disorder (PTSD) after severe traumatic injury to the brain.Patients who sustained a severe traumatic brain injury (N=96) were assessed for PTSD 6 months after the injury with the PTSD Interview, a structured clinical interview based on DSM-III-R criteria.PTSD was diagnosed in 26 (27.1%) of the patients. While only 19.2% (N=5) of the patients with PTSD reported intrusive memories of the trauma, 96.2% (N=25) reported emotional reactivity. Intrusive memories, nightmares, and emotional reactivity had very strong positive predictive values for the presence of PTSD.These findings indicate that PTSD can develop after severe traumatic brain injury. The predominance of emotional reactivity and the relative absence of traumatic memories in patients with PTSD who suffered impaired consciousness during trauma suggest that traumatic experiences can mediate PTSD at an implicit level.",0 +https://doi.org/10.1016/j.rehab.2014.08.010,Cognitive and behavioural post-traumatic impairments: What is the specificity of a brain injury ? A study within the ESPARR cohort,"The variety and extent of impairments occurring after traumatic brain injury vary according to the nature and severity of the lesions. In order to better understand their interactions and long-term outcome, we have studied and compared the cognitive and neurobehavioral profile one year post onset of patients with and without traumatic brain injury in a cohort of motor vehicle accident victims.The study population is composed of 207 seriously injured persons from the ESPARR cohort. This cohort, which has been followed up in time, consists in 1168 motor vehicle accident victims (aged 16 years or more) with injuries with all degrees of severity. Inclusion criteria were: living in Rhone county, victim of a traffic accident having involved at least one wheel-conducted vehicle and having occurred in Rhone county, alive at the time of arrival in hospital and having presented in one of the different ER facilities of the county. The cohort's representativeness regarding social and geographic criteria and the specificities of the accidents were ensured by the specific targeting of recruitment. Deficits and impairments were assessed one year after the accident using the Neurobehavioral Rating Scale - Revised and the Trail-Making Test. Within our seriously injured group, based on the Glasgow Score, the presence of neurological deficits, aggravation of neurological condition in the first 72hours and/or abnormal cerebral imaging, we identified three categories: (i) moderate/severe traumatic brain injury (n=48), (ii) mild traumatic brain injury (n=89), and (iii) severely injured but without traumatic brain injury (n=70).The most frequently observed symptoms were anxiety, irritability, memory and attention impairments, depressive mood and emotional lability. While depressive mood and irritability were observed with similar frequency in all three groups, memory and attention impairments, anxiety and reduced initiative were more specific to traumatic brain injury whereas executive disorders were associated with moderate/severe traumatic brain injury.The presence and the initial severity of a traumatic brain injury condition the nature and frequency of residual effects after one year. Some impairments such as irritability, which is generally associated with traumatic brain injury, do not appear to be specific to this population, nor does depressive mood. Substantial interactions between cognitive, affective and neurobehavioral disorders have been highlighted.",0 +https://doi.org/10.1080/1047840x.2015.992677,"The Temporal Elements of Psychological Resilience: An Integrative Framework for the Study of Individuals, Families, and Communities","Psychological resilience has become a popular concept. Owing to that popularity, the word resilience has taken on myriad and often overlapping meanings. To be a useful framework for psychological research and theory, the authors argue, the study of resilience must explicitly reference each of four constituent temporal elements: (a) baseline or preadversity functioning, (b) the actual aversive circumstances, (c) postadversity resilient outcomes, and (d) predictors of resilient outcomes. Using this framework to review the existing literature, the most complete body of evidence is available on individual psychological resilience in children and adults. By contrast, the research on psychological resilience in families and communities is far more limited and lags well behind the rich theoretical perspective available from those literatures. The vast majority of research on resilience in families and communities has focused primarily on only one temporal element, possible predictors of resilient outcomes. Surpr...",0 +https://doi.org/10.1186/1753-2000-5-8,A longitudinal follow-up of posttraumatic stress: from 9 months to 20 years after a major road traffic accident,"Although road traffic accidents (RTA) are a major cause of injury and a cause of posttraumatic stress (PTS) in the aftermath, little is known about the long-term psychological effects of RTA.This prospective longitudinal study assessed long-term PTS, grief, and general mental health after a bus carrying 23 sixth-grade schoolchildren crashed on a school outing and 12 children died. Directly affected (i.e., children in the crash) and indirectly affected children (i.e., all pupils in the sixth grade who were not in the crash) were surveyed at 9 months (N = 102), 4 years (N = 51), and 20 years (N = 40) after the event. Psychological distress was assessed by single items, including sadness, avoidance, intrusions, and guilt. After 20 years, PTS was assessed by the Impact of Event Scale-Revised.Stress reactions were prevalent 9 months after the event, with sadness (69%) and avoidance (59%) being highly represented in both directly and indirectly affected groups, whereas, nightmares (60%) and feelings of guilt (50%) were only frequent in those directly affected. The frequency of sadness and avoidance decreased after 4 years in the indirectly exposed (ps < .05). After 20 years, the directly affected had a higher prevalence of PTS (p = .003), but not decreased general mental health (p = .14), than those indirectly affected.The limitations preclude assertive conclusions. Nonetheless, the findings corroborate previous studies reporting traumatic events are associated with long-term PTS, but not with decreased general mental health.",0 +https://doi.org/10.1016/j.neulet.2010.05.052,"Single prolonged stress decreases glutamate, glutamine, and creatine concentrations in the rat medial prefrontal cortex","Application of single prolonged stress (SPS) in rats induces changes in neuroendocrine function and arousal that are characteristic of post traumatic stress disorder (PTSD). PTSD, in humans, is associated with decreased neural activity in the prefrontal cortex, increased neural activity in the amygdala complex, and reduced neuronal integrity in the hippocampus. However, the extent to which SPS models these aspects of PTSD has not been established. In order to address this, we used high-resolution magic angle spinning proton magnetic resonance spectroscopy (HR-MAS (1)H MRS) ex vivo to assay levels of neurochemicals critical for energy metabolism (creatine and lactate), excitatory (glutamate and glutamine) and inhibitory (gamma amino butyric acid (GABA)) neurotransmission, and neuronal integrity (N-acetylaspartate (NAA)) in the medial prefrontal cortex (mPFC), amygdala complex, and hippocampus of SPS and control rats. Glutamate, glutamine, and creatine levels were decreased in the mPFC of SPS rats when compared to controls, which suggests decreased excitatory tone in this region. SPS did not alter the neurochemical profiles of either the hippocampus or amygdala. These data suggest that SPS selectively attenuates excitatory tone, without a disruption of neuronal integrity, in the mPFC.",0 +https://doi.org/10.1111/jasp.12168,PATH: a program to build resilience and thriving in undergraduates,"We developed and tested a brief three-session program to build resilience (protection from depressive symptoms) and thriving (positive growth) in undergraduates by teaching adaptive explanatory styles. In Study 1, a pretest–posttest waiting list control experiment with 28 undergraduates found that our Program for Accelerated Thriving and Health (PATH) significantly increased optimistic and personal control explanatory styles (Attributional Style Questionnaire), resilience (Beck Depression Inventory-II), and thriving (Connor–Davidson Resilience Scale 10). In Study 2, a placebo control experiment with 63 undergraduates found a modified version of the program to significantly increase resilience. All effects were at least moderate in size. As predicted, a personal control explanatory style significantly predicted thriving in both studies. Predictors of resilience and thriving were discussed in terms of differentiating the constructs.",0 +https://doi.org/10.1517/14656566.4.10.1829,Paroxetine in the treatment of post-traumatic stress disorder: pooled analysis of placebo-controlled studies,"Post-traumatic stress disorder (PTSD) is increasingly understood to be a medical disorder characterised by particular psychobiological dysfunctions that respond to specific treatments. Paroxetine is a selective serotonin re-uptake inhibitor that has been found effective in the treatment of major depression as well as a range of anxiety disorders. This paper reviews data on the use of paroxetine for the treatment of adult PTSD. There have been three 12-week, placebo-controlled studies of paroxetine in PTSD. As these followed a partly similar design, a pooled analysis of the studies is possible and is reported here. Paroxetine is effective in the short-term treatment of PTSD, resulting in significantly better response and remission rates than placebo, improving sleep disturbance and reducing each of the symptom clusters of PTSD, as well as the disability associated with this condition. The medication is effective in both male and female PTSD patients and whether or not there are comorbid disorders such as depression.",0 +https://doi.org/10.1080/1047840x.2014.1002378,The Missing Link in Resilience Research,"Bonanno, Romero and Klein (this issue) review many aspects of individual, family and community resilience studies, highlighting the fact that resilience is a multi-dimensional, complex construct wh...",0 +https://doi.org/10.1016/j.psychres.2015.05.062,Risk factors of severity of post-traumatic stress disorder among survivors with physical disabilities one year after the Wenchuan earthquake,"On May 12, 2008, a devastating earthquake measuring 8.0 on the Richter scale struck Wenchuan County and surrounding areas in China. This study aimed to assess post-traumatic stress disorder (PTSD) in the aftermath of the earthquake, and to evaluate factors of severity of PTSD symptoms among survivors with physical disabilities. We conducted a population-based cross-sectional survey and recruited 817 survivors with physical disabilities in three stricken areas. Assessment measures included the PTSD Checklist-Civilian Version (PCL-C) and the 12-item General Health Questionnaire (GHQ-12). Our study showed that 27.42% of the survivors with physical disabilities had PTSD symptoms one year after the Wenchuan earthquake. In the regression model, geographic location, female, suffering from paralysis following the earthquake, and going into a coma in the earthquake were associated with severe PTSD symptoms. Our findings suggest that a substantial proportion of physically disabled survivors of a big earthquake may have severe PTSD symptoms. The associated factors of PTSD identified in our study could inform the implementation of preventive programs for this population and give hint on the way to cope with this kind of disaster in the future.",0 +https://doi.org/10.1007/s00127-008-0360-y,"Clinical epidemiology in patients admitted at Mathari Psychiatric Hospital, Nairobi, Kenya","Background: Knowledge of types and co-morbidities of disorders seen in any facility is useful for clinical practice and planning for services. Aim: To study the pattern of co-morbidities of and correlations betweenpsychiatric disorders in in-patients of Mathari Hospital, the premier psychiatric hospital in Kenya. Study Design: Cross-sectional. Methods: All the patients who were admitted at Mathari Hospital in June 2004 and were well enough to participate in the study were approached for informed consent. Trained psychiatric charge nurses interviewed them using the Structured Clinical Interview for DSM-IV Axis I disorders Clinical Version (SCID-I). Information on their socio-demographic profiles and hospital diagnoses was extracted from their clinical notes using a structured format. Results: Six hundred and ninety-one patients participated in the study. Sixty-three percent were male. More than three quarters (78%) of the patients were aged between 21 and 45 years. More than half (59.5%) of the males and slightly less than half (49.4%) of the females were single. All the patients were predominantly of the Christian faith. Over 85% were dependants of another family member and the remainder were heads of households who supported their own families. Schizophrenia, bipolar I disorder, psychosis, substance use disorder and schizo-affective disorder were the most common hospital and differential diagnoses. Of the anxiety disorders, only three patients were under treatment for post-traumatic stress disorder (PTSD). Nearly a quarter (24.6%) of the patients were currently admitted for a similar previous diagnosis. Schizophrenia was the most frequent DSM-IV (Diagnostic and Statistical Manual of Mental Disorders' fourth edition) diagnosis (51%), followed by bipolar I disorder (42.3%), substance use disorder (34.4%) and major depressive illness (24.6%). Suicidal features were common in the depressive group, with 14.7% of this group reporting a suicidal attempt. All DSM-IV anxiety disorders, including obsessive-compulsive disorders, were highly prevalent although, with the exception of three cases of PTSD, none of these anxiety disorders were diagnosed clinically. Traumatic events were reported in 33.3% of the patients. These were multiple and mainly violent events. Despite the multiplicity of these events, only 7.4% of the patients had a PTSD diagnosis in a previous admission while 4% were currently diagnosed with PTSD. The number of DSM-IV diagnoses was more than the total number of patients, suggesting co-morbidity, which was confirmed by significant 2-tailed correlation tests. Conclusion: DSM-IV substance use disorders, major psychiatric disorders and anxiety disorders were prevalent and co-morbid. However, anxiety disorders were hardly diagnosed and therefore not managed. Suicidal symptoms were common. These results call for more inclusive clinical diagnostic practice. Standardized clinical practice using a diagnostic tool on routine basis will go a long way in ensuring that no DSM-IV diagnosis is missed. This will improve clinical management of patients and documentation. © Springer-Verlag 2008.",0 +https://doi.org/10.1002/acp.1830,Linguistic Predictors of Post-Traumatic Stress Disorder Symptoms Following 11 September 2001,"Summary Prior research has linked content analysis drawn from text narratives to psychopathology in trauma survivors. This study used a longitudinal design to determine whether linguistic elements of narrative memories of first hearing about the events of 11 September 2001 predict later post-traumatic stress disorder (PTSD). Narratives and self-report PTSD symptoms were collected within 1 week and again 5 months after 9/11 in 40 undergraduates. People who used more “we” words at Time 1 had fewer acute PTSD symptoms. Use of more cognitive mechanism words, more religion words, more first-person singular pronouns, and fewer anxiety words at Time 1 were related to more chronic PTSD symptoms. Linguistic characteristics accounted for variance in chronic PTSD symptoms above and beyond acute PTSD symptoms. This study provides evidence that lasting PTSD symptoms can be predicted through language in the immediate aftermath of the trauma. Copyright © 2011 John Wiley & Sons, Ltd.",0 +https://doi.org/10.1002/jcop.1017,"Political violence, social integration, and youth functioning: Palestinian youth from the Intifada","Informed by social ecological, social capital, and social disorganization theories, this study tested an ecological model of youth experience in the Palestinian Intifada. The sample included 6,000 Palestinian 14 year olds, assessed in 1994 and 1995 after the end of the conflict. Data from retrospective self-reports of youth exposure to and involvement in political violence, and self-reports of current individual functioning (depression and antisocial behavior) and integration in several social contexts (family, peer relations, religion, education, and community), revealed: direct associations between Intifada experience and antisocial behavior and depression (females only); Intifada experience was positively associated with religiosity and unrelated to social integration in family, school, and peer relations; in some cases, social integration in family, education, religion, and peer relations significantly moderated the associations between Intifada experience and youth problems; integration in the several social contexts was directly related in predictable ways to youth problem behaviors, with neighborhood disorganization the most consistent and powerful predictor. The discussion centers around youth resilience to the effects of political violence, the role of psychological meaning children and adolescents can attach to political violence, and the overall salience of social integration in youth development. © 2001 John Wiley & Sons, Inc.",0 +https://doi.org/10.1037/a0037920,The temporal relationship between posttraumatic stress disorder and problem alcohol use following traumatic injury.,"Chronic alcohol abuse is a major public health concern following trauma exposure; however, little is known about the temporal association between posttraumatic stress disorder (PTSD) symptoms and problem alcohol use. The current study examined the temporal relationship between PTSD symptom clusters (re-experiencing, effortful avoidance, emotional numbing, and hyperarousal) and problem alcohol use following trauma exposure. This study was a longitudinal survey of randomly selected traumatic injury patients interviewed at baseline, 3 months, 12 months, and 24 months following injury. Participants were 1,139 injury patients recruited upon admission from 4 Level 1 trauma centers across Australia. Participants were assessed using the Clinician Administered PTSD Scale and Alcohol Use Disorders Identification Test. Results indicated that high levels of re-experiencing, effortful avoidance, and hyperarousal symptoms at 12 months were associated with greater increases (or smaller decreases) in problem alcohol use between 12 and 24 months. Findings also suggested that high levels of problem alcohol use at 12 months were associated with greater increases (or smaller decreases) in emotional numbing symptoms between 12 and 24 months. These findings highlight the critical importance of the chronic period following trauma exposure in the relationship between PTSD symptoms and problem alcohol use.",0 +https://doi.org/10.1002/msj.20026,Mental health of workers and volunteers responding to events of 9/11: Review of the literature,"Background: Disaster workers responding to the events of September 11th were exposed to traumatic events. No study has systematically investigated the diverse mental health status and needs of the heterogeneous population of disaster workers responding to the events of September 11th. Methods: Using PubMed and Medline and the search terms of “September 11, 2001” or “September 11” or “9/11”or “WTC” or “World Trade Center”, the authors reviewed all articles that examined the mental health outcomes of workers at one of the three September 11th crash sites or the Fresh Kills landfill in New York City. Results: In total, 25 articles met study inclusion criteria, often using different methodologies. The articles described varying degrees of mental health symptomatology, risk factors for adverse mental health outcomes, and utilization of mental health services. Conclusions: The mental health needs of workers exposed to the events of September 11th ranged from little to no care to pharmacotherapy. A range of risk factors, including exposures at the WTC site and occupational activities, impacted on these needs but the role of specific mental health interventions was less clear. These findings suggest the need for a future program for disaster workers consisting of an accessible mental health treatment service supported by comprehensive postdisaster surveillance and emphasis on pre-disaster mental wellness. A number of areas for further consideration and study were identified, including the need for a more diverse exploration of involved responder populations as well as investigation of potential mental health outcomes beyond post-traumatic stress disorder (PTSD). Mt Sinai J Med 75:115–127, 2008 © 2008 Mount Sinai School of Medicine",0 +https://doi.org/10.1002/jts.20256,An epidemiologic approach to the development of early trauma focused intervention,"Early, trauma-focused intervention development has emphasized unidirectional trajectories that begin with basic research and efficacy trials followed later by effectiveness and dissemination studies. In this article, the authors present methods derived from social and clinical epidemiology that constitute foundational research in the development of early trauma-focused intervention. They also describe how population-based practice research may serve to feed back and inform what has been conceptualized as earlier stages of intervention development such as efficacy trials. Examples of relevant epidemiologic research methods are presented to illustrate these points. The authors posit that the continued application of population-based methods may produce treatments that can be feasibly applied to the unique patient, provider, organizational, and community contexts relevant to early interventions for survivors of trauma.",0 +https://doi.org/10.1007/s00406-015-0638-5,Altered lipid peroxidation markers are related to post-traumatic stress disorder (PTSD) and not trauma itself in earthquake survivors,"The traumatic life events, including earthquakes, war, and interpersonal conflicts, cause a cascade of psychological and biological changes known as post-traumatic stress disorder (PTSD). Malondialdehyde (MDA) is a reliable marker of lipid peroxidation, and paraoxonase is a known antioxidant enzyme. The aims of this study were to investigate the relationship between earthquake trauma, PTSD effects on oxidative stress and the levels of serum paraoxonase 1 (PON1) enzyme activity, and levels of serum MDA. The study was carried out on three groups called: the PTSD group, the traumatized with earthquake exercise group, and healthy control group, which contained 32, 31, and 38 individuals, respectively. Serum MDA levels and PON1 enzyme activities from all participants were measured, and the results were compared across all groups. There were no significant differences between the PTSD patients and non-PTSD earthquake survivors in terms of the study variables. The mean PON1 enzyme activity from PTSD patients was significantly lower, while the mean MDA level was significantly higher than that of the healthy control group (p < 0.01 for both measurements). Similarly, earthquake survivors who did not develop PTSD showed higher MDA levels and lower PON1 activity when compared to healthy controls. However, the differences between these groups did not reach a statistically significant level. Increased MDA level and decreased PON1 activity measured in PTSD patients after earthquake and may suggest increased oxidative stress in these patients. The nonsignificant trends that are observed in lipid peroxidation markers of earthquake survivors may indicate higher impact of PTSD development on these markers than trauma itself. For example, PTSD diagnosis seems to add to the effect of trauma on serum MDA levels and PON1 enzyme activity. Thus, serum MDA levels and PON1 enzyme activity may serve as biochemical markers of PTSD diagnosis. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1016/0022-3956(91)90002-r,Post-traumatic stress disorder: Issues of co-morbidity,"There is considerable controversy over whether or not post-traumatic stress disorder (PTSD) should be considered as a separate diagnostic entity. The present study utilized the Symptom Checklist-90 (SCL-90) in order to examine the degree of overlap between PTSD and the related diagnoses of anxiety, depression and obsession-compulsion in a group of Israeli Lebanon War PTSD casualties. We found that the SCL-90 was able both to identify and discriminate between the clinical groups. Multiple discriminant analysis showed that although there is overlap between PTSD and obsessive-compulsive disorder, PTSD is, in fact, discriminated from all the other patient groups.",0 +https://doi.org/10.1037/a0033942,"Psychophysiologic reactivity, subjective distress, and their associations with PTSD diagnosis.","Intense subjective distress and physiologic reactivity upon exposure to reminders of the traumatic event are each diagnostic features of posttraumatic stress disorder (PTSD). However, subjective reports and psychophysiological data often suggest different conclusions. For the present study, we combined data from five previous studies to assess the contributions of these two types of measures in predicting PTSD diagnosis. One hundred fifty trauma-exposed participants who were classified into PTSD or non-PTSD groups based on structured diagnostic interviews completed the same script-driven imagery procedure, which quantified measures of psychophysiologic reactivity and self-reported emotional responses. We derived four discriminant functions (DiscFxs) that each maximally separated the PTSD from the non-PTSD group using (1) psychophysiologic measures recorded during personal mental imagery of the traumatic event; (2) self-report ratings in response to the trauma imagery; (3) psychophysiologic measures recorded during personal mental imagery of another highly stressful experience unrelated to the index traumatic event; and (4) self-report ratings in response to this other stressor. When PTSD status was simultaneously regressed on all four DiscFxs, trauma-related psychophysiological reactivity was a significant predictor, but physiological reactivity resulting from the highly stressful, but not traumatic script, was not. Self-reported distress to the traumatic experience and the other stressful event were both predictive of PTSD diagnosis. Trauma-related psychophysiologic reactivity was the best predictor of PTSD diagnosis, but self-reported distress contributed additional variance. These results are discussed in relation to the Research Domain Criteria framework.",0 +https://doi.org/10.7205/milmed-d-13-00097,Alcohol Use Biomarkers Predicting Cognitive Performance: A Secondary Analysis in Veterans With Alcohol Dependence and Posttraumatic Stress Disorder,"We conducted a secondary analysis of baseline data from a recently completed pharmacological pilot clinical trial among 30 veterans with alcohol dependence and posttraumatic stress disorder (PTSD). This trial included baseline measures of alcohol use biomarkers, both indirect (carbohydrate-deficient transferrin, GGT [γ-glutamyltransferase], mean corpuscular volume, AST [aspartate aminotransferase], alanine aminotransferase) and direct (ethyl glucuronide, ethyl sulfate), as well as neurocognitive measures (Trail Making Test parts A and B, Hopkins Verbal Learning Test-Revised, Balloon Analogue Risk Task, Delay Discounting Task).Two regression models were estimated and tested for each neurocognitive measure (dependent measure). The first model included the alcohol use biomarker alone as the predictor. The second model included the alcohol use biomarker along with the following 3 additional predictors: Beck Depression Inventory, Clinician-Administered PTSD Scale, and receiving medications.In both models, the indirect biomarkers, such as GGT and AST, significantly predicted performance on the Hopkins Verbal Learning Test-Revised %Retention. GGT alone significantly predicted performance on the Trail Making Test part A.Indirect alcohol use biomarkers may have a specific role in identifying those veterans with alcohol dependence and PTSD who have impaired cognitive performance. However, direct alcohol use biomarkers may not share such a role.",0 +https://doi.org/10.1891/0886-6708.vv-d-12-00097r1,Dimensions of Trauma and Specific Symptoms of Complex Posttraumatic Stress Disorder in Inner-City Youth: A Preliminary Study,"We examined relations of posttraumatic stress disorder (PTSD) symptoms with dimensions of trauma, including environment (Domestic vs. Community) and proximity (Indirect vs. Direct trauma) among inner-city youth. Participants (n = 65) reported traumatic events they had experienced on a version of the UCLA PTSD Reaction Index Trauma Exposure Screen, and reported PTSD symptoms with the PTSD Checklist--Civilian version (PCL-C). High rates of trauma and PTSD were found, consistent with other reports of inner-city youth. The 49% of youth surveyed met criteria for PTSD on the PCL-C symptom scale with a score cutoff of 35. Females reported elevated PTSD symptom scores and a higher incidence of Domestic trauma than did males but similar incidence of other trauma types. When males and females were combined, Domestic trauma significantly correlated with each of the PTSD symptom clusters of intrusions, numbing/avoidance, and hyperarousal. When participants with Community trauma were excluded from analyses to reduce confounding environmental influence, Domestic trauma marginally correlated with numbing/avoidance symptoms. Our findings suggest that Domestic trauma may result in more emotional numbing/avoidance symptoms than other types of trauma. Further analyses suggested that Community trauma may result in more intrusions and hyperarousal symptoms rather than emotional numbing. Environmental aspects of trauma, rather than the proximity of trauma, may have greater impact on presentation of PTSD. Future studies with larger samples are needed to confirm these findings.",0 +https://doi.org/10.1037/a0019062,Social relationships and PTSD symptomatology in combat veterans.,"The primary purpose of this study is to determine if recent combat veterans discriminate between different sources of social support, and then preliminarily investigate the relationship of social support source on posttraumatic stress disorder (PTSD) symptomatology. Participants included 83 married male combat veterans. Principal-axis factor analysis with equamax rotation observed four distinct latent factors for each source of support examined. ANOVAs were performed to determine the relationship of each source of support from the distinct latent factors on the level of PTSD. Results indicate that the level of PTSD is related to support received from a significant other, F(1, 81) 30.36, p .001, family, F(1, 81) 8.10, p .006, and military peers, F(1, 81) 6.70, p .011, but not friends, F(1, 81) 1.79, p .18. In general, higher levels of support from each category were associated with lower levels of PTSD in combat veterans. The results suggest that combat veterans distinguish between specific sources of social support, which may have a protective effect on the level of PTSD.",0 +https://doi.org/10.1186/1471-2202-15-65,Regional differences in acute corticosterone-induced dendritic remodeling in the rat brain and their behavioral consequences,"Glucocorticoid released by stressful stimuli elicits various stress responses. Acute treatment with a single dose of corticosterone (CORT; predominant glucocorticoid of rats) alone has previously been shown to trigger anxiety behavior and robust dendritic hypertrophy of neurons in the basolateral amygdala (BLA). Neurons in the medial prefrontal cortex (mPFC) are also known to be highly sensitive to stress and regulate anxiety-like behaviors. Nevertheless, we know less about acute CORT-induced structural changes of other brain regions and their behavioral outcomes. In addition, the temporal profile of acute CORT effects remains to be examined. The current study investigates time course changes of dendritic architectures in the stress vulnerable brain areas, the BLA and mPFC, and their behavioral consequences after acute treatment with a single dose of CORT.Acute CORT treatment produced delayed onset of dendritic remodeling in the opposite direction in the BLA and mPFC with different time courses. Acute CORT induced dendritic hypertrophy of BLA spiny neurons, which was paralleled by heightened anxiety, both peaked 12 days after the treatment. Meanwhile, CORT-induced dendritic atrophy of mPFC pyramidal neurons peaked on day 6, concomitantly with impaired working memory. Both changed dendritic morphologies and altered behavioral outcomes were fully recovered.Our results suggest that stress-induced heightened anxiety appears to be a functional consequence of dendritic remodeling of BLA neurons but not that of mPFC. Instead, stress-induced dendritic atrophy of mPFC neurons is relevant to working memory deficit. Therefore, structural changes in the BLA and the mPFC might be specifically associated with distinct behavioral symptoms observed in stress-related mental disorders. Remarkably, stress-induced dendritic remodeling in the BLA as well as mPFC is readily reversible. The related behavioral outcomes also follow the similar time course in a reversible manner. Therefore, further studies on the cellular mechanism for the plasticity of dendrites architecture might provide new insight into the etiological factors for stress-related mental illness such as posttraumatic stress disorder (PTSD).",0 +https://doi.org/10.1093/eurpub/ckl067,The Synthetic Evaluation Model for Analysis of Flooding Hazards,"Although many previous epidemiological studies have reported the incidence of diseases, mortality rate and economic losses after natural disasters, none of these studies has been comprehensive enough. Our aim was to establish a synthetic evaluation model (SEM) that can be used to analyze flood hazards.Initial evaluation indicators were selected using systematic and literature data analysis. These indicators were tested with single or multiple variable analyses. Final evaluation indicators and their weights were determined using the Delphi procedure. We established a SEM of flood hazards using the hierarchy method and tested the model using jack-knife analysis.The SEM on flood hazards consists of 6 first-rank indicators and 24 second-rank indicators. First-rank indicators were: direct casualties (w = 0.2123), the increased incidence and prevalence rate of the disease (w = 0.1715), excess mortality rate (w = 0.1745), mental injury (w = 0.1038), epidemic focus expansion (w = 0.1572) and economic loss (w = 0.1807). The agreement of the model reached 98.2% tested with the jack-knife analysis.A SEM of flood hazards was established with an agreement of 98.2%, which can be used to evaluate the hazards, and assist public health-care workers provide appropriate flood disaster management.",0 +https://doi.org/10.3233/wor-141926,Post-deployment Multi-symptom Disorder rehabilitation: An integrated approach to rehabilitation,"Veterans and active duty service members returning from Operation New Dawn and those having returned from Operations Iraqi and Enduring Freedom frequently report the presence of overlapping, co-morbid symptom clusters consisting of chronic pain, mild cognitive complaints, and posttraumatic stress symptoms/disorder or mood disturbance. This presentation has been called Post-deployment Multi-symptom Disorder (PMD) and its implications not only impact various functional domains, but have also influenced a system/continuum of care to rise to meet the challenges of treating PMD. This continuum is based on innovation informed by evidence-based therapies, systemic limitations, and a focus on functional improvement rather than diagnostic classification.The purpose of this paper is to describe the symptomatic, functional and systemic challenges inherent to PMD conceptualization and treatment.The constituent clusters of PMD are defined and exemplified, its functional impact is illustrated, and a continuum of care at a large southeastern Veterans Affairs (VA) hospital offering an interdisciplinary approach to integrated rehabilitation is described. Three case examples are provided that that underscore the importance of vocation for improved behavioral health and quality of life.The case examples demonstrate how vocational rehabilitation services are an integral component of PMD treatment.}",0 +https://doi.org/10.1037/mil0000018,Functional Impairment as a Variable in Adjustment Post-Combat,"This study examined how functional impairment relates to postcombat adjustment over time, controlling for the influence of combat exposure. Analyses used sequential random coefficient models to examine 2 hypotheses: a) combat exposure and functional impairment predict the change in posttraumatic stress, depression, and anger/aggression symptoms during the first year postcombat; and b) combat exposure and functional impairment at reintegration predict symptom scores at 1 year postdeployment. A Brigade Combat Team completed surveys at reintegration, 4 months, and 12 months after a 1-year deployment to Iraq. Soldiers reporting high functional impairment at reintegration had higher symptoms at both follow-up periods, and functional impairment was a significant predictor of symptoms at the last time point, even after accounting for the influence of combat exposure. There was also an interaction effect, such that functional impairment exacerbated the impact of combat exposure on posttraumatic stress and anger/a...",0 +https://doi.org/10.1176/appi.ajp.158.9.1474,A Longitudinal and Retrospective Study of PTSD Among Older Prisoners of War,"The authors examined the longitudinal changes in posttraumatic stress disorder (PTSD) symptom levels and prevalence rates over a 4-year time period among American former prisoners of war (POWs) from World War II and the Korean War. Retrospective symptom reports by World War II POWs dating back to shortly after repatriation were examined for 1) additional evidence of changing PTSD symptom levels and 2) evidence of PTSD cases with a long-delayed onset.PTSD prevalence rates and symptom levels were measured by the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder. For the longitudinal portion of the study, participants were 177 community-dwelling World War II and Korean POWs. For the retrospective portion, participants were 244 community-dwelling World War II POWs.PTSD prevalence rates and symptom levels increased significantly over the 4-year measurement interval. Retrospective symptom reports indicated that symptoms were highest shortly after the war, declined for several decades, and increased within the past two decades. Long-delayed onset of PTSD symptoms was rare. Demographic and psychosocial variables were used to characterize participants whose symptoms increased over 4 years and differentiate participants who reported a long-delayed symptom onset.Both longitudinal and retrospective data support a PTSD symptom pattern of immediate onset and gradual decline, followed by increasing PTSD symptom levels among older survivors of remote trauma.",0 +https://doi.org/10.1007/978-1-61779-313-4_12,The “Cut-Off Behavioral Criteria” Method: Modeling Clinical Diagnostic Criteria in Animal Studies of PTSD,"Posttraumatic stress disorder (PTSD) is clinically defined by exposure to a significantly threatening and/or horrifying event and the presence of a certain number of symptoms from each of three symptom clusters at least one month after the event. The procedures involved in defining clinical diagnostic criteria for mental disorders are lengthy and quit stringent. The APA and WHO (responsible for the DSM and ICD, respectively) periodically review the diagnostic criteria, a process which engenders heated discussion in the literature, with the aim of refining and improving their clinical, epidemiological, and research validity.Animal behavioral studies, however, have generally tended to overlook this aspect and have commonly regarded the entire group of animals subjected to certain study conditions as homogeneous. The method to be described below was developed in an attempt to model diagnostic criteria in terms of individual patterns of response using behavioral measures and determining cut-off scores to distinguish between extremes of response or nonresponse, leaving a sizeable proportion of subjects in a middle group, outside each set of cut-off criteria. This chapter will discuss the concept of the model and its background, provide detailed protocols for each of its components, and present a selection of studies employing and examining the model, alongside the underlying translational rationale of each. © 2011 Springer Science+Business Media, LLC.",0 +https://doi.org/10.1016/0376-8716(94)90110-4,Substance abuse and post-traumatic stress disorder comorbidity,"This article reviews the extant literature on substance abusers with and without a comorbid diagnosis of post-traumatic stress disorder (PTSD) and reveals the discontinuity between clinical lore and empirical research. Included is an overview of PTSD-substance abuse theoretical models and comorbidity prevalence rates, as well as an evaluation of the comparative data on treatment outcome and psychosocial factors, such as coping skills, for PTSD versus non-PTSD substance abusers. In addition, we discuss the controversy surrounding sequential versus simultaneous treatment approaches for such 'dually-diagnosed' patients. We conclude by identifying gaps in current knowledge about the nature and impact of PTSD on substance abuse treatment outcome and outlining needs for future research.",0 +https://doi.org/10.1007/s11126-009-9096-4,The Link Between Post-traumatic Stress Disorder and Physical Comorbidities: A Systematic Review,"Context: Returning veterans from Afghanistan and Iraq will increase frequency of post-traumatic stress disorder (PTSD). Little is known about its impact on physical health. Objective: Systematic literature review focusing on the association between PTSD and specific physical disorders. Data Sources: An electronic search using PUBMED and hand search of four journals with an anxiety focus for studies published between January 1981 and July 2008, plus a manual search of article bibliographies. Study Selection: Original research reports focusing on PTSD and its association with physical health. Studies investigating only PTSD symptoms, trauma and physical disorders classified at the organ-system level were excluded. Eighty studies were reviewed and seven selected for final analysis. Data Extraction Specific physical-health diagnoses were organized by system and tabulated. They were considered positive only if results were statistically significant. Total number of positive and negative studies for each diagnosis was then calculated for review. Results: Seven studies examined the relationship between PTSD and specific physical disorders. Arthritis was associated with PTSD in most studies. Data conflicted regarding diabetes, coronary heart disease, and stroke. Conclusions: Few studies have examined the relationship between PTSD and physical health. Large, prospective epidemiological trials are needed. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1002/jts.21816,A Prospective Study on the Association Between Caregiver Psychological Symptomatology and Symptom Clusters of Pediatric Posttraumatic Stress Disorder,"This study investigated the influence of caregiver psychological symptoms on posttraumatic stress disorder (PTSD) symptoms in traumatized children. One-hundred eleven children and caretakers were assessed in this study. Children (N = 59) with a history of exposure to interpersonal violence were evaluated for reexperiencing, avoidance/numbing, and hyperarousal symptom clusters using the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA). The 52 primary caregivers were evaluated using the Symptom Checklist-90-Revised (SCL-90-R) on 9 domains of psychological symptomatology: anxiety, depression, hostility, interpersonal sensitivity, obsessive-compulsive disorder, paranoid ideation, phobic anxiety, psychoticism, and somatization. At 14-month follow-up, 45 of the children were re-evaluated with the CAPS-CA. Caregiver psychological symptoms in the domains of anxiety, depression, interpersonal sensitivity, obsessive-compulsive disorder, and paranoid ideation were associated with less improvement in total pediatric PTSD symptoms. Analysis of PTSD symptoms by cluster showed that greater caregiver symptomatology in the domains of anxiety, depression, interpersonal sensitivity, and obsessive-compulsive disorder were associated with less improvement in the hyperarousal symptom cluster. These results suggest caregiver symptomatology may be specifically associated with hyperarousal symptoms in pediatric trauma.",0 +https://doi.org/10.1080/10911359.2014.983257,Women Reentering the Community: Understanding Addiction and Trauma-Related Characteristics of Recidivism,"Women represent 26% of those arrested for serious crimes; many have posttraumatic stress and co-occurring substance use disorders, which may influence recidivism. This study examined 57 women residing in a community re-entry program after exiting prison. Participants completed the Trauma Symptom Inventory and Substance Abuse Subtle Screening Inventory. A discriminant function analysis accounted for 34% of between-group variability and provided a profile of women who recidivated. Women who recidivated had greater alcohol dependence and lower rates of sexual dysfunction and sexual concerns. Practitioners should consider potential links between substance abuse, trauma, and sexual behavior in treatment settings.",0 +https://doi.org/10.1016/0006-3223(95)00310-x,Serum triiodothyronine elevation in Israeli combat veterans with posttraumatic stress disorder: A cross-cultural study,"This study examines the thyroid hormonal profile in Israeli combat veterans with posttraumatic stress disorder (PTSD) and compares it with the previously reported profile in American Vietnam combat veterans with PTSD. Eleven male combat veterans with PTSD were compared with 11 normal subjects. Thyroid junction was evaluated by the measurement of serum total triiodothyronine (TT3), free triiodothyronine (FT3), total thyroxine (TT4), free thyroxine (FT4), thyroxine-binding globulin (TBG), and thyroid-stimulating hormone (TSH). The mean total T3 level in the Israeli PTSD patients (160.5 ng/dL) was significantly elevated (t = 2.53, p < .02) above that of the comparison group (135.5 ng/dL). Total T3 mean levels were not significantly different between the Israeli PTSD group and two American PTSD groups, but all three PTSD groups had significantly higher total T3 levels than both Israeli and American comparison groups. This preliminary study indicates that T3 elevation in combat-related PTSD may extend across cultures and suggests that further comparison of Israeli and American PTSD and normal groups may be useful in evaluating the significance and implications of the unusual alterations in the thyroid system in PTSD.",0 +https://doi.org/10.1016/s0005-7967(99)00123-0,A cognitive model of posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) is a common reaction to traumatic events. Many people recover in the ensuing months, but in a significant subgroup the symptoms persist, often for years. A cognitive model of persistence of PTSD is proposed. It is suggested that PTSD becomes persistent when individuals process the trauma in a way that leads to a sense of serious, current threat. The sense of threat arises as a consequence of: (1) excessively negative appraisals of the trauma and/or its sequelae and (2) a disturbance of autobiographical memory characterised by poor elaboration and contextualization, strong associative memory and strong perceptual priming. Change in the negative appraisals and the trauma memory are prevented by a series of problematic behavioural and cognitive strategies. The model is consistent with the main clinical features of PTSD, helps explain several apparently puzzling phenomena and provides a framework for treatment by identifying three key targets for change. Recent studies have provided preliminary support for several aspects of the model.",0 +https://doi.org/10.1177/0004867413484367,Post-traumatic stress disorder symptoms form a traumatic and non-traumatic stress response dimension,"Objective: This study aims to determine whether symptoms of post-traumatic stress disorder (PTSD) form a latent dimension reflecting responsivity to life events and whether PTSD symptoms are specific to traumatic life events. Method: A 30-year longitudinal study of a general population sample of 987 individuals were assessed for PTSD symptoms, exposure to adverse life events, and a variety of psychosocial measures. PTSD symptoms were tested using a confirmatory factor model and a range of fitted models were used to identify significant predictors of latent PTSD symptoms. Results: The rate of DSM IV PTSD was 1.9%. However, subjects reported high rates of at least one significant traumatic or negative life event and PTSD symptoms. The PTSD symptoms conformed well to a single latent factor. There were strong linear associations between severity of PTSD symptoms and exposure to traumatic and non-traumatic life events. Factors contributing to latent PTSD symptoms were gender, childhood anxiety, neuroticism, self-esteem, and quality of parental care. Conclusion: Criteria for PTSD form an underlying dimension reflecting the individual’s level of responsivity to traumatic and non-traumatic stressful life events. PTSD symptoms form a continuum of severity with minor stress symptoms at one end and severe PTSD at the other.",0 +https://doi.org/10.1023/a:1023756326443,Time does not heal all wounds: Quality of life and psychological distress of people who survived the Holocaust as children 55 years later,"The present study assessed posttraumatic stress disorder (PTSD) symptoms, psychological distress, and subjective quality of life (QoL) in a group of 43 child Holocaust survivors and a community sample of 44 persons who had not personally experienced the Holocaust. The participants were administered the PTSD-Scale, the SCL-90, and the WHOQOL-Bref. Results showed that the child survivors had higher PTSD symptom scores, higher depression, anxiety, somatization, and anger-hostility scores; and lower physical, psychological, and social QoL than did the comparison group. The findings suggest that the psychological consequences of being a child during the Holocaust can be long lasting.",0 +https://doi.org/10.1111/j.1533-2500.2010.00395.x,In Search of an Effective Treatment for Combat-Related Post-Traumatic Stress Disorder (PTSD): Can the Stellate Ganglion Block Be the Answer?,"Notes that post-traumatic stress disorder (PTSD) is a common and intractable condition associated with severe stress and trauma. PTSD has been difficult to treat with conventional methods. A glimmer of hope for this condition may be found in the use of stellate ganglion block (SGB), a technique traditionally used for the treatment of chronic pain-anesthetic blockade of a sympathetic ganglion administered at C7. In this edition of Pain Practice, S. W. Mulvaney et al. (see record 2010-14345-013) describe a significant resolution of PTSD symptoms using SGB in a pilot study of Operation Iraqi Freedom veterans, leading to a subsequent complete weaning of the patients off their psychiatric drugs. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0 +https://doi.org/10.1016/j.jpsychires.2014.09.006,Frequency of trauma exposure and Post-Traumatic Stress Disorder in Italy: analysis from the World Mental Health Survey Initiative,"Epidemiological studies have examined the relative importance of Traumatic Events (TEs) in accounting for the societal burden of post-traumatic stress disorder (PTSD). However, most studies used the worst trauma experienced, which can lead to an overestimation of the conditional risk of PTSD. Although a number of epidemiological surveys on PTSD have been carried out in the United States, only a few studies in limited sample have been conducted in Italy. This study, carried out in the framework of the World Mental Health Survey Initiative, is a cross-sectional household survey of a representative sample of the Italian adult population. Lifetime prevalence of TEs and 12-month prevalence of PTSD were evaluated using the Composite International Diagnostic Interview (CIDI). Reports of PTSD associated with randomly selected TEs were weighted by the individual-level probabilities of TE selection to generate estimates of population-level PTSD risk associated with each TE. Network events was the most commonly reported class of TEs (29.4%). War events had the highest conditional risk of PTSD (12.2%). The TEs that contributed most to societal PTSD burden were unexpected death of a loved one (24.1%) and having seen atrocities (18.2%). Being female was related to high risk of PTSD after experiencing a TE. Exposure to network events is commonly reported among Italian adults, but two TEs are responsible for the highest burden associated with PTSD: the unexpected death of someone close and sexual assault. These results can help designing public health interventions to reduce the societal PTSD burden. • Prevalence of exposure to at least one lifetime traumatic event was 56.1%. • The TE contributing most to PTSD burden was unexpected death of a loved one. • Being female was related to high risk of PTSD after experiencing a TE.",0 +https://doi.org/10.1093/acprof:oso/9780195182910.003.0015,"The Roles of Love, Attachment, and Altruism in the Adjustment to Military Trauma","Abstract This chapter summarizes research on the associations among love in the form of a secure adult attachment, posttraumatic stress disorder (PTSD), and altruism. The chapter is organized into five sections. The first section briefly reviews PTSD and its symptom clusters. The second section provides an overview of attachment theory and explores evidence that early childhood attachment patterns endure as adult attachment styles. The third section efforts to link attachment theory to the concept of adult love. The fourth section explores the relationship between attachment styles and the development of PTSD in those exposed to trauma, suggesting that love and secure attachment may protect against PTSD or ameliorate its course. The final section introduces altruistic intent into the adult attachment equation and examines the relationships among altruism, loving attachments, and PTSD.",0 +https://doi.org/10.1016/j.yebeh.2013.07.012,Psychiatric disorders in patients with psychogenic nonepileptic seizures and drug-resistant epilepsy: A study of an Argentine population,"Epidemiological data show that up to 20-30% of patients with psychogenic nonepileptic seizures (PNESs), resembling drug-resistant epilepsy (DRE), are referred to tertiary epilepsy centers. Furthermore, both disorders present high psychiatric comorbidity, and video-EEG is the gold standard to make differential diagnoses. In this study, we described and compared the clinical presentation and the frequency of psychiatric disorders codified in DSM IV in two groups of patients, one with PNESs and the other with DRE, admitted in a tertiary care epilepsy center of Buenos Aires, Argentina. We included 35 patients with PNESs and 49 with DRE; all were admitted in the video-EEG unit in order to confirm an epilepsy diagnosis and determine surgical treatment possibilities. All patients underwent a neurological and psychiatric assessment, according to standardized protocol (SCID I and II; DSM IV criteria). Student's t test was performed to compare continuous variables and Chi square test to compare qualitative variables. In this study, 33 (67%) patients with DRE and 35 (100%) patients with PNESs met criteria for at least one disorder codified in Axis I of DSM IV (p=0.003). Differences in the frequency of psychiatric disorder presentation were found between groups. Anxiety disorders (16.32% vs 40%; p=0.015), trauma history (24.5% vs 48.57%; p=0.02), posttraumatic stress disorder (4.08% vs 22.85%; p=0.009), and personality cluster B disorders (18.37% vs 42.86%; p=0.02) were more frequent in the group with PNESs. Psychotic disorders were more frequent in the group with DRE (20.4% vs 2.85%; p=0.019). Depression was equally prevalent in both groups. Standardized psychiatric assessment provides information that could be used by the mental health professional who receives the referral in order to improve quality of care and smooth transitions to proper PNES treatment, which should include a multidisciplinary approach including neurology and psychiatry.",0 +https://doi.org/10.1176/ajp.149.3.328,Dissociation and posttraumatic stress disorder in Vietnam combat veterans,"This study compared current dissociative symptoms and dissociation at the time of specific traumatic events in Vietnam combat veterans with posttraumatic stress disorder (PTSD) and Vietnam combat veterans without PTSD.Vietnam combat veterans who sought treatment for PTSD (N = 53) were compared to Vietnam combat veterans without PTSD (N = 32) who sought treatment for medical problems. Dissociative symptoms were evaluated with the Dissociative Experiences Scale. Dissociation at the time of a combat-related traumatic event was evaluated retrospectively with the modified Dissociative Experiences Questionnaire. The Combat Exposure Scale was used to measure level of combat exposure.There was a significantly higher level of dissociative symptoms, as measured by the Dissociative Experiences Scale, in patients with PTSD (mean = 27.0, SD = 18.0) than in patients without PTSD (mean = 13.7, SD = 16.0). This difference persisted when the difference in level of combat exposure was controlled with analysis of covariance. PTSD patients also reported more dissociative symptoms at the time of combat trauma, as measured retrospectively by the Dissociative Experiences Questionnaire (mean = 11.5, SD = 1.6) than non-PTSD patients (mean = 1.8, SD = 2.1).Dissociative symptoms are an important element of the long-term psychopathological response to trauma.",0 +https://doi.org/10.1016/b978-0-08-045048-3.00013-0,PTSD and Associated Mental Health Consequences of Motor Vehicle Collisions,"The frequency with which motor vehicle collisions (MVCs) occur makes them one of the greatest causes of posttraumatic psychopathology. While the physical injury associated with severe MVC is the focus of highly sophisticated hospital care services, the psychological injury that often accompanies surviving severe MVC is mostly overlooked. This chapter establishes the prevalence of posttraumatic stress disorder (PTSD) and other forms of psychopathology that occur following MVCs, outlining the course of MVC-related traumatic stress symptoms, and describing the impact of traumatic stress symptoms on the quality of life and functional status of traumatized individuals. For an MVC to be considered potentially traumatic, it must involve actual or threatened injury. This point is important in interpreting the literature because the majority of studies that have examined the prevalence of psychopathology following MVC have used injury survivors. The pretrauma, peritrauma, and posttrauma factors that are considered most predictive of posttrauma psychopathology are also reviewed.",0 +https://doi.org/10.1037/a0021339,The Minnesota Multiphasic Personality Inventory–2 Restructured Form in National Guard soldiers screening positive for posttraumatic stress disorder and mild traumatic brain injury.,"The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2 RF) was administered to 251 National Guard soldiers who had recently returned from deployment to Iraq. Soldiers were also administered questionnaires to identify posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). On the basis of responses to the screening instruments, the National Guard soldiers who produced a valid MMPI-2 RF were classified into four groups: 21 soldiers who screened positive for PTSD only, 33 soldiers who screened positive for mTBI only, 9 soldiers who screened positive for both conditions, and 166 soldiers who did not screen positive for either condition. Results showed that the MMPI-2 RF was able to differentiate across the groups with the MMPI-2 RF specific problem scale Anxiety adding incrementally to MMPI-2 Restructured Clinical scales in predicting PTSD. Both MMPI-2 RC1 (Somatic Complaints) and MMPI-2 RF head pain complaints predicted mTBI screen but did not add incrementally to each other. Of note, all of the MMPI-2 RF validity scales associated with overreporting, including Symptom Validity-Revised (FBS-r), were not significantly elevated in the mTBI group. These findings support the use of the MMPI-2 RF in assessing PTSD in non-treatment-seeking veterans. This further suggests that a positive screen for mTBI alone is not associated with significant emotional disturbance.",0 +https://doi.org/10.1016/j.yebeh.2012.01.009,Emotion regulation profiles in psychogenic non-epileptic seizures,"

Abstract

Background

Psychogenic non-epileptic seizures (PNES) are frequently encountered in epilepsy referral centers, yet there is limited understanding of the emotion processing style in this psychiatrically heterogeneous population. Understanding profiles of emotion regulation in PNES will provide further evidence of the psychogenic nature of the disorder and will potentially inform psychotherapeutic interventions.

Methods

Fifty-five patients with PNES underwent a neuropsychiatric evaluation and completed self-report questionnaires that measured difficulties in emotion regulation, psychopathology severity and quality of life.

Results

Through the use of cluster analysis, two groups were identified; Cluster 1 represented a highly emotion dysregulated group while Cluster 2 represented a low emotion dysregulated group. Additional analyses revealed that each group significantly differed from normative data. Finally, Cluster 1 was significantly associated with several measures of psychiatric symptoms, higher rates of comorbid psychiatric diagnoses and impairment in quality of life.

Conclusions

These findings suggest that patients with PNES may be subject to high levels of emotion dysregulation, severe psychiatric symptomatology and impaired quality of life, or to low emotion dysregulation characterized by emotional unawareness or avoidance. These profiles clearly differ from normative data regarding emotion regulation and their identification may help tailor psychotherapeutic interventions.",0 +https://doi.org/10.1016/j.jad.2009.02.029,Posttraumatic stress disorder after childbirth: Analysis of symptom presentation and sampling,"There is converging evidence that approximately 2% of women fulfill PTSD criteria following childbirth. This study examined the presentation and symptom structure of PTSD after birth and key risk factors in women from internet and community samples. PTSD was measured in 1423 women after birth recruited via the community ( n = 502) or internet ( n = 921). Demographic, obstetric, and trauma history variables were also measured. Full PTSD diagnostic criteria were endorsed by 2.5% of women from the community and 21% of women on the internet. Many more endorsed individual PTSD symptom criteria, suggesting this might be inflated by postnatal factors. Samples differed on demographic and obstetric characteristics. Factor analysis found two PTSD symptom clusters of re-experiencing and avoidance (RA) and numbing and arousal (NA). PTSD cases were predicted by parity, delivery type, NA and RA symptoms, and the interaction between sexual trauma and delivery type. This correctly identified 60% of PTSD cases. Questionnaire measurement of PTSD means prevalence rates may be over-estimated. Differences between samples suggest that internet samples over represent symptomatic women. Results emphasise the importance of measuring full diagnostic criteria in postnatal samples, as reports of symptoms may be inflated. In addition a few risk factors are identified that could be used to screen for women at risk.",0 +https://doi.org/10.1007/s10566-013-9206-1,Children’s Postdisaster Trajectories of PTS Symptoms: Predicting Chronic Distress,"There are no studies of the distinct trajectories of children's psychological distress over the first year after a destructive natural disaster and the determinants of these trajectories.We examined these issues using an existing dataset of children exposed to Hurricane Andrew, one of the most devastating natural disasters in US history.At 3-months postdisaster, 568 children (55 % girls; grades 3-5) residing in areas most directly affected by the hurricane completed measures of hurricane exposure and stressors, social support, coping, and general anxiety. Children also reported major life events occurring since the hurricane (at 7-months) and posttraumatic stress (PTS) symptoms at 3-, 7-, and 10-months postdisaster.Latent growth mixture modeling identified three trajectories of PTS reactions: resilient (37 %), recovering (43 %), and chronic distress (20 %). Predictors of the trajectories were examined. Odds ratios indicated that, compared to the resilient trajectory, girls were more likely to be in the recovering and chronically distressed trajectories, as were children reporting higher anxiety and greater use of coping strategies that reflected poor emotion regulation. Compared to the recovering trajectory, children in the chronically distressed trajectory had greater odds of reporting high anxiety, less social support, more intervening life events, and greater use of poor emotion regulation strategies.Hurricane exposure may be less effective in identifying children who develop chronic postdisaster distress than other child (anxiety, coping) and contextual variables (social support, life events). Effective screening after disasters is critical for identifying youth most in need of limited clinical resources.",1 +https://doi.org/10.1586/14737175.6.3.269,Treatment of anxiety disorders with venlafaxine XR,"When venlafaxine was introduced in 1994, it was the first of the newer generation antidepressants to be classified as a serotonin norepinephrine reuptake inhibitor (SNRI). An extended release (XR) formulation of venlafaxine, introduced in 1997, subsequently received regulatory approval for treatment of three anxiety disorders: generalized anxiety disorder, social anxiety disorder and panic disorder. Although less extensively studied, venlafaxine XR also appears to have efficacy for two other anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder. In contrast to the treatment of depression, for which meta-analyses suggest an efficacy advantage relative to selective serotonin reuptake inhibitors (SSRIs), evidence of differential efficacy has not yet been established for any of the anxiety disorders. The overall tolerability profile of venlafaxine XR is generally comparable to that of the SSRIs, although there is greater incidence of noradrenergically mediated side effects (i.e., dry mouth and constipation), as well as a dose-dependent risk of treatment-emergent high blood pressure. Concerns about safety in overdose have also recently emerged. Despite these caveats, venlafaxine XR is an effective and generally well-tolerated option for treatment of anxiety disorders.",0 +https://doi.org/10.1016/j.biopsycho.2010.08.001,Disorder specificity despite comorbidity: Resting EEG alpha asymmetry in major depressive disorder and post-traumatic stress disorder,"The approach-withdrawal and valence-arousal models highlight that specific brain laterality profiles may distinguish depression and anxiety. However, studies remain to be conducted in multiple clinical populations that directly test the diagnostic specificity of these hypotheses. The current study compared electroencephalographic data under resting state, eyes closed conditions in patients with major depressive disorder (MDD) (N=15) and post-traumatic stress disorder (PTSD) (N=14) relative to healthy controls (N=15) to examine the specificity of brain laterality in these disorders. Key findings included (1) reduced left-frontal activity in MDD, (2) a positive correlation between PTSD severity and right-frontal lateralisation, (3) greater activity in PTSD patients relative to MDD within the right-parietotemporal region, and (4) globally increased alpha power in MDD. Findings partially support the diagnostic applicability of the theoretical frameworks. Future studies may benefit from examining task-driven differences between groups.",0 +https://doi.org/10.1097/iae.0b013e31825d7ea4,DIAGNOSIS OF POSTTRAUMATIC STRESS DISORDER AFTER SURGERY FOR PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT,"To investigate the prevalence of posttraumatic stress disorder (PTSD) in patients who underwent surgery for primary rhegmatogenous retinal detachment and to explore variables associated with the disorder.Subjects eligible for the study were patients aged 18 years or older, who underwent surgery for primary rhegmatogenous retinal detachment at the Goldschleger Eye Institute, from January 1, 2004, to December 31, 2009, and were followed for at least 1 month. Study patients were screened for the existence of PTSD symptoms via a telephone survey, and positively identified patients were asked to undergo a structured psychiatric interview. Posttraumatic stress disorder was assessed by the Clinician Administered PTSD Scale, and the 25-item National Eye Institute visual function questionnaire (NEI-VFQ-25) was used as a measure of vision-related quality of life. Objective clinical measures were obtained from the patient's medical records. Clinical variables were compared between PTSD-diagnosed patients, patients who were screened for PTSD but were found to be PTSD negative in the interview (false-positive group), and patients who were found negative for PTSD in the screening survey.Of the 547 eligible patients, 366 were enrolled in the study. Nine patients (2.5%) met the criteria for PTSD diagnosis. Posttraumatic stress disorder patients reported significantly more traumatic events in their past (P = 0.015), and for these patients, NEI-VFQ-25 composite score was significantly lower (P < 0.001). Clinical measures were not found as independent risk factors for PTSD prediction.Posttraumatic stress disorder may develop in the aftermath of primary rhegmatogenous retinal detachment. Previous traumatic events and NEI-VFQ-25 scores were found as independent risk factors for PTSD prediction.",0 +https://doi.org/10.3382/ps.2011-02023,"Performance, egg quality, and immune response of laying hens fed diets supplemented with mannan-oligosaccharide or an essential oil mixture under moderate and hot environmental conditions","In total, 432 thirty-six-week-old laying hens were fed a basal diet supplemented with mannan-oligosaccharide (MOS) or an essential oil mixture (EOM) from 36 to 51 wk of age. Hens were divided into 3 equal groups replicated 6 times with 24 hens per replicate. No significant difference was observed among the dietary treatments in terms of performance indices. Different from the dietary manipulation, high environmental temperatures negatively influenced all of the laying performance traits except the feed conversion ratio in association with the diminished feed consumption. The MOS, and particularly the EOM, tended to alleviate the deleterious effect of heat stress on BW gain. Mortality was higher in MOS-fed hens than with other treatments. A supplementation diet with MOS or EOM provided increments in eggshell weight (P < 0.01). Relative albumen weight was significantly decreased (P < 0.05) in response to EOM or MOS supplementation; however, this was not the case in the yolk weight rate. The MOS decreased albumen height and Haugh unit (P < 0.05). High environmental temperatures hampered entire egg quality characteristics except for the eggshell breaking strength and egg yolk weight. These results indicated that heat stress adversely affected both productive performance and egg quality. As for the results of this study, neither MOS nor EOM was efficacious in improving efficiency of egg production and stimulating humoral immune response in laying hens reared under moderate and hot climatic conditions. However, the ameliorative effect exerted by MOS and EOM on eggshell characteristics is conclusive.",0 +https://doi.org/10.1001/archpsyc.1995.03950240066012,Posttraumatic Stress Disorder in the National Comorbidity Survey,"Data were obtained on the general population epidemiology of DSM-III-R posttraumatic stress disorder (PTSD), including information on estimated life-time prevalence, the kinds of traumas most often associated with PTSD, sociodemographic correlates, the comorbidity of PTSD with other lifetime psychiatric disorders, and the duration of an index episode.Modified versions of the DSM-III-R PTSD module from the Diagnostic Interview Schedule and of the Composite International Diagnostic Interview were administered to a representative national sample of 5877 persons aged 15 to 54 years in the part II subsample of the National Comorbidity Survey.The estimated lifetime prevalence of PTSD is 7.8%. Prevalence is elevated among women and the previously married. The traumas most commonly associated with PTSD are combat exposure and witnessing among men and rape and sexual molestation among women. Posttraumatic stress disorder is strongly comorbid with other lifetime DSM-III-R disorders. Survival analysis shows that more than one third of people with an index episode of PTSD fail to recover even after many years.Posttraumatic stress disorder is more prevalent than previously believed, and is often persistent. Progress in estimating age-at-onset distributions, cohort effects, and the conditional probabilities of PTSD from different types of trauma will require future epidemiologic studies to assess PTSD for all lifetime traumas rather than for only a small number of retrospectively reported ""most serious"" traumas.",0 +https://doi.org/10.1002/jts.20133,Alexithymia and PTSD symptoms in urban police officers: Cross-sectional and prospective findings,"The relationship of alexithymia to posttraumatic stress disorder (PTSD) symptomatology was examined cross-sectionally in 166 urban police officers surveyed between 1998 and 1999 and prospectively in 54 of these officers who participated in a follow-up survey after the September 11, 2001 (9/11) terrorist attacks. In cross-sectional analyses, alexithymia scores were positively associated with PTSD symptom levels and self-reported childhood emotional abuse--neglect, but not with cumulative level of critical incident exposure. Alexithymia scores accounted for 11.2% of the variance in PTSD symptoms prior to accounting for additional predictors, but did not retain significance in the final model. In prospective analyses, alexithymia scores significantly predicted 9/11-related PTSD symptom severity over and above pre-9/11 PTSD symptoms.",0 +https://doi.org/10.3109/00952990.2015.1058389,Brain cortical thickness in male adolescents with serious substance use and conduct problems,"Adolescents with substance use disorder (SUD) and conduct problems exhibit high levels of impulsivity and poor self-control. Limited work to date tests for brain cortical thickness differences in these youths.To investigate differences in cortical thickness between adolescents with substance use and conduct problems and controls.We recruited 25 male adolescents with SUD, and 19 male adolescent controls, and completed structural 3T magnetic resonance brain imaging. Using the surface-based morphometry software FreeSurfer, we completed region-of-interest (ROI) analyses for group cortical thickness differences in left, and separately right, inferior frontal gyrus (IFG), orbitofrontal cortex (OFC) and insula. Using FreeSurfer, we completed whole-cerebrum analyses of group differences in cortical thickness.Versus controls, the SUD group showed no cortical thickness differences in ROI analyses. Controlling for age and IQ, no regions with cortical thickness differences were found using whole-cerebrum analyses (though secondary analyses co-varying IQ and whole-cerebrum cortical thickness yielded a between-group cortical thickness difference in the left posterior cingulate/precuneus). Secondary findings showed that the SUD group, relative to controls, demonstrated significantly less right > left asymmetry in IFG, had weaker insular-to-whole-cerebrum cortical thickness correlations, and showed a positive association between conduct disorder symptom count and cortical thickness in a superior temporal gyrus cluster.Functional group differences may reflect a more nuanced cortical morphometric difference than ROI cortical thickness. Further investigation of morphometric differences is needed. If replicable findings can be established, they may aid in developing improved diagnostic or more targeted treatment approaches.",0 +https://doi.org/10.1176/ajp.142.11.1304,Symptom patterns associated with posttraumatic stress disorder among Vietnam veterans exposed to war trauma,"The authors tested whether the relationship between traumatic stress and posttraumatic stress disorder is captured more accurately by aggregating symptoms, as in DSM-III, or differentiating them into the subtypes of denial and reexperiencing. Their findings indicate that distinguishing between the responses of denial and reexperiencing is an alternative and potentially more useful approach for understanding posttraumatic stress disorder and its origins in war trauma than the comprehensive model proposed in DSM-III. The analysis suggests that biases in the current model of posttraumatic stress disorder may lead to underestimation of its prevalence. The authors conclude that reconsideration of what constitutes the disorder is warranted.",0 +https://doi.org/10.1016/j.drugalcdep.2013.04.030,Drug use disorders and post-traumatic stress disorder over 25 adult years: Role of psychopathology in relational networks,"In traumatized populations, drug use disorders and post-traumatic stress disorder (PTSD) persist for many years. Relational factors that mediate this persistence have rarely been systematically examined. Our aim is to examine the relative effects of psychopathology in familial and non-familial networks on the persistence of both disorders over adulthood.We utilized longitudinal data from an epidemiologically ascertained sample of male Vietnam veterans (n=642). Measures included DSM-IV drug use disorders, other psychiatric disorders, network problem history and time-varying marital and employment characteristics. Longitudinal measures of veterans' psychopathology and social functioning were retrospectively obtained for each year over a 25 year period. We used generalized estimating equations (GEE) to estimate the relative effects of network problems on veteran's drug use disorders and PTSD after adjusting for covariates.Veterans' mean age was 47 years in 1996. Prevalence of illicit drug disorders declined from 29.8% in 1972 to 8.3% in 1996, but PTSD remained at 11.7% from 13.2% in 1972. While 17.0% of veterans reported a familial drug use problem, 24.9% reported a non-familial drug use problem. In full GEE models, a non-familial drug problem was a significant predictor of illicit drug use disorders over 25 years (OR=2.21, CI=1.59-3.09), while both familial depression (OR=1.69, CI=1.07-2.68) and non-familial drinking problem (OR=1.66, CI=1.08-2.54) were significant predictors of PTSD over 25 years.Familial and non-familial problems in networks differentially affect the persistence of drug use disorders and PTSD in traumatized male adults.",0 +https://doi.org/10.1007/978-3-642-45375-5_12,Posttraumatic Stress Disorders and Addiction,"Disorders related to stress or trauma are common among patients with substance use disorders (SUD). In clinical samples of patients with SUD, the prevalence of lifetime Posttraumatic Stress Disorder (PTSD) ranges from 26 % to 52 %, and from 15 % to 41 % for current PTSD. A substantial number of these patients suffer from the consequences of severe and prolonged interpersonal trauma usually referred to as “Complex PTSD”. Another common consequence of repeated interpersonal trauma in childhood are dissociative symptoms that may or may not co-occur with PTSD in SUD patients. While several hypotheses can explain the relationships between SUD and PTSD, the self-medication hypothesis has the strongest empirical support. Patients with both disorder have a more severe clinical profile than SUD patients without PTSD, poorer adherence to treatment, a shorter duration of abstinence, and worse outcomes across a variety of measures. Their clinical needs often make a treatment approach necessary that integrates SUD specific and trauma specific interventions. Several trauma treatments focusing on the present (i.e. providing skills training and psycho-education) and, more recently, also past-focused (i.e. exposure-based) treatments have been evaluated in SUD patients with co-occurring PTSD. Some of them outperformed SUD treatment-as-usual on PTSD and/or substance use outcomes. Findings on the effects of medication in patients with SUD and co-occurring PTSD are scarce and remain inconclusive. © Springer-Verlag Berlin Heidelberg 2015.",0 +https://doi.org/10.1016/j.jsat.2010.07.010,Estimating statistical power for open-enrollment group treatment trials,"

Abstract

Modeling turnover in group membership has been identified as a key barrier contributing to a disconnect between the manner in which behavioral treatment is conducted (open-enrollment groups) and the designs of substance abuse treatment trials (closed-enrollment groups, individual therapy). Latent class pattern mixture models (LCPMMs) are emerging tools for modeling data from open-enrollment groups with membership turnover in recently proposed treatment trials. The current article illustrates an approach to conducting power analyses for open-enrollment designs based on the Monte Carlo simulation of LCPMM models using parameters derived from published data from a randomized controlled trial comparing Seeking Safety to a Community Care condition for women presenting with comorbid posttraumatic stress disorder and substance use disorders. The example addresses discrepancies between the analysis framework assumed in power analyses of many recently proposed open-enrollment trials and the proposed use of LCPMM for data analysis.",0 +https://doi.org/10.1111/j.2044-8260.1995.tb01475.x,An open trial of exposure therapy based on deconditioning for post-traumatic stress disorder,"Twenty-three patients who had experienced a major stressful event were given a debriefing session followed by eight weekly sessions of imaginal exposure and in vivo exposure. Patients recounted their traumatic experiences aloud, using the first person and the present tense, and included as much detail as possible. This account was audiotaped and patients were asked to listen to the tape between treatment sessions. There were reductions of 42 percent in the Impact of Events Scale (IES), of 61 percent in the General Health Questionnaire (GHQ), of 38 percent in the Symptom Checklist-90 (SCL-90) questionnaire, and of 35 percent in the Clinician Administered Post-Traumatic Stress scale (CAPS), all of which were statistically significant. The number of patients who satisfied the diagnostic criteria for post-traumatic stress disorder was halved.",0 +https://doi.org/10.1093/jpepsy/jsm057,"Brief Report: Pediatric Cancer, Parental Coping Style, and Risk for Depressive, Posttraumatic Stress, and Anxiety Symptoms","According to the stress and coping goodness of fit model, parents' risk for psychological symptoms was hypothesized to decrease as a function of using emotional regulation and problem appraisal strategies more frequently, and to increase as a function of using problem-solving and avoidant behaviors more frequently to cope with an uncontrollable stressor--pediatric cancer diagnosis.Parents (N = 150) completed measures of depression, PTSD, anxiety, and coping style.Regression analyses revealed that symptoms decreased as a function of using problem appraisal and an emotional regulation strategy (social support) more frequently; and increased as a function of using problem-solving strategies, avoidant coping (substance use), and another emotional regulation strategy (negative self-blame) more frequently.The findings provide some support for the model but suggest that the method of coping (e.g., social support) might be considered in addition to the focus of the coping strategy (e.g., emotional regulation).",0 +https://doi.org/10.1002/1097-4679(198503)41:2<152::aid-jclp2270410204>3.0.co;2-3,The MMPI and the post-traumatic stress syndrome in vietnam era veterans,"MMPI profiles of Post-traumatic Stress outpatient and newly admitted Random Psychiatric inpatient veterans are practically identical, which indicates the severity of delayed response to stress in Vietnam veterans, especially those from urban, disadvantaged environments.",0 +https://doi.org/10.1207/s15327752jpa5101_13,A Reevaluation of the Use of the MMPI in the Assessment of Combat-Related Posttraumatic Stress Disorder,"This study attempts to validate previously developed, empirically based Minnesota Multiphasic Personality Inventory (MMPI) decision rules (Keane, Malloy, & Fairbank, 1984) to aid in the diagnosis of combat-related posttraumatic stress disorder (PTSD). Four groups of 21 subjects each were identified: PTSD, psychotic, depressed, and chronic pain. A decision rule based on the standard clinical scales resulted in a correct classification rate (PTSD vs. non-PTSD) of 81% across the four-group sample. An empirically derived MMPI PTSD scale resulted in a correct classification rate of 77%. However, 43% of the PTSD subjects were incorrectly classified as non-PTSD by these rules. Independent, blind sorting of the 84 MMPI profiles by two doctoral-level clinical psychologists resulted in ""hit rates"" similar to the MMPI decision rules. The present results suggest that the previously derived, empirically based MMPI decision rules for PTSD do scarcely better than chance on correct classification of individuals with PTSD. We suggest that the differential diagnosis of PTSD is difficult because of the wide variety of symptoms in common with other diagnostic groups, and hence the variability of PTSD subjects on psychometric measures. We also suggest that the MMPI decision rules of Keane et al. (1984) may have utility in identifying subgroup(s) of combat-related PTSDs.",0 +https://doi.org/10.2147/ndt.s10389,Cognitive behavioral therapy for the treatment of post-traumatic stress disorder: a review,"Post-traumatic stress disorder (PTSD) is a psychiatric sequel to a stressful event or situation of an exceptionally threatening or catastrophic nature. Cognitive behavioral therapy (CBT) has been used in the management of PTSD for many years. This paper reviews the effectiveness of CBT for the treatment of PTSD following various types of trauma, its potential to prevent PTSD, methods used in CBT, and reflects on the mechanisms of action of CBT in PTSD.Electronic databases, including PubMed, were searched for articles on CBT and PTSD. Manual searches were conducted for cross-references in the relevant journal sites.The current literature reveals robust evidence that CBT is a safe and effective intervention for both acute and chronic PTSD following a range of traumatic experiences in adults, children, and adolescents. However, nonresponse to CBT by PTSD can be as high as 50%, contributed to by various factors, including comorbidity and the nature of the study population. CBT has been validated and used across many cultures, and has been used successfully by community therapists following brief training in individual and group settings. There has been effective use of Internet-based CBT in PTSD. CBT has been found to have a preventive role in some studies, but evidence for definitive recommendations is inadequate. The effect of CBT has been mediated mostly by the change in maladaptive cognitive distortions associated with PTSD. Many studies also report physiological, functional neuroimaging, and electroencephalographic changes correlating with response to CBT.There is scope for further research on implementation of CBT following major disasters, its preventive potential following various traumas, and the neuropsychological mechanisms of action.",0 +https://doi.org/10.2466/pr0.1998.82.2.387,Correlates of Battered Women's Psychological Distress: Severity of Abuse and Duration of the Postabuse Period,"Although psychological disturbances among abused women are well documented, it is unclear whether such disturbances are a reaction to the abusive experience. The present study hypothesized that, if the disturbances are a reactive state, the severity of disturbance would be related to the time since the relationship ended as well as the severity of the psychological and physical abuse experienced. Participants were 50 abused women who completed valid MMPI-2s and revised Conflict Tactic Scales. The results indicated that MMPI-2 scores were significantly correlated with both types of abuse but not with duration of time since the abusive relationship was terminated. The MMPI-2 profiles of abused women and suggestions for research are discussed.",0 +https://doi.org/10.1037/a0029085,Transition and change: Prospective effects of posttraumatic stress on smoking trajectories in the first year of college.,"College matriculation begins a period of transition that is marked by new freedoms and responsibilities and by increases in a variety of risky behaviors, including smoking. Trauma and posttraumatic stress disorder (PTSD) are well-established risk factors for smoking outcomes, and thus may be a point of intervention for college smoking. Yet, no studies have examined associations among trauma, PTSD, and smoking in college students. The present study provides such an examination.Matriculating student smokers (N = 346) completed surveys in September (T1) and at 5 subsequent time points (T2-T6) over their first year of college. With latent growth analysis, we modeled smoking trajectories conditioned on PTSD symptom status (i.e., No PTSD Symptoms vs. Partial PTSD vs. Full PTSD).Results showed that although smoking tended to decline during the first semester for all groups, significant risk for escalation in smoking during the second semester was conferred specifically by the presence of PTSD at matriculation.Interventions that offer support and resources to students entering college with PTSD may help to prevent smoking behaviors from escalating and may ultimately prevent the adoption of daily smoking in later adulthood.",0 +https://doi.org/10.1016/j.jad.2011.02.017,The effect of trauma onset and frequency on PTSD-associated symptoms,"Different trauma characteristics have been suggested to lead to distinct symptom profiles. This study investigates the effect of two trauma characteristics, age of onset and frequency, on PTSD symptom profiles.Trauma characteristics (childhood versus adulthood trauma and single versus multiple trauma), psychiatric diagnosis, PTSD severity, depressive symptoms, dissociation, guilt, shame, anger, and interpersonal sensitivity were assessed in 110 PTSD outpatients.Single versus multiple trauma and childhood versus adulthood trauma groups did not differ in depressive symptom and co-morbidity. Multiple trauma patients reported more dissociation, guilt, shame, and interpersonal sensitivity than those that experienced single trauma. Anger of multiple trauma patients was more often directed towards themselves, whereas anger in single trauma patients was more often directed towards others. Childhood trauma patients reported more dissociation and state anger than adulthood trauma patients. However, with the exception of multiple trauma patients having more dissociation and shame than those with single trauma, all differences disappeared after controlling for PTSD severity.This study is a first step in unraveling the impact of different trauma characteristics. Causal inferences are limited, though, because of the cross-sectional design.The results suggest that experiencing trauma at young age or multiple times may lead to different symptom profiles but these are, with the exception of dissociation and shame, dependent on PTSD severity. These results support the proposed DSM-V criteria in which these symptoms appear as part of the disorder, and stress the importance of early treatment.",0 +https://doi.org/10.1037/rep0000052,Resilience following spinal cord injury: A prospective controlled study investigating the influence of the provision of group cognitive behavior therapy during inpatient rehabilitation.,"To examine change in resilience in people with spinal cord injury (SCI) when group cognitive behavior therapy (GCBT) was added to routine psychosocial rehabilitation (RPR).A prospective repeated-measures cohort design was used to determine the efficacy of the addition of GCBT (n = 50). The control group consisted of individuals receiving RPR, which included access to individual CBT (ICBT) when required (n = 38). Groups were assessed on 3 occasions: soon after admission, within 2 weeks of discharge, and 6-months postdischarge. Measures included sociodemographic, injury, and psychosocial factors. The outcome variable was resilience, considered an important outcome measure for recovery. To adjust for baseline differences in self-efficacy, depressive mood and anxiety between the 2 groups, these factors were entered into a repeated measures multivariate analysis of covariance (MANCOVA) as covariates. Latent class analysis was used to determine the best-fitting model of resilience trajectories for both groups.The MANCOVA indicated that the addition of GCBT to psychosocial rehabilitation did not result in improved resilience compared with the ICBT group. Trajectory data indicated over 60% were demonstrating acceptable resilience irrespective of group.Changes in resilience mean scores suggest the addition of GCBT adds little to resilience outcomes. Latent class modeling indicated both groups experienced similar trajectories of improvement and deterioration. Results highlight the importance of conducting multivariate modeling analysis that isolates subgroups of related cases over time to understand complex trajectories. Further research is needed to clarify individual differences in CBT intervention preference as well as other factors which impact on resilience.",0 +https://doi.org/10.1186/1476-069x-12-115,Measuring psychological resilience to disasters: are evidence-based indicators an achievable goal?,"Despite rising interest on the concept of societal resilience and its measurement, little has been done to provide operational indicators. Importantly, an evidence-based approach to assess the suitability of indicators remains unexplored. Furthermore few approaches that exist do not investigate indicators of psychological resilience, which is emerging as an important component of societal resilience to disasters. Disasters are events which overwhelm local capacities, often producing human losses, injury and damage to the affected communities. As climate hazards and disasters are likely to increase in the coming decades, strengthening the capacity of societies to withstand these shocks and recover quickly is vital. In this review, we search the Web of Knowledge to summarize the evidence on indicators of psychological resilience to disasters and provided a qualitative assessment of six selected studies. We find that an evidence-based approach using features from systematic reviews is useful to compile, select and assess the evidence and elucidate robust indicators. We conclude that strong social support received after a disaster is associated with an increased psychological resilience whereas a female gender is connected with a decrease in the likelihood of a resilient outcome. These results are consistent across disaster settings and cultures and are representative of approximately 13 million disaster-exposed civilians of adult age. An approach such as this that collects and evaluates evidence will allow indicators of resilience to be much more revealing and useful in the future. They will provide a robust basis to prioritize indicators to act upon through intersectoral policies and post-disaster public health interventions.",0 +https://doi.org/10.7205/milmed.171.6.562,"Health Care Utilization by United Nations Peacekeeping Veterans with Co-occurring, Self-Reported, Post-Traumatic Stress Disorder and Depression Symptoms versus Those Without","It remains to be determined whether patients with comorbid post-traumatic stress disorder (PTSD) and depression use more health care resources than do those without. United Nations peacekeeping veterans from Canada were divided into four groups, i.e., PTSD alone (n = 23), depression alone (n = 167), comorbid PTSD and depression (n = 119), and neither (n = 164), and compared with respect to total number of visits to any health care professional in the past year. Analysis of variance revealed that the groups significantly differed in total visits. Post hoc analyses indicated that veterans with co-occurring PTSD and depression symptoms had more visits than did those in the other groups and that veterans with PTSD symptoms alone and depression symptoms alone had more visits than did those with neither PTSD nor depression. Additional analyses revealed that veterans with co-occurring PTSD and depression symptoms made more visits to general practitioners, specialists, pharmacists, and mental health professionals than did the others. Future research directions and implications for treatment planning are discussed.",0 +https://doi.org/10.1037/tra0000063,Risk factors for DSM–5 posttraumatic stress symptoms (PTSS) among Israeli civilians during the 2014 Israel-Hamas war.,"In light of current modifications in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria for posttraumatic stress disorder (PTSD), this study aimed to revalidate well-known PTSD risk factors related to terrorism and war in Israel, namely, proximity to the Gaza Strip, dissociative symptoms, acute stress disorder (ASD) symptoms, and social support. One hundred and sixty Israeli civilians were assessed during the 2014 Israel-Hamas war at 2 time points: 1 week after the beginning of the operation (t1) and 1 month after initial evaluation (t2), using the DSM-5 PTSD Symptom Levels Scale (PSLS; Gil, Weinberg, Or-Chen, & Harel, 2015). A paired t test analysis showed significant reduction in the respondents' posttraumatic stress symptoms (PTSS) 1 month after the initial assessment point. A structural equation model (SEM) showed that higher ASD symptoms at t1 and higher dissociative symptoms at t2 increased the risk for PTSS at t2. Conversely, higher peritraumatic dissociation at t1 decreased the risk for PTSS at t2. Proximity to the Gaza Strip, and social support, failed to demonstrate significant association with PTSS at t2. DSM-5 PTSS 1 month after prolonged traumatic exposure are strongly associated with high ASD symptoms at 1 week as a risk factor; high levels of peritraumatic dissociation at 1 week as a protective factor; and high levels of dissociative symptoms at 1 month as a risk factor. Theoretically and clinically the findings of the study further suggest that ongoing massive terrorism and war cannot be viewed or treated as identical to other traumas.",0 +https://doi.org/10.1891/0886-6708.09-135,Risk Factors for Posttraumatic Stress Disorder in Female Help-Seeking Victims of Sexual Assault,"Posttraumatic stress disorder (PTSD) is common in the aftermath of rape and other sexual assault, but the risk factors leading to PTSD following rape have been shown to differ from those related to PTSD following nonsexual assault. This prospective study examined risk factors for PTSD severity in 148 female help-seeking victims of sexual assault. Approximately 70% of the victims experienced significant levels of traumatization, with 45% reporting symptoms consistent with a probable PTSD diagnosis. Regression analyses showed that relationship with the assailant, number of assailants, the nature of the assault, perceived positive social support, support satisfaction, feeling let down by others, and prior exposure to sexual trauma did not significantly predict PTSD severity at the final level of analysis. In accordance with suggestions by Dancu, Riggs, Hearst-Ikeda, and Shoyer (1996), it is suggested that this is partly caused by a very high degree of traumatization in the sample. Instead, previous nonsexual traumatic experiences and negative affectivity accounted for 30% of the variance in PTSD severity. Although more research is needed on risk factors of assault-related PTSD, these findings suggest that although sexual assault is associated with a high degree of PTSD severity, prior nonsexual victimization and high levels of negative affectivity appear to further increase the vulnerability toward developing symptoms of assault-related PTSD. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0 +https://doi.org/10.1037/a0013730,Contrasting models of posttraumatic stress disorder: Reply to Monroe and Mineka (2008).,"We address the four main points in Monroe and Mineka (2008)'s Comment. First, we first show that the DSM PTSD diagnosis includes an etiology and that it is based on a theoretical model with a distinguished history in psychology and psychiatry. Two tenets of this theoretical model are that voluntary (strategic) recollections of the trauma are fragmented and incomplete while involuntary (spontaneous) recollections are vivid and persistent and yield privileged access to traumatic material. Second, we describe differences between our model and other cognitive models of PTSD. We argue that these other models share the same two tenets as the diagnosis and we show that these two tenets are largely unsupported by empirical evidence. Third, we counter arguments about the strength of the evidence favoring the mnemonic model, and fourth, we show that concerns about the causal role of memory in PTSD are based on views of causality that are generally inappropriate for the explanation of PTSD in the social and biological sciences.",0 +https://doi.org/10.1002/ajim.22446,Chronic probable ptsd in police responders in the world trade center health registry ten to eleven years after 9/11,"Background Police enrolled in the World Trade Center Health Registry (WTCHR) demonstrated increased probable posttraumatic stress disorder (PTSD) after the terrorist attack of 9/11/2001. Methods Police enrollees without pre-9/11 PTSD were studied. Probable PTSD was assessed by Posttraumatic Stress Check List (PCL). Risk factors for chronic, new onset or resolved PTSD were assessed using multinomial logistic regression. Results Half of police with probable PTSD in 2003-2007 continued to have probable PTSD in 2011–2012. Women had higher prevalence of PTSD than men (15.5% vs. 10.3%, P = 0.008). Risk factors for chronic PTSD included decreased social support, unemployment, 2+ life stressors in last 12 months, 2+ life-threatening events since 9/11, 2+ injuries during the 9/11 attacks, and unmet mental health needs. Conclusion Police responders to the WTC attacks continue to bear a high mental health burden. Improved early access to mental health treatment for police exposed to disasters may be needed. Am. J. Ind. Med. 58:483–493, 2015. © 2015 Wiley Periodicals, Inc.",0 +https://doi.org/10.1016/j.psyneuen.2014.10.017,Genomic predictors of combat stress vulnerability and resilience in U.S. Marines: A genome-wide association study across multiple ancestries implicates PRTFDC1 as a potential PTSD gene,"Research on the etiology of post-traumatic stress disorder (PTSD) has rapidly matured, moving from candidate gene studies to interrogation of the entire human genome in genome-wide association studies (GWAS). Here we present the results of a GWAS performed on samples from combat-exposed U.S. Marines and Sailors from the Marine Resiliency Study (MRS) scheduled for deployment to Iraq and/or Afghanistan. The MRS is a large, prospective study with longitudinal follow-up designed to identify risk and resiliency factors for combat-induced stress-related symptoms. Previously implicated PTSD risk loci from the literature and polygenic risk scores across psychiatric disorders were also evaluated in the MRS cohort.Participants (N=3494) were assessed using the Clinician-Administered PTSD Scale and diagnosed using the DSM-IV diagnostic criterion. Subjects with partial and/or full PTSD diagnosis were called cases, all other subjects were designated controls, and study-wide maximum CAPS scores were used for longitudinal assessments. Genomic DNA was genotyped on the Illumina HumanOmniExpressExome array. Individual genetic ancestry was determined by supervised cluster analysis for subjects of European, African, Hispanic/Native American, and other descent. To test for association of SNPs with PTSD, logistic regressions were performed within each ancestry group and results were combined in meta-analyses. Measures of childhood and adult trauma were included to test for gene-by-environment (GxE) interactions. Polygenic risk scores from the Psychiatric Genomic Consortium were used for major depressive disorder (MDD), bipolar disorder (BPD), and schizophrenia (SCZ).The array produced >800K directly genotyped and >21M imputed markers in 3494 unrelated, trauma-exposed males, of which 940 were diagnosed with partial or full PTSD. The GWAS meta-analysis identified the phosphoribosyl transferase domain containing 1 gene (PRTFDC1) as a genome-wide significant PTSD locus (rs6482463; OR=1.47, SE=0.06, p=2.04×10(-9)), with a similar effect across ancestry groups. Association of PRTFDC1 with PTSD in an independent military cohort showed some evidence for replication. Loci with suggestive evidence of association (n=25 genes, p<5×10(-6)) further implicated genes related to immune response and the ubiquitin system, but these findings remain to be replicated in larger GWASs. A replication analysis of 25 putative PTSD genes from the literature found nominally significant SNPs for the majority of these genes, but associations did not remain significant after correction for multiple comparison. A cross-disorder analysis of polygenic risk scores from GWASs of BPD, MDD, and SCZ found that PTSD diagnosis was associated with risk sores of BPD, but not with MDD or SCZ.This first multi-ethnic/racial GWAS of PTSD highlights the potential to increase power through meta-analyses across ancestry groups. We found evidence for PRTFDC1 as a potential novel PTSD gene, a finding that awaits further replication. Our findings indicate that the genetic architecture of PTSD may be determined by many SNPs with small effects, and overlap with other neuropsychiatric disorders, consistent with current findings from large GWAS of other psychiatric disorders.",0 +https://doi.org/10.1016/j.pain.2011.01.056,Similar factors predict disability and posttraumatic stress disorder trajectories after whiplash injury,"Distinct developmental trajectories for neck disability and posttraumatic stress disorder (PTSD) symptoms after whiplash injury have recently been identified. This study aimed to identify baseline predictors of membership to these trajectories and to explore their dual development. In a prospective study, 155 individuals with whiplash were assessed at or = 13° C (OR = 26.320, 95% CI = 4.981-139.09), initial pain level (VAS) (OR = 4.3, 95% CI = 4.98-139.1), and age (OR = 1.109, 95% CI = 1.043-1.180) predicted a chronic/severe disability trajectory. The same baseline factors also predicted chronic moderate/severe PTSD (CPT > or = 13° C, OR = 9.7, 95% CI = 2.22-42.44; initial pain level [VAS]: OR = 2.13, 95% CI = 1.43-3.17; age: OR = 1.07, 95% CI = 1.01-1.14). There was good correspondence of trajectory group for both disability and PTSD. These findings support the proposal of links between the development of chronic neck related disability and PTSD after whiplash injury. Developmental trajectories of disability and posttraumatic stress disorder (PTSD) after whiplash injury are mostly in synchrony, and similar factors predict their membership. This suggests links between the development of chronic neck pain-related disability and PTSD.",0 +https://doi.org/10.2147/ijwh.s51988,Cultural protection against traumatic stress: traditional support of children exposed to the ritual of female genital cutting,"This study explores the factors addressed in folk psychology in The Gambia for protecting the girl-child from the potential traumatic stress of female genital cutting (FGC). The type and quality of the psychological care was analyzed and compared with research on traumatic stress and principles for crisis and trauma intervention. Thirty-three qualitative indepth interviews were conducted with mothers who had supervised their daughters' FGC, women who had been circumcised, and professional circumcisers. The findings indicate that the girls have largely managed to handle the potentially traumatic event of FGC. The event is placed in a meaningful system of understanding, and the stress is dealt with in a traditional way that to a great extent follows empirically-based and evidence-based principles of crisis intervention. However, the approach tends to be culturally encoded, based on the local cultural belief system. This puts circumcised individuals in a potentially vulnerable position if they are living outside the homeland's supportive cultural context, with consequences for psychological and culturally competent FGC health care in exile.",0 +https://doi.org/10.1097/yco.0b013e3282f0ffd9,Clinical challenges in the treatment of patients with posttraumatic stress disorder and substance abuse,"The aim of this article is to review the current literature on co-occuring posttraumatic stress disorder and substance-use disorder, with an emphasis on clinical aspects and emerging treatments.In clinical populations (focusing on either disorder), about 25-50% have a lifetime dual diagnosis of posttraumatic stress disorder and substance-use disorder. Patients with both disorders have a more severe clinical profile than those with either disorder alone, lower functioning, poorer well being, and worse outcomes across a variety of measures. In recent years, several promising treatment programs have been developed specifically for co-occuring posttraumatic stress disorder and substance-use disorder, with one model having been established as effective thus far.Comorbid posttraumatic stress disorder/substance-use disorder is a frequent diagnosis in clinical populations that severely affects course and outcome. Treatment approaches appropriate for this vulnerable population need to be evaluated further and implemented in routine practice.",0 +https://doi.org/10.1001/archgenpsychiatry.2011.127,Prevention of Posttraumatic Stress Disorder by Early Treatment,"Preventing posttraumatic stress disorder (PTSD) is a pressing public health need.To compare early and delayed exposure-based, cognitive, and pharmacological interventions for preventing PTSD.Equipoise-stratified randomized controlled study.Hadassah Hospital unselectively receives trauma survivors from Jerusalem and vicinity.Consecutively admitted survivors of traumatic events were assessed by use of structured telephone interviews a mean (SD) 9.61 (3.91) days after the traumatic event. Survivors with symptoms of acute stress disorder were referred for clinical assessment. Survivors who met PTSD symptom criteria during the clinical assessment were invited to receive treatment.Twelve weekly sessions of prolonged exposure (PE; n = 63), or cognitive therapy (CT; n = 40), or double blind treatment with 2 daily tablets of either escitalopram (10 mg) or placebo (selective serotonin reuptake inhibitor/placebo; n = 46), or 12 weeks in a waiting list group (n = 93). Treatment started a mean (SD) 29.8 (5.7) days after the traumatic event. Waiting list participants with PTSD after 12 weeks received PE a mean (SD) 151.8 (42.4) days after the traumatic event (delayed PE).Proportion of participants with PTSD after treatment, as determined by the use of the Clinician-Administered PTSD Scale (CAPS) 5 and 9 months after the traumatic event. Treatment assignment and attendance were concealed from the clinicians who used the CAPS.At 5 months, 21.6% of participants who received PE and 57.1% of comparable participants on the waiting list had PTSD (odds ratio [OR], 0.21 [95% CI, 0.09-0.46]). At 5 months, 20.0% of participants who received CT and 58.7% of comparable participants on the waiting list had PTSD (OR, 0.18 [CI, 0.06-0.48]). The PE group did not differ from the CT group with regard to PTSD outcome (OR, 0.87 [95% CI, 0.29-2.62]). The PTSD prevalence rates did not differ between the escitalopram and placebo subgroups (61.9% vs 55.6%; OR, 0.77 [95% CI, 0.21-2.77]). At 9 months, 20.8% of participants who received PE and 21.4% of participants on the waiting list had PTSD (OR, 1.04 [95% CI, 0.40-2.67]). Participants with partial PTSD before treatment onset did similarly well with and without treatment.Prolonged exposure, CT, and delayed PE effectively prevent chronic PTSD in recent survivors. The lack of improvement from treatment with escitalopram requires further evaluation. Trauma-focused clinical interventions have no added benefit to survivors with subthreshold PTSD symptoms. Trial Registration clinicaltrials.gov Identifier: NCT00146900.",0 +https://doi.org/10.3402/ejpt.v4i0.21171,Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study,"In the empirical and clinical literature, complex posttraumatic stress disorder (PTSD) and personality disorders (PDs) are suggested to be predictive of drop-out or reduced treatment effectiveness in trauma-focused PTSD treatment.In this study, we aimed to investigate if personality characteristics would predict treatment compliance and effectiveness in stabilizing complex PTSD treatment.In a randomized controlled trial on a 20-week stabilizing group cognitive behavioral treatment (CBT) for child-abuse-related complex PTSD, we included 71 patients of whom 38 were randomized to a psycho-educational and cognitive behavioral stabilizing group treatment. We compared the patients with few PD symptoms (adaptive) (N=14) with the non-adaptive patients (N=24) as revealed by a cluster analysis.We found that non-adaptive patients compared to the adaptive patients showed very low drop-out rates. Both non-adaptive patients, classified with highly different personality profiles ""withdrawn"" and ""aggressive,"" were equally compliant. With regard to symptom reduction, we found no significant differences between subtypes. Post-hoc, patients with a PD showed lower drop-out rates and higher effect sizes in terms of complex PTSD severity, especially on domains that affect regulation and interpersonal problems.Contrary to our expectations, these preliminary findings indicate that this treatment is well tolerated by patients with a variety of personality pathology. Larger sample sizes are needed to study effectiveness for subgroups of complex PTSD patients.",0 +https://doi.org/10.1016/j.euroneuro.2011.06.001,High dose hydrocortisone immediately after trauma may alter the trajectory of PTSD: Interplay between clinical and animal studies,"High-dose corticosteroids have been reported to reduce symptoms of acute stress and post-traumatic stress in polytrauma patients and in animal studies. The underlying mechanism of action remains largely unclear. These issues were addressed in parallel in the clinical and preclinical studies below. In this preliminary study, 25 patients with acute stress symptoms were administered a single intravenous bolus of high-dose hydrocortisone (100-140 mg) or placebo within 6 h of a traumatic event in a prospective, randomized, double-blind, placebo-controlled pilot study. Early single high-dose hydrocortisone intervention attenuated the core symptoms of both the acute stress and of subsequent PTSD in patients. High-dose hydrocortisone treatment given in the first few hours after a traumatic experience was associated with significant favorable changes in the trajectory of exposure to trauma, as expressed by the reduced risk of the development of PTSD post-trauma. In parallel, a comparative study of morphological arborization in dentate gyrus and its modulating molecules was performed in stress-exposed animals treated with high-dose hydrocortisone. Steroid-treated stressed animals displayed significantly increased dendritic growth and spine density, with increased levels of brain-derived neurotrophic factor (BDNF) and obtunded postsynaptic density-95 (PSD-95) levels. The animal study provided insights into the potential mechanism of this intervention, as it identified relevant morphological and biochemical associations to the clinical observations. Thus, evidence from clinical and animal studies suggests that there is a ""window of opportunity"" in the early aftermath of trauma to help those who are vulnerable to the development of chronic PTSD.",0 +https://doi.org/10.1016/j.janxdis.2008.08.001,A factor analytic comparison of five models of PTSD symptoms,"This study examined the factor structure of PTSD symptoms in a sample of college students (n=344) reporting exposure to a range of traumatic events. The sample was randomly split and an exploratory factor analysis was conducted with half of the sample. The factor structure obtained in the exploratory analysis was evaluated against three other models using confirmatory factor analysis utilizing the second half of the sample. This series of factor analyses identified and confirmed a three-factor symptom structure consisting of intrusion/avoidance, dysphoria, and hyperarousal clusters. These results add to the body of literature which has found that PTSD includes a cluster of symptoms shared with other diagnoses (dysphoria) and a more specific factor related directly to the effects of encountering traumatic experiences.",0 +https://doi.org/10.1016/j.jpsychores.2006.07.008,Relationship between posttraumatic stress disorder symptoms and the course of whiplash complaints,"This study investigates the relationship between posttraumatic stress disorder (PTSD) symptoms (avoidance, reexperiencing, and hyperarousal) and the presence, severity, and duration of neck complaints after motor vehicle accidents. Individuals who had been involved in traffic accidents and had initiated compensation claim procedures with a Dutch insurance company were sent questionnaires (Q1) containing complaint-related questions and the Self-Rating Scale for PTSD. Of the 997 questionnaires that were dispatched, 617 (62%) were returned. Only car accident victims were included in this study ( n =240). Complaints were monitored using additional questionnaires that were administered 6 months (Q2) and 12 months (Q3) after the accident. PTSD was related to the presence and severity of concurrent post-whiplash syndrome. More specifically, the intensity of hyperarousal symptoms that were related to PTSD at Q1 was found to have predictive validity for the persistence and severity of post-whiplash syndrome at 6 and 12 months follow-up. Results are consistent with the idea that PTSD hyperarousal symptoms have a detrimental influence on the recovery and severity of whiplash complaints following car accidents.",0 +,Advances in genomics and epigenetic biomarkers for vulnerability and treatment response in mood and anxiety disorders,"Objective: Our current efforts in identifying reliable markers to stratify patients with mood and anxiety disorders into biologically relevant categories have so far not been highly successful. Here we will highlight approaches that combine genetic and environmental risk factors and epigenetic measures to identify subsets of patients that are likely biologically more homogeneous and may profit from similar treatment strategies. Methods: DNA methylation, gene expression and genotyping, combined with endocrine and neuroimaging measures as well as information on antidepressant treatment response from different studies will be presented. Results: Interaction of a specific functional polymorphism in the FKBP5 gene together with exposure to early trauma leads to epigenetic changes that further derepress the transcription of that gene. This interaction of two risk factors is on the one hand associated with a number of distinct psychiatric diagnoses, including depression, PTSD and psychosis. On the other hand, patients with this specific epigenetic profile represent a subgroup of patients with unique endocrine, gene expression and neuroimaging biomarkers. Preliminary evidence suggest that depressed patients with the FKBP5 risk allele and exposure to early trauma may preferentially respond to cognitive behavioral therapy (CBT). We will also present data from genome-wide genetic and epigenetic studies investigating pattern associated with differential antidepressive response to CBT vs. medication. Conclusion: This series of studies highlights that identifying subgroups of patients using epigenetic measures and integrating genetic and environmental factors could be useful for more targeted treatment approaches that make use of pathophysiologic findings that can transcend current diagnostic categories.",0 +https://doi.org/10.3389/fnbeh.2013.00100,The endocannabinoid system as a possible target to treat both the cognitive and emotional features of post-traumatic stress disorder (PTSD),"Post-traumatic stress disorder (PTSD) is a psychiatric disorder of significant prevalence and morbidity, whose pathogenesis relies on paradoxical changes of emotional memory processing. An ideal treatment would be a drug able to block the pathological over-consolidation and continuous retrieval of the traumatic event, while enhancing its extinction and reducing the anxiety symptoms. While the latter benefit from antidepressant medications, no drug is available to control the cognitive symptomatology. Endocannabinoids regulate affective states and participate in memory consolidation, retrieval, and extinction. Clinical findings showing a relationship between Cannabis use and PTSD, as well as changes in endocannabinoid activity in PTSD patients, further suggest the existence of a link between endocannabinoids and maladaptive brain changes after trauma exposure. Along these lines, we suggest that endocannabinoid degradation inhibitors may be an ideal therapeutic approach to simultaneously treat the emotional and cognitive features of PTSD, avoiding the unwanted psychotropic effects of compounds directly binding cannabinoid receptors.",0 +https://doi.org/10.1037/a0022621,The modeling of internalizing disorders on the basis of patterns of lifetime comorbidity: Associations with psychosocial functioning and psychiatric disorders among first-degree relatives.,"Two broadband latent factors--internalizing and externalizing--have frequently been identified in studies of the hierarchical structure of psychopathology. In the present research, 3 competing measurement models of putative internalizing disorders (i.e., a parsimonious single-factor model, a model based on the Diagnostic and Statistical Manual of Mental Disorders [4th ed., American Psychiatric Association, 1994], and an alternative model proposed by Krueger, 1999, and Watson, 2005) were evaluated in terms of their ability to account for lifetime patterns of diagnostic comorbidity. Four diagnostic assessments were performed on an age-based cohort of 816 persons over a 15-year interval. Each of the 3 measurement models demonstrated adequate or good fit to the data and similar approximating abilities. Additional analyses, however, suggested that nonspecific aspects of lifetime mood/anxiety or distress/fear disorders (i.e., general negative affect) largely accounted for indicators of psychosocial functioning at age 30 as well as densities of specific psychiatric disorders among the 1st-degree relatives of probands. The relevance of these findings for theoretical and descriptive models of internalizing disorders is discussed.",0 +https://doi.org/10.1586/14737175.5.2.267,Emerging roles for atypical antipsychotics in chronic post-traumatic stress disorder,"Post-traumatic stress disorder is an anxiety disorder that may occur after the individual is exposed to severe psychologic trauma such as combat, sexual assault, or childhood physical or sexual abuse. Chronic post-traumatic stress disorder may result in considerable psychologic pain and suffering for the individual in addition to significant functional impairment. In addition to the heterogeneity of symptoms that occur in post-traumatic stress disorder, there may also be extensive comorbidity with other anxiety disorders, mood disorders, psychotic disorders, and other psychiatric disorders. This complicates the treatment picture. Currently, accepted treatments for post-traumatic stress disorder include psychotherapy, in particular cognitive behavioral-based approaches and antidepressant medication. However, many patients are refractory to these initial treatments or have only a partial response. In light of this, may clinicians combine additional classes of psychotropic agents and different psychotherapeutic approaches to enhance treatment response. This article reviews the literature on the use of atypical antipsychotics in the treatment of post-traumatic stress disorder. Most of the research to date has involved combat veterans partially responsive or refractory to treatment, namely with antidepressants. Studies have shown improvement across post-traumatic stress disorder symptom clusters, as well as improvement in comorbid psychotic symptoms or disorders. More research is needed to confirm these recent findings and further delineate the role of atypical antipsychotics in the treatment of post-traumatic stress disorder. Currently, possible indications for their use include treatment-resistant post-traumatic stress disorder and post-traumatic stress disorder with comorbid psychotic features.",0 +https://doi.org/10.1521/psyc.2008.71.1.35,Distinguishing distress and psychopathology among survivors of the Oakland/Berkeley firestorm.,"Disaster mental health research has historically focused on assessment of psychopathology, using measures of psychiatric symptoms and disorders. The Oakland/Berkeley firestorm provided an opportunity to explore resilience among highly exposed survivors through consideration of psychiatric variables in the context of personality. The Diagnostic Interview Schedule/Disaster Supplement was administered to 62 firestorm survivors at approximately 4, 16, and 39 months and the Temperament and Character Inventory administered at 16 months postdisaster. Few individuals had postdisaster psychopathology (16% with any diagnosis, 5%with PTSD). There was considerable evidence of distress, however, indicated by an abundance of reported posttraumatic symptoms, functional impairments, and endorsement of emotional upset, all of which decreased substantially over time. Group C (avoidance/numbing) posttraumatic symptoms were relatively uncommon and were specifically associated with elevated Self-Transcendence. Groups B (intrusion) and D (hyperarousal) symptoms were prevalent and were associated with high Harm Avoidance and low Self-Directedness. The generally healthy personality profiles of these firestorm survivors reflected their psychological resilience. Examination of symptoms and distress in the context of psychiatric disorders after this disaster demonstrated that symptomatic distress is not inconsistent with psychological resilience. The choice of research focus and methods can provide very different portraits of outcomes post-disaster.",0 +https://doi.org/10.1017/s1092852900022380,Treatment-Resistant Posttraumatic Stress Disorder: Strategies for Intervention,"Abstract The mainstay of treatment for chronic posttraumatic stress disorder (PTSD) is a combination of psychotherapy and medication treatments. The first-line medications for PTSD are antidepressants, with two selective serotonin reuptake inhibitors (sertraline and paroxetine) currently Food and Drug Administration-indicated for PTSD. However, many patients do not have an adequate response to antidepressants, therefore, combinations with other antidepressants or with other classes of psychotropic medication are often utilized to enhance the therapeutic response. Other agents that have been used include mood stabilizers, antiadrenergics, anxiolytics, and atypical antipsychotics. The heterogeneity of symptom clusters in PTSD as well as the complex psychiatric comorbidities (eg, with depression or substance abuse) further support the notion that combinations of medications may be needed. To date, there is a paucity of data to support specific strategies for augmenting antidepressants in PTSD. This review will address representative existing studies and discuss several potential pharmacologic strategies for patients suffering from treatment refractory PTSD.",0 +https://doi.org/10.9758/cpn.2013.11.3.137,"Comparative Study of Heart Rate Variability in Patients with Schizophrenia, Bipolar Disorder, Post-traumatic Stress Disorder, or Major Depressive Disorder","Heart rate variability (HRV) changes as a function of psychiatric illness. This study aimed to evaluate HRV among patients with various psychiatric disorders.The present study recruited patients with schizophrenia (n=35), bipolar disorder (n=41), post-traumatic stress disorder (PTSD; n=34), or major depressive disorder (n=34) as well as healthy controls (n=27). The time-domain analysis (the standard deviation of all RR intervals [SDNN] and the square root of the mean squared differences of successive normal sinus intervals [RMSSD]), the frequency-domain analysis (very low frequency, low frequency [LF], high frequency [HF], and total power [TP]), and a non-linear complexity measure the approximate entropy were computed.SDNN and HF were significantly reduced in patients with schizophrenia compared with healthy controls. SDNN, RMSSD, TP, LF, and HF were significantly reduced in bipolar patients compared with healthy controls. HF was significantly reduced in PTSD patients compared with healthy controls.Our findings indicate that HRV is not sufficiently powerful to discriminate among various psychiatric illnesses. However, our results suggest that HRV, particularly HF, could be used as a tool for discriminating between psychiatric patients and healthy controls.",0 +https://doi.org/10.1037/a0018477,All PTSD symptoms are highly associated with general distress: Ramifications for the dysphoria symptom cluster.,"This study used longitudinal data collected from two trauma-exposed samples, survivors of community violence (N = 294) and wildfire evacuees (N = 234), to examine a key claim underlying a proposed reformulation of the symptom structure of posttraumatic stress disorder (PTSD). This theory, which we term the PTSD-dysphoria model, posits that 8 of 17 symptoms of PTSD reflect dysphoria or general psychological distress and might be deemphasized to improve the utility of the PTSD construct (Simms, Watson, & Doebbeling, 2002). For each sample, we analyzed PTSD symptoms and measures of general distress administered at 2 time points. A consistent pattern of findings was observed across assessments for each sample: All 17 PTSD symptoms were highly associated with measures of general distress. Moreover, we found no evidence that dysphoria symptoms were more highly correlated than PTSD-specific symptoms with general distress. Results call into question both the conceptual basis and the clinical utility of differentiating between symptoms that appear to be relatively specific to PTSD and those that seem more broadly characteristic of general psychological distress.",0 +https://doi.org/10.1007/s10926-013-9432-2,Changes in Pain Catastrophizing Following Physical Therapy for Musculoskeletal Injury: The Influence of Depressive and Post-traumatic Stress Symptoms,"Purpose: The aim of the present study was to investigate the factors that influence the change in pain catastrophizing during the course of a physical therapy intervention for musculoskeletal injury. Methods: 187 clients enrolled in a 7-week physical therapy intervention were divided into four mutually exclusive groups on the basis of a pre-treatment assessment: (1) clients whose pre-treatment catastrophizing scores and measures of mental health problems were below clinical threshold, (2) clients whose pre-treatment catastrophizing scores were above clinical threshold but who scores on measures of mental health problems were below clinical threshold, (3) clients whose pre-treatment catastrophizing scores were above clinical threshold and whose scores on measures of mental health problems were also above clinical threshold, and (4) clients whose pre-treatment catastrophizing scores were below clinical threshold but whose scores on measures of mental health problems were above clinical threshold. Results: The most prevalent risk profile consisted of clients with high levels of pain catastrophizing and high mental health problems (37 %), followed by the low catastrophizing and low mental health problems profile (35 %), the high catastrophizing and low mental health problems profile (16 %), and low catastrophizing and high mental health problems profile (10 %). Clients were considered non-responders if their post-treatment catastrophizing score remained above clinical threshold following treatment. Chi square analyses revealed a significantly higher proportion of non-responders in the high catastrophizing and mental health problem group than in any other group. Conclusions: The presence of mental health symptoms markedly reduces the effectiveness of physical therapy for reducing catastrophizing scores. The 'risk value' of high catastrophizing scores thus appears to vary as a function of the presence or absence of mental health symptoms. The findings argue for the inclusion of measures of mental health problems in the routine screening of individuals treated in physical therapy. © 2013 Springer Science+Business Media New York.",0 +https://doi.org/10.1016/j.jpeds.2014.08.039,Neurodevelopment and Behavior after Transcatheter versus Surgical Closure of Secundum Type Atrial Septal Defect,"To assess the neuropsychological and behavioral profiles of school-aged children treated for atrial septal defect, secundum type (ASD-II) with open-heart surgery or catheterization.Patients (n = 48; mean age, 9 years, 3 months) and a matched healthy group (mean age, 9 years, 2 months) were evaluated with a shortened intelligence scale (Wechsler Intelligence Scale for Children, third edition, Dutch version) and a developmental neuropsychological test battery (Developmental Neuropsychological Assessment, second edition, Dutch version). Parents completed behavioral checklists (Achenbach Child Behavior Checklist for Children aged 6-18). Hospitalization variables were retrieved from medical files for studying associations with long-term neurodevelopment.Compared with the healthy matched controls, patients treated for ASD-II had significantly lower scores on subtasks underlying such Developmental Neuropsychological Assessment, second edition, Dutch version domains as Attention and Executive Functioning, Language, Working Memory, Sensorimotor Functioning, Social Cognition, and Visuospatial Information Processing. Only subtle differences, mainly in Visuospatial Information Processing, were found between the surgical repair and transcatheter repair groups. Socioeconomic status, longer hospital stay, and larger defect size were associated with neurocognitive outcome measures. Parents of patients reported more thought problems, posttraumatic stress problems, and lower school performance compared with parents of healthy peers.After treatment for ASD-II, children display a range of neuropsychologic difficulties that may increase their risk for learning problems and academic underachievement. Differences related to treatment were not found. Our results suggest that neurodevelopmental and behavioral follow-up at school age is warranted in this group.",0 +https://doi.org/10.1089/neu.2011.1895,A Phase I Study of Low-Pressure Hyperbaric Oxygen Therapy for Blast-Induced Post-Concussion Syndrome and Post-Traumatic Stress Disorder,"This is a preliminary report on the safety and efficacy of 1.5 ATA hyperbaric oxygen therapy (HBOT) in military subjects with chronic blast-induced mild to moderate traumatic brain injury (TBI)/post-concussion syndrome (PCS) and post-traumatic stress disorder (PTSD). Sixteen military subjects received 40 1.5 ATA/60 min HBOT sessions in 30 days. Symptoms, physical and neurological exams, SPECT brain imaging, and neuropsychological and psychological testing were completed before and within 1 week after treatment. Subjects experienced reversible middle ear barotrauma (5), transient deterioration in symptoms (4), and reversible bronchospasm (1); one subject withdrew. Post-treatment testing demonstrated significant improvement in: symptoms, neurological exam, full-scale IQ (+14.8 points; p<0.001), WMS IV Delayed Memory (p=0.026), WMS-IV Working Memory (p=0.003), Stroop Test (p<0.001), TOVA Impulsivity (p=0.041), TOVA Variability (p=0.045), Grooved Pegboard (p=0.028), PCS symptoms (Rivermead PCSQ: p=0.0002), PTSD symptoms (PCL-M: p<0.001), depression (PHQ-9: p<0.001), anxiety (GAD-7: p=0.007), quality of life (MPQoL: p=0.003), and self-report of percent of normal (p<0.001), SPECT coefficient of variation in all white matter and some gray matter ROIs after the first HBOT, and in half of white matter ROIs after 40 HBOT sessions, and SPECT statistical parametric mapping analysis (diffuse improvements in regional cerebral blood flow after 1 and 40 HBOT sessions). Forty 1.5 ATA HBOT sessions in 1 month was safe in a military cohort with chronic blast-induced PCS and PTSD. Significant improvements occurred in symptoms, abnormal physical exam findings, cognitive testing, and quality-of-life measurements, with concomitant significant improvements in SPECT.",0 +https://doi.org/10.1016/j.jad.2010.05.005,A longitudinal analysis of posttraumatic stress disorder symptoms and their relationship with Fear and Anxious-Misery disorders: Implications for DSM-V,"This paper examined the hypothesis that PTSD-unique symptom clusters of re-experiencing, active avoidance and hyperarousal were more related to the fear/phobic disorders, while shared PTSD symptoms of dysphoria were more closely related to Anxious-Misery disorders (MDD/GAD). Confirmatory factor and correlation analyses examining PTSD, anxiety and mood disorder data from 714 injury survivors interviewed 3, 12 and 24-months following their injury supported this hypothesis with these relationships remaining robust from 3-24 months posttrauma. Of the nine unique fear-oriented PTSD symptoms, only one is currently required for a DSM-IV diagnosis. Increasing emphasis on PTSD fear symptoms in DSM-V, such as proposed DSM-V changes to mandate active avoidance, is critical to improve specificity, ensure inclusion of dimensionally distinct features and facilitate tailoring of treatment.",0 +https://doi.org/10.1111/j.1751-9004.2007.00054.x,An Introduction to Latent Class Growth Analysis and Growth Mixture Modeling,"In recent years, there has been a growing interest among researchers in the use of latent class and growth mixture modeling techniques for applications in the social and psychological sciences, in part due to advances in and availability of computer software designed for this purpose (e.g., Mplus and SAS Proc Traj). Latent growth modeling approaches, such as latent class growth analysis (LCGA) and growth mixture modeling (GMM), have been increasingly recognized for their usefulness for identifying homogeneous subpopulations within the larger heterogeneous population and for the identification of meaningful groups or classes of individuals. The purpose of this paper is to provide an overview of LCGA and GMM, compare the different techniques of latent growth modeling, discuss current debates and issues, and provide readers with a practical guide for conducting LCGA and GMM using the Mplus software.",0 +https://doi.org/10.1176/ajp.150.2.235,Childhood physical abuse and combat-related posttraumatic stress disorder in Vietnam veterans,"Early trauma in the form of childhood physical or sexual abuse has been associated with adult psychopathology. The purpose of this study was to compare rates of childhood abuse in Vietnam veterans with and without combat-related posttraumatic stress disorder (PTSD).Premilitary stressful and traumatic events including childhood abuse and other potential predisposing factors were assessed in Vietnam combat veterans who sought treatment for PTSD (N = 38) and Vietnam combat veterans without PTSD who sought treatment for medical disorders (N = 28). Stressful and traumatic events including childhood physical abuse were assessed with the Checklist of Stressful and Traumatic Events and a clinician-administered interview for the assessment of childhood abuse. Level of combat exposure was measured with the Combat Exposure Scale.Vietnam veterans with PTSD had higher rates of childhood physical abuse than Vietnam veterans without PTSD (26% versus 7%). The association between childhood abuse and PTSD persisted after controlling for the difference in level of combat exposure between the two groups. Patients with PTSD also had a significantly higher rate of total traumatic events before joining the military than patients without PTSD (mean = 4.6, SD = 4.5, versus mean = 2.8, SD = 2.9).These findings suggest that patients seeking treatment for combat-related PTSD have higher rates of childhood physical abuse than combat veterans without PTSD. Childhood physical abuse may be an antecedent to the development of combat-related PTSD in Vietnam combat veterans.",0 +https://doi.org/10.1007/s10826-014-0079-1,Children with Multi-Trauma Histories: Special Considerations for Care and Implications for Treatment Selection,"The complex symptom profiles of young children with histories of trauma exposure underscore the importance of matching individual child characteristics and symptom needs with existing evidence-based treatment protocols. Children (N = 134) between the ages of 2–12 and their caregivers were administered the Child Behavioral Checklist, Trauma Symptom Checklist for Young Children, and the Trauma Symptom Checklist for Children-Alternate Version at baseline and end of treatment. ANCOVA analyses examined the relationships between the number of different types of trauma exposures, child gender, placement status, child age, type of treatment received, and end of treatment symptom scores. Child age at the start of treatment was found to influence externalizing and total problem scores at the end of treatment when baseline scale scores were held constant. Older children were found to have significantly higher levels of externalizing and total problem scores at the end of treatment compared to younger children in the sample. Significant improvements were found between baseline and termination outcome scores regardless of treatment type, however, results suggest that differences in severity of symptoms may vary by treatment type. Study findings suggest that latency age children and their caregivers may have differing trauma-related treatment needs compared to younger children and may benefit from an adjusted focus in treatment. The matching of individual child characteristics and need can help maximize emotional and behavioral outcomes and the addition of a cognitive-based treatment modality may be indicated for some children.",0 +https://doi.org/10.1111/appy.12143,Possible cultural effects on the increments of somatic symptoms in subjectively resilient depressed patients,"Introduction While previous literatures have provided substantial evidence on the burden of somatic symptoms and the prognostic value of resilience in the treatment course of depression, little is speculated on the relationship between resilience and somatic symptoms in depressed patients. We aimed to clarify the relationship between resilience and somatic symptoms in depressed patients retrospectively. Methods Two hundred and fifty-four outpatients with depressive disorders participated in the study and completed self-administered questionnaires regarding demographic, clinical and psychological factors. We divided the patients into four groups based on their scores of Connor-Davidson Resilience Scale and Beck Depression Inventory. The partial correlation analysis was implemented to show the relationship between somatic symptoms and resilience after controlling for depression, and one-way analysis of variance was conducted to demonstrate the differences in somatization scores of Symptoms Checklist-90-Revised in the aforementioned four groups. Results After the correlation analysis, somatization was significantly correlated with resilience even after controlling for depressive symptoms. The one-way analysis of vairance and post-hoc analysis revealed statistically significant differences in somatization scores between the four groups, with the high Beck Depression Inventory, high Connor-Davidson Resilience Scale group having the highest somatization scores. Discussion Striving to be resilient during the peak of depression, cultural factors and positive illusions of depressed patients can result in high resilience scores and high somatization scores in depressed patients, and such clinical implications would help clinicians evaluate resilience and somatization in depressed patients with multidimensional aspects.",0 +https://doi.org/10.1016/j.janxdis.2013.07.007,PTSD's underlying symptom dimensions and relations with behavioral inhibition and activation,"• We examined the relation between PTSD factors and BIS/BAS dimensions in a primary care sample. • PTSD's avoidance and dysphoria factor had a significantly greater association with BIS compared to BAS. • PTSD's re-experiencing factor related more to BIS than BAS. • PTSD's avoidance significantly mediated the relation between BIS/BAS and PTSD's dysphoria. Reinforcement sensitivity theory (RST) stipulates that individuals have a behavioral activation system (BAS) guiding approach (rewarding) behaviors ( Gray, 1971 , Gray, 1981 ), and behavioral inhibition system (BIS) guiding conflict resolution between approach and avoidance (punishment) behaviors ( Gray & McNaughton, 2000 ). Posttraumatic stress disorder (PTSD) severity overall relates to both BIS (e.g., Myers et al., 2012 , Pickett et al., 2011 ) and BAS ( Pickett et al., 2011 ). Using a more refined approach, we assessed specific relations between PTSD's latent factors ( Simms, Watson, & Doebbeling, 2002 ) and observed variables measuring BIS and BAS using 308 adult, trauma-exposed primary care patients. Confirmatory factor analysis and Wald chi-square tests demonstrated a significantly greater association with BIS severity compared to BAS severity for PTSD's dysphoria, avoidance, and re-experiencing factors. Further, PTSD's avoidance factor significantly mediated relations between BIS/BAS severity and PTSD's dysphoria factor.",0 +https://doi.org/10.1016/j.jad.2013.04.018,Cognitive-behavioural interventions for mood and anxiety disorders in HIV: A systematic review,"Mood and anxiety disorders are highly prevalent and comorbid with HIV/AIDS. However, there is a paucity of research on the effectiveness of cognitive-behavioural interventions (CBI) for common mental disorders in HIV-infected adults. The present study sought to review the existing literature on the use of CBI for depression and anxiety in HIV-positive adults and to assess the effect size of these interventions.We did duplicate searches of databases (from inception to 17-22 May 2012). The following online databases were searched: PubMed, The Cochrane Central Register of Controlled Trials and PsychArticles.We identified 20 studies suitable for inclusion. A total of 2886 participants were enroled in these studies, of which 2173 participants completed treatment. The present review of the literature suggests that CBI may be effective in the treatment of depression and anxiety in individuals living with HIV/AIDS. Significant reductions in depression and anxiety were reported in intervention studies that directly and indirectly targeted depression and/or anxiety. Effect sizes ranged from 0.02 to 1.02 for depression and 0.04 to 0.70 for anxiety.Some trials included an immediate postintervention assessment but no follow-up assessments of outcome. This omission makes it difficult to determine whether the intervention effects are sustainable over time.The present review of the literature suggests that CBI may have a positive impact on the treatment of depression and anxiety in adults living with HIV/AIDS.",0 +https://doi.org/10.1080/08039480802298705,Substance use disorders among personality disordered patients admitted for day hospital treatment. Implications for service developments,"Personality disorders (PD) and substance use disorders (SUD) are highly comorbid conditions. However, their treatment services are often separated. The aims of this study was to investigate how extensive this separation was prior to a Norwegian health reform (2004) that promoted integration, and to discuss clinical challenges for an integrated treatment of PD and SUD. All patients with a diagnosis of PD (n=1783) admitted to 10 day hospital treatment programs (1993-2003) were examined. Diagnoses were assessed by Mini International Neuropsychiatric Interview and Structured Clinical Interview for DSM-IV interviews. Socio-demographic data, psychosocial functioning (Global Assessment of Functioning Scale), symptom distress (Symptom Check List-90-Revised), interpersonal problems (Circumplex of Interpersonal Problems) and treatment course were recorded. The majority of patients were females (72%) and the prevalence of SUD was low (14%). SUD occurred among all PD categories. Patients with borderline PD were over-represented and patients with cluster C disorders were under-represented in the SUD sample. The SUD sample contained more men and it was associated with more previous violence against self and others. The reported violence was partly explained by gender (males) and diagnoses (borderline and SUD). PD patients with SUD also displayed more aggression during treatment and dropped out more frequently. The findings demonstrate that the female dominated specialized psychiatric treatment services for PD to a large extent had excluded PD patients who also had SUD. The reasons are probably related to the surplus problems that characterized the SUD sample and gender issues. Implications for the development of the PD and SUD services with respect to an integrated treatment for these comorbid conditions are discussed.",0 +https://doi.org/10.1111/j.1440-1819.2011.02300.x,Hemispheric asymmetry in non-linear interdependence of EEG in post-traumatic stress disorder,"While volumetric and metabolic imaging on post-traumatic stress disorder (PTSD) patients has been intensively performed, few studies using electroencephalograms (EEG) have been done as yet. The aim of the present study was to investigate abnormalities in functional connectivity of cortical networks in PTSD.Non-linear interdependence (NI), a measure of bidirectional, non-linear information transmission between two time series, was used. Resting EEG were recorded for 18 PTSD patients and 18 sex-matched healthy subjects on 16 channels with their eyes closed.The NI patterns in PTSD patients were hemisphere asymmetric: an increase in NI in the fronto-parieto-temporal regions of the left hemisphere (F7, F3, T3, C3, T5 and P3) and a decrease in the fronto-parieto-occipital regions of the right hemisphere (F4, C4, P4 and O2). The non-linearity of NI in EEG, estimated from the surrogate data method, exhibited an increase in the PTSD patients as compared with that of healthy subjects, particularly in the left hemispheric cortex.Abnormal functional connectivity in PTSD can be assessed using NI, a measure of multi-channel EEG.",0 +https://doi.org/10.1590/s1516-44462008000400011,Aripiprazole in the treatment of posttraumatic stress disorder: an open-label trial,"Post traumatic stress disorder is frequent in the general population (7.8%-lifetime-USA). The selective serotonin reuptake inhibitors are the first choice of treatment but result in low remission rates. This study aims to evaluate the effect of aripiprazole monotherapy for the treatment of post traumatic stress disorder.Thirty-two patients diagnosed with post traumatic stress disorder were included in a 16-week open label trial of aripiprazole. They were evaluated at baseline, week 8, and 16 with the Clinician-Administered PTSD Scale, Beck Depression Inventory, Beck Anxiety Inventory, Medical Outcome Study Short Form 36, and Social Adjustment Scale. Statistical analysis were performed with an intention-to-treat approach and last observation carried forward. A general linear model for repeated measures comparing the factor with 3 continuous measures from baseline, 8 and 16 weeks was used. A between-subject factor was includedNine patients discontinued the treatment. The mean aripiprazole dose was 9.6 (+/- 4.3) mg/day. The mean scores at baseline and endpoint for all measures were: Clinician-Administered PTSD Scale - 82.7 (+/- 23.1) and 51.4 (+/- 31.4) (F = 11.247, p = 0.001); Beck Anxiety Inventory - 31.7 (+/- 13.4) and 25.4 (+/- 18.2) (F = 8.931, p = 0.011); Social Adjustment Scale - 2.4 (+/- 0.45) and 2.27 (+/- 0.57) (F = 8.633, p = 0.012); Medical Outcome Study Short Form 36 - 76.6 (+/- 14.11) and 94.01 (+/- 25.06) (F = 10.127 p = 0.007); and Beck Depression Inventory - 26.06 (+/- 11.6) and 21.35 (+/- 12.6) (F = 1.580, p = 0.042). In all measurements, the differences were statistically significant.Patients achieved a good response to treatment with aripiprazole, but placebo-controlled studies are needed for more accurate results.",0 +https://doi.org/10.1002/gps.2725,Posttraumatic stress disorder in older adults: an overview of characteristics and treatment approaches,"Posttraumatic stress disorder (PTSD) is a common and disabling condition following a traumatic event. Despite its high prevalence rates, relatively little is known about the manifestation and course of the disorder in older adults. Moreover, there has been little evaluation of the efficacy of psychotherapeutic treatment approaches for older patients.This overview aims to summarize available data on the prevalence and symptoms of late-life PTSD and to review the current treatment approaches for older adults.The course and severity of PTSD symptoms in older adults depend on the time the trauma occurred (early versus late life). In the case of acute traumatization, lower prevalence rates and symptom severities are generally observed in older than in younger populations. In the case of early-life traumatization, a decline in PTSD symptom severity can be observed over the life course. Research on treatment approaches has produced promising results, indicating that disorder-specific interventions (i.e., trauma confrontation and cognitive restructuring) can be effectively combined with an age-specific narrative life-review approach.Given the limited empirical evidence, caution is warranted in generalizing the reported findings. Nevertheless, it is possible to draw a number of conclusions concerning the characteristics and treatment of PTSD in older adults. Further research is needed to better understand the various presentations of PTSD in late life and to validate and improve the effectiveness of available treatment approaches.",0 +https://doi.org/10.1038/tp.2013.93,N-glycosylation profiling of plasma provides evidence for accelerated physiological aging in post-traumatic stress disorder,"The prevalence of age-related diseases is increased in individuals with post-traumatic stress disorder (PTSD). However, the underlying biological mechanisms are still unclear. N-glycosylation is an age-dependent process, identified as a biomarker for physiological aging (GlycoAge Test). To investigate whether traumatic stress accelerates the aging process, we analyzed the N-glycosylation profile in n=13 individuals with PTSD, n=9 trauma-exposed individuals and in n=10 low-stress control subjects. Individuals with PTSD and trauma-exposed individuals presented an upward shift in the GlycoAge Test, equivalent to an advancement of the aging process by 15 additional years. Trauma-exposed individuals presented an intermediate N-glycosylation profile positioned between severely traumatized individuals with PTSD and low-stress control subjects. In conclusion, our data suggest that cumulative exposure to traumatic stressors accelerates the process of physiological aging.",0 +https://doi.org/10.1016/j.eurpsy.2010.07.005,Hippocampal volume in borderline personality disorder with and without comorbid posttraumatic stress disorder: A meta-analysis,"Abstract Background Several studies have found a reduction in hippocampal volume in borderline personality disorder (BPD) patients. Methods In order to investigate the degree to which comorbid posttraumatic stress disorder (PTSD) could account for reduction in hippocampal volume in these patients, we conducted a systematic review and meta-analysis of studies that compared hippocampal volume in BPD patients with and without PTSD relative to healthy controls. Results Seven articles, involving 124 patients and 147 controls, were included. We found a statistically significant reduction for the left and right hippocampus. Data from the four studies that discriminated BPD patients with and without PTSD indicate that hippocampal volumes were reduced bilaterally in BPD patients with PTSD, relative to healthy controls, but that results were mixed for BPD patients without PTSD, relative to healthy controls. Conclusions Results from this meta-analysis suggest that hippocampal volumes are reduced in patients with BPD, relative to healthy controls, but particularly in cases in which patients are diagnosed with comorbid PTSD.",0 +https://doi.org/10.1007/s11469-012-9378-1,Two Sides of the Same Coin: Cannabis Dependence and Mental Health Problems in Help-Seeking Adolescent and Young Adult Outpatients,"The aim of the current study was to delineate the psychiatric profile of cannabis dependent young people (14-29 years old) with mental health problems (N = 36) seeking treatment via a research study. To do so, the Structured Clinical Interview for DSM-IV-TR Axis I Disorders and the Structured Clinical Interview for DSM-IV Childhood Diagnoses were used to obtain DSM-IV diagnoses, while a modified Timeline Followback interview and self-reports were used to measure cannabis use, cannabis-related problems, and impairment. Most individuals had at least two Axis I disorders in addition to cannabis dependence. Anxiety disorders were common, with posttraumatic stress disorder, social phobia, and generalised anxiety disorder accounting for the majority of these diagnoses. On average, young people reported a moderate degree of dependence and functional impairment, and a substantial number of cannabis-related problems. Although both males and females reported using similar quantities of cannabis per month, females reported using cannabis more frequently than males. The current data suggest that young people who present for cannabis use treatment in the context of a mental health issue may have a variety of psychiatric problems that need addressed and that males and females may have slightly different profiles. If cannabis use treatments are to advance for this population, more attention needs to be paid to the complex issues that young people present to treatment with.",0 +https://doi.org/10.1080/17439760.2010.498615,"Affective forecasts and the Valentine's Day shootings at NIU: People are resilient, but unaware of it","People overestimate the extent to which emotion-producing life events affect subsequent affect. However, research has yet to conclusively demonstrate that this phenomenon occurs following significant trauma affecting entire communities, or whether it applies to predictions of discrete emotions. Exploring such issues, student reports of emotion states were collected both before and after the oncampus Valentine's Day, 2008 shootings at Northern Illinois University (NIU). A separate group of students not on campus when the shootings occurred provided emotion state reports and predictions of the emotions they would expect to experience 2 weeks after a shooting occurred. Examination of these data suggests that: (1) emotion states of NIU students reflected resilience, and (2) students made affective forecasting errors indicating that this resilience was unexpected. These data confirm results of prior affective forecasting studies, extending them to cases of traumatic experiences, and suggest that such studies c...",0 +https://doi.org/10.1097/nci.0b013e3181c930a3,Impact of Chronic Critical Illness on the Psychological Outcomes of Family Members,"The uncertain trajectory of chronic critical illness exposes the patient's family to heightened levels of psychological distress. Symptoms of psychological distress affect more than half of family members exposed to the patient's chronic critical illness. Although symptoms often dissipate over time, a significant proportion of family members will remain at moderate to high risk for psychological distress well after the patient's death or discharge from the intensive care unit. Family members of chronically critically ill patients are often involved in the decision making for the patients. Irrational or uninformed decision making can occur when family members experience high levels of psychological distress. Attention to the psychological needs and provision of support to family members enhance the formulation of treatment decisions consistent with the patient's preferences and mitigate unnecessary resource use. In this article, the impact of chronic critical illness on family members' risk for depression, anxiety, and posttraumatic stress disorder is described and a review of evidence-based strategies to support the psychological needs of family members coping with a patient's chronic critical illness is provided.",0 +https://doi.org/10.1177/1534765606296531,Characterizing the resilient officer: Individual attributes at point of entry to policing.,"Research investigating the process of adaptation in newly recruited police officers is scarce and has yielded mixed results. Some research highlights the incidence of difficulty in adjusting to the role of police officer such as predictors of elevated stress and symptoms of posttraumatic stress disorder (PTSD). Others have investigated why the majority of officers are resilient to the work and organizational challenges presented. This article examines personality, prior experience, and coping strategies of 94 newly recruited Australian police officers. The data provide a picture of police personnel who are not selected with personality profiling. Results demonstrated that the officers' personality profiles, as measured by the NEO Five-Factor Inventory, were consistent with U.S. adult norms, except for elevated levels of extraversion. Common coping strategies include positive reinterpretation, acceptance, and planning. Measures of PTSD and positive posttrauma changes were higher in recruits who had endured...",0 +https://doi.org/10.1038/npp.2015.261,Prevention of Trauma and Stressor-Related Disorders: A Review,"Posttraumatic stress disorder (PTSD) is a common, frequently chronic, and disabling condition which, along with acute stress disorder (ASD), is categorized as a trauma- and stressor-related disorder by the DSM-5. These disorders are unique in requiring exposure to a severe stressor, which implies that potential sufferers could be identified and helped before developing a disorder. Research on prevention strategies for stress-related disorders has taken a number of avenues, including intervention before and after trauma and the use of both psychosocial and somatic approaches. Despite advances in neurobiological understanding of response to trauma, clinical evidence for preventive interventions remains sparse. This review provides an overview of prevention approaches and summarizes the existing literature on prevention of ASD and PTSD, including clinical and preclinical studies. Given the potential benefits to trauma survivors and society, the development of effective preventive interventions should be given greater priority. Resources should be directed to adequately test promising interventions in clinical trials, and research should be conducted according to translational research principles in which preclinical research informs the design of clinical studies.",0 +https://doi.org/10.1037/1082-989x.8.3.364,Mixture or Homogeneous? Comment on Bauer and Curran (2003).,"D. J. Bauer and P. J. Curran (2003) raised some interesting issues with respect to mixture models of growth curves. Many useful lessons can be learned from their work, and more can be learned by extending the inquiry in related directions. These lessons involve the following issues: (a) what a mixture distribution looks like, (b) the meaning of the term homogeneous distribution, (c) the importance of model checking, (d) advantages and disadvantages of using mixtures and similar procedures to approximate complicated distributions, and (e) intrinsic versus nonintrinsic transformability.",0 +https://doi.org/10.2174/157340311797484277,Psychosocial Implications During Adolescence for Infant Heart Transplant Recipients,"As more heart transplant recipients survive into late adolescence, research addressing long-term psychosocial and neurodevelopmental outcomes is imperative. The limited literature available suggests risk for psychosocial difficulties and lower cognitive, academic, and neuropsychological functioning. This paper reviews topic-related literature and provides preliminary data examining psychosocial and neuropsychological functioning of adolescents who received their heart transplant during infancy.This paper offers a literature review AND presents preliminary data from studies conducted through Loma Linda University Children's Hospital (LLUCH). Study one examined psychosocial functioning and quality of life of adolescent infant heart transplant recipients. In study two, cognitive, academic, and neuropsychological data were analyzed.Study 1: Overall psychosocial functioning fell in the Average range, however, a significant percentage of participants presented with difficulties on one or more of the psychosocial domains. Quality of life was also within normal limits, though concerns with general health and bodily discomfort were noted. Study 2: Cognitive functioning was assessed to be Below Average, with 43-62% of the participants demonstrating significant impairments. Neuropsychological functioning yielded significant weakness on language functioning, and mild weakness on visual-motor integration and executive functioning.While the majority of the participants demonstrate psychosocial resiliency, a subgroup present with difficulties suggesting the need for intervention. Cognitive/neuropsychological functioning suggests poorer functioning with patterns similar to other high-risk pediatric populations. These results are preliminary and further research on long-term psychosocial and neuropsychological development of pediatric heart transplant recipients is needed to better understand and ameliorate developmental trajectories.",0 +https://doi.org/10.1080/09540121.2013.764381,Posttraumatic stress disorder symptom severity and HIV-risk behaviors among substance-dependent inpatients,"Despite findings that the co-occurrence of posttraumatic stress disorder (PTSD) and substance use disorders (SUD) is associated with heightened risk for a variety of risky behaviors, few studies have examined behaviors linked to heightened risk for HIV infection and transmission in particular, or explored the unique associations between specific PTSD symptom clusters and these HIV-risk behaviors. Therefore, the goal of this study was to examine the associations between PTSD symptom severity and HIV-risk behaviors (i.e., risky sexual behavior [RSB] and injection drug use [INJ]) within an ethnically diverse sample of 85 SUD patients in residential SUD treatment. Participants completed a battery of questionnaires assessing PTSD symptom severity and HIV-risk behaviors, including RSB and INJ. Results demonstrated significant positive associations between PTSD symptom severity and RSB; however, no significant relationship between PTSD symptom severity and INJ was found. Furthermore, the severity of hyperarousal symptoms in particular was found to significantly predict RSB above and beyond age and all other PTSD symptom clusters. Results of this study suggest that PTSD symptoms (and, more specifically, the hyperarousal symptoms of PTSD) may heighten the risk for some forms of HIV-risk behaviors (RSB) but not others (INJ). Results highlight the importance of identifying and targeting hyperarousal symptoms in the treatment of SUD patients experiencing symptoms of PTSD in order to reduce HIV infection or transmission risk.",0 +https://doi.org/10.1080/15325024.2012.679119,"Trauma Type and Gender Effects on PTSD, General Distress, and Peritraumatic Dissociation","This study examined the independent and interaction effects of trauma type and gender on posttraumatic stress disorder (PTSD), general psychopathology, and peritraumatic dissociation. We assessed 1,503 college students (58.3% female) who experienced a natural disaster, loss of a loved one, or interpersonal violence. Interpersonal violence survivors, those with multiple trauma histories, and women reported more PTSD symptoms, general psychopathology, and peritraumatic dissociation than other trauma group survivors, single trauma group survivors, and men. A trauma type by gender interaction was identified for peritraumatic dissociation. The results are discussed within the context of clinical practice and assessment.",0 +https://doi.org/10.1017/s1355617712000458,Impaired Response Inhibition in Veterans with Post-Traumatic Stress Disorder and Mild Traumatic Brain Injury,"Abstract Combat veterans with post-traumatic stress disorder (PTSD) can show impairments in executive control and increases in impulsivity. The current study examined the effects of PTSD on motor response inhibition, a key cognitive control function. A Go/NoGo task was administered to veterans with a diagnosis of PTSD based on semi-structured clinical interview using DSM-IV criteria ( n = 40) and age-matched control veterans ( n = 33). Participants also completed questionnaires to assess self-reported levels of PTSD and depressive symptoms. Performance measures from the patients (error rates and reaction times) were compared to those from controls. PTSD patients showed a significant deficit in response inhibition, committing more errors on NoGo trials than controls. Higher levels of PTSD and depressive symptoms were associated with higher error rates. Of the three symptom clusters, re-experiencing was the strongest predictor of performance. Because the co-morbidity of mild traumatic brain injury (mTBI) and PTSD was high in this population, secondary analyses compared veterans with PTSD+mTBI ( n = 30) to veterans with PTSD only ( n = 10). Although preliminary, results indicated the two patient groups did not differ on any measure ( p > .88). Since cognitive impairments could hinder the effectiveness of standard PTSD therapies, incorporating treatments that strengthen executive functions might be considered in the future. ( JINS , 2012, 18 , 1–10)",0 +https://doi.org/10.1111/ajpy.12032,Predicting post‐traumatic growth and post‐traumatic stress in firefighters,"Emergency service workers (e.g., firefighters, police, and paramedics) are exposed to elevated levels of potentially traumatising events through the course of their work. Such exposure can have lasting negative consequences (e.g., post‐traumatic stress disorder (PTSD)) and/or positive outcomes (e.g., post‐traumatic growth (PTG)). Research had implicated trauma, occupational and personal variables that account for variance in post‐trauma outcomes yet at this stage no research has investigated these factors and their relative influence on both PTSD and PTG in a single study. Based in Calhoun and Tedeschi's model of PTG and previous research, in this study regression models of PTG and PTSD symptoms among 218 firefighters were tested. Results indicated organisational factors predicted symptoms of PTSD, while there was partial support for the hypothesis that coping and social support would be predictors of PTG. Experiencing multiple sources of trauma, higher levels of organisational and operational stress, and utilising cognitive reappraisal coping were all significant predictors of PTSD symptoms. Increases in PTG were predicted by experiencing trauma from multiple sources and the use of self‐care coping. Results highlight the importance of organisational factors in the development of PTSD symptoms, and of individual factors for promoting PTG.",0 +https://doi.org/10.1016/j.brat.2013.09.001,Mechanisms of change in cognitive behavioral therapy for panic disorder: The unique effects of self-efficacy and anxiety sensitivity,"The present study examined temporal dependencies of change of panic symptoms and two promising mechanisms of change (self-efficacy and anxiety sensitivity) during an 11-session course of cognitive-behavior therapy (CBT) for Panic Disorder (PD). 361 individuals with a principal diagnosis of PD completed measures of self-efficacy, anxiety sensitivity, and PD symptoms at each session during treatment. Effect size analyses indicated that the greatest changes in anxiety sensitivity occurred early in treatment, whereas the greatest changes in self-efficacy occurred later in treatment. Results of parallel process latent growth curve models indicated that changes in self-efficacy and anxiety sensitivity across treatment uniquely predicted changes in PD symptoms. Bivariate and multivariate latent difference score models indicated, as expected, that changes in anxiety sensitivity and self-efficacy temporally preceded changes in panic symptoms, and that intraindividual changes in anxiety sensitivity and self-efficacy independently predicted subsequent intraindividual changes in panic symptoms. These results provide strong evidence that changes in self-efficacy and anxiety sensitivity during CBT influence subsequent changes in panic symptoms, and that self-efficacy and anxiety sensitivity may therefore be two distinct mechanisms of change of CBT for PD that have their greatest impact at different stages of treatment.",0 +https://doi.org/10.2105/ajph.2012.300689,Examining a Comprehensive Model of Disaster-Related Posttraumatic Stress Disorder in Systematically Studied Survivors of 10 Disasters,"Objectives. Using a comprehensive disaster model, we examined predictors of posttraumatic stress disorder (PTSD) in combined data from 10 different disasters. Methods. The combined sample included data from 811 directly exposed survivors of 10 disasters between 1987 and 1995. We used consistent methods across all 10 disaster samples, including full diagnostic assessment. Results. In multivariate analyses, predictors of PTSD were female gender, younger age, Hispanic ethnicity, less education, ever-married status, predisaster psychopathology, disaster injury, and witnessing injury or death; exposure through death or injury to friends or family members and witnessing the disaster aftermath did not confer additional PTSD risk. Intentionally caused disasters associated with PTSD in bivariate analysis did not independently predict PTSD in multivariate analysis. Avoidance and numbing symptoms represented a PTSD marker. Conclusions. Despite confirming some previous research findings, we found no associations between PTSD and disaster typology. Prospective research is needed to determine whether early avoidance and numbing symptoms identify individuals likely to develop PTSD later. Our findings may help identify at-risk populations for treatment research.",0 +https://doi.org/10.1037/a0023759,What we don't expect when expecting: Evidence for heterogeneity in subjective well-being in response to parenthood.,"A recent article in New York Magazine echoed what psychological studies of parenthood have consistently demonstrated since the 1970s: ""Most people assume that having children will make them happier. Yet a wide variety of academic research shows that parents are not happier than their childless peers, and in many cases are less so"" (Senior, 2010). There is consistent evidence that, as opposed to other life events that cause transient disruptions in life satisfaction, becoming a parent appears to cause harm to individual subjective well-being (Twenge, Campbell, & Foster, 2003), and that this harm is sustained over time (Clark, Diener, Georgellis, & Lucas, 2008). The current investigation was predicated on the concern that these findings may be the result of the methodology used to examine them. As the experience of parenthood does not represent a unified phenomenon, we employed a methodological approach that allows for the exploration of heterogeneity as well as its predictors. By modeling heterogeneous trajectories within a prospective design from 4 years prior to 4 years after the birth of a parent's first child, we find that the majority of individuals (84.2%) demonstrate no long-term effects on life satisfaction in response to childbirth. Only a small percentage demonstrate the sustained declines (7.2%), and a significant cohort, previously unobserved in the literature, demonstrate dramatic and sustained improvements in response to parenthood (4.3%), providing compelling evidence for heterogeneity in life satisfaction among parents. Key demographic covariates that distinguish between trajectories of response are also explored.",0 +https://doi.org/10.1016/s0193-953x(18)30290-9,An Office Mental Status Examination for Complex Chronic Dissociative Symptoms and Multiple Personality Disorder,"Chronic complex dissociative symptoms can be readily inquired about in the diagnostic interview leading to a clinical diagnosis of MPD in many cases. It is most useful to begin with inquiry about amnesia, autohypnotic, posttraumatic, pseudopsychotic, and passive-influence symptoms, and childhood abuse or traumatization. As this proceeds, overt dissociation is commonly noted including spontaneous trances, age-regression, blending or overlap of states, or frank switching. When this occurs, the interviewer can pursue more detailed information about the patient's experiences. Tracking these processes may readily lead to the clear appearance of an alter personality or will help make the patient sufficiently comfortable that he or she will allow the full emergence of an alter if this is directly requested. In other cases, however, methods such as use of ideomotor signals, formal induction of trance, and even barbiturate-facilitated interviews may be necessary to permit the full emergence of an alter. The symptom-cluster method is a useful clinical diagnostic tool to elicit dissociative symptoms for the diagnosis of MPD. Combined with diagnostic tools such as the DES, the DDIS, and the SCID-D, this method can help the clinician make the diagnosis of MPD in a far more expeditious and rigorous fashion. In addition, all psychiatric patients should be screened for a history of blackouts, time loss, trance experiences, childhood trauma, and PTSD symptoms. This will improve case finding to help clinicians begin to treat the single largest preventable cause of mental illness: the sequelae of childhood abuse, trauma, and family violence.",0 +https://doi.org/10.5209/rev_sjop.2012.v15.n3.39419,Prediction of PTSD in Police Officers after Six Months – a Prospective Study,"The aim of this prospective study was to explore the predictors for the development of PTSD in police officers six months after encountering situations of a potentially traumatic nature. Fifty-nine police officers were studied immediately after the event (T1) and six months later (T2). At T2 PTSD was assessed using the Structured Clinical Interview for DSM-IV (SCID-I). PTSD was predicted by intrusions (Impact of Event Scale–Revised; IES-R), the impairment scale (is), global assessment of functioning scale (GAF), gender, age and sense of coherence scale (SOC). The diagnosis of an acute stress disorder (ASD) at T1 had a high specificity for identifying PTSD at T2. The strongest predictor for the development of PTSD was found to be the factor intrusions. Contrary to our expectations, age was not a significant predictive factor for PTSD. Thus, acute stress disorder (ASD) and a high degree of intrusions experienced immediately after a traumatic incident helped to identify early police officers at risk of developing chronic PTSD.",0 +https://doi.org/10.1002/jts.22075,Long-Term Trajectories of PTSD in Vietnam-Era Veterans: The Course and Consequences of PTSD in Twins,"We estimated the temporal course of posttraumatic stress disorder (PTSD) in Vietnam-era veterans using a national sample of male twins with a 20-year follow-up. The complete sample included those twins with a PTSD diagnostic assessment in 1992 and who completed a DSM-IV PTSD diagnostic assessment and a self-report PTSD checklist in 2012 (n = 4,138). Using PTSD diagnostic data, we classified veterans into 5 mutually exclusive groups, including those who never had PTSD, and 4 PTSD trajectory groups: (a) early recovery, (b) late recovery, (c) late onset, and (d) chronic. The majority of veterans remained unaffected by PTSD throughout their lives (79.05% of those with theater service, 90.85% of those with nontheater service); however, an important minority (10.50% of theater veterans, 4.45% of nontheater veterans) in 2012 had current PTSD that was either late onset (6.55% theater, 3.29% nontheater) or chronic (3.95% theater, 1.16% nontheater). The distribution of trajectories was significantly different by theater service (p < .001). PTSD remains a prominent issue for many Vietnam-era veterans, especially for those who served in Vietnam.",0 +https://doi.org/10.1111/cp.12000,Brief report: The relationship between post‐traumatic stress disorder symptoms and overgeneral autobiographical memory in older adults,The aim of this study was to investigate the relationship between post‐traumatic stress disorder (PTSD) symptoms and autobiographical memory specificity in older adults.Older adult trauma survivors...,0 +https://doi.org/10.1519/jsc.0000000000000295,Effects of Heat Stress and Sex on Pacing in Marathon Runners,"Recent research suggests that women tend to exhibit less of a precipitous decline in run velocity during the latter stages of a marathon than men when the covariates of age and run time are controlled for. The purpose of this study was to examine this sex effect with the added covariate of heat stress on pacing, defined as the mean velocity of the last 12.2 km divided by the mean velocity of the first 30 km. A secondary purpose of this investigation was to compare the pacing profiles of the elite men and women runners and the pacing profiles of the elite and nonelite runners. Subjects included 22,990 men and 13,233 women runners from the 2007 and 2009 Chicago marathons for which the mean ambient temperatures were 26.67° C and 2.77° C, respectively. Each 5-km split time was measured via an electronic chip worn on the participants' shoe. Multiple regression analysis indicated that age, sex, heat stress, and overall finish time (p < 0.01 for each) were simultaneous independent elements of pacing. Nonelite women were consistently better pacers than nonelite men in both marathons, and this sex difference was magnified from cold to warm race temperatures. No difference (p < 0.05) in pacing was found between elite men and women runners. Elite men and women had enhanced pacing over their nonelite counterparts. In hotter temperatures, coaches of novice runners should advise their athletes to implement a slower initial velocity to maintain or increase running velocity later in the race.",0 +https://doi.org/10.1037/0022-006x.64.5.1054,The relationship of peritraumatic dissociation and posttraumatic stress: Findings in female Vietnam theater veterans.,,0 +https://doi.org/10.1353/hpu.2013.0120,"The Prevalence of Trauma and Childhood Adversity in an Urban, Hospital-Based Violence Intervention Program","Hospitals represent a promising locus for preventing recurrent interpersonal violence and its psychological sequella. We conducted a cross-sectional analysis to assess the prevalence of post-traumatic stress disorder (PTSD) and adverse childhood experiences (ACEs) among victims of interpersonal violence participating in a hospital-based violence intervention program. Participants completed PTSD and ACE screenings four to six weeks after violent injury, and data were exported from a case management database for analysis. Of the 35 program participants who completed the ACE and/or PTSD screenings, 75.0% met full diagnostic criteria for PTSD, with a larger proportion meeting diagnostic criteria for symptom-specific clusters. For the ACE screening, 56.3% reported three or more ACEs, 34.5% reported five or more ACEs, and 18.8% reported seven or more ACEs. The median ACE score was 3.5. These findings underscore the importance of trauma-informed approaches to violence prevention in urban hospitals and have implications for emergency medicine research and policy.",0 +https://doi.org/10.1016/s0005-7967(99)00069-8,Dysfunctional meaning of posttraumatic intrusions in chronic PTSD,"The paper suggests that the negative idiosyncratic meaning of posttraumatic intrusions (e.g., 'I am going crazy') and cognitive strategies intended to control the intrusions play a major role in maintaining posttraumatic stress disorder. Two studies of 159 and 138 motor vehicle accidents survivors showed that the dysfunctional meaning of intrusions explained a proportion of the variance of the intrusion-related distress, strategies used to end the intrusions, and PTSD severity that was not explained by intrusion frequency, accident severity, or by general catastrophic thoughts when anxious. Rumination, thought suppression, and distraction when having intrusions showed substantial correlations with PTSD severity, as did avoidance of reminders of the accident. The results have implications for the treatment of chronic PTSD.",0 +https://doi.org/10.1016/j.beth.2015.09.005,Mechanisms of Change in Written Exposure Treatment of Posttraumatic Stress Disorder,"Although the effectiveness of exposure therapy for PTSD is recognized, treatment mechanisms are not well understood. Emotional processing theory (EPT) posits that fear reduction within and between sessions creates new learning, but evidence is limited by self-report assessments and inclusion of treatment components other than exposure. We examined trajectories of physiological arousal and their relation to PTSD treatment outcome in a randomized controlled trial of written exposure treatment, a protocol focused on exposure to trauma memories. Hierarchical linear modeling was used to model reduction in Clinician Administered PTSD Scale score as a predictor of initial activation and within- and between-session change in physiological arousal. Treatment gains were significantly associated with initial physiological activation, but not with within- or between-session changes in physiological arousal. Treatment gains were associated with larger between-session reductions in self-reported arousal. These findings highlight the importance of multimethod arousal assessment and add to a growing literature suggesting refinements of EPT.",0 diff --git a/examples/prior_example/generated_data/dataset_with_priors.csv b/examples/prior_example/generated_data/dataset_with_priors.csv new file mode 100644 index 0000000..140b387 --- /dev/null +++ b/examples/prior_example/generated_data/dataset_with_priors.csv @@ -0,0 +1,7172 @@ +record_id,title,abstract,label,makita_priors +0,Statistical Issues in Drug Development,"Drug development is the process of finding and producing therapeutically useful pharmaceuticals, turning them into safe and effective medicine, and producing reliable information regarding the appropriate dosage and dosing intervals. With regulatory authorities demanding increasingly higher standards in such developments, statistics has become an intrinsic and critical element in the design and conduct of drug development programmes. Statistical Issues in Drug Development presents an essential and thought provoking guide to the statistical issues and controversies involved in drug development. This highly readable second edition has been updated to include: Comprehensive coverage of the design and interpretation of clinical trials. Expanded sections on missing data, equivalence, meta-analysis and dose finding. An examination of both Bayesian and frequentist methods. A new chapter on pharmacogenomics and expanded coverage of pharmaco-epidemiology and pharmaco-economics. Coverage of the ICH guidelines, in particular ICH E9, Statistical Principles for Clinical Trials. It is hoped that the book will stimulate dialogue between statisticians and life scientists working within the pharmaceutical industry. The accessible and wide-ranging coverage make it essential reading for both statisticians and non-statisticians working in the pharmaceutical industry, regulatory bodies and medical research institutes. There is also much to benefit undergraduate and postgraduate students whose courses include a medical statistics component. © 2007 John Wiley & Sons, Ltd.",0,1 +1,Kindness reduces avoidance goals in socially anxious individuals,"Social avoidance goals have been linked to negative social outcomes and may contribute to the social impairment experienced by socially anxious individuals. In this study, we examined whether engaging in acts of kindness, a technique designed to increase happiness, decreases social avoidance goals in socially anxious participants and whether social anxiety reduction and hedonic enhancement (i.e., increased positive affect) mediate this effect. Socially anxious undergraduates were randomly assigned to three conditions: performing acts of kindness (AK; N = 38); exposure only (EO; N = 41); and recording life details (LD; N = 36), a neutral control condition. Participants engaged in these activities for 4 weeks. AK resulted in the greatest decrease in social avoidance goals by post-intervention. EO also reduced avoidance goals over time relative to LD. The effect of task condition on avoidance goals over time was fully mediated by social anxiety reduction over time. Neither AK nor EO increased positive affect. Implications for social anxiety treatment are discussed. © 2015, Springer Science+Business Media New York.",0,1 +2,Individual and province inequalities in health among older people in China: Evidence and policy implications,"This paper uses multi-level modelling to analyse data from the nationally-representative Chinese Health and Retirement Longitudinal Study (CHARLS) in order to investigate the characteristics associated with poor health among older people, including individual and household characteristics as well as the characteristics of the provinces in which the older person lives (contextual effects). The results show that older Chinese women, rural residents, those with an education level lower than high school, without individual income sources, who are ex-smokers, and those from poor economic status households are more likely to report disability and poor self-rated health. Differentials in the health outcomes remain substantial between provinces even after controlling for a number of individual and household characteristics.",0,1 +3,Comprehensive decision analytical modelling in economic evaluation: a Bayesian approach,"Decision analytical models are widely used in economic evaluation of health care interventions with the objective of generating valuable information to assist health policy decision-makers to allocate scarce health care resources efficiently. The whole decision modelling process can be summarised in four stages: (i) a systematic review of the relevant data (including meta-analyses), (ii) estimation of all inputs into the model (including effectiveness, transition probabilities and costs), (iii) sensitivity analysis for data and model specifications, and (iv) evaluation of the model. The aim of this paper is to demonstrate how the individual components of decision modelling, outlined above, may be addressed simultaneously in one coherent Bayesian model (sometimes known as a comprehensive decision analytical model) and evaluated using Markov Chain Monte Carlo simulation implemented in the specialist software WinBUGS. To illustrate the method described, it is applied to two illustrative examples: (1) The prophylactic use of neurominidase inhibitors for the prevention of influenza. (2) The use of taxanes for the second-line treatment of advanced breast cancer. The advantages of integrating the four stages outlined into one comprehensive decision analytical model, compared to the conventional 'two-stage' approach, are discussed.",0,1 +4,"On the Use, the Misuse, and the Very Limited Usefulness of Cronbach’s Alpha","This discussion paper argues that both the use of Cronbach's alpha as a reliability estimate and as a measure of internal consistency suffer from major problems. First, alpha always has a value, which cannot be equal to the test score's reliability given the interitem covariance matrix and the usual assumptions about measurement error. Second, in practice, alpha is used more often as a measure of the test's internal consistency than as an estimate of reliability. However, it can be shown easily that alpha is unrelated to the internal structure of the test. It is further discussed that statistics based on a single test administration do not convey much information about the accuracy of individuals' test performance. The paper ends with a list of conclusions about the usefulness of alpha.",0,1 +5,The form of the forgetting curve and the fate of memories,"Psychologists have debated the form of the forgetting curve for over a century. We focus on resolving three problems that have blocked a clear answer on this issue. First, we analyzed data from a longitudinal experiment measuring cued recall and stem completion from 1 min to 28 days after study, with more observations per interval per participant than in previous studies. Second, we analyzed the data using hierarchical models, avoiding distortions due to averaging over participants. Third, we implemented the models in a Bayesian framework, enabling our analysis to account for the ability of candidate forgetting functions to imitate each other. An exponential function provided the best fit to individual participant data collected under both explicit and implicit retrieval instructions, but Bayesian model selection favored a power function. All analysis supported above chance asymptotic retention, suggesting that, despite quite brief study, storage of some memories was effectively permanent.",0,1 +6,A class of shrinkage priors for the dependence structure in longitudinal data,"We review a general class of priors for the dependence in longitudinal (temporal) data in settings where a parametric form is often assumed and place them in the context of the literature. The idea is to embed priors on the parameters of the structure within a richer, more flexible class of priors. These priors are shown to contain standard objective priors for structured and unstructured dependence models as special cases under certain conditions and parameterizations. Recommendations and specific details regarding their use are provided.",0,1 +7,Examining the association between psychological wellbeing with daily and intra-individual variation in subjective wellbeing,"Abstract A number of studies identify distinct dimensions of psychological and subjective wellbeing. However, few investigations have examined how these distinctive wellbeing dimensions may be related over time. The present study aimed to contribute to this growing body of research by adopting a measurement burst design to examine the association between psychological functioning with daily and intra-individual variation in affect over a 14-day period, controlling for personality. Participants ( N  = 45) comprised a sample of Australian adults from Canberra, Australia who were observed on up to 14 days over a 2-week period (Mobs = 10.9 (SD = 3.1)). Maximum Likelihood (ML) estimates from a multi-level structural equation model identified psychological functioning as only weakly associated with daily positive affect, and unrelated to daily levels of negative affect and intra-individual variation in both affect domains when adjusting for demographic, personality and daily stressors. Positive and negative daily events were most strongly associated with positive and negative feelings, respectively. Post-hoc analysis within a Bayesian context confirmed our ML results whilst a Monte Carlo simulation identified sufficient statistical power of significant parameters. Overall, evidence for an association between psychological functioning and daily affect was not identified.",0,1 +8,RTSYS: A DOS application for the analysis of reaction time data,"RTSYS is a menu-driven DOS application for the manipulation, analysis, and graphical display of reaction time data. It can be used either in a single-task environment under DOS, with access to a set operating system commands, or as an application under Windows. All functions have context-sensitive help. RTSYS fits the ex-Gaussian distribution to reaction time data without the difficulties usually associated with numerical parameter estimation. Distribution fitting and flexible censoring and rescaling options allow RTSYS to address the problems of reaction time distribution skew and outlying responses with reasonable sample sizes. RTSYS can automatically process multiple input files from experiments with arbitrary designs and produce formatted output of statistics for further processing by graphical and inferential statistical packages. The present article reviews and explains techniques used by RTSYS and provides an overview of the operation of the program.",0,1 +9,Comparison of Approaches to Constructing Confidence Intervals for Mediating Effects Using Structural Equation Models,"Abstract Mediators are variables that explain the association between an independent variable and a dependent variable. Structural equation modeling (SEM) is widely used to test models with mediating effects. This article illustrates how to construct confidence intervals (CIs) of the mediating effects for a variety of models in SEM. Specifically, mediating models with 1 mediator, 2 intermediate mediators, 2 specific mediators, and 1 mediator in 2 independent groups are illustrated. By using phantom variables (Rindskopf, 1984), a Wald CI, percentile bootstrap CI, bias-corrected bootstrap CI, and a likelihood-based CI on the mediating effect are easily constructed with some existing SEM packages, such as LISREL, M plus, and Mx. Monte Carlo simulation studies are used to compare the coverage probabilities of these CIs. The results show that the coverage probabilities of these CIs are comparable when the mediating effect is large or when the sample size is large. However, when the mediating effect and the sam...",0,1 +10,Inference and Interval Estimation Methods for Indirect Effects With Latent Variable Models,"Although much is known about the performance of recent methods for inference and interval estimation for indirect or mediated effects with observed variables, little is known about their performance in latent variable models. This article presents an extensive Monte Carlo study of 11 different leading or popular methods adapted to structural equation models with latent variables. Manipulated variables included sample size, number of indicators per latent variable, internal consistency per set of indicators, and 16 different path combinations between latent variables. Results indicate that some popular or previously recommended methods, such as the bias-corrected bootstrap and asymptotic standard errors had poorly calibrated Type I error and coverage rates in some conditions. Likelihood-based confidence intervals, the distribution of the product method, and the percentile bootstrap emerged as leading methods for both interval estimation and inference, whereas joint significance tests and the partial poster...",0,1 +11,Bayesian multivariate process modeling for prediction of forest attributes,"This article investigates multivariate spatial process models suitable for predicting multiple forest attributes using a multisource forest inventory approach. Such data settings involve several spatially dependent response variables arising in each location. Not only does each variable vary across space, they are likely to be correlated among themselves. Traditional approaches have attempted to model such data using simplifying assumptions, such as a common rate of decay in the spatial correlation or simplified cross-covariance structures among the response variables. Our current focus is to produce spatially explicit, tree species specific, prediction of forest biomass per hectare over a region of interest. Modeling such associations presents challenges in terms of validity of probability distributions as well as issues concerning identifiability and estimability of parameters. Our template encompasses several models with different correlation structures. These models represent different hypotheses whose tenability are assessed using formal model comparisons. We adopt a Bayesian hierarchical approach offering a sampling-based inferential framework using efficient Markov chain Monte Carlo methods for estimating model parameters. © 2008 American Statistical Association and the International Biometric Society.",0,1 +12,Robust Restricted Maximum Likelihood in Mixed Linear Models,"SUMMARY Definitions of robust maximum likelihood (robust ML) and robust restricted maximum likelihood (robust REML) are introduced, and the definitions are applied to data from biological and chemical experiments. A simulation study is undertaken to investigate the asymptotic properties of robust ML and robust REML in small samples and to examine the advantages of using robust methods. 1. Introduction and Definitions Linear models with multiple sources of error are widely used in designed experiments across many scientific fields. An example of such an experiment is described by Patterson and Nabugoomu (1992), from Patterson and Silvey (1980). Six varieties of wheat were grown at ten centres that formed a sample of the main types of growing area for wheat in Scotland, and the yields in tonnes/hectare were recorded. The experiment is unbalanced because, of 60 possible variety-centre combinations, only 46 were used. At seven centres, four varieties were grown and at the remaining three centres, all six varieties were grown. In this paper we fit the simplest mixed linear model proposed for this data by Patterson and Nabugoomu, namely:",0,1 +13,Multiple Imputation for Multivariate Missing-Data Problems: A Data Analyst's Perspective,"Analyses of multivariate data are frequently hampered by missing values. Until recently, the only missing-data methods available to most data analysts have been relatively ad1 hoc practices such as listwise deletion. Recent dramatic advances in theoretical and computational statistics, however, have produced anew generation of flexible procedures with a sound statistical basis. These procedures involve multiple imputation (Rubin, 1987), a simulation technique that replaces each missing datum with a set of m > 1 plausible values. The rn versions of the complete data are analyzed by standard complete-data methods, and the results are combined using simple rules to yield estimates, standard errors, and p-values that formally incorporate missing-data uncertainty. New computational algorithms and software described in a recent book (Schafer, 1997a) allow us to create proper multiple imputations in complex multivariate settings. This article reviews the key ideas of multiple imputation, discusses the software programs currently available, and demonstrates their use on data from the Adolescent Alcohol Prevention Trial (Hansen & Graham, 199 I).",0,1 +14,Associations of self-compassion and global self-esteem with positive and negative affect and stress reactivity in daily life: Findings from a smart phone study,"The present study examined trait self-compassion and trait self-esteem in relation to positive (PA) and negative affect (NA), as well as their associations with stress reactivity in daily life. One hundred and one subjects completed questionnaires on perceived stress and affect twice a day for 14 consecutive days on smart phones. Results indicated that self-compassion and global self-esteem were positively related to PA and negatively to NA. After controlling for self-esteem, self-compassion remained significantly associated with PA and NA, whereas self-esteem was no longer associated with PA and NA after controlling for self-compassion. Furthermore, results indicated that self-compassion buffered the effect of stress on NA, whereas this was not the case for global self-esteem. Neither self-compassion nor self-esteem moderated the relation of stress on PA in separate models. The results of the present study add to the growing literature regarding beneficial relations of self-compassion and psychological well-being and further emphasize the distinction of self-compassion and global self-esteem.",0,1 +15,Testing Measurement Invariance: A Comparison of Multiple-Group Categorical CFA and IRT,"This study investigated two major approaches in testing measurement invariance for ordinal measures: multiple-group categorical confirmatory factor analysis (MCCFA) and item response theory (IRT). Unlike the ordinary linear factor analysis, MCCFA can appropriately model the ordered-categorical measures with a threshold structure. A simulation study under various conditions was conducted for the comparison of MCCFA and IRT with respect to the power to detect the lack of invariance across groups. Both MCCFA and IRT showed reasonable power to identify the noninvariant item when differential item functioning (DIF) was large. The false positive rates were relatively high in both methods, however. The adjustment of critical values improved the performance of MCCFA by reducing false positive rates substantially and yet yielding adequate power. Alternative model fit indexes of MCCFA were also examined and they were found to be reliable to detect DIF, in general.",0,1 +16,The Model-Size Effect on Traditional and Modified Tests of Covariance Structures,"According to Kenny and McCoach (2003), chi-square tests of structural equation models produce inflated Type I error rates when the degrees of freedom increase. So far, the amount of this bias in large models has not been quantified. In a Monte Carlo study of confirmatory factor models with a range of 48 to 960 degrees of freedom it was found that the traditional maximum likelihood ratio statistic, T ML , overestimates nominal Type I error rates up to 70% under conditions of multivariate normality. Some alternative statistics for the correction of model-size effects were also investigated: the scaled Satorra–Bentler statistic, T SC ; the adjusted Satorra–Bentler statistic, T AD (Satorra & Bentler, 1988, 1994); corresponding Bartlett corrections, T MLb , T SCb , and T ADb (Bartlett, 1950); and corresponding Swain corrections, T MLs , T SCs , and T ADs (Swain, 1975). The empirical findings indicate that the model test statistic T MLs should be applied when large structural equation models are analyzed and th...",0,1 +17,Coping with stress through decisional control: Quantification of negotiating the environment,"Coping with stress through 'decisional control' - positioning oneself in a multifaceted stressing situation so as to minimize the likelihood of an untoward event - is modelled within a tree-structure scenario, whose architecture hierarchically nests elements of varying threat. Analytic and simulation platforms quantify the game-like interplay of cognitive demands and threat reduction. When elements of uncertainty enter the theoretical structure, specifically at more subordinate levels of the hierarchy, the mathematical expectation of threat is particularly exacerbated. As quantified in this model, the exercise of decisional control is demonstrably related to reduction in expected threat (the minimum correlation across comprehensive parameter settings being .55). Disclosure of otherwise intractable stress-coping subtleties, endowed by the quantitative translation of verbal premises, is underscored. Formalization of decisional stress control is seen to usher in linkages to augmenting formal developments from fields of cognitive science, preference and choice modelling, and nonlinear dynamical systems theory. Model-prescribed empirical consequences are stipulated.",0,1 +18,Using Simulation Results to Choose a Latent Trait Model,"A latent trait model goodness-of-fit statistic was defined, and its relationships to several other com monly used fit statistics were described. Simulation data were used to examine the behavior of these fit statistics under conditions similar to those found with real data. The simulation data were generated for 36 pseudo-items and 1,000 simulees using three-, two-, and one-parameter logistic latent trait models. The data were analyzed using three-, two-, and one-parameter models. Between-model comparisons were made of the fit statistics, trait es timates, and item parameter estimates. The three generating models produced clearly different pat terns of results. The simulation results were com pared to results for real data involving seventh- and eighth-grade students' performance on eight achievement tests. The achievement test results ap peared most similar to the simulation results based on data generated with the three-parameter model. Some practical problems that can result from using an inappropriate model with multiple-choice tests are discussed.",0,1 +19,The D-Optimality Item Selection Criterion in the Early Stage of CAT: A Study With the Graded Response Model,"During the early stage of computerized adaptive testing (CAT), item selection criteria based on Fisher’s information often produce less stable latent trait estimates than the Kullback-Leibler global information criterion. Robustness against early stage instability has been reported for the D-optimality criterion in a polytomous CAT with the Nominal Response Model and is shown herein to be reproducible for the Graded Response Model. For comparative purposes, the A-optimality and the global information criteria are also applied. Their item selection is investigated as a function of test progression and item bank composition. The results indicate how the selection of specific item parameters underlies the criteria performances evaluated via accuracy and precision of estimation. In addition, the criteria item exposure rates are compared, without the use of any exposure controlling measure. On the account of stability, precision, accuracy, numerical simplicity, and less evidently, item exposure rate, the D-opt...",0,1 +20,Latent growth mixture modeling : a simulation study,"Latent growth curve modeling (LGM) combined with the latent classes (LGMM) in the SEM context, is the method under investigation in this study. This dynamic way of analyzing longitudinal data takes an increasingly central position in the social sciences, e.g. in psychology. Despite twenty years development of the theory behind the LGM and LGMM, these are novel methods in analyzing data in practice. With limited sample size the functionality of the model is unknown. The aim of this dissertation was to examine the functionality of the linear LGM model with four repeated measurements, which is a typical case in longitudinal research. LGMM parameters were estimated using maximum likelihood estimation with robust standard errors (MLR). The effect of differences between latent classes in mean values of latent components with varying sample sizes is examined in this study. Other affecting factors examined are reliability of observed variables, number of repeated measures, model construct and additional measurement points. The functionality of LGMM was approached from three different viewpoints: 1) problems in estimation of model parameters expressed as number of failed estimations and as the number of negative variance estimates, 2) the ability of AIC, BIC and aBIC information criteria and VLMR, LMR and BLRT statistical tests to decide the number of latent classes, and 3) good parameter estimation, which was evaluated using four different criteria: MSE, proportion of bias in MSE, bias of standard error, and 95 % coverage. The results of Monte Carlo simulations suggest that from information criteria AIC, BIC aBIC and VLMR and LMR tests, BIC is most useful with small sample sizes ( ) and aBIC with large sample sizes ( ). The few results suggest that the BLRT test could be useful in any situation. More investigation is needed to further support the functionality of this test. The study reveals that the estimation of LGMM fails only in a few cases, and problems in estimation appear mainly in the negative variance estimates. The results of the simulations suggest that it is possible to identify the true two-latent classes when SMD is at least 2, in which case reliability of observed variables should be high and the sample size should be relatively large. In that case estimation produce good parameter estimates. When SMD is 4 or 5, the probability in identifying the right two-latent-class solution instead of the wrong one-class solution is greater than .70 with the smallest sample size (n=50) using BIC in models with high reliability. To achieve reliable results in estimation, the sample size should be greater than 50. 500 < n 500 ≥ n",0,1 +21,Curriculum-Based Oral Reading Fluency Norms for Students in Grades 2 through 5,,0,1 +22,Evaluating model fit for growth curve models: Integration of fit indices from SEM and MLM frameworks.,"Evaluating overall model fit for growth curve models involves 3 challenging issues. (a) Three types of longitudinal data with different implications for model fit may be distinguished: balanced on time with complete data, balanced on time with data missing at random, and unbalanced on time. (b) Traditional work on fit from the structural equation modeling (SEM) perspective has focused only on the covariance structure, but growth curve models have four potential sources of misspecification: within-individual covariance matrix, between-individuals covariance matrix, marginal mean structure, and conditional mean structure. (c) Growth curve models can be estimated in both the SEM and multilevel modeling (MLM) frameworks; these have different emphases for the evaluation of model fit. In this article, the authors discuss the challenges presented by these 3 issues in the calculation and interpretation of SEM- and MLM-based fit indices for growth curve models and conclude by identifying some lines for future research.",0,1 +23,Variation in New Zealand hospital outcomes: combining hierarchical Bayesian modeling and propensity score methods for hospital performance comparisons,"Two major statistical issues confronting comparative analyses of hospital outcomes are adequacy of case-mix adjustment and proper accounting for random variation. Hierarchical modeling has been proposed to improve precision and reduce the impact of random variation but becomes difficult to implement when there are numerous case-mix factors to control. In this paper we formulate the problem of hospital performance comparisons within the framework of potential outcomes and illustrate an approach to hospital comparisons which combines multiple category propensity score methods for the control of case-mix variations with hierarchical Bayesian modeling of case-mix adjusted summaries. The approach is similar to that proposed by Huang et al. (Health Serv Res 40:253-278, 2005) but extends their approach by using a Bayesian model to accommodate hospital level attributes and to facilitate joint modeling of performance for multiple outcomes. The analytical approach is illustrated by a comparison of 30 day post admission mortality risks for patients treated for acute myocardial infarction, pneumonia or stroke in 34 New Zealand public hospitals. In a small simulation study, reported in electronic supplementary material, hierarchical models outperformed non-hierarchical models, achieving both better credible interval coverage and shorter average interval lengths for measures of between hospital variation based on contrasts between the 90th and 10th percentiles of the mortality risk distribution. Simulation performance of hierarchical and non-hierarchical models in detecting unusual performance was similar. © 2012 Springer Science+Business Media, LLC.",0,1 +24,More Statistical and Methodological Myths and Urban Legends,"The study of urban legends represents the application of concepts developed in the academic study of traditional folktales to stories circulating in the modern world. Vandenberg adapted the notion of ‘‘urban legends’’ into the area of organizational research methods and coined the term statistical and methodological myths and urban legends (SMMULs) to refer to the collection of various rules of thumb and other ‘‘received doctrines’’ that often guide researchers’ scientific behavior. Various SMMULs have been examined over 7 years in a number of symposia at scientific conferences, in a previous Feature Topic in Organizational Research Methods (2006), and in an edited book. This Feature Topic continues this tradition by presenting five new SMMULs.",0,1 +25,Methodological Advances in the Analysis of Individual Growth With Relevance to Education Policy,"The purpose of this article is to demonstrate how recent methodological developments in the analysis of individual growth can inform important problems in education policy. Specifically, this article focuses on a method referred to as growth mixture modeling. Growth mixture modeling is a relatively new procedure for the analysis of longitudinal data that relaxes many of the assumptions associated with conventional growth curve modeling. In particular, growth mixture modeling tests for the existence of unique growth trajectory classes through a combination of latent class analysis and standard growth curve modeling. Antecedent predictors of the latent classes can be incorporated as well as relations from the latent classes to specific outcomes. This article applies growth mixture modeling to data from the Early Childhood Longitudinal Study-Kindergarten class of 1998-1999. The specific policy question posed in this article focuses on the estimation of latent growth trajectory classes in reading proficiency ...",0,1 +26,Increasing the efficiency of oncology basket trials using a Bayesian approach,"With the rapid growth of targeted and immune-oncology therapies, novel statistical design approaches are needed to increase the flexibility and efficiency of early phase oncology trials. Basket trials enroll patients with defined biological deficiencies, but with multiple histologic tumor types (or indications), to discover in which indications the drug is active. In such designs different indications are typically analyzed independently. This, however, ignores potential biological similarities among the indications. Our research provides a statistical methodology to enhance such basket trials by assessing the homogeneity of the response rates among indications at an interim analysis, and applying a Bayesian hierarchical modeling approach in the second stage if the efficacy is deemed reasonably homogenous across indications. This increases the power of the study by allowing indications with similar response rates to borrow information from each other. Via simulations, we quantify the efficiency gain of our proposed approach relative to the conventional parallel approach. The operating characteristics of our method depend on the similarity of the response rates between the different indications. If the response rates are comparable in most or all indications after treatment with the investigational drug, a substantial increase in efficiency as compared to the conventional approach can be obtained as fewer patients are required or a higher power is attained. We also demonstrate that efficacy again decreases if the response rates vary considerably among tumor types but it is still better than the conventional approach.",0,1 +27,Temporal-order judgment of visual and auditory stimuli: modulations in situations with and without stimulus discrimination,"Temporal-order judgment (TOJ) tasks are an important paradigm to investigate processing times of information in different modalities. There are a lot of studies on how temporal order decisions can be influenced by stimuli characteristics. However, so far it has not been investigated whether the addition of a choice reaction time (RT) task has an influence on TOJ. Moreover, it is not known when during processing the decision about the temporal order of two stimuli is made. We investigated the first of these two questions by comparing a regular TOJ task with a dual task (DT). In both tasks, we manipulated different processing stages to investigate whether the manipulations have an influence on TOJ and to determine thereby the time of processing at which the decision about temporal order is made. The results show that the addition of a choice RT task does have an influence on the TOJ, but the influence seems to be linked to the kind of manipulation of the processing stages that is used. The results of the manipulations indicate that the temporal order decision in the DT paradigm is made after perceptual processing of the stimuli.",0,1 +28,Statistical methods for dealing with publication bias in meta-analysis,"Publication bias is an inevitable problem in the systematic review and meta-analysis. It is also one of the main threats to the validity of meta-analysis. Although several statistical methods have been developed to detect and adjust for the publication bias since the beginning of 1980s, some of them are not well known and are not being used properly in both the statistical and clinical literature. In this paper, we provided a critical and extensive discussion on the methods for dealing with publication bias, including statistical principles, implementation, and software, as well as the advantages and limitations of these methods. We illustrated a practical application of these methods in a meta-analysis of continuous support for women during childbirth. Copyright © 2014 John Wiley & Sons, Ltd.",0,1 +29,Quantifying the effect of intertrial dependence on perceptual decisions,"In the perceptual sciences, experimenters study the causal mechanisms of perceptual systems by probing observers with carefully constructed stimuli. It has long been known, however, that perceptual decisions are not only determined by the stimulus, but also by internal factors. Internal factors could lead to a statistical influence of previous stimuli and responses on the current trial, resulting in serial dependencies, which complicate the causal inference between stimulus and response. However, the majority of studies do not take serial dependencies into account, and it has been unclear how strongly they influence perceptual decisions. We hypothesize that one reason for this neglect is that there has been no reliable tool to quantify them and to correct for their effects. Here we develop a statistical method to detect, estimate, and correct for serial dependencies in behavioral data. We show that even trained psychophysical observers suffer from strong history dependence. A substantial fraction of the decision variance on difficult stimuli was independent of the stimulus but dependent on experimental history.We discuss the strong dependence of perceptual decisions on internal factors and its implications for correct data interpretation.",0,1 +30,Diffusion model analysis with MATLAB: A DMAT primer,"The Ratcliff diffusion model has proved to be a useful tool in reaction time analysis. However, its use has been limited by the practical difficulty of estimating the parameters. We present a software tool, the Diffusion Model Analysis Toolbox (DMAT), intended to make the Ratcliff diffusion model for reaction time and accuracy data more accessible to experimental psychologists. The tool takes the form of a MATLAB toolbox and can be freely downloaded from ppw.kuleuven.be/okp/dmatoolbox. Using the program does not require a background in mathematics, nor any advanced programming experience (but familiarity with MATLAB is useful). We demonstrate the basic use of DMAT with two examples.",0,1 +31,How Many Countries for Multilevel Modeling? A Comparison of Frequentist and Bayesian Approaches,"Researchers in comparative research increasingly use multilevel models to test effects of country-level factors on individual behavior and preferences. However, the asymptotic justification of widely employed estimation strategies presumes large samples and applications in comparative politics routinely involve only a small number of countries. Thus, researchers and reviewers often wonder if these models are applicable at all. In other words, how many countries do we need for multilevel modeling? I present results from a large-scale Monte Carlo experiment comparing the performance of multilevel models when few countries are available. I find that maximum likelihood estimates and confidence intervals can be severely biased, especially in models including cross-level interactions. In contrast, the Bayesian approach proves to be far more robust and yields considerably more conservative tests.",1,1 +32,Sample size in factor analysis.,"The factor analysis literature includes a range of recommendations regarding the minimum sample size necessary to obtain factor solutions that are adequately stable and that correspond closely to population factors. A fundamental misconception about this issue is that the minimum sample size, or the",0,1 +33,Adoptive transfer of peripheral immune cells potentiates allodynia in a graded chronic constriction injury model of neuropathic pain,"► Intraperitoneal adoptive transfer of peripheral immune cells potentiates chronic constriction injury-induced allodynia . ► Peripheral immune cells only capable of potentiating existing allodynia, rather than establishing allodynia. ► Intraperitoneal adoptive transfer of high pain splenocytes may induce the migration of host-derived immune cells from the spleen to the CNS. ► Intrathecal transfer of “pain-activated” CD45 + cells results in potentiated allodynia. Recent evidence demonstrates that peripheral immune cells contribute to the nociceptive hypersensitivity associated with neuropathic pain by infiltrating the central nervous system (CNS). We have recently developed a rat model of graded chronic constriction injury (CCI) by varying the exposure of the sciatic nerve and control non-nerve tissue to surgical placement of chromic gut. We demonstrate that splenocytes can contribute significantly to CCI-induced allodynia, as adoptive transfer of these cells from high pain donors to low pain recipients potentiates allodynia ( P < 0.001). The phenomenon was replicated with peripheral blood mononuclear cells ( P < 0.001). Adoptive transfer of allodynia was not achieved in sham recipients, indicating that peripheral immune cells are only capable of potentiating existing allodynia, rather than establishing allodynia. As adoptively transferred cells were found by flow cytometry to migrate to the spleen ( P < 0.05) and potentiation of allodynia was prevented in splenectomised low pain recipients, adoptive transfer of high pain splenocytes may induce the migration of host-derived immune cells from the spleen to the CNS as observed by flow cytometry ( P < 0.05). Importantly, intrathecal transfer of CD45 + cells prepared from spinal cords of high pain donors into low pain recipients led to potentiated allodynia ( P < 0.001), confirming that infiltrating immune cells are not passive bystanders, but actively contribute to nociceptive hypersensitivity in the lumbar spinal cord.",0,1 +34,"Upper respiratory tract disease, force of infection, and effects on survival of gopher tortoises","Upper respiratory tract disease (URTD) caused by Mycoplasma agassizii has been hypothesized to contribute to the decline of some wild populations of gopher tortoises (Gopherus polyphemus). However, the force of infection (FOI) and the effect of URTD on survival in free-ranging tortoise populations remain unknown. Using four years (2003-2006) of mark-recapture and epidemiological data collected from 10 populations of gopher tortoises in central Florida, USA, we estimated the FOI (probability per year of a susceptible tortoise becoming infected) and the effect of URTD (i.e., seropositivity to M. agassizii) on apparent survival rates. Sites with high (> or = 25%) seroprevalence had substantially higher FOI (0.22 +/- 0.03; mean +/- SE) than low (< 25%) seroprevalence sites (0.04 +/- 0.01). Our results provide the first quantitative evidence that the rate of transmission of M. agassizii is directly related to the seroprevalence of the population. Seropositive tortoises had higher apparent survival (0.99 +/- 0.0001) than seronegatives (0.88 +/- 0.03), possibly because seropositive tortoises represent individuals that survived the initial infection, developed chronic disease, and experienced lower mortality during the four-year span of our study. However, two lines of evidence suggested possible effects of mycoplasmal URTD on tortoise survival. First, one plausible model suggested that susceptible (seronegative) tortoises in high seroprevalence sites had lower apparent survival rates than did susceptible tortoises in low seroprevalence sites, indicating a possible acute effect of infection. Second, the number of dead tortoise remains detected during annual site surveys increased significantly with increasing site seroprevalence, from approximately 1 to approximately 5 shell remains per 100 individuals. If (as our results suggest) URTD in fact reduces adult survival, it could adversely influence the population dynamics and persistence of this late- maturing, long-lived species.",0,1 +35,The dynamic interplay between negative and positive emotions in daily life predicts response to treatment in depression: A momentary assessment study,"Although the treatment of depressive illness aims to restore the imbalance between an excess of negative affect (NA) and a shortage of positive affect (PA), no study has examined how NA and PA may influence each other in depression. This study examines how NA and PA dynamically influence each other in depression and how this may impact on treatment response.Depressed help-seeking individuals participated in the Experience Sampling Method (ESM), which enables visualization of subtle dynamic alterations of momentary affective states over time. Thereafter, participants received a combination of antidepressant treatment and psychotherapy, and were followed up each month.NA and PA were assessed during ESM at 10 random moments per day for 6 days. Depressive symptoms were assessed at baseline and at monthly intervals during treatment.Future response to treatment was associated with altered baseline NA-PA dynamics in individuals with previous depressive episodes. Their daily life boosts of PA were followed by a stronger suppression of NA over subsequent hours than in other depressed groups or controls.Subtle individual differences in daily life emotional dynamics predict future treatment outcome in depression.",0,1 +36,Basic and Advanced Bayesian Structural Equation Modeling,"This book provides clear instructions to researchers on how to apply Structural Equation Models (SEMs) for analyzing the inter relationships between observed and latent variables. Basic and Advanced Bayesian Structural Equation Modeling introduces basic and advanced SEMs for analyzing various kinds of complex data, such as ordered and unordered categorical data, multilevel data, mixture data, longitudinal data, highly non-normal data, as well as some of their combinations. In addition, Bayesian semiparametric SEMs to capture the true distribution of explanatory latent variables are introduced, whilst SEM with a nonparametric structural equation to assess unspecified functional relationships among latent variables are also explored. Statistical methodologies are developed using the Bayesian approach giving reliable results for small samples and allowing the use of prior information leading to better statistical results. Estimates of the parameters and model comparison statistics are obtained via powerful Markov Chain Monte Carlo methods in statistical computing. Introduces the Bayesian approach to SEMs, including discussion on the selection of prior distributions, and data augmentation. Demonstrates how to utilize the recent powerful tools in statistical computing including, but not limited to, the Gibbs sampler, the Metropolis-Hasting algorithm, and path sampling for producing various statistical results such as Bayesian estimates and Bayesian model comparison statistics in the analysis of basic and advanced SEMs. Discusses the Bayes factor, Deviance Information Criterion (DIC), and $L_\nu$-measure for Bayesian model comparison. Introduces a number of important generalizations of SEMs, including multilevel and mixture SEMs, latent curve models and longitudinal SEMs, semiparametric SEMs and those with various types of discrete data, and nonparametric structural equations. Illustrates how to use the freely available software WinBUGS to produce the results. Provides numerous real examples for illustrating the theoretical concepts and computational procedures that are presented throughout the book. Researchers and advanced level students in statistics, biostatistics, public health, business, education, psychology and social science will benefit from this book. © 2012 John Wiley & Sons, Ltd. All rights reserved.",0,1 +37,Posterior bimodality in the balanced one-way random-effects model,"Summary. Although some researchers have examined posterior multimodality for specific richly parameterized models, multimodality is not well characterized for any such model. The paper characterizes bimodality of the joint and marginal posteriors for a conjugate analysis of the balanced one-way random-effects model with a flat prior on the mean. This apparently simple model has surprisingly complex and even bizarre mode behaviour. Bimodality usually arises when the data indicate a much larger between-groups variance than does the prior. We examine an example in detail, present a graphical display for describing bimodality and use real data sets from a statistical practice to shed light on the practical relevance of bimodality for these models.",0,1 +38,League Tables and Their Limitations: Statistical Issues in Comparisons of Institutional Performance,"SUMMARY In the light of an increasing interest in the accountability of public institutions, this paper sets out the statistical issues involved in making quantitative comparisons between institutions in the areas of health and education. We deal in detail with the need to take account of model-based uncertainty in making comparisons. We discuss the need to establish appropriate measures of institutional 'outcomes' and base-line measures and the need to exercise care and sensitivity when interpreting apparent differences. The paper emphasizes that statistical methods exist which can contribute to an understanding of the extent and possible reasons for differences between institutions. It also urges caution by discussing the limitations of such methods.",0,1 +39,A General Maximum Likelihood Analysis of Variance Components in Generalized Linear Models,"This paper describes an EM algorithm for nonparametric maximum likelihood (ML) estimation in generalized linear models with variance component structure. The algorithm provides an alternative analysis to approximate MQL and PQL analyses (McGilchrist and Aisbett, 1991, Biometrical Journal 33, 131-141; Breslow and Clayton, 1993; Journal of the American Statistical Association 88, 9-25; McGilchrist, 1994, Journal of the Royal Statistical Society, Series B 56, 61-69; Goldstein, 1995, Multilevel Statistical Models) and to GEE analyses (Liang and Zeger, 1986, Biometrika 73, 13-22). The algorithm, first given by Hinde and Wood (1987, in Longitudinal Data Analysis, 110-126), is a generalization of that for random effect models for overdispersion in generalized linear models, described in Aitkin (1996, Statistics and Computing 6, 251-262). The algorithm is initially derived as a form of Gaussian quadrature assuming a normal mixing distribution, but with only slight variation it can be used for a completely unknown mixing distribution, giving a straightforward method for the fully nonparametric ML estimation of this distribution. This is of value because the ML estimates of the GLM parameters can be sensitive to the specification of a parametric form for the mixing distribution. The nonparametric analysis can be extended straightforwardly to general random parameter models, with full NPML estimation of the joint distribution of the random parameters. This can produce substantial computational saving compared with full numerical integration over a specified parametric distribution for the random parameters. A simple method is described for obtaining correct standard errors for parameter estimates when using the EM algorithm. Several examples are discussed involving simple variance component and longitudinal models, and small-area estimation.",0,1 +40,A randomized trial of a dissonance-based eating disorder prevention program,"As psychoeducational eating disorder prevention programs have not been shown to reduce bulimic pathology, we developed and evaluated a dissonance-based intervention for high-risk populations.Young women (N = 87) with body image concerns were randomized to this intervention, which involves verbal, written, and behavioral exercises requiring them to critique the thin-ideal, or to a healthy weight management control group. Participants completed a baseline, termination, and 4-week follow-up survey.Participants in the dissonance intervention reported decreased thin-ideal internalization, body dissatisfaction, dieting, negative affect, and bulimic symptoms at termination and at 4-week follow-up. Unexpectedly, participants in the healthy weight management control group also reported some benefits.Taken in conjunction with past findings, these preliminary results suggest that the dissonance intervention, and to a lesser extent the healthy weight management intervention, may reduce bulimic pathology and risk factors for eating disturbances.",0,1 +41,How do amplitude spectra influence rapid animal detection?,"Amplitude spectra might provide information for natural scene classification. Amplitude does play a role in animal detection because accuracy suffers when amplitude is normalized. However, this effect could be due to an interaction between phase and amplitude, rather than to a loss of amplitude-only information. We used an amplitude-swapping paradigm to establish that animal detection is partly based on an interaction between phase and amplitude. A difference in false alarms for two subsets of our distractor stimuli suggests that the classification of scene environment (man-made versus natural) may also be based on an interaction between phase and amplitude. Examples of interaction between amplitude and phase are discussed.",0,1 +42,Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing,"SUMMARY The common approach to the multiplicity problem calls for controlling the familywise error rate (FWER). This approach, though, has faults, and we point out a few. A different approach to problems of multiple significance testing is presented. It calls for controlling the expected proportion of falsely rejected hypotheses -the false discovery rate. This error rate is equivalent to the FWER when all hypotheses are true but is smaller otherwise. Therefore, in problems where the control of the false discovery rate rather than that of the FWER is desired, there is potential for a gain in power. A simple sequential Bonferronitype procedure is proved to control the false discovery rate for independent test statistics, and a simulation study shows that the gain in power is substantial. The use of the new procedure and the appropriateness of the criterion are illustrated with examples.",0,1 +43,Mixed and Mixture Regression Models for Continuous Bounded Responses Using the Beta Distribution,"Doubly bounded continuous data are common in the social and behavioral sciences. Examples include judged probabilities, confidence ratings, derived proportions such as percent time on task, and bounded scale scores. Dependent variables of this kind are often difficult to analyze using normal theory models because their distributions may be quite poorly modeled by the normal distribution. The authors extend the beta-distributed generalized linear model (GLM) proposed in Smithson and Verkuilen (2006) to discrete and continuous mixtures of beta distributions, which enables modeling dependent data structures commonly found in real settings. The authors discuss estimation using both deterministic marginal maximum likelihood and stochastic Markov chain Monte Carlo (MCMC) methods. The results are illustrated using three data sets from cognitive psychology experiments.",0,1 +44,The Theory of Legal Cynicism and Sunni Insurgent Violence in Post-Invasion Iraq,"We elaborate a cultural framing theory of legal cynicism—previously used to account for neighborhood variation in Chicago homicides—to explain Arab Sunni victimization and insurgent attacks during the U.S. post-invasion occupation of Iraq. Legal cynicism theory has an unrecognized power to explain collective and interpersonal violence in international as well as U.S. settings. We expand on how “double and linked” roles of state and non-state actors can be used to analyze violence against Arab Sunni civilians. Arab Sunnis responded to reports of unnecessary violent attacks by U.S./Coalition soldiers with a legally cynical framing of the U.S./Coalition-led invasion and occupation, the new Shia-dominated Iraqi state, and its military and police. A post-invasion frame amplification of beliefs about state-based illegitimacy, unresponsiveness, and insecurity made it not only possible but predictable that Arab Sunni insurgent attacks would continue against U.S./Coalition forces and transfer to Shia-dominated Iraqi government forces. Violence in Iraq persisted despite U.S. surge efforts to end the Arab Sunni insurgency.",0,1 +45,Computerized Adaptive Testing in Computer Assisted Learning?,"AbstractA major goal in computerized learning systems is to optimize learning, while in computerized adaptive tests (CAT) efficient measurement of the proficiency of students is the main focus. There seems to be a common interest to integrate computerized adaptive item selection in learning systems and testing. Item selection is a well founded building block of CAT. However, there are a number of problems that prevent the application of a standard approach, based on item response theory, of computerized adaptive item selection to learning systems. In this work attention will be paid to three unresolved points: item banking, item selection, and choice of IRT model. All problems will be discussed, and an approach to automated item bank generation is presented. Finally some recommendations are given.Keywordsitem-based computer assisted learningcomputer adaptive testingitem bankingitem response theoryitem selection",0,1 +46,Do Attitudes toward School Influence the Underachievement of Turkish and Moroccan Minority Students in Flanders? The Attitude-Achievement Paradox Revisited,"While many ethnic minority students underachieve compared with their ethnic majority peers, they often hold very positive school attitudes. Mickelson (1990) explained this attitude-achievement paradox by the existence of a double set of attitudes. Abstract attitudes reflect the dominant ideas about schooling, while concrete attitudes refer to a person’s perceptions of reality and originate from the educational benefits people expect to obtain on the labor market. According to Mickelson, only students’ concrete attitudes influence achievement. Applying Mickelson’s theory in Flanders, regarding students of Turkish and Moroccan descent, we could not find evidence that abstract and concrete attitudes play a role in the achievement of ethnic minority students. Qualitative research suggests that this could be due to distinct interpretations of success and ways of dealing with perceived constraints. This contrasts with ethnic majority students, who are more likely to end the school year unsuccessfully if they hold pessimistic concrete attitudes.",0,1 +47,Bayesian analysis of autoregressive panel data model: application in genetic evaluation of beef cattle,"The animal breeding values forecasting at futures times is a relevant technological innovation in the field of Animal Science, since its enables a previous indication of animals that will be either kept by the producer for breeding purposes or discarded. This study discusses an MCMC Bayesian methodology applied to panel data in a time series context. We consider Bayesian analysis of an autoregressive, AR(p), panel data model of order p, using an exact likelihood function, comparative analysis of prior distributions and predictive distributions of future observations. The methodology was tested by a simulation study using three priors: hierarchical Multivariate Normal-Inverse Gamma (model 1), independent Multivariate Student's t Inverse Gamma (model 2) and Jeffrey's (model 3). Comparisons by Pseudo-Bayes Factor favored model 2. The proposed methodology was applied to longitudinal data relative to Expected Progeny Difference (EPD) of beef cattle sires. The forecast efficiency was around 80%. Regarding the mean width of the EPD interval estimation (95%) in a future time, a great advantage was observed for the proposed Bayesian methodology over usual asymptotic frequentist method.",0,1 +48,Meaningful aspects of change as novel random coefficients: A general method for reparameterizing longitudinal models.,"A fundamental goal of longitudinal modeling is to obtain estimates of model parameters that reflect meaningful aspects of change over time. Often, a linear or nonlinear model may be sensible from a theoretical perspective, yet may have parameters that are difficult to interpret in a way that sheds light on substantive hypotheses. Fortunately, such models may be reparameterized to yield more easily interpretable parameters. This article has 3 goals. First, we provide theoretical background and elaboration on Preacher and Hancock's (2012) 4-step method for reparameterizing growth curve models. Second, we extend this method by providing a user-friendly modification of the structured latent curve model in the third step that enables fitting models that are not estimable with the original method. This modification also allows researchers to specify the mean structure without having to determine which parameters enter nonlinearly and without needing to solve complex matrix expressions. Third, we illustrate how this general reparameterization method allows researchers to treat the average rate of change, half-life, and knot (transition point) as random coefficients; these aspects of change have not before been treated as random coefficients in structural equation modeling. We supply Mplus code for illustrative examples in an online supplement. Our core message is that growth curve models are considerably more flexible than most researchers may suspect. Virtually any parameter can be treated as a random coefficient that varies across individuals. Alternative parameterizations of a given model may yield unique insights that are not available with traditional parameterizations.",0,1 +49,Advanced Insights into Functional Brain Connectivity by Combining Tensor Decomposition and Partial Directed Coherence,"Quantification of functional connectivity in physiological networks is frequently performed by means of time-variant partial directed coherence (tvPDC), based on time-variant multivariate autoregressive models. The principle advantage of tvPDC lies in the combination of directionality, time variance and frequency selectivity simultaneously, offering a more differentiated view into complex brain networks. Yet the advantages specific to tvPDC also cause a large number of results, leading to serious problems in interpretability. To counter this issue, we propose the decomposition of multi-dimensional tvPDC results into a sum of rank-1 outer products. This leads to a data condensation which enables an advanced interpretation of results. Furthermore it is thereby possible to uncover inherent interaction patterns of induced neuronal subsystems by limiting the decomposition to several relevant channels, while retaining the global influence determined by the preceding multivariate AR estimation and tvPDC calculation of the entire scalp. Finally a comparison between several subjects is considerably easier, as individual tvPDC results are summarized within a comprehensive model equipped with subject-specific loading coefficients. A proof-of-principle of the approach is provided by means of simulated data; EEG data of an experiment concerning visual evoked potentials are used to demonstrate the applicability to real data.",0,1 +50,"Estimation of bivariate measurements having different change points, with application to cognitive ageing","Longitudinal studies of ageing make repeated observations of multiple measurements on each subject. Change point models are often used to model longitudinal data. We demonstrate the use of Bayesian and profile likelihood methods to simultaneously estimate different change points in the longitudinal course of two different measurements of cognitive function in subjects in the Bronx Aging Study who developed Alzheimer's disease (AD). Analyses show that accelerated memory decline, as measured by Buschke Selective Reminding, begins between seven and eight years before diagnosis of AD, while decline in performance on speeded tasks as measured by WAIS Performance IQ begins slightly more than two years before diagnosis, significantly after the decline in memory.",0,1 +51,Optimal Designs for Empirical Bayes Estimators of Individual Linear and Quadratic Growth Curves in Linear Mixed Models,"Many studies on optimal designs for linear mixed model analysis of repeated measures data have focussed on estimating the fixed effects. The present study investigates the optimal number of time points and subjects in case random effects have to be estimated. Linear mixed models with a linear or quadratic trend across equidistant time points are studied. Given a particular cost function, we examine which designs minimise the expected average squared prediction error. Robustness of the optimal design, important when one does not know the underlying model, is also treated.",0,1 +52,The benefits of looking at intraindividual dynamics in cognitive training data.,"Over the last decade, the prospect of improving or maintaining cognitive functioning has provoked a steadily increasing number of cognitive training studies. Central target populations are individuals at risk for a disadvantageous development, such as older adults exhibiting cognitive decline or children with learning impairments. They rely on cognitive resources to meet the challenges of an independent life in old age or requirements at school. To support daily cognitive functioning, training outcomes need to generalize to other cognitive abilities. Such transfer effects are, however, highly discussed. For example, recent meta-analyses on working memory training differed in the conclusion on the presence (Au et al., 2015; Karbach and Verhaeghen, 2014) or absence of transfer effects (Melby-Lervag and Hulme, 2013). Usually training-specific design factors such as type, intensity, duration, and feedback routines are discussed as reasons for such inconsistent findings. However, even individuals participating in exactly the same training regime highly differ in their training outcomes. We argue that it is time to study the individual development during trainings to understand these differential outcomes. It is time to have a closer look at the intraindividual training data.",0,1 +53,Assessing variance components in multilevel linear models using approximate Bayes factors: a case-study of ethnic disparities in birth weight,"Racial/ethnic disparities in birthweight are a large source of differential morbidity and mortality worldwide and have remained largely unexplained in epidemiologic models. We assess the impact of maternal ancestry and census tract residence on infant birth weights in New York City and the modifying effects of race and nativity by incorporating random effects in a multilevel linear model. Evaluating the significance of these predictors involves the test of whether the variances of the random effects are equal to zero. This is problematic because the null hypothesis lies on the boundary of the parameter space. We generalize an approach for assessing random effects in the two-level linear model to a broader class of multilevel linear models by scaling the random effects to the residual variance and introducing parameters that control the relative contribution of the random effects. After integrating over the random effects and variance components, the resulting integrals needed to calculate the Bayes factor can be efficiently approximated with Laplace's method.",0,1 +54,Bayesian modeling of the dependence in longitudinal data via partial autocorrelations and marginal variances,"Many parameters and positive-definiteness are two major obstacles in estimating and modelling a correlation matrix for longitudinal data. In addition, when longitudinal data is incomplete, incorrectly modelling the correlation matrix often results in bias in estimating mean regression parameters. In this paper, we introduce a flexible and parsimonious class of regression models for a covariance matrix parameterized using marginal variances and partial autocorrelations. The partial autocorrelations can freely vary in the interval (-1, 1) while maintaining positive definiteness of the correlation matrix so the regression parameters in these models will have no constraints. We propose a class of priors for the regression coefficients and examine the importance of correctly modeling the correlation structure on estimation of longitudinal (mean) trajectories and the performance of the DIC in choosing the correct correlation model via simulations. The regression approach is illustrated on data from a longitudinal clinical trial.",0,1 +55,A Review of Multilevel Modeling: Some Methodological Issues and Advances,"Multilevel modeling is a recently new class of statistical methods to handle nested data. Mainly thanks to the wide range of applicability and the great increase of statistical softwares, in the last decades multilevel modeling has enjoyed an explosion of published papers and books in both methodological and application field. Currently, there is a need to not only develop the research on multilevel approach for the analysis of complex data, but also to have instructions to properly address the usage. This work aims at summarizing methodological aspects related to multilevel models, illustrating good-practices, advantages, and limits by reviewing applications in various fields, such as socio-economic, educational, health, and medical sciences. We further focus our attention on the latest advances of multilevel modeling towards, e.g., the inclusion of latent variables and the Bayesian approach.",0,1 +56,Meta-Analysis of Observational Studies with Unmeasured Confounders,"Meta-analysis of observational studies is an exciting new area of innovation in statistical science. Unlike randomized controlled trials, which are the gold standard for proving causation, observational studies are prone to biases including confounding. In this article, we describe a novel Bayesian procedure to control for a confounder that is missing across the sequence of studies in a meta-analysis. We motivate the discussion with the example of a meta-analysis of cohort, case-control and cross-sectional studies examining the relationship between oral contraceptives and endometriosis. An important unmeasured confounder is dysmennoreah, which is an indication for oral contraceptive use. To adjust for unmeasured confounding, we combine random effects models with probabilistic sensitivity analysis techniques. Information about the unmeasured confounder is incorporated into the analysis via prior distributions, and we use MCMC to sample from posterior.",0,1 +57,Strange bedfellows: Coalition makeup and perceptions of democratic performance among electoral winners,"We argue that the partisan makeup of governing coalitions affects perceptions of democratic performance among those who voted for a government party. We introduce ambivalence toward the governing parties as the mechanism that drives this relationship, and we argue that such ambivalence, which occurs when favorability ratings of the parties vary, will be more common where the parties are more ideologically diverse. After advancing our theory, we test our expectations with post-election survey data from several countries. Evidence demonstrates that coalition ambivalence is greater where governing parties are ideologically divergent, and, even when controlling for this ideological divergence, ambivalence leads to more negative perceptions of democratic performance, bringing the attitudes of electoral winners closer to those of individuals who did not vote for a party in government.",0,1 +58,Hierarchical Regression Models for Interviewer and Respondent Effects,"It is generally recognized that interviewers may have an important effect on the quality of the data collected in survey research. This article presents an application of the hierarchical regression model in the analysis of interviewer effects. The hierarchical regression model offers an elegant way of analyzing the simultaneous effects of specific interviewer and respondent characteristics. It is especially attractive if the research design does not provide for a random assignment of respondents to interviewers, because it allows the researcher to use statistical rather than experimental control by modeling the interviewer effects conditional on the respondent effects.",0,1 +59,Analysis of Circulating Cholesterol Levels as a Mediator of an Association Between ABO Blood Group and Coronary Heart Disease,"Background— Non-O type of ABO blood group has been associated with a predisposition to coronary heart disease. It is thought that this association is partly mediated by increased cholesterol levels in non–O-type individuals. In this study, we sought to estimate the mediation effect size. Methods and Results— In a group of individuals (n=6476) undergoing coronary angiography, we detected associations of non-O type with significant coronary artery disease with >50% stenosis in ≥1 coronary arteries (odds ratio, 1.24; 95% confidence interval, 1.10–1.39; P =2.6×10 −4 ) and with prevalent or incident myocardial infarction (odds ratio, 1.22; 95% confidence interval, 1.09–1.37; P =1.2×10 −3 ). Subjects of non-O type had higher levels of total cholesterol, low-density lipoprotein cholesterol, and non–high-density lipoprotein cholesterol (mean [SEM] in mmol/L: 4.931[0.021], 3.041 [0.018], and 3.805 [0.020] in non-O type compared with 4.778 [0.026], 2.906 [0.021], and 3.669 [0.024] in O type; P =3.8×10 −7 , P =1.5×10 −7 , and P =3.1×10 −7 , respectively). Mediation analyses indicated that 10% of the effect of non-O type on coronary artery disease susceptibility was mediated by increased low-density lipoprotein cholesterol level ( P =7.8×10 −4 ) and that 11% of the effect of non-O type on myocardial infarction risk was mediated by raised low-density lipoprotein cholesterol level ( P =2.0×10 −3 ). Conclusions— In a model in which it is presumed that cholesterol is a mediator of the associations of ABO group with coronary artery disease and myocardial infarction, around 10% of the effect of non-O type on coronary artery disease and myocardial infarction susceptibility was mediated by its influence on low-density lipoprotein cholesterol level.",0,1 +60,Estimation of genetic parameters.,,0,1 +61,"An initial investigation of spinal mechanisms underlying pain enhancement induced by fractalkine, a neuronally released chemokine","Fractalkine is a chemokine that is tethered to the extracellular surface of neurons. Fractalkine can be released, forming a diffusible signal. Spinal fractalkine (CX3CL1) is expressed by sensory afferents and intrinsic neurons, whereas its receptor (CX3CR1) is predominantly expressed by microglia. Pain enhancement occurs in response both to intrathecally administered fractalkine and to spinal fractalkine endogenously released by peripheral neuropathy. The present experiments examine whether fractalkine-induced pain enhancement is altered by a microglial inhibitor (minocycline) and/or by antagonists/inhibitors of three putative glial products implicated in pain enhancement: interleukin-1 (IL1), interleukin-6 (IL6) and nitric oxide (NO). In addition, it extends a prior study that demonstrated that intrathecal fractalkine-induced mechanical allodynia is blocked by a neutralizing antibody to the rat fractalkine receptor, CX3CR1. Here, intrathecal anti-CX3CR1 also blocked fractalkine-induced thermal hyperalgesia. Furthermore, blockade of microglial activation with minocycline prevented both fractalkine-induced mechanical allodynia (von Frey test) and thermal hyperalgesia (Hargreaves test). Microglial activation appears to lead to the release of IL1, given that pretreatment with IL1 receptor antagonist blocked both fractalkine-induced mechanical allodynia and thermal hyperalgesia. IL1 is not the only proinflammatory cytokine implicated, as a neutralizing antibody to rat IL6 also blocked fractalkine-induced pain facilitation. Lastly, NO appears to be importantly involved, as l-NAME, a broad-spectrum NO synthase inhibitor, also blocked fractalkine-induced effects. Taken together, these data support that neuronally released fractalkine enhances pain via activation of spinal cord glia. Thus, fractalkine may be a neuron-to-glia signal triggering pain facilitation.",0,1 +62,Complex elliptical distributions with application to shape analysis,"We introduce a general class of complex elliptical distributions on a complex sphere that includes many of the most commonly used distributions, like the complex Watson, Bingham, angular central Gaussian and several others. We study properties of this family of distributions and apply the distribution theory for modeling shapes in two dimensions. We develop maximum likelihood and Bayesian methods of estimation to describe shape and obtain confidence bounds and credible regions for shapes. The methodology is illustrated through an example where estimation of shape of mouse vertebrae is desired.",0,1 +63,Allowing for correlations between correlations in random-effects meta-analysis of correlation matrices.,"Practical meta-analysis of correlation matrices generally ignores covariances (and hence correlations) between correlation estimates. The authors consider various methods for allowing for covariances, including generalized least squares, maximum marginal likelihood, and Bayesian approaches, illustrated using a 6-dimensional response in a series of psychological studies concerning prediction of exercise behavior change. Quantities of interest include the overall population mean correlation matrix, the contrast between the mean correlations, the predicted correlation matrix in a new study, and the conflict between the existing studies and a new correlation matrix. The authors conclude that accounting for correlations between correlations is unnecessary when interested in individual correlations but potentially important if concerned with a composite measure involving 2 or more correlations. A simulation study indicates the asymptotic normal assumption appears reasonable. Because of potential instability in the generalized least squares methods, they recommend a model-based approach, either the maximum marginal likelihood approach or a full Bayesian analysis.",0,1 +64,Detecting Intervention Effects in a Cluster-Randomized Design Using Multilevel Structural Equation Modeling for Binary Responses,"Multilevel modeling (MLM) is frequently used to detect group differences, such as an intervention effect in a pre-test–post-test cluster-randomized design. Group differences on the post-test scores are detected by controlling for pre-test scores as a proxy variable for unobserved factors that predict future attributes. The pre-test and post-test scores that are most often used in MLM are summed item responses (or total scores). In prior research, there have been concerns regarding measurement error in the use of total scores in using MLM. To correct for measurement error in the covariate and outcome, a theoretical justification for the use of multilevel structural equation modeling (MSEM) has been established. However, MSEM for binary responses has not been widely applied to detect intervention effects (group differences) in intervention studies. In this article, the use of MSEM for intervention studies is demonstrated and the performance of MSEM is evaluated via a simulation study. Furthermore, the consequences of using MLM instead of MSEM are shown in detecting group differences. Results of the simulation study showed that MSEM performed adequately as the number of clusters, cluster size, and intraclass correlation increased and outperformed MLM for the detection of group differences.",0,1 +65,Reporting bayesian analyses of clinical trials,"Many clinicians wrongly interpret p-values as probabilities that treatment has an adverse effect and confidence intervals as probability intervals. Such inferences can be validly drawn from Bayesian analyses of trial results. These analyses use the data to update the prior (or pre-trial) beliefs to give posterior (or post-trial) beliefs about the magnitude of a treatment effect. However, for these methods to gain acceptance in the medical literature, understanding between statisticians and clinicians of the issues involved in choosing appropriate prior distributions for trial reporting needs to be reached. I focus on two types of prior that deserve consideration. The first is the non-informative prior giving standardized likelihood distributions as post-trial probability distributions. Their use is unlikely to be controversial among statisticians whilst being intuitively appealing to clinicians. The second type of prior has a spike of probability mass at the point of no treatment effect. Varying the magnitude of the spike illustrates the sensitivity of the conclusions drawn to the degree of prior scepticism in a treatment effect. With both, graphical displays provide clinical readers with the opportunity to explore the results more fully. An example of how a clinical trial might be reported in the medical literature using these methods is given.",0,1 +66,Acting on intentions: The role of anticipated regret,"Three studies tested the hypothesis that anticipated regret (AR) increases consistency between exercise intentions and behaviour. Study 1 employed a longitudinal survey design (N = 384). Measures specified by the theory of planned behaviour, past behaviour, and AR were used to predict self-reported exercise behaviour 2 weeks later. AR moderated the intention-behaviour relationship such that participants were most likely to exercise if they both intended to exercise and anticipated regret if they failed to exercise. Study 2 used an experimental design to examine the effect of focusing on AR prior to reporting intentions (N = 229). Exercise was measured 2 weeks later and the AR-focus manipulation was found to moderate the intention-behaviour relationship in a similar manner to that observed in Study 1. In Study 3 (N = 97), moderation was replicated and was shown to be mediated by the temporal stability of intention.",0,1 +67,Bayesian meta-analysis and meta-regression for gene–disease associations and deviations from Hardy–Weinberg equilibrium,"Violation of Hardy–Weinberg equilibrium (HWE) can raise doubts about the validity of the conclusions from genetic association studies. However, for most currently performed gene–disease association studies, the available tests have low power to detect deviations from HWE. We consider this issue from a meta-analysis perspective, and suggest an approach to estimate the deviation and investigate its relationship with the observed genetic effects. Different degrees of deviation from HWE have previously been proposed as a potential source of heterogeneity across studies. We present a hierarchical meta-regression model that can be applied to test this assumption, using the concept of the fixation coefficient. We re-analyse seven meta-analyses to illustrate these methods. The uncertainty in the genetic effect estimate tended to increase once the fixation coefficient was taken into account. Dependence of the genetic effect size on the deviation from HWE was found in one meta-analysis, while in the other six examples, deviations from HWE did not clearly explain between-study heterogeneity in the genetic effects. The proposed hierarchical models allow the synthesis of data across gene–disease association studies with appropriate consideration of HWE issues. Copyright © 2006 John Wiley & Sons, Ltd.",0,1 +68,Bayesian Analysis of Multivariate Latent Curve Models With Nonlinear Longitudinal Latent Effects,"In longitudinal studies, investigators often measure multiple variables at multiple time points and are interested in investigating individual differences in patterns of change on those variables. Furthermore, in behavioral, social, psychological, and medical research, investigators often deal with latent variables that cannot be observed directly and should be measured by 2 or more manifest variables. Longitudinal latent variables occur when the corresponding manifest variables are measured at multiple time points. Our primary interests are in studying the dynamic change of longitudinal latent variables and exploring the possible interactive effect among the latent variables.Much of the existing research in longitudinal studies focuses on studying change in a single observed variable at different time points. In this article, we propose a novel latent curve model (LCM) for studying the dynamic change of multivariate manifest and latent variables and their linear and interaction relationships. The proposed LCM has the following useful features: First, it can handle multivariate variables for exploring the dynamic change of their relationships, whereas conventional LCMs usually consider change in a univariate variable. Second, it accommodates both first- and second-order latent variables and their interactions to explore how changes in latent attributes interact to produce a joint effect on the growth of an outcome variable. Third, it accommodates both continuous and ordered categorical data, and missing data.",0,1 +69,Comments on Bayesian and frequentist analysis and interpretation of clinical trials,"In this commentary I will advance opinions about the role and usefulness of Bayesian statistical methods in randomized clinical trials (RCTs). This commentary deals with RCTs to establish the efficacy of a treatment-what are often categorized as phase III trials in the U.S. Food and Drug Administration (FDA) regulatory setting. Both frequentist and Bayesian trial designs represent “moving targets”; furthermore, the meaning of frequentist or Bayesian methods has different meanings to different individuals. I shall use the term Bayesian here to refer to methods that use the subjective probability assessments of individuals (often based on considerable data). Thus I will not be speaking to any proposals that would (1) use empirical Bayes prior distributions or (2) use standardized diffuse, improper, minimum information or “noninformative” prior distributions. Such methods of analysis I will call “stylized Bayesian methods” and will address briefly at the end of this commentary. Savage [ll presents a compelling argument that humans should behave in a Bayesian fashion unless (when forced to make bets) one wants to be in a losing position for every possible true state of affairs (i.e., a “state of nature”). Such Bayesian behavior is “coherent“ in Savage’s terminology. Otherwise behavior is “incoherent.” The psychological literature (which is referenced somewhat in the following) refers to “normative” behavior. Here normative means “of, relating or conforming to, or prescribing norms or standards” [21. For reasoning involving probabilities the norm used is that of the usual calculus of probability. In a situation with prior distributions the norm involves an appropriate use of Bayes’s theorem. Speck, quoted above, apparently does not believe that humans follow this normative behavior.",0,1 +70,On the propriety of a modified Jeffreys's prior for variance components in binary random effects models,"This paper proves that a modified Jeffreys's prior on the variance components in binary random effects models is integrable under mild conditions on the link function. These conditions are shown to be satisfied for two commonly used link functions, the logit and probit functions.",0,1 +71,Pharmacologic interventions for painful diabetic neuropathy: an umbrella systematic review and comparative effectiveness network meta-analysis (Protocol),"Neuropathic pain can reduce the quality of life and independence of 30% to 50% of patients with diabetes. The comparative effectiveness of analgesics for patients with diabetic neuropathy remains unclear. The aim of the current work, therefore, was to summarize the evidence about the analgesic effectiveness of the most common oral and topical agents used for the treatment of peripheral diabetic neuropathy.We will use an umbrella approach (systematic review of systematic reviews) to identify eligible randomized controlled trials (RCTs) for the most common oral or topical analgesics for painful diabetic neuropathy. Two reviewers will independently determine RCT eligibility. Disagreement will be solved by consensus and arbitrated by a third reviewer. We will extract descriptive, methodological and efficacy data in duplicate. Results will be pooled and analyzed using classic random-effects meta-analyses and network meta-analyses to compute the absolute and relative efficacy of therapeutic options. We will use the I2 statistic and Cochran's Q test to assess heterogeneity. Risk of bias and publication bias, if appropriate, will be evaluated, as well as overall strength of the evidence.This network meta-analysis aims to synthesize available direct and indirect evidence of effectiveness of analgesics in the treatment of painful diabetic neuropathy. The network approach will offer the opportunity to generate a ranking based on efficacy and along with known side effects, costs, and administration burdens will enable patients and clinicians to make choices that best reflect their preferences for treatment of painful diabetic neuropathy.",0,1 +72,Does Arrest Really Deter Wife Battery? An Effort to Replicate the Findings of the Minneapolis Spouse Abuse Experiment,"In this paper we try to replicate the findings from the Minneapolis Spouse Abuse Experiment (Sherman and Berk, 1984). Using longitudinal data from the criminal justice system on 783 wife-battery incidents, an ex post factor design coupled with a propensity-score analysis reveals that arrests substantially reduce the number of new incidents of wife battery. In addition, the reductions are greatest for batterers whom the police would ordinarily be especially inclined to arrest. Policy and theoretical implications are discussed. (abstract Adapted from Source: American Sociological Review, 1985. Copyright © 1985 by the American Sociological Association) Domestic Violence Intervention Arrest Effects Domestic Violence Offender Spouse Abuse Offender Spouse Abuse Intervention Deterrence Male Offender Male Violence Adult Male Adult Offender Adult Violence Law Enforcement Intervention Offender Arrest Violence Against Women Partner Violence California Replication Studies 11-01",0,1 +73,Work experience during higher education and post-graduation occupational outcomes: A comparative study on four European countries,"This article examines the relationship between work experience acquired during higher education and post-graduation labour market outcomes in four European countries: Germany, Italy, Norway and Spain. A theoretical framework that shows in which institutional contexts work experience may be a ‘competitive advantage’ for young graduates is developed. In the empirical analysis, data from the Higher Education and Graduate Employment in Europe (CHEERS) and Research into Employment and Professional Flexibility (REFLEX) surveys are used to examine the effect of a typology of student employment (accounting for both length and coherence of work experience with the field of study attended) on several occupational outcomes 4–5 years after graduation. The empirical results show that, in Italy and especially in Spain, work activities during tertiary education are associated with better labour market positions after graduation: any type of work experience increases employability and reduces the risk of unemployment, and furthermore, previous work experience – especially when coherent with the field of study – decreases the probability of skill mismatch in future occupations. The effect of student employment, however, is smaller for most outcomes in Germany and negligible in Norway.",0,1 +74,21 Assessing the Fit of Item Response Theory Models,"Publisher Summary Item response theory (IRT) provides a framework for modeling and analyzing item response data. Assessing IRT model fit to item response data is one of the crucial steps before an IRT model can be applied with confidence to estimate proficiency or ability levels of examinees, to link tests across administrations, and to assess adequate yearly progress. Assessing model fit is an important part of the test validation process. It is multifaceted and, as in the verification of any scientific theory, it is an ongoing process where only through the accumulation of empirical evidence can one be confident of the appropriateness of IRT for the solution of a particular measurement problem. The procedures for assessing model–data fit described in this chapter have the potential for addressing the vexing problem of determining if the measurement procedures used are appropriate for addressing the practical measurement problems faced by practitioners.",0,1 +75,An explicit no response instead of time-out in automated visual-field testing,"Background: To evaluate the effect of response-acquisition technique on psychometric performance in visual-field testing, the conventional one-button yes/time-out method was compared with a two-button yes/no method for responding whether or not the stimulus was detected. There are a number of situations in which the single-button technique leads to ambiguous results. In this study, we thus expected the yes/no method to reduce tendencies towards habituation and automatic responding. Our hypothesis was that the two-button technique could reduce the rate of erroneous responses. Methods: Luminance-difference sensitivity for bright stimuli (32′) on a photopic background was evaluated at 26 locations within the central visual field (30°) using a specially equalised video display unit and a modified 4/2-dB staircase strategy (six reversals, maximum-likelihood threshold estimation). Sixty-one ophthalmologically normal subjects (aged 20-30 years) were examined twice with each method. Results: Mean sensitivities with the two-button yes/no method were found to be, on average, 0.13 dB above those measured with the one-button yes/time-out technique - a difference without clinical relevance. Within-subject variability did not differ between the two methods. However, the less intuitive two-button yes/no method had a slightly higher number of false responses in catch trials. Conclusion: Compared to the conventional one-button yes/time-out method, the two-button yes/no method in normal young subjects thus showed little difference in mean sensitivities and equivalent within-subject variabilities. Concerning our initial hypothesis, the yes/no method is of somewhat higher complexity and is not able to reduce the rate of erroneous responses. The one-button yes/time-out method fared a little better in error rate. In summary, the yes/no method is an alternative and additional possibility of response acquisition in visual-field testing, which is worthy of being tested in a clinical study with elderly subjects.",0,1 +76,Bayesian three-dimensional reconstruction of toothed whale trajectories: Passive acoustics assisted with visual and tagging measurements,The author describes and evaluates a Bayesian method to reconstruct three-dimensional toothed whale trajectories from a series of echolocation signals. Localization by using passive acoustic data (time of arrival of source signals at receptors) is assisted by using visual data (coordinates of the whale when diving and resurfacing) and tag information (movement statistics). The efficiency of the Bayesian method is compared to the standard minimum mean squared error statistical approach by comparing the reconstruction results of 48 simulated sperm whale (Physeter macrocephalus) trajectories. The use of the advanced Bayesian method reduces bias (standard deviation) with respect to the standard method up to a factor of 8.9 (13.6). The author provides open-source software which is functional with acoustic data which would be collected in the field from any three-dimensional receptor array design. This approach renews passive acoustics as a valuable tool to study the underwater behavior of toothed whales.,0,1 +77,Mechanisms and mediation in survival analysis: towards an integrated analytical framework,"A wide-ranging debate has taken place in recent years on mediation analysis and causal modelling, raising profound theoretical, philosophical and methodological questions. The authors build on the results of these discussions to work towards an integrated approach to the analysis of research questions that situate survival outcomes in relation to complex causal pathways with multiple mediators. The background to this contribution is the increasingly urgent need for policy-relevant research on the nature of inequalities in health and healthcare.The authors begin by summarising debates on causal inference, mediated effects and statistical models, showing that these three strands of research have powerful synergies. They review a range of approaches which seek to extend existing survival models to obtain valid estimates of mediation effects. They then argue for an alternative strategy, which involves integrating survival outcomes within Structural Equation Models via the discrete-time survival model. This approach can provide an integrated framework for studying mediation effects in relation to survival outcomes, an issue of great relevance in applied health research. The authors provide an example of how these techniques can be used to explore whether the social class position of patients has a significant indirect effect on the hazard of death from colon cancer.The results suggest that the indirect effects of social class on survival are substantial and negative (-0.23 overall). In addition to the substantial direct effect of this variable (-0.60), its indirect effects account for more than one quarter of the total effect. The two main pathways for this indirect effect, via emergency admission (-0.12), on the one hand, and hospital caseload, on the other, (-0.10) are of similar size.The discrete-time survival model provides an attractive way of integrating time-to-event data within the field of Structural Equation Modelling. The authors demonstrate the efficacy of this approach in identifying complex causal pathways that mediate the effects of a socio-economic baseline covariate on the hazard of death from colon cancer. The results show that this approach has the potential to shed light on a class of research questions which is of particular relevance in health research.",0,1 +78,Multilevel Latent Polynomial Regression for Modeling (In)Congruence Across Organizational Groups,"This article addresses (in)congruence across different kinds of organizational respondents or “organizational groups”—such as managers versus non-managers or women versus men—and the effects of congruence on organizational outcomes. We introduce a novel multilevel latent polynomial regression model (MLPM) that treats standings of organizational groups as latent “random intercepts” at the organization level while subjecting these to latent interactions that enable response surface modeling to test congruence hypotheses. We focus on the case of organizational culture research, which usually samples managers and excludes non-managers. Reanalyzing data from 67 hospitals with 6,731 managers and non-managers, we find that non-managers perceive their organizations’ cultures as less humanistic and innovative and more controlling than managers, and we find that less congruence between managers and non-managers in these perceptions is associated with lower levels of quality improvement in organizations. Our results call into question the validity of findings from organizational culture and other research that tends to sample one organizational group to the exclusion of others. We discuss our findings and the MLPM, which can be extended to estimate latent interactions for tests of multilevel moderation/interactions.",0,1 +79,Bayesian factor analysis for multilevel binary observations,"Multilevel covariance structure models have become increasingly popular in the psychometric literature in the past few years to account for population heterogeneity and complex study designs. We develop practical simulation based procedures for Bayesian inference of multilevel binary factor analysis models. We illustrate how Markov Chain Monte Carlo procedures such as Gibbs sampling and Metropolis-Hastings methods can be used to perform Bayesian inference, model checking and model comparison without the need for multidimensional numerical integration. We illustrate the proposed estimation methods using three simulation studies and an application involving student's achievement results in different areas of mathematics.",0,1 +80,Modeling incomplete longitudinal and cross-sectional data using latent growth structural models,"In this paper we describe some mathematical and statistical models for identifying and dealing with changes over age. We concentrate specifically on the use of a latent growth structural equation model approach to deal with issues of: (1) latent growth models of change, (2) differences in longitudinal and cross-sectional results, and (3) differences due to longitudinal attrition. This is a methodological paper using simulated data, but we base our models on practical and conceptual principles of modeling change in developmental psychology. Our results illustrate both benefits and limitations using structural models to analyze incomplete longitudinal data.",0,1 +81,Working memory capacity — facets of a cognitive ability construct,"Abstract Working memory capacity is differentiated theoretically along two dimensions: contents and functions. The resulting 3×3 matrix was operationalized by 23 tasks sampled from the literature. Data for these tasks from 128 participants were analyzed by exploratory and confirmatory factor analysis. Regarding the content facet, spatial working memory was clearly distinct from the other two content categories. A distinction between verbal and numerical working memory was not warranted. On the functional dimension the postulated categories of simultaneous storage and transformation and of coordination could not be separated. The third category was clearly separate from the first two functions. This factor could be interpreted to reflect a mixture of variance due to mental speed and to supervisory functions of the central executive.",0,1 +82,Extracting the truth from conflicting eyewitness reports: A formal modeling approach.,"Eyewitnesses often report details of the witnessed crime incorrectly. However, there is usually more than 1 eyewitness observing a crime scene. If this is the case, one approach to reconstruct the details of a crime more accurately is aggregating across individual reports. Although aggregation likely improves accuracy, the degree of improvement largely depends on the method of aggregation. The most straightforward method is the majority rule. This method ignores individual differences between eyewitnesses and selects the answer shared by most eyewitnesses as being correct. We employ an alternative method based on cultural consensus theory (CCT) that accounts for differences in the eyewitnesses' knowledge. To test the validity of this approach, we showed 30 students 1 of 2 versions of a video depicting a heated quarrel between 2 people. The videos differed in the amount of information pertaining to the critical event. Participants then answered questions about the critical event. Analyses based on CCT rendered highly accurate eyewitness competence estimates that mirrored the amount of information available in the video. Moreover, CCT estimates resulted in a more precise reconstruction of the video content than the majority rule did. This was true for group sizes ranging from 4 to 15 eyewitnesses, with the difference being more pronounced for larger groups. Thus, through simultaneous consideration of multiple witness statements, CCT provides a new approach to the assessment of eyewitness accuracy that outperforms standard methods of information aggregation.",0,1 +83,An informed reference prior for between-study heterogeneity in meta-analyses of binary outcomes,"It is well known that when a Bayesian meta-analysis includes a small number of studies, inference can be sensitive to the choice of prior for the between-study variance. Choosing a vague prior does not solve the problem, as inferences can be substantially different depending on the degree of vagueness. Moreover, because the data provide little information on between-study heterogeneity, posterior inferences for the between-study variance based on vague priors will tend to be unrealistic. It is thus preferable to adopt a reasonable, informed prior for the between-study variance. However, relatively little is known about what constitutes a realistic distribution. On the basis of data from the Cochrane Database of Systematic Reviews, this paper describes the distribution of between-study variance in published meta-analyses, and proposes some realistic, informed priors for use in meta-analyses of binary outcomes. It is hoped that these priors will improve the calibration of inferences from Bayesian meta-analyses.",0,1 +84,Multidimensional adaptive testing with constraints on test content,"The case of adaptive testing under a multidimensional response model with large numbers of constraints on the content of the test is addressed. The items in the test are selected using a shadow test approach. The 0-1 linear programming model that assembles the shadow tests maximizes posterior expected Kullback-Leibler information in the test. The procedure is illustrated for five different cases of multidimensionality. These cases differ in (a) the numbers of ability dimensions that are intentional or should be considered as ""nuisance dimensions"" and (b) whether the test should or should not display a simple structure with respect to the intentional ability dimensions.",0,1 +85,An application of item response theory to fMRI data: Prospects and pitfalls,"When using functional brain imaging to study neuropsychiatric patients an important challenge is determining whether the imaging task assesses individual differences with equal precision in healthy control and impaired patient groups. Classical test theory (CTT) requires separate reliability studies of patients and controls to determine equivalent measurement precision with additional studies to determine measurement precision for different levels of disease severity. Unlike CTT, item response theory (IRT) provides estimates of measurement error for different levels of ability, without the need for separate studies, and can determine if different tests are equivalently difficult when investigating differential deficits between groups. To determine the potential value of IRT in functional brain imaging, IRT was applied to behavioral data obtained during a multi-center functional MRI (fMRI) study of working memory (WM). Average item difficulty was approximately one standard deviation below the ability scale mean, supporting the task's sensitivity to individual differences within the ability range of patients with WM impairment, but not within the range of most controls. The correlation of IRT estimated ability with fMRI activation during the task recognition period supported the linkage of the latent IRT scale to brain activation data. IRT can meaningfully contribute to the design of fMRI tasks.",0,1 +86,"Controlled and automatic human information processing: I. Detection, search, and attention.","A 2-process theory of human information processing is proposed and applied to detection, search, and attention phenomena. Automatic processing is activation of a learned sequence of elements in long-term memory that is initiated by appropriate inputs and then proceeds automatically-without S control, without stressing the capacity limitations of the system, and without necessarily demanding attention. Controlled processing is a temporary activation of a sequence of elements that can be set up quickly and easily but requires attention, is capacity-limited (usually serial in nature), and is controlled by the S. A series of studies, with approximately 8 Ss, using both reaction time and accuracy measures is presented, which traces these concepts in the form of automatic detection and controlled search through the areas of detection, search, and attention. Results in these areas are shown to arise from common mechanisms. Automatic detection is shown to develop following consistent mapping of stimuli to responses over trials. Controlled search was utilized in varied-mapping paradigms, and in the present studies, it took the form of serial, terminating search. (60 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1977 American Psychological Association.",0,1 +87,Hierarchical Spatial Process Models for Multiple Traits in Large Genetic Trials,"This article expands upon recent interest in Bayesian hierarchical models in quantitative genetics by developing spatial process models for inference on additive and dominance genetic variance within the context of large spatially referenced trial datasets of multiple traits of interest. Direct application of such multivariate models to large spatial datasets is often computationally infeasible because of cubic order matrix algorithms involved in estimation. The situation is even worse in Markov chain Monte Carlo (MCMC) contexts where such computations are performed for several thousand iterations. Here, we discuss approaches that help obviate these hurdles without sacrificing the richness in modeling. For genetic effects, we demonstrate how an initial spectral decomposition of the relationship matrices negates the expensive matrix inversions required in previously proposed MCMC methods. For spatial effects we discuss a multivariate predictive process that reduces the computational burden by projecting the original process onto a subspace generated by realizations of the original process at a specified set of locations (or knots). We illustrate the proposed methods using a synthetic dataset with multivariate additive and dominant genetic effects and anisotropic spatial residuals, and a large dataset from a scots pine (Pinus sylvestris L.) progeny study conducted in northern Sweden. Our approaches enable us to provide a comprehensive analysis of this large trial which amply demonstrates that, in addition to violating basic assumptions of the linear model, ignoring spatial effects can result in downwardly biased measures of heritability.",0,1 +88,How Many Imputations are Really Needed? Some Practical Clarifications of Multiple Imputation Theory,"Multiple imputation (MI) and full information maximum likelihood (FIML) are the two most common approaches to missing data analysis. In theory, MI and FIML are equivalent when identical models are tested using the same variables, and when m, the number of imputations performed with MI, approaches infinity. However, it is important to know how many imputations are necessary before MI and FIML are sufficiently equivalent in ways that are important to prevention scientists. MI theory suggests that small values of m, even on the order of three to five imputations, yield excellent results. Previous guidelines for sufficient m are based on relative efficiency, which involves the fraction of missing information (gamma) for the parameter being estimated, and m. In the present study, we used a Monte Carlo simulation to test MI models across several scenarios in which gamma and m were varied. Standard errors and p-values for the regression coefficient of interest varied as a function of m, but not at the same rate as relative efficiency. Most importantly, statistical power for small effect sizes diminished as m became smaller, and the rate of this power falloff was much greater than predicted by changes in relative efficiency. Based our findings, we recommend that researchers using MI should perform many more imputations than previously considered sufficient. These recommendations are based on gamma, and take into consideration one's tolerance for a preventable power falloff (compared to FIML) due to using too few imputations.",0,1 +89,Can’t get it out of my mind: Employee rumination after customer mistreatment and negative mood in the next morning.,"Drawing on cognitive rumination theories and conceptualizing customer service interaction as a goal attainment situation for service employees, the current study examined employee rumination about negative service encounters as an intermediate cognitive process that explains the within-person fluctuations in negative emotional reactions resulting from customer mistreatment. Multilevel analyses of 149 call-center employees' 1,189 daily surveys revealed that on days that a service employee received more (vs. less) customer mistreatment, he or she ruminated more (vs. less) at night about negative encounters with customers, which in turn led to higher (vs. lower) levels of negative mood experienced in the next morning. In addition, service rule commitment and perceived organizational support moderated the within-person effect of customer mistreatment on rumination, such that this effect was stronger among those who had higher (vs. lower) levels of service rule commitment but weaker among those who had higher (vs. lower) levels of perceived organizational support. Theoretical and practical implications of these findings are discussed.",0,1 +90,On the Use of Nonparametric Item Characteristic Curve Estimation Techniques for Checking Parametric Model Fit,"The purpose of this study was to assess the model fit of a 2PL through comparison with the nonparametric item characteristic curve (ICC) estimation procedures. Results indicate that three nonparametric procedures implemented produced ICCs that are similar to that of the 2PL for items simulated to fit the 2PL. However for misfitting items, especially nonmonotone items, the greatest difference is between the 2PL and kernel smoothing procedures. In general, the differences between ICCs from the nonparametric procedures and the 2PL are reduced as both sample size and test length increase. The false positive rate of the test for model fit is promising for nonparametric ICC estimation methods. Power to detect misfitting items simulated with 4PL is low. Power to detect nonmonotone items is generally much higher. Power is best for kernel smoothing but also good for isotonic regression in the medium to large sample sizes and longer test length conditions. Power for the smoothed isotonic regression is uniformly low.",0,1 +91,Scaled test statistics and robust standard errors for non-normal data in covariance structure analysis: A Monte Carlo study,"Research studying robustness of maximum likelihood (ML) statistics in covariance structure analysis has concluded that test statistics and standard errors are biased under severe non-normality. An estimation procedure known as asymptotic distribution free (ADF), making no distributional assumption, has been suggested to avoid these biases. Corrections to the normal theory statistics to yield more adequate performance have also been proposed. This study compares the performance of a scaled test statistic and robust standard errors for two models under several non-normal conditions and also compares these with the results from ML and ADF methods. Both ML and ADF test statistics performed rather well in one model and considerably worse in the other. In general, the scaled test statistic seemed to behave better than the ML test statistic and the ADF statistic performed the worst. The robust and ADF standard errors yielded more appropriate estimates of sampling variability than the ML standard errors, which were usually downward biased, in both models under most of the non-normal conditions. ML test statistics and standard errors were found to be quite robust to the violation of the normality assumption when data had either symmetric and platykurtic distributions, or non-symmetric and zero kurtotic distributions.",0,1 +92,How Can Significance Tests Be Deinstitutionalized?,"The purpose of this article is to propose possible solutions to the methodological problem of null hypothesis significance testing (NHST), which is framed as deeply embedded in the institutional structure of the social and organizational sciences. The core argument is that, for the deinstitutionalization of statistical significance tests, minor methodological changes within an unreformed epistemology will be as unhelpful as emotive exaggerations of the ill effects of NHST. Instead, several institutional-epistemological reforms affecting cultural-cognitive, normative, and regulative processes and structures in the social sciences are necessary and proposed in this article. In the conclusion, the suggested research reforms, ranging from greater emphasis on inductive and abductive reasoning to statistical modeling and Bayesian epistemology, are classified according to their practical importance and the time horizon expected for their implementation. Individual-level change in researchers' use of NHST is unli...",0,1 +93,Item Selection in Computerized Classification Testing,"Several alternatives for item selection algorithms based on item response theory in computerized classification testing (CCT) have been suggested, with no conclusive evidence on the substantial superiority of a single method. It is argued that the lack of sizable effect is because some of the methods actually assess items very similarly through different calculations and will usually select the same item. Consideration of methods that assess information across a wider range is often unnecessary under realistic conditions, although it might be advantageous to utilize them only early in a test. In addition, the efficiency of item selection approaches depend on the termination criteria that are used, which is demonstrated through didactic example and Monte Carlo simulation. Item selection at the cut score, which seems conceptually appropriate for CCT, is not always the most efficient option. A broad framework for item selection in CCT is presented that incorporates these points.",0,1 +94,A formal model of capacity limits in working memory,"A mathematical model of working-memory capacity limits is proposed on the key assumption of mutual interference between items in working memory. Interference is assumed to arise from overwriting of features shared by these items. The model was fit to time-accuracy data of memory-updating tasks from four experiments using nonlinear mixed effect (NLME) models as a framework. The model gave a good account of the data from a numerical and a spatial task version. The performance pattern in a combination of numerical and spatial updating could be explained by variations in the interference parameter: assuming less feature overlap between contents from different domains than between contents from the same domain, the model can account for double dissociations of content domains in dual-task experiments. Experiment 3 extended this idea to similarity within the verbal domain. The decline of memory accuracy with increasing memory load was steeper with phonologically similar than with dissimilar material, although processing speed was faster for the similar material. The model captured the similarity effects with a higher estimated interference parameter for the similar than for the dissimilar condition. The results are difficult to explain with alternative models, in particular models incorporating time-based decay and models assuming limited resource pools.",0,1 +95,A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity,"This paper presents a parameter covariance matrix estimator which is consistent even when the disturbances of a linear regression model are heteroskedastic. This estimator does not depend on a formal model of the structure of the heteroskedasticity. By comparing the elements of the new estimator to those of the usual covariance estimator, one obtains a direct test for heteroskedasticity, since in the absence of heteroskedasticity, the two estimators will be approximately equal, but will generally diverge otherwise. The test has an appealing least squares interpretation.",0,1 +96,A Comparison of Methods to Test for Mediation in Multisite Experiments,"A Monte Carlo study extended the research of MacKinnon, Lockwood, Hoffman, West, and Sheets (2002) for single-level designs by examining the statistical performance of four methods to test for mediation in a multilevel experimental design. The design studied was a two-group experiment that was replicated across several sites, included a single intervening variable and outcome, and assumed that the effects of the treatment and mediator were constant across sites. The findings provide new evidence of the benefits of and further support for using the asymmetric confidence limits approach to test for mediation. In addition, the authors provide further support for using confidence intervals to assess if treatment effects are completely mediated, as using traditional hypothesis testing may lead to erroneous conclusions.",0,1 +97,Bayesian robustness in meta-analysis for studies with zero responses,"Statistical meta-analysis is mostly carried out with the help of the random effect normal model, including the case of discrete random variables. We argue that the normal approximation is not always able to adequately capture the underlying uncertainty of the original discrete data. Furthermore, when we examine the influence of the prior distributions considered, in the presence of rare events, the results from this approximation can be very poor. In order to assess the robustness of the quantities of interest in meta-analysis with respect to the choice of priors, this paper proposes an alternative Bayesian model for binomial random variables with several zero responses. Particular attention is paid to the coherence between the prior distributions of the study model parameters and the meta-parameter. Thus, our method introduces a simple way to examine the sensitivity of these quantities to the structure dependence selected for study. For illustrative purposes, an example with real data is analysed, using the proposed Bayesian meta-analysis model for binomial sparse data. Copyright © 2016 John Wiley & Sons, Ltd.",0,1 +98,Automated generation of node‐splitting models for assessment of inconsistency in network meta‐analysis,"Network meta-analysis enables the simultaneous synthesis of a network of clinical trials comparing any number of treatments. Potential inconsistencies between estimates of relative treatment effects are an important concern, and several methods to detect inconsistency have been proposed. This paper is concerned with the node-splitting approach, which is particularly attractive because of its straightforward interpretation, contrasting estimates from both direct and indirect evidence. However, node-splitting analyses are labour-intensive because each comparison of interest requires a separate model. It would be advantageous if node-splitting models could be estimated automatically for all comparisons of interest. We present an unambiguous decision rule to choose which comparisons to split, and prove that it selects only comparisons in potentially inconsistent loops in the network, and that all potentially inconsistent loops in the network are investigated. Moreover, the decision rule circumvents problems with the parameterisation of multi-arm trials, ensuring that model generation is trivial in all cases. Thus, our methods eliminate most of the manual work involved in using the node-splitting approach, enabling the analyst to focus on interpreting the results.",0,1 +99,On thinning of chains in MCMC,"Summary 1. Markov chain Monte Carlo (MCMC) is a simulation technique that has revolutionised the analysis of ecological data, allowing the fitting of complex models in a Bayesian framework. Since 2001, there have been nearly 200 papers using MCMC in publications of the Ecological Society of America and the British Ecological Society, including more than 75 in the journal Ecology and 35 in the Journal of Applied Ecology. 2. We have noted that many authors routinely ‘thin’ their simulations, discarding all but every kth sampled value; of the studies we surveyed with details on MCMC implementation, 40% reported thinning. 3. Thinning is often unnecessary and always inefficient, reducing the precision with which features of the Markov chain are summarised. The inefficiency of thinning MCMC output has been known since the early 1990’s, long before MCMC appeared in ecological publications. 4. We discuss the background and prevalence of thinning, illustrate its consequences, discuss circumstances when it might be regarded as a reasonable option and recommend against routine thinning of chains unless necessitated by computer memory limitations.",0,1 +100,Latent Curve Models,"Preface. 1 Introduction. 1.1 Conceptualization and Analysis of Trajectories. 1.2 Three Initial Questions About Trajectories. 1.3 Brief History of Latent Curve Models. 1.4 Organization of the Remainder of the Book. 2 Unconditional Latent Curve Model. 2.1 Repeated Measures. 2.2 General Model and Assumptions. 2.3 Identification. 2.4 Case-By-Case Approach. 2.5 Structural Equation Model Approach. 2.6 Alternative Approaches to the SEM. 2.7 Conclusions. Appendix 2A: Test Statistics, Nonnormality, and Statistical Power. 3 Missing Data and Alternative Metrics of Time. 3.1 Missing Data. 3.2 Missing Data and Alternative Metrics of Time. 3.3 Conclusions. 4 Nonlinear Trajectories and the Coding of Time. 4.1 Modeling Nonlinear Functions of Time. 4.2 Nonlinear Curve Fitting: Estimated Factor Loadings. 4.3 Piecewise Linear Trajectory Models. 4.4 Alternative Parametric Functions. 4.5 Linear Transformations of the Metric of Time. 4.6 Conclusions. Appendix 4A: Identification of Quadratic and Piecewise Latent Curve Models. 4A.1 Quadratic LCM. 4A.2 Piecewise LCM. 5 Conditional Latent Curve Models. 5.1 Conditional Model and Assumptions. 5.2 Identification. 5.3 Structural Equation Modeling Approach. 5.4 Interpretation of Conditional Model Estimates. 5.5 Empirical Example. 5.6 Conclusions. 6 The Analysis of Groups. 6.1 Dummy Variable Approach. 6.2 Multiple-Group Analysis. 6.3 Unknown Group Membership. 6.4 Conclusions. Appendix 6A: Case-by-Case Approach to Analysis of Various Groups. 6A.1 Dummy Variable Method. 6A.2 Multiple-Group Analysis. 6A.3 Unknown Group Membership. 6A.4 Appendix Summary. 7 Multivariate Latent Curve Models. 7.1 Time-Invariant Covariates. 7.2 Time-Varying Covariates. 7.3 Simultaneous Inclusion of Time-Invariant and Time-Varying Covariates. 7.4 Multivariate Latent Curve Models. 7.5 Autoregressive Latent Trajectory Model. 7.6 General Equation for All Models. 7.7 Implied Moment Matrices. 7.8 Conclusions. 8 Extensions of Latent Curve Models. 8.1 Dichotomous and Ordinal Repeated Measures. 8.2 Repeated Latent Variables with Multiple Indicators. 8.3 Latent Covariates. 8.4 Conclusions. References. Author Index. Subject Index.",0,1 +101,A Bayesian Multilevel Modeling Approach to Time-Series Cross-Sectional Data,"The analysis of time-series cross-sectional (TSCS) data has become increasingly popular in political science. Meanwhile, political scientists are also becoming more interested in the use of multilevel models (MLM). However, little work exists to understand the benefits of multilevel modeling when applied to TSCS data. We employ Monte Carlo simulations to benchmark the performance of a Bayesian multilevel model for TSCS data. We find that the MLM performs as well or better than other common estimators for such data. Most importantly, the MLM is more general and offers researchers additional advantages.",0,1 +102,Proactive interference and the dynamics of free recall.,"Proactive interference (PI) has long been recognized as a major cause of forgetting. We conducted two experiments that offer another look at the subject by providing a detailed analysis of recall latency distributions during the buildup of and release from PI. These functions were accurately characterized by the convolution of the normal and exponential distributions (viz., the ex-Gaussian), which previously has been shown to describe recognition latency distributions. Further, the fits revealed that the increase in recall latency associated with the buildup of PI results from a slowing of the exponential retrieval stage only. The same result was found even when a short retention interval was used (and recall probability remained constant). These findings suggest that free-recall latency may be a sensitive index of the increased search set size that has often been assumed to accompany the buildup of PI. A central insight emerging from the memory literature of the 1950s and 1960s was that previously learned information can result in the rapid forgetting of more recently learned information. Underwood (1957) argued that this phenomenon, termed proactive interference (PI), was by far the major cause of forgetting in everyday life. Indeed, even in laboratory experiments, the degree of retroactive interference encountered over the course of hours or days was assumed to pale in comparison with the degree of proactive interference resulting from years of prior learning. Although its preeminent (and still unexplained) role in the process of forgetting continues to be recognized, interest in the subject of PI has waned in recent years. The present article contributes a new empirical analysis of this important subject and pursues a detailed theoretical exploration into its underlying nature. In a typical PI experiment, subjects receive blocks of Brown-Peterson trials involving words from a single category (Wickens, 1972). Within a block, free-recall performance declines with each successive trial (the buildup of PI) but recovers each time a new category is introduced (release from PI). In most cases, the dependent variable used in these experiments was the percentage of correct free-recall responses. However, in the research to be presented here, we focus on latency to free recall. Research on free-recall latency in any context is very limited, and in the study of PI it is almost nonexistent. Why might free-recall latency be an interesting variable to investigate? Because such a measure provides important information about the process of retrieval that is likely to be missed by static measures, such as probability of recall. Before addressing the question of exactly what that information might be, we review the scant literature pertaining to the more general and purely empirical question of whether these",0,1 +103,Cultural Consensus Theory: Comparing different concepts of cultural truth,"Abstract Cultural Consensus Theory (CCT) is a model-based approach to aggregating the responses of informants (respondents) to questions (items) about some domain of their shared cultural knowledge. The purpose of CCT is to allow a researcher to discover consensus knowledge in cultural groups. This paper compares and contrasts two CCT models for items requiring a dichotomous, true/false answer. The first model is the General Condorcet Model (GCM). A special case of the GCM is already in wide use, especially in cultural anthropology, and this paper generalizes that version and provides new mathematical and statistical results for it. The character of the GCM is that of a general signal detection model, where the item-trial type (signal or noise) as well as the respondents’ hit and false alarm rates, are latent rather than observable. The second model, the Latent Truth Model (LTM), is a new model that allows cultural truth to assume continuous values in the unit interval rather than the two-valued truth assumption of the GCM. Both models are compared analytically, and hierarchical Bayesian inference for each is developed. A posterior predictive model check is established for both models that bears directly on the assumption that there is a single consensus truth. In addition, the similarities and differences between the models are illustrated both with mathematical and statistical results, as well as by analyzing real and simulated data sets, and a second posterior predictive check that tends to differentiate the models is also provided.",0,1 +104,On the locus of the word frequency effect in visual word recognition.,"Abstract The pattern of factor effects on response time (RT) performance in multi-factor experiments provides a powerful technique for inferring the structure of underlying mental processes. The results of the present lexical decision experiment show that additive effects of stimulus quality and word frequency are observed in mean RTs, variances, and the exGaussian parameters of the RT distribution. These findings are consistent with the conclusion that word frequency and stimulus quality affect separate stages of processing. This is consistent with the conclusion that word frequency effects reflect mapping operations between stages, but, when taken in conjunction with other reports in the literature, is inconsistent with the received view in many activation models that word frequency exerts its effect within the word detector level of representation. Resume Le schema des effets du facteur sur l'execution du temps de reponse (TR) dans les experiences a multiples facteurs fournissent une technique efficace pour fixer la structure des processus mentaux sous-jacents. Les resultats de la presente experience de decision lexicale montrent que les effets additifs de la qualite du stimulus et de la frequence du mot sont observes dans les TR moyens, les variances et les parametres ex-gaussiens de la distribution du TR. Ces conclusions confirment que la frequence du mot et la qualite du stimulus influencent les phases separees du traitement. Elles confirment egalement que les effets de la frequence du mot refletent les operations de correspondance entre les phases, mais, lorsque comparees a d'autres rapports, les conclusions ne correspondent pas a la vision etablie dans plusieurs modeles d'activation qui veut que la frequence du mot exerce ses effets au niveau de representation du detecteur du mot. It is well established that a word's frequency of occurrence in printed English is a strong determinant of performance in word recognition tasks such as lexical decision. For example, high frequency words such as CAT are typically recognized more quickly than lower frequency words such as VAT (e.g., Forster & Chambers, 1973; Frederiksen & Kroll, 1976; see also Monsell, 1991, for a review). One account of this word frequency effect is given by a number of models in the Activation class. Thus, models such as Morton's (1969) logogen model and variants of McClelland and Rumelhart's (1981) interactiveactivation model (e.g., Coltheart, Curtis, Atkins, & Haller, 1993; Grainger & Jacobs, 1996) all assume a word level of representation in the form of orthographic and phonological word detectors for each word the reader knows. These word detectors accumulate activation over time, and both models assume that low frequency words take longer to reach a threshold than do high frequency words. The models differ in that the interactive-activation model assumes that high frequency words start with a higher resting level of activation than do low frequency words whereas the logogen model assumes a common resting level of activation but different recognition thresholds for high and low frequency words One difficulty with the activation explanation is that a simple main effect of word frequency in lexical decision does not allow one to determine the locus of the effect; it merely informs us that word frequency affects performance in this task. A number of investigators have therefore applied Sternberg's (1969) additive factors logic to this issue by manipulating word frequency in conjunction with other factors that affect performance in lexical decision because predictions can be derived from the models as to how the effects of these factors on response time (RT) should combine (e.g., Becker & Killion, 1977; Besner & Smith, 1992; Besner & Swan, 1982). WORD FREQUENCY, STIMULUS QUALITY, AND CONTEXT It is well documented that stimulus quality affects word recognition: Clearly presented stimuli are recognized more quickly than degraded ones. …",0,1 +105,A Covariance Estimator for GEE with Improved Small‐Sample Properties,"In this paper, we propose an alternative covariance estimator to the robust covariance estimator of generalized estimating equations (GEE). Hypothesis tests using the robust covariance estimator can have inflated size when the number of independent clusters is small. Resampling methods, such as the jackknife and bootstrap, have been suggested for covariance estimation when the number of clusters is small. A drawback of the resampling methods when the response is binary is that the methods can break down when the number of subjects is small due to zero or near-zero cell counts caused by resampling. We propose a bias-corrected covariance estimator that avoids this problem. In a small simulation study, we compare the bias-corrected covariance estimator to the robust and jackknife covariance estimators for binary responses for situations involving 10-40 subjects with equal and unequal cluster sizes of 16-64 observations. The bias-corrected covariance estimator gave tests with sizes close to the nominal level even when the number of subjects was 10 and cluster sizes were unequal, whereas the robust and jackknife covariance estimators gave tests with sizes that could be 2-3 times the nominal level. The methods are illustrated using data from a randomized clinical trial on treatment for bone loss in subjects with periodontal disease.",0,1 +106,Estimation of Average Treatment Effects Based on Propensity Scores,"In this paper, we give a short overview of some propensity score matching estimators suggested in the evaluation literature, and we provide a set of Stata programs, which we illustrate using the National Supported Work (NSW) demonstration widely known in labor economics.",0,1 +107,"Comments on ‘Trying to be precise about vagueness’ by Stephen Senn, Statistics in Medicine 2007; 26 :1417-1430",http://onlinelibrary.wiley.com/doi/10.1002/sim.3043/epdf,0,1 +108,USING A META-ANALYTIC PERSPECTIVE TO ENHANCE JOB COMPONENT VALIDATION,"This paper develops synthetic validity estimates based on a metaanalytic-weighted least squares (WLS) approach to job component validity (JCV), using position analysis questionnaire (PAQ) estimates of job characteristics, and the Data, People, & Things ratings from the Dictionary of Occupational Titles as indices of job complexity. For the general aptitude test battery database of 40,487 employees, nine validity coefficients were estimated for 192 positions. The predicted validities from the WLS approach had lower estimated variability than would be obtained from either the classic JCV approach or local criterion-related validity studies. Data, People, & Things summary ratings did not consistently moderate validity coefficients, whereas the PAQ data did moderate validity coefficients. In sum, these results suggest that synthetic validity procedures should incorporate a WLS regression approach. Moreover, researchers should consider a comprehensive set of job characteristics when considering job complexity rather than a single aggregated index. Over half a century ago, Lawshe (1952) coined the term “synthetic validity,” inspired by the analogous engineering process of “synthetic time.” As applied to selection, synthetic validity involves inferring the validity of a selection tool for a specific job based on job analysis data from a variety of other jobs. In other words, synthetic validity facilitates the creation of test batteries and selection systems without the need to conduct a criterion validity study in every situation. Synthetic validity promises many advantages over local validation studies, including drastically reduced costs, improved selection of qualified candidates, and greater legal defensibility (e.g., Hoffman, Rashkovsky, & D’Egidio, 2007; Johnson, 2007; Steel, Huffcutt, & Kammeyer-Mueller, 2006). Synthetic validity can also estimate the validity of a battery of selection instruments for jobs in which there are no incumbents yet. Over the decades since synthetic validity was first proposed, a variety of estimation methods have been designed, with mixed success (Guion, 2006; Scherbaum, 2005). One of",0,1 +109,Examining the Dynamic Structure of Daily Internalizing and Externalizing Behavior at Multiple Levels of Analysis,"Psychiatric diagnostic covariation suggests that the underlying structure of psychopathology is not one of circumscribed disorders. Quantitative modeling of individual differences in diagnostic patterns has uncovered several broad domains of mental disorder liability, of which the Internalizing and Externalizing spectra have garnered the greatest support. These dimensions have generally been estimated from lifetime or past-year comorbidity patters, which are distal from the covariation of symptoms and maladaptive behavior that ebb and flow in daily life. In this study, structural models are applied to daily diary data (Median = 94 days) of maladaptive behaviors collected from a sample (N = 101) of individuals diagnosed with personality disorders (PDs). Using multilevel and unified structural equation modeling, between-person, within-person, and person-specific structures were estimated from 16 behaviors that are encompassed by the Internalizing and Externalizing spectra. At the between-person level (i.e., individual differences in average endorsement across days) we found support for a two-factor Internalizing-Externalizing model, which exhibits significant associations with corresponding diagnostic spectra. At the within-person level (i.e., dynamic covariation among daily behavior pooled across individuals) we found support for a more differentiated, four-factor, Negative Affect-Detachment-Hostility-Disinhibition structure. Finally, we demonstrate that the person-specific structures of associations between these four domains are highly idiosyncratic.",0,1 +110,Counterfactuals and Causal Inference,"In this second edition of Counterfactuals and Causal Inference, completely revised and expanded, the essential features of the counterfactual approach to observational data analysis are presented with examples from the social, demographic, and health sciences. Alternative estimation techniques are first introduced using both the potential outcome model and causal graphs; after which, conditioning techniques, such as matching and regression, are presented from a potential outcomes perspective. For research scenarios in which important determinants of causal exposure are unobserved, alternative techniques, such as instrumental variable estimators, longitudinal methods, and estimation via causal mechanisms, are then presented. The importance of causal effect heterogeneity is stressed throughout the book, and the need for deep causal explanation via mechanisms is discussed.",0,1 +111,Integration of ordinal and metric cues in depth processing,"J. Burge, M. A. Peterson, and S. E. Palmer (2005) reported that ordinal, configural cues of familiarity and convexity influence perceived depth even when unambiguous metric information in the form of binocular disparity is available. In their study, a shape that was both convex and familiar (i.e., a face) increased perceived depth in random dot stereograms if the shape was shown in the foreground and decreased perceived depth if it was shown in the background. It is generally assumed that luminance cues are necessary for pre-figural shape representation to influence figure-ground computations in this way (M. A. Peterson & B. S. Gibson, 1993); thus, Burge et al. (2005) had used a luminance edge. In this research, we asked whether configural cues need to be defined by luminance, contrast, or neither. For a sufficiently large disparity pedestal (about 2.5 arcmin), configural cues influenced perceived depth both for second-order contours and for contours defined only by disparity. The integration of ordinal and metric cues seems to be driven by the general saliency of the contours and not only by luminance information. This challenges the notion that the integration of such cues always needs to arise during figure-ground organization through early combinations of luminance-defined shape and binocular disparity.",0,1 +112,A Bayesian Approach for Estimating Mediation Effects With Missing Data,"Methodologists have developed mediation analysis techniques for a broad range of substantive applications, yet methods for estimating mediating mechanisms with missing data have been understudied. This study outlined a general Bayesian missing data handling approach that can accommodate mediation analyses with any number of manifest variables. Computer simulation studies showed that the Bayesian approach produced frequentist coverage rates and power estimates that were comparable to those of maximum likelihood with the bias-corrected bootstrap. We share a SAS macro that implements Bayesian estimation and use two data analysis examples to demonstrate its use.",0,1 +113,Whose Vote Should Count More: Optimal Integration of Labels from Labelers of Unknown Expertise,"Modern machine learning-based approaches to computer vision require very large databases of hand labeled images. Some contemporary vision systems already require on the order of millions of images for training (e.g., Omron face detector [9]). New Internet-based services allow for a large number of labelers to collaborate around the world at very low cost. However, using these services brings interesting theoretical and practical challenges: (1) The labelers may have wide ranging levels of expertise which are unknown a priori, and in some cases may be adversarial; (2) images may vary in their level of difficulty; and (3) multiple labels for the same image must be combined to provide an estimate of the actual label of the image. Probabilistic approaches provide a principled way to approach these problems. In this paper we present a probabilistic model and use it to simultaneously infer the label of each image, the expertise of each labeler, and the difficulty of each image. On both simulated and real data, we demonstrate that the model outperforms the commonly used Majority Vote heuristic for inferring image labels, and is robust to both noisy and adversarial labelers.",0,1 +114,Species distribution models and ecological theory: A critical assessment and some possible new approaches,"Given the importance of knowledge of species distribution for conservation and climate change management, continuous and progressive evaluation of the statistical models predicting species distributions is necessary. Current models are evaluated in terms of ecological theory used, the data model accepted and the statistical methods applied. Focus is restricted to Generalised Linear Models (GLM) and Generalised Additive Models (GAM). Certain currently unused regression methods are reviewed for their possible application to species modelling. A review of recent papers suggests that ecological theory is rarely explicitly considered. Current theory and results support species responses to environmental variables to be unimodal and often skewed though process-based theory is often lacking. Many studies fail to test for unimodal or skewed responses and straight-line relationships are often fitted without justification. Data resolution (size of sampling unit) determines the nature of the environmental niche models that can be fitted. A synthesis of differing ecophysiological ideas and the use of biophysical processes models could improve the selection of predictor variables. A better conceptual framework is needed for selecting variables. Comparison of statistical methods is difficult. Predictive success is insufficient and a test of ecological realism is also needed. Evaluation of methods needs artificial data, as there is no knowledge about the true relationships between variables for field data. However, use of artificial data is limited by lack of comprehensive theory. Three potentially new methods are reviewed. Quantile regression (QR) has potential and a strong theoretical justification in Liebig's law of the minimum . Structural equation modelling (SEM) has an appealing conceptual framework for testing causality but has problems with curvilinear relationships. Geographically weighted regression (GWR) intended to examine spatial non-stationarity of ecological processes requires further evaluation before being used. Synthesis and applications: explicit theory needs to be incorporated into species response models used in conservation. For example, testing for unimodal skewed responses should be a routine procedure. Clear statements of the ecological theory used, the nature of the data model and sufficient details of the statistical method are needed for current models to be evaluated. New statistical methods need to be evaluated for compatibility with ecological theory before use in applied ecology . Some recent work with artificial data suggests the combination of ecological knowledge and statistical skill is more important than the precise statistical method used. The potential exists for a synthesis of current species modelling approaches based on their differing ecological insights not their methodology.",0,1 +115,Alternative Methods for Solving the Problem of Selection Bias in Evaluating the Impact of Treatments on Outcomes,"Social scientists never have access to true experimental data of the type sometimes available to laboratory scientists.1 Our inability to use laboratory methods to independently vary treatments to eliminate or isolate spurious channels of causation places a fundamental limitation on the possibility of objective knowledge in the social sciences. In place of laboratory experimental variation, social scientists use subjective thought experiments. Assumptions replace data. In the jargon of modern econometrics, minimal identifying assumptions are invoked.",0,1 +116,A longitudinal multilevel CFA-MTMM model for interchangeable and structurally different methods,"One of the key interests in the social sciences is the investigation of change and stability of a given attribute. Although numerous models have been proposed in the past for analyzing longitudinal data including multilevel and/or latent variable modeling approaches, only few modeling approaches have been developed for studying the construct validity in longitudinal multitrait-multimethod (MTMM) measurement designs. The aim of the present study was to extend the spectrum of current longitudinal modeling approaches for MTMM analysis. Specifically, a new longitudinal multilevel CFA-MTMM model for measurement designs with structurally different and interchangeable methods (called Latent-State-Combination-Of-Methods model, LS-COM) is presented. Interchangeable methods are methods that are randomly sampled from a set of equivalent methods (e.g., multiple student ratings for teaching quality), whereas structurally different methods are methods that cannot be easily replaced by one another (e.g., teacher, self-ratings, principle ratings). Results of a simulation study indicate that the parameters and standard errors in the LS-COM model are well recovered even in conditions with only five observations per estimated model parameter. The advantages and limitations of the LS-COM model relative to other longitudinal MTMM modeling approaches are discussed.",0,1 +117,Extracting thresholds from noisy psychophysical data,"Psychophysical studies with infants or with patients often are unable to use pilot data, training, or large numbers of trials. To evaluate threshold estimates under these conditions, computer simulations of experiments with small numbers of trials were performed by using psychometric functions based on a model of two types of noise: stimulus-related noise (affecting slope) and extraneous noise (affecting upper asymptote). Threshold estimates were biased and imprecise when extraneous noise was high, as were the estimates of extraneous noise. Strategies were developed for rejecting data sets as too noisy for unbiased and precise threshold estimation; these strategies were most successful when extraneous noise was low for most of the data sets. An analysis of 1,026 data sets from visual function tests of infants and toddlers showed that extraneous noise is often considerable, that experimental paradigms can be developed that minimize extraneous noise, and that data analysis that does not consider the effects of extraneous noise may underestimate test-retest reliability and overestimate interocular differences.",0,1 +118,Estimating individual treatment effects from multiple-baseline data: A Monte Carlo study of multilevel-modeling approaches,"While conducting intervention research, researchers and practitioners are often interested in how the intervention functions not only at the group level, but also at the individual level. One way to examine individual treatment effects is through multiple-baseline studies analyzed with multilevel modeling. This analysis allows for the construction of confidence intervals, which are strongly recommended in the reporting guidelines of the American Psychological Association. The purpose of this study was to examine the accuracy of confidence intervals of individual treatment effects obtained from multilevel modeling of multiple-baseline data. Monte Carlo methods were used to examine performance across conditions varying in the number of participants, the number of observations per participant, and the dependency of errors. The accuracy of the confidence intervals depended on the method used, with the greatest accuracy being obtained when multilevel modeling was coupled with the Kenward-Roger method of estimating degrees of freedom.",0,1 +119,Samples in applied psychology: Over a decade of research in review.,"This study examines sample characteristics of articles published in Journal of Applied Psychology (JAP) from 1995 to 2008. At the individual level, the overall median sample size over the period examined was approximately 173, which is generally adequate for detecting the average magnitude of effects of primary interest to researchers who publish in JAP. Samples using higher units of analyses (e.g., teams, departments/work units, and organizations) had lower median sample sizes (Mdn ≈ 65), yet were arguably robust given typical multilevel design choices of JAP authors despite the practical constraints of collecting data at higher units of analysis. A substantial proportion of studies used student samples (~40%); surprisingly, median sample sizes for student samples were smaller than working adult samples. Samples were more commonly occupationally homogeneous (~70%) than occupationally heterogeneous. U.S. and English-speaking participants made up the vast majority of samples, whereas Middle Eastern, African, and Latin American samples were largely unrepresented. On the basis of study results, recommendations are provided for authors, editors, and readers, which converge on 3 themes: (a) appropriateness and match between sample characteristics and research questions, (b) careful consideration of statistical power, and (c) the increased popularity of quantitative synthesis. Implications are discussed in terms of theory building, generalizability of research findings, and statistical power to detect effects.",0,1 +120,The Effect of Small Sample Size on Two-Level Model Estimates: A Review and Illustration,"Multilevel models are an increasingly popular method to analyze data that originate from a clustered or hierarchical structure. To effectively utilize multilevel models, one must have an adequately large number of clusters; otherwise, some model parameters will be estimated with bias. The goals for this paper are to (1) raise awareness of the problems associated with a small number of clusters, (2) review previous studies on multilevel models with a small number of clusters, (3) to provide an illustrative simulation to demonstrate how a simple model becomes adversely affected by small numbers of clusters, (4) to provide researchers with remedies if they encounter clustered data with a small number of clusters, and (5) to outline methodological topics that have yet to be addressed in the literature.",0,1 +121,Analyzing small data sets using Bayesian estimation: the case of posttraumatic stress symptoms following mechanical ventilation in burn survivors,"Background : The analysis of small data sets in longitudinal studies can lead to power issues and often suffers from biased parameter values. These issues can be solved by using Bayesian estimation in conjunction with informative prior distributions. By means of a simulation study and an empirical example concerning posttraumatic stress symptoms (PTSS) following mechanical ventilation in burn survivors, we demonstrate the advantages and potential pitfalls of using Bayesian estimation. Methods : First, we show how to specify prior distributions and by means of a sensitivity analysis we demonstrate how to check the exact influence of the prior (mis-) specification. Thereafter, we show by means of a simulation the situations in which the Bayesian approach outperforms the default, maximum likelihood and approach. Finally, we re-analyze empirical data on burn survivors which provided preliminary evidence of an aversive influence of a period of mechanical ventilation on the course of PTSS following burns. Results : Not suprisingly, maximum likelihood estimation showed insufficient coverage as well as power with very small samples. Only when Bayesian analysis, in conjunction with informative priors, was used power increased to acceptable levels. As expected, we showed that the smaller the sample size the more the results rely on the prior specification. Conclusion : We show that two issues often encountered during analysis of small samples, power and biased parameters, can be solved by including prior information into Bayesian analysis. We argue that the use of informative priors should always be reported together with a sensitivity analysis.",1,1 +122,Measurement and Structural Model Class Separation in Mixture CFA: ML/EM Versus MCMC,"Parameter recovery was assessed within mixture confirmatory factor analysis across multiple estimator conditions under different simulated levels of mixture class separation. Mixture class separation was defined in the measurement model (through factor loadings) and the structural model (through factor variances). Maximum likelihood (ML) via the EM algorithm was compared to a Markov chain Monte Carlo (MCMC) estimator condition using weak priors and a condition using tight priors. Results indicated that the MCMC weak condition produced the highest bias, particularly with a weak Dirichlet prior for the mixture class proportions. Specifically, the weak Dirichlet prior affected parameter estimates under all mixture class separation conditions, even with moderate and large sample sizes. With little knowledge about parameters, ML/EM should be used over MCMC weak. However, MCMC tight produced the lowest bias under all mixture class separation conditions and should be used if tight and accurate priors can be plac...",1,1 +123,A Bayesian approach to analyze energy balance data from lactating dairy cows,"The objective of the present investigation was to develop a Bayesian framework for updating and integrating covariate information into key parameters of metabolizable energy (ME) systems for dairy cows. The study addressed specifically the effects of genetic improvements and feed quality on key parameters in current ME systems. These are net and metabolizable energy for maintenance (NE(M) and ME(M), respectively), efficiency of utilization of ME for milk production (k(L)) and growth (k(G)), and efficiency of utilization of body stores for milk production (k(T)). Data were collated from 38 studies, yielding 701 individual cow observations on milk energy, ME intake, and tissue gain and loss. A function based on a linear relationship between milk energy and ME intake and correcting for tissue energy loss or gain served as the basis of a full Bayesian hierarchical model. The within-study variability was modeled by a Student t-distribution and the between-study variability in the structural parameters was modeled by a multivariate normal distribution. A meaningful relationship between genetic improvements in milk production and the key parameters could not be established. The parameter k(L) was linearly related to feed metabolizability, and the slope predicted a 0.010 (-0.0004; 0.0210) change per 0.1-unit change in metabolizability. The effect of metabolizability on k(L) was smaller than assumed in present feed evaluation systems and its significance was dependent on collection of studies included in the analysis. Three sets of population estimates (with 95% credible interval in parentheses) were generated, reflecting different degrees of prior belief: (1) Noninformative priors yielded 0.28 (0.23; 0.33) MJ/(kg(0.75)d), 0.55 (0.51; 0.58), 0.86 (0.81; 0.93) and 0.66 (0.58; 0.75), for NE(M), k(L), k(G), and k(T), respectively; (2) Introducing an informative prior that was derived from a fasting metabolism study served to combine the most recent information on energy metabolism in modern dairy cows. The new estimates of NE(M), k(L), k(G) and k(T) were 0.34 (0.28; 0.39) MJ/(kg(0.75)d), 0.58 (0.54; 0.62), 0.89 (0.85; 0.95), and 0.69 (0.60; 0.79), respectively; (3) finally, all informative priors were used that were established from literature, yielding estimates for NE(M), k(L), k(G), and k(T) of 0.29 (0.11; 0.46) MJ/(kg(0.75)d), 0.60 (0.54; 0.70), 0.70 (0.50; 0.88), and 0.80 (0.67; 0.97), respectively. Bayesian methods are especially applicable in meta-analytical studies as information can enter at various stages in the hierarchical model.",0,1 +124,Using student-choice behaviour to estimate tuition elasticity in higher education,"Prior research on student response to changes in university prices (tuition) finds that demand is inelastic. We present results, based on separate models for 11 colleges (n = 5606) at a major US un...",0,1 +125,Beta-MPT: Multinomial processing tree models for addressing individual differences,"Abstract Traditionally, multinomial processing tree (MPT) models are applied to groups of homogeneous participants, where all participants within a group are assumed to have identical MPT model parameter values. This assumption is unreasonable when MPT models are used for clinical assessment, and it often may be suspect for applications to ordinary psychological experiments. One method for dealing with parameter variability is to incorporate random effects assumptions into a model. This is achieved by assuming that participants’ parameters are drawn independently from some specified multivariate hyperdistribution. In this paper we explore the assumption that the hyperdistribution consists of independent beta distributions, one for each MPT model parameter. These beta-MPT models are ‘hierarchical models’, and their statistical inference is different from the usual approaches based on data aggregated over participants. The paper provides both classical (frequentist) and hierarchical Bayesian approaches to statistical inference for beta-MPT models. In simple cases the likelihood function can be obtained analytically; however, for more complex cases, Markov Chain Monte Carlo algorithms are constructed to assist both approaches to inference. Examples based on clinical assessment studies are provided to demonstrate the advantages of hierarchical MPT models over aggregate analysis in the presence of individual differences.",0,1 +126,Integrative Genomics and Computational Systems Medicine,"The exponential growth in generation of large amounts of genomic data from biological samples has driven the emerging field of systems medicine. This field is promising because it improves our understanding of disease processes at the systems level. However, the field is still in its young stage. There exists a great need for novel computational methods and approaches to effectively utilize and integrate various omics data.",0,1 +127,A tutorial on adaptive MCMC,"We review adaptive Markov chain Monte Carlo algorithms (MCMC) as a mean to optimise their performance. Using simple toy examples we review their theoretical underpinnings, and in particular show why adaptive MCMC algorithms might fail when some fundamental properties are not satisfied. This leads to guidelines concerning the design of correct algorithms. We then review criteria and the useful framework of stochastic approximation, which allows one to systematically optimise generally used criteria, but also analyse the properties of adaptive MCMC algorithms. We then propose a series of novel adaptive algorithms which prove to be robust and reliable in practice. These algorithms are applied to artificial and high dimensional scenarios, but also to the classic mine disaster dataset inference problem. © 2008 Springer Science+Business Media, LLC.",0,1 +128,Bayesian Analysis of Structural Equation Models With Nonlinear Covariates and Latent Variables,"In this article, we formulate a nonlinear structural equation model (SEM) that can accommodate covariates in the measurement equation and nonlinear terms of covariates and exogenous latent variables in the structural equation. The covariates can come from continuous or discrete distributions. A Bayesian approach is developed to analyze the proposed model. Markov chain Monte Carlo methods for obtaining Bayesian estimates and their standard error estimates, highest posterior density intervals, and a PP p value are developed. Results obtained from two simulation studies are reported to respectively reveal the empirical performance of the proposed Bayesian estimation in analyzing complex nonlinear SEMs, and in analyzing nonlinear SEMs with the normal assumption of the exogenous latent variables violated. The proposed methodology is further illustrated by a real example. Detailed interpretation about the interaction terms is presented.",0,1 +129,On the use of MCMC computerized adaptive testing with empirical prior information to improve efficiency,"The paper deals with the introduction of empirical prior information in the estimation of candidate's ability within computerized adaptive testing (CAT). CAT is generally applied to improve efficiency of test administration. In this paper, it is shown how the inclusion of background variables both in the initialization and the ability estimation is able to improve the accuracy of ability estimates. In particular, a Gibbs sampler scheme is proposed in the phases of interim and final ability estimation. By using both simulated and real data, it is proved that the method produces more accurate ability estimates, especially for short tests and when reproducing boundary abilities. This implies that operational problems of CAT related to weak measurement precision under particular conditions, can be reduced as well. In the empirical examples, the methods were applied to CAT for intelligence testing in the area of personnel selection and to educational measurement. Other promising applications would be in the medical world, where testing efficiency is of paramount importance as well. © 2012 Springer-Verlag Berlin Heidelberg.",0,1 +130,Market Share Predictions: A New Model with Rating-Based Conjoint Analysis,"Conjoint Analysis (CA) is a technique heavily used by industry in support of product development, pricing and positioning, and market share predictions. This generic term CA encompasses a variety of experimental protocols and estimation models (e.g. rating-based or choice-based), as well as several probabilistic models for predicting market share. As for the rating conjoint, existing probabilistic models from the literature cannot be considered as reliable because they suffer from the Independence of Irrelevant Alternatives (IIA) property, in addition to depending on an arbitrary rating scale selected by the experimenter. In this article, after a brief overview of CA and of models used for market share predictions, we propose a new model for market share predictions, RFC-BOLSE, which avoids the IIA problem, yields convergent results for different rating scales, and outputs predictions that match regression reliability. The model is described in details and simulations and a case study on truck tyres will illustrate the reliability of RFC-BOLSE.",0,1 +131,On Obtaining Estimates of the Fraction of Missing Information From Full Information Maximum Likelihood,"Fraction of missing information λ j is a useful measure of the impact of missing data on the quality of estimation of a particular parameter. This measure can be computed for all parameters in the model, and it communicates the relative loss of efficiency in the estimation of a particular parameter due to missing data. It has been recommended that researchers working with incomplete data sets routinely report this measure, as it is more informative than percent missing data (Bodner, 2008 Bodner, T. E. 2008. What improves with increasing missing data imputations?. Structural Equation Modeling, 15: 651–675. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]; Schafer, 1997 Schafer, J. L. 1997. Analysis of incomplete multivariate data. London: Chapman & Hall.. [Crossref] , [Google Scholar]). However, traditional estimates of λ j require the implementation of multiple imputation (MI). Many researchers prefer to fit structural equation models using full information maximum likelihood rather than MI. This article demonstrates how to obtain an estimate of λ j using maximum likelihood estimation routines only and argues that this estimate is superior to the estimate obtained via MI when the number of imputations is small. Interpretation of λ j is also addressed.",0,1 +132,Deviance information criteria for missing data models,"The deviance information criterion (DIC) introduced by is directly inspired by linear and generalised linear models, but it is not so naturally defined for missing data models. In this paper, we reassess the criterion for such models, testing the behaviour of various extensions in the cases of mixture and random effect models.",0,1 +133,Meta-analytic Reviews in the Organizational Sciences: Two Meta-analytic Schools on the Way to MARS (the Meta-analytic Reporting Standards),"Purpose: The purpose of this study was to review the Meta-Analysis Reporting Standards (MARS) of the American Psychological Association (APA) and highlight opportunities for improvement of meta-analytic reviews in the organizational sciences. Design/Methodology/Approach: The paper reviews MARS, describes ""best"" meta-analytic practices across two schools of meta-analysis, and shows how implementing such practices helps achieve the aims set forth in MARS. Examples of best practices are provided to aid readers in finding models for their own research. Implications/Value: Meta-analytic reviews are a primary avenue for the accumulation of knowledge in the organizational sciences as well as many other areas of science. Unfortunately, many meta-analytic reviews in the organizational sciences do not fully follow professional guidelines and standards as closely as they should. Such deviations from best practice undermine the transparency and replicability of the reviews and thus their usefulness for the generation of cumulative knowledge and evidence-based practice. This study shows how implementing ""best"" meta-analytic practices helps to achieve the aims set forth in MARS. Although the paper is written primarily for organizational scientists, the paper's recommendations are not limited to any particular scientific domain. © 2013 Springer Science+Business Media New York.",0,1 +134,A bias correction for covariance estimators to improve inference with generalized estimating equations that use an unstructured correlation matrix,"Generalized estimating equations (GEEs) are routinely used for the marginal analysis of correlated data. The efficiency of GEE depends on how closely the working covariance structure resembles the true structure, and therefore accurate modeling of the working correlation of the data is important. A popular approach is the use of an unstructured working correlation matrix, as it is not as restrictive as simpler structures such as exchangeable and AR-1 and thus can theoretically improve efficiency. However, because of the potential for having to estimate a large number of correlation parameters, variances of regression parameter estimates can be larger than theoretically expected when utilizing the unstructured working correlation matrix. Therefore, standard error estimates can be negatively biased. To account for this additional finite-sample variability, we derive a bias correction that can be applied to typical estimators of the covariance matrix of parameter estimates. Via simulation and in application to a longitudinal study, we show that our proposed correction improves standard error estimation and statistical inference.",0,1 +135,Simultaneous factor analysis in several populations,"This paper is concerned with the study of similarities and differences in factor structures between different groups. A common situation occurs when a battery of tests has been administered to samples of examinees from several populations. A very general model is presented, in which any parameter in the factor analysis models (factor loadings, factor variances, factor covariances, and unique variances) for the different groups may be assigned an arbitrary value or constrained to be equal to some other parameter. Given such a specification, the model is estimated by the maximum likelihood method yielding a large sample x2 of goodness of fit. By computing several solutions under different specifications one can test various hypotheses. The method is capable of dealing with any degree of invariance, from the one extreme, where nothing is invariant, to the other extreme, where everything is invariant. Neither the number of tests nor the number of common factors need to be the same for all groups, but to be at all interesting, it is assumed that there is a common core of tests in each battery that is the same or at least content-wise comparable. © 1971 Psychometric Society.",0,1 +136,Point-Referenced Spatial Modeling,,0,1 +137,Multilevel Modeling,"Mortality is the most frequently modeled outcome in injury research. It is easy to recognize, relatively free from measurement error, and fundamentally interesting. Injury researchers in public health or clinical medicine have become familiar with logistic regression as a standard way to model a binary outcome like mortality (or alternatively survival). Many other outcomes encountered in injury research can also be considered binary, such as the occurrence of a serious complication or an extended length of stay in hospital. © Springer Science+Business Media, LLC 2012. All rights reserved.",0,1 +138,Generalized linear mixed models: a practical guide for ecology and evolution,"How should ecologists and evolutionary biologists analyze nonnormal data that involve random effects? Nonnormal data such as counts or proportions often defy classical statistical procedures. Generalized linear mixed models (GLMMs) provide a more flexible approach for analyzing nonnormal data when random effects are present. The explosion of research on GLMMs in the last decade has generated considerable uncertainty for practitioners in ecology and evolution. Despite the availability of accurate techniques for estimating GLMM parameters in simple cases, complex GLMMs are challenging to fit and statistical inference such as hypothesis testing remains difficult. We review the use (and misuse) of GLMMs in ecology and evolution, discuss estimation and inference and summarize ‘best-practice' data analysis procedures for scientists facing this challenge.",0,1 +139,Spatial four-alternative forced-choice method is the preferred psychophysical method for naive observers,"H. R. Blackwell (1952) investigated the influence of different psychophysical methods and procedures on detection thresholds. He found that the temporal two-interval forced-choice method (2-IFC) combined with feedback, blocked constant stimulus presentation with few different stimulus intensities, and highly trained observers resulted in the ""best"" threshold estimates. This recommendation is in current practice in many psychophysical laboratories and has entered the psychophysicists' ""folk wisdom"" of how to run proper psychophysical experiments. However, Blackwell's recommendations explicitly require experienced observers, whereas many psychophysical studies, particularly with children or within a clinical setting, are performed with naïve observers. In a series of psychophysical experiments, we find a striking and consistent discrepancy between naïve observers' behavior and that reported for experienced observers by Blackwell: Naïve observers show the ""best"" threshold estimates for the spatial four-alternative forced-choice method (4-AFC) and the worst for the commonly employed temporal 2-IFC. We repeated our study with a highly experienced psychophysical observer, and he replicated Blackwell's findings exactly, thus suggesting that it is indeed the difference in psychophysical experience that causes the discrepancy between our findings and those of Blackwell. In addition, we explore the efficiency of different methods and show 4-AFC to be more than 3.5 times more efficient than 2-IFC under realistic conditions. While we have found that 4-AFC consistently gives lower thresholds than 2-IFC in detection tasks, we have found the opposite for discrimination tasks. This discrepancy suggests that there are large extrasensory influences on thresholds--sensory memory for IFC methods and spatial attention for spatial forced-choice methods--that are critical but, alas, not part of theoretical approaches to psychophysics such as signal detection theory.",0,1 +140,Random effects models.,,0,1 +141,A comparison of the efficiency and accuracy of BILOG and LOGIST,"Comparisons are made between BILOG version 2.2 and LOGIST 5.0 Version 2.5 in estimating the item parameters, traits, item characteristic functions (ICFs), and test characteristic functions (TCFs) for the three-parameter logistic model. Data analyzed are simulated item responses for 1000 simulees and one 10-item test, four 20-item tests, and four 40-item tests. LOGIST usually was faster than BILOG in producing maximum likelihood estimates. BILOG almost always produced more accurate estimates of individual item parameters. In estimating ICFs and TCFs BILOG was more accurate for the 10-item test, and the two programs were about equally accurate for the 20- and 40-item tests. © 1987 The Psychometric Society.",0,1 +142,Dynamic but Structural Equation Modeling of Repeated Measures Data,"The term “dynamic” is broadly defined as a pattern of change. Many scientists have searched for dynamics by calculating df/dt: the ratio of changes or differences d in a function f relative to changes in time t.This simple dynamic equation was used in the 16th and 17th century motion experiments of Galileo, in the 17th and 18th century gravitation experiments of Newton, and in the 19th century experiments of many physicists and chemists (see Morris, 1985). I also use this dynamic equation, but here I examine multivariate psychological change data using the 20th century developments of latent variable structural equation modeling.",0,1 +143,Genome-scale metabolic model of Rhodococcus jostii RHA1 (iMT1174) to study the accumulation of storage compounds during nitrogen-limited condition,"Rhodococcus jostii RHA1 growing on different substrates is capable of accumulating simultaneously three types of carbon storage compounds: glycogen, polyhydroxyalkanoates (PHA), and triacylglycerols (TAG). Under nitrogen-limited (N-limited) condition, the level of storage increases as is commonly observed for other bacteria. The proportion of each storage compound changes with substrate, but it remains unclear what modelling approach should be adopted to predict the relative composition of the mixture of the storage compounds. We analyzed the growth of R. jostii RHA1 under N-limited conditions using a genome-scale metabolic modelling approach to determine which global metabolic objective function could be used for the prediction.The R. jostii RHA1 model (iMT1174) produced during this study contains 1,243 balanced metabolites, 1,935 unique reactions, and 1,174 open reading frames (ORFs). Seven objective functions used with flux balance analysis (FBA) were compared for their capacity to predict the mixture of storage compounds accumulated after the sudden onset of N-limitation. Predictive abilities were determined using a Bayesian approach. Experimental data on storage accumulation mixture (glycogen, polyhydroxyalkanoates, and triacylglycerols) were obtained for batch cultures grown on glucose or acetate. The best FBA simulation results were obtained using a novel objective function for the N-limited condition which combined the maximization of the storage fluxes and the minimization of metabolic adjustments (MOMA) with the preceding non-limited conditions (max storage + environmental MOMA). The FBA solutions for the non-limited growth conditions were simply constrained by the objective function of growth rate maximization. Measurement of central metabolic fluxes by (13)C-labelling experiments of amino acids further supported the application of the environmental MOMA principle in the context of changing environment. Finally, it was found that the quantitative predictions of the storage mixture during N-limited storage accumulation were fairly sensitive to the biomass composition, as expected.The genome-scale metabolic model analysis of R. jostii RHA1 cultures suggested that the intracellular reaction flux profile immediately after the onset of N-limited condition are impacted by the values of the same fluxes during the period of non-limited growth. PHA turned out to be the main storage pool of the mixture in R. jostii RHA1.",0,1 +144,A study of algorithms for covariance structure analysis with specific comparisons using factor analysis,"Several algorithms for covariance structure analysis are considered in addition to the Fletcher-Powell algorithm. These include the Gauss-Newton, Newton-Raphson, Fisher Scoring, and Fletcher-Reeves algorithms. Two methods of estimation are considered, maximum likelihood and weighted least squares. It is shown that the Gauss-Newton algorithm which in standard form produces weighted least squares estimates can, in iteratively reweighted form, produce maximum likelihood estimates as well. Previously unavailable standard error estimates to be used in conjunction with the Fletcher-Reeves algorithm are derived. Finally all the algorithms are applied to a number of maximum likelihood and weighted least squares factor analysis problems to compare the estimates and the standard errors produced. The algorithms appear to give satisfactory estimates but there are serious discrepancies in the standard errors. Because it is robust to poor starting values, converges rapidly and conveniently produces consistent standard errors for both maximum likelihood and weighted least squares problems, the Gauss-Newton algorithm represents an attractive alternative for at least some covariance structure analyses. © 1979 The Psychometric Society.",0,1 +145,The Role of Coding Time in Estimating and Interpreting Growth Curve Models.,"The coding of time in growth curve models has important implications for the interpretation of the resulting model that are sometimes not transparent. The authors develop a general framework that includes predictors of growth curve components to illustrate how parameter estimates and their standard errors are exactly determined as a function of receding time in growth curve models. Linear and quadratic growth model examples are provided, and the interpretation of estimates given a particular coding of time is illustrated. How and why the precision and statistical power of predictors of lower order growth curve components changes over time is illustrated and discussed. Recommendations include coding time to produce readily interpretable estimates and graphing lower order effects across time with appropriate confidence intervals to help illustrate and understand the growth process.",0,1 +146,Power estimation in social relations analyses.,"This article is intended for investigators interested in applying the Social Relations Model (SRM) to the study of dyadic processes. On the basis of theory and simulation, the authors provide practical advice concerning optimal number of persons per research group, number of research groups, type of research design, and significance testing method. Power depends more on group size than on number of groups. Power also is greater with the round-robin design than with the block design and greater with an asymptotic test of significance than with the test usually used. The authors discuss the effect of skew on theoretical power.",0,1 +147,Efficient nonparametric approaches for estimating the operating characteristics of discrete item responses,"Rationale and the actual procedures of two nonparametric approaches, called Bivariate P.D.F. Approach and Conditional P.D.F. Approach, for estimating the operating characteristic of a discrete item response, or the conditional probability, given latent trait, that the examinee's response be that specific response, are introduced and discussed. These methods are featured by the facts that: (a) estimation is made without assuming any mathematical forms, and (b) it is based upon a relatively small sample of several hundred to a few thousand examinees. Some examples of the results obtained by the Simple Sum Procedure and the Differential Weight Procedure of the Conditional P.D.F. Approach are given, using simulated data. The usefulness of these nonparametric methods is also discussed.",0,1 +148,"Boys Might Catch Up, Family Influences Continue: Influences on Behavioral Self-Regulation in Children From an Affluent Region in Germany Before School Entry","Research Findings: Behavioral self-regulation is crucial for school success. Although behavioral self-regulation typically grows rapidly during the preschool period, children in this age group vary widely in their behavioral self-regulation capacities. The present study investigated 3 potential determinants of growth rates in behavioral self-regulation in children from an affluent region in Germany: family educational resources, child gender, and child negative affectivity. Using a longitudinal design, we observed children (N = 60) during the last 2 years before school entry. Children from families with relatively fewer educational resources started off with a lower level of behavioral self-regulation and did not catch up with their more advantaged peers. Boys showed poorer initial behavioral self-regulation than girls, but their gains in behavioral self-regulation were greater over time compared to girls’. Negative affectivity influenced neither the initial level of nor growth in behavioral self-regulati...",0,1 +149,A Semiparametric Model for Jointly Analyzing Response Times and Accuracy in Computerized Testing,"The item response times (RTs) collected from computerized testing represent an underutilized type of information about items and examinees. In addition to knowing the examinees’ responses to each item, we can investigate the amount of time examinees spend on each item. Current models for RTs mainly focus on parametric models, which have the advantage of conciseness, but may suffer from reduced flexibility to fit real data. We propose a semiparametric approach, specifically, the Cox proportional hazards model with a latent speed covariate to model the RTs, embedded within the hierarchical framework proposed by van der Linden to model the RTs and response accuracy simultaneously. This semiparametric approach combines the flexibility of nonparametric modeling and the brevity and interpretability of the parametric modeling. A Markov chain Monte Carlo method for parameter estimation is given and may be used with sparse data obtained by computerized adaptive testing. Both simulation studies and real data analysis are carried out to demonstrate the applicability of the new model.",0,1 +150,Multilevel models for the experimental psychologist: Foundations and illustrative examples,"Although common in the educational and developmental areas, multilevel models are not often utilized in the analysis of data from experimental designs. This article illustrates how multilevel models can be useful with two examples from experimental designs with repeated measurements not involving time. One example demonstrates how to properly examine independent variables for experimental stimuli or individuals that are categorical, continuous, or semicontinuous in the presence of missing data. The second example demonstrates how response times and error rates can be modeled simultaneously within a multivariate model in order to examine speed-accuracy trade-offs at the experimental-condition and individual levels, as well as to examine differences in the magnitude of effects across outcomes. SPSS and SAS syntax for the examples are available electronically.",0,1 +151,Fitting Residual Error Structures for Growth Models in SAS PROC MCMC,"In behavioral sciences broadly, estimating growth models with Bayesian methods is becoming increasingly common, especially to combat small samples common with longitudinal data. Although M plus is becoming an increasingly common program for applied research employing Bayesian methods, the limited selection of prior distributions for the elements of covariance structures makes more general software more advantages under certain conditions. However, as a disadvantage of general software’s software flexibility, few preprogrammed commands exist for specifying covariance structures. For instance, PROC MIXED has a few dozen such preprogrammed options, but when researchers divert to a Bayesian framework, software offer no such guidance and requires researchers to manually program these different structures, which is no small task. As such the literature has noted that empirical papers tend to simplify their covariance matrices to circumvent this difficulty, which is not desirable because such a simplification will likely lead to biased estimates of variance components and standard errors. To facilitate wider implementation of Bayesian growth models that properly model covariance structures, this article overviews how to generally program a growth model in SAS PROC MCMC and then demonstrates how to program common residual error structures. Full annotated SAS code and an applied example are provided.",0,1 +152,Affinely Invariant Matching Methods with Ellipsoidal Distributions,"Matched sampling is a common technique used for controlling bias in observational studies. We present a general theoretical framework for studying the performance of such matching methods. Specifically, results are obtained concerning the performance of affinely invariant matching methods with ellipsoidal distributions, which extend previous results on equal percent bias reducing methods. Additional extensions cover conditionally affinely invariant matching methods for covariates with conditionally ellipsoidal distributions. These results decompose the effects of matching into one subspace containing the best linear discriminant, and the subspace of variables uncorrelated with the discriminant. This characterization of the effects of matching provides a theoretical foundation for understanding the performance of specific methods such as matched sampling using estimated propensity scores. Calculations for such methods are given in subsequent articles.",0,1 +153,Augmented Beta rectangular regression models: A Bayesian perspective,"Mixed effects Beta regression models based on Beta distributions have been widely used to analyze longitudinal percentage or proportional data ranging between zero and one. However, Beta distributions are not flexible to extreme outliers or excessive events around tail areas, and they do not account for the presence of the boundary values zeros and ones because these values are not in the support of the Beta distributions. To address these issues, we propose a mixed effects model using Beta rectangular distribution and augment it with the probabilities of zero and one. We conduct extensive simulation studies to assess the performance of mixed effects models based on both the Beta and Beta rectangular distributions under various scenarios. The simulation studies suggest that the regression models based on Beta rectangular distributions improve the accuracy of parameter estimates in the presence of outliers and heavy tails. The proposed models are applied to the motivating Neuroprotection Exploratory Trials in Parkinson's Disease (PD) Long-term Study-1 (LS-1 study, n = 1741), developed by The National Institute of Neurological Disorders and Stroke Exploratory Trials in Parkinson's Disease (NINDS NET-PD) network.",0,1 +154,Maximum-likelihood psychometric procedures in two-alternative forced-choice: Evaluation and recommendations,"Several new adaptive psychometric procedures have been proposed that use maximum-likelihood methods to estimate points on a subject’s psychophysical function. These developments are summarized, and some psychometric situations that pose special problems for the new approaches are examined. The problem areas include the effects of threshold changes during the testing session, the impact of errors made by the subject, and differences between yes-no and two-alternative forced-choice situations. Data are presented from both human subjects and computer simulations. Strengths and weaknesses of the new procedures are identified and recommendations are made for their use.",0,1 +155,Psychometric procedures for administering CAT-ASVAB.,,0,1 +156,Hypothesis testing and model selection,,0,1 +157,A comparison of generalized linear mixed model procedures with estimating equations for variance and covariance parameter estimation in longitudinal studies and group randomized trials,"Response data in longitudinal studies and group randomized trials are gathered on units that belong to clusters, within which data are usually positively correlated. Therefore, estimates and confidence intervals for intraclass correlation or variance components are helpful when designing a longitudinal study or group randomized trial. Data simulated from both study designs are used to investigate the estimation of variance and covariance parameters from the following procedures: for continuous outcomes, restricted maximum likelihood (REML) and estimating equations (EE); for binary outcomes, restricted pseudo-likelihood (REPL) and estimating equations (EE). We evaluate these procedures to see which provide valid and precise estimates as well as correct standard errors for the intraclass correlation coefficient or variance components. REML seems the better choice for estimating terms related to correlation for models with normal outcomes, especially in group randomized trial situations. Results for REML and EE are mixed when outcomes are continuous and non-normal. With binary outcomes neither REPL nor EE provides satisfactory estimation or inference in longitudinal study situations, while REPL is preferable for group randomized trials.",0,1 +158,Synthesis of evidence on heterogeneous interventions with multiple outcomes recorded over multiple follow-up times reported inconsistently: a smoking cessation case-study,"Health technology assessment requires the synthesis of evidence from multiple sources to assess the cost-effectiveness of competing interventions. However, the format of the available reported evidence is often complex. We present a case-study of electronic aids to smoking cessation, which raises various methodological challenges. The evidence base evaluated highly complex and diverse interventions, reporting one or both of two different, but related, outcome measures. Furthermore, there were differences between studies in the number and timing of follow-up times reported, whereas 12-month continuous abstinence is required in the cost-effectiveness analysis. We develop a categorization system to evaluate the interventions, and we use network meta-analysis of time-to-relapse model parameters to estimate coherent intervention effects for any pair of categories. We compare the fit of alternative time-to-relapse models and explore the effect of joint models for both outcome measures, which can be used to estimate treatment effects when a given outcome is not reported, so that all the available evidence can be combined. © 2013 Royal Statistical Society.",0,1 +159,Highly local environmental variability promotes intrapopulation divergence of quantitative traits: an example from tropical rain forest trees,"In habitat mosaics, plant populations face environmental heterogeneity over short geographical distances. Such steep environmental gradients can induce ecological divergence. Lowland rainforests of the Guiana Shield are characterized by sharp, short-distance environmental variations related to topography and soil characteristics (from waterlogged bottomlands on hydromorphic soils to well-drained terra firme on ferralitic soils). Continuous plant populations distributed along such gradients are an interesting system to study intrapopulation divergence at highly local scales. This study tested (1) whether conspecific populations growing in different habitats diverge at functional traits, and (2) whether they diverge in the same way as congeneric species having different habitat preferences.Phenotypic differentiation was studied within continuous populations occupying different habitats for two congeneric, sympatric, and ecologically divergent tree species (Eperua falcata and E. grandiflora, Fabaceae). Over 3000 seeds collected from three habitats were germinated and grown in a common garden experiment, and 23 morphological, biomass, resource allocation and physiological traits were measured.In both species, seedling populations native of different habitats displayed phenotypic divergence for several traits (including seedling growth, biomass allocation, leaf chemistry, photosynthesis and carbon isotope composition). This may occur through heritable genetic variation or other maternally inherited effects. For a sub-set of traits, the intraspecific divergence associated with environmental variation coincided with interspecific divergence.The results indicate that mother trees from different habitats transmit divergent trait values to their progeny, and suggest that local environmental variation selects for different trait optima even at a very local spatial scale. Traits for which differentiation within species follows the same pattern as differentiation between species indicate that the same ecological processes underlie intra- and interspecific variation.",0,1 +160,Statistical significance in psychological research.,"Most theories in the areas of personality, clinical, and social psychology predict no more than the direction of a correlation, group difference, or treatment effect. Since the null hypothesis is never strictly true, such predictions have about a SO-SO chance of being confirmed by experiment when the theory in question is false, since the statistical significance of the result is a function of the sample size. Confirmation of a single directional prediction should usually add little to one's confidence in the theory being tested. Most theories should be tested by multiple corroboration and most empirical generalizations by constructive replication. Statistical significance is perhaps the least important attribute of a good experiment; it is never a sufficient condition for claiming that a theory has been usefully corroborated, that a meaningful empirical fact has been established, or that an experimental report ought to be published. In a recent journal article Sapolsky (1964) developed the following substantive theory: Some psychiatric patients entertain an unconscious belief in the theory of birth which involves the notions of oral impregnation and anal parturition. Such patients should be inclined to manifest eating disorders: compulsive eating in the case of those who wish to get pregnant and anorexia in those who do not. Such patients should also be inclined to see cloacal animals, such as frogs, on the Rorschach. This reasoning led Sapolsky to predict that Rorschach frog responders show",0,1 +161,Effect Sizes and Statistical Methods for Meta-Analysis in Higher Education,"Quantitative meta-analysis is a very useful, yet underutilized, technique for synthesizing research findings in higher education. Meta-analytic inquiry can be more challenging in higher education than in other fields of study as a result of (a) concerns about the use of regression coefficients as a metric for comparing the magnitude of effects across studies, and (b) the non-independence of observations that occurs when a single study contains multiple effect sizes. This methodological note discusses these two important issues and provides concrete suggestions for addressing them. First, meta-analysis scholars have concluded that standardized regression coefficients, which are often provided in higher education manuscripts, constitute an appropriate metric of effect size. Second, hierarchical linear modeling (HLM) analyses provide an effective method for conducting meta-analytic research while accounting for the non-independence of observations, and HLM is generally superior to other proposed methods that attempt to remedy this same problem. A discussion of how to implement these techniques appropriately is provided. © 2011 Springer Science+Business Media, LLC.",0,1 +162,A Systematic Review of Propensity Score Methods in the Social Sciences,"The use of propensity scores in psychological and educational research has been steadily increasing in the last 2 to 3 years. However, there are some common misconceptions about the use of different estimation techniques and conditioning choices in the context of propensity score analysis. In addition, reporting practices for propensity score analyses often lack important details that allow other researchers to confidently judge the appropriateness of reported analyses and potentially to replicate published findings. In this article we conduct a systematic literature review of a large number of published articles in major areas of social science that used propensity scores up until the fall of 2009. We identify common errors in estimation, conditioning, and reporting of propensity score analyses and suggest possible solutions.",0,1 +163,Estimation of a Covariance Matrix Using the Reference Prior,"Estimation of a covariance matrix $\sum$ is a notoriously difficult problem; the standard unbiased estimator can be substantially suboptimal. We approach the problem from a noninformative prior Bayesian perspective, developing the reference noninformative prior for a covariance matrix and obtaining expressions for the resulting Bayes estimators. These expressions involve the computation of high-dimensional posterior expectations, which is done using a recent Markov chain simulation tool, the hit-and-run sampler. Frequentist risk comparisons with previously suggested estimators are also given, and determination of the accuracy of the estimators is addressed.",0,1 +164,Bayesian estimation of Karhunen–Loève expansions; A random subspace approach,"One of the most widely-used procedures for dimensionality reduction of high dimensional data is Principal Component Analysis (PCA). More broadly, low-dimensional stochastic representation of random fields with finite variance is provided via the well known Karhunen–Loève expansion (KLE). The KLE is analogous to a Fourier series expansion for a random process, where the goal is to find an orthogonal transformation for the data such that the projection of the data onto this orthogonal subspace is optimal in the L 2 sense, i.e., which minimizes the mean square error. In practice, this orthogonal transformation is determined by performing an SVD (Singular Value Decomposition) on the sample covariance matrix or on the data matrix itself. Sampling error is typically ignored when quantifying the principal components, or, equivalently, basis functions of the KLE. Furthermore, it is exacerbated when the sample size is much smaller than the dimension of the random field. In this paper, we introduce a Bayesian KLE procedure, allowing one to obtain a probabilistic model on the principal components, which can account for inaccuracies due to limited sample size. The probabilistic model is built via Bayesian inference, from which the posterior becomes the matrix Bingham density over the space of orthonormal matrices. We use a modified Gibbs sampling procedure to sample on this space and then build probabilistic Karhunen–Loève expansions over random subspaces to obtain a set of low-dimensional surrogates of the stochastic process. We illustrate this probabilistic procedure with a finite dimensional stochastic process inspired by Brownian motion.",0,1 +165,A Global Information Approach to Computerized Adaptive Testing,"Most item selection in computerized adaptive testing is based on Fisher information (or item information). At each stage, an item is selected to maximize the Fisher information at the currently estimated trait level (θ). However, this application of Fisher information could be much less efficient than assumed if the estimators are not close to the true θ, especially at early stages of an adaptive test when the test length (number of items) is too short to provide an accurate estimate for true θ. It is argued here that selection procedures based on global information should be used, at least at early stages of a test when θ estimates are not likely to be close to the true θ. For this purpose, an item selection procedure based on average global information is proposed. Re sults from pilot simulation studies comparing the usual maximum item information item selection with the pro posed global information approach are reported, indicat ing that the new method leads to improvement in terms of bias and mean squared error reduction under many circumstances. Index terms: computerized adaptive testing, Fisher information, global information, infor mation surface, item information, item response theory, Kullback-Leibler information, local information, test in formation.",0,1 +166,Intangible Values in Financial Accounting and Reporting,"Academics and practitioners argue that intangible values have become significant value drivers of today's economy. Major production inputs no longer comprise of property, plant and equipment, but rather of brands, knowledge and other technological innovation. Based on this notion, information on such phenomena is supposedly crucial for existing and potential capital providers in making decisions whether to allocate resources to a company. This thesis examines the information use and needs of financial analysts with respect to intangible values. The purpose is to shed light on the usefulness of such information from the perspective of one of the primary user groups of IFRSs. © Springer Fachmedien Wiesbaden 2015.",0,1 +167,Modeling Dynamic Functional Neuroimaging Data Using Structural Equation Modeling,"The aims of this study were to present a method for developing a path analytic network model using data acquired from positron emission tomography. Regions of interest within the human brain were identified through quantitative activation likelihood estimation meta-analysis. Using this information, a ""true"" or population path model was then developed using Bayesian structural equation modeling. To evaluate the impact of sample size on parameter estimation bias, proportion of parameter replication coverage, and statistical power, a 2 group (clinical/control) × 6 (sample size: N = 10, N = 15, N = 20, N = 25, N = 50, N = 100) Markov chain Monte Carlo study was conducted. Results indicate that using a sample size of less than N = 15 per group will produce parameter estimates exhibiting bias greater than 5% and statistical power below .80.",0,1 +168,"Survey Design and Analysis: Principles, Cases, and Procedures",,0,1 +169,Peripheral kappa and delta opioid receptors are involved in the antinociceptive effect of crotalphine in a rat model of cancer pain,"Cancer pain is an important clinical problem and may not respond satisfactorily to the current analgesic therapy. We have characterized a novel and potent analgesic peptide, crotalphine, from the venom of the South American rattlesnake Crotalus durissus terrificus . In the present work, the antinociceptive effect of crotalphine was evaluated in a rat model of cancer pain induced by intraplantar injection of Walker 256 carcinoma cells. Intraplantar injection of tumor cells caused the development of hyperalgesia and allodynia, detected on day 5 after tumor cell inoculation. Crotalphine (6 μg/kg), administered p.o., blocked both phenomena. The antinociceptive effect was detected 1 h after treatment and lasted for up to 48 h. Intraplantar injection of nor-binaltorphimine (50 g/paw), a selective antagonist of κ-opioid receptors, antagonized the antinociceptive effect of the peptide, whereas N , N -diallyl-Tyr-Aib-Phe-Leu (ICI 174,864, 10 μg/paw), a selective antagonist of δ-opioid receptors, partially reversed this effect. On the other hand, D-Phe-Cys-Tyr-D-Trp-Orn-Thr-Pen-Thr amide (CTOP, 20 g/paw), an antagonist of μ-opioid receptors, did not modify crotalphine-induced antinociception. These data indicate that crotalphine induces a potent and long lasting opioid-mediated antinociception in cancer pain. • We investigate the antinociceptive effect of crotalphine in cancer pain. • Crotalphine inhibits hyperalgesia, allodynia and spontaneous pain induced by tumor. • Crotalphine induces a potent and long-lasting (2 days) antinociceptive effect. • Peripheral kappa and delta opioid receptors are involved in the antinociceptive.",0,1 +170,Incorporating engineering intuition for parameter estimation in thermal sciences,"This paper proposes a new method of incorporating priors based on engineering intuition for solving inverse problems. The thesis of this paper is that if an asymptote can be found to a problem in applied sciences or engineering, estimation of parameters can be first done for this asymptotic variant, which in principle should be simpler, since one or more parameters of the original problem may vanish for the asymptotic variant. Even so, by solving the inverse problem associated with the asymptotic variant, estimates of key parameters of the full problem can be obtained. This information can then be quantitatively incorporated as priors in the estimation of parameters for the full version of the problem which we call as prior generation through asymptotic variant. The goal is to see if this methodology will significantly reduce the uncertainties in the resulting estimates. To demonstrate this methodology, the classic problem of unsteady heat transfer from a one dimensional fin is chosen. The inverse problem is posed as the simultaneous estimation of the temperature dependent transfer coefficient (h θ ) and the thermal diffusivity (α) of the fin material, given experimentally measured temperature-time histories at various locations along the fin. The asymptotic variant θ (x,t) is the steady state problem where the influence of thermal diffusivity vanishes. Using surrogate temperature data generated from assumed values of h θ, first the asymptotic variant of the problem is solved using the Markov Chain Monte Carlo method in a Bayesian framework to generate an estimate of h θ . The estimate of h θ is then used as an informative prior for solving the inverse problem of determining h θ and α from θ (x,t), and the effect of prior is quantitatively assessed by performing estimation with and without the prior. Finally, for purposes of validation, in-house experiments have been done where θ (x,t) is generated using liquid crystal thermography and these data are used to estimate h θ and α. A comparison of experimentally measured temperatures with those that are simulated by using estimated values of (h θ, α) to solve the governing equation to the problem is also done. © 2013 Springer-Verlag Berlin Heidelberg.",0,1 +171,Bayesian Hierarchical Models Combining Different Study Types and Adjusting for Covariate Imbalances: A Simulation Study to Assess Model Performance,"Bayesian hierarchical models have been proposed to combine evidence from different types of study designs. However, when combining evidence from randomised and non-randomised controlled studies, imbalances in patient characteristics between study arms may bias the results. The objective of this study was to assess the performance of a proposed Bayesian approach to adjust for imbalances in patient level covariates when combining evidence from both types of study designs.Simulation techniques, in which the truth is known, were used to generate sets of data for randomised and non-randomised studies. Covariate imbalances between study arms were introduced in the non-randomised studies. The performance of the Bayesian hierarchical model adjusted for imbalances was assessed in terms of bias. The data were also modelled using three other Bayesian approaches for synthesising evidence from randomised and non-randomised studies. The simulations considered six scenarios aimed at assessing the sensitivity of the results to changes in the impact of the imbalances and the relative number and size of studies of each type. For all six scenarios considered, the Bayesian hierarchical model adjusted for differences within studies gave results that were unbiased and closest to the true value compared to the other models.Where informed health care decision making requires the synthesis of evidence from randomised and non-randomised study designs, the proposed hierarchical Bayesian method adjusted for differences in patient characteristics between study arms may facilitate the optimal use of all available evidence leading to unbiased results compared to unadjusted analyses.",0,1 +172,Addressing between-study heterogeneity and inconsistency in mixed treatment comparisons: Application to stroke prevention treatments in individuals with non-rheumatic atrial fibrillation,"Mixed treatment comparison models extend meta-analysis methods to enable comparisons to be made between all relevant comparators in the clinical area of interest. In such modelling it is imperative that potential sources of variability are explored to explain both heterogeneity (variation in treatment effects between trials within pairwise contrasts) and inconsistency (variation in treatment effects between pairwise contrasts) to ensure the validity of the analysis.The objective of this paper is to extend the mixed treatment comparison framework to allow for the incorporation of study-level covariates in an attempt to explain between-study heterogeneity and reduce inconsistency. Three possible model specifications assuming different assumptions are described and applied to a 17-treatment network for stroke prevention treatments in individuals with non-rheumatic atrial fibrillation.The paper demonstrates the feasibility of incorporating covariates within a mixed treatment comparison framework and using model fit statistics to choose between alternative model specifications. Although such an approach may adjust for inconsistencies in networks, as for standard meta-regression, the analysis will suffer from low power if the number of trials is small compared with the number of treatment comparators.",0,1 +173,Using indirect comparisons to compare interventions within a Cochrane review: a tool for comparative effectiveness research,"Aim: Assessing relative performance among competing interventions is an important part of comparative effectiveness research. Bayesian indirect comparisons add information to existing Cochrane reviews, such as which intervention is likely to perform best. However, heterogeneity variance priors may influence results and, potentially, clinical guidance. Methods: We highlight the features of Bayesian indirect comparisons using a case study of a Cochrane review update in asthma care. The probability that one self-management educational intervention outperforms others is estimated. Simulation studies investigate the effect of heterogeneity variance prior distributions. Results: Results suggest a 55% probability that individual education is best, followed by combination (39%) and group (6%). The intervention with few trials was sensitive to prior distributions. Conclusion: Bayesian indirect comparisons updates of Cochrane reviews are valuable comparative effectiveness research tools.",0,1 +174,A Comparison of Single Sample and Bootstrap Methods to Assess Mediation in Cluster Randomized Trials,"A Monte Carlo study examined the statistical performance of single sample and bootstrap methods that can be used to test and form confidence interval estimates of indirect effects in two cluster randomized experimental designs. The designs were similar in that they featured random assignment of clusters to one of two treatment conditions and included a single intervening variable and outcome, but they differed in whether the mediator was measured at the participant or site level. A bias-corrected bootstrap had the best statistical performance for each design and was closely followed by the empirical-Mtest, either of which is recommended for testing and estimating indirect effects in multilevel designs. In addition, consistent with previous research, the commonly used z test had relatively poor performance.",0,1 +175,Generalized Causal Mediation Analysis,"The goal of mediation analysis is to assess direct and indirect effects of a treatment or exposure on an outcome. More generally, we may be interested in the context of a causal model as characterized by a directed acyclic graph (DAG), where mediation via a specific path from exposure to outcome may involve an arbitrary number of links (or ""stages""). Methods for estimating mediation (or pathway) effects are available for a continuous outcome and a continuous mediator related via a linear model, while for a categorical outcome or categorical mediator, methods are usually limited to two-stage mediation. We present a method applicable to multiple stages of mediation and mixed variable types using generalized linear models. We define pathway effects using a potential outcomes framework and present a general formula that provides the effect of exposure through any specified pathway. Some pathway effects are nonidentifiable and their estimation requires an assumption regarding the correlation between counterfactuals. We provide a sensitivity analysis to assess the impact of this assumption. Confidence intervals for pathway effect estimates are obtained via a bootstrap method. The method is applied to a cohort study of dental caries in very low birth weight adolescents. A simulation study demonstrates low bias of pathway effect estimators and close-to-nominal coverage rates of confidence intervals. We also find low sensitivity to the counterfactual correlation in most scenarios.",0,1 +176,Adaptive fitting of linear mixed-effects models with correlated random effects,"Linear mixed-effects model has been widely used in longitudinal data analyses. In practice, the fitting algorithm can fail to converge due to boundary issues of the estimated random-effects covariance matrix G, i.e., being near-singular, non-positive definite, or both. Current available algorithms are not computationally optimal because the condition number of matrix G is unnecessarily increased when the random-effects correlation estimate is not zero. We propose an adaptive fitting (AF) algorithm using an optimal linear transformation of the random-effects design matrix. It is a data-driven adaptive procedure, aiming at reducing subsequent random-effects correlation estimates down to zero in the optimal transformed estimation space. Simulations show that AF significantly improves the convergent properties, especially under small sample size, relative large noise and high correlation settings. One real data for Insulin-like Growth Factor (IGF) protein is used to illustrate the application of this algorithm implemented with software package R (nlme).",0,1 +177,On the estimation of polychoric correlations and their asymptotic covariance matrix,A general theory for parametric inference in contingency tables is outlined. Estimation of polychoric correlations is seen as a special case of this theory. The asymptotic covariance matrix of the estimated polychoric correlations is derived for the case when the thresholds are estimated from the univariate marginals and the polychoric correlations are estimated from the bivariate marginals for given thresholds. Computational aspects are also discussed. © 1994 The Psychometric Society.,0,1 +178,Bayesian analysis of mixtures in structural equation models with non-ignorable missing data,"Structural equation models (SEMs) have become widely used to determine the interrelationships between latent and observed variables in social, psychological, and behavioural sciences. As heterogeneous data are very common in practical research in these fields, the analysis of mixture models has received a lot of attention in the literature. An important issue in the analysis of mixture SEMs is the presence of missing data, in particular of data missing with a non-ignorable mechanism. However, only a limited amount of work has been done in analysing mixture SEMs with non-ignorable missing data. The main objective of this paper is to develop a Bayesian approach for analysing mixture SEMs with an unknown number of components and non-ignorable missing data. A simulation study shows that Bayesian estimates obtained by the proposed Markov chain Monte Carlo methods are accurate and the Bayes factor computed via a path sampling procedure is useful for identifying the correct number of components, selecting an appropriate missingness mechanism, and investigating various effects of latent variables in the mixture SEMs. A real data set on a study of job satisfaction is used to demonstrate the methodology.",0,1 +179,A comparison of statistical methods for meta-analysis,"Meta-analysis may be used to estimate an overall effect across a number of similar studies. A number of statistical techniques are currently used to combine individual study results. The simplest of these is based on a fixed effects model, which assumes the true effect is the same for all studies. A random effects model, however, allows the true effect to vary across studies, with the mean true effect the parameter of interest. We consider three methods currently used for estimation within the framework of a random effects model, and illustrate them by applying each method to a collection of six studies on the effect of aspirin after myocardial infarction. These methods are compared using estimated coverage probabilities of confidence intervals for the overall effect. The techniques considered all generally have coverages below the nominal level, and in particular it is shown that the commonly used DerSimonian and Laird method does not adequately reflect the error associated with parameter estimation, especially when the number of studies is small.",0,1 +180,A Modified EM Algorithm for Estimation in Generalized Mixed Models,"Application of the EM algorithm for estimation in the generalized mixed model has been largely unsuccessful because the E-step cannot be determined in most instances. The E-step computes the conditional expectation of the complete data log-likelihood and when the random effect distribution is normal, this expectation remains an intractable integral. The problem can be approached by numerical or analytic approximations; however, the computational burden imposed by numerical integration methods and the absence of an accurate analytic approximation have limited the use of the EM algorithm. In this paper, Laplace's method is adapted for analytic approximation within the E-step. The proposed algorithm is computationally straightforward and retains much of the conceptual simplicity of the conventional EM algorithm, although the usual convergence properties are not guaranteed. The proposed algorithm accommodates multiple random factors and random effect distributions besides the normal, e.g., the log-gamma distribution. Parameter estimates obtained for several data sets and through simulation show that this modified EM algorithm compares favorably with other generalized mixed model methods.",0,1 +181,Multilevel multidimensional item response model with a multilevel latent covariate,"In a pre-test-post-test cluster randomized trial, one of the methods commonly used to detect an intervention effect involves controlling pre-test scores and other related covariates while estimating an intervention effect at post-test. In many applications in education, the total post-test and pre-test scores, ignoring measurement error, are used as response variable and covariate, respectively, to estimate the intervention effect. However, these test scores are frequently subject to measurement error, and statistical inferences based on the model ignoring measurement error can yield a biased estimate of the intervention effect. When multiple domains exist in test data, it is sometimes more informative to detect the intervention effect for each domain than for the entire test. This paper presents applications of the multilevel multidimensional item response model with measurement error adjustments in a response variable and a covariate to estimate the intervention effect for each domain.",0,1 +182,Coefficient alpha and the internal structure of tests,"A general formula (α) of which a special case is the Kuder-Richardson coefficient of equivalence is shown to be the mean of all split-half coefficients resulting from different splittings of a test. α is therefore an estimate of the correlation between two random samples of items from a universe of items like those in the test. α is found to be an appropriate index of equivalence and, except for very short tests, of the first-factor concentration in the test. Tests divisible into distinct subtests should be so divided before using the formula. The index\(\bar r_{ij} \), derived from α, is shown to be an index of inter-item homogeneity. Comparison is made to the Guttman and Loevinger approaches. Parallel split coefficients are shown to be unnecessary for tests of common types. In designing tests, maximum interpretability of scores is obtained by increasing the first-factor concentration in any separately-scored subtest and avoiding substantial group-factor clusters within a subtest. Scalability is not a requisite.",0,1 +183,Using Bayesian Multilevel Whole Genome Regression Models for Partial Pooling of Training Sets in Genomic Prediction,"Training set size is an important determinant of genomic prediction accuracy. Plant breeding programs are characterized by a high degree of structuring, particularly into populations. This hampers the establishment of large training sets for each population. Pooling populations increases training set size but ignores unique genetic characteristics of each. A possible solution is partial pooling with multilevel models, which allows estimating population-specific marker effects while still leveraging information across populations. We developed a Bayesian multilevel whole-genome regression model and compared its performance with that of the popular BayesA model applied to each population separately (no pooling) and to the joined data set (complete pooling). As an example, we analyzed a wide array of traits from the nested association mapping maize population. There we show that for small population sizes (e.g., <50), partial pooling increased prediction accuracy over no or complete pooling for populations represented in the training set. No pooling was superior; however, when populations were large. In another example data set of interconnected biparental maize populations either partial or complete pooling was superior, depending on the trait. A simulation showed that no pooling is superior when differences in genetic effects among populations are large and partial pooling when they are intermediate. With small differences, partial and complete pooling achieved equally high accuracy. For prediction of new populations, partial and complete pooling had very similar accuracy in all cases. We conclude that partial pooling with multilevel models can maximize the potential of pooling by making optimal use of information in pooled training sets.",0,1 +184,Marginal Maximum A Posteriori Item Parameter Estimation for the Generalized Graded Unfolding Model,"A marginal maximum a posteriori (MMAP) procedure was implemented to estimate item parameters in the generalized graded unfolding model (GGUM). Estimates from the MMAP method were compared with those derived from marginal maximum likelihood (MML) and Markov chain Monte Carlo (MCMC) procedures in a recovery simulation that varied sample size, questionnaire length, and number of item response categories. MMAP item parameter estimates were generally the most accurate and had the smallest standard errors on average. In contrast, the accuracy and variability of MML estimates suffered substantially when the number of item response categories was small and the true item locations were extreme. MMAP estimates were also more computationally efficient than corresponding MCMC estimates. Consequently, the MMAP procedure is recommended for estimation of GGUM item parameters.",0,1 +185,Finite-Sample Properties of Propensity-Score Matching and Weighting Estimators,"The finite-sample properties of matching and weighting estimators, often used for estimating average treatment effects, are analyzed. Potential and feasible precision gains relative to pair matching are examined. Local linear matching (with and without trimming), k-nearest-neighbor matching, and particularly the weighting estimators performed worst. Ridge matching, on the other hand, leads to an approximately 25% smaller MSE than does pair matching. In addition, ridge matching is least sensitive to the design choice.",0,1 +186,Neural computation of log likelihood in control of saccadic eye movements,"The latency between the appearance of a visual target and the start of the saccadic eye movement made to look at it varies from trial to trial to an extent that is inexplicable in terms of ordinary 'physiological' processes such as synaptic delays and conduction velocities. An alternative interpretation is that it represents the time needed to decide whether a target is in fact present: decision processes are necessarily stochastic, because they depend on extracting information from noisy sensory signals'. In one such model, the presence of a target causes a signal in a decision unit to rise linearly at a rate r from its initial value s, until it reaches a fixed threshold θ, when a saccade is initiated, One can regard this decision signal as a neural estimate of the log likelihood of the hypothesis that the target is present, the threshold being the significance criterion or likelihood level at which the target is presumed to be present, Experiments manipulating the prior probability of the target's appearing confirm this notion: the latency distribution then changes in the way expected if so simply reflects the prior log likelihood of the stimulus.",0,1 +187,Adolescents' Use of Sexually Explicit Internet Material and Sexual Uncertainty: The Role of Involvement and Gender,"Research has shown that adolescents' use of sexually explicit Internet material (SEIM) is positively associated with an important characteristic of the developing sexual self, sexual uncertainty. However, the causal relation between SEIM use and sexual uncertainty is unclear. Moreover, we do not know which processes underlie this relation and whether gender moderates these processes. Based on a three-wave panel survey among 956 Dutch adolescents, structural equation modeling revealed that more frequent SEIM use increased adolescents' sexual uncertainty. This influence was mediated by adolescents' involvement in SEIM. The impact of SEIM use on involvement was stronger for female than for male adolescents. Future research on the effects of SEIM may benefit from greater attention to experiential states during SEIM use.",0,1 +188,An information capacity limitation of visual short-term memory.,"Research suggests that visual short-term memory (VSTM) has both an item capacity, of around 4 items, and an information capacity. We characterize the information capacity limits of VSTM using a task in which observers discriminated the orientation of a single probed item in displays consisting of 1, 2, 3, or 4 orthogonally oriented Gabor patch stimuli that were presented in noise for 50 ms, 100 ms, 150 ms, or 200 ms. The observed capacity limitations are well described by a sample-size model, which predicts invariance of ∑(i)(d'(i))² for displays of different sizes and linearity of (d'(i))² for displays of different durations. Performance was the same for simultaneous and sequentially presented displays, which implicates VSTM as the locus of the observed invariance and rules out explanations that ascribe it to divided attention or stimulus encoding. The invariance of ∑(i)(d'(i))² is predicted by the competitive interaction theory of Smith and Sewell (2013), which attributes it to the normalization of VSTM traces strengths arising from competition among stimuli entering VSTM.",0,1 +189,A review of causal estimation of effects in mediation analyses,"We describe causal mediation methods for analysing the mechanistic factors through which interventions act on outcomes. A number of different mediation approaches have been presented in the biomedical, social science and statistical literature with an emphasis on different aspects of mediation. We review the different sets of assumptions that allow identification and estimation of effects in the simple case of a single intervention, a temporally subsequent mediator and outcome. These assumptions include various no confounding assumptions including sequential ignorability assumptions and also interaction assumptions involving the treatment and mediator. The understanding of such assumptions is crucial since some can be assessed under certain conditions (e.g. treatment–mediator interactions), whereas others cannot (sequential ignorability). These issues become more complex with multiple mediators and longitudinal outcomes. In addressing these assumptions, we review several causal approaches to mediation analyses.",0,1 +190,"Perceiving others’ personalities: Examining the dimensionality, assumed similarity to the self, and stability of perceiver effects.","In interpersonal perception, ""perceiver effects"" are tendencies of perceivers to see other people in a particular way. Two studies of naturalistic interactions examined perceiver effects for personality traits: seeing a typical other as sympathetic or quarrelsome, responsible or careless, and so forth. Several basic questions were addressed. First, are perceiver effects organized as a global evaluative halo, or do perceptions of different traits vary in distinct ways? Second, does assumed similarity (as evidenced by self-perceiver correlations) reflect broad evaluative consistency or trait-specific content? Third, are perceiver effects a manifestation of stable beliefs about the generalized other, or do they form in specific contexts as group-specific stereotypes? Findings indicated that perceiver effects were better described by a differentiated, multidimensional structure with both trait-specific content and a higher order global evaluation factor. Assumed similarity was at least partially attributable to trait-specific content, not just to broad evaluative similarity between self and others. Perceiver effects were correlated with gender and attachment style, but in newly formed groups, they became more stable over time, suggesting that they grew dynamically as group stereotypes. Implications for the interpretation of perceiver effects and for research on personality assessment and psychopathology are discussed.",0,1 +191,The Efficiency of Cox's Likelihood Function for Censored Data,Abstract D.R. Cox has suggested a simple method for the regression analysis of censored data. We carry out an information calculation which shows that Cox's method has full asymptotic efficiency under conditions which are likely to be satisfied in many realistic situations. The connection of Cox's method with the Kaplan-Meier estimator of a survival curve is made explicit.,0,1 +192,Bayesian Thinking in Spatial Statistics,"In the sections below we review basic motivations for spatial statistical analysis, review three general categories of data structure and associated inferential questions, and describe Bayesian methods for achieving inference. Our goal is to highlight similarities across spatial analytic methods, particularly with regards to how hierarchical probability structures often link approaches developed in one area of spatial analysis to components within other areas. By choosing to highlight similarities, we focus on general concepts in spatial inference, and often defer details of several interesting and current threads of development to the relevant literature. We conclude with a listing of some of these developing areas of interest and references for further reading.",0,1 +193,How much are stranding records affected by variation in reporting rates? A case study of small delphinids in the Bay of Biscay,"Marine vertebrate strandings offer an opportunistic sampling scheme that can provide abundant data over long periods. Because the stranding process involves biological, physical and sociological parameters, confounding complicates the interpretation of results. The statistical analysis of these data relies on generalized linear or additive models in order to infer long-term trends, but does not easily account for drift or variation in reporting rates. Here, we capitalized on county-level (administrative) variation following the passing of a law for compulsory reporting of stranded marine mammals in France to investigate how variation in reporting rates may affect the observed trend in stranded small delphinids in the Bay of Biscay. Using a time-series spanning more than 30 years across eight administrative counties, we built variance partitioning models for the analysis of count data. We discussed the choice of an appropriate likelihood to conclude the Negative Binomial useful and interpretable in the context of small delphinid strandings. We expanded the model with a recent methodology to detect structural breaks in the time series, focusing on overdispersion. We performed statistical robustness checks with respect to variations in reporting rates and discuss their causal interpretation in the context of observational data. Stranding frequencies increased on average 7-fold over 30 years. We conclude that reporting rates to the French stranding network have been stable since the early 1990s, and the average 3-fold increase in stranded small delphinids observed in the Bay of Biscay since 1990 is due to other factors, including bycatch. Codes and data are available to replicate the analysis to other national stranding networks. © 2014 Springer Science+Business Media Dordrecht.",0,1 +194,Likelihood-Based Item-Fit Indices for Dichotomous Item Response Theory Models,"New goodness-of-fit indices are introduced for dichotomous item response theory (IRT) models. These indices are based on the likelihoods of number-correct scores derived from the IRT model, and they provide a direct comparison of the modeled and observed frequencies for correct and incorrect responses for each number-correct score. The behavior of Pearson’s X 2 ( S- X 2 ) and the likelihood ratio G 2 ( S- G 2 ) was assessed in a simulation study and compared with two fit indices similar to those currently in use ( Q1- X 2 and Q 1 - G 2 ). The simulations included three conditions in which the simulating and fitting models were identical and three conditions involving model misspecification. S- X 2 performed well, with Type I error rates close to the expected .05 and .01 levels. Performance of this index improved with increased test length. S- G 2 tended to reject the null hypothesis too often, as did Q 1 - X 2 and Q 1 - G 2 . The power of S- X 2 appeared to be similar for all test lengths, but varied depending on the type of model misspecification.",0,1 +195,Methods in health service research: An introduction to bayesian methods in health technology assessment,"This is the third of four articles Bayes's theorem arose from a posthumous publication in 1763 by Thomas Bayes, a non-conformist minister from Tunbridge Wells. Although it gives a simple and uncontroversial result in probability theory, specific uses of the theorem have been the subject of considerable controversy for more than two centuries. In recent years a more balanced and pragmatic perspective has emerged, and in this paper we review current thinking on the value of the Bayesian approach to health technology assessment. A concise definition of bayesian methods in health technology assessment has not been established, but we suggest the following: the explicit quantitative use of external evidence in the design, monitoring, analysis, interpretation, and reporting of a health technology assessment. This approach acknowledges that judgments about the benefits of a new technology will rarely be based solely on the results of a single study but should synthesise evidence from multiple sources—for example, pilot studies, trials of similar interventions, and even subjective judgments about the generalisability of the study's results. A bayesian perspective leads to an approach to clinical trials that is claimed to be more flexible and ethical than traditional methods,1 and to elegant ways of handling multiple substudies—for example, when simultaneously estimating the effects of a treatment on many subgroups.2 Proponents have also argued that a bayesian approach allows conclusions to be provided in a form that is most suitable for decisions specific to patients and decisions affecting public policy.3 #### Summary points Bayesian methods interpret data from a study in the light of external evidence and judgment, and the form in which conclusions are drawn contributes naturally to decision making Prior plausibility of hypotheses is taken into account, just as when interpreting the results of a diagnostic test Scepticism about large treatment effects can be formally …",0,1 +196,A Comparison of Inverse-Wishart Prior Specifications for Covariance Matrices in Multilevel Autoregressive Models,"Multilevel autoregressive models are especially suited for modeling between-person differences in within-person processes. Fitting these models with Bayesian techniques requires the specification of prior distributions for all parameters. Often it is desirable to specify prior distributions that have negligible effects on the resulting parameter estimates. However, the conjugate prior distribution for covariance matrices-the Inverse-Wishart distribution-tends to be informative when variances are close to zero. This is problematic for multilevel autoregressive models, because autoregressive parameters are usually small for each individual, so that the variance of these parameters will be small. We performed a simulation study to compare the performance of three Inverse-Wishart prior specifications suggested in the literature, when one or more variances for the random effects in the multilevel autoregressive model are small. Our results show that the prior specification that uses plug-in ML estimates of the variances performs best. We advise to always include a sensitivity analysis for the prior specification for covariance matrices of random parameters, especially in autoregressive models, and to include a data-based prior specification in this analysis. We illustrate such an analysis by means of an empirical application on repeated measures data on worrying and positive affect.",0,1 +197,A New Procedure to Test Mediation With Missing Data Through Nonparametric Bootstrapping and Multiple Imputation,"This article proposes a new procedure to test mediation with the presence of missing data by combining nonparametric bootstrapping with multiple imputation (MI). This procedure performs MI first and then bootstrapping for each imputed data set. The proposed procedure is more computationally efficient than the procedure that performs bootstrapping first and then MI for each bootstrap sample. The validity of the procedure is evaluated using a simulation study under different sample size, missing data mechanism, missing data proportion, and shape of distribution conditions. The result suggests that the proposed procedure performs comparably to the procedure that combines bootstrapping with full information maximum likelihood under most conditions. However, caution needs to be taken when using this procedure to handle missing not-at-random or nonnormal data.",0,1 +198,Management of frozen shoulder: a systematic review and cost-effectiveness analysis.,"Frozen shoulder is condition in which movement of the shoulder becomes restricted. It can be described as either primary (idiopathic) whereby the aetiology is unknown, or secondary, when it can be attributed to another cause. It is commonly a self-limiting condition, of approximately 1 to 3 years' duration, though incomplete resolution can occur.To evaluate the clinical effectiveness and cost-effectiveness of treatments for primary frozen shoulder, identify the most appropriate intervention by stage of condition and highlight any gaps in the evidence.A systematic review was conducted. Nineteen databases and other sources including the Cumulative Index to Nursing and Allied Health (CINAHL), Science Citation Index, BIOSIS Previews and Database of Abstracts of Reviews of Effects (DARE) were searched up to March 2010 and EMBASE and MEDLINE up to January 2011, without language restrictions. MEDLINE, CINAHL and PsycINFO were searched in June 2010 for studies of patients' views about treatment.Randomised controlled trials (RCTs) evaluating physical therapies, arthrographic distension, steroid injection, sodium hyaluronate injection, manipulation under anaesthesia, capsular release or watchful waiting, alone or in combination were eligible for inclusion. Patients with primary frozen shoulder (with or without diabetes) were included. Quasi-experimental studies were included in the absence of RCTs and case series for manipulation under anaesthesia (MUA) and capsular release only. Full economic evaluations meeting the intervention and population inclusion criteria of the clinical review were included. Two researchers independently screened studies for relevance based on the inclusion criteria. One reviewer extracted data and assessed study quality; this was checked by a second reviewer. The main outcomes of interest were pain, range of movement, function and disability, quality of life and adverse events. The analysis comprised a narrative synthesis and pair-wise meta-analysis. A mixed-treatment comparison (MTC) was also undertaken. An economic decision model was intended, but was found to be implausible because of a lack of available evidence. Resource use was estimated from clinical advisors and combined with quality-adjusted life-years obtained through mapping to present tentative cost-effectiveness results.Thirty-one clinical effectiveness studies and one economic evaluation were included. The clinical effectiveness studies evaluated steroid injection, sodium hyaluronate, supervised neglect, physical therapy (mainly physiotherapy), acupuncture, MUA, distension and capsular release. Many of the studies identified were at high risk of bias. Because of variation in the interventions and comparators few studies could be pooled in a meta-analysis. Based on single RCTs, and for some outcomes only, short-wave diathermy may be more effective than home exercise. High-grade mobilisation may be more effective than low-grade mobilisation in a population in which most patients have already had treatment. Data from two RCTs showed that there may be benefit from adding a single intra-articular steroid injection to home exercise in patients with frozen shoulder of < 6 months' duration. The same two trials showed that there may be benefit from adding physiotherapy (including mobilisation) to a single steroid injection. Based on a network of nine studies the MTC found that steroid combined with physiotherapy was the only treatment showing a statistically and clinically significant beneficial treatment effect compared with placebo for short-term pain (standardised mean difference -1.58, 95% credible interval -2.96 to -0.42). This analysis was based on only a subset of the evidence, which may explain why the findings are only partly supportive of the main analysis. No studies of patients' views about the treatments were identified. Average costs ranged from £36.16 for unguided steroid injections to £2204 for capsular release. The findings of the mapping suggest a positive relationship between outcome and European Quality of Life-5 Dimensions (EQ-5D) score: a decreasing visual analogue scale score (less pain) was accompanied by an increasing (better) EQ-5D score. The one published economic evaluation suggested that low-grade mobilisation may be more cost-effective than high-grade mobilisation. Our tentative cost-effectiveness analysis suggested that steroid alone may be more cost-effective than steroid plus physiotherapy or physiotherapy alone. These results are very uncertain.The key limitation was the lack of data available. It was not possible to undertake the planned synthesis exploring the influence of stage of frozen shoulder or the presence of diabetes on treatment effect. As a result of study diversity and poor reporting of outcome data there were few instances where the planned quantitative synthesis was possible or appropriate. Most of the included studies had a small number of participants and may have been underpowered. The lack of available data made the development of a decision-analytic model implausible. We found little evidence on treatment related to stage of condition, treatment pathways, the impact on quality of life, associated resource use and no information on utilities. Without making a number of questionable assumptions modelling was not possible.There was limited clinical evidence on the effectiveness of treatments for primary frozen shoulder. The economic evidence was so limited that no conclusions can be made about the cost-effectiveness of the different treatments. High-quality primary research is required.",0,1 +199,The Freiburg Visual Acuity Test-Variability unchanged by post-hoc re-analysis,"Background: The Freiburg Visual Acuity and Contrast Test (FrACT) has been further developed; it is now available for Macintosh and Windows free of charge at http://www.michaelbach.de/fract.html. The present study sought to reduce the test-retest variability of visual acuity on short runs (18 trials) by post-hoc re-analysis. Methods: The FrACT employs advanced computer graphics to present Landolt Cs over the full range of visual acuity. The sequence of optotypes presented follows an adaptive staircase procedure, the Best-PEST algorithm. The Best-PEST threshold obtained after 18 trials was compared to the result of a post-hoc re-analysis of the acquired data, where both threshold and slope of the psychometric function were estimated via a maximum-likelihood fit. Results: Testing time was 1.7 min per run on average. Test-retest reproducibility was ±2 lines (or ±0.2 logMAR) for a 95% confidence band (using 18 optotype presentations per test run). Post-hoc psychometric fitting reproduced the Best-PEST result within 1%, although the individual slopes varied widely; test-retest reproducibility was not improved. Conclusions: The FrACT offers advantages over traditional chart testing with respect to objectivity and reliability. The similarity between the results of the Best-PEST vs. post-hoc analysis, fitting both slope and threshold, suggest that there is no disadvantage to the constant slope assumed by Best PEST. Furthermore, since variability was not reduced by post-hoc analysis, for high reliability more trials should be employed than the 18 trials per run used here. © Springer-Verlag 2007.",0,1 +200,Probability summation over time,"Abstract Frequency-of-seeing and sensitivity-duration curves were collected for temporal signals of limited spectral extent. A comparison of the two sorts of data suggests that a stimulus is detected whenever the excursions of its linearly filtered, noise-perturbed temporal waveform exceed some fixed magnitude.",0,1 +201,"QMPE: Estimating Lognormal, Wald, and Weibull RT distributions with a parameter-dependent lower bound","We describe and test quantile maximum probability estimator (QMPE), an open-source ANSI Fortran 90 program for response time distribution estimation. QMPE enables users to estimate parameters for the ex-Gaussian and Gumbel (1958) distributions, along with three ""shifted"" distributions (i.e., distributions with a parameter-dependent lower bound): the Lognormal, Wald, and Weibul distributions. Estimation can be performed using either the standard continuous maximum likelihood (CML) method or quantile maximum probability (QMP; Heathcote & Brown, in press). We review the properties of each distribution and the theoretical evidence showing that CML estimates fail for some cases with shifted distributions, whereas QMP estimates do not. In cases in which CML does not fail, a Monte Carlo investigation showed that QMP estimates were usually as good, and in some cases better, than CML estimates. However, the Monte Carlo study also uncovered problems that can occur with both CML and QMP estimates, particularly when samples are small and skew is low, highlighting the difficulties of estimating distributions with parameter-dependent lower bounds.",0,1 +202,"The psychometric function: I. Fitting, sampling, and goodness of fit","The psychometric function relates an observer's performance to an independent variable, usually some physical quantity of a stimulus in a psychophysical task. This paper, together with its companion paper (Wichmann & Hill, 2001), describes an integrated approach to (1) fitting psychometric functions, (2) assessing the goodness of fit, and (3) providing confidence intervals for the function's parameters and other estimates derived from them, for the purposes of hypothesis testing. The present paper deals with the first two topics, describing a constrained maximum-likelihood method of parameter estimation and developing several goodness-of-fit tests. Using Monte Carlo simulations, we deal with two specific difficulties that arise when fitting functions to psychophysical data. First, we note that human observers are prone to stimulus-independent errors (or lapses). We show that failure to account for this can lead to serious biases in estimates of the psychometric function's parameters and illustrate how the problem may be overcome. Second, we note that psychophysical data sets are usually rather small by the standards required by most of the commonly applied statistical tests. We demonstrate the potential errors of applying traditional chi2 methods to psychophysical data and advocate use of Monte Carlo resampling techniques that do not rely on asymptotic theory. We have made available the software to implement our methods.",0,1 +203,Analysis of a Two-Level Structural Equation Model With Missing Data,"Structural equation models are widely used to model relationships among latent unobservable constructs and observable variables. In some studies, the data set used for analysis is comprised of observations that are drawn from a known hierarchical structure and involves missing entries. A two-level structural equation model can be used to analyze such data sets. Direct maximum likelihood methods for analyzing two-level structural equation models are available in software, such as LISREL and Mplus. These software programs also have options to handle missing observations. The authors develop an alternative procedure that uses an expectation maximization (EM) type algorithm. Using appropriate approximations, the procedure can be implemented using simple statistical software in combination with a basic structural equation modeling program. The authors address the implementation of the procedure in detail and provide syntax codes in R, which is available in the public domain, to implement the proposed procedure. The discussion of the procedure is made with reference to the analysis of a data set that studies job characteristic variables. The authors also use simulation studies to examine the performance of the proposed procedure. The results indicate that the proposed method, which is easily accessible to users, represents a reliable alternative for analyzing two-level structural equation models with missing data.",0,1 +204,New Light on the Correlation Coefficient and its Transforms,,0,1 +205,Latent curve analysis,"As a method for representing development, latent trait theory is presented in terms of a statistical model containing individual parameters and a structure on both the first and second moments of the random variables reflecting growth. Maximum likelihood parameter estimates and associated asymptotic tests follow directly. These procedures may be viewed as an alternative to standard repeated measures ANOVA and to first-order auto-regressive methods. As formulated, the model encompasses cohort sequential designs and allow for period or practice effects. A numerical illustration using data initially collected by Nesselroade and Baltes is presented. © 1990 The Psychometric Society.",0,1 +206,Market Segmentation: Conceptual and Methodological Foundations,Part 1: Introduction. 1. The Historical Development of the Market Segmentation Concept. 2. Segmentation Bases. 3. Segmentation Methods. 4. Tools for Market Segmentation. Part 2: Segmentation Methodology. 5. Clustering Methods. 6. Mixture Models. 7. Mixture Regression Models. 8. Mixture Unfolding Models. 9. Profiling Segments. 10. Dynamic Segmentation. Part 3: Special Topics in Market Segmentation. 11. Joint Segmentation. 12. Market Segmentation with Tailored Interviewing. 13. Model-Based Segmentation Using Structural Equation Models. 14. Segmentation Based on Product Dissimilarity Judgements. Part 4: Applied Market Segmentation. 15. General Observable Bases: Geo-demographics. 16. General Unobservable Bases: Values and Lifestyles. 17. Product-specific observable Bases: Response-based Segmentation. 18. Product-Specific Unobservable Bases: Conjoint Analysis. Part 5: Conclusions and Directions for Future Research. 19. Conclusions: Representations of Heterogeneity. 20. Directions for Future Research. References. Index.,0,1 +207,A Bayesian missing data framework for generalized multiple outcome mixed treatment comparisons,"Bayesian statistical approaches to mixed treatment comparisons (MTCs) are becoming more popular because of their flexibility and interpretability. Many randomized clinical trials report multiple outcomes with possible inherent correlations. Moreover, MTC data are typically sparse (although richer than standard meta-analysis, comparing only two treatments), and researchers often choose study arms based upon which treatments emerge as superior in previous trials. In this paper, we summarize existing hierarchical Bayesian methods for MTCs with a single outcome and introduce novel Bayesian approaches for multiple outcomes simultaneously, rather than in separate MTC analyses. We do this by incorporating partially observed data and its correlation structure between outcomes through contrast-based and arm-based parameterizations that consider any unobserved treatment arms as missing data to be imputed. We also extend the model to apply to all types of generalized linear model outcomes, such as count or continuous responses. We offer a simulation study under various missingness mechanisms (e.g., missing completely at random, missing at random, and missing not at random) providing evidence that our models outperform existing models in terms of bias, mean squared error, and coverage probability then illustrate our methods with a real MTC dataset. We close with a discussion of our results, several contentious issues in MTC analysis, and a few avenues for future methodological development.",0,1 +208,Modeling individual differences in cognition,"Many evaluations of cognitive models rely on data that have been averaged or aggregated across all experimental subjects, and so fail to consider the possibility of important individual differences between subjects. Other evaluations are done at the single-subject level, and so fail to benefit from the reduction of noise that data averaging or aggregation potentially provides. To overcome these weaknesses, we have developed a general approach to modeling individual differences using families of cognitive models in which different groups of subjects are identified as having different psychological behavior. Separate models with separate parameterizations are applied to each group of subjects, and Bayesian model selection is used to determine the appropriate number of groups. We evaluate this individual differences approach in a simulation study and show that it is superior in terms of the key modeling goals of prediction and understanding. We also provide two practical demonstrations of the approach, one using the ALCOVE model of category learning with data from four previously analyzed category learning experiments, the other using multidimensional scaling representational models with previously analyzed similarity data for colors. In both demonstrations, meaningful individual differences are found and the psychological models are able to account for this variation through interpretable differences in parameterization. The results highlight the potential of extending cognitive models to consider individual differences.",0,1 +209,Pseudo-empirical Bayes estimation of small area means based on James-Stein estimation in linear regression models with functional measurement error,en,0,1 +210,History and rationale of longitudinal research,,0,1 +211,A comparison of methods to test mediation and other intervening variable effects.,A Monte Carlo study compared 14 methods to test the statistical significance of the intervening variable effect. An intervening variable (mediator) transmits the effect of an independent variable to a dependent variable. The commonly used R. M. Baron and D. A. Kenny (1986) approach has low statistical power. Two methods based on the distribution of the product and 2 difference-in-coefficients methods have the most accurate Type I error rates and greatest statistical power except in 1 important case in which Type I error rates are too high. The best balance of Type I error and statistical power across all cases is the test of the joint significance of the two effects comprising the intervening variable effect.,0,1 +212,Maximally Reliable Composites for Unidimensional Measures,"A general approach to obtaining weights and reliability coefficients of maximally reliable composites is offered for a variety of test theoretic models which assume a single common underlying dimension. The reliability maximizing weights are related to the theoretically specified true score scaling weights to show there is a constant relationship between them that is invariant under separate linear transformations on each variable in the system. Furthermore, an argument is made that test theoretic relations should be derived for the most general model available and not for unnecessarily constrained models.",0,1 +213,A theoretico-historical review of the threshold concept.,"This paper traces the concept of threshold from its classical beginnings and shows the relation of the concept to selected issues in contemporary psychology. Emphasis is placed on 3 main problems: the designation of the origin point on a psychological continuum; the interpretation of the sensory threshold as an intervening variable and the issue of sensory continuity-noncontinuity; and the specification of the response threshold as a dependent variable of behavior, rather than an index of organismic sensitivity. Reference is made to adaptation level theory and the theory of signal detection as possible approaches to the development of a complete psychophysics which does not start from the concept of threshold. (74 ref.) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1963 American Psychological Association.",0,1 +214,An EM Approach to Parameter Estimation for the Zinnes and Griggs Paired Comparison IRT Model,"Borman et al. recently proposed a computer adaptive performance appraisal system called CARS II that utilizes paired comparison judgments of behavioral stimuli. To implement this approach,the paired comparison ideal point model developed by Zinnes and Griggs was selected. In this article,the authors describe item response and information functions for the Zinnes and Griggs model and present procedures for estimating stimulus and person parameters. Monte carlo simulations were conducted to assess the accuracy of the parameter estimation procedures. The results indicated that at least 400 ratees (i.e.,ratings) are required to obtain reasonably accurate estimates of the stimulus parameters and their standard errors. In addition,latent trait estimation improves as test length increases. The implications of these results for test construction are also discussed.",0,1 +215,Estimating Mediated Effects in Prevention Studies,The purpose of this article is to describe statistical procedures to assess how prevention and intervention programs achieve their effects. The analyses require the measurement of intervening or mediating variables hypothesized to represent the causal mechanism by which the prevention program achieves its effects. Methods to estimate mediation are illustrated in the evaluation of a health promotion program designed to reduce dietary cholesterol and a school-based drug prevention program. The methods are relatively easy to apply and the information gained from such analyses should add to our understanding of prevention.,0,1 +216,Pushing the Limits,"Abstract. Longitudinal developmental research is often focused on patterns of change or growth across different (sub)groups of individuals. Particular to some research contexts, developmental inquiries may involve one or more (sub)groups that are small in nature and therefore difficult to properly capture through statistical analysis. The current study explores the lower-bound limits of subsample sizes in a multiple group latent growth modeling by means of a simulation study. We particularly focus on how the maximum likelihood (ML) and Bayesian estimation approaches differ when (sub)sample sizes are small. The results show that Bayesian estimation resolves computational issues that occur with ML estimation and that the addition of prior information can be the key to detect a difference between groups when sample and effect sizes are expected to be limited. The acquisition of prior information with respect to the smaller group is especially influential in this context.",1,1 +217,Meta‐Analysis of Therapist Effects in Psychotherapy Outcome Studies,"In a meta-analysis, we examined factors that could account for the differences in therapist efficacy evidenced in psychotherapy outcome studies. The factors investigated were: (1) the use of a treatment manual, (2) the average level of therapist experience, (3) the length of treatment, and (4) the type of treatment (cognitive/behavioral versus psychodynamic). Data were obtained from fifteen psychotherapy outcome studies that produced 27 separate treatment groups. For each treatment group, the amount of outcome variance due to differences between therapists was calculated and served as the dependent variable for the meta-analysis. Each separate treatment group was coded on the above four variables, and multiple regression analyses related the independent variables to the size of therapist effects. Results indicated that the use of a treatment manual and more experienced therapists were associated with small differences between therapists, whereas more inexperienced therapists and no treatment manual were a...",0,1 +218,Firm Sustainability Performance Index Modeling,"The main objective of this paper is to bring a model for firm sustainability performance index by applying both classical and Bayesian structural equation modeling (parametric and semi-parametric modeling). Both techniques are considered to the research data collected based on a survey directed to the China, Taiwan, and Malaysia food manufacturing industry. For estimating firm sustainability performance index we consider three main indicators include knowledge management, organizational learning, and business strategy. Based on the both Bayesian and classical methodology, we confirmed that knowledge management and business strategy have significant impact on firm sustainability performance index.",0,1 +219,Attachment avoidance and commitment aversion: A script for relationship failure,"Do avoidantly attached individuals, with fears of closeness and dependency, expect their relationships to fail? Moreover, do they expect specific events that will lead to failure? Canadian students outlined their expectations for a new romantic relationship by ordering a series of dating events using a card sorting procedure. Avoidance was associated with both expectations of relationship failure and commitment aversion (the absence of positive commitment-enhancing events and presence of negative commitment-undermining events). Commitment aversion mediated the relationship between avoidance and expected failure, and a multiple mediation model showed unique paths for positive and negative events. This suggests that avoidantly attached individuals enter into new relationships with detailed scripts for commitment aversion that lead them to expect relationship failure.",0,1 +220,A criterion-based model comparison statistic for structural equation models with heterogeneous data,"Heterogeneous data are common in social, educational, medical and behavioral sciences. Recently, finite mixture structural equation models (SEMs) and two-level SEMs have been respectively proposed to analyze different kinds of heterogeneous data. Due to the complexity of these two kinds of SEMs, model comparison is difficult. For instance, the computational burden in evaluating the Bayes factor is heavy, and the Deviance Information Criterion may not be appropriate for mixture SEMs. In this paper, a Bayesian criterion-based method called the L v measure, which involves a component related to the variability of the prediction and a component related to the discrepancy between the data and the prediction, is proposed. Moreover, the calibration distribution is introduced for formal comparison of competing models. Two simulation studies, and two applications based on real data sets are presented to illustrate the satisfactory performance of the L v measure in model comparison.",0,1 +221,Spinal Glia and Proinflammatory Cytokines Mediate Mirror-Image Neuropathic Pain in Rats,"Mirror-image allodynia is a mysterious phenomenon that occurs in association with many clinical pain syndromes. Allodynia refers to pain in response to light touch/pressure stimuli, which normally are perceived as innocuous. Mirror-image allodynia arises from the healthy body region contralateral to the actual site of trauma/inflammation. Virtually nothing is known about the mechanisms underlying such pain. A recently developed animal model of inflammatory neuropathy reliably produces mirror-image allodynia, thus allowing this pain phenomenon to be analyzed. In this sciatic inflammatory neuropathy (SIN) model, decreased response threshold to tactile stimuli (mechanical allodynia) develops in rats after microinjection of immune activators around one healthy sciatic nerve at mid-thigh level. Low level immune activation produces unilateral allodynia ipsilateral to the site of sciatic inflammation; more intense immune activation produces bilateral (ipsilateral + mirror image) allodynia. The present studies demonstrate that both ipsilateral and mirror-image SIN-induced allodynias are (1) reversed by intrathecal (peri-spinal) delivery of fluorocitrate, a glial metabolic inhibitor; (2) prevented and reversed by intrathecal CNI-1493, an inhibitor of p38 mitogen-activated kinases implicated in proinflammatory cytokine production and signaling; and (3) prevented or reversed by intrathecal proinflammatory cytokine antagonists specific for interleukin-1, tumor necrosis factor, or interleukin-6. Reversal of ipsilateral and mirror-image allodynias was rapid and complete even when SIN was maintained constantly for 2 weeks before proinflammatory cytokine antagonist administration. These results provide the first evidence that ipsilateral and mirror-image inflammatory neuropathy pain are created both acutely and chronically through glial and proinflammatory cytokine actions.",0,1 +222,Using SAS to conduct nonparametric residual bootstrap multilevel modeling with a small number of groups,"In multilevel modeling, researchers often encounter data with a relatively small number of units at the higher levels. As a result, of this and/or non-normality of the residuals, model parameter estimates, particularly the variance components and standard errors of parameter estimates at the group level, may be biased, thus the corresponding statistical inferences may not be trustworthy. This problem can be addressed by using bootstrap methods to estimate the standard errors of the parameter estimates for significance testing. This study illustrates how to use statistical analysis system (SAS) to conduct nonparametric residual bootstrap multilevel modeling. Specific SAS programs for such modeling are provided.",0,1 +223,On the Frequency Function of $xy$,"Given the distribution function of x and y, what can be said of the distribution of the product xy? The author has had two inquiries during the last two years, one from an investigator in business statistics and the other from a psychologist, concerning the probable error of the product of two quantities, each of known probable error. There seems to be very little in the literature of mathematical statistics on this question. If x and y are independent and are each distributed according to the same normal frequency law, it is well known that the distribution function of",0,1 +224,A controlled study of progabide in partial seizures: Methodology and results,"The results of a multicenter, double-blind, placebo-controlled clinical trial of the efficacy and safety of progabide (PGB) in the treatment of partial seizures are presented. This study was performed with a number of rigorous controls not usually present in clinical trials. These included uniform co-medication in which all patients received only phenytoin and carbamazepine; concentrations of these two drugs were maintained within narrow, predefined concentration ranges. There was no statistically significant difference between PGB and placebo in seizure frequency and seizure duration for most of the analyses performed. One patient was withdrawn from the study because of hepatotoxicity. PGB was associated with a significant inhibition of phenytoin but not carbamazepine clearance. The results of this study indicate that PGB was not a potent antiepileptic drug in this population of persons with intractable epilepsy.",0,1 +225,Hierarchical Bayesian modeling of heterogeneous cluster- and subject-level associations between continuous and binary outcomes in dairy production,"The augmentation of categorical outcomes with underlying Gaussian variables in bivariate generalized mixed effects models has facilitated the joint modeling of continuous and binary response variables. These models typically assume that random effects and residual effects (co)variances are homogeneous across all clusters and subjects, respectively. Motivated by conflicting evidence about the association between performance outcomes in dairy production systems, we consider the situation where these (co)variance parameters may themselves be functions of systematic and/or random effects. We present a hierarchical Bayesian extension of bivariate generalized linear models whereby functions of the (co)variance matrices are specified as linear combinations of fixed and random effects following a square-root-free Cholesky reparameterization that ensures necessary positive semidefinite constraints. We test the proposed model by simulation and apply it to the analysis of a dairy cattle data set in which the random herd-level and residual cow-level effects (co)variances between a continuous production trait and binary reproduction trait are modeled as functions of fixed management effects and random cluster effects.",0,1 +226,"Survey Methods in Multinational, Multiregional, and Multicultural Contexts",This book provides up-to-date insight into key aspects of methodological research for comparative surveys. It discusses methodological considerations for surveys that are deliberately designed for ...,0,1 +227,The relative judgment theory of two choice response time,Choice reaction times and response probabilities are analyzed in terms of a random walk decision process. The theory of relative judgment which gives rise to this analysis assumes that a presented stimulus is compared by the subject to an internal psychological standard or referent. Discrepancies between the stimulus and the referent are accumulated until one or the other of two response thresholds is exceeded. Results from three experiments are examined in detail. In each experiment a particular feature of the theory is tested and shown to be supported by the data. Methods of estimating the two parameters of the theory are given and an appendix presents a summary of theoretical results.,0,1 +228,"Message content in keyword campaigns, click behavior, and price-consciousness: A study of millennial consumers","Abstract Building upon the expectancy theory, this study suggests that message content in keyword advertising influences click behavior. The moderating role of price consciousness is also examined. An online experiment using an ex-post filter sampling method is implemented (final n=165). The results of binary logistic regressions indicate that descriptive message content is more clicked than commercial. Price-consciousness appears to moderate the relationship, with high price-conscious consumers being more influenced by descriptive content than less price-conscious consumers. The obtained results are meaningful and significant for the millennial consumers under study.",0,1 +229,Pattern identification as a function of stimulation on a fingertip-scanned electrotactile display,"Two studies were conducted to determine the effect of stimulation current on pattern perception on a 49-point fingertip-scanned electrotactile (electrocutaneous) display. Performance increased monotonically from near chance levels at the lowest sub-threshold current levels tested to approximately 90% at the highest comfortable current levels. This suggests the existence of a tradeoff between spatial performance and usable ""gray scale"" range in electrotactile presentation of graphical information.",0,1 +230,Structural equation models with continuous and polytomous variables,"A two-stage procedure is developed for analyzing structural equation models with continuous and polytomous variables. At the first stage, the maximum likelihood estimates of the thresholds, polychoric covariances and variances, and polyserial covariances are simultaneously obtained with the help of an appropriate transformation that significantly simplifies the computation. An asymptotic covariance matrix of the estiates is also computed. At the second stage, the parameters in the structural covariance model are obtained via the generalized least squares approach. Basic statistical properties of the estimates are derived and some illustrative examples and a small simulation study are reported. © 1992 The Psychometric Society.",0,1 +231,A method of moments technique for fitting interaction effects in structural equation models,"The desire to fit structural equation models containing an interaction term has received much methodological attention in the social science literature. This paper presents a technique for the cross-product structural model that utilizes factor score estimates and results in closed-form moments-type estimators. The technique, which does not require normality for the underlying factors, was originally introduced in a very general form by Wall and Amemiya (2000) for any polynomial structural model. In this paper, the practical implementation of this method, including standard error estimation, is presented specifically for the cross-product model. The procedure is applied to an example from social/behavioural epidemiology where the flexibility of the cross-product model provides a useful description of the underlying theory. A simulation study is also presented comparing the method of moments for the cross-product model with three other procedures.",0,1 +232,The Rise of Markov Chain Monte Carlo Estimation for Psychometric Modeling,"Markov chain Monte Carlo (MCMC) estimation strategies represent a powerful approach to estimation in psychometric models. Popular MCMC samplers and their alignment with Bayesian approaches to modeling are discussed. Key historical and current developments of MCMC are surveyed, emphasizing how MCMC allows the researcher to overcome the limitations of other estimation paradigms, facilitates the estimation of models that might otherwise be intractable, and frees the researcher from certain possible misconceptions about the models.",0,1 +233,Determining the impact of prenatal tobacco exposure on self-regulation at 6 months.,"Our goal in the present study was to examine the effects of maternal smoking during pregnancy on infant self-regulation, exploring birth weight as a mediator and sex as a moderator of risk. A prospective sample of 218 infants was assessed at 6 months of age. Infants completed a battery of tasks assessing working memory/inhibition, attention, and emotional reactivity and regulation. Propensity scores were used to statistically control for confounding risk factors associated with maternal smoking during pregnancy. After prenatal and postnatal confounds were controlled, prenatal tobacco exposure was related to reactivity to frustration and control of attention during stimulus encoding. Birth weight did not mediate the effect of prenatal exposure but was independently related to reactivity and working memory/inhibition. The effect of tobacco exposure was not moderated by sex.",0,1 +234,Unpacking the Black Box of Causality: Learning about Causal Mechanisms from Experimental and Observational Studies,"Identifying causal mechanisms is a fundamental goal of social science. Researchers seek to study not only whether one variable affects another but also how such a causal relationship arises. Yet commonly used statistical methods for identifying causal mechanisms rely upon untestable assumptions and are often inappropriate even under those assumptions. Randomizing treatment and intermediate variables is also insufficient. Despite these difficulties, the study of causal mechanisms is too important to abandon. We make three contributions to improve research on causal mechanisms. First, we present a minimum set of assumptions required under standard designs of experimental and observational studies and develop a general algorithm for estimating causal mediation effects. Second, we provide a method for assessing the sensitivity of conclusions to potential violations of a key assumption. Third, we offer alternative research designs for identifying causal mechanisms under weaker assumptions. The proposed approach is illustrated using media framing experiments and incumbency advantage studies.",0,1 +235,Nonlinear Structural Equation Modeling as a Statistical Method,"Structural equation analysis allows exploring and modeling relationships among latent variables. The most traditional analysis deals only with linear relationships. However, in applied problems, relevant research questions can be associated with some form of nonlinear relations. Also, from a statistical modeling or data analysis point of view, capabilities to address unrestricted nonlinear relations would be welcome. A review is given for the existing approaches that have been developed and designed for specific nonlinear models. Then, a statistical formulation of general nonlinear structural equation analysis is introduced, and a general model fitting procedure applicable under weak assumptions on latent variable distributions is developed. An example with a nonpolynomial nonlinear structural model is discussed using the new method.",0,1 +236,The Well-Calibrated Bayesian,"Abstract Suppose that a forecaster sequentially assigns probabilities to events. He is well calibrated if, for example, of those events to which he assigns a probability 30 percent, the long-run proportion that actually occurs turns out to be 30 percent. We prove a theorem to the effect that a coherent Bayesian expects to be well calibrated, and consider its destructive implications for the theory of coherence.",0,1 +237,THE ESTIMATION OF CAUSAL EFFECTS FROM OBSERVATIONAL DATA,"▪ Abstract When experimental designs are infeasible, researchers must resort to the use of observational data from surveys, censuses, and administrative records. Because assignment to the independent variables of observational data is usually nonrandom, the challenge of estimating causal effects with observational data can be formidable. In this chapter, we review the large literature produced primarily by statisticians and econometricians in the past two decades on the estimation of causal effects from observational data. We first review the now widely accepted counterfactual framework for the modeling of causal effects. After examining estimators, both old and new, that can be used to estimate causal effects from cross-sectional data, we present estimators that exploit the additional information furnished by longitudinal data. Because of the size and technical nature of the literature, we cannot offer a fully detailed and comprehensive presentation. Instead, we present only the main features of methods that are accessible and potentially of use to quantitatively oriented sociologists.",0,1 +238,Estimation of a covariance matrix,,0,1 +239,Effect of Tapentadol Extended Release on Productivity,"To compare the effects of tapentadol-extended release versus oxycodone-controlled release for pain relief on productivity by combining evidence from different sources.Multiparameter evidence synthesis. Three sources were used. The first consisted of 3 randomized double-blind controlled trials that evaluated the efficacy and safety of tapentadol and oxycodone for the management of chronic pain. The second was published data on the incidence of constipation in patients exposed to opioids, and the third was a published survey that evaluated the effect of opioid-induced constipation on productivity. In the trials, a patient was classified as constipated if constipation was reported at any time during the 15 weeks of double-blinded assessment after randomization. In the survey, the effect of constipation on productivity was measured using the Work Productivity and Activity Impairment Questionnaire. All analyses were performed using Bayesian Markov chain Monte Carlo simulations in WinBUGS.The odds of developing constipation were 60% lower with tapentadol than with oxycodone (odds ratio=0.40, 95% credible interval, 0.32-0.50). Tapentadol was associated with less time missed from work, less impairment while working, and a lower overall loss in work productivity compared with oxycodone. The gain in overall work productivity with tapentadol was 1.92% compared with oxycodone (95% credible interval, 1.32-2.59), which translates to a gain of almost 1 hour per week worked.Tapentadol was associated with increases in all productivity dimensions compared with oxycodone. Multiparameter evidence synthesis capitalizes on available evidence, so that better informed medical decisions can be made.",0,1 +240,Optimizing prediction of binge eating episodes: a comparison approach to test alternative conceptualizations of the affect regulation model,"Although a wealth of studies have tested the link between negative mood states and likelihood of a subsequent binge eating episode, the assumption that this relationship follows a typical linear dose-response pattern (i.e., that risk of a binge episode increases in proportion to level of negative mood) has not been challenged. The present study demonstrates the applicability of an alternative, non-linear conceptualization of this relationship, in which the strength of association between negative mood and probability of a binge episode increases above a threshold value for the mood variable relative to the slope below this threshold value (threshold dose response model).A sample of 93 women aged 18 to 40 completed an online survey at random intervals seven times per day for a period of one week. Participants self-reported their current mood state and whether they had recently engaged in an eating episode symptomatic of a binge.As hypothesized, the threshold approach was a better predictor than the linear dose-response modeling of likelihood of a binge episode. The superiority of the threshold approach was found even at low levels of negative mood (3 out of 10, with higher scores reflecting more negative mood). Additionally, severity of negative mood beyond this threshold value appears to be useful for predicting time to onset of a binge episode.Present findings suggest that simple dose-response formulations for the association between negative mood and onset of binge episodes miss vital aspects of this relationship. Most notably, the impact of mood on binge eating appears to depend on whether a threshold value of negative mood has been breached, and elevation in mood beyond this point may be useful for clinicians and researchers to identify time to onset.",0,1 +241,Family community ethnic identity and the use of formal health care services in Guatemala.,In this paper we investigate family choices about type of prenatal care and assistance at delivery (childbirth) and the use of childhood immunizations in Guatemala during the early and mid-1980s. Our objective is to investigate the reasons underlying relatively low use of formal health care services in Guatemala particularly among the large indigenous population. (EXCERPT),0,1 +242,A Bayesian hierarchical model for risk assessment of methylmercury,"This article uses a Bayesian hierarchical model to quantify the adverse health effects associated with in-utero exposure to methylmercury. By allowing for study-to-study as well as outcome-to-outcome variability, the approach provides a useful meta-analytic tool for multi-outcome, multi-study environmental risk assessments. The analysis presented here expands on the findings of a National Academy of Sciences (NAS) committee, charged with advising the United States Environmental Protection Agency (EPA) on an appropriate approach to conducting a risk assessment for methylmercury. The NAS committee, for which the senior author (Ryan) was a committee member, reviewed the findings from several conflicting studies and reported the results from a Bayesian hierarchical model that synthesized information across several studies and for several outcomes. Although the NAS committee did not suggest that the hierarchical model be used as the actual basis for a methylmercury risk assessment, the results from the model were used to justify and support the final recommendation that the risk analysis be based on data from a study conducted in the Faroe Islands, which had found an association between in-utero exposure to methylmercury and impaired neurological development. We consider a variety of statistical issues, but particularly sensitivity to model specification. © 2003 American Statistical Association and the International Biometric Society.",0,1 +243,Bayesian Cultural Consensus Theory,"In this article, we present a Bayesian inference framework for cultural consensus theory (CCT) models for dichotomous (True/False) response data and provide an associated, user-friendly software package along with a detailed user’s guide to carry out the inference. We believe that the time is ripe for Bayesian statistical inference to become the default choice in the field of CCT. Unfortunately, a lack of publications presenting a practical description of the Bayesian framework in the context of CCT models as well as a dearth of accessible software to apply Bayesian inference to CCT data has so far prevented this from happening. We introduce the Bayesian treatment of several CCT models, focusing on the various merits of Bayesian parameter estimation and interpretation of results, and also introduce the Bayesian Cultural Consensus Toolbox software package.",0,1 +244,Bayesian latent variable models for clustered mixed outcomes,"A general framework is proposed for modelling clustered mixed outcomes. A mixture of generalized linear models is used to describe the joint distribution of a set of underlying variables, and an arbitrary function relates the underlying variables to be observed outcomes. The model accommodates multilevel data structures, general covariate effects and distinct link functions and error distributions for each underlying variable. Within the framework proposed, novel models are developed for clustered multiple binary, unordered categorical and joint discrete and continuous outcomes. A Markov chain Monte Carlo sampling algorithm is described for estimating the posterior distributions of the parameters and latent variables. Because of the flexibility of the modelling framework and estimation procedure, extensions to ordered categorical outcomes and more complex data structures are straightforward. The methods are illustrated by using data from a reproductive toxicity study.",0,1 +245,Hierarchical Bayes Models for Response Time Data,"Human response time (RT) data are widely used in experimental psychology to evaluate theories of mental processing. Typically, the data constitute the times taken by a subject to react to a succession of stimuli under varying experimental conditions. Because of the sequential nature of the experiments there are trends (due to learning, fatigue, fluctuations in attentional state, etc.) and serial dependencies in the data. The data also exhibit extreme observations that can be attributed to lapses, intrusions from outside the experiment, and errors occurring during the experiment. Any adequate analysis should account for these features and quantify them accurately. Recognizing that Bayesian hierarchical models are an excellent modeling tool, we focus on the elaboration of a realistic likelihood for the data and on a careful assessment of the quality of fit that it provides. We judge quality of fit in terms of the predictive performance of the model. We demonstrate how simple Bayesian hierarchical models can be built for several RT sequences, differentiating between subject-specific and condition-specific effects. © The Psychometric Society 2010.",0,1 +246,Deterioration of Neurobehavioral Performance in Resident Physicians During Repeated Exposure to Extended Duration Work Shifts,"Although acute sleep loss during 24- to 30-h extended duration work shifts (EDWS) has been shown to impair the performance of resident physicians, little is known about the effects of cumulative sleep deficiency on performance during residency training. Chronic sleep restriction induces a gradual degradation of neurobehavioral performance and exacerbates the effects of acute sleep loss in the laboratory, yet the extent to which this occurs under real-world conditions is unknown. In this study, the authors quantify the time course of neurobehavioral deterioration due to repeated exposure to EDWS during a 3-week residency rotation.A prospective, repeated-measures, within-subject design.Medical and cardiac intensive care units, Brigham and Women's Hospital, Boston, MA.Thirty-four postgraduate year one resident physicians (23 males; age 28.0 ± 1.83 (standard deviation) years)Residents working a 3-week Q3 schedule (24- to 30-h work shift starts every 3(rd) day), consisting of alternating 24- to 30-h (EDWS) and approximately 8-h shifts, underwent psychomotor vigilance testing before, during, and after each work shift. Mean response time, number of lapses, and slowest 10% of responses were calculated for each test. Residents also maintained daily sleep/wake/work logs. EDWS resulted in cumulative sleep deficiency over the 21-day rotation (6.3 h sleep obtained per day; average 2.3 h sleep obtained per extended shift). Response times deteriorated over a single 24- to 30-h shift (P < 0.0005), and also cumulatively with each successive EDWS: Performance on the fifth and sixth shift was significantly worse than on the first shift (P < 0.01). Controlling for time of day, there was a significant acute (time on shift) and chronic (successive EDWS) interaction on psychomotor vigilance testing response times (P < 0.05).Chronic sleep deficiency caused progressive degradation in residents' neurobehavioral performance and exacerbated the effects of acute sleep loss inherent in the 24- to 30-h EDWS that are commonly used in resident schedules.",0,1 +247,Fast and accurate measurement of taste and smell thresholds using a maximum-likelihood adaptive staircase procedure,"This paper evaluates the use of a maximum-likelihood adaptive staircase psychophysical procedure (ML-PEST), originally developed in vision and audition, for measuring detection thresholds in gustation and olfaction. The basis for the psychophysical measurement of thresholds with the ML-PEST procedure is developed. Then, two experiments and four simulations are reported. In the first experiment, ML-PEST was compared with the Wetherill and Levitt up-down staircase method and with the Cain ascending method of limits in the measurement of butyl alcohol thresholds. The four Monte Carlo simulations compared the three psychophysical procedures. In the second experiment, the test-retest reliability of MLPEST for measuring NaCl and butyl alcohol thresholds was assessed. The results indicate that the ML-PEST method gives reliable and precise threshold measurements. Its ability to detect malingerers shows considerable promise. It is recommended for use in clinical testing.",0,1 +248,Therapist Effects on Attrition in Psychotherapy Outpatients,Dirk Zimmermann illustrates that some therapists significantly differ concerning their average dropout rates. He points out that initial impairment is a strong predictor of early termination. Different dropout criteria as well as various explaining variables on patient and on therapist level were assessed. Premature treatment termination is a common phenomenon in psychotherapy with mean dropout rates of about 20%. Therapist effects account for 3%-4% of the variation in dropout. © Springer Fachmedien Wiesbaden 2015.,0,1 +249,The Many Flavors of Model-Based Meta-Analysis: Part I-Introduction and Landmark Data,Meta-analysis is an increasingly important aspect of drug development as companies look to benchmark their own compounds with the competition. There is scope to carry out a wide range of analyses addressing key research questions from preclinical through to postregistration. This set of tutorials will take the reader through key model-based meta-analysis (MBMA) methods with this first installment providing a general introduction before concentrating on classical and Bayesian methods for landmark data.,0,1 +250,Statistics and Causal Inference,"Abstract Problems involving causal inference have dogged at the heels of statistics since its earliest days. Correlation does not imply causation, and yet causal conclusions drawn from a carefully designed experiment are often valid. What can a statistical model say about causation? This question is addressed by using a particular model for causal inference (Holland and Rubin 1983; Rubin 1974) to critique the discussions of other writers on causation and causal inference. These include selected philosophers, medical researchers, statisticians, econometricians, and proponents of causal modeling.",0,1 +251,How Are the Form and Magnitude of DIF Effects in Multiple-Choice Items Determined by Distractor-Level Invariance Effects?,"This article explores how the magnitude and form of differential item functioning (DIF) effects in multiple-choice items are determined by the underlying differential distractor functioning (DDF) effects, as modeled under the nominal response model. The results of a numerical investigation indicated that (a) the presence of one or more nonzero DDF effects implies a nonzero DIF effect; (b) the magnitude of the DDF effects creates an upper bound to the magnitude of the resulting DIF effect; (c) the presence of a large DDF effect does not necessarily imply a large DIF effect; (d) under the condition of constant DDF effects the resulting DIF effect is independent of other item properties (i.e., location and discrimination parameters), but under the condition of varying DDF effects the resulting DIF effect magnitude is dependent on other item properties; and (e) although crossing DIF can only exist with divergent (varying in sign) DDF effects, divergent DDF effects do not always yield crossing DIF. Implications of these findings for evaluating DIF effects and interpreting the causes of DIF effects are discussed.",0,1 +252,Advanced Nonlinear Latent Variable Modeling: Distribution Analytic LMS and QML Estimators of Interaction and Quadratic Effects,"Interaction and quadratic effects in latent variable models have to date only rarely been tested in practice. Traditional product indicator approaches need to create product indicators (e.g., x 1 2, x 1 x 4) to serve as indicators of each nonlinear latent construct. These approaches require the use of complex nonlinear constraints and additional model specifications and do not directly address the nonnormal distribution of the product terms. In contrast, recently developed, easy-to-use distribution analytic approaches do not use product indicators, but rather directly model the nonlinear multivariate distribution of the measured indicators. This article outlines the theoretical properties of the distribution analytic Latent Moderated Structural Equations (LMS; Klein & Moosbrugger, 2000) and Quasi-Maximum Likelihood (QML; Klein & Muthen, 2007) estimators. It compares the properties of LMS and QML to those of the product indicator approaches. A small simulation study compares the two approaches and illustra...",0,1 +253,Cultural Consensus Theory: Aggregating Continuous Responses in a Finite Interval,"Cultural consensus theory (CCT) consists of cognitive models for aggregating responses of “informants” to test items about some domain of their shared cultural knowledge. This paper develops a CCT model for items requiring bounded numerical responses, e.g. probability estimates, confidence judgments, or similarity judgments. The model assumes that each item generates a latent random representation in each informant, with mean equal to the consensus answer and variance depending jointly on the informant and the location of the consensus answer. The manifest responses may reflect biases of the informants. Markov Chain Monte Carlo (MCMC) methods were used to estimate the model, and simulation studies validated the approach. The model was applied to an existing cross-cultural dataset involving native Japanese and English speakers judging the similarity of emotion terms. The results sharpened earlier studies that showed that both cultures appear to have very similar cognitive representations of emotion terms.",0,1 +254,Generalized Fiducial Inference for Binary Logistic Item Response Models,"Generalized fiducial inference (GFI) has been proposed as an alternative to likelihood-based and Bayesian inference in mainstream statistics. Confidence intervals (CIs) can be constructed from a fiducial distribution on the parameter space in a fashion similar to those used with a Bayesian posterior distribution. However, no prior distribution needs to be specified, which renders GFI more suitable when no a priori information about model parameters is available. In the current paper, we apply GFI to a family of binary logistic item response theory models, which includes the two-parameter logistic (2PL), bifactor and exploratory item factor models as special cases. Asymptotic properties of the resulting fiducial distribution are discussed. Random draws from the fiducial distribution can be obtained by the proposed Markov chain Monte Carlo sampling algorithm. We investigate the finite-sample performance of our fiducial percentile CI and two commonly used Wald-type CIs associated with maximum likelihood (ML) estimation via Monte Carlo simulation. The use of GFI in high-dimensional exploratory item factor analysis was illustrated by the analysis of a set of the Eysenck Personality Questionnaire data. © 2016, The Psychometric Society.",0,1 +255,Using Bayesian statistics for modeling PTSD through Latent Growth Mixture Modeling: implementation and discussion,"After traumatic events, such as disaster, war trauma, and injuries including burns (which is the focus here), the risk to develop posttraumatic stress disorder (PTSD) is approximately 10% (Breslau & Davis, 1992). Latent Growth Mixture Modeling can be used to classify individuals into distinct groups exhibiting different patterns of PTSD (Galatzer-Levy, 2015). Currently, empirical evidence points to four distinct trajectories of PTSD patterns in those who have experienced burn trauma. These trajectories are labeled as: resilient, recovery, chronic, and delayed onset trajectories (e.g., Bonanno, 2004; Bonanno, Brewin, Kaniasty, & Greca, 2010; Maercker, Gäbler, O'Neil, Schützwohl, & Müller, 2013; Pietrzak et al., 2013). The delayed onset trajectory affects only a small group of individuals, that is, about 4-5% (O'Donnell, Elliott, Lau, & Creamer, 2007). In addition to its low frequency, the later onset of this trajectory may contribute to the fact that these individuals can be easily overlooked by professionals. In this special symposium on Estimating PTSD trajectories (Van de Schoot, 2015a), we illustrate how to properly identify this small group of individuals through the Bayesian estimation framework using previous knowledge through priors (see, e.g., Depaoli & Boyajian, 2014; Van de Schoot, Broere, Perryck, Zondervan-Zwijnenburg, & Van Loey, 2015).We used latent growth mixture modeling (LGMM) (Van de Schoot, 2015b) to estimate PTSD trajectories across 4 years that followed a traumatic burn. We demonstrate and compare results from traditional (maximum likelihood) and Bayesian estimation using priors (see, Depaoli, 2012, 2013). Further, we discuss where priors come from and how to define them in the estimation process.We demonstrate that only the Bayesian approach results in the desired theory-driven solution of PTSD trajectories. Since the priors are chosen subjectively, we also present a sensitivity analysis of the Bayesian results to illustrate how to check the impact of the prior knowledge integrated into the model.We conclude with recommendations and guidelines for researchers looking to implement theory-driven LGMM, and we tailor this discussion to the context of PTSD research.",0,1 +256,Nested Logit Models for Multiple-Choice Item Response Data,"Nested logit item response models for multiple-choice data are presented. Relative to previous models, the new models are suggested to provide a better approximation to multiple-choice items where the application of a solution strategy precedes consideration of response options. In practice, the models also accommodate collapsibility across all distractor categories, making it easier to allow decisions about including distractor information to occur on an item-by-item or application-by-application basis without altering the statistical form of the correct response curves. Marginal maximum likelihood estimation algorithms for the models are presented along with simulation and real data analyses. © 2010 The Psychometric Society.",0,1 +257,Incorporating Bayesian Ideas into Health-Care Evaluation,"We argue that the Bayesian approach is best seen as providing additional tools for those carrying out health-care evaluations, rather than replacing their traditional methods. A distinction is made between those features that arise from the basic Bayesian philosophy and those that come from the modern ability to make inferences using very complex models. Selected examples of the former include explicit recognition of the wide cast of stakeholders in any evaluation, simple use of Bayes theorem and use of a community of prior distributions. In the context of complex models, we selectively focus on the possible role of simple Monte Carlo methods, alternative structural models for incorporating historical data and making inferences on complex functions of indirectly estimated parameters. These selected issues are illustrated by two worked examples presented in a standardized format. The emphasis throughout is on inference rather than decision-making.",0,1 +258,Discrete and Continuous Representations of Unobserved Heterogeneity in Choice Modeling,"We attempt to provide insights into how heterogeneity has been and can be addressed in choice modeling. In doing so, we deal with three topics: Models of heterogeneity. Methods of estimation and Substantive issues. In describing models we focus on discrete versus continuous representations of heterogeneity. With respect to estimation we contrast Markov Chain Monte Carlo methods and (simulated) likelihood methods. The substantive issues discussed deal with empirical tests of heterogeneity assumptions, the formation of empirical generalisations, the confounding of heterogeneity with state dependence and consideration sets, and normativesegmentation.",0,1 +259,A general class of latent variable models for ordinal manifest variables with covariate effects on the manifest and latent variables,Previous work on a general class of multidimensional latent variable models for analysing ordinal manifest variables is extended here to allow for direct covariate effects on the manifest ordinal variables and covariate effects on the latent variables. A full maximum likelihood estimation method is used to estimate all the model parameters simultaneously. Goodness-of-fit statistics and standard errors are discussed. Two examples from the 1996 British Social Attitudes Survey are used to illustrate the methodology.,0,1 +260,On the Relationship between Bayesian and Non-Bayesian Interval Estimates,"SUMMARY Let Y1,..., Y, denote independent observations each distributed according to a density depending on a scalar parameter 0. Suppose that we are interested in constructing an interval estimate for 0. One approach is to construct a confidence region with a specified coverage probability based on the likelihood ratio test statistic. Another approach is to construct a highest posterior density region with a specified posterior probability. The goal of this paper is to study the relationship between these two approaches. In particular, we derive asymptotic expansions for the posterior probability of confidence regions based on the likelihood ratio test statistic and for the coverage probability of highest posterior density regions. Conditions under which the two methods lead to identical regions, at least approximately, are also given.",0,1 +261,The psychophysics of uneconomical choice: non-linear reward evaluation by a nectar feeder,"Uneconomical choices by humans or animals that evaluate reward options challenge the expectation that decision-makers always maximize the return currency. One possible explanation for such deviations from optimality is that the ability to sense differences in physical value between available alternatives is constrained by the sensory and cognitive processes for encoding profitability. In this study, we investigated the capacity of a nectarivorous bat species (Glossophaga commissarisi) to discriminate between sugar solutions with different concentrations. We conducted a two-alternative free-choice experiment on a population of wild electronically tagged bats foraging at an array of computer-automated artificial flowers that recorded individual choices. We used a Bayesian approach to fit individual psychometric functions, relating the strength of preferring the higher concentration option to the intensity of the presented stimulus. Psychometric analysis revealed that discrimination ability increases non-linearly with respect to intensity. We combined this result with a previous psychometric analysis of volume perception. Our theoretical analysis of choice for rewards that vary in two quality dimensions revealed regions of parameter combinations where uneconomic choice is expected. Discrimination ability may be constrained by non-linear perceptual and cognitive encoding processes that result in uneconomical choice.",0,1 +262,Bayesian switching factor analysis for estimating time-varying functional connectivity in fMRI,"There is growing interest in understanding the dynamical properties of functional interactions between distributed brain regions. However, robust estimation of temporal dynamics from functional magnetic resonance imaging (fMRI) data remains challenging due to limitations in extant multivariate methods for modeling time-varying functional interactions between multiple brain areas. Here, we develop a Bayesian generative model for fMRI time-series within the framework of hidden Markov models (HMMs). The model is a dynamic variant of the static factor analysis model (Ghahramani and Beal, 2000). We refer to this model as Bayesian switching factor analysis (BSFA) as it integrates factor analysis into a generative HMM in a unified Bayesian framework. In BSFA, brain dynamic functional networks are represented by latent states which are learnt from the data. Crucially, BSFA is a generative model which estimates the temporal evolution of brain states and transition probabilities between states as a function of time. An attractive feature of BSFA is the automatic determination of the number of latent states via Bayesian model selection arising from penalization of excessively complex models. Key features of BSFA are validated using extensive simulations on carefully designed synthetic data. We further validate BSFA using fingerprint analysis of multisession resting-state fMRI data from the Human Connectome Project (HCP). Our results show that modeling temporal dependencies in the generative model of BSFA results in improved fingerprinting of individual participants. Finally, we apply BSFA to elucidate the dynamic functional organization of the salience, central-executive, and default mode networks-three core neurocognitive systems with central role in cognitive and affective information processing (Menon, 2011). Across two HCP sessions, we demonstrate a high level of dynamic interactions between these networks and determine that the salience network has the highest temporal flexibility among the three networks. Our proposed methods provide a novel and powerful generative model for investigating dynamic brain connectivity.",0,1 +263,Bayesian Spatial Quantile Regression,"Tropospheric ozone is one of the six criteria pollutants regulated by the United States Environmental Protection Agency under the Clean Air Act and has been linked with several adverse health effects, including mortality. Due to the strong dependence on weather conditions, ozone may be sensitive to climate change and there is great interest in studying the potential effect of climate change on ozone, and how this change may affect public health. In this paper we develop a Bayesian spatial model to predict ozone under different meteorological conditions, and use this model to study spatial and temporal trends and to forecast ozone concentrations under different climate scenarios. We develop a spatial quantile regression model that does not assume normality and allows the covariates to affect the entire conditional distribution, rather than just the mean. The conditional distribution is allowed to vary from site-to-site and is smoothed with a spatial prior. For extremely large datasets our model is computationally infeasible, and we develop an approximate method. We apply the approximate version of our model to summer ozone from 1997-2005 in the Eastern U.S., and use deterministic climate models to project ozone under future climate conditions. Our analysis suggests that holding all other factors fixed, an increase in daily average temperature will lead to the largest increase in ozone in the Industrial Midwest and Northeast.",0,1 +264,How many IRT parameters does it take to model psychopathology items?,"The authors compared the fit of the 2- and 3-parameter logistic models (2PLM; 3PLM) on 15 unidimensional factor scales derived from the Minnesota Multiphasic Personality Inventory--Adolescent item pool. Log-likelihood chi-square deviance tests indicated that a 3PLM provided an improved fit. However, residual statistics indicated that the difference in fit between the 2 models was negligible. An unexpected finding was that from 10% to 30% of the items had substantial lower asymptote parameters (c > or = .10) when the scales were scored in the pathology or nonpathology directions. The authors argue that the large lower asymptote parameters are attributable to item-content ambiguity possibly caused by item-level multidimensionality. These findings suggest that the direction of scoring can critically affect an item response theory analysis.",0,1 +265,Under What Assumptions Do Site-by-Treatment Instruments Identify Average Causal Effects?,"The increasing availability of data from multisite randomized trials provides a potential opportunity to use instrumental variables (IV) methods to study the effects of multiple hypothesized mediators of the effect of a treatment. We derive nine assumptions needed to identify the effects of multiple mediators when using site-by-treatment interactions to generate multiple instruments. Three of these assumptions are unique to the multiple-site, multiple-mediator case: (1) the assumption that the mediators act in parallel (no mediator affects another mediator); (2) the assumption that the site-average effect of the treatment on each mediator is independent of the site-average effect of each mediator on the outcome; and (3) the assumption that the site-by-compliance matrix has sufficient rank. The first two of these assumptions are nontrivial and cannot be empirically verified, suggesting that multiple-site, multiple-mediator IV models must be justified by strong theory.",0,1 +266,Addressing among-group variation in covariate effects using multilevel models,"Multilevel models are used to model processes associated with hierarchical data structures. Despite infrequent use in the biological and environmental sciences, the use of these models with hierarchically-structured data conveys multiple advantages. These include the assessment of whether covariate effects differ among groups or clusters, and separate estimation of covariate effects by hierarchical level (thereby addressing atomistic and aggregation fallacy concerns). We illustrate these advantages using larval mayfly count data derived from annual surveys on the Mississippi River and a continuous covariate (water depth). © 2009 Springer Science+Business Media, LLC.",0,1 +267,"Testing homogeneity in a random intercept model using asymptotic, posterior predictive and plug-in p-values","In this paper three statistics and three discrepancy measures with which homogeneity in the random intercept model can be investigated will be evaluated. The first two can be used to test the homogeneity of level one residual variances across level two units and the third can be used to test whether effects should be fixed or random. Each statistic and discrepancy measure will be evaluated using asymptotic (if available), posterior predictive and plug in p-values. A simulation study will be used to investigate the frequency properties of these p-values. In the discussion it will be indicated how the results obtained for the random intercept model with one explanatory variable can be useful during the construction of general two level models.",0,1 +268,Standard errors for EM estimation,"The EM algorithm is a popular method for computing maximum likelihood estimates. One of its drawbacks is that it does not produce standard errors as a by-product. We consider obtaining standard errors by numerical differentiation. Two approaches are considered. The first differentiates the Fisher score vector to yield the Hessian of the log-likelihood. The second differentiates the EM operator and uses an identity that relates its derivative to the Hessian of the log-likelihood. The well-known SEM algorithm uses the second approach. We consider three additional algorithms: one that uses the first approach and two that use the second. We evaluate the complexity and precision of these three and the SEM in algorithm seven examples. The first is a single-parameter example used to give insight. The others are three examples in each of two areas of EM application: Poisson mixture models and the estimation of covariance from incomplete data. The examples show that there are algorithms that are much simpler and more accurate than the SEM algorithm. Hopefully their simplicity will increase the availability of standard error estimates in EM applications. It is shown that, as previously conjectured, a symmetry diagnostic can accurately estimate errors arising from numerical differentiation. Some issues related to the speed of the EM algorithm and algorithms that differentiate the EM operator are identified.",0,1 +269,Extending the simple linear regression model to account for correlated responses: An introduction to generalized estimating equations and multi-level mixed modelling,"Much of the research in epidemiology and clinical science is based upon longitudinal designs which involve repeated measurements of a variable of interest in each of a series of individuals. Such designs can be very powerful, both statistically and scientifically, because they enable one to study changes within individual subjects over time or under varied conditions. However, this power arises because the repeated measurements tend to be correlated with one another, and this must be taken into proper account at the time of analysis or misleading conclusions may result. Recent advances in statistical theory and in software development mean that studies based upon such designs can now be analysed more easily, in a valid yet flexible manner, using a variety of approaches which include the use of generalized estimating equations, and mixed models which incorporate random effects. This paper provides a particularly simple illustration of the use of these two approaches, taking as a practical example the analysis of a study which examined the response of portable peak expiratory flow meters to changes in true peak expiratory flow in 12 children with asthma. The paper takes the reader through the relevant practicalities of model fitting, interpretation and criticism and demonstrates that, in a simple case such as this, analyses based upon these model-based approaches produce reassuringly similar inferences to standard analyses based upon more conventional methods.",0,1 +270,Bayesian methods for cluster randomized trials with continuous responses,"Bayesian methods for cluster randomized trials extend the random-effects formulation by allowing both the use of external evidence on parameters and straightforward relaxation of the standard normality and constant variance assumptions. Care is required in specifying prior distributions on variance components, and a number of different options are explored with implied prior distributions for other parameters given in closed form. Markov chain Monte Carlo (MCMC) methods permit the fitting of very general models and the introduction of parameter uncertainty into power calculations. We illustrate these ideas using a published example in which general practices were randomized to intervention or control, and show that different choices of supposedly 'non-informative' prior distributions can have substantial influence on conclusions. We also illustrate the use of forward simulation methods in power calculations with uncertainty on multiple inputs. Bayesian methods have the potential to be very useful but guidance is required as to appropriate strategies for robust analysis. Our current experience leads us to recommend a standard 'non-informative' prior distribution for the within-cluster sampling variance, and an independent prior on the intraclass correlation coefficient (ICC). The latter may exploit background evidence or, as a reference analysis, be a uniform ICC or a 'uniform shrinkage' prior.",0,1 +271,Bias and the Effect of Priors in Bayesian Estimation of Parameters of Item Response Models,"The effectiveness of a Bayesian approach to the es timation problem in item response models has been sufficiently documented in recent years. Although re search has indicated that Bayesian estimates, in gen eral, are more accurate than joint maximum likelihood (JML) estimates, the effect of choice of priors on the Bayesian estimates is not well known. Moreover, the extent to which the Bayesian estimates are biased in comparison with JML estimates is not known. The ef fect of priors and the amount of bias in Bayesian esti mates is examined in this paper through simulation studies. It is shown that different specifications of prior information have relatively modest effects on the Bayesian estimates. For small samples, it is shown that the Bayesian estimates are less biased than their JML counterparts. Index terms: accuracy, Bayesian estimates, bias, item response models, joint maximum likelihood estimates, priors.",0,1 +272,Adolescents' alcohol and drug use trajectories in the year following treatment.,"Beyond the initial relapse episode, little is known about short-term patterns of alcohol and other drug use in treated adolescents. This study characterized treated teens' short-term alcohol and other drug use trajectories over 1-year follow-up.Adolescents (N = 110, ages 12-18, 65% male, 94% white) recruited from addictions treatment, with a current DSM-IV alcohol diagnosis, reported on daily alcohol and other drug use in monthly telephone contacts over 1-year follow-up using the Timeline Follow-Back procedure. Latent class mixture modeling identified trajectories based on maximum number of consecutive abstinent days per month, separately for alcohol and other drugs.Four alcohol trajectories were identified: high abstinence (53%), decreasing abstinence (10%), increasing abstinence (16%) and low abstinence (21%). The alcohol trajectories were distinguished by gender, age, readiness to change substance use and alcohol-related coping. To characterize changes in alcohol abstinence in relation to abstinence from other drugs, four other drug trajectories were identified: high (59%), decreasing (12%), increasing (14%) and low (15%) abstinence. Cross-classification of the alcohol and drug trajectories indicated a moderate level of concordance (kappa = 0.49).Multiple pathways of short-term change in alcohol and other drug use were identified. Although changes in abstinence from alcohol and other drug use tended to co-occur, exceptions were observed. Differences between alcohol trajectories in readiness to change substance use and use of substance coping suggest the potentially positive impact of targeted and effectively timed interventions that focus on motivational enhancement and on improving substance coping for certain adolescent subgroups.",0,1 +273,Instrumental variables estimates of peer effects in social networks,"• Instrumental variables play a crucial role in estimating causal peer effects in social networks. • Measurement error in smoking can lead to both under- and imprecise estimates of peer effects. • The analysis shows consistent and robust evidence for peer effects on smoking. • Sharing cigarettes is a plausible mechanism for peer effects on smoking. Estimating peer effects with observational data is very difficult because of contextual confounding, peer selection, simultaneity bias, and measurement error, etc. In this paper, I show that instrumental variables (IVs) can help to address these problems in order to provide causal estimates of peer effects. Based on data collected from over 4000 students in six middle schools in China, I use the IV methods to estimate peer effects on smoking. My design-based IV approach differs from previous ones in that it helps to construct potentially strong IVs and to directly test possible violation of exogeneity of the IVs. I show that measurement error in smoking can lead to both under- and imprecise estimations of peer effects. Based on a refined measure of smoking, I find consistent evidence for peer effects on smoking. If a student’s best friend smoked within the past 30 days, the student was about one fifth (as indicated by the OLS estimate) or 40 percentage points (as indicated by the IV estimate) more likely to smoke in the same time period. The findings are robust to a variety of robustness checks. I also show that sharing cigarettes may be a mechanism for peer effects on smoking. A 10% increase in the number of cigarettes smoked by a student’s best friend is associated with about 4% increase in the number of cigarettes smoked by the student in the same time period.",0,1 +274,Mechanisms of Moral Disengagement in the Endorsement of Asylum Seeker Policies in Australia,"Moral disengagement is a process whereby the self-regulatory mechanisms that would otherwise sanction unethical conduct can be selectively disabled. The present research proposed that moral disengagement might be adopted in the endorsement of asylum seeker policies in Australia, and in order to test this, a scale was developed and was validated in two studies. Factor analysis demonstrated that a 2-factor, 16-item structure had the best fit, and the construct validity of the scale was supported. Results provide evidence for the use of moral disengagement in the context of asylum seekers as a means of rationalizing conduct that may otherwise be sanctioned.",0,1 +275,Assessing Mediational Models: Testing and Interval Estimation for Indirect Effects,"Theoretical models specifying indirect or mediated effects are common in the social sciences. An indirect effect exists when an independent variable's influence on the dependent variable is mediated through an intervening variable. Classic approaches to assessing such mediational hypotheses ( Baron & Kenny, 1986 ; Sobel, 1982 ) have in recent years been supplemented by computationally intensive methods such as bootstrapping, the distribution of the product methods, and hierarchical Bayesian Markov chain Monte Carlo (MCMC) methods. These different approaches for assessing mediation are illustrated using data from Dunn, Biesanz, Human, and Finn (2007). However, little is known about how these methods perform relative to each other, particularly in more challenging situations, such as with data that are incomplete and/or nonnormal. This article presents an extensive Monte Carlo simulation evaluating a host of approaches for assessing mediation. We examine Type I error rates, power, and coverage. We study normal and nonnormal data as well as complete and incomplete data. In addition, we adapt a method, recently proposed in statistical literature, that does not rely on confidence intervals (CIs) to test the null hypothesis of no indirect effect. The results suggest that the new inferential method-the partial posterior p value-slightly outperforms existing ones in terms of maintaining Type I error rates while maximizing power, especially with incomplete data. Among confidence interval approaches, the bias-corrected accelerated (BC a ) bootstrapping approach often has inflated Type I error rates and inconsistent coverage and is not recommended; In contrast, the bootstrapped percentile confidence interval and the hierarchical Bayesian MCMC method perform best overall, maintaining Type I error rates, exhibiting reasonable power, and producing stable and accurate coverage rates.",0,1 +276,Do Men and Women Exhibit Different Preferences for Mates? A Replication of Eastwick and Finkel (2008),"Evolutionary theory predicts that men will prefer physically attractive romantic partners, and women will prefer wealthy, high-status partners. This theory is well-supported when examining ideal hypothetical partner preferences, but less support has been found when people interact face-to-face. The present study served as a direct replication of results reported in Eastwick and Finkel (2008). We recruited 307 participants and utilized a speed-dating methodology to allow in-person interactions, then administered follow-up surveys to measure romantic interest over 30 days. Data were analyzed using multilevel modeling and were aggregated using meta-analysis. Consistent with previous findings, our results showed that participants were more romantically interested in potential partners if they were viewed as attractive and good potential earners, and these associations were not moderated by gender. Results suggest that gender differences predicted by evolutionary theory may not hold when people interact with potential romantic partners face-to-face. However, we discuss these results in light of some general methodological limitations and evidence from other lines of research.",0,1 +277,Modelling the random effects covariance matrix in longitudinal data,"A common class of models for longitudinal data are random effects (mixed) models. In these models, the random effects covariance matrix is typically assumed constant across subject. However, in many situations this matrix may differ by measured covariates. In this paper, we propose an approach to model the random effects covariance matrix by using a special Cholesky decomposition of the matrix. In particular, we will allow the parameters that result from this decomposition to depend on subject-specific covariates and also explore ways to parsimoniously model these parameters. An advantage of this parameterization is that there is no concern about the positive definiteness of the resulting estimator of the covariance matrix. In addition, the parameters resulting from this decomposition have a sensible interpretation. We propose fully Bayesian modelling for which a simple Gibbs sampler can be implemented to sample from the posterior distribution of the parameters. We illustrate these models on data from depression studies and examine the impact of heterogeneity in the covariance matrix on estimation of both fixed and random effects.",0,1 +278,Hierarchical Approximate Bayesian Computation,"Approximate Bayesian computation (ABC) is a powerful technique for estimating the posterior distribution of a model's parameters. It is especially important when the model to be fit has no explicit likelihood function, which happens for computational (or simulation-based) models such as those that are popular in cognitive neuroscience and other areas in psychology. However, ABC is usually applied only to models with few parameters. Extending ABC to hierarchical models has been difficult because high-dimensional hierarchical models add computational complexity that conventional ABC cannot accommodate. In this paper, we summarize some current approaches for performing hierarchical ABC and introduce a new algorithm called Gibbs ABC. This new algorithm incorporates well-known Bayesian techniques to improve the accuracy and efficiency of the ABC approach for estimation of hierarchical models. We then use the Gibbs ABC algorithm to estimate the parameters of two models of signal detection, one with and one without a tractable likelihood function.",0,1 +279,Variance component estimation techniques compared for two mating designs with forest genetic architecture through computer simulation,"Computer simulation was used to compare minimum variance quadratic estimation (MIVQUE), minimum norm quadratic unbiased estimation (MINQUE), restricted maximum likelihood (REML), maximum likelihood (ML), and Henderson's Method 3 (HM3) on the basis of variance among estimates, mean square error (MSE), bias and probability of nearness for estimation of both individual variance components and three ratios of variance components. The investigation also compared three procedures for dealing with negative estimates and included the use of both individual observations and plot means as the experimental unit of the analysis. The structure of data simulated (field design, mating designs, genetic architecture and imbalance) represented typical analysis problems in quantitative forest genetics. Results of comparing the estimation techniques demonstrated that: estimates of probability of nearness did not discriminate among techniques; bias was discriminatory among procedures for dealing with negative estimates but not among estimation techniques (except ML); sampling variance among estimates was discriminatory among procedures for dealing with negative estimates, estimation techniques and unit of observation; and MSE provided no additional information to variance of the estimates. HM3 and REML were the closest competitors under these criteria; however, REML demonstrated greater robustness to imbalance. Of the three negative estimate procedures, two are of practical significance and guidelines for their application are presented. Estimates from individual observations were always preferable to those from plot means over the experimental levels of this study. © 1994 Springer-Verlag.",0,1 +280,Development of a general solution to the problem of validity generalization.,"U. S. Civil Service Commission andGeorge Washington UniversityJohn E. HunterMichigan State UniversityPersonnel psychologists have traditionally believed that employment test valid-ities are situation specific. This study presents a Bayesian statistical modelwhich allows one to explore the alternate hypothesis that variation in validityoutcomes from study to study for similar jobs and tests is artifactual in nature.Certain outcomes using this model permit validity generalization to new settingswithout carrying out a validation study of any kind. Where such generalizationis not justified, the procedure provides an improved method of data analysisand decision making for the necessary situational validity study. Application tofour distributions of empirical validity coefficients demonstrated the power ofthe model.A recent study (Schmidt, Hunter, & Urry,1976) addressed the belief, dominant in per-sonnel psychology, that meaningful empiricalvalidation studies are possible for most, if notall, jobs in most organizations. This studyshowed that, because of range restriction andless than perfect criterion reliability, thesample sizes necessary to provide adequatestatistical power are usually much larger thanhas typically been assumed, This finding leadsto the conclusion that empirical validitystudies are technically feasible much lessfrequently than the profession has assumed.The present study is addressed to another ofthe orthodoxies of personnel psychology: thebelief that test validity is generally highlysituation specific. Considerable variabilityfrom study to study is observed in raw valida-tion results even when jobs and tests appearto be similar or essentially identical (Ghiselli,1966). The explanation usually advanced forthis phenomenon is that the factor structureof job performance is different from job tojob and that the human observer or job ana-lyst is simply too poor an information receiver",0,1 +281,Methods for Meta-Analysis in Medical Research,PART A: META-ANALYSIS METHODOLOGY: THE BASICS Introduction: Meta-analysis: Its Development and Uses Defining Outcome Measures used for Combining via Meta-analysis Random Effects Models for Combining Study Estimates Exploring Between Study Heterogeneity Publication Bias Study Quality Sensitivity Analysis Reporting the Results of a Meta-analysis Fixed Effects Methods for Combining Study Estimates PART B: ADVANCED AND SPECIALIZED META-ANALYSIS TOPICS Bayesian Methods in Meta-analysis Meta Regression Meta-analysis of Different Types of Data Incorporating Study Quality into a Meta-analysis Meta-analysis of Multiple and Correlated Outcome Measures Meta-analysis of Epidemiological and other Observational Studies Generalised Synthesis of Evidence - Combining Different Sources of Evidence Meta-analysis of Survival Data Cumulative Meta-analysis Miscellaneous and Developing Areas of Applications in Meta-Analysis Appendix I: Software Used for the Examples in this Book,0,1 +282,Fitting Partially Nonlinear Random Coefficient Models as SEMs,"The nonlinear random coefficient model has become increasingly popular as a method for describing individual differences in longitudinal research. Although promising, the nonlinear model it is not utilized as often as it might be because software options are still somewhat limited. In this article we show that a specialized version of the model can be fit to data using SEM software. The specialization is to a model in which the parameters that enter the function in a linear manner are random, whereas those that are nonlinear are common to all individuals. Although this kind of function is not as general as is the fully nonlinear model, it still is applicable to many different data sets. Two examples are presented to show how the models can be estimated using popular SEM computer programs.",0,1 +283,Bayesian Sensitivity Analysis of a Nonlinear Dynamic Factor Analysis Model with Nonparametric Prior and Possible Nonignorable Missingness,"Many psychological concepts are unobserved and usually represented as latent factors apprehended through multiple observed indicators. When multiple-subject multivariate time series data are available, dynamic factor analysis models with random effects offer one way of modeling patterns of within- and between-person variations by combining factor analysis and time series analysis at the factor level. Using the Dirichlet process (DP) as a nonparametric prior for individual-specific time series parameters further allows the distributional forms of these parameters to deviate from commonly imposed (e.g., normal or other symmetric) functional forms, arising as a result of these parameters' restricted ranges. Given the complexity of such models, a thorough sensitivity analysis is critical but computationally prohibitive. We propose a Bayesian local influence method that allows for simultaneous sensitivity analysis of multiple modeling components within a single fitting of the model of choice. Five illustrations and an empirical example are provided to demonstrate the utility of the proposed approach in facilitating the detection of outlying cases and common sources of misspecification in dynamic factor analysis models, as well as identification of modeling components that are sensitive to changes in the DP prior specification.",0,1 +284,Developing a Random Coefficient Model for Nonlinear Repeated Measures Data,,0,1 +285,"Statistical power and parameter stability when subjects are few and tests are many: Comment on Peterson, Smith, Martorana, and Owens (2003).","Comments on the original article ""The impact of chief executive officer personality on top management team dynamics: One mechanism by which leadership affects organizational performance"", by R. S. Peterson et al.. This comment illustrates how small sample sizes, when combined with many statistical tests, can generate unstable parameter estimates and invalid inferences. Although statistical power for 1 test in a small-sample context is too low, the experimentwise power is often high when many tests are conducted, thus leading to Type I errors that will not replicate when retested. This comment's results show how radically the specific conclusions and inferences in R. S. Peterson, D. B. Smith, P. V. Martorana, and P. D. Owens's (2003) study changed with the inclusion or exclusion of 1 data point. When a more appropriate experimentwise statistical test was applied, the instability in the inferences was eliminated, but all the inferences become nonsignificant, thus changing the positive conclusions.",0,1 +286,"Comparison of Meta-Analytic Results of Indirect, Direct, and Combined Comparisons of Drugs for Chronic Insomnia in Adults: A Case Study","Our Center recently conducted a systematic review of the manifestations and management of chronic insomnia in adults. The efficacy and safety of benzodiazepines and nonbenzodiazepines, relative to placebo, were compared indirectly.Determine how the results of indirect comparisons made in the review compare with the results of direct comparisons, as well as with estimates derived from Bayesian mixed treatment comparisons. Establish general appropriateness of the use of results of indirect or mixed treatment comparisons.Treatments were compared using frequentist direct, indirect, and combined methods, as well as Bayesian direct and mixed methods.Estimates for comparisons tended to be clinically and statistically similar across methods. Estimates obtained through indirect comparisons were not biased and were similar to those obtained through direct analysis.Results of indirect comparisons made in the review, accurately reflected the current evidence. Frequentist and Bayesian methods of analysis of indirect comparisons should be considered when performing meta-analyses.",0,1 +287,"The Performance of ML, GLS, and WLS Estimation in Structural Equation Modeling Under Conditions of Misspecification and Nonnormality","This simulation study demonstrates how the choice of estimation method affects indexes of fit and parameter bias for different sample sizes when nested models vary in terms of specification error and the data demonstrate different levels of kurtosis. Using a fully crossed design, data were generated for 11 conditions of peakedness, 3 conditions of misspecification, and 5 different sample sizes. Three estimation methods (maximum likelihood [ML], generalized least squares [GLS], and weighted least squares [WLS]) were compared in terms of overall fit and the discrepancy between estimated parameter values and the true parameter values used to generate the data. Consistent with earlier findings, the results show that ML compared to GLS under conditions of misspecification provides more realistic indexes of overall fit and less biased parameter values for paths that overlap with the true model. However, despite recommendations found in the literature that WLS should be used when data are not normally distribute...",0,1 +288,Probabilistic sensitivity analysis of complex models: a Bayesian approach,"Summary.  In many areas of science and technology, mathematical models are built to simulate complex real world phenomena. Such models are typically implemented in large computer programs and are also very complex, such that the way that the model responds to changes in its inputs is not transparent. Sensitivity analysis is concerned with understanding how changes in the model inputs influence the outputs. This may be motivated simply by a wish to understand the implications of a complex model but often arises because there is uncertainty about the true values of the inputs that should be used for a particular application. A broad range of measures have been advocated in the literature to quantify and describe the sensitivity of a model's output to variation in its inputs. In practice the most commonly used measures are those that are based on formulating uncertainty in the model inputs by a joint probability distribution and then analysing the induced uncertainty in outputs, an approach which is known as probabilistic sensitivity analysis. We present a Bayesian framework which unifies the various tools of prob- abilistic sensitivity analysis. The Bayesian approach is computationally highly efficient. It allows effective sensitivity analysis to be achieved by using far smaller numbers of model runs than standard Monte Carlo methods. Furthermore, all measures of interest may be computed from a single set of runs.",0,1 +289,Measuring Prestige of Journals in Industrial-Organizational Psychology,,0,1 +290,Estimation of Finite Mixture Distributions Through Bayesian Sampling,"SUMMARY A formal Bayesian analysis of a mixture model usually leads to intractable calculations, since the posterior distribution takes into account all the partitions of the sample. We present approximation methods which evaluate the posterior distribution and Bayes estimators by Gibbs sampling, relying on the missing data structure of the mixture model. The data augmentation method is shown to converge geometrically, since a duality principle transfers properties from the discrete missing data chain to the parameters. The fully conditional Gibbs alternative is shown to be ergodic and geometric convergence is established in the normal case. We also consider non-informative approximations associated with improper priors, assuming that the sample corresponds exactly to a k-component mixture.",0,1 +291,Evaluating Educational Interventions Using Multilevel Growth Curves: The Case of Reading Recovery,"Educational interventions are notoriously difficult to evaluate. This article describes an application of multilevel modelling to repeated measures as part of an evaluation of Reading Recovery in England. Growth curve and multivariate models are applied to the within and between school aspects of the design, which also included a phonological intervention. Reading Recovery is shown to be effective in the short term but not in the long term. A measure of social disadvantage is a powerful predictor of reading growth in the long term.",0,1 +292,Estimation and Comparison of Changes in the Presence of Informative Right Censoring by Modeling the Censoring Process,"In the estimation and comparison of the rates of change of a continuous variable between two groups, the unweighted averages of individual simple least squares estimates from each group are often used. Under a linear random effects model, when all individuals have complete observations at identical time points, these statistics are maximum likelihood estimates for the expected rates of change. However, with censored or missing data, these estimates are no longer efficient when compared to generalized least squares estimates. When, in addition, the right-censoring process is dependent on the individual rates of change (i.e., informative right censoring), the generalized least squares estimates will be biased. Likelihood-ratio tests for informativeness of the censoring process and maximum likelihood estimates for the expected rates of change and the parameters of the right-censoring process are developed under a linear random effects model with a probit model for the right-censoring process. In realistic situations, we illustrate that the bias in estimating group rate of change and the reduction of power in comparing group differences could be substantial when strong dependency of the right-censoring process on individual rates of change is ignored.",0,1 +293,Can informal economic activities be explained by social and institutional factors? A comparative analysis,"Empirical literature on informal activities often builds on macro-economic country estimates, which impedes testing behavioural hypotheses. The European Social Survey (ESS), documenting self-reported tax evasion in 26 countries, allows us to test individual and institutional factors simultaneously. We model the effect of institutional and social capital factors affecting informal transactions. We predict that informality is fostered by social relations and trust, and curbed by institutional trust. Regulation and taxation fuel informal transactions, while effective enforcement inhibits them. These predictions are simultaneously tested with individual-level data from the ESS, complemented with country-level data on regulation, taxation levels and enforcement. Multilevel binary and multinomial logit, fixed effects, Markov chain Monte Carlo method and adaptive Gaussian quadrature regressions confirm the predictions regarding social capital, trust and tax burden. Contrary to much prior research, we find weak and inconsistent effects of regulation and enforcement, which may also be due to the limited variation of our country sample. © The Author 2015.",0,1 +294,Making treatment effect inferences from multiple-baseline data: The utility of multilevel modeling approaches,"Multiple-baseline studies are prevalent in behavioral research, but questions remain about how to best analyze the resulting data. Monte Carlo methods were used to examine the utility of multilevel models for multiple-baseline data under conditions that varied in the number of participants, number of repeated observations per participant, variance in baseline levels, variance in treatment effects, and amount of autocorrelation in the Level 1 errors. Interval estimates of the average treatment effect were examined for two specifications of the Level 1 error structure (sigma(2)I and first-order autoregressive) and for five different methods of estimating the degrees of freedom (containment, residual, between-within, Satterthwaite, and Kenward-Roger). When the Satterthwaite or Kenward-Roger method was used and an autoregressive Level 1 error structure was specified, the interval estimates of the average treatment effect were relatively accurate. Conversely, the interval estimates of the treatment effect variance were inaccurate, and the corresponding point estimates were biased.",0,1 +295,Multilevel Structural Equation Modeling,,0,1 +296,On the inefficiency of propensity score matching,"Propensity score matching is now widely used in empirical applications for estimating treatment effects. Propensity score matching (PSM) is preferred to matching on X because of the lower dimension of the estimation problem. In this note, however, it is shown that PSM is inefficient compared to matching on X. Hence, matching on X should be considered as a serious alternative.",0,1 +297,On Multilevel Model Reliability Estimation From the Perspective of Structural Equation Modeling,A covariance structure modeling perspective on reliability estimation can be used to construct a formal approach to estimation of reliability in multilevel models. This article presents a didactic discussion of the relation between a structural modeling procedure for scale reliability estimation and the notion of reliability of observed means in unconditional multilevel models. The utility of the method is demonstrated as an alternative means for conceptualizing multilevel modeling reliability. The relationship between the underlying two reliability notions is illustrated on a set of hierarchical data.,0,1 +298,The importance of covariate selection in controlling for selection bias in observational studies.,"The assumption of strongly ignorable treatment assignment is required for eliminating selection bias in observational studies. To meet this assumption, researchers often rely on a strategy of selecting covariates that they think will control for selection bias. Theory indicates that the most important covariates are those highly correlated with both the real selection process and the potential outcomes. However, when planning a study, it is rarely possible to identify such covariates with certainty. In this article, we report on an extensive reanalysis of a within-study comparison that contrasts a randomized experiment and a quasi-experiment. Various covariate sets were used to adjust for initial group differences in the quasi-experiment that was characterized by self-selection into treatment. The adjusted effect sizes were then compared with the experimental ones to identify which individual covariates, and which conceptually grouped sets of covariates, were responsible for the high degree of bias reduction achieved in the adjusted quasi-experiment. Such results provide strong clues about preferred strategies for identifying the covariates most likely to reduce bias when planning a study and when the true selection process is not known.",0,1 +299,Religiöse Diversität und Sozialintegration im internationalen Vergleich,"Following Robert D. Putnams (2007) thesis that ethnic diversity weakens social cohesion, this study addresses the social consequences of religious diversity. Instead of contrasting social-psychological mechanisms it takes a macro-sociological perspective that focuses on different structural forms of religious diversity and relates them to the trust relations within a population. The empirical results based on a cross-national comparison of 41 European and Non- European societies show that religious macro-structures are indeed related to social trust. But contrary to Putnam's ""hunkering down"" thesis religious diversity does not lead to social anomia and isolation but has different effects on social trust toward religious in- and out-groups. Key is the result that different macro-structural forms of religious diversity have different consequences for social cohesion. The question, whether religious diversity poses a threat or opportunity for the social integration of society, therefore crucially depends on its concrete form. © 2013 Springer Fachmedien Wiesbaden.",0,1 +300,Likelihood-based inference for correlated diffusions,"The authors address the problem of likelihood based inference for correlated diffusions. Such a task presents two issues; the positive definite constraints of the diffusion matrix and the likelihood intractability. The first issue is handled by using the Cholesky factorisation on the diffusion matrix. To deal with the likelihood unavailability, a generalisation of the data augmentation framework of Roberts and Stramer (2001 Biometrika 88(3), 603-621) to d-dimensional correlated diffusions, including multivariate stochastic volatility models, is given. The methodology is illustrated through simulated and real datasets.",0,1 +301,Applications of nonparametric adaptive methods for simple reaction time experiments,"Adaptive methods are commonly used in psychophysical research for detection and discrimination (see Leek, 2001; Treutwein, 1995, for reviews). In recent years, researchers have investigated via simulations some asymptotic and small-sample properties of two nonparametric adaptive methods—namely, the fixed-step-size up-down (García-Pérez, 1998, 2001) and the (accelerated) stochastic approximation (Faes et al., 2007). In the present article, we extend both methods to the simple reaction time (RT) situation for the measure of signal intensities that elicit certain (fixed) RT percentiles. We focus on extending the following four methods: the stochastic approximation of Robbins and Monro (1951), its accelerated version of Kesten (1958), the transformed up-down of Wetherill (1963), and the “biased coin design” of Durham and Flournoy (1994, 1995). In all simulations, we assume that the RT is Weibull distributed and that there is a linear relationship between the mean RT and its standard deviation. The convergences of the asymptotic and small-sample properties for different starting values, step sizes, and response criteria are systematically investigated.",0,1 +302,Systematic review and mixed treatment comparison meta-analysis of randomized clinical trials of primary oral antifungal prophylaxis in allogeneic hematopoietic cell transplant recipients,"BackgroundAntifungal prophylaxis is a promising strategy for reducing invasive fungal infections (IFIs) in allogeneic hematopoietic cell transplant (alloHCT) recipients, but the optimum prophylactic agent is unknown. We used mixed treatment comparison (MTC) meta-analysis to compare clinical trials examining the use of oral antifungals for prophylaxis in alloHCT recipients, with the goal of informing medical decision-making.MethodsRandomized controlled trials (RCTs) of fluconazole, itraconazole, posaconazole, and voriconazole for primary antifungal prophylaxis were identified through a systematic literature review. Outcomes of interest (incidence of IFI/invasive aspergillosis/invasive candidiasis, all-cause mortality, and use of other antifungals) were extracted from eligible RCTs and incorporated into a Bayesian hierarchical random-effects MTC.ResultsFive eligible RCTs, randomizing 2147 patients in total, were included. Relative to fluconazole, prophylaxis with itraconazole (odds ratio [OR]: 0.52; interquartile range [IQR]: 0.35–0.76), posaconazole (OR: 0.56; IQR: 0.32–0.99), and voriconazole (OR: 0.46; IQR: 0.28–0.73) reduced incidence of overall proven/probable IFI. Posaconazole (OR: 0.31; IQR: 0.17–0.58) and voriconazole (OR: 0.33; IQR: 0.17–0.58) prophylaxis reduced proven/probable invasive aspergillosis more than itraconazole (OR: 0.68; IQR: 0.42–1.12). All-cause mortality was similar across all mould-active agents.ConclusionAs expected, mould-active azoles prevented IFIs, particularly invasive aspergillosis, more effectively than fluconazole in alloHCT recipients. The paucity of comparative efficacy data suggests that other factors such as long-term tolerability, availability of intravenous formulations, local IFI epidemiology, and drug costs may need to form the basis for selection among the mould-active azoles.",0,1 +303,How Do Exit Rates from Social Assistance Benefit in Belgium Vary with Individual and Local Agency Characteristics?,"Abstract The administration of social assistance benefits is devolved to local agencies in Belgium, which raises questions about how much variation in spell lengths of benefit receipt is associated with differences across agencies. We address this issue by analysing the monthly hazard of benefit exit using administrative record data for 14,270 individuals in 574 welfare agencies. Our random-effects model allows for differences in both the observed and unobserved characteristics of beneficiaries and of local agencies. There are large differences in median benefit duration for individuals serviced by different welfare agencies: the range is from two months to more than 24 months. We find strong associations between beneficiary characteristics (sex, age, foreign nationality, citizenship acquisition, work history and being a student) and spell length. The estimates show higher odds of exiting social assistance receipt in bigger municipalities and in agencies which provide more generous supplementary assistance, and also strong evidence of shorter episodes in agencies where active labour market programme participation rates are higher.",0,1 +304,Avoiding zero between-study variance estimates in random-effects meta-analysis,"Fixed-effects meta-analysis has been criticized because the assumption of homogeneity is often unrealistic and can result in underestimation of parameter uncertainty. Random-effects meta-analysis and meta-regression are therefore typically used to accommodate explained and unexplained between-study variability. However, it is not unusual to obtain a boundary estimate of zero for the (residual) between-study standard deviation, resulting in fixed-effects estimates of the other parameters and their standard errors. To avoid such boundary estimates, we suggest using Bayes modal (BM) estimation with a gamma prior on the between-study standard deviation. When no prior information is available regarding the magnitude of the between-study standard deviation, a weakly informative default prior can be used (with shape parameter 2 and rate parameter close to 0) that produces positive estimates but does not overrule the data, leading to only a small decrease in the log likelihood from its maximum. We review the most commonly used estimation methods for meta-analysis and meta-regression including classical and Bayesian methods and apply these methods, as well as our BM estimator, to real datasets. We then perform simulations to compare BM estimation with the other methods and find that BM estimation performs well by (i) avoiding boundary estimates; (ii) having smaller root mean squared error for the between-study standard deviation; and (iii) better coverage for the overall effects than the other methods when the true model has at least a small or moderate amount of unexplained heterogeneity.",0,1 +305,"Cow, Farm, and Management Factors During the Dry Period that Determine the Rate of Clinical Mastitis After Calving","The purpose of the research was to investigate cow characteristics, farm facilities, and herd management strategies during the dry period to examine their joint influence on the rate of clinical mastitis after calving. Data were collected over a 2-yr period from 52 commercial dairy farms throughout England and Wales. Cows were separated for analysis into those housed for the dry period (8,710 cow-dry periods) and those at pasture (9,964 cow-dry periods). Multilevel models were used within a Bayesian framework with 2 response variables, the occurrence of a first case of clinical mastitis within the first 30 d of lactation and time to the first case of clinical mastitis during lactation. A variety of cow and herd management factors were identified as being associated with an increased rate of clinical mastitis and these were found to occur throughout the dry period. Significant cow factors were increased parity and at least one somatic cell count > or = 200,000 cells/mL in the 90 d before drying off. A number of management factors related to hygiene were significantly associated with an increased rate of clinical mastitis. These included measures linked to the administration of dry-cow treatments and management of the early and late dry-period accommodation and calving areas. Other farm factors associated with a reduced rate of clinical mastitis were vaccination with a leptospirosis vaccine, selection of dry-cow treatments for individual cows within a herd rather than for the herd as a whole, routine body condition scoring of cows at drying off, and a pasture rotation policy of grazing dry cows for a maximum of 2 wk before allowing the pasture to remain nongrazed for a period of 4 wk. Models demonstrated a good ability to predict the farm incidence rate of clinical mastitis in a given year, with model predictions explaining over 85% of the variability in the observed data. The research indicates that specific dry-period management strategies have an important influence on the rate of clinical mastitis during the next lactation.",0,1 +306,Predicting Psychological Needs and Well-Being of Individuals Engaging in Weight Management: The Role of Important Others,"Background: Using the self-determination theory (SDT) framework, we examined how significant others might support or thwart psychological needs of people with weight management goals, and in turn might affect their psychological well-being and weight control behaviors. Design: Longitudinal design with three sets of questionnaires administered over a 6-month period. Methods: One hundred and fifty-six eligible participants (age = 31.01 ± 13.21 years) were asked to complete questionnaires of SDT-based constructs, weight management behaviors, and psychological well-being. Hypotheses were tested using Bayesian path analysis. Results: Perceived autonomy support from significant others was related to psychological need satisfaction, while controlling behaviors by others were associated with need thwarting. In turn, need satisfaction was associated with some beneficial outcomes such as life satisfaction, and need thwarting was related to some maladaptive outcomes such as higher levels of depressive symptoms and increases in unhealthy diet behaviors. Conclusions: Our findings indicate that the quality of interactions between individuals engaged in weight management and their significant others matters in terms of predicting the psychological needs and well-being of the former.",0,1 +307,Unobserved Heterogeneity in Hospitality and Tourism Research,"Despite the growing complexity of structural equation model (SEM) applications in tourism, it is surprising that most applications have estimated these models without accounting for unobserved heterogeneity. In this article, we aim to discuss the concept of unobserved heterogeneity in more detail, highlighting its serious threats to the validity and reliability of SEMs. We describe a Bayesian finite mixture modeling framework for estimating SEMs while accounting for unobserved heterogeneity. We provide a comprehensive description of this model, and provide guidance on its estimation using the WinBUGS software. We illustrate the importance of unobserved heterogeneity and the finite mixture modeling framework using a didactic application on brand equity where heterogeneity is likely to play an important role because of the differences in how consumers perceive the different dimensions of brand equity. We compare between various models and illustrate the differences between the standard and heterogeneous SEM and discuss the implications for research and practice.",0,1 +308,A Comparison of Two Probability Encoding Methods: Fixed Probability vs. Fixed Variable Values,"We present the results of an experiment comparing two popular methods for encoding probability distributions of continuous variables in decision analysis: eliciting values of a variable, X, through comparisons with a fixed probability wheel and eliciting the percentiles of the cumulative distribution, F(X), through comparisons with fixed values of the variable. We show slight but consistent superiority for the fixed variable method along several dimensions such as monotonicity, accuracy, and precision of the estimated fractiles. The fixed variable elicitation method was also slightly faster and preferred by most participants. We discuss the reasons for its superiority and conclude with several recommendations for the practice of probability assessment.",0,1 +309,"Stochastic dynamics of stimulus encoding in schizophrenia: Theory, testing, and application","Abstract Cognitive processing among schizophrenia participants, entailing encoding of presenting stimulation into a format facilitating collateral processes (e.g., memory search), is examined in light of stochastic mathematical models of performance. Results implicate additional encoding operations (encoding subprocesses) as the source of schizophrenia encoding-process elongation. Convergent evidence for this inference, including that from auxiliary neuro-connectionist simulations, are brought forth. Developments from initial, fixed-parameter accounts include random-parameter mixtures, and their Bayesian extensions, formally mediating group-level results to assessment of individual performance. Outgrowths bear on model-selection methodology, according to coherence of group-level and individual-level model functioning (in part addressing the issue of “small-trial-sample model testing”); longitudinal monitoring of encoding-specific treatment response; evaluation of treatment-regimen efficacy with respect to encoding efficiency; and specification of times of measurement interest, in fMRI. The symptom significance of encoding elongation, strongly hinted at by model developments, along with a model-endowed window on exacerbating effects of stress, are drawn out.",0,1 +310,Fitting Nonlinear Latent Growth Curve Models With Individually Varying Time Points,"Individual growth trajectories of psychological phenomena are often theorized to be nonlinear. Additionally, individuals’ measurement schedules might be unique. In a structural equation framework, latent growth curve model (LGM) applications typically have either (a) modeled nonlinearity assuming some degree of balance in measurement schedules, or (b) accommodated truly individually varying time points, assuming linear growth. This article describes how to fit 4 popular nonlinear LGMs (polynomial, shape-factor, piecewise, and structured latent curve) with truly individually varying time points, via a definition variable approach. The extension is straightforward for certain nonlinear LGMs (e.g., polynomial and structured latent curve) but in the case of shape-factor LGMs requires a reexpression of the model, and in the case of piecewise LGMs requires introduction of a general framework for imparting piecewise structure, along with tools for its automation. All 4 nonlinear LGMs with individually varying ti...",0,1 +311,Influences of intra- and crossmodal grouping on visual and tactile Ternus apparent motion,"Previous studies of dynamic crossmodal integration have revealed that the direction of apparent motion in a target modality can be influenced by a spatially incongruent motion stream in another, distractor modality. Yet, it remains to be examined whether non-motion intra- and crossmodal perceptual grouping can affect apparent motion in a given target modality. To address this question, we employed Ternus apparent-motion displays, which consist of three horizontal aligned visual (or tactile) stimuli that can alternately be seen as either 'element motion' or 'group motion'. We manipulated intra- and crossmodal grouping by cueing the middle stimulus with different cue-target onset asynchronies (CTOAs). In unimodal conditions, we found Ternus apparent motion to be readily biased towards 'element motion' by precues with short or intermediate CTOAs in the visual modality and by precues with short CTOAs in the tactile modality. By contrast, crossmodal precues with short or intermediate CTOAs had no influence on Ternus apparent motion. However, crossmodal synchronous tactile cues led to dominant 'group motion' percepts. And for unimodal visual apparent motion, precues with long CTOAs shifted apparent motion towards 'group motion' in general. The results suggest that intra- and crossmodal interactions on visual and tactile apparent motion take place in different temporal ranges, but both are subject to attentional modulations at long CTOAs.",0,1 +312,Sensitivity analysis in Bayesian generalized linear mixed models for binary data,"Generalized linear mixed models (GLMMs) enjoy increasing popularity because of their ability to model correlated observations. Integrated nested Laplace approximations (INLAs) provide a fast implementation of the Bayesian approach to GLMMs. However, sensitivity to prior assumptions on the random effects precision parameters is a potential problem. To quantify the sensitivity to prior assumptions, we develop a general sensitivity measure based on the Hellinger distance to assess sensitivity of the posterior distributions with respect to changes in the prior distributions for the precision parameters. In addition, for model selection we suggest several cross-validatory techniques for Bayesian GLMMs with a dichotomous outcome. Although the proposed methodology holds in greater generality, we make use of the developed methods in the particular context of the well-known salamander mating data. We arrive at various new findings with respect to the best fitting model and the sensitivity of the estimates of the model components.",0,1 +313,An Empirical Comparison of Logit Choice Models with Discrete versus Continuous Representations of Heterogeneity,"Currently, there is an important debate about the relative merits of models with discrete and continuous representations of consumer heterogeneity. In a recent JMR study, Andrews, Ansari, and Currim (2002 ; hereafter AAC) compared metric conjoint analysis models with discrete and continuous representations of heterogeneity and found no differences between the two models with respect to parameter recovery and prediction of ratings for holdout profiles. Models with continuous representations of heterogeneity fit the data better than models with discrete representations of heterogeneity. The goal of the current study is to compare the relative performance of logit choice models with discrete versus continuous representations of heterogeneity in terms of the accuracy of household-level parameters, fit, and forecasting accuracy. To accomplish this goal, the authors conduct an extensive simulation experiment with logit models in a scanner data context, using an experimental design based on AAC and other recent simulation studies. One of the main findings is that models with continuous and discrete representations of heterogeneity recover household-level parameter estimates and predict holdout choices about equally well except when the number of purchases per household is small, in which case the models with continuous representations perform very poorly. As in the AAC study, models with continuous representations of heterogeneity fit the data better.",0,1 +314,How to detect indications of potential sources of bias in peer review: A generalized latent variable modeling approach exemplified by a gender study,"Abstract The universalism norm of the ethos of science requires that contributions to science are not excluded because of the contributors’ gender, nationality, social status, or other irrelevant criteria. Here, a generalized latent variable modeling approach is presented that grant program managers at a funding organization can use in order to obtain indications of potential sources of bias in their peer review process (such as the applicants’ gender). To implement the method, the data required are the number of approved and number of rejected applicants for grants among different groups (for example, women and men or natural and social scientists). Using the generalized latent variable modeling approach indications of potential sources of bias can be examined not only for grant peer review but also for journal peer review.",0,1 +315,Comparing and unifying slope estimates across psychometric function models,"The psychometric function relating stimulus intensity to response probability generally presents itself as a monotonically increasing sigmoid profile. Two summary parameters of the function are particularly important as measures of perceptual performance: the threshold parameter, which defines the location of the function over the stimulus axis (abscissa), and the slope parameter, which defines the (local) rate at which response probability increases with increasing stimulus intensity. In practice, the psychometric function may be modeled by a variety of mathematical structures, and the resulting algebraic expression describing the slope parameter may vary considerably between different functions fitted to the same experimental data. This variation often restricts comparisons between studies that select different functions and compromises the general interpretation of slope values. This article reviews the general characteristics of psychometric function models, discusses three strategies for resolving the issue of slope value differences, and presents mathematical expressions for implementing each strategy.",0,1 +316,"The Relation Among Fit Indexes, Power, and Sample Size in Structural Equation Modeling","The relation among fit indexes, power, and sample size in structural equation modeling is examined. The noncentrality parameter is required to compute power. The 2 existing methods of computing power have estimated the noncentrality parameter by specifying an alternative hypothesis or alternative fit. These methods cannot be implemented easily and reliably. In this study, 4 fit indexes (RMSEA, CFI, McDonald's Fit Index, and Steiger's gamma) were used to compute the noncentrality parameter and sample size to achieve certain level of power. The resulting power and sample size varied as a function of (a) choice of fit index, (b) number of variables/degrees of freedom, (c) relation among the variables, and (d) value of the fit index. However, if the level of misspecification were held constant, then the resulting power and sample size would be identical.",0,1 +317,Bayesian Causal Mediation Analysis for Group Randomized Designs with Homogeneous and Heterogeneous Effects: Simulation and Case Study,"A fully Bayesian approach to causal mediation analysis for group-randomized designs is presented. A unique contribution of this article is the combination of Bayesian inferential methods with G-computation to address the problem of heterogeneous treatment or mediator effects. A detailed simulation study shows that this approach has excellent frequentist properties, particularly in the case of small sample sizes with accurate informative priors. The simulation study also demonstrates that the proposed approach can take into account heterogeneous treatment or mediator effects without bias. A case study using data from a school-based randomized intervention designed to increase parent social capital leading to improved behavioral and academic outcomes in children is offered to illustrate the Bayesian approach to causal mediation in group-randomized designs.",0,1 +318,Does 401(k) eligibility increase saving?,"By comparing 401(k) eligible and ineligible households’ wealth, this paper estimates that, on average, about one half of 401(k) balances represent new private savings, and about one quarter of 401(k) balances represent new national savings. Responses to eligibility vary considerably, however, with households who normally save the most largely contributing funds they would have saved anyway. This paper improves on previous research by: (1) employing propensity score subclassification to control more completely for observed household characteristics, (2) controlling for more household characteristics, including several correlated with unobserved savings preferences, and (3) adjusting the observed measure of households’ wealth to reduce measurement error.",0,1 +319,Analysis of structural equation model with ignorable missing continuous and polytomous data,"The main purpose of this article is to develop a Bayesian approach for structural equation models with ignorable missing continuous and polytomous data. Joint Bayesian estimates of thresholds, structural parameters and latent factor scores are obtained simultaneously. The idea of data augmentation is used to solve the computational difficulties involved. In the posterior analysis, in addition to the real missing data, latent variables and latent continuous measurements underlying the polytomous data are treated as hypothetical missing data. An algorithm that embeds the Metropolis-Hastings algorithm within the Gibbs sampler is implemented to produce the Bayesian estimates. A goodness-of-fit statistic for testing the posited model is presented. It is shown that the proposed approach is not sensitive to prior distributions and can handle situations with a large number of missing patterns whose underlying sample sizes may be small. Computational efficiency of the proposed procedure is illustrated by simulation studies and a real example.",0,1 +320,Simple Penalties on Maximum-Likelihood Estimates of Genetic Parameters to Reduce Sampling Variation,"Abstract Multivariate estimates of genetic parameters are subject to substantial sampling variation, especially for smaller data sets and more than a few traits. A simple modification of standard, maximum-likelihood procedures for multivariate analyses to estimate genetic covariances is described, which can improve estimates by substantially reducing their sampling variances. This is achieved by maximizing the likelihood subject to a penalty. Borrowing from Bayesian principles, we propose a mild, default penalty—derived assuming a Beta distribution of scale-free functions of the covariance components to be estimated—rather than laboriously attempting to determine the stringency of penalization from the data. An extensive simulation study is presented, demonstrating that such penalties can yield very worthwhile reductions in loss, i.e., the difference from population values, for a wide range of scenarios and without distorting estimates of phenotypic covariances. Moreover, mild default penalties tend not to increase loss in difficult cases and, on average, achieve reductions in loss of similar magnitude to computationally demanding schemes to optimize the degree of penalization. Pertinent details required for the adaptation of standard algorithms to locate the maximum of the likelihood function are outlined.",0,1 +321,Piecewise Linear–Linear Latent Growth Mixture Models With Unknown Knots,"Latent growth curve models with piecewise functions are flexible and useful analytic models for investigating individual behaviors that exhibit distinct phases of development in observed variables. As an extension of this framework, this study considers a piecewise linear–linear latent growth mixture model (LGMM) for describing segmented change of individual behavior over time where the data come from a mixture of two or more unobserved subpopulations (i.e., latent classes). Thus, the focus of this article is to illustrate the practical utility of piecewise linear–linear LGMM and then to demonstrate how this model could be fit as one of many alternatives—including the more conventional LGMMs with functions such as linear and quadratic. To carry out this study, data ( N = 214) obtained from a procedural learning task research were used to fit the three alternative LGMMs: (a) a two-class LGMM using a linear function, (b) a two-class LGMM using a quadratic function, and (c) a two-class LGMM using a piecewise linear–linear function, where the time of transition from one phase to another (i.e., knot) is not known a priori, and thus is a parameter to be estimated.",0,1 +322,Bayesian Computation Via the Gibbs Sampler and Related Markov Chain Monte Carlo Methods,"The use of the Gibbs sampler for Bayesian computation is reviewed and illustrated in the context of some canonical examples. Other Markov chain Monte Carlo simulation methods are also briefly described, and comments are made on the advantages of sample-based approaches for Bayesian inference summaries",0,1 +323,Modeling Affect Dynamics: State of the Art and Future Challenges,"The current article aims to provide an up-to-date synopsis of available techniques to study affect dynamics using intensive longitudinal data (ILD). We do so by introducing the following eight dichotomies that help elucidate what kind of data one has, what process aspects are of interest, and what research questions are being considered: (1) single- versus multiple-person data; (2) univariate versus multivariate models; (3) stationary versus nonstationary models; (4) linear versus nonlinear models; (5) discrete time versus continuous time models; (6) discrete versus continuous variables; (7) time versus frequency domain; and (8) modeling the process versus computing descriptives. In addition, we discuss what we believe to be the most urging future challenges regarding the modeling of affect dynamics.",0,1 +324,An Application of a Mixed-Effects Location Scale Model for Analysis of Ecological Momentary Assessment (EMA) Data,"For longitudinal data, mixed models include random subject effects to indicate how subjects influence their responses over repeated assessments. The error variance and the variance of the random effects are usually considered to be homogeneous. These variance terms characterize the within-subjects (i.e., error variance) and between-subjects (i.e., random-effects variance) variation in the data. In studies using ecological momentary assessment (EMA), up to 30 or 40 observations are often obtained for each subject, and interest frequently centers around changes in the variances, both within and between subjects. In this article, we focus on an adolescent smoking study using EMA where interest is on characterizing changes in mood variation. We describe how covariates can influence the mood variances, and also extend the standard mixed model by adding a subject-level random effect to the within-subject variance specification. This permits subjects to have influence on the mean, or location, and variability, or (square of the) scale, of their mood responses. Additionally, we allow the location and scale random effects to be correlated. These mixed-effects location scale models have useful applications in many research areas where interest centers on the joint modeling of the mean and variance structure.",0,1 +325,Calling European Union Treaty Referendums: Electoral and Institutional Politics,"Many European integration treaties – most notably the failed Constitutional Treaty – have faced ratification by referendum in various member states. Although the literature on voting behaviour in these referendums in now well established, the reasons why these referendums were held in the first place is under-scrutinised. This article examines the reasons EU member states decide to call referendums in order to ratify EU treaties and argues that they do so primarily as a result of domestic political pressure arising from three sources: electoral pressure when the EU is unpopular and elections are close, rules governing the use of referendums, and domestic institutional veto players. This theory is tested using a combination of single and multi-level logistic regression analysis, which finds support for the hypotheses developed here.",0,1 +326,The Impact of Categorization With Confirmatory Factor Analysis,"This study investigated the impact of categorization on confirmatory factor analysis (CFA) parameter estimates, standard errors, and 5 ad hoc fit indexes. Models were generated that represented empirical research situations in terms of model size, sample sizes, and loading values. CFA results obtained from analysis of normally distributed, continuous data were compared to results obtained from 5-category Likert-type data with normal distributions. The ordered categorical data were analyzed using the estimators: Weighted Least Squares (WLS; with polychoric correlation [PC] input) and Maximum Likelihood (ML; with Pearson Product-Moment [PPM] input). ML-PPM-based parameter estimates reported moderate levels of negative bias for all conditions, WLS-PC-based standard errors showed high amounts of bias, especially with a small sample size and moderate loading values. With nonnormally distributed, ordered categorical data, ML-PPM-based parameter estimates, standard errors, and factor intercorrelation showed high...",0,1 +327,Bayesian measures of model complexity and fit,"Summary. We consider the problem of comparing complex hierarchical models in which the number of parameters is not clearly defined. Using an information theoretic argument we derive a measure pD for the effective number of parameters in a model as the difference between the posterior mean of the deviance and the deviance at the posterior means of the parameters of interest. In general pD approximately corresponds to the trace of the product of Fisher's information and the posterior covariance, which in normal models is the trace of the ‘hat’ matrix projecting observations onto fitted values. Its properties in exponential families are explored. The posterior mean deviance is suggested as a Bayesian measure of fit or adequacy, and the contributions of individual observations to the fit and complexity can give rise to a diagnostic plot of deviance residuals against leverages. Adding pD to the posterior mean deviance gives a deviance information criterion for comparing models, which is related to other information criteria and has an approximate decision theoretic justification. The procedure is illustrated in some examples, and comparisons are drawn with alternative Bayesian and classical proposals. Throughout it is emphasized that the quantities required are trivial to compute in a Markov chain Monte Carlo analysis.",0,1 +328,Estimation of mediation effects for zero-inflated regression models,"The goal of mediation analysis is to identify and explicate the mechanism that underlies a relationship between a risk factor and an outcome via an intermediate variable (mediator). In this paper, we consider the estimation of mediation effects in zero-inflated (ZI) models intended to accommodate 'extra' zeros in count data. Focusing on the ZI negative binomial models, we provide a mediation formula approach to estimate the (overall) mediation effect in the standard two-stage mediation framework under a key sequential ignorability assumption. We also consider a novel decomposition of the overall mediation effect for the ZI context using a three-stage mediation model. Estimation of the components of the overall mediation effect requires an assumption involving the joint distribution of two counterfactuals. Simulation study results demonstrate low bias of mediation effect estimators and close-to-nominal coverage probability of confidence intervals. We also modify the mediation formula method by replacing 'exact' integration with a Monte Carlo integration method. The method is applied to a cohort study of dental caries in very low birth weight adolescents. For overall mediation effect estimation, sensitivity analysis was conducted to quantify the degree to which key assumption must be violated to reverse the original conclusion.",0,1 +329,Asymptotic Distribution of P Values in Composite Null Models,"We investigate the compatibility of a null model H0 with the data by calculating a p value; that is, the probability, under H0, that a given test statistic T exceeds its observed value. When the null model consists of a single distribution, the p value is readily obtained, and it has a uniform distribution under H0. On the other hand, when the null model depends on an unknown nuisance parameter θ, one must somehow get rid of θ, (e.g., by estimating it) to calculate a p value. Various proposals have been suggested to ""remove"" θ, each yielding a different candidate p value. But unlike the simple case, these p values typically are not uniformly distributed under the null model. In this article we investigate their asymptotic distribution under H0. We show that when the asymptotic mean of the test statistic T depends on θ, the posterior predictive p value of Guttman and Rubin, and the plug-in p value are conservative (i.e., their asymptotic distributions are more concentrated around 1/2 than a uniform), with the posterior predictive p value being the more conservative. In contrast, the partial posterior predictive and conditional predictive p values of Bayarri and Berger are asymptotically uniform. Furthermore, we show that the discrepancy p value of Meng and Gelman and colleagues can be conservative, even when the discrepancy measure has mean 0 under the null model. We also describe ways to modify the conservative p values to make their distributions asymptotically uniform.",0,1 +330,On Bayesian estimation and model comparison of an integrated structural equation model,"In this paper, we introduce a Bayesian approach to the estimation and model comparison of an integrated two-level nonlinear structural equation model with mixed continuous, dichotomous, and ordered categorical data that may be missing at random. This general model can accommodate nonlinearities of latent variables and the effects of fixed covariates on measurement and structural equations in within-groups and between-groups models. A sampling-based algorithm that combines the Gibbs sampler and the Metropolis-Hastings algorithm is proposed for posterior simulation. A procedure that utilizes path sampling is implemented to compute the Bayes factor for model comparison under the framework of the proposed integrated model. Empirical performances of Bayesian methodologies are illustrated via analysis of a real example.",0,1 +331,Bayesian Interval Estimation of Multiple Correlations with Missing Data: A Gibbs Sampling Approach.,"A Bayesian method for obtaining an interval estimate of the population squared multiple correlation from an incomplete multivariate normal data set is described. The method is applicable to data sets where values are missing on any combination of the dependent and independent variables. Further, the missing data need not be missing in a completely random fashion. The estimates are constructed using a Markov Chain Monte Carlo procedure known as Gibbs Sampling. The important issues of the convergence properties of the Gibbs sampler, the effect of the choice of a reference prior, and the empirical coverage probabilities of the estimates are considered in detail. Investigations using simulated data suggest that the proposed method can yield accurate interval estimates of the population squared multiple correlation.",0,1 +332,General Growth Mixture Analysis of Adolescents' Developmental Trajectories of Anxiety: The Impact of Untested Invariance Assumptions on Substantive Interpretations,"Substantively, this study investigates potential heterogeneity in the developmental trajectories of anxiety in adolescence. Methodologically, this study demonstrates the usefulness of general growth mixture analysis (GGMA) in addressing these issues and illustrates the impact of untested invariance assumptions on substantive interpretations. This study relied on data from the Montreal Adolescent Depression Development Project (MADDP), a 4-year follow-up of more than 1,000 adolescents who completed the Beck Anxiety Inventory each year. GGMA models relying on different invariance assumptions were empirically compared. Each of these models converged on a 5-class solution, but yielded different substantive results. The model with class-varying variance–covariance matrices was retained as providing a better fit to the data. These results showed that although elevated levels of anxiety might fluctuate over time, they clearly do not represent a transient phenomenon. This model was then validated in relation to m...",0,1 +333,A ‘sheep-goat effect’ in repetition avoidance: Extra-sensory perception as an effect of subjective probability?,"Performance on extra-sensory perception (ESP) and on subjective random generation (SRG) has been shown independently to differ along a number of personality dimensions. One of the variables known consistently to influence ESP performance but not studied yet in SRG experiments is belief in the paranormal. We report three experiments on subjective randomness as a function of belief in ESP: (1) a retrospective analysis of randomness in multiple choice answers of a telepathy experiment revealed that believers in ESP (‘sheep’) avoided repetitive responses significantly more than non-believers (‘goats’); (2) in an experiment where subjects had to produce random strings of the digits 1−6, sheep avoided repetitions significantly more than goats; (3) in an experiment where subjects had to compare equiprobable short random sequences, sheep underestimated the number of mathematically expected repetitions significantly more than goats. In all three experiments a stronger bias against the incidence of direct repetitions was found for subjects believing in ESP than for those denying its possibility. This may indicate that believers are more prone to an illusion of causality in the face of everyday coincidences. We suggest that effects of subjective probability and, particularly, of subjective randomness should be considered in future studies concerned with individual differences in ESP scoring.",0,1 +334,Multilevel modelling of medical data,This tutorial presents an overview of multilevel or hierarchical data modelling and its applications in medicine. A description of the basic model for nested data is given and it is shown how this can be extended to fit flexible models for repeated measures data and more complex structures involving cross-classifications and multiple membership patterns within the software package MLwiN. A variety of response types are covered and both frequentist and Bayesian estimation methods are described.,0,1 +335,Small Sample Correction for the Variance of GEE Estimators,"When clustered multinomial responses are fit using the generalized logistic link, Morel (1989) introduced a small sample correction in the Taylor series based estimator of the covariance matrix of the parameter estimates. The correction reduces the bias of the Type I error rates in small samples and guarantees positive definiteness of the estimated variance-covariance matrix. It is well known that small sample bias in the use of the Delta method persists in any application of the Generalized Estimating Equations (GEE) methodology. In this article, we extend the correction originally suggested for the generalized logistic link, to other link functions and distributions, when parameters are estimated by GEE. In a Monte Carlo study with correlated data generated under different sampling schemes, the small sample correction has been shown to be effective in reducing the Type I error rates when the number of clusters is relatively small.",0,1 +336,Get Over It! A Multilevel Threshold Autoregressive Model for State-Dependent Affect Regulation,"Intensive longitudinal data provide rich information, which is best captured when specialized models are used in the analysis. One of these models is the multilevel autoregressive model, which psychologists have applied successfully to study affect regulation as well as alcohol use. A limitation of this model is that the autoregressive parameter is treated as a fixed, trait-like property of a person. We argue that the autoregressive parameter may be state-dependent, for example, if the strength of affect regulation depends on the intensity of affect experienced. To allow such intra-individual variation, we propose a multilevel threshold autoregressive model. Using simulations, we show that this model can be used to detect state-dependent regulation with adequate power and Type I error. The potential of the new modeling approach is illustrated with two empirical applications that extend the basic model to address additional substantive research questions.",0,1 +337,Population-averaged predictions with generalized linear mixed-effects models in forestry: an estimator based on Gauss−Hermite quadrature,"Data in forestry are often spatially and (or) serially correlated. In the last two decades, mixed models have become increasingly popular for the analysis of such data because they can relax the assumption of independent observations. However, when the relationship between the response variable and the covariates is nonlinear, as is the case in generalized linear mixed models (GLMMs), population-averaged predictions cannot be obtained from the fixed effects alone. This study proposes an estimator, which is based on a five-point Gauss−Hermite quadrature, for population-averaged predictions in the context of GLMM. The estimator was tested through Monte Carlo simulation and compared with a regular generalized linear model (GLM). The estimator was also applied to a real-world case study, a harvest model. The results showed that GLM predictions were unbiased but that their confidence intervals did not achieve their nominal coverage. On the other hand, the proposed estimator yielded unbiased predictions with reliable confidence intervals. The predictions based on the fixed effects of a GLMM exhibited the largest biases. If statistical inferences are needed, the proposed estimator should be used. It is easily implemented as long as the random effect specification does not contain multiple random effects for the same hierarchical level.",0,1 +338,Modeling Heterogeneous Variance–Covariance Components in Two-Level Models,"Applications of multilevel models to continuous outcomes nearly always assume constant residual variance and constant random effects variances and covariances. However, modeling heterogeneity of variance can prove a useful indicator of model misspecification, and in some educational and behavioral studies, it may even be of direct substantive interest. The purpose of this article is to review, describe, and illustrate a set of recent extensions to two-level models that allow the residual and random effects variance–covariance components to be specified as functions of predictors. These predictors can then be entered with random coefficients to allow the Level-1 heteroscedastic relationships to vary across Level-2 units. We demonstrate by simulation that ignoring Level-2 variability in residual variances leads the Level-1 variance function regression coefficients to be estimated with spurious precision. We discuss software options for fitting these extensions, and we illustrate them by reanalyzing the classic High School and Beyond data and two-level school effects models presented by Raudenbush and Bryk.",0,1 +339,Adaptive item-based learning environments based on the item response theory: possibilities and challenges,"The popularity of intelligent tutoring systems (ITSs) is increasing rapidly. In order to make learning environments more efficient, researchers have been exploring the possibility of an automatic adaptation of the learning environment to the learner or the context. One of the possible adaptation techniques is adaptive item sequencing by matching the difficulty of the items to the learner's knowledge level. This is already accomplished to a certain extent in adaptive testing environments, where the test is tailored to the person's ability level by means of the item response theory (IRT). Even though IRT has been a prevalent computerized adaptive test (CAT) approach for decades and applying IRT in item-based ITSs could lead to similar advantages as in CAT (e.g. higher motivation and more efficient learning), research on the application of IRT in such learning environments is highly restricted or absent. The purpose of this paper was to explore the feasibility of applying IRT in adaptive item-based ITSs. Therefore, we discussed the two main challenges associated with IRT application in such learning environments: the challenge of the data set and the challenge of the algorithm. We concluded that applying IRT seems to be a viable solution for adaptive item selection in item-based ITSs provided that some modifications are implemented. Further research should shed more light on the adequacy of the proposed solutions.",0,1 +340,Statistical Power of Multilevel Modelling in Dental Caries Clinical Trials: A Simulation Study,"Outcome data from dental caries clinical trials have a naturally hierarchical structure, with surfaces clustered within teeth, clustered within individuals. Data are often aggregated into the DMF index for each individual, losing tooth- and surface-specific information. If these data are to be analysed by tooth or surface, allowing exploration of effects of interventions on different teeth and surfaces, appropriate methods must be used to adjust for the clustered nature of the data. Multilevel modelling allows analysis of clustered data using individual observations without aggregating data, and has been little used in the field of dental caries. A simulation study was conducted to investigate the performance of multilevel modelling methods and standard caries increment analysis. Data sets were simulated from a three-level binomial distribution based on analysis of a caries clinical trial in Scottish adolescents, with varying sample sizes, treatment effects and random tooth level effects based on trials reported in Cochrane reviews of topical fluoride, and analysed to compare the power of multilevel models and traditional analysis. 40,500 data sets were simulated. Analysis showed that estimated power for the traditional caries increment method was similar to that for multilevel modelling, with more variation in smaller data sets. Multilevel modelling may not allow significant reductions in the number of participants required in a caries clinical trial, compared to the use of traditional analyses, but investigators interested in exploring the effect of their intervention in more detail may wish to consider the application of multilevel modelling to their clinical trial data.",0,1 +341,Back to the Future: Effects of Olfaction induced Episodic Memories on Consumer Creativity and Innovation Adoption,,0,1 +342,Assessing Mood in Daily Life,"Abstract. The repeated measurement of moods in everyday life, as is common in ambulatory monitoring, requires parsimonious scales, which may challenge the reliability of the measures. The current paper evaluates the factor structure, the reliability, and the sensitivity to change of a six-item mood scale designed for momentary assessment in daily life. We analyzed data from 187 participants who reported their current mood four times per day during seven consecutive days using a multilevel approach. The results suggest that the proposed three factors Calmness, Valence, and Energetic arousal are appropriate to assess fluctuations within persons over time. However, calmness and valence are not distinguishable at the between-person level. Furthermore, the analyses showed that two-item scales provide measures that are reliable at the different levels and highly sensitive to change.",0,1 +343,Recent developments in meta-analysis,"The art and science of meta-analysis, the combination of results from multiple independent studies, is now more than a century old. In the last 30 years, however, as the need for medical research and clinical practice to be based on the totality of relevant and sound evidence has been increasingly recognized, the impact of meta-analysis has grown enormously. In this paper, we review highlights of recent developments in meta-analysis in medical research. We outline in particular how emphasis has been placed on (i) heterogeneity and random-effects analyses; (ii) special consideration in different areas of application; (iii) assessing bias within and across studies; and (iv) extension of ideas to complex evidence synthesis. We conclude the paper with some remarks on ongoing challenges and possible directions for the future.",0,1 +344,On the relationship between item response theory and factor analysis of discretized variables,"Equivalence of marginal likelihood of the two-parameter normal ogive model in item response theory (IRT) and factor analysis of dichotomized variables (FA) was formally proved. The basic result on the dichotomous variables was extended to multicategory cases, both ordered and unordered categorical data. Pair comparison data arising from multiple-judgment sampling were discussed as a special case of the unordered categorical data. A taxonomy of data for the IRT and FA models was also attempted. © 1987 The Psychometric Society.",0,1 +345,Aging and Recognition Memory: Changes in Regional Cerebral Blood Flow Associated with Components of Reaction Time Distributions,"Abstract We used H2 15O positron emission tomography (PET) to measure age-related changes in regional cerebral blood flow (rCBF) during a verbal recognition memory task. Twelve young adults (20 to 29 years) and 12 older adults (62 to 79 years) participated. Separate PET scans were conducted during Encoding, Baseline, and Retrieval conditions. Each of the conditions involved viewing a series of 64 words and making a two-choice response manually. The complete reaction time (RT) distributions in each task condition were characterized in terms of an ex-Gaussian model (convolution of exponential and Gaussian functions). Parameter estimates were obtained for the mean of the exponential component (τ), representing a task-specific decision process and the mean of the Gaussian component (μ), representing residual sensory coding and response processes. Independently of age group, both μ and τ were higher in the Encoding and Retrieval conditions than in the Baseline condition, and τ was higher during Retrieval than during Encoding. Age-related slowing in task performance was evident primarily in μ. For young adults, rCBF activation in the right prefrontal cortex, in the Retrieval condition, was correlated positively with μ but not with τ. For older adults, rCBF changes (both increases and decreases) in several cortical regions were correlated with both μ and τ. The data suggest that the attentional demands of this task are relatively greater for older adults and consequently lead to the recruitment of additional neural systems during task performance.",0,1 +346,Fuels and fires influence vegetation via above- and belowground pathways in a high-diversity plant community,"Summary Fire strongly influences plant populations and communities around the world, making it an important agent of plant evolution. Fire influences vegetation through multiple pathways, both above- and belowground. Few studies have yet attempted to tie these pathways together in a mechanistic way through soil heating even though the importance of soil heating for plants in fire-prone ecosystems is increasingly recognized. Here we combine an experimental approach with structural equation modelling (SEM) to simultaneously examine multiple pathways through which fire might influence herbaceous vegetation. In a high-diversity longleaf pine groundcover community in Louisiana, USA, we manipulated fine-fuel biomass and monitored the resulting fires with high-resolution thermocouples placed in vertical profile above- and belowground. We predicted that vegetation response to burning would be inversely related to fuel load owing to relationships among fuels, fire temperature, duration and soil heating. We found that fuel manipulations altered fire properties and vegetation responses, of which soil heating proved to be a highly accurate predictor. Fire duration acting through soil heating was important for vegetation response in our SEMs, whereas fire temperature was not. Our results indicate that in this herbaceous plant community, fire duration is a good predictor of soil heating and therefore of vegetation response to fire. Soil heating may be the key determinant of vegetation response to fire in ecosystems wherein plants persist by resprouting or reseeding from soil-stored propagules. Synthesis. Our SEMs demonstrate how the complex pathways through which fires influence plant community structure and dynamics can be examined simultaneously. Comparative studies of these pathways across different communities will provide important insights into the ecology, evolution and conservation of fire-prone ecosystems.",0,1 +347,Default Bayesian model determination methods for generalised linear mixed models,"A default strategy for fully Bayesian model determination for generalised linear mixed models (GLMMs) is considered which addresses the two key issues of default prior specification and computation. In particular, the concept of unit-information priors is extended to the parameters of a GLMM. A combination of Markov chain Monte Carlo (MCMC) and Laplace approximations is used to compute approximations to the posterior model probabilities to find a subset of models with high posterior model probability. Bridge sampling is then used on the models in this subset to approximate the posterior model probabilities more accurately. The strategy is applied to four examples.",0,1 +348,Mixture or Homogeneous? Comment on Bauer and Curran (2003).,"D. J. Bauer and P. J. Curran (2003) raised some interesting issues with respect to mixture models of growth curves. Many useful lessons can be learned from their work, and more can be learned by extending the inquiry in related directions. These lessons involve the following issues: (a) what a mixture distribution looks like, (b) the meaning of the term homogeneous distribution, (c) the importance of model checking, (d) advantages and disadvantages of using mixtures and similar procedures to approximate complicated distributions, and (e) intrinsic versus nonintrinsic transformability.",0,1 +349,A comparison of girls' and boys' aggressive-disruptive behavior trajectories across elementary school: Prediction to young adult antisocial outcomes.,"Multiple group analysis and general growth mixture modeling was used to determine whether aggressive- disruptive behavior trajectories during elementary school, and their association with young adulthood antisocial outcomes, vary by gender. Participants were assessed longitudinally beginning at age 6 as part of an evaluation of 2 school-based preventive programs. Two analogous trajectories were found for girls and boys: chronic high aggression- disruption (CHAD) and stable low aggression- disruption (LAD). A 3rd class of low moderate aggression- disruption (LMAD) for girls and increasing aggression- disruption (IAD) for boys also was found. Girls and boys in analogous CHAD classes did not differ in trajectory level and course, but girls in the CHAD and LAD classes had lower rates of antisocial outcomes than boys. Girls with the LMAD trajectory differed from boys with the IAD trajectory.",0,1 +350,Foliar interception of radionuclides in dry conditions: a meta-analysis using a Bayesian modeling approach,"Uncertainty on the parameters that describe the transfer of radioactive materials into the (terrestrial) environment may be characterized thanks to datasets such as those compiled within International Atomic Energy Agency (IAEA) documents. Nevertheless, the information included in these documents is too poor to derive a relevant and informative uncertainty distribution regarding dry interception of radionuclides by the pasture grass and the leaves of vegetables. In this paper, 145 sets of dry interception measurements by the aboveground biomass of specific plants were collected from published scientific papers. A Bayesian meta-analysis was performed to derive the posterior probability distributions of the parameters that reflect their uncertainty given the collected data. Four competing models were compared in terms of both fitting performances and predictive abilities to reproduce plausible dry interception data. The asymptotic interception factor, applicable whatever the species and radionuclide to the highest aboveground biomass values (e.g. mature leafy vegetables), was estimated with the best model, to be 0.87 with a 95% credible interval (0.85, 0.89).",0,1 +351,On the Performance of Maximum Likelihood Versus Means and Variance Adjusted Weighted Least Squares Estimation in CFA,"This simulation study compared maximum likelihood (ML) estimation with weighted least squares means and variance adjusted (WLSMV) estimation. The study was based on confirmatory factor analyses with 1, 2, 4, and 8 factors, based on 250, 500, 750, and 1,000 cases, and on 5, 10, 20, and 40 variables with 2, 3, 4, 5, and 6 categories. There was no model misspecification. The most important results were that with 2 and 3 categories the rejection rates of the WLSMV chi-square test corresponded much more to the expected rejection rates according to an alpha level of. 05 than the rejection rates of the ML chi-square test. The magnitude of the loadings was more precisely estimated by means of WLSMV when the variables had only 2 or 3 categories. The sample size for WLSMV estimation needed not to be larger than the sample size for ML estimation.",0,1 +352,Traits versus Issues,"As female candidates may face greater challenges in establishing their “qualifications” for office, coverage of their personal traits may be pernicious, because it tends to de-emphasize substantive qualifications. This study focuses on relative amounts of trait and issue coverage of contests with and without women candidates. We find that races with female candidates yield more coverage of traits than male versus male contests and races with female candidates are less likely to generate issue coverage than trait coverage. Candidate gender and office interact; female gubernatorial candidates are most likely to garner trait coverage and least likely to engender issue coverage.",0,1 +353,Selective Monoacylglycerol Lipase Inhibitors: Antinociceptive versus Cannabimimetic Effects in Mice,"The endogenous cannabinoid 2-arachidonoylglycerol (2-AG) plays an important role in a variety of physiologic processes, but its rapid breakdown by monoacylglycerol lipase (MAGL) results in short-lived actions. Initial MAGL inhibitors were limited by poor selectivity and low potency. In this study, we tested JZL184 [4-nitrophenyl 4-[bis(2H-1,3-benzodioxol-5-yl)(hydroxy)methyl]piperidine-1-carboxylate] and MJN110 [2,5-dioxopyrrolidin-1-yl 4-(bis(4-chlorophenyl)methyl)piperazine-1-carboxylate], MAGL inhibitors that possess increased selectivity and potency, in mouse behavioral assays of neuropathic pain [chronic constriction injury (CCI) of the sciatic nerve], interoceptive cannabimimetic effects (drug-discrimination paradigm), and locomotor activity in an open field test. MJN110 (1.25 and 2.5 mg/kg) and JZL184 (16 and 40 mg/kg) significantly elevated 2-AG and decreased arachidonic acid but did not affect anandamide in whole brains. Both MAGL inhibitors significantly reduced CCI-induced mechanical allodynia with the following potencies [ED50 (95% confidence limit [CL]) values in mg/kg: MJN110 (0.43 [0.30-0.63]) > JZL184 (17.8 [11.6-27.4])] and also substituted for the potent cannabinoid receptor agonist CP55,940 [2-[(1R,2R,5R)-5-hydroxy-2-(3-hydroxypropyl)cyclohexyl]-5-(2-methyloctan-2-yl)phenol] in the drug-discrimination paradigm [ED50 (95% CL) values in mg/kg: MJN110 (0.84 [0.69-1.02]) > JZL184 (24.9 [14.6-42.5])]; however, these compounds elicited differential effects on locomotor behavior. Similar to cannabinoid 1 (CB1) receptor agonists, JZL184 produced hypomotility, whereas MJN110 increased locomotor behavior and did not produce catalepsy or hypothermia. Although both drugs substituted for CP55,940 in the drug discrimination assay, MJN110 was more potent in reversing allodynia in the CCI model than in producing CP55,940-like effects. Overall, these results suggest that MAGL inhibition may alleviate neuropathic pain, while displaying limited cannabimimetic effects compared with direct CB1 receptor agonists.",0,1 +354,Task complexity and contingent processing in decision making: An information search and protocol analysis,"Abstract Two process tracing techniques, explicit information search and verbal protocols, were used to examine the information processing strategies subjects use in reaching a decision. Subjects indicated preferences among apartments. The number of alternatives available and number of dimensions of information available was varied across sets of apartments. When faced with a two alternative situation, the subjects employed search strategies consistent with a compensatory decision process. In contrast, when faced with a more complex (multialternative) decision task, the subjects employed decision strategies designed to eliminate some of the available alternatives as quickly as possible and on the basis of a limited amount of information search and evaluation. The results demonstrate that the information processing leading to choice will vary as a function of task complexity. An integration of research in decision behavior with the methodology and theory of more established areas of cognitive psychology, such as human problem solving, is advocated.",0,1 +355,Latent class metric conjoint analysis,"A latent class methodology for conjoint analysis is proposed, which simultaneously estimates market segment membership and part-worth utilities for each derived market segment using mixtures of multivariate conditional normal distributions. An E-M algorithm to estimate the parameters of these mixtures is briefly discussed. Finally, an application of the methodology to a commercial study (pretest) examining the design of a remote automobile entry device is presented.",0,1 +356,Tactile flash lag effect: Taps with changing intensities lead briefly flashed taps,"A brief flash, presented in spatial alignment with a moving object, appears to lag behind the moving object. This illusion has been known as the visual flash lag effect. Sheth et al. (2000) demonstrated that when observers compared the colors of a linear array of flashing circular disks with that of a concurrently-flashed disk of the same color, the former was perceived to lead the latter. An analogous tactile flash-lag illusion is reported here. A sequence of tactile taps with increasing (or decreasing) intensity was presented on one finger. The temporally-middle tap in the sequence was perceived to be weaker in both cases than a synchronous single tap on another finger. This illusion could be accounted by a mechanism of temporal compensation and tactile masking.",0,1 +357,Statistical analysis of nonlinear structural equation models with continuous and polytomous data,"A general nonlinear structural equation model with mixed continuous and polytomous variables is analysed. A Bayesian approach is proposed to estimate simultaneously the thresholds, the structural parameters and the latent variables. To solve the computational difficulties involved in the posterior analysis, a hybrid Markov chain Monte Carlo method that combines the Gibbs sampler and the Metropolis-Hasting algorithm is implemented to produce the Bayesian solution. Statistical inferences, which involve estimation of parameters and their standard errors, residuals and outliers analyses, and goodness-of-fit statistics for testing the posited model, are discussed. The proposed procedure is illustrated by a simulation study and a real example.",0,1 +358,The New Person-Specific Paradigm in Psychology,"Most research methodology in the behavioral sciences employs interindividual analyses, which provide information about the state of affairs of the population. However, as shown by classical mathematical-statistical theorems (the ergodic theorems), such analyses do not provide information for, and cannot be applied at, the level of the individual, except on rare occasions when the processes of interest meet certain stringent conditions. When psychological processes violate these conditions, the interindividual analyses that are now standardly applied have to be replaced by analysis of intraindividual variation in order to obtain valid results. Two illustrations involving analysis of intraindividual variation of personality and emotional processes are given.",0,1 +359,The impact of transitions into wage-employment for satisfied and unsatisfied entrepreneurs,"Purpose – Should unsatisfied/satisfied entrepreneurs transition into wage-employment? The purpose of this paper is to investigate the financial, physical, social and emotional consequences of the decision. Design/methodology/approach – The paper uses an Australian, nationally representative panel for two Bayesian multivariate regressions. Findings – Unsatisfied entrepreneurs that transition from self- to wage-employment improve their income, life and job satisfaction. For satisfied entrepreneurs, continuing or transitioning makes little difference: job and life satisfaction develop similarly. The health of continuing entrepreneurs suffers regardless of whether they are satisfied or unsatisfied. Research limitations/implications – Unobserved heterogeneity is only addressed within cohorts, not across cohorts. It is possible, that transitioning entrepreneurs are inherently different from continuing entrepreneurs. Further research could include a more fine-grained study of entrepreneurship’s negative health implications or include work-family balance as return to self-employment. Practical implications – The findings offer clear advice to entrepreneurs that are unsatisfied with their venture: they will likely benefit from transitioning to wage-employment. In addition, it offers a warning to individuals with existing health issues who are considering self-employment. Originality/value – Academic interest in entrepreneurship exit is growing. This paper is the first to study the financial, physical, social and emotional life consequences of both satisfied and unsatisfied entrepreneurs. It contributes to the discussion of what motivates entrepreneurs to become and remain self-employed.",0,1 +360,Effects of Video Feedback on Early Coercive Parent–Child Interactions: The Intervening Role of Caregivers’ Relational Schemas,"We examined the effect of adding a video feedback intervention component to the assessment feedback session of the Family Check-Up (FCU) intervention (Dishion & Stormshak, 2007). We hypothesized that the addition of video feedback procedures during the FCU feedback at child age 2 would have a positive effect on caregivers' negative relational schemas of their child, which in turn would mediate reductions in observed coercive caregiver-child interactions assessed at age 5. We observed the caregiver-child interaction videotapes of 79 high-risk families with toddlers exhibiting clinically significant problem behaviors. A quasi-random sample of families was provided with direct feedback on their interactions during the feedback session of the FCU protocol. Path analysis indicated that reviewing and engaging in feedback about videotaped age 2 assessment predicted reduced caregivers' negative relational schemas of the child at age 3, which acted as an intervening variable on the reduction of observed parent-child coercive interactions recorded at age 5. Video feedback predicted improved family functioning over and above level of engagement in the FCU in subsequent years, indicating the important incremental contribution of using video feedback procedures in early family-based preventive interventions for problem behaviors. Supportive video feedback on coercive family dynamics is an important strategy for promoting caregiver motivation to reduce negative attributions toward the child, which fuel coercive interactions. Our study also contributes to the clinical and research literature concerning coercion theory and effective intervention strategies by identifying a potential mechanism of change.",0,1 +361,Fixed- and random-effects meta-analytic structural equation modeling: Examples and analyses in R,"Meta-analytic structural equation modeling (MASEM) combines the ideas of meta-analysis and structural equation modeling for the purpose of synthesizing correlation or covariance matrices and fitting structural equation models on the pooled correlation or covariance matrix. Cheung and Chan (Psychological Methods 10:40-64, 2005b, Structural Equation Modeling 16:28-53, 2009) proposed a two-stage structural equation modeling (TSSEM) approach to conducting MASEM that was based on a fixed-effects model by assuming that all studies have the same population correlation or covariance matrices. The main objective of this article is to extend the TSSEM approach to a random-effects model by the inclusion of study-specific random effects. Another objective is to demonstrate the procedures with two examples using the metaSEM package implemented in the R statistical environment. Issues related to and future directions for MASEM are discussed. © 2013 Psychonomic Society, Inc.",0,1 +362,Bayesian analysis of two-level nonlinear structural equation models with continuous and polytomous data,"Two-level structural equation models with mixed continuous and polytomous data and nonlinear structural equations at both the between-groups and within-groups levels are important but difficult to deal with. A Bayesian approach is developed for analysing this kind of model. A Markov chain Monte Carlo procedure based on the Gibbs sampler and the Metropolis-Hasting algorithm is proposed for producing joint Bayesian estimates of the thresholds, structural parameters and latent variables at both levels. Standard errors and highest posterior density intervals are also computed. A procedure for computing Bayes factor, based on the key idea of path sampling, is established for model comparison.",0,1 +363,Estimation with Quadratic Loss,"It has long been customary to measure the adequacy of an estimator by the smallness of its mean squared error. The least squares estimators were studied by Gauss and by other authors later in the nineteenth century. A proof that the best unbiased estimator of a linear function of the means of a set of observed random variables is the least squares estimator was given by Markov [12], a modified version of whose proof is given by David and Neyman [4]. A slightly more general theorem is given by Aitken [1]. Fisher [5] indicated that for large samples the maximum likelihood estimator approximately minimizes the mean squared error when compared with other reasonable estimators. This paper will be concerned with optimum properties or failure of optimum properties of the natural estimator in certain special problems with the risk usually measured by the mean squared error or, in the case of several parameters, by a quadratic function of the estimators. We shall first mention some recent papers on this subject and then give some results, mostly unpublished, in greater detail.",0,1 +364,Asymptotic accuracy of distribution-based estimation of latent variables,"Hierarchical statistical models are widely employed in information science and data engineering. The models consist of two types of variables: observable variables that represent the given data and latent variables for the unobservable labels. An asymptotic analysis of the models plays an important role in evaluating the learning process; the result of the analysis is applied not only to theoretical but also to practical situations, such as optimal model selection and active learning. There are many studies of generalization errors, which measure the prediction accuracy of the observable variables. However, the accuracy of estimating the latent variables has not yet been elucidated. For a quantitative evaluation of this, the present paper formulates distribution-based functions for the errors in the estimation of the latent variables. The asymptotic behavior is analyzed for both the maximum likelihood and the Bayes methods.",0,1 +365,Parameter estimation of multiple item response profile model,"Multiple item response profile (MIRP) models are models with crossed fixed and random effects. At least one between-person factor is crossed with at least one within-person factor, and the persons nested within the levels of the between-person factor are crossed with the items within levels of the within-person factor. Maximum likelihood estimation (MLE) of models for binary data with crossed random effects is challenging. This is because the marginal likelihood does not have a closed form, so that MLE requires numerical or Monte Carlo integration. In addition, the multidimensional structure of MIRPs makes the estimation complex. In this paper, three different estimation methods to meet these challenges are described: the Laplace approximation to the integrand; hierarchical Bayesian analysis, a simulation-based method; and an alternating imputation posterior with adaptive quadrature as the approximation to the integral. In addition, this paper discusses the advantages and disadvantages of these three estimation methods for MIRPs. The three algorithms are compared in a real data application and a simulation study was also done to compare their behaviour.",0,1 +366,The analysis of very small samples of repeated measurements I: An adjusted sandwich estimator,"The statistical analysis of repeated measures or longitudinal data always requires the accommodation of the covariance structure of the repeated measurements at some stage in the analysis. The general linear mixed model is often used for such analyses, and allows for the specification of both a mean model and a covariance structure. Often the covariance structure itself is not of direct interest, but only a means to producing valid inferences about the response. Existing methods of analysis are often inadequate where the sample size is small. More precisely, statistical measures of goodness of fit are not necessarily the right measure of the appropriateness of a covariance structure and inferences based on conventional Wald-type procedures do not approximate sufficiently well their nominal properties when data are unbalanced or incomplete. This is shown to be the case when adopting the Kenward-Roger adjustment where the sample size is very small. A generalization of an approach to Wald tests using a bias-adjusted empirical sandwich estimator for the covariance matrix of the fixed effects parameters from generalized estimating equations is developed for Gaussian repeated measurements. This is shown to attain the correct test size but has very low power. Copyright © 2010 John Wiley & Sons, Ltd.",0,1 +367,"National Uniformity, and State and Local Effects on Australian Voting: A Multilevel Approach","The existence and extent of influences arising within spatial contexts is an important issue in the study of voting behaviour. This paper extends previous Australian research by using the relatively new technique of multilevel analysis to draw together individual survey data from the 1993 Australian Election Study and ecological census data to investigate the question. The results show that, once individual voter characteristics are taken into account, influences on first preference voting for the ALP at the 1993 election were quite uniform nationally, with relatively small spatial variations. Moreover, those spatial variations which were present were at the divisional, not the state, level and can be almost completely explained by a very small number of sociotropic factors, especially a local economic prosperity influence and the well-known rural-urban cleavage. As far as influences on voting at the 1993 election at the level of individual voters are concerned, these multilevel analyses provide some new ...",0,1 +368,"To Bayes or Not to Bayes, From Whether to When: Applications of Bayesian Methodology to Modeling","This article presents relevant research on Bayesian methods and their major applications to modeling in an effort to lay out differences between the frequentist and Bayesian paradigms and to look at the practical implications of these differences. Before research is reviewed, basic tenets and methods of the Bayesian approach to modeling are presented and contrasted with basic estimation results from a frequentist perspective. It is argued that Bayesian methods have become a viable alternative to traditional maximum likelihood-based estimation techniques and may be the only solution for more complex psychometric data structures. Hence, neither the applied nor the theoretical measurement community can afford to neglect the exciting new possibilities that have opened up on the psychometric horizon.",0,1 +369,"Collinearity, Bias, and Effect Size: Modeling “the” Effect of Track on Achievement","Abstract The estimated effect of any factor can be highly dependent on both the model and the data used for the analyses. This article presents an example of the estimated effect of one factor in two different data sets under three different forms of the standard linear model using the effect of track placement on achievement as an example. Some relative advantages and disadvantages of each model are considered. The analyses demonstrate that, given collinearity among the predictor variables, a model with a poorer statistical fit may be useful for some interpretive purposes.",0,1 +370,Analysis of structural equation models with Incomplete Polytomous Data,"A two-stage estimation procedure is developed to analyze structural equation models of polytomous variables based on incomplete data. At the first stage, the partition maximum likelihood approach is used to obtain the estimates of the elements in the correlation matrix. It will be shown that the asymptotic distribution of these estimates is jointly multivariate normal. The second stage estimates the structural parameters in the correlation matrix by the generalized least squared approach with a correctly specified weight matrix. Asymptotic properties of the second stage estimates are also provided. Extension of the theory to multisample models, and some illustrative examples are also included.",0,1 +371,A Two-Component G-Prior for Variable Selection,"We present a Bayesian variable selection method based on an extension of the Zellner’s g-prior in linear models. More specifically, we propose a two-component G-prior, wherein a tuning parameter, calibrated by use of pseudo-variables, is introduced to adjust the distance between the two components. We show that implementing the proposed prior in variable selection is more efficient than using the Zellner’s g-prior. Simulation results also indicate that models selected using the method with the two-component G-prior are generally more favorable with smaller losses compared to other methods considered in our work. The proposed method is further demonstrated using our motivating gene expression data from a lung disease study, and ozone data analyzed in earlier studies.",0,1 +372,Rationality in psychological research: The good-enough principle.," This article reexamines a number of methodological and procedural issues raised by Meehl (1967, 1978) seem to question rationality of psychological inquiry. The first issue concerns asymmetry in theory testing between psychology and physics and resulting paradox that, because psychological null hypothesis is always false, increases in precision in psychology always lead to weaker tests of a theory, whereas converse is true in physics. The second issue, related to first, regards slow progress observed in psychological research and seeming unwillingness of social scientists to take seriously Popperian requirements for intellectual honesty. We propose a principle to resolve Meehl's methodological paradox and appeal to a more powerful reconstruction of science developed by Lakatos (1978a, 1978b) to account for actual practice of psychological researchers. From time to time every research discipline must reevaluate its method for generating and certifying knowledge. The actual practice of working scientists in a discipline must continually be subjected to severe criticism and be held accountable to standards of intellectual honesty, standards are themselves revised in light of critical appraisal (Lakatos, 1978a). If, on a metatheoretical level, scientific methodology cannot be defended on rational grounds, then metatheory must be reconstructed so as to make science rationally justifiable. The history of science is replete with numerous such reconstructions, from portrayal of science as being inductive and justificationist, to more recent reconstructions favored by (naive and sophisticated) methodological falsificationists, such as Popper (1959), Lakatos (1978a), and Zahar (1973). In last two decades psychology, too, has been subjected to criticism for its research methodology. Of increasing concern is empirical psychology's use of inferential hypothesis-testing techniques and way in which information derived from these procedures is used to help us make decisions about theories under test (e.g., Bakan, 1966; Lykken, 1968; Rozeboom, 1960). In two penetrating essays, Meehl (1967, 1978) has cogently and effectively faulted use of traditional null-hypothesis significance test in psychological research. According to Meehl (1978, p. 817), the almost universal reliance on merely refuting null hypothesis as standard method for corroborating substantive theories [in psychology] is a terrible mistake, is basically unsound, poor scientific strategy, and one of worst things ever happened in history of He maintained it leads to a methodological paradox when compared to theory testing in physics. In addition, Meehl (1978) pointed to apparently slow progress in psychological research and deleterious effect null-hypothesis testing has had on detection of progress in accumulation of psychological knowledge. The cumulative effect of this criticism is to do nothing less than call into question rational character of our empirical inquiries. As yet there has been no attempt to deal with problems raised by Meehl by reconstructing actual practice of psychologists into a logically defensible form. This is purpose of present article. The two articles by Meehl seem to deal with two disparate issues--null-hypothesis testing and slow progress. Both issues, however, are linked in methodological falsificationist reconstruction of science to necessity for scientists to agree on what experimental outcomes are to be considered as disconfirming instances. We will argue methodological paradox can be ameliorated with help of a good-enough principle, to be proposed here, so hypothesis testing in psychology is not rationally disadvantaged when compared to physics. We will also account for apparent slow progress in psychological research, and we will take issue with certain (though not all) claims made by Meehl (1978) in this regard. Both methodological and progress issues will be resolved by an appeal to (sophisticated) methodological falsificationist reconstruction of science developed by Lakatos (1978a), an approach with which Meehl is familiar but one he did not apply to psychology in his articles. January 1985 • American Psychologist Copyright 1985 by American Psychological Association, Inc. 0003-066X/85/$00.75 Vol. 40, No. 1, 73-83 73 Meehl's Asymmetry Argument Let us develop Meehl's argument. It is his contention improved measurement precision has widely different effects in psychology and physics on success of a theory in overcoming an observational hurdle. Perfect precision in behavioral provides an easier hurdle for theories, whereas such accuracy in physics makes it much more difficult for a theory to survive. According to Popperian reconstruction of science (Popper, 1959), scientific theories must be continually subjected to severe tests. But if social are immanently incapable of generating such tests, if they cannot expose their theories to strongest possible threat of refutation, even with ever-increasing measurement precision, then their claim to scientific status might reasonably be questioned. Further, according to this view of research in social sciences, there can be no question of scientific progress based on rational consideration of experimental outcomes. Instead, progress is more a matter of psychological conversion (Kuhn, 1962). Let us look more closely at standard practice in psychology. On basis of some theory T we derive conclusion a parameter 6 will differ for two populations. In order to examine this conclusion, we can set up a point-null hypothesis, Ho: = 0, and test this hypothesis against predicted outcome, H~: 6 4: 0. However, it has also been recognized (Kaiser, 1960; Kimmel, 1957) another question of interest is whether difference is in a certain direction, and so we could instead test directional null hypothesis, I-I~: 6 ~ 0, against directional alternative, H*: ~ > 0. In such tests, we can make two types of errors. The Type I error would lead to rejecting Ho or H~ when they are indeed true, whereas Type II error involves not rejecting Ho or HJ when they are false. The conventional methodology sets Type I (or alpha) error rate at 5% and seeks to reduce frequency of Type II errors. Such a reduction in Type II error rate can be achieved by improving logical structure of experiment, reducing measurement errors, or increasing sample size. Meehl pointed out in behavioral sciences, because of large number of factors affecting variables, we would never expect two populations to have literally equal means. Hence, he concluded An earlier version of this article was read at 1983 meeting of American Educational Research Association. The authors are grateful to Robbie Case, Joel R. Lcvin, and Leonard Marascuilo for reading earlier drafts, and to Crescent L. Kringle for her help with manuscript. Requests for reprints should be sent to Ronald C. Serlin, Department of Educational Psychology, University of Wisconsin, Madison, Wisconsin 53706. point-null hypothesis is always false. With infinite precision, we would always reject Ho. This is perhaps one reason to prefer directional null hypothesis H~. But Meehl then conducted a thought experiment in which direction predicted by T was assigned at random. In such an experiment, T provides no logical connection to predicted direction and so is totally without merit. Because H0 is always false, two populations will always differ, but because direction in H~ is assigned at random, with infinite precision we will reject HJ half of time. Hence, Meehl concluded that effect of increased p r e c i s i o n . . , is to yield a probability approaching 1/2 of corroborating our substantive theory by a significance test, even i f theory is totally without merit (Meehl, 1967, p. 111, emphasis in original). Meehl contrasted this state of affairs with in physics, wherein usual situation involves prediction of a point value. That which corresponds to point-null hypothesis is value flowing as a consequence of a substantive theory T. An increase in statistical power in physics has effect of stiffening experimental hurdle by 'decreasing prior probability of a successful experimental outcome if theory lacks verisimilitude, is, precisely reverse of situation obtaining in social sciences (Meehl, 1967, p. 113). With infinite precision, and if theory has no merit, logical probability of it surviving such a test in physics is negligible; in social sciences, this logical probability for H~ is one half. Perhaps another way of describing asymmetry in hypothesis testing between psychology and physics is to note that, in psychology, point-null hypothesis is not what is derived from a substantive theory. Rather, it is a straw-man competitor whose rejection we interpret as increasing plausibility of T. In physics, on other hand, theories entail point-null statistical hypotheses are very ones physicists take seriously and hope to confirm. If 0 is a predicted outcome of interest, and 0 is its logical complement, then depiction of null and alternative statistical hypotheses in two disciplines can be written as follows:",0,1 +373,Salesperson CLV orientation's effect on performance,"Abstract Previous studies show how strategies based on the customer lifetime value (CLV) can lead to an increase of profitability for a firm. In this context, marketing serves the purpose of maximizing CLV and customer equity (the CLV of current and future customers). For most types of service firms, salespeople are direct participants in implementing the CLV concept. However, prior research does not answer the question of whether or how salesperson CLV orientation can enhance profits. Using data on salespeople in a large Chilean retail bank, this study shows that the effect of salesperson CLV orientation on salesperson performance follows an S-shaped function (which is first convex and then concave). Additionally, data does not support the idea that the optimum level of CLV orientation depends on salesperson customer orientation, salesperson adaptive selling behavior, or salesperson experience (i.e., CLV-oriented behaviors could be effective across a wide range of salespeople). As such, this study addresses an important concern among researchers and managers that is related to how to increase the salesperson performance. The findings of this study suggest that firms need to monitor individual salesperson CLV orientation more closely.",0,1 +374,Bayesian Cohort and Cross-Sectional Analyses of the PINCER Trial: A Pharmacist-Led Intervention to Reduce Medication Errors in Primary Care,"Medication errors are an important source of potentially preventable morbidity and mortality. The PINCER study, a cluster randomised controlled trial, is one of the world's first experimental studies aiming to reduce the risk of such medication related potential for harm in general practice. Bayesian analyses can improve the clinical interpretability of trial findings.Experts were asked to complete a questionnaire to elicit opinions of the likely effectiveness of the intervention for the key outcomes of interest--three important primary care medication errors. These were averaged to generate collective prior distributions, which were then combined with trial data to generate bayesian posterior distributions. The trial data were analysed in two ways: firstly replicating the trial reported cohort analysis acknowledging pairing of observations, but excluding non-paired observations; and secondly as cross-sectional data, with no exclusions, but without acknowledgement of the pairing. Frequentist and bayesian analyses were compared.Bayesian evaluations suggest that the intervention is able to reduce the likelihood of one of the medication errors by about 50 (estimated to be between 20% and 70%). However, for the other two main outcomes considered, the evidence that the intervention is able to reduce the likelihood of prescription errors is less conclusive.Clinicians are interested in what trial results mean to them, as opposed to what trial results suggest for future experiments. This analysis suggests that the PINCER intervention is strongly effective in reducing the likelihood of one of the important errors; not necessarily effective in reducing the other errors. Depending on the clinical importance of the respective errors, careful consideration should be given before implementation, and refinement targeted at the other errors may be something to consider.",0,1 +375,Factorial invariance of LibQUAL+® as a measure of library service quality over time,"Abstract LibQUAL+® is an instrument purported to measure three dimensions of library service quality: service affect, library as a place, and information control. After changes were made to the instrument in 2003, however, no confirmatory factor analyses have been published in peer-reviewed journals affirming the three-factor structure of LibQUAL+®. These deficiencies were addressed by testing the hypothesized three-factor structure and the stability of that structure over time. Specifically, data from three samples (n = 550; n = 3261; n = 2103) were collected over a five-year period and analyzed using a multi-group confirmatory factor analysis. Results suggest that the theoretical model fit the data across the three samples and demonstrates factorial invariance over time. Multicollinearity between affect of service and information control, however, indicate that service quality may be measured as two dimensions rather than three, providing a more parsimonious explanation of service quality.",0,1 +376,Distributional Assumptions of Growth Mixture Models: Implications for Overextraction of Latent Trajectory Classes.,"Growth mixture models are often used to determine if subgroups exist within the population that follow qualitatively distinct developmental trajectories. However, statistical theory developed for finite normal mixture models suggests that latent trajectory classes can be estimated even in the absence of population heterogeneity if the distribution of the repeated measures is nonnormal. By drawing on this theory, this article demonstrates that multiple trajectory classes can be estimated and appear optimal for nonnormal data even when only 1 group exists in the population. Further, the within-class parameter estimates obtained from these models are largely uninterpretable. Significant predictive relationships may be obscured or spurious relationships identified. The implications of these results for applied research are highlighted, and future directions for quantitative developments are suggested.",0,1 +377,Oscillatory Brain State Predicts Variability in Working Memory,"Our capacity to remember and manipulate objects in working memory (WM) is severely limited. However, this capacity limitation is unlikely to be fixed because behavioral models indicate variability from trial to trial. We investigated whether fluctuations in neural excitability at stimulus encoding, as indexed by low-frequency oscillations (in the alpha band, 8-14 Hz), contribute to this variability. Specifically, we hypothesized that the spontaneous state of alpha band activity would correlate with trial-by-trial fluctuations in visual WM. Electroencephalography recorded from human observers during a visual WM task revealed that the prestimulus desynchronization of alpha oscillations predicts the accuracy of memory recall on a trial-by-trial basis. A model-based analysis indicated that this effect arises from a modulation in the precision of memorized items, but not the likelihood of remembering them (the recall rate). The phase of posterior alpha oscillations preceding the memorized item also predicted memory accuracy. Based on correlations between prestimulus alpha levels and stimulus-related visual evoked responses, we speculate that the prestimulus state of the visual system prefigures a cascade of state-dependent processes, ultimately affecting WM-guided behavior. Overall, our results indicate that spontaneous changes in cortical excitability can have profound consequences for higher visual cognition.",0,1 +378,Investigating spousal influence using moment-to-moment affect data from marital conflict.,"Gottman and colleagues proposed using a dynamical systems model to study dyadic interaction in marriage. In this model, each spouse's affect in each 6-s window is described as a function of an uninfluenced linear steady state and a nonlinear influence function of the partner's affect in the previous window. Recently, an alternative parameter estimation procedure for the equations of marriage was introduced, which is based on threshold autoregressive models. We apply this estimation procedure to data from a study of couples (N = 124) and newlyweds (N = 130) to compare different forms of spousal influence using the Bayesian information criterion. Although results show some statistically significant evidence for influence, this is only slightly greater than what would be expected by random association. One model of influence does not fit all couples. This suggests that for many people initial state and emotional inertia dictate the outcome of the conflict discussion far more than the moment-to-moment affect of the spouse. This latter finding is in conflict with most models of couples' interaction, which suggest that the outcome of conflict discussions are determined by the nature of the couples' mutual influence processes.",0,1 +379,Bayesian Computation and Stochastic Systems,"Markov chain Monte Carlo (MCMC) methods have been used extensively in statistical physics over the last 40 years, in spatial statistics for the past 20 and in Bayesian image analysis over the last decade. In the last five years, MCMC has been introduced into significance testing, general Bayesian inference and maximum likelihood estimation. This paper presents basic methodology of MCMC, emphasizing the Bayesian paradigm, conditional probability and the intimate relationship with Markov random fields in spatial statistics. Hastings algorithms are discussed, including Gibbs, Metropolis and some other variations. Pairwise difference priors are described and are used subsequently in three Bayesian applications, in each of which there is a pronounced spatial or temporal aspect to the modeling. The examples involve logistic regression in the presence of unobserved covariates and ordinal factors; the analysis of agricultural field experiments, with adjustment for fertility gradients; and processing of low-resolution medical images obtained by a gamma camera. Additional methodological issues arise in each of these applications and in the Appendices. The paper lays particular emphasis on the calculation of posterior probabilities and concurs with others in its view that MCMC facilitates a fundamental breakthrough in applied Bayesian modeling.",0,1 +380,Ignoring Clustering in Confirmatory Factor Analysis: Some Consequences for Model Fit and Standardized Parameter Estimates,"In many situations, researchers collect multilevel (clustered or nested) data yet analyze the data either ignoring the clustering (disaggregation) or averaging the micro-level units within each cluster and analyzing the aggregated data at the macro level (aggregation). In this study we investigate the effects of ignoring the nested nature of data in confirmatory factor analysis (CFA). The bias incurred by ignoring clustering is examined in terms of model fit and standardized parameter estimates, which are usually of interest to researchers who use CFA. We find that the disaggregation approach increases model misfit, especially when the intraclass correlation (ICC) is high, whereas the aggregation approach results in accurate detection of model misfit in the macro level. Standardized parameter estimates from the disaggregation and aggregation approaches are deviated toward the values of the macro- and micro-level standardized parameter estimates, respectively. The degree of deviation depends on ICC and cluster size, particularly for the aggregation method. The standard errors of standardized parameter estimates from the disaggregation approach depend on the macro-level item communalities. Those from the aggregation approach underestimate the standard errors in multilevel CFA (MCFA), especially when ICC is low. Thus, we conclude that MCFA or an alternative approach should be used if possible.",0,1 +381,Variable Selection and Covariance Selection in Multivariate Regression Models,This article provides a general framework for Bayesian variable selection and covariance selection in a multivariate regression model with Gaussian errors. By variable selection we mean allowing certain regression coefficients to be zero. By covariance selection we mean allowing certain elements of the inverse covariance matrix to be zero. We estimate all the model parameters by model averaging using a Markov chain Monte Carlo simulation method. The methodology is illustrated by applying it to four real data sets. The effectiveness of variable selection and covariance selection in estimating the multivariate regression model is assessed by using four loss functions and four simulated data sets. Each of the simulated data sets is based on parameter estimates obtained from a corresponding real data set.,0,1 +382,The Nelder-Mead Simplex Procedure for Function Minimization,"The Nelder-Mead simplex method for function minimization is a “direct” method requiring no derivatives. The objective function is evaluated at the vertices of a simplex, and movement is away from the poorest value. The process is adaptive, causing the simplexes to be continually revised to best conform to the nature of the response surface. The generality of the method is illust'rated by using it. to solve six problems appearing in the May 1973 issue of Technometrics.",0,1 +383,Cultural consensus theory for multiple consensus truths,"Abstract Cultural Consensus Theory (CCT) is a popular information pooling methodology used in the social and behavioral sciences. CCT consists of cognitive models designed to determine a consensus truth shared by a group of informants (respondents), and to better understand the cognitive characteristics of the informants (e.g. level knowledge, response biases). However prior to this paper, no CCT models have been developed that allow the possibility of the informant responses to come from a mixture of two or more consensus answer patterns. The major advance in the current paper is to endow one of the popular CCT models, the General Condorcet Model (GCM) for dichotomous responses, with the possibility of having several latent consensus answer patterns, each corresponding to a different, latent subgroup of informants. In addition, we augment the model to allow the possibility of questions having differential difficulty (cultural saliency). This is the first CCT finite-mixture model, and it is named the Multi-Culture GCM (MC-GCM). The model is developed axiomatically and a notable property is derived that can suggest the appropriate number of mixtures for a given data set. The model is extended in a hierarchical Bayesian framework and its application is successfully demonstrated on both simulated and real data, including a new experimental data set on political viewpoints.",0,1 +384,Applications of Multilevel Structural Equation Modeling to Cross-Cultural Research,"Multilevel structural equation modeling (MSEM) has been proposed as an extension to structural equation modeling for analyzing data with nested structure. We have begun to see a few applications in cross-cultural research in which MSEM fits well as the statistical model. However, given that cross-cultural studies can only afford collecting data from a relatively small number of countries, the appropriateness of MSEM has been questioned. Using the data from the International Social Survey Program (1997; N = 15,244 from 27 countries), we first showed how Muth�n's MSEM procedure could be applied to a real data set on cross-cultural research. Given a small country-level sample size (27 countries) we then demonstrated that results on the individual level were quite stable even when using small individual-level sample sizes, whereas the group-level parameter estimates and their standard errors were affected unsystematically by varying individual-level sample sizes. Use of the findings for cross-cultural researc...",0,1 +385,Association between somatic cell count early in the first lactation and the longevity of Irish dairy cows,"Reduced longevity of cows is an important component of mastitis costs, and increased somatic cell count (SCC) early in the first lactation has been reported to increase culling risk throughout the first lactation. Generally, cows must survive beyond the first lactation to break even on their rearing costs. The aim of this research was to assess the association between SCC of primiparous cows at 5 to 30 days in milk (SCC1), and survival over a 5-y period for cows in Irish dairy herds. The data set used for model development was based on 147,458 test day records from 7,537 cows in 812 herds. Cows were censored at their last recording if identified at a later date in other herds or if recorded at the last available test date for their herd, otherwise, date of disposal was taken to be at the last test date for each cow. Survival time was calculated as the number of days between the dates of first calving and the last recording, which was split into 50-d intervals. Data were analyzed in discrete time logistic survival models that accounted for clustering of 50-d intervals within cows, and cows within herds. Models were fitted in a Bayesian framework using Markov chain Monte Carlo simulations. Model fit was assessed by comparison of posterior predictions to the observed disposal risk for cows aggregated by parameters in the model. Model usefulness was assessed by cross validation in a separate data set, which contained 144,113 records from 7,353 cows in 808 herds, and posterior predictions were compared with the observed disposal risk for cows aggregated by parameters of biological importance. Disposal odds increased by a factor of 5% per unit increase in ln SCC1. Despite this, posterior predictive distributions revealed that the probability of reducing replacement costs by >€10 per heifer calved, through decreasing the herd level prevalence of cows with SCC1 ≥ 400,000 cells/mL (from an initial prevalence of ≥ 20 to <10%) only exceeded 50% for less than 1 in 5 Irish herds. These results indicate that the effect of a reduction in the prevalence of cows with SCC1 ≥ 400,000 cells/mL on replacement costs alone for most Irish dairy herds is small, and future research should investigate other potential losses, such as the effect of SCC1 on lifetime milk yield.",0,1 +386,Influence of Transportation Access and Market Dynamics on Property Values,"This paper presents housing price models by using multilevel modeling techniques. The key motivation of using the multilevel modeling technique is that it clearly identifies and differentiates between-cluster heterogeneity (i.e., intrinsic differences across aggregated units) and heterogeneity between units of analysis that are nested within aggregated clusters. Two different specifications are tested: two-level spatial and mixed two-level spatiotemporal random effects models. Whereas the first specification assumes that dwelling units are nested within spatial clusters (i.e., neighborhoods), the second specification hypothesizes that dwelling units are nested within spatiotemporal clusters (neighborhoods in a given time period). The unique contribution of this paper is that it accounts for temporal heterogeneity simultaneously with spatial heterogeneity in the housing price models. The study uses an extensive sample of more than 250,000 housing property transactions in 1987–1995 in the Greater Toronto Area of Canada. The paper examines the functional form of the hedonic price model and chooses a semilogarithmic model for subsequent multilevel housing price modeling. The results suggest that the spatiotemporal model performs better in terms of explanatory power and parameter estimates.",0,1 +387,Item Clusters and Computerized Adaptive Testing: A Case for Testlets,"It is observed that many sorts of difficulties may preclude the uneventful construction of tests by a computerized algorithm, such as those currently in favor in Computerized Adaptive Testing (CAT). In this essay we discuss a number of these problems, as well as some possible avenues of solution. We conclude with the development of the “testlet,” a bundle of items that can be arranged either hierarchically or linearly, thus maintaining the efficiency of an adaptive test while keeping the quality control of test construction that is possible currently only with careful expert scrutiny. Performance on the separate testlets is aggregated to yield ability estimates.",0,1 +388,Effectiveness of training in organizations: A meta-analysis of design and evaluation features.,"The authors used meta-analytic procedures to examine the relationship between specified training design and evaluation features and the effectiveness of training in organizations. Results of the meta-analysis revealed training effectiveness sample-weighted mean ds of 0.60 (k = 15, N = 936) for reaction criteria, 0.63 (k = 234, N = 15,014) for learning criteria, 0.62 (k = 122, N = 15,627) for behavioral criteria, and 0.62 (k = 26, N = 1,748) for results criteria. These results suggest a medium to large effect size for organizational training. In addition, the training method used, the skill or task characteristic trained, and the choice of evaluation criteria were related to the effectiveness of training programs. Limitations of the study along with suggestions for future research are discussed.",0,1 +389,The parameters in the near-miss-to-Weber's law,"Abstract Many empirical data support the hypothesis that the sensitivity function grows as a power function of the stimulus intensity. This is usually referred to as the near-miss-to-Weber's law. The aim of the paper is to examine the near-miss-to-Weber's law in the context of psychometric models of discrimination. We study two types of psychometric functions, characterized by the representations P a ( x ) = F ( ρ ( a ) x γ ( a ) ) (type A), and P a ( x ) = F ( γ ( a ) + ρ ( a ) x ) (type B). A central result shows that both types of psychometric functions are compatible with the near-miss-to-Weber's law. If a representation of type B exists, then the exponent in the near-miss is necessarily a constant function, that is, does not depend on the criterion value used to define “just noticeably different”. If, on the other hand, a representation of type A exists, then the exponent in the near-miss-to-Weber's law can vary with the criterion value. In that case, the parameters in the near-miss co-vary systematically.",0,1 +390,Principles of an Adaptive Method for Measuring the Slope of the Psychometric Function,"Recent developments in the efficient estimation of threshold are here extended to the problem of how best to estimate the slope of the psychometric function. An adaptive method is described for selecting stimulus intensities that are optimal for slope estimation. A two-dimensional array of probabilities of different thresholds and slopes is used to calculate the stimulus intensity for the next trial; this array is updated after the trial, using Bayes' theorem to incorporate information from the subject's response. The practical implementation and efficiency of the method are demonstrated and discussed. © 1997 Elsevier Science Ltd.",0,1 +391,Computational Modeling in Cognition: Principles and Practice,Preface 1. Introduction 1.1 Models and Theories in Science 1.2 Why Quantitative Modeling? 1.3 Quantitative Modeling in Cognition 1.4 The Ideas Underlying Modeling and Its Distinct Applications 1.5 What Can We Expect From Models? 1.6 Potential Problems 2. From Words to Models: Building a Toolkit 2.1 Working Memory 2.2 The Phonological Loop: 144 Models of Working Memory 2.3 Building a Simulation 2.4 What Can We Learn From These Simulations? 2.5 The Basic Toolkit 2.6 Models and Data: Sufficiency and Explanation 3. Basic Parameter Estimation Techniques 3.1 Fitting Models to Data: Parameter Estimation 3.2 Considering the Data: What Level of Analysis? 4. Maximum Likelihood Estimation 4.1 Basics of Probabilities 4.2 What Is a Likelihood? 4.3 Defining a Probability Function 4.4 Finding the Maximum Likelihood 4.5 Maximum Likelihood Estimation for Multiple Participants 4.6 Properties of Maximum Likelihood Estimators 5. Parameter Uncertainty and Model Comparison 5.1 Error on Maximum Likelihood Estimates 5.2 Introduction to Model Selection 5.3 The Likelihood Ratio Test 5.4 Information Criteria and Model Comparison 5.5 Conclusion 6. Not Everything That Fits Is Gold: Interpreting the Modeling 6.1 Psychological Data and The Very Bad Good Fit 6.2 Parameter Identifiability and Model Testability 6.3 Drawing Lessons and Conclusions From Modeling 7. Drawing It All Together: Two Examples 7.1 WITNESS: Simulating Eyewitness Identification 7.2 Exemplar Versus Boundary Models: Choosing Between Candidates 7.3 Conclusion 8. Modeling in a Broader Context 8.1 Bayesian Theories of Cognition 8.2 Neural Networks 8.3 Neuroscientific Modeling 8.4 Cognitive Architectures 8.5 Conclusion References Author Index Subject Index About the Authors,0,1 +392,The Relative Trustworthiness of Inferential Tests of the Indirect Effect in Statistical Mediation Analysis,"A content analysis of 2 years of Psychological Science articles reveals inconsistencies in how researchers make inferences about indirect effects when conducting a statistical mediation analysis. In this study, we examined the frequency with which popularly used tests disagree, whether the method an investigator uses makes a difference in the conclusion he or she will reach, and whether there is a most trustworthy test that can be recommended to balance practical and performance considerations. We found that tests agree much more frequently than they disagree, but disagreements are more common when an indirect effect exists than when it does not. We recommend the bias-corrected bootstrap confidence interval as the most trustworthy test if power is of utmost concern, although it can be slightly liberal in some circumstances. Investigators concerned about Type I errors should choose the Monte Carlo confidence interval or the distribution-of-the-product approach, which rarely disagree. The percentile bootstrap confidence interval is a good compromise test.",0,1 +393,Bayesian Estimation of Multilevel Models,,0,1 +394,Life satisfaction shows terminal decline in old age: Longitudinal evidence from the German Socio-Economic Panel Study (SOEP).,"Longitudinal data spanning 22 years, obtained from deceased participants of the German Socio-Economic Panel Study (SOEP; N = 1,637; 70- to 100-year-olds), were used to examine if and how life satisfaction exhibits terminal decline at the end of life. Changes in life satisfaction were more strongly associated with distance to death than with distance from birth (chronological age). Multiphase growth models were used to identify a transition point about 4 years prior to death where the prototypical rate of decline in life satisfaction tripled from -0.64 to -1.94 T-score units per year. Further individual-level analyses suggest that individuals dying at older ages spend more years in the terminal periods of life satisfaction decline than individuals dying at earlier ages. Overall, the evidence suggests that late-life changes in aspects of well-being are driven by mortality-related mechanisms and characterized by terminal decline.",0,1 +395,Nonlinear Mixed Effects Models for Repeated Measures Data,"We propose a general, nonlinear mixed effects model for repeated measures data and define estimators for its parameters. The proposed estimators are a natural combination of least squares estimators for nonlinear fixed effects models and maximum likelihood (or restricted maximum likelihood) estimators for linear mixed effects models. We implement Newton-Raphson estimation using previously developed computational methods for nonlinear fixed effects models and for linear mixed effects models. Two examples are presented and the connections between this work and recent work on generalized linear mixed effects models are discussed.",0,1 +396,Cross-Validation Of Covariance Structures,"This paper examines methods for comparing the suitability of alternative models for covariance matrices. A cross-validation procedure is suggested and its properties are examined. To motivate the discussion, a series of examples is presented using longitudinal data.",0,1 +397,EQUATE 2.0: A Computer Program for the Characteristic Curve Method of IRT Equating,,0,1 +398,Monte Carlo Studies in Item Response Theory,"Monte carlo studies are being used in item response theory (IRT) to provide information about how validly these methods can be applied to realistic datasets (e.g., small numbers of examinees and multidimensional data). This paper describes the conditions under which monte carlo studies are appropriate in IRT-based re search, the kinds of problems these techniques have been applied to, available computer programs for gen erating item responses and estimating item and exam inee parameters, and the importance of conceptualizing these studies as statistical sampling experiments that should be subject to the same principles of experimen tal design and data analysis that pertain to empirical studies. The number of replications that should be used in these studies is also addressed.",0,1 +399,Augmenting Conjoint Analysis to Estimate Consumer Reservation Price,"Consumer reservation price is a key concept in marketing and economics. Theoretically, this concept has been instrumental in studying consumer purchase decisions,competitive pricing strategies,and welfare economics. Managerially,knowledge of consumer reservation prices is critical for implementing many pricing tactics such as bundling,tar get promotions,nonlinear pricing,and one-to-one pricing,and for assessing the impact of marketing strategy on demand. Despite the practical and theoretical importance of this concept, its measurement at the individual level in a practical setting proves elusive. We propose a conjoint-based approach to estimate consumer-level reservation prices. This approach integrates the preference estimation of traditional conjoint with the economic theory of consumer choice. This integration augments the capability of traditional conjoint such that consumers' reservation prices for a product can be derived directly from the individuallevel estimates of conjoint coefficients. With this augmentation,we can model a consumer's decision of not only which product to buy,but also whether to buy at all in a category. Thus, we can simulate simultaneously three effects that a change in price or the introduction of a new product may generate in a market: the customer switching effect,the cannibalization effect,and the market expansion effect. We show in a pilot application how this approach can aid product and pricing decisions. We also demonstrate the predictive validity of our approach using data from a commercial study of automobile batteries.",0,1 +400,VALIDATING SYNTHETIC VALIDATION: COMPARING TRADITIONAL AND SYNTHETIC VALIDITY COEFFICIENTS,"We describe a unique application of a synthetic validation technique to a selection system development project in a large organization. Job analysis data were collected from 4,725 job incumbents and 619 supervisors, and were used to identify 11 job families and 27 job components. We developed 12 tests to predict performance on these job components and conducted a concurrent validation study to collect test and job component data for 1,926 incumbents. We created a test composite for each job component and then chose a test battery for each job family based on its relevant job components. Synthetic validity coefficients were computed for each test battery and compared to traditional validity coefficients that were computed within job families with large sample sizes. The synthetic validity coefficient was very close to the within-family validity coefficient for most job families and was within the bounds of sampling error for all job families. Validities tended to be highest when predictors were weighted according to the number of job components to which they were relevant and job component criterion measures were unit weighted.",0,1 +401,Structural equation modeling: a Bayesian approach,About the Author. Preface. Chapter 1. Introduction. Chapter 2. Some Basic Structural Equation Models. Chapter 3. Covariance Structure Analysis. Chapter 4. Bayesian Estimation of Structural Equation Models. Chapter 5. Model Comparison and Model Checking. Chapter 6. Structural Equation Models with Continuous and Ordered Categorical Variables. Chapter 7. Structural Equation Models with Dichotomous Variables. Chapter 8. Nonlinear Structural Equation Models. Chapter 9. Two-level Nonlinear Structural Equation Models. Chapter 10. Multisample Analysis of Structural Equation Models. Chapter 11. Finite Mixtures in Structural Equation Models. Chapter 12. Structural Equation Models with Missing Data. Chapter 13. Structural Equation Models with Exponential Family of Distributions. Chapter 14. Conclusion. Index.,0,1 +402,Advancing Science and Policy Through a Coordinated International Study of Physical Activity and Built Environments: IPEN Adult Methods,"Background: National and international strategies to increase physical activity emphasize environmental and policy changes that can have widespread and long-lasting impact. Evidence from multiple countries using comparable methods is required to strengthen the evidence base for such initiatives. Because some environment and policy changes could have generalizable effects and others may depend on each country’s context, only international studies using comparable methods can identify the relevant differences. Methods: Currently 12 countries are participating in the International Physical Activity and the Environment Network (IPEN) study. The IPEN Adult study design involves recruiting adult participants from neighborhoods with wide variations in environmental walkability attributes and socioeconomic status (SES). Results: Eleven of twelve countries are providing accelerometer data and 11 are providing GIS data. Current projections indicate that 14,119 participants will provide survey data on built environments and physical activity and 7145 are likely to provide objective data on both the independent and dependent variables. Though studies are highly comparable, some adaptations are required based on the local context. Conclusions: This study was designed to inform evidence-based international and country-specific physical activity policies and interventions to help prevent obesity and other chronic diseases that are high in developed countries and growing rapidly in developing countries.",0,1 +403,Bayesian Inference for Comparative Research,"Regression analysis in comparative research suffers from two distinct problems of statistical inference. First, because the data constitute all the available observations from a population, conventional inference based on the long-run behavior of a repeatable data mechanism is not appropriate. Second, the small and collinear data sets of comparative research yield imprecise estimates of the effects of explanatory variables. We describe a Bayesian approach to statistical inference that provides a unified solution to these two problems. This approach is illustrated in a comparative analysis of unionization.",0,1 +404,Structural equation models in medical research,"Structural equation modelling (SEM) is a modern statistical method that allows one to evaluate causal hypotheses on a set of intercorrelated nonexperimental data. The sample variances and covariances, and possibly the means, are compared to those predicted by a theory-based hypothetical model after optimal estimation of the parameters of the model. The goodness-of-fit of the empirical data to the hypothesized model is evaluated statistically. This review describes the underlying statistical theory and rationale of SEM. Both confirmatory factor analysis and latent variable path models are discussed. The applicability of SEM to assessment of reliability and validity is noted. A detailed example is provided, and several examples from the medical literature are briefly reviewed. Cautions regarding the possible misuse or misinterpretation of the technique are also mentioned. Possible future directions for the use of SEM in medical research are suggested. Two appendices provide more technical details.",0,1 +405,An objective measure of auditory stream segregation based on molecular psychophysics,"Auditory stream segregation is an important paradigm in the study of auditory scene analysis. Performance-based measures of auditory stream segregation have received increasing use as a complement to subjective reports of streaming. For example, the sensitivity in discriminating a temporal shift imposed on one B tone in an ABA sequence consisting of A and B tones that differ in frequency is often used to infer the perceptual organization (one stream vs. two streams). Limitations of these measures are discussed here, and an alternative measure based on the combination of decision weights and sensitivity is suggested. In the experiment, for ABA and ABB sequences varying in tempo (fast/slow) and duration (long/short), the sensitivity (d′) in the temporal shift discrimination task did not differ between fast and slow sequences, despite strong differences in perceptual organization. The decision weights assigned to within-stream and between-stream interonset intervals also deviated from the idealized pattern of near-exclusive reliance on between-stream information in the subjectively integrated case, and on within-stream information in the subjectively segregated case. However, an estimate of internal noise computed using a combination of the estimated decision weights and sensitivity differentiated between sequences that were predominantly perceived as integrated or segregated, with significantly higher internal noise estimates for the segregated case. Therefore, the method of using a combination of decision weights and sensitivity provides a measure of auditory stream segregation that overcomes some of the limitations of purely sensitivity-based measures. © 2014 Psychonomic Society, Inc.",0,1 +406,Causal Mediation Analysis With a Binary Outcome and Multiple Continuous or Ordinal Mediators: Simulations and Application to an Alcohol Intervention,"We investigate a method to estimate the combined effect of multiple continuous/ordinal mediators on a binary outcome: 1) fit a structural equation model with probit link for the outcome and identity/probit link for continuous/ordinal mediators, 2) predict potential outcome probabilities, and 3) compute natural direct and indirect effects. Step 2 involves rescaling the latent continuous variable underlying the outcome to address residual mediator variance/covariance. We evaluate the estimation of risk-difference- and risk-ratio-based effects (RDs, RRs) using the ML, WLSMV and Bayes estimators in Mplus. Across most variations in path-coefficient and mediator-residual-correlation signs and strengths, and confounding situations investigated, the method performs well with all estimators, but favors ML/WLSMV for RDs with continuous mediators, and Bayes for RRs with ordinal mediators. Bayes outperforms WLSMV/ML regardless of mediator type when estimating RRs with small potential outcome probabilities and in two other special cases. An adolescent alcohol prevention study is used for illustration.",0,1 +407,The trajectory of fidelity in a multiyear trial of the family check-up predicts change in child problem behavior.,"Therapist fidelity to evidence-based family interventions has consistently been linked to child and family outcomes. However, few studies have evaluated the potential ebb and flow of fidelity of therapists over time. We examined therapist drift in fidelity over 4 years in the context of a Family Check-Up prevention services in early childhood (ages 2-5 years).At age 2, families engaging in Women, Infants, and Children Nutritional Supplement Program services were randomized and offered annual Family Check-Ups. Seventy-nine families with a child in the clinical range of problem behaviors at age 2 years were included in this analysis.Latent growth modeling revealed a significant linear decline in fidelity over time (M = -0.35, SD = 0.35) and that steeper declines were related to less improvement in caregiver-reported problem behaviors assessed at ages 7.5/8.5 years (b = -.69, p = .003; β = -.95, 95% CI [-2.11, -0.22]).These findings add to the literature concerning the need to continually monitor therapist fidelity to an evidence-based practice over time to optimize family benefits. Limitations and directions for future research are discussed.",0,1 +408,A hierarchical approach for fitting curves to response time measurements,"Understanding how response time (RT) changes with manipulations has been critical in distinguishing among theories in cognition. It is well known that aggregating data distorts functional relationships (e.g., Estes, 1956). Less well appreciated is a second pitfall: Minimizing squared errors (i.e., OLS regression) also distorts estimated functional forms with RT data. We discuss three properties of RT that should be modeled for accurate analysis and, on the basis of these three properties, provide a hierarchical Weibull regression model for regressing RT onto covariates. Hierarchical regression model analysis of lexical decision task data reveals that RT decreases as a power function of word frequency with the scale of RT decreasing 11% for every doubling of word frequency. A detailed discussion of the model and analysis techniques are presented as archived materials and may be downloaded from www.psychonomic.org/archive. © 2008 Psychonomic Society, Inc.",0,1 +409,The Politicized Participant,"Modern liberal democracies demand high and equal levels of political action. Unequal levels of political action between ideological groups may ultimately lead to biased policy. But to what extent do citizens’ ideological preferences affect their likelihood to participate politically? And does the institutional environment moderate this relationship? From rivaling theories, the authors construct hypotheses regarding the relationship between ideological preferences and participation and those regarding the moderating effect of state institutions. They test them for six modes of political action—voting, contacting, campaigning, cooperating, persuading, and protesting—through multilevel analyses of 27 elections in 20 Western democracies. First, they find that citizens’ ideological preferences are an important determinant political action. Second, they find that majoritarianism outperforms consensualism: In majoritarian systems, political action is more widespread and not less equal across the crucial factor of ideological preferences. The field should therefore reconsider Lijphart’s conclusions about the superiority of consensualism.",0,1 +410,Identification and Sensitivity Analysis for Multiple Causal Mechanisms: Revisiting Evidence from Framing Experiments,"Social scientists are often interested in testing multiple causal mechanisms through which a treatment affects outcomes. A predominant approach has been to use linear structural equation models and examine the statistical significance of the corresponding path coefficients. However, this approach implicitly assumes that the multiple mechanisms are causally independent of one another. In this article, we consider a set of alternative assumptions that are sufficient to identify the average causal mediation effects when multiple, causally related mediators exist. We develop a new sensitivity analysis for examining the robustness of empirical findings to the potential violation of a key identification assumption. We apply the proposed methods to three political psychology experiments, which examine alternative causal pathways between media framing and public opinion. Our analysis reveals that the validity of original conclusions is highly reliant on the assumed independence of alternative causal mechanisms, highlighting the importance of proposed sensitivity analysis. All of the proposed methods can be implemented via an open source R package, mediation .",0,1 +411,A Rasch Hierarchical Measurement Model,"In this article, a hierarchical measurement model is developed that enables researchers to measure a latent trait variable and model the error variance corresponding to multiple levels. The Rasch hierarchical measurement model (HMM) results when a Rasch IRT model and a one-way ANOVA with random effects are combined ( Bryk & Raudenbush, 1992 ; Goldstein, 1987 ; Rasch, 1960 ). This model is appropriate for modeling dichotomous response strings nested within a contextual level. Examples of this type of structure include responses from students nested within schools and multiple response strings nested within people. Model parameter estimates of the Rasch HMM were obtained using the Bayesian data analysis methods of Gibbs sampling and the Metropolis-Hastings algorithm ( Gelfand, Hills, Racine-Poon, & Smith, 1990 ; Hastings, 1970 ; Metropolis, Rosenbluth, Rosenbluth, Teller, & Teller, 1953 ). The model is illustrated with two simulated data sets and data from the Sloan Study of Youth and Social Development. The results are discussed and parameter estimates for the simulated data sets are compared to parameter estimates obtained using a two-step estimation approach.",0,1 +412,A novel method for modeling facial allodynia associated with migraine in awake and freely moving rats,"Migraine is a neurovascular disorder that induces debilitating headaches associated with multiple symptoms including facial allodynia, characterized by heightened responsivity to normally innocuous mechanical stimuli. It is now well accepted that immune activation and immune-derived inflammatory mediators enhance pain responsivity, including the trigeminal system. Nociceptive (""pain"" responsive) trigeminal nerves densely innervate the cranial meninges. We have recently proposed that the meninges may serve as a previously unidentified, key interface between the peripheral immune system and the CNS with potential implications for understanding underlying migraine mechanisms. Our focus here is the development of a model for facial allodynia associated with migraine. We developed a model wherein an indwelling catheter is placed between the skull and dura, allowing immunogenic stimuli to be administered over the dura in awake and freely moving rats. Since the catheter does not contact the brain itself, any proinflammatory cytokines induced following manipulation derive from resident or recruited meningeal immune cells. While surgery alone does not alter immune activation markers, TNF or IL6 mRNA and/or protein, it does decrease gene expression and increase protein expression of IL-1 at 4 days after surgery. Using this model we show the induction of facial allodynia in response to supradural administration of either the HIV glycoprotein gp120 or inflammatory soup (bradykinin, histamine, serotonin, and prostaglandin E2), and the induction of hindpaw allodynia in our model after inflammatory soup. This model allows time- and dose-dependent assessment of the relationship between changes in meningeal inflammation and corresponding exaggerated pain behaviors.",0,1 +413,Regime-Switching Bivariate Dual Change Score Model,"Mixture structural equation model with regime switching (MSEM-RS) provides one possible way of representing over-time heterogeneities in dynamic processes by allowing a system to manifest qualitatively or quantitatively distinct change processes conditional on the latent ""regime"" the system is in at a particular time point. Unlike standard mixture structural equation models such as growth mixture models, MSEM-RS allows individuals to transition between latent classes over time. This class of models, often referred to as regime-switching models in the time series and econometric applications, can be specified as regime-switching mixture structural equation models when the number of repeated measures involved is not large. We illustrate the empirical utility of such models using one special case-a regime-switching bivariate dual change score model in which two growth processes are allowed to manifest regime-dependent coupling relations with one another. The proposed model is illustrated using a set of longitudinal reading and arithmetic performance data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 study (ECLS-K; U.S. Department of Education, National Center for Education Statistics, 2010).",0,1 +414,Bayes Estimates for the Linear Model,,0,1 +415,Comparison of Methods for Estimating and Testing Latent Variable Interactions,"Structural equation modeling methods for estimating and testing hypotheses about an interaction between continuous variables were investigated. The methods were (a) Bollen's (1996) 2-stage least squares (TSLS) method, Ping's (1996) 2-step maximum likelihood (ML) method, and Jaccard and Wan's (1995) ML method for the Kenny-Judd model (Kenny & Judd, 1984); (b) a 2-step ML procedure and ML estimation of the Joreskog-Yang model (Joreskog & Yang 1996); and (c) ML estimation of a revised Joreskog-Yang model. The TSLS procedure exhibited more bias and lower power than the other methods. Under ML estimation of the Joreskog-Yang model, Type I error rates were not well controlled when robust standard errors were used. Among the remaining procedures, the Jaccard-Wan procedure and ML estimation of the revised Joreskog-Yang procedure were most effective, with the latter having some small advantages over the former.",0,1 +416,The aggregate site frequency spectrum for comparative population genomic inference,"Understanding how assemblages of species responded to past climate change is a central goal of comparative phylogeography and comparative population genomics, an endeavour that has increasing potential to integrate with community ecology. New sequencing technology now provides the potential to perform complex demographic inference at unprecedented resolution across assemblages of nonmodel species. To this end, we introduce the aggregate site frequency spectrum (aSFS), an expansion of the site frequency spectrum to use single nucleotide polymorphism (SNP) data sets collected from multiple, co-distributed species for assemblage-level demographic inference. We describe how the aSFS is constructed over an arbitrary number of independent population samples and then demonstrate how the aSFS can differentiate various multispecies demographic histories under a wide range of sampling configurations while allowing effective population sizes and expansion magnitudes to vary independently. We subsequently couple the aSFS with a hierarchical approximate Bayesian computation (hABC) framework to estimate degree of temporal synchronicity in expansion times across taxa, including an empirical demonstration with a data set consisting of five populations of the threespine stickleback (Gasterosteus aculeatus). Corroborating what is generally understood about the recent postglacial origins of these populations, the joint aSFS/hABC analysis strongly suggests that the stickleback data are most consistent with synchronous expansion after the Last Glacial Maximum (posterior probability = 0.99). The aSFS will have general application for multilevel statistical frameworks to test models involving assemblages and/or communities, and as large-scale SNP data from nonmodel species become routine, the aSFS expands the potential for powerful next-generation comparative population genomic inference.",0,1 +417,Aging and Tennis Playing in a Coincidence-Timing Task With an Accelerating Object: The Role of Visuomotor Delay,"The purpose of the present study was to determine whether playing a specific ball sport, such as tennis, could maintain the coincidence-timing (CT) performance of older adults at a similar level to that of younger ones. To address this question, tennis players and nonplayers of three different age ranges (ages 20-30, 60-70, and 70-80 years) performed a simple CT task consisting of timing their response (pressing a button) to coincide with the arrival of a stimulus at a target. The stimulus moved at either an accelerating, constant, or decelerating velocity. As expected, all participants were affected by the velocity manipulation, which led to late and early responses to accelerating and decelerating stimuli, respectively. Whereas this response bias was increasingly pronounced with advancing age in nonplayers, no difference was found among player groups of different ages. Finally, we showed that the length of the visuomotor delay could explain the effect of nonconstant velocities. ©2005 by the American Alliance for Health, Physical Education, Recreation and Dance.",0,1 +418,Bayesian multilevel modelling of cosmological populations,"Introduction Surveying the Universe is the ultimate remote sensing problem. Inferring the intrinsic properties of the galaxy population, via analysis of survey-generated catalogues, is a major challenge for twenty-first century cosmology, but this challenge must be met without any prospect of measuring these properties in situ. Thus, for example, our knowledge of the intrinsic luminosity and spatial distribution of galaxies is filtered by imperfect distance information and by observational selection effects, issues which have come to be known generically in the literature as 'Malmquist bias'. Figure 11.1 shows schematically how such effects may distort our inferences about the underlying population since, in general, these must be derived from a noisy, sparse and truncated sample of galaxies. There is a long (and mostly honourable!) tradition in the astronomical literature of attempts to cast such remote surveying problems within a rigorous statistical framework. Indeed, it is interesting to note that seminal examples from the early twentieth century (Eddington 1913, 1940; Malmquist 1920, 1922) display, at least with hindsight, hints of a Bayesian formulation long before the recent renaissance of Bayesian methods in astronomy. Unfortunately, space does not permit us to review in detail that early literature, nor many of the more recent papers which evolved from it. A more thorough discussion of the literature on statistical analysis of survey data can be found in, e.g., Hendry and Simmons (1995), Strauss and Willick (1995), Teerikorpi (1997) and Loredo (2007). © Cambridge University Press, 2010.",0,1 +419,Panel Models in Sociological Research: Theory into Practice,"A selection of panel studies appearing in the American Sociological Review and the American Journal of Sociology between 1990 and 2003 shows that sociologists have been slow to capitalize on the advantages of panel data for controlling unobservables that threaten causal inference in observational studies. This review emphasizes regression methods that capitalize on the strengths of panel data for consistently estimating causal parameters in models for metric outcomes when measured explanatory variables are correlated with unit-specific unobservables. Both static and dynamic models are treated. Among the major subjects are fixed versus random effects methods, Hausman tests, Hausman-Taylor models, and instrumental variables methods, including Arrelano-Bond and Anderson-Hsaio estimation for models with lagged endogenous variables.",0,1 +420,Increasing clinicians' EBT exploration and preparation behavior in youth mental health services by changing organizational culture with ARC,"Clinician EBT exploration and preparation behavior is essential to the ongoing implementation of new EBTs. This study examined the effect of the ARC organizational intervention on clinician EBT exploration and preparation behavior and assessed the mediating role of organizational culture as a linking mechanism.Fourteen community mental health agencies that serve youth in a major Midwestern metropolis along with 475 clinicians who worked in those agencies, were randomly assigned to either the three-year ARC intervention or control condition. Organizational culture was assessed with the Organizational Social Context (OSC) measure at baseline and follow-up. EBT exploration and preparation behavior was measured as clinician participation in nine separate community EBT workshops held over a three-year period.There was 69 percent greater odds (OR = 1.69, p < .003) of clinicians in the ARC condition (versus control) attending each subsequent workshop. Workshop attendance in the control group remained under two percent and declined over three years while attendance in the ARC condition grew from 3.6 percent in the first workshop to 12 percent in the ninth and final workshop. Improvement in proficient organizational culture mediated the positive effect of the ARC intervention on clinicians' workshop attendance (a × b = .21; 95% CI:LL = .05, UL = .40).Organizational interventions that create proficient mental health agency cultures can increase clinician EBT exploration and preparation behavior that is essential to the ongoing implementation of new EBTs in community youth mental health settings.",0,1 +421,A Bootstrap Test of Shape Invariance Across Distributions,,0,1 +422,Covariance Structure Models for Maximal Reliability of Unit-Weighted Composites,"Abstract When developing or evaluating scales, the internal consistency reliability of the scale based on its items or parts is always an important issue. The growth of structural modeling has allowed the easy computation of model-based estimates of reliability. These are typically touted as replacements for coefficient alpha, which remains the most widely used measure of internal consistency. Among model-based estimates, coefficients based on a 1-factor model have been most widely recommended. However, when the 1-factor model does not fit the data, the meaning of such a coefficient is unclear. A new identification condition for factor analytic models is proposed that assures the composite can be modeled with only one common factor even if the components are multidimensional. This common factor is maximally correlated with the composite, and the reliability of the composite is the maximal internal consistency coefficient for a unit-weighted composite. The coefficient also describes k-factor reliability, the greatest lower bound to reliability, and reliability for any composite from a latent variable model with additive errors. Reliability coefficients for differentially-weighted composites are also described, and differentially-weighted maximal reliability is contrasted with unit-weighted maximal reliability. Computational methods for these coefficients are described.",0,1 +423,Assessing Spurious Interaction Effects in Structural Equation Modeling,"Several studies have stressed the importance of simultaneously estimating interaction and quadratic effects in multiple regression analyses, even if theory only suggests an interaction effect should be present. Specifically, past studies suggested that failing to simultaneously include quadratic effects when testing for interaction effects could result in Type I errors, Type II errors, or misleading interactions. Research investigating this issue has been limited to multiple regression models. Contrarily, structural equation modeling is a more appropriate analysis when hypotheses include latent variables. The current study utilized Monte Carlo simulation to investigate whether quadratic effects should be included in the latent variable interaction model. Consistent with previous research, it was found that including latent variable quadratic effects in the model successfully reduced the frequency of spurious interaction effects but at a cost of low power to detect true interaction effects, inaccurate parameter estimates, inaccurate standard error estimates, and reduced convergence rates. Based on findings from the current study, we recommend that researchers hypothesizing interactions between latent variables should test for these relations using the latent variable interaction model rather than the interaction quadratic model. If researchers are concerned about spurious interactions, then they may want to consider including quadratic effects in the model, provided that they have sample sizes of at least 500 and high indicator reliability. We caution all researchers to base higher order effects models on theory.",0,1 +424,A Bayesian Analysis of Some Nonparametric Problems,"The Bayesian approach to statistical problems, though fruitful in many ways, has been rather unsuccessful in treating nonparametric problems. This is due primarily to the difficulty in finding workable prior distributions on the parameter space, which in nonparametric ploblems is taken to be a set of probability distributions on a given sample space. There are two desirable properties of a prior distribution for nonparametric problems. (I) The support of the prior distribution should be large--with respect to some suitable topology on the space of probability distributions on the sample space. (II) Posterior distributions given a sample of observations from the true probability distribution should be manageable analytically. These properties are antagonistic in the sense that one may be obtained at the expense of the other. This paper presents a class of prior distributions, called Dirichlet process priors, broad in the sense of (I), for which (II) is realized, and for which treatment of many nonparametric statistical problems may be carried out, yielding results that are comparable to the classical theory. In Section 2, we review the properties of the Dirichlet distribution needed for the description of the Dirichlet process given in Section 3. Briefly, this process may be described as follows. Let $\mathscr{X}$ be a space and $\mathscr{A}$ a $\sigma$-field of subsets, and let $\alpha$ be a finite non-null measure on $(\mathscr{X}, \mathscr{A})$. Then a stochastic process $P$ indexed by elements $A$ of $\mathscr{A}$, is said to be a Dirichlet process on $(\mathscr{X}, \mathscr{A})$ with parameter $\alpha$ if for any measurable partition $(A_1, \cdots, A_k)$ of $\mathscr{X}$, the random vector $(P(A_1), \cdots, P(A_k))$ has a Dirichlet distribution with parameter $(\alpha(A_1), \cdots, \alpha(A_k)). P$ may be considered a random probability measure on $(\mathscr{X}, \mathscr{A})$, The main theorem states that if $P$ is a Dirichlet process on $(\mathscr{X}, \mathscr{A})$ with parameter $\alpha$, and if $X_1, \cdots, X_n$ is a sample from $P$, then the posterior distribution of $P$ given $X_1, \cdots, X_n$ is also a Dirichlet process on $(\mathscr{X}, \mathscr{A})$ with a parameter $\alpha + \sum^n_1 \delta_{x_i}$, where $\delta_x$ denotes the measure giving mass one to the point $x$. In Section 4, an alternative definition of the Dirichlet process is given. This definition exhibits a version of the Dirichlet process that gives probability one to the set of discrete probability measures on $(\mathscr{X}, \mathscr{A})$. This is in contrast to Dubins and Freedman [2], whose methods for choosing a distribution function on the interval [0, 1] lead with probability one to singular continuous distributions. Methods of choosing a distribution function on [0, 1] that with probability one is absolutely continuous have been described by Kraft [7]. The general method of choosing a distribution function on [0, 1], described in Section 2 of Kraft and van Eeden [10], can of course be used to define the Dirichlet process on [0, 1]. Special mention must be made of the papers of Freedman and Fabius. Freedman [5] defines a notion of tailfree for a distribution on the set of all probability measures on a countable space $\mathscr{X}$. For a tailfree prior, posterior distribution given a sample from the true probability measure may be fairly easily computed. Fabius [3] extends the notion of tailfree to the case where $\mathscr{X}$ is the unit interval [0, 1], but it is clear his extension may be made to cover quite general $\mathscr{X}$. With such an extension, the Dirichlet process would be a special case of a tailfree distribution for which the posterior distribution has a particularly simple form. There are disadvantages to the fact that $P$ chosen by a Dirichlet process is discrete with probability one. These appear mainly because in sampling from a $P$ chosen by a Dirichlet process, we expect eventually to see one observation exactly equal to another. For example, consider the goodness-of-fit problem of testing the hypothesis $H_0$ that a distribution on the interval [0, 1] is uniform. If on the alternative hypothesis we place a Dirichlet process prior with parameter $\alpha$ itself a uniform measure on [0, 1], and if we are given a sample of size $n \geqq 2$, the only nontrivial nonrandomized Bayes rule is to reject $H_0$ if and only if two or more of the observations are exactly equal. This is really a test of the hypothesis that a distribution is continuous against the hypothesis that it is discrete. Thus, there is still a need for a prior that chooses a continuous distribution with probability one and yet satisfies properties (I) and (II). Some applications in which the possible doubling up of the values of the observations plays no essential role are presented in Section 5. These include the estimation of a distribution function, of a mean, of quantiles, of a variance and of a covariance. A two-sample problem is considered in which the Mann-Whitney statistic, equivalent to the rank-sum statistic, appears naturally. A decision theoretic upper tolerance limit for a quantile is also treated. Finally, a hypothesis testing problem concerning a quantile is shown to yield the sign test. In each of these problems, useful ways of combining prior information with the statistical observations appear. Other applications exist. In his Ph. D. dissertation [1], Charles Antoniak finds a need to consider mixtures of Dirichlet processes. He treats several problems, including the estimation of a mixing distribution, bio-assay, empirical Bayes problems, and discrimination problems.",0,1 +425,Improving Classroom Quality with The RULER Approach to Social and Emotional Learning: Proximal and Distal Outcomes,"The RULER Approach to Social and Emotional Learning (""RULER"") is designed to improve the quality of classroom interactions through professional development and classroom curricula that infuse emotional literacy instruction into teaching-learning interactions. Its theory of change specifies that RULER first shifts the emotional qualities of classrooms, which are then followed, over time, by improvements in classroom organization and instructional support. A 2-year, cluster randomized controlled trial was conducted to test hypotheses derived from this theory. Sixty-two urban schools either integrated RULER into fifth- and sixth-grade English language arts (ELA) classrooms or served as comparison schools, using their standard ELA curriculum only. Results from multilevel modeling with baseline adjustments and structural equation modeling support RULER's theory of change. Compared to classrooms in comparison schools, classrooms in RULER schools exhibited greater emotional support, better classroom organization, and more instructional support at the end of the second year of program delivery. Improvements in classroom organization and instructional support at the end of Year 2 were partially explained by RULER's impacts on classroom emotional support at the end of Year 1. These findings highlight the important contribution of emotional literacy training and development in creating engaging, empowering, and productive learning environments.",0,1 +426,An Extended Cultural Consensus Theory Model to Account for Cognitive Processes in Decision Making in Social Surveys,"In recent decades, cultural consensus theory (CCT) models have been extensively applied across research domains to explore shared cultural knowledge and beliefs. These models are parameterized in terms of person-specific cognitive parameters such as abilities and guessing biases as well as item difficulties. Although psychometric test theory is also formalized in terms of abilities and item difficulties, a quality that clearly sets CCT models apart from other test theory models is their specification to operate on data in which the answer key is latent. In doing so, CCT models specify the answer key as parameters of the model, and also involved with this specification are procedures to verify the integrity of the answer key that is estimated. In this article, the authors develop the following methods to propagate the application of these CCT models in the field of social surveys: (1) by extending the underlying cognitive model to be able to account for uncertainty in decision making (“don’t know” responses), (2) by allowing covariate information to be entered in the analysis, and (3) by deriving statistical inference in the hierarchical Bayesian framework. The proposed model is fit to data describing knowledge on science and on aging to demonstrate the novel findings that can be achieved by the approach.",0,1 +427,A Bayesian multilevel model for fMRI data analysis,"Bayesian approaches have been proposed by several functional magnetic resonance imaging (fMRI) researchers in order to overcome the fundamental limitations of the popular statistical parametric mapping method. However, the difficulties associated with subjective prior elicitation have prevented the widespread adoption of the Bayesian methodology by the neuroimaging community. In this paper, we present a Bayesian multilevel model for the analysis of brain fMRI data. The main idea is to consider that all the estimated group effects (fMRI activation patterns) are exchangeable. This means that all the collected voxel time series are considered manifestations of a few common underlying phenomena. In contradistinction to other Bayesian approaches, we think of the estimated activations as multivariate random draws from the same distribution without imposing specific prior spatial and/or temporal information for the interaction between voxels. Instead, a two-stage empirical Bayes prior approach is used to relate voxel regression equations through correlations between the regression coefficient vectors. The adaptive shrinkage properties of the Bayesian multilevel methodology are exploited to deal with spatial variations, and noise outliers. The characteristics of the proposed model are evaluated by considering its application to two real data sets.",0,1 +428,Converting between measures of slope of the psychometric function,"The psychometric function's slope provides information about the reliability of psychophysical threshold estimates. Furthermore, knowing the slope allows one to compare, across studies, thresholds that were obtained at different performance criterion levels. Unfortunately, the empirical validation of psychometric function slope estimates is hindered by the bewildering variety of slope measures that are in use. The present article provides conversion formulas for the most popular cases, including the logistic, Weibull, Quick, cumulative normal, and hyperbolic tangent functions as analytic representations, in both linear and log coordinates and to different log bases, the practical decilog unit, the empirically based interquartile range measure of slope, and slope in a d' representation of performance.",0,1 +429,Bayesian function-on-function regression for multilevel functional data,"Medical and public health research increasingly involves the collection of complex and high dimensional data. In particular, functional data-where the unit of observation is a curve or set of curves that are finely sampled over a grid-is frequently obtained. Moreover, researchers often sample multiple curves per person resulting in repeated functional measures. A common question is how to analyze the relationship between two functional variables. We propose a general function-on-function regression model for repeatedly sampled functional data on a fine grid, presenting a simple model as well as a more extensive mixed model framework, and introducing various functional Bayesian inferential procedures that account for multiple testing. We examine these models via simulation and a data analysis with data from a study that used event-related potentials to examine how the brain processes various types of images.",0,1 +430,"Using Matching to Estimate Treatment Effects: Data Requirements, Matching Metrics, and Monte Carlo Evidence","We compare propensity-score matching methods with covariatematching estimators. We first discuss the data requirements of propensity-score matching estimators and covariate matching estimators. Then we propose two new matching metrics incorporating the treatment outcome information and participation indicator information, and discuss the motivations of different metrics. Next we study the small-sample properties of propensity-score matching versus covariate matching estimators, and of different matching metrics, through Monte Carlo experiments. Through a series of simulations, we provide some guidance to practitioners on how to choose among different matching estimators and matching metrics.",0,1 +431,"A Structural Equation Model Analysis of Relationships among ENSO, Seasonal Descriptors and Wildfires","Seasonality drives ecological processes through networks of forcings, and the resultant complexity requires creative approaches for modeling to be successful. Recently ecologists and climatologists have developed sophisticated methods for fully describing seasons. However, to date the relationships among the variables produced by these methods have not been analyzed as networks, but rather with simple univariate statistics. In this manuscript we used structural equation modeling (SEM) to analyze a proposed causal network describing seasonality of rainfall for a site in south-central Florida. We also described how this network was influenced by the El Niño-Southern Oscillation (ENSO), and how the network in turn affected the site's wildfire regime. Our models indicated that wet and dry seasons starting later in the year (or ending earlier) were shorter and had less rainfall. El Niño conditions increased dry season rainfall, and via this effect decreased the consistency of that season's drying trend. El Niño conditions also negatively influenced how consistent the moistening trend was during the wet season, but in this case the effect was direct and did not route through rainfall. In modeling wildfires, our models showed that area burned was indirectly influenced by ENSO via its effect on dry season rainfall. Area burned was also indirectly reduced when the wet season had consistent rainfall, as such wet seasons allowed fewer wildfires in subsequent fire seasons. Overall area burned at the study site was estimated with high accuracy (R (2) score = 0.63). In summary, we found that by using SEMs, we were able to clearly describe causal patterns involving seasonal climate, ENSO and wildfire. We propose that similar approaches could be effectively applied to other sites where seasonality exerts strong and complex forcings on ecological processes.",0,1 +432,Parenting Stress Related to Behavioral Problems and Disease Severity in Children with Problematic Severe Asthma,"Our study examined parenting stress and its association with behavioral problems and disease severity in children with problematic severe asthma. Research participants were 93 children (mean age 13.4 ± 2.7 years) and their parents (86 mothers, 59 fathers). As compared to reference groups analyzed in previous research, scores on the Parenting Stress Index in mothers and fathers of the children with problematic severe asthma were low. Higher parenting stress was associated with higher levels of internalizing and externalizing behavioral problems in children (Child Behavior Checklist). Higher parenting stress in mothers was also associated with higher airway inflammation (FeNO). Thus, although parenting stress was suggested to be low in this group, higher parenting stress, especially in the mother, is associated with more airway inflammation and greater child behavioral problems. This indicates the importance of focusing care in this group on all possible sources of problems, i.e., disease exacerbations and behavioral problems in the child as well as parenting stress.",0,1 +433,Assessing Differential Area Mortality Trends via Bayesian Random Effects,"Changes in area mortality are important for assessing spatial health inequality. They are likely to be differentiated by age as well as spatially and may vary by demographic strata (e.g., gender, ethnic group). A simple approach assumes linear improvement in log mortality risks, with noninteracting area and age coefficients. By contrast, this article considers parsimonious models for mortality change allowing nonlinear trends and interactions between ages and areas in mortality levels and trends. A case study considers trends in mortality in 32 London boroughs over the 8-year period 1999–2006 for deaths data disaggregated by age, sex, and area.",0,1 +434,"Social inequality in morbidity, framed within the current economic crisis in Spain","Inspired by the 'Fundamental Cause Theory (FCT)' we explore social inequalities in preventable versus relatively less-preventable illnesses in Spain. The focus is on the education-health gradient, as education is one of the most important components of an individual's socioeconomic status (SES). Framed in the context of the recent economic crisis, we investigate the education gradient in depression, diabetes, and myocardial infarction (relatively highly preventable illnesses) and malignant tumors (less preventable), and whether this educational gradient varies across the regional-economic context and changes therein.We use data from three waves of the Spanish National Health Survey (2003-2004, 2006-2007, and 2011-2012), and from the 2009-2010 wave of the European Health Survey in Spain, which results in a repeated cross-sectional design. Logistic multilevel regressions are performed with depression, diabetes, myocardial infarction, and malignant tumors as dependent variables. The multilevel design has three levels (the individual, period-regional, and regional level), which allows us to estimate both longitudinal and cross-sectional macro effects. The regional-economic context and changes therein are assessed using the real GDP growth rate and the low work intensity indicator.Education gradients in more-preventable illness are observed, while this is far less the case in our less-preventable disease group. Regional economic conditions seem to have a direct impact on depression among Spanish men (y-stand. OR = 1.04 [95 % CI: 1.01-1.07]). Diabetes is associated with cross-regional differences in low work intensity among men (y-stand. OR = 1.02 [95 % CI: 1.00-1.05]) and women (y-stand. OR = 1.04 [95 % CI: 1.01-1.06]). Economic contraction increases the likelihood of having diabetes among men (y-stand. OR = 1.04 [95 % CI: 1.01-1.06]), and smaller decreases in the real GDP growth rate are associated with lower likelihood of myocardial infarction among women (y-stand. OR = 0.83 [95 % CI: 0.69-1.00]). Finally, there are interesting associations between the macroeconomic changes across the crisis period and the likelihood of suffering from myocardial infarction among lower educated groups, and the likelihood of having depression and diabetes among less-educated women.Our findings partially support the predictions of the FCT for Spain. The crisis effects on health emerge especially in the case of our more-preventable illnesses and among lower educated groups. Health inequalities in Spain could increase rapidly in the coming years due to the differential effects of recession on socioeconomic groups.",0,1 +435,Differences in within- and between-person factor structure of positive and negative affect: Analysis of two intensive measurement studies using multilevel structural equation modeling.,"The Positive and Negative Affect Schedule (PANAS) is a widely used measure of emotional experience. The factor structure of the PANAS has been examined predominantly with cross-sectional designs, which fails to disaggregate within-person variation from between-person differences. There is still uncertainty as to the factor structure of positive and negative affect and whether they constitute 2 distinct independent factors. The present study examined the within-person and between-person factor structure of the PANAS in 2 independent samples that reported daily affect over 7 and 14 occasions, respectively. Results from multilevel confirmatory factor analyses revealed that a 2-factor structure at both the within-person and between-person levels, with correlated specific factors for overlapping items, provided good model fit. The best-fitting solution was one where within-person factors of positive and negative affect were inversely correlated, but between-person factors were independent. The structure was further validated through multilevel structural equation modeling examining the effects of cognitive interference, daily stress, physical symptoms, and physical activity on positive and negative affect factors.",0,1 +436,Bayesian model selection using encompassing priors,"This paper deals with Bayesian selection of models that can be specified using inequality constraints among the model parameters. The concept of encompassing priors is introduced, that is, a prior distribution for an unconstrained model from which the prior distributions of the constrained models can be derived. It is shown that the Bayes factor for the encompassing and a constrained model has a very nice interpretation: it is the ratio of the proportion of the prior and posterior distribution of the encompassing model in agreement with the constrained model. It is also shown that, for a specific class of models, selection based on encompassing priors will render a virtually objective selection procedure. The paper concludes with three illustrative examples: an analysis of variance with ordered means; a contingency table analysis with ordered odds-ratios; and a multilevel model with ordered slopes.",0,1 +437,Quest: A Bayesian adaptive psychometric method,"An adaptive psychometric procedure that places each trial at the current most probable Bayesian estimate of threshold is described. The procedure takes advantage of the common finding that the human psychometric function is invariant in form when expressed as a function of log intensity. The procedure is simple, fast, and efficient, and may be easily implemented on any computer.",0,1 +438,Perceptions-Based Analysis of Tourism Products and Service Providers,"Perceptions-based analysis is a general framework for analyzing tourist choice alternatives involving large sets of perceived attributes. Its development in tourism research was encouraged as tourism is characterized by multifaceted choice alternatives such as destinations and other experiential “products” that the tourists cannot succinctly evaluate with a small number of attributes. PBA differentiates between the generic perceptions of a class of choice alternatives (destinations, product/service providers; e.g., “metropolitan city”; “tour operator”), the perceptual profiles of a specific choice alternative (“San Francisco”; “Thomas Cook”), and the profiles of the choice alternatives preferred or actually selected. It condenses the attribute profiles into distinguished perceptual positions and analyzes their competitive relationships by diagnosing the perceptual strengths and weaknesses of the choice alternatives. Further analysis reveals the number of choice decisions made in favor of a uniquely positioned choice alternative or one sharing its position with others. An empirical example for tour operators illustrates the various data processing steps and discusses their policy implications.",0,1 +439,Toward an Organizational Model of Change in Elementary Schools,"Purpose: This study explored a theoretical model that links teachers’ perceived uncertainty and teachers’ sense of collective efficacy with organizational learning mechanisms (OLMs) in elementary schools. OLMs serve as a mediator construct. Research Design: For testing the primary theoretical model, 801 teachers from 61 elementary schools (33 urban and 28 suburban) in Israel’s largest district responded to the research instruments. The authors used structural equation modeling to determine whether OLMs mediate between teachers’ perceived uncertainty and their sense of collective efficacy. Findings: A significant model, which included direct and indirect effects of teachers’ perceived uncertainty on teachers’ sense of collective efficacy, emerged for the urban school context. Although OLMs (storing, retrieving, and putting to use of information) served as a prominent mediating variable in the urban school context, OLMs did not play a mediating role in the research model for the suburban school context. Conclusions: This study strengthens the feasibility of the OLMs framework, based on information processing, to provide a concrete description of organizational learning processes in schools. The study provides a deeper understanding of how OLMs can serve as a significant link between the dynamic school environment and teachers’ attitudes, which may ultimately improve teachers’ work and students’ learning.",0,1 +440,Evaluating expectations about negative emotional states of aggressive boys using Bayesian model selection.,"Researchers often have expectations about the research outcomes in regard to inequality constraints between, e.g., group means. Consider the example of researchers who investigated the effects of inducing a negative emotional state in aggressive boys. It was expected that highly aggressive boys would, on average, score higher on aggressive responses toward other peers than moderately aggressive boys, who would in turn score higher than nonaggressive boys. In most cases, null hypothesis testing is used to evaluate such hypotheses. We show, however, that hypotheses formulated using inequality constraints between the group means are generally not evaluated properly. The wrong hypotheses are tested, i.e.. the null hypothesis that group means are equal. In this article, we propose an innovative solution to these above-mentioned issues using Bayesian model selection, which we illustrate using a case study.",0,1 +441,Quantile maximum likelihood estimation of response time distributions,"We introduce and evaluate via a Monte Carlo study a robust new estimation technique that fits distribution functions to grouped response time (RT) data, where the grouping is determined by sample quantiles. The new estimator, quantile maximum likelihood (QML), is more efficient and less biased than the best alternative estimation technique when fitting the commonly used ex-Gaussian distribution. Limitations of the Monte Carlo results are discussed and guidance provided for the practical application of the new technique. Because QML estimation can be computationally costly, we make fast open source code for fitting available that can be easily modified to use QML in the estimation of any distribution function.",0,1 +442,Comparative effectiveness of antiviral treatment for hepatitis B,"A wide variety of competing drugs are available to patients for the treatment of chronic hepatitis B. We update a recent meta-analysis to include additional trial evidence with the aim of determining which treatment is the most effective.Twelve monotherapy or combination therapy were evaluated in treatment-naive individuals with hepatitis B e antigen (HBeAg) positive or negative patients. Databases were searched for randomized controlled trials in the first year of therapy. Bayesian random effects network meta-analysis was used to calculate the pairwise odds ratios, 95% credible intervals and ranking of six surrogate outcomes.In total, 22 studies were identified (7508 patients): 12 studies analysed HBeAg-positive patients, six analysed HBeAg-negative patients, and four evaluated both. Tenofovir was most effective at increasing efficacy in HBeAg-positive patients, ranking first for three outcomes and increased odds of undetectable levels of hepatitis B virus (HBV) DNA compared with seven other therapies (such as lamivudine: odds ratio 33.0; 95% credible interval 7.0-292.7). For HBeAg-negative patients, the large network (seven therapies) ranked entecavir alone or in combination with tenofovir highly for reduction in HBV DNA and histologic improvement. In the smaller network (three therapies), tenofovir ranked first for undetectable HBV DNA and histologic improvement. No data existed to directly or indirectly compare these treatments.For HBeAg-positive patients tenofovir is the most effective at increasing efficacy, whereas for HBeAg-negative patients, either tenofovir or entecavir is most effective. Further research should focus on strengthening the network connections, in particular comparing tenofovir and entecavir in HBeAg-negative patients.",0,1 +443,"Gen(d)eralized Trust: Women, Work, and Trust in Strangers","This article deals with the question as to whether gender equality in labour force participation affects generalized trust. Following the seminal work of Rothstein and Uslaner, a first hypothesis m ...",0,1 +444,Conscientiousness and the Theory of Planned Behavior: Toward a more Complete Model of the Antecedents of Intentions and Behavior,"Two studies explored the relationship between past behavior, personality traits, intentions, and behavior. Study 1 (N = 181) considered intentions to engage in goal-directed activity (health protection). Cognitions specified by the Theory of Planned Behavior were examined as mediators of the relationship between past behavior, personality, and intentions. The effect of conscientiousness on intention was partially mediated by cognitions, whereas the effect of past behavior was partially mediated by cognitions and conscientiousness. Study 2 (N = 123) examined predictions of intentions and self-reported behavior in relation to both health protection and exercise, a more specific behavior. In both cases, the effect of conscientiousness on intention was totally mediated, whereas the effect on behavior was partially mediated. Similarly, the effects of past behavior on intentions were totally mediated, whereas the effects on behavior were partially mediated by cognitions and conscientiousness. Thus, combining personality traits and cognitions provided a more sufficient account of the determinants of intentions and behavior.",0,1 +445,Pulling the Sobel Test Up By Its Bootstraps,,0,1 +446,Assessing and Controlling Acquiescent Responding When Acquiescence and Content Are Related: A Comprehensive Factor-Analytic Approach,"This article proposes procedures for assessing and controlling acquiescence in personality scales when acquiescence is related to the content that the scale intends to measure. Our proposal is comprehensive in that it can be applied to different item response formats fitted with response models that can be parameterized as factor-analytic models. In the calibration stage, our proposal makes joint use of a balanced scale and a set of markers for acquiescence, and consists of 2 sequential procedures: a direct semirestricted solution, and a restricted solution with minimal identification constraints. In the scoring stage, we discuss how the information given by the acquiescence–content relation can be used to obtain Bayes expected a posteriori scores. The robustness of the direct procedure is assessed both analytically and by simulation. A free, user-friendly program that implements the procedures proposed is made available. Practical issues of use and interpretation are discussed and illustrated with an emp...",0,1 +447,Choosing among Alternative Nonexperimental Methods for Estimating the Impact of Social Programs: The Case of Manpower Training,The recent literature on evaluating manpower training programs demonstrates that alternative nonexperimental estimators of the same program produce a array of estimates of program impact. These findings have led to the call for experiments to be used to perform credible program evaluations. Missing in all of the recent pessimistic analyses of nonexperimental methods is any systematic discussion of how to choose among competing estimators. This paper explores the value of simple specification tests in selecting an appropriate nonexperimental estimator. A reanalysis of the National Supported Work Demonstration Data previously analyzed by proponents of social experiments reveals that a simple testing procedure eliminates the range of nonexperimental estimators that are at variance with the experimental estimates of program impact.,0,1 +448,Profile Likelihood-Based Confidence Intervals and Regions for Structural Equation Models,"Structural equation models (SEM) are widely used for modeling complex multivariate relationships among measured and latent variables. Although several analytical approaches to interval estimation in SEM have been developed, there lacks a comprehensive review of these methods. We review the popular Wald-type and lesser known likelihood-based methods in linear SEM, emphasizing profile likelihood-based confidence intervals (CIs). Existing algorithms for computing profile likelihood-based CIs are described, including two newer algorithms which are extended to construct profile likelihood-based confidence regions (CRs). Finally, we illustrate the use of these CIs and CRs with two empirical examples, and provide practical recommendations on when to use Wald-type CIs and CRs versus profile likelihood-based CIs and CRs. OpenMx example code is provided in an Online Appendix for constructing profile likelihood-based CIs and CRs for SEM. © 2015, The Psychometric Society.",0,1 +449,Conditional logit analysis of qualitative choice behavior,,0,1 +450,Bivariate Binomial Spatial Modeling of Loa loa Prevalence in Tropical Africa,"We present a state-of-the-art application of smoothing for dependent bivariate binomial spatial data to Loa loa prevalence mapping in West Africa. This application starts with the nonspatial calibration of survey instruments, continues with the spatial model building and assessment, and ends with robust, tested software intended for use by field workers for online prevalence map updating. From a statistical perspective, we address several important methodological issues: building spatial models that are sufficiently complex to capture the structure of the data but remain computationally usable, reducing the computational burden in the handling of very large covariate data sets, and devising methods for comparing spatial prediction methods for a given exceedance policy threshold.",0,1 +451,Equity in specialist waiting times by socioeconomic groups: evidence from Spain,"In countries with publicly financed health care systems, waiting time - rather than price - is the rationing mechanism for access to health care services. The normative statement underlying such a rationing device is that patients should wait according to need and irrespective of socioeconomic status or other non-need characteristics. The aim of this paper is to test empirically that waiting times for publicly funded specialist care do not depend on patients' socioeconomic status. Waiting times for specialist care can vary according to the type of medical specialty, type of consultation (review or diagnosis) and the region where patients' reside. In order to take into account such variability, we use Bayesian random parameter models to explain waiting times for specialist care in terms of need and non-need variables. We find that individuals with lower education and income levels wait significantly more time than their counterparts. © 2013 Springer-Verlag Berlin Heidelberg.",0,1 +452,Order-free co-regionalized areal data models with application to multiple-disease mapping,"Summary. With the ready availability of spatial databases and geographical information system software, statisticians are increasingly encountering multivariate modelling settings featuring associations of more than one type: spatial associations between data locations and associations between the variables within the locations. Although flexible modelling of multivariate point-referenced data has recently been addressed by using a linear model of co-regionalization, existing methods for multivariate areal data typically suffer from unnecessary restrictions on the covariance structure or undesirable dependence on the conditioning order of the variables. We propose a class of Bayesian hierarchical models for multivariate areal data that avoids these restrictions, permitting flexible and order-free modelling of correlations both between variables and across areal units. Our framework encompasses a rich class of multivariate conditionally autoregressive models that are computationally feasible via modern Markov chain Monte Carlo methods. We illustrate the strengths of our approach over existing models by using simulation studies and also offer a real data application involving annual lung, larynx and oesophageal cancer death-rates in Minnesota counties between 1990 and 2000.",0,1 +453,Editorial.,"The Journal of Applied Psychology is the oldest and largest top-tier journal publishing theory and research relevant to industrial and organizational psychology, organizational behavior, and human resources management. The primary emphasis of this journal is the publication of original investigations that advance theoretical understanding and create new knowledge for applied psychology within the broad scope of the organizational sciences. We are primarily interested in publishing empirical research and conceptual articles that enhance understanding of psychological phenomena in human and organizational systems. This editorial also covers the expectations and review process that the Journal of Applied Psychology has for manuscripts submitted to the journal. (PsycINFO Database Record (c) 2009 APA, all rights reserved).",0,1 +454,Unobserved Heterogeneity in Income Dynamics: An Empirical Bayes Perspective,"Empirical Bayes methods for Gaussian compound decision problems involving longitudinal data are considered. The new convex optimization formulation of the nonparametric (Kiefer–Wolfowitz) maximum likelihood estimator for mixture models is employed to construct nonparametric Bayes rules for compound decisions. The methods are first illustrated with some simulation examples and then with an application to models of income dynamics. Using panel data, we estimate a simple dynamic model of earnings that incorporates bivariate heterogeneity in intercept and variance of the innovation process. Profile likelihood is employed to estimate an AR(1) parameter controlling the persistence of the innovations. We find that persistence is relatively modest, ρ^≈0.48, when we permit heterogeneity in variances. Evidence of negative dependence between individual intercepts and variances is revealed by the nonparametric estimation of the mixing distribution, and has important consequences for forecasting future income trajecto...",0,1 +455,"A Multilevel AR(1) Model: Allowing for Inter-Individual Differences in Trait-Scores, Inertia, and Innovation Variance.","In this article we consider a multilevel first-order autoregressive [AR(1)] model with random intercepts, random autoregression, and random innovation variance (i.e., the level 1 residual variance). Including random innovation variance is an important extension of the multilevel AR(1) model for two reasons. First, between-person differences in innovation variance are important from a substantive point of view, in that they capture differences in sensitivity and/or exposure to unmeasured internal and external factors that influence the process. Second, using simulation methods we show that modeling the innovation variance as fixed across individuals, when it should be modeled as a random effect, leads to biased parameter estimates. Additionally, we use simulation methods to compare maximum likelihood estimation to Bayesian estimation of the multilevel AR(1) model and investigate the trade-off between the number of individuals and the number of time points. We provide an empirical illustration by applying the extended multilevel AR(1) model to daily positive affect ratings from 89 married women over the course of 42 consecutive days.",0,1 +456,A quadrature method for Bayesian sequential threshold estimation,"For two-alternative forced-choice (2AFC) sequential threshold estimation, a finite Bayesian method (Emerson, 1986b) has been found to perform better than a closely related maximum-likelihood (ML) method. The comparison was especially apt because the two methods used all the same computations (Shelton, 1983) in maintaining and updating the representation of the log-likelihood function. This representation was in the form of a finite discrete array of about 50 equally spaced numerical elements in computer memory. The updating consisted of a series of offset lookups and additions from either of two precomputed arrays representing the log-likelihoods of correct and incorrect responses on a single trial. The difference between the ML and Bayesian methods was in the way the updated log-likelihood array was used to obtain the new estimate of the threshold after each trial. For the ML method, the array was merely scanned for its maximal element. For the Bayesian method, each element was exponentiated and the results were treated as unnormalized probabilities. These were then summed, with and without a multiplicative factor of the array index, to obtain the Bayesian normalizing constant and expected value of the threshold. These additional computations made the Bayesian method considerably slower than the ML method. Real-time use of that finite Bayesian method requires a compiled version of the program, rather than interpretive BASIC, and one of the faster PC-class computers. Statistically, the Bayesian estimates were generally better than the ML in that (1) there was no general negative bias, (2) biases toward the initial estimate decreased rapidly with increasing trials in the run, (3) variances were generally smaller, and (4) the biases and variances depended much less on the location of the true threshold in the assumed stimulus range.",0,1 +457,Commercial use of conjoint analysis in Europe: Results and critical reflections,"Abstract We report the incidence of conjoint analysis applications by European market research suppliers. Based on responses to a survey, we document about 1,000 commercial projects over a five-year period and show breakdowns by product category, study purpose, and other characteristics such as study design, data collection, and data analysis. The results are compared with information collected for an earlier time period in the United States. We also discuss recent conjoint research results, identify issues that warrant further study, and suggest how the current practice of conjoint analysis can be improved.",0,1 +458,Evaluation of suspected measles incidence rate trend in Iran and the affecting factors: Negative-Binomial mixed model,"Introduction: The identifying incidence rate trend of disease and its changes lead to update response of surveillance system. Syndromic surveillance system is based on the suspected cases, so it has high speed in detecting outbreaks. This study aimed to evaluate trend of fever and rash incidence rates and detect affecting factors. Materials and Methods: This study was a retrospective cohort study and the data included the suspected measles cases in provinces of Iran in 1977-2012, which extracted from surveillance system of vaccine preventable diseases. We fitted Poisson and Negative-Binomial regression models with random effect. Modeling and inferences were based on a Bayesian algorithm. We used R and OpenBUGS software. The fitted models were compared based on Deviance and Chi-square goodness of fit statistics. Results: Interaction effect between year and immunization campaign was statistically significant (95% CrI:1.083,1.737), after immunization campaign, trend was increasing. The variance of random component in model was statistically significant (95% CrI: 0.219,0.430). On the other hand, province-specific characterizes found affecting factor on suspected incidence rate. Conclusion: In attention to increasing trend of this incidence in Iran, especially in recently years, and affecting of province-specific characterizes on suspected incidence rate, We found that more accurate control and improvement of quality vaccination is essential. © 2015, Semnan University of Medical Sciences. All rights reserved.",0,1 +459,Comparing Methods of Assessing Differential Item Functioning in a Computerized Adaptive Testing Environment,"Mantel-Haenszel and SIBTEST, which have known difficulty in detecting non-unidirectional differential item functioning (DIF), have been adapted with some success for computerized adaptive testing (CAT). This study adapts logistic regression (LR) and the item-response-theory-likelihood-ratio test (IRT-LRT), capable of detecting both unidirectional and non-unidirectional DIF, to the CAT environment in which pretest items are assumed to be seeded in CATs but not used for trait estimation. The proposed adaptation methods were evaluated with simulated data under different sample size ratios and impact conditions in terms of Type I error, power, and specificity in identifying the form of DIF. The adapted LR and IRT-LRT procedures are more powerful than the CAT version of SIBTEST for non-unidirectional DIF detection. The good Type I error control provided by IRT-LRT under extremely unequal sample sizes and large impact is encouraging. Implications of these and other findings are discussed.",0,1 +460,Logistic random effects regression models: a comparison of statistical packages for binary and ordinal outcomes,"Abstract Background Logistic random effects models are a popular tool to analyze multilevel also called hierarchical data with a binary or ordinal outcome. Here, we aim to compare different statistical software implementations of these models. Methods We used individual patient data from 8509 patients in 231 centers with moderate and severe Traumatic Brain Injury (TBI) enrolled in eight Randomized Controlled Trials (RCTs) and three observational studies. We fitted logistic random effects regression models with the 5-point Glasgow Outcome Scale (GOS) as outcome, both dichotomized as well as ordinal, with center and/or trial as random effects, and as covariates age, motor score, pupil reactivity or trial. We then compared the implementations of frequentist and Bayesian methods to estimate the fixed and random effects. Frequentist approaches included R (lme4), Stata (GLLAMM), SAS (GLIMMIX and NLMIXED), MLwiN ([R]IGLS) and MIXOR, Bayesian approaches included WinBUGS, MLwiN (MCMC), R package MCMCglmm and SAS experimental procedure MCMC. Three data sets (the full data set and two sub-datasets) were analysed using basically two logistic random effects models with either one random effect for the center or two random effects for center and trial. For the ordinal outcome in the full data set also a proportional odds model with a random center effect was fitted. Results The packages gave similar parameter estimates for both the fixed and random effects and for the binary (and ordinal) models for the main study and when based on a relatively large number of level-1 (patient level) data compared to the number of level-2 (hospital level) data. However, when based on relatively sparse data set, i.e. when the numbers of level-1 and level-2 data units were about the same, the frequentist and Bayesian approaches showed somewhat different results. The software implementations differ considerably in flexibility, computation time, and usability. There are also differences in the availability of additional tools for model evaluation, such as diagnostic plots. The experimental SAS (version 9.2) procedure MCMC appeared to be inefficient. Conclusions On relatively large data sets, the different software implementations of logistic random effects regression models produced similar results. Thus, for a large data set there seems to be no explicit preference (of course if there is no preference from a philosophical point of view) for either a frequentist or Bayesian approach (if based on vague priors). The choice for a particular implementation may largely depend on the desired flexibility, and the usability of the package. For small data sets the random effects variances are difficult to estimate. In the frequentist approaches the MLE of this variance was often estimated zero with a standard error that is either zero or could not be determined, while for Bayesian methods the estimates could depend on the chosen ""non-informative"" prior of the variance parameter. The starting value for the variance parameter may be also critical for the convergence of the Markov chain.",0,1 +461,Context Matters: Economic Voting in the 2009 and 2014 European Parliament Elections,"Using the 2009 and 2014 European Election Studies (EES), we explore the effect of the economy on the vote in the 2009 and 2014 European Parliament (EP) elections. The paper demonstrates that the economy did influence voters in both contests. However, its impact was heterogeneous across the two elections and between countries. While assessments of the economy directly motivated voters in 2009 by 2014 economic appraisals were conditioned by how much responsibility voters felt the national government had for the state of the economy, implying a shift in calculus between the two elections. The analysis suggests that voters in 2009 were simply reacting to the economic tsunami that was the Global Financial Crisis, with motivations primarily driven by the unfavourable economic conditions countries faced. But in 2014, evaluations were conditioned by judgments about responsibility for the economy, suggesting a more conscious holding to account of the government. Our paper also reveals cross-country differences in the influence of the economy on vote. Attribution of responsibility and economic evaluations had a more potent impact on support for the government in bailout countries compared to non-bailout countries in 2014. Our findings demonstrate the importance of economy on vote in EP elections but also highlight how its impact on vote can vary based on context.",0,1 +462,Diagnostic Procedures for Detecting Nonlinear Relationships Between Latent Variables,"Structural equation models are commonly used to estimate relationships between latent variables. Almost universally, the fitted models specify that these relationships are linear in form. This assumption is rarely checked empirically, largely for lack of appropriate diagnostic techniques. This article presents and evaluates two procedures that can be used to visualize and detect nonlinear relationships between latent variables. The first procedure involves fitting a linear structural equation model and then inspecting plots of factor score estimates for evidence of nonlinearity. The second procedure is to use a mixture of linear structural equation models to approximate the underlying, potentially nonlinear function. Targeted simulations indicate that the first procedure is more efficient, but that the second procedure is less biased. The mixture modeling approach is recommended, particularly with medium to large samples.",0,1 +463,Nonparametric Bayesian Modeling for Multivariate Ordinal Data,"This article proposes a probability model for k-dimensional ordinal outcomes, that is, it considers inference for data recorded in k-dimensional contingency tables with ordinal factors. The proposed approach is based on full posterior inference, assuming a flexible underlying prior probability model for the contingency table cell probabilities. We use a variation of the traditional multivariate probit model, with latent scores that determine the observed data. In our model, a mixture of normals prior replaces the usual single multivariate normal model for the latent variables. By augmenting the prior model to a mixture of normals we generalize inference in two important ways. First, we allow for varying local dependence structure across the contingency table. Second, inference in ordinal multivariate probit models is plagued by problems related to the choice and resampling of cutoffs defined for these latent variables. We show how the proposed mixture model approach entirely removes these problems. We ill...",0,1 +464,Fractional Bayes Factors for Model Comparison,"Bayesian comparison of models is achieved simply by calculation of posterior probabilities of the models themselves. However, there are difficulties with this approach when prior information about the parameters of the various models is weak. Partial Bayes factors offer a resoIution of the problem by setting aside part of the data as a training sampIe. The training sampIe is used to obtain an initiaI informative posterior distribution of the parameters in each model. Model comparison is then based on a Bayes factor calculated from the remaining data. Properties of partial Bayes factors are discussed, particularly in the context of weak prior information, and they are found to have advantages over other proposed methods of model comparison. A new variant of the partial Bayes factor, the fractional Bayes factor, is advocated on grounds of consistency, simplicity, robustness and coherence",0,1 +465,Estimating and testing interactions in linear regression models when explanatory variables are subject to classical measurement error,"Estimating and testing interactions in a linear regression model when normally distributed explanatory variables are subject to classical measurement error is complex, since the interaction term is a product of two variables and involves errors of more complex structure. Our aim is to develop simple methods, based on the method of moments (MM) and regression calibration (RC) that yield consistent estimators of the regression coefficients and their standard errors when the model includes one or more interactions. In contrast to previous work using structural equations models framework, our methods allow errors that are correlated with each other and can deal with measurements of relatively low reliability. Using simulations, we show that, under the normality assumptions, the RC method yields estimators with negligible bias and is superior to MM in both bias and variance. We also show that the RC method also yields the correct type I error rate of the test of the interaction. However, when the true covariates are not normally distributed, we recommend using MM. We provide an example relating homocysteine to serum folate and B12 levels.",0,1 +466,Simulating multivariate nonnormal distributions,"A method for generating multivariate nonnormal distributions with specified intercorrelations and marginal means, variances, skews, and kurtoses is proposed. As an example, the method is applied to the generation of simulated scores on three psychological tests administered to a single group of individuals. © 1983 The Psychometric Society.",0,1 +467,Some latent trait models and their use in inferring an examinee's ability,,0,1 +468,"Prospective Relations Among Fearful Temperament, Protective Parenting, and Social Withdrawal: The Role of Maternal Accuracy in a Moderated Mediation Framework","Early social withdrawal and protective parenting predict a host of negative outcomes, warranting examination of their development. Mothers' accurate anticipation of their toddlers' fearfulness may facilitate transactional relations between toddler fearful temperament and protective parenting, leading to these outcomes. Currently, we followed 93 toddlers (42 female; on average 24.76 months) and their mothers (9% underrepresented racial/ethnic backgrounds) over 3 years. We gathered laboratory observation of fearful temperament, maternal protective behavior, and maternal accuracy during toddlerhood and a multi-method assessment of children's social withdrawal and mothers' self-reported protective behavior at kindergarten entry. When mothers displayed higher accuracy, toddler fearful temperament significantly related to concurrent maternal protective behavior and indirectly predicted kindergarten social withdrawal and maternal protective behavior. These results highlight the important role of maternal accuracy in linking fearful temperament and protective parenting, which predict further social withdrawal and protection, and point to toddlerhood for efforts of prevention of anxiety-spectrum outcomes.",0,1 +469,A shrinkage estimator for spectral densities,"SUMMARY We propose a shrinkage estimator for spectral densities based on a multilevel normal hierarchical model. The first level captures the sampling variability via a likelihood con structed using the asymptotic properties of the periodogram. At the second level, the spectral density is shrunk towards a parametric time series model. To avoid selecting a particular parametric model for the second level, a third level is added which induces an estimator that averages over a class of parsimonious time series models. The estimator derived from this model, the model averaged shrinkage estimator, is consistent, is shown to be highly competitive with other spectral density estimators via simulations, and is computationally inexpensive.",0,1 +470,Who supports minority rights in popular votes? Empirical evidence from Switzerland,"Recent research shows that well-educated citizens are more supportive of minority rights in direct democratic votes than people with less education. This article however suggests that educational effects on minority rights only emerge under certain conditions. A Bayesian multilevel analysis of 39 referendums and initiatives on minority rights in Switzerland (1981–2009) shows that educational effects are particularly strong when the rights of lesser-known cultural minorities are to be extended. They are entirely absent, however, when referenda address the curtailment of rights for well-known minority groups. • We study educational effects on minority rights in direct democratic votes. • We use individual data (surveys) from 39 referendums and initiatives on minority rights in Switzerland (1981–2009) and conduct a Bayesian multilevel analysis. • We show that the relationship between education and pro-minority voting behaviour is very strong when a ballot proposition aims at expanding the rights of out-group minorities (e.g. foreigners). • Educational effects are absent when referenda address the curtailment of rights for well-known minority groups (e.g. disabled persons).",0,1 +471,An analysis of correlation matrices: Equal correlations,"SUMMARY We study the large-sample joint distribution of Z, the -fp(p - 1) Fisher z-transforms of the elements in a p variable correlation matrix. Under the null hypothesis of equal population correlations the variance matrix of Z has just three projector matrices in its spectral decomposition. These define three mutually orthogonal invariant subspaces of sample space, or 'error strata' as they would be called in the analysis of variance. The squared lengths of the projections of the sample vector onto each of these subspaces, when divided by the stratum variance, provide a natural partition for the large-sample chi-squared test for equality of correlations. A linear model is given which provides a statistical interpretation for the error strata, and hence the components in the partition. As well as providing a simple test for equality of correlations, the procedure indicates how familiar techniques in the spirit of analysis of variance can be used to investigate correlation matrices.",0,1 +472,A Bayesian approach for generalized random coefficient structural equation models for longitudinal data with adjacent time effects,This paper proposes a generalized random coefficient structural equation model for analyzing longitudinal data by incorporating the correlated structure due to adjacent time effects and by allowing structural parameters to vary across individuals. The coregionalization for modeling multivariate spatial data is adopted to formulate the correlated structure between adjacent time points. A Bayesian approach coupled with the Gibbs sampler and the Metropolis-Hastings algorithm is developed to obtain the Bayesian estimates of unknown parameters and latent variables simultaneously. A simulation study and a real example related to an emotion study are presented to illustrate the newly developed methodology.,0,1 +473,A Box-Cox normal model for response times,"The log-transform has been a convenient choice in response time modelling on test items. However, motivated by a dataset of the Medical College Admission Test where the lognormal model violated the normality assumption, the possibilities of the broader class of Box-Cox transformations for response time modelling are investigated. After an introduction and an outline of a broader framework for analysing responses and response times simultaneously, the performance of a Box-Cox normal model for describing response times is investigated using simulation studies and a real data example. A transformation-invariant implementation of the deviance information criterium (DIC) is developed that allows for comparing model fit between models with different transformation parameters. Showing an enhanced description of the shape of the response time distributions, its application in an educational measurement context is discussed at length.",0,1 +474,Pharmacologic Interventions for Painful Diabetic Neuropathy,"Multiple treatments for painful diabetic peripheral neuropathy are available.To evaluate the comparative effectiveness of oral and topical analgesics for diabetic neuropathy.Multiple electronic databases between January 2007 and April 2014, without language restriction.Parallel or crossover randomized, controlled trials that evaluated pharmacologic treatments for adults with painful diabetic peripheral neuropathy.Duplicate extraction of study data and assessment of risk of bias.65 randomized, controlled trials involving 12 632 patients evaluated 27 pharmacologic interventions. Approximately one half of these studies had high or unclear risk of bias. Nine head-to-head trials showed greater pain reduction associated with serotonin-norepinephrine reuptake inhibitors (SNRIs) than anticonvulsants (standardized mean difference [SMD], -0.34 [95% credible interval {CrI}, -0.63 to -0.05]) and with tricyclic antidepressants (TCAs) than topical capsaicin 0.075%. Network meta-analysis showed that SNRIs (SMD, -1.36 [CrI, -1.77 to -0.95]), topical capsaicin (SMD, -0.91 [CrI, -1.18 to -0.08]), TCAs (SMD, -0.78 [CrI, -1.24 to -0.33]), and anticonvulsants (SMD, -0.67 [CrI, -0.97 to -0.37]) were better than placebo for short-term pain control. Specifically, carbamazepine (SMD, -1.57 [CrI, -2.83 to -0.31]), venlafaxine (SMD, -1.53 [CrI, -2.41 to -0.65]), duloxetine (SMD, -1.33 [CrI, -1.82 to -0.86]), and amitriptyline (SMD, -0.72 [CrI, -1.35 to -0.08]) were more effective than placebo. Adverse effects included somnolence and dizziness with TCAs, SNRIs, and anticonvulsants; xerostomia with TCAs; and peripheral edema and burning sensation with pregabalin and capsaicin.Confidence in findings was limited because most evidence came from indirect comparisons of trials with short (≤3 months) follow-up and unclear or high risk of bias.Several medications may be effective for short-term management of painful diabetic neuropathy, although their comparative effectiveness is unclear.Mayo Foundation for Medical Education and Research.",0,1 +475,SYNTHETIC VALIDITY AND ITS APPLICATION TO THE UNIFORM GUIDELINES VALIDATION REQUIREMENTS,"The Uniform Guidelines for Employee Selection Procedures have served to create an urgent need for efficient validation methods that can be generalized to a class of occupations. The one method currently authorized for such a purpose by the Guidelines is synthetic validation. (The Guidelines erroneously describe the synthetic validity paradigm as construct validity.) Approaches to synthetic validity employed by Lawshe, Guion, McCormick, and Primoff are described. Their extent of conformance to the Guidelines validation requirements is noted. Primoff's J-Coefficient approach is recommended for two reasons; it meets the Guidelines requirements and under certain circumstances it permits the test user to estimate the traditional validity coefficient. An illustrated example of Primoff's method is presented.",0,1 +476,Hierarchical Encoding in Visual Working Memory,"Influential models of visual working memory treat each item to be stored as an independent unit and assume that there are no interactions between items. However, real-world displays have structure that provides higher-order constraints on the items to be remembered. Even in the case of a display of simple colored circles, observers can compute statistics, such as mean circle size, to obtain an overall summary of the display. We examined the influence of such an ensemble statistic on visual working memory. We report evidence that the remembered size of each individual item in a display is biased toward the mean size of the set of items in the same color and the mean size of all items in the display. This suggests that visual working memory is constructive, encoding displays at multiple levels of abstraction and integrating across these levels, rather than maintaining a veridical representation of each item independently.",0,1 +477,Bayesian Predictive Inference of a Proportion Under a Twofold Small-Area Model,"Abstract We extend the twofold small-area model of Stukel and Rao (1997; 1999) to accommodate binary data. An example is the Third International Mathematics and Science Study (TIMSS), in which pass-fail data for mathematics of students from US schools (clusters) are available at the third grade by regions and communities (small areas). We compare the finite population proportions of these small areas. We present a hierarchical Bayesian model in which the firststage binary responses have independent Bernoulli distributions, and each subsequent stage is modeled using a beta distribution, which is parameterized by its mean and a correlation coefficient. This twofold small-area model has an intracluster correlation at the first stage and an intercluster correlation at the second stage. The final-stage mean and all correlations are assumed to be noninformative independent random variables. We show how to infer the finite population proportion of each area. We have applied our models to synthetic TIMSS data to show that the twofold model is preferred over a onefold small-area model that ignores the clustering within areas. We further compare these models using a simulation study, which shows that the intracluster correlation is particularly important.",0,1 +478,Sulla determinazione empirica di una legge di distribuzione,,0,1 +479,How Much Power and Speed Is Measured in This Test?,"An old issue in psychological assessment is to what extent power and speed each are measured by a given intelligence test. Starting from accuracy and response time data, an approach based on posterior time limits (cut-offs of recorded response time) leads to three kinds of recoded data: time data (whether or not the response precedes the cut-off), time-accuracy data (whether or not a response is correct and precedes the cut-off), and accuracy data (as time-accuracy data, but coded as missing when not preceding the time cut-off). Each type of data can be modeled as binary responses. Speed and power are investigated through the effect of posterior time limits on two main aspects: (a) the latent variable that is measured: whether it is more power-related or more speed-related; (b) how well the latent variable (of whatever kind) is measured through the item(s). As empirical data, we use responses and response times for a verbal analogies test. The main findings are that, independent of the posterior time limit, basically the same latent speed trait was measured through the time data, and basically the same latent power trait was measured through the accuracy data, while for the time-accuracy data the nature of the latent trait moved from power to speed when the posterior time limit was reduced. It was also found that a reduction of the posterior time limit had no negative effect on the reliability of the latent trait measures (of whatever kind).",0,1 +480,Improved small sample inference in the mixed linear model: Bartlett correction and adjusted likelihood,"Summary. The mixed linear model is a popular method for analysing unbalanced repeated measurement data. The classical statistical tests for parameters in this model are based on asymptotic theory that is unreliable in the small samples that are often encountered in practice. For testing a given fixed effect parameter with a small sample, we develop and investigate refined likelihood ratio (LR) tests. The refinements considered are the Bartlett correction and use of the Cox-Reid adjusted likelihood; these are examined separately and in combination. We illustrate the various LR tests on an actual data set and compare them in two simulation studies. The conventional LR test yields type I error rates that are higher than nominal. The adjusted LR test yields rates that are lower than nominal, with absolute accuracy similar to that of the conventional LR test in the first simulation study and better in the second. The Bartlett correction substantially improves the accuracy of the type I error rates with either the conventional or the adjusted LR test. In many cases, error rates that are very close to nominal are achieved with the refined methods.",0,1 +481,Small N Justifies Rasch Model,The usual Birnbaum item response function requires the determination of three parameters for each item; the Rasch model requires only one. It would be useful to know how large the sample of examinees must be before it is worthwhile to use a two- or three-parameter item response model in preference to the Rasch model. The answer to this question depends on the purpose to be served. This chapter answers this question only for the two-parameter logistic model and only for one very limited situation. It points out the problem to indicate a method of solution and to provide some numerical results indicating the sample size required when there is no guessing.,0,1 +482,Hindrances are not threats: Advancing the multidimensionality of work stress.,"The challenge-hindrance framework has proved useful for explaining inconsistencies in relationships between work stressors and important outcomes. By introducing the distinction between threat and hindrance to this framework, we capture the potential for personal harm or loss (threat) associated with stressors, as distinct from the potential to block goal attainment (hindrance) or promote gain (challenge). In Study 1, survey data were collected from 609 retail workers, 220 of whom responded 6 months later. The results supported a 3-factor threat-hindrance-challenge stressor structure and showed that threat stressors are associated with increased psychological distress and emotional exhaustion, and reduced dedication, whereas hindrance stressors undermine dedication but may not be related to distress or exhaustion with threats included in the model. Study 2 utilized a diary study design, with data collected from 207 workers over 3 workdays. Findings revealed that the threat, hindrance, and challenge appraisals of individual workers are statistically distinct, and associated with stressors and well-being as anticipated: threats with role conflict and anxiety, hindrances with organizational constraints and fatigue, and challenges with skill demands and enthusiasm. Overall, moving to a 3-dimensional challenge-hindrance-threat framework for stressors and stress appraisals will support a more accurate picture regarding the nature, processes, and effects of stressors on individuals and organizations, and ensure prevention efforts are not misguided.",0,1 +483,Fitting Item Response Theory Models to Two Personality Inventories: Issues and Insights,"The present study compared the fit of several IRT models to two personality assessment instruments. Data from 13,059 individuals responding to the US-English version of the Fifth Edition of the Sixteen Personality Factor Questionnaire (16PF) and 1,770 individuals responding to Goldberg's 50 item Big Five Personality measure were analyzed. Various issues pertaining to the fit of the IRT models to personality data were considered. We examined two of the most popular parametric models designed for dichotomously scored items (i.e., the two- and three-parameter logistic models) and a parametric model for polytomous items (Samejima's graded response model). Also examined were Levine's nonparametric maximum likelihood formula scoring models for dichotomous and polytomous data, which were previously found to provide good fits to several cognitive ability tests (Drasgow, Levine, Tsien, Williams, & Mead, 1995). The two- and three-parameter logistic models fit some scales reasonably well but not others; the graded response model generally did not fit well. The nonparametric formula scoring models provided the best fit of the models considered. Several implications of these findings for personality measurement and personnel selection were described.",0,1 +484,Specifying optimum examinees for item parameter estimation in item response theory,,0,1 +485,A Bayesian Hierarchical Model for Learning Natural Scene Categories,"We propose a novel approach to learn and recognize natural scene categories. Unlike previous work, it does not require experts to annotate the training set. We represent the image of a scene by a collection of local regions, denoted as codewords obtained by unsupervised learning. Each region is represented as part of a theme. In previous work, such themes were learnt from hand-annotations of experts, while our method learns the theme distributions as well as the codewords distribution over the themes without supervision. We report satisfactory categorization performances on a large set of 13 categories of complex scenes.",0,1 +486,"Weber’s Law, the Magnitude Effect and Discrimination of Sugar Concentrations in Nectar-Feeding Animals","Weber's law quantifies the perception of difference between stimuli. For instance, it can explain why we are less likely to detect the removal of three nuts from a bowl if the bowl is full than if it is nearly empty. This is an example of the magnitude effect - the phenomenon that the subjective perception of a linear difference between a pair of stimuli progressively diminishes when the average magnitude of the stimuli increases. Although discrimination performances of both human and animal subjects in various sensory modalities exhibit the magnitude effect, results sometimes systematically deviate from the quantitative predictions based on Weber's law. An attempt to reformulate the law to better fit data from acoustic discrimination tasks has been dubbed the ""near-miss to Weber's law"". Here, we tested the gustatory discrimination performance of nectar-feeding bats (Glossophaga soricina), in order to investigate whether the original version of Weber's law accurately predicts choice behavior in a two-alternative forced choice task. As expected, bats either preferred the sweeter of the two options or showed no preference. In 4 out of 6 bats the near-miss to Weber's law provided a better fit and Weber's law underestimated the magnitude effect. In order to test the generality of this observation in nectar-feeders, we reviewed previously published data on bats, hummingbirds, honeybees, and bumblebees. In all groups of animals the near-miss to Weber's law provided better fits than Weber's law. Furthermore, whereas the magnitude effect was stronger than predicted by Weber's law in vertebrates, it was weaker than predicted in insects. Thus nectar-feeding vertebrates and insects seem to differ in how their choice behavior changes as sugar concentration is increased. We discuss the ecological and evolutionary implications of the observed patterns of sugar concentration discrimination.",0,1 +487,A Meta-Analytic Review of the Theories of Reasoned Action and Planned Behavior in Physical Activity: Predictive Validity and the Contribution of Additional Variables,"The aim of the present study was to examine relations between behavior, intentions, attitudes, subjective norms, perceived behavioral control, self-efficacy, and past behavior across studies using the Theories of Reasoned Action (TRA) and Planned Behavior (TPB) in a physical activity context. Meta-analytic techniques were used to correct the correlations between the TRA/TPB constructs for statistical artifacts across 72 studies, and path analyses were conducted to examine the pattern of relationships among the variables. Results demonstrated that the TRA and TPB both exhibited good fit with the corrected correlation matrices, but the TPB accounted for more variance in physical activity intentions and behavior. In addition, self-efficacy explained unique variance in intention, and the inclusion of past behavior in the model resulted in the attenuation of the intention-behavior, attitude-intention, self-efficacy-intention, and self-efficacy-behavior relationships. There was some evidence that the study relationships were moderated by attitude-intention strength and age, but there was a lack of homogeneity in the moderator groups. It was concluded that the major relationships of the TRA/TPB were supported in this quantitative integration of the physical activity literature, and the inclusion of self-efficacy and past behavior are important additions to the model.",0,1 +488,Bayesian methods of analysis for cluster randomized trials with count outcome data,"Bayesian approaches to inference in cluster randomized trials have been investigated for normally distributed and binary outcome measures. However, relatively little attention has been paid to outcome measures which are counts of events. We discuss an extension of previously published Bayesian hierarchical models to count data, which usually can be assumed to be distributed according to a Poisson distribution. We develop two models, one based on the traditional rate ratio, and one based on the rate difference which may often be more intuitively interpreted for clinical trials, and is needed for economic evaluation of interventions. We examine the relationship between the intracluster correlation coefficient (ICC) and the between-cluster variance for each of these two models. In practice, this allows one to use the previously published evidence on ICCs to derive an informative prior distribution which can then be used to increase the precision of the posterior distribution of the ICC. We demonstrate our models using a previously published trial assessing the effectiveness of an educational intervention and a prior distribution previously derived. We assess the robustness of the posterior distribution for effectiveness to departures from a normal distribution of the random effects.",0,1 +489,The Measurement of Latent Traits by Proximity Items,"A probabilistic parallelogram model for the mea surement of latent traits by proximity items (the PARELLA model) is introduced. This model assumes that the responses of persons to items result from proximity relations: the smaller the distance between person and item, the larger the probability that the person will agree with the content of the item. The model is unidimensional and assigns locations to items and persons on the latent trait. The parameters of the PARELLA model are estimated by marginal maximum likelihood and expectation maximization. The efficiency of the estimation procedure is illustrated, a diagnostic for the fit of items to the model is presented, and the PARELLA model is used for the analysis of three empirical datasets.",0,1 +490,Four Theorems on the Psychometric Function,"In a 2-alternative forced-choice (2AFC) discrimination task, observers choose which of two stimuli has the higher value. The psychometric function for this task gives the probability of a correct response for a given stimulus difference, Δx. This paper proves four theorems about the psychometric function. Assuming the observer applies a transducer and adds noise, Theorem 1 derives a convenient general expression for the psychometric function. Discrimination data are often fitted with a Weibull function. Theorem 2 proves that the Weibull ""slope"" parameter, β, can be approximated by β(Noise) x β(Transducer), where β(Noise) is the β of the Weibull function that fits best to the cumulative noise distribution, and β(Transducer) depends on the transducer. We derive general expressions for β(Noise) and β(Transducer), from which we derive expressions for specific cases. One case that follows naturally from our general analysis is Pelli's finding that, when d' ∝ (Δx)(b), β ≈ β(Noise) x b. We also consider two limiting cases. Theorem 3 proves that, as sensitivity improves, 2AFC performance will usually approach that for a linear transducer, whatever the actual transducer; we show that this does not apply at signal levels where the transducer gradient is zero, which explains why it does not apply to contrast detection. Theorem 4 proves that, when the exponent of a power-function transducer approaches zero, 2AFC performance approaches that of a logarithmic transducer. We show that the power-function exponents of 0.4-0.5 fitted to suprathreshold contrast discrimination data are close enough to zero for the fitted psychometric function to be practically indistinguishable from that of a log transducer. Finally, Weibull β reflects the shape of the noise distribution, and we used our results to assess the recent claim that internal noise has higher kurtosis than a Gaussian. Our analysis of β for contrast discrimination suggests that, if internal noise is stimulus-independent, it has lower kurtosis than a Gaussian.",0,1 +491,Cultural Consensus Theory: Aggregating Signed Graphs under a Balance Constraint,"Cultural Consensus Theory (CCT) consists of cognitive models for aggregating the responses of experts to test questions about some domain of their shared cultural knowledge. This paper proposes a new CCT model for a situation where experts judge the ties in a complete signed graph. New to CCT is that the model imposes a side constraint on the aggregation process that requires that the consensus signed graph satisfy the social network property of structural balance. Balanced signed graphs require that the nodes can be partitioned into two sets with positive ties between nodes in the same set and negative ties between nodes in different sets. While the balance constraint is imposed on the consensus aggregation, it is not assumed that each expert's responses satisfy balance because they may be error-prone or biased. The model is presented in terms of signal detection assumptions that allow heterogeneity in expert ability and item difficulty. Bayesian inference of the model is developed using a specially designed Markov Chain Monte Carlo sampler. It is shown that the sampler can recover parameters from simulated data, and then the model is applied to interpret experimental data. Of particular interest is that the model aggregation reveals a single consensus balanced signed graph with a high posteriori probability despite the fact that none of the experts' responses satisfy the balance constraint.",0,1 +492,Recovery of Item Parameters in the Nominal Response Model: A Comparison of Marginal Maximum Likelihood Estimation and Markov Chain Monte Carlo Estimation,"Markov chain Monte Carlo (MCMC) methods, such as Gibbs sampling, present an alternative to marginal maximum likelihood (MML) estimation, which offers some promise for parameter estimation particularly with complex models, in small sample situations, and for other applications where MML algorithms have not been established. MCMC circumvents the problems associated with implementing an estimation algorithm for complex, multidimensional probability distributions by sampling the parameters from each of the one-dimensional conditional posterior distributions at each stage of the Markov chain. In this article, the authors compared the quality of item parameter estimates for MML and MCMC with one type of complex item response theory model, the nominal response model. The quality of item parameter recovery was nearly identical for both MML and MCMC. Both methods tended to produce good estimates, even for short tests and relatively small sample sizes. Parameter recovery was best for items of moderate dif.culty (i.e., items matched to the latent trait distribution); recovery was worst for items that were extremely easy or dif.cult. The quality of item parameter recovery improved as test length increased from 10 to 30 items, but did not change as test length increased from 20 to 30 items. MCMC estimation takes substantially longer but appears to be a good surrogate for MML for those situations for which an MML algorithm has not been developed.",0,1 +493,Mixed-effects Models in the Study of Individual Differences with Repeated Measures Data,Nonlinear mixed-effects models are used to describe each person's set of scores from a longitudinal design or repeated measures study by a function that includes an overall group effect plus an effect for the individual. The model is ideal for many kinds of behavioral data. Some characteristics of mixed models are reviewed in this article and illustrated by a series of examples.,0,1 +494,A novel animal model of graded neuropathic pain: Utility to investigate mechanisms of population heterogeneity,"The mechanisms underlying neuropathic pain are not well understood, resulting in unsatisfactory treatment outcomes for many patients. Animal models underpin much of the current understanding of pain mechanisms due to their perceived ability to mimic pain hypersensitivities; however, are limited by their binomial approach (pain vs. control), which does not reflect the clinical heterogeneity in nociceptive hypersensitivity. We modified the chronic constriction injury model by varying the number of sciatic nerve chromic gut sutures. Each Sprague Dawley rat received 4 pieces of chromic gut to control for the inflammatory challenge posed by the gut. Treatment groups were neuronal sutures (N), subcutaneous sutures (S) N0S0, N0S4, N1S3, N2S2 and N4S0. At postoperative (PO) day 29, there was a 'dose-response' relationship between the number of perineural sutures and von Frey threshold (N0S40.9) and associated in the dorsolateral funiculus (DLF; P=0.10, r(2)>0.8) at PO day 14. Astrocyte GFAP expression was positively associated with graded allodynia in the ipsilateral dorsal horn (P=0.18, r(2)>0.6) and ipsilateral DLF (P<0.05, r(2)>0.9). DLF glial activation may represent a contributor to contralateral pain. Our novel graded model has a dynamic range, allowing sensitive detection of interactions and subtle influences on neuropathic pain processing.",0,1 +495,Modeling target group heterogeneity in experimental consumer studies,"Abstract Acceptance of a product by a consumer may result from a convoluted interplay between product attributes and individual characteristics of that consumer. Different methods that systematically combine product properties with consumer groups segmented on such characteristics have provided unprecedented insight, but ignore heterogeneity in acceptance within each consumer group. Although such knowledge is invaluable for targeted marketing, dedicated methods for consumer group heterogeneity are lacking. The authors aim to fill this gap by the Individual Differences (InD) method, which models differences between consumers within the same target group. The method scores the ‘diffusion’ within each group, shows how much each consumer contributes to that, and relates this information to product properties. Thereby also novel groups may be discovered, with attributes not covered in the consumer segmentation. The illustrative consumer study on apple juice reveals how young women differ in their price-consciousness and their acceptance on specific preparation technologies more than older women. Although men exhibit heterogeneity on the same product attributes, their mutual variability is considerably lower and they thereby form more homogeneous target groups.",0,1 +496,Antecedents of Entrepreneurial Intention among Laid-Off Individuals: A Cognitive Appraisal Approach,This study contributes to our understanding of why laid‐off individuals might explore entrepreneurial careers. Findings among 838 laid‐off individuals suggest that financial strain is associated wi...,0,1 +497,An Empirical Bayes Procedure for Improving Individual-Level Estimates and Predictions From Finite Mixtures of Multinomial Logit Models,"Unobserved heterogeneity in random utility choice models can be dealt with by specifying either a multinomial or a normal distribution of the coefficients, leading to finite mixture logit and mixed logit models. Focusing on the former, we show that individual-level estimates and predictions of finite mixtures estimated by maximizing the likelihood function can be improved through integration over the estimation error of the hyperparameters, using an empirical Bayes approach. We investigate the conjecture that this approach is more robust against departures of the underlying assumptions of the finite mixture model in two Monte Carlo studies. We show that our approach improves the performance of the finite mixture model in representing individual-level parameters and producing hold-out forecasts. We illustrate with two examples that our approach may offer advantages in empirical applications involving the analysis of heterogeneous choice data.",0,1 +498,MCMC estimation for the p2 network regression model with crossed random effects,"The p2 model is a statistical model for the analysis of binary relational data with covariates, as occur in social network studies. It can be characterized as a multinomial regression model with crossed random effects that reflect actor heterogeneity and dependence between the ties from and to the same actor in the network. Three Markov chain Monte Carlo (MCMC) estimation methods for the p2 model are presented to improve iterative generalized least squares (IGLS) estimation developed earlier, two of which use random walk proposals. The third method, an independence chain sampler, and one of the random walk algorithms use normal approximations of the binary network data to generate proposals in the MCMC algorithms. A large-scale simulation study compares MCMC estimates with IGLS estimates for networks with 20 and 40 actors. It was found that the IGLS estimates have a smaller variance but are severely biased, while the MCMC estimates have a larger variance with a small bias. For networks with 20 actors, mean squared errors are generally comparable or smaller for the IGLS estimates. For networks with 40 actors, mean squared errors are the smallest for the MCMC estimates. Coverage rates of confidence intervals are good for the MCMC estimates but not for the IGLS estimates.",0,1 +499,Space—time zero-inflated count models of Harbor seals,"Environmental data are spatial, temporal, and often come with many zeros. In this paper, we included space-time random effects in zero-inflated Poisson (ZIP) and ‘hurdle’ models to investigate haulout patterns of harbor seals on glacial ice. The data consisted of counts, for 18 dates on a lattice grid of samples, of harbor seals hauled out on glacial ice in Disenchantment Bay, near Yakutat, Alaska. A hurdle model is similar to a ZIP model except it does not mix zeros from the binary and count processes. Both models can be used for zero-inflated data, and we compared space-time ZIP and hurdle models in a Bayesian hierarchical model. Space-time ZIP and hurdle models were constructed by using spatial conditional autoregressive (CAR) models and temporal first-order autoregressive (AR(1)) models as random effects in ZIP and hurdle regression models. We created maps of smoothed predictions for harbor seal counts based on ice density, other covariates, and spatio-temporal random effects. For both models predictions around the edges appeared to be positively biased. The linex loss function is an asymmetric loss function that penalizes overprediction more than underprediction, and we used it to correct for prediction bias to get the best map for space-time ZIP and hurdle models. Published in 2007 by John Wiley & Sons, Ltd.",0,1 +500,Discrete capacity limits in visual working memory,"The amount of information we can actively maintain ‘in mind’ is very limited. This capacity limitation, known as working memory (WM) capacity, has been of great interest because of its wide scope influence on the variety of intellectual abilities. Recently, there has been an ongoing debate about how this capacity should be best characterized. One viewpoint argues that WM capacity is allocated in a discrete fashion with an upper limit of three to four representations. An alternative viewpoint argues that the capacity can be allocated in a continuous fashion with no upper limit in the number of representations. In this article, we will review recent neurobiological and behavioral evidence that has helped shape the debate regarding one of the more central mechanisms in cognitive neuroscience.",0,1 +501,A Mixture Model Analysis of Differential Item Functioning,"Once a differential item functioning (DIF) item has been identified, little is known about the examinees for whom the item functions differentially. This is because DIF focuses on manifest group characteristics that are associated with it, but do not ex plain why examinees respond differentially to items. We first analyze item response patterns for gender DIF and then illustrate, through the use of a mixture item re sponse theory (IRT) model, how the manifest characteristic associated with DIF of ten has a very weak relationship with the latent groups actually being advantaged or disadvantaged by the item(s). Next, we propose an alternative approach to DIF as sessment that first uses an exploratory mixture model analysis to define the primary dimension(s) that contribute to DIF, and secondly studies examinee characteristics associated with those dimensions in order to understand the cause(s) of DIF. Com parison of academic characteristics of these examinees across classes reveals some clear differences in manifest characteristics between groups. Differential item functioning (DIF) can be attributed to the presence of nuisance dimensions intruding on the ability intended to be measured (Ackerman, 1992). DIF is typically investigated by examining the relationship between some manifest ex aminee characteristic, such as gender or ethnic group membership, with differential performance on the item. Unfortunately, this strategy is not ideal for understanding the root causes of DIF. One problem with this approach is that it focuses on the examinee characteristic of interest, not on the dimension causing the DIF. Conse quently, when differences are found, it is not so readily apparent who is primarily being advantaged or disadvantaged by the DIF items. We illustrate the limitations of this strategy by first using a standard DIF detection approach to identify DIF items on the basis of a manifest characteristic, in this case, gender. Results of the DIF analysis are used to define a two-group mixture IRT model with groups defined by gender, and only gender DIF items are allowed to assume different parameters across groups. We proceed next by assuming that the actual respondents advantaged or disadvan taged by the items may be better regarded as latent classes in the data. Holding the estimates of the multigroup IRT model as fixed, we classify examinees (irrespective of gender) into the group for which their response patterns are most similar. We then demonstrate that membership in these latent classes may be only slightly associated with gender. In the second study, we illustrate an alternative approach. The strategy first identifies the latent groups of examinees for whom DIF is greatest. We begin by fitting a mixture item response theory (IRT) model to the data so as to identify content classes of examinees for which the test performs most differentially. Then",0,1 +502,Predicting costs over time using Bayesian Markov chain Monte Carlo methods: an application to early inflammatory polyarthritis,"This article focuses on the modelling and prediction of costs due to disease accrued over time, to inform the planning of future services and budgets. It is well documented that the modelling of cost data is often problematic due to the distribution of such data; for example, strongly right skewed with a significant percentage of zero-cost observations. An additional problem associated with modelling costs over time is that cost observations measured on the same individual at different time points will usually be correlated. In this study we compare the performance of four different multilevel/hierarchical models (which allow for both the within-subject and between-subject variability) for analysing healthcare costs in a cohort of individuals with early inflammatory polyarthritis (IP) who were followed-up annually over a 5-year time period from 1990/1991. The hierarchical models fitted included linear regression models and two-part models with log-transformed costs, and two-part model with gamma regression and a log link. The cohort was split into a learning sample, to fit the different models, and a test sample to assess the predictive ability of these models. To obtain predicted costs on the original cost scale (rather than the log-cost scale) two different retransformation factors were applied. All analyses were carried out using Bayesian Markov chain Monte Carlo (MCMC) simulation methods.",0,1 +503,Posterior Predictive $p$-Values,"Extending work of Rubin, this paper explores a Bayesian counterpart of the classical $p$-value, namely, a tail-area probability of a ""test statistic"" under a null hypothesis. The Bayesian formulation, using posterior predictive replications of the data, allows a ""test statistic"" to depend on both data and unknown (nuisance) parameters and thus permits a direct measure of the discrepancy between sample and population quantities. The tail-area probability for a ""test statistic"" is then found under the joint posterior distribution of replicate data and the (nuisance) parameters, both conditional on the null hypothesis. This posterior predictive $p$-value can also be viewed as the posterior mean of a classical $p$-value, averaging over the posterior distribution of (nuisance) parameters under the null hypothesis, and thus it provides one general method for dealing with nuisance parameters. Two classical examples, including the Behrens-Fisher problem, are used to illustrate the posterior predictive $p$-value and some of its interesting properties, which also reveal a new (Bayesian) interpretation for some classical $p$-values. An application to multiple-imputation inference is also presented. A frequency evaluation shows that, in general, if the replication is defined by new (nuisance) parameters and new data, then the Type I frequentist error of an $\alpha$-level posterior predictive test is often close to but less than $\alpha$ and will never exceed $2\alpha$.",0,1 +504,Informative Drop-Out in Longitudinal Data Analysis,"A model is proposed for continuous longitudinal data with non-ignorable or informative drop-out (ID). The model combines a multivariate linear model for the underlying response with a logistic regression model for the drop-out process. The latter incorporates dependence of the probability of drop-out on unobserved, or missing, observations. Parameters in the model are estimated by using maximum likelihood (ML) and inferences drawn through conventional likelihood procedures. In particular, likelihood ratio tests can be used to assess the informativeness of the drop-out process through comparison of the full model with reduced models corresponding to random drop-out (RD) and completely random processes",0,1 +505,"Legislative Involvement in Parliamentary Systems: Opportunities, Conflict, and Institutional Constraints","In parliamentary systems, the need to preserve the political agreement that sustains the executive often motivates legislative involvement in policymaking. Institutional arrangements regulating executive–legislative relations and ministerial autonomy also structure parliamentary participation. However, empirical evidence of these effects remains limited to a few policies and countries. European Union legislation provides the opportunity to test expectations about legislative involvement for different types of measure across various institutional arrangements, across multiple policy areas, and across time. In this article, we investigate legislative involvement in the transposition of 724 directives in 15 member states from 1978 to 2004. Our results confirm that involvement increases as conflict between the responsible minister and her coalition partners intensifies. The discretionary scope embedded in the directive further inflates this effect. Additionally, parliamentary involvement decreases as the government's institutional advantage over the legislature increases, especially if intracoalitional conflict deepens.",0,1 +506,Quantifying and Testing Indirect Effects in Simple Mediation Models When the Constituent Paths Are Nonlinear,Most treatments of indirect effects and mediation in the statistical methods literature and the corresponding methods used by behavioral scientists have assumed linear relationships between variables in the causal system. Here we describe and extend a method first introduced by Stolzenberg (1980) for estimating indirect effects in models of mediators and outcomes that are nonlinear functions but linear in their parameters. We introduce the concept of the instantaneous indirect effect of X on Y through M and illustrate its computation and describe a bootstrapping procedure for inference. Mplus code as well as SPSS and SAS macros are provided to facilitate the adoption of this approach and ease the computational burden on the researcher.,0,1 +507,A General Item Response Theory Model for Unfolding Unidimensional Polytomous Responses,"The generalized graded unfolding model (GGUM) is developed. This model allows for either binary or graded responses and generalizes previous item response models for unfolding in two useful ways. First, it implements a discrimination parameter that varies across items, which allows items to discriminate among respondents in different ways. Second, the GGUM permits response category threshold parameters to vary across items. Amarginal maximum likelihood algorithm is implemented to estimate GGUM item parameters, whereas person parameters are derived from an expected a posteriori technique. The applicability of the GGUM to common attitude testing situations is illustrated with real data on student attitudes toward abortion.",0,1 +508,The empirical coverage of confidence intervals: Point estimates and confidence intervals for confidence levels,"Many confidence intervals calculated in practice are potentially not exact, either because the requirements for the interval estimator to be exact are known to be violated, or because the (exact) distribution of the data is unknown. If a confidence interval is approximate, the crucial question is how well its true coverage probability approximates its intended coverage probability. In this paper we propose to use the bootstrap to calculate an empirical estimate for the (true) coverage probability of a confidence interval. In the first instance, the empirical coverage can be used to assess whether a given type of confidence interval is adequate for the data at hand. More generally, when planning the statistical analysis of future trials based on existing data pools, the empirical coverage can be used to study the coverage properties of confidence intervals as a function of type of data, sample size, and analysis scale, and thus inform the statistical analysis plan for the future trial. In this sense, the paper proposes an alternative to the problematic pretest of the data for normality, followed by selection of the analysis method based on the results of the pretest. We apply the methodology to a data pool of bioequivalence studies, and in the selection of covariance patterns for repeated measures data.",0,1 +509,The Sensitive Left and the Impervious Right,"Recent years have seen increased attention to integrating what we know about individual citizens with what we know about macro-level contexts that vary across countries. This article discusses the growing literature on how people's interpretations, opinions, and actions are shaped by variable contextual parameters and provides a novel substantive application. Using surveys conducted in 20 European democracies, the authors examine the effect of income inequality on people's attitudes about the functioning of the political system and trust in public institutions. They find that citizens in countries with higher levels of income inequality express more negative attitudes toward public institutions. Moreover, they show that the negative effect of inequality on attitudes toward the political system is particularly powerful among individuals on the political left. In contrast, inequality's negative effect on people's faith in the system is muted among those on the right.",0,1 +510,Structural Equation Models of Latent Interactions: Evaluation of Alternative Estimation Strategies and Indicator Construction.,"Interactions between (multiple indicator) latent variables are rarely used because of implementation complexity and competing strategies. Based on 4 simulation studies, the traditional constrained approach performed more poorly than did 3 new approaches--unconstrained, generalized appended product indicator, and quasi-maximum-likelihood (QML). The authors' new unconstrained approach was easiest to apply. All 4 approaches were relatively unbiased for normally distributed indicators, but the constrained and QML approaches were more biased for nonnormal data; the size and direction of the bias varied with the distribution but not with the sample size. QML had more power, but this advantage was qualified by consistently higher Type I error rates. The authors also compared general strategies for defining product indicators to represent the latent interaction factor.",0,1 +511,Are Nonprofit Antipoverty Organizations Located Where They Are Needed? A Spatial Analysis of the Greater Hartford Region,"The geographic distribution of nonprofit antipoverty organizations has important implications for economic development, social services, public health, and policy efforts. With counts of antipoverty nonprofits at the census tract level in Greater Hartford, Connecticut, we examine whether these organizations are located in areas with high levels of poverty with a spatial zero-inflated-Poisson model. Covariates that measure need, resources, urban structure, and demographic characteristics are incorporated into both the zero-inflation component and the Poisson component of the model. Variation not explained by the covariates is captured by the combination of a spatial random effect and an unstructured random effect. Statistical inferences are done within the Bayesian framework. Model comparison with the conditional predictive ordinate suggests that the random effects and the zero-inflation are both important components in fitting the data. All three need measures—proportion of people below the poverty line, ...",0,1 +512,Prevalence and correlates of young people's sexual aggression perpetration and victimisation in 10 European countries: a multi-level analysis,"Data are presented on young people's sexual victimisation and perpetration from 10 European countries (Austria, Belgium, Cyprus, Greece, Lithuania, the Netherlands, Poland, Portugal, Slovakia and Spain) using a shared measurement tool (N = 3480 participants, aged between 18 and 27 years). Between 19.7 and 52.2% of female and between 10.1 and 55.8% of male respondents reported having experienced at least one incident of sexual victimisation since the age of consent. In two countries, victimisation rates were significantly higher for men than for women. Between 5.5 and 48.7% of male and 2.6 and 14.8% of female participants reported having engaged in a least one act of sexual aggression perpetration, with higher rates for men than for women in all countries. Victimisation rates correlated negatively with sexual assertiveness and positively with alcohol use in sexual encounters. Perpetration rates correlated positively with attitudes condoning physical dating violence and with alcohol use in men, and negatively with sexual assertiveness in women. At the country level, lower gender equality in economic power and in the work domain was related to higher male perpetration rates. Lower gender equality in political power and higher sexual assertiveness in women relative to men were linked to higher male victimisation rates.",0,1 +513,Growth curves of deviant behavior in early adolescence: A multilevel analysis,"Multilevel growth curve models provide a means of analyzing individual differences in the growth of deviance, allow a number of theories to be integrated in a single model, and can help to unify research on deviant/delinquent/criminal careers at different stages of the life cycle. Building on the distinction between ""population heterogeneity"" and ""state dependence"" as alternative explanations of persistent individual differences in deviance (Heckman, 1981; Nagin and Paternoster, 1991), we show that models with two levels can be used to represent and analyze a variety of criminological theories. The first level (level 1) uses repeated measurements on individuals to estimate individual-level growth curves. The second level treats the level 1 growth curve parameters (e.g., slope, intercept) as outcome variables and uses time-invariant factors to explain variation in these parameters across individuals. We illustrate this approach by estimating a model of growth in deviance drawn from Gottfredson and Hirschi's deviant propensity theory. An innovative feature is the assumption that adolescents' expected growth curves of deviance follow a classical Pearl-Verhulst logistic growth model (Pearl, 1930). The results suggest that five risk factors - parental psychiatric problems, lack of parental support, living arrangements with zero or one parent in residence, low family income, and male gender - have strongly positive effects on deviant propensity. For example, adolescents with no supportive parents, and no other risk factors, have expected asymptotic levels of deviance (peak levels attained at about age 18) that are about twice as high as those of adolescents with no risk factors. Yet more than two-thirds of the individual-level variability in growth curves is unexplained by the five risk factors. This unobserved heterogeneity would remain hidden in analyses using conventional structural equations models and the same explanatory variables. © 1997 Plenum Publishing Corporation.",0,1 +514,Accounting for seasonal dependence in hydrological model errors and prediction uncertainty,"[1] Streamflows often vary strongly with season, and this leads to seasonal dependence in hydrological model errors and prediction uncertainty. In this study, we introduce three error models to describe errors from a monthly rainfall-runoff model: a seasonally invariant model, a seasonally variant model, and a hierarchical error model. The seasonally variant model and the hierarchical error model use month-specific parameters to explicitly account for seasonal dependence, while the seasonally invariant model does not. A Bayesian prior is used in the hierarchical error model to account for potential variation and connection among model parameters of different months. The three error models are applied to predicting streamflows for five Australian catchments and are compared by various performance scores and diagnostic plots. The seasonally variant model and the hierarchical model both perform substantially better than the seasonally invariant model. From a cross-validation analysis, the hierarchical error model provides both the most accurate prediction mean and the most reliable prediction uncertainty distribution in most situations. The use of the prior to constrain the model parameters in the hierarchical model produces more robust parameter estimation than the other two models.",0,1 +515,Longitudinal Data Analysis,"Longitudinal data analysis for biomedical and behavioral sciences. This innovative book sets forth and describes methods for the analysis of longitudinaldata, emphasizing applications to problems in the biomedical and behavioral sciences. Reflecting the growing importance and use of longitudinal data across many areas of research, the text is designed to help users of statistics better analyze and understand this type of data. Much of the material from the book grew out of a course taught by Dr. Hedeker on longitudinal data analysis. The material is, therefore, thoroughly classroom tested and includes a number of features designed to help readers better understand and apply the material. Statistical procedures featured within the text include: Repeated measures analysis of variance; Multivariate analysis of variance for repeated measures; Random-effects regression models (RRM); Covariance-pattern models; Generalized-estimating equations (GEE) models; Generalizations of RRM and GEE for categorical outcomes. Practical in their approach, the authors emphasize the applications of the methods, using real-world examples for illustration. Some syntax examples are provided, although the authors do not generally focus on software in this book. Several datasets and computer syntax examples are posted on this title's companion Web site. The authors intend to keep the syntax examples current as new versions of the software programs emerge. This text is designed for both undergraduate and graduate courses in longitudinal data analysis. Instructors can take advantage of overheads and additional course materials available online for adopters. Applied statisticians in biomedicine and the social sciences can also use the book as a convenient reference. © 2006 by John Wiley & Sons, Inc. All rights reserved.",0,1 +516,A comparison of some methodologies for the factor analysis of non-normal Likert variables: A note on the size of the model,"This paper expands on a recent study by Muthen & Kaplan (1985) by examining the impact of non-normal Likert variables on testing and estimation in factor analysis for models of various size. Normal theory GLS and the recently developed ADF estimator are compared for six cases of non-normality, two sample sizes, and four models of increasing size in a Monte Carlo framework with a large number of replications. Results show that GLS and ADF chi-square tests are increasingly sensitive to non-normality when the size of the model increases. No parameter estimate bias was observed for GLS and only slight parameter bias was found for ADF. A downward bias in estimated standard errors was found for GLS which remains constant across model size. For ADF, a downward bias in estimated standard errors was also found which became increasingly worse with the size of the model.",0,1 +517,Issues in Multiple Regression,"Controlling for variables implies conceptual distinctness between the control and zero-order variables. However, there are different levels of distinctness, some more subtle than others. These levels are determined by the theoretical context of the research. Failure to specify the theoretical context creates ambiguity as to the level of distinctness, and leads to the partialling fallacy, in which one controls for variables that are distinct in terms of appropriate theory. Although this can occur in using any control procedure, it is especially likely to occur in multiple regression, where high-order partial regression coefficients are routinely obtained in order to determine the relative importance of variables. Four major ways in which these regression coefficients can be seriously misleading are discussed. Although warnings concerning multicollinearity are to be found in statistics texts, they are insufficiently informative to prevent the mistakes described here. This is because the problem is essentially one of substantive interpretation rather than one of mathematical statistics per se.",0,1 +518,Multilevel quantile function modeling with application to birth outcomes,"Infants born preterm or small for gestational age have elevated rates of morbidity and mortality. Using birth certificate records in Texas from 2002 to 2004 and Environmental Protection Agency air pollution estimates, we relate the quantile functions of birth weight and gestational age to ozone exposure and multiple predictors, including parental age, race, and education level. We introduce a semi-parametric Bayesian quantile approach that models the full quantile function rather than just a few quantile levels. Our multilevel quantile function model establishes relationships between birth weight and the predictors separately for each week of gestational age and between gestational age and the predictors separately across Texas Public Health Regions. We permit these relationships to vary nonlinearly across gestational age, spatial domain and quantile level and we unite them in a hierarchical model via a basis expansion on the regression coefficients that preserves interpretability. Very low birth weight is a primary concern, so we leverage extreme value theory to supplement our model in the tail of the distribution. Gestational ages are recorded in completed weeks of gestation (integer-valued), so we present methodology for modeling quantile functions of discrete response data. In a simulation study we show that pooling information across gestational age and quantile level substantially reduces MSE of predictor effects. We find that ozone is negatively associated with the lower tail of gestational age in south Texas and across the distribution of birth weight for high gestational ages. Our methods are available in the R package BSquare.",0,1 +519,A Monte Carlo Implementation of the EM Algorithm and the Poor Man's Data Augmentation Algorithms,"Abstract The first part of this article presents the Monte Carlo implementation of the E step of the EM algorithm. Given the current guess to the maximizer of the posterior distribution, latent data patterns are generated from the conditional predictive distribution. The expected value of the augmented log-posterior is then updated as a mixture of augmented log-posteriors, mixed over the generated latent data patterns (multiple imputations). In the M step of the algorithm, this mixture is maximized to obtain the update to the maximizer of the observed posterior. The gradient and Hessian of the observed log posterior are also expressed as mixtures, mixed over the multiple imputations. The relation between the Monte Carlo EM (MCEM) algorithm and the data augmentation algorithm is noted. Two modifications to the MCEM algorithm (the poor man's data augmentation algorithms), which allow for the calculation of the entire posterior, are then presented. These approximations serve as diagnostics for the validity o...",0,1 +520,Prior sensitivity analysis in default Bayesian structural equation modeling.,"Bayesian structural equation modeling (BSEM) has recently gained popularity because it enables researchers to fit complex models and solve some of the issues often encountered in classical maximum likelihood estimation, such as nonconvergence and inadmissible solutions. An important component of any Bayesian analysis is the prior distribution of the unknown model parameters. Often, researchers rely on default priors, which are constructed in an automatic fashion without requiring substantive prior information. However, the prior can have a serious influence on the estimation of the model parameters, which affects the mean squared error, bias, coverage rates, and quantiles of the estimates. In this article, we investigate the performance of three different default priors: noninformative improper priors, vague proper priors, and empirical Bayes priors-with the latter being novel in the BSEM literature. Based on a simulation study, we find that these three default BSEM methods may perform very differently, especially with small samples. A careful prior sensitivity analysis is therefore needed when performing a default BSEM analysis. For this purpose, we provide a practical step-by-step guide for practitioners to conducting a prior sensitivity analysis in default BSEM. Our recommendations are illustrated using a well-known case study from the structural equation modeling literature, and all code for conducting the prior sensitivity analysis is available in the online supplemental materials. (PsycINFO Database Record",1,1 +521,Psychological interpretation of the ex-Gaussian and shifted Wald parameters: A diffusion model analysis,"A growing number of researchers use descriptive distributions such as the ex-Gaussian and the shifted Wald to summarize response time data for speeded two-choice tasks. Some of these researchers also assume that the parameters of these distributions uniquely correspond to specific cognitive processes. We studied the validity of this cognitive interpretation by relating the parameters of the ex-Gaussian and shifted Wald distributions to those of the Ratcliff diffusion model, a successful model whose parameters have well-established cognitive interpretations. In a simulation study, we fitted the ex-Gaussian and shifted Wald distributions to data generated from the diffusion model by systematically varying its parameters across a wide range of plausible values. In an empirical study, the two descriptive distributions were fitted to published data that featured manipulations of task difficulty, response caution, and a priori bias. The results clearly demonstrate that the ex-Gaussian and shifted Wald parameters do not correspond uniquely to parameters of the diffusion model. We conclude that researchers should resist the temptation to interpret changes in the ex-Gaussian and shifted Wald parameters in terms of cognitive processes. Supporting materials may be downloaded from http://pbr.psychonomic-journals .org/content/supplemental.",0,1 +522,A Bayesian model for repeated measures zero-inflated count data with application to outpatient psychiatric service use,"In applications involving count data, it is common to encounter an excess number of zeros. For example, in the study of outpatient service utilization, the number of utilization days will take on integer values, with many subjects having no utilization (zero values). Mixed distribution models, such as the zero-inflated Poisson and zero-inflated negative binomial, are often used to fit such data. A more general class of mixture models, called hurdle models, can be used to model zero deflation as well as zero inflation. Several authors have proposed frequentist approaches to fitting zero-inflated models for repeated measures. We describe a practical Bayesian approach which incorporates prior information, has optimal small-sample properties and allows for tractable inference. The approach can be easily implemented using standard Bayesian software. A study of psychiatric outpatient service use illustrates the methods.",0,1 +523,A latent trait model for response times on tests employing the proportional hazards model,"For computer-administered tests, response times can be recorded conjointly with the corresponding responses. This broadens the scope of potential modelling approaches because response times can be analysed in addition to analysing the responses themselves. For this purpose, we present a new latent trait model for response times on tests. This model is based on the Cox proportional hazards model. According to this model, latent variables alter a baseline hazard function. Two different approaches to item parameter estimation are described: the first approach uses a variant of the Cox model for discrete time, whereas the second approach is based on a profile likelihood function. Properties of each estimator will be compared in a simulation study. Compared to the estimator for discrete time, the profile likelihood estimator is more efficient, that is, has smaller variance. Additionally, we show how the fit of the model can be evaluated and how the latent traits can be estimated. Finally, the applicability of the model to an empirical data set is demonstrated.",0,1 +524,On the Reliability and Validity of a Numerical Reasoning Speed Dimension Derived From Response Times Collected in Computerized Testing,Data from 181 college students were used to assess whether math reasoning item response times in computerized testing can provide valid and reliable measures of a speed dimension. The alternate forms reliability of the speed dimension was .85. A two-dimensional structural equation model suggests that the speed dimension is related to the accuracy of speeded responses. Speed factor scores were significantly correlated with performance on the ACT math scale. Results suggest that the speed dimension underlying response times can be reliably measured and that the dimension is related to the accuracy of performance under the pressure of time limits.,0,1 +525,Estimation of Reliability for Multiple-Component Measuring Instruments in Hierarchical Designs,"A method for estimation of reliability for multiple-component measuring instruments with clustered data is outlined. The approach is applicable with hierarchical designs where individuals are nested within higher order units and exhibit possibly related performance on components of a scale of interest. The procedure is developed within the framework of multilevel covariance structure modeling. The described method is useful for point and interval estimation of the degree of consistency of measurement with congeneric composites in hierarchical populations, and is illustrated with an empirical example.",0,1 +526,A comparison of Bayesian and likelihood-based methods for fitting multilevel models,"We use simulation studies, whose design is realistic for educational andmedicalresearch(aswellasotherfleldsofinquiry),tocompareBayesianand likelihood-basedmethodsforflttingvariance-components(VC)andrandom-efiects logistic regression (RELR) models. The likelihood (and approximate likelihood) approachesweexaminearebasedonthemethodsmostwidelyusedincurrentap- plied multilevel (hierarchical) analyses: maximum likelihood (ML) and restricted ML(REML)forGaussianoutcomes,andmarginalandpenalizedquasi-likelihood (MQL and PQL) for Bernoulli outcomes. Our Bayesian methods use Markov chain Monte Carlo (MCMC) estimation, with adaptive hybrid Metropolis-Gibbs sampling for RELR models, and several difiuse prior distributions (i i1 (†;†) and U(0; 1 ) priors for variance components). For evaluation criteria we consider bias of point estimates and nominal versus actual coverage of interval estimates in re- peated sampling. In two-level VC models we flnd that (a) both likelihood-based and Bayesian approaches can be made to produce approximately unbiased esti- mates, although the automatic manner in which REML accomplishes this is an advantage, but (b) both approaches had di-culty achieving nominal coverage in smallsamplesandwithsmallvaluesoftheintraclasscorrelation. Withthethree- levelRELRmodelsweexamineweflndthat(c)quasi-likelihoodmethodsforesti- mating random-efiects variances perform badly with respect to bias and coverage intheexamplewesimulated,and(d)Bayesiandifiuse-priormethodsleadtowell- calibratedpointandintervalRELRestimates. Whileitistruethatthelikelihood- based methods we study are considerably faster computationally than MCMC, (i) steady improvements in recent years in both hardware speed and e-ciency of MonteCarloalgorithmsand(ii)thelackofcalibrationoflikelihood-basedmethods insomecommonhierarchicalsettingscombinetomakeMCMC-basedBayesianflt- tingofmultilevelmodelsanattractiveapproach,evenwithratherlargedatasets. Other analytic strategies based on less approximate likelihood methods are also possible butwouldbeneflt fromfurtherstudy ofthe type summarized here.",1,1 +527,"Cronbach’s α, Revelle’s β, and Mcdonald’s ωH: their relations with each other and two alternative conceptualizations of reliability","We make theoretical comparisons among five coefficients - Cronbach's α, Revelle's β, McDonald's ω h, and two alternative conceptualizations of reliability. Though many end users and psychometricians alike may not distinguish among these five coefficients, we demonstrate formally their nonequivalence. Specifically, whereas there are conditions under which α, β, and ω h are equivalent to each other and to one of the two conceptualizations of reliability considered here, we show that equality with this conceptualization of reliability and between α and ω h holds only under a highly restrictive set of conditions and that the conditions under which β equals ω h are only somewhat more general. The nonequivalence of α, β, and ω h suggests that important information about the psychometric properties of a scale may be missing when scale developers and users only report α as is almost always the case. © 2005 The Psychometric Society.",0,1 +528,Hierarchical spatial models for predicting tree species assemblages across large domains,"Spatially explicit data layers of tree species assemblages, referred to as forest types or forest type groups, are a key component in large-scale assessments of forest sustainability, biodiversity, timber biomass, carbon sinks and forest health monitoring. This paper explores the utility of coupling georeferenced national forest inventory (NFI) data with readily available and spatially complete environmental predictor variables through spatially-varying multinomial logistic regression models to predict forest type groups across large forested landscapes. These models exploit underlying spatial associations within the NFI plot array and the spatially-varying impact of predictor variables to improve the accuracy of forest type group predictions. The richness of these models incurs onerous computational burdens and we discuss dimension reducing spatial processes that retain the richness in modeling. We illustrate using NFI data from Michigan, USA, where we provide a comprehensive analysis of this large study area and demonstrate improved prediction with associated measures of uncertainty.",0,1 +529,A time-varying effect model for intensive longitudinal data.,"Understanding temporal change in human behavior and psychological processes is a central issue in the behavioral sciences. With technological advances, intensive longitudinal data (ILD) are increasingly generated by studies of human behavior that repeatedly administer assessments over time. ILD offer unique opportunities to describe temporal behavioral changes in detail and identify related environmental and psychosocial antecedents and consequences. Traditional analytical approaches impose strong parametric assumptions about the nature of change in the relationship between time-varying covariates and outcomes of interest. This article introduces time-varying effect models (TVEMs) that explicitly model changes in the association between ILD covariates and ILD outcomes over time in a flexible manner. In this article, we describe unique research questions that the TVEM addresses, outline the model-estimation procedure, share a SAS macro for implementing the model, demonstrate model utility with a simulated example, and illustrate model applications in ILD collected as part of a smoking-cessation study to explore the relationship between smoking urges and self-efficacy during the course of the pre- and postcessation period.",0,1 +530,Using Threshold Autoregressive Models to Study Dyadic Interactions,"Considering a dyad as a dynamic system whose current state depends on its past state has allowed researchers to investigate whether and how partners influence each other. Some researchers have also focused on how differences between dyads in their interaction patterns are related to other differences between them. A promising approach in this area is the model that was proposed by Gottman and Murray, which is based on nonlinear coupled difference equations. In this paper, it is shown that their model is a special case of the threshold autoregressive (TAR) model. As a consequence, we can make use of existing knowledge about TAR models with respect to parameter estimation, model alternatives and model selection. We propose a new estimation procedure and perform a simulation study to compare it to the estimation procedure developed by Gottman and Murray. In addition, we include an empirical example based on interaction data of three dyads.",0,1 +531,Meta-analysis of diagnostic test studies using individual patient data and aggregate data,"A meta-analysis of diagnostic test studies provides evidence-based results regarding the accuracy of a particular test, and usually involves synthesizing aggregate data (AD) from each study, such as the 2 by 2 tables of diagnostic accuracy. A bivariate random-effects meta-analysis (BRMA) can appropriately synthesize these tables, and leads to clinical results, such as the summary sensitivity and specificity across studies. However, translating such results into practice may be limited by between-study heterogeneity and that they relate to some 'average' patient across studies.In this paper we describe how the meta-analysis of individual patient data (IPD) from diagnostic studies can lead to clinical results more tailored to the individual patient. We develop IPD models that extend the BRMA framework to include study-level covariates, which help explain the between-study heterogeneity, and also patient-level covariates, which allow one to assess the effect of patient characteristics on test accuracy. We show how the inclusion of patient-level covariates requires a careful separation of within-study and across-study accuracy-covariate effects, as the latter are particularly prone to confounding. Our models are assessed through simulation and extended to allow IPD studies to be combined with AD studies, as IPD are not always available for all studies. Application is made to 23 studies assessing the accuracy of ear thermometers for diagnosing fever in children, with 16 IPD and 7 AD studies. The models reveal that between-study heterogeneity is partly explained by the use of different measurement devices, but there is no evidence that being an infant modifies diagnostic accuracy.",0,1 +532,A Bayesian approach to testing decision making axioms,"Abstract Theories of decision making are often formulated in terms of deterministic axioms, which do not account for stochastic variation that attends empirical data. This study presents a Bayesian inference framework for dealing with fallible data. The Bayesian framework provides readily applicable statistical procedures addressing typical inference questions that arise when algebraic axioms are tested against empirical data. The key idea of the Bayesian framework is to employ a prior distribution representing the parametric order constraints implied by a given axiom. Modern methods of Bayesian computation such as Markov chain Monte Carlo are used to estimate the posterior distribution, which provides the information that allows an axiom to be evaluated. Specifically, we adopt the Bayesian p -value as the criterion to assess the descriptive adequacy of a given model (axiom) and we use the deviance information criterion (DIC) to select among a set of candidate models. We illustrate the Bayesian framework by testing well-known axioms of decision making, including the axioms of monotonicity of joint receipt and stochastic transitivity.",0,1 +533,A fast scoring algorithm for maximum likelihood estimation in unbalanced mixed models with nested random effects,On decrit un algorithme qui utilise des formules explicites pour l'inverse et le determinant de la matrice de covariance donnee par La Motte (1972) et evite l'inversion des grandes matrices,0,1 +534,Parametric Empirical Bayes Inference: Theory and Applications,"Abstract This article reviews the state of multiparameter shrinkage estimators with emphasis on the empirical Bayes viewpoint, particularly in the case of parametric prior distributions. Some successful applications of major importance are considered. Recent results concerning estimates of error and confidence intervals are described and illustrated with data.",0,1 +535,The Analysis of Multilevel Data in Educational Research and Evaluation,,0,1 +536,The Forgotten Ones? The Validity of Consideration and Initiating Structure in Leadership Research.,"This study provided a meta-analysis of the relationship of the Ohio State leadership behaviors--Consideration and Initiating Structure--with leadership. Overall, 163 independent correlations for Consideration and 159 correlations for Initiating Structure were analyzed. Results revealed that both Consideration (.48) and Initiating Structure (.29) have moderately strong, nonzero relations with leadership outcomes. Consideration was more strongly related to follower satisfaction (leader satisfaction, job satisfaction), motivation, and leader effectiveness, and Initiating Structure was slightly more strongly related to leader job performance and group-organization performance. Validities did vary by leadership measure, but in most cases validities generalized regardless of the measure used. Overall, the results provide important support for the validity of Initiating Structure and Consideration in leadership research.",0,1 +537,Design-Comparable Effect Sizes in Multiple Baseline Designs,"In single-case research, the multiple baseline design is a widely used approach for evaluating the effects of interventions on individuals. Multiple baseline designs involve repeated measurement of outcomes over time and the controlled introduction of a treatment at different times for different individuals. This article outlines a general framework for defining effect sizes in multiple baseline designs that are directly comparable to the standardized mean difference from a between-subjects randomized experiment. The target, design-comparable effect size parameter can be estimated using restricted maximum likelihood together with a small sample correction analogous to Hedges’s g. The approach is demonstrated using hierarchical linear models that include baseline time trends and treatment-by-time interactions. A simulation compares the performance of the proposed estimator to that of an alternative, and an application illustrates the model-fitting process.",0,1 +538,Applying multilevel confirmatory factor analysis techniques to the study of leadership,"Statistical issues associated with multilevel data are becoming increasingly important to organizational researchers. This paper concentrates on the issue of assessing the factor structure of a construct at aggregate levels of analysis. Specifically, we describe a recently developed procedure for performing multilevel confirmatory factor analysis (MCFA) [Muthen, B.O. (1990). Mean and covariance structure analysis of hierarchical data. Paper presented at the Psychometric Society, Princeton, NJ; Muthen, B.O. (1994). Multilevel covariance structure analysis. Sociological Methods and Research, 22, 376–398], and provide an illustrative example of its application to leadership data reflecting both the organizational and societal level of analysis. Overall, the results of our illustrative analysis support the existence of a valid societal-level leadership construct, and show the potential of this multilevel confirmatory factor analysis procedure for leadership research and the field of I/O psychology in general.",0,1 +539,Effect of Decision Load on Whole-Display Superiority in Change Detection,"Visual short-term memory (VSTM) refers to our ability in remembering visual information for a limited amount of time. In the VSTM literature, mixed findings have been reported regarding whether items are encoded individually or globally in the context of other items. This study adopted a color change detection task and manipulated color and spatial relations of the items on display to test whether inter-item relational information and processing can facilitate change detection performance. Results showed that only when a post-cue was presented to reduce decision load (Experiments 1 and 3), both color and spatial relations facilitated color change detection. However, when there was no post-cue to lessen the decision load, preserving spatial relations at test impaired color change detection (Experiment 2). Furthermore, spatial and color relational processing interactively affected color change detection. Benefit of the spatial relations was observed only when color grouping cues can aid change detection, and the utilization of color relations was optimized when spatial relations were preserved to cue the retrieval of color relations. Our results support the hierarchical representation hypothesis, which assumes that both individual items and item relations are encoded and maintained in VSTM. The amount of cognitive resources for retrieving different levels of representations is highly constrained by the decision load.",0,1 +540,The Collapsed Gibbs Sampler in Bayesian Computations with Applications to a Gene Regulation Problem,"Abstract This article describes a method of “grouping” and “collapsing” in using the Gibbs sampler and proves from an operator theory viewpoint that the method is in general beneficial. The norms of the forward operators associated with the corresponding nonreversible Markov chains are used to discriminate among different simulation schemes. When applied to Bayesian missing data problems, the idea of collapsing suggests skipping the steps of sampling parameter(s) values in standard data augmentation. By doing this, we obtain a predictive update version of the Gibbs sampler. A procedure of calculating the posterior odds ratio via the collapsed Gibbs sampler when incomplete observations are involved is presented. As an illustration of possible applications, three examples, along with a Bayesian treatment for identifying common protein binding sites in unaligned DNA sequences, are provided.",0,1 +541,Customer-perceived value in business-to-business relationships: A study of software customers,"Abstract Despite the importance of relationships in business-to-business (B2B) contexts, there is limited research as to what customers expect and value from relationships in industrial contexts. This study, therefore, seeks to understand customer-perceived value better by investigating actual and prospective customers in the software industry. A two-level analysis of customer perspectives on relationship attributes was conducted. First, semi-structured interviews were conducted with customers of a micro software firm. Insights from these interviews were then used to inform the second stage of the study, an online survey using Adaptive Conjoint Analysis, to identify the relative significance of these attributes. A total of 256 industrial buyers completed the survey. A new Customer Relationship Attributes Model (CRAM) is presented which encapsulates major attributes that current and prospective customers consider when entering into a relationship with their software supplier. The CRAM identifies five produ...",0,1 +542,Distortions in recall from visual memory: Two classes of attractors at work,"In a trio of experiments, a matching procedure generated direct, analogue measures of short-term memory for the spatial frequency of Gabor stimuli. Experiment 1 showed that when just a single Gabor was presented for study, a retention interval of just a few seconds was enough to increase the variability of matches, suggesting that noise in memory substantially exceeds that in vision. Experiment 2 revealed that when a pair of Gabors was presented on each trial, the remembered appearance of one of the Gabors was influenced by: (1) the relationship between its spatial frequency and the spatial frequency of the accompanying, task-irrelevant non-target stimulus; and (2) the average spatial frequency of Gabors seen on previous trials. These two influences, which work on very different time scales, were approximately additive in their effects, each operating as an attractor for remembered appearance. Experiment 3 showed that a timely pre-stimulus cue allowed selective attention to curtail the influence of a task-irrelevant non-target, without diminishing the impact of the stimuli seen on previous trials. It appears that these two separable attractors influence distinct processes, with perception being influenced by the non-target stimulus and memory being influenced by stimuli seen on previous trials.",0,1 +543,Multilevel Modeling in Psychosomatic Medicine Research,"The primary purpose of this study is to provide an overview of multilevel modeling for Psychosomatic Medicine readers and contributors. The article begins with a general introduction to multilevel modeling. Multilevel regression modeling at two levels is emphasized because of its prevalence in psychosomatic medicine research. Simulated data sets based on some core ideas from the Familias Unidas effectiveness study are used to illustrate key concepts including communication of model specification, parameter interpretation, sample size and power, and missing data. Input and key output files from Mplus and SAS are provided. A cluster randomized trial with repeated measures (i.e., three-level regression model) is then briefly presented with simulated data based on some core ideas from a cognitive-behavioral stress management intervention in prostate cancer.",0,1 +544,Sufficient Sample Sizes for Multilevel Modeling,"Abstract. An important problem in multilevel modeling is what constitutes a sufficient sample size for accurate estimation. In multilevel analysis, the major restriction is often the higher-level sample size. In this paper, a simulation study is used to determine the influence of different sample sizes at the group level on the accuracy of the estimates (regression coefficients and variances) and their standard errors. In addition, the influence of other factors, such as the lowest-level sample size and different variance distributions between the levels (different intraclass correlations), is examined. The results show that only a small sample size at level two (meaning a sample of 50 or less) leads to biased estimates of the second-level standard errors. In all of the other simulated conditions the estimates of the regression coefficients, the variance components, and the standard errors are unbiased and accurate.",0,1 +545,Suppression of Voluntary Wheel Running in Rats Is Dependent on the Site of Inflammation: Evidence for Voluntary Running as a Measure of Hind Paw-Evoked Pain,"

Abstract

Decreased voluntary wheel running has recently been proposed as a preclinical pain measure for inflammatory pain, but whether this reflects pain evoked by use of the affected limbs is unknown. To assess the role of inflammation site as a determinant of this measure, complete Freund's adjuvant (CFA), formalin, or equivolume vehicle was subcutaneously injected into the plantar surface of the hind paws (bilateral) or L1 dorsum dermatome (leaving paws unaffected) of male Sprague Dawley rats. CFA-induced hind paw mechanical allodynia (P < .001) did not correlate with reduced voluntary wheel running. Intraplantar formalin did not attenuate voluntary running, despite eliciting robust licking/writhing/flinching behavior and hind paw mechanical allodynia (P < .001). Subcutaneous L1 dorsum dermatome formalin, but not CFA, induced licking/writhing/flinching behavior (P < .001), but neither induced hind paw mechanical allodynia or attenuated voluntary running. That voluntary running is decreased by hind paw CFA, but not by L1 dorsum CFA, implies that the behavior is a measure of CFA-induced pain evoked by use of the affected limbs rather than supraspinal pain processing that is independent of inflammation site. Furthermore, the results suggest that interpretation of voluntary wheel running data cannot simply be explained by correlation with mechanical allodynia.

Perspective

Whether decreased voluntary running is dependent on inflammation site is unknown. We show that intraplantar, but not L1 dorsum, CFA suppressed voluntary running and formalin-induced licking/writhing/flinching behavior but had no effect on voluntary running. These data suggest that suppressed voluntary running by CFA likely reflects pain evoked by use of the affected limbs.",0,1 +546,Relationship of personality to performance motivation: A meta-analytic review.,"This article provides a meta-analysis of the relationship between the five-factor model of personality and 3 central theories of performance motivation (goal-setting, expectancy, and self-efficacy motivation). The quantitative review includes 150 correlations from 65 studies. Traits were organized according to the five-factor model of personality. Results indicated that Neuroticism (average validity = -.31) and Conscientiousness (average validity = .24) were the strongest and most consistent correlates of performance motivation across the 3 theoretical perspectives. Results further indicated that the validity of 3 of the Big Five traits - Neuroticism, Extraversion, and Conscientiousness - generalized across studies. As a set, the Big Five traits had an average multiple correlation of .49 with the motivational criteria, suggesting that the Big Five traits are an important source of performance motivation.",0,1 +547,Detection of Differential Item Functioning in the Graded Response Model,"Methods for detecting differential item func tioning (DIF) have been proposed primarily for the item response theory dichotomous response model. Three measures of DIF for the dichotomous response model are extended to include Samejima's graded response model: two measures based on area differences between item true score functions, and a χ 2 statistic for comparing differences in item parameters. An illustrative example is presented.",0,1 +548,Small sample characteristics of generalized estimating equations,"The aim of this study was to investigate the Type I error rate of hypothesis testing based on generalized estimating equations (GEE) for data characteristic of periodontal clinical trials. The data in these studies consist of a large number of binary responses from each subject and a small number of subjects (Haffajee et al. (1983), Goodson (1986), Jenkins et al. (1988)) Computer simulations were employed to investigate GEE based both on an empirical estimate of the variance-covariance matrix and a model-based estimate. Results from this investigation indicate that hypothesis testing based on GEE resulted in inappropriate Type I error rates when small samples are employed. Only an increase in the number of subjects to the point where it matched the number of observations per subject resulted in appropriate Type I error rates",0,1 +549,Objective priors for the bivariate normal model,"Study of the bivariate normal distribution raises the full range of issues involving objective Bayesian inference, including the different types of objective priors (e.g., Jeffreys, invariant, reference, matching), the different modes of inference (e.g., Bayesian, frequentist, fiducial) and the criteria involved in deciding on optimal objective priors (e.g., ease of computation, frequentist performance, marginalization paradoxes). Summary recommendations as to optimal objective priors are made for a variety of inferences involving the bivariate normal distribution. In the course of the investigation, a variety of surprising results were found, including the availability of objective priors that yield exact frequentist inferences for many functions of the bivariate normal parameters, including the correlation coefficient.",0,1 +550,Combining Correlation Matrices: Simulation Analysis of Improved Fixed-Effects Methods,"The originally proposed multivariate meta-analysis approach for correlation matrices?analyze Pearson correlations, with each study's observed correlations replacing their population counterparts in its conditional-covariance matrix? performs poorly. Two refinements are considered: Analyze Fisher Z-transformed correlations, and substitute better estimates of correlations in the conditional covariances. Fixed-effects methods with and without each refinement were exam ined in a Monte Carlo study; number of studies and the distribution of within study sample sizes were varied. Both refinements improved element-wise point and interval estimates, as well as Type I error control for homogeneity tests, especially with many small studies. Practical recommendations and suggestions for future methodological work are offered. An appendix describes how to trans form Fisher-Z (co)variances to the Pearson-v metric.",0,1 +551,Effects of Prior Knowledge and Experience and Phase of the Choice Process on Consumer Decision Processes: A Protocol Analysis,Effects of prior knowledge and experience and phase of the choice on decision processes were investigated using a protocol coding scheme. Consumers with moderate knowledge and experience did more processing of available information than did the high or low groups. More knowledgeable consumers tended to process by brand. Consumers tended to use attribute-based evaluations in early and brand-based evaluations in later phases of choice.,0,1 +552,Bayesian Estimation and Inference,"This paper introduces the “Bayesian revolution” that is sweeping across multiple disciplines but has yet to gain a foothold in organizational research. The foundations of Bayesian estimation and inference are first reviewed. Then, two empirical examples are provided to show how Bayesian methods can overcome limitations of frequentist methods: (a) a structural equation model of testosterone’s effect on status in teams, where a Bayesian approach allows directly testing a traditional null hypothesis as a research hypothesis and allows estimating all possible residual covariances in a measurement model, neither of which are possible with frequentist methods; and (b) an ANOVA-style model from a true experiment of ego depletion’s effects on performance, where Bayesian estimation with informative priors allows results from all previous research (via a meta-analysis and other previous studies) to be combined with estimates of study effects in a principled manner, yielding support for hypotheses that is not obtained with frequentist methods. Data are available from the first author, code for the program Mplus is provided, and tables illustrate how to present Bayesian results. In conclusion, the many benefits and few hindrances of Bayesian methods are discussed, where the major hindrance has been an easily solvable lack of familiarity by organizational researchers.",0,1 +553,A multivariate CAR model for improving the estimation of relative risks,"Disease mapping studies have been widely performed at univariate level, that is considering only one disease in the estimated models. Nonetheless, simultaneous modelling of different diseases can be a valuable tool both from the epidemiological and from the statistical point of view. In this paper we propose a model for multivariate disease mapping that generalizes the univariate conditional auto-regressive distribution. The proposed model is proven to be an effective alternative to existing multivariate models, mainly because it overcome some restrictive hypotheses underlying models previously proposed in this context. Model performances are checked via a simulation study and via application to a case study.",0,1 +554,Design and analysis of clinical trials with clustering effects due to treatment,"Where patients receive therapy as a group, there are good theoretical reasons to believe that variation in the outcome will be smaller for patients treated in the same group than for patients treated in different groups. Similarly, where different therapists treat different groups of patients, outcome for patients treated by the same therapist may differ less than outcome for patients treated by different therapists. Clinical trials evaluating such therapies need to consider this potential lack of independence. As with cluster-randomized trials, this has implications for the precision of treatment effects estimates and statistical power. There are nevertheless differences between clustering due to the organization of treatment and that due to randomization. In cluster-randomized trials the distribution of cluster sizes in each treatment arm should be similar as a consequence of randomization unless there is differential loss to follow-up. With clustering due to therapy group or therapist, cluster size may differ systematically between treatment arms, due to size of therapy groups or differing health professional caseload. Intra-cluster correlation may also differ between treatment arms. The implications of differential cluster size and intracluster correlation for design and analysis will be illustrated by data from two trials, the first comparing nurse practitioner care with general practitioner care, and the second comparing a group therapy with individual treatment as usual. The special case where a group therapy or therapist is compared with an unclustered treatment is examined in detail using a simulation study. The implications of differential clustering effects for sample size and power are addressed. It is argued that the design and analysis of this type of trial should take account of possible heterogeneity in cluster size and intracluster correlation.",0,1 +555,Crossed Random Effect Models for Multiple Outcomes in a Study of Teratogenesis,"Human teratogens often manifest themselves through a broad spectrum of adverse effects. Although often not serious when considered individually, such outcomes taken together may represent a syndrome that can lead to serious developmental problems. Accordingly, studies that investigate the effect of human teratogens on fetal development typically record the presence or absence of a multitude of abnormalities, resulting in the data of multivariate binary form for each infant. Such studies typically have three objectives: (1) estimate an overall effect of exposure across outcomes, (2) identify subjects having the syndrome, and (3) identify those outcomes that constitute the syndrome so that doctors know what to look for when diagnosing the syndrome in other exposed newborns. This article proposes the use of a logistic regression model with crossed random effect structure to address all three questions simultaneously. We use the proposed models to analyze data from a study investigating the effects of in uter...",0,1 +556,Applying the Quadruple Process model to evaluate change in implicit attitudinal responses during therapy for panic disorder,"This study explored the automatic and controlled processes that may influence performance on an implicit measure across cognitive-behavioral group therapy for panic disorder.The Quadruple Process model was applied to error scores from an Implicit Association Test evaluating associations between the concepts Me (vs. Not Me) + Calm (vs. Panicked) to evaluate four distinct processes: Association Activation, Detection, Guessing, and Overcoming Bias. Parameter estimates were calculated in the panic group (n = 28) across each treatment session where the IAT was administered, and at matched times when the IAT was completed in the healthy control group (n = 31).Association Activation for Me + Calm became stronger over treatment for participants in the panic group, demonstrating that it is possible to change automatically activated associations in memory (vs. simply overriding those associations) in a clinical sample via therapy. As well, the Guessing bias toward the calm category increased over treatment for participants in the panic group.This research evaluates key tenets about the role of automatic processing in cognitive models of anxiety, and emphasizes the viability of changing the actual activation of automatic associations in the context of treatment, versus only changing a person's ability to use reflective processing to overcome biased automatic processing.",0,1 +557,Multicollinearity in Regression Analysis: Comment,"In recent paper this REVIEW,' Farrar and Glauber (hereafter FG) revisit problem of regression analysis. Viewing problem of as both facet and symptom of poor experimental design, 2 FG propose a three-stage hierarchy of increasing detailed tests presence, location, and pattern, 3 of multicollinearity. The first this series of three tests, on which other two are conditional, is desigped provide useful first measure of presence and severity of multicollinearity 4 sample on hand. Bartlett's well-known statistic testing joint distribution of sample correlations under assumption of vanishing parent correlations between variables is used by FG detecting multicollinearity. Bartlett shows that (natural) logarithm of intercorrelation determinant computed from sample drawn from multivariate, ortho-normal distribution, multiplied by factor k, is approximately distributed as Chi Square with v 1/2 n (n 1) degrees of freedom, where k = -[N 1 1/6 (2n + 5)], N is sample size and n is number of variables considered. If investigator concludes from first stage that exists and that it is severe enough warrant some action, FG propose regress consecutively each explanatory variable on remaining ones. The rp'silting F statistics will test for dependence of particular variables on other members 5 of set of explanatory variables. Finally, patterns of interdependence among independent variables are examined by testing significa-nce of partial correlations of every pair of explanatory variables, all other variables held constant. The main pillar of this three-level test is, of course, Bartlett's test which is properly used making inferences,6 under null hypothesis that all population correlations are zero. Since FG claim, however, that they are not interested drawing inferences from sample population (inferences from sample population . . . are possible . . . however, little importance is attached properties of population from which set of data has been drawn. Attention focuses largely, if not entirely, on sample itself 7), their use of Chi-Square statistic is questionable. Moreover, it is neither practical nor necessary assume orthogonality between parent economic variables, 4f one wishes make such inferences. Here we come heart of problem of multicollinearity. One may agree with FG that it is preferable think of in terms of [its] severity rather than its existence or nonexistence. 8 If one agrees with this approach, natural way proceed is indeed to define terms of departures from hypothesized statistical condition. 9 But what is this hypothesized condition? For FG this condition is the requirement that explanatory variables be truly independent of one another. 10 However, there is no such requirement least-squares solution. On contrary, least squares solu* I share with D. C. Farrar and R. R. Glauber my indebtedness Professor John R. Meyer who introduced us problem, and I am grateful his comments on an earlier draft. I am also grateful Professors J. Johnston, N. Wallace, D. Farrar, and R. Glauber valuable discussions. I am particularly thankful D. Farrar who did not spare his efforts order dig out old forgotten data, which enabled me recompute his regression equations. 1D. C. Farrar and R. R. Glauber, Multicollinearity Regression Analysis: The Problem Revisited, this REvIEw, XLIX (Feb. 1967). 2Ibid., p. 93. 3 Ibid., p. 104. ' Ibid., p. 101. BIbid., p. 104. Bartlett has originally developed this statistic order test number of meaningful components that can be extracted from set of variables. concise statement is given by Bartlett: A Note on Multiplying Factors Various x2 Approximations, Journal of Royal Statistical Society (B), XVI, no. 2 (1954), pp. 296-298. 7D. C. Farrar and R. R. Glauber, op. cit., 100. 8Ibid., p. 106. 9 Ibid., p. 92. 10Ibid., pp. 92 and 100.",0,1 +558,Linear and nonlinear associations between general intelligence and personality in Project TALENT.,"Research on the relations of personality traits to intelligence has primarily been concerned with linear associations. Yet, there are no a priori reasons why linear relations should be expected over nonlinear ones, which represent a much larger set of all possible associations. Using 2 techniques, quadratic and generalized additive models, we tested for linear and nonlinear associations of general intelligence (g) with 10 personality scales from Project TALENT (PT), a nationally representative sample of approximately 400,000 American high school students from 1960, divided into 4 grade samples (Flanagan et al., 1962). We departed from previous studies, including one with PT (Reeve, Meyer, & Bonaccio, 2006), by modeling latent quadratic effects directly, controlling the influence of the common factor in the personality scales, and assuming a direction of effect from g to personality. On the basis of the literature, we made 17 directional hypotheses for the linear and quadratic associations. Of these, 53% were supported in all 4 male grades and 58% in all 4 female grades. Quadratic associations explained substantive variance above and beyond linear effects (mean R² between 1.8% and 3.6%) for Sociability, Maturity, Vigor, and Leadership in males and Sociability, Maturity, and Tidiness in females; linear associations were predominant for other traits. We discuss how suited current theories of the personality-intelligence interface are to explain these associations, and how research on intellectually gifted samples may provide a unique way of understanding them. We conclude that nonlinear models can provide incremental detail regarding personality and intelligence associations.",0,1 +559,Modeling Incomplete Scaled Questionnaire Data with a Partial Credit Hierarchical Measurement Model,"The partial credit hierarchical measurement model (HMM) results when a partial credit IRT model and a hierarchical linear model are combined ( Bryk & Raudenbush, 1992 ; Masters, 1982 ). This combined model enables the standard errors of parameters to be estimated accurately. The partial credit HMM is illustrated using a subset of data from the Sloan Study of Youth and Social Development, a five-year longitudinal project studying the career aspirations of adolescents. The data used for this study consisted of a subset of students’ responses to multiple administrations of an attitudinal questionnaire, as well as student-level covariates. Using student responses to seven seven-point semantic differential items tapping student mood, the partial credit HMM was used to explore the effects of gender and classroom activity upon student mood as students were engaged in a mathematics classroom. Gibbs sampling and the Metropolis-Hastings algorithm were used to impute values for the missing data and to estimate the parameters of the model. The results of the data analysis indicated that female students had lower mood than male students did for all classroom activities.",0,1 +560,The peripheral L-arginine–nitric oxide–cyclic GMP pathway and ATP-sensitive K+ channels are involved in the antinociceptive effect of crotalphine on neuropathic pain in rats,"Crotalphine, a 14 amino acid peptide first isolated from the venom of the South American rattlesnake Crotalus durissus terrificus, induces a peripheral long-lasting and opioid receptor-mediated antinociceptive effect in a rat model of neuropathic pain induced by chronic constriction of the sciatic nerve. In the present study, we further characterized the molecular mechanisms involved in this effect, determining the type of opioid receptor responsible for this effect and the involvement of the nitric oxide-cyclic GMP pathway and of K⁺ channels. Crotalphine (0.2 or 5 μg/kg, orally; 0.0006 μg/paw), administered on day 14 after nerve constriction, inhibited mechanical hyperalgesia and low-threshold mechanical allodynia. The effect of the peptide was antagonized by intraplantar administration of naltrindole, an antagonist of δ-opioid receptors, and partially reversed by norbinaltorphimine, an antagonist of κ-opioid receptors. The effect of crotalphine was also blocked by 7-nitroindazole, an inhibitor of the neuronal nitric oxide synthase; by 1H-(1,2,4) oxadiazolo[4,3-a]quinoxaline-1-one, an inhibitor of guanylate cyclase activation; and by glibenclamide, an ATP-sensitive K⁺ channel blocker. The results suggest that peripheral δ-opioid and κ-opioid receptors, the nitric oxide-cyclic GMP pathway, and ATP-sensitive K⁺ channels are involved in the antinociceptive effect of crotalphine. The present data point to the therapeutic potential of this peptide for the treatment of chronic neuropathic pain.",0,1 +561,Discrete fixed-resolution representations in visual working memory,"Limits on the storage capacity of working memory significantly affect cognitive abilities in a wide range of domains, but the nature of these capacity limits has been elusive. Some researchers have proposed that working memory stores a limited set of discrete, fixed-resolution representations, whereas others have proposed that working memory consists of a pool of resources that can be allocated flexibly to provide either a small number of high-resolution representations or a large number of low-resolution representations. Here we resolve this controversy by providing independent measures of capacity and resolution. We show that, when presented with more than a few simple objects, human observers store a high-resolution representation of a subset of the objects and retain no information about the others. Memory resolution varied over a narrow range that cannot be explained in terms of a general resource pool but can be well explained by a small set of discrete, fixed-resolution representations.",0,1 +562,A bayesian approach to confirmatory factor analysis,"Confirmatory factor analysis is considered from a Bayesian viewpoint, in which prior information on parameter is incorporated in the analysis. An iterative algorithm is developed to obtain the Bayes estimates. A numerical example based on longitudinal data is presented. A simulation study is designed to compare the Bayesian approach with the maximum likelihood method. © 1981 The Psychometric Society.",0,1 +563,Reducing Bias in Observational Studies Using Subclassification on the Propensity Score,"The propensity score is the conditional probability of assignment to a particular treatment given a vector of observed covariates. Previous theoretical arguments have shown that subclassification on the propensity score will balance all observed covariates. Subclassification on an estimated propensity score is illustrated, using observational data on treatments for coronary artery disease. Five subclasses defined by the estimated propensity score are constructed that balance 74 covariates, and thereby provide estimates of treatment effects using direct adjustment. These subclasses are applied within sub-populations, and model-based adjustments are then used to provide estimates of treatment effects within these sub-populations. Two appendixes address theoretical issues related to the application: the effectiveness of subclassification on the propensity score in removing bias, and balancing properties of propensity scores with incomplete data. © 1984 Taylor & Francis Group, LLC.",0,1 +564,A Bayesian Account of Reconstructive Memory,"It is well established that prior knowledge influences reconstruction from memory, but the specific interactions of memory and knowledge are unclear. Extending work by Huttenlocher et al. (Psychological Review, 98 [1991] 352; Journal of Experimental Psychology: General, 129 [2000] 220), we propose a Bayesian model of reconstructive memory in which prior knowledge interacts with episodic memory at multiple levels of abstraction. The combination of prior knowledge and noisy memory representations is dependent on familiarity. We present empirical evidence of the influences of prior knowledge at multiple levels of abstraction, showing that the reconstruction of familiar objects is influenced toward the specific prior for that object, while unfamiliar objects are influenced toward the overall category.",0,1 +565,Growth Curve Analysis in Contemporary Psychological Research,"The term “growth curve” is used to describe data where: (1) the same entities are repeatedly observed, (2) the same procedures of measurement and scaling of observations are used, and (3) the timing of the observations is known. Growth curves are now common in many areas of psychological research, and some of these are presented here. The term “growth curve analysis” denotes the processes of describing, testing hypotheses, and making scientific inferences about the growth and change patterns in a wide range of time-related phenomena. In this sense, growth curve analyses are a specific form of the larger set of developmental and longitudinal research methods, but the unique features of growth data permit unique kinds of analyses. Formal models for the analysis of growth curves which have been developed in many different substantive domains are described here in five sections: (1) An introduction to growth curves, (2) linear models of growth, (3) multiple groups in growth curve models, (4) aspects of dynamic theory for growth models, and (5) multiple variables in growth curve analyses. We conclude with a discussion of future issues raised by the current growth models.",0,1 +566,Caudal Granular Insular Cortex Is Sufficient and Necessary for the Long-Term Maintenance of Allodynic Behavior in the Rat Attributable to Mononeuropathy,"Mechanical allodynia, the perception of innocuous tactile stimulation as painful, is a severe symptom of chronic pain often produced by damage to peripheral nerves. Allodynia affects millions of people and remains highly resistant to classic analgesics and therapies. Neural mechanisms for the development and maintenance of allodynia have been investigated in the spinal cord, brainstem, thalamus, and forebrain, but manipulations of these regions rarely produce lasting effects. We found that long-term alleviation of allodynic manifestations is produced by discreetly lesioning a newly discovered somatosensory representation in caudal granular insular cortex (CGIC) in the rat, either before or after a chronic constriction injury of the sciatic nerve. However, CGIC lesions alone have no effect on normal mechanical stimulus thresholds. In addition, using electrophysiological techniques, we reveal a corticospinal loop that could be the anatomical source of the influence of CGIC on allodynia.",0,1 +567,Deciding on the Number of Classes in Latent Class Analysis and Growth Mixture Modeling: A Monte Carlo Simulation Study,"Mixture modeling is a widely applied data analysis technique used to identify unobserved heterogeneity in a population. Despite mixture models' usefulness in practice, one unresolved issue in the application of mixture models is that there is not one commonly accepted statistical indicator for deciding on the number of classes in a study population. This article presents the results of a simulation study that examines the performance of likelihood-based tests and the traditionally used Information Criterion (ICs) used for determining the number of classes in mixture modeling. We look at the performance of these tests and indexes for 3 types of mixture models: latent class analysis (LCA), a factor mixture model (FMA), and a growth mixture models (GMM). We evaluate the ability of the tests and indexes to correctly identify the number of classes at three different sample sizes (n = 200, 500, 1,000). Whereas the Bayesian Information Criterion performed the best of the ICs, the bootstrap likelihood ratio test ...",0,1 +568,Local solutions in the estimation of growth mixture models.,"Finite mixture models are well known to have poorly behaved likelihood functions featuring singularities and multiple optima. Growth mixture models may suffer from fewer of these problems, potentially benefiting from the structure imposed on the estimated class means and covariances by the specified growth model. As demonstrated here, however, local solutions may still be problematic. Results from an empirical case study and a small Monte Carlo simulation show that failure to thoroughly consider the possible presence of local optima in the estimation of a growth mixture model can sometimes have serious consequences, possibly leading to adoption of an inferior solution that differs in substantively important ways from the actual maximum likelihood solution. Often, the defaults of current software need to be overridden to thoroughly evaluate the parameter space and obtain confidence that the maximum likelihood solution has in fact been obtained.",0,1 +569,Diagnosis of Calcific Tendonitis of the Rotator Cuff by Using Susceptibility-weighted MR Imaging,"To evaluate the diagnostic performance of susceptibility-weighted imaging (SWI) and standard shoulder joint magnetic resonance (MR) sequences in comparison to that of conventional radiography for the identification of calcifications in the rotator cuff in patients with calcific tendonitis.The institutional review board approved this prospective study. Written informed consent was obtained from all subjects. Fifty-four patients clinically suspected of having calcific tendonitis of the rotator cuff were included. On radiographs (the standard of reference), 27 patients had positive calcification findings, and 27 did not. Standard MR sequences and SWI, including magnitude and phase imaging, were performed. The diameter of calcifications was measured to assess intermodality correlations. Sensitivity, specificity, and intra- and interobserver agreement were calculated. Phantom measurements were performed to assess the detection limit of SWI.Fifty-six calcifications were detected with radiography in 27 patients. Most (55 calcifications, 98%) could be identified as calcifications by using SWI. Standard T1- and T2-weighted sequences were used to identify 33 calcifications (59%). SWI yielded a sensitivity of 98% (95% confidence interval [CI]: 0.943, 1) and specificity of 96% (95% CI: 0.886, 1) for the identification of calcifications when compared with radiography. Standard rotator cuff MR sequences yielded a sensitivity of 59% (95% CI: 0.422, 0.758) and specificity of 67% (95% CI: 0.493, 0.847). Diameter measurements demonstrated a high correlation between SWI and radiography (R(2) = 0.90), with overestimation of lesion diameter at SWI (mean ± standard deviation for SWI, 7.6 mm ± 5.4; for radiography, 5.3 mm ± 5.1). SWI yielded higher interobserver agreement (R(2) = 0.99, P < .001; 95% CI: 0.989, 0.996) compared with standard MR sequences (R(2) = 0.67, P = .62; 95% CI: 0.703, 0.899). In phantom experiments, SWI and computed tomography were used to identify small calcifications that were missed at radiography.SWI enables the reliable detection of calcifications in the rotator cuff in patients with calcific tendonitis by using conventional radiography as a reference and offers better sensitivity and specificity than standard rotator cuff MR sequences.",0,1 +570,Markov Chain Monte Carlo Methods and the Label Switching Problem in Bayesian Mixture Modeling,"In the past ten years there has been a dramatic increase of interest in the Bayesian analysis of finite mixture models. This is primarily because of the emergence of Markov chain Monte Carlo (MCMC) methods. While MCMC provides a convenient way to draw inference from complicated statistical models, there are many, perhaps underappreciated, problems associated with the MCMC analysis of mixtures. The problems are mainly caused by the nonidentifiability of the components under symmetric priors, which leads to so-called label switching in the MCMC output. This means that ergodic averages of component specific quantities will be identical and thus useless for inference. We review the solutions to the label switching problem, such as artificial identifiability constraints, relabelling algorithms and label invariant loss functions. We also review various MCMC sampling schemes that have been suggested for mixture models and discuss posterior sensitivity to prior specification.",0,1 +571,Autoregressive Latent Trajectory (ALT) Models A Synthesis of Two Traditions,"Although there are a variety of statistical methods available for the analysis of longitudinal panel data, two approaches are of particular historical importance: the autoregressive (simplex) model and the latent trajectory (curve) model. These two approaches have been portrayed as competing methodologies such that one approach is superior to the other. We argue that the autoregressive and trajectory models are special cases of a more encompassing model that we call the autoregressive latent trajectory (ALT) model. In this paper we detail the underlying statistical theory and mathematical identification of this model, and demonstrate the ALT model using two empirical data sets. The first reanalyzes a simulated repeated measures data set that was previously used to argue against the autoregressive model, and we illustrate how the ALT model can recover the true latent curve model. Second, we apply the ALT model to real family income data on N=3912 adults over a seven year period and find evidence for both autoregressive and latent trajectory processes. Extensions and limitations are discussed.",0,1 +572,"Homonegativity among first and second generation migrants in Europe: The interplay of time trends, origin, destination and religion","• There is few previous research into approval of homosexuality among migrants. • We analyze time trends, and the influence of origin, destination and religion. • A specific HAPC model is developed. • Homonegativity declines both over time as across cohorts. • Migrants conform to levels of homonegativity in the host society. Previous studies reported declining disapproval of homosexuality in Europe but have simultaneously identified the decelerating effect of religiosity and the higher disapproval of homosexuality among migrants. In this paper, we address disapproval of homosexuality among first- and second-generation migrants in Europe by assessing (1) period and cohort changes, (2) origin and destination country influences and (3) the role of religiosity. We develop a specific cross-classified multilevel design enabling us to simultaneously examine these influences. We test hypotheses using a subsample of the European Social Survey (ESS), containing 19,878 first and second generation migrants. The analyses lead to three important conclusions. Firstly, disapproval of homosexuality is declining both over time and across cohorts. Secondly, migrants conform to levels of disapproval of homosexuality among natives in the destination country, and this explains the decline among migrants over time. Thirdly, religion has a multi-faceted influence on levels of disapproval of homosexuality among migrants.",0,1 +573,A new round robin analysis of variance for social interaction data.,"Experimental social psychology has dealt primarily with situations that are not true social interactions; in a typical study, a subject responds to a fixed, artificial social stimulus such as a photograph, written description, or performance by a confederate. Although these artificial social stimuli provide experimental control over independent variables and can be analyzed using the types of statistical models originally developed for nonsocial experimental research, they provide little or no information about the interactive aspects of social behavior—the reciprocity or mutual contingency of the behavior of interaction partners. This paper describes a nonexperimenta l design specifically tailored to social interaction data that provides more information about individual differences and social influence in social interactions: a round robin design in which each person interacts with every other person. After a brief review of available models, a new and more general model for the analysis of social interaction data is presented, with an empirical demonstration using vocal activity data.",0,1 +574,Computerized Adaptive Testing: The Capitalization on Chance Problem,"This paper describes several simulation studies that examine the effects of capitalization on chance in the selection of items and the ability estimation in CAT, employing the 3-parameter logistic model. In order to generate different estimation errors for the item parameters, the calibration sample size was manipulated ( N = 500, 1000 and 2000 subjects) as was the ratio of item bank size to test length (banks of 197 and 788 items, test lengths of 20 and 40 items), both in a CAT and in a random test. Results show that capitalization on chance is particularly serious in CAT, as revealed by the large positive bias found in the small sample calibration conditions. For broad ranges of θ, the overestimation of the precision (asymptotic Se) reaches levels of 40%, something that does not occur with the RMSE (θ). The problem is greater as the item bank size to test length ratio increases. Potential solutions were tested in a second study, where two exposure control methods were incorporated into the item selection algorithm. Some alternative solutions are discussed.",0,1 +575,Asymptotic Properties of Maximum Likelihood Estimators and Likelihood Ratio Tests under Nonstandard Conditions,"Abstract Large sample properties of the likelihood function when the true parameter value may be on the boundary of the parameter space are described. Specifically, the asymptotic distribution of maximum likelihood estimators and likelihood ratio statistics are derived. These results generalize the work of Moran (1971), Chant (1974), and Chernoff (1954). Some of Chant's results are shown to be incorrect. The approach used in deriving these results follows from comments made by Moran and Chant. The problem is shown to be asymptotically equivalent to the problem of estimating the restricted mean of a multivariate Gaussian distribution from a sample of size 1. In this representation the Gaussian random variable corresponds to the limit of the normalized score statistic and the estimate of the mean corresponds to the limit of the normalized maximum likelihood estimator. Thus the limiting distribution of the maximum likelihood estimator is the same as the distribution of the projection of the Gaussian random v...",0,1 +576,Joint mean-covariance models with applications to longitudinal data: unconstrained parameterisation,"SUMMARY We provide unconstrained parameterisation for and model a covariance using covariates. The Cholesky decomposition of the inverse of a covariance matrix is used to associate a unique unit lower triangular and a unique diagonal matrix with each covariance matrix. The entries of the lower triangular and the log of the diagonal matrix are unconstrained and have meaning as regression coefficients and prediction variances when regressing a measurement on its predecessors. An extended generalised linear model is introduced for joint modelling of the vectors of predictors for the mean and covariance subsuming the joint modelling strategy for mean and variance heterogeneity, Gabriel's antedependence models, Dempster's covariance selection models and the class of graphical models. The likelihood function and maximum likelihood estimators of the covariance and the mean parameters are studied when the observations are normally distributed. Applications to modelling nonstationary dependence structures and multivariate data are discussed and illustrated using real data. A graphical method, similar to that based on the correlogram in time series, is developed and used to identify parametric models for nonstationary covariances.",0,1 +577,Odds Ratios for Mediation Analysis for a Dichotomous Outcome,"For dichotomous outcomes, the authors discuss when the standard approaches to mediation analysis used in epidemiology and the social sciences are valid, and they provide alternative mediation analysis techniques when the standard approaches will not work. They extend definitions of controlled direct effects and natural direct and indirect effects from the risk difference scale to the odds ratio scale. A simple technique to estimate direct and indirect effect odds ratios by combining logistic and linear regressions is described that applies when the outcome is rare and the mediator continuous. Further discussion is given as to how this mediation analysis technique can be extended to settings in which data come from a case-control study design. For the standard mediation analysis techniques used in the epidemiologic and social science literatures to be valid, an assumption of no interaction between the effects of the exposure and the mediator on the outcome is needed. The approach presented here, however, will apply even when there are interactions between the effect of the exposure and the mediator on the outcome.",0,1 +578,Real world performance of choice-based conjoint models,"Conjoint analysis is one of the most important tools to support product development, pricing and positioning decisions in management practice. For this purpose various models have been developed. It is widely accepted that models that take consumer heterogeneity into account, outperform aggregate models in terms of hold-out tasks. The aim of our study is to investigate empirically whether predictions of choice-based conjoint models which incorporate heterogeneity can successfully be generalized to a whole market. To date no studies exist that examine the real world performance of choice-based conjoint models by use of aggregate scanner panel data. Our analysis is based on four commercial choice-based conjoint pricing studies including a total of 43 stock keeping units (SKU) and the corresponding weekly scanning data for approximately two years. An aggregate model serves as a benchmark for the performance of two models that take heterogeneity into account, hierarchical Bayes and latent class. Our empirical analysis demonstrates that, in contrast to the performance using hold-out tasks, the real world performance of hierarchical Bayes and latent class is similar to the performance of the aggregate model. Our results indicate that heterogeneity cannot be generalized to a whole market and suggest that aggregate models are sufficient to predict market shares. (author's abstract)",0,1 +579,Between exclusion and calculating solidarity? Preferences for private versus public welfare provision and the size of the informal sector,"This article examines how the informal sector, as a group of potential 'free riders' for public welfare goods, relates to individual social policy preferences in low- and middle-income countries. The exclusion hypothesis proposes that a large informal sector lowers the preferences from formal workers and the middle- and high-income groups for social services to be provided by the state, and raises these groups' preferences for public welfare goods to become club goods. In contrast, the prospect hypothesis argues that formal workers, particularly the middle-income group, ally themselves to the informal sector to insure against the risk of future employment in informality. The study examines individual preferences for the provision of pensions and health care by either the state or private enterprises. The two competing hypotheses are tested with a hierarchical model using survey data from Latin America for 1995, 1998 and 2008. The findings offer support for the exclusion hypothesis. © The Author 2015.",0,1 +580,Partitioning Degrees of Freedom in Hierarchical and Other Richly Parameterized Models,"Hodges & Sargent (2001) developed a measure of a hierarchical model's complexity, degrees of freedom (DF), that is consistent with definitions for scatterplot smoothers, interpretable in terms of simple models, and that enables control of a fit's complexity by means of a prior distribution on complexity. DF describes complexity of the whole fitted model but in general it is unclear how to allocate DF to individual effects. We give a new definition of DF for arbitrary normal-error linear hierarchical models, consistent with Hodges & Sargent's, that naturally partitions the n observations into DF for individual effects and for error. The new conception of an effect's DF is the ratio of the effect's modeled variance matrix to the total variance matrix. This gives a way to describe the sizes of different parts of a model (e.g., spatial clustering vs. heterogeneity), to place DF-based priors on smoothing parameters, and to describe how a smoothed effect competes with other effects. It also avoids difficulties with the most common definition of DF for residuals. We conclude by comparing DF to the effective number of parameters p(D) of Spiegelhalter et al (2002). Technical appendices and a dataset are available online as supplemental materials.",0,1 +581,Sampling Correlation Matrices in Bayesian Models With Correlated Latent Variables,"Hierarchical model specifications using latent variables are frequently used to reflect correlation structure in data. Motivated by the structure of a Bayesian multivariate probit model, we demonstrate a parameter-extended Metropolis-Hastings algorithm for sampling from the posterior distribution of a correlation matrix. Our sampling algorithms lead directly to two readily interpretable families of prior distributions for a correlation matrix. The methodology is illustrated through a simulation study and through an application with repeated binary outcomes on individuals from a study of a suicide prevention intervention.",0,1 +582,"Network meta-analysis of prasugrel, ticagrelor, high- and standard-dose clopidogrel in patients scheduled for percutaneous coronary interventions","Summary Since novel antiplatelet treatments (prasugrel, ticagrelor, high-dose clopidogrel) have been predominantly tested against standard-dose clopidogrel, data on direct comparisons between these therapies are scarce. We therefore indirectly compared their efficacy and safety in patients undergoing percutaneous coronary intervention. Electronic databases were searched systematically to identify head-to-head randomised controlled trials (RCTs). Network meta-analysis was performed using generalised linear mixed models with adjustment for length of follow-up. Findings were corroborated by mixed treatment comparison through Bayesian methods. Fourteen RCTs were identified and included in the analysis (high- vs. standard-dose clopidogrel: 9 trials, prasugrel vs. high-dose clopidogrel: 2 trials, prasugrel vs. standard-dose clopidogrel: 2 trials, ticagrelor vs. standard-dose clopidogrel: 1 trial). No significant differences were found for efficacy outcomes except for stent thrombosis favouring prasugrel (vs. ticagrelor: odds ratio [OR] 0.63, 95% confidence interval [CI]: 0.42, 0.94; vs. high-dose clopidogrel: OR 0.70, 95%CI: 0.48, 1.01). Prasugrel exhibited a similar bleeding risk as high-dose clopidogrel, but more major (OR 1.43, 95%CI 1.07, 1.90) and major or minor bleeding (OR 1.36, 95%CI 1.09, 1.69) compared to ticagrelor. Ticagrelor was also associated with less major or minor bleeding compared to high-dose clopidogrel (OR 0.81, 95%CI 0.69, 0.96). No differences were seen for non CABG-related major bleeding between the three strategies. Results were corroborated in a subgroup analysis comprising only patients with acute coronary syndromes. In the absence of head-to-head clinical trials, network meta-analysis suggests potentially relevant differences in efficacy and bleeding risk among novel antiplatelet treatments and may thereby advance understanding of their differential therapeutic properties.",0,1 +583,"Political Trust, Corruption, and Ratings of the IMF and the World Bank","There are only a handful of studies that examine public support for the IMF and World Bank. Public opinion data on attitudes to the economy feature prominently in these studies. Utilizing data from the Afrobarometer survey, we find that evaluations of the economy, ideology, and a range of sociodemographic factors including age, gender, employment status, health, education, and living conditions are not significantly related to ratings of effectiveness. Rather, we find that political trust and corruption—two very important concepts in the wider literature on individual-level attitudes toward international relations and foreign policy issues—are strongly associated with ratings of effectiveness.",0,1 +584,Mediation Analysis with Missing Data Through Multiple Imputation and Bootstrap,"A method using multiple imputation and bootstrap for dealing with missing data in mediation analysis is introduced and implemented in both SAS and R. Through simulation studies, it is shown that the method performs well for both MCAR and MAR data without and with auxiliary variables. It is also shown that the method can work for MNAR data if auxiliary variables related to missingness are included. The application of the method is demonstrated through the analysis of a subset of data from the National Longitudinal Survey of Youth. Mediation analysis with missing data can be conducted using the provided SAS macros and R package bmem.",0,1 +585,Sparse group factor analysis for biclustering of multiple data sources,"Abstract Motivation: Modelling methods that find structure in data are necessary with the current large volumes of genomic data, and there have been various efforts to find subsets of genes exhibiting consistent patterns over subsets of treatments. These biclustering techniques have focused on one data source, often gene expression data. We present a Bayesian approach for joint biclustering of multiple data sources, extending a recent method Group Factor Analysis to have a biclustering interpretation with additional sparsity assumptions. The resulting method enables data-driven detection of linear structure present in parts of the data sources. Results: Our simulation studies show that the proposed method reliably infers biclusters from heterogeneous data sources. We tested the method on data from the NCI-DREAM drug sensitivity prediction challenge, resulting in an excellent prediction accuracy. Moreover, the predictions are based on several biclusters which provide insight into the data sources, in this case on gene expression, DNA methylation, protein abundance, exome sequence, functional connectivity fingerprints and drug sensitivity. Availability and Implementation: http://research.cs.aalto.fi/pml/software/GFAsparse/ Contacts: kerstin.bunte@googlemail.com or samuel.kaski@aalto.fi",0,1 +586,Bayesian predictive densities based on superharmonic priors for the 2-dimensional Wishart model,Bayesian predictive densities for the 2-dimensional Wishart model are investigated. The performance of predictive densities is evaluated by using the Kullback–Leibler divergence. It is proved that a Bayesian predictive density based on a prior exactly dominates that based on the Jeffreys prior if the prior density satisfies some geometric conditions. An orthogonally invariant prior is introduced and it is shown that the Bayesian predictive density based on the prior is minimax and dominates that based on the right invariant prior with respect to the triangular group.,0,1 +587,The theory of planned behavior,"Research dealing with various aspects of* the theory of planned behavior (Ajzen, 1985, 1987) is reviewed, and some unresolved issues are discussed. In broad terms, the theory is found to be well supported by empirical evidence. Intentions to perform behaviors of different kinds can be predicted with high accuracy from attitudes toward the behavior, subjective norms, and perceived behavioral control; and these intentions, together with perceptions of behavioral control, account for considerable variance in actual behavior. Attitudes, subjective norms, and perceived behavioral control are shown to be related to appropriate sets of salient behavioral, normative, and control beliefs about the behavior, but the exact nature of these relations is still uncertain. Expectancy— value formulations are found to be only partly successful in dealing with these relations. Optimal rescaling of expectancy and value measures is offered as a means of dealing with measurement limitations. Finally, inclusion of past behavior in the prediction equation is shown to provide a means of testing the theory*s sufficiency, another issue that remains unresolved. The limited available evidence concerning this question shows that the theory is predicting behavior quite well in comparison to the ceiling imposed by behavioral reliability. © 1991 Academic Press. Inc.",0,1 +588,Maximum Likelihood and Bayesian Estimation for Nonlinear Structural Equation Models,,0,1 +589,Estimation for structural equation models with missing data,"A direct method in handling incomplete data in general covariance structural models is investigated. Asymptotic statistical properties of the generalized least squares method are developed. It is shown that this approach has very close relationships with the maximum likelihood approach. Iterative procedures for obtaining the generalized least squares estimates, the maximum likelihood estimates, as well as their standard error estimates are derived. Computer programs for the confirmatory factor analysis model are implemented. A longitudinal type data set is used as an example to illustrate the results. © 1986 The Psychometric Society.",0,1 +590,A Point-by-Point Analysis of Performance in a Fencing Match: Psychological Processes Associated with Winning and Losing Streaks,"This study aimed to revisit the complex nature of serial dependency of performance during a match, examining the prospective associations between psychological processes and subsequent performance at the within-person level of analysis, and explore whether psychological processes are associated with the likelihood of winning series of points. A process-oriented sequential approach was used with 16 elite fencers during a simulated competition. Multilevel regression analyses revealed that serial dependency of performance fluctuates within a match. Results of a Bayesian multilevel structural equation model showed that prior performance subsequently influenced psychological processes. Although psychological processes did not predict performance in the subsequent point, successive winnings were associated with higher perceived control and task-oriented coping and lower negative affectivity compared with both losing streaks and nonstreaks. Overall, serial dependencies of performance are nonstationary during a match whereas psychological processes significantly differ in episodes of winning after winning versus losing after losing.",0,1 +591,An ideal observer analysis of visual working memory.,"Limits in visual working memory (VWM) strongly constrain human performance across many tasks. However, the nature of these limits is not well understood. In this article we develop an ideal observer analysis of human VWM by deriving the expected behavior of an optimally performing but limited-capacity memory system. This analysis is framed around rate-distortion theory, a branch of information theory that provides optimal bounds on the accuracy of information transmission subject to a fixed information capacity. The result of the ideal observer analysis is a theoretical framework that provides a task-independent and quantitative definition of visual memory capacity and yields novel predictions regarding human performance. These predictions are subsequently evaluated and confirmed in 2 empirical studies. Further, the framework is general enough to allow the specification and testing of alternative models of visual memory (e.g., how capacity is distributed across multiple items). We demonstrate that a simple model developed on the basis of the ideal observer analysis-one that allows variability in the number of stored memory representations but does not assume the presence of a fixed item limit-provides an excellent account of the empirical data and further offers a principled reinterpretation of existing models of VWM.",0,1 +592,"To prosper, organizational psychology should … overcome methodological barriers to progress","Progress in organizational psychology (OP) research depends on the rigor and quality of the methods we use. This paper identifies ten methodological barriers to progress and offers suggestions for overcoming the barriers, in part or whole. The barriers address how we derive hypotheses from theories, the nature and scope of the questions we pursue in our studies, the ways we address causality, the manner in which we draw samples and measure constructs, and how we conduct statistical tests and draw inferences from our research. The paper concludes with recommendations for integrating research methods into our ongoing development goals as scholars and framing methods as tools that help us achieve shared objectives in our field. Copyright © 2008 John Wiley & Sons, Ltd.",0,1 +593,Hierarchical Bayesian Modeling for Test Theory Without an Answer Key,"Cultural Consensus Theory (CCT) models have been applied extensively across research domains in the social and behavioral sciences in order to explore shared knowledge and beliefs. CCT models operate on response data, in which the answer key is latent. The current paper develops methods to enhance the application of these models by developing the appropriate specifications for hierarchical Bayesian inference. A primary contribution is the methodology for integrating the use of covariates into CCT models. More specifically, both person- and item-related parameters are introduced as random effects that can respectively account for patterns of inter-individual and inter-item variability. © 2013, The Psychometric Society.",0,1 +594,Nonlinear Structured Growth Mixture Models in Mplusand OpenMx,"Growth mixture models (GMMs; Muthén & Muthén, 2000; Muthén & Shedden, 1999) are a combination of latent curve models (LCMs) and finite mixture models to examine the existence of latent classes that follow distinct developmental patterns. GMMs are often fit with linear, latent basis, multiphase, or polynomial change models because of their common use, flexibility in modeling many types of change patterns, the availability of statistical programs to fit such models, and the ease of programming. In this paper, we present additional ways of modeling nonlinear change patterns with GMMs. Specifically, we show how LCMs that follow specific nonlinear functions can be extended to examine the presence of multiple latent classes using the Mplus and OpenMx computer programs. These models are fit to longitudinal reading data from the Early Childhood Longitudinal Study-Kindergarten Cohort to illustrate their use.",0,1 +595,Attitudes towards student support: How positive feedback-effects prevent change in the Four Worlds of Student Finance,"This article provides a detailed analysis of individual preferences towards public financial aid to students from low-income families. Who favours/opposes such aid? What are the determinants of the respective preferences? I argue that three sets of factors jointly shape these preferences: materialistic self-interests, political attitudes, and the status quo of the higher education subsidy systems by generating positive feedback-effects. Results of multilevel ordered logit models utilizing the International Social Survey Program (ISSP) data for up to 22 countries over two decades indicate that self-interest matters: students strongly favour subsidies as do their parents, while those paying for the spending and those not expecting to benefit oppose such aid. Moreover, political attitudes are important: Supporters of redistribution and of increased public education spending in general, as well as leftwing voters, are much more likely to support students. On the macro-level, the findings suggest that positive feedback-effects exist: in countries with generous subsidy systems, public support for subsidies is higher. This article is the first to systematically analyse preferences towards higher education subsidies across countries and time and demonstrates how positive feedback-effects increasingly lock-in countries’ tuition-subsidy paths, making the systems resistant to (radical) change. As such, it speaks to the literature on the political economy of skill formation, the welfare state, public opinion and the public opinion–policy link.",0,1 +596,A Bayesian Approach for Nonlinear Structural Equation Models With Dichotomous Variables Using Logit and Probit Links,"Analysis of ordered binary and unordered binary data has received considerable attention in social and psychological research. This article introduces a Bayesian approach, which has several nice features in practical applications, for analyzing nonlinear structural equation models with dichotomous data. We demonstrate how to use the software WinBUGS and R2WinBUGS to obtain Bayesian estimates of the unknown parameters, estimates of latent variables, and the Deviance Information Criterion for model comparison. An illustrative example with an artificial data set is provided. Finally, simulation studies are conducted, not only to reveal the empirical performance of the Bayesian approach, but also to show that incorrectly treating binary data as ordinal, and vice versa, would produce misleading results.",0,1 +597,Effects of Modeling the Heterogeneity on Inferences Drawn from Multilevel Designs,"This article uses Monte Carlo techniques to examine the effect of heterogeneity of variance in multilevel analyses in terms of relative bias, coverage probability, and root mean square error (RMSE). For all simulated data sets, the parameters were estimated using the restricted maximum-likelihood (REML) method both assuming homogeneity and incorporating heterogeneity into multilevel models. We find that (a) the estimates for the fixed parameters are unbiased, but the associated standard errors are frequently biased when heterogeneity is ignored; by contrast, the standard errors of the fixed effects are almost always accurate when heterogeneity is considered; (b) the estimates for the random parameters are slightly overestimated; (c) both the homogeneous and heterogeneous models produce standard errors of the variance component estimates that are underestimated; however, taking heterogeneity into account, the REML-estimations give correct estimates of the standard errors at the lowest level and lead to less underestimated standard errors at the highest level; and (d) from the RMSE point of view, REML accounting for heterogeneity outperforms REML assuming homogeneity; a considerable improvement has been particularly detected for the fixed parameters. Based on this, we conclude that the solution presented can be uniformly adopted. We illustrate the process using a real dataset.",0,1 +598,Estimation of IRT graded response models: Limited versus full information methods.,"The performance of parameter estimates and standard errors in estimating F. Samejima's graded response model was examined across 324 conditions. Full information maximum likelihood (FIML) was compared with a 3-stage estimator for categorical item factor analysis (CIFA) when the unweighted least squares method was used in CIFA's third stage. CIFA is much faster in estimating multidimensional models, particularly with correlated dimensions. Overall, CIFA yields slightly more accurate parameter estimates, and FIML yields slightly more accurate standard errors. Yet, across most conditions, differences between methods are negligible. FIML is the best election in small sample sizes (200 observations). CIFA is the best election in larger samples (on computational grounds). Both methods failed in a number of conditions, most of which involved 200 observations, few indicators per dimension, highly skewed items, or low factor loadings. These conditions are to be avoided in applications.",0,1 +599,Alternating imputation posterior estimation of models with crossed random effects,"Generalized linear mixed models or latent variable models for categorical data are difficult to estimate if the random effects or latent variables vary at non-nested levels, such as persons and test items. Clayton and Rasbash (1999) suggested an Alternating Imputation Posterior (AIP) algorithm for approximate maximum likelihood estimation. For item response models with random item effects, the algorithm iterates between an item wing in which the item mean and variance are estimated for given person effects and a person wing in which the person mean and variance are estimated for given item effects. The person effects used for the item wing are sampled from the conditional posterior distribution estimated in the person wing and vice versa. Clayton and Rasbash (1999) used marginal quasi-likelihood (MQL) and penalized quasi-likelihood (PQL) estimation within the AIP algorithm, but this method has been shown to produce biased estimates in many situations, so we use maximum likelihood estimation with adaptive quadrature. We apply the proposed algorithm to the famous salamander mating data, comparing the estimates with many other methods, and to an educational testing dataset. We also present a simulation study to assess performance of the AIP algorithm and the Laplace approximation with different numbers of items and persons and a range of item and person variances.",0,1 +600,Harris recurrence of Metropolis-within-Gibbs and trans-dimensional Markov chains,"A ϕ-irreducible and aperiodic Markov chain with stationary probability distribution will converge to its stationary distribution from almost all starting points. The property of Harris recurrence allows us to replace “almost all” by “all,” which is potentially important when running Markov chain Monte Carlo algorithms. Full-dimensional Metropolis–Hastings algorithms are known to be Harris recurrent. In this paper, we consider conditions under which Metropolis-within-Gibbs and trans-dimensional Markov chains are or are not Harris recurrent. We present a simple but natural two-dimensional counter-example showing how Harris recurrence can fail, and also a variety of positive results which guarantee Harris recurrence. We also present some open problems. We close with a discussion of the practical implications for MCMC algorithms.",0,1 +601,Measuring the complexity of generalized linear hierarchical models,en,0,1 +602,Structural equation models of latent interaction and quadratic effects.,,0,1 +603,Hierarchical longitudinal models of relationships in social networks,Summary Motivated by the need to understand the dynamics of relationship formation and dissolution over time in real world social networks we develop a new longitudinal model for transitions in the relationship status of pairs of individuals (‘dyads’). We first specify a model for the relationship status of a single dyad and then extend it to account for important interdyad dependences (e.g. transitivity—‘a friend of a friend is a friend’) and heterogeneity. Model parameters are estimated by using Bayesian analysis implemented via Markov chain Monte Carlo sampling. We use the model to perform novel analyses of two diverse longitudinal friendship networks: an excerpt of the Teenage Friends and Lifestyle Study (a moderately sized network) and the Framingham Heart Study (a large network).,0,1 +604,Integrated analysis of content and construct validity of psychometric instruments,"Establishing adequacy of psychometric properties of an instrument involves acquisition and evaluation of evidence based on item content and internal structure. Content validity evidence consists of subject matter experts providing quantitative ratings of the extent to which items are a representative sample of targeted domain. Evidence of internal structure includes factor analytic studies and examination of item interrelationships based on item responses from participants. Although subject matter expert ratings and participant response data are traditionally analyzed separately, each serves to inform the other in important ways. We propose integrating subject matter experts' and participants' data seamlessly to establish a unified model of validity evidence. The approach is applied to an instrument designed to measure nursing home culture change (i. e., resident-centered care). The proposed method has been demonstrated to be useful with a posterior distribution resulting in stable estimates of psychometric parameters superior to traditional analytic approaches. To illustrate the efficacy of the methodology, we present a simulation study and discuss its place in psychometric methods. © 2011 Springer Science+Business Media B.V.",0,1 +605,A Hierarchical Bayesian Methodology for Treating Heterogeneity in Structural Equation Models,"Structural equation models are widely used in marketing and psychometric literature to model relationships between unobserved constructs and manifest variables and to control for measurement error. Most applications of structural equation models assume that data come from a homogeneous population. This assumption may be unrealistic, as individuals are likely to be heterogeneous in their perceptions and evaluations of unobserved constructs. In addition, individuals may exhibitdifferent measurement reliabilities. It is well-known in statistical literature that failure to account for unobserved sources of individual differences can resultin misleading inferences and incorrect conclusions. We develop a hierarchical Bayesian framework for modeling general forms of heterogeneity in partially recursive structural equation models. Our framework elucidates the motivations for accommodating heterogeneity and illustrates theoretically the types of misleading inferences that can result when unobserved heterogeneity is ignored. We describe in detail the choices that researchers can make in incorporating different forms of measurement and structural heterogeneity. Current random-coefficient models in psychometric literature can accommodate heterogeneity solely in mean structures. We extend these models by allowing for heterogeneity both in mean and covariance structures. Specifically, in addition to heterogeneity in measurement intercepts and factor means, we account for heterogeneity in factor covariance structure, measurement error, and structural parameters. Models such as random-coefficient factor analysis, random-coefficientsecond-order factor analysis, and random-coefficient, partially recursive simultaneous equation models are special cases of our proposed framework. We also develop Markov Chain Monte Carlo (MCMC) procedures to perform Bayesian inference in partially recursive, random-coefficient structural equation models. These procedures provide individual-specific estimates of the factor scores, structural coefficients, and other model parameters. We illustrate our approach using two applications. The first application illustrates our methods on synthetic data, whereas the second application uses consumer satisfaction data involving measurements on satisfaction, expectation disconfirmation, and performance variables obtained from a panel of subjects. Our results from the synthetic data application show that our Bayesian procedures perform well in recovering the true parameters. More importantly, we find that models that ignore heterogeneity can yield a severely distorted picture of the nature of associations among variables and can therefore generate misleading inferences. Specifically, we find that ignoring heterogeneity can result in inflated estimates of measurement reliability, wrong signs of factor covariances, and can yield attenuated model fit and standard errors. The results from the consumer satisfaction study show that individuals vary both in means and covariances and indicate that conventional psychometric methods are not appropriate for our data. In addition, we find that heterogeneous models outperform the standard structural equation model in predictive ability. Managerially, we show how one can use the individual-level factor scores and structural parameter estimates from the Bayesian approach to perform quadrantanalysis and refine marketing policy (e.g., develop a one-on-one marketing policy). The framework introduced in this paper and the inference procedures we describe should be of interest to researchers in a wide range of disciplines in which measurement error and unobserved heterogeneity are problematic. In particular, our approach is suitable for studies in which panel data or multiple observations are available for a given set of respondents or objects (e.g., firms, organizations, markets). At a practical level, our procedures can be used by managers and other policymakers to customize marketing activities or policies. Future research should extend our procedures to deal with the general nonrecursive structural equation model and to handle binary and ordinal data situations.",0,1 +606,Reliability estimation in a multilevel confirmatory factor analysis framework.,"Scales with varying degrees of measurement reliability are often used in the context of multistage sampling, where variance exists at multiple levels of analysis (e.g., individual and group). Because methodological guidance on assessing and reporting reliability at multiple levels of analysis is currently lacking, we discuss the importance of examining level-specific reliability. We present a simulation study and an applied example showing different methods for estimating multilevel reliability using multilevel confirmatory factor analysis and provide supporting Mplus program code. We conclude that (a) single-level estimates will not reflect a scale's actual reliability unless reliability is identical at each level of analysis, (b) 2-level alpha and composite reliability (omega) perform relatively well in most settings, (c) estimates of maximal reliability (H) were more biased when estimated using multilevel data than either alpha or omega, and (d) small cluster size can lead to overestimates of reliability at the between level of analysis. We also show that Monte Carlo confidence intervals and Bayesian credible intervals closely reflect the sampling distribution of reliability estimates under most conditions. We discuss the estimation of credible intervals using Mplus and provide R code for computing Monte Carlo confidence intervals.",0,1 +607,A dangerous discrepancy,"This study aims to uncover how horizontal inequality affects support for violent and nonviolent resistance among Palestinians in the West Bank and Gaza. National survey data are introduced to operationalize the mechanisms proposed in the horizontal inequality literature on the individual level. Results point to the operation of political and economic horizontal inequality mechanisms in the Palestinian case. Higher perceived status of civil and political rights is associated with a lower probability of supporting violent over nonviolent resistance. Individuals are also more likely to support violent over nonviolent resistance the larger the difference in household expenditure and consumer durable ownership between their own region and the closest Israeli subdistrict. Corresponding differences in educational attainment have no corresponding effect. The results demonstrate how economic and political horizontal inequality can increase the risk that an individual becomes part of the mobilizational potential of violent social movements. This can lead to participation in a wide range of supportive actions that increase the viability of such movements, ranging from material support to direct participation in violence. The level of public support for violent resistance in key constituencies could also influence public opinion sensitive actors like Hamas in their choice between violent and nonviolent resistance strategies.",0,1 +608,Optimal Matching for Observational Studies,"Abstract Matching is a common method of adjustment in observational studies. Currently, matched samples are constructed using greedy heuristics (or “stepwise” procedures) that produce, in general, suboptimal matchings. With respect to a particular criterion, a matched sample is suboptimal if it could be improved by changing the controls assigned to specific treated units, that is, if it could be improved with the data at hand. Here, optimal matched samples are obtained using network flow theory. In addition to providing optimal matched-pair samples, this approach yields optimal constructions for several statistical matching problems that have not been studied previously, including the construction of matched samples with multiple controls, with a variable number of controls, and the construction of balanced matched samples that combine features of pair matching and frequency matching. Computational efficiency is discussed. Extensive use is made of ideas from two essentially disjoint literatures, namely st...",0,1 +609,"Bayesian Smoothing and Regression for Longitudinal, Spatial and Event History Data","Several recent advances in smoothing and semiparametric regression are presented in this book from a unifying, Bayesian perspective. Simulation-based full Bayesian Markov chain Monte Carlo (MCMC) inference, as well as empirical Bayes procedures closely related to penalized likelihood estimation and mixed models, are considered here. Throughout, the focus is on semiparametric regression and smoothing based on basis expansions of unknown functions and effects in combination with smoothness priors for the basis coefficients. Beginning with a review of basic methods for smoothing and mixed models, longitudinal data, spatial data, and event history data are treated in separate chapters. Worked examples from various fields such as forestry, development economics, medicine, and marketing are used to illustrate the statistical methods covered in this book. Most of these examples have been analysed using implementations in the Bayesian software, BayesX, and some with R Codes.",0,1 +610,Bayesian subset analysis in a colorectal cancer clinical trial,"Subset analysis is the examination of treatment comparisons within groups of patients with restricted levels of patient characteristics. Such analyses are vulnerable to multiplicity effects. We examine the problem in the context of a proportional hazards model with terms for treatment, each of several dichotomous covariates representing the patient characteristics of interest, and treatment-by-covariate interaction effects. Parametrically, a subset-specific treatment effect is equal to the treatment effect term plus a linear combination of the interaction terms. We present Bayesian point and interval estimates under the assumption that the interaction terms are exchangeable and the prior distributions for the other regression parameters are locally uniform. This produces a shrinking of the estimated interaction effects towards zero, thereby discounting them and dealing in a natural way with multiplicity. We illustrate the method using results of a recent North Central Cancer Treatment Group/Mayo Clinic study in advanced colorectal cancer.",0,1 +611,Structured Latent Curve Models for the Study of Change in Multivariate Repeated Measures.,"This article considers a structured latent curve model for multiple repeated measures. In a structured latent curve model, a smooth nonlinear function characterizes the mean response. A first-order Taylor polynomial taken with regard to the mean function defines elements of a restricted factor matrix that may include parameters that enter nonlinearly. Similar to factor scores, random coefficients are combined with the factor matrix to produce individual latent curves that need not follow the same form as the mean curve. Here the associations between change characteristics in multiple repeated measures are studied. A factor analysis model for covariates is included as a means of relating latent covariates to the factors characterizing change in different repeated measures. An example is provided.",0,1 +612,On Fitting Nonlinear Latent Curve Models to Multiple Variables Measured Longitudinally,"This article shows how nonlinear latent curve models may be fitted for simultaneous analysis of multiple variables measured longitudinally using Mx statistical software. Longitudinal studies often involve observation of several variables across time with interest in the associations between change characteristics of different variables measured within individuals. Other applications involve repeated measures for distinguishable individuals nested within small groups, such as families, with interest in the associations between change characteristics in variables for individuals within groups. This article shows how Mx can be used to carry out analysis of multiple variables measured over time where at least one variable is described by a function that includes one or more parameters that enter the model nonlinearly. An example is provided.",0,1 +613,Bayesian analysis of structural equation models with multinomial variables and an application to type 2 diabetic nephropathy,"There is now increasing evidence proving that many complex diseases can be significantly influenced by correlated phenotype and genotype variables, as well as their interactions. Effective and rigorous assessment of such influence is difficult, because the number of phenotype and genotype variables of interest may not be small, and a genotype variable is an unordered categorical variable that follows a multinomial distribution. To address the problem, we establish a novel nonlinear structural equation model for analysing mixed continuous and multinomial data that can be missing at random. A confirmatory factor analysis model with Kronecker product is proposed for grouping the manifest continuous and multinomial variables into latent variables according to their functions; and a nonlinear structural equation is formulated to assess the linear and interaction effects of the independent latent variables to the dependent latent variables. Bayesian methods for estimation and model comparison are developed through Markov chain Monte Carlo techniques and path sampling. The newly developed methodologies are applied to a case-control cohort of type 2 diabetic patients with nephropathy.",0,1 +614,Mental architectures with selectively influenced but stochastically interdependent components,"Abstract The way external factors influence distribution functions for the overall time required to perform a mental task (such as responding to a stimulus, or solving a problem) may be informative as to the underlying mental architecture, the hypothetical network of interconnected processes some of which are selectively influenced by some of the external factors. Under the assumption that all processes contributing to the overall performance time are stochastically independent, several basic results have been previously established. These results relate patterns of response time distribution functions produced by manipulating external factors to such questions as whether the hypothetical constituent processes in the mental architecture enter AND gates or OR gates, and whether pairs of processes are sequential or concurrent. The present study shows that all these results are also valid for stochastically interdependent component times, provided the selective dependence of these components upon external factors is understood within the framework of a recently proposed theory of selective influence. According to this theory each component is representable as a function of three arguments: the factor set selectively influencing it, a component-specific source of randomness, and a source of randomness shared by all the components.",0,1 +615,Bayesian methods in health technology assessment: a review.,"Bayesian methods may be defined as the explicit quantitative use of external evidence in the design, monitoring, analysis, interpretation and reporting of a health technology assessment. In outline, the methods involve formal combination through the use of Bayes's theorem of: 1. a prior distribution or belief about the value of a quantity of interest (for example, a treatment effect) based on evidence not derived from the study under analysis, with 2. a summary of the information concerning the same quantity available from the data collected in the study (known as the likelihood), to yield 3. an updated or posterior distribution of the quantity of interest. These methods thus directly address the question of how new evidence should change what we currently believe. They extend naturally into making predictions, synthesising evidence from multiple sources, and designing studies: in addition, if we are willing to quantify the value of different consequences as a 'loss function', Bayesian methods extend into a full decision-theoretic approach to study design, monitoring and eventual policy decision-making. Nonetheless, Bayesian methods are a controversial topic in that they may involve the explicit use of subjective judgements in what is conventionally supposed to be a rigorous scientific exercise.This report is intended to provide: 1. a brief review of the essential ideas of Bayesian analysis 2. a full structured review of applications of Bayesian methods to randomised controlled trials, observational studies, and the synthesis of evidence, in a form which should be reasonably straightforward to update 3. a critical commentary on similarities and differences between Bayesian and conventional approaches 4. criteria for assessing the reporting of a Bayesian analysis 5. a comprehensive list of published 'three-star' examples, in which a proper prior distribution has been used for the quantity of primary interest 6. tutorial case studies of a variety of types 7. recommendations on how Bayesian methods and approaches may be assimilated into health technology assessments in a variety of contexts and by a variety of participants in the research process.The BIDS ISI database was searched using the terms 'Bayes' or 'Bayesian'. This yielded almost 4000 papers published in the period 1990-98. All resultant abstracts were reviewed for relevance to health technology assessment; about 250 were so identified, and used as the basis for forward and backward searches. In addition EMBASE and MEDLINE databases were searched, along with websites of prominent authors, and available personal collections of references, finally yielding nearly 500 relevant references. A comprehensive review of all references describing use of 'proper' Bayesian methods in health technology assessment (those which update an informative prior distribution through the use of Bayes's theorem) has been attempted, and around 30 such papers are reported in structured form. There has been very limited use of proper Bayesian methods in practice, and relevant studies appear to be relatively easily identified.Bayesian methods in the health technology assessment context 1. Different contexts may demand different statistical approaches. Prior opinions are most valuable when the assessment forms part of a series of similar studies. A decision-theoretic approach may be appropriate where the consequences of a study are reasonably predictable. 2. The prior distribution is important and not unique, and so a range of options should be examined in a sensitivity analysis. Bayesian methods are best seen as a transformation from initial to final opinion, rather than providing a single 'correct' inference. 3. The use of a prior is based on judgement, and hence a degree of subjectivity cannot be avoided. However, subjective priors tend to show predictable biases, and archetypal priors may be useful for identifying a reasonable range of prior opinion.",0,1 +616,Bayesian Analysis of ROC Data,"This chapter highlights Bayesian analysis of ROC data. When measured on a dichotomous scale, the performance of a diagnostic test can be summarized by two quantities: the false positive fraction (FPF) and the true positive fraction (TPF). The FPF is defined as the fraction of “healthy” subjects who test positive, but who do not have the condition that the test is designed to detect. The TPF is the fraction of subjects, who are correctly diagnosed as having the condition. An ROC curve describes the tradeoff between FPF and TPF as the disease threshold is changed. More specifically, an ROC curve can be defined as the curve defined by the set of points. Moreover, the choice of a threshold determines the relative tradeoff between false positive rates and true positive rates. Receiver operating characteristics (ROC) methodology provides a framework for analyzing this tradeoff as the threshold applied to the diagnostic test is varied. The most common application of ROC methodology arises in the comparison of new diagnostic technologies. Finally, this chapter explores that ROC methodology is especially prevalent in the evaluation of radiological devices, where it has been used extensively to determine whether one imaging modality is superior to another.",0,1 +617,Empirical Bayes Confidence Intervals Based on Bootstrap Samples,"Abstract Consider the model with data generated by the following two-stage process. First, a parameter θ is sampled from a prior distribution G, and then an observation is sampled from the conditional distribution f(y | θ). If the prior distribution is known, then the Bayes estimate under squared error loss is the posterior expectation of θ conditional on the data y. For example, if G is Gaussian with mean μ and variance τ2 and f(y | θ) is Gaussian with mean θ and variance σ2, then the posterior distribution is Gaussian with mean B μ + (1 – B)y and variance σ2(1 – B), where B = σ2/(σ2 + τ2). Inferences about θ are based on this distribution. We study the application of the bootstrap to situations where the prior must be estimated from the data (empirical Bayes methods). For this model, we observe data Y T = [Y 1, …, Y K]T, each independent Y K following the compound model described previously. As first shown by James and Stein (1961), setting each θk equal to its estimated posterior mean, where , and , pr...",0,1 +618,Improvement of spinal non-viral IL-10gene delivery by D-mannose as a transgene adjuvant to control chronic neuropathic pain,"Peri-spinal subarachnoid (intrathecal; i.t.) injection of non-viral naked plasmid DNA encoding the anti-inflammatory cytokine, IL-10 (pDNA-IL-10) suppresses chronic neuropathic pain in animal models. However, two sequential i.t. pDNA injections are required within a discrete 5 to 72-hour period for prolonged efficacy. Previous reports identified phagocytic immune cells present in the peri-spinal milieu surrounding the i.t injection site that may play a role in transgene uptake resulting in subsequent IL-10 transgene expression.In the present study, we aimed to examine whether factors known to induce pro-phagocytic anti-inflammatory properties of immune cells improve i.t. IL-10 transgene uptake using reduced naked pDNA-IL-10 doses previously determined ineffective. Both the synthetic glucocorticoid, dexamethasone, and the hexose sugar, D-mannose, were factors examined that could optimize i.t. pDNA-IL-10 uptake leading to enduring suppression of neuropathic pain as assessed by light touch sensitivity of the rat hindpaw (allodynia).Compared to dexamethasone, i.t. mannose pretreatment significantly and dose-dependently prolonged pDNA-IL-10 pain suppressive effects, reduced spinal IL-1β and enhanced spinal and dorsal root ganglia IL-10 immunoreactivity. Macrophages exposed to D-mannose revealed reduced proinflammatory TNF-α, IL-1β, and nitric oxide, and increased IL-10 protein release, while IL-4 revealed no improvement in transgene uptake. Separately, D-mannose dramatically increased pDNA-derived IL-10 protein release in culture supernatants. Lastly, a single i.t. co-injection of mannose with a 25-fold lower pDNA-IL-10 dose produced prolonged pain suppression in neuropathic rats.Peri-spinal treatment with D-mannose may optimize naked pDNA-IL-10 transgene uptake for suppression of allodynia, and is a novel approach to tune spinal immune cells toward pro-phagocytic phenotype for improved non-viral gene therapy.",0,1 +619,Your Best Self Helps Reveal Your True Self,"How does trying to make a positive impression on others impact the accuracy of impressions? In an experimental study, the impact of positive self-presentation on the accuracy of impressions was examined by randomly assigning targets to either “put their best face forward” or to a control condition with low self-presentation demands. First, self-presenters successfully elicited more positive impressions from others, being viewed as more normative and better liked than those less motivated to self-present. Importantly, self-presenters were also viewed with greater accuracy than control targets, being perceived more in line with their self-reported distinctive personality traits and their IQ test scores. Mediational analyses were consistent with the hypothesis that self-presenters were more engaging than controls, which in turn led these individuals to be viewed with greater distinctive self–other agreement. In sum, positive self-presentation facilitates more accurate impressions, indicating that putting one’s best self forward helps reveal one’s true self.",0,1 +620,"Thermal hyperalgesia and mechanical allodynia produced by intrathecal administration of the human immunodeficiency virus-1 (HIV-1) envelope glycoprotein, gp120","Astrocytes and microglia in the spinal cord have recently been reported to contribute to the development of peripheral inflammation-induced exaggerated pain states. Both lowering of thermal pain threshold (thermal hyperalgesia) and lowering of response threshold to light tactile stimuli (mechanical allodynia) have been reported. The notion that spinal cord glia are potential mediators of such effects is based on the disruption of these exaggerated pain states by drugs thought to preferentially affect glial function. Activation of astrocytes and microglia can release many of the same substances that are known to mediate thermal hyperalgesia and mechanical allodynia. The aim of the present series of studies was to determine whether exaggerated pain states could also be created in rats by direct, intraspinal immune activation of astrocytes and microglia. The immune stimulus used was peri-spinal (intrathecal, i.t.) application of the Human Immunodeficiency Virus type 1 (HIV-1) envelope glycoprotein, gp120. This portion of HIV-1 is known to bind to and activate microglia and astrocytes. Robust thermal hyperalgesia (tail-flick, TF, and Hargreaves tests) and mechanical allodynia (von Frey and touch-evoked agitation tests) were observed in response to i.t. gp120. Heat denaturing of the complex protein structure of gp120 blocked gp120-induced thermal hyperalgesia. Lastly, both thermal hyperalgesia and mechanical allodynia to i.t. gp120 were blocked by spinal pretreatment with drugs (fluorocitrate and CNI-1493) thought to preferentially disrupt glial function.",0,1 +621,Invariance of the psychometric function for character recognition across the visual field,"The psychometric function for recognition of singly presented digits as a function of digit contrast was measured at 2 degrees steps across the horizontal meridian of the visual field, under monocular and binocular viewing conditions. A maximum-likelihood staircase procedure was used in a 10-alternative forced-choice recognition paradigm to gather the data Both the Weibull and the logistic psychometric functions provide excellent fits to the observed data. The slopes of these functions at their point of inflection ranged from 4.0 to 5.0 proportion-correct/log10-unit contrast, for both monocular and binocular viewing and for all loci in the visual field. These slope values correspond to short-term measurements (around 30 trials, or 1 min) and do not include performance variations of longer duration; the latter are estimated to increase slope by a factor of about 1.5. A single psychometric function shape, centered around a threshold value, therefore describes recognition performance at all retinal loci and binocularity. An empirical comparison of slope results across the literature shows that the function's slope is about twice that reported for a number of detection tasks. The comparison of recognition contrast thresholds, percentage correct values, and other performance measures across studies requires the knowledge of the psychometric function's slope, and our results thus provide a firm basis for the study of low-contrast character recognition.",0,1 +622,Item Parameter Estimation Under Conditions of Test Speededness: Application of a Mixture Rasch Model With Ordinal Constraints,"When tests are administered under fixed time constraints, test performances can be affected by speededness. Among other consequences, speededness can result in inaccurate parameter estimates in item response theory (IRT) models, especially for items located near the end of tests (Oshima, 1994). This article presents an IRT strategy for reducing contamination in item difficulty estimates due to speededness. Ordinal constraints are applied to a mixture Rasch model (Rost, 1990) so as to distinguish two latent classes of examinees: (a) a “speeded” class, comprised of examinees that had insufficient time to adequately answer end-of-test items, and (b) a “nonspeeded” class, comprised of examinees that had sufficient time to answer all items. The parameter estimates obtained for end-of-test items in the nonspeeded class are shown to more accurately approximate their difficulties when the items are administered at earlier locations on a different form of the test. A mixture model can also be used to estimate the class memberships of individual examinees. In this way, it can be determined whether membership in the speeded class is associated with other student characteristics. Results are reported for gender and ethnicity.",0,1 +623,State space modeling for analysis of behavior in learning experiments,"Introduction: During the process of learning the brain undergoes changes that can be observed at both the cellular and systems level. Being able to track accurately simultaneous changes in behavior and neural activity is key to understanding how the brain learns new tasks and information. Learning is studied in a large number of experimental paradigms involving, for example, testing effects on learning of brain lesions (Whishaw & Tomie 1991; Dias et al. 1997; Dusek & Eichenbaum 1997; Wise & Murray 1999; Fox et al. 2003; Kim & Frank 2009; Kayser & D'Esposito 2013), attentional modulation (Cook & Maunsell 2002; Hudson et al. 2009), optogenetic manipulation (Warden et al. 2012) and pharmacological interventions (Stefani et al. 2003). Studies are also performed to understand how learning is affected by aging (Harris & Wolbers 2012), stroke (Panarese et al. 2012) and psychological conditions including autism (Solomon et al. 2011) and synesthesia (Brang et al. 2013). The learning process is also studied in relation to changes in neural activity in specific brain regions (Jog et al. 1999; Wirth et al. 2003; Suzuki & Brown 2005; Brovelli et al. 2011; Mattfeld & Stark 2011). In most cases, the response accuracy of a subject is binary, with a one representing a correct response and a zero representing an incorrect response. In its raw form, binary response accuracy can be difficult to visualize, especially if the time series is long, and the exact time when learning occurs can be difficult to identify. Typically, an experimenter is interested in deriving two things from the learning data: a learning trial and a learning curve. The first item is the time point at which responses significantly change relative to a baseline value such as chance performance. The second is estimation of a curve that defines the probability of a correct response as a function of trial. From these estimates, it is possible to compare changes in learning with other measurements such as, for example, localized brain oxygen consumption (via fMRI) or electrical activity. © Cambridge University Press 2015",0,1 +624,Emotional inertia prospectively predicts the onset of depressive disorder in adolescence.,"Emotional inertia refers to the degree to which a person's current emotional state is predicted by their prior emotional state, reflecting how much it carries over from one moment to the next. Recently, in a cross-sectional study, we showed that high inertia is an important characteristic of the emotion dynamics observed in psychological maladjustment such as depression. In the present study, we examined whether emotional inertia prospectively predicts the onset of first-episode depression during adolescence. Emotional inertia was assessed in a sample of early adolescents (N = 165) based on second-to-second behavioral coding of videotaped naturalistic interactions with a parent. Greater inertia of both negative and positive emotional behaviors predicted the emergence of clinical depression 2.5 years later. The implications of these findings for the understanding of the etiology and early detection of depression are discussed.",0,1 +625,A comparison of methods for estimating quadratic effects in nonlinear structural equation models.,"Two Monte Carlo simulations were performed to compare methods for estimating and testing hypotheses of quadratic effects in latent variable regression models. The methods considered in the current study were (a) a 2-stage moderated regression approach using latent variable scores, (b) an unconstrained product indicator approach, (c) a latent moderated structural equation method, (d) a fully Bayesian approach, and (e) marginal maximum likelihood estimation. Of the 5 estimation methods, it was found that overall the methods based on maximum likelihood estimation and the Bayesian approach performed best in terms of bias, root-mean-square error, standard error ratios, power, and Type I error control, although key differences were observed. Similarities as well as disparities among methods are highlight and general recommendations articulated. As a point of comparison, all 5 approaches were fit to a reparameterized version of the latent quadratic model to educational reading data.",0,1 +626,Profile-Likelihood Approach for Estimating Generalized Linear Mixed Models With Factor Structures,"In this article, the authors suggest a profile-likelihood approach for estimating complex models by maximum likelihood (ML) using standard software and minimal programming. The method works whenever setting some of the parameters of the model to known constants turns the model into a standard model. An important class of models that can be estimated this way is generalized linear mixed models with factor structures. Such models are useful in educational research, for example, for estimation of value-added teacher or school effects with persistence parameters and for analysis of large-scale assessment data using multilevel item response models with discrimination parameters. The authors describe the profile-likelihood approach, implement it in the R software, and apply the method to longitudinal data and binary item response data. Simulation studies and comparison with gllamm show that the profile-likelihood method performs well in both types of applications. The authors also briefly discuss other types of models that can be estimated using the profile-likelihood idea.",0,1 +627,Assessing individual differences in categorical data,"In cognitive modeling, data are often categorical observations taken over participants and items. Usually subsets of these observations are pooled and analyzed by a cognitive model assuming the category counts come from a multinomial distribution with the same model parameters underlying all observations. It is well known that if there are individual differences in participants and/or items, a model analysis of the pooled data may be quite misleading, and in such cases it may be appropriate to augment the cognitive model with parametric random effects assumptions. On the other hand, if random effects are incorporated into a cognitive model that is not needed, the resulting model may be more flexible than the multinomial model that assumes no heterogeneity, and this may lead to overfitting. This article presents Monte Carlo statistical tests for directly detecting individual participant and/or item heterogeneity that depend only on the data structure itself. These tests are based on the fact that heterogeneity in participants and/or items results in overdispersion of certain category count statistics. It is argued that the methods developed in the article should be applied to any set of participant x item categorical data prior to cognitive model-based analyses.",0,1 +628,Does pay for performance diminish intrinsic interest?,"One concern with pay for individual performance (PFIP) is that it may undermine intrinsic interest, thus having little or no positive net influence on performance. A major basis for this concern is cognitive evaluation theory [CET; Deci and Ryan (1985), Intrinsic Motivation and Self-Determination in Human Behavior, New York: Plenum Press]. Most evidence on CET, however, comes from non-work settings and, even in that arena, there is debate regarding the undermining effect of PFIP. There is little workplace-based evidence on the validity of the undermining hypothesis and none that makes use of data on between-employer differences in PFIP. Also, a close reading of CET, reinforced by recent developments, suggests that PFIP plans could, under common workplace conditions, have a positive, rather than negative, influence on intrinsic interest. To our knowledge, there is no research that examines between-organization differences in PFIP and how they relate to employee intrinsic interest. There is also no research on whether employees having a preference for PFIP plans are likely to gravitate to organizations using such plans. To the extent such attraction–selection–attrition or sorting processes take place, the likelihood of detrimental consequences (e.g. diminished intrinsic interest) of PFIP plans due to mismatches between how the organization pays and how the employees are motivated should be less likely. We find no evidence of a detrimental effect of PFIP plans on intrinsic interest. Instead, intrinsic interest is actually higher under PFIP. We also find that organizations placing greater emphasis on PFIP plans tend to have employees with motivation orientations matching their PFIP plans, which may reduce the probability of a detrimental effect of PFIP.",0,1 +629,A note on the existence of the posterior distribution for a class of mixed models for binomial responses,SUMMARY Necessary and sufficient conditions are given for the existence of the posterior distribution of the variance components in a class of mixed models for binomial responses. The implications of our results are illustrated through an example.,0,1 +630,Perceptions of racism in healthcare among patients with systemic lupus erythematosus: a cross-sectional study,"Racial disparities in the clinical outcomes of systemic lupus erythematosus (SLE) exist. Perceived racial discrimination may contribute to disparities in health.To determine if perceived racism in healthcare differs by race among patients with SLE and to evaluate its contribution to racial disparities in SLE-related outcomes.163 African-American (AA) and 180 white (WH) patients with SLE were enrolled. Structured interviews and chart reviews were done to determine perceptions of racism, SLE-related outcomes (Systemic Lupus International Collaborating Clinics (SLICC) Damage Index, SLE Disease Activity, Center for Epidemiologic Studies-Depression (CES-D)), and other variables that may affect perceptions of racism. Serial hierarchical multivariable logistic regression models were conducted. Race-stratified analyses were also performed.56.0% of AA patients compared with 32.8% of WH patients had high perceptions of discrimination in healthcare (p<0.001). This difference remained (OR 4.75 (95% CI 2.41 to 8.68)) after adjustment for background, identity and healthcare experiences. Female gender (p=0.012) and lower trust in physicians (p<0.001) were also associated with high perceived racism. The odds of having greater disease damage (SLICC damage index ≥2) were higher in AA patients than in WH patients (crude OR 1.55 (95% CI 1.01 to 2.38)). The odds of having moderate to severe depression (CES-D ≥17) were also higher in AA patients than in WH patients (crude OR 1.94 (95% CI 1.26 to 2.98)). When adjusted for sociodemographic and clinical characteristics, racial disparities in disease damage and depression were no longer significant. Among AA patients, higher perceived racism was associated with having moderate to severe depression (adjusted OR 1.23 (95% CI 1.05 to 1.43)) even after adjusting for sociodemographic and clinical variables.Perceptions of racism in healthcare were more common in AA patients than in WH patients with SLE and were associated with depression. Interventions aimed at modifiable factors (eg, trust in providers) may reduce higher perceptions of race-based discrimination in SLE.",0,1 +631,"The ProActivetrial protocol – a randomised controlled trial of the efficacy of a family-based, domiciliary intervention programme to increase physical activity among individuals at high risk of diabetes [ISRCTN61323766]","BackgroundIncreasing prevalence of obesity and disorders associated with sedentary living constitute a major global public health problem. While previous evaluations of interventions to increase physical activity have involved communities or individuals with established disease, less attention has been given to interventions for individuals at risk of disease.Methods/design ProActiveaims to evaluate the efficacy of a theoretical, evidence- and family-based intervention programme to increase physical activity in a sedentary population, defined as being at-risk through having a parental family history of diabetes. Primary care diabetes or family history registers were used to recruit 365 individuals aged 30–50 years, screened for activity level. Participants were assigned by central randomisation to three intervention programmes: brief written advice (comparison group), or a psychologically based behavioural change programme, delivered either by telephone (distance group) or face-to-face in the family home over one year. The protocol-driven intervention programme is delivered by trained facilitators, and aims to support increases in physical activity through the introduction and facilitation of a range of self-regulatory skills (e.g. goal setting). The primary outcome is daytime energy expenditure and its ratio to resting energy expenditure, measured at baseline and one year using individually calibrated heart rate monitoring. Secondary measures include self-report of individual and family activity, psychological mediators of behaviour change, physiological and biochemical correlates, acceptability, and costs, measured at baseline, six months and one year. The primary intention to treat analysis will compare groups at one-year post randomisation. Estimation of the impact on diabetes incidence will be modelled using data from a parallel ten-year cohort study using similar measures.Discussion ProActiveis the first efficacy trial of an intervention programme to promote physical activity in a defined high-risk group accessible through primary care. The intervention programme is based on psychological theory and evidence; it introduces and facilitates the use of self-regulatory skills to support behaviour change and maintenance. The trial addresses a range of methodological weaknesses in the field by careful specification and quality assurance of the intervention programme, precise characterisation of participants, year-long follow-up and objective measurement of physical activity. Due to report in 2005, ProActivewill provide estimates of the extent to which this approach could assist at-risk groups who could benefit from changes in behaviours affecting health, and inform future pragmatic trials.",0,1 +632,Flexibility of Bayesian generalized linear mixed models for oral health research,"Many outcome variables in oral research are characterized by positive values and heavy skewness in the right tail. Examples are provided by many distributions of dental variables such as DMF (decayed, missing, filled teeth) scores, oral health impact profile score, gingival index scores, and microbiologic counts. Moreover, heterogeneity in data arises when more than one tooth is studied for each patient, due to the clusterization. Over the past decade, linear mixed models (LMEs) have become a common statistical tool to account for within-subject correlation in data with repeated measures. When a normal error is reasonably assumed, estimates of LMEs are supported by many statistical packages. Such is not the case for skewed data, where generalized linear mixed models (GLMMs) are required. However, the current software available supports only special cases of GLMMs or relies on crude Laplace-type approximation of integrals. In this study, a Bayesian approach is taken to estimate GLMMs for clustered skewed dental data. A Gamma GLMM and a log-normal model are employed to allow for heterogeneity across clusters, deriving from the patient-operator-tooth susceptibility typical of this clinical context. A comparison to the frequentist framework is also provided. In our case, Gamma GLMM fits data better than the log-normal distribution, while providing more precise estimates compared with the likelihood approach. A key advantage of the Bayesian framework is its ability to readily provide a flexible approach for implementation while simultaneously providing a formal procedure for solving inference problems. Copyright © 2009 John Wiley & Sons, Ltd.",0,1 +633,Valence and satisfaction with democracy: A cross-national analysis of nine Western European democracies,"In recent studies, scholars have highlighted factors that influence citizen satisfaction with democracy, with particular emphasis on the role played by the institutional features of political systems, and ideology. This article presents the first empirical study of whether changes in important party characteristics can affect individuals’ satisfaction with democracy. Using a measure of parties’ character-valence derived from content analysis of news reports, evidence is presented that when governing parties’ images decline with respect to important valence-related attributes such as competence, unity and integrity, then citizen satisfaction with democracy similarly declines. However, this relationship is conditional on the performance of opposition parties. These findings are relevant to studies of regime support, political representation, democratic accountability and voter behaviour.",0,1 +634,Testing for group membership effects during and after treatment: The example of group therapy for smoking cessation,"Behavioral interventions often are administered in groups, yet the effects of group membership rarely have been evaluated. The current research examined 33 groups of clients ( M = 5.5 clients per group, SD = 2.5) volunteering for a group smoking cessation intervention. The intervention consisted of 6 group therapy sessions over an 11-day period. Attendance at the sessions and smoking behavior during the 11-day period were the dependent variables. Hierarchical linear modeling (HLM) revealed a statistically significant ( p",0,1 +635,Computational Aspects Related to Inference in Gaussian Graphical Models With the G-Wishart Prior,"We describe a comprehensive framework for performing Bayesian inference for Gaussian graphical models based on the G-Wishart prior with a special focus on efficiently including nondecomposable graphs in the model space. We develop a new approximation method to the normalizing constant of a G-Wishart distribution based on the Laplace approximation. We review recent developments in stochastic search algorithms and propose a new method, the mode oriented stochastic search (MOSS), that extends these techniques and proves superior at quickly finding graphical models with high posterior probability. We then develop a novel stochastic search technique for multivariate regression models and conclude with a real-world example from the recent covariance estimation literature. Supplemental materials are available online.",0,1 +636,Estimating psychometric functions in forced-choice situations: Significant biases found in threshold and slope estimations when small samples are used,"When a theoretical psychometric function is fitted to experimental data (as in the obtaining of a psychophysical threshold), maximum-likelihood or probit methods are generally used. In the present paper, the behavior of these curve-fitting methods is studied for the special case of forced-choice experiments, in which the probability of a subject's making a correct response by chance is not zero. A mathematical investigation of the variance of the threshold and slope estimators shows that, in this case, the accuracy of the methods is much worse, and their sensitivity to the way data are sampled is greater, than in the case in which chance level is zero. Further, Monte Carlo simulations show that, in practical situations in which only a finite number of observations are made, the mean threshold and slope estimates are significantly biased. The amount of bias depends on the curve-fitting method and on the range of intensity values, but it is always greater in forced-choice situations than when chance level is zero.",0,1 +637,Stylised fact or situated messiness? The diverse effects of increasing debt on national economic growth,"This article reanalyses data used by Reinhart and Rogoff (2010c, American Economic Review, 100: 573–78—RR), and later Herndon et al. (2013, Cambridge Journal of Economics, online, doi: 10.1093/cje/bet075) to consider the relationship between growth and debt in developed countries. The consistency over countries and the causal direction of RR’s so called ‘stylised fact’ is considered. Using multilevel models, we find that when the effect of debt on growth is allowed to vary, and linear time trends are fully controlled for, the average effect of debt on growth disappears, whilst country-specific debt relations vary significantly. Additionally, countries with high debt levels appear more volatile in their growth rates. Regarding causality, we develop a new method extending distributed lag models to multilevel situations. These models suggest the causal direction is predominantly growth-to-debt, and is consistent (with some exceptions) across countries. We argue that RR’s findings are too simplistic, with limited policy relevance, whilst demonstrating how multilevel models can explicate realistically complex scenarios.",0,1 +638,BSMac: A MATLAB toolbox implementing a Bayesian spatial model for brain activation and connectivity,"We present a statistical and graphical visualization MATLAB toolbox for the analysis of functional magnetic resonance imaging (fMRI) data, called the Bayesian Spatial Model for activation and connectivity (BSMac). BSMac simultaneously performs whole-brain activation analyses at the voxel and region of interest (ROI) levels as well as task-related functional connectivity (FC) analyses using a flexible Bayesian modeling framework (Bowman et al., 2008). BSMac allows for inputting data in either Analyze or Nifti file formats. The user provides information pertaining to subgroup memberships, scanning sessions, and experimental tasks (stimuli), from which the design matrix is constructed. BSMac then performs parameter estimation based on Markov Chain Monte Carlo (MCMC) methods and generates plots for activation and FC, such as interactive 2D maps of voxel and region-level task-related changes in neural activity and animated 3D graphics of the FC results. The toolbox can be downloaded from http://www.sph.emory.edu/bios/CBIS/. We illustrate the BSMac toolbox through an application to an fMRI study of working memory in patients with schizophrenia.",0,1 +639,Using the open-source statistical language R to analyze the dichotomous Rasch model,"R, an open-source statistical language and data analysis tool, is gaining popularity among psychologists currently teaching statistics. R is especially suitable for teaching advanced topics, such as fitting the dichotomous Rasch model--a topic that involves transforming complicated mathematical formulas into statistical computations. This article describes R's use as a teaching tool and a data analysis software program in the analysis of the Rasch model in item response theory. It also explains thetheory behind, as well as an educator's goals for, fitting the Rasch model with joint maximum likelihood estimation. This article also summarizes the R syntax for parameter estimation and the calculation of fit statistics. The results produced by R is compared with the results obtained from MINISTEP and the output of a conditional logit model. The use of R is encouraged because it is free, supported by a network of peer researchers, and covers both basic and advanced topics in statistics frequently used by psychologists.",0,1 +640,On Consistency and Inconsistency of Estimating Equations,"The primary concern is to establish a fairly general framework in which estimators resulting from estimating equations g nθ = 0 are not consistent. This leads on to consistency by an intuitive route. Asymptotic distributions of consistent estimators are also touched upon, and the results are applied to various examples.",0,1 +641,Properties of hypothesis testing techniques and (Bayesian) model selection for exploration-based and theory-based (order-restricted) hypotheses,"In this paper, the performance of six types of techniques for comparisons of means is examined. These six emerge from the distinction between the method employed (hypothesis testing, model selection using information criteria, or Bayesian model selection) and the set of hypotheses that is investigated (a classical, exploration-based set of hypotheses containing equality constraints on the means, or a theory-based limited set of hypotheses with equality and/or order restrictions). A simulation study is conducted to examine the performance of these techniques. We demonstrate that, if one has specific, a priori specified hypotheses, confirmation (i.e., investigating theory-based hypotheses) has advantages over exploration (i.e., examining all possible equality-constrained hypotheses). Furthermore, examining reasonable order-restricted hypotheses has more power to detect the true effect/non-null hypothesis than evaluating only equality restrictions. Additionally, when investigating more than one theory-based hypothesis, model selection is preferred over hypothesis testing. Because of the first two results, we further examine the techniques that are able to evaluate order restrictions in a confirmatory fashion by examining their performance when the homogeneity of variance assumption is violated. Results show that the techniques are robust to heterogeneity when the sample sizes are equal. When the sample sizes are unequal, the performance is affected by heterogeneity. The size and direction of the deviations from the baseline, where there is no heterogeneity, depend on the effect size (of the means) and on the trend in the group variances with respect to the ordering of the group sizes. Importantly, the deviations are less pronounced when the group variances and sizes exhibit the same trend (e.g., are both increasing with group number).",0,1 +642,Inference for multivariate normal hierarchical models,"This paper provides a new method and algorithm for making inferences about the parameters of a two-level multivariate normal hierarchical model. One has observed J p-dimensional vector outcomes, distributed at level 1 as multivariate normal with unknown mean vectors and with known covariance matrices. At level 2, the unknown mean vectors also have normal distributions, with common unknown covariance matrix A and with means depending on known covariates and on unknown regression coefficients. The algorithm samples independently from the marginal posterior distribution of A by using rejection procedures. Functions such as posterior means and covariances of the level 1 mean vectors and of the level 2 regression coefficient are estimated by averaging over posterior values calculated conditionally on each value of A drawn. This estimation accounts for the uncertainty in A, unlike standard restricted maximum likelihood empirical Bayes procedures. It is based on independent draws from the exact posterior distributions, unlike Gibbs sampling. The procedure is demonstrated for profiling hospitals based on patients' responses concerning p = 2 types of problems (non-surgical and surgical). The frequency operating characteristics of the rule corresponding to a particular vague multivariate prior distribution are shown via simulation to achieve their nominal values in that setting.",0,1 +643,Meta-analysis of incidence rate data in the presence of zero events,"When summary results from studies of counts of events in time contain zeros, the study-specific incidence rate ratio (IRR) and its standard error cannot be calculated because the log of zero is undefined. This poses problems for the widely used inverse-variance method that weights the study-specific IRRs to generate a pooled estimate.We conducted a simulation study to compare the inverse-variance method of conducting a meta-analysis (with and without the continuity correction) with alternative methods based on either Poisson regression with fixed interventions effects or Poisson regression with random intervention effects. We manipulated the percentage of zeros in the intervention group (from no zeros to approximately 80 percent zeros), the levels of baseline variability and heterogeneity in the intervention effect, and the number of studies that comprise each meta-analysis. We applied these methods to an example from our own work in suicide prevention and to a recent meta-analysis of the effectiveness of condoms in preventing HIV transmission.As the percentage of zeros in the data increased, the inverse-variance method of pooling data shows increased bias and reduced coverage. Estimates from Poisson regression with fixed interventions effects also display evidence of bias and poor coverage, due to their inability to account for heterogeneity. Pooled IRRs from Poisson regression with random intervention effects were unaffected by the percentage of zeros in the data or the amount of heterogeneity.Inverse-variance methods perform poorly when the data contains zeros in either the control or intervention arms. Methods based on Poisson regression with random effect terms for the variance components are very flexible offer substantial improvement.",0,1 +644,Sampling Plans for Fitting the Psychometric Function,"Research on estimation of a psychometric function Ψ has usually focused on comparing alternative algorithms to apply to the data, rarely addressing how best to gather the data themselves (i.e., what sampling plan best deploys the affordable number of trials). Simulation methods were used here to assess the performance of several sampling plans in yes–no and forced-choice tasks, including the QUEST method and several variants of up–down staircases and of the method of constant stimuli (MOCS). We also assessed the efficacy of four parameter estimation methods. Performance comparisons were based on analyses of usability (i.e., the percentage of times that a plan yields usable data for the estimation of all the parameters of Ψ) and of the resultant distributions of parameter estimates. Maximum likelihood turned out to be the best parameter estimation method. As for sampling plans, QUEST never exceeded 80% usability even when 1000 trials were administered and rendered accurate estimates of threshold but misestimated the remaining parameters. MOCS and up–down staircases yielded similar and acceptable usability (above 95% with 400–500 trials) and, although neither type of plan allowed estimating all parameters with optimal precision, each type appeared well suited to estimating a distinct subset of parameters. An analysis of the causes of this differential suitability allowed designing alternative sampling plans (all based on up–down staircases) for yes–no and forced-choice tasks. These alternative plans rendered near optimal distributions of estimates for all parameters. The results just described apply when the fitted Ψ has the same mathematical form as the actual Ψ generating the data; in case of form mismatch, all parameters except threshold were generally misestimated but the relative performance of all the sampling plans remained identical. Detailed practical recommendations are given.",0,1 +645,Evaluation of model fit in nonlinear multilevel structural equation modeling,"Evaluating model fit in nonlinear multilevel structural equation models (MSEM) presents a challenge as no adequate test statistic is available. Nevertheless, using a product indicator approach a likelihood ratio test for linear models is provided which may also be useful for nonlinear MSEM. The main problem with nonlinear models is that product variables are nonnormally distributed. Although robust test statistics have been developed for linear SEM to ensure valid results under the condition of nonnormality, they were not yet investigated for nonlinear MSEM. In a Monte Carlo study, the performance of the robust likelihood ratio test was investigated for models with single-level latent interaction effects using the unconstrained product indicator approach. As overall model fit evaluation has a potential limitation in detecting the lack of fit at a single level even for linear models, level-specific model fit evaluation was also investigated using partially saturated models. Four population models were considered: a model with interaction effects at both levels, an interaction effect at the within-group level, an interaction effect at the between-group level, and a model with no interaction effects at both levels. For these models the number of groups, predictor correlation, and model misspecification was varied. The results indicate that the robust test statistic performed sufficiently well. Advantages of level-specific model fit evaluation for the detection of model misfit are demonstrated.",0,1 +646,Statistical and Substantive Checking in Growth Mixture Modeling: Comment on Bauer and Curran (2003).,This commentary discusses the D. J. Bauer and P. J. Curran (2003) investigation of growth mixture modeling. Single-class modeling of nonnormal outcomes is compared with modeling with multiple latent trajectory classes. New statistical tests of multiple-class models are discussed. Principles for substantive investigation of growth mixture model results are presented and illustrated by an example of high school dropout predicted by low mathematics achievement development in Grades 7-10.,0,1 +647,A Improved Statistical Model Analysis the Mental Health of Rural-to-Urban Migrants in China,"The mental health of rural-to-urban migrants in China is a critical issue. The aim of this study was to test the migrants' mental health. The findings drawn from this qualitative study of 769 migrants in Wuhan in 2012 based on the Bayesian structural equation model. Overall, the survey found that leisure plays the greatest positive role in migrants' mental health, as well as work, interpersonal relationships, and health status have a negative role in migrants' mental health. Thus, the government must set relevant regulations to help migrants establish a better life and work values to work energetically. China is an agricultural country, and farmers comprise more than 75% of the total population. A large number of farmers have poured into the cities over the past 30 years, which caused the rapid growth of the migrant population in China. The sixth census data released by the National Bureau of Statistics show that the number of migrants in China has reached 0.26 billion, which are the largest scale of labor migration in the history of mankind (CNBS, 2011). According to the National Bureau of Statistics, rural-to-urban migrants are those who migrate from the countryside to cities to seek more job opportunities and higher quality of life, but they have no permanent urban residency (CNBS, 2001). These migrants who migrated from rural to urban areas are affected by the limitations of the traditional urban-rural dual structure. Farmers can live and work in the cities, but they are not included in the city Hukou. Therefore, they are not included in the welfare and public distribution system of the city, and they do not enjoy the same treatment as the city residents in terms of labor and social security, health insurance, and children's education. They are the targets of social discrimination and are isolated in the edge of urban communities(Yang, Li, & Wang,2006; Wang et al., 2010; McGuire, Li, & Wang, 2009), causing their mental health to become a common issue of concern. The characteristics and demands of migrants have changed since China's 30-year economic reform. Young migrants occupy a large proportion of the total numbers (Liu,2007). This new generation of migrants usually aims for social mobility, with more prominent laddering migration characteristics. They are sensitive, self-recognized, and have a higher education level. They are different from their parents who are a tough breed and only pursue income. Young migrants aspire for a high quality of life and hope to enjoy the same social status as their peers in the cities. New factors may appear as migrants change in the 21 st century.",0,1 +648,A Bayesian nonparametric method for model evaluation: application to genetic studies,"Statistical models applied to genetic studies commonly assume linear relationships (between disease and risk factors) and simple distributional forms (by relying on asymptotic methods) for inference. However, when the sample size is small, inference using traditional asymptotic models can be problematic. Moreover, the gene-disease relationship is not always linear. In this article, we present a new nonparametric Bayesian method for model assessment, and we demonstrate the advantages of this approach particularly when the sample size is small and/or the true model is non-linear. We evaluate our approach on simulated data and find that it performs substantially better than alternative models. We also apply our method to two real studies: diagnosis of conventional high-grade non-metastatic osteosarcoma, and survival in Burkitt's lymphoma.",0,1 +649,Latent variable scores and their uses,,0,1 +650,A Quantitative Process for Enhancing End of Phase 2 Decisions,"The objectives of the phase 2 stage in a drug development program are to evaluate the safety and tolerability of different doses, select a promising dose range, and look for early signs of activity. At the end of phase 2, a decision to initiate phase 3 studies is made that involves the commitment of considerable resources. This multifactorial decision, generally made by balancing the current condition of a development organization's portfolio, the future cost of development, the competitive landscape, and the expected safety and efficacy benefits of a new therapy, needs to be a good one. In this article, we present a practical quantitative process that has been implemented for drugs entering phase 2 at Amgen Ltd. to ensure a consistent and explicit evidence-based approach is used to contribute to decisions for new drug candidates. Broadly following this process will also help statisticians increase their strategic influence in drug development programs. The process is illustrated using an example from the pancreatic cancer indication. Embedded within the process is a predominantly Bayesian approach to predicting the probability of efficacy success in a future (frequentist) phase 3 program.",0,1 +651,,"Most large-scale secondary data sets used in higher education research (e.g., NP-SAS or BPS) are constructed using complex survey sample designs where the population of interest is stratified on a number of dimensions and oversampled within certain of these strata. Moreover, these complex sample designs often cluster lower level units (e.g., students) within higher level units (e.g., colleges) to achieve efficiencies in the sampling process. Ignoring oversampling (unequal probability of selection) in complex survey designs presents problems when trying to make inferences-data from these designs are, in their raw form, admittedly nonrepresentative of the population to which they are designed to generalize. Ignoring the clustering of observations in these sampling designs presents a second set of problems when making inferences about variability in the population and testing hypotheses and usually leads to an increased likelihood of committing Type I errors (declaring something as an effect when in fact it is not). This article presents an extended example using complex sample survey data to demonstrate how researchers can address problems associated with oversampling and clustering of observations in these designs.",0,1 +652,Covariance Estimation: The GLM and Regularization Perspectives,"Finding an unconstrained and statistically interpretable reparameterization of a covariance matrix is still an open problem in statistics. Its solution is of central importance in covariance estimation, particularly in the recent high-dimensional data environment where enforcing the positive-definiteness constraint could be computationally expensive. We provide a survey of the progress made in modeling covariance matrices from two relatively complementary perspectives: (1) generalized linear models (GLM) or parsimony and use of covariates in low dimensions, and (2) regularization or sparsity for high-dimensional data. An emerging, unifying and powerful trend in both perspectives is that of reducing a covariance estimation problem to that of estimating a sequence of regression problems. We point out several instances of the regression-based formulation. A notable case is in sparse estimation of a precision matrix or a Gaussian graphical model leading to the fast graphical LASSO algorithm. Some advantages and limitations of the regression-based Cholesky decomposition relative to the classical spectral (eigenvalue) and variance-correlation decompositions are highlighted. The former provides an unconstrained and statistically interpretable reparameterization, and guarantees the positive-definiteness of the estimated covariance matrix. It reduces the unintuitive task of covariance estimation to that of modeling a sequence of regressions at the cost of imposing an a priori order among the variables. Elementwise regularization of the sample covariance matrix such as banding, tapering and thresholding has desirable asymptotic properties and the sparse estimated covariance matrix is positive definite with probability tending to one for large samples and dimensions.",0,1 +653,Controlling Item Exposure and Test Overlap in Computerized Adaptive Testing,"This article proposes an item exposure control method, which is the extension of the Sympson and Hetter procedure and can provide item exposure control at both the item and test levels. Item exposure rate and test overlap rate are two indices commonly used to track item exposure in computerized adaptive tests. By considering both indices, item exposure can be monitored at both the item and test levels. To control the item exposure rate and test overlap rate simultaneously, the modified procedure attempted to control not only the maximum value but also the variance of item exposure rates. Results indicated that the item exposure rate and test overlap rate could be controlled simultaneously by implementing the modified procedure. Item exposure control was improved and precision of trait estimation decreased when a prespecified maximum test overlap rate was stringent.",0,1 +654,Adaptation to visual or auditory time intervals modulates the perception of visual apparent motion,"It is debated whether sub-second timing is subserved by a centralized mechanism or by the intrinsic properties of task-related neural activity in specific modalities (Ivry and Schlerf, 2008). By using a temporal adaptation task, we investigated whether adapting to different time intervals conveyed through stimuli in different modalities (i.e., frames of a visual Ternus display, visual blinking discs, or auditory beeps) would affect the subsequent implicit perception of visual timing, i.e., inter-stimulus interval (ISI) between two frames in a Ternus display. The Ternus display can induce two percepts of apparent motion (AM), depending on the ISI between the two frames: ""element motion"" for short ISIs, in which the endmost disc is seen as moving back and forth while the middle disc at the overlapping or central position remains stationary; ""group motion"" for longer ISIs, in which both discs appear to move in a manner of lateral displacement as a whole. In Experiment 1, participants adapted to either the typical ""element motion"" (ISI = 50 ms) or the typical ""group motion"" (ISI = 200 ms). In Experiments 2 and 3, participants adapted to a time interval of 50 or 200 ms through observing a series of two paired blinking discs at the center of the screen (Experiment 2) or hearing a sequence of two paired beeps (with pitch 1000 Hz). In Experiment 4, participants adapted to sequences of paired beeps with either low pitches (500 Hz) or high pitches (5000 Hz). After adaptation in each trial, participants were presented with a Ternus probe in which the ISI between the two frames was equal to the transitional threshold of the two types of motions, as determined by a pretest. Results showed that adapting to the short time interval in all the situations led to more reports of ""group motion"" in the subsequent Ternus probes; adapting to the long time interval, however, caused no aftereffect for visual adaptation but significantly more reports of group motion for auditory adaptation. These findings, suggesting amodal representation for sub-second timing across modalities, are interpreted in the framework of temporal pacemaker model.",0,1 +655,Bayesian Inference for Causal Effects: The Role of Randomization,"Causal effects are comparisons among values that would have been observed under all possible assignments of treatments to experimental units. In an experiment, one assignment of treatments is chosen and only the values under that assignment can be observed. Bayesian inference for causal effects follows from finding the predictive distribution of the values under the other assignments of treatments. This perspective makes clear the role of mechanisms that sample experimental units, assign treatments and record data. Unless these mechanisms are ignorable (known probabilistic functions of recorded values), the Bayesian must model them in the data analysis and, consequently, confront inferences for causal effects that are sensitive to the specification of the prior distribution of the data. Moreover, not all ignorable mechanisms can yield data from which inferences for causal effects are insensitive to prior specifications. Classical randomized designs stand out as especially appealing assignment mechanisms designed to make inference for causal effects straightforward by limiting the sensitivity of a valid Bayesian analysis.",0,1 +656,Recognition memory for realistic synthetic faces,"A series of experiments examined short-term recognition memory for trios of briefly presented, synthetic human faces derived from three real human faces. The stimuli were a graded series of faces, which differed by varying known amounts from the face of the average female. Faces based on each of the three real faces were transformed so as to lie along orthogonal axes in a 3-D face space. Experiment 1 showed that the synthetic faces' perceptual similarity structure strongly influenced recognition memory. Results were fit by a noisy exemplar model (NEMO) of perceptual recognition memory. The fits revealed thatrecognition memory was influenced both by the similarity of the probe to the series items and by the similarities among the series items themselves. Nonmetric multidimensional scaling (MDS) showed that the faces' perceptual representations largely preserved the 3-D space in which the face stimuli were arrayed. NEMO gave a better account of the results when similarity was defined as perceptual MDS similarity, rather than as the physical proximity of one face to another. Experiment 2 confirmed the importance of within-list homogeneity directly, without mediation of a model. We discuss the affinities and differences between visual memory for synthetic faces and memory for simpler stimuli.",0,1 +657,Interregional alpha-band synchrony supports temporal cross-modal integration,"In a continuously changing environment, time is a key property that tells us whether information from the different senses belongs together. Yet, little is known about how the brain integrates temporal information across sensory modalities. Using high-density EEG combined with a novel psychometric timing task in which human subjects evaluated durations of audiovisual stimuli, we show that the strength of alpha-band (8-12 Hz) phase synchrony between localizer-defined auditory and visual regions depended on cross-modal attention: during encoding of a constant 500 ms standard interval, audiovisual alpha synchrony decreased when subjects attended audition while ignoring vision, compared to when they attended both modalities. In addition, alpha connectivity during a variable target interval predicted the degree to which auditory stimulus duration biased time estimation while attending vision. This cross-modal interference effect was estimated using a hierarchical Bayesian model of a psychometric function that also provided an estimate of each individual's tendency to exhibit attention lapses. This lapse rate, in turn, was predicted by single-trial estimates of the stability of interregional alpha synchrony: when attending to both modalities, trials with greater stability in patterns of connectivity were characterized by reduced contamination by lapses. Together, these results provide new insights into a functional role of the coupling of alpha phase dynamics between sensory cortices in integrating cross-modal information over time.",0,1 +658,How Low Can You Go?,"Whereas general sample size guidelines have been suggested when estimating multilevel models, they are only generalizable to a relatively limited number of data conditions and model structures, both of which are not very feasible for the applied researcher. In an effort to expand our understanding of two-level multilevel models under less than ideal conditions, Monte Carlo methods, through SAS/IML, were used to examine model convergence rates, parameter point estimates (statistical bias), parameter interval estimates (confidence interval accuracy and precision), and both Type I error control and statistical power of tests associated with the fixed effects from linear two-level models estimated with PROC MIXED. These outcomes were analyzed as a function of: (a) level-1 sample size, (b) level-2 sample size, (c) intercept variance, (d) slope variance, (e) collinearity, and (f) model complexity. Bias was minimal across nearly all conditions simulated. The 95% confidence interval coverage and Type I error rate tended to be slightly conservative. The degree of statistical power was related to sample sizes and level of fixed effects; higher power was observed with larger sample sizes and level-1 fixed effects.",0,1 +659,Estimating the covariance matrix: a new approach,"In this paper, we consider the problem of estimating the covariance matrix and the generalized variance when the observations follow a nonsingular multivariate normal distribution with unknown mean. A new method is presented to obtain a truncated estimator that utilizes the information available in the sample mean matrix and dominates the James–Stein minimax estimator. Several scale equivariant minimax estimators are also given. This method is then applied to obtain new truncated and improved estimators of the generalized variance; it also provides a new proof to the results of Shorrock and Zidek (Ann. Statist. 4 (1976) 629) and Sinha (J. Multivariate Anal. 6 (1976) 617).",0,1 +660,The intermediate endpoint effect in logistic and probit regression,"Background An intermediate endpoint is hypothesized to be in the middle of the causal sequence relating an independent variable to a dependent variable. The intermediate variable is also called a surrogate or mediating variable and the corresponding effect is called the mediated, surrogate endpoint, or intermediate endpoint effect. Clinical studies are often designed to change an intermediate or surrogate endpoint and through this intermediate change influence the ultimate endpoint. In many intermediate endpoint clinical studies the dependent variable is binary, and logistic or probit regression is used. Purpose The purpose of this study is to describe a limitation of a widely used approach to assessing intermediate endpoint effects and to propose an alternative method, based on products of coefficients, that yields more accurate results. Methods The intermediate endpoint model for a binary outcome is described for a true binary outcome and for a dichotomization of a latent continuous outcome. Plots of true values and a simulation study are used to evaluate the different methods. Results Distorted estimates of the intermediate endpoint effect and incorrect conclusions can result from the application of widely used methods to assess the intermediate endpoint effect. The same problem occurs for the proportion of an effect explained by an intermediate endpoint, which has been suggested as a useful measure for identifying intermediate endpoints. A solution to this problem is given based on the relationship between latent variable modeling and logistic or probit regression. Limitations More complicated intermediate variable models are not addressed in the study, although the methods described in the article can be extended to these more complicated models. Conclusions Researchers are encouraged to use an intermediate endpoint method based on the product of regression coefficients. A common method based on difference in coefficient methods can lead to distorted conclusions regarding the intermediate effect. Clinical Trials 2007; 4: 499—513. http://ctj.sagepub.com",0,1 +661,The pattern of influence of perceived behavioral control upon exercising behavior: An application of Ajzen's theory of planned behavior,"The aim of the present studies was to verify the basic assumptions underlying the theory of planned behavior for the prediction of exercising intentions and behavior among adults of the general population (study 1) and a group of pregnant women (study 2). In both studies, baseline data were collected at home with trained interviewers and with the use of paper-and-pencil questionnaires. The self-report on behavior was obtained 6 months (study 1) and between 8 and 9 months (study 2) after baseline data collection. In study 1, perceived behavioral control influenced behavior only through intention. In study 2, none of the Ajzen model variables was associated to exercising behavior. Nonetheless, intention was influenced by attitude, habit, and perceived behavioral control. The results of the present studies suggest that perceived behavioral control contributes to the understanding of intentions to exercise but not to the prediction of exercising behavior. © 1993 Plenum Publishing Corporation.",0,1 +662,Longitudinal Methods.,,0,1 +663,Guilt in Bereavement: The Role of Self-Blame and Regret in Coping with Loss,"Despite the apparent centrality of guilt in complicating reactions following bereavement, scientific investigation has been limited. Establishing the impact of specific components associated with guilt could enhance understanding. The aim of this study was to examine the relationships between two guilt-related manifestations, namely self-blame and regret, with grief and depression. A longitudinal investigation was conducted 4-7 months, 14 months and 2 years post-loss. Participants were bereaved spouses (30 widows; 30 widowers); their mean age was 53.05 years. Results showed that self-blame was associated with grief at the initial time-point and with its decline over time. Such associations were not found for depression. Initial levels of regret were neither associated with initial levels of grief and depression, nor were they related to the decline over time in either outcome variable. These results demonstrate the importance of examining guilt-related manifestations independently, over time, and with respect to both generic and grief-specific outcome variables. A main conclusion is that self-blame (but not regret) is a powerful determinant of grief-specific difficulties following the loss of a loved one. Implications for intervention are considered.",0,1 +664,Disorders of the auditory brain,"© Oxford University Press, 2010. All rights reserved. This article is concerned with the disorders of the auditory system and their clinical assessment. It shows the importance of obtaining the history and neurological examination before detailed psychophysical testing. The assessment of disorders of the central auditory system in clinic is a multidisciplinary exercise, involving a key collaboration between neurology and audiological medicine. Patients with a suspected disorder of the central auditory system require audiological evaluation of middle ear and cochlear function. Continuous EEG is sometimes needed to seek evidence of abnormal epileptic activity that might be associated with auditory processing disorders. The article considers disorders defined on the basis of positive auditory symptoms. It also discusses abnormal auditory cognition in common clinical disorders in which the auditory features do not define the disorder. It aims to define auditory deficits in terms of the level in the system at which they are caused.",0,1 +665,The Non-Procedural Determinants of Responsiveness,"This article starts from the remarks by Peter Mair on the growing gap between responsiveness and responsibility – or middle-run responsiveness – and the declining capacity of parties to bridge that gap. It focuses on the empirical analysis of the association between economic and substantive democratic dimensions and responsiveness, which are highly relevant to the way in which parties compete and govern within contemporary democracies. Following an introduction of the topic, the second section puts forward key concepts and hypotheses; the third presents the operationalisation of the variables and the applied method; the fourth and primary empirical section of the article analyses the non-procedural determinants of political and economic responsiveness, including freedom and equality as well as several key economic structural factors. The concluding remarks recapitulate the main empirical findings and submit a number of aspects that party leaders ought to take into account when addressing the thorny issue ...",0,1 +666,ACCOUNTING FOR BETWEEN-STUDY VARIATION IN INCREMENTAL NET BENEFIT IN VALUE OF INFORMATION METHODOLOGY,"Previous applications of value of information methods for determining optimal sample size in randomized clinical trials have assumed no between-study variation in mean incremental net benefit. By adopting a hierarchical model, we provide a solution for determining optimal sample size with this assumption relaxed. The solution is illustrated with two examples from the literature. Expected net gain increases with increasing between-study variation, reflecting the increased uncertainty in incremental net benefit and reduced extent to which data are borrowed from previous evidence. Hence, a trial can become optimal where current evidence is sufficient assuming no between-study variation. However, despite the expected net gain increasing, the optimal sample size in the illustrated examples is relatively insensitive to the amount of between-study variation. Further percentage losses in expected net gain were small even when choosing sample sizes that reflected widely different between-study variation.",0,1 +667,An Evaluation of a Markov Chain Monte Carlo Method for the Rasch Model,"The accuracy of the Gibbs sampling Markov chain monte carlo procedure was examined for estimating item and person ( .) parameters in the one-parameter logistic model. Four datasets were analyzed using the Gibbs sampling method, conditional maximum likelihood, marginal maximum likelihood, and joint maximum likelihood. Maximum likelihood and expected a posteriori. estimation methods were used with marginal maximum likelihood estimation of item parameters. Item parameter estimates from the four methods were almost identical;. estimates from Gibbs sampling were similar to those obtained from the expected a posteriori method.",0,1 +668,Matching and Propensity Scores,"The popularity of matching techniques has increased considerably during the last decades. They are mainly used for matching treatment and control units to estimate causal treatment effects from observational studies or for integrating two or more data sets that share a common subset of covariates. In focusing on causal inference with observational studies, we discuss multivariate matching techniques and several propensity score methods, like propensity score matching, subclassification, inverse-propensity weighting, and regression estimation. In addition to the theoretical aspects, we give practical guidelines for implementing these techniques and discuss the conditions under which these techniques warrant a causal interpretation of the estimated treatment effect. In particular, we emphasize that the selection of covariates and their reliable measurement is more important than the choice of a specific matching strategy.",0,1 +669,Latent Variable Analysis: Growth Mixture Modeling and Related Techniques for Longitudinal Data,,0,1 +670,Infeasibility in Automated Test Assembly Models: A Comparison Study of Different Methods,"Several techniques exist to automatically put together a test meeting a number of specifications. In an item bank, the items are stored with their characteristics. A test is constructed by selecting a set of items that fulfills the specifications set by the test assembler. Test assembly problems are often formulated in terms of a model consisting of restrictions and an objective to be maximized or minimized. A problem arises when it is impossible to construct a test from the item pool that meets all specifications, that is, when the model is not feasible. Several methods exist to handle these infeasibility problems. In this article, test assembly models resulting from two practical testing programs were reconstructed to be infeasible. These models were analyzed using methods that forced a solution (Goal Programming, Multiple-Goal Programming, Greedy Heuristic), that analyzed the causes (Relaxed and Ordered Deletion Algorithm (RODA), Integer Randomized Deletion Algorithm (IRDA), Set Covering (SC), and Item Sampling), or that analyzed the causes and used this information to force a solution (Irreducible Infeasible Set-Solver). Specialized methods such as the IRDA and the Irreducible Infeasible Set-Solver performed best. Recommendations about the use of different methods are given.",0,1 +671,A probabilistic clustering theory of the organization of visual short-term memory.,"Experimental evidence suggests that the content of a memory for even a simple display encoded in visual short-term memory (VSTM) can be very complex. VSTM uses organizational processes that make the representation of an item dependent on the feature values of all displayed items as well as on these items' representations. Here, we develop a probabilistic clustering theory (PCT) for modeling the organization of VSTM for simple displays. PCT states that VSTM represents a set of items in terms of a probability distribution over all possible clusterings or partitions of those items. Because PCT considers multiple possible partitions, it can represent an item at multiple granularities or scales simultaneously. Moreover, using standard probabilistic inference, it automatically determines the appropriate partitions for the particular set of items at hand and the probabilities or weights that should be allocated to each partition. A consequence of these properties is that PCT accounts for experimental data that have previously motivated hierarchical models of VSTM, thereby providing an appealing alternative to hierarchical models with prespecified, fixed structures. We explore both an exact implementation of PCT based on Dirichlet process mixture models and approximate implementations based on Bayesian finite mixture models. We show that a previously proposed 2-level hierarchical model can be seen as a special case of PCT with a single cluster. We show how a wide range of previously reported results on the organization of VSTM can be understood in terms of PCT. In particular, we find that, consistent with empirical evidence, PCT predicts biases in estimates of the feature values of individual items and also predicts a novel form of dependence between estimates of the feature values of different items. We qualitatively confirm this last prediction in 3 novel experiments designed to directly measure biases and dependencies in subjects' estimates.",0,1 +672,Small Sample Properties of Bayesian Multivariate Autoregressive Time Series Models,"The aim of this study was to compare the small sample (N = 1, 3, 5, 10, 15) performance of a Bayesian multivariate vector autoregressive (BVAR-SEM) time series model relative to frequentist power and parameter estimation bias. A multivariate autoregressive model was developed based on correlated autoregressive time series vectors of varying lengths (T = 25, 50, 75, 100, 125) using Statistical Analysis System (SAS) version 9.2. Autoregressive components for the 5 series vectors included coefficients of .80, .70, .65, .50 and .40. Error variance components included values of .20, .20, .10, .15, and .15, with cross-lagged coefficients of .10, .10, .15, .10, and .10. A Monte Carlo study revealed that in comparison to frequentist methods, the Bayesian approach provided increased sensitivity for hypothesis testing and detecting Type I error.",1,1 +673,Social Influence Interpretation of Interpersonal Processes and Team Performance Over Time Using Bayesian Model Selection,"The team behavior literature is ambiguous about the relations between members’ interpersonal processes—task debate and task conflict—and team performance. From a social influence perspective, we show why members’ interpersonal processes determine team performance over time in small groups. Together, over time, dissenting in-group minorities who share information (via debate) with majorities, who selectively engage with them to consider their alternative proposals (via conflict), can improve their team performance (via innovation). The context/comparison model of social influence and its leniency contract extension to the special case of in-group minorities suggest a pattern of members’ interpersonal processes that unfolds over time to reconcile factions with the same social identity who hold different approaches to shared projects. Conditional on typical levels of task debate, we predict that (a) in early episodes, task conflict increases the relation between task debate and team performance; (b) in middle episodes, task conflict decreases the relation; and (c) in late episodes, task conflict increases the relation again. We explore our thesis using a longitudinal design with a sample of 60 student teams (360 individuals) working together for course credit over 5 months (21 weeks) to write a first business plan for a new venture. We use a multilevel structural equation modeling approach with Bayesian estimation. We found support for our theory expressed in informative hypotheses using Bayesian model selection. These results were not evident from conventional graphing and post hoc statistical probing of simple slopes against the null hypothesis.",0,1 +674,Experimental analysis of choice,"Our paper reviews and summarizes the state-of-the-art in the design and analysis of consumer choice experiments. We emphasize experiments involving discrete choices, but also review related work on the design and analysis of ranking and resource allocation experiments. Major topics include 1) Choice experiments and conjoint analysis, 2) Random utility and constant utility probabilistic discrete choice models as a theoretical foundation for choice experiments, and 3) The design of choice experiments. Other topics include a) Experimental procedure, b) Model specification, c) Model estimation, and d) Model validation. Suggestions for future research are made with respect to each topic. © 1991 Kluwer Academic Publishers.",0,1 +675,Multiple Objective Test Assembly Problems,"Mathematical programming techniques for optimal test assembly are discussed. Most methods optimize a single objective: for instance, the amount of information in a test, subject to a number of constraints. However, some test assembly problems have multiple objectives. A recent example in the literature is the problem of assembling test that measure multiple traits, where the amount of information in the test about each different trait has to be maximized. The present paper proposes methods appropriate for solving multiple objective test assembly problems. An overview of multiple objective optimization methods is given. The impact of the method on the optimality of the solution is shown and the appropriateness of the methods is discussed. The methods are illustrated using an empirical example of a test assembly problem for a two-dimensional mathematics item pool.",0,1 +676,Beyond SEM: General Latent Variable Modeling,"This article gives an overview of statistical analysis with latent variables. Using traditional structural equation modeling as a starting point, it shows how the idea of latent variables captures a wide variety of statistical concepts, including random effects, missing data, sources of variation in hierarchical data, finite mixtures. latent classes, and clusters. These latent variable applications go beyond the traditional latent variable useage in psychometrics with its focus on measurement error and hypothetical constructs measured by multiple indicators. The article argues for the value of integrating statistical and psychometric modeling ideas. Different applications are discussed in a unifying framework that brings together in one general model such different analysis types as factor models, growth curve models, multilevel models, latent class models and discrete-time survival models. Several possible combinations and extensions of these models are made clear due to the unifying framework.",0,1 +677,How to fit a response time distribution,"Among the most valuable tools in behavioral science is statistically fitting mathematical models of cognition to data-response time distributions, in particular. However, techniques for fitting distributions vary widely, and little is known about the efficacy of different techniques. In this article, we assess several fitting techniques by simulating six widely cited models of response time and using the fitting procedures to recover model parameters. The techniques include the maximization of likelihood and least squares fits of the theoretical distributions to different empirical estimates of the simulated distributions. A running example is used to illustrate the different estimation and fitting procedures. The simulation studies reveal that empirical density estimates are biased even for very large sample sizes. Some fitting techniques yield more accurate and less variable parameter estimates than do others. Methods that involve least squares fits to density estimates generally yield very poor parameter estimates.",0,1 +678,"Democracy Based on Difference: Examining the Links Between Structural Heterogeneity, Heterogeneity of Discussion Networks, and Democratic Citizenship","This study explores the direct and indirect links between structural heterogeneity, network heterogeneity, and political participation. We review the often conflicting scholarship on discussion network heterogeneity and political participation and place it within a multilevel conceptual framework of heterogeneity. Based on this integrated theoretical model, our study uses a combination of macro-level and individual-level survey data from various sources. First, we use a cross-sectional national data set, based on a telephone survey with a probability sample of almost 800 adults. Second, we combine these individual-level data with county-level data on religious, political, and racial heterogeneity. Based on these data sets, we develop a path model linking structure, context, and networks into an integrated pathway to evaluate the direct and indirect effects of heterogeneity on political participation. Our results show positive links between structural and network heterogeneity that are both direct and indirect, that is, mediated through various communication processes.",0,1 +679,An alternative two stage least squares (2SLS) estimator for latent variable equations,"The Maximum-likelihood estimator dominates the estimation of general structural equation models. Noniterative, equation-by-equation estimators for factor analysis have received some attention, but little has been done on such estimators for latent variable equations. I propose an alternative 2SLS estimator of the parameters in LISREL type models and contrast it with the existing ones. The new 2SLS estimator allows observed and latent variables to originate from nonnormal distributions, is consistent, has a known asymptotic covariance matrix, and is estimable with standard statistical software. Diagnostics for evaluating instrumental variables are described. An empirical example illustrates the estimator.",0,1 +680,Data-analytic strategies for examining the effectiveness of daily interventions,"Interest in the use of ecological momentary interventions – that is, interventions that are implemented in participants' everyday lives – to change experiences and behaviours has grown rapidly in recent years. In particular, EMIs in which the intervention is delivered on a daily basis (daily interventions) can be easily combined with daily diary studies to analyse intervention effects on dependent variables (DVs) that fluctuate over time. This article first provides a typology of research designs to classify daily intervention studies according to (1) the type of assessment of the DV (global assessment on a small number of fixed occasions, daily assessment, and repeated assessment within days) and (2) the type of control (within-subjects vs. between-subjects designs) used in the studies. We then demonstrate how multilevel models can be used to examine the effects of a daily intervention on the mean levels of the DV. We differentiate between general effectiveness, differential effectiveness, and conditional effectiveness and show how these effects are represented in the models. As an illustration, we apply some of the models to data from a daily intervention workplace study (N = 51 full-time employees) that focused on the effects of savouring exercises on calm mood and vigour",0,1 +681,The Time Has Come,"The use of Bayesian methods for data analysis is creating a revolution in fields ranging from genetics to marketing. Yet, results of our literature review, including more than 10,000 articles publi...",0,1 +682,Unpacking Cultural Differences in Alexithymia,"The current study provides a cultural examination of alexithymia, a multifaceted personality construct that refers to a general deficit in the ability to identify and describe emotional states, and that has been linked to a number of psychiatric illnesses. Though this construct has been critiqued as heavily rooted in “Western” norms of emotional expression, it has not received much empirical attention from a cultural perspective. Recently, Ryder et al. (2008) found that higher levels of alexithymia among Chinese versus Euro-Canadian outpatients were explained by group differences in one component of alexithymia, externally oriented thinking (EOT); they proposed that Chinese cultural contexts may encourage EOT due to a greater emphasis on social relationships and interpersonal harmony rather than inner emotional experience. The current study examined the hypothesis that EOT is more strongly shaped by cultural values than are two other components of alexithymia, difficulty identifying feelings (DIF) and difficulty describing feelings (DDF). Euro-Canadian ( n = 271) and Chinese-Canadian ( n = 237) undergraduates completed measures of alexithymia and cultural values. Chinese-Canadians showed higher levels of EOT than Euro-Canadians ( p < .001). EOT, and not DIF or DDF, was predicted by Modernization and Euro-American values in both groups. Furthermore, cultural values mediated the effect of group membership on levels of EOT. These results suggest that cultural differences in alexithymia may be explained by culturally based variations in the importance placed on emotions, rather than deficits in emotional processing. The study also raises questions about the measurement and meaning of EOT, particularly from a cross-cultural perspective.",0,1 +683,Discrete Latent Markov Models for Normally Distributed Response Data,"Van de Pol and Langeheine (1990) presented a general framework for Markov modeling of repeatedly measured discrete data. We discuss analogical single indicator models for normally distributed responses. In contrast to discrete models, which have been studied extensively, analogical continuous response models have hardly been considered. These models are formulated as highly constrained multinormal finite mixture models (McLachlan & Peel, 2000). The assumption of conditional independence, which is often postulated in the discrete models, may be relaxed in the normal-based models. In these models, the observed correlation between two variables may thus be due to the presence of two or more latent classes and the presence of within-class dependence. The latter may be subjected to structural equation modeling. In addition to presenting various normal-based Markov models, we demonstrate how these models, formulated as multinormal finite mixtures, may be fitted using the freely available program Mx (Neale, Boker, Xie, & Maes, 2002). To illustrate the application of some of the models, we report the analysis of data relating to the understanding of the conservation of continuous quantity (i.e., a Piagetian construct).",0,1 +684,USING RANDOM RATHER THAN FIXED EFFECTS MODELS IN META-ANALYSIS: IMPLICATIONS FOR SITUATIONAL SPECIFICITY AND VALIDITY GENERALIZATION,"Combining statistical information across studies (i.e., meta-analysis) is a standard research tool in applied psychology. The most common meta-analytic approach in applied psychology, the fixed effects approach, assumes that individual studies are homogeneous and are sampled from the same population. This model assumes that sampling error alone explains the majority of observed differences in study effect sizes and its use has lead some to challenge the notion of situational specificity in favor of validity generalization. We critique the fixed effects methodology and propose an advancement–the random effects model (RE) which provides estimates of how between-study differences influence the relationships under study. RE models assume that studies are heterogeneous since they are often conducted by different investigators under different settings. Parameter estimates of both models are compared and evidence in favor of the random effects approach is presented. We argue against use of the fixed effects model because it may lead to misleading conclusions about situational specificity.",0,1 +685,A generalized approach to modeling and estimating indirect effects in ecology,"The need to model and test hypotheses about complex ecological systems has led to a steady increase in use of path analytical techniques, which allow the modeling of multiple multivariate dependencies reflecting hypothesized causation and mechanisms. The aim is to achieve the estimation of direct, indirect, and total effects of one variable on another and to assess the adequacy of whole models. Path analytical techniques based on maximum likelihood currently used in ecology are rarely adequate for ecological data, which are often sparse, multi-level, and may contain nonlinear relationships as well as nonnormal response data such as counts or proportion data. Here I introduce a more flexible approach in the form of the joint application of hierarchical Bayes, Markov chain Monte Carlo algorithms, Shipley's d-sep test, and the potential outcomes framework to fit path models as well as to decompose and estimate effects. An example based on the direct and indirect interactions between ants, two insect herbivores, and a plant species demonstrates the implementation of these techniques, using freely available software.",0,1 +686,Information and other criteria in structural equation model selection,"This article presents the results of a simulation study evaluating information criteria in conjunction with other well-known criteria for model selection in structural equation modeling (SEM). Two sets of simulation experiments were performed. In both sets, sample sizes of n = 100,400,1000,6000 were used and the performance of 18 criteria was assessed by the frequency with which each of five analytic models was selected as best by each criterion in 500 replications. In the first set of experiments correctly specified analytic models (noncentrality parameter 0) were entertained in combination with misspecified ones, while in the second set all five models were misspecified. In both sets of experiments, we found that the information criteria perform better than the other criteria overall, but that Cudeck and Browne's cross-validation index ( CVI) remains an attractive option. Within the class of information criteria, Akaike's information criterion (AIC) is found to show some overfitting tendency. We demonst...",0,1 +687,The Mini-IPIP6: Tiny yet highly stable markers of Big Six personality,"Abstract We assessed the stability of a short-form six-factor personality measure over a one-year period in a large national probability sample (N = 4289). Personality was assessed using the Mini-IPIP6—a short-form measure assessing Extraversion, Agreeableness, Conscientiousness, Neuroticism, Openness to Experience, and Honesty-Humility. Standardized estimates calculated using Bayesian Structural Equation Modelling (BSEM) indicated that all six personality dimensions were extremely stable. An alternative model using Maximum Likelihood estimation, in which residual item variances were associated over repeated assessments, yielded similar findings. These results highlight the stability of personality in the general population, even when assessed using short-form scales. The use of Bayesian models to examine the stability of personality and their application for study of change in specific developmental periods is discussed.",0,1 +688,A Comparison of the LR and DFIT Frameworks of Differential Functioning Applied to the Generalized Graded Unfolding Model,"Recently, applied psychological measurement researchers have become interested in the application of the generalized graded unfolding model (GGUM), a parametric item response theory model that posits an ideal point conception of the relationship between latent attributes and observed item responses. Little attention has been given to considerations for the detection of differential item functioning (DIF) under the GGUM. In this article, the authors present a Monte Carlo simulation meant to assess the efficacy of the likelihood ratio (LR) and differential functioning of items and tests (DFIT) frameworks, two popular ways of detecting DIF. Findings indicate a marked superiority of the LR approach over DFIT in terms of true and false positive rates under the GGUM. The discussion centers on possible explanations for the poor performance of the DFIT framework in detecting DIF under the GGUM and addresses limitations of the current study as well as future research directions.",0,1 +689,Stimulus selection in adaptive psychophysical procedures,"In adaptive psychophysical procedures, the stimulus should be presented at a relatively high level rather than near the middle of the psychometric function, which is often defined as the ""threshold"" value. For some psychometric functions, the optimal stimulus placement level produces 84% to 94% correct responses in a two-alternative forced-choice task. This result is disquieting because the popular two-down one-up rule tracks a relatively low percentage of correct responses, 70.7%. Computer simulations and a variety of psychometric functions were used to confirm the validity of this analysis. These simulations also demonstrate that the precise form of the psychometric function is not critical in achieving the high efficiencies. Finally, data from human listeners indicate that the standard deviation of threshold estimates is indeed larger when the stimulus presented on each trial is at a stimulus level corresponding to 70.7% rather than 94% correct responses.",0,1 +690,Switch and maintenance of task set in schizophrenia,"Task set maintenance and switching deficits are robust in schizophrenia. However, little is known about how these constructs are related to one another. The development of an improved understanding of set switching and maintenance deficits in schizophrenia requires that these constructs be explicated in terms of elementary cognitive processes rather than grouped into broad psychological concepts like executive functioning. A relevant dichotomy has been proposed in which sensory and perceptual (""attentional"") processes are distinguished from decisional (""intentional"") processes in task maintenance and switching; however, the contributions these processes make to performance deficits in schizophrenia is not known. In the present study, 30 participants with schizophrenia and 27 healthy comparisons completed a cued attentional set switching task. In addition to analyses of mean response times, the contributions of attentional and intentional processes to task performance were estimated using an ex-Gaussian distributional analysis. Schizophrenia was associated with a set maintenance deficit that was accounted for by an attentional, rather than intentional, dysfunction. Both groups showed significant switch costs that could be attributed to attentional processes, but there was no evidence for an attentional set switching deficit in schizophrenia. The findings suggest that set switching and set maintenance may reflect distinct cognitive deficits in schizophrenia and that they may be associated with unique information processing mechanisms.",0,1 +691,Clustered data with small sample sizes: Comparing the performance of model-based and design-based approaches,Two classes of methods properly account for clustering of data: design-based methods and model-based methods. Estimates from both methods have been shown to be approximately equal with large sample...,0,1 +692,A Specification Error Test That Uses Instrumental Variables to Detect Latent Quadratic and Latent Interaction Effects,"The relations between the latent variables in structural equation models are typically assumed to be linear in form. This article aims to explain how a specification error test using instrumental variables (IVs) can be employed to detect unmodeled interactions between latent variables or quadratic effects of latent variables. An empirical example is presented, and the results of a simulation study are reported to evaluate the sensitivity and specificity of the test and compare it with the commonly employed chi-square model test. The results show that the proposed test can identify most unmodeled latent interactions or latent quadratic effects in moderate to large samples. Furthermore, its power is higher when the number of indicators used to define the latent variables is large. Altogether, this article shows how the IV-based test can be applied to structural equation models and that it is a valuable tool for researchers using structural equation models.",0,1 +693,Performance of growth mixture models in the presence of time-varying covariates,"Growth mixture modeling is often used to identify unobserved heterogeneity in populations. Despite the usefulness of growth mixture modeling in practice, little is known about the performance of this data analysis technique in the presence of time-varying covariates. In the present simulation study, we examined the impacts of five design factors: the proportion of the total variance of the outcome explained by the time-varying covariates, the number of time points, the error structure, the sample size, and the mixing ratio. More precisely, we examined the impact of these factors on the accuracy of parameter and standard error estimates, as well as on the class enumeration accuracy. Our results showed that the consistent Akaike information criterion (CAIC), the sample-size-adjusted CAIC (SCAIC), the Bayesian information criterion (BIC), and the integrated completed likelihood criterion (ICL-BIC) proved to be highly reliable indicators of the true number of latent classes in the data, across design conditions, and that the sample-size-adjusted BIC (SBIC) also proved quite accurate, especially in larger samples. In contrast, the Akaike information criterion (AIC), the entropy, the normalized entropy criterion (NEC), and the classification likelihood criterion (CLC) proved to be unreliable indicators of the true number of latent classes in the data. Our results also showed that substantial biases in the parameter and standard error estimates tended to be associated with growth mixture models that included only four time points.",0,1 +694,Reciprocity as a trigger of social cooperation in contemporary immigration societies?,"While the system stabilizing function of reciprocity is widely acknowledged, much less attention has been paid to the argument that reciprocity might initiate social cooperation in the first place. This paper tests Gouldner’s early assumption that reciprocity may act as a ‘starting mechanism’ of social cooperation in consolidating societies. The empirical test scenario builds on unequal civic engagement between immigrants and nationals, as this engagement gap can be read as a lack of social cooperation in consolidating immigration societies. Empirical analyses using survey data on reciprocal norms and based on Bayesian hierarchical modelling lend support for Gouldner’s thesis, underlining thereby the relevance of reciprocity in today’s increasingly diverse societies: individual norms of altruistic reciprocity elevate immigrants’ propensity to volunteer, reducing thereby the engagement gap between immigrants and natives in the area of informal volunteering. In other words, compliance with altruistic reciprocity may trigger cooperation in social strata, where it is less likely to occur. The positive moderation of the informal engagement gap through altruistic reciprocity turns out to be most pronounced for immigrants who are least likely to engage in informal volunteering, meaning low, but also highly educated immigrants.",0,1 +695,The robustness of estimates of total indirect effects in covariance structure models estimated by maximum,"The large sample distribution of total indirect effects in covariance structure models in well known. Using Monte Carlo methods, this study examines the applicability of the large sample theory to maximum likelihood estimates oftotal indirect effects in sample sizes of 50, 100, 200, 400, and 800. Two models are studied. Model 1 is a recursive model with observable variables and Model 2 is a nonrecursive model with latent variables. For the large sample theory to apply, the results suggest that sample szes of 200 or more and 400 or more are required for models such as Model 1 and Model 2, respectively. © 1990 The Psychometric Society.",0,1 +696,Climate Change and Reproductive Intentions in Europe,"The harsh impacts of climate change and its related hazards are increasingly being felt across the world. A large consensus has emerged among natural scientists about the nature and the impact of climate change. It is recognized that climate change is largely anthropogenic and that, in turn, a continuous worsening of environmental conditions has strong impacts on populations’ and individuals’ well-being (Lutz, 2010).",0,1 +697,Factorial Structure of the Family Values Scale From a Multilevel-Multicultural Perspective,"In cross-cultural research, there is a tendency for researchers to draw inferences at the country level based on individual-level data. Such action implicitly and often mistakenly assumes that both the measuring instrument and its underlying construct(s) are operating equivalently across both levels. Based on responses from 5,482 college students sampled from 27 countries, we took a structural equation modeling approach to addressing this issue of level equivalence. Purposes of the study were: (a) to validate the hypothesized two-factor structure of the Family Values Scale (FV Scale; Georgas, 1999) within a multilevel framework that took individual- and country-level information into account; (b) to test equivalence of the FV Scale across individual and country levels; and (c) to evaluate relations between the FV Scale and three possibly important covariates—gender at the individual level, and affluence and religion at the country level. Implications of findings and importance of multilevel equivalence in...",0,1 +698,Shrinkage Estimators for Covariance Matrices,"Estimation of covariance matrices in small samples has been studied by many authors. Standard estimators, like the unstructured maximum likelihood estimator (ML) or restricted maximum likelihood (REML) estimator, can be very unstable with the smallest estimated eigenvalues being too small and the largest too big. A standard approach to more stably estimating the matrix in small samples is to compute the ML or REML estimator under some simple structure that involves estimation of fewer parameters, such as compound symmetry or independence. However, these estimators will not be consistent unless the hypothesized structure is correct. If interest focuses on estimation of regression coefficients with correlated (or longitudinal) data, a sandwich estimator of the covariance matrix may be used to provide standard errors for the estimated coefficients that are robust in the sense that they remain consistent under misspecification of the covariance structure. With large matrices, however, the inefficiency of the sandwich estimator becomes worrisome. We consider here two general shrinkage approaches to estimating the covariance matrix and regression coefficients. The first involves shrinking the eigenvalues of the unstructured ML or REML estimator. The second involves shrinking an unstructured estimator toward a structured estimator. For both cases, the data determine the amount of shrinkage. These estimators are consistent and give consistent and asymptotically efficient estimates for regression coefficients. Simulations show the improved operating characteristics of the shrinkage estimators of the covariance matrix and the regression coefficients in finite samples. The final estimator chosen includes a combination of both shrinkage approaches, i.e., shrinking the eigenvalues and then shrinking toward structure. We illustrate our approach on a sleep EEG study that requires estimation of a 24 x 24 covariance matrix and for which inferences on mean parameters critically depend on the covariance estimator chosen. We recommend making inference using a particular shrinkage estimator that provides a reasonable compromise between structured and unstructured estimators.",0,1 +699,Bootstrap confidence intervals,"This article surveys bootstrap methods for producing good approximate confidence intervals. The goal is to improve by an order of magnitude upon the accuracy of the standard intervals $\hat{\theta} \pm z^{(\alpha)} \hat{\sigma}$, in a way that allows routine application even to very complicated problems. Both theory and examples are used to show how this is done. The first seven sections provide a heuristic overview of four bootstrap confidence interval procedures: $BC_a$, bootstrap-t , ABC and calibration. Sections 8 and 9 describe the theory behind these methods, and their close connection with the likelihood-based confidence interval theory developed by Barndorff-Nielsen, Cox and Reid and others.",0,1 +700,Multivariate meta‐analysis: Potential and promise,"The multivariate random effects model is a generalization of the standard univariate model. Multivariate meta-analysis is becoming more commonly used and the techniques and related computer software, although continually under development, are now in place. In order to raise awareness of the multivariate methods, and discuss their advantages and disadvantages, we organized a one day 'Multivariate meta-analysis' event at the Royal Statistical Society. In addition to disseminating the most recent developments, we also received an abundance of comments, concerns, insights, critiques and encouragement. This article provides a balanced account of the day's discourse. By giving others the opportunity to respond to our assessment, we hope to ensure that the various view points and opinions are aired before multivariate meta-analysis simply becomes another widely used de facto method without any proper consideration of it by the medical statistics community. We describe the areas of application that multivariate meta-analysis has found, the methods available, the difficulties typically encountered and the arguments for and against the multivariate methods, using four representative but contrasting examples. We conclude that the multivariate methods can be useful, and in particular can provide estimates with better statistical properties, but also that these benefits come at the price of making more assumptions which do not result in better inference in every case. Although there is evidence that multivariate meta-analysis has considerable potential, it must be even more carefully applied than its univariate counterpart in practice.",0,1 +701,Corporate effectuation: Entrepreneurial action and its impact on R&D project performance,"Abstract Innovative products are widely recognized as an important source of competitive advantage. However, many companies have difficulties finding efficient and successful approaches to different types of R&D projects, particularly those that involve a high level of innovativeness. Therefore, the present study moves effectuation theory from the entrepreneurial context to R&D research. First, the characteristics of an effectual approach in the context of R&D projects are developed and differentiated from those of conventional prediction-based strategies (causation). Second, using a thorough qualitative and quantitative scale-development process to capture particularities of effectual and causal dimensions in the R&D context, expert interviews and a pilot study (123 R&D projects), the study develops a multi-factor measurement model of effectuation and causation. These measures are validated in a follow-up study with a larger sample of 400 projects. Third, the new measures are applied to test two central hypotheses: (a) effectuation is positively related to success in highly innovative contexts, (b) causation approaches are beneficial in projects with low levels of innovativeness. Overall, this study moves the effectuation logic from the entrepreneurial to the corporate R&D context, captures its particularities, and investigates its performance outcomes.",0,1 +702,Estimator Conditioning Diagnostics for Covariance Structure Models,This article studies the utility of a general set of diagnostics for assessing conditioning problems in the covariance structure modeling framework. The diagnostics are based on extensions of the condition index and variance decomposition proportions advanced by Belsley and are based on using the covariance matrix of the estimates. A series of simulations with a variety of covariance structure models as well as a real data example show that these diagnostics are useful for gauging the sensitivity of parameter estimates to conditioning problems arising from collinearity in the raw data. The relationship between ill-conditioning and local identification as it pertains to the proposed diagnostics is also discussed. It is suggested that these diagnostics be implemented in existing covariance structure modeling software.,0,1 +703,Hierarchical models for assessing variability among functions,"SUMMARY In many applications of functional data analysis, summarising functional variation based on fits, without taking account of the estimation process, runs the risk of attributing the estimation variation to the functional variation, thereby overstating the latter. For example, the first eigenvalue of a sample covariance matrix computed from estimated functions may be biased upwards. We display a set of estimated neuronal Poisson-process intensity functions where this bias is substantial, and we discuss two methods for account ing for estimation variation. One method uses a random-coefficient model, which requires all functions to be fitted with the same basis functions. An alternative method removes the same-basis restriction by means of a hierarchical Gaussian process model. In a small simulation study the hierarchical Gaussian process model outperformed the random coefficient model and greatly reduced the bias in the estimated first eigenvalue that would result from ignoring estimation variability. For the neuronal data the hierarchical Gaussian process estimate of the first eigenvalue was much smaller than the naive estimate that ignored variability due to function estimation. The neuronal setting also illustrates the benefit of incorporating alignment parameters into the hierarchical scheme.",0,1 +704,Choosing the best method for local validity estimation: Relative accuracy of meta-analysis versus a local study versus Bayes-analysis.,"This study assessed the relative accuracy of 3 techniques--local validity studies, meta-analysis, and Bayesian analysis--for estimating test validity, incremental validity, and adverse impact in the local selection context. Bayes-analysis involves combining a local study with nonlocal (meta-analytic) validity data. Using tests of cognitive ability and personality (conscientiousness) as predictors, an empirically driven selection scenario illustrates conditions in which each of the 3 estimation techniques performs best. General recommendations are offered for how to estimate local parameters, based on true population variability and the number of studies in the meta-analytic prior. Benefits of empirical Bayesian analysis for personnel selection are demonstrated, and equations are derived to help guide the choice of a local validity technique (i.e., meta-analysis vs. local study vs. Bayes-analysis).",0,1 +705,An Illustration of Second-Order Latent Growth Models,"Methods of latent curve analysis (latent growth modeling) have recently emerged as a versatile tool for investigating longitudinal change in measured variables. This article, using higher order factor models as suggested by McArdle (1988) and Tisak and Meredith (1990), illustrates latent curve analysis for the purpose of modeling longitudinal change directly in a latent construct. The construct of interest is assumed to be indicated by several measured variables, all of which are observed at the same multiple time points. Examples with simultaneous estimation of covariance and mean structures are provided for both a single group and a two-group scenario.",0,1 +706,Publication Bias in Recent Meta-Analyses,"Positive results have a greater chance of being published and outcomes that are statistically significant have a greater chance of being fully reported. One consequence of research underreporting is that it may influence the sample of studies that is available for a meta-analysis. Smaller studies are often characterized by larger effects in published meta-analyses, which can be possibly explained by publication bias. We investigated the association between the statistical significance of the results and the probability of being included in recent meta-analyses.For meta-analyses of clinical trials, we defined the relative risk as the ratio of the probability of including statistically significant results favoring the treatment to the probability of including other results. For meta-analyses of other studies, we defined the relative risk as the ratio of the probability of including biologically plausible statistically significant results to the probability of including other results. We applied a Bayesian selection model for meta-analyses that included at least 30 studies and were published in four major general medical journals (BMJ, JAMA, Lancet, and PLOS Medicine) between 2008 and 2012.We identified 49 meta-analyses. The estimate of the relative risk was greater than one in 42 meta-analyses, greater than two in 16 meta-analyses, greater than three in eight meta-analyses, and greater than five in four meta-analyses. In 10 out of 28 meta-analyses of clinical trials, there was strong evidence that statistically significant results favoring the treatment were more likely to be included. In 4 out of 19 meta-analyses of observational studies, there was strong evidence that plausible statistically significant outcomes had a higher probability of being included.Publication bias was present in a substantial proportion of large meta-analyses that were recently published in four major medical journals.",0,1 +707,A parameterization for individual human growth curves.,,0,1 +708,A theory of memory retrieval.,"A theory of memory retrieval is developed and is shown to apply over a range of experimental paradigms. Access to memory traces is viewed in terms of a resonance metaphor. The probe item evokes the search set on the basis of probe-memory item relatedness, just as a ringing tuning fork evokes sympathetic vibrations in other tuning forks. Evidence is accumulated in parallel from each probe-memory item comparison, and each comparison is modeled by a continuous random walk process. In item recognition, the decision process is self-terminating on matching comparisons and exhaustive on nonmatching comparisons. The mathematical model produces predictions about accuracy, mean reaction time, error latency, and reaction time distributions that are in good accord with experimental data. The theory is applied to four item recognition paradigms (Sternberg, prememorized list, study-test, and continuous) and to speed-accuracy paradigms; results are found to provide a basis for comparison of these paradigms. It is noted that neural network models can be interfaced to the retrieval theory with little difficulty and that semantic memory models may benefit from such a retrieval scheme.",0,1 +709,Bayesian Analyses of Mediational Models for Survival Outcome,,0,1 +710,The Effect of Different Forms of Centering in Hierarchical Linear Models,"Multilevel models are becoming increasingly used in applied educational social and economic research for the analysis of hierarchically nested data. In these random coefficient regression models the parameters are allowed to differ over the groups in which the observations are nested. For computational ease in deriving parameter estimates, predictors are often centered around the mean. In nested or grouped data, the option of centering around the grand mean is extended with an option to center within groups or contexts. Both are statistically sound ways to improve parameter estimation. In this article we study the effects of these two different ways of centering, in comparison to the use of raw scores, on the parameter estimates in random coefficient models. The conclusion is that centering around the group mean amounts to fitting a different model from that obtained by centering around the grand mean or by using raw scores. The choice between the two options for centering can only be made on a theoretical basis. Based on this study, we conclude that centering rules valid for simple models, such as the fixed coefficients regression model. are no longer applicable to more complicated models, such as the random coefficient model. We think researchers should be made aware of the consequences of the choice of particular centering options.",0,1 +711,Nonparametric Tests of Stochastic Dominance in Income Distributions,"Tests for stochastic dominance, based upon extensions of the Goodness of Fit Test to the nonparametric comparison of income distributions, are proposed, implemented, and compared with indirect tests of second order stochastic dominance currently utilized in income distribution studies.",0,1 +712,Asymptotic Confidence Intervals for Indirect Effects in Structural Equation Models,"For comments on an earlier draft of this chapter and for detailed advice I am indebted to Robert M. Hauser, Halliman H. Winsborough, and Toni Richards, several anonymous reviewers, and the editor of this volume. I also wish to thank John Raisian, Nancy Rytina, and Barbara Mann for their comments and Mark Wilson for able research assistance. The opinions expressed here are the sole responsibility of the author.",0,1 +713,Logistic Regression With Multiple Random Effects: A Simulation Study of Estimation Methods and Statistical Packages,"Several statistical packages are capable of estimating generalized linear mixed models and these packages provide one or more of three estimation methods: penalized quasi-likelihood, Laplace, and Gauss–Hermite. Many studies have investigated these methods’ performance for the mixed-effects logistic regression model. However, the authors focused on models with one or two random effects and assumed a simple covariance structure between them, which may not be realistic. When there are multiple correlated random effects in a model, the computation becomes intensive, and often an algorithm fails to converge. Moreover, in our analysis of smoking status and exposure to antitobacco advertisements, we have observed that when a model included multiple random effects, parameter estimates varied considerably from one statistical package to another even when using the same estimation method. This article presents a comprehensive review of the advantages and disadvantages of each estimation method. In addition, we compare the performances of the three methods across statistical packages via simulation, which involves two- and three-level logistic regression models with at least three correlated random effects. We apply our findings to a real dataset. Our results suggest that two packages—SAS GLIMMIX Laplace and SuperMix Gaussian quadrature—perform well in terms of accuracy, precision, convergence rates, and computing speed. We also discuss the strengths and weaknesses of the two packages in regard to sample sizes.",0,1 +714,Direct and Indirect Effects: Classical and Bootstrap Estimates of Variability,"The decomposition of effects in structural equation models has been of considerable interest to social scientists. Finite-sample or asymptotic results for the sampling distribution of estimators of direct effects are widely available. Statistical inferences about indirect effects have relied exclusively on asymptotic methods which assume that the limiting distribution of the estimator is normal, with a standard error derived from the delta method. We examine bootstrap procedures as another way to generate standard errors and confidence intervals and to estimate the sampling distributions of estimators of direct and indirect effects. We illustrate the classical and the bootstrap methods with three empirical examples. We find that in a moderately large sample, the bootstrap distribution of an estimator is close to that assumed with the",0,1 +715,Improved Approximations for Multilevel Models with Binary Responses,"SUMMARY This paper discusses the use of improved approximations for the estimation of generalized linear multilevel models where the response is a proportion. Simulation studies by Rodriguez and Goldman have shown that in extreme situations large biases can occur, most notably when the response is binary, the number of level 1 units per level 2 unit is small and the underlying random parameter values are large. An improved approximation is introduced which largely eliminates the biases in the situation described by Rodriguez and Goldman. Keywortis: �BINARY RESPONSE; GENERALIZED LINEAR MODEL; HIERARCHICAL DATA; MARGINAL MODEL; MULTILEVEL MODEL; QUASI-LIKELIHOOD; UNIT-SPECIFIC MODEL",0,1 +716,Plausibility of multivariate normality assumption when multiply imputing non-Gaussian continuous outcomes: a simulation assessment,"Multiple imputation under the assumption of multivariate normality has emerged as a frequently used model-based approach in dealing with incomplete continuous data in recent years. Despite its simplicity and popularity, however, its plausibility has not been thoroughly evaluated via simulation. In this work, the performance of multiple imputation under a multivariate Gaussian model with unstructured covariances was examined on a broad range of simulated incomplete data sets that exhibit varying distributional characteristics such as skewness and multimodality that are not accommodated by a Gaussian model. Behavior of efficiency and accuracy measures was explored to determine the extent to which the procedure works properly. The conclusion drawn is that although the real data rarely conform with multivariate normality, imputation under the assumption of normality is a fairly reasonable tool, even when the assumption of normality is clearly violated; the fraction of missing information is high, especially w...",0,1 +717,Exploring gains in reading and mathematics achievement among regular and exceptional students using growth curve modeling,"Abstract Using four-wave longitudinal reading and mathematics data (4th to 7th grades) from a large urban school district, growth curve modeling was used as a tool for examining three research questions: Are achievement gaps closing in reading and mathematics? What are the associations between prior-achievement and growth across the reading and mathematics domains? Is there an association between the receipt of additional services (special education, English-as-second-language, free and reduced lunch program) and reading and mathematics achievement? Results showed that rates of growth in achievement diminished over time and achievement gaps closed in reading, but not mathematics. Reading ability was directly related to gains in mathematics. Analysis of the time-varying covariates showed that there tended to be positive effects of the receipt of English-as-second language instruction on both reading and mathematics achievement, whereas students receiving special education and free and reduced lunch programs consistently had lower academic achievement levels. Implications for the achievement literature are discussed.",0,1 +718,Stochastic Dependencies in Parallel and Serial Models: Effects on Systems Factorial Interactions,"Abstract This paper examines the behavior of stochastically dependent serial and parallel processing models in the setting of a 2 x 2 factorial experiment. Interactions found in factorial experiments can provide insight into the underlying mental architecture operating in a given psychological task. Recent theoretical results classify mental networks according to the types of factorial interaction they predict when selectivity of the factors is assumed. When one allows this selectivity to break down through a stochastic dependence between processes, the characteristic patterns associated with distinct architectures are disturbed. We investigate the relationships among: (a) parallel and serial architectures, (b) positive, negative, and zero dependencies, and (c) types of mean reaction time factorial interaction. In particular, we show that in some cases, observable symptoms of a stochastic dependence arise. One of these, which we term a single factor reversal of mean processing times, arises as a result of a negative dependence under certain circumstances. Another characteristic of dependent systems that may contribute to their identifiability is that the interactions can be subadditive for some levels of the factors and superadditive at other levels. This change in contrast is not possible for independent serial and parallel models with selective influence.",0,1 +719,A stochastic unfolding model derived from the partial credit model,,0,1 +720,An Integrated Bayesian Model for DIF Analysis,"In this article, an integrated bayesian model for differential item functioning (DIF) analysis is proposed. The model is integrated in the sense of modeling the responses along with the DIF analysis. This approach allows DIF detection and explanation in a simultaneous setup. Previous empirical studies and/or subjective beliefs about the item parameters, including differential functioning behavior, may be conveniently expressed in terms of prior distributions. Values of indicator variables are estimated in the model, indicating which items have DIF and which do not; as a result, the data analyst may not be required to specify an “anchor set” of items that do not exhibit DIF a priori to identify the model. It reduces the iterative procedures that are commonly used for proficiency purification and DIF detection and explanation. Examples demonstrate the efficiency of this method in simulated and real situations.",0,1 +721,Indirect effects of fidelity to the family check-up on changes in parenting and early childhood problem behaviors.,"This study examines observations of client in-session engagement and fidelity of implementation to the Family Check-Up (FCU) as they relate to improvements in caregivers' positive behavior support (PBS) and children's problem behavior in the context of a randomized prevention trial. The psychometric properties of fidelity scores obtained with a new rating system are also explored.The FCU feedback sessions of 79 families with children with elevated problem behavior scores at age 2 were coded by trained raters of fidelity, who used an observational coding system developed specifically for this intervention model.Path analysis indicated that fidelity to the FCU results in greater caregiver engagement in the feedback session, which directly predicts improvements in caregivers' PBS 1 year later (β = 0.06, 95% CI [.007, .129]). Similarly, engagement and PBS directly predict reductions in children's problem behavior measured 2 years later (β = -0.24, 95% CI [-.664, -.019]).These results suggest fidelity within the context of this randomized intervention trial. Ratings of fidelity to the FCU covary with observed improvements in parenting and children's problem behavior in early childhood. Overall reliability of the fidelity scores was found to be acceptable, but some single-item reliability estimates were low, suggesting revisions to the rating system might be needed. Accurately assessing fidelity and understanding its relationship to change during intervention studies is an underdeveloped area of research and has revealed some inconsistent findings. Our results shed light on the mixed conclusions of previous studies, suggesting that future research ought to assess the role of intervening variable effects, such as observed engagement.",0,1 +722,Practical propensity score matching: a reply to Smith and Todd,"Abstract This paper discusses propensity score matching in the context of Smith and Todd's (Does matching overcome Lalonde's critique of nonexperimental estimators, J. Econom., in press) reanalysis of Dehejia and Wahba (J. Am. Statist. Assoc. 97 (1999) 1053; National Bereau of Economics Research working Paper No. 6829, Rev. Econom. Statist., 2002, forthcoming). Propensity score methods require that a separate propensity score specification be estimated for each treatment group-comparison group combination. Furthermore, a researcher should always examine the sensitivity of the estimated treatment effect to small changes in the propensity score specification; this is a useful diagnostic on the quality of the comparison group. When these are borne in mind, propensity score methods are useful in analyzing all of the subsamples of the NSW data considered in Smith and Todd (Does matching overcome Lalonde's critique of nonexperimental estimators, J. Econom., in press).",0,1 +723,Multilevel Autoregressive Modeling of Interindividual Differences in the Stability of a Process,"Most psychological phenomena have been studied through the consideration of data gathered at relatively few occasions of measurement over time. However, a current wave of diary-based studies has generated many databases with more intensively collected longitudinal data. The number of occasions can be greater than those gathered in a normal panel study, but less than the very high numbers of occasions typically found in the time-series domain. The same types of questions that could be answered based on a smaller number of occasions could also be proposed for these longer time series. Normally, scientific questions for which longitudinal data have been collected have been the focus with change and stability.",0,1 +724,A Bayesian semiparametric factor analysis model for subtype identification,"Abstract: Disease subtype identification (clustering) is an important problem in biomedical research. Gene expression profiles are commonly utilized to infer disease subtypes, which often lead to biologically meaningful insights into disease. Despite many successes, existing clustering methods may not perform well when genes are highly correlated and many uninformative genes are included for clustering due to the high dimensionality. In this article, we introduce a novel subtype identification method in the Bayesian setting based on gene expression profiles. This method, called BCSub, adopts an innovative semiparametric Bayesian factor analysis model to reduce the dimension of the data to a few factor scores for clustering. Specifically, the factor scores are assumed to follow the Dirichlet process mixture model in order to induce clustering. Through extensive simulation studies, we show that BCSub has improved performance over commonly used clustering methods. When applied to two gene expression datasets, our model is able to identify subtypes that are clinically more relevant than those identified from the existing methods.",0,1 +725,Multilevel models for estimating incremental net benefits in multinational studies,"Multilevel models (MLMs) have been recommended for estimating incremental net benefits (INBs) in multicentre cost-effectiveness analysis (CEA). However, these models have assumed that the INBs are exchangeable and that there is a common variance across all centres. This paper examines the plausibility of these assumptions by comparing various MLMs for estimating the mean INB in a multinational CEA. The results showed that the MLMs that assumed the INBs were exchangeable and had a common variance led to incorrect inferences. The MLMs that included covariates to allow for systematic differences across the centres, and estimated different variances in each centre, made more plausible assumptions, fitted the data better and led to more appropriate inferences. We conclude that the validity of assumptions underlying MLMs used in CEA need to be critically evaluated before reliable conclusions can be drawn. Copyright © 2006 John Wiley & Sons, Ltd.",0,1 +726,The Multilevel Crossed Random Effects Growth Model for Estimating Teacher and School Effects: Issues and Extensions,"This article examines the multilevel linear crossed random effects growth model for estimating teacher and school effects from repeated measurements of student achievement. Results suggest that even a small degree of unmodeled nonlinearity can result in a substantial upward bias in the magnitude of the teacher effect, which raises concerns about its appropriateness for estimating teacher effects. To address this issue, a piecewise linear crossed random effect growth model is proposed. A comparison with the linear growth form shows that the piecewise specification provides more accurate estimates of teacher effects when achievement growth departs from linear growth across grade levels or over summer, which are prevalent conditions. Fitted examples using nationally representative data and Bayesian estimation methods are provided.",0,1 +727,Sample Size and Accuracy of Estimates in Multilevel Models,"In a multilevel framework several researches have investigated the behavior of estimates in finite samples, particularly for continuous dependent variables. Some findings show poor precise estimates for the variance components. On the other hand, discrete response multilevel models have been investigated less widely. In this paper we analyze the influence of different factors on the accuracy of estimates and standard errors of estimates in a binary response 2-level model, through a Monte Carlo simulation study. We investigate the hypothesis of: (a) small sample sizes; (b) different intraclass correlation coefficients; (c) different numbers of quadrature points in the estimation procedure. Standard errors of estimates are studied through a noncoverage indicator. In all instances we have considered, the point estimates are unbiased (even with very small sample sizes), while the variance components are underestimated. The accuracy of the standard errors of variance estimates needs a very large number of groups.",0,1 +728,A Two-Step Bayesian Approach for Propensity Score Analysis: Simulations and Case Study,"A two-step Bayesian propensity score approach is introduced that incorporates prior information in the propensity score equation and outcome equation without the problems associated with simultaneous Bayesian propensity score approaches. The corresponding variance estimators are also provided. The two-step Bayesian propensity score is provided for three methods of implementation: propensity score stratification, weighting, and optimal full matching. Three simulation studies and one case study are presented to elaborate the proposed two-step Bayesian propensity score approach. Results of the simulation studies reveal that greater precision in the propensity score equation yields better recovery of the frequentist-based treatment effect. A slight advantage is shown for the Bayesian approach in small samples. Results also reveal that greater precision around the wrong treatment effect can lead to seriously distorted results. However, greater precision around the correct treatment effect parameter yields quite good results, with slight improvement seen with greater precision in the propensity score equation. A comparison of coverage rates for the conventional frequentist approach and proposed Bayesian approach is also provided. The case study reveals that credible intervals are wider than frequentist confidence intervals when priors are non-informative.",0,1 +729,Analysis of longitudinal data using the hierarchical linear model,"The hierarchical linear model in a linear model with nested random coefficients, fruitfully used for multilevel research. A tutorial is presented on the use of this model for the analysis of longitudinal data, i.e., repeated data on the same subjects. An important advantage of this approach is that differences across subjects in the numbers and spacings of measurement occasions do not present a problem, and that changing covariates can easily be handled. The tutorial approaches the longitudinal data as measurements on populations of (subject-specific) functions.",0,1 +730,What are the advantages of MCMC based inference in latent variable models?,"Recent developments in Markov chain Monte Carlo [MCMC] methods have increased the popularity of Bayesian inference in many fields of research in economics, such as marketing research and financial econometrics. Gibbs sampling in combination with data augmentation allows inference in statistical/econometric models with many unobserved variables. The likelihood functions of these models may contain many integrals, which often makes a standard classical analysis difficult or even unfeasible. The advantage of the Bayesian approach using MCMC is that one only has to consider the likelihood function conditional on the unobserved variables. In many cases this implies that Bayesian parameter estimation is faster than classical maximum likelihood estimation. In this paper we illustrate the computational advantages of Bayesian estimation using MCMC in several popular latent variable models.",0,1 +731,Bayesian Structural Equation Modeling in Sport and Exercise Psychology,"Bayesian statistics is on the rise in mainstream psychology, but applications in sport and exercise psychology research are scarce. In this article, the foundations of Bayesian analysis are introduced, and we will illustrate how to apply Bayesian structural equation modeling in a sport and exercise psychology setting. More specifically, we contrasted a confirmatory factor analysis on the Sport Motivation Scale II estimated with the most commonly used estimator, maximum likelihood, and a Bayesian approach with weakly informative priors for cross-loadings and correlated residuals. The results indicated that the model with Bayesian estimation and weakly informative priors provided a good fit to the data, whereas the model estimated with a maximum likelihood estimator did not produce a well-fitting model. The reasons for this discrepancy between maximum likelihood and Bayesian estimation are discussed as well as potential advantages and caveats with the Bayesian approach.",0,1 +732,Effect of extended cefquinome treatment on clinical persistence or recurrence of environmental clinical mastitis,"The effectiveness of antibiotic treatment of clinical mastitis (CM) is classically evaluated using bacteriological cure, which provides a concise and objective way of assessing efficacy but does not reflect the situation in the field where persistence or recurrence of clinical signs lead to perceived treatment failure. If clinical signs persist or recur, intramammary (IMM) treatment is often extended or supplemented with parenteral therapy in the expectation of a more efficient elimination of clinical signs or a lower probability of recurrence. The objective of this study was to evaluate the efficacy against clinical persistence or recurrence of three cefquinome treatment regimes, standard 1.5-day intramammary (SIMM), 5-day extended intramammary (EIMM) and combination of EIMM plus 5-day extended parenteral (ECOMBO) treatment. The study was conducted on three dairy farms with a high recurrence rate of environmental mastitis. Efficacy was evaluated using a multi-level model at the quarter and at the cow level, based on the persistence or recurrence of clinical signs at any time during a 105-day period following the end of the initial treatment, independent of pathogen. The most prevalent pathogens were E. coli (16.9%) and S. uberis (11.97%). EIMM and ECOMBO significantly decreased the persistence or recurrence of CM by 8% and 6% at the quarter level and by 9% and 8% at the cow level, respectively. ECOMBO may not reduce the persistence or recurrence of CM beyond EIMM. Whilst extended treatment regimens offered an improved outcome in this study, the producer and practitioner need to carefully consider such regimens from the perspective of prudent antibiotic use.",0,1 +733,Assessing Joint Distributions with Isoprobability Contours,"We present a new method for constructing joint probability distributions of continuous random variables using isoprobability contours—sets of points with the same joint cumulative probability. This approach reduces the joint probability assessment into a one-dimensional cumulative probability assessment using a sequence of binary choices between various combinations of the variables of interest. The approach eliminates the need to assess directly the dependence, or association, between the variables. We discuss properties of isoprobability contours and methods for their assessment in practice. We also report results of a study in which subjects assessed the 50th percentile isoprobability contour of the joint distribution of weight and height. We use the data to show how to use the assessed contours to construct the joint distribution and to infer (indirectly) the dependence between the variables.",0,1 +734,Two-Stage Least Squares Estimation of Interaction Effects,"This chapter provides a largely nontechnical description of an alternative technique to include interactions of latent variables in structural equation models. It also provides a generic description of a model with interactions of latent variables with multiple indicators. The chapter presents the two-stage least squares (2SLS) method to model such interactions. It discusses the D. A. Kenny and C. M. Judd and related methods for handling such interactions. If the new measurement equations and nonlinear constraints are included, Kenny and Judd showed that the coefficients for the nonlinear variables could be consistently estimated with generalized least squares estimation. The chapter compares the two techniques with the simulation and empirical data that Kenny and Judd provided in their original paper. It focuses on a 2SLS method to handle interactions of latent variables that have multiple indicators. The chapter concludes with comments and contrasts the alternative methods and their properties.",0,1 +735,Modelling Pathways to Rubisco Degradation: A Structural Equation Network Modelling Approach,"'Omics analysis (transcriptomics, proteomics) quantifies changes in gene/protein expression, providing a snapshot of changes in biochemical pathways over time. Although tools such as modelling that are needed to investigate the relationships between genes/proteins already exist, they are rarely utilised. We consider the potential for using Structural Equation Modelling to investigate protein-protein interactions in a proposed Rubisco protein degradation pathway using previously published data from 2D electrophoresis and mass spectrometry proteome analysis. These informed the development of a prior model that hypothesised a pathway of Rubisco Large Subunit and Small Subunit degradation, producing both primary and secondary degradation products. While some of the putative pathways were confirmed by the modelling approach, the model also demonstrated features that had not been originally hypothesised. We used Bayesian analysis based on Markov Chain Monte Carlo simulation to generate output statistics suggesting that the model had replicated the variation in the observed data due to protein-protein interactions. This study represents an early step in the development of approaches that seek to enable the full utilisation of information regarding the dynamics of biochemical pathways contained within proteomics data. As these approaches gain attention, they will guide the design and conduct of experiments that enable 'Omics modelling to become a common place practice within molecular biology.",0,1 +736,The Influence of Item Calibration Error on Variable-Length Computerized Adaptive Testing,"Variable-length computerized adaptive testing (VL-CAT) allows both items and test length to be “tailored” to examinees, thereby achieving the measurement goal (e.g., scoring precision or classification) with as few items as possible. Several popular test termination rules depend on the standard error of the ability estimate, which in turn depends on the item parameter values. However, items are chosen on the basis of their parameter estimates, and capitalization on chance may occur. In this article, the authors investigated the effects of capitalization on chance on test length and classification accuracy in several VL-CAT simulations. The results confirm that capitalization on chance occurs in VL-CAT and has complex effects on test length, ability estimation, and classification accuracy. These results have important implications for the design and implementation of VL-CATs.",0,1 +737,Evidence for a role of heat shock protein-90 in toll like receptor 4 mediated pain enhancement in rats,"Spinal cord microglial toll-like receptor 4 (TLR4) has been implicated in enhancing neuropathic pain and opposing morphine analgesia. The present study was initiated to explore TLR4-mediated pain modulation by intrathecal lipopolysaccharide, a classic TLR4 agonist. However, our initial study revealed that intrathecal lipopolysaccharide failed to induce low-threshold mechanical allodynia in naive rats, suggestive that TLR4 agonism may be insufficient to enhance pain. These studies explore the possibility that a second signal is required; namely, heat shock protein-90 (HSP90). This candidate was chosen for study given its known importance as a regulator of TLR4 signaling. A combination of in vitro TLR4 cell signaling and in vivo behavioral studies of pain modulation suggest that TLR4-enhancement of neuropathic pain and TLR4-suppression of morphine analgesia each likely require HSP90 as a cofactor for the effects observed. In vitro studies revealed that dimethyl sulfoxide (DMSO) enhances HSP90 release, suggestive that this may be a means by which DMSO enhances TLR4 signaling. While 2 and 100 microg lipopolysaccharide intrathecally did not induce mechanical allodynia across the time course tested, co-administration of 1 microg lipopolysaccharide with a drug that enhances HSP90-mediated TLR4 signaling now induced robust allodynia. In support of this allodynia being mediated via a TLR4/HSP90 pathway, it was prevented or reversed by intrathecal co-administration of a HSP90 inhibitor, a TLR4 inhibitor, a microglia/monocyte activation inhibitor (as monocyte-derived cells are the predominant cell type expressing TLR4), and interleukin-1 receptor antagonist (as this proinflammatory cytokine is a downstream consequence of TLR4 activation). Together, these results suggest for the first time that TLR4 activation is necessary but not sufficient to induce spinally mediated pain enhancement. Rather, the data suggest that TLR4-dependent pain phenomena may require contributions by multiple components of the TLR4 receptor complex.",0,1 +738,Longitudinal Associations Between Reading and Mathematics Achievement,"The association between early reading skills and changes in mathematics was examined in a large, low-income sample to determine whether students who have a greater level of reading skills in early elementary school exhibit more rapid gains in tests of mathematics. The longitudinal associations between third grade reading comprehension and changes in three components of mathematics achievement (Problem Solving and Data Interpretation, Mathematical Concepts and Estimation, Mathematical Computation) from third through eighth grade were examined. Latent growth models were fit to the repeated assessments of each mathematics component and the students' third grade reading and global mathematics scores were included as predictors of the intercept and slope. Gender, poverty status, and ethnicity were included in the models as control variables. The results showed males and African-American students tended to have shallower rates of change than females and non-African-American/non-Hispanic students. In terms of the effect of reading on changes in mathematics, third grade reading comprehension was found to be a positive significant predictor of change for each component of mathematics, suggesting students with a greater level of reading achievement in early elementary school change more rapidly in mathematics skills controlling for prior mathematics skills and student characteristics. The largest effects were shown for the Problem Solving and Data Interpretation test, a test focused on the applications of mathematics knowledge, and the Mathematical Concepts and Estimation test. Negligible effects were found for changes in Mathematical Computation. Thus, early reading comprehension was shown to be related to a conceptual understanding of mathematics and the application of mathematics knowledge. These findings lend support for the notion that early reading skills are important for success in mathematics.",0,1 +739,Markov chain estimation for test theory without an answer key,"This study develops Markov Chain Monte Carlo (MCMC) estimation theory for the General Condorcet Model (GCM), an item response model for dichotomous response data which does not presume the analyst knows the correct answers to the test a priori (answer key). In addition to the answer key, respondent ability, guessing bias, and difficulty parameters are estimated. With respect to data-fit, the study compares between the possible GCM formulations, using MCMC-based methods for model assessment and model selection. Real data applications and a simulation study show that the GCM can accurately reconstruct the answer key from a small number of respondents.",0,1 +740,Design and Analysis of Monte Carlo Experiments: Attacking the Conventional Wisdom,"The design and analysis of Monte Carlo experiments, with special reference to structural equation modelling, is discussed in this article. These topics merit consideration, since the validity of the conclusions drawn from a Monte Carlo study clearly hinges on these features. It is argued that comprehensive Monte Carlo experiments can be implemented on a PC if the experiments are adequately designed. This is especially important when investigating modern computer intensive methodologies like resampling and Markov Chain Monte Carlo methods. We are faced with three fundamental challenges in Monte Carlo experimentation. The first problem is statistical precision, which concerns the reliability of the obtained results. External validity, on the other hand, depends on the number of experimental conditions, and is crucial for the prospects of generalising the results beyond the specific experiment. Finally, we face the constraint on available computer resources. The conventional wisdom in designing and analysing Monte Carlo experiments embodies no explicit specification of meta-model for analysing the output of the experiment, the use of case studies or full factorial designs as experimental plans, no use of variance reduction techniques, a large number of replications, and ""eyeballing"" of the results. A critical examination of the conventional wisdom is presented in this article. We suggest that the following alternative procedures should be considered. First of all, we argue that it is profitable to specify explicit meta-models, relating the chosen performance statistics and experimental conditions. Regarding the experimental plan, we recommend the use of incomplete designs, which will often result in considerable savings. We also consider the use of common random numbers in the simulation phase, since this may enhance the precision in estimating meta-models. The use of fewer replications per trial, enabling us to investigate an increased number of experimental conditions, should also be considered in order to improve the external validity at the cost of the conventionally excessive precision.",0,1 +741,Bayesianly Justifiable and Relevant Frequency Calculations for the Applied Statistician,"A common reaction among applied statisticians is that the Bayesian statistician's energies in an applied problem must be directed at the a priori elicitation of one model specification from which an optimal design and all inferences follow automatically by applying Bayes's theorem to calculate conditional distributions of unknowns given knowns. I feel, however, that the applied Bayesian statistician's tool-kit should be more extensive and include tools that may be usefully labeled frequency calculations. Three types of Bayesianly justifiable and relevant frequency calculations are presented using examples to convey their use for the applied statistician.",0,1 +742,Modeling between-trial variance structure in mixed treatment comparisons,"In mixed treatment comparison (MTC) meta-analysis, modeling the heterogeneity in between-trial variances across studies is a difficult problem because of the constraints on the variances inherited from the MTC structure. Starting from a consistent Bayesian hierarchical model for the mean treatment effects, we represent the variance configuration by a set of triangle inequalities on the standard deviations. We take the separation strategy (Barnard and others, 2000) to specify prior distributions for standard deviations and correlations separately. The covariance matrix of the latent treatment arm effects can be employed as a vehicle to load the triangular constraints, which in addition allows incorporation of prior beliefs about the correlations between treatment effects. The spherical parameterization based on Cholesky decomposition (Pinheiro and Bates, 1996) is used to generate a positive-definite matrix for the prior correlations in Markov chain Monte Carlo (MCMC). Elicited prior information on correlations between treatment arms is introduced in the form of its equivalent data likelihood. The procedure is implemented in a MCMC framework and illustrated with example data sets from medical research practice.",0,1 +743,Doubly Robust Estimation in Missing Data and Causal Inference Models,"The goal of this article is to construct doubly robust (DR) estimators in ignorable missing data and causal inference models. In a missing data model, an estimator is DR if it remains consistent when either (but not necessarily both) a model for the missingness mechanism or a model for the distribution of the complete data is correctly specified. Because with observational data one can never be sure that either a missingness model or a complete data model is correct, perhaps the best that can be hoped for is to find a DR estimator. DR estimators, in contrast to standard likelihood-based or (nonaugmented) inverse probability-weighted estimators, give the analyst two chances, instead of only one, to make a valid inference. In a causal inference model, an estimator is DR if it remains consistent when either a model for the treatment assignment mechanism or a model for the distribution of the counterfactual data is correctly specified. Because with observational data one can never be sure that a model for the treatment assignment mechanism or a model for the counterfactual data is correct, inference based on DR estimators should improve upon previous approaches. Indeed, we present the results of simulation studies which demonstrate that the finite sample performance of DR estimators is as impressive as theory would predict. The proposed method is applied to a cardiovascular clinical trial.",0,1 +744,Testing for robustness in Monte Carlo studies.,"Monte Carlo studies provide the information needed to help researchers select appropriate analytical procedures under design conditions in which the underlying assumptions of the procedures are not met. In Monte Carlo studies, the 2 errors that one could commit involve (a) concluding that a statistical procedure is robust when it is not or (b) concluding that it is not robust when it is. In previous attempts to apply standard statistical design principles to Monte Carlo studies, the less severe of these errors has been wrongly designated the Type I error. In this article, a method is presented for controlling the appropriate Type I error rate; the determination of the number of iterations required in a Monte Carlo study to achieve desired power is described; and a confidence interval for a test's true Type I error rate is derived. A robustness criterion is also proposed that is a compromise between W. G. Cochran's (1952) and J. V. Bradley's (1978) criteria.",0,1 +745,Estimating Multilevel Logistic Regression Models When the Number of Clusters is Low: A Comparison of Different Statistical Software Procedures,"Multilevel logistic regression models are increasingly being used to analyze clustered data in medical, public health, epidemiological, and educational research. Procedures for estimating the parameters of such models are available in many statistical software packages. There is currently little evidence on the minimum number of clusters necessary to reliably fit multilevel regression models. We conducted a Monte Carlo study to compare the performance of different statistical software procedures for estimating multilevel logistic regression models when the number of clusters was low. We examined procedures available in BUGS, HLM, R, SAS, and Stata. We found that there were qualitative differences in the performance of different software procedures for estimating multilevel logistic models when the number of clusters was low. Among the likelihood-based procedures, estimation methods based on adaptive Gauss-Hermite approximations to the likelihood (glmer in R and xtlogit in Stata) or adaptive Gaussian quadrature (Proc NLMIXED in SAS) tended to have superior performance for estimating variance components when the number of clusters was small, compared to software procedures based on penalized quasi-likelihood. However, only Bayesian estimation with BUGS allowed for accurate estimation of variance components when there were fewer than 10 clusters. For all statistical software procedures, estimation of variance components tended to be poor when there were only five subjects per cluster, regardless of the number of clusters.",0,1 +746,Bayesian analysis of latent variable models with non-ignorable missing outcomes from exponential family,"To provide a comprehensive framework for analysing complex non-normal medical and biological data, we propose a Bayesian approach for a non-linear latent variable model with covariates, and non-ignorable missing data, under the exponential family of distributions. The non-ignorable missing mechanism is defined via a logistic regression model. Based on conjugate prior distributions, full conditional distributions for the implementation of Markov chain Monte Carlo methods in simulating observations from the joint posterior distribution are derived. These observations are used in computing the Bayesian estimates, as well as in implementing a path sampling procedure to evaluate the Bayes factor for model comparison. The proposed methods are illustrated using real data from a study on the non-adherence of hypertension patients.",0,1 +747,"The Institutional Context of Tolerance for Ethnic Minorities: A Comparative, Multilevel Analysis of Western Europe","Drawing on recent insights in the nationalism and citizenship regime literatures, this article develops a macrotheoretical framework for understanding cross-national variations in tolerance of ethnic minorities. Specifically, it tests the hypothesis that the degree to which the dominant ethnic tradition or culture is institutionalized in the laws and policies of a nation-state affects citizen tolerance of ethnic minorities. Employing a multilevel regression model, it systematically tests the framework, as well as competing individual and country-level explanations, for all member states of the European Union in 1997. Results confirm a strong relationship between the laws governing the acquisition and expression of citizenship, that is, citizenship regime type, and individual tolerance judgments. Moreover, citizenship regime type has a strong mediating effect on three individual-level variables previously shown to predict tolerance: ingroup national identity, political ideology, and satisfaction with democracy.",0,1 +748,Improving Cognitive Diagnostic Computerized Adaptive Testing by Balancing Attribute Coverage: The Modified Maximum Global Discrimination Index Method,"This article proposes a new item selection method, namely, the modified maximum global discrimination index (MMGDI) method, for cognitive diagnostic computerized adaptive testing (CD-CAT). The new method captures two aspects of the appeal of an item: (a) the amount of contribution it can make toward adequate coverage of every attribute and (b) the amount of contribution it can make toward recovering the latent cognitive profile. A simulation study shows that the new method ensures adequate coverage of every attribute, which improves the validity of the test scores, and defensibility of the proposed uses of the test. Furthermore, compared with the original global discrimination index method, the MMGDI method improves the recovery rate of each attribute and of the entire cognitive profile, especially the latter. Therefore, the new method improves both the validity and reliability of the test scores from a CD-CAT program.",0,1 +749,A typical morning in preschool: Observations of teacher–child interactions in German preschools,"Abstract The study examined the applicability and generalizability of the Classroom Assessment Scoring System Pre-K (CLASS Pre-K; Pianta, La Paro, & Hamre, 2008) and the associated conceptual Teaching through Interaction framework to understand classroom processes in the German early education system. Three broad domains describe effective teacher–child interactions: Emotional Support, Classroom Organization, and Instructional Support. In the present study, we observed teacher–child interactions in 63 classrooms drawn from 26 different preschools using the CLASS Pre-K. Consistent with research from the United States, CLASS Pre-K scores demonstrated that the quality of teacher–child interactions varied widely. Data indicated that the levels of Emotional Support and Classroom Organization were moderate. In contrast, the level of Instructional Support was rather low and even decreased over the course of the morning. Furthermore, Emotional Support was found to decrease over the day in classrooms with a higher child–teacher ratio. Results have important implications for policy and practice with regard to the quality of care and education in German preschools.",0,1 +750,Becoming more specific: Measuring and modeling teachers' perceived usefulness of ICT in the context of teaching and learning,"Studies on teachers' acceptance and use of information and communication technology (ICT) have revealed perceived usefulness to be a crucial determinant for integrating ICT in classrooms. In consequence, the present study focuses on teachers' perceived usefulness of ICT for teaching and learning and is aimed at describing its structure and relations to self-efficacy, ICT use, and teachers' age. By means of Bayesian analysis, we specified confirmatory factor-analytic and structural equation models to a large-scale data set of N?=?1190 Norwegian teachers. Our results supported the hypothesized four-factor structure of teachers' perceived usefulness of ICT, signifying different facets of ICT-related teaching goals in classrooms. Moreover, it was possible to disentangle general and specific components of the construct in nested factor models. In support of existing research, we found positive relations to self-efficacy and ICT use, but a negative relation to teachers' age. Our study provides evidence on a multidimensional conceptualization of teachers' perceived usefulness of ICT for teaching and learning, and verifies the relations to teacher-related characteristics. Implications for the measurement and modeling of the construct, and future research directions are discussed. Teachers' perceived usefulness of ICT for teaching and learning is multifaceted.A general factor and specific factors can be distinguished.Bayesian models with cross-loadings represent the structure of the construct.Perceived usefulness is positively related to self-efficacy and ICT use.Perceived usefulness is negatively related to teachers' age.",0,1 +751,The Impact of Sample Size and Other Factors When Estimating Multilevel Logistic Models,"The design of research studies utilizing binary multilevel models must necessarily incorporate knowledge of multiple factors, including estimation method, variance component size, or number of predictors, in addition to sample sizes. This Monte Carlo study examined the performance of random effect binary outcome multilevel models under varying methods of estimation, level-1 and level-2 sample size, outcome prevalence, variance component sizes, and number of predictors using SAS software. Mean estimates of statistical power were influenced primarily by sample sizes at both levels. In addition, confidence interval coverage and width and the likelihood of nonpositive definite random effect covariance matrices were impacted by variance component size and estimation method. The interactions of these and other factors with various model performance outcomes are explored.",0,1 +752,Accelerating Monte Carlo Markov chain convergence for cumulative-link generalized linear models,"The ordinal probit, univariate or multivariate, is a generalized linear model (GLM) structure that arises frequently in such disparate areas of statistical applications as medicine and econometrics. Despite the straightforwardness of its implementation using the Gibbs sampler, the ordinal probit may present challenges in obtaining satisfactory convergence. We present a multivariate Hastings-within-Gibbs update step for generating latent data and bin boundary parameters jointly, instead of individually from their respective full conditionals. When the latent data are parameters of interest, this algorithm substantially improves Gibbs sampler convergence for large datasets. We also discuss Monte Carlo Markov chain (MCMC) implementation of cumulative logit (proportional odds) and cumulative complementary log-log (proportional hazards) models with latent data. © 1996 Chapman & Hall.",0,1 +753,Bayesian Analysis of Realistically Complex Models,SUMMARY Models with complex structure arise in many social science applications and appear natural candidates for the use of Markov chain Monte Carlo methods for inference. Conditional independence assumptions simplify the model specification and make estimation using Gibbs sampling particularly appropriate. Two examples are discussed: random effects models for repeated ordered categorical data and sensitivity analysis to assumptions concerning the mechanism underlying informative drop-out in a longitudinal study. The use of a program BUGS is demonstrated.,0,1 +754,Measurement of minimum angle of resolution (MAR) in the stereoscopic display using the optotype of stereoscopic stimuli,"In stereoscopic images, the crossing point of the viewing directions of the two eyes determines the perceived depth. Assuming that accommodation is affected by the positions of the crossing point, the effect of crossing point on minimum angle of resolution (MAR) was investigated. For 40 participants, MAR was measured by two-alternative forced choice where Snellen optotype E of up and down directions were used as two kinds of stimuli. As the crossing point of the viewing direction of the left and right eyes moves farther from the sample display, the ability to identify the direction of letter E decreases at the optotype of the same line thickness. The change of MAR shows linear trends with respect to the optical power change that are the reciprocal of the distance from the participant to the crossing points located out of screen and on screen.",0,1 +755,Bayesian longitudinal low-rank regression models for imaging genetic data from longitudinal studies,"To perform a joint analysis of multivariate neuroimaging phenotypes and candidate genetic markers obtained from longitudinal studies, we develop a Bayesian longitudinal low-rank regression (L2R2) model. The L2R2 model integrates three key methodologies: a low-rank matrix for approximating the high-dimensional regression coefficient matrices corresponding to the genetic main effects and their interactions with time, penalized splines for characterizing the overall time effect, and a sparse factor analysis model coupled with random effects for capturing within-subject spatio-temporal correlations of longitudinal phenotypes. Posterior computation proceeds via an efficient Markov chain Monte Carlo algorithm. Simulations show that the L2R2 model outperforms several other competing methods. We apply the L2R2 model to investigate the effect of single nucleotide polymorphisms (SNPs) on the top 10 and top 40 previously reported Alzheimer disease-associated genes. We also identify associations between the interactions of these SNPs with patient age and the tissue volumes of 93 regions of interest from patients' brain images obtained from the Alzheimer's Disease Neuroimaging Initiative.",0,1 +756,Retention of latent segments in regression-based marketing models,"Abstract Product design and marketing mix decisions for segmented markets depend crucially on the correct specification of marketing models used as input to these decisions. With real-world data, the true number of segments in a market is unknown. Current evidence from simulation studies suggests that the accuracy of commonly used criteria for determining the number of segments in a market depends on the usage context, including the type of distribution being used to describe the data, the model specification, and the characteristics of the market. This study investigates via simulation the performance of seven segment retention criteria used with finite mixture regression models for normal data. This is one of the most important analysis contexts in marketing research since regression models are used, for example, in conjoint analysis and market response analysis, yet no previous study in either the marketing or statistics literatures explores the segment retention problem for mixture regression models. The study shows that one criterion, Akaike's Information Criterion (AIC) with a per-parameter penalty factor of 3 (AIC3), is clearly the best criterion to use across a wide variety of model specifications and data configurations, having the highest success rate and producing very low parameter bias. Currently, this criterion is rarely, if ever, used in the marketing literature.",0,1 +757,Analysing repeated measurements data: a practical comparison of methods,"A variety of methods are available for analysing repeated measurements data where the outcome is continuous. However, there is little information on how established methods, such as summary statistics and repeated measures analysis of variance (RMAOV), compare in practice with methods that have become available to applied statisticians more recently, such as marginal models (based on generalized estimating equation methodology) and multilevel models (that is, hierarchical random effects models). The aim of this paper is to exemplify the use of these methods, and directly compare their results by application to a clinical trial data set. The focus is on practical aspects rather than technical issues. The data considered were taken from a clinical trial of treatments for asthma in 240 children, in which a baseline and four post-randomization measurements of outcomes were taken. The simplicity of the method of summary statistics using the post-randomization mean of observations provided a useful initial analysis. However, fixed time effects or treatment-time interactions cannot be included in such an analysis, and choice of appropriate weighting when there is substantial missing data is problematic. RMAOV, marginal models and multilevel models generally provided similar estimates and standard errors for the treatment effects, although in one example with a relatively complex variance structure the marginal model produced less efficient estimates. Two advantages of multilevel models are that they provide direct estimates of variance components which are often of interest in their own right, and that they can be naturally extended to handle multivariate outcomes.",0,1 +758,Walker 256 Tumor-Bearing Rats as a Model to Study Cancer Pain,"An animal model of cancer pain induced by injection of Walker 256 carcinoma cells into the plantar surface of rat hind paw is described. Tumor growth and the occurrence of metastasis were investigated by histopathological analysis. Tumor cell growth was also analyzed plethysmographically by the increase in paw volume. For characterization of pain symptoms, hyperalgesia, allodynia, and spontaneous pain were evaluated 5 to 8 days after cell injection. The volume of the inoculated paw started to increase on day 2 after inoculation, being 40% higher on day 5 after injection. At this time, there was a marked proliferation of tumor cells, with the presence of anaplastic and pleomorphic cells, nucleoli, and atypical mitotic features. On days 7 and 8 after injection, histopathological analysis of popliteal lymph nodes showed the presence of tumor cells. The intraplantar injection of Walker 256 cells caused hyperalgesia at day 5 after cell inoculation. Low-threshold mechanical allodynia was significant 2 days after cell injection, being increased on day 5. In addition, inoculation of tumor cells induced gross behavior, characterized by a significant increase in licking and lifting of the injected paw 5 days after injection. The pain-enhancing effect caused by cell inoculation was partially inhibited by indomethacin on day 2 after cell injection, whereas morphine blocked allodynia on days 2 and 5. These results indicate that intraplantar injection of Walker 256 cells cause pain symptoms characteristic of cancer pain. This experimental model can then be used to investigate new analgesic or anti-tumor drugs.This article presents a new animal model for studying cancer pain and metastasis. This model could help in understanding the mechanisms involved in cancer pain symptoms and may be used for the investigation of new analgesic or anti-tumor drugs.",0,1 +759,A comparison of Bayesian and frequentist model selection methods for factor analysis models.,"We compare the performances of well-known frequentist model fit indices (MFIs) and several Bayesian model selection criteria (MCC) as tools for cross-loading selection in factor analysis under low to moderate sample sizes, cross-loading sizes, and possible violations of distributional assumptions. The Bayesian criteria considered include the Bayes factor (BF), Bayesian Information Criterion (BIC), Deviance Information Criterion (DIC), a Bayesian leave-one-out with Pareto smoothed importance sampling (LOO-PSIS), and a Bayesian variable selection method using the spike-and-slab prior (SSP; Lu, Chow, & Loken, 2016). Simulation results indicate that of the Bayesian measures considered, the BF and the BIC showed the best balance between true positive rates and false positive rates, followed closely by the SSP. The LOO-PSIS and the DIC showed the highest true positive rates among all the measures considered, but with elevated false positive rates. In comparison, likelihood ratio tests (LRTs) are still the preferred frequentist model comparison tool, except for their higher false positive detection rates compared to the BF, BIC and SSP under violations of distributional assumptions. The root mean squared error of approximation (RMSEA) and the Tucker-Lewis index (TLI) at the conventional cut-off of approximate fit impose much more stringent ""penalties"" on model complexity under conditions with low cross-loading size, low sample size, and high model complexity compared with the LRTs and all other Bayesian MCC. Nevertheless, they provided a reasonable alternative to the LRTs in cases where the models cannot be readily constructed as nested within each other. (PsycINFO Database Record",0,1 +760,"Exploring the application of participatory modeling approaches in the Sonora River Basin, Mexico","This study presents the results from evaluation of a hydrologic modeling workshop for 46 water resource decision makers in Hermosillo, Mexico. This region has serious, ongoing water quantity and quality problems. Our goals were to assess participants' perceptions of our workshop and associated hydrologic and water quality models and to learn whether it changed their perceptions of local water resource-related problems, causes, and solutions. We administered on-site pre-and post-workshop surveys to assess any changes and to collect evaluations of the workshop and models. A few about water quality problems changed significantly over the course of the workshop, but most measured perceptions did not. On average, participants rated the workshop highly and believed that the presented models could assist their future decision-making. These results could contribute to future watershed modeling workshop efforts. A participatory watershed modeling workshop in Hermosillo, Mexico was evaluated.Pre and post workshop surveys assessed changes in participants' perceptions.A few perceptions regarding water quality problems changed significantly.Participants believed that the models presented could assist future decision making.",0,1 +761,Bayesian or Non-Bayesian: A Comparison Study of Item Parameter Estimation in the Three-Parameter Logistic Model,"Through a large-scale simulation study, this article compares item parameter estimates obtained by the marginal maximum likelihood estimation (MMLE) and marginal Bayes modal estimation (MBME) procedures in the 3-parameter logistic model. The impact of different prior specifications on the MBME estimates is also investigated using carefully selected prior distributions. The results indicate that, in general, the MBME provides more accurate item parameter estimates than the MMLE procedure. The impact of different priors on the Bayesian estimates is modest when the examinee sample size is not extremely small.",0,1 +762,Prevalence of Mental Illness in Immigrant and Non-Immigrant U.S. Latino Groups,"Although widely reported among Latino populations, contradictory evidence exists regarding the generalizability of the immigrant paradox, i.e., that foreign nativity protects against psychiatric disorders. The authors examined whether this paradox applies to all Latino groups by comparing estimates of lifetime psychiatric disorders among immigrant Latino subjects, U.S-born Latino subjects, and non-Latino white subjects.The authors combined and examined data from the National Latino and Asian American Study and the National Comorbidity Survey Replication, two of the largest nationally representative samples of psychiatric information.In the aggregate, risk of most psychiatric disorders was lower for Latino subjects than for non-Latino white subjects. Consistent with the immigrant paradox, U.S.-born Latino subjects reported higher rates for most psychiatric disorders than Latino immigrants. However, rates varied when data were stratified by nativity and disorder and adjusted for demographic and socioeconomic differences across groups. The immigrant paradox consistently held for Mexican subjects across mood, anxiety, and substance disorders, while it was only evident among Cuban and other Latino subjects for substance disorders. No differences were found in lifetime prevalence rates between migrant and U.S.-born Puerto Rican subjects.Caution should be exercised in generalizing the immigrant paradox to all Latino groups and for all psychiatric disorders. Aggregating Latino subjects into a single group masks significant variability in lifetime risk of psychiatric disorders, with some subgroups, such as Puerto Rican subjects, suffering from psychiatric disorders at rates comparable to non-Latino white subjects. Our findings thus suggest that immigrants benefit from a protective context in their country of origin, possibly inoculating them against risk for substance disorders, particularly if they emigrated to the United States as adults.",0,1 +763,Evaluation of a Bayesian Approach to Estimating Nonlinear Mixed-Effects Mixture Models,"The growth mixture model has become increasingly popular, given the willingness to acknowledge developmental heterogeneity in populations. Typically, linear growth mixture models, based on polynomials or piecewise functions, are used in substantive applications and evaluated quantitatively through simulation. Growth mixture models that follow inherently nonlinear trajectories, referred to as nonlinear mixed-effects mixture models, have received comparatively little attention—likely due to estimation complexity. Previous work on the estimation of these models has involved multistep routines (Kelley, 2008), maximum likelihood estimation (MLE) via the E-M algorithm (Harring, 2005, 2012), Taylor series expansion and MLE within the structural equation modeling framework (Grimm, Ram, & Estabrook, 2010), and MLE by adaptive Gauss–Hermite quadrature (Codd & Cudeck, 2014). This article proposes and evaluates the use of Bayesian estimation with OpenBUGS (Lunn, Spiegelhalter, Thomas, & Best, 2009), a free program, a...",1,1 +764,The Construction of Customized Two-Stage Tests,"In this paper mixed integer linear programming models for customizing two-stage tests are given. Model constraints are imposed with respect to test composition, administration time, inter-item dependencies, and other practical considerations. It is not difficult to modify the models to make them useful in constructing multistage tests.",0,1 +765,"Stochastic Relaxation, Gibbs Distributions, and the Bayesian Restoration of Images","We make an analogy between images and statistical mechanics systems. Pixel gray levels and the presence and orientation of edges are viewed as states of atoms or molecules in a lattice-like physical system. The assignment of an energy function in the physical system determines its Gibbs distribution. Because of the Gibbs distribution, Markov random field (MRF) equivalence, this assignment also determines an MRF image model. The energy function is a more convenient and natural mechanism for embodying picture attributes than are the local characteristics of the MRF. For a range of degradation mechanisms, including blurring, nonlinear deformations, and multiplicative or additive noise, the posterior distribution is an MRF with a structure akin to the image model. By the analogy, the posterior distribution defines another (imaginary) physical system. Gradual temperature reduction in the physical system isolates low energy states (``annealing''), or what is the same thing, the most probable states under the Gibbs distribution. The analogous operation under the posterior distribution yields the maximum a posteriori (MAP) estimate of the image given the degraded observations. The result is a highly parallel ``relaxation'' algorithm for MAP estimation. We establish convergence properties of the algorithm and we experiment with some simple pictures, for which good restorations are obtained at low signal-to-noise ratios.",0,1 +766,Modeling covariance matrices via partial autocorrelations,"We study the role of partial autocorrelations in the reparameterization and parsimonious modeling of a covariance matrix. The work is motivated by and tries to mimic the phenomenal success of the partial autocorrelations function (PACF) in model formulation, removing the positive-definiteness constraint on the autocorrelation function of a stationary time series and in reparameterizing the stationarity-invertibility domain of ARMA models. It turns out that once an order is fixed among the variables of a general random vector, then the above properties continue to hold and follows from establishing a one-to-one correspondence between a correlation matrix and its associated matrix of partial autocorrelations. Connections between the latter and the parameters of the modified Cholesky decomposition of a covariance matrix are discussed. Graphical tools similar to partial correlograms for model formulation and various priors based on the partial autocorrelations are proposed. We develop frequentist/Bayesian procedures for modelling correlation matrices, illustrate them using a real dataset, and explore their properties via simulations.",0,1 +767,Bayesian parametric estimation of stop-signal reaction time distributions.,"The cognitive concept of response inhibition can be measured with the stop-signal paradigm. In this paradigm, participants perform a 2-choice response time (RT) task where, on some of the trials, the primary task is interrupted by a stop signal that prompts participants to withhold their response. The dependent variable of interest is the latency of the unobservable stop response (stop-signal reaction time, or SSRT). Based on the horse race model (Logan & Cowan, 1984), several methods have been developed to estimate SSRTs. None of these approaches allow for the accurate estimation of the entire distribution of SSRTs. Here we introduce a Bayesian parametric approach that addresses this limitation. Our method is based on the assumptions of the horse race model and rests on the concept of censored distributions. We treat response inhibition as a censoring mechanism, where the distribution of RTs on the primary task (go RTs) is censored by the distribution of SSRTs. The method assumes that go RTs and SSRTs are ex-Gaussian distributed and uses Markov chain Monte Carlo sampling to obtain posterior distributions for the model parameters. The method can be applied to individual as well as hierarchical data structures. We present the results of a number of parameter recovery and robustness studies and apply our approach to published data from a stop-signal experiment.",0,1 +768,Integrating episodic memories and prior knowledge at multiple levels of abstraction,"Prior knowledge can have a large influence on recall when the memory for the original event is error prone or incomplete. We investigated the interaction between memory and prior knowledge in a recall task involving natural objects such as fruits and vegetables. We first quantified prior knowledge for the sizes of objects in a norming experiment. We then assessed the influence of prior knowledge in a memory experiment in which we compared the actual size of objects shown during a study phase with the reconstructed size of an object during the test phase. Recall was biased both by the mean size of the specific object studied and by the mean size of all objects in the category. This result suggests that the influence of prior knowledge can come from multiple, hierarchically related levels of representation, such as the object-category and superordinate-category levels.",0,1 +769,Longitudinal dynamic analyses of cognition in the health and retirement study panel,"The purpose of this paper is to highlight some classic issues in the measurement of change and to show how contemporary solutions can be used to deal with some of these issues. Five classic issues will be raised here: (1) Separating individual changes from group differences; (2) options for incomplete longitudinal data over time, (3) options for nonlinear changes over time; (4) measurement invariance in studies of changes over time; and (5) new opportunities for modeling dynamic changes. For each issue we will describe the problem, and then review some contemporary solutions to these problems base on Structural Equation Models (SEM). We will fit these SEM to using existing panel data from the Health & Retirement Study (HRS) cognitive variables. This is not intended as an overly technical treatment, so only a few basic equations are presented, examples will be displayed graphically, and more complete references to the contemporary solutions will be given throughout.",0,1 +770,Self-perceived health status of schizophrenic patients in Spain: analysis of geographic differences,"This report explores the use of regression models for estimating health status of schizophrenic patients from a Bayesian perspective. The aims are: to obtain a set of values of health states of the EQ-5D based on self-assessed health from a sample of schizophrenic patients; and to analyze the differences in the health status and in patients' perceptions of their health status between four mental health districts in Spain. The authors develop two linear models with dummy variables. The first model seeks to obtain an index of the health status of the patients using a visual analog scale as a dependent variable and the different dimensions of EQ-5D as regressors. The second model enables analysis of the differences between the self-assessed health status in the different geographic areas and also the differences between the patients' self-assessed health states, irrespective of their actual health state, in the different geographic areas. The analysis is done using a Bayesian approach with Gibbs sampling (computer program WinBUGS 1.4). Data concerning self-assessed EQ-5D with visual analog scale from four geographic areas of schizophrenic patients were obtained for the purposes of this analysis. The health status index for this sample was obtained and the differences for this index between the four geographic areas were analyzed. The study reveals variables that explain the differences in patients' health status and health state assessment. Four possible scenarios are considered.",0,1 +771,Bayesian model selection for mixtures of structural equation models with an unknown number of components,"This paper considers mixtures of structural equation models with an unknown number of components. A Bayesian model selection approach is developed based on the Bayes factor. A procedure for computing the Bayes factor is developed via path sampling, which has a number of nice features. The key idea is to construct a continuous path linking the competing models; then the Bayes factor can be estimated efficiently via grids in [0, 1] and simulated observations that are generated by the Gibbs sampler from the posterior distribution. Bayesian estimates of the structural parameters, latent variables, as well as other statistics can be produced as by-products. The properties and merits of the proposed procedure are discussed and illustrated by means of a simulation study and a real example.",0,1 +772,An Investigation of the Item Parameter Recovery Characteristics of a Gibbs Sampling Procedure,"The item parameter recovery characteristics of a Gibb's sampling method (Albert, 1992) for IRT item parameter estimation were investigated using a simulation study. The item parameters were estimated, under a normal ogive item response function model, using Gibbs sampling and BILOG (Mislevy & Bock, 1989). The item parameter estimates were then equated to the metric of the underlying item parameters for tests with 10, 20, 30, and 50 items, and samples of 30, 60, 120, and 500 examinees. Summary statistics of the equating coefficients showed that Gibbs sampling and BILOG both produced trait scale metrics with units of measurement that were too small, but yielding a proper midpoint of the metric. When expressed in a common metric, the biases of the BILOG estimates of the item discriminations were uniformly smaller and less variable than those from Gibbs sampling. The biases of the item difficulty estimates yielded by the two estimation procedures were small and similar to each other. In addition, the item parameter recovery characteristics were comparable for the largest dataset of 50 items and 500 examinees. However, for short tests and sample sizes the item parameter recovery characteristics of BILOG were superior to those of the Gibbs sampling approach.",0,1 +773,Observational Studies,,0,1 +774,"A review of two different approaches for the analysis of growth data using longitudinal mixed linear models: Comparing hierarchical linear regression (ML3, HLM) and repeated measures designs with structured covariance matrices (BMDP5V)","Abstract In this paper we review two approaches for the analysis of growth data by means of longitudinal mixed linear models. In these models the individual growth parameters, (most often) specifying polynomial growth curves, may vary randomly across individuals. This variation may in turn be accounted for by explaining variables. The first approach we discuss, is a type of multilevel model in which growth data are treated as having a hierarchical structure: measurements are ‘nested’ within individuals. The second is a version of a MANOVA repeated measures model employing a structured (error)covariance matrix. Of both approaches we examine the underlying statistical models and their interrelations. Apart from this theoretical comparison we review software by which they can be applied for real data analysis: two multilevel programs, ML3 and HLM, and one repeated measures program, BMDP5V. The programs are described and discussed with respect to several more general criteria, such as data setup and handling, implemented numerical routines and user friendliness, and, in particular, with respect to their application in longitudinal situations, i.e. their capabilities for the analysis of data on growth. Two data sets are used to compare the results of analyses performed by the three programs. Although both ways of specifying growth curve models show some shortcomings, each appears to be a fruitful method to handle growth data, theoretically, as well as in a practical sense. For the most part, shortcomings are induced by the accompanying software, developed within different scientific traditions. Applied to comparable problems, the three programs produce equivalent results.",0,1 +775,A note on the sampling properties of the Vincentizing (quantile averaging) procedure,"Abstract To assess the effect of a manipulation on a response time distribution, psychologists often use Vincentizing or quantile averaging to construct group or “average” distributions. We provide a theorem characterizing the large sample properties of the averaged quantiles when the individual RT distributions all belong to the same location-scale family. We then apply the theorem to estimating parameters for the quantile-averaged distributions. From the theorem, it is shown that parameters of the group distribution can be estimated by generalized least squares. This method provides accurate estimates of standard errors of parameters and can therefore be used in formal inference. The method is benchmarked in a small simulation study against both a maximum likelihood method and an ordinary least-squares method. Generalized least squares essentially is the only method based on the averaged quantiles that is both unbiased and provides accurate estimates of parameter standard errors. It is also proved that for location-scale families, performing generalized least squares on quantile averages is formally equivalent to averaging parameter estimates from generalized least squares performed on individuals. A limitation on the method is that individual RT distributions must be members of the same location-scale family.",0,1 +776,Test Design Optimization in CAT Early Stage with the Nominal Response Model,"The early stage of computerized adaptive testing (CAT) refers to the phase of the trait estimation during the administration of only a few items. This phase can be characterized by bias and instability of estimation. In this study, an item selection criterion is introduced in an attempt to lessen this instability: the D-optimality criterion. A polytomous unconstrained CAT simulation is carried out to evaluate this criterion's performance under different test premises. The simulation shows that the extent of early stage instability depends primarily on the quality of the item pool information and its size and secondarily on the item selection criteria. The efficiency of the D-optimality criterion is similar to the efficiency of other known item selection criteria. Yet, it often yields estimates that, at the beginning of CAT, display a more robust performance against instability.",0,1 +777,Predictive distributions were developed for the extent of heterogeneity in meta-analyses of continuous outcome data,"Estimation of between-study heterogeneity is problematic in small meta-analyses. Bayesian meta-analysis is beneficial because it allows incorporation of external evidence on heterogeneity. To facilitate this, we provide empirical evidence on the likely heterogeneity between studies in meta-analyses relating to specific research settings.Our analyses included 6,492 continuous-outcome meta-analyses within the Cochrane Database of Systematic Reviews. We investigated the influence of meta-analysis settings on heterogeneity by modeling study data from all meta-analyses on the standardized mean difference scale. Meta-analysis setting was described according to outcome type, intervention comparison type, and medical area. Predictive distributions for between-study variance expected in future meta-analyses were obtained, which can be used directly as informative priors.Among outcome types, heterogeneity was found to be lowest in meta-analyses of obstetric outcomes. Among intervention comparison types, heterogeneity was lowest in meta-analyses comparing two pharmacologic interventions. Predictive distributions are reported for different settings. In two example meta-analyses, incorporating external evidence led to a more precise heterogeneity estimate.Heterogeneity was influenced by meta-analysis characteristics. Informative priors for between-study variance were derived for each specific setting. Our analyses thus assist the incorporation of realistic prior information into meta-analyses including few studies.",0,1 +778,Variational methods for fitting complex Bayesian mixed effects models to health data,"We consider approximate inference methods for Bayesian inference to longitudinal and multilevel data within the context of health science studies. The complexity of these grouped data often necessitates the use of sophisticated statistical models. However, the large size of these data can pose significant challenges for model fitting in terms of computational speed and memory storage. Our methodology is motivated by a study that examines trends in cesarean section rates in the largest state of Australia, New South Wales, between 1994 and 2010. We propose a group-specific curve model that encapsulates the complex nonlinear features of the overall and hospital-specific trends in cesarean section rates while taking into account hospital variability over time. We use penalized spline-based smooth functions that represent trends and implement a fully mean field variational Bayes approach to model fitting. Our mean field variational Bayes algorithms allow a fast (up to the order of thousands) and streamlined analytical approximate inference for complex mixed effects models, with minor degradation in accuracy compared with the standard Markov chain Monte Carlo methods.",0,1 +779,Evaluating Group-Based Interventions When Control Participants Are Ungrouped,"Individually randomized treatments are often administered within a group setting. As a consequence, outcomes for treated individuals may be correlated due to provider effects, common experiences within the group, and/or informal processes of socialization. In contrast, it is often reasonable to regard outcomes for control participants as independent, given that these individuals are not placed into groups. Although this kind of design is common in intervention research, the statistical models applied to evaluate the treatment effects are usually inconsistent with the resulting data structure, potentially leading to biased inferences. This article presents an alternative model that explicitly accounts for the fact that only treated participants are grouped. In addition to providing a useful test of the overall treatment effect, this approach also permits one to formally determine the extent to which treatment effects vary over treatment groups and whether there is evidence that individuals within treatment groups become similar to one another. This strategy is demonstrated with data from the Reconnecting Youth program for high school students at risk of school failure and behavioral disorders.",0,1 +780,Latent Growth Mixture Models to estimate PTSD trajectories,"No abstract available. (Published: 2 March 2015) Citation: European Journal of Psychotraumatology 2015, 6 : 27503 - http://dx.doi.org/10.3402/ejpt.v6.27503 This paper is part of the Special Issue: Estimating PTSD trajectories . More papers from this issue can be found at http://www.ejpt.net",0,1 +781,A proposed method of bias adjustment for meta-analyses of published observational studies,"Interpretation of meta-analyses of published observational studies is problematic because of numerous sources of bias. We develop bias assessment, elicitation and adjustment methods, and apply them to a systematic review of longitudinal observational studies of the relationship between objectively measured physical activity and subsequent change in adiposity in children.We separated internal biases that reflect study quality from external biases that reflect generalizability to a target setting. Since published results were presented in different formats, these were all converted to correlation coefficients. Biases were considered as additive or proportional on the correlation scale. Opinions about the extent of each bias in each study, together with its uncertainty, were elicited in a formal process from quantitatively trained assessors for the internal biases and subject-matter specialists for the external biases. Bias-adjusted results for each study were combined across assessors using median pooling, and results combined across studies by random-effects meta-analysis.Before adjusting for bias, the pooled correlation is difficult to interpret because the studies varied substantially in quality and design, and there was considerable heterogeneity. After adjusting for both the internal and external biases, the pooled correlation provides a meaningful quantitative summary of all available evidence, and the confidence interval incorporates the elicited uncertainties about the extent of the biases. In the adjusted meta-analysis, there was no apparent heterogeneity.This approach provides a viable method of bias adjustment for meta-analyses of observational studies, allowing the quantitative synthesis of evidence from otherwise incompatible studies. From the meta-analysis of longitudinal observational studies, we conclude that there is no evidence that physical activity is associated with gain in body fat.",0,1 +782,Statistical properties of forced-choice psychometric functions: Implications of probit analysis,"Probit analysis was applied to the problem of threshold estimation from psychometric functions derived from the two-alternative forced-choice (2AFC) method of constant stimuli. Threshold estimates from 2AFC experiments are surprisingly poor: They are about twice as variable as corresponding estimates based on the traditional yes-no method of constant stimuli, and their asymmetrical confidence limits are not readily predicted from conventional standard error formulas. All of these faults are exacerbated in small samples. Computer simulations demonstrated that, for small samples, the probit analysis equations do not give a valid estimate of threshold variability. The variability of staircase estimates of threshold cannot be less than the variability of threshold estimates derived from the method of constant stimuli given an optimum placement of trials. Hence our findings also define the minimum variability of all staircase estimators under the assumptions of probit analysis.",0,1 +783,Item Selection in Multidimensional Computerized Adaptive Testing—Gaining Information from Different Angles,"Over the past thirty years, obtaining diagnostic information from examinees' item responses has become an increasingly important feature of educational and psychological testing. The objective can be achieved by sequentially selecting multidimensional items to fit the class of latent traits being assessed, and therefore Multidimensional Computerized Adaptive Testing (MCAT) is one reasonable approach to such task. This study conducts a rigorous investigation on the relationships among four promising item selection methods: D-optimality, KL information index, continuous entropy, and mutual information. Some theoretical connections among the methods are demonstrated to show how information about the unknown vector θ can be gained from different perspectives. Two simulation studies were carried out to compare the performance of the four methods. The simulation results showed that mutual information not only improved the overall estimation accuracy but also yielded the smallest conditional mean squared error in most region of θ. In the end, the overlap rates were calculated to empirically show the similarity and difference among the four methods. © 2011 The Psychometric Society.",0,1 +784,Investigation of a Nonparametric Procedure for Assessing Goodness-of-Fit in Item Response Theory,"Tests of model misfit are often performed to validate the use of a particular model in item response theory. Douglas and Cohen (2001) introduced a general nonparametric approach for detecting misfit under the two-parameter logistic model. However, the statistical properties of their approach, and empirical comparisons to other methods, have not been examined. In the present study, a Monte Carlo simulation study was used to examine the empirical Type I error rates and power of two nonparametric statistics based on the Douglas and Cohen (2001) approach. The procedures are compared to two commonly used goodness-of-fit statistics, S-X 2 (Orlando & Thissen, 2000) and BILOG's G 2 (Mislevy & Bock, 1990), across conditions varied by test length, sample size, and the percentage of misfitting items. Overall, the nonparametrically based statistics controlled the Type I error rate and exhibited the most power across all conditions. Due to its close association with a graphical representation of the item response func...",0,1 +785,A Conceptual Framework for Measuring E-fulfillment Dimensions: A Consumer Perspective,"The purpose of this study is to propose a conceptual framework for measuring the key dimensions of the e-fulfillment process and its relationship with online shopping satisfaction in pure e-tailing. The key dimensions relevant to the e-fulfillment process are explored in the literature during the first part of the study. These dimensions are categorized into three distinct processes of e-fulfillment: order procurement, order fulfillment, and product returns. In the second part of the study, the authors propose a conceptual framework and develop hypotheses to understand the relationship between the key dimensions of the e-fulfillment process, including e-business quality, product quality, availability, timeliness, condition, billing accuracy, ease of return, and online shopping satisfaction. Furthermore, the constructs in the proposed framework were empirically tested. This study will help e-tailers, academicians, and practitioners understand the consumers’ expectations regarding the key dimensions of the ...",0,1 +786,Multicollinearity and Measurement Error in Structural Equation Models: Implications for Theory Testing,"The literature on structural equation models is unclear on whether and when multicollinearity may pose problems in theory testing (Type II errors). Two Monte Carlo simulation experiments show that multicollinearity can cause problems under certain conditions, specifically: (1) when multicollinearity is extreme, Type II error rates are generally unacceptably high (over 80%), (2) when multicollinearity is between 0.6 and 0.8, Type II error rates can be substantial (greater than 50% and frequently above 80%) if composite reliability is weak, explained variance (R 2 ) is low, and sample size is relatively small. However, as reliability improves (0.80 or higher), explained variance R 2 reaches 0.75, and sample becomes relatively large, Type II error rates become negligible. (3) When multicollinearity is between 0.4 and 0.5, Type II error rates tend to be quite small, except when reliability is weak, R 2 is low, and sample size is small, in which case error rates can still be high (greater than 50%). Methods for detecting and correcting multicollinearity are briefly discussed. However, since multicollinearity is difficult to manage after the fact, researchers should avoid problems by carefully managing the factors known to mitigate multicollinearity problems (particularly measurement error).",0,1 +787,Efficacy of Vitamin D Supplementation in Depression in Adults: A Systematic Review,"Randomized controlled trials (RCTs) investigating the efficacy of vitamin D (Vit D) in depression provided inconsistent results.We aim to summarize the evidence of RCTs to assess the efficacy of oral Vit D supplementation in depression compared to placebo.We searched electronic databases, two conference proceedings, and gray literature by contacting authors of included studies.We selected parallel RCTs investigating the effect of oral Vit D supplementation compared with placebo on depression in adults at risk of depression, with depression symptoms or a primary diagnosis of depression.Two reviewers independently extracted data from relevant literature.Classical and Bayesian random-effects meta-analyses were used to pool relative risk, odds ratio, and standardized mean difference. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool.Six RCTs were identified with 1203 participants (72% females) including 71 depressed patients; five of the studies involved adults at risk of depression, and one trial used depressed patients. Results of the classical meta-analysis showed no significant effect of Vit D supplementation on postintervention depression scores (standardized mean difference = -0.14, 95% confidence interval = -0.41 to 0.13, P = .32; odds ratio = 0.93, 95% confidence interval = 0.54 to 1.59, P = .79). The quality of evidence was low. No significant differences were demonstrated in subgroup or sensitivity analyses. Similar results were found when Bayesian meta-analyses were applied.There is insufficient evidence to support the efficacy of Vit D supplementation in depression symptoms, and more RCTs using depressed patients are warranted.",0,1 +788,Full maximum likelihood analysis of structural equation models with polytomous variables,Abstract This paper is concerned with the analysis of structural equation models with polytomous variables. Identification conditions for the basic model are discussed. Theory for the full simultaneous maximum likelihood estimation of the thresholds and the covariance structure parameters is developed. An example is presented to illustrate the method.,0,1 +789,A Hierarchical Bayesian Model With Correlated Residuals for Investigating Stability and Change in Intensive Longitudinal Data Settings,"The present paper’s focus is the modeling of interindividual and intraindividual variability in longitudinal data. We propose a hierarchical Bayesian model with correlated residuals, employing an autoregressive parameter AR(1) for focusing on intraindividual variability. The hierarchical model possesses four individual random effects: intercept, slope, variability, and autocorrelation. The performance of the proposed Bayesian estimation is investigated in simulated longitudinal data with three different sample sizes (N = 100, 200, 500) and three different numbers of measurement points (T = 10, 20, 40). The initial simulation values are selected according to the results of the first 20 measurement occasions from a longitudinal study on working memory capacity in 9th graders. Within this simulation study, we investigate the root mean square error (RMSE), bias, relative percentage bias, and the 90% coverage probability of parameter estimates. Results indicate that more accurate estimates are associated with a larger sample size. One exception to this tendency is the autocorrelation parameter, which shows more sensitivity to an increasing number of time points.",0,1 +790,Bayesian Statistical Modelling,"Bayesian methods combine the evidence from the data at hand with previous quantitative knowledge to analyse practical problems in a wide range of areas. The calculations were previously complex, but it is now possible to routinely apply Bayesian methods due to advances in computing technology and the use of new sampling methods for estimating parameters. Such developments together with the availability of freeware such as WINBUGS and R have facilitated a rapid growth in the use of Bayesian methods, allowing their application in many scientific disciplines, including applied statistics, public health research, medical science, the social sciences and economics. Following the success of the first edition, this reworked and updated book provides an accessible approach to Bayesian computing and analysis, with an emphasis on the principles of prior selection, identification and the interpretation of real data sets. The second edition: Provides an integrated presentation of theory, examples, applications and computer algorithms. Discusses the role of Markov Chain Monte Carlo methods in computing and estimation. Includes a wide range of interdisciplinary applications, and a large selection of worked examples from the health and social sciences. Features a comprehensive range of methodologies and modelling techniques, and examines model fitting in practice using Bayesian principles. Provides exercises designed to help reinforce the reader's knowledge and a supplementary website containing data sets and relevant programs. Bayesian Statistical Modelling is ideal for researchers in applied statistics, medical science, public health and the social sciences, who will benefit greatly from the examples and applications featured. The book will also appeal to graduate students of applied statistics, data analysis and Bayesian methods, and will provide a great source of reference for both researchers and students. Praise for the First Edition: ""It is a remarkable achievement to have carried out such a range of analysis on such a range of data sets. I found this book comprehensive and stimulating, and was thoroughly impressed with both the depth and the range of the discussions it contains."" - ISI - Short Book Reviews. ""This is an excellent introductory book on Bayesian modelling techniques and data analysis"" - Biometrics. ""The book fills an important niche in the statistical literature and should be a very valuable resource for students and professionals who are utilizing Bayesian methods."" - Journal of Mathematical Psychology. © 2006 John Wiley & Sons Ltd. All Rights Reserved.",0,1 +791,Constructing personality scales under the assumptions of an ideal point response process: Toward increasing the flexibility of personality measures.,"The main aim of this article is to explicate why a transition to ideal point methods of scale construction is needed to advance the field of personality assessment. The study empirically demonstrated the substantive benefits of ideal point methodology as compared with the dominance framework underlying traditional methods of scale construction. Specifically, using a large, heterogeneous pool of order items, the authors constructed scales using traditional classical test theory, dominance item response theory (IRT), and ideal point IRT methods. The merits of each method were examined in terms of item pool utilization, model-data fit, measurement precision, and construct and criterion-related validity. Results show that adoption of the ideal point approach provided a more flexible platform for creating future personality measures, and this transition did not adversely affect the validity of personality test scores.",0,1 +792,"Education, Mental Health, and Education-Labor Market Misfit","Higher-educated people experience enhanced mental health. We ponder whether the mental health benefits of educational attainment are limitless. At the individual level, we look at the impact of job-education mismatch. At the societal level, we hypothesize that diminishing economic returns on education limit its mental health benefits. Using a subsample of individuals aged 20 to 65 years (N = 28,288) from 21 countries in the European Social Survey (ESS 2006), we estimate the impact on depressive symptoms of characteristics at both the employee level (years of education and job-education mismatch) and the labor market/country level (the gap between the nontertiary and tertiary educated in terms of unemployment risks and earnings). The results show that educational attainment produces mental health benefits in most European countries. However, in some of the countries, these benefits are limited or even completely eliminated by education-labor market misfit.",0,1 +793,Bayesian Analysis for the Poly-Weibull Distribution,"Abstract In this article Bayesian analysis for a Poly-Weibull distribution using informative priors is discussed. This distribution typically arises when the data is the minimum of several Weibull failure times from competing risks. To perform the Bayesian computations, simulation using the Gibbs sampler is suggested. This can be used to find posterior moments, the marginal posterior probability density function, and the predictive risk or reliability.",0,1 +794,Multicollinearity in Regression Analysis: The Problem Revisited,"T O MOST economists, the single equation least-squares regression model, like an old friend, is tried and true. Its properties and limitations have been extensively studied and documented and are, for the most part, wellknown. Any good text in econometrics can lay out the assumptions on which common versions of the model are based and provide a reasonably coherent perhaps even a lucid discussion of problems that arise as particular assumptions are violated. A short bibliography of definitive papers on such classical problems as non-normality, heteroscedasticity, serial correlation, feedback, etc., completes the job. As with most old friends, however, the longer one knows least squares, the more one learns about it. An admiration for its robustness under departures from many assumptions is sure to grow. The admiration must be tempered, however, by an appreciation of the model's sensitivity to certain other conditions. The requirement that explanatory variables be truly independent of one another is one of these. Proper of the model's classical problems ordinarily involves two separate stages: detection and correction. The DurbinWatson test for serial correlation, combined with Cochrane and Orcutt's suggested first differencing procedure, is an obvious example.' Bartlett's test for variance heterogeneity followed by a data transformation to restore homoscedasticity is another.2 No such treatment has been developed, however, for problems that arise as multicollinearity is encountered in regression analysis. Attention will focus here on what we consider to be the first step in a proper of the multicollinearity problem its detection, or diagnosis. Economists are coming more and more to agree that the second step, correction, requires the generation of additional information.3 Just how this information is to be obtained depends largely on the tastes of an investigator and on the specifics of a particular problem. It may involve additional primary data collection, the use of extraneous parameter estimates from secondary data sources, or the application of subjective information through constrained regression, or through Bayesian estimation procedures. Whatever its source, however, selectivity and thereby efficiency in generating the added information requires a systematic procedure for detecting its need i.e., for detecting the existence, measuring the extent, and pinpointing the location and causes of multicollinearity within a set of independent variables. Measures are proposed here that, in our opinion, fill this need. The paper's basic organization can be outlined briefly as follows. In the next section the multicollinearity problem's basic, formal nature is developed and illustrated. A discussion of historical approaches to the problem follows. With this as background, an attempt is made to define multicollinearity in terms of departures from a hypothesized statistical condition, and * The authors are Associate Professor of Finance at the Sloan School of Management, M.I.T., and Assistant Professor of Business Administration at the Harvard Business School, respectively. We are indebted to Professor John R. Meyer for introducing us to the multicollinearity problem and for advice and encouragement during the present effort to place it in perspective, and to Professors John Lintner and Robert Schlaifer for their comments and criticisms. Responsibility for specific interpretations, especially erroneous ones, remains our own. This research was supported by the Institute of Naval Studies, of which both authors were members at the time the work was conducted, and by grants from the Ford Foundation to both the Sloan School of Management and the Harvard Business School. Computation time and facilities were provided by the Computation Centers of Harvard and M.I.T. 1J Durbin and G. S. Watson, Testing for Serial Correlation in Least Squares Regression, Biometrika, 37-38, (1950-1951); and C. Cochrane and G. H. Orcutt, Application of Least Squares Regression to Relationships Containing Autocorrelated Error Terms Journal of the American Statistical Association, 44 (1949). 2F. David and J. Neyman, Extension of the Markoff Theorem on Least Squares, Statistical Research Memoirs, II (London, 1938). 'J. Johnston, Econometric Methods (McGraw-Hill, 1963), 207; J. Meyer and R. Glauber, Investment Decisions, Economic Forecasting, and Public Policy (Division of Research, Graduate School of Business Administration, Harvard University, 1964), 181 ff.",0,1 +795,The function of the vibrissae in the behavior of the white rat,,0,1 +796,"Psychometric Methods in Marketing Research: Part I, Conjoint Analysis",,0,1 +797,Beyond multilevel regression modeling: Multilevel analysis in a general latent variable framework.,"The outline of the chapter is as follows. Section 2.2 discusses two extensions of two-level regression analysis, Section 2.3 discusses two-level path analysis and structural equation modeling, Section 2.4 presents an example of two-level exploratory factor analysis (EFA), Section 2.5 discusses two-level growth modeling using a two-part model, Section 2.6 discusses an unconventional approach to three-level growth modeling, and Section 2.7 presents an example of multilevel growth mixture modeling.",0,1 +798,Small Sample Estimation in Dichotomous Item Response Models: Effect of Priors Based on Judgmental Information on the Accuracy of Item Parameter Estimates,"Large item banks with properly calibrated test items are essential for ensuring the validity of computer-based tests. At the same time, item calibrations with small samples are desirable to minimize the amount of pretesting and limit item exposure. Bayesian estimation procedures show considerable promise with small examinee samples. The purposes of the study were (a) to examine how prior information for Bayesian item parameter estimation can be specified and (b) to investigate the relationship between sample size and the specification of prior information on the accuracy of item parameter estimates. The results of the simulation study were clear: Estimation of IRT model item parameters can be improved considerably. Improvements in the one-parameter model were modest; considerable improvements with the two- and three-parameter models were observed. Both the study of different forms of priors and ways to improve the judgmental data used in forming the priors appear to be promising directions for future research.",0,1 +799,Capturing consumer heterogeneity in metric conjoint analysis using Bayesian mixture models,"Abstract We address unobserved preference heterogeneity within an omitted variable framework which provides a theoretical rationale for more continuous preference distributions, multivariate normal in the limit. A comparison of the random coefficients model (RCM) and the latent class model (LCM) using simulated data illustrates that the RCM dominates the LCM if the underlying distribution is strictly continuous. The LCM dominates the RCM if the underlying distribution is strictly discrete once the sample is informative enough to support the true number of classes. The simulation further documents that the optimal number of classes in an LCM is an unrestricted function of the sample size if the underlying distribution is continuous. Finally, we present an application to the mineral water market, where a finite mixture with random effects model with two components performs best. All models are estimated fully Bayesian, and model comparisons are based on model likelihoods and analyses of holdout data.",0,1 +800,On the performance of multiple imputation for multivariate data with small sample size,,0,1 +801,Restrictive Stochastic Item Selection Methods in Cognitive Diagnostic Computerized Adaptive Testing,"This paper proposes two new item selection methods for cognitive diagnostic computerized adaptive testing: the restrictive progressive method and the restrictive threshold method. They are built upon the posterior weighted Kullback-Leibler (KL) information index but include additional stochastic components either in the item selection index or in the item selection procedure. Simulation studies show that both methods are successful at simultaneously suppressing overexposed items and increasing the usage of underexposed items. Compared to item selection based upon (1) pure KL information and (2) the Sympson-Hetter method, the two new methods strike a better balance between item exposure control and measurement accuracy. The two new methods are also compared with Barrada et al.'s (2008) progressive method and proportional method.",0,1 +802,New Participatory Dimensions in Civil Society,"1. Introduction: Democracy, Professionalization and Participation Jan W. van Deth and William A. Maloney Part 1: Professionalization and Democratic Politics 2. How to Domesticate Civil Society by Public-Private Partnerships: Evidence from German Local Health Policy Matthias Freise 3. Entrepreneurial Participation in International Local Politics: The Case of Marseille, European Capital of Culture for 2013 Nicolas Maisetti 4. New Issues, New Forms of Action? Climate Change and Environmental Activism in Britain Christopher Rootes 5. The Professionalization of EU's Civil Society: A Conceptual Framework Sabine Saurugger 6. The Democratic Contribution of Professionalized Representation William A. Maloney 7. Professionalized Supply-Side Mobilization: Are Financial Contributors 'Meaningful Participants'? Grant Jordan Part 2: Changing Democratic Engagement 8. New Modes of Participation and Norms of Citizenship Jan W. van Deth 9. A Remedy for Unequal Participation? How Welfare States Impact on Social and Political Engagement Isabelle Stadelmann-Steffen 10. Peripheral Participants: The Activation of the Politically Less Engaged in Advanced Democracies Eline A. de Rooij 11. Surrogates for the Underrepresented? Ideology and Participatory Inequality in Personal and Professional Political Action Tom W.G. van der Meer 12. The Stability of Individualized Collective Action: Results of a Panel Study among Belgian Late Adolescents Ellen Quintelier and Marc Hooghe 13. Youth Participation from the Top-Down: The Perspectives of Government and Community Sector Decision-Makers in Australia Ariadne Vromen 14. Conclusions: How Democratic is Professionalized and Individualized Political Action? Jan W. van Deth and William A. Maloney",0,1 +803,Incorporating randomness in the Fisher information for improving item-exposure control in CATs,"The most commonly employed item selection rule in a computerized adaptive test (CAT) is that of selecting the item with the maximum Fisher information for the estimated trait level. This means a highly unbalanced distribution of item-exposure rates, a high overlap rate among examinees and, for item bank management, strong pressure to replace items with a high discrimination parameter in the bank. An alternative for mitigating these problems involves, at the beginning of the test, basing item selection mainly on randomness. As the test progresses, the weight of information in the selection increases. In the present work we study, for two selection rules, the progressive methods (Revuelta & Ponsoda, 1998) and the proportional method (Segall, 2004a), different functions that define the weight of the random component according to the position in the test of the item to be administered. The functions were tested in simulated item banks and in an operative bank. We found that both the progressive and the proportional methods tolerate a high weight of the random component with minimal or zero loss of accuracy, while bank security and maintenance are improved.",0,1 +804,To thine own self be true: Psychological adjustment promotes judgeability via personality–behavior congruence.,"Well-adjusted individuals are highly judgeable in that their personalities tend to be seen more accurately than the personalities of less adjusted individuals (Colvin, 1993a, 1993b; Human & Biesanz, 2011a). The mechanisms behind this effect, however, are not well understood. How does adjustment facilitate judgeability? In the present video-perceptions study, we examined potential mechanisms through which adjustment could promote judgeability at 3 stages of the Realistic Accuracy Model (RAM; Funder, 1995): (a) cue relevance, (b) cue availability, and (c) cue detection. We found that well-adjusted individuals were more judgeable because they provided more relevant cues: Specifically, well-adjusted individuals behaved more in line with their distinctive personalities, which in turn led them to be seen more accurately. In contrast, neither cue availability nor detection could sufficiently account for the link between adjustment and judgeability. In sum, well-adjusted individuals are more judgeable because to their own selves, they are true.",0,1 +805,Heuristic Approach to the Kolmogorov-Smirnov Theorems,"Asymptotic theorems on the difference between the (empirical) distribution function calculated from a sample and the true distribution function governing the sampling process are well known. Simple proofs of an elementary nature have been obtained for the basic theorems of Komogorov and Smirnov by Feller, but even these proofs conceal to some extent, in their emphasis on elementary methodology, the naturalness of the results (qualitatively at least), and their mutual relations. Feller suggested that the author publish his own approach (which had also been used by Kac), which does not have these disadvantages, although rather deep analysis would be necessary for its rigorous justification. The approach is therefore presented (at one critical point) as heuristic reasoning which leads to results in investigations of this kind, even though the easiest proofs may use entirely different methods. No calculations are required to obtain the qualitative results, that is the existence of limiting distributions for large samples of various measures of the discrepancy between empirical and true distribution functions. The numerical evaluation of these limiting distributions requires certain results concerning the Brownian movement stochastic process and its relation to other Gaussian processes which will be derived in the Appendix.",0,1 +806,An analysis of latency and interresponse time in free recall,"In four experiments, subjects freely recalled previously studied items while a voice key and computer recorded each item’s recall latency relative to the onset of the recall period. The measures of recall probability and mean recall latency were shown to be empirically independent, demonstrating that there exists no a priori relationship between the two. In all four experiments, latency distributions were fit well by the ex-Gaussian, suggesting that retrieval includes a brief normally distributed initiation stage followed by a longer exponentially distributed search stage. Further, the variation in mean latency stemmed from the variation in the duration of the search stage, not the initiation stage. Interresponse times (IRTs), the time elapsed between two successive item recalls, were analyzed as well. The growth of mean IRTs, plotted as a function of output position, was shown to be a simple function of the number of items not yet recalled. Finally, the mathematical nature of both free recall latency and IRT growth are shown to be consistent with a simple theoretical account of retrieval that depicts mean recall latency as a measure of the breadth of search.",0,1 +807,Bayesian parsimonious covariance estimation for hierarchical linear mixed models,"We consider a non-centered parameterization of the standard random-effects model, which is based on the Cholesky decomposition of the variance-covariance matrix. The regression type structure of the non-centered parameterization allows us to use Bayesian variable selection methods for covariance selection. We search for a parsimonious variance-covariance matrix by identifying the non-zero elements of the Cholesky factors. With this method we are able to learn from the data for each effect whether it is random or not, and whether covariances among random effects are zero. An application in marketing shows a substantial reduction of the number of free elements in the variance-covariance matrix.",0,1 +808,"Context, learning, and extinction.","A. Redish et al. (2007) proposed a reinforcement learning model of context-dependent learning and extinction in conditioning experiments, using the idea of ""state classification"" to categorize new observations into states. In the current article, the authors propose an interpretation of this idea in terms of normative statistical inference. They focus on renewal and latent inhibition, 2 conditioning paradigms in which contextual manipulations have been studied extensively, and show that online Bayesian inference within a model that assumes an unbounded number of latent causes can characterize a diverse set of behavioral results from such manipulations, some of which pose problems for the model of Redish et al. Moreover, in both paradigms, context dependence is absent in younger animals, or if hippocampal lesions are made prior to training. The authors suggest an explanation in terms of a restricted capacity to infer new causes.",0,1 +809,JAGS: A program for analysis of Bayesian graphical models using Gibbs sampling,"JAGS is a program for Bayesian Graphical modelling which aims for compatibility with Classic BUGS. The program could eventually be developed as an R package. This article explains the motivations for this program, briefly describes the architecture and then discusses some ideas for a vectorized form of the BUGS language.",0,1 +810,Implementation and performance issues in the Bayesian and likelihood fitting of multilevel models,"Computational Statistics, September 2000, Volume 15, Issue 3, pp 391-420",1,1 +811,Marginal Likelihood for a Class of Bayesian Generalized Linear Models,"The Bayes factor has become an important tool for model selection. The marginal likelihoods are also important because they can be used to rank the models. In fact, the Bayes factor is the ratio of the marginal likelihoods for two models with proper prior densities. We discuss the marginal likelihood for a class of generalized linear models used in small area estimation for mortality data analysis. Computation in these models is intensive and requires the implementation of Markov chain Monte Carlo (MCMC) methods. A sophisticated method for computing the marginal likelihoods for generalized linear models using reduced Metropolis-Hastings (M-H) samplers has recently been introduced. Also, a much simpler method that uses the Laplace approximation has been proposed. Our method lies between these two in simplicity, and it uses importance sampling via a simple output analysis from a MCMC sampler. We also show that the new method can be approximated without using the MCMC sampler. We illustrate our methods for t...",0,1 +812,A new model of sciatic inflammatory neuritis (SIN): induction of unilateral and bilateral mechanical allodynia following acute unilateral peri-sciatic immune activation in rats,"Immune activation near healthy peripheral nerves may have a greater role in creating pathological pain than previously recognized. We have developed a new model of sciatic inflammatory neuritis to assess how such immune activation may influence somatosensory processing. The present series of experiments reveal that zymosan (yeast cell walls) acutely injected around the sciatic nerve of awake unrestrained rats rapidly (within 3h) produces low threshold mechanical allodynia in the absence of thermal hyperalgesia. Low (4 microg) doses of zymosan produce both territorial and extra-territorial allodynia restricted to the ipsilateral hindpaw. Higher (40-400 microg) doses of zymosan again produce both territorial and extra-territorial allodynia. However, allodynia is now expressed both in the ipsilateral as well as contralateral hindpaws. Several lines of evidence are provided that the appearance of this contralateral ('mirror') allodynia reflects local actions of zymosan on the sciatic nerve rather than spread of this immune activator to the general circulation. Since many clinical neuropathies result from inflammation/infection of peripheral nerves rather than frank physical trauma, understanding how immune activation alters pain processing may suggest novel approaches to pain control.",0,1 +813,One’s motor performance predictably modulates the understanding of others’ actions through adaptation of premotor visuo-motor neurons,"Neurons firing both during self and other's motor behavior (mirror neurons) have been described in the brain of vertebrates including humans. The activation of somatic motor programs driven by perceived behavior has been taken as evidence for mirror neurons' contribution to cognition. The inverse relation, that is the influence of motor behavior on perception, is needed for demonstrating the long-hypothesized causal role of mirror neurons in action understanding. We provide here conclusive behavioral and neurophysiological evidence for that causal role by means of cross-modal adaptation coupled with a novel transcranial magnetic stimulation (TMS)-adaptation paradigm. Blindfolded repeated motor performance of an object-directed action (push or pull) induced in healthy participants a strong visual after-effect when categorizing others' actions, as a result of motor-to-visual adaptation of visuo-motor neurons. TMS over the ventral premotor cortex, but not over the primary motor cortex, suppressed the after-effect, thus localizing the population of adapted visuo-motor neurons in the premotor cortex. These data are exquisitely consistent in humans with the existence of premotor mirror neurons that have access to the action meaning. We also show that controlled manipulation of the firing properties of this neural population produces strong predictable changes in the way we categorize others' actions.",0,1 +814,Mixed treatment comparison meta-analysis of altered fractionated radiotherapy and chemotherapy in head and neck cancer,"

Abstract

Objective

Different treatments have been investigated in head and neck cancers (HNCs) but not all of them have been appraised using pairwise comparison. This has resulted in failure to directly identify the best treatment with standard methods. Mixed treatment comparison (MTC) meta-analysis allows one to perform simultaneous inference regarding all treatments and select the best among them.

Study Design and Setting

We applied MTC models to the Meta-Analyses of Chemotherapy and Radiotherapy in HNC, which pooled individual patient data concerning more than 24,000 patients involved in 102 trials. Fixed- and random-effects models, models with or without consistency factors, possibly adapted to multiarm trials are discussed.

Results

Altered fractionated concomitant chemoradiotherapy (AF-CRT) leads to the highest probability of survival in nonmetastatic HNC. The probability that AF-CRT is the best treatment is 94% with random-effects models. There was no relevant inconsistency. When only the most recent trials were selected, AF-CRT and concomitant chemoradiotherapy (CRT) were the two best treatments. AF-CRT remains better than CRT but with a lower posterior probability.

Conclusion

MTC is a powerful method for investigating networks of randomized trials. Homogeneity, similarity of trial designs, populations, and the consistency of the network should be thoroughly checked.",0,1 +815,Bayesian Mixture Labeling by Highest Posterior Density,"A fundamental problem for Bayesian mixture model analysis is label switching, which occurs as a result of the nonidentifiability of the mixture components under symmetric priors. We propose two labeling methods to solve this problem. The first method, denoted by PM(ALG), is based on the posterior modes and an ascending algorithm generically denoted ALG. We use each Markov chain Monte Carlo sample as the starting point in an ascending algorithm, and label the sample based on the mode of the posterior to which it converges. Our natural assumption here is that the samples converged to the same mode should have the same labels. The PM(ALG) labeling method has some computational advantages over other popular labeling methods. Additionally, it automatically matches the “ideal” labels in the highest posterior density credible regions. The second method does labeling by maximizing the normal likelihood of the labeled Gibbs samples. Using a Monte Carlo simulation study and a real dataset, we demonstrate the succes...",0,1 +816,Equal Partners in Dialogue? Participation Equality in a Transnational Deliberative Poll (Europolis),"By gathering a representative sample of citizens from all 27 EU Member States, the deliberative poll Europolis created the opportunity for the inclusion of a wide variety of European voices. Taking up claims of difference democrats who argue that informal hurdles to participation can endure even after individuals gain formal access to the floor, this article argues for an extended approach to evaluate equality in deliberative minipublics. Specifically, it assesses whether participants contributed in roughly equal measures to the discussion and whether their discussion partners considered their contributions on equal merits. In doing so, the article adds to the small but growing literature on deliberation that expresses reservations about taking the willingness to engage with others' claims for granted. In order to account for the intrinsically relational aspect of interpersonal communication, measures of social network analysis are introduced as possible tools to evaluate participation equality in deliberative encounters.",0,1 +817,Generating gamma variates by a modified rejection technique,"A suitable square root transformation of a gamma random variable with mean a ≥ 1 yields a probability density close to the standard normal density. A modification of the rejection technique then begins by sampling from the normal distribution, being able to accept and transform the initial normal observation quickly at least 85 percent of the time (95 percent if a ≥ 4). When used with efficient subroutines for sampling from the normal and exponential distributions, the resulting accurate method is significantly faster than competing algorithms.",0,1 +818,R: A language and environment for statistical computing.,,0,1 +819,A Method for Maintaining Scale Stability in the Presence of Test Speededness,"Administering tests under time constraints may result in poorly estimated item parameters, particularly for items at the end of the test (Douglas, Kim, Habing, & Gao, 1998; Oshima, 1994). Bolt, Cohen, and Wollack (2002) developed an item response theory mixture model to identify a latent group of examinees for whom a test is overly speeded, and found that item parameter estimates for end-of-test items in the nonspeeded group were similar to estimates for those same items when administered earlier in the test. In this study, we used the Bolt et al. (2002) method to study the effect of removing speeded examinees on the stability of a score scale over an II-year period. Results indicated that using only the nonspeeded examinees for equating and estimating item parameters provided a more unidimensional scale, smaller effects of item parameter drift (including fewer drifting items), and less scale drift (i.e., bias) and variability (i.e., root mean squared errors) when compared to the total group of examinees.",0,1 +820,Maximum Likelihood Analysis of a General Latent Variable Model with Hierarchically Mixed Data,"A general two-level latent variable model is developed to provide a comprehensive framework for model comparison of various submodels. Nonlinear relationships among the latent variables in the structural equations at both levels, as well as the effects of fixed covariates in the measurement and structural equations at both levels, can be analyzed within the framework. Moreover, the methodology can be applied to hierarchically mixed continuous, dichotomous, and polytomous data. A Monte Carlo EM algorithm is implemented to produce the maximum likelihood estimate. The E-step is completed by approximating the conditional expectations through observations that are simulated by Markov chain Monte Carlo methods, while the M-step is completed by conditional maximization. A procedure is proposed for computing the complicated observed-data log likelihood and the BIC for model comparison. The methods are illustrated by using a real data set.",0,1 +821,Nonlinear structural equation models: The Kenny-Judd model with Interaction effects,,0,1 +822,A fully Bayesian application of the Copas selection model for publication bias extended to network meta-analysis,"The Copas parametric model is aimed at exploring the potential impact of publication bias via sensitivity analysis, by making assumptions regarding the probability of publication of individual studies related to the standard error of their effect sizes. Reviewers often have prior assumptions about the extent of selection in the set of studies included in a meta-analysis. However, a Bayesian implementation of the Copas model has not been studied yet. We aim to present a Bayesian selection model for publication bias and to extend it to the case of network meta-analysis where each treatment is compared either with placebo or with a reference treatment creating a star-shaped network. We take advantage of the greater flexibility offered in the Bayesian context to incorporate in the model prior information on the extent and strength of selection. To derive prior distributions, we use both external data and an elicitation process of expert opinion.",0,1 +823,Propriety of posteriors in structured additive regression models: Theory and empirical evidence,"Abstract Structured additive regression comprises many semiparametric regression models such as generalized additive (mixed) models, geoadditive models, and hazard regression models within a unified framework. In a Bayesian formulation, non-parametric functions, spatial effects and further model components are specified in terms of multivariate Gaussian priors for high-dimensional vectors of regression coefficients. For several model terms, such as penalized splines or Markov random fields, these Gaussian prior distributions involve rank-deficient precision matrices, yielding partially improper priors. Moreover, hyperpriors for the variances (corresponding to inverse smoothing parameters) may also be specified as improper, e.g. corresponding to Jeffreys prior or a flat prior for the standard deviation. Hence, propriety of the joint posterior is a crucial issue for full Bayesian inference in particular if based on Markov chain Monte Carlo simulations. We establish theoretical results providing sufficient (and sometimes necessary) conditions for propriety and provide empirical evidence through several accompanying simulation studies.",0,1 +824,"A Manifesto on Psychology as Idiographic Science: Bringing the Person Back Into Scientific Psychology, This Time Forever","Psychology is focused on variation between cases (interindividual variation). Results thus obtained are considered to be generalizable to the understanding and explanation of variation within single cases (intraindividual variation). It is indicated, however, that the direct consequences of the classical ergodic theorems for psychology and psychometrics invalidate this conjectured generalizability: only under very strict conditions-which are hardly obtained in real psychological processes-can a generalization be made from a structure of interindividual variation to the analogous structure of intraindividual variation. Illustrations of the lack of this generalizability are given in the contexts of psychometrics, developmental psychology, and personality theory.",0,1 +825,A SAS Interface for Bayesian Analysis With WinBUGS,"Bayesian methods are becoming very popular despite some practical difficulties in implementation. To assist in the practical application of Bayesian methods, we show how to implement Bayesian analysis with WinBUGS as part of a standard set of SAS routines. This implementation procedure is first illustrated by fitting a multiple regression model and then a linear growth curve model. A third example is also provided to demonstrate how to iteratively run WinBUGS inside SAS for Monte Carlo simulation studies. The SAS codes used in this study are easily extended to accommodate many other models with only slight modification. This interface can be of practical benefit in many aspects of Bayesian methods because it allows the SAS users to benefit from the implementation of Bayesian estimation and it also allows the WinBUGS user to benefit from the data processing routines available in SAS.",0,1 +826,Bayesian Meta-analysis of Hormone Therapy and Mortality in Younger Postmenopausal Women,"There is uncertainty over the risks and benefits of hormone therapy. We performed a Bayesian meta-analysis to evaluate the effect of hormone therapy on total mortality in younger postmenopausal women. This analysis synthesizes evidence from different sources, taking into account varying views on the issue.A comprehensive search from 1966 through January 2008 identified randomized controlled trials of at least 6 month's duration that evaluated hormone therapy in women with mean age <60 years and reported at least one death, and prospective observational cohort studies that evaluated the relative risk of mortality associated with hormone therapy after adjustment for confounding variables.The results were synthesized using a hierarchical random-effects Bayesian meta-analysis. The pooled results from 19 randomized trials, with 16,000 women (mean age 55 years) followed for 83,000 patient-years, showed a mortality relative risk of 0.73 (95% credible interval 0.52-0.96). When data from 8 observational studies were added to the analysis, the resultant relative risk was 0.72 (credible interval 0.62-0.82). The posterior probability that hormone therapy reduces total mortality in younger women is almost 1.The synthesis of data using Bayesian meta-analysis indicates a reduction in mortality in younger postmenopausal women taking hormone therapy compared with no treatment. This finding should be interpreted taking into account the potential benefits and harms of hormone therapy.",0,1 +827,Fixed vs. variable noise in 2AFC contrast discrimination: lessons from psychometric functions,"Recent discussion regarding whether the noise that limits 2AFC discrimination performance is fixed or variable has focused either on describing experimental methods that presumably dissociate the effects of response mean and variance or on reanalyzing a published data set with the aim of determining how to solve the question through goodness-of-fit statistics. This paper illustrates that the question cannot be solved by fitting models to data and assessing goodness-of-fit because data on detection and discrimination performance can be indistinguishably fitted by models that assume either type of noise when each is coupled with a convenient form for the transducer function. Thus, success or failure at fitting a transducer model merely illustrates the capability (or lack thereof) of some particular combination of transducer function and variance function to account for the data, but it cannot disclose the nature of the noise. We also comment on some of the issues that have been raised in recent exchange on the topic, namely, the existence of additional constraints for the models, the presence of asymmetric asymptotes, the likelihood of history-dependent noise, and the potential of certain experimental methods to dissociate the effects of response mean and variance.",0,1 +828,Modeling and calculating the effect of treatment at baseline from panel outcomes,"We propose and examine a panel data model for isolating the effect of a treatment, taken once at baseline, from outcomes observed over subsequent time periods. In the model, the treatment intake and outcomes are assumed to be correlated, due to unobserved or unmeasured confounders. Intake is partly determined by a set of instrumental variables and the confounding on unobservables is modeled in a flexible way, varying both by time and treatment state. Covariate effects are assumed to be subject-specific and potentially correlated with other covariates. Estimation and inference is by Bayesian methods that are implemented by tuned Markov chain Monte Carlo methods. Because our analysis is based on the framework developed by Chib [2004. Analysis of treatment response data without the joint distribution of counterfactuals. Journal of Econometrics, in press], the modeling and estimation does not involve either the unknowable joint distribution of the potential outcomes or the missing counterfactuals. The problem of model choice through marginal likelihoods and Bayes factors is also considered. The methods are illustrated in simulation experiments and in an application dealing with the effect of participation in high school athletics on future labor market earnings.",0,1 +829,Teaching Through Interactions in Secondary School Classrooms,"Valid measurement of how students’ experiences in secondary school classrooms lead to gains in learning requires a developmental approach to conceptualizing classroom processes. This article presents a potentially useful theoretical model, the Teaching Through Interactions framework, which posits teacher-student interactions as a central driver for student learning and that teacher-student interactions can be organized into three major domains. Results from 1,482 classrooms provide evidence for distinct emotional, organizational, and instructional domains of teacher-student interaction. It also appears that a three-factor structure is a better fit to observational data than alternative one- and two-domain models of teacher-student classroom interactions, and that the three-domain structure is generalizable from 6th through 12th grade. Implications for practitioners, stakeholders, and researchers are discussed.",0,1 +830,Hypothesis Testing and Model Comparison in Two-level Structural Equation Models,"One basic and important problem in two-level structural equation modeling is to find a good model for the observed sample data. This article demonstrates the use of the well-known Bayes factor in the Bayesian literature for hypothesis testing and model comparison in general two-level structural equation models. It is shown that the proposed methodology is flexible, and can be applied to situations with a wide variety of nonnested models. Moreover, some problems encountered in using existing methods for goodness-of-fit assessment of the proposed model can be alleviated. An illustrative example with some real data from an AIDS care study is presented.",0,1 +831,Bayesian statistics in medicine: a 25 year review,"This review examines the state of Bayesian thinking as Statistics in Medicine was launched in 1982, reflecting particularly on its applicability and uses in medical research. It then looks at each subsequent five-year epoch, with a focus on papers appearing in Statistics in Medicine, putting these in the context of major developments in Bayesian thinking and computation with reference to important books, landmark meetings and seminal papers. It charts the growth of Bayesian statistics as it is applied to medicine and makes predictions for the future. From sparse beginnings, where Bayesian statistics was barely mentioned, Bayesian statistics has now permeated all the major areas of medical statistics, including clinical trials, epidemiology, meta-analyses and evidence synthesis, spatial modelling, longitudinal modelling, survival modelling, molecular genetics and decision-making in respect of new technologies.",0,1 +832,Hierarchical network meta-analysis models to address sparsity of events and differing treatment classifications with regard to adverse outcomes,"Meta-analysis for adverse events resulting from medical interventions has many challenges, in part due to small numbers of such events within primary studies. Furthermore, variability in drug dose, potential differences between drugs within the same pharmaceutical class and multiple indications for a specific treatment can all add to the complexity of the evidence base.This paper explores the use of synthesis methods, incorporating mixed treatment comparisons, to estimate the risk of adverse events for a medical intervention, while acknowledging and modelling the complexity of the structure of the evidence base.The motivating example was the effect on malignancy of three anti-tumour necrosis factor (anti-TNF) drugs (etanercept, adalimumab and infliximab) indicated to treat rheumatoid arthritis. Using data derived from 13 primary studies, a series of meta-analysis models of increasing complexity were applied. Models ranged from a straightforward comparison of anti-TNF against non-anti-TNF controls, to more complex models in which a treatment was defined by individual drug and its dose. Hierarchical models to allow ‘borrowing strength’ across treatment classes and dose levels, and models involving constraints on the impact of dose level, are described.These models provide a flexible approach to estimating sparse, often adverse, outcomes associated with interventions. Each model makes its own set of assumptions, and approaches to assessing goodness of fit of the various models will usually be extremely limited in their effectiveness, due to the sparse nature of the data. Both methodological and clinical considerations are required to fit realistically complex models in this area and to evaluate their appropriateness. Copyright © 2014 John Wiley & Sons, Ltd.",0,1 +833,Effects on Scale Linking of Different Definitions of Criterion Functions for the IRT Characteristic Curve Methods,"Under item response theory, the characteristic curve methods (Haebara and Stocking-Lord methods) are used to link two ability scales from separate calibrations. The linking methods use their respective criterion functions that can be defined differently according to the symmetry- and distribution-related schemes. The symmetry-related scheme relates to which scale, targeted or transformed, should be used for the definition. The distribution-related scheme refers to a way of incorporating underlying ability distributions into the definition. Through simulations, this study examined if a certain optimal combination of the two schemes exists regardless of differences in proficiency distribution between samples involved in scale linking. Concurrent calibration was considered for comparative purposes and, across all nine combinations of proficiency distributions to be linked, its performance was better in linking accuracy than the linking methods. There was no optimal combination of the symmetry- and distribution-related schemes that led to minimal linking error across the nine combinations.",0,1 +834,Principles of multilevel modelling,"Multilevel modelling, also known as hierarchical regression, generalizes ordinary regression modelling to distinguish multiple levels of information in a model. Use of multiple levels gives rise to an enormous range of statistical benefits. To aid in understanding these benefits, this article provides an elementary introduction to the conceptual basis for multilevel modelling, beginning with classical frequentist, Bayes, and empirical-Bayes techniques as special cases. The article focuses on the role of multilevel averaging ('shrinkage') in the reduction of estimation error, and the role of prior information in finding good averages.",0,1 +835,A random change point model for assessing variability in repeated measures of cognitive function,"Some cognitive functions undergo transitions in old age, which motivates the use of a change point model for the individual trajectory. The age when the change occurs varies between individuals and is treated as random. We illustrate the properties of a random change point model and use it for data from a Swedish study of change in cognitive function in old age. Variance estimates are obtained from Markov chain Monte Carlo simulation using Gibbs sampling. The random change point model is compared with models within the family of linear random effects models. The focus is on the ability to capture variability in measures of cognitive function. The models make different assumptions about the variance over the age span, and we demonstrate that the random change point model has the most reasonable structure. Copyright © 2008 John Wiley & Sons, Ltd.",0,1 +836,Analyzing Individual Status and Change with Hierarchical Linear Models:Illustration with Depression in College Students,"A recently developed class of multilevel or hierarchical linear models (HLM) provides an intuitive and efficient way to estimate individual growth or change curves. The approach also models the between-subjects variation of the individual change curves with treatment factors and individual attributes. Unlike other repeated measures analysis methods common in the behavioral sciences, HLM allows the fit of data with unequal numbers of repeated observations for each subject, variable timing of observations, and missing data, features which are often characteristic of data from field studies. The application of HLM for the analysis of repeated psychological measures is discussed and illustrated here with depression data for college students. Strengths and limitations of the approach are discussed.",0,1 +837,Conditional Item-Exposure Control in Adaptive Testing Using Item-Ineligibility Probabilities,"Two conditional versions of the exposure-control method with item-ineligibility constraints for adaptive testing in van der Linden and Veldkamp (2004 ) are presented. The first version is for unconstrained item selection, the second for item selection with content constraints imposed by the shadow-test approach. In both versions, the exposure rates of the items are controlled using probabilities of item ineligibility given θ that adapt the exposure rates automatically to a goal value for the items in the pool. In an extensive empirical study with an adaptive version of the Law School Admission Test, the authors show how the method can be used to drive conditional exposure rates below goal values as low as 0.025. Obviously, the price to be paid for minimal exposure rates is a decrease in the accuracy of the ability estimates. This trend is illustrated with empirical data.",0,1 +838,Challenges in Nonlinear Structural Equation Modeling,"Abstract. Challenges in evaluating nonlinear effects in multiple regression analyses include reliability, validity, multicollinearity, and dichotomization of continuous variables. While reliability and validity issues are solved by employing nonlinear structural equation modeling, multicollinearity remains a problem which may even be aggravated when using latent variable approaches. Further challenges of nonlinear latent analyses comprise the distribution of latent product terms, a problem especially relevant for approaches using maximum likelihood estimation methods based on multivariate normally distributed variables, and unbiased estimates of nonlinear effects under multicollinearity. The only methods that explicitly take the nonnormality of nonlinear latent models into account are latent moderated structural equations (LMS) and quasi-maximum likelihood (QML). In a small simulation study both methods yielded unbiased parameter estimates and correct estimates of standard errors for inferential statistics. The advantages and limitations of nonlinear structural equation modeling are discussed.",0,1 +839,Hierarchical Multinomial Processing Tree Models: A Latent-Trait Approach,"Multinomial processing tree models are widely used in many areas of psychology. A hierarchical extension of the model class is proposed, using a multivariate normal distribution of person-level parameters with the mean and covariance matrix to be estimated from the data. The hierarchical model allows one to take variability between persons into account and to assess parameter correlations. The model is estimated using Bayesian methods with weakly informative hyperprior distribution and a Gibbs sampler based on two steps of data augmentation. Estimation, model checks, and hypotheses tests are discussed. The new method is illustrated using a real data set, and its performance is evaluated in a simulation study. © 2009 The Psychometric Society.",0,1 +840,An effectiveness trial of a dissonance-based eating disorder prevention program for high-risk adolescent girls.,"Efficacy trials indicate that an eating disorder prevention program involving dissonance-inducing activities that decrease thin-ideal internalization reduces risk for current and future eating pathology, yet it is unclear whether this program produces effects under real-world conditions. The present effectiveness trial tested whether this program produced effects when school staff recruit participants and deliver the intervention. Adolescent girls with body image concerns (N = 306; M age = 15.7, SD = 1.1) randomized to the dissonance intervention showed significantly greater decreases in thin-ideal internalization, body dissatisfaction, dieting attempts, and eating disorder symptoms from pretest to posttest than did those assigned to a psychoeducational brochure control condition, with the effects for body dissatisfaction, dieting, and eating disorder symptoms persisting through 1-year follow-up. Effects were slightly smaller than those observed in a prior efficacy trial, suggesting that this program is effective under real-world conditions, but that facilitator selection, training, and supervision could be improved.",0,1 +841,An Analysis of an Incomplete Marked Point Pattern of Heat-Related 911 Calls,"We analyze an incomplete marked point pattern of heat-related 911 calls between the years 2006–2010 in Houston, TX, to primarily investigate conditions that are associated with increased vulnerability to heat-related morbidity and, secondarily, build a statistical model that can be used as a public health tool to predict the volume of 911 calls given a time frame and heat exposure. We model the calls as arising from a nonhomogenous Cox process with unknown intensity measure. By using the kernel convolution construction of a Gaussian process, the intensity surface is modeled using a low-dimensional representation and properly adheres to circular domain constraints. We account for the incomplete observations by marginalizing the joint intensity measure over the domain of the missing marks and also demonstrate model based imputation. We find that spatial regions of high risk for heat-related 911 calls are temporally dynamic with the highest risk occurring in urban areas during the day. We also find that elde...",0,1 +842,"The Europeanization of interest groups: Group type, resources and policy area","Large variation exists in the extent to which national interest groups focus on European Union (EU) legislation and carry out their political activities in Brussels and Strasbourg. What explains this variation? We propose a series of hypotheses that suggest that business groups, and groups active in policy areas with high EU competence, are more Europeanized than other groups. The effect of group type, moreover, is conditional on the material resources a group possesses: we expect the difference between business and non-business groups to be largest for actors that are well endowed with material resources. Using novel data on 880 national associations, gained from a survey of interest groups in five European countries, we find support for these hypotheses. The article has implications for the literatures on lobbying, Europeanization, and theories of European integration.",0,1 +843,The Application of an Unfolding Model of the PIRT Type to the Measurement of Attitude,"Unfolding data for unidimensional variables con structed from direct responses (e.g., agreement or dis agreement) are characterized by single peaked func tions involving the locations of each person and each stimulus. A continuous discrirninal process, of the form postulated by Thurstone when he proposed his Law of Comparative Judgment, is suggested. This process is transformed to a qualitative dichotomous re sponse in which the probability of endorsement is governed by the square of the distance between the lo cations of the person and the stimulus. Maximum like lihood estimates of the parameters are derived, and it is shown that the information associated with any re sponse is a bimodal function of the difference between the person and stimulus locations. The feasibility of parameter estimation is demonstrated with a limited simulation study. The model is applied to a set of statements designed to measure attitudes toward capi tal punishment and scaled by the methods of Thur stone. The responses conformed to the unfolding mechanism, and the scale values of the statements are statistically equivalent to those obtained by Thur stone's methods. Index terms: Attitude measure ment, Developmental data, Discriminal process, Item response theory, Person response theory, Thurstone scaling, Unfolding data, Unidimensional scaling.",0,1 +844,"Activation of adult rat CNS endothelial cells by opioid-induced toll-like receptor 4 (TLR4) signaling induces proinflammatory, biochemical, morphological, and behavioral sequelae","CNS immune signaling contributes to deleterious opioid effects including hyperalgesia, tolerance, reward, and dependence/withdrawal. Such effects are mediated by opioid signaling at toll-like receptor 4 (TLR4), presumptively of glial origin. Whether CNS endothelial cells express TLR4 is controversial. If so, they would be well positioned for activation by blood-borne opioids, contributing to opioid-induced pro-inflammatory responses. These studies examined adult primary rat CNS endothelial cell responses to (-)-morphine or its mu opioid receptor (MOR)-inactive metabolite morphine-3-glucuronide (M3G), both known TLR4 agonists. We demonstrate that adult rat CNS endothelial cells express functional TLR4. M3G activated nuclear factor kappaB (NF-κB), increased tumor necrosis factor-α (TNFα) and cyclooxygenase-2 (COX2) mRNAs, and released prostaglandin E2 (PGE2) from these cells. (-)-Morphine-induced upregulation of TNFα mRNA and PGE2 release were unmasked by pre-treatment with nalmefene, a MOR antagonist without TLR4 activity (unlike CTAP, shown to have both MOR- and TLR4-activity), suggestive of an interplay between MOR and TLR4 co-activation by (-)-morphine. In support, MOR-dependent Protein Kinase A (PKA) opposed TLR4 signaling, as PKA inhibition (H-89) also unmasked (-)-morphine-induced TNFα and COX2 mRNA upregulation. Intrathecal injection of CNS endothelial cells, stimulated in vitro with M3G, produced TLR4-dependent tactile allodynia. Further, cortical suffusion with M3G in vivo induced TLR4-dependent vasodilation. Finally, endothelial cell TLR4 activation by lipopolysaccharide and/or M3G was blocked by the glial inhibitors AV1013 and propentofylline, demonstrating endothelial cells as a new target of such drugs. These data indicate that (-)-morphine and M3G can activate CNS endothelial cells via TLR4, inducing proinflammatory, biochemical, morphological, and behavioral sequelae. CNS endothelial cells may have previously unanticipated roles in opioid-induced effects, in phenomena blocked by presumptive glial inhibitors, as well as TLR4-mediated phenomena more broadly.",0,1 +845,Increasing the Homogeneity of CAT's Item-Exposure Rates by Minimizing or Maximizing Varied Target Functions While Assembling Shadow Tests,"A computerized adaptive testing (CAT) algorithm that has the potential to increase the homogeneity of CAT's item-exposure rates without significantly sacrificing the precision of ability estimates was proposed and assessed in the shadow-test (van der Linden & Reese, 1998) CAT context. This CAT algorithm was formed by a combination of maximizing or minimizing varied target functions while assembling shadow tests. There were four target functions to be separately used in the first, second, third, and fourth quarter test of CAT. The elements to be used in the four functions were associated with (a) a random number assigned to each item, (b) the absolute difference between an examinee's current ability estimate and an item difficulty, (c) the absolute difference between an examinee's current ability estimate and an optimum item difficulty, and (d) item information. The results indicated that this combined CAT fully utilized all the items in the pool, reduced the maximum exposure rates, and achieved more homogeneous exposure rates. Moreover, its precision in recovering ability estimates was similar to that of the maximum item-information method. The combined CAT method resulted in the best overall results compared with the other individual CAT item-selection methods. The findings from the combined CAT are encouraging. Future uses are discussed.",0,1 +846,The theory of planned behaviour: The effects of perceived behavioural control and self-efficacy,"The present study was undertaken to assess the utility of the theory of planned behaviour, using separate measures of the two variables that are considered to comprise the notion of perceived behavioural control, namely, beliefs concerning the controllability of the behaviour and efficacy expectancies. The study was concerned with the prediction of intentions to engage in regular exercise (for at least 20 minutes, three times a week for a fortnight) and actual exercise behaviour. A sample of 146 undergraduate subjects participated in the study. It was prospective in design; measures of attitudes, norms, intentions, perceived control and self-efficacy were obtained at the first wave of data collection, while actual behaviour was assessed two weeks later. The results of the study revealed support for the view that separate measures of self-efficacy and perceived behavioural control should be employed in the theory of planned behaviour. In the first instance, confirmatory factor analysis revealed that the two variables could be empirically distinguished. Second, the effects of perceived behavioural control and self-efficacy on behavioural intentions and actual behaviour differed. As predicted, efficacy expectancies influenced behavioural intentions, but not actual behaviour. In contrast, levels of perceived behavioural control had no effect on behavioural intentions, but emerged as a significant (positive) predictor of actual behaviour (there was also evidence that the effects of intentions on behaviour were moderated by the level of perceived behavioural control).",0,1 +847,Consensus analysis of three‐way social network data,"Three‐way social network data occurs when every actor in a social network generates a digraph of the entire network. This paper presents a statistical model based on cultural consensus analysis for aggregating these separate digraphs into a single consensus digraph. In addition, the model allows estimation of separate hit and false alarm rates for each actor that can vary within each actor in different regions of the digraph. Several standard signal detection models are used to interpret the hit and false alarm parameters in terms of knowledge and response bias. A published three‐way data set by Kumbasar, Romney, and Batchelder (American Journal of Sociology, 1994) is analyzed, and the model reveals that both response bias and knowledge decrease with distance from ego.",0,1 +848,How to Use a Monte Carlo Study to Decide on Sample Size and Determine Power,"A common question asked by researchers is, What sample size do I need for my study? Over the years, several rules of thumb have been proposed. In reality there is no rule of thumb that applies to all situations. The sample size needed for a study depends on many factors, including the size of the model, distribution of the variables, amount of missing data, reliability of the variables, and strength of the relations among the variables. The purpose of this article is to demonstrate how substantive researchers can use a Monte Carlo study to decide on sample size and determine power. Two models are used as examples, a confirmatory factor analysis (CFA) model and a growth model. The analyses are carried out using the Mplus program (Muthen& Muthen 1998).",0,1 +849,"The effect of sampling error on convergence, improper solutions, and goodness-of-fit indices for maximum likelihood confirmatory factor analysis","A Monte Carlo study assessed the effect of sampling error and model characteristics on the occurrence of nonconvergent solutions, improper solutions and the distribution of goodness-of-fit indices in maximum likelihood confirmatory factor analysis. Nonconvergent and improper solutions occurred more frequently for smaller sample sizes and for models with fewer indicators of each factor. Effects of practical significance due to sample size, the number of indicators per factor and the number of factors were found for GFI, AGFI, and RMR, whereas no practical effects were found for the probability values associated with the chi-square likelihood ratio test. © 1984 The Psychometric Society.",0,1 +850,Comparison of methods for estimating the intraclass correlation coefficient for binary responses in cancer prevention cluster randomized trials,"The intraclass correlation coefficient (ICC) is a fundamental parameter of interest in cluster randomized trials as it can greatly affect statistical power. We compare common methods of estimating the ICC in cluster randomized trials with binary outcomes, with a specific focus on their application to community-based cancer prevention trials with primary outcome of self-reported cancer screening. Using three real data sets from cancer screening intervention trials with different numbers and types of clusters and cluster sizes, we obtained point estimates and 95% confidence intervals for the ICC using five methods: the analysis of variance estimator, the Fleiss-Cuzick estimator, the Pearson estimator, an estimator based on generalized estimating equations and an estimator from a random intercept logistic regression model. We compared estimates of the ICC for the overall sample and by study condition. Our results show that ICC estimates from different methods can be quite different, although confidence intervals generally overlap. The ICC varied substantially by study condition in two studies, suggesting that the common practice of assuming a common ICC across all clusters in the trial is questionable. A simulation study confirmed pitfalls of erroneously assuming a common ICC. Investigators should consider using sample size and analysis methods that allow the ICC to vary by study condition.",0,1 +851,Signal detection theory and vestibular perception: III. Estimating unbiased fit parameters for psychometric functions,"Psychophysics generally relies on estimating a subject's ability to perform a specific task as a function of an observed stimulus. For threshold studies, the fitted functions are called psychometric functions. While fitting psychometric functions to data acquired using adaptive sampling procedures (e.g., ""staircase"" procedures), investigators have encountered a bias in the spread (""slope"" or ""threshold"") parameter that has been attributed to the serial dependency of the adaptive data. Using simulations, we confirm this bias for cumulative Gaussian parametric maximum likelihood fits on data collected via adaptive sampling procedures, and then present a bias-reduced maximum likelihood fit that substantially reduces the bias without reducing the precision of the spread parameter estimate and without reducing the accuracy or precision of the other fit parameters. As a separate topic, we explain how to implement this bias reduction technique using generalized linear model fits as well as other numeric maximum likelihood techniques such as the Nelder-Mead simplex. We then provide a comparison of the iterative bootstrap and observed information matrix techniques for estimating parameter fit variance from adaptive sampling procedure data sets. The iterative bootstrap technique is shown to be slightly more accurate; however, the observed information technique executes in a small fraction (0.005 %) of the time required by the iterative bootstrap technique, which is an advantage when a real-time estimate of parameter fit variance is required.",0,1 +852,The Presence of a Weapon Shrinks the Functional Field of View,"Summary This study examined whether the functional field of view shrinks by the presence of a weapon or the increase of emotional arousal. In Experiment 1, participants viewed two types of pictures depicting scenes involving weapons or control objects and were asked to identify digits presented at the periphery when the pictures disappeared. The results showed that the presence of a weapon impaired identification of the peripheral digits, even when the pictures were equal with respect to emotional arousal level. In Experiment 2, participants viewed emotionally arousing pictures or neutral pictures, neither of which included weapons, and they were asked to identify digits presented at the periphery when the pictures disappeared. The results revealed that the increased emotional arousal did not impair identification of the peripheral digits. These results indicate that the functional field of view shrinks because of the presence of a weapon but not because of increased emotional arousal.Copyright © 2015 John Wiley & Sons, Ltd.",0,1 +853,A Method for Obtaining Standard Errors and Confidence Intervals of Composite Reliability for Congeneric Items,"A method for obtaining standard errors and confidence intervals of composite reliability co-efficients based on the bootstrap method is proposed. Using a structural equation modeling framework for estimating composite reliability of congeneric measures (Raykov, 1997), the approach takes repeated samples from a given sample and then estimates reliability. This approach extends earlier research on the distribution of scale reliability that is primarily concerned with Cronbach's coefficient alpha, and represents a general method based on fewer assumptions. It also permits testing hypotheses about composite reliability. Its use is demonstrated on simulated data.",0,1 +854,Rejoinder,"In the main article I presented a series of objections to Bayesian inference, written in the voice of a hypothetical anti-Bayesian statistician. Here I respond to these objections along with some other comments made by four discussants. © 2008 International Society for Bayesian Analysis.",0,1 +855,Model Selection Criteria for Latent Growth Models Using Bayesian Methods,"Research in applied areas, such as statistical, psychological, behavioral, and educational areas, often involves the selection of the best available model from among a large set of candidate models. Considering that there is no well-defined model selection criterion in a Bayesian context and that latent growth mixture models are becoming popular in many areas, the goal of this study is to investigate the performance of a series of model selection criteria in the framework of latent growth mixture models with missing data and outliers in a Bayesian context. This study conducted five simulation studies to cover different cases, including latent growth curve models with missing data, latent growth curve models with missing data and outliers, growth mixture models with missing data and outliers, extended growth mixture models with missing data and outliers, and latent growth models with different classes. Simulation results show that almost all the proposed criteria can effectively identify the true models. This study also illustrated the application of these model selection criteria in real data analysis. The results will help inform the selection of growth models by researchers seeking to provide states with accurate estimates of the growth of their students. © Springer International Publishing Switzerland 2015.",0,1 +856,The Effect of Aging and Tennis Playing on Coincidence-Timing Accuracy,"This study examined the effect of tennis playing on the coincidence timing (CT) of older adults. Young, younger-old and older-old (20–30, 60–69, and 70–79 years old, respectively) tennis players and nonplayers were asked to synchronize a simple response (pressing a button) with the arrival of a moving stimulus at a target. Results showed that the older tennis players responded with a slight bias similar to that of the young players. Two experiments were conducted to determine whether the elimination of age effects through tennis playing was a result of maintaining basic perceptuomotor and perceptual processes or of some possible compensation strategy. The results revealed that the age-related increase in the visuomotor delay was significantly correlated with CT performance in older nonplayers but not in older tennis players. These results suggest that playing tennis is beneficial to older adults, insofar as they remained as accurate as younger ones despite less efficient perceptuomotor processes. This supports the compensation hypothesis.",0,1 +857,Job resources and flow at work: Modelling the relationship via latent growth curve and mixture model methodology,"The aim of the present three-wave follow-up study (n = 335) among employees of an employment agency was to investigate the association between job resources and work-related flow utilizing both variable- and person-oriented approaches. In addition, emotional exhaustion was studied as a moderator of the job resources–flow relationship, and as a predictor of the development of job resources and flow. The variable-oriented approach, based on latent growth curve analyses, revealed that the levels of job resources and flow at work, as well as changes in these variables, were positively associated with each other. The person-oriented inspection with the growth mixture modelling identified four trajectories based on the mean levels of job resources and flow and on the changes of these mean levels over time: (a) moderate work-related resources (n = 166), (b) declining work-related resources (n = 87), (c) high work-related resources (n = 46), and (d) low work-related resources (n = 36). Exhaustion was found to be an important predictor of job resources and flow, but it did not moderate their mutual association. Specifically, a low level of exhaustion was found to predict high levels of job resources and flow. Overall, these results suggest the importance of a person-oriented view of motivational processes at work. In addition, in order to fully understand positive motivational processes it seems important to investigate the role of negative well-being states as well.",0,1 +858,A Multilevel CFA-MTMM Model for Nested Structurally Different Methods,"The numerous advantages of structural equation modeling (SEM) for the analysis of multitrait–multimethod (MTMM) data are well known. MTMM-SEMs allow researchers to explicitly model the measurement error, to examine the true convergent and discriminant validity of the given measures, and to relate external variables to the latent trait as well as the latent method factors in the model. According to Eid et al. (2008) different MTMM measurement designs require different types of MTMM-SEMs. Eid et al. (2008) proposed three different MTMM-SEMs for measurement designs with (a) structurally different methods, (b) interchangeable methods, and (c) a combination of both types of methods. In the present work, we extend this taxonomy to a multilevel correlated traits–correlated methods minus one [CTC(M − 1)] model for nested structurally different methods. The new model enables researchers to study method effects on both measurement levels (i.e., within and between clusters, classes, schools, etc.) and evaluate the convergent and discriminant validity of the measures. The statistical performance of the model is examined by a simulation study, and recommendations for the application of the model are given.",0,1 +859,Genetic evaluation of mastitis liability and recovery through longitudinal analysis of transition probabilities,"Many methods for the genetic analysis of mastitis use a cross-sectional approach, which omits information on, e.g., repeated mastitis cases during lactation, somatic cell count fluctuations, and recovery process. Acknowledging the dynamic behavior of mastitis during lactation and taking into account that there is more than one binary response variable to consider, can enhance the genetic evaluation of mastitis.Genetic evaluation of mastitis was carried out by modeling the dynamic nature of somatic cell count (SCC) within the lactation. The SCC patterns were captured by modeling transition probabilities between assumed states of mastitis and non-mastitis. A widely dispersed SCC pattern generates high transition probabilities between states and vice versa. This method can model transitions to and from states of infection simultaneously, i.e. both the mastitis liability and the recovery process are considered. A multilevel discrete time survival model was applied to estimate breeding values on simulated data with different dataset sizes, mastitis frequencies, and genetic correlations.Correlations between estimated and simulated breeding values showed that the estimated accuracies for mastitis liability were similar to those from previously tested methods that used data of confirmed mastitis cases, while our results were based on SCC as an indicator of mastitis. In addition, unlike the other methods, our method also generates breeding values for the recovery process.The developed method provides an effective tool for the genetic evaluation of mastitis when considering the whole disease course and will contribute to improving the genetic evaluation of udder health.",0,1 +860,Nonlinear Random-Effects Mixture Models for Repeated Measures,"A mixture model for repeated measures based on nonlinear functions with random effects is reviewed. The model can include individual schedules of measurement, data missing at random, nonlinear functions of the random effects, of covariates and of residuals. Individual group membership probabilities and individual random effects are obtained as empirical Bayes predictions. Although this is a complicated model that combines a mixture of populations, nonlinear regression, and hierarchical models, it is straightforward to estimate by maximum likelihood using SAS PROC NLMIXED. Many different models can be studied with this procedure. The model is more general than those that can be estimated with most special purpose computer programs currently available because the response function is essentially any form of nonlinear regression. Examples and sample code are included to illustrate the method. © 2013 The Psychometric Society.",0,1 +861,Bayesian SEM for Specification Search Problems in Testing Factorial Invariance,"Specification search problems refer to two important but under-addressed issues in testing for factorial invariance: how to select proper reference indicators and how to locate specific non-invariant parameters. In this study, we propose a two-step procedure to solve these issues. Step 1 is to identify a proper reference indicator using the Bayesian structural equation modeling approach. An item is selected if it is associated with the highest likelihood to be invariant across groups. Step 2 is to locate specific non-invariant parameters, given that a proper reference indicator has already been selected in Step 1. A series of simulation analyses show that the proposed method performs well under a variety of data conditions, and optimal performance is observed under conditions of large magnitude of non-invariance, low proportion of non-invariance, and large sample sizes. We also provide an empirical example to demonstrate the specific procedures to implement the proposed method in applied research. The importance and influences are discussed regarding the choices of informative priors with zero mean and small variances. Extensions and limitations are also pointed out.",0,1 +862,ESTIMATION OF SAMPLING VARIANCE OF CORRELATIONS IN META-ANALYSIS,"Monte Carlo simulations were conducted to compare the performance of the traditional (Fisher, 1954) and mean (Hunter & Schmidt, 1990) estimators of the sampling variance of correlations in meta-analysis. The mean estimator differs from the traditional estimator in that it uses the mean observed correlation, averaged across studies, in the sampling variance formula. The simulations investigated the homogeneous (i.e., no true correlation variance across studies) and heterogeneous case (i.e., true correlation variance across studies). Results reveal that, compared to the traditional estimator, the mean estimator provides less negatively biased estimates of sampling variance in the homogeneous and heterogeneous cases and more positively biased estimates in the heterogenous case. Thus, results support the use of the mean estimator unless strong, theory-based hypotheses regarding moderating effects exist.",0,1 +863,The statistical analysis of data from small groups.,"The authors elaborate the complications and the opportunities inherent in the statistical analysis of small-group data. They begin by discussing nonindependence of group members' scores and then consider standard methods for the analysis of small-group data and determine that these methods do not take into account this nonindependence. A new method is proposed that uses multilevel modeling and allows for negative nonindependence and mutual influence. Finally, the complications of interactions, different group sizes, and differential effects are considered. The authors strongly urge that the analysis model of data from small-group studies should mirror the psychological processes that generate those data.",0,1 +864,Multiphase mixed-effects models for repeated measures data.,"Behavior that develops in phases may exhibit distinctively different rates of change in one time period than in others. In this article, a mixed-effects model for a response that displays identifiable regimes is reviewed. An interesting component of the model is the change point. In substantive terms, the change point is the time when development switches from one phase to another. In a mixed-effects model, the change point can be a random coefficient. This possibility allows individuals to make the transition from one phase to another at different ages or after different lengths of time in treatment. Two examples are reviewed in detail, both of which can be estimated with software that is widely available.",0,1 +865,Robust inference using weighted least squares and quadratic estimating equations in latent variable modeling with categorical and continuous outcomes,,0,1 +866,Structural Equation Models of Latent Interactions: An Appropriate Standardized Solution and Its Scale-Free Properties,"Standardized parameter estimates are routinely used to summarize the results of multiple regression models of manifest variables and structural equation models of latent variables, because they facilitate interpretation. Although the typical standardization of interaction terms is not appropriate for multiple regression models, straightforward alternatives are well known (Aiken & West, 1991; Friedrich, 1982). Whereas the analogous problem exists for the estimation of latent interactions in structural equation modeling (SEM), the problem is more complex and apparently has not been resolved. Here we demonstrate that the appropriate “standardized” parameter estimates are easily formulated from parameter estimates routinely available from existing SEM software packages. Some properties of the appropriate “standardized” solution are mathematically derived, including the demonstration that the main and interaction effects are scale-free, as are the factor loadings. These desirable properties of the standardized...",0,1 +867,Fitting multilevel multivariate models with missing data in responses and covariates that may include interactions and non-linear terms,"Summary The paper extends existing models for multilevel multivariate data with mixed response types to handle quite general types and patterns of missing data values in a wide range of multilevel generalized linear models. It proposes an efficient Bayesian modelling approach that allows missing values in covariates, including models where there are interactions or other functions of covariates such as polynomials. The procedure can also be used to produce multiply imputed complete data sets. A simulation study is presented as well as the analysis of a longitudinal data set. The paper also shows how existing multiprocess models for handling endogeneity can be extended by the framework proposed.",0,1 +868,Improved Prediction of Rates of Visual Field Loss in Glaucoma Using Empirical Bayes Estimates of Slopes of Change,"To describe and test a new methodology for estimation of rates of progressive visual field loss in glaucoma.This observational cohort study enrolled 643 eyes of 368 patients recruited from the Diagnostic Innovations in Glaucoma Study, followed for an average of 6.5±2.0 years. The visual field index was used to evaluate degree of visual field loss in standard automated perimetry. Growth mixture models were used to evaluate visual field index changes over time. Empirical Bayes estimates of best linear unbiased predictions (BLUPs) were used to obtain slopes of change based on the first 5 visual fields for each eye. These slopes were then used to predict future observations. The same procedure was done for ordinary least squares (OLS) estimates. The mean square error of the predictions was used to compare the predictive performance of the different methods.The growth mixture model successfully identified subpopulations of nonprogressors, slow, moderate, and fast progressors. The mean square error was significantly higher for OLS compared with the BLUP method (32.3 vs 13.9, respectively; P<0.001), indicating a better performance of the BLUP method to predict future observations. The benefit of BLUP predictions was especially evident in eyes with moderate and fast rates of change.Empirical Bayes estimates of rates of change performed significantly better than the commonly used technique of OLS regression in predicting future observations. Use of BLUP estimates should be considered when evaluating rates of functional change in glaucoma and predicting future impairment from the disease.",0,1 +869,Restricted unbiased iterative generalized least-squares estimation,SUMMARY It is shown that the iterative least-squares procedure for estimating the parameters in a general multilevel random coefficients linear model can be modified to produce unbiased estimates of the random parameters. In the multivariate normal case these are equivalent to restricted maximum likelihood estimates.,0,1 +870,Bayesian estimation in the two-parameter logistic model,"A Bayesian procedure is developed for the estimation of parameters in the two-parameter logistic item response model. Joint modal estimates of the parameters are obtained and procedures for the specification of prior information are described. Through simulation studies it is shown that Bayesian estimates of the parameters are superior to maximum likelihood estimates in the sense that they are (a) more meaningful since they do not drift out of range, and (b) more accurate in that they result in smaller mean squared differences between estimates and true values. © 1985 The Psychometric Society.",0,1 +871,Does “Made in …” Also Apply to Services? An Empirical Assessment of the Country-of-Origin Effect in Service Settings,"ABSTRACT The country-of-origin (COO) effect is one of the most prominent phenomena in the field of international marketing. Its influence on consumer quality perception, as well as on purchase decision, is strongly supported by a notable amount of empirical work. However, despite the obvious managerial relevance, most COO studies have been conducted with respect to products, whereas the impact of COO in service settings is a woefully underresearched area. This article fills that void by using limit conjoint analysis to empirically test the role of COO effect for services in two experimental settings. Specifically, the study investigates how much the relative importance of COO changes if additional quality cues are available for the consumer. Results lend support for the relevance of COO effects for services and provide useful implications for ways to utilize COO effects in international services marketing.",0,1 +872,Recovery of inter-block information when block sizes are unequal,"SUMMARY A method is proposed for estimating intra-block and inter-block weights in the analysis of incomplete block designs with block sizes not necessarily equal. The method consists of maximizing the likelihood, not of all the data, but of a set of selected error contrasts. When block sizes are equal results are identical with those obtained by the method of Nelder (1968) for generally balanced designs. Although mainly concerned with incomplete block designs the paper also gives in outline an extension of the modified maximum likelihood procedure to designs with a more complicated block structure. In this paper we consider the estimation of weights to be used in the recovery of interblock information in incomplete block designs with possibly unequal block sizes. The problem can also be thought of as one of estimating constants and components of variance from data arranged in a general two-way classification when the effects of one classification are regarded as fixed and the effects of the second classification are regarded as random. Nelder (1968) described the efficient estimation of weights in generally balanced designs, in which the blocks are usually, although not always, of equal size. Lack of balance resulting from unequal block sizes is, however, common in some experimental work, for example in animal breeding experiments. The maximum likelihood procedure described by Hartley & Rao (1967) can be used but does not give the same estimates as Nelder's method in the balanced case. As will be shown, the two methods in effect use the same weighted sums of squares of residuals but assign different expectations. In the maximum likelihood approach, expectations are taken over a conditional distribution with the treatment effects fixed at their estimated values. In contrast Nelder uses unconditional expectations. The difference between the two methods is analogous to the well-known difference between two methods of estimating the variance o2 of a normal distribution, given a random sample of n values. Both methods use the same total sum of squares of deviations. But",0,1 +873,Discovering statistics using SPSS for Windows.,"The book Discovering Statistics Using SPSS for Windows is exactly that! Since it calculates amazingly fast, in the recent years, the computer has become the most useful and helpful tool for the researchers in almost every field of knowledge be it open and distance education, psychology, sociology, management or else. Quality research not only depends on fair data collection techniques but also on the respectable treatment of that data. Once the data have been collected, what is most important is the storage of data, their fast and 'as it is' retrieval when required, and their proper processing and analyses. Computers are of immense help in all these operations. However, it is interesting to note that computer is just a tool and what it will vomit (or produce) depends entirely upon the fingers and mind of its operator (or the researcher in the research settings). The computer has no mind (up to now!). So, it is the researcher who should be held responsible for the unfair treatment of the data. Proper treatment of the research data not only requires research attitude but also research aptitude, and proficiency and a solid background in statistical treatment of the data. For this purpose, some good textbooks are available that explain statistical theory and techniques. And some other good textbooks are also there on the role of computers and statistical software (e.g. SPSS) in the practical application of these statistical procedures employed on the data through computers. Here, the present book by Andy Field is a rare and excellent combination of both statistical theory as well as statistical treatment of the data using SPSS under one umbrella.",0,1 +874,Estimating the Reliability of Aggregated and Within-Person Centered Scores in Ecological Momentary Assessment,"A procedure for estimating the reliability of test scores in the context of ecological momentary assessment (EMA) was proposed to take into account the characteristics of EMA measures. Two commonly used test scores in EMA were considered: the aggregated score (AGGS) and the within-person centered score (WPCS). Conceptually, AGGS and WPCS represent the interindividual differences and the intraindividual differences, respectively. The reliability coefficients for AGGS and WPCS were derived using a multilevel factor model with a serial correlation structure framework. Point estimates and confidence intervals of these coefficients were obtained using Mx ( Neale, Boker, Xie, & Maes, 2004 ). A simulation study showed that the proposed procedure performed well empirically. Diary data from Huang (2009) , which recorded daily joy level of 110 undergraduate students for 8 days, was used to illustrate the applicability of the proposed method.",0,1 +875,Empirical Bayes Estimation of the Multivariate Normal Covariance Matrix,"Let $\mathbf{S}_{p \times p}$ have a Wishart distribution with scale matrix $\Sigma$ and $k$ degrees of freedom. Estimators of $\Sigma$ are given for each of the loss functions $L_1(\hat{\Sigma}, \Sigma) = \operatorname{tr} (\hat{\Sigma}\Sigma^{-1}) - \log \det (\hat{\Sigma}\Sigma^{-1}) - p$ and $L_2(\hat{\Sigma}, \Sigma) = \operatorname{tr} (\hat{\Sigma}\Sigma^{-1} - I)^2$. The obvious estimators of $\Sigma$ are the scalar multiples of $\mathbf{S}$, i.e., $a\mathbf{S}$ where $0 < a \leqslant 1/k$. (Recall that $(1/k)\mathbf{S}$ is unbiased.) For each problem $(\Sigma, \hat{\Sigma}, L_i), i = 1, 2$, we provide empirical Bayes estimators which dominate $a\mathbf{S}$ by a substantial amount. It is seen that the uniform reduction in the risk function determined by $L_2$ is at least $100(p + 1)/(k + p + 1){\tt\%}$. Dominance results for $L_1$ and $L_2$ were first given by James and Stein.",0,1 +876,Implementation of Marginal Bayesian Estimation with Four-Parameter Beta Prior Distributions,"Item parameter estimation for the threeparameter logistic model (3PLM) is sometimes problematic. The estimation algorithm of the 3PLM maximum likelihood estimation procedure often fails, which results in invalid parameter estimates. A procedure based on the marginal Bayesian estimation method introduced by Bock & Aitkin (1981), Swaminathan & Gifford (1985, 1986), and Mislevy & Bock (1990) is proposed here to improve the item parameter estimates for the 3PLM. Four-parameter beta distributions are used as prior distributions for estimating item parameters. A computer simulation study suggested that implementing the marginal Bayesian estimation algorithm with four-parameter beta prior distributions and then updating the priors with empirical means of the updated intermediate estimates can improve item parameter estimation when accurate prior information about the unknown parameters is not available.",0,1 +877,Applications of ideal point approaches to scale construction and scoring in personality measurement: The development of a six-faceted measure of conscientiousness.,,0,1 +878,Maximum Likelihood Item Easiness Models for Test Theory Without an Answer Key,Cultural consensus theory (CCT) is a data aggregation technique with many applications in the social and behavioral sciences. We describe the intuition and theory behind a set of CCT models for continuous type data using maximum likelihood inference methodology. We describe how bias parameters can be incorporated into these models. We introduce two extensions to the basic model in order to account for item rating easiness/difficulty. The first extension is a multiplicative model and the second is an additive model. We show how the multiplicative model is related to the Rasch model. We describe several maximum-likelihood estimation procedures for the models and discuss issues of model fit and identifiability. We describe how the CCT models could be used to give alternative consensus-based measures of reliability. We demonstrate the utility of both the basic and extended models on a set of essay rating data and give ideas for future research.,0,1 +879,MCMC algorithms for constrained variance matrices,The problem of finding a generic algorithm for applying Markov chain Monte Carlo (MCMC) estimation procedures to statistical models that include variance matrices with additional parameter constraints is considered. Such problems can be split between additional constraints across variance matrices and within variance matrices. The case of additional constraints across variance matrices is considered here for the first time and a review of existing work on the case of additional parameter constraints within a variance matrix is given. Two simple single-site updating random walk Metropolis algorithms are described which have the advantage of generality in that they can be applied to virtually all scenarios. Four applications where these methods can be used in practice are given. Some situations when such single-site algorithms break down are described and multiple-site alternatives are briefly discussed.,0,1 +880,Finite Mixture and Markov Switching Models,"WINNER OF THE 2007 DEGROOT PRIZE! The prominence of finite mixture modelling is greater than ever. Many important statistical topics like clustering data, outlier treatment, or dealing with unobserved heterogeneity involve finite mixture models in some way or other. The area of potential applications goes beyond simple data analysis and extends to regression analysis and to non-linear time series analysis using Markov switching models. For more than the hundred years since Karl Pearson showed in 1894 how to estimate the five parameters of a mixture of two normal distributions using the method of moments, statistical inference for finite mixture models has been a challenge to everybody who deals with them. In the past ten years, very powerful computational tools emerged for dealing with these models which combine a Bayesian approach with recent Monte simulation techniques based on Markov chains. This book reviews these techniques and covers the most recent advances in the field, among them bridge sampling techniques and reversible jump Markov chain Monte Carlo methods. It is the first time that the Bayesian perspective of finite mixture modelling is systematically presented in book form. It is argued that the Bayesian approach provides much insight in this context and is easily implemented in practice. Although the main focus is on Bayesian inference, the author reviews several frequentist techniques, especially selecting the number of components of a finite mixture model, and discusses some of their shortcomings compared to the Bayesian approach. The aim of this book is to impart the finite mixture and Markov switching approach to statistical modelling to a wide-ranging community. This includes not only statisticians, but also biologists, economists, engineers, financial agents, market researcher, medical researchers or any other frequent user of statistical models. This book should help newcomers to the field to understand how finite mixture and Markov switching models are formulated, what structures they imply on the data, what they could be used for, and how they are estimated. Researchers familiar with the subject also will profit from reading this book. The presentation is rather informal without abandoning mathematical correctness. Previous notions of Bayesian inference and Monte Carlo simulation are useful but not needed.",0,1 +881,Improving transparency and replication in Bayesian statistics: The WAMBS-Checklist.,"Bayesian statistical methods are slowly creeping into all fields of science and are becoming ever more popular in applied research. Although it is very attractive to use Bayesian statistics, our personal experience has led us to believe that naively applying Bayesian methods can be dangerous for at least 3 main reasons: the potential influence of priors, misinterpretation of Bayesian features and results, and improper reporting of Bayesian results. To deal with these 3 points of potential danger, we have developed a succinct checklist: the WAMBS-checklist (When to worry and how to Avoid the Misuse of Bayesian Statistics). The purpose of the questionnaire is to describe 10 main points that should be thoroughly checked when applying Bayesian analysis. We provide an account of ""when to worry"" for each of these issues related to: (a) issues to check before estimating the model, (b) issues to check after estimating the model but before interpreting results, (c) understanding the influence of priors, and (d) actions to take after interpreting results. To accompany these key points of concern, we will present diagnostic tools that can be used in conjunction with the development and assessment of a Bayesian model. We also include examples of how to interpret results when ""problems"" in estimation arise, as well as syntax and instructions for implementation. Our aim is to stress the importance of openness and transparency of all aspects of Bayesian estimation, and it is our hope that the WAMBS questionnaire can aid in this process. (PsycINFO Database Record",0,1 +882,Combining estimates of effect size.,,0,1 +883,Economic Inequality and Intolerance: Attitudes toward Homosexuality in 35 Democracies,"Using hierarchical linear models fitted to data from the World Values Survey and national statistics for 35 countries, this article builds on the postmaterialist thesis by assessing the impact of economic inequality across and within nations on attitudes toward homosexuality. It provides evidence that tolerance tends to decline as national income inequality rises. For professionals and managers, the results also support the postmaterialist argument that economic development leads to more tolerant attitudes. On the other hand, attitudes of the working class are generally less tolerant, and contrary to expectations of the postmaterialist thesis, are seemingly unaffected by economic development. In other words, economic development influences attitudes only for those who benefit most. These findings have political implications, suggesting that state policies that have the goal of economic growth but fail to consider economic inequality may contribute to intolerant social and political values, an attribute widely considered detrimental for the health of democracy. I nglehart’s (1987, 1990, 1997) postmaterialist thesis suggests that liberal values result from democracy, economic development, and modernization. Important to this argument is the idea that the prosperity of modern societies allows people to shift their attentionfrommaterialconcernstoso-called“postmaterialist” concerns, such as social issues and self-expression. This shift to postmaterialist values allegedly results in greater social tolerance. Moreover, by focusing on average value differences across country and time, the postmaterialist thesis implies that economic prosperity affects the attitudes of citizens in all economic positions within a given nationinmuchthesameway.Althoughinequalitywithin nationsisnotentirelydiscounted,thetheoryassumesthat once economic development reaches a particularly high level, inequality lessens to the point that it no longer influences values (Inglehart 1987). The present research takes issue with the assumption that national economic prosperity affects all members within a nation in a similar manner. Given the vast differences in economic conditions and life chances according to income group, social class, and occupation, even within rich democracies, it is not controversial to argue",0,1 +884,Multivariate meta-analysis: the effect of ignoring within-study correlation,"Summary. Multivariate meta-analysis allows the joint synthesis of summary estimates from multiple end points and accounts for their within-study and between-study correlation. Yet practitioners usually meta-analyse each end point independently. I examine the role of within-study correlation in multivariate meta-analysis, to elicit the consequences of ignoring it. Using analytic reasoning and a simulation study, the within-study correlation is shown to influence the ‘borrowing of strength’ across end points, and wrongly ignoring it gives meta-analysis results with generally inferior statistical properties; for example, on average it increases the mean-square error and standard error of pooled estimates, and for non-ignorable missing data it increases their bias. The influence of within-study correlation is only negligible when the within-study variation is small relative to the between-study variation, or when very small differences exist across studies in the within-study covariance matrices. The findings are demonstrated by applied examples within medicine, dentistry and education. Meta-analysts are thus encouraged to account for the correlation between end points. To facilitate this, I conclude by reviewing options for multivariate meta-analysis when within-study correlations are unknown; these include obtaining individual patient data, using external information, performing sensitivity analyses and using alternatively parameterized models.",0,1 +885,Bayesian estimation and testing of structural equation models,"The Gibbs sampler can be used to obtain samples of arbitrary size from the posterior distribution over the parameters of a structural equation model (SEM) given covariance data and a prior distribution over the parameters. Point estimates, standard deviations and interval estimates for the parameters can be computed from these samples. If the prior distribution over the parameters is uninformative, the posterior is proportional to the likelihood, and asymptotically the inferences based on the Gibbs sample are the same as those based on the maximum likelihood solution, for example, output from LISREL or EQS. In small samples, however, the likelihood surface is not Gaussian and in some cases contains local maxima. Nevertheless, the Gibbs sample comes from the correct posterior distribution over the parameters regardless of the sample size and the shape of the likelihood surface. With an informative prior distribution over the parameters, the posterior can be used to make inferences about the parameters of underidentified models, as we illustrate on a simple errors-in-variables model.",0,1 +886,Latent growth curve analysis with dichotomous items: Comparing four approaches,"A Monte Carlo study was used to compare four approaches to growth curve analysis of subjects assessed repeatedly with the same set of dichotomous items: A two-step procedure first estimating latent trait measures using MULTILOG and then using a hierarchical linear model to examine the changing trajectories with the estimated abilities as the outcome variable; a structural equation model using modified weighted least squares (WLSMV) estimation; and two approaches in the framework of multilevel item response models, including a hierarchical generalized linear model using Laplace estimation, and Bayesian analysis using Markov chain Monte Carlo (MCMC). These four methods have similar power in detecting the average linear slope across time. MCMC and Laplace estimates perform relatively better on the bias of the average linear slope and corresponding standard error, as well as the item location parameters. For the variance of the random intercept, and the covariance between the random intercept and slope, all estimates are biased in most conditions. For the random slope variance, only Laplace estimates are unbiased when there are eight time points.",0,1 +887,The role of spatiotemporal and spectral cues in segregating short sound events: evidence from auditory Ternus display,"Previous studies using auditory sequences with rapid repetition of tones revealed that spatiotemporal cues and spectral cues are important cues used to fuse or segregate sound streams. However, the perceptual grouping was partially driven by the cognitive processing of the periodicity cues of the long sequence. Here, we investigate whether perceptual groupings (spatiotemporal grouping vs. frequency grouping) could also be applicable to short auditory sequences, where auditory perceptual organization is mainly subserved by lower levels of perceptual processing. To find the answer to that question, we conducted two experiments using an auditory Ternus display. The display was composed of three speakers (A, B and C), with each speaker consecutively emitting one sound consisting of two frames (AB and BC). Experiment 1 manipulated both spatial and temporal factors. We implemented three 'within-frame intervals' (WFIs, or intervals between A and B, and between B and C), seven 'inter-frame intervals' (IFIs, or intervals between AB and BC) and two different speaker layouts (inter-distance of speakers: near or far). Experiment 2 manipulated the differentiations of frequencies between two auditory frames, in addition to the spatiotemporal cues as in Experiment 1. Listeners were required to make two alternative forced choices (2AFC) to report the perception of a given Ternus display: element motion (auditory apparent motion from sound A to B to C) or group motion (auditory apparent motion from sound 'AB' to 'BC'). The results indicate that the perceptual grouping of short auditory sequences (materialized by the perceptual decisions of the auditory Ternus display) was modulated by temporal and spectral cues, with the latter contributing more to segregating auditory events. Spatial layout plays a less role in perceptual organization. These results could be accounted for by the 'peripheral channeling' theory. © 2013 Springer-Verlag Berlin Heidelberg.",0,1 +888,Using Multilevel Modeling in Large-Scale Planned Variation Educational Experiments: Improving Understanding of Intervention Effects,"The author shows how one can combine a large-scale planned variation experimental design and multilevel analysis to address research questions that go beyond the issue of overall treatment effectiveness. In particular, the design and analysis approach presented here can address the following research questions: how an educational intervention produces its results, for whom the intervention works, and whether the intervention works well across different contexts. The author used data based on a large-scale educational field experiment to describe multilevel models that one can use to address this set of research questions. Important design and analysis considerations are highlighted, especially with regard to assessing the impact of school-level characteristics.",0,1 +889,A maximum‐likelihood method for estimating thresholds in a yes–no task,"A maximum-likelihood procedure for estimating threshold values in a yes-no task is presented. In computer simulations of this procedure, it is demonstrated that the variability of the threshold estimates is little affected by the density of the hypotheses tested for a fixed range, or by serious misestimates of the slope of the psychometric functions. The threshold value is also largely independent of the starting value of the signal. The standard deviation of the threshold estimates appears to decrease with the square root of the number of trials, with a 2- to 3-dB standard deviation possible if only 12 trials are used in the threshold estimates. Data are presented using human listeners tested on 5 days. Two threshold estimates, based on 12 trials, were made at each of the six audiometric frequencies on each day. The mean data appear sensible, and the standard deviation of the measured thresholds is about 3 dB. Using this procedure, it takes less than 3 min to measure the audiogram for a single ear.",0,1 +890,Bayesian multivariate meta-analysis with multiple outcomes,"There has been a recent growth in developments of multivariate meta-analysis. We extend the methodology of Bayesian multivariate meta-analysis to the situation when there are more than two outcomes of interest, which is underexplored in the current literature. Our objective is to meta-analyse summary data from multiple outcomes simultaneously, accounting for potential dependencies among the data. One common issue is that studies do not all report all of the outcomes of interests, and we take an approach relying on marginal modelling of only the reported data. We employ a separation prior for the between-study variance-covariance matrix, which offers an improvement on the conventional inverse-Wishart prior, showing robustness in estimation and flexibility in incorporating prior information. Particular challenges arise when the number of outcomes is large relative to the number of studies because the number of parameters in the variance-covariance matrix can become substantial and there can be very little information with which to estimate between-study correlation coefficients. We explore assumptions that reduce the number of parameters in this matrix, including assumptions of homogenous variances, homogenous correlations for certain outcomes and positive correlation coefficients. We illustrate the methods with an example data set from the Cochrane Database of Systematic Reviews.",0,1 +891,The Effects of Educational Diversity in a National Sample of Law Students: Fitting Multilevel Latent Variable Models in Data With Categorical Indicators,"Controversy surrounding the use of race-conscious admissions can be partially resolved with improved empirical knowledge of the effects of racial diversity in educational settings. We use a national sample of law students nested in 64 law schools to test the complex and largely untested theory regarding the effects of educational diversity on student outcomes. Social scientists who study these outcomes frequently encounter both latent variables and nested data within a single analysis. Yet, until recently, an appropriate modeling technique has been computationally infeasible, and consequently few applied researchers have estimated appropriate models to test their theories, sometimes limiting the scope of their research question. Our results, based on disaggregated multilevel structural equation models, show that racial diversity is related to a reduction in prejudiced attitudes and increased perceived exposure to diverse ideas and that these effects are mediated by more frequent interpersonal contact with diverse peers. These findings provide support for the idea that administrative manipulation of educational diversity may lead to improved student outcomes. Admitting a racially/ethnically diverse student body provides an educational experience that encourages increased exposure to diverse ideas and belief systems.",0,1 +892,Rational approximations to rational models: Alternative algorithms for category learning.,"Rational models of cognition typically consider the abstract computational problems posed by the environment, assuming that people are capable of optimally solving those problems. This differs from more traditional formal models of cognition, which focus on the psychological processes responsible for behavior. A basic challenge for rational models is thus explaining how optimal solutions can be approximated by psychological processes. We outline a general strategy for answering this question, namely to explore the psychological plausibility of approximation algorithms developed in computer science and statistics. In particular, we argue that Monte Carlo methods provide a source of rational process models that connect optimal solutions to psychological processes. We support this argument through a detailed example, applying this approach to Anderson's (1990, 1991) rational model of categorization (RMC), which involves a particularly challenging computational problem. Drawing on a connection between the RMC and ideas from nonparametric Bayesian statistics, we propose 2 alternative algorithms for approximate inference in this model. The algorithms we consider include Gibbs sampling, a procedure appropriate when all stimuli are presented simultaneously, and particle filters, which sequentially approximate the posterior distribution with a small number of samples that are updated as new data become available. Applying these algorithms to several existing datasets shows that a particle filter with a single particle provides a good description of human inferences.",0,1 +893,"The Common Structure of Statistical Models of Truncation, Sample Selection and Limited Dependent Variables and a Simple Estimator for Such Models",,0,1 +894,"Temporal associations between low body condition, lameness and milk yield in a UK dairy herd","Previous work has hypothesised that cows in low body condition become lame. We tested this in a prospective longitudinal study. Body condition score (BCS), causes of lameness and milk yield were collected from a 600-cow herd over 44-months. Mixed effect binomial models and a continuous outcome model were used to investigate the associations between lameness, BCS and milk yield. In total, 14,320 risk periods were obtained from 1137 cows. There were 1510 lameness treatments: the most common causes of lameness were sole ulcer (SU) (39%), sole haemorrhage (SH) (13%), digital dermatitis (DD) (10%) and white line disease (WLD) (8%). These varied by year and year quarter. Body condition was scored at 60-day intervals. BCS ranged from 1 to 5 with a mean of 2.5, scores were higher in very early lactation but varied widely throughout lactation; approximately 45% of scores were <2.5. The key finding was that BCS<2.5 was associated with an increased risk of treatment for lameness in the following 0-2 months and >2-4 months for all causes of lameness and also specifically for SU/WLD lameness. BCS<2.5 was associated with an increased risk of treatment for SH in the following 0-2 months but not >2-4 months. There was no such association with DD. All lameness, SU/WLD, SH and DD were significantly more likely to occur in cows that had been lame previously, but the effect of BCS was present even when all repeat cases of lameness were excluded from the analysis. Milk yield was significantly higher and fell in the month before treatment in cows lame with SU/WLD but it was not significantly higher for cows that were treated for DD compared with non-lame cows. These findings support the hypothesis that low BCS contributes to the development of horn related claw lameness but not infectious claw diseases in dairy cows. One link between low BCS and lameness is a thin digital cushion which has been proposed as a trigger for claw horn disease. Cows with BCS 2 produced more milk than cows with BCS 2.5, however, this was only approximately 100 kg difference in yield over a 305-day lactation. Given the increased risk of lameness in cows with BCS 2, the direct costs of lameness and the small variability in milk yield by BCS, preventing cows from falling to BCS<2.5 would improve cow welfare and be economically beneficial.",0,1 +895,Estimating the nonlinear and interactive effects of latent variables.,"Describes a procedure that enables researchers to estimate nonlinear and interactive effects of latent variables in structural equation models. Given that the latent variables are normally distributed, the parameters of such models can be estimated. To do this, products of the measured variables are used as indicators of latent product variables. Estimation must be done using a procedure that allows nonlinear constraints on parameters. The procedure is demonstrated in 3 examples. The 1st 2 examples use artificial data with known parameter values. These parameters are successfully recovered by the procedure. The final complex example uses national election survey data. (14 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1984 American Psychological Association.",0,1 +896,Network meta-analysis of treatments for type 2 diabetes mellitus following failure with metformin plus sulfonylurea,"Aims The efficacy and safety of sodium-glucose linked transporters (SGLT2s) plus metformin and a sulfonylurea (MET + SU) for the treatment of type 2 diabetes mellitus (T2DM) in patients who fail to achieve glycemic control with MET + SU, relative to other triple therapies licensed in the EU, were estimated. Methods A systematic literature review and network meta-analysis (NMA) of randomized controlled trials (RCTs) involving anti-diabetes treatments added to MET + SU were conducted.Of 2236 abstracts identified through a systematic literature review, 30 RCTs published between 2003 and 2013 were included. RCTs ranged from 12 to 52 weeks in duration, included 28 to 1274 patients, were of parallel design, and most were open-label. Comparators included placebo (reference treatment), SGLT2 inhibitors, dipeptidyl peptidase-4 (DPP-4) inhibitors, thiazolidinediones (TZDs), alpha-glucosidase inhibitors (AGIs), meglitinides, glucagon-like peptide 1 (GLP-1) analogues, and basal, bolus, and biphasic insulin, all added on to MET + SU, as well as basal and biphasic insulin added to MET and monotherapy. The mean change (%) in HbA1c levels compared to placebo was -0.86 for SGLT2 inhibitors, -0.68 for DPP-4 inhibitors, -0.93 for TZDs, and -1.07 for GLP-1 analogues, respectively. Only SGLT2 inhibitors and GLP-1 analogues led to a weight loss (-1.71 kg and -1.14 kg, respectively) and decrease in systolic blood pressure (SBP; -3.73 mmHg and -2.90 mmHg, respectively), while all other treatments showed either an increase or no changes in weight or SBP. Conclusion SGLT2 inhibitors are at least as effective as other classes of antidiabetic agents at controlling HbA1c levels, while providing the additional benefits of weight loss and reducing SBP. Additionally, since the risk of hypoglycemia is similar or reduced with SGLT2 inhibitors, patients do not have to trade off efficacy for tolerability. Similar findings were observed for GLP-1 analogues.",0,1 +897,A generalized Q–Q plot for longitudinal data,"Most biomedical research is carried out using longitudinal studies. The method of generalized estimating equations (GEEs) introduced by Liang and Zeger [Longitudinal data analysis using generalized linear models, Biometrika 73 (1986), pp. 13-22] and Zeger and Liang [Longitudinal data analysis for discrete and continuous outcomes, Biometrics 42 (1986), pp. 121-130] has become a standard method for analyzing non-normal longitudinal data. Since then, a large variety of GEEs have been proposed. However, the model diagnostic problem has not been explored intensively. Oh et al. [Modeldiagnostic plots for repeated measures data using the generalized estimating equations approach, Comput. Statist. Data Anal. 53 (2008), pp. 222-232] proposed residual plots based on the quantile-quantile (Q-Q) plots of the chi(2)-distribution for repeated-measures data using the GEE methodology. They considered the Pearson, Anscombe and deviance residuals. In this work, we propose to extend this graphical diagnostic using a generalized residual. A simulation study is presented as well as two examples illustrating the proposed generalized Q-Q plots.",0,1 +898,Intrinsic Motivation Inventory: Psychometric Properties in the Context of First Language and Mathematics Learning,"Intrinsic Motivation Inventory (IMI) is a multidimensional measurement grounded on the Self-Determination Theory (SDT) used in assessing the subjective experiences of participants when developing an activity. The aim of this study is to analyze the characteristics of IMI among Portuguese students, testing four organizational models (unidimensional, multidimensional, hierarchical and bi-factor). A total of 3685 students from the 5th to the 12th grades (50.4% boys) participated in the study (M = 13.67, SD = 2.26). Two versions of IMI were used (First Language and Mathematics) with twenty-one items distributed over five subscales: Enjoyment, Perceived Competence, Pressure/Tension, Perceived Choice and Value/Utility. The confirmatory factor analysis corroborated the multidimensionality of intrinsic motivation, and that the bi-factor model presented the best fit indexes. This model showed the existence of one general factor, resulting from the contribution of all individual dimensions and the particularities of most of them. Furthermore, results also highlighted satisfactory reliability scores both through Cronbach's alpha scores and Composite reliability scores. These results indicate that this scale is appropriate to evaluate the underlying constructs of the theoretical model of SDT and allows for the calculation of a global measure of intrinsic motivation, as well as specific measures for their predictors.",0,1 +899,How vague is vague? A simulation study of the impact of the use of vague prior distributions in MCMC using WinBUGS,"There has been a recent growth in the use of Bayesian methods in medical research. The main reasons for this are the development of computer intensive simulation based methods such as Markov chain Monte Carlo (MCMC), increases in computing power and the introduction of powerful software such as WinBUGS. This has enabled increasingly complex models to be fitted. The ability to fit these complex models has led to MCMC methods being used as a convenient tool by frequentists, who may have no desire to be fully Bayesian. Often researchers want 'the data to dominate' when there is no prior information and thus attempt to use vague prior distributions. However, with small amounts of data the use of vague priors can be problematic. The results are potentially sensitive to the choice of prior distribution. In general there are fewer problems with location parameters. The main problem is with scale parameters. With scale parameters, not only does one have to decide the distributional form of the prior distribution, but also whether to put the prior distribution on the variance, standard deviation or precision. We have conducted a simulation study comparing the effects of 13 different prior distributions for the scale parameter on simulated random effects meta-analysis data. We varied the number of studies (5, 10 and 30) and compared three different between-study variances to give nine different simulation scenarios. One thousand data sets were generated for each scenario and each data set was analysed using the 13 different prior distributions. The frequentist properties of bias and coverage were investigated for the between-study variance and the effect size. The choice of prior distribution was crucial when there were just five studies. There was a large variation in the estimates of the between-study variance for the 13 different prior distributions. With a large number of studies the choice of prior distribution was less important. The effect size estimated was not biased, but the precision with which it was estimated varied with the choice of prior distribution leading to varying coverage intervals and, potentially, to different statistical inferences. Again there was less of a problem with a larger number of studies. There is a particular problem if the between-study variance is close to the boundary at zero, as MCMC results tend to produce upwardly biased estimates of the between-study variance, particularly if inferences are based on the posterior mean. The choice of 'vague' prior distribution can lead to a marked variation in results, particularly in small studies. Sensitivity to the choice of prior distribution should always be assessed.",0,1 +900,Latent variable interaction and quadratic effect estimation: A two-step technique using structural equation analysis.,"The author proposes an alternative estimation technique for latent variable interactions and quadraties. Available techniques for specifying these variables in structural equation models require adding variables or constraint equations that can produce specification tedium and errors or estimation difficulties. The proposed technique avoids these difficulties and may be useful for EQS, LISREL 7, and LISREL 8 users. First, measurement parameters for indicator Ioadings and errors of linear latent variables are estimated in a measurement model that excludes the interaction and quadratic variables. Next, these estimates are used to calculate values for the indicator loadings and error variances ofthe interaction and quadratic latent variables. Then, these calculated values are specified as constants in the structural model containing the interaction and quadratic variables. Interaction and quadratic effects are routinely reported for categorical independent variables (i.e., in analysis of variance) frequently to aid in the interpretation of significant main effects. However, interaction and quadratic effects are less frequently reported for continuous independent variables.",0,1 +901,"The effect of exposure duration on visual character identification in single, whole, and partial report.","The psychometric function of single-letter identification is typically described as a function of stimulus intensity. However, the effect of stimulus exposure duration on letter identification remains poorly described. This is surprising because the effect of exposure duration has played a central role in modeling performance in whole and partial report (Shibuya & Bundesen, 1988). Therefore, we experimentally investigated visual letter identification as a function of exposure duration. We compared the exponential, the gamma, and the Weibull psychometric functions, all with a temporal offset included, as well as the ex-Gaussian, the log-logistic, and finally the squared-logistic, which is a psychometric function that to our knowledge has not been described before. The log-logistic and the squared-logistic psychometric function fit well to experimental data. Also, we conducted an experiment to test the ability of the psychometric functions to fit single-letter identification data, at different stimulus contrast levels; also here the same psychometric functions prevailed. Finally, after insertion into Bundesen's Theory of Visual Attention (Bundesen, 1990), the same psychometric functions enable closer fits to data from a previous whole and partial report experiment.",0,1 +902,Environment sensitivity in hierarchical representations,,0,1 +903,"Predicting the extent of heterogeneity in meta-analysis, using empirical data from the Cochrane Database of Systematic Reviews","Many meta-analyses contain only a small number of studies, which makes it difficult to estimate the extent of between-study heterogeneity. Bayesian meta-analysis allows incorporation of external evidence on heterogeneity, and offers advantages over conventional random-effects meta-analysis. To assist in this, we provide empirical evidence on the likely extent of heterogeneity in particular areas of health care.Our analyses included 14 886 meta-analyses from the Cochrane Database of Systematic Reviews. We classified each meta-analysis according to the type of outcome, type of intervention comparison and medical specialty. By modelling the study data from all meta-analyses simultaneously, using the log odds ratio scale, we investigated the impact of meta-analysis characteristics on the underlying between-study heterogeneity variance. Predictive distributions were obtained for the heterogeneity expected in future meta-analyses.Between-study heterogeneity variances for meta-analyses in which the outcome was all-cause mortality were found to be on average 17% (95% CI 10-26) of variances for other outcomes. In meta-analyses comparing two active pharmacological interventions, heterogeneity was on average 75% (95% CI 58-95) of variances for non-pharmacological interventions. Meta-analysis size was found to have only a small effect on heterogeneity. Predictive distributions are presented for nine different settings, defined by type of outcome and type of intervention comparison. For example, for a planned meta-analysis comparing a pharmacological intervention against placebo or control with a subjectively measured outcome, the predictive distribution for heterogeneity is a log-normal (-2.13, 1.58(2)) distribution, which has a median value of 0.12. In an example of meta-analysis of six studies, incorporating external evidence led to a smaller heterogeneity estimate and a narrower confidence interval for the combined intervention effect.Meta-analysis characteristics were strongly associated with the degree of between-study heterogeneity, and predictive distributions for heterogeneity differed substantially across settings. The informative priors provided will be very beneficial in future meta-analyses including few studies.",0,1 +904,Improving the Meta-Analytic Assessment of Effect Size Variance With an Informed Bayesian Prior,"Meta-analytic estimation of effect size variance is critical for determining the degree to which a relationship or finding generalizes across contexts. In most meta-analyses, population effect size variability is estimated by subtracting expected sampling error variance from observed variance, using only information from a limited set of available studies. We propose an improved Bayesian variance estimation technique that incorporates findings from previous meta-analytic research through an informed prior distribution of likely levels of effect size variance. The logic of exchangeability as a conceptual foundation for using an informed prior is explicated. On the basis of Monte Carlo simulations, we find the traditional method of meta-analytic variance estimation the most biased and least accurate technique across all sizes of meta-analyses considered. The Bayesian methodology incorporating an informed prior proved to be the most accurate and overall least biased of all estimation methods. Conceptual advantages and limitations that must be taken into account when incorporating an informed prior to estimate variability of effect sizes in a meta-analysis are also discussed.",0,1 +905,Methods for calculating confidence and credible intervals for the residual between-study variance in random effects meta-regression models,"Meta-regression is becoming increasingly used to model study level covariate effects. However this type of statistical analysis presents many difficulties and challenges. Here two methods for calculating confidence intervals for the magnitude of the residual between-study variance in random effects meta-regression models are developed. A further suggestion for calculating credible intervals using informative prior distributions for the residual between-study variance is presented.Two recently proposed and, under the assumptions of the random effects model, exact methods for constructing confidence intervals for the between-study variance in random effects meta-analyses are extended to the meta-regression setting. The use of Generalised Cochran heterogeneity statistics is extended to the meta-regression setting and a Newton-Raphson procedure is developed to implement the Q profile method for meta-analysis and meta-regression. WinBUGS is used to implement informative priors for the residual between-study variance in the context of Bayesian meta-regressions.Results are obtained for two contrasting examples, where the first example involves a binary covariate and the second involves a continuous covariate. Intervals for the residual between-study variance are wide for both examples.Statistical methods, and R computer software, are available to compute exact confidence intervals for the residual between-study variance under the random effects model for meta-regression. These frequentist methods are almost as easily implemented as their established counterparts for meta-analysis. Bayesian meta-regressions are also easily performed by analysts who are comfortable using WinBUGS. Estimates of the residual between-study variance in random effects meta-regressions should be routinely reported and accompanied by some measure of their uncertainty. Confidence and/or credible intervals are well-suited to this purpose.",0,1 +906,Bayesian perspectives for epidemiological research: I. Foundations and basic methods,"One misconception (of many) about Bayesian analyses is that prior distributions introduce assumptions that are more questionable than assumptions made by frequentist methods; yet the assumptions in priors can be more reasonable than the assumptions implicit in standard frequentist models. Another misconception is that Bayesian methods are computationally difficult and require special software. But perfectly adequate Bayesian analyses can be carried out with common software for frequentist analysis. Under a wide range of priors, the accuracy of these approximations is just as good as the frequentist accuracy of the software--and more than adequate for the inaccurate observational studies found in health and social sciences. An easy way to do Bayesian analyses is via inverse-variance (information) weighted averaging of the prior with the frequentist estimate. A more general method expresses the prior distributions in the form of prior data or 'data equivalents', which are then entered in the analysis as a new data stratum. That form reveals the strength of the prior judgements being introduced and may lead to tempering of those judgements. It is argued that a criterion for scientific acceptability of a prior distribution is that it be expressible as prior data, so that the strength of prior assumptions can be gauged by how much data they represent.",0,1 +907,On the Importance of Reliable Covariate Measurement in Selection Bias Adjustments Using Propensity Scores,"The effect of unreliability of measurement on propensity score (PS) adjusted treatment effects has not been previously studied. The authors report on a study simulating different degrees of unreliability in the multiple covariates that were used to estimate the PS. The simulation uses the same data as two prior studies. Shadish, Clark, and Steiner showed that a PS formed from many covariates demonstrably reduced selection bias, while Steiner, Cook, Shadish, and Clark identified the subsets of covariates from the larger set that were most effective for bias reduction. Adding different degrees of random error to these covariates in a simulation, the authors demonstrate that unreliability of measurement can degrade the ability of PSs to reduce bias. Specifically, increases in reliability only promote bias reduction, if the covariates are effective in reducing bias to begin with. Increasing or decreasing the reliability of covariates that do not effectively reduce selection bias makes no difference at all.",0,1 +908,Factorial comparison of working memory models.,"Three questions have been prominent in the study of visual working memory limitations: (a) What is the nature of mnemonic precision (e.g., quantized or continuous)? (b) How many items are remembered? (c) To what extent do spatial binding errors account for working memory failures? Modeling studies have typically focused on comparing possible answers to a single one of these questions, even though the result of such a comparison might depend on the assumed answers to both others. Here, we consider every possible combination of previously proposed answers to the individual questions. Each model is then a point in a 3-factor model space containing a total of 32 models, of which only 6 have been tested previously. We compare all models on data from 10 delayed-estimation experiments from 6 laboratories (for a total of 164 subjects and 131,452 trials). Consistently across experiments, we find that (a) mnemonic precision is not quantized but continuous and not equal but variable across items and trials; (b) the number of remembered items is likely to be variable across trials, with a mean of 6.4 in the best model (median across subjects); (c) spatial binding errors occur but explain only a small fraction of responses (16.5% at set size 8 in the best model). We find strong evidence against all 6 documented models. Our results demonstrate the value of factorial model comparison in working memory.",0,1 +909,Constrained versus unconstrained estimation in structural equation modeling.,"Recently, R. D. Stoel, F. G. Garre, C. Dolan, and G. van den Wittenboer (2006) reviewed approaches for obtaining reference mixture distributions for difference tests when a parameter is on the boundary. The authors of the present study argue that this methodology is incomplete without a discussion of when the mixtures are needed and show that they only become relevant when constrained difference tests are conducted. Because constrained difference tests can hide important model misspecification, a reliable way to assess global model fit under constrained estimation would be needed. Examination of the options for assessing model fit under constrained estimation reveals that no perfect solutions exist, although the conditional approach of releasing a degree of freedom for each active constraint appears to be the most methodologically sound one. The authors discuss pros and cons of constrained and unconstrained estimation and their implementation in 5 popular structural equation modeling packages and argue that unconstrained estimation is a simpler method that is also more informative about sources of misfit. In practice, researchers will have trouble conducting constrained difference tests appropriately, as this requires a commitment to ignore Heywood cases. Consequently, mixture distributions for difference tests are rarely appropriate.",0,1 +910,Meta-analysis of heterogeneously reported trials assessing change from baseline,"This paper considers the quantitative synthesis of published comparative study results when the outcome measures used in the individual studies and the way in which they are reported varies between studies. Whilst the former difficulty may be overcome, at least to a limited extent, by the use of standardized effects, the latter is often more problematic. Two potential solutions to this problem are; sensitivity analyses and a fully Bayesian approach, in which pertinent external information is included. Both approaches are illustrated using the results of two systematic reviews and meta-analyses which consider the difference in mean change in systolic blood pressure and the difference in physical functioning between an intervention and control group. The two examples illustrate that by adopting a fully Bayesian approach, as opposed to undertaking sensitivity analyses assuming fixed values for unknown parameters, the overall intervention effect can be estimated with greater uncertainty, but that assessing the sensitivity of results to choice of prior distributions in such analyses is crucial.",0,1 +911,Reviews of Market Drivers of New Product Performance: Effects and Relationships,"This study adopts a meta-analytic approach to review the performance effects of the market predictors of new product performance and their structural relationships. Based on empirical findings from the relevant studies published before 2011, this study has a number of interesting findings. First, market orientation, competitor orientation, product advantage and launch proficiency are the dominant drivers of new product performance. Second, market orientation, marketing synergy, product advantage and competitive intensity have significant effects on new product performance. Third, product advantage serves as an important intermediary between the market predictors and new product performance. Fourth, product innovativeness per se does not affect new product performance. Finally, launch proficiency translates the effect of market orientation into new product performance. These findings not only identify the dominant market drivers of new product performance, but also profile the routes leading to better new product performance. Some important implications for market research and practice are also provided.",0,1 +912,Using a Multivariate Multilevel Polytomous Item Response Theory Model to Study Parallel Processes of Change: The Dynamic Association Between Adolescents' Social Isolation and Engagement With Delinquent Peers in the National Youth Survey,"The application of multidimensional item response theory models to repeated observations has demonstrated great promise in developmental research. It allows researchers to take into consideration both the characteristics of item response and measurement error in longitudinal trajectory analysis, which improves the reliability and validity of the latent growth curve (LGC) model. The purpose of this study is to demonstrate the potential of Bayesian methods and the utility of a comprehensive modeling framework, the one combining a measurement model (e.g., a multidimensional graded response model, MGRM) with a structural model (e.g., an associative latent growth curve analysis, ALGC). All analyses are implemented in WinBUGS 1.4.3 ( Spiegelhalter, Thomas, Best, & Lunn, 2003 ), which allows researchers to use Markov chain Monte Carlo simulation methods to fit complex statistical models and circumvent intractable analytic or numerical integrations. The utility of this MGRM-ALGC modeling framework was investigated with both simulated and empirical data, and promising results were obtained. As the results indicate, being a flexible multivariate multilevel model, this MGRM-ALGC model not only produces item parameter estimates that are readily estimable and interpretable but also estimates the corresponding covariation in the developmental dimensions. In terms of substantive interpretation, as adolescents perceived themselves more socially isolated, the chance that they are engaged with delinquent peers becomes profoundly larger. Generally, boys have a higher initial exposure extent than girls. However, there is no gender difference associated with other latent growth parameters.",0,1 +913,Structural Equation Modeling with Small Samples: Test Statistics,"Structural equation modeling is a well-known technique for studying relationships among multivariate data. In practice, high dimensional nonnormal data with small to medium sample sizes are very common, and large sample theory, on which almost all modeling statistics are based, cannot be invoked for model evaluation with test statistics. The most natural method for nonnormal data, the asymptotically distribution free procedure, is not defined when the sample size is less than the number of nonduplicated elements in the sample covariance. Since normal theory maximum likelihood estimation remains defined for intermediate to small sample size, it may be invoked but with the probable consequence of distorted performance in model evaluation. This article studies the small sample behavior of several test statistics that are based on maximum likelihood estimator, but are designed to perform better with nonnormal data. We aim to identify statistics that work reasonably well for a range of small sample sizes and distribution conditions. Monte Carlo results indicate that Yuan and Bentler's recently proposed F-statistic performs satisfactorily.",0,1 +914,Interactions of latent variables in structural equation models,"Interactions of variables occur in a variety of statistical analyses. The best known procedures for models with interactions of latent variables are technically demanding. Not only does the potential user need to be familiar with structural equation modeling (SEM), but the researcher must be familiar with programming nonlinear and linear constraints and must be comfortable with fairly large and complicated models. This article provides a largely nontechnical description of an alternative two‐stage least squares (2SLS) technique to include interactions of latent variables in SEM. The method requires the selection of instrumental variables and we give rules for their selection in the most common cases. We compare the 2SLS method to the alternatives. Some of the important advantages of the 2SLS are that it can handle nonnormal observed variables, is readily available in major statistical software packages, and has a known asymptotic distribution. In providing the comparisons, we reanalyze all the interaction...",0,1 +915,A Bayesian approach to Markov modelling in cost-effectiveness analyses: application to taxane use in advanced breast cancer,"Summary. The paper demonstrates how cost-effectiveness decision analysis may be implemented from a Bayesian perspective, using Markov chain Monte Carlo simulation methods for both the synthesis of relevant evidence input into the model and the evaluation of the model itself. The desirable aspects of a Bayesian approach for this type of analysis include the incorporation of full parameter uncertainty, the ability to perform all the analysis, including each meta-analysis, in a single coherent model and the incorporation of expert opinion either directly or regarding the relative credibility of different data sources. The method is described, and its ease of implementation demonstrated, through a practical example to evaluate the cost-effectiveness of using taxanes for the second-line treatment of advanced breast cancer compared with conventional treatment. For completeness, the results from the Markov chain Monte Carlo simulation model are compared and contrasted with those from a classical Monte Carlo simulation model.",0,1 +916,R. A. Fisher and multivariate analysis,This paper reviews R. A. Fisher's many fundamental contri- butions to multivariate statistical analysis-from the derivation of the distribution of the sample correlation coefficient to discriminant analysis. The emphasis here is on the conceptual and mathematical development. All of his papers on multivariate analysis will be included in this survey.,0,1 +917,Bayesian Aspects of Small Area Estimation,"This chapter deals with the Bayesian aspects of small area estimation. It discusses only some aspects of small area estimation, particularly the model based EB and HB approach. Models play a major role in modern small area estimation. There are several advantages of model based inference over the traditional indirect estimators. EB produce approximate estimates whereas HB provides accurate estimates. For HB analysis, the standard Bayesian model diagnostics tools are applied so far. The chapter addresses the basic models, and mentions some extensions of those models. This chapter focuses mainly on empirical Bayes and hierarchical Bayes estimators related to small area models. The Bayes estimators are usually obtained under squared error loss. This chapter concludes that Empirical Bayes estimators are obtained as estimated posterior mean, while for hierarchical Bayes usually subjective prior distributions are assumed for the model parameters.",0,1 +918,The psychometric function: The lapse rate revisited,"In their influential paper, Wichmann and Hill (2001) have shown that the threshold and slope estimates of a psychometric function may be severely biased when it is assumed that the lapse rate equals zero but lapses do, in fact, occur. Based on a large number of simulated experiments, Wichmann and Hill claim that threshold and slope estimates are essentially unbiased when one allows the lapse rate to vary within a rectangular prior during the fitting procedure. Here, I replicate Wichmann and Hill's finding that significant bias in parameter estimates results when one assumes that the lapse rate equals zero but lapses do occur, but fail to replicate their finding that freeing the lapse rate eliminates this bias. Instead, I show that significant and systematic bias remains in both threshold and slope estimates even when one frees the lapse rate according to Wichmann and Hill's suggestion. I explain the mechanisms behind the bias and propose an alternative strategy to incorporate the lapse rate into psychometric function models, which does result in essentially unbiased parameter estimates.",0,1 +919,Using Response Times for Item Selection in Adaptive Testing,"Response times on items can be used to improve item selection in adaptive testing provided that a probabilistic model for their distribution is available. In this research, the author used a hierarchical modeling framework with separate first-level models for the responses and response times and a second-level model for the distribution of the ability and speed parameters in the population of test takers. The framework allows the author to retrofit an empirical prior distribution for the ability parameter on each occurrence of a new response time. In an example with an adaptive version of the Law School Admission Test (LSAT), the author shows how this additional update of the posterior distribution of the ability leads to a substantial improvement of the ability estimator. Two ways of applying the procedure in real-world adaptive testing are discussed.",0,1 +920,Finite mixtures in confirmatory factor-analysis models,"In this paper, various types of finite mixtures of confirmatory factor-analysis models are proposed for handling data heterogeneity. Under the proposed mixture approach, observations are assumed to be drawn from mixtures of distinct confirmatory factor-analysis models. But each observation does not need to be identified to a particular model prior to model fitting. Several classes of mixture models are proposed. These models differ by their unique representations of data heterogeneity. Three different sampling schemes for these mixture models are distinguished. A mixed type of the these three sampling schemes is considered throughout this article. The proposed mixture approach reduces to regular multiple-group confirmatory factor-analysis under a restrictive sampling scheme, in which the structural equation model for each observation is assumed to be known. By assuming a mixture of multivariate normals for the data, maximum likelihood estimation using the EM (Expectation-Maximization) algorithm and the AS (Approximate-Scoring) method are developed, respectively. Some mixture models were fitted to a real data set for illustrating the application of the theory. Although the EM algorithm and the AS method gave similar sets of parameter estimates, the AS method was found computationally more efficient than the EM algorithm. Some comments on applying the mixture approach to structural equation modeling are made.",0,1 +921,Rethinking perceived service quality: An alternative to hierarchical and multidimensional models,"Measuring perceived service quality continues to be a controversial topic in management literature. Brady and Cronin's (2001) hierarchical and multidimensional model overcame several limitations of previously proposed models. Nevertheless, Brady and Cronin's conceptualisation has been the object of substantial criticism. This research describes the most important limitations of the Brady and Cronin's (2001) model, pointing out some newly identified drawbacks to this kind of conceptualisation and to using the methodology for analysing service quality models. To overcome these shortcomings, a new procedure is proposed, based on the proper identification of service quality attributes and on the study of unobserved heterogeneity in customer perceptions. An application of this procedure to the insurance industry shows the possible advantages of using this method for studying perceived quality in services. The results of the empirical study confirm the presence of several latent classes formed by customers with...",0,1 +922,Comparison of Software Algorithms for Calculating REML Wald Type Confidence Limits for the Between-Group Variance Component in a Small Sample One-Way Random Effects Model Example,"Confidence limits for variance components in mixed effects models can be readily estimated by procedures such as PROC MIXED (SAS®), MIXED (SPSS®), LME (S-PLUS®), and XTMIXED (Stata®). For a small sample unbalanced one-way random effects model case study, the REML Wald type confidence limits for the between-group variance obtained from PROC MIXED differ substantially from those from MIXED, LME, and XTMIXED. Simulations indicate that the Satterthwaite approximation used by PROC MIXED results in highly inflated confidence interval lengths, while the interval lengths from the other procedures are usually similar but also biased upward. The coverage rates of the confidence limits from all four procedures appear above the nominal value. Extreme upper limits and problems with computing the confidence limits are also possible, especially with PROC MIXED. In general, one should avoid the naive use of statistical software packages when estimating REML confidence limits for variance components with small datasets, a...",0,1 +923,A Bayesian analysis of finite mixtures in the LISREL model,"In this paper, we propose a Bayesian framework for estimating finite mixtures of the LISREL model. The basic idea in our analysis is to augment the observed data of the manifest variables with the latent variables and the allocation variables. The Gibbs sampler is implemented to obtain the Bayesian solution. Other associated statistical inferences, such as the direct estimation of the latent variables, establishment of a goodness-of-fit assessment for a posited model, Bayesian classification, residual and outlier analyses, are discussed. The methodology is illustrated with a simulation study and a real example.",0,1 +924,A Simulation Study of Mediated Effect Measures,"Analytical solutions for point and variance estimators of the mediated effect, the ratio of the mediated to the direct effect, and the proportion of the total effect that is mediated were studied with statistical simulations. We compared several approximate solutions based on the multivariate delta method and second order Taylor series expansions to the empirical standard deviation of each estimator and theoretical standard error when available. The simulations consisted of 500 replications of three normally distributed variables for eight sample sizes (N = 10, 25, 50, 100, 500, 1000, and 5000) and 64 parameter value combinations. The different solutions for the standard error of the indirect effect were very similar for sample sizes of at least 50, except when the independent variable was dichotomized. A sample size of at least 500 was needed for accurate point and variance estimates of the proportion mediated. The point and variance estimates of the ratio of the mediated to nonmediated effect did not stabilize until the sample size was 2,000 for the all continuous variable case. Implications for the estimation of mediated effects in experimental and nonexperimental studies are discussed.",0,1 +925,An item analysis of the Conditional Reasoning Test of Aggression.,"This manuscript uses item response theory (IRT) to estimate item characteristics of the Conditional Reasoning Test of Aggression (CRT-A). Using a sample size of 5,511 respondents, the present analysis provides an accurate assessment of the capability of the CRT-A to measure latent aggression. The one-parameter logistic (1PL) model, two-parameter logistic (2PL) model, and three-parameter logistic (3PL) model are compared before the item analysis. Results suggest that the 2PL model is the most appropriate dichotomous IRT model for describing the item characteristics of the CRT-A. Potential multdimensionality in the CRT-A is also examined. Results suggest that CRT-A items work as theoretically intended, with the probability of selecting an aggressive response increasing with latent trait levels. Information curves indicate that the CRT-A is best suited for use with individuals who are high on latent aggression. Exploratory analyses include an examination of polytomous IRT models and DIF comparing student and employee respondents. The results have implications for future research using the CRT-A as well as the identification of populations appropriate for measurement using this assessment tool.",0,1 +926,Healthy weight control and dissonance-based eating disorder prevention programs: Results from a controlled trial,"Because universal psychoeducational eating disorder prevention programs have had little success, we developed and evaluated two interventions for high-risk populations: a healthy weight control intervention and a dissonance-based intervention.Adolescent girls (N = 148) with body image concerns were randomized to one of these interventions or to a waitlist control group. Participants completed baseline, termination, and 1, 3, and 6-month follow-up surveys.Participants in both interventions reported decreased thin-ideal internalization, negative affect, and bulimic symptoms at termination and follow-up relative to controls. However, no effects were observed for body dissatisfaction or dieting and effects diminished over time.Results provide evidence that both interventions effectively reduce bulimic pathology and risk factors for eating disturbances.",0,1 +927,Using Propensity Score Subclassification for Multiple Treatment Doses to Evaluate a National Antidrug Media Campaign,"In 1998, the U.S. Office of National Drug Control Policy launched a national media campaign in an effort to reduce and prevent drug use among young Americans. Because the campaign was implemented nationwide, there is no control group available for use in evaluating the effects of the campaign. Nevertheless, it is possible to use propensity score methods to evaluate the effects of the campaign. However, because teens receive varying degrees of exposure to the media campaign, it is necessary to apply propensity score methods that accommodate multiple treatment doses. This work extends that of previous authors to subclassification on the propensity score for observational studies with multiple treatment doses, rather than matching on the propensity score, and proposes modifications to accommodate complex survey data. This methodology is illustrated using data from a pilot study for the media campaign evaluation.",0,1 +928,Bayesian Structural Equation Models for Cumulative Theory Building in Information Systems―A Brief Tutorial Using BUGS and R,"Structural equation models (SEM) are frequently used in information systems (IS) to analyze and test theoretical propositions. As IS researchers frequently reuse measurement instruments and adapt or extend theories, they frequently re-estimate regression relationships in their SEM that have been examined in previous studies. We advocate the use of Bayesian estimation of structural equation models as an aid to cumulative theory building; Bayesian statistics offer a statistically sound way to incorporate prior knowledge into SEM estimation, allowing researchers to keep a “running tally” of the best estimates of model parameters. This tutorial on the application of Bayesian principles to SEM estimation discusses when and why the use of Bayesian estimation should be considered by IS researchers, presents an illustrative example using best practices, and makes recommendations to guide IS researchers in the application of Bayesian SEM.",0,1 +929,Discussion on the paper by Pardoe and Weidner,,0,1 +930,Joint Bayesian Inference Reveals Model Properties Shared between Multiple Experimental Conditions,"Statistical modeling produces compressed and often more easily interpretable descriptions of experimental data in form of model parameters. When experimental manipulations target selected parameters, it is necessary for their interpretation that other model components remain constant. For example, psychophysicists use dose rate models to describe how behavior changes as a function of a single stimulus variable. The main interest is on shifts of this function induced by experimental manipulation, assuming invariance in other aspects of the function. Combining several experimental conditions in a joint analysis that takes such invariance constraints into account can result in a complex model for which no robust standard procedures are available. We formulate a solution for the joint analysis through repeated applications of standard procedures by allowing an additional assumption. This way, experimental conditions can be analyzed separately such that all conditions are implicitly taken into account. We investigate the validity of the supplementary assumption through simulations. Furthermore, we present a natural way to check whether a joint treatment is appropriate. We illustrate the method for the specific case of the psychometric function; however the procedure applies to other models that encompass multiple experimental conditions.",0,1 +931,Random-Effects Meta-analysis of Inconsistent Effects: A Time for Change,"A primary goal of meta-analysis is to improve the estimation of treatment effects by pooling results of similar studies. This article explains how the most widely used method for pooling heterogeneous studies--the Der Simonian-Laird (DL) estimator--can produce biased estimates with falsely high precision. A classic example is presented to show that use of the DL estimator can lead to erroneous conclusions. Particular problems with the DL estimator are discussed, and several alternative methods for summarizing heterogeneous evidence are presented. The authors support replacing universal use of the DL estimator with analyses based on a critical synthesis that recognizes the uncertainty in the evidence,focuses on describing and explaining the probable sources of variation in the evidence, and uses random-effects estimates that provide more accurate confidence limits than the DL estimator.",0,1 +932,Estimating High Dimensional Covariance Matrices and Its Applications,"Estimating covariance matrices is an important part of portfolio selection, risk management, and asset pricing. This paper reviews the recent development in estimating high dimensional covariance matrices, where the number of variables can be greater than the number of observations. The limitations of the sample covariance matrix are discussed. Several new approaches are presented, including the shrinkage method, the observable and latent factor method, the Bayesian approach, and the random matrix theory approach. For each method, the construction of covariance matrices is given. The relationships among these methods are discussed.",0,1 +933,The Hausman Test Statistic can be Negative even Asymptotically,"Summary We show that under the alternative hypothesis the Hausman chi-square test statistic can be negative not only in small samples but even asymptotically. Therefore in large samples such a result is only compatible with the alternative and should be interpreted accordingly. Applying a known insight from finite samples, this can only occur if the different estimation precisions (often the residual variance estimates) under the null and the alternative both enter the test statistic. In finite samples, using the absolute value of the test statistic is a remedy that does not alter the null distribution and is thus admissible. Even for positive test statistics the relevant covariance matrix difference should be routinely checked for positive semi-definiteness, because we also show that otherwise test results may be misleading. Of course the preferable solution still is to impose the same nuisance parameter (i.e., residual variance) estimate under the null and alternative hypotheses, if the model context permits that with relative ease. We complement the likelihood-based exposition by a formal proof in an omitted-variable context, we present simulation evidence for the test of panel random effects, and we illustrate the problems with a panel homogeneity test.",0,1 +934,Combining Functional Data Registration and Factor Analysis,"ABSTRACTWe extend the definition of functional data registration to encompass a larger class of registration models. In contrast to traditional registration models, we allow for registered functions that have more than one primary direction of variation. The proposed Bayesian hierarchical model simultaneously registers the observed functions and estimates the two primary factors that characterize variation in the registered functions. Each registered function is assumed to be predominantly composed of a linear combination of these two primary factors, and the function-specific weights for each observation are estimated within the registration model. We show how these estimated weights can easily be used to classify functions after registration using both simulated data and a juggling dataset. Supplementary materials for this article are available online.",0,1 +935,Getting stuck in depression: The roles of rumination and emotional inertia,"Like many other mental disorders, depression is characterised by psychological inflexibility. Two instances of such inflexibility are rumination: repetitive cognitions focusing on the causes and consequences of depressive symptoms; and emotional inertia: the tendency for affective states to be resistant to change. In two studies, we tested the predictions that: (1) rumination and emotional inertia are related; and (2) both independently contribute to depressive symptoms. We examined emotional inertia of subjective affective experiences in daily life among a sample of non-clinical undergraduates (Study 1), and of affective behaviours during a family interaction task in a sample of clinically depressed and non-depressed adolescents (Study 2), and related it to self-reported rumination and depression severity. In both studies, rumination (particularly the brooding facet) and emotional inertia (particularly of sad/dysphoric affect) were positively associated, and both independently predicted depression severity. These findings demonstrate the importance of studying both cognitive and affective inflexibility in depression.",0,1 +936,Bayesian analysis of longitudinal data using growth curve models,"Bayesian methods for analyzing longitudinal data in social and behavioral research are recommended for their ability to incorporate prior information in estimating simple and complex models. We first summarize the basics of Bayesian methods before presenting an empirical example in which we fit a latent basis growth curve model to achievement data from the National Longitudinal Survey of Youth. This step-by-step example illustrates how to analyze data using both noninformative and informative priors. The results show that in addition to being an alternative to the maximum likelihood estimation (MLE) method, Bayesian methods also have unique strengths, such as the systematic incorporation of prior information from previous studies. These methods are more plausible ways to analyze small sample data compared with the MLE method.",0,1 +937,"Emotional Reactivity to Everyday Problems, Affective Inertia, and Neuroticism","A naturalistic diary recording study was conducted to assess affective responses to everyday stress. Community-residing male participants made diary recordings regarding problem occurrence and mood several times a day for 8 days. In addition to reporting more frequent daily problems, persons scoring high in neuroticism were more reactive to stressors and were more distressed by recurrent problems than were persons scoring low in neuroticism. New problems affected everyone comparably. There was also evidence of affective inertia, such that bad mood was more likely to carry over to the next assessment. This lag effect tended to be stronger among more neurotic individuals.",0,1 +938,ON DESIGN CONSIDERATIONS AND RANDOMIZATION-BASED INFERENCE FOR COMMUNITY INTERVENTION TRIALS,"This paper discusses design considerations and the role of randomization-based inference in randomized community intervention trials. We stress that longitudinal follow-up of cohorts within communities often yields useful information on the effects of intervention on individuals, whereas cross-sectional surveys can usefully assess the impact of intervention on group indices of health. We also discuss briefly special design considerations, such as sampling cohorts from targeted subpopulations (for example, heavy smokers), matching the communities, calculating sample size, and other practical issues. We present randomization tests for matched and unmatched cohort designs. As is well known, these tests necessarily have proper size under the strong null hypothesis that treatment has no effect on any community response. It is less well known, however, that the size of randomization tests can exceed nominal levels under the 'weak' null hypothesis that intervention does not affect the average community response. Because this weak null hypothesis is of interest in community intervention trials, we study the size of randomization tests by simulation under conditions in which the weak null hypothesis holds but the strong null hypothesis does not. In unmatched studies, size may exceed nominal levels under the weak null hypothesis if there are more intervention than control communities and if the variance among community responses is larger among control communities than among intervention communities; size may also exceed nominal levels if there are more control than intervention communities and if the variance among community responses is larger among intervention communities. Otherwise, size is likely near nominal levels. To avoid such problems, we recommend use of the same numbers of control and intervention communities in unmatched designs. Pair-matched designs usually have size near nominal levels, even under the weak null hypothesis. We have identified some extreme cases, unlikely to arise in practice, in which even the size of pair-matched studies can exceed nominal levels. These simulations, however, tend to confirm the robustness of randomization tests for matched and unmatched community intervention trials, particularly if the latter designs have equal numbers of intervention and control communities. We also describe adaptations of randomization tests to allow for covariate adjustment, missing data, and application to cross-sectional surveys. We show that covariate adjustment can increase power, but such power gains diminish as the random component of variation among communities increases, which corresponds to increasing intraclass correlation of responses within communities. We briefly relate our results to model-based methods of inference for community intervention trials that include hierarchical models such as an analysis of variance model with random community effects and fixed intervention effects. Although we have tailored this paper to the design of community intervention trials, many of the ideas apply to other experiments in which one allocates groups or clusters of subjects at random to intervention or control treatments.",0,1 +939,Bayesian Structural Equation Models for Cumulative Theory Building in Information Systems.,"Theories are sets of causal relationships between constructs and their proxy indicator variables. Theories are tested and their numerical parameters are estimated using statistical models of latent and observed variables. A considerable amount of theoretical development in Information Systems occurs by theory extension or adaptation. Moreover, researchers are encouraged to reuse existing measurement instruments when possible. As a consequence, there are many cases when a relationship between two variables (latent and/or observed) is re-estimated in a new study with a new sample or in a new context. To aid in cumulative theory building, a re-estimation of parameters should take into account our prior knowledge about their likely values. In this paper, we show how Bayesian statistical models can provide a statistically sound way of incorporating prior knowledge into parameter estimation, allowing researchers to keep a “running tally” of the best estimates of model parameters.",0,1 +940,Effects of Practical Constraints on Item Selection Rules at the Early Stages of Computerized Adaptive Testing,"The purpose of this study was to compare the effects of four item selection rules—(1) Fisher information (F), (2) Fisher information with a posterior distribution (FP), (3) Kullback-Leibler information with a posterior distribution (KP), and (4) completely randomized item selection (RN)—with respect to the precision of trait estimation and the extent of item usage at the early stages of computerized adaptive testing. The comparison of the four item selection rules was carried out under three conditions: (1) using only the item information function as the item selection criterion; (2) using both the item information function and content balancing; and (3) using the item information function, content balancing, and item exposure control. When test length was less than 10 items, FP and KP tended to outperform F at extreme trait levels in Condition 1. However, in more realistic settings, it could not be concluded that FP and KP outperformed F, especially when item exposure control was imposed. When test length was greater than 10 items, the three nonrandom item selection procedures performed similarly no matter what the condition was, while F had slightly higher item usage.",0,1 +941,The Effect of Multicollinearity on Multilevel Modeling Parameter Estimates and Standard Errors,"This study investigates the quality of multilevel model parameter estimates and standard errors as a function of varying magnitudes of correlation among Level 1 predictors and model characteristics. The results of the study showthat with multicollinearity presented at Level 1 of a two-level mixed-effects linear model, the fixed-effect parameter estimates produce relatively unbiased values; however, the variance and covariance component estimates produce downwardly biased values except for Level 1 variance (< 5%). The standard errors associated with the parameter estimates are also biased under varied magnitudes of Level 1 predictor correlation.",0,1 +942,Statistical analysis of group-administered intervention data: Reanalysis of two randomized trials,"Group-administered interventions often create statistical dependencies, which, if ignored, increase the rate of Type I errors. The authors analyzed data from two randomized trials involving group interventions to document the impact of statistical dependency on tests of intervention effects and to provide estimates of statistical dependency. Intraclass correlations ranged from .02 to .12. Adjusting for dependencies increased p values for the tests of intervention effects. The increase in the p values depended on the magnitude of the statistical dependence and available degrees of freedom. Results suggest that the literature may overstate the efficacy of group interventions and imply that it will be important to study why groups create dependencies. The authors discuss how dependencies impact statistical power and how researchers can address this concern.",0,1 +943,Statistical power of latent growth curve models to detect quadratic growth,"Latent curve models (LCMs) have been used extensively to analyze longitudinal data. However, little is known about the power of LCMs to detect nonlinear trends when they are present in the data. For this study, we utilized simulated data to investigate the power of LCMs to detect the mean of the quadratic slope, Type I error rates, and rates of nonconvergence during the estimation of quadratic LCMs. Five factors were examined: the number of time points, growth magnitude, interindividual variability, sample size, and the R 2s of the measured variables. The results showed that the empirical Type I error rates were close to the nominal value of 5 %. The empirical power to detect the mean of the quadratic slope was affected by the simulation factors. Finally, a substantial proportion of samples failed to converge under conditions of no to small variation in the quadratic factor, small sample sizes, and small R 2 of the repeated measures. In general, we recommended that quadratic LCMs be based on samples of (a) at least 250 but ideally 400, when four measurement points are available; (b) at least 100 but ideally 150, when six measurement points are available; (c) at least 50 but ideally 100, when ten measurement points are available. © 2013 Psychonomic Society, Inc.",0,1 +944,HIV-1 gp120 Stimulates proinflammatory cytokine-mediated pain facilitation via activation of nitric oxide synthase-I (nNOS),"It has become clear that spinal cord glia (microglia and astrocytes) importantly contribute to the creation of exaggerated pain responses. One model used to study this is peri-spinal (intrathecal, i.t.) administration of gp120, an envelope protein of HIV-1 known to activate glia. Previous studies demonstrated that i.t. gp120 produces pain facilitation via the release of glial proinflammatory cytokines. The present series of studies tested whether spinal nitric oxide (NO) contributes to i.t. gp120-induced mechanical allodynia and, if so, what effect NO has on spinal proinflammatory cytokines. gp120 stimulation of acutely isolated lumbar dorsal spinal cords released NO as well as proinflammatory cytokines (tumor necrosis factor-alpha, interleukin-1beta (IL1), interleukin-6 (IL6)), thus identifying NO as a candidate mediator of gp120-induced behavioral effects. Behaviorally, identical effects were observed when gp120-induced mechanical allodynia was challenged by i.t. pre-treatment with either a broad-spectrum nitric oxide synthase (NOS) inhibitor (L-NAME) or 7-NINA, a selective inhibitor of NOS type-I (nNOS). Both abolished gp120-induced mechanical allodynia. While the literature pre-dominantly documents that proinflammatory cytokines stimulate the production of NO rather than the reverse, here we show that gp120-induced NO increases proinflammatory cytokine mRNA levels (RT-PCR) and both protein expression and protein release (serial ELISA). Furthermore, gp120 increases mRNA for IL1 converting enzyme and matrix metalloproteinase-9, enzymes responsible for activation and release of proinflammatory cytokines.",0,1 +945,A meta-analysis of the determinants of organic sales growth,"Abstract We present the results of a meta-analysis on drivers of organic sales growth conducted using a Hierarchical Bayes estimation technique. Based on a comprehensive review of a diverse set of literatures on organic sales growth, we identify eleven drivers of organic sales growth performance of firms: (i) innovation, (ii) marketing orientation (iii) advertising (iv) interorganizational networks, (v) entrepreneurial orientation, (vi) management capacity, (vii) firm age, (viii) firm size, (ix) competition, (x) munificence, and (xi) dynamism. Among the variables under a manager's control, innovation, advertising, market orientation, interorganizational networks, entrepreneurial orientation and managerial capacity serve as positive drivers of organic growth. Older firms and firms operating in dynamic and competitive environments face constraints in terms of organic growth. We find that the omission of marketing variables in empirical models biases the elasticities of eight of the drivers of organic growth. Three study design characteristics impact the magnitude of elasticity of organic growth drivers: using cross-sectional data instead of panel data, using growth rates instead of absolute change as operationalization of growth and using market share instead of sales as a measure of revenues.",0,1 +946,Reference priors for linear models with general covariance structures,"Abstract We develop a new class of reference priors for linear models with general covariance structures. A general Markov chain Monte Carlo algorithm is also proposed for implementing the computation. We present several examples to demonstrate the results: Bayesian penalized spline smoothing, a Bayesian approach to bivariate smoothing for a spatial model, and prior specification for structural equation models.",0,1 +947,A hierarchical modelling framework for identifying unusual performance in health care providers,"Summary. A wide variety of statistical methods have been proposed for detecting unusual performance in cross-sectional data on health care providers. We attempt to create a unified framework for comparing these methods, focusing on a clear distinction between estimation and hypothesis testing approaches, with the corresponding distinction between detecting ‘extreme’ and ‘divergent’ performance. When assuming a random-effects model the random-effects distribution forms the null hypothesis, and there appears little point in testing whether individual effects are greater or less than average. The hypothesis testing approach uses p-values as summaries and brings with it the standard problems of multiple testing, whether Bayesian or classical inference is adopted. A null random-effects formulation allows us to answer appropriate questions of the type: ‘is a particular provider worse than we would expect the true worst provider (but still part of the null distribution) to be'? We outline a broad three-stage strategy of exploratory detection of unusual providers, detailed modelling robust to potential outliers and confirmation of unusual performance, illustrated by using two detailed examples. The concepts are most easily handled within a Bayesian analytic framework using Markov chain Monte Carlo methods, but the basic ideas should be generally applicable.",0,1 +948,Advantages of Monte Carlo Confidence Intervals for Indirect Effects,"Monte Carlo simulation is a useful but underutilized method of constructing confidence intervals for indirect effects in mediation analysis. The Monte Carlo confidence interval method has several distinct advantages over rival methods. Its performance is comparable to other widely accepted methods of interval construction, it can be used when only summary data are available, it can be used in situations where rival methods (e.g., bootstrapping and distribution of the product methods) are difficult or impossible, and it is not as computer-intensive as some other methods. In this study we discuss Monte Carlo confidence intervals for indirect effects, report the results of a simulation study comparing their performance to that of competing methods, demonstrate the method in applied examples, and discuss several software options for implementation in applied settings.",0,1 +949,Implementation of a robust bayesian method,"In this work we study robustness in Bayesian models through a generalization of the Normal distribution. We show new appropriate techniques in order to deal with this distribution in Bayesian inference. Then we propose two approaches to decide, in some applications, if we should replace the usual Normal model by this generalization. First, we pose this dilemma as a model rejection problem, using diagnostic measures. In the second approach we evaluate the model's predictive efficiency. We illustrate those perspectives with a simulation study, a non linear model and a longitudinal data model.",0,1 +950,Using theory to evaluate personality and job-performance relations: A socioanalytic perspective.,"The authors used socioanalytic theory to understand individual differences in people's performance at work. Specifically, if predictors and criteria are aligned by using theory, then the meta-analytic validity of personality measures exceeds that of atheoretical approaches. As performance assessment moved from general to specific job criteria, all Big Five personality dimensions more precisely predicted relevant criterion variables, with estimated true validities of .43 (Emotional Stability), .35 (Extraversion-Ambition), .34 (Agreeableness), .36 (Conscientiousness), and .34 (Intellect-Openness to Experience).",0,1 +951,Evidence synthesis for count distributions based on heterogeneous and incomplete aggregated data,"The analysis of count data is commonly done using Poisson models. Negative binomial models are a straightforward and readily motivated generalization for the case of overdispersed data, that is, when the observed variance is greater than expected under a Poissonian model. Rate and overdispersion parameters then need to be considered jointly, which in general is not trivial. Here, we are concerned with evidence synthesis in the case where the reporting of data is rather heterogeneous, that is, events are reported either in terms of mean event counts, the proportion of event-free patients, or rate estimates and standard errors. Either figure carries some information about the relevant parameters, and it is the joint modeling that allows for coherent inference on the parameters of interest. The methods are motivated and illustrated by a systematic review in chronic obstructive pulmonary disease.",0,1 +952,Empirical Bayes estimation in finite population sampling under functional measurement error models,"Abstract The paper considers simultaneous estimation of finite population means for several strata. A model-based approach is taken, where the covariates in the super-population model are subject to measurement errors. Empirical Bayes (EB) estimators of the strata means are developed and an asymptotic expression for the MSE of the EB estimators is provided. It is shown that the proposed EB estimators are “first order optimal” in the sense of Robbins [1956. An empirical Bayes approach to statistics. In: Proceedings of the Third Berkeley Symposium on Mathematical Statistics and Probability, vol. 1, University of California Press, Berkeley, pp. 157–164], while the regular EB estimators which ignore the measurement error are not.",0,1 +953,Testlet Response Theory: An Analog for the 3PL Model Useful in Testlet-Based Adaptive Testing,"The invention of short multiple choice test items provided an enormous technical and practical advantage for test developers; certainly the items could be scored easily, but that was just one of the reasons for their popular adoption in the early part of the 20th century. A more important reason was the increase in validity offered because of the speed with which such items could be answered. This meant that a broad range of content specifications could be addressed, and hence an examinee need no longer be penalized because of an unfortunate choice of constructed response (e.g., essay) question. These advantages, as well as many others (see Anastasi, 1976, 415-417) led the multiple choice format to become, by far, the dominant form used in large-scale standardized mental testing throughout this century. Nevertheless, this breakthrough in test construction, dominant at least since the days of Army is currently being reconsidered. Critics of tests that are made up of large numbers of short questions suggest that decontextualized items yield a task that is abstracted too far from the domain of inference for many potential uses. For several reasons, only one of them as a response to this criticism, variations in test theory were considered that would allow the retention of the shortanswer format while at the same time eliminating the shortcomings expressed by those critics. One of these variations was the development of item response theory (IRT), an analytic breakthrough in test scoring. A key feature of IRT is that examinee responses are conceived of as reflecting evidence of a particular location on a single underlying latent",0,1 +954,"The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations.","In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators. © 1986 American Psychological Association.",0,1 +955,On structural equation modeling with data that are not missing completely at random,"A general latent variable model is given which includes the specification of a missing data mechanism. This framework allows for an elucidating discussion of existing general multivariate theory bearing on maximum likelihood estimation with missing data. Here, missing completely at random is not a prerequisite for unbiased estimation in large samples, as when using the traditional listwise or pairwise present data approaches. The theory is connected with old and new results in the area of selection and factorial invariance. It is pointed out that in many applications, maximum likelihood estimation with missing data may be carried out by existing structural equation modeling software, such as LISREL and LISCOMP. Several sets of artifical data are generated within the general model framework. The proposed estimator is compared to the two traditional ones and found superior.",0,1 +956,Convergence results for the EM approach to mixtures of experts architectures,"The Expectation-Maximization (EM) algorithm is an iterative approach to maximum likelihood parameter estimation. Jordan and Jacobs (1993) recently proposed an EM algorithm for the mixture of experts architecture of Jacobs, Jordan, Nowlan and Hinton (1991) and the hierarchical mixture of experts architecture of Jordan and Jacobs (1992). They showed empirically that the EM algorithm for these architectures yields significantly faster convergence than gradient ascent. In the current paper we provide a theoretical analysis of this algorithm. We show that the algorithm can be regarded as a variable metric algorithm with its searching direction having a positive projection on the gradient of the log likelihood. We also analyze the convergence of the algorithm and provide an explicit expression for the convergence rate. In addition, we describe an acceleration technique that yields a significant speedup in simulation experiments.",0,1 +957,A Bayesian approach for sample size determination in method comparison studies,"Studies involving two methods for measuring a continuous response are regularly conducted in health sciences to evaluate agreement of a method with itself and agreement between methods. Notwithstanding their wide usage, the design of such studies, in particular, the sample size determination, has not been addressed in the literature when the goal is the simultaneous evaluation of intra- and inter-method agreement. We fill this need by developing a simulation-based Bayesian methodology for determining sample sizes in a hierarchical model framework. Unlike a frequentist approach, it takes into account uncertainty in parameter estimates. This methodology can be used with any scalar measure of agreement available in the literature. We demonstrate this for four currently used measures. The proposed method is applied to an ongoing proteomics project, where we use pilot data to determine the number of individuals and the number of replications needed to evaluate the agreement between two methods for measuring protein ratios. We also apply our method to determine the sample size for an experiment involving measurement of blood pressure. Copyright © 2007 John Wiley & Sons, Ltd.",0,1 +958,The Consequences of Ignoring Multilevel Data Structures in Nonhierarchical Covariance Modeling,"This study examined the effects of ignoring multilevel data structures in nonhierarchical covariance modeling using a Monte Carlo simulation. Multilevel sample data were generated with respect to 3 design factors: (a) intraclass correlation, (b) group and member configuration, and (c) the models that underlie the between-group and within-group variance components associated with multilevel data. Covariance models that ignored the multilevel structure were then fit to the data. Results indicated that when variables exhibit minimal levels of intraclass correlation, the chi-square model/data fit statistic, the parameter estimators, and the standard error estimators are relatively unbiased. However, as the level of intraclass correlation increases, the chi-square statistic, the parameters, and their standard errors all exhibit estimation problems. The specific group/member configurations as well as the underlying between-group and within-group model structures further exacerbate the estimation problems encoun...",0,1 +959,Notice of Retraction: A study of equating of Computer-Based College English Placement Test,"This paper was to investigate the application of item response theory to specify an appropriate item response model for the equating of the mixed-format of multiple-choice items and open-ended items, since equating is the precondition of the development of an item bank for the Computer-Based College English Placement Test. It was shown that the equating approach based on common-item nonequivalent groups design and the two-parameter logistic model is ideal to be used to calibrate item and ability parameters in two alternate test forms since this model fits data of all listening and reading sections in both forms.",0,1 +960,Using Generalized Estimating Equations for Longitudinal Data Analysis,"The generalized estimating equation (GEE) approach of Zeger and Liang facilitates analysis of data collected in longitudinal, nested, or repeated measures designs. GEEs use the generalized linear model to estimate more efficient and unbiased regression parameters relative to ordinary least squares regression in part because they permit specification of a working correlation matrix that accounts for the form of within-subject correlation of responses on dependent variables of many different distributions, including normal, binomial, and Poisson. The author briefly explains the theory behind GEEs and their beneficial statistical properties and limitations and compares GEEs to suboptimal approaches for analyzing longitudinal data through use of two examples. The first demonstration applies GEEs to the analysis of data from a longitudinal lab study with a counted response variable; the second demonstration applies GEEs to analysis of data with a normally distributed response variable from subjects nested within branch offices ofan organization.",0,1 +961,Modeling Longitudinal Data with Nonignorable Dropouts Using a Latent Dropout Class Model,"In longitudinal studies with dropout, pattern-mixture models form an attractive modeling framework to account for nonignorable missing data. However, pattern-mixture models assume that the components of the mixture distribution are entirely determined by the dropout times. That is, two subjects with the same dropout time have the same distribution for their response with probability one. As that is unlikely to be the case, this assumption made lead to classification error. In addition, if there are certain dropout patterns with very few subjects, which often occurs when the number of observation times is relatively large, pattern-specific parameters may be weakly identified or require identifying restrictions. We propose an alternative approach, which is a latent-class model. The dropout time is assumed to be related to the unobserved (latent) class membership, where the number of classes is less than the number of observed patterns; a regression model for the response is specified conditional on the latent variable. This is a type of shared-parameter model, where the shared ""parameter"" is discrete. Parameter estimates are obtained using the method of maximum likelihood. Averaging the estimates of the conditional parameters over the distribution of the latent variable yields estimates of the marginal regression parameters. The methodology is illustrated using longitudinal data on depression from a study of HIV in women.",0,1 +962,A Simulation Study Comparison of Bayesian Estimation With Conventional Methods for Estimating Unknown Change Points,"The main purpose of this research is to evaluate the performance of a Bayesian approach for estimating unknown change points using Monte Carlo simulations. The univariate and bivariate unknown change point mixed models were presented and the basic idea of the Bayesian approach for estimating the models was discussed. The performance of Bayesian estimation was evaluated using simulation studies of longitudinal data with different sample sizes, varying change point values, different levels of Level-1 variances, and univariate versus bivariate outcomes. The numerical results compared the performance of the Bayesian methods with the first-order Taylor expansion method and the adaptive Gaussian quadrature method implemented in SAS PROC NLMIXED. These simulation results showed that the first-order Taylor expansion method and the adaptive Gaussian quadrature method were sensitive to the initial values, making the results somewhat unreliable. In contrast, these simulation results showed that Bayesian estimation w...",0,1 +963,Causal Inference With General Treatment Regimes,"In this article we develop the theoretical properties of the propensity function, which is a generalization of the propensity score of Rosenbaum and Rubin. Methods based on the propensity score have long been used for causal inference in observational studies; they are easy to use and can effectively reduce the bias caused by nonrandom treatment assignment. Although treatment regimes need not be binary in practice, the propensity score methods are generally confined to binary treatment scenarios. Two possible exceptions have been suggested for ordinal and categorical treatments. In this article we develop theory and methods that encompass all of these techniques and widen their applicability by allowing for arbitrary treatment regimes. We illustrate our propensity function methods by applying them to two datasets; we estimate the effect of smoking on medical expenditure and the effect of schooling on wages. We also conduct simulation studies to investigate the performance of our methods.",0,1 +964,"Perimetric Evaluation of Saccadic Latency, Saccadic Accuracy, and Visual Threshold for Peripheral Visual Stimuli in Young Compared With Older Adults","Using a novel automated perimetry technique, we tested the hypothesis that older adults will have increased latency and decreased accuracy of saccades, as well as higher visual thresholds, to peripheral visual stimuli when compared with younger adults.We tested 20 healthy subjects aged 18 to 30 years (""young"") and 21 healthy subjects at least 60 years old (""older"") for detection of briefly flashed peripheral stimuli of differing sizes in eight locations along the horizontal meridian (±4°, ±12°, ±20°, and ±28°). With the left eye occluded, subjects were instructed to look quickly toward any seen stimuli. Right eye movements were recorded with an EyeLink 1000 infrared camera system. Limiting our analysis to the four stimulus positions in the nasal hemifield (-4°, -12°, -20°, and -28°), we evaluated for group-level differences in saccadic latency, accuracy, and visual threshold at each stimulus location.Saccadic latency increased as stimulus size decreased in both groups. Older subjects had significantly increased saccadic latencies (at all locations; P < 0.05), decreased accuracies (at all locations; P < 0.05), and higher visual thresholds (at the -12°, -20°, and -28° locations; P < 0.05). Additionally, there were significant relationships between visual threshold and latency, visual threshold and accuracy, and latency and accuracy (P < 0.0001).Older adults have increased latency and decreased accuracy of saccades, as well as higher visual thresholds, to peripheral visual stimuli when compared with younger adults. Saccadic latency and accuracy are related to visual threshold, suggesting that saccadic latency and accuracy could be useful as perimetric outcome measures.",0,1 +965,Culture as Consensus: A Theory of Culture and Informant Accuracy,"This paper presents and tests a formal mathematical model for the analysis of informant responses to systematic interview questions. We assume a situation in which the ethnographer does not know how much each informant knows about the cultural domain under consideration nor the answers to the questions. The model simultaneously provides an estimate of the cultural competence or knowledge of each informant and an estimate of the correct answer to each question asked of the informant. The model currently handles true-false, multiple-choice, andfill-in-the-blank type question formats. In familiar cultural domains the model produces good results from as few as four informants. The paper includes a table showing the number of informants needed to provide stated levels of confidence given the mean level of knowledge among the informants. Implications are discussed.",0,1 +966,Sex differences in mechanical allodynia: how can it be preclinically quantified and analyzed?,"Translating promising preclinical drug discoveries to successful clinical trials remains a significant hurdle in pain research. Although animal models have significantly contributed to understanding chronic pain pathophysiology, the majority of research has focused on male rodents using testing procedures that produce sex difference data that do not align well with comparable clinical experiences. Additionally, the use of animal pain models presents ongoing ethical challenges demanding continuing refinement of preclinical methods. To this end, this study sought to test a quantitative allodynia assessment technique and associated statistical analysis in a modified graded nerve injury pain model with the aim to further examine sex differences in allodynia. Graded allodynia was established in male and female Sprague Dawley rats by altering the number of sutures placed around the sciatic nerve and quantified by the von Frey test. Linear mixed effects modeling regressed response on each fixed effect (sex, oestrus cycle, pain treatment). On comparison with other common von Frey assessment techniques, utilizing lower threshold filaments than those ordinarily tested, at 1 s intervals, appropriately and successfully investigated female mechanical allodynia, revealing significant sex and oestrus cycle difference across the graded allodynia that other common behavioral methods were unable to detect. Utilizing this different von Frey approach and graded allodynia model, a single suture inflicting less allodynia was sufficient to demonstrate exaggerated female mechanical allodynia throughout the phases of dioestrus and pro-oestrus. Refining the von Frey testing method, statistical analysis technique and the use of a graded model of chronic pain, allowed for examination of the influences on female mechanical nociception that other von Frey methods cannot provide.",0,1 +967,Multilevel Poisson sample selection models and alternative methods for estimating hospital effects on long-term outcomes,"Hospital care focuses on improving patients’ long-term quality of life, yet hospital quality metrics typically focus on short-term processes. Attempting to understand a patient’s long-term process introduces sample selection bias since patients must survive the hospitalization in order to observe post-hospitalization outcomes. As a result, proper analysis of long-term outcomes should account for clustering, due to the hierarchical structure of hospital data, as well as sample selection bias. The objective of this paper was to evaluate random effect parameter estimation and higher-level ranking of long-term count outcomes and short-term selection processes in the presence of cluster and selection bias by comparing multilevel Poisson models, multilevel zero-inflated Poisson models, and multilevel Poisson sample selection models (MPSSMs) in a series of simulations. We simulated an outcome resembling a post-discharge Poisson count with a pre-specified selection process determining a patient’s hospitalization survival with each hospital having a unique effect on both processes. In order to clarify the methodology, we also analyzed a real-world hospital dataset involving a count outcome conditioned on the selection process of hospital survival. Across all simulations, the random effect parameter estimates were directly compared and the empirical Bayes estimates were extracted, ranked, and compared using the Spearman rank correlation. Results show that the MPSSM produces more accurate random effect parameter estimates and higher-level empirical Bayes ranks. When modeling multilevel effects on long-term count outcomes observed after a short-term selection process, higher-level effects are more reliably measured using MPSSMs. © 2015, Springer Science+Business Media New York (outside the USA).",0,1 +968,A Choice That Matters?,"Decision-analytic cost-effectiveness (CE) models combine many different parameters like transition probabilities, event probabilities, utilities and costs, which are often obtained after meta-analysis. The method of meta-analysis may affect the CE estimate.Our aim was to perform a simulation study that compares the performance of different methods of meta-analysis, especially with respect to model-based health economic (HE) outcomes.A reference patient population of 50,000 was simulated from which sets of samples were drawn. Each sample drawn represented a clinical trial comparing two fictitious interventions. In several scenarios, the heterogeneity between these trials was varied, by drawing one or more of the trials from predefined subpopulations. Parameter estimates from these trials were combined using frequentist fixed (FFE) and random effects (FRE), and Bayesian fixed (BFE) and random effects (BRE) meta-analysis. The pooled parameter estimates were entered into a probabilistic cost-effectiveness Markov model. The four methods of meta-analysis resulted in different parameter estimates and HE outcomes, which were compared with the true values in the reference population. Performance statistics were: (1) the percentage of repetitions that the confidence interval of the probabilistic sensitivity analysis covers the true value (coverage), (2) the difference between the estimated and true value (bias), (3) the mean absolute value of the bias (MAD) and (4) the percentage of repetitions that result in a statistically significant difference between the two interventions (statistical power). As the differences between methods could be due to chance, we repeated every step of the analysis 1,000 times to study whether differences were systematic.FFE, FRE and BFE lead to different parameter estimates, but, when entered into the model, they do not lead to large differences in the point estimates of the HE outcomes, even in scenarios where we built in heterogeneity. Random effects methods do not necessarily reduce bias when heterogeneity is added to the trials, and may even increase bias in certain situations. BRE tends to overestimate uncertainty reflected in the CE acceptability curve.FFE, FRE and BFE lead to comparable HE outcomes. BRE tends to overestimate uncertainty. Based on this study, we recommend FRE as the preferred method of meta-analysis.",0,1 +969,Perceiver effects as projective tests: What your perceptions of others say about you.,"In 3 studies, we document various properties of perceiver effects--or how an individual generally tends to describe other people in a population. First, we document that perceiver effects have consistent relationships with dispositional characteristics of the perceiver, ranging from self-reported personality traits and academic performance to well-being and measures of personality disorders, to how liked the person is by peers. Second, we document that the covariation in perceiver effects among trait dimensions can be adequately captured by a single factor consisting of how positively others are seen across a wide range of traits (e.g., how nice, interesting, trustworthy, happy, and stable others are generally seen). Third, we estimate the 1-year stability of perceiver effects and show that individual differences in the typical perception of others have a level of stability comparable to that of personality traits. The results provide compelling evidence that how individuals generally perceive others is a stable individual difference that reveals much about the perceiver's own personality.",0,1 +970,The Importance of Isomorphism for Conclusions about Homology: A Bayesian Multilevel Structural Equation Modeling Approach with Ordinal Indicators,"We describe a Monte Carlo study examining the impact of assuming item isomorphism (i.e., equivalent construct meaning across levels of analysis) on conclusions about homology (i.e., equivalent structural relations across levels of analysis) under varying degrees of non-isomorphism in the context of ordinal indicator multilevel structural equation models (MSEMs). We focus on the condition where one or more loadings are higher on the between level than on the within level to show that while much past research on homology has ignored the issue of psychometric isomorphism, psychometric isomorphism is in fact critical to valid conclusions about homology. More specifically, when a measurement model with non-isomorphic items occupies an exogenous position in a multilevel structural model and the non-isomorphism of these items is not modeled, the within level exogenous latent variance is under-estimated leading to over-estimation of the within level structural coefficient, while the between level exogenous latent variance is overestimated leading to underestimation of the between structural coefficient. When a measurement model with non-isomorphic items occupies an endogenous position in a multilevel structural model and the non-isomorphism of these items is not modeled, the endogenous within level latent variance is under-estimated leading to under-estimation of the within level structural coefficient while the endogenous between level latent variance is over-estimated leading to over-estimation of the between level structural coefficient. The innovative aspect of this article is demonstrating that even minor violations of psychometric isomorphism render claims of homology untenable. We also show that posterior predictive p-values for ordinal indicator Bayesian MSEMs are insensitive to violations of isomorphism even when they lead to severely biased within and between level structural parameters. We highlight conditions where poor estimation of even correctly specified models rules out empirical examination of isomorphism and homology without taking precautions, for instance, larger Level-2 sample sizes, or using informative priors.",0,1 +971,Independence of the completion effect from the noncompletion effect in illusory contour perception,"Spatially separated object information can be effortlessly completed in the visual system, as demonstrated by the well-known Kanizsa-type illusory contours. The perception of illusory contours is closely associated with the spatial configuration of contour fragments, leading to the long-lasting difficulty in distinguishing the effect of the completion process that interpolates the contour fragments from the effect of the noncompletion process that analyzes the contour fragments. However, a close relationship does not necessarily imply nonindependence, e.g., two people may show similar behaviors in one situation but may not in another situation. Inspired by this simple common sense, we conducted a contour discrimination task (i.e., discriminating between the interpolated contours) and a fragment discrimination task (i.e., discriminating between the physically-specified contour fragments) for Kanizsa squares and Kanizsa circles. The performance difference between the contour and fragment discrimination tasks was much larger for Kanizsa circles than for Kanizsa squares. This independence of the completion effect--as indicated by the performance in the contour task--from the noncompletion effect--as indicated by the performance in the fragment task--provides new insights into the understanding of the mechanism of visual completion.",0,1 +972,On the Half-Cauchy Prior for a Global Scale Parameter,"This paper argues that the half-Cauchy distribution should replace the inverseGamma distribution as a default prior for a top-level scale parameter in Bayesian hierarchical models, at least for cases where a proper prior is necessary. Our arguments involve a blend of Bayesian and frequentist reasoning, and are intended to complement the original case made by Gelman (2006) in support of the folded-t family of priors. First, we generalize the half-Cauchy prior to the wider class of hypergeometric inverted-beta priors. We derive expressions for posterior moments and marginal densities when these priors are used for a top-level normal variance in a Bayesian hierarchical model. We go on to prove a proposition that, together with the results for moments and marginals, allows us to characterize the frequentist risk of the Bayes estimators under all global-shrinkage priors in the class. These theoretical results, in turn, allow us to study the frequentist properties of the half-Cauchy prior versus a wide class of alternatives. The half-Cauchy occupies a sensible “middle ground” within this class: it performs very well near the origin, but does not lead to drastic compromises in other parts of the parameter space. This provides an alternative, classical justification for the repeated, routine use of this prior. We also consider situations where the underlying mean vector is sparse, where we argue that the usual conjugate choice of an inverse-gamma prior is particularly inappropriate, and can lead to highly distorted posterior inferences. Finally, we briefly summarize some open issues in the specification of default priors for scale terms in hierarchical models.",0,1 +973,Detecting Mixtures From Structural Model Differences Using Latent Variable Mixture Modeling: A Comparison of Relative Model Fit Statistics,"The accuracy of structural model parameter estimates in latent variable mixture modeling was explored with a 3 (sample size) × 3 (exogenous latent mean difference) × 3 (endogenous latent mean difference) × 3 (correlation between factors) × 3 (mixture proportions) factorial design. In addition, the efficacy of several likelihood-based statistics (Akaike's Information Criterion [AIC], Bayesian Information Ctriterion [BIC], the sample-size adjusted BIC [ssBIC], the consistent AIC [CAIC], the Vuong-Lo-Mendell-Rubin adjusted likelihood ratio test [aVLMR]), classification-based statistics (CLC [classification likelihood information criterion], ICL-BIC [integrated classification likelihood], normalized entropy criterion [NEC], entropy), and distributional statistics (multivariate skew and kurtosis test) were examined to determine which statistics best recover the correct number of components. Results indicate that the structural parameters were recovered, but the model fit statistics were not exceedingly accurat...",0,1 +974,Nonparametric Bayes modeling for case control studies with many predictors,"It is common in biomedical research to run case-control studies involving high-dimensional predictors, with the main goal being detection of the sparse subset of predictors having a significant association with disease. Usual analyses rely on independent screening, considering each predictor one at a time, or in some cases on logistic regression assuming no interactions. We propose a fundamentally different approach based on a nonparametric Bayesian low rank tensor factorization model for the retrospective likelihood. Our model allows a very flexible structure in characterizing the distribution of multivariate variables as unknown and without any linear assumptions as in logistic regression. Predictors are excluded only if they have no impact on disease risk, either directly or through interactions with other predictors. Hence, we obtain an omnibus approach for screening for important predictors. Computation relies on an efficient Gibbs sampler. The methods are shown to have high power and low false discovery rates in simulation studies, and we consider an application to an epidemiology study of birth defects.",0,1 +975,On the Merits of Orthogonalizing Powered and Product Terms: Implications for Modeling Interactions Among Latent Variables,"The goals of this article are twofold: (a) briefly highlight the merits of residual centering for representing interaction and powered terms in standard regression contexts (e.g., Lance, 1988), and (b) extend the residual centering procedure to represent latent variable interactions. The proposed method for representing latent variable interactions has potential advantages over extant procedures. First, the latent variable interaction is derived from the observed covariation pattern among all possible indicators of the interaction. Second, no constraints on particular estimated parameters need to be placed. Third, no recalculations of parameters are required. Fourth, model estimates are stable and interpretable. In our view, the orthogonalizing approach is technically and conceptually straightforward, can be estimated using any structural equation modeling software package, and has direct practical interpretation of parameter estimates. Its behavior in terms of model fit and estimated standard errors is v...",0,1 +976,The Analysis of Repeated Measurements with Mixed-Model Adjusted F Tests,"One approach to the analysis of repeated measures data allows researchers to model the covariance structure of their data rather than presume a certain structure, as is the case with conventional univariate and multivariate test statistics. This mixed-model approach, available through SAS PROC MIXED, was compared to a Welch-James type statistic. The Welch-James approach is known to provide generally robust tests of treatment effects in a repeated measures between-by within-subjects design under assumption violations given certain sample size requirements. The mixed-model F tests were based on Kenward-Roger’s adjusted degrees of freedom solution, an approach specifically proposed for small sample settings. The authors investigated Type I error control for repeated measures main and interaction effects in unbalanced designs when normality and covariance homogeneity assumptions did not hold. The mixed-model Kenward-Roger’s adjusted F tests showed superior Type I error control in small sample size conditions in which the Welch-James type statistic was nonrobust; power rates, however, did not favor one approach over the other.",0,1 +977,Surprise Leads to Noisier Perceptual Decisions,"Surprising events in the environment can impair task performance. This might be due to complete distraction, leading to lapses during which performance is reduced to guessing. Alternatively, unpredictability might cause a graded withdrawal of perceptual resources from the task at hand and thereby reduce sensitivity. Here we attempt to distinguish between these two mechanisms. Listeners performed a novel auditory pitch—duration discrimination, where stimulus loudness changed occasionally and incidentally to the task. Responses were slower and less accurate in the surprising condition, where loudness changed unpredictably, than in the predictable condition, where the loudness was held constant. By explicitly modelling both lapses and changes in sensitivity, we found that unpredictable changes diminished sensitivity but did not increase the rate of lapses. These findings suggest that background environmental uncertainty can disrupt goal-directed behaviour. This graded processing strategy might be adaptive in potentially threatening contexts, and reflect a flexible system for automatic allocation of perceptual resources.",0,1 +978,,"This purpose of this introductory paper is threefold. First, it introduces the Monte Carlo method with emphasis on probabilistic machine learning. Second, it reviews the main building blocks of modern Markov chain Monte Carlo simulation, thereby providing and introduction to the remaining papers of this special issue. Lastly, it discusses new interesting research horizons.",0,1 +979,Single-Level and Multilevel Mediation Analysis,"Mediation analysis is a statistical approach used to examine how the effect of an independent variable on an outcome is transmitted through an intervening variable (mediator). In this article, we provide a gentle introduction to single-level and multilevel mediation analyses. Using single-level data, we demonstrate an application of structural equation modeling (SEM) in estimating mediation models with multiple mediators and multiple outcomes. We also describe the estimation and interpretation of a 2→1→1 multilevel mediation model in which the first, second, and third numbers correspond to the measurement levels of the independent, mediator, and outcome variables, respectively. We present two numerical examples that use simulated data based on published studies in adolescence research to demonstrate how to specify, estimate, and interpret the results of single-level and multilevel mediation analyses to answer key research questions. We briefly discuss underlying assumptions required to make a valid causal interpretation of a mediation analysis.",0,1 +980,Using self-determination theory to understand motivation for walking: Instrument development and model testing using Bayesian structural equation modelling,"Abstract Objective The motivational processes underpinning walking behaviour are not well understood. This study aimed to develop walking-specific motivation measures drawn from self-determination theory (SDT), assess the psychometric properties of the measures, incorporating Baysesian structural equation modelling (BSEM), and examine how these variables relate to walking behaviour. Method Participants (n = 298; mean age = 41.69; S.D. = 11.06; male = 57) completed the Behavioural Regulations in Walking Questionnaire (BRWQ), Psychological Needs Satisfaction for Walking Scale (PNSWS) and the IPAQ-long form, from which measures of workplace, transport and leisure walking were extracted. BSEM was used to test the hypothesized factor structures of the BRWQ and PNSWS. Internal reliabilities were assessed using the composite reliability coefficient. Convergent and discriminant validity were assessed by examining the relationships between the variables in relation to established theory. Results BSEM showed excellent fit for the BRWQ and PNSWS measurement models. The scales demonstrated good internal consistency. The associations within and between the BRWQ and PNSWS subscales were generally as expected. The relationship between the BRWQ subscales and walking for transport and leisure were also generally as expected, but there were no significant relationships for walking at work. Two PNSWS subscales were significantly related to walking for leisure, but no significant relationships were evident for walking for transport and at work. Conclusions There is preliminary evidence for the acceptable psychometric properties of instruments to measure SDT constructs in walking, and the findings highlight the advantages of BSEM. The findings also suggest that the motivational processes underpinning walking may vary by type of walking.",0,1 +981,Better Bootstrap Confidence Intervals,"Abstract We consider the problem of setting approximate confidence intervals for a single parameter θ in a multiparameter family. The standard approximate intervals based on maximum likelihood theory, , can be quite misleading. In practice, tricks based on transformations, bias corrections, and so forth, are often used to improve their accuracy. The bootstrap confidence intervals discussed in this article automatically incorporate such tricks without requiring the statistician to think them through for each new application, at the price of a considerable increase in computational effort. The new intervals incorporate an improvement over previously suggested methods, which results in second-order correctness in a wide variety of problems. In addition to parametric families, bootstrap intervals are also developed for nonparametric situations.",0,1 +982,"The Persistence of Underpowered Studies in Psychological Research: Causes, Consequences, and Remedies.","Underpowered studies persist in the psychological literature. This article examines reasons for their persistence and the effects on efforts to create a cumulative science. The ""curse of multiplicities"" plays a central role in the presentation. Most psychologists realize that testing multiple hypotheses in a single study affects the Type I error rate, but corresponding implications for power have largely been ignored. The presence of multiple hypothesis tests leads to 3 different conceptualizations of power. Implications of these 3 conceptualizations are discussed from the perspective of the individual researcher and from the perspective of developing a coherent literature. Supplementing significance tests with effect size measures and confidence intervals is shown to address some but not necessarily all problems associated with multiple testing.",0,1 +983,First graders' literacy and self-regulation gains: The effect of individualizing student instruction,"We examined the effect of individualizing student instruction (ISI; N=445 students, 46 classrooms) on first graders' self-regulation gains compared to a business-as-usual control group. Self-regulation, conceptualized as a constellation of executive skills, was positively associated with academic development. We hypothesized that the ISI intervention's emphasis on teacher planning and organization, classroom management, and the opportunity for students to work independently and in small groups would promote students' self-regulation. We found no main effect of ISI on self-regulation gains. However, for students with weaker initial self-regulation, ISI was associated with greater self-regulation gains compared to peers in control classrooms. The ISI effect on self-regulation was greater when the intervention was more fully implemented.",0,1 +984,The Influence of Dimensionality on Parameter Estimation Accuracy in the Generalized Graded Unfolding Model,"The generalized graded unfolding model (GGUM) is an ideal point model of responding that is consistent with the Thurstonian theory of respondent behavior. Ideal point models have recently generated interest in the realms of attitude and personality assessment. One unclear aspect of applying ideal point models is the influence of multidimensionality on GGUM item and person parameters estimation accuracy. Using simulated data, the authors tested the influence of the balance, or ratio, of items loading onto two dimensions, the degree of bidimensionality and sample size on parameter estimation accuracy. The results suggest that bidimensionality and the proportion of items loading onto a second trait increases estimation error. The second trait was chosen in estimation when a large number of the items in the survey reflected a highly irrelevant second trait. Estimation error was greater for persons and items at the extreme ends of the continuum; positive estimates were biased upward and positive parameters downward. The results suggest that although the GGUM chooses another trait in estimation, in most cases conventional fit analyses and checks for item parameter extremity are likely to be successful in identifying items measuring another trait. Furthermore, the conditions in which the trait being estimated may not be clear should be rare in practice. The implications of these results for researchers who wish to apply these models to real-life data are discussed.",0,1 +985,The area between two item characteristic curves,"Formulas for computing the exact signed and unsigned areas between two item characteristic curves (ICCs) are presented. It is further shown that when the c parameters are unequal, the area between two ICCs is infinite. The significance of the exact area measures for item bias research is discussed. © 1988 The Psychometric Society.",0,1 +986,A mixture hierarchical model for response times and response accuracy,"In real testing, examinees may manifest different types of test-taking behaviours. In this paper we focus on two types that appear to be among the more frequently occurring behaviours – solution behaviour and rapid guessing behaviour. Rapid guessing usually happens in high-stakes tests when there is insufficient time, and in low-stakes tests when there is lack of effort. These two qualitatively different test-taking behaviours, if ignored, will lead to violation of the local independence assumption and, as a result, yield biased item/person parameter estimation. We propose a mixture hierarchical model to account for differences among item responses and response time patterns arising from these two behaviours. The model is also able to identify the specific behaviour an examinee engages in when answering an item. A Monte Carlo expectation maximization algorithm is proposed for model calibration. A simulation study shows that the new model yields more accurate item and person parameter estimates than a non-mixture model when the data indeed come from two types of behaviour. The model also fits real, high-stakes test data better than a non-mixture model, and therefore the new model can better identify the underlying test-taking behaviour an examinee engages in on a certain item.",0,1 +987,Improved estimation procedures for multilevel models with binary response: a case‐study,"During recent years, analysts have been relying on approximate methods of inference to estimate multilevel models for binary or count data. In an earlier study of random-intercept models for binary outcomes we used simulated data to demonstrate that one such approximation, known as marginal quasi-likelihood, leads to a substantial attenuation bias in the estimates of both fixed and random effects whenever the random effects are non-trivial. In this paper, we fit three-level random-intercept models to actual data for two binary outcomes, to assess whether refined approximation procedures, namely penalized quasi-likelihood and second-order improvements to marginal and penalized quasi-likelihood, also underestimate the underlying parameters. The extent of the bias is assessed by two standards of comparison: exact maximum likelihood estimates, based on a Gauss–Hermite numerical quadrature procedure, and a set of Bayesian estimates, obtained from Gibbs sampling with diffuse priors. We also examine the effectiveness of a parametric bootstrap procedure for reducing the bias. The results indicate that second-order penalized quasi-likelihood estimates provide a considerable improvement over the other approximations, but all the methods of approximate inference result in a substantial underestimation of the fixed and random effects when the random effects are sizable. We also find that the parametric bootstrap method can eliminate the bias but is computationally very intensive.",0,1 +988,Bayesian methods in meta-analysis and evidence synthesis,"This paper reviews the use of Bayesian methods in meta-analysis. Whilst there has been an explosion in the use of meta-analysis over the last few years, driven mainly by the move towards evidence-based healthcare, so too Bayesian methods are being used increasingly within medical statistics. Whilst in many meta-analysis settings the Bayesian models used mirror those previously adopted in a frequentist formulation, there are a number of specific advantages conferred by the Bayesian approach. These include: full allowance for all parameter uncertainty in the model, the ability to include other pertinent information that would otherwise be excluded, and the ability to extend the models to accommodate more complex, but frequently occurring, scenarios. The Bayesian methods discussed are illustrated by means of a meta-analysis examining the evidence relating to electronic fetal heart rate monitoring and perinatal mortality in which evidence is available from a variety of sources.",0,1 +989,Longitudinal Analysis of Quality of Life for Stroke Survivors Using Latent Curve Models,"For the survivors, activities of daily living, handicap, and depression have a significant impact on health-related quality of life (HRQOL). How the dynamic changes of these variables relate to HRQOL over time in the subacute phase of stroke recovery has not been investigated. The objective of this study was to study longitudinal behaviors of HRQOL of the stroke survivors in relation to the changes in activities of daily living, handicap, and depression after stroke.This was a prospective cohort study of first disabling patients with stroke. Subjects were interviewed at 3, 6, and 12 months after stroke for modified Barthel Index, London Handicap Scale, Geriatric Depression Scale, and the World Health Organization Quality of Life questionnaire (abbreviated Hong Kong version). A latent curve model was developed to analyze how the dynamic changes in activities of daily living, handicap, and depressive mood related to the changes in HRQOL.Two hundred forty-seven of 303 patients (82%) followed up at 3 months after stroke could complete the quality-of-life questionnaire. Their mean age was 68.8 years. The latent curve model analysis revealed that initial physical health HRQOL was independently associated with activities of daily living, handicap, and depression. The other 3 HRQOL domain scores were primarily associated with depression only. The rates of change in all 4 domains of HRQOL were significantly and inversely associated with rate of change in the Geriatric Depression Scale only.Change in mood in the postacute phase of stroke recovery is the most significant determinant of change in HRQOL. More attention should be paid to the detection and management of poststroke depression.",0,1 +990,Multilevel Modeling of Individual and Group Level Mediated Effects,"This article combines procedures for single-level mediational analysis with multilevel modeling techniques in order to appropriately test mediational effects in clustered data. A simulation study compared the performance of these multilevel mediational models with that of single-level mediational models in clustered data with individual- or group-level initial independent variables, individual- or group-level mediators, and individual level outcomes. The standard errors of mediated effects from the multilevel solution were generally accurate, while those from the single-level procedure were downwardly biased, often by 20% or more. The multilevel advantage was greatest in those situations involving group-level variables, larger group sizes, and higher intraclass correlations in mediator and outcome variables. Multilevel mediational modeling methods were also applied to data from a preventive intervention designed to reduce intentions to use steroids among players on high school football teams. This example illustrates differences between single-level and multilevel mediational modeling in real-world clustered data and shows how the multilevel technique may lead to more accurate results.",0,1 +991,Estimation of MIMIC Model Parameters with Multilevel Data,"The purpose of this simulation study was to assess the performance of latent variable models that take into account the complex sampling mechanism that often underlies data used in educational, psychological, and other social science research. Analyses were conducted using the multiple indicator multiple cause (MIMIC) model, which is a flexible and effective tool for relating observed and latent variables. The data were simulated in a hierarchical framework (e.g., individuals nested in schools) so that a multilevel modeling approach would be appropriate. Analyses were conducted accounting for and not accounting for the nested data to determine the impact of ignoring such multilevel data structures in full structural equation models. Results highlight the differences in modeling results when the analytic strategy is congruent with the data structure and what occurs when this congruency is absent. Type I error rates and power for the standard and multilevel methods were similar for within-cluster variables ...",0,1 +992,Paradoxes of Social Policy,"Korpi and Palme’s (1998) classic “The Paradox of Redistribution and Strategies of Equality” claims that universal social policy better reduces poverty than social policies targeted at the poor. This article revisits Korpi and Palme’s classic, and in the process, explores and informs a set of enduring questions about social policy, politics, and social equality. Specifically, we investigate the relationships between three dimensions of welfare transfers—transfer share (the average share of household income from welfare transfers), low-income targeting, and universalism—and poverty and preferences for redistribution. We analyze rich democracies like Korpi and Palme, but we also generalize to a broader sample of developed and developing countries. Consistent with Korpi and Palme, we show (1) poverty is negatively associated with transfer share and universalism; (2) redistribution preferences are negatively associated with low-income targeting; and (3) universalism is positively associated with transfer share. Contrary to Korpi and Palme, redistribution preferences are not related to transfer share or universalism; and low-income targeting is neither positively associated with poverty nor negatively associated with transfer share. Therefore, instead of the “paradox of redistribution” we propose two new paradoxes of social policy: non-complementarity and undermining. The non-complementarity paradox entails a mismatch between the dimensions that matter to poverty and the dimension that matters to redistribution preferences. The undermining paradox emphasizes that the dimension (transfer share) that most reduces poverty tends to increase with the one dimension (low-income targeting) that reduces support for redistribution.",0,1 +993,COMBINING INDIVIDUAL PARTICIPANT DATA AND SUMMARY STATISTICS FROM BOTH CONTINUOUSLY VALUED AND BINARY VARIABLES TO ESTIMATE REGRESSION PARAMETERS,"Summary Recent research has extended standard methods for meta-analysis to more general forms of evidence synthesis, where the aim is to combine different data types or data summaries that contain information about functions of multiple parameters to make inferences about the parameters of interest. We consider one such scenario in which the goal is to make inferences about the association between a primary binary exposure and continuously valued outcome in the context of several confounding exposures, and where the data are available in various different forms: individual participant data (IPD) with repeated measures, sample means that have been aggregated over strata, and binary data generated by thresholding the underlying continuously valued outcome measure. We show that an estimator of the population mean of a continuously valued outcome can be constructed using binary threshold data provided that a separate estimate of the outcome standard deviation is available. The results of a simulation study show that this estimator has negligible bias but is less efficient than the sample mean – the minimum variance ratio is based on a Taylor series expansion. Combining this estimator with sample means and IPD from different sources (such as a series of published studies) using both linear and probit regression does, however, improve the precision of estimation considerably by incorporating data that would otherwise have been excluded for being in the wrong format. We apply these methods to investigate the association between the G277S mutation in the transferrin gene and serum ferritin (iron) levels separately in pre- and post-menopausal women based on data from three published studies.",0,1 +994,Bayesian Methods for Conjoint Analysis-Based Predictions: Do We Still Need Latent Classes?,"AbstractRecently, more and more Bayesian methods have been proposed for modeling heterogeneous preference structures of consumers (see, e.g., Allenby et al., J Mark Res 32:152–162, 1995, 35:384–389, 1998; Baier and Polasek, Stud Classif Data Anal Knowl Organ 22:413–421, 2003; Otter et al., Int J Res Mark 21(3):285–297, 2004). Comparisons have shown that these new methods compete well with the traditional ones where latent classes are used for this purpose (see Ramaswamy and Cohen (2007) Latent class models for conjoint analysis. In: Gustafsson A, Herrmann A, Huber (eds) Conjoint measurement – methods and applications, 4th edn. Springer, Berlin, pp 295–320) for an overview on these traditional methods). This applies especially when the prediction of choices among products is the main objective (e.g. Moore et al., Mark Lett 9(2):195–207, 1998; Andrews et al., J Mark Res 39:479–487, 2002a; 39:87–98, 2002b; Moore, Int J Res Mark 21:299–312, 2004; Karniouchina et al., Eur J Oper Res 19(1):340–348, 2009, with comparative results). However, the question is still open whether this superiority still holds when the latent class approach is combined with the Bayesian one. This paper responds to this question. Bayesian methods with and without latent classes are used for modeling heterogeneous preference structures of consumers and for predicting choices among competing products. The results show a clear superiority of the combined approach over the purely Bayesian one. It seems that we still need latent classes for conjoint analysis-based predictions.KeywordsRoot Mean Square ErrorPosterior DistributionLatent ClassPredictive ValidityMarket SegmentThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.",0,1 +995,Analyzing Structural Relations in Multivariate Dyadic Binary Data,"In social network studies, most often only a single relation (or link) between the actors is investigated. When more than one link has been recorded, the two-way sociomatrix becomes a three-way array with the set of links being the third way. In this paper, we present a model which simultaneously accounts for the three ways in the data. Random effects are used to model the between-actor variability, both on senders and receivers side. In addition, structural relations between the linking variables are investigated. The model is applied to a study of popularity and strength in a class of students. It is shown that popularity can be seen as a linear function of strength on the receivers’ side, but not on the senders’ side.",0,1 +996,Windowed Sine Bursts: In Search of Optimal Test Signals for Detecting the Threshold of Audibility of Temporal Decays,"A slow decay in an audio signal is perceived as ringing and is commonly caused by room modes. This affects the perception of intelligibility, clarity, definition, and spatial rendering. A method has previously been devised to find the threshold of audibility of the decay in low-frequency narrow-band signals. One of the test signals in the largescale listening test will be a low-frequency sine burst, but spectral spreading at the start and end of the test signal acts as an additional non-modal cue. This effect is removed by windowing, for example a half Hann. The aim of this paper is to determine the window length required (threshold) to render the end of the test signal free from audible spectral spreading. The Parameter Estimation by Sequential Testing (PEST) method and calibrated headphones (to remove factors associated with the listening environment) are used in subjective listening tests. The window length threshold is found to be constant above 200 Hz but rises exponentially towards low frequencies, and is replay level dependent. Threshold may be related to the absolute threshold of hearing, masking curves and/or auditory filter bandwidth.",0,1 +997,A Bayesian Geostatistical Moran Curve Model for Estimating Net Changes of Tsetse Populations in Zambia,"For the first time a Bayesian geostatistical version of the Moran Curve, a logarithmic form of the Ricker stock recruitment curve, is proposed that is able to give an estimate of net change in population demographic rates considering components such as fertility and density dependent and density independent mortalities. The method is applied to spatio-temporally referenced count data of tsetse flies obtained from fly-rounds. The model is a linear regression with three components: population rate of change estimated from the Moran curve, an explicit spatio-temporal covariance, and the observation error optimised within a Bayesian framework. The model was applied to the three main climate seasons of Zambia (rainy--January to April, cold-dry--May to August, and hot-dry--September to December) taking into account land surface temperature and (seasonally changing) cattle distribution. The model shows a maximum positive net change during the hot-dry season and a minimum between the rainy and cold-dry seasons. Density independent losses are correlated positively with day-time land surface temperature and negatively with night-time land surface temperature and cattle distribution. The inclusion of density dependent mortality increases considerably the goodness of fit of the model. Cross validation with an independent dataset taken from the same area resulted in a very accurate estimate of tsetse catches. In general, the overall framework provides an important tool for vector control and eradication by identifying vector population concentrations and local vector demographic rates. It can also be applied to the case of sustainable harvesting of natural populations.",0,1 +998,On the existence of maximum likelihood estimates in logistic regression models,"SUMMARY The problems of existence, uniqueness and location of maximum likelihood estimates in log linear models have received special attention in the literature (Haberman, 1974, Chapter 2; Wedderburn, 1976; Silvapulle, 1981). For multinomial logistic regression models, we prove existence theorems by considering the possible patterns of data points, which fall into three mutually exclusive and exhaustive categories: complete separation, quasicomplete separation and overlap. Our results suggest general rules for identifying infinite parameter estimates in log linear models for frequency tables.",0,1 +999,Genetic and environmental contributions to the acquisition of a motor skill,"Practice, with feedback, is a fundamental variable that influences the aquisition of motor skills: with it, everyone improves, but some improve more than others. This simple fact has led to frequent debate over the relative importance of genetic and environmental influences on motor learning. In principle these factors could influence subjects' initial level of proficiency, their rate of improvement or their final level of attainment. The problem has been investigated using the rotary pursuit (RP) task, in which subjects learn to track a rotating target with a stylus; this is a factorially pure task which is relatively unaffected by cognitive or verbal factors. Earlier studies of twins reared together indicated that heredity was the primary factor responsible for individual differences in motor skill. Here we have studied learning in a sample of monozygotic (MZA) and dizygotic (DZA) twins who had been reared apart. Heritability of performance was high even in the initial phase, and increased with practice. The rate of learning was also significantly heritable. We propose that the effect of practice is to decrease the effect of environmental variation (previous learning) and increase the relative strength of genetic influences on motor performance.",0,1 +1000,A Bayesian Approach to Multilevel Structural Equation Modeling With Continuous and Dichotomous Outcomes,"Multilevel Structural equation models are most often estimated from a frequentist framework via maximum likelihood. However, as shown in this article, frequentist results are not always accurate. Alternatively, one can apply a Bayesian approach using Markov chain Monte Carlo estimation methods. This simulation study compared estimation quality using Bayesian and frequentist approaches in the context of a multilevel latent covariate model. Continuous and dichotomous variables were examined because it is not yet known how different types of outcomes—most notably categorical—affect parameter recovery in this modeling context. Within the Bayesian estimation framework, the impact of diffuse, weakly informative, and informative prior distributions were compared. Findings indicated that Bayesian estimation may be used to overcome convergence problems and improve parameter estimate bias. Results highlight the differences in estimation quality between dichotomous and continuous variable models and the importance o...",1,1 +1001,Asymptotic Effect of Misspecification in the Random Part of the Multilevel Model,"The authors examine the asymptotic effect of omitting a random coefficient in the multilevel model and derive expressions for the change in (a) the variance components estimator and (b) the estimated variance of the fixed effects estimator. They apply the method of moments, which yields a closed form expression for the omission effect. In practice, the model parameters are estimated by maximum likelihood; however, since the moment estimator and the maximum likelihood estimator are both consistent, the presented expression for the change in the variance components estimator asymptotically holds for the maximum likelihood estimator as well. The results are illustrated with an analysis of mathematics performance data.",0,1 +1002,The PHLAME (Promoting Healthy Lifestyles: Alternative Models??? Effects) Firefighter Study: Outcomes of Two Models of Behavior Change,"PHLAME's (Promoting Healthy Lifestyles: Alternative Models' Effects) objective was to assess and compare two means to promote healthy lifestyles.Prospective trial among 599 firefighters randomized by station to 1) team-centered curriculum, 2) one-on-one motivational interviewing (MI), and 3) controls. Assessment included dietary behavior, physical activity, weight, and general well-being at baseline and 12 months. Program effects were determined using an analysis of covariance (ANCOVA) based approach, and models for relationships were evaluated with path analysis.Both interventions were acceptable and delivered with high fidelity. The team and MI programs increased fruit and vegetable consumption (P < 0.01 and 0.05, respectively) and general well-being (P < 0.01). Significantly less weight gain occurred in both (P < 0.05). A cross-sectional model was consistent with mediation differing between interventions.Both a team-centered and individual-oriented intervention promoted healthy behaviors. The scripted team curriculum is innovative, exportable, and may enlist influences not accessed with individual formats.",0,1 +1003,Extended Generalized Linear Latent and Mixed Model,"The generalized linear latent and mixed modeling (GLLAMM framework) includes many models such as hierarchical and structural equation models. However, GLLAMM cannot currently accommodate some models because it does not allow some parameters to be random. GLLAMM is extended to overcome the limitation by adding a submodel that specifies a distribution of the additional random effects (Extended-GLLAMM). The extension is extremely simple to implement through the Bayesian framework with the WinBUGS software. Our approach is illustrated through the analysis of data from a youth tobacco cessation study.",0,1 +1004,Bayesian adaptive estimation of threshold versus contrast external noise functions: The quick TvC method,"External noise paradigms, measuring contrast threshold as a function of external noise contrast (the “ TvC ” function), provide a valuable tool for studying perceptual mechanisms. However, measuring TvC functions at the multiple performance criteria needed to constrain observer models has previously involved demanding data collection (often > 2000 trials). To ease this task, we developed a novel Bayesian adaptive procedure, the “quick TvC ” or “ qTvC ” method, to rapidly estimate multiple TvC functions, by adapting a strategy originally developed to estimate psychometric threshold and slope [Cobo-Lewis, A. B. (1996). An adaptive method for estimating multiple parameters of a psychometric function. Journal of Mathematical Psychology , 40 , 353–354; Kontsevich, L. L., & Tyler, C. W. (1999). Bayesian adaptive estimation of psychometric slope and threshold. Vision Research , 39 (16), 2729–2737]. Exploiting the regularities observed in empirical TvC functions, the qTvC method estimates three parameters: the optimal threshold c 0 , the critical noise level N c , and the common slope, η , of log-parallel psychometric functions across external noise conditions. Before each trial, the qTvC uses a one-step-ahead search to select the stimulus (jointly defined by signal and noise contrast) that minimizes the expected entropy of the three-dimensional posterior probability distribution, p ( N c , c 0 , η ). The method’s accuracy and precision, for estimating TvC functions at three performance criteria (65%, 79%, and 92% correct), were evaluated using Monte-Carlo simulations and a psychophysical task. Simulations showed that less than 300 trials were needed to estimate TvC functions at three widely separated criteria with good accuracy (bias < 5%) and precision (mean root mean square error <1.5 dB). Using an orientation identification task, we found excellent agreement (weighted r 2 > .95) between TvC estimates obtained with the qTvC and the method of constant stimuli, although the qTvC used only 12% of the data collection (240 vs 1920 trials). The qTvC may hold considerable practical value for applying the external noise method to study mechanisms of observer state changes and special populations. We suggest that the same adaptive strategy can be applied to directly estimate other classical functions, such as the contrast sensitivity function, elliptical equi-discrimination contours, and sensory memory decay functions.",0,1 +1005,Response Time Modeling Based on the Proportional Hazards Model,"Response time data are regularly analyzed in psychology. When several response times are assessed per participant, it is common practice to use latent trait models in order to account for the dependency of the response times from the same participant. One such model is the proportional hazards model with random effects. Despite its popularity in survival analysis, this model is rarely used in psychology because of the difficulty of model estimation when latent variables are present. In this article, a new estimation method is proposed. This method is based on the rank correlation matrix containing Kendall's Tau coefficients and unweighted least squares estimation ( Kendall, 1938 ). Compared with marginal maximum likelihood estimation, the new estimation approach is simple, not computationally intensive, and almost as efficient. Additionally, the approach allows the implementation of a test for model fit. Feasibility of the estimation method and validity of the fit test is demonstrated with a simulation study. An application of the model to a real data set is provided.",0,1 +1006,Comparing models for perfluorooctanoic acid pharmacokinetics using Bayesian analysis,"Selecting the appropriate pharmacokinetic (PK) model given the available data is investigated for perfluorooctanoic acid (PFOA), which has been widely analyzed with an empirical, one-compartment model. This research examined the results of experiments [Kemper R. A., DuPont Haskell Laboratories, USEPA Administrative Record AR-226.1499 (2003)] that administered single oral or iv doses of PFOA to adult male and female rats. PFOA concentration was observed over time; in plasma for some animals and in fecal and urinary excretion for others. There were four rats per dose group, for a total of 36 males and 36 females. Assuming that the PK parameters for each individual within a gender were drawn from the same, biologically varying population, plasma and excretion data were jointly analyzed using a hierarchical framework to separate uncertainty due to measurement error from actual biological variability. Bayesian analysis using Markov Chain Monte Carlo (MCMC) provides tools to perform such an analysis as well as quantitative diagnostics to evaluate and discriminate between models. Starting from a one-compartment PK model with separate clearances to urine and feces, the model was incrementally expanded using Bayesian measures to assess if the expansion was supported by the data. PFOA excretion is sexually dimorphic in rats; male rats have bi-phasic elimination that is roughly 40 times slower than that of the females, which appear to have a single elimination phase. The male and female data were analyzed separately, keeping only the parameters describing the measurement process in common. For male rats, including excretion data initially decreased certainty in the one-compartment parameter estimates compared to an analysis using plasma data only. Allowing a third, unspecified clearance improved agreement and increased certainty when all the data was used, however a significant amount of eliminated PFOA was estimated to be missing from the excretion data. Adding an additional PK compartment reduced the unaccounted-for elimination to amounts comparable to the cage wash. For both sexes, an MCMC estimate of the appropriateness of a model for a given data type, the Deviance Information Criterion, indicated that this two-compartment model was better suited to describing PFOA PK. The median estimate was 142.1 ± 37.6 ml/kg for the volume of the primary compartment and 1.24 ± 1.1 ml/kg/h for the clearances of male rats and 166.4 ± 46.8 ml/kg and 30.3 ± 13.2 ml/kg/h, respectively for female rats. The estimates for the second compartment differed greatly with gender-volume 311.8 ± 453.9 ml/kg with clearance 3.2 ± 6.2 for males and 1400 ± 2507.5 ml/kg and 4.3 ± 2.2 ml/kg/h for females. The median estimated clearance was 12 ± 6% to feces and 85 ± 7% to urine for male rats and 8 ± 6% and 77 ± 9% for female rats. We conclude that the available data may support more models for PFOA PK beyond two-compartments and that the methods employed here will be generally useful for more complicated, including PBPK, models. © 2008 Springer Science+Business Media, LLC.",0,1 +1007,Markov Chains for Exploring Posterior Distributions,"Several Markov chain methods are available for sampling from a posterior distribution. Two important examples are the Gibbs sampler and the Metropolis algorithm. In addition, several strategies are available for constructing hybrid algorithms. This paper outlines some of the basic methods and strategies and discusses some related theoretical and practical issues. On the theoretical side, results from the theory of general state space Markov chains can be used to obtain convergence rates, laws of large numbers and central limit theorems for estimates obtained from Markov chain methods. These theoretical results can be used to guide the construction of more efficient algorithms. For the practical use of Markov chain methods, standard simulation methodology provides several variance reduction techniques and also give guidance on the choice of sample size and allocation.",0,1 +1008,10 Structural Equation Modeling,"Structural equation modeling (SEM), by segregating measurement errors from the true scores of attributes, provides a methodology to model the latent variables, such as attitudes, IQ, personality traits, political liberalism or conservatism, and socio-economic status, directly. The methodology of SEM has enjoyed tremendous developments since 1970, and is now widely applied. The idea of multiple indicators for a latent variable is from factor analysis. SEM is often regarded as an extension of factor analysis in the psychometric literature. This methodology also covers several widely used statistical models in various disciplines. This chapter presents several specific models before introducing the general mean and covariance structures. It is noted that unlike the exploratory factor analysis (EFA) model, the zero loadings in a general confirmatory factor analysis (CFA) model are specified a priori based on subject-matter knowledge, and their number and placement guarantee that the model is identified without any rotational constraints.",0,1 +1009,How and when does complex reasoning occur? Empirically driven development of a learning progression focused on complex reasoning about biodiversity,"In order to compete in a global economy, students are going to need resources and curricula focusing on critical thinking and reasoning in science. Despite awareness for the need for complex reasoning, American students perform poorly relative to peers on international standardized tests measuring complex thinking in science. Research focusing on learning progressions is one effort to provide more coherent science curricular sequences and assessments that can be focused on complex thinking about focal science topics. This article describes an empirically driven, five-step process to develop a 3-year learning progression focusing on complex thinking about biodiversity. Our efforts resulted in empirical results and work products including: (1) a revised definition of learning progressions, (2) empirically driven, 3-year progressions for complex thinking about biodiversity, (3) an application of statistical approaches for the analysis of learning progression products, (4) Hierarchical Linear Modeling results demonstrating significant student achievement on complex thinking about biodiversity, and (5) Growth Model results demonstrating strengths and weaknesses of the first version of our curricular units. The empirical studies present information to inform both curriculum and assessment development. For curriculum development, the role of learning progressions as templates for the development of organized sequences of curricular units focused on complex science is discussed. For assessment development, learning progression-guided assessments provide a greater range and amount of information that can more reliably discriminate between students of differing abilities than a contrasting standardized assessment measure that was also focused on biodiversity content. © 2009 Wiley Periodicals, Inc. J Res Sci Teach 46: 610–631, 2009",0,1 +1010,Objective Bayesian estimation of the probability of default,"Summary Reliable estimation of the probability of default (PD) of a customer is one of the most important tasks in credit risk modelling for banks applying the internal ratings-based approach under the Basel II–III framework. Motivated by the desire to analyse reliably a low default portfolio of non-profit housing companies, we consider PD estimation within a Bayesian framework and develop objective priors for the parameter θ representing the PD in the Gaussian and the Student t single-factor models. A marginal reference prior and limiting versions of it are presented and their posterior propriety is studied. The priors are shown to be direct generalizations of the Jeffreys prior in the binomial model. We use Markov chain Monte Carlo strategies to sample efficiently from the posterior distributions and compare the developed priors on the grounds of the frequentist properties of the resulting Bayesian inferences with subjective priors previously proposed in the literature. Finally, the analysis of the non-profit housing companies portfolio highlights the ultility of the methodological developments.",0,1 +1011,Evaluation of Bayesian models for focused clustering in health data,"This paper examines the ability of Bayesian hierarchical models to recover evidence of disease risk excess around a fixed location. This location can be a putative source of health hazard, such as an incinerator, mobile phone mast or dump site. While Bayesian models are convenient to use for modeling, it is useful to consider how well these models perform in the true risk scenarios. In what follows, we evaluate the ability of these models to recover the true risk under simulation. It is surprising that the resulting posterior parameters estimates are heavily biased. Using the credible intervals for distance decline parameter to assess ‘coverage or power’ of detecting distance effect, the ‘power’ decreases with increasing correlation in the background population effect. The inclusion of correlated heterogeneity in models does affect the ability of the models to detect the stronger distance decline scenarios. The uncorrelated heterogeneity seems little affect this ability however. Copyright © 2007 John Wiley & Sons, Ltd.",0,1 +1012,Antiplatelet regimens in the long-term secondary prevention of transient ischaemic attack and ischaemic stroke: an updated network meta-analysis,"To examine the comparative efficacy and safety of different antiplatelet regimens in patients with prior non-cardioembolic ischaemic stroke or transient ischaemic attack.Systematic review and network meta-analysis.As on 31 March 2015, all randomised controlled trials that investigated the effects of antiplatelet agents in the long-term (≥ 3 months) secondary prevention of non-cardioembolic transient ischaemic attack or ischaemic stroke were searched and identified.The primary outcome measure of efficacy was serious vascular events (non-fatal stroke, non-fatal myocardial infarction and vascular death). The outcome measure of safety was any bleeding.A total of 36 randomised controlled trials (82,144 patients) were included. Network meta-analysis showed that cilostazol was significantly more effective than clopidogrel (OR 0.77, 95% credible interval 0.60-0.98) and low-dose (75-162 mg daily) aspirin (0.69, 0.55-0.86) in the prevention of serious vascular events. Aspirin (50 mg daily) plus dipyridamole (400 mg daily) and clopidogrel reduced the risk of serious vascular events compared with low-dose aspirin; however, the difference was not statistically significant. Furthermore, low-dose aspirin was as effective as higher daily doses. Cilostazol was associated with a significantly lower bleeding risk than most of the other regimens. Moreover, aspirin plus clopidogrel was associated with significantly more haemorrhagic events than other regimens. Direct comparisons showed similar results as the network meta-analysis.Cilostazol was significantly more effective than aspirin and clopidogrel alone in the long-term prevention of serious vascular events in patients with prior non-cardioembolic ischaemic stroke or transient ischaemic attack. Cilostazol was associated with a significantly lower bleeding risk than low-dose aspirin (75-162 mg daily) and aspirin (50 mg daily) plus dipyridamole (400 mg daily). Low-dose aspirin was as effective as higher daily doses. However, further large, randomised, controlled, head-to-head trials are needed, especially in non-Asian ethnic groups.",0,1 +1013,Further results on estimation of covariance matrix,"Abstract This paper considers the problem of estimating a covariance matrix under Stein’s loss. Sufficient conditions for the modified Efron–Morris estimator to be minimax under weighted quadratic loss are shown, which provide a general method for improving the estimator of the covariance matrix.",0,1 +1014,A unifying expression for the maximal reliability of a linear composite,"A formally simple expression for the maximal reliability of a linear composite is provided, its theoretical implications and its relation to existing results for reliability are discussed.",0,1 +1015,A Multilevel Model of Early Retirement Decisions among Autoworkers in Plants with Different Futures,"During the period of their 1986-1989 General Motors (GM)-United Auto Workers (UAW) contract, about 17% of all GM autoworkers who were eligible to elect early retirement did so. Those who did were distinctive in theoretically expected ways, with expectations defined by individual characteristics such as age, physical health, and pension wealth. But some of the workers were employed in plants that GM had decided to abandon. Did that difference in organizational context make a difference in individual workers’ decisions about early retirement? Would workers who chose to take early retirement and who were employed in plants scheduled to close have made the same decision had their plants not been selected for closure? If the rate of early retirement was higher in plants scheduled to close, and it was, how did that difference relate to the process by which individual workers reached their decisions? These are some of the questions asked and answered through multilevel analyses of data from a probability sample of GM’s autoworkers. These analyses generate findings not detected in single-level analyses of the same data.",0,1 +1016,Processes Linking Father Absence to Educational Attainment Among African American Females,"Previous researchers have assessed how father absence influences both socioeconomic and reproductive development, but have not analyzed these relationships jointly or used theoretical support for explaining why father absence affects socioeconomic and reproductive development, especially for African American girls. Guided by the family economic stress model and psychosocial acceleration theory, this study investigates how and why these relationships exist for 532 African American females. Structural equation modeling revealed that longer duration of father absence predicted lowered educational attainment in early adulthood via lower income, increased economic pressure, accelerated reproductive development, and lowered educational expectations. We include recommendations for the use of these perspectives to better understand the interplay between family socioeconomic processes and reproductive maturation in African American females.",0,1 +1017,Design and Analysis of Long-term Ecological Monitoring Studies,"To provide useful and meaningful information, long-term ecological programs need to implement solid and efficient statistical approaches for collecting and analyzing data. This volume provides rigorous guidance on quantitative issues in monitoring, with contributions from world experts in the field. These experts have extensive experience in teaching fundamental and advanced ideas and methods to natural resource managers, scientists and students. The chapters present a range of tools and approaches, including detailed coverage of variance component estimation and quantitative selection among alternative designs; spatially balanced sampling; sampling strategies integrating design- and model-based approaches; and advanced analytical approaches such as hierarchical and structural equation modelling. Making these tools more accessible to ecologists and other monitoring practitioners across numerous disciplines, this is a valuable resource for any professional whose work deals with ecological monitoring. Supplementary example software code is available online at www.cambridge.org/9780521191548.",0,1 +1018,The Persistent Sciatic Inflammatory Neuropathy (SIN) Rat Model of Neuropathic Pain Does Not Involve Small-Fiber Axon Damage,"ABSTRACTMost neuropathic pain conditions are caused by damage to peripheral nociceptive neurons known as “small-fibers.” Examination of punch skin biopsies immunolabeled with pan-axonal markers has identified degeneration of distal nociceptive axons as a pathological hallmark of most neuralgias including numerous polyneuropathies, postherpetic neuralgia, and complex regional pain syndrome. Similar axonopathy is present in several rodent models of neuralgia (chronic constriction injury and spared nerve injury). Here we have measured the density of distal cutaneous small-fiber axons in rats with persistent mechanical allodynia caused by the sciatic inflammatory neuropathy (SIN), a model of painful neuritis. We have evaluated whether perineural immune activation sufficient to cause evoked-pain behaviors is also associated with loss of distal epidermal innervation.SIN was created in adult male Sprague-Dawley rats by perineural zymosan administration using established methods. Unoperated rats provided controls...",0,1 +1019,A Bayesian Approach to More Stable Estimates of Group-Level Effects in Contextual Studies,"Multilevel analyses are often used to estimate the effects of group-level constructs. However, when using aggregated individual data (e.g., student ratings) to assess a group-level construct (e.g., classroom climate), the observed group mean might not provide a reliable measure of the unobserved latent group mean. In the present article, we propose a Bayesian approach that can be used to estimate a multilevel latent covariate model, which corrects for the unreliable assessment of the latent group mean when estimating the group-level effect. A simulation study was conducted to evaluate the choice of different priors for the group-level variance of the predictor variable and to compare the Bayesian approach with the maximum likelihood approach implemented in the software Mplus. Results showed that, under problematic conditions (i.e., small number of groups, predictor variable with a small ICC), the Bayesian approach produced more accurate estimates of the group-level effect than the maximum likelihood approach did.",0,1 +1020,"The psi-marginal adaptive method: How to give nuisance parameters the attention they deserve (no more, no less)","Adaptive testing methods serve to maximize the information gained regarding the values of the parameters of a psychometric function (PF). Such methods typically target only one or two (""threshold"" and ""slope"") of the PF's four parameters while assuming fixed values for the ""nuisance"" parameters (""guess rate"" and ""lapse rate""). Here I propose the ""psi-marginal"" adaptive method, which can target nuisance parameters but only when this is the most optimal manner in which to reduce uncertainty in the value of the parameters of primary interest. The method is based on Kontsevich and Tyler's (1999) psi-method. However, in the proposed method a posterior distribution defined across all parameters of unknown value is maintained. Each of the parameters is specified either as a parameter of primary interest whose estimation should be optimized or as a nuisance parameter whose estimation should be subservient to the estimation of the parameters of primary interest. Critically, selection of stimulus intensities is based on the expected information gain in the marginal posterior distribution defined across the parameters of interest only. The appeal of this method is that it will target nuisance parameters adaptively and only when doing so maximizes the expected information gain regarding the values of the parameters of interest. Simulations indicate that treating the lapse rate as a nuisance parameter in the psi-marginal method results in smaller bias and higher precision in threshold and slope estimates compared to the original psi method. The method is highly flexible and various other uses are discussed.",0,1 +1021,A Bayesian Non-Parametric Dynamic AR Model for Multiple Time Series Analysis,"In this article, we propose a Bayesian non-parametric model for the analysis of multiple time series. We consider an autoregressive structure of order p for each of the series and borrow strength across the series by considering a common error population that is also evolving in time. The error populations (distributions) are assumed non-parametric whose law is based on a series of dependent Polya trees with zero median. This dependence is of order q and is achieved via a dependent beta process that links the branching probabilities of the trees. We study the prior properties and show how to obtain posterior inference. The model is tested under a simulation study and is illustrated with the analysis of the economic activity index of the 32 states of Mexico.",0,1 +1022,Asymptotic Properties of Conditional Maximum-Likelihood Estimators,The problem of obtaining consistent estimates for structural parameters in the presence of infinitely many incidental parameters was discussed first by Neyman and Scott (1948). In this paper a maximum-likelihood method based on the conditional distribution given minimal sufficient statistics for the incidental parameters is suggested. It is proved that conditional maximumlikelihood estimates in the regular case are consistent and asymptotically normally distributed with a simple asymptotic variance. The efficiency problem of this new estimator is discussed in particular with respect to some situations with ancillary information.,0,1 +1023,Effects of marijuana use on impulsivity and hostility in daily life,"Marijuana use is increasingly prevalent among young adults. While research has found adverse effects associated with marijuana use within experimentally controlled laboratory settings, it is unclear how recreational marijuana use affects day-to-day experiences in users. The present study sought to examine the effects of marijuana use on within-person changes in impulsivity and interpersonal hostility in daily life using smartphone administered assessments.Forty-three participants with no substance dependence reported on their alcohol consumption, tobacco use, recreational marijuana use, impulsivity, and interpersonal hostility over the course of 14 days. Responses were analyzed using multilevel modeling.Marijuana use was associated with increased impulsivity on the same day and the following day relative to days when marijuana was not used, independent of alcohol use. Marijuana was also associated with increased hostile behaviors and perceptions of hostility in others on the same day when compared to days when marijuana was not used. These effects were independent of frequency of marijuana use or alcohol use. There were no significant effects of alcohol consumption on impulsivity or interpersonal hostility.Marijuana use is associated with changes in impulse control and hostility in daily life. This may be one route by which deleterious effects of marijuana are observed for mental health and psychosocial functioning. Given the increasing prevalence of recreational marijuana use and the potential legalization in some states, further research on the potential consequences of marijuana use in young adults' day-to-day life is warranted.",0,1 +1024,The Accuracy of Multilevel Structural Equation Modeling With Pseudobalanced Groups and Small Samples,"Hierarchical structured data cause problems in analysis, because the usual assumptions of independently and identically distributed variables are violated. Muthen (1989) described an estimation method for multilevel factor and path analysis with hierarchical data. This article assesses the robustness of the method with unequal groups, small sample sizes at both the individual and the group level, in the presence of a low or a high intraclass correlation (ICC). The within-groups part of the model poses no problems. The most important problem in the between-groups part of the model is the occurrence of inadmissible estimates, especially when group level sample size is small (50) while the intracluster correlation is low. This is partly compensated by using large group sizes. When an admissible solution is reached, the factor loadings are generally accurate. However, the residual variances are underestimated, and the standard errors are generally too small. Having more or larger groups or a higher ICC does n...",0,1 +1025,Bayesian hierarchical grouping: Perceptual grouping as mixture estimation.,"We propose a novel framework for perceptual grouping based on the idea of mixture models, called Bayesian hierarchical grouping (BHG). In BHG, we assume that the configuration of image elements is generated by a mixture of distinct objects, each of which generates image elements according to some generative assumptions. Grouping, in this framework, means estimating the number and the parameters of the mixture components that generated the image, including estimating which image elements are ""owned"" by which objects. We present a tractable implementation of the framework, based on the hierarchical clustering approach of Heller and Ghahramani (2005). We illustrate it with examples drawn from a number of classical perceptual grouping problems, including dot clustering, contour integration, and part decomposition. Our approach yields an intuitive hierarchical representation of image elements, giving an explicit decomposition of the image into mixture components, along with estimates of the probability of various candidate decompositions. We show that BHG accounts well for a diverse range of empirical data drawn from the literature. Because BHG provides a principled quantification of the plausibility of grouping interpretations over a wide range of grouping problems, we argue that it provides an appealing unifying account of the elusive Gestalt notion of Prägnanz.",0,1 +1026,Test theory without an answer key,"A general model is presented for homogeneous, dichotomous items when the answer key is not known a priori. The model is structurally related to the two-class latent structure model with the roles of respondents and items interchanged. For very small sets of respondents, iterative maximum likelihood estimates of the parameters can be obtained by existing methods. For other situations, new estimation methods are developed and assessed with Monte Carlo data. The answer key can be accurately reconstructed with relatively small sets of respondents. The model is useful when a researcher wants to study objectively the knowledge possessed by members of a culturally coherent group that the researcher is not a member of. © 1987 The Psychometric Society.",0,1 +1027,Parameter expansion for sampling a correlation matrix: an efficient GPX-RPMH algorithm,"Sampling the correlation matrix (R) plays an important role in statistical inference for correlated models. There are two main constraints on a correlation matrix: positive definiteness and fixed diagonal elements. These constraints make sampling R difficult. In this paper, an efficient generalized parameter expanded re-parametrization and Metropolis-Hastings (GPX-RPMH) algorithm for sampling a correlation matrix is proposed. Drawing all components of R simultaneously from its full conditional distribution is realized by first drawing a covariance matrix from the derived parameter expanded candidate density (PXCD), and then translating it back to a correlation matrix and accepting it according to a Metropolis-Hastings (M-H) acceptance rate. The mixing rate in the M-H step can be adjusted through a class of tuning parameters embedded in the generalized candidate prior (GCP), which is chosen for R to derive the PXCD. This algorithm is illustrated using multivariate regression (MVR) models and a simulation s...",0,1 +1028,Advances in prospect theory: Cumulative representation of uncertainty,"We develop a new version of prospect theory that employs cumulative rather than separable decision weights and extends the theory in several respects. This version, called cumulative prospect theory, applies to uncertain as well as to risky prospects with any number of outcomes, and it allows different weighting functions for gains and for losses. Two principles, diminishing sensitivity and loss aversion, are invoked to explain the characteristic curvature of the value function and the weighting functions. A review of the experimental evidence and the results of a new experiment confirm a distinctive fourfold pattern of risk attitudes: risk aversion for gains and risk seeking for losses of high probability; risk seeking for gains and risk aversion for losses of low probability. This article has benefited from discussions with Colin Camerer, Chew Soo-Hong, David Freedman, and David H. Krantz. We are especially grateful to Peter P. Wakker for his invaluable input and contribution to the axiomatic analysis. We are indebted to Richard Gonzalez and Amy Hayes for running the experiment and analyzing the data. This work was supported by Grants 89-0064 and 88-0206 from the Air Force Office of Scientific Research, by Grant SES-9109535 from the National Science Foundation, and by the Sloan Foundation. © 1992 Kluwer Academic Publishers.",0,1 +1029,Intraclass Correlation Values for Planning Group-Randomized Trials in Education,"Experiments that assign intact groups to treatment conditions are increasingly common in social research. In educational research, the groups assigned are often schools. The design of group-randomized experiments requires knowledge of the intraclass correlation structure to compute statistical power and sample sizes required to achieve adequate power. This article provides a compilation of intraclass correlation values of academic achievement and related covariate effects that could be used for planning group-randomized experiments in education. It also provides variance component information that is useful in planning experiments involving covariates. The use of these values to compute the statistical power of group-randomized experiments is illustrated.",0,1 +1030,The Performance of Methods to Test Upper-Level Mediation in the Presence of Nonnormal Data,"A Monte Carlo study compared the statistical performance of standard and robust multilevel mediation analysis methods to test indirect effects for a cluster randomized experimental design under various departures from normality. The performance of these methods was examined for an upper-level mediation process, where the indirect effect is a fixed effect and a group-implemented treatment is hypothesized to impact a person-level outcome via a person-level mediator. Two methods-the bias-corrected parametric percentile bootstrap and the empirical-M test-had the best overall performance. Methods designed for nonnormal score distributions exhibited elevated Type I error rates and poorer confidence interval coverage under some conditions. Although preliminary, the findings suggest that new mediation analysis methods may provide for robust tests of indirect effects.",0,1 +1031,The place of human psychophysics in modern neuroscience,"Human psychophysics is the quantitative measurement of our own perceptions. In essence, it is simply a more sophisticated version of what humans have done since time immemorial: noticed and reflected upon what we can see, hear, and feel. In the 21st century, when hugely powerful techniques are available that enable us to probe the innermost structure and function of nervous systems, is human psychophysics still relevant? I argue that it is, and that in combination with other techniques, it will continue to be a key part of neuroscience for the foreseeable future. I discuss these points in detail using the example of binocular stereopsis, where human psychophysics in combination with physiology and computational vision, has made a substantial contribution.",0,1 +1032,A basis for analyzing test-retest reliability,"Three sources of variation in experimental results for a test are distinguished: trials, persons, and items. Unreliability is defined only in terms of variation over trials. This definition leads to a more complete analysis than does the conventional one; Spearman's contention is verified that the conventional approach-which was formulated by Yule-introduces unnecessary hypotheses. It is emphasized that at least two trials are necessary to estimate the reliability coefficient. This paper is devoted largely to developing lower bounds to the reliability coefficient that can be computed from but a single trial; these avoid the experimental difficulties of making two independent trials. Six different lower bounds are established, appropriate for different situations. Some of the bounds are easier to compute than are conventional formulas, and all the bounds assume less than do conventional formulas. The terminology used is that of psychological and sociological testing, but the discussion actually provides a general analysis of the reliability of the sum of n variables. © 1945 Psychometric Society.",0,1 +1033,"Point Estimation, Hypothesis Testing, and Interval Estimation Using the RMSEA: Some Comments and a Reply to Hayduk and Glaser","Hayduk and Glaser (2000) asserted that the most commonly used point estimate of the Root Mean Square Error of Approximation index of fit (Steiger & Lind, 1980) has two significant problems: (a) The frequently cited target value of. 05 is not a stable target, but a sample size adjustment; and (b) the truncated point estimate Rt = max(R, 0) effectively throws away a substantial part of the sampling distribution of the test statistic with proper models, rendering it useless a substantial portion of the time. In this article, I demonstrate that both issues discussed by Hayduk and Glaser are actually not problems at all. The first derives from a false premise by Hayduk and Glaser that Steiger (1995) specifically warned about in an earlier publication. The second so-called problem results from the point estimate satisfying a fundamental property of a good estimator and can be shown to have virtually no negative implications for statistical practice.",0,1 +1034,Bayesian Methods for Evidence Synthesis in Cost-Effectiveness Analysis,"Recently, health systems internationally have begun to use cost-effectiveness research as formal inputs into decisions about which interventions and programmes should be funded from collective resources. This process has raised some important methodological questions for this area of research. This paper considers one set of issues related to the synthesis of effectiveness evidence for use in decision-analytic cost-effectiveness (CE) models, namely the need for the synthesis of all sources of available evidence, although these may not 'fit neatly' into a CE model. Commonly encountered problems include the absence of head-to-head trial evidence comparing all options under comparison, the presence of multiple endpoints from trials and different follow-up periods. Full evidence synthesis for CE analysis also needs to consider treatment effects between patient subpopulations and the use of nonrandomised evidence. Bayesian statistical methods represent a valuable set of analytical tools to utilise indirect evidence and can make a powerful contribution to the decision-analytic approach to CE analysis. This paper provides a worked example and a general overview of these methods with particular emphasis on their use in economic evaluation. © 2006 Adis Data Information BV. All rights reserved.",0,1 +1035,Bayesian inference for generalized linear mixed models,"Generalized linear mixed models (GLMMs) continue to grow in popularity due to their ability to directly acknowledge multiple levels of dependency and model different data types. For small sample sizes especially, likelihood-based inference can be unreliable with variance components being particularly difficult to estimate. A Bayesian approach is appealing but has been hampered by the lack of a fast implementation, and the difficulty in specifying prior distributions with variance components again being particularly problematic. Here, we briefly review previous approaches to computation in Bayesian implementations of GLMMs and illustrate in detail, the use of integrated nested Laplace approximations in this context. We consider a number of examples, carefully specifying prior distributions on meaningful quantities in each case. The examples cover a wide range of data types including those requiring smoothing over time and a relatively complicated spline model for which we examine our prior specification in terms of the implied degrees of freedom. We conclude that Bayesian inference is now practically feasible for GLMMs and provides an attractive alternative to likelihood-based approaches such as penalized quasi-likelihood. As with likelihood-based approaches, great care is required in the analysis of clustered binary data since approximation strategies may be less accurate for such data.",0,1 +1036,Determinants of patient preferences for total knee replacement: African-Americans and whites,"Patient preferences contribute to marked racial disparities in the utilization of total knee replacement (TKR). The objectives of this study were to identify the determinants of knee osteoarthritis (OA) patients' preferences regarding TKR by race and to identify the variables that may mediate racial differences in willingness to undergo TKR.Five hundred fourteen White (WH) and 285 African-American (AA) patients with chronic knee pain and radiographic evidence of OA participated in the study. Participants were recruited from the community, an academic medical center, and a Veterans Affairs hospital. Structured interviews were conducted to collect socio-demographics, disease severity, socio-cultural determinants, and treatment preferences. Logistic regression was performed, stratified by race, to identify determinants of preferences. Clinical and socio-cultural factors were entered simultaneously into the models. Stepwise selection identified factors for inclusion in the final models (p < 0.20).Compared to WHs, AAs were less willing to undergo TKR (80 % vs. 62 %, respectively). Better expectations regarding TKR surgery outcomes determined willingness to undergo surgery in both AAs (odds ratio (OR) 2.08, 95 % confidence interval (CI) 0.91-4.79 for 4(th) vs. 1(st) quartile) and WHs (OR 5.11, 95 % CI 2.31-11.30 for 4(th) vs. 1(st) quartile). Among AAs, better understanding of the procedure (OR 1.80, 95 % CI 0.97-3.35), perceiving a short hospital course (OR 0.81, 95 % CI 0.58-1.13), and believing in less post-surgical pain (OR 0.73, 95 % CI 0.39-1.35) and walking difficulties (OR 0.66, 95 % CI 0.37-1.16) also determined willingness. Among WHs, having surgical discussion with a physician (OR 1.96, 95 % CI 1.05-3.68), not ever receiving surgical referral (OR 0.56, 95 % CI 0.32-0.99), and higher trust in the healthcare system (OR 1.58, 95 % CI 0.75-3.31 for 4(th) vs. 1(st) quartile) additionally determined willingness. Among the variables considered, only knowledge-related matters pertaining to TKR attenuated the racial difference in knee OA patients' treatment preference.Expectations of surgical outcomes influence preference for TKR in all patients, but clinical and socio-cultural factors exist that shape marked racial differences in preferences for TKR. Interventions to reduce or eliminate racial disparities in the utilization of TKR should consider and target these factors.",0,1 +1037,Estimation and Optimization of Functions,,0,1 +1038,Selective Influence and Response Time Cumulative Distribution Functions in Serial-Parallel Task Networks,"We analyze sets of mental processes, some of which are concurrent and some of which are sequential, under the assumption that the processes are partially ordered, that is, arranged in a directed acyclic network. Information about the process arrangement can be discovered by examining the effects on response time of selectively influencing process durations. Previous work has mainly focused on analyses of mean response times. Here we consider analyses based on cumulative distribution functions, for one of the major classes of directed acyclic networks, serial-parallel networks. When two processes are selectively influenced, patterns in the cumulative distribution functions can be used to test whether the processes are sequential or concurrent and whether the task network has AND gates or OR gates. Cumulative distribution functions are potentially more informative than means, and some previous results for means are shown to follow from our results for cumulative distribution functions. Copyright 2000 Academic Press.",0,1 +1039,"Spatio-temporal Properties of Elementary Perception: An Investigation of Parallel, Serial, and Coactive Theories","A mathematical theory and related experimental methodology are developed that permit strong, converging tests of parallel versus serial versus channel summation processing and of exhaustive versus self-terminating processing. An experimental design is used for two studies, in which the presence or absence of a target in each of two positions, is factorially combined with two levels of brightness (a version of the double factorial paradigm). When both targets are present (redundant target condition) the two levels of brightness permit factorial technology to determine mental architecture and stopping rules. Comparison of the single versus double target conditions allows capacity analyses that strongly reinforce the double target factorial phase of the investigation. The results provide decisive support for parallel channels with either a self-terminating stopping rule or a coactive summation of information. General serial models and any variety of exhaustive processing were conclusively falsified.",0,1 +1040,Properties of the size–weight illusion as shown by lines of subjective equality,"We studied the size-weight illusion through comparative judgments. The experiment had two direct aims: to verify whether the relative contribution of size to apparent heaviness can differ for different stimulus sets, and to verify whether that contribution can differ for different methods of comparing two objects (consecutive vs. simultaneous weighing). Thirty university students participated. Results show that the relative contribution of size depends on stimulus set, but is independent of the method used for comparing objects. The first finding implies that a linear model cannot describe the integration of size and weight information in the illusion; the second finding is evidence for the low-level character of the integration process.",0,1 +1041,New developments in LISREL: analysis of ordinal variables using polychoric correlations and weighted least squares,New developments in LISREL: : Analysis of ordinal variables using polychoric correlations and weighted least squares,0,1 +1042,Fitting a linear–linear piecewise growth mixture model with unknown knots: A comparison of two common approaches to inference.,"A linear-linear piecewise growth mixture model (PGMM) is appropriate for analyzing segmented (disjointed) change in individual behavior over time, where the data come from a mixture of 2 or more latent classes, and the underlying growth trajectories in the different segments of the developmental process within each latent class are linear. A PGMM allows the knot (change point), the time of transition from 1 phase (segment) to another, to be estimated (when it is not known a priori) along with the other model parameters. To assist researchers in deciding which estimation method is most advantageous for analyzing this kind of mixture data, the current research compares 2 popular approaches to inference for PGMMs: maximum likelihood (ML) via an expectation-maximization (EM) algorithm, and Markov chain Monte Carlo (MCMC) for Bayesian inference. Monte Carlo simulations were carried out to investigate and compare the ability of the 2 approaches to recover the true parameters in linear-linear PGMMs with unknown knots. The results show that MCMC for Bayesian inference outperformed ML via EM in nearly every simulation scenario. Real data examples are also presented, and the corresponding computer codes for model fitting are provided in the Appendix to aid practitioners who wish to apply this class of models.",0,1 +1043,A three-level model for binary time-series data: the effects of air pollution on school absences in the Southern California Children's Health Study,"A three-level model is proposed to simultaneously examine the effects of daily exposure to air pollution and individual risk factors on health outcomes without aggregating over subjects or time. We used a logistic transition model with random effects to take into account heterogeneity and overdispersion of the observations. A distributed lag structure for pollution has been included, assuming that the event on day t for a subject depends on the levels of air pollution for several preceding days. We illustrate this proposed model via detailed analysis of the effect of air pollution on school absenteeism based on data from the Southern California Children's Health Study.",0,1 +1044,Diagnosing Global Case Influence on MAR Versus MNAR Model Comparisons,"When missingness is suspected to be not at random (MNAR) in longitudinal studies, researchers sometimes compare the fit of a target model that assumes missingness at random (here termed a MAR model) and a model that accommodates a hypothesized MNAR missingness mechanism (here termed a MNAR model). It is well known that such comparisons are only interpretable conditional on the validity of the chosen MNAR model’s assumptions about the missingness mechanism. For that reason, researchers often perform a sensitivity analysis comparing the MAR model to not one, but several, plausible alternative MNAR models. In the social sciences, it is not widely known that such model comparisons can be particularly sensitive to case influence, such that conclusions drawn could depend on a single case. This article describes two convenient diagnostics suited for detecting case influence on MAR–MNAR model comparisons. Both diagnostics require much less computational burden than global influence diagnostics that have been used...",0,1 +1045,Bayesian Assessment of Null Values Via Parameter Estimation and Model Comparison,"Psychologists have been trained to do data analysis by asking whether null values can be rejected. Is the difference between groups nonzero? Is choice accuracy not at chance level? These questions have been traditionally addressed by null hypothesis significance testing (NHST). NHST has deep problems that are solved by Bayesian data analysis. As psychologists transition to Bayesian data analysis, it is natural to ask how Bayesian analysis assesses null values. The article explains and evaluates two different Bayesian approaches. One method involves Bayesian model comparison (and uses Bayes factors). The second method involves Bayesian parameter estimation and assesses whether the null value falls among the most credible values. Which method to use depends on the specific question that the analyst wants to answer, but typically the estimation approach (not using Bayes factors) provides richer information than the model comparison approach.",0,1 +1046,Prediction of occupational accident statistics and work time loss distributions using Bayesian analysis,"This paper uses Bayesian analysis tools for the stochastic evaluation of work time losses due to occupational accidents in a workplace. Models are developed for accident frequencies, duration of recovery from an accident, and the worker unavailability. The unavailability statistics are hereby derived considering a two state stochastic model, to provide estimates for the expected work time losses over a base period of workplace operation. The above models are applied on real multiyear accident data collected from the Greek Petrochemical Industry.",0,1 +1047,Centering predictor variables in cross-sectional multilevel models: A new look at an old issue.,"Appropriately centering Level 1 predictors is vital to the interpretation of intercept and slope parameters in multilevel models (MLMs). The issue of centering has been discussed in the literature, but it is still widely misunderstood. The purpose of this article is to provide a detailed overview of grand mean centering and group mean centering in the context of 2-level MLMs. The authors begin with a basic overview of centering and explore the differences between grand and group mean centering in the context of some prototypical research questions. Empirical analyses of artificial data sets are used to illustrate key points throughout. The article provides a number of practical recommendations designed to facilitate centering decisions in MLM applications.",0,1 +1048,Fixed effects models.,,0,1 +1049,Modeling Complex Spatial Dependencies: Low-Rank Spatially Varying Cross-Covariances With Application to Soil Nutrient Data,"Advances in geo-spatial technologies have created data-rich environments which provide extraordinary opportunities to understand the complexity of large and spatially indexed data in ecology and the natural sciences. Our current application concerns analysis of soil nutrients data collected at La Selva Biological Station, Costa Rica, where inferential interest lies in capturing the spatially varying relationships among the nutrients. The objective here is to interpolate not just the nutrients across space, but also associations among the nutrients that are posited to vary spatially. This requires spatially varying cross-covariance models. Fully process-based specifications using matrix-variate processes are theoretically attractive but computationally prohibitive. Here we develop fully process-based low-rank but non-degenerate spatially varying cross-covariance processes that can effectively yield interpolate cross-covariances at arbitrary locations. We show how a particular low-rank process, the predictive process, which has been widely used to model large geostatistical datasets, can be effectively deployed to model non-degenerate cross-covariance processes. We produce substantive inferential tools such as maps of nonstationary cross-covariances that constitute the premise of further mechanistic modeling and have hitherto not been easily available for environmental scientists and ecologists. © 2013 International Biometric Society.",0,1 +1050,Unfolding item response model using best-worst scaling,"In attitude measurement and sensory tests, the unfolding model is typically used. In this model, response probability is formulated by the distance between the person and the stimulus. In this study, we proposed an unfolding item response model using best-worst scaling (BWU model), in which a person chooses the best and worst stimulus among repeatedly presented subsets of stimuli. We also formulated an unfolding model using best scaling (BU model), and compared the accuracy of estimates between the BU and BWU models. A simulation experiment showed that the BWU modell performed much better than the BU model in terms of bias and root mean square errors of estimates. With reference to Usami (2011), the proposed models were apllied to actual data to measure attitudes toward tardiness. Results indicated high similarity between stimuli estimates generated with the proposed models and those of Usami (2011).",0,1 +1051,Restricted Maximum Likelihood (REML) Estimation of Variance Components in the Mixed Model,"The maximum likelihood (ML) procedure of Hartley aud Rao [2] is modified by adapting a transformation from Pattersou and Thompson [7] which partitions the likelihood render normality into two parts, one being free of the fixed effects. Maximizing this part yields what are called restricted maximum likelihood (REML) estimators. As well as retaining the property of invariance under translation that ML estimators have, the REML estimators have the additional property of reducing to the analysis variance (ANOVA) estimators for many, if not all, cases of balanced data (equal subclass numbers). A computing algorithm is developed, adapting a transformation from Hemmerle and Hartley [6], which reduces computing requirements to dealing with matrices having order equal to the dimension of the parameter space rather than that of the sample space. These same matrices also occur in the asymptotic sampling variances of the estimators.",0,1 +1052,"Bayesian methods in cost-effectiveness studies: objectivity, computation and other relevant aspects","In a probabilistic sensitivity analysis (PSA) of a cost–effectiveness (CE) study, the unknown parameters are considered as random variables. A crucial question is what probabilistic distribution is suitable for synthesizing the available information (mainly data from clinical trials) about these parameters. In this context, the important role of Bayesian methodology has been recognized, where the parameters are of a random nature. We explore, in the context of CE analyses, how formal objective Bayesian methods can be implemented. We fully illustrate the methodology using two CE problems that frequently appear in the CE literature. The results are compared with those obtained with other popular approaches to PSA. We find that the discrepancies can be quite marked, specially when the number of patients enrolled in the simulated cohort under study is large. Finally, we describe in detail the numerical methods that need to be used to obtain the results. Copyright © 2009 John Wiley & Sons, Ltd.",0,1 +1053,Multilevel models of burnout: separating group level and individual level effects in burnout research,"For nearly two decades, there has been a growing trend toward a multilevel perspective of individual behavior in organizations (Klein et al., 1994; Kozlowski & Klein, 2000). More recently, there has been an increasing emphasis on multilevel explanations within the stress literature, both from psychological and public health researchers (Bliese & Jex, 2002). Burnout research has followed a similar pattern to many organizational behavior constructs. Throughout the years, burnout has fairly consistently been defined as an individual phenomenon (Halbesleben & Buckley, 2004; Maslach et al., 2001). However, throughout that same time, there have been suggestions that burnout has a collective or shared element to it (Edelwich & Brodsky, 1980; Gonzalez-Morales et al., 2012). For example, Gonzalez-Morales et al. (2012) defined collective burnout in terms of the shared experience of burnout among coworkers in the same work environment. They argued that the contextual antecedents and experiences of burnout (e.g., Bakker & Schaufeli, 2000; Bakker et al., 2009) suggest that burnout can be conceptualized as an individual phenomenon or a socially constructed experience.",0,1 +1054,"Breaking Bad: Two Decades of Life-Course Data Analysis in Criminology, Developmental Psychology, and Beyond","Studies of human development require longitudinal data analysis methods that describe within- and between-individual variation in developmental and behavioral trajectories. This article reviews life-course data analysis methods for modeling these trajectories, as well as their application in studies of antisocial behavior and of crime in childhood, in adolescence, and throughout life. We set the stage by introducing growth curve (hierarchical linear) models. We focus our review on finite mixture models for life-course data, known as group-based trajectory and growth mixture models. We then discuss how these models are applied within criminology and developmental psychology, recent controversies over their substantive use and interpretation, and important issues of statistical practice and the challenges they raise. Building on the critical literature, we offer several recommendations for the applied users of the models. Finally, we present the most recent method of examining behavioral trajectories in criminology, the unimodal curve registration (UCR) approach. We briefly contrast the UCR model with growth curve and finite mixture models for life-course data analysis.",0,1 +1055,Listening Effort and Perceived Clarity for Normal-Hearing Children With the Use of Digital Noise Reduction,"Objectives The goal of this study was to evaluate how digital noise reduction (DNR) impacts listening effort and judgment of sound clarity in children with normal hearing. It was hypothesized that when two DNR algorithms differing in signal-to-noise ratio (SNR) output are compared, the algorithm that provides the greatest improvement in overall output SNR will reduce listening effort and receive a better clarity rating from child listeners. A secondary goal was to evaluate the relation between the inversion method measurements and listening effort with DNR processing. Design Twenty-four children with normal hearing (ages 7 to 12 years) participated in a speech recognition task in which consonant-vowel-consonant nonwords were presented in broadband background noise. Test stimuli were recorded through two hearing aids with DNR off and DNR on at 0 dB and +5 dB input SNR. Stimuli were presented to listeners and verbal response time (VRT) and phoneme recognition scores were measured. The underlying assumption was that an increase in VRT reflects an increase in listening effort. Children rated the sound clarity for each condition. The two commercially available HAs were chosen based on: (1) an inversion technique, which was used to quantify the magnitude of change in SNR with the activation of DNR, and (2) a measure of magnitude-squared coherence, which was used to ensure that DNR in both devices preserved the spectrum. Results One device provided a greater improvement in overall output SNR than the other. Both DNR algorithms resulted in minimal spectral distortion as measured using coherence. For both devices, VRT decreased for the DNR-on condition, suggesting that listening effort decreased with DNR in both devices. Clarity ratings were also better in the DNR-on condition for both devices. The device showing the greatest improvement in output SNR with DNR engaged improved phoneme recognition scores. The magnitude of this improved phoneme recognition was not accurately predicted with measurements of output SNR. Measured output SNR varied in the ability to predict other outcomes. Conclusions Overall, results suggest that DNR effectively reduces listening effort and improves subjective clarity ratings in children with normal hearing but that these improvements are not necessarily related to the output SNR improvements or preserved speech spectra provided by the DNR.",0,1 +1056,Bayesian approaches to random-effects meta-analysis: A comparative study,"Current methods for meta-analysis still leave a number of unresolved issues, such as the choice between fixed- and random-effects models, the choice of population distribution in a random-effects analysis, the treatment of small studies and extreme results, and incorporation of study-specific covariates. We describe how a full Bayesian analysis can deal with these and other issues in a natural way, illustrated by a recent published example that displays a number of problems. Such analyses are now generally available using the BUGS implementation of Markov chain Monte Carlo numerical integration techniques. Appropriate proper prior distributions are derived, and sensitivity analysis to a variety of prior assumptions carried out. Current methods are briefly summarized and compared to the full Bayes analysis.",0,1 +1057,Estimation of the standard error and confidence interval of the indirect effect in multiple mediator models,,0,1 +1058,Model Likelihoods and Bayes Factors for Switching and Mixture Models,"In the present paper we discuss the problem of estimating model likelihoods from the MCMC output for a general mixture and switching model. Estimation is based on the method of bridge sampling (Meng and Wong, 1996), where the MCMC sample is combined with an iid sample from an importance density. The importance density is constructed in an unsupervised manner from the MCMC output using a mixture of complete data posteriors. Whereas the importance sampling estimator as well as the reciprocal importance sampling estimator are sensitive to the tail behaviour of the importance density, we demonstrate that the bridge sampling estimator is far more robust in this concern. Our case studies range from computing marginal likelihoods for a mixture of multivariate normal distributions, testing for the inhomogeneity of a discrete time Poisson process, to testing for the presence of Markov switching and order selection in the MSAR model. (author's abstract)",0,1 +1059,Analysis of response time distributions in the study of cognitive processes.,"Examined the convolution analysis of RT distributions in 3 experiments employing 4 cognitive tasks with 14 college students. In Exp I (n = 6), a visual search task was contrasted with a short-term memory search task. In Exp II (n = 4) and Exp III (n = 4), a relative judgment of recency task was contrasted with a 2-alternative, forced-choice recognition task. Taken together, the experiments demonstrate that the convolution analysis provides a good description of RT distributions in a variety of tasks and that the parameters of the convolution analysis can behave differentially in different tasks. It is argued that the parameters of the convolution analysis can play an important role in discriminating between models and in critically evaluating models that may be otherwise acceptable. (26 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1984 American Psychological Association.",0,1 +1060,Maximum likelihood versus multiple imputation for missing data in small longitudinal samples with nonnormality.,"The study examined the performance of maximum likelihood (ML) and multiple imputation (MI) procedures for missing data in longitudinal research when fitting latent growth models. A Monte Carlo simulation study was conducted with conditions of small sample size, intermittent missing data, and nonnormality. The results indicated that ML tended to display slightly smaller degrees of bias than MI across missing completely at random (MCAR) and missing at random (MAR) conditions. Although specification of prior information in the MI imputation-posterior (I-P) phase influenced the performance of MI, especially with nonnormal small samples and missing not at random (MNAR), the impact of this tight specification was not dramatic. Several corrected ML test statistics showed proper rejections rates across research designs, whereas posterior predictive p values for MI methods were more likely to be influenced by distribution shape and yielded higher rejection rates in MCAR and MAR than in MNAR. In conclusion, ML appears to be preferable to MI in research conditions with small missing samples and multivariate nonnormality whether or not strong prior information for the I-P phase of MI analysis is available. (PsycINFO Database Record",0,1 +1061,"From the Work One Knows the Worker: A Systematic Review of the Challenges, Solutions, and Steps to Creating Synthetic Validity","Synthetic validity has been promised as the future for selection, providing an inexpensive, fast, high-quality, legally defensible, and easily administered process. Despite 50 years of development, this promise has yet to be realized. However, recent advances in areas such as validity generalization indicate that synthetic validity is technically feasible and practically achievable. Consolidating new and previous work carried out on two synthetic validity strategies, the job-requirement matrix and job component validity, we review the methodological steps required to build them and provide working examples. Although the resources required for full realization of synthetic validity are large, similar, although larger, projects have been undertaken in the past and in the present, and there is increasing infrastructure to facilitate them in the future.",0,1 +1062,Release the BEESTS: Bayesian Estimation of Ex-Gaussian STop-Signal reaction time distributions,"The stop-signal paradigm is frequently used to study response inhibition. In this paradigm, participants perform a two-choice response time (RT) task where the primary task is occasionally interrupted by a stop-signal that prompts participants to withhold their response. The primary goal is to estimate the latency of the unobservable stop response (stop signal reaction time or SSRT). Recently, Matzke et al. (2013) have developed a Bayesian parametric approach (BPA) that allows for the estimation of the entire distribution of SSRTs. The BPA assumes that SSRTs are ex-Gaussian distributed and uses Markov chain Monte Carlo sampling to estimate the parameters of the SSRT distribution. Here we present an efficient and user-friendly software implementation of the BPA-BEESTS-that can be applied to individual as well as hierarchical stop-signal data. BEESTS comes with an easy-to-use graphical user interface and provides users with summary statistics of the posterior distribution of the parameters as well various diagnostic tools to assess the quality of the parameter estimates. The software is open source and runs on Windows and OS X operating systems. In sum, BEESTS allows experimental and clinical psychologists to estimate entire distributions of SSRTs and hence facilitates the more rigorous analysis of stop-signal data.",0,1 +1063,Evaluation of the Bayesian and Maximum Likelihood Approaches in Analyzing Structural Equation Models with Small Sample Sizes,"The main objective of this article is to investigate the empirical performances of the Bayesian approach in analyzing structural equation models with small sample sizes. The traditional maximum likelihood (ML) is also included for comparison. In the context of a confirmatory factor analysis model and a structural equation model, simulation studies are conducted with the different magnitudes of parameters and sample sizes n = da, where d = 2, 3, 4 and 5, and a is the number of unknown parameters. The performances are evaluated in terms of the goodness-of-fit statistics, and various measures on the accuracy of the estimates. The conclusion is: for data that are normally distributed, the Bayesian approach can be used with small sample sizes, whilst ML cannot.",1,1 +1064,Bayes Factors,"In a 1935 paper and in his book Theory of Probability, Jeffreys developed a methodology for quantifying the evidence in favor of a scientific theory. The centerpiece was a number, now called the Bayes factor, which is the posterior odds of the null hypothesis when the prior probability on the null is one-half. Although there has been much discussion of Bayesian hypothesis testing in the context of criticism of P-values, less attention has been given to the Bayes factor as a practical tool of applied statistics. In this article we review and discuss the uses of Bayes factors in the context of five scientific applications in genetics, sports, ecology, sociology, and psychology. We emphasize the following points: • From Jeffreys’ Bayesian viewpoint, the purpose of hypothesis testing is to evaluate the evidence in favor of a scientific theory. • Bayes factors offer a way of evaluating evidence in favor of a null hypothesis. • Bayes factors provide a way of incorporating external information into the evaluation of evidence about a hypothesis. • Bayes factors are very general and do not require alternative models to be nested. • Several techniques are available for computing Bayes factors, including asymptotic approximations that are easy to compute using the output from standard packages that maximize likelihoods. • In “nonstandard†statistical models that do not satisfy common regularity conditions, it can be technically simpler to calculate Bayes factors than to derive non-Bayesian significance tests. • The Schwarz criterion (or BIC) gives a rough approximation to the logarithm of the Bayes factor, which is easy to use and does not require evaluation of prior distributions. • When one is interested in estimation or prediction, Bayes factors may be converted to weights to be attached to various models so that a composite estimate or prediction may be obtained that takes account of structural or model uncertainty. • Algorithms have been proposed that allow model uncertainty to be taken into account when the class of models initially considered is very large. • Bayes factors are useful for guiding an evolutionary model-building process. • It is important, and feasible, to assess the sensitivity of conclusions to the prior distributions used. © 1995 Taylor & Francis Group, LLC.",0,1 +1065,The Girls Set the Tone,"In a four-wave longitudinal study with N = 1,321 adolescents in Germany, we examined the impact of class-level normative beliefs about aggression on aggressive norms and behavior at the individual level over the course of 3 years. At each data wave, participants indicated their normative acceptance of aggressive behavior and provided self-reports of physical and relational aggression. Multilevel analyses revealed significant cross-level interactions between class-level and individual-level normative beliefs at T1 on individual differences in physical aggression at T2, and the indirect interactive effects were significant up to T4. Normative approval of aggression at the class level, especially girls’ normative beliefs, defined the boundary conditions for the expression of individual differences in aggressive norms and their impact on physically and relationally aggressive behavior for both girls and boys. The findings demonstrate the moderating effect of social norms on the pathways from individual normative beliefs to aggressive behavior in adolescence.",0,1 +1066,On the Failure of the Bootstrap for Matching Estimators,"Matching estimators are widely used in empirical economics for the evaluation of programs or treatments. Researchers using matching methods often apply the bootstrap to calculate the standard errors. However, no formal justification has been provided for the use of the bootstrap in this setting. In this article, we show that the standard bootstrap is, in general, not valid for matching estimators, even in the simple case with a single continuous covariate where the estimator is root-N consistent and asymptotically normally distributed with zero asymptotic bias. Valid inferential methods in this setting are the analytic asymptotic variance estimator of Abadie and Imbens (2006a) as well as certain modifications of the standard bootstrap, like the subsampling methods in Politis and Romano (1994).",0,1 +1067,Starting size and tadpole performance in the frog Rana latastei,"Egg provisioning is a major maternal effect in amphibians. We evaluated the relationship between starting body size (a proxy of egg provisioning) and multiple measures of larval performance in the Italian agile frog Rana latastei; we analysed within-clutch variation, to remove co-variation between provisioning and genetic maternal effect. We reared tadpoles from multiple clutches in a common environment under two food treatments (high- and low-protein content), and measured the mortality, tadpole size during development and development rate. We used a Bayesian framework (Markov chain Monte Carlo generalized linear mixed models) for the multivariate analysis of performance measures. Tadpoles with a large starting size remained the largest ones through the entire larval development, and attained metamorphosis earlier. Food with a high-protein content reduced mortality and increased the growth and development rate; the choice of food may be important in captive-breeding/headstarting programmes. We did not detect effects of the interaction between provisioning and type of food on tadpole performance. Our study confirms the importance of egg provisioning in amphibians, showing that it can affect multiple traits, and that their effects can last through the entire larval development.",0,1 +1068,Testing the constancy of validity with computer-generated sampling distributions of the multiplicative model variance estimate: Results for petroleum industry validation research.,"A comparison of computer-generated sampling distributions showed that increases in total N resulting from greater sample size/validity study reduced the sampling variation of multiplicative model estimates of true validity variance more than did increases in total N resulting from a larger number of studies. Validity coefficients, range restriction, and criterion reliability data for 5 tests predicting job performance and training performance were obtained from studies conducted at petroleum industry plants. Those tests included the Richardson-Bellows-Henry Ability, Arithmetic Reasoning, and Chemical Comprehension Tests; the Bennett Mechanical Comprehension Tests; and the Mathematics scale of the California Achievement Tests. Studies for 3 job categories (operation, maintenance, and laboratory) were combined for analysis to maximize sensitivity to job and plant differences. Sampling distributions of true validity variance estimates were generated for each test-criterion type combination. A comparison of actual variance estimates with critical values indicated that 3 of the 5 tests did not vary significantly in true validities for job performance or for training criteria. Results for 2 arithmetic reasoning tests support the existence of variation in true validities for job performance and for training criteria. (19 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1981 American Psychological Association.",0,1 +1069,A Microsoft-Excel-based tool for running and critically appraising network meta-analyses—an overview and application of NetMetaXL,"The use of network meta-analysis has increased dramatically in recent years. WinBUGS, a freely available Bayesian software package, has been the most widely used software package to conduct network meta-analyses. However, the learning curve for WinBUGS can be daunting, especially for new users. Furthermore, critical appraisal of network meta-analyses conducted in WinBUGS can be challenging given its limited data manipulation capabilities and the fact that generation of graphical output from network meta-analyses often relies on different software packages than the analyses themselves.We developed a freely available Microsoft-Excel-based tool called NetMetaXL, programmed in Visual Basic for Applications, which provides an interface for conducting a Bayesian network meta-analysis using WinBUGS from within Microsoft Excel. . This tool allows the user to easily prepare and enter data, set model assumptions, and run the network meta-analysis, with results being automatically displayed in an Excel spreadsheet. It also contains macros that use NetMetaXL's interface to generate evidence network diagrams, forest plots, league tables of pairwise comparisons, probability plots (rankograms), and inconsistency plots within Microsoft Excel. All figures generated are publication quality, thereby increasing the efficiency of knowledge transfer and manuscript preparation.We demonstrate the application of NetMetaXL using data from a network meta-analysis published previously which compares combined resynchronization and implantable defibrillator therapy in left ventricular dysfunction. We replicate results from the previous publication while demonstrating result summaries generated by the software.Use of the freely available NetMetaXL successfully demonstrated its ability to make running network meta-analyses more accessible to novice WinBUGS users by allowing analyses to be conducted entirely within Microsoft Excel. NetMetaXL also allows for more efficient and transparent critical appraisal of network meta-analyses, enhanced standardization of reporting, and integration with health economic evaluations which are frequently Excel-based.",0,1 +1070,"Deliberative Performance of Television News in Three Types of Democracy: Insights from the United States, Germany, and Russia","We show that television news is considerably more deliberative in established (United States, Germany) than in defective democracies (Russia) and slightly more deliberative in a power-sharing political system (Germany) than in a power-concentrating system (United States). We further demonstrate that public-service channels, nonpartisan programs, and in-depth news shows make stronger overall contributions toward deliberativeness than their respective counterparts. While national news cultures produce distinct national styles of mediated deliberation, individual channels in the United States (Fox, CNN) and Russia (REN) cut across these national patterns. The significance of deliberative media content for citizens and political elites is discussed.",0,1 +1071,Bayesian Structural Equation Modeling,"Abstract Structural equation models (SEMs) with latent variables are routinely used in social science research, and are of increasing importance in biomedical applications. Standard practice in implementing SEMs relies on frequentist methods. A simple and concise description of an alternative Bayesian approach is developed. Furthermore, a brief overview of the literature, a description of Bayesian specification of SEMs, and an outline of a Gibbs sampling strategy for model fitting is provided. Bayesian inferences are illustrated through an industrialization and democratization case study from the literature. The Bayesian approach has some distinct advantages, due to the availability of samples from the joint posterior distribution of the model parameters and latent variables, that are highlighted. These posterior samples provide important information not contained in the measurement and structural parameters. As is illustrated using the case study, this information can often provide valuable insight into structural relationships.",0,1 +1072,"Dietary Carotenoids Are Associated with Cardiovascular Disease Risk Biomarkers Mediated by Serum Carotenoid Concentrations ,","Hyperlipidemia and elevated circulating C-reactive protein (CRP) and total homocysteine (tHcy) concentrations are cardiovascular disease (CVD) risk factors. Previous studies indicated that higher serum carotenoid concentrations were inversely associated with some of these biomarkers. However, whether dietary carotenoid intake is inversely associated with these CVD risk biomarkers is not well known. We assessed the associations between individual dietary carotenoid intake and CVD risk biomarkers and tested whether the serum carotenoid concentrations explain (mediate) or influence the strength of (moderate) the associations, if any association exists. Dietary data collected from 2 24-h dietary recalls and serum measurements in adult men (n = 1312) and women (n = 1544) from the NHANES 2003-2006 were used. Regression models designed for survey analysis were used to examine the associations between individual dietary carotenoids and log-transformed blood cholesterol, CRP, and tHcy. The corresponding individual serum carotenoid concentration was considered as mediator (and moderator if applicable). After adjustment for covariates, significant inverse associations with LDL cholesterol were observed for dietary β-carotene (P < 0.05) and lutein + zeaxanthin (P < 0.001), and with tHcy for dietary β-carotene (P < 0.05), lycopene (P < 0.05), and total carotenoids (P < 0.05). Dietary lutein + zeaxanthin intake was also positively associated with HDL cholesterol concentrations (P < 0.01). Most of these associations were null after additional adjustment for corresponding serum carotenoid concentrations, indicating the complete mediation effects of serum carotenoids. Serum β-carotene significantly moderated the associations between dietary β-carotene and CRP (P-interaction < 0.05), and quartile 4 of dietary β-carotene was associated with lower CRP concentrations only among participants with serum β-carotene > 0.43 μmol/L. In this population-based cross-sectional study, serum carotenoids were mediators of dietary carotenoids and CVD risk biomarker associations. Serum β-carotene was also a moderator of the dietary β-carotene and CRP association. These findings may help in the design of future intervention studies on dietary carotenoids in the prevention of CVD.",0,1 +1073,A Bayesian Model For The Estimation Of Latent Interaction And Quadratic Effects When Latent Variables Are Non-Normally Distributed,"Structural equation models with interaction and quadratic effects have become a standard tool for testing nonlinear hypotheses in the social sciences. Most of the current approaches assume normally distributed latent predictor variables. In this article, we present a Bayesian model for the estimation of latent nonlinear effects when the latent predictor variables are nonnormally distributed. The nonnormal predictor distribution is approximated by a finite mixture distribution. We conduct a simulation study that demonstrates the advantages of the proposed Bayesian model over contemporary approaches (Latent Moderated Structural Equations [LMS], Quasi-Maximum-Likelihood [QML], and the extended unconstrained approach) when the latent predictor variables follow a nonnormal distribution. The conventional approaches show biased estimates of the nonlinear effects; the proposed Bayesian model provides unbiased estimates. We present an empirical example from work and stress research and provide syntax for substantive researchers. Advantages and limitations of the new model are discussed.",0,1 +1074,Introduction to stochastic actor-based models for network dynamics,"Abstract Stochastic actor-based models are models for network dynamics that can represent a wide variety of influences on network change, and allow to estimate parameters expressing such influences, and test corresponding hypotheses. The nodes in the network represent social actors, and the collection of ties represents a social relation. The assumptions posit that the network evolves as a stochastic process ‘driven by the actors’, i.e., the model lends itself especially for representing theories about how actors change their outgoing ties. The probabilities of tie changes are in part endogenously determined, i.e., as a function of the current network structure itself, and in part exogenously, as a function of characteristics of the nodes (‘actor covariates’) and of characteristics of pairs of nodes (‘dyadic covariates’). In an extended form, stochastic actor-based models can be used to analyze longitudinal data on social networks jointly with changing attributes of the actors: dynamics of networks and behavior. This paper gives an introduction to stochastic actor-based models for dynamics of directed networks, using only a minimum of mathematics. The focus is on understanding the basic principles of the model, understanding the results, and on sensible rules for model selection.",0,1 +1075,A Comparison of Item Selection Rules at the Early Stages of Computerized Adaptive Testing,"The effects of five item selection rules—Fisher information (FI), Fisher interval information (FII), Fisher information with a posterior distribution (FIP), Kullback-Leibler information (KL), and Kullback-Leibler information with a posterior distribution (KLP)—were compared with respect to the efficiency and precision of trait (Θ) estimation at the early stages of computerized adaptive testing (CAT). FII, FIP, KL, and KLP performed marginally better than FI at the early stages of CAT for Θ= -3 and -2. For tests longer than 10 items,there appeared to be no precision advantage for any of the selection rules.",0,1 +1076,Markov chain Monte Carlo Estimation of Classical and Dynamic Switching and Mixture Models,"Bayesian estimation of a very general model class, where the distribution of the observations depends on a latent process taking values in a discrete state space, is discussed in this article. This model class covers finite mixture modeling, Markov switching autoregressive modeling, and dynamic linear models with switching. The consequences the unidentifiability of this type of model has on Markov chain Monte Carlo (MCMC) estimation are explicitly dealt with. Joint Bayesian estimation of all latent variables, model parameters, and parameters that determine the probability law of the latent process is carried out by a new MCMC method called permutation sampling. The permutation sampler first samples from the unconstrained posterior–which often can be done in a convenient multimove manner–and then applies a permutation of the current labeling of the states of the latent process. In a first run, the random permutation sampler used selected the permutation randomly. The MCMC output of the random permutation s...",0,1 +1077,The use of multilevel models for the prediction of road accident outcomes,"An important problem in road traffic accident research is the resolution of the magnitude by which individual accident characteristics affect the risk of fatality for each person involved. This article introduces the potential of a recently developed form of regression models, known as multilevel models, for quantifying the various influences on casualty outcomes. The application of multilevel models is illustrated by the analysis of the predictors of outcome amongst over 16,000 fatally and seriously injured casualties involved in accidents between 1985 and 1996 in Norway. Risk of fatality was found to be associated with casualty age and sex, as well as the type of vehicles involved, the characteristics of the impact, the attributes of the road section on which it took place, the time of day, and whether alcohol was suspected. After accounting for these factors, the multilevel analysis showed that 16% of unexplained variation in casualty outcomes was between accidents, whilst approximately 1% was associated with the area of Norway in which each incident occurred. The benefits of using multilevel models to analyse accident data are discussed along with the limitations of traditional regression modelling approaches.",0,1 +1078,Derivative free analogues of the Levenberg-Marquardt and Gauss algorithms for nonlinear least squares approximation,"In this paper we give two derivative-free computational algorithms for nonlinear least squares approximation. The algorithms are finite difference analogues of the Levenberg-Marquardt and Gauss methods. Local convergence theorems for the algorithms are proven. In the special case when the residuals are zero at the minimum, we show that certain computationally simple choices of the parameters lead to quadratic convergence. Numerical examples are included. © 1971 Springer-Verlag.",0,1 +1079,Some Covariance Models for Longitudinal Count Data with Overdispersion,"A family of covariance models for longitudinal counts with predictive covariates is presented. These models account for overdispersion, heteroscedasticity, and dependence among repeated observations. The approach is a quasi-likelihood regression similar to the formulation given by Liang and Zeger (1986, Biometrika 73, 13-22). Generalized estimating equations for both the covariate parameters and the variance-covariance parameters are presented. Large-sample properties of the parameter estimates are derived. The proposed methods are illustrated by an analysis of epileptic seizure count data arising from a study of progabide as an adjuvant therapy for partial seizures.",0,1 +1080,Recent Advances in Causal Modeling Methods for Organizational and Management Research,"The purpose of this article is to review recent advanced applications of causal modeling methods in organizational and management research. Developments over the past 10 years involving research on measurement and structural components of causal models will be discussed. Specific topics to be addressed include reflective vs. formative measurement, multidimensional construct assessment, method variance, measurement invariance, latent growth modeling (LGM), moderated structural relationships, and analysis of latent variable means. For each of the areas mentioned above an overview of developments will be presented, and examples from organizational and management research will be provided.",0,1 +1081,"Building reliable evidence from real-world data: methods, cautiousness and recommendations","Routinely stored information on healthcare utilisation in everyday clinical practice has proliferated over the past several decades. There is, however, some reluctance on the part of many health professionals to use observational data to support healthcare decisions, especially when data are derived from large databases. Challenges in conducting observational studies based on electronic databases include concern about the adequacy of study design and methods to minimise the effect of both misclassifications (in the absence of direct assessments of exposure and outcome validity) and confounding (in the absence of randomisation). This paper points out issues that may compromise the validity of such studies, and approaches to managing analytic challenges. First, strategies of sampling within a large cohort, as an alternative to analysing the full cohort, will be presented. Second, methods for controlling outcome and exposure misclassifications will be described. Third, several techniques that take into account both measured and unmeasured confounders will also be presented. Fourth, some considerations regarding random uncertainty in the framework of observational studies using healthcare utilisation data will be discussed. Finally, some recommendations for good research practice are listed in this paper. The aim is to provide researchers with a methodological framework, while commenting on the value of new techniques for more advanced users.",0,1 +1082,"Missing Data, Imputation, and the Bootstrap","Missing data refers to a class of problems made difficult by the absence of some portions of a familiar data structure. For example, a regression problem might have some missing values in the predi...",0,1 +1083,Built environment and physical activity in New Zealand adolescents: a protocol for a cross-sectional study: Table 1,"Built-environment interventions have the potential to provide population-wide effects and the means for a sustained effect on behaviour change. Population-wide effects for adult physical activity have been shown with selected built environment attributes; however, the association between the built environment and adolescent health behaviours is less clear. This New Zealand study is part of an international project across 10 countries (International Physical Activity and the Environment Network-adolescents) that aims to characterise the links between built environment and adolescent health outcomes.An observational, cross-sectional study of the associations between measures of the built environment with physical activity, sedentary behaviour, body size and social connectedness in 1600 New Zealand adolescents aged 12-18 years will be conducted in 2013-2014. Walkability and neighbourhood destination accessibility indices will be objectively measured using Geographic Information Systems (GIS). Physical activity and sedentary behaviours will be objectively measured using accelerometers over seven consecutive days. Body mass index will be calculated as weight divided by squared height. Demographics, socioeconomic status, active commuting behaviours and perceived neighbourhood walkability will be assessed using the Neighbourhood Environment Walkability Scale for Youth and psychosocial indicators. A web-based computer-assisted personal interview tool Visualisation and Evaluation of Route Itineraries, Travel Destinations, and Activity Spaces (VERITAS) and Global Positioning System (GPS) receivers will be used in a subsample of 300 participants. A qualitative research component will explore barriers and facilitators for physical activity in adolescents with respect to the built and social environment in a subsample of 80 participants.The study received ethical approval from the Auckland University of Technology Ethics Committee (12/161). Data will be entered and stored into a secure (password protected) database. Only the named researchers will have access to the data. Data will be stored for 10 years and permanently destroyed thereafter. The results papers will be submitted for publication in peer-reviewed journals.",0,1 +1084,Bayesian Inference for the Causal Effect of Mediation,Summary We propose a nonparametric Bayesian approach to estimate the natural direct and indirect effects through a mediator in the setting of a continuous mediator and a binary response. Several conditional independence assumptions are introduced (with corresponding sensitivity parameters) to make these effects identifiable from the observed data. We suggest strategies for eliciting sensitivity parameters and conduct simulations to assess violations to the assumptions. This approach is used to assess mediation in a recent weight management clinical trial.,0,1 +1085,State work engagement and state affect: Similar yet distinct concepts,"Abstract State work engagement (SWE), a multidimensional construct of work-related well-being, was originally conceptualized as a trait, but diary studies have revealed substantial within-person fluctuations. Given that SWE is conceptualized as a work-related affective-motivational construct, the question arises as to whether SWE can be differentiated from other affective constructs. Thus, the goal of the present study was to compare SWE and state affect with respect to their degree of within-person variability and to examine their distinct relationships with health and performance variables (i.e., sleep quality and job performance). Fifty-two employees (44% female) participated in the study, which included 3 assessments per day over the course of 2 weeks. Our results revealed that energetic arousal and tense arousal fluctuated more strongly within days than vigor and absorption. Multilevel analyses demonstrated that high sleep quality predicted higher state affect but not higher SWE. In addition, vigor exhibited an inverted U-shaped relation with performance. In sum, SWE as a time-varying construct showed some overlap with state affect but also demonstrated discriminant validity.",0,1 +1086,Missing Observations in Multivariate Statistics III: Large Sample Analysis of Simple Linear Regression,"Abstract We derive the asymptotic distribution of several estimators for the parameters of the linear regression of y on x when some observations on y and on x are missing. Then, we compare estimators using a mean square error criterion. We find for example that a simple estimator of the linear regression function has asymptotic efficiency no worse than 0.95 compared with the maximum likelihood estimator (assuming bivariate normality) provided that no more than 30 per cent of the y's and 30 per cent of the x's are missing. This simple estimator is defined without assuming bivariate normality in Section 8.1.",0,1 +1087,The Difficulty of Test Items That Measure More Than One Ability,Many test items require more than one ability to obtain a correct response. This article proposes a mul tidimensional index of item difficulty that can be used with items of this type. The proposed index describes multidimensional item difficulty as the direction in the multidimensional space in which the item provides the most information and the distance in that direction to the most informative point. The multidimensional dif ficulty is derived for a particular item response theory model and an example of its application is given using the ACT Mathematics Usage Test.,0,1 +1088,Three-Level Models for Indirect Effects in School- and Class-Randomized Experiments in Education,"Due to the clustered nature of field data, multi-level modeling has become commonly used to analyze data arising from educational field experiments. While recent methodological literature has focused on multi-level mediation analysis, relatively little attention has been devoted to mediation analysis when three levels (e.g., student, class, school) are present in a study setting. This article presents analysis models that can be used to test indirect effects in experimental designs having three levels where random assignment is at the third (school) or second (class) level and where the indirect effect may be random. In the presentation, simulated datasets are used to illustrate model specification and results interpretation for hypothetical three-level educational experiments involving mediation and moderation of treatment effects.",0,1 +1089,Nutzenermittlung in wahlbasierter Conjoint-Analyse: Ein Vergleich von Latent-Class- und hierarchischem Bayes-Verfahren,"Two different concepts of disentangling noise from systematic deviations in Choice-Based Conjoint evaluations are compared: The Latent Class Technique and the Hierarchical Bayes procedure. In addition, a probabilistic interpretation of LC estimates is presented as an interims model. Conceptual differences between these models are discussed and hypotheses on resulting differences in estimates are derived. These are tested in a large-scale empirical study. The relative performance is evaluated in two distinct application areas: segment/level and individual/level estimates. The expected patterns are confirmed only partly by empirical evidence. It is shown that the structure of the underlying heterogeneity concept influences the achievable outcomes. Contrary to expectations it is shown that the segment-level estimates are highly stable across methods. While individual Hierarchical Bayes estimates are often of questionable quality, they are to be preferred against the Latent Class estimates, because they detect outliers reasonably well and provide more flexibility in the data evaluation.",0,1 +1090,Comparison of variants of canonical correlation analysis and partial least squares for combined analysis of MRI and genetic data,"The standard analysis approach in neuroimaging genetics studies is the mass-univariate linear modeling (MULM) approach. From a statistical view, however, this approach is disadvantageous, as it is computationally intensive, cannot account for complex multivariate relationships, and has to be corrected for multiple testing. In contrast, multivariate methods offer the opportunity to include combined information from multiple variants to discover meaningful associations between genetic and brain imaging data. We assessed three multivariate techniques, partial least squares correlation (PLSC), sparse canonical correlation analysis (sparse CCA) and Bayesian inter-battery factor analysis (Bayesian IBFA), with respect to their ability to detect multivariate genotype-phenotype associations. Our goal was to systematically compare these three approaches with respect to their performance and to assess their suitability for high-dimensional and multi-collinearly dependent data as is the case in neuroimaging genetics studies. In a series of simulations using both linearly independent and multi-collinear data, we show that sparse CCA and PLSC are suitable even for very high-dimensional collinear imaging data sets. Among those two, the predictive power was higher for sparse CCA when voxel numbers were below 400 times sample size and candidate SNPs were considered. Accordingly, we recommend Sparse CCA for candidate phenotype, candidate SNP studies. When voxel numbers exceeded 500 times sample size, the predictive power was the highest for PLSC. Therefore, PLSC can be considered a promising technique for multivariate modeling of high-dimensional brain-SNP-associations. In contrast, Bayesian IBFA cannot be recommended, since additional post-processing steps were necessary to detect causal relations. To verify the applicability of sparse CCA and PLSC, we applied them to an experimental imaging genetics data set provided for us. Most importantly, application of both methods replicated the findings of this data set.",0,1 +1091,"Performance of Factor Mixture Models as a Function of Model Size, Covariate Effects, and Class-Specific Parameters","Abstract Factor mixture models are designed for the analysis of multivariate data obtained from a population consisting of distinct latent classes. A common factor model is assumed to hold within each of the latent classes. Factor mixture modeling involves obtaining estimates of the model parameters, and may also be used to assign subjects to their most likely latent class. This simulation study investigates aspects of model performance such as parameter coverage and correct class membership assignment and focuses on covariate effects, model size, and class-specific versus class-invariant parameters. When fitting true models, parameter coverage is good for most parameters even for the smallest class separation investigated in this study (0.5 SD between 2 classes). The same holds for convergence rates. Correct class assignment is unsatisfactory for the small class separation without covariates, but improves dramatically with increasing separation, covariate effects, or both. Model performance is not influe...",0,1 +1092,Latent variable structural equation modeling with categorical data,"Structural equation modeling with latent variables is overviewed for situations involving a mixture of dichotomous, ordered polytomous, and continuous indicators of latent variables. Special emphasis is placed on categorical variables. Models in psychometrics, econometrics and biometrics are interrelated via a general model due to Muthén. Limited information least squares estimators and full information estimation are discussed. An example is estimated with a model for a four-wave longitudinal data set, where dichotomous responses are related to each other and a set of independent variables via latent variables with a variance component structure.",0,1 +1093,IRT Parameter Estimation With Response Times as Collateral Information,"Hierarchical modeling of responses and response times on test items facilitates the use of response times as collateral information in the estimation of the response parameters. In addition to the regular information in the response data, two sources of collateral information are identified: (a) the joint information in the responses and the response times summarized in the estimates of the second-level parameters and (b) the information in the posterior distribution of the response parameters given the response times. The latter is shown to be a natural empirical prior distribution for the estimation of the response parameters. Unlike traditional hierarchical item response theory (IRT) modeling, where the gain in estimation accuracy is typically paid for by an increase in bias, use of this posterior predictive distribution improves both the accuracy and the bias of IRT parameter estimates. In an empirical study, the improvements are demonstrated for the estimation of the person and item parameters in a three-parameter response model.",0,1 +1094,Availability of convenience stores and adolescent alcohol use in Taiwan: a multi-level analysis of national surveys,"Aim To examine the association between alcohol in school environments and adolescent alcohol use over the previous 6 months. Design A multi-level logistic regression analysis was performed of cross-sectional surveys conducted in 2004, 2005 and 2006. Participants and setting A total of 52 214 students aged 11–19 years from 387 middle or high schools were selected from a nationally representative, multi-stage, stratified probability sampling across Taiwan. Measurements Information on socio-demographic features and substance use experiences was collected using self-administered questionnaires. The alcohol in the environment was measured using the availability of convenience stores surrounding the schools. Using geographical information systems, the weighted numbers of convenience stores within 1 km, a 12–15-minute walk, of a school were calculated. The schools were later categorized into three subgroups via the tertile of nearby convenience stores. Findings Considering the compositional characteristics, the availability of convenience stores was found to account for 1.5% of the school-level variance of youthful drinking. The odds ratios (95% confidence interval) of alcohol use over the previous 6 months among youth attending schools with medium and high availability were 1.04 (0.96–1.13) and 1.08 (1.00–1.17), respectively, with a P-value of 0.04 in the trend test. Conclusion The greater availability of convenience stores near a school is associated with an increased risk of alcohol use among adolescents over the previous 6 months.",0,1 +1095,"Prior distributions for the intracluster correlation coefficient, based on multiple previous estimates, and their application in cluster randomized trials","Numerous estimates for the intracluster correlation coefficient (ICC) are available in research databases and publications. When planning a cluster randomized trial, an anticipated value for the ICC is required; currently, researchers base their choice informally on the magnitude of previous ICC estimates. In this paper, we make use of the wealth of ICC information by formally constructing informative prior distributions, while acknowledging the varying relevance and precision of the estimates available. Typically, for a planned trial in a given clinical setting, multiple relevant ICC estimates are available from each of several completed studies. Our preferred model allows for the imprecision in each ICC estimate around its underlying true value and, separately, allows for the similarity of ICC values from the same study. The relevance of each previous estimate to the planned clinical setting is considered, and estimates corresponding to less relevant outcomes or population types are given less influence. We find that such downweighting can increase the precision of the anticipated ICC. In trial design, the prior distribution constructed allows uncertainty about the ICC to be acknowledged, and we describe how to choose a design that provides adequate power across the range of likely ICC values. Prior information on the ICC can also be incorporated in analysis of the trial data, when taking a Bayesian approach. The methods proposed enable available ICC information to be summarised appropriately by an informative prior distribution, which is of direct practical use in cluster randomized trials.",0,1 +1096,Distinguishing Between Latent Classes and Continuous Factors with Categorical Outcomes: Class Invariance of Parameters of Factor Mixture Models,"Factor mixture models (FMM's) are latent variable models with categorical and continuous latent variables which can be used as a model-based approach to clustering. A previous paper covered the results of a simulation study showing that in the absence of model violations, it is usually possible to choose the correct model when fitting a series of models with different numbers of classes and factors within class. The response format in the first study was limited to normally distributed outcomes. The current paper has two main goals, firstly, to replicate parts of the first study with 5-point Likert scale and binary outcomes, and secondly, to address the issue of testing class invariance of thresholds and loadings. Testing for class invariance of parameters is important in the context of measurement invariance and when using mixture models to approximate non-normal distributions. Results show that it is possible to discriminate between latent class models and factor models even if responses are categorical. Comparing models with and without class-specific parameters can lead to incorrectly accepting parameter invariance if the compared models differ substantially with respect to the number of estimated parameters. The simulation study is complemented with an illustration of a factor mixture analysis of ten binary depression items obtained from a female subsample of the Virginia Twin Registry.",0,1 +1097,Multilevel Modelling,"Data often form a complex hierarchy, where multiple observations are made from within the same cluster. This natural clustering or nesting of observations results in data that possesses a lack of independence, which violates an important assumption of conventional single-level analyses and poses an issue in its correct implementation. In contrast, multilevel modelling (MLM) exploits this lack of independence to its advantage. Through outlining the notation used to specify MLM formulation, the theory of MLM is introduced. The pitfalls of ignoring the hierarchy in data are outlined. The assumptions and limitations of MLM are outlined and contrasted with those of the single-level model. The initial MLM considers the variance components model, which is further developed to illustrate random intercepts, slopes, and complex variation at both levels 1 and 2. Markov Chain Monte Carlo (MCMC) methods appropriate for estimating MLMs are introduced. Finally, complex hierarchies, such as cross-classified and multiple-membership structures are considered. These concepts are illustrated using various clinical examples. © Springer Science+Business Media Dordrecht 2012.",0,1 +1098,The Relative Validity of Inferences About Mediation as a Function of Research Design Characteristics,"Tests of assumed mediation models are common in the organizational sciences. However, the validity of inferences about mediation is a function of experimental design and the setting of a study. Regrettably, most tests of mediation have relied on the application of so-called ``causal modeling'' techniques to data from nonexperimental studies. As we demonstrate, inferences about the validity of assumed mediation models are highly suspect when they are based on the findings of nonexperimental research. One of the many reasons for this is the failure of the model being tested to be consistent with reality. Valid research-based inferences about mediation are possible. However, inferences from such tests are most likely to be valid when they are based on research that uses randomized experimental designs. Strategies for conducting research using these and other designs are described. Finally, we offer a set of conclusions and recommendations that stem from our analysis.",0,1 +1099,Model comparison of nonlinear structural equation models with fixed covariates,"Recently, it has been recognized that the commonly used linear structural equation model is inadequate to deal with some complicated substantive theory. A new nonlinear structural equation model with fixed covariates is proposed in this article. A procedure, which utilizes the powerful path sampling for computing the Bayes factor, is developed for model comparison. In the implementation, the required random observations are simulated via a hybrid algorithm that combines the Gibbs sampler and the Metropolis-Hastings algorithm. It is shown that the proposed procedure is efficient and flexible; and it produces Bayesian estimates of the parameters, latent variables, and their highest posterior density intervals as by-products. Empirical performances of the proposed procedure such as sensitivity to prior inputs are illustrated by a simulation study and a real example.",0,1 +1100,Cost Utility of Tumour Necrosis Factor-α Inhibitors for Rheumatoid Arthritis,"Rheumatoid arthritis (RA) is a chronic autoimmune disease that affects approximately 1.5 million people in the US. Tumour necrosis factor (TNF)α; inhibitors have been shown to effectively treat and maintain remission in patients with moderately to severely active RA compared with conventional agents. The high acquisition cost of TNFα; inhibitors prohibits access, which mandates economic investigations into their affordability. The lack of head-to-head comparisons between these agents makes it difficult to determine which agent is the most cost effective. Objective: This study aimed to determine which TNFα; inhibitor was the most cost-effective agent for the treatment of moderately to severely active RA from the US healthcare payer's perspective. Methods: A Markov model was constructed to analyse the cost utility of five TNFα; inhibitors (in combination with methotrexate [+MTX]) versus MTX monotherapy using Bayesian methods for evidence synthesis. The model had a cycle length of 3 months and an overall time horizon of 5 years. Transition probabilities and utility scores were based on published studies. Total direct costs were adjusted to year 2009 US using the medical component of the Consumer Price Index. All costs and QALYs were discounted at a rate of 3% per year. Patient response to the different strategies was determined by the American College of Rheumatology (ACR)50 criteria. One-way and probabilistic sensitivity analyses (PSAs) were performed to test the robustness of the base-case scenario. The base-case scenario was changed to ACR20 criteria (scenario 1) and ACR70 criteria (scenario 2) to determine the model's robustness. Cost-effectiveness acceptability curves and cost-effectiveness frontiers were used to estimate the cost-effectiveness probability of each treatment strategy. A willingness-to-pay (WTP) threshold was defined as three times the US GDP per capita (US139 143 per additional QALY gained). Primary results were presented as incremental cost-effective ratios (ICERs).Results: Etanercept+MTX was the most cost-effective treatment strategy in the base-case scenario up to a WTP threshold of US546 449 per QALY gained. At a WTP threshold of greater than US546 499 per QALY gained, certolizumab+MTX was the most cost-effective treatment strategy. One-way analyses showed that the base-case scenario was sensitive to the probability of achieving ACR50 criteria for MTX and each TNFα; inhibitor, and changes in the utility score for patients who achieved the ACR50 criteria. With the exception of infliximab, all of the TNFα; inhibitors were sensitive to drug cost per cycle. In the scenario analyses, certolizumab+MTX was a dominant treatment strategy using ACR20 criteria, but etanercept+MTX was a dominant treatment strategy using ACR70 criteria. Conclusions: Etanercept+MTX was a cost-effective treatment strategy in the base-case scenario; however, the model was sensitive to parameter uncertainties and ACR response criteria. Although Bayesian methods were used to determine transition probabilities, future studies will need to focus on head-tohead comparisons of multiple TNFα; inhibitors to provide valid comparisons. Adis © 2012 Springer International Publishing AG.",0,1 +1101,Spatially Adaptive Bayesian Penalized Splines With Heteroscedastic Errors,"Penalized splines have become an increasingly popular tool for nonparametric smoothing because of their use of low-rank spline bases, which makes computations tractable while maintaining accuracy as good as smoothing splines. This article extends penalized spline methodology by both modeling the variance function nonparametrically and using a spatially adaptive smoothing parameter. This combination is needed for satisfactory inference and can be implemented effectively by Bayesian MCMC. The variance process controlling the spatially adaptive shrinkage of the mean and the variance of the heteroscedastic error process are modeled as log-penalized splines. We discuss the choice of priors and extensions of the methodology, in particular, to multivariate smoothing. A fully Bayesian approach provides the joint posterior distribution of all parameters, in particular, of the error standard deviation and penalty functions. MATLAB, C, and FORTRAN programs implementing our methodology are publicly available.",0,1 +1102,Estimation of the correlation coefficient using the Bayesian Approach and its applications for epidemiologic research,"BackgroundThe Bayesian approach is one alternative for estimating correlation coefficients in which knowledge from previous studies is incorporated to improve estimation. The purpose of this paper is to illustrate the utility of the Bayesian approach for estimating correlations using prior knowledge.MethodsThe use of the hyperbolic tangent transformation (ρ = tanh ξ and r = tanh z) enables the investigator to take advantage of the conjugate properties of the normal distribution, which are expressed by combining correlation coefficients from different studies.ConclusionsOne of the strengths of the proposed method is that the calculations are simple but the accuracy is maintained. Like meta-analysis, it can be seen as a method to combine different correlations from different studies.",0,1 +1103,Does identity or economic rationality drive public opinion on European integration,How do citizens respond to the reallocation of authority across levels of government? This article investigates the relative importance of economic versus identity bases of citizen support for the most far-reaching example of authority migration—European integration.,0,1 +1104,Randomized controlled trial and uncontrolled 9-month follow-up of an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder,"Background Despite the clinical importance of deliberate self-harm (DSH; also referred to as non-suicidal self-injury) within borderline personality disorder (BPD), empirically supported treatments for this behavior among individuals with BPD are difficult to implement in many clinical settings. To address this limitation, a 14-week, adjunctive emotion regulation group therapy (ERGT) for DSH among women with BPD was developed. The current study examined the efficacy of this ERGT in a randomized controlled trial (RCT) and the durability of treatment gains over a 9-month uncontrolled follow-up period. Method Female out-patients with BPD and recent recurrent DSH were randomly assigned to receive this ERGT in addition to their ongoing out-patient therapy immediately ( n = 31) or after 14 weeks ( n = 30). Measures of DSH and other self-destructive behaviors, psychiatric symptoms, adaptive functioning and the proposed mechanisms of change (emotion dysregulation/avoidance) were administered pre- and post-treatment or -waitlist (to assess treatment efficacy), and 3 and 9 months post-treatment (to assess durability of treatment gains). Results Intent-to-treat (ITT) analyses ( n = 61) revealed significant effects of this ERGT on DSH and other self-destructive behaviors, emotion dysregulation, BPD symptoms, depression and stress symptoms, and quality of life. Analyses of all participants who began ERGT (across treatment and waitlist conditions; n = 51) revealed significant improvements from pre- to post-treatment on all outcomes, additional significant improvements from post-treatment to 9-month follow-up for DSH, emotion dysregulation/avoidance, BPD symptoms and quality of life, and no significant changes from post-treatment to 9-month follow-up on the other measures. Conclusions The results support the efficacy of this ERGT and the durability of treatment gains.",0,1 +1105,Measurement of minimum angle of resolution (MAR) for the spatial grating consisting of lines of two colors,"Abstract Minimum angle of resolution (MAR) was measured for the grating which consisted of lines of two colors selected from Red, Green, Blue, White and Black. Method of two alternative forced choice (2AFC) was used where the participants were asked to answer the direction of the color grating of the horizontal or vertical directions. From the measured psychometric function of the ratio of the correct answers, MAR which corresponded to the threshold of 75% correct answer ratio was determined. MAR of the grating patches with more than one primary color was measured to be affected by the combination of colors and to be 10–30% larger than that of the grating patch of White–Black. While the resolving power for Blue pattern had been known to be worse than those for Green and Red patterns, MAR of the grating including Blue was not always the worst.",0,1 +1106,Mediating Various Direct-effect Approaches,,0,1 +1107,Hierarchical bivariate time series models: a combined analysis of the effects of particulate matter on morbidity and mortality,"In this paper we develop a hierarchical bivariate time series model to characterize the relationship between particulate matter less than 10 microns in aerodynamic diameter (PM10) and both mortality and hospital admissions for cardiovascular diseases. The model is applied to time series data on mortality and morbidity for 10 metropolitan areas in the United States from 1986 to 1993. We postulate that these time series should be related through a shared relationship with PM10. At the first stage of the hierarchy, we fit two seemingly unrelated Poisson regression models to produce city-specific estimates of the log relative rates of mortality and morbidity associated with exposure to PM10 within each location. The sample covariance matrix of the estimated log relative rates is obtained using a novel generalized estimating equation approach that takes into account the correlation between the mortality and morbidity time series. At the second stage, we combine information across locations to estimate overall log relative rates of mortality and morbidity and variation of the rates across cities. Using the combined information across the 10 locations we find that a 10 microg/m3 increase in average PM10 at the current day and previous day is associated with a 0.26% increase in mortality (95% posterior interval -0.37, 0.65), and a 0.71% increase in hospital admissions (95% posterior interval 0.35, 0.99). The log relative rates of mortality and morbidity have a similar degree of heterogeneity across cities: the posterior means of the between-city standard deviations of the mortality and morbidity air pollution effects are 0.42 (95% interval 0.05, 1.18), and 0.31 (95% interval 0.10, 0.89), respectively. The city-specific log relative rates of mortality and morbidity are estimated to have very low correlation, but the uncertainty in the correlation is very substantial (posterior mean = 0.20, 95% interval -0.89, 0.98). With the parameter estimates from the model, we can predict the hospitalization log relative rate for a new city for which hospitalization data are unavailable, using that city's estimated mortality relative rate. We illustrate this prediction using New York as an example.",0,1 +1108,Embedding IRT in Structural Equation Models: A Comparison With Regression Based on IRT Scores,"This article reviews the problems associated with using item response theory (IRT)-based latent variable scores for analytical modeling, discusses the connection between IRT and structural equation modeling (SEM)-based latent regression modeling for discrete data, and compares regression parameter estimates obtained using predicted IRT scores and standardized number-right scores in Ordinary Least Squares (OLS) regression with regression estimates obtained using the combined IRT-SEM approach. The Monte Carlo results show the expected a posteriori (EA approach is insensitive to sample size as expected but leads to appreciable attenuation in regression parameter estimates. Standardized number-right estimates and EAP regression estimates were found to be highly comparable. On the other hand, the IRT-SEM method produced smaller finite sample bias, and as expected, generated consistent regression estimates for suitably large sample sizes.",0,1 +1109,Using R and WinBUGS to fit a generalized partial credit model for developing and evaluating patient-reported outcomes assessments,"The US Food and Drug Administration recently announced the final guidelines on the development and validation of patient-reported outcomes (PROs) assessments in drug labeling and clinical trials. This guidance paper may boost the demand for new PRO survey questionnaires. Henceforth, biostatisticians may encounter psychometric methods more frequently, particularly item response theory (IRT) models to guide the shortening of a PRO assessment instrument. This article aims to provide an introduction on the theory and practical analytic skills in fitting a generalized partial credit model (GPCM) in IRT. GPCM theory is explained first, with special attention to a clearer exposition of the formal mathematics than what is typically available in the psychometric literature. Then, a worked example is presented, using self-reported responses taken from the international personality item pool. The worked example contains step-by-step guides on using the statistical languages r and WinBUGS in fitting the GPCM. Finally, the Fisher information function of the GPCM model is derived and used to evaluate, as an illustrative example, the usefulness of assessment items by their information contents. This article aims to encourage biostatisticians to apply IRT models in the re-analysis of existing data and in future research.",0,1 +1110,Balancing Flexible Constraints and Measurement Precision in Computerized Adaptive Testing,"Managing test specifications—both multiple nonstatistical constraints and flexibly defined constraints—has become an important part of designing item selection procedures for computerized adaptive tests (CATs) in achievement testing. This study compared the effectiveness of three procedures: constrained CAT, flexible modified constrained CAT, and the weighted penalty model in balancing multiple flexible constraints and maximizing measurement precision in a fixed-length CAT. The study also addressed the effect of two different test lengths—25 items and 50 items—and of including or excluding the randomesque item exposure control procedure with the three methods, all of which were found effective in selecting items that met flexible test constraints when used in the item selection process for longer tests. When the randomesque method was included to control for item exposure, the weighted penalty model and the flexible modified constrained CAT models performed better than did the constrained CAT procedure in maintaining measurement precision. When no item exposure control method was used in the item selection process, no practical difference was found in the measurement precision of each balancing method.",0,1 +1111,Climate Sensitivity Distributions Dependence on the Possibility that Models Share Biases,"Abstract Uncertainty about biases common across models and about unknown and unmodeled feedbacks is important for the tails of temperature change distributions and thus for climate risk assessments. This paper develops a hierarchical Bayes framework that explicitly represents these and other sources of uncertainty. It then uses models’ estimates of albedo, carbon cycle, cloud, and water vapor–lapse rate feedbacks to generate posterior probability distributions for feedback strength and equilibrium temperature change. The posterior distributions are especially sensitive to prior beliefs about models’ shared structural biases: nonzero probability of shared bias moves some probability mass toward lower values for climate sensitivity even as it thickens the distribution’s positive tail. Obtaining additional models of these feedbacks would not constrain the posterior distributions as much as narrowing prior beliefs about shared biases or, potentially, obtaining feedback estimates having biases uncorrelated with those impacting climate models. Carbon dioxide concentrations may need to fall below current levels to maintain only a 10% chance of exceeding official 2°C limits on global average temperature change.",0,1 +1112,"The effect of patient, provider and financing regulations on the intensity of ambulatory physical therapy episodes: a multilevel analysis based on routinely available data","BackgroundMany studies have found considerable variations in the resource intensity of physical therapy episodes. Although they have identified several patient- and provider-related factors, few studies have examined their relative explanatory power. We sought to quantify the contribution of patients and providers to these differences and examine how effective Swiss regulations are (nine-session ceiling per prescription and bonus for first treatments).MethodsOur sample consisted of 87,866 first physical therapy episodes performed by 3,365 physiotherapists based on referrals by 6,131 physicians. We modeled the number of visits per episode using a multilevel log linear regression with crossed random effects for physiotherapists and physicians and with fixed effects for cantons. The three-level explanatory variables were patient, physiotherapist and physician characteristics.ResultsThe median number of sessions was nine (interquartile range 6–13). Physical therapy use increased with age, women, higher health care costs, lower deductibles, surgery and specific conditions. Use rose with the share of nine-session episodes among physiotherapists or physicians, but fell with the share of new treatments. Geographical area had no influence. Most of the variance was explained at the patient level, but the available factors explained only 4% thereof. Physiotherapists and physicians explained only 6% and 5% respectively of the variance, although the available factors explained most of this variance. Regulations were the most powerful factors.ConclusionAgainst the backdrop of abundant physical therapy supply, Swiss financial regulations did not restrict utilization. Given that patient-related factors explained most of the variance, this group should be subject to closer scrutiny. Moreover, further research is needed on the determinants of patient demand.",0,1 +1113,A Gentle Introduction to Bayesian Analysis: Applications to Developmental Research,"Bayesian statistical methods are becoming ever more popular in applied and fundamental research. In this study a gentle introduction to Bayesian analysis is provided. It is shown under what circumstances it is attractive to use Bayesian estimation, and how to interpret properly the results. First, the ingredients underlying Bayesian methods are introduced using a simplified example. Thereafter, the advantages and pitfalls of the specification of prior knowledge are discussed. To illustrate Bayesian methods explained in this study, in a second example a series of studies that examine the theoretical framework of dynamic interactionism are considered. In the Discussion the advantages and disadvantages of using Bayesian statistics are reviewed, and guidelines on how to report on Bayesian statistics are provided.",0,1 +1114,What Future Quantitative Social Science Research Could Look Like: Confidence Intervals for Effect Sizes,"An improved quantitative science would emphasize the use of confidence intervals (CIs), and especially CIs for effect sizes. This article reviews some definitions and issues related to developing these intervals. Confidence intervals for effect sizes are especially valuable because they facilitate meta-analytic thinking and the interpretation of intervals via comparison with the effect intervals from related prior studies. Several recommendations for the thoughtful use of such CIs are presented.",0,1 +1115,Prior distributions for variance parameters in hierarchical models (comment on article by Browne and Draper),"Various prior distributions have been suggested for scale parameters in hierarchical models. We construct a new folded-noncentral-$t$ family of conditionally conjugate priors for hierarchical standard deviation parameters, and then consider and weakly informative priors in this family. We use an example to illustrate serious problems with the inverse-gamma family of noninformative prior distributions. We suggest instead to use a uniform prior on the hierarchical standard deviation, using the half-$t$ family when the number of groups is small and in other settings where a weakly informative prior is desired. We also illustrate the use of the half-$t$ family for hierarchical modeling of multiple variance parameters such as arise in the analysis of variance.",0,1 +1116,Using Data Augmentation and Markov Chain Monte Carlo for the Estimation of Unfolding Response Models,"Unfolding response models, a class of item response theory (IRT) models that assume a unimodal item response function (IRF), are often used for the measurement of attitudes. Verhelst and Verstralen (1993) and Andrich and Luo (1993) independently developed unfolding response models by relating the observed responses to a more common monotone IRT model using a latent response model (LRM; Maris, 1995 ). This article generalizes their approach, and suggests a data augmentation scheme for the estimation of any unfolding response model. The article introduces two Markov chain Monte Carlo (MCMC) estimation procedures for the Bayesian estimation of unfolding model parameters; one is a direct implementation of MCMC, and the second utilizes the data augmentation method. We use the estimation procedure to analyze three data sets, one simulated, and two from real attitudinal surveys.",0,1 +1117,Bayesian estimation of item response curves,"Item response curves for a set of binary responses are studied from a Bayesian viewpoint of estimating the item parameters. For the two-parameter logistic model with normally distributed ability, restricted bivariate beta priors are used to illustrate the computation of the posterior mode via the EM algorithm. The procedure is illustrated by data from a mathematics test. © 1986 The Psychometric Society.",0,1 +1118,A Bayesian Approach for Multigroup Nonlinear Factor Analysis,"The main purpose of this article is to develop a Bayesian approach for a general multigroup nonlinear factor analysis model. Joint Bayesian estimates of the factor scores and the structural parameters subjected to some constraints across different groups are obtained simultaneously. A hybrid algorithm that combines the Metropolis-Hastings algorithm and the Gibbs sampler is implemented to produce these joint Bayesian estimates. It is shown that this algorithm is computationally efficient. The Bayes factor approach is introduced for comparing models under various degrees of invariance across groups. The Schwarz criterion (BIC), a simple and useful approximation of the Bayes factor, is calculated on the basis of simulated observations from the Gibbs sampler. Efficiency and flexibility of the proposed Bayesian procedure are illustrated by some simulation results and a real-life example.",0,1 +1119,Detecting Individual Differences in Change: Methods and Comparisons,"This study examined and compared various statistical methods for detecting individual differences in change. Considering 3 issues including test forms (specific vs. generalized), estimation procedures (constrained vs. unconstrained), and nonnormality, we evaluated 4 variance tests including the specific Wald variance test, the generalized Wald variance test, the specific likelihood ratio (LR) variance test, and the generalized LR variance test under both constrained and unconstrained estimation for both normal and nonnormal data. For the constrained estimation procedure, both the mixture distribution approach and the alpha correction approach were evaluated for their performance in dealing with the boundary problem. To deal with the nonnormality issue, we used the sandwich standard error (SE) estimator for the Wald tests and the Satorra–Bentler scaling correction for the LR tests. Simulation results revealed that testing a variance parameter and the associated covariances (generalized) had higher power th...",0,1 +1120,Efficient Estimation of Covariance Matrices using Posterior Mode Multiple Shrinkage,"We propose an approach to the regularization of covariance matrices that can be applied to any model for which the likelihood is available in closed form. The approach is based on using mixtures of double exponential or normal distributions as priors for correlation parameters, and on maximizing the resulting log-posterior (or penalized likelihood) using a stochastic optimization algorithm. The mixture priors are capable of clustering the correlations in several groups, each with separate mean and variance, and can therefore capture a large variety of structures besides sparsity. We apply this approach to the normal linear multivariate regression model as well as several other models that are popular in the literature but have not been previously studied for the purpose of regularization, including multivariate t, normal and t copulas, and mixture of normal distributions. Simulation experiments show the potential for large efficiency gains in estimating the density of the observations in all these models. Sizable gains are also obtained in four real applications. Copyright The Author, 2012. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org, Oxford University Press.",0,1 +1121,Computerized Classification Testing Under the Generalized Graded Unfolding Model,"The generalized graded unfolding model (GGUM) has been recently developed to describe item responses to Likert items (agree—disagree) in attitude measurement. In this study, the authors (a) developed two item selection methods in computerized classification testing under the GGUM, the current estimate/ability confidence interval method and the cut score/sequential probability ratio test method and (b) evaluated their accuracy and efficiency in classification through simulations. The results indicated that both methods were very accurate and efficient. The more points each item had and the fewer the classification categories, the more accurate and efficient the classification would be. However, the latter method may yield a very low accuracy in dichotomous items with a short maximum test length. Thus, if it is to be used to classify examinees with dichotomous items, the maximum text length should be increased.",0,1 +1122,A detection theory account of change detection,"Previous studies have suggested that visual short-term memory (VSTM) has a storage limit of approximately four items. However, the type of high-threshold (HT) model used to derive this estimate is based on a number of assumptions that have been criticized in other experimental paradigms (e.g., visual search). Here we report findings from nine experiments in which VSTM for color, spatial frequency, and orientation was modeled using a signal detection theory (SDT) approach. In Experiments 1-6, two arrays composed of multiple stimulus elements were presented for 100 ms with a 1500 ms ISI. Observers were asked to report in a yes/no fashion whether there was any difference between the first and second arrays, and to rate their confidence in their response on a 1-4 scale. In Experiments 1-3, only one stimulus element difference could occur (T = 1) while set size was varied. In Experiments 4-6, set size was fixed while the number of stimuli that might change was varied (T = 1, 2, 3, and 4). Three general models were tested against the receiver operating characteristics generated by the six experiments. In addition to the HT model, two SDT models were tried: one assuming summation of signals prior to a decision, the other using a max rule. In Experiments 7-9, observers were asked to directly report the relevant feature attribute of a stimulus presented 1500 ms previously, from an array of varying set size. Overall, the results suggest that observers encode stimuli independently and in parallel, and that performance is limited by internal noise, which is a function of set size.",0,1 +1123,Round Robin Analysis of Variance via Maximum Likelihood,"Abstract A class of two-way random-effects models is presented for analyzing data that arise in a large variety of round robin designs. Examples of such designs can be found in numerous games, tournaments, and social interactions. The proposed models provide information not only about individual differences but also about the mutual contingency of the behaviors of interaction dyads. The statistical inference of the linear effects is discussed and a converging algorithm based on the EM algorithm is proposed for obtaining the maximum likelihood estimates of the covariance components. A balanced data set is analyzed using the methodology developed.",0,1 +1124,The Externalities of Inequality: Fear of Crime and Preferences for Redistribution in Western Europe,"Why is the difference in redistribution preferences between the rich and the poor high in some countries and low in others? In this article, we argue that it has a lot to do with the rich and very little to do with the poor. We contend that while there is a general relative income effect on redistribution preferences, the preferences of the rich are highly dependent on the macrolevel of inequality. The reason for this effect is not related to immediate tax and transfer considerations but to a negative externality of inequality: crime. We will show that the rich in more unequal regions in Western Europe are more supportive of redistribution than the rich in more equal regions because of their concern with crime. In making these distinctions between the poor and the rich, the arguments in this article challenge some influential approaches to the politics of inequality.",0,1 +1125,INFERENCE IN DIRICHLET PROCESS MIXED GENERALIZED LINEAR MODELS BY USING MONTE CARLO EM,"Summary Generalized linear mixed models are widely used for describing overdispersed and correlated data. Such data arise frequently in studies involving clustered and hierarchical designs. A more flexible class of models has been developed here through the Dirichlet process mixture. An additional advantage of using such mixture models is that the observations can be grouped together on the basis of the overdispersion present in the data. This paper proposes a partial empirical Bayes method for estimating all the model parameters by adopting a version of the EM algorithm. An augmented model that helps to implement an efficient Gibbs sampling scheme, under the non-conjugate Dirichlet process generalized linear model, generates observations from the conditional predictive distribution of unobserved random effects and provides an estimate of the average number of mixing components in the Dirichlet process mixture. A simulation study has been carried out to demonstrate the consistency of the proposed method. The approach is also applied to a study on outdoor bacteria concentration in the air and to data from 14 retrospective lung-cancer studies.",0,1 +1126,Estimation methods for nonlinear state-space models in ecology,"The use of nonlinear state-space models for analyzing ecological systems is increasing. A wide range of estimation methods for such models are available to ecologists, however it is not always clear, which is the appropriate method to choose. To this end, three approaches to estimation in the theta logistic model for population dynamics were benchmarked by Wang (2007). Similarly, we examine and compare the estimation performance of three alternative methods using simulated data. The first approach is to partition the state-space into a finite number of states and formulate the problem as a hidden Markov model (HMM). The second method uses the mixed effects modeling and fast numerical integration framework of the AD Model Builder (ADMB) open-source software. The third alternative is to use the popular Bayesian framework of BUGS. The study showed that state and parameter estimation performance for all three methods was largely identical, however with BUGS providing overall wider credible intervals for parameters than HMM and ADMB confidence intervals. © 2011 Elsevier B.V. All rights reserved.",0,1 +1127,Temperature-dependent bioaccumulation of copper in an estuarine oyster,"Bioaccumulation models are an important and widely-used tool for assessing ecosystem health with regards to heavy metal contamination. However, these models do not usually account for the potentially significant effect of temperature-dependency in metal uptake. In this study, we explored the role of temperature-dependency in heavy metal bioaccumulation by developing and comparing two kinetic-based copper bioaccumulation models for a common estuarine oyster (Saccostrea glomerata): (i) a standard first-order model that ignores temperature effects; and (ii) a modified first-order model that uses a standard temperature function to account for the temperature-dependency of the uptake rate constant. The models were calibrated within a Bayesian framework so that parameters could be treated as random variables and any uncertainty propagated through to the model output. A 12-month biomonitoring study was carried out within Moreton Bay, Queensland, Australia to provide time-series data for the modelling. Results of the modelling showed that the two bioaccumulation models provided comparable fits of the biomonitoring field data. However, dependent on the time of year and monitoring period selected, the copper uptake rate would vary dramatically due to temperature effects, which could result in an overestimation or underestimation of the copper uptake rate. Finally by calibrating the bioaccumulation models within a Bayesian framework, these models were able to utilize prior knowledge of the model parameters as part of the calibration process and also account for the uncertainty and variability in the bioaccumulation predictions. The ability to account for uncertainty and variability is an important consideration when undertaking environmental risk assessments especially in coastal waterways where there are strong seasonal variations.",0,1 +1128,Robustness of the linear mixed model to misspecified error distribution,"A simulation study is performed to investigate the robustness of the maximum likelihood estimator of fixed effects from a linear mixed model when the error distribution is misspecified. Inference for the fixed effects under the assumption of independent normally distributed errors with constant variance is shown to be robust when the errors are either non-gaussian or heteroscedastic, except when the error variance depends on a covariate included in the model with interaction with time. Inference is impaired when the errors are correlated. In the latter case, the model including a random slope in addition to the random intercept is more robust than the random intercept model. The use of Cholesky residuals and conditional residuals to evaluate the fit of a linear mixed model is also discussed.",0,1 +1129,Matching Using Estimated Propensity Scores: Relating Theory to Practice,"Matched sampling is a standard technique in the evaluation of treatments in observational studies. Matching on estimated propensity scores comprises an important class of procedures when there are numerous matching variables. Recent theoretical work (Rubin, D. B. and Thomas, N., 1992, The Annals of Statistics 20, 1079-1093) on affinely invariant matching methods with ellipsoidal distributions provides a general framework for evaluating the operating characteristics of such methods. Moreover, Rubin and Thomas (1992, Biometrika 79, 797-809) uses this framework to derive several analytic approximations under normality for the distribution of the first two moments of the matching variables in samples obtained by matching on estimated linear propensity scores. Here we provide a bridge between these theoretical approximations and actual practice. First, we complete and refine the normal- based analytic approximations, thereby making it possible to apply these results to practice. Second, we perform Monte Carlo evaluations of the analytic results under normal and nonnormal ellipsoidal distributions, which confirm the accuracy of the analytic approximations, and demonstrate the predictable ways in which the approximations deviate from simulation results when normal assumptions are violated within the ellipsoidal family. Third, we apply the analytic approximations to real data with clearly nonellipsoidal distributions, and show that the theoretical expressions, although derived under artificial distributional conditions, produce useful guidance for practice. Our results delineate the wide range of settings in which matching on estimated linear propensity scores performs well, thereby providing useful information for the design of matching studies. When matching with a particular data set, our theoretical approximations provide benchmarks for expected performance under favorable conditions, thereby identifying matching variables requiring special treatment. After matching is complete and data analysis is at hand, our results provide the variances required to compute valid standard errors for common estimators.",0,1 +1130,Impact of Assessments of Validity Generalization and Situational Specificity on the Science and Practice of Personnel Selection,"The application of meta-analysis, in particular validity generalization (VG) analysis, to the cumulative literature on the validity of selection tests has fundamentally changed the science and practice of personnel selection. VG analyses suggest that the validities of standardized tests and other structured assessments are both higher and more consistent across jobs and organizations than was previously believed. As a result, selection researchers and practitioners can draw on the research literature to make reasonably accurate forecasts about the validity and usefulness of different tests in particular applications. Distinctions between tests of validity generalization and tests of situational specificity are described, and difficulties in demonstrating that validity is constant across the different settings where tests are used are outlined.",0,1 +1131,Mixing Habermas with Bayes: Methodological and Theoretical Advances in the Study of Deliberation,"Two challenges stand out in the study of deliberation: the development of appropriate methodological tools and the development of more unified analytical frameworks. On the one hand, analysing deliberative processes is demanding and time-consuming; hence we tend to have only few and non-randomly selected cases at the group or context level. In addition, the real world of deliberation presents us with a complex matrix of nested, cross-classified, and repeated speakers. This article shows that Bayesian multi-level modelling provides an elegant way to tackle these methodological problems. On the other hand, we attempt to enrich comparative institutionalism with individual characteristics and psychologically relevant variables (such as group composition). Focusing on Swiss and German parliamentary debates we show that institutional factors - in particular, consensus systems -, the gender composition of committees and plenary sessions, and age matter for the quality of deliberation. Furthermore, we also show that partisan affiliation - government or opposition status of MPs - affects deliberative quality and can refine institutional arguments. We conclude that a multi-level approach to deliberation focusing on contextual and actor-related characteristics and using Bayesian hierarchical modelling paves the way toward a more advanced understanding - and methodological handling - of deliberative processes.",0,1 +1132,An Assessment of the Magnitude of Effect Sizes,"This study compiles information from more than 250 meta-analyses conducted over the past 30 years to assess the magnitude of reported effect sizes in the organizational behavior (OB)/human resources (HR) literatures. Our analysis revealed an average uncorrected effect of r = .227 and an average corrected effect of ρ = .278 ( SDρ = .140). Based on the distribution of effect sizes we report, Cohen’s effect size benchmarks are not appropriate for use in OB/HR research as they overestimate the actual breakpoints between small, medium, and large effects. We also assessed the average statistical power reported in meta-analytic conclusions and found substantial evidence that the majority of primary studies in the management literature are statistically underpowered. Finally, we investigated the impact of the file drawer problem in meta-analyses and our findings indicate that the file drawer problem is not a significant concern for meta-analysts. We conclude by discussing various implications of this study for OB/HR researchers.",0,1 +1133,Confirmatory Factor Analysis of Ordinal Variables With Misspecified Models,Ordinal variables are common in many empirical investigations in the social and behavioral sciences. Researchers often apply the maximum likelihood method to fit structural equation models to ordin ...,0,1 +1134,Implementation and Measurement Efficiency of Multidimensional Computerized Adaptive Testing,"Multidimensional adaptive testing (MAT) procedures are proposed for the measurement of several latent traits by a single examination. Bayesian latent trait estimation and adaptive item selection are derived. Simulations were conducted to compare the measurement efficiency of MAT with those of unidimensional adaptive testing and random administration. The results showed that the higher the correlation between latent traits, the more latent traits there were, and the more scoring levels there were in the items, the more efficient MAT was than the other two procedures. For tests containing multidimensional items, only MAT is applicable, whereas unidimensional adaptive testing is not. Issues in implementing MAT are discussed.",0,1 +1135,Resampling and Distribution of the Product Methods for Testing Indirect Effects in Complex Models,"Recent advances in testing mediation have found that certain resampling methods and tests based on the mathematical distribution of 2 normal random variables substantially outperform the traditional z test. However, these studies have primarily focused only on models with a single mediator and 2 component paths. To address this limitation, a simulation was conducted to evaluate these alternative methods in a more complex path model with multiple mediators and indirect paths with 2 and 3 paths. Methods for testing contrasts of 2 effects were evaluated also. The simulation included 1 exogenous independent variable, 3 mediators and 2 outcomes and varied sample size, number of paths in the mediated effects, test used to evaluate effects, effect sizes for each path, and the value of the contrast. Confidence intervals were used to evaluate the power and Type I error rate of each method, and were examined for coverage and bias. The bias-corrected bootstrap had the least biased confidence intervals, greatest power to detect nonzero effects and contrasts, and the most accurate overall Type I error. All tests had less power to detect 3-path effects and more inaccurate Type I error compared to 2-path effects. Confidence intervals were biased for mediated effects, as found in previous studies. Results for contrasts did not vary greatly by test, although resampling approaches had somewhat greater power and might be preferable because of ease of use and flexibility.",0,1 +1136,The Distribution of Chi-Square,,0,1 +1137,A tutorial on analyzing data from speed-dating studies with heterosexual dyads,"Speed-dating studies provide a useful venue for studying attraction and other relationship initiation processes. They provide researchers with a unique opportunity to assess how much a dyadic behavior (e.g., attraction) is due to some relationship-specific adjustment or the dispositional tendencies of the two people interacting. Researchers can also investigate the impact of individual difference variables on relationship initiation outcomes. This article shows researchers how to address such interesting questions by providing an extended treatment of how to apply the social relations model (D. A. Kenny & L. La Voie, 1984) to data from a typical speed-dating study with heterosexual dyads. The statistical program SPSS is used given its widespread use and accessibility.",0,1 +1138,"A multilevel approach to theory and research in organizations: Contextual, temporal, and emergent processes.",,0,1 +1139,Experiences With Markov Chain Monte Carlo Convergence Assessment in Two Psychometric Examples,"There is an increasing use of Markov chain Monte Carlo (MCMC) algorithms for fitting statistical models in psychometrics, especially in situations where the traditional estimation techniques are very difficult to apply. One of the disadvantages of using an MCMC algorithm is that it is not straightforward to determine the convergence of the algorithm. Using the output of an MCMC algorithm that has not converged may lead to incorrect inferences on the problem at hand. The convergence is not one to a point, but that of the distribution of a sequence of generated values to another distribution, and hence is not easy to assess; there is no guaranteed diagnostic tool to determine convergence of an MCMC algorithm in general. This article examines the convergence of MCMC algorithms using a number of convergence diagnostics for two real data examples from psychometrics. Findings from this research have the potential to be useful to researchers using the algorithms. For both the examples, the number of iterations required (suggested by the diagnostics) to be reasonably confident that the MCMC algorithm has converged may be larger than what many practitioners consider to be safe.",0,1 +1140,Linear mixed models for skew-normal/independent bivariate responses with an application to periodontal disease,"Bivariate clustered (correlated) data often encountered in epidemiological and clinical research are routinely analyzed under a linear mixed model (LMM) framework with underlying normality assumptions of the random effects and within-subject errors. However, such normality assumptions might be questionable if the data set particularly exhibits skewness and heavy tails. Using a Bayesian paradigm, we use the skew-normal/independent (SNI) distribution as a tool for modeling clustered data with bivariate non-normal responses in an LMM framework. The SNI distribution is an attractive class of asymmetric thick-tailed parametric structure which includes the skew-normal distribution as a special case. We assume that the random effects follow multivariate SNI distributions and the random errors follow SNI distributions which provides substantial robustness over the symmetric normal process in an LMM framework. Specific distributions obtained as special cases, viz. the skew-t, the skew-slash and the skew-contaminated normal distributions are compared, along with the default skew-normal density. The methodology is illustrated through an application to a real data which records the periodontal health status of an interesting population using periodontal pocket depth (PPD) and clinical attachment level (CAL).",0,1 +1141,Bayesian estimation in the three-parameter logistic model,"A joint Bayesian estimation procedure for the estimation of parameters in the three-parameter logistic model is developed in this paper. Procedures for specifying prior beliefs for the parameters are given. It is shown through simulation studies that the Bayesian procedure (i) ensures that the estimates stay in the parameter space, and (ii) produces better estimates than the joint maximum likelihood procedure as judged by such criteria as mean squared differences between estimates and true values. © 1986 The Psychometric Society.",0,1 +1142,Transcranial magnetic stimulation in the visual system. I. The psychophysics of visual suppression,"When applied over the occipital pole, transcranial magnetic stimulation (TMS) disrupts visual perception and induces phosphenes. Both the underlying mechanisms and the brain structures involved are still unclear. The first part of the study characterizes the suppressive effect of TMS by psychophysical methods. Luminance increment thresholds for orientation discrimination were determined in four subjects using an adaptive staircase procedure. Coil position was controlled with a stereotactic positioning device. Threshold values were modulated by TMS, reaching a maximum effect at a stimulus onset asynchrony (SOA) of approx. 100 ms after visual target presentation. Stronger TMS pulses increased the maximum threshold while decreasing the SOA producing the maximum effect. Slopes of the psychometric function were flattened with TMS masking by a factor of 2, compared to control experiments in the absence of TMS. No change in steepness was observed in experiments using a light flash as the mask instead of TMS. Together with the finding that at higher TMS intensities, threshold elevation occurs even with shorter SOAs, this suggests lasting inhibitory processes as masking mechanisms, contradicting the assumption that the phosphene as excitatory equivalent causes masking. In the companion contribution to this one we present perimetric measurements and phosphene forms as a function of the stimulation site in the brain and discuss the putative generator structures. © Springer-Verlag 2004.",0,1 +1143,Modeling environmental factors affecting assimilation of bomb-produced Δ14C in the North Pacific Ocean: Implications for age validation studies,"Abstract The bomb-produced radiocarbon (14C) chronometer has become the gold standard for assessing the accuracy of otolith growth ring based fish age estimates. In the northeast Pacific Ocean, nearly a dozen age validation studies have been conducted, ranging from California to Alaska, most of which have relied on a single reference chronology from the Gulf of Alaska. We developed a Bayesian hierarchical model using data sets of bomb-produced radiocarbon in the northeast Pacific Ocean and investigated whether latitude and upwelling exerts an influence on the parameters that describe the rapid Δ14C increase in marine calcium carbonates. Models incorporating both latitude and upwelling as linear covariates of a 4-parameter logistic model were favored based on ΔDIC statistics. There was substantial evidence to support that the timing of the Δ14C pulse was advanced and that total Δ14C uptake increased with increasing latitude. In contrast, increased oceanographic upwelling resulted in lower total radiocarbon input as well as a delay in the timing of the pulse curve, as was demonstrated in the upwelling dominated California Current System. Within the observed latitudinal and upwelling range of the data sets examined in this study the predicted timing of the bomb pulse curve varied by as much as 3 years, which could be misinterpreted as aging error. Our results suggest that new reference chronologies may be needed for regions of the North Pacific Ocean differing in latitude, seasonal upwelling strength and other mixing factors that can potentially change the functional form of the Δ14C curve.",0,1 +1144,A componential analysis of leadership using the social relations model,"The social relations model (SRM; Kenny, 1994) explicitly proposes that leadership simultaneously operates at three levels of analysis: group, dyad, and individual (perceiver and target). With this model, researchers can empirically determine the amount of variance at each level as well as those factors that explain variance at these different levels. This chapter shows how the SRM can be used to address many theoretically important questions in the study of leadership and can be used to advance both the theory of and research in leadership. First, based on analysis of leadership ratings from seven studies, we find that there is substantial agreement (i.e., target variance) about who in the group is the leader and little or no reciprocity in the perceptions of leadership. We then consider correlations of leadership perceptions. In one analysis, we examine the correlations between task-oriented and socioemotional leadership. In another analysis, we examine the effect of gender and gender composition on the perception of leadership. We also explore how self-ratings of leadership differ from member perceptions of leadership. Finally, we discuss how the model can be estimated using conventional software.",0,1 +1145,Bayesian estimation with integrated nested Laplace approximation for binary logit mixed models,"In multilevel models for binary responses, estimation is computationally challenging due to the need to evaluate intractable integrals. In this paper, we investigate the performance of integrated nested Laplace approximation (INLA), a fast deterministic method for Bayesian inference. In particular, we conduct an extensive simulation study to compare the results obtained with INLA to the results obtained with a traditional stochastic method for Bayesian inference (MCMC Gibbs sampling), and with maximum likelihood through adaptive quadrature. Particular attention is devoted to the case of small number of clusters. The specification of the prior distribution for the cluster variance plays a crucial role and it turns out to be more relevant than the choice of the estimation method. The simulations show that INLA has an excellent performance as it achieves good accuracy (similar to MCMC) with reduced computational times (similar to adaptive quadrature).",0,1 +1146,Conjugate Priors for Exponential Families,Let $X$ be a random vector distributed according to an exponential family with natural parameter $\theta \in \Theta$. We characterize conjugate prior measures on $\Theta$ through the property of linear posterior expectation of the mean parameter of $X : E\{E(X|\theta)|X = x\} = ax + b$. We also delineate which hyperparameters permit such conjugate priors to be proper.,0,1 +1147,Examining factor structures on the Test of Early Mathematics Ability — 3: A longitudinal approach,"Assessment of early mathematics skills in young children is important both psychometrically and practically. The TEMA-3 (Ginsburg & Baroody, 2003) yields a total score (Math Ability Score) and provides useful information on children's overall mathematics performance, but not about performance in specific skill areas that are targeted by state early learning guidelines and by the National Council of Teachers of Mathematics (NCTM) and Common Core State Standards for Mathematics as important content for Understanding Number in early childhood. This study examined the factor structure of the TEMA-3 to examine whether items reflect the conceptual categories in the TEMA-3 Examiner's Manual (Ginsburg & Baroody, 2003) or a priori categories reflecting Understanding Number. Longitudinal data from 389 children (182 males), mean age 54.46 months at first assessment, were obtained in fall and spring of pre-kindergarten, spring of kindergarten, and spring of 1st grade. Changes in factor structure are examined across measurement points. The a priori factor structure was found by confirmatory factor analysis to better fit the data. The numbers of factors identified increased across time. Subscale scores reflecting children's knowledge of specific mathematics concepts related to number concepts could enable teachers and parents to select activities to strengthen children's mathematical knowledge in those skill areas.",0,1 +1148,Which types of multi-stage marketing increase direct customers' willingness-to-pay? Evidence from a scenario-based experiment in a B2B setting,"The present study investigates empirically which types of multi-stage marketing by a business-to-business supplier affect its direct customers' willingness-to-pay. We conceptually develop comprehensive and selective multi-stage marketing as well as multi-stage awareness as distinct types of this concept. Their properties lead to differentiated hypotheses concerning their effects on direct customers' relationship value perceptions and perceived price importance which in turn influence willingness-to-pay. The paper also demonstrates how the direct customers' power position toward their own customers affects the effectiveness of a supplier's multi-stage marketing endeavors. We conduct a scenario-based, experimental study among 103 knowledgeable purchasing managers in customer companies to the adhesives industry, measuring willingness-to-pay, perceived relationship value, and price importance with a limit conjoint analysis. Multi-level modeling is used to test our hypotheses. The results show that comprehensive multi-stage marketing significantly increases purchasing agents' willingness-to-pay, mostly through their relationship value perception, and especially when the customer company is in a less powerful position toward its own customers. For managers, our study highlights the benefits of comprehensive multi-stage marketing over the other multi-stage marketing types.",0,1 +1149,A versatile statistical analysis algorithm to detect genome copy number variation,"We have developed a versatile statistical analysis algorithm for the detection of genomic aberrations in human cancer cell lines. The algorithm analyzes genomic data obtained from a variety of array technologies, such as oligonucleotide array, bacterial artificial chromosome array, or array-based comparative genomic hybridization, that operate by hybridizing with genomic material obtained from cancer and normal cells and allow detection of regions of the genome with altered copy number. The number of probes (i.e., resolution), the amount of uncharacterized noise per probe, and the severity of chromosomal aberrations per chromosomal region may vary with the underlying technology, biological sample, and sample preparation. Constrained by these uncertainties, our algorithm aims at robustness by using a priorless maximum a posteriori estimator and at efficiency by a dynamic programming implementation. We illustrate these characteristics of our algorithm by applying it to data obtained from representational oligonucleotide microarray analysis and array-based comparative genomic hybridization technology as well as to synthetic data obtained from an artificial model whose properties can be varied computationally. The algorithm can combine data from multiple sources and thus facilitate the discovery of genes and markers important in cancer, as well as the discovery of loci important in inherited genetic disease.",0,1 +1150,Is Bayes Posterior just Quick and Dirty Confidence?,"Bayes [Philos. Trans. R. Soc. Lond. 53 (1763) 370--418; 54 296--325] introduced the observed likelihood function to statistical inference and provided a weight function to calibrate the parameter; he also introduced a confidence distribution on the parameter space but did not provide present justifications. Of course the names likelihood and confidence did not appear until much later: Fisher [Philos. Trans. R. Soc. Lond. Ser. A Math. Phys. Eng. Sci. 222 (1922) 309--368] for likelihood and Neyman [Philos. Trans. R. Soc. Lond. Ser. A Math. Phys. Eng. Sci. 237 (1937) 333--380] for confidence. Lindley [J. Roy. Statist. Soc. Ser. B 20 (1958) 102--107] showed that the Bayes and the confidence results were different when the model was not location. This paper examines the occurrence of true statements from the Bayes approach and from the confidence approach, and shows that the proportion of true statements in the Bayes case depends critically on the presence of linearity in the model; and with departure from this linearity the Bayes approach can be a poor approximation and be seriously misleading. Bayesian integration of weighted likelihood thus provides a first-order linear approximation to confidence, but without linearity can give substantially incorrect results.",0,1 +1151,A 2 × 2 taxonomy of multilevel latent contextual models: Accuracy–bias trade-offs in full and partial error correction models.,"In multilevel modeling, group-level variables (L2) for assessing contextual effects are frequently generated by aggregating variables from a lower level (L1). A major problem of contextual analyses in the social sciences is that there is no error-free measurement of constructs. In the present article, 2 types of error occurring in multilevel data when estimating contextual effects are distinguished: unreliability that is due to measurement error and unreliability that is due to sampling error. The fact that studies may or may not correct for these 2 types of error can be translated into a 2 × 2 taxonomy of multilevel latent contextual models comprising 4 approaches: an uncorrected approach, partial correction approaches correcting for either measurement or sampling error (but not both), and a full correction approach that adjusts for both sources of error. It is shown mathematically and with simulated data that the uncorrected and partial correction approaches can result in substantially biased estimates of contextual effects, depending on the number of L1 individuals per group, the number of groups, the intraclass correlation, the number of indicators, and the size of the factor loadings. However, the simulation study also shows that partial correction approaches can outperform full correction approaches when the data provide only limited information in terms of the L2 construct (i.e., small number of groups, low intraclass correlation). A real-data application from educational psychology is used to illustrate the different approaches.",0,1 +1152,Conceptual Issues in Response-Time Modeling,"Two different traditions of response-time (RT) modeling are reviewed: the tradition of distinct models for RTs and responses, and the tradition of model integration in which RTs are incorporated in response models or the other way around. Several conceptual issues underlying both traditions are made explicit and analyzed for their consequences. We then propose a hierarchical modeling framework consistent with the first tradition but with the integration of their parameter structures as a second level of modeling. Two examples of the framework are presented. Also, a fundamental equation is derived which relates the RTs on test items to the speed of the test taker and the time intensity of the items. The equation serves as the core of the RT model in the framework. Finally, empirical applications of the framework demonstrating its practical value are reviewed. Test theorists have always been intrigued by the relationship between responses to test items and the time used by a test taker to produce them. Both seem indicative of the same behavior on test items. Nevertheless, their relationship appears to be difficult to conceptualize, let alone represent coherently in a statistical model. Although the computerization of educational tests has been a major impetus to the current interest in response-time (RT) modeling, it would be wrong to ignore its historical origins. One early development that has left traces in our current thinking about RTs was Woodbury’s (1951, 1963) treatment of test scores as the result of a time-dependent stochastic response process. His theory, which is summarized in Lord and Novick (1968, chap. 5), has linear axioms and theorems that are entirely parallel to those of regular classical test theory. But, more important to the scope of this article, it also lent statistical sophistication to the intuitive idea that total time and numbers of items completed are equivalent measures of the test taker’s performance (see the example in Lord & Novick, pp. 104‐105). The same idea was present in Gulliksen’s (1950, chap. 17) treatment of speed and power tests. He defined a pure speed test as a test with an unlimited number of items that are easy enough to be answered correctly. Such tests can be scored in two different ways, as (a) the total time used to complete a fixed number of items, and (b) the number of items completed in a fixed time interval. On the other hand, a pure power test was defined by him as a test with unlimited time but a fixed number of items of varying difficulty. Such tests can be scored only by counting the number of correct responses. A fundamental problem exists with respect to the asymmetry between Gulliksen’s scoring rules for speed and power tests. At a practical level, the problem becomes manifest when a test taker produces an incorrect answer on a speed test, which is not very likely for high-ability test takers and easy items but certainly possible. How should we treat such responses? And would it be fair to treat their RTs as equivalent",0,1 +1153,"Analyzing developmental trajectories: A semiparametric, group-based approach.","Carnegie Mellon UniversityA developmental trajectory describes the course of a behavior over age or time. Agroup-based method for identifying distinctive groups of individual trajectorieswithin the population and for profiling the characteristics of group members isdemonstrated. Such clusters might include groups of increasers. decreasers,and no changers. Suitably defined probability distributions are used to handle 3data types—count, binary, and psychometric scale data. Four capabilities are dem-onstrated: (a) the capability to identify rather than assume distinctive groups oftrajectories, (b) the capability to estimate the proportion of the population followingeach such trajectory group, (c) the capability to relate group membership probabil-ity to individual characteristics and circumstances, and (d) the capability to use thegroup membership probabilities for various other purposes such as creating profilesof group members.",0,1 +1154,Reversible jump methods for generalised linear models and generalised linear mixed models,"A reversible jump algorithm for Bayesian model determination among generalised linear models, under relatively diffuse prior distributions for the model parameters, is proposed. Orthogonal projections of the current linear predictor are used so that knowledge from the current model parameters is used to make effective proposals. This idea is generalised to moves of a reversible jump algorithm for model determination among generalised linear mixed models. Therefore, this algorithm exploits the full flexibility available in the reversible jump method. The algorithm is demonstrated via two examples and compared to existing methods. © 2010 Springer Science+Business Media, LLC.",0,1 +1155,Cultural Consensus Theory: Aggregating Expert Judgments about Ties in a Social Network,"This paper describes an approach to information aggregation called Cultural Consensus Theory (CCT). CCT is a statistical modeling approach to pooling information from informants (experts, automated sources) who share a common culture or knowledge base. Each informant responds to the same set of questions, and the goal is to estimate the consensus knowledge of the informants. CCT has become a leading methodology for determining consensus beliefs of groups in the social sciences, especially cultural and medical anthropology. The paper illustrates CCT by providing a model for aggregating expert judgments about ties in a social network. Expert sources each provide a digraph on the same set of nodes, and the CCT model is used to estimate the most likely digraph to represent their shared knowledge. © Springer Science + Business Media, LLC 2009.",0,1 +1156,Bayesian inference for causal effects in randomized experiments with noncompliance,"For most of this century, randomization has been a cornerstone of scientific experimentation, especially when dealing with humans as experimental units. In practice, however, noncompliance is relatively common with human subjects, complicating traditional theories of inference that require adherence to the random treatment assignment. In this paper we present Bayesian inferential methods for causal estimands in the presence of noncompliance, when the binary treatment assignment is random and hence ignorable, but the binary treatment received is not ignorable. We assume that both the treatment assigned and the treatment received are observed. We describe posterior estimation using EM and data augmentation algorithms. Also, we investigate the role of two assumptions often made in econometric instrumental variables analyses, the exclusion restriction and the monotonicity assumption, without which the likelihood functions generally have substantial regions of maxima. We apply our procedures to real and artificial data, thereby demonstrating the technology and showing that our new methods can yield valid inferences that differ in practically important ways from those based on previous methods for analysis in the presence of noncompliance, including intention-to-treat analyses and analyses based on econometric instrumental variables techniques. Finally, we perform a simulation to investigate the operating characteristics of the competing procedures in a simple setting, which indicates relatively dramatic improvements in frequency operating characteristics attainable using our Bayesian procedures.",0,1 +1157,A Comparison of Approaches for the Analysis of Interaction Effects Between Latent Variables Using Partial Least Squares Path Modeling,"In social and business sciences, the importance of the analysis of interaction effects between manifest as well as latent variables steadily increases. Researchers using partial least squares (PLS) to analyze interaction effects between latent variables need an overview of the available approaches as well as their suitability. This article presents 4 PLS-based approaches: a product indicator approach (Chin, Marcolin, & Newsted, 2003), a 2-stage approach (Chin et al., 2003; Henseler & Fassott, in press), a hybrid approach (Wold, 1982), and an orthogonalizing approach (Little, Bovaird, & Widaman, 2006), and contrasts them using data related to a technology acceptance model. By means of a more extensive Monte Carlo experiment, the different approaches are compared in terms of their point estimate accuracy, their statistical power, and their prediction accuracy. Based on the results of the experiment, the use of the orthogonalizing approach is recommendable under most circumstances. Only if the orthogonalizing approach does not find a significant interaction effect, the 2-stage approach should be additionally used for significance test, because it has a higher statistical power. For prediction accuracy, the orthogonalizing and the product indicator approach provide a significantly and substantially more accurate prediction than the other two approaches. Among these two, the orthogonalizing approach should be used in case of small sample size and few indicators per construct. If the sample size or the number of indicators per construct is medium to large, the product indicator approach should be used.",0,1 +1158,Contemporary Issues in Exploratory Data Mining in the Behavioral Sciences,,0,1 +1159,Practical Markov Chain Monte Carlo,"Markov chain Monte Carlo using the Metropolis-Hastings algorithm is a general method for the simulation of stochastic processes having probability densities known up to a constant of proportionality. Despite recent advances in its theory, the practice has remained controversial. This article makes the case for basing all inference on one long run of the Markov chain and estimating the Monte Carlo error by standard nonparametric methods well-known in the time-series and operations research literature. In passing it touches on the Kipnis-Varadhan central limit theorem for reversible Markov chains, on some new variance estimators, on judging the relative efficiency of competing Monte Carlo schemes, on methods for constructing more rapidly mixing Markov chains and on diagnostics for Markov chain Monte Carlo.",0,1 +1160,Confirmatory Factor Analysis,"Measures that are reliable, valid, and can be used across diverse populations are vital to social work research, but the development of new measures is an expensive and time-consuming process. An array of existing measures can provide a cost-effective alternative, but in order to take this expedient step with confidence, researchers must ensure that the existing measure is appropriate for the new study. Confirmatory factor analysis (CFA) is one of the ways to do so. CFA has four primary functions-psychometric evaluation of measures, construct validation, testing method effects, and testing measurement invariance. This book provides an overview of the method, step-by-step guides to creating a CFA model and assessing its fit, and explanations of the requirements for using CFA, as well the book underscores the issues that are necessary to consider when using multiple groups or equivalent and multilevel models. Real-world examples, screenshots from the Amos software program that can be used to conduct CFA, and reading suggestions for each chapter form part of the book. © Oxford University Press, 2013.",0,1 +1161,On Bayesian estimation of marginal structural models,"The purpose of inverse probability of treatment (IPT) weighting in estimation of marginal treatment effects is to construct a pseudo-population without imbalances in measured covariates, thus removing the effects of confounding and informative censoring when performing inference. In this article, we formalize the notion of such a pseudo-population as a data generating mechanism with particular characteristics, and show that this leads to a natural Bayesian interpretation of IPT weighted estimation. Using this interpretation, we are able to propose the first fully Bayesian procedure for estimating parameters of marginal structural models using an IPT weighting. Our approach suggests that the weights should be derived from the posterior predictive treatment assignment and censoring probabilities, answering the question of whether and how the uncertainty in the estimation of the weights should be incorporated in Bayesian inference of marginal treatment effects. The proposed approach is compared to existing methods in simulated data, and applied to an analysis of the Canadian Co-infection Cohort.",0,1 +1162,Maximum likelihood estimation of generalised linear models for multivariate normal covariance matrix,"The positive-definiteness constraint is the most awkward stumbling block in modelling the covariance matrix. Pourahmadi's (1999) unconstrained parameterisation models covariance using covariates in a similar manner to mean modelling in generalised linear models. The new covariance parameters have statistical interpretation as the regression coefficients and logarithms of prediction error variances corresponding to regressing a response on its predecessors. In this paper, the maximum likelihood estimators of the parameters of a generalised linear model for the covariance matrix, their consistency and their asymptotic normality are studied when the observations are normally distributed. These results along with the likelihood ratio test and penalised likelihood criteria such as BIC for model and variable selection are illustrated using a real dataset.",0,1 +1163,A Strategy for Developing a Common Metric in Item Response Theory When Parameter Posterior Distributions Are Known,"Growing interest in fully Bayesian item response models begs the question: To what extent can model parameter posterior draws enhance existing practices? One practice that has traditionally relied on model parameter point estimates but may be improved by using posterior draws is the development of a common metric for two independently calibrated test forms. Before parameter estimates from independently calibrated forms can be compared, at least one form's estimates must be adjusted such that both forms share a common metric. Because this adjustment is estimated, there is a propagation of error effect when it is applied. This effect is typically ignored, which leads to overconfidence in the adjusted estimates; yet, when model parameter posterior draws are available, it may be accounted for with a simple sampling strategy. In this paper, it is shown using simulated data that the proposed sampling strategy results in adjusted posteriors with superior coverage properties than those obtained using traditional point-estimate-based methods.",0,1 +1164,"Family, School, and Community Correlates of Children’s Subjective Well-being: An International Comparative Study","The primary purposes of this study are twofold: to examine how family, school, and community factors are related to children’s subjective well-being; and to examine the patterns of the relationships between family, school, and community variables and children’s subjective well-being across nations. We use the data from the pilot study of the International Survey of Children’s Well-Being for our analysis. We use multiple regression and multilevel methods in the study. We find that family, school, and community lives all significantly affect the levels of children’s subjective well-being. We also find that family, school, and community lives of children are important predictors of subjective well-being even after controlling for the country-specific cultural and contextual factors. We find that the economic variables of GDP and inequality are not significant factors predicting children’s subjective well-being. Rather it is the nature of children’s relationships with immediate surrounding environments, such as frequency of family activities, frequency of peer activities, and neighborhood safety, are most consistently related to the levels of children’s subjective well-being across the nations. © 2014, Springer Science+Business Media Dordrecht.",0,1 +1165,A Note on Estimating the Jöreskog-Yang Model for Latent Variable Interaction Using LISREL 8.3,"Kenny and Judd (1984) developed a latent variable interaction model for observed variables centered around their population means. They estimated the model by using a covariance matrix calculated from sample-mean-centered variables and products of these variables. Subsequently,Joreskog and Yang (1996) identified the need to include intercepts for the measurement and structural equations and estimated the model by using a covariance matrix calculated from noncentered observed variables and products of these variables, and means of the observed variables and the products of noncentered variables. Evidence is presented that the Joreskog-Yang procedure for estimating the Kenny-Judd interaction model is subject to severe convergence problems when implemented in LISREL8.3 and means for the indicators of the latent exogenous variables are nonzero. An alternative procedure is presented that solves the convergence problem and provides consistent estimators of the parameters.",0,1 +1166,Analysis of Reading Skills Development from Kindergarten through First Grade: An Application of Growth Mixture Modeling to Sequential Processes,Methods for investigating the influence of an early developmental process on a later process are discussed. Conventional growth modeling is found inadequate but a general growth mixture model is sufficiently flexible. The growth mixture model allows prediction of the later process using different trajectory classes for the early process. The growth mixture model is applied to the study of progress in reading skills among first-grade students.,0,1 +1167,Small area estimation when auxiliary information is measured with error,"SUMMARY Small area estimation methods typically combine direct estimates from a survey with pre dictions from a model in order to obtain estimates of population quantities with reduced mean squared error. When the auxiliary information used in the model is measured with error, using a small area estimator such as the Fay-Herriot estimator while ignoring measurement error may be worse than simply using the direct estimator. We propose a new small area estimator that accounts for sampling variability in the auxiliary information, and derive its properties, in particular show ing that it is approximately unbiased. The estimator is applied to predict quantities measured in the U.S. National Health and Nutrition Examination Survey, with auxiliary information from the U.S. National Health Interview Survey.",0,1 +1168,The importance of adjusting for potential confounders in Bayesian hierarchical models synthesising evidence from randomised and non-randomised studies: an application comparing treatments for abdominal aortic aneurysms,"Informing health care decision making may necessitate the synthesis of evidence from different study designs (e.g., randomised controlled trials, non-randomised/observational studies). Methods for synthesising different types of studies have been proposed, but their routine use requires development of approaches to adjust for potential biases, especially among non-randomised studies. The objective of this study was to extend a published Bayesian hierarchical model to adjust for bias due to confounding in synthesising evidence from studies with different designs.In this new methodological approach, study estimates were adjusted for potential confounders using differences in patient characteristics (e.g., age) between study arms. The new model was applied to synthesise evidence from randomised and non-randomised studies from a published review comparing treatments for abdominal aortic aneurysms. We compared the results of the Bayesian hierarchical model adjusted for differences in study arms with: 1) unadjusted results, 2) results adjusted using aggregate study values and 3) two methods for downweighting the potentially biased non-randomised studies. Sensitivity of the results to alternative prior distributions and the inclusion of additional covariates were also assessed.In the base case analysis, the estimated odds ratio was 0.32 (0.13,0.76) for the randomised studies alone and 0.57 (0.41,0.82) for the non-randomised studies alone. The unadjusted result for the two types combined was 0.49 (0.21,0.98). Adjusted for differences between study arms, the estimated odds ratio was 0.37 (0.17,0.77), representing a shift towards the estimate for the randomised studies alone. Adjustment for aggregate values resulted in an estimate of 0.60 (0.28,1.20). The two methods used for downweighting gave odd ratios of 0.43 (0.18,0.89) and 0.35 (0.16,0.76), respectively. Point estimates were robust but credible intervals were wider when using vaguer priors.Covariate adjustment using aggregate study values does not account for covariate imbalances between treatment arms and downweighting may not eliminate bias. Adjustment using differences in patient characteristics between arms provides a systematic way of adjusting for bias due to confounding. Within the context of a Bayesian hierarchical model, such an approach could facilitate the use of all available evidence to inform health policy decisions.",0,1 +1169,Estimation of variances and covariances for high‐dimensional data: a selective review,"Estimation of variances and covariances is required for many statistical methods such as t-test, principal component analysis and linear discriminant analysis. High-dimensional data such as gene expression microarray data and financial data pose challenges to traditional statistical and computational methods. In this paper, we review some recent developments in the estimation of variances, covariance matrix, and precision matrix, with emphasis on the applications to microarray data analysis. WIREs Comput Stat 2014, 6:255–264. doi: 10.1002/wics.1308 For further resources related to this article, please visit the WIREs website. Conflict of interest: The authors have declared no conflicts of interest for this article.",0,1 +1170,A simulation study on tests of hypotheses and confidence intervals for fixed effects in mixed models for blocked experiments with missing data,"This article considers the analysis of experiments with missing data from various experimental designs frequently used in agricultural research (randomized complete blocks, split plots, strip plots). We investigate the small sample properties of REML-based Wald-type F tests using linear mixed models. Several methods for approximating the denominator degrees of freedom are employed, all of which are available with the MIXED procedure of the SAS System (8.02). The simulation results show that the Kenward-Roger method provides the best control of the Type I error rate and is not inferior to other methods in terms of power. © 2005 American Statistical Association and the International Biometric Society.",0,1 +1171,A test of the International Personality Item Pool representation of the Revised NEO Personality Inventory and development of a 120-item IPIP-based measure of the five-factor model.,"There has been a substantial increase in the use of personality assessment measures constructed using items from the International Personality Item Pool (IPIP) such as the 300-item IPIP-NEO (Goldberg, 1999), a representation of the Revised NEO Personality Inventory (NEO PI-R; Costa & McCrae, 1992). The IPIP-NEO is free to use and can be modified to accommodate its users' needs. Despite the substantial interest in this measure, there is still a dearth of data demonstrating its convergence with the NEO PI-R. The present study represents an investigation of the reliability and validity of scores on the IPIP-NEO. Additionally, we used item response theory (IRT) methodology to create a 120-item version of the IPIP-NEO. Using an undergraduate sample (n = 359), we examined the reliability, as well as the convergent and criterion validity, of scores from the 300-item IPIP-NEO, a previously constructed 120-item version of the IPIP-NEO (Johnson, 2011), and the newly created IRT-based IPIP-120 in comparison to the NEO PI-R across a range of outcomes. Scores from all 3 IPIP measures demonstrated strong reliability and convergence with the NEO PI-R and a high degree of similarity with regard to their correlational profiles across the criterion variables (rICC = .983, .972, and .976, respectively). The replicability of these findings was then tested in a community sample (n = 757), and the results closely mirrored the findings from Sample 1. These results provide support for the use of the IPIP-NEO and both 120-item IPIP-NEO measures as assessment tools for measurement of the five-factor model.",0,1 +1172,A meta-analytic study of the effects of goal setting on task performance: 1966–1984,"A meta-analytic study was conducted involving primarily published research from 1966 to 1984 and focusing on the relationship between goal-setting variables and task performance. Two major sets of studies were analyzed, those contrasting hard goals (goal difficulty) versus easy goals, and those comparing specific hard goals (goal specificity/difficulty) versus general goals, “do best” instructions, or no goal. As expected, strong support was obtained for the goal difficulty and goal specificity/difficulty components of E. A. Locke's (1968a , Organizational Behavior and Human Performance , 3 , 157–189) theory. A two-stage approach was employed to identify potential moderators of the goal difficulty and goal specificity/difficulty—performance relationships. Setting (laboratory versus field) was identified as a moderator of the relationship between goal specificity/difficulty and task performance. Two supplemental meta-analyses yielded support for the efficacy of combining specific hard goals with feedback versus specific hard goals without feedback and for participatively set goals versus assigned goal setting (when goal level is held constant), although this latter finding was interpreted as inconclusive based on the limited studies available. Implications for future research are addressed.",0,1 +1173,Interleukin-6 mediates low-threshold mechanical allodynia induced by intrathecal HIV-1 envelope glycoprotein gp120,"Spinal cord glia (microglia and astrocytes) contribute to enhanced pain states. One model that has been used to study this phenomenon is intrathecal (i.t.) administration of gp120, an envelope glycoprotein of HIV-1 known to activate spinal cord glia and thereby induce low-threshold mechanical allodynia, a pain symptom where normally innocuous (non-painful) stimuli are perceived as painful. Previous studies have shown that i.t. gp120-induced allodynia is mediated via the release of the glial pro-inflammatory cytokines, tumor necrosis factor-alpha (TNF), and interleukin-1beta (IL-1). As we have recently reported that i.t. gp120 induces the release of interleukin-6 (IL-6), in addition to IL-1 and TNF, the present study tested whether this IL-6 release in spinal cord contributes to gp120-induced mechanical allodynia and/or to gp120-induced increases in TNF and IL-1. An i.t. anti-rat IL-6 neutralizing antibody was used to block IL-6 actions upon its release by i.t. gp120. This IL-6 blockade abolished gp120-induced mechanical allodynia. While the literature predominantly documents the cascade of pro-inflammatory cytokines as beginning with TNF, followed by the stimulation of IL-1, and finally TNF plus IL-1 stimulating the release of IL-6, the present findings indicate that a blockade of IL-6 inhibits the gp120-induced elevations of TNF, IL-1, and IL-6 mRNA in dorsal spinal cord, elevation of IL-1 protein in lumbar dorsal spinal cord, and TNF and IL-1 protein release into the surrounding lumbosacral cerebrospinal fluid. These results would suggest that IL-6 induces pain facilitation, and may do so in part by stimulating the production and release of other pro-inflammatory cytokines.",0,1 +1174,Forced-choice staircases with fixed step sizes: asymptotic and small-sample properties,"Visual detection and discrimination thresholds are often measured using adaptive staircases, and most studies use transformed (or weighted) up/down methods with fixed step sizes—in the spirit of Wetherill and Levitt (Br J Mathemat Statist Psychol 1965;18:1–10) or Kaernbach (Percept Psychophys 1991;49:227–229)—instead of changing step size at each trial in accordance with best-placement rules—in the spirit of Watson and Pelli (Percept Psychophys 1983;47:87–91). It is generally assumed that a fixed-step-size (FSS) staircase converges on the stimulus level at which a correct response occurs with the probabilities derived by Wetherill and Levitt or Kaernbach, but this has never been proved rigorously. This work used simulation techniques to determine the asymptotic and small-sample convergence of FSS staircases as a function of such parameters as the up/down rule, the size of the steps up or down, the starting stimulus level, or the spread of the psychometric function. The results showed that the asymptotic convergence of FSS staircases depends much more on the sizes of the steps than it does on the up/down rule. Yet, if the size Δ + of a step up differs from the size Δ − of a step down in a way that the ratio Δ − /Δ + is constant at a specific value that changes with up/down rule, then convergence percent-correct is unaffected by the absolute sizes of the steps. For use with the popular one-, two-, three- and four-down/one-up rules, these ratios must respectively be set at 0.2845, 0.5488, 0.7393 and 0.8415, rendering staircases that converge on the 77.85%-, 80.35%-, 83.15%- and 85.84%-correct points. Wetherill and Levitt's transformed up/down rules—which require Δ − /Δ + =1—and the general version of Kaernbach's weighted up/down rule—which allows any Δ − /Δ + ratio—fail to reach their presumed targets. The small-sample study showed that, even with the optimal settings, short FSS staircases (up to 20 reversals in length) are subject to some bias, and their precision is less than reasonable, but their characteristics improve when the size Δ + of a step up is larger than half the spread of the psychometric function. Practical recommendations are given for the design of efficient and trustworthy FSS staircases.",0,1 +1175,A well-conditioned estimator for large-dimensional covariance matrices,"Many applied problems require a covariance matrix estimator that is not only invertible, but also well-conditioned (that is, inverting it does not amplify estimation error). For large-dimensional covariance matrices, the usual estimator—the sample covariance matrix—is typically not well-conditioned and may not even be invertible. This paper introduces an estimator that is both well-conditioned and more accurate than the sample covariance matrix asymptotically. This estimator is distribution-free and has a simple explicit formula that is easy to compute and interpret. It is the asymptotically optimal convex linear combination of the sample covariance matrix with the identity matrix. Optimality is meant with respect to a quadratic loss function, asymptotically as the number of observations and the number of variables go to infinity together. Extensive Monte Carlo confirm that the asymptotic results tend to hold well in finite sample.",0,1 +1176,Space-time stick-breaking processes for small area disease cluster estimation,"We propose a space-time stick-breaking process for the disease cluster estimation. The dependencies for spatial and temporal effects are introduced by using space-time covariate dependent kernel stick-breaking processes. We compared this model with the space-time standard random effect model by checking each model’s ability in terms of cluster detection of various shapes and sizes. This comparison was made for simulated data where the true risks were known. For the simulated data, we have observed that space-time stick-breaking process performs better in detecting medium- and high-risk clusters. For the real data, county specific low birth weight incidences for the state of South Carolina for the years 1997–2007, we have illustrated how the proposed model can be used to find grouping of counties of higher incidence rate.",0,1 +1177,Conceptualizing and testing random indirect effects and moderated mediation in multilevel models: New procedures and recommendations.,"The authors propose new procedures for evaluating direct, indirect, and total effects in multilevel models when all relevant variables are measured at Level 1 and all effects are random. Formulas are provided for the mean and variance of the indirect and total effects and for the sampling variances of the average indirect and total effects. Simulations show that the estimates are unbiased under most conditions. Confidence intervals based on a normal approximation or a simulated sampling distribution perform well when the random effects are normally distributed but less so when they are nonnormally distributed. These methods are further developed to address hypotheses of moderated mediation in the multilevel context. An example demonstrates the feasibility and usefulness of the proposed methods.",0,1 +1178,Bayesian Statistics,"Article Outline: Glossary Definition of the Subject and Introduction The Bayesian Statistical Paradigm Three Examples Comparison with the Frequentist Statistical Paradigm Future Directions Bibliography © 2012 Springer Science+Business Media, LLC. All rights reserved.",0,1 +1179,Nonlinear models for repeated measurement data: An overview and update,"Nonlinear mixed effects models for data in the form of continuous, repeated measurements on each of a number of individuals, also known as hierarchical nonlinear models, are a popular platform for analysis when interest focuses on individual-specific characteristics. This framework first enjoyed widespread attention within the statistical research community in the late 1980s, and the 1990s saw vigorous development of new methodological and computational techniques for these models, the emergence of general-purpose software, and broad application of the models in numerous substantive fields. This article presents an overview of the formulation, interpretation, and implementation of nonlinear mixed effects models and surveys recent advances and applications. © 2003 American Statistical Association and the International Biometric Society.",0,1 +1180,The measurement of reliability of social relations components from round-robin designs,"The social relations model (SRM) is a useful tool for measuring relationship effects, defined as the unique perceptions or behaviors of 2 people. The sources of variance in SRM studies are persons (actors and partners), groups, and items; the relationship effect is defined as the actor–partner interaction. By removing variance because of persons and groups, a measure of a “pure” relationship effect is obtained. In this article, generalizability theory (G Theory) is applied to estimate the reliability of SRM components from round-robin data structures. Using G Theory, reliability formulas for actor, partner, group, and relationship are developed and interpretations for the reliability estimates are provided. The authors also discuss how these formulas can be used in both planning and interpreting results from relationship research.",0,1 +1181,Discovering Hidden Structures Using Mixture Models: Application to Nonlinear Time Series Processes,"This paper discuses the application of mixture models for analyzing data with hidden structure. More specifically, we are interested in situations where the structure is due to some unobserved factors. Detecting the latent structures in data is not trivial. On the other hand, since such structures could obscure the effect of the observed variables, ignoring them (e.g., using simple linear models) could result in wrong inference. To address this issue, we propose to use Dirichlet process mixtures. In this approach, the mixture identifier (i.e., the latent variable that assigns each component to a data point) acts as a surrogate for possible missing factors and provides insight into possible hidden structure in the data. An illustrative example is provided to show the usefulness of this approach. We also discuss the application of our method for analyzing time series processes that are subject to regime changes where there is no specific economic theory about the structure of the model.",0,1 +1182,Quasi-Maximum Likelihood Estimation of Structural Equation Models With Multiple Interaction and Quadratic Effects,"In this article, a nonlinear structural equation model is introduced and a quasi-maximum likelihood method for simultaneous estimation and testing of multiple nonlinear effects is developed. The fo...",0,1 +1183,An fMRI investigation of empathic processing in boys with conduct problems and varying levels of callous-unemotional traits,"The ability to empathise relies in part on using one's own affective experience to simulate the affective experience of others. This process is supported by a number of brain areas including the anterior insula (AI), anterior cingulate cortex (ACC), medial prefrontal cortex (mPFC), and the amygdala. Children with conduct problems (CP), and in particular those with high levels of callous-unemotional traits (CP/HCU) present with less empathy than their peers. They also show reduced neural response in areas supporting empathic processing when viewing other people in distress. The current study focused on identifying brain areas co-activated during affective introspection of: i) One's own emotions ('Own emotion'); ii) Others' emotions ('Other emotion'); and iii) One's feelings about others' emotions ('Feel for other') during fearful vs neutral scenarios in typically developing boys (TD; n = 31), boys with CP/HCU (n = 31), and boys with CP and low levels of CU (CP/LCU; n = 33). The conjunction analysis across conditions within the TD group revealed significant clusters of activation in the AI, ACC/mPFC, and occipital cortex. Conjunction analyses across conditions in the CP/HCU and CP/LCU groups did not identify these areas as significantly activated. However, follow-up analyses were not able to confirm statistically significant differences between groups across the whole network, and Bayes-factor analyses did not provide substantial support for either the null or alternate hypotheses. Post-hoc comparisons indicated that the lack of conjunction effects in the CP/HCU group may reflect reduced affective introspection in the 'Other emotion' and 'Feel for other' conditions, and by reduced affective introspection in the 'Own emotion' condition in the CP/LCU group. These findings provide limited and ultimately equivocal evidence for altered affective introspection regarding others in CP/HCU, and altered affective introspection for own emotions in CP/LCU, and highlight the need for further research to systematically investigate the precise nature of empathy deficits in children with CP.",0,1 +1184,Random changepoint modelling of HIV immunologic responses,"We propose a changepoint model for the analysis of longitudinal CD4 T-cell counts for HIV infected subjects following highly active antiretroviral treatment. The profile of CD4 counts for each subject follows a simple, 'broken stick' changepoint model, with random subject-specific parameters, including the changepoint. The model accounts for baseline covariates. The longitudinal CD4 records are censored at the time of the subject going off-study-treatment. This is a potentially informative drop-out mechanism, which we address by modelling it jointly with the CD4 count outcome. The drop-out model incorporates terms from the CD4 model, including the changepoint. The estimation is done in a Bayesian framework, with implementation via Markov chain Monte Carlo methods in the WinBUGS software. Model selection using DIC indicates that the data support the complex random changepoint and informative censoring model.",0,1 +1185,SIMULATING RATIOS OF NORMALIZING CONSTANTS VIA A SIMPLE IDENTITY: A THEORETICAL EXPLORATION,"Let pi(w) ,i =1 , 2, be two densities with common support where each density is known up to a normalizing constant: pi(w )= qi(w)/ci .W e have draws from each density (e.g., via Markov chain Monte Carlo), and we want to use these draws to simulate the ratio of the normalizing constants, c1/c2. Such a compu- tational problem is often encountered in likelihood and Bayesian inference, and arises in fields such as physics and genetics. Many methods proposed in statistical and other literature (e.g., computational physics) for dealing with this problem are based on various special cases of the following simple identity: c1 c2 = E2(q1(w)α(w)) E1(q2(w)α(w)) . Here Ei denotes the expectation with respect to pi (i =1 , 2), and α is an arbitrary function such that the denominator is non-zero. A main purpose of this paper is to provide a theoretical study of the usefulness of this identity, with focus on (asymptotically) optimal and practical choices of α. Using a simple but informa- tive example, we demonstrate that with sensible (not necessarily optimal) choices of α, we can reduce the simulation error by orders of magnitude when compared to the conventional importance sampling method, which corresponds to α =1 /q2. We also introduce several generalizations of this identity for handling more compli- cated settings (e.g., estimating several ratios simultaneously) and pose several open problems that appear to have practical as well as theoretical value. Furthermore, we discuss related theoretical and empirical work.",0,1 +1186,Applying a Two-Step Strategy to the Analysis of Cross-National Public Opinion Data,"In recent years, large sets of national surveys with shared content have increasingly been used for cross-national opinion research. But scholars have not yet settled on the most flexible and efficient models for utilizing such data. We present a two-step strategy for such analysis that takes advantage of the fact that in such datasets each “cluster” (i.e., country sample) is large enough to sustain separate analysis of its internal variances and covariances. We illustrate the method by examining a puzzle of comparative electoral behavior—why does turnout decline rather than increase with the number of parties competing in an election (Blais and Dobryzynska 1998, for example)? This discussion demonstrates the ease with which a two-step strategy incorporates confounding variables operating at different levels of analysis. Technical appendices demonstrate that the two-step strategy does not lose efficiency of estimation as compared with a pooling strategy.",0,1 +1187,Residual Structures in Latent Growth Curve Modeling,"Several alternatives are available for specifying the residual structure in latent growth curve modeling. Two specifications involve uncorrelated residuals and represent the most commonly used residual structures. The first, building on repeated measures analysis of variance and common specifications in multilevel models, forces residual variances to be invariant across measurement occasions. The second, generally arising from structural equation modeling perspectives, allows residual variances to be freely estimated across occasions. Usually an afterthought, alternate specifications of the residual structure can have sizable effects on variance and covariance estimates for the intercept and slope factors (Ferron, Dailey, & Yi, 2002; Kwok, West, & Green, 2007; Sivo, Fan, & Witta, 2005), the fit of the model, and model convergence. We propose additional residual structures in latent growth modeling arising from ideas regarding growth curve reliability. These structures allow residual variances to change ac...",0,1 +1188,Assessing Appearance-Related Disturbances in HIV-Infected Men Who have Sex with Men (MSM): Psychometrics of the Body Change and Distress Questionnaire—Short Form (ABCD-SF),"Appearance-related disturbances are common among HIV-infected MSM; however, to date, there have been limited options in the valid assessment of this construct. The aim of the current study was to assess the structural, internal, and convergent validity of the assessment of body change distress questionnaire (ABCD) and its short version. Exploratory and confirmatory factor analyses indicated that both versions fit the data well. Four subfactors were revealed measuring the following body disturbance constructs: (1) negative affect about appearance, (2) HIV health-related outcomes and stigma, (3) eating and exercise confusion, and (4) ART non-adherence. The subfactors and total scores revealed bivariate associations with salient health outcomes, including depressive symptoms, HIV sexual transmission risk behaviors, and ART non-adherence. The ABCD and its short form, offer valid means to assess varied aspects of body image disturbance among HIV-infected MSM, and require modest participant burden.",0,1 +1189,The Use of Multilevel Item Response Theory Modeling in Applied Research: An Illustration,"Embedding item response theory (IRT) models within a multilevel modeling framework has been shown by many authors to allow better estimation of the relationships between predictor variables and IRT latent traits (Adams, Wilson, & Wu,1997). A multilevel IRT model recently proposed by Kamata (1998, 2001) yields the additional benefit of being able to accommodate data that are collected in hierarchical settings. This expansion of multilevel IRT models to three levels allows not only the dependency typically found in hierarchical data to be accommodated, but also the estimation of (a) latent traits at different levels and (b) the relationships between predictor variables and latent traits at different levels. The purpose of this article is to provide both a description and application of Kamata's 3-level IRT model. The advantages and disadvantages of using multilevel IRT models in applied research are discussed and directions for future research are given.",0,1 +1190,Political Competition and Attitudes towards Immigration in Africa,"This paper examines the political conditions under which individuals are more likely to oppose immigration. We focus on immigration attitudes in Africa, which has been overlooked in existing literature and where there is wide variation on political factors. Drawing on existing case study literature that links exclusionary politics in that region to on-going processes of political liberalisation, we hypothesise that political competition heightens opposition to immigration by raising the salience of the issue and legitimising hostile attitudes. Using multilevel mixed-effect ordered logistic regression analysis with survey data from African countries, we find that opposition to immigration is significantly higher among individuals in countries that are more democratic, that have dominant party systems, and when the survey is conducted shortly before or after a national election. Our analysis also shows that opposition to immigration is more likely in African countries with higher levels of ethnic diversity ...",0,1 +1191,Generalized linear mixed models a pseudo-likelihood approach,"A useful extension of the generalized linear model involves the addition of random effects andlor correlated errors. A pseudo-likelihood estimation procedure is developed to fit this class of mixed models based on an approximate marginal model for the mean response. The procedure is implemented via iterated fitting of a weighted Gaussian linear mixed model to a modified dependent variable. The approach allows for flexible specification of covariance structures for both the random effects and the correlated errors. An estimate of an additional dispersion parameter for underlying exponential family distributions is optionally automatic. The method allows for subject-specific and population-averaged inference, and the Salamander data example from McCullagh and Nelder (1989) is used to illustrate both.",0,1 +1192,Consumer Preference for a No‐Choice Option,"The traditional focus in the decision-making literature has been on understanding how consumers choose among a given set of alternatives. The notion that preference uncertainty may lead to choice deferral when no single alternative has a decisive advantage is tested in seven studies. Building on recent research, the article shows that the decision to defer choice is influenced by the absolute difference in attractiveness among the alternatives provided and is not consistent with trade-off difficulty or the theory of search. These findings are then extended to show that choice deferral can also be modified for the same alternatives by manipulations that make them appear more similar in attractiveness, or that decrease the need to differentiate among them. The results are consistent with the notion that preference uncertainty results in a hesitation to commit to any single action since small differences in attractiveness among the alternatives are potentially reversible. Consistent with this premise, the effect of attractiveness difference on choice deferral decreased significantly when subjects were first allowed to practice making monetary trade-offs among the available alternatives.",0,1 +1193,Cluster randomized trials with treatment noncompliance.,"Cluster randomized trials (CRTs) have been widely used in field experiments treating a cluster of individuals as the unit of randomization. This study focused particularly on situations where CRTs are accompanied by a common complication, namely, treatment noncompliance or, more generally, intervention nonadherence. In CRTs, compliance may be related not only to individual characteristics but also to the environment of clusters individuals belong to. Therefore, analyses ignoring the connection between compliance and clustering may not provide valid results. Although randomized field experiments often suffer from both noncompliance and clustering of the data, these features have been studied as separate rather than concurrent problems. On the basis of Monte Carlo simulations, this study demonstrated how clustering and noncompliance may affect statistical inferences and how these two complications can be accounted for simultaneously. In particular, the effect of the intervention on individuals who not only were assigned to active intervention but also abided by this intervention assignment (complier average causal effect) was the focus. For estimation of intervention effects considering noncompliance and data clustering, an ML-EM estimation method was employed.",0,1 +1194,"Relationships between leader reward and punishment behavior and subordinate attitudes, perceptions, and behaviors: A meta-analytic review of existing and new research","Despite decades of research on the relationships between leader reward and punishment behaviors and employee attitudes, perceptions, and performance, no comprehensive examination of these relationships has been reported in the literature. This paper reports the results of two studies that address this issue. In the Wrst study, data from 20 new samples were gathered on the relationships between leader reward and punishment behaviors and some criterion variables that have not been examined extensively in previous research. In the second study, a meta-analytic review was conducted incorporating both the new and existing research in order to provide estimates of the bivariate relationships between these leader behaviors and a variety of employee criterion variables across 78 studies containing 118 independent samples. Results of regression analyses designed to control for the eVects of the other leader behaviors showed that: (a) the relationships between leader reward and punishment behaviors and employee attitudes, perceptions, and behaviors were more functional when the rewards or punishments were administered contingently than when they were administered non-contingently, and (b) these leader reward and punishment behaviors were strongly related to two variables (employees’ perceptions of justice and role ambiguity) that were expected to be key mediators of the relationships between these leader behaviors and the employee criterion variables. In addition, meta-analytic evidence from longitudinal studies suggested that the same leader behavior can be a cause of some employee criterion variables, and a consequence of others. Implications of these Wndings for future research in the area are discussed.",0,1 +1195,"Analyzing indirect effects in cluster randomized trials. The effect of estimation method, number of groups and group sizes on accuracy and power","Cluster randomized trials assess the effect of an intervention that is carried out at the group or cluster level. Ajzen's theory of planned behavior is often used to model the effect of the intervention as an indirect effect mediated in turn by attitude, norms and behavioral intention. Structural equation modeling (SEM) is the technique of choice to estimate indirect effects and their significance. However, this is a large sample technique, and its application in a cluster randomized trial assumes a relatively large number of clusters. In practice, the number of clusters in these studies tends to be relatively small, e.g., much less than fifty. This study uses simulation methods to find the lowest number of clusters needed when multilevel SEM is used to estimate the indirect effect. Maximum likelihood estimation is compared to Bayesian analysis, with the central quality criteria being accuracy of the point estimate and the confidence interval. We also investigate the power of the test for the indirect effect. We conclude that Bayes estimation works well with much smaller cluster level sample sizes such as 20 cases than maximum likelihood estimation; although the bias is larger the coverage is much better. When only 5-10 clusters are available per treatment condition even with Bayesian estimation problems occur.",1,1 +1196,Validity and reliability of an online visual–spatial working memory task for self-reliant administration in school-aged children,"Working memory is an important predictor of academic performance, and of math performance in particular. Most working memory tasks depend on one-to-one administration by a testing assistant, which makes the use of such tasks in large-scale studies time-consuming and costly. Therefore, an online, self-reliant visual-spatial working memory task (the Lion game) was developed for primary school children (6-12 years of age). In two studies, the validity and reliability of the Lion game were investigated. The results from Study 1 (n = 442) indicated satisfactory six-week test-retest reliability, excellent internal consistency, and good concurrent and predictive validity. The results from Study 2 (n = 5,059) confirmed the results on the internal consistency and predictive validity of the Lion game. In addition, multilevel analysis revealed that classroom membership influenced Lion game scores. We concluded that the Lion game is a valid and reliable instrument for the online computerized and self-reliant measurement of visual-spatial working memory (i.e., updating).",0,1 +1197,"What makes education positional? Institutions, overeducation and the competition for jobs","We compare three theoretical models for the relationship between schooling and labor market outcomes. On the one hand, the job competition model, which views education as a positional good with relative value on the labor market; on the other hand, the human capital and the social closure models, which view the value of education as absolute but differ in their expectations about returns to years of education above what required for the job. We analyze European countries using data from the European Social Survey (2010), and investigate the incidence of overeducation and the returns to years of overeducation in order to distinguish between the three theoretical models. We then relate these theoretical perspectives to institutions of the education system and of labor market coordination. Our empirical results indicate that education is more likely to function as a positional good in countries with weakly developed vocational education systems, where individuals have an incentive to acquire higher levels of education in order to stay ahead of the labor queue. However, no convincing support was found for the relationship we hypothesized between wage coordination and returns to years of overeducation.",0,1 +1198,Analyzing the dynamics of free recall: An integrative review of the empirical literature,"Relatively few experiments have measured the time course of free recall from episodic or semantic memory. Of those that have, most report that cumulative recall is a negatively accelerated exponential (or hyperbolic) function that is characterized by two properties: asymptotic recall and rate of approach to asymptote. The most common measure of free recall performance (viz., the number of items recalled) provides a reasonably good estimate of asymptotic recall if a relatively long recall period is used (which is rare), but the effect of experimental manipulations on the rate of approach to asymptote cannot be determined without timing when recall responses occur. The research reviewed herein suggests that the rate of approach to asymptote may offer an estimate of the breadth of search through long-term memory. The search in question, unlike most of those investigated in the memory literature, is unique in that it requires minutes rather than milliseconds to complete.",0,1 +1199,Topographic influences on the distribution of white pine blister rust inPinus albicaulistreeline communities,"The exotic disease white pine blister rust (caused by Cronartium ribicola) damages and kills whitebark pine (Pinus albicaulis), even in the extreme environments of alpine treeline communities. We surveyed P. albicaulis trees and tree islands for blister rust in 2 distinct alpine treeline communities in Montana, USA, and examined meso- and microtopographic factors potentially related to the climatic requirements for blister rust infection. For each of 60 sampling plots, we created high-resolution digital elevation models, derived microtopography variables, and compared these and distance to water feature variables with blister rust occurrence and intensity (number of cankers per infected tree) for every sampled P. albicaulis tree. Infection rates were 19% (of 328 sampled trees) and 24% (of 585 sampled trees) at the 2 sites. Tree island P. albicaulis had higher infection percentages than solitary trees. Using Bayesian analysis and a zero-inflated Poisson regression model, we determined that solar radiation and moisture-related variables correlated with both presence and number of blister rust cankers on P. albicaulis. Site factors that influence moisture, such as local topography, hydrology, and climate, differed between the 2 treeline study areas, which may account for the model variability.",0,1 +1200,Examining assumptions about item responding in personality assessment: Should ideal point methods be considered for scale development and scoring?,"The present study investigated whether the assumptions of an ideal point response process, similar in spirit to Thurstone's work in the context of attitude measurement, can provide viable alternatives to the traditionally used dominance assumptions for personality item calibration and scoring. Item response theory methods were used to compare the fit of 2 ideal point and 2 dominance models with data from the 5th edition of the Sixteen Personality Factor Questionnaire (S. Conn & M. L. Rieke, 1994). The authors' results indicate that ideal point models can provide as good or better fit to personality items than do dominance models because they can fit monotonically increasing item response functions but do not require this property. Several implications of these findings for personality measurement and personnel selection are described.",0,1 +1201,Uncertainty Quantification and Polynomial Chaos Techniques in Computational Fluid Dynamics,"The quantification of uncertainty in computational fluid dynamics (CFD) predictions is both a significant challenge and an important goal. Probabilistic uncertainty quantification (UQ) methods have been used to propagate uncertainty from model inputs to outputs when input uncertainties are large and have been characterized probabilistically. Polynomial chaos (PC) methods have found increased use in probabilistic UQ over the past decade. This review describes the use of PC expansions for the representation of random variables/fields and discusses their utility for the propagation of uncertainty in computational models, focusing on CFD models. Many CFD applications are considered, including flow in porous media, incompressible and compressible flows, and thermofluid and reacting flows. The review examines each application area, focusing on the demonstrated use of PC UQ and the associated challenges. Cross-cutting challenges with time unsteadiness and long time horizons are also discussed.",0,1 +1202,Measuring the Threshold of Audibility of Temporal Decays,"A listening test system designed to measure the threshold of audibility of the decay time of low frequency resonances is described. The system employs the Parameter Estimation by Sequential Testing (PEST) technique and the listening test is conducted on calibrated headphones to remove factors associated with the listening environment. Program signal, replay level, and resonance frequency are believed to influence decay time threshold. A trial listening test shows that the system reveals realistic results but the temporal resonance modeling filter requires some adjustment to remove audible non-modal cues. Transducer limitations still affect the test at low frequencies and high replay levels. Factors for future large-scale listening tests are refined. Early indications are that temporal decay thresholds rise with reduced frequency and SPL.",0,1 +1203,Computation of reference Bayesian inference for variance components in longitudinal studies,"Generalized linear mixed models (GLMMs) have been applied widely in the analysis of longitudinal data. This model confers two important advantages, namely, the flexibility to include random effects and the ability to make inference about complex covariances. In practice, however, the inference of variance components can be a difficult task due to the complexity of the model itself and the dimensionality of the covariance matrix of random effects. Here we first discuss for GLMMs the relation between Bayesian posterior estimates and penalized quasi-likelihood (PQL) estimates, based on the generalization of Harville's result for general linear models. Next, we perform fully Bayesian analyses for the random covariance matrix using three different reference priors, two with Jeffreys' priors derived from approximate likelihoods and one with the approximate uniform shrinkage prior. Computations are carried out via the combination of asymptotic approximations and Markov chain Monte Carlo methods. Under the criterion of the squared Euclidean norm, we compare the performances of Bayesian estimates of variance components with that of PQL estimates when the responses are non-normal, and with that of the restricted maximum likelihood (REML) estimates when data are assumed normal. Three applications and simulations of binary, normal, and count responses with multiple random effects and of small sample sizes are illustrated. The analyses examine the differences in estimation performance when the covariance structure is complex, and demonstrate the equivalence between PQL and the posterior modes when the former can be derived. The results also show that the Bayesian approach, particularly under the approximate Jeffreys' priors, outperforms other procedures. © 2008 Springer-Verlag.",1,1 +1204,Changing emotion dynamics: Individual differences in the effect of anticipatory social stress on emotional inertia.,"Emotional inertia-the degree to which people's feelings carry over from one moment to the next-is an important property of the temporal dynamics of emotions. Thus far, emotional inertia has only been examined as a stable, trait-like characteristic. However, internal or external events (e.g., stress) may trigger changes in people's emotion dynamics, particularly among individuals with heightened sensitivity to such events. The current study investigated how emotional inertia is influenced by the anticipation of social stress, and how this effect is moderated by individual differences in depression, self-esteem, and fear of negative evaluation. We measured participants' (n = 71) emotional inertia in daily life using experience sampling before and after experimentally manipulating anticipatory social stress. Consistent with previous research, psychological maladjustment was associated with higher emotional inertia during ""normal"" daily life. However, when anticipating a socially stressful event, levels of emotional inertia dropped, particularly among participants scoring high on depression and fear of negative evaluation and low on self-esteem. These results demonstrate that emotion dynamics can vary as a function of contextual factors and identify moderators of such variation.",0,1 +1205,A Comparison of Two Area Measures for Detecting Differential Item Functioning,"The area between two item response functions is often used as a measure of differential item functioning under item response theory. This area can be measured over either an open interval (i.e., exact) or closed interval. Formulas are presented for com puting the closed-interval signed and unsigned areas. Exact and closed-interval measures were estimated on data from a test with embedded items intentionally constructed to favor one group over another. No real differences in detection of these items were found between exact and closed-interval methods.",0,1 +1206,Context-general and Context-specific Determinants of Online Satisfaction and Loyalty for Commerce and Content Sites,"We use the context-general and context-specific factor approach to examine the generalizability of satisfaction and loyalty models across two disparate online contexts—online retailing and content site browsing. Our conceptual models include the moderating effects of user-characteristic Web expertise, besides main effects of Web site factors and Web expertise. Results indicate that satisfaction and loyalty judgments are sensitive to both context-general and context-specific determinants, as well as to some interactions between them. Among context-general determinants, ease of use and customer service are positively related to satisfaction, Web community to loyalty, and Web expertise to both satisfaction and loyalty. Flow, a context-specific determinant, has a significant positive effect on satisfaction alone; security affects loyalty alone; and fulfillment/reliability and information quality are significant predictors of both satisfaction and loyalty. The results show that Web expertise moderates the effect of ease of use on satisfaction. The study contributes to marketing theory and practice by identifying satisfaction and loyalty mechanisms that are potentially generalizable across the two online contexts and providing a guiding framework for simultaneous consideration of context-specific and context-general factors in future research.",0,1 +1207,Familiality of addiction and its developmental mechanisms in girls,"Drug use disorders (DUD) have been theorized to share sources of risk variation with other consummatory behaviors. We hypothesized that common mechanisms exist for familial risk for DUD, physiological maturation and nutritional status in girls. Whereas body fat content must exceed a threshold to enable adrenarche and gonadarche, nutritional status may also be a behavior risk indicator. Impaired psychological self-regulation associated with DUD risk may manifest in early overeating, which could in turn accelerate reproductive maturation, resulting in a greater likelihood of affiliation with deviant/older peers and drug use.The sample consisted of families ascertained through the father who either had (N=95) or did not have (N=130) a DUD, and who had a 10-12 year old daughter and her mother available for study. Correlation, survival and path analyses of three consecutive assessments evaluated the relationships between parental DUD (number of affected parents, NAP), nutritional status (NS, subscapular skinfold measurements and body mass index), sexual maturation (Tanner stage), peer delinquency, and the daughter's lifetime DUD diagnosis.NAP was positively related to the girls' nutritional status. Longitudinal path analysis indicated mediation of the relationship between NAP and peer delinquency by sexual maturation. The relationship between NAP and sexual maturation is mediated by NS. The effect of sexual maturation at age ∼11 on the girls' DUD risk is mediated by peer delinquency.The data are consistent with mediation of intergenerational transmission of DUD risk in females by elevated nutrition, leading to accelerated maturation, and affiliation with deviant peers.",0,1 +1208,"Interpreting Biomedical Science: Experiment, Evidence, and Belief","Interpreting Biomedical Science: Experiment, Evidence, and Belief discusses what can go wrong in biological science, providing an unbiased view and cohesive understanding of scientific methods, statistics, data interpretation, and scientific ethics that are illustrated with practical examples and real-life applications. Casting a wide net, the reader is exposed to scientific problems and solutions through informed perspectives from history, philosophy, sociology, and the social psychology of science. The book shows the differences and similarities between disciplines and different eras and illustrates the concept that while sound methodology is necessary for the progress of science, we cannot succeed without a right culture of doing things.Features theoretical concepts accompanied by examples from biological literatureContains an introduction to various methods, with an emphasis on statistical hypothesis testingPresents a clear argument that ties the motivations and ethics of individual scientists to the success of their scienceProvides recommendations on how to safeguard against scientific misconduct, fraud, and retractionsArms young scientists with practical knowledge that they can use every day",0,1 +1209,Robust mediation analysis based on median regression.,"Mediation analysis has many applications in psychology and the social sciences. The most prevalent methods typically assume that the error distribution is normal and homoscedastic. However, this assumption may rarely be met in practice, which can affect the validity of the mediation analysis. To address this problem, we propose robust mediation analysis based on median regression. Our approach is robust to various departures from the assumption of homoscedasticity and normality, including heavy-tailed, skewed, contaminated, and heteroscedastic distributions. Simulation studies show that under these circumstances, the proposed method is more efficient and powerful than standard mediation analysis. We further extend the proposed robust method to multilevel mediation analysis, and demonstrate through simulation studies that the new approach outperforms the standard multilevel mediation analysis. We illustrate the proposed method using data from a program designed to increase reemployment and enhance mental health of job seekers.",0,1 +1210,Handling Missing Covariates in Conditional Mixture Models Under Missing at Random Assumptions,"Mixture modeling is a popular method that accounts for unobserved population heterogeneity using multiple latent classes that differ in response patterns. Psychologists use conditional mixture models to incorporate covariates into between-class and/or within-class regressions. Although psychologists often have missing covariate data, conditional mixtures are currently fit with a conditional likelihood, treating covariates as fixed and fully observed. Under this exogenous-x approach, missing covariates are handled primarily via listwise deletion. This sacrifices efficiency and does not allow missingness to depend on observed outcomes. Here we describe a modified joint likelihood approach that (a) allows inference about parameters of the exogenous-x conditional mixture even with nonnormal covariates, unlike a conventional multivariate mixture; (b) retains all cases under missing at random assumptions; (c) yields lower bias and higher efficiency than the exogenous-x approach under a variety of conditions with missing covariates; and (d) is straightforward to implement in available commercial software. The proposed approach is illustrated with an empirical analysis predicting membership in latent classes of conduct problems. Recommendations for practice are discussed.",0,1 +1211,"Growth Mixture Models Outperform Simpler Clustering Algorithms When Detecting Longitudinal Heterogeneity, Even With Small Sample Sizes","Identifying subpopulations based on longitudinal trajectories can provide new avenues to answer theoretically interesting research questions. Although many techniques to accomplish this task exist, a common method used in psychology is the growth mixture model. Recent simulations have found that this analytic method shows a decline in performance for smaller sample sizes commonly found in psychological research (Kim, 2012; Peugh & Fan, 2012). This raises this question: Are there better methods available for smaller sample sizes? Monte Carlo simulations were used to explicitly compare growth mixture models with other clustering methods, ranging on a spectrum from not informed to very informed, across different simulation conditions. To compare results both between and within analytic method, Kullback–Leibler divergence is introduced as a measure of cluster solution misfit. Results show that despite this decreased performance for smaller sample sizes, growth mixture models still outperform simpler, more gen...",0,1 +1212,Bayesian modeling of several covariance matrices and some results on propriety of the posterior for linear regression with correlated and/or heterogeneous errors,"We explore simultaneous modeling of several covariance matrices across groups using the spectral (eigenvalue) decomposition and modified Cholesky decomposition. We introduce several models for covariance matrices under different assumptions about the mean structure. We consider ‘dependence’ matrices, which tend to have many parameters, as constant across groups and/or parsimoniously modeled via a regression formulation. For ‘variances’, we consider both unrestricted across groups and more parsimoniously modeled via log-linear models. In all these models, we explore the propriety of the posterior when improper priors are used on the mean and ‘variance’ parameters (and in some cases, on components of the ‘dependence’ matrices). The models examined include several common Bayesian regression models, whose propriety has not been previously explored, as special cases. We propose a simple approach to weaken the assumption of constant dependence matrices in an automated fashion and describe how to compute Bayes factors to test the hypothesis of constant ‘dependence’ across groups. The models are applied to data from two longitudinal clinical studies.",0,1 +1213,Multilevel analysis of the changing relationship between class and party in Britain 1964?1992,"Previous analyses of the changing relationship between class and vote in Britain have assumed that the British Election Surveys constitute simple random samples. In fact, they are all clustered samples, and the number of sampling points has varied substantially over time. The paper uses the statistical technique of multi-level modelling to investigate the effects of this clustering and compares the results with those obtained with single-level logistic models. In general, the multilevel and single-level models lead to similar conclusions about the changing relation between class and vote; they both show evidence of a change in the class/vote relationship over time. However, the multilevel models also show that, while the clustering does not affect conclusions about the class dealignment debate, there are other important substantive findings which emerge from the multilevel approach. First, there is clear evidence of substantial constituency differences in the intercepts; that is, individuals had very different propensities to vote Conservative in different constituencies. Second, there were also significant constituency differences in class voting, that is, constituencies seemed to vary in their level of class polarization.",0,1 +1214,A robust mixed linear model analysis for longitudinal data,"This paper describes robust procedures for estimating parameters of a mixed effects linear model as applied to longitudinal data. In addition to fixed regression parameters, the model incorporates random subject effects to accommodate between-subjects variability and autocorrelation for within-subject variability. Robust empirical Bayesian estimation of subject effects is briefly discussed. As an illustration, the procedures are applied to data from a multiple sclerosis clinical trial.",0,1 +1215,Bayesian Analysis for Penalized Spline Regression Using Win BUGS,"Penalized splines can be viewed as BLUPs in a mixed model framework, which allows the use of mixed model software for smoothing. Thus, software originally developed for Bayesian analysis of mixed models can be used for penalized spline regression. Bayesian inference for nonparametric models enjoys the flexibility of nonparametric models and the exact inference provided by the Bayesian inferential machinery. This paper provides a simple, yet comprehensive, set of programs for the implementation of nonparametric Bayesian analysis in WinBUGS.",0,1 +1216,Empirical Tests of Stochastic Dominance in Capital Investment Planning: A Spreadsheet Framework,"The empirical inadequacy of direct application of stochastic dominance rules and their variants has led to the development of statistical tests for making dominance inferences. Yet very little is known about their application in capital investment planning, and the algorithms for their implementation are not readily available to the analyst who uses spreadsheets for capital investment planning. Therefore, this article develops a spreadsheet framework for conducting empirical tests of stochastic dominance when comparing alternative capital investment plans under uncertainty. It uses bootstrap and simulation methodology to compute the p-values required for making first- and second-order dominance inferences. Results from numerical examples show that empirical tests yield robust inferences when the structure of risk profiles and their integrals is such that dominance inferences by visual inspection are difficult. Therefore, analysts should model and empirically test for these relationships if they want to ma...",0,1 +1217,Localizing Putative Markers in Genetic Association Studies by Incorporating Linkage Disequilibrium into Bayesian Hierarchical Models,"Numerous methods have been proposed to model the association between multiple single nucleotide polymorphisms (SNPs) and a phenotype. Often these methods do not explicitly model the information regarding the linkage disequilibrium (LD) between SNPs. Furthermore, many methods shrink the SNP effects towards zero, rather than to an unknown latent gene-level effect.We outline the use of bayesian hierarchical models for gene-level analysis that incorporates LD information. Four different bayesian models, with either the inclusion or exclusion of LD information and 'shrinkage' of SNP effects to a latent gene-level effect or zero, were applied to a pharmacogenomic study and simulation STUDY.We observed that the inclusion of LD information resulted in increased precision in the SNP parameter estimates. The simulation study also demonstrated that the bayesian models were able to determine the simulated 'causative' variant more often with less false-positive associations as compared to commonly used multi-SNP analysis methods.Incorporating LD information in the analysis of multiple SNPs results in more precise estimates of SNP effects. In addition, the bayesian models are able to isolate the simulated 'causative' variant more often than commonly used regression modeling methods.",0,1 +1218,Racial differences in treatment preferences among lupus patients: a two-site study.,"To identify the demographic, clinical and psychosocial characteristics associated with racial differences in willingness to receive cyclophosphamide (CYC) or participate in a research clinical trial (RCT) among patients with systemic lupus erythematosus (SLE).Data from 163 African-American (AA) and 180 white (WH) SLE patients were evaluated. Structured interviews and chart reviews were conducted to determine treatment preferences in hypothetical situations and identify variables that may affect preferences. Logistic regression models were performed to evaluate the relationship between patient preferences and race, adjusted for patient characteristics.Among patients who had never received CYC (n=293), 62.9% AAs compared to 87.6% WHs were willing to receive the medication (p<0.001). This difference persisted (OR 0.37 [95% CI, 0.16-0.87]) after adjusting for socio-demographics, clinical characteristics, and perceptions about CYC and physicians. Income and higher perception of CYC effectiveness were other determinants of willingness to receive CYC. Among patients who had never participated in an RCT (n=326), 64.9% AAs compared to 84.3% WHs were willing to do so (p<0.001). This difference persisted (OR 0.41 [95% CI, 0.20-0.83]) after adjusting for socio-demographics, clinical context and patients' perceptions of physicians. SLE damage score, number of immunosuppressive medications and higher trust in physicians were also independently associated with willingness to participate in an RCT.Race remains an independent determinant of treatment preferences after adjustment for income, medications, medication efficacy expectations and trust in physicians. While some factors related to racial differences in preferences are relatively fixed, others that may alleviate these differences also exist, including medication beliefs and provider trust.",0,1 +1219,Involvement of spinal cord nuclear factor κB activation in rat models of proinflammatory cytokine-mediated pain facilitation,"Proinflammatory cytokines, such as interleukin-1beta and tumour necrosis factor-alpha, are released by activated glial cells in the spinal cord and play a major role in pain facilitation. These cytokines exert their actions, at least partially, through the activation of the transcription factor, nuclear factor kappaB (NF-kappaB). In turn, NF-kappaB regulates the transcription of many inflammatory mediators, including cytokines. We have previously shown that intrathecal injection of the human immunodeficiency virus-1 (HIV-1) envelope glycoprotein, gp120, induces mechanical allodynia via the release of proinflammatory cytokines. Here, we investigated whether NF-kappaB is involved in gp120-induced pain behaviour in Sprague-Dawley rats. Intrathecal administration of NF-kappaB inhibitors, pyrrolidinedithiocarbamate (PDTC) and SN50, prior to gp120 partially attenuated gp120-induced allodynia. In addition, PDTC delayed and reversed allodynia in a model of neuropathic pain induced by sciatic nerve inflammation. These observations suggest that intrathecal gp120 may lead to activation of NF-kappaB within the spinal cord. To reveal NF-kappaB activation, we assessed inhibitory factor kappaBalpha (IkappaBalpha) mRNA expression by in situ hybridization, as NF-kappaB activation up-regulates IkappaBalpha gene expression as part of an autoregulatory feedback loop. No or low levels of IkappaBalpha mRNA were detected in the lumbar spinal cord of vehicle-injected rats, whereas IkappaBalpha mRNA expression was markedly induced in the spinal cord following intrathecal gp120 in predominantly astrocytes and endothelial cells. Moreover, IkappaBalpha mRNA expression positively correlated with proinflammatory cytokine protein levels in lumbosacral cerebrospinal fluid. Together, these results demonstrate that spinal cord NF-kappaB activation is involved, at least in part, in exaggerated pain states.",0,1 +1220,A comparison of propensity score methods: a case-study estimating the effectiveness of post-AMI statin use,"There is an increasing interest in the use of propensity score methods to estimate causal effects in observational studies. However, recent systematic reviews have demonstrated that propensity score methods are inconsistently used and frequently poorly applied in the medical literature. In this study, we compared the following propensity score methods for estimating the reduction in all-cause mortality due to statin therapy for patients hospitalized with acute myocardial infarction: propensity-score matching, stratification using the propensity score, covariate adjustment using the propensity score, and weighting using the propensity score. We used propensity score methods to estimate both adjusted treated effects and the absolute and relative risk reduction in all-cause mortality. We also examined the use of statistical hypothesis testing, standardized differences, box plots, non-parametric density estimates, and quantile-quantile plots to assess residual confounding that remained after stratification or matching on the propensity score. Estimates of the absolute reduction in 3-year mortality ranged from 2.1 to 4.5 per cent, while estimates of the relative risk reduction ranged from 13.3 to 17.0 per cent. Adjusted estimates of the reduction in the odds of 3-year death varied from 15 to 24 per cent across the different propensity score methods.",0,1 +1221,Cost-Effectiveness Analysis Using Data from Multinational Trials: The Use of Bivariate Hierarchical Modeling,"Health care cost-effectiveness analysis (CEA) often uses individual patient data (IPD) from multinational randomized controlled trials. Although designed to account for between-patient sampling variability in the clinical and economic data, standard analytical approaches to CEA ignore the presence of between-location variability in the study results. This is a restrictive limitation given that countries often differ in factors that could affect the results of CEAs, such as the availability of health care resources, their unit costs, clinical practice, and patient case mix. The authors advocate the use of Bayesian bivariate hierarchical modeling to analyze multinational cost-effectiveness data. This analytical framework explicitly recognizes that patient-level costs and outcomes are nested within countries. Using real-life data, the authors illustrate how the proposed methods can be applied to obtain (a) more appropriate estimates of overall cost-effectiveness and associated measure of sampling uncertainty compared to standard CEA and (b) country-specific cost-effectiveness estimates that can be used to assess the between-location variability of the study results while controlling for differences in country-specific and patientspecific characteristics. It is demonstrated that results from standard CEA using IPD from multinational trials display a large degree of variability across the 17 countries included in the analysis, producing potentially misleading results. In contrast, ``shrinkage estimates'' obtained from the modeling approach proposed here facilitate the appropriate quantification of country-specific cost-effectiveness estimates while weighting the results based on the level of information available within each country. The authors suggest that the methods presented here represent a general framework for the analysis of economic data collected from different locations.",0,1 +1222,Predicting Purchase Decisions with Different Conjoint Analysis Methods: A Monte Carlo Simulation,"To forecast purchase decisions, different conjoint-based approaches have been discussed. Nevertheless, there is no clear evidence on which variant performs best. This study uses a Monte Carlo simulation to systematically compare different choice-based models and different models of a modified traditional conjoint variant, namely limit conjoint analysis (LCA), which allows for integrating choice decisions. All models compared, except the aggregate logit model, are rather robust. However, the hierarchical Bayes approaches perform best with both choice-based and limit data. The limit models are more efficient than those based on choice data. Thus, to predict purchase decision in practice, the limit hierarchical Bayes model should be considered first. © 2007 The Market Research Society. https://www.mrs.org.uk/ijmr_article/article/85657",0,1 +1223,Another 'futile quest'? A simulation study of Yang and Land's Hierarchical Age-Period-Cohort model,"Background: Whilst some argue that a solution to the age-period-cohort (APC) 'identification problem' is impossible, numerous methodological solutions have been proposed, including Yang and Land's Hierarchical-APC (HAPC) model: a multilevel model considering periods and cohorts as cross-classified contexts in which individuals exist. Objective: To assess the assumptions made by the HAPC model, and the situations in which it does and does not work. Methods: Simulation study. Simulation scenarios assess the effect of (a) cohort trends in the Data Generating Process (DGP) (compared to only random variation), and (b) grouping cohorts (in both DGP and fitted model). Results: The model only works if either (a) we can assume that there are no linear (or non-linear) trends in periods or cohorts, (b) we control any cohort trend in the model's fixed part and assume there is no period trend, or (c) we group cohorts in such a way that they exactly match the groupings in the (unknown) DGP. Otherwise, the model can arbitrarily reapportion APC effects, radically impacting interpretation. Conclusions: Since the purpose of APC analysis is often to ascertain the presence of period and/or cohort trends, and since we rarely have solid (if any) theory regarding cohort groupings, there are few circumstances in which this model achieves what Yang and Land claim it can. The results bring into question findings of several published studies using the HAPC model. However, the structure of the model remains a conceptual advance that is useful when we can assume the DGP has no period trends.",0,1 +1224,Evidence-based sample size calculations based upon updated meta-analysis,"Meta-analyses of randomized controlled trials (RCTs) provide the highest level of evidence regarding the effectiveness of interventions and as such underpin much of evidence-based medicine. Despite this, meta-analyses are usually produced as observational by-products of the existing literature, with no formal consideration of future meta-analyses when individual trials are being designed. Basing the sample size of a new trial on the results of an updated meta-analysis which will include it, may sometimes make more sense than powering the trial in isolation. A framework for sample size calculation for a future RCT based on the results of a meta-analysis of the existing evidence is presented. Both fixed and random effect approaches are explored through an example. Bayesian Markov Chain Monte Carlo simulation modelling is used for the random effects model since it has computational advantages over the classical approach. Several criteria on which to base inference and hence power are considered. The prior expectation of the power is averaged over the prior distribution for the unknown true treatment effect. An extension to the framework allowing for consideration of the design for a series of new trials is also presented. Results suggest that power can be highly dependent on the statistical model used to meta-analyse the data and even very large studies may have little impact on a meta-analysis when there is considerable between study heterogeneity. This raises issues regarding the appropriateness of the use of random effect models when designing and drawing inferences across a series of studies.",0,1 +1225,Analytic Estimation of Standard Error and Confidence Interval for Scale Reliability,"An analytic approach to standard error and confidence interval estimation of scale reliability with fixed congeneric measures is proposed that is based on a generally applicable estimator stability evaluation procedure, the delta method (e.g., Ogasawara, 1999). The approach complements wide-spread point estimation of composite reliability in behavioral scale construction and development, and can be used to evaluate precision of estimates and plausible ranges for reliability of multiple-component instruments in studied populations. The method is illustrated by means of a numerical example.",0,1 +1226,Bayesian designs for hierarchical linear models,"Two Bayesian optimal design criteria for hierarchical linear models are discussed – the ?? criterion for the estimation of individual-level parameters ?, and the ?? criterion for the estimation of hyperparameters ?. We focus on a specific case in which all subjects receive the same set of treatments and in which the covariates are independent of treatments. We obtain the explicit structure of ??- and ??- optimal continuous (approximate) designs for the case of independent random effects, and for some special cases of correlated random effects. Through examples and simulations, we compare ??- and ??-optimal designs under more gen- eral scenarios of correlated random effects. While orthogonal designs are often ??-optimal even when the random effects are correlated, ??-optimal designs tend to be nonorthogonal and unbalanced. In our study of the robustness of ??- and ??-optimal designs, both types of designs are found to be insensitive to various specifications of the response errors and the vari- ances of the random effects, but sensitive to the specifications of the signs of the correlations of the random effects.",0,1 +1227,Surveying Cultures,"Surveying Cultures uniquely employs techniques rooted in survey methodology to discover cultural patterns in social science research. Examining both classical and emerging methods that are used to survey and assess differing norms among populations, the book successfully breaks new ground in the field, introducing a theory of measurement for ethnographic studies that employs the consensus-as-culture model. The book begins with a basic overview of cross-cultural measurement of sentiments and presents innovative and sophisticated analyses of measurement issues and of homogeneity among respondents. Subsequent chapters explore topics that are at the core of successful data collection and analysis in culture studies, including: The role of bipolar scales and Internet data collection in measuring sentiments. Key methodological variables that determine the quality of quantitative data, including measurement errors, validity, and reliability. New approaches to reliability and several new methods of assessing a respondent's degree of inculcation into group culture. Sampling, coverage, nonresponse, and measurement errors, with an in-depth discussion of their occurrence in culture surveys, their impact assessments, and how current measurement techniques are constructed to help prevent these kinds of errors. Common problems often encountered in the acquisition and communication of data, including identifying error variances, interpreting gender differences in responses, and defining the difference between cultures and subcultures. Throughout the book, each topic is accompanied by a review of related methodological literature. For many of the presented concepts, the author includes a formal analysis of the related issues in measuring cultural norms and reports on analyses. Each chapter concludes with an organized list of major findings as well as an insightful outline of specific recommendations regarding practical problems in culture studies. Surveying Cultures serves as a valuable supplemental book to courses on survey and research methods at the upper-undergraduate and graduate levels. It is also an excellent reference for researchers in the fields of sociology, anthropology, psychology, and political science. © 2010 John Wiley & Sons, Inc.",0,1 +1228,"Bayesian Modal Estimation of the Four-Parameter Item Response Model in Real, Realistic, and Idealized Data Sets","In this study, we explored item and person parameter recovery of the four-parameter model (4PM) in over 24,000 real, realistic, and idealized data sets. In the first analyses, we fit the 4PM and three alternative models to data from three Minnesota Multiphasic Personality Inventory-Adolescent form factor scales using Bayesian modal estimation (BME). Our results indicated that the 4PM fits these scales better than simpler item Response Theory (IRT) models. Next, using the parameter estimates from these real data analyses, we estimated 4PM item parameters in 6,000 realistic data sets to establish minimum sample size requirements for accurate item and person parameter recovery. Using a factorial design that crossed discrete levels of item parameters, sample size, and test length, we also fit the 4PM to an additional 18,000 idealized data sets to extend our parameter recovery findings. Our combined results demonstrated that 4PM item parameters and parameter functions (e.g., item response functions) can be accurately estimated using BME in moderate to large samples (N ⩾ 5, 000) and person parameters can be accurately estimated in smaller samples (N ⩾ 1, 000). In the supplemental files, we report annotated [Formula: see text] code that shows how to estimate 4PM item and person parameters in [Formula: see text] (Chalmers, 2012 ).",0,1 +1229,Multilevel analysis quantifies variation in the experimental effect while optimizing power and preventing false positives,"In neuroscience, experimental designs in which multiple measurements are collected in the same research object or treatment facility are common. Such designs result in clustered or nested data. When clusters include measurements from different experimental conditions, both the mean of the dependent variable and the effect of the experimental manipulation may vary over clusters. In practice, this type of cluster-related variation is often overlooked. Not accommodating cluster-related variation can result in inferential errors concerning the overall experimental effect.The exact effect of ignoring the clustered nature of the data depends on the effect of clustering. Using simulation studies we show that cluster-related variation in the experimental effect, if ignored, results in a false positive rate (i.e., Type I error rate) that is appreciably higher (up to ~20-~50 %) than the chosen [Formula: see text]-level (e.g., [Formula: see text] = 0.05). If the effect of clustering is limited to the intercept, the failure to accommodate clustering can result in a loss of statistical power to detect the overall experimental effect. This effect is most pronounced when both the magnitude of the experimental effect and the sample size are small (e.g., ~25 % less power given an experimental effect with effect size d of 0.20, and a sample size of 10 clusters and 5 observations per experimental condition per cluster).When data is collected from a research design in which observations from the same cluster are obtained in different experimental conditions, multilevel analysis should be used to analyze the data. The use of multilevel analysis not only ensures correct statistical interpretation of the overall experimental effect, but also provides a valuable test of the generalizability of the experimental effect over (intrinsically) varying settings, and a means to reveal the cause of cluster-related variation in experimental effect.",0,1 +1230,Semiparametric spatio-temporal frailty modeling,"Recent developments in GIS have encouraged health science databases to incorporate geographical information about the subjects under study. Such databases have in turn generated interest among statisticians to develop and analyze models that account for spatial clustering and variation. In this article we develop a semiparametric (Cox) hierarchical Bayesian frailty model for capturing spatio-temporal heterogeneity in the survival patterns of women diagnosed with breast cancer in Iowa. In the absence of appropriate surrogates for standards of treatments and health care for cancer patients in the different counties, epidemiologists and health-care professionals are interested in discerning spatial patterns in survival from breast cancer that might be present among the counties. In addition, it is naturally of interest to see if the counties show discernible temporal trends over the years. The SEER (Surveillance Epidemiology and End Results) database from the National Cancer Institute (NCI) provides data on a cohort of breast cancer patients observed progressively through time, spanning 26 years. We implement our hierarchical spatio-temporal models on data extracted from the database for the 99 counties of Iowa. Our results suggest log-relative hazards that are generally flat initially, but steadily decrease for more recent years. Copyright © 2003 John Wiley & Sons, Ltd.",0,1 +1231,"Some Bayesian and Non-Bayesian Procedures for the Analysis of Comparative Experiments and for Small-Area Estimation: Computational Aspects, Frequentist Properties, and Relationships","Abstract The estimation of a treatment contrast from experimental data and the estimation of a small-area mean are special cases of the prediction of the realization of a linear combination of fixed and random effects in a possibly unbalanced two-part mixed linear model. In this article a Bayesian approach to point and interval prediction is presented and its computational requirements are examined. Differences between the Bayesian approach and the traditional (classical) approach are discussed in general terms and, in addition, in terms of two examples taken from the literature: (1) the comparison of drug formulations in a bioavailability trial (Westlake) and (2) the estimation of corn-crop areas using satellite data (Battese, Harter, and Fuller). Some deficiencies in the classical approach are pointed out, and the Bayesian approach is considered from a frequentist perspective. It is shown, via a Monte Carlo study, that, for certain (noninformative) choices of the prior distribution, the frequentist prop...",0,1 +1232,Trust in Typical and High-Reliability Contexts: Building and Reacting to Trust among Firefighters,We develop theory that distinguishes trust among employees in typical task contexts (marked by low levels of situational unpredictability and danger) from trust in “high-reliability” task contexts ...,0,1 +1233,Estimation of maximal reliability: A note on a covariance structure modelling approach,"A one-step covariance structure analysis procedure for estimation of maximal reliability of linear composites with congeneric measures is outlined. The approach is readily employed within a single modelling session using popular covariance structure analysis software, and permits simultaneous estimation of the optimal measure weights with standard errors. The method is illustrated by a numerical example.",0,1 +1234,An introduction to Bayesian statistics in health psychology,"The aim of the current article is to provide a brief introduction to Bayesian statistics within the field of health psychology. Bayesian methods are increasing in prevalence in applied fields, and they have been shown in simulation research to improve the estimation accuracy of structural equation models, latent growth curve (and mixture) models, and hierarchical linear models. Likewise, Bayesian methods can be used with small sample sizes since they do not rely on large sample theory. In this article, we discuss several important components of Bayesian statistics as they relate to health-based inquiries. We discuss the incorporation and impact of prior knowledge into the estimation process and the different components of the analysis that should be reported in an article. We present an example implementing Bayesian estimation in the context of blood pressure changes after participants experienced an acute stressor. We conclude with final thoughts on the implementation of Bayesian statistics in health psychology, including suggestions for reviewing Bayesian manuscripts and grant proposals. We have also included an extensive amount of online supplementary material to complement the content presented here, including Bayesian examples using many different software programmes and an extensive sensitivity analysis examining the impact of priors.",0,1 +1235,Group reaction time distributions and an analysis of distribution statistics.,"A method of obtaining an average reaction time distribution for a group of subjects is described. The method is particularly useful for cases in which data from many subjects are available but there are only 10-20 reaction time observations per subject cell. Essentially, reaction times for each subject are organized in ascending order, and quantiles are calculated. The quantiles are then averaged over subjects to give group quantiles (cf. Vincent learning curves). From the group quantiles, a group reaction time distribution can be constructed. It is shown that this method of averaging is exact for certain distributions (i.e., the resulting distribution belongs to the same family as the individual distributions). Furthermore, Monte Carlo studies and application of the method to the combined data from three large experiments provide evidence that properties derived from the group reaction time distribution are much the same as average properties derived from the data of individual subjects. This article also examines how to quantitatively describe the shape of reaction time distributions. The use of moments and cumulants as sources of information about distribution shape is evaluated and rejected because of extreme dependence on long, outlier reaction times. As an alternative, the use of explicit distribution functions as approximations to reaction time distributions is considered.",0,1 +1236,An experimental investigation of the role of negative mood in worry: The role of appraisals that facilitate systematic information processing,"Negative mood is associated with increased worry levels, and also with deployment of a systematic information processing style. An experimental study assessed the potential role of systematic information processing in mediating the facilitative effect of negative mood on worry (e.g. Johnston & Davey, 1997).Participants underwent appropriate vignette-based mood inductions (negative, neutral, and cognitive priming). Participants completed visual analogue scales measuring variables that reflect a raised processing sufficiency threshold and are known to increase systematic processing (responsibility, accountability, desire for control, and need for cognition), a measure of 'as many as can' worry stop rule deployment, and two measures of worry (the catastrophising interview and the Penn State Worry Questionnaire, PSWQ, Meyer, Miller, Metzger, & Borkovec, 1990).Experimentally-induced negative mood facilitated the endorsement of cognitive appraisals known to increase systematic as opposed to heuristic information processing. In addition, a meditational analysis showed that the systematic processing facilitators measure together with a measure of 'as many as can' worry stop rule deployment fully mediated the relationship between negative mood and a measure of worry frequency (PSWQ).Future studies should develop and validate direct measures of systematic processing.Similarities and differences between systematic processing and chronic worrying as effortful forms of information processing are discussed, and a role for systematic processing as an information processing style relevant to understanding worrisome thought is described.",0,1 +1237,Education Policy and Educational Inequality--Evidence from the Swiss Laboratory,"This article examines how the different education policies in the subnational units of Switzerland - the cantons - affect educational inequality. The article builds on previous research arguing that in order to properly evaluate education policy and its outcomes in decentralized countries, regional disparities must been taken into account. Switzerland has one of the most decentralized education systems in the world and is thus an exemplary case for a subnational analysis. Applying multilevel models the article illustrates that small class size, public investments in education as well as the mobility between ability groups are related to a lower degree of educational inequality. In contrast, longer schooldays strengthen inequality in education, implying that school instruction in the Swiss cantons does not provide equal opportunities to pupils irrespective of social class. © 2011 The Author. Published by Oxford University Press. All rights reserved.",0,1 +1238,Latent variable modeling in heterogeneous populations,"Common applications of latent variable analysis fail to recognize that data may be obtained from several populations with different sets of parameter values. This article describes the problem and gives an overview of methodology that can address heterogeneity. Artificial examples of mixtures are given, where if the mixture is not recognized, strongly distorted results occur. MIMIC structural modeling is shown to be a useful method for detecting and describing heterogeneity that cannot be handled in regular multiple-group analysis. Other useful methods instead take a random effects approach, describing heterogeneity in terms of random parameter variation across groups. These random effects models connect with emerging methodology for multilevel structural equation modeling of hierarchical data. Examples are drawn from educational achievement testing, psychopathology, and sociology of education. Estimation is carried out by the LISCOMP program.",0,1 +1239,"Modeling Annual Growth Variation using a Hierarchical Bayesian Approach and the von Bertalanffy Growth Function, with Application to Lake Trout in Southern Lake Huron","We compared two models for time-varying growth using a hierarchical Bayesian approach to inference. Both models were derived from the same time-invariant von Bertalanffy growth function (VBGF), and our model comparisons were based on the deviance information criterion. We fit models to length and age data for 15,675 individual lake trout Salvelinus namaycush collected during annual spring gill-net surveys in southern Lake Huron from 1976 to 2004. We found that a model structured with both year and cohort effects outperformed a model that only used the same year-specific VBGF parameters for all age-groups. For the better model, the full version that allowed all VBGF parameters to vary over time also outperformed alternatives for which some parameters were constant. Length at age changed greatly over the 1976-2004 period, and in some years different ages changed in different directions. These complex patterns, which were due to the combination of cohort-specific growth and year-specific changes in growth environment, were well captured by our model. When we modeled growth as varying over time, inferences about VBGF parameters differed between the two models, and correlations among VBGF parameters also differed from the usually reported relations based on time-invariant models.",0,1 +1240,"Group Climate, Cohesion, Alliance, and Empathy in Group Psychotherapy: Multilevel Structural Equation Models.","This study examined the definitional and statistical overlap among 4 key group therapeutic relationship constructs—group climate, cohesion, alliance, and empathy—across member–member, member–group, and member–leader relationships. Three multilevel structural equation models were tested using selfreport measures completed by 662 participants from 111 counseling center and personal growth groups. As hypothesized, almost all measures of therapeutic relationship were significantly correlated. Hypothesized 1-factor, 2-factor (Working and Bonding factors), and 3-factor (Member, Leader, and Group factors) models did not fit the data adequately. An exploratory model with Bonding, Working, and Negative factors provided the best fit to the data. Group members distinguished among relationships primarily according to relationship quality rather than the status or role of others (i.e., leader, member, or whole group).",0,1 +1241,Improving costing methods in multicentre economic evaluation: the use of multiple imputation for unit costs,"Economic evaluations must use appropriate costing methods. However, in multicentre cost-effectiveness analyses (CEA) a fundamental issue of how best to measure and analyse unit costs has been neglected. Multicentre CEA commonly take the mean unit cost from a national database, such as NHS reference costs. This approach does not recognise that unit costs vary across centres and are unavailable in some centres. This paper proposes the use of multiple imputation (MI) to predict those centre-specific unit costs that are not available, while recognising the statistical uncertainty surrounding this imputation.We illustrate MI with a CEA of a multicentre randomised trial (1014 patients, 60 centres), implemented using multilevel modelling. We use MI to derive centre-specific unit costs, based on centre characteristics including average casemix, and compare this to using mean NHS reference costs. In this case study, using MI unit costs rather than mean reference costs led to less heterogeneity across centres, more precise estimates of incremental cost, but similar estimates of incremental cost-effectiveness.We conclude that using MI to predict unit costs can preserve correlations, maximise the use of available data, and, when combined with multilevel modelling is an appropriate method for recognising the statistical uncertainty in multicentre CEA.",0,1 +1242,"Cost-Effectiveness Analysis of Linezolid, Daptomycin, and Vancomycin in Methicillin-Resistant Staphylococcus aureus: Complicated Skin and Skin Structure Infection Using Bayesian Methods for Evidence Synthesis","Methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and skin structure infection (cSSSI) is a prominent infection encountered in hospital and outpatient settings that is associated with high resource use for the health-care system.A decision analytic (DA) model was developed to evaluate the cost-effectiveness analysis (CEA) of linezolid, daptomycin, and vancomycin in MRSA cSSSI.Bayesian methods for evidence synthesis were used to generate efficacy and safety parameters for a DA model using published clinical trials. CEA was done from the US health-care perspective. Efficacy was defined as a successfully treated patient at the test of cure without any adverse reaction. Primary outcome was the incremental cost-effectiveness ratio between linezolid and vancomycin, daptomycin and vancomycin, and linezolid and daptomycin in MRSA cSSSI. Univariate and probabilistic sensitivity analyses were performed to test the robustness of the model.The total direct costs of linezolid, daptomycin, and vancomycin were $18,057, $20,698, and $23,671, respectively. The cost-effectiveness ratios for linezolid, daptomycin, and vancomycin were $37,604, $44,086, and $52,663 per successfully treated patient, respectively. Linezolid and daptomycin were dominant strategies compared to vancomycin. However, linezolid was dominant when compared to daptomycin. The model was sensitive to the duration of daptomycin and linezolid treatment.Linezolid and daptomycin are potentially cost-effective based on the assumptions of the DA model; however, linezolid appears to be more cost-effective compared to daptomycin and vancomycin for MRSA cSSSIs.",0,1 +1243,Bayesian item selection criteria for adaptive testing,Owen (1975) proposed an approximate empirical Bayes procedure for item selection in computerized adaptive testing (CAT). The procedure replaces the true posterior by a normal approximation with closed-form expressions for its first two moments. This approximation was necessary to minimize the computational complexity involved in a fully Bayesian approach but is no longer necessary given the computational power currently available for adaptive testing. This paper suggests several item selection criteria for adaptive testing which are all based on the use of the true posterior. Some of the statistical properties of the ability estimator produced by these criteria are discussed and empirically characterized.,0,1 +1244,Robustness issues in multilevel regression analysis,"A multilevel problem concerns a population with a hierarchical structure. A sample from such a population can be described as a multistage sample. First, a sample of higher level units is drawn (e.g. schools or organizations), and next a sample of the sub-units from the available units (e.g. pupils in schools or employees in organizations). In such samples, the individual observations are in general not completely independent. Multilevel analysis software accounts for this dependence and in recent years these programs have been widely accepted. Two problems that occur in the practice of multilevel modeling will be discussed. The first problem is the choice of the sample sizes at the different levels. What are sufficient sample sizes for accurate estimation? The second problem is the normality assumption of the level-2 error distribution. When one wants to conduct tests of significance, the errors need to be normally distributed. What happens when this is not the case? In this paper, simulation studies are used to answer both questions. With respect to the first question, the results show that a small sample size at level two (meaning a sample of 50 or less) leads to biased estimates of the second-level standard errors. The answer to the second question is that only the standard errors for the random effects at the second level are highly inaccurate if the distributional assumptions concerning the level-2 errors are not fulfilled. Robust standard errors turn out to be more reliable than the asymptotic standard errors based on maximum likelihood.",0,1 +1245,Properties of Ability Estimation Methods in Computerized Adaptive Testing,"Simulations of computerized adaptive tests (CATs) were used to evaluate results yielded by four commonly used ability estimation methods: maximum likelihood estimation (MLE) and three Bayesian approaches—Owen's method, expected a posteriori (EAP), and maximum a posteriori. In line with the theoretical nature of the ability estimates and previous empirical research, the results showed clear distinctions between MLE and the Bayesian methods, with MLE yielding lower bias, higher standard errors, higher root mean square errors, lower fidelity, and lower administrative efficiency. Standard errors for MLE based on test information underestimated actual standard errors, whereas standard errors for the Bayesian methods based on posterior distribution standard deviations accurately estimated actual standard errors. Among the Bayesian methods, Owen's provided the worst overall results, and EAP provided the best. Using a variable starting rule in which examinees were initially classified into three broad/ability groups greatly reduced the bias for the Bayesian methods, but had little effect on the results for MLE. On the basis of these results, guidelines are offered for selecting appropriate CAT ability estimation methods in different decision contexts.",0,1 +1246,General Design Bayesian Generalized Linear Mixed Models,"Linear mixed models are able to handle an extraordinary range of complications in regression-type analyses. Their most common use is to account for within-subject correlation in longitudinal data analysis. They are also the standard vehicle for smoothing spatial count data. However, when treated in full generality, mixed models can also handle spline-type smoothing and closely approximate kriging. This allows for nonparametric regression models (e.g., additive models and varying coefficient models) to be handled within the mixed model framework. The key is to allow the random effects design matrix to have general structure; hence our label general design. For continuous response data, particularly when Gaussianity of the response is reasonably assumed, computation is now quite mature and supported by the R, SAS and S-PLUS packages. Such is not the case for binary and count responses, where generalized linear mixed models (GLMMs) are required, but are hindered by the presence of intractable multivariate integrals. Software known to us supports special cases of the GLMM (e.g., PROC NLMIXED in SAS or glmmML in R) or relies on the sometimes crude Laplace-type approximation of integrals (e.g., the SAS macro glimmix or glmmPQL in R). This paper describes the fitting of general design generalized linear mixed models. A Bayesian approach is taken and Markov chain Monte Carlo (MCMC) is used for estimation and inference. In this generalized setting, MCMC requires sampling from nonstandard distributions. In this article, we demonstrate that the MCMC package WinBUGS facilitates sound fitting of general design Bayesian generalized linear mixed models in practice.",0,1 +1247,A regional estimate of postfire streamflow change in California,"The effect of fire on annual streamflow has been examined in numerous watershed studies, with some studies observing postfire increases in streamflow while other have observed no conclusive change. Despite this inherent variability in streamflow response, the management of water resources for flood protection, water supply, water quality, and the environment necessitates an understanding of postfire effects on streamflow at regional scales. In this study, the regional effect of wildfire on annual streamflow was investigated using 12 paired watersheds in central and southern California. A mixed model was used to pool and statistically examine the combined paired-watershed data, with emphasis on the effects of percentage area burned, postfire recovery of vegetation, and postfire wetness conditions on postfire streamflow change. At a regional scale, postfire annual streamflow increased 134% (82%–200%) during the first postfire year assuming 100% area burned and average annual wetness conditions. Postfire response decreased with lower percentages of percentage area burned and during subsequent years as vegetation recovered following fire. Annual streamflow response to fire was found to be sensitive to annual wetness conditions, with postfire response being smallest during dry years, greatest during wet years, and slowly decreasing during very wet years. These findings provide watershed managers with a first-order estimate for predicting postfire streamflow response in both gauged and ungauged watersheds.",0,1 +1248,What Type of Resources? Household Effects and Female Electoral Participation,"This paper investigates the relationship between socioeconomic resources and women's political participation, more precisely whether the distinction between individual and household resources helps to identify different mechanisms behind a possible “resource effect”. Based on a Bayesian multilevel analysis using the Swiss Election Study 2011, we show that both individual and household resources matter for explaining female electoral participation. However, resource effects must not necessarily be positive: While higher education of women and their partners tend to increase female participation, a demanding job of either the woman and/or her partner rather decreases her propensity to vote. Moreover, the mechanisms behind partner effects are contingent on women's individual resource endowment. While low and medium educated women most strongly profit from higher educational partner resources, i.e. from a compensatory mechanism, the resource “time” seems to particularly confine political involvement of women with both high professional status or no employment.",0,1 +1249,Formal Bayes Estimation with Application to a Random Effects Model,,0,1 +1250,Bayesian propensity score analysis for observational data,"In the analysis of observational data, stratifying patients on the estimated propensity scores reduces confounding from measured variables. Confidence intervals for the treatment effect are typically calculated without acknowledging uncertainty in the estimated propensity scores, and intuitively this may yield inferences, which are falsely precise. In this paper, we describe a Bayesian method that models the propensity score as a latent variable. We consider observational studies with a dichotomous treatment, dichotomous outcome, and measured confounders where the log odds ratio is the measure of effect. Markov chain Monte Carlo is used for posterior simulation. We study the impact of modelling uncertainty in the propensity scores in a case study investigating the effect of statin therapy on mortality in Ontario patients discharged from hospital following acute myocardial infarction. Our analysis reveals that the Bayesian credible interval for the treatment effect is 10 per cent wider compared with a conventional propensity score analysis. Using simulations, we show that when the association between treatment and confounders is weak, then this increases uncertainty in the estimated propensity scores. Bayesian interval estimates for the treatment effect are longer on average, though there is little improvement in coverage probability. A novel feature of the proposed method is that it fits models for the treatment and outcome simultaneously rather than one at a time. The method uses the outcome variable to inform the fit of the propensity model. We explore the performance of the estimated propensity scores using cross-validation. Copyright © 2008 John Wiley & Sons, Ltd.",0,1 +1251,ELEMENTAL DEPLETIONS IN THE MAGELLANIC CLOUDS AND THE EVOLUTION OF DEPLETIONS WITH METALLICITY,"We present a study of the composition of gas and dust in the Large and Small Magellanic Clouds (LMC and SMC, together -- the MCs) as measured by UV absorption spectroscopy. We have measured P II and Fe II along 85 sightlines toward the MCs using archival FUSE observations. For 16 of those sightlines, we have measured Si II, Cr II, and Zn II from new HST COS observations. We have combined these measurements with H I and H$_2$ column densities and reference stellar abundances from the literature to derive gas-phase abundances, depletions, and gas-to-dust ratios (GDRs). 80 of our 84 P measurements and 13 of our 16 Zn measurements are depleted by more than 0.1 decades, suggesting that P and Zn abundances are not accurate metallicity indicators at and above the metallicity of the SMC. The maximum P and Zn depletions are the same in the MW, LMC, and SMC. Si, Cr, and Fe are systematically less depleted in the SMC than in the MW or LMC. The minimum Si depletion in the SMC is consistent with zero. Our depletion-derived GDRs broadly agree with GDRs from the literature. The GDR varies from location to location within a galaxy by a factor of up to 2 in the LMC and up to 5 in the SMC. This variation is evidence of dust destruction and/or growth in the diffuse neutral phase of the interstellar medium.",0,1 +1252,Microcomputer-based estimation of psychophysical thresholds: The Best PEST,"A new, maximally efficient technique for measuring psychophysical thresholds (Pentland, 1980) has been implemented on the microcomputer. This PEST (parameter estimation by sequential testing) technique is the most efficient sequential parameter estimation technique possible, given that the form of the psychometric function is known. The technique is similar to but faster and more accurate than other staircase procedures and may be applied whenever staircase techniques are applicable. The “Best PEST” is easily implemented on the micro-computer; a BASIC program for the Apple II which does so is presented. The Best PEST is compared with other staircase procedures, including one recently implemented on a micro-computer (Corwin, Kintz, & Beaty, 1979).",0,1 +1253,The Problem of Negative Estimates of Variance Components,"The usefulness of variance component techniques is frequently limited by the occurrence of negative estimates of essentially positive parameters. This paper uses a restricted maximum likelihood principle to remove this objectionable characteristic for certain experimental models. Section 2 discusses certain necessary results from the theory of non-linear programming. Section 3 derives specific formulae for estimating the variance components of the random one-way and two-way classification models. The problem of determining the precision of instruments in the two instrument case is dealt with in section 4, and a surprising though not unreasonable answer is obtained. The remaining sections provide an algorithm for solving the problem of negative estimates of variance components for all random effects models whose expected mean square column may be thought of as forming a mathematical tree in a certain sense. The algorithm is as follows: Consider the minimum mean square in the entire array; if this mean square is the root of the tree then equate it to its expectation. If the minimum mean square is not the root then pool it with its predecessor. In either case the problem is reduced to an identical one having one less variable, and hence in a finite number of steps the process will yield estimates of the variance components. These estimates are non-negative and have a maximum likelihood property.",0,1 +1254,Bayesian Analysis of Linear and Nonlinear Latent Variable Models with Fixed Covariate and Ordered Categorical Data,"In this paper, ordered categorical variables are used to compare between linear and nonlinear interactions of fixed covariate and latent variables Bayesian structural equation models. Gibbs sampling method is applied for estimation and model comparison. Hidden continuous normal distribution (censored normal distribution) is used to handle the problem of ordered categorical data. Statistical inferences, which involve estimation of parameters and their standard deviations, and residuals analyses for testing the selected model, are discussed. The proposed procedure is illustrated by a simulation data obtained from R program. Analysis are done by using OpenBUGS program.",0,1 +1255,Bayesian methods for latent trait modelling of longitudinal data,"Latent trait models have long been used in the social science literature for studying variables that can only be measured indirectly through multiple items. However, such models are also very useful in accounting for correlation in multivariate and longitudinal data, particularly when outcomes have mixed measurement scales. Bayesian methods implemented with Markov chain Monte Carlo provide a flexible framework for routine fitting of a broad class of latent variable (LV) models, including very general structural equation models. However, in considering LV models, a number of challenging issues arise, including identifiability, confounding between the mean and variance, uncertainty in different aspects of the model, and difficulty in computation. Motivated by the problem of modelling multidimensional longitudinal data, this article reviews the recent literature, provides some recommendations and highlights areas in need of additional research, focusing on methods for model uncertainty.",0,1 +1256,The Beast of Aggregating Cognitive Load Measures in Technology-Based Learning.,"An increasing part of cognitive load research in technology-based learning includes a component of repeated measurements, that is: participants are measured two or more times on the same performance, mental effort or other variable of interest. In many cases, researchers aggregate scores obtained from repeated measurements to one single sum or average score per participant and use these aggregated scores in subsequent analysis. This paper demonstrates some dangers of this commonly encountered aggregation approach and presents two comprehensive alternatives: Split-plot analysis of variance (ANOVA) and more flexible two-level regression analysis. The core message of this paper is that the application of the aggregation approach can seriously distort our view of effects and relations of interest and should therefore not be used in cognitive load research. Multilevel analysis of repeated measurements data can account for various features of the data and constitutes a best practice.",0,1 +1257,An Empirical Evaluation of Mediation Effect Analysis With Manifest and Latent Variables Using Markov Chain Monte Carlo and Alternative Estimation Methods,"Recently, the Markov chain Monte Carlo (MCMC) estimation method has become explosively popular in a variety of quantitative research methods. In mediation effect analysis (MEA), the MCMC estimation methods can be a promising tool and an important alternative as compared with traditional methods (e.g., the z test using the delta method and the bias-corrected bootstrapping method) in addressing issues such as nonconvergence and complex modeling. In this article, a subject-level MCMC approach for the single MEA is empirically evaluated and compared with traditional methods through Monte Carlo simulation. The evaluation covers point and interval estimates of both manifest and latent variables across conditions including sample size, effect size, and magnitude of factor loadings. BUGS codes for MEA with both manifest and latent variables are provided that can be easily adapted to fit various MEA models in practice.",1,1 +1258,A MULTIVARIATE PROBIT LATENT VARIABLE MODEL FOR ANALYZING DICHOTOMOUS RESPONSES,"We propose a multivariate probit model that is dened by a conrmatory factor analysis model with covariates for analyzing dichotomous data in medical re- search. Our proposal is a generalization of several useful multivariate probit models, and provides a exible framework for practical applications. We implement a Monte Carlo EM algorithm for maximum likelihood estimation of the model, and develop a path sampling procedure to compute the observed-data log-likelihood for evalu- ating the Bayesian Information Criterion for model comparison. Our methodology is illustrated by analyzing two data sets in medical research.",0,1 +1259,Exposure of sheep to mosquito bites: possible consequences for the transmission risk of Rift Valley Fever in Senegal,"Abstract. Rift Valley Fever (RVF) is a growing health problem in West Africa. In northern Senegal, the candidate vectors of this arbovirosis are Aedes (Aedimorphus) vexans Meigen and Culex (Culex) poicilipes Theobald (Diptera: Culicidae). Domestic ruminants are the reservoirs of the virus. A study was undertaken during the 2002 rainy season to assess spatial and temporal variations in exposure to mosquito bites in sheep herds, and to evaluate the possible consequences on the risk of RVF transmission to sheep. Mosquitoes were collected with sheep-baited traps. The number of Ae. vexans females (the predominant species during the 2002 rainy season) trapped per trap-night was the dependent variable in statistical analyses. The trapping periods were divided into six series of two to five consecutive days, from July to November 2002. Three temporary ponds were selected according to their ecological features: depth, bank slope, size and vegetation cover. Traps were laid on the pond bank and in the nearest available compound, close to the sheep night pen. Data were analysed using mixed-effects Poisson models. The explanatory variables were the trapping period, the pond, and the capture site. The exposure to mosquito bites varied according to the pond type, suggesting that the risk of transmission was spatially heterogeneous. However, there was no obvious trend in transmission risk due to the effect of the distance from the compound to the pond. The period with the highest exposure was in October, i.e. when transhumant herds left the Ferlo to relocate to their dry-season settlement. It is thus hypothesized that transhumance, the seasonal movements of herds, plays a significant role in the dissemination of RVF virus in the region.",0,1 +1260,Principal Stratification Approach to Broken Randomized Experiments,"The precarious state of the educational system in the inner cities of the United States, as well as its potential causes and solutions, have been popular topics of debate in recent years. Part of the difficulty in resolving this debate is the lack of solid empirical evidence regarding the true impact of educational initiatives. The efficacy of so-called “school choice” programs has been a particularly contentious issue. A current multimillion dollar program, the School Choice Scholarship Foundation Program in New York, randomized the distribution of vouchers in an attempt to shed some light on this issue. This is an important time for school choice, because on June 27, 2002 the U.S. Supreme Court upheld the constitutionality of a voucher program in Cleveland that provides scholarships both to secular and religious private schools. Although this study benefits immensely from a randomized design, it suffers from complications common to such research with human subjects: noncompliance with assigned “treatmen...",0,1 +1261,Multilevel Covariance Structure Analysis,"This article gives an introduction to some new techniques for multilevel covariance structure modeling with latent variables. Although these techniques only incorporate a subset of models that are relevant to multilevel data, the techniques do provide a large set of new analysis possibilities and have the advantage that they only require conventional structural equation modeling software. The presentation draws on methodology presented in earlier works by the author.",0,1 +1262,Invited Commentary: Pushing the Mediation Envelope,"The very insightful and clear paper by VanderWeele and Vansteelandt in this issue of the Journal (Am J Epidemiol. 2010;172(12):1339-1348) bridges the gap between biostatistics methodologists focusing on causal methods for mediation analyses and the practitioners of mediational analyses to the benefit of both groups. In an effort to continue the bridging of this gap, this invited commentary relates the important issue of ""natural direct effects"" to the well-known epidemiologic method of direct standardization. Additionally, attention is paid to the importance of temporal sequencing to help substantiate the mediation relations among the exposure, mediation, and outcome. A crucial mathematical distortion under the logistics model, called ""absence of collapsibility,"" is noted in motivating VanderWeele and Vansteelandt's use of the log-linear model for comparing the effect of exposure adjusted for the mediator with the effect of exposure unadjusted for the mediator. It is also noted that this issue applies to one approach to assessing confounding. Finally, some issues are raised for consideration when testing the interaction between the exposure and mediator before assessing mediation.",0,1 +1263,Limiting the Risk of Bayes and Empirical Bayes Estimators—Part II: The Empirical Bayes Case,Abstract We discuss compromises between Stein's estimator and the MLE which limit the risk to individual components of the estimation problem while sacrificing only a small fraction of the savings in total squared error loss given by Stein's rule. The compromise estimators “limit translation” away from the MLE. The calculations are pursued in an empirical Bayesian manner by considering their performance against an entire family of prior distributions on the unknown parameters.,0,1 +1264,A comparison of two response time models applied to perceptual matching,"Two models, a Poisson race model and a diffusion model, are fit to data from a perceptual matching task. In each model, information about the similarity or the difference between two stimuli accumulates toward thresholds for either response. Stimulus variables are assumed to influence the rate at which information accumulates, and response variables are assumed to influence the level of the response thresholds. Three experiments were conducted to assess the performance of each model. In Experiment 1, observers performed under different response deadlines; in Experiment 2, response bias was manipulated by changing the relative frequency of same and different stimuli. In Experiment 3, stimulus pairs were presented at three eccentricities: foveal, parafoveal, and peripheral. We examined whether the race and diffusion models could fit the response time and accuracy data through changes only in response parameters (for Experiments 1 and 2) or stimulus parameters (for Experiment 3). Comparisons between the two models suggest that the race model, which has not been studied extensively, can account for perceptual matching data at least as well as the diffusion model. Furthermore, without the constraints on the parameters provided by the experimental conditions, the diffusion and the race models are indistinguishable. This finding emphasizes the importance of fitting models across several conditions and imposing logical psychological constraints on the parameters of models.",0,1 +1265,A Joint Modeling Approach for Reaction Time and Accuracy in Psycholinguistic Experiments,"In the psycholinguistic literature, reaction times and accuracy can be analyzed separately using mixed (logistic) effects models with crossed random effects for item and subject. Given the potential correlation between these two outcomes, a joint model for the reaction time and accuracy may provide further insight. In this paper, a Bayesian hierarchical framework is proposed that allows estimation of the correlation between time intensity and difficulty at the item level, and between speed and ability at the subject level. The framework is shown to be flexible in that reaction times can follow a (log-) normal or (shifted) Weibull distribution. A simulation study reveals the reduction in bias gains possible when using joint models, and an analysis of an example from a Dutch–English word recognition study illustrates the proposed method.",0,1 +1266,High-dimensional Exploratory Item Factor Analysis by A Metropolis–Hastings Robbins–Monro Algorithm,"A Metropolis–Hastings Robbins–Monro (MH-RM) algorithm for high-dimensional maximum marginal likelihood exploratory item factor analysis is proposed. The sequence of estimates from the MH-RM algorithm converges with probability one to the maximum likelihood solution. Details on the computer implementation of this algorithm are provided. The accuracy of the proposed algorithm is demonstrated with simulations. As an illustration, the proposed algorithm is applied to explore the factor structure underlying a new quality of life scale for children. It is shown that when the dimensionality is high, MH-RM has advantages over existing methods such as numerical quadrature based EM algorithm. Extensions of the algorithm to other modeling frameworks are discussed.",0,1 +1267,Standardized Effect Size Measures for Mediation Analysis in Cluster-Randomized Trials,"This article presents 3 standardized effect size measures to use when sharing results of an analysis of mediation of treatment effects for cluster-randomized trials. The authors discuss 3 examples of mediation analysis (upper-level mediation, cross-level mediation, and cross-level mediation with a contextual effect) with demonstration of the calculation and interpretation of the effect size measures using a simulated dataset and an empirical dataset from a cluster-randomized trial of peer tutoring. SAS syntax is provided for parametric percentile bootstrapped confidence intervals of the effect sizes. The use of any of the 3 standardized effect size measures depends on the nature of the inference the researcher wishes to make within a single site, across the broad population, or at the site level.",0,1 +1268,Latent variable models with mixed continuous and polytomous data,"Owing to the nature of the problems and the design of questionnaires, discrete polytomous data are very common in behavioural, medical and social research. Analysing the relationships between the manifest and the latent variables based on mixed polytomous and continuous data has proven to be difficult. A general structural equation model is investigated for these mixed outcomes. Maximum likelihood (ML) estimates of the unknown thresholds and the structural parameters in the covariance structure are obtained. A Monte Carlo-EM algorithm is implemented to produce the ML estimates. It is shown that closed form solutions can be obtained for the M-step, and estimates of the latent variables are produced as a by-product of the analysis. The method is illustrated with a real example.",0,1 +1269,Covariance components models for longitudinal family data,"A longitudinal family study is an epidemiological design that involves repeated measurements over time in a sample that includes families. Such studies, that may also include relative pairs and unrelated individuals, allow closer investigation of not only the factors that cause a disease to arise, but also the genetic and environmental determinants that modulate the subsequent progression of that disease. Knowledge of such determinants may pay high dividends in terms of prognostic assessment and in the development of new treatments that may be tailored to the prognostic profile of individual patients. Unfortunately longitudinal family studies are difficult to analyse. They conflate the complex within-family correlation structure of a cross-sectional family study with the correlation over time that is intrinsic to longitudinal repeated measures. Here we describe an approach to analysis that is relatively straightforward to implement, yet is flexible in its application. It represents a natural extension of a Gibbs-sampling-based approach to the analysis of cross-sectional family studies that we have described previously. The approach can be applied to pedigrees of arbitrary complexity. It is applicable to continuous traits, repeated binary disease states, and repeated counts or rates with a Poisson distribution. It not only supports the analysis of observed determinants, including measured genotypes, but also allows decomposition of the correlation structure, thereby permitting conclusions to be drawn about the effect of unobserved genes and environment on key features of disease progression, and hence to estimate the heritability of these features. We demonstrate the efficacy of our methods using a range of simulated data analyses, and illustrate its practical application to longitudinal blood pressure data measured in families from the Framingham Heart Study.",0,1 +1270,A closer look at combining data among a small number of binomial experiments,"In a regulatory environment, the regulators and the regulated may not be able to agree on the use of subjective prior information for a clinical trial. The use of a data-based prior offers a greater possibility for agreement, however, the degree of importance given to the prior data may still be contentious. The use of a hierarchical model to link the prior data and the current trial is shown to provide a relatively objective method for assigning weight to the prior data. Using a series of examples combining two binomial experiments, the effect of a hierarchical model on estimating rates, on the degree to which data is combined and on hypothesis testing is illustrated. In addition, the phenomenon in which combining data reduces the precision is explained. Simpler models based on finite mixtures of beta distributions are shown to work as well as the more computationally intensive, continuous mixtures. Lastly, an example combining three concurrent studies is illustrated. Published in 2001 by John Wiley & Sons, Ltd.",0,1 +1271,A test for the increasing convex order based on the cumulative residual entropy,"The complete cumulative residual entropy can be generalized to the incomplete cumulative residual entropy (ICRE). In this paper, we introduce a partial ordering in terms of ICRE. The relationship between this ordering and some important orderings of lifetime distributions are investigated. We use this order to establish a test statistic for testing the stochastic equality against increasing convex order alternative. The performance of the test statistic is evaluated using a simulation study. Finally, a numerical example illustrating the theory is also given. © 2015 The Korean Statistical Society.",0,1 +1272,Contributions to factor analysis of dichotomous variables,"A new method is proposed for the factor analysis of dichotomous variables. Similar to the method of Christoffersson this uses information from the first and second order proportions to fit a multiple factor model. Through a transformation into a new set of sample characteristics, the estimation is considerably simplified. A generalized least-squares estimator is proposed, which asymptotically is as efficient as the corresponding estimator of Christoffersson, but which demands less computing time. © 1978 Psychometric Society.",0,1 +1273,A Shrinkage Approach to Large-Scale Covariance Matrix Estimation and Implications for Functional Genomics,"Inferring large-scale covariance matrices from sparse genomic data is an ubiquitous problem in bioinformatics. Clearly, the widely used standard covariance and correlation estimators are ill-suited for this purpose. As statistically efficient and computationally fast alternative we propose a novel shrinkage covariance estimator that exploits the Ledoit-Wolf (2003) lemma for analytic calculation of the optimal shrinkage intensity.Subsequently, we apply this improved covariance estimator (which has guaranteed minimum mean squared error, is well-conditioned, and is always positive definite even for small sample sizes) to the problem of inferring large-scale gene association networks. We show that it performs very favorably compared to competing approaches both in simulations as well as in application to real expression data.",0,1 +1274,The Impact of Inaccurate “Informative” Priors for Growth Parameters in Bayesian Growth Mixture Modeling,"Within Bayesian estimation, prior distributions are placed on model parameters and these distributions can take on many different levels of informativeness. Although much of the research conducted within this estimation framework uses what are called diffuse (or noninformative) priors, there are certain models and modeling circumstances where it is more optimal to use what are referred to as informative priors. This study focuses on the latter situation and examines the effects of inaccurate informative priors on the growth parameters within the context of growth mixture modeling. Overall, results indicated that growth mixture modeling is relatively robust to the use of inaccurate mean hyperparameters for the growth parameters, as long as the variance hyperparameters are somewhat large.",0,1 +1275,Emotional Inertia and Psychological Maladjustment,"In this article, we examine the concept of emotional inertia as a fundamental property of the emotion dynamics that characterize psychological maladjustment. Emotional inertia refers to the degree to which emotional states are resistant to change. Because psychological maladjustment has been associated with both emotional underreactivity and ineffective emotion-regulation skills, we hypothesized that its overall emotion dynamics would be characterized by high levels of inertia. We provide evidence from two naturalistic studies that, using different methods, showed that the emotional fluctuations of individuals who exhibited low self-esteem (Study 1) and depression (Study 2) were characterized by higher levels of inertia in both positive and negative emotions than the emotional fluctuations of people who did not exhibit low self-esteem and depression. We also discuss the usefulness of the concept of emotional inertia as a hallmark of maladaptive emotion dynamics.",0,1 +1276,The Impartiality of International Judges: Evidence from the European Court of Human Rights,"Can international judges be relied upon to resolve disputes impartially? If not, what are the sources of their biases? Answers to these questions are critically important for the functioning of an emerging international judiciary, yet we know remarkably little about international judicial behavior. An analysis of a new dataset of dissents in the European Court of Human Rights (ECtHR) yields a mixed set of answers. On the bright side, there is no evidence that judges systematically employ cultural or geopolitical biases in their rulings. There is some evidence that career insecurities make judges more likely to favor their national government when it is a party to a dispute. Most strongly, the evidence suggests that international judges are policy seekers. Judges vary in their inclination to defer to member states in the implementation of human rights. Moreover, judges from former socialist countries are more likely to find violations against their own government and against other former socialist governments, suggesting that they are motivated by rectifying a particular set of injustices. I conclude that the overall picture is mostly positive for the possibility of impartial review of government behavior by judges on an international court. Like judges on domestic review courts, ECtHR judges are politically motivated actors in the sense that they have policy preferences on how to best apply abstract human rights in concrete cases, not in the sense that they are using their judicial power to settle geopolitical scores.",0,1 +1277,Have Multilevel Models Been Structural Equation Models All Along?,"A core assumption of the standard multiple regression model is independence of residuals, the violation of which results in biased standard errors and test statistics. The structural equation model (SEM) generalizes the regression model in several key ways, but the SEM also assumes independence of residuals. The multilevel model (MLM) was developed to extend the regression model to dependent data structures. Attempts have been made to extend the SEM in similar ways, but several complications currently limit the general application of these techniques in practice. Interestingly, it is well known that under a broad set of conditions SEM and MLM longitudinal ""growth curve"" models are analytically and empirically identical. This is intriguing given the clear violation of independence in growth modeling that does not detrimentally affect the standard SEM. Better understanding the source and potential implications of this isomorphism is my focus here. I begin by exploring why SEM and MLM are analytically equivalent methods in the presence of nesting due to repeated observations over time. I then capitalize on this equivalency to allow for the extension of SEMs to a general class of nested data structures. I conclude with a description of potential opportunities for multilevel SEMs and directions for future developments.",0,1 +1278,A Bayesian approach to estimating causal vaccine effects on binary post-infection outcomes,"To estimate causal effects of vaccine on post-infection outcomes, Hudgens and Halloran (2006) defined a post-infection causal vaccine efficacy estimand VEI based on the principal stratification framework. They also derived closed forms for the maximum likelihood estimators of the causal estimand under some assumptions. Extending their research, we propose a Bayesian approach to estimating the causal vaccine effects on binary post-infection outcomes. The identifiability of the causal vaccine effect VEI is discussed under different assumptions on selection bias. The performance of the proposed Bayesian method is compared with the maximum likelihood method through simulation studies and two case studies - a clinical trial of a rotavirus vaccine candidate and a field study of pertussis vaccination. For both case studies, the Bayesian approach provided similar inference as the frequentist analysis. However, simulation studies with small sample sizes suggest that the Bayesian approach provides smaller bias and shorter confidence interval length.",0,1 +1279,Calibration ofρValues for Testing Precise Null Hypotheses,"P values are the most commonly used tool to measure evidence against a hypothesis or hypothesized model. Unfortunately, they are often incorrectly viewed as an error probability for rejection of the hypothesis or, even worse, as the posterior probability that the hypothesis is true. The fact that these interpretations can be completely misleading when testing precise hypotheses is first reviewed, through consideration of two revealing simulations. Then two calibrations of a ρ value are developed, the first being interpretable as odds and the second as either a (conditional) frequentist error probability or as the posterior probability of the hypothesis.",0,1 +1280,Similarity comparisons with remembered and perceived magnitudes: Memory psychophysics and fundamental measurement,"At the outset, subjects learned to associate a label with each element in a set of perceptual magnitudes (visual extents), using traditional paired-associate learning methods. Subsequently, on some trials, subjects indicated which pair of two pairs of labels corresponded to the more similar perceptual referents, and, on other trials, they selected the more dissimilar pair. It is shown that these similarity comparisons satisfy the axioms (transitivity and intradimensional subtractivity) necessary to conclude that they are based on computation of the difference of the differences of analogue-based interval scale representations. The findings also permitted refutation of the idea that memory for elementary percepts arises from their reperception. Notably, the memory exponent was 0.697, but the perception exponent was 0.546, and the reperception idea requires that the memory exponent be the square of the perception exponent (0.546(2) = 0.298). Symbolic distance effects and enhanced response time-based semantic congruity effects, typically found with binary comparisons, extend the range of commonalties found between perceptual and memory psychophysics.",0,1 +1281,Bayesian Multilevel Models,,0,1 +1282,How Many Iterations in the Gibbs Sampler?,"Abstract : When the Gibbs sampler is used to estimate posterior distributions (Gelfand and Smith, 1990) the question of how many iterations are required is central to its implementation. When interest focuses on quantiles of functionals of the posterior distribution, we describe an easily-implemented method for determining the total number of iterations required, and also the number of initial iterations that should be discarded to allow for burn-in. The method uses only the Gibbs iterates themselves, and does not, for example, require external specification of characteristics of the posterior density. Here the method is described for the situation where one long run is generated, but it can also be easily applied if there are several runs from different starting points. It also applies more generally to Markov chain Monte Carlo schemes other than the quantities of interest are probabilities rather than full posterior distributions, and when the draws from the posterior distribution are required to be approximately independent. The method is applied to several different posterior distributions. These include a multivariate normal posterior distribution with independent parameters, a bimodal distribution, a cigar-shaped multivariate normal distribution in ten dimensions, and a highly complex 190-dimensional posterior distribution arising in spatial statistics. In each case the method appears to give satisfactory results.",0,1 +1283,A general model for two-level data with responses missing at random,"A general model for two-level multivariate data, with responses possibly missing at random, is described. The model combines regressions on fixed explanatory variables with structured residual covariance matrices. The likelihood function is reduced to a form enabling computational methods for estimating the model to be devised. © 1993 The Psychometric Society.",0,1 +1284,A Comparison of Confidence Interval Methods for the Concordance Correlation Coefficient and Intraclass Correlation Coefficient with Small Number of Raters,"The intraclass correlation coefficient (ICC) with fixed raters or, equivalently, the concordance correlation coefficient (CCC) for continuous outcomes is a widely accepted aggregate index of agreement in settings with small number of raters. Quantifying the precision of the CCC by constructing its confidence interval (CI) is important in early drug development applications, in particular in qualification of biomarker platforms. In recent years, there have been several new methods proposed for construction of CIs for the CCC, but their comprehensive comparison has not been attempted. The methods consisted of the delta method and jackknifing with and without Fisher's Z-transformation, respectively, and Bayesian methods with vague priors. In this study, we carried out a simulation study, with data simulated from multivariate normal as well as heavier tailed distribution (t-distribution with 5 degrees of freedom), to compare the state-of-the-art methods for assigning CI to the CCC. When the data are normally distributed, the jackknifing with Fisher's Z-transformation (JZ) tended to provide superior coverage and the difference between it and the closest competitor, the Bayesian method with the Jeffreys prior was in general minimal. For the nonnormal data, the jackknife methods, especially the JZ method, provided the coverage probabilities closest to the nominal in contrast to the others which yielded overly liberal coverage. Approaches based upon the delta method and Bayesian method with conjugate prior generally provided slightly narrower intervals and larger lower bounds than others, though this was offset by their poor coverage. Finally, we illustrated the utility of the CIs for the CCC in an example of a wake after sleep onset (WASO) biomarker, which is frequently used in clinical sleep studies of drugs for treatment of insomnia.",0,1 +1285,Meta‐Analysis Methods,"Meta-analysis is the quantitative synthesis of information from several studies. It is applicable to a variety of study designs in genetics, from family-based linkage studies and population-based association studies to genome-wide scans and genome-wide association studies. By combining relevant evidence from many studies, statistical power is increased and more precise estimates may be obtained. Most importantly, meta-analysis provides a framework for the appreciation and assessment of between-study heterogeneity, that is, the methodological, epidemiological, clinical, and biological dissimilarity across the various studies. Being a retrospective research design in most cases, meta-analysis is subject to a variety of selection biases that may undermine its validity. A major challenge is to differentiate genuine between-study heterogeneity from systematic errors and biases.",0,1 +1286,Toward a Reconciliation of the Bayesian and Frequentist Approaches to Point Estimation,"Abstract The Bayesian and frequentist approaches to point estimation are reviewed. The status of the debate regarding the use of one approach over the other is discussed, and its inconclusive character is noted. A criterion for comparing Bayesian and frequentist estimators within a given experimental framework is proposed. The competition between a Bayesian and a frequentist is viewed as a contest with the following components: a random observable, a true prior distribution unknown to both statisticians, an operational prior used by the Bayesian, a fixed frequentist rule used by the frequentist, and a fixed loss criterion. This competition is studied in the context of exponential families, conjugate priors, and squared error loss. The class of operational priors that yield Bayes estimators superior to the “best” frequentist estimator is characterized. The implications of the existence of a threshold separating the space of operational priors into good and bad priors are explored, and their relevance in ar...",0,1 +1287,Structural Equation Modeling,"Structural equation modeling , Structural equation modeling , کتابخانه دیجیتال جندی شاپور اهواز",0,1 +1288,Gender differences in activity and travel behavior in the Arab world,"Abstract The purpose of this study is to extend the research on gendered differences in travel patterns in the Arab world by an in-depth study of the interrelationship of travel-related activities and various socio-economic and demographic characteristics. This study is based on a unique data set that includes activity and travel diaries collected from three Arab communities in the Galilee region of Israel. Through descriptive statistics and nonlinear structural equations modeling, we found that gender plays an important role in both activity participation and travel behavior in these communities. Women tend to travel less than men in terms of both number of tours, defined as chain of trip segments that start and end at home, trips, and total time spent traveling. Women tend to work more within their communities and to conduct more of their activities by walking; they are also the ones who make more child-serving stops, which affect their travel patterns. Women tend to travel by car more as passengers, whereas men tend to be drivers. Those who made more tours also tended to make more complex tours, with more stops per tour, although, in general, complex tours are not substituted for making additional tours. People who work outside the community and make complex tours are more likely to drive, as the car is needed for these types of trips, which men make more than women. From a policy perspective, these findings suggest that public transportation services are needed to help overcome gender differences in travel behavior. Improving transit service for school trips and improving urban design through a friendlier environment, especially for children, will beneficially affect the complexity of women’s daily activity patterns and their quality of life.",0,1 +1289,Simulation Run Length Control in the Presence of an Initial Transient,"This paper studies the estimation of the steady state mean of an output sequence from a discrete event simulation. It considers the problem of the automatic generation of a confidence interval of prespecified width when there is an initial transient present. It explores a procedure based on Schruben's Brownian bridge model for the detection of nonstationarity and a spectral method for estimating the variance of the sample mean. The procedure is evaluated empirically for a variety of output sequences. The performance measures considered are bias, confidence interval coverage, mean confidence interval width, mean run length, and mean amount of deleted data. If the output sequence contains a strong transient, then inclusion of a test for stationarity in the run length control procedure results in point estimates with lower bias, narrower confidence intervals, and shorter run lengths than when no check for stationarity is performed. If the output sequence contains no initial transient, then the performance measures of the procedure with a stationarity test are only slightly degraded from those of the procedure without such a test. If the run length is short relative to the extent of the initial transient, the stationarity tests may not be powerful enough to detect the transient, resulting in a procedure with unreliable point and interval estimates.",0,1 +1290,Moving in Parallel Toward a Modern Modeling Epistemology: Bayes Factors and Frequentist Modeling Methods,"The Bayesian-frequentist debate typically portrays these statistical perspectives as opposing views. However, both Bayesian and frequentist statisticians have expanded their epistemological basis away from a singular focus on the null hypothesis, to a broader perspective involving the development and comparison of competing statistical/mathematical models. For frequentists, statistical developments such as structural equation modeling and multilevel modeling have facilitated this transition. For Bayesians, the Bayes factor has facilitated this transition. The Bayes factor is treated in articles within this issue of Multivariate Behavioral Research. The current presentation provides brief commentary on those articles and more extended discussion of the transition toward a modern modeling epistemology. In certain respects, Bayesians and frequentists share common goals.",0,1 +1291,Space-time confounding adjusted determinants of child HIV/TB mortality for large zero-inflated data in rural South Africa,"South Africa is experiencing a major burden of HIV/TB. We used longitudinal data from the Agincourt sub-district in rural northeast South Africa over the years 2000 to 2005. A total of 187 HIV/TB deaths were observed among 16,844 children aged 1-5 years coming from 8,863 households. In this paper we used Bayesian models to assess risk factors for child HIV/TB mortality taking into account the presence of spatial correlation. Bayesian zero inflated spatiotemporal models were able to detect hidden patterns within the data. Our main finding was that maternal orphans experienced a threefold greater risk of HIV/TB death compared to those with living mothers (AHR=2.93, 95% CI[1.29;6.93]). Risk factor analyses which adjust for person, place and time provide evidence for policy makers that includes a spatial distribution of risk. Child survival is dependent on the mother's survival; hence programs that promote maternal survival are critical.",0,1 +1292,Reciprocity and volunteering,"This paper evaluates whether volunteering is imbued with altruistic or strategic reciprocity. Although scholars have intensively studied the motivations and social norms to volunteer, to date there is no agreement why human beings perform activities in which time is freely given up in order to benefit another person, group or organization. We argue that attitudes towards reciprocity and volunteering are related, but that this relationship becomes only visible if we refine the conceptual framework for both concepts. Using data from the Swiss Volunteering Survey 2009, the empirical results of our Bayesian multilevel models show the following: firstly, individuals exhibiting high levels of altruistic reciprocity are more likely to engage in informal volunteering; secondly, we find a negative relationship between altruist reciprocity and the individual likeliness to do voluntary work within non-solidary associations; thirdly, once individuals opted to engage in formal volunteering, we find that strategic reciprocity is clearly related to voluntary engagement in non-solidary associations. Overall, our conceptual foundation provides a more appropriate model to explain the formation of volunteering.",0,1 +1293,Estimating population kinetics.,"This paper will review the methods that have been advanced for the estimation of parameters of models quantifying the population characteristics of the kinetic behavior of endogenous and exogenous substances in individuals of the population. Such methods are used frequently, for example, in pharmacokinetic studies. In certain populations, especially biological ones, considerable kinetic variability between population members is present. The models with which we are concerned describe this variability. Some interindividual kinetic variability may be explainable on the basis of measureable concomitant variables, but much of it may remain unexplainable on such a basis. We give this matter particular attention. The assumptions underlying the models are critically discussed.",0,1 +1294,A Hierarchical Model to Estimate Fish Abundance in Alpine Streams by using Removal Sampling Data from Multiple Locations,"The author compares 12 hierarchical models in the aim of estimating the abundance of fish in alpine streams by using removal sampling data collected at multiple locations. The most expanded model accounts for (i) variability of the abundance among locations, (ii) variability of the catchability among locations, and (iii) residual variability of the catchability among fish. Eleven model reductions are considered depending which variability is included in the model. The more restrictive model considers none of the aforementioned variabilities. Computations of the latter model can be achieved by using the algorithm presented by Carle and Strub (Biometrics 1978, 34, 621–630). Maximum a posteriori and interval estimates of the parameters as well as the Akaike and the Bayesian information criterions of model fit are computed by using samples simulated by a Markov chain Monte Carlo method. The models are compared by using a trout (Salmo trutta fario) parr (0+) removal sampling data set collected at three locations in the Pyrénées mountain range (Haute-Garonne, France) in July 2006. Results suggest that, in this case study, variability of the catchability is not significant, either among fish or locations. Variability of the abundance among locations is significant. 95% interval estimates of the abundances at the three locations are [0.15, 0.24], [0.26, 0.36], and [0.45, 0.58] parrs per m2. Such differences are likely the consequence of habitat variability.",0,1 +1295,Bayesian inference using WBDev: A tutorial for social scientists,"Over the last decade, the popularity of Bayesian data analysis in the empirical sciences has greatly increased. This is partly due to the availability of WinBUGS, a free and flexible statistical software package that comes with an array of predefined functions and distributions, allowing users to build complex models with ease. For many applications in the psychological sciences, however, it is highly desirable to be able to define one's own distributions and functions. This functionality is available through the WinBUGS Development Interface (WBDev). This tutorial illustrates the use of WBDev by means of concrete examples, featuring the expectancy-valence model for risky behavior in decision making, and the shifted Wald distribution of response times in speeded choice.",0,1 +1296,Models for Longitudinal Data: A Generalized Estimating Equation Approach,"This article discusses extensions of generalized linear models for the analysis of longitudinal data. Two approaches are considered: subject-specific (SS) models in which heterogeneity in regression parameters is explicitly modelled; and population-averaged (PA) models in which the aggregate response for the population is the focus. We use a generalized estimating equation approach to fit both classes of models for discrete and continuous outcomes. When the subject-specific parameters are assumed to follow a Gaussian distribution, simple relationships between the PA and SS parameters are available. The methods are illustrated with an analysis of data on mother's smoking and children's respiratory disease.",0,1 +1297,Validity Issues in the Likert and Thurstone Approaches to Attitude Measurement,"This article highlights the theoretical differences between the Likert and Thurstone approaches to attitude measurement and demonstrates how such differences can lead to discrepant attitude estimates for individuals with the most extreme opinions. Both simulated data and real data on attitude toward abortion are used to demonstrate this discrepancy. The results suggest that attitude researchers should, at the very least, devote more attention to the empirical response characteristics of items on a Likert attitude questionnaire. At most, these results suggest that other methods, such as the Thurstone technique or one of its recently developed item response theory counterparts, should be used to derive attitude estimates from disagree-agree responses.",0,1 +1298,"Determining thresholds using adaptive procedures and psychometric fits: evaluating efficiency using theory, simulations, and human experiments","When measuring thresholds, careful selection of stimulus amplitude can increase efficiency by increasing the precision of psychometric fit parameters (e.g., decreasing the fit parameter error bars). To find efficient adaptive algorithms for psychometric threshold (""sigma"") estimation, we combined analytic approaches, Monte Carlo simulations, and human experiments for a one-interval, binary forced-choice, direction-recognition task. To our knowledge, this is the first time analytic results have been combined and compared with either simulation or human results. Human performance was consistent with theory and not significantly different from simulation predictions. Our analytic approach provides a bound on efficiency, which we compared against the efficiency of standard staircase algorithms, a modified staircase algorithm with asymmetric step sizes, and a maximum likelihood estimation (MLE) procedure. Simulation results suggest that optimal efficiency at determining threshold is provided by the MLE procedure targeting a fraction correct level of 0.92, an asymmetric 4-down, 1-up staircase targeting between 0.86 and 0.92 or a standard 6-down, 1-up staircase. Psychometric test efficiency, computed by comparing simulation and analytic results, was between 41 and 58% for 50 trials for these three algorithms, reaching up to 84% for 200 trials. These approaches were 13-21% more efficient than the commonly used 3-down, 1-up symmetric staircase. We also applied recent advances to reduce accuracy errors using a bias-reduced fitting approach. Taken together, the results lend confidence that the assumptions underlying each approach are reasonable and that human threshold forced-choice decision making is modeled well by detection theory models and mimics simulations based on detection theory models.",0,1 +1299,An empirical Bayesian approach to stein-optimal covariance matrix estimation,"This paper proposes a conjugate Bayesian regression model to estimate the covariance matrix of a large number of securities. Characterizing the return generating process with an unrestricted factor model, prior beliefs impose structure while preserving estimator consistency. This framework accommodates economically-motivated prior beliefs and nests shrinkage covariance matrix estimators, providing a common model for their interpretation. Minimizing posterior finite-sample square error delivers a fully-automated covariance matrix estimator with beliefs that become diffuse as the sample grows relative to the dimension of the problem. In application, this Stein-optimal posterior covariance matrix performs well in a large set of simulation experiments.",0,1 +1300,Driver Fatigue Classification With Independent Component by Entropy Rate Bound Minimization Analysis in an EEG-Based System,"This paper presents a two-class electroencephal-ography-based classification for classifying of driver fatigue (fatigue state versus alert state) from 43 healthy participants. The system uses independent component by entropy rate bound minimization analysis (ERBM-ICA) for the source separation, autoregressive (AR) modeling for the features extraction, and Bayesian neural network for the classification algorithm. The classification results demonstrate a sensitivity of 89.7%, a specificity of 86.8%, and an accuracy of 88.2%. The combination of ERBM-ICA (source separator), AR (feature extractor), and Bayesian neural network (classifier) provides the best outcome with a p-value < 0.05 with the highest value of area under the receiver operating curve (AUC-ROC = 0.93) against other methods such as power spectral density as feature extractor (AUC-ROC = 0.81). The results of this study suggest the method could be utilized effectively for a countermeasure device for driver fatigue identification and other adverse event applications.",0,1 +1301,Data Analysis Using Stein's Estimator and its Generalizations,"Abstract In 1961, James and Stein exhibited an estimator of the mean of a multivariate normal distribution having uniformly lower mean squared error than the sample mean. This estimator is reviewed briefly in an empirical Bayes context. Stein's rule and its generalizations are then applied to predict baseball averages, to estimate toxomosis prevalence rates, and to estimate the exact size of Pearson's chi-square test with results from a computer simulation. In each of these examples, the mean square error of these rules is less than half that of the sample mean.",0,1 +1302,Positive or Negative Policy Feedbacks? Explaining Popular Attitudes Towards Pragmatic Pension Policy Reforms,"Recent decades have seen increased interest in public attitudes towards public pension policies. Most previous research, however, relies heavily on dependent variables that fail to reflect the effective alternatives being discussed in most affluent democracies. This article seeks to improve our understanding of public attitudes towards pragmatic welfare policy options by examining cross-national differences in attitudes towards (i) cuts in old-age pension benefits, (ii) increases in social security contributions, and (iii) increases in the statutory retirement age. We test predictions of the dominant positive policy feedback theory and the alternative negative policy feedback theory. These approaches argue that policies induce consequences and attitudes that reinforce (positive feedback) or undermine (negative feedback) past policymaking trajectories. Empirical results obtained by multilevel analyses from a sample of 27 European countries are consistent mainly with the negative feedback approach. In countries with higher statutory retirement ages, citizens are more likely to support a postponement of retirement. However, in countries with higher elderly poverty, citizens are less likely to support cuts in pension benefits. In countries with higher social security contributions, citizens are less likely to support further increases in these contributions. © The Author 2012.",0,1 +1303,Weight gain prevention in young adults: design of the study of novel approaches to weight gain prevention (SNAP) randomized controlled trial,"Weight gain during young adulthood is common and is associated with increased cardiovascular risk. Preventing this weight gain from occurring may be critical to improving long-term health. Few studies have focused on weight gain prevention, and these studies have had limited success. SNAP (Study of Novel Approaches to Weight Gain Prevention) is an NIH-funded randomized clinical trial examining the efficacy of two novel self-regulation approaches to weight gain prevention in young adults compared to a minimal treatment control. The interventions focus on either small, consistent changes in eating and exercise behaviors, or larger, periodic changes to buffer against expected weight gains.SNAP targets recruitment of six hundred young adults (18-35 years) with a body mass index between 21.0-30.0 kg/m2, who will be randomly assigned with equal probability to: (1) minimal intervention control; (2) self-regulation with Small Changes; or (3) self-regulation with Large Changes. Both interventions receive 8 weekly face-to-face group sessions, followed by 2 monthly sessions, with two 4-week refresher courses in each of subsequent years. Participants are instructed to report weight via web at least monthly thereafter, and receive monthly email feedback. Participants in Small Changes are taught to make small daily changes (~100 calorie changes) in how much or what they eat and to accumulate 2000 additional steps per day. Participants in Large Changes are taught to create a weight loss buffer of 5-10 pounds once per year to protect against anticipated weight gains. Both groups are encouraged to self-weigh daily and taught a self-regulation color zone system that specifies action depending on weight gain prevention success. Individualized treatment contact is offered to participants who report weight gains. Participants are assessed at baseline, 4 months, and then annually. The primary outcome is weight gain over an average of 3 years of follow-up; secondary outcomes include diet and physical activity behaviors, psychosocial measures, and cardiovascular disease risk factors.SNAP is unique in its focus on weight gain prevention in young adulthood. The trial will provide important information about whether either or both of these novel interventions are effective in preventing weight gain.ClinicalTrials.gov, NCT01183689.",0,1 +1304,Integration of Meta-analysis and Economic Decision Modeling for Evaluating Diagnostic Tests,"Meta-analysis of diagnostic test accuracy data is more difficult than of effectiveness data because of 1) statistical challenges of dealing with multiple measures of accuracy (e.g., sensitivity and specificity) simultaneously and 2) incorporating threshold effects. A number of meta-analysis models are in use, ranging from naïve synthesis of independent sensitivity and specificity to optimization of a hierarchical summary receiver operating characteristic (SROC) curve. Little work has been done on how such analyses should inform decision models. This article aims to present a unified framework for the synthesis of primary data and economic evaluation of alternative diagnostic testing strategies using Bayesian Markov Chain Monte Carlo simulation methods. The authors extend this previous work by using systematic review to derive model parameters, fully allowing for uncertainty in their estimation, and formally incorporating variability between study results into the decision analysis. Using a simple decision model comparing alternative testing strategies for suspected deep vein thrombosis as an example, the authors consider how to use outputs of different alternative meta-analysis models in decision models. They also explore the limitations of diagnostic test studies, particularly when there is no obvious threshold value. To correct some of the limitations of diagnostic test studies, they propose that tests with implicit and explicit thresholds should be studied using distinctly different frameworks. Specifically, when a threshold exists, quantitative threshold information should be included in meta-analysis models to aid interpretation of SROCs. Setting policy to relate to a specific point may be much more difficult for studies with implicit thresholds.",0,1 +1305,The Bootstrap and Markov-Chain Monte Carlo,"This note concerns the use of parametric bootstrap sampling to carry out Bayesian inference calculations. This is only possible in a subset of those problems amenable to Markov-Chain Monte Carlo (MCMC) analysis, but when feasible the bootstrap approach offers both computational and theoretical advantages. The discussion here is in terms of a simple example, with no attempt at a general analysis.",0,1 +1306,Using SEM to Analyze Complex Survey Data: A Comparison between Design-Based Single-Level and Model-Based Multilevel Approaches,"Both ad-hoc robust sandwich standard error estimators (design-based approach) and multilevel analysis (model-based approach) are commonly used for analyzing complex survey data with nonindependent observations. Although these 2 approaches perform equally well on analyzing complex survey data with equal between- and within-level model structures (B. O. Muthen & Satorra, 1995), the performances of these 2 approaches for analyzing multilevel data with unequal between- and within-level structures have not yet been systematically examined. In this study, we extended B. O. Muthen and Satorra's (1995) study by comparing these 2 approaches and an additional model-based maximum model for analyzing multilevel data considering number of clusters, cluster size, intraclass correlation, and the equality of different level structures. The simulation results showed the model-based maximum model generally performed well across conditions. This model is also recommended as an alternative for analyzing nonindependent survey...",0,1 +1307,Explanation of Two Anomalous Results in Statistical Mediation Analysis,"Previous studies of different methods of testing mediation models have consistently found two anomalous results. The first result is elevated Type I error rates for the bias-corrected and accelerated bias-corrected bootstrap tests not found in nonresampling tests or in resampling tests that did not include a bias correction. This is of special concern as the bias-corrected bootstrap is often recommended and used due to its higher statistical power compared with other tests. The second result is statistical power reaching an asymptote far below 1.0 and in some conditions even declining slightly as the size of the relationship between X and M, a, increased. Two computer simulations were conducted to examine these findings in greater detail. Results from the first simulation found that the increased Type I error rates for the bias-corrected and accelerated bias-corrected bootstrap are a function of an interaction between the size of the individual paths making up the mediated effect and the sample size, such that elevated Type I error rates occur when the sample size is small and the effect size of the nonzero path is medium or larger. Results from the second simulation found that stagnation and decreases in statistical power as a function of the effect size of the a path occurred primarily when the path between M and Y, b, was small. Two empirical mediation examples are provided using data from a steroid prevention and health promotion program aimed at high school football players (Athletes Training and Learning to Avoid Steroids; Goldberg et al., 1996), one to illustrate a possible Type I error for the bias-corrected bootstrap test and a second to illustrate a loss in power related to the size of a. Implications of these findings are discussed.",0,1 +1308,A Hyperbolic Cosine Latent Trait Model For Unfolding Dichotomous Single-Stimulus Responses,"Social-psychological variables are typically measured using either cumulative or unfolding response processes. In the former, the greater the location of a person relative to the location of a stimulus on the continuum, the greater the proba bility of a positive response; in the latter, the closer the location of the person to the location of the statement, irrespective of direction, the greater the probability of a positive response. Formal probability models for these processes are, respec tively, monotonically increasing and single-peaked as a function of the location of the person relative to the location of the statement. In general, these models have been considered to be independent of each other. However, if statements constructed on the basis of a cumulative model have three ordered response categories, the response function within the statement for the middle category is in fact single-peaked. Using this observation, a unidimen sional model for responses to statements that have an unfolding structure was constructed from the cumulative Rasch model for ordered response categories. A location and unit of measurement parameter exist for each statement. A joint maxi mum likelihood estimation procedure was inves tigated. Analysis of a small simulation study and a small real dataset showed that the model is readily applicable.",0,1 +1309,Analyzing individual differences in sentence processing performance using multilevel models,"The use of multilevel models is increasingly common in the behavioral sciences for analyzing hierarchically structured data, including repeated measures data. These models are flexible and easily implemented via a variety of commercially available statistical software programs. We consider their application in the context of an eye-movement experiment testing readers' responses to a semantic plausibility manipulation in temporarily ambiguous sentences. Multilevel models were used to study the relationship between working memory capacity and the extent to which readers were disrupted by syntactic misanalysis. This represented a cross-level interaction between an individual difference measure and a sentence-level characteristic. We compare a multilevel modeling approach to a standard approach based on ANOVA.",0,1 +1310,Multilevel IRT using dichotomous and polytomous response data,"A structural multilevel model is presented where some of the variables cannot be observed directly but are measured using tests or questionnaires. Observed dichotomous or ordinal polytomous response data serve to measure the latent variables using an item response theory model. The latent variables can be defined at any level of the multilevel model. A Bayesian procedure Markov chain Monte Carlo (MCMC), to estimate all parameters simultaneously is presented. It is shown that certain model checks and model comparisons can be done using the MCMC output. The techniques are illustrated using a simulation study and an application involving students' achievements on a mathematics test and test results regarding management characteristics of teachers and principles.",0,1 +1311,Testing Multilevel Mediation Using Hierarchical Linear Models,"Testing multilevel mediation using hierarchical linear modeling (HLM) has gained tremendous popularity in recent years. However, potential confounding in multilevel mediation effect estimates can arise in these models when within-group effects differ from between-group effects. This study summarizes three types of HLM-based multilevel mediation models, and then explains that in two types of these models confounding can be produced and erroneous conclusions may be derived when using popularly recommended procedures. A Monte Carlo simulation study illustrates that these procedures can underestimate or overestimate true mediation effects. Recommendations are provided for appropriately testing multilevel mediation and for differentiating within-group versus between-group effects in multilevel settings.",0,1 +1312,A Bayesian approach for the analysis of triadic data in cognitive social structures,Summary The paper proposes a fully Bayesian approach for the analysis of triadic data in social networks. Inference is based on Markov chain Monte Carlo methods as implemented in the software package WinBUGS. We apply the methodology to two data sets to highlight the ease with which cognitive social structures can be analysed.,0,1 +1313,Establishing short-term prognosis in Frontotemporal Lobar Degeneration spectrum: Role of genetic background and clinical phenotype,"Establishing the short-term prognosis in Frontotemporal Lobar Degeneration (FTLD) is a clinical challenge for defining disease outcomes and monitoring therapeutic interventions. No reliable neuropsychological assessment balancing all FTLD aspects is available yet, thus no clear-cut follow-up study has been performed.To evaluate the rate of progression and the predictors of worsening in FTLD patients.One-hundred twenty-seven FTLD patients entered the study and were re-evaluated at 1-year follow-up. A statistical driven approach on wide neuropsychological, behavioral, and functional data was applied to identify homogeneous groups both at baseline and at follow-up within FTLD. Three set of predictors on disease progression were considered: (i) the demographic characteristics, (ii) the genetic background, i.e. Apolipoprotein E (APOE) genotype, Tau haplotype, and functional polymorphisms affecting serotonin and dopamine pathways, and (iii) the clinical phenotype.Among FTLD, two groups of patients were recognized on the basis of the overall assessment, thus termed for different disease severity as ""good performers"" and ""bad performers"". At 1-year follow-up, almost 30% of FTLD patients progressed from ""good"" to ""bad"" performances, whilst 70% maintained stable ""good"" performances. APOE varepsilon4 allele, Tau H2 haplotype and behavioral variant FTD phenotype were associated with worse prognosis over time.This preliminary study proposed genetic and clinical predictors in FTLD progression. The identification of disease-modifying predictors of prognosis opens a new avenue in studying FTLD, and may contribute to define outcomes and to monitor pharmacological targets.",0,1 +1314,Further Investigation of the Performance of S - X2: An Item Fit Index for Use With Dichotomous Item Response Theory Models,"This study presents new findings on the utility of S - X 2 as an item fit index for dichotomous item response theory models. Results are based on a simulation study in which item responses were generated and calibrated for 100 tests under each of 27 conditions. The item fit indices S - X 2 and Q 1 - X 2 were calculated for each item. ROC curves were constructed based on the hit and false alarm rates of the two indices. Examination of these curves indicated that in general, the performance of S - X 2 improved with test length and sample size. The performance of S - X 2 was superior to that of Q 1 - X 2 under most but not all conditions. Results from this study imply that S - X 2 may be a useful tool in detecting the misfit of one item contained in an otherwise well-fitted test, lending additional support to the utility of the index for use with dichotomous item response theory models. Index Terms: item response theory, S - X 2 , Q 1 - X, model = data fit, item fit index.",0,1 +1315,Does body satisfaction influence self‐esteem in adolescents' daily lives? An experience sampling study,"This study examined, within the context of the Contingencies of Self-Worth model, state-based associations between self-esteem and body satisfaction using the experience sampling method. One hundred and forty-four adolescent girls (mean age = 14.28 years) completed up to 6 assessments per day for one week using Palm Digital Assistants, in addition to baseline measures of trait body satisfaction and self-esteem. Results showed considerable variation in both state-based constructs within days, and evidence of effects of body satisfaction on self-esteem, but not vice versa. Although these state-based associations were small in size and weakened as the time lag between assessments increased for the sample as a whole, individual differences in the magnitude of these effects were observed and predicted by trait self-esteem and body satisfaction. Collectively, these findings offer support for key tenets of the Contingencies of Self-Worth model.",0,1 +1316,"Mixed treatment comparison of dronedarone, amiodarone, sotalol, flecainide, and propafenone, for the management of atrial fibrillation","Mixed treatment comparisons (MTC) were performed to assess the relative efficacy and tolerability of the main anti-arrhythmic drugs used for the treatment of atrial fibrillation (AF)/flutter.Electronic databases were systematically searched to identify randomized controlled trials (RCTs) examining amiodarone, dronedarone, flecainide, propafenone, sotalol, or placebo for the treatment of AF. Thirty-nine RCTs met inclusion criteria and were combined using MTC models to provide direct and indirect comparisons in a single analysis. Results are presented vs. placebo. Amiodarone had the largest effect in reducing AF recurrence (OR 0.22, 95% CI 0.16-0.29). Amiodarone was associated with the highest rate of patients experiencing at least one serious adverse event (OR 2.41, 95% CI 0.96-6.06) and treatment withdrawals due to adverse events (OR 2.91, 95% CI 1.66-5.11). Dronedarone was associated with the lowest rate of proarrhythmic events including bradycardia (OR 1.45, 95% CI 1.02-2.08). Dronedarone significantly reduced the risk of stroke (OR 0.69, 95% CI 0.57-0.84). Trends towards increased mortality for sotalol (OR 3.44, 95% CI 1.02-11.59) and amiodarone (OR 2.17, 95% CI 0.63-7.51) were found, which were stronger when small studies randomizing <100 subjects per group were excluded.Amiodarone has been demonstrated to be the most effective drug in maintaining sinus rhythm. Differences in outcomes between the anti-antiarrhythmic drugs were reported, with sotalol and possibly amiodarone increasing mortality and dronedarone possibly decreasing the incidence of serious adverse events and proarrhythmia.",0,1 +1317,Randomization of Clusters Versus Randomization of Persons Within Clusters,"Many experiments aim at populations with persons nested within clusters. Randomization to treatment conditions can be done at the cluster level or at the person level within each cluster. The latter may result in control group contamination, and cluster randomization is therefore often preferred in practice. This article models the control group contamination, calculates the required sample sizes for both levels of randomization, and gives the degree of contamination for which cluster randomization is preferable above randomization of persons within clusters. Moreover, it provides examples of situations where one has to make a choice between both levels of randomization.",0,1 +1318,Recognizing spatial patterns: a noisy exemplar approach,"Models of categorization typically rely on the use of stimuli composed of well-defined dimensions (e.g., Ashby & Maddox (1998) in Choice , decision , and measurement: Essays in honor of R. Duncan Luce , p. 251–301, Mahwah, NJ: Erlbaum). We apply a similar approach to the analysis of recognition memory. Using a version of short-term recognition paradigm (Sternberg, Science 153 (1966) 652), we asked whether NEMO Sternberg's, a noisy exemplar summed-similarity model, could account for variation in mean performance on individual trials. NEMO provided a very good overall fit to recognition data from three experiments. However, its failure to fit data for certain lists of stimuli suggested a revision of the summed-similarity assumption. Our model-based analysis showed that subjects used interitem similarity, in addition to probe-item similarity, as the basis for their decisions. This represents a major departure from existing recognition models that assume subjects' judgments depend exclusively on the summed similarity of the probe to the study items.",0,1 +1319,Power prior distributions for regression models,"We propose a general class of prior distributions for arbitrary regression models. We discuss parametric and semiparametric models. The prior specification for the regression coefficients focuses on observ- able quantities in that the elicitation is based on the availability of his- torical data Do and a scalar quantity ao quantifying the uncertainty in Do. Then Do and ao are used to specify a prior for the regression coeffi- cients in a semiautomatic fashion. The most natural specification of Do arises when the raw data from a similar previous study are available. The availability of historical data is quite common in clinical trials, car- cinogenicity studies, and environmental studies, where large data bases are available from similar previous studies. Although the methodology we present here is quite general, we will focus only on using historical data from similar previous studies to construct the prior distributions. The prior distributions are based on the idea of raising the likelihood function of the historical data to the power ao, where 0 < ao < 1. We call such prior distributions power prior distributions. We examine the power prior for four commonly used classes of regression models. These include generalized linear models, generalized linear mixed models, semipara- metric proportional hazards models, and cure rate models for survival data. For these classes of models, we discuss the construction of the power prior, prior elicitation issues, propriety conditions, model selec- tion, and several other properties. For each class of models, we present real data sets to demonstrate the proposed methodology.",0,1 +1320,Mixed-effects logistic regression for estimating transitional probabilities in sequentially coded observational data.,"This article demonstrates the use of mixed-effects logistic regression (MLR) for conducting sequential analyses of binary observational data. MLR is a special case of the mixed-effects logit modeling framework, which may be applied to multicategorical observational data. The MLR approach is motivated in part by G. A. Dagne, G. W. Howe, C. H. Brown, & B. O. Muthén (2002) advances in general linear mixed models for sequential analyses of observational data in the form of contingency table frequency counts. The advantage of the MLR approach is that it circumvents obstacles in the estimation of random sampling error encountered using Dagne and colleagues' approach. This article demonstrates the MLR model in an analysis of observed sequences of communication in a sample of young adult same-sex peer dyads. The results obtained using MLR are compared with those of a parallel analysis using Dagne and colleagues' linear mixed model for binary observational data in the form of log odds ratios. Similarities and differences between the results of the 2 approaches are discussed. Implications for the use of linear mixed models versus mixed-effects logit models for sequential analyses are considered.",0,1 +1321,A rasch model for partial credit scoring,"A unidimensional latent trait model for responses scored in two or more ordered categories is developed. This ""Partial Credit"" model is a member of the family of latent trait models which share the property of parameter separability and so permit ""specifically objective"" comparisons of persons and items. The model can be viewed as an extension of Andrich's Rating Scale model to situations in which ordered response alternatives are free to vary in number and structure from item to item. The difference between the parameters in this model and the ""category boundaries"" in Samejima's Graded Response model is demonstrated. An unconditional maximum likelihood procedure for estimating the model parameters is developed. © 1982 The Psychometric Society.",0,1 +1322,Longitudinal course of physical and psychological symptoms after a natural disaster,"After disaster, physical symptoms are common although seldom recognized due to lack of knowledge of the course of symptoms and relation to more studied psychological symptoms.This study aimed to investigate the change in the reporting of different physical symptoms after a disaster, including possible factors for change, and whether psychological symptoms predict physical symptoms reporting at a later point in time.A longitudinal study of citizens of Stockholm who survived the 2004 Indian Ocean tsunami. A total of 1,101 participants completed questionnaires on somatic symptoms, general distress, posttraumatic stress, exposure, and demographic details 14 months and 3 years after the disaster. Physical symptoms occurring daily or weekly during the last year were investigated in four symptom indices: neurological, cardiorespiratory, gastrointestinal, and musculoskeletal. We used generalized estimating equations (GEE) analysis to determine odds ratios for a change in symptoms, and pathway analysis to predict the influence of psychological symptoms on physical symptoms.There was a general decrease of reporting in all physical symptom indices except the musculoskeletal symptom index. The change in the neurological symptom index showed the strongest association with exposure, and for women. General distress and posttraumatic stress at 14 months postdisaster predicted physical symptoms at 3 years.Physical symptoms were predicted by psychological symptoms at an earlier time point, but in a considerable proportion of respondents, physical symptoms existed independently from psychological symptoms. Physicians should be observant on the possible connection of particular pseudoneurological symptoms with prior adversities.",0,1 +1323,Comparing multilevel and Bayesian spatial random effects survival models to assess geographical inequalities in colorectal cancer survival: a case study,"Multilevel and spatial models are being increasingly used to obtain substantive information on area-level inequalities in cancer survival. Multilevel models assume independent geographical areas, whereas spatial models explicitly incorporate geographical correlation, often via a conditional autoregressive prior. However the relative merits of these methods for large population-based studies have not been explored. Using a case-study approach, we report on the implications of using multilevel and spatial survival models to study geographical inequalities in all-cause survival.Multilevel discrete-time and Bayesian spatial survival models were used to study geographical inequalities in all-cause survival for a population-based colorectal cancer cohort of 22,727 cases aged 20-84 years diagnosed during 1997-2007 from Queensland, Australia.Both approaches were viable on this large dataset, and produced similar estimates of the fixed effects. After adding area-level covariates, the between-area variability in survival using multilevel discrete-time models was no longer significant. Spatial inequalities in survival were also markedly reduced after adjusting for aggregated area-level covariates. Only the multilevel approach however, provided an estimation of the contribution of geographical variation to the total variation in survival between individual patients.With little difference observed between the two approaches in the estimation of fixed effects, multilevel models should be favored if there is a clear hierarchical data structure and measuring the independent impact of individual- and area-level effects on survival differences is of primary interest. Bayesian spatial analyses may be preferred if spatial correlation between areas is important and if the priority is to assess small-area variations in survival and map spatial patterns. Both approaches can be readily fitted to geographically enabled survival data from international settings.",0,1 +1324,The choice of prior distribution for a covariance matrix in multivariate meta-analysis: a simulation study,"Bayesian meta-analysis is an increasingly important component of clinical research, with multivariate meta-analysis a promising tool for studies with multiple endpoints. Model assumptions, including the choice of priors, are crucial aspects of multivariate Bayesian meta-analysis (MBMA) models. In a given model, two different prior distributions can lead to different inferences about a particular parameter. A simulation study was performed in which the impact of families of prior distributions for the covariance matrix of a multivariate normal random effects MBMA model was analyzed. Inferences about effect sizes were not particularly sensitive to prior choice, but the related covariance estimates were. A few families of prior distributions with small relative biases, tight mean squared errors, and close to nominal coverage for the effect size estimates were identified. Our results demonstrate the need for sensitivity analysis and suggest some guidelines for choosing prior distributions in this class of problems. The MBMA models proposed here are illustrated in a small meta-analysis example from the periodontal field and a medium meta-analysis from the study of stroke. Copyright © 2015 John Wiley & Sons, Ltd.",0,1 +1325,The relationship between ethnic diversity and classroom disruption in the context of migration policies,"This paper studies the relationship between ethnic school composition and classroom disruption in secondary education in the context of migration policies. We measured classroom disruption using students’ reports from 3533 schools in 20 countries provided by cross-national PISA (Programme for International Student Assessment) 2009 data. We employ the migrant share and the ethnic diversity net of the native share as indicators of the ethnic composition of a school. The MIPEX (Immigrant Integration Policy indEX) is used as an indicator of migration policies. Our results show a positive association between ethnic school diversity net of the migrant share and classroom disruption. Furthermore, we show a negative interaction term of the migration policy and ethnic diversity. Consequently, our results indicate that students in countries with a more inclusive migration policy are at least less harmed by influence of ethnic school diversity regarding classroom disruption. Findings partly support the “contact hypo...",0,1 +1326,Procedures for Selecting Items for Computerized Adaptive Tests,"Many procedures have been developed for selecting the best items for a computerized adaptive test. There is a trend toward the use of adaptive testing in applied settings such as licensure tests, program entrance tests, and educational tests. It is useful to consider procedures for item selection and the special needs of applied testing settings to facilitate test design. The current study reviews several classical approaches and alternative approaches to item selection and discusses their relative merit. This study also describes procedures for constrained computerized adaptive testing (C-CAT) that may be added to classical item selection approaches to allow them to be used for applied testing, while maintaining the high measurement precision and short test length that made adaptive testing attractive to practitioners initially.",0,1 +1327,A new methodology providing evidence of two distinct processes in the production of hand/foot simultaneous responses,"To get simultaneous responses of the hand and the foot, it is mandatory to compensate for the longer peripheral motor conduction delay of the foot. According to the reactive-projective model [Paillard, J. (1948). Quelques données psychophysiologiques relatives au déclenchement de la commande motrice (Some psychophysiological data in relation to the releasing of the motor commands). Année Psychologique, 28-47; Paillard, J. (1990). Réactif et prédictif: deux modes de gestion du geste de la motricité. In V. Nougier, & J. Blanchi (Eds.), Pratiques sportives et modélisation du geste (Sport activity and gesture modeling) (pp. 13-56). Grenoble: Université Joseph-Fourier.] no compensation occurs in a reaction time situation; the hand responds before the foot, which indicates a single motor command released for both effectors. However, in a self-initiated condition, the foot tends to precede the hand suggesting that two distinct motor commands are issued, with the foot command first. Fully self-initiated movements are not usual. It is more usual to prepare a response in anticipation of the time occurrence of a stimulus (e.g., a musician following a conductor, synchronized swimmers emerging together with the music). Therefore, we developed a methodology to test whether the model holds in an anticipation coincidence task. In Experiment 1, the participants were asked to initiate a synchronized hand/foot response when the continuous visual stimulus (constant speed) reaches a target. The results fitted the model. In Experiment 2, anticipation coincidence tasks were performed in three conditions: using the foot (1) or the hand (2) alone, and using the hand and the foot simultaneously (3). Following a constant stimulus protocol, short tones were randomly produced, prior the stimulus, to indicate the participants to inhibit their response. As expected, the frequencies of correct inhibition in each preset period followed a sigmoid curve. The command release is assumed to occur at the biserial point (50% of inhibition). The results confirmed that the motor command of the foot is released sooner than the command of the hand. The hand/foot delay is lower in the simultaneous condition, because the command of the hand is released 40 ms earlier; while the foot command is 10 ms earlier. These data confirm and extend the projective-reactive model to a new category of coordination behavior.",0,1 +1328,Generalized Multilevel Functional Regression,"We introduce Generalized Multilevel Functional Linear Models (GMFLMs), a novel statistical framework for regression models where exposure has a multilevel functional structure. We show that GMFLMs are, in fact, generalized multilevel mixed models (GLMMs). Thus, GMFLMs can be analyzed using the mixed effects inferential machinery and can be generalized within a well researched statistical framework. We propose and compare two methods for inference: 1) a two-stage frequentist approach; and 2) a joint Bayesian analysis. Our methods are motivated by and applied to the Sleep Heart Health Study (SHHS), the largest community cohort study of sleep. However, our methods are general and easy to apply to a wide spectrum of emerging biological and medical data sets. Supplemental materials for this article are available online.",0,1 +1329,Multilevel Models for Ordinal Data,"This chapter is concerned with regression models for ordinal responses, with special emphasis on random effects models for multilevel or clustered data. After a brief discussion on ordinal variables, it reviews the most common regression models for ordinal responses, focusing on cumulative models, namely models based on cumulative probabilities. The chapter then deals with random effects cumulative models for multilevel data, discussing several issues peculiar to the random effects extension such as the distinction between marginal and conditional effects, the measures of unobserved cluster-level heterogeneity, the consequences of adding covariates, and the main types of predicted probabilities. It also deals with estimation, inference and prediction, with a brief look on available software. Finally, it presents an application of random effects cumulative models to the analysis of student ratings of university courses. © 2012 John Wiley & Sons, Ltd. All rights reserved.",0,1 +1330,Hierarchical Graphical Bayesian Models in Psychology,The improvement of graphical methods in psychological research can promote their use and a better comprehension of their expressive power. The application of hierarchical Bayesian graphical models has recently become more frequent in psychological research. The aim of this contribution is to introduce suggestions for the improvement of hierarchical Bayesian graphical models in psychology. This novel set of suggestions stems from the description and comparison between two main approaches concerned with the use of plate notation and distribution pictograms. It is concluded that the combination of relevant aspects of both models might improve the use of powerful hierarchical Bayesian graphical models in psychology.,0,1 +1331,Proper Bayes Minimax Estimators of the Multivariate Normal Mean,,0,1 +1332,"Testing the significance of a correlation with nonnormal data: Comparison of Pearson, Spearman, transformation, and resampling approaches.","It is well known that when data are nonnormally distributed, a test of the significance of Pearson's r may inflate Type I error rates and reduce power. Statistics textbooks and the simulation literature provide several alternatives to Pearson's correlation. However, the relative performance of these alternatives has been unclear. Two simulation studies were conducted to compare 12 methods, including Pearson, Spearman's rank-order, transformation, and resampling approaches. With most sample sizes (n ≥ 20), Type I and Type II error rates were minimized by transforming the data to a normal shape prior to assessing the Pearson correlation. Among transformation approaches, a general purpose rank-based inverse normal transformation (i.e., transformation to rankit scores) was most beneficial. However, when samples were both small (n ≤ 10) and extremely nonnormal, the permutation test often outperformed other alternatives, including various bootstrap tests.",0,1 +1333,Multidimensional Constrained Test Assembly,"Two mathematical programming approaches are presented for the assembly of ability tests from item pools calibrated under a multidimensional item response theory model. Item selection is based on Fisher information matrix. Several criteria can be used to optimize this matrix. In this article, the A-criterion and the D-criterion are applied. Empirical examples for a two-dimensional mathematics item pool illustrate the methods. Both criteria provided good results. Recommendations are provided about when to apply either approach.",0,1 +1334,Average causal effects from nonrandomized studies: A practical guide and simulated example.,"In a well-designed experiment, random assignment of participants to treatments makes causal inference straightforward. However, if participants are not randomized (as in observational study, quasi-experiment, or nonequivalent control-group designs), group comparisons may be biased by confounders that influence both the outcome and the alleged cause. Traditional analysis of covariance, which includes confounders as predictors in a regression model, often fails to eliminate this bias. In this article, the authors review Rubin's definition of an average causal effect (ACE) as the average difference between potential outcomes under different treatments. The authors distinguish an ACE and a regression coefficient. The authors review 9 strategies for estimating ACEs on the basis of regression, propensity scores, and doubly robust methods, providing formulas for standard errors not given elsewhere. To illustrate the methods, the authors simulate an observational study to assess the effects of dieting on emotional distress. Drawing repeated samples from a simulated population of adolescent girls, the authors assess each method in terms of bias, efficiency, and interval coverage. Throughout the article, the authors offer insights and practical guidance for researchers who attempt causal inference with observational data.",0,1 +1335,RMPW extensions to alternative designs and measurement,,0,1 +1336,A practical introduction to multivariate meta-analysis,"Multivariate meta-analysis is becoming increasingly popular and official routines or self-programmed functions have been included in many statistical software. In this article, we review the statistical methods and the related software for multivariate meta-analysis. Emphasis is placed on Bayesian methods using Markov chain Monte Carlo, and codes in WinBUGS are provided. The various model-fitting options are illustrated in two examples and specific guidance is provided on how to run a multivariate meta-analysis using various software packages.",0,1 +1337,Evaluating academic outcomes of Head Start: an application of general growth mixture modeling,"Abstract This study intends to illustrate the utility of general growth mixture modeling (GGMM) for evaluation of early childhood education programs, using a sample of children with Head Start experience. In the first analysis of this study growth mixture modeling (GMM) found that children with Head Start experience had two distinct growth patterns. In the second analysis of this study general growth mixture modeling found that children with two or more years of program participation did not have faster achievement growth, on average, than children with only one year of program participation. This study also found that a gender gap in mathematics and an income gap in reading and mathematics were exclusively exhibited by the children with no preschool experience. Therefore, it was concluded that the Head Start program may be reducing both a gender gap in mathematics and an income gap in reading and mathematics.",0,1 +1338,"Updating Schemes, Correlation Structure, Blocking and Parameterization for the Gibbs Sampler",In this paper many convergence issues concerning the implementation of the Gibbs sampler are investigated. Exact computable rates of convergence for Gaussian target distributions are obtained. Different random and non-random updating strategies and blocking combinations are compared using the rates. The effect of dimensionality and correlation structure on the convergence rates are studied. Some examples are considered to demonstrate the results. For a Gaussian image analysis problem several updating strategies are described and compared. For problems in Bayesian linear models several possible parameterizations are analysed in terms of their convergence rates characterizing the optimal choice.,0,1 +1339,Use of Wishart Prior and Simple Extensions for Sparse Precision Matrix Estimation,"A conjugate Wishart prior is used to present a simple and rapid procedure for computing the analytic posterior (mode and uncertainty) of the precision matrix elements of a Gaussian distribution. An interpretation of covariance estimates in terms of eigenvalues is presented, along with a simple decision-rule step to improve the performance of the estimation of sparse precision matrices and associated graphs. In this, elements of the estimated precision matrix that are zero or near zero can be detected and shrunk to zero. Simulated data sets are used to compare posterior estimation with decision-rule with two other Wishart-based approaches and with graphical lasso. Furthermore, an empirical Bayes procedure is used to select prior hyperparameters in high dimensional cases with extension to sparsity.",0,1 +1340,Estimation and adjustment of bias in randomized evidence by using mixed treatment comparison meta-analysis,"Summary.  There is good empirical evidence that specific flaws in the conduct of randomized controlled trials are associated with exaggeration of treatment effect estimates. Mixed treatment comparison meta-analysis, which combines data from trials on several treatments that form a network of comparisons, has the potential both to estimate bias parameters within the synthesis and to produce bias-adjusted estimates of treatment effects. We present a hierarchical model for bias with common mean across treatment comparisons of active treatment versus control. It is often unclear, from the information that is reported, whether a study is at risk of bias or not. We extend our model to estimate the probability that a particular study is biased, where the probabilities for the ‘unclear’ studies are drawn from a common beta distribution. We illustrate these methods with a synthesis of 130 trials on four fluoride treatments and two control interventions for the prevention of dental caries in children. Whether there is adequate allocation concealment and/or blinding are considered as indicators of whether a study is at risk of bias. Bias adjustment reduces the estimated relative efficacy of the treatments and the extent of between-trial heterogeneity.",0,1 +1341,"THE THEORETICAL FOUNDATIONS OF PRINCIPAL FACTOR ANALYSIS, CANONICAL FACTOR ANALYSIS, AND ALPHA FACTOR ANALYSIS","It is shown that PFA, CFA and AFA are particular cases of a scale-invariant factoring procedure based on variance ratios of certain weighted combinations of variables. Standard derivations in the literature are shown, in contrast, to have unsatisfactory features. It is suggested that the choice between PFA, CFA and AFA involves relatively independent choices of features of each, and that in most cases CFA is to be preferred.",0,1 +1342,Assessing Traffic Accident Occurrence of Road Segments through an Optimized Decision Rule,"Statistical models for estimating the safety status of transportation facilities have received great attention in the last two decades. These models also perform an important role in transportation safety planning as well as diagnoses of locations with high accident risks. However, the current methods largely rely on regression analyses and therefore they could ignore the multicollinearity characteristics of factors, which may provide additional information for enhancing the performance of forecasting models. This study seeks to develop more precise models for forecasting safety status as well as addressing the issue of multicollinearity of dataset. The proposed mathematical approach is indeed a discriminant analysis with respect to the goal of minimizing Bayes risks given multivariate distributions of factors. Based on this model, numerical analyses also perform with the application of a simulated dataset and an empirically observed dataset of traffic accidents in road segments. These examples essentially illustrate the process of Bayes risk minimization on predicating the safety status of road segments toward the objective of smallest misclassification rate. The paper finally concludes with a discussion of this methodology and several important avenues for future studies are also provided.",0,1 +1343,"Estimating the SCAN⁎PRO model of store sales: HB, FM or just OLS?","In this paper we investigate whether consideration of store-level heterogeneity in marketing mix effects improves the accuracy of the marketing mix elasticities, fit, and forecasting accuracy of the widely-applied SCAN*PRO model of store sales. Models with continuous and discrete representations of heterogeneity, estimated using hierarchical Bayes (HB) and finite mixture (FM) techniques, respectively, are empirically compared to the original model, which does not account for store-level heterogeneity in marketing mix effects, and is estimated using ordinary least squares (OLS). The empirical comparisons are conducted in two contexts: Dutch store-level scanner data for the shampoo product category, and an extensive simulation experiment. The simulation investigates how between- and within-segment variance in marketing mix effects, error variance, the number of weeks of data, and the number of stores impact the accuracy of marketing mix elasticities, model fit, and forecasting accuracy. Contrary to expectations, accommodating store-level heterogeneity does not improve the accuracy of marketing mix elasticities relative to the homogeneous SCAN*PRO model, suggesting that little may be lost by employing the original homogeneous SCAN*PRO model estimated using ordinary least squares. Improvements in fit and forecasting accuracy are also fairly modest. We pursue an explanation for this result since research in other contexts has shown clear advantages from assuming some type of heterogeneity in market response models. In an Afterthought section, we comment on the controversial nature of our result, distinguishing factors inherent to household-level data and associated models vs. general store-level data and associated models vs. the unique SCAN*PRO model specification.",0,1 +1344,Consequences of interpersonal spin on couple-relevant goal progress and relationship satisfaction in romantic relationships.,"Large fluctuations in a person's interpersonal behavior across situations and over time are thought to be associated with poor personal and interpersonal outcomes. This study examined 2 outcomes, relationship satisfaction and goal progress, that could be associated with individual differences in dispersion of interpersonal behavior (interpersonal spin) in romantic relationships. Need satisfaction and perceived autonomy support for goal pursuit from the partner were examined as mediator variables. Spin was measured using an event-contingent recording (ECR) methodology with a sample of 93 cohabiting couples who reported their interpersonal behavior in interactions with each other during a 20-day period. Relationship satisfaction and goal completion were measured at the end of the ECR procedure (T2) and approximately 7 months after the ECR (T3). Need satisfaction and perceived autonomy support were measured at T2. In both genders, higher spin was associated with lower T2 relationship satisfaction. There was also a decline in relationship satisfaction from T2 to T3 among men with high spin partners. In both genders, higher spin was associated with lower need satisfaction, and lower need satisfaction was associated with a decline in relationship satisfaction from T2 to T3. In both genders, higher spin was associated with lower perceived autonomy support, and lower support was associated with decreased progress in goal completion from T2 to T3. The effects of spin were independent of the effects of mean levels of behavior. These findings extend the understanding of the detrimental consequences of dispersion in interpersonal behavior to the disruption of the person's romantic relationships.",0,1 +1345,Modeling age-based turning points in longitudinal life-span growth curves of cognition,,0,1 +1346,Some Practical Issues in the Evaluation of Heterogeneous Labour Market Programmes by Matching Methods,"Summary Recently several studies have analysed active labour market policies by using a recently proposed matching estimator for multiple programmes. Since there is only very limited practical experience with this estimator, this paper checks its sensitivity with respect to issues that are of practical importance in this kind of evaluation study. The estimator turns out to be fairly robust to several features that concern its implementation. Furthermore, the paper demonstrates that the matching approach per se is no panacea for solving all the problems of evaluation studies, but that its success depends critically on the information that is available in the data. Finally, a comparison with a bootstrap distribution provides some justification for using a simplified approximation of the distribution of the estimator that ignores its sequential nature.",0,1 +1347,Algorithm AS 287: Adaptive Rejection Sampling from Log-Concave Density Functions,,0,1 +1348,Generalized graded unfolding model with structural equation for subject parameters,"The generalized graded unfolding model (GGUM) is capable of analyzing polytomous scored, unfolding data such as agree-disagree responses to attitude statements. In the present study, we proposed a GGUM with structural equation for subject parameters, which enabled us to evaluate the relation between subject parameters and covariates and/or latent variables simultaneously, in order to avoid the influence of attenuation. Additionally, an algorithm for parameter estimation is newly implemented via the Markov Chain Monte Carlo (MCMC) method, based on Bayesian statistics. In the simulation, we compared the accuracy of estimates of regression coefficients between the proposed model and a conventional method using a GGUM (where regression coefficients are estimated using estimates of θ). As a result, the proposed model performed much better than the conventional method in terms of bias and root mean squared errors of estimates of regression coefficients. The study concluded by verifying the efficacy of the proposed model, using an actual data example of attitude measurement.",0,1 +1349,Bilinear Mixed-Effects Models for Dyadic Data,"This article discusses the use of a symmetric multiplicative interaction effect to capture certain types of third-order dependence patterns often present in social networks and other dyadic datasets. Such an effect, along with standard linear fixed and random effects, is incorporated into a generalized linear model, and a Markov chain Monte Carlo algorithm is provided for Bayesian estimation and inference. In an example analysis of international relations data, accounting for such patterns improves model fit and predictive performance.",0,1 +1350,Intergroup perception in naturally occurring groups of differential status: A social relations perspective.,"This study investigated intergroup perception in well-acquainted groups. Also of interest were the effects of a naturally occurring status differential on these perceptions. The study is framed within the social relations model, which provides a measure of in-group bias as well as 3 innovative measures of out-group homogeneity. Results indicated that low-status groups consistently displayed out-group favoritism. High-status groups displayed in-group bias, but only on ratings of leadership ability. The results also provided consistent evidence of out-group homogeneity. In instances when group status moderated out-group homogeneity effects, members of the high-status groups perceived their in-group as more variable than the out-group, whereas members of the low-status groups tended to see the in-group and out-group as equally variable.",0,1 +1351,Outcome measure for the treatment of cone photoreceptor diseases: orientation to a scene with cone-only contrast,"Inherited retinal degenerations (IRDs) preferentially affecting cone photoreceptor function are being considered for treatment trials aiming to improve day vision. The purpose of the current work was to develop cone-specific visual orientation outcomes that can differentiate day vision improvement in the presence of retained night vision.A lighted wall (1.4 m wide, 2 m high) resembling a beaded curtain was formed with 900 individually addressable red, blue and green LED triplets placed in 15 vertical strips hanging 0.1 m apart. Under computer control, different combination of colors and intensities were used to produce the appearance of a door on the wall. Scotopically-matched trials were designed to be perceptible to the cone-, but not rod-, photoreceptor based visual systems. Unmatched control trials were interleaved at each luminance level to determine the existence of any vision available for orientation. Testing started with dark-adapted eyes and a scene luminance attenuated 8 log units from the maximum attainable, and continued with progressively increasing levels of luminance. Testing was performed with a three-alternative forced choice method in healthy subjects and patients with Leber congenital amaurosis (LCA) caused by mutations in GUCY2D, the gene that encodes retinal guanylate cyclase-1.Normal subjects could perform the orientation task using cone vision at 5 log attenuation and brighter luminance levels. Most GUCY2D-LCA patients failed to perform the orientation task with scotopically-matched test trials at any luminance level even though they were able to perform correctly with unmatched control trials. These results were consistent with a lack of cone system vision and use of the rod system under ambient conditions normally associated with cone system activity. Two GUCY2D-LCA patients demonstrated remnant cone vision but at a luminance level 2 log brighter than normal.The newly developed device can probe the existence or emergence of cone-based vision in patients for an orientation task involving the identification of a door on the wall under free-viewing conditions. This key advance represents progress toward developing an appropriate outcome measure for a clinical trial to treat currently incurable eye diseases severely affecting cone vision despite retained rod vision.",0,1 +1352,A Maximum Likelihood Approach for Multisample Nonlinear Structural Equation Models With Missing Continuous and Dichotomous Data,"Structural equation models are widely appreciated in social-psychological research and other behavioral research to model relations between latent constructs and manifest variables and to control for measurement error. Most applications of SEMs are based on fully observed continuous normal data and models with a linear structural equation. However, discrete nonnormal data and missing data are rather common, and sometimes it is necessary to incorporate nonlinear structural equations for assessing the impact of nonlinear terms of the exogenous latent variables to the endogenous latent variables. Moreover, to study the behaviors of different populations, it is necessary to extend from a single sample model to a multisample model. In this article, a maximum likelihood (ML) approach is developed for analyzing a multisample nonlinear structural equation model, in the context of mixed continuous and dichotomous data that involve data that are missing at random. The article demonstrates the newly developed method...",0,1 +1353,New Results in Test Theory Without an Answer Key,"This paper discusses some recent developments in a new methodology for the social sciences being developed jointly by the authors. The methodology is called cultural consensus analysis, and it is designed to aggregate informant responses to test items about their common culture. The object is to determine correct knowledge about the nature of that culture. Our methods estimate informant competency parameters and “correct” answers to each item from the informant response data. The methodology is designed for anthropological field studies and related research designs. This paper studies the consequences of relaxing the axioms of our model for dichotomous items, and it presents new models for other testing formats.",0,1 +1354,"Snake venom phospholipase A2s (Asp49 and Lys49) induce mechanical allodynia upon peri-sciatic administration: involvement of spinal cord glia, proinflammatory cytokines and nitric oxide","Snakebites constitute a serious public health problem in Central and South America, where species of the lancehead pit vipers (genus Bothrops) cause the majority of accidents. Bothrops envenomations are very painful, and this effect is not neutralized by antivenom treatment. Two variants of secretory phospholipases A2 (sPLA2), corresponding to Asp49 and Lys49 PLA2s, have been isolated from Bothrops asper venom. These sPLA2s induce hyperalgesia in rats following subcutaneous injection. However, venom in natural Bothrops bites is frequently delivered intramuscularly, thereby potentially reaching peripheral nerve bundles. Thus, the present series of experiments tested whether these sPLA2s could exert pain-enhancing effects following administration around healthy sciatic nerve. Both were found to produce mechanical allodynia ipsilateral to the injection site; no thermal hyperalgesia was observed. As no prior study has examined potential spinal mechanisms underlying sPLA2 actions, a series of anatomical and pharmacological studies were performed. These demonstrated that both sPLA2s produce activation of dorsal horn astrocytes and microglia that is more prominent ipsilateral to the site of injection. As proinflammatory cytokines and nitric oxide have each been previously implicated in spinally mediated pain facilitation, the effect of pharmacological blockade of these substances was tested. The results demonstrate that mechanical allodynia induced by both sPLA2s is blocked by interleukin-1 receptor antagonist, anti-rat interleukin-6 neutralizing antibody, the anti-inflammatory cytokine interleukin-10, and a nitric oxide synthesis inhibitor (L-NAME). As a variety of immune cells also produce and release sPLA2s during inflammatory states, the data may have general implications for the understanding of inflammatory pain.",0,1 +1355,Structural Equation Models in a Redundancy Analysis Framework With Covariates,"A recent method to specify and fit structural equation modeling in the Redundancy Analysis framework based on so-called Extended Redundancy Analysis (ERA) has been proposed in the literature. In this approach, the relationships between the observed exogenous variables and the observed endogenous variables are moderated by the presence of unobservable composites, estimated as linear combinations of exogenous variables. However, in the presence of direct effects linking exogenous and endogenous variables, or concomitant indicators, the composite scores are estimated by ignoring the presence of the specified direct effects. To fit structural equation models, we propose a new specification and estimation method, called Generalized Redundancy Analysis (GRA), allowing us to specify and fit a variety of relationships among composites, endogenous variables, and external covariates. The proposed methodology extends the ERA method, using a more suitable specification and estimation algorithm, by allowing for covariates that affect endogenous indicators indirectly through the composites and/or directly. To illustrate the advantages of GRA over ERA we propose a simulation study of small samples. Moreover, we propose an application aimed at estimating the impact of formal human capital on the initial earnings of graduates of an Italian university, utilizing a structural model consistent with well-established economic theory.",0,1 +1356,Using Redundant Parameterizations to Fit Hierarchical Models,"Hierarchical linear and generalized linear models can be fit using Gibbs samplers and Metropolis algorithms; these models, however, often have many parameters, and convergence of the seemingly most natural Gibbs and Metropolis algorithms can sometimes be slow. We examine solutions that involve reparameterization and over-parameterization. We begin with parameter expansion using working parameters, a strategy developed for the EM algorithm. This strategy can lead to algorithms that are much less susceptible to becoming stuck near zero values of the variance parameters than are more standard algorithms. Second, we consider a simple rotation of the regression coefficients based on an estimate of their posterior covariance matrix. This leads to a Gibbs algorithm based on updating the transformed parameters one at a time or a Metropolis algorithm with vector jumps; either of these algorithms can perform much better (in terms of total CPU time) than the two standard algorithms: one-at-a-time updating of untrans...",0,1 +1357,Kernel smoothing approaches to nonparametric item characteristic curve estimation,"The option characteristic curve, the relation between ability and probability of choosing a particular option for a test item, can be estimated by nonparametric smoothing techniques. What is smoothed is the relation between some function of estimated examinee ability rankings and the binary variable indicating whether or not the option was chosen. This paper explores the use of kernel smoothing, which is particularly well suited to this application. Examples show that, with some help from the fast Fourier transform, estimates can be computed about 500 times as rapidly as when using commonly used parametric approaches such as maximum marginal likelihood estimation using the three-parameter logistic distribution. Simulations suggest that there is no loss of efficiency even when the population curves are three-parameter logistic. The approach lends itself to several interesting extensions. © 1991 The Psychometric Society.",0,1 +1358,The Infinite Gaussian Mixture Model,In a Bayesian mixture model it is not necessary a priori to limit the number of components to be finite. In this paper an infinite Gaussian mixture model is presented which neatly sidesteps the difficult problem of finding the right number of mixture components. Inference in the model is done using an efficient parameter-free Markov Chain that relies entirely on Gibbs sampling.,0,1 +1359,Variance components analysis for pedigree-based censored survival data using generalized linear mixed models (GLMMs) and Gibbs sampling in BUGS,"Complex human diseases are an increasingly important focus of genetic research. Many of the determinants of these diseases are unknown and there is often a strong residual covariance between relatives even when all known genetic and environmental factors have been taken into account. This must be modeled correctly whether scientific interest is focused on fixed effects, as in an association analysis, or on the covariance structure itself. Analysis is straightforward for multivariate normally distributed traits, but difficulties arise with other types of trait. Generalized linear mixed models (GLMMs) offer a potentially unifying approach to analysis for many classes of phenotype including right censored survival times. This includes age-at-onset and age-at-death data and a variety of other censored traits. Markov chain Monte Carlo (MCMC) methods, including Gibbs sampling, provide a convenient framework within which such GLMMs may be fitted. In this paper, we use BUGS (“Bayesian inference using Gibbs sampling”: a readily available, generic Gibbs sampler) to fit GLMMs for right-censored survival times in nuclear and extended families. We discuss parameter interpretation and statistical inference, and show how to circumvent a number of important theoretical and practical problems. Using simulated data, we show that model parameters are consistent. We further illustrate our methods using data from an ongoing cohort study. Finally, we propose that the random effects associated with a genetic component of variance (e.g., σ2A) in a GLMM may be regarded as an adjusted “phenotype” and used as input to a conventional model-based or model-free linkage analysis. This provides a simple way to conduct a linkage analysis for a trait reflected in a right-censored survival time while comprehensively adjusting for observed confounders at the level of the individual and latent environmental effects shared across families. Genet. Epidemiol. 19:127–148, 2000. © 2000 Wiley-Liss, Inc.",0,1 +1360,Modeling Variation in Mass-Length Relations and Condition Indices of Lake Trout and Chinook Salmon in Lake Huron: A Hierarchical Bayesian Approach,"Abstract Commonly used approaches to studying mass-length relations and condition indices often do not adequately address covariance between mass-length parameters, usually ignore heterogeneity in individual variance for body mass at a given length, and assume that length distributions of fish samples are similar across regions and years. We used body mass at selected lengths as condition indices based on statistical modeling and a hierarchical Bayesian approach to inferences, and our approach allowed us to avoid using restrictive assumptions. We estimated spatial and annual variation in mass-length relations, where the process errors in parameters are drawn from a multivariate distribution. We also estimated region-, year-, and size-group-specific variance for individual variation in mass at given lengths. We applied our approach to study mass-length relations of lake trout Salvelinus namaycush (1977-2005) and Chinook salmon Oncorhynchus tshawytscha (1983-2004) in U.S. waters of Lake Huron. We found that...",0,1 +1361,Estimation of epistasis among finite polygenic loci for complex traits with a mixed model using Gibbs sampling,"Epistasis among loci is important factor behind the expression of many complex traits, but many analyses have ruled out its possibility. A method to estimate epistasis was introduced with a mixed model using Gibbs sampling (MMGS). The posterior mean estimate for every possible genotype combined from multiple loci was calculated as the mean of the conditional expected values of the parameters in post warming-up rounds from Gibbs sampling. A simulation study was performed to compare MMGS with restricted partition method (RPM). Mean square prediction error (MSPE) using MMGS was smaller than that using RPM ( P < 0.05), which might be due to information loss introduced by grouping of genotypes in RPM. This was also supported by the result that MSPE increased as the number of merged groups decreased. The simulation study implied that MMGS was more plausible in estimating epistatic effects than the RPM.",0,1 +1362,Bayesian Model Averaging for Propensity Score Analysis,"This article considers Bayesian model averaging as a means of addressing uncertainty in the selection of variables in the propensity score equation. We investigate an approximate Bayesian model averaging approach based on the model-averaged propensity score estimates produced by the R package BMA but that ignores uncertainty in the propensity score. We also provide a fully Bayesian model averaging approach via Markov chain Monte Carlo sampling (MCMC) to account for uncertainty in both parameters and models. A detailed study of our approach examines the differences in the causal estimate when incorporating noninformative versus informative priors in the model averaging stage. We examine these approaches under common methods of propensity score implementation. In addition, we evaluate the impact of changing the size of Occam's window used to narrow down the range of possible models. We also assess the predictive performance of both Bayesian model averaging propensity score approaches and compare it with the case without Bayesian model averaging. Overall, results show that both Bayesian model averaging propensity score approaches recover the treatment effect estimates well and generally provide larger uncertainty estimates, as expected. Both Bayesian model averaging approaches offer slightly better prediction of the propensity score compared with the Bayesian approach with a single propensity score equation. Covariate balance checks for the case study show that both Bayesian model averaging approaches offer good balance. The fully Bayesian model averaging approach also provides posterior probability intervals of the balance indices.",0,1 +1363,"Evaluating statistical difference, equivalence, and indeterminacy using inferential confidence intervals: An integrated alternative method of conducting null hypothesis statistical tests.","Null hypothesis statistical testing (NHST) has been debated extensively but always successfully defended. The technical merits of NHST are not disputed in this article. The widespread misuse of NHST has created a human factors problem that this article intends to ameliorate. This article describes an integrated, alternative inferential confidence interval approach to testing for statistical difference, equivalence, and indeterminacy that is algebraically equivalent to standard NHST procedures and therefore exacts the same evidential standard. The combined numeric and graphic tests of statistical difference, equivalence, and indeterminacy are designed to avoid common interpretive problems associated with NHST procedures. Multiple comparisons, power, sample size, test reliability, effect size, and cause-effect ratio are discussed. A section on the proper interpretation of confidence intervals is followed by a decision rule summary and caveats.",0,1 +1364,Antinociceptive effect of the C-terminus of murine S100A9 protein on experimental neuropathic pain,"The synthetic peptide identical to the C-terminus of murine S100A9 protein (mS100A9p) has antinociceptive effect on different acute inflammatory pain models. In this study, the effect of mS100A9p was investigated on neuropathic pain induced by chronic constriction injury (CCI) of the sciatic nerve in rats. Hyperalgesia, allodynia, and spontaneous pain were assessed to evaluate nociception. These three signs were detected as early as 2 days after sciatic nerve constriction and lasted for over 14 days after CCI. Rats were treated with different doses of mS100A9p by intraplantar, oral, or intrathecal routes on day 14 after CCI, and nociception was evaluated 1h later. These three routes of administration blocked hyperalgesia, allodynia and spontaneous pain. The duration of the effect of mS100A9p depends on the route used and phenomenon analyzed. Moreover, intraplantar injection of mS100A9p in the contralateral paw inhibited the hyperalgesia on day 14 days after CCI. The results obtained herein demonstrate the antinociceptive effect of the C-terminus of murine S100A9 protein on experimental neuropathic pain, suggesting a potential therapeutic use for it in persistent pain syndromes, assuming that tolerance does not develop to mS100A9p.",0,1 +1365,Multilevel pharmacokinetics-driven modeling of metabolomics data,"Multilevel modeling is a quantitative statistical method to investigate variability and relationships between variables of interest, taking into account population structure and dependencies. It can be used for prediction, data reduction and causal inference from experiments and observational studies allowing for more efficient elucidation of knowledge.In this study we introduced the concept of multilevel pharmacokinetics (PK)-driven modelling for large-sample, unbalanced and unadjusted metabolomics data comprising nucleoside and creatinine concentration measurements in urine of healthy and cancer patients.A Bayesian multilevel model was proposed to describe the nucleoside and creatinine concentration ratio considering age, sex and health status as covariates. The predictive performance of the proposed model was summarized via area under the ROC, sensitivity and specificity using external validation.Cancer was associated with an increase in methylthioadenosine/creatinine excretion rate by a factor of 1.42 (1.09-2.03) which constituted the highest increase among all nucleosides. Age influenced nucleosides/creatinine excretion rates for all nucleosides in the same direction which was likely caused by a decrease in creatinine clearance with age. There was a small evidence of sex-related differences for methylthioadenosine. The individual a posteriori prediction of patient classification as area under the ROC with 5th and 95th percentile was 0.57(0.5-0.67) with sensitivity and specificity of 0.59(0.42-0.76) and 0.57(0.45-0.7), respectively suggesting limited usefulness of 13 nucleosides/creatinine urine concentration measurements in predicting disease in this population.Bayesian multilevel pharmacokinetics-driven modeling in metabolomics may be useful in understanding the data and may constitute a new tool for searching towards potential candidates of disease indicators.",0,1 +1366,Using empirical bayes methods in biopharmaceutical research,"A compound sampling model, where a unit-specific parameter is sampled from a prior distribution and then observed are generated by a sampling distribution depending on the parameter, underlies a wide variety of biopharmaceutical data. For example, in a multi-centre clinical trial the true treatment effect varies from centre to centre. Observed treatment effects deviate from these true effects through sampling variation. Knowledge of the prior distribution allows use of Bayesian analysis to compute the posterior distribution of clinic-specific treatment effects (frequently summarized by the posterior mean and variance). More commonly, with the prior not completely specified, observed data can be used to estimate the prior and use it to produce the posterior distribution: an empirical Bayes (or variance component) analysis. In the empirical Bayes model the estimated prior mean gives the typical treatment effect and the estimated prior standard deviation indicates the heterogeneity of treatment effects. In both the Bayes and empirical Bayes approaches, estimated clinic effects are shrunken towards a common value from estimates based on single clinics. This shrinkage produces more efficient estimates. In addition, the compound model helps structure approaches to ranking and selection, provides adjustments for multiplicity, allows estimation of the histogram of clinic-specific effects, and structures incorporation of external information. This paper outlines the empirical Bayes approach. Coverage will include development and comparison of approaches based on parametric priors (for example, a Gaussian prior with unknown mean and variance) and non-parametric priors, discussion of the importance of accounting for uncertainty in the estimated prior, comparison of the output and interpretation of fixed and random effects approaches to estimating population values, estimating histograms, and identification of key considerations in the use and interpretation of empirical Bayes methods.",0,1 +1367,When the Going Gets Tough: The Differential Impact of National Unemployment on the Perceived Threats of Immigration,"Economic competition theory predicts that anti-immigration sentiments will increase in periods with high unem-ployment, in particular among low-skilled workers. Using five rounds of cross-sectional data from the European Social Survey and utilising the rise in unemployment in many European countries due to the financial crisis, this article provides a more effective empirical test of interest-based theories than previous studies. It employs hierarchical, two-stage regression techniques to estimate the relationship between aggregate unemployment rates and immigration opinion, and explores whether the relationship differs according to respondent’s level of education. It is found that high unemployment rates are associated with a high level of economic concern over immigration – particularly if the size of the foreign-born population is large. The relationship is stronger among the low skilled, implying a tendency for polarisation of opinions about immigration in economic recessions. Finally, it is discovered that the general level of cultural concern over immigration is unrelated to variation in unemployment.",0,1 +1368,Sample Size Estimation in Cluster Randomized Educational Trials: An Empirical Bayes Approach,"The educational field has now accumulated an extensive literature reporting on values of the intraclass correlation coefficient, a parameter essential to determining the required size of a planned cluster randomized trial. We propose here a simple simulation-based approach including all relevant information that can facilitate this task. An example and corresponding computer code is attached.",0,1 +1369,A Model Fit Statistic for Generalized Partial Credit Model,"Investigating the fit of a parametric model is an important part of the measurement process when implementing item response theory (IRT), but research examining it is limited. A general nonparametric approach for detecting model misfit, introduced by J. Douglas and A. S. Cohen (2001), has exhibited promising results for the two-parameter logistic model and Samejima s graded response model. This study extends this approach to test the fit of generalized partial credit model (GPCM). The empirical Type I error rate and power of the proposed method are assessed for various test lengths, sample sizes, and type of assessment. Overall, the proposed fit statistic performed well under the studied conditions in that the Type I error rate was not inflated and the power was acceptable, especially for moderate to large sample sizes. A further advantage of the nonparametric approach is that it provides a convenient graphical display of possible misfit.",0,1 +1370,USAGE OF DIFFERENT PRIOR DISTRIBUTIONS IN BAYESIAN VECTOR AUTOREGRESSIVE MODELS,"In Bayesian vector autoregressive models, the Litterman or Minnesota Prior is widely used. However, in some cases, the Minnesota prior is not the best prior distribution that can be used. Thus, other prior dis- tributions can also be applied. In this paper, as well as the Minnesota prior, four other prior distributions have been studied. Based on these prior distributions, five different Bayesian vector autoregressive models have been built to forecast the Turkish unemployment rate and the in- dustrial production index for the two periods of the year 2008. Finally, the five priors have been compared with each other according to the forecasting performances of the models that they are used in.",0,1 +1371,An Alternative Approach for Nonlinear Latent Variable Models,"In the last decades there has been an increasing interest in nonlinear latent variable models. Since the seminal paper of Kenny and Judd, several methods have been proposed for dealing with these kinds of models. This article introduces an alternative approach. The methodology involves fitting some third-order moments in addition to the means and covariances. This article discusses how the model equations can be formulated and how several standard tests, like the model fit and Lagrange multiplier tests, can be performed. The new method compares favorably with the maximum likelihood method in several studies and can provide evidence of interaction that earlier approaches might ignore.",0,1 +1372,Systems Factorial Technology provides new insights on global–local information processing in autism spectrum disorders,"Previous studies of global-local processing in autism spectrum disorders (ASDs) have indicated mixed findings, with some evidence of a local processing bias, or preference for detail-level information, and other results suggesting typical global advantage, or preference for the whole or gestalt. Findings resulting from this paradigm have been used to argue for or against a detail focused processing bias in ASDs, and thus have important theoretical implications. We applied Systems Factorial Technology, and the associated Double Factorial Paradigm (both defined in the text), to examine information processing characteristics during a divided attention global-local task in high-functioning individuals with an ASD and typically developing controls. Group data revealed global advantage for both groups, contrary to some current theories of ASDs. Information processing models applied to each participant revealed that task performance, although showing no differences at the group level, was supported by different cognitive mechanisms in ASD participants compared to controls. All control participants demonstrated inhibitory parallel processing and the majority demonstrated a minimum-time stopping rule. In contrast, ASD participants showed exhaustive parallel processing with mild facilitatory interactions between global and local information. Thus our results indicate fundamental differences in the stopping rules and channel dependencies in individuals with an ASD.",0,1 +1373,Neural Population Coding of Multiple Stimuli,"In natural scenes, objects generally appear together with other objects. Yet, theoretical studies of neural population coding typically focus on the encoding of single objects in isolation. Experimental studies suggest that neural responses to multiple objects are well described by linear or nonlinear combinations of the responses to constituent objects, a phenomenon we call stimulus mixing. Here, we present a theoretical analysis of the consequences of common forms of stimulus mixing observed in cortical responses. We show that some of these mixing rules can severely compromise the brain's ability to decode the individual objects. This cost is usually greater than the cost incurred by even large reductions in the gain or large increases in neural variability, explaining why the benefits of attention can be understood primarily in terms of a stimulus selection, or demixing, mechanism rather than purely as a gain increase or noise reduction mechanism. The cost of stimulus mixing becomes even higher when the number of encoded objects increases, suggesting a novel mechanism that might contribute to set size effects observed in myriad psychophysical tasks. We further show that a specific form of neural correlation and heterogeneity in stimulus mixing among the neurons can partially alleviate the harmful effects of stimulus mixing. Finally, we derive simple conditions that must be satisfied for unharmful mixing of stimuli.",0,1 +1374,Introduction to Robustness in Multidimensional Wellbeing Analysis,"The multidimensional nature of wellbeing is now the widely accepted approach in frontier research on poverty, inequality and policy analysis. However, significant challenges and disagreement remain...",0,1 +1375,Is CO2 a good proxy for indoor air quality in classrooms? Part 2: Health outcomes and perceived indoor air quality in relation to classroom exposure and building characteristics,"The aim of this paper is to investigate whether keeping indoor thermal conditions and carbon dioxide (CO 2 ) levels within the current guideline values can provide a healthy and comfortable school environment. The study was organised as a longitudinal investigation over an academic year using a cohort of 376 students aged 9 to 11 (response rate: 87%) attending 15 classrooms in five London primary schools. The prevalence of asthmatic symptoms and asthma attacks was significantly higher among children attending urban schools (10.2%) than suburban schools (1.5%), and was significantly related to exposure to higher nitrogen dioxide (NO 2 ) concentrations (odds ratio: 1.11, 95% confidence interval: 1.00–1.19). Self-reported dermal, mucosal, respiratory and general symptoms were 18.5%, 60.7%, 28.2% and 43.6% respectively in the heating season, and decreased in the non-heating season. Infiltration rates were negatively associated with prevalence and incidence of all sick building syndrome symptoms. Exposure to traffic-related pollutants, such NO 2 , ozone (O 3 ) and tetrachloroethylene (T4CE), associated with mucosal symptoms, also increased dissatisfaction with indoor air quality (IAQ) and, therefore, perceived IAQ might be a first indication of exposure. Among targeted microbial counts, only Trichoderma viride remained significant predictors of satisfaction with IAQ even at low concentrations. The study provides evidence that simultaneous provision for limiting indoor CO 2 levels and thermal conditions below current guidelines (e.g. below 1000 ppm and 26℃ or 22℃ depending on season) may improve perceived IAQ. This paper stresses the need to go beyond current regulations to investigate concentrations of specific pollutants to ensure a healthy school environment, and closes with a section on the practical implications on the UK policy and the building design industry. Practical application: The findings highlight the role and responsibility of stakeholders, from regulators to designers and school authorities, to account for the external environment and take the steps needed to ensure that schools provide a healthy indoor environment for their students. The recommendations focus on the need to decrease outdoor pollution levels in the school vicinity, thus improving health of the students and reducing the prevalence of respiratory illness. Building designers and engineers shall adopt an integrated approach for the simultaneous provision of adequate thermal conditions and IAQ in classrooms.",0,1 +1376,Conducting quantitative synthesis when comparing medical interventions: AHRQ and the Effective Health Care Program,"

Abstract

Objective

This article is to establish recommendations for conducting quantitative synthesis, or meta-analysis, using study-level data in comparative effectiveness reviews (CERs) for the Evidence-based Practice Center (EPC) program of the Agency for Healthcare Research and Quality.

Study Design and Setting

We focused on recurrent issues in the EPC program and the recommendations were developed using group discussion and consensus based on current knowledge in the literature.

Results

We first discussed considerations for deciding whether to combine studies, followed by discussions on indirect comparison and incorporation of indirect evidence. Then, we described our recommendations on choosing effect measures and statistical models, giving special attention to combining studies with rare events; and on testing and exploring heterogeneity. Finally, we briefly presented recommendations on combining studies of mixed design and on sensitivity analysis.

Conclusion

Quantitative synthesis should be conducted in a transparent and consistent way. Inclusion of multiple alternative interventions in CERs increases the complexity of quantitative synthesis, whereas the basic issues in quantitative synthesis remain crucial considerations in quantitative synthesis for a CER. We will cover more issues in future versions and update and improve recommendations with the accumulation of new research to advance the goal for transparency and consistency.",0,1 +1377,Thought self-leadership and effectiveness in self-management teams,"This study empirically examines the multilevel nature of thought self-leadership at work. Furthermore, this study tests the relationship between team level thought self-leadership and team effectiveness (i.e. performance and viability) through collective efficacy. A total of 103 self-management teams (453 individuals), enrolled in a five-week management competition participated in the study. The results from multilevel confirmatory factor analysis suggest that thought self-leadership is functionally equivalent across levels of analysis (i.e. individuals and teams). In addition, we found an indirect effect of team level thought self-leadership on team effectiveness criteria, through collective efficacy. These findings extend previous work on thought self-leadership and team effectiveness, and open new roads for research in self-managing work teams. Finally, this study also provides guidelines for organizations in case they wish to foster team performance and viability in their work force.",0,1 +1378,Estimating Unknown Transition Times Using a Piecewise Nonlinear Mixed-Effects Model in Men with Prostate Cancer,Abstract It may be clinically useful to know when prostate-specific antigen (PSA) levels first begin to rise rapidly and to determine if the natural history of PSA progression is different in men with locally confined prostate cancers compared to men with metastatic tumors. This article uses a nonlinear mixed-effects model to describe longitudinal changes in PSA in men before their prostate cancers were detected clinically. Repeated measurements of PSA are available for 18 subjects with a diagnosis of prostate cancer based on prostate biopsy. PSA measurements were determined on repeated frozen serum samples collected from subjects with at least 10.0 years and up to 25.6 years of observation before the cancer was detected. A piecewise model is used to describe this data. The model is linear long before the cancer was detected and exponential nearer the time the cancer was detected. The time at which the PSA levels change from linear to exponential PSA progression is unknown but can be estimated by includin...,0,1 +1379,A Bayesian approach to nonlinear latent variable models using the Gibbs sampler and the metropolis-hastings algorithm,"Nonlinear latent variable models are specified that include quadratic forms and interactions of latent regressor variables as special cases. To estimate the parameters, the models are put in a Bayesian framework with conjugate priors for the parameters. The posterior distributions of the parameters and the latent variables are estimated using Markov chain Monte Carlo methods such as the Gibbs sampler and the Metropolis-Hastings algorithm. The proposed estimation methods are illustrated by two simulation studies and by the estimation of a non-linear model for the dependence of performance on task complexity and goal specificity using empirical data.",0,1 +1380,A method for simulating non-normal distributions,"A method of introducing a controlled degree of skew and kurtosis for Monte Carlo studies was derived. The form of such a transformation on normal deviates [X ≈N(0, 1)] is Y =a +bX +cX2 +dX3. Analytic and empirical validation of the method is demonstrated. © 1978 Psychometric Society.",0,1 +1381,Developing Ideal Intermediate Personality Items for the Ideal Point Model,"The importance of intermediate items has been overlooked since the emergence of dominance-based Likert-type scales. The current study aims to advance our understanding of the psychometric properties of intermediate items by showing that they can be successfully calibrated by an ideal point model. A student sample and an MTurk sample were selected to answer personality scales with intermediate items included. Results showed that personality scales with intermediate items demonstrated satisfactory model fits to the ideal point model, but not to the dominance model. When analyzed with the ideal point model, intermediate items provided more information than extreme items for respondents with high latent trait levels. Among four proposed domains of intermediate items (Frequency, Average, Condition, and Transition, “FACT”), the Average domain was consistently found to exhibit the best properties. The proportion of intermediate items in the scale also affected the model fit and the validity of the scale.",0,1 +1382,Nonlinear Change Models in Populations with Unobserved Heterogeneity,"When unobserved heterogeneity exists in populations where the phenomenon of interest is governed by a functional form of change linear in its parameters, the growth mixture model (GMM) is useful for modeling change conditional on latent class. However, when the functional form of interest is nonlinear in its parameters, the GMM is not very useful because it is based on a system of equations linear in its parameters. The nonlinear change mixture model (NCMM) is proposed, which explicitly addresses unobserved heterogeneity in situations where change follows a nonlinear functional form. Due to the integration of nonlinear multilevel models and finite mixture models, neither of which generally have closed form solutions, analytic solutions do not generally exist for the NCMM. Five methods of parameter estimation are developed and evaluated with a comprehensive Monte Carlo simulation study. The simulation showed that the parameters of the NCMM can be accurately estimated with several of the proposed methods, and that the method of choice depends on the precise question of interest.",0,1 +1383,No evidence for a fixed object limit in working memory: Spatial ensemble representations inflate estimates of working memory capacity for complex objects.,"A central question for models of visual working memory is whether the number of objects people can remember depends on object complexity. Some influential ""slot"" models of working memory capacity suggest that people always represent 3-4 objects and that only the fidelity with which these objects are represented is affected by object complexity. The primary evidence supporting this claim is the finding that people can detect large changes to complex objects (consistent with remembering at least 4 individual objects), but that small changes cannot be detected (consistent with low-resolution representations). Here we show that change detection with large changes greatly overestimates individual item capacity when people can use global representations of the display to detect such changes. When the ability to use such global ensemble or texture representations is reduced, people remember individual information about only 1-2 complex objects. This finding challenges models that propose people always remember a fixed number of objects, regardless of complexity, and supports a more flexible model with an important role for spatial ensemble representations.",0,1 +1384,Propensity scores used for analysis of cluster randomized trials with selection bias: a simulation study,"Cluster randomized trials (CRTs) are often prone to selection bias despite randomization. Using a simulation study, we investigated the use of propensity score (PS) based methods in estimating treatment effects in CRTs with selection bias when the outcome is quantitative. Of four PS-based methods (adjustment on PS, inverse weighting, stratification, and optimal full matching method), three successfully corrected the bias, as did an approach using classical multivariable regression. However, they showed poorer statistical efficiency than classical methods, with higher standard error for the treatment effect, and type I error much smaller than the 5% nominal level.",0,1 +1385,Addressing the Problem of Switched Class Labels in Latent Variable Mixture Model Simulation Studies,"The discrimination between alternative models and the detection of latent classes in the context of latent variable mixture modeling depends on sample size, class separation, and other aspects that are related to power. Prior to a mixture analysis it is useful to investigate model performance in a simulation study that reflects the research settings. Multiple data sets are generated under 1 or more models, and alternative models are fitted to the data. The aggregation of results over multiple data sets is complicated by the fact that mixture models are only identified up to a permutation of the class labels. Estimated class labels are arbitrary, with the effect that the estimated parameters for Class 1 could be incorrectly labeled as Class 2, Class 3, and so forth, relative to their data generating labels. In a simulation study, the detection of switched labels needs to be automated. Switched class labels are not necessarily simple to detect. This article describes different possible scenarios of switched...",0,1 +1386,A Simulation Study Comparing Recent Approaches for the Estimation of Nonlinear Effects in SEM Under the Condition of Nonnormality,"In the past decade new approaches for the estimation of latent nonlinear interaction and quadratic effects in structural equation modeling have been proposed (Kelava & Brandt, 2009; Klein & Moosbrugger, 2000; Klein & Muthen, 2007; Marsh, Wen, & Hau, 2004; Mooijaart & Bentler, 2010; Wall & Amemiya, 2003). Most approaches have been developed for the analysis of normally distributed latent predictor variables. In this article, we investigate the performance of five recent approaches under the condition of nonnormally distributed data: the extended unconstrained approach (Kelava & Brandt, 2009), LMS (Klein & Moosbrugger, 2000), QML (Klein & Muthen, 2007), the 2SMM approach (Wall & Amemiya, 2003), and the method of moments approach by Mooijaart and Bentler (2010). Advantages and limitations of the approaches are discussed.",0,1 +1387,A Version of Quadratic Regression with Interpretable Parameters,"The quadratic regression model is popular and effective in describing a wide variety of data, but it is based on a function whose parameters are not easy to interpret. We suggest an alternative form of the quadratic model that has the same expectation function, but also has the useful feature that its parameters are interpretable. Examples are provided of a simple regression problem and also of a nonlinear mixed-effects model. The models can be estimated with available software.",0,1 +1388,"Mediators, moderators, and tests for mediation.","Abstract : The following points are developed. First, mediation relations are generally thought of in causal terms. Influences of an antecedent are transmitted to a consequence through an intervening mediator. Second, mediation relations may assume a number of functional forms, including nonadditive, nonlinear, and nonrecursive forms. Special attention is given to nonadditive forms, or moderated mediation, where it is shown that while mediation and moderation are distinguishable processes, a particular variable may be both a mediator and a moderator within a single set of functional relations. Third, current procedures for testing mediation relations in industrial and organizational psychology need to be updated because these procedures often involve a dubious interplay between exploratory (correlational) statistical tests and causal inference. It is suggested that no middle ground exists between exploratory and confirmatory (causal) analysis, and that attempts to explain how mediation processes occur require well-specified causal models. Given such models, confirmatory analytic techniques furnish the more informative tests of mediation. (Author)",0,1 +1389,The value of a datum - how little data do we need for a quantitative risk analysis?,"Aim Conservation managers are typically faced with limited resources, time and information. The philosophy underlying risk assessment should be robust to these limitations. While there is a broad support for the concept of risk assessments, there is a tendency to rely on expert opinion and exclude formal data analysis, possibly because available information is often scarce. When data analyses are conducted, often much simplified models are advocated, even though this means excluding processes believed by experts to be important. In this manuscript, we ask: should statistical analyses be conducted and decisions modified based on a single datum? How many data points are needed before predictions are meaningful? Given limited data, how complex should models be? Location World-wide. Methods We use simulation approaches with known ‘true’ values to assess which inferences are possible, given different amounts of information. We use two metrics of performance: the magnitude of uncertainty (using posterior mean squared error) and bias (using P–P plots). We assess six models of relevance to conservation ecologists. Results We show that the greatest reduction in uncertainty occurred at the smallest sample sizes for models examined, and much of parameter space could be excluded. Thus, analyses based on even a single datum potentially can be useful. Further, with only a few observations, the predicted distribution of outcomes matched the probabilities of actual occurrences, even for relatively complex state-space models with multiple sources of stochasticity. Main conclusions We highlight the utility of quantitative analyses even with severely limited data, given existing practices and arguments in the conservation literature. The purpose of our manuscript is in part a philosophical discourse, as modifications are needed to how conservation ecologists are often trained to think about problems and data, and in part a demonstration via simulation analysis.",0,1 +1390,From state neuroticism to momentary task performance: A person × situation approach,"The goal of this article was to investigate the mechanisms through which personality relates to task performance. We argue that perceptions of work pressure and task complexity trigger momentary levels of neuroticism (i.e., state neuroticism) and that these momentary levels of neuroticism predict momentary task performance. Moreover, we hypothesized that the relationship between momentary job demands and state neuroticism is moderated by trait neuroticism. To test this model, we conducted an event reconstruction study and a day reconstruction study. The results revealed that trait neuroticism indeed moderated the momentary job demands–state neuroticism relationship, and in three out of four cases state neuroticism was found to mediate the relationship between momentary job demands and momentary task performance. From a practical point-of-view our results suggest that employees’ task performance can be improved by enhancing the way in which individuals perceive job demands. This strategy would be particula...",0,1 +1391,A Monte Carlo sample size study: How many countries are needed for accurate multilevel SEM?,"Recently, there has been growing scientific interest for cross-national survey research. Various scholars have used multilevel techniques to link individual characteristics to aspects of the national context. At first sight, multilevel SEM seems to be a promising tool for this purpose, as it integrates multilevel modeling within a latent variable framework. However, due to the fact that the number of countries in most international surveys does not exceed 30, the application of multilevel SEM in cross-national research is problematic. Taking European Social Survey (ESS) data as a point of departure, this paper uses Monte Carlo studies to assess the estimation accuracy of multilevel SEM with small group sample sizes. The results indicate that a group sample size of 20 ‐ a situation common in cross-national research ‐ does not guarantee accurate estimation at all. Unacceptable amounts of parameter and standard error bias are present for the between-level estimates. Unless the standardized e ect is very large (0.75), statistical power for detecting a significant between-level structural e ect is seriously lacking. Required group sample sizes depend strongly on the specific interests of the researcher, the expected e ect sizes and the complexity of the model. If the between-level model is relatively simple and one is merely interested in the between-level factor structure, a group sample size of 40 could be su cient. To detect large (>0.50) structural e ects at the between level, at least 60 groups are required. To have an acceptable probability of detecting smaller e ects, more than 100 groups are needed. These guidelines are shown to be quite robust for varying cluster sizes and intra-class correlations (ICCs).",0,1 +1392,Bayesian estimation of a multilevel IRT model using gibbs sampling,"In this article, a two-level regression model is imposed on the ability parameters in an item response theory (IRT) model. The advantage of using latent rather than observed scores as dependent variables of a multilevel model is that it offers the possibility of separating the influence of item difficulty and ability level and modeling response variation and measurement error. Another advantage is that, contrary to observed scores, latent scores are test-independent, which offers the possibility of using results from different tests in one analysis where the parameters of the IRT model and the multilevel model can be concurrently estimated. The two-parameter normal ogive model is used for the IRT measurement model. It will be shown that the parameters of the two-parameter normal ogive model and the multilevel model can be estimated in a Bayesian framework using Gibbs sampling. Examples using simulated and real data are given.",0,1 +1393,Theory-Testing in Psychology and Physics: A Methodological Paradox,"Because physical theories typically predict numerical values, an improvement in experimental precision reduces the tolerance range and hence increases corroborability. In most psychological research, improved power of a statistical design leads to a prior probability approaching ½ of finding a significant difference in the theoretically predicted direction. Hence the corroboration yielded by “success” is very weak, and becomes weaker with increased precision. “Statistical significance” plays a logical role in psychology precisely the reverse of its role in physics. This problem is worsened by certain unhealthy tendencies prevalent among psychologists, such as a premium placed on experimental “cuteness” and a free reliance upon ad hoc explanations to avoid refutation.",0,1 +1394,Examining the Rule of Thumb of Not Using Multilevel Modeling: The “Design Effect Smaller Than Two” Rule,"Educational researchers commonly use the rule of thumb of “design effect smaller than 2” as the justification of not accounting for the multilevel or clustered structure in their data. The rule, however, has not yet been systematically studied in previous research. In the present study, we generated data from three different models (which differ in the location of the clustering effect). With a 3 (design effect) × 5 (cluster size) × 4 (number of clusters) Monte Carlo simulation study we found that the rule should not be applied when researchers: (a) are interested in the effects of higher-level predictors, or (b) have a cluster size less than 10. Implications of the findings and limitations of the study are discussed.",0,1 +1395,Estimation of covariance matrices based on hierarchical inverse-Wishart priors,"Abstract This paper focuses on Bayesian shrinkage methods for covariance matrix estimation. We examine posterior properties and frequentist risks of Bayesian estimators based on new hierarchical inverse-Wishart priors. More precisely, we give the conditions for the existence of the posterior distributions. Advantages in terms of numerical simulations of posteriors are shown. A simulation study illustrates the performance of the estimation procedures under three loss functions for relevant sample sizes and various covariance structures.",0,1 +1396,An alternative to post hoc model modification in confirmatory factor analysis: The Bayesian lasso.,"As a commonly used tool for operationalizing measurement models, confirmatory factor analysis (CFA) requires strong assumptions that can lead to a poor fit of the model to real data. The post hoc modification model approach attempts to improve CFA fit through the use of modification indexes for identifying significant correlated residual error terms. We analyzed a 28-item emotion measure collected for n = 175 participants. The post hoc modification approach indicated that 90 item-pair errors were significantly correlated, which demonstrated the challenge in using a modification index, as the error terms must be individually modified as a sequence. Additionally, the post hoc modification approach cannot guarantee a positive definite covariance matrix for the error terms. We propose a method that enables the entire inverse residual covariance matrix to be modeled as a sparse positive definite matrix that contains only a few off-diagonal elements bounded away from zero. This method circumvents the problem of having to handle correlated residual terms sequentially. By assigning a Lasso prior to the inverse covariance matrix, this Bayesian method achieves model parsimony as well as an identifiable model. Both simulated and real data sets were analyzed to evaluate the validity, robustness, and practical usefulness of the proposed procedure. (PsycINFO Database Record",0,1 +1397,Propensity score methods for estimating relative risks in cluster randomized trials with low-incidence binary outcomes and selection bias,"Despite randomization, selection bias may occur in cluster randomized trials. Classical multivariable regression usually allows for adjusting treatment effect estimates with unbalanced covariates. However, for binary outcomes with low incidence, such a method may fail because of separation problems. This simulation study focused on the performance of propensity score (PS)-based methods to estimate relative risks from cluster randomized trials with binary outcomes with low incidence. The results suggested that among the different approaches used (multivariable regression, direct adjustment on PS, inverse weighting on PS, and stratification on PS), only direct adjustment on the PS fully corrected the bias and moreover had the best statistical properties.",0,1 +1398,Going public against institutional constraints? Analyzing the online presence intensity of 2014 European Parliament election candidates,"Political parties and candidates have not been immune to the changes that the Internet and social media have introduced in electoral campaigns. Yet, as the use of digital media by political elites is becoming a norm in the United States, in Europe, the decision to develop an online presence depends on the cross-national differences regarding candidates’ constraints and incentives. European Parliament elections present an exceptional comparative opportunity to measure this potential diversity. Using an original database on the online presence of more than 5000 candidates competing under the label of incumbent parties in 2014, we demonstrate that there are two relevant groups of nonadopters, and that candidates’ online campaign intensity varies significantly depending on incumbency and the ballot structure in their countries.",0,1 +1399,Comprehensive Decision-Analytic Model and Bayesian Value-of-Information Analysis,"Objective: To conduct a Bayesian value-of-information analysis of the cost effectiveness of pentoxifylline (vs placebo) as an adjunct to compression for venous leg ulcers. Methods: A probabilistic Markov model was developed to estimate mean clinical benefits and costs associated with oral pentoxifylline (400mg three times daily) and placebo. Clinical data were obtained from a systematic review and synthesised using Bayesian methods. The decision uncertainty associated with the adoption of pentoxifylline as well as the maximum value associated with further research were estimated before and after the completion of the largest 'definitive' treatment trial. Resource use was obtained from a UK national audit and unit costs applied (£, 2004 values). Results: The prior and posterior analyses suggest that pentoxifylline is a dominant therapy versus placebo. In the prior analysis, patients in the pentoxifylline group healed an average of 8.28 weeks quicker than patients in the placebo group (95% credibility interval [CI] 1.89, 14.56), had a 0.02 gain in QALYs (95% CI -0.12, 0.17) and an average reduction in cost of £153.4 (95% CI -53.11, 354.9). Estimates of the uncertainty surrounding the cost effectiveness of pentoxifylline and the value of perfect information in both analyses did not suggest further research was justified. In the prior analysis, for willingness-to-pay values of £0, £100 and £500 per QALY gained, the estimated values of perfect information were £128 200, £127 100 and £126 700, respectively. Incorporation of the information from the largest randomised controlled trial on pentoxifylline did improve the estimate of the clinical effect associated with this drug; however, the variation was not large enough to reverse either the decision regarding the dominance of pentoxifylline or the maximum value associated with further research. Conclusion: Bayesian value-of-information analysis represents a valuable tool for healthcare decision making. Had the results from this analysis been available before the largest trial was funded, a more efficient allocation of research and development resources could have been made. © 2006 Adis Data Information BV. All rights reserved.",0,1 +1400,Further characterization of high mobility group box 1 (HMGB1) as a proinflammatory cytokine: central nervous system effects,"High mobility group box 1 (HMGB1), an abundant, highly conserved cellular protein, is widely known as a nuclear DNA-binding protein. HMGB1 has been recently implicated as a proinflammatory cytokine because of its role as a late mediator of endotoxin lethality and ability to stimulate release of proinflammatory cytokines from monocytes. Production of central cytokines is a critical step in the pathway by which endotoxin and peripheral proinflammatory cytokines, including interleukin-1beta (IL-1) and tumor necrosis factor-alpha (TNF), produce sickness behaviors and fever. Intracerebroventricular (ICV) administration of HMGB1 has been shown to increase TNF expression in mouse brain and induce aphagia and taste aversion. Here we show that ICV injections of HMGB1 induce fever and hypothalamic IL-1 in rats. Furthermore, we show that intrathecal administration of HMGB1 produces mechanical allodynia (lowering of the response threshold to calibrated stimuli). Finally, while endotoxin (lipopolysaccharide, LPS) administration elevates IL-1 and TNF mRNA in various brain regions, HMGB1 mRNA is unchanged. It remains possible that HMGB1 protein is released in brain in response to LPS. Nonetheless, these data suggest that HMGB1 may play a role as an endogenous pyrogen and support the concept that HMGB1 has proinflammatory characteristics within the central nervous system.",0,1 +1401,A general approach to causal mediation analysis.,"Traditionally in the social sciences, causal mediation analysis has been formulated, understood, and implemented within the framework of linear structural equation models. We argue and demonstrate that this is problematic for 3 reasons: the lack of a general definition of causal mediation effects independent of a particular statistical model, the inability to specify the key identification assumption, and the difficulty of extending the framework to nonlinear models. In this article, we propose an alternative approach that overcomes these limitations. Our approach is general because it offers the definition, identification, estimation, and sensitivity analysis of causal mediation effects without reference to any specific statistical model. Further, our approach explicitly links these 4 elements closely together within a single framework. As a result, the proposed framework can accommodate linear and nonlinear relationships, parametric and nonparametric models, continuous and discrete mediators, and various types of outcome variables. The general definition and identification result also allow us to develop sensitivity analysis in the context of commonly used models, which enables applied researchers to formally assess the robustness of their empirical conclusions to violations of the key assumption. We illustrate our approach by applying it to the Job Search Intervention Study. We also offer easy-to-use software that implements all our proposed methods.",0,1 +1402,Improved models of harvest-induced bark damage,"We provided a precise quantitative analysis of the factors at the origin of bark damage during harvesting operations and developed a model able to predict them accurately. The major factors were the distance of trees to skid trails, the intensity of removals, the harvesting system as well as the interactions between the distance of trees to skid trails with harvesting systems, the average skidding distance, the tree species and tree height. During timber harvesting, trees in the remaining stand may suffer bark damage resulting from tree-felling or log manipulation. Although a multitude of case studies and empirical observations provide qualitative and quantitative information with respect to the potential causal factors, the basic quantitative relationship between major factors of influence and the resulting degree of bark damage remains largely unclear. The objective was to provide a precise quantitative analysis of impact factors explaining the occurrence of bark damage during harvesting operations. Three different modelling approaches were tested: boosted regression tree (BRT), a generalised linear mixed effects model (GLMM) and Bayesian Markov chain Monte Carlo generalised linear mixed models (MCMCglmm). The major factors with a significant impact on the occurrence of bark damage were the distance of trees to skid trails, the intensity of removals, the harvesting system and the interaction term between the distance of trees to skid trails with harvesting systems, average skidding distance, tree species and tree height. The final model includes the relevant major factors impacting on the infliction of bark damage during practical harvesting operations. Furthermore, it discriminates well with respect to the occurrence of bark damage, and it provides managers with a rational and conclusive tool for optimising harvesting operations.",0,1 +1403,"Norms of 300 general-information questions: Accuracy of recall, latency of recall, and feeling-of-knowing ratings","Normative data were collected on 300 general-information questions from a wide variety of topics, including history, sports, art, geography, literature, and entertainment. Male and female undergraduates at two different universities made a one-word response to each question either in a response booklet or at a computer console. The reported data include the following for each question: (a) probability of recall for all 270 undergraduates, for males versus females, and for University of Washington subjects versus University of California, Irvine, subjects, (b) latency of correct recall, (c) latency of errors, and (d) feeling-of-knowing ratings for nonrecalled items. Correlations among these dependent variables, along with measures of reliability, are also reported.",0,1 +1404,Performance of empirical Bayes estimators of random coefficients in multilevel analysis: Some results for the random intercept-only model,"For a multilevel model with two levels and only a random intercept, the quality of different estimators of the random intercept is examined. Analytical results are given for the marginal model interpretation where negative estimates of the variance components are allowed for. Except for four or five level-2 units, the Empirical Bayes Estimator (EBE) has a lower average Bayes risk than the Ordinary Least Squares Estimator (OLSE). The EBEs based on restricted maximum likelihood (REML) estimators of the variance components have a lower Bayes risk than the EBEs based on maximum likelihood (ML) estimators. For the hierarchical model interpretation, where estimates of the variance components are restricted being positive, Monte Carlo simulations were done. In this case the EBE has a lower average Bayes risk than the OLSE, also for four or five level-2 units. For large numbers of level-1 (30) or level-2 units (100), the performances of REML-based and ML-based EBEs are comparable. For small numbers of level-1 (10) and level-2 units (25), the REML-based EBEs have a lower Bayes risk than ML-based EBEs only for high intraclass correlations (0.5).",0,1 +1405,Mutual Information Item Selection Method in Cognitive Diagnostic Computerized Adaptive Testing With Short Test Length,"Cognitive diagnostic computerized adaptive testing (CD-CAT) purports to combine the strengths of both CAT and cognitive diagnosis. Cognitive diagnosis models aim at classifying examinees into the correct mastery profile group so as to pinpoint the strengths and weakness of each examinee whereas CAT algorithms choose items to determine those strengths and weakness as efficiently as possible. Most of the existing CD-CAT item selection algorithms are evaluated when test length is relatively long whereas several applications of CD-CAT, such as in interim assessment, require an item selection algorithm that is able to accurately recover examinees’ mastery profile with short test length. In this article, we introduce the mutual information item selection method in the context of CD-CAT and then provide a computationally easier formula to make the method more amenable in real time. Mutual information is then evaluated against common item selection methods, such as Kullback–Leibler information, posterior weighted Kullback–Leibler information, and Shannon entropy. Based on our simulations, mutual information consistently results in nearly the highest attribute and pattern recovery rate in more than half of the conditions. We conclude by discussing how the number of attributes, Q-matrix structure, correlations among the attributes, and item quality affect estimation accuracy.",0,1 +1406,"Relative magnitude of cohort, age, and year effects on size at age of exploited marine fishes","Abstract Variation in individual growth rates contributes to changes over time in compensatory population growth and surplus production for marine fishes. However, there is little evidence regarding the prevalence and magnitude of time-varying growth for exploited marine fishes in general, whether it is best approximated using changes in length-at-age or weight-at-length parameters, or how it can be represented parsimoniously. We therefore use a database of average weight in each year and age for 91 marine fish stocks from 25 species, and fit models with random variation in length and weight parameters by year, age, or cohort (birth-year). Results show that year effects are more parsimonious than age or cohort effects and that variation in length and weight parameters provide roughly similar fit to average weight-at-age data, although length parameters show a greater magnitude of variability than weight parameters. Finally, the saturated model can explain nearly 2/3 of total variability, while a single time-varying factor can explain nearly 1/2 of variability in weight-at-age data. We conclude that time-varying growth can often be estimated parsimoniously using a single time-varying factor, either internally or prior to including ‘empirical’ weight at age in population dynamics models.",0,1 +1407,Examining classroom influences on student perceptions of school climate: The role of classroom management and exclusionary discipline strategies,"There is growing emphasis on the use of positive behavior supports rather than exclusionary discipline strategies to promote a positive classroom environment. Yet, there has been limited research examining the association between these two different approaches to classroom management and students' perceptions of school climate. Data from 1902 students within 93 classrooms that were nested within 37 elementary schools were examined using multilevel structural equation modeling procedures to investigate the association between two different classroom management strategies (i.e., exclusionary discipline strategies and the use of positive behavior supports) and student ratings of school climate (i.e., fairness, order and discipline, student-teacher relationship, and academic motivation). The analyses indicated that greater use of exclusionary discipline strategies was associated with lower order and discipline scores, whereas greater use of classroom-based positive behavior supports was associated with higher scores on order and discipline, fairness, and student-teacher relationship. These findings suggest that pre-service training and professional development activities should promote teachers' use of positive behavior support strategies and encourage reduced reliance on exclusionary discipline strategies in order to enhance the school climate and conditions for learning.",0,1 +1408,Bootstrapping in Multilevel Models,"We note, however, that even as the number of bootstrap replications tends to infinity, the estimate of the population density function that is used to generate the bootstrap samples is the empirical “plug in” one derived from the actual sampled observations by placing mass points (e.g., equal probabilities) at each one. In other words the sample is assumed to be a reasonable representation of the population. Thus, with nonparametric bootstrapping, we do not have exact inference. This does not carry over to the parametric case that we describe below, where the model-based (assumed) population distribution is used for sampling: we shall return to this case later. In fact, in some situations the nonparametric bootstrap can perform very badly, for example, in small or moderate samples where the statistic of interest is the smallest or largest value, say of a set of higher level residuals in a multilevel model.",0,1 +1409,THE EFFECTS OF RESIDENTIAL TURNOVER ON HOUSEHOLD VICTIMIZATION*,"Americans move frequently, and moving alters their risks of victimization. This study uses unique longitudinal, multilevel data from the 1980–1985 National Crime Survey to examine the effects of residential turnover on household victimization. The two major findings of the study are as follows: First, housing turnover is a transition that independently increases the risk that a dwelling will experience a crime. This finding is true even controlling for persistent differences in crime vulnerability between dwellings. Second, changes in the composition and routine activities of households also alter the risks of victimization. These findings provide support for social disorganization and crime opportunity theories.",0,1 +1410,The capacity of visual working memory for features and conjunctions,"Short-term memory storage can be divided into separate subsystems for verbal information and visual information, and recent studies have begun to delineate the neural substrates of these working-memory systems. Although the verbal storage system has been well characterized, the storage capacity of visual working memory has not yet been established for simple, suprathreshold features or for conjunctions of features. Here we demonstrate that it is possible to retain information about only four colours or orientations in visual working memory at one time. However, it is also possible to retain both the colour and the orientation of four objects, indicating that visual working memory stores integrated objects rather than individual features. Indeed, objects defined by a conjunction of four features can be retained in working memory just as well as single-feature objects, allowing sixteen individual features to be retained when distributed across four objects. Thus, the capacity of visual working memory must be understood in terms of integrated objects rather than individual features, which places significant constraints on cognitive and neurobiological models of the temporary storage of visual information.",0,1 +1411,Metaanalyse–praktische Schritte und Entscheidungen im Umsetzungsprozess,"In diesem Beitrag wird der Durchführungsprozess metaanalytischer Techniken nach Hunter und Schmidt (2004) Schritt für Schritt beschrieben. In Form eines Tutoriums geben wir evidenzbasierte Empfehlungen, verweisen auf relevante Quellen und Hilfsmittel und bewerten alternative Vorgehensweisen in Bezug auf ihre Güte und Akzeptanz. Wir wenden uns an Forschende, die eine Metaanalyse mit der Besonderheit der Artefaktkorrekturen nach Hunter und Schmidt durchführen wollen und geben Anregungen für die Verbreitung metaanalytischer Ergebnisse sowohl im Wissenschaftskontext als auch im Austausch mit Praktikern.",0,1 +1412,A General Approach for Assessing Person Fit and Person Reliability in Typical-Response Measurement,"In constant-θ IRT models, person unreliability is regarded as a source of person misfit. In Variable-θ IRT models, on the other hand, it is regarded as a relevant individual characteristic, which is modeled as an additional person parameter. As in any IRT application, person fit must be assessed when a variable-θ model is fitted to real data. This assessment aims to detect inconsistent response patterns once person unreliability has been taken into account. The present paper makes a general proposal for assessing person fit based on variable-θ models that are intended to be used with personality and attitude measures. For the three types of variable-θ IRT models developed to date—binary, graded, and (approximately) continuous response models—(a) graphical procedures, (b) global person-fit indices, and (c) residual indices at the item level are proposed and discussed. A multistage approach for using the indices and procedures is also proposed and illustrated using an empirical example.",0,1 +1413,Multivariate autoregressive models,"Functional neuroimaging has been used to corroborate functional specialization as a principle of organization in the human brain. However, disparate regions of the brain do not operate in isolation and, more recently, neuroimaging has been used to characterize the network properties of the brain under speci.c cognitive states Buchel and Friston, 1997a  and  Buchel and Friston, 2000 . These studies address a complementary principle of organization, functional integration.",0,1 +1414,Maximum Likelihood Estimation of Nonlinear Structural Equation Models with Ignorable Missing Data,"The existing maximum likelihood theory and its computer software in structural equation modeling are established on the basis of linear relationships among latent variables with fully observed data. However, in social and behavioral sciences, nonlinear relationships among the latent variables are important for establishing more meaningful models and it is very common to encounter missing data. In this article, an EM type algorithm is developed for maximum likelihood estimation of a general nonlinear structural equation model with ignorable missing data, which are missing at random with an ignorable mechanism. To avoid computation of the complicated multiple integrals involved in the conditional expectations, the E-step is completed by a hybrid algorithm that combines the Gibbs sampler and the Metropolis-Hastings algorithm; while the M-step is completed efficiently by conditional maximization. Standard errors of the maximum likelihood estimates are obtained via Louis’s formula. The methodology is illustrated with results obtained from a simulation study and a real data set with rather complicated missing patterns and a large number of missing entries.",0,1 +1415,Bayesian and likelihood methods for fitting multilevel models with complex level-1 variation,"In multilevel modelling it is common practice to assume constant variance at level 1 across individuals. In this paper we consider situations where the level-1 variance depends on predictor variables. We examine two cases using a dataset from educational research; in the first case the variance at level 1 of a test depends on a continuous intake score predictor, and in the second case the variance is assumed to differ according to gender. We contrast two maximum-likelihood methods based on iterative generalised least squares with two Markov chain Monte Carlo (MCMC) methods based on adaptive hybrid versions of the Metropolis-Hastings (MH) algorithm, and we use two simulation experiments to compare these four methods. We find that all four approaches have good repeated-sampling behaviour in the classes of models we simulate. We conclude by contrasting raw- and log-scale formulations of the level-1 variance function, and we find that adaptive MH sampling is considerably more efficient than adaptive rejection sampling when the heteroscedasticity is modelled polynomially on the log scale.",0,1 +1416,Small Farmers and Big Retail: Trade-offs of Supplying Supermarkets in Nicaragua,"Summary In Nicaragua and elsewhere in Central America, small-scale farmers are weighing the risks of entering into contracts with supermarket chains. We use unique data from cooperatives supplying supermarkets to study the effect of supply agreements on producers’ mean output prices and price stability. We find that prices paid by the domestic retail chain approximate the traditional market in mean and variance while mean prices paid by Walmart are significantly lower than the traditional market. However, the Walmart contract is found to systematically reduce price volatility. We find some evidence, however, that farmers may be paying too much for this contractual insurance against price variation.",0,1 +1417,Data analysis in social psychology.,,0,1 +1418,Storage and binding of object features in visual working memory,"An influential conception of visual working memory is of a small number of discrete memory ""slots"", each storing an integrated representation of a single visual object, including all its component features. When a scene contains more objects than there are slots, visual attention controls which objects gain access to memory. A key prediction of such a model is that the absolute error in recalling multiple features of the same object will be correlated, because features belonging to an attended object are all stored, bound together. Here, we tested participants' ability to reproduce from memory both the color and orientation of an object indicated by a location cue. We observed strong independence of errors between feature dimensions even for large memory arrays (6 items), inconsistent with an upper limit on the number of objects held in memory. Examining the pattern of responses in each dimension revealed a gaussian distribution of error centered on the target value that increased in width under higher memory loads. For large arrays, a subset of responses were not centered on the target but instead predominantly corresponded to mistakenly reproducing one of the other features held in memory. These misreporting responses again occurred independently in each feature dimension, consistent with 'misbinding' due to errors in maintaining the binding information that assigns features to objects. The results support a shared-resource model of working memory, in which increasing memory load incrementally degrades storage of visual information, reducing the fidelity with which both object features and feature bindings are maintained.",0,1 +1419,Fit Indices Versus Test Statistics,"Model evaluation is one of the most important aspects of structural equation modeling (SEM). Many model fit indices have been developed. It is not an exaggeration to say that nearly every publication using the SEM methodology has reported at least one fit index. Most fit indices are defined through test statistics. Studies and interpretation of fit indices commonly assume that the test statistics follow either a central chi-square distribution or a noncentral chi-square distribution. Because few statistics in practice follow a chi-square distribution, we study properties of the commonly used fit indices when dropping the chi-square distribution assumptions. The study identifies two sensible statistics for evaluating fit indices involving degrees of freedom. We also propose linearly approximating the distribution of a fit index/statistic by a known distribution or the distribution of the same fit index/statistic under a set of different conditions. The conditions include the sample size, the distribution of the data as well as the base-statistic. Results indicate that, for commonly used fit indices evaluated at sensible statistics, both the slope and the intercept in the linear relationship change substantially when conditions change. A fit index that changes the least might be due to an artificial factor. Thus, the value of a fit index is not just a measure of model fit but also of other uncontrollable factors. A discussion with conclusions is given on how to properly use fit indices.",0,1 +1420,Flexible random-effects models using Bayesian semi-parametric models: applications to institutional comparisons,"Random effects models are used in many applications in medical statistics, including meta-analysis, cluster randomized trials and comparisons of health care providers. This paper provides a tutorial on the practical implementation of a flexible random effects model based on methodology developed in Bayesian non-parametrics literature, and implemented in freely available software. The approach is applied to the problem of hospital comparisons using routine performance data, and among other benefits provides a diagnostic to detect clusters of providers with unusual results, thus avoiding problems caused by masking in traditional parametric approaches. By providing code for Winbugs we hope that the model can be used by applied statisticians working in a wide variety of applications.",0,1 +1421,Hierarchical Modelling: Multilevel Modelling of Medical Data,"This tutorial presents an overview of multilevel or hierarchical data modelling and its applications in medicine. A description of the basic model for nested data is given and it is shown how this can be extended to fit flexible models for repeated measures data and more complex structures involving cross-classi cations and multiple membership patterns within the software package MLwiN. A variety of response types are covered and both frequentist and Bayesian estimation methods are described. © 2004 John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester. All Rights Reserved.",0,1 +1422,A system for the assessment and training of temporal-order discrimination,"Two programs were developed for psychophysical assessment and training of temporal-order thresholds in the visual and auditory modalities. Order threshold is defined as the minimum onset interval between two sensory events (stimulus onset asynchrony, SOA) that must exist before an observer is able to indicate the correct order of the events. Brain-injured patients with aphasia and children with language-learning impairments, i.e. those who have been diagnosed as performing poorly on temporal-order tasks and in discriminating stop-consonant vowel syllables, can effectively be trained by a feedback training procedure in which the SOA is manipulated. The performance in the temporal-order task and the ability to discriminate phonemes improves with this procedure. In the diagnostic program, the SOA is changed by an adaptive procedure that generates a sequence of SOAs converging to the threshold and is driven by the responses of the subject. The feedback-training program begins with the presentation of SOAs, which are slightly above the individual order threshold; they are subsequently varied according to the responses of the subject.",0,1 +1423,Generalization of Euler Angles to N‐Dimensional Orthogonal Matrices,"An algorithm is presented whereby an N‐dimensional orthogonal matrix can be represented in terms of ½N(N − 1) independent parameters θk(ν)[ν=2,3,…,N;k=1,2,…,(ν−1)]. The parameters have the character of angles, whose compact domains are defined in a manner such that there exists a one‐to‐one correspondence between the points in the parameter space and the group of orthogonal matrices. Explicit formulas are given which express all matrix elements in terms of the angles, and formulas are given which express the angles in terms of the matrix elements. Special choices of angles give block‐diagonal matrices. For three‐dimensional matrices, the parametrization is equivalent to that of Euler.",0,1 +1424,Snake venom components enhance pain upon subcutaneous injection: an initial examination of spinal cord mediators,"Snakebites are a relevant public health problem in Central and South America. Snake bite envenomations cause intense pain, not relieved by anti-venom. The fangs of many species are short, causing subcutaneous injection. Fangs of larger species inflict subcutaneous or intramuscular envenomation. To understand pain induced by subcutaneous venom, this study examined spinal mechanisms involved in pain-enhancing effects of subcutaneous Lys49 and Asp49 secretory phospholipase-A(2) (sPLA2), two components of Bothrops asper snake venom showing highly different enzymatic activities. Unilateral intraplantar sPLA2-Lys49 (catalytically inactive) or sPLA2-Asp49 (catalytically active) into rat hindpaws each induced mechanical hyperalgesia (Randall-Selitto test), whereas only catalytically active sPLA2-Asp49 caused mechanical allodynia (von Frey test). Effects induced by both sPLA2s were inhibited by intrathecal fluorocitrate, a reversible glial metabolic inhibitor. In support, immunohistochemical analysis revealed activation of dorsal horn astrocytes and microglia after intraplantar injection of either sPLA2. Spinal proinflammatory cytokines, nitric oxide, and prostanoids each appear to be involved in the pain-enhancing effects of these sPLA2s. Blockade of interleukin-1 (IL1) inhibited hyperalgesia induced by both sPLA2s, while leaving allodynia unaffected. Blockade of tumor necrosis factor reduced responses to sPLA2-Asp49. An inhibitor of neuronal nitric oxide synthase, 7-nitroindazole (7-NI), inhibited hyperalgesia induced by both sPLA2s, without interfering with allodynia induced by sPLA2-Asp49. On the other hand, L-N(6)-(1-iminoethyl)lysine (L-NI), an inhibitor of the inducible nitric oxide synthase, did not alter any sPLA2-induced effect. Lastly, celecoxib, an inhibitor of cyclooxygenase-2, attenuated sPLA2 actions. These data provide the first evidence of spinal mediators involved in pain facilitation induced by subcutaneous venoms.",0,1 +1425,"Evidence for a persistent, major excess in all cause admissions to hospital in children with type-1 diabetes: results from a large Welsh national matched community cohort study","

Objectives

To estimate the excess in admissions associated with type1 diabetes in childhood.

Design

Matched-cohort study using anonymously linked hospital admission data.

Setting

Brecon Group Register of new cases of childhood diabetes in Wales linked to hospital admissions data within the Secure Anonymised Information Linkage Databank.

Population

1577 Welsh children (aged between 0 and 15 years) from the Brecon Group Register with newly-diagnosed type-1 diabetes between 1999–2009 and 7800 population controls matched on age, sex, county, and deprivation, randomly selected from the local population.

Main outcome measures

Difference in all-cause hospital admission rates, 30-days post-diagnosis until 31 May 2012, between participants and controls.

Results

Children with type-1 diabetes were followed up for a total of 12 102 person years and were at 480% (incidence rate ratios, IRR 5.789, (95% CI 5.34 to 6.723), p<0.0001) increased risk of hospital admission in comparison to matched controls. The highest absolute excess of admission was in the age group of 0–5 years, with a 15.4% (IRR 0.846, (95% CI 0.744 to 0.965), p=0.0061) reduction in hospital admissions for every 5-year increase in age at diagnosis. A trend of increasing admission rates in lower socioeconomic status groups was also observed, but there was no evidence of a differential rate of admissions between men and women when adjusted for background risk. Those receiving outpatient care at large centres had a 16.1% (IRR 0.839, (95% CI 0.709 to 0.990), p=0.0189) reduction in hospital admissions compared with those treated at small centres.

Conclusions

There is a large excess of hospital admissions in paediatric patients with type-1 diabetes. Rates are highest in the youngest children with low socioeconomic status. Factors influencing higher admission rates in smaller centres (eg, “out of hours resources”) need to be explored with the aim of targeting modifiable influences on admission rates.",0,1 +1426,Estimation of high-dimensional prior and posterior covariance matrices in Kalman filter variants,"This work studies the effects of sampling variability in Monte Carlo-based methods to estimate very high-dimensional systems. Recent focus in the geosciences has been on representing the atmospheric state using a probability density function, and, for extremely high-dimensional systems, various sample-based Kalman filter techniques have been developed to address the problem of real-time assimilation of system information and observations. As the employed sample sizes are typically several orders of magnitude smaller than the system dimension, such sampling techniques inevitably induce considerable variability into the state estimate, primarily through prior and posterior sample covariance matrices. In this article, we quantify this variability with mean squared error measures for two Monte Carlo-based Kalman filter variants: the ensemble Kalman filter and the ensemble square-root Kalman filter. Expressions of the error measures are derived under weak assumptions and show that sample sizes need to grow proportionally to the square of the system dimension for bounded error growth. To reduce necessary ensemble size requirements and to address rank-deficient sample covariances, covariance-shrinking (tapering) based on the Schur product of the prior sample covariance and a positive definite function is demonstrated to be a simple, computationally feasible, and very effective technique. Rules for obtaining optimal taper functions for both stationary as well as non-stationary covariances are given, and optimal taper lengths are given in terms of the ensemble size and practical range of the forecast covariance. Results are also presented for optimal covariance inflation. The theory is verified and illustrated with extensive simulations.",0,1 +1427,Parsimonious Covariance Matrix Estimation for Longitudinal Data,"This article proposes a data-driven method to identify parsimony in the covariance matrix of longitudinal data and to exploit any such parsimony to produce a statistically efficient estimator of the covariance matrix. The approach parameterizes the covariance matrix through the Cholesky decomposition of its inverse. For longitudinal data, this is a one-step-ahead predictive representation, and the Cholesky factor is likely to have off-diagonal elements that are zero or close to zero. A hierarchical Bayesian model is used to identify any such zeros in the Cholesky factor, similar to approaches that have been successful in Bayesian variable selection. The model is estimated using a Markov chain Monte Carlo sampling scheme that is computationally efficient and can be applied to covariance matrices of high dimension. It is demonstrated through simulations that the proposed method compares favorably in terms of statistical efficiency with a highly regarded competing approach. The estimator is applied to three ...",0,1 +1428,A general multilevel SEM framework for assessing multilevel mediation.,"Several methods for testing mediation hypotheses with 2-level nested data have been proposed by researchers using a multilevel modeling (MLM) paradigm. However, these MLM approaches do not accommodate mediation pathways with Level-2 outcomes and may produce conflated estimates of between- and within-level components of indirect effects. Moreover, these methods have each appeared in isolation, so a unified framework that integrates the existing methods, as well as new multilevel mediation models, is lacking. Here we show that a multilevel structural equation modeling (MSEM) paradigm can overcome these 2 limitations of mediation analysis with MLM. We present an integrative 2-level MSEM mathematical framework that subsumes new and existing multilevel mediation approaches as special cases. We use several applied examples and accompanying software code to illustrate the flexibility of this framework and to show that different substantive conclusions can be drawn using MSEM versus MLM.",0,1 +1429,Bayesian mediation analysis.,"In this article, we propose Bayesian analysis of mediation effects. Compared with conventional frequentist mediation analysis, the Bayesian approach has several advantages. First, it allows researchers to incorporate prior information into the mediation analysis, thus potentially improving the efficiency of estimates. Second, under the Bayesian mediation analysis, inference is straightforward and exact, which makes it appealing for studies with small samples. Third, the Bayesian approach is conceptually simpler for multilevel mediation analysis. Simulation studies and analysis of 2 data sets are used to illustrate the proposed methods. (PsycINFO Database Record (c) 2009 APA, all rights reserved).",1,1 +1430,Evaluation of Reliability Coefficients for Two-Level Models via Latent Variable Analysis,"A latent variable analysis procedure for evaluation of reliability coefficients for 2-level models is outlined. The method provides point and interval estimates of group means' reliability, overall reliability of means, and conditional reliability. In addition, the approach can be used to test simple hypotheses about these parameters. The procedure is applicable with unconditional models as well as with conditional models including higher level explanatory variables. The proposed method is illustrated with an empirical example.",0,1 +1431,An evaluation of homogeneity tests in meta-analyses in pain using simulations of individual patient data,"In this paper we consider the validity and power of some commonly used statistics for assessing the degree of homogeneity between trials in a meta-analysis. We show, using simulated individual patient data typical of that occurring in randomized controlled trials in pain, that the most commonly used statistics do not give the expected levels of statistical significance (i.e. the proportion of trials giving a significant result is not equal to the proportion expected due to random chance) when used with truly homogeneous data. In addition, all such statistics are shown to have extremely low power to detect true heterogeneity even when that heterogeneity is very large. Since, in most practical situations, failure to detect heterogeneity does not allow us to say with any helpful degree of certainty that the data is truly homogeneous, we advocate the quantitative combination of results only where the trials contained in a meta-analysis can be shown to be clinically homogeneous. We propose as a definition of clinical homogeneity that all trials have (i) fixed and clearly defined inclusion criteria and (ii) fixed and clearly defined outcomes or outcome measures. In pain relief, for example, the first of these would be satisfied by all patients having moderate or severe pain, whilst the second would be satisfied by using at least 50% pain relief as the successful outcome measure.",0,1 +1432,Constraining Cognitive Abstractions Through Bayesian Modeling,"There are many ways to combine neural and behavioral measures to study cognition. Someways are theoretical, and otherways are statistical. The predominant statistical approach treats both sources of data as independent and the relationship between the two measures is inferred by way of a (post hoc) regression analysis. Inthis chapter, we review an alternative approach that allows for flexible modeling of both measures simultaneously.We then explore and elaborate on several of the most important benefits of this modeling approach, and close with a model comparison of the Linear Ballistic Accumulator model and a drift diffusion model on neural and behavioral data. © Springer Science+Business Media, LLC 2015.",0,1 +1433,Patterns of Change within Latent Variable Structural Equation Models,"This chapter demonstrates how selected hypotheses about patterns of change can be investigated using concepts derived from linear structural equation modeling. In Section 5.1 we discuss the concept of structuring correlations by structural equation methods. In Section 5.2 we describe some longitudinal data and illustrate technical aspects of various structural models for these summary statistics. Here we describe the relations between the algebraic and graphic representation of linear models and the nonlinear expectations they imply. In Section 5.3 four different models of change are presented and fitted to these longitudinal data using structural equation model algorithms. These models include an autoregressive change model, a difference components change model, a growth curve change model, and a factor analysis change model. In Section 5.4 some of these ideas are considered together in a multivariate framework. These examples demonstrate the merger of contemporary issues in developmental psychology and structural equation analysis.",0,1 +1434,Reinterpreting the development of reading skills,"Theories about reading have neglected basic differences in the developmental trajectories of skills related to reading. This essay proposes that some reading skills, such as learning the letters of the alphabet, are constrained to small sets of knowledge that are mastered in relatively brief periods of development. In contrast, other skills, such as vocabulary, are unconstrained by the knowledge to be acquired or the duration of learning. The conceptual, developmental, and methodological constraints on different reading skills are described in this essay that identifies various types of constraints on reading constructs and measures. Examples of reading research and assessment are discussed to illustrate (a) how the constraints can help to explain transitory correlational patterns among reading data, (b) how proxy effects surrounding constrained skills influence interpretations of reading development, (c) how prescriptions to teach constrained skills are causal misinterpretations of longitudinal correlations, and (d) why interventions on constrained skills usually lead only to temporary gains on skills aligned with the constrained skill. Because constrained skills are not normally distributed conceptually or empirically, except on special occasions, analyses based on parametric statistics are inappropriate. This essay describes implications for theories of reading development, research methods, and educational policies; the “extra” commentary linked to the online version of the article expands on this latter theme. Las teorias acerca de la lectura han descuidado diferencias basicas en el camino evolutivo de las habilidades relacionadas con la lectura. Este ensayo propone que ciertas habilidades de lectura, como el aprendizaje de las letras del alfabeto, estan restringidas a pequenos conjuntos de conocimientos cuyo dominio se concreta en periodos relativamente breves. En contraste, otras habilidades tales como el vocabulario, no estan restringidas por el conocimiento que se adquirira ni por la duracion del aprendizaje. En este ensayo se describen las restricciones conceptuales, evolutivas y metodologicas en diferentes habilidades de lectura; el mismo identifica varios tipos de restricciones en las conceptualizaciones sobre la lectura y en las medidas de lectura. Se discuten ejemplos de investigacion y evaluacion en lectura para ilustrar: a) de que modo las restricciones pueden ayudar a explicar patrones correlacionales transitorios entre los datos de lectura, b) como efectos secundarios proximos a las habilidades restringidas influencian las interpretaciones del desarrollo en lectura, c) como ciertas propuestas para ensenar habilidades restringidas son malas interpretaciones causales de correlaciones longitudinales y d) por que las intervenciones sobre las habilidades restringidas generalmente conducen solo a logros temporarios en habilidades afines a la habilidad restringida. Debido a que las habilidades restringidas, excepto en ocasiones especiales, no estan normalmente distribuidas conceptual o empiricamente, son inapropiados los analisis basados en la estadistica parametrica. El ensayo describe implicancias para las teorias del desarrollo lector, los metodos de investigacion y las politicas educativas. Theorien ubers Lesen haben die grundsatzlichen Unterschiede in den aufs Lesen bezogenen sich entwickelnden Leistungsbahnen vernachlassigt. Dieser Aufsatz vertritt die Ansicht, das einige Leseleistungen, wie beispielsweise das Erlernen der Buchstaben des Alphabets, auf eng begrenzte Erkenntniswerte beschrankt sind, die in relativ kurzen Entwicklungsperioden beherrscht werden. Im Gegensatz dazu sind andere Kenntnisse, wie das Vokabular, unbegrenzt im zu erlernenden Wissen oder in der Dauer beim Lernen. Die konzeptualen, entwicklungsbedingten und methodologischen Beschrankungen auf unterschiedliche Leseleistungen werden in diesem Aufsatz beschrieben, welcher verschiedene Typen von Einschrankungen im Lesen von Wortfugungen und Abschatzungen identifiziert. Beispiele aus der Leseforschung und Bewertung werden diskutiert, um zu illustrieren, (a) wie die Einschrankungen dazu verhelfen konnen, transitorische Korrelationsmuster zwischen den Lesedaten zu erklaren, (b) wie Vertretungsfunktionen umgebende Auswertungen von Leistungseinwirkungen der Leseentwicklung beeinflust, (c) wie Verordnungen zum Unterrichten eingegrenzter Kenntnisse kausale Fehlinterpretationen der Langenkorrelationen sind, und (d) warum Interventionen bei eingegrenzten Kenntnissen meistens nur zu zeitweisen Fortschritten der angeglichenen Leistungen eingeschrankter Fahigkeiten fuhren. Da eingeschrankte Befahigungen normalerweise nicht konzeptionell oder empirisch eingeteilt sind, auser bei speziellen Anlassen, sind die auf parametrische Statistiken basierte Analysen ungeeignet. Dieser Aufsatz beschreibt Implikationen fur Theorien zur Leseentwicklung, Forschungsmethoden und Unterrichtsverfahren. Les theories de la lecture ont neglige des differences de base dans les trajectoires du developpement des competences relatives a la lecture. Cet essai enonce que certaines competences de lecture telles que les lettres de l'alphabet se reduisent a de petits ensembles de connaissances qui sont maitrisees au cours de periodes de developpement relativement breves. Par contre, d'autres competences telles que le vocabulaire ne sont pas limitees par les connaissances a acquerir ou par la duree de l'apprentissage. On decrit dans cet essai, qui identifie differents types de contraintes sur les constructs et les evaluations de la lecture, les contraintes conceptuelles, developpementales, et methodologiques de differentes competences de lecture. On discute des exemples de recherche et d'evaluation de la lecture afin de montrer a) comment les contraintes peuvent aider a expliquer certains patrons provisoires de correlations entre resultats de lecture, b) comment des effets voisins qui se trouvent autour des competences reduites jouent un role sur les interpretations du developpement de la lecture, c) comment les prescriptions d'enseignement de competences reduites sont responsables d'erreurs d'interpretation des correlations longitudinales, et d) pourquoi des interventions sur des competences reduites ne conduisent en general qu'a des gains temporaires sur des competences liees a celles-ci. Du fait que, sauf en de rares occasions, les competences reduites ne sont pas distribuees normalement, tant conceptuellement qu'empiriquement, les analyses reposant sur des statistiques parametriques sont inappropriees. Cet essai enonce enfin des implications sur les theories du developpement de la lecture, les methodes de recherche, et les politiques educatives.",0,1 +1435,The PHLAME (Promoting Healthy Lifestyles: Alternative Models' Effects) firefighter study: Testing mediating mechanisms.,"This paper examines the mechanisms by which PHLAME (Promoting Healthy Lifestyles: Alternative Models' Effects), a health promotion intervention, improved healthy eating and exercise behavior among firefighters, a population at high risk for health problems due to occupational hazards. In a randomized trial, 397 firefighters participated in either the PHLAME team intervention with their work shift or a control condition. Intervention sessions taught benefits of a healthy diet and regular exercise, and sought to improve social norms and social support from coworkers for healthy behavior. At posttest, team intervention participants had increased their fruit and vegetable consumption as compared to control participants. An increase in knowledge of fruit and vegetable benefits and improved dietary coworker norms partially mediated these effects. Exercise habits and VO2 max were related to targeted mediators but were not significantly changed by the team intervention. Partial support was found for both the action and conceptual theories underlying the intervention. Our findings illustrate how an effective program's process can be deconstructed to understand the underpinnings of behavior change and refine interventions. Further, fire stations may improve the health of firefighters by emphasizing the benefits of healthy diet and exercise behaviors while also encouraging behavior change by coworkers as a whole.",0,1 +1436,Variance component models for longitudinal count data with baseline information: epilepsy data revisited,"Random effect models have often been used in longitudinal data analysis since they allow for association among repeated measurements due to unobserved heterogeneity. Various approaches have been proposed to extend mixed models for repeated count data to include dependence on baseline counts. Dependence between baseline counts and individual-specific random effects result in a complex form of the (conditional) likelihood. An approximate solution can be achieved ignoring this dependence, but this approach could result in biased parameter estimates and in wrong inferences. We propose a computationally feasible approach to overcome this problem, leaving the random effect distribution unspecified. In this context, we show how the EM algorithm for nonparametric maximum likelihood (NPML) can be extended to deal with dependence of repeated measures on baseline counts. © Springer Science + Business Media, LLC 2006.",0,1 +1437,,"Markov chain Monte Carlo (MCMC) techniques have revolutionized the field of Bayesian statistics by enabling posterior inference for arbitrarily complex models. The now widely used WinBUGS software has, over the years, made the methodology accessible to a great many applied scientists, in all fields of research. Despite this, serious application of MCMC methods within the field of population PK/PD has been comparatively limited. We appreciate that for many applied pharmacokineticists the prospect of conducting a Bayesian analysis will require numerous alien concepts to be taken on board and it may be difficult to justify investing the time and effort required in order to understand them (especially since the approach is so computer-intensive). For this reason we provide here a thorough (but often informal) discussion of all aspects of Bayesian inference as they apply specifically to population PK/PD. We also acknowledge that while the WinBUGS software is general purpose, model specification for some types of problem, population PK/PD being a prime example, can be very difficult, to the extent that a specialized interface for describing the problem at hand is often a practical necessity. In the latter part of this paper we describe such an interface, namely PKBugs. A principal aim of the paper is to offer sufficient technical background, in an easy to follow format, that the reader may develop both the confidence and know-how to make appropriate use of the PKBugs/WinBUGS framework (or similar software) for their own data analysis needs, should they choose to adopt a Bayesian approach.",0,1 +1438,Mutual Information Item Selection in Adaptive Classification Testing,"A general approach for item selection in adaptive multiple-category classification tests is provided. The approach uses mutual information (MI), a special case of the Kullback-Leibler distance, or relative entropy. MI works efficiently with the sequential probability ratio test and alleviates the difficulties encountered with using other local- and global-information measures in the multiple-category classification setting. Results from simulation studies using three item selection methods, Fisher information (FI), posterior-weighted FI (FIP), and MI, are provided for an adaptive four-category classification test. Both across and within the four classification categories, it is shown that in general, MI item selection classifies the highest proportion of examinees correctly and yields the shortest test lengths. The next best performance is observed for FIP item selection, followed by FI.",0,1 +1439,Maximum likelihood estimation of the polychoric correlation coefficient,"The polychoric correlation is discussed as a generalization of the tetrachoric correlation coefficient to more than two classes. Two estimation methods are discussed: Maximum likelihood estimation, and what may be called ""two-step maximum likelihood"" estimation. For the latter method, the thresholds are estimated in the first step. For both methods, asymptotic covariance matrices for estimates are derived, and the methods are illustrated and compared with artificial and real data. © 1979 The Psychometric Society.",0,1 +1440,The Theory of Planned Behaviour and exercise: Evidence for the moderating role of past behaviour,"Objectives. This study reports an application of the Theory of Planned Behaviour (TPB) to the prediction of exercise intentions and behaviour over a 6-month period. The study also considers the moderating effect of past behaviour on the intention-behaviour and perceived behavioural control-behaviour relationships. Design and methods. A sample of 87 patients attending health promotions clinics in a primary care setting completed questionnaires on the TPB and exercise behaviour after their clinic appointment and were followed-up at 6 months. Results. The TPB was found to be predictive of initial exercise intentions and future exercise behaviour at 6-month follow-up, with the perceived behavioural control construct emerging as the sole independent predictor in both cases. Past behaviour was found to have a direct effect on future exercise behaviour over and above the influence of the TPB. In addition, past behaviour moderated the perceived behavioural control-behaviour relationship which was found to be significant when the frequency of past behaviour was moderate or high, but non-significant when the frequency of past behaviour was low. Conclusion. The results highlight (1) the importance of the perceived behavioural control construct of the TPB in the prediction of exercise intentions and behaviour, and (2) the need to consider the moderating effect of past behaviour on TPB-behaviour relations.",0,1 +1441,Dissonance and healthy weight eating disorder prevention programs: A randomized efficacy trial.,"In this trial, adolescent girls with body dissatisfaction (N = 481, M age = 17 years) were randomized to an eating disorder prevention program involving dissonance-inducing activities that reduce thin-ideal internalization, a prevention program promoting healthy weight management, an expressive writing control condition, or an assessment-only control condition. Dissonance participants showed significantly greater reductions in eating disorder risk factors and bulimic symptoms than healthy weight, expressive writing, and assessment-only participants, and healthy weight participants showed significantly greater reductions in risk factors and symptoms than expressive writing and assessment-only participants from pretest to posttest. Although these effects faded over 6-month and 12-month follow-ups, dissonance and healthy weight participants showed significantly lower binge eating and obesity onset and reduced service utilization through 12-month follow-up, suggesting that both interventions have public health potential.",0,1 +1442,Accuracy and Precision of an Effect Size and Its Variance From a Multilevel Model for Cluster Randomized Trials: A Simulation Study,"This article investigates an effect size (MLM ES) and its variance for cluster randomized trials based on parameter estimates from multilevel modeling analysis. Accuracy and precision of MLM ES were evaluated using Monte Carlo simulation methods and compared with the performance of an effect size, computed from summary statistics, proposed by Hedges (2007; Hedges' dB ). Simulation results indicated that MLM ES had acceptable accuracy in all conditions, also demonstrating efficiency and consistency. With small sample sizes, MLM ES did not suffer from the same negative bias as Hedges' dB due to overestimation of between-cluster variance. With large sample sizes, MLM ES and Hedges' dB were comparable for accuracy and efficiency. Both MLM ES and Hedges' dB showed considerable bias in some conditions when cluster sizes were unequal. An illustrative example using real data was provided.",0,1 +1443,The Social Relations Model,"Publisher Summary The Social Relations Model represents one method of studying two-person relationships. It attempts to separate the effects of persons and dyad. The Social Relations Model has three potential contributions to the study of dyads. First, it provides a purely methodological-statistical solution to the analysis of dyadic data. The Social Relations Model represents a new approach to the analysis of dyadic data structures. Second, the model can provide social psychology with better procedures to resolve the theoretical issues of the discipline. Third, the model is useful because it looks at social behavior as simultaneously operating at multiple levels. Very different principles operate at these different levels and only by simultaneously examining social behavior at different levels, the complexity and simplicity of social life can be fully appreciated.",0,1 +1444,Ethnic group differences in measures of job performance: A new meta-analysis.,"The authors conducted a new meta-analysis of ethnic group differences in job performance. Given a substantially increased set of data as compared with earlier analyses, the authors were able to conduct analyses of Black-White differences within more homogeneous categories of job performance and to reexamine findings on objective versus subjective measurement. Contrary to one perspective sometimes adopted in the field, objective measures are associated with very similar, if not somewhat larger, standardized ethnic group differences (ds) than subjective measures across a variety of indicators. This trend was consistent across quality, quantity, and absenteeism measures. Further, work samples and job knowledge tests are associated with larger ds than performance ratings or measures of absenteeism. Analysis of Hispanic-White standardized differences shows that they are generally lower than Black-White differences in several categories.",0,1 +1445,Using geocoded survey data to improve the accuracy of multilevel small area synthetic estimates,"This paper examines the secondary data requirements for multilevel small area synthetic estimation (ML-SASE). This research method uses secondary survey data sets as source data for statistical models. The parameters of these models are used to generate data for small areas. The paper assesses the impact of knowing the geographical location of survey respondents on the accuracy of estimates, moving beyond debating the generic merits of geocoded social survey datasets to examine quantitatively the hypothesis that knowing the approximate location of respondents can improve the accuracy of the resultant estimates. Four sets of synthetic estimates are generated to predict expected levels of limiting long term illnesses using different levels of knowledge about respondent location. The estimates were compared to comprehensive census data on limiting long term illness (LLTI). Estimates based on fully geocoded data were more accurate than estimates based on data that did not include geocodes.",0,1 +1446,Factors Affecting Perceptions of Family Function in Caregivers of Children With Attention Deficit Hyperactivity Disorders,"Attention deficit and hyperactivity disorder (ADHD) is the most common neurobehavioral disorder of childhood. ADHD has been shown to persist into adulthood in 30%-70% of cases. The long-term and escalating nature of ADHD creates an increasing burden on families because of the influence of hyperactivity and impulsivity on academic achievement and social interaction. There is a lack of information on factors influencing function in the families of children with ADHD.The purpose of this study was to test theoretically derived relationships among family demographic characteristics; family factors such as support, hardiness, and caregiver health; and family-functioning outcomes.This study used a cross-sectional study and structural equation modeling approach. A self-report questionnaire collected information from 122 caregivers on demographics, income, employment, and marital status data as well as on personal health, family support, family hardiness, and family function statuses as determined, respectively, using the Duke Health Profile, Family APGAR score, Family Hardiness Index, and Family Assessment Device.Structural equation modeling provided a reasonable fit to the data using AMOS (χ = .249, df = 1, p = .613, minimum discrepancy C = .249), goodness-of-fit index (.999), adjusted goodness of fit index (.990), normed fit index (.999), comparative fit index (1.0), and root mean square error of approximation (.000). Results indicated a 55.6% probability of becoming the construct model, with family hardiness and family support directly affecting family function and caregiver health. Family support functioned as a mediator in the relationship between family hardiness and family function.The findings of this study help nurses improve professional assessments and interventions for families of children with ADHD by highlighting the importance of increased family support, promoting family hardiness, and promoting caregivers' health to improved family function.",0,1 +1447,Maximum Likelihood Analysis of a Two-Level Nonlinear Structural Equation Model With Fixed Covariates,"In this article, a maximum likelihood (ML) approach for analyzing a rather general two-level structural equation model is developed for hierarchically structured data that are very common in educational and/or behavioral research. The proposed two-level model can accommodate nonlinear causal relations among latent variables as well as effects of fixed covariate in its various components. Methods for computing the ML estimates, and the Bayesian information criterion (BIC) for model comparison are established on the basis of powerful tools in statistical computing such as the Monte Carlo EM algorithm, Gibbs sampler, Metropolis–Hastings algorithm, conditional maximization, bridge sampling, and path sampling. The newly developed procedures are illustrated by results obtained from a simulation study and analysis of a real data set in education.",0,1 +1448,"Evaluating EIV, OLS, and SEM Estimators of Group Slope Differences in the Presence of Measurement Error","Measurement error significantly biases interaction effects and distorts researchers’ inferences regarding interactive hypotheses. This article focuses on the single-indicator case and shows how to accurately estimate group slope differences by disattenuating interaction effects with errors-in-variables (EIV) regression. New analytic findings were presented along with simulation results to compare the relative bias, power, and Type I error rates of EIV, ordinary least squares (OLS), and sparse (i.e., single indicator) multigroup structural equation model (SEM) estimators of interaction effects in the presence of measurement error. The results suggest that EIV was less biased than were OLS and sparse SEM. Furthermore, OLS and sparse SEM were unable to control the Type I error rate for tests of slope differences in circumstances where groups differ in predictor reliability. Additional derivations examined the impact of using Cronbach’s alpha, which is typically a lower bound for reliability, with EIV. The results provided evidence that using alpha does result in overcorrected EIV estimates and the bias in EIV estimates associated with using Cronbach’s alpha increases with variability in item loadings and bias decreases as either test length or the average loading increases. The bias in EIV estimates when using alpha is not larger than the bias produced by using OLS or sparse SEM. In summary, the results provide compelling evidence that researchers should use EIV instead of OLS and sparse SEM to estimate group slope differences in the presence of measurement error.",0,1 +1449,On appropriate procedures for combining probability distributions within the same family,"Abstract This article considers procedures for combining individual probability distributions that belong to some “family” into a “group” probability distribution that belongs to the same family. The procedures considered are Vincentizing, in which quantiles are averaged across distributions; generalized Vincentizing, in which the quantiles are transformed before averaging; and pooling based on the distribution function or the probability density function. Some of these results are applied to models of reaction time in psychological experiments.",0,1 +1450,Inference and monitoring convergence,,0,1 +1451,Sample size considerations in observational health care quality studies,"A common objective in health care quality studies involves measuring and comparing the quality of care delivered to cohorts of patients by different health care providers. The data used for inference involve observations on units grouped within clusters, such as patients treated within hospitals. Unlike cluster randomization trials where often clusters are randomized to interventions to learn about individuals, the target of inference in health quality studies is the cluster. Furthermore, randomization is often not performed and the resulting biases may invalidate standard tests. In this paper, we discuss approaches to sample size determination in the design of observational health quality studies when the outcome is binary. Methods for calculating sample size using marginal models are briefly reviewed, but the focus is on hierarchical binomial models. Sample size in unbalanced clusters and stratified designs are characterized. We draw upon the experiences that have arisen from a study funded by the Agency for Healthcare Research and Quality involving assessment of quality of care for patients with cardiovascular disease. If researchers are interested in comparing clusters, hierarchical models are preferred. Copyright © 2002 John Wiley & Sons, Ltd.",0,1 +1452,Personality mediators of psychopathy and substance dependence in male offenders,"Psychopathy and substance dependence (SUD) is highly prevalent in incarcerated populations and tends to co-occur in the same individuals. The factors underlying this relationship are not clearly understood. The primary purpose of this study was to investigate whether two personality models mediate the relationship between psychopathy and substance misuse in male offenders. Ninety-two inmates in provincial correctional centers in New Brunswick completed questionnaires, including the Sensitivity to Reward Sensitivity to Punishment Questionnaire to measure behavioral activation and behavioral inhibition, the Substance Use Risk Profile Scale to measure anxiety sensitivity, introversion/hopelessness, sensation seeking and impulsivity, and the Psychopathic Personality Inventory—Revised to assess psychopathy levels. Results revealed that high impulsivity indirectly mediated the relationship between psychopathy and stimulant dependence. In addition, low anxiety sensitivity indirectly mediated the relationship between psychopathy and opioid dependence. Finally, impulsivity indirectly and inconsistently mediated the relationship between psychopathy and alcohol dependence. These results suggest that individuals with psychopathic traits are at increased risk of misusing certain drugs due to underlying personality-based differences. ► Psychopathy traits/substance misuse are highly prevalent and comorbid in offenders. ► We recruited inmates and measured psychopathy, personality, and substance dependence. ► High impulsivity was an indirect mediator of psychopathy and stimulant/alcohol SUD. ► Low anxiety sensitivity was an indirect mediator of psychopathy and opioid SUD. ► Psychopathic traits are distinctly related with SUDS due to personality differences.",0,1 +1453,Multilevel Modeling with Correlated Effects,"When there exist omitted effects, measurement error, and/or simultaneity in multilevel models, explanatory variables may be correlated with random components, and standard estimation methods do not provide consistent estimates of model parameters. This paper introduces estimators that are consistent under such conditions. By employing generalized method of moments (GMM) estimation techniques in multilevel modeling, the authors present a series of estimators along a robust to efficient continuum. This continuum depends on the assumptions that the analyst makes regarding the extent of the correlated effects. It is shown that the GMM approach provides an overarching framework that encompasses well-known estimators such as fixed and random effects estimators and also provides more options. These GMM estimators can be expressed as instrumental variable (IV) estimators which enhances their interpretability. Moreover, by exploiting the hierarchical structure of the data, the current technique does not require additional variables unlike traditional IV methods. Further, statistical tests are developed to compare the different estimators. A simulation study examines the finite sample properties of the estimators and tests and confirms the theoretical order of the estimators with respect to their robustness and efficiency. It further shows that not only are regression coefficients biased, but variance components may be severely underestimated in the presence of correlated effects. Empirical standard errors are employed as they are less sensitive to correlated effects when compared to model-based standard errors. An example using student achievement data shows that GMM estimators can be effectively used in a search for the most efficient among unbiased estimators. © 2007 The Psychometric Society.",0,1 +1454,Comparison of PQL and Laplace 6 estimates of hierarchical linear models when comparing groups of small incident rates in cluster randomised trials,"The variances of the random components in hierarchical generalised linear models (HGLMs) with binary outcomes have been reported to have a considerable downward bias when estimated with the commonly used penalised quasilikelihood (PQL) technique. The more recently proposed Laplace 6 approximation promises to reduce this bias. This study compares the performance of these two techniques when estimating the parameters of a particular HGLM. This comparison is performed via Monte Carlo simulations in which the difference between two groups of proportions, modelled after those appearing in many epidemiological cluster randomised interventions, are tested using this model. The Laplace 6 approximation does reduce the bias mentioned above, but at the price of a higher mean square error. The results of this study suggest that the optimal solution involves using a combination of these two techniques. This combination is illustrated by analysing a data set from a real cluster randomised intervention.",0,1 +1455,A Nonlinear Mixed Effects Model for Latent Variables,"The nonlinear mixed effects model for continuous repeated measures data has become an increasingly popular and versatile tool for investigating nonlinear longitudinal change in observed variables. In practice, for each individual subject, multiple measurements are obtained on a single response variable over time or condition. This structure can be adapted to examine the change in latent variables rather than modeling change in manifest variables. This article considers a nonlinear mixed effects model for describing nonlinear change of a latent construct over time, where the latent construct of interest is measured by multiple indicators gathered at each measurement occasion. To accomplish this, the nonlinear mixed effects model is modified to include a measurement model that explicitly expresses the relationship of the observed variables to the latent constructs. A method for marginal maximum likelihood estimation of this model is presented and discussed. An example using education data is provided to illustrate the utility of the model.",0,1 +1456,Double pulse resolution in the visual field: the influence of temporal stimulus characteristics,"I. It has been suggested that measuring double-pulse resolution in the visual field is more useful than performing flicker perimetry. Yet it is difficult to assess the diagnostic potentials of this technique unless a number of methodological difficulties are overcome. 2. We succeeded to show that double-pulse resolution can be measured efficiently and reliably by varying pulse durations over a wide temporal range, by employing a nine-alternative forced-choice paradigm with nine locations in the visual field, and by employing a maximum likelihood estimate of the threshold parameter. Our results, which have been obtained at the central fovea and at eight locations on the principal meridians with 3.4° eccentricity, reveal three main properties of visual performance. 3. Temporal resolution is worst (i.e. 50-70 ms) at a duration of the leading pulse of 20 ms. It monotonically improves to assume an asymptotic value of about 20 ms beyond pulse durations of say 150 ms. Resolution may also improve if the pulse duration is as brief as 10 ms. 4. The prolongation of the trailing pulse has virtually no effect on double-pulse resolution. 5. Double-pulse resolution in the central fovea is, almost independently of the pulse duration, 10-20 ms better than in the peripheral visual field.",0,1 +1457,The Adaptive Nature of Visual Working Memory,"A growing body of scientific evidence suggests that visual working memory and statistical learning are intrinsically linked. Although visual working memory is severely resource limited, in many cases, it makes efficient use of its available resources by adapting to statistical regularities in the visual environment. However, experimental evidence also suggests that there are clear limits and biases in statistical learning. This raises the intriguing possibility that performance limitations observed in visual working memory tasks can to some degree be explained in terms of limits and biases in statistical-learning ability, rather than limits in memory capacity.",0,1 +1458,Stratification and weighting via the propensity score in estimation of causal treatment effects: a comparative study,"Estimation of treatment effects with causal interpretation from observational data is complicated because exposure to treatment may be confounded with subject characteristics. The propensity score, the probability of treatment exposure conditional on covariates, is the basis for two approaches to adjusting for confounding: methods based on stratification of observations by quantiles of estimated propensity scores and methods based on weighting observations by the inverse of estimated propensity scores. We review popular versions of these approaches and related methods offering improved precision, describe theoretical properties and highlight their implications for practice, and present extensive comparisons of performance that provide guidance for practical use. Copyright © 2004 John Wiley & Sons, Ltd.",0,1 +1459,Estimation of Composite Reliability for Congeneric Measures,"A structural equation model is described that permits estimation of the reliability index and coefficient of a composite test for congeneric measures. The method is also helpful in exploring the factorial structure of an item set, and its use in scale reliability estimation and development is illustrated. The modeling. estimator of composite reliability it yields does not possess the general underestimation property of Cronbach's coefficient a.",0,1 +1460,Proinflammatory cytokines oppose opioid-induced acute and chronic analgesia,"Spinal proinflammatory cytokines are powerful pain-enhancing signals that contribute to pain following peripheral nerve injury (neuropathic pain). Recently, one proinflammatory cytokine, interleukin-1, was also implicated in the loss of analgesia upon repeated morphine exposure (tolerance). In contrast to prior literature, we demonstrate that the action of several spinal proinflammatory cytokines oppose systemic and intrathecal opioid analgesia, causing reduced pain suppression. In vitro morphine exposure of lumbar dorsal spinal cord caused significant increases in proinflammatory cytokine and chemokine release. Opposition of analgesia by proinflammatory cytokines is rapid, occurring < or =5 min after intrathecal (perispinal) opioid administration. We document that opposition of analgesia by proinflammatory cytokines cannot be accounted for by an alteration in spinal morphine concentrations. The acute anti-analgesic effects of proinflammatory cytokines occur in a p38 mitogen-activated protein kinase and nitric oxide dependent fashion. Chronic intrathecal morphine or methadone significantly increased spinal glial activation (toll-like receptor 4 mRNA and protein) and the expression of multiple chemokines and cytokines, combined with development of analgesic tolerance and pain enhancement (hyperalgesia, allodynia). Statistical analysis demonstrated that a cluster of cytokines and chemokines was linked with pain-related behavioral changes. Moreover, blockade of spinal proinflammatory cytokines during a stringent morphine regimen previously associated with altered neuronal function also attenuated enhanced pain, supportive that proinflammatory cytokines are importantly involved in tolerance induced by such regimens. These data implicate multiple opioid-induced spinal proinflammatory cytokines in opposing both acute and chronic opioid analgesia, and provide a novel mechanism for the opposition of acute opioid analgesia.",0,1 +1461,Sciatic inflammatory neuritis (SIN): Behavioral allodynia is paralleled by peri‐sciatic proinflammatory cytokine and superoxide production,"We have recently developed a model of sciatic inflammatory neuritis (SIN) to assess how immune activation near peripheral nerves influences somatosensory processing. Administration of zymosan (yeast cell walls) around a single sciatic nerve produces dose-dependent low-threshold mechanical allodynia without thermal hyperalgesia. Low (4 microg) doses produce both territorial and extraterritorial allodynia restricted to the injected hindleg. In contrast, higher (40 microg) doses produce territorial and extraterritorial allodynias of both hindlegs, an effect not accounted for by systemic spread of the zymosan. The aim of these experiments was to determine whether these behavioral allodynias were correlated with immunological and/or anatomical changes in or around the sciatic nerve. These experiments reveal that zymosan-induced bilateral allodynia was associated with the following: (a) increased release of both interleukin-1beta and tumor necrosis factor-alpha from peri-sciatic immune cells; (b) increased release of reactive oxygen species from perisciatic immune cells; (c) no change in circulating levels of proinflammatory cytokine; (d) no apparent zymosan-induced influx of immune cells into the sciatic nerve from the endoneurial blood vessels; (e) mild edema of the sciatic, which was predominantly restricted to superficial regions closest to the peri-sciatic immune cells; and (f) no anatomic evidence of changes in either the ipsilateral saphenous nerve or contralateral sciatic nerve that could account for the appearance of extraterritorial or contralateral (""mirror"") allodynia, respectively. No reliable differences were found when the low-dose zymosan was compared with vehicle controls. Taken together, these data suggest that substances released by peri-sciatic immune cells may induce changes in the sciatic nerve, leading to the appearance of bilateral allodynia.",0,1 +1462,Extending the Theory of Planned Behavior: A Review and Avenues for Further Research,"This paper describes and reviews the theory of planned behavior (TPB). The focus is on evidence supporting the further extension of the TPB in various ways. Empirical and theoretical evidence to support the addition of 6 variables to the TPB is reviewed: belief salience measures, past behaviodhabit, perceived behavioral control (PBC) vs. selfefficacy, moral norms, self-identity, and affective beliefs. In each case there appears to be growing empirical evidence to support their addition to the TPB and some understanding of the processes by which they may be related to other TPB variables, intentions, and behavior. Two avenues for expansion of the TPB are presented. First, the possibility of incorporating the TPB into a dual-process model of attitude-behavior relationships is reviewed. Second, the expansion of the TPB to include consideration of the volitional processes determining how goal intentions may lead to goal achievement is discussed.",0,1 +1463,Hierarchical cosmic shear power spectrum inference,"We develop a Bayesian hierarchical modelling approach for cosmic shear power spectrum inference, jointly sampling from the posterior distribution of the cosmic shear field and its (tomographic) power spectra. Inference of the shear power spectrum is a powerful intermediate product for a cosmic shear analysis, since it requires very few model assumptions and can be used to perform inference on a wide range of cosmological models \emph{a posteriori} without loss of information. We show that joint posterior for the shear map and power spectrum can be sampled effectively by Gibbs sampling, iteratively drawing samples from the map and power spectrum, each conditional on the other. This approach neatly circumvents difficulties associated with complicated survey geometry and masks that plague frequentist power spectrum estimators, since the power spectrum inference provides prior information about the field in masked regions at every sampling step. We demonstrate this approach for inference of tomographic shear $E$-mode, $B$-mode and $EB$-cross power spectra from a simulated galaxy shear catalogue with a number of important features; galaxies distributed on the sky and in redshift with photometric redshift uncertainties, realistic random ellipticity noise for every galaxy and a complicated survey mask. The obtained posterior distributions for the tomographic power spectrum coefficients recover the underlying simulated power spectra for both $E$- and $B$-modes.",0,1 +1464,Homogeneity computation: How interitem similarity in visual short-term memory alters recognition,"Visual short-term recognition memory for multiple stimuli is strongly influenced by the study items’ similarity to one another—that is, by their homogeneity. However, the mechanism responsible for this homogeneity effect has remained unclear. We evaluated competing explanations of this effect, using controlled sets of Gabor patches as study items and probe stimuli. Our results, based on recognition memory for spatial frequency, rule out the possibility that the homogeneity effect arises because similar study items are encoded and/or maintained with higher fidelity in memory than dissimilar study items are. Instead, our results support the hypothesis that the homogeneity effect reflects trial-by-trial comparisons of study items, which generate a homogeneity signal. This homogeneity signal modulates recognition performance through an adjustment of the subject’s decision criterion. Additionally, it seems the homogeneity signal is computed prior to the presentation of the probe stimulus, by evaluating the familiarity of each new stimulus with respect to the items already in memory. This suggests that recognition-like processes operate not only on the probe stimulus, but on study items as well.",0,1 +1465,Bayesian Two-Stage Biomarker-Based Adaptive Design for Targeted Therapy Development,"We propose a Bayesian two-stage biomarker-based adaptive randomization (AR) design for the development of targeted agents. The design has three main goals: (1) to test the treatment efficacy, (2) to identify prognostic and predictive markers for the targeted agents, and (3) to provide better treatment for patients enrolled in the trial. To treat patients better, both stages are guided by the Bayesian AR based on the individual patient's biomarker profiles. The AR in the first stage is based on a known marker. A Go/No-Go decision can be made in the first stage by testing the overall treatment effects. If a Go decision is made at the end of the first stage, a two-step Bayesian lasso strategy will be implemented to select additional prognostic or predictive biomarkers to refine the AR in the second stage. We use simulations to demonstrate the good operating characteristics of the design, including the control of per-comparison type I and type II errors, high probability in selecting important markers, and treating more patients with more effective treatments. Bayesian adaptive designs allow for continuous learning. The designs are particularly suitable for the development of multiple targeted agents in the quest of personalized medicine. By estimating treatment effects and identifying relevant biomarkers, the information acquired from the interim data can be used to guide the choice of treatment for each individual patient enrolled in the trial in real time to achieve a better outcome. The design is being implemented in the BATTLE-2 trial in lung cancer at the MD Anderson Cancer Center.",0,1 +1466,Path Dependency and the Politics of Socialized Health Care,"Abstract Rich democracies exhibit vast cross-national and historical variation in the socialization of health care. Yet, cross-national analyses remain relatively rare in the health policy literature, and health care remains relatively neglected in the welfare state literature. We analyze pooled time series models of the public share of total health spending for eighteen rich democracies from 1960 to 2010. Building on path dependency theory, we present a strategy for modeling the relationship between the initial 1960 public share and the current public share. We also examine two contrasting accounts for how the 1960 public share interacts with conventional welfare state predictors: the self-reinforcing hypothesis expecting positive feedbacks and the counteracting hypothesis expecting negative feedbacks. We demonstrate that most of the variation from 1960 to 2010 in the public share can be explained by a country's initial value in 1960. This 1960 value has a large significant effect in models of 1961–2010, and including the 1960 value alters the coefficients of conventional welfare state predictors. To investigate the mechanism whereby prior social policy influences public opinion about current social policy, we use the 2006 International Social Survey Programme (ISSP). This analysis confirms that the 1960 values predict individual preferences for government spending on health. Returning to the pooled time series, we demonstrate that the 1960 values interact significantly with several conventional welfare state predictors. Some interactions support the self-reinforcing hypothesis, while others support the counteracting hypothesis. Ultimately, this study illustrates how historical legacies of social policy exert substantial influence on the subsequent politics of social policy.",0,1 +1467,Empirical and Hierarchical Bayesian Estimation in Finite Population Sampling under Structural Measurement Error Models,".  This paper considers simultaneous estimation of means from several strata. A model-based approach is taken, where the covariates in the superpopulation model are subject to measurement errors. Empirical Bayes (EB) and Hierarchical Bayes estimators of the strata means are developed and asymptotic optimality of EB estimators is proved. Their performances are examined and compared with that of the sample mean in a simulation study as well as in data analysis.",0,1 +1468,A Heterogeneous Growth Curve Model for Nonnormal Data,"The heterogeneous growth curve model (HGM; Klein & Muthén, 2006 ) is a method for modeling heterogeneity of growth rates with a heteroscedastic residual structure for the slope factor. It has been developed as an extension of a conventional growth curve model and a complementary tool to growth curve mixture models. In this article, a robust version of the heterogeneous growth curve model (HGM-R) is presented that extends the original HGM with a mixture model to allow for an unbiased parameter estimation under the condition of nonnormal data. In two simulation studies, the performance of the method is examined under the condition of nonnormality and a misspecified heteroscedastic residual structure. The results of the simulation studies suggest an unbiased estimation of the heterogeneity by the HGM-R when sample size was large enough and a good approximation of the heteroscedastic residual structure even when the functional form of the heteroscedasticity was misspecified. The practical application of the approach is demonstrated for a data set from HIV-infected patients.",0,1 +1469,Tests of Mediation: Paradoxical Decline in Statistical Power as a Function of Mediator Collinearity,"Increasing the correlation between the independent variable and the mediator (a coefficient) increases the effect size (ab) for mediation analysis; however, increasing a by definition increases collinearity in mediation models. As a result, the standard error of product tests increase. The variance inflation due to increases in a at some point outweighs the increase of the effect size (ab) and results in a loss of statistical power. This phenomenon also occurs with nonparametric bootstrapping approaches because the variance of the bootstrap distribution of ab approximates the variance expected from normal theory. Both variances increase dramatically when a exceeds the b coefficient, thus explaining the power decline with increases in a. Implications for statistical analysis and applied researchers are discussed.",0,1 +1470,Evaluating models for partially clustered designs.,"Partially clustered designs, where clustering occurs in some conditions and not others, are common in psychology, particularly in prevention and intervention trials. This article reports results from a simulation comparing 5 approaches to analyzing partially clustered data, including Type I errors, parameter bias, efficiency, and power. Results indicate that multilevel models adapted for partially clustered data are relatively unbiased and efficient and consistently maintain the nominal Type I error rate when using appropriate degrees of freedom. To attain sufficient power in partially clustered designs, researchers should attend primarily to the number of clusters in the study. An illustration using data from a partially clustered eating disorder prevention trial is provided.",0,1 +1471,Sequential Estimation of Quantal Response Curves,,0,1 +1472,Models for Intensive Longitudinal Data,A new class of longitudinal data has emerged with the use of technological devices for scientific data collection. This class of data is called intensive longitudinal data (ILD). This volume features state-of-the-art applied statistical modelling strategies developed by leading statisticians and methodologists working in conjunction with behavioural scientists.,0,1 +1473,Markov chain Monte Carlo method and its application,"The Markov chain Monte Carlo (MCMC) method, as a computer-intensive statistical tool, has enjoyed an enormous upsurge in interest over the last few years. This paper provides a simple, comprehensive and tutorial review of some of the most common areas of research in this field. We begin by discussing how MCMC algorithms can be constructed from standard building-blocks to produce Markov chains with the desired stationary distribution. We also motivate and discuss more complex ideas that have been proposed in the literature, such as continuous time and dimension jumping methods. We discuss some implementational issues associated with MCMC methods. We take a look at the arguments for and against multiple replications, consider how long chains should be run for and how to determine suitable starting points. We also take a look at graphical models and how graphical approaches can be used to simplify MCMC implementation. Finally, we present a couple of examples, which we use as case-studies to highlight some of the points made earlier in the text. In particular, we use a simple changepoint model to illustrate how to tackle a typical Bayesian modelling problem via the MCMC method, before using mixture model problems to provide illustrations of good sampler output and of the implementation of a reversible jump MCMC algorithm",0,1 +1474,Stochastic Dominance and Expected Utility: Survey and Analysis,"While Stochastic Dominance has been employed in various forms as early as 1932, it has only been since 1969–1970 that the notion has been developed and extensively employed in the area of economics, finance, agriculture, statistics, marketing and operations research. In this survey, the first-, second- and third-order stochastic dominance rules are discussed with an emphasis on the development in the area since the 1980s.",0,1 +1475,Consumer willingness to pay for food safety in Tanzania: an incentive-aligned conjoint analysis,"In this paper, we present results from a consumer experiment in Tanzania focusing on food safety. We elicit consumers' willingness to pay (WTP) a premium for tomatoes that have been inspected by health officials to meet the standards set by the Tanzania Bureau of Standards. We also elicit consumers' WTP for tomato attributes that can be associated with different food safety standards: conventional vs. organically produced and various origins. Two hundred sixty-nine urban consumers from Morogoro, Tanzania took part in the experiment where they evaluated tomatoes using the Becker–deGroot–Marschak mechanism. The results show that on average, consumers in Tanzania are willing to pay a premium for inspected and organically produced tomatoes. Consumers have a strong preference for tomatoes produced in Tanzania and do not discount tomatoes produced in areas associated with poor agricultural practices. However, consumers do significantly discount tomatoes imported from South Africa.",0,1 +1476,Influence of reported study design characteristics on intervention effect estimates from randomised controlled trials: combined analysis of meta-epidemiological studies.,"Background The design of randomised controlled trials (RCTs) should incorporate characteristics (such as concealment of randomised allocation and blinding of participants and personnel) that avoid biases resulting from lack of comparability of the intervention and control groups. Empirical evidence suggests that the absence of such characteristics leads to biased intervention effect estimates, but the findings of different studies are not consistent. Objectives To examine the influence of unclear or inadequate random sequence generation and allocation concealment, and unclear or absent double blinding, on intervention effect estimates and between-trial heterogeneity, and whether or not these influences vary with type of clinical area, intervention, comparison and outcome measure. Data sources and methods Data were combined from seven contributing meta-epidemiological studies (collections of meta-analyses in which trial characteristics are assessed and results recorded). The resulting database was used to identify and remove overlapping meta-analyses. Outcomes were coded such that odds ratios < 1 correspond to beneficial intervention effects. Outcome measures were classified as mortality, other objective or subjective. We examined agreement between assessments of trial characteristics in trials assessed in more than one contributing study. We used hierarchical Bayesian bias models to estimate the effect of trial characteristics on average bias [quantified as ratios of odds ratios (RORs) with 95% credible intervals (CrIs) comparing trials with and without a characteristic] and in increasing between-trial heterogeneity. Results The analysis data set contained 1973 trials included in 234 meta-analyses. Median kappa statistics for agreement between assessments of trial characteristics were: sequence generation 0.60, allocation concealment 0.58 and blinding 0.87. Intervention effect estimates were exaggerated by an average 11% in trials with inadequate or unclear (compared with adequate) sequence generation (ROR 0.89, 95% CrI 0.82 to 0.96); between-trial heterogeneity was higher among such trials. Bias associated with inadequate or unclear sequence generation was greatest for subjective outcomes (ROR 0.83, 95% CrI 0.74 to 0.94) and the increase in heterogeneity was greatest for such outcomes [standard deviation (SD) 0.20, 95% CrI 0.03 to 0.32]. The effect of inadequate or unclear (compared with adequate) allocation concealment was greatest among meta-analyses with a subjectively assessed outcome intervention effect (ROR 0.85, 95% CrI 0.75 to 0.95), and the increase in between-trial heterogeneity was also greatest for such outcomes (SD 0.20, 95% CrI 0.02 to 0.33). Lack of, or unclear, double blinding (compared with double blinding) was associated with an average 13% exaggeration of intervention effects (ROR 0.87, 95% CrI 0.79 to 0.96), and between-trial heterogeneity was increased for such studies (SD 0.14, 95% CrI 0.02 to 0.30). Average bias (ROR 0.78, 95% CrI 0.65 to 0.92) and between-trial heterogeneity (SD 0.37, 95% CrI 0.19 to 0.53) were greatest for meta-analyses assessing subjective outcomes. Among meta-analyses with subjectively assessed outcomes, the effect of lack of blinding appeared greater than the effect of inadequate or unclear sequence generation or allocation concealment. Conclusions Bias associated with specific reported study design characteristics leads to exaggeration of beneficial intervention effect estimates and increases in between-trial heterogeneity. For each of the three characteristics assessed, these effects were greatest for subjectively assessed outcomes. Assessments of the risk of bias in RCTs should account for these findings. Further research is needed to understand the effects of attrition bias, as well as the relative importance of blinding of patients, care-givers and outcome assessors, and thus separate the effects of performance and detection bias. Funding National Institute for Health Research Health Technology Assessment programme.",0,1 +1477,Hierarchical Generalised Linear Models with Time-Dependent Clustering: Assessing the Effect of Health Sector Reform on Patient Outcomes in New Zealand,"New Zealand has one of the most reformed health systems in the world. This paper is primarily concerned with modelling the impact on hospital outcomes of the reforms of the early 1990s, when as part of a major, health sector wide reform process, the administration of public hospitals passed from elected Area Health Boards (AHBs) to Crown Health Enterprises (CHEs) operating under a competitive model of health care provision dominated by the funder/purchaser/provider split. The impact of reform processes on public hospitals is of particular interest since they consume 40%-50% of public expenditure on health, and have been repeatedly restructured in an attempt to contain the ever-expanding cost of health care. There is concern among both health professionals and the general public that these restructurings are reducing the quality of hospital services, and therefore negatively effecting patient outcomes. Using data from a study of 34 New Zealand public hospitals, we discuss the application of Bayesian hierarchical generalised linear models to the analysis of trends in patient outcomes over the period 1988-2001. The time-varying nature of the grouping of hospitals within larger health authorities complicates the application of HGLMs because the cluster structure of the data changes over the study period. An approach to dealing with such ""time-dependent clustering"" by introducing period-specific authority level effects is developed. The analysis does not support the proposition that higher level authorities had an effect on outcome trends, or that the administrative changeover from AHBs to CHEs impacted on 60-day post-admission mortality. © 2004 Kluwer Academic Publishers.",0,1 +1478,Do Integration Policies Affect Immigrants' Voluntary Engagement? An Exploration at Switzerland's Subnational Level,"This paper investigates whether integration policies influence immigrants' propensity to volunteer, the latter being an important element of immigrants' integration into the host society. By distinguishing different categories of integration policies at Switzerland's subnational level and applying a Bayesian multilevel approach, our results suggest varying policy effects: while policies fostering socio-structural rights enhance immigrants' propensity to volunteer, we observe a negative curvilinear relationship between cultural rights and obligations and immigrants' volunteerism implying that a combination of cultural entitlements and obligations is most conducive to immigrants' civic engagement.",0,1 +1479,Computerized Adaptive Testing Using a Class of High-Order Item Response Theory Models,"In the human sciences, a common assumption is that latent traits have a hierarchical structure. Higher order item response theory models have been developed to account for this hierarchy. In this study, computerized adaptive testing (CAT) algorithms based on these kinds of models were implemented, and their performance under a variety of situations was examined using simulations. The results showed that the CAT algorithms were very effective. The progressive method for item selection, the Sympson and Hetter method with online and freeze procedure for item exposure control, and the multinomial model for content balancing can simultaneously maintain good measurement precision, item exposure control, content balance, test security, and pool usage.",0,1 +1480,Multivariate and Propensity Score Matching Software with Automated Balance Optimization: The Matching Package for R,"Matching is an R package which provides functions for multivariate and propensity score matching and for finding optimal covariate balance based on a genetic search algorithm. A variety of univariate and multivariate metrics to determine if balance actually has been obtained are provided. The underlying matching algorithm is written in C++, makes extensive use of system BLAS and scales efficiently with dataset size. The genetic algorithm which finds optimal balance is parallelized and can make use of multiple CPUs or a cluster of computers. A large number of options are provided which control exactly how the matching is conducted and how balance is evaluated.",0,1 +1481,Using the SPSS Mixed Procedure to Fit Cross-Sectional and Longitudinal Multilevel Models,"Beginning with Version 11, SPSS implemented the MIXED procedure, which is capable of performing many common hierarchical linear model analyses. The purpose of this article was to provide a tutorial for performing cross-sectional and longitudinal analyses using this popular software platform. In doing so, the authors borrowed heavily from Singer’s overview of SAS PROC MIXED, duplicating her analyses using the SPSS MIXED procedure.",0,1 +1482,Bayesian Multivariate Logistic Regression,"Bayesian analyses of multivariate binary or categorical outcomes typically rely on probit or mixed effects logistic regression models that do not have a marginal logistic structure for the individual outcomes. In addition, difficulties arise when simple noninformative priors are chosen for the covariance parameters. Motivated by these problems, we propose a new type of multivariate logistic distribution that can be used to construct a likelihood for multivariate logistic regression analysis of binary and categorical data. The model for individual outcomes has a marginal logistic structure, simplifying interpretation. We follow a Bayesian approach to estimation and inference, developing an efficient data augmentation algorithm for posterior computation. The method is illustrated with application to a neurotoxicology study.",0,1 +1483,Consumer-oriented new product development: a review of recent developments,"Firms need to continuously develop new products or redesign their existing ones, due to the intense competition they are facing, as well as the rapidly changing economical and sociopolitical environment. In this context, consumer behaviour modelling has become an important and inextricable part of successful new product development during the last decades. This paper constitutes a survey of the literature in consumer-oriented new product development. We review a total of 60 research propositions in consumer behaviour modelling as a part of the product development procedure. The findings indicate a trend for integrative methodologies that approach the new product development process from both a marketing and an engineering perspective. The incorporation of dynamic consumer behaviour models into the product development methodologies seems to be the most promising area for future research.",0,1 +1484,Mediation in experimental and nonexperimental studies: New procedures and recommendations.,"Mediation is said to occur when a causal effect of some variable X on an outcome Y is explained by some intervening variable M. The authors recommend that with small to moderate samples, bootstrap methods (B. Efron & R. Tibshirani. 1993) be used to assess mediation. Bootstrap tests are powerful because they detect that the sampling distribution of the mediated effect is skewed away from 0. They argue that R. M. Baron and D. A. Kenny's (1986) recommendation of first testing the X → Y association for statistical significance should not be a requirement when there is a priori belief that the effect size is small or suppression is a possibility. Empirical examples and computer setups for bootstrap analyses are provided.",0,1 +1485,"The mental health consequences of the economic crisis in Europe among the employed, the unemployed, and the non-employed","Applying a multi-level framework to the data from the European Social Survey's Round 3 (2006) and Round 6 (2012), we assessed the crisis by increases in rates of unemployment, while also controlling for countries' pre-crisis economic conditions. We found a positive relationship between depression and an increase in national unemployment rates. This relationship can be only partly ascribed to an increase in the number of unemployed and those employed in nonstandard job conditions-with the exception of the self-employed and women working part-time. The crisis effect is more pronounced among men and those between 35 and 49years of age. Moreover, in strongly effected countries, the crisis has changed the relationship between part-time work and depression, between depression and certain subcategories of the unemployed (looking for a job or not looking), and between depression and the non-employed.",0,1 +1486,Bayesian estimation in unrestricted factor analysis: A treatment for heywood cases,"A Bayesian procedure is given for estimation in unrestricted common factor analysis. A choice of the form of the prior distribution is justified. It is shown empirically that the procedure achieves its objective of avoiding inadmissible estimates of unique variances, and is reasonably insensitive to certain variations in the shape of the prior distribution. © 1975 Psychometric Society.",0,1 +1487,An Index and Test of Linear Moderated Mediation,"I describe a test of linear moderated mediation in path analysis based on an interval estimate of the parameter of a function linking the indirect effect to values of a moderator-a parameter that I call the index of moderated mediation. This test can be used for models that integrate moderation and mediation in which the relationship between the indirect effect and the moderator is estimated as linear, including many of the models described by Edwards and Lambert ( 2007 ) and Preacher, Rucker, and Hayes ( 2007 ) as well as extensions of these models to processes involving multiple mediators operating in parallel or in serial. Generalization of the method to latent variable models is straightforward. Three empirical examples describe the computation of the index and the test, and its implementation is illustrated using Mplus and the PROCESS macro for SPSS and SAS.",0,1 +1488,Three case studies in the Bayesian analysis of cognitive models,"Bayesian statistical inference offers a principled and comprehensive approach for relating psychological models to data. This article presents Bayesian analyses of three influential psychological models: multidimensional scaling models of stimulus representation, the generalized context model of category learning, and a signal detection theory model of decision making. In each case, the model is recast as a probabilistic graphical model and is evaluated in relation to a previously considered data set. In each case, it is shown that Bayesian inference is able to provide answers to important theoretical and empirical questions easily and coherently. The generality of the Bayesian approach and its potential for the understanding of models and data in psychology are discussed.",0,1 +1489,Analyzing multiple outcomes in clinical research using multivariate multilevel models.,"Multilevel models have become a standard data analysis approach in intervention research. Although the vast majority of intervention studies involve multiple outcome measures, few studies use multivariate analysis methods. The authors discuss multivariate extensions to the multilevel model that can be used by psychotherapy researchers.Using simulated longitudinal treatment data, the authors show how multivariate models extend common univariate growth models and how the multivariate model can be used to examine multivariate hypotheses involving fixed effects (e.g., does the size of the treatment effect differ across outcomes?) and random effects (e.g., is change in one outcome related to change in the other?). An online supplemental appendix provides annotated computer code and simulated example data for implementing a multivariate model.Multivariate multilevel models are flexible, powerful models that can enhance clinical research.",0,1 +1490,Individual Participant Data Meta-Analysis for a Binary Outcome: One-Stage or Two-Stage?,"A fundamental aspect of epidemiological studies concerns the estimation of factor-outcome associations to identify risk factors, prognostic factors and potential causal factors. Because reliable estimates for these associations are important, there is a growing interest in methods for combining the results from multiple studies in individual participant data meta-analyses (IPD-MA). When there is substantial heterogeneity across studies, various random-effects meta-analysis models are possible that employ a one-stage or two-stage method. These are generally thought to produce similar results, but empirical comparisons are few.We describe and compare several one- and two-stage random-effects IPD-MA methods for estimating factor-outcome associations from multiple risk-factor or predictor finding studies with a binary outcome. One-stage methods use the IPD of each study and meta-analyse using the exact binomial distribution, whereas two-stage methods reduce evidence to the aggregated level (e.g. odds ratios) and then meta-analyse assuming approximate normality. We compare the methods in an empirical dataset for unadjusted and adjusted risk-factor estimates.Though often similar, on occasion the one-stage and two-stage methods provide different parameter estimates and different conclusions. For example, the effect of erythema and its statistical significance was different for a one-stage (OR = 1.35, [Formula: see text]) and univariate two-stage (OR = 1.55, [Formula: see text]). Estimation issues can also arise: two-stage models suffer unstable estimates when zero cell counts occur and one-stage models do not always converge.When planning an IPD-MA, the choice and implementation (e.g. univariate or multivariate) of a one-stage or two-stage method should be prespecified in the protocol as occasionally they lead to different conclusions about which factors are associated with outcome. Though both approaches can suffer from estimation challenges, we recommend employing the one-stage method, as it uses a more exact statistical approach and accounts for parameter correlation.",0,1 +1491,Institutionalizing Bayesianism Within the Organizational Sciences,"Bayesian estimation and inference remain infrequently used in organizational science research. Despite innumerable warnings regarding the entrenched frequentist paradigm, our field has yet to embrace the Bayesian “revolution” that seems to be sweeping through so many other disciplines. With this context as a backdrop, we address a simple yet difficult question: What is the likelihood that Bayesian methodologies eventually will supplement or even supplant traditional frequentist methodologies in the organizational science community? We draw on institutional theory to address this question, highlighting the cultural-cognitive, normative, and regulative forces that play important roles. As novel contributions to the discussion, we go beyond our own ideas and previously published opinions on the subject to report the opinions of 26 institutional elites (current and former officers of academic associations, editors, and editorial board members). These leading scholars help us shed light not only on the likelihood that Bayesianism will take root in the field but also on practical steps that could be taken to assist in this process. In some ways, we build Bayesian priors about Bayesian analysis, where those priors will be qualified on the basis of future events and outcomes.",0,1 +1492,Perceptual organization influences visual working memory,"Previous studies have demonstrated that top-down factors can bias the storage of information in visual working memory. However, relatively little is known about the role that bottom-up stimulus characteristics play in visual working memory storage. In the present study, subjects performed a change detection task in which the to-be-remembered objects were organized in accordance with Gestalt grouping principles. When an attention-capturing cue was presented at the location of one object, other objects that were perceptually grouped with the cued object were more likely to be stored in working memory than were objects that were not grouped with the cued object. Thus, objects that are grouped together tend to be stored together, indicating that bottom-up perceptual organization influences the storage of information in visual working memory.",0,1 +1493,Bayesian Fusion of Multi-Band Images,"In this paper, a Bayesian fusion technique for remotely sensed multi-band images is presented. The observed images are related to the high spectral and high spatial resolution image to be recovered through physical degradations, e.g., spatial and spectral blurring and/or subsampling defined by the sensor characteristics. The fusion problem is formulated within a Bayesian estimation framework. An appropriate prior distribution exploiting geometrical consideration is introduced. To compute the Bayesian estimator of the scene of interest from its posterior distribution, a Markov chain Monte Carlo algorithm is designed to generate samples asymptotically distributed according to the target distribution. To efficiently sample from this high-dimension distribution, a Hamiltonian Monte Carlo step is introduced in the Gibbs sampling strategy. The efficiency of the proposed fusion method is evaluated with respect to several state-of-the-art fusion techniques. In particular, low spatial resolution hyperspectral and multispectral images are fused to produce a high spatial resolution hyperspectral image.",0,1 +1494,Introduction to WinBUGS for Ecologists,"Bayesian statistics has exploded into biology and its sub-disciplines such as ecology over the past decade. The free software program WinBUGS and its open-source sister OpenBugs is currently the only flexible and general-purpose program available with which the average ecologist can conduct their own standard and non-standard Bayesian statistics. Introduction to WINBUGS for Ecologists goes right to the heart of the matter by providing ecologists with a comprehensive, yet concise, guide to applying WinBUGS to the types of models that they use most often: linear (LM), generalized linear (GLM), linear mixed (LMM) and generalized linear mixed models (GLMM).Introduction to WinBUGS for Ecologists combines the use of simulated data sets ""paired"" analyses using WinBUGS (in a Bayesian framework for analysis) and in R (in a frequentist mode of inference) and uses a very detailed step-by-step tutorial presentation style that really lets the reader repeat every step of the application of a given mode in their own research.- Introduction to the essential theories of key models used by ecologists- Complete juxtaposition of classical analyses in R and Bayesian Analysis of the same models in WinBUGS- Provides every detail of R and WinBUGS code required to conduct all analyses- Written with ecological language and ecological examples- Companion Web Appendix that contains all code contained in the book, additional material (including more code and solutions to exercises)- Tutorial approach shows ecologists how to implement Bayesian analysis in practical problems that they face. © 2010 Elsevier Inc. All rights reserved.",0,1 +1495,Individual patient data meta-analysis of survival data using Poisson regression models,"Abstract Background An Individual Patient Data (IPD) meta-analysis is often considered the gold-standard for synthesising survival data from clinical trials. An IPD meta-analysis can be achieved by either a two-stage or a one-stage approach, depending on whether the trials are analysed separately or simultaneously. A range of one-stage hierarchical Cox models have been previously proposed, but these are known to be computationally intensive and are not currently available in all standard statistical software. We describe an alternative approach using Poisson based Generalised Linear Models (GLMs). Methods We illustrate, through application and simulation, the Poisson approach both classically and in a Bayesian framework, in two-stage and one-stage approaches. We outline the benefits of our one-stage approach through extension to modelling treatment-covariate interactions and non-proportional hazards. Ten trials of hypertension treatment, with all-cause death the outcome of interest, are used to apply and assess the approach. Results We show that the Poisson approach obtains almost identical estimates to the Cox model, is additionally computationally efficient and directly estimates the baseline hazard. Some downward bias is observed in classical estimates of the heterogeneity in the treatment effect, with improved performance from the Bayesian approach. Conclusion Our approach provides a highly flexible and computationally efficient framework, available in all standard statistical software, to the investigation of not only heterogeneity, but the presence of non-proportional hazards and treatment effect modifiers.",0,1 +1496,Matching as Nonparametric Preprocessing for Reducing Model Dependence in Parametric Causal Inference,"Although published works rarely include causal estimates from more than a few model specifications, authors usually choose the presented estimates from numerous trial runs readers never see. Given the often large variation in estimates across choices of control variables, functional forms, and other modeling assumptions, how can researchers ensure that the few estimates presented are accurate or representative? How do readers know that publications are not merely demonstrations that it is possible to find a specification that fits the author's favorite hypothesis? And how do we evaluate or even define statistical properties like unbiasedness or mean squared error when no unique model or estimator even exists? Matching methods, which offer the promise of causal inference with fewer assumptions, constitute one possible way forward, but crucial results in this fast-growing methodological literature are often grossly misinterpreted. We explain how to avoid these misinterpretations and propose a unified approach that makes it possible for researchers to preprocess data with matching (such as with the easy-to-use software we offer) and then to apply the best parametric techniques they would have used anyway. This procedure makes parametric models produce more accurate and considerably less model-dependent causal inferences.",0,1 +1497,Multilevel Factor Analysis and Structural Equation Modeling of Daily Diary Coping Data: Modeling Trait and State Variation,"The current study used multilevel modeling of daily diary data to model within-person (state) and between-person (trait) components of coping variables. This application included the introduction of multilevel factor analysis (MFA) and a comparison of the predictive ability of these trait/state factors. Daily diary data was collected on a large (n = 366) multiethnic sample over the course of five days. Intraclass correlation coefficient for the derived factors suggested approximately equal amounts of variability in coping usage at the state and trait levels. MFAs showed that Problem-Focused Coping and Social Support emerged as stable factors at both the within-person and between-person levels. Other factors (Minimization, Emotional Rumination, Avoidance, Distraction) were specific to the within-person or between-person levels, but not both. Multilevel structural equation modeling (MSEM) showed that the prediction of daily positive and negative affect differed as a function of outcome and level of coping factor. The Discussion section focuses primarily on a conceptual and methodological understanding of modeling state and trait coping using daily diary data with MFA and MSEM to examine covariation among coping variables and predicting outcomes of interest.",0,1 +1498,Rejoinder,,0,1 +1499,Investigating inter-individual differences in short-term intra-individual variability.,"Intra-individual variability over a short period of time may contain important information about how individuals differ from each other. In this article we begin by discussing diverse indicators for quantifying intra-individual variability and indicate their advantages and disadvantages. Then we propose an alternative method that models inter-individual differences in intra-individual variability by separately considering both the amplitude of fluctuations and temporal dependency in the data. In the proposed model, temporal dependency and amplitude of fluctuations are both included as random effects. Parameter estimation is done with a multiple-step approach using maximum likelihood, or with a recommended 1-step approach using a Bayesian method. The similarities and differences between the proposed method and some existing methods are discussed and investigated using diary study data from older adults. The results from empirical data analysis revealed that temporal dependency and amplitude of fluctuations have different predictability of health outcomes and thus should be modeled and considered separately.",0,1 +1500,Response Time Distributions in Memory Scanning,"Abstract This article reports the results of a memory scanning experiment (S. Sternberg. 1966, Science, 153 , 652-654) in which each of four subjects participated in about 1500 experimental trials per memory set size. These large samples made it possible to test a number of important nonparametric (i.e., model-free) properties of the response time (RT) distributions. These properties place severe constraints on the various memory scanning models and they provide a deeper description of the data than summary statistics or goodness-of-fit values. Five conclusions stood out. First, increasing the size of the memory set induced the strongest possible form of stochastic dominance on both target present and target absent trials. Second, the RT hazard functions were nonmonotonic, thereby falsifying a large class of serial searell models, Third, strong evidence was obtained against art exhaustive search. Fourth, some evidence was found that adding an item to the memory set inserts a stage with exponentially distributed duration into the processing claim, at least on largest absent trials. Fifth, the data supported the hypothesis that three of the subjects stored the representations of the memory set items in a visual short-term memory system and the fourth subject used all acoustic short-term system. To our knowledge, the only extant model of memory scanning that is consistent with all these results assumes that search is parallel, self-terminating, and of very limited capacity.",0,1 +1501,Quantifying geographic variations in associations between alcohol distribution and violence: a comparison of geographically weighted regression and spatially varying coefficient models,"Past studies consistently indicate measurable local associations between alcohol distribution and the incidence of violence. These results, coupled with measurements of spatial correlation, reveal the importance of spatial analysis in the study of the interaction of alcohol and violence. While studies increasingly incorporate spatial correlation among model residuals to improve precision and reduce bias, to date, most analyses assume associations that are constant and independent of location, an assumption coming under increasing scrutiny in the quantitative geography literature. In this paper, we review and contrast two approaches for the estimation of and inference for spatially heterogeneous effects (i.e., associative factors whose impacts on the outcome of interest vary throughout geographic space). Specifically, we provide an in-depth comparison of 'geographically weighted regression' models (allowing covariate effects to vary in space but only allowing relatively ad hoc inference) with 'variable coefficient' models (allowing varying effects via spatial random fields and providing model-based estimation and inference, but requiring more advanced computational techniques). We compare the approaches with respect to underlying conceptual structures, computational implementation, and inferential output. We apply both approaches to violent crime, illegal drug arrest, and alcohol distribution data from Houston, Texas and compare results in light of the differing methodological structures of the two approaches. © Springer-Verlag 2007.",0,1 +1502,People are variables too: Multilevel structural equations modeling.,"The article uses confirmatory factor analysis (CFA) as a template to explain didactically multilevel structural equation models (ML-SEM) and to demonstrate the equivalence of general mixed-effects models and ML-SEM. An intuitively appealing graphical representation of complex ML-SEMs is introduced that succinctly describes the underlying model and its assumptions. The use of definition variables (i.e., observed variables used to fix model parameters to individual specific data values) is extended to the case of ML-SEMs for clustered data with random slopes. Empirical examples of multilevel CFA and ML-SEM with random slopes are provided along with scripts for fitting such models in SAS Proc Mixed, Mplus, and Mx. Methodological issues regarding estimation of complex ML-SEMs and the evaluation of model fit are discussed. Further potential applications of ML-SEMs are explored.",0,1 +1503,Handling missing values in cost effectiveness analyses that use data from cluster randomized trials,"Public policy makers use cost effectiveness analyses (CEAs) to decide which health and social care interventions to provide. Missing data are common in CEAs, but most studies use complete-case analysis. Appropriate methods have not been developed for handling missing data in complex settings, exemplified by CEAs that use data from cluster randomized trials. We present a multilevel multiple-imputation approach that recognizes the hierarchical structure of the data and is compatible with the bivariate multilevel models that are used to report cost effectiveness. We contrast this approach with single-level multiple imputation and complete-case analysis, in a CEA alongside a cluster randomized trial. The paper highlights the importance of adopting a principled approach to handling missing values in settings with complex data structures.",0,1 +1504,Confirmatory factor analysis of ordered categorical variables with large models,"This simulation study examined the utility of a categorical variable methodology developed by Muthen (1984) for confirmatory factor analysis of ordinal variables. Multivariate normal data were generated according to four different factor models (4, 9, 15 and 22 parameters) for samples of 500 and 1000. Indicators were classified into Five categories so that manifest variables displayed negative, zero, positive or highly positive kurtosis. Each of the 32 design cells was replicated 100 times. Parameter estimates exhibited little or no bias under any condition. Standard errors were underestimated with respect to the standard deviation of the parameter estimates. This negative bias worsened as model size grew or as positive kurtosis increased; it was more severe for factor correlations than indicator loadings. Chi-square fit statistics rejected the true model more often than expected for nine-parameter and larger models. Although variables with high positive kurtosis led to the greatest misfit in large models, fit was poor even with variables of zero kurtosis. As expected, larger samples always yielded more accurate results.",0,1 +1505,Analyzing measurement models of latent variables through multilevel confirmatory factor analysis and hierarchical linear modeling approaches,"Confirmatory factor analysis (CFA) is often used in the social sciences to estimate a measurement model in which multiple measurement items are hypothesized to assess a particular latent construct. This article presents the utility of multilevel CFA (MCFA; Muthen, 1991, 1994) and hierarchical linear modeling (HLM; Raudenbush, Rowan, & Kang, 1991) methods in testing measurement models in which the underlying attribute may vary as a function of various levels of observation. An illustrative example using a real dataset is provided in which an unconditional model specification and parameter estimates from the MCFA and HLM are shown. The article demonstrates the comparability of the two methods in estimating measurement parameters of interest (i.e., true variance at levels the measures are used and measurement errors).",0,1 +1506,Psychometric analysis of the Ten-Item Perceived Stress Scale.,"Although the 10-item Perceived Stress Scale (PSS-10) is a popular measure, a review of the literature reveals 3 significant gaps: (a) There is some debate as to whether a 1- or a 2-factor model best describes the relationships among the PSS-10 items, (b) little information is available on the performance of the items on the scale, and (c) it is unclear whether PSS-10 scores are subject to gender bias. These gaps were addressed in this study using a sample of 1,236 adults from the National Survey of Midlife Development in the United States II. Based on self-identification, participants were 56.31% female, 77% White, 17.31% Black and/or African American, and the average age was 54.48 years (SD = 11.69). Findings from an ordinal confirmatory factor analysis suggested the relationships among the items are best described by an oblique 2-factor model. Item analysis using the graded response model provided no evidence of item misfit and indicated both subscales have a wide estimation range. Although t tests revealed a significant difference between the means of males and females on the Perceived Helplessness Subscale (t = 4.001, df = 1234, p < .001), measurement invariance tests suggest that PSS-10 scores may not be substantially affected by gender bias. Overall, the findings suggest that inferences made using PSS-10 scores are valid. However, this study calls into question inferences where the multidimensionality of the PSS-10 is ignored.",0,1 +1507,Some implications of psychotherapy research for therapeutic practice.,"Implications for practice and research are drawn from a survey of psychotherapy research findings, condensed into 6 broad conclusions: (1) psychotherapy causes clients to become better or worse adjusted than controls; (2) control Ss improve with time as a result of informal therapeutic encounters; (3) therapeutic progress varies with therapist warmth, empathy, adjustment, and experience; (4) client-centered therapy is the only interview-oriented method that has been validated by research; (5) traditional therapies are seriously limited in effectiveness and are relevant for a small minority of disturbances; and (6) behavior therapies have considerable promise for enhancing therapeutic effectiveness and should be utilized or experimented with more widely. (2 p. ref.) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1966 American Psychological Association.",0,1 +1508,Inference by Eye: Confidence Intervals and How to Read Pictures of Data.,"Wider use in psychology of confidence intervals (CIs), especially as error bars in figures, is a desirable development. However, psychologists seldom use CIs and may not understand them well. The authors discuss the interpretation of figures with error bars and analyze the relationship between CIs and statistical significance testing. They propose 7 rules of eye to guide the inferential use of figures with error bars. These include general principles: Seek bars that relate directly to effects of interest, be sensitive to experimental design, and interpret the intervals. They also include guidelines for inferential interpretation of the overlap of CIs on independent group means. Wider use of interval estimation in psychology has the potential to improve research communication substantially.",0,1 +1509,That BLUP is a Good Thing: The Estimation of Random Effects,"In animal breeding, Best Linear Unbiased Prediction, or BLUP, is a technique for estimating genetic merits. In general, it is a method of estimating random effects. It can be used to derive the Kalman filter, the method of Kriging used for ore reserve estimation, credibility theory used to work out insurance premiums, and Hoadley's quality measurement plan used to estimate a quality index. It can be used for removing noise from images and for small-area estimation. This paper presents the theory of BLUP, some examples of its application and its relevance to the foundations of statistics. Understanding of procedures for estimating random effects should help people to understand some complicated and controversial issues about fixed and random effects models and also help to bridge the apparent gulf between the Bayesian and Classical schools of thought.",0,1 +1510,Further insights on the French WISC–IV factor structure through Bayesian structural equation modeling.,"The interpretation of the Wechsler Intelligence Scale for Children--Fourth Edition (WISC-IV) is based on a 4-factor model, which is only partially compatible with the mainstream Cattell-Horn-Carroll (CHC) model of intelligence measurement. The structure of cognitive batteries is frequently analyzed via exploratory factor analysis and/or confirmatory factor analysis. With classical confirmatory factor analysis, almost all cross-loadings between latent variables and measures are fixed to zero in order to allow the model to be identified. However, inappropriate zero cross-loadings can contribute to poor model fit, distorted factors, and biased factor correlations; most important, they do not necessarily faithfully reflect theory. To deal with these methodological and theoretical limitations, we used a new statistical approach, Bayesian structural equation modeling (BSEM), among a sample of 249 French-speaking Swiss children (8-12 years). With BSEM, zero-fixed cross-loadings between latent variables and measures are replaced by approximate zeros, based on informative, small-variance priors. Results indicated that a direct hierarchical CHC-based model with 5 factors plus a general intelligence factor better represented the structure of the WISC-IV than did the 4-factor structure and the higher order models. Because a direct hierarchical CHC model was more adequate, it was concluded that the general factor should be considered as a breadth rather than a superordinate factor. Because it was possible for us to estimate the influence of each of the latent variables on the 15 subtest scores, BSEM allowed improvement of the understanding of the structure of intelligence tests and the clinical interpretation of the subtest scores.",0,1 +1511,"Why Multicollinearity Matters: A Reexamination of Relations Between Self-Efficacy, Self-Concept, and Achievement.","Multicollinearity is a well-known general problem, but it also seriously threatens valid interpretations in structural equation models. Illustrating this problem, J. Pietsch, R. Walker, and E. Chapman (2003) found paths leading to achievement were apparently much larger for self-efficacy (.55) than self-concept (-.05), suggesting - erroneously, as the authors' reanalysis shows - that self-efficacy was a better predictor of achievement. However, because standard errors for these two paths were so huge (.25) thanks to the extremely high correlation between self-concept and self-efficacy (r = .93), interpretations were problematic. In a model comparison approach to this multicollinearity problem, constraining these two paths to be equal provided a better, more parsimonious fit to the data and also substantially reduced the standard errors (from .25 to .03).",0,1 +1512,Comparing intention to avoid malware across contexts in a BYOD-enabled Australian university: A Protection Motivation Theory approach,"Malware have been regarded as a persistent threat to both individuals and organisations due to its wide spread via various means of infection. With the increasing use of personal mobile devices and the trending adoption of Bring Your Own Device (BYOD) practices, this threat has become even more versatile and dreadful as it could hide behind the users' typical and daily Internet activities. The importance of investigating whether the user's intention to perform malware avoidance behaviours would change across multiple contexts is emphasised. Consequently, this study determines the contributing factors and compares their impacts on such intention by extending Protection Motivation Theory in two different contexts. A total of 252 Australian higher education students were surveyed when using mobile devices such as smartphone, laptop and tablet at home and at a BYOD-enabled university. Paired t- test, Bayesian structural equation modelling, and revised z -test were employed for data analysis. The empirical findings reveal that intention to perform malware avoidance behaviours differed across the contexts. Furthermore, the researchers found perceptions of self-efficacy and vulnerability to have different impacts on such intention and other variables in the model. As a result, such findings suggested developing community of practice and repeated trainings to maintain the users' confidence in their own abilities to cope with malware threats. Message that focuses on the threats' consequences was suggested to improve home users' intention to avoid malware, along with a number of factors that could be critical to designing information security education programs. Moreover, these implications particularly address information security management at educational institutions that adopt BYOD policy. Finally, theoretical contributions include an extended model based on Protection Motivation Theory that reflects the users' intention to avoid malware threats in BYOD context, from which directions for future research were also provided.",0,1 +1513,General Multiple Mediation Analysis With an Application to Explore Racial Disparities in Breast Cancer Survival,"Mediation refers to the effect transmitted by mediators that intervenes in the relationship between an exposure and a response variable. Mediation analysis has been broadly studied in many fields. However, it remains a challenge for researchers to differentiate individual effect from multiple mediators. This paper proposes general definitions of mediation effects that are consistent for all different types (categorical or continuous) of response, exposure, or mediation variables. With these definitions, multiple mediators can be considered simultaneously, and the indirect effects carried by individual mediators can be separated from the total effect. Moreover, the derived mediation analysis can be performed with general predictive models. For linear predictive models with continuous mediators, we show that the proposed method is equivalent to the conventional coefficients product method. We also establish the relationship between the proposed definitions of direct or indirect effect and the natural direct or indirect effect for binary exposure variables. The proposed method is demonstrated by both simulations and a real example examining racial disparities in three-year survival rates for female breast cancer patients in Louisiana.",0,1 +1514,Bayesian Covariance Selection in Generalized Linear Mixed Models,"The generalized linear mixed model (GLMM), which extends the generalized linear model (GLM) to incorporate random effects characterizing heterogeneity among subjects, is widely used in analyzing correlated and longitudinal data. Although there is often interest in identifying the subset of predictors that have random effects, random effects selection can be challenging, particularly when outcome distributions are nonnormal. This article proposes a fully Bayesian approach to the problem of simultaneous selection of fixed and random effects in GLMMs. Integrating out the random effects induces a covariance structure on the multivariate outcome data, and an important problem that we also consider is that of covariance selection. Our approach relies on variable selection-type mixture priors for the components in a special Cholesky decomposition of the random effects covariance. A stochastic search MCMC algorithm is developed, which relies on Gibbs sampling, with Taylor series expansions used to approximate intractable integrals. Simulated data examples are presented for different exponential family distributions, and the approach is applied to discrete survival data from a time-to-pregnancy study.",0,1 +1515,A simulation study to assess statistical methods for binary repeated measures data,"Binary repeated measures data are commonly encountered in both experimental and observational veterinary studies. Among the wide range of statistical methods and software applicable to such data one major distinction is between marginal and random effects procedures. The objective of the study was to review and assess the performance of marginal and random effects estimation procedures for the analysis of binary repeated measures data. Two simulation studies were carried out, using relatively small, balanced, two-level (time within subjects) datasets. The first study was based on data generated from a marginal model with first order autocorrelation, the second on a random effects model with autocorrelated random effects within subjects. Three versions of the models were considered in which a dichotomous treatment was modelled additively, either between or within subjects, or modelled by a time interaction. Among the studied statistical procedures were: generalized estimating equations (GEE), Marginal Quasi Likelihood, likelihood based on numerical integration, penalized quasi-likelihood, restricted pseudo likelihood and Bayesian Markov Chain Monte Carlo. Results for data generated by the marginal model showed autoregressive GEE to be highly efficient when treatment was within subjects, even with strongly correlated responses. For treatment between subjects, random effects procedures also performed well in some situations; however, a relatively small number of subjects with a short time series proved a challenge for both marginal and random effects procedures. Results for data generated by the random effects model showed bias in estimates from random effects procedures when autocorrelation was present in the data, while the marginal procedures generally gave estimates close to the marginal parameters.",0,1 +1516,Modeling Heterogeneity in Relationships Between Initial Status and Rates of Change: Treating Latent Variable Regression Coefficients as Random Coefficients in a Three-Level Hierarchical Model,"In studies of change in education and numerous other fields, interest often centers on how differences in the status of individuals at the start of a period of substantive interest relate to differences in subsequent change. In this article, the authors present a fully Bayesian approach to estimating three-level Hierarchical Models in which latent variable regression (LVR) coefficients capturing the relationship between initial status and rates of change within each of J schools (Bw j , j = 1, …, J) are treated as varying across schools. Specifically, the authors treat within-group LVR coefficients as random coefficients in three-level models. Through analyses of data from the Longitudinal Study of American Youth, the authors show how modeling differences in Bw j as a function of school characteristics can broaden the kinds of questions they can address in school effects research. They also illustrate the possibility of conducting sensitivity analyses using t distributional assumptions at each level of such models (termed latent variable regression in a three-level hierarchical model [LVR-HM3s]), and present results from a small-scale simulation study that help provide some guidance concerning the specification of priors for variance components in LVR-HM3s. They outline extensions of LVR-HM3s to settings in which growth is nonlinear, and discuss the use of LVR-HM3s in other types of research including multisite evaluation studies in which time-series data are collected during a preintervention period, and cross-sectional studies in which within-cluster LVR slopes are treated as varying across clusters.",0,1 +1517,SMALL AREA ESTIMATION USING SURVEY WEIGHTS WITH FUNCTIONAL MEASUREMENT ERROR IN THE COVARIATE,"Summary Nested error linear regression models using survey weights have been studied in small area estimation to obtain efficient model-based and design-consistent estimators of small area means. The covariates in these nested error linear regression models are not subject to measurement errors. In practical applications, however, there are many situations in which the covariates are subject to measurement errors. In this paper, we develop a nested error linear regression model with an area-level covariate subject to functional measurement error. In particular, we propose a pseudo-empirical Bayes (PEB) predictor to estimate small area means. This predictor borrows strength across areas through the model and makes use of the survey weights to preserve the design consistency as the area sample size increases. We also employ a jackknife method to estimate the mean squared prediction error (MSPE) of the PEB predictor. Finally, we report the results of a simulation study on the performance of our PEB predictor and associated jackknife MSPE estimator.",0,1 +1518,Bayesian Inference for Growth Mixture Models with Latent Class Dependent Missing Data,"Growth mixture models (GMMs) with nonignorable missing data have drawn increasing attention in research communities but have not been fully studied. The goal of this article is to propose and to evaluate a Bayesian method to estimate the GMMs with latent class dependent missing data. An extended GMM is first presented in which class probabilities depend on some observed explanatory variables and data missingness depends on both the explanatory variables and a latent class variable. A full Bayesian method is then proposed to estimate the model. Through the data augmentation method, conditional posterior distributions for all model parameters and missing data are obtained. A Gibbs sampling procedure is then used to generate Markov chains of model parameters for statistical inference. The application of the model and the method is first demonstrated through the analysis of mathematical ability growth data from the National Longitudinal Survey of Youth 1997 (Bureau of Labor Statistics, U.S. Department of Labor, 1997). A simulation study considering 3 main factors (the sample size, the class probability, and the missing data mechanism) is then conducted and the results show that the proposed Bayesian estimation approach performs very well under the studied conditions. Finally, some implications of this study, including the misspecified missingness mechanism, the sample size, the sensitivity of the model, the number of latent classes, the model comparison, and the future directions of the approach, are discussed.",0,1 +1519,On Bayesian Analysis of Mixtures with an Unknown Number of Components,"SUMMARY New methodology for fully Bayesian mixture analysis is developed, making use of reversible jump Markov chain Monte Carlo methods that are capable of jumping between the parameter subspaces corresponding to different numbers of components in the mixture. A sample from the full joint distribution of all unknown variables is thereby generated, and this can be used as a basis for a thorough presentation of many aspects of the posterior distribution. The methodology is applied here to the analysis of univariate normal mixtures, using a hierarchical prior model that offers an approach to dealing with weak prior information while avoiding the mathematical pitfalls of using improper priors in the mixture context.",0,1 +1520,HHV-8 seroprevalence: a global view,"Human herpes virus 8 (HHV-8) is the underlying infectious cause of Kaposi sarcoma (KS) and other proliferative diseases; that is, primary effusion lymphoma and multicentric Castleman disease. In regions with high HHV-8 seroprevalence in the general population, KS accounts for a major burden of disease. Outside these endemic regions, HHV-8 prevalence is high in men who have sex with men (MSM) and in migrants from endemic regions. We aim to conduct a systematic literature review and meta-analysis in order 1) to define the global distribution of HHV-8 seroprevalence (primary objective) and 2) to identify risk factors for HHV-8 infection, with a focus on HIV status (secondary objective).We will include observational studies reporting data on seroprevalence of HHV-8 in children and/or adults from any region in the world. Case reports and case series as well as any studies with fewer than 50 participants will be excluded. We will search MEDLINE, EMBASE, and relevant conference proceedings without language restriction. Two reviewers will independently screen the identified studies and extract data on study characteristics and quality, study population, risk factors, and reported outcomes, using a standardized form. For the primary objective we will pool the data using a fully bayesian approach for meta-analysis, with random effects at the study level. For the secondary objective (association of HIV and HHV-8) we aim to pool odds ratios for the association of HIV and HHV-8 using a fully bayesian approach for meta-analysis, with random effects at the study level. Sub-group analyses and meta-regression analyses will be used to explore sources of heterogeneity, including factors such as geographical region, calendar years of recruitment, age, gender, ethnicity, socioeconomic status, different risk groups for sexually and parenterally transmitted infections (MSM, sex workers, hemophiliacs, intravenous drug users), comorbidities such as organ transplantation and malaria, test(s) used to measure HHV-8 infection, study design, and study quality.Using the proposed systematic review and meta-analysis, we aim to better define the global seroprevalence of HHV-8 and its associated risk factors. This will improve the current understanding of HHV-8 epidemiology, and could suggest measures to prevent HHV-8 infection and to reduce its associated cancer burden.",0,1 +1521,Computerized Adaptive Testing for the Random Weights Linear Logistic Test Model,"This article discusses four-item selection rules to design efficient individualized tests for the random weights linear logistic test model (RWLLTM): minimum posterior-weighted [Formula: see text]-error [Formula: see text]minimum expected posterior-weighted [Formula: see text]-error [Formula: see text]maximum expected Kullback–Leibler divergence between subsequent posteriors ( KLP), and maximum mutual information ( MUI). The RWLLTM decomposes test items into a set of subtasks or cognitive features and assumes individual-specific effects of the features on the difficulty of the items. The model extends and improves the well-known linear logistic test model in which feature effects are only estimated at the aggregate level. Simulations show that the efficiencies of the designs obtained with the different criteria appear to be equivalent. However, KLP and MUI are given preference over [Formula: see text] and [Formula: see text] due to their lesser complexity, which significantly reduces the computational burden.",0,1 +1522,Determining odour detection thresholds: Incorporating a method-independent definition into the implementation of ASTM E679,"Abstract ASTM international standard practice E679 prescribes the use of a 3-alternative forced-choice (3AFC) method with an ascending concentration series for measuring odour detection thresholds. It recommends obtaining an individual’s threshold by geometrically averaging the concentrations at which the judge’s detection response reverses from incorrect to correct. The legitimate reversal point is defined by a stopping rule. Previous researchers have identified some methodological flaws with this calculation approach, relating to the use of stopping rules and the method’s unconventional definition of thresholds. The current study aims to empirically investigate these issues in more depth. Thresholds for three odorants were obtained for 100 judges. 1,8-Cineole, isobutyraldehyde and β-damascenone were tested in accordance with the data collection procedure of ASTM E679. Initially, thresholds were estimated by the ASTM-based method with four different stopping rules. These estimates were subsequently compared against thresholds estimated by an alternative method; that of fitting psychometric functions. The theoretical grounds on which the latter method is based, and the clear connection between performance and stimulus concentration that it demonstrates, provide a thorough comparison of both conventionally-defined thresholds and method-independent thresholds against the ASTM-based method. Comparisons between the thresholds resulting from the various estimation methods demonstrated (1) the choice of stopping rule had a significant effect on threshold estimates (P",0,1 +1523,Being sceptical about meta-analyses: a Bayesian perspective on magnesium trials in myocardial infarction,"There has been extensive discussion of the apparent conflict between meta-analyses and a mega-trial investigating the benefits of intravenous magnesium following myocardial infarction, in which the early trial results have been said to be 'too good to be true'.We apply Bayesian methods of meta-analysis to the trials available before and after the publication of the ISIS-4 results. We show how scepticism can be formally incorporated into an analysis as a Bayesian prior distribution, and how Bayesian meta-analysis models allow appropriate exploration of hypotheses that the treatment effect depends on the size of the trial or the risk in the control group.Adoption of a sceptical prior would have led early enthusiasm for magnesium to be suitably tempered, but only if combined with a random effects meta-analysis, rather than the fixed effect analysis that was actually conducted.We argue that neither a fixed effect nor a random effects analysis is appropriate when the mega-trial is included. The Bayesian framework provides many possibilities for flexible exploration of clinical hypotheses, but there can be considerable sensitivity to apparently innocuous assumptions.",0,1 +1524,Empirical Bayesian estimation of normal variances and covariances,"This paper derives and evaluates an algorithm for estimating normal covariances. A particular concern is the performance of the estimator when the dimension of the space exceeds the number of observations. The algorithm is simple, tolerably well founded, and seems to be more accurate for its purpose than the alternatives. Other topics discussed are the joint estimation of variances in one and many dimensions; the loss function appropriate to a variance estimator; and its connection with a certain Bayesian prescription.",0,1 +1525,Computer-modeling and Graphical Strategies for Meta-analysis,,0,1 +1526,Nonparametric Item Response Function Estimation for Assessing Parametric Model Fit,"Methods are developed that investigate the fit of parametric item response models by comparing them to models fitted under nonparametric assumptions. The approach is primarily graphical, but is made inferential through resampling from an estimated parametric model. The identifiability and estimation consistency of item response theory models are discussed and shown to be vital to the interpretation of differences between two fitted item response theory models. Simulation studies and real-data examples illustrate these techniques.",0,1 +1527,A Comparison of Two Procedures for Computing IRT Equating Coefficients,"In order to equate tests under Item Response Theory (IRT), one must obtain the slope and intercept coefficients of the appropriate linear transformation. This article compares two methods for computing such equating coefficients–Loyd and Hoover (1980) and Stocking and Lord (1983). The former is based upon summary statistics of the test calibrations; the latter is based upon matching test characteristic curves by minimizing a quadratic loss function. Three types of equating situations: horizontal, vertical, and that inherent in IRT parameter recovery studies–were investigated. The results showed that the two computing procedures generally yielded similar equating coefficients in all three situations. In addition, two sets of SAT data were equated via the two procedures, and little difference in the obtained results was observed. Overall, the results suggest that the Loyd and Hoover procedure usually yields acceptable equating coefficients. The Stocking and Lord procedure improves upon the Loyd and Hoover values and appears to be less sensitive to atypical test characteristics. When the user has reason to suspect that the test calibrations may be associated with data sets that are typically troublesome to calibrate, the Stocking and Lord procedure is to be preferred.",0,1 +1528,Psychometric function for nectar volume perception of a flower-visiting bat,"For foraging pollinators one aspect of floral quality is the volume of nectar available. Thus, nectar-feeding animals should be able to estimate volumes of received nectar. In this study, we determined the psychometric function for nectar volume discrimination of a Neotropical flower-visiting bat Glossophaga soricina. For this, we examined the ability of bats to discriminate between two nectar volumes in a two-alternative forced-choice paradigm. We used a Bayesian inference approach to determine psychometric functions. From the derived psychometric function we assessed the discrimination threshold at a value of 0.69. G. soricina could clearly distinguish between two volumes, when the difference between the two nectar volumes divided by their average exceeded this value. This indicates that bats possess a sense for the perception and discrimination of volumes of nectar that is better developed than in honeybees. © 2006 Springer-Verlag.",0,1 +1529,Comparing Bayesian and frequentist methods of fisheries models: Hierarchical catch curves,"Bayesian inference is an emerging statistical paradigm and is becoming an increasingly used alternative to frequentist inference. Unfortunately, little is known about the efficacy of Bayesian inference and how it relates to the historical methodology of evaluating fisheries related models. Mortality information is routinely used in fisheries management to describe fish population abundance over time and has been historically estimated using catch curves and frequentist inference (i.e., maximum likelihood estimation). The objective of this study was to compare frequentist and Bayesian inference approaches to estimate instantaneous mortality (Z) from a hierarchical catch curve model. The data used in the comparison were from a long term monitoring program of yellow perch Perca flavescens from southern Lake Michigan in addition to a simulated dataset where parameter estimates were compared to known values. Point estimates of Z were similar among both methods. Similarly, Bayesian inference 95% credible intervals were concordant with frequentist 95% confidence intervals. However, the root mean squared error of frequentist inference increased at a higher rate than Bayesian inference with increasing variability in the simulated dataset. Our study builds on the literature that seeks to compare results between these two paradigms to assist managers to make the best decision possible when deciding what statistical paradigm to employ.",0,1 +1530,Lure similarity affects visual episodic recognition: Detailed tests of a noisy exemplar model,"Summed-similarity models of visual episodic recognition memory successfully predict the variation in false alarm rates across different test items. With data averaged across subjects, Kahana and Sekuler demonstrated that subjects' performance appears to change along with the mean similarity among study items; with high interstimulus similarity, subjects were less likely to commit false alarms to similar lures. We examined this effect in detail by systematically varying the coordinates of study and test items along a critical stimulus dimension and measuring memory performance at each point. To reduce uncontrolled variance associated with individual differences in vision, the coordinates of study and test items were scaled according to each subject's discrimination threshold. Fitting each of four summed-similarity models to the individual subjects' data demonstrated a clear superiority for models that take account of interitem similarity on a trialwise basis.",0,1 +1531,Model-free estimation of the psychometric function,"A subject's response to the strength of a stimulus is described by the psychometric function, from which summary measures, such as a threshold or a slope, may be derived. Traditionally, this function is estimated by fitting a parametric model to the experimental data, usually the proportion of successful trials at each stimulus level. Common models include the Gaussian and Weibull cumulative distribution functions. This approach works well if the model is correct, but it can mislead if not. In practice, the correct model is rarely known. Here, a nonparametric approach based on local linear fitting is advocated. No assumption is made about the true model underlying the data, except that the function is smooth. The critical role of the bandwidth is identified, and its optimum value is estimated by a cross-validation procedure. As a demonstration, seven vision and hearing data sets were fitted by the local linear method and by several parametric models. The local linear method frequently performed better and never worse than the parametric ones. Supplemental materials for this article can be downloaded from app.psychonomic-journals.org/content/supplemental.",0,1 +1532,Three-Element Item Selection Procedures for Multiple Forms Assembly,"In educational measurement, building multiple alternate test forms is usually highly desirable in practice. Test assembly problems are classified as NP-hard (Non-deterministic Polynomial-time hard) problems, and their computation time increases exponentially as the problem size grows. The purpose of this study was to construct parallel forms item-by-item based on a seed test, using two proposed item selection heuristic methods (random item sequence assigned to maximum distance form with content balance [R-MD-B] and random item sequence assigned to random form with content balancing [R-R-B]) incorporating a flexible content balancing method. The results were compared with two modified versions of the Armstrong, Jones, and Wu heuristics (random item sequence assigned to maximum distance form with Armstrong’s replacement [R-MD-R] and random item sequence assigned to random form with Armstrong’s replacement [R-R-R]) and two models incorporating mixed integer programming (MIP) methods. The results showed that the R-MD-B and R-R-B methods yielded results comparable with the two MIP methods with less computation time in terms of the item information functions, test characteristic curves, and content coverage. The results also showed that R-MD-B and R-R-B can be extended to handle test assembly constraints in practical settings.",0,1 +1533,The Lognormal Race: A Cognitive-Process Model of Choice and Latency with Desirable Psychometric Properties,"We present a cognitive process model of response choice and response time performance data that has excellent psychometric properties and may be used in a wide variety of contexts. In the model there is an accumulator associated with each response option. These accumulators have bounds, and the first accumulator to reach its bound determines the response time and response choice. The times at which accumulator reaches its bound is assumed to be lognormally distributed, hence the model is race or minima process among lognormal variables. A key property of the model is that it is relatively straightforward to place a wide variety of models on the logarithm of these finishing times including linear models, structural equation models, autoregressive models, growth-curve models, etc. Consequently, the model has excellent statistical and psychometric properties and can be used in a wide range of contexts, from laboratory experiments to high-stakes testing, to assess performance. We provide a Bayesian hierarchical analysis of the model, and illustrate its flexibility with an application in testing and one in lexical decision making, a reading skill. © 2014, The Psychometric Society.",0,1 +1534,Comparing interval estimates for small sample ordinal CFA models,"Robust maximum likelihood (RML) and asymptotically generalized least squares (AGLS) methods have been recommended for fitting ordinal structural equation models. Studies show that some of these methods underestimate standard errors. However, these studies have not investigated the coverage and bias of interval estimates. An estimate with a reasonable standard error could still be severely biased. This can only be known by systematically investigating the interval estimates. The present study compares Bayesian, RML, and AGLS interval estimates of factor correlations in ordinal confirmatory factor analysis models (CFA) for small sample data. Six sample sizes, 3 factor correlations, and 2 factor score distributions (multivariate normal and multivariate mildly skewed) were studied. Two Bayesian prior specifications, informative and relatively less informative were studied. Undercoverage of confidence intervals and underestimation of standard errors was common in non-Bayesian methods. Underestimated standard errors may lead to inflated Type-I error rates. Non-Bayesian intervals were more positive biased than negatively biased, that is, most intervals that did not contain the true value were greater than the true value. Some non-Bayesian methods had non-converging and inadmissible solutions for small samples and non-normal data. Bayesian empirical standard error estimates for informative and relatively less informative priors were closer to the average standard errors of the estimates. The coverage of Bayesian credibility intervals was closer to what was expected with overcoverage in a few cases. Although some Bayesian credibility intervals were wider, they reflected the nature of statistical uncertainty that comes with the data (e.g., small sample). Bayesian point estimates were also more accurate than non-Bayesian estimates. The results illustrate the importance of analyzing coverage and bias of interval estimates, and how ignoring interval estimates can be misleading. Therefore, editors and policymakers should continue to emphasize the inclusion of interval estimates in research.",1,1 +1535,Bayesian random effects meta-analysis of trials with binary outcomes: methods for the absolute risk difference and relative risk scales,"When conducting a meta-analysis of clinical trials with binary outcomes, a normal approximation for the summary treatment effect measure in each trial is inappropriate in the common situation where some of the trials in the meta-analysis are small, or the observed risks are close to 0 or 1. This problem can be avoided by making direct use of the binomial distribution within trials. A fully Bayesian method has already been developed for random effects meta-analysis on the log-odds scale using the BUGS implementation of Gibbs sampling. In this paper we demonstrate how this method can be extended to perform analyses on both the absolute and relative risk scales. Within each approach we exemplify how trial-level covariates, including underlying risk, can be considered. Data from 46 trials of the effect of single-dose ibuprofen on post-operative pain are analysed and the results contrasted with those derived from classical and Bayesian summary statistic methods. The clinical interpretation of the odds ratio scale is not straightforward. The advantages and flexibility of a fully Bayesian approach to meta-analysis of binary outcome data, considered on an absolute risk or relative risk scale, are now available.",0,1 +1536,"Math achievement is important, but task values are critical, too: examining the intellectual and motivational factors leading to gender disparities in STEM careers","Although young women now obtain higher course grades in math than boys and are just as likely to be enrolled in advanced math courses in high school, females continue to be underrepresented in some Science, Technology, Engineering, and Mathematics (STEM) occupations. This study drew on expectancy-value theory to assess (1) which intellectual and motivational factors in high school predict gender differences in career choices and (2) whether students' motivational beliefs mediated the pathway of gender on STEM career via math achievement by using a national longitudinal sample in the United States. We found that math achievement in 12th grade mediated the association between gender and attainment of a STEM career by the early to mid-thirties. However, math achievement was not the only factor distinguishing gender differences in STEM occupations. Even though math achievement explained career differences between men and women, math task value partially explained the gender differences in STEM career attainment that were attributed to math achievement. The identification of potential factors of women's underrepresentation in STEM will enhance our ability to design intervention programs that are optimally tailored to female needs to impact STEM achievement and occupational choices.",0,1 +1537,Leader–member exchange and affective organizational commitment: The contribution of supervisor's organizational embodiment.,"In order to account for wide variation in the relationship between leader-member exchange and employees' affective organizational commitment, we propose a concept termed supervisor's organizational embodiment (SOE), which involves the extent to which employees identify their supervisor with the organization. With samples of 251 social service employees in the United States (Study 1) and 346 employees in multiple Portuguese organizations (Study 2), we found that as SOE increased, the association between leader-member exchange and affective organizational commitment became greater. This interaction carried through to in-role and extra-role performance. With regard to antecedents, we found in Study 1 that supervisor's self-reported identification with the organization increased supervisor's expression of positive statements about the organization, which in turn increased subordinates' SOE.",0,1 +1538,Nonconjugate Bayesian Analysis of Variance Component Models,"Summary. We consider the usual normal linear mixed model for variance components from a Bayesian viewpoint. With conjugate priors and balanced data, Gibbs sampling is easy to implement; however, simulating from full conditionals can become difficult for the analysis of unbalanced data with possibly nonconjugate priors, thus leading one to consider alternative Markov chain Monte Carlo schemes. We propose and investigate a method for posterior simulation based on an independence chain. The method is customized to exploit the structure of the variance component model, and it works with arbitrary prior distributions. As a default reference prior, we use a version of Jeffreys' prior based on the integrated (restricted) likelihood. We demonstrate the ease of application and flexibility of this approach in familiar settings involving both balanced and unbalanced data.",0,1 +1539,Statistical Modelling of Neighbor Treatment Effects in Aquaculture Clinical Trials,"In the design of clinical trials involving fish observed over time in tanks, there may be advantages in housing several treatment groups within the same tank. In particular, such ""within-tank"" designs will be more efficient than designs with treatment groups in separate tanks when substantial between-tank variability is expected. One potential problem with within-tank designs is that it may not be possible to include all treatments in one tank; in statistical terms this means that the blocks (tanks) are incomplete. In incomplete block designs, there may be a concern that the treatments present in the same tank (denoted here as ""neighbors"") affect each other in their performance; thus the need for an assessment of neighbor effects. In this paper, we propose two statistical approaches to assess and account for neighbor effects. The first approach is based on a non-linear mixed model and the second involves cross-classified and multiple membership models. Both approaches are illustrated on simulated data as well as data from a clinical ISAV (Infectious Salmon Anaemia Virus) trial; corresponding computer code is available online. The simulation studies demonstrated that both models show promise in capturing neighbor treatment effects of the type assumed for the models, whenever such neighbor effects are of at least moderate magnitude. In the absence of or with low magnitudes of neighbor effects, the non-linear mixed model faced numerical challenges and produced noisy results. One version of the cross-classified and multiple membership model was shown to depend strongly on prior information about variance-covariance parameters for datasets similar to the ISAV data. Analyses of the ISAV trial data by both models did not provide any evidence of substantial neighbor effects. © 2010 International Biometric Society.",0,1 +1540,Mood and Emotion in Major Depression,"Nothing is more familiar to people than their moods and emotions. Oddly, however, it is not clear how these two kinds of affective processes are related. Intuitively, it makes sense that emotional reactions are stronger when they are congruent with a preexisting mood, an idea reinforced by contemporary emotion theory. Yet empirically, it is uncertain whether moods actually facilitate emotional reactivity to mood-congruent stimuli. One approach to the question of how moods affect emotions is to study mood-disturbed individuals. This review describes recent experimental studies of emotional reactivity conducted with individuals suffering from major depression. Counter to intuitions, major depression is associated with reduced emotional reactivity to sad contexts. A novel account of emotions in depression is advanced to assimilate these findings. Implications for the study of depression and normal mood variation are considered.",0,1 +1541,Scar Effects of Unemployment: An Assessment of Institutional Complementarities,"This article uses panel data from the Survey of Income and Program Participation (SIPP) and the European Community Household Panel (ECHP) for a comparative analysis of workers' post-unemployment earnings trajectories in the United States and 12 Western European countries. Across the study sample of industrialized countries, results of difference-in-difference propensity score matching show post-unemployment earnings losses to be largely permanent and particularly significant for high-wage and older workers as well as for women. The analyses also show that negative effects of unemployment on workers' subsequent earnings are mitigated through either generous unemployment benefit systems or strict labor market regulation. These effects stem partly from favorable behavioral responses that prevent downward occupational and industrial mobility and partly from changes in the overall structure of labor markets favoring the transferability of worker skills between jobs. These positive effects materialize despite the fact that labor market policies tend to successfully protect the core work force from experiencing a job loss in the first place.",0,1 +1542,Prior distributions for variance parameters in hierarchical models,"Various prior distributions have been suggested for scale parameters in hierarchical models. We construct a new folded-noncentral-t family of conditionally conjugate priors for hierarchical standard deviation pa- rameters, and then consider and weakly informative priors in this family. We use an example to illustrate serious problems with the inverse-gamma family of noninformative prior distributions. We suggest instead to use a uni- form prior on the hierarchical standard deviation, using the half-t family when the number of groups is small and in other settings where a weakly informative prior is desired. We also illustrate the use of the half-t family for hierarchical modeling of multiple variance parameters such as arise in the analysis of variance.",0,1 +1543,A Robust Bayesian Approach for Structural Equation Models with Missing Data,"In this paper, normal/independent distributions, including but not limited to the multivariate t distribution, the multivariate contaminated distribution, and the multivariate slash distribution, are used to develop a robust Bayesian approach for analyzing structural equation models with complete or missing data. In the context of a nonlinear structural equation model with fixed covariates, robust Bayesian methods are developed for estimation and model comparison. Results from simulation studies are reported to reveal the characteristics of estimation. The methods are illustrated by using a real data set obtained from diabetes patients. © 2008 The Psychometric Society.",0,1 +1544,Using cross-classified multivariate mixed response models with application to life history traits in great tits (Parus major),"Longitudinal observations on known individuals are an important source of data with which to test evolutionary theory within natural populations, in particular, the evolution and maintenance of life-history traits. In this paper, we concentrate on the reproductive behaviour and survival of a small passerine bird, the great tit ( Parus major). The dataset we consider is taken from the long-term study of great tits in Wytham Woods in Oxfordshire. The models we consider are designed to relate variation in several phenotypic response variables that are linked to evolutionary fitness, alongside the correlations between them, to both general environmental and individual-specific factors. We fit multivariate cross-classified random effects models using a Markov chain Monte Carlo (MCMC) estimation algorithm described in the paper. Our results show for which traits variability is influenced by environmental factors and for which traits individual bird factors are more important. The partitioning of correlations is particularly illuminating, producing some pairs of ‘antagonistic’ correlations which are biologically meaningful.",0,1 +1545,Modeling Seroadaptation and Sexual Behavior Among HIV+Study Participants with a Simultaneously Multilevel and Multivariate Longitudinal Count Model,"Longitudinal behavioral intervention trials to reduce HIV transmission risk collect complex multilevel and multivariate data longitudinally for each subject with important correlation structures across time, level, and variables. Accurately assessing the effects of these trials are critical for determining which interventions are effective. Both numbers of partners and numbers of sex acts with each partner are reported at each time point. Sex acts with each partner are further differentiated into protected and unprotected acts with correspondingly differing risks of HIV/STD transmission. These trials generally also have eligibility criteria limiting enrollment to participants with some minimal level of risky sexual behavior tied directly to the outcome of interest. The combination of these factors makes it difficult to quantify sexual behaviors and the effects of intervention. We propose a multivariate multilevel count model that simultaneously models the number of partners, acts within partners, and accounts for recruitment eligibility. Our methods are useful in the evaluation of intervention trials and provide a more accurate and complete model for sexual behavior. We illustrate the contributions of our model by examining seroadaptive behavior defined as risk reducing behavior that depends on the serostatus of the partner. Several forms of seroadaptive risk reducing behavior are quantified and distinguished from nonseroadaptive risk reducing behavior.",0,1 +1546,Bayesian model comparison of nonlinear structural equation models with missing continuous and ordinal categorical data,"Missing data are very common in behavioural and psychological research. In this paper, we develop a Bayesian approach in the context of a general nonlinear structural equation model with missing continuous and ordinal categorical data. In the development, the missing data are treated as latent quantities, and provision for the incompleteness of the data is made by a hybrid algorithm that combines the Gibbs sampler and the Metropolis-Hastings algorithm. We show by means of a simulation study that the Bayesian estimates are accurate. A Bayesian model comparison procedure based on the Bayes factor and path sampling is proposed. The required observations from the posterior distribution for computing the Bayes factor are simulated by the hybrid algorithm in Bayesian estimation. Our simulation results indicate that the correct model is selected more frequently when the incomplete records are used in the analysis than when they are ignored. The methodology is further illustrated with a real data set from a study concerned with an AIDS preventative intervention for Filipina sex workers.",0,1 +1547,The Art of Data Augmentation,"The term data augmentation refers to methods for constructing iterative optimization or sampling algorithms via the introduction of unobserved data or latent variables. For deterministic algorithms, the method was popularized in the general statistical community by the seminal article by Dempster, Laird, and Rubin on the EM algorithm for maximizing a likelihood function or, more generally, a posterior density. For stochastic algorithms, the method was popularized in the statistical literature by Tanner and Wong's Data Augmentation algorithm for posterior sampling and in the physics literature by Swendsen and Wang's algorithm for sampling from the Ising and Potts models and their generalizations; in the physics literature, the method of data augmentation is referred to as the method of auxiliary variables. Data augmentation schemes were used by Tanner and Wong to make simulation feasible and simple, while auxiliary variables were adopted by Swendsen and Wang to improve the speed of iterative simulation. In...",0,1 +1548,A Psychological Model for Aggregating Judgments of Magnitude,"In this paper, we develop and illustrate a psychologically-motivated model for aggregating judgments of magnitude across experts. The model assumes that experts’ judgments are perturbed from the truth by both systematic biases and random error, and it provides aggregated estimates that are implicitly based on the application of nonlinear weights to individual judgments. The model is also easily extended to situations where experts report multiple quantile judgments. We apply the model to expert judgments concerning flange leaks in a chemical plant, illustrating its use and comparing it to baseline measures.",0,1 +1549,Multivariate Veränderungsmodelle für Schulnoten und Schülerleistungen in Deutsch und Mathematik,"Zusammenfassung. Schülerleistungen in standardisierten Leistungstests weisen einen mittleren Zusammenhang zu Schulnoten im gleichen Fach auf. Über die Fächergrenzen hinweg sind die Zusammenhänge geringer aber positiv. Über längsschnittliche Zusammenhänge zwischen Schulnoten und Schülerleistungen ist wenig bekannt. In dieser Studie untersuchen wir längsschnittliche Zusammenhänge zwischen Schülerleistungen und Schulnoten in Deutsch und Mathematik. Die vorliegenden Analysen wurden an Prä- und Postmessungen einer Gymnasialstichprobe (N=168) vorgenommen, die zu Studien- und Kontrollgruppen einer intensiv-längsschnittlichen Studie gehörte. Multigruppenanalysen weisen auf vollständige Messinvarianz zwischen beiden Gruppen hin, Testungseffekte zeigen sich nicht. Die längsschnittlichen Zusammenhänge wurden mit dem Change-Score-Modell analysiert. Die Veränderungen in Schülerleistungen in beiden Schulfächern korrelieren nicht signifikant, die Veränderungen in Schulnoten beider Schulfächer korrelieren positiv. In beiden Schulfächern zeigen Veränderungen der Schülerleistungen und der Schulnoten einen positiven Zusammenhang. Die Korrelation ist nur moderat, da Schulnoten aus Gründen wie Referenzrahmeneffekte auch querschnittlich nur moderat mit Schülerleistungen korrelieren. Der Leistungszuwachs lässt sich am effektivsten mit normreferenzierten Skalen quantifizieren.",0,1 +1550,A Dirichlet process mixture model for clustering longitudinal gene expression data,"Subgroup identification (clustering) is an important problem in biomedical research. Gene expression profiles are commonly utilized to define subgroups. Longitudinal gene expression profiles might provide additional information on disease progression than what is captured by baseline profiles alone. Therefore, subgroup identification could be more accurate and effective with the aid of longitudinal gene expression data. However, existing statistical methods are unable to fully utilize these data for patient clustering. In this article, we introduce a novel clustering method in the Bayesian setting based on longitudinal gene expression profiles. This method, called BClustLonG, adopts a linear mixed-effects framework to model the trajectory of genes over time, while clustering is jointly conducted based on the regression coefficients obtained from all genes. In order to account for the correlations among genes and alleviate the high dimensionality challenges, we adopt a factor analysis model for the regression coefficients. The Dirichlet process prior distribution is utilized for the means of the regression coefficients to induce clustering. Through extensive simulation studies, we show that BClustLonG has improved performance over other clustering methods. When applied to a dataset of severely injured (burn or trauma) patients, our model is able to identify interesting subgroups. Copyright © 2017 John Wiley & Sons, Ltd.",0,1 +1551,A Bayesian analysis of mixture structural equation models with non-ignorable missing responses and covariates,"In behavioral, biomedical, and social-psychological sciences, it is common to encounter latent variables and heterogeneous data. Mixture structural equation models (SEMs) are very useful methods to analyze these kinds of data. Moreover, the presence of missing data, including both missing responses and missing covariates, is an important issue in practical research. However, limited work has been done on the analysis of mixture SEMs with non-ignorable missing responses and covariates. The main objective of this paper is to develop a Bayesian approach for analyzing mixture SEMs with an unknown number of components, in which a multinomial logit model is introduced to assess the influence of some covariates on the component probability. Results of our simulation study show that the Bayesian estimates obtained by the proposed method are accurate, and the model selection procedure via a modified DIC is useful in identifying the correct number of components and in selecting an appropriate missing mechanism in the proposed mixture SEMs. A real data set related to a longitudinal study of polydrug use is employed to illustrate the methodology.",0,1 +1552,Frequency Distribution of the Values of the Correlation Coefficient in Samples from an Indefinitely Large Population,,0,1 +1553,Center-adjusted inference for a nonparametric Bayesian random effect distribution,"Dirichlet process (DP) priors are a popular choice for semiparametric Bayesian random effect models. The fact that the DP prior implies a non-zero mean for the random effect distribution creates an identifiability problem that complicates the interpretation of, and inference for, the fixed effects that are paired with the random effects. Similarly, the interpretation of, and inference for, the variance components of the random effects also becomes a challenge. We propose an adjustment of conventional inference using a post-processing technique based on an analytic evaluation of the moments of the random moments of the DP. The adjustment for the moments of the DP can be conveniently incorporated into Markov chain Monte Carlo simulations at essentially no additional computational cost. We conduct simulation studies to evaluate the performance of the proposed inference procedure in both a linear mixed model and a logistic linear mixed effect model. We illustrate the method by applying it to a prostate specific antigen dataset. We provide an R function that allows one to implement the proposed adjustment in a post-processing step of posterior simulation output, without any change to the posterior simulation itself.",0,1 +1554,Making BUGS open,,0,1 +1555,Methods for Mediation Analysis with Missing Data,"Despite wide applications of both mediation models and missing data techniques, formal discussion of mediation analysis with missing data is still rare. We introduce and compare four approaches to dealing with missing data in mediation analysis including listwise deletion, pairwise deletion, multiple imputation (MI), and a two-stage maximum likelihood (TS-ML) method. An R package bmem is developed to implement the four methods for mediation analysis with missing data in the structural equation modeling framework, and two real examples are used to illustrate the application of the four methods. The four methods are evaluated and compared under MCAR, MAR, and MNAR missing data mechanisms through simulation studies. Both MI and TS-ML perform well for MCAR and MAR data regardless of the inclusion of auxiliary variables and for AV-MNAR data with auxiliary variables. Although listwise deletion and pairwise deletion have low power and large parameter estimation bias in many studied conditions, they may provide useful information for exploring missing mechanisms. © 2012 The Psychometric Society.",0,1 +1556,"The applicability of deadline models: Comment on Glickman, Gray, and Morales (2005)","Glickman, Gray, and Morales (this issue) propose a statistical model for measuring the unobserved latency of stimulus-controlled processes. The model accounts for both speed and accuracy and does so by assuming that participants set an internal deadline. If a stimulus-controlled response is not produced by the deadline, the participant then guesses. The applicability of the model is discussed in this Comment. The deadline model yields specific predictions for the case in which stimulus difficulty is manipulated in a within-block manner. In this case, it is reasonable to assume that stimulus difficulty does not affect the deadline. It is shown that in common perceptual and cognitive domains, extant data do not fully meet these predictions. Hence, practitioners need be aware of the possibility and consequences of model misspecification. © 2005 The Psychometric Society.",0,1 +1557,Decomposing the reaction time distribution: Pure insertion and selective influence revisited,"Abstract This paper investigates the consequences of extending the assumptions of pure insertion and selective influence (popular in RT theorizing) to the level of the distribution. In the case of pure insertion and under the additional assumption that the additive random variable is exponentially distributed, a solution is obtained which not only allows estimation of the exponential-rate parameter but also provides a test of the assumptions. The result is shown to be applicable not only when processing is serial but also for certain parallel models. In addition, discrimination between self-terminating and exhaustive search strategies is provided, and in the case of either, both parameter estimation and tests of the model are possible. Extensions to nonexponential models are investigated and a general method of moments solution is outlined. In the case of selective influence a general nonparametric alternative to Sternberg's additive factor method is developed. The problem of empirical estimation and application is then considered. Simulations which place bounds on the type I and II error are reported. Finally the first theorem is provided an illustrative application with data from a memory scanning experiment. The results provide some support for the double assumption of pure insertion and that the additive random variable is distributed exponentially.",0,1 +1558,Evaluating and Using Statistical Methods in the Social Sciences,,0,1 +1559,AN ANALYSIS OF SURVEY DATA ON SMOKING USING PROPENSITY SCORES,"SUMMARY. Responses to questions on perceived health risks from smoking, amount of exercise, overall health, and desire to quit smoking vary across smoking groups. The smoking groups also have very different distributions of covariates. Categorizing respondents based on estimated propensities to smoke, as in blocking, creates groups with less measurable imbalance in distributions of covariates. Adjustment of results using propensity score classes lessens some effect estimates while increasing others and changes results of some significance tests. However, even after adjusting for covariates through the use of propensity scores, smokers report a higher risk of disease than do nonsmokers.",0,1 +1560,Understanding the Metropolis-Hastings Algorithm,"Abstract We provide a detailed, introductory exposition of the Metropolis-Hastings algorithm, a powerful Markov chain method to simulate multivariate distributions. A simple, intuitive derivation of this method is given along with guidance on implementation. Also discussed are two applications of the algorithm, one for implementing acceptance-rejection sampling when a blanketing function is not available and the other for implementing the algorithm with block-at-a-time scans. In the latter situation, many different algorithms, including the Gibbs sampler, are shown to be special cases of the Metropolis-Hastings algorithm. The methods are illustrated with examples.",0,1 +1561,"Changing the pond, not the fish: Following high-ability students across different educational environments.","Big-fish-little-pond effect (BFLPE) research (e.g., Marsh & Parker, 1984) has found that perceptions of academic ability are generally positively related to individual ability and negatively related to classroom and school average ability. However, BFLPE research typically relies on environmental differences as a between-subjects factor. Unlike most previous BFLPE research, the current study used group average ability as a within-subject variable by measuring student self-concept before and after high-ability students left their regular school environment to participate in a supplemental academic summer program. Results revealed that academic self-concept (ASC) and educational aspirations did not undergo significant declines when students were in the relatively higher ability environment. Even with ceiling effects limiting potential increases in ASC, participants were more than 2 times as likely to increase or maintain their ASC as they were to report declines in ASC. Further, several boosts were found in nonacademic self-concepts. Such findings indicate that BFLPEs are not necessarily associated with supplemental educational environments.",0,1 +1562,Generalized multilevel structural equation modeling,"A unifying framework for generalized multilevel structural equation modeling is introduced. The models in the framework, called generalized linear latent and mixed models (GLLAMM), combine features of generalized linear mixed models (GLMM) and structural equation models (SEM) and consist of a response model and a structural model for the latent variables. The response model generalizes GLMMs to incorporate factor structures in addition to random intercepts and coefficients. As in GLMMs, the data can have an arbitrary number of levels and can be highly unbalanced with different numbers of lower-level units in the higher-level units and missing data. A wide range of response processes can be modeled including ordered and unordered categorical responses, counts, and responses of mixed types. The structural model is similar to the structural part of a SEM except that it may include latent and observed variables varying at different levels. For example, unit-level latent variables (factors or random coefficients) can be regressed on cluster-level latent variables. Special cases of this framework are explored and data from the British Social Attitudes Survey are used for illustration. Maximum likelihood estimation and empirical Bayes latent score prediction within the GLLAMM framework can be performed using adaptive quadrature in gllamm, a freely available program running in Stata.",0,1 +1563,Bayesian Multilevel Analysis and MCMC,"Multilevel models have gained wide acceptance over the past 20 years in many fields, including education and medicine [e.g., 26, 43, 45], as an important methodology for dealing appropriately with nested or clustered data. The idea of conducting an experiment in such a way that the levels of one factor are nested inside those of another goes back all the way to the initial development, in the 1920s, of the analysis of variance (ANOVA; [34]), so there?s nothing new in working with nested data; the novelty in recent decades is in the methods for fitting multilevel models, the ability to work with data possessing many levels of nesting and multiple predictor variables at any or all levels, and an increased flexibility in distributional assumptions. The earliest designs featured one-way ANOVA models such as1 yij = μ + αTj + aSij , j = 1, . . . , J, i = 1, . . . , nj , ∑j=1J nj = N, ∑Jj=1 αTj = 0, aSij∼iid N(0, σ2S), in which the subject factor S (indexed by i), treated as random, is nested within the treatment factor T (indexed by j), treated as fixed. Under the normality assumption in (2.1) such models required little for the (frequentist) estimation of the parameters μ, σ2S , and the αTj beyond minor extensions of the least squares methods known since the time of Legendre [51] and Gauss [36]. Regarding the treatment factor as random, however, by changing the αTj to aTj ∼iid N(0, α2T ) (with the a Tj and aS ij mutually independent), created substantial new difficulties in model fitting-indeed, as late as the 1950s, one of the leading estimation methods [e.g., 65] was based on unbiased estimates of the variance components α2T and α2 s , the former of which can easily, and embarrassingly, go negative when α2T is small. Fisher [33] had much earlier pioneered the use of maximum likelihood estimation, but before the widespread use of fast computers this approach was impractical in random-effects and mixed models such as yij = β0 + β1(xij ? xÌ„) + aTj + aSij , j = 1, . . . , J, i = 1, . . . , nj , XJj=1 nj = N, aTj∼iid N(0, σ;a2 T), aSij∼iid N(0, σ2S) (where the xij are fixed known values of a predictor variable and ?x is the sample mean of this variable), because the likelihood equations in such models can only be solved iteratively. Multilevel modeling entered a new phase in the 1980s, with the development of computer programs such as ML3, VARCL, and HLM using likelihood-based estimation approaches based on iterative generalized least squares [42], Fisher scoring [52], and the EM algorithm [e.g., 15], respectively. In particular, the latest versions of MLwiN (the successor to ML3; [60]) and HLM [66] have worldwide user bases in the social and biomedical sciences numbering in the thousands, and likelihood-based fitting of at least some multilevel models is also now obtainable in more general-purpose statistical packages such as SAS [64] and Stata [71]. However, the use of the likelihood function alone in multilevel modeling can lead to the following technical problems: Maximum-likelihood estimates (MLEs) and their (estimated asymptotic) standard errors (SEs) can readily be found by iterative means for the parameters in Gaussian multilevel models such as (2.2), but interval stimates of those parameters can be problematic when J, the number of level-2 units, is small. For example, simple ?95%? intervals of the form α̂2T ± 1.96 b se(α̂2T ) (based on the large-sample Gaussian repeated-sampling distribution of α̂2T ) can go negative and can have actual coverage levels substantially below 95%, and other methods based only on α̂2T and b se(α̂2T ) (which are the default outputs of packages such as MLwiN and HLM) are not guaranteed to do much better, in part because (with small sample sizes) the MLE of α2T can be 0 even when the true value of α2T is well away from 0 [e.g., 12]. The situation becomes even more difficult when the outcome variable y in the multilevel model is dichotomous rather than Gaussian, as in randomeffects logistic regression (RELR) models such as (yij | p ij) ∼indep Bernoulli(pij), where logit(pij) = β0 + β1(xij ? xÌ„) + uj , uj ∼iid N(0, α2u). Here the likelihood methods that work with Gaussian outcomes fail; the likelihood function itself cannot even be evaluated without integrating out the random effects uj from (2.3). Available software such as MLwiN fits RELR models via quasi-likelihood methods [7]; this approach to fitting nonlinear models such as (2.3) proceeds by linearizing the second line of the model via Taylor series expansion, yielding marginal and penalized quasi-likelihood (MQL and PQL) estimates according to the form of the expansion used. These are not full likelihood methods and would be better termed likelihood-based techniques. Browne and Draper [12] have shown that the actual coverage of nominal 95% interval estimates with this approach in RELR models can be far less than 95% when the intervals are based only on MQL and PQL point estimates and their (estimated asymptotic) SEs; see Section 2.3.3 below. Calibration results of this kind for other methods which attempt to more accurately approximate the actual likelihood function [e.g., 1, 50, 53, 57, 61] are sparse and do not yet fully cover the spectrum of models in routine use, and user-friendly software for many of these methods is still hard to come by. This chapter concerns the Bayesian approach to fitting multilevel models, which (a) attempts to remedy the above problems (though not without introducing some new challenges of its own) and (b) additionally provides a mechanism for the formal incorporation of any prior information which may be available about the parameters of the multilevel model of interest external to the current data set. A computing revolution based on Markov chain Monte Carlo (MCMC) methods, and the availability of much faster (personal) computers, have together made the Bayesian fitting of multilevel models increasingly easier since the early 1990s. In this chapter I (1) describe the basic outline of a Bayesian analysis (multilevel or not), in the context of a case study, (2) motivate the need for simulation-based computing methods, (3) describe MCMC methods in general and their particular application to multilevel modeling, (4) discuss MCMC diagnostic methods (to ensure accuracy of the computations), and (5) present an MCMC solution to the multilevel modeling case study. © 2008 Springer Science+Business Media, LLC.",0,1 +1564,Does Money Matter? A Theory-Driven Growth Mixture Model to Explain Travel-Mode Choice with Experimental Data,"In the present article we apply a growth mixture model using Mplus via STREAMS to delineate the mechanism underlying travel-mode choice. Three waves of an experimental field study conducted in Frankfurt Main, Germany, are applied for the statistical analysis. Five major questions are addressed: (1) whether the choice of public transport rather than the car changes over time; (2) whether a soft policy intervention to change travel mode choice has any effect on the travel-mode chosen; (3) whether one can identify different groups of people regarding the importance allocated to monetary and time considerations for the decision of which travel mode to use; (4) whether the different subgroups of people have different initial states and rates of change in their travel-model choices; (5) whether sociodemographic variables have an additional effect on the latent class variables and on the changes in travel-mode choice over time. We also found that choice of public transportation in our study is stable over time. Moreover, the intervention has an effect only on one of the classes. We identify four classes of individuals. One class allocates a low importance to both monetary and time considerations, the second allocates high importance to money and low importance to time, the third allocates high importance to both, and the fourth allocates a low importance to money and a high importance to time. We found no difference in the patterns of travel-mode changes over time in the four classes. We also found some additional effects of sociodemographic characteristics on the latent class variables and on behavior in the different classes. The model specification and the empirical findings are discussed in light of the theory of the allocation of time of Gary Becker.",0,1 +1565,Errors-in-Variables Regression Using Stein Estimates,"Abstract A method is proposed for estimating regression parameters from data containing covariate measurement errors by using Stein estimates of the unobserved true covariates. The method produces consistent estimates for the slope parameter in the classical linear errors-in-variables model and applies to a broad range of nonlinear regression problems, provided the measurement error is Gaussian with known variance. Simulations are used to examine the performance of the estimates in a nonlinear regression problem and to compare them with the usual naive ones obtained by ignoring error and with other estimates proposed recently in the literature.",0,1 +1566,Classification into two Multivariate Normal Distributions with Different Covariance Matrices,"Linear procedures for classifying an observation as coming from one of two multivariate normal distributions are studied in the case that the two distributions differ both in mean vectors and covariance matrices. We find the class of admissible linear procedures, which is the minimal complete class of linear procedures. It is shown how to construct the linear procedure which minimizes one probability of misclassification given the other and how to obtain the minimax linear procedure; Bayes linear procedures are also discussed.",0,1 +1567,Heterogeneous factor analysis models: A bayesian approach,"Multilevel factor analysis models are widely used in the social sciences to account for heterogeneity in mean structures. In this paper we extend previous work on multilevel models to account for general forms of heterogeneity in confirmatory factor analysis models. We specify various models of mean and covariance heterogeneity in confirmatory factor analysis and develop Markov Chain Monte Carlo (MCMC) procedures to perform Bayesian inference, model checking, and model comparison. We test our methodology using synthetic data and data from a consumption emotion study. The results from synthetic data show that our Bayesian model perform well in recovering the true parameters and selecting the appropriate model. More importantly, the results clearly illustrate the consequences of ignoring heterogeneity. Specifically, we find that ignoring heterogeneity can lead to sign reversals of the factor covariances, inflation of factor variances and underappreciation of uncertainty in parameter estimates, The results from the emotion study show that subjects vary both in means and covariances, Thus traditional psychometric methods cannot fully capture the heterogeneity in our data.",0,1 +1568,Minocycline attenuates mechanical allodynia and proinflammatory cytokine expression in rat models of pain facilitation,"Activated glial cells (microglia and astroglia) in the spinal cord play a major role in mediating enhanced pain states by releasing proinflammatory cytokines and other substances thought to facilitate pain transmission. In the present study, we report that intrathecal administration of minocycline, a selective inhibitor of microglial cell activation, inhibits low threshold mechanical allodynia, as measured by the von Frey test, in two models of pain facilitation. In a rat model of neuropathic pain induced by sciatic nerve inflammation (sciatic inflammatory neuropathy, SIN), minocycline delayed the induction of allodynia in both acute and persistent paradigms. Moreover, minocycline was able to attenuate established SIN-induced allodynia 1 day, but not 1 week later, suggesting a limited role of microglial activation in more perseverative pain states. Our data are consistent with a crucial role for microglial cells in initiating, rather than maintaining, enhanced pain responses. In a model of spinal immune activation by intrathecal HIV-1 gp120, we show that the anti-allodynic effects of minocycline are associated with decreased microglial activation, attenuated mRNA expression of interleukin-1beta (IL-1beta), tumor necrosis factor-alpha (TNF-alpha), IL-1beta-converting enzyme, TNF-alpha-converting enzyme, IL-1 receptor antagonist and IL-10 in lumbar dorsal spinal cord, and reduced IL-1beta and TNF-alpha levels in the CSF. In contrast, no significant effects of minocycline were observed on gp120-induced IL-6 and cyclooxygenase-2 expression in spinal cord or CSF IL-6 levels. Taken together these data highlight the importance of microglial activation in the development of exaggerated pain states.",0,1 +1569,"RWA Web: A Free, Comprehensive, Web-Based, and User-Friendly Tool for Relative Weight Analyses","Over the last 15 years, a number of methodological developments have enabled researchers to draw more accurate inferences concerning the relative contribution (i.e., relative importance) among multiple (often correlated) predictor variables in a regression analysis. One such development has been relative weight analysis (RWA). Researchers can use a RWA to decompose the total variance predicted in a regression model (R2) into weights that accurately reflect the proportional contribution of the various predictor variables. Prior to RWA, researchers were forced to rely on traditional statistics (e.g., correlations; standardized regression weights), which are known to yield faulty or misleading information concerning variable importance (especially when predictor variables are correlated with one another, which is often the case in organizational research). Although there has been a surge of interest in RWA over the last 10 years, integration of this statistical tool into organizational research has been hampered by the lack of a user-friendly statistical package for implementing RWA. Indeed, most popular statistical packages (e.g., SPSS, SAS) have yet to include RWA protocols into their regression modules. The purpose of this paper is to present a new, free, comprehensive, web-based, user-friendly resource, RWA-Web, which may be used by anyone having simple access to the internet. Our paper is structured as a tutorial on using RWA-Web to examine relative importance in the classic multiple regression model, the multivariate multiple regression model, and the logistic regression model. We also illustrate how RWA-Web may be used to conduct null hypothesis significance tests using advanced bootstrapping procedures.",0,1 +1570,"Association Between Physical Activity and Sleep in Adults With Chronic Pain: A Momentary, Within-Person Perspective","Background Individuals with chronic pain consider improved sleep to be one of the most important outcomes of treatment. Physical activity has been shown to have beneficial effects on sleep in the general population. Despite these findings, the physical activity–sleep relationship has not been directly examined in a sample of people with chronic pain. Objective This study aimed to examine the association between objective daytime physical activity and subsequent objective sleep for individuals with chronic pain while controlling for pain and psychosocial variables. Design An observational, prospective, within-person study design was used. Methods A clinical sample of 50 adults with chronic pain was recruited. Participation involved completing a demographic questionnaire followed by 5 days of data collection. Over this period, participants wore a triaxial accelerometer to monitor their daytime activity and sleep. Participants also carried a handheld computer that administered a questionnaire measuring pain, mood, catastrophizing, and stress 6 times throughout the day. Results The results demonstrated that higher fluctuations in daytime activity significantly predicted shorter sleep duration. Furthermore, higher mean daytime activity levels and a greater number of pain sites contributed significantly to the prediction of longer periods of wakefulness at night. Limitations The small sample size used in this study limits the generalizability of the findings. Missing data may have led to overestimations or underestimations of effect sizes, and additional factors that may be associated with sleep (eg, medication usage, environmental factors) were not measured. Conclusions The results of this study suggest that engagement in high-intensity activity and high fluctuations in activity are associated with poorer sleep at night; hence, activity modulation may be a key treatment strategy to address sleep complaints in individuals with chronic pain.",0,1 +1571,Multicollinearity and Missing Constraints,"Multicollinearity complicates the simultaneous estimation of interaction and quadratic effects in structural equation modeling (SEM). So far, approaches developed within the Kenny-Judd (1984 ) tradition have failed to specify additional and necessary constraints on the measurement error covariances of the nonlinear indicators. Given that the constraints comprise, in part, latent linear predictor correlations, multicollinearity poses a problem for such approaches. Klein and Moosbrugger’s (2000 ) latent moderated structural equations approach (LMS) approach does not utilize nonlinear indicators and should therefore not be affected by this problem. In the context of a simulation study, we varied predictor correlation and the number of nonlinear effects in order to compare the performance of three approaches developed for the estimation of simultaneous nonlinear effects: Ping’s (1996 ) two-step approach, a correctly extended Jöreskog-Yang (1996 ) approach, and LMS. Results show that in contrast to the Jöreskog-Yang approach and LMS, the two-step approach produces biased parameter estimates and false inferences under heightened multicollinearity. Ping’s approach resulted in overestimated interaction effects and underestimated quadratic effects.",0,1 +1572,The Multigroup Multilevel Categorical Latent Growth Curve Models,"Longitudinal data describe developmental patterns and enable predictions of individual changes beyond sampled time points. Major methodological issues in longitudinal data include modeling random effects, subject effects, growth curve parameters, and autoregressive residuals. This study embedded the longitudinal model within a multigroup multilevel framework and allowed for autoregressive residuals. The parameter in the new model can be estimated using the computer program WinBUGS, which adopts Markov Chain Monte Carlo algorithms. Two simulation studies were conducted. An empirical example was raised and established based on models generated by the results of empirical data, which have been fitted and compared.",0,1 +1573,Overstating the evidence – double counting in meta-analysis and related problems,"The problem of missing studies in meta-analysis has received much attention. Less attention has been paid to the more serious problem of double counting of evidence.Various problems in overstating the precision of results from meta-analyses are described and illustrated with examples, including papers from leading medical journals. These problems include, but are not limited to, simple double counting of the same studies, double counting of some aspects of the studies, inappropriate imputation of results, and assigning spurious precision to individual studies.Some suggestions are made as to how the quality and reliability of meta-analysis can be improved. It is proposed that the key to quality in meta-analysis lies in the results being transparent and checkable.Existing quality check lists for meta-analysis do little to encourage an appropriate attitude to combining evidence and to statistical analysis. Journals and other relevant organisations should encourage authors to make data available and make methods explicit. They should also act promptly to withdraw meta-analyses when mistakes are found.",0,1 +1574,Challenging Conventional Wisdom for Multivariate Statistical Models With Small Samples,"In education research, small samples are common because of financial limitations, logistical challenges, or exploratory studies. With small samples, statistical principles on which researchers rely...",0,1 +1575,Rendezvous Overdue,"Bayesian estimation and inference have been core features of scientific knowledge generation since the work of Sir Thomas Bayes was built upon by Pierre-Simone Laplace from the late 1700s through the early 1800s. Although present-day statistical analysis in organizational research is “frequentist” in nature (due to the influence of scholars such as Sir Ronald Fisher and Jerzey Neyman), the past 20 years has seen a veritable explosion of Bayesian applications across the social and physical sciences. This special issue highlights these applications and the many opportunities they carry, including precise and flexible methods for testing hypotheses and very intuitive ways of describing results. For this special issue, three editorial commentaries were solicited from world-renowned experts in statistics, probability, and their historical and current applications. These papers offer a view from outside management, giving fresh insight into topics that are rarely covered in management research, including critical perspectives on existing paradigms in our field and recommendations for improvements in statistical methods and research design. The topics covered relate to (a) the apparent desire for universal or default methods of inquiry and inference—whether Bayesian or frequentist—which narrows researchers’ focus and reduces their ability to develop and deploy a larger “toolbox” of methods and approaches; (b) the many limitations of existing frequentist tools, which tend to be underestimated or ignored because of their institutionalized and habitual nature; and (c) the existence and importance of",0,1 +1576,"Living Arrangements and Children’s Development in Low-Income White, Black, and Latino Families","This article uses longitudinal data from approximately 2,000 low-income families participating in the national evaluation of the Comprehensive Child Development Program to examine the associations between preschool children's living arrangements and their cognitive achievement and emotional adjustment. The analysis distinguishes families in which children live only with their mothers from children who live in biological father, blended, and multigenerational households. Linkages are examined separately for White, Black, and Latino children. Fixed effects regression techniques reveal few significant associations between living arrangements and child development. These findings suggest that substantial diversity exists in the developmental contexts among children living in the same family structure. Policies seeking to change the living arrangements of low-income children may do little to improve child well-being.",0,1 +1577,An assessment of estimation methods for generalized linear mixed models with binary outcomes,"Two main classes of methodology have been developed for addressing the analytical intractability of generalized linear mixed models: likelihood-based methods and Bayesian methods. Likelihood-based methods such as the penalized quasi-likelihood approach have been shown to produce biased estimates especially for binary clustered data with small clusters sizes. More recent methods using adaptive Gaussian quadrature perform well but can be overwhelmed by problems with large numbers of random effects, and efficient algorithms to better handle these situations have not yet been integrated in standard statistical packages. Bayesian methods, although they have good frequentist properties when the model is correct, are known to be computationally intensive and also require specialized code, limiting their use in practice. In this article, we introduce a modification of the hybrid approach of Capanu and Begg, 2011, Biometrics 67, 371-380, as a bridge between the likelihood-based and Bayesian approaches by employing Bayesian estimation for the variance components followed by Laplacian estimation for the regression coefficients. We investigate its performance as well as that of several likelihood-based methods in the setting of generalized linear mixed models with binary outcomes. We apply the methods to three datasets and conduct simulations to illustrate their properties. Simulation results indicate that for moderate to large numbers of observations per random effect, adaptive Gaussian quadrature and the Laplacian approximation are very accurate, with adaptive Gaussian quadrature preferable as the number of observations per random effect increases. The hybrid approach is overall similar to the Laplace method, and it can be superior for data with very sparse random effects.",0,1 +1578,Longitudinal Data Analysis. A Comparison Between Generalized Estimating Equations and Random Coefficient Analysis,"The analysis of data from longitudinal studies requires special techniques, which take into account the fact that the repeated measurements within one individual are correlated. In this paper, the two most commonly used techniques to analyze longitudinal data are compared: generalized estimating equations (GEE) and random coefficient analysis. Both techniques were used to analyze a longitudinal dataset with six measurements on 147 subjects. The purpose of the example was to analyze the relationship between serum cholesterol and four predictor variables, i.e., physical fitness at baseline, body fatness (measured by sum of the thickness of four skinfolds), smoking and gender. The results showed that for a continuous outcome variable, GEE and random coefficient analysis gave comparable results, i.e., GEE-analysis with an exchangeable correlation structure and random coefficient analysis with only a random intercept were the same. There was also no difference between both techniques in the analysis of a dataset with missing data, even when the missing data was highly selective on earlier observed data. For a dichotomous outcome variable, the magnitude of the regression coefficients and standard errors was higher when calculated with random coefficient analysis then when calculated with GEE-analysis. Analysis of a dataset with missing data with a dichotomous outcome variable showed unpredictable results for both GEE and random coefficient analysis. It can be concluded that for a continuous outcome variable, GEE and random coefficient analysis are comparable. Longitudinal data-analysis with dichotomous outcome variables should, however, be interpreted with caution, especially when there are missing data. © 2004 Kluwer Academic Publishers.",0,1 +1579,Belief in the law of small numbers.,"Reports that people have erroneous intuitions about the laws of chance. In particular, they regard a sample randomly drawn from a population as highly representative, I.e., similar to the population in all essential characteristics. The prevalence of the belief and its unfortunate consequences for psychological research are illustrated by the responses of 84 professional psychologists to a questionnaire concerning research decisions. (PsycINFO Database Record (c) 2012 APA, all rights reserved) Language: en",0,1 +1580,Reconceptualizing Individual Differences in Self-Enhancement Bias: An Interpersonal Approach.,"Self-enhancement bias has been studied from 2 perspectives: L. Festinger's (1954) social comparison theory (self-enhancers perceive themselves more positively than they perceive others) and G. W. Allport's (1937) self-insight theory (self-enhancers perceive themselves more positively than they are perceived by others). These 2 perspectives are theoretically and empirically distinct, and the failure to recognize their differences has led to a protracted debate. A new interpersonal approach to self-enhancement decomposes self-perception into 3 components: perceiver effect, target effect, and unique self-perception. Both theoretical derivations and an illustrative study suggest that this resulting measure of self-enhancement is less confounded by unwanted components of interpersonal perception than previous social comparison and self-insight measures. Findings help reconcile conflicting views about whether self-enhancement is adaptive or maladaptive.",0,1 +1581,Bayesian Methods for Highly Correlated Exposure Data,"Studies that include individuals with multiple highly correlated exposures are common in epidemiology. Because standard maximum likelihood techniques often fail to converge in such instances, hierarchical regression methods have seen increasing use. Bayesian hierarchical regression places prior distributions on exposure-specific regression coefficients to stabilize estimation and incorporate prior knowledge, if available. A common parametric approach in epidemiology is to treat the prior mean and variance as fixed constants. An alternative parametric approach is to place distributions on the prior mean and variance to allow the data to help inform their values. As a more flexible semiparametric option, one can place an unknown distribution on the coefficients that simultaneously clusters exposures into groups using a Dirichlet process prior. We also present a semiparametric model with a variable-selection prior to allow clustering of coefficients at 0. We compare these 4 hierarchical regression methods and demonstrate their application in an example estimating the association of herbicides with retinal degeneration among wives of pesticide applicators.",0,1 +1582,Publication bias in meta-analysis: a Bayesian data-augmentation approach to account for issues exemplified in the passive smoking debate,"Publication bias is a relatively new statistical phenomenon that only arises when one attempts through a meta-analysis to review all studies, significant or insignificant, in order to provide a total perspective on a particular issue. This has recently received some notoriety as an issue in the evaluation of the relative risk of lung cancer associated with passive smoking, following legal challenges to a 1992 Environmental Protection Agency analysis which concluded that such exposure is associated with significant excess risk of lung cancer. We introduce a Bayesian approach which estimates and adjusts for publication bias. Estimation is based on a data-augmentation principle within a hierarchical model, and the number and outcomes of unobserved studies are simulated using Gibbs sampling methods. This technique yields a quantitative adjustment for the passive smoking meta-analysis. We estimate that there may be both negative and positive but insignificant studies omitted, and that failing to allow for these would mean that the estimated excess risk may be overstated by around 30%, both in U.S. studies and in the global collection of studies.",0,1 +1583,A Bayesian Approach to Diffusion Models of Decision-Making and Response Time,"We present a computational Bayesian approach for Wiener diffusion models, which are prominent accounts of response time distributions in decision-making. We first develop a general closed-form analytic approximation to the response time distributions for one-dimensional diffusion processes, and derive the required Wiener diffusion as a special case. We use this result to undertake Bayesian modeling of benchmark data, using posterior sampling to draw inferences about the interesting psychological parameters. With the aid of the benchmark data, we show the Bayesian account has several advantages, including dealing naturally with the parameter variation needed to account for some key features of the data, and providing quantitative measures to guide decisions about model construction.",0,1 +1584,"Addressing Moderated Mediation Hypotheses: Theory, Methods, and Prescriptions","This article provides researchers with a guide to properly construe and conduct analyses of conditional indirect effects, commonly known as moderated mediation effects. We disentangle conflicting definitions of moderated mediation and describe approaches for estimating and testing a variety of hypotheses involving conditional indirect effects. We introduce standard errors for hypothesis testing and construction of confidence intervals in large samples but advocate that researchers use bootstrapping whenever possible. We also describe methods for probing significant conditional indirect effects by employing direct extensions of the simple slopes method and Johnson-Neyman technique for probing significant interactions. Finally, we provide an SPSS macro to facilitate the implementation of the recommended asymptotic and bootstrapping methods. We illustrate the application of these methods with an example drawn from the Michigan Study of Adolescent Life Transitions, showing that the indirect effect of intrinsic student interest on mathematics performance through teacher perceptions of talent is moderated by student math self-concept.",0,1 +1585,Reassessing the trade-off hypothesis: How misery drives the corruption effect on presidential approval,"Do economic conditions drive voters to punish politicians that tolerate corruption? Previous scholarly work contends that citizens in young democracies support corrupt governments that are capable of promoting good economic outcomes, the so-called trade-off hypothesis. We test this hypothesis based on mass surveys in eighteen Latin American countries throughout 2004–2012. We find that citizens that report bribe attempts from bureaucrats are always more likely to report presidential disapproval than citizens that report no such attempts, that is, Latin American victims of corruption are not duped by good economic performance. However, we find some evidence for a weaker form of the trade-off hypothesis: presidential disapproval among corruption victims might be more pronounced in contexts of high inflation and high unemployment.",0,1 +1586,Treatment strategies for coronary in-stent restenosis: systematic review and hierarchical Bayesian network meta-analysis of 24 randomised trials and 4880 patients,"What is the most safe and effective interventional treatment for coronary in-stent restenosis?In a hierarchical Bayesian network meta-analysis, PubMed, Embase, Scopus, Cochrane Library, Web of Science, ScienceDirect, and major scientific websites were screened up to 10 August 2015. Randomised controlled trials of patients with any type of coronary in-stent restenosis (either of bare metal stents or drug eluting stents; and either first or recurrent instances) were included. Trials including multiple treatments at the same time in the same group or comparing variants of the same intervention were excluded. Primary endpoints were target lesion revascularisation and late lumen loss, both at six to 12 months. The main analysis was complemented by network subanalyses, standard pairwise comparisons, and subgroup and sensitivity analyses.Twenty four trials (4880 patients), including seven interventional treatments, were identified. Compared with plain balloons, bare metal stents, brachytherapy, rotational atherectomy, and cutting balloons, drug coated balloons and drug eluting stents were associated with a reduced risk of target lesion revascularisation and major adverse cardiac events, and with reduced late lumen loss. Treatment ranking indicated that drug eluting stents had the highest probability (61.4%) of being the most effective for target lesion vascularisation; drug coated balloons were similarly indicated as the most effective treatment for late lumen loss (probability 70.3%). The comparative efficacy of drug coated balloons and drug eluting stents was similar for target lesion revascularisation (summary odds ratio 1.10, 95% credible interval 0.59 to 2.01) and late lumen loss reduction (mean difference in minimum lumen diameter 0.04 mm, 95% credible interval -0.20 to 0.10). Risks of death, myocardial infarction, and stent thrombosis were comparable across all treatments, but these analyses were limited by a low number of events. Trials had heterogeneity regarding investigation periods, baseline characteristics, and endpoint reporting, with a lack of information at long term follow-up. Direct and indirect evidence was also inconsistent for the comparison between drug eluting stents and drug coated balloons.Compared with other currently available interventional treatments for coronary in-stent restenosis, drug coated balloons and drug eluting stents are associated with superior clinical and angiographic outcomes, with a similar comparative efficacy.This study received no external funding. The authors declare no competing interests. No additional data available.",0,1 +1587,Weighting and adjusting for design effects in secondary data analyses,Institutional researchers frequently use national datasets such as those provided by the National Center for Education Statistics (NCES). The authors of this chapter explore the adjustments required when analyzing NCES data collected using complex sample designs.,0,1 +1588,TripleR: An R package for social relations analyses based on round-robin designs,"In this article, we present TripleR, an R package for the calculation of social relations analyses (Kenny, 1994) based on round-robin designs. The scope of existing software solutions is ported to R and enhanced with previously unimplemented methods of significance testing in single groups (Lashley & Bond, 1997) and handling of missing values. The package requires only minimal knowledge of R, and results can be exported for subsequent analyses to other software packages. We demonstrate the use of TripleR with several didactic examples.",0,1 +1589,A Tale of Two Methods,"The structural equation modeling approach to testing for mediation is compared to the Baron and Kenny approach. The approaches are essentially the same when the hypothesis being tested predicts partial mediation. The approaches differ, however, in how each tests for complete mediation. Disparities in both theory and statistical estimators are identified and discussed. A strategy for future tests of mediation is recommended.",0,1 +1590,The Shape of Correlation Matrices,"Abstract A correlation matrix between three variables has to satisfy certain conditions. Such a matrix essentially contains three numbers and thus can be represented by a point in three dimensions. The set of all possible correlation matrices yields a convex solid body with an uncommon shape. All its cross sections perpendicular to the axes are ellipses. At the same time, its surface contains the vertices and edges of a regular tetrahedron. Another unusual shape is obtained for banded correlation matrices between four variables.",0,1 +1591,Ueber die Maassbestimmungen des Ortssinnes der Haut mittels der Methode der richtigen und falschen Fälle,,0,1 +1592,Trust and Rationality,"Combining economic, social-psychological and sociological approaches to trust, this book provides a general theoretical framework to causally explain conditional and unconditional trust; it also presents an experimental test of the corresponding integrative model and its predictions. Broadly, it aims at advancing a cognitive turn in trust research by highlighting the importance of (1) an actor’s context-dependent definition of the situation and (2) the flexible and dynamic degree of rationality involved. In essence, trust is as ""multi-faceted"" as there are cognitive routes that take us to the choice of a trusting act. Therefore, variable rationality has to be incorporated as an orthogonal dimension to the typological space of trust. The theory presents an analytically tractable model; the empirical test combines trust games, high- and low-incentive conditions, framing manipulations, and psychometric measurements, and is complemented by decision-time analyses. © Springer Fachmedien Wiesbaden 2015.",0,1 +1593,Implementing Matching Estimators for Average Treatment Effects in Stata,This paper presents an implementation of matching estimators for average treatment effects in Stata. The nnmatch command allows you to estimate the average effect for all units or only for the treated or control units; to choose the number of matches; to specify the distance metric; to select a bias adjustment; and to use heteroskedastic-robust variance estimators.,0,1 +1594,Isotonic ordinal probabilistic models (ISOP),"The concept of an ordinal instrumental probabilistic comparison is introduced. It relies on an ordinal scale given a priori and on the concept of stochastic dominance. It is used to define a weakly independently ordered system, or isotonic ordinal probabilistic (ISOP) model, which allows the construction of separate ""sample-free"" ordinal scales on a set of ""subjects"" and a set of ""items"". The ISOP-model is a common nonparametric theoretical structure for unidimensional models for quantitative, ordinal and dichotomous variables. Fundamental theorems on dichotomous and polytomous weakly independently ordered systems are derived. It is shown that the raw score system has the same formal properties as the latent system, and therefore the latter can be tested at the observed empirical level. © 1995 The Psychometric Society.",0,1 +1595,Fitting Segmented Polynomial Regression Models Whose Join Points Have to Be Estimated,Abstract The study considers the problem of finding the least squares estimates for the unknown parameters of a regression model which consists of grafted polynomial submodels. The abscissae of the join points are a subset of the unknown parameters. Examples are given to illustrate how continuity and differentiability conditions on the model can be used to reparameterize the model so as to allow Modified Gauss-Newton fitting. A slightly generalized version of Hartley's theorem is stated to extend the Modified Gauss-Newton method to this problem.,0,1 +1596,Spinal upregulation of glutamate transporter GLT-1 by ceftriaxone: therapeutic efficacy in a range of experimental nervous system disorders,"Glutamate neurotransmission is highly regulated, largely by glutamate transporters. In the spinal cord, the glutamate transporter GLT-1 is primarily responsible for glutamate clearance. Downregulation of GLT-1 can occur in activated astrocytes, and is associated with increased extracellular glutamate and neuroexcitation. Among other conditions, astrocyte activation occurs following repeated opioids and in models of chronic pain. If GLT-1 downregulation occurs in these states, GLT-1 could be a pharmacological target for improving opioid efficacy and controlling chronic pain. The present studies explored whether daily intrathecal treatment of rats with ceftriaxone, a beta-lactam antibiotic that upregulates GLT-1 expression, could prevent development of hyperalgesia and allodynia following repeated morphine, reverse pain arising from central or peripheral neuropathy, and reduce glial activation in these models. Ceftriaxone pre-treatment attenuated the development of hyperalgesia and allodynia in response to repeated morphine, and prevented associated astrocyte activation. In a model of multiple sclerosis (experimental autoimmune encephalomyelitis; EAE), ceftriaxone reversed tactile allodynia and halted the progression of motor weakness and paralysis. Similarly, ceftriaxone reversed tactile allodynia induced by chronic constriction nerve injury (CCI). EAE and CCI each significantly reduced the expression of membrane-bound, dimerized GLT-1 protein in lumbar spinal cord, an effect normalized by ceftriaxone. Lastly, ceftriaxone normalized CCI- and EAE-induced astrocyte activation in lumbar spinal cord. Together, these data indicate that increasing spinal GLT-1 expression attenuates opioid-induced paradoxical pain, alleviates neuropathic pain, and suppresses associated glial activation. GLT-1 therefore may be a therapeutic target that could improve available treatment options for patients with chronic pain.",0,1 +1597,Bayesian computerized adaptive testing,"Computerized adaptive testing (CAT) comes with many advantages. Unfortunately, it still is quite expensive to develop and maintain an operational CAT. In this paper, various steps involved in developing an operational CAT are described and literature on these topics is reviewed. Bayesian CAT is introduced as an alternative, and the use of empirical priors is proposed for estimating item and person parameters to reduce the costs of CAT. Methods to elicit empirical priors are presented and a two small examples are presented that illustrate the advantages of Bayesian CAT. Implications of the use of empirical priors are discussed, limitations are mentioned and some suggestions for further research are formulated.",0,1 +1598,Bayesian methods of analysis for cluster randomized trials with binary outcome data,"We explore the potential of Bayesian hierarchical modelling for the analysis of cluster randomized trials with binary outcome data, and apply the methods to a trial randomized by general practice. An approximate relationship is derived between the intracluster correlation coefficient (ICC) and the between-cluster variance used in a hierarchical logistic regression model. By constructing an informative prior for the ICC on the basis of available information, we are thus able implicitly to specify an informative prior for the between-cluster variance. The approach also provides us with a credible interval for the ICC for binary outcome data. Several approaches to constructing informative priors from empirical ICC values are described. We investigate the sensitivity of results to the prior specified and find that the estimate of intervention effect changes very little in this data set, while its interval estimate is more sensitive. The Bayesian approach allows us to assume distributions other than normality for the random effects used to model the clustering. This enables us to gain insight into the robustness of our parameter estimates to the classical normality assumption. In a model with a more complex variance structure, Bayesian methods can provide credible intervals for a difference between two variance components, in order for example to investigate whether the effect of intervention varies across clusters. We compare our results with those obtained from classical estimation, discuss the relative merits of the Bayesian framework, and conclude that the flexibility of the Bayesian approach offers some substantial advantages, although selection of prior distributions is not straightforward.",0,1 +1599,Application of Multidimensional Selective Item Response Regression Model for Studying Multiple Gene Methylation in SV40 Oncogenic Pathways,"Alteration of gene methylation patterns has been reported to be involved in the early onsets of many human malignancies. Many exogenous risk factors, such as cigarette smoke, dietary additives, chemical exposures, radiation, and biologic agents including viral infection, are involved in the methylation pathways of cancers. We propose a multidimensional selective item response regression model to describe and test how a risk factor may alter molecular pathways involving aberrant methylation of multiple genes in oncogenesis. Our modeling framework is built on an item response model for multivariate dichotomous responses of high dimension, such as aberrant methylation of multiple tumor-suppressor genes, but we allow risk factors such as SV40 viral infection to alter the distribution of the latent factors that subsequently affect the outcome of cancer. We postulate empirical identification conditions under our model formulation. Moreover, we do not prespecify the links between the multiple dichotomous methylation responses and the latent factors, but rather conduct specification searches with a genetic algorithm to discover the links. Parameter estimation through maximum likelihood and specification searches in models with multidimensional latent factors for multivariate binary responses have become practical only recently, due to modern statistical computing development. We illustrate our proposal with the biological finding that simultaneous methylation of multiple tumor-suppressor genes is associated with the presence of SV40 viral sequences and with the cancer status of lymphoma/leukemia.We are able to test whether the data are consistent with the causal hypothesis that SV40 induces aberrant methylation of multiple genes in its oncogenic pathways. At the same time, we are able to evaluate the role of SV40 in the methylation pathway and to determine whether the methylation pathway is responsible for the development of leukemia/lymphoma.",0,1 +1600,The team-level model of climate for innovation: A two-level confirmatory factor analysis,"The level structure of West's (1990) four-factor model of team climate for innovation was assessed by means of multi-level confirmatory factor analysis (MCFA). The sample consisted of 1,487 individuals (195 teams) from a wide range of professions. Results showed that a considerable portion of the variance in the data was explained on the team level with intra-class correlations ranging from .30 to .39. Furthermore, the results demonstrated that the overall measurement model fitted the data well at both the team and individual levels, while the factor loadings were slightly different across the levels with item loadings showing partial invariance. Results from confirmatory factor analyses conducted on separate levels, however, showed that the four-factor model displayed the best fit to the data for both individual and team levels. A second-order one-factor model also fitted the data well on both levels. The results indicate that the team climate for innovation model can be used as a team-level consensus model of team climate for innovation.",0,1 +1601,"New aQTL SNPs for the CYP2D6 Identified by a Novel Mediation Analysis of Genome-Wide SNP Arrays, Gene Expression Arrays, and CYP2D6 Activity","Background . The genome-wide association studies (GWAS) have been successful during the last few years. A key challenge is that the interpretation of the results is not straightforward, especially for transacting SNPs. Integration of transcriptome data into GWAS may provide clues elucidating the mechanisms by which a genetic variant leads to a disease. Methods . Here, we developed a novel mediation analysis approach to identify new expression quantitative trait loci (eQTL) driving CYP2D6 activity by combining genotype, gene expression, and enzyme activity data. Results . 389,573 and 1,214,416 SNP-transcript-CYP2D6 activity trios are found strongly associated (P<10-5,FDR=16.6% and 11.7%) for two different genotype platforms, namely, Affymetrix and Illumina, respectively. The majority of eQTLs are trans-SNPs. A single polymorphism leads to widespread downstream changes in the expression of distant genes by affecting major regulators or transcription factors (TFs), which would be visible as an eQTL hotspot and can lead to large and consistent biological effects. Overlapped eQTL hotspots with the mediators lead to the discovery of 64 TFs. Conclusions . Our mediation analysis is a powerful approach in identifying the trans-QTL-phenotype associations. It improves our understanding of the functional genetic variations for the liver metabolism mechanisms.",0,1 +1602,Relative Performance of Categorical Diagonally Weighted Least Squares and Robust Maximum Likelihood Estimation,"Robust maximum likelihood (ML) and categorical diagonally weighted least squares (cat-DWLS) estimation have both been proposed for use with categorized and nonnormally distributed data. This study compares results from the 2 methods in terms of parameter estimate and standard error bias, power, and Type I error control, with unadjusted ML and WLS estimation methods included for purposes of comparison. Conditions manipulated include model misspecification, level of asymmetry, level and categorization, sample size, and type and size of the model. Results indicate that cat-DWLS estimation method results in the least parameter estimate and standard error bias under the majority of conditions studied. Cat-DWLS parameter estimates and standard errors were generally the least affected by model misspecification of the estimation methods studied. Robust ML also performed well, yielding relatively unbiased parameter estimates and standard errors. However, both cat-DWLS and robust ML resulted in low power under cond...",0,1 +1603,A Note on the Efficiency of Sandwich Covariance Matrix Estimation,"The sandwich estimator, also known as robust covariance matrix estimator, heteroscedasticity-consistent covariance matrix estimate, or empirical covariance matrix estimator, has achieved increasing use in the econometric literature as well as with the growing popularity of generalized estimating equations. Its virtue is that it provides consistent estimates of the covariance matrix for parameter estimates even when the fitted parametric model fails to hold or is not even specified. Surprisingly though, there has been little discussion of properties of the sandwich method other than consistency. We investigate the sandwich estimator in quasi-likelihood models asymptotically, and in the linear case analytically. We show that under certain circumstances when the quasi-likelihood model is correct, the sandwich estimate is often far more variable than the usual parametric variance estimate. The increased variance is a fixed feature of the method and the price that one pays to obtain consistency even when the p...",0,1 +1604,The capacity of social policies to combat poverty among new social risk groups,"This article considers groups who are most likely to be vulnerable to new social risks and tests the effects of social policies on their poverty levels. Specifically, the article conducts multi-level regression analyses across 18 OECD countries around the year 2004, analysing the effects of social policies on the likelihood of being poor for low-skilled young women and men, and for those at risk of possessing obsolete skills, namely low-educated men aged 55–64 years. The central question asks which policies – active labour market policies (ALMP), passive labour market policies (PLMP), employment protection legislation (EPL), family policies, and government daycare spending – are effective at combating new social risks. In addition to analysing social policies, the article also considers union density and representation of women in national parliaments as two measures that depict agents who are most intent on combating old and new social risks, respectively. The findings show that ALMP are the most important predictor of a decrease in poverty levels among the low skilled. The negative effect of PLMP on poverty is only significant for the older male group. Family policies are related to a reduction in poverty for both low-skilled young women and men. Gross public social spending as a measure of overall welfare generosity is found to be associated with a reduction in poverty only of the older male group, but not that of the younger groups. The article’s analyses suggest that some social policies remain geared towards older segments of society, leaving the younger population at greater financial and therefore social risk.",0,1 +1605,Investigating the effect of intolerance of uncertainty on catastrophic worrying and mood,"Intolerance of uncertainty (IU) is a construct known to influence catastrophic worry and is often observed in Generalized Anxiety Disorder (GAD). Research into the psychological manifestations of GAD suggests IU is associated with worry, but has not confirmed a causal link. The current study investigated the relationship between catastrophic worry and IU in a non-clinical undergraduate and postgraduate population (n = 46), with a mean age of 26.8 (SD = 5.52 years), where 71.74% were women. Participants received either a high or low IU manipulation, mood was measured throughout the study on 100 point visual analogue scales (VAS), and worry was measured using the catastrophising interview (CI). The high IU group generated significantly more catastrophising steps than the low IU group. Increased levels of sadness and anxiety were observed in the high as compared to the low IU group post IU manipulation, and this difference was maintained throughout the CI interview. A mediation analysis revealed that sadness and anxiety did not significantly mediate the relationship between IU and number of CI steps. These findings have implications for GAD treatment, as they suggest that manipulating IU affects measures of worry and its associated emotional and behavioural symptoms.",0,1 +1606,"Search for GeVγ-Ray Pair Halos Around Low Redshift Blazars","We report on the results of a search for $\gamma$-ray pair halos with a stacking analysis of low-redshift blazars using data from the Fermi Large Area Telescope. For this analysis we used a number of a-priori selection criteria, including the spatial and spectral properties of the Fermi sources. The angular distribution of $\sim$ 1GeV photons around 24 stacked isolated high-synchrotron-peaked BL Lacs with redshift $z<0.5$ shows an excess over that of point-like sources. A statistical analysis yields a Bayes factor of $\mathrm{log}_{10}B_{10}>2$, providing evidence in favor of extended emission against the point-source hypothesis, consistent with expectations for pair halos produced in the IGMF with strength $B_{\mathrm{IGMF}}\sim 10^{-17}-10^{-15}\mathrm{G}$.",0,1 +1607,The magical number 4 in short-term memory: A reconsideration of mental storage capacity,"Miller (1956) summarized evidence that people can remember about seven chunks in short-term memory (STM) tasks. However, that number was meant more as a rough estimate and a rhetorical device than as a real capacity limit. Others have since suggested that there is a more precise capacity limit, but that it is only three to five chunks. The present target article brings together a wide variety of data on capacity limits suggesting that the smaller capacity limit is real. Capacity limits will be useful in analyses of information processing only if the boundary conditions for observing them can be carefully described. Four basic conditions in which chunks can be identified and capacity limits can accordingly be observed are: (1) when information overload limits chunks to individual stimulus items, (2) when other steps are taken specifically to block the recording of stimulus items into larger chunks, (3) in performance discontinuities caused by the capacity limit, and (4) in various indirect effects of the capacity limit. Under these conditions, rehearsal and long-term memory cannot be used to combine stimulus items into chunks of an unknown size; nor can storage mechanisms that are not capacity-limited, such as sensory memory, allow the capacity-limited storage mechanism to be refilled during recall. A single, central capacity limit averaging about four chunks is implicated along with other, noncapacity-limited sources. The pure STM capacity limit expressed in chunks is distinguished from compound STM limits obtained when the number of separately held chunks is unclear. Reasons why pure capacity estimates fall within a narrow range are discussed and a capacity limit for the focus of attention is proposed.",0,1 +1608,Structural Equation Modeling,,0,1 +1609,A Reproducing Kernel-Based Spatial Model in Poisson Regressions,"A semi-parametric spatial model for spatial dependence is proposed in Poisson regressions to study the effects of risk factors on incidence outcomes. The spatial model is constructed through an application of reproducing kernels. A Bayesian framework is proposed to infer the unknown parameters. Simulations are performed to compare the reproducing kernel-based method with several commonly used approaches in spatial modeling, including independent Gaussian and CAR models. Compared with these models, the reproducing kernel-based method is easy to implement and more flexible in terms of the ability to model various spatial dependence patterns. To further demonstrate the proposed method, two real data applications are discussed: Scottish lip cancer data and Florida smoke-related cancer data.",0,1 +1610,Laplace's approximation for nonlinear mixed models,"SUMMARY An approximation to Laplace's method for integrals is applied to marginal distributions of data arising from models in which both fixed and random effects enter nonlinearly. The approach provides alternative derivations of some recent algorithms for fitting such models, and it has direct ties with Gaussian restricted maximum likelihood and the accompanying mixed model equations.",0,1 +1611,Methods for Restricting Maximum Exposure Rate in Computerized Adaptative Testing,"Abstract. The Sympson-Hetter (1985) method provides a means of controlling maximum exposure rate of items in Computerized Adaptive Testing. Through a series of simulations, control parameters are set that mark the probability of administration of an item on being selected. This method presents two main problems: it requires a long computation time for calculating the parameters and the maximum exposure rate is slightly above the fixed limit. Van der Linden (2003) presented two alternatives which appear to solve both of the problems. The impact of these methods in the measurement accuracy has not been tested yet. We show how these methods over-restrict the exposure of some highly discriminating items and, thus, the accuracy is decreased. It also shown that, when the desired maximum exposure rate is near the minimum possible value, these methods offer an empirical maximum exposure rate clearly above the goal. A new method, based on the initial estimation of the probability of administration and the probability of selection of the items with the restricted method ( Revuelta & Ponsoda, 1998 ), is presented in this paper. It can be used with the Sympson-Hetter method and with the two van der Linden's methods. This option, when used with Sympson-Hetter, speeds the convergence of the control parameters without decreasing the accuracy.",0,1 +1612,On the Effect of the Number of Quadrature Points in a Logistic Random Effects Model: An Example,"SUMMARY Although generalized linear mixed models are recognized to be of major practical importance, it is also known that they can be computationally demanding. The problem is the evaluation of the integral in calculating the marginalized likelihood. The straightforward method is based on the Gauss–Hermite technique, based on Gaussian quadrature points. Another approach is provided by the class of penalized quasi-likelihood methods. It is commonly believed that the Gauss–Hermite method works relatively well in simple situations but fails in more complicated structures. However, we present here a strikingly simple example of a logistic random-intercepts model in the context of a longitudinal clinical trial where the method gives valid results only for a high number of quadrature points (Q). As a consequence, this result warns the practitioner to examine routinely the dependence of the results on Q. The adaptive Gaussian quadrature, as implemented in the new SAS procedure NLMIXED, offered the solution to our problem. However, even the adaptive version of Gaussian quadrature needs careful handling to ensure convergence.",0,1 +1613,Network Meta-Analysis: Development of a Three-Level Hierarchical Modeling Approach Incorporating Dose-Related Constraints,"Network meta-analysis (NMA) is commonly used in evidence synthesis; however, in situations in which there are a large number of treatment options, which may be subdivided into classes, and relatively few trials, NMAs produce considerable uncertainty in the estimated treatment effects, and consequently, identification of the most beneficial intervention remains inconclusive.To develop and demonstrate the use of evidence synthesis methods to evaluate extensive treatment networks with a limited number of trials, making use of classes.Using Bayesian Markov chain Monte Carlo methods, we build on the existing work of a random effects NMA to develop a three-level hierarchical NMA model that accounts for the exchangeability between treatments within the same class as well as for the residual between-study heterogeneity. We demonstrate the application of these methods to a continuous and binary outcome, using a motivating example of overactive bladder. We illustrate methods for incorporating ordering constraints in increasing doses, model selection, and assessing inconsistency between the direct and indirect evidence.The methods were applied to a data set obtained from a systematic literature review of trials for overactive bladder, evaluating the mean reduction in incontinence episodes from baseline and the number of patients reporting one or more adverse events. The data set involved 72 trials comparing 34 interventions that were categorized into nine classes of interventions, including placebo.Bayesian three-level hierarchical NMAs have the potential to increase the precision in the effect estimates while maintaining the interpretability of the individual interventions for decision making.",0,1 +1614,Dealing with label switching in mixture models,"Summary. In a Bayesian analysis of finite mixture models, parameter estimation and clustering are sometimes less straightforward than might be expected. In particular, the common practice of estimating parameters by their posterior mean, and summarizing joint posterior distributions by marginal distributions, often leads to nonsensical answers. This is due to the so-called 'label switching' problem, which is caused by symmetry in the likelihood of the model parameters. A frequent response to this problem is to remove the symmetry by using artificial identifiability constraints. We demonstrate that this fails in general to solve the problem, and we describe an alternative class of approaches, relabelling algorithms, which arise from attempting to minimize the posterior expected loss under a class of loss functions. We describe in detail one particularly simple and general relabelling algorithm and illustrate its success in dealing with the label switching problem on two examples.",0,1 +1615,Some Comments on Multicollinearity in Regression,"In contrast to the views put forward in a recent paper, the following points are made concerning multicollinearity in regression models: firstly, multicollinearity is almost invariably a problem of degree rather than kind; and, secondly, the search for an appropriate functional form for a regression equation should not be confused with the treatment of multicollinearity. Finally, some comments are made on the role of prior detrending in both linear and nonlinear models.",0,1 +1616,Constructing priors based on model size for nondecomposable Gaussian graphical models: A simulation based approach,"A method for constructing priors is proposed that allows the off-diagonal elements of the concentration matrix of Gaussian data to be zero. The priors have the property that the marginal prior distribution of the number of nonzero off-diagonal elements of the concentration matrix (referred to below as model size) can be specified flexibly. The priors have normalizing constants for each model size, rather than for each model, giving a tractable number of normalizing constants that need to be estimated. The article shows how to estimate the normalizing constants using Markov chain Monte Carlo simulation and supersedes the method of Wong et al. (2003) [24] because it is more accurate and more general. The method is applied to two examples. The first is a mixture of constrained Wisharts. The second is from Wong et al. (2003) [24] and decomposes the concentration matrix into a function of partial correlations and conditional variances using a mixture distribution on the matrix of partial correlations. The approach detects structural zeros in the concentration matrix and estimates the covariance matrix parsimoniously if the concentration matrix is sparse.",0,1 +1617,The effect of estimation method and sample size in multilevel structural equation modeling,"Multilevel structural equation modeling (multilevel SEM) has become an established method to analyze multilevel multivariate data. The first useful estimation method was the pseudobalanced method. This method is approximate because it assumes that all groups have the same size, and ignores unbalance when it exists. In addition, full information maximum likelihood (ML) estimation is now available, which is often combined with robust chi-squares and standard errors to accommodate unmodeled heterogeneity (MLR). In addition, diagonally weighted least squares (DWLS) methods have become available as estimation methods. This article compares the pseudobalanced estimation method, ML(R), and two DWLS methods by simulating a multilevel factor model with unbalanced data. The simulations included different sample sizes at the individual and group levels and different intraclass correlation (ICC). The within-group part of the model posed no problems. In the between part of the model, the different ICC sizes had no effect. There is a clear interaction effect between number of groups and estimation method. ML reaches unbiasedness fastest, then the two DWLS methods, then MLR, and then the pseudobalanced method (which needs more than 200 groups). We conclude that both ML(R) and DWLS are genuine improvements on the pseudobalanced approximation. With small sample sizes, the robust methods are not recommended.",0,1 +1618,A Hierarchical Bayesian Model of Human Decision-Making on an Optimal Stopping Problem,"We consider human performance on an optimal stopping problem where people are presented with a list of numbers independently chosen from a uniform distribution. People are told how many numbers are in the list, and how they were chosen. People are then shown the numbers one at a time, and are instructed to choose the maximum, subject to the constraint that they must choose a number at the time it is presented, and any choice below the maximum is incorrect. We present empirical evidence that suggests people use threshold-based models to make decisions, choosing the first currently maximal number that exceeds a fixed threshold for that position in the list. We then develop a hierarchical generative account of this model family, and use Bayesian methods to learn about the parameters of the generative process, making inferences about the threshold decision models people use. We discuss the interesting aspects of human performance on the task, including the lack of learning, and the presence of large individual differences, and consider the possibility of extending the modeling framework to account for individual differences. We also use the modeling results to discuss the merits of hierarchical, generative and Bayesian models of cognitive processes more generally.",0,1 +1619,Individual socialization or polito-cultural context? The cultural roots of volunteering in Switzerland,"Volunteering rates in Switzerland vary substantially across language regions. In this article, we investigate the cultural roots of this variation by presenting and empirically testing two different conceptualizations of how linguistic culture is related to individual volunteering. Whereas the first perspective perceives the individual as belonging to a particular language community and its norms and values as crucial for individual volunteering, the other sees the linguistic culture mainly as an important context in which an individual lives and which therefore influences individual volunteering. Empirically, we base our analysis on new survey data from 60 Swiss communes and apply a Bayesian multi-level analysis in order to disentangle the linguistic group from contextual effects. Our analysis supports the view that cultural patterns of civic self-organization can indeed explain regional volunteering behaviour in Switzerland. Whereas the propensity to volunteer is generally highest in German-speaking Switzerland, our findings reveal that it is the group of French speakers that exhibits the highest propensity to volunteer when controlling for language region. © 2015 Macmillan Publishers Limited.",0,1 +1620,Multiple imputation of discrete and continuous data by fully conditional specification,"The goal of multiple imputation is to provide valid inferences for statistical estimates from incomplete data. To achieve that goal, imputed values should preserve the structure in the data, as well as the uncertainty about this structure, and include any knowledge about the process that generated the missing data. Two approaches for imputing multivariate data exist: joint modeling (JM) and fully conditional specification (FCS). JM is based on parametric statistical theory, and leads to imputation procedures whose statistical properties are known. JM is theoretically sound, but the joint model may lack flexibility needed to represent typical data features, potentially leading to bias. FCS is a semi-parametric and flexible alternative that specifies the multivariate model by a series of conditional models, one for each incomplete variable. FCS provides tremendous flexibility and is easy to apply, but its statistical properties are difficult to establish. Simulation work shows that FCS behaves very well in the cases studied. The present paper reviews and compares the approaches. JM and FCS were applied to pubertal development data of 3801 Dutch girls that had missing data on menarche (two categories), breast development (five categories) and pubic hair development (six stages). Imputations for these data were created under two models: a multivariate normal model with rounding and a conditionally specified discrete model. The JM approach introduced biases in the reference curves, whereas FCS did not. The paper concludes that FCS is a useful and easily applied flexible alternative to JM when no convenient and realistic joint distribution can be specified.",0,1 +1621,Short-term recognition memory for serial order and timing,"Recent evidence suggests that a common temporal representation underlies memory for serial order of items in a sequence, and the timing of items in a sequence. This stands in contrast to other data suggesting a reliance on only ordinal information in short-term memory tasks. An experiment is reported here in which participants were post cued to perform a comparison between a probe and study list of items irregularly spaced in time, on the basis of order or temporal information.Participants' performance on theserial recognition task was notaffected by the temporal proximity of items, although participants were able to use temporal information to perform a temporal recognition task. Application of a temporal matching model of serial and temporal recognition suggests that although participants were able to remember the timing of items, this memory for timing was unlikely to determine serial recognition performance. The results suggest a dissociation between ordinal and temporal information in short-term memory.",0,1 +1622,Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models,"Hypotheses involving mediation are common in the behavioral sciences. Mediation exists when a predictor affects a dependent variable indirectly through at least one intervening variable, or mediator. Methods to assess mediation involving multiple simultaneous mediators have received little attention in the methodological literature despite a clear need. We provide an overview of simple and multiple mediation and explore three approaches that can be used to investigate indirect processes, as well as methods for contrasting two or more mediators within a single model. We present an illustrative example, assessing and contrasting potential mediators of the relationship between the helpfulness of socialization agents and job satisfaction. We also provide SAS and SPSS macros, as well as Mplus and LISREL syntax, to facilitate the use of these methods in applications.",0,1 +1623,A Bayesian hierarchical model for categorical longitudinal data from a social survey of immigrants,"The paper investigates a Bayesian hierarchical model for the analysis of categorical longitudinal data from a large social survey of immigrants to Australia. Data for each subject are observed on three separate occasions, or waves, of the survey. One of the features of the data set is that observations for some variables are missing for at least one wave. A model for the employment status of immigrants is developed by introducing, at the first stage of a hierarchical model, a multinomial model for the response and then subsequent terms are introduced to explain wave and subject effects. To estimate the model, we use the Gibbs sampler, which allows missing data for both the response and the explanatory variables to be imputed at each iteration of the algorithm, given some appropriate prior distributions. After accounting for significant covariate effects in the model, results show that the relative probability of remaining unemployed diminished with time following arrival in Australia.",0,1 +1624,A comparison of the hierarchical likelihood and Bayesian approaches to spatial epidemiological modelling,"Recently Bayesian methods have been widely used in disease mapping. Hierarchical (h-) likelihood methods allow reliable likelihood inference in random-effect models and it is therefore interesting to compare h-likelihood and Bayesian methods. For comparison we consider three examples: low birth weight and cancer mortality data in South Carolina and lip cancer data in Scotland. Mean estimates from both h-likelihood and Bayesian approaches are almost identical, while variance-component estimates can be somewhat different, depending upon choice of priors. Copyright © 2007 John Wiley & Sons, Ltd.",0,1 +1625,A multiple group item response theory model with centered skew-normal latent trait distributions under a Bayesian framework,"Very often, in psychometric research, as in educational assessment, it is necessary to analyze item response from clustered respondents. The multiple group item response theory (IRT) model proposed by Bock and Zimowski [12] provides a useful framework for analyzing such type of data. In this model, the selected groups of respondents are of specific interest such that group-specific population distributions need to be defined. The usual assumption for parameter estimation in this model, which is that the latent traits are random variables following different symmetric normal distributions, has been questioned in many works found in the IRT literature. Furthermore, when this assumption does not hold, misleading inference can result. In this paper, we consider that the latent traits for each group follow different skew-normal distributions, under the centered parameterization. We named it skew multiple group IRT model. This modeling extends the works of Azevedo et al. [4], Bazan et al. [11] and Bock and Zimo...",0,1 +1626,Safety and effectiveness of long-acting versus intermediate-acting insulin for patients with type 1 diabetes: protocol for a systematic review and individual patient data network meta-analysis,"The choice of a basal insulin regimen to manage type 1 diabetes mellitus (T1DM) may have different risks of adverse events and effectiveness, due to the difference in the effectiveness of these agents across patient characteristics (eg, baseline glycosylated haemoglobin; A1C). Currently, there is a lack of high quality evidence to support the tailoring of insulin regimens according to an individual's needs. The aim of this study is to update our previous systematic review and perform an individual patient data network meta-analysis (IPD-NMA) to evaluate the comparative safety and effectiveness of long-acting versus intermediate-acting insulin in different subgroups of patients with T1DM.We will update our previous literature search from January 2013 onwards searching relevant electronic databases (eg, MEDLINE), as well as perform grey literature search through relevant society/association websites, and conference abstracts, and scan reference lists of the eligible studies. We will include randomised clinical trials of any duration examining long-acting versus intermediate-acting insulin preparations for adult patients with T1DM. We will focus on A1C and severe hypoglycaemia outcomes. For each pairwise treatment comparison, we will combine all IPD from all studies in a single multilevel model, where each study is a different cluster. For a connected network of trials, we will perform an IPD-NMA to identify potential effect modifiers, and estimate the most effective and safe treatments for patients with different characteristics. If we are not successful in obtaining IPD for at least one study, we will include aggregated data (AD) abstracted from the included RCTs in our analysis, combining IPD and AD into a single model. We will report our results using the PRISMA-IPD statement.The results of this systematic review and IPD-NMA will be of interest to stakeholders and will help in improving existing guideline recommendations.CRD42015023511.",0,1 +1627,A new approach to causal inference in mortality studies with a sustained exposure period—application to control of the healthy worker survivor effect,"In observational cohort mortality studies with prolonged periods of exposure to the agent under study, it is not uncommon for risk factors for death to be determinants of subsequent exposure. For instance, in occupational mortality studies date of termination of employment is both a determinant of future exposure (since terminated individuals receive no further exposure) and an independent risk factor for death (since disabled individuals tend to leave employment). When current risk factor status determines subsequent exposure and is determined by previous exposure, standard analyses that estimate age-specific mortality rates as a function of cumulative exposure may underestimate the true effect of exposure on mortality whether or not one adjusts for the risk factor in the analysis. This observation raises the question, which if any population parameters can be given a causal interpretation in observational mortality studies? In answer, we offer a graphical approach to the identification and computation of causal parameters in mortality studies with sustained exposure periods. This approach is shown to be equivalent to an approach in which the observational study is identified with a hypothetical double-blind randomized trial in which data on each subject's assigned treatment protocol has been erased from the data file. Causal inferences can then be made by comparing mortality as a function of treatment protocol, since, in a double-blind randomized trial missing data on treatment protocol, the association of mortality with treatment protocol can still be estimated. We reanalyze the mortality experience of a cohort of arsenic-exposed copper smelter workers with our method and compare our results with those obtained using standard methods. We find an adverse effect of arsenic exposure on all-cause and lung cancer mortality which standard methods fail to detect.",0,1 +1628,Automatic and effortful processes in memory.,"Proposes a framework for the conceptualization of a broad range of memory phenomena that integrates research on memory performance in young children, the elderly, and individuals under stress with research on memory performance in normal college students. One basic assumption is that encoding operations vary in their attentional requirements. Operations that drain minimal energy from limited-capacity attentional mechanisms are called automatic. Automatic operations function at a constant level under all circumstances, occur without intention, and do not benefit from practice. Effortful operations, such as rehearsal and elaborative mnemonic activities, require considerable capacity, interfere with other cognitive activities also requiring capacity, are initiated intentionally, and show benefits from practice. A 2nd assumption is that attentional capacity varies both within and among individuals. Depression, high arousal levels, and old age are variables thought to reduce attentional capacity. The conjunction of the 2 assumptions of the framework yields the prediction that the aged and individuals under stress will show a decrease in performance only on tasks requiring effortful processing. Evidence from the literature on development, aging, depression, arousal, and normal memory is presented in support of the framework, and 4 experiments with 301 5-40 yr old Ss are described. (51/2 p ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1979 American Psychological Association.",0,1 +1629,A Hierarchical Multivariate Two-Part Model for Profiling Providers' Effects on Health Care Charges,"Procedures for analyzing and comparing health care providers' effects on health services delivery and outcomes have been referred to as provider profiling. In a typical profiling procedure, patient-level responses are measured for clusters of patients treated by providers that in turn can be considered statistically exchangeable. Thus a hierarchical model naturally represents the structure of the data. When provider effects on multiple responses are profiled, a multivariate model rather than a series of univariate models can capture associations among responses at both the provider and patient levels. When responses are in the form of charges for health care services and sampled patients include nonusers of services, charge variables are a mix of 0's and highly skewed positive values that present a modeling challenge. For analysis of covariate effects on charges for a single service, a frequently used approach is a two-part model that combines logistic or probit regression on any use of the service and li...",0,1 +1630,Modeling Multilevel Data Structures,"data are becoming quite common in political science and provide numerous opportunities for theory testing and development. Unfortunately this type of data typically generates a number of statistical problems, of which clustering is particularly impor? tant. To exploit the opportunities of? fered by multilevel data, and to solve the statistical problems inherent in them, special statistical techniques are required. In this article, we focus on a technique that has become popular in educational statistics and sociology?multilevel analysis. In multilevel analysis, researchers build models that capture the layered structure of multilevel data, and determine how layers interact and impact a dependent variable of interest. Our objective in this article is to introduce the logic and statistical theory behind multilevel models, to illustrate how such models can be applied fruitfully in political science, and to call atten? tion to some of the pitfalls in multilevel analysis.",0,1 +1631,Correlation and causality,,0,1 +1632,Investigating preventive-medicine consultations in first-opinion small-animal practice in the United Kingdom using direct observation,"Preventive-medicine consultations account for a large proportion of the veterinary caseload and previous research has suggested these consultations are fundamentally different from those in which the animal is presented for a specific health problem. There has been recent controversy around some aspects of preventive medicine for cats and dogs, and the full health benefits of the preventive-medicine consultation remain unclear. The aim of this study was to compare characteristics of the consultation and the problems discussed during the consultation between preventive-medicine consultations and other types of consultations. Data were gathered during direct observation of small-animal consultations in seven first-opinion practices in the United Kingdom. Data collected included type of clinical examination performed, patient signalment, and details of all problems discussed (including whether the problem was presenting or non-presenting, new or pre-existing, who had raised the problem, body system affected and whether an action was taken). A two-level multivariable logistic-regression model was developed, with canine and feline patients at Level 1 nested within consulting veterinary surgeons at Level 2, and a binary outcome variable of preventive-medicine consultation versus specific health-problem consultation. A total of 1807 patients were presented, of which 690 (38.2%) presented for a preventive-medicine consultation. Dogs were the most frequently presented species (n=1168; 64.6%) followed by cats (n=510; 28.2%), rabbits (n=86; 4.8%) and patients of other species (n=43; 2.4%). The five variables remaining in the multi-level model were whether multiple patients were presented, patient age, clinical examination type, weighing and number of problems discussed. Species, breed, sex, neutering status and practice did not remain in the final model. Many non-presenting problems, including both preventive-medicine problems and specific-health problems, were discussed and acted upon during all types of consultations. Dental and behavioural non-presenting problems were discussed more frequently during preventive-medicine consultations compared with specific health-problem consultations. Preventive-medicine consultations represent an opportunity for veterinary surgeons to discuss other aspects of preventive medicine, and to detect and manage new and ongoing health problems. A greater evidence base is needed to understand whether detecting and managing underlying disease during the preventive-medicine consultation has a positive impact on lifelong patient health and welfare.",0,1 +1633,Meta-analytic structural equation modeling: A two-stage approach.,"To synthesize studies that use structural equation modeling (SEM), researchers usually use Pearson correlations (univariate r), Fisher z scores (univariate z), or generalized least squares (GLS) to combine the correlation matrices. The pooled correlation matrix is then analyzed by the use of SEM. Questionable inferences may occur for these ad hoc procedures. A 2-stage structural equation modeling (TSSEM) method is proposed to incorporate meta-analytic techniques and SEM into a unified framework. Simulation results reveal that the univariate-r, univariate-z, and TSSEM methods perform well in testing the homogeneity of correlation matrices and estimating the pooled correlation matrix. When fitting SEM, only TSSEM works well. The GLS method performed poorly in small to medium samples.",0,1 +1634,A Bayesian Sequential Procedure for Quantal Response in the Context of Adaptive Mental Testing,Abstract This article is concerned with a generalization of the problem of estimation of median effective dose in bioassay with a normal quantal response curve. A new kind of Bayesian motivated procedure is introduced which leads to a strongly consistent estimator. The convergence is robust in that it holds for a bundle of sequences of design vectors—an important feature in a mental testing context where a specified design vector cannot be produced on demand.,0,1 +1635,Are There Test Administrator Effects in Large-Scale Educational Assessments?,"Abstract. In large-scale educational assessments such as the Third International Mathematics and Sciences Study (TIMSS) or the Program for International Student Assessment (PISA), sizeable numbers of test administrators (TAs) are needed to conduct the assessment sessions in the participating schools. TA training sessions are run and administration manuals are compiled with the aim of ensuring standardized, comparable, assessment situations in all student groups. To date, however, there has been no empirical investigation of the effectiveness of these standardizing efforts. In the present article, we probe for systematic TA effects on mathematics achievement and sample attrition in a student achievement study. Multilevel analyses for cross-classified data using Markov Chain Monte Carlo (MCMC) procedures were performed to separate the variance that can be attributed to differences between schools from the variance associated with TAs. After controlling for school effects, only a very small, nonsignificant proportion of the variance in mathematics scores and response behavior was attributable to the TAs (< 1%). We discuss practical implications of these findings for the deployment of TAs in educational assessments.",0,1 +1636,"Contextual Factors and the Extreme Right Vote in Western Europe, 1980-2002","Research on the voters of the extreme right in Western Europe has become a minor industry, but relatively little attention has been paid to the twin question of why support for these parties is often unstable, and why the extreme right is so weak in many countries. Moreover, the findings from different studies often contradict each other. This article aims at providing a more comprehensive and satisfactory answer to this research problem by employing a broader database and a more adequate modeling strategy. The main finding is that while immigration and unemployment rates are important, their interaction with other political factors is much more complex than suggested by previous research. Moreover, persistent country effects prevail even if a whole host of individual and contextual variables is controlled for.",0,1 +1637,Large Sample Properties of Matching Estimators for Average Treatment Effects,"Matching estimators for average treatment effects are widely used in evaluation research despite the fact that their large sample properties have not been established in many cases. The absence of formal results in this area may be partly due to the fact that standard asymptotic expansions do not apply to matching estimators with a fixed number of matches because such estimators are highly nonsmooth functionals of the data. In this article we develop new methods for analyzing the large sample properties of matching estimators and establish a number of new results. We focus on matching with replacement with a fixed number of matches. First, we show that matching estimators are not N 1/2 -consistent in general and describe conditions under which matching estimators do attain N 1/2 -consistency. Second, we show that even in settings where matching estimators are N 1/2 -consistent, simple matching estimators with a fixed number of matches do not attain the semiparametric efficiency bound. Third, we provide a consistent estimator for the large sample variance that does not require consistent nonparametric estimation of unknown functions. Software for implementing these methods is available in Matlab, Stata, and R.",0,1 +1638,Advances in Mediation Analysis: A Survey and Synthesis of New Developments,"Mediation processes are fundamental to many classic and emerging theoretical paradigms within psychology. Innovative methods continue to be developed to address the diverse needs of researchers studying such indirect effects. This review provides a survey and synthesis of four areas of active methodological research: (a) mediation analysis for longitudinal data, (b) causal inference for indirect effects, (c) mediation analysis for discrete and nonnormal variables, and (d) mediation assessment in multilevel designs. The aim of this review is to aid in the dissemination of developments in these four areas and suggest directions for future research.",0,1 +1639,Bayesian Analysis of the Heterogeneity Model,"We consider Bayesian estimation of a finite mixture of models with random effects, which is also known as the heterogeneity model. First, we discuss the properties of various Markov chain Monte Carlo samplers that are obtained from full conditional Gibbs sampling by grouping and collapsing. Whereas full conditional Gibbs sampling turns out to be sensitive to the parameterization chosen for the mean structure of the model, the alternative sampler is robust in this respect. However, the logical extension of the approach to the sampling of the group variances does not further increase the efficiency of the sampler. Second, we deal with the identifiability problem due to the arbitrary labeling within the model. Finally, a case study involving metric conjoint analysis serves as a practical illustration.",0,1 +1640,"Ethnic Residential Segregation: A Multilevel, Multigroup, Multiscale Approach Exemplified by London in 2011","Abstract We develop and apply a multilevel modeling approach that is simultaneously capable of assessing multigroup and multiscale segregation in the presence of substantial stochastic variation that accompanies ethnicity rates based on small absolute counts. Bayesian MCMC estimation of a log-normal Poisson model allows the calculation of the variance estimates of the degree of segregation in a single overall model, and credible intervals are obtained to provide a measure of uncertainty around those estimates. The procedure partitions the variance at different levels and implicitly models the dependency (or autocorrelation) at each spatial scale below the topmost one. Substantively, we apply the model to 2011 census data for London, one of the world’s most ethnically diverse cities. We find that the degree of segregation depends both on scale and group.",0,1 +1641,How Exclusive is Assembly Democracy? Citizens' Assembly and Ballot Participation Compared,"This paper analyses the difference between two specific forms of citizens’ involvements, namely whether a vote is cast by ballot or in a citizens’ assembly in which people gather in town halls to decide legislative questions in a deliberative manner. We show both theoretically and empirically how citizens’ assemblies and decisions at the ballot box substantially differ not only in terms of their underlying model of democracy, but also in their structural conditions and, thus, with respect to the social inequality of participation. We test our hypotheses in a Bayesian multilevel framework using real participation data collected from 15 political decisions made in a Swiss commune. Our results show that citizens’ assemblies are not only characterised by lower participation rates, but also by a particular composition of the electorate. While citizens’ assemblies are more equal regarding income groups, ballots favour a more equitable participation in terms of gender and age.",0,1 +1642,Alternatives to Multilevel Modeling for the Analysis of Clustered Data,"Multilevel modeling has grown in use over the years as a way to deal with the nonindependent nature of observations found in clustered data. However, other alternatives to multilevel modeling are available that can account for observations nested within clusters, including the use of Taylor series linearization for variance estimation, the design effect adjusted standard errors approach, and fixed effects modeling. Using 1,000 replications of 12 conditions with varied Level 1 and Level 2 sample sizes, the author compared parameter estimates, standard errors, and statistical significance using various alternative procedures. Results indicate that several acceptable procedures can be used in lieu of or together with multilevel modeling, depending on the type of research question asked and the number of clusters under investigation. Guidelines for applied researchers are discussed.",0,1 +1643,Statistical Problems of Fitting Individual Growth Curves,"A thorough-going longitudinal study of a child’s growth can produce upward of forty observations spaced over the years from birth to maturity. Such a data record is too long and inevitably too noisy (because of measurement error and short-run growth variation) to be interpreted without some sort of condensation and smoothing. The length of the record forces attention to certain critical regions or features of the curve, but the noisiness of the data makes it risky to characterize these regions or features by a few isolated measurements. The only safe approach to interpretation of individual growth data is via a statistical method capable of revealing the essential trend and concisely describing its main features.",0,1 +1644,YAAP: yet another adaptive procedure.,"YAAP is an implementation of an adaptive psychophysical method, based on Bayesian statistics, for estimating the threshold of a psychometric function. On the basis of Bayesian probability intervals, a dynamic termination criterion allows for threshold estimation within pre-specified confidence limits.",0,1 +1645,Comparison of two random-effects methods of meta-analysis.,"Two studies compared the Schmidt-Hunter method of meta-analysis (J. E. Hunter & F. L. Schmidt, 1990) with the method described by L. V. Hedges and J. L. Vevea (1998). Study 1 evaluated estimates of à �Ì„, à ƒà �, and resulting credibility intervals for both models through Monte Carlo methods. Results showed slight differences between the 2 methods. In Study 2, a reanalysis of published meta-analyses using both methods with several artifact distributions showed that although both choice of technique and type of correction could matter, the technique of meta-analysis used is less influential on the study outcome than is the choice of artifact correction.",0,1 +1646,Multicollinearity caused by Specification Errors,The advantages of using linear least squares regressions induce us to adopt functions which are linear in parameters. Often this imposes unrealistically rigid constraints which may create multicollinearity. Using more realistic non‐linear forms and non‐linear least squares regressions is likely to overcome this problem as shown in a study of a production function.,0,1 +1647,Efficient estimation of sensory thresholds,"Laboratory computers permit detection and discrimination thresholds to be measured rapidly, efficiently, and accurately. In this paper, the general natures of psychometric functions and of thresholds are reviewed, and various methods for estimating sensory thresholds are summarized. The most efficient method, in principle, using maximum-likelihood threshold estimations, is examined in detail. Four techniques are discussed that minimize the reported problems found with the maximum-likelihood method. A package of FORTRAN subroutines, ML-TEST, which implements the maximum-likelihood method, is described. These subroutines are available on request from the author.",0,1 +1648,Fast transfer of crossmodal time interval training,"Sub-second time perception is essential for many important sensory and perceptual tasks including speech perception, motion perception, motor coordination, and crossmodal interaction. This study investigates to what extent the ability to discriminate sub-second time intervals acquired in one sensory modality can be transferred to another modality. To this end, we used perceptual classification of visual Ternus display (Ternus in Psychol Forsch 7:81-136, 1926) to implicitly measure participants' interval perception in pre- and posttests and implemented an intra- or crossmodal sub-second interval discrimination training protocol in between the tests. The Ternus display elicited either an ""element motion"" or a ""group motion"" percept, depending on the inter-stimulus interval between the two visual frames. The training protocol required participants to explicitly compare the interval length between a pair of visual, auditory, or tactile stimuli with a standard interval or to implicitly perceive the length of visual, auditory, or tactile intervals by completing a non-temporal task (discrimination of auditory pitch or tactile intensity). Results showed that after fast explicit training of interval discrimination (about 15 min), participants improved their ability to categorize the visual apparent motion in Ternus displays, although the training benefits were mild for visual timing training. However, the benefits were absent for implicit interval training protocols. This finding suggests that the timing ability in one modality can be rapidly acquired and used to improve timing-related performance in another modality and that there may exist a central clock for sub-second temporal processing, although modality-specific perceptual properties may constrain the functioning of this clock. © 2014 Springer-Verlag.",0,1 +1649,The social relations model for family data: A multilevel approach,"Multilevel models are proposed to study relational or dyadic data from multiple persons in families or other groups. The variable under study is assumed to refer to a dyadic relation between individuals in the groups. The proposed models are elaborations of the Social Relations Model. The different roles of father, mother, and child are emphasized in these models. Multilevel models provide researchers with a method to estimate the variances and correlations of the Social Relations Model and to incorporate the effects of covariates and test specialized models, even with missing observations.",0,1 +1650,The Interpersonal Process Model of Intimacy in Marriage: A Daily-Diary and Multilevel Modeling Approach.,"This study used daily reports of interactions in marriage to examine predictions from the conceptualization of intimacy as the outcome of an interpersonal process. Both partners of 96 married couples completed daily diaries assessing self-disclosure, partner disclosure, perceived partner responsiveness, and intimacy on each of 42 consecutive days. Multivariate multilevel modeling revealed that self-disclosure and partner disclosure both significantly and uniquely contributed to the contemporaneous prediction of intimacy. Perceived partner responsiveness partially mediated the effects of self-disclosure and partner disclosure on intimacy. Global marital satisfaction, relationship intimacy, and demand-withdraw communication were related to daily levels of intimacy. Implications for the importance of perceived partner responsiveness in the intimacy process for married partners are discussed.",0,1 +1651,Fitting the psychometric function,"A constrained generalized maximum likelihood routine for fitting psychometric functions is proposed, which determines optimum values for the complete parameter set—that is, threshold and slopeas well as for guessing and lapsing probability. The constraints are realized by Bayesian prior distributions for each of these parameters. The fit itself results from maximizing the posterior distribution of the parameter values by a multidimensional simplex method. We present results from extensive Monte Carlo simulations by which we can approximate bias and variability of the estimated parameters of simulated psychometric functions. Furthermore, we have tested the routine with data gathered in real sessions of psychophysical experimenting.",0,1 +1652,What Can We Learn about Neighborhood Effects from the Moving to Opportunity Experiment?,Experimental estimates from Moving to Opportunity (MTO) show no significant impacts of moves to lower‐poverty neighborhoods on adult economic self‐sufficiency four to seven years after random assignment. The authors disagree with Clampet‐Lundquist and Massey's claim that MTO was a weak intervention and therefore uninformative about neighborhood effects. MTO produced large changes in neighborhood environments that improved adult mental health and many outcomes for young females. Clampet‐Lundquist and Massey's claim that MTO experimental estimates are plagued by selection bias is erroneous. Their new nonexperimental estimates are uninformative because they add back the selection problems that MTO's experimental design was intended to overcome.,0,1 +1653,Allure or alternative? Direct democracy and party identification,"This article presents the first investigation of whether and how party identification is influenced by direct democratic institutions. The concept of party identification is of central interest to political science. Despite declining partisan attachment and increasing dealignment among voters, little systematic evidence exists as to which factors influence individual party identification. Our article contributes to improving on this lacuna by considering the educative effects of direct democratic institutions. Theoretically, two competing hypotheses are plausible. On the one hand, direct democracy might strengthen political parties and promote the need for cues so that voters succumb to the allure of partisan attachment. On the other hand, direct democracy might provide an alternative to the representational function of political parties thus rendering party identification less essential. Drawing on recent data from the Swiss cantons, we estimate multi-level models. Our analyses, though giving support to the alternative hypothesis, yield some surprising findings.",0,1 +1654,Asymptotically distribution-free methods for the analysis of covariance structures,Methods for obtaining tests of fit of structural models for covariance matrices and estimator standard errors which are asymptotically distribution free are derived. Modifications to standard normal theory tests and standard errors which make them applicable to the wider class of elliptical distributions are provided. A random sampling experiment to investigate some of the proposed methods is described.,0,1 +1655,The M word: Multicollinearity in multiple regression,,0,1 +1656,The Interplay of Bayesian and Frequentist Analysis,"Statistics has struggled for nearly a century over the issue of whether the Bayesian or frequentist paradigm is superior. This debate is far from over and, indeed, should continue, since there are fundamental philosophical and pedagogical issues at stake. At the methodological level, however, the debate has become considerably muted, with the recognition that each approach has a great deal to contribute to statistical practice and each is actually essential for full development of the other approach. In this article, we embark upon a rather idiosyncratic walk through some of these issues.",0,1 +1657,Premature Sampling in Random Walks,"Abstract Premature sampling is a plausible modification of the random walk that is regarded as sufficient in allowing the sequential probability ratio test (SPRT) model of choice response time to account for the frequent observation that mean error response latency is smaller than that for correct responses. This paper establishes a mathematical framework for random walks with premature sampling. Four important points are made. First, Wald's Identity and the small steps assumption fail to make the problem tractable in its fullest generality. Second, Laming's (1968) derivation of the important result that premature sampling leads to smaller mean latencies for error responses than correct responses in the SPRT model may be flawed by a tenuous approximation. Third, expressions for response probabilities and mean latencies are derived for the general model on the assumption that premature sampling is not sufficient, by itself, to trigger a response, although it does influence the process. Fourth, the SPRT model with premature sampling does not necessarily imply that when conditioned on a response, mean response time for error responses is smaller than that for correct responses—and counterexamples to this claim are provided.",0,1 +1658,Individual differences in components of reaction time distributions and their relations to working memory and intelligence.,"The authors bring together approaches from cognitive and individual differences psychology to model characteristics of reaction time distributions beyond measures of central tendency. Ex-Gaussian distributions and a diffusion model approach are used to describe individuals' reaction time data. The authors identified common latent factors for each of the 3 ex-Gaussian parameters and for 3 parameters central to the diffusion model using structural equation modeling for a battery of choice reaction tasks. These factors had differential relations to criterion constructs. Parameters reflecting the tail of the distribution (i.e., tau in the ex-Gaussian and drift rate in the diffusion model) were the strongest unique predictors of working memory, reasoning, and psychometric speed. Theories of controlled attention and binding are discussed as potential theoretical explanations.",0,1 +1659,An investigation of the impact of young children's self-knowledge of trustworthiness on school adjustment: A test of the realistic self-knowledge and positive illusion models,"The study aimed to examine the relationship between self-knowledge of trustworthiness and young children's school adjustment. One hundred and seventy-three (84 male and 89 female) children from school years 1 and 2 in the United Kingdom (mean age 6 years 2 months) were tested twice over 1-year. Children's trustworthiness was assessed using: (a) self-report at Time 1 and Time 2; (b) peers' reports at Time 1 and Time 2; and (c) teacher-reports at Time 2. School adjustment was assessed by child-rated school-liking and the Short-Form Teacher Rating Scale of School Adjustment (Short-Form TRSSA). Longitudinal quadratic relationships were found between school adjustment and children's self-knowledge, using peer-reported trustworthiness as a reference: more accurate self-knowledge of trustworthiness predicted increases in school adjustment. Comparable concurrent quadratic relationships were found between teacher-rated school adjustment and children's self-knowledge, using teacher-reported trustworthiness as a reference, at Time 2. The findings support the conclusion that young children's psychosocial adjustment is best accounted for by the realistic self-knowledge model (Colvin & Block, 1994).",0,1 +1660,Beyond the individual: Group effects in mindfulness-based stress reduction,"The authors explored the group as a source of change in mindfulness-based stress reduction (MBSR). Participants consisted of 606 adults in 59 groups who completed an 8-week MBSR program. The authors examined change in the General Symptom Index (GSI) of the Symptom Checklist-90-Revised and the Medical Symptom Checklist (MSC) from pre- to postintervention. Multilevel models were used to examine the extent to which groups differed in the amount of change reported by the participants. After controlling for pretreatment severity, group accounted for 7% of the variability in the GSI and 0% in the MSC. The authors discuss the implications of these findings for the practice of MBSR as well as for research investigating the effects of MBSR and other programs or psychotherapies.",0,1 +1661,Intelligence at adulthood: A twenty-five year follow-up.,"This paper reports findings from 111 Ss tested with the Stanford-Binet (S-B) at preschool and adolescence who were administered the S-B and WAIS at adulthood. Correlations of preschool IQs with adult S-B and full WAIS IQs are .59 and .64; of adolescent IQs with adult IQs, .85 and .80. Mean S-B IQ increase from adolescence to adulthood is 11 points, indicating that mental growth continues beyond 16 years. Males show more IQ gain after adolescence than do females (p<.01). Girls with high IQs increase least. Analysis of increases in percent passing S-B items shows more growth after adolescence in abstract reasoning and vocabulary than in rote memory and practical reasoning. Preschool verbal and memory items are better predictors than nonverbal items of both verbal and performance adult IQs. Pattern of individual differences in relative amounts of these abilities shows some stability over 25 years. (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1962 American Psychological Association.",0,1 +1662,Distinguishing Between Latent Classes and Continuous Factors: Resolution by Maximum Likelihood?,"Latent variable models exist with continuous, categorical, or both types of latent variables. The role of latent variables is to account for systematic patterns in the observed responses. This article has two goals: (a) to establish whether, based on observed responses, it can be decided that an underlying latent variable is continuous or categorical, and (b) to quantify the effect of sample size and class proportions on making this distinction. Latent variable models with categorical, continuous, or both types of latent variables are fitted to simulated data generated under different types of latent variable models. If an analysis is restricted to fitting continuous latent variable models assuming a homogeneous population and data stem from a heterogeneous population, overextraction of factors may occur. Similarly, if an analysis is restricted to fitting latent class models, overextraction of classes may occur if covariation between observed variables is due to continuous factors. For the data-generating models used in this study, comparing the fit of different exploratory factor mixture models usually allows one to distinguish correctly between categorical and/or continuous latent variables. Correct model choice depends on class separation and within-class sample size.",0,1 +1663,Scale Coarseness as a Methodological Artifact,"Scale coarseness is a pervasive yet ignored methodological artifact that attenuates observed correlation coefficients in relation to population coefficients. The authors describe how to disattenuate correlations that are biased by scale coarseness in primary-level as well as meta-analytic studies and derive the sampling error variance for the corrected correlation. Results of two Monte Carlo simulations reveal that the correction procedure is accurate and show the extent to which coarseness biases the correlation coefficient under various conditions (i.e., value of the population correlation, number of item scale points, and number of scale items). The authors also offer a Web-based computer program that disattenuates correlations at the primary-study level and computes the sampling error variance as well as confidence intervals for the corrected correlation. Using this program, which implements the correction in primary-level studies, and incorporating the suggested correction in meta-analytic reviews will lead to more accurate estimates of construct-level correlation coefficients.",0,1 +1664,"Efficient and unbiased modifications of the QUEST threshold method: Theory, simulations, experimental evaluation and practical implementation","QUEST [Watson and Pelli, Perception and Psychophysics, 13, 113-120 (1983)] is an efficient method of measuring thresholds which is based on three steps: (1) Specification of prior knowledge and assumptions, including an initial probability density function (p.d.f.) of threshold (i.e. relative probability of different thresholds in the population). (2) A method for choosing the stimulus intensity of any trial. (3) A method for choosing the final threshold estimate. QUEST introduced a Bayesian framework for combining prior knowledge with the results of previous trials to calculate a current p.d.f.; this is then used to implement Steps 2 and 3. While maintaining this Bayesian approach, this paper evaluates whether modifications of the QUEST method (particularly Step 2, but also Steps 1 and 3) can lead to greater precision and reduced bias. Four variations of the QUEST method (differing in Step 2) were evaluated by computer simulations. In addition to the standard method of setting the stimulus intensity to the mode of the current p.d.f. of threshold, the alternatives of using the mean and the median were evaluated. In the fourth variation--the Minimum Variance Method--the next stimulus intensity is chosen to minimize the expected variance at the end of the next trial. An exact enumeration technique with up to 20 trials was used for both yes-no and two-alternative forced-choice (2AFC) experiments. In all cases, using the mean (here called ZEST) provided better precision than using the median which in turn was better than using the mode. The Minimum Variance Method provided slightly better precision than ZEST. The usual threshold criterion--based on the ""ideal sweat factor""--may not provide optimum precision; efficiency can generally be improved by optimizing the threshold criterion. We therefore recommend either using ZEST with the optimum threshold criterion or the more complex Minimum Variance Method. A distinction is made between ""measurement bias"", which is derived from the mean of repeated threshold estimates for a single real threshold, and ""interpretation bias"", which is derived from the mean of real thresholds yielding a single threshold estimate. If their assumptions are correct, the current methods have no interpretation bias, but they do have measurement bias. Interpretation bias caused by errors in the assumptions used by ZEST is evaluated. The precisions and merits of yes-no and 2AFC techniques are compared.(ABSTRACT TRUNCATED AT 400 WORDS)",0,1 +1665,Human Computation,"Human computation is a new and evolving research area that centers around harnessing human intelligence to solve computational problems that are beyond the scope of existing Artificial Intelligence (AI) algorithms. With the growth of the Web, human computation systems can now leverage the abilities of an unprecedented number of people via the Web to perform complex computation. There are various genres of human computation applications that exist today. Games with a purpose (e.g., the ESP Game) specifically target online gamers who generate useful data (e.g., image tags) while playing an enjoyable game. Crowdsourcing marketplaces (e.g., Amazon Mechanical Turk) are human computation systems that coordinate workers to perform tasks in exchange for monetary rewards. In identity verification tasks, users perform computation in order to gain access to some online content; an example is reCAPTCHA, which leverages millions of users who solve CAPTCHAs every day to correct words in books that optical character recognition (OCR) programs fail to recognize with certainty. This book is aimed at achieving four goals: (1) defining human computation as a research area; (2) providing a comprehensive review of existing work; (3) drawing connections to a wide variety of disciplines, including AI, Machine Learning, HCI, Mechanism/Market Design and Psychology, and capturing their unique perspectives on the core research questions in human computation; and (4) suggesting promising research directions for the future. © 2011 by Morgan & Claypool.",0,1 +1666,"SO MANY JOBS, SO LITTLE ""N"": APPLYING EXPANDED VALIDATION MODELS TO SUPPORT GENERALIZATION OF COGNITIVE TEST VALIDITY","This paper describes a case study in which practitioners were faced with the challenge of validating cognitive ability tests in a setting where additional criterion-related validation research was not technically feasible. Research conducted within this organization had reached the point of diminishing returns because most of the “large incumbent” jobs had already been the subject of validation research, and the remaining jobs had relatively few incumbents. Landy (1986), and more recently, Binning and Barrett (1989), characterized validation as the process of accumulating a variety of forms of judgmental and empirical evidence to support inferences regarding psychological constructs and operational measures of those constructs. The converging lines of evidence brought together in this study by the synthesisof data from externally conducted VG research, internal validation studies, test transportability, job component validity, and analysis of attributes requirements support inferences regarding the validity of cognitive ability tests for predicting training and job performance for company nonmanagement jobs. This study demonstrates the soundness and practicality of the advice that Landy and Binning and Barrett provided regarding validity models. Although this study does not fit neatly into any one of the three “boxes” (Landy, 1986) the Guidelines allow in supporting validation efforts, it is likely more defensible than if we had followed Guidefines prescriptions by rote. The interlinking systems of job families and test batteries described here and in Hoffman (1999) are also responsive to company needs regarding cost containment and quick implementation of staffing systems.",0,1 +1667,Mediation and Spillover Effects in Group-Randomized Trials: A Case Study of the 4Rs Educational Intervention,"Peer influence and social interactions can give rise to spillover effects in which the exposure of one individual may affect outcomes of other individuals. Even if the intervention under study occurs at the group or cluster level as in group-randomized trials, spillover effects can occur when the mediator of interest is measured at a lower level than the treatment. Evaluators who choose groups rather than individuals as experimental units in a randomized trial often anticipate that the desirable changes in targeted social behaviors will be reinforced through interference among individuals in a group exposed to the same treatment. In an empirical evaluation of the effect of a school-wide intervention on reducing individual students' depressive symptoms, schools in matched pairs were randomly assigned to the 4Rs intervention or the control condition. Class quality was hypothesized as an important mediator assessed at the classroom level. We reason that the quality of one classroom may affect outcomes of children in another classroom because children interact not simply with their classmates but also with those from other classes in the hallways or on the playground. In investigating the role of class quality as a mediator, failure to account for such spillover effects of one classroom on the outcomes of children in other classrooms can potentially result in bias and problems with interpretation. Using a counterfactual conceptualization of direct, indirect and spillover effects, we provide a framework that can accommodate issues of mediation and spillover effects in group randomized trials. We show that the total effect can be decomposed into a natural direct effect, a within-classroom mediated effect and a spillover mediated effect. We give identification conditions for each of the causal effects of interest and provide results on the consequences of ignoring ""interference"" or ""spillover effects"" when they are in fact present. Our modeling approach disentangles these effects. The analysis examines whether the 4Rs intervention has an effect on children's depressive symptoms through changing the quality of other classes as well as through changing the quality of a child's own class.",0,1 +1668,The use of random effects models to allow for clustering in individually randomized trials,"Background We describe different forms of clustering that may occur in individually randomized trials, where the observed outcomes for different individuals cannot be regarded as independent. We propose random effects models to allow for such clustering, across a range of contexts and trial designs, and investigate their effect on estimation and interpretation of the treatment effect. Methods We apply our proposed models to two individually randomized trials with potential for clustering, a trial of teleconsultation in hospital referral (the main outcome being offer of a further hospital appointment) and a trial of exercise therapy delivered by physiotherapists for low back pain (the outcome being a back pain score). Extensions to the methods include the possibility of explaining heterogeneity between clusters using cluster level characteristics and the potential dilution of cluster effects due to noncompliance. Results In the teleconsultation trial, the odds ratio was significant (1.52, 95% CI 1.27 to 1.82) when clustering was ignored, but smaller and nonsignificant (1.36, 95% CI 0.85 to 2.13) when clustering by hospital consultant was taken into account. The 95% range of estimated treatment effects across consultants was from 0.21 to 8.76. This variability was only partially explained by the specialty of the consultant. In the back pain trial, although there was an overall benefit of exercise (change of 20.51 points on the back pain score) and little evidence of clustering, the estimated treatment effects for different physiotherapists ranged from 21.26 to +0.26 points. Conclusions Clustering is an important issue in many individually randomized trials. Ignoring it can lead to underestimates of the uncertainty and too extreme P-values. Even when there is little apparent heterogeneity across clusters, it can still have a large impact on the estimation and interpretation of the treatment effect.",0,1 +1669,Mathematical contributions to the theory of evolution. IV. On the probable errors of frequency constants and on the influence of random selection on variation and correlation,"This memoir starts with a general theorem, by which the probable errors made in calculating the constants of any frequency distribution may be determined. It is shown that these probable errors form a correlated system approximately following the normal law of frequency, whatever be the nature of the original frequency distribution, i. e .,whether it be skew or normal. The importance of this result for the theory of evolution is then drawn attention to.",0,1 +1670,Social Inequality in Political Participation: The Dark Sides of Individualisation,"Has the participatory gap between social groups widened over the past decades? And if so, how can it be explained? Based on a re-analysis of 94 electoral surveys in eight Western European countries between 1956 and 2009, this article shows that the difference in national election turnout between the half of the population with the lowest level of education and the half with the highest has increased. It shows that individualisation – the decline of social integration and social control – is a major cause of this trend. In their electoral choices, citizens with fewer resources – in terms of education – rely more heavily on cues and social control of the social groups to which they belong. Once the ties to these groups loosen, these cues and mobilising norms are no longer as strong as they once were, resulting in an increasing abstention of the lower classes on Election Day. In contrast, citizens with abundant resources rely much less on cues and social control, and the process of individualisation impacts ...",0,1 +1671,A Bayesian confirmatory factor model for multivariate observations in the form of two-way tables of data,"Researchers collected multiple measurements on patients with schizophrenia and their relatives, as well as control subjects and their relatives, to study vulnerability factors for schizophrenics and their near relatives. Observations across individuals from the same family are correlated, and also the multiple outcome measures on the same individuals are correlated. Traditional data analyses model outcomes separately and thus do not provide information about the interrelationships among outcomes. We propose a novel Bayesian family factor model (BFFM), which extends the classical confirmatory factor analysis model to explain the correlations among observed variables using a combination of family-member and outcome factors. Traditional methods for fitting confirmatory factor analysis models, such as full-information maximum likelihood (FIML) estimation using quasi-Newton optimization (QNO), can have convergence problems and Heywood cases (lack of convergence) caused by empirical underidentification. In contrast, modern Bayesian Markov chain Monte Carlo handles these inference problems easily. Simulations compare the BFFM to FIML-QNO in settings where the true covariance matrix is identified, close to not identified, and not identified. For these settings, FIML-QNO fails to fit the data in 13%, 57%, and 85% of the cases, respectively, while MCMC provides stable estimates. When both methods successfully fit the data, estimates from the BFFM have smaller variances and comparable mean-squared errors. We illustrate the BFFM by analyzing data on data from schizophrenics and their family members.",0,1 +1672,Joint consistency of nonparametric item characteristic curve and ability estimation,The simultaneous and nonparametric estimation of latent abilities and item characteristic curves is considered. The asymptotic properties of ordinal ability estimation and kernel smoothed nonparametric item characteristic curve estimation are investigated under very general assumptions on the underlying item response theory model as both the test length and the sample size increase. A large deviation probability inequality is stated for ordinal ability estimation. The mean squared error of kernel smoothed item characteristic curve estimates is studied and a strong consistency result is obtained showing that the worst case error in the item characteristic curve estimates over all items and ability levels converges to zero with probability equal to one.,0,1 +1673,A Cognitive Model for Aggregating People's Rankings,"We develop a cognitive modeling approach, motivated by classic theories of knowledge representation and judgment from psychology, for combining people's rankings of items. The model makes simple assumptions about how individual differences in knowledge lead to observed ranking data in behavioral tasks. We implement the cognitive model as a Bayesian graphical model, and use computational sampling to infer an aggregate ranking and measures of the individual expertise. Applications of the model to 23 data sets, dealing with general knowledge and prediction tasks, show that the model performs well in producing an aggregate ranking that is often close to the ground truth and, as in the ""wisdom of the crowd"" effect, usually performs better than most of individuals. We also present some evidence that the model outperforms the traditional statistical Borda count method, and that the model is able to infer people's relative expertise surprisingly well without knowing the ground truth. We discuss the advantages of the cognitive modeling approach to combining ranking data, and in wisdom of the crowd research generally, as well as highlighting a number of potential directions for future model development.",0,1 +1674,A Longitudinal Analysis of Student Creativity Scripts,"In the present study we used bayesian latent growth modeling to asses the impact of a one-semester creativity course on the development of engineering students' creativity scripts. We compared a treatment (N = 52) and a control (N = 42) group with respect to individual differences in initial status and in rate of change. Results revealed that the development of creativity scripts followed a linear change over time, with the rate of change being higher for the treatment compared to the control group. Furthermore, substantial individual variability in the rate of creativity scripts gain across students was detected, where students with richer creativity scripts had a weaker rate of increase. The present exploratory effort lays the groundwork for further theoretical and empirical research on the effects of intervention programs for fostering creativity.",0,1 +1675,Mean Field Variational Bayes for Elaborate Distributions,"We develop strategies for mean eld variational Bayes approximate inference for Bayesian hierarchical models containing elaborate distributions. We loosely dene elaborate distributions to be those having more complicated forms compared with common distributions such as those in the Normal and Gamma families. Examples are Asymmetric Laplace, Skew Normal and Generalized Ex- treme Value distributions. Such models suer from the diculty that the param- eter updates do not admit closed form solutions. We circumvent this problem through a combination of (a) specially tailored auxiliary variables, (b) univariate quadrature schemes and (c) nite mixture approximations of troublesome den-",0,1 +1676,Spatial generalized linear mixed models of electric power outages due to hurricanes and ice storms,"Abstract This paper presents new statistical models that predict the number of hurricane- and ice storm-related electric power outages likely to occur in each 3 km×3 km grid cell in a region. The models are based on a large database of recent outages experienced by three major East Coast power companies in six hurricanes and eight ice storms. A spatial generalized linear mixed modeling (GLMM) approach was used in which spatial correlation is incorporated through random effects. Models were fitted using a composite likelihood approach and the covariance matrix was estimated empirically. A simulation study was conducted to test the model estimation procedure, and model training, validation, and testing were done to select the best models and assess their predictive power. The final hurricane model includes number of protective devices, maximum gust wind speed, hurricane indicator, and company indicator covariates. The final ice storm model includes number of protective devices, ice thickness, and ice storm indicator covariates. The models should be useful for power companies as they plan for future storms. The statistical modeling approach offers a new way to assess the reliability of electric power and other infrastructure systems in extreme events.",0,1 +1677,Doing Bayesian Data Analysis: A Tutorial with R and BUGS,"Bayesian reasoning is a blessed relief to those who have always struggled with the idea that the probability of heads coming up in a supposedly fair coin flip is always 50%, even after a long series of coin flips has come up tails each time. According to Bayes, if a coin keeps coming up tails we should adjust our prior belief that the probability is 50% in the light of the posterior belief that the coin appears to be biased towards tails. John Kruschke’s book is a 600 page development of this Bayesian theme. The 23 chapters cover the basics of parameters, probability, Baye’s rule, the R and BUGS statistical programmes, the fundamentals applied to inferring a binomial proportion, and how all of this is applied to the generalized linear model. Kruschke has the rare ability amongst statistical textbook authors of writing very engagingly about knotty topics. For those who want to do what the title of the book suggests – learning to do Bayesian data analysis by learning programs languages R and BUGS – this book must be ideal.",0,1 +1678,An exact likelihood analysis of the multinomial probit model,"Abstract We develop new methods for conducting a finite sample, likelihood-based analysis of the multinomial probit model. Using a variant of the Gibbs sampler, an algorithm is developed to draw from the exact posterior of the multinomial probit model with correlated errors. This approach avoids direct evaluation of the likelihood and, thus, avoids the problems associated with calculating choice probabilities which affect both the standard likelihood and method of simulated moments approaches. Both simulated and actual consumer panel data are used to fit six-dimensional choice models. We also develop methods for analyzing random coefficient and multiperiod probit models.",0,1 +1679,"Hierarchical Bayes versus Finite Mixture Conjoint Analysis Models: A Comparison of Fit, Prediction, and Partworth Recovery","A study conducted by Vriens, Wedel, and Wilms (1996) and published in Journal of Marketing Research found that finite mixture (FM) conjoint models had the best overall performance of nine conjoint segmentation methods in terms of fit, prediction, and parameter recovery. Since that study, hierarchical Bayes (HB) conjoint analysis methods have been proposed to estimate individual-level partworths and have received much attention in the marketing research literature. However, no study has compared the relative effectiveness of FM and HB conjoint analysis models in terms of fit, prediction, and parameter recovery. To conduct such a comparison, the authors employ the simulation methodology proposed by Vriens, Wedel, and Wilms with some modification. The authors estimate traditional individual-level conjoint models as well. The authors show that FM and HB models are equally effective in recovering individual-level parameters and predicting ratings of holdout profiles. Two surprising findings are that (1) HB performs well even when partworths come from a mixture of distributions and (2) FM produces good parameter estimates, even at the individual level. The authors show that both models are quite robust to violations of underlying assumptions and that traditional individual-level models overfit the data.",0,1 +1680,Item Analysis by the Hierarchical Generalized Linear Model,"The hierarchical generalized linear model (HGLM) is presented as an explicit, two-level formulation of a multilevel item response model. In this paper, it is shown that the HGLM is equivalent to the Rasch model and that, characteristic of the HGLM, person ability can be expressed in the form of random effects rather than parameters. The two-level item analysis model is presented as a latent regression model with person-characteristic variables. Furthermore, it is shown that the two-level HGLM model can be extended to a three-level latent regression model that permits investigation of the variation of students' performance across groups, such as is found in classrooms and schools, and of the interactive effect of person-and group-characteristic variables.",0,1 +1681,MIXREG: a computer program for mixed-effects regression analysis with autocorrelated errors,"MIXREG is a program that provides estimates for a mixed-effects regression model (MRM) for normally-distributed response data including autocorrelated errors. This model can be used for analysis of unbalanced longitudinal data, where individuals may be measured at a different number of timepoints, or even at different timepoints. Autocorrelated errors of a general form or following an AR(1), MA(1), or ARMA(1,1) form are allowable. This model can also be used for analysis of clustered data, where the mixed-effects model assumes data within clusters are dependent. The degree of dependency is estimated jointly with estimates of the usual model parameters, thus adjusting for clustering. MIXREG uses maximum marginal likelihood estimation, utilizing both the EM algorithm and a Fisher-scoring solution. For the scoring solution, the covariance matrix of the random effects is expressed in its Gaussian decomposition, and the diagonal matrix reparameterized using the exponential transformation. Estimation of the individual random effects is accomplished using an empirical Bayes approach. Examples illustrating usage and features of MIXREG are provided.",0,1 +1682,Self-schemas and the theory of planned behaviour,"This paper argues that empirical, conceptual, and statistical difficulties characterise previous demonstrations that self-schemas moderate the relationship between intentions and behaviour. A longitudinal study (n=163) was designed to overcome limitations of previous research. Theory of planned behaviour variables, past behaviour, and self-schemas were assessed in relation to exercise. Behaviour was followed up two weeks later. Findings showed that self-schemas moderated the intention–behaviour relation such that schematics were more likely to enact their intentions to exercise compared to unschematics. Evidence suggested that the importance dimension of self-schema measures was responsible for the moderator effect. Self-schemas were also associated with improved prediction of behavioural intentions after controlling for the other predictors. Copyright © 2000 John Wiley & Sons, Ltd.",0,1 +1683,Matching As An Econometric Evaluation Estimator: Evidence from Evaluating a Job Training Programme,"This paper considers whether it is possible to devise a nonexperimental procedure for evaluating a prototypical job training programme. Using rich nonexperimental data, we examine the performance of a two-stage evaluation methodology that (a) estimates the probability that a person participates in a programme and (b) uses the estimated probability in extensions of the classical method of matching. We decompose the conventional measure of programme evaluation bias into several components and find that bias due to selection on unobservables, commonly called selection bias in econometrics, is empirically less important than other components, although it is still a sizeable fraction of the estimated programme impact. Matching methods applied to comparison groups located in the same labour markets as participants and administered the same questionnaire eliminate much of the bias as conventionally measured, but the remaining bias is a considerable fraction of experimentally-determined programme impact estimates. We test and reject the identifying assumptions that justify the classical method of matching. We present a nonparametric conditional difference-in-differences extension of the method of matching that is consistent with the classical index-sufficient sample selection model and is not rejected by our tests of identifying assumptions. This estimator is effective in eliminating bias, especially when it is due to temporally-invariant omitted variables.",0,1 +1684,Bayesian network meta-analysis for unordered categorical outcomes with incomplete data,"We develop a Bayesian multinomial network meta-analysis model for unordered (nominal) categorical outcomes that allows for partially observed data in which exact event counts may not be known for each category. This model properly accounts for correlations of counts in mutually exclusive categories and enables proper comparison and ranking of treatment effects across multiple treatments and multiple outcome categories. We apply the model to analyze 17 trials, each of which compares two of three treatments (high and low dose statins and standard care/control) for three outcomes for which data are complete: cardiovascular death, non-cardiovascular death and no death. We also analyze the cardiovascular death category divided into the three subcategories (coronary heart disease, stroke and other cardiovascular diseases) that are not completely observed. The multinomial and network representations show that high dose statins are effective in reducing the risk of cardiovascular disease.",0,1 +1685,A Method for the Comparison of Item Selection Rules in Computerized Adaptive Testing,"In a typical study comparing the relative efficiency of two item selection rules in computerized adaptive testing, the common result is that they simultaneously differ in accuracy and security, making it difficult to reach a conclusion on which is the more appropriate rule. This study proposes a strategy to conduct a global comparison of two or more selection rules. A plot showing the performance of each selection rule for several maximum exposure rates is obtained and the whole plot is compared with other rule plots. The strategy was applied in a simulation study with fixed-length CATs for the comparison of six item selection rules: the point Fisher information, Fisher information weighted by likelihood, Kullback-Leibler weighted by likelihood, maximum information stratification with blocking, progressive and proportional methods. Our results show that there is no optimal rule for any overlap value or root mean square error (RMSE). The fact that a rule, for a given level of overlap, has lower RMSE than another does not imply that this pattern holds for another overlap rate. A fair comparison of the rules requires extensive manipulation of the maximum exposure rates. The best methods were the Kullback-Leibler weighted by likelihood, the proportional method, and the maximum information stratification method with blocking.",0,1 +1686,Network meta-analysis combining individual patient and aggregate data from a mixture of study designs with an application to pulmonary arterial hypertension,"BackgroundNetwork meta-analysis (NMA) is a methodology for indirectly comparing, and strengthening direct comparisons of two or more treatments for the management of disease by combining evidence from multiple studies. It is sometimes not possible to perform treatment comparisons as evidence networks restricted to randomized controlled trials (RCTs) may be disconnected. We propose a Bayesian NMA model that allows to include single-arm, before-and-after, observational studies to complete these disconnected networks. We illustrate the method with an indirect comparison of treatments for pulmonary arterial hypertension (PAH).MethodsOur method uses a random effects model for placebo improvements to include single-arm observational studies into a general NMA. Building on recent research for binary outcomes, we develop a covariate-adjusted continuous-outcome NMA model that combines individual patient data (IPD) and aggregate data from two-arm RCTs with the single-arm observational studies. We apply this model to a complex comparison of therapies for PAH combining IPD from a phase-III RCT of imatinib as add-on therapy for PAH and aggregate data from RCTs and single-arm observational studies, both identified by a systematic review.ResultsThrough the inclusion of observational studies, our method allowed the comparison of imatinib as add-on therapy for PAH with other treatments. This comparison had not been previously possible due to the limited RCT evidence available. However, the credible intervals of our posterior estimates were wide so the overall results were inconclusive. The comparison should be treated as exploratory and should not be used to guide clinical practice.ConclusionsOur method for the inclusion of single-arm observational studies allows the performance of indirect comparisons that had previously not been possible due to incomplete networks composed solely of available RCTs. We also built on many recent innovations to enable researchers to use both aggregate data and IPD. This method could be used in similar situations where treatment comparisons have not been possible due to restrictions to RCT evidence and where a mixture of aggregate data and IPD are available.",0,1 +1687,"Measuring, estimating, and understanding the psychometric function: A commentary","The psychometric function, relating the subject's response to the physical stimulus, is fundamental to psychophysics. This paper examines various psychometric function topics, many inspired by this special symposium issue of Perception & Psychophysics: What are the relative merits of objective yes/no versus forced choice tasks (including threshold variance)? What are the relative merits of adaptive versus constant stimuli methods? What are the relative merits of likelihood versus up-down staircase adaptive methods? Is 2AFC free of substantial bias? Is there no efficient adaptive method for objective yes/no tasks? Should adaptive methods aim for 90% correct? Can adding more responses to forced choice and objective yes/no tasks reduce the threshold variance? What is the best way to deal with lapses? How is the Weibull function intimately related to the d' function? What causes bias in the likelihood goodness-of-fit? What causes bias in slope estimates from adaptive methods? How good are nonparametric methods for estimating psychometric function parameters? Of what value is the psychometric function slope? How are various psychometric functions related to each other? The resolution of many of these issues is surprising.",0,1 +1688,An analysis of the costs of treating schizophrenia in Spain: a hierarchical Bayesian approach.,"Health care decisions should incorporate cost of illness and treatment data, particularly for disorders such as schizophrenia with a high morbidity rate and a disproportionately low allocation of resources. Previous cost of illness analyses may have disregarded geographical aspects relevant for resource consumption and unit cost calculation.To compare the utilisation of resources and the care costs of schizophrenic patients in four mental-health districts in Spain (in Madrid, Catalonia, Navarra and Andalusia), and to analyse factors that determine the costs and the differences between areas.A treated prevalence bottom-up three year follow-up design was used for obtaining data concerning socio-demography, clinical evolution and the utilisation of services. 1997 reference prices were updated for years 1998-2000 in euros. We propose two different scenarios, varying in the prices applied. In the first (Scenario 0) the reference prices are those obtained for a single geographic area, and so the cost variations are only due to differences in the use of resources. In the second situation (Scenario 1), we analyse the variations in resource utilisation at different levels, using the prices applicable to each healthcare area. Bayesian hierarchical models are used to discuss the factors that determine such costs and the differences between geographic areas.In scenario 0, the estimated mean cost was 4918.948 euros for the first year. In scenario 1 the highest cost was in Gava (Catalonia) and the lowest in Loja (Andalusia). Mean costs were respectively 4547.24 and 2473.98 euros. With respect to the evolution of costs over time, we observed an increase during the second year and a reduction during the third year. Geographical differences appeared in follow-up costs. The variables related to lower treatment costs were: residence in the family household, higher patient age and being in work. On the contrary, the number of relapses is directly related to higher treatment costs. No differences were observed between health areas concerning resource utilisation.Calculating the costs of a given disease involves two principal factors: the resource utilisation and the prices. In most studies, emphasis is placed on the analysis of resource utilisation. Other evaluations, however, have recognized the implications of incorporating different prices into the final results. In this study we show both scenarios. The factors that determine the cost of schizophrenia for the Spanish case are similar to the factors encountered in studies carried out in other countries.Treatment costs may be reduced by the prevention of psychotic symptoms and relapse.The use of the same price data in multicentre studies may not be realistic. More effort should be made to obtain price data from all the centres or countries participating in a study. In the present study, only direct healthcare and social costs have been included. Future research should consider informal and indirect costs.",0,1 +1689,Joint Effects of the N-Acetyltransferase 1 and 2 (NAT1 and NAT2) Genes and Smoking on Bladder Carcinogenesis: A Literature-based Systematic HuGE Review and Evidence Synthesis,"Bladder cancer is an increasingly important international public health problem, with over 330,000 new cases being diagnosed each year worldwide. In a systematic review and evidence synthesis, the authors investigated the joint effects of the N-acetyltransferase genes NAT1 and NAT2 and cigarette smoking on bladder carcinogenesis. Studies were identified through an exhaustive search of multiple electronic databases and reference lists and through direct contact with study authors and experts. Random-effects meta-analysis was used within a Bayesian framework to investigate individual effects of NAT1 and NAT2 acetylation status on bladder cancer risk, while a novel approach was used to investigate joint effects of these two genes with cigarette smoking. An increased risk of bladder cancer was found in NAT2 slow acetylators (odds ratio = 1.46, 95% credible interval (CI): 1.26, 1.68) but not in NAT1 fast acetylators (odds ratio = 1.01, 95% CI: 0.86, 1.22). The joint effects in the highest risk category (NAT2 slow acetylator, NAT1 fast acetylator, and current or ever cigarette smoking) as compared with the reference category (NAT2 fast acetylator, NAT1 slow acetylator, and never smoking) were associated with an odds ratio of 2.73 (95% CI: 1.70, 4.31). The importance of considering joint effects between genetic and environmental factors in the etiology of common complex diseases is underlined.",0,1 +1690,Statistical Methods for Modeling Human Dynamics,,0,1 +1691,"The effects of establishment practices, knowledge and attitudes on condom use among Filipina sex workers","The findings for a baseline assessment for a community-based HIV/STD prevention intervention for commercial sex workers (CSWs) and managers of the establishments that employ them in the Philippines is presented in this study. CSW knowledge, attitudes, behaviours and establishment policies concerning HIV prevention were assessed. Baseline assessments are part of an iterative process that will be used to modify the planned intervention. The preliminary findings point to the importance of an intervention that stresses changes in establishment policies and expectations as a means of reducing risk behaviours associated with HIV/STD transmission.As of May 1996, 1025 HIV-infected individuals had been identified in the Philippines, 260 of whom had AIDS. However, in the Philippines' total population of 65 million, approximately 18,000 adults are estimated to carry HIV. Unprotected sex and multiple partners place prostitutes at risk of contracting and transmitting HIV and other STDs. There are 65,000 registered prostitutes and 200,000 or more freelance sex workers in the Philippines. 1394 registered prostitutes, of whom 98.6% were female, were recruited from commercial sex work establishments in 4 sites about 400 miles from Manila for participation in a study assessing prostitutes' knowledge, attitudes, behaviors, and establishment policies concerning HIV prevention. The participants were aged 15-54 of mean age 23.5 years. Establishment policies and practices appear to be more important than prostitutes' knowledge of HIV transmission or their attitudes toward condoms. Any intervention to prevent HIV/STD among prostitutes in the Philippines should therefore consider and possibly target sex work establishments' policies.",0,1 +1692,Penalized Item Response Theory Models: Application to Epigenetic Alterations in Bladder Cancer,"Increasingly used in health-related applications, latent variable models provide an appealing framework for handling high-dimensional exposure and response data. Item response theory (IRT) models, which have gained widespread popularity, were originally developed for use in the context of educational testing, where extremely large sample sizes permitted the estimation of a moderate-to-large number of parameters. In the context of public health applications, smaller sample sizes preclude large parameter spaces. Therefore, we propose a penalized likelihood approach to reduce mean square error and improve numerical stability. We present a continuous family of models, indexed by a tuning parameter, that range between the Rasch model and the IRT model. The tuning parameter is selected by cross validation or approximations such as Akaike Information Criterion. While our approach can be placed easily in a Bayesian context, we find that our frequentist approach is more computationally efficient. We demonstrate our methodology on a study of methylation silencing of gene expression in bladder tumors. We obtain similar results using both frequentist and Bayesian approaches, although the frequentist approach is less computationally demanding. In particular, we find high correlation of methylation silencing among 16 loci in bladder tumors, that methylation is associated with smoking and also with patient survival.",0,1 +1693,Why We (Usually) Don't Have to Worry About Multiple Comparisons,"Abstract Applied researchers often find themselves making statistical inferences in settings that would seem to require multiple comparisons adjustments. We challenge the Type I error paradigm that underlies these corrections. Moreover we posit that the problem of multiple comparisons can disappear entirely when viewed from a hierarchical Bayesian perspective. We propose building multilevel models in the settings where multiple comparisons arise. Multilevel models perform partial pooling (shifting estimates toward each other), whereas classical procedures typically keep the centers of intervals stationary, adjusting for multiple comparisons by making the intervals wider (or, equivalently, adjusting the p values corresponding to intervals of fixed width). Thus, multilevel models address the multiple comparisons problem and also yield more efficient estimates, especially in settings with low group-level variation, which is where multiple comparisons are a particular concern.",0,1 +1694,Sound sample detection and numerosity estimation using auditory display,"This article investigates the effect of various design parameters of auditory information display on user performance in two basic information retrieval tasks. We conducted a user test with 22 participants in which sets of sound samples were presented. In the first task, the test participants were asked to detect a given sample among a set of samples. In the second task, the test participants were asked to estimate the relative number of instances of a given sample in two sets of samples. We found that the stimulus onset asynchrony (SOA) of the sound samples had a significant effect on user performance in both tasks. For the sample detection task, the average error rate was about 10% with an SOA of 100 ms. For the numerosity estimation task, an SOA of at least 200 ms was necessary to yield average error rates lower than 30%. Other parameters, including the samples' sound type (synthesized speech or earcons) and spatial quality (multichannel loudspeaker or diotic headphone playback), had no substantial effect on user performance. These results suggest that diotic, or indeed monophonic, playback with appropriately chosen SOA may be sufficient in practical applications for users to perform the given information retrieval tasks, if information about the sample location is not relevant. If location information was provided through spatial playback of the samples, test subjects were able to simultaneously detect and localize a sample with reasonable accuracy.",0,1 +1695,A Comparison of Methods for Nonparametric Estimation of Item Characteristic Curves for Binary Items,"This study compares the performance of three nonparametric item characteristic curve (ICC) estimation procedures: isotonic regression, smoothed isotonic regression, and kernel smoothing. Smoothed isotonic regression, employed along with an appropriate kernel function, provides better estimates and also satisfies the assumption of strict monotonicity. As the number of items and the sample size increase, the kernel smoothing and smoothed isotonic regression ICC estimation procedures yield similar results across all conditions.",0,1 +1696,Bayesian correlation estimation,"We propose prior probability models for variance-covariance matrices in order to address two important issues. First, the models allow a researcher to represent substantive prior information about the strength of correlations among a set of variables. Secondly, even in the absence of such information, the increased flexibility of the models mitigates dependence on strict parametric assumptions in standard prior models. For example, the model allows a posteriori different levels of uncertainty about correlations among different subsets of variables. We achieve this by including a clustering mechanism in the prior probability model. Clustering is with respect to variables and pairs of variables. Our approach leads to shrinkage towards a mixture structure implied by the clustering. We discuss appropriate posterior simulation schemes to implement posterior inference in the proposed models, including the evaluation of normalising constants that are functions of parameters of interest. The normalising constants result from the restriction that the correlation matrix be positive definite. We discuss examples based on simulated data, a stock return dataset and a population genetics dataset.",0,1 +1697,Semantic models for ranking medical images using Dirichlet non-parametric mixture models,"With recent advances in diagnostic medical imaging, huge quantities of medical images are produced and stored in digital image repositories. While these repositories are difficult to be analyzed manually by medical experts, they can be evaluated using computer-based methods to enrich the process of decision making. For example, query by image methods can be used by medical experts for differential diagnosis by displaying previously evaluated cases that contain similar visual patterns. Also, less experienced practitioners can benefit from query-by-semantic methods in training processes especially for difficult-to-interpret cases with multiple pathologies. In this article we develop a methodology for ranking medical images based on Dirichlet process nonparametric distributions. Our approach uses natural groupings of images in a generated feature space to evaluate associative semantic mappings. Relevant semantic mappings are then used to generate additive computer models of semantic understanding of visual patterns found in images. We evaluate the performance of our method using mean average precision and precision-recall charts.",0,1 +1698,Perceptual compression of visual space during eye-head gaze shifts,"In primates, inspection of a visual scene is typically interrupted by frequent gaze shifts, occurring at an average rate of three to five times per second. Perceptually, these gaze shifts are accompanied by a compression of visual space toward the saccade target, which may be attributed to an oculomotor signal that transiently influences visual processing. While previous studies of compression have focused exclusively on saccadic eye movements made with the head artificially immobilized, many brain structures involved in saccade generation also encode combined eye-head gaze shifts. Thus, in order to understand the interaction between gaze motor and visual signals, we studied perception during eye-head gaze shifts and found a powerful compression of visual space that was spatially directed toward the intended gaze (and not the eye movement) target location. This perceptual compression was nearly constant in duration across gaze shift amplitudes, suggesting that the signal that triggers compression is largely independent of the size and kinematics of the gaze shift. The spatial pattern of results could be captured by a model that involves interactions, on a logarithmic map of visual space, between two loci of neural activity that encode the gaze shift vector and visual stimulus position relative to the fovea.",0,1 +1699,Introduction to the Special Issue,"The use of multilevel models—models in which lower-level (“micro”) units are nested within higher-level (“macro”) units—has blossomed recently in political science. Possible relationships in such models include macro variables influencing macro variables; micro variables influencing micro variables; macro variables influencing micro variables, and vice versa; and often most interestingly, micro-micro relationships varying interactively with macro variables. Most work in political science has drawn on the useful introductions of Raudenbush and Bryk (2002), Western (1998), and Steenbergen and Jones (2002). We refer readers to good general introductions/reviews of multi-level modeling in the articles in this issue by Bowers and Drake and by Franzese.",0,1 +1700,Evaluating Model Fit in Bayesian Confirmatory Factor Analysis With Large Samples: Simulation Study Introducing the BRMSEA,"Bayesian confirmatory factor analysis (CFA) offers an alternative to frequentist CFA based on, for example, maximum likelihood estimation for the assessment of reliability and validity of educational and psychological measures. For increasing sample sizes, however, the applicability of current fit statistics evaluating model fit within Bayesian CFA is limited. We propose, therefore, a Bayesian variant of the root mean square error of approximation (RMSEA), the BRMSEA. A simulation study was performed with variations in model misspecification, factor loading magnitude, number of indicators, number of factors, and sample size. This showed that the 90% posterior probability interval of the BRMSEA is valid for evaluating model fit in large samples ( N≥ 1,000), using cutoff values for the lower (<.05) and upper limit (<.08) as guideline. An empirical illustration further shows the advantage of the BRMSEA in large sample Bayesian CFA models. In conclusion, it can be stated that the BRMSEA is well suited to evaluate model fit in large sample Bayesian CFA models by taking sample size and model complexity into account.",0,1 +1701,Value added as an indicator of educational effectiveness in Dutch senior secondary vocational education,"This study investigates the possibilities of estimating value added as a performance indicator in senior secondary vocational education. Value added is interesting in this context because it is considered as a reliable tool for comparing the effectiveness of educational institutions. Although value added indicators have been developed since the 1980s for both primary and secondary educations, the research on school effectiveness has largely neglected vocational education because of its complexity. For estimating value added in this study, data concerning almost 90,000 students in Dutch senior secondary vocational education are used. Factors such as ethnicity, living in problematic neighbourhoods and students’ prior educational attainment appear to be significant predictors of student outcomes. The results indicate considerable differences in the effectiveness among clusters of training programmes, whereas there are hardly any differences between the educational institutions. Of the total variance among th...",0,1 +1702,Unveiling patterns of affective responses in daily life may improve outcome prediction in depression: A momentary assessment study,"Daily life affective responses are closely linked to vulnerability and resilience in depression. Prediction of future clinical course may be improved if information on daily life emotional response patterns is taken into account.Female subjects with a history of major depression (n=83), recruited from a population twin register, participated in a longitudinal study using momentary assessment technology with 4 follow-up measurements. The effect of baseline daily life emotional response patterns (affect variability, stress-sensitivity and reward experience) on follow-up depressive symptomatology was examined.Both reward experience (B=-0.30, p=0.001) and negative affect variability (B=0.46, p=0.001) predicted future negative affective symptoms independent of all other dynamic emotional patterns and conventional predictors.Daily life information on dynamic emotional patterns adds to the prediction of future clinical course, independent of severity of symptoms and neuroticism score. Better prediction of course may improve decision-making regarding quantitative and qualitative aspects of treatment.",0,1 +1703,Sociologies of Formality and Informality,status: publishe,0,1 +1704,Multilevel models with multivariate mixed response types,"We build upon the existing literature to formulate a class of models for multivariate mixtures of Gaussian, ordered or unordered categorical responses and continuous distributions that are not Gaussian, each of which can be defined at any level of a multilevel data hierarchy. We describe a Markov chain Monte Carlo algorithm for fitting such models. We show how this unifies a number of disparate problems, including partially observed data and missing data in generalized linear modelling. The two-level model is considered in detail with worked examples of applications to a prediction problem and to multiple imputation for missing data. We conclude with a discussion outlining possible extensions and connections in the literature. Software for estimating the models is freely available.",0,1 +1705,Combining patient-level and summary-level data for Alzheimer’s disease modeling and simulation: a beta regression meta-analysis,"Our objective was to develop a beta regression (BR) model to describe the longitudinal progression of the 11 item Alzheimer's disease (AD) assessment scale cognitive subscale (ADAS-cog) in AD patients in both natural history and randomized clinical trial settings, utilizing both individual patient and summary level literature data. Patient data from the coalition against major diseases database (3,223 patients), the Alzheimer's disease neruroimaging initiative study database (186 patients), and summary data from 73 literature references (representing 17,235 patients) were fit to a BR drug-disease-trial model. Treatment effects for currently available acetyl cholinesterase inhibitors, longitudinal changes in disease severity, dropout rate, placebo effect, and factors influencing these parameters were estimated in the model. Based on predictive checks and external validation, an adequate BR meta-analysis model for ADAS-cog using both summary-level and patient-level data was developed. Baseline ADAS-cog was estimated from baseline MMSE score. Disease progression was dependent on time, ApoE4 status, age, and gender. Study drop out was a function of time, baseline age, and baseline MMSE. The use of the BR constrained simulations to the 0-70 range of the ADAS-cog, even when residuals were incorporated. The model allows for simultaneous fitting of summary and patient level data, allowing for integration of all information available. A further advantage of the BR model is that i t constrains values to the range of the original instrument for simulation purposes, in contrast to methodologies that provide appropriate constraints only for conditional expectations. © Springer Science+Business Media, LLC 2012.",0,1 +1706,Longitudinal Data Analysis for Discrete and Continuous Outcomes,"Longitudinal data sets are comprised of repeated observations of an outcome and a set of covariates for each of many subjects. One objective of statistical analysis is to describe the marginal expectation of the outcome variable as a function of the covariates while accounting for the correlation among the repeated observations for a given subject. This paper proposes a unifying approach to such analysis for a variety of discrete and continuous outcomes. A class of generalized estimating equations (GEEs) for the regression parameters is proposed. The equations are extensions of those used in quasi-likelihood (Wedderburn, 1974, Biometrika 61, 439-447) methods. The GEEs have solutions which are consistent and asymptotically Gaussian even when the time dependence is misspecified as we often expect. A consistent variance estimate is presented. We illustrate the use of the GEE approach with longitudinal data from a study of the effect of mothers' stress on children's morbidity.",0,1 +1707,A general model for the analysis of multilevel data,"A general model is developed for the analysis of multivariate multilevel data structures. Special cases of the model include repeated measures designs, multiple matrix samples, multilevel latent variable models, multiple time series, and variance and covariance component models.",0,1 +1708,"Wheel running, skeletal muscle aerobic capacity and 1-methyl-1-nitrosourea induced mammary carcinogenesis in the rat","Emerging evidence indicates that intrinsic differences and induced changes in aerobic capacity are probably to play a critical role in the development of chronic diseases like cancer. This study was initiated: (i) to determine how citrate synthase activity, which is routinely used as a marker of aerobic capacity and mitochondrial density in skeletal muscle, was affected by voluntary running on either a motorized activity wheel or a non-motorized free wheel and (ii) to investigate the association between aerobic capacity and the carcinogenic response induced in the mammary gland by intraperitoneal injection of 1-methyl-1-nitrosurea. Overall, wheel running reduced cancer incidence (96 versus 72%, P = 0.0006) and the number of cancers per animal (2.84 versus 1.78, P < 0.0001) and induced citrate synthase activity (276 versus 353 U/mg, P < 0.0001, sedentary control versus wheel running,respectively). Both motorized and free wheel running increased citrate synthase activity (373 +/- 24, 329 +/- 11 and 276 +/- 9 U/mg protein, P < 0.0001) and reduced the average number of cancers per rat (2.84, 1.96 and 1.63, P < 0.01), sedentary control, free wheel and motorized wheel, respectively. However, regression analyses failed to provide evidence of a significant association between citrate synthase activity and either cancer incidence or cancer multiplicity. Citrate synthase activity is a single measure in a complex pathway that determines aerobic capacity. The multifaceted nature of intrinsic and inducible aerobic capacity limits the usefulness of citrate synthase activity alone in elucidating the relationship between aerobic capacity and the carcinogenic response.",0,1 +1709,Operationalization of goal difficulty as a moderator of the goal difficulty-performance relationship.,"Examined the research studies cumulated in recent quantitative reviews of the relationship between goal difficulty and performance to determine how goal difficulty has been operationalized. 4 categories (assigned goal level, self-set goal level, performance improvement, and difficulty perceptions) of operationalization were discovered, and the operationalization of goal difficulty was tested as a moderator of the relationship between goal difficulty and performance",0,1 +1710,Systematic review of methods used in meta-analyses where a primary outcome is an adverse or unintended event,"Abstract Background Adverse consequences of medical interventions are a source of concern, but clinical trials may lack power to detect elevated rates of such events, while observational studies have inherent limitations. Meta-analysis allows the combination of individual studies, which can increase power and provide stronger evidence relating to adverse events. However, meta-analysis of adverse events has associated methodological challenges. The aim of this study was to systematically identify and review the methodology used in meta-analyses where a primary outcome is an adverse or unintended event, following a therapeutic intervention. Methods Using a collection of reviews identified previously, 166 references including a meta-analysis were selected for review. At least one of the primary outcomes in each review was an adverse or unintended event. The nature of the intervention, source of funding, number of individual meta-analyses performed, number of primary studies included in the review, and use of meta-analytic methods were all recorded. Specific areas of interest relating to the methods used included the choice of outcome metric, methods of dealing with sparse events, heterogeneity, publication bias and use of individual patient data. Results The 166 included reviews were published between 1994 and 2006. Interventions included drugs and surgery among other interventions. Many of the references being reviewed included multiple meta-analyses with 44.6% (74/166) including more than ten. Randomised trials only were included in 42.2% of meta-analyses (70/166), observational studies only in 33.7% (56/166) and a mix of observational studies and trials in 15.7% (26/166). Sparse data, in the form of zero events in one or both arms where the outcome was a count of events, was found in 64 reviews of two-arm studies, of which 41 (64.1%) had zero events in both arms. Conclusions Meta-analyses of adverse events data are common and useful in terms of increasing the power to detect an association with an intervention, especially when the events are infrequent. However, with regard to existing meta-analyses, a wide variety of different methods have been employed, often with no evident rationale for using a particular approach. More specifically, the approach to dealing with zero events varies, and guidelines on this issue would be desirable.",0,1 +1711,"Extrinsic motivation, PSM and labour market characteristics: a multilevel model of public sector employment preference in 26 countries","Research findings have been contradictory with respect to the determinants of why people choose a public sector job. In this article we use an internationally comparative design with data from 26 countries to explain public sector employment preference. The study shows that on the individual level, public service motivation and extrinsic motivation are both important drivers for this preference. Intrinsic motivation, in turn, is negatively related to people’s inclination to work for the public sector. Moreover, having a lower income and lower education is associated with a greater preference for public sector employment. This suggests that working for the public sector is seen as a good and safe career option. Our results furthermore show that variation in this preference can only partly be explained by country differences. Nevertheless, in countries with a career- rather than position-based system of public employment, people are more likely to prefer public employment. Points for practitioners Attracting the best and brightest to work for the public sector requires an insight into why people prefer public over private sector employment. This article looks at what makes people prefer public sector employment in 26 countries. Findings reveal that public service motivation (helping other people, being useful to society) and extrinsic motives (job security, a high income, opportunities for advancement) play an important role in this preference. Still, there are considerable differences between countries. In countries with a career-based system of public employment, working in the public sector is seen as more attractive.",0,1 +1712,Approaches to heterogeneity in meta-analysis,"This paper reviews publications from January 1999 to March 2001 on reproductive health topics that were self-identified as meta-analysis or were indexed as meta-analysis in MEDLINE. It sought to assess whether tests of statistical heterogeneity were done, whether the results were reported, and how a finding of significance for a test of statistical heterogeneity was handled and the results interpreted. The review identified some concerns. Tests of statistical heterogeneity were not done universally even though virtually all writers on the topic emphasize their importance. Even when done, results of these tests were not universally reported. Although the consensus appears to be that heterogeneity tests are conservative for meta-analysis of studies and a probability value of 0.10 is preferred, many meta-analyses used the conventional value of 0.05 without providing a reason. The rationale for the choice of a random or fixed effects model was not generally evident. The review also provided some positive models and some recommendations for assessing, reporting and exploring heterogeneity are made considering these models and the published recommendations of experts.",0,1 +1713,Evidence Synthesis for Decision Making in Healthcare,"In the evaluation of healthcare, rigorous methods of quantitative assessment are necessary to establish interventions that are both effective and cost-effective. Usually a single study will not fully address these issues and it is desirable to synthesize evidence from multiple sources. This book aims to provide a practical guide to evidence synthesis for the purpose of decision making, starting with a simple single parameter model, where all studies estimate the same quantity (pairwise meta-analysis) and progressing to more complex multi-parameter structures (including meta-regression, mixed treatment comparisons, Markov models of disease progression, and epidemiology models). A comprehensive, coherent framework is adopted and estimated using Bayesian methods. Key features: A coherent approach to evidence synthesis from multiple sources. Focus is given to Bayesian methods for evidence synthesis that can be integrated within cost-effectiveness analyses in a probabilistic framework using Markov Chain Monte Carlo simulation. Provides methods to statistically combine evidence from a range of evidence structures. Emphasizes the importance of model critique and checking for evidence consistency. Presents numerous worked examples, exercises and solutions drawn from a variety of medical disciplines throughout the book. WinBUGS code is provided for all examples. Evidence Synthesis for Decision Making in Healthcare is intended for health economists, decision modelers, statisticians and others involved in evidence synthesis, health technology assessment, and economic evaluation of health technologies. © 2012 John Wiley & Sons, Ltd. All rights reserved.",0,1 +1714,Preservice Teachers and Self-Assessing Digital Competence,"This study compares matched surveys of subjective self-assessment and objective assessment on seven domains of digital competence for preservice teachers at a large Southwest public university. The results, consistent with earlier studies, confirm that the participating preservice teachers inaccurately self-assessed their digital competence. The study concluded that subjective self-assessment lacks appropriate validity and is not an accurate stand-alone predictor of digital competence among preservice teachers. However, if considered in conjunction with other means, self-assessment may prove to be useful for preservice teachers to aid in their reflection of their competence, skills, and knowledge and to aid them in adjusting their perceptions and attitudes regarding technology throughout their professional practice. In addition, self-assessment in conjunction with other means may assist teacher educators in providing opportunities to improve the competence in teacher training programs.",0,1 +1715,Estimation and comparison of Changes in the Presence of Informative Right Censoring: Conditional Linear Model,"A general linear regression model for the usual least squares estimated rate of change (slope) on censoring time is described as an approximation to account for informative right censoring in estimating and comparing changes of a continuous variable in two groups. Two noniterative estimators for the group slope means, the linear minimum variance unbiased (LMVUB) estimator and the linear minimum mean squared error (LMMSE) estimator, are proposed under this conditional model. In realistic situations, we illustrate that the LMVUB and LMMSE estimators, derived under a simple linear regression model, are quite competitive compared to the pseudo maximum likelihood estimator (PMLE) derived by modeling the censoring probabilities. Generalizations to polynomial response curves and general linear models are also described.",0,1 +1716,"Recent development of propensity score methods in observational studies: Multi-categorical treatment, causal mediation, and heterogeneity","This article reviews and comments on three major expansions of propensity score methods in recent decades. First, how to use generalized propensity scores to tackle multi-categorical or continuous treatment variables is shown in procedures of propensity score regression adjustment and propensity score weighting. Second, the counterfactual framework of causal inference in the analysis of mediation mechanisms is reviewed and the decomposition of the causal relationship between variables into causal direct effects and causal indirect effects is illustrated. Third, the heterogeneous treatment effect across the distribution of propensity score values is discussed in the framework of the stratification-multilevel model. For each methodological breakthrough, this article comments on potential issues which deserve serious attention in the practical application of these methods.",0,1 +1717,State versus Action Orientation and the Theory of Reasoned Action: An Application to Coupon Usage,"This article investigates how the individual difference variable of state versus action orientation moderates the pattern of relationships among constructs in the theory of reasoned action. State orientation refers to a low capacity for the enactment of action-related mental structures, whereas action orientation refers to a high capacity for this type of enactment. A field study was conducted in the context of consumers' self-reported usage of coupons for grocery shopping. The results showed that state versus action orientation moderates the relative importance of determinants of intentions; specifically, subjective norms become more important as people become state oriented, whereas the relative importance of attitudes increases as people become action oriented. In addition, the study showed that past behavior is a determinant of intentions to use coupons.",0,1 +1718,Does Satisfaction with Democracy Really Increase Happiness? Direct Democracy and Individual Satisfaction in Switzerland,"This paper takes the influential “direct democracy makes people happy”-research as a starting point and asks whether direct democracy impacts individual satisfaction. Unlike former studies we distinguish two aspects of individual satisfaction, namely satisfaction with life (“happiness”) and with how democracy works. Based on multilevel analysis of the 26 Swiss cantons we show that the theoretical assumption on which the happiness hypothesis is based has to be questioned, as there is very little evidence for a robust relationship between satisfaction with democracy and life satisfaction. Furthermore, we do not find a substantive positive effect of direct democracy on happiness. However, with respect to satisfaction with democracy, our analysis shows some evidence for a procedural effect of direct democracy, i.e. positive effects related to using direct democratic rights, rather than these rights per se.",0,1 +1719,Corporate Social and Financial Performance: A Meta-Analysis,"Most theorizing on the relationship between corporate social/environmental performance (CSP) and corporate financial performance (CFP) assumes that the current evidence is too fractured or too variable to draw any generalizable conclusions. With this integrative, quantitative study, we intend to show that the mainstream claim that we have little generalizable knowledge about CSP and CFP is built on shaky grounds. Providing a methodologically more rigorous review than previous efforts, we conduct a meta-analysis of 52 studies (which represent the population of prior quantitative inquiry) yielding a total sample size of 33,878 observations. The meta-analytic findings suggest that corporate virtue in the form of social responsibility and, to a lesser extent, environmental responsibility is likely to pay off, although the operationalizations of CSP and CFP also moderate the positive association. For example, CSP appears to be more highly correlated with accounting-based measures of CFP than with market-based indicators, and CSP reputation indices are more highly correlated with CFP than are other indicators of CSP. This meta-analysis establishes a greater degree of certainty with respect to the CSP-CFP relationship than is currently assumed to exist by many business scholars.",0,1 +1720,Relationship satisfaction moderates the associations between male partner responses and depression in women with vulvodynia: A dyadic daily experience study,"Abstract Vulvodynia is a prevalent vulvovaginal pain condition that interferes with women’s psychological health. Given the central role of sexuality and relationships in vulvodynia, relationship satisfaction may be an important moderator of daily partner responses to this pain and associated negative sequelae, such as depression. Sixty-nine women (M age = 28.12 years, SD = 6.68) with vulvodynia and their cohabiting partners (M age = 29.67 years, SD = 8.10) reported their daily relationship satisfaction, and male partner responses on sexual intercourse days (M = 3.74, SD = 2.47) over 8 weeks. Women also reported their depressive symptoms. Relationship satisfaction on the preceding day moderated the associations between partner responses and women’s depressive symptoms in several significant ways: (1) On days after women reported higher relationship satisfaction than usual, their perception of greater facilitative male partner responses was associated with their decreased depression; (2) on days after women reported lower relationship satisfaction than usual, their perception of greater negative male partner responses was associated with their increased depression; (3) on days after men reported higher relationship satisfaction than usual, their self-reported higher negative responses were associated with decreased women’s depression, and higher solicitous responses were associated with increased women’s depression, whereas (4) on days after men reported lower relationship satisfaction than usual, their self-reported higher negative responses were related to increased women’s depression, and higher solicitous responses were associated with decreased women’s depression. Targeting partner responses and relationship satisfaction may enhance the quality of interventions aimed at reducing depression in women with vulvodynia.",0,1 +1721,"Authoritarianism, socioethnic diversity and political participation across countries","It is argued in this article that threatening stimuli affect political participation levels among non-authoritarians more than among authoritarians. Focusing on socioethnic diversity, which is known to be particularly threatening to authoritarians and to relate negatively to political participation in the general public, analyses of individual- and macro-level data from 53 countries is presented which supports this thesis. Participation levels among authoritarians are largely static, regardless of a country's level of socioethnic heterogeneity, while non-authoritarians participate considerably less in countries with relatively high levels of socioethnic heterogeneity. This suggests that authoritarians participate to a proportionately greater degree in the most diverse countries.",0,1 +1722,Parameter Recovery in the Graded Response Model Using MULTILOG,"The graded response model can be used to describe test-taking behavior when item responses are classified into ordered categories. In this study, parameter recovery in the graded response model was investigated using the MULTILOG computer program under default conditions. Based on items having five response categories, 36 simulated data sets were generated that varied on true θ distribution, true item discrimination distribution, and calibration sample size. The findings suggest, first, the correlations between the true and estimated parameters were consistently greater than 0.85 with sample sizes of at least 500. Second, the root mean square error differences between true and estimated parameters were comparable with results from binary data parameter recovery studies. Of special note was the finding that the calibration sample size had little influence on the recovery of the true ability parameter but did influence item-parameter recovery. Therefore, it appeared that item-parameter estimation error, due to small calibration samples, did not result in poor person-parameter estimation. It was concluded that at least 500 examinees are needed to achieve an adequate calibration under the graded model.",0,1 +1723,"Hierarchical generalised linear models: A synthesis of generalised linear models, random-effect models and structured dispersions","SUMMARY Hierarchical generalised linear models are developed as a synthesis of generalised linear models, mixed linear models and structured dispersions. We generalise the restricted maximum likelihood method for the estimation of dispersion to the wider class and show how the joint fitting of models for mean and dispersion can be expressed by two interconnected generalised linear models. The method allows models with (i) any combination of a generalised linear model distribution for the response with any conjugate distribution for the random effects, (ii) structured dispersion components, (iii) different link and variance functions for the fixed and random effects, and (iv) the use of quasilikelihoods in place of likelihoods for either or both of the mean and dispersion models. Inferences can be made by applying standard procedures, in particular those for model checking, to components of either generalised linear model. We also show by numerical studies that the new method gives an efficient estimation procedure for substantial class of models of practical importance. Likelihood-type inference is extended to this wide class of models in a unified way.",0,1 +1724,Network meta-analysis of multiple outcome measures accounting for borrowing of information across outcomes,"BackgroundNetwork meta-analysis (NMA) enables simultaneous comparison of multiple treatments while preserving randomisation. When summarising evidence to inform an economic evaluation, it is important that the analysis accurately reflects the dependency structure within the data, as correlations between outcomes may have implication for estimating the net benefit associated with treatment. A multivariate NMA offers a framework for evaluating multiple treatments across multiple outcome measures while accounting for the correlation structure between outcomes.MethodsThe standard NMA model is extended to multiple outcome settings in two stages. In the first stage, information is borrowed across outcomes as well across studies through modelling the within-study and between-study correlation structure. In the second stage, we make use of the additional assumption that intervention effects are exchangeable between outcomes to predict effect estimates for all outcomes, including effect estimates on outcomes where evidence is either sparse or the treatment had not been considered by any one of the studies included in the analysis. We apply the methods to binary outcome data from a systematic review evaluating the effectiveness of nine home safety interventions on uptake of three poisoning prevention practices (safe storage of medicines, safe storage of other household products, and possession of poison centre control telephone number) in households with children. Analyses are conducted in WinBUGS using Markov Chain Monte Carlo (MCMC) simulations.ResultsUnivariate and the first stage multivariate models produced broadly similar point estimates of intervention effects but the uncertainty around the multivariate estimates varied depending on the prior distribution specified for the between-study covariance structure. The second stage multivariate analyses produced more precise effect estimates while enabling intervention effects to be predicted for all outcomes, including intervention effects on outcomes not directly considered by the studies included in the analysis.ConclusionsAccounting for the dependency between outcomes in a multivariate meta-analysis may or may not improve the precision of effect estimates from a network meta-analysis compared to analysing each outcome separately.",0,1 +1725,Iteration of Partially Specified Target Matrices: Applications in Exploratory and Bayesian Confirmatory Factor Analysis,"We describe and evaluate a factor rotation algorithm, iterated target rotation (ITR). Whereas target rotation (Browne, 2001) requires a user to specify a target matrix a priori based on theory or prior research, ITR begins with a standard analytic factor rotation (i.e., an empirically informed target) followed by an iterative search procedure to update the target matrix. In Study 1, Monte Carlo simulations were conducted to evaluate the performance of ITR relative to analytic rotations from the Crawford-Ferguson family with population factor structures varying in complexity. Simulation results: (a) suggested that ITR analyses will be particularly useful when evaluating data with complex structures (i.e., multiple cross-loadings) and (b) showed that the rotation method used to define an initial target matrix did not materially affect the accuracy of the various ITRs. In Study 2, we: (a) demonstrated the application of ITR as a way to determine empirically informed priors in a Bayesian confirmatory factor analysis (BCFA; Muthén & Asparouhov, 2012) of a rater-report alexithymia measure (Haviland, Warren, & Riggs, 2000) and (b) highlighted some of the challenges when specifying empirically based priors and assessing item and overall model fit.",0,1 +1726,Piecewise growth curve modeling approach for longitudinal prevention study,"Abstract Conventional growth curve modeling typically involves a single growth profile to represent changes in an outcome variable across time. This study applies an alternative growth curve model with multiple profiles to incorporate multiple developmental stages from which longitudinal data have been obtained. Identifying and modeling the multiple transitional stages involved in repeated measures are both theoretically and empirically important in longitudinal study. A longitudinal data set obtained from a substance use prevention study was used as an example to illustrate this application. The data contained a total of 50 junior high schools (23 control and 27 program schools) observed for seven waves crossing junior high school and high school stages, with the prevalence rate of monthly cigarette use as the outcome measure. Comparisons showed that the piecewise growth curve models incorporating multiple stages demonstrated significant improvement on model fitting compared to the single-piece growth curve model. Results showed marginal prevention effects in the junior high school stage but not in the high school stage. Piecewise growth curve models offer more both substantively and analytically appropriate model specification and flexibility in incorporating transitional periods in studying changes across time.",0,1 +1727,The Double-Edged Sword of Genetic Accounts of Criminality,"Much debate exists surrounding the applicability of genetic information in the courtroom, making the psychological processes underlying how people consider this information important to explore. This article addresses how people think about different kinds of causal explanations in legal decision-making contexts. Three studies involving a total of 600 Mechanical Turk and university participants found that genetic, versus environmental, explanations of criminal behavior lead people to view the applicability of various defense claims differently, perceive the perpetrator's mental state differently, and draw different causal attributions. Moreover, mediation and path analyses highlight the double-edged nature of genetic attributions-they simultaneously reduce people's perception of the perpetrator's sense of control while increasing people's tendencies to attribute the cause to internal factors and to expect the perpetrator to reoffend. These countervailing relations, in turn, predict sentencing in opposite directions, although no overall differences in sentencing or ultimate verdicts were found.",0,1 +1728,Conceptualizing and Measuring Self-Criticism as Both a Personality Trait and a Personality State,"Blatt's ( 2004 , 2008 ) conceptualization of self-criticism is consistent with a state-trait model that postulates meaningful variation in self-criticism both between persons (traits) and within person (states). We tested the state-trait model in a 7-day diary study with 99 college student participants. Each evening they completed a 6-item measure of self-criticism, as well as measures of perceived social support, positive and negative affect, compassionate and self-image goals during interactions with others, and interpersonal behavior, including overt self-criticism and given social support. As predicted, self-criticism displayed both trait-like variance between persons and daily fluctuations around individuals' mean scores for the week; slightly more than half of the total variance was between persons (ICC = .56). Numerous associations at both the between-persons and within-person levels were found between self-criticism and the other variables, indicating that individuals' mean levels of self-criticism over the week, and level of self-criticism on a given day relative to their personal mean, were related to their cognitions, affect, interpersonal goals, and behavior. The results supported the construct validity of the daily self-criticism measure. Moreover, the findings were consistent with the state-trait model and with Blatt's theoretical analysis of self-critical personality.",0,1 +1729,Nonlinear Growth Curves in Developmental Research,"Developmentalists are often interested in understanding change processes, and growth models are the most common analytic tool for examining such processes. Nonlinear growth curves are especially valuable to developmentalists because the defining characteristics of the growth process such as initial levels, rates of change during growth spurts, and asymptotic levels can be estimated. A variety of growth models are described beginning with the linear growth model and moving to nonlinear models of varying complexity. A detailed discussion of nonlinear models is provided, highlighting the added insights into complex developmental processes associated with their use. A collection of growth models are fit to repeated measures of height from participants of the Berkeley Growth and Guidance Studies from early childhood through adulthood.",0,1 +1730,The use of hierarchical models for estimating relative risks of individual genetic variants: An application to a study of melanoma,"For major genes known to influence the risk of cancer, an important task is to determine the risks conferred by individual variants, so that one can appropriately counsel carriers of these mutations. This is a challenging task, since new mutations are continually being identified, and there is typically relatively little empirical evidence available about each individual mutation. Hierarchical modeling offers a natural strategy to leverage the collective evidence from these rare variants with sparse data. This can be accomplished when there are available higher-level covariates that characterize the variants in terms of attributes that could distinguish their association with disease. In this article, we explore the use of hierarchical modeling for this purpose using data from a large population-based study of the risks of melanoma conferred by variants in the CDKN2A gene. We employ both a pseudo-likelihood approach and a Bayesian approach using Gibbs sampling. The results indicate that relative risk estimates tend to be primarily influenced by the individual case-control frequencies when several cases and/or controls are observed with the variant under study, but that relative risk estimates for variants with very sparse data are more influenced by the higher-level covariate values, as one would expect. The analysis offers encouragement that we can draw strength from the aggregating power of hierarchical models to provide guidance to medical geneticists when they offer counseling to patients with rare or even hitherto unobserved variants. However, further research is needed to validate the application of asymptotic methods to such sparse data.",0,1 +1731,Consequences of Test Anxiety on Adaptive Versus Fixed Item Testing,"We investigated the effects of test anxiety on test performance using computerized adaptive testing (CAT) versus conventional fixed item testing (FIT). We hypothesized that tests containing mainly items with medium probabilities of being solved would have negative effects on test performance for testtakers high in test anxiety. A total of 110 students (aged 16 to 20) from a German secondary modern school filled out a short form of the Test Anxiety Inventory (TAI-G; Wacker, Jaunzeme, & Jaksztat, 2008 ) and then were presented with items from the Adaptive Matrices Test (AMT; Hornke, Etzel, & Rettig, 1999 ) on the computer, either in CAT form or in a fixed item test form with a selection of items arranged in order of increasing item difficulty. Additionally, half of the students were given a short summary of information about the mode of item selection in adaptive testing before working on the CAT. In a moderated regression approach, a significant interaction of test anxiety and test mode was revealed. The effect of test mode on the AMT score was stronger for students with higher scores on test anxiety than for students with lower test anxiety. Furthermore, getting information about CAT led to significantly better results than receiving standard test instructions. Results are discussed with reference to test fairness.",0,1 +1732,"MetaAnalysisCorr: An SAS/IML Program to Synthesize Correlation Matrices with Hunter and Schmidt, Hedges and Olkin, and Generalized Least Squares Approaches","Meta-analysis, the analysis of analyses, is a standard statistical procedure for summarizing research findings in behavioral sciences. The Hunter-Schmidt approach (Hunter & Schmidt, 1990) and the Hedges-Olkin (Hedges & Olkin, 1985) approach are the two most frequently used procedures. When dealing with multivariate cases, for instance, correlation matrices, these procedures are applied to individual correlation coefficients of the correlation matrix separately. A better approach, however, is to use the generalized least squares approach, which was proposed for multivariate effect sizes (e.g., Becker, 1992, 1995; Hedges & Olkin, 1985).",0,1 +1733,SOURCES OF VARIATION IN DETECTION OF WADING BIRDS FROM AERIAL SURVEYS IN THE FLORIDA EVERGLADES,"Abstract We conducted dual-observer trials to estimate detection probabilities (probability that a group that is present and available is detected) for fixed-wing aerial surveys of wading birds in the Everglades system, Florida. Detection probability ranged from <0.2 to ~0.75 and varied according to species, group size, observer, and the observer's position in the aircraft (front or rear seat). Aerial-survey simulations indicated that incomplete detection can have a substantial effect on assessment of population trends, particularly over relatively short intervals (≤3 years) and small annual changes in population size (≤3%). We conclude that detection bias is an important consideration for interpreting observations from aerial surveys of wading birds, potentially limiting the use of these data for comparative purposes and trend analyses. We recommend that workers conducting aerial surveys for wading birds endeavor to reduce observer and other controllable sources of detection bias and account for uncontro...",0,1 +1734,Models for learning data.,,0,1 +1735,Journal of econometrics,,0,1 +1736,The Theory of Reasoned Action: A Meta-Analysis of Past Research with Recommendations for Modifications and Future Research,"Two meta-analyses were conducted to Investigate the effectiveness of the Fishbein and Ajzen model in research to date. Strong overall evidence for the predictive utility of the model was found. Although numerous instances were identified in which researchers overstepped the boundary conditions initially proposed for the model, the predictive utility remained strong across conditions. However, three variables were proposed and found to moderate the effectiveness of the model. Suggested extensions to the model are discussed and general directions for future research are given.",0,1 +1737,The Cultural Mind: Environmental Decision Making and Cultural Modeling Within and Across Populations.,"This article describes cross-cultural research on the relation between how people conceptualize nature and how they act in it. Mental models of nature differ dramatically among populations living in the same area and engaged in similar activities. This has novel implications for environmental decision making and management, including common problems. The research offers a distinct perspective on cultural modeling and a unified approach to studies of culture and cognition. The authors argue that cultural transmission and formation consist primarily not in shared rules or norms but in complex distributions of causally connected representations across minds interacting with the environment. The cultural stability and diversity of these representations often derive from rich, biologically prepared mental mechanisms that limit variation to readily transmissible psychological forms. This framework addresses several methodological issues, such as limitations on conceiving culture to be a well-defined system, bounded entity, independent variable, or an internalized component of minds.",0,1 +1738,"Explaining Differences in Subjective Well-Being Across 33 Nations Using Multilevel Models: Universal Personality, Cultural Relativity, and National Income","This multinational study simultaneously tested three prominent hypotheses--universal disposition, cultural relativity, and livability--that explained differences in subjective well-being across nations. We performed multilevel structural equation modeling to examine the hypothesized relationships at both individual and cultural levels in 33 nations. Participants were 6,753 university students (2,215 men; 4,403 women; 135 did not specify), and the average age of the entire sample was 20.97 years (SD = 2.39). Both individual- and cultural-level analyses supported the universal disposition and cultural relativity hypotheses by revealing significant associations of subjective well-being with Extraversion, Neuroticism, and independent self-construal. In addition, interdependent self-construal was positively related to life satisfaction at the individual level only, whereas aggregated negative affect was positively linked with aggregate levels of Extraversion and interdependent self-construal at the cultural level only. Consistent with the livability hypothesis, gross national income (GNI) was related to aggregate levels of negative affect and life satisfaction. There was also a quadratic relationship between GNI and aggregated positive affect. Our findings reveal that universal disposition, cultural self-construal, and national income can elucidate differences in subjective well-being, but the multilevel analyses advance the literature by yielding new findings that cannot be identified in studies using individual-level analyses alone.",0,1 +1739,Effect size measures for mediation models: Quantitative strategies for communicating indirect effects.,"The statistical analysis of mediation effects has become an indispensable tool for helping scientists investigate processes thought to be causal. Yet, in spite of many recent advances in the estimation and testing of mediation effects, little attention has been given to methods for communicating effect size and the practical importance of those effect sizes. Our goals in this article are to (a) outline some general desiderata for effect size measures, (b) describe current methods of expressing effect size and practical importance for mediation, (c) use the desiderata to evaluate these methods, and (d) develop new methods to communicate effect size in the context of mediation analysis. The first new effect size index we describe is a residual-based index that quantifies the amount of variance explained in both the mediator and the outcome. The second new effect size index quantifies the indirect effect as the proportion of the maximum possible indirect effect that could have been obtained, given the scales of the variables involved. We supplement our discussion by offering easy-to-use R tools for the numerical and visual communication of effect size for mediation effects.",0,1 +1740,Two-Phase Item Selection Procedure for Flexible Content Balancing in CAT,"Content balancing is an important issue in the design and implementation of computerized adaptive testing (CAT). Content-balancing techniques that have been applied in fixed content balancing, where the number of items from each content area is fixed, include constrained CAT (CCAT), the modified multinomial model (MMM), modified constrained CAT (MCCAT), and others. In this article, four methods are proposed to address the flexible content-balancing issue with the a-stratification design, named STR_C. The four methods are MMM+, an extension of MMM; MCCAT+, an extension of MCCAT; the TPM method, a two-phase content-balancing method using MMM in both phases; and the TPF method, a two-phase content-balancing method using MMM in the first phase and MCCAT in the second. Simulation results show that all of the methods work well in content balancing, and TPF performs the best in item exposure control and item pool utilization while maintaining measurement precision.",0,1 +1741,On the use of nonparametric regression for model checking,"SUMMARY The use of nonparametric regression is explored to check the fit of a parametric regression model. The principal aim is to check the validity of the regression curve rather than necessarily to detect outliers. A pseudo likelihood ratio test is developed to provide a global assessment of fit and simulation bands are used to indicate the nature of departures from the model. The types of data considered include discrete response variables, where standard diagnostic techniques are often not appropriate, and first-order autoregressive series. Several numerical examples are given. Nonparametric regression can be used in an informal graphical way to assess the relationship between a response and an explanatory variable. In this paper we aim to develop more formal methods of assessing the assumptions of a parametric model, in particular when regression diagnostics of the type developed for normal linear models are not readily available. The principal aim is to check the validity of the systematic part of the model by comparing a nonparametric estimate of the regression curve with a parametric one. Such a comparison may also identify outliers, although the distinction between outliers and model inadequacy is not always easy. Two techniques are used to assess the fit of a parametric model. In ? 2, confidence bands are constructed around the fitted regression curve by simulation. A comparison of these with the nonparametric curve gives an indication of the nature of any departures from the model. In ? 3, a pseudo likelihood ratio test is developed. This provides a quantitative global assessment of fit. In applying these ideas, special emphasis is given to discrete data, and notably logistic regression, because of the difficulty in applying standard residual-based model checking techniques to this type of response variable. A Poisson regression example is discussed in ? 4. However, the underlying ideas have wider applications. Autoregressive time series of order 1 are discussed in ? 6. Sections 5 and 7 discuss general issues. We first discuss the context of binary regression with a single covariate and the difficulties caused by the discreteness of the response variable. The observed data are assumed to be of the form (xi, yi, ni), where xi is a covariate value, and yi has a binomial",0,1 +1742,Grasping the Diversity of Cohabitation: Fertility Intentions Among Cohabiters Across Europe,"The authors examined the association between different meanings of cohabitation and fertility intentions. Using data from the Generations and Gender Surveys on 5,565 cohabiters from 9 European countries (Austria, Bulgaria, France, Germany, Hungary, Lithuania, Norway, Romania, and Russia), they proposed a cohabitation typology based on attitudes toward marriage, intentions to marry, and perceived economic deprivation. Despite substantial variation in the prevalence and types of cohabiting relationships across Europe, cohabitation has become a living arrangement within which childbearing intentions are commonly formed and at times carried out. The authors found that the meaning that cohabiters attached to their union influenced significantly their short-term fertility intentions, net of other covariates. Cohabiters who viewed their unions as a prelude to marriage were the most likely to plan to have a child in the near future, both in Western and Eastern European societies. The association between fertility intentions and marriage intentions was particularly strong among cohabiters who do not as yet have children in common, but it was also present in a more muted form among cohabitating parents. The findings suggest that, although marriage and childbearing are becoming less closely linked life events, they are not disconnected decisions for a large majority of cohabiters across Europe. Keywords: cohabitation; cohabitation typology; Europe; fertility intentions; Generations and Gender Surveys",0,1 +1743,The robustness of maximum likelihood estimation in structural equation models,"Introduction General methods for the analysis of covariance structures were introduced by Joreskog (1970, 1973). Within the general theoretical framework it is possible to estimate parameters and their corresponding standard errors and to test the goodness-of-fit of a linear structural equation system by means of maximum likelihood methods . Although other methods of estimating such models (least squares procedures, instrumental variable methods) are available, we do not discuss them here. For an introduction to the general model the reader is referred to Chapter 2 and for more detailed statistical discussions to Joreskog (1978, 1982a, b). The LISREL model considers a data matrix Z ( N × k ) of N observations on k random vaŕiables. It is assumed that the rows of Z are independently distributed, each having a multivariate normal distribution with the same mean vector μ and the same covariance matrix ∑; that is, each case in the data is independently sampled from the same population. In a specified model there are s independent model parameters co, to be estimated. For large samples the sampling distribution of the estimated parameters ŵ i and the sampling distribution of the likelihood ratio estimate for goodness-of-fit are approximately known, provided that the preceding assumptions hold. Under the same conditions the standard errors of the estimated parameters se ŵ i are also known asymptotically. In the following, standardized parameter estimates are defined by ŵ* i = (ŵ i − ω i )/ se ŵ i . For large samples the sampling distribution of ŵ* i is approximately standard normal, and the goodness-of-fit estimate has an approximate chi-square distribution with k ( k + 1)/2 – s degrees of freedom.",0,1 +1744,Differential Secondary School Effectiveness: comparing the performance of different pupil groups,"Abstract This article reports the results of an Economic and Social Research Council (ESRC) funded study which focuses on the differential academic achievement of different groups of pupils. The paper describes the findings on the size and extent of school effects across 3 years (1990, 1991, 1992) for different groups of pupils (classified by gender, eligibility for free school means [FSM], ethnic group and by prior attainment). Pupils’ overall General Certificate of Secondary Education performance and their performance in selected subjects (English, English literature, French, history, mathematics and science) have been analysed using multilevel modelling, employing a total sample of 94 inner London secondary schools. A ‘value added’ approach is adopted, controlling for selected student background measures of prior attainment (at secondary transfer), gender, age, ethnicity and low income to provide statistical controls for differences between schools in the characteristics of their intakes. Differential ...",0,1 +1745,"Peri-sciatic proinflammatory cytokines, reactive oxygen species, and complement induce mirror-image neuropathic pain in rats","In inflammatory neuropathy, immune activation near intact peripheral nerves induces mechanical allodynia. The identity of the peripheral immune product(s) that lead to these changes in pain behavior is unknown. The present series of studies utilized the sciatic inflammatory neuropathy (SIN) model to examine this question. Here, inflammatory neuropathy is created by injecting an immune activator (zymosan) around one sciatic nerve via an indwelling catheter. Our prior studies demonstrated that peri-sciatic zymosan activated macrophages and neutrophils to release proinflammatory cytokines and reactive oxygen species (ROS). In addition, zymosan is a classical activator of the complement cascade. Thus the present series of experiments examined whether any of these inflammatory mediators are involved in the initial induction of SIN-induced ipsilateral or bilateral allodynias. Peri-sciatic injection of selective inhibitors/antagonists revealed that a number of immune products are early mediators of the resultant allodynias, including proinflammatory cytokines (tumor necrosis factor, interleukin-1, and interleukin-6), ROS, and complement. Thus these immune-derived substances can markedly alter sensory nerve function at mid-axon.",0,1 +1746,Are lexical decisions a good measure of lexical access? The role of word frequency in the neglected decision stage.,"Three experiments with 80 undergraduates investigated the impact of 5 lexical variables (instance dominance, category dominance, word frequency, word length in letters, and word length in syllables) on performance in 3 tasks involving word recognition: category verification, lexical decision, and pronunciation. Although the same set of words was used in each task, the relationship of the lexical variables to RT varied significantly with the task within which the words were embedded. The effect of word frequency was minimal in the category verification task, whereas it was significantly larger in the pronunciation task and significantly larger yet in the lexical decision task. It is argued that decision processes having little to do with lexical access accentuate the word-frequency effect in the lexical decision task and that results from this task have questionable value in testing the assumption that word frequency orders the lexicon, thereby affecting time to access the mental lexicon. A simple 2-stage model is outlined to account for the role of word frequency and other variables in lexical decision. The model is applied to the results of the reported experiments and some of the findings in other studies of lexical decision and pronunciation. (49 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1984 American Psychological Association.",0,1 +1747,Bayesian analysis of covariance matrices and dynamic models for longitudinal data,"Parsimonious modelling of the within‐subject covariance structure while heeding its positive‐definiteness is of great importance in the analysis of longitudinal data. Using the Cholesky decomposition and the ensuing unconstrained and statistically meaningful reparameterisation, we provide a convenient and intuitive framework for developing conditionally conjugate prior distributions for covariance matrices and show their connections with generalised inverse Wishart priors. Our priors offer many advantages with regard to elicitation, positive definiteness, computations using Gibbs sampling, shrinking covariances toward a particular structure with considerable flexibility, and modelling covariances using covariates. Bayesian estimation methods are developed and the results are compared using two simulation studies. These simulations suggest simpler and more suitable priors for the covariance structure of longitudinal data.",0,1 +1748,MML and EAP Estimation in Testlet-based Adaptive Testing,"In the previous chapter, Wainer, Bradlow and Du (this volume) presented a generalization of the three-parameter item response model in which the dependencies generated by a testlet structure are explicitly taken into account. That chapter is an extension of their prior work that developed the generalization for the two-parameter model (Bradlow, Wainer, & Wang, 1999). Their approach is to use a fully Bayesian formulation of the problem, coupled with a Markov Chain Monte Carlo (MCMC) procedure to estimate the posterior distribution of the model parameters. They then use the estimated posterior distribution to compute interval and point estimates. In this chapter, we derive estimates for the parameters of the Wainer, Bradlow, and Du testlet model using more traditional estimation methodology; maximum marginal likelihood (MML) and expected a posteriori (EAP) estimates. We also show how the model might be used within a CAT environment. After deriving the estimation equations, we compare the results of MCMC and MML estimation procedures and we examine the extent to which ignoring the testlet structure affects the precision of item calibration and the estimation of ability within a CAT procedure.",0,1 +1749,A cognitive latent variable model for the simultaneous analysis of behavioral and personality data,"I describe a cognitive latent variable model , a combination of a cognitive model and a latent variable model that can be used to aggregate information regarding cognitive parameters across participants and tasks. The model is ideally suited for uncovering relationships between latent task abilities as they are expressed in experimental paradigms, but can also be used as data fusion tools to connect latent abilities with external covariates from entirely different data sources. An example application deals with the structure of cognitive abilities underlying an executive functioning task and its relation to personality traits. • Cognitive models and latent variable models are combined into a single framework. • The framework can be applied in a Bayesian inferential context. • An application uses data from an RT experiment and questionnaires in a single model.",0,1 +1750,Equating Tests Under The Nominal Response Model,"Under item response theory, test equating involves finding the coefficients of a linear trans formation of the metric of one test to that of another. A procedure for finding these equating coefficients when the items in the two tests are nominally scored was developed. A quadratic loss function based on the differences between response category probabilities in the two tests is employed. The gradients of this loss function needed by the iterative multivariate search procedure used to obtain the equating coefficients were derived for the nominal response case. Examples of both hori zontal and vertical equating are provided. The empirical results indicated that tests scored under a nominal response model can be placed on a com mon metric in both horizontal and vertical equatings.",0,1 +1751,Methods to estimate the between‐study variance and its uncertainty in meta‐analysis,"Meta-analyses are typically used to estimate the overall/mean of an outcome of interest. However, inference about between-study variability, which is typically modelled using a between-study variance parameter, is usually an additional aim. The DerSimonian and Laird method, currently widely used by default to estimate the between-study variance, has been long challenged. Our aim is to identify known methods for estimation of the between-study variance and its corresponding uncertainty, and to summarise the simulation and empirical evidence that compares them. We identified 16 estimators for the between-study variance, seven methods to calculate confidence intervals, and several comparative studies. Simulation studies suggest that for both dichotomous and continuous data the estimator proposed by Paule and Mandel and for continuous data the restricted maximum likelihood estimator are better alternatives to estimate the between-study variance. Based on the scenarios and results presented in the published studies, we recommend the Q-profile method and the alternative approach based on a 'generalised Cochran between-study variance statistic' to compute corresponding confidence intervals around the resulting estimates. Our recommendations are based on a qualitative evaluation of the existing literature and expert consensus. Evidence-based recommendations require an extensive simulation study where all methods would be compared under the same scenarios.",0,1 +1752,Putting Broca’s region into context: fMRI evidence for a role in predictive language processing,"Broca’s region is known to play a key role in speech production as well as in the processing of language input. Still, the exact function (or functions) of Broca’s region remains highly disputed. Within the generativist framework it has been argued that part of Broca’s region is dedicated to syntactical analysis. Others, however, have related Broca’s region activity to more domain-general processes, e.g. working memory load and argument hierarchy demands. We here present results that show how contextual cues completely alter the effects of syntax in behaviour and in Broca’s region, and suggest that activation in this area reflects general linguistic processing costs or prediction error. We review the fMRI literature in the light of this theory. Introduction: the controversy over Broca's region In 1861 Paul Broca presented the brain of one of his patients to the anthropological society in Paris. Before his death, this patient had displayed a severe speech deficit, being unable to say more than a single word, Tan', while apparently maintaining many of his other mental faculties (Broca, 1861). Broca found that the patient had a large lesion in the brain's left inferior frontal gyrus (LIFG). Since then, this area, now often referred to as Broca's region, has been considered a key speech/language brain region. With the advent of cell-staining techniques, Korbinian Brodmann (Brodmann, 1909) found that the LIFG, based on the cytoarchitecture, could be subdivided into distinct regions: Brodmann areas 44, 45 and 47 (BA 44/45/47). The subregions are depicted in Plate 8.1 (see colour plate section). Agrammatical speech was already early considered to be a specific symptom in aphasiology (e.g. Kussmaul, 1877), and it has subsequently been argued that Broca's region plays a significant role in the processing of syntax, both in comprehension and production of language (Friedmann, 2006; Grodzinsky & Santi, 2008). © Cambridge University Press 2015.",0,1 +1753,Level-Specific Evaluation of Model Fit in Multilevel Structural Equation Modeling,"In multilevel structural equation modeling, the “standard” approach to evaluating the goodness of model fit has a potential limitation in detecting the lack of fit at the higher level. Level-specific model fit evaluation can address this limitation and is more informative in locating the source of lack of model fit. We proposed level-specific test statistics for the test of overall model fit, comparative fit index, and root mean squared error of approximation using partially saturated models, and we also considered another level-specific approach proposed by Yuan and Bentler (2007) Yuan, K.-H. and Bentler, P. M. 2007. Multilevel covariance structure analysis by fitting multiple single-level models.. Sociological Methodology, 37: 53–82. [Crossref], [Web of Science ®] , [Google Scholar]. A simulation study showed that the standard approach failed to detect the lack of fit at the group level. The fit indexes produced by the level-specific approaches both successfully detected the lack of model fit at each level. There were only minor differences in the performance of the 2 level-specific approaches.",0,1 +1754,Inference from Simulations and Monitoring Convergence,"Markov chainMonteCarlo (MCMC)methodshavebeenaround for almost as longasMonte Carlo techniques, even though their impact on statistics was not truly felt until the very early 1990s, except in the specialized fields of spatial statistics and image analysis, where those methods appeared earlier. The emergence of Markov based techniques in physics is a story that remains untold within this survey (see Landau and Binder, 2005). Also, we will not enter into a description of MCMC techniques, unless they have some historical link, as the remainder of this volume covers the technical aspects.Acomprehensive treatment with further references can also be found in Robert and Casella (2004). We will distinguish between the introduction of Metropolis-Hastings based algorithmsand those related to Gibbs sampling, since they each stem from radically different origins, even though their mathematical justification via Markov chain theory is the same. Tracing the development of Monte Carlo methods, we will also briefly mention what we might call the “second-generation MCMC revolution.” Starting in the mid to late 1990s, this includes the development of particle filters, reversible jump and perfect sampling, and concludes with more current work on population or sequential Monte Carlo and regeneration and the computing of “honest” standard errors. As mentioned above, the realization that Markov chains could be used in a wide varietyof situations only came (tomainstream statisticians)withGelfand and Smith (1990), despite earlier publications in the statistical literature such as Hastings (1970), Geman and Geman (1984), and Tanner and Wong (1987). Several reasons can be advanced: lack of computing machinery (think of the computers of 1970!), or background onMarkov chains, or hesitation to trust in the practicality of themethod. It thus required visionary researchers like Gelfand and Smith to convince the community, supported by papers that demonstrated, through a series of applications, that the method was easy to understand, easy to implement and practical (Gelfand et al., 1990, 1992; Smith and Gelfand, 1992; Wakefield et al., 1994). The rapid emergence of the dedicated BUGS (Bayesian inference using Gibbs sampling) software as early as 1991, when a paper on BUGS was presented at the Valencia meeting, was another compelling argument for adopting, at large, MCMC algorithms.∗Monte Carlo methods were born in Los Alamos, New Mexico, during World War II, eventually resulting in theMetropolis algorithm in the early 1950s. WhileMonte Carlo methods were in use by that time, MCMC was brought closer to statistical practicality by the work of Hastings in the 1970s. What can be reasonably seen as the first MCMC algorithm is what we now call theMetropolis algorithm, published by Metropolis et al. (1953). It emanates from the same group of scientists who produced the Monte Carlo method, namely the research scientists of Los Alamos, mostly physicists working on mathematical physics and the atomic bomb. MCMC algorithms therefore date back to the same time as the development of regular(MC only) Monte Carlo methods, which are usually traced to Ulam and von Neumann in the late 1940s. StanislawUlam associates the original ideawith an intractable combinatorial computation he attempted in 1946 (calculating the probability of winning at the solitaire card game). This ideawas enthusiastically adopted by John vonNeumann for implementationwith direct applications to neutron diffusion, the name “Monte Carlo” being suggested by Nicholas Metropolis. Eckhardt (1987) describes these early Monte Carlo developments, and Hitchcock (2003) gives a brief history of the Metropolis algorithm. These occurrences very closely coincide with the appearance of the very first general-purpose digital computer, the ENIAC,which came to life in February 1946, after three years of construction. The Monte Carlo method was set up by von Neumann, who was using it on thermonuclear and fission problems as early as 1947. That same year, Ulam and vonNeumann invented inversion andaccept-reject techniques (also recounted inEckhardt, 1987) to simulate from nonuniform distributions. Without computers, a rudimentary version invented by Fermi in the 1930s went unrecognized (Metropolis, 1987). Note also that, as early as 1949, a symposiumonMonteCarlowas supported byRand, theNational Bureau of Standards, and theOakRidge laboratory and thatMetropolis andUlam (1949) published the very first paper about the Monte Carlo method.",0,1 +1755,The structure of simple reaction time to step-function signals,"Simple reaction time to a step-function signal of amplitude A can be additively decomposed into a signal-dependent component, T ( A ) (converging to zero as A increases), and a signal-independent component, R . The two components, however, are not mutually independent, they both are increasing deterministic functions of a single random variable; T ( A ) = T ( A , C ) and R = R ( C ). C is interpreted as a “criterion” or “inhibition factor” controlling simultaneously “readiness to detect” and “readiness to respond”. The model is not based on a priori distributional assumptions. RT percentiles of a given rank P computed across RT distributions for different values of A , have a deterministic structure, RT P ( A ) = T ( A , C P ) + R ( C P ), where C P is the P th percentile of C . Subtracting RT P (A ∗ ) for a very large A ∗ from RT P ( A ), one gets an estimate of T ( A , C P ), the P th percentile of T ( A ). Applying this to different values of P , one can a posteriori reconstruct the joint distribution of the two RT components. The asymptotic consequences of this model (for sufficiently large A ) are corroborated by data on the RT to instantaneous displacements of a visual target.",0,1 +1756,Testing Evidence Accrual Models by Manipulating Stimulus Onset,"Many models of response time assume that subjects accrue stimulus ""evidence"" samples in time (e.g., random walk models, counter models). In this paper, the concept of one stimulus dominating another is used to construct a test of the whole class of evidence accrual models. For an example of dominance, consider stimuli that are presented either virtually instantaneously (stepped) or in a gradually increasing manner (ramped). Ramped stimuli are presented such that the ramped portion precedes the stepped onset of stepped stimuli. In this case ramped stimuli dominate stepped stimuli. In this paper the class of evidence accrual models is formalized. It is shown that under appropriate assumptions evidence accrual models do predict more accurate responses to dominating stimuli. However, this result does not hold for response latencies. There are anomalous cases where an evidence accrual model (the accumulator model of Vickers (1970, Ergonomics 13, 37-58)) predicts slower mean correct response latencies to dominating stimuli. It is shown through extensive computer simulation that these anomalous cases occur only when response criteria are so asymmetric that there are exceedingly extreme response biases. For experiments where response biases are not exceedingly extreme, random walk and accumulator models predict more accurate and quicker correct responses to dominating stimuli. In sum, manipulating the time course of stimuli in accordance with the concept of dominance can provide empirical tests of the class of evidence accrual models. Copyright 2001 Academic Press.",0,1 +1757,"Facing off with Scylla and Charybdis: a comparison of scalar, partial, and the novel possibility of approximate measurement invariance","Measurement invariance (MI) is a pre-requisite for comparing latent variable scores across groups. The current paper introduces the concept of approximate MI building on the work of Muthén and Asparouhov and their application of Bayesian Structural Equation Modeling (BSEM) in the software Mplus. They showed that with BSEM exact zeros constraints can be replaced with approximate zeros to allow for minimal steps away from strict MI, still yielding a well-fitting model. This new opportunity enables researchers to make explicit trade-offs between the degree of MI on the one hand, and the degree of model fit on the other. Throughout the paper we discuss the topic of approximate MI, followed by an empirical illustration where the test for MI fails, but where allowing for approximate MI results in a well-fitting model. Using simulated data, we investigate in which situations approximate MI can be applied and when it leads to unbiased results. Both our empirical illustration and the simulation study show approximate MI outperforms full or partial MI In detecting/recovering the true latent mean difference when there are (many) small differences in the intercepts and factor loadings across groups. In the discussion we provide a step-by-step guide in which situation what type of MI is preferred. Our paper provides a first step in the new research area of (partial) approximate MI and shows that it can be a good alternative when strict MI leads to a badly fitting model and when partial MI cannot be applied.",0,1 +1758,How and why criteria defining moderators and mediators differ between the Baron & Kenny and MacArthur approaches.,"In recognition of the increasingly important role of moderators and mediators in clinical research, clear definitions are sought of the two terms to avoid inconsistent, ambiguous, and possibly misleading results across clinical research studies.The criteria used to define moderators and mediators proposed by the Baron & Kenny approach, which have been long used in social/behavioral research, are directly compared to the criteria proposed by the recent MacArthur approach, which modified the Baron & Kenny criteria.After clarifying the differences in criteria between approaches, the rationale for the modifications is clarified and the implications for the design and interpretation of future studies considered.Researchers may find modifications introduced in the MacArthur approach more appropriate to their research objectives, particularly if their research might have a direct influence on decision making.",0,1 +1759,The Variational Form of Certain Bayes Estimators,"A general representation is obtained for formal Bayes of a parameter matrix. We assume that prior distribution is symmetric in some sense, but it is not specified otherwise. The formal Bayes risk is minimized subject to order constraints by a variational technique; hence our representation is called the variational form of Bayes estimator (VFBE). The VFBE is used to obtain estimators that have good frequency properties relative to usual estimators. Such estimators are obtained for mean vector and covariance matrix of a multivariate normal distribution. Also, for possibly nonnormal data, we give VFBE of several Pearson means. A certain emphasis is placed on problem of estimating covariance matrix. For that problem, our constrained optimization provides an with very good properties: Its eigenvalues are in proper order, and they are not as distorted as those in sample covariance matrix. The VFBE for covariance matrix is related to an of Stein. Of two, VFBE deals with order relations in a more natural way; that is, it is more criterion dependent. In addition, it is easier to compute than Stein's estimator, and a brief Monte Carlo simulation indicates that it has better risk properties as well.",0,1 +1760,The Influence of Different Haptic Environments on Time Delay Discrimination in Force Feedback,"Time delay in haptic telepresence arising from compression or communication alters the phase characteristics of the environment impedance. This paper describes how well a human operator can discriminate these changes in haptic environments. Three different environments are rendered on a haptic interface and manually excited by a human operator using sinusoidal movements. We find that time delay in haptic feedback can be discriminated starting from 15 ms in a pure damper environment, 36 ms in a spring system, and 72 ms when moving a damped inertia. We conclude that the discrimination thresholds increase with the absolute phase between velocity and force signals resulting from the remote environment characteristics. These results may benefit the human-centered design of high-fidelity haptic communication protocols and haptic filters.",0,1 +1761,"Effect size estimates: Current use, calculations, and interpretation.","The Publication Manual of the American Psychological Association (American Psychological Association, 2001, American Psychological Association, 2010) calls for the reporting of effect sizes and their confidence intervals. Estimates of effect size are useful for determining the practical or theoretical importance of an effect, the relative contributions of factors, and the power of an analysis. We surveyed articles published in 2009 and 2010 in the Journal of Experimental Psychology: General, noting the statistical analyses reported and the associated reporting of effect size estimates. Effect sizes were reported for fewer than half of the analyses; no article reported a confidence interval for an effect size. The most often reported analysis was analysis of variance, and almost half of these reports were not accompanied by effect sizes. Partial η2 was the most commonly reported effect size estimate for analysis of variance. For t tests, 2/3 of the articles did not report an associated effect size estimate; Cohen's d was the most often reported. We provide a straightforward guide to understanding, selecting, calculating, and interpreting effect sizes for many types of data and to methods for calculating effect size confidence intervals and power analysis.",0,1 +1762,Simulating normalizing constants: from importance sampling to bridge sampling to path sampling,"Computing (ratios of) normalizing constants of probability models is a fundamental computational problem for many statistical and scientific studies. Monte Carlo simulation is an effective technique, especially with complex and high-dimensional models. This paper aims to bring to the attention of general statistical audiences of some effective methods originating from theoretical physics and at the same time to explore these methods from a more statistical perspective, through establishing theoretical connections and illustrating their uses with statistical problems. We show that the acceptance ratio method and thermodynamic integration are natural generalizations of importance sampling, which is most familiar to statistical audiences. The former generalizes importance sampling through the use of a single ""bridge"" density and is thus a case of bridge sampling in the sense of Meng and Wong. Thermodynamic integration, which is also known in the numerical analysis literature as Ogata's method for high-dimensional integration, corresponds to the use of infinitely many and continuously connected bridges (and thus a ""path""). Our path sampling formulation offers more flexibility and thus potential efficiency to thermodynamic integration, and the search of optimal paths turns out to have close connections with the Jeffreys prior density and the Rao and Hellinger distances between two densities. We provide an informative theoretical example as well as two empirical examples (involving 17- to 70-dimensional integrations) to illustrate the potential and implementation of path sampling. We also discuss some open problems.",0,1 +1763,Bootstrap Tests for Distributional Treatment Effects in Instrumental Variable Models,"This article considers the problem of assessing the distributional consequences of a treatment on some outcome variable of interest when treatment intake is (possibly) nonrandomized, but there is a binaryinstrument available for the researcher. Such a scenario is common in observational studies and in randomized experiments with imperfect compliance. One possible approach to this problem is to compare the counterfactual cumulative distribution functions of the outcome with and without the treatment. This article shows how to estimate these distributions using instrumental variable methods and a simple bootstrap procedure is proposed to test distributional hypotheses, such as equality of distributions, first-order and second-order stochastic dominance. These tests and estimators are applied to the study of the effects of veteran status on the distribution of civilian earnings. The results show a negative effect of military service during the Vietnam era that appears to be concentrated on the lower tail of ...",0,1 +1764,Efficient estimation of covariance selection models,"SUMMARY A Bayesian method is proposed for estimating an inverse covariance matrix from Gaussian data. The method is based on a prior that allows the off-diagonal elements of the inverse covariance matrix to be zero, and in many applications results in a parsimonious parameterisation of the covariance matrix. No assumption is made about the structure of the corresponding graphical model, so the method applies to both nondecomposable and decomposable graphs. All the parameters are estimated by model averaging using an efficient Metropolis-Hastings sampling scheme. A simulation study demonstrates that the method produces statistically efficient estimators of the covariance matrix, when the inverse covariance matrix is sparse. The methodology is illustrated by applying it to three examples that are high-dimensional relative to the sample size.",0,1 +1765,WebBUGS: Conducting Bayesian Statistical Analysis Online,"A web interface, named WebBUGS, is developed to conduct Bayesian analysis online over the Internet through OpenBUGS and R. WebBUGS can be used with the minimum requirement of a web browser both remotely and locally. WebBUGS has many collaborative features such as email notification and sharing. WebBUGS also eases the use of OpenBUGS by providing built-in model templates, data management module, and other useful modules. In this paper, the use of WebBUGS is illustrated and discussed.",0,1 +1766,Graphical models for visual object recognition and tracking,"We develop statistical methods which allow effective visual detection, categorization, and tracking of objects in complex scenes. Such computer vision systems must be robust to wide variations in object appearance; the often small size of training databases, and ambiguities induced by articulated or partially occluded objects. Graphical models provide a powerful framework for encoding the statistical structure of visual scenes, and developing corresponding learning and inference algorithms. In this thesis, we describe several models which integrate graphical representations with nonparametric statistical methods. This approach leads to inference algorithms which tractably recover high-dimensional, continuous object pose variations, and learning procedures which transfer knowledge among related recognition tasks. Motivated by visual tracking problems, we first develop a nonparametric extension of the belief propagation (BP) algorithm. Using Monte Carlo methods, we provide general procedures for recursively updating particle-based approximations of continuous sufficient statistics. Efficient multiscale sampling methods then allow this nonparametric BP algorithm to be flexibly adapted to many different applications. As a particular example, we consider a graphical model describing the hand's three-dimensional (3D) structure, kinematics, and dynamics. This graph encodes global hand pose via the 3D position and orientation of several rigid components, and thus exposes local structure in a high-dimensional articulated model. Applying nonparametric BP, we recover a hand tracking algorithm which is robust to outliers and local visual ambiguities. Via a set of latent occupancy masks, we also extend our approach to consistently infer occlusion events in a distributed fashion. In the second half of this thesis, we develop methods for learning hierarchical models of objects, the parts composing them, and the scenes surrounding them. Our approach couples topic models originally developed for text analysis with spatial transformations, and thus consistently accounts for geometric constraints. By building integrated scene models, we may discover contextual relationships, and better exploit partially labeled training images. We first consider images of isolated objects, and show that sharing parts among object categories improves accuracy when learning from few examples. Turning to multiple object scenes, we propose nonparametric models which use Dirichlet processes to automatically learn the number of parts underlying each object category, and objects composing each scene. Adapting these transformed Dirichlet processes to images taken with a binocular stereo camera, we learn integrated, 3D models of object geometry and appearance. This leads to a Monte Carlo algorithm which automatically infers 3D scene structure from the predictable geometry of known object categories. (Copies available exclusively from MIT Libraries, Rm. 14-0551, Cambridge, MA 02139-4307. Ph. 617-253-5668; Fax 617-253-1690.)",0,1 +1767,Educational expansion and the education gradient in health: A hierarchical age-period-cohort analysis,"Researchers have recently been investigating the temporal variation in the educational gradient in health. While there is abundant literature concerning age trajectories, theoretical knowledge about cohort differences is relatively limited. Therefore, in analogy with the life course perspective, we introduce two contrasting cohort-specific hypotheses. The diminishing health returns hypothesis predicts a decrease in educational disparities in health across cohorts. By contrast, the cohort accretion hypothesis suggests that the education-health gap will be more pronounced among younger cohorts. To shed light on this, we perform a hierarchical age-period-cohort analysis (HAPC), using data from a subsample of individuals between 25 and 85 years of age (N = 232,573) from 32 countries in the European Social Survey (six waves: 2002-2012). The analysis leads to three important conclusions. First, we observe a widening health gap between different educational levels over the life course. Second, we find that these educational differences in the age trajectories of health seem to strengthen with each successive birth cohort. However, the two age-related effects disappear when we control for employment status, household income, and family characteristics. Last, when adjusting for these mediators, we reveal evidence to support the diminishing health returns hypothesis, implying that it is primarily the direct association between education and health that decreases across cohorts. This finding raises concerns about potential barriers to education being a vehicle for empowerment and the promotion of health.",0,1 +1768,Evaluation of the Validity of a Maximum Likelihood Adaptive Staircase Procedure for Measurement of Olfactory Detection Threshold in Mice,"Threshold is defined as the stimulus intensity necessary for a subject to reach a specified percent correct on a detection test. MLPEST (maximum likelihood parameter estimation by sequential testing) is a method that is able to determine threshold accurately and more rapidly than many other methods. Originally developed for human auditory and visual tasks, it has been adapted for human olfactory and gustatory tests. In order to utilize this technique for olfactory testing in mice, we have adapted MLPEST methodology for use with computerized olfactometry as a tool to estimate odor detection thresholds. Here we present Monte Carlo simulations and operant conditioning data that demonstrate the potential utility of this technique in mice, we explore the ramifications of altering MLPEST test parameters on performance, and we discuss the advantages and disadvantages of using MLPEST compared to other methods for the estimation of thresholds in rodents. Using MLPEST, we find that olfactory detection thresholds in mice deficient for the cyclic nucleotide-gated channel subunit A2 are similar to those of wild-type animals for odorants the knockout animals are able to detect.",0,1 +1769,Generalized Linear Models with Random Effects; a Gibbs Sampling Approach,"Abstract Generalized linear models have unified the approach to regression for a wide variety of discrete, continuous, and censored response variables that can be assumed to be independent across experimental units. In applications such as longitudinal studies, genetic studies of families, and survey sampling, observations may be obtained in clusters. Responses from the same cluster cannot be assumed to be independent. With linear models, correlation has been effectively modeled by assuming there are cluster-specific random effects that derive from an underlying mixing distribution. Extensions of generalized linear models to include random effects has, thus far, been hampered by the need for numerical integration to evaluate likelihoods. In this article, we cast the generalized linear random effects model in a Bayesian framework and use a Monte Carlo method, the Gibbs sampler, to overcome the current computational limitations. The resulting algorithm is flexible to easily accommodate changes in the number...",0,1 +1770,Distribution of the product confidence limits for the indirect effect: Program PRODCLIN,"This article describes a program, PRODCLIN (distribution of the PRODuct Confidence Limits for INdirect effects), written for SAS, SPSS, and R, that computes confidence limits for the product of two normal random variables. The program is important because it can be used to obtain more accurate confidence limits for the indirect effect, as demonstrated in several recent articles (MacKinnon, Lockwood, & Williams, 2004; Pituch, Whittaker, & Stapleton, 2005). Tests of the significance of and confidence limits for indirect effects based on the distribution of the product method have more accurate Type I error rates and more power than other, more commonly used tests. Values for the two paths involved in the indirect effect and their standard errors are entered in the PRODCLIN program, and distribution of the product confidence limits are computed. Several examples are used to illustrate the PRODCLIN program. The PRODCLIN programs in rich text format may be downloaded from www.psychonomic.org/archive.",0,1 +1771,Analysis of multiplicative combination rules when the causal variables are measured with error.,"Evaluates the validity of the observational method used to test multiplicative combination rules with respect to 2 measurement issues: measurement level (i.e., the effects produced by allowing monotonic transformations of the measures) and measurement error (i.e., the effects produced by using unreliable measures of the causal variables). The evaluation is based on a theoretical distinction between the structural model (the set of equations relating theoretical constructs to each other) and the measurement model (the set of equations relating the theoretical constructs to the observed measures). It is concluded that hierarchical regression analysis is inadequate for determining whether the structural model is additive or multiplicative for 2 reasons: First, an additive structural model may produce multiplicative effects through a nonlinear measurement model. Second, a multiplicative structural model may produce nondetectable multiplicative effects because of multiplicative measurement error. Some alternatives to hierarchical regression analysis are described. (35 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1983 American Psychological Association.",0,1 +1772,Gibbs Sampling Methods for Stick-Breaking Priors,"A rich and flexible class of random probability measures, which we call stick-breaking priors, can be constructed using a sequence of independent beta random variables. Examples of random measures that have this characterization include the Dirichlet process, its two-parameter extension, the two-parameter Poisson–Dirichlet process, finite dimensional Dirichlet priors, and beta two-parameter processes. The rich nature of stick-breaking priors offers Bayesians a useful class of priors for nonparametric problems, while the similar construction used in each prior can be exploited to develop a general computational procedure for fitting them. In this article we present two general types of Gibbs samplers that can be used to fit posteriors of Bayesian hierarchical models based on stick-breaking priors. The first type of Gibbs sampler, referred to as a Polya urn Gibbs sampler, is a generalized version of a widely used Gibbs sampling method currently employed for Dirichlet process computing. This method applies t...",0,1 +1773,Auditory Short-Term Memory Behaves Like Visual Short-Term Memory,"Are the information processing steps that support short-term sensory memory common to all the senses? Systematic, psychophysical comparison requires identical experimental paradigms and comparable stimuli, which can be challenging to obtain across modalities. Participants performed a recognition memory task with auditory and visual stimuli that were comparable in complexity and in their neural representations at early stages of cortical processing. The visual stimuli were static and moving Gaussian-windowed, oriented, sinusoidal gratings (Gabor patches); the auditory stimuli were broadband sounds whose frequency content varied sinusoidally over time (moving ripples). Parallel effects on recognition memory were seen for number of items to be remembered, retention interval, and serial position. Further, regardless of modality, predicting an item's recognizability requires taking account of (1) the probe's similarity to the remembered list items (summed similarity), and (2) the similarity between the items in memory (inter-item homogeneity). A model incorporating both these factors gives a good fit to recognition memory data for auditory as well as visual stimuli. In addition, we present the first demonstration of the orthogonality of summed similarity and inter-item homogeneity effects. These data imply that auditory and visual representations undergo very similar transformations while they are encoded and retrieved from memory.",0,1 +1774,An encompassing prior generalization of the Savage–Dickey density ratio,"An encompassing prior (EP) approach to facilitate Bayesian model selection for nested models with inequality constraints has been previously proposed. In this approach, samples are drawn from the prior and posterior distributions of an encompassing model that contains an inequality restricted version as a special case. The Bayes factor in favor of the inequality restriction then simplifies to the ratio of the proportions of posterior and prior samples consistent with the inequality restriction. This formalism has been applied almost exclusively to models with inequality or ''about equality'' constraints. It is shown that the EP approach naturally extends to exact equality constraints by considering the ratio of the heights for the posterior and prior distributions at the point that is subject to test (i.e., the Savage-Dickey density ratio). The EP approach generalizes the Savage-Dickey ratio method, and can accommodate both inequality and exact equality constraints. The general EP approach is found to be a computationally efficient procedure to calculate Bayes factors for nested models. However, the EP approach to exact equality constraints is vulnerable to the Borel-Kolmogorov paradox, the consequences of which warrant careful consideration.",0,1 +1775,Distribution-free tests of stochastic dominance for small samples,"One variable is said to “stochastically dominate” another if the probability of observations smaller than x is greater for one variable than the other, for all x. Inferring stochastic dominance from data samples is important for many applications of econometrics and experimental psychology, but little is known about the performance of existing inferential methods. Through simulation, we show that three of the most widely used inferential methods are inadequate for use in small samples of the size commonly encountered in many applications (up to 400 observations from each distribution). We develop two new inferential methods that perform very well in a limited, but practically important, case where the two variables are guaranteed not to be equal in distribution. We also show that extensions of these new methods, and an improved version of an existing method, perform quite well in the original, unlimited case.",0,1 +1776,Cross-Cultural Analysis,"Intended to bridge the gap between the latest methodological developments and cross-cultural research, this interdisciplinary resource presents the latest strategies for analyzing cross-cultural data. Techniques are demonstrated through the use of applications that employ cross national data sets such as the latest European Social Survey. With an emphasis on the generalized latent variable approach, internationally-prominent researchers from a variety of fields explain how the methods work, how to apply them, and how they relate to other methods presented in the book. Syntax and graphical and verbal explanations of the techniques are included. A website features some of the data sets and syntax commands used in the book. Applications from the behavioral and social sciences that use real data-sets demonstrate: * The use of samples from 17 countries to validate the resistance to change scale across these nations * How to test the cross-national invariance properties of social trust * The interplay between social structure, religiosity, values, and social attitudes * A comparison of anti-immigrant attitudes and patterns of religious orientations across European countries. The book is divided into techniques for analyzing cross-cultural data within the generalized-latent-variable approach: multiple-group confirmatory factor analysis and multiple-group structural equation modeling; multi-level analysis; latent class analysis; and item-response theory. Since researchers from various disciplines often use different methodological approaches, a consistent framework for describing and applying each method is used so as to cross 'methodological borders' between disciplines. Some chapters describe the basic strategy and how it relates to other techniques presented in the book, others apply the techniques and address specific research questions, and a few combine the two. A table in the preface highlights for each chapter: a brief description of the contents, the statistical methods used, the goal(s) of the analysis, and the data set employed. This book is intended for researchers, practitioners, and advanced students interested in cross-cultural research. Because the applications span a variety of disciplines, the book will appeal to cross-cultural researchers and students in: psychology, political science, sociology, education, marketing and economics, geography, criminology, psychometrics, epidemiology, and public health, as well as those interested in social-science and behavioral methodology. It is also appropriate for an advanced methods course in cross-cultural analysis.",0,1 +1777,Estimation of Parameters in the Three-Parameter Latent Trait Model,"This chapter discusses a study to investigate the efficiency of the Urry procedure and the maximum likelihood procedure to estimate parameters in the three-parameter model, to study the properties of the estimators, and to provide some guidelines regarding the conditions under which they should be employed. In particular, the issues investigated were (1) the accuracy of the two estimation procedures; (2) the relations among the number of items, examinees, and the accuracy of estimation; (3) the effect of the distribution of ability on the estimates of item and ability parameters; and (4) the statistical properties, such as bias and consistency, of the estimators. To investigate the issues mentioned above, artificial data were generated according to the three-parameter logistic model using the DATGEN program of Hambleton and Rovinelli. Data were generated to simulate various testing situations by varying the test length, the number of examinees, and the ability distribution of the examinees. In the Urry estimation procedure, the relationships that exist for item discrimination and item difficulty between the latent trait theory parameters and the classical item parameters are exploited. These relationships are derived under the assumption that ability is normally distributed and that the item characteristic curve is the normal ogive. To study how the departures from the assumption of normally distributed abilities affect the Urry procedure, three ability distributions were considered: normal, uniform, and negatively skewed.",0,1 +1778,The Product of Two Normally Distributed Random Variables,,0,1 +1779,Implications of empirical Bayes meta-analysis for test validation.,"Empirical Bayes meta-analysis provides a useful framework for examining test validation. The fixedeffects case in which Ï� has a single value corresponds to the inference that the situational specificity hypothesis can be rejected in a validity generalization study. A Bayesian analysis of such a case provides a simple and powerful test of Ï� = 0; such a test has practical implications for significance testing in test validation. The random-effects case in which σ2Ï� > 0 provides an explicit method with which to assess the relative importance of local validity studies and previous meta-analyses. Simulated data are used to illustrate both cases. Results of published meta-analyses are used to show that local validation becomes increasingly important as σ2Ï� increases. The meaning of the term validity generalization is explored, and the problem of what can be inferred about test transportability in the random-effects case is described.",0,1 +1780,A Study of Clustered Data and Approaches to Its Analysis,"Statistical analysis is critical in the interpretation of experimental data across the life sciences, including neuroscience. The nature of the data collected has a critical role in determining the best statistical approach to take. One particularly prevalent type of data is referred to as ""clustered data."" Clustered data are characterized as data that can be classified into a number of distinct groups or ""clusters"" within a particular study. Clustered data arise most commonly in neuroscience when data are compiled across multiple experiments, for example in electrophysiological or optical recordings taken from synaptic terminals, with each experiment providing a distinct cluster of data. However, there are many other types of experimental design that can yield clustered data. Here, we provide a statistical model for intracluster correlation and systematically investigate a range of methods for analyzing clustered data. Our analysis reveals that it is critical to take data clustering into account and suggests appropriate statistical approaches that can be used to account for data clustering.",0,1 +1781,DEALING WITH SPATIAL NORMALIZATION ERRORS IN fMRI GROUP INFERENCE USING HIERARCHICAL MODELING,"An important challenge in neuroimaging multi-subject studies is to take into account that different brains cannot be aligned perfectly. To this end, we extend the classical mass univariate model for group analysis to incorporate uncer- tainty on localization by introducing, for each subject, a spatial jitter variable to be marginalized out. We derive a Bayes factor to test for the mean popula- tion effect's sign in each voxel of a search volume, and discuss a Gibbs sampler to compute it. This Bayes factor, which generalizes the classical t-statistic, may be combined with a permutation test in order to control the frequentist false positive rate. Results on both simulated and experimental data suggest that this test may outperform conventional mass univariate tests in terms of detection power, while limiting the problem of overestimating the size of activity clusters.",0,1 +1782,The posterior distribution of the fixed and random effects in a mixed-effects linear model,"The subject of this paper is Bayesian inference about the fixed and random effects of a mixed-effects linear statistical model with two variance components. It is assumed that a priori the fixed effects have a noninformative distribution and that the reciprocals of the variance components are distributed independently (of each other and of the fixed effects) as gamma random variables. It is shown that techniques similar to those employed in a ridge analysis of a response surface can be used to construct a one-dimensional curve that contains all of the stationary points of the posterior density of the random effects. The “ridge analysis” (of the posterior density) can be useful (from a computational standpoint) in finding the number and the locations of the stationary points and can be very informative about various features of the posterior density. Depending on what is revealed by the ridge analysis, a multivariate normal or multivariate-t distribution that is centered at a posterior mode may provide a s...",0,1 +1783,Domain-Level Covariance Analysis for Multilevel Survey Data With Structured Nonresponse,"Health care quality surveys in the United States are administered to individual respondents (i.e., hospital patients, health plan members) to evaluate the performance of health care organizations (i.e., hospitals, health plans), which thus constitute estimation domains. For better understanding and more parsimonious reporting of dimensions of quality, we analyze relationships among quality measures at the domain level. Rather than specifying a full parametric model for the observed responses and the nonresponse patterns at the lower (patient) level, we first fit generalized variance–covariance functions that take into account nonresponse patterns in the survey responses, then specify a likelihood function for the domain mean responses using these generalized variance–covariance functions. This allows us to model directly the relationships among domain means for different items. Because the response scales are bounded, we assume that these means follow a truncated multivariate normal distribution. We calcu...",0,1 +1784,Variance Components Testing in the Longitudinal Mixed Effects Model,"This article discusses the asymptotic behavior of likelihood ratio tests for nonzero variance components in the longitudinal mixed effects linear model described by Laird and Ware (1982, Biometrics 38, 963-974). Our discussion of the large-sample behavior of likelihood ratio tests for nonzero variance components is based on the results for nonstandard testing situations by Self and Liang (1987, Journal of the American Statistical Association 82, 605-610).",0,1 +1785,13 Structural Equation Modeling,"Structural equation modeling (SEM) is a multivariate statistical technique for testing hypotheses about the influences of sets of variables on other variables. Hypotheses can involve correlational and regression-like relations among observed variables as well as latent variables. The adequacy of such hypotheses is evaluated by modeling the mean and covariance structures of the observed variables. After an introduction, we present the statistical model. Then we discuss estimation methods and hypothesis tests with an emphasis on the maximum likelihood method based on the assumption of multivariate normal data, including the issues of model (parameter) identification and regularity conditions. We also discuss estimation and testing with non-normal data and with misspecified models, as well as power analysis. To supplement model testing, fit indices have been developed to measure the degree of fit for a SEM model. We describe the major ones. When an initial model does not fit well, Lagrange Multiplier (score) and Wald tests can be used to identify how an initial model might be modified. In addition to these standard topics, we discuss extensions of the model to multiple groups, to repeated observations (growth curve SEM), to data with a hierarchical structure (multi-level SEM), and to nonlinear relationships between latent variables. We also discuss more practical topics such as treatment of missing data, categorical dependent variables, and software information.",0,1 +1786,"Dyadic conflict, drinking to cope, and alcohol-related problems: A psychometric study and longitudinal actor–partner interdependence model.","The motivational model of alcohol use posits that individuals may consume alcohol to cope with negative affect. Conflict with others is a strong predictor of coping motives, which in turn predict alcohol-related problems. Two studies examined links between conflict, coping motives, and alcohol-related problems in emerging adult romantic dyads. It was hypothesized that the association between conflict and alcohol-related problems would be mediated by coping-depression and coping-anxiety motives. It was also hypothesized that this would be true for actor (i.e., how individual factors influence individual behaviors) and partner effects (i.e., how partner factors influence individual behaviors) and at the between- (i.e., does not vary over the study period) and within-subjects (i.e., varies over the study period) levels. Both studies examined participants currently in a romantic relationship who consumed ≥12 alcoholic drinks in the past year. Study 1 was cross-sectional using university students (N = 130 students; 86.9% female; M = 21.02 years old, SD = 3.43). Study 2 used a 4-wave, 4-week longitudinal design with romantic dyads (N = 100 dyads; 89% heterosexual; M = 22.13 years old, SD = 5.67). In Study 2, coping-depression motives emerged as the strongest mediator of the conflict-alcohol-related problems association, and findings held for actor effects but not partner effects. Supplemental analyses revealed that this mediational pathway only held among women. Within any given week, alcohol-related problems changed systematically in the same direction between romantic partners. Interventions may wish to target coping-depression drinking motives within couples in response to conflict to reduce alcohol-related problems.",0,1 +1787,Item Selection Rules in Computerized Adaptive Testing,"The item selection rule (ISR) most commonly used in computerized adaptive testing (CAT) is to select the item with maximum Fisher information for the current trait estimation (PFI). Several alternative ISRs have been proposed. Among them, Fisher information considered in an interval (FI*I), Fisher information weighted with the likelihood function (FI*L), Kullback-Leibler information considered in an interval (KL*I) and Kullback-Leibler weighted with the likelihood function (KL*L) have shown a greater precision of trait estimation at the early stages of CAT. A new ISR is proposed, Fisher information by interval with geometric mean (FI*IG), which tries to rectify some detected problems in FI*I. We evaluate accuracy and item bank security for these six ISRs. FI*IG is the only ISR which simultaneously outperforms PFI in both variables. For the other ISRs, there seems to be a trade-off between accuracy and security, PFI being the one with worse accuracy and greater security, and the ISRs using the likelihood function the reverse.",0,1 +1788,"Economics and Public Support for the European Union: An Analysis at the National, Regional, and Individual Levels","The intention of this paper is to explore the sources of public attitudes toward the European Union over the last two decades, using cumulative data available from the Eurobarometer series of publi...",0,1 +1789,Default Bayesian analysis for multivariate generalized CAR models,"In recent years, multivariate spatial models have been proven to be an effective tool for analyzing spatially related multidimensional data arising from a common underlying spatial process. Currently, the Bayesian analysis is perhaps the only solution available in this framework where prior selection plays an important role in the inference. The present article contributes towards the development of Bayesian inferential methodology for multivariate generalized linear mixed models, in particular, multivariate conditional autoregressive (CAR) models. The two main contributions of this article are the development of a shrinkage-type default prior for the covariance matrices and innovative computational techniques for the Gibbs sampling implementation. The default prior elicitation is non-informative but results in a proper posterior on the related parameter spaces. This elicitation not only provides robust inference (with respect to prior choice), but also provides improved estimation. In the computational step, we have developed a transformation of the parameters that avoids sampling from restricted domains, thus providing more stability and efficiency in the Gibbs implementation. The methodology has been extended to the case of missing responses in the multi-dimensional setup. Both simulations and real examples are provided to validate and illustrate the proposed methodology.",0,1 +1790,Monte Carlo Experiments: Design and Implementation,"The use of Monte Carlo simulations for the empirical assessment of statistical estimators is becoming more common in structural equation modeling research. Yet, there is little guidance for the researcher interested in using the technique. In this article we illustrate both the design and implementation of Monte Carlo simulations. We present 9 steps in planning and performing a Monte Carlo analysis: (1) developing a theoretically derived research question of interest, (2) creating a valid model, (3) designing specific experimental conditions, (4) choosing values of population parameters, (5) choosing an appropriate software package, (6) executing the simulations, (7) file storage, (8) troubleshooting and verification, and (9) summarizing results. Throughout the article, we use as a running example a Monte Carlo simulation that we performed to illustrate many of the relevant points with concrete information and detail.",0,1 +1791,A Feedback Control Strategy for Enhancing Item Selection Efficiency in Computerized Adaptive Testing,"A computerized adaptive test (CAT) may be modeled as a closed-loop system, where item selection is influenced by trait level (θ) estimation and vice versa. When discrepancies exist between an examinee's estimated and true θ levels, nonoptimal item selection is a likely result. Nevertheless, examinee response behavior consistent with optimal item selection can be predicted using item response theory (IRT), without knowledge of an examinee's true θ level, yielding a specific reference point for applying an internal correcting or feedback control mechanism. Incorporating such a mechanism in a CAT is shown to be an effective strategy for increasing item selection efficiency. Results from simulation studies using maximum likelihood (ML) and modal a posteriori (MAP) trait-level estimation and Fisher information (FI) and Fisher interval information (FII) item selection are provided.",0,1 +1792,"The effect of state core self-evaluations on task performance, organizational citizenship behaviour, and counterproductive work behaviour","Although the personality–performance relationship has been studied extensively, most studies focused on the relationship between between-person differences in the Big Five personality dimensions and between-person differences in job performance. The current paper extends this research in two ways. First, we build on core self-evaluations (CSEs): an alternative, broad personality dimension that has proven to be a good predictor of job performance. Second, we tested concurrent and lagged within-person relationships between CSEs and task performance, organizational citizenship behaviour (OCB), and counterproductive work behaviour (CWB). To this end, we conducted two experience sampling studies; the first one assessing the relationship between state CSEs and levels of momentary task performance and OCB, and a second study in which employees reported on their level of state CSEs and momentary CWB. Results showed that there is substantial within-person variability in CSEs and that these within-person fluctuatio...",0,1 +1793,Attuned to the positive? Awareness and responsiveness to others’ positive emotion experience and display,"Positive emotions are implicated in affiliation and cooperation processes that are central to human social life. For this reason, we hypothesized that people should be highly aware of and responsive to the positive emotions of others. Study 1 examined awareness by testing the accuracy with which perceivers tracked others’ positive emotions. Study 2 examined responsiveness by testing whether positive emotions were predictive of perceivers responding to new relationship opportunity. In Study 1, multilevel analyses of dating couples’ estimates of their partner’s emotions across four semi-structured interactions revealed that both women and men tracked partner positive emotions with considerable accuracy. Additional analyses indicated that tracking accuracy was most pronounced for positive emotions whose display is known to include the Duchenne smile. In Study 2, multilevel analyses of dyads who watched a set of positive and negative emotion-eliciting film clips with a stranger indicated that only positive emotion display predicted subsequent closeness. Together, these findings show that people are highly attuned to the positive emotions of others and can be more attuned to others’ positive emotions than negative emotions. © 2015, Springer Science+Business Media New York.",0,1 +1794,Bayesian Inference in Semiparametric Mixed Models for Longitudinal Data,"We consider Bayesian inference in semiparametric mixed models (SPMMs) for longitudinal data. SPMMs are a class of models that use a nonparametric function to model a time effect, a parametric function to model other covariate effects, and parametric or nonparametric random effects to account for the within-subject correlation. We model the nonparametric function using a Bayesian formulation of a cubic smoothing spline, and the random effect distribution using a normal distribution and alternatively a nonparametric Dirichlet process (DP) prior. When the random effect distribution is assumed to be normal, we propose a uniform shrinkage prior (USP) for the variance components and the smoothing parameter. When the random effect distribution is modeled nonparametrically, we use a DP prior with a normal base measure and propose a USP for the hyperparameters of the DP base measure. We argue that the commonly assumed DP prior implies a nonzero mean of the random effect distribution, even when a base measure with mean zero is specified. This implies weak identifiability for the fixed effects, and can therefore lead to biased estimators and poor inference for the regression coefficients and the spline estimator of the nonparametric function. We propose an adjustment using a postprocessing technique. We show that under mild conditions the posterior is proper under the proposed USP, a flat prior for the fixed effect parameters, and an improper prior for the residual variance. We illustrate the proposed approach using a longitudinal hormone dataset, and carry out extensive simulation studies to compare its finite sample performance with existing methods.",0,1 +1795,A Note on the Delta Method,Abstract The delta method is an intuitive technique for approximating the moments of functions of random variables. This note reviews the delta method and conditions under which delta-method approximate moments are accurate.,0,1 +1796,Violence and Women's Psychological Distress After Birth: An Exploratory Study in Italy,"Our aim in conducting this study was to analyze the relationships between violence and maternal psychological distress 8 months after a birth, taking into account other important psychosocial factors, known to be associated both with violence and with new mothers’ mental health. A total of 352 women responded to a questionnaire after the birth at a maternity hospital in northern Italy, and 292 also participated in a telephone interview 8 months later. We evaluated psychological distress with the General Health Questionnaire (GHQ), and partner and family violence with a 28-item scale. Eight months postpartum, 5% of women showed high psychological distress; 10% were currently experiencing violence from the partner or another family member. After adjustment for covariates, the odds ratio for depressive symptoms was 13.74 for women experiencing violence. We believe that these results provide support for the important role of violence in postpartum maternal psychological distress.",0,1 +1797,Spatial Epidemiology,,0,1 +1798,Multivariate Meta-Analysis as Structural Equation Models,"Multivariate meta-analysis has become increasingly popular in the educational, social, and medical sciences. It is because the outcome measures in a meta-analysis can involve more than one effect size. This article proposes 2 mathematically equivalent models to implement multivariate meta-analysis in structural equation modeling (SEM). Specifically, this article shows how multivariate fixed-, random- and mixed-effects meta-analyses can be formulated as structural equation models. metaSEM (a free R package based on OpenMx) and Mplus are used to implement the proposed procedures. A real data set is used to illustrate the procedures. Formulating multivariate meta-analysis as structural equation models provides many new research opportunities for methodological development in both meta-analysis and SEM. Issues related to and extensions on the SEM-based meta-analysis are discussed.",0,1 +1799,An assessment of fixed-capacity models of visual working memory,"Visual working memory is often modeled as having a fixed number of slots. We test this model by assessing the receiver operating characteristics (ROC) of participants in a visual-working-memory change-detection task. ROC plots yielded straight lines with a slope of 1.0, a tell-tale characteristic of all-or-none mnemonic representations. Formal model assessment yielded evidence highly consistent with a discrete fixed-capacity model of working memory for this task.",0,1 +1800,A Multilevel Analysis of School Examination Results,"Data on examination results from inner London schools are analysed in relation to intake achievement, pupil gender and school type. The examination achieve- ment, averaged over subjects, is studied as is achievement in the separate subjects of mathematics and English. Multilevel models are fitted, so that the variation between schools can be studied. It is shown that confidence intervals for school 'residuals' or 'effects' are wide, so that few schools can be separated reliably. In particular, no fine rank ordering of schools legitimately can be produced. A bivariate model for mathematics and English examination achievement scores is fitted. The student level variance for both subjects is shown to increase from the lowest to the highest intake achievement group, with moderately high correlation between the subjects. The paper discusses the implications of these findings for the publication of 'league tables' of school examination and test scores.",0,1 +1801,The EM Algorithm-an Old Folk-song Sung to a Fast New Tune,"Celebrating the 20th anniversary of the presentation of the paper by Dempster, Laird and Rubin which popularized the EM algorithm, we investigate, after a brief historical account, strategies that aim to make the EM algorithm converge faster while maintaining its simplicity and stability (e.g. automatic monotone convergence in likelihood). First we introduce the idea of a ‘working parameter’ to facilitate the search for efficient data augmentation schemes and thus fast EM implementations. Second, summarizing various recent extensions of the EM algorithm, we formulate a general alternating expectation–conditional maximization algorithm AECM that couples flexible data augmentation schemes with model reduction schemes to achieve efficient computations. We illustrate these methods using multivariate t-models with known or unknown degrees of freedom and Poisson models for image reconstruction. We show, through both empirical and theoretical evidence, the potential for a dramatic reduction in computational time with little increase in human effort. We also discuss the intrinsic connection between EM-type algorithms and the Gibbs sampler, and the possibility of using the techniques presented here to speed up the latter. The main conclusion of the paper is that, with the help of statistical considerations, it is possible to construct algorithms that are simple, stable and fast.",0,1 +1802,"A Bayesian method for analyzing combinations of continuous, ordinal, and nominal categorical data with missing values","From a Bayesian perspective, we propose a general method for analyzing a combination of continuous, ordinal (including binary), and categorical/nominal multivariate measures with missing values. We assume multivariate normal linear regression models for multivariate continuous measures, multivariate probit models for correlated ordinal measures, and multivariate multinomial probit models for multivariate categorical/nominal measures. Then we assume a multivariate normal linear model on the continuous vector comprised of continuous variables and those underlying normal variables for ordinal variables from multivariate probit models and for categorical variables from multinomial probit models. We develop a Markov chain Monte Carlo (MCMC) algorithm to estimate unknown parameters including regression parameters, cut-points for ordinal data from the multivariate probit models, and the covariance matrix encompassing both continuous variables and the underlying normal latent variables. Combining the continuous variables and the normal latent variables allows us to model combinations of continuous, ordinal, and categorical multivariate data simultaneously. The framework incorporates flexible priors for the covariance matrix, provides a foundation for inference about the underlying covariance structure, and imputes missing data where needed. The method is illustrated through simulated examples and two real data applications.",0,1 +1803,Pain Intensity and Duration Can Be Enhanced by Prior Challenge: Initial Evidence Suggestive of a Role of Microglial Priming,"

Abstract

Activation of spinal microglia and consequent release of proinflammatory mediators facilitate pain. Under certain conditions, responses of activated microglia can become enhanced. Enhanced microglial production of proinflammatory products may result from priming (sensitization), similar to macrophage priming. We hypothesized that if spinal microglia were primed by an initial inflammatory challenge, subsequent challenges may create enhanced pain. Here, we used a ""two-hit"" paradigm using 2 successive challenges, which affect overlapping populations of spinal microglia, presented 2 weeks apart. Mechanical allodynia and/or activation of spinal glia were assessed. Initially, laparotomy preceded systemic lipopolysaccharide (LPS). Prior laparotomy caused prolonged microglial (not astrocyte) activation plus enhanced LPS-induced allodynia. In this ""two-hit"" paradigm, minocycline, a microglial activation inhibitor, significantly reduced later exaggerated pain induced by prior surgery when minocycline was administered intrathecally for 5 days starting either at the time of surgery or 5 days before LPS administration. To test generality of the priming effect, subcutaneous formalin preceded intrathecal HIV-1 gp120, which activates spinal microglia and causes robust allodynia. Prior formalin enhanced intrathecal gp120-induced allodynia, suggesting that microglial priming is not limited to laparotomy and again supporting a spinal site of action. Therefore, spinal microglial priming may increase vulnerability to pain enhancement.

Perspective

Spinal microglia may become ""primed"" (sensitized) following their activation by disparate forms of peripheral trauma/inflammation. As a result, such primed microglia may overrespond to subsequent challenges, thereby enhancing pain intensity and duration.",0,1 +1804,Flexibly-Bounded Rationality in Interstate Conflict,"This chapter applies the theory of flexibly bounded rationality to interstate conflict. Flexibly bounded rationality is a theory that states that the bounds prescribed by Herbert Simon in his theory of bounded rationality are flexible. On contextualizing the theory of flexibly bounded rationality, inference, the theory of rational expectation, the theory of rational choice and the theory of rational conterfactuals are described. The theory of flexibly bounded rationality is applied for decision making process. This is done by using a multi-layer perceptron network and particle swarm optimization.",0,1 +1805,Testing Random Effects in the Linear Mixed Model Using Approximate Bayes Factors,"Deciding which predictor effects may vary across subjects is a difficult issue. Standard model selection criteria and test procedures are often inappropriate for comparing models with different numbers of random effects due to constraints on the parameter space of the variance components. Testing on the boundary of the parameter space changes the asymptotic distribution of some classical test statistics and causes problems in approximating Bayes factors. We propose a simple approach for testing random effects in the linear mixed model using Bayes factors. We scale each random effect to the residual variance and introduce a parameter that controls the relative contribution of each random effect free of the scale of the data. We integrate out the random effects and the variance components using closed-form solutions. The resulting integrals needed to calculate the Bayes factor are low-dimensional integrals lacking variance components and can be efficiently approximated with Laplace's method. We propose a default prior distribution on the parameter controlling the contribution of each random effect and conduct simulations to show that our method has good properties for model selection problems. Finally, we illustrate our methods on data from a clinical trial of patients with bipolar disorder and on data from an environmental study of water disinfection by-products and male reproductive outcomes.",0,1 +1806,Nearly unbiased estimators for the three-parameter Weibull distribution with greater efficiency than the iterative likelihood method,"The maximum likelihood estimation (MLE) method is the most commonly used method to estimate the parameters of the three-parameter Weibull distribution. However, it returns biased estimates. In this paper, we show how to calculate weights which cancel the biases contained in the MLE equations. The exact weights can be computed when the population parameters are known and the expected weights when they are not. Two of the three weights' expected values are dependent only on the sample size, whereas the third also depends on the population shape parameters. Monte Carlo simulations demonstrate the practicability of the weighted MLE method. When compared with the iterative MLE technique, the bias is reduced by a factor of 7 (irrespective of the sample size) and the variability of the parameter estimates is also reduced by a factor of 7 for very small sample sizes, but this gain disappears for large sample sizes.",0,1 +1807,Multilevel Modelling of Country Effects: A Cautionary Tale,"Country effects on outcomes for individuals are often analysed using multilevel (hierarchical) models applied to harmonized multi-country data sets such as ESS, EU-SILC, EVS, ISSP, and SHARE. We point out problems with the assessment of country effects that appear not to be widely appreciated, and develop our arguments using Monte Carlo simulation analysis of multilevel linear and logit models. With large sample sizes of individuals within each country but only a small number of countries, analysts can reliably estimate individual-level effects but estimates of parameters summarizing country effects are likely to be unreliable. Multilevel modelling methods are no panacea.",0,1 +1808,On the Role of the Propensity Score in Efficient Semiparametric Estimation of Average Treatment Effects,"In this paper, the role of the propensity score in the efficient estimation of average treatment effects is examined. Under the assumption that the treatment is ignorable given some observed characteristics, it is shown that the propensity score is ancillary for estimation of the average treatment effects. The propensity score is not ancillary for estimation of average treatment effects on the treated. It is suggested that the marginal value of the propensity score lies entirely in the dimension reduction. Efficient semiparametric estimators of average treatment effects and average treatment effects on the treated are shown to take the form of relevant sample averages of the data completed by the nonparametric imputation method. It is shown that the projection on the propensity score is not necessary for efficient semiparametric estimation of average treatment effects on the treated even if the propensity score is known. An application to the experimental data reveals that conditioning on the propensity score may even result in a loss of efficiency.",0,1 +1809,Bayesian and maximum likelihood estimation of hierarchical response time models,"Hierarchical (or multilevel) statistical models have become increasingly popular in psychology in the last few years. In this article, we consider the application of multilevel modeling to the ex-Gaussian, a popular model of response times. We compare single-level and hierarchical methods for estimation of the parameters of ex-Gaussian distributions. In addition, for each approach, we compare maximum likelihood estimation with Bayesian estimation. A set of simulations and analyses of parameter recovery show that although all methods perform adequately well, hierarchical methods are better able to recover the parameters of the ex-Gaussian, by reducing variability in the recovered parameters. At each level, little overall difference was observed between the maximum likelihood and Bayesian methods.",1,1 +1810,Commensurate Priors for Incorporating Historical Information in Clinical Trials Using General and Generalized Linear Models,"Assessing between-study variability in the context of conventional random-effects meta-analysis is notoriously difficult when incorporating data from only a small number of historical studies. In order to borrow strength, historical and current data are often assumed to be fully homogeneous, but this can have drastic consequences for power and Type I error if the historical information is biased. In this paper, we propose empirical and fully Bayesian modifications of the commensurate prior model (Hobbs et al. 2011) extending Pocock (1976), and evaluate their frequentist and Bayesian properties for incorporating patient-level historical data using general and generalized linear mixed regression models. Our proposed commensurate prior models lead to preposterior admissible estimators that facilitate alternative bias-variance trade-offs than those offered by pre-existing methodologies for incorporating historical data from a small number of historical studies. We also provide a sample analysis of a colon cancer trial comparing time-to-disease progression using a Weibull regression model.",0,1 +1811,The College Board computerized placement tests: an application of computerized adaptive testing,,0,1 +1812,Statistical assessment of mediational effects for logistic mediational models,"The concept of mediation has broad applications in medical health studies. Although the statistical assessment of a mediational effect under the normal assumption has been well established in linear structural equation models (SEM), it has not been extended to the general case where normality is not a usual assumption. In this paper, we propose to extend the definition of mediational effects through causal inference. The new definition is consistent with that in linear SEM and does not rely on the assumption of normality. Here, we focus our attention on the logistic mediation model, where all variables involved are binary. Three approaches to the estimation of mediational effects-Delta method, bootstrap, and Bayesian modelling via Monte Carlo simulation are investigated. Simulation studies are used to examine the behaviour of the three approaches. Measured by 95 per cent confidence interval (CI) coverage rate and root mean square error (RMSE) criteria, it was found that the Bayesian method using a non-informative prior outperformed both bootstrap and the Delta methods, particularly for small sample sizes. Case studies are presented to demonstrate the application of the proposed method to public health research using a nationally representative database. Extending the proposed method to other types of mediational model and to multiple mediators are also discussed.",0,1 +1813,Monte Carlo Based Null Distribution for an Alternative Goodness-of-Fit Test Statistic in IRT Models,"Assessing the correspondence between model predictions and observed data is a recommended procedure for justifying the application of an IRT model. However, with shorter tests, current goodness-of-fit procedures that assume precise point estimates of ability, are inappropriate. The present paper describes a goodness-of-fit statistic that considers the imprecision with which ability is estimated and involves constructing item fit tables based on each examinee's posterior distribution of ability, given the likelihood of their response pattern and an assumed marginal ability distribution. However, the posterior expectations that are computed are dependent and the distribution of the goodness-of-fit statistic is unknown. The present paper also describes a Monte Carlo resampling procedure that can be used to assess the significance of the fit statistic and compares this method with a previously used method. The results indicate that the method described herein is an effective and reasonably simple procedure for assessing the validity of applying IRT models when ability estimates are imprecise.",0,1 +1814,"A general structural equation model with dichotomous, ordered categorical, and continuous latent variable indicators","A structural equation model is proposed with a generalized measurement part, allowing for dichotomous and ordered categorical variables (indicators) in addition to continuous ones. A computationally feasible three-stage estimator is proposed for any combination of observed variable types. This approach provides large-sample chi-square tests of fit and standard errors of estimates for situations not previously covered. Two multiple-indicator modeling examples are given. One is a simultaneous analysis of two groups with a structural equation model underlying skewed Likert variables. The second is a longitudinal model with a structural model for multivariate probit regressions.",0,1 +1815,Finite Mixture Modeling with Mixture Outcomes Using the EM Algorithm,"This paper discusses the analysis of an extended finite mixture model where the latent classes corresponding to the mixture components for one set of observed variables influence a second set of observed variables. The research is motivated by a repeated measurement study using a random coefficient model to assess the influence of latent growth trajectory class membership on the probability of a binary disease outcome. More generally, this model can be seen as a combination of latent class modeling and conventional mixture modeling. The EM algorithm is used for estimation. As an illustration, a random-coefficient growth model for the prediction of alcohol dependence from three latent classes of heavy alcohol use trajectories among young adults is analyzed.",0,1 +1816,Pseudo-empirical Bayes estimation of small area means under a nested error linear regression model with functional measurement errors,"Abstract Small area estimation is studied under a nested error linear regression model with area level covariate subject to measurement error. Ghosh and Sinha (2007) obtained a pseudo-Bayes (PB) predictor of a small area mean and a corresponding pseudo-empirical Bayes (PEB) predictor, using the sample means of the observed covariate values to estimate the true covariate values. In this paper, we first derive an efficient PB predictor by using all the available data to estimate true covariate values. We then obtain a corresponding PEB predictor and show that it is asymptotically “optimal”. In addition, we employ a jackknife method to estimate the mean squared prediction error (MSPE) of the PEB predictor. Finally, we report the results of a simulation study on the performance of our PEB predictor and associated jackknife MSPE estimator. Our results show that the proposed PEB predictor can lead to significant gain in efficiency over the previously proposed PEB predictor. Area level models are also studied.",0,1 +1817,Sample Size in Factor Analysis: The Role of Model Error,"This article examines effects of sample size and other design features on correspondence between factors obtained from analysis of sample data and those present in the population from which the samples were drawn. We extend earlier work on this question by examining these phenomena in the situation in which the common factor model does not hold exactly in the population. We present a theoretical framework for representing such lack of fit and examine its implications in the population and sample. Based on this approach we hypothesize that lack of fit of the model in the population will not, on the average, influence recovery of population factors in analysis of sample data, regardless of degree of model error and regardless of sample size. Rather, such recovery will be affected only by phenomena related to sampling error which have been studied previously. These hypotheses are investigated and verified in two sampling studies, one using artificial data and one using empirical data.",0,1 +1818,Bayesian analysis of structural equation models with mixed exponential family and ordered categorical data,"Structural equation models are very popular for studying relationships among observed and latent variables. However, the existing theory and computer packages are developed mainly under the assumption of normality, and hence cannot be satisfactorily applied to non-normal and ordered categorical data that are common in behavioural, social and psychological research. In this paper, we develop a Bayesian approach to the analysis of structural equation models in which the manifest variables are ordered categorical and/or from an exponential family. In this framework, models with a mixture of binomial, ordered categorical and normal variables can be analysed. Bayesian estimates of the unknown parameters are obtained by a computational procedure that combines the Gibbs sampler and the Metropolis-Hastings algorithm. Some goodness-of-fit statistics are proposed to evaluate the fit of the posited model. The methodology is illustrated by results obtained from a simulation study and analysis of a real data set about non-adherence of hypertension patients in a medical treatment scheme.",0,1 +1819,High-Speed Scanning in Human Memory,"When subjects judge whether a test symbol is contained in a short memorized sequence of symbols, their mean reaction-time increases linearly with the length of the sequence. The linearity and slope of the function imply the existence of an internal serial-comparison process whose average rate is between 25 and 30 symbols per second.",0,1 +1820,Estimation of the latent mediated effect with ordinal data using the limited-information and Bayesian full-information approaches,"It is common to encounter latent variables with ordinal data in social or behavioral research. Although a mediated effect of latent variables (latent mediated effect, or LME) with ordinal data may appear to be a straightforward combination of LME with continuous data and latent variables with ordinal data, the methodological challenges to combine the two are not trivial. This research covers model structures as complex as LME and formulates both point and interval estimates of LME for ordinal data using the Bayesian full-information approach. We also combine weighted least squares (WLS) estimation with the bias-corrected bootstrapping (BCB; Efron Journal of the American Statistical Association, 82, 171–185, 1987) method or the traditional delta method as the limited-information approach. We evaluated the viability of these different approaches across various conditions through simulation studies, and provide an empirical example to illustrate the approaches. We found that the Bayesian approach with reasonably informative priors is preferred when both point and interval estimates are of interest and the sample size is 200 or above. © 2014, Psychonomic Society, Inc.",1,1 +1821,Hopes and cautions in implementing Bayesian structural equation modeling.,"Muthén and Asparouhov (2012) have proposed and demonstrated an approach to model specification and estimation in structural equation modeling (SEM) using Bayesian methods. Their contribution builds on previous work in this area by (a) focusing on the translation of conventional SEM models into a Bayesian framework wherein parameters fixed at zero in a conventional model can be respecified using small-variance priors and (b) implementing their approach in software that is widely accessible. We recognize potential benefits for applied researchers as discussed by Muthén and Asparouhov, and we also see a tradeoff in that effective use of the proposed approach introduces increased demands in terms of expertise of users to navigate new complexities in model specification, parameter estimation, and evaluation of results. We also raise cautions regarding the issues of model modification and model fit. Although we see significant potential value in the use of Bayesian SEM, we also believe that effective use will require an awareness of these complexities.",0,1 +1822,An Approximate Distribution of Estimates of Variance Components,,0,1 +1823,A Multidimensional and Multilevel Extension of a Random-Effect Approach to Subjective Judgment in Rating Scales,"In responding to rating scale items, respondents may hold different perspectives on the given categories. The random-effect rating scale model (RERSM), developed to account for variations in the category thresholds across respondents, is unidimensional and unilevel. It becomes statistically inefficient when multiple unidimensional tests have to be analyzed and inapplicable when data have a multilevel structure (e.g., respondents nested within organizations, students nested within schools). To resolve these problems, this study develops a multidimensional and multilevel version of the RERSM. The parameters can be estimated with existing computer software. Thus, there is no need to develop estimation procedures or corresponding computer programs. Simulation studies were conducted to evaluate the parameter recovery of the multidimensional RERSM, the multilevel RERSM, and the multidimensional and multilevel RERSM using WinBUGS. The results showed that the parameter recovery was generally satisfactory. An empirical example of the application of the multidimensional and multilevel RERSM to 2006 Program for International Student Assessment inventories about attitudes toward learning sciences is provided.",0,1 +1824,Multiple roots of estimating functions,en,0,1 +1825,Structural Equation Modeling: A Framework for Ocular and Other Medical Sciences Research,"Structural equation modeling (SEM) is a modeling framework that encompasses many types of statistical models and can accommodate a variety of estimation and testing methods. SEM has been used primarily in social sciences but is increasingly used in epidemiology, public health, and the medical sciences. SEM provides many advantages for the analysis of survey and clinical data, including the ability to model latent constructs that may not be directly observable. Another major feature is simultaneous estimation of parameters in systems of equations that may include mediated relationships, correlated dependent variables, and in some instances feedback relationships. SEM allows for the specification of theoretically holistic models because multiple and varied relationships may be estimated together in the same model. SEM has recently expanded by adding generalized linear modeling capabilities that include the simultaneous estimation of parameters of different functional form for outcomes with different distributions in the same model. Therefore, mortality modeling and other relevant health outcomes may be evaluated. Random effects estimation using latent variables has been advanced in the SEM literature and software. In addition, SEM software has increased estimation options. Therefore, modern SEM is quite general and includes model types frequently used by health researchers, including generalized linear modeling, mixed effects linear modeling, and population average modeling. This article does not present any new information. It is meant as an introduction to SEM and its uses in ocular and other health research.",0,1 +1826,Relative efficacy and safety of simeprevir and telaprevir in treatment-naïve hepatitis C-infected patients in a Japanese population: A Bayesian network meta-analysis,"Simeprevir (SMV) is an oral, once-daily protease inhibitor for the treatment of chronic hepatitis C virus (HCV) genotype 1 infection. In phase II/III randomized controlled trials (RCT) conducted in Japan, SMV, in combination with peginterferon-α and ribavirin (PEG IFN/RBV), demonstrated potent efficacy in HCV genotype 1-infected patients relative to PEG IFN/RBV and was generally well tolerated. Telaprevir (TVR) in combination with PEG IFN/RBV is licensed for the treatment of HCV in Japan. In the absence of head-to-head comparisons of TVR and SMV in a Japanese population, we undertook a network meta-analysis (NMA) to examine the relative efficacy and safety of SMV and TVR in combination with PEG IFN/RBV.A systematic review identified SMV and TVR RCT in Japanese treatment-naïve patients. Bayesian NMA was performed assuming fixed study effects.Three studies met our inclusion criteria: two SMV and one TVR. SMV showed a higher mean odds ratio (OR) of achieving SVR versus TVR (OR, 1.68 (95% credible interval 0.66-4.26)). SMV showed a lower mean OR of discontinuation: overall, 0.35 (0.12-1.00); and due to AE, 0.87 (0.23-3.34) versus TVR. SMV showed a lower mean OR of experiencing anemia 0.20 (0.07-0.56) and rash 0.41 (0.17-0.99) but a higher mean OR of experiencing pruritus 1.26 (0.46-3.47) versus TVR.In this indirect treatment comparison, SMV, in combination with PEG IFN/RBV, showed a favorable risk-benefit profile compared with TVR with PEG IFN/RBV in Japanese treatment-naïve HCV patients.",0,1 +1827,Editor's Introduction,,0,1 +1828,A Monte Carlo Comparison of Estimators for the Multinomial Logit Model,,0,1 +1829,Item Selection Criteria With Practical Constraints for Computerized Classification Testing,"This study compares four item selection criteria for a two-category computerized classification testing: (1) Fisher information (FI), (2) Kullback—Leibler information (KLI), (3) weighted log-odds ratio (WLOR), and (4) mutual information (MI), with respect to the efficiency and accuracy of classification decision using the sequential probability ratio test as well as the extent of item usage. The comparability of the four item selection criteria are examined primarily under three types of item selection conditions: (1) using only the four item selection algorithms, (2) using the four item selection algorithms and content balancing control, and (3) using the four item selection algorithms, content balancing control, and item exposure control. The comparability of the four item selection criteria is also evaluated in two types of proficiency distribution and three levels of indifference region width. The results show that the differences of the four item selection criteria are washed out as more realistic constraints are imposed. Moreover, within two-category classification testing, the use of MI does not necessarily generate greater efficiency than FI, WLOR, and KLI, although MI might seem attractive for its general form of formula in item selection.",0,1 +1830,"Bayesian Methods for Analyzing Structural Equation Models With Covariates, Interaction, and Quadratic Latent Variables","The analysis of interaction among latent variables has received much attention. This article introduces a Bayesian approach to analyze a general structural equation model that accommodates the general nonlinear terms of latent variables and covariates. This approach produces a Bayesian estimate that has the same statistical optimal properties as a maximum likelihood estimate. Other advantages over the traditional approaches are discussed. More important, we demonstrate through examples how to use the freely available software WinBUGS to obtain Bayesian results for estimation and model comparison. Simulation studies are conducted to assess the empirical performances of the approach for situations with various sample sizes and prior inputs.",0,1 +1831,On Estimating Standard Errors in Multilevel Analysis,"Standard errors of maximum likelihood estimators are commonly estimated from the inverse of the information matrix. When the information matrix is a function of parameters, some of which are estimated with little precision, the standard error may be estimated very poorly. This problem is discussed in the context of two-level (random-coefficient) models, and some remedies are proposed.",0,1 +1832,Markov Chain Monte Carlo: Can We Trust the Third Significant Figure?,"Current reporting of results based on Markov chain Monte Carlo computations could be improved. In particular, a measure of the accuracy of the resulting estimates is rarely reported. Thus we have little ability to objectively assess the quality of the reported estimates. We address this issue in that we discuss why Monte Carlo standard errors are important, how they can be easily calculated in Markov chain Monte Carlo and how they can be used to decide when to stop the simulation. We compare their use to a popular alternative in the context of two examples.",0,1 +1833,"The health impact of health care on families: a matched cohort study of hospice use by decedents and mortality outcomes in surviving, widowed spouses","Alternative ways of caring for seriously ill patients might have implications not only for patients' own outcomes, but also, indirectly, for the health outcomes of their family members. Clinical observation suggests that patients who die ""good deaths"" may impose less stress on their spouses. Consequently, we sought to assess whether hospice use by a decedent is associated with decreased risk of death in surviving, bereaved spouses. We conducted a matched retrospective cohort study involving a population-based sample of 195,553 elderly couples in the USA. A total of 30,838 couples where the decedent used hospice care were matched using the propensity score method to 30,838 couples where the decedent did not use hospice care. Our principal outcome of interest was the duration of survival of bereaved widow/ers. After adjustment for other measured variables, 5.4% of bereaved wives died by 18 months after the death of their husband when their deceased husband did not use hospice and 4.9% died when their deceased husband did use hospice, yielding an odds ratio (OR) of 0.92 (95% CI: 0.84-0.99) in favor of hospice use. Similarly, whereas 13.7% of bereaved husbands died by 18 months when their deceased wife did not use hospice, 13.2% died when their deceased wife did use hospice, yielding an OR of 0.95 (95% CI: 0.84-1.06) in favor of hospice use. Our findings suggest a possible beneficial impact of hospice--as a particularly supportive type of end-of-life care--on the spouses of patients who succumb to their disease. Hospice care might attenuate the ordinarily increased mortality associated with becoming widowed. This effect is present in both men and women, but it is statistically significant and possibly larger in bereaved wives. The size of this effect is comparable to the reductions in the risk of death seen in a variety of other modifiable risk factors in women. Health care may have positive, group-level health ""externalities"": it may affect the health not only of patients but also of patients' family members.",0,1 +1834,Classroom Effects on Children’s Achievement Trajectories in Elementary School,"This nonexperimental, longitudinal field study examines the extent to which variation in observed classroom supports (quality of emotional and instructional interactions and amount of exposure to literacy and math activities) predicts trajectories of achievement in reading and math from 54 months to fifth grade. Growth mixture modeling detected two latent classes of readers: fast readers whose skills developed rapidly and leveled off, and a typical group for which reading growth was somewhat less rapid. Only one latent class was identified for math achievement. For reading, there were small positive associations between observed emotional quality of teacher-child interactions and growth. Growth in math achievement showed small positive relations with observed emotional interactions and exposure to math activities. There was a significant interaction between quality and quantity of instruction for reading such that at higher levels of emotional quality there was less of a negative association between amount of literacy exposure and reading growth.",0,1 +1835,An item response model for Likert-type data that incorporates response time in personality measurements,"This study defines a measurement index for the differences in response probabilities to an item. Based on the difference index, a probability–difficulty (PD) hypothesis is proposed. A general framework for modelling responses and response times (RTs) on Likert-type personality items is presented, in which the submodel describing the item responses can be a graded item response theory model, and the submodel describing RTs is developed based on the PD hypothesis. This framework is exemplified by employing the generalized partial credit model for responses and a log-normal model for RTs. Furthermore, Bayesian methods for estimating model parameters and for assessing the model–data fit are described. A simulation study shows that the new approach improves the accuracy of estimating the individual trait levels with the ancillary information contained in RTs. Finally, the applicability of our approach is illustrated by an empirical example in personality measurements.",0,1 +1836,"The Rasch model, additive conjoint measurement, and new models of probabilistic measurement theory.","This research describes some of the similarities and differences between additive conjoint measurement (a type of fundamental measurement) and the Rasch model. It seems that there are many similarities between the two frameworks, however, their differences are nontrivial. For instance, while conjoint measurement specifies measurement scales using a data-free, non-numerical axiomatic frame of reference, the Rasch model specifies measurement scales using a numerical frame of reference that is, by definition, data dependent. In order to circumvent difficulties that can be realistically imposed by this data dependence, this research formalizes new non-parametric item response models. These models are probabilistic measurement theory models in the sense that they explicitly integrate the axiomatic ideas of measurement theory with the statistical ideas of order-restricted inference and Markov Chain Monte Carlo. The specifications of these models are rather flexible, as they can represent any one of several models used in psychometrics, such as Mokken's (1971) monotone homogeneity model, Scheiblechner's (1995) isotonic ordinal probabilistic model, or the Rasch (1960) model. The proposed non-parametric item response models are applied to analyze both real and simulated data sets.",0,1 +1837,Monotonicity of effect sizes: Questioning kappa-squared as mediation effect size measure.,"Mediation analysis is important for research in psychology and other social and behavioral sciences. Great progress has been made in testing mediation effects and in constructing their confidence intervals. Mediation effect sizes have also been considered. Preacher and Kelley (2011) proposed and recommended κ² as an effect size measure for a mediation effect. In this article, we argue that κ² is not an appropriate effect size measure for mediation models, because of its lack of the property of rank preservation (e.g., the magnitude of κ² may decrease when the mediation effect that κ² represents increases). Furthermore, κ² can lead to paradoxical results in multiple mediation models. We show that the problem of κ² is due to (a) the improper calculation of the maximum possible value of the indirect effect, and (b) mathematically, the maximum possible indirect effect is infinity, implying that the definition of κ² is mathematically incorrect. At this time, it appears that the traditional mediation effect size measure PM (the ratio of the indirect effect to the total effect), together with some other statistical information, should be preferred for basic mediation models. But for inconsistent mediation models where the indirect effect and the direct effect have opposite signs, the situation is less clear. Other considerations and suggestions for future research are also discussed.",0,1 +1838,The Effects of School Work Pressure on Depression and Substance Use: A Cross-National Study of School-Aged Children in Canada and Finland,,0,1 +1839,The typification of Hispanics as criminals and support for punitive crime control policies,"The Hispanic population is now the largest and fastest growing minority in the United States, so it is not surprising that ethnic threat linked to Hispanics has been associated with harsher crime control. While minority threat research has found that individuals who associate blacks with crime are more likely to support harsh criminal policies, the possibility that this relationship exists for those who typify Hispanics as criminal has yet to be examined. Using a national random sample, this study is the first to use HLM to find that perceptions of Hispanics as criminals do increase support for punitive crime control measures, controlling for various individual and state influences. Moderated and contextual analyses indicate this relationship is most applicable for individuals who are less apt to typify criminals as black, less prejudiced, less fearful of victimization, politically liberal or moderate, not parents, and living in states with relatively fewer Latin American immigrants.",0,1 +1840,A Bayesian propensity score adjustment for latent variable modeling and MCMC algorithm,"The estimation of the differences among groups in observational studies is frequently inaccurate owing to a bias caused by differences in the distributions of covariates. In order to estimate the average treatment effects when the treatment variable is binary, Rosenbaum and Rubin [1983. The central role of the propensity score in observational studies for causal effects. Biometrika 70, 41-55] proposed an adjustment method for pre-treatment variables using propensity scores. Imbens [2000. The role of the propensity score in estimating dose-response functions. Biometrika 87, 706-710] extended the propensity score methodology for estimation of average treatment effects with multivalued treatments. However, these studies focused only on estimating the marginal mean structure. In many substantive sciences such as the biological and social sciences, a general estimation method is required to deal with more complex analyses other than regression, such as testing group differences on latent variables. For latent variable models, the EM algorithm or the traditional Monte Carlo methods are necessary. However, in propensity score adjustment, these methods cannot be used because the full distribution is not specified. In this paper, we propose a quasi-Bayesian estimation method for general parametric models that integrate out the distributions of covariates using propensity scores. Although the proposed Bayes estimates are shown to be consistent, they can be calculated by existing Markov chain Monte Carlo methods such as Gibbs sampler. The proposed method is useful to estimate parameters in latent variable models, while the previous methods were unable to provide valid estimates for complex models such as latent variable models. We also illustrated the procedure using the data obtained from the US National Longitudinal Survey of Children and Youth (NLSY1979-2002) for estimating the effect of maternal smoking during pregnancy on the development of the child's cognitive functioning.",0,1 +1841,Interpersonal Perception: A Social Relations Analysis,"Seven basic research questions in interpersonal perception are posed concerning issues of consensus, assimilation, reciprocity, accuracy, congruence, assumed similarity and self—other agreement. All questions can be addressed at the individual level, and three at the dyadic level. It is shown how the Social Relations Model can be used to answer the questions.",0,1 +1842,Doubly-Latent Models of School Contextual Effects: Integrating Multilevel and Structural Equation Approaches to Control Measurement and Sampling Error,"This article is a methodological-substantive synergy. Methodologically, we demonstrate latent-variable contextual models that integrate structural equation models (with multiple indicators) and multilevel models. These models simultaneously control for and unconfound measurement error due to sampling of items at the individual (L1) and group (L2) levels and sampling error due the sampling of persons in the aggregation of L1 characteristics to form L2 constructs. We consider a set of models that are latent or manifest in relation to sampling items (measurement error) and sampling of persons (sampling error) and discuss when different models might be most useful. We demonstrate the flexibility of these 4 core models by extending them to include random slopes, latent (single-level or cross-level) interactions, and latent quadratic effects. Substantively we use these models to test the big-fish-little-pond effect (BFLPE), showing that individual student levels of academic self-concept (L1-ASC) are positively associated with individual level achievement (L1-ACH) and negatively associated with school-average achievement (L2-ACH)-a finding with important policy implications for the way schools are structured. Extending tests of the BFLPE in new directions, we show that the nonlinear effects of the L1-ACH (a latent quadratic effect) and the interaction between gender and L1-ACH (an L1 × L1 latent interaction) are not significant. Although random-slope models show no significant school-to-school variation in relations between L1-ACH and L1-ASC, the negative effects of L2-ACH (the BFLPE) do vary somewhat with individual L1-ACH. We conclude with implications for diverse applications of the set of latent contextual models, including recommendations about their implementation, effect size estimates (and confidence intervals) appropriate to multilevel models, and directions for further research in contextual effect analysis.",0,1 +1843,A Systematic Review of Endophthalmitis after Microincisional versus 20-Gauge Vitrectomy,"Endophthalmitis is a rare but severe complication of vitrectomy.Post-surgical endophthalmitis is suspected to be more frequent after microincisional (23- and 25-gauge) compared with standard (20-gauge) vitrectomy.We conducted a systematic review of studies that compared microincisional and standard vitrectomy by searching MEDLINE and EMBASE up to November 2012. We used the Bayesian meta-analysis method to compute the odds ratio (OR) of endophthalmitis. We conducted subgroup analyses to compare the effect of different incision types and use of perioperative antibiotics.We identified 3 small randomized and 18 nonrandomized studies that reported 68 cases of endophthalmitis in 148 643 participants. The overall OR of endophthalmitis for microincisional versus standard vitrectomy was 2.3 (95% credible interval [CrI], 0.8-5.8). We found an increased risk of endophthalmitis using a microincisional straight approach compared with standard vitrectomy (OR, 15.1; 95% CrI, 2.01-179), but not for a beveled approach (OR, 0.82; 95% CrI, 0.23-2.28). The OR of studies that reported on mixed microincision was between these 2 values (OR, 4.4; 95% CrI, 1.32-14.3). We estimated that the overall rate of endophthalmitis with 20-gauge vitrectomy was 3 cases in 10 000 procedures, and the probability that a beveled microincision increases the rate of endophthalmitis to more than 6 or 9 events was small (no more than 5% or 1%, respectively).We did not find an increased risk of endophthalmitis for microincisional vitrectomy compared with standard vitrectomy. The beveled approach seems to be safer than a straight approach, supporting the current recommendation of its adoption in microincisional vitrectomy. However, these findings must be interpreted cautiously because of the small number of endophthalmitis events reported from included studies.",0,1 +1844,A Probabilistic Palimpsest Model of Visual Short-term Memory,"Working memory plays a key role in cognition, and yet its mechanisms remain much debated. Human performance on memory tasks is severely limited; however, the two major classes of theory explaining the limits leave open questions about key issues such as how multiple simultaneously-represented items can be distinguished. We propose a palimpsest model, with the occurrent activity of a single population of neurons coding for several multi-featured items. Using a probabilistic approach to storage and recall, we show how this model can account for many qualitative aspects of existing experimental data. In our account, the underlying nature of a memory item depends entirely on the characteristics of the population representation, and we provide analytical and numerical insights into critical issues such as multiplicity and binding. We consider representations in which information about individual feature values is partially separate from the information about binding that creates single items out of multiple features. An appropriate balance between these two types of information is required to capture fully the different types of error seen in human experimental data. Our model provides the first principled account of misbinding errors. We also suggest a specific set of stimuli designed to elucidate the representations that subjects actually employ.",0,1 +1845,Adaptive Rejection Metropolis Sampling within Gibbs Sampling,"Gibbs sampling is a powerful technique for statistical inference. It involves little more than sampling from full conditional distributions, which can be both complex and computationally expensive to evaluate. Gilks and Wild have shown that in practice full conditionals are often log‐concave, and they proposed a method of adaptive rejection sampling for efficiently sampling from univariate log‐concave distributions. In this paper, to deal with non‐log‐concave full conditional distributions, we generalize adaptive rejection sampling to include a Hastings‐Metropolis algorithm step. One important field of application in which statistical models may lead to non‐log‐concave full conditionals is population pharmacokinetics. Here, the relationship between drug dose and blood or plasma concentration in a group of patients typically is modelled by using nonlinear mixed effects models. Often, the data used for analysis are routinely collected hospital measurements, which tend to be noisy and irregular. Consequently, a robust (t‐distributed) error structure is appropriate to account for outlying observations and/or patients. We propose a robust nonlinear full probability model for population pharmacokinetic data. We demonstrate that our method enables Bayesian inference for this model, through an analysis of antibiotic administration in new‐born babies.",0,1 +1846,Sensitivity of Fit Indexes to Misspecified Structural or Measurement Model Components: Rationale of Two-Index Strategy Revisited,"In previous research (Hu & Bentler, 1998, 1999), 2 conclusions were drawn: standardized root mean squared residual (SRMR) was the most sensitive to misspecified factor covariances, and a group of other fit indexes were most sensitive to misspecified factor loadings. Based on these findings, a 2-index strategy-that is, SRMR coupled with another index-was proposed in model fit assessment to detect potential misspecification in both the structural and measurement model parameters. Based on our reasoning and empirical work presented in this article, we conclude that SRMR is not necessarily most sensitive to misspecified factor covariances (structural model misspecification), the group of indexes (TLI, BL89, RNI, CFI, Gamma hat, Mc, or RMSEA) are not necessarily more sensitive to misspecified factor loadings (measurement model misspecification), and the rationale for the 2-index presentation strategy appears to have questionable validity.",0,1 +1847,Healthcare service quality: what really matters to the female patient?,Purpose – This paper aims to develop a model that encompasses the constructs and sub-constructs consumers use in evaluating healthcare service quality (HSQ) in Egypt. Design/methodology/approach – Factor analysis was performed on 40 variables to identify the constructs. Ordinal logistic regression was also used to identify the sub-constructs and examine the effect of each sub-construct on patients’ overall perception of service quality. Findings – Factor analysis confirmed an eight-construct framework: hospital premises and employees; doctor medical service; nursing medical service; diagnostic medical service; admission; discharge; rooms and housekeeping; and meals. Ordinal logistic regression established 17 sub-constructs – physician reliability; physician assurance; physician interaction; physician’s competence; nursing tangibles; nursing reliability; nursing assurance; nursing interaction; nursing responsiveness; diagnostic service competence; diagnostic service reliability; hospital premises and employees tangibles; admission responsiveness; admission knowledge and courtesy; meals tangibles; rooms tangibles and housekeeping courtesy; and discharge knowledge and courtesy – that have significant effect on HSQ. Some sub-constructs had a significantly greater impact on overall perception of service quality than others. Practical implications – Healthcare providers will be able to pinpoint areas of service quality shortfall and better satisfy their patients. This will ultimately lead to repeat patronage and positive recommendation behavior. Originality/value – The model is the first comprehensive model in the Middle East that takes into account all constructs and sub-constructs patients use for evaluation of HSQ.,0,1 +1848,Prediction interval for disease mapping using hierarchical likelihood,"In disease mapping, the Bayesian approach is widely used for forming the prediction interval of relative risks. In this paper we propose a hierarchical-likelihood interval for disease mapping, which accounts for the inflation of standard error estimates caused by uncertainty in the estimation of the fixed parameters. Comparison is made with the Bayesian prediction intervals derived from penalized quasi-likelihood and fully Bayesian methods. Through simulation studies, we show that prediction intervals for random effects using hierarchical likelihood maintains the required level. © 2010 Springer-Verlag.",0,1 +1849,A hierarchical bayesian statistical framework for response time distributions,"This paper provides a statistical framework for estimating higher-order characteristics of the response time distribution, such as the scale (variability) and shape. Consideration of these higher order characteristics often provides for more rigorous theory development in cognitive and perceptual psychology (e.g., Luce, 1986). RT distribution for a single participant depends on certain participant characteristics, which in turn can be thought of as arising from a distribution of latent variables. The present work focuses on the three-parameter Weibull distribution, with parameters for shape, scale, and shift (initial value). Bayesian estimation in a hierarchical framework is conceptually straightforward. Parameter estimates, both for participant quantities and population parameters, are obtained through Markov Chain Monte Carlo methods. The methods are illustrated with an application to response time data in an absolute identification task. The behavior of the Bayes estimates are compared to maximum likelihood (ML) estimates through Monte Carlo simulations. For small sample size, there is an occasional tendency for the ML estimates to be unreasonably extreme. In contrast, by borrowing strength across participants, Bayes estimation “shrinks” extreme estimates. The results are that the Bayes estimators are more accurate than the corresponding ML estimators.",0,1 +1850,The Great Smoky Mountains Study: developmental epidemiology in the southeastern United States,"To describe the Great Smoky Mountains Study (GSMS).GSMS is a longitudinal study of child psychiatric disorders that began in 1992 to look at need for mental health services in a rural area of the USA. Over 20 years it has expanded its range to include developmental epidemiology more generally, not only the development of psychiatric and substance abuse problems but also their correlates and predictors: family and environmental risk, physical development including puberty, stress and stress-related hormones, trauma, the impact of poverty, genetic markers, and epigenetics. Now that participants are in their 30s the focus has shifted to adult outcomes of childhood psychopathology and risk, and early physical, cognitive, and psychological markers of aging.This paper describes the results from over 11,000 interviews, examples of the study's contributions to science and policy, and plans for the future.Longitudinal studies can provide insights that aid in policy planning.",0,1 +1851,Ethnic Diversity and Generalized Trust in Europe,"While most current research documents a negative relation between ethnic diversity and generalized trust, it has to be acknowledged that these results often originate from one-country analyses in North America. In this article, attitudinal measurements from the European Social Survey are combined with Organization for Economic Co-Operation and Development data on migration patterns, thus examining the relationship between diversity and trust in a comparative manner across 20 European countries. More fine-grained measurements of diversity (including type and rise of diversity over time and legal status of immigrants) are included in a multilevel model. At the individual level, most of the familiar relations were confirmed. At the country level, hardly any indicators for migration or diversity proved to be strongly and consistently related to generalized trust. Results suggest that the pessimistic conclusions about the negative effects of ethnic diversity on generalized trust cannot be confirmed at the aggregate level across European countries.",0,1 +1852,Morbidity and mortality in Brazilian municipalities: a multilevel study of the association between socioeconomic and healthcare indicators,"Socioeconomic and healthcare indicators are major determinants of health outcomes. The impact of social and healthcare inequalities on Brazilian morbidity and mortality indicators is of concern but it is not well studied.A multilevel ecological study was performed in order to investigate the association between a set of socioeconomic and healthcare indicators and five morbidity and mortality outcomes. Datasets were presented at three hierarchical levels: local (lower level), regional (intermediate level) and state (higher level). A Poisson regression model was estimated for each outcome with random intercept and fixed regression coefficients for independent variables at the three levels. The magnitude of outcome variability at intermediate and higher levels was assessed for all models.All outcomes were associated with both socioeconomic and healthcare variables, with predominance of associations at the local level. General and high-complexity healthcare infrastructures were directly associated with indicators related to later stages of the demographic and epidemiological transition process. A mild effect on morbidity and mortality related to political voting patterns was found at the local level.Healthcare conditions and socioeconomic indicators are associated with health outcomes in a complex way at the local level in Brazil, but part of the variability of health outcomes is related to factors operating at higher levels. Some possible interaction effects and cross-sectional design limitations of this study must be considered.",0,1 +1853,Biological Mediators of Effect of Diet and Stress Reduction on Prostate Cancer,"Background. A 6-month pilot intervention trial was conducted to determine whether adoption of a plant-based diet, reinforced by stress reduction, could reduce the rate of prostate-specific antigen (PSA) increase, a marker of disease progression, in asymptomatic, hormonally untreated patients experiencing consistently increasing PSA levels after surgery or radiation. Methods. A pre—post design was used to examine (1) the effect of intervention on potential mediators of disease progression, including body composition and weight-related biomarkers (sex steroid hormones and cytokines), and (2) whether changes in these variables were associated with change in rate of PSA increase. The baseline rate of PSA increase (from the time of posttreatment recurrence to the start of intervention) was ascertained from medical records. Body composition and biomarkers were assessed at baseline (prior to intervention), during the intervention (3 months), and at the end of the intervention (6 months). Changes in body composition and biomarkers were determined and compared with rates of PSA increase over the corresponding time intervals. Results. There was a significant reduction in waist-to-hip ratio ( P = .03) and increase in circulating sex hormone binding globulin ( P = .04). The rate of PSA increase decreased from the preintervention period (PSA slope = 0.059) to the period from 0 to 3 months (PSA slope = 0.002, P < .01) and increased slightly, although not significantly, from 0 to 3 months to the period from 3 to 6 months (0.029, P = .43). Conclusions. Adoption of a plant-based diet and stress reduction may reduce central adiposity and improve the hormonal milieu in patients with recurrent PC. Changes in the rate of increase in PSA were in the same direction as changes in waist-to-hip ratio and opposite those of sex hormone binding globulin, raising the possibility that the effect of the intervention may have been mediated, in part, by these variables.",0,1 +1854,How should meta-regression analyses be undertaken and interpreted?,"Appropriate methods for meta-regression applied to a set of clinical trials, and the limitations and pitfalls in interpretation, are insufficiently recognized. Here we summarize recent research focusing on these issues, and consider three published examples of meta-regression in the light of this work. One principal methodological issue is that meta-regression should be weighted to take account of both within-trial variances of treatment effects and the residual between-trial heterogeneity (that is, heterogeneity not explained by the covariates in the regression). This corresponds to random effects meta-regression. The associations derived from meta-regressions are observational, and have a weaker interpretation than the causal relationships derived from randomized comparisons. This applies particularly when averages of patient characteristics in each trial are used as covariates in the regression. Data dredging is the main pitfall in reaching reliable conclusions from meta-regression. It can only be avoided by prespecification of covariates that will be investigated as potential sources of heterogeneity. However, in practice this is not always easy to achieve. The examples considered in this paper show the tension between the scientific rationale for using meta-regression and the difficult interpretative problems to which such analyses are prone.",0,1 +1855,MCMC for nonlinear hierarchical models,,0,1 +1856,THE BIG FIVE PERSONALITY DIMENSIONS AND JOB PERFORMANCE: A META-ANALYSIS,"This study investigated the relation of the “Big Five” personality dimensions (Extraversion, Emotional Stability, Agreeableness, Conscientiousness, and Openness to Experience) to three job performance criteria (job proficiency, training proficiency, and personnel data) for five occupational groups (professionals, police, managers, sales, and skilled/semi-skilled). Results indicated that one dimension of personality, Conscientiousness, showed consistent relations with all job performance criteria for all occupational groups. For the remaining personality dimensions, the estimated true score correlations varied by occupational group and criterion type. Extraversion was a valid predictor for two occupations involving social interaction, managers and sales (across criterion types). Also, both Openness to Experience and Extraversion were valid predictors of the training proficiency criterion (across occupations). Other personality dimensions were also found to be valid predictors for some occupations and some criterion types, but the magnitude of the estimated true score correlations was small (ρ < .10). Overall, the results illustrate the benefits of using the 5-factor model of personality to accumulate and communicate empirical findings. The findings have numerous implications for research and practice in personnel psychology, especially in the subfields of personnel selection, training and development, and performance appraisal.",0,1 +1857,Evidence that exogenous and endogenous fractalkine can induce spinal nociceptive facilitation in rats,"Recent evidence suggests that spinal cord glia can contribute to enhanced nociceptive responses. However, the signals that cause glial activation are unknown. Fractalkine (CX3C ligand-1; CX3CL1) is a unique chemokine expressed on the extracellular surface of spinal neurons and spinal sensory afferents. In the dorsal spinal cord, fractalkine receptors are primarily expressed by microglia. As fractalkine can be released from neurons upon strong activation, it has previously been suggested to be a neuron-to-glial signal that induces glial activation. The present series of experiments provide an initial investigation of the spinal pain modulatory effects of fractalkine. Intrathecal fractalkine produced dose-dependent mechanical allodynia and thermal hyperalgesia. In addition, a single injection of fractalkine receptor antagonist (neutralizing antibody against rat CX3C receptor-1; CX3CR1) delayed the development of mechanical allodynia and/or thermal hyperalgesia in two neuropathic pain models: chronic constriction injury (CCI) and sciatic inflammatory neuropathy. Intriguingly, anti-CX3CR1 reduced nociceptive responses when administered 5–7 days after CCI, suggesting that prolonged release of fractalkine may contribute to the maintenance of neuropathic pain. Taken together, these initial investigations of spinal fractalkine effects suggest that exogenous and endogenous fractalkine are involved in spinal sensitization, including that induced by peripheral neuropathy.",0,1 +1858,Posterior Predictive Assessment of Item Response Theory Models,"Model checking in item response theory (IRT) is an underdeveloped area. There is no universally accepted tool for checking IRT models. The posterior predictive model-checking method is a popular Bayesian model-checking tool because it has intuitive appeal, is simple to apply, has a strong theoretical basis, and can provide graphical or numerical evidence about model misfit. An important issue with the application of the posterior predictive model-checking method is the choice of a discrepancy measure (which plays a role like that of a test statistic in traditional hypothesis tests). This article examines the performance of a number of discrepancy measures for assessing different aspects of fit of the common IRT models and makes specific recommendations about what measures are most useful in assessing model fit. Graphical summaries of model-checking results are demonstrated to provide useful insights about model fit.",0,1 +1859,Applied Longitudinal Data Analysis,"Abstract Change is constant in everyday life. Infants crawl and then walk, children learn to read and write, teenagers mature in myriad ways, and the elderly become frail and forgetful. Beyond these natural processes and events, external forces and interventions instigate and disrupt change: test scores may rise after a coaching course, drug abusers may remain abstinent after residential treatment. By charting changes over time and investigating whether and when events occur, researchers reveal the temporal rhythms of our lives. This book is concerned with behavioral, social, and biomedical sciences. It offers a presentation of two of today's most popular statistical methods: multilevel models for individual change and hazard/survival models for event occurrence (in both discrete- and continuous-time). Using data sets from published studies, the book takes you step by step through complete analyses, from simple exploratory displays that reveal underlying patterns through sophisticated specifications of complex statistical models.",0,1 +1860,Dimensions of Family Policy and Female Labor Market Participation: Analyzing Group-Specific Policy Effects,"This article investigates whether and how family policy influences the probability and intensity of mothers' labor market participation. Unlike previous studies, this contribution focuses on group-specific policy effects, thereby accounting for the fact that, theoretically, women with different resources and preferences should respond differently to given policy measures. The analyses show that varying individual characteristics indeed influence the impact family policy measures have on women's individual behavior. First and foremost, family policies most strongly influence mothers with medium levels of education, for whom labor market participation tends to be “optional.” Moreover, high direct and indirect cash benefits to families, which primarily stem from traditional conservative family policy, reduce the probability of employment for women with low to medium levels of education.",0,1 +1861,Relational information in visual short-term memory: The structural gist,"Over the past 20 years, storage of visual items in visual short-term memory has been extensively studied by many research groups. In addition to questions concerning the format of object storage is a more global question that focuses on the organization of information in visual short-term memory. In a series of experiments we investigated how relations across visual items determined the accessibility of individual item information. This relational information seems to be very strong within the store devoted to each feature dimension. We also investigated the role of selective attention on the storage of relational information. The experiments suggest a broadening of the parallel store model of visual short-term memory proposed by M. E. Wheeler and A. M. Treisman (2002) to include the notion of what we call ""structural gist.""",0,1 +1862,"Modeling covariance matrices in terms of standard deviations and correlations, with application to shrinkage","The covariance matrix plays an important role in statistical inference, yet modeling a covariance matrix is often a difficult task in practice due to its dimensionality and the non-negative definite constraint. In order to model a co- variance matrix effectively, it is typically broken down into components based on modeling considerations or mathematical convenience. Decompositions that have received recent research attention include variance components, spectral decompo- sition, Cholesky decomposition, and matrix logarithm. In this paper we study a statistically motivated decomposition which appears to be relatively unexplored for the purpose of modeling. We model a covariance matrix in terms of its correspond- ing standard deviations and correlation matrix. We discuss two general modeling situations where this approach is useful: shrinkage estimation of regression co- efficients, and a general location-scale model for both categorical and continuous variables. We present some simple choices for priors in terms of standard deviations and the correlation matrix, and describe a straightforward computational strategy for obtaining the posterior of the covariance matrix. We apply our method to real and simulated data sets in the context of shrinkage estimation.",0,1 +1863,Rifampin inhibits Toll‐like receptor 4 signaling by targeting myeloid differentiation protein 2 and attenuates neuropathic pain,"Rifampin has been used for the treatment of bacterial infections for many years. Clinically, rifampin has been found to possess immunomodulatory effects. However, the molecular target responsible for the immunosuppressive effects of rifampin is not known. Herein, we show that rifampin binds to myeloid differentiation protein 2 (MD-2), the key coreceptor for innate immune TLR4. Rifampin blocked TLR4 signaling induced by LPS, including NF-κB activation and the overproduction of proinflammatory mediators nitric oxide, interleukin 1β, and tumor necrosis factor α in mouse microglia BV-2 cells and macrophage RAW 264.7 cells. Rifampin's inhibition of TLR4 signaling was also observed in immunocompetent rat primary macrophage, microglia, and astrocytes. Further, we show that rifampin (75 or 100 mg/kg b.i.d. for 3 d, intraperitoneal) suppressed allodynia induced by chronic constriction injury of the sciatic nerve and suppressed nerve injury-induced activation of microglia. Our findings indicate that MD-2 is a important target of rifampin in its inhibition of innate immune function and contributes to its clinically observed immune-suppressive effect. The results also suggest that rifampin may be repositioned as an agent for the treatment of neuropathic pain.",0,1 +1864,Modeling visual working memory with the MemToolbox,"The MemToolbox is a collection of MATLAB functions for modeling visual working memory. In support of its goal to provide a full suite of data analysis tools, the toolbox includes implementations of popular models of visual working memory, real and simulated data sets, Bayesian and maximum likelihood estimation procedures for fitting models to data, visualizations of data and fit, validation routines, model comparison metrics, and experiment scripts. The MemToolbox is released under the permissive BSD license and is available at http://memtoolbox.org.",0,1 +1865,HIERARCHICAL BAYESIAN MODELLING OF SOCIAL VARIATION IN THE AGE DEPENDENCE OF DISABILITY PREVALENCE,"Summary Motivated by a study of social variation in the relationship of functional limitation prevalence to age, this paper examines methods for modelling social variation in health outcomes. It is argued that, from a Bayesian perspective, modelling the dependence of functional limitation prevalence on age separately for each social group, corresponds to an implausible prior model, in addition to leading to imprecise estimates for some groups. The alternative strategy of fitting a single model, perhaps including some age-by-group interactions but omitting higher-order interactions, requires a strong prior commitment to the absence of such effects. Hierarchical Bayesian modelling is proposed as a compromise between these two analytical approaches. Under all hierarchical Bayes analyses there is strong evidence for an ethnic group difference in limitation prevalence in early- to mid-adulthood among tertiary-qualified males. In contrast, the single-model approach largely misses this effect, while the group-specific analyses exhibit an unrealistically large degree of heterogeneity in gender-education-specific ethnicity effects. The sensitivity of posterior inferences to prior specifications is studied.",0,1 +1866,Citizens as veto players: climate change policy and the constraints of direct democracy,"The search for and implementation of effective climate change policies is one of the crucial challenges of policy-makers. One strand of literature argues that domestic factors and in particular institutional prerequisites or veto points strongly influence the quality and pace of a country's policy innovation and adaptation. Focusing on a particular institutional veto point – direct democracy – how does direct democracy influence a country's adaptive capacity in the areas of climate change and, more precisely, what kind of climate change policies have the best chances to be accepted in citizen's direct decision-making? The analyses demonstrate that direct democracy makes it difficult to implement far-reaching, but probably most effective climate change policies, while its direct and indirect impact on the policy-making process rather produces politics of small steps that are supported by a broad political elite.",0,1 +1867,Bayesian Analysis for the Social Sciences,"List of Figures. List of Tables. Preface. Acknowledgments. Introduction. Part I: Introducing Bayesian Analysis. 1. The foundations of Bayesian inference. 1.1 What is probability? 1.2 Subjective probability in Bayesian statistics. 1.3 Bayes theorem, discrete case. 1.4 Bayes theorem, continuous parameter. 1.5 Parameters as random variables, beliefs as distributions. 1.6 Communicating the results of a Bayesian analysis. 1.7 Asymptotic properties of posterior distributions. 1.8 Bayesian hypothesis testing. 1.9 From subjective beliefs to parameters and models. 1.10 Historical note. 2. Getting started: Bayesian analysis for simple models. 2.1 Learning about probabilities, rates and proportions. 2.2 Associations between binary variables. 2.3 Learning from counts. 2.4 Learning about a normal mean and variance. 2.5 Regression models. 2.6 Further reading. Part II: Simulation Based Bayesian Analysis. 3. Monte Carlo methods. 3.1 Simulation consistency. 3.2 Inference for functions of parameters. 3.3 Marginalization via Monte Carlo integration. 3.4 Sampling algorithms. 3.5 Further reading. 4. Markov chains. 4.1 Notation and definitions. 4.2 Properties of Markov chains. 4.3 Convergence of Markov chains. 4.4 Limit theorems for Markov chains. 4.5 Further reading. 5. Markov chain Monte Carlo. 5.1 Metropolis-Hastings algorithm. 5.2 Gibbs sampling. 6. Implementing Markov chain Monte Carlo. 6.1 Software for Markov chain Monte Carlo. 6.2 Assessing convergence and run-length. 6.3 Working with BUGS/JAGS from R. 6.4 Tricks of the trade. 6.5 Other examples. 6.6 Further reading. Part III: Advanced Applications in the Social Sciences. 7. Hierarchical Statistical Models. 7.1 Data and parameters that vary by groups: the case for hierarchical modeling. 7.2 ANOVA as a hierarchical model. 7.3 Hierarchical models for longitudinal data. 7.4 Hierarchical models for non-normal data. 7.5 Multi-level models. 8. Bayesian analysis of choice making. 8.1 Regression models for binary responses. 8.2 Ordered outcomes. 8.3 Multinomial outcomes. 8.4 Multinomial probit. 9. Bayesian approaches to measurement. 9.1 Bayesian inference for latent states. 9.2 Factor analysis. 9.3 Item-response models. 9.4 Dynamic measurement models. Part IV: Appendices. Appendix A: Working with vectors and matrices. Appendix B: Probability review. B.1 Foundations of probability. B.2 Probability densities and mass functions. B.3 Convergence of sequences of random variabales. Appendix C: Proofs of selected propositions. C.1 Products of normal densities. C.2 Conjugate analysis of normal data. C.3 Asymptotic normality of the posterior density. References. Topic index. Author index.",0,1 +1868,Modeling Nonlinear Structural Equation Models: A Comparison of the Two-Stage Generalized Additive Models and the Finite Mixture Structural Equation Model,"Researchers have devoted some time and effort to developing methods for fitting nonlinear relationships among latent variables. In particular, most of these have focused on correctly modeling interactions between 2 exogenous latent variables, and quadratic relationships between exogenous and endogenous variables. All of these approaches require prespecification of the nonlinearity by the researcher, and are limited to fairly simple nonlinear relationships. Other work has been done using mixture structural equation models (SEMM) in an attempt to fit more complex nonlinear relationships. This study expands on this earlier work by introducing the 2-stage generalized additive model (2SGAM) approach for fitting regression splines in the context of structural equation models. The model is first described and then investigated through the use of simulated data, in which it was compared with the SEMM approach. Results demonstrate that the 2SGAM is an effective tool for fitting a variety of nonlinear relationships...",0,1 +1869,Flexible covariance estimation in graphical Gaussian models,"In this paper, we propose a class of Bayes estimators for the covariance matrix of graphical Gaussian models Markov with respect to a decomposable graph G. Working with the WPG family defined by Letac and Massam [Ann. Statist. 35 (2007) 1278–1323] we derive closed-form expressions for Bayes estimators under the entropy and squared-error losses. The WPG family includes the classical inverse of the hyper inverse Wishart but has many more shape parameters, thus allowing for flexibility in differentially shrinking various parts of the covariance matrix. Moreover, using this family avoids recourse to MCMC, often infeasible in high-dimensional problems. We illustrate the performance of our estimators through a collection of numerical examples where we explore frequentist risk properties and the efficacy of graphs in the estimation of high-dimensional covariance structures.",0,1 +1870,Computing the distribution of the product of two continuous random variables,"We present an algorithm for computing the probability density function of the product of two independent random variables, along with an implementation of the algorithm in a computer algebra system. We combine this algorithm with the earlier work on transformations of random variables to create an automated algorithm for convolutions of random variables. Some examples demonstrate the algorithm's application.",0,1 +1871,The Combination of Estimates from Different Experiments,"When we are trying to make the best estimate of some quantity A that is available from the research conducted to date, the problem of combining results from different experiments is encountered. The problem is often troublesome, particularly if the individual estimates were made by different workers using different procedures. This paper discusses one of the simpler aspects of the problem, in which there is sufficient uniformity of experimental methods so that the ith experiment provides an estimate xi of u, and an estimate si of the standard error of xi . The experiments may be, for example, determinations of a physical or astronomical constant by different scientists, or bioassays carried out in different laboratories, or agricultural field experiments laid out in different parts of a region. The quantity xi may be a simple mean of the observations, as in a physical determination, or the difference between the means of two treatments, as in a comparative experiment, or a median lethal dose, or a regression coefficient. The problem of making a combined estimate has been discussed previously by Cochran (1937) and Yates and Cochran (1938) for agricultural experiments, and by Bliss (1952) for bioassays in different laboratories. The last two papers give recommendations for the practical worker. My purposes in treating the subject again are to discuss it in more general terms, to take account of some recent theoretical research, and, I hope, to bring the practical recommendations to the attention of some biologists who are not acquainted with the previous papers. The basic issue with which this paper deals is as follows. The simplest method of combining estimates made in a number of different experiments is to take the arithmetic mean of the estimates. If, however, the experiments vary in size, or appear to be of different precision, the investigator may wonder whether some kind of weighted meani would be more precise. This paper gives recommendations about the kinds of weighted mean that are appropriate, the situations in which they",0,1 +1872,A Bayesian analysis of generalized latent curve mixture models,"Latent curve models for longitudinal data have received increasing attention in medical, educational, psychological, and behavioral sciences. In these applied areas of research, heterogeneous longitudinal data are common. This paper proposes the use of generalized latent curve models for analyzing heterogenous longitudinal data. The basic model features a mixture of trajectories. It also employs a multinomial logit model for assessing the influence of fixed covariates and explanatory latent variables on the class membership probability within the mixture model. This broad class of models also handles non-normal data from the exponential family distributions. A Bayesian approach is implemented for data analysis. We report a simulation study that proves the satisfactory performance of the proposed approach. Furthermore, we analyzed a real data set extracted from the National Longitudinal Survey of Youth to illustrate the practical value of the proposed model and methodology.",0,1 +1873,Central relationship themes in group psychotherapy: A social relations model analysis of transference.,"Group members (N = 55) in 11 therapy groups reported central relationship themes (CRTs) (wishes, responses of others, and responses of self) with other group members and with a romantic partner. Social relations model analyses were used to partition the variance in group member CRT ratings with other members into perceiver, target, and relationship plus error variance components. Significant perceiver variance in member CRT ratings was proposed to serve as a proxy for transference. Overall, significant perceiver variance and mostly insignificant target variance was found, and the perceiver effect accounted for substantially more variance than the target effect. As an exploratory question, the authors wondered to what extent relationship variance accounted for the total variance in member ratings of their CRT? Unfortunately, relationship variance could not be separated from error in this study. Relationship plus error variance accounted for, on average, 42% of the variance in scores. In addition, as a test of the social microcosm of the group theory, it was hypothesized that group member CRTs within the group would relate to member CRTs with a romantic partner outside of the group. Contrary to expectation, this hypothesis was not supported. © 2008 American Psychological Association.",0,1 +1874,Multilevel confirmatory ordinal factor analysis of the Life Skills Profile–16.,"The aim of this study was to assess the factor structure of the Life skills profile-16 (LSP-16; Buckingham, Burgess, Solomon, Pirkis, & Eagar, 1998a, 1998b) with a view to meeting the assumption of statistical independence that is at significant risk of violation due to the dependency introduced to the data by pooling numerous ratings made by the same observers across independent patients. The sample consisted of 20,181 outpatients rated by 2,071 clinicians employed within 54 mental health organizations within the New South Wales public adult mental health service. To estimate the extent to which the item scores were contaminated with rater-level intraclass correlations (ICC), I fit 16 3-level multinominal ordered proportional odds intercept only models that revealed large ICCs associated with Level 2 (the rater of the LSP-16) demonstrating that a multilevel analysis was required. A multilevel confirmatory factor analysis (M-CFA) using robust weighted least squares (B. O. Muthén, du Toit, & Spisic, 1997) with polychoric correlation was used to test the fit of 2 measurement models that were hypothesized a priori. The 2 models failed to provide an acceptable fit to the sample data and within- and between-level CFAs were used to inform revisions to the 4-factor model. A 15-item version of the LSP was developed, which provided an improved approximate fit in an M-CFA. Limitations of these findings are discussed.",0,1 +1875,Characterizing the effect of matching using linear propensity score methods with normal distributions,"SUMMARY Matched sampling is a standard technique for controlling bias in observational studies due to specific covariates. Since Rosenbaum & Rubin (1983), multivariate matching methods based on estimated propensity scores have been used with increasing frequency in medical, educational, and sociological applications. We obtain analytic expressions for the effect of matching using linear propensity score methods with normal distributions. These expressions cover cases where the propensity score is either known, or estimated using either discriminant analysis or logistic regression, as is typically done in current practice. The results show that matching using estimated propensity scores not only reduces bias along the population propensity score, but also controls variation of components orthogonal to it. Matching on estimated rather than population propensity scores can therefore lead to relatively large variance reduction, as much as a factor of two in common matching settings where close matches are possible. Approximations are given for the magnitude of this variance reduction, which can be computed using estimates obtained from the matching pools. Related expressions for bias reduction are also presented which suggest that, in difficult matching situations, the use of population scores leads to greater bias reduction than the use of estimated scores.",0,1 +1876,On Using Bayesian Methods to Address Small Sample Problems,"As Bayesian methods continue to grow in accessibility and popularity, more empirical studies are turning to Bayesian methods to model small sample data. Bayesian methods do not rely on asympotics, a property that can be a hindrance when employing frequentist methods in small sample contexts. Although Bayesian methods are better equipped to model data with small sample sizes, estimates are highly sensitive to the specification of the prior distribution. If this aspect is not heeded, Bayesian estimates can actually be worse than frequentist methods, especially if frequentist small sample corrections are utilized. We show with illustrative simulations and applied examples that relying on software defaults or diffuse priors with small samples can yield more biased estimates than frequentist methods. We discuss conditions that need to be met if researchers want to responsibly harness the advantages that Bayesian methods offer for small sample problems as well as leading small sample frequentist methods.",1,1 +1877,How few countries will do? Comparative survey analysis from a Bayesian perspective,"Meuleman and Billiet (2009) have carried out a simulation study aimed at the question how many countries are needed for accurate multilevel SEM estimation in comparative studies. The authors concluded that a sample of 50 to 100 countries is needed for accurate estimation. Recently, Bayesian estimation methods have been introduced in structural equation modeling which should work well with much lower sample sizes. The current study reanalyzes the simulation of Meuleman and Billiet using Bayesian estimation to find the lowest number of countries needed when conducting multilevel SEM. The main result of our simulations is that a sample of about 20 countries is sufficient for accurate Bayesian estimation, which makes multilevel SEM practicable for the number of countries commonly available in large scale comparative surveys.",1,1 +1878,Meta-analysis of repeated measures study designs,"Repeated measures studies are found in many areas of research, particularly in areas of healthcare. There is currently little information available to inform the method of meta-analysis of repeated measures studies so that the structural dependence of the data is appropriately accommodated and the findings are meaningful.Using a published meta-analysis on the impact of diet advice on weight reduction of obese or overweight individuals, we demonstrate possible approaches for repeated measures meta-analysis. These approaches differ in terms of the type of result obtained (e.g. effect at a particular time-point, trend over time, change between time-points) and the data needed for the analysis (e.g. means, regression slope estimates). Some approaches involve violating assumptions of independence in the data structure and so to investigate the impact of this violation a simulation study is carried out.The different approaches described for the meta-analyses of repeated measures studies can all provide useful effect estimates depending on the question to be addressed by the meta-analysis. However, violation of the independence assumption in some approaches can lead to biased estimates.In practice, the methods available to carry out meta-analyses of repeated measures studies will not only depend upon the question of interest, but also on the data available from the primary studies.",0,1 +1879,Reliable Estimation of Generalized Linear Mixed Models using Adaptive Quadrature,"Generalized linear mixed models or multilevel regression models have become increasingly popular. Several methods have been proposed for estimating such models. However, to date there is no single method that can be assumed to work well in all circumstances in terms of both parameter recovery and computational efficiency. Stata's xt commands for two-level generalized linear mixed models (e.g., xtlogit) employ Gauss–Hermite quadrature to evaluate and maximize the marginal log likelihood. The method generally works very well, and often better than common contenders such as MQL and PQL, but there are cases where quadrature performs poorly. Adaptive quadrature has been suggested to overcome these problems in the two-level case. We have recently implemented a multilevel versionofthismethodin gllamm, a program that fits a large class of multilevel latent variable models including multilevel generalized linear mixed models. As far as we know, this is the first time that adaptive quadrature has been proposed for multilevel models. We show that adaptive quadrature works well in problems where ordinary quadrature fails. Furthermore, even when ordinary quadrature works, adaptive quadrature is often computationally more efficient since it requires fewer quadrature points to achieve the same precision.",0,1 +1880,The Social Relations Model: How to Understand Dyadic Processes,The social relations model (SRM) is an intriguing tool both to conceptualize and to analyze dyadic processes. We begin with explaining why interpersonal phenomena in everyday life are more complex than often considered. We then show how the SRM accounts for these complexities by decomposing interpersonal perceptions and behaviors into three independent components and describe the designs required to investigate these components. We then provide a step-by-step,0,1 +1881,Some Practical Examples of Computer-Adaptive Sequential Testing,"Computerized testing has created new challenges for the production and administration of test forms. Many testing organizations engaged in or considering computerized testing may find themselves changing from well-established procedures for handcrafting a small number of paper-and-pencil test forms to procedures for mass producing many computerized test forms. This paper describes an integrated approach to test development and administration called computer-adaptive sequential testing, or CAST. CAST is a structured approach to test construction which incorporates both adaptive testing methods with automated test assembly to allow test developers to maintain a greater degree of control over the production, quality assurance, and administration of different types of computerized tests. CAST retains much of the efficiency of traditional computer adaptive testing (CAT) and can be modified for computer mastery testing (CMT) applications. The CAST framework is described in detail and several applications are demonstrated using a medical licensure example.",0,1 +1882,When Deliberative Theory Meets Empirical Political Science: Theoretical and Methodological Challenges in Political Deliberation,"Re-linking deliberative theory with empirical political science has become a major theme in the discipline. But when philosophical concepts are to be integrated into positive political science, researchers confront both theoretical and methodological challenges. Focusing on deliberative democracy, a major theoretical challenge is the practical implementation of deliberative ideals. Comparative scholars have explored institutional contexts that favour deliberation, but they have largely neglected actor-centric and cultural variables that might affect deliberative quality as well. Focusing on legislatures in Switzerland and Germany, we show that political institutions as well as partisan strategies and status strongly affect deliberative action, while the effects of culture are less clear. Methodologically, one (frequently neglected) challenge concerns the appropriate statistical tools with which to study deliberation. On the one hand, analysing deliberative processes is demanding and time consuming; hence we tend to have only few and non-randomly selected cases at the group or context level. In addition, the real world of deliberation presents us with a complex matrix of cross-classified speakers. We demonstrate that Bayesian multi-level modelling provides an elegant way to tackle these methodological problems.",0,1 +1883,Bayesian analysis of non-linear structural equation models with non-ignorable missing outcomes from reproductive dispersion models,"Non-linear structural equation models are widely used to analyze the relationships among outcomes and latent variables in modern educational, medical, social and psychological studies. However, the existing theories and methods for analyzing non-linear structural equation models focus on the assumptions of outcomes from an exponential family, and hence can’t be used to analyze non-exponential family outcomes. In this paper, a Bayesian method is developed to analyze non-linear structural equation models in which the manifest variables are from a reproductive dispersion model (RDM) and/or may be missing with non-ignorable missingness mechanism. The non-ignorable missingness mechanism is specified by a logistic regression model. A hybrid algorithm combining the Gibbs sampler and the Metropolis–Hastings algorithm is used to obtain the joint Bayesian estimates of structural parameters, latent variables and parameters in the logistic regression model, and a procedure calculating the Bayes factor for model comparison is given via path sampling. A goodness-of-fit statistic is proposed to assess the plausibility of the posited model. A simulation study and a real example are presented to illustrate the newly developed Bayesian methodologies.",0,1 +1884,International students' everyday life information seeking: The informational value of social networking sites,"Abstract Sojourns to other countries, such as for studying abroad, are increasingly common. However, adjusting to life in a different country can be stressful and require significant effort. Sojourners need to not only maintain and expand their social networks, but they also continuously seek information about their new environment. While international students are a sizable group, their daily information behavior is not well understood. This study posits that social networking sites (SNS), such as Facebook, may play an important role in international students' everyday life information seeking (ELIS). Using descriptive statistics, ANOVA, and structural equation modeling (SEM), the study analyzed international students' everyday life information needs, their usage of SNS for ELIS, and the relationships among demographics, personality traits, SNS usage, and perceived usefulness of the acquired everyday life information. Findings indicate that a majority of the respondents frequently used SNS for ELIS. Younger students, undergraduates, and extroverts were more likely to use SNS for ELIS, while no gender difference was found. Notably, among the nine user characteristics and behavior factors, SNS usage emerged as the only positive predictor of perceived usefulness of acquired information in meeting daily needs. This indicates that SNS serve as a valuable channel for purposeful everyday life information seeking. Beyond its social support value, the ELIS value of SNS is a fruitful area for future research.",0,1 +1885,Performance of Modified Test Statistics in Covariance and Correlation Structure Analysis Under Conditions of Multivariate Nonnormality,"Questions of whether hypothesized structure models are appropriate representations of the pattern of association among a group of variables can be addressed using a wide variety of statistical procedures. These procedures include covariance structure analysis techniques and correlation structure analysis techniques, in which covariance structure procedures are based on distribution theory for covariances, and correlation structure procedures are based on distribution theory for correlations. The present article provides an overview of standard and modified normal theory and asymptotically distribution-free covariance and correlation structure analysis techniques and also details Monte Carlo simulation results on the Type I and Type II error control as a function of structure model type, number of variables in the model, sample size, and distributional nonnormality. The present Monte Carlo simulation demonstrates clearly that the robustness and nonrobustness of structure analysis techniques vary as a funct...",0,1 +1886,Surface color perception and equivalent illumination models,"Vision provides information about the properties and identity of objects. The ease with which we perceive object properties belies the difficulty of the underlying information-processing task. In the case of object color, retinal information about object reflectance is confounded with information about the illumination as well as about the object's shape and pose. There is no obvious rule that allows transformation of the retinal image to a color representation that depends primarily on object surface reflectance. Under many circumstances, however, object color appearance is remarkably stable across scenes in which the object is viewed. Here, we review a line of experiments and theory that aim to understand how the visual system stabilizes object color appearance. Our emphasis is on models derived from explicit analysis of the computational problem of estimating the physical properties of illuminants and surfaces from the retinal image, and experiments that test these models. We argue that this approach has considerable promise for allowing generalization from simplified laboratory experiments to richer scenes that more closely approximate natural viewing. We discuss the relation between the work we review and other theoretical approaches available in the literature.",0,1 +1887,Multidimensional adaptive testing,"Maximum likelihood and Bayesian procedures for item selection and scoring of multidimensional adaptive tests are presented. A demonstration using simulated response data illustrates that multidimensional adaptive testing (MAT) can provide equal or higher reliabilities with about one-third fewer items than are required by one-dimensional adaptive testing (OAT). Furthermore, holding test-length constant across the MAT and OAT approaches, substantial improvements in reliability can be obtained from multidimensional assessment. A number of issues relating to the operational use of multidimensional adaptive testing are discussed.",0,1 +1888,Detecting DIF With Ideal Point Models,"Ideal point models have become increasingly popular in research and practice, but little is known about how traditional methods for linking and detecting differential item functioning (DIF) perform with data satisfying ideal point assumptions. Very few studies have been conducted on this topic, and the results of some well-known area and parameter difference DIF detection methods have been inconsistent with previous research involving dominance models. Consequently, the authors conducted a Monte Carlo study to help identify sources of these discrepancies. Specifically, they compared the effectiveness of the Lord’s chi-square parameter difference method and the differential functioning of items and tests (DFIT) area method for detecting DIF with the Generalized Graded Unfolding Model (GGUM). The results clearly indicated that when DIF was simulated via parameter shifts that produced constant magnitudes of effect for all designated items, Lord’s chi-square and DFIT performed similarly well. In addition, the authors found that iterative item characteristic curve (ICC) linking outperformed iterative test characteristic curve (TCC) linking in most experimental conditions. The implications of these findings for DIF detection research and practice with ideal point models are discussed.",0,1 +1889,Classical and Bayesian Estimation in the Logistic Regression Model Applied to Diagnosis of Child Attention Deficit Hyperactivity Disorder,"The limitations inherent to classical estimation of the logistic regression models are known. The Bayesian approach in statistical analysis is an alternative to be considered, given that it makes it possible to introduce prior information about the phenomenon under study. The aim of the present work is to analyze binary and multinomial logistic regression simple models estimated by means of a Bayesian approach in comparison to classical estimation. To that effect, Child Attention Deficit Hyperactivity Disorder (ADHD) clinical data were analyzed. The sample included 286 participants of 6-12 years (78% boys, 22% girls) with ADHD positive diagnosis in 86.7% of the cases. The results show a reduction of standard errors associated to the coefficients obtained from the Bayesian analysis, thus bringing a greater stability to the coefficients. Complex models where parameter estimation may be easily compromised could benefit from this advantage.",0,1 +1890,Unpredictable environments lead to the evolution of parental neglect in birds,"A nest of begging chicks invites an intuitive explanation: needy chicks want to be fed and parents want to feed them. Surprisingly, however, in a quarter of species studied, parents ignore begging chicks. Furthermore, parents in some species even neglect smaller chicks that beg more, and preferentially feed the biggest chicks that beg less. This extreme variation across species, which contradicts predictions from theory, represents a major outstanding problem for the study of animal signalling. We analyse parent-offspring communication across 143 bird species, and show that this variation correlates with ecological differences. In predictable and good environments, chicks in worse condition beg more, and parents preferentially feed those chicks. In unpredictable and poor environments, parents pay less attention to begging, and instead rely on size cues or structural signals of quality. Overall, these results show how ecological variation can lead to different signalling systems being evolutionarily stable in different species.",0,1 +1891,Normal theory based test statistics in structural equation modelling,"Even though data sets in psychology are seldom normal, the statistics used to evaluate covariance structure models are typically based on the assumption of multivariate normality. Consequently, many conclusions based on normal theory methods are suspect. In this paper, we develop test statistics that can be correctly applied to the normal theory maximum likelihood estimator. We propose three new asymptotically distribution-free (ADF) test statistics that technically must yield improved behaviour in samples of realistic size, and use Monte Carlo methods to study their actual finite sample behaviour. Results indicate that there exists an ADF test statistic that also performs quite well in finite sample situations. Our analysis shows that various forms of ADF test statistics are sensitive to model degrees of freedom rather than to model complexity. A new index is proposed for evaluating whether a rescaled statistic will be robust. Recommendations are given regarding the application of each test statistic.",0,1 +1892,Comparison of Absolute Thresholds Derived from an Adaptive Forced-Choice Procedure and from Reaction Probabilities and Reaction Times in a Simple Reaction Time Paradigm,"An understanding of the auditory system's operation requires knowledge of the mechanisms underlying thresholds. In this work we compare detection thresholds obtained with a three-interval-three-alternative forced-choice paradigm with reaction thresholds extracted from both reaction probabilities (RP) and reaction times (RT) in a simple RT paradigm from the same listeners under otherwise nearly identical experimental conditions. Detection thresholds, RP, and RT to auditory stimuli exhibited substantial variation from session to session. Most of the intersession variation in RP and RT could be accounted for by intersession variation in a listener's absolute sensitivity. The reaction thresholds extracted from RP were very similar, if not identical, to those extracted from RT. On the other hand, reaction thresholds were always higher than detection thresholds. The difference between the two thresholds can be considered as the additional amount of evidence required by each listener to react to a stimulus in an unforced design on top of that necessary for detection in the forced-choice design. This difference is inversely related to the listener's probability of producing false alarms. We found that RT, once corrected for some irreducible minimum RT, reflects the time at which a given stimulus reaches the listener's reaction threshold. This suggests that the relationships between simple RT and loudness (reported in the literature) are probably caused by a tight relationship between temporal summation at threshold and temporal summation of loudness.",0,1 +1893,Reliability analysis of supply chain in strategy synergetic networks based on hierarchical Bayesian method,"The reliability computing formula of supply chain is achieved based on the analysis and judgment of supply chain reliability within the strategy synergetic networks.Accounting to the statistical characteristic of supply chain reliability of the strategy synergetic networks,there are three estimation methods,two Bayesian estimation methods and one hierarchical Bayesian estimation method,used for the evaluation of supply chain specimen's reliability.The test of the estimation of supply chain reliability shows that the hierarchical Bayesian estimation method is more effective than others.",0,1 +1894,Factor analysis of dichotomized variables,An approach for multiple factor analysis of dichotomized variables is presented. It is based on the distribution of the first and second order joint probabilities of the binary scored items. The estimator is based on the generalized least squares principle. Standard errors and a test of the fit of the model is given. © 1975 Psychometric Society.,0,1 +1895,Approximations to the Log-Likelihood Function in the Nonlinear Mixed-Effects Model,"Abstract Nonlinear mixed-effects models have received a great deal of attention in the statistical literature in recent years because of the flexibility they offer in handling the unbalanced repeated-measures data that arise in different areas of investigation, such as pharmacokinetics and economics. Several different methods for estimating the parameters in nonlinear mixed-effects model have been proposed. We concentrate here on two of them—maximum likelihood and restricted maximum likelihood. A rather complex numerical issue for (restricted) maximum likelihood estimation in nonlinear mixed-effects models is the evaluation of the log-likelihood function of the data, because it involves the evaluation of a multiple integral that, in most cases, does not have a closed-form expression. We consider here four different approximations to the log-likelihood, comparing their computational and statistical properties. We conclude that the linear mixed-effects (LME) approximation suggested by Lindstrom and Bates, t...",0,1 +1896,Introducing Markov chain Monte Carlo,,0,1 +1897,Low-Income Students and the Socioeconomic Composition of Public High Schools,"Increasing constraints placed on race-based school diversification have shifted attention to socioeconomic desegregation. Although past research suggests that socioeconomic desegregation can produce heightened achievement, the “frog pond” perspective points to potential problems with socioeconomic desegregation in nonachievement domains. Such problems are important in their own right, and they may also chip away at the magnitude of potential achievement benefits. In this article, I report conducted propensity score analyses and robustness calculations on a sample of public high schools in the National Longitudinal Study of Adolescent Health. As the proportion of the student body with middle- or high-income parents increased, low-income students progressed less far in math and science. Moreover, as the proportion of the student body with middle- or high-income or college-educated parents increased, low-income students experienced more psychosocial problems. Such patterns were often more pronounced among African American and Latino students. These findings suggest curricular and social psychological mechanisms of oft-noted frog pond effects in schools and extend the frog pond framework beyond achievement itself to demographic statuses (e.g., race/ethnicity and SES) perceptually linked to achievement. In terms of policy, these findings indicate that socioeconomic desegregation plans should also attend to equity in course enrollments and the social integration of students more generally.",0,1 +1898,Associations between udder health and reproductive performance in United Kingdom dairy cows,"The objective of this research was to evaluate the relationship between udder health and reproductive performance in UK dairy cows. Data from 80 herds were restructured such that each unit of data represented a 2-d period during lactation where a cow was at risk of becoming pregnant. Multilevel discrete-time survival models were then used within a Bayesian framework to explore associations between reproductive outcomes and a variety of potential explanatory variables. Separate models were constructed using 2 different univariate binary outcomes: a cow becoming pregnant during a risk period and a cow becoming pregnant as a result of a given service. Potential explanatory variables included occurrence of clinical mastitis and a categorical representation of individual cow somatic cell count (SCC), both at a variety of timings relative to the risk period. Posterior predictions were used to assess model fit and to check model building assumptions. These demonstrated that the model represented the data well. Within-sample Monte Carlo simulation (i.e., use of the model to predict outcomes for cases within the data set, repeated over a large number of iterations) was used to illustrate results as posterior predicted relative risks. A negative association was found between reproductive performance and cases of clinical mastitis over a wide time frame relative to the risk period (from 28 d before to 70 d after the risk period). A similar negative association with the probability of a service leading to a pregnancy (pregnancy rate) was observed over the same time frame. Higher SCC recordings (i.e., those more likely to be associated with an intramammary infection) were also associated with decreased reproductive performance, especially where an individual cow SCC of greater than 399,000/mL was recorded in the 30 d following a risk period or service. This research demonstrates that both clinical and subclinical mastitis are associated with a reduction in reproductive performance, and that this influence varies in magnitude but can be exerted over a prolonged period.",0,1 +1899,Dynamic Task Selection in Learning Arithmetic: The Role of Learner Control and Adaptation Based on a Hierarchy of Skills 1Dieser Beitrag wurde unter der geschäftsführenden Herausgeberschaft von Jens Möller angenommen,"Abstract.The effects of locus of instructional control in computer-assisted practice of arithmetic skills and word problem solving were investigated in a field experiment with 13 third grade classes. In a program-controlled condition (n = 95), the selection of practice problems was based on a hypothetical hierarchy of skills. This was expected to regulate cognitive load to a moderate level. In a condition with shared control (n = 89), subjects could select problems from a subset provided by the program. Results show that program-controlled selection of problems based on the hierarchy of skills was more successful in supporting skill development than the students’ selection. In the shared control condition, students tended to select too easy problems, regardless of their level of expertise. Both conditions with computer assisted instruction caused more progress than traditional instruction (n = 94). Ways of improving the regulation of cognitive load within a shared control approach are discussed.",0,1 +1900,Detecting short-term change and variation in health-related quality of life: within- and between-person factor structure of the SF-36 health survey,"A major goal of much aging-related research and geriatric medicine is to identify early changes in health and functioning before serious limitations develop. To this end, regular collection of patient-reported outcome measure (PROMs) in a clinical setting may be useful to identify and monitor these changes. However, existing PROMs were not designed for repeated administration and are more commonly used as one-time screening tools; as such, their ability to detect variation and measurement properties when administered repeatedly remain unknown. In this study we evaluated the potential of the RAND SF-36 Health Survey as a repeated-use PROM by examining its measurement properties when modified for administration over multiple occasions.To distinguish between-person (i.e., average) from within-person (i.e., occasion) levels, the SF-36 Health Survey was completed by a sample of older adults (N = 122, M age = 66.28 years) daily for seven consecutive days. Multilevel confirmatory factor analysis (CFA) was employed to investigate the factor structure at both levels for two- and eight-factor solutions.Multilevel CFA models revealed that the correlated eight-factor solution provided better model fit than the two-factor solution at both the between-person and within-person levels. Overall model fit for the SF-36 Health Survey administered daily was not substantially different from standard survey administration, though both were below optimal levels as reported in the literature. However, individual subscales did demonstrate good reliability.Many of the subscales of the modified SF-36 for repeated daily assessment were found to be sufficiently reliable for use in repeated measurement designs incorporating PROMs, though the overall scale may not be optimal. We encourage future work to investigate the utility of the subscales in specific contexts, as well as the measurement properties of other existing PROMs when administered in a repeated measures design. The development and integration of new measures for this purpose may ultimately be necessary.",0,1 +1901,When One Size Does Not Fit All: A Simple Statistical Method to Deal with Across-Individual Variations of Effects,"In science, it is a common experience to discover that although the investigated effect is very clear in some individuals, statistical tests are not significant because the effect is null or even opposite in other individuals. Indeed, t-tests, Anovas and linear regressions compare the average effect with respect to its inter-individual variability, so that they can fail to evidence a factor that has a high effect in many individuals (with respect to the intra-individual variability). In such paradoxical situations, statistical tools are at odds with the researcher's aim to uncover any factor that affects individual behavior, and not only those with stereotypical effects. In order to go beyond the reductive and sometimes illusory description of the average behavior, we propose a simple statistical method: applying a Kolmogorov-Smirnov test to assess whether the distribution of p-values provided by individual tests is significantly biased towards zero. Using Monte-Carlo studies, we assess the power of this two-step procedure with respect to RM Anova and multilevel mixed-effect analyses, and probe its robustness when individual data violate the assumption of normality and homoscedasticity. We find that the method is powerful and robust even with small sample sizes for which multilevel methods reach their limits. In contrast to existing methods for combining p-values, the Kolmogorov-Smirnov test has unique resistance to outlier individuals: it cannot yield significance based on a high effect in one or two exceptional individuals, which allows drawing valid population inferences. The simplicity and ease of use of our method facilitates the identification of factors that would otherwise be overlooked because they affect individual behavior in significant but variable ways, and its power and reliability with small sample sizes (<30-50 individuals) suggest it as a tool of choice in exploratory studies.",0,1 +1902,EM and beyond,"The basic theme of the EM algorithm, to repeatedly use complete-data methods to solve incomplete data problems, is also a theme of several more recent statistical techniques. These techniques-multiple imputation, data augmentation, stochastic relaxation, and sampling importance resampling-combine simulation techniques with complete-data methods to attack problems that are difficult or impossible for EM. © 1991 The Psychometric Society.",0,1 +1903,A Comparison of Two Bias-Corrected Covariance Estimators for Generalized Estimating Equations,"Mancl and DeRouen (2001, Biometrics57, 126-134) and Kauermann and Carroll (2001, JASA96, 1387-1398) proposed alternative bias-corrected covariance estimators for generalized estimating equations parameter estimates of regression models for marginal means. The finite sample properties of these estimators are compared to those of the uncorrected sandwich estimator that underestimates variances in small samples. Although the formula of Mancl and DeRouen generally overestimates variances, it often leads to coverage of 95% confidence intervals near the nominal level even in some situations with as few as 10 clusters. An explanation for these seemingly contradictory results is that the tendency to undercoverage resulting from the substantial variability of sandwich estimators counteracts the impact of overcorrecting the bias. However, these positive results do not generally hold; for small cluster sizes (e.g., <10) their estimator often results in overcoverage, and the bias-corrected covariance estimator of Kauermann and Carroll may be preferred. The methods are illustrated using data from a nested cross-sectional cluster intervention trial on reducing underage drinking.",0,1 +1904,Interaction Effects in Latent Growth Models: Evaluation of Alternative Estimation Approaches,"The purpose of this investigation is to compare and evaluate 2 approaches for estimating interaction effects in latent growth models (LGMs): the unconstrained approach and the latent moderated structural equations (LMS) approach. To reduce the complexity of modeling interactions in LGMs, we created difference-product indicators to replace the traditional product indicators used in the unconstrained approach because these differences in original indicators represent changes over time. Our focus was to verify the performance of this simplified interaction model of LGMs with difference-product indicators by using the unconstrained approach and comparing it with the LMS approach. Our simulation study showed that the LMS approach generally resulted in smaller biases in the estimated parameters and was consistently more precise than the unconstrained approach under normal conditions, particularly when the sample size was small. When normality assumptions were violated, however, the unconstrained approach was sh...",0,1 +1905,Bayesian dynamic mediation analysis.,"Most existing methods for mediation analysis assume that mediation is a stationary, time-invariant process, which overlooks the inherently dynamic nature of many human psychological processes and behavioral activities. In this article, we consider mediation as a dynamic process that continuously changes over time. We propose Bayesian multilevel time-varying coefficient models to describe and estimate such dynamic mediation effects. By taking the nonparametric penalized spline approach, the proposed method is flexible and able to accommodate any shape of the relationship between time and mediation effects. Simulation studies show that the proposed method works well and faithfully reflects the true nature of the mediation process. By modeling mediation effect nonparametrically as a continuous function of time, our method provides a valuable tool to help researchers obtain a more complete understanding of the dynamic nature of the mediation process underlying psychological and behavioral phenomena. We also briefly discuss an alternative approach of using dynamic autoregressive mediation model to estimate the dynamic mediation effect. The computer code is provided to implement the proposed Bayesian dynamic mediation analysis. (PsycINFO Database Record",0,1 +1906,Covariate Balance in Bayesian Propensity Score Approaches for Observational Studies,"AbstractBayesian alternatives to frequentist propensity score approaches have recently been proposed. However, few studies have investigated their covariate balancing properties. This article compares a recently developed two-step Bayesian propensity score approach to the frequentist approach with respect to covariate balance. The effects of different priors on covariate balance are evaluated and the differences between frequentist and Bayesian covariate balance are discussed. Results of the case study reveal that both the Bayesian and frequentist propensity score approaches achieve good covariate balance. The frequentist propensity score approach performs slightly better on covariate balance for stratification and weighting methods, whereas the two-step Bayesian approach offers slightly better covariate balance in the optimal full matching method. Results of a comprehensive simulation study reveal that accuracy and precision of prior information on propensity score model parameters do not greatly influen...",0,1 +1907,An application of confidence intervals and of maximum likelihood to the estimation of an examinee's ability,"A mathematical definition of the theoretical relation between the examinee's actual responses to the test items and his ""true ability"" is selected. A maximum-likelihood solution is obtained for estimating the examinee's ""true ability"" from his responses to the items. The standard error of the maximum-likelihood estimate is obtained, its relation to the discriminating power of the test is pointed out, and some generalizations are drawn as to the optimum level of item difficulty. The Neyman-Pearson power function is applied to determine which of two psychological tests is the most powerful for the selection of ""successful"" examinees. © 1953 Psychometric Society.",0,1 +1908,A multilevel analysis of the role of the family and the state in self-rated health of elderly Chinese,"This study examines the geographical variations of self-rated health of the elderly based on the 2008 Chinese Longitudinal Healthy Longevity Survey. Multilevel logistic models are employed to estimate how individual, family, and institutional factors affect the health of the elderly at both individual and province levels. Results show that while individual characteristics help to explain self-rated health, the family remains an important determinant. Those with nobody to care for them, those in poverty and those who have to rely on medical insurance report the worst health. The role of the state is relatively limited in contributing to the health of the elderly. There are substantial between province differences.",0,1 +1909,Generalized Appended Product Indicator Procedure for Nonlinear Structural Equation Analysis,Interest in considering nonlinear structural equation models is well documented in the behavioral and social sciences as well as in the education and marketing literature. This article considers estimation of polynomial structural models. An existing method is shown to have a limitation that the produced estimator is inconsistent for most practical situations. A new procedure is introduced and defined for a general model using products of observed indicators. The resulting estimator is consistent without assuming any distributional form for the underlying factors or errors. Identification assessment and standard error estimation are discussed. A simulation study addresses statistical issues including comparisons of discrepancy functions and the choice of appended product indicators. Application of the new procedure in a substance abuse prevention study is also reported.,0,1 +1910,Visual apparent motion can be modulated by task-irrelevant lexical information,"Previous studies have repeatedly demonstrated the impact of Gestalt structural grouping principles upon the parsing of motion correspondence in ambiguous apparent motion. Here, by embedding Chinese characters in a visual Ternus display that comprised two stimulus frames, we showed that the perception of visual apparent motion can be modulated by activation of task-irrelevant lexical representations. Each frame had two disks, with the second disk of the first frame and the first disk of the second frame being presented at the same location. Observers could perceive either ""element motion,"" in which the endmost disk is seen as moving back and forth while the middle disk at the central position remains stationary, or ""group motion,"" in which both disks appear to move laterally as a whole. More reports of group motion, as opposed to element motion, were obtained when the embedded characters formed two-character compound words than when they formed nonwords, although this lexicality effect appeared to be attenuated by the use of the same characters at the overlapping position across the two frames. Thus, grouping of visual elements in a changing world can be guided by both structural principles and prior world knowledge, including lexical information.",0,1 +1911,Approximate Bayesian computation with differential evolution,"a b s t r a c t Approximate Bayesian computation (ABC) is a simulation-based method for estimating the posterior distribution of the parameters of a model. The ABC approach is instrumental when a likelihood function for a model cannot be mathematically specified, or has a complicated form. Although difficulty in calculating a model's likelihood is extremely common, current ABC methods suffer from two problems that have largely prevented their mainstream adoption: long computation time and an inability to scale beyond a few parameters. We introduce differential evolution as a computationally efficient genetic algorithm for proposal generation in our ABC sampler. We show how using this method allows our new ABC algorithm, called ABCDE, to obtain accurate posterior estimates in fewer iterations than kernel-based ABC algorithms and to scale to high-dimensional parameter spaces that have proven difficult for current ABC methods.",0,1 +1912,Neighborhoods and Violent Crime: A Multilevel Study of Collective Efficacy,"It is hypothesized that collective efficacy, defined as social cohesion among neighbors combined with their willingness to intervene on behalf of the common good, is linked to reduced violence. This hypothesis was tested on a 1995 survey of 8782 residents of 343 neighborhoods in Chicago, Illinois. Multilevel analyses showed that a measure of collective efficacy yields a high between-neighborhood reliability and is negatively associated with variations in violence, when individual-level characteristics, measurement error, and prior violence are controlled. Associations of concentrated disadvantage and residential instability with violence are largely mediated by collective efficacy.",0,1 +1913,Coefficient alpha and the reliability of composite measurements,"Following a general approach due to Guttman, coefficient α is rederived as a lower bound on the reliability of a test. A necessary and sufficient condition under which equality is attained in this inequality and hence that α is equal to the reliability of the test is derived and shown to be closely related to the recent redefinition of the concept of parallel measurements due to Novick. This condition is then also shown to be closely related to the unit rank assumption originally adopted by Kuder and Richardson in the derivation of their formula 20. The assumption later adopted by Jackson and Ferguson and the one adopted by Gulliksen are shown to be related to the necessary and sufficient condition derived here. It is then pointed out that the statement that ""coefficient α is equal to the mean of the split-half reliabilities"" is true only under the restricted condition assumed by Cronbach in the body of his derivation of this result. Finally some limitations on the uses of any function of α as a measure of internal consistency are noted. © 1967 Psychometric Society.",0,1 +1914,"Multilevel multivariate modelling of childhood growth, numbers of growth measurements and adult characteristics",Summary. A general latent normal model for multilevel data with mixtures of response types is extended in the case of ordered responses to deal with variates having a large number of categories and including count data. An example is analysed by using repeated measures data on child growth and adult measures of body mass index and glucose. Applications are described that are concerned with the flexible prediction of adult measurements from collections of growth measurements and for studying the relationship between the number of measurement occasions and growth trajectories.,0,1 +1915,Conducting Three-Level Cross-Sectional Analyses,"Applied early adolescent researchers often sample students (Level 1) from within classrooms (Level 2) that are nested within schools (Level 3), resulting in data that requires multilevel modeling analysis to avoid Type 1 errors. Although several articles have been published to assist researchers with analyzing sample data nested at two levels, few articles are available to researchers seeking assistance with three-level data analyses. The purpose of this article is to extend the presentational logic and pedagogical flow employed in previous two-level pedagogical publications to illustrate the relevant issues researchers face, the decisions to be made, and the proper procedures needed, when analyzing cross-sectional three-level data. These procedures are demonstrated with a generated three-level data example based on the Early Childhood Longitudinal Study (ECLS-K) public use dataset. The generated data used in this article, as well as the SPSS, SAS, and Mplus model specification syntax files needed to reproduce all analyses in this article, and additional illustrative examples, are available as supplemental online materials at http://jea.sagepub.com/content/early/recent .",0,1 +1916,A general latent assignment approach for modeling psychological contaminants,"Abstract Data from psychological experiments are rife with ‘contaminants’, which can generally be defined as data generated by psychological processes different from those intended as the object of study. Contaminant data can interfere with the testing of substantive psychological models and their parameters, so it is important to have methods for their identification and removal. After noting that current practices in cognitive modeling for dealing with contaminants are not completely satisfactory, we argue for a general latent mixture approach to the problem. We demonstrate the tractability and effectiveness of the approach concretely, through a series of four applications. These applications involve a simple choice problem, a diffusion model of a response time and accuracy in decision-making, a hierarchical signal detection model of recognition memory, and a reinforcement learning model of decision-making on bandit problems. We conclude that developing models of contaminant processes requires the same sort of creative effort that is needed to model substantive psychological processes, but that it is a necessary endeavour that can be coherently and usefully pursued within the latent mixture modeling approach.",0,1 +1917,Efficient parametrisations for normal linear mixed models,"SUMMARY The generality and easy programmability of modern sampling-based methods for maximisation of likelihoods and summarisation of posterior distributions have led to a tremendous increase in the complexity and dimensionality of the statistical models used in practice. However, these methods can often be extremely slow to converge, due to high correlations between, or weak identifiability of, certain model parameters. We present simple hierarchical centring reparametrisations that often give improved convergence for a broad class of normal linear mixed models. In particular, we study the two-stage hierarchical normal linear model, the Laird-Ware model for longitudinal data, and a general structure for hierarchically nested linear models. Using analytical arguments, simulation studies, and an example involving clinical markers of acquired immune deficiency syndrome (AIDS), we indicate when reparametrisation is likely to provide substantial gains in efficiency.",0,1 +1918,Testing Mediation and Suppression Effects of Latent Variables,"Because of the importance of mediation studies, researchers have been continuously searching for the best statistical test for mediation effect. The approaches that have been most commonly employed include those that use zero-order and partial correlation, hierarchical regression models, and structural equation modeling (SEM). This study extends MacKinnon and colleagues (MacKinnon, Lockwood, Hoffmann, West, & Sheets, 2002; MacKinnon, Lockwood, & Williams, 2004, MacKinnon, Warsi, & Dwyer, 1995) works by conducting a simulation that examines the distribution of mediation and suppression effects of latent variables with SEM, and the properties of confidence intervals developed from eight different methods. Results show that SEM provides unbiased estimates of mediation and suppression effects, and that the bias-corrected bootstrap confidence intervals perform best in testing for mediation and suppression effects. Steps to implement the recommended procedures with Amos are presented.",0,1 +1919,A general non-linear multilevel structural equation mixture model,"In the past 2 decades latent variable modeling has become a standard tool in the social sciences. In the same time period, traditional linear structural equation models have been extended to include non-linear interaction and quadratic effects (e.g., Klein and Moosbrugger, 2000), and multilevel modeling (Rabe-Hesketh et al., 2004). We present a general non-linear multilevel structural equation mixture model (GNM-SEMM) that combines recent semiparametric non-linear structural equation models (Kelava and Nagengast, 2012; Kelava et al., 2014) with multilevel structural equation mixture models (Muthén and Asparouhov, 2009) for clustered and non-normally distributed data. The proposed approach allows for semiparametric relationships at the within and at the between levels. We present examples from the educational science to illustrate different submodels from the general framework.",0,1 +1920,Conceptualizing and assessing self-enhancement bias: A componential approach.,"Four studies implemented a componential approach to assessing self-enhancement and contrasted this approach with 2 earlier ones: social comparison (comparing self-ratings with ratings of others) and self-insight (comparing self-ratings with ratings by others). In Study 1, the authors varied the traits being rated to identify conditions that lead to more or less similarity between approaches. In Study 2, the authors examined the effects of acquaintance on the conditions identified in Study 1. In Study 3, the authors showed that using rankings renders the self-insight approach equivalent to the component-based approach but also has limitations in assessing self-enhancement. In Study 4, the authors compared the social-comparison and the component-based approaches in terms of their psychological implications; the relation between self-enhancement and adjustment depended on the self-enhancement approach used, and the positive-adjustment correlates of the social-comparison approach disappeared when the confounding influence of the target effect was controlled.",0,1 +1921,Calibrated Bayes,"The lack of an agreed inferential basis for statistics makes life interesting for academic statisticians, but at the price of negative implications for the status of statistics in industry, science, and government. The practice of our discipline will mature only when we can come to a basic agreement about how to apply statistics to real problems. Simple and more general illustrations are given of the negative consequences of the existing schism between frequentists and Bayesians. An assessment of strengths and weaknesses of the frequentist and Bayes systems of inference suggests that calibrated Bayes-a compromise based on the works of Box, Rubin, and others-captures the strengths of both approaches and provides a roadmap for future advances. The approach asserts that inferences under a particular model should be Bayesian, but model assessment can and should involve frequentist ideas. This article also discusses some implications of this proposed compromise for the teaching and practice of statistics.",0,1 +1922,Bayesian hierarchical linear mixed models for additive smoothing splines,"Bayesian hierarchical models have been used for smoothing splines, thin-plate splines, and L-splines. In analyzing high dimensional data sets, additive models and backfitting methods are often used. A full Bayesian analysis for such models may include a large number of random effects, many of which are not intuitive, so researchers typically use noninformative improper or nearly improper priors. We investigate propriety of the posterior for these cases. Our findings extend known results for normal linear mixed models to certain cases with Bayesian additive smoothing spline models. © 2007 The Institute of Statistical Mathematics.",0,1 +1923,Fitting the three-parameter weibull distribution: review and evaluation of existing and new methods,"The three-parameter Weibull distribution is a commonly-used distribution for the study of reliability and breakage data. However, given a data set, it is difficult to estimate the parameters of the distribution and that, for many reasons: (1) the equations of the maximum likelihood estimators are not all available in closed form. These equations can be estimated using iterative methods. However, (2) they return biased estimators and the exact amount of bias is not known. (3) The Weibull distribution does not meet the regularity conditions so that in addition to being biased, the maximum likelihood estimators may also be highly variable from one sample to another (weak efficiency). The methods to estimate parameters of a distribution can be divided into three classes: a) the maximizing approaches, such as the maximum likelihood method, possibly followed by a bias-correction operation; b) the methods of moments; and c) a mixture of the previous two classes of methods. We found using Monte Carlo simulations that a mixed method was the most accurate to estimate the parameters of the Weibull distribution across many shapes and sample sizes, followed by the weighted maximum likelihood estimation method. If the shape parameter is known to be larger than 1, the maximum product of spacing method is the most accurate whereas in the opposite case, the mixed method is to be preferred. A test that can detect if the shape parameter is smaller than 1 is discussed and evaluated. Overall, the maximum likelihood estimation method was the worst, with errors of estimation almost twice as large as those of the best methods.",0,1 +1924,Neighbourhood social capital: measurement issues and associations with health outcomes,"We compared ecometric neighbourhood scores of social capital (contextual variation) to mean neighbourhood scores (individual and contextual variation), using several health-related outcomes (i.e. self-rated health, weight status and obesity-related behaviours). Data were analysed from 5,900 participants in the European SPOTLIGHT survey. Factor analysis of the 13-item social capital scale revealed two social capital constructs: social networks and social cohesion. The associations of ecometric and mean neighbourhood-level scores of these constructs with self-rated health, weight status and obesity-related behaviours were analysed using multilevel regression analyses, adjusted for key covariates. Analyses using ecometric and mean neighbourhood scores, but not mean neighbourhood scores adjusted for individual scores, yielded similar regression coefficients. Higher levels of social network and social cohesion were not only associated with better self-rated health, lower odds of obesity and higher fruit consumption, but also with prolonged sitting and less transport-related physical activity. Only associations with transport-related physical activity and sedentary behaviours were associated with mean neighbourhood scores adjusted for individual scores. As analyses using ecometric scores generated the same results as using mean neighbourhood scores, but different results when using mean neighbourhood scores adjusted for individual scores, this suggests that the theoretical advantage of the ecometric approach (i.e. teasing out individual and contextual variation) may not be achieved in practice. The different operationalisations of social network and social cohesion were associated with several health outcomes, but the constructs that appeared to represent the contextual variation best were only associated with two of the outcomes.",0,1 +1925,A Generalization of Sampling Without Replacement from a Finite Universe,"This paper presents a general technique for the treatment of samples drawn without replacement from finite universes when unequal selection probabilities are used. Two sampling schemes are discussed in connection with the problem of determining optimum selection probabilities according to the information available in a supplementary variable. Admittedly, these two schemes have limited application. They should prove useful, however, for the first stage of sampling with multi-stage designs, since both permit unbiased estimation of the sampling variance without resorting to additional assumptions.Journal Paper No. J2139 of the Iowa Agricultural Experiment Station, Ames, Iowa, Project 1005. Presented to the Institute of Mathematical Statistics, March 17, 1951. © Taylor & Francis Group, LLC.",0,1 +1926,Model-Driven Meta-Analyses for Informing Health Care,"A relatively novel type of meta-analysis, a model-driven meta-analysis, involves the quantitative synthesis of descriptive, correlational data and is useful for identifying key predictors of health outcomes and informing clinical guidelines. Few such meta-analyses have been conducted and thus, large bodies of research remain unsynthesized and uninterpreted for application in health care. We describe the unique challenges of conducting a model-driven meta-analysis, focusing primarily on issues related to locating a sample of published and unpublished primary studies, extracting and verifying descriptive and correlational data, and conducting analyses. A current meta-analysis of the research on predictors of key health outcomes in diabetes is used to illustrate our main points.",0,1 +1927,Meta-analysis by random effect modelling in generalized linear models,"The meta-analysis of multi-centre trials can be based on either fixed or random effect models. This paper argues for the general use of random effect models, and illustrates the value of non-parametric maximum likelihood (NPML) analysis of such trials. The same general approach unifies administrative 'league table' analyses in epidemiological and other studies. Several examples of the NPML analysis are given, including a 70-centre trial.",0,1 +1928,Implementing Restricted Maximum Likelihood Estimation in Structural Equation Models,"Structural equation modeling (SEM) is now a generic modeling framework for many multivariate techniques applied in the social and behavioral sciences. Many statistical models can be considered either as special cases of SEM or as part of the latent variable modeling framework. One popular extension is the use of SEM to conduct linear mixed-effects modeling (LMM) such as cross-sectional multilevel modeling and latent growth modeling. It is well known that LMM can be formulated as structural equation models. However, one main difference between the implementations in SEM and LMM is that maximum likelihood (ML) estimation is usually used in SEM, whereas restricted (or residual) maximum likelihood (REML) estimation is the default method in most LMM packages. This article shows how REML estimation can be implemented in SEM. Two empirical examples on latent growth model and meta-analysis are used to illustrate the procedures implemented in OpenMx. Issues related to implementing REML in SEM are discussed.",0,1 +1929,Posterior Propriety for Hierarchical Models with Log-Likelihoods That Have Norm Bounds,"Statisticians often use improper priors to express ignorance or to provide good frequency properties, requiring that posterior propriety be verified. This paper addresses generalized linear mixed models, GLMMs, when Level I parameters have Normal distributions, with many commonly-used hyperpriors. It provides easy-to-verify sufficient posterior propriety conditions based on dimensions, matrix ranks, and exponentiated norm bounds, ENBs, for the Level I likelihood. Since many familiar likelihoods have ENBs, which is often verifiable via log-concavity and MLE finiteness, our novel use of ENBs permits unification of posterior propriety results and posterior MGF/moment results for many useful Level I distributions, including those commonly used with multilevel generalized linear models, e.g., GLMMs and hierarchical generalized linear models, HGLMs. Those who need to verify existence of posterior distributions or of posterior MGFs/moments for a multilevel generalized linear model given a proper or improper multivariate F prior as in Section 1 should find the required results in Sections 1 and 2 and Theorem 3 (GLMMs), Theorem 4 (HGLMs), or Theorem 5 (posterior MGFs/moments).",0,1 +1930,Investigating population heterogeneity with factor mixture models.,"Sources of population heterogeneity may or may not be observed. If the sources of heterogeneity are observed (e.g., gender), the sample can be split into groups and the data analyzed with methods for multiple groups. If the sources of population heterogeneity are unobserved, the data can be analyzed with latent class models. Factor mixture models are a combination of latent class and common factor models and can be used to explore unobserved population heterogeneity. Observed sources of heterogeneity can be included as covariates. The different ways to incorporate covariates correspond to different conceptual interpretations. These are discussed in detail. Characteristics of factor mixture modeling are described in comparison to other methods designed for data stemming from heterogeneous populations. A step-by-step analysis of a subset of data from the Longitudinal Survey of American Youth illustrates how factor mixture models can be applied in an exploratory fashion to data collected at a single time point.",0,1 +1931,Estimating high dimensional covariance matrices: A new look at the Gaussian conjugate framework,"In this paper, we describe and study a class of linear shrinkage estimators of the covariance matrix that is well-suited for high dimensional matrices, has a rather wide domain of applicability, and is rooted into the Gaussian conjugate framework of Chen (1979). We propose here a new look at this framework. The linear shrinkage estimator is thereby obtained as the posterior mean of the covariance, using a Bayesian Gaussian model with conjugate inverse Wishart prior, and deriving the shrinkage intensity and target matrix by marginal likelihood maximization. We introduce some extensions to the seminal approach by deriving a closed-form expression of the marginal likelihood as well as computationally light schemes for its maximization. Further, these developments are implemented in a variety of situations and include a simulation-based performance comparison with a recent, widely used class of linear shrinkage estimators. The Gaussian conjugate estimators are found to outperform these estimators in every tested situation where the latter are available and to be more widely and directly applicable. • We (re)introduce a class of linear shrinkage estimators of the covariance matrix. • We follow an empirical Bayesian approach to obtain shrinkage intensity and target. • The method is generally applicable to any class of target matrices. • Estimators are found to outperform those of the state-of-the-art Ledoit–Wolf class. • The implementation is computationally light.",0,1 +1932,Robust statistical modelling using the multivariate skew t distribution with complete and incomplete data,"Missing data is inevitable in many situations that could hamper data analysis for scientific investigations. We establish flexible analytical tools for multivariate skew t models when fat-tailed, asymmetric and missing observations simultaneously occur in the input data. For the ease of computation and theoretical developments, two auxiliary indicator matrices are incorporated into the model for the determination of observed and missing components of each observation that can effectively reduce the computational complexity. Under the missing at random assumption, we present a Monte Carlo version of the expectation conditional maximization algorithm, which is performed to estimate the parameters and retrieve each missing observation with a single value. Additionally, a Metropolis–Hastings within Gibbs sampler with data augmentation is developed to account for the uncertainty of parameters as well as missing outcomes. The methodology is illustrated through two real data sets.",0,1 +1933,Straight Lines with a Change-Point: A Bayesian Analysis of Some Renal Transplant Data,"Y1=(X2+f2xi+ei, i=zT+l,..., (1) where the ei are independently, normally distributed, N(O, a2), 1 < T < T (al f,) $ (a2, ,B2) and all the parameters a,, f1 a25 ,B25 a2, T are unknown. The two straight lines in (1) intersect at a point with x coordinate v = (a1 a2)/(12 fl1). If we further assume that X1 < X2 <... < XT (in many applications, x will denote time), it is useful to distinguish two versions of (1) according to whether v satisfies x, < v < x+ 1 or not. When this constraint is assumed, we shall refer to the constrained case of switching straight lines. It has been found see, for example, Knapp et al. (1977)-that the constrained version provides a satisfactory statistical model for monitoring the function of renal transplants. Following a transplant, daily measurements are made of serum-creatinine, a substance which indicates the level of functioning of the patient's kidney and a plot of the reciprocal of bodyweight corrected serum-creatinine (y) is then made against time (x). Fig. 1 shows part of two typical plots obtained from patients undergoing treatment at the City Hospital, Nottingham. An increasing straight line indicates successful functioning of the transplanted kidney. A sudden switch to a decreasing straight line indicates that rejection has occurred. It might be argued that rejection is not an instantaneous process, so that the sharp intersection of the two lines is a fiction, and an approach assuming a less sharp transition, such as that of Bacon and Watts (1971), might be more reasonable. On present evidence, however, any transition period would appear to be usually very short compared with the interval between measurements, and so the switching straight line model provides a reasonable approximation. With this assumption, in the renal transplant application the intersection point, y, corresponds to the time at which a rejection occurs. This parameter is of very great interest, both in the treatment of individual patients and because inferences about v for each of a number of patients permit inferences about daily and hourly variations in the rates of rejection. This, in turn, has implications for treatment and monitoring procedures in the hospital (see Knapp et al., 1979).",0,1 +1934,A randomized trial of individual and couple behavioral alcohol treatment for women.,"Although alcohol use disorders (AUDs) adversely affect women, research on efficacious treatments for women is limited. In this randomized efficacy trial of 102 heterosexual women with AUDs, the authors compared alcohol behavioral couple therapy (ABCT) and alcohol behavioral individual therapy (ABIT) on percentage of days abstinent (PDA) and percentage of days of heavy drinking (PDH) over 6 months of treatment and 12 months of posttreatment follow-up. Baseline relationship functioning and comorbid disorders were tested as moderators of outcome. Piecewise linear growth models were used to model outcomes. During treatment, women increased their PDA and decreased their PDH, with significantly greater improvements in ABCT than in ABIT (d = 0.59 for PDA; d = 0.79 for PDH). Differences favoring ABCT were maintained during follow-up. Women with poorer baseline relationship functioning improved more on PDA during treatment with ABCT than with ABIT. For PDH, results during treatment and follow-up favored ABCT for women with better baseline relationship functioning. ABCT resulted in better outcomes than ABIT for women with Axis I disorders at the end of follow-up (PDA), and for women with Axis II disorders at the end of treatment (PDA) and at the end of follow-up (PDH).",0,1 +1935,CAML—Maximum likelihood consensus analysis,"Consensus analysis enables estimation of individual differences in competencies and response tendencies when answer keys to dichotomous forced-choice questions are unknown. CAML, a set of functions written in R, implements maximum likelihood estimation for the general Condorcet model that underlies consensus analysis. CAML avoids problems of alternative approaches that have often rendered consensus analysis impractical or unfeasible in the past. It provides (1) measures of model fit, (2) a measure of consensus, (3) point and interval estimates of competencies and response tendencies, and (4) an estimate of the unknown answer key. The present article describes the general Condorcet model, the CAML algorithms, and the handling of the software. In addition, the validity of CAML results is tested in a recognition memory study using selective experimental manipulations of the parameters. The results show that CAML works very well in practice and provides valid estimates of competencies, response tendencies, and answer keys.",0,1 +1936,,"Event history models typically assume that the entire population is at risk of experiencing the event of interest throughout the observation period. However, there will often be individuals, referred to as long-term survivors, who may be considered a priori to have a zero hazard throughout the study period. In this paper, a discrete-time mixture model is proposed in which the probability of long-term survivorship and the timing of event occurrence are modelled jointly. Another feature of event history data that often needs to be considered is that they may come from a population with a hierarchical structure. For example, individuals may be nested within geographical regions and individuals in the same region may have similar risks of experiencing the event of interest due to unobserved regional characteristics. Thus, the discrete-time mixture model is extended to allow for clustering in the likelihood and timing of an event within regions. The model is further extended to allow for unobserved individual heterogeneity in the hazard of event occurrence. The proposed model is applied in an analysis of contraceptive sterilization in Bangladesh. The results show that a woman's religion and education level affect her probability of choosing sterilization, but not when she gets sterilized. There is also evidence of community-level variation in sterilization timing, but not in the probability of sterilization.",0,1 +1937,Modeling Latent Growth Curves With Incomplete Data Using Different Types of Structural Equation Modeling and Multilevel Software,"This article offers different examples of how to fit latent growth curve (LGC) models to longitudinal data using a variety of different software programs (i.e., LISREL, Mx, Mplus, AMOS, SAS). The article shows how the same model can be fitted using both structural equation modeling and multilevel software, with nearly identical results, even in the case of models of latent growth fitted to incomplete data. The general purpose of this article is to provide a demonstration that integrates programming features from different software. The most immediate goal is to help researchers implement these LGC models as a useful way to test hypotheses of growth.",0,1 +1938,Bayesian Estimation of the Logistic Positive Exponent IRT Model,"A Bayesian inference approach using Markov Chain Monte Carlo (MCMC) is developed for the logistic positive exponent (LPE) model proposed by Samejima and for a new skewed Logistic Item Response Theory (IRT) model, named Reflection LPE model. Both models lead to asymmetric item characteristic curves (ICC) and can be appropriate because a symmetric ICC treats both correct and incorrect answers symmetrically, which results in a logical contradiction in ordering examinees on the ability scale. A data set corresponding to a mathematical test applied in Peruvian public schools is analyzed, where comparisons with other parametric IRT models also are conducted. Several model comparison criteria are discussed and implemented. The main conclusion is that the LPE and RLPE IRT models are easy to implement and seem to provide the best fit to the data set considered.",0,1 +1939,Extended Bayesian model averaging for heritability in twin studies,"Family studies are often conducted to examine the existence of familial aggregation. Particularly, twin studies can model separately the genetic and environmental contribution. Here we estimate the heritability of quantitative traits via variance components of random-effects in linear mixed models (LMMs). The motivating example was a myopia twin study containing complex nesting data structures: twins and siblings in the same family and observations on both eyes for each individual. Three models are considered for this nesting structure. Our proposal takes into account the model uncertainty in both covariates and model structures via an extended Bayesian model averaging (EBMA) procedure. We estimate the heritability using EBMA under three suggested model structures. When compared with the results under the model with the highest posterior model probability, the EBMA estimate has smaller variation and is slightly conservative. Simulation studies are conducted to evaluate the performance of variance-componen...",0,1 +1940,Assessing Goodness of Fit of Item Response Theory Models: A Comparison of Traditional and Alternative Procedures,"Testing the goodness of fit of item response theory (IRT) models is relevant to validating IRT models, and new procedures have been proposed. These alternatives compare observed and expected response frequencies conditional on observed total scores, and use posterior probabilities for responses across 0 levels rather than cross-classifying examinees using point estimates of 0 and score responses. This research compared these alternatives with regard to their methods, properties (Type I error rates and empirical power), available research, and practical issues (computational demands, treatment of missing data, effects of sample size and sparse data, and available computer programs). Different advantages and disadvantages related to these characteristics are discussed. A simulation study provided additional information about empirical power and Type I error rates. Item response theory (IRT) involves a class of mathematical models that are used to predict examinee performance using item and person characteristics. The properties of these models offer many well-known advantages in testing applications. However, the extent to which these properties are attained is dependent on the degree to which the IRT model itself is appropriate. To validate the use of an IRT model, goodness of fit for a model, or correspondence between model predictions and observed data, is often examined (see Hambleton & Swaminathan, 1985, for a discussion of other useful validation studies). When a model is not appropriate or does not fit the data, use of estimated parameters may be compromised. Several alternative approaches to assessing IRT model-data-fit have emerged in response to using traditional methods in different testing applications. Orlando and Thissen (2000) described a fit statistic that does not use ability estimates but provides a comparison of observed and expected frequencies for score responses across total score levels. Stone, Mislevy, and Mazzeo (1994) argued that uncertainty in ability estimation was responsible for deviations in the approximation of the goodness-of-fit statistics to the null distribution, and discussed a fit statistic based on posterior expectations that addressed the issue. A scaling correction for the chi-squared fit statistic based on resampling methods was subsequently described (Stone, 2000a). Donoghue and Hombo (1999, 2001a) also used the fit statistic based on posterior probabilities to evaluate goodness of fit for National Assessment of Educational Progress (NAEP) items, but derived a distribution for the fit statistic (labeled QDH) that could be used for hypothesis testing.",0,1 +1941,Lisrel 8: Structural Equation Modeling With the Simplis Command Language,"This text introduces the SIMPLIS command language for structural equation modelling. It is written for students and researchers with limited mathematical and statistical training who need to use structural equation models to analyze their data, and for those who have tried but failed to learn the LISREL command language. It is not a textbook on factor analysis, structural equations or latent variable models, although there are many examples of such in the book. Rather, it is assumed that the reader is already familiar with the basic ideas and principles of these types of analyses and techniques. The main objective is to demonstrate that structural equation modelling can be done easily without the technical jargon with which it has been associated. The SIMPLIS language shifts the focus away from the technical question How to do it, so that researchers can concentrate on the question, What does it all mean? Although the SIMPLIS language makes it easier to specify models and to carry out the analysis, the substantive specification and interpretation remain the same as with the LISREL command language.",0,1 +1942,A simple mechanism to incentive-align conjoint experiments,"Recent literature has established the importance of incentive-aligning research participants in conjoint analysis. Pertinent studies have also proposed and validated a fairly general incentive-aligning mechanism (willingness-to-pay, or WTP) that achieves incentive alignment by using respondents' data to determine their value for a reward product (Ding, 2007). This mechanism, however, requires an estimation of the value of money and is relatively difficult for the average respondent to understand. We propose an alternative mechanism based on inferred rank order for situations where conjoint practitioners have more than one version of real products. In an empirical test of choice-based conjoint, we show that the RankOrder mechanism leads to substantial improvement in predictive performance when compared to non-aligned hypothetical choices. A second test shows that both incentive-aligned mechanisms – RankOrder and WTP – produce very similar predictive performances. RankOrder, however, dominates the WTP mechanism in user preference, an outcome shown both by perceived understanding and by the incentive-aligned money that respondents are willing to pay to switch from one mechanism to the other.",0,1 +1943,Meta-analysis of randomized phase II trials to inform subsequent phase III decisions,"If multiple Phase II randomized trials exist then meta-analysis is favorable to increase statistical power and summarize the existing evidence about an intervention's effect in order to help inform Phase III decisions. We consider some statistical issues for meta-analysis of Phase II trials for this purpose, as motivated by a real example involving nine Phase II trials of bolus thrombolytic therapy in acute myocardial infarction with binary outcomes.We propose that a Bayesian random effects logistic regression model is most suitable as it models the binomial distribution of the data, helps avoid continuity corrections, accounts for between-trial heterogeneity, and incorporates parameter uncertainty when making inferences. The model also allows predictions that inform Phase III decisions, and we show how to derive: (i) the probability that the intervention will be truly beneficial in a new trial, and (ii) the probability that, in a new trial with a given sample size, the 95% credible interval for the odds ratio will be entirely in favor of the intervention. As Phase II trials are potentially optimistic due to bias in design and reporting, we also discuss how skeptical prior distributions can reduce this optimism to make more realistic predictions.In the example, the model identifies heterogeneity in intervention effect missed by an I-squared of 0%. Prediction intervals accounting for this heterogeneity are shown to support subsequent Phase III trials. The probability of success in Phase III trials increases as the sample size increases, up to 0.82 for intracranial hemorrhage and 0.79 for reinfarction outcomes.The choice of meta-analysis methods can influence the decision about whether a trial should proceed to Phase III and thus need to be clearly documented and investigated whenever a Phase II meta-analysis is performed.",0,1 +1944,Using Generalizability Theory in Counseling and Development,"(1988). Using Generalizability Theory in Counseling and Development. Measurement and Evaluation in Counseling and Development: Vol. 21, No. 2, pp. 81-90.",0,1 +1945,Incorporating Mobility in Growth Modeling for Multilevel and Longitudinal Item Response Data,"Multilevel data often cannot be represented by the strict form of hierarchy typically assumed in multilevel modeling. A common example is the case in which subjects change their group membership in longitudinal studies (e.g., students transfer schools; employees transition between different departments). In this study, cross-classified and multiple membership models for multilevel and longitudinal item response data (CCMM-MLIRD) are developed to incorporate such mobility, focusing on students' school change in large-scale longitudinal studies. Furthermore, we investigate the effect of incorrectly modeling school membership in the analysis of multilevel and longitudinal item response data. Two types of school mobility are described, and corresponding models are specified. Results of the simulation studies suggested that appropriate modeling of the two types of school mobility using the CCMM-MLIRD yielded good recovery of the parameters and improvement over models that did not incorporate mobility properly. In addition, the consequences of incorrectly modeling the school effects on the variance estimates of the random effects and the standard errors of the fixed effects depended upon mobility patterns and model specifications. Two sets of large-scale longitudinal data are analyzed to illustrate applications of the CCMM-MLIRD for each type of school mobility.",0,1 +1946,Bayesian Analysis of Constrained Parameter and Truncated Data Problems Using Gibbs Sampling,"Abstract Constrained parameter problems arise in a wide variety of applications, including bioassay, actuarial graduation, ordinal categorical data, response surfaces, reliability development testing, and variance component models. Truncated data problems arise naturally in survival and failure time studies, ordinal data models, and categorical data studies aimed at uncovering underlying continuous distributions. In many applications both parameter constraints and data truncation are present. The statistical literature on such problems is very extensive, reflecting both the problems’ widespread occurrence in applications and the methodological challenges that they pose. However, it is striking that so little of this applied and theoretical literature involves a parametric Bayesian perspective. From a technical viewpoint, this perhaps is not difficult to understand. The fundamental tool for Bayesian calculations in typical realistic models is (multidimensional) numerical integration, which often is problem...",0,1 +1947,Simulating the Effects of Common and Specific Abilities on Test Performance: An Evaluation of Factor Analysis,"Purpose Factor analysis is a useful technique to aid in organizing multivariate data characterizing speech, language, and auditory abilities. However, knowledge of the limitations of factor analysis is essential for proper interpretation of results. The present study used simulated test scores to illustrate some characteristics of factor analysis. Method Linear models were used to simulate test scores that were determined by multiple latent variables. These simulated test scores were evaluated with principal components analysis and, in certain cases, structural equation modeling. In addition, a subset of simulated individuals characterized by poor test performance was examined. Results The number of factors recovered and their identity do not necessarily correspond to the structure of the latent variables that generated the test scores. The first principal component may represent variance from multiple uncorrelated sources. Practices such as correction or control for general cognitive ability may produce misleading results. Conclusions Inferences from the results of factor analysis should be primarily about the structure of test batteries rather than the structure of human mental abilities. Researchers and clinicians should consider multiple sources of evidence to evaluate hypotheses about the processes generating test results.",0,1 +1948,A simulation study of sample size for multilevel logistic regression models,"BackgroundMany studies conducted in health and social sciences collect individual level data as outcome measures. Usually, such data have a hierarchical structure, with patients clustered within physicians, and physicians clustered within practices. Large survey data, including national surveys, have a hierarchical or clustered structure; respondents are naturally clustered in geographical units (e.g., health regions) and may be grouped into smaller units. Outcomes of interest in many fields not only reflect continuous measures, but also binary outcomes such as depression, presence or absence of a disease, and self-reported general health. In the framework of multilevel studies an important problem is calculating an adequate sample size that generates unbiased and accurate estimates.MethodsIn this paper simulation studies are used to assess the effect of varying sample size at both the individual and group level on the accuracy of the estimates of the parameters and variance components of multilevel logistic regression models. In addition, the influence of prevalence of the outcome and the intra-class correlation coefficient (ICC) is examined.ResultsThe results show that the estimates of the fixed effect parameters are unbiased for 100 groups with group size of 50 or higher. The estimates of the variance covariance components are slightly biased even with 100 groups and group size of 50. The biases for both fixed and random effects are severe for group size of 5. The standard errors for fixed effect parameters are unbiased while for variance covariance components are underestimated. Results suggest that low prevalent events require larger sample sizes with at least a minimum of 100 groups and 50 individuals per group.ConclusionWe recommend using a minimum group size of 50 with at least 50 groups to produce valid estimates for multi-level logistic regression models. Group size should be adjusted under conditions where the prevalence of events is low such that the expected number of events in each group should be greater than one.",0,1 +1949,The use of simple reparameterizations to improve the efficiency of Markov chain Monte Carlo estimation for multilevel models with applications to discrete time survival models,"We consider the application of Markov chain Monte Carlo (MCMC) estimation methods to random-effects models and in particular the family of discrete time survival models. Survival models can be used in many situations in the medical and social sciences and we illustrate their use through two examples that differ in terms of both substantive area and data structure. A multilevel discrete time survival analysis involves expanding the data set so that the model can be cast as a standard multilevel binary response model. For such models it has been shown that MCMC methods have advantages in terms of reducing estimate bias. However, the data expansion results in very large data sets for which MCMC estimation is often slow and can produce chains that exhibit poor mixing. Any way of improving the mixing will result in both speeding up the methods and more confidence in the estimates that are produced. The MCMC methodological literature is full of alternative algorithms designed to improve mixing of chains and we describe three reparameterization techniques that are easy to implement in available software. We consider two examples of multilevel survival analysis: incidence of mastitis in dairy cattle and contraceptive use dynamics in Indonesia. For each application we show where the reparameterization techniques can be used and assess their performance.",0,1 +1950,Subjective insecurity and the role of institutions,"The issue of social insecurity is high on the public and scientific agenda. Most research, however, looks at objective forms of insecurity like growing labour market volatilities or atypical employment. Less has been done with regard to the way people perceive these changes and the role of institutions therein. While recent studies have highlighted the relatively weak role of institutions in explaining different levels of subjective insecurity, they were limited in their understanding in the institutions–security interplay. This special issue aims to understand how institutions generate and moderate the outcomes of subjective insecurity, as well as to overcome some of the methodological limitations of previous studies. The introduction provides a state-of-the-art literature review and unfolds the research question addressed in the special issue. It concludes with some thoughts for future research in the field of social insecurity and institutions.",0,1 +1951,Generalized latent variable models with non-linear effects,"Until recently, item response models such as the factor analysis model for metric responses, the two-parameter logistic model for binary responses and the multinomial model for nominal responses considered only the main effects of latent variables without allowing for interaction or polynomial latent variable effects. However, non-linear relationships among the latent variables might be necessary in real applications. Methods for fitting models with non-linear latent terms have been developed mainly under the structural equation modelling approach. In this paper, we consider a latent variable model framework for mixed responses (metric and categorical) that allows inclusion of both non-linear latent and covariate effects. The model parameters are estimated using full maximum likelihood based on a hybrid integration-maximization algorithm. Finally, a method for obtaining factor scores based on multiple imputation is proposed here for the non-linear model.",0,1 +1952,A Multi-Level Analysis of School Improvement: Changes in Schools' Performance over Time,"ABSTRACT The improvement of schools takes place over extended periods of time. Consequently longitudinal studies which track successive cohorts of pupils through their schooling are required if estimates of the extent of improvement are to be established. To date, hardly any studies have collected the necessary data. Those studies which have had appropriate data have tended to emphasise the extent of stability of schools' effectiveness over time rather than the extent of any changes. A shift in conceptual framework is called for if improvements in schools' effectiveness are to be the central focus of concern. The study is based on three successive cohorts of pupils passing through some 30 English secondary schools. It uses examination results as the outcome measure and includes a prior attainment measure amongst the variables used to control for differences between schools' intakes. A multi‐level strategy for conceptualising and modelling data on schools' changes in performance over time is offered. In co...",0,1 +1953,Goal Striving and Well-Being in Sport: The Role of Contextual and Personal Motivation,"This investigation sought to clarify mixed results in the literature exploring coach behaviors, basic psychological needs, goal motivation, and well- and ill-being. Regional-level team sport athletes ( N = 241) completed questionnaires on the aforementioned variables at the beginning of the season. A subsample ( n = 70) provided saliva samples to assess physical ill-being. At the end of the season, athletes ( n = 98) reported their goal motivation and attainment. Structural equation modeling demonstrated that coach behaviors were related to needs satisfaction and thwarting, which were related to autonomous and controlled goal motives respectively. Autonomous motives were related to well- and ill-being; controlled motives were only related to ill-being. Over time, only end-of-season autonomous goal motives were related to goal attainment. The findings provide an insight into how coaches can facilitate optimum goal striving and well-being in their athletes.",0,1 +1954,Bayesian Graphical Lasso Models and Efficient Posterior Computation,"Recently, the graphical lasso procedure has become popular in estimating Gaussian graphical models. In this paper, we introduce a fully Bayesian treatment of graphical lasso models. We first investigate the graphical lasso prior that has been relatively unexplored. Using data augmentation, we develop a simple but highly efficient block Gibbs sampler for simulating covariance matrices. We then generalize the Bayesian graphical lasso to the Bayesian adaptive graphical lasso. Finally, we illustrate and compare the results from our approach to those obtained using the standard graphical lasso procedures for real and simulated data. In terms of both covariance matrix estimation and graphical structure learning, the Bayesian adaptive graphical lasso appears to be the top overall performer among a range of frequentist and Bayesian methods.",0,1 +1955,Reduced Stress-Sensitivity or Increased Reward Experience: The Psychological Mechanism of Response to Antidepressant Medication,"Depression has often been associated with increased negative affect reactivity to stress (Stress-Sensitivity) and reduced capacity to experience pleasure or positive affect (Reward Experience). To date, no studies have prospectively examined changes in Stress-Sensitivity and Reward Experience following antidepressant treatment. The sample included 83 depressed patients and 22 healthy controls. A randomized controlled trial was carried out with patients receiving either imipramine or placebo for 6 weeks. At baseline and 6 weeks, patients and controls participated in an Experience Sampling procedure, prospectively measuring ecologically valid daily life appraisals of activities and mood states. The course of depression was assessed with the Hamilton Depression Rating Scale (HDRS). Multilevel linear regression analyses showed that patients had higher negative and lower positive appraisals of activities than controls. In addition, patients showed increased Stress-Sensitivity (negative affect reactivity to negatively appraised activities). Treatment with imipramine decreased Stress-Sensitivity and increased Reward Experience (positive affect reactivity to positively appraised activities). Changes in Stress-Sensitivity and Reward Experience were in part reducible to changes in the process of activity appraisal itself. However, increase in Reward Experience, but not decrease in Stress-Sensitivity, discriminated between patients who responded and those who did not, independent of changes in the process of activity appraisal itself. Response to treatment in depression may be conditional on restoration of hedonic capacity, the cerebral substrate of which requires further study in relation to antidepressant response. A search for (synergistic) antidepressant therapies specifically targeting ability to experience reward may be warranted.",0,1 +1956,Complex Sample Data in Structural Equation Modeling,"Large-scale surveys using complex sample designs are frequently carried out by government agencies. The statistical analysis technology available for such data is, however, limited in scope. This study investigates and further develops statistical methods that could be used in software for the analysis of data collected under complex sample designs. First, it identifies several recent methodological lines of inquiry which taken together provide a powerful and general statistical basis for a complex sample, structural equation modeling analysis. Second, it extends some of this research to new situations of interest. A Monte Carlo study that empirically evaluates these techniques on simulated data comparable to those in largescale complex surveys demonstrates that they work well in practice. Due to the generality of the approaches, the methods cover not only continuous normal variables but also continuous nonnormal variables and dichotomous variables. Two methods designed to take into account the complex sample structure were",0,1 +1957,Spatial working memory in children with high-functioning autism: Intact configural processing but impaired capacity.,"Visual attention and visual working memory exert severe capacity limitations on cognitive processing. Impairments in both functions may exacerbate the social and communication deficits seen in children with an autism spectrum disorder (ASD). This study characterizes spatial working memory and visual attention in school-age children with high-functioning autism. Children with ASD, and age, gender, and IQ-matched typically developing (TD) children performed 2 tasks: a spatial working memory task and an attentive tracking task. Compared with TD children, children with ASD showed a more pronounced deficit in the spatial working memory task than the attentive tracking task, even though the latter placed significant demands on sustained attention, location updating, and distractor inhibition. Because both groups of children were sensitive to configuration mismatches between the sample and test arrays, the spatial working memory deficit was not because of atypical organization of spatial working memory. These findings show that attention and working memory are dissociable, and that children with ASD show a specific deficit in buffering visual information across temporal discontinuity.",0,1 +1958,Benefits and Risks Associated With Thrombolysis for Pulmonary Embolism,,0,1 +1959,Evaluation of Structural Equation Mixture Models: Parameter Estimates and Correct Class Assignment,"Structural Equation Mixture Models(SEMMs) are latent class models that permit the estimation of a structural equation model within each class. Fitting SEMMs is illustrated using data from one wave of the Notre Dame Longitudinal Study of Aging. Based on the model used in the illustration, SEMM parameter estimation and correct class assignment are investigated in a large scale simulation study. Design factors of the simulation study are (im)balanced class proportions, (im)balanced factor variances, sample size, and class separation. We compare the fit of models with correct and misspecified within-class structural relations. In addition, we investigate the potential to fit SEMMs with binary indicators. The structure of within-class distributions can be recovered under a wide variety of conditions, indicating the general potential and flexibility of SEMMs to test complex within-class models. Correct class assignment is limited.",0,1 +1960,Estimating discrimination performance in two-alternative forced choice tasks: Routines for MATLAB and R,"Ulrich and Vorberg (Attention, Perception, & Psychophysics 71: 1219-1227, 2009) introduced a novel approach for estimating discrimination performance in two-alternative forced choice (2AFC) tasks. This approach avoids pitfalls that are inherent when the order of the standard and the comparison is neglected in estimating the difference limen (DL), as in traditional approaches. The present article provides MATLAB and R routines that implement this novel procedure for estimating DLs. These routines also allow to account for processing failures such as lapses or finger errors and can be applied to experimental designs in which the standard and comparison differ only along the task-relevant dimension, as well as to designs in which the stimuli differ in more than one dimension. In addition, Monte Carlo simulations were conducted to check the quality of our routines. © 2012 Psychonomic Society, Inc.",0,1 +1961,"Controlling Neuropathic Pain by Adeno-Associated Virus Driven Production of the Anti-Inflammatory Cytokine, Interleukin-10","Despite many decades of drug development, effective therapies for neuropathic pain remain elusive. The recent recognition of spinal cord glia and glial pro-inflammatory cytokines as important contributors to neuropathic pain suggests an alternative therapeutic strategy; that is, targeting glial activation or its downstream consequences. While several glial-selective drugs have been successful in controlling neuropathic pain in animal models, none are optimal for human use. Thus the aim of the present studies was to explore a novel approach for controlling neuropathic pain. Here, an adeno-associated viral (serotype II; AAV2) vector was created that encodes the anti-inflammatory cytokine, interleukin-10 (IL-10). This anti-inflammatory cytokine is known to suppress the production of pro-inflammatory cytokines. Upon intrathecal administration, this novel AAV2-IL-10 vector was successful in transiently preventing and reversing neuropathic pain. Intrathecal administration of an AAV2 vector encoding beta-galactosidase revealed that AAV2 preferentially infects meningeal cells surrounding the CSF space. Taken together, these data provide initial support that intrathecal gene therapy to drive the production of IL-10 may prove to be an efficacious treatment for neuropathic pain.",0,1 +1962,Logical-rules and the classification of integral dimensions: individual differences in the processing of arbitrary dimensions,"A variety of converging operations demonstrate key differences between separable dimensions, which can be analyzed independently, and integral dimensions, which are processed in a non-analytic fashion. A recent investigation of response time distributions, applying a set of logical rule-based models, demonstrated that integral dimensions are pooled into a single coactive processing channel, in contrast to separable dimensions, which are processed in multiple, independent processing channels. This paper examines the claim that arbitrary dimensions created by factorially morphing four faces are processed in an integral manner. In two experiments, 16 participants completed a categorization task in which either upright or inverted morph stimuli were classified in a speeded fashion. Analyses focused on contrasting different assumptions about the psychological representation of the stimuli, perceptual and decisional separability, and the processing architecture. We report consistent individual differences which demonstrate a mixture of some observers who demonstrate coactive processing with other observers who process the dimensions in a parallel self-terminating manner.",0,1 +1963,"Regression calibration for models with two predictor variables measured with error and their interaction, using instrumental variables and longitudinal data","Regression calibration provides a way to obtain unbiased estimators of fixed effects in regression models when one or more predictors are measured with error. Recent development of measurement error methods has focused on models that include interaction terms between measured-with-error predictors, and separately, methods for estimation in models that account for correlated data. In this work, we derive explicit and novel forms of regression calibration estimators and associated asymptotic variances for longitudinal models that include interaction terms, when data from instrumental and unbiased surrogate variables are available but not the actual predictors of interest. The longitudinal data are fit using linear mixed models that contain random intercepts and account for serial correlation and unequally spaced observations. The motivating application involves a longitudinal study of exposure to two pollutants (predictors) - outdoor fine particulate matter and cigarette smoke - and their association in interactive form with levels of a biomarker of inflammation, leukotriene E4 (LTE 4 , outcome) in asthmatic children. Because the exposure concentrations could not be directly observed, we used measurements from a fixed outdoor monitor and urinary cotinine concentrations as instrumental variables, and we used concentrations of fine ambient particulate matter and cigarette smoke measured with error by personal monitors as unbiased surrogate variables. We applied the derived regression calibration methods to estimate coefficients of the unobserved predictors and their interaction, allowing for direct comparison of toxicity of the different pollutants. We used simulations to verify accuracy of inferential methods based on asymptotic theory.",0,1 +1964,Longitudinal data analysis using generalized linear models,"SUMMARY This paper proposes an extension of generalized linear models to the analysis of longitudinal data. We introduce a class of estimating equations that give consistent estimates of the regression parameters and of their variance under mild assumptions about the time dependence. The estimating equations are derived without specifying the joint distribution of a subject's observations yet they reduce to the score equations for multivariate Gaussian outcomes. Asymptotic theory is presented for the general class of estimators. Specific cases in which we assume independence, m-dependence and exchangeable correlation structures from each subject are discussed. Efficiency of the proposed estimators in two simple situations is considered. The approach is closely related to quasi-likelih ood. Some key ironh: Estimating equation; Generalized linear model; Longitudinal data; Quasi-likelihood; Repeated measures.",0,1 +1965,Multilevel mixed linear model analysis using iterative generalized least squares,"SUMMARY Models for the analysis of hierarchically structured data are discussed. An iterative generalized least squares estimation procedure is given and shown to be equivalent to maximum likelihood in the normal case. There is a discussion of applications to complex surveys, longitudinal data, and estimation in multivariate models with missing responses. An example is given using educational data.",0,1 +1966,"Risk Perception, Experience, and Objective Risk: A Cross-National Study with European Emergency Survivors","Understanding public risk perceptions and their underlying processes is important in order to learn more about the way people interpret and respond to hazardous emergency events. Direct experience with an involuntary hazard has been found to heighten the perceived risk of experiencing the same hazard and its consequences in the future, but it remains unclear if cross-over effects are possible (i.e., experience with one hazard influencing perceived risk for other hazards also). Furthermore, the impact of objective risk and country of residence on perceived risk is not well understood. As part of the BeSeCu (Behavior, Security, and Culture) Project, a sample of 1,045 survivors of emergencies from seven European countries (i.e., Germany, the Czech Republic, Poland, Sweden, Spain, Turkey, and Italy) was drawn. Results revealed heightened perceived risk for emergency events (i.e., domestic and public fires, earthquakes, floods, and terrorist attacks) when the event had been experienced previously plus some evidence of cross-over effects, although these effects were not so strong. The largest country differences in perceived risk were observed for earthquakes, but this effect was significantly reduced by taking into account the objective earthquake risk. For fires, floods, terrorist attacks, and traffic accidents, only small country differences in perceived risk were found. Further studies including a larger number of countries are welcomed.",0,1 +1967,Hierarchical modelling of species sensitivity distribution: Development and application to the case of diatoms exposed to several herbicides,"The species sensitivity distribution (SSD) is a key tool to assess the ecotoxicological threat of contaminants to biodiversity. For a contaminant, it predicts which concentration is safe for a community of species. Widely used, this approach suffers from several drawbacks: (i) summarizing the sensitivity of each species by a single value entails a loss of valuable information about the other parameters characterizing the concentration-effect curves; (ii) it does not propagate the uncertainty on estimated sensitivities into the SSD; (iii) the hazardous concentration estimated with SSD only indicates the threat to biodiversity, without any insight about a global response of the community related to the measured endpoint. To remedy these drawbacks, we built a global hierarchical model including the concentration-effect model together with the distribution law of the SSD. We revisited the current SSD approach to account for more sources of variability and uncertainty into the prediction than the traditional analysis and to assess a global response for the community. Working within a Bayesian framework, we were able to compute an SSD taking into account the uncertainty from the original raw data. We also developed a quantitative indicator of a global response of the community to the contaminant. We applied this methodology to study the toxicity and the risk of six herbicides to benthic diatoms from Lake Geneva, based on the biomass endpoint. Our approach highlighted a wide variability within the set of diatom species for all the parameters of the concentration-effect model and a potential correlation between them. Remarkably, variability of the shape parameter of the model and correlation had not been considered before. Comparison between the SSD and the global response of the community revealed that protecting 95% of the species might preserve only 80-86% of the global response. Finally, propagating the uncertainty on the estimated sensitivity showed that building an SSD on a low level of effect, such as EC10, might be unreasonable as it induces a large uncertainty on the result.",0,1 +1968,"Psychological pathways linking social support to health outcomes: A visit with the “ghosts” of research past, present, and future","Contemporary models postulate the importance of psychological mechanisms linking perceived and received social support to physical health outcomes. In this review, we examine studies that directly tested the potential psychological mechanisms responsible for links between social support and health-relevant physiological processes (1980s-2010). Inconsistent with existing theoretical models, no evidence was found that psychological mechanisms such as depression, perceived stress, and other affective processes are directly responsible for links between support and health. We discuss the importance of considering statistical/design issues, emerging conceptual perspectives, and limitations of our existing models for future research aimed at elucidating the psychological mechanisms responsible for links between social support and physical health outcomes.",0,1 +1969,A New Derivation of the Rasch Model,"Abstract The Rasch model is usually derived from statistical requirements of estimation of its parameters. The principle of 'specific objectivity' or, equivalently, 'sample independence' requires that subject parameters can be estimated independent from the item parameters and vice versa. This in turn requires that sufficient statistics exist for the parameters, from which the Rasch model follows. Rather than using a statistical argument, the present paper presents a derivation of the Rasch model based on the requirement that the probability of inferential ordering of subjects (or items, resp.) is sample independent. The derivation parallels Ducamp & Falmagne's axiomatization of the Guttman scale (composite measurement); it is first given for the ordering of two items or subjects, and subsequently generalized to the probability of a multiple ordering. The core equation in the derivation is, of course, not different from the core equation in the statistical derivation.",0,1 +1970,Modeling multivariate effect sizes.,"In this article, we present a flexible approach to the modeling of multiple effect sizes in meta-analysis. The method uses generalized least squares regression to account for interdependence among multiple outcomes within studies and to allow for different numbers of effect sizes across studies. Furthermore, the approach allows great flexibility in modeling linear equations for multivariate outcomes by means of the inclusion of different sets of predictors for each outcome. We use data from studies of the effectiveness of coaching on performance on the Scholastic Aptitude Test to illustrate application of the method.",0,1 +1971,A weakly informative default prior distribution for logistic and other regression models,"We propose a new prior distribution for classical (nonhierarchical) logistic regression models, constructed by first scaling all nonbinary variables to have mean 0 and standard deviation 0.5, and then placing independent Student-$t$ prior distributions on the coefficients. As a default choice, we recommend the Cauchy distribution with center 0 and scale 2.5, which in the simplest setting is a longer-tailed version of the distribution attained by assuming one-half additional success and one-half additional failure in a logistic regression. Cross-validation on a corpus of datasets shows the Cauchy class of prior distributions to outperform existing implementations of Gaussian and Laplace priors. We recommend this prior distribution as a default choice for routine applied use. It has the advantage of always giving answers, even when there is complete separation in logistic regression (a common problem, even when the sample size is large and the number of predictors is small), and also automatically applying more shrinkage to higher-order interactions. This can be useful in routine data analysis as well as in automated procedures such as chained equations for missing-data imputation. We implement a procedure to fit generalized linear models in R with the Student-$t$ prior distribution by incorporating an approximate EM algorithm into the usual iteratively weighted least squares. We illustrate with several applications, including a series of logistic regressions predicting voting preferences, a small bioassay experiment, and an imputation model for a public health data set.",0,1 +1972,"Intraclass Correlation Estimates in a School-based Smoking Prevention Study: Outcome and Mediating Variables, by Sex and Ethnicity","Most school-based smoking prevention studies employ designs in which schools or classrooms are assigned to different treatment conditions while observations are made on individual students. This design requires that the treatment effect be assessed against the between-school variance. However, the between-school variance is usually larger than the variance that would be obtained if students were individually randomized to different conditions. Consequently, the power of the test for a treatment effect is reduced, and it becomes difficult to detect important treatment effects. To assess the potential loss of power or to calculate appropriate sample sizes, investigators need good estimates of the intraclass correlations for the variables of interest. The authors calculated intraclass correlations for some common outcome variables in a school-based smoking prevention study, using a three-level model-i.e., students nested within classrooms and classrooms nested within schools. The authors present the intraclass correlation estimates for the entire data set, as well as separately by sex and ethnicity. They also illustrate the use of these estimates in the planning of future studies.",0,1 +1973,A multivariate model for the meta‐analysis of study level survival data at multiple times,"Motivated by our meta-analytic dataset involving survival rates after treatment for critical leg ischemia, we develop and apply a new multivariate model for the meta-analysis of study level survival data at multiple times. Our data set involves 50 studies that provide mortality rates at up to seven time points, which we model simultaneously, and we compare the results to those obtained from standard methodologies. Our method uses exact binomial within-study distributions and enforces the constraints that both the study specific and the overall mortality rates must not decrease over time. We directly model the probabilities of mortality at each time point, which are the quantities of primary clinical interest. We also present I2 statistics that quantify the impact of the between-study heterogeneity, which is very considerable in our data set. © 2014 The Authors. Research Synthesis Methods published by John Wiley & Sons, Ltd.",0,1 +1974,"Prediction of self-reported knowledge with over-claiming, fluid and crystallized intelligence and typical intellectual engagement","abstract Article history:Received 19 April 2011Received in revised form 7 September 2011Accepted 9 September 2011Keywords:Over-Claiming Technique (OCT)Over-Claiming Questionnaire (OCQ)Self-reported knowledgeFluid and crystallized intelligenceIntellectual engagement We investigated the usefulness of the Over-Claiming Questionnaire (OCQ) as a measure of cognitive abilities. InOCQs respondents are asked to rate their familiarity with items of academic or everyday knowledge (Paulhus,Harms, Bruce, & Lysy, 2003). Some items exist in reality (reals), and others do not (foils). We developed fourOCQs, each consisting of 40 reals and 8 foils from the domains of Science, Humanities and Civics. The OCQswere administered in a longitudinal rotation design to 112 participants who attended the 9th school grade atthe beginning ofthestudy. Inlatent variableregression analyses53% ofvariation inthe reals couldbeexplainedbyfluidandcrystallizedintelligenceandover-claimingasindicatedbyresponsestofoils.Furthervariationinre-sponses to reals and foils was explained by intellectual engagement. Our results show that self-reported knowl-edge, although positively related to measures of ability, to a large extent reflects over-claiming.© 2011 Elsevier Inc. All rights reserved.",0,1 +1975,Statistically based tests for the number of common factors,,0,1 +1976,Approximate uniform shrinkage prior for a multivariate generalized linear mixed model,Multivariate generalized linear mixed models (MGLMM) are used for jointly modeling the clustered mixed outcomes obtained when there are two or more responses repeatedly measured on each individual in scientific studies. Bayesian methods are widely used techniques for analyzing MGLMM. The need for noninformative priors arises when there is insufficient prior information on the model parameters. The main aim of the present study is to propose an approximate uniform shrinkage prior for the random effect variance components in the Bayesian analysis for the MGLMM. This prior is an extension of the approximate uniform shrinkage prior proposed by Natarajan and Kass (2000). This prior is easy to apply and is shown to possess several nice properties. The use of the approximate uniform shrinkage prior is illustrated in terms of both a simulation study and osteoarthritis data.,0,1 +1977,WEIGHTING FOR BATTERY RELIABILITY AND PREDICTION,,0,1 +1978,Modeling DIF Effects Using Distractor-Level Invariance Effects: Implications for Understanding the Causes of DIF,"In 2008, Penfield showed that measurement invariance across all response options of a multiple-choice item (correct option and the J distractors) can be modeled using a nominal response model that included a differential distractor functioning (DDF) effect for each of the J distractors. This article extends this concept to consider how the differential item functioning (DIF) effect (i.e., the conditional between-group differences in the probability of correct response) is determined by the J DDF effects. In particular, this article shows how the DIF effect can be modeled as a function of the J DDF effects and thus reveals the conditions that must hold for uniform DIF, nonuniform DIF, and crossing DIF to exist. The results provide insight into the potential item-level properties that lead to uniform, nonuniform, and crossing DIF. The findings may shed light on the etiology of different forms of DIF, which may help analysts target the particular causes of the DIF effect.",0,1 +1979,"Testing the four-factor model of personality vulnerability to alcohol misuse: A three-wave, one-year longitudinal study.","The 4-factor model of personality vulnerability identifies 4 personality risk factors for alcohol misuse: hopelessness, anxiety sensitivity, impulsivity, and sensation seeking. These personality traits are associated with distinct mechanisms and motivations for alcohol misuse. Individuals high in hopelessness drink to regulate dysphoric affect, while those high in anxiety sensitivity drink to reduce anxiety and to conform to peer expectations. Individuals high in sensation seeking are highly sensitive to the rewarding properties of alcohol, and misuse alcohol to maximize enjoyment. Impulsivity is a broad risk factor contributing to all drinking motives. We hypothesized that personality vulnerabilities would indirectly predict alcohol quantity and problems through specific drinking motives theorized by the 4-factor model. The present study tested hypotheses using a 3-wave, 1-year longitudinal study of undergraduate drinkers (N = 302). Data were analyzed using multilevel path analysis. Hopelessness and impulsivity were positively related to drinking motives in the expected fashion. Anxiety sensitivity was related to coping-anxiety and conformity motives only in the between-subjects model (partially supporting hypotheses), while sensation seeking was generally unrelated to all drinking motives and alcohol outcomes (failing to support hypotheses). Enhancement motives predicted alcohol quantity and problems at both levels, coping-depression motives predicted alcohol problems at the between-subjects level only, and coping-anxiety, conformity, and social motives failed to predict alcohol outcomes beyond other motives. Overall, this study partially supports the 4-factor model, with the strongest support emerging for impulsivity and hopelessness. This study suggests that personality traits such as impulsivity and hopelessness may be important targets in prevention and treatment with undergraduate drinkers.",0,1 +1980,The Choice of a Noninformative Prior on Between-Study Variance Strongly Affects Predictions of Future Treatment Effect,"Purpose. Bayesian random-effects meta-analyses require the analyst to specify the prior distribution for between-study variance of the treatment effect. We assessed the sensitivity of prediction and other outputs of the meta-analysis to the choice of this prior. Methods. We reanalyzed 7 published meta-analyses (5–14 trials) with rare (event rates <5%), moderate (15%–50%), and frequent binary outcomes (>50%). We examined 10 noninformative priors: inverse gamma on between-study variance ( τ 2 ), 2 uniforms on each of the between-study standard deviation ( τ) and τ 2 , uniform shrinkage on τ 2 , DuMouchel shrinkage on τ, half-normal on τ 2 , and half-normal priors on τ with large and small variances. For each analysis, we calculated the posterior distributions for τ, the population treatment effect in current studies, and the predicted treatment effect in a future study. We assessed goodness of fit using total residual deviance, the deviance information criterion, and predictive deviance (by cross-validations). Results. According to total residual deviance, the best-fitting priors were uniform on τ 2 . According to predictive deviance, half-normal on τ 2 and the shrinkage priors were optimal. Across analyses with the 10 priors, there were no important differences in the posteriors for the population treatment effect, but there were substantial differences in the posteriors for τ and predictions. The priors that fitted best according to predictive deviance resulted in less uncertainty around predictions of future treatment effect. Conclusions. In this sample of Bayesian meta-analyses with binary outcomes, the choice of noninformative prior for between-study variance affected model fit and the predictions of future treatment effect. When the predictive distribution is of interest, we highly recommend examination of multiple prior distributions for between-study variance, especially the half-normal on τ 2 and the shrinkage priors.",0,1 +1981,Public opinion and the reform of the pension systems in Europe: the influence of solidarity principles,"The demographic changes that have occurred in European countries in recent decades have made the policies of the public pension system one of the most debated issues of the welfare state. In this paper, I focus on preferences for three pension policy reforms with different distributive consequences: raising contributions, raising the age of retirement, and allowing free choice between public and private pension plans. I use multilevel models to analyse how individual attachment to different solidarity principles (universalistic, conservative, liberal and familistic) affects attitudes toward pension system reforms while controlling for institutional factors. The empirical results strongly support the hypothesis that solidarity principles have a significant influence on individual preferences. I find that individuals who adhere to universalistic or conservative principles are more in favour of increasing contributions in order to maintain the level of pensions, whereas they oppose a postponement of retirement age. In contrast, those who adhere to liberal or familistic principles are against increasing contributions and prefer extending retirement age. The findings at least partially support the ‘regime hypothesis’, as a more generous pension system appears to increase support for raising contributions while decreasing support for a raise in the age of retirement.",0,1 +1982,Fitting distributions using maximum likelihood: Methods and packages,"The most powerful tests of response time (RT) models often involve the whole shape of the RT distribution, thus avoiding mimicking that can occur at the level of RT means and variances. Nonparametric distribution estimation is, in principle, the most appropriate approach, but such estimators are sometimes difficult to obtain. On the other hand, distribution fitting, given an algebraic function, is both easy and compact. We review the general approach to performing distribution fitting with maximum likelihood (ML) and a method based on quantiles (quantile maximum probability, QMP). We show that QMP has both small bias and good efficiency when used with common distribution functions (the ex-Gaussian, Gumbel, lognormal, Wald, and Weibull distributions). In addition, we review some software packages performing ML (PASTIS, QMPE, DISFIT, and MATHEMATICA) and compare their results. In general, the differences between packages have little influence on the optimal solution found, but the form of the distribution function has: Both the lognormal and the Wald distributions have non-linear dependencies between the parameter estimates that tend to increase the overall bias in parameter recovery and to decrease efficiency. We conclude by laying out a few pointers on how to relate descriptive models of RT to cognitive models of RT. A program that generated the random deviates used in our studies may be downloaded from www.psychonomic.org/archive/.",0,1 +1983,Full Matching in an Observational Study of Coaching for the SAT,"Among matching techniques for observational studies, full matching is in principle the best, in the sense that its alignment of comparable treated and control subjects is as good as that of any alternate method, and potentially much better. This article evaluates the practical performance of full matching for the first time, modifying it in order to minimize variance as well as bias and then using it to compare coached and uncoached takers of the SAT. In this new version, with restrictions on the ratio of treated subjects to controls within matched sets, full matching makes use of many more observations than does pair matching, but achieves far closer matches than does matching with k≥ 2 controls. Prior to matching, the coached and uncoached groups are separated on the propensity score by 1.1 SDs. Full matching reduces this separation to 1% or 2% of an SD. In older literature comparing matching and regression, Cochran expressed doubts that any method of adjustment could substantially reduce observed bias ...",0,1 +1984,The case for objective Bayesian analysis,"Bayesian statistical practice makes extensive use of versions of objective Bayesian analysis. We discuss why this is so, and address some of the criticisms that have been raised concerning objective Bayesian analysis. The dangers of treating the issue too casually are also considered. In particular, we suggest that the statistical community should accept formal objective Bayesian techniques with confidence, but should be more cautious about casual objective Bayesian techniques.",0,1 +1985,Developing a scale measuring perceived knowledge and skills dimensions for mental health promotion: a pilot test using a convenience sample,"Purpose – Against the background of rising mental health (MH) problems many practitioners and health programmers require tools to plan and implement mental health promotion (MHP). A Likert scale to measure Perceived Knowledge of Skills needed for MHP (PKSMHP) was developed and pilot tested. The paper aims to discuss these issues. Design/methodology/approach – A convenience sample of leading personnel ( n =106) in three settings (43 schools, 24 workplaces, 39 care facilities) was drawn in five European countries. A descriptive item analysis, an exploratory and confirmatory factor analysis, and a scales’ performance analysis was adopted. Findings – The validated PKSMHP scale included nine high-quality items measuring the knowledge level of three skills dimensions: MHP management/planning, MHP tools/methods/services and recognition/detection of MH problems. Taken together these can be seen to represent the overall type of skills needed for implementing MHP. Originality/value – The short scale showed very good scale performance values in this pilot study. After further testing the scale might be used as a baseline assessment of MHP needs, as a building block for MHP training and organisational capacity building.",0,1 +1986,A measurement-theoretic analysis of the fuzzy logic model of perception.,"The fuzzy logic model of perception (FLMP) is analyzed from a measurement-theoretic perspective. FLMP has an impressive history of fitting factorial data, suggesting that its probabilistic form is valid. The authors raise questions about the underlying processing assumptions of FLMP. Although FLMP parameters are interpreted as fuzzy logic truth values, the authors demonstrate that for several factorial designs widely used in choice experiments, most desirable fuzzy truth value properties fail to hold under permissible rescalings, suggesting that the fuzzy logic interpretation may be unwarranted. The authors show that FLMP's choice rule is equivalent to a version of G. Rasch's (1960) item response theory model, and the nature of FLMP measurement scales is transparent when stated in this form. Statistical inference theory exists for the Rasch model and its equivalent forms. In fact, FLMP can be reparameterized as a simple 2-category logit model, thereby facilitating interpretation of its measurement scales and allowing access to commercially available software for performing statistical inference.",0,1 +1987,Re-considering the variance parameterization in multiple precision models,"Recent developments in Bayesian computing allow accurate estimation of integrals, making advanced Bayesian analysis feasible. However, some problems remain difficult, such as estimating posterior distributions for variance parameters. For models with three or more variances, this paper proposes a simplex parameterization for the variance structure, which has appealing properties and eases the related burden of specifying a reference prior. This parameterization can be profitably used in several multiple-precision models, including crossed random-effect models, many linear mixed models, smoothed ANOVA, and the conditionally autoregressive (CAR) model with two classes of neighbor relations, often useful for spatial data. The simplex parameterization has at least two attractive features. First, it typically leads to simple MCMC algorithms with good mixing properties regardless of the parameterization used to specify the model's reference prior. Thus, a Bayesian analysis can take computational advantage of the simplex parameterization even if its prior was specified using another parameterization. Second, the simplex parameterization suggests a natural reference prior that is proper, invariant under multiplication of the data by a constant, and which appears to reduce the posterior correlation of smoothing parameters with the error precision. We use simulations to compare the simplex parameterization, with its reference prior, to other parameterizations with their reference priors, according to bias and mean-squared error of point estimates and coverage of posterior 95% credible intervals. The results suggest advantages for the simplex approach, particularly when the error precision is small. We offer results in the context of two real data sets from the fields of periodontics and prosthodontics.",0,1 +1988,Comprehensive meta-analysis of the construct validity of the employment interview,"This article presents a series of meta-analyses carried out, exploring the construct validity of personnel selection interviews. Accordingly, the interviews were divided into two different groups: conventional interviews and behavior interviews. Conventional interviews are typically composed of questions directed at checking credentials, description of experience, and self-evaluative information. Behavior interviews mainly include questions concerning job knowledge, job experience, and behavior descriptions. The results showed that conventional interviews assessed general mental ability, job experience, the Big Five personality dimensions, and social skills, whereas behavior interviews mainly assessed job knowledge, job experience, situational judgment, and social skills. According to these findings, conventional and behavior interviews seem to be different interviews.",0,1 +1989,Unfolding the Measurement of the Creative Personality,"ABSTRACT Gough’s Creative Personality Scale (CPS) is a self-report personality inventoryfor creativity assessment. We investigated the undimensionality and the responseprocess on the CPS from an ideal point (unfolding) perspective. The Graded Unfold-ing Model (GUM) was used to model binary responses and participants were228 engineering students who completed a Greek version of the CPS. Resultssupport the undimensionality of the CPS construct and suggest that unfoldingmeasurement models may provide new insights to the assessment of creativity. Keywords: Creativity measurement, ideal point models, GUM, Greece INTRODUCTION Creativity assessments seek to identify the creative individual and this is one ofthe most exciting adventures in creativity research (Runco, 2007). Psychometrictests (i.e. tests of divergent thinking, attitude and interest inventories, personalityinventories, and biographical inventories) are one general approach used in thestudy of creativity (Hocevar and Bachelor, 1989). Researchers have devoted sub-stantial efforts to demonstrating the psychometric quality of creativity tests; andthe importance of understanding the psychometric properties of creativity mea-sures has been recognized (Plucker and Renzulli, 1999). Yet, the techniques usedin these efforts have not kept pace with the advances in psychometric theory andmethods. In the field of creativity, the application of modern test theory — notablyItem Response Theory (IRT) and its variants, such as unfolding models is rare.This is regrettable given that modern test theory may bring more psychometricrigor to the problem of measuring creativity, over and above traditional psycho-metric techniques.",0,1 +1990,Accounting for uncertainty in ecological analysis: the strengths and limitations of hierarchical statistical modeling,"Analyses of ecological data should account for the uncertainty in the process(es) that generated the data. However, accounting for these uncertainties is a difficult task, since ecology is known for its complexity. Measurement and/or process errors are often the only sources of uncertainty modeled when addressing complex ecological problems, yet analyses should also account for uncertainty in sampling design, in model specification, in parameters governing the specified model, and in initial and boundary conditions. Only then can we be confident in the scientific inferences and forecasts made from an analysis. Probability and statistics provide a framework that accounts for multiple sources of uncertainty. Given the complexities of ecological studies, the hierarchical statistical model is an invaluable tool. This approach is not new in ecology, and there are many examples (both Bayesian and non-Bayesian) in the literature illustrating the benefits of this approach. In this article, we provide a baseline for concepts, notation, and methods, from which discussion on hierarchical statistical modeling in ecology can proceed. We have also planted some seeds for discussion and tried to show where the practical difficulties lie. Our thesis is that hierarchical statistical modeling is a powerful way of approaching ecological analysis in the presence of inevitable but quantifiable uncertainties, even if practical issues sometimes require pragmatic compromises.",0,1 +1991,Signal detection and threshold modeling of confidence-rating ROCs: A critical test with minimal assumptions.,"An ongoing discussion in the recognition-memory literature concerns the question of whether recognition judgments reflect a direct mapping of graded memory representations (a notion that is instantiated by signal detection theory) or whether they are mediated by a discrete-state representation with the possibility of complete information loss (a notion that is instantiated by threshold models). These 2 accounts are usually evaluated by comparing their (penalized) fits to receiver operating characteristic data, a procedure that is predicated on substantial auxiliary assumptions, which if violated can invalidate results. We show that the 2 accounts can be compared on the basis of critical tests that invoke only minimal assumptions. Using previously published receiver operating characteristic data, we show that confidence-rating judgments are consistent with a discrete-state account. (PsycINFO Database Record",0,1 +1992,No role for initial severity on the efficacy of antidepressants: results of a multi-meta-analysis,"During the last decade, a number of meta-analyses questioned the clinically relevant efficacy of antidepressants. Part of the debate concerned the method used in each of these meta-analyses as well as the quality of the data set.The Kirsch data set was analysed with a number of different methods, and eight key questions were tackled. We fit random effects models in both Bayesian and frequentist statistical frameworks using raw mean difference and standardised mean difference scales. We also compare between-study heterogeneity estimates and produce treatment rank probabilities for all antidepressants. The role of the initial severity is further examined using meta-regression methods.The results suggest that antidepressants have a standardised effect size equal to 0.34 which is lower but comparable to the effect of antipsychotics in schizophrenia and acute mania. The raw HDRS difference from placebo is 2.82 with the value of 3 included in the confidence interval (2.21-3.44). No role of initial severity was found after partially controlling for the effect of structural (mathematical) coupling. Although data are not definite, even after controlling for baseline severity, there is a strong possibility that venlafaxine is superior to fluoxetine, with the other two agents positioned in the middle. The decrease in the difference between the agent and placebo in more recent studies in comparison to older ones is attributed to baseline severity alone.The results reported here conclude the debate on the efficacy of antidepressants and suggest that antidepressants are clearly superior to placebo. They also suggest that baseline severity cannot be utilized to dictate whether the treatment should include medication or not. Suggestions like this, proposed by guidelines or institutions (e.g. the NICE), should be considered mistaken.",0,1 +1993,Bayesian analysis of longitudinal multitrait-multimethod data with ordinal response variables,"A new multilevel latent state graded response model for longitudinal multitrait-multimethod (MTMM) measurement designs combining structurally different and interchangeable methods is proposed. The model allows researchers to examine construct validity over time and to study the change and stability of constructs and method effects based on ordinal response variables. We show how Bayesian estimation techniques can address a number of important issues that typically arise in longitudinal multilevel MTMM studies and facilitates the estimation of the model presented. Estimation accuracy and the impact of between- and within-level sample sizes as well as different prior specifications on parameter recovery were investigated in a Monte Carlo simulation study. Findings indicate that the parameters of the model presented can be accurately estimated with Bayesian estimation methods in the case of low convergent validity with as few as 250 clusters and more than two observations within each cluster. The model was applied to well-being data from a longitudinal MTMM study, assessing the change and stability of life satisfaction and subjective happiness in young adults after high-school graduation. Guidelines for empirical applications are provided and advantages and limitations of a Bayesian approach to estimating longitudinal multilevel MTMM models are discussed.",0,1 +1994,Harnessing pain heterogeneity and RNA transcriptome to identify blood-based pain biomarkers: a novel correlational study design and bioinformatics approach in a graded chronic constriction injury model,"A quantitative, peripherally accessible biomarker for neuropathic pain has great potential to improve clinical outcomes. Based on the premise that peripheral and central immunity contribute to neuropathic pain mechanisms, we hypothesized that biomarkers could be identified from the whole blood of adult male rats, by integrating graded chronic constriction injury (CCI), ipsilateral lumbar dorsal quadrant (iLDQ) and whole blood transcriptomes, and pathway analysis with pain behavior. Correlational bioinformatics identified a range of putative biomarker genes for allodynia intensity, many encoding for proteins with a recognized role in immune/nociceptive mechanisms. A selection of these genes was validated in a separate replication study. Pathway analysis of the iLDQ transcriptome identified Fcγ and Fcε signaling pathways, among others. This study is the first to employ the whole blood transcriptome to identify pain biomarker panels. The novel correlational bioinformatics, developed here, selected such putative biomarkers based on a correlation with pain behavior and formation of signaling pathways with iLDQ genes. Future studies may demonstrate the predictive ability of these biomarker genes across other models and additional variables.",0,1 +1995,Effective Analysis of Reaction Time Data,"Most analyses of reaction time (RT) data are conducted by using the statistical techniques with which psychologists are most familiar, such as analysis of variance on the sample mean. Unfortunately, these methods are usually inappropriate for RT data, because they have little power to detect genuine differences in RT between conditions. In addition, some statistical approaches can, under certain circumstances, result in findings that are artifacts of the analysis method itself. A corpus of research has shown more effective analytical methods, such as analyzing the whole RT distribution, although this research has had limited influence. The present article will summarize these advances in methods for analyzing RT data.",0,1 +1996,Systematic review and economic modelling of the effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence,"To assess the clinical effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence (SUI) through systematic review and economic modelling.The Cochrane Incontinence Group Specialised Register, electronic databases and the websites of relevant professional organisations and manufacturers, and the following databases: CINAHL, EMBASE, BIOSIS, Science Citation Index and Social Science Citation Index, Current Controlled Trials, ClinicalTrials.gov and the UKCRN Portfolio Database.The study comprised three distinct elements. (1) A survey of 188 women with SUI to identify outcomes of importance to them (activities of daily living; sex, hygiene and lifestyle issues; emotional health; and the availability of services). (2) A systematic review and meta-analysis of non-surgical treatments for SUI to find out which are most effective by comparing results of trials (direct pairwise comparisons) and by modelling results (mixed-treatment comparisons - MTCs). A total of 88 randomised controlled trials (RCTs) and quasi-RCTs reporting data from 9721 women were identified, considering five generic interventions [pelvic floor muscle training (PFMT), electrical stimulation (ES), vaginal cones (VCs), bladder training (BT) and serotonin-noradrenaline reuptake inhibitor (SNRI) medications], in many variations and combinations. Data were available for 37 interventions and 68 treatment comparisons by direct pairwise assessment. Mixed-treatment comparison models compared 14 interventions, using data from 55 trials (6608 women). (3) Economic modelling, using a Markov model, to find out which combinations of treatments (treatment pathways) are most cost-effective for SUI.Titles and abstracts identified were assessed by one reviewer and full-text copies of all potentially relevant reports independently assessed by two reviewers. Any disagreements were resolved by consensus or arbitration by a third person.Direct pairwise comparison and MTC analysis showed that the treatments were more effective than no treatment. Delivering PFMT in a more intense fashion, either through extra sessions or with biofeedback (BF), appeared to be the most effective treatment [PFMT extra sessions vs no treatment (NT) odds ratio (OR) 10.7, 95% credible interval (CrI) 5.03 to 26.2; PFMT + BF vs NT OR 12.3, 95% CrI 5.35 to 32.7]. Only when success was measured in terms of improvement was there evidence that basic PFMT was better than no treatment (PFMT basic vs NT OR 4.47, 95% CrI 2.03 to 11.9). Analysis of cost-effectiveness showed that for cure rates, the strategy using lifestyle changes and PFMT with extra sessions followed by tension-free vaginal tape (TVT) (lifestyle advice-PFMT extra sessions-TVT) had a probability of greater than 70% of being considered cost-effective for all threshold values for willingness to pay for a QALY up to 50,000 pounds. For improvement rates, lifestyle advice-PFMT extra sessions-TVT had a probability of greater than 50% of being considered cost-effective when society's willingness to pay for an additional QALY was more than 10,000 pounds. The results were most sensitive to changes in the long-term performance of PFMT and also in the relative effectiveness of basic PFMT and PFMT with extra sessions.Although a large number of studies were identified, few data were available for most comparisons and long-term data were sparse. Challenges for evidence synthesis were the lack of consensus on the most appropriate method for assessing incontinence and intervention protocols that were complex and varied considerably across studies.More intensive forms of PFMT appear worthwhile, but further research is required to define an optimal form of more intensive therapy that is feasible and efficient for the NHS to provide, along with further definitive evidence from large, well-designed studies.",0,1 +1997,Maximum Likelihood Analysis of Nonlinear Structural Equation Models With Dichotomous Variables,"In this article, a maximum likelihood approach is developed to analyze structural equation models with dichotomous variables that are common in behavioral, psychological and social research. To assess nonlinear causal effects among the latent variables, the structural equation in the model is defined by a nonlinear function. The basic idea of the development is to augment the observed dichotomous data with the hypothetical missing data that involve the latent underlying continuous measurements and the latent variables in the model. An EM algorithm is implemented. The conditional expectation in the E-step is approximated via observations simulated from the appropriate conditional distributions by a Metropolis-Hastings algorithm within the Gibbs sampler, whilst the M-step is completed by conditional maximization. Convergence is monitored by bridge sampling. Standard errors are also obtained. Results from a simulation study and a real example are presented to illustrate the methodology.",0,1 +1998,A Multilevel Factor Model for Mixed Binary and Ordinal Indicators of Women's Status,"The authors present a factor model for the analysis of categorical responses with a two-level hierarchical structure. The model allows for multiple, potentially correlated factors at each level as well as covariate effects on the responses. Estimation using Markov chain Monte Carlo (MCMC) methods is described. The methodology is applied in an analysis of women's status in Bangladesh. Two dimensions of women's status are considered—social independence and decision-making power—and the factor structure of the responses at the woman and district levels is explored.",0,1 +1999,A Comparative Review of Interaction and Nonlinear Modeling,,0,1 +2000,How Do We Judge Confidence-Interval Adequacy?,"Abstract Simulation studies of confidence-interval procedures often only report coverage rates. This is not sufficient to judge whether the intervals are “unbiased,” that is, whether they are equally likely to be above as below the true value if they do not cover the true value. Most procedures suggest that they are forming such intervals.",0,1 +2001,Adaptive psychophysical procedures,"Improvements in measuring thresholds, or points on a psychometric function, have advanced the field of psychophysics in the last 30 years. The arrival of laboratory computers allowed the introduction of adaptive procedures, where the presentation of the next stimulus depends on previous responses of the subject. Unfortunately, these procedures present themselves in a bewildering variety, though some of them differ only slightly. Even someone familiar with several methods cannot easily name the differences, or decide which method would be best suited for a particular application. This review tries to illuminate the historical background of adaptive procedures, explain their differences and similarities, and provide criteria for choosing among the various techniques.",0,1 +2002,Engagement in Training as a Mechanism to Understanding Fidelity of Implementation of the Responsive Classroom Approach,"Fidelity of implementation of classroom interventions varies greatly, a reality that is concerning because higher fidelity of implementation relates to greater effectiveness of the intervention. We analyzed 126 fourth and fifth grade teachers from the treatment group of a randomized controlled trial of the Responsive Classroom® (RC) approach. Prior to training in the intervention, we assessed factors that had the potential to represent a teacher’s readiness to implement with fidelity. These included teachers’ observed emotional support, teacher-rated use of intervention practices, teacher-rated self-efficacy, teacher-rated collective responsibility, education level, and years of experience, and they were not directly related to observed fidelity of implementation 2 years later. Further analyses indicated, however, that RC trainers’ ratings of teachers’ engagement in the initial weeklong RC training mediated the relation between initial observed emotional support and later observed fidelity of implementation. We discuss these findings as a way to advance understanding of teachers’ readiness to implement new interventions with fidelity. © 2014, Society for Prevention Research.",0,1 +2003,Cross-domain collaborative filtering via bilinear multilevel analysis,"Cross-domain collaborative filtering (CDCF), which aims to leverage data from multiple domains to relieve the data sparsity issue, is becoming an emerging research topic in recent years. However, current CDCF methods that mainly consider user and item factors but largely neglect the heterogeneity of domains may lead to improper knowledge transfer issues. To address this problem, we propose a novel CDCF model, the Bilinear Multilevel Analysis (BLMA), which seamlessly introduces multilevel analysis theory to the most successful collaborative filtering method, matrix factorization (MF). Specifically, we employ BLMA to more efficiently address the determinants of ratings from a hierarchical view by jointly considering domain, community, and user effects so as to overcome the issues caused by traditional MF approaches. Moreover, a parallel Gibbs sampler is provided to learn these effects. Finally, experiments conducted on a realworld dataset demonstrate the superiority of the BLMA over other state-of-the-art methods.",0,1 +2004,Small-Sample Robust Estimators of Noncentrality-Based and Incremental Model Fit,"Traditional estimators of fit measures based on the noncentral chi–square distribution (root mean square error of approximation [RMSEA], Steiger's γ, etc.) tend to overreject acceptable models when the sample size is small. To handle this problem, it is proposed to employ Bartlett's (1950) Bartlett, M. S. 1950. Tests of significance in factor analysis. British Journal of Psychology (Statistical Section), 3: 77–85. [Crossref], [Web of Science ®] , [Google Scholar], Yuan's (2005) Yuan, K.-H. 2005. Fit indices versus test statistics. Multivariate Behavioral Research, 40: 115–148. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar], or Swain's (1975) Swain, A. J. 1975. Analysis of parametric structures for variance matrices., Australia: Department of Statistics, University of Adelaide. Unpublished doctoral dissertation [Google Scholar] correction of the maximum likelihood chi–square statistic for the estimation of noncentrality–based fit measures. In a Monte Carlo study, it is shown that Swain's correction especially produces reliable estimates and confidence intervals for different degrees of model misspecification (RMSEA range: 0.000–0.096) and sample sizes (50, 75, 100, 150, 200). In the second part of the article, the study is extended to incremental fit indexes (Tucker–Lewis Index, Comparative Fit Index, etc.). For their small–sample robust estimation, use of Swain's correction is recommended only for the target model, not for the independence model. The Swain–corrected estimators only require a ratio of sample size to estimated parameters of about 2:1 (sometimes even less) and are thus strongly recommended for applied research. R software is provided for convenient use.",0,1 +2005,A Multilevel Perspective on the Design and Analysis of Intervention Studies,"The level (pupil, classroom or school) at which an educational intervention is assigned affects both the kinds of questions which can be answered in evaluation research, and the statistical methods used to answer them. This paper sets out ways of analysing different kinds of designs using multilevel models. It also considers practical issues such as the method used to allocate interventions, leakage, integrity of delivery, and cost, and how these interact with the more technical issues of model specification. These practical issues are illustrated by two recent British intervention studies. Resume Le niveau - eleve, classe ou ecole - auquel s'adresse une intervention educative affecte tout a la fois le genre de questions qui peuvent trouver reponse dans la recherche evaluative et les methodes statistiques pour y repondre. Cet article presente des voies pour analyser differents types de design qui utilisent des modeles a plusieurs niveaux. Il traite aussi de certains aspects pratiques tels que la methode...",0,1 +2006,Explaining the Gibbs Sampler,"Abstract Computer-intensive algorithms, such as the Gibbs sampler, have become increasingly popular statistical tools, both in applied and theoretical work. The properties of such algorithms, however, may sometimes not be obvious. Here we give a simple explanation of how and why the Gibbs sampler works. We analytically establish its properties in a simple case and provide insight for more complicated cases. There are also a number of examples.",0,1 +2007,"Robust growth mixture models with non-ignorable missingness: Models, estimation, selection, and application","Challenges in the analyses of growth mixture models include missing data, outliers, estimation, and model selection. Four non-ignorable missingness models to recover the information due to missing data, and three robust models to reduce the effect of non-normality are proposed. A full Bayesian method is implemented by means of data augmentation algorithm and Gibbs sampling procedure. Model selection criteria are also proposed in the Bayesian context. Simulation studies are then conducted to evaluate the performances of the models, the Bayesian estimation method, and selection criteria under different situations. The application of the models is demonstrated through the analysis of education data on children's mathematical ability development. The models can be widely applied to longitudinal analyses in medical, psychological, educational, and social research. Four non-ignorable missingness models are proposed.Three robust models to deal with outliers are proposed.A full Bayesian method is implemented.Model selection criteria are proposed in a Bayesian context.Three simulation studies and one real data case study are conducted.",0,1 +2008,Measuring adaptive performance in individuals and teams,"Purpose – While scales were developed to measure individual adaptive performance (IAP), fewer contributions have been done to assess the construct at the team level of analysis. This issue is addressed through two related studies: Study 1 builds on Pulakos et al. (2000) to develop a measure of IAP. Study 2 follows from the results in Study 1 and tests a measure of team adaptive performance (Chan, 1998). Design/methodology/approach – Scale development was done adopting a single level (Study 1) and multi-level (Study 2) structural equations modeling approach. Findings – Results suggest that both measures of individual and team adaptive performance are reliable and show evidence supporting the adequacy of adopting referent-shift methodologies to the measurement and aggregation of team members’ rating of team adaptive performance. Originality/value – The study offers a reliable, parsimonious and easy to apply measure of individual and team adaptive performance in organizational work environments.",0,1 +2009,Fluency Has a Role in the Simple View of Reading,"The Simple View of Reading (SVR) suggests that the components of reading comprehension are decoding and linguistic comprehension. Given research that suggests that fluency is a separate construct from decoding and linguistic comprehension in fourth grade, the aim of this study was to examine the role of fluency in the SVR model. Analyses of data from 248 fourth-grade children explored whether the influence of fluency on reading comprehension is direct or whether fluency plays an indirect role on reading comprehension as a mediator or moderator of decoding. Structural equation modeling and latent regression analyses revealed that reading fluency plays a mediating role in explaining the relation between decoding and reading comprehension. This novel finding is placed in the context of studies that reported either a direct effect or no effect of reading fluency in SVR.",0,1 +2010,A skew item response model,"We introduce a new skew-probit link for item response theory (IRT) by considering an accumulated skew-normal distribution. The model extends the symmetric probit-normal IRT model by considering a new item (or skewness) parameter for the item characteristic curve. A special interpretation is given for this parameter, and a latent linear structure is indicated for the model when an augmented likelihood is considered. Bayesian MCMC inference approach is developed and an efficiency study in the estimation of the model parameters is undertaken for a data set from (Tanner 1996, pg. 190) by using the notion of effective sample size (ESS) as defined in Kass et al. (1999) and the sample size per second (ESS/s) as considered in Sahu (2002). The methodology is illustrated using a data set corresponding to a Mathematical Test applied in Peruvian schools for which a sensitivity analysis of the chosen priors is conducted and also a comparison with seven parametric IRT models is conducted. The main conclusion is that the skew-probit item response model seems to provide the best fit.",0,1 +2011,On the importance of avoiding shortcuts in applying cognitive models to hierarchical data,"Psychological experiments often yield data that are hierarchically structured. A number of popular shortcut strategies in cognitive modeling do not properly accommodate this structure and can result in biased conclusions. To gauge the severity of these biases, we conducted a simulation study for a two-group experiment. We first considered a modeling strategy that ignores the hierarchical data structure. In line with theoretical results, our simulations showed that Bayesian and frequentist methods that rely on this strategy are biased towards the null hypothesis. Secondly, we considered a modeling strategy that takes a two-step approach by first obtaining participant-level estimates from a hierarchical cognitive model and subsequently using these estimates in a follow-up statistical test. Methods that rely on this strategy are biased towards the alternative hypothesis. Only hierarchical models of the multilevel data lead to correct conclusions. Our results are particularly relevant for the use of hierarchical Bayesian parameter estimates in cognitive modeling.",0,1 +2012,"Academic Performance, Career Potential, Creativity, and Job Performance: Can One Construct Predict Them All?","This meta-analysis addresses the question of whether 1 general cognitive ability measure developed for predicting academic performance is valid for predicting performance in both educational and work domains. The validity of the Miller Analogies Test (MAT; W. S. Miller, 1960) for predicting 18 academic and work-related criteria was examined. MAT correlations with other cognitive tests (e.g., Raven's Matrices [J. C. Raven, 1965]; Graduate Record Examinations) also were meta-analyzed. The results indicate that the abilities measured by the MAT are shared with other cognitive ability instruments and that these abilities are generalizably valid predictors of academic and vocational criteria, as well as evaluations of career potential and creativity. These findings contradict the notion that intelligence at work is wholly different from intelligence at school, extending the voluminous literature that supports the broad importance of general cognitive ability (g).",0,1 +2013,Identifying Variables Responsible for Data not Missing at Random,"When data are not missing at random (NMAR), maximum likelihood (ML) procedure will not generate consistent parameter estimates unless the missing data mechanism is correctly modeled. Understanding NMAR mechanism in a data set would allow one to better use the ML methodology. A survey or questionnaire may contain many items; certain items may be responsible for NMAR values in other items. The paper develops statistical procedures to identify the responsible items. By comparing ML estimates (MLE), statistics are developed to test whether the MLEs are changed when excluding items. The items that cause a significant change of the MLEs are responsible for the NMAR mechanism. Normal distribution is used for obtaining the MLEs; a sandwich-type covariance matrix is used to account for distribution violations. The class of nonnormal distributions within which the procedure is valid is provided. Both saturated and structural models are considered. Effect sizes are also defined and studied. The results indicate that more missing data in a sample does not necessarily imply more significant test statistics due to smaller effect sizes. Knowing the true population means and covariances or the parameter values in structural equation models may not make things easier either. © 2008 The Psychometric Society.",0,1 +2014,Estimating Statistical Power and Required Sample Sizes for Organizational Research Using Multilevel Modeling,"The use of multilevel modeling to investigate organizational phenomena is rapidly increasing. Unfortunately, little advice is readily available for organizational researchers attempting to determine statistical power when using multilevel models or when determining sample sizes for each level that will maximize statistical power. This article presents an introduction to statistical power in multilevel models. The unique factors influencing power in multilevel models and calculations for estimating power for simple fixed effects, variance components, and cross-level interactions are presented. The results of simulation studies and the existing general rules of thumb are discussed, and the available power analysis software is reviewed.",0,1 +2015,Modelling heterogeneity variances in multiple treatment comparison meta-analysis – Are informative priors the better solution?,"BackgroundMultiple treatment comparison (MTC) meta-analyses are commonly modeled in a Bayesian framework, and weakly informative priors are typically preferred to mirror familiar data driven frequentist approaches. Random-effects MTCs have commonly modeled heterogeneity under the assumption that the between-trial variance for all involved treatment comparisons are equal (i.e., the ‘common variance’ assumption). This approach ‘borrows strength’ for heterogeneity estimation across treatment comparisons, and thus, ads valuable precision when data is sparse. The homogeneous variance assumption, however, is unrealistic and can severely bias variance estimates. Consequently 95% credible intervals may not retain nominal coverage, and treatment rank probabilities may become distorted. Relaxing the homogeneous variance assumption may be equally problematic due to reduced precision. To regain good precision, moderately informative variance priors or additional mathematical assumptions may be necessary.MethodsIn this paper we describe four novel approaches to modeling heterogeneity variance - two novel model structures, and two approaches for use of moderately informative variance priors. We examine the relative performance of all approaches in two illustrative MTC data sets. We particularly compare between-study heterogeneity estimates and model fits, treatment effect estimates and 95% credible intervals, and treatment rank probabilities.ResultsIn both data sets, use of moderately informative variance priors constructed from the pair wise meta-analysis data yielded the best model fit and narrower credible intervals. Imposing consistency equations on variance estimates, assuming variances to be exchangeable, or using empirically informed variance priors also yielded good model fits and narrow credible intervals. The homogeneous variance model yielded high precision at all times, but overall inadequate estimates of between-trial variances. Lastly, treatment rankings were similar among the novel approaches, but considerably different when compared with the homogenous variance approach.ConclusionsMTC models using a homogenous variance structure appear to perform sub-optimally when between-trial variances vary between comparisons. Using informative variance priors, assuming exchangeability or imposing consistency between heterogeneity variances can all ensure sufficiently reliable and realistic heterogeneity estimation, and thus more reliable MTC inferences. All four approaches should be viable candidates for replacing or supplementing the conventional homogeneous variance MTC model, which is currently the most widely used in practice.",0,1 +2016,Estimating the Standard Error of the Maximum Likelihood Ability Estimator in Adaptive Testing Using the Posterior-Weighted Test Information Function,"The standard error of the maximum likelihood ability estimator is commonly estimated by evaluating the test information function at an examinee's current maximum likelihood estimate (a point estimate) of ability. Because the test information function evaluated at the point estimate may differ from the test information function evaluated at an examinee's true ability value, the estimated standard error may be biased under certain conditions. This is of particular concern in adaptive testing because the height of the test information function is expected to be higher at the current estimate of ability than at the actual value of ability. This article proposes using the posterior-weighted test information function in computing the standard error of the maximum likelihood ability estimator for adaptive test sessions. A simulation study showed that the proposed approach provides standard error estimates that are less biased and more efficient than those provided by the traditional point estimate approach.",0,1 +2017,"Structural Ecosystems Therapy for HIV-Seropositive African American Women: Effects on Psychological Distress, Family Hassles, and Family Support.","This study tests the efficacy of Structural Ecosystems Therapy (SET), a family-ecological intervention, in improving psychosocial functioning when compared with an attention-comparison person-centered condition and a community control condition. A sample of 209 HIV-seropositive, urban, low-income, African American women was randomized into 1 of the 3 conditions. Results of growth curve analyses over 5 time points revealed that SET was more efficacious than either of the control conditions in reducing psychological distress and family-related hassles. However, contrary to hypotheses, SET was not more efficacious in increasing family support. Latent growth mixture modeling analyses indicated that SET was most efficacious for women who, on average, were at or near the clinical threshold for psychological distress and for women with high levels of family hassles. Implications for further intervention development are discussed.",0,1 +2018,Genetic variance components analysis for binary phenotypes using generalized linear mixed models (GLMMs) and Gibbs sampling,"The common complex diseases such as asthma are an important focus of genetic research, and studies based on large numbers of simple pedigrees ascertained from population-based sampling frames are becoming commonplace. Many of the genetic and environmental factors causing these diseases are unknown and there is often a strong residual covariance between relatives even after all known determinants are taken into account. This must be modelled correctly whether scientific interest is focused on fixed effects, as in an association analysis, or on the covariances themselves. Analysis is straightforward for multivariate Normal phenotypes, but difficulties arise with other types of trait. Generalized linear mixed models (GLMMs) offer a potentially unifying approach to analysis for many classes of phenotype including multivariate Normal traits, binary traits, and censored survival times. Markov Chain Monte Carlo methods, including Gibbs sampling, provide a convenient framework within which such models may be fitted. In this paper, Bayesian inference Using Gibbs Sampling (a generic Gibbs sampler; BUGS) is used to fit GLMMs for multivariate Normal and binary phenotypes in nuclear families. BUGS is easy to use and readily available. We motivate a suitable model structure for Normal phenotypes and show how the model extends to binary traits. We discuss parameter interpretation and statistical inference and show how to circumvent a number of important theoretical and practical problems that we encountered. Using simulated data we show that model parameters seem consistent and appear unbiased in smaller data sets. We illustrate our methods using data from an ongoing cohort study.",0,1 +2019,Influence of Adherence to Treatment and Response of Cholesterol on Mortality in the Coronary Drug Project,"The Coronary Drug Project was carried out to evaluate the efficacy and safety of several lipid-influencing drugs in the long-term treatment of coronary heart disease. The five-year mortality in 1103 men treated with clofibrate was 20.0 per cent, as compared with 20.9 per cent in 2789 men given placebo (P = 0.55). Good adherers to clofibrate, i.e., patients who took 80 per cent of more of the protocol prescription during the five-year follow-up period, had a substantially lower five-year mortality than did poor adherers to clofibrate (15.0 vs. 24.6 per cent; P = 0.00011). However, similar findings were noted in the placebo group, i.e., 15.1 per cent mortality for good adherers and 28.3 per cent for poor adherers (P = 4.7x10-16). These findings and various other analyses of mortality in the clofibrate and placebo groups of the project show the serious difficulty, if not impossibility, of evaluating treatment efficacy in subgroups determined by patient responses (e.g., adherence or cholesterol change) to the treatment protocol after randomization.",0,1 +2020,Statistical controversies in clinical research: scientific and ethical problems with adaptive randomization in comparative clinical trials,"In recent years, various outcome adaptive randomization (AR) methods have been used to conduct comparative clinical trials. Rather than randomizing patients equally between treatments, outcome AR uses the accumulating data to unbalance the randomization probabilities in favor of the treatment arm that currently is superior empirically. This is motivated by the idea that, on average, more patients in the trial will be given the treatment that is truly superior, so AR is ethically more desirable than equal randomization. AR remains controversial, however, and some of its properties are not well understood by the clinical trials community.Computer simulation was used to evaluate properties of a 200-patient clinical trial conducted using one of four Bayesian AR methods and compare them to an equally randomized group sequential design.Outcome AR has several undesirable properties. These include a high probability of a sample size imbalance in the wrong direction, which might be surprising to nonstatisticians, wherein many more patients are assigned to the inferior treatment arm, the opposite of the intended effect. Compared with an equally randomized design, outcome AR produces less reliable final inferences, including a greatly overestimated actual treatment effect difference and smaller power to detect a treatment difference. This estimation bias becomes much larger if the prognosis of the accrued patients either improves or worsens systematically during the trial.AR produces inferential problems that decrease potential benefit to future patients, and may decrease benefit to patients enrolled in the trial. These problems should be weighed against its putative ethical benefit. For randomized comparative trials to obtain confirmatory comparisons, designs with fixed randomization probabilities and group sequential decision rules appear to be preferable to AR, scientifically, and ethically.",0,1 +2021,On Mean Squared Prediction Error Estimation in Small Area Estimation Problems,"For a general linear mixed normal model, a new linearized weighted jackknife method is proposed to estimate the mean squared prediction error (MSPE) of an empirical best linear unbiased predictor (EBLUP) of a general mixed effect. Different MSPE estimators are compared using a Monte Carlo simulation study.",0,1 +2022,Bayes Empirical Bayes,"Abstract A Bayesian approach is given for various kinds of empirical Bayes problems. In particular it is shown that empirical Bayes procedures are really non-Bayesian, asymptotically optimal, classical procedures for mixtures. In some situations these procedures are Bayes with respect to some prior and in other situations, there is no prior for which they are Bayes. Several examples of these concepts are given as well as a general theory showing the difference between an empirical Bayes model and a Bayes empirical Bayes model.",0,1 +2023,Moderated Mediation Analysis Using Bayesian Methods,"Conventionally, moderated mediation analysis is conducted through adding relevant interaction terms into a mediation model of interest. In this study, we illustrate how to conduct moderated mediation analysis by directly modeling the relation between the indirect effect components including a and b and the moderators, to permit easier specification and interpretation of moderated mediation. With this idea, we introduce a general moderated mediation model that can be used to model many different moderated mediation scenarios including the scenarios described in Preacher, Rucker, and Hayes (2007). Then we discuss how to estimate and test the conditional indirect effects and to test whether a mediation effect is moderated using Bayesian approaches. How to implement the estimation in both BUGS and Mplus is also discussed. Performance of Bayesian methods is evaluated and compared to that of frequentist methods including maximum likelihood (ML) with 1st-order and 2nd-order delta method standard errors and mL with bootstrap (percentile or bias-corrected confidence intervals) via a simulation study. The results show that Bayesian methods with diffuse (vague) priors implemented in both BUGS and Mplus yielded unbiased estimates, higher power than the ML methods with delta method standard errors, and the ML method with bootstrap percentile confidence intervals, and comparable power to the ML method with bootstrap bias-corrected confidence intervals. We also illustrate the application of these methods with the real data example used in Preacher et al. (2007). Advantages and limitations of applying Bayesian methods to moderated mediation analysis are also discussed.",0,1 +2024,Simple adaptive testing with the weighted up-down method,"This paper proposes a method for adaptive testing that is less complicated than the commonly used transformed up-down methods (1 up 2 down, 1 up 3 down, etc.). In addition, the weighted up-down method can converge to any desired point of the psychometric function. The rule is very simple: Each correct response leads to a decrease in signal level, each incorrect response to an increase. The only difference from the simple up-down method (1 up 1 down) is that the steps upward and the steps downward are of a different size. The straightforward construction of the novel procedure pays off in efficiency and stability: A Monte Carlo simulation reveals a definite advantage, though small, of the weighted up-down method over the 1-up-2-down rule.",0,1 +2025,"Fixed effects, random effects and GEE: What are the differences?","For analyses of longitudinal repeated-measures data, statistical methods include the random effects model, fixed effects model and the method of generalized estimating equations. We examine the assumptions that underlie these approaches to assessing covariate effects on the mean of a continuous, dichotomous or count outcome. Access to statistical software to implement these models has led to widespread application in numerous disciplines. However, careful consideration should be paid to their critical assumptions to ascertain which model might be appropriate in a given setting. To illustrate similarities and differences that might exist in empirical results, we use a study that assessed depressive symptoms in low-income pregnant women using a structured instrument with up to five assessments that spanned the pre-natal and post-natal periods. Understanding the conceptual differences between the methods is important in their proper application even though empirically they might not differ substantively. The choice of model in specific applications would depend on the relevant questions being addressed, which in turn informs the type of design and data collection that would be relevant. Copyright © 2008 John Wiley & Sons, Ltd.",0,1 +2026,Reliability of Scales With General Structure: Point and Interval Estimation Using a Structural Equation Modeling Approach,"A method for obtaining point and interval estimates of reliability for composites of measures with a general structure is discussed. The approach is based on fitting a correspondingly constrained structural equation model and generalizes earlier covariance structure analysis methods for scale reliability estimation with congeneric tests. The procedure can be used with weighted or unweighted composites, in which the weights need not be known in advance but may be estimated simultaneously. The approach allows one also to obtain an approximate standard error and confidence interval for scale reliability using the bootstrap methodology.",0,1 +2027,The General Factor of Personality: A meta-analysis of Big Five intercorrelations and a criterion-related validity study,"Recently, it has been proposed that a General Factor of Personality (GFP) occupies the top of the hierarchical personality structure. We present a meta-analysis (K = 212, total N = 144,117) on the intercorrelations among the Big Five personality factors (Openness, Conscientiousness, Extraversion, Agreeableness, and Neuroticism) to test for the existence of a GFP. In addition, we report a multi-method validity study testing the relationship between the GFP and supervisor-rated job performance. The meta-analysis provided supporting evidence for the two meta-factors Stability and Plasticity (ora and b, respectively) and a GFP at the highest hierarchal level. The validity study indicated that the GFP has a substantive component as it is related to supervisor-rated job performance.",0,1 +2028,An approach to combining parallel and cross-over trials with and without run-in periods using individual patient data,"Background In active run-in trials, where patients may be excluded after a run-in period based on their response to the treatment, it is implicitly assumed that patients have individual treatment effects. If individual patient data are available, active run-in trials can be modelled using patient-specific random effects. With more than one trial on the same medication available, one can obtain a more precise overall treatment effect estimate. Methods We present a model for joint analysis of a two-sequence, four-period cross-over trial (AABB/BBAA) and a three-sequence, two-period active run-in trial (AB/AA/A), where the aim is to investigate the effect of a new treatment for patients with pain due to osteoarthritis. Results Our approach enables us to separately estimate the direct treatment effect for all patients, for the patients excluded after the active run-in trial prior to randomisation, and for the patients who completed the active run-in trial. A similar model approach can be used to analyse other types of run-in trials, but this depends on the data and type of other trials available. Limitations We assume equality of the various carry-over effects over time. Conclusions The proposed approach is flexible and can be modified to handle other designs. Our results should be encouraging for those responsible for planning cost-efficient clinical development programmes.",0,1 +2029,The Monte Carlo Method,"Abstract We shall present here the motivation and a general description of a method dealing with a class of problems in mathematical physics. The method is, essentially, a statistical approach to the study of differential equations, or more generally, of integro-differential equations that occur in various branches of the natural sciences.",0,1 +2030,Modeling life-span growth curves of cognition using longitudinal data with multiple samples and changing scales of measurement.,"The authors use multiple-sample longitudinal data from different test batteries to examine propositions about changes in constructs over the life span. The data come from 3 classic studies on intellectual abilities in which, in combination, 441 persons were repeatedly measured as many as 16 times over 70 years. They measured cognitive constructs of vocabulary and memory using 8 age-appropriate intelligence test batteries and explore possible linkage of these scales using item response theory (IRT). They simultaneously estimated the parameters of both IRT and latent curve models based on a joint model likelihood approach (i.e., NLMIXED and WINBUGS). They included group differences in the model to examine potential interindividual differences in levels and change. The resulting longitudinal invariant Rasch test analyses lead to a few new methodological suggestions for dealing with repeated constructs based on changing measurements in developmental studies.",0,1 +2031,Modulation of tactile duration judgments by emotional pictures,"Judging the duration of emotional stimuli is known to be influenced by their valence and arousal values. However, whether and how perceiving emotion in one modality affects time perception in another modality is still unclear. To investigate this, we compared the influence of different types of emotional pictures-a picture of threat, disgust, or a neutral picture presented at the start of a trial-on temporal bisection judgments of the duration of a subsequently presented vibrotactile stimulus. We found an overestimation of tactile duration following exposure to pictures of threat, but not pictures of disgust (even though these scored equally high on arousal), in a short-range temporal bisection task (range 300/900 ms). Follow-up experiments revealed that this duration lengthening effect was abolished when the range to be bisected was increased (1000/1900 ms). However, duration overestimation was maintained in the short-range bisection task regardless of whether the interval between the visual and tactile events was short or long. This pattern is inconsistent with a general arousal interpretation of duration distortion and suggests that crossmodal linkages in the processing of emotions and emotional regulation are two main factors underlying the manifestation of crossmodal duration modulation.",0,1 +2032,"An exploratory multilevel analysis of income, income inequality and self-rated health of the elderly in China","In the last three decades, China has experienced rapid economic development and growing economic inequality, such that economic disparities between rural and urban areas, as well as coastal and interior areas have deepened. Since the late 1990s China has also experienced an ageing population which has attracted attention to the wellbeing of the rapidly growing number of elderly. This research aims to characterise province differences in health and to explore the effects of individual income and economic disparity in the form of income inequality on health outcomes of the elderly. The study is based on the Chinese Longitudinal Healthy Longevity Survey data collected in 2008 for 23 provinces. Multilevel logistic models are employed to investigate the relationship between income, income inequality and self-rated health for the elderly using both individual and province-level variables. Results are presented as relative odds ratios, and for province differentials as Median Odds Ratios. The analysis is deliberately exploratory so as to find evidence of income effects if they exist and particular attention is placed on how province-level inequality (contemporaneous and lagged) may moderate individual relationships. The results show that the health of the elderly is not only affected by individual income (the odds of poor health are 3 times greater for the elderly with the lowest income compared to those at the upper quartile) but also by a small main effect for province-level income inequality (odds ratio of 1.019). There are significant cross-level interactions such that where inequality is high there are greater differences between those with and without formal education, and between men and women with the latter experiencing poorer health.",0,1 +2033,A design‐by‐treatment interaction model for network meta‐analysis with random inconsistency effects,"Network meta-analysis is becoming more popular as a way to analyse multiple treatments simultaneously and, in the right circumstances, rank treatments. A difficulty in practice is the possibility of ‘inconsistency’ or ‘incoherence’, where direct evidence and indirect evidence are not in agreement. Here, we develop a random-effects implementation of the recently proposed design-by-treatment interaction model, using these random effects to model inconsistency and estimate the parameters of primary interest. Our proposal is a generalisation of the model proposed by Lumley and allows trials with three or more arms to be included in the analysis. Our methods also facilitate the ranking of treatments under inconsistency. We derive R and I2 statistics to quantify the impact of the between-study heterogeneity and the inconsistency. We apply our model to two examples. © 2014 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd.",0,1 +2034,SPSS and SAS procedures for estimating indirect effects in simple mediation models,"Researchers often conduct mediation analysis in order to indirectly assess the effect of a proposed cause on some outcome through a proposed mediator. The utility of mediation analysis stems from its ability to go beyond the merely descriptive to a more functional understanding of the relationships among variables. A necessary component of mediation is a statistically and practically significant indirect effect. Although mediation hypotheses are frequently explored in psychological research, formal significance tests of indirect effects are rarely conducted. After a brief overview of mediation, we argue the importance of directly testing the significance of indirect effects and provide SPSS and SAS macros that facilitate estimation of the indirect effect with a normal theory approach and a bootstrap approach to obtaining confidence intervals, as well as the traditional approach advocated by Baron and Kenny (1986). We hope that this discussion and the macros will enhance the frequency of formal mediation tests in the psychology literature. Electronic copies of these macros may be downloaded from the Psychonomic Society’s Web archive atwww.psychonomic.org/archive/.",0,1 +2035,A Bayesian multinomial model to analyse spatial patterns of childhood co-morbidity in Malawi,"Children in less developed countries die from relatively small number of infectious disease, some of which epidemiologically overlap. Using self-reported illness data from the 2000 Malawi Demographic and Health Survey, we applied a random effects multinomial model to assess risk factors of childhood co-morbidity of fever, diarrhoea and pneumonia, and quantify area-specific spatial effects. The spatial structure was modelled using the conditional autoregressive prior. Various models were fitted and compared using deviance information criterion. Inference was Bayesian and was based on Markov Chain Monte Carlo simulation techniques. We found spatial variation in childhood co-morbidity and determinants of each outcome category differed. Specifically, risk factors associated with child co-morbidity included age of the child, place of residence, undernutrition, bednet use and Vitamin A. Higher residual risk levels were identified in the central and southern-eastern regions, particularly for fever, diarrhoea and pneumonia; fever and pneumonia; and fever and diarrhoea combinations. This linkage between childhood health and geographical location warrants further research to assess local causes of these clusters. More generally, although each disease has its own mechanism, overlapping risk factors suggest that integrated disease control approach may be cost-effective and should be employed. © 2007 Springer Science+Business Media B.V.",0,1 +2036,A Contextual Effect of 2nd-Order Configural Processing of Non-Face Objects by Non-Experts,"We investigated here the detection of 2nd-order configural relations both in faces and in non-face objects. In experiment 1 it was shown that observers were more sensitive to feature displacements in upright faces and houses than in inverted faces and houses. The presence of an inversion effect in the house stimuli suggested that 2nd-order relational processing was applied to the non-face stimuli. In experiment 2, the inversion effect for houses was absent when only houses were presented. In experiment 3, face and house stimuli were once again presented in the same task and inversion effects were again seen for both types of stimuli. Together, these results suggest that 2nd-order relational processing can be flexibly applied to non-face objects when they are presented in the context of faces.",0,1 +2037,The horizontal tuning of face perception relies on the processing of intermediate and high spatial frequencies,"It was recently shown that expert face perception relies on the extraction of horizontally oriented visual cues. Picture-plane inversion was found to eliminate horizontal, suggesting that this tuning contributes to the specificity of face processing. The present experiments sought to determine the spatial frequency (SF) scales supporting the horizontal tuning of face perception. Participants were instructed to match upright and inverted faces that were filtered both in the frequency and orientation domains. Faces in a pair contained horizontal or vertical ranges of information in low, middle, or high SF (LSF, MSF, or HSF). Our findings confirm that upright (but not inverted) face perception is tuned to horizontal orientation. Horizontal tuning was the most robust in the MSF range, next in the HSF range, and absent in the LSF range. Moreover, face inversion selectively disrupted the ability to process horizontal information in MSF and HSF ranges. This finding was replicated even when task difficulty was equated across orientation and SF at upright orientation. Our findings suggest that upright face perception is tuned to horizontally oriented face information carried by intermediate and high SF bands. They further indicate that inversion alters the sampling of face information both in the orientation and SF domains.",0,1 +2038,Four applications of permutation methods to testing a single-mediator model,"Four applications of permutation tests to the single-mediator model are described and evaluated in this study. Permutation tests work by rearranging data in many possible ways in order to estimate the sampling distribution for the test statistic. The four applications to mediation evaluated here are the permutation test of ab, the permutation joint significance test, and the noniterative and iterative permutation confidence intervals for ab. A Monte Carlo simulation study was used to compare these four tests with the four best available tests for mediation found in previous research: the joint significance test, the distribution of the product test, and the percentile and bias-corrected bootstrap tests. We compared the different methods on Type I error, power, and confidence interval coverage. The noniterative permutation confidence interval for ab was the best performer among the new methods. It successfully controlled Type I error, had power nearly as good as the most powerful existing methods, and had better coverage than any existing method. The iterative permutation confidence interval for ab had lower power than do some existing methods, but it performed better than any other method in terms of coverage. The permutation confidence interval methods are recommended when estimating a confidence interval is a primary concern. SPSS and SAS macros that estimate these confidence intervals are provided.",0,1 +2039,Nonparametric Bayesian analysis of a proportion for a small area under nonignorable nonresponse,"In small area estimation, it is a standard practice to assume that the area effects are exchangeable. This is obtained by assuming that the area effects have a common parametric distribution, and a Bayesian approach is attractive. The Dirichlet process prior (DPP) has been used to provide a nonparametric version of this approach. The DPP is useful because it makes the procedure more robust, and the Bayesian approach helps to reduce the effect of nonidentifiability prominent in nonignorable nonresponse models. Using the DPP, we develop a Bayesian methodology for the analysis of nonignorable nonresponse binary data from many small areas, and for each area, we estimate the proportion of individuals with a particular characteristic. Our DPP model is centered on a baseline model, a standard parametric model. We use Markov chain Monte Carlo methods to fit the DPP model and the baseline model, and our methodology is illustrated using data on victimization in ten domains from the National Crime Survey. Our compar...",0,1 +2040,"Structural Equation Modeling: Strengths, Limitations, and Misconceptions","Because structural equation modeling (SEM) has become a very popular data-analytic technique, it is important for clinical scientists to have a balanced perception of its strengths and limitations. We review several strengths of SEM, with a particular focus on recent innovations (e.g., latent growth modeling, multilevel SEM models, and approaches for dealing with missing data and with violations of normality assumptions) that underscore how SEM has become a broad data-analytic framework with flexible and unique capabilities. We also consider several limitations of SEM and some misconceptions that it tends to elicit. Major themes emphasized are the problem of omitted variables, the importance of lower-order model components, potential limitations of models judged to be well fitting, the inaccuracy of some commonly used rules of thumb, and the importance of study design. Throughout, we offer recommendations for the conduct of SEM analyses and the reporting of results.",0,1 +2041,Structural equation modeling with near singular covariance matrices,"Conventional structural equation modeling involves fitting a structural model to the sample covariance matrix S. Due to collinearity or small samples with practical data, nonconvergences often occur in the estimation process. For a small constant a, this paper proposes to fit the structural model to the covariance matrix Sa=S+aI. When treating Sa as the sample covariance matrix in the maximum likelihood (ML) procedure, consistent parameter estimates are still obtained. The asymptotic distributions of the parameter estimates and the corresponding likelihood ratio statistic are studied and compared to those by the conventional ML. Two rescaled statistics for the overall model evaluation with modeling Sa are constructed. Empirical results imply that the estimates from modeling Sa are more efficient than those of fitting the structural model to S even when data are normally distributed. Simulations and real data examples indicate that modeling Sa allows us to evaluate the overall model structure even when S is literally singular. Implications of modeling Sa in a broader context are discussed.",0,1 +2042,A Procedure for Evaluating Sensitivity to Within-Person Change: Can Mood Measures in Diary Studies Detect Change Reliably?,"The recent growth in diary and experience sampling research has increased research attention on how people change over time in natural settings. Often however, the measures in these studies were originally developed for studying between-person differences, and their sensitivity to within-person changes is usually unknown. Using a Generalizability Theory framework, the authors illustrate a procedure for developing reliable measures of change using a version of the Profile of Mood States (POMS; McNair, Lorr, & Droppleman, 1992) shortened for diary studies. Analyzing two data sets, one composed of 35 daily reports from 68 persons experiencing a stressful examination and another composed of daily reports from 164 persons over a typical 28-day period, we demonstrate that three-item measures of anxious mood, depressed mood, anger, fatigue, and vigor have appropriate reliability to detect within-person change processes.",0,1 +2043,A methodological review of statistical methods for handling multilevel non-nested longitudinal data in educational research,"As applications of multilevel modelling in educational research increase, researchers realize that multilevel data collected in many educational settings are often not purely nested. The most common multilevel non-nested data structure is one that involves student mobility in longitudinal studies. This article provides a methodological review of three statistical methods for handling student mobility in longitudinal studies: a multilevel approach, a cross-classified approach, and a cross-classified multiple membership approach. The strengths and weaknesses of each approach and the essential differences between the three approaches are discussed. The Early Childhood Longitudinal Study Kindergarten Cohort data are analysed to demonstrate the differences in parameter estimates and statistical inference between the three approaches. Potential applications of the three approaches in educational research and beyond and directions for further methodological investigations are discussed.",0,1 +2044,Utilizing Response Time Distributions for Item Selection in CAT,"Traditional methods for item selection in computerized adaptive testing only focus on item information without taking into consideration the time required to answer an item. As a result, some examinees may receive a set of items that take a very long time to finish, and information is not accrued as efficiently as possible. The authors propose two item-selection criteria that utilize information from a lognormal model for response times. The first modifies the maximum information criterion to maximize information per time unit. The second is an inverse time-weighted version of a-stratification that takes advantage of the response time model, but achieves more balanced item exposure than the information-based techniques. Simulations are conducted to compare these procedures against their counterparts that ignore response times, and efficiency of estimation, time-required, and item exposure rates are assessed.",0,1 +2045,Modeling agreement on categorical scales in the presence of random scorers,"Kappa coefficients are often used to assess agreement between two fixed scorers on categorical scales. Cohen's version is popular for nominal scales and the weighted version for ordinal scales. In the present paper, similar agreement coefficients are defined for random scorers. A partial-Bayesian methodology is then developed to directly relate these agreement coefficients to predictors through a multilevel model. Statistical properties of the proposed approach are studied using simulations. Finally, the approach is applied to gynecological and medical imaging data.",0,1 +2046,Likelihood ratio tests in linear mixed models with one variance component,Summary. We consider the problem of testing null hypotheses that include restrictions on the variance component in a linear mixed model with one variance component and we derive the finite sample and asymptotic distribution of the likelihood ratio test and the restricted likelihood ratio test. The spectral representations of the likelihood ratio test and the restricted likelihood ratio test statistics are used as the basis of efficient simulation algorithms of their null distributions. The large sample χ2 mixture approximations using the usual asymptotic theory for a null hypothesis on the boundary of the parameter space have been shown to be poor in simulation studies. Our asymptotic calculations explain these empirical results. The theory of Self and Liang applies only to linear mixed models for which the data vector can be partitioned into a large number of independent and identically distributed subvectors. One-way analysis of variance and penalized splines models illustrate the results.,0,1 +2047,Comment on article by Browne and Draper,http://projecteuclid.org/euclid.ba/1340371050#ui-tabs-1,0,1 +2048,Are unshifted distributional models appropriate for response time?,"Van Breukelen (this issue) provides an approach to using both response time (RT) and accuracy for (1) measuring latent abilities of participants even when they may trade speed for accuracy, and for (2) providing insight into the psychological processes underlying task performance. In this commentary, I focus on the second of these aims and assess how useful this approach is for exploring cognition. The approach is based on formulating statistical rather than substantive models on accuracy and RT. I focus here on the appropriateness of the RT component model. This RT model joins a family of recent statistical approaches to RT including those of Glickman, Gray, and Morales (in press); Peruggia, Van Zandt, and Chen (2002); Rouder, Lu, Speckman, Sun, and Jiang (in press); Schnipke and Scrams (1997); and Wenger and Gibson (2004). The advantage of these statistical rather than substantive models is robust estimation and sound inference when data are collected across disparate individuals and items. It is not hard to see how these statistical developments will lead to better substantive theory testing and development in cognitive psychology. Van Breukelen’s model for the ith participant’s RT to the j th item is given by:",0,1 +2049,Contextual effects in visual working memory reveal hierarchically structured memory representations,"Influential slot and resource models of visual working memory make the assumption that items are stored in memory as independent units, and that there are no interactions between them. Consequently, these models predict that the number of items to be remembered (the set size) is the primary determinant of working memory performance, and therefore these models quantify memory capacity in terms of the number and quality of individual items that can be stored. Here we demonstrate that there is substantial variance in display difficulty within a single set size, suggesting that limits based on the number of individual items alone cannot explain working memory storage. We asked hundreds of participants to remember the same sets of displays, and discovered that participants were highly consistent in terms of which items and displays were hardest or easiest to remember. Although a simple grouping or chunking strategy could not explain this individual-display variability, a model with multiple, interacting levels of representation could explain some of the display-by-display differences. Specifically, a model that includes a hierarchical representation of items plus the mean and variance of sets of the colors on the display successfully accounts for some of the variability across displays. We conclude that working memory representations are composed only in part of individual, independent object representations, and that a major factor in how many items are remembered on a particular display is interitem representations such as perceptual grouping, ensemble, and texture representations.",0,1 +2050,Uncovering mental representations with Markov chain Monte Carlo,"A key challenge for cognitive psychology is the investigation of mental representations, such as object categories, subjective probabilities, choice utilities, and memory traces. In many cases, these representations can be expressed as a non-negative function defined over a set of objects. We present a behavioral method for estimating these functions. Our approach uses people as components of a Markov chain Monte Carlo (MCMC) algorithm, a sophisticated sampling method originally developed in statistical physics. Experiments 1 and 2 verified the MCMC method by training participants on various category structures and then recovering those structures. Experiment 3 demonstrated that the MCMC method can be used estimate the structures of the real-world animal shape categories of giraffes, horses, dogs, and cats. Experiment 4 combined the MCMC method with multidimensional scaling to demonstrate how different accounts of the structure of categories, such as prototype and exemplar models, can be tested, producing samples from the categories of apples, oranges, and grapes.",0,1 +2051,Possible involvement of toll-like receptor 4/myeloid differentiation factor-2 activity of opioid inactive isomers causes spinal proinflammation and related behavioral consequences,"Opioid-induced glial activation and its proinflammatory consequences have been associated with both reduced acute opioid analgesia and the enhanced development of tolerance, hyperalgesia and allodynia following chronic opioid administration. Intriguingly, recent evidence demonstrates that these effects can result independently from the activation of classical, stereoselective opioid receptors. Here, a structurally disparate range of opioids cause activation of signaling by the innate immune receptor toll like receptor 4 (TLR4), resulting in proinflammatory glial activation. In the present series of studies, we demonstrate that the (+)-isomers of methadone and morphine, which bind with negligible affinity to classical opioid receptors, induced upregulation of proinflammatory cytokine and chemokine production in rat isolated dorsal spinal cord. Chronic intrathecal (+)-methadone produced hyperalgesia and allodynia, which were associated with significantly increased spinal glial activation (TLR4 mRNA and protein) and the expression of multiple chemokines and cytokines. Statistical analysis suggests that a cluster of cytokines and chemokines may contribute to these nociceptive behavioral changes. Acute intrathecal (+)-methadone and (+)-morphine were also found to induce microglial, interleukin-1 and TLR4/myeloid differentiation factor-2 (MD-2) dependent enhancement of pain responsivity. In silico docking analysis demonstrated (+)-naloxone sensitive docking of (+)-methadone and (+)-morphine to human MD-2. Collectively, these data provide the first evidence of the pro-nociceptive consequences of small molecule xenobiotic activation of spinal TLR4 signaling independent of classical opioid receptor involvement.",0,1 +2052,Small Sample Inference for Fixed Effects from Restricted Maximum Likelihood,"Restricted maximum likelihood (REML) is now well established as a method for estimating the parameters of the general Gaussian linear model with a structured covariance matrix, in particular for mixed linear models. Conventionally, estimates of precision and inference for fixed effects are based on their asymptotic distribution, which is known to be inadequate for some small-sample problems. In this paper, we present a scaled Wald statistic, together with an F approximation to its sampling distribution, that is shown to perform well in a range of small sample settings. The statistic uses an adjusted estimator of the covariance matrix that has reduced small sample bias. This approach has the advantage that it reproduces both the statistics and F distributions in those settings where the latter is exact, namely for Hotelling T2 type statistics and for analysis of variance F-ratios. The performance of the modified statistics is assessed through simulation studies of four different REML analyses and the methods are illustrated using three examples.",0,1 +2053,Estimating Causal Effects With Matching Methods in the Presence and Absence of Bias Cancellation,"This article explores the implications of bias cancellation on the estimate of average treatment effects using ordinary least squares (OLS) and Rubin-style matching methods. Bias cancellation (offsetting biases at high and low propensities for treatment in estimates of treatment effects that are uncorrected for nonrandom selection) has been observed when job training is the treatment variable and earnings is the outcome variable. Contrary to published assertions in the literature, bias cancellation is not explainable in terms of the standard selection model, which assumes a symmetric distribution for the errors in the structural and assignment equations. A substantive rationale for bias cancellation is offered, which conceptualizes bias cancellation as the result of a mixture process based on two distinct individual-level decision-making models. While the general properties are unknown, the existence of bias cancellation appears to reduce the average bias in both OLS and matching methods relative to the symmetric distribution case.",0,1 +2054,Use of posterior predictive assessments to evaluate model fit in multilevel logistic regression,"Assessing the fit of a model is an important final step in any statistical analysis, but this is not straightforward when complex discrete response models are used. Cross validation and posterior predictions have been suggested as methods to aid model criticism. In this paper a comparison is made between four methods of model predictive assessment in the context of a three level logistic regression model for clinical mastitis in dairy cattle; cross validation, a prediction using the full posterior predictive distribution and two “mixed” predictive methods that incorporate higher level random effects simulated from the underlying model distribution. Cross validation is considered a gold standard method but is computationally intensive and thus a comparison is made between posterior predictive assessments and cross validation. The analyses revealed that mixed prediction methods produced results close to cross validation whilst the full posterior predictive assessment gave predictions that were over-optimistic (closer to the observed disease rates) compared with cross validation. A mixed prediction method that simulated random effects from both higher levels was best at identifying the outlying level two (farm-year) units of interest. It is concluded that this mixed prediction method, simulating random effects from both higher levels, is straightforward and may be of value in model criticism of multilevel logistic regression, a technique commonly used for animal health data with a hierarchical structure.",0,1 +2055,Ridge structural equation modelling with correlation matrices for ordinal and continuous data,"This paper develops a ridge procedure for structural equation modelling (SEM) with ordinal and continuous data by modelling the polychoric/polyserial/product-moment correlation matrix R. Rather than directly fitting R, the procedure fits a structural model to R(a) =R+aI by minimizing the normal distribution-based discrepancy function, where a > 0. Statistical properties of the parameter estimates are obtained. Four statistics for overall model evaluation are proposed. Empirical results indicate that the ridge procedure for SEM with ordinal data has better convergence rate, smaller bias, smaller mean square error, and better overall model evaluation than the widely used maximum likelihood procedure.",0,1 +2056,A Hybrid Approximation Bayesian Test of Variance Components for Longitudinal Data,"The test of variance components of possibly correlated random effects in generalized linear mixed models (GLMMs) can be used to examine if there exists heterogeneous effects. The Bayesian test with Bayes factors offers a flexible method. In this article, we focus on the performance of Bayesian tests under three reference priors and a conjugate prior: an approximate uniform shrinkage prior, modified approximate Jeffreys' prior, half-normal unit information prior and Wishart prior. To compute Bayes factors, we propose a hybrid approximation approach combining a simulated version of Laplace's method and importance sampling techniques to test the variance components in GLMMs.",0,1 +2057,Assessing spatial vision — automated measurement of the contrast-sensitivity function in the hooded rat,"The contrast-sensitivity function (CSF) provides a concise and thorough description of an organism’s spatial vision; it is widely used to describe vision in animals and humans, to track developmental changes in vision, and to compare vision among different species. Despite the predominance of rats in neuroscience research, their vision is not thoroughly studied due to the complexity of psychophysical measurement and a generally held notion that rat vision is poor. We therefore designed an economical and rapid method to assess the hooded rat’s CSF, using a computer monitor to display stimuli and an infrared touch screen to record responses. A six-alternative forced-choice task presented trials in which a sine-wave grating (S+), varying in spatial frequency and contrast, was displayed at different locations along with five gray stimuli (S−). Nose pokes to the S+ but not the S− produced water reinforcers. Contrasts were tested at each spatial frequency with a simple adaptive procedure until stimulus detection fell below chance. Psychometric functions were obtained by maximum-likelihood fitting of a logistic function to the raw data, obtaining the threshold as the function’s point of inflection. As in previous studies with rats, CSFs showed an inverse-U shape with peak sensitivity at 0.12 cyc/deg and acuity just under 1 cyc/deg. The results indicate the present computer-controlled behavioral testing device is a precise and efficient instrument to assess spatial visual function in rats.",0,1 +2058,Getting the most out of family data with the R package fSRM.,"Family research aims to explore family processes, but is often limited to the examination of unidirectional processes. As the behavior of 1 person has consequences that go beyond that individual, family functioning should be investigated in its full complexity. The social relations model (SRM; Kenny & La Voie, 1984) is a conceptual and analytical model that can disentangle family data from a round-robin design at 3 different levels: the individual level (actor and partner effects), the dyadic level (relationship effects), and the family level (family effect). Its statistical complexity may however be a hurdle for family researchers. The user-friendly R package fSRM performs almost automatically those rather complex SRM analyses and introduces new possibilities for assessing differences between SRM means and between SRM variances, both within and between groups of families. Using family data on negative processes, different type of research questions are formulated and corresponding analyses with fSRM are presented.",0,1 +2059,Changing concepts of working memory,"Working memory is widely considered to be limited in capacity, holding a fixed, small number of items, such as Miller's 'magical number' seven or Cowan's four. It has recently been proposed that working memory might better be conceptualized as a limited resource that is distributed flexibly among all items to be maintained in memory. According to this view, the quality rather than the quantity of working memory representations determines performance. Here we consider behavioral and emerging neural evidence for this proposal.",0,1 +2060,Empirically supported treatments or type I errors? Problems with the analysis of data from group-administered treatments.,"When treatments are administered in groups, clients interact in ways that lead to violations of a key assumption of most statistical analyses-the assumption of independence of observations. The resulting dependencies, when not properly accounted for, can increase Type I errors dramatically. Of the 33 studies of group-administered treatment on the empirically supported treatments list, none appropriately analyzed their data. The current authors provide corrections that can be applied to improper analyses. After the corrections, only 12.4% to 68.2% of tests that were originally reported as significant remained significant, depending on what assumptions were made about how large the dependencies among observations really are. Of the 33 studies, 6-19 studies no longer had any significant results after correction. The authors end by providing recommendations for researchers planning group-administered treatment research.",0,1 +2061,The ECME algorithm: A simple extension of EM and ECM with faster monotone convergence,"A generalisation of the ECM algorithm (Meng & Rubin, 1993), which is itselfan extension of the EM algorithm (Dempster, Laird & Rubin, 1977), can be obtained by replacing some CM-steps of ECM, which maximise the constrained expected complete-data loglikelihood function, with steps that maximise the correspondingly constrained actual likelihood function. This algorithm, which we call ECME algorithm, for Expectation /Conditional Maximisation Either, shares with both EM and ECM their stable monotone convergence and basic simplicity of implementation relative to competing faster converging methods. Moreover, ECME can have a substantially faster convergence rate than either EM or ECM, measured using either the number of iterations or actual computer time",0,1 +2062,MCMC Sampling for a Multilevel Model With Nonindependent Residuals Within and Between Cluster Units,"In this article, we discuss the effect of removing the independence assumptions between the residuals in two-level random effect models. We first consider removing the independence between the Level 2 residuals and instead assume that the vector of all residuals at the cluster level follows a general multivariate normal distribution. We demonstrate how this assumption can allow us to fit higher levels of clustering and school competition effects via an example from education. We then consider removing the assumption of independence between Level 1 residuals within clusters. We show how this extension can allow time series type models. Both normal and binary responses are considered.",0,1 +2063,Joint Bayesian Analysis of Factor Scores and Structural Parameters in the Factor Analysis Model,"A Bayesian approach is developed to assess the factor analysis model. Joint Bayesian estimates of the factor scores and the structural parameters in the covariance structure are obtained simultaneously. The basic idea is to treat the latent factor scores as missing data and augment them with the observed data in generating a sequence of random observations from the posterior distributions by the Gibbs sampler. Then, the Bayesian estimates are taken as the sample means of these random observations. Expressions for implementing the algorithm are derived and some statistical properties of the estimates are presented. Some aspects of the algorithm are illustrated by a real example and the performance of the Bayesian procedure is studied using simulation.",0,1 +2064,A General SEM Framework for Integrating Moderation and Mediation: The Constrained Approach,"Modeling the combination of latent moderating and mediating effects is a significant issue in the social and behavioral sciences. Chen and Cheng (Structural Equation Modeling: A Multidisciplinary Journal 21: 94-101, 2014) generalized Jöreskog and Yang’s (Advanced structural equation modeling: Issues and techniques (pp. 57-88). Mahwah, NJ: Lawrence Erlbaum, 1996) constrained approach to allow for the concurrent modeling of moderation and mediation within the context of SEM. Unfortunately, due to restrictions related to Chen and Cheng’s partitioning scheme, their framework cannot completely conceptualize and interpret moderation of indirect effects in a mediated model. In the current study, the Chen and Cheng (abbreviated below as C & C) framework is extended to accommodate situations in which any two pathways that constitute a particular indirect effect in a mediated model can be differentially or collectively moderated by the moderator variable(s). By preserving the inherent advantage of the C & C framework, i.e., the matrix partitioning technique, while at the same time further generalizing its applicability, it is expected that the current framework enhances the potential usefulness of the constrained approach as well as the entire class of the product indicator approaches. © Springer International Publishing Switzerland 2015.",0,1 +2065,Inferred components of reaction times as functions of foreperiod duration.,"A distribution function representing simple reaction-time distributions was derived, assuming RT is the sum of 2 component variables with exponential and normal distributions. 4 Ss each gave 100 RTs to an auditory stimulus following each of 4 foreperiods, under each of 2 conditions: (a) foreperiod constant within sessions but varied over sessions, and (b) foreperiods appearing in a random sequence. The derived distribution function provided completely satisfactory representations of all 32 RT distributions, and the relations of the fitted parameters of this function to foreperiod suggest that the variation of RT as a function of foreperiod is due to variation in the normally distributed component. (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1965 American Psychological Association.",0,1 +2066,"Effects of sources of variability on sample sizes required for RCTs, applied to trials of lipid-altering therapies on carotid artery intima-media thickness","Objective Studies measuring progression of carotid artery intima-media thickness (cIMT) have been used to estimate the effect of lipid-modifying therapies cardiovascular event risk. The likelihood that future cIMT clinical trials will detect a true treatment effect is estimated by leveraging results from prior studies. The present analyses assess the impact of between- and within-study variability based on currently published data from prior clinical studies on the likelihood that ongoing or future cIMT trials will detect the true treatment effect of lipid-modifying therapies. Methods Published data from six contemporary cIMT studies (ASAP, ARBITER 2, RADIANCE 1, RADIANCE 2, ENHANCE, and METEOR) including data from a total of 3563 patients were examined. Bayesian and frequentist methods were used to assess the impact of between study variability on the likelihood of detecting true treatment effects on 1-year cIMT progression/regression and to provide a sample size estimate that would specifically compensate for the effect of between-study variability. Results In addition to the well-described within-study variability, there is considerable between-study variability associated with the measurement of annualized change in cIMT. Accounting for the additional between-study variability decreases the power for existing study designs. In order to account for the added between-study variability, it is likely that future cIMT studies would require a large increase in sample size in order to provide substantial probability (≥90%) to have 90% power of detecting a true treatment effect. Limitation Analyses are based on study level data. Future meta-analyses incorporating patient-level data would be useful for confirmation. Conclusion Due to substantial within- and between-study variability in the measure of 1-year change of cIMT, as well as uncertainty about progression rates in contemporary populations, future study designs evaluating the effect of new lipid-modifying therapies on atherosclerotic disease progression are likely to be challenged by large sample sizes in order to demonstrate a true treatment effect.",0,1 +2067,Bayesian methods for the analysis of small sample multilevel data with a complex variance structure.,"Inferences from multilevel models can be complicated in small samples or complex data structures. When using (restricted) maximum likelihood methods to estimate multilevel models, standard errors and degrees of freedom often need to be adjusted to ensure that inferences for fixed effects are correct. These adjustments do not address problems in estimating variance/covariance components. An alternative to the adjusted likelihood method is to use Bayesian methods, which can produce accurate inferences about fixed effects and variance/covariance parameters. In this article, the authors contrast the benefits and limitations of likelihood and Bayesian methods in the estimation of multilevel models. The issues are discussed in the context of a partially clustered intervention study, a common intervention design that has been shown to require an adjusted likelihood analysis. The authors report a Monte Carlo study that compares the performance of an adjusted restricted maximum likelihood (REML) analysis to a Bayesian analysis. The results suggest that for fixed effects, the models perform equally well with respect to bias, efficiency, and coverage of interval estimates. Bayesian models with a carefully selected gamma prior for the variance components were more biased but also more efficient with respect to estimation of the variance components than the REML model. However, the results also show that the inferences about the variance components in partially clustered studies are sensitive to the prior distribution when sample sizes are small. Finally, the authors compare the results of a Bayesian and adjusted likelihood model using data from a partially clustered intervention trial.",1,1 +2068,A tutorial on approximate Bayesian computation,"Abstract This tutorial explains the foundation of approximate Bayesian computation (ABC), an approach to Bayesian inference that does not require the specification of a likelihood function, and hence that can be used to estimate posterior distributions of parameters for simulation-based models. We discuss briefly the philosophy of Bayesian inference and then present several algorithms for ABC. We then apply these algorithms in a number of examples. For most of these examples, the posterior distributions are known, and so we can compare the estimated posteriors derived from ABC to the true posteriors and verify that the algorithms recover the true posteriors accurately. We also consider a popular simulation-based model of recognition memory (REM) for which the true posteriors are unknown. We conclude with a number of recommendations for applying ABC methods to solve real-world problems.",0,1 +2069,General Test Overlap Control,"This article proposed a new online test overlap control algorithm that is an improvement of Chen’s algorithm in controlling general test overlap rate for item pooling among a group of examinees. Chen’s algorithm is not very efficient in that not only item pooling between current examinee and prior examinees is controlled for but also item pooling between previous examinees, which would have been controlled for when they were current examinees. The proposed improvement increases efficiency by only considering item pooling between current and previous examinees, and its improved performance over Chen is demonstrated in a simulated computerized adaptive testing (CAT) environment. Moreover, the proposed algorithm is adapted for computerized classification testing (CCT) using the sequential probability ratio test procedure and is evaluated against some existing exposure control procedures. The proposed algorithm appears to work best in controlling general test overlap rate among the exposure control procedures examined without sacrificing much classification precision, though longer tests might be required for more stringent control of item pooling among larger groups. Given the capability of the proposed algorithm in controlling item pooling among a group of examinees of any size and its ease of implementation, it appears to be a good test overlap control method.",0,1 +2070,Mixture class recovery in GMM under varying degrees of class separation: Frequentist versus Bayesian estimation.,"Growth mixture modeling (GMM) represents a technique that is designed to capture change over time for unobserved subgroups (or latent classes) that exhibit qualitatively different patterns of growth. The aim of the current article was to explore the impact of latent class separation (i.e., how similar growth trajectories are across latent classes) on GMM performance. Several estimation conditions were compared: maximum likelihood via the expectation maximization (EM) algorithm and the Bayesian framework implementing diffuse priors, ""accurate"" informative priors, weakly informative priors, data-driven informative priors, priors reflecting partial-knowledge of parameters, and ""inaccurate"" (but informative) priors. The main goal was to provide insight about the optimal estimation condition under different degrees of latent class separation for GMM. Results indicated that optimal parameter recovery was obtained though the Bayesian approach using ""accurate"" informative priors, and partial-knowledge priors showed promise for the recovery of the growth trajectory parameters. Maximum likelihood and the remaining Bayesian estimation conditions yielded poor parameter recovery for the latent class proportions and the growth trajectories.",1,1 +2071,Mean Square Efficiency of Estimators of Variance Components,Abstract Various estimators of components of variance for the balanced one way layout are compared using mean squared error as a measure of performance. Several modifications of the maximum likelihood estimator and several formal Bayes estimators are compared and mean square error relationships are given. Inadmissibility is established for a large class of translation and scale invariant estimators. Numerical results are tabled and graphed to exhibit the relative efficiency of the estimators considered.,0,1 +2072,Conceptualizing and Estimating Process Speed in Studies Employing Ecological Momentary Assessment Designs: A Multilevel Variance Decomposition Approach,"Researchers have been making use of ecological momentary assessment (EMA) and other study designs that sample feelings and behaviors in real time and in naturalistic settings to study temporal dynamics and contextual factors of a wide variety of psychological, physiological, and behavioral processes. As EMA designs become more widespread, questions are arising about the frequency of data sampling, with direct implications for participants' burden and researchers' ability to capture and study dynamic processes. Traditionally, spectral analytic techniques are used for time series data to identify process speed. However, the nature of EMA data, often collected with fewer than 100 measurements per person, sampled at randomly spaced intervals, and replete with planned and unplanned missingness, precludes application of traditional spectral analytic techniques. Building on principles of variance partitioning used in the generalizability theory of measurement and spectral analysis, we illustrate the utility of multilevel variance decompositions for isolating process speed in EMA-type data. Simulation and empirical data from a smoking-cessation study are used to demonstrate the method and to evaluate the process speed of smoking urges and quitting self-efficacy. Results of the multilevel variance decomposition approach can inform process-oriented theory and future EMA study designs.",0,1 +2073,Linear and nonlinear growth models: Describing a Bayesian perspective.,"Conventional estimation of longitudinal growth models can produce inaccurate parameter estimates under certain research scenarios (e.g., smaller sample sizes and nonlinear growth patterns) and thus lead to potentially misleading interpretations of results (i.e., interpreting growth patterns that do not reflect the population patterns). The current article used patterns of change in cigarette and alcohol abuse prevalence and depression levels to demonstrate an alternative method for estimating growth models more accurately under these conditions, namely, via the Bayesian estimation framework. This article acts as an introduction and tutorial for implementing Bayesian methods when examining growth or change over time, particularly nonlinear growth.The National Longitudinal Survey of Youth 1997 database was used to highlight different linear and nonlinear (quadratic and logistic) growth models via growth curve modeling (GCM) and growth mixture modeling (GMM). The specific focus was on changes in cigarette/alcohol consumption and depression throughout adolescence and young adulthood. Specifically, a nationally representative group of individuals between the ages of 12 and 16 years were assessed at 4 time-points for levels of cigarette consumption, alcohol use, and depression.The results for each example illustrated different patterns of linear and nonlinear growth via GCM and GMM through the versatile Bayesian estimation framework.Growth models may benefit from the Bayesian perspective by incorporating prior information or knowledge into the model, especially when sample sizes are small or growth is nonlinear. A step-by-step tutorial for assessing various growth models via the Bayesian perspective is provided as online supplemental material.",0,1 +2074,The Calculation of Posterior Distributions by Data Augmentation,"Abstract The idea of data augmentation arises naturally in missing value problems, as exemplified by the standard ways of filling in missing cells in balanced two-way tables. Thus data augmentation refers to a scheme of augmenting the observed data so as to make it more easy to analyze. This device is used to great advantage by the EM algorithm (Dempster, Laird, and Rubin 1977) in solving maximum likelihood problems. In situations when the likelihood cannot be approximated closely by the normal likelihood, maximum likelihood estimates and the associated standard errors cannot be relied upon to make valid inferential statements. From the Bayesian point of view, one must now calculate the posterior distribution of parameters of interest. If data augmentation can be used in the calculation of the maximum likelihood estimate, then in the same cases one ought to be able to use it in the computation of the posterior distribution. It is the purpose of this article to explain how this can be done. The basic idea ...",0,1 +2075,"Factor analysis of variables with 2, 3, 5 and 7 response categories: A comparison of categorical variable estimators using simulated data","Two estimators in the factor analysis of categorical items are studied, the weighted least squares function implemented in the tandem PRELIS-LISREL 7 and a generalized least squares function implemented in LISCOMP. Of main interest is the performance of these estimators in relatively small samples (200 to 400) and the comparison of their performance with the normal theory maximum likelihood estimator given an increasing number of response categories. The evaluation of the performance of these estimators concerns the variability of the parameter estimates, the bias of the parameter estimates, the distribution of the parameter estimates and the χ2 goodness-of-fit statistics. The model used in the simulation is an 8-indicator single common factor model. The effect of model size (12- and 16-indicator models) on the categorical item estimator of LISREL 7 is investigated briefly. The results indicate that in the ideal circumstances of the simulation study, 200 is too small a sample size to justify the use of large sample statistics associated with these estimators.",0,1 +2076,The perceived value of team players: a longitudinal study of how group identification affects status in work groups,"Theory and research on status attainment in work groups primarily focuses on members’ abilities and characteristics that make them appear competent as predictors of their status in the group. We complement the abilities perspective with a social identity perspective by arguing that another important determinant of a member’s status is based on the extent to which the member serves the group’s interests. Specifically, we assert that a member’s identification with the group affects performance on behalf of the group, which in turn affects other members’ assessment of the member’s status. We test this social identity perspective on status attainment by studying the influence of members’ group identification on their performance and status in the group, while controlling for the members’ abilities and status characteristics. In a three-wave longitudinal field study following 33 work groups during a six-month group project, we find that members’ identification enhances their performance on behalf of the group,...",0,1 +2077,Monte Carlo Confidence Intervals for Complex Functions of Indirect Effects,"One challenge in mediation analysis is to generate a confidence interval (CI) with high coverage and power that maintains a nominal significance level for any well-defined function of indirect and direct effects in the general context of structural equation modeling (SEM). This study discusses a proposed Monte Carlo extension that finds the CIs for any well-defined function of the coefficients of SEM such as the product of k coefficients and the ratio of the contrasts of indirect effects, using the Monte Carlo method. Finally, we conduct a small-scale simulation study to compare CIs produced by the Monte Carlo, nonparametric bootstrap, and asymptotic-delta methods. Based on our simulation study, we recommend researchers use the Monte Carlo method to test a complex function of indirect effects.",0,1 +2078,Judge neural networks for multi-channel retailing competition,"With the development of online commerce, its becoming more and more important to deal with multi-channel problem, especially when there is an e-channel. In this paper, we establish neural networks to describe customers' decision process. Based on the neural networks, a new price setting game is proposed, which can simulate the competition in multichannel. Since the networks can reflect the real situation well, in simulation experiments, the game and neural networks have shown their ability of describing the multi-channel competition. This provides a powerful tool for retail companies' decision making.",0,1 +2079,Generalized multilevel function-on-scalar regression and principal component analysis,"This manuscript considers regression models for generalized, multilevel functional responses: functions are generalized in that they follow an exponential family distribution and multilevel in that they are clustered within groups or subjects. This data structure is increasingly common across scientific domains and is exemplified by our motivating example, in which binary curves indicating physical activity or inactivity are observed for nearly 600 subjects over 5 days. We use a generalized linear model to incorporate scalar covariates into the mean structure, and decompose subject-specific and subject-day-specific deviations using multilevel functional principal components analysis. Thus, functional fixed effects are estimated while accounting for within-function and within-subject correlations, and major directions of variability within and between subjects are identified. Fixed effect coefficient functions and principal component basis functions are estimated using penalized splines; model parameters are estimated in a Bayesian framework using Stan, a programming language that implements a Hamiltonian Monte Carlo sampler. Simulations designed to mimic the application have good estimation and inferential properties with reasonable computation times for moderate datasets, in both cross-sectional and multilevel scenarios; code is publicly available. In the application we identify effects of age and BMI on the time-specific change in probability of being active over a 24-hour period; in addition, the principal components analysis identifies the patterns of activity that distinguish subjects and days within subjects.",0,1 +2080,On maximum likelihood and restricted maximum likelihood approaches to estimation of variance components,"Two variations of the dispersion-mean correspondence model for varince components lead to the ML and REML equations. This formulation provides for addition of a nonnegativity constraint to the computational method of T. W. Anderson (1971, 1973), an iterative procedure for obtaining ML and REML estimates, which not only assures that estimates will be within the parameter space, but contributes to the stability of the algorithm as well. Estimates of the variance components obtained in this way (which includes MINQUE) are simulated for four balanced and two unbalanced random effects designs. The effect of the nonnegativity constraint on mean squared error is compared to the alternative of replacing negative values of unconstrained estimates to zero, for both the REML and ML approaches. For the two unbalanced designs, the effect of initial starting values and the significance of iterating are also assessed. The simulation results are an extension of those reported by Rich and Brown (1979) for the REML approac...",0,1 +2081,Trajectories of Depression Severity in Clinical Trials of Duloxetine,"The high percentage of failed clinical trials in depression may be due to high placebo response rates and the failure of standard statistical approaches to capture heterogeneity in treatment response.To assess whether growth mixture modeling can provide insights into antidepressant and placebo responses in clinical trials of patients with major depression.We reanalyzed clinical trials of duloxetine to identify distinct trajectories of Hamilton Scale for Depression (HAM-D) scores during treatment. We analyzed the trajectories in the entire sample and then separately in all active arms and in all placebo arms. Effects of duloxetine hydrochloride, selective serotonin reuptake inhibitor (SSRI), and covariates on the probability of following a particular trajectory were assessed. Outcomes in different trajectories were compared using mixed-effects models.Seven randomized double-blind clinical trials of duloxetine vs placebo and comparator SSRI. Patients A total of 2515 patients with major depression.Duloxetine and comparator SSRI. Main Outcome Measure Total score on the HAM-D.In the entire sample and in the antidepressant-treated subsample, we identified trajectories of responders (76.3% of the sample) and nonresponders (23.7% of the sample). However, placebo-treated patients were characterized by a single response trajectory. Duloxetine and SSRI did not differ in efficacy, and compared with placebo they significantly decreased the odds of following the nonresponder trajectory. Antidepressant responders had significantly better HAM-D scores over time than placebo-treated patients, but antidepressant nonresponders had significantly worse HAM-D scores over time than the placebo-treated patients.Most patients treated with serotonergic antidepressants showed a clinical trajectory over time that is superior to that of placebo-treated patients. However, some patients receiving these medications did more poorly than patients receiving placebo. These data highlight the importance of ongoing monitoring of medication risks and benefits during serotonergic antidepressant treatment. They should further stimulate the search for biomarkers or other predictors of responder status in guiding antidepressant treatment.",0,1 +2082,Informal Political Conversation in Old and New Democracies in a Comparative Perspective,,0,1 +2083,Design Effects for a Regression Slope in a Cluster Sample,,0,1 +2084,Bayesian bivariate meta-analysis of diagnostic test studies using integrated nested Laplace approximations,"For bivariate meta-analysis of diagnostic studies, likelihood approaches are very popular. However, they often run into numerical problems with possible non-convergence. In addition, the construction of confidence intervals is controversial. Bayesian methods based on Markov chain Monte Carlo (MCMC) sampling could be used, but are often difficult to implement, and require long running times and diagnostic convergence checks. Recently, a new Bayesian deterministic inference approach for latent Gaussian models using integrated nested Laplace approximations (INLA) has been proposed. With this approach MCMC sampling becomes redundant as the posterior marginal distributions are directly and accurately approximated. By means of a real data set we investigate the influence of the prior information provided and compare the results obtained by INLA, MCMC, and the maximum likelihood procedure SAS PROC NLMIXED. Using a simulation study we further extend the comparison of INLA and SAS PROC NLMIXED by assessing their performance in terms of bias, mean-squared error, coverage probability, and convergence rate. The results indicate that INLA is more stable and gives generally better coverage probabilities for the pooled estimates and less biased estimates of variance parameters. The user-friendliness of INLA is demonstrated by documented R-code.",0,1 +2085,Summarising and validating test accuracy results across multiple studies for use in clinical practice,"Following a meta-analysis of test accuracy studies, the translation of summary results into clinical practice is potentially problematic. The sensitivity, specificity and positive (PPV) and negative (NPV) predictive values of a test may differ substantially from the average meta-analysis findings, because of heterogeneity. Clinicians thus need more guidance: given the meta-analysis, is a test likely to be useful in new populations, and if so, how should test results inform the probability of existing disease (for a diagnostic test) or future adverse outcome (for a prognostic test)? We propose ways to address this. Firstly, following a meta-analysis, we suggest deriving prediction intervals and probability statements about the potential accuracy of a test in a new population. Secondly, we suggest strategies on how clinicians should derive post-test probabilities (PPV and NPV) in a new population based on existing meta-analysis results and propose a cross-validation approach for examining and comparing their calibration performance. Application is made to two clinical examples. In the first example, the joint probability that both sensitivity and specificity will be >80% in a new population is just 0.19, because of a low sensitivity. However, the summary PPV of 0.97 is high and calibrates well in new populations, with a probability of 0.78 that the true PPV will be at least 0.95. In the second example, post-test probabilities calibrate better when tailored to the prevalence in the new population, with cross-validation revealing a probability of 0.97 that the observed NPV will be within 10% of the predicted NPV.",0,1 +2086,Meta-analysis of multiple outcomes by regression with random effects,"Earlier work showed how to perform fixed-effects meta-analysis of studies or trials when each provides results on more than one outcome per patient and these multiple outcomes are correlated. That fixed-effects generalized-least-squares approach analyzes the multiple outcomes jointly within a single model, and it can include covariates, such as duration of therapy or quality of trial, that may explain observed heterogeneity of results among the trials. Sometimes the covariates explain all the heterogeneity, and the fixed-effects regression model is appropriate. However, unexplained heterogeneity may often remain, even after taking into account known or suspected covariates. Because fixed-effects models do not make allowance for this remaining unexplained heterogeneity, the potential exists for bias in estimated coefficients, standard errors and p-values. We propose two random-effects approaches for the regression meta-analysis of multiple correlated outcomes. We compare their use with fixed-effects models and with separate-outcomes models in a meta-analysis of periodontal clinical trials. A simulation study shows the advantages of the random-effects approach. These methods also facilitate meta-analysis of trials that compare more than two treatments.",0,1 +2087,Cross-Validation Study Using Item Response Theory,"The Health-Related Quality of Life for Eating Disorder–Short questionnaire is one of the most suitable existing instruments for measuring quality of life in patients with eating disorders. The objective of the study was to evaluate its reliability, validity, and responsiveness in a cohort of 377 patients. A comprehensive validation process was performed, including confirmatory factor analysis and a graded response model, and assessments of reliability and responsiveness at 1 year of follow-up. The confirmatory factor analysis confirmed the two second-order latent traits, social maladjustment, and mental health and functionality. The graded response model results showed that all items were good for discriminating their respective latent traits. Cronbach’s alpha coefficients were high, and responsiveness parameters showed moderate changes. In conclusion, this short questionnaire has good psychometric properties. Its simplicity and ease of application further enhance its acceptability and usefulness in clinical research and trials, as well as in routine practice.",0,1 +2088,A tutorial on the Bayesian approach for analyzing structural equation models,"Abstract In this paper, we provide a tutorial exposition on the Bayesian approach in analyzing structural equation models (SEMs). SEMs, which can be regarded as regression models with observed and latent variables, have been widely applied to substantive research. However, the classical methods and most commercial software in this area are based on the covariance structure approach, which would encounter serious difficulties when dealing with complicated models and/or data structures. In contrast, the Bayesian approach has much more flexibility in handling complex situations. We give a brief introduction to SEMs and a detailed description of how to apply the Bayesian approach to this kind of model. Advantages of the Bayesian approach are discussed, and results obtained from a simulation study are provided for illustration. The intended audience is statisticians/methodologists who either know about SEMs or simple Bayesian statistics, and Ph.D. students in statistics, psychometrics, or mathematical psychology.",0,1 +2089,Matching As An Econometric Evaluation Estimator,"This paper develops the method of matching as an econometric evaluation estimator. A rigorous distribution theory for kernel-based matching is presented. The method of matching is extended to more general conditions than the ones assumed in the statistical literature on the topic. We focus on the method of propensity score matching and show that it is not necessarily better, in the sense of reducing the variance of the resulting estimator, to use the propensity score method even if propensity score is known. We extend the statistical literature on the propensity score by considering the case when it is estimated both parametrically and nonparametrically. We examine the benefits of separability and exclusion restrictions in improving the efficiency of the estimator. Our methods also apply to the econometric selection bias estimator. Matching is a widely-used method of evaluation. It is based on the intuitively attractive idea of contrasting the outcomes of programme participants (denoted Y1) with the outcomes of comparable nonparticipants (denoted Y0). Differences in the outcomes between the two groups are attributed to the programme. Let 1 and 11 denote the set of indices for nonparticipants and participants, respectively. The following framework describes conventional matching methods as well as the smoothed versions of these methods analysed in this paper. To estimate a treatment effect for each treated person iecI, outcome Yli is compared to an average of the outcomes Yoj for matched persons je10 in the untreated sample. Matches are constructed on the basis of observed characteristics X in Rd. Typically, when the observed characteristics of an untreated person are closer to those of the treated person ieI1, using a specific distance measure, the untreated person gets a higher weight in constructing the match. The estimated gain for each person i in the treated sample is",0,1 +2090,Small Sample Statistics for Incomplete Nonnormal Data: Extensions of Complete Data Formulae and a Monte Carlo Comparison,"Incomplete nonnormal data are common occurrences in applied research. Although these 2 problems are often dealt with separately by methodologists, they often cooccur. Very little has been written about statistics appropriate for evaluating models with such data. This article extends several existing statistics for complete nonnormal data to incomplete data and evaluates their performance via a Monte Carlo study. The focus is on statistics that also perform well in small samples. The following statistics are defined and studied: corrected residual-based statistic, residual-based F statistic, scaled chi-square, adjusted chi-square, Bartlett-corrected scaled chi-square, and Swain-corrected scaled chi-square. Both Type I error rates and power are studied with missing completely at random nonnnormally distributed data and varying degrees of nonnormality. Sample size, model size, and number of variables containing missingness are also varied. For power comparisons, both minor and major model misspecifications a...",0,1 +2091,Semi-parametric proportional hazards models with crossed random effects for psychometric response times,"The semi-parametric proportional hazards model with crossed random effects has two important characteristics: it avoids explicit specification of the response time distribution by using semi-parametric models, and it captures heterogeneity that is due to subjects and items. The proposed model has a proportionality parameter for the speed of each test taker, for the time intensity of each item, and for subject or item characteristics of interest. It is shown how all these parameters can be estimated by Markov chain Monte Carlo methods (Gibbs sampling). The performance of the estimation procedure is assessed with simulations and the model is further illustrated with the analysis of response times from a visual recognition task.",0,1 +2092,A prior for the variance in hierarchical models,"The choice of prior distributions for the variances can be important and quite difficult in Bayesian hierarchical and variance component models. For situations where little prior information is available, a ‘nonin-formative’ type prior is usually chosen. ‘Noninformative’ priors have been discussed by many authors and used in many contexts. However, care must be taken using these prior distributions as many are improper and thus, can lead to improper posterior distributions. Additionally, in small samples, these priors can be ‘informative’. In this paper, we investigate a proper ‘vague’ prior, the uniform shrinkage prior (Strawder-man 1971; Christiansen & Morris 1997). We discuss its properties and show how posterior distributions for common hierarchical models using this prior lead to proper posterior distributions. We also illustrate the attractive frequentist properties of this prior for a normal hierarchical model including testing and estimation. To conclude, we generalize this prior to the multivariate situation of a covariance matrix. Le choix d'une loi a priori pour les variances peut s'averer a la fois difficile et important dans le cadre d'une analyse bayesienne hierarchique ou d'un modele des composantes de la variance. En l'absence totale ou quasi-totale d'information a priori, l'emploi d'une loi ‘non informative’ est de mise. Plusieurs lois de ce type ont ete proposees dans differents contextes, mais leur utilisation est delicate, puisque certaines d'entre elles sont impropres et peuvent conduire a des lois a posteriori non integrables. Dans de petits echantillons, ces lois peuvent aussi se reveler ‘informatives’. Cet article est consacre a l'etude d'une loi a priori a la fois vague et integrable, la loi a priori a retrecissement uniforme (Strawderman 1971; Christiansen & Morris, 1997). Certaines de ses proprietes sont evoquees, notamment le fait que les lois a posteriori auxquelles elle conduit dans certains modeles hierarchiques classiques sont bel et bien integrables. Ses proprietes frequentistes sont egalement mises en valeur dans des situations d'estimation et de test au sein du modele hierarchique gaussien. On montre en outre comment elle peut ětre generalisee au cas multivarie d'une matrice de covariance.",0,1 +2093,Florida State University Libraries,,0,1 +2094,Comparing Propensity Score Methods in Balancing Covariates and Recovering Impact in Small Sample Educational Program Evaluations.,"Propensity score applications are often used to evaluate educational program impact. However, various options are available to estimate both propensity scores and construct comparison groups. This study used a student achievement dataset with commonly available covariates to compare different propensity scoring estimation methods (logistic regression, boosted regression, and Bayesian logistic regression) in combination with different methods for constructing comparison groups (nearest-neighbor matching, optimal matching, weighting) relative to balancing pre-existing differences and recovering a simulated treatment effect in small samples. Results indicated that applied researchers evaluating program impact should first consider use of standard logistic regression methods with nearest-neighbor or optimal matching or boosted regression in combination with propensity score weighting. Advantages and disadvantages of the methods are discussed.",0,1 +2095,Fitting a response model forn dichotomously scored items,"A method of estimating the parameters of the normal ogive model for dichotomously scored item-responses by maximum likelihood is demonstrated. Although the procedure requires numerical integration in order to evaluate the likelihood equations, a computer implemented Newton-Raphson solution is shown to be straightforward in other respects. Empirical tests of the procedure show that the resulting estimates are very similar to those based on a conventional analysis of item ""difficulties"" and first factor loadings obtained from the matrix of tetrachoric correlation coefficients. Problems of testing the fit of the model, and of obtaining invariant parameters are discussed. © 1970 Psychometric Society.",0,1 +2096,Educational choice in secondary school in Flanders: the relative impact of occupational interests on option choice,"The present study aims at unravelling the myriad of student-level (i.e., gender, socioeconomic status [SES], academic self-concept, achievement, ability, and occupational interests) and school-level (i.e., gender composition, maths composition, and SES composition) determinants of option choice in the academic track of secondary school in Flanders. We focused on 2 decisional thresholds in Flemish secondary education, namely, the transition from Grade 8 to Grade 9 (N = 2518) and from Grade 10 to Grade 11 (N = 2871). Data were analyzed through multinomial multilevel analysis. Our results strongly confirm Lent's (2005) jigsaw puzzle metaphor in that different factors go into a complex and dynamic interplay. Especially in the first grades, prior achievement is a major predictor of option choice in secondary education, whereas in the last years occupational interests become increasingly important. From a gender perspective, boys rather choose math/sciences-oriented options than girls. Option choice is mainly d...",0,1 +2097,Mobile mental health: a challenging research agenda,"The field of mobile health (""m-Health"") is evolving rapidly and there is an explosive growth of psychological tools on the market. Exciting high-tech developments may identify symptoms, help individuals manage their own mental health, encourage help seeking, and provide both preventive and therapeutic interventions. This development has the potential to be an efficient cost-effective approach reducing waiting lists and serving a considerable portion of people globally (""g-Health""). However, few of the mobile applications (apps) have been rigorously evaluated. There is little information on how valid screening and assessment tools are, which of the mobile intervention apps are effective, or how well mobile apps compare to face-to-face treatments. But how feasible is rigorous scientific evaluation with the rising demands from policy makers, business partners, and users for their quick release? In this paper, developments in m-Health tools-targeting screening, assessment, prevention, and treatment-are reviewed with examples from the field of trauma and posttraumatic stress disorder. The academic challenges in developing and evaluating m-Health tools are being addressed. Evidence-based guidance is needed on appropriate research designs that may overcome some of the public and ethical challenges (e.g., equity, availability) and the market-driven wish to have mobile apps in the ""App Store"" yesterday rather than tomorrow.",0,1 +2098,Large sample estimation and hypothesis testing,"Asymptotic distribution theory is the primary method used to examine the properties of econometric estimators and tests. We present conditions for obtaining cosistency and asymptotic normality of a very general class of estimators (extremum estimators). Consistent asymptotic variance estimators are given to enable approximation of the asymptotic distribution. Asymptotic efficiency is another desirable property then considered. Throughout the chapter, the general results are also specialized to common econometric estimators (e.g. MLE and GMM), and in specific examples we work through the conditions for the various results in detail. The results are also extended to two-step estimators (with finite-dimensional parameter estimation in the first step), estimators derived from nonsmooth objective functions, and semiparametric two-step estimators (with nonparametric estimation of an infinite-dimensional parameter in the first step). Finally, the trinity of test statistics is considered within the quite general setting of GMM estimation, and numerous examples are given.",0,1 +2099,An Error-Components Model for Prediction of County Crop Areas Using Survey and Satellite Data,"Abstract Knowledge of the area under different crops is important to the U.S. Department of Agriculture. Sample surveys have been designed to estimate crop areas for large regions, such as crop-reporting districts, individual states, and the United States as a whole. Predicting crop areas for small areas such as counties has generally not been attempted, due to a lack of available data from farm surveys for these areas. The use of satellite data in association with farm-level survey observations has been the subject of considerable research in recent years. This article considers (a) data for 12 Iowa counties, obtained from the 1978 June Enumerative Survey of the U.S. Department of Agriculture and (b) data obtained from land observatory satellites (LANDSAT) during the 1978 growing season. Emphasis is given to predicting the area under corn and soybeans in these counties. A linear regression model is specified for the relationship between the reported hectares of corn and soybeans within sample segments in...",0,1 +2100,Key advances in the history of structural equation modeling.,,0,1 +2101,Estimation of the Inverse Covariance Matrix: Random Mixtures of the Inverse Wishart Matrix and the Identity,"Let $S_{p \times p}$ have a nonsingular Wishart distribution with unknown matrix $\Sigma$ and $k$ degrees of freedom. For two different loss functions, estimators of $\Sigma^{-1}$ are given which dominate the obvious estimators $aS^{-1}, 0 < a \leqslant k - p - 1$. Our class of estimators $\mathscr{C}$ includes random mixtures of $S^{-1}$ and $I$. A subclass $\mathscr{C}_0 \subset \mathscr{C}$ was given by Haff. Here, we show that any member of $\mathscr{C}_0$ is dominated in $\mathscr{C}$. Some troublesome aspects of the estimation problem are discussed, and the theory is supplemented by simulation results.",0,1 +2102,Reliability and Validity of Adaptive Ability Tests in a Military Setting,"Publisher Summary This chapter presents a research to discuss the reliability and validity of adaptive ability tests in a military setting. It discusses a research with the purpose to report the results of the first in a series of live-testing studies investigating the psychometric characteristics of computer-administered adaptive testing in comparison with a conventional test. A pilot study based on a small sample of Marine recruits was followed by a larger study based on the same research design. The two studies were designed in part to address two psychometric research questions: (1) whether a computer-administered adaptive test is more reliable than a conventional test, holding test length constant and (2) whether a computer-administered test is more valid than a comparable conventional test with test length constant. These questions were motivated by the results of previous research. The question of the advantages of adaptive tests over conventional ones in terms of reliability has a clear and positive theoretical answer: Holding test length and all else constant, a good adaptive test is superior, provided that highly discriminating test items are available. The general method used in both studies was that of equivalent tests administered to independent examinee groups. One group took two equivalent computer-administered adaptive tests. The other group took two equivalent conventional tests, also administered by computer. To control for item quality, both test types were made up of items from the same source—a common pool of 150 verbal ability items, which had previously been calibrated using item response theory methods in large samples of Marine recruits.",0,1 +2103,An empirical comparison of methods to measure willingness to pay by examining the hypothetical bias,"In the literature, several methods to measure willingness to pay (WTP) have been proposed. However, there is still little knowledge about their reliability. We empirically test the appropriateness of two methods - open-ended contingent valuation (CV) and limit conjoint analysis (LCA) - for measuring willingness to pay, by examining their hypothetical bias. Significant differences of the WTP values were found between the two methods. Comparing the respective hypothetical biases, LCA performs better than CV, yielding non-significant differences in different purchase situations. Nevertheless, our results may depend on the product category analysed. As a consequence, further studies are needed to determine which factors influence the appropriateness of methods for measuring WTP. © 2005 The Market Research Society.",0,1 +2104,An Assessment of Estimation Procedures for Multilevel Models with Binary Responses,"We evaluate two software packages that are available for fitting multilevel models to binary response data, namely VARCL and ML3, by using a Monte Carlo study designed to represent quite closely the actual structure of a data set used in an analysis of health care utilization in Guatemala. We find that the estimates of fixed effects and variance components produced by the software packages are subject to very substantial downward bias when the random effects are sufficiently large to be interesting. In fact, the fixed effect estimates are no better than the estimates obtained by using standard logit models that ignore the hierarchical structure of the data. The estimates of standard errors appear to be reasonably accurate and superior to those obtained by ignoring clustering, although one might question their utility in the presence of large biases. We conclude that alternative estimation procedures need to be developed and implemented for the binary response case",0,1 +2105,Bayesian Methods for Scalable Multivariate Value-Added Assessment,There is increased interest in value-added models relying on longitudinal student-level test score data to isolate teachers’ contributions to student achievement. The complex linkage of students to...,0,1 +2106,A Bayesian model for inference on population proportions,"In recent times and even up to now, traffic congestion and parking difficulties, especially during morning and evening rush hours, have become a major concern to members of the University of Lagos (UNILAG) community and visitors alike. UNILAG has witnessed unprecedented growth in student enrollment during the past 10 years or so culminating in the current total enrollment of more than 35,000 students, of which about 25,000 are undergraduates. In order to study the worrisome traffic situation at UNILAG in the wake of these large numbers, independent, although similar, sample surveys of undergraduate students of the eight faculties on the main campus of UNILAG were conducted in 2007. The purpose of the surveys was to collect data on undergraduate students who owned or used motor vehicles on campus. Furthermore, to investigate possible temporal trends, the surveys were repeated in 2009. The types of data obtained from the surveys provided veritable impetus for the application of empirical Bayes (EB) analysis to estimate the proportions of students of individual faculties who used motor vehicles on campus roads during the periods under reference. The EB technique, being a Bayesian method, combines prior information and sample information in a manner that ‘shrinks’ an EB estimator toward the sample estimator if a vague prior (proper prior with a large variance) is used. The main result is that in 2007 about one in four students used motor vehicles, and this result held almost across the eight faculties. Although results of the 2009 surveys were generally similar there were faculties that recorded some reduction in the estimated proportions of students who used motor vehicles. WIREs Comput Stat 2012 doi: 10.1002/wics.1218",0,1 +2107,Multilevel Model Prediction,"Multilevel models are proven tools in social research for modeling complex, hierarchical systems. In multilevel modeling, statistical inference is based largely on quantification of random variables. This paper distinguishes among three types of random variables in multilevel modeling - model disturbances, random coefficients, and future response outcomes - and provides a unified procedure for predicting them. These predictors are best linear unbiased and are commonly known via the acronym BLUP; they are optimal in the sense of minimizing mean square error and are Bayesian under a diffuse prior. For parameter estimation purposes, a multilevel model can be written as a linear mixed-effects model. In this way, parameters of the many equations can be estimated simultaneously and hence efficiently. For prediction purposes, we show that it is more convenient to retain the multiple equation feature of multilevel models. In this way, the efficient BLUPs are easy to compute and retain their intuitively appealing recursive form. We also derive explicit equations for standard errors of these different types of predictors. Prediction in multilevel modeling is important in a wide range of applications. To demonstrate the applicability of our results, this paper discusses prediction in the context of a study of school effectiveness. © 2006 The Psychometric Society.",0,1 +2108,A generalized rasch model for manifest predictors,"A logistic regression model is suggested for estimating the relation between a set of manifest predictors and a latent trait assumed to be measured by a set of k dichotomous items. Usually the estimated subject parameters of latent trait models are biased, especially for short tests. Therefore, the relation between a latent trait and a set of predictors should not be estimated with a regression model in which the estimated subject parameters are used as a dependent variable. Direct estimation of the relation between the latent trait and one or more independent variables is suggested instead. Estimation methods and test statistics for the Rasch model are discussed and the model is illustrated with simulated and empirical data. © 1991 The Psychometric Society.",0,1 +2109,Crotalphine induces potent antinociception in neuropathic pain by acting at peripheral opioid receptors,"Neuropathic pain is an important clinical problem and it is usually resistant to the current therapy. We have recently characterized a novel analgesic peptide, crotalphine, from the venom of the South American rattlesnake Crotalus durissus terrificus. In the present work, the antinociceptive effect of crotalphine was evaluated in an experimental model of neuropathic pain induced in rats by chronic constriction of sciatic nerve. The effect of the peptide was compared to that induced by the crude venom, which confirmed that crotalphine is responsible for the antinociceptive effect of the crotalid venom on neuropathic pain. For characterization of neuropathic pain, the presence of hyperalgesia, allodynia and spontaneous pain was assessed at different times after nerve constriction. These phenomena were detected 24 h after surgery and persisted at least for 14 days. The pharmacological treatments were performed on day 14 after surgery. Crotalphine (0.2-5 microg/kg) and the crude venom (400-1600 microg/kg) administered p.o. inhibited hyperalgesia, allodynia and spontaneous pain induced by nerve constriction. The antinociceptive effect of the peptide and crude venom was long lasting, since it was detected up to 3 days after treatment. Intraplantar injection of naloxone (1 microg/paw) blocked the antinociceptive effect, indicating the involvement of opioid receptors in this phenomenon. Gabapentin (200 mg/kg, p.o.), and morphine (5 mg/kg, s.c.), used as positive controls, blocked hyperalgesia and partially inhibited allodynia induced by nerve constriction. These data indicate that crotalphine induces a potent and long lasting opioid antinociceptive effect in neuropathic pain that surpasses that observed with standard analgesic drugs.",0,1 +2110,A Bayesian sensitivity study of risk difference in the meta-analysis of binary outcomes from sparse data,"In most cases, including those of discrete random variables, statistical meta-analysis is carried out using the normal random effect model. The authors argue that normal approximation does not always properly reflect the underlying uncertainty of the original discrete data. Furthermore, in the presence of rare events the results from this approximation can be very poor. This review proposes a Bayesian meta-analysis to address binary outcomes from sparse data and also introduces a simple way to examine the sensitivity of the quantities of interest in the meta-analysis with respect to the structure dependence selected. The findings suggest that for binary outcomes data it is possible to develop a Bayesian procedure, which can be directly applied to sparse data without ad hoc corrections. By choosing a suitable class of linking distributions, the authors found that a Bayesian robustness study can be easily implemented. For illustrative purposes, an example with real data is analyzed using the proposed Bayesian meta-analysis for binomial sparse data.",0,1 +2111,The central role of the propensity score in observational studies for causal effects,"Abstract : The results of observational studies are often disputed because of nonrandom treatment assignment. For example, patients at greater risk may be overrepresented in some treatment group. This paper discusses the central role of propensity scores and balancing scores in the analysis of observational studies. The propensity score is the (estimated) conditional probability of assignment to a particular treatment given a vector of observed covariates. Both large and small sample theory show that adjustment for the scalar propensity score is sufficient to remove bias due to all observed covariates. Applications include: matched sampling on the univariate propensity score which is equal percent bias reducing under more general conditions than required for discriminant matching, multivariate adjustment by subclassification on balancing scores where the same subclasses are used to estimate treatment effects for all outcome variables and in all subpopulations, and visual representation of multivariate adjustment by a two-dimensional plot. (Author)",0,1 +2112,An introduction to finite mixture distributions,"Finite mixture densities can be used to model data from populations known or suspected to contain a number of separate subpopulations. Most commonly used are mixture densities with Gaussian (univariate or multivariate) components, but mixtures with other types of component are also increas ingly used to model, for example, survival times. This paper gives a general introduction to the topic which should help when considering the other more specialized papers in this issue.",0,1 +2113,Extraversion and Agreeableness: Divergent Routes to Daily Satisfaction With Social Relationships,"We examined the unique effects of extraversion and agreeableness (and honesty-humility) on everyday satisfaction with family, friends, romantic life, and acquaintances, and explored potential mediators of these effects. Three diary studies (Ns = 206, 139, 185) were conducted on Singaporean university students. In Studies 1 and 2, participants rated their satisfaction with different relationship categories. In Study 3, participants rated their satisfaction and social interactions with 10 target individuals each day for a 1-week period. Both extraversion and agreeableness predicted relationship satisfaction. However, the effect of extraversion was mediated by greater levels of trust in others, whereas the effect of agreeableness was mediated by less frequent negative exchanges (e.g., criticism, perceived anger, and perceived neglect). The effect of honesty-humility on negative exchanges was similar to agreeableness. When both were entered as predictors, only the effect of honesty-humility was significant. We discuss how the processes by which personality affect relationship satisfaction vary depending on the trait as well as the particular measure that is used (IPIP NEO PI-R, California Q-Set, and IPIP-HEXACO).",0,1 +2114,Latent Variable Regression: A Technique for Estimating Interaction and Quadratic Coefficients,"The article proposes a technique to estimate regression coefficients for interaction and quadratic latent variables that combines regression analysis with the measurement model portion of structural equation analysis (e.g., analysis involving CALLS, EQS or LISREL). The measurement model provides parameter estimates that can be combined to correct the variance-covariance matrix used in regression, as Heise (1986) and others recommend. The proposed technique will provide coefficient estimates for regression models involving existing measures, or new measures for which a priori error estimates are not available.",0,1 +2115,Robust Inference With Multiway Clustering,"In this article we propose a variance estimator for the OLS estimator as well as for nonlinear estimators such as logit, probit, and GMM. This variance estimator enables cluster-robust inference when there is two-way or multiway clustering that is nonnested. The variance estimator extends the standard cluster-robust variance estimator or sandwich estimator for one-way clustering (e.g., Liang and Zeger 1986; Arellano 1987) and relies on similar relatively weak distributional assumptions. Our method is easily implemented in statistical packages, such as Stata and SAS, that already offer cluster-robust standard errors when there is one-way clustering. The method is demonstrated by a Monte Carlo analysis for a two-way random effects model; a Monte Carlo analysis of a placebo law that extends the state–year effects example of Bertrand, Duflo, and Mullainathan (2004) to two dimensions; and by application to studies in the empirical literature where two-way clustering is present.",0,1 +2116,On the implications of the classical ergodic theorems: Analysis of developmental processes has to focus on intra-individual variation,"It is argued that general mathematical-statistical theorems imply that standard statistical analysis techniques of inter-individual variation are invalid to investigate developmental processes. Developmental processes have to be analyzed at the level of individual subjects, using time series data characterizing the patterns of intra-individual variation. It is shown that standard statistical techniques based on the analysis of inter-individual variation appear to be insensitive to the presence of arbitrary large degrees of inter-individual heterogeneity in the population. An important class of nonlinear epigenetic models of neural growth is described which can explain the occurrence of such heterogeneity in brain structures and behavior. Links with models of developmental instability are discussed. A simulation study based on a chaotic growth model illustrates the invalidity of standard analysis of inter-individual variation, whereas time series analysis of intra-individual variation is able to recover the true state of affairs.",0,1 +2117,A Comparison of Segment Retention Criteria for Finite Mixture Logit Models,"Despite the widespread application of finite mixture models in marketing research, the decision of how many segments to retain in the models is an important unresolved issue. Almost all applications of the models in marketing rely on segment retention criteria such as Akaike's information criterion, Bayesian information criterion, consistent Akaike's information criterion, and information complexity to determine the number of latent segments to retain. Because these applications employ real-world data in which the true number of segments is unknown, it is not clear whether these criteria are effective. Retaining the true number of segments is crucial because many product design and marketing decisions depend on it. The purpose of this extensive simulation study is to determine how well commonly used segment retention criteria perform in the context of simulated multinomial choice data, as obtained from supermarket scanner panels, in which the true number of segments is known. The authors find that an Akaike's information criterion with a penalty factor of three rather than the traditional value of two has the highest segment retention success rate across nearly all experimental conditions. Currently, this criterion is rarely, if ever, applied in the marketing literature. Experimental factors of particular interest in marketing contexts, such as the number of choices per household, the number of choice alternatives, the error variance of the choices, and the minimum segment size, have not been considered in the statistics literature. The authors show that they, among other factors, affect the performance of segment retention criteria.",0,1 +2118,Truth and consequences of ordinal differences in statistical distributions: Toward a theory of hierarchical inference.,"A theory is presented that establishes a dominance hierarchy of potential distinctions (order relations) between two distributions. It is proposed that it is worthwhile for researchers to ascertain the strongest possible distinction, because all weaker distinctions are logically implied. Implications of the theory for hypothesis testing, theory construction, and scales of measurement are considered. Open problems for future research are outlined.",0,1 +2119,Optimal Assembly of Psychological and Educational Tests,"The advent of computers in psychological and educational measurement has led to the need for algorithms for optimal assembly of tests from item banks. This paper reviews optimal test assembly literature and introduces the contributions to this Special Issue. Four approaches to computerized test assembly are discussed: heuristic-based test assembly, 0-1 linear programming, network-flow programming, and an optimal design approach. Ap-plications of these methods to a variety of problems are examined, including IRT-based test assembly, classical test assembly, assembling multiple test forms, item matching, observed-score equating, constrained adaptive testing, assembling tests with item sets, item bank design, and assembling tests with multiple traits. A bibliography on optimal test assembly is provided.",0,1 +2120,Comparison of Approaches in Estimating Interaction and Quadratic Effects of Latent Variables,"Various approaches using the maximum likelihood (ML) option of the LISREL program and products of indicators have been proposed to analyze structural equation models with non-linear latent effects on the basis of Kenny and Judd's formulation. Recently, some methods based on the Bayesian approach and the exact ML approaches have been developed. This article reviews, elaborates and compares several approaches for analyzing nonlinear models with interaction and/or quadratic effects. A total of four approaches are examined, including the product indicator ML approaches proposed by Jaccard and Wan (1995) and Joreskog and Yang (1996), a Bayesian approach and an exact ML approach. The empirical performances of these approaches are assessed using simulation studies in terms of their capabilities in producing reliable parameter and standard error estimates. It is found that whilst the Bayesian and the exact ML approaches produce satisfactory results in all the settings under consideration, and are in general very reliable; the product indicator ML approaches can only produce reasonable results in simple models with large sample sizes.",0,1 +2121,Variability in encoding precision accounts for visual short-term memory limitations,"It is commonly believed that visual short-term memory (VSTM) consists of a fixed number of ""slots"" in which items can be stored. An alternative theory in which memory resource is a continuous quantity distributed over all items seems to be refuted by the appearance of guessing in human responses. Here, we introduce a model in which resource is not only continuous but also variable across items and trials, causing random fluctuations in encoding precision. We tested this model against previous models using two VSTM paradigms and two feature dimensions. Our model accurately accounts for all aspects of the data, including apparent guessing, and outperforms slot models in formal model comparison. At the neural level, variability in precision might correspond to variability in neural population gain and doubly stochastic stimulus representation. Our results suggest that VSTM resource is continuous and variable rather than discrete and fixed and might explain why subjective experience of VSTM is not all or none.",0,1 +2122,A method for efficiently sampling from distributions with correlated dimensions.,"Bayesian estimation has played a pivotal role in the understanding of individual differences. However, for many models in psychology, Bayesian estimation of model parameters can be difficult. One reason for this difficulty is that conventional sampling algorithms, such as Markov chain Monte Carlo (MCMC), can be inefficient and impractical when little is known about the target distribution--particularly the target distribution's covariance structure. In this article, we highlight some reasons for this inefficiency and advocate the use of a population MCMC algorithm, called differential evolution Markov chain Monte Carlo (DE-MCMC), as a means of efficient proposal generation. We demonstrate in a simulation study that the performance of the DE-MCMC algorithm is unaffected by the correlation of the target distribution, whereas conventional MCMC performs substantially worse as the correlation increases. We then show that the DE-MCMC algorithm can be used to efficiently fit a hierarchical version of the linear ballistic accumulator model to response time data, which has proven to be a difficult task when conventional MCMC is used.",0,1 +2123,An intervention trial on efficacy of atropine and multi-focal glasses in controlling myopic progression,"This randomized clinical trial assessed the treatment effects of atropine and/or multi-focal lenses in decreasing the progression rate of myopia in children.Two hundred and twenty-seven schoolchildren with myopia, aged from 6 to 13 years, who were stratified based on gender, age and the initial amount of myopia were randomly assigned to three treatment groups: 0.5% atropine with multi-focal glasses, multi-focal glasses, and single vision spectacles. Each subject was followed for at least eighteen months. These results report on the 188 patients available for the follow-up.The mean progression of myopia in atropine with multi-focal glasses group (0.41 D) was significantly less than the multi-focal (1.19 D) and single vision group (1.40 D) (p < 0.0001). But no significant difference was noted between the last two groups (p = 0.44). The progression of myopia was significantly correlated with the increases of axial length (r = 0.65, p = 0.0001), but not with the changes of corneal power (r=-0.09), anterior chamber depth (r = -0.023), lens thickness (r = -0.08), or intra-ocular pressure (r = -0.008).The 0.5% atropine with multi-focal lenses can slow down the progression rate of myopia. However, multi-focal lenses alone showed no difference in effect compared to control.",0,1 +2124,Formulation and Application of the Hierarchical Generalized Random-Situation Random-Weight MIRID,"The process-component approach has become quite popular for examining many psychological concepts. A typical example is the model with internal restrictions on item difficulty (MIRID) described by Butter (1994) and Butter, De Boeck, and Verhelst (1998). This study proposes a hierarchical generalized random-situation random-weight MIRID. The proposed model is more flexible for formulating endogenous latent variables within a multilevel framework, allowing the analysis of polytomous data with complex models (e.g., including item discriminations, random situations, random weights, and heteroskedasticity). The parameters in the proposed model can be estimated using the computer program WinBUGS, which adopts Markov Chain Monte Carlo algorithms. To illustrate the application of the proposed model, a real data set about guilt is analyzed and a comparison of MIRIDs for various conditions is conducted.",0,1 +2125,A new look at the statistical model identification,The history of the development of statistical hypothesis testing in time series analysis is reviewed briefly and it is pointed out that the hypothesis testing procedure is not adequately defined as the procedure for statistical model identification. The classical maximum likelihood estimation procedure is reviewed and a new estimate minimum information theoretical criterion (AIC) estimate (MAICE) which is designed for the purpose of statistical identification is introduced. When there are several competing models the MAICE is defined by the model and the maximum likelihood estimates of the parameters which give the minimum of AIC defined by AIC = (-2)log-(maximum likelihood) + 2(number of independently adjusted parameters within the model). MAICE provides a versatile procedure for statistical model identification which is free from the ambiguities inherent in the application of conventional hypothesis testing procedure. The practical utility of MAICE in time series analysis is demonstrated with some numerical examples.,0,1 +2126,Assessing Fit of Unidimensional Graded Response Models Using Bayesian Methods,"The posterior predictive model checking method is a flexible Bayesian model-checking tool and has recently been used to assess fit of dichotomous IRT models. This paper extended previous research to polytomous IRT models. A simulation study was conducted to explore the performance of posterior predictive model checking in evaluating different aspects of fit for unidimensional graded response models. A variety of discrepancy measures (test-level, item-level, and pair-wise measures) that reflected different threats to applications of graded IRT models to performance assessments were considered. Results showed that posterior predictive model checking exhibited adequate power in detecting different aspects of misfit for graded IRT models when appropriate discrepancy measures were used. Pair-wise measures were found more powerful in detecting violations of the unidimensionality and local independence assumptions.",0,1 +2127,Modeling individual differences using Dirichlet processes,"Abstract We introduce a Bayesian framework for modeling individual differences, in which subjects are assumed to belong to one of a potentially infinite number of groups. In this model, the groups observed in any particular data set are not viewed as a fixed set that fully explains the variation between individuals, but rather as representatives of a latent, arbitrarily rich structure. As more people are seen, and more details about the individual differences are revealed, the number of inferred groups is allowed to grow. We use the Dirichlet process—a distribution widely used in nonparametric Bayesian statistics—to define a prior for the model, allowing us to learn flexible parameter distributions without overfitting the data, or requiring the complex computations typically required for determining the dimensionality of a model. As an initial demonstration of the approach, we present three applications that analyze the individual differences in category learning, choice of publication outlets, and web-browsing behavior.",0,1 +2128,The Routledge Companion to Philosophy of Psychology,21 page(s,0,1 +2129,Small area estimation of general parameters with application to poverty indicators: A hierarchical Bayes approach,"Poverty maps are used to aid important political decisions such as allocation of development funds by governments and international organizations. Those decisions should be based on the most accurate poverty figures. However, often reliable poverty figures are not available at fine geographical levels or for particular risk population subgroups due to the sample size limitation of current national surveys. These surveys cannot cover adequately all the desired areas or population subgroups and, therefore, models relating the different areas are needed to 'borrow strength"" from area to area. In particular, the Spanish Survey on Income and Living Conditions (SILC) produces national poverty estimates but cannot provide poverty estimates by Spanish provinces due to the poor precision of direct estimates, which use only the province specific data. It also raises the ethical question of whether poverty is more severe for women than for men in a given province. We develop a hierarchical Bayes (HB) approach for poverty mapping in Spanish provinces by gender that overcomes the small province sample size problem of the SILC. The proposed approach has a wide scope of application because it can be used to estimate general nonlinear parameters. We use a Bayesian version of the nested error regression model in which Markov chain Monte Carlo procedures and the convergence monitoring therein are avoided. A simulation study reveals good frequentist properties of the HB approach. The resulting poverty maps indicate that poverty, both in frequency and intensity, is localized mostly in the southern and western provinces and it is more acute for women than for men in most of the provinces.",0,1 +2130,How Test Takers See Test Examiners,Abstract. We addressed potential test takers’ preferences for women or men as examiners as well as how examiners were perceived depending on their gender. We employed an online design with 375 students who provided preferences for and ratings of examiners based on short video clips. The clips showed four out of 15 psychologists who differed in age (young vs. middle-aged) and gender giving an introduction to a fictional intelligence test session. Employing multivariate multilevel analyses we found female examiners to be perceived as more social competent and middle-aged examiners being perceived as more competent. Data analyses revealed a significant preference for choosing women as examiners. Results were discussed with reference to test performance and fairness.,0,1 +2131,Cultural Consensus Theory: Applications and Frequently Asked Questions,"In the ethnographic context, where answers to questions are unknown, consensus theory estimates the culturally appropriate or correct answers to the questions and individual differences in cultural knowledge. The cultural consensus model is a formal model of the process for asking and answering questions and is limited to categorical response data. An informal version of the model is available as a set of analytic procedures and obtains similar information with fewer assumptions. This article describes the assumptions, appropriate interview materials, and analytic procedures for carrying out a consensus analysis. Finally, issues that sometimes arise during the application of a consensus analysis are discussed.",0,1 +2132,Spinal Cord Glia and Interleukin-1 Do Not Appear to Mediate Persistent Allodynia Induced by Intramuscular Acidic Saline in Rats,"Spinal glial activation and consequent interleukin-1 (IL-1) release are implicated in pain facilitation induced by inflammation/damage to skin and peripheral nerves. It is unclear whether pain facilitation induced at deep tissue sites also depends on these. We investigated whether spinal IL-1 and/or glial activation mediates bilateral allodynia induced by repeated unilateral intramuscular injections of acidic saline to rats. Given the prominent role of spinal IL-1 in various bilateral pain models, we predicted that intrathecal IL-1 receptor antagonist (IL-1ra) would suppress bilateral allodynia in this model as well. Surprisingly, neither single nor repeated intrathecal injections of IL-1ra affected allodynia, measured by the von Frey test, induced by prior intramuscular acidic saline compared with vehicle-injected controls. In addition, we tested the effect of 2 additional intrathecal manipulations that are broadly efficacious in suppressing glially mediated pain facilitation: (1) a glial metabolic inhibitor (fluorocitrate) and (2) the anti-inflammatory cytokine, interleukin-10 (IL-10). Like IL-1ra, fluorocitrate and IL-10 each failed to reverse allodynia. Finally, we observed no significant activation of glial cells, as assessed by immunohistochemistry of glial activation markers, in the lumbar spinal cord in response to intramuscular acidic saline. Taken together, the present data suggest that acidic saline-induced bilateral allodynia is created independently of glial activation.From converging lines of evidence, the current studies suggest that persistent bilateral allodynia induced by repeated intramuscular acidic saline is not mediated by spinal IL-1 and/or spinal glial activation. As such, this might represent the first evidence for pain facilitation occurring in the absence of glial involvement.",0,1 +2133,Statistical analyses for round robin interaction data,"This paper considers the analysis of round robin interaction data whereby individuals from a group of subjects interact with one another, producing a pair of outcomes, one for each individual. The authors provide an overview of the various analyses applied to these types of data and extend the work in several directions. In particular, they provide a fully Bayesian analysis for such data and use a real data example for illustration purposes.",0,1 +2134,The analysis of very small samples of repeated measurements II: A modified Box correction,"There is a need for appropriate methods for the analysis of very small samples of continuous repeated measurements. A key feature of such analyses is the role played by the covariance matrix of the repeated observations. When subjects are few it can be difficult to assess the fit of parsimonious structures for this matrix, while the use of an unstructured form may lead to a serious lack of power. The Kenward-Roger adjustment is now widely adopted as a means of providing an appropriate inferences in small samples, but does not perform adequately in very small samples. Adjusted tests based on the empirical sandwich estimator can be constructed that have good nominal properties, but are seriously underpowered. Further, when such data are incomplete, or unbalanced, or non-saturated mean models are used, exact distributional results do not exist that justify analyses with any sample size. In this paper, a modification of Box's correction applied to a linear model-based F-statistic is developed for such small sample settings and is shown to have both the required nominal properties and acceptable power across a range of settings for repeated measurements.",0,1 +2135,Application of the Theories of Reasoned Action and Planned Behavior to Exercise Behavior: A Meta-Analysis,"The primary purpose of this study was to use meta-analysis to statistically examine the utility of the theory of reasoned action (TRA) and the theory of planned behavior (TPB) for the explanation and prediction of exercise behavior. The results showed that the effect size for the relationships (a) between intention and exercise behavior, attitude and intention, attitude and exercise behavior, perceived behavioral control and intention, and perceived behavioral control and exercise behavior was large; (b) between subjective norm and intention was moderate; and (c) between subjective norm and exercise behavior was zero-order. The results also supported the conclusions that (a) TPB is superior to TRA in accounting for exercise behavior, (b) there is no differences in the ability to predict exercise behavior from proximal and distal measures of intention, and (c) expectation is a better predictor of exercise behavior than intention.",0,1 +2136,A Decline in the Quality of Debate? The Evolution of Cognitive Complexity in Swiss Parliamentary Debates on Immigration (1968-2014),"This article explores the evolution of debate quality in the Swiss parliament. Focusing on immigration debates, we employ a psychological construct—cognitive complexity (CC)—which captures both epistemic and accommodative dimensions of political argumentation. We find a decrease in CC in parliamentary immigration debates over time, but this decrease was driven by the rise of the SVP (Swiss People's Party). However, there was almost no “spillover” of this new communication style to other parties. Moreover, we also find a constant difference between the Standerat and the Nationalrat, with the former scoring higher on CC and thus asserting its role as a “chambre de reflexion” in immigration debates. Our diachronic focus on the quality of political debate takes a novel perspective on the dynamics of consensus democracy as well as on elite political culture. While our results indicate that the rise of the SVP has transformed the traditional consensual and deliberative pattern of Swiss policy-making style into one which is geared towards less accommodation and a higher simplicity of political talk, there is still remarkable resilience against this new style of political interaction.",0,1 +2137,The Political Economy of Gender: Explaining Cross-National Variation in the Gender Division of Labor and the Gender Voting Gap,"Mainstream political economy has tended to treat the family as a unit when examining the distributional consequences of labor market institutions and of public policy. In a world with high divorce rates, we argue that this simplification is more likely to obscure than to instruct. We find that labor market opportunities for women, which vary systematically with the position of countries in the international division of labor and with the structure of the welfare state, affect women's bargaining power within the family and as a result, can explain much of the cross country variation in the gender division of labor as well as the gender gap in political preferences.",0,1 +2138,Methotrexate monotherapy and methotrexate combination therapy with traditional and biologic disease modifying antirheumatic drugs for rheumatoid arthritis: abridged Cochrane systematic review and network meta-analysis,"To compare methotrexate based disease modifying antirheumatic drug (DMARD) treatments for rheumatoid arthritis in patients naive to or with an inadequate response to methotrexate.Systematic review and Bayesian random effects network meta-analysis of trials assessing methotrexate used alone or in combination with other conventional synthetic DMARDs, biologic drugs, or tofacitinib in adult patients with rheumatoid arthritis.Trials were identified from Medline, Embase, and Central databases from inception to 19 January 2016; abstracts from two major rheumatology meetings from 2009 to 2015; two trial registers; and hand searches of Cochrane reviews.Randomized or quasi-randomized trials that compared methotrexate with any other DMARD or combination of DMARDs and contributed to the network of evidence between the treatments of interest.American College of Rheumatology (ACR) 50 response (major clinical improvement), radiographic progression, and withdrawals due to adverse events. A comparison between two treatments was considered statistically significant if its credible interval excluded the null effect, indicating >97.5% probability that one treatment was superior.158 trials were included, with between 10 and 53 trials available for each outcome. In methotrexate naive patients, several treatments were statistically superior to oral methotrexate for ACR50 response: sulfasalazine and hydroxychloroquine (""triple therapy""), several biologics (abatacept, adalimumab, etanercept, infliximab, rituximab, tocilizumab), and tofacitinib. The estimated probability of ACR50 response was similar between these treatments (range 56-67%), compared with 41% with methotrexate. Methotrexate combined with adalimumab, etanercept, certolizumab, or infliximab was statistically superior to oral methotrexate for inhibiting radiographic progression, but the estimated mean change over one year with all treatments was less than the minimal clinically important difference of 5 units on the Sharp-van der Heijde scale. Triple therapy had statistically fewer withdrawals due to adverse events than methotrexate plus infliximab. After an inadequate response to methotrexate, several treatments were statistically superior to oral methotrexate for ACR50 response: triple therapy, methotrexate plus hydroxychloroquine, methotrexate plus leflunomide, methotrexate plus intramuscular gold, methotrexate plus most biologics, and methotrexate plus tofacitinib. The probability of response was 61% with triple therapy and ranged widely (27-70%) with other treatments. No treatment was statistically superior to oral methotrexate for inhibiting radiographic progression. Methotrexate plus abatacept had a statistically lower rate of withdrawals due to adverse events than several treatments.Triple therapy (methotrexate plus sulfasalazine plus hydroxychloroquine) and most regimens combining biologic DMARDs with methotrexate were effective in controlling disease activity, and all were generally well tolerated in both methotrexate naive and methotrexate exposed patients.",0,1 +2139,Improved non-negative estimation of variance components for exposure assessment,"Hygiene surveys of pollutants exposure data can be analyzed by analysis of variance (ANOVA) model with a random worker effect. Typically, workers are classified into homogeneous exposure groups, so it is very common to obtain a zero or negative ANOVA estimate of the between-worker variance (à ƒB2). Negative estimates are not sensible and also pose problems for estimating the probability (ÃŽËœ) that in a job group, a randomly selected worker's mean exposure exceeds the occupational exposure standard. Therefore, it was suggested by Rappaport et al. to replace a non-positive estimate with an approximate one-sided 60% upper confidence bound. This article develops an alternative estimator, based on the upper tolerance interval suggested by Wang and Iyer. We compared the performance of the two methods using real data and simulations with respect to estimating both the between-worker variance and the probability of overexposure in balanced designs. We found that the method of Rappaport et al. has three main disadvantages: (i) the estimated à ƒB2 remains negative for some data sets; (ii) the estimator performs poorly in estimating à ƒB2 and ÃŽËœ with two repeated measures per worker and when true à ƒB2 is quite small, which are quite common situations when studying exposure; (iii) the estimator can be extremely sensitive to small changes in the data. Our alternative estimator offers a solution to these problems.",0,1 +2140,Efficacy of telaprevir and boceprevir in treatment-naïve and treatment-experienced genotype 1 chronic hepatitis C patients: an indirect comparison using Bayesian network meta-analysis,"To indirectly compare the efficacy of telaprevir (TVR) and boceprevir (BOC) combined with peginterferon/ribavirin α-2a/2b (PR) in achieving sustained viral response (SVR) in treatment-naïve and treatment-experienced patients with genotype 1 chronic hepatitis C virus (HCV) infection.A systematic literature review was conducted to identify randomized controlled trials reporting the efficacy of PR-based treatment in genotype 1 chronic HCV patients. A Bayesian network meta-analysis was performed on the endpoint of SVR, assuming fixed study effects. For treatment-experienced patients, only previous relapsers and partial responders were included, as no results in prior null responders were available for boceprevir.Eleven publications were included. In treatment-naïve patients, the odds ratios (OR) (posterior median [95% credible interval]) for telaprevir (12 weeks + response guided treatment [RGT] 24/48 weeks PR) and boceprevir (24 weeks + RGT 28/48 weeks PR) versus PR were respectively 3.80 (2.78-5.22) and 2.99 (2.23-4.01). The OR for telaprevir versus boceprevir was 1.42 (0.89-2.25), with a probability for telaprevir being more effective (P[OR > 1]) of 0.93. In treatment-experienced patients, the OR of telaprevir (12 weeks + 48 weeks PR) and boceprevir (32 weeks + RGT 36/48 weeks PR) versus PR were respectively 13.11 (7.30-24.43) and 5.36 (2.90-10.30). The OR for telaprevir versus boceprevir was 2.45 (1.02-5.80), with telaprevir having a probability of 0.98 of being more effective.The main limitation of this study is the low number of trials included in the analysis, especially for the treatment-experienced patient population, which only allowed random-effect models to be explored. We tried to identify potential biases due to study heterogeneity.In the absence of direct comparative head-to-head studies between telaprevir and boceprevir for the treatment of chronic HCV genotype 1 patients, an indirect comparison based on Bayesian network meta-analysis suggests better efficacy for telaprevir than boceprevir in both treatment-naïve and treatment-experienced patients.",0,1 +2141,An Empirical Evaluation of Alternative Methods of Estimation for Confirmatory Factor Analysis With Ordinal Data.,"Confirmatory factor analysis (CFA) is widely used for examining hypothesized relations among ordinal variables (e.g., Likert-type items). A theoretically appropriate method fits the CFA model to polychoric correlations using either weighted least squares (WLS) or robust WLS. Importantly, this approach assumes that a continuous, normal latent process determines each observed variable. The extent to which violations of this assumption undermine CFA estimation is not well-known. In this article, the authors empirically study this issue using a computer simulation study. The results suggest that estimation of polychoric correlations is robust to modest violations of underlying normality. Further, WLS performed adequately only at the largest sample size but led to substantial estimation difficulties with smaller samples. Finally, robust WLS performed well across all conditions.",0,1 +2142,Fixed and Random Effects Selection in Mixed Effects Models,"We consider selecting both fixed and random effects in a general class of mixed effects models using maximum penalized likelihood (MPL) estimation along with the smoothly clipped absolute deviation (SCAD) and adaptive least absolute shrinkage and selection operator (ALASSO) penalty functions. The MPL estimates are shown to possess consistency and sparsity properties and asymptotic normality. A model selection criterion, called the IC(Q) statistic, is proposed for selecting the penalty parameters (Ibrahim, Zhu, and Tang, 2008, Journal of the American Statistical Association 103, 1648-1658). The variable selection procedure based on IC(Q) is shown to consistently select important fixed and random effects. The methodology is very general and can be applied to numerous situations involving random effects, including generalized linear mixed models. Simulation studies and a real data set from a Yale infant growth study are used to illustrate the proposed methodology.",0,1 +2143,Calibration-Based Empirical Probability,"Probability forecasts for a sequence of uncertain events may be compared with the outcomes of those events by means of a natural criterion of empirical validity, calibration. It is shown that any two sequences of forecasts which both meet this criterion must be in asymptotic agreement. These agreed values can then be considered as correct objective probability forecasts for the particular sequence of outcome results obtained. However, the objective forecasts vary with the extent of the information taken into account when they are formulated. We thus obtain a general theory of empirical probability, relative to an information base. This theory does not require that such probabilities be interpreted in terms of repeated trials of the same event. Some implications of this theory are discussed.",0,1 +2144,Detecting and describing heterogeneity in meta-analysis,"The investigation of heterogeneity is a crucial part of any meta-analysis. While it has been stated that the test for heterogeneity has low power, this has not been well quantified. Moreover the assumptions of normality implicit in the standard methods of meta-analysis are often not scrutinized in practice. Here we simulate how the power of the test for heterogeneity depends on the number of studies included, the total information (that is total weight or inverse variance) available and the distribution of weights among the different studies. We show that the power increases with the total information available rather than simply the number of studies, and that it is substantially lowered if, as is quite common in practice, one study comprises a large proportion of the total information. We also describe normal plots that are useful in assessing whether the data conform to a fixed effect or random effects model, together with appropriate tests, and give an application to the analysis of a multi-centre trial of blood pressure reduction. We conclude that the test of heterogeneity should not be the sole determinant of model choice in meta-analysis, and inspection of relevant normal plots, as well as clinical insight, may be more relevant to both the investigation and modelling of heterogeneity.",0,1 +2145,A Computer Adaptive Testing Method for Intelligent Tutoring Systems,"AbstractThe growth of popularity of computers increases interest of adaptive testing in tutoring systems. Computer adaptive testing is a form of educational measurement that is adaptable to examine proficiency. In a procedure of adaptive testing it is required to determine a selection of the first item, a method of estimation of student’s proficiency, a method of selection of the next item and a termination criterion. In this paper the original algorithm of adaptive testing with all basic steps is proposed. The level of difficulty of the first item is set using user’s profile. Such solution allows to start a test, where the first item is suitable for student’s preferences. In our method 2-parameter IRT model is applied to choose the next item.KeywordsTest ItemItem Response TheoryItem Response Theory ModelIntelligent Tutor SystemProficiency LevelThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.",0,1 +2146,Statistical power analysis for growth curve models using SAS,"Power analysis is critical in research designs. This study discusses a simulation-based approach utilizing the likelihood ratio test to estimate the power of growth curve analysis. The power estimation is implemented through a set of SAS macros. The application of the SAS macros is demonstrated through several examples, including missing data and nonlinear growth trajectory situations. The results of the examples indicate that the power of growth curve analysis increases with the increase of sample sizes, effect sizes, and numbers of measurement occasions. In addition, missing data can reduce power. The SAS macros can be modified to accommodate more complex power analysis for both linear and nonlinear growth curve models.",0,1 +2147,On the psychometric function for contrast detection,"Abstract The frequent current use in probability summation calculations of equations of the form. P = 1 − (1−γ)exp[−(I/α)β] to represent the psychometric function for contrast detection is based on two assumptions: (1) γ can be changed without affecting α and β (the high-threshold assumption) and (2) β is the same for all pattern-detecting mechnisms (the homogeneity assumption). Results of yes-no, rating-scale, and forced-choice experiments contradict the high-threshold assumption: estimates of α and β covary with γ. Contrary to the homogeneity assumption, bipartite fields yield lower values of β than do 12 c/deg gratings. Some consequences of these findings for probability summation calculations are discussed.",0,1 +2148,Psychometric functions for pure-tone frequency discrimination,"The form of the psychometric function (PF) for auditory frequency discrimination is of theoretical interest and practical importance. In this study, PFs for pure-tone frequency discrimination were measured for several standard frequencies (200-8000 Hz) and levels [35-85 dB sound pressure level (SPL)] in normal-hearing listeners. The proportion-correct data were fitted using a cumulative-Gaussian function of the sensitivity index, d', computed as a power transformation of the frequency difference, Δf. The exponent of the power function corresponded to the slope of the PF on log(d')-log(Δf) coordinates. The influence of attentional lapses on PF-slope estimates was investigated. When attentional lapses were not taken into account, the estimated PF slopes on log(d')-log(Δf) coordinates were found to be significantly lower than 1, suggesting a nonlinear relationship between d' and Δf. However, when lapse rate was included as a free parameter in the fits, PF slopes were found not to differ significantly from 1, consistent with a linear relationship between d' and Δf. This was the case across the wide ranges of frequencies and levels tested in this study. Therefore, spectral and temporal models of frequency discrimination must account for a linear relationship between d' and Δf across a wide range of frequencies and levels.",0,1 +2149,Analysis of Clinical Data Using Imprecise Prior Probabilities,"This paper describes a new method based on the theory of imprecise probabilities, for analysing clinical data in the form of a contingency table. The method is applied to a well-known set of statistical data from randomized clinical trials of two treatments for severe cardiorespiratory failure in newborn babies. Two problems are distinguished. The inference problem is to draw conclusions about which treatment is more effective. The decision problem is to determine whether one treatment should be preferred to another for the next patient, or whether it is ethical to select the treatment by randomization. The two problems are analysed using three possible models for prior ignorance about the statistical parameters, and one of the models is modified to take account of earlier clinical data. In this example the four models produce essentially the same conclusions.",0,1 +2150,"IMF Conditionality, Government Partisanship, and the Progress of Economic Reforms","The International Monetary Fund (IMF) often seeks to influence countries' domestic public policy via varying levels of conditionality—linking financial support to borrowing governments' commitment to policy reforms. When does extensive conditionality encourage domestic economic reforms and when does it impede them? We argue that, rather than universally benefiting or harming reforms, the effects of stricter IMF conditionality depend on domestic partisan politics. More IMF conditions can pressure left-wing governments into undertaking more ambitious reforms with little resistance from partisan rivals on the right; under right governments, however, more conditions hinder reform implementation by heightening resistance from the left while simultaneously reducing leaders' ability to win their support through concessions or compromise. Using data on post-communist IMF programs for the period 1994–2010, we find robust evidence supporting these claims, even after addressing the endogeneity of IMF programs via instrumental variables analysis.",0,1 +2151,Evaluation of the CATSIB DIF Procedure in a Pretest Setting,"A new procedure, CATSIB, for assessing differential item functioning (DIF) on computerized adaptive tests (CATs) is proposed. CATSIB, a modified SIBTEST procedure, matches test takers on estimated ability and controls for impact-induced Type 1 error inflation by employing a CAT version of the SIBTEST “regression correction.” The performance of CATSIB in terms of detection of DIF in pretest items was evaluated in a simulation study. Simulated test takers were adaptively administered 25 operational items from a pool of 1,000 and were linearly administered 16 pretest items that were evaluated for DIF. Sample size varied from 250 to 500 in each group. Simulated impact levels ranged from a 0- to 1-standard-deviation difference in mean ability levels. The results showed that CATSIB with the regression correction displayed good control over Type 1 error, whereas CATSIB without the regression correction displayed impact-induced Type 1 error inflation. With 500 test takers in each group, power rates were exceptionally high (84% to 99%) for values of DIF at the boundary between moderate and large DIF. For smaller samples of 250 test takers in each group, the corresponding power rates ranged from 47% to 95%. In addition, in all cases, CATSIB was very accurate in estimating the true values of DIF, displaying at most only minor estimation bias.",0,1 +2152,An alternative approach to analysis of mental states in experimental social cognition research,"Establishing the mental states that affect human behavior is a primary goal of experiments on social cognitive processes. Such mental states can be manipulated only indirectly; therefore, after delivering a manipulation, researchers attempt to verify that the mental state of interest, the representation of a mental state, was in fact changed by the manipulation and that this change caused the observed effect. The usual procedure is to examine mean differences in a measure of the mental state of interest (a manipulation check) among experimental conditions and to infer whether the manipulation was effective. We describe a procedure that strengthens the construct validity of manipulations and, hence, causal inferences in experiments that focus on mental states using analyses familiar to most researchers. This procedure employs a traditional manipulation check that assesses the relationship between manipulations and mental states but, additionally, tests the relationship between the manipulation check and dependent measure. © 2013 Psychonomic Society, Inc.",0,1 +2153,The ability of ratings and choice conjoint to predict market shares: a Monte Carlo simulation,"We use a Monte Carlo simulation with many synthetic data sets to compare ratings and choice conjoint analysis in their ability to correctly predict market shares under varying market conditions. Our results provide guidance to researchers seeking to use conjoint analysis for managerial decisions. Our recommendations are quite different from the recommendations of prior researchers who compared conjoint methods using single empirical data sets. Our results indicate that one must, at least roughly, assess the degree of consumers' heterogeneity in preferences, product similarity in the marketplace, typical consumers' choice-rule (probabilistic or deterministic), and magnitude of error in measurement of utilities in order to make a prudent choice between ratings and choice conjoint analysis.",0,1 +2154,Evaluating and excluding swap errors in analogue tests of working memory,"Abstract When observers retrieve simple visual features from working memory, two kinds of error are typically confounded in their recall. First, responses reflect noise or variability within the feature dimension they were asked to report. Second, responses are corrupted by “swap errors”, in which a different item from the memory set is reported in place of the one that was probed. Independent evaluation of these error sources is vital for understanding the structure of internal representations and their binding. However, previous methods for disentangling these errors have been critically dependent on assumptions about the noise distribution, which is a priori unknown. Here I address this question with novel non-parametric (NP) methods, which estimate swap frequency and feature variability with fewer prior assumptions and without a fitting procedure. The results suggest that swap errors are considerably more prevalent than previously appreciated (accounting for more than a third of responses at set size 8). These methods also identify which items are swapped in for targets: when the target item is cued by location, the items in closest spatial proximity are most likely to be incorrectly reported, thus implicating noise in the probe feature dimension as a source of swap errors.",0,1 +2155,Protecting the Integrity of Computerized Testing Item Pools,What are the issues and techniques involved in protecting the integrity of item pools in computerized testing? How can item exposure be limited? How do security issues differ in computerized testing and paper-and-pencil testing?,0,1 +2156,"Identification, Inference and Sensitivity Analysis for Causal Mediation Effects","Causal mediation analysis is routinely conducted by applied researchers in a variety of disciplines. The goal of such an analysis is to investigate alternative causal mechanisms by examining the roles of intermediate variables that lie in the causal paths between the treatment and outcome variables. In this paper we first prove that under a particular version of sequential ignorability assumption, the average causal mediation effect (ACME) is nonparametrically identified. We compare our identification assumption with those proposed in the literature. Some practical implications of our identification result are also discussed. In particular, the popular estimator based on the linear structural equation model (LSEM) can be interpreted as an ACME estimator once additional parametric assumptions are made. We show that these assumptions can easily be relaxed within and outside of the LSEM framework and propose simple nonparametric estimation strategies. Second, and perhaps most importantly, we propose a new sensitivity analysis that can be easily implemented by applied researchers within the LSEM framework. Like the existing identifying assumptions, the proposed sequential ignorability assumption may be too strong in many applied settings. Thus, sensitivity analysis is essential in order to examine the robustness of empirical findings to the possible existence of an unmeasured confounder. Finally, we apply the proposed methods to a randomized experiment from political psychology. We also make easy-to-use software available to implement the proposed methods.",0,1 +2157,Bayesian Inference for the Spatial Random Effects Model,"Spatial statistical analysis of massive amounts of spatial data can be challenging because computation of optimal procedures can break down. The Spatial Random Effects (SRE) model uses a fixed number of known but not necessarily orthogonal (multiresolutional) spatial basis functions, which gives a flexible family of nonstationary covariance functions, results in dimension reduction, and yields optimal spatial predictors whose computations are scalable. By modeling spatial data in a hierarchical manner with a process model that includes the SRE model, the choice is whether to estimate the SRE model’s parameters or to take a Bayesian approach and put a prior distribution on them. In this article, we develop Bayesian inference for the SRE model when the spatial basis functions are multiresolutional. Then the covariance matrix of the random effects decomposes naturally in terms of Givens angles and eigenvalues, for which a new class of prior distributions is developed. This approach to prior specification of ...",0,1 +2158,"Calibrated Bayes, for Statistics in General, and Missing Data in Particular","It is argued that the Calibrated Bayesian (CB) approach to statistical inference capitalizes on the strength of Bayesian and frequentist approaches to statistical inference. In the CB approach, inferences under a particular model are Bayesian, but frequentist methods are useful for model development and model checking. In this article the CB approach is outlined. Bayesian methods for missing data are then reviewed from a CB perspective. The basic theory of the Bayesian approach, and the closely related technique of multiple imputation, is described. Then applications of the Bayesian approach to normal models are described, both for monotone and nonmonotone missing data patterns. Sequential Regression Multivariate Imputation and Penalized Spline of Propensity Models are presented as two useful approaches for relaxing distributional assumptions.",0,1 +2159,Drugs commonly associated with weight change: umbrella systematic review and meta-analysis (Protocol),"Abstract Background Many drugs and treatments given to patients for various reasons affect their weight. This side effect is of great importance to patients and is also a concern for the treating physician because weight change may lead to the emergence or worsening of other health conditions. Objective The aim of this study is to summarize the evidence about commonly prescribed drugs and their association with weight change. Methods/Design Umbrella systematic review and meta-analysis of randomized controlled trials. We will use an umbrella approach to identify eligible randomized controlled trials (RCTs). We will search for systematic reviews of RCTs that compare any of the drugs that have been associated with weight gain (obesogenic) or weight loss (leptogenic); these have been summarized by our experts’ panel in a predefined list. Two reviewers will independently determine RCT eligibility. Disagreement will be solved by consensus and arbitrated by a third reviewer. We will extract descriptive, methodological, and efficacy data in duplicate. Our primary continuous outcomes will be weight loss or gain expressed as a mean difference (MD) for weight (kg) or BMI (kg/m 2 ). We will calculate the MD considering the mean difference in weight or BMI between baseline and the last available follow-up in both study arms (drugs and placebo). Our primary dichotomous outcome, presented as a relative risk, will compare the ratio of the incidence of weight change in each trial arm. When possible, results will be pooled using classic random-effects meta-analyses and a summary estimate with 95% confidence interval will provided. We will use the I 2 statistic and Cochran’s Q test to assess heterogeneity. The risk of bias will be assessed using the Cochrane risk of bias tool. Publication bias, if appropriate, will be evaluated, as well as overall strength of the evidence. Discussion This systematic review will offer the opportunity to generate a ranking of commonly prescribed drugs in terms of their effect on weight, allowing guideline developers and patient-physician dyad to choose between available therapies.",0,1 +2160,Alternative Estimation Methods for Conjoint Analysis: A Monte Carlo Study,,0,1 +2161,Nonlinear Multilevel Models for Repeated Measures Data,,0,1 +2162,Comparison of CAT Item Selection Criteria for Polytomous Items,"Item selection is a core component in computerized adaptive testing (CAT). Several studies have evaluated new and classical selection methods; however, the few that have applied such methods to the use of polytomous items have reported conflicting results. To clarify these discrepancies and further investigate selection method properties, six different selection methods are compared systematically. The results showed no clear benefit from more sophisticated selection criteria and showed one method previously believed to be superior—the maximum expected posterior weighted information (MEPWI)—to be mathematically equivalent to a simpler method, the maximum posterior weighted information (MPWI).",0,1 +2163,Use of early lactation milk recording data to predict the calving to conception interval in dairy herds,"Economic success in dairy herds is heavily reliant on obtaining pregnancies at an early stage of lactation. Our objective in this study was to attempt to predict the likelihood of conception occurring by d 100 and 150 of lactation (days in milk, DIM) by Markov chain Monte Carlo analysis using test day milk recording data and reproductive records gathered retrospectively from 8,750 cows from 33 dairy herds located in the United Kingdom. Overall, 65% of cows recalved with 30, 46, and 65% of cows conceiving by 100 DIM, 150 DIM, and beyond 150 DIM, respectively. Overall conception rate (total cows pregnant/total number of inseminations) was 27.47%. Median and mean calving to conception intervals were 123 and 105 d, respectively. The probability of conception by both 100 DIM and 150 DIM was positively associated with the average daily milk weight produced during the fourth week of lactation (W4MK) and protein percentage for test day samples collected between 0 to 30 and 31 to 60 DIM. Butterfat percentage at 0 to 30 DIM was negatively associated with the probability of conception by 100 DIM but not at 150 DIM. High somatic cell count (SCC) at both 0 to 30 and 31 to 60 DIM was negatively associated with the probability of conception by 100 DIM, whereas high SCC at 31 to 60 DIM was associated with a reduced probability of conception by 150 DIM. Increasing parity was associated with a reduced odds of pregnancy. Posterior predictions of the likelihood of conception for cows categorized as having ""good"" (W4MK >30kg and protein percentage at 0 to 30 and 31 to 60 DIM >3.2%) or ""poor"" (W4MK <25kg and protein percentage at 0 to 30 and 31 to 60 DIM <3.0%) early lactation attributes with actual observed values indicated model fit was good. The predicted likelihood of a ""good"" cow conceiving by 100 and 150 DIM was 0.39 and 0.57, respectively (actual observed values 0.40 and 0.59). The corresponding values for a ""poor"" cow were 0.28 and 0.42 (actual observed values 0.26 and 0.37). Predictions of the future reproductive success of cows may be possible using a limited number of early lactation attributes.",0,1 +2164,The effect of horizontal eye movements on free recall: A preregistered adversarial collaboration.,"A growing body of research has suggested that horizontal saccadic eye movements facilitate the retrieval of episodic memories in free recall and recognition memory tasks. Nevertheless, a minority of studies have failed to replicate this effect. This article attempts to resolve the inconsistent results by introducing a novel variant of proponent-skeptic collaboration. The proposed approach combines the features of adversarial collaboration and purely confirmatory preregistered research. Prior to data collection, the adversaries reached consensus on an optimal research design, formulated their expectations, and agreed to submit the findings to an academic journal regardless of the outcome. To increase transparency and secure the purely confirmatory nature of the investigation, the 2 parties set up a publicly available adversarial collaboration agreement that detailed the proposed design and all foreseeable aspects of the data analysis. As anticipated by the skeptics, a series of Bayesian hypothesis tests indicated that horizontal eye movements did not improve free recall performance. The skeptics suggested that the nonreplication may partly reflect the use of suboptimal and questionable research practices in earlier eye movement studies. The proponents countered this suggestion and used a p curve analysis to argue that the effect of horizontal eye movements on explicit memory did not merely reflect selective reporting.",0,1 +2165,Meta-Analytic Methods of Pooling Correlation Matrices for Structural Equation Modeling Under Different Patterns of Missing Data.,"Three methods of synthesizing correlations for meta-analytic structural equation modeling (SEM) under different degrees and mechanisms of missingness were compared for the estimation of correlation and SEM parameters and goodness-of-fit indices by using Monte Carlo simulation techniques. A revised generalized least squares (GLS) method for synthesizing correlations, weighted-covariance GLS (W-COV GLS), was compared with univariate weighting with untransformed correlations (univariate r) and univariate weighting with Fisher's z-transformed correlations (univariate z). These 3 methods were crossed with listwise and pairwise deletion. Univariate z and W-COV GLS performed similarly, with W-COV GLS providing slightly better estimation of parameters and more correct model rejection rates. Missing not at random data produced high levels of relative bias in correlation and model parameter estimates and higher incorrect SEM model rejection rates. Pairwise deletion resulted in inflated standard errors for all synthesis methods and higher incorrect rejection rates for the SEM model with univariate weighting procedures.",0,1 +2166,Objective Bayesian Inference for a Generalized Marginal Random Effects Model,"An objective Bayesian inference is proposed for the generalized marginal random effects model p(x|μ,σλ)=f((x−μ1)T(V+σλ2I)−1(x−μ1))/det(V+σλ2I). The matrix V is assumed to be known, and the goal is to infer μ given the observations x=(x1,…,xn)T, while σλ is a nuisance parameter. In metrology this model has been applied for the adjustment of inconsistent data x1,…,xn, where the matrix V contains the uncertainties quoted for x1,…,xn. We show that the reference prior for grouping {μ,σλ} is given by π(μ,σλ)∝F22, where F22 denotes the lower right element of the Fisher information matrix F. We give an explicit expression for the reference prior, and we also prove propriety of the resulting posterior as well as the existence of mean and variance of the marginal posterior for μ. Under the additional assumption of normality, we relate the resulting reference analysis to that known for the conventional balanced random effects model in the asymptotic case when the number of repeated within-class observations for that model tends to infinity. We investigate the frequentist properties of the proposed inference for the generalized marginal random effects model through simulations, and we also study its robustness when the underlying distributional assumptions are violated. Finally, we apply the model to the adjustment of current measurements of the Planck constant.",0,1 +2167,Credential and Skill Mismatches Among Tertiary Graduates: The effect of labour market institutions on the differences between fields of study in 18 countries,"ABSTRACTThis study provides new empirical evidence about tertiary graduates’ overeducation, by analysing the influence of labour market institutions on the incidence and distribution of the phenomenon across fields of study. In particular, the analyses focus on the level of employment protection, the regulation of access to the so-called liberal professions, and the propensity of welfare states to hire skilled workers. Data from two comparative surveys – REFLEX and HEGESCO – are used, and a wide set of information is employed to split overeducation in two forms of suboptimal allocation of individuals in the labour market: credential and skill mismatches. The first term refers to the mismatch between formal educational credentials and job requirements, whereas the second term refers to the mismatch between the skills acquired through education and those needed to perform a job. Results suggest that field of study differentials vary by country and that welfare and labour market institutions illuminate these...",0,1 +2168,Variational Inference for Generalized Linear Mixed Models Using Partially Noncentered Parametrizations,"The effects of different parametrizations on the convergence of Bayesian computational algorithms for hierarchical models are well explored. Techniques such as centering, noncentering and partial noncentering can be used to accelerate convergence in MCMC and EM algorithms but are still not well studied for variational Bayes (VB) methods. As a fast deterministic approach to posterior approximation, VB is attracting increasing interest due to its suitability for large high-dimensional data. Use of different parametrizations for VB has not only computational but also statistical implications, as different parametrizations are associated with different factorized posterior approximations. We examine the use of partially noncentered parametrizations in VB for generalized linear mixed models (GLMMs). Our paper makes four contributions. First, we show how to implement an algorithm called nonconjugate variational message passing for GLMMs. Second, we show that the partially noncentered parametrization can adapt to the quantity of information in the data and determine a parametrization close to optimal. Third, we show that partial noncentering can accelerate convergence and produce more accurate posterior approximations than centering or noncentering. Finally, we demonstrate how the variational lower bound, produced as part of the computation, can be useful for model selection.",0,1 +2169,Fertilizer type and species composition affect leachate nutrient concentrations in coffee agroecosystems,"Intensification of coffee (Coffea arabica) production is associated with increases in inorganic fertilizer application and decreases in species diversity. Both the use of organic fertilizers and the incorporation of trees on farms can, in theory, reduce nutrient loss in comparison with intensified practices. To test this, we measured nutrient concentrations in leachate at 15 and 100 cm depths on working farms. We examined (1) organically managed coffee agroforests (38 kg N ha -1 - year -1 ; n = 4), (2) conventionally managed coffee agroforests (96 kg N ha -1 year -1 ; n = 4), and (3) one conventionally managed monoculture coffee farm in Costa Rica (300 kg N ha -1 year -1 ). Concentrations of nitrate (NO3 - -N) and phosphate (PO4 3- -P) were higher in the monoculture compared to agroforests at both depths. Nitrate concentrations were higher in conven- tional than organic agroforests at 15 cm only. Soil solutions collected under nitrogen (N)-fixing Erythrina poeppigiana had elevated NO3 - -N concentrations at 15 cm compared to Musa acuminata (banana) or Coffea. Total soil N and carbon (C) were also higher under Erythrina. This research shows that both fertilizer type and species affect concentrations of N and P in leachate in coffee agroecosystems.",0,1 +2170,Forecasting television ratings,"Abstract Despite the state of flux in media today, television remains the dominant player globally for advertising spending. Since television advertising time is purchased on the basis of projected future ratings, and ad costs have skyrocketed, there is increasingly pressure to forecast television ratings accurately. The forecasting methods that have been used in the past are not generally very reliable, and many have not been validated; also, even more distressingly, none have been tested in today’s multichannel environment. In this study we compare eight different forecasting models, ranging from a naive empirical method to a state-of-the-art Bayesian model-averaging method. Our data come from a recent time period, namely 2004–2008, in a market with over 70 channels, making the data more typical of today’s viewing environment. The simple models that are commonly used in industry do not forecast as well as any econometric models. Furthermore, time series methods are not applicable, as many programs are broadcast only once. However, we find that a relatively straightforward random effects regression model often performs as well as more sophisticated Bayesian models in out-of-sample forecasting. Finally, we demonstrate that making improvements in ratings forecasts could save the television industry between $250 and $586 million per year.",0,1 +2171,A multivariate multilevel Gaussian model with a mixed effects structure in the mean and covariance part,"A traditional Gaussian hierarchical model assumes a nested multilevel structure for the mean and a constant variance at each level. We propose a Bayesian multivariate multilevel factor model that assumes a multilevel structure for both the mean and the covariance matrix. That is, in addition to a multilevel structure for the mean we also assume that the covariance matrix depends on covariates and random effects. This allows to explore whether the covariance structure depends on the values of the higher levels and as such models heterogeneity in the variances and correlation structure of the multivariate outcome across the higher level values. The approach is applied to the three-dimensional vector of burnout measurements collected on nurses in a large European study to answer the research question whether the covariance matrix of the outcomes depends on recorded system-level features in the organization of nursing care, but also on not-recorded factors that vary with countries, hospitals, and nursing units. Simulations illustrate the performance of our modeling approach.",0,1 +2172,Tracking of nociceptive thresholds using adaptive psychophysical methods,"Psychophysical thresholds reflect the state of the underlying nociceptive mechanisms. For example, noxious events can activate endogenous analgesic mechanisms that increase the nociceptive threshold. Therefore, tracking thresholds over time facilitates the investigation of the dynamics of these underlying mechanisms. Threshold tracking techniques should use efficient methods for stimulus selection and threshold estimation. This study compares, in simulation and in human psychophysical experiments, the performance of different combinations of adaptive stimulus selection procedures and threshold estimation methods. Monte Carlo simulations were first performed to compare the bias and precision of threshold estimates produced by three different stimulus selection procedures (simple staircase, random staircase, and minimum entropy procedure) and two estimation methods (logistic regression and Bayesian estimation). Logistic regression and Bayesian estimations resulted in similar precision only when the prior probability distributions (PDs) were chosen appropriately. The minimum entropy and simple staircase procedures achieved the highest precision, while the random staircase procedure was the least sensitive to different procedure-specific settings. Next, the simple staircase and random staircase procedures, in combination with logistic regression, were compared in a human subject study (n = 30). Electrocutaneous stimulation was used to track the nociceptive perception threshold before, during, and after a cold pressor task, which served as the conditioning stimulus. With both procedures, habituation was detected, as well as changes induced by the conditioning stimulus. However, the random staircase procedure achieved a higher precision. We recommend using the random staircase over the simple staircase procedure, in combination with logistic regression, for nonstationary threshold tracking experiments. © 2013 Psychonomic Society, Inc.",0,1 +2173,Random effects meta-analysis of event outcome in the framework of the generalized linear mixed model with applications in sparse data,"We consider random effects meta-analysis where the outcome variable is the occurrence of some event of interest. The data structures handled are where one has one or more groups in each study, and in each group either the number of subjects with and without the event, or the number of events and the total duration of follow-up is available. Traditionally, the meta-analysis follows the summary measures approach based on the estimates of the outcome measure(s) and the corresponding standard error(s). This approach assumes an approximate normal within-study likelihood and treats the standard errors as known. This approach has several potential disadvantages, such as not accounting for the standard errors being estimated, not accounting for correlation between the estimate and the standard error, the use of an (arbitrary) continuity correction in case of zero events, and the normal approximation being bad in studies with few events. We show that these problems can be overcome in most cases occurring in practice by replacing the approximate normal within-study likelihood by the appropriate exact likelihood. This leads to a generalized linear mixed model that can be fitted in standard statistical software. For instance, in the case of odds ratio meta-analysis, one can use the non-central hypergeometric distribution likelihood leading to mixed-effects conditional logistic regression. For incidence rate ratio meta-analysis, it leads to random effects logistic regression with an offset variable. We also present bivariate and multivariate extensions. We present a number of examples, especially with rare events, among which an example of network meta-analysis.",0,1 +2174,On the unnecessary ubiquity of hierarchical linear modeling.,"In psychology and the behavioral sciences generally, the use of the hierarchical linear model (HLM) and its extensions for discrete outcomes are popular methods for modeling clustered data. HLM and its discrete outcome extensions, however, are certainly not the only methods available to model clustered data. Although other methods exist and are widely implemented in other disciplines, it seems that psychologists have yet to consider these methods in substantive studies. This article compares and contrasts HLM with alternative methods including generalized estimating equations and cluster-robust standard errors. These alternative methods do not model random effects and thus make a smaller number of assumptions and are interpreted identically to single-level methods with the benefit that estimates are adjusted to reflect clustering of observations. Situations where these alternative methods may be advantageous are discussed including research questions where random effects are and are not required, when random effects can change the interpretation of regression coefficients, challenges of modeling with random effects with discrete outcomes, and examples of published psychology articles that use HLM that may have benefitted from using alternative methods. Illustrative examples are provided and discussed to demonstrate the advantages of the alternative methods and also when HLM would be the preferred method. (PsycINFO Database Record",0,1 +2175,IRT Model Selection Methods for Dichotomous Items,"Fit of the model to the data is important if the benefits of item response theory (IRT) are to be obtained. In this study, the authors compared model selection results using the likelihood ratio test, two information-based criteria, and two Bayesian methods. An example illustrated the potential for inconsistency in model selection depending on which of the indices was used. Results from a simulation study indicated that the inconsistencies among the indices were common but that model selection was relatively accurate for longer tests administered to larger sample of examinees. The cross-validation log-likelihood (CVLL) appeared to work the best of the five models for the conditions simulated in this study.",0,1 +2176,A dynamic Thurstonian item response theory of motive expression in the picture story exercise: Solving the internal consistency paradox of the PSE.,"The measurement of implicit or unconscious motives using the picture story exercise (PSE) has long been a target of debate in the psychological literature. Most debates have centered on the apparent paradox that PSE measures of implicit motives typically show low internal consistency reliability on common indices like Cronbach's alpha but nevertheless predict behavioral outcomes. I describe a dynamic Thurstonian item response theory (IRT) model that builds on dynamic system theories of motivation, theorizing on the PSE response process, and recent advancements in Thurstonian IRT modeling of choice data. To assess the models' capability to explain the internal consistency paradox, I first fitted the model to archival data (Gurin, Veroff, & Feld, 1957) and then simulated data based on bias-corrected model estimates from the real data. Simulation results revealed that the average squared correlation reliability for the motives in the Thurstonian IRT model was .74 and that Cronbach's alpha values were similar to the real data (<.35). These findings suggest that PSE motive measures have long been reliable and increase the scientific value of extant evidence from motivational research using PSE motive measures.",0,1 +2177,Confidence Limits for the Indirect Effect: Distribution of the Product and Resampling Methods,"The most commonly used method to test an indirect effect is to divide the estimate of the indirect effect by its standard error and compare the resulting z statistic with a critical value from the standard normal distribution. Confidence limits for the indirect effect are also typically based on critical values from the standard normal distribution. This article uses a simulation study to demonstrate that confidence limits are imbalanced because the distribution of the indirect effect is normal only in special cases. Two alternatives for improving the performance of confidence limits for the indirect effect are evaluated: (a) a method based on the distribution of the product of two normal random variables, and (b) resampling methods. In Study 1, confidence limits based on the distribution of the product are more accurate than methods based on an assumed normal distribution but confidence limits are still imbalanced. Study 2 demonstrates that more accurate confidence limits are obtained using resampling methods, with the bias-corrected bootstrap the best method overall.",0,1 +2178,A framework for ML estimation of parameters of (mixtures of) common reaction time distributions given optional truncation or censoring,"We present a framework for distributional reaction time (RT) analysis, based on maximum likelihood (ML) estimation. Given certain information relating to chosen distribution functions, one can estimate the parameters of these distributions and of finite mixtures of these distributions. In addition, left and/or right censoring or truncation may be imposed. Censoring and truncation are useful methods by which to accommodate outlying observations, which are a pervasive problem in RT research. We consider five RT distributions: the Weibull, the ex-Gaussian, the gamma, the log-normal, and the Wald. We employ quasi-Newton optimization to obtain ML estimates. Multicase distributional analyses can be carried out, which enable one to conduct detailed (across or within subjects) comparisons of RT data by means of loglikelihood difference tests. Parameters may be freely estimated, estimated subject to boundary constraints, constrained to be equal (within or over cases), or fixed. To demonstrate the feasibility of ML estimation and to illustrate some of the possibilities offered by the present approach, we present three small simulation studies. In addition, we present three illustrative analyses of real data.",0,1 +2179,Assessment of auditory temporal-order thresholds - a comparison of different measurement procedures and the influences of age and gender.,"The relationship between auditory temporal-order perception and phoneme discrimination has been discussed for several years, based on findings, showing that patients with cerebral damage in the left hemisphere and aphasia, as well as children with specific language impairments, show deficits in temporal-processing and phoneme discrimination. Over the last years several temporal-order measurement procedures and training batteries have been developed. However, there exists no standard diagnostic tool for adults that could be applied to patients with aphasia. Therefore, our study aimed at identifying a feasible, reliable and efficient measurement procedure to test for auditory-temporal processing in healthy young and elderly adults, which in a further step can be applied to patients with aphasia.The tasks varied according to adaptive procedures (staircase vs. maximum-likelihood), stimuli (tones vs. clicks) and stimulation modes (binaural- vs. alternating monaural) respectively. A phoneme-discrimination task was also employed to assess the relationship between temporal and language processing.The results show that auditory temporal-order thresholds are stimulus dependent, age related, and influenced by gender. Furthermore, the cited relationship between temporal-order threshold and phoneme discrimination can only be confirmed for measurements with pairs of tones.Our results indicate, that different norms have to be established for different gender and age groups. Furthermore, temporal-order measurements with tones seem to be more suitable for clinical intervention studies than measurements with clicks, as they show higher re-test reliabilities, and only for measurements with tones an association with phoneme-discrimination abilities was found.",0,1 +2180,Updating meta-analytic research findings: Bayesian approaches versus the medical model.,"The authors examine 3 methods of combining new studies into existing meta-analyses: (a) adding the new study or studies to the database and recalculating the meta-analysis (the medical model); (b) using the Bayesian procedure advocated by F. L. Schmidt and J. E. Hunter (1977) and F. L. Schmidt, J. E. Hunter, K. Pearlman, and G. S. Shane (1979) to update the meta-analysis; and (c) using the Bayesian methods advocated by these authors and M. T. Brannick (2001) and M. T. Brannick, S. M. Hall, and Y. Liu (2002) to estimate study-specific parameters. Method b was found to severely overweight new studies relative to the previous studies contained in the meta-analysis, and Method c was found to do the same while also requiring an assumption with a low prior probability of being correct, causing the method to violate Bayesian principles. The authors present an alternative Bayesian procedure that does not suffer from these drawbacks and yields meta-analytic results very similar to those obtained with the medical model. They recommend use of the medical model or this alternative Bayesian procedure.",0,1 +2181,Psychometric Accuracy and (the Continuing Need for) Quality Thinking in Meta-Analysis,"The four feature-topic articles advance the accuracy of meta-analytic techniques. As might be expected, most articles focus on more precise ways to aggregate all available relationships in a given topic domain. Such aggregation results in overall estimates of relationships and estimates conditional on particular moderators. However, scholars and practitioners can expect more than empirical aggregation from meta-analysis. Careful attention to underlying theory, application, and important methodological issues will result in clearer understanding and explanation. Using the situational judgment testing literature as an example, the current analysis suggests the need for much more upfront, reflective thinking about each meta-analytic study's purpose and how this thinking relates to the inclusion or choice of primary studies, analytic method, coding, and so on. For example, when the focus is on prediction, frequent use of concurrent designs may bias aggregated parameter estimates. Also, it is noted that methods and constructs continue to be confounded in the research literatures.",0,1 +2182,Giving up Linearity : Absorptive Capacity and Performance,"INTRODUCTION Absorptive capacity (ACAP) is defined as one of the firm's key learning processes with regard to identifying, assimilating, and exploiting knowledge from the environment (Cohen and Levinthal, 1989; Lane et al., 2006; Lane and Lubatkin, 1998). This process arises from the seminal work of Cohen and Levinthal (1989, 1990, and 1994) and enables firms to profit from external knowledge. ACAP has received broad attention in research as innovative capabilities have become more and more important in sustaining a competitive advantage (Bower and Christensen, 1995; Eisenhardt and Martin, 2000; Helfat, 2000; Li and Atuahene-Gima, 2001) and, particularly, as innovation from external sources is on the rise (Jansen et al., 2005; Zollo et al., 2002). Even though the construct of ACAP has been studied widely during the past two decades (Easterby-Smith et al., 2008; Lane et al., 2006), there have not been any findings yet on curvilinear relationships between ACAP and performance. The existing literature has provided considerable empirical work on ACAP and its relationship to innovation (Tsai, 2001), interorganizational learning (Lane and Lubatkin, 1998; Lane et al., 2001; Lichtenthaler, 2009), intra-organizational transfer of knowledge (Gupta et al., 2006; Szulanski, 1996), and firm performance (Lane et al., 2001; Lichtenthaler, 2009; Tsai, 2001). However, in its analysis of the relationship between ACAP and a second variable, current research has relied primarily on the assumption of linearity and has not taken into account the extent to which the variables are developed. Nevertheless, non-linear relationships could exist in many cases, e.g., when a dependent variable develops positively to a certain optimum with respect to an independent variable and then decreases after having reached this optimal point (Ahuja and Lampert, 2001; Tang et al., 2008). Curvilinear relationships between ACAP and a certain dependent variable could, for example, reflect decreasing or even negative marginal growth. Thus, by assuming a linear relationship, recent research may have neglected U-shaped or inverted U-shaped relationships and, therefore, may have led practitioners to nonoptimal resource allocations--maybe even to the point of decreasing marginal growth (Herold et al., 2006). To put it more concretely, as the development of ACAP requires resources, it would be entirely possible that the positive effects of ACAP do not outweigh their respective investments at a certain level of development. Although some scholars engaged in ACAP research have pointed out the possibility of meaningful curvilinear relationships (Lane et al., 2006; Lichtenthaler, 2009), no empirical studies of ACAP and performance have examined this phenomenon explicitly. This deficiency in the field of ACAP research is rooted in two causes. First, recent research on ACAP has usually built upon linear structural equation models (e.g., Flatten et al., 2009, 2011; Lichtenthaler, 2009; Jansen et al., 2005). However, even though these second-generation methods (e.g., Lisrel and PLS) offer a wide range of advantages (e.g., depiction of complex models, evaluation of models, capture of measurement errors) compared to the first generation (Fornell and Bookstein, 1982), curvilinear effects can be pictured in a limited way only (Lee et al., 2004). In the past, most researchers captured ACAP via research and development (RD Szulanski, 1996; Therin, 2007). Now that validated operationalizations of ACAP (Flatten et al., 2009; Lichtenthaler, 2009) have been published, a basis for further understanding ACAP and its effect on performance has been established. The purpose of this paper is to address the described research gap and to contribute to existing literature in the following way. …",0,1 +2183,Modeling Differential Item Functioning Using a Generalization of the Multiple-Group Bifactor Model,"The authors present a generalization of the multiple-group bifactor model that extends the classical bifactor model for categorical outcomes by relaxing the typical assumption of independence of the specific dimensions. In addition to the means and variances of all dimensions, the correlations among the specific dimensions are allowed to differ between groups. By including group-specific difficulty parameters, the model can be used to assess differential item functioning (DIF) for testlet-based tests. The model encompasses various item response models for polytomous data by allowing for different link functions, and it includes testlet and second-order models as special cases. Importantly, by assuming that the testlet dimensions are conditionally independent given the general dimension, the authors show, using a graphical model framework, that the integration over all latent variables can be carried out through a sequence of computations in two-dimensional subspaces, making full-information maximum likelihood estimation feasible for high-dimensional problems and large datasets. The importance of relaxing the orthogonality assumption and allowing for a different covariance structure of the dimensions for each group is demonstrated in the context of the assessment of DIF. Through a simulation study, it is shown that ignoring between-group differences in the structure of the multivariate latent space can result in substantially biased estimates of DIF.",0,1 +2184,Optimal Design in Educational Testing,,0,1 +2185,Hierarchical modeling of sequential behavioral data: Examining complex association patterns in mediation models.,"This article presents new methods for modeling the strength of association between multiple behaviors in a behavioral sequence, particularly those involving substantively important interaction patterns. Modeling and identifying such interaction patterns becomes more complex when behaviors are assigned to more than two categories, as is the case for most observational research. The authors propose multilevel empirical Bayes methods to overcome the challenges inherent in such data. Furthermore, these methods allow the study of how variation in interaction patterns can mediate the effects of antecedents or intervention on distal outcomes. New procedures are developed to compare alternative mediation models and pinpoint which random effects operate as mediators. These models are then applied to observational data taken from a study of the behavioral interactions of 254 couples.",0,1 +2186,Bayesian hierarchical modeling of Pacific geoduck growth increment data and climate indices,"Growth increment widths from hard structures of marine and freshwater fish and bivalve species are increasingly used to model growth and elucidate relationships with environmental variability. Fully characterizing the intrinsic age-related growth variation among individuals within and between populations, while estimating the extrinsic environmental effects simultaneously, can be challenging. Using the long-lived bivalve Pacific geoduck (Panopea generosa), we develop an integrated approach to analyze the relationship between growth increment data and climate indices using Bayesian hierarchical methods. Fitting models to growth increment data from multiple individuals over two sites, we examined different covariance structures related to random individual effects, long- and short-term environmental effects and unexplained errors. The best fitting hierarchical model accounted for a site-specific mean growth response, individual growth variability through random parameter effects, and site-specific error variances. Extrinsic environmental effects on growth were also significant and included a random year effect and the Pacific Decadal Oscillation (PDO) as a predictor of mean growth across both individuals and sites. Once intrinsic age-related growth was accounted for, PDO accounted for 18% to total variability in growth increment data; geoduck shell size was predicted to increase as a function of larger PDO anomalies. However, the greatest variability in growth increment data was explained by random year effects (∼60–70%), and while largely unexplained, sea surface temperature (SST) is a likely determinant on geoduck growth rates showing a positive growth–SST response.",0,1 +2187,Explaining numeracy development in weak performing kindergartners,"• 990 Children were screened for weak early numeracy at the start of kindergarten. • Early numeracy development was monitored at four points throughout kindergarten. • Growth was predicted by several predictors together in one multilevel model. • Math language is underestimated as important factor in numeracy development. Gaining better insight into precursors of early numeracy in young children is important, especially in those with inadequate numeracy skills. Therefore, in the current study, visual and verbal working memory, non-symbolic and symbolic comparison skills, and specific math-related language were used to explain early numeracy performance and development of weak performing children throughout kindergarten. The early numeracy ability of both weak performers and typical performers was measured at four time points during 2 years of kindergarten to compare growth rates. Results show a significant faster development of early numeracy in the weak performers. The development of weak performers’ numeracy was influenced by verbal working memory, symbolic comparison skills, and math language, whereas only math language was positively related to the slope of typical performers’ numeracy. In the weak performers, visual working memory, non-symbolic comparison skills, and math language showed an effect on the initial early numeracy level of these children. The intercept of the typical performers was predicted by five covariates, all except non-symbolic comparison.",0,1 +2188,Cultural Variation in the Minimal Group Effect,"The minimal group effect (MGE) is one of the most robust psychological findings in studies of intergroup conflict, yet there is little evidence comparing its magnitude across cultures. Recent evidence suggests that the MGE is due in part to a projection of one’s own perceived characteristics onto the novel in-group. Because of cultural variability in self-enhancement motivations, we thus expected that those from East Asian cultures would exhibit a diminished MGE relative to Westerners. A large and diverse sample of Japanese and American participants completed a traditional minimal group study. American participants were more likely to show an in-group bias in group identification, perceived group intelligence, perceived group personality traits, and resource allocation. Furthermore, these cultural differences were partially mediated by self-esteem. We discuss the implication of these findings for theories of intergroup conflict and suggest multiple directions for future cross-cultural research on the MGE.",0,1 +2189,Multilevel Bayesian networks for the analysis of hierarchical health care data,"Large health care datasets normally have a hierarchical structure, in terms of levels, as the data have been obtained from different practices, hospitals, or regions. Multilevel regression is the technique commonly used to deal with such multilevel data. However, for the statistical analysis of interactions between entities from a domain, multilevel regression yields little to no insight. While Bayesian networks have proved to be useful for analysis of interactions, they do not have the capability to deal with hierarchical data. In this paper, we describe a new formalism, which we call multilevel Bayesian networks; its effectiveness for the analysis of hierarchically structured health care data is studied from the perspective of multimorbidity.Multilevel Bayesian networks are formally defined and applied to analyze clinical data from family practices in The Netherlands with the aim to predict interactions between heart failure and diabetes mellitus. We compare the results obtained with multilevel regression.The results obtained by multilevel Bayesian networks closely resembled those obtained by multilevel regression. For both diseases, the area under the curve of the prediction model improved, and the net reclassification improvements were significantly positive. In addition, the models offered considerable more insight, through its internal structure, into the interactions between the diseases.Multilevel Bayesian networks offer a suitable alternative to multilevel regression when analyzing hierarchical health care data. They provide more insight into the interactions between multiple diseases. Moreover, a multilevel Bayesian network model can be used for the prediction of the occurrence of multiple diseases, even when some of the predictors are unknown, which is typically the case in medicine.",0,1 +2190,The Mediating Role of Visuospatial Planning Skills on Adaptive Function Among Young–Adult Survivors of Childhood Brain Tumor,"The Boston Qualitative Scoring System (BQSS) was used as a method to examine executive skills on the Rey-Osterrieth complex figure (ROCF). Young-adult survivors of childhood brain tumor (N = 31) and a demographically-matched comparison group (N = 33) completed the ROCF copy version and Grooved Pegboard, and informants were administered the Scales of Independent Behavior-Revised (SIB-R) and Behavior Rating Inventory of Executive Function (BRIEF). Survivors had significantly lower BQSS planning and SIB-R community living skills and greater perseveration. Mediation analyses found that BQSS planning skills mediate the relationship between group and community living skills. Convergent findings of the BRIEF Planning, and discriminant findings with the BQSS Fragmentation, BRIEF Emotional Control, and Grooved Pegboard support the planning construct as the specific mediator in this model. Together, these findings highlight the role of planning skills in adaptive functions of young-adult survivors of childhood brain tumor.",0,1 +2191,An Empirical Study to Develop a Decision Support System (DSS) for Measuring the Impact of Quality Measurements over Agile Software Development (ASD),"Background/Objectives: Primarily, this quantitative research aims to study the impact of integrating quality measurements with ASD, quantify it, and develop a DSS for predicting its outcome. Methods/Statistical Analysis: Included within a survey, the population sample is represented by project managers, who were divided into two independent groups: The first one adopts an explicit quality measurement framework while the second group does not apply quality measurements. After that, the researcher tested both groups in an independent samples t-test, and analysed results statistically. After experimenting different machine learning models, the researcher developed a DSS based on Linear Regression. Findings: Only 150 responded out of 200 respondents. The research dataset passed the “independent t-test” validity test with the fulfilment of the six assumptions. After conducting the independent t-test design, the researcher found that the value of Sig. (2-tailed) is less than .05, which means that the differences between the experimented groups are statistically significant. After that, the researcher utilized WEKA experimenter with 10-folds cross validation to test the dataset fitness with four different machine learning algorithms, which are Linear Regression (base), Multilayer Perceptron, KStar, and Decision Stump. The results showed that Linear Regression (base) provides better fitness with the dataset. Moreover, The R Square for it is .836. Based on Linear Regression, the researcher developed web and windows version of the DSS using VB.NET. In summary, research results shows that there is empirical evidence to support the proposition that quality measurements integration with ASD presents a strategic value to organizations. The contribution of these findings is materialized in its empirical nature and the scariness of research in this domain. Application/Improvements: Henceforward, the researcher are planning to expand the population sample, publishing the developed DSS online with integrated feedback, and developing other DSSs for supporting integrating quality measurements with ASD.",0,1 +2192,Intraclass Correlation Associated with Therapists: Estimates and Applications in Planning Psychotherapy Research,"It is essential that outcome research permit clear conclusions to be drawn about the efficacy of interventions. The common practice of nesting therapists within conditions can pose important methodological challenges that affect interpretation, particularly if the study is not powered to account for the nested design. An obstacle to the optimal design of these studies is the lack of data about the intraclass correlation coefficient (ICC), which measures the statistical dependencies introduced by nesting. To begin the development of a public database of ICC estimates, the authors investigated ICCs for a variety outcomes reported in 20 psychotherapy outcome studies. The magnitude of the 495 ICC estimates varied widely across measures and studies. The authors provide recommendations regarding how to select and aggregate ICC estimates for power calculations and show how researchers can use ICC estimates to choose the number of patients and therapists that will optimize power. Attention to these recommendations will strengthen the validity of inferences drawn from psychotherapy studies that nest therapists within conditions.",0,1 +2193,Conducting Indirect-Treatment-Comparison and Network-Meta-Analysis Studies: Report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices: Part 2,"Evidence-based health care decision making requires comparison of all relevant competing interventions. In the absence of randomized controlled trials involving a direct comparison of all treatments of interest, indirect treatment comparisons and network meta-analysis provide useful evidence for judiciously selecting the best treatment(s). Mixed treatment comparisons, a special case of network meta-analysis, combine direct evidence and indirect evidence for particular pairwise comparisons, thereby synthesizing a greater share of the available evidence than traditional meta-analysis. This report from the International Society for Pharmacoeconomics and Outcomes Research Indirect Treatment Comparisons Good Research Practices Task Force provides guidance on technical aspects of conducting network meta-analyses (our use of this term includes most methods that involve meta-analysis in the context of a network of evidence). We start with a discussion of strategies for developing networks of evidence. Next we briefly review assumptions of network meta-analysis. Then we focus on the statistical analysis of the data: objectives, models (fixed-effects and random-effects), frequentist versus Bayesian approaches, and model validation. A checklist highlights key components of network meta-analysis, and substantial examples illustrate indirect treatment comparisons (both frequentist and Bayesian approaches) and network meta-analysis. A further section discusses eight key areas for future research.",0,1 +2194,Piecewise Growth Mixture Modeling of Adolescent Alcohol Use Data,"This article addresses issues of heterogeneity in multiple-stage development as it corresponds to qualitatively different development in alcohol use during adolescence. Using a piecewise growth mixture modeling methodology proposed by Muthen (in press), a 2-piece linear growth model capturing growth trajectories in adolescent alcohol use during the transition from middle school (ages 11 to 13) to high school (ages 14 to 17; N = 81) was examined. It was hypothesized that 2 stages of alcohol use development with varying trajectories would exist in these data, the 1st corresponding to development during middle school (Growth Rate 1), followed by a 2nd stage of continuing growth during high school (Growth Rate 2). Results suggested the tenability of the 2-piece linear development in alcohol use and the emergence of 2 latent classes with individually varying transition points. Class 1 showed linear increases only during high school, whereas Class 2 showed a continued, linear growth throughout the middle and hi...",0,1 +2195,Higher-order latent trait models for cognitive diagnosis,"Higher-order latent traits are proposed for specifying the joint distribution of binary attributes in models for cognitive diagnosis. This approach results in a parsimonious model for the joint distribution of a high-dimensional attribute vector that is natural in many situations when specific cognitive information is sought but a less informative item response model would be a reasonable alternative. This approach stems from viewing the attributes as the specific knowledge required for examination performance, and modeling these attributes as arising from a broadly-defined latent trait resembling theϑ of item response models. In this way a relatively simple model for the joint distribution of the attributes results, which is based on a plausible model for the relationship between general aptitude and specific knowledge. Markov chain Monte Carlo algorithms for parameter estimation are given for selected response distributions, and simulation results are presented to examine the performance of the algorithm as well as the sensitivity of classification to model misspecification. An analysis of fraction subtraction data is provided as an example.",0,1 +2196,The Measurement and Prediction of Judgment and Choice,,0,1 +2197,Applying Bayesian statistics to the study of psychological trauma: A suggestion for future research.,"Several contemporary researchers have noted the virtues of Bayesian methods of data analysis. Although debates continue about whether conventional or Bayesian statistics is the ""better"" approach for researchers in general, there are reasons why Bayesian methods may be well suited to the study of psychological trauma in particular. This article describes how Bayesian statistics offers practical solutions to the problems of data non-normality, small sample size, and missing data common in research on psychological trauma.After a discussion of these problems and the effects they have on trauma research, this article explains the basic philosophical and statistical foundations of Bayesian statistics and how it provides solutions to these problems using an applied example.Results of the literature review and the accompanying example indicates the utility of Bayesian statistics in addressing problems common in trauma research.Bayesian statistics provides a set of methodological tools and a broader philosophical framework that is useful for trauma researchers. Methodological resources are also provided so that interested readers can learn more.",0,1 +2198,Inference from Iterative Simulation Using Multiple Sequences,"The Gibbs sampler, the algorithm of Metropolis and similar iterative simulation methods are potentially very helpful for summarizing multivariate distributions. Used naively, however, iterative simulation can give misleading answers. Our methods are simple and generally applicable to the output of any iterative simulation; they are designed for researchers primarily interested in the science underlying the data and models they are analyzing, rather than for researchers interested in the probability theory underlying the iterative simulations themselves. Our recommended strategy is to use several independent sequences, with starting points sampled from an overdispersed distribution. At each step of the iterative simulation, we obtain, for each univariate estimand of interest, a distributional estimate and an estimate of how much sharper the distributional estimate might become if the simulations were continued indefinitely. Because our focus is on applied inference for Bayesian posterior distributions in real problems, which often tend toward normality after transformations and marginalization, we derive our results as normal-theory approximations to exact Bayesian inference, conditional on the observed simulations. The methods are illustrated on a random-effects mixture model applied to experimental measurements of reaction times of normal and schizophrenic patients.",0,1 +2199,Organization principles in visual working memory: Evidence from sequential stimulus display,"Although the mechanisms of visual working memory (VWM) have been studied extensively in recent years, the active property of VWM has received less attention. In the current study, we examined how VWM integrates sequentially presented stimuli by focusing on the role of Gestalt principles, which are important organizing principles in perceptual integration. We manipulated the level of Gestalt cues among three or four sequentially presented objects that were memorized. The Gestalt principle could not emerge unless all the objects appeared together. We distinguished two hypotheses: a perception-alike hypothesis and an encoding-specificity hypothesis. The former predicts that the Gestalt cue will play a role in information integration within VWM; the latter predicts that the Gestalt cue will not operate within VWM. In four experiments, we demonstrated that collinearity (Experiment 1) and closure (Experiment 2) cues significantly improved VWM performance, and this facilitation was not affected by the testing manner (Experiment 3) or by adding extra colors to the memorized objects (Experiment 4). Finally, we re-established the Gestalt cue benefit with similarity cues (Experiment 5). These findings together suggest that VWM realizes and uses potential Gestalt principles within the stored representations, supporting a perception-alike hypothesis.",0,1 +2200,Efficient estimation of sensory thresholds with ML-PEST,"A set of C and C+2 routines are described that allow the efficient estimation of sensory thresholds in psychophysical experiments using a maximum-likelihood staircase procedure. They have been used effectively in visual, auditory, gustatory, and olfactory psychophysics.",0,1 +2201,Dynamic Models Incorporating Individual Heterogeneity: Utility Evolution in Conjoint Analysis,"It has been shown in the behavioral decision making, marketing research, and psychometric literature that the structure underlying preferences can change during the administration of repeated measurements (e.g., conjoint analysis) and data collection because of effects from learning, fatigue, boredom, and so on. In this research note, we propose a new class of hierarchical dynamic Bayesian models for capturing such dynamic effects in conjoint applications, which extend the standard hierarchical Bayesian random effects and existing dynamic Bayesian models by allowing for individual-level heterogeneity around an aggregate dynamic trend. Using simulated conjoint data, we explore the performance of these new dynamic models, incorporating individual-level heterogeneity across a number of possible types of dynamic effects, and demonstrate the derived benefits versus static models. In addition, we introduce the idea of an unbiased dynamic estimate, and demonstrate that using a counterbalanced design is important from an estimation perspective when parameter dynamics are present.",0,1 +2202,Estimability and Likelihood Inference for Generalized Linear Mixed Models Using Data Cloning,"Maximum likelihood estimation for Generalized Linear Mixed Models (GLMM), an important class of statistical models with substantial applications in epidemiology, medical statistics, and many other fields, poses significant computational difficulties. In this article, we use data cloning, a simple computational method that exploits advances in Bayesian computation, in particular the Markov Chain Monte Carlo method, to obtain maximum likelihood estimators of the parameters in these models. This method also leads to a simple estimator of the asymptotic variance of the maximum likelihood estimators. Determining estimability of the parameters in a mixed model is, in general, a very difficult problem. Data cloning provides a simple graphical test to not only check if the full set of parameters is estimable but also, and perhaps more importantly, if a specified function of the parameters is estimable. One of the goals of mixed models is to predict random effects. We suggest a frequentist method to obtain predict...",0,1 +2203,R2WinBUGS: A Package for Running WinBUGS from R,"The R2WinBUGS package provides convenient functions to call WinBUGS from R. It automatically writes the data and scripts in a format readable by WinBUGS for processing in batch mode, which is possible since version 1.4. After the WinBUGS process has finished, it is possible either to read the resulting data into R by the package itself-which gives a compact graphical summary of inference and convergence diagnostics-or to use the facilities of the coda package for further analyses of the output. Examples are given to demonstrate the usage of this package.",0,1 +2204,Non-linear structural equation models with correlated continuous and discrete data,"Structural equation models (SEMs) have been widely applied to examine interrelationships among latent and observed variables in social and psychological research. Motivated by the fact that correlated discrete variables are frequently encountered in practical applications, a non-linear SEM that accommodates covariates, and mixed continuous, ordered, and unordered categorical variables is proposed. Maximum likelihood methods for estimation and model comparison are discussed. One real-life data set about cardiovascular disease is used to illustrate the methodologies.",0,1 +2205,Bayesian predictive inference of a finite population proportion under selection bias,"Abstract We show how to infer about a finite population proportion using data from a possibly biased sample. In the absence of any selection bias or survey weights, a simple ignorable selection model, which assumes that the binary responses are independent and identically distributed Bernoulli random variables, is not unreasonable. However, this ignorable selection model is inappropriate when there is a selection bias in the sample. We assume that the survey weights (or their reciprocals which we call ‘selection’ probabilities) are available, but there is no simple relation between the binary responses and the selection probabilities. To capture the selection bias, we assume that there is some correlation between the binary responses and the selection probabilities (e.g., there may be a somewhat higher/lower proportion of positive responses among the sampled units than among the nonsampled units). We use a Bayesian nonignorable selection model to accommodate the selection mechanism. We use Markov chain Monte Carlo methods to fit the nonignorable selection model. We illustrate our method using numerical examples obtained from NHIS 1995 data.",0,1 +2206,Conservative prior distributions for variance parameters in hierarchical models,"Bayesian hierarchical models typically involve specifying prior distributions for one or more variance components. This is rather removed from the observed data, so specification based on expert knowledge can be difficult. While there are suggestions for default priors in the literature, often a condi tionally conjugate inverse-gamma specification is used, despite documented drawbacks of this choice. The authors suggest conservative prior distributions for variance components, which deliberately give more weight to smaller values. These are appropriate for investigators who are skeptical about the presence of variability in the second-stage parameters (random effects) and want to particularly guard against inferring more structure than is really present. The suggested priors readily adapt to various hierarchical modelling settings, such as fitting smooth curves, modelling spatial variation and combining data from multiple sites. Lois a priori pour les parametres de variance de modeles hierarchiques Rgsum6: Les modeles bay6siens hierarchiques comportent g6n6ralement une ou des composantes de va riance que l'on doit doter de lois a priori. Le choix de ces lois est delicat car la variation est un aspect des donn6es difficile a cemer. De toutes les lois a priori par defaut, une loi conjuguee inverse-gamma con ditionnelle est la plus souvent employ6e, malgr6 ses inconvenients. Les auteurs proposent des lois a priori conservatrices pour les composantes de la variance qui privilegient les petites valeurs. Elles conviennent bien aux situations oiu le chercheur s'interroge sur la presence r6elle de variabilit6 dans les parametres de deuxieme degre (effets aleatoires) et qu'il veut eviter d'imposer une structure artificielle. Les lois a priori sugg6rdes s'adaptent A diverses situations propices a la mod6lisation hierarchique, notamment l'ajustement de courbes lisses et la modelisation de variation spatiale ou de donn6es issues de nombreux sites.",0,1 +2207,The psychophysics of sugar concentration discrimination and contrast evaluation in bumblebees,"The capacity to discriminate between choice options is crucial for a decision-maker to avoid unprofitable options. The physical properties of rewards are presumed to be represented on context-dependent, nonlinear cognitive scales that may systematically influence reward expectation and thus choice behavior. In this study, we investigated the discrimination performance of free-flying bumblebee workers (Bombus impatiens) in a choice between sucrose solutions with different concentrations. We conducted two-alternative free choice experiments on two B. impatiens colonies containing some electronically tagged bumblebees foraging at an array of computer-automated artificial flowers that recorded individual choices. We mimicked natural foraging conditions by allowing uncertainty in the probability of reward delivery while maintaining certainty in reward concentration. We used a Bayesian approach to fit psychometric functions, relating the strength of preference for the higher concentration option to the relative intensity of the presented stimuli. Psychometric analysis was performed on visitation data from individually marked bumblebees and pooled data from unmarked individuals. Bumblebees preferred the more concentrated sugar solutions at high stimulus intensities and showed no preference at low stimulus intensities. The obtained psychometric function is consistent with reward evaluation based on perceived concentration contrast between choices. We found no evidence that bumblebees reduce reward expectations upon experiencing non-rewarded visits. We compare psychometric function parameters between the bumblebee B. impatiens and the flower bat Glossophaga commissarisi and discuss the relevance of psychophysics for pollinator-exerted selection pressures on plants.",0,1 +2208,A Hierarchical Approach to Covariance Function Estimation for Time Series,"The covariance function in time series models is typically modelled via a parametric family. This ensures straightforward best linear prediction while maintaining positive-definiteness of the covariance function. We suggest an alternative approach, which will result in data-determined shrinkage towards this parametric model. Positive-definiteness is maintained by carrying out the shrinkage in the spectral domain. We offer both a fully Bayesian hierarchical approach and an approximate hierarchical approach that will be much simpler computationally. These are implemented on the frequently analysed Canadian lynx data and compared to other models that have been fitted to these data.",0,1 +2209,Temporal expectation and information processing: A model-based analysis,"People are able to use temporal cues to anticipate the timing of an event, enabling them to process that event more efficiently. We conducted two experiments, using the fixed-foreperiod paradigm (Experiment 1) and the temporal-cueing paradigm (Experiment 2), to assess which components of information processing are speeded when subjects use such temporal cues to predict the onset of a target stimulus. We analyzed the observed temporal expectation effects on task performance using sequential-sampling models of decision making: the Ratcliff diffusion model and the shifted-Wald model. The results from the two experiments were consistent: temporal expectation affected the duration of nondecision processes (target encoding and/or response preparation) but had little effect on the two main components of the decision process: response-threshold setting and the rate of evidence accumulation. Our findings provide novel evidence about the psychological processes underlying temporal-expectation effects on reaction time.",0,1 +2210,Latent variable growth within behavior genetic models,"The purpose of this paper is to introduce one kind of latent-variable structural-equation model for multivariate longitudinal data which includes behavioral genetic components. A generic structural-equation model termed RAM (McArdle, J. J. and McDonald, R. P. (1984). Br. J. Math. Stat. Psychol., 37:239-251.) is used to define the univariate twin design, including both covariances and means. This model is extended to multivariate form using a latent-variable growth-curve model recently presented by W. Meredith and J. Tisak [(1984). ""Tuckerizing"" curves. Psychometric Society Annual Meetings]. The model presented herein further permits hypothesis testing of various biometric models of the sources of these individual differences in latent growth. Aspects of this model are illustrated using the LISREL algorithm [Jöreskog, K. G. and Sörbom, D. (1979). Advances in Factor Analysis and Structural Equation Models, Abt Books, Cambridge, Mass.] and longitudinal twin data on early childhood abilities [Wilson, R. S. (1983). Child Dev.54:298-316]. © 1986 Plenum Publishing Corporation.",0,1 +2211,Evaluating estimation methods for ordinal data in structural equation modeling,"This study examined the performance of two alternative estimation approaches in structural equation modeling for ordinal data under different levels of model misspecification, score skewness, sample size, and model size. Both approaches involve analyzing a polychoric correlation matrix as well as adjusting standard error estimates and model chi-squared, but one estimates model parameters with maximum likelihood and the other with robust weighted least-squared. Relative bias in parameter estimates and standard error estimates, Type I error rate, and empirical power of the model test, where appropriate, were evaluated through Monte Carlo simulations. These alternative approaches generally provided unbiased parameter estimates when the model was correctly specified. They also provided unbiased standard error estimates and adequate Type I error control in general unless sample size was small and the measured variables were moderately skewed. Differences between the methods in convergence problems and the evaluation criteria, especially under small sample and skewed variable conditions, were discussed. © 2007 Springer Science + Business Media B.V.",0,1 +2212,An Odds Ratio Approach for Assessing Differential Distractor Functioning Effects under the Nominal Response Model,"Investigations of differential distractor functioning (DDF) can provide valuable information concerning the location and possible causes of measurement invariance within a multiple-choice item. In this article, I propose an odds ratio estimator of the DDF effect as modeled under the nominal response model. In addition, I propose a simultaneous distractor-level (SDL) test of invariance based on the results of the distractor-level tests of DDF. The results of a simulation study indicated that the DDF effect estimator maintained good statistical properties under a variety of conditions, and the SDL test displayed substantially higher power than the traditional Mantel-Haenszel test of no DIF when the DDF effect varied in magnitude and/or size across the distractors.",0,1 +2213,Accounting for vessel effects when standardizing catch rates from cooperative surveys,"Interpretation of fishery-dependent and independent-survey data requires accounting for changes in the proportion of local individuals that are caught by fishing gear (“catchability”). Catchability may be influenced by measured characteristics of fishing gear, and even standardized fishing techniques may experience changing catchability over time due to changes in fishing vessel characteristics and personnel. The importance of vessel power has long been recognized in the analysis of fishery dependent catch per unit effort data, but less-studied in the analysis of fishery independent data collected by research vessel surveys. Here we demonstrate how differences in catchability among vessels (“vessel effects”), as well as random variation in vessel-specific catchability over time (“vessel-year effects”) can be incorporated into generalized linear mixed models through their treatment as random effects. We apply these methods to data for 28 groundfish species caught in a standardized survey using contracted fishery vessels and personnel in the Northeast Pacific. Model selection shows that vessel, vessel-year, and both effects simultaneously are supported by available data for at least a few species. However, vessel-year effects generally have a larger effect on catch rates than vessel-effects and hence abundance indices estimated using both vessel- and vessel-year effects are generally similar to estimates when using just vessel-year effects. Additionally, models indicate little support for the hypothesis that characteristics such as length and displacement of the contracted vessels used in this survey have a substantial impact on catch rates. Finally, inclusion of vessel- or vessel-year effects generally results in wider estimates of credible intervals for resulting indices of abundance. This increased credible interval width is consistent with statistical theory, because vessel effects will result in non-independence of different sampling occasions, thus decreasing effective sample sizes. For this reason, we advocate that future analyses include vessel- and/or vessel-year effects when standardizing survey data from cooperative research programs.",0,1 +2214,A Procedure for Controlling General Test Overlap in Computerized Adaptive Testing,"To date, exposure control procedures that are designed to control test overlap in computerized adaptive tests (CATs) are based on the assumption of item sharing between pairs of examinees. However, in practice, examinees may obtain test information from more than one previous test taker. This larger scope of information sharing needs to be considered in conducting test overlap control. The purpose of this study is to propose a test overlap control method such that the proportion of overlapping items encountered by an examinee with a group of previous examinees (described as general test overlap rate) can be controlled. Results indicated that item exposure rate and general test overlap rate could be simultaneously controlled by implementing the procedure. In addition, these two indices were controlled on the fly without any iterative simulations conducted prior to operational CATs. Thus, the proposed procedure would be an efficient method for controlling both the item exposure and general test overlap in CATs.",0,1 +2215,Semiparametric Regression for the Social Sciences,List of Tables. List of Figures. Preface. 1 Introduction: Global versus Local Statistics. 1.1 The Consequences of Ignoring Nonlinearity. 1.2 Power Transformations. 1.3 Nonparametric and Semiparametric Techniques. 1.4 Outline of the Text. 2 Smoothing and Local Regression. 2.1 Simple Smoothing. 2.1.1 Local Averaging. 2.1.2 Kernel Smoothing. 2.2 Local Polynomial Regression. 2.3 Nonparametric Modeling Choices. 2.3.1 The Span. 2.3.2 Polynomial Degree and Weight Function. 2.3.3 A Note on Interpretation. 2.4 Statistical Inference for Local Polynomial Regression. 2.5 Multiple Nonparametric Regression. 2.6 Conclusion. 2.7 Exercises. 3 Splines. 3.1 Simple Regression Splines. 3.1.1 Basis Functions. 3.2 Other Spline Models and Bases. 3.2.1 Quadratic and Cubic Spline Bases. 3.2.2 Natural Splines. 3.2.3 B-splines. 3.2.4 Knot Placement and Numbers. 3.2.5 Comparing Spline Models. 3.3 Splines and Overfitting. 3.3.1 Smoothing Splines. 3.3.2 Splines as Mixed Models. 3.3.3 Final Notes on Smoothing Splines. 3.3.4 Thin Plate Splines. 3.4 Inference for Splines. 3.5 Comparisons and Conclusions. 3.6 Exercises. 4 Automated Smoothing Techniques. 4.1 Span by Cross-Validation. 4.2 Splines and Automated Smoothing. 4.2.1 Estimating Smoothing Through the Likelihood. 4.2.2 Smoothing Splines and Cross-Validation. 4.3 Automated Smoothing in Practice. 4.4 Automated Smoothing Caveats. 4.5 Exercises. 5 Additive and Semiparametric Regression Models. 5.1 Additive Models. 5.2 Semiparametric Regression Models. 5.3 Estimation. 5.3.1 Backfitting. 5.4 Inference. 5.5 Examples. 5.5.1 Congressional Elections. 5.5.2 Feminist Attitudes. 5.6 Discussion. 5.7 Exercises. 6 Generalized Additive Models. 6.1 Generalized Linear Models. 6.2 Estimation of GAMS. 6.3 Statistical Inference. 6.4 Examples. 6.4.1 Logistic Regression: The Liberal Peace. 6.4.2 Ordered Logit: Domestic Violence. 6.4.3 Count Models: Supreme Court Overrides. 6.4.4 Survival Models: Race Riots. 6.5 Discussion. 6.6 Exercises. 7 Extensions of the Semiparametric Regression Model. 7.1 Mixed Models. 7.2 Bayesian Smoothing. 7.3 Propensity Score Matching. 7.4 Conclusion. 8 Bootstrapping. 8.1 Classical Inference. 8.2 Bootstrapping - An Overview. 8.2.1 Bootstrapping. 8.2.2 An Example: Bootstrapping the Mean. 8.2.3 Bootstrapping Regression Models. 8.2.4 An Example: Presidential Elections. 8.3 Bootstrapping Nonparametric and Semiparametric Regression Models. 8.3.1 Bootstrapping Nonparametric Fits. 8.3.2 Bootstrapping Nonlinearity Tests. 8.4 Conclusion. 8.5 Exercises. 9 Epilogue. Appendix: Software. Bibliography. Author Index. Subject Index.,0,1 +2216,R functions for quantifying nonindependence in standard dyadic and SRM designs,"Interdependence is the main feature of dyadic relationships and, in recent years, various statistical procedures have been proposed for quantifying and testing this social attribute in different dyadic designs. The purpose of this paper is to develop several functions for this kind of statistical tests in an R package, known as nonindependence, for use by applied social researchers. A Graphical User Interface (GUI) is also developed to facilitate the use of the functions included in this package. Examples drawn from psychological research and simulated data are used to illustrate how the software works.",0,1 +2217,Hierarchical Generalized Linear Models,"We consider hierarchical generalized linear models which allow extra error components in the linear predictors of generalized linear models. The distribution of these components is not restricted to be normal; this allows a broader class of models, which includes generalized linear mixed models. We use a generalization of Henderson's joint likelihood, called a hierarchical or h-likelihood, for inferences from hierarchical generalized linear models. This avoids the integration that is necessary when marginal likelihood is used. Under appropriate conditions maximizing the h-likelihood gives fixed effect estimators that are asymptotically equivalent to those obtained from the use of marginal likelihood; at the same time we obtain the random effect estimates that are asymptotically best unbiased predictors. An adjusted profile h-likelihood is shown to give the required generalization of restricted maximum likelihood for the estimation of dispersion components. A scaled deviance test for the goodness of fit, a model selection criterion for choosing between various dispersion models and a graphical method for checking the distributional assumption of random effects are proposed. The ideas of quasi-likelihood and extended quasi-likelihood are generalized to the new class. We give examples of the Poisson-gamma, binomial-beta and gamma-inverse gamma hierarchical generalized linear models. A resolution is proposed for the apparent difference between population-averaged and subject-specific models. A unified framework is provided for viewing and extending many existing methods.",0,1 +2218,Bayesian Structural Equation Models for Multilevel Data,,0,1 +2219,"Is CO2 a good proxy for indoor air quality in classrooms? Part 1: The interrelationships between thermal conditions, CO2 levels, ventilation rates and selected indoor pollutants","Current indoor air quality (IAQ) guidelines in school buildings are framed around thermal conditions, carbon dioxide (CO 2 ) levels and corresponding ventilation rates without considering specific indoor pollution levels. Drawing on detailed monitoring data from a sample of 18 classrooms from six London schools, the aim of this paper is to highlight behavioural and environmental factors that affect pollution levels in classrooms, and evaluate the adequacy of CO 2 as an overall predictor for IAQ using multilevel modelling. Together with elimination of indoor emission sources, keeping the temperatures below 26℃, and preferably below 22℃ depending on season, may limit total volatile organic compounds below thresholds associated with sensory irritations. The models suggested that after removing dust reservoirs from the classrooms, lowering average indoor CO 2 levels below 1000 ppm by increasing ventilation rates can limit indoor airborne particulate matter concentrations below recommended annual WHO 2010 guidelines. Uncontrolled infiltration rates may increase indoor NO 2 levels and microbial counts of fungal and bacterial groups, whose presence is associated with wet and moist materials. Overall, indoor CO 2 levels were a useful proxy for indoor investigations as they can prevent overheating, dilute pollutants with indoor sources and purge concentrations of airborne particles; however, they were a poor predictor of traffic related pollutants. Practical implications of the findings on the UK policy and building design industry are discussed. Practical application: Driven by the growing population, and many years of intensive use, the UK building stock is in need of rapid expanding, extensive refurbishment and maintenance. However, local authorities lack the money for comprehensive and specialist renovations. The recommendations presented in this paper take into account specific needs and possibilities, and target building designers, engineers and occupants involved with daily operation and management of school buildings. Timely control of ventilation and heating systems, informed selection of construction materials, interior finishing and elimination of indoor sources may improve IAQ of school classrooms.",0,1 +2220,Posterior propriety and admissibility of hyperpriors in normal hierarchical models,"Hierarchical modeling is wonderful and here to stay, but hyperparameter priors are often chosen in a casual fashion. Unfortunately, as the number of hyperparameters grows, the effects of casual choices can multiply, leading to considerably inferior performance. As an extreme, but not uncommon, example use of the wrong hyperparameter priors can even lead to impropriety of the posterior. For exchangeable hierarchical multivariate normal models, we first determine when a standard class of hierarchical priors results in proper or improper posteriors. We next determine which elements of this class lead to admissible estimators of the mean under quadratic loss; such considerations provide one useful guideline for choice among hierarchical priors. Finally, computational issues with the resulting posterior distributions are addressed.",0,1 +2221,Who Wants To Revise Privatization? The Complementarity of Market Skills and Institutions,"Using survey data from 28 transition countries, we test for the complementarity and substitutability of market-relevant skills and institutions. We show that democracy and good governance complement market skills in transition economies. Under autocracy and weak governance institutions, there is no significant difference in support for revising privatization between high- and low-skilled respondents. As the level of democracy and the quality of governance increases, the difference in the level of support for revising privatization between the high and low skilled grows dramatically. This finding contributes to our understanding of microfoundations of the politics of economic reform.",0,1 +2222,Random effect modelling using Bayesian methods,"Bayesian methods are increasingly used in a variety of academic disciplines, and important applications in ecology, medicine, management science, operations research and finance. The continued use of these methods depends on understanding the strengths and weaknesses of current Bayesian modelling practice. In this paper, we examine important implementation issues within the context of data analysis with statistical models which contain random effects or unmeasured heterogeneity. Random effect models provide an effective way to incorporate sources of variation not able to be modelled by covariate information, and these models lead naturally to Bayesian formulations using prior distributions for the variance components. We examine implications for specifying scale parameters in hierarchical models.",0,1 +2223,Reversible jump Markov chain Monte Carlo computation and Bayesian model determination,"Markov chain Monte Carlo methods for Bayesian computation have until recently been restricted to problems where the joint distribution of all variables has a density with respect to some fixed standard underlying measure. They have therefore not been available for application to Bayesian model determination, where the dimensionality of the parameter vector is typically not fixed. This paper proposes a new framework for the construction of reversible Markov chain samplers that jump between parameter subspaces of differing dimensionality, which is flexible and entirely constructive. It should therefore have wide applicability in model determination problems. The methodology is illustrated with applications to multiple change-point analysis in one and two dimensions, and to a Bayesian comparison of binomial experiments.",0,1 +2224,Bayesian inference for psychometric functions,"In psychophysical studies, the psychometric function is used to model the relation between physical stimulus intensity and the observer's ability to detect or discriminate between stimuli of different intensities. In this study, we propose the use of Bayesian inference to extract the information contained in experimental data to estimate the parameters of psychometric functions. Because Bayesian inference cannot be performed analytically, we describe how a Markov chain Monte Carlo method can be used to generate samples from the posterior distribution over parameters. These samples are used to estimate Bayesian confidence intervals and other characteristics of the posterior distribution. In addition, we discuss the parameterization of psychometric functions and the role of prior distributions in the analysis. The proposed approach is exemplified using artificially generated data and in a case study for real experimental data. Furthermore, we compare our approach with traditional methods based on maximum likelihood parameter estimation combined with bootstrap techniques for confidence interval estimation and find the Bayesian approach to be superior.",0,1 +2225,A Hierarchical Framework for Modeling Speed and Accuracy on Test Items,"Current modeling of response times on test items has been strongly influenced by the paradigm of experimental reaction-time research in psychology. For instance, some of the models have a parameter structure that was chosen to represent a speed-accuracy tradeoff, while others equate speed directly with response time. Also, several response-time models seem to be unclear as to the level of parametrization they represent. A hierarchical framework for modeling speed and accuracy on test items is presented as an alternative to these models. The framework allows a plug-and-play approach with alternative choices of models for the response and response-time distributions as well as the distributions of their parameters. Bayesian treatment of the framework with Markov chain Monte Carlo (MCMC) computation facilitates the approach. Use of the framework is illustrated for the choice of a normal-ogive response model, a lognormal model for the response times, and multivariate normal models for their parameters with Gibbs sampling from the joint posterior distribution.",0,1 +2226,A spatial beta-binomial model for clustered count data on dental caries,"One of the most important indicators of dental caries prevalence is the total count of decayed, missing or filled surfaces in a tooth. These count data are often clustered in nature (several count responses clustered within a subject), over-dispersed as well as spatially referenced (a diseased tooth might be positively influencing the decay process of a set of neighbouring teeth). In this article, we develop a multivariate spatial betabinomial (BB) model for these data that accommodates both over-dispersion as well as latent spatial associations. Using a Bayesian paradigm, the re-parameterised marginal mean (as well as variance) under the BB framework are modelled using a regression on subject/tooth-specific co-variables and a conditionally autoregressive prior that models the latent spatial process. The necessity of exploiting spatial associations to model count data arising in dental caries research is demonstrated using a small simulation study. Real data confirms that our spatial BB model provides a superior estimation and model fit as compared to other sub-models that do not consider modelling spatial associations.",0,1 +2227,Simulation of truncated normal variables,We provide simulation algorithms for one-sided and two-sided truncated normal distributions. These algorithms are then used to simulate multivariate normal variables with convex restricted parameter space for any covariance structure.,0,1 +2228,Bayesian road safety analysis: Incorporation of past evidence and effect of hyper-prior choice,"This paper aims to address two related issues when applying hierarchical Bayesian models for road safety analysis, namely: (a) how to incorporate available information from previous studies or past experiences in the (hyper) prior distributions for model parameters and (b) what are the potential benefits of incorporating past evidence on the results of a road safety analysis when working with scarce accident data (i.e., when calibrating models with crash datasets characterized by a very low average number of accidents and a small number of sites).A simulation framework was developed to evaluate the performance of alternative hyper-priors including informative and non-informative Gamma, Pareto, as well as Uniform distributions. Based on this simulation framework, different data scenarios (i.e., number of observations and years of data) were defined and tested using crash data collected at 3-legged rural intersections in California and crash data collected for rural 4-lane highway segments in Texas.This study shows how the accuracy of model parameter estimates (inverse dispersion parameter) is considerably improved when incorporating past evidence, in particular when working with the small number of observations and crash data with low mean. The results also illustrates that when the sample size (more than 100 sites) and the number of years of crash data is relatively large, neither the incorporation of past experience nor the choice of the hyper-prior distribution may affect the final results of a traffic safety analysis.As a potential solution to the problem of low sample mean and small sample size, this paper suggests some practical guidance on how to incorporate past evidence into informative hyper-priors. By combining evidence from past studies and data available, the model parameter estimates can significantly be improved. The effect of prior choice seems to be less important on the hotspot identification.The results show the benefits of incorporating prior information when working with limited crash data in road safety studies.",0,1 +2229,Methods of Controlling the Exposure of Items in CAT,,0,1 +2230,Approximations for Standard Errors of Estimators of Fixed and Random Effects in Mixed Linear Models,"Abstract Best linear unbiased estimators of the fixed and random effects of mixed linear models are available when the true values of the variance ratios are known. If the true values are replaced by estimated values, the mean squared errors of the estimators of the fixed and random effects increase in size. The magnitude of this increase is investigated, and a general approximation is proposed. The performance of this approximation is investigated in the context of (a) the estimation of the effects of the balanced one-way random model and (b) the estimation of treatment contrasts for balanced incomplete block designs.",0,1 +2231,The Probability Function of the Product of Two Normally Distributed Variables,"Let $x$ and $y$ follow a normal bivariate probability function with means $\bar X, \bar Y$, standard deviations $\sigma_1, \sigma_2$, respectively, $r$ the coefficient of correlation, and $\rho_1 = \bar X/\sigma_1, \rho_2 = \bar Y/\sigma_2$. Professor C. C. Craig [1] has found the probability function of $z = xy/\sigma_1\sigma_2$ in closed form as the difference of two integrals. For purposes of numerical computation he has expanded this result in an infinite series involving powers of $z, \rho_1, \rho_2$, and Bessel functions of a certain type; in addition, he has determined the moments, semin-variants, and the moment generating function of $z$. However, for $\rho_1$ and $\rho_2$ large, as Craig points out, the series expansion converges very slowly. Even for $\rho_1$ and $\rho_2$ as small as 2, the expansion is unwieldy. We shall show that as $\rho_1$ and $\rho_2 \rightarrow \infty$, the probability function of $z$ approaches a normal curve and in case $r = 0$ the Type III function and the Gram-Charlier Type A series are excellent approximations to the $z$ distribution in the proper region. Numerical integration provides a substitute for the infinite series wherever the exact values of the probability function of $z$ are needed. Some extensions of the main theorem are given in section 5 and a practical problem involving the probability function of $z$ is solved.",0,1 +2232,Robust Methods for Multilevel Analysis,,0,1 +2233,"Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine","We review evidence for links between personality traits and longevity. We provide an overview of personality for health scientists, using the primary organizing framework used in the study of personality and longevity. We then review data on various aspects of personality linked to longevity. In general, there is good evidence that higher level of conscientiousness and lower levels of hostility and Type D or “distressed” personality are associated with greater longevity. Limited evidence suggests that extraversion, openness, perceived control, and low levels of emotional suppression may be associated with longer lifespan. Findings regarding neuroticism are mixed, supporting the notion that many component(s) of neuroticism detract from life expectancy, but some components at some levels may be healthy or protective. Overall, evidence suggests various personality traits are significant predictors of longevity and points to several promising directions for further study. We conclude by discussing the implications of these links for epidemiologic research and personalized medicine and lay out a translational research agenda for integrating the psychology of individual differences into public health and medicine.",0,1 +2234,New Algorithms for Item Selection and Exposure Control with Computerized Adaptive Testing.,"Computerized adaptive testing (CAT) offers the prospect of both reducing testing time and increasing measurement precision when compared to conventional pencil-and-paper tests. Although adaptive tests acquire their efficiency by successively selecting items that provide optimal` *. measurement at each examinee's estimated level of ability, operational testing programs will typically consider additional factors in item selection. In practice, items are generally selected with regard to at least three, often conflicting goals: 1) to maximize test efficiency by measuring examinees as quickly and as accurately as possible, 2) to protect the security of the item pool by controlling the rates at which popular items can be administered, and 3) to assure that the test measures the same composite of multiple traits for each examinee by balancing the rates at which items with different content properties are administered. This paper focuses on the goals of maximizing test efficiency and controlling item exposure rates, avoiding discussion of content balance. While a number of algorithms for accomplishing these goals have been developed, all are problematic to some extent. We briefly sketch the nature of these problems, and then present alternative algorithms that offer at least a partial solution. U.S. DEPARTMENT OF EDUCATION Office of Educational Research and Improvement EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC) Crfhis document has been reproduced as received from the person or organization originating it. Minor changes have heen made to improve reproduction quality. Points of view or opinions stated in this CO document do not necessarily represent official OERI position or policy. Co tN 2 PERMISSION TO REPRODUCE AND DISSEMINATE THIS MATERIAL HAS BEEN GRANTED BY iclhAc511A.IL TO THE EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC) 1 Paper presented at the annual meeting of the American Educational Research Association, April 18-22, 1995, San Francisco New Algorithms for CAT 2 New Algorithms for Item Selection and Exposure Control with Computerized Adaptive Testing",0,1 +2235,Bayesian inference for a skew-normal IRT model under the centred parameterization,"Item response theory (IRT) comprises a set of statistical models which are useful in many fields, especially when there is interest in studying latent variables. These latent variables are directly considered in the Item Response Models (IRM) and they are usually called latent traits. A usual assumption for parameter estimation of the IRM, considering one group of examinees, is to assume that the latent traits are random variables which follow a standard normal distribution. However, many works suggest that this assumption does not apply in many cases. Furthermore, when this assumption does not hold, the parameter estimates tend to be biased and misleading inference can be obtained. Therefore, it is important to model the distribution of the latent traits properly. In this paper we present an alternative latent traits modeling based on the so-called skew-normal distribution; see Genton (2004) . We used the centred parameterization, which was proposed by Azzalini (1985) . This approach ensures the model identifiability as pointed out by Azevedo et al. (2009b) . Also, a Metropolis–Hastings within Gibbs sampling (MHWGS) algorithm was built for parameter estimation by using an augmented data approach. A simulation study was performed in order to assess the parameter recovery in the proposed model and the estimation method, and the effect of the asymmetry level of the latent traits distribution on the parameter estimation. Also, a comparison of our approach with other estimation methods (which consider the assumption of symmetric normality for the latent traits distribution) was considered. The results indicated that our proposed algorithm recovers properly all parameters. Specifically, the greater the asymmetry level, the better the performance of our approach compared with other approaches, mainly in the presence of small sample sizes (number of examinees). Furthermore, we analyzed a real data set which presents indication of asymmetry concerning the latent traits distribution. The results obtained by using our approach confirmed the presence of strong negative asymmetry of the latent traits distribution.",0,1 +2236,Maximum‐Likelihood Sequential Procedure for Estimation of Psychometric Functions,"This paper describes a computer‐oriented sequential procedure for the estimation of parameters of a psychometric function. In common with other sequential procedures (BUDTIF, PEST, UDTR), the goal is to concentrate observations in the region of interest. The experimenter assumes a parametric form of the psychometric function (cumulative normal from 0 to 1, for example, but any other desired form could be used). After each response, values of the parameters are computed that maximize the probability of the set of responses that have been obtained, given the set of stimuli that have been presented. These values are then used to determine the placement of the next stimulus. A compromise between fidelity of tracking a time‐varying threshold and accuracy can be effected by appropriate choice of the weighting function for previous observations. The procedure has been simulated on a GE‐645 computer and applied in the laboratory with a DDP‐516 computer.",0,1 +2237,The Multiple-Choice Model,"This article deals with some of the problems that have hindered the application of Samejima's and Thissen and Steinberg's multiple-choice models: (a) parameter estimation difficulties owing to the large number of parameters involved, (b) parameter identifiability problems in the Thissen and Steinberg model, and (c) their treatment of omitted responses. The authors propose a new multiple-choice model (Restricted Samejima Multiple-Choice Model) that is more explicit about the assumed omitting mechanisms and takes advantage of this knowledge to improve the estimation of parameters. The three above-mentioned models and the Nominal Response Model were fitted to a 3,224-subject sample that took a Written English Test. Fit plots, X 2 statistics, and information-based fit indexes were obtained to assess the goodness of fit. Results show that the new model proposed fits as well as the other two multiple-choice models and better than the Nominal model. A parameter recovery simulation study was also carried out to confirm that its estimation features are indeed improved. Parameters are better recovered in the new model than in the other two multiple-choice models.",0,1 +2238,Estimating item parameters and latent ability when responses are scored in two or more nominal categories,"A multivariate logistic latent trait model for items scored in two or more nominal categories is proposed. Statistical methods based on the model provide 1) estimation of two item parameters for each response alternative of each multiple choice item and 2) recovery of information from “wrong” responses when estimating latent ability. An application to a large sample of data for twenty vocabulary items shows excellent fit of the model according to a chi-square criterion. Item and test information curves are compared for estimation of ability assuming multiple category and dichotomous scoring of these items. Multiple scoring proves substantially more precise for subjects of less than median ability, and about equally precise for subjects above the median.",0,1 +2239,Multivariate Empirical Bayes and Estimation of Covariance Matrices,"The problem of estimating several normal mean vectors in an empirical Bayes situation is considered. In this case, it reduces to the problem of estimating the inverse of a covariance matrix in the standard multivariate normal situation using a particular loss function. Estimators which dominate any constant multiple of the inverse sample covariance matrix are presented. These estimators work by shrinking the sample eigenvalues toward a central value, in much the same way as the James-Stein estimator for a mean vector shrinks the maximum likelihood estimators toward a common value. These covariance estimators then lead to a class of multivariate estimators of the mean, each of which dominates the maximum likelihood estimator.",0,1 +2240,Fitting multilevel models with ordinal outcomes: Performance of alternative specifications and methods of estimation.,"Previous research has compared methods of estimation for fitting multilevel models to binary data, but there are reasons to believe that the results will not always generalize to the ordinal case. This article thus evaluates (a) whether and when fitting multilevel linear models to ordinal outcome data is justified and (b) which estimator to employ when instead fitting multilevel cumulative logit models to ordinal data, maximum likelihood (ML), or penalized quasi-likelihood (PQL). ML and PQL are compared across variations in sample size, magnitude of variance components, number of outcome categories, and distribution shape. Fitting a multilevel linear model to ordinal outcomes is shown to be inferior in virtually all circumstances. PQL performance improves markedly with the number of ordinal categories, regardless of distribution shape. In contrast to binary data, PQL often performs as well as ML when used with ordinal data. Further, the performance of PQL is typically superior to ML when the data include a small to moderate number of clusters (i.e., ≤ 50 clusters).",0,1 +2241,Statistical properties of four effect-size measures for mediation models,"This project examined the performance of classical and Bayesian estimators of four effect size measures for the indirect effect in a single-mediator model and a two-mediator model. Compared to the proportion and ratio mediation effect sizes, standardized mediation effect-size measures were relatively unbiased and efficient in the single-mediator model and the two-mediator model. Percentile and bias-corrected bootstrap interval estimates of ab/s Y , and ab(s X )/s Y in the single-mediator model outperformed interval estimates of the proportion and ratio effect sizes in terms of power, Type I error rate, coverage, imbalance, and interval width. For the two-mediator model, standardized effect-size measures were superior to the proportion and ratio effect-size measures. Furthermore, it was found that Bayesian point and interval summaries of posterior distributions of standardized effect-size measures reduced excessive relative bias for certain parameter combinations. The standardized effect-size measures are the best effect-size measures for quantifying mediated effects.",1,1 +2242,Corruption as an obstacle to women’s political representation,"This article presents evidence from 18 European countries showing that where levels of corruption are high, the proportion of women elected is low. We hypothesize that corruption indicates the presence of ‘shadowy arrangements’ that benefit the already privileged and pose a direct obstacle to women when male-dominated networks influence political parties’ candidate selection. There is also an indirect signal effect derived from citizen’s experiences with a broad range of government authorities. The article uses data that are more fine-grained than usual in this literature. We conduct an empirical test on a new dataset on locally elected councilors in 167 regions in Europe. Using a novel measure of regional quality of government and corruption we perform a multi-level analysis with several regional- and national-level controls. This study provides a unique picture of the proportion of women in locally elected assemblies throughout Europe and a new way of understanding the variations found.",0,1 +2243,Bayesian structural equation modeling for the health index,"There are many factors which could influence the level of health of an individual. These factors are interactive and their overall effects on health are usually measured by an index which is called as health index. The health index could also be used as an indicator to describe the health level of a community. Since the health index is important, many research have been done to study its determinant. The main purpose of this study is to model the health index of an individual based on classical structural equation modeling (SEM) and Bayesian SEM. For estimation of the parameters in the measurement and structural equation models, the classical SEM applies the robust-weighted least-square approach, while the Bayesian SEM implements the Gibbs sampler algorithm. The Bayesian SEM approach allows the user to use the prior information for updating the current information on the parameter. Both methods are applied to the data gathered from a survey conducted in Hulu Langat, a district in Malaysia. Based on the cl...",0,1 +2244,Judging Inference Adequacy in Logistic Regression,"Abstract Inference for logistic regression based on the information matrix may be poor. This is noted in two examples in which confidence regions are examined. A measure to detect such inadequacies is presented; it judges the quadratic approximation to the likelihood surface, which justifies the usual procedure.",0,1 +2245,Flexible Parametric Measurement Error Models,"Inferences in measurement error models can be sensitive to modeling assumptions. Specifically, if the model is incorrect, the estimates can be inconsistent. To reduce sensitivity to modeling assumptions and yet still retain the efficiency of parametric inference, we propose using flexible parametric models that can accommodate departures from standard parametric models. We use mixtures of normals for this purpose. We study two cases in detail: a linear errors-in-variables model and a change-point Berkson model.",0,1 +2246,Estimating Standard Errors in Finance Panel Data Sets: Comparing Approaches,"In both corporate finance and asset pricing empirical work, researchers are often confronted with panel data. In these data sets, the residuals may be correlated across firms and across time, and OLS standard errors can be biased. Historically, the two literatures have used different solutions to this problem. Corporate finance has relied on clustered standard errors, while asset pricing has used the Fama-MacBeth procedure to estimate standard errors. This paper examines the different methods used in the literature and explains when the different methods yield the same (and correct) standard errors and when they diverge. The intent is to provide intuition as to why the different approaches sometimes give different answers and give researchers guidance for their use.",0,1 +2247,FORTY QUESTIONS ABOUT VALIDITY GENERALIZATION AND META-ANALYSIS.,,0,1 +2248,A Comparison of Four Item-Selection Methods for Severely Constrained CATs,"This study compared four item-selection procedures developed for use with severely constrained computerized adaptive tests (CATs). Severely constrained CATs refer to those adaptive tests that seek to meet a complex set of constraints that are often not conclusive to each other (i.e., an item may contribute to the satisfaction of several constraints at the same time). The procedures examined in the study included the weighted deviation model (WDM), the weighted penalty model (WPM), the maximum priority index (MPI), and the shadow test approach (STA). In addition, two modified versions of the MPI procedure were introduced to deal with an edge case condition that results in the item selection procedure becoming dysfunctional during a test. The results suggest that the STA worked best among all candidate methods in terms of measurement accuracy and constraint management. For the other three heuristic approaches, they did not differ significantly in measurement accuracy and constraint management at the lower bound level. However, the WPM method appears to perform considerably better in overall constraint management than either the WDM or MPI method. Limitations and future research directions were also discussed.",0,1 +2249,A Bayesian analysis of the multinomial probit model with fully identified parameters,"We present a new prior and corresponding algorithm for Bayesian analysis of the multinomial probit model. Our new approach places a prior directly on the identified parameter space. The key is the specification of a prior on the covariance matrix so that the (1,1) element if fixed at 1 and it is possible to draw from the posterior using standard distributions. Analytical results are derived which can be used to aid in assessment of the prior.",0,1 +2250,The Impact of Misspecifying the Within-Subject Covariance Structure in Multiwave Longitudinal Multilevel Models: A Monte Carlo Study,"This Monte Carlo study examined the impact of misspecifying the Σ matrix in longitudinal data analysis under both the multilevel model and mixed model frameworks. Under the multilevel model approach, under-specification and general-misspecification of the Σ matrix usually resulted in overestimation of the variances of the random effects (e.g., τ00, ττ11 ) and standard errors of the corresponding growth parameter estimates (e.g., SEβ 0, SEβ 1). Overestimates of the standard errors led to lower statistical power in tests of the growth parameters. An unstructured Σ matrix under the mixed model framework generally led to underestimates of standard errors of the growth parameter estimates. Underestimates of the standard errors led to inflation of the type I error rate in tests of the growth parameters. Implications of the compensatory relationship between the random effects of the growth parameters and the longitudinal error structure for model specification were discussed.",0,1 +2251,Structural Equation Models,"In this article, we introduce structural equation models which are powerful multivariate tools in analyzing interrelationships among observed and latent variables. Useful models, including the standard linear model and its generalizations such as the nonlinear models, multilevel models, and models with ordered categorical data are discussed. In addition, the maximum likelihood approach, a Bayesian approach for estimation and model comparison, as well as the freely available software WinBUGS for obtaining the Bayesian results are described.",0,1 +2252,Bayesian structural equation model,"Latent variables that should be measured by multiple observed variable are common in substantive research. Structural equation models SEMs, which can be regarded as regression models with observed and latent variables, are useful models to assess interrelationships among these variables and have been widely applied to many fields. When applied with data augmentation and recent techniques in statistical computing, the Bayesian approach has been found to be a powerful tool for analysing many important extensions of the basic SEMs. Here, we introduce the basic SEM, present a brief discussion on the Bayesian approach and illustrate it with a simulation study, and review some recent extension, such as two-level SEMs, transformation SEMs, and nonparametric SEMs. WIREs Comput Stat 2014, 6:276-287. doi: 10.1002/wics.1311",0,1 +2253,Enhancing marketing with engineering: Optimal product line design for heterogeneous markets,"article i nfo Successful product line design and development often require a balance of technical and market tradeoffs. Quantitative methods for optimizing product attribute levels using preference elicitation (e.g., conjoint) data are useful for many product types. However, products with substantial engineering content involve critical tradeoffs in the ability to achieve those desired attribute levels. Technical tradeoffs in product design must be made with an eye toward market consequences, particularly when heterogeneous market preferences make differentiation and strategic positioning critical to capturing a range of market segments and avoiding cannibalization. We present a unified methodology for product line optimization that coordinates positioning and design models to achieve realizable firm-level optima. The approach overcomes several shortcomings of prior product line optimization models by incorporating a general Bayesian account of consumer preference heterogeneity, managing attributes over a continuous domain to alleviate issues of combinatorial complexity, and avoiding solutions that are impossible to realize. The method is demonstrated for a line of dial-readout scales, using physical models and conjoint-based consumer choice data. The results show that the optimal number of products in the line is not necessarily equal to the number of market segments, that an optimal single product for a heterogeneous market differs from that for a homogeneous one, and that the representational form for consumer heterogeneity has a substantial impact on the design and profitability of the resulting optimal product line — even for the design of a single product. The method is managerially valuable because it yields product line solutions efficiently, accounting for marketing-based preference heterogeneity as well as engineering-based constraints with which product attributes can be realized.",0,1 +2254,Enriched conjugate and reference priors for the Wishart family on symmetric cones,"A general Wishart family on a symmetric cone is a natural exponential family (NEF) having a homogeneous quadratic variance function. Using results in the abstract theory of Euclidean Jordan algebras, the structure of conditional reducibility is shown to hold for such a family, and we identify the associated parameterization $\phi$ and analyze its properties. The enriched standard conjugate family for $\phi$ and the mean parameter $\mu$ are defined and discussed. This family is considerably more flexible than the standard conjugate one. The reference priors for $\phi$ and $\mu$ are obtained and shown to belong to the enriched standard conjugate family; in particular, this allows us to verify that reference posteriors are always proper. The above results extend those available for NEFs having a simple quadratic variance function. Specifications of the theory to the cone of real symmetric and positive-definite matrices are discussed in detail and allow us to perform Bayesian inference on the covariance matrix $\Sigma$ of a multivariate normal model under the enriched standard conjugate family. In particular, commonly employed Bayes estimates, such as the posterior expectation of $\Sigma$ and $\Sigma^{-1}$, are provided in closed form.",0,1 +2255,Spatial Analyses of Periodontal Data Using Conditionally Autoregressive Priors Having Two Classes of Neighbor Relations,"Attachment loss, the extent of a tooth's root (in millimeters) that is no longer attached to surrounding bone by periodontal ligament, is often used to measure the current state of a patient's periodontal disease and monitor disease progression. Attachment loss data can be analyzed using a conditionally autoregressive (CAR) prior distribution that smooths fitted values toward neighboring values. However, it may be desirable to have more than one class of neighbor relation in the spatial structure, so the different classes of neighbor relations can induce different degrees of smoothing. For example, we may wish to allow smoothing of neighbor pairs bridging the gap between teeth to differ from smoothing of pairs that do not bridge such gaps. Adequately modeling the spatial structure may improve the monitoring of periodontal disease progression. This article develops a two-neighbor-relation CAR model to handle this situation and presents associated theory to help explain the sometimes unusual posterior distr...",0,1 +2256,An estimating equations approach for the LISCOMP model,"Maximum likelihood estimation is computationally infeasible for latent variable models involving multivariate categorical responses, in particular for the LISCOMP model. A three-stage generalized least squares approach introduced by Muthén (1983, 1984) can experience problems of instability, bias, non-convergence, and non-positive definiteness of weight matrices in situations of low prevalence, small sample size and large numbers of observed indicator variables. We propose a quadratic estimating equations approach that only requires specification of the first two moments. By performing simultaneous estimation of parameters, this method does not encounter the problems mentioned above and experiences gains in efficiency. Methods are compared through a numerical study and an application to a study of life-events and neurotic illness.",0,1 +2257,Default “Gunel and Dickey” Bayes factors for contingency tables,"The analysis of R×C contingency tables usually features a test for independence between row and column counts. Throughout the social sciences, the adequacy of the independence hypothesis is generally evaluated by the outcome of a classical p-value null-hypothesis significance test. Unfortunately, however, the classical p-value comes with a number of well-documented drawbacks. Here we outline an alternative, Bayes factor method to quantify the evidence for and against the hypothesis of independence in R×C contingency tables. First we describe different sampling models for contingency tables and provide the corresponding default Bayes factors as originally developed by Gunel and Dickey (Biometrika, 61(3):545-557 (1974)). We then illustrate the properties and advantages of a Bayes factor analysis of contingency tables through simulations and practical examples. Computer code is available online and has been incorporated in the ""BayesFactor"" R package and the JASP program ( jasp-stats.org ).",0,1 +2258,The Role of Parametric Assumptions in Adaptive Bayesian Estimation.,"Variants of adaptive Bayesian procedures for estimating the 5% point on a psychometric function were studied by simulation. Bias and standard error were the criteria to evaluate performance. The results indicated a superiority of (a) uniform priors, (b) model likelihood functions that are odd symmetric about threshold and that have parameter values larger than their counterparts in the psychometric function, (c) stimulus placement at the prior mean, and (d) estimates defined as the posterior mean. Unbiasedness arises in only 10 trials, and 20 trials ensure constant standard errors. The standard error of the estimates equals 0.617 times the inverse of the square root of the number of trials. Other variants yielded bias and larger standard errors.",0,1 +2259,Promoting Healthy Lifestyles: Alternative Models' Effects (PHLAME),"The Promoting Healthy Lifestyles: Alternative Models' Effects (PHLAME) study evaluates the efficacy of two intervention strategies for improving nutrition and physical activity practices in fire fighters: a team-centered program and a one-on-one format targeting the individual. PHLAME compares these two behavior change models (the team-based versus the one-on-one approaches) against a usual-care control group. As a group, fire fighters have a concentration of the same harmful behaviors and health risks commonly afflicting the US population. Fire fighters have a unique work structure which is ideal for a team-centered model of behavior change. This strategy, based on Social Learning Theory, focuses on a team of fire fighters who work together on the same shift. If this team-centered model proves successful, it could provide a cost-effective method to impact behavior, and be disseminated among fire bureaus and in other team settings. The one-on-one intervention incorporates the Transtheoretical Model of behavior change, uses Motivational Interviewing for its counseling strategy and could be used in the more typical provider-client clinic setting. Findings from PHLAME will provide information about the process and outcomes of these models' ability to achieve health behavior change.",0,1 +2260,Multilevel Generalized Linear Models,"Two of the most influential papers in applied statistics published in the last few decades are Nelder and Wedderburn [65], introducing generalized linear models (GLMs), and Cox [20], the seminal paper introducing life tables with regression, better known as proportional hazard models. As we will see, these two developments are closely related. Nelder and Wedderburn?s unique contribution was to provide a unified conceptual framework for studying a large range of statistical models, including not only classical linear models, but also logit and probit models for binary data, log-linear Poisson models for count data, and others. The unification was not only conceptual, but also led to common estimation procedures in the form of an iteratively re-weighted least squares (IRLS) algorithm. The first implementation of these procedures appeared in the highly successful program GLIM [3], which for many statisticians became synonymous with GLMs. In this chapter we follow Wong and Mason [94], Longford [54, 56], Goldstein [30], Breslow and Clayton [11], and others in exploring extensions of GLMs to include random effects in a multilevel setting. Chapter 1 in this handbook has described multilevel models for continuous outcomes, while Chapter 6 has focused on multilevel models for categorical outcomes. Here we adopt a unified approach that views the general linear mixed model and many of the random-effects models for categorical data discussed in earlier chapters as special cases of the Multilevel Generalized Linear Model (MGLM). This approach has conceptual merit in emphasizing the similarities among these models, and provides a common framework to study and evaluate estimation methods. Alas, we do not have a single estimation procedure that can be applied to all MGLMs with the same measure of success that IRLS achieved for GLMs. Instead, we must choose between quick but sometimes biased approximations, and more accurate but often compute-intensive maximum likelihood and Bayesian approaches. Part of our task in this chapter is to describe and illustrate the alternatives. Section 9.2 develops the modeling framework. We introduce generalized linear models (GLMs) as an extension of linear models, and proceed to an analogous derivation of multilevel generalized linear models (MGLMs) as an extension of multilevel linear models. The ideas discussed apply more generally to generalized linear mixed models (GLMMs) and our notation reflects this broader applicability, but we tend to focus the narrative on the multilevel case. We review survival models, note their close connection with GLMs, and describe a natural extension to the multilevel case. We draw an important distinction between conditional and marginal models that is significant in the generalized linear case. Finally, we introduce non-linear mixed models and contrast them with MGLMs. Section 9.3 is devoted to a discussion of estimation procedures. It turns out that calculation of the likelihood function for MGLMs involves intractable integrals. We discuss several alternatives and assess their performance in realistic situations, referring to some of our earlier work using simulated data and a case study [81, 82] and introducing new results.We review a range of approximate estimation procedures that, unfortunately, can be severely biased when random effects are substantial. We describe maximum likelihood estimation using Gauss-Hermite quadrature, a method that appears to work remarkably well, but is limited to relatively low-dimensional models. We also discuss Bayesian estimation procedures focusing on the Gibbs sampler, a Markov Chain Monte Carlo (MCMC) method that can be pplied to more complex models involving high-dimensional integrals, albeit not without difficulty. We close this section with a brief discussion of other approaches to estimation, an active area of current research. Section 9.4 is devoted to an application of MGLMs to the study of infant and child mortality in Kenya, using data from a national survey conducted in 1998. We use a three-level piece-wise exponential survival model that allows for clustering of infant and child deaths at both the family and community levels, and fit it to data using the equivalent MGLM with Poisson errors and log link. We compare estimates that ignore clustering, and estimates obtained by approximate quasi-likelihood and by full maximum likelihood. The discussion emphasizes interpretation of the results, particularly the family and community random parameters. Finally, we show how the model can be used to estimate measures of intra-family and intra-community correlation in infant and child deaths. Section 9.5 is a brief discussion and summary of our conclusions. © 2008 Springer Science+Business Media, LLC.",0,1 +2261,Factors affecting cure when treating bovine clinical mastitis with cephalosporin-based intramammary preparations,"Data were collated for an independent scientific analysis from 2 international, multicenter studies that had compared the efficacy of 3 different cephalosporin-containing intramammary preparations in the treatment of clinical mastitis in dairy cattle [cefalexin (first generation) in combination with kanamycin; cefquinome (fourth generation); and cefoperazone (third generation)]. Quarters were assessed using standard bacteriological techniques before treatment and at 16 and 25 d posttreatment. Additional data were also available on individual cows and study farms, including parity, breed, and cow somatic cell count histories, herd bulk milk somatic cell counts, and farm management regimens. Sufficient data for analysis were available from a total of 491 cases on 192 farms in 3 countries (United Kingdom, France, and Germany) with up to 16 cases being recruited from any one farm. Clinical cases were of diverse etiology, representing both contagious and environmental pathogens. Univariable analysis demonstrated that quarters in the cefalexin + kanamycin and cefquinome treatment groups were not significantly different from each other, but were both significantly more likely to be pathogen free posttreatment than quarters in the cefoperazone group. Multivariable analysis was undertaken using conventional random effects models. Two models were built, with the first incorporating only information available to the practitioner at the time of treatment and the second including all information collected during the study. These models indicated that country, pretreatment rectal temperature (above-normal temperature associated with an increased chance of being pathogen free posttreatment), individual cow somatic cell count (increased somatic cell count associated with a decreased chance of being pathogen free posttreatment), and pathogen (Staphylococcus aureus isolation associated with a decreased chance of being pathogen free posttreatment) were useful predictors of pathogen free status; parity, yield, bulk milk somatic cell counts, and other farm management factors were not. The importance of country in the analysis demonstrates the need to generate local data when assessing treatment regimens. In addition, these results suggest that the factors important in predicting the outcome of treatment of clinical mastitis cases may be dissimilar to those reported to affect the likelihood of cure when treating subclinical intramammary infections.",0,1 +2262,The Decomposition of Effects in Path Analysis,"This paper is about the logic of interpreting recursive causal theories in sociology. We review the distinction between associations and effects and discuss the decomposition of effects into direct and indirect components. We then describe a general method for decomposing effects into their components by the systematic application of ordinary least squares regression. The method involves successive computation of reduced-form equations, beginning with an equation containing only exogenous variables, then computing equations which add intervening variables in sequence from cause to effect. This generates all the information required to decompose effects into their various direct and indirect parts. This method is a substitute for the often more cumbersome computation of indirect effects from the structural coefficients (direct effects) of the causal model Finally, we present a way of summarizing this information in tabular form and illustrate the procedures using an empirical example.",0,1 +2263,Assessing Direct and Indirect Effects in Multilevel Designs with Latent Variables,"Researchers commonly ask whether relationships between exogenous predictors, X, and outcomes, Y, are mediated by a third set of variables, Z. Simultaneous equations decompose the relationship between X and Y into an indirect component, operating through Z, and a direct component, the relationship between X and Y given Z. Often, X, Y, and/or Z are measured with error. Structural equation modeling is widely used in this scenario. However, sociological data commonly have a nested structure (students within schools, residents within local areas). Hierarchical linear models represent such multilevel data well and can handle errors of measurement, but have not incorporated simultaneous equations for direct and indirect effects. This article incorporates the study of such mediated effects into the hierarchical linear model, naturally extending the analysis to include unbalanced, multilevel designs and missing data. The authors illustrate the approach by examining the extent to which neighborhood social control mediates the relationship between neighborhood social composition and violence in Chicago.",0,1 +2264,Structural equation modeling with interchangeable dyads.,"Structural equation modeling (SEM) can be adapted in a relatively straightforward fashion to analyze data from interchangeable dyads (i.e., dyads in which the 2 members cannot be differentiated). The authors describe a general strategy for SEM model estimation, comparison, and fit assessment that can be used with either dyad-level or pairwise (double-entered) dyadic data. They present applications illustrating this approach with the actor-partner interdependence model, confirmatory factor analysis, and latent growth curve analysis.",0,1 +2265,Level-adjusted funnel plots based on predicted marginal expectations: an application to prophylactic antibiotics in gallstone surgery,"Funnel plots are widely used to visualize grouped data, for example, in institutional comparison. This paper extends the concept to a multi-level setting, displaying one level at a time, adjusted for the other levels, as well as for covariates at all levels. These level-adjusted funnel plots are based on a Markov chain Monte Carlo fit of a random effects model, translating the estimated model parameters to predicted marginal expectations. Working within the estimation framework, we accommodate outlying institutions using heavy-tailed random effects distributions. We also develop computer-efficient methods to compute predicted probabilities in the case of dichotomous outcome data and various random effect distributions. We apply the method to a data set on prophylactic antibiotics in gallstone surgery.",0,1 +2266,Additive Multilevel Item Structure Models with Random Residuals: Item Modeling for Explanation and Item Generation,"An additive multilevel item structure (AMIS) model with random residuals is proposed. The model includes multilevel latent regressions of item discrimination and item difficulty parameters on covariates at both item and item category levels with random residuals at both levels. The AMIS model is useful for explanation purposes and also for prediction purposes as in an item generation context. The parameters can be estimated with an alternating imputation posterior algorithm that makes use of adaptive quadrature, and the performance of this algorithm is evaluated in a simulation study. © 2013 The Psychometric Society.",0,1 +2267,Recovery of Graded Response Model Parameters,"Markov chain Monte Carlo (MCMC) methods enable a fully Bayesian approach to parameter estimation of item response models. In this simulation study, the authors compared the recovery of graded response model parameters using marginal maximum likelihood (MML) and Gibbs sampling (MCMC) under various latent trait distributions, test lengths, and sample sizes. Sample size and test length explained the largest amount of variance in item and person parameter estimates, respectively. There was little difference in item parameter recovery between MML and MCMC in samples with 300 or more respondents. MCMC recovered some item threshold parameters better in samples with 75 or 150 respondents. Bias in threshold parameter estimates depended on the generating value and the type of threshold. Person parameters were comparable between MCMC and MML/expected a posteriori for all test lengths.",0,1 +2268,What explains ‘generosity’ in the public financing of high-tech drugs? An empirical investigation of 25 OECD countries and 11 controversial drugs,"In times of increasing cost pressures, public healthcare systems in Organisation for Economic Co-operation and Development (OECD) countries face the question of whether and to which extent new high-tech drugs are to be financed within their public healthcare systems. Systematic empirical research that explains across-country variation in these decisions is, however, almost non-existent. We analyse an original dataset that contains coverage decisions for 11 controversial drugs in 25 OECD countries using multilevel modelling. Our results indicate that the ‘generosity’ with which controversial new drugs are publicly financed is unrelated to a country’s wealth and general expenditure levels for healthcare. However, healthcare systems financed through social insurance contributions tend to be more generous than tax-financed ones. Moreover, we uncover evidence suggesting that the institutional characteristics of the decision-making process matter systematically for decisions on whether to finance controversial drugs.",0,1 +2269,Food sharing networks in lowland Nicaragua: An application of the social relations model to count data,"Abstract Previous research on food sharing in small-scale societies provides support for multiple evolutionary hypotheses, but evolutionary anthropologists have devoted relatively little attention to the broader relational context of inter-household transfers of food. The present research observes transfers of meat over a yearlong period among 25 households of indigenous Mayangna and Miskito horticulturalists in Nicaragua. To analyze these data, we extend the multilevel formulation of the social relations model to count data, namely the number of portions of meat exchanged between households. Along with other covariates, we examine the effect of an “association index,” which reflects the amount of time that households interact with one another. The association index exhibits a positive effect on sharing, and our overall results indicate that food sharing networks largely correspond to kin-based networks of social interaction, suggesting that food sharing is embedded in broader social relationships between households. We discuss possible extensions of our methodological approach, as appropriate for research on food sharing and social network analysis more broadly.",0,1 +2270,I've Fallen and I Can't Get Up: Can High-Ability Students Recover From Early Mistakes in CAT?,"A difficult result to interpret in Computerized Adaptive Tests (CATs) occurs when an ability estimate initially drops and then ascends continuously until the test ends, suggesting that the true ability may be higher than implied by the final estimate. This study explains why this asymmetry occurs and shows that early mistakes by high-ability students can lead to considerable underestimation, even in tests with 45 items. The opposite response pattern, where low-ability students start with lucky guesses, leads to much less bias. The authors show that using Barton and Lord's four-parameter model (4PM) and a less informative prior can lower bias and root mean square error (RMSE) for high-ability students with a poor start, as the CAT algorithm ascends more quickly after initial underperformance. Results also show that the 4PM slightly outperforms a CAT in which less discriminating items are initially used. The practical implications and relevance for psychological measurement more generally are discussed.",0,1 +2271,"The problem of multicollinearity in a multistage causal alienation model: A comparison of ordinary least squares, maximum-likelihood and ridge estimators",,0,1 +2272,Bayesian Analysis of Dyadic Data,"SYNOPTIC ABSTRACTThis paper considers the Bayesian analysis of dyadic data with particular emphasis on applications in social psychology. Various existing models are extended and unified under a class of models where a single value is elicited to complete the prior specification. Certain situations which have sometimes been problematic (e.g. incomplete data, non-standard covariates, missing data, unbalanced data) are easily handled under the proposed class of Bayesian models. Inference is straightforward using software that is based on Markov chain Monte Carlo methods. Examples are provided which highlight the variety of data sets that can be entertained and the ease in which they can now be analyzed.",0,1 +2273,Two-Step Hierarchical Estimation: Beyond Regression Analysis,"Two-step estimators for hierarchical models can be constructed even when neither stage is a conventional linear regression model. For example, the first stage might consist of probit models, or duration models, or event count models. The second stage might be a nonlinear regression specification. This note sketches some of the considerations that arise in ensuring that two-step estimators are consistent in such cases.",0,1 +2274,Detecting Misspecified Multilevel Structural Equation Models with Common Fit Indices: A Monte Carlo Study,"This study investigated the sensitivity of common fit indices (i.e., RMSEA, CFI, TLI, SRMR-W, and SRMR-B) for detecting misspecified multilevel SEMs. The design factors for the Monte Carlo study were numbers of groups in between-group models (100, 150, and 300), group size (10, 20, 30, and 60), intra-class correlation (low, medium, and high), and the types of model misspecification (Simple and Complex). The simulation results showed that CFI, TLI, and RMSEA could only identify the misspecification in the within-group model. Additionally, CFI, TLI, and RMSEA were more sensitive to misspecification in pattern coefficients while SRMR-W was more sensitive to misspecification in factor covariance. Moreover, TLI outperformed both CFI and RMSEA in terms of the hit rates of detecting the within-group misspecification in factor covariance. On the other hand, SRMR-B was the only fit index sensitive to misspecification in the between-group model and more sensitive to misspecification in factor covariance than misspecification in pattern coefficients. Finally, we found that the influence of ICC on the performance of targeted fit indices was trivial.",0,1 +2275,Maximum likelihood estimation of latent interaction effects with the LMS method,"In the context of structural equation modeling, a general interaction model with multiple latent interaction effects is introduced. A stochastic analysis represents the nonnormal distribution of the joint indicator vector as a finite mixture of normal distributions. The Latent Moderated Structural Equations (LMS) approach is a new method developed for the analysis of the general interaction model that utilizes the mixture distribution and provides a ML estimation of model parameters by adapting the EM algorithm. The finite sample properties and the robustness of LMS are discussed. Finally, the applicability of the new method is illustrated by an empirical example.",0,1 +2276,Small sample mediation testing: Misplaced confidence in bootstrapped confidence intervals.,"Bootstrapping is an analytical tool commonly used in psychology to test the statistical significance of the indirect effect in mediation models. Bootstrapping proponents have particularly advocated for its use for samples of 20-80 cases. This advocacy has been heeded, especially in the Journal of Applied Psychology, as researchers are increasingly utilizing bootstrapping to test mediation with samples in this range. We discuss reasons to be concerned with this escalation, and in a simulation study focused specifically on this range of sample sizes, we demonstrate not only that bootstrapping has insufficient statistical power to provide a rigorous hypothesis test in most conditions but also that bootstrapping has a tendency to exhibit an inflated Type I error rate. We then extend our simulations to investigate an alternative empirical resampling method as well as a Bayesian approach and demonstrate that they exhibit comparable statistical power to bootstrapping in small samples without the associated inflated Type I error. Implications for researchers testing mediation hypotheses in small samples are presented. For researchers wishing to use these methods in their own research, we have provided R syntax in the online supplemental materials.",1,1 +2277,Who Learns from What in Policy Diffusion Processes?,"The idea that policy makers in different states or countries may learn from one another has fascinated scholars for a long time, but little systematic evidence has been produced so far. This article improves our understanding of this elusive argument by distinguishing between the policy and political consequences of reforms and by emphasizing the conditional nature of learning processes. Using a directed dyadic approach and multilevel methods, the analysis of unemployment benefits retrenchment in OECD countries demonstrates that policy makers learn selectively from the experience of others. Right governments tend to be more sensitive to information on the electoral consequences of reforms, while left governments are more likely to be influenced by their policy effects.",0,1 +2278,Mediation designs for tobacco prevention research,"This paper describes research designs and statistical analyses to investigate how tobacco prevention programs achieve their effects on tobacco use. A theoretical approach to program development and evaluation useful for any prevention program guides the analysis. The theoretical approach focuses on action theory for how the program affects mediating variables and on conceptual theory for how mediating variables are related to tobacco use. Information on the mediating mechanisms by which tobacco prevention programs achieve effects is useful for the development of efficient programs and provides a test of the theoretical basis of prevention efforts. Examples of these potential mediating mechanisms are described including mediated effects through attitudes, social norms, beliefs about positive consequences, and accessibility to tobacco. Prior research provides evidence that changes in social norms are a critical mediating mechanism for successful tobacco prevention. Analysis of mediating variables in single group designs with multiple mediators are described as well as multiple group randomized designs which are the most likely to accurately uncover important mediating mechanisms. More complicated dismantling and constructive designs are described and illustrated based on current findings from tobacco research. Mediation analysis for categorical outcomes and more complicated statistical methods are outlined.",0,1 +2279,Modeling Clustered Data with Very Few Clusters,"Small-sample inference with clustered data has received increased attention recently in the methodological literature, with several simulation studies being presented on the small-sample behavior of many methods. However, nearly all previous studies focus on a single class of methods (e.g., only multilevel models, only corrections to sandwich estimators), and the differential performance of various methods that can be implemented to accommodate clustered data with very few clusters is largely unknown, potentially due to the rigid disciplinary preferences. Furthermore, a majority of these studies focus on scenarios with 15 or more clusters and feature unrealistically simple data-generation models with very few predictors. This article, motivated by an applied educational psychology cluster randomized trial, presents a simulation study that simultaneously addresses the extreme small sample and differential performance (estimation bias, Type I error rates, and relative power) of 12 methods to account for clustered data with a model that features a more realistic number of predictors. The motivating data are then modeled with each method, and results are compared. Results show that generalized estimating equations perform poorly; the choice of Bayesian prior distributions affects performance; and fixed effect models perform quite well. Limitations and implications for applications are also discussed.",1,1 +2280,Item Parameter Recovery for the Nominal Response Model,"Establishing guidelines for reasonable item parameter estimation is fundamental to use of the nominal response model. Factors studied were the sample size ratio (SSR), latent trait distribution (LD), and amount of item information. Results showed that the LD accounted for 42.5% of the variability in the accuracy of estimating the slope parameter; the SSR and the maximum item information factors accounted for 29.5% and 3.5% of the accuracy, respectively. In general, as the LD departed from a normal distribution, a larger number of examinees was required to accurately estimate the slope and intercept parameters. Results indicated that an SSR of 10:1 can produce reasonably accurate item parameter estimates when the LD is normal.",0,1 +2281,Controlling item exposure and test overlap on the fly in computerized adaptive testing,"This paper proposes an on-line version of the Sympson and Hetter procedure with test overlap control (SHT) that can provide item exposure control at both the item and test levels on the fly without iterative simulations. The on-line procedure is similar to the SHT procedure in that exposure parameters are used for simultaneous control of item exposure rates and test overlap rate. The exposure parameters for the on-line procedure, however, are updated sequentially on the fly, rather than through iterative simulations conducted prior to operational computerized adaptive tests (CATs). Unlike the SHT procedure, the on-line version can control item exposure rate and test overlap rate without time-consuming iterative simulations even when item pools or examinee populations have been changed. Moreover, the on-line procedure was found to perform better than the SHT procedure in controlling item exposure and test overlap for examinees who take tests earlier. Compared with two other on-line alternatives, this proposed on-line method provided the best all-around test security control. Thus, it would be an efficient procedure for controlling item exposure and test overlap in CATs.",0,1 +2282,Gay Rights in the States: Public Opinion and Policy Responsiveness,"We study the effects of policy-specific public opinion on state adoption of policies affecting gays and lesbians, and the factors that condition this relationship. Using national surveys and advances in opinion estimation, we create new estimates of state-level support for eight policies, including civil unions and nondiscrimination laws. We differentiate between responsiveness to opinion and congruence with opinion majorities. We find a high degree of responsiveness, controlling for interest group pressure and the ideology of voters and elected officials. Policy salience strongly increases the influence of policy-specific opinion (directly and relative to general voter ideology). There is, however, a surprising amount of noncongruence—for some policies, even clear supermajority support seems insufficient for adoption. When noncongruent, policy tends to be more conservative than desired by voters; that is, there is little progay policy bias. We find little to no evidence that state political institutions affect policy responsiveness or congruence.",0,1 +2283,Longitudinal data analysis (repeated measures) in clinical trials,"Longitudinal data is often collected in clinical trials to examine the effect of treatment on the disease process over time. This paper reviews and summarizes much of the methodological research on longitudinal data analysis from the perspective of clinical trials. We discuss methodology for analysing Gaussian and discrete longitudinal data and show how these methods can be applied to clinical trials data. We illustrate these methods with five examples of clinical trials with longitudinal outcomes. We also discuss issues of particular concern in clinical trials including sequential monitoring and adjustments for missing data. A review of current software for analysing longitudinal data is also provided. Published in 1999 by John Wiley & Sons, Ltd. This article is a US Government work and is the public domain in the United States.",0,1 +2284,Attention to baseline: does orienting visuospatial attention really facilitate target detection?,"Standard protocols testing the orientation of visuospatial attention usually present spatial cues before targets and compare valid-cue trials with invalid-cue trials. The valid/invalid contrast results in a relative behavioral or physiological difference that is generally interpreted as a benefit of attention orientation. However, growing evidence suggests that inhibitory control of response is closely involved in this kind of protocol that requires the subjects to withhold automatic responses to cues, probably biasing behavioral and physiological baselines. Here, we used two experiments to disentangle the inhibitory control of automatic responses from orienting of visuospatial attention in a saccadic reaction time task in humans, a variant of the classical cue-target detection task and a sustained visuospatial attentional task. Surprisingly, when referring to a simple target detection task in which there is no need to refrain from reacting to avoid inappropriate responses, we found no consistent evidence of facilitation of target detection at the attended location. Instead, we observed a cost at the unattended location. Departing from the classical view, our results suggest that reaction time measures of visuospatial attention probably relie on the attenuation of elementary processes involved in visual target detection and saccade initiation away from the attended location rather than on facilitation at the attended location. This highlights the need to use proper control conditions in experimental designs to disambiguate relative from absolute cueing benefits on target detection reaction times, both in psychophysical and neurophysiological studies.",0,1 +2285,Econometric Issues in the Analysis of Regressions with Generated Regressors,,0,1 +2286,Matching Estimators of Causal Effects,"As the counterfactual model of causality has increased in popularity, sociologists have returned to matching as a research methodology. In this article, advances over the past two decades in matching estimators are explained, and the practical limitations of matching techniques are emphasized. The authors introduce matching methods by focusing first on ideal scenarios in which stratification and weighting procedures warrant causal inference. Then, they discuss how matching is often undertaken in practice, offering an overview of the most prominent data analysis routines. With four hypothetical examples, they demonstrate how the assumptions behind matching estimators often break down in practice. Even so, the authors argue that matching techniques can be used effectively to strengthen the prosecution of causal questions in sociology.",0,1 +2287,An Application of the Estimated Dependent Variable Approach: Trade Union Members' Support for Active Labor Market Policies and Insider-Outsider Politics,,0,1 +2288,Maximum likelihood estimation of nonlinear structural equation models,"The existing maximum likelihood theory and its computer software in structural equation modeling are established based on linear relationships among manifest variables and latent variables. However, models with nonlinear relationships are often encountered in social and behavioral sciences. In this article. an EM type algorithm is developed for maximum likelihood estimation of a general nonlinear structural equation model. To avoid computation of the complicated multiple integrals involved, the E-step is completed by a Metropolis-Hastings algorithm. It is shown that the M-step can be completed efficiently by simple conditional maximization. Standard errors of the maximum likelihood estimates are obtained via Louis's formula. The methodology is illustrated with results from a simulation study and two real examples.",0,1 +2289,Interspecies extrapolation in environmental exposure standard setting: A Bayesian synthesis approach,"Currently the extrapolation of evidence from studies of non-human species to the setting of environmental exposure standards for humans includes the imposition of a variety of uncertainty factors reflecting unknown aspects of the procedure, including the relevance of evidence from one species to impacts in another. This paper develops and explores more flexible modelling of aspects of this extrapolation, using models proposed by DuMouchel [DuMouchel, W.H., Harris, J.E., 1983. Bayes methods for combining the results of cancer studies in humans and other species (with comment). J. Am. Statist. Assoc. 78, 293–308.] The approaches are based on Bayesian meta-analysis methods involving explicit modelling of relevance in the prior distributions, estimated using Markov chain Monte Carlo (MCMC) methods. The methods are applied to evidence relating chlorinated by-products exposure to adverse reproductive health effects. The relative merits of various approaches are discussed, and developments and next steps are outlined.",0,1 +2290,Latent Variable Models and Factor Analysis,"Latent Variable Models and Factor Analysis provides a comprehensive and unified approach to factor analysis and latent variable modeling from a statistical perspective. This book presents a general framework to enable the derivation of the commonly used models, along with updated numerical examples. Nature and interpretation of a latent variable is also introduced along with related techniques for investigating dependency. This book: Provides a unified approach showing how such apparently diverse methods as Latent Class Analysis and Factor Analysis are actually members of the same family. Presents new material on ordered manifest variables, MCMC methods, non-linear models as well as a new chapter on related techniques for investigating dependency. Includes new sections on structural equation models (SEM) and Markov Chain Monte Carlo methods for parameter estimation, along with new illustrative examples. Looks at recent developments on goodness-of-fit test statistics and on non-linear models and models with mixed latent variables, both categorical and continuous. No prior acquaintance with latent variable modelling is pre-supposed but a broad understanding of statistical theory will make it easier to see the approach in its proper perspective. Applied statisticians, psychometricians, medical statisticians, biostatisticians, economists and social science researchers will benefit from this book. © 2011 John Wiley & Sons, Ltd. All rights reserved.",0,1 +2291,Joint prior distributions for variance parameters in Bayesian analysis of normal hierarchical models,"In random effect models, error variance (stage 1 variance) and scalar random effect variance components (stage 2 variances) are a priori modeled independently. Considering the intrinsic link between the stages 1 and 2 variance components and their interactive effect on the parameter draws in Gibbs sampling, we propose modeling the variances of the two stages a priori jointly in a multivariate fashion. We use random effects linear growth model for illustration and consider multivariate distributions to model the variance components jointly including the recently developed generalized multivariate log gamma (G-MVLG) distribution. We discuss these variance priors as well as the independent variance priors exercised in the literature in different aspects including noninformativeness and propriety of the associated posterior density. We show through an extensive simulation experiment that modeling the variance components of different stages multivariately results in better estimation properties for the response and random effect model parameters compared to independent modeling. We scrutinize the sensitivity of response model coefficient estimates to the parameters of considered noninformative variance priors and find that their full conditional expectations are insensitive to noninformative G-MVLG prior parameters. We apply independent and joint models for analysis of a real dataset and find that multivariate priors for variance components lead to better fitted hierarchical model than the univariate variance priors.",0,1 +2292,Inequality Constrained Analysis of Variance: A Bayesian Approach.,"Researchers often have one or more theories or expectations with respect to the outcome of their empirical research. When researchers talk about the expected relations between variables if a certain theory is correct, their statements are often in terms of one or more parameters expected to be larger or smaller than one or more other parameters. Stated otherwise, their statements are often formulated using inequality constraints. In this article, a Bayesian approach to evaluate analysis of variance or analysis of covariance models with inequality constraints on the (adjusted) means is presented. This evaluation contains two issues: estimation of the parameters given the restrictions using the Gibbs sampler and model selection using Bayes factors in the case of competing theories. The article concludes with two illustrations: a one-way analysis of covariance and an analysis of a three-way table of ordered means.",0,1 +2293,Small sample inference for the fixed effects in the mixed linear model,"The small sample performance of several procedures for testing a given fixed effect in a mixed linear model is investigated. Using simulations, constructed on the basis of a study of growth of children with Gaucher's disease, standard normal-theory Wald tests for both ML and REML estimates, the likelihood ratio test (LRT), a modified LRT based on Bartlett correction, and a number of adjusted tests based on t and F distributions are evaluated. Methods used for determining the denominator degrees of freedom in the t and F tests include the residual degrees of freedom method, the between and within degrees of freedom, the containment method, the naive method and the Satterthwaite method. A test based on a sandwich-type estimator of the variance of the parameter estimate is evaluated as well and the effect of mis-specifying the random-effects distribution is considered. Results show that Type I error rates for the Wald-type test with chi-square approximation are substantially inflated, though less so with REML estimates than with ML estimates. The LRT based on ML estimates yielded Type I error rates similar to those observed for the Wald-type chi-square test with REML estimates. A substantial improvement in Type I error rates for testing on both the intercept and slope is provided by each of the three following modifications: the Satterthwaite and naive methods with REML-based estimates and the Bartlett-corrected LRT.",0,1 +2294,Bayesian Analysis of Structural Equation Model With Fixed Covariates,"This article extends the LISREL model to incorporate fixed covariates at both the measurement and the structural equations of the model. A Bayesian procedure with conjugate type prior distributions is established. The joint Bayesian estimates of the latent variables and the structural parameters that involve the regression coefficients of the covariates, the variances, covariances and causations among the manifest and latent variables are obtained via the Gibbs sampler algorithm. It is shown that the conditional distributions required in the Gibbs sampler are familiar distributions, hence the algorithm is very efficient. A goodness of fit statistic for assessing the proposed model is presented. An illustrative example with some real data is presented.",0,1 +2295,Multivariate meta‐analysis using individual participant data,"When combining results across related studies, a multivariate meta-analysis allows the joint synthesis of correlated effect estimates from multiple outcomes. Joint synthesis can improve efficiency over separate univariate syntheses, may reduce selective outcome reporting biases, and enables joint inferences across the outcomes. A common issue is that within-study correlations needed to fit the multivariate model are unknown from published reports. However, provision of individual participant data (IPD) allows them to be calculated directly. Here, we illustrate how to use IPD to estimate within-study correlations, using a joint linear regression for multiple continuous outcomes and bootstrapping methods for binary, survival and mixed outcomes. In a meta-analysis of 10 hypertension trials, we then show how these methods enable multivariate meta-analysis to address novel clinical questions about continuous, survival and binary outcomes; treatment–covariate interactions; adjusted risk/prognostic factor effects; longitudinal data; prognostic and multiparameter models; and multiple treatment comparisons. Both frequentist and Bayesian approaches are applied, with example software code provided to derive within-study correlations and to fit the models. © 2014 The Authors. Research Synthesis Methods published by John Wiley & Sons, Ltd.",0,1 +2296,Latent Variable Models Under Misspecification: Two-Stage Least Squares (2SLS) and Maximum Likelihood (ML) Estimators,"This article compares maximum likelihood (ML) estimation to three variants of two-stage least squares (2SLS) estimation in structural equation models. The authors use models that are both correctly and incorrectly specified. Simulated data are used to assess bias, efficiency, and accuracy of hypothesis tests. Generally, 2SLS with reduced sets of instrumental variables performs similarly to ML when models are correctly specified. Under correct specification, both estimators have little bias except at the smallest sample sizes and are approximately equally efficient. As predicted, when models are incorrectly specified, 2SLS generally performs better, with less bias and more accurate hypothesis tests. Unless a researcher has tremendous confidence in the correctness of his or her model, these results suggest that a 2SLS estimator should be considered.",0,1 +2297,"Where similarity beats redundancy: The importance of context, higher order similarity, and response assignment.","People are especially efficient in processing certain visual stimuli such as human faces or good configurations. It has been suggested that topology and geometry play important roles in configural perception. Visual search is one area in which configurality seems to matter. When either of 2 target features leads to a correct response and the sequence includes trials in which either or both targets are present, the result is a redundant-target paradigm. It is common for such experiments to find faster performance with the double target than with either alone, something that is difficult to explain with ordinary serial models. This redundant-targets study uses figures that can be dissimilar in their topology and geometry and manipulates the stimulus set and the stimulus?response assignments. The authors found that the combination of higher order similarity (e.g., topological) among the features in the stimulus set and response assignment can effectively overpower or facilitate the redundant-target effect, depending on the exact nature of the former characteristics. Several reasonable models of redundant-targets performance are falsified. Parallel models with the potential for channel interactions are supported by the data.",0,1 +2298,Testing multiple biological mediators simultaneously,"Abstract Motivation: Modern biomedical and epidemiological studies often measure hundreds or thousands of biomarkers, such as gene expression or metabolite levels. Although there is an extensive statistical literature on adjusting for ‘multiple comparisons’ when testing whether these biomarkers are directly associated with a disease, testing whether they are biological mediators between a known risk factor and a disease requires a more complex null hypothesis, thus offering additional methodological challenges. Results: We propose a permutation approach that tests multiple putative mediators and controls the family wise error rate. We demonstrate that, unlike when testing direct associations, replacing the Bonferroni correction with a permutation approach that focuses on the maximum of the test statistics can significantly improve the power to detect mediators even when all biomarkers are independent. Through simulations, we show the power of our method is 2–5× larger than the power achieved by Bonferroni correction. Finally, we apply our permutation test to a case-control study of dietary risk factors and colorectal adenoma to show that, of 149 test metabolites, docosahexaenoate is a possible mediator between fish consumption and decreased colorectal adenoma risk. Availability and implementation: R-package included in online Supplementary Material. Contact: joshua.sampson@nih.gov Supplementary information: Supplementary materials are available at Bioinformatics online.",0,1 +2299,Individual differences in dyadic cooperative learning.,"The impact of individual differences on the performance of 2 roles-learner and learning facilitator-was assessed during dyadic cooperative learning. Eighty university students, 40 men and 40 women, participated in same-sex groups of 4. Each student cooperatively learned a text passage with 1 partner and then learned a 2nd passage with another partner. It a later session, the students recalled the information contained within both text passages and completed several personality measures. A social relations analysis (D. A. Kenny & L. LaVoie, 1984) was used to partition the variability in recall for the passages into various sources. Variability in recall depended strongly on individual differences in learning ability and (to a lesser extent) on individual differences in the ability to facilitate others' learning. Differences in the ability to learn text passages were independent of individual differences in the ability to facilitate others' learning. Effective learners were high in verbal ability, whereas effective learning facilitators were low in public self-consciousness and in self-monitoring. The influence of cognitive and rapport factors on the performance of the learner role and the learning facilitator role is discussed.",0,1 +2300,Dynamic causal modelling of brain–behaviour relationships,"In this work, we expose a mathematical treatment of brain-behaviour relationships, which we coin behavioural Dynamic Causal Modelling or bDCM. This approach aims at decomposing the brain's transformation of stimuli into behavioural outcomes, in terms of the relative contribution of brain regions and their connections. In brief, bDCM places the brain at the interplay between stimulus and behaviour: behavioural outcomes arise from coordinated activity in (hidden) neural networks, whose dynamics are driven by experimental inputs. Estimating neural parameters that control network connectivity and plasticity effectively performs a neurobiologically-constrained approximation to the brain's input-outcome transform. In other words, neuroimaging data essentially serves to enforce the realism of bDCM's decomposition of input-output relationships. In addition, post-hoc artificial lesions analyses allow us to predict induced behavioural deficits and quantify the importance of network features for funnelling input-output relationships. This is important, because this enables one to bridge the gap with neuropsychological studies of brain-damaged patients. We demonstrate the face validity of the approach using Monte-Carlo simulations, and its predictive validity using empirical fMRI/behavioural data from an inhibitory control task. Lastly, we discuss promising applications of this work, including the assessment of functional degeneracy (in the healthy brain) and the prediction of functional recovery after lesions (in neurological patients).",0,1 +2301,Observations on the Use of Growth Mixture Models in Psychological Research,"Psychologists are applying growth mixture models at an increasing rate. This article argues that most of these applications are unlikely to reproduce the underlying taxonic structure of the population. At a more fundamental level, in many cases there is probably no taxonic structure to be found. Latent growth classes then categorically approximate the true continuum of individual differences in change. This approximation, although in some cases potentially useful, can also be problematic. The utility of growth mixture models for psychological science thus remains in doubt. Some ways in which these models might be more profitably used are suggested.",0,1 +2302,Eliciting prior information to enhance the predictive performance of bayesian graphical models,"Both knowledge-based systems and statistical models are typically concerned with making predictions about future observables. Here we focus on assessment of predictive performance and provide two techniques for improving the predictive performance of Bayesian graphical models. First, we present Bayesian model averaging, a technique for accounting for model uncertainty. Second, we describe a technique for eliciting a prior distribution for competing models from domain experts. We explore the predictive performance of both techniques in the context of a urological diagnostic problem.",0,1 +2303,Model-Based Direct Adjustment,"Abstract Direct adjustment or standardization applies population weights to subclass means in an effort to estimate population quantities from a sample that is not representative of the population. Direct adjustment has several attractive features, but when there are many subclasses it can attach large weights to small quantities of data, often in a fairly erratic manner. In the extreme, direct adjustment can attach infinite weight to nonexistent data, a noticeable inconvenience in practice. This article proposes a method of model-based direct adjustment that preserves the attractive features of conventional direct adjustment while stabilizing the weights attached to small subclasses. The sample mean and conventional direct adjustment are both special cases of model-based direct adjustment under two different extreme models for the subclass-specific selection probabilities. The discussion of this method provides some insights into the behavior of true and estimated propensity scores: the estimated scores ...",0,1 +2304,Propensity score matching without conditional independence assumption—with an application to the gender wage gap in the United Kingdom,"revised version of Discussion paper 2002-08#### Propensity score matching is frequently used for estimating average treatment effects. Its applicability, however, is not confined to treatment evaluation. In this paper it is shown that propensity score matching does not hinge on a selection on observables assumption and can be used to estimate not only adjusted means but also their distributions, even with non-iid sampling. Propensity score matching is used to analyze the gender wage gap among graduates in the UK. It is found that subject of degree contributes substantially to explaining the gender wage gap, particularly at higher quantiles of the wage distribution. Download Discussion Paper: (pdf, 910 kb)",0,1 +2305,"2 Statistical Inference for Causal Effects, With Emphasis on Applications in Epidemiology and Medical Statistics","Abstract A central problem in epidemiology and medical statistics is how to draw inferences about the causal effects of treatments (i.e., interventions) from randomized and nonrandomized data. For example, does the new drug really reduce heart disease, or does exposure to that chemical in drinking water increase cancer rates relative to drinking water without that chemical? This chapter provides an overview of the approach to the estimation of such causal effects based on the concept of potential outcomes. We discuss randomization-based approaches and the Bayesian posterior predictive approach.",0,1 +2306,Modeling visual search using three-parameter probability functions in a hierarchical Bayesian framework,"In this study, we applied Bayesian-based distributional analyses to examine the shapes of response time (RT) distributions in three visual search paradigms, which varied in task difficulty. In further analyses we investigated two common observations in visual search-the effects of display size and of variations in search efficiency across different task conditions-following a design that had been used in previous studies (Palmer, Horowitz, Torralba, & Wolfe, Journal of Experimental Psychology: Human Perception and Performance, 37, 58-71, 2011; Wolfe, Palmer, & Horowitz, Vision Research, 50, 1304-1311, 2010) in which parameters of the response distributions were measured. Our study showed that the distributional parameters in an experimental condition can be reliably estimated by moderate sample sizes when Monte Carlo simulation techniques are applied. More importantly, by analyzing trial RTs, we were able to extract paradigm-dependent shape changes in the RT distributions that could be accounted for by using the EZ2 diffusion model. The study showed that Bayesian-based RT distribution analyses can provide an important means to investigate the underlying cognitive processes in search, including stimulus grouping and the bottom-up guidance of attention.",0,1 +2307,"A Comparison of ML, WLSMV, and Bayesian Methods for Multilevel Structural Equation Models in Small Samples: A Simulation Study","Multilevel structural equation models are increasingly applied in psychological research. With increasing model complexity, estimation becomes computationally demanding, and small sample sizes pose further challenges on estimation methods relying on asymptotic theory. Recent developments of Bayesian estimation techniques may help to overcome the shortcomings of classical estimation techniques. The use of potentially inaccurate prior information may, however, have detrimental effects, especially in small samples. The present Monte Carlo simulation study compares the statistical performance of classical estimation techniques with Bayesian estimation using different prior specifications for a two-level SEM with either continuous or ordinal indicators. Using two software programs (Mplus and Stan), differential effects of between- and within-level sample sizes on estimation accuracy were investigated. Moreover, it was tested to which extent inaccurate priors may have detrimental effects on parameter estimates in categorical indicator models. For continuous indicators, Bayesian estimation did not show performance advantages over ML. For categorical indicators, Bayesian estimation outperformed WLSMV solely in case of strongly informative accurate priors. Weakly informative inaccurate priors did not deteriorate performance of the Bayesian approach, while strong informative inaccurate priors led to severely biased estimates even with large sample sizes. With diffuse priors, Stan yielded better results than Mplus in terms of parameter estimates.",1,1 +2308,Modeling Response Times for Two-Choice Decisions,"The diffusion model for two-choice real-time decisions is applied to four psychophysical tasks. The model reveals how stimulus information guides decisions and shows how the information is processed through time to yield sometimes correct and sometimes incorrect decisions. Rapid two-choice decisions yield multiple empirical measures: response times for correct and error responses, the probabilities of correct and error responses, and a variety of interactions between accuracy and response time that depend on instructions and task difficulty. The diffusion model can explain all these aspects of the data for the four experiments we present. The model correctly accounts for error response times, something previous models have failed to do. Variability within the decision process explains how errors are made, and variability across trials correctly predicts when errors are faster than correct responses and when they are slower.",0,1 +2309,Marginalized Maximum Likelihood Estimation for the 1PL-AG IRT Model,Marginal maximum likelihood estimation based on the expectation–maximization algorithm (MML/EM) is developed for the one-parameter logistic model with ability-based guessing (1PL-AG) item response theory (IRT) model. The use of the MML/EM estimator is cross-validated with estimates from NLMIXED procedure (PROC NLMIXED) in Statistical Analysis System. Numerical data are provided for comparisons of results from MML/EM and PROC NLMIXED.,0,1 +2310,Surface shape analysis with an application to brain surface asymmetry in schizophrenia,"Some methods for the statistical analysis of surface shapes and asymmetry are introduced. We focus on a case study where magnetic resonance images of the brain are available from groups of 30 schizophrenia patients and 38 controls, and we investigate large-scale brain surface shape differences. Key aspects of shape analysis are to remove nuisance transformations by registration and to identify which parts of one object correspond with the parts of another object. We introduce maximum likelihood and Bayesian methods for registering brain images and providing large-scale correspondences of the brain surfaces. Brain surface size-and-shape analysis is considered using random field theory, and also dimension reduction is carried out using principal and independent components analysis. Some small but significant differences are observed between the the patient and control groups. We then investigate a particular type of asymmetry called torque. Differences in asymmetry are observed between the control and patient groups, which add strength to other observations in the literature. Further investigations of the midline plane location in the 2 groups and the fitting of nonplanar curved midlines are also considered.",0,1 +2311,A New Maximum Likelihood Estimator for the Population Squared Multiple Correlation,"Using maximum likelihood estimation as described by R. A. Fisher (1912) , a new estimator for the population squared multiple correlation was developed. This estimator ( ρcirc; 2 (ML) ) was derived by examining all possible values of the population squared multiple correlation for a given sample size and number of predictors, and finding the one for which the observed sample value had the highest probability of occurring. The new estimator is shown to have greater accuracy than other estimators and to generate values that always fall within the parameter space. The utility of ρcirc; 2 (ML) in terms of providing the basis for the development of small sample significance tests is demonstrated. A Microsoft Excel workbook for computing ρcirc; 2 (ML) and its regions of nonsignificance and for computing a normal transformation for R 2 is offered.",0,1 +2312,A Comparison of Item Selection Techniques for Testlets,"This study examined the performance of the maximum Fisher’s information, the maximum posterior weighted information, and the minimum expected posterior variance methods for selecting items in a computerized adaptive testing system when the items were grouped in testlets. A simulation study compared the efficiency of ability estimation among the item selection techniques under varying conditions of local-item dependency when the response model was either the three-parameter-logistic item response theory or the three-parameter-logistic testlet response theory. The item selection techniques performed similarly within any particular condition, the practical implications of which are discussed within the article.",0,1 +2313,Anti-tumor necrosis factor (TNF) drugs for the treatment of psoriatic arthritis: an indirect comparison meta-analysis,"To evaluate the comparative effectiveness of available tumor necrosis factor-α inhibitors (anti-TNFs) for the management of psoriatic arthritis (PsA) in patients with an inadequate response to disease-modifying antirheumatic drugs (DMARDs).We used an exhaustive search strategy covering randomized clinical trials, systematic reviews and health technology assessments (HTA) published on anti-TNFs for PsA. We performed indirect comparisons of the available anti-TNFs (adalimumab, etanercept, golimumab, and infliximab) measuring relative risks (RR) for the psoriatic arthritis response criteria (PsARC), mean differences (MDs) for improvements from baseline for the Health Assessment Questionnaire (HAQ) by PsARC responders and non-responders, and MD for the improvements from baseline for the psoriasis area and severity index (PASI). When the reporting of data on intervention group response rates and improvements were incomplete, we used straightforward conversions based on the available data.We retrieved data from 20 publications representing seven trials, as well as two HTAs. All anti-TNFs were significantly better than control, but the indirect comparison did not reveal any statistically significant difference between the anti-TNFs. For PsARC response, golimumab yielded the highest RR and etanercept the second highest; adalimumab and infliximab both yielded notably smaller RRs. For HAQ improvement, etanercept and infliximab yielded the largest MD among PsARC responders. For PsARC nonresponders, etanercept, infliximab, and golimumab yielded similar MDs, and adalimumab a notably lower MD. For PASI improvement, infliximab yielded the largest MD and golimumab the second largest, while etanercept yielded the smallest MD. In some instances, the estimated magnitudes of effect were notably different from the estimates of previous HTA indirect comparisons.There is insufficient statistical evidence to demonstrate differences in effectiveness between available anti-TNFs for PsA. Effect estimates seem sensitive to the analytic approach, and this uncertainty should be taken into account in future economic evaluations.",0,1 +2314,A Nonlinear Structural Equation Mixture Modeling Approach for Nonnormally Distributed Latent Predictor Variables,"Structural equation models with interaction and quadratic effects have become a standard tool for testing nonlinear hypotheses in the social sciences. Most of the current approaches assume normally distributed latent predictor variables. In this article, we describe a nonlinear structural equation mixture approach that integrates the strength of parametric approaches (specification of the nonlinear functional relationship) and the flexibility of semiparametric structural equation mixture approaches for approximating the nonnormality of latent predictor variables. In a comparative simulation study, the advantages of the proposed mixture procedure over contemporary approaches [Latent Moderated Structural Equations approach (LMS) and the extended unconstrained approach] are shown for varying degrees of skewness of the latent predictor variables. Whereas the conventional approaches show either biased parameter estimates or standard errors of the nonlinear effects, the proposed mixture approach provides unbias...",0,1 +2315,Making Civil Society Work: Models of Democracy and Their Impact on Civic Engagement,"This article evaluates the influence of different models of democracy on individual volunteering in associations and organizations. More precisely, we investigate the extent to which the degree of liberal and participatory conceptions of democracy respectively shapes the conditions under which voluntary engagement thrives. We apply multilevel analysis—a method that corresponds well to the central hypothesis of institutional approaches and is most suitable for modeling the relationship between the democratic context and individual volunteering. We show that both a representative conception of democracy, as well as strong direct democracy, leads to advantageous conditions for civic engagement. In contrast, if the two models of democracy are combined, the two different logics of the democratic process disturb one another, resulting in less voluntary engagement.",0,1 +2316,Effect of the Number of Variables on Measures of Fit in Structural Equation Modeling,"There has been relatively little systematic investigation of the effect of the number of variables on measures of model fit in structural equation modeling. There is conflicting evidence as to whether measures of fit tend to improve or decline as more variables are added to the model. We consider 3 different types of specification error: minor factors, 2-factor models, and method errors. Using a formal method based on the noncentrality parameter (NCP), we find that root mean squared error of approximation (RMSEA) tends to improve regardless of the type of specification error and that the comparative fit index (CFI) and Tucker-Lewis Index (TLI), generally, though not always, tend to worsen as the number of variables in the model increases. The formal method that we develop can be used to investigate other measures of fit and other types of misspecification.",0,1 +2317,A threshold theory account of psychometric functions with response confidence under the balance condition,"The study of thresholds for discriminability has been of long-standing interest in psychophysics. While threshold theories embrace the concept of discrete-state thresholds, signal detection theory discounts such a concept. In this paper we concern ourselves with the concept of thresholds from the discrete-state modelling viewpoint. In doing so, we find it necessary to clarify some fundamental issues germane to the psychometric function (PF), which is customarily constructed using psychophysical methods with a binary-response format. We challenge this response format and argue that response confidence also plays an important role in the construction of PFs, and thus should have some impact on threshold estimation. We motivate the discussion by adopting a three-state threshold theory for response confidence proposed by Krantz (1969, Psychol. Rev., 76, 308–324), which is a modification of Luce's (1963, Psychol. Rev., 70, 61–79) low-threshold theory. In particular, we discuss the case in which the practice of averaging over order (or position) is enforced in data collection. Finally, we illustrate the fit of the Luce–Krantz model to data from a line-discrimination task with response confidence.",0,1 +2318,Temporal shifts in top-down vs. bottom-up control of epiphytic algae in a seagrass ecosystem,"In coastal marine food webs, small invertebrate herbivores (mesograzers) have long been hypothesized to occupy an important position facilitating dominance of habitat-forming macrophytes by grazing competitively superior epiphytic algae. Because of the difficulty of manipulating mesograzers in the field, however, their impacts on community organization have rarely been rigorously documented. Understanding mesograzer impacts has taken on increased urgency in seagrass systems due to declines in seagrasses globally, caused in part by widespread eutrophication favoring seagrass overgrowth by faster-growing algae. Using cage-free field experiments in two seasons (fall and summer), we present experimental confirmation that mesograzer reduction and nutrients can promote blooms of epiphytic algae growing on eelgrass (Zostera marina). In this study, nutrient additions increased epiphytes only in the fall following natural decline of mesograzers. In the summer, experimental mesograzer reduction stimulated a 447% increase in epiphytes, appearing to exacerbate seasonal dieback of eelgrass. Using structural equation modeling, we illuminate the temporal dynamics of complex interactions between macrophytes, mesograzers, and epiphytes in the summer experiment. An unexpected result emerged from investigating the interaction network: drift macroalgae indirectly reduced epiphytes by providing structure for mesograzers, suggesting that the net effect of macroalgae on seagrass depends on macroalgal density. Our results show that mesograzers can control proliferation of epiphytic algae, that top-down and bottom-up forcing are temporally variable, and that the presence of macroalgae can strengthen top-down control of epiphytic algae, potentially contributing to eelgrass persistence.",0,1 +2319,The Achievement Emotions Questionnaire: Validation for Pre-Adolescent Students,"The Achievement Emotions Questionnaire (AEQ) is a self-report instrument developed to measure the emotions of students in academic situations. The main purpose of this research was to adapt and validate this questionnaire to assess pre-adolescents' class- and test-related emotions towards mathematics. The participants were 1515 Portuguese students from grades 5 and 7 (age range 10–13 years). Confirmatory factor analyses and descriptive statistics confirm the reliability and internal validity of the AEQ for Pre-Adolescents (AEQ-PA), providing evidence that the AEQ-PA is an effective instrument to assess pre-adolescent achievement emotions towards mathematics classes and tests.",0,1 +2320,Facilitating the Gibbs Sampler: The Gibbs Stopper and the Griddy-Gibbs Sampler,"Abstract The article briefly reviews the history, literature, and form of the Gibbs sampler. An importance sampling device is proposed for converting the output of the Gibbs sampler to a sample from the exact posterior. This Gibbs stopper technique is also useful for assessing convergence of the Gibbs sampler for moderate sized problems. Also presented is an approach for implementing the Gibbs sampler in nonconjugate situations. The basic idea is to approximate the true cdf of each conditional distribution by a piecewise linear function and then sample from the approximation. Questions relating to the number of nodes in the approximation, gap size between successive nodes, and the treatment of unbounded intervals for a given conditional are discussed. The methodology is illustrated using a genetic linkage model, a nonlinear regression model, and the Cox model.",0,1 +2321,The pursuit of missing information in negotiation,A large body of research has focused on how people exchange and use information during the negotiation process. This work tends to treat information as if it all were readily available upon request. The current research investigated how delays in the pursuit of missing information can influence people's ex-ante priorities and the final settlements they reach. Study 1 found that negotiators achieved more value on an issue after seeking missing information about that issue compared to when the same information was readily accessible. Study 2 found that the effect of searching for information on outcomes was mediated by changes in how important negotiators perceived the issue to be. Theoretical and practical implications are discussed.,0,1 +2322,Job search and employment: A personality-motivational analysis and meta-analytic review.,"A motivational, self-regulatory conceptualization of job search was used to organize and investigate the relationships between personality, expectancies, self, social, motive, and biographical variables and individual differences in job search behavior and employment outcomes. Meta-analytic results indicated that all antecedent variables, except optimism, were significantly related to job search behavior, with estimated population correlations ranging from -.15 to .46. As expected, job search behavior was significantly and positively related to finding employment. Several antecedents of job search were also significantly related to employment success, although the size of these relationships was consistently smaller than those obtained for job search. Moderator analyses showed significant differences in the size of variable relationships for type of job search measure (effort vs. intensity) and sample type (job loser vs. employed job seeker vs. new entrant).",0,1 +2323,Objective Bayesian meta-analysis for sparse discrete data,"This paper presents a Bayesian model for meta-analysis of sparse discrete binomial data, which are out of the scope of the usual hierarchical normal random-effect models. Treatment effectiveness data are often of this type. The crucial linking distribution between the effectiveness conditional on the healthcare center and the unconditional effectiveness is constructed from specific bivariate classes of distributions with given marginals. This assures coherency between the marginal and conditional prior distributions utilized in the analysis. Further, we impose a bivariate class of priors that is able to accommodate a wide range of heterogeneity degrees between the multicenter clinical trials involved. Applications to real multicenter data are given and compared with previous meta-analysis. Copyright © 2014 John Wiley & Sons, Ltd.",0,1 +2324,Complex span versus updating tasks of working memory: The gap is not that deep.,"How to best measure working memory capacity is an issue of ongoing debate. Besides established complex span tasks, which combine short-term memory demands with generally unrelated secondary tasks, there exists a set of paradigms characterized by continuous and simultaneous updating of several items in working memory, such as the n-back, memory updating, or alpha span tasks. With a latent variable analysis (N = 96) based on content-heterogeneous operationalizations of both task families, the authors found a latent correlation between a complex span factor and an updating factor that was not statistically different from unity (r = .96). Moreover, both factors predicted fluid intelligence (reasoning) equally well. The authors conclude that updating tasks measure working memory equally well as complex span tasks. Processes involved in building, maintaining, and updating arbitrary bindings may constitute the common working memory ability underlying performance on reasoning, complex span, and updating tasks.",0,1 +2325,Risk propensity differences between entrepreneurs and managers: A meta-analytic review.,"Research examining the relative risk-taking propensities of entrepreneurs and managers has produced conflicting findings and no consensus, posing an impediment to theory development. To overcome the limitations of narrative reviews, the authors used psychometric meta-analysis to mathematically cumulate the literature concerning risk propensity differences between entrepreneurs and managers. Results indicate that the risk propensity of entrepreneurs is greater than that of managers. Moreover, there are larger differences between entrepreneurs whose primary goal is venture growth versus those whose focus is on producing family income. Results also underscore the importance of precise construct definitions and rigorous measurement.",0,1 +2326,Inference of nested variance components in a longitudinal myopia intervention trial,"This paper was motivated by a double-blind randomized clinical trial of myopia intervention. In addition to the primary goal of comparing treatment effects, we are concerned with the modelling of correlation that may come from two possible sources, one among the longitudinal observations and the other between measurements taken from both eyes per subject. The data are nested repeated measurements. We suggest three models for analysis. Each one expresses the correlation differently in various covariance structures. We articulate their differences and describe the implementations in estimation using commercial statistical software. The computer output can be further utilized to perform model selection with Schwarz criterion. Simulation studies are conducted to evaluate the performance under each model. Data of the myopia intervention trial are reanalysed with these models for illustration. The results indicate that atropine is more effective in reducing the progression rate, the rates are homogeneous across subjects, and, among the suggested models, the one with independent random effects of two eyes fits best. We conclude that model selection is a crucial step before making inference with estimates; otherwise the correlation may be attributed incorrectly to a different mechanism. The same conclusion applies to other variance components as well.",0,1 +2327,Local influence analysis of nonlinear structural equation models,"By regarding the latent random vectors as hypothetical missing data and based on the conditional expectation of the complete-data log-likelihood function in the EM algorithm, we investigate assessment of local influence of various perturbation schemes in a nonlinear structural equation model. The basic building blocks of local influence analysis are computed via observations of the latent variables generated by the Metropolis-Hastings algorithm, while the diagnostic measures are obtained via the conformal normal curvature. Seven perturbation schemes, including some perturbation schemes on latent vectors, are investigated. The proposed procedure is illustrated by a simulation study and a real example. © 2004 The Psychometric Society.",0,1 +2328,The Impact of Misspecifying Class-Specific Residual Variances in Growth Mixture Models,"The purpose of this study was to examine the impact of misspecifying a growth mixture model (GMM) by assuming that Level-1 residual variances are constant across classes, when they do, in fact, vary in each subpopulation. Misspecification produced bias in the within-class growth trajectories and variance components, and estimates were substantially less precise than those obtained from a correctly specified GMM. Bias and precision became worse as the ratio of the largest to smallest Level-1 residual variances increased, class proportions became more disparate, and the number of class-specific residual variances in the population increased. Although the Level-1 residuals are typically of little substantive interest, these results suggest that researchers should carefully estimate and report these parameters in published GMM applications.",0,1 +2329,An Integrated Approach to Evaluating Alternative Risk Prediction Strategies: A Case Study Comparing Alternative Approaches for Preventing Invasive Fungal Disease,"This article proposes an integrated approach to the development, validation, and evaluation of new risk prediction models illustrated with the Fungal Infection Risk Evaluation study, which developed risk models to identify non-neutropenic, critically ill adult patients at high risk of invasive fungal disease (IFD).Our decision-analytical model compared alternative strategies for preventing IFD at up to three clinical decision time points (critical care admission, after 24 hours, and end of day 3), followed with antifungal prophylaxis for those judged ""high"" risk versus ""no formal risk assessment."" We developed prognostic models to predict the risk of IFD before critical care unit discharge, with data from 35,455 admissions to 70 UK adult, critical care units, and validated the models externally. The decision model was populated with positive predictive values and negative predictive values from the best-fitting risk models. We projected lifetime cost-effectiveness and expected value of partial perfect information for groups of parameters.The risk prediction models performed well in internal and external validation. Risk assessment and prophylaxis at the end of day 3 was the most cost-effective strategy at the 2% and 1% risk threshold. Risk assessment at each time point was the most cost-effective strategy at a 0.5% risk threshold. Expected values of partial perfect information were high for positive predictive values or negative predictive values (£11 million-£13 million) and quality-adjusted life-years (£11 million).It is cost-effective to formally assess the risk of IFD for non-neutropenic, critically ill adult patients. This integrated approach to developing and evaluating risk models is useful for informing clinical practice and future research investment.",0,1 +2330,MCMC estimation and some model-fit analysis of multidimensional IRT models,A Bayesian procedure to estimate the three-parameter normal ogive model and a generalization of the procedure to a model with multidimensional ability parameters are presented. The procedure is a generalization of a procedure by Albert (1992) for estimating the two-parameter normal ogive model. The procedure supports analyzing data from multiple populations and incomplete designs. It is shown that restrictions can be imposed on the factor matrix for testing specific hypotheses about the ability structure. The technique is illustrated using simulated and real data.,0,1 +2331,Small-sample adjustments in using the sandwich variance estimator in generalized estimating equations,"The generalized estimating equation (GEE) approach is widely used in regression analyses with correlated response data. Under mild conditions, the resulting regression coefficient estimator is consistent and asymptotically normal with its variance being consistently estimated by the so-called sandwich estimator. Statistical inference is thus accomplished by using the asymptotic Wald chi-squared test. However, it has been noted in the literature that for small samples the sandwich estimator may not perform well and may lead to much inflated type I errors for the Wald chi-squared test. Here we propose using an approximate t- or F-test that takes account of the variability of the sandwich estimator. The level of type I error of the proposed t- or F-test is guaranteed to be no larger than that of the Wald chi-squared test. The satisfactory performance of the proposed new tests is confirmed in a simulation study. Our proposal also has some advantages when compared with other new approaches based on direct modifications of the sandwich estimator, including the one that corrects the downward bias of the sandwich estimator. In addition to hypothesis testing, our result has a clear implication on constructing Wald-type confidence intervals or regions.",0,1 +2332,On seeking moderator variables in the meta-analysis of correlational data: A Monte Carlo investigation of statistical power and resistance to Type I error.,"A series of Monte Carlo computer simulations was conducted to investigate (a) the likelihood that meta-analysis will detect true differences in effect sizes rather than attributing differences to methodological artifact and (b) the likelihood that meta-analysis will suggest the presence of moderator variables when in fact differences in effect sizes are due to methodological artifact. The simulations varied the magnitude of the true population differences between correlations, the number of studies included in the meta-analysis, and the average sample size. Simulations were run both correcting for and not correcting for measurement error. The power of three indexes-the Schmidt-Hunter ratio of expected to observed variance, the Callender-Osburn procedure, and a chi-square test-to detect true differences was investigated. Small true differences will not be detected regardless of sample size and number of studies, and moderate true differences will not be detected with small numbers of studies or small sample sizes. Hence there is a need for caution in attributing observed variation across studies to artifact. © 1986 American Psychological Association.",0,1 +2333,Evaluating Mediation in Longitudinal Multivariate Data: Mediation Effects for the Aban Aya Youth Project Drug Prevention Program,"This study illustrates a method to evaluate mediational mechanisms in a longitudinal prevention trial, the Aban Aya Youth Project (AAYP). In previous studies, interventions of AAYP were found to be effective in reducing the growth of violence, substance use and unsafe sex among African American adolescents. In this article, we hypothesized that the effects of the interventions in reducing the growth of substance use behavior were achieved through their effects in changing intermediate processes such as behavioral intentions, attitudes toward the behavior, estimates of peers' behaviors, best friends' behaviors, and peer group pressure. In evaluating these mediational mechanisms, difficulties arise because the growth trajectories of the substance use outcome variable and some of the mediating variables were curvilinear. In addition, all of the multivariate mediational measures had planned missing data so that a score from the multiple items for a mediator could not be formed easily. In this article, we introduce a latent growth modeling (LGM) approach; namely, a two-domain LGM mediation model, in which the growth curves of the outcome and the mediator are simultaneously modeled and the mediation effects are evaluated. Results showed that the AAYP intervention effects on adolescent drug use were mediated by normative beliefs of prevalence estimates, friends' drug use behavior, perceived friends' encouragement to use, and attitudes toward the behavior. © 2009 Society for Prevention Research.",0,1 +2334,Longitudinal Rasch Modeling in the Context of Psychotherapy Outcomes Assessment,"The present study illustrates an extension of Kamata's (2001) restricted form of the hierarchical generalized linear model that provides a multilevel longitudinal Rasch measurement model appropriate for use with polytomous responses. This extension can be used to assess average and interindividual change in the latent trait of interest, concurrently with an assessment of the invariance of item locations over time. Responses of 1,353 college students to three subscales (namely, measures of depression/ anxiety, stress, and well-being) of the Outcome Questionnaire were used for demonstration purposes. Interpretation of the results is provided, and the benefits of using a multilevel item response theory model with longitudinal data are discussed.",0,1 +2335,Sample Size Limits for Estimating Upper Level Mediation Models Using Multilevel SEM,"This simulation study investigated use of the multilevel structural equation model (MLSEM) for handling measurement error in both mediator and outcome variables (M and Y) in an upper level multilevel mediation model. Mediation and outcome variable indicators were generated with measurement error. Parameter and standard error bias, confidence interval coverage, and power to detect the ab mediated effect using Empirical-M confidence interval estimates were assessed for the correct MLSEM versus a conventional multilevel model (MM) that used composite scores for M and Y. The following conditions were manipulated: level 1 and 2 sample sizes, intraclass correlation, degree of measurement error in M, and the true value of ab. The MLSEM more accurately recovered the ab effect's value, but serious convergence issues were encountered with MLSEM estimates based on fewer than 80 clusters. More power for detecting a nonzero ab was found for MM than for MLSEM estimates.",0,1 +2336,The multiple faces of working memory,"Investigated the distinctiveness of working memory functions and their components against the background of a multi-facet model. 133 university students (mean age 26 years) performed a series of specially constructed working memory tasks. Each task represented an operationalization of specific cells of the proposed taxonomy of working memory functional and content-related facets. Dependent variables included recall performance and reaction time. Structural equation modeling yielded 3 distinct working memory functions: (1) simultaneous storage of information in the context of processing, (2) supervision, and (3) coordination of elements into structures. Further analyses allowed for a more detailed subdivision of each function into specific components. Only a minimal portion of the variance associated with working memory functions is specific to the verbal or the spatial domain. Overall, the findings demonstrate that working memory is best characterized as a highly interrelated collection of cognitive functions.",0,1 +2337,The Influence of Compositional and Contextual Factors on Non-Receipt of Basic Vaccines among Children of 12-23-Month Old in India: A Multilevel Analysis,"Children unreached by vaccination are at higher risk of poor health outcomes and India accounts for nearly a quarter of unvaccinated children worldwide. The objective of this study was to investigate compositional and contextual determinants of non-receipt of childhood vaccines in India using multilevel modelling.We studied characteristics of unvaccinated children using the District Level Health and Facility Survey 3, a nationally representative probability sample containing 65 617 children aged 12-23 months from 34 Indian states and territories. We developed four-level Bayesian binomial regression models to examine the determinants of non-vaccination. The analysis considered two outcomes: completely unvaccinated (CUV) children who had not received any of the eight vaccine doses recommended by India's Universal Immunization Programme, and children who had not received any dose from routine immunisation services (no RI). The no RI category includes CUV children and those who received only polio doses administered via mass campaigns. Overall, 4.83% (95% CI: 4.62-5.06) of children were CUV while 12.01% (11.68-12.35) had received no RI. Individual compositional factors strongly associated with CUV were: non-receipt of tetanus immunisation for mothers during pregnancy (OR = 3.65 [95% CrI: 3.30-4.02]), poorest household wealth index (OR = 2.44 [1.81-3.22] no maternal schooling (OR = 2.43 [1.41-4.05]) and no paternal schooling (OR = 1.83 [1.30-2.48]). In rural settings, the influence of maternal illiteracy disappeared whereas the role of household wealth index was reinforced. Factors associated with no RI were similar to those for CUV, but effect sizes for individual compositional factors were generally larger. Low maternal education was the strongest risk factor associated with no RI in all models. All multilevel models found significant variability at community, district, and state levels net of compositional factors.Non-vaccination in India is strongly related to compositional characteristics and is geographically distinct. Tailored strategies are required to overcome current barriers to immunisation.",0,1 +2338,Conjoint Analysis in Consumer Research: Issues and Outlook,Since 1971 conjoint analysis has been applied to a wide variety of problems in consumer research. This paper discusses various issues involved in implementing conjoint analysis and describes some new technical developments and application areas for the methodology.,0,1 +2339,Latent Variable Interaction Modeling,Latent variable interaction modeling with continuous observed variables is presented using 2 different approaches. The 1st approach analyzes data using a LISREL 8.30 program where the latent interaction variable is defined by multiplying pairs of observed variables. The 2nd approach analyzes data using PRELIS2 and SIMPLIS programs where the latent interaction variable is defined by multiplying the latent variable scores of the exogeneous latent independent variables. The programs used to create the multivariate normal observed variables and conduct the analyses for the 2 different approaches are given in the appendixes. The product indicant and latent variable score approach produced similar gamma coefficients in their hypothesized models but differed in their standard errors for the gamma coefficients. The latent variable score approach holds the promise of being easier to implement and can be applied to more complex latent variable interaction models.,0,1 +2340,Slope bias of psychometric functions derived from adaptive data,"Several investigators have fit psychometric functions to data from adaptive procedures for threshold estimation. Although the threshold estimates are in general quite correct, one encounters a slope bias that has not been explained up to now. The present paper demonstrates slope bias for parametric and nonparametric maximum-likelihood fits and for Spearman-Kärber analysis of adaptive data. The examples include staircase and stochastic approximation procedures. The paper then presents an explanation of slope bias based on serial data dependency in adaptive procedures. Data dependency is first illustrated with simple two-trial examples and then extended to realistic adaptive procedures. Finally, the paper presents an adaptive staircase procedure designed to measure threshold and slope directly. In contrast to classical adaptive threshold-only procedures, this procedure varies both a threshold and a spread parameter in response to double trials.",0,1 +2341,A Primer for Using and Understanding Weights With National Datasets,"Using data from the National Study of Postsecondary Faculty and the Early Childhood Longitudinal Study—Kindergarten Class of 1998-99, the author provides guidelines for incorporating weights and design effects in single-level analysis using Windows-based SPSS and AM software. Examples of analyses that do and do not employ weights and design effects are also provided to illuminate the differential results of key parameter estimates and standard errors using varying degrees of using or not using the weighting and design effect continuum. The author gives recommendations on the most appropriate weighting options, with specific reference to employing a strategy to accommodate both oversampled groups and cluster sampling (i.e., using weights and design effects) that leads to the most accurate parameter estimates and the decreased potential of committing a Type I error. However, using a design effect adjusted weight in SPSS may produce underestimated standard errors when compared with accurate estimates produce...",0,1 +2342,"Psychometric Models, Test Designs and Item Types for the Next Generation of Educational and Psychological Tests",,0,1 +2343,The Bilevel Reticular Action Model for Path Analysis with Latent Variables,"A two-level (hierarchical) model for path analysis with latent variables is described, together with some properties of a computer program written to implement the model. A simple illustrative example is given.",0,1 +2344,A Semiparametric Approach to Modeling Nonlinear Relations Among Latent Variables,"To date, finite mixtures of structural equation models (SEMMs) have been developed and applied almost exclusively for the purpose of providing model-based cluster analyses. This type of analysis constitutes a direct application of the model wherein the estimated component distributions of the latent classes are thought to represent the characteristics of distinct unobserved subgroups of the population. This article instead considers an indirect application of the SEMM in which the latent classes are estimated only in the service of more flexibly modeling the characteristics of the aggregate population as a whole. More specifically, the SEMM is used to semiparametrically model nonlinear latent variable regression functions. This approach is first developed analytically and then demonstrated empirically through analyses of simulated and real data.",0,1 +2345,The influence of professional athlete philanthropy on donation intentions,"Athlete-supported charities and foundations have become increasingly popular forms of philanthropy in the professional sport landscape. However, a paucity of research has examined whether the high-profile status of a professional athlete can influence third-party donations to the charitable cause the athlete supports. Based on theory and prior literature, the image of, and identification with, a professional National Basketball Association athlete were hypothesized to influence donation intentions from potential donors in the Orlando, Florida area. In addition, the intervening effects of personal involvement with the athlete's cause and trust toward the athlete were examined. The results suggest that athlete identification, image of the athlete, trust toward the athlete, and cause involvement significantly influenced donation intentions. The results also indicate that athlete trust mediated the relationship between identification, image, and donation intentions. Finally, cause involvement moderated the re...",0,1 +2346,Alternative Methods for Assessing Mediation in Multilevel Data: The Advantages of Multilevel SEM,"Multilevel modeling (MLM) is a popular way of assessing mediation effects with clustered data. Two important limitations of this approach have been identified in prior research and a theoretical rationale has been provided for why multilevel structural equation modeling (MSEM) should be preferred. However, to date, no empirical evidence of MSEM's advantages relative to MLM approaches for multilevel mediation analysis has been provided. Nor has it been demonstrated that MSEM performs adequately for mediation analysis in an absolute sense. This study addresses these gaps and finds that the MSEM method outperforms 2 MLM-based techniques in 2-level models in terms of bias and confidence interval coverage while displaying adequate efficiency, convergence rates, and power under a variety of conditions. Simulation results support prior theoretical work regarding the advantages of MSEM over MLM for mediation in clustered data.",0,1 +2347,Categorization as nonparametric Bayesian density estimation,"Abstract The authors apply the state of the art techniques from machine learning and statistics to reconceptualize the problem of unsupervised category learning, and to relate it to previous psychologically motivated models, especially Anderson's rational analysis of categorization. The resulting analysis provides a deeper understanding of the motivations underlying the classic models of category representation, based on prototypes or exemplars, as well as shedding new light on the empirical data. Exemplar models assume that a category is represented by a set of stored exemplars, and categorizing new stimuli involves comparing these stimuli to the set of exemplars in each category. Prototype models assume that a category is associated with a single prototype and categorization involves comparing new stimuli to these prototypes. These approaches to category learning correspond to different strategies for density estimation used in statistics, being nonparametric and parametric density estimation respectively.",0,1 +2348,Analysis of Nonlinear Patterns of Change with Random Coefficient Models,"Abstract Nonlinear patterns of change arise frequently in the analysis of repeated measures from longitudinal studies in psychology. The main feature of nonlinear development is that change is more rapid in some periods than in others. There generally also are strong individual differences, so although there is a general similarity of patterns for different persons over time, individuals exhibit substantial heterogeneity in their particular response. To describe data of this kind, researchers have extended the random coefficient model to accommodate nonlinear trajectories of change. It can often produce a statistically satisfying account of subject-specific development. In this review we describe and illustrate the main ideas of the nonlinear random coefficient model with concrete examples.",0,1 +2349,Approaches for Empirical Bayes Confidence Intervals,"Abstract Parametric empirical Bayes (EB) methods of point estimation date to the landmark paper by James and Stein (1961). Interval estimation through parametric empirical Bayes techniques has a somewhat shorter history, which was summarized by Laird and Louis (1987). In the exchangeable case, one obtains a “naive” EB confidence interval by simply taking appropriate percentiles of the estimated posterior distribution of the parameter, where the estimation of the prior parameters (“hyperparameters”) is accomplished through the marginal distribution of the data. Unfortunately, these “naive” intervals tend to be too short, since they fail to account for the variability in the estimation of the hyperparameters. That is, they do not attain the desired coverage probability in the EB sense defined by Morris (1983a, b). They also provide no statement of conditional calibration (Rubin 1984). In this article we propose a conditional bias correction method for developing EM intervals that corrects these deficiencies...",0,1 +2350,Testing for monotone increasing hazard rate,"A test of the null hypothesis that a hazard rate is monotone nondecreasing, versus the alternative that it is not, is proposed. Both the test statistic and the means of calibrating it are new. Unlike previous approaches, neither is based on the assumption that the null distribution is exponential. Instead, empirical information is used to effectively identify and eliminate from further consideration parts of the line where the hazard rate is clearly increasing; and to confine subsequent attention only to those parts that remain. This produces a test with greater apparent power, without the excessive conservatism of exponential-based tests. Our approach to calibration borrows from ideas used in certain tests for unimodality of a density, in that a bandwidth is increased until a distribution with the desired properties is obtained. However, the test statistic does not involve any smoothing, and is, in fact, based directly on an assessment of convexity of the distribution function, using the conventional empirical distribution. The test is shown to have optimal power properties in difficult cases, where it is called upon to detect a small departure, in the form of a bump, from monotonicity. More general theoretical properties of the test and its numerical performance are explored.",0,1 +2351,Maximum likelihood estimation via the ECM algorithm: A general framework,"Two major reasons for the popularity of the EM algorithm are that its maximum step involves only complete-data maximum likelihood estimation, which is often computationally simple, and that its convergence is stable, with each iteration increasing the likelihood. When the associated complete-data maximum likelihood estimation itself is complicated, EM is less attractive because the M-step is computationally unattractive. In many cases, however, complete-data maximum likelihood estimation is relatively simple when conditional on some function of the parameters being estimated",0,1 +2352,Evaluating Small Sample Approaches for Model Test Statistics in Structural Equation Modeling,"Through Monte Carlo simulation, small sample methods for evaluating overall data-model fit in structural equation modeling were explored. Type I error behavior and power were examined using maximum likelihood (ML), Satorra-Bentler scaled and adjusted (SB; Satorra & Bentler, 1988, 1994), residual-based (Browne, 1984), and asymptotically distribution free (ADF; Browne, 1982, 1984) test statistics. To accommodate small sample sizes the ML and SB statistics were adjusted using a k-factor correction (Bartlett, 1950); the residual-based and ADF statistics were corrected using modified x2 and F statistics (Yuan & Bentler, 1998, 1999). Design characteristics include model type and complexity, ratio of sample size to number of estimated parameters, and distributional form. The k-factor-corrected SB scaled test statistic was especially stable at small sample sizes with both normal and nonnormal data. Methodologists are encouraged to investigate its behavior under a wider variety of models and distributional forms.",0,1 +2353,Eliciting Donor Preferences,"Most charity organizations depend on contributions from the general public, but little research is conducted on donor preferences. Do donors have geographical, recipient, or thematic preferences? We designed a conjoint analysis experiment in which people rated development aid projects by donating money in dictator games. We find that our sample show strong age, gender, regional, and thematic preferences. Furthermore, we find significant differences between segments. The differences in donations are consistent with differences in donors’ attitudes toward development aid and their beliefs about differences in poverty and vulnerability of the recipients. The method here used for development projects can easily be adapted to elicit preferences for other kinds of projects that rely on gifts from private donors.",0,1 +2354,Statistical mediation analysis with a multicategorical independent variable,"Virtually all discussions and applications of statistical mediation analysis have been based on the condition that the independent variable is dichotomous or continuous, even though investigators frequently are interested in testing mediation hypotheses involving a multicategorical independent variable (such as two or more experimental conditions relative to a control group). We provide a tutorial illustrating an approach to estimation of and inference about direct, indirect, and total effects in statistical mediation analysis with a multicategorical independent variable. The approach is mathematically equivalent to analysis of (co)variance and reproduces the observed and adjusted group means while also generating effects having simple interpretations. Supplementary material available online includes extensions to this approach and Mplus, SPSS, and SAS code that implements it.",0,1 +2355,Bayesian Hierarchical Modeling and the Integration of Heterogeneous Information on the Effectiveness of Cardiovascular Therapies,"When making therapeutic decisions for an individual patient or formulating treatment guidelines on a population level, it is often necessary to utilize information arising from different study designs, settings, or treatments. In clinical practice, heterogeneous information is frequently synthesized qualitatively, whereas in comparative effectiveness research and guideline development, it is imperative that heterogeneous data are integrated quantitatively and in a manner that accurately captures the true uncertainty in the results. Bayesian hierarchical modeling is a technique that utilizes all available information from multiple sources and naturally yields a revised estimate of the treatment effect associated with each source. A hierarchical model consists of multiple levels (ie, a hierarchy) of probability distributions that represent relationships between information arising within single populations or trials, as well as relationships between information arising from different populations or trials. We describe the structure of Bayesian hierarchical models and discuss their advantages over simpler models when multiple information sources are relevant. Two examples are presented that illustrate this technique: a meta-analysis of immunosuppressive therapy in idiopathic dilated cardiomyopathy and a subgroup analysis of the National Institute of Neurological Disorders and Stroke Intravenous Tissue Plasminogen Activator Stroke Trial.",0,1 +2356,Non-Hierarchical Multilevel Models,"In the models discussed in this book so far we have assumed that the structures of the populations from which the data have been drawn are hierarchical. This assumption is sometimes not justified. In this chapter two main types of non-hierarchical model are considered. Firstly, cross-classified models. The notion of cross-classification is probably reasonably familiar to most readers. Secondly, we consider multiple membership models, where lower level units are influenced by more than one higher-level unit from the same classification. For example, some pupils may attend more than one school. We also consider situations that contain a mixture of hierarchical, crossed and multiple membership relationships. © 2008 Springer Science+Business Media, LLC.",0,1 +2357,The Random-Threshold Generalized Unfolding Model and Its Application of Computerized Adaptive Testing,"The random-threshold generalized unfolding model (RTGUM) was developed by treating the thresholds in the generalized unfolding model as random effects rather than fixed effects to account for the subjective nature of the selection of categories in Likert items. The parameters of the new model can be estimated with the JAGS (Just Another Gibbs Sampler) freeware, which adopts a Bayesian approach for estimation. A series of simulations was conducted to evaluate the parameter recovery of the new model and the consequences of ignoring the randomness in thresholds. The results showed that the parameters of RTGUM were recovered fairly well and that ignoring the randomness in thresholds led to biased estimates. Computerized adaptive testing was also implemented on RTGUM, where the Fisher information criterion was used for item selection and the maximum a posteriori method was used for ability estimation. The simulation study showed that the longer the test length, the smaller the randomness in thresholds, and the more categories in an item, the more precise the ability estimates would be.",0,1 +2358,Likelihood-based and Bayesian methods for Tweedie compound Poisson linear mixed models,"The Tweedie compound Poisson distribution is a subclass of the exponential dispersion family with a power variance function, in which the value of the power index lies in the interval (1,2). It is well known that the Tweedie compound Poisson density function is not analytically tractable, and numerical procedures that allow the density to be accurately and fast evaluated did not appear until fairly recently. Unsurprisingly, there has been little statistical literature devoted to full maximum likelihood inference for Tweedie compound Poisson mixed models. To date, the focus has been on estimation methods in the quasi-likelihood framework. Further, Tweedie compound Poisson mixed models involve an unknown variance function, which has a significant impact on hypothesis tests and predictive uncertainty measures. The estimation of the unknown variance function is thus of independent interest in many applications. However, quasi-likelihood-based methods are not well suited to this task. This paper presents several likelihood-based inferential methods for the Tweedie compound Poisson mixed model that enable estimation of the variance function from the data. These algorithms include the likelihood approximation method, in which both the integral over the random effects and the compound Poisson density function are evaluated numerically; and the latent variable approach, in which maximum likelihood estimation is carried out via the Monte Carlo EM algorithm, without the need for approximating the density function. In addition, we derive the corresponding Markov Chain Monte Carlo algorithm for a Bayesian formulation of the mixed model. We demonstrate the use of the various methods through a numerical example, and conduct an array of simulation studies to evaluate the statistical properties of the proposed estimators. © 2012 Springer Science+Business Media, LLC.",0,1 +2359,Bayesian meta-analytical methods to incorporate multiple surrogate endpoints in drug development process,"A number of meta-analytical methods have been proposed that aim to evaluate surrogate endpoints. Bivariate meta-analytical methods can be used to predict the treatment effect for the final outcome from the treatment effect estimate measured on the surrogate endpoint while taking into account the uncertainty around the effect estimate for the surrogate endpoint. In this paper, extensions to multivariate models are developed aiming to include multiple surrogate endpoints with the potential benefit of reducing the uncertainty when making predictions. In this Bayesian multivariate meta-analytic framework, the between-study variability is modelled in a formulation of a product of normal univariate distributions. This formulation is particularly convenient for including multiple surrogate endpoints and flexible for modelling the outcomes which can be surrogate endpoints to the final outcome and potentially to one another. Two models are proposed, first, using an unstructured between-study covariance matrix by assuming the treatment effects on all outcomes are correlated and second, using a structured between-study covariance matrix by assuming treatment effects on some of the outcomes are conditionally independent. While the two models are developed for the summary data on a study level, the individual-level association is taken into account by the use of the Prentice's criteria (obtained from individual patient data) to inform the within study correlations in the models. The modelling techniques are investigated using an example in relapsing remitting multiple sclerosis where the disability worsening is the final outcome, while relapse rate and MRI lesions are potential surrogates to the disability progression.",0,1 +2360,The development of alcohol use and outcome expectancies among American Indian young adults: A growth mixture model,"Adolescence is an important developmental period for understanding alcohol use. American Indian youth are a group for whom various preventive interventions focusing on alcohol use have been implemented but have not necessarily been widely successful, highlighting the need to further refine our approaches. In the work reported here, we followed 464 14- to 18-year-old American Indian youth annually for seven years. We examined the development of alcohol use and positive alcohol outcome expectancies in parallel, using growth mixture modeling to identify classes with different trajectories of alcohol use and expectancies. We found five classes; the largest (n = 198) was made up of youth who experienced increases in both alcohol use and positive outcome expectancies. Initial levels of outcome expectancies were related to subsequent changes in alcohol use, while the reverse was not true, suggesting that interventions focusing on outcome expectancies are appropriate for a substantial number of youth. However, class heterogeneity in the relationships between the two processes pointed out that changes in expectancies may not always precede changes in alcohol use. Thus, intervention design implications are discussed for the class structures.",0,1 +2361,An improved approximation to the precision of fixed effects from restricted maximum likelihood,"An approximate small sample variance estimator for fixed effects from the multivariate normal linear model, together with appropriate inference tools based on a scaled F pivot, is now well established in practice and there is a growing literature on its properties in a variety of settings. Although effective under linear covariance structures, there are examples of nonlinear structures for which it does not perform as well. The cause of this problem is shown to be a missing term in the underlying Taylor series expansion which accommodates the bias in the estimators of the parameters of the covariance structure. The form of this missing term is derived, and then used to adjust the small sample variance estimator. The behaviour of the resulting estimator is explored in terms of invariance under transformation of the covariance parameters and also using a simulation study. It is seen to perform successfully in the way predicted from its derivation.",0,1 +2362,Multilevel Models,"This book covers a broad range of topics about multilevel modeling. The goal is to help readersto understand the basic concepts, theoretical frameworks, and application methods of multilevel modeling. Itis at a level also accessible to non-mathematicians, focusing on the methods and applications of various multilevel models and using the widely used statistical software SAS.Examples are drawn from analysis of real-world research data. © 2012 Higher Education Press and Walter de Gruyter GmbH & Co. KG, Berlin/Boston.",0,1 +2363,Distinguishing Between Cross- and Cluster-Level Mediation Processes in the Cluster Randomized Trial,"For the cluster randomized trial, the treatment, implemented at the cluster level, may be hypothesized to impact a final outcome of interest via a mediating variable, with the mediator and outcome being measured typically at the participant level. Two opposing views—one that allows the mediation process to flow through a participant-level mediator and one that does not—have been presented in the literature. We integrate these perspectives and argue that it is the theoretical model and the nature of the mediating variable that determines whether the treatment effect may be mediated by a participant-level or only a cluster-level mediator in this design. An accompanying simulation study shows that when the mediation process is unnecessarily restricted to the cluster level, the power to detect the presence of mediation is substantially reduced.",0,1 +2364,Time changes with feeling of speed: an embodied perspective,"The speed of moving stimuli can bias duration perception. Here, we investigated whether words describing different speeds influence subjective duration estimation in a temporal bisection task. Duration estimations of two different types of speed words (fast- vs. slow-speed words) were compared. We found that the time bisection point was significantly lower for fast-speed words than for slow-speed words, suggesting that the durations of fast-speed words were overestimated compared to the slow-speed words. In contrast, fast- and slow-speed words did not significantly differ in just noticeable differences and Weber fractions, indicating that the types of speed words did not influence the sensitivity of duration estimation. These results provide new evidence to support the theory of embodied cognition in the context of implicit meaning of a speed word.",0,1 +2365,A time-lagged momentary assessment study on daily life physical activity and affect.,"Novel study designs using within-subject methodology and frequent and prospective measurements are required to unravel direction of causality and dynamic processes of behavior over time. The current study examined the effects of physical activity on affective state. A primary and within-study replication sample was derived from twin pairs.Female twins (n = 504) participated in an experience sampling method study at baseline. Positive and negative affective changes were examined before and following daily life increases in physical activity. Neuroticism was measured at baseline and depressive symptoms were assessed at baseline and at each of four follow-up assessments. Diagnoses, derived by Structured Clinical Interview for Diagnostic and Statistical Manual for Mental Health-IV axis I disorders, (A. P. A., 1994) were obtained at baseline.A significant increase in positive affect (PA) following the moment of increase in physical activity was replicated across both samples up to 180 min after physical activity. There was no effect of physical activity on negative affect (NA). Across the two samples, a history of fulfilling diagnostic criteria for depression at least once moderated the effect of physical activity on PA, in that the effect was lost more rapidly.The study supports a causal effect of physical activity on PA. However, people with past experience of clinical depression may benefit less from the PA-inducing effect of physical activity. These findings have implications for the use of physical exercise in clinical practice.",0,1 +2366,A Review of Inference Procedures for the Intraclass Correlation Coefficient in the One-Way Random Effects Model,"Summary Recent theory and methodology for inferences concerning the intraclass correlation coefficient are reviewed, under the assumption of an underlying random effects model. Topics discussed include point and interval estimation, significance-testing for nonzero values of the intraclass correlation, and inference procedures in multiple samples.",0,1 +2367,On a Class of Shrinkage Priors for Covariance Matrix Estimation,"We propose a flexible class of models based on scale mixture of uniform distributions to construct shrinkage priors for covariance matrix estimation. This new class of priors enjoys a number of advantages over the traditional scale mixture of normal priors, including its simplicity and flexibility in characterizing the prior density. We also exhibit a simple, easy to implement Gibbs sampler for posterior simulation which leads to efficient estimation in high dimensional problems. We first discuss the theory and computational details of this new approach and then extend the basic model to a new class of multivariate conditional autoregressive models for analyzing multivariate areal data. The proposed spatial model flexibly characterizes both the spatial and the outcome correlation structures at an appealing computational cost. Examples consisting of both synthetic and real-world data show the utility of this new framework in terms of robust estimation as well as improved predictive performance.",0,1 +2368,Effects of Calibration Sample Size and Item Bank Size on Ability Estimation in Computerized Adaptive Testing,"This study aimed to investigate the effects of calibration sample size and item bank size on examinee ability estimation in computerized adaptive testing (CAT). For this purpose, a 500-item bank pre-calibrated using the three-parameter logistic model with 10,000 examinees was simulated. Calibration samples of varying sizes (150, 250, 350, 500, 750, 1,000, 2,000, 3,000, and 5,000) were selected from the parent sample, and item banks that represented small (100) and medium size (200 and 300) banks were drawn from the 500-item bank. Items in these banks were recalibrated using the drawn samples, and their estimated parameters were used in post-hoc simulations to re-estimate ability parameters for the simulated 10,000 examinees. The findings showed that ability estimates in CAT are robust against fluctuations in item parameter estimation and that accurate ability parameter estimates can be obtained with a calibration sample of 150 examinees. Moreover, a 200-item bank pre-calibrated with as few as 150 examinees can be used for some purposes in CAT as long as it has sufficient information at targeted ability levels.",0,1 +2369,Dynamic Shifts of Limited Working Memory Resources in Human Vision,"Our ability to remember what we have seen is very limited. Most current views characterize this limit as a fixed number of items—only four objects—that can be held in visual working memory. We show that visual memory capacity is not fixed by the number of objects, but rather is a limited resource that is shared out dynamically between all items in the visual scene. This resource can be shifted flexibly between objects, with allocation biased by selective attention and toward targets of upcoming eye movements. The proportion of resources allocated to each item determines the precision with which it is remembered, a relation that we show is governed by a simple power law, allowing quantitative estimates of resource distribution in a scene.",0,1 +2370,Structural Equation Modeling in Marketing: Some Practical Reminders,"The authors review issues related to the application of structural equation modeling (SEM) in marketing. The discussion begins by considering issues related to the process of applying SEM in empirical research, including model specification, identification, estimation, evaluation, and respecification, and reporting of results. In addition to these process issues, a number of other issues, such as formulation of multiple theoretical models, model error versus sampling error, and relating study objectives to the capabilities of SEM, are considered, and suggestions offered regarding ways that SEM applications might be improved.",0,1 +2371,Differential attentional modulation of cortical responses to S-cone and luminance stimuli,"Neural signals driven by short-wave-sensitive (S) cones are, to a large degree, anatomically and functionally separate from the achromatic luminance pathway until at least one synapse into V1. Attentional mechanisms that act at an anatomically early stage in V1 may, therefore, affect S-cone and luminance signals differently. Here, we used a steady-state visually evoked potential (SSVEP) paradigm combined with electrical source imaging to study the effects of contrast and attention on neural responses to both chromatic S-cone isolating and achromatic stimuli in five human visual areas including V1. The responses to these gratings were affected very differently by changes in contrast and attention. Increasing cone contrast increased the response amplitude for both types of stimulus. For the S-cone-defined stimuli, we also observed a systematic decrease in the response phase of the first harmonic with increasing stimulus contrast, but there was no corresponding change in phase for the first harmonic of the luminance probes. Attending to the contrast of the grating increased the amplitude and phase of luminance-driven responses but had no effect on S-cone-driven responses. We conclude that while attentional modulation can be observed in achromatic pathways as early as V1, attention may not affect SSVEP signals generated by S-cone stimuli.",0,1 +2372,How to Improve Teaching Practices,"Purpose: Although it is expected that building schoolwide capacity for teacher learning will improve teaching practices, there is little systematic evidence to support this claim. This study aimed to examine the relative impact of transformational leadership practices, school organizational conditions, teacher motivational factors, and teacher learning on teaching practices. Research Design: Data were collected from a survey of 502 teachers from 32 elementary schools in the Netherlands. A structural model was tested on the within-school covariance matrix and a chi-square test taking into account nonindependence of observations. Findings: Results suggest that teachers’ engagement in professional learning activities, in particular experimenting and reflection, is a powerful predictor for teaching practices. Teachers’ sense of self-efficacy appeared to be the most important motivational factor for explaining teacher learning and teaching practices. Motivational factors also mediate the effects of school organizational conditions and leadership practices on teacher learning and teaching practices. Finally, transformational leadership practices stimulate teachers’ professional learning and motivation and improve school organizational conditions. Conclusions: For school leaders, to foster teacher learning and improve teaching practices a combination of transformational leadership behaviors is required. Further research is needed to examine the relative effects of transformational leadership dimensions on school organizational conditions, teacher motivation, and professional learning in schools. Finally, conditions for school improvement were examined at one point in time. Longitudinal studies to school improvement are required to model changes in schools’ capacities and growth and their subsequent effects on teaching practices.",0,1 +2373,POSTERIOR PREDICTIVE ASSESSMENT OF MODEL FITNESS VIA REALIZED DISCREPANCIES,"This paper considers Bayesian counterparts of the classical tests for good- ness of fit and their use in judging the fit of a single Bayesian model to the observed data. We focus on posterior predictive assessment, in a framework that also includes conditioning on auxiliary statistics. The Bayesian formulation facilitates the con- struction and calculation of a meaningful reference distribution not only for any (classical) statistic, but also for any parameter-dependent statistic or discrep- ancy. The latter allows us to propose the realized discrepancy assessment of model fitness, which directly measures the true discrepancy between data and the posited model, for any aspect of the model which we want to explore. The computation required for the realized discrepancy assessment is a straightforward byproduct of the posterior simulation used for the original Bayesian analysis. We illustrate with three applied examples. The first example, which serves mainly to motivate the work, illustrates the difficulty of classical tests in assessing the fitness of a Poisson model to a positron emission tomography image that is constrained to be nonnegative. The second and third examples illustrate the details of the posterior predictive approach in two problems: estimation in a model with inequality constraints on the parameters, and estimation in a mixture model. In all three examples, standard test statistics (either a χ 2 or a likelihood ratio) are not pivotal: the difficulty is not just how to compute the reference distribution for the test, but that in the classical framework no such distribution exists, independent of the unknown model parameters.",0,1 +2374,Temporal Associations Among Chronic PTSD Symptoms in U.S. Combat Veterans,"The present study examined fluctuation over time in symptoms of posttraumatic stress disorder (PTSD) among 34 combat veterans (28 with diagnosed PTSD, 6 with subclinical symptoms) assessed every 2 weeks for up to 2 years (range of assessments = 13-52). Temporal relationships were examined among four PTSD symptom clusters (reexperiencing, avoidance, emotional numbing, and hyperarousal) with particular attention to the influence of hyperarousal. Multilevel cross-lagged random coefficients autoregression for intensive time series data analyses were used to model symptom fluctuation decades after combat experiences. As anticipated, hyperarousal predicted subsequent fluctuations in the 3 other PTSD symptom clusters (reexperiencing, avoidance, emotional numbing) at subsequent 2-week intervals (rs = .45, .36, and .40, respectively). Additionally, emotional numbing influenced later reexperiencing and avoidance, and reexperiencing influenced later hyperarousal (rs = .44, .40, and .34, respectively). These findings underscore the important influence of hyperarousal. Furthermore, results indicate a bidirectional relationship between hyperarousal and reexperiencing as well as a possible chaining of symptoms (hyperarousal → emotional numbing → reexperiencing → hyperarousal) and establish potential internal, intrapersonal mechanisms for the maintenance of persistent PTSD symptoms. Results suggested that clinical interventions targeting hyperarousal and emotional numbing symptoms may hold promise for PTSD of long duration.",0,1 +2375,A Model for Optimal Constrained Adaptive Testing,"A model for constrained computerized adaptive testing is proposed in which the information in the test at the trait level (0) estimate is maximized subject to a number of possible constraints on the content of the test. At each item-selection step, a full test is assembled to have maximum information at the current 0 estimate, fixing the items already administered. Then the item with maximum in-formation is selected. All test assembly is optimal because a linear programming (LP) model is used that automatically updates to allow for the attributes of the items already administered and the new value of the 0 estimator. The LP model also guarantees that each adaptive test always meets the entire set of constraints. A simulation study using a bank of 753 items from the Law School Admission Test showed that the 0 estimator for adaptive tests of realistic lengths did not suffer any loss of efficiency from the presence of 433 constraints on the item selection process.",0,1 +2376,Separation of individual-level and cluster-level covariate effects in regression analysis of correlated data,"The focus of this paper is regression analysis of clustered data. Although the presence of intracluster correlation (the tendency for items within a cluster to respond alike) is typically viewed as an obstacle to good inference, the complex structure of clustered data offers significant analytic advantages over independent data. One key advantage is the ability to separate effects at the individual (or item-specific) level and the group (or cluster-specific) level. We review different approaches for the separation of individual-level and cluster-level effects on response, their appropriate interpretation and give recommendations for model fitting based on the intent of the data analyst. Unlike many earlier papers on this topic, we place particular emphasis on the interpretation of the cluster-level covariate effect. The main ideas of the paper are highlighted in an analysis of the relationship between birth weight and IQ using sibling data from a large birth cohort study.",0,1 +2377,Testing for Second-Order Stochastic Dominance of Two Distributions,"A distribution function F is said to stochastically dominate another distribution function G in the second-order sense if , for all x . Second-order stochastic dominance plays an important role in economics, finance, and accounting. Here a statistical test has been constructed to test , for some x ∈ [ a , b ], against the hypothesis , for all x ∈ [ a , b ], where a and b are any two real numbers. The test has been shown to be consistent and has an upper bound α on the asymptotic size. The test is expected to have usefulness for comparison of random prospects for risk averters.",0,1 +2378,Authors' Reply,,0,1 +2379,Modelling clustered data in autobiographical memory research: the multilevel approach,"Much memory research involves recording several autobiographical memories for each of several people. These memories are not independent of each other, an assumption of the statistical procedures used in many cognitive psychology papers. In recent years there have been both statistical and computational advances for modelling these hierarchical data structures. This is often called multilevel modelling. Using data from recent memory research (Burt et al., 1995), I describe this approach and show how it compares favourably with traditional approaches. © 1998 John Wiley & Sons, Ltd.",0,1 +2380,Comparison of inference methods of genetic parameters with an application to body weight in broilers,"Abstract. REML (restricted maximum likelihood) has become the standard method of variance component estimation in animal breeding. Inference in Bayesian animal models is typically based upon Markov chain Monte Carlo (MCMC) methods, which are generally flexible but time-consuming. Recently, a new Bayesian computational method, integrated nested Laplace approximation (INLA), has been introduced for making fast non-sampling-based Bayesian inference for hierarchical latent Gaussian models. This paper is concerned with the comparison of estimates provided by three representative programs (ASReml, WinBUGS and the R package AnimalINLA) of the corresponding methods (REML, MCMC and INLA), with a view to their applicability for the typical animal breeder. Gaussian and binary as well as simulated data were used to assess the relative efficiency of the methods. Analysis of 2319 records of body weight at 35 days of age from a broiler line suggested a purely additive animal model, in which the heritability estimates ranged from 0.31 to 0.34 for the Gaussian trait and from 0.19 to 0.36 for the binary trait, depending on the estimation method. Although in need of further development, AnimalINLA seems a fast program for Bayesian modeling, particularly suitable for the inference of Gaussian traits, while WinBUGS appeared to successfully accommodate a complicated structure between the random effects. However, ASReml remains the best practical choice for the serious animal breeder.",0,1 +2381,An introduction to Bayesian hierarchical models with an application in the theory of signal detection,"Although many nonlinear models of cognition have been proposed in the past 50 years, there has been little consideration of corresponding statistical techniques for their analysis. In analyses with nonlinear models, unmodeled variability from the selection of items or participants may lead to asymptotically biased estimation. This asymptotic bias, in turn, renders inference problematic. We show, for example, that a signal detection analysis of recognition memory data leads to asymptotic underestimation of sensitivity. To eliminate asymptotic bias, we advocate hierarchical models in which participant variability, item variability, and measurement error are modeled simultaneously. By accounting for multiple sources of variability, hierarchical models yield consistent and accurate estimates of participant and item effects in recognition memory. This article is written in tutorial format; we provide an introduction to Bayesian statistics, hierarchical modeling, and Markov chain Monte Carlo computational techniques.",0,1 +2382,Advances in Analysis of Mean and Covariance Structure when Data are Incomplete,"Missing data arise in many areas of empirical research. One such area is in the context of structural equation models (SEM). A review is presented of the methodological advances in fitting data to SEM and, more generally, to mean and covariance structure models when there is missing data. This encompasses common missing data mechanisms and some widely used methods for handling missing data. The methods fall under the classifications of ad-hoc, likelihood-based, and simulation-based. Also included are the results of some of the published simulation studies. In order to encourage further research, a method is proposed for performing sensitivity analysis, which up to now has been seemingly lacking. A simulation study was done to demonstrate the method using a three-factor factor analysis model, focusing on MCAR and MNAR data. Parameter estimates from samples of all available data, in the form of box plots, are compared with parameter estimates from only the complete data. The results indicate a possible distinction for determining missing data mechanisms.",0,1 +2383,"Felt Security in Daily Interactions as a Mediator of the Effect of Attachment on Relationship Satisfaction†Some of the Results Reported in this Article Were Previously Presented at the Annual Meeting of the Society for Interpersonal Theory and Research in Montreal, Canada (May 2012).","This study examined how felt security in interpersonal situations with one's romantic partner mediated the effect of global (dispositional) attachment on relationship satisfaction. Felt security was measured using an event–contingent recording (ECR) methodology with a sample of 93 cohabiting couples who reported their social interactions with each other during a 20–day period. Global attachment was measured at the beginning of the ECR procedure. Relationship satisfaction was measured at the end of the ECR procedure (T1) and approximately 7 months after the ECR procedure (T2). Results confirmed the established links between attachment and relationship satisfaction such that higher attachment avoidance and attachment anxiety were associated with decline in satisfaction over time. Results also indicated that attachment avoidance but not attachment anxiety was negatively related to felt security, both within–partner and across–partners. As expected, lower felt security exerted a negative effect on relationship satisfaction at T1 and T2, and partly mediated the effect of attachment avoidance on relationship satisfaction at T1 and T2, both within–partner and across–partners. Partners’ gender emerged as a moderator of these results. Findings suggest higher attachment avoidance leads to less felt security in daily social interactions, which leads to less satisfaction with the romantic relationship. Copyright © 2015 European Association of Personality Psychology",0,1 +2384,Lower Level Mediation Effect Analysis in Two-Level Studies: A Note on a Multilevel Structural Equation Modeling Approach,"This article presents a didactic discussion of a multilevel covariance structure modeling approach to estimation of lowest level mediation effect indexes in two-level studies. The procedure is useful when addressing questions about relations among total and indirect effects between variables of interest while accounting for the hierarchical structure of analyzed data. The discussed method also permits interval estimation and hypothesis tests with respect to related quantities of relevance when evaluating mediated effects with clustered data, and is illustrated on a two-level data set.",0,1 +2385,Bias correction in generalised linear mixed models with a single component of dispersion,"SUMMARY General expressions are derived for the asymptotic biases in three approximate estimators of regression coefficients and variance component, for small values of the variance component, in generalised linear mixed models with canonical link function and a single source of extraneous variation. The estimators involve first and second order Laplace expansions of the integrated likelihood and a related procedure known as penalised quasilikelihood. Numerical studies of a series of matched pairs of binary outcomes show that the first order estimators of the variance component are seriously biased. Easily computed correction factors produce satisfactory estimators of small variance components, comparable to those obtained with a second order Laplace expansion, and markedly improve the asymptotic performance for larger values. For a series of matched pairs of binomial observations, the variance correction factors rapidly approach one as the binomial denominators increase. These results greatly extend the range of parameter values for which the approximate estimation procedures have satisfactory asymptotic properties.",0,1 +2386,Estimating the safety effects of lane widths on urban streets in Nebraska using the propensity scores-potential outcomes framework,"A sufficient understanding of the safety impact of lane widths in urban areas is necessary to produce geometric designs that optimize safety performance for all users. The overarching trend found in the research literature is that as lane widths narrow, crash frequency increases. However, this trend is inconsistent and is the result of multiple cross-sectional studies that have issues related to lack of control for potential confounding variables, unobserved heterogeneity or omitted variable bias, or endogeneity among independent variables, among others. Using ten years of mid-block crash data on urban arterials and collectors from four cities in Nebraska, crash modification factors (CMFs) were estimated for various lane widths and crash types. These CMFs were developed using the propensity scores-potential outcomes methodology. This method reduces many of the issues associated with cross-sectional regression models when estimating the safety effects of infrastructure-related design features. Generalized boosting, a non-parametric modeling technique, was used to estimate the propensity scores. Matching was performed using both Nearest Neighbor and Mahalanobis matching techniques. CMF estimation was done using mixed-effects negative binomial or Poisson regression with the matched data. Lane widths included in the analysis included 9ft, 10ft, 11ft, and 12ft. Some of the estimated CMFs were point estimates while others were functions of traffic volume (i.e., the CMF changed depending on the traffic volume). Roadways with 10ft travel lanes were found to experience the highest crash frequency relative to other lane widths. Meanwhile, roads with 9ft travel lanes were found to experience the lowest relative crash frequency. While this may be due to increased driver caution when traveling on narrow lanes, it is possible that unobserved factors influenced this result. CMFs for target crash types (sideswipe same-direction and sideswipe opposite-direction) were consistent with the values currently used in the Highway Safety Manual (HSM).",0,1 +2387,Tables of the Studentized Maximum Modulus Distribution and an Application to Multiple Comparisons Among Means,"Tables of the upper α-points m α; k*, v of the studentized maximum modulus distribution with parameter k* and v degrees of freedom are given for α = .01, .05, 10, and .20, twelve values 01 V, and k* = k(k − 1)/2 for k = 3(1)20. The tables are of use in applying Hochberg's GT2-Method [6] of multiple comparison and extend the use of this method to cases with k ≤ 20 means. As conjectured in [15]. the GT2-Method is in almost all cases the strongest of several competitors of Spodtvoll and Stoline's T′-Method [11] for carrying out the set of k* pairwise comparisons between the means of k groups with arbitrary sample sizes. The auxiliary tables of [15], in which the T′-Method and other procedures are compared, are extended here. These tables should aid the user in choosing between the T′ and GT2-Methods. The results of the comparisons continue to support the fact that the T-Method is preferred if the unbalance of the sample sizes is slight and that T becomes a stronger competitor as α increases.",0,1 +2388,"Systemic administration of CNI-1493, a p38 mitogen-activated protein kinase inhibitor, blocks intrathecal human immunodeficiency virus-1 gp120-induced enhanced pain states in rats","Intrathecal administration of the human immunodeficiency virus-1 envelope glycoprotein, gp120, activates astrocytes and microglia to release products that induce thermal hyperalgesia and mechanical allodynia. Both pain states are disrupted by intrathecal CNI-1493, a p38 mitogen-activated protein (MAP) kinase inhibitor. Whether CNI-1493, or any other p38 MAP kinase inhibitor, can cross the blood-brain barrier to affect spinal cord function is unknown. Given that several such drugs are in clinical trials, it is of interest to determine whether they may be potentially useful in treating centrally mediated pain. The aim of the present studies was to determine whether systemic CNI-1493 could block intrathecal gp120-induced thermal hyperalgesia and/or mechanical allodynia. Because p38 MAP kinase inhibition would be expected to prevent proinflammatory cytokine release and/or signal transduction, we sought to determine from the same animals the likely mechanism by which CNI-1493 blocks gp120-induced pain states. These studies show that systemic CNI-1493 blocks intrathecal gp120-induced thermal hyperalgesia and mechanical allodynia. Because CNI-1493 did not block proinflammatory cytokine release, this may suggest disruption at the level of signal transduction. These studies provide the first evidence that systemic p38 MAP kinase inhibitors can prevent centrally mediated exaggerated pain states. Thus, CNI-1493 may provide a novel therapeutic approach for the treatment of pain.",0,1 +2389,Balanced versus unbalanced designs for linear structural relations in two-level data,"A general two-level model for multivariate data is described and illustrated by specializations to a common factor model and a path model with latent variables. The problem of estimation is treated, and in the special case of a balanced sampling design, a likelihood-based discrepancy function and a test of goodness of fit are obtained in terms of some simple sufficient statistics.",0,1 +2390,Environmental Philanthropy and Environmental Behavior in Five Countries: Is There Convergence Among Youth?,"This paper compares and contrasts environmental philanthropy, environmental behavior, and their determinants among university students in five countries: Canada, Germany, Israel, South Korea, and the United States. The paper’s unique contribution to the nonprofit literature is its focus on environmental philanthropy as an unexplored form of philanthropic behavior, and the ability to test environmental philanthropy in an international setting and in comparison to other modes of environmental behavior. By environmental philanthropy, we mean giving to, and volunteering in, various environmental non-governmental organizations, and by environmental behavior, we refer to daily behaviors in the private sphere with ecological implications. We hypothesize that although the five countries vary on several characteristics, the student populations who are young, educated, and exposed to global ideas and norms will be relatively similar to each other in their environmental and philanthropic behavior and in the determinants of such behavior. To test this hypothesis, a standardized questionnaire was administered to 8,477 students on five campuses. Results show significant differences between students in their environmental philanthropic behavior, as well as in the demographic and attitudinal determinants of such behaviors. © 2014, International Society for Third-Sector Research and The Johns Hopkins University.",0,1 +2391,Discovering objects and their location in images,"We seek to discover the object categories depicted in a set of unlabelled images. We achieve this using a model developed in the statistical text literature: probabilistic latent semantic analysis (pLSA). In text analysis, this is used to discover topics in a corpus using the bag-of-words document representation. Here we treat object categories as topics, so that an image containing instances of several categories is modeled as a mixture of topics. The model is applied to images by using a visual analogue of a word, formed by vector quantizing SIFT-like region descriptors. The topic discovery approach successfully translates to the visual domain: for a small set of objects, we show that both the object categories and their approximate spatial layout are found without supervision. Performance of this unsupervised method is compared to the supervised approach of Fergus et al. (2003) on a set of unseen images containing only one object per image. We also extend the bag-of-words vocabulary to include 'doublets' which encode spatially local co-occurring regions. It is demonstrated that this extended vocabulary gives a cleaner image segmentation. Finally, the classification and segmentation methods are applied to a set of images containing multiple objects per image. These results demonstrate that we can successfully build object class models from an unsupervised analysis of images.",0,1 +2392,DLs in reminder and 2AFC tasks: Data and models,"García-Pérez and Alcalá-Quintana (2010) dispute the conclusion of Lapid, Ulrich, and Rammsayer (2008) that the two-alternative forced choice (2AFC) task yields meaningfully larger estimates of the difference limen (DL) than does the reminder task. García-Pérez and Alcalá-Quintana overlook, however, fundamental properties of 2AFC psychometric functions and Type B order errors in their reanalysis. In addition, their favored theory (i.e., the difference model with guessing) does not provide a plausible account for why the 2AFC task tends to yield larger DLs (by about 50%) than does the reminder task. In trying to clarify these issues, I hope to advance the proper assessment of discrimination performance in 2AFC tasks.",0,1 +2393,Confidence Intervals vs Bayesian Intervals,"For many years, statistics textbooks have followed this ‘canonical’ procedure: (1) the reader is warned not to use the discredited methods of Bayes and Laplace, (2) an orthodox method is extolled as superior and applied to a few simple problems, (3) the corresponding Bayesian solutions are not worked out or described in any way. The net result is that no evidence whatsoever is offered to substantiate the claim of superiority of the orthodox method.",0,1 +2394,Using a Bayesian latent growth curve model to identify trajectories of positive affect and negative events following myocardial infarction,"Positive and negative affect data are often collected over time in psychiatric care settings, yet no generally accepted means are available to relate these data to useful diagnoses or treatments. Latent class analysis attempts data reduction by classifying subjects into one of K unobserved classes based on observed data. Latent class models have recently been extended to accommodate longitudinally observed data. We extend these approaches in a Bayesian framework to accommodate trajectories of both continuous and discrete data. We consider whether latent class models might be used to distinguish patients on the basis of trajectories of observed affect scores, reported events, and presence or absence of clinical depression.",0,1 +2395,Cultural Consensus Theory,,0,1 +2396,Comparison of Two Procedures for Analyzing Small Sets of Repeated Measures Data,"This article compares two methods for analyzing small sets of repeated measures data under normal and non-normal heteroscedastic conditions: a mixed model approach with the Kenward-Roger correction and a multivariate extension of the modified Brown-Forsythe (BF) test. These procedures differ in their assumptions about the covariance structure of the data and in the method of estimation of the parameters defining the mean structure. Simulation results show that the BF test outperformed its competitor, in terms of Type I errors, particularly when the total sample size was small, and the data were normally distributed. Under non-normal distributions the BF test tended to err on the side of conservatism. Results also indicate that neither method was uniformly more powerful. With very few exceptions, the power differences between these two methods depended on the population covariance structure, the nature of the pairing of covariance matrices and group sizes, and the relationship between mean vectors and dispersion matrices.",0,1 +2397,Generalized Linear Models with Random Effects; Salamander Mating Revisited,"In recent years much effort has been devoted to extending regression methodology to non-Gaussian data, where responses are not independent. These methods for dependent responses are suitable for data from longitudinal studies or nested designs. However, use of these methods for crossed designs seems to have serious limitations due to the intensive computations involved because of the intractable nature of the joint distribution. In this paper, we cast the problem in a Bayesian framework and use a Monte Carlo method, the Gibbs sampler, to avoid current computational limitations. The flexibility of this approach is illustrated by analyzing the interesting salamander mating data reported by McCullagh and Nelder (1989, Generalized Linear Models, 2nd edition, London: Chapman and Hall).",0,1 +2398,A Bayesian framework for word segmentation: Exploring the effects of context,"Since the experiments of Saffran et al. [Saffran, J., Aslin, R., & Newport, E. (1996). Statistical learning in 8-month-old infants. Science, 274, 1926-1928], there has been a great deal of interest in the question of how statistical regularities in the speech stream might be used by infants to begin to identify individual words. In this work, we use computational modeling to explore the effects of different assumptions the learner might make regarding the nature of words--in particular, how these assumptions affect the kinds of words that are segmented from a corpus of transcribed child-directed speech. We develop several models within a Bayesian ideal observer framework, and use them to examine the consequences of assuming either that words are independent units, or units that help to predict other units. We show through empirical and theoretical results that the assumption of independence causes the learner to undersegment the corpus, with many two- and three-word sequences (e.g. what's that, do you, in the house) misidentified as individual words. In contrast, when the learner assumes that words are predictive, the resulting segmentation is far more accurate. These results indicate that taking context into account is important for a statistical word segmentation strategy to be successful, and raise the possibility that even young infants may be able to exploit more subtle statistical patterns than have usually been considered.",0,1 +2399,The glial modulatory drug AV411 attenuates mechanical allodynia in rat models of neuropathic pain,"Abstract Controlling neuropathic pain is an unmet medical need and we set out to identify new therapeutic candidates. AV411 (ibudilast) is a relatively nonselective phosphodiesterase inhibitor that also suppresses glial-cell activation and can partition into the CNS. Recent data strongly implicate activated glial cells in the spinal cord in the development and maintenance of neuropathic pain. We hypothesized that AV411 might be effective in the treatment of neuropathic pain and, hence, tested whether it attenuates the mechanical allodynia induced in rats by chronic constriction injury (CCI) of the sciatic nerve, spinal nerve ligation (SNL) and the chemotherapeutic paclitaxel (Taxol ¯ ). Twice-daily systemic administration of AV411 for multiple days resulted in a sustained attenuation of CCI-induced allodynia. Reversal of allodynia was of similar magnitude to that observed with gabapentin and enhanced efficacy was observed in combination. We further show that multi-day AV411 reduces SNL-induced allodynia, and reverses and prevents paclitaxel-induced allodynia. Also, AV411 cotreatment attenuates tolerance to morphine in nerve-injured rats. Safety pharmacology, pharmacokinetic and initial mechanistic analyses were also performed. Overall, the results indicate that AV411 is effective in diverse models of neuropathic pain and support further exploration of its potential as a therapeutic agent for the treatment of neuropathic pain.",0,1 +2400,An Introduction to Empirical Bayes Data Analysis,"Abstract Empirical Bayes methods have been shown to be powerful data-analysis tools in recent years. The empirical Bayes model is much richer than either the classical or the ordinary Bayes model and often provides superior estimates of parameters. An introduction to some empirical Bayes methods is given, and these methods are illustrated with two examples.",0,1 +2401,Improved estimation of the covariance matrix of stock returns with an application to portfolio selection,"This paper proposes to estimate the covariance matrix of stock returns by an optimally weighted average of two existing estimators: the sample covariance matrix and single-index covariance matrix. This method is generally known as shrinkage, and it is standard in decision theory and in empirical Bayesian statistics. Our shrinkage estimator can be seen as a way to account for extra-market covariance without having to specify an arbitrary multi-factor structure. For NYSE and AMEX stock returns from 1972 to 1995, it can be used to select portfolios with significantly lower out-of-sample variance than a set of existing estimators, including multi-factor models.",0,1 +2402,Order-Constrained Bayes Inference for Dichotomous Models of Unidimensional Nonparametric IRT,"This study introduces an order-constrained Bayes inference framework useful for analyzing data containing dichotomous-scored item responses, under the assumptions of either the monotone homogeneity model or the double monotonicity model of nonparametric item response theory (NIRT). The framework involves the implementation of Gibbs sampling to estimate order-constrained parameters, followed by inference with the posterior-predictive distribution to test the monotonicity, invariant item ordering, and local independence assumptions of NIRT. The Bayes framework is demonstrated through the analysis of real test data, and possible extensions of it are discussed.",0,1 +2403,A feature-integration theory of attention,"A new hypothesis about the role of focused attention is proposed. The feature-integration theory of attention suggests that attention must be directed serially to each stimulus in a display whenever conjunctions of more than one separable feature are needed to characterize or distinguish the possible objects presented. A number of predictions were tested in a variety of paradigms including visual search, texture segregation, identification and localization, and using both separable dimensions (shape and color) and local elements or parts of figures (lines, curves, etc. in letters) as the features to be integrated into complex wholes. The results were in general consistent with the hypothesis. They offer a new set of criteria for distinguishing separable from integral features and a new rationale for predicting which tasks will show attention limits and which will not.",0,1 +2404,"A Flexible, Efficient Binomial Mixed Model for Identifying Differential DNA Methylation in Bisulfite Sequencing Data","Identifying sources of variation in DNA methylation levels is important for understanding gene regulation. Recently, bisulfite sequencing has become a popular tool for investigating DNA methylation levels. However, modeling bisulfite sequencing data is complicated by dramatic variation in coverage across sites and individual samples, and because of the computational challenges of controlling for genetic covariance in count data. To address these challenges, we present a binomial mixed model and an efficient, sampling-based algorithm (MACAU: Mixed model association for count data via data augmentation) for approximate parameter estimation and p-value computation. This framework allows us to simultaneously account for both the over-dispersed, count-based nature of bisulfite sequencing data, as well as genetic relatedness among individuals. Using simulations and two real data sets (whole genome bisulfite sequencing (WGBS) data from Arabidopsis thaliana and reduced representation bisulfite sequencing (RRBS) data from baboons), we show that our method provides well-calibrated test statistics in the presence of population structure. Further, it improves power to detect differentially methylated sites: in the RRBS data set, MACAU detected 1.6-fold more age-associated CpG sites than a beta-binomial model (the next best approach). Changes in these sites are consistent with known age-related shifts in DNA methylation levels, and are enriched near genes that are differentially expressed with age in the same population. Taken together, our results indicate that MACAU is an efficient, effective tool for analyzing bisulfite sequencing data, with particular salience to analyses of structured populations. MACAU is freely available at www.xzlab.org/software.html.",0,1 +2405,Shrinkage estimators for large covariance matrices in multivariate real and complex normal distributions under an invariant quadratic loss,"The problem of estimating large covariance matrices of multivariate real normal and complex normal distributions is considered when the dimension of the variables is larger than the number of samples. The Stein–Haff identities and calculus on eigenstructure for singular Wishart matrices are developed for real and complex cases, respectively. By using these techniques, the unbiased risk estimates for certain classes of estimators for the population covariance matrices under invariant quadratic loss functions are obtained for real and complex cases, respectively. Based on the unbiased risk estimates, shrinkage estimators which are counterparts of the estimators due to Haff [L.R. Haff, Empirical Bayes estimation of the multivariate normal covariance matrix, Ann. Statist. 8 (1980) 586–697] are shown to improve upon the best scalar multiple of the empirical covariance matrix under the invariant quadratic loss functions for both real and complex multivariate normal distributions in the situation where the dimension of the variables is larger than the number of samples.",0,1 +2406,A dynamic factor model for the analysis of multivariate time series,"As a method to ascertain the structure of intra-individual variation, P-technique has met difficulties in the handling of a lagged covariance structure. A new statistical technique, coined dynamic factor analysis, is proposed, which accounts for the entire lagged covariance function of an arbitrary second order stationary time series. Moreover, dynamic factor analysis is shown to be applicable to a relatively short stretch of observations and therefore is considered worthwhile for psychological research. At several places the argumentation is clarified through the use of examples. © 1985 The Psychometric Society.",0,1 +2407,High-Dimensional Multivariate Probit Analysis,"A computationally practical form of probit analysis for multiple response variables based on an assumed common factor model for the latent tolerances is proposed. Numerical integration over the factor space provides maximum likelihood estimation of the probit regression parameters and of the probabilities of response combinations under the model. The procedure is applied to five variables from the Pneumoconiosis Field Trial, two variables of which were previously analyzed by Ashford and Sowden (1970, Biometrics 26, 535-546).",0,1 +2408,Illustration of Bayesian Inference in Normal Data Models Using Gibbs Sampling,"Abstract The use of the Gibbs sampler as a method for calculating Bayesian marginal posterior and predictive densities is reviewed and illustrated with a range of normal data models, including variance components, unordered and ordered means, hierarchical growth curves, and missing data in a crossover trial. In all cases the approach is straightforward to specify distributionally and to implement computationally, with output readily adapted for required inference summaries.",0,1 +2409,Adequacy of approximations to distributions of test statistics in complex mixed linear models,"A recent study of lady beetle antennae was a small sample repeated measures design involving a complex covariance structure. Distributions of test statistics based on mixed models fitted to such data are unknown, but two recently developed methods for approximating the distributions of test statistics in mixed linear models have been included as options in the latest release of the MIXED procedure of SAS®. One method (FC, from Fai and Cornelius) computes degrees of freedom of an approximating F distribution for the test statistic using spectral decomposition of the hypothesis matrix together with repeated application of a method for single-degree-of-freedom tests. The other method (KR, from Kenward and Roger) adjusts the estimated covariance matrix of the parameter estimates, computes a scale adjustment to the test statistic, and computes the degrees of freedom of an approximating F distribution. Using the two methods, p values for a hypothesis of interest in the lady beetle study were quite different. Simulation studies on the Proc MIXED implementation of these methods showed that Type I error rates of both methods are affected by covariance structure complexity, sample size, and imbalance. Nonetheless, the KR method performs well in situations with fairly complicated covariance structures when sample sizes are moderate to small and the design is reasonably balanced. The KR method should be used in preference to the FC method, although it had inflated Type I error rates for complex covariance structures combined with small sample sizes. © 2002 American Statistical Association and the International Biometric Society.",0,1 +2410,Methods for meta-analysis in genetic association studies: a review of their potential and pitfalls,"Meta-analysis offers the opportunity to combine evidence from retrospectively accumulated or prospectively generated data. Meta-analyses may provide summary estimates and can help in detecting and addressing potential inconsistency between the combined datasets. Application of meta-analysis in genetic associations presents considerable potential and several pitfalls. In this review, we present basic principles of meta-analytic methods, adapted for human genome epidemiology. We describe issues that arise in the retrospective or the prospective collection of relevant data through various sources, common traps to consider in the appraisal of evidence and potential biases that may interfere. We describe the relative merits and caveats for common methods used to trace inconsistency across studies along with possible reasons for non-replication of proposed associations. Different statistical models may be employed to combine data and some common misconceptions may arise in the process. Several meta-analysis diagnostics are often applied or misapplied in the literature, and we comment on their use and limitations. An alternative to overcome limitations arising from retrospective combination of data from published studies is to create networks of research teams working in the same field and perform collaborative meta-analyses of individual participant data, ideally on a prospective basis. We discuss the advantages and the challenges inherent in such collaborative approaches. Meta-analysis can be a useful tool in dissecting the genetics of complex diseases and traits, provided its methods are properly applied and interpreted. © Springer-Verlag 2007.",0,1 +2411,Marketing models of consumer heterogeneity,"The distribution of consumer preferences plays a central role in many marketing activities. Pricing and product design decisions, for example, are based on an understanding of the differences among consumers in price sensitivity and valuation of product attributes. In addition, marketing activities which target specific households require household level parameter estimates. Thus, the modeling of consumer heterogeneity is the central focus of many statistical marketing applications. In contrast, heterogeneity is often regarded as an ancillary nuisance problem in much of the applied econometrics literature which must be dealt with but is not the focus of the investigation. The focus is instead on estimating average effects of policy variables. In this paper, we discuss various approaches to modeling consumer heterogeneity and evaluate the utility of these approaches for marketing applications.",0,1 +2412,P Values for Composite Null Models,,0,1 +2413,Objective Bayesian Analysis of Geometrically Anisotropic Spatial Data,"Anisotropic models are often used in spatial statistics to analyze spatially referenced data. Within a Bayesian framework we develop default priors for the anisotropic Gaussian random field model with and without including a nugget parameter accounting for the effects of microscale variations and measurement errors. We present Jeffreys priors and a reference prior and study their posterior propriety. Moreover, we obtain that the predictive distributions at ungauged locations have finite variance. We also show that the seemingly uninformative uniform prior for the anisotropy parameters, ratio and angle, yields an improper posterior. Finally, we find that the proposed priors have good frequentist properties and we illustrate our approach by analyzing two data sets for which we discuss model choice as well as predictions and uncertainty estimates. © 2013 International Biometric Society.",0,1 +2414,A cross-validity comparison of rating-based and choice-based conjoint analysis models,"Abstract This paper compares OLS, hierarchical Bayes (HB), and latent segment, rating-based conjoint models to HB and latent segment choice-based conjoint models. The biggest systematic difference between rating- and choice-based parameters is consistent with a compatibility effect. This leads to a stronger prominence effect for rating-based models. The HB rating-based model has the highest hit rate and choice share validations and the OLS model has the second highest. Within both rating- and choice-based models, hierarchical Bayes models have higher hit rate and choice share validations than latent segment models. Using a choice simulator, the profiles predicted to be optimal with an HB choice-based model are similar to those predicted to be optimal with an HB rating-based model.",0,1 +2415,Markov Chain Monte Carlo Maximum Likelihood,"http://conservancy.umn.edu/handle/11299/58440 Markov chain Monte Carlo (e. g., the Metropolis algorithm and Gibbs sampler) is a general tool for simulation of complex stochastic processes useful in many types of statistical inference. The basics of Markov chain Monte Carlo are reviewed, including choice of algorithms and variance estimation, and some new methods are introduced. The use of Markov chain Monte Carlo for maximum likelihood estimation is explained, and its performance is compared with maximum pseudo likelihood estimation.",0,1 +2416,Using the general linear mixed model to analyse unbalanced repeated measures and longitudinal data,"The general linear mixed model provides a useful approach for analysing a wide variety of data structures which practising statisticians often encounter. Two such data structures which can be problematic to analyse are unbalanced repeated measures data and longitudinal data. Owing to recent advances in methods and software, the mixed model analysis is now readily available to data analysts. The model is similar in many respects to ordinary multiple regression, but because it allows correlation between the observations, it requires additional work to specify models and to assess goodness-of-fit. The extra complexity involved is compensated for by the additional flexibility it provides in model fitting. The purpose of this tutorial is to provide readers with a sufficient introduction to the theory to understand the method and a more extensive discussion of model fitting and checking in order to provide guidelines for its use. We provide two detailed case studies, one a clinical trial with repeated measures and dropouts, and one an epidemiological survey with longitudinal follow-up.",0,1 +2417,The effectiveness and safety of treatments used for acute diarrhea and acute gastroenteritis in children: protocol for a systematic review and network meta-analysis,"Acute diarrhea and acute gastroenteritis (AD/AGE) are common among children in low- and middle-income countries (LMIC) and high-income countries (HIC). Supportive therapy including maintaining feeding, prevention of dehydration, and use of oral rehydration solution (ORS), is the mainstay of treatment in all children. Several additional treatments aiming to reduce the episode duration have been compared to placebo, but the differences in effectiveness among them are unknown.We will conduct a systematic review of all randomized controlled trials evaluating the use of zinc, vitamin A, probiotics, prebiotics, synbiotics, racecadotril, smectite, and fermented and lactose-free milk/formula for AD/AGE treatment in children. The primary outcomes are diarrhea duration and mortality. Secondary outcomes are diarrhea lasting 3 or 7 days, stool frequency, treatment failure, hospitalizations, and adverse events. We will search MEDLINE, Ovid EMBASE, CINAHL, the Cochrane Central Register of Controlled Trials (CENTRAL), and LILACS through Ovid, as well as grey literature resources. Two reviewers will independently screen titles and abstracts, review full texts, extract information, and assess the risk of bias (ROB) and the confidence in the estimate (with the grading of recommendations, assessment, development, and evaluation [GRADE] approach). Results will be summarized narratively and statistically. Subgroup analysis according to HIC vs. LMIC, age, nutrition status, and ROB is planned. We will perform a Bayesian network meta-analysis to combine the pooled direct and indirect treatment effect estimates for each outcome, if adequate data is available.This is the first systematic review and network meta-analysis that aims to determine the relative effectiveness of pharmacological and nutritional treatments for reducing the duration of AD/AGE in children. The results will help to reduce the uncertainty of the effectiveness of the interventions, find knowledge gaps, and/or encourage further research for other therapeutic options.PROSPERO registration number: CRD42015023778.",0,1 +2418,A note on A. Albert and J. A. Anderson's conditions for the existence of maximum likelihood estimates in logistic regression models,"SUMMARY This note expands the paper by Albert & Anderson (1984) on the existence and uniqueness of maximum likelihood estimates in logistic regression models. Their three possible mutually exclusive data pattems: (i) overlap, (ii) complete separation, and (iii) quasiseparation are considered. The maximum likelihood estimate exists only in (i). Modifications of the statement and proofs of Albert & Anderson's results are given for (ii) and (iii). The identifiability for a more general model arising in the study of (iii) is discussed together with the maximization of the corresponding likelihood. A linear program is presented which determines whether data is of type (i), (ii) or (iii), and in the case of (iii) identifies Albert & Anderson's minimal set Qm.",0,1 +2419,A Use of the Information Function in Tailored Testing,"Several important and useful implications in latent trait theory, with direct implications for individualized adaptive or tailored testing, are pointed out. A way of using the information function in tailored testing in connection with the standard error of estimation of the ability level using maximum likelihood estimation is suggested. It is emphasized that the standard error of estimation should be considered as the major index of dependability, as opposed to the reliability of a test. The concept of weak parallel forms is expanded to testing procedures in which different sets of items are presented to different examinees. Examples are given. Researchers have tended to use latent trait theory rather than classical test theory in research on individualized adaptive or tailored testing. This is quite natural, since latent trait theory has definite merits over classical test theory in many crucial matters. Because of the lack of opportunities to really learn the theory, however, these researchers tend to overlook some important implications in latent trait theory. As a result, its full use has not yet materialized. Not only are information functions seldom used to maximum advantage, but also those who have tried to use latent trait theory still use some popular concepts in classical test theory, such as reliability. expanded to testing procedures in which different sets of items are presented to different examinees. Examples are given. In this paper, the author points out some important implications in latent trait theory which are not fully understood and appreciated among researchers, and gives some practical suggestions for its use",0,1 +2420,Secondary Education Systems and the General Skills of Less- and Intermediate-educated Adults,"We investigate the impact of external differentiation and vocational orientation of (lower and upper) secondary education on country variation in the mean numeracy skills of, and skills gaps between, adults with low and intermediate formal qualifications. We use data on 30- to 44-year-olds in 18 countries from the 2011–12 round of the Program for the International Assessment of Adult Competencies. We find that higher levels of external differentiation (tracking) amplify skills gaps between less- and intermediate-educated adults. This is mainly due to lower mean skills achievement of less-educated adults. By contrast, greater emphasis on vocational skills in upper-secondary education is positively related to numeracy skills for both less- and intermediate-educated adults. Gains are larger for the less educated, so the gap in numeracy skills tends to fall with the degree of vocational orientation. We discuss implications of our findings for research on educational and labor market inequalities.",0,1 +2421,Trying to be precise about vagueness,"A previous investigation by Lambert et al., which used computer simulation to examine the influence of choice of prior distribution on inferences from Bayesian random effects meta-analysis, is critically examined from a number of viewpoints. The practical example used is shown to be problematic. The various prior distributions are shown to be unreasonable in terms of what they imply about the joint distribution of the overall treatment effect and the random effects variance. An alternative form of prior distribution is tentatively proposed. Finally, some practical recommendations are made that stress the value both of fixed effect analyses and of frequentist approaches as well as various diagnostic investigations.",0,1 +2422,Bayes factors: Prior sensitivity and model generalizability,"Model selection is a central issue in mathematical psychology. One useful criterion for model selection is generalizability; that is, the chosen model should yield the best predictions for future data. Some researchers in psychology have proposed that the Bayes factor can be used for assessing model generalizability. An alternative method, known as the generalization criterion, has also been proposed for the same purpose. We argue that these two methods address different levels of model generalizability (local and global), and will often produce divergent conclusions. We illustrate this divergence by applying the Bayes factor and the generalization criterion to a comparison of retention functions. The application of alternative model selection criteria will also be demonstrated within the framework of model generalizability.",0,1 +2423,Implementing MCMC,"The reversible jump Markov chain Monte Carlo (MCMC) sampler (Green, 1995) provides a general framework for Markov chain Monte Carlo simulation in which the dimension of the parameter space can vary between iterates of the Markov chain. The reversible jump sampler can be viewed as an extension of the Metropolis-Hastings algorithm onto more general state spaces. To understand this in a Bayesian modeling context, suppose that for observed data x wehavea countable collectionof candidatemodelsM = {M1,M2, . . .} indexedbyaparameter k ∈ K. The index k can be considered as an auxiliarymodel indicator variable, such thatMk′ denotes themodel where k = k′. EachmodelMk has an nk-dimensional vector of unknown parameters, θk ∈ Rnk , where nk can take different values for different models k ∈ K. The joint posterior distribution of (k, θk) given observed data, x, is obtained as the product of the likelihood, L(x | k, θk), and the joint prior, p(k, θk) = p(θk | k)p(k), constructed from the prior distribution of θk under model Mk , and the prior for the model indicator k (i.e. the prior for model Mk). Hence, the joint posterior isπ(k, θk | x) = L(x | k, θk)p(θk | k)p(k)∑ k′∈K∫ R nk′ L(x | k′, θ′k′)p(θ′k′ | k′)p(k′)dθ′k′. (3.1)The reversible jump algorithm uses the joint posterior distribution in Equation 3.1 as the target of an MCMC sampler over the state space Θ = ⋃k∈K({k} × Rnk ), where the states of the Markov chain are of the form (k, θk), the dimension of which can vary over the state space. Accordingly, from the output of a single Markov chain sampler, the user is able to obtain a full probabilistic description of the posterior probabilities of each model having observed the data, x, in addition to the posterior distributions of the individual models. This chapter aims to provide an overview of the reversible jump sampler. Wewill outlinethe sampler’s theoretical underpinnings, present the latest and most popular techniques for enhancing algorithmperformance, and discuss the analysis of sampler output. Through the use of numerous worked examples it is hoped that the reader will gain a broad appreciation of the issues involved in multi-model simulation, and the confidence to implement reversible jump samplers in the course of their own studies.",0,1 +2424,Generalized Robust Conjoint Estimation,"We introduce methods from statistical learning theory to the field of conjoint analysis for preference modeling. We present a method for estimating preference models that can be highly nonlinear and robust to noise. Like recently developed polyhedral methods for conjoint analysis, our method is based on computationally efficient optimization techniques. We compare our method with standard logistic regression, hierarchical Bayes, and the polyhedral methods using standard, widely used simulation data. The experiments show that the proposed method handles noise significantly better than both logistic regression and the recent polyhedral methods and is never worse than the best method among the three mentioned above. It can also be used for estimating nonlinearities in preference models faster and better than all other methods. Finally, a simple extension for handling heterogeneity shows promising results relative to hierarchical Bayes. The proposed method can therefore be useful, for example, for analyzing large amounts of data that are noisy or for estimating interactions among product features.",0,1 +2425,A Hierarchical Model for Studying School Effects,"When researchers investigate how school policies, practices, or climates affect student outcomes, they use multilevel, hierarchical data. Though methodologists have consistently warned of the formidable inferential problems such data pose for traditional statistical methods, no comprehensive alternative analytic strategy has been available. This paper presents a general statistical methodology for such hierarchically structured data and illustrates its use by reexamining the High School and Beyond data and the controversy over the effectiveness of public and Catholic schools. The model enables the researcher to utilize mean achievement and certain structural parameters that characterize the equity in the social distribution of achievement as multivariate outcomes for each school. Variation in these school-level outcomes is then explained as a function of school characteristics.",0,1 +2426,Performance of Empirical Bayes Estimators of Level-2 Random Parameters in Multilevel Analysis: A Monte Carlo Study for Longitudinal Designs,"Multilevel analysis is a useful technique for analyzing longitudinal data. To describe a person’s development across time, the quality of the estimates of the random coefficients, which relate time to individual changes in a relevant dependent variable, is of importance. The present study compares three estimators of the random coefficients: the Bayes estimator (BE), the empirical Bayes estimator (EBE), and the ordinary least squares estimator (OLSE). Using MLwiN, Monte Carlo simulations are carried out to study the performance of the estimators, while systematically varying the size of the sample as well as the number of measurement occasions. First, we examine for normally distributed random coefficients to what extent the EBE performs better than the OLSE and to what extent the EBE preserves the good properties of the BE. Second, we examine the robustness of the EBE which is based on a normal distribution of the random parameters, by comparing its performance to the OLSE for data being generated from two distributions other than the normal distribution: a modified t-distribution and a modified exponential distribution. As performance criteria we examine the Bayes risk as well as a criterion based on the frequentist notion of mean squared error.",0,1 +2427,A Poor Person’s Posterior Predictive Checking of Structural Equation Models,"Posterior predictive model checking (PPMC) is a Bayesian model checking method that compares the observed data to (plausible) future observations from the posterior predictive distribution. We propose an alternative to PPMC in the context of structural equation modeling, which we term the poor person’s PPMC (PP-PPMC), for the situation wherein one cannot afford (or is unwilling) to draw samples from the full posterior. Using only by-products of likelihood-based estimation (maximum likelihood estimate and information matrix), the PP-PPMC offers a natural method to handle parameter uncertainty in model fit assessment. In particular, a coupling relationship between the classical p values from the model fit chi-square test and the predictive p values from the PP-PPMC method is carefully examined, suggesting that PP-PPMC might offer an alternative, principled approach for model fit assessment. We also illustrate the flexibility of the PP-PPMC approach by applying it to case-influence diagnostics.",0,1 +2428,Retrospective benzene exposure assessment for a multi-center case-cohort study of benzene-exposed workers in China,"Quality of exposure assessment has been shown to be related to the ability to detect risk of lymphohematopoietic disorders in epidemiological investigations of benzene, especially at low levels of exposure. We set out to build a statistical model for reconstructing exposure levels for 2898 subjects from 501 factories that were part of a nested case-cohort study within the NCI-CAPM cohort of more than 110,000 workers. We used a hierarchical model to allow for clustering of measurements by factory, workshop, job, and date. To calibrate the model we used historical routine monitoring data. Measurements below the limit of detection were accommodated by constructing a censored data likelihood. Potential non-linear and industry-specific time-trends and predictor effects were incorporated using regression splines and random effects. A partial validation of predicted exposures in 2004/2005 was performed through comparison with full-shift measurements from an exposure survey in facilities that were still open. Median cumulative exposure to benzene at age 50 for subjects that ever held an exposed job (n=1175) was 509 mg/m 3 years. Direct comparison of model estimates with measured full-shift personal exposure in the 2004/2005 survey showed moderate correlation and a potential downward bias at low (<1 mg/m 3) exposure estimates. The modeling framework enabled us to deal with the data complexities generally found in studies using historical exposure data in a comprehensive way and we therefore expect to be able to investigate effects at relatively low exposure levels. © 2016 Nature America, Inc.",0,1 +2429,Rod and cone contrast gains derived from reaction time distribution modeling,"Contrast gain reflects the rapidity of response amplitude increase with increase in stimulus contrast. In physiology, contrast gain can be measured directly as the initial slope of cell contrast response function. In psychophysics, contrast gain estimation is not straightforward. Further, rod and cone contrast gains have not been measured psychophysically at mesopic light levels where both rods and cones are active, due to the difficulty in producing stimuli that excite rods and cones separately at the same adaptation level. Here, we estimated rod and contrast gains by fitting reaction time distributions measured at a light level in which rods alone (scotopic), rods and cones (mesopic), or cones alone (photopic) mediate vision. The reaction time distributions were modeled by two different strategies, a simplified diffusion model that assumes a stochastic accumulation process and a model we developed that begins with sensory input based on early visual processing impulse response functions and assumes the reaction time variability originates in the response criterion. Estimates of contrast gain from both models were comparable and consistent with primate physiology measurements.",0,1 +2430,A comparison between traditional methods and multilevel regression for the analysis of multicenter intervention studies,"This article reviews three traditional methods for the analysis of multicenter trials with persons nested within clusters, i.e., centers, namely naïve regression (persons as units of analysis), fixed effects regression, and the use of summary measures (clusters as units of analysis), and compares these methods with multilevel regression. The comparison is made for continuous (quantitative) outcomes, and is based on the estimator of the treatment effect and its standard error, because these usually are of main interest in intervention studies. When the results of the experiment have to be valid for some larger population of centers, the centers in the intervention study have to present a random sample from this population and multilevel regression may be used. It is shown that the treatment effect and especially its standard error, are generally incorrectly estimated by the traditional methods, which should, therefore, not in general be used as an alternative to multilevel regression.",0,1 +2431,"Where, With Whom, and How Much Alcohol Is Consumed on Drinking Events Involving Aggression? Event-Level Associations in a Canadian National Survey of University Students","Epidemiological research using event-level data can provide a better understanding of the association between alcohol consumption, characteristics of drinking contexts, and the likelihood of aggressive behavior. The present research assessed whether alcohol intake and characteristics of the drinking context were associated with the likelihood of aggression within individuals across 3 drinking events based on a national sample of university students, taking into account individual characteristics and university level variables. Additionally, we determined whether individual characteristics, particularly drinking pattern, were associated with alcohol-related aggression controlling for drinking event characteristics, and whether relations of aggression to alcohol and drinking contexts differed by gender.Secondary analyses of the 2004 Canadian Campus Survey (CCS), a national survey of 6,282 university students (41% response rate) at 40 Canadian universities, were conducted. Respondents were asked about their three most recent drinking events, including whether they were in an argument or fight with someone, number of drinks consumed, and characteristics of the drinking context as well as their usual drinking frequency and heavy episodic drinking. We used multi-level analyses to account for the nested structure of the data (i.e., drinking events nested within individuals who were nested within universities).The number of drinks consumed was positively associated with aggression. Drinking contexts found to be positively associated with aggression included being at a party, at a fraternity/sorority and/or residence, at three or more drinking places (versus 1 or 2), and having a partner present whereas having a meal reduced the likelihood of aggression. A significant interaction was found between gender and being at a party, with a significant effect found for women but not for men.These results support experimental evidence indicating a direct role of alcohol in aggression and point to characteristics of the drinking context that might be targeted in future prevention initiatives.",0,1 +2432,"The multilevel latent covariate model: A new, more reliable approach to group-level effects in contextual studies.","In multilevel modeling (MLM), group-level (L2) characteristics are often measured by aggregating individual-level (L1) characteristics within each group so as to assess contextual effects (e.g., group-average effects of socioeconomic status, achievement, climate). Most previous applications have used a multilevel manifest covariate (MMC) approach, in which the observed (manifest) group mean is assumed to be perfectly reliable. This article demonstrates mathematically and with simulation results that this MMC approach can result in substantially biased estimates of contextual effects and can substantially underestimate the associated standard errors, depending on the number of L1 individuals per group, the number of groups, the intraclass correlation, the sampling ratio (the percentage of cases within each group sampled), and the nature of the data. To address this pervasive problem, the authors introduce a new multilevel latent covariate (MLC) approach that corrects for unreliability at L2 and results in unbiased estimates of L2 constructs under appropriate conditions. However, under some circumstances when the sampling ratio approaches 100%, the MMC approach provides more accurate estimates. Based on 3 simulations and 2 real-data applications, the authors evaluate the MMC and MLC approaches and suggest when researchers should most appropriately use one, the other, or a combination of both approaches.",0,1 +2433,Multilevel Models,"Abstract This article addresses multilevel models in which units are nested within one another. The focus is primarily two-level models. It also describes cross-unit heterogeneity. Moreover, it assesses the fixed and random effects from the multilevel model. It generally tries to convey the scope of multilevel models but in a very compact way. Multilevel models provide great promise for exploiting information in hierarchical data structures. There are a range of alternatives for such data and it bears repeating that sometimes, simpler-to-apply correctives are best.",0,1 +2434,A tutorial on Bayesian bivariate meta-analysis of mixed binary-continuous outcomes with missing treatment effects,"Bivariate random-effects meta-analysis (BVMA) is a method of data synthesis that accounts for treatment effects measured on two outcomes. BVMA gives more precise estimates of the population mean and predicted values than two univariate random-effects meta-analyses (UVMAs). BVMA also addresses bias from incomplete reporting of outcomes. A few tutorials have covered technical details of BVMA of categorical or continuous outcomes. Limited guidance is available on how to analyze datasets that include trials with mixed continuous-binary outcomes where treatment effects on one outcome or the other are not reported. Given the advantages of Bayesian BVMA for handling missing outcomes, we present a tutorial for Bayesian BVMA of incompletely reported treatment effects on mixed bivariate outcomes. This step-by-step approach can serve as a model for our intended audience, the methodologist familiar with Bayesian meta-analysis, looking for practical advice on fitting bivariate models. To facilitate application of the proposed methods, we include our WinBUGS code. As an example, we use aggregate-level data from published trials to demonstrate the estimation of the effects of vitamin K and bisphosphonates on two correlated bone outcomes, fracture, and bone mineral density. We present datasets where reporting of the pairs of treatment effects on both outcomes was 'partially' complete (i.e., pairs completely reported in some trials), and we outline steps for modeling the incompletely reported data. To assess what is gained from the additional work required by BVMA, we compare the resulting estimates to those from separate UVMAs. We discuss methodological findings and make four recommendations. Copyright © 2015 John Wiley & Sons, Ltd.",0,1 +2435,"Policy spillover and the policing of protest in New York City, 1960–2006","Scholars have suggested that the policing of protest have become more permissive in Western democracies since the 1960s. While widely accepted, studies affirming a softening of police conduct have focused on national trends despite awareness that police tactics have unevenly diffused across the USA. This study examines the temporal trends in protest policing in New York City to evaluate how and why the dominant strategies of protest control have changed over time. Drawing on the widespread privatisation of public space in New York during the 1980s coupled with the adoption of Broken Windows crime control strategies, I develop an alternative explanation of the temporal dynamics of protest policing that is based on policy spillover, or the unintentional spillover effects that policy decisions unrelated to protest policing may nonetheless have on police conduct. Using a sample of 6147 protest events occurring in New York between 1960 and 2006, I confirm that the prevalence of arrests and other forms of polic...",0,1 +2436,Bayesian statistical inference in psychology: Comment on Trafimow (2003).,"D. Trafimow (2003) presented an analysis of null hypothesis significance testing (NHST) using Bayes's theorem. Among other points, he concluded that NHST is logically invalid, but that logically valid Bayesian analyses are often not possible. The latter conclusion reflects a fundamental misunderstanding of the nature of Bayesian inference. This view needs correction, because Bayesian methods have an important role to play in many psychological problems where standard techniques are inadequate. This comment, with the help of a simple example, explains the usefulness of Bayesian inference for psychology.",0,1 +2437,"The BUGS project: Evolution, critique and future directions","BUGS is a software package for Bayesian inference using Gibbs sampling. The software has been instrumental in raising awareness of Bayesian modelling among both academic and commercial communities internationally, and has enjoyed considerable success over its 20-year life span. Despite this, the software has a number of shortcomings and a principal aim of this paper is to provide a balanced critical appraisal, in particular highlighting how various ideas have led to unprecedented flexibility while at the same time producing negative side effects. We also present a historical overview of the BUGS project and some future perspectives.",0,1 +2438,Signal Detection Models with Random Participant and Item Effects,"The theory of signal detection is convenient for measuring mnemonic ability in recognition memory paradigms. In these paradigms, randomly selected participants are asked to study randomly selected items. In practice, researchers aggregate data across items or participants or both. The signal detection model is nonlinear; consequently, analysis with aggregated data is not consistent. In fact, mnemonic ability is underestimated, even in the large-sample limit. We present two hierarchical Bayesian models that simultaneously account for participant and item variability. We show how these models provide for accurate estimation of participants' mnemonic ability as well as the memorability of items. The model is benchmarked with a simulation study and applied to a novel data set. © 2007 The Psychometric Society.",0,1 +2439,Guessing-testlet response model,"The psychometric standard of fairness can be violated if the guessing effect is improperly handled. The two most common ways of handling guessing effect are through item design and guessing effect modeling. Items with lower priori guessing probability helps to reduce guessing effect. This paper proposes a two-parameter logistic guessing-testlet response model to model such items. The proposed model is an extended testlet response model where items of the same guessing priori guessing probability are grouped in the same testlet. To reduce the priori guessing probabilities, the items are designed to have multiple-correct responses and the number of correct responses is varying across items. Simulation result shows that the proposed model outperforms the two-parameter logistic item response model in model fit. The proposed guessing-testlet merits ability with no guessing but penalizes ability with guessing.",0,1 +2440,Factor Analysis with Ordinal Indicators: A Monte Carlo Study Comparing DWLS and ULS Estimation,"Factor analysis models with ordinal indicators are often estimated using a 3-stage procedure where the last stage involves obtaining parameter estimates by least squares from the sample polychoric correlations. A simulation study involving 324 conditions (1,000 replications per condition) was performed to compare the performance of diagonally weighted least squares (DWLS) and unweighted least squares (ULS) in the procedure's third stage. Overall, both methods provided accurate and similar results. However, ULS was found to provide more accurate and less variable parameter estimates, as well as more precise standard errors and better coverage rates. Nevertheless, convergence rates for DWLS are higher. Our recommendation is therefore to use ULS, and, in the case of nonconvergence, to use DWLS, as this method might converge when ULS does not.",0,1 +2441,From Intentions to Actions: A Theory of Planned Behavior,"There appears to be general agreement among social psychologists that most human behavior is goal-directed (e. g., Heider, 1958 ; Lewin, 1951). Being neither capricious nor frivolous, human social behavior can best be described as following along lines of more or less well-formulated plans. Before attending a concert, for example, a person may extend an invitation to a date, purchase tickets, change into proper attire, call a cab, collect the date, and proceed to the concert hall. Most, if not all, of these activities will have been designed in advance; their execution occurs as the plan unfolds. To be sure, a certain sequence of actions can become so habitual or routine that it is performed almost automatically, as in the case of driving from home to work or playing the piano. Highly developed skills of this kind typically no longer require conscious formulation of a behavioral plan. Nevertheless, at least in general outline, we are normally well aware of the actions required to attain a certain goal. Consider such a relatively routine behavior as typing a letter. When setting this activity as a goal, we anticipate the need to locate a typewriter, insert a sheet of paper, adjust the margins, formulate words and sentences, strike the appropriate keys, and so forth. Some parts of the plan are more routine, and require less conscious thought than others, but without an explicit or implicit plan to guide the required sequence of acts, no letter would get typed.",0,1 +2442,Unbalanced Repeated-Measures Models with Structured Covariance Matrices,"The question of how to analyze unbalanced or incomplete repeated-measures data is a common problem facing analysts. We address this problem through maximum likelihood analysis using a general linear model for expected responses and arbitrary structural models for the within-subject covariances. Models that can be fit include standard univariate and multivariate models with incomplete data, random-effects models, and models with time-series and factor-analytic error structures. We describe Newton-Raphson and Fisher scoring algorithms for computing maximum likelihood estimates, and generalized EM algorithms for computing restricted and unrestricted maximum likelihood estimates. An example fitting several models to a set of growth data is included.",0,1 +2443,In-season prediction of batting averages: A field test of empirical Bayes and Bayes methodologies,"Batting average is one of the principle performance measures for an individual baseball player. It is natural to statistically model this as a binomial-variable proportion, with a given (observed) number of qualifying attempts (called “at-bats”), an observed number of successes (“hits”) distributed according to the binomial distribution, and with a true (but unknown) value of pi that represents the player’s latent ability. This is a common data structure in many statistical applications; and so the methodological study here has implications for such a range of applications. We look at batting records for each Major League player over the course of a single season (2005). The primary focus is on using only the batting records from an earlier part of the season (e.g., the first 3 months) in order to estimate the batter’s latent ability, pi, and consequently, also to predict their batting-average performance for the remainder of the season. Since we are using a season that has already concluded, we can then validate our estimation performance by comparing the estimated values to the actual values for the remainder of the season. The prediction methods to be investigated are motivated from empirical Bayes and hierarchical Bayes interpretations. A newly proposed nonparametric empirical Bayes procedure performs particularly well in the basic analysis of the full data set, though less well with analyses involving more homogeneous subsets of the data. In those more homogeneous situations better performance is obtained from appropriate versions of more familiar methods. In all situations the poorest performing choice is the naïve predictor which directly uses the current average to predict the future average. One feature of all the statistical methodologies here is the preliminary use of a new form of variance stabilizing transformation in order to transform the binomial data problem into a somewhat more familiar structure involving (approximately) Normal random variables with known variances. This transformation technique is also used in the construction of a new empirical validation test of the binomial model assumption that is the conceptual basis for all our analyses.",0,1 +2444,Markov Chain Monte Carlo Estimation of Item Parameters for the Generalized Graded Unfolding Model,"The authors present a Markov Chain Monte Carlo (MCMC) parameter estimation procedure for the generalized graded unfolding model (GGUM) and compare it to the marginal maximum likelihood (MML) approach implemented in the GGUM2000 computer program, using simulated and real personality data. In the simulation study, test length, number of response options, and sample size were manipulated. Results indicate that the two methods are comparable in terms of item parameter estimation accuracy. Although the MML estimates exhibit slightly smaller bias than MCMC estimates, they also show greater variability, which results in larger root mean squared errors. Of the two methods, only MCMC provides reasonable standard error estimates for all items.",0,1 +2445,Implementation of G-Computation on a Simulated Data Set: Demonstration of a Causal Inference Technique,The growing body of work in the epidemiology literature focused on G-computation includes theoretical explanations of the method but very few simulations or examples of application. The small number of G-computation analyses in the epidemiology literature relative to other causal inference approaches may be partially due to a lack of didactic explanations of the method targeted toward an epidemiology audience. The authors provide a step-by-step demonstration of G-computation that is intended to familiarize the reader with this procedure. The authors simulate a data set and then demonstrate both G-computation and traditional regression to draw connections and illustrate contrasts between their implementation and interpretation relative to the truth of the simulation protocol. A marginal structural model is used for effect estimation in the G-computation example. The authors conclude by answering a series of questions to emphasize the key characteristics of causal inference techniques and the G-computation procedure in particular.,0,1 +2446,Bayesian assessment of times to diagnosis in breast cancer screening,"Breast cancer is one of the diseases with the most profound impact on health in developed countries and mammography is the most popular method for detecting breast cancer at a very early stage. This paper focuses on the waiting period from a positive mammogram until a confirmatory diagnosis is carried out in hospital. Generalized linear mixed models are used to perform the statistical analysis, always within the Bayesian reasoning. Markov chain Monte Carlo algorithms are applied for estimation by simulating the posterior distribution of the parameters and hyperparameters of the model through the free software WinBUGS.",0,1 +2447,Bayesian estimation and test for factor analysis model with continuous and polytomous data in several populations,"The main purpose of this paper is to develop a Bayesian approach for the multisample factor analysis model with continuous and polytomous variables. Joint Bayesian estimates of the thresholds, the factor scores and the structural parameters subjected to some simple constraints across groups are obtained simultaneously. The Gibbs sampler is used to produce the joint Bayesian estimates. It is shown that the conditional distributions involved in the implementation are the familiar uniform, gamma, normal, univariate truncated normal and Wishart distributions. The Bayes factor is introduced to test hypotheses involving constraints among the structural parameters of the factor analysis models across groups. Two procedures for computing the test statistics are developed, one based on the Schwarz criterion (or Bayesian information criterion), while the other computes the posterior densities and likelihood ratios by means of draws from the appropriate conditional distributions via the Gibbs sampler. The empirical performance of the proposed Bayesian procedure and its sensitivity to prior distributions are illustrated by some simulation results and two real-life examples.",0,1 +2448,The Truth is out there! how External Validity can Lead to Better Marketing Decisions,"Marketing managers typically have to use and integrate many pieces of data and marketing intelligence when taking decisions such as whether to launch a product and, if so, at what price. Conjoint experiments and analysis remain popular marketing research tools with business practitioners to test and measure how the market will react to different actions. There is a growing body of work that focuses on, first, how to construct the experiments so that they better represent real market conditions and, second, the use of sophisticated model specifications that provide information on consumers' responses. The market researcher typically uses internal validation for model validity - a comparison of model prediction and within-sample holdout data. We contend in this paper that customers and users of market research information need to adopt a different and wider meaning of validity, referred to as external validity, to facilitate improved decision making. In this research, a case study is used as an example to demonstrate how marketing managers can use the information from a choice-based conjoint derived choice model differently depending on the manner in which the model validation is carried out. © 2009 The Market Research Society.",0,1 +2449,Recalibration of the Multisensory Temporal Window of Integration Results from Changing Task Demands,"The notion of the temporal window of integration, when applied in a multisensory context, refers to the breadth of the interval across which the brain perceives two stimuli from different sensory modalities as synchronous. It maintains a unitary perception of multisensory events despite physical and biophysical timing differences between the senses. The boundaries of the window can be influenced by attention and past sensory experience. Here we examined whether task demands could also influence the multisensory temporal window of integration. We varied the stimulus onset asynchrony between simple, short-lasting auditory and visual stimuli while participants performed two tasks in separate blocks: a temporal order judgment task that required the discrimination of subtle auditory-visual asynchronies, and a reaction time task to the first incoming stimulus irrespective of its sensory modality. We defined the temporal window of integration as the range of stimulus onset asynchronies where performance was below 75% in the temporal order judgment task, as well as the range of stimulus onset asynchronies where responses showed multisensory facilitation (race model violation) in the reaction time task. In 5 of 11 participants, we observed audio-visual stimulus onset asynchronies where reaction time was significantly accelerated (indicating successful integration in this task) while performance was accurate in the temporal order judgment task (indicating successful segregation in that task). This dissociation suggests that in some participants, the boundaries of the temporal window of integration can adaptively recalibrate in order to optimize performance according to specific task demands.",0,1 +2450,Multilevel Factor Analysis of Class and Student Achievement Components,"Multilevel Factor Analysis of Class and Student Achievement Components Author(s): Bengt O. Muthen Source: Journal of Educational Measurement, Vol. 28, No. 4 (Winter, 1991), pp. 338-354 Published by: National Council on Measurement in Education Stable URL: http://www.jstor.org/stable/1434897 . Accessed: 18/05/2011 18:39 Your use of the JSTOR archive indicates your acceptance of JSTOR's Terms and Conditions of Use, available at . http://www.jstor.org/page/info/about/policies/terms.jsp. JSTOR's Terms and Conditions of Use provides, in part, that unless you have obtained prior permission, you may not download an entire issue of a journal or multiple copies of articles, and you may use content in the JSTOR archive only for your personal, non-commercial use. Please contact the publisher regarding any further use of this work. Publisher contact information may be obtained at . http://www.jstor.org/action/showPublisher?publisherCode=ncme. . Each copy of any part of a JSTOR transmission must contain the same copyright notice that appears on the screen or printed page of such transmission. JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org. National Council on Measurement in Education is collaborating with JSTOR to digitize, preserve and extend access to Journal of Educational Measurement. http://www.jstor.org",0,1 +2451,The theory of the estimation of test reliability,"The theoretically best estimate of the reliability coefficient is stated in terms of a precise definition of the equivalence of two forms of a test. Various approximations to this theoretical formula are derived, with reference to several degrees of completeness of information about the test and to special assumptions. The familiar Spearman-Brown Formula is shown to be a special case of the general formulation of the problem of reliability. Reliability coefficients computed in various ways are presented for comparative purposes. © 1937 Psychometric Society.",0,1 +2452,Using Data-Dependent Priors to Mitigate Small Sample Bias in Latent Growth Models,"Mixed-effects models (MEMs) and latent growth models (LGMs) are often considered interchangeable save the discipline-specific nomenclature. Software implementations of these models, however, are not interchangeable, particularly with small sample sizes. Restricted maximum likelihood estimation that mitigates small sample bias in MEMs has not been widely developed for LGMs, and fully Bayesian methods, while not dependent on asymptotics, can encounter issues because the choice for the factor covariance matrix prior distribution has substantial influence with small samples. This tutorial discusses differences between LGMs and MEMs and demonstrates how data-dependent priors, an established class of methods that blend frequentist and Bayesian paradigms, can be implemented within M plus 7.1 to abate the small sample bias that is prevalent with LGM software while keeping additional programming to the bare minimum.",1,1 +2453,Split-Plot Designs for Robotic Serial Dilution Assays,"This article explores effective implementation of split-plot designs in serial dilution bioassay using robots. We show that the shortest path for a robot to fill plate wells for a split-plot design is equivalent to the shortest common supersequence problem in combinatorics. We develop an algorithm for finding the shortest common supersequence, provide an R implementation, and explore the distribution of the number of steps required to implement split-plot designs for bioassay through simulation. We also show how to construct collections of split plots that can be filled in a minimal number of steps, thereby demonstrating that split-plot designs can be implemented with nearly the same effort as strip-plot designs. Finally, we provide guidelines for modeling data that result from these designs.",0,1 +2454,Comparison of three-level cluster randomized trials using quantile dispersion graphs,"The purpose of this article is to evaluate and compare several three-level cluster randomized designs on the basis of their power functions. The power function of cluster designs depends on the intracluster correlations (ICCs), which are generally unknown at the planning stage. Thus, to compare these designs a prior knowledge of the ICCs is required. Three interval estimation methods are proposed for assigning joint confidence intervals to the two ICCs (corresponding to each cluster level). A detailed simulation study comparing the confidence intervals attained by the different techniques is given. The technique of quantile dispersion graphs is used for comparing the three-level cluster designs. For a given design, quantiles of the power function, are obtained for various effect sizes. These quantiles are functions of the unknown ICC coefficients. To address the dependence of the quantiles on the correlations, a 100(1−α)% confidence region is computed, and used as a parameter space. A three-level nested d...",0,1 +2455,A digitally delivered and fully automated internet- and mobile-based smoking cessation programme : a randomized controlled trial,,0,1 +2456,Two Cross-Platform Programs for Inferences and Interval Estimation About Indirect Effects in Mediational Models,"In this article, we describe two new programs that compute both p-values and confidence intervals (CI) for the indirect effect in mediational models, including (a) a p-value based on the partial posterior method, which we refer to as p 3 computed across the posterior distribution of the regression coefficients; (b) a variant of p 3 that uses a normal approximation for the posterior distributions, p 3N ; (c) Hierarchical Bayesian CIs (CI HB ) based on the posterior distributions of the regression coefficients; and (d) CIs based on the Monte Carlo method (CI MC ). These programs do not require access to raw data as do resampling methods. Similar to Sobel’s test, p 3 and p 3N constitute a single p-value for the indirect effect while performing substantially better in terms of Type I and II error rates. Furthermore, we include a memory efficient computational algorithm for CI HB and CI MC that allows for precision beyond that in existing alternative implementations. The underlying programs can utilize multicore processors, and their performance is tested through a simulation study. Finally, the use of these programs is illustrated with an empirical example.",0,1 +2457,Multidimensional latent trait linear mixed model: an application in clinical studies with multivariate longitudinal outcomes,"Multilevel item response theory (MLIRT) models have been widely used to analyze the multivariate longitudinal data of mixed types (e.g., categorical and continuous) in clinical studies. The MLIRT models often have unidimensional assumption, that is, the multiple outcomes are clinical manifestations of a univariate latent variable. However, the unidimensional assumption may be unrealistic because some diseases may be heterogeneous and characterized by multiple impaired domains with variable clinical symptoms and disease progressions. We relax this assumption and propose a multidimensional latent trait linear mixed model (MLTLMM) to allow multiple latent variables and within-item multidimensionality (one outcome can be a manifestation of more than one latent variable). We conduct extensive simulation studies to assess the unidimensional MLIRT model and the proposed MLTLMM model. The simulation studies suggest that the MLTLMM model outperforms unidimensional model when the multivariate longitudinal outcomes are manifested by multiple latent variables. The proposed model is applied to two motivating studies of amyotrophic lateral sclerosis: a clinical trial of ceftriaxone and the Pooled Resource Open-Access ALS Clinical Trials database. Copyright © 2017 John Wiley & Sons, Ltd.",0,1 +2458,Preventing Weight Gain and Obesity: Indirect Effects of the Family Check-Up in Early Childhood,"The early signs of obesity are observable in early childhood. Although the most promising prevention approaches are family-centered, few relevant early prevention programs exist. This study evaluated the effects of an evidence-based, home-visiting intervention, the Family Check-Up (FCU), on the trajectory of children's weight gain. The FCU was designed to prevent the development of behavior problems by improving family management practices; children's weight has not been an explicit target. On the basis of previous research and conceptual models, we hypothesized that intervention effects on parenting practices, specifically caregivers' use of positive behavior support (PBS) strategies in toddlerhood, would mediate improvements in children's weight trajectories. A total of 731 indigent caregiver-child dyads from a multisite randomized intervention trial were examined. Observational assessment of parenting and mealtime behaviors occurred from age 2-5 years. The child's body mass index (BMI) was assessed yearly from age 5-9.5 years. Path analysis with a latent growth model revealed a significant indirect effect of the FCU on the trajectory of BMI in later childhood. Improvements in caregivers' PBS in toddlerhood, which was related to the nutritional quality of the meals caregivers served to the child during the mealtime task, served as the intervening process. Furthermore, findings indicate that the FCU prevents progression to overweight and obese status amongst at-risk children. These study results add to existing evidence that has demonstrated that family-based interventions aimed at improving general family management skills are effective at preventing weight gain. Future directions are discussed.",0,1 +2459,Application of a Multidimensional Nested Logit Model to Multiple-Choice Test Items,"Nested logit models have been presented as an alternative to multinomial logistic models for multiple-choice test items (Suh and Bolt in Psychometrika 75:454-473, 2010) and possess a mathematical structure that naturally lends itself to evaluating the incremental information provided by attending to distractor selection in scoring. One potential concern in attending to distractors is the possibility that distractor selection reflects a different trait/ability than that underlying the correct response. This paper illustrates a multidimensional extension of a nested logit item response model that can be used to evaluate such distinctions and also defines a new framework for incorporating collateral information from distractor selection when differences exist. The approach is demonstrated in application to questions faced by a university testing center over whether to incorporate distractor selection into the scoring of its multiple-choice tests. Several empirical examples are presented. © 2012 The Psychometric Society.",0,1 +2460,Bayesian Hierarchical Models for Cost-Effectiveness Analyses that Use Data from Cluster Randomized Trials,"Cost-effectiveness analyses (CEA) may be undertaken alongside cluster randomized trials (CRTs) where randomization is at the level of the cluster (for example, the hospital or primary care provider) rather than the individual. Costs (and outcomes) within clusters may be correlated so that the assumption made by standard bivariate regression models, that observations are independent, is incorrect. This study develops a flexible modeling framework to acknowledge the clustering in CEA that use CRTs. The authors extend previous Bayesian bivariate models for CEA of multicenter trials to recognize the specific form of clustering in CRTs. They develop new Bayesian hierarchical models (BHMs) that allow mean costs and outcomes, and also variances, to differ across clusters. They illustrate how each model can be applied using data from a large (1732 cases, 70 primary care providers) CRT evaluating alternative interventions for reducing postnatal depression. The analyses compare cost-effectiveness estimates from BHMs with standard bivariate regression models that ignore the data hierarchy. The BHMs show high levels of cost heterogeneity across clusters (intracluster correlation coefficient, 0.17). Compared with standard regression models, the BHMs yield substantially increased uncertainty surrounding the cost-effectiveness estimates, and altered point estimates. The authors conclude that ignoring clustering can lead to incorrect inferences. The BHMs that they present offer a flexible modeling framework that can be applied more generally to CEA that use CRTs.",0,1 +2461,Gender effects in peer nominations for aggression and social status,"Little prior research has examined children’s interpersonal perceptions of peers from a social relations model framework. This study examines the degree of actor and partner variances, as well as generalised and dyadic reciprocities, in a sample of 351 sixth graders’ peer nominations of different forms and functions of aggression and aspects of social status. Gender differences in these nominations are also explored. Results indicate significant actor and partner variances for all measures, and generalised reciprocity in social status perceptions. Clear gender differences were noted in rates of nominations, such that more same-sex than cross-sex nominations were generally given for both positive and negative aspects; however, we found mixed evidence of gender differences in the variance partitioning and reciprocity correlation estimates.",0,1 +2462,A Bayesian approach to inequality constrained linear mixed models: estimation and model selection,Constrained parameter problems arise in a wide variety of applications. This article deals with estimation and model selection in linear mixed models with inequality constraints on the parameters. It is shown that different theories can be translated into statistical models by putting constraints on the model parameters yielding a set of competing models. A new approach based on the principle of encompassing priors is proposed and used to compute Bayes factors and subsequently posterior model probabilities. Model selection is based on posterior model probabilities. The approach is illustrated using a longitudinal data set.,0,1 +2463,Meta-regression with partial information on summary trial or patient characteristics,"We present a model for meta-regression in the presence of missing information on some of the study level covariates, obtaining inferences using Bayesian methods. In practice, when confronted with missing covariate data in a meta-regression, it is common to carry out a complete case or available case analysis. We propose to use the full observed data, modelling the joint density as a factorization of a meta-regression model and a conditional factorization of the density for the covariates. With the inclusion of several covariates, inter-relations between these covariates are modelled. Under this joint likelihood-based approach, it is shown that the lesser assumption of the covariates being Missing At Random is imposed, instead of the more usual Missing Completely At Random (MCAR) assumption. The model is easily programmable in WinBUGS, and we examine, through the analysis of two real data sets, sensitivity and robustness of results to the MCAR assumption.",0,1 +2464,Post-conditioning experience with acute or chronic inflammatory pain reduces contextual fear conditioning in the rat,"There is evidence that pain can impact cognitive function in people. The present study evaluated whether Pavlovian fear conditioning in rats would be reduced if conditioning were followed by persistent inflammatory pain induced by a subcutaneous injection of dilute formalin or complete Freund's adjuvant (CFA) on the dorsal lumbar surface of the back. Formalin-induced pain specifically impaired contextual fear conditioning but not auditory cue conditioning (Experiment 1A). Moreover, formalin pain only impaired contextual fear conditioning if it was initiated within 1h of conditioning and did not have a significant effect if initiated 2, 8 or 32 h after (Experiments 1A and 1B). Experiment 2 showed that formalin pain initiated after a session of context pre-exposure reduced the ability of that pre-exposure to facilitate contextual fear when the rat was limited to a brief exposure to the context during conditioning. Similar impairments in context- but not CS-fear conditioning were also observed if the rats received an immediate post-conditioning injection with CFA (Experiment 3). Finally, we confirmed that formalin and CFA injected s.c. on the back induced pain-indicative behaviours, hyperalgesia and allodynia with a similar timecourse to intraplantar injections (Experiment 4). These results suggest that persistent pain impairs learning in a hippocampus-dependent task, and may disrupt processes that encode experiences into long-term memory.",0,1 +2465,Comparing Methods of Data Synthesis,"Background: Cost-effectiveness models should always be amendable to updating once new data on important model parameters become available. However, several methods of synthesizing data exist and the choice of method may affect the cost-effectiveness estimates. Objectives: To investigate the impact of the different methods of metaanalysis on final estimates of cost effectiveness from a probabilistic Markov model for chronic obstructive pulmonary disease (COPD). Methods: We compared four different methods to synthesize data for the parameters of a cost-effectiveness model for COPD: frequentist and Bayesian fixed-effects (FE) and random-effects (RE) meta-analyses. These methods were applied to obtain new transition probabilities between stable disease states and new event probabilities. Results: The four methods resulted in different estimates of probabilities and their standard errors (SE). The effects of using different synthesis techniques were most prominent in the estimation of the SEs. We found up to 9-fold differences in SEs of the exacerbation probabilities and up to almost 3-fold differences in SEs of the transition probabilities. We found that the frequentist FE model produced the lowest SEs, whereas the Bayesian RE model produced the highest for all parameters. The estimates of differences between treatments in total costs, QALYs and cost-effectiveness acceptability curves (CEAC) also varied depending on the synthesis method. The CEAC was 15% lower with a Bayesian RE model than with any of the other models. Conclusions: Health economic modellers should be aware that the choice of synthesis technique can affect resulting model parameters considerably, which can in turn affect estimates of cost effectiveness and the uncertainty around them. © 2011 Adis Data Information BV. All rights reserved.",0,1 +2466,Interindividual differences in intraindividual change.,,0,1 +2467,"Intrathecal cannabilactone CB2R agonist, AM1710, controls pathological pain and restores basal cytokine levels","Spinal glial and proinflammatory cytokine actions are strongly implicated in pathological pain. Spinal administration of the anti-inflammatory cytokine interleukin (IL)-10 abolishes pathological pain and suppresses proinflammatory IL-1β and tumor necrosis factor alpha (TNF-α). Drugs that bind the cannabinoid type-2 receptor (CB(2)R) expressed on spinal glia reduce mechanical hypersensitivity. To better understand the CB(2)R-related anti-inflammatory profile of key anatomical nociceptive regions, we assessed mechanical hypersensitivity and protein profiles following intrathecal application of the cannabilactone CB(2)R agonist, AM1710, in 2 animal models; unilateral sciatic nerve chronic constriction injury (CCI), and spinal application of human immunodeficiency virus-1 glycoprotein 120 (gp120), a model of peri-spinal immune activation. In CCI animals, lumbar dorsal spinal cord and corresponding dorsal root ganglia (DRG) were evaluated by immunohistochemistry for expression of IL-10, IL-1β, phosphorylated p38-mitogen-activated-kinase (p-p38MAPK), a pathway associated with proinflammatory cytokine production, glial cell markers, and degradative endocannabinoid enzymes, including monoacylglycerol lipase (MAGL). AM1710 reversed bilateral mechanical hypersensitivity. CCI revealed decreased IL-10 expression in dorsal spinal cord and DRG, while AM1710 resulted in increased IL-10, comparable to controls. Adjacent DRG and spinal sections revealed increased IL-1β, p-p38MAPK, glial markers, and/or MAGL expression, while AM1710 suppressed all but spinal p-p38MAPK and microglial activation. In spinal gp120 animals, AM1710 prevented bilateral mechanical hypersensitivity. For comparison to immunohistochemistry, IL-1β and TNF-α protein quantification from lumbar spinal and DRG homogenates was determined, and revealed increased DRG IL-1β protein levels from gp120, that was robustly prevented by AM1710 pretreatment. Cannabilactone CB(2)R agonists are emerging as anti-inflammatory agents with pain therapeutic implications.",0,1 +2468,Optimal Full Matching and Related Designs via Network Flows,"In the matched analysis of an observational study, confounding on covariates X is addressed by comparing members of a distinguished group (Z = 1) to controls (Z = 0) only when they belong to the same matched set. The better matchings, therefore, are those whose matched sets exhibit both dispersion in Z and uniformity in X. For dispersion in Z, pair matching is best, creating matched sets that are equally balanced between the groups; but actual data place limits, often severe limits, on matched pairs' uniformity in X. At the other extreme is full matching, the matched sets of which are as uniform in X as can be, while often so poorly dispersed in Z as to sacrifice efficiency.This article presents an algorithm for exploring the intermediate territory. Given requirements on matched sets' uniformity in X and dispersion in Z, the algorithm first decides the requirements' feasibility. In feasible cases, it furnishes a match that is optimal for X-uniformity among matches with Z-dispersion as stipulated. To illus...",0,1 +2469,Social Support and Immunity,"Abstract Social support has been reliably related to lower rates of morbidity and mortality across a number of diseases. However, little is known about the more specific pathways and mechanisms responsible for such links. In this chapter, we argue that part of the link between social support and health is explained by immune-system alternations that, in turn, influence broad-based disease outcomes. Recent studies suggest that social support is related to lower IL-6 and better immune function in biologically relevant contexts (e.g., vaccinations, cancer patients). The implications of these findings are discussed in light of a broad model hypothesizing that social support may influence health outcomes via behavioral (e.g., health behaviors), psychological (e.g., stress appraisals), and neuroendocrine-immune mechanisms. Important future research areas are also emphasized, especially the need to uncover the psychological pathways by which social support may be health-promoting.",0,1 +2470,Bayesian implementation of a genetic model-free approach to the meta-analysis of genetic association studies,"A genetic model-free method for the meta-analysis of genetic association studies is described that estimates the mode of inheritance from the data rather than assuming that it is known. For a bi-allelic polymorphism, with G as risk allele and g as wild-type, the genetic model depends on the ratio of the two log odds ratios, lambda = log OR(Gg)/log OR(GG), where OR(GG) compares GG with gg and OR(Gg) compares Gg with gg. Modelling log OR(GG) as a random effect creates a hierarchical model that can be implemented within a Bayesian framework. In Bayesian modelling, vague prior distributions have to be specified for all unknown parameters when no external information is available. When the data are sparse even supposedly vague prior distributions may have an influence on the posterior estimates. We investigate the impact of different vague prior distributions for the between-study standard deviation of log OR(GG) and for lambda, by considering three published meta-analyses and associated simulations. Our results show that depending on the characteristics of the meta-analysis the results may indeed be sensitive to the choice of vague prior distribution for either parameter. Genetic association studies usually use a case-control design that should be analysed by the corresponding retrospective likelihood. However, under some circumstances the prospective likelihood has been shown to produce identical results and it is usually preferred for its simplicity. In our meta-analyses the two likelihoods give very similar results.",0,1 +2471,"Plant damage and herbivore performance change with latitude for two old-field plant species, but rarely as predicted","A long standing hypothesis in biogeography is that latitudinal gradients in plant defenses (LGPD) should arise because selection for plant defenses is greater in the tropics compared to temperate areas. Previous studies have focused on plant traits thought to confer resistance, yet many traits may not actually confer resistance (putative resistance) or interact to influence herbivore performance. In this study, I used a multi-trophic approach to examine relationships between latitude, herbivore pressure, and plant resistance (measured as the growth rates of herbivores) of two old-field plant species (Solanum carolinense and Solidago altissima) using a field survey across a 12 degree gradient in the eastern US combined with laboratory bioassays measuring the performance of generalist and specialist herbivores. I used structural equation modeling to examine the direct and indirect pathways by which latitude influences herbivore pressure and plant resistance. A latitudinal gradient in plant damage was observed in the expected direction for S. caroliense (damage decreased with latitude), but the opposite relationship was observed for S. altissima. Damage to both plant species was mediated by herbivore abundances, which was in turn influenced by predator abundances. Resistance to herbivores also varied with latitude but the form of the relationship was dependent on herbivore and plant species. There were direct, non-linear relationships between latitude and resistance (for Spodoptera exigua and Schistocerca americana feeding on S. altissima; S. exigua and Manduca sexta feeding on S. carolinense). Herbivore growth rates were also mediated by the density of S. carolinense for Leptinotarsa juncta and S. americana feeding on S. carolinense. There was no relationship between plant resistance and herbivore pressure and no indication of feedbacks. Results from this study indicate that latitudinal variation in plant resistance is complex, possibly constrained by resource availability and tradeoffs in plant defenses.",0,1 +2472,Simulation studies of structural equation models with covariates in a redundancy analysis framework,"A recent approach to structural equation modelling based on so-called extended redundancy analysis (ERA) has been proposed in the literature, enhanced with the added characteristic of generalizing redundancy analysis (GRA) models for more than two blocks. In this approach, the relationships between the observed exogenous variables and the observed endogenous variables are moderated by the presence of unobservable composites, estimated as linear combinations of exogenous variables. However, in presence of direct effects linking exogenous and endogenous variables, the composite scores are estimated by ignoring the presence of the specified direct effects. In this paper, we generalize the ERA, extending this new class of models to allow for external covariate effects. In particular, covariates are allowed to affect endogenous indicators indirectly through the composites and/or directly. The method proposed herein is called GRA, which allows us to specify and fit a variety of relationships among composites and endogenous variables. In the paper we propose two simulation studies aimed to illustrate the advantages of GRA over ERA in terms of recovery of the original underlying structure of the data in small samples. Moreover, other than the proposal of this new methodology, a second aspect of originality of this paper is that, to our knowledge, no existing empirical research addresses the behaviour of ERA with external covariate effect in simulation studies. © 2014, Springer Science+Business Media Dordrecht.",0,1 +2473,On some small sample properties of generalized estimating equationEstimates for multivariate dichotomous outcomes,"(1992). On some small sample properties of generalized estimating equationEstimates for multivariate dichotomous outcomes. Journal of Statistical Computation and Simulation: Vol. 41, No. 1-2, pp. 19-29.",0,1 +2474,Imposing structure on an unstructured environment : Ontogenetic changes in the ability to form rules of behavior under conditions of low environmental predictability,,0,1 +2475,Tests of the Three-Path Mediated Effect,"In a three-path mediational model, two mediators intervene in a series between an independent and a dependent variable. Methods of testing for mediation in such a model are generalized from the more often used single-mediator model. Six such methods are introduced and compared in a Monte Carlo study in terms of their Type I error, power, and coverage. Based on its results, the joint significance test is preferred when only a hypothesis test is of interest. The percentile bootstrap and bias-corrected bootstrap are preferred when a confidence interval on the mediated effect is desired, with the latter having more power but also slightly inflated Type I error in some conditions.",0,1 +2476,Bayesian Estimation for Item Factor Analysis Models with Sparse Categorical Indicators,"Psychometric models for item-level data are broadly useful in psychology. A recurring issue for estimating item factor analysis (IFA) models is low-item endorsement (item sparseness), due to limited sample sizes or extreme items such as rare symptoms or behaviors. In this paper, I demonstrate that under conditions characterized by sparseness, currently available estimation methods, including maximum likelihood (ML), are likely to fail to converge or lead to extreme estimates and low empirical power. Bayesian estimation incorporating prior information is a promising alternative to ML estimation for IFA models with item sparseness. In this article, I use a simulation study to demonstrate that Bayesian estimation incorporating general prior information improves parameter estimate stability, overall variability in estimates, and power for IFA models with sparse, categorical indicators. Importantly, the priors proposed here can be generally applied to many research contexts in psychology, and they do not impact results compared to ML when indicators are not sparse. I then apply this method to examine the relationship between suicide ideation and insomnia in a sample of first-year college students. This provides an important alternative for researchers who may need to model items with sparse endorsement.",0,1 +2477,Bayesian structural equation modeling: A more flexible representation of substantive theory.,"This article proposes a new approach to factor analysis and structural equation modeling using Bayesian analysis. The new approach replaces parameter specifications of exact zeros with approximate zeros based on informative, small-variance priors. It is argued that this produces an analysis that better reflects substantive theories. The proposed Bayesian approach is particularly beneficial in applications where parameters are added to a conventional model such that a nonidentified model is obtained if maximum-likelihood estimation is applied. This approach is useful for measurement aspects of latent variable modeling, such as with confirmatory factor analysis, and the measurement part of structural equation modeling. Two application areas are studied, cross-loadings and residual correlations in confirmatory factor analysis. An example using a full structural equation model is also presented, showing an efficient way to find model misspecification. The approach encompasses 3 elements: model testing using posterior predictive checking, model estimation, and model modification. Monte Carlo simulations and real data are analyzed using Mplus. The real-data analyses use data from Holzinger and Swineford's (1939) classic mental abilities study, Big Five personality factor data from a British survey, and science achievement data from the National Educational Longitudinal Study of 1988.",0,1 +2478,Evaluating cognitive theory: A joint modeling approach using responses and response times.,"In current psychological research, the analysis of data from computer-based assessments or experiments is often confined to accuracy scores. Response times, although being an important source of additional information, are either neglected or analyzed separately. In this article, a new model is developed that allows the simultaneous analysis of accuracy scores and response times of cognitive tests with a rule-based design. The model is capable of simultaneously estimating ability and speed on the person side as well as difficulty and time intensity on the task side, thus dissociating information that is often confounded in current analysis procedures. Further, by integrating design matrices on the task side, it becomes possible to assess the effects of design parameters (e.g., cognitive processes) on both task difficulty and time intensity, offering deeper insights into the task structure. A Bayesian approach, using Markov Chain Monte Carlo methods, has been developed to estimate the model. An application of the model in the context of educational assessment is illustrated using a large-scale investigation of figural reasoning ability.",0,1 +2479,A double-structure structural equation model for three-mode data.,"Structural equation models are commonly used to analyze 2-mode data sets, in which a set of objects is measured on a set of variables. The underlying structure within the object mode is evaluated using latent variables, which are measured by indicators coming from the variable mode. Additionally, when the objects are measured under different conditions, 3-mode data arise, and with this, the simultaneous study of the correlational structure of 2 modes may be of interest. In this article the authors present a model with a simultaneous latent structure for 2 of the 3 modes of such a data set. They present an empirical illustration of the method using a 3-mode data set (person by situation by response) exploring the structure of anger and irritation across different interpersonal situations as well as across persons.",0,1 +2480,Bayesian sampling-based approach for factor analysis models with continuous and polytomous data,"Factor analysis is an important technique in behavioural science research in explaining the interdependence and assessing causations and correlations of the observed variables and the latent factors. Recently, generalization of the model to handle polytomous variables has received a lot of attention. In this paper, a Bayesian approach to analysing the model with continuous and polytomous variables is developed. In the posterior analysis, the observed continuous and polytomous data are augmented with the latent factor scores and the unobserved measurements underlying the polytomous variables. Random observations from the posterior distributions are simulated via the Gibbs sampler algorithm. It is shown that the conditional distributions involved in the implementation of the algorithm are the familiar distributions, hence the simulation is rather straightforward. Joint Bayesian estimates of the unknown thresholds, structural parameters and the factor scores are produced simultaneously. The efficiency and accuracy of our approach are demonstrated by a real-life example and a simulation study.",0,1 +2481,Beyond Individual Differences: Exploring School Effects on SAT Scores,"This article explores the complex, hierarchical relation among school characteristics, individual differences in academic achievement, extracurricular activities, and socioeconomic background on performance on the verbal and mathematics Scholastic Aptitude Test (SAT). Using multilevel structural equation models (SEMs) with latent means, we analyzed data from a national sample of college-bound high school students. A nested series of SEMs were fit simultaneously to eight subgroups (disaggregated by both gender and ethnicity) of high school students. Our analyses suggest that (a) multilevel SEMs provide a reasonably good fit to the data, (b) family background influences SAT scores directly and indirectly, learning opportunities in and outside the school curriculum are related to SAT performance, and (c) the characteristics of the schools matter when it comes to performance on the SAT. We argue that context matters and that researchers ought to move beyond analyses of individual differences when attempting t...",0,1 +2482,Stumbling block or stepping stone? The influence of direct democracy on individual participation in parliamentary elections,"This paper evaluates whether direct democracy supplements or undermines traditional representative democracy. While a first approach assumes that a culture of active direct democracy stimulates citizens’ political interest and ultimately bolsters participation in parliamentary elections, a competing hypothesis proposes a negative relationship between the frequency of ballot measures and electoral participation due to voter fatigue and decreased significance of elections. Our multilevel analysis of the 26 Swiss cantons challenges recent studies conducted for the U.S. states: In the Swiss context, where direct democracy is more important in the political process than the less salient parliamentary elections, greater use of direct democratic procedures is associated with a lower individual probability to participate in elections. Furthermore, by distinguishing between short and long-term effects of direct democracy, we show that the relationship observed is of a long-term nature and can therefore be seen as a result of adaptive learning processes rather than of instantaneous voter fatigue.",0,1 +2483,Direct and Indirect Effects in Linear Structural Equation Models,"This article discusses total indirect effects in linear structural equation models. First, I define these effects. Second, I show how the delta method may be used to obtain the standard errors of the sample estimates of these effects and test hypotheses about the magnitudes of the indirect effects. To keep matters simple, I focus throughout on a particularly simple linear structural equation system; for a treatment of the general case, see Sobel (1986). To illustrate the ideas and results, a detailed example is presented.",0,1 +2484,Statistical Inference in Factor Analysis,"In this paper we discuss some methods of factor analysis. The entire discussion is centered around one general probability model. We consider some mathematical problems of the model, such as whether certain kinds of observed data determine the model uniquely. We treat the statistical problems of estimation and tests of certain hypotheses. For these purposes the asymptotic distribution theory of some statistics is treated. The primary aim of this paper is to give a unified exposition of this part of factor analysis from the viewpoint of the mathematical statistician. The literature on factor analysis is scattered; moreover, the many papers and books have been written from many different points of view. By confining ourselves to one model and by emphasizing statistical inferences for this model we hope to present a clear picture to the statistician. The development given here is expected to point up features of model-building and statistical inference that occur in other areas where statistical theories are being developed. For example, nearly all of the problems met in factor analysis are met in latent structure analysis. There are also some new results given in this paper. The proofs of these are mainly given in a technical Part II of the paper. In confining.ourselves to the mathematical and statistical aspects of one model, we are leaving out of consideration many important and interesting topics. We shall not consider how useful this model may be nor in what substantive areas one may expect to find data (and problems) that fit the model. We also do not consider methods based on other models. In doing this, we do not mean to imply that the model considered here is the most useful or important. It seems that this model has some usefulness and importance, it has been studied considerably, and one can give a fairly unified exposition of it. Extensive discussion of the purposes and applications (as well as other developments) of factor analysis is given in books by psychologists (for example, Holzinger and Harmon [10], Thomson [23], Thurstone [24]). Some general discussion of statistical inference has been given in papers by Bartlett [9] and Kendall [12].",0,1 +2485,Expediting Clinical and Translational Research via Bayesian Instrument Development,"Developing valid and reliable instruments is crucial, but costly and time-consuming in health care research and evaluation. The Food and Drug Administration (FDA) and the National Institutes of Health (NIH) have set up guidelines for developing patient-reported outcome (PRO) instruments. However, the guidelines are not applicable to cases of small sample sizes. Instead of using an exact estimation procedure to examine psychometric properties, the Bayesian Instrument Development (BID) method integrates expert data and participant data into a single seamless analysis. Using a novel set of priors, simulated data were used to compare BID to classical instrument development procedures and test the stability of BID. To display BID to non-statisticians, a graphical user interface (GUI) based on R and WINBUGS is developed and demonstrated with data on a small sample of heart failure patients. Costs were saved by eliminating the need for unnecessary continuation of data collection for larger samples as required by the classical instrument development approach.",0,1 +2486,Simultaneous Use of Multiple Answer Copying Indexes to Improve Detection Rates,"Many of the currently available statistical indexes to detect answer copying lack sufficient power at small α levels or when the amount of copying is relatively small. Furthermore, there is no one index that is uniformly best. Depending on the type or amount of copying, certain indexes are better than others. The purpose of this article was to explore the utility of simultaneously using multiple copying indexes to detect different types and amounts of answer copying. This study compared eight copying indexes: S1 and S2 (Sotaridona & Meijer, 2003), K¯ 2 (Sotaridona & Meijer, 2002), ω (Wollack, 1997),B and H (Angoff, 1974), and new indexes Runs and MaxStrings, plus all possible pairs and triplets of the 8 indexes using multiple comparison procedures (Dunn, 1961) to adjust the critical α level for each index in a pair or triplet. Empirical Type-I error rates and power of all indexes, pairs, and triplets were examined in a real data simulation (i.e., where actual examinee responses to items [rather than gener...",0,1 +2487,On Some Principles of Statistical Inference,"Summary Statistical theory aims to provide a foundation for studying the collection and interpretation of data, a foundation that does not depend on the particular details of the substantive field in which the data are being considered. This gives a systematic way to approach new problems, and a common language for summarising results; ideally, the foundations and common language ensure that statistical aspects of one study, or of several studies on closely related phenomena, can be broadly accessible. We discuss some principles of statistical inference, to outline how these are, or could be, used to inform the interpretation of results, and to provide a greater degree of coherence for the foundations of statistics.",0,1 +2488,A Hierarchical Model for Quantifying Forest Variables Over Large Heterogeneous Landscapes With Uncertain Forest Areas,"We are interested in predicting one or more continuous forest variables (e.g., biomass, volume, age) at a fine resolution (e.g., pixel level) across a specified domain. Given a definition of forest/nonforest, this prediction is typically a two-step process. The first step predicts which locations are forested. The second step predicts the value of the variable for only those forested locations. Rarely is the forest/nonforest status predicted without error. However, the uncertainty in this prediction is typically not propagated through to the subsequent prediction of the forest variable of interest. Failure to acknowledge this error can result in biased estimates of forest variable totals within a domain. In response to this problem, we offer a modeling framework that will allow propagation of this uncertainty. Here we envision two latent processes generating the data. The first is a continuous spatial process while the second is a binary spatial process. The continuous spatial process controls the spatial association structure of the forest variable of interest, while the binary process indicates presence of a possible nonzero value for the forest variable at a given location. The proposed models are applied to georeferenced National Forest Inventory (NFI) data and spatially coinciding remotely sensed predictor variables. Due to the large number of observed locations in this dataset we seek dimension reduction not just in the likelihood, but also for unobserved stochastic processes. We demonstrate how a low-rank predictive process can be adapted to our setting and reduce the dimensionality of the data and ease the computational burden.",0,1 +2489,Addressing Score Bias and Differential Item Functioning Due to Individual Differences in Response Style,"A multidimensional item response theory model that accounts for response style factors is presented. The model, a multidimensional extension of Bock's nominal response model, is shown to allow for the study and control of response style effects in ordered rating scale data so as to reduce bias in measurement of the intended trait. In the current application, the model is also used to investigate response style as an underlying cause of differential item functioning. The approach is illustrated using the item responses of cigarette smokers to the Wisconsin Inventory of Smoking Dependence Motives, a self-report measure of tobacco dependence.",0,1 +2490,A Model for Teacher Effects From Longitudinal Data Without Assuming Vertical Scaling,"There is an increasing interest in using longitudinal measures of student achievement to estimate individual teacher effects. Current multivariate models assume each teacher has a single effect on student outcomes that persists undiminished to all future test administrations (complete persistence [CP]) or can diminish with time but remains perfectly correlated (variable persistence [VP]). However, when state assessments do not use a vertical scale or the evolution of the mix of topics present across a sequence of vertically aligned assessments changes as students advance in school, these assumptions of persistence may not be consistent with the achievement data. We develop the “generalized persistence” (GP) model, a Bayesian multivariate model for estimating teacher effects that accommodates longitudinal data that are not vertically scaled by allowing less than perfect correlation of a teacher’s effects across test administrations. We illustrate the model using mathematics assessment data.",0,1 +2491,Bayesian Inference for a Normal Dispersion Matrix and its Application to Stochastic Multiple Regression Analysis,"SUMMARY This paper discusses Bayesian inference procedures for a normal dispersion matrix. Structural information for the prior mean of the dispersion matrix is incorporated into the analysis through a Normal-Wishart prior distribution. Many of the resulting Bayes estimates are invariant, consistent and asymptotically efficient. Using this procedure, a coherent Bayesian argument for stochastic multiple regression analysis is developed, where dependent and independent variables are jointly random, without experimental control. It is shown that ordinary least squares, a general form of ridge regression, and factor analysis regression methods can be represented as special cases within this general framework. The preliminary report of a simulation study indicates that the Bayesian regression techniques demonstrate substantial improvements over least squares, even using frequentist criteria. Finally, the related problem of joint estimation of the normal population mean and dispersion matrix is briefly discussed in Section 5. The resulting Bayes estimate for the population mean is shown to be closely related to Stein estimates.",0,1 +2492,A Longitudinal Study of Mathematical Competencies in Children With Specific Mathematics Difficulties Versus Children With Comorbid Mathematics and Reading Difficulties,"Mathematical competencies of 180 children were examined at 4 points between 2nd and 3rd grades (age range between 7 and 9 years). Children were initially classified into one of 4 groups: math difficulties but normal reading (MD only), math and reading difficulties (MD-RD), reading difficulties but normal math (RD only), and normal achievement in math and reading (NA). The groups did not differ significantly in rate of development. However, at the end of 3rd grade the MD only group performed better than the MD-RD group in problem solving but not in calculation. The NA and RD only groups performed better than the MD-RD group in most areas. Deficiencies in fact mastery and calculation fluency, in particular, are defining features of MD, with or without RD.",0,1 +2493,Bayesian Variable Selection in Multilevel Item Response Theory Models with Application in Genomics,"The goal of this paper is to present an implementation of stochastic search variable selection (SSVS) to multilevel model from item response theory (IRT). As experimental settings get more complex and models are required to integrate multiple (and sometimes massive) sources of information, a model that can jointly summarize and select the most relevant characteristics can provide better interpretation and a deeper insight into the problem. A multilevel IRT model recently proposed in the literature for modeling multifactorial diseases is extended to perform variable selection in the presence of thousands of covariates using SSVS. We derive conditional distributions required for such a task as well as an acceptance-rejection step that allows for the SSVS in high dimensional settings using a Markov Chain Monte Carlo algorithm. We validate the variable selection procedure through simulation studies, and illustrate its application on a study with genetic markers associated with the metabolic syndrome.",0,1 +2494,A General Bayesian Model for Testlets: Theory and Applications,"The need for more realistic and richer forms of assessment in educational tests has led to the inclusion (in many tests) of polytomously scored items, multiple items based on a single stimulus (a “testlet”), and the increased use of a generalized mixture of binary and polytomous item formats. In this paper, the authors extend earlier work on the modeling of testlet-based response data to include the situation in which a test is composed, partially or completely, of polytomously scored items and/or testlets. The model they propose, a modified version of commonly employed item response models, is embedded within a fully Bayesian framework, and inferences under the model are obtained using Markov chain Monte Carlo techniques. The authors demonstrate its use within a designed series of simulations and by analyzing operational data from the North Carolina Test of Computer Skills and the Educational Testing Service’s Test of Spoken English. Their empirical findings suggest that the North Carolina Test of Computer Skills exhibits significant testlet effects, indicating significant dependence of item scores obtained from common stimuli, whereas the Test of Spoken English does not.",0,1 +2495,A Spatial Analysis of Basketball Shot Chart Data,"Basketball coaches at all levels use shot charts to study shot locations and outcomes for their own teams as well as upcoming opponents. Shot charts are simple plots of the location and result of each shot taken during a game. Although shot chart data are rapidly increasing in richness and availability, most coaches still use them purely as descriptive summaries. However, a team's ability to defend a certain player could potentially be improved by using shot data to make inferences about the player's tendencies and abilities. This article develops hierarchical spatial models for shot-chart data, which allow for spatially varying effects of covariates. Our spatial models permit differential smoothing of the fitted surface in two spatial directions, which naturally correspond to polar coordinates: distance to the basket and angle from the line connecting the two baskets. We illustrate our approach using the 2003–2004 shot chart data for Minnesota Timberwolves guard Sam Cassell.",0,1 +2496,A New Algorithm for Simulating a Correlation Matrix Based on Parameter Expansion and Reparameterization,"The correlation matrix (denoted by R) plays an important role in many statistical models. Unfortunately, sampling the correlation matrix in Markov chain Monte Carlo (MCMC) algorithms can be problematic. In addition to the positive definite constraint of covariance matrices, correlation matrices have diagonal elements fixed at one. In this article, we propose an efficient two-stage parameter expanded reparameterization and Metropolis-Hastings (PX-RPMH) algorithm for simulating R. Using this algorithm, we draw all elements of R simultaneously by first drawing a covariance matrix from an inverse Wishart distribution, and then translating it back to a correlation matrix through a reduction function and accepting it based on a Metropolis-Hastings acceptance probability. This algorithm is illustrated using multivariate probit (MVP) models and multivariate regression (MVR) models with a common correlation matrix across groups. Via both a simulation study and a real data example, the performance of the PX-RPMH al...",0,1 +2497,Estimating causal effects of treatments in randomized and nonrandomized studies.,"A discussion of matching, randomization, random sampling, and other methods of controlling extraneous variation is presented. The objective is to specify the benefits of randomization in estimating causal effects of treatments. The basic conclusion is that randomization should be employed whenever possible but that the use of carefully controlled nonrandomized data to estimate causal effects is a reasonable and necessary procedure in many cases. Recent psychological and educational literature has included extensive criticism of the use of nonrandomized studies to estimate causal effects of treatments (e.g., Campbell & Erlebacher, 1970). The implication in much of this literature is that only properly randomized experiments can lead to useful estimates of causal effects. If taken as applying to all fields of study, this position is untenable. Since the extensive use of randomized experiments is limited to the last half century,8 and in fact is not used in much scientific investigation today,4 one is led to the conclusion that most scientific truths have been established without using randomized experiments. In addition, most of us successfully determine the causal effects of many of our everyday actions, even interpersonal behaviors, without the benefit of randomization. Even if the position that causal effects of treatments can only be well established from randomized experiments is taken as applying only to the social sciences in which",0,1 +2498,Auditory temporal modulation of the visual Ternus effect: the influence of time interval,"Research on multisensory interactions has shown that the perceived timing of a visual event can be captured by a temporally proximal sound. This effect has been termed 'temporal ventriloquism effect.' Using the Ternus display, we systematically investigated how auditory configurations modulate the visual apparent-motion percepts. The Ternus display involves a multielement stimulus that can induce either of two different percepts of apparent motion: 'element motion' or 'group motion'. We found that two sounds presented in temporal proximity to, or synchronously with, the two visual frames, respectively, can shift the transitional threshold for visual apparent motion (Experiments 1 and 3). However, such effects were not evident with single-sound configurations (Experiment 2). A further experiment (Experiment 4) provided evidence that time interval information is an important factor for crossmodal interaction of audiovisual Ternus effect. The auditory interval was perceived as longer than the same physical visual interval in the sub-second range. Furthermore, the perceived audiovisual interval could be predicted by optimal integration of the visual and auditory intervals. © 2010 Springer-Verlag.",0,1 +2499,Intrathecal interleukin-10 gene therapy attenuates paclitaxel-induced mechanical allodynia and proinflammatory cytokine expression in dorsal root ganglia in rats,"Paclitaxel is a commonly used cancer chemotherapy drug that frequently causes painful peripheral neuropathies. The mechanisms underlying this dose-limiting side effect are poorly understood. Growing evidence supports that proinflammatory cytokines, such as interleukin-1 (IL-1) and tumor necrosis factor (TNF), released by activated spinal glial cells and within the dorsal root ganglia (DRG) are critical in enhancing pain in various animal models of neuropathic pain. Whether these cytokines are involved in paclitaxel-induced neuropathy is unknown. Here, using a rat neuropathic pain model induced by repeated systemic paclitaxel injections, we examined whether paclitaxel upregulates proinflammatory cytokine gene expression, and whether these changes and paclitaxel-induced mechanical allodynia can be attenuated by intrathecal IL-1 receptor antagonist (IL-1ra) or intrathecal delivery of plasmid DNA encoding the anti-inflammatory cytokine, interleukin-10 (IL-10). The data show that paclitaxel treatment induces mRNA expression of IL-1, TNF, and immune cell markers in lumbar DRG. Intrathecal IL-1ra reversed paclitaxel-induced allodynia and intrathecal IL-10 gene therapy both prevented, and progressively reversed, this allodynic state. Moreover, IL-10 gene therapy resulted in increased IL-10 mRNA levels in lumbar DRG and meninges, measured 2 weeks after initiation of therapy, whereas paclitaxel-induced expression of IL-1, TNF, and CD11b mRNA in lumbar DRG was markedly decreased. Taken together, these data support that paclitaxel-induced neuropathic pain is mediated by proinflammatory cytokines, possibly released by activated immune cells in the DRG. We propose that targeting the production of proinflammatory cytokines by intrathecal IL-10 gene therapy may be a promising therapeutic strategy for the relief of paclitaxel-induced neuropathic pain.",0,1 +2500,Normal distribution based pseudo ML for missing data: With applications to mean and covariance structure analysis,"When missing data are either missing completely at random (MCAR) or missing at random (MAR), the maximum likelihood (ML) estimation procedure preserves many of its properties. However, in any statistical modeling, the distribution specification for the likelihood function is at best only an approximation to the real world. In particular, since the normal-distribution-based ML is typically applied to data with heterogeneous marginal skewness and kurtosis, it is necessary to know whether such a practice still generates consistent parameter estimates. When the manifest variables are linear combinations of independent random components and missing data are MAR, this paper shows that the normal-distribution-based MLE is consistent regardless of the distribution of the sample. Examples also show that the consistency of the MLE is not guaranteed for all nonnormally distributed samples. When the population follows a confirmatory factor model, and data are missing due to the magnitude of the factors, the MLE may not be consistent even when data are normally distributed. When data are missing due to the magnitude of measurement errors/uniqueness, MLEs for many of the covariance parameters related to the missing variables are still consistent. This paper also identifies and discusses the factors that affect the asymptotic biases of the MLE when data are not missing at random. In addition, the paper also shows that, under certain data models and MAR mechanism, the MLE is asymptotically normally distributed and the asymptotic covariance matrix is consistently estimated by the commonly used sandwich-type covariance matrix. The results indicate that certain formulas and/or conclusions in the existing literature may not be entirely correct.",0,1 +2501,Monte Carlo sampling methods using Markov chains and their applications,"SUMMARY A generalization of the sampling method introduced by Metropolis et al. (1953) is presented along with an exposition of the relevant theory, techniques of application and methods and difficulties of assessing the error in Monte Carlo estimates. Examples of the methods, including the generation of random orthogonal matrices and potential applications of the methods to numerical problems arising in statistics, are discussed. For numerical problems in a large number of dimensions, Monte Carlo methods are often more efficient than conventional numerical methods. However, implementation of the Monte Carlo methods requires sampling from high dimensional probability distributions and this may be very difficult and expensive in analysis and computer time. General methods for sampling from, or estimating expectations with respect to, such distributions are as follows. (i) If possible, factorize the distribution into the product of one-dimensional conditional distributions from which samples may be obtained. (ii) Use importance sampling, which may also be used for variance reduction. That is, in order to evaluate the integral J = X) p(x)dx = Ev(f), where p(x) is a probability density function, instead of obtaining independent samples XI, ..., Xv from p(x) and using the estimate J, = Zf(xi)/N, we instead obtain the sample from a distribution with density q(x) and use the estimate J2 = Y{f(xj)p(x1)}/{q(xj)N}. This may be advantageous if it is easier to sample from q(x) thanp(x), but it is a difficult method to use in a large number of dimensions, since the values of the weights w(xi) = p(x1)/q(xj) for reasonable values of N may all be extremely small, or a few may be extremely large. In estimating the probability of an event A, however, these difficulties may not be as serious since the only values of w(x) which are important are those for which x -A. Since the methods proposed by Trotter & Tukey (1956) for the estimation of conditional expectations require the use of importance sampling, the same difficulties may be encountered in their use. (iii) Use a simulation technique; that is, if it is difficult to sample directly from p(x) or if p(x) is unknown, sample from some distribution q(y) and obtain the sample x values as some function of the corresponding y values. If we want samples from the conditional dis",0,1 +2502,Equating Tests Under the Graded Response Model,"The Stocking and Lord (1983) procedure for computing equating coefficients for tests having dichotomously scored items is extended to the case of graded response items. A system of equations for obtaining the equating coefficients under Samejima's (1969, 1972) graded response model is derived. These equations are used to compute equating coefficients in two related situations. Under the first, the equating coefficients are obtained by matching, on an examinee by examinee basis, the true scores on two tests. In the second case, the equating coefficients are obtained by matching the test characteristic curves (TCCS) of the two tests. Several examples of computing equating coefficients in these two situations are provided. The TCC matching ap proach was much less demanding computationally and yielded equating coefficients that differed little from those obtained through the true score distribution matching approach.",0,1 +2503,A Language and Program for Complex Bayesian Modelling,"Gibbs sampling has enormous potential for analysing complex data sets. However, routine use of Gibbs sampling has been hampered by the lack of general purpose software for its implementation. Until now all applications have involved writing one-off computer code in low or intermediate level languages such as C or Fortran. We describe some general purpose software that we are currently developing for implementing Gibbs sampling: BUGS (Bayesian inference using Gibbs sampling). The BUGS system comprises three components: first, a natural language for specifying complex models; second, an 'expert system' for deciding appropriate methods for obtaining samples required by the Gibbs sampler; third, a sampling module containing numerical routines to perform the sampling. S objects are used for data input and output. BUGS is written in Modula-2 and runs under both DOS and UNIX.",0,1 +2504,Comparative safety and effectiveness of cognitive enhancers for Alzheimer's dementia: protocol for a systematic review and individual patient data network meta-analysis,"Alzheimer's dementia (AD) is the most common cause of dementia, and several organisations, such as the National Institute for Health and Care Excellence, suggest that management of patients with AD should be tailored to their needs. To date, little research has been conducted on the treatment effect in different subgroups of patients with AD. The aim of this study is to examine the comparative effectiveness and safety of cognitive enhancers for different patient characteristics.We will update our previous literature search from January 2015 forward, using the same terms and electronic databases (eg, MEDLINE) from our previous review. We will additionally search grey literature and scan the reference lists of the included studies. Randomised clinical trials of any duration conducted at any time comparing cognitive enhancers alone or in any combination against other cognitive enhancers, or placebo in adults with AD will be eligible. The outcomes of interest are cognition according to the Mini-Mental State Examination, and overall serious adverse events. For each outcome and treatment comparison, we will perform a Bayesian hierarchical random-effects meta-analysis combining the individual patient data (IPD) from each eligible study. If the identified treatment comparisons form a connected network diagram, we will perform an IPD network meta-analysis (NMA) to estimate subgroup effects for patients with different characteristics, such as AD severity and sex. We will combine aggregated data from studies that we will not be able to obtain IPD, with the IPD provided by the original authors, in a single model. We will use the PRISMA-IPD and PRISMA-NMA statements to report our findings.The findings of this study will be of interest to stakeholders, including decision makers, guideline developers, clinicians, methodologists and patients, and they will help to improve guidelines for the management of patients with AD.CRD42015023507.",0,1 +2505,Bayesian Semiparametric Structural Equation Models with Latent Variables,"Structural equation models (SEMs) with latent variables are widely useful for sparse covariance structure modeling and for inferring relationships among latent variables. Bayesian SEMs are appealing in allowing for the incorporation of prior information and in providing exact posterior distributions of unknowns, including the latent variables. In this article, we propose a broad class of semiparametric Bayesian SEMs, which allow mixed categorical and continuous manifest variables while also allowing the latent variables to have unknown distributions. In order to include typical identifiability restrictions on the latent variable distributions, we rely on centered Dirichlet process (CDP) and CDP mixture (CDPM) models. The CDP will induce a latent class model with an unknown number of classes, while the CDPM will induce a latent trait model with unknown densities for the latent traits. A simple and efficient Markov chain Monte Carlo algorithm is developed for posterior computation, and the methods are illustrated using simulated examples, and several applications. © 2010 The Psychometric Society.",0,1 +2506,Multilevel Modeling in the Context of Growth Modeling,"Multilevel modeling is a flexible approach for the analysis of nested data structures, such as those encountered in longitudinal studies with repeated measures of an outcome of interest taken across time and nested within subjects. The baseline score on the outcome and rate of change vary across subjects, and subject level predictor variables may be used to explain part of the between-subject variability. This contribution shows how to formulate linear and logistic models for continuous and binary outcomes. A study of the effect of growth hormone in adolescents with short stature is used as an illustrative example to demonstrate the use of these models and to aid in the interpretation of model parameter estimates. Attention is also paid to sufficient sample sizes, and two methods to explore the relation between sample size and power of statistical tests are discussed.",0,1 +2507,Subjective probability: A judgment of representativeness,"This paper explores a heuristic — representativeness — according to which the subjective probability of an event, or a sample, is determined by the degree to which it: (i) is similar in essential characteristics to its parent population; and (ii) reflects the salient features of the process by which it is generated. This heuristic is explicated in a series of empirical examples demonstrating predictable and systematic errors in the evaluation of uncertain events. In particular, since sample size does not represent any property of the population, it is expected to have little or no effect on judgment of likelihood. This prediction is confirmed in studies showing that subjective sampling distributions and posterior probability judgments are determined by the most salient characteristic of the sample (e.g., proportion, mean) without regard to the size of the sample. The present heuristic approach is contrasted with the normative (Bayesian) approach to the analysis of the judgment of uncertainty.",0,1 +2508,Task differences as moderators of aptitude test validity in selection: A red herring.,"This article describes results of two studies, based on a total sample size of nearly 400,000, examining the traditional belief that between-job task differences cause aptitude tests to be valid for some jobs but not for others. Results indicate that aptitude tests are valid across jobs. The moderating effect of tasks is negligible even when jobs differ grossly in task makeup and is probably nonexistent when task differences are less extreme. These results have important implications for validity generalization, for the use of task-oriented job analysis in selection research, for criterion construction, for moderator research, and for proper interpretation of the Uniform Guidelines on Employee Selection Procedures. The philosophy of science and methodological assumptions historically underlying belief in the hypothesis that tasks are important moderators of test validities are examined and critiqued. It is concluded that the belief in this hypothesis can be traced to behaviorist assumptions introduced into personnel psychology in the early 1960s and that, in retrospect, these assumptions can be seen to be false.",0,1 +2509,On feeling good at work: the role of regulatory mode and passion in psychological adjustment,"Abstract The major postulate of this work is that regulatory modes influence the type ofpassion people experience with regard to an activity,which in turn influences theirpsychological adjustment. Integrating regulatory mode theory and the dualisticmodelof passion,wehypothesizedthatlocomotion—associatedwithintrinsicandautonomousmotivations—wouldpositivelypredictharmoniouspassion,whichinturn would enhance workers’ psychological adjustment. In contrast, we hypoth-esized that assessment—associated with extrinsic and non-autonomousmotivations—would positively predict obsessive passion, which in turn wouldreduce workers’ psychological adjustment. Two field studies supported thesehypotheseswithpsychologicaladjustmentmeasuresofstress(Study1)andburnout(Study2)indifferentworkcontexts.SusanandClaireworkforthesamefinancialdepartmentofahardware supply company.At work,they assist their manag-ers in making strategic decisions and ensure that the comp-any’s operations run smoothly. Susan is a“doer,”she bustlesabout all day and works relentlessly to get the job done,whereasClaireismoredetail-orientedandalwaysensuresheisdoing“therightthing.”Despite,havingsimilarresponsibil-ities and being equally committed to their work, Susan andClaire’s work experience is much different. Susan is con-stantly full of energy and copes very well with stress.After aday’s work, she can easily let go of her responsibilities andenjoy other activities in her life. Claire, on the other hand,feels emotionally drained and constantly preoccupied withherwork,evenoutsideworkinghours.Howcanthisbe?Inthelastdecades,muchresearchhasfocusedonworker’spsychological adjustment: a billion dollar problem drainingorganizational profit by increasing turnover rates (Gupta B Schaufeli & Salanova,2007). For instance, extensive work has been conductedon topics such as supervisor–subordinate relationships(Landeweerd & Boumans, 1994; Tepper, 2000) and socialsupport at work (for a review, see Viswesvaran, Sanchez, &Fisher, 1999).However,as the preceding example illustrates,one important question that remains is how can peopleexperience diametrically opposed psychological adjustmentdespite working in similar environment? The presentresearch addresses this theoretical question by investigatingthe interface between regulatory mode theory (Kruglanskiet al., 2000) and the dualistic model of passion (Vallerandet al.,2003).Inthepresentarticle,weproposethatonepivotalfactorforpsychologicaladjustmentcanbefoundinworkers’attitudetowardtheirwork.Specifically,wesuggestthatbasicself-regulatory processes such as locomotion (i.e., being a“doer”) and assessment (i.e., “doing the right thing”) canimpact individuals’ psychological adjustment by influencingthe type of passion individuals entertain for an importantactivity(e.g.,work).Inturn,thetypeofpassion(harmoniousvs.obsessive)onedevelopsforanactivitycaneitherfacilitateorpreventtheoccurrenceof stressandburnoutatwork.",0,1 +2510,Perception of out-group homogeneity and levels of social categorization: Memory for the subordinate attributes of in-group and out-group members.,"Four experiments were conducted to explore the hypothesis that in-group members perceive their own group as more variegated and complex than do out-group members (the out-group homogeneity principle). The first three experiments were designed to demonstrate this effect in a symmetric manner for both parties of the in-group-out-group dichotomy, and the fourth experiment tested one particular theoretical account of this phenomenon. In Experiments 1 and 2, men and women subjects estimated the proportion of men or women who would endorse a variety of personality/attitude items. The items were constructed to vary on the dimensions of stereotypic meaning (masculinity-femininity) and social desirability (favorable-unfavorable). It was predicted and found that outgroup members viewed a group as endorsing more stereotypic and fewer counterstereotypic items than, did in-group members. These findings were interpreted as support for the out-group homogeneity principle, and it was argued that since this effect was general across items varying in social desirability, the phenomenon was independent of traditional ethnocentrism effects. Experiment 3 asked members of three campus sororities to directly judge the degree of intragroup similarity for their own group and two other groups. Again, each group judged its own members to be more dissimilar to one another than did out-group judges. In Experiment 4 a theory was proposed suggesting that different levels of social categorization are used to encode in-group and out-group members' behavior and that this process could account for the perception of out-group homogeneity. It was predicted and found that men and women were more likely to remember the subordinate attributes of an in-group member than of an out-group member, which provides some evidence for the theoretical model.",0,1 +2511,The determinants of individual attitudes towards immigration,"The paper formulates hypotheses and reports on individual attitudes towards immigration based on data for 24 countries on socioeconomic position, sociodemographic characteristics and political attitudes. The results are consistent with the predictions of factor proportions trade theory, but also suggest that a range of other economic and cultural factors influence attitudes towards immigration.",0,1 +2512,Performance of a Bayesian state-space model of semelparous species for stock-recruitment data subject to measurement error,"Abstract Measurement errors in spawner abundance create problems for fish stock assessment scientists. To deal with measurement error, we develop a Bayesian state-space model for stock-recruitment data that contain measurement error in spawner abundance, process error in recruitment, and time series bias. Through extensive simulations across numerous scenarios, we compare the statistical performance of the Bayesian state-space model with that of standard regression for a traditional stock-recruitment model that only considers process error. Performance varies depending on the information content in data, as determined by stock productivity, types of harvest situations, and amount of measurement error. Overall, in terms of estimating optimal spawner abundance S MSY , the Ricker density-dependence parameter β , and optimal harvest rate h MSY , the Bayesian state-space model works best for informative data from low and variable harvest rate situations for high-productivity salmon stocks. The traditional stock-recruitment model (TSR) may be used for estimating α and h MSY for low-productivity stocks from variable and high harvest rate situations. However, TSR can severely overestimate S MSY when spawner abundance is measured with large error in low and variable harvest rate situations. We also found that there is substantial merit in using h MSY (or benchmarks derived from it) instead of S MSY as a management target.",0,1 +2513,Spinal gap junctions: Potential involvement in pain facilitation,"Glia are now recognized as important contributors in pathological pain creation and maintenance. Spinal cord glia exhibit extensive gap junctional connectivity, raising the possibility that glia are involved in the contralateral spread of excitation resulting in mirror image pain. In the present experiments, the gap junction decoupler carbenoxolone was administered intrathecally after induction of neuropathic pain in response to sciatic nerve inflammation (sciatic inflammatory neuropathy) or partial nerve injury (chronic constriction injury). In both neuropathic pain models, a low dose of carbenoxolone reversed mirror image mechanical allodynia, while leaving ipsilateral mechanical allodynia unaffected. Ipsilateral thermal hyperalgesia was briefly attenuated. Critically, blockade of mechanical allodynia and thermal hyperalgesia was not observed in response to intrathecal glycyrrhizic acid, a compound similar to carbenoxolone in all respects but it does not decouple gap junctions. Thus, blockade of mechanical allodynia and thermal hyperalgesia by carbenoxolone does appear to reflect an effect on gap junctions. Examination of carbenoxolone's effects on intrathecal human immunodeficiency virus type 1 gp120 showed that blockade of pain facilitation might result, at least in part, via suppression of interleukin-1 and, in turn, interleukin-6. These data provide the first suggestion that spread of excitation via gap junctions might contribute importantly to inflammatory and traumatic neuropathic pain.The current studies provide evidence for involvement of gap junctions in spinal cord pain facilitation. Intrathecal carbenoxolone, a gap junction decoupler, reversed neuropathy-induced mirror image pain and intrathecal gp120-induced allodynia. In addition, it decreased gp120-induced proinflammatory cytokines. This suggests gap junction activation might lead to proinflammatory cytokine release by distantly activated glia.",0,1 +2514,Bayesian analysis of multi-group nonlinear structural equation models with application to behavioral finance,"Structural equation models (SEMs) have been widely used to determine the relationships among certain observed and latent variables in behavioral finance. The purpose of this paper is to develop a Bayesian approach for analysing multi-group nonlinear SEMs. Using recently developed tools in statistical computing, such as the Gibbs sampler, we propose an efficient method to estimate parameters and select an appropriate model. The proposed method is used to investigate the relationships among all identified influential factors that have an impact on the motivation for insider trading within the framework of behavioral finance.",0,1 +2515,"A Choice Model with Conjunctive, Disjunctive, and Compensatory Screening Rules","Many theories of consumer behavior involve thresholds and discontinuities. In this paper, we investigate consumers' use of screening rules as part of a discrete-choice model. Alternatives that pass the screen are evaluated in a manner consistent with random utility theory; alternatives that do not pass the screen have a zero probability of being chosen. The proposed model accommodates conjunctive, disjunctive, and compensatory screening rules. We estimate a model that reflects a discontinuous decision process by employing the Bayesian technique of data augmentation and using Markov-chain Monte Carlo methods to integrate over the parameter space. The approach has minimal information requirements and can handle a large number of choice alternatives. The method is illustrated using a conjoint study of cameras. The results indicate that 92% of respondents screen alternatives on one or more attributes.",0,1 +2516,Bayesian Factor Analysis as a Variable-Selection Problem: Alternative Priors and Consequences,"Factor analysis is a popular statistical technique for multivariate data analysis. Developments in the structural equation modeling framework have enabled the use of hybrid confirmatory/exploratory approaches in which factor-loading structures can be explored relatively flexibly within a confirmatory factor analysis (CFA) framework. Recently, Muthén & Asparouhov proposed a Bayesian structural equation modeling (BSEM) approach to explore the presence of cross loadings in CFA models. We show that the issue of determining factor-loading patterns may be formulated as a Bayesian variable selection problem in which Muthén and Asparouhov's approach can be regarded as a BSEM approach with ridge regression prior (BSEM-RP). We propose another Bayesian approach, denoted herein as the Bayesian structural equation modeling with spike-and-slab prior (BSEM-SSP), which serves as a one-stage alternative to the BSEM-RP. We review the theoretical advantages and disadvantages of both approaches and compare their empirical performance relative to two modification indices-based approaches and exploratory factor analysis with target rotation. A teacher stress scale data set is used to demonstrate our approach.",0,1 +2517,Does Prior Specification Matter in Hotspot Identification and Before–After Road Safety Studies?,"This study investigated the effects of prior assumptions in applications of full Bayes methods in road safety analysis. The effect of prior choice was evaluated in the accuracy of model parameters, hotspot identification, goodness of fit, and a treatment effectiveness index in before–after studies. Particular attention was devoted to conditions with a lack of data, which were referenced as the low-mean and small-sample problem. In this research, informative, semi-informative, and noninformative priors were determined on the basis of past published studies. A simulation framework was used to evaluate various scenarios of sample size and crash occurrence mean. Quasi-simulated data were generated on the basis of two empirical databases of divided and undivided rural highway segments in New York and Texas. Various sample mean values were obtained on the basis of time period (number of years) and classifying accidents in fatal–injury and total accidents. The outcomes under low-mean and small-sample conditions were found to be significantly biased. However, the introduction of informative priors can make observational before–after studies feasible when a few observations from treatment or comparison sites are used. Informative priors can help provide more accurate estimates of the effectiveness of the treatment. Finally, in accordance with previous works, the inverse dispersion parameter was significantly affected by prior specifications; nevertheless, regression parameters, goodness of fit, and hotspot identification were less sensitive to prior choices.",0,1 +2518,"Monte Carlo Comparison of ANOVA, MIVQUE, REML, and ML Estimators of Variance Components","For the one-way classification random model with unbalanced data, we compare five estimators of σ2 a and σ2 e , the among- and within-treatments variance components: analysis of variance (ANOVA), maximum likelihood (ML), restricted maximum likelihood (REML), and two minimum variance quadratic unbiased (MIVQUE) estimators. MIVQUE(0) is MIVQUE with a priori values = 0 and = 1; MIVQUE(A) is MIVQUE with the ANOVA estimates used as a priori's, We enforce nonnegativity for all estimators, setting any negative estimate to zero in accord with usual practice. The estimators are compared through their biases and MSE's, estimated by Monte Carlo simulation. Our results indicate that the ANOVA estimators perform well, except with seriously unbalanced data when σ2 a /σ2 e > 1; ML is excellent when σ2 a /σ2 e < 0.5, and MIVQUE(A) is adequate; further iteration to the REML estimates is unnecessary. When σ2 a /σ2 e ≥ 1, MIVQUE(0) (the default for SASS PROCEDURE VARCOMP) is poor for estimating σ2 a and very poor for σ2 e ,...",0,1 +2519,A re-evaluation of random-effects meta-analysis,"Meta-analysis in the presence of unexplained heterogeneity is frequently undertaken by using a random-effects model, in which the effects underlying different studies are assumed to be drawn from a normal distribution. Here we discuss the justification and interpretation of such models, by addressing in turn the aims of estimation, prediction and hypothesis testing. A particular issue that we consider is the distinction between inference on the mean of the random-effects distribution and inference on the whole distribution. We suggest that random-effects meta-analyses as currently conducted often fail to provide the key results, and we investigate the extent to which distribution-free, classical and Bayesian approaches can provide satisfactory methods. We conclude that the Bayesian approach has the advantage of naturally allowing for full uncertainty, especially for prediction. However, it is not without problems, including computational intensity and sensitivity to a priori judgements. We propose a simple prediction interval for classical meta-analysis and offer extensions to standard practice of Bayesian meta-analysis, making use of an example of studies of 'set shifting' ability in people with eating disorders.",0,1 +2520,The impact of ignoring multiple membership data structures in multilevel models,"This study compared the use of the conventional multilevel model (MM) with that of the multiple membership multilevel model (MMMM) for handling multiple membership data structures. Multiple membership data structures are commonly encountered in longitudinal educational data sets in which, for example, mobile students are members of more than one higher-level unit (e.g., school). While the conventional MM requires the user either to delete mobile students' data or to ignore prior schools attended, MMMM permits inclusion of mobile students' data and models the effect of all schools attended on student outcomes. The simulation study identified underestimation of the school-level predictor coefficient, as well as underestimation of the level-two variance component with corresponding overestimation of the level-one variance when multiple membership data structures were ignored. Results are discussed along with limitations and ideas for future MMMM methodological research as well as implications for applied researchers.",0,1 +2521,"Understanding the New Statistics: Effect Sizes, Confidence Intervals, and Meta-Analysis","Preface. About this Book 1. Introduction to The New Statistics 2. From Null Hypothesis Significance Testing to Effect Sizes 3. Confidence Intervals 4. Confidence Intervals, Error Bars, and p Values 5. Replication 6. Two Simple Designs 7. Meta-Analysis 1: Introduction and Forest Plots 8. Meta-Analysis 2: Models 9. Meta-Analysis 3: Large-Scale Analyses 10. The Noncentral t Distribution 11. Cohen's d 12. Power 13. Precision for Planning 14. Correlations, Proportions, and Further Effect Size Measures 15. More Complex Designs and The New Statistics in Practice. Glossary. Appendixes A. Loading and Using ESCI. B. ESCI for the Normal and t Distributions, and Values of z and t. C. Guide to the ESCI Modules and Pages",0,1 +2522,Model-Based Segmentation Featuring Simultaneous Segment-Level Variable Selection,"The authors propose a new Bayesian latent structure regression model with variable selection to solve various commonly encountered marketing problems related to market segmentation and heterogeneity. The proposed procedure simultaneously performs segmentation and regression analysis within the derived segments, in addition to determining the optimal subset of independent variables per derived segment. The authors present comparative analyses contrasting the performance of the proposed methodology against standard latent class regression and traditional Bayesian finite mixture regression. They demonstrate that their proposed Bayesian model compares favorably with these traditional benchmark models. They then present an actual commercial customer satisfaction study performed for an electric utility company in the southeastern United States, in which they examine the heterogeneous drivers of perceived quality. Finally, they discuss limitations of the research and provide several directions for further research.",0,1 +2523,Round-robin analysis of social interaction: Exact and estimated standard errors,Kenny has proposed a variance-components model for dyadic social interaction. His Social Relations model estimates variances and covariances from a round-robin of two-person interactions. The current paper presents a matrix formulation of the Social Relations model. It uses the formulation to derive exact and estimated standard errors for round-robin estimates of Social Relations parameters.,0,1 +2524,Approximate Bayesian Inference in Conditionally Independent Hierarchical Models (Parametric Empirical Bayes Models),"Abstract We consider two-stage models of the kind used in parametric empirical Bayes (PEB) methodology, calling them conditionally independent hierarchical models. We suppose that there are k “units,” which may be experimental subjects, cities, study centers, etcetera. At the first stage, the observation vectors Yi for units i = 1, …, k are independently distributed with densities p(yi | θi ), or more generally, p(yi | θi, λ). At the second stage, the unit-specific parameter vectors θi are iid with densities p(θi | λ). The PEB approach proceeds by regarding the second-stage distribution as a prior and noting that, if λ were known, inference about θ could be based on its posterior. Since λ is not known, the simplest PEB methods estimate the parameter λ by maximum likelihood or some variant, and then treat λ as if it were known to be equal to this estimate. Although this procedure is sometimes satisfactory, a well-known defect is that it neglects the uncertainty due to the estimation of λ. In this article w...",0,1 +2525,INCORPORATING VARIABILITY IN ESTIMATES OF HETEROGENEITY IN THE RANDOM EFFECTS MODEL IN META-ANALYSIS,"When combining results from separate investigations in a meta-analysis, random effects methods enable the modelling of differences between studies by incorporating a heterogeneity parameter τ2 that accounts explicitly for across-study variation. We develop a simple form for the variance of Cochran's homogeneity statistic Q, leading to interval estimation of τ2 utilizing an approximating distribution for Q; this enables us to extend the point estimation of DerSimonian and Laird. We also develop asymptotic likelihood methods and compared them with this method. We then use these approximating distributions to give a new method of calculating the weight given to the individual studies’ results when estimating the overall mean which takes into account variation in these point estimates of τ2. Two examples illustrate the methods presented, where we show that the new weighting scheme is between the standard fixed and random effects models in down-weighting the results of large studies and up-weighting those of small studies. © 1997 by John Wiley & Sons, Ltd.",0,1 +2526,Item factor analysis: Current approaches and future directions.,"The rationale underlying factor analysis applies to continuous and categorical variables alike; however, the models and estimation methods for continuous (i.e., interval or ratio scale) data are not appropriate for item-level data that are categorical in nature. The authors provide a targeted review and synthesis of the item factor analysis (IFA) estimation literature for ordered-categorical data (e.g., Likert-type response scales) with specific attention paid to the problems of estimating models with many items and many factors. Popular IFA models and estimation methods found in the structural equation modeling and item response theory literatures are presented. Following this presentation, recent developments in the estimation of IFA parameters (e.g., Markov chain Monte Carlo) are discussed. The authors conclude with considerations for future research on IFA, simulated examples, and advice for applied researchers.",0,1 +2527,Use of Bayesian Markov Chain Monte Carlo Methods to Model Cost-of-Illness Data,"It is well known that the modeling of cost data is often problematic due to the distribution of such data. Commonly observed problems include 1) a strongly right-skewed data distribution and 2) a significant percentage of zero-cost observations. This article demonstrates how a hurdle model can be implemented from a Bayesian perspective by means of Markov Chain Monte Carlo simulation methods using the freely available software WinBUGS. Assessment of model fit is addressed through the implementation of two cross-validation methods. The relative merits of this Bayesian approach compared to the classical equivalent are discussed in detail. To illustrate the methods described, patient-specific non-health-care resource-use data from a prospective longitudinal study and the Norfolk Arthritis Register (NOAR) are utilized for 218 individuals with early inflammatory polyarthritis (IP). The NOAR database also includes information on various patient-level covariates.",0,1 +2528,Reparameterizing the generalized linear model to accelerate gibbs sampler convergence,"Albert and Chib introduced a complete Bayesian method to analyze data arising from the generalized linear model in which they used the Gibbs sampling algorithm facilitated by latent variables. Recently, Cowles proposed an alternative algorithm to accelerate the convergence of the Albert-Chib algorithm. The novelty in this latter algorithm is achieved by using a Hastings algorithm to generate latent variables and bin boundary parameters jointly instead of individually from their respective full conditionals. In the same spirit, we reparameterize the cumulative-link generalized linear model to accelerate the convergence of Cowles’ algorithm even further. One important advantage of our method is that for the three-bin problem it does not require the Hastings algorithm. In addition, for problems with more than three bins, while the Hastings algorithm is required, we provide a proposal density based on the Dirichlet distribution which is more natural than the truncated normal density used in the competing algo...",0,1 +2529,Assessing the evidence for response time mixture distributions,"I describe a technique for comparing two simple accounts of a distribution of response times: A mixture model and a generalized-shift model. In the mixture model, a target distribution is assumed to be a mixture of response times from two other (reference) distributions. In the generalized-shift model, the target distribution is assumed to be a quantile average of the reference distributions. In order to distinguish these two possibilities, quantiles for the target distribution are estimated from the quantiles of the reference distributions assuming either a shift or a mixture, and the predicted quantiles are used to calculate the multinomial likelihood of the obtained data. Monte Carlo simulations reported here demonstrate that the index is relatively unbiased, is effective with moderate sample sizes and modest spreads between the reference distributions, is relatively unaffected by changes in the number of bins or by data trimming, can be used with data aggregated across subjects, and is relatively insensitive to a range of subject variations in distribution shape and in mixture or shift proportion. As an illustration, the index is applied to the interpretation of three effects from distinct paradigms: residual switch costs in the task-switching paradigm, the psychological refractory period effect, and sequential effects in the Simon task. I conclude that the multinomial likelihood index provides a useful and easily applied tool for the interpretation of effects on response time distributions.",0,1 +2530,Estimating Item Response Theory Models Using Markov Chain Monte Carlo Methods,"The purpose of this ITEMS module is to provide an introduction to Markov chain Monte Carlo (MCMC) estimation for item response models. A brief description of Bayesian inference is followed by an overview of the various facets of MCMC algorithms, including discussion of prior specification, sampling procedures, and methods for evaluating chain convergence. Model comparison and fit issues in the context of MCMC are also considered. Finally, an illustration is provided in which a two-parameter logistic (2PL) model is fit to item response data from a university mathematics placement test through MCMC using the WINBUGS 1.4 software. While MCMC procedures are often complex and can be easily misused, it is suggested that they offer an attractive methodology for experimentation with new and potentially complex IRT models, as are frequently needed in real-world applications in educational measurement.",0,1 +2531,Stratified and Maximum Information Item Selection Procedures in Computer Adaptive Testing,"In this study we evaluated and compared three item selection procedures: the maximum Fisher information procedure (F), the a-stratified multistage computer adaptive testing (CAT) (STR), and a refined stratification procedure that allows more items to be selected from the high a strata and fewer items from the low a strata (USTR), along with completely random item selection (RAN). The comparisons were with respect to error variances, reliability of ability estimates and item usage through CATs simulated under nine test conditions of various practical constraints and item selection space. The results showed that F had an apparent precision advantage over STR and USTR under unconstrained item selection, but with very poor item usage. USTR reduced error variances for STR under various conditions, with small compromises in item usage. Compared to F, USTR enhanced item usage while achieving comparable precision in ability estimates; it achieved a precision level similar to F with improved item usage when items were selected under exposure control and with limited item selection space. The results provide implications for choosing an appropriate item selection procedure in applied settings.",0,1 +2532,Gaussian predictive process models for large spatial data sets,"With scientific data available at geocoded locations, investigators are increasingly turning to spatial process models for carrying out statistical inference. Over the last decade, hierarchical models implemented through Markov chain Monte Carlo methods have become especially popular for spatial modelling, given their flexibility and power to fit models that would be infeasible with classical methods as well as their avoidance of possibly inappropriate asymptotics. However, fitting hierarchical spatial models often involves expensive matrix decompositions whose computational complexity increases in cubic order with the number of spatial locations, rendering such models infeasible for large spatial data sets. This computational burden is exacerbated in multivariate settings with several spatially dependent response variables. It is also aggravated when data are collected at frequent time points and spatiotemporal process models are used. With regard to this challenge, our contribution is to work with what we call predictive process models for spatial and spatiotemporal data. Every spatial (or spatiotemporal) process induces a predictive process model (in fact, arbitrarily many of them). The latter models project process realizations of the former to a lower dimensional subspace, thereby reducing the computational burden. Hence, we achieve the flexibility to accommodate non-stationary, non-Gaussian, possibly multivariate, possibly spatiotemporal processes in the context of large data sets. We discuss attractive theoretical properties of these predictive processes. We also provide a computational template encompassing these diverse settings. Finally, we illustrate the approach with simulated and real data sets.",0,1 +2533,Identifying and Analyzing Extremes: Illustrated by CEOs’ Pay and Performance,"This article presents statistical methods for identifying outcomes in a given sample that can be inferred as plausible extreme and whether the extremes on two variables are associated. Applications to CEO pay and performance of 50 top-paid CEOs illustrate these methodologies. Thresholds between extremes and nonextremes are found using high probability intervals under the probability distributions that govern sampling variations of the sample extremes. A Bayesian approach is used to compute odds on the association between the extremes of the two variables. The extreme pay—performance analysis of 50 top-paid CEOs reveals astonishing odds in favor of a company being extreme high only on one of the two versus on both variables. The result is considered decisive evidence for a negative association between extreme on CEO pay and extreme on performance among such top-paid CEOs. By contrast, analysis of the nonextreme CEOs yielded no evidence of any association between CEO pay and performance.",0,1 +2534,"Assessing and testing prediction uncertainty for single tree-based models: A case study applied to northern hardwood stands in southern Québec, Canada","Abstract Estimating prediction uncertainty for a single tree-based model is hindered by the complex structure of these models. In this paper, we addressed this issue with a case study applied to northern hardwood stands in Quebec, Canada. SaMARE is a stochastic single tree-based model that was designed for these types of stands. Using a Monte Carlo approach, the model can provide a mean predicted value and its confidence limits for some plot-level attributes. The mean predicted values were compared to observed values in terms of bias and accuracy. In addition to these common statistics, we compared nominal coverage of Monte Carlo-simulated confidence intervals with real (observed) coverage to verify the adequacy of the simulated uncertainty. A comparison was made using several plot-level attributes, which exhibited an increasing discriminative complexity. This complexity ranges from coarse attributes, such as all-species basal area, up to more complex ones, such as basal area for stems of a particular species and with sawlog potential. The results showed that in terms of absolute value, biases were small, but could be relatively high with respect to the average observed value when the discriminative complexity of the attribute increased. The comparison between nominal and real coverage of confidence intervals gave satisfactory results for all-species plot-level attributes. However, for some species-specific attributes, the Monte Carlo-simulated confidence intervals overestimated the real coverage.",0,1 +2535,Kernel-Smoothing Estimation of Item Characteristic Functions for Continuous Personality Items: An Empirical Comparison with the Linear and the Continuous-Response Models,"This study used kernel-smoothing procedures to estimate the item characteristic functions (ICFs) of a set of continuous personality items. The nonparametric ICFs were compared with the ICFs estimated (a) by the linear model and (b) by Samejima’s continuous-response model. The study was based on a conditioned approach and used an error-in-variables kernel model. The assumptions of the model were approximately correct in the present conditions. The results obtained with the kernel procedure suggested that (a) the ICFs of these items were essentially sigmoid curves, as is usually assumed in parametric item response theory, and (b) for most of the items, these curves were well approximated by both the linear and the continuous-response model.",0,1 +2536,Bayesian Analysis of Nonlinear Structural Equation Models with Nonignorable Missing Data,"A Bayesian approach is developed for analyzing nonlinear structural equation models with nonignorable missing data. The nonignorable missingness mechanism is specified by a logistic regression model. A hybrid algorithm that combines the Gibbs sampler and the Metropolis - Hastings algorithm is used to produce the joint Bayesian estimates of structural parameters, latent variables, parameters in the nonignorable missing model, as well as their standard errors estimates. A goodness-of-fit statistic for assessing the plausibility of the posited nonlinear structural equation model is introduced, and a procedure for computing the Bayes factor for model comparison is developed via path sampling. Results obtained with respect to different missing data models, and different prior inputs are compared via simulation studies. In particular, it is shown that in the presence of nonignorable missing data, results obtained by the proposed method with a nonignorable missing data model are significantly better than those that are obtained under the missing at random assumption. A real example is presented to illustrate the newly developed Bayesian methodologies. © 2006 The Psychometric Society.",0,1 +2537,Exploratory Movement Generates Higher-Order Information That Is Sufficient for Accurate Perception of Scaled Egocentric Distance,"Body movement influences the structure of multiple forms of ambient energy, including optics and gravito-inertial force. Some researchers have argued that egocentric distance is derived from inferential integration of visual and non-visual stimulation. We suggest that accurate information about egocentric distance exists in perceptual stimulation as higher-order patterns that extend across optics and inertia. We formalize a pattern that specifies the egocentric distance of a stationary object across higher-order relations between optics and inertia. This higher-order parameter is created by self-generated movement of the perceiver in inertial space relative to the illuminated environment. For this reason, we placed minimal restrictions on the exploratory movements of our participants. We asked whether humans can detect and use the information available in this higher-order pattern. Participants judged whether a virtual object was within reach. We manipulated relations between body movement and the ambient structure of optics and inertia. Judgments were precise and accurate when the higher-order optical-inertial parameter was available. When only optic flow was available, judgments were poor. Our results reveal that participants perceived egocentric distance from the higher-order, optical-inertial consequences of their own exploratory activity. Analysis of participants' movement trajectories revealed that self-selected movements were complex, and tended to optimize availability of the optical-inertial pattern that specifies egocentric distance. We argue that accurate information about egocentric distance exists in higher-order patterns of ambient energy, that self-generated movement can generate these higher-order patterns, and that these patterns can be detected and used to support perception of egocentric distance that is precise and accurate.",0,1 +2538,A UNIFIED THEORY OF STATISTICAL ANALYSIS AND INFERENCE FOR VARIANCE COMPONENT MODELS FOR DYADIC DATA,"Using the covariance structure induced by the exchangeability of sampling units, a unified approach to the analysis of dyadic data is proposed. Dyadic data, encountered in diallel designs in genetics and other substantive scientific fields, arise when pairs of sampling units are studied. The problem has been addressed independently in a number of different areas of study. This paper argues that dyadic data structures involve the same statistical elements as those of ordinary analysis of variance and multivariate analysis. In addition to a synthesis of the available literature, the article provides a closed form expression of the Gaussian likelihood, the sufficient statistics and their joint distributions, and outlines for EM and ECM algorithms for handling missing data and other complications. The approach is illustrated with an applied example. The objective is to show that the analysis of dyadic data can be developed as a standard statistical method not unlike the analysis of variance, albeit with a multivariate twist. Dyadic data structures can be treated similarly to ordinary factorial structures and have the potential to be more widely used.",0,1 +2539,Investigating underlying risk as a source of heterogeneity in meta-analysis,"In a meta-analysis of clinical trials, an important issue is whether the treatment benefit varies according to the underlying risk of the patients in the different trials. The usual naive analyses employed to investigate this question use either the observed risk of events in the control groups, or the average risk in the control and treatment groups, as a measure of underlying risk. These analyses are flawed and can produce seriously misleading results. We show how their biases depend on three components of variability, the within-trial and between-trial variances of the control group risks, and the between-trial variance of the treatment effects. We propose a Bayesian solution to the problem which can be carried out using the BUGS implementation of Gibbs sampling. The analysis is illustrated for a meta-analysis of bleeding and mortality data in trials of sclerotherapy for patients with cirrhosis, and the results contrasted with those from the naive approaches. Comparisons with other methods recently proposed for this problem are also made. We conclude that the Bayesian solution presented in this paper is not only more appropriate than other proposed methods, but is also sufficiently easy to implement that it can be used by applied researchers undertaking meta-analyses.",0,1 +2540,"Empirical Bayes MCMC estimation for modeling treatment processes, mechanisms of change, and clinical outcomes in small samples.","The current analysis demonstrates the use of empirical Bayes (EB) estimation methods with data-derived prior parameters for studying clinically intricate process-mechanism-outcome linkages using structural equation modeling (SEM) with small samples.The data were obtained from a small subsample of 23 families receiving Functional Family Therapy (FFT) for adolescent substance abuse during a completed randomized clinical trial. Two or 3 video-recorded FFT sessions were randomly selected for each family. The middle 20-min portion of each session was observed and coded. An SEM examining the influence of a select set of observed therapist behaviors on pre- to posttreatment change in mother reports of family functioning and, in turn, pre- to posttreatment change in adolescent reports of adolescent marijuana use and delinquent behavior was specified. The SEM was implemented using EB estimation with data-derived maximum likelihood (ML) prior parameters and Markov Chain Monte Carlo (MCMC) estimation of the joint posterior distribution.The EB SEM results indicated that a relatively high proportion of individually focused general interventions (i.e., seek information, acknowledge) as well as relationally focused meaning change interventions by therapists during sessions of FFT were predictive of pre- to posttreatment increases in levels of family functioning as reported by mothers in families of substance-abusing adolescents. In turn, increases in mother-reported family functioning were predictive of reductions in levels of adolescent-reported delinquent behavior.EB MCMC methods produced more stable results than did ML, especially regarding the variances on the change factors in the SEM. EB MCMC estimation is a viable alternative to ML estimation of SEMs in clinical research with prohibitively small samples.",0,1 +2541,Similarities in Choice Behavior Across Product Categories,"Differences between consumers in sensitivity to marketing mix variables have been extensively documented in the scanner panel data. All studies of consumer heterogeneity focus on a specific category of products and ignore the fact that the purchase behavior of panel households is often observed simultaneously in multiple categories. If sensitivity to marketing mix variables is a common consumer trait, then one should expect to see similarities in sensitivity across multiple categories. The goal in this paper is to measure the covariance of both observed (linked to measured characteristics of households) and unobserved heterogeneity in marketing mix sensitivity across multiple categories. Measurement of correlation in sensitivities across categories will serve to guide the interpretation of the literature on household heterogeneity. If there is a large correlation, one can be more confident that sensitivity to marketing variables is a fundamental household property and not simply a category-specific anomaly. Detection of correlation in sensitivities across categories requires an appropriate methodology that can handle the high dimensional covariance structures and properly account for uncertainty in estimation. For example, a simple approach might be to fit a brand choice model to each of the available categories in turn, ignoring the data in the other categories. For each category, household parameter estimates could be obtained for the parameters corresponding to price, display, and feature sensitivity. These parameter estimates could be viewed as data and the correlations across categories could be computed. Such a procedure could induce a downward bias in the estimation of correlation due to the independent sampling errors, which are present in each parameter estimate. We develop a hierarchical model structure that introduces an explicit correlation structure across categories and utilizes the data in multiple categories at the same time. To reduce the size of the covariance matrix, we use a variance components approach. We introduce household-specific demographic variables to decompose the correlation across categories into that which can be ascribed to observable and unobservable sources. Shopping behavior variables such as shopping frequency and market basket size as well as intensity of shopping in a category are also included in the model. Using data on five categories, we find substantial and statistically important correlations ranging from .32 for price sensitivities to .58 for feature sensitivity. These correlations are much larger than the correlations obtained with the state-of-the-art techniques available prior to our work. We attribute our ability to detect substantial correlations to our method, which involves the joint use of multiple category data in a parsimonious and efficient manner. Unlike previous studies with panel data, household demographic variables are found to be strongly related to price sensitivity. Higher income households are less price sensitive and large families are more price sensitive. Shopping behavior variables are also important in explaining price sensitivity. Households that visit the store often are more price sensitive. Households with larger market baskets are less price sensitive, confirming the view of Bell and Lattin (1998). Heavy user households tend to be both less price sensitive and less display sensitive. The evidence presented here of substantial correlations validates, in part, the notion that sensitivity to marketing mix variables is a consumer trait and is not unique to specific product categories. It also opens the possibility of using information across categories in making inferences about consumer brand preference and marketing mix sensitivity, providing a richer source of information for target marketing.",0,1 +2542,Fitting Psychometric Functions Using a Fixed-Slope Parameter: An Advanced Alternative for Estimating Odor Thresholds With Data Generated by ASTM E679,"Psychometric functions are predominately used for estimating detection thresholds in vision and audition. However, the requirement of large data quantities for fitting psychometric functions (>30 replications) reduces their suitability in olfactory studies because olfactory response data are often limited (<4 replications) due to the susceptibility of human olfactory receptors to fatigue and adaptation. This article introduces a new method for fitting individual-judge psychometric functions to olfactory data obtained using the current standard protocol-American Society for Testing and Materials (ASTM) E679. The slope parameter of the individual-judge psychometric function is fixed to be the same as that of the group function; the same-shaped symmetrical sigmoid function is fitted only using the intercept. This study evaluated the proposed method by comparing it with 2 available methods. Comparison to conventional psychometric functions (fitted slope and intercept) indicated that the assumption of a fixed slope did not compromise precision of the threshold estimates. No systematic difference was obtained between the proposed method and the ASTM method in terms of group threshold estimates or threshold distributions, but there were changes in the rank, by threshold, of judges in the group. Overall, the fixed-slope psychometric function is recommended for obtaining relatively reliable individual threshold estimates when the quantity of data is limited.",0,1 +2543,Constructing a Control Group Using Multivariate Matched Sampling Methods That Incorporate the Propensity Score,"Matched sampling is a method for selecting units from a large reservoir of potential controls to produce a control group of modest size that is similar to a treated group with respect to the distribution of observed covariates. We illustrate the use of multivariate matching methods in an observational study of the effects of prenatal exposure to barbiturates on subsequent psychological development. A key idea is the use of the propensity score as a distinct matching variable. © 1985 Taylor & Francis Group, LLC.",0,1 +2544,Constrained maximum likelihood estimation of two-level covariance structure model via EM type algorithms,"In this paper, the constrained maximum likelihood estimation of a two-level covariance structure model with unbalanced designs is considered. The two-level model is reformulated as a single-level model by treating the group level latent random vectors as hypothetical missing-data. Then, the popular EM algorithm is extended to obtain the constrained maximum likelihood estimates. For general nonlinear constraints, the multiplier method is used at the M-step to find the constrained minimum of the conditional expectation. An accelerated EM gradient procedure is derived to handle linear constraints. The empirical performance of the proposed EM type algorithms is illustrated by some artifical and real examples.",0,1 +2545,A Note on the Specification of Error Structures in Latent Interaction Models,"Latent interaction models have motivated a great deal of methodological research, mainly in the area of estimating such models. Product-indicator methods have been shown to be competitive with other methods of estimation in terms of parameter bias and standard error accuracy, and their continued popularity in empirical studies is due, in part, to their straightforward implementation and relative ease of estimation in mainstream structural equation modeling software. In recent years, the impact of different specifications of the mean structure of the structural model has been the focus of a fair amount of investigation in this area. Yet the effects of misspecification of the error structure of the observed variables implied by the model have not been investigated. In this study, the authors demonstrate algebraically the ramifications of misspecifying these error structures for the unconstrained product-indicator approach. Recommendations to practitioners based on these results are discussed.",0,1 +2546,Intrathecal HIV-1 Envelope Glycoprotein gp120 Induces Enhanced Pain States Mediated by Spinal Cord Proinflammatory Cytokines,"Perispinal (intrathecal) injection of the human immunodeficiency virus-1 (HIV-1) envelope glycoprotein gp120 creates exaggerated pain states. Decreases in response thresholds to both heat stimuli (thermal hyperalgesia) and light tactile stimuli (mechanical allodynia) are rapidly induced after gp120 administration. gp120 is the portion of HIV-1 that binds to and activates microglia and astrocytes. These glial cells have been proposed to be key mediators of gp120-induced hyperalgesia and allodynia because these pain changes are blocked by drugs thought to affect glial function preferentially. The aim of the present series of studies was to determine whether gp120-induced pain changes involve proinflammatory cytokines [interleukin-1β (IL-1) and tumor necrosis factor-α (TNF-α)], substances released from activated glia. IL-1 and TNF antagonists each prevented gp120-induced pain changes. Intrathecal gp120 produced time-dependent, site-specific increases in TNF and IL-1 protein release into lumbosacral CSF; parallel cytokine increases in lumbar dorsal spinal cord were also observed. Intrathecal administration of fluorocitrate (a glial metabolic inhibitor), TNF antagonist, and IL-1 antagonist each blocked gp120-induced increases in spinal IL-1 protein. These results support the concept that activated glia in dorsal spinal cord can create exaggerated pain states via the release of proinflammatory cytokines.",0,1 +2547,"Computer methods for sampling from gamma, beta, poisson and bionomial distributions","Accurate computer methods are evaluated which transform uniformly distributed random numbers into quantities that follow gamma, beta, Poisson, binomial and negative-binomial distributions. All algorithms are designed for variable parameters. The known convenient methods are slow when the parameters are large. Therefore new procedures are introduced which can cope efficiently with parameters of all sizes. Some algorithms require sampling from the normal distribution as an intermediate step. In the reported computer experiments the normal deviates were obtained from a recent method which is also described. © 1974 Springer-Verlag.",0,1 +2548,The influence of leadership on product and process innovations in China: The contingent role of knowledge acquisition capability,"Abstract Building upon upper echelon theory and a dynamic capability perspective, this study investigates the relative effectiveness of two types of leadership on product and process innovations in emerging economies. The authors found that in China transformational-charismatic (TC) leadership has a stronger effect on product innovation, while transactional leadership has a stronger effect on process innovation. The authors further study the boundary conditions of leadership and empirically examine the contingent effects of organizational level capability on the relationships between leadership and innovation. The moderating effects are intriguing: knowledge acquisition capability strengthens the effect of TC leadership on process innovation and that of transactional leadership on product innovation. However, knowledge acquisition capability attenuates the positive relationship between TC leadership and product innovation as well as the positive relationship between transactional leadership and process innovation.",0,1 +2549,Inference for Surrogate Endpoint Validation in the Binary Case,"Surrogate endpoint validation for a binary surrogate endpoint and a binary true endpoint is investigated using the criteria of proportion explained (PE) and the relative effect (RE). The concepts of generalized confidence intervals and fiducial intervals are used for computing confidence intervals for PE and RE. The numerical results indicate that the proposed confidence intervals are satisfactory in terms of coverage probability, whereas the intervals based on Fieller's theorem and the delta method fall short in this regard. Our methodology can also be applied to interval estimation problems in a causal inference-based approach to surrogate endpoint validation.",0,1 +2550,Autism and Overcoming Job Barriers: Comparing Job-Related Barriers and Possible Solutions in and outside of Autism-Specific Employment,"The aim of this study was to discover how individuals with autism succeed in entering the job market. We therefore sought to identify expected and occurred barriers, keeping them from taking up and staying in employment as well as to identify the solutions used to overcome these barriers. Sixty-six employed individuals with autism--17 of them with autism-specific employment--participated in an online survey. Results showed a variety of possible barriers. Individuals in autism-specific employment named formality problems--problems with organizational and practical process-related aspects of the job entry--most frequently while individuals in non-autism-specific employment mentioned social problems--obstacles concerning communication and human interaction--most. In terms of solutions, both groups used their own resources as much as external help, but differed in their specific strategies. In addition, correlations of an autism-specific employment with general and occupational self-efficacy as well as life and job satisfaction were examined. Possible implications of the results are discussed with regard to problem solving behavior and the use of strengths.",0,1 +2551,Bayesian Data-Model Fit Assessment for Structural Equation Modeling,"Bayesian approaches to modeling are receiving an increasing amount of attention in the areas of model construction and estimation in factor analysis, structural equation modeling (SEM), and related...",0,1 +2552,Current Topics in the Theory and Application of Latent Variable Models,"M. C. Edwards, R. C. MacCallum, Introduction: Complexity and Meaning in Latent Variable Modeling. Part I. Complexities in Latent Variable Modeling. R. Cudeck, J. R. Harring, Estimating the Correlation between Two Variables when Individuals are Measured Repeatedly. R. Gonzalez, D. Griffin, Deriving Estimators and Their Standard Errors in Dyadic Data Analysis: Examples Using a Symbolic Computation Program. P. F. Craigmile, M. Peruggia, T. Van Zandt, A Bayesian Hierarchical Model for Response Time Data Providing Evidence for Criteria Changes Over Time. I. Moustaki, A Review of Estimation Methods for Latent Variable Models. G. Zhang, C.T. Lee, Standard Errors for Ordinary Least Squares Estimates of Parameters in Structural Equation Modeling. L. Cai, Three Cheers for the Asymptotically Distribution Free Theory of Estimation and Inference: Some Recent Applications in Linear and Nonlinear Latent Variable Modeling. K. A. Duncan, S. N. MacEachern, Nonparametric Bayesian Modeling of Item Response Curves with a Three Parameter Logistic Prior Mean. W. A. Nicewander, Exact Solutions for IRT Latent Regression Slopes and Latent Variable Intercorrelations. S. du Toit, Analysis of Structural Equation Models Based on a Mixture of Continuous and Ordinal Random Variables in the Case of Complex Survey Data. Part II. Drawing Meaning from Latent Variable Models. R. E. Millsap, A Simulation Paradigm for Evaluating Approximate Fit. R. C. MacCallum, T. Lee, M. W. Browne, Fungible Parameter Values in Latent Curve Models. A. Shapiro, Statistical Inference of Moment/Covariance Structures. J. L. Rodgers, W. H. Beasley, Fisher, Gosset, and Alternative Hypothesis Significance Testing (AHST): Using the Bootstrap to Test Scientific Hypotheses about the Multiple Correlation. S. M. Boker, M. Martin, On The Equilibrium Dynamics of Meaning. K. Tateneni, M. Schiller, Applying Components Analysis to Attitudinal Segmentation.",0,1 +2553,Cantonal variations of integration policy and their impact on immigrant educational inequality,"Migration policy regimes are mainly analysed from an international comparative perspective, whereas subnational policy variations, although they are particularly pronounced in federal states, remain largely neglected. By transferring an international concept of integration policy to Switzerland’s cantonal level, we show that cantonal variations of integration policy are not only considerable but even occasionally exceed international variance. Subsequent outcome analyses further undermine the relevance of cantonal integration polices, suggesting that liberal and culturally pluralist policies moderate immigrant educational inequality in schools. As the results of our Bayesian multilevel analyses show, a combination of different policy aspects representing inclusive cantonal integration policies has the greatest potential to ameliorate immigrants’ equal opportunities in school. Accounting for immigrants’ heterogeneity in terms of linguistic and social background moreover reveals that integration policy differently affects various groups of immigrants.",0,1 +2554,Simultaneous Assembly of Multiple Test Forms,"An algorithm for the assembly of multiple test forms is proposed in which the multiple-form problem is reduced to a series of computationally less intensive two-form problems. At each step, one form is assembled to its true specifications; the other form is a dummy assembled only to maintain a balance between the quality of the current form and the remaining forms. It is shown how the method can be implemented using the technique of O-1 linear programming. Two empirical examples using a former item pool from the LSAT are given - one in which a set of parallel forms is assembled and another in which the targets for the information functions of the forms are shifted systematically.",0,1 +2555,The cost of misremembering: Inferring the loss function in visual working memory,"Visual working memory (VWM) is a highly limited storage system. A basic consequence of this fact is that visual memories cannot perfectly encode or represent the veridical structure of the world. However, in natural tasks, some memory errors might be more costly than others. This raises the intriguing possibility that the nature of memory error reflects the costs of committing different kinds of errors. Many existing theories assume that visual memories are noise-corrupted versions of afferent perceptual signals. However, this additive noise assumption oversimplifies the problem. Implicit in the behavioral phenomena of visual working memory is the concept of a loss function: a mathematical entity that describes the relative cost to the organism of making different types of memory errors. An optimally efficient memory system is one that minimizes the expected loss according to a particular loss function, while subject to a constraint on memory capacity. This paper describes a novel theoretical framework for characterizing visual working memory in terms of its implicit loss function. Using inverse decision theory, the empirical loss function is estimated from the results of a standard delayed recall visual memory experiment. These results are compared to the predicted behavior of a visual working memory system that is optimally efficient for a previously identified natural task, gaze correction following saccadic error. Finally, the approach is compared to alternative models of visual working memory, and shown to offer a superior account of the empirical data across a range of experimental datasets.",0,1 +2556,Multilevel factor analytic models for assessing the relationship between nurse-reported adverse events and patient safety,"Summary We explore health outcomes and nurse staffing data that are multivariate multilevel structured. These data can be used to relate latent constructs such as patient safety to hospital, nursing unit, nurse and patient characteristics by using factor analytic models. It is important that the multilevel nature of the data is taken into account; otherwise it can lead to invalid inferences. We explore the relationship between patient safety and nurse-reported adverse events from the Belgian chapter of the Europe Nurse Forecasting Survey. The data were split into a learning and a validation data set. Since no a priori factor structure has been proposed in the literature, we establish the factor structure by using a frequentist exploratory factor analysis on the learning data set and validate the factor structure proposed by using a Bayesian confirmatory factor analysis on the validation data set. Multivariate analysis-of-variance discrepancy measures were used to assess the need for multilevel factor analysis. We establish that there was substantial between-nursing-unit, but not between-hospital, variability to warrant the use of multilevel factor analyses. The final model was a two-level (nurse level and nursing unit level) factor analytic model with two factors at both levels. The Bayesian approach offers more flexibility in fitting the multilevel confirmatory factor analysis. To avoid double usage of the data the validation and learning data sets were used to fit and assess the goodness of fit of the multilevel confirmatory factor analysis respectively.",0,1 +2557,A Nondegenerate Penalized Likelihood Estimator for Variance Parameters in Multilevel Models,"Group-level variance estimates of zero often arise when fitting multilevel or hierarchical linear models, especially when the number of groups is small. For situations where zero variances are implausible a priori, we propose a maximum penalized likelihood approach to avoid such boundary estimates. This approach is equivalent to estimating variance parameters by their posterior mode, given a weakly informative prior distribution. By choosing the penalty from the log-gamma family with shape parameter greater than 1, we ensure that the estimated variance will be positive. We suggest a default log-gamma(2,λ) penalty with λ → 0, which ensures that the maximum penalized likelihood estimate is approximately one standard error from zero when the maximum likelihood estimate is zero, thus remaining consistent with the data while being nondegenerate. We also show that the maximum penalized likelihood estimator with this default penalty is a good approximation to the posterior median obtained under a noninformative prior.Our default method provides better estimates of model parameters and standard errors than the maximum likelihood or the restricted maximum likelihood estimators. The log-gamma family can also be used to convey substantive prior information. In either case-pure penalization or prior information-our recommended procedure gives nondegenerate estimates and in the limit coincides with maximum likelihood as the number of groups increases.",0,1 +2558,"Hierarchical Bayesian spatial models for predicting multiple forest variables using waveform LiDAR, hyperspectral imagery, and large inventory datasets","a b s t r a c t In this paper we detail a multivariate spatial regression model that couples LiDAR, hyperspectral and for- est inventory data to predict forest outcome variables at a high spatial resolution. The proposed model is used to analyze forest inventory data collected on the US Forest Service Penobscot Experimental Forest (PEF), ME, USA. In addition to helping meet the regression model's assumptions, results from the PEF analysis suggest that the addition of multivariate spatial random effects improves model fit and pre- dictive ability, compared with two commonly applied modeling approaches. This improvement results from explicitly modeling the covariation among forest outcome variables and spatial dependence among observations through the random effects. Direct application of such multivariate models to even moder- ately large datasets is often computationally infeasible because of cubic order matrix algorithms involved in estimation. We apply a spatial dimension reduction technique to help overcome this computational hurdle without sacrificing richness in modeling.",0,1 +2559,"The Social Consequences and Mechanisms of Personality: How to Analyse Longitudinal Data from Individual, Dyadic, Round–Robin and Network Designs","There is a growing interest among personality psychologists in the processes underlying the social consequences of personality. To adequately tackle this issue, complex designs and sophisticated mathematical models must be employed. In this article, we describe established and novel statistical approaches to examine social consequences of personality for individual, dyadic and group (round–robin and network) data. Our overview includes response surface analysis (RSA), autoregressive path models and latent growth curve models for individual data; actor–partner interdependence models and dyadic RSAs for dyadic data; and social relations and social network analysis for round–robin and network data. Altogether, our goal is to provide an overview of various analytical approaches, the situations in which each can be employed and a first impression about how to interpret their results. Three demo data sets and scripts show how to implement the approaches in R. Copyright © 2015 European Association of Personality Psychology",0,1 +2560,Can Psychometric Measurement Models Inform Behavior Genetic Models? A Bayesian Model Comparison Approach,"As methodologists have increasingly noted, the role of psychometrics in operationalizing a construct is often overlooked when evaluating research claims (Borsboom, 2006). In a related vein, others have noted that psychological research appears to move away from assessment and interpretation of a single a priori statistical model to a more nuanced comparison of models which assess the trade-off between a model’s parsimony and complexity in explaining behavior (e.g., Rodgers, 2010). The genetic factor model is one such statistical model often used to estimate the relative contributions of genetic and environmental components of observed behavior in genetically informative designs (Heath, Neale, Hewitt, Eaves, & Fulker, 1989; Martin, Eaves et al., 1977; Neale & Cardon, 1992). Mathematically, the genetic factor model decomposes observed phenotypic variability into additive genetic (A), common (C), and unique (E) environmental components and is, for that reason, often referred to as the ACE model.",0,1 +2561,Dynamic Structural Equation Modeling in Longitudinal Experimental Studies,,0,1 +2562,"The Percutaneous shunting in Lower Urinary Tract Obstruction (PLUTO) study and randomised controlled trial: evaluation of the effectiveness, cost-effectiveness and acceptability of percutaneous vesicoamniotic shunting for lower urinary tract obstruction","Congenital lower urinary tract obstruction (LUTO) is a disease associated with high perinatal mortality and childhood morbidity. Fetal vesicoamniotic shunting (VAS) bypasses the obstruction with the potential to improve outcome.To determine the effectiveness, cost-effectiveness and patient acceptability of VAS for fetal LUTO.A multicentre, randomised controlled trial incorporating a prospective registry, decision-analytic health economic model and preplanned Bayesian analysis using elicited opinions. Patient acceptability was evaluated by interview in a qualitative study.Fetal medicine departments in the UK, Ireland and the Netherlands.Pregnant women with a male singleton fetus with LUTO.In utero percutaneous VAS compared with conservative care.The primary outcome was survival to 28 days. Secondary outcome measures were survival and renal function at 1 year of age, cost of care and cost per additional life-year and per disability-free survival at the end of 1 year.The trial stopped early with 31 women randomised because of difficulties in recruitment. Of those randomised to VAS and conservative management, 3/16 (19%) and 2/15 (13%), respectively, did not receive their allocated intervention. Based on intention-to-treat analysis, survival at 28 days was higher if allocated VAS (50%) than conservative management (27%) [relative risk (RR) 1.88, 95% confidence interval (CI) 0.71 to 4.96, p = 0.27]. At 12 months survival was 44% in the VAS arm and 20% in the conservative arm (RR 2.19, 95% CI 0.69 to 6.94, p = 0.25). Neither difference was statistically significant. Of survivors at 1 year, two in the VAS arm had no evidence of renal impairment and four in the VAS arm and two in the conservative arm required medical management. One baby in the conservative arm had end-stage renal failure at 1 year. VAS was more expensive because of additional surgery and intensive care. VAS cost £15,500 per survivor at 1 year and £43,900 per disability-free year. Elicited expert opinions showed uncertainty in the effect of VAS at 28 days. In a Bayesian analysis combining elicited opinion with the results, uncertainty of the benefit of VAS remained (RR 1.31, 95% credible interval 0.84 to 2.18). The acceptability study identified visualisation of the fetus during ultrasound scanning, perceiving a personal benefit, and altruism as positive influences on recruitment. Fear of the VAS procedure and the perceived severity of LUTO influenced non-participation. The need for more detailed information about the condition and its implications during pregnancy and following delivery was a further important finding of this research. Recruitment was hampered by logistical and regulatory difficulties, a lower incidence of LUTO and lower antenatal diagnosis rate [estimated to be 3.34 (95% CI 2.95 to 3.72) per 10,000 total births and 47%, respectively, in an associated epidemiological study] and high termination of pregnancy rates. In the registry women also demonstrated a clear preference for conservative management.Survival to 28 days and 1 year appears to be higher with VAS than with conservative management, but it is not possible to prove benefit beyond reasonable doubt. Notably, prognosis in both arms for survival and renal function is poor. VAS was substantially more costly and unlikely to be regarded as cost-effective based on the 1-year data. Parents should be counselled about the risks of pregnancy loss with or without VAS insertion. The National Institute for Health and Care Excellence interventional procedures guidance (IPG 202) should be updated to reflect this new evidence. Babies in the PLUTO trial should be followed up long term for the different outcomes.ISRCTN53328556.This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol. 17, No. 59. See the NIHR Journals Library website for further project information.",0,1 +2563,Statistical Problems in Agricultural Experimentation,,0,1 +2564,Emergence of internal and external motivations to respond without prejudice in White children,"This research examined White U.S. children’s internal and external motivations to respond without prejudice (IMS and EMS). Study 1 examined the psychometric properties of IMS and EMS scales adapted from Plant and Devine (1998) in a predominately White sample of children ( N = 123, ages 7–12, M age = 9.50, SD = 1.66). Among children aged 8 and older, both scales were reliable and correlated with theoretically relevant constructs. Study 2 examined whether IMS and EMS mediate the inverse relation between age and explicit prejudice in a sample of White children ( N = 145, ages 8–10, M age = 8.98, SD = 0.82). When ethnic labeling was present, EMS mediated the inverse relation between age and explicit ethnic bias. When ethnic labeling was absent, IMS mediated the inverse relation between age and explicit ethnic bias. Results indicate IMS and EMS emerge in childhood and bear implications for theories of ethnic attitude development.",0,1 +2565,A general and flexible approach to estimating the social relations model using Bayesian methods.,"The social relations model (SRM) is a conceptual, methodological, and analytical approach that is widely used to examine dyadic behaviors and interpersonal perception within groups. This article introduces a general and flexible approach to estimating the parameters of the SRM that is based on Bayesian methods using Markov chain Monte Carlo techniques. The Bayesian approach overcomes several statistical problems that have plagued SRM researchers. First, it provides a single unified approach to estimating SRM parameters that can be easily extended to more specialized models (e.g., measurement models, moderator variables, categorical outcome variables). Second, sampling-based Bayesian methods allow statistically reliable inferences to be made about variance components and correlations, even with small sample sizes. Third, the Bayesian approach is able to handle designs with missing data. In a simulation study, the statistical properties (bias, root-mean-square error, coverage rate) of the parameter estimates produced by the Bayesian approach are compared with those of the method of moment estimates that have been used in previous research. A data example is presented to illustrate how discrete person moderators can be included in SRM analyses using the Bayesian approach. Finally, further extensions of the SRM are discussed, and suggestions for applied research are made.",0,1 +2566,Orthology-Based Multilevel Modeling of Differentially Expressed Mouse and Human Gene Pairs,"There is great interest in finding human genes expressed through pharmaceutical intervention, thus opening a genomic window into benefit and side-effect profiles of a drug. Human insight gained from FDA-required animal experiments has historically been limited, but in the case of gene expression measurements, proposed biological orthologies between mouse and human genes provide a foothold for animal-to-human extrapolation. We have investigated a five-component, multilevel, bivariate normal mixture model that incorporates mouse, as well as human, gene expression data. The goal is two-fold: to increase human differential gene-finding power; and to find a subclass of gene pairs for which there is a direct exploitable relationship between animal and human genes. In simulation studies, the dual-species model boasted impressive gains in differential gene-finding power over a related marginal model using only human data. Bias in parameter estimation was problematic, however, and occasionally led to failures in control of the false discovery rate. Though it was considerably more difficult to find species-extrapolative gene-pairs (than differentially expressed human genes), simulation experiments deemed it to be possible, especially when traditional FDR controls are relaxed and under hypothetical parameter configurations.",0,1 +2567,Bayesian analysis of structural equation models with dichotomous variables,"Structural equation modelling has been used extensively in the behavioural and social sciences for studying interrelationships among manifest and latent variables. Recently, its uses have been well recognized in medical research. This paper introduces a Bayesian approach to analysing general structural equation models with dichotomous variables. In the posterior analysis, the observed dichotomous data are augmented with the hypothetical missing values, which involve the latent variables in the model and the unobserved continuous measurements underlying the dichotomous data. An algorithm based on the Gibbs sampler is developed for drawing the parameters values and the hypothetical missing values from the joint posterior distributions. Useful statistics, such as the Bayesian estimates and their standard error estimates, and the highest posterior density intervals, can be obtained from the simulated observations. A posterior predictive p-value is used to test the goodness-of-fit of the posited model. The methodology is applied to a study of hypertensive patient non-adherence to medication.",0,1 +2568,"A Role for Proinflammatory Cytokines and Fractalkine in Analgesia, Tolerance, and Subsequent Pain Facilitation Induced by Chronic Intrathecal Morphine","The present experiments examined the role of spinal proinflammatory cytokines [interleukin-1β (IL-1)] and chemokines (fractalkine) in acute analgesia and in the development of analgesic tolerance, thermal hyperalgesia, and tactile allodynia in response to chronic intrathecal morphine. Chronic (5 d), but not acute (1 d), intrathecal morphine was associated with a rapid increase in proinflammatory cytokine protein and/or mRNA in dorsal spinal cord and lumbosacral CSF. To determine whether IL-1 release modulates the effects of morphine, intrathecal morphine was coadministered with intrathecal IL-1 receptor antagonist (IL-1ra). This regimen potentiated acute morphine analgesia and inhibited the development of hyperalgesia, allodynia, and analgesic tolerance. Similarly, intrathecal IL-1ra administered after the establishment of morphine tolerance reversed hyperalgesia and prevented the additional development of tolerance and allodynia. Fractalkine also appears to modulate the effects of intrathecal morphine because coadministration of morphine with intrathecal neutralizing antibody against the fractalkine receptor (CX3CR1) potentiated acute morphine analgesia and attenuated the development of tolerance, hyperalgesia, and allodynia. Fractalkine may be exerting these effects via IL-1 because fractalkine (CX3CL1) induced the release of IL-1 from acutely isolated dorsal spinal cord in vitro . Finally, gene therapy with an adenoviral vector encoding for the release of the anti-inflammatory cytokine IL-10 also potentiated acute morphine analgesia and attenuated the development of tolerance, hyperalgesia, and allodynia. Taken together, these results suggest that IL-1 and fractalkine are endogenous regulators of morphine analgesia and are involved in the increases in pain sensitivity that occur after chronic opiates.",0,1 +2569,Application of Structural Equation Models to Quality of Life,"Quality of life (QOL) has become an important concept for health care. As QOL is a multidimensional concept that is best evaluated by a number of latent constructs, it is well recognized that latent variable models, such as exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) are useful tools for analyzing QOL data. Recently, QOL researchers have realized the potential of structural equation modeling (SEM), which is a generalization of EFA and CFA in formulating a regression type equation in the model for studying the effects of the latent constructs to the QOL or health-related QOL. However, as the items in a QOL questionnaire are usually measured on an ordinal categorical scale, standard methods in SEM that are based on the normal distribution may produce misleading results. In this article, we propose an approach that uses a threshold specification to handle the ordinal categorical variables. Then, on the basis of observed ordinal categorical data, a maximum likelihood (ML) approach...",0,1 +2570,"Happy Medium, Happy Citizens","Institutional and behavioral theories of democracy abound but rarely intersect. Do executive lawmaking power and prowess condition democratic regime support in presidential democracies? We develop theoretical expectations linking the lawmaking powers of the president and mass regime support and test them by analyzing survey data from eighteen Latin American countries over ten years. As hypothesized, results indicate that preference for, and satisfaction with, democracy is highest where presidents have moderate legislative powers and success and lowest where presidents either dominate policymaking or face gridlock. Hence, a “happy medium” of presidential power promotes the attitudinal foundations of democracy.",0,1 +2571,Methods and Measures: Growth mixture modeling: A method for identifying differences in longitudinal change among unobserved groups,"Growth mixture modeling (GMM) is a method for identifying multiple unobserved sub-populations, describing longitudinal change within each unobserved sub-population, and examining differences in change among unobserved sub-populations. We provide a practical primer that may be useful for researchers beginning to incorporate GMM analysis into their research. We briefly review basic elements of the standard latent basis growth curve model, introduce GMM as an extension of multiple-group growth modeling, and describe a four-step approach to conducting a GMM analysis. Example data from a cortisol stress-response paradigm are used to illustrate the suggested procedures.",0,1 +2572,An effect size measure and Bayesian analysis of single-case designs,"This article describes a linear modeling approach for the analysis of single-case designs (SCDs). Effect size measures in SCDs have been defined and studied for the situation where there is a level change without a time trend. However, when there are level and trend changes, effect size measures are either defined in terms of changes in R(2) or defined separately for changes in slopes and intercept coefficients. We propose an alternate effect size measure that takes into account changes in slopes and intercepts in the presence of serial dependence and provides an integrated procedure for the analysis of SCDs through estimation and inference based directly on the effect size measure. A Bayesian procedure is described to analyze the data and draw inferences in SCDs. A multilevel model that is appropriate when several subjects are available is integrated into the Bayesian procedure to provide a standardized effect size measure comparable to effect size measures in a between-subjects design. The applicability of the Bayesian approach for the analysis of SCDs is demonstrated through an example.",0,1 +2573,A process dissociation framework: Separating automatic from intentional uses of memory,"Abstract This paper begins by considering problems that have plagued investigations of automatic or unconscious influences of perception and memory. A process dissociation procedure that provides an escape from those problems is introduced. The process dissociation procedure separates the contributions of different types of processes to performance of a task, rather than equating processes with tasks. Using that procedure, I provide new evidence in favor of a two-factor theory of recognition memory; one factor relies on automatic processes and the other relies on intentional processes. Recollection (an intentional use of memory) is hampered when attention is divided, rather than full, at the time of test. In contrast, the use of familiarity as a basis for recognition memory judgments (an automatic use of memory) is shown to be invariant across full versus divided attention, manipulated at test. Process dissociation procedures provide a general framework for separating automatic from intentional forms of processing in a variety of domains; including perception, memory, and thought.",0,1 +2574,The curvilinear relationship between work pressure and momentary task performance: the role of state and trait core self-evaluations,"Whereas several studies have demonstrated that core self-evaluations (CSE)-or one's appraisals about one's own self-worth, capabilities, and competences-relate to job outcomes, less is known about the mechanisms underlying these relationships. In the present study, we address this issue by examining the role of within- and between-person variation in CSE in the relationship between work pressure and task performance. We hypothesized that (a) work pressure relates to task performance in a curvilinear way, (b) state CSE mediates the curvilinear relationship between work pressure and task performance, and (c) the relationship between work pressure and state CSE is moderated by trait CSE. Our hypotheses were tested via a 10-day daily diary study with 55 employees in which trait CSE was measured at baseline, while work pressure, task performance, and state CSE were assessed on a daily basis. Bayesian multilevel path analysis showed that work pressure affects task performance via state CSE, with state CSE increasing as long as the employee feels that (s)he is able to handle the work pressure, while it decreases when the level of work pressure exceeds the employees' coping abilities. Moreover, we found that for people low on trait CSE, the depleting effect of work pressure via state CSE happens for low levels of work pressure, while for people high in trait CSE the depleting effect is located at high levels of work pressure. Together, our findings suggest that the impact of work pressure on task performance is driven by a complex interplay of between- and within-person differences in CSE.",0,1 +2575,Evaluating the Proportion of Treatment Effect Explained by a Continuous Surrogate Marker in Logistic or Probit Regression Models,"Using surrogate endpoints in clinical trials is desirable for drug development because the trials can be shortened and therefore more cost-effective. Validating a surrogate for the clinical endpoint is critical in this context. One of the key steps in statistical validation of a surrogate for a single trial is to estimate the proportion of treatment effect explained (PTE or PE) by a surrogate. Often the measure for PTE is estimated from the difference in coefficients of treatment from two models with or without adjusting for the surrogate for clinical endpoint. Inherent problems with the method are: the two models may not be valid simultaneously; and the estimate can often lie outside the interval [0, 1]. In this article, we provide alternative measures for evaluating the proportion of treatment effect explained by a surrogate in logistic or probit regression models. Our measures can be estimated easily with any statistical programs capable of binary linear regression modeling, and the interpretation of the measures can be illustrated using Ordinal Dominance (OD) curves. The concept can be visually understood by any practical user. Simulation shows our alternative measures yield more accurate estimates which are less biased, less variable, and with narrower confidence intervals. A clinical trial example is provided.",0,1 +2576,A Comparison of Maximum Likelihood and Expected A Posteriori Estimation for Polychoric Correlation Using Monte Carlo Simulation,"This study aims to compare the maximum likelihood (ML) and expected a posterior (EAP) estimation for polychoric correlation (PCC) under diverse conditions, especially when considering a sample size. As the ML is the classical solution to estimate PCC, the EAP is a new method based on Bayes’ theorem. Different types of prior distributions are also adapted to investigate the sensitivity of prior distribution onto the PCC estimate for the EAP case. The Monte Carlo simulation is used for this comparison by a specialized program code in MATLAB.",0,1 +2577,An EZ-diffusion model for response time and accuracy,"The EZ-diffusion model for two-choice response time tasks takes mean response time, the variance of response time, and response accuracy as inputs. The model transforms these data via three simple equations to produce unique values for the quality of information, response conservativeness, and nondecision time. This transformation of observed data in terms of unobserved variables addresses the speed-accuracy trade-off and allows an unambiguous quantification of performance differences in two-choice response time tasks. The EZ-diffusion model can be applied to data-sparse situations to facilitate individual subject analysis. We studied the performance of the EZ-diffusion model in terms of parameter recovery and robustness against misspecification by using Monte Carlo simulations. The EZ model was also applied to a real-world data set.",0,1 +2578,Empirical Bayes Gibbs sampling,"The wide applicability of Gibbs sampling has increased the use of more complex and multi-level hierarchical models. To use these models entails dealing with hyperparameters in the deeper levels of a hierarchy. There are three typical methods for dealing with these hyperparameters: specify them, estimate them, or use a 'flat' prior. Each of these strategies has its own associated problems. In this paper, using an empirical Bayes approach, we show how the hyperparameters can be estimated in a way that is both computationally feasible and statistically valid.",0,1 +2579,Misunderstanding the affective consequences of everyday social interactions: the hidden benefits of putting one's best face forward.,"Positive self-presentation may have beneficial consequences for mood that are typically overlooked. Across a series of studies, participants underestimated how good they would feel in situations that required them to put their best face forward. In Studies 1 and 2A, participants underestimated the emotional benefits of interacting with an opposite sex stranger versus the benefits of interacting with a romantic partner. In Study 2B, participants who were instructed to engage in self-presentation felt happier after interacting with their romantic partner than participants who were not given this instruction, although other participants serving as forecasters did not anticipate such benefits. Increasing the generalizability of this self-presentation effect across contexts, the authors demonstrated that participants also underestimated how good they would feel before and after being evaluated by another person (Studies 3 and 4). This failure to recognize the affective benefits of putting one's best face forward may underlie forecasting errors regarding the emotional consequences of the most common forms of social interactions.",0,1 +2580,Partner Selection in Brand Alliances: An Empirical Investigation of the Drivers of Brand Fit,"We investigate whether partners in a brand alliance should be similar or dissimilar in brand image to foster favorable perceptions of brand fit. Using a Bayesian nonlinear structural equation model and evaluations of 1,200 brand alliances, we find that the conceptual coherence in brand personality profiles predicts attitudes towards a brand alliance. More specifically, we find that similarity in Sophistication and Ruggedness and moderate dissimilarity in Sincerity and Competence result in more favorable brand alliance evaluations. Overall, we find that similarity effects are more pronounced than dissimilarity effects. Implications for brand alliance strategies and marketing managers are discussed.",0,1 +2581,Investigating the relationship between item exposure and test overlap: Item sharing and item pooling,"To date, exposure control procedures that are designed to control item exposure and test overlap simultaneously are based on the assumption of item sharing between pairs of examinees. However, examinees may obtain test information from more than one examinee in practice. This larger scope of information sharing needs to be taken into account in refining exposure control procedures. To control item exposure and test overlap among a group of examinees larger than two, the relationship between the two indices needs to be identified first. The purpose of this paper is to analytically derive the relationships between item exposure rate and each of the two forms of test overlap, item sharing and item pooling, for fixed-length computerized adaptive tests. Item sharing is defined as the number of common items shared by all examinees in a group, while item pooling is the number of overlapping items that an examinee has with a group of examinees. The accuracy of the derived relationships was verified using numerical examples. The relationships derived will lay the foundation for future development of procedures to simultaneously control item exposure and item sharing or item pooling among a group of examinees larger than two.",0,1 +2582,Volume and Error Variance Estimation Using Integrated Stem Taper Models,"In this study, we propose two volume and error variance estimators based on an integrated nonlinear mixed-effects stem taper model. The estimators rely either on a first- or a second-order Taylor series expansion. They were first tested through Monte Carlo simulations. The accuracy of the volume and error variance estimates was then tested against more than 1,000 observations. Empirical and nominal coverage of the confidence intervals were also compared under the assumption of a Gaussian distribution. For the volume estimators, results showed that the first-order estimator tends to slightly underestimate the volume, mainly because the stem taper model had random effects specified in a nonlinear manner. The second-order estimator was more accurate with neither under- nor overestimations of volume. For both the first- and the second-order variance estimators, the confidence intervals had empirical coverage that closely matches nominal coverage for probability levels >0.9. Although the proposed estimators require the stem taper model to predict the squared diameter of the cross section, they have the benefit of providing a tractable estimate of the variance. The covariances between different stem sections are quickly estimated because there is no need for repeated numerical integrations. © 2013 by the Society of American Foresters.",0,1 +2583,Statistical analysis of nonlinear factor analysis models,"This paper presents a Bayesian analysis of a general nonlinear factor analysis model. Both the non-informative and conjugate prior distributions are considered. A hybrid algorithm that combines the Metropolis-Hastings algorithm and the Gibbs sampler is implemented to produce direct estimates of the latent factor scores and the structural parameters. Standard errors estimates as well as a goodness-of-fit statistic for assessing the posited model are presented. To illustrate the methodology, results from a simulation study and a real example are reported.",0,1 +2584,Prior distribution for item response curves,"The paper examines the use of the ordered Dirichlet prior for binary logistic item response models. This prior is based on the investigator's prior information about the probabilities of correct response to items from examinees at several ability levels. The effect of the prior is examined in terms of the posterior mode of the item parameters computed via the EM algorithm. An illustration is used to explore the application of a 1981 ACT math test to form a prior that is then used on a similar 1987 test. A novel feature of the paper is the emphasis placed on the entire item response curves, rather than the item parameters per se. Detailed computational expressions for the three-parameter logistic model are summarized in an Appendix.",0,1 +2585,Small-Sample Adjustments for Wald-Type Tests Using Sandwich Estimators,"The sandwich estimator of variance may be used to create robust Wald-type tests from estimating equations that are sums of K independent or approximately independent terms. For example, for repeated measures data on K individuals, each term relates to a different individual. These tests applied to a parameter may have greater than nominal size if K is small, or more generally if the parameter to be tested is essentially estimated from a small number of terms in the estimating equation. We offer some practical modifications to these robust Wald-type tests, which asymptotically approach the usual robust Wald-type tests. We show that one of these modifications provides exact coverage for a simple case and examine by simulation the modifications applied to the generalized estimating equations of Liang and Zeger (1986), conditional logistic regression, and the Cox proportional hazard model.",0,1 +2586,Over-education among Immigrants in Europe: The Value of Civic Involvement,"The present study investigates the effect of social connectedness through associational involvement on over-education among immigrants in 19 European societies, addressing the often-claimed importance of weak ties. Based on the idea that the effectiveness of social networks in distributing relevant information may depend on the degree to which such networks are linked to other networks, it thereby specifically distinguishes between associations that are connected to the wider community and those that are rather isolated. Using pooled individual-level data from the European Social Survey, empirical analyses indeed reveal active participation in associations to be related to lower risk of experiencing over-education. Moreover, the effect appears type specific, indicating access to multiple associations which are widely connected to different parts of society to be of particular benefit, especially in case of more recent migration.",0,1 +2587,A two-stage estimation of structural equation models with continuous and polytomous variables,"This paper develops a computationally efficient procedure for analysis of structural equation models with continuous and polytomous variables. A partition maximum likelihood approach is used to obtain the first stage estimates of the thresholds and the polyserial and polychoric correlations in the underlying correlation matrix. Then, based on the joint asymptotic distribution of the first stage estimator and an appropriate weight matrix, a generalized least squares approach is employed to estimate the structural parameters in the correlation structure. Asymptotic properties of the estimators are derived. Some simulation studies are conducted to study the empirical behaviours and robustness of the procedure, and compare it with some existing methods.",0,1 +2588,The influence of violations of assumptions on multilevel parameter estimates and their standard errors,"A crucial problem in the statistical analysis of hierarchically structured data is the dependence of the observations at the lower levels. Multilevel modeling programs account for this dependence and in recent years these programs have been widely accepted. One of the major assumptions of the tests of significance used in the multilevel programs is normality of the error distributions involved. Simulations were used to assess how important this assumption is for the accuracy of multilevel parameter estimates and their standard errors. Simulations varied the number of groups, the group size, and the intraclass correlation, with the second level residual errors following one of three non-normal distributions. In addition asymptotic maximum likelihood standard errors are compared to robust (Huber/White) standard errors. The results show that non-normal residuals at the second level of the model have little or no effect on the parameter estimates. For the fixed parameters, both the maximum likelihood-based standard errors and the robust standard errors are accurate. For the parameters in the random part of the model, the maximum likelihood-based standard errors at the lowest level are accurate, while the robust standard errors are often overcorrected. The standard errors of the variances of the level-two random effects are highly inaccurate, although the robust errors do perform better than the maximum likelihood errors. For good accuracy, robust standard errors need at least 100 groups. Thus, using robust standard errors as a diagnostic tool seems to be preferable to simply relying on them to solve the problem.",0,1 +2589,Multilevel Structural Equation Models for the Analysis of Comparative Data on Educational Performance,The Programme for International Student Assessment comparative study of reading performance among 15-year-olds is reanalyzed using statistical procedures that allow the full complexity of the data ...,0,1 +2590,,"We consider methods for estimating causal effects of treatments when treatment assignment is unconfounded with outcomes conditional on a possibly large set of covariates. Robins and Rotnitzky (1995) suggested combining regression adjustment with weighting based on the propensity score (Rosenbaum and Rubin, 1983). We adopt this approach, allowing for a flexible specification of both the propensity score and the regression function. We apply these methods to data on the effects of right heart catheterization (RHC) studied in Connors et al (1996), and we find that our estimator gives stable estimates over a wide range of values for the two parameters governing the selection of variables.",0,1 +2591,"Toward terminological, conceptual, and statistical clarity in the study of mediators and moderators: Examples from the child-clinical and pediatric psychology literatures.","Numerous recent attempts to identify mediated and moderated effects in child-clinical and pediatric research on child adjustment have been characterized by terminological, conceptual, and statistical inconsistencies. To promote greater clarity, the terms mediating and moderating are defined and differentiated. Recommended statistical strategies that can be used to test for these effects are reviewed (i.e., multiple regression and structural equation modeling techniques). The distinction between mediated and indirect effects is also discussed. Examples of troublesome and appropriate uses of these terms in the child-clinical and pediatric psychology literatures are highlighted.",0,1 +2592,"Multilevel models for meta-analysis, and their application to absolute risk differences","Meta-analysis can be considered a multilevel statistical problem, since information within studies is combined in the presence of potential heterogeneity between studies. Here a general multilevel model framework is developed for meta-analysis to combine either summary data or individual patient outcome data from each study, and to include either study or individual level covariates that might explain heterogeneity. Classical and Bayesian approaches to estimation are contrasted. These methods are applied to a meta-analysis of trials of thrombolytic therapy after myocardial infarction. Subgroups within the trials were available, categorized by the time delay until treatment, so that a three-level random effects model that includes time delay as a covariate is proposed. In addition it was desired to represent the treatment effect as an absolute risk reduction, rather than the conventional odds ratio. We show how this can be achieved within a Bayesian analysis, while still recognizing the binary nature of the original outcome data.",0,1 +2593,Multilevel Analysis,"This practical introduction helps readers apply multilevel techniques to their research. Noted as an accessible introduction, the book also includes advanced extensions, making it useful as both an introduction and as a reference to students, researchers, and methodologists. Basic models and examples are discussed in non-technical terms with an emphasis on understanding the methodological and statistical issues involved in using these models. The estimation and interpretation of multilevel models is demonstrated using realistic examples from various disciplines. For example, readers will find data sets on stress in hospitals, GPA scores, survey responses, street safety, epilepsy, divorce, and sociometric scores, to name a few. The data sets are available on the website in SPSS, HLM, MLwiN, LISREL and/or Mplus files. Readers are introduced to both the multilevel regression model and multilevel structural models. Highlights of the second edition include: Two new chapters—one on multilevel models for ordinal and count data (Ch. 7) and another on multilevel survival analysis (Ch. 8). Thoroughly updated chapters on multilevel structural equation modeling that reflect the enormous technical progress of the last few years. The addition of some simpler examples to help the novice, whilst the more complex examples that combine more than one problem have been retained. A new section on multivariate meta-analysis (Ch. 11). Expanded discussions of covariance structures across time and analyzing longitudinal data where no trend is expected. Expanded chapter on the logistic model for dichotomous data and proportions with new estimation methods. An updated website at http://www.joophox.net/ with data sets for all the text examples and up-to-date screen shots and PowerPoint slides for instructors. Ideal for introductory courses on multilevel modeling and/or ones that introduce this topic in some detail taught in a variety of disciplines including: psychology, education, sociology, the health sciences, and business. The advanced extensions also make this a favorite resource for researchers and methodologists in these disciplines. A basic understanding of ANOVA and multiple regression is assumed. The section on multilevel structural equation models assumes a basic understanding of SEM.",0,1 +2594,Addressing complications of intention-to-treat analysis in the combined presence of all-or-none treatment-noncompliance and subsequent missing outcomes,"SUMMARY We study the combined impact that all-or-none compliance and subsequent missing outcomes can have on the estimation of the intention-to-treat effect of assignment in randomised studies. In this setting, a standard analysis, which drops subjects with missing outcomes and ignores compliance information, can be biased for the intention-to-treat effect. To address all-or-none compliance that is followed by missing outcomes, we construct a new estimation procedure for the intention-to-treat effect that maintains good randomisation-based properties under more plausible, nonignorable noncompliance and nonignorable missing-outcome conditions: the 'compound exclusion restriction' on the effect of assignment and the 'latent ignorability' of the missing data mechanism. We present both theoretical results and a simulation study. Moreover, we show how the two key concepts of compound exclusion and latent ignorability are relevant in more complicated settings, such as right censoring of a time-to-event outcome.",0,1 +2595,MCMC GGUM,Link_to_subscribed_fulltex,0,1 +2596,Proactive inhibitory control varies with task context,"The goal of executive control is to adjust our behaviour to the environment. It involves not only the continuous planning and adaptation of actions but also the inhibition of inappropriate movements. Recently, a proactive form of inhibitory control has been shown, demonstrating that actions can be withheld, in an uncertain environment, thanks to the proactive locking of the mechanism by which motor commands are triggered (e.g. while waiting at traffic lights in a dense pedestrian zone, one will refrain in anticipation of a brisk acceleration when the green light comes on). However, little is known about this executive function and it remains unclear whether the overall amount of inhibitory control can be modulated as a function of the context. Here, we show that the level of this control varies parametrically as a function of the exogenous and endogenous factors setting the task context. We also show that the level of implemented proactive inhibitory control is dynamically readjusted to match the implicit temporal structure of the environment. These observations are discussed in relation to possible underlying functional substrates and related neurological and psychiatric pathologies.",0,1 +2597,xtmixed and Denominator Degrees of Freedom: Myth or Magic,A review of issues and controversy surrounding F-ratio denominator degrees of freedom (DDF) in linear mixed models. The presentation will look at the history of denominator degrees of freedom as well survey their use in various statistical packages.,0,1 +2598,Antibiotic Prophylaxis for the Prevention of Surgical Site Infection after Tension-Free Hernia Repair: A Bayesian and Frequentist Meta-Analysis,"Efficacy of antibiotic prophylaxis for the prevention of surgical site infection (SSI) after open tension-free hernia repair remains controversial. In light of additional data, the aim of this study was to determine whether antibiotic prophylaxis reduces SSI after hernia repair.We conducted a systematic review and meta-analysis to identify randomized controlled trials comparing antibiotic prophylaxis and the subsequent incidence of SSI after inguinal or femoral hernia repair. The primary outcomes measure was the incidence of SSI. Subgroup analysis was evaluated by stratifying the categories of SSI. The meta-analysis was performed using Bayesian and frequentist methods.Twelve studies were included in this meta-analysis; 1,902 patients received antibiotic prophylaxis and the other 1,936 patients were allocated to the control group. Incidence of SSI was 47 (pooled rate 3.0%) in the antibiotic group and 91 (6.0%) in the control group. The number needed to treat to prevent 1 episode of SSI is 41. The Bayesian meta-analysis yielded a significant reduction of SSI in the antibiotic group (odds ratio = 0.49; 95% credible interval 0.25-0.81). Subgroup analysis showed that an antibiotic prophylaxis was beneficial for the prevention of superficial SSI (odds ratio = 0.40; 95% credible interval 0.12-0.98), but not beneficial for prevention of deep SSI (odds ratio = 0.59; 95% credible interval 0.11-3.20). Also, the results were similar to those with frequentist methods.This meta-analysis suggests that antibiotic prophylaxis is efficacious for the prevention of SSI after open mesh hernia repair.",0,1 +2599,Marginal Maximum Likelihood Estimation of a Latent Variable Model With Interaction,"There has been considerable interest in nonlinear latent variable models specifying interaction between latent variables. Although it seems to be only slightly more complex than linear regression without the interaction, the model that includes a product of latent variables cannot be estimated by maximum likelihood assuming normality. Consequently, many approximate methods have been proposed. Recently, a maximum likelihood method of estimation based on the expectation–maximization algorithm has been suggested that is optimum if the distribution assumptions are true. In this article, the authors outline an alternative marginal maximum likelihood estimator using numerical quadrature. A key feature of the approach is that in the marginal distribution of the manifest variables the complicated integration can be reduced, often to a single dimension. This allows a direct approach to maximizing the log-likelihood and makes the method relatively straightforward to use.",0,1 +2600,"Immunofluorescent spectral analysis reveals the intrathecal cannabinoid agonist, AM1241, produces spinal anti‐inflammatory cytokine responses in neuropathic rats exhibiting relief from allodynia","During pathological pain, the actions of the endocannabinoid system, including the cannabinoid 2 receptor (CB(2)R), leads to effective anti-allodynia and modifies a variety of spinal microglial and astrocyte responses. Here, following spinal administration of the CB(2)R compound, AM1241, we examined immunoreactive alterations in markers for activated p38 mitogen-activated protein kinase, interleukin-1β (IL-1β), the anti-inflammatory cytokine, interleukin-10 (IL-10) as well as degradative endocannabinoid enzymes, and markers for altered glial responses in neuropathic rats. In these studies, the dorsal horn of the spinal cord and dorsal root ganglia were examined. AM1241 produced profound anti-allodynia with corresponding immunoreactive levels of p38 mitogen-activated kinase, IL-1β, IL-10, the endocannabinoid enzyme monoacylglycerol lipase, and astrocyte activation markers that were similar to nonneuropathic controls. In contrast, spinal AM1241 did not suppress the increased microglial responses observed in neuropathic rats. The differences in fluorescent markers were determined within discrete anatomical regions by applying spectral analysis methods, which virtually eliminated nonspecific signal during the quantification of specific immunofluorescent intensity. These data reveal expression profiles that support the actions of intrathecal AM1241 control pathological pain through anti-inflammatory mechanisms by modulating critical glial factors, and additionally decrease expression levels of endocannabinoid degradative enzymes.",0,1 +2601,A Bayesian semiparametric latent variable approach to causal mediation,"In assessing causal mediation effects in randomized studies, a challenge is that the direct and indirect effects can vary across participants due to different measured and unmeasured characteristics. In that case, the population effect estimated from standard approaches implicitly averages over and does not estimate the heterogeneous direct and indirect effects. We propose a Bayesian semiparametric method to estimate heterogeneous direct and indirect effects via clusters, where the clusters are formed by both individual covariate profiles and individual effects due to unmeasured characteristics. These cluster-specific direct and indirect effects can be estimated through a set of regression models where specific coefficients are clustered by a stick-breaking prior. To let clustering be appropriately informed by individual direct and indirect effects, we specify a data-dependent prior. We conduct simulation studies to assess performance of the proposed method compared to other methods. We use this approach to estimate heterogeneous causal direct and indirect effects of an expressive writing intervention for patients with renal cell carcinoma.",0,1 +2602,A finite mixture model of growth trajectories of adolescent alcohol use: Predictors and consequences.,"The current study sought to identify classes of growth trajectories of adolescent alcohol use and to examine the predictors and outcomes associated with the classes. Alcohol use was assessed from Grades 7 to 12 in a school-based sample. Latent growth mixture modeling was used, and results indicated 5 discrete longitudinal drinking patterns. The 2 most common drinking patterns included occasional very light drinking from Grades 7 to 12 and moderate escalation in both quantity and frequency of alcohol use. One group drank infrequently but at high levels throughout the study period. Another group exhibited rapid escalation in both quantity and frequency. The final group started at high levels of frequency and quantity in Grade 7 and showed rapid de-escalation in frequency. Emotional distress and risk taking distinguished the classes, and all classes, particularly rapid escalators, showed elevated levels of alcohol-related problems relative to occasional very light drinkers.",0,1 +2603,Motivational Affordance and Risk-Taking Across Decision Domains,"We propose a motivational affordance account to explain both stability and variability in risk-taking propensity in major decision domains. We draw on regulatory focus theory to differentiate two types of motivation (prevention, promotion) that play a key role in predicting risk-taking. Study 1 demonstrated that prevention motivation is negatively associated with risk-taking across six key decision domains, including health/safety, ethics, recreation, gambling, investment, and social. In contrast, promotion motivation is positively associated with risk-taking in the social and investment domains. Study 2 replicated the same pattern and provided direct evidence that promotion motivation is a strong predictor of risk-taking only in domains where there is true potential for gains. Study 3 manipulated promotion (vs. prevention) motivation experimentally to demonstrate that motivational affordance is a critical mechanism for understanding risk-taking behaviors.",0,1 +2604,Mediation Analysis,"Abstract Mediating variables are prominent in psychological theory and research. A mediating variable transmits the effect of an independent variable on a dependent variable. Differences between mediating variables and confounders, moderators, and covariates are outlined. Statistical methods to assess mediation and modern comprehensive approaches are described. Future directions for mediation analysis are discussed.",0,1 +2605,"Cow, Farm, and Herd Management Factors in the Dry Period Associated with Raised Somatic Cell Counts in Early Lactation","This study investigated cow characteristics, farm facilities, and herd management strategies during the dry period to examine their joint influence on somatic cell counts (SCC) in early lactation. Data from 52 commercial dairy farms throughout England and Wales were collected over a 2-yr period. For the purpose of analysis, cows were separated into those housed for the dry period (6,419 cow-dry periods) and those at pasture (7,425 cow-dry periods). Bayesian multilevel models were specified with 2 response variables: ln SCC (continuous) and SCC >199,000 cells/mL (binary), both within 30 d of calving. Cow factors associated with an increased SCC after calving were parity, an SCC >199,000 cells/mL in the 60 d before drying off, increasing milk yield 0 to 30 d before drying off, and reduced DIM after calving at the time of SCC estimation. Herd management factors associated with an increased SCC after calving included procedures at drying off, aspects of bedding management, stocking density, and method of pasture grazing. Posterior predictions were used for model assessment, and these indicated that model fit was generally good. The research demonstrated that specific dry-period management strategies have an important influence on SCC in early lactation.",0,1 +2606,Social competence and depression: The role of illusory self-perceptions.,"Attempted to evaluate the role in clinical depression of 2 personal variables: social competencies (as perceived by others) and their encoding or self-perception by the individual. Both self-ratings and ratings from observers were obtained for 71 depressed, 59 psychiatric control, and 73 normal control individuals following a group interaction at different times in the course of treatment. As expected, the depressed Ss initially rated themselves and were rated by others as less socially competent than the 2 control groups, and their self-perceptions improved with treatment. Surprisingly, the depressed were more realistic in their self-perceptions than the controls. Specifically, the controls perceived themselves more positively than others saw them, whereas the depressed saw themselves as they were seen. This realism of the depressed tended to decrease in the course of treatment. The theoretical implications of a possibly illusory flow for appropriate affect and self-regulation are discussed. (20 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1980 American Psychological Association.",0,1 +2607,The Influence of Affective and Instrumental Beliefs on Exercise Intentions and Behavior: A Longitudinal Analysis,"Programs encouraging exercise might reduce coronary illness. Ajzen's theory of planned behavior is a useful model for understanding exercise motivation. The current study investigated the contribution of the instrumental and affective components of attitude. As part of a community-based study of exercise behavior, 424 men and 572 women completed questionnaires, with 365 participants providing 6-month follow-up data. Regressions highlighted the affective component as a much more powerful predictor of intention compared to the instrumental component. After controlling for prior exercise, intention was not predictive of later exercise, although the affective component was. The implications for exercise promotion are discussed.",0,1 +2608,A unified jackknife theory for empirical best prediction with M-estimation,"The paper presents a unified jackknife theory for a fairly general class of mixed models which includes some of the widely used mixed linear models and generalized linear mixed models as special cases. The paper develops jackknife theory for the important, but so far neglected, prediction problem for the general mixed model. For estimation of fixed parameters, a jackknife method is considered for a general class of M-estimators which includes the maximum likelihood, residual maximum likelihood and ANOVA estimators for mixed linear models and the recently developed method of simulated moments estimators for generalized linear mixed models. For both the prediction and estimation problems, a jackknife method is used to obtain estimators of the mean squared errors (MSE). Asymptotic unbiasedness of the MSE estimators is shown to hold essentially under certain moment conditions. Simulation studies undertaken support our theoretical results.",0,1 +2609,The Central Role of Bayes’ Theorem for Joint Estimation of Causal Effects and Propensity Scores,"Although propensity scores have been central to the estimation of causal effects for over 30 years, only recently has the statistical literature begun to consider in detail methods for Bayesian estimation of propensity scores and causal effects. Underlying this recent body of literature on Bayesian propensity score estimation is an implicit discordance between the goal of the propensity score and the use of Bayes theorem. The propensity score condenses multivariate covariate information into a scalar to allow estimation of causal effects without specifying a model for how each covariate relates to the outcome. Avoiding specification of a detailed model for the outcome response surface is valuable for robust estimation of causal effects, but this strategy is at odds with the use of Bayes theorem, which presupposes a full probability model for the observed data that adheres to the likelihood principle. The goal of this paper is to explicate this fundamental feature of Bayesian estimation of causal effects with propensity scores in order to provide context for the existing literature and for future work on this important topic.",0,1 +2610,A framework for evidence-based mental health care and policy,"Care planning integrates a growing number of disciplines, research fields and analysis techniques. A framework of the main areas of interest with regard to evidence-based health care in mental health is provided here.The framework is based on the experience of working with data analysts and health and social decision makers at the PSICOST/RIRAG network, a Spanish research association which includes psychiatrists, health economists and health policy experts, as well as on a review of the literature.Three main areas have been identified and described here: outcomes management, knowledge discovery from data, and decision support systems. Their use in mental health care is reviewed.It is important to promote bridging strategies among these new fields in order to enhance communication and information transfer between the different parts involved in mental health decision making: i) clinicians and epidemiologists, ii) data analysts, iii) care policy makers and other end-users.",0,1 +2611,"The theory of planned behaviour and exercise: An investigation into the role of prior behaviour, behavioural intentions and attitude variability","This paper reports a prospective study which applied the Theory of Planned Behaviour (TPB) to the prediction of exercise behaviour over a six-month period. The study addressed a number of issues which have been identified in the literature on the TPB; these being the role of prior behaviour in the TPB, the distinction between desires and self-predictions, and the question of attitude variability. The findings showed prior behaviour to be the strongest predictor of exercise behaviour at six months. Contrary to expectations, the self-prediction measure was not found to be a better predictor of behaviour than the desire measure. Attitude variability was found to be related to perceptions of control. However, attitude variability was not found to moderate relationships between components of the TPB. The implications of the results for the development of the TPB are discussed.",0,1 +2612,A Note Concerning a Selection “Paradox” of Dawid's,"This article briefly reviews a selection “paradox” of Dawid's, whereby Bayesian inference appears to be unchanged whether or not treatments have been selected for inspection on the basis of extreme values. The problem is recast in terms of a hierarchical model. This offers an alternative explanation of the paradox but also reveals a disturbing dependence of inference on prior specification. The example may also be used to deepen students' understanding of the implications of using conjugate nonhierarchical priors in Bayesian analysis. To illustrate, some simulations are presented.",0,1 +2613,"Maternal depression, child behavior, and injury","

Summary

Background and objectives

Recent interest has focused on wait listing patients without pretreating coronary artery disease to expedite transplantation. Our practice is to offer coronary revascularization before transplantation if indicated.

Design, setting, participants, & measurements

Between 2006 and 2009, 657 patients (427 men, 230 women; ages, 56.5 ± 9.94 years) underwent pretransplant assessment with coronary angiography. 573 of 657 (87.2%) patients were wait listed; 247 of 573 (43.1%) patients were transplanted during the follow-up period, 30.09 ± 11.67 months.

Results

Patient survival for those not wait listed was poor, 83.2% and 45.7% at 1 and 3 years, respectively. In wait-listed patients, survival was 98.9% and 95.3% at 1 and 3 years, respectively. 184 of 657 (28.0%) patients were offered revascularization. Survival in patients (n = 16) declining revascularization was poor: 75% survived 1 year and 37.1% survived 3 years. Patients undergoing revascularization followed by transplantation (n = 51) had a 98.0% and 88.4% cardiac event–free survival at 1 and 3 years, respectively. Cardiac event–free survival for patients revascularized and awaiting deceased donor transplantation was similar: 94.0% and 90.0% at 1 and 3 years, respectively.

Conclusions

Our data suggest pre-emptive coronary revascularization is not only associated with excellent survival rates in patients subsequently transplanted, but also in those patients waiting on dialysis for a deceased donor transplant.",0,1 +2614,Principles and selected applications of item response theory.,,0,1 +2615,"Nonconvergence, improper solutions, and starting values in lisrel maximum likelihood estimation","In the framework of a robustness study on maximum likelihood estimation with LISREL three types of problems are dealt with: nonconvergence, improper solutions, and choice of starting values. The purpose of the paper is to illustrate why and to what extent these problems are of importance for users of LISREL. The ways in which these issues may affect the design and conclusions of robustness research is also discussed.",0,1 +2616,Classroom Climate and Contextual Effects: Conceptual and Methodological Issues in the Evaluation of Group-Level Effects,"Classroom context and climate are inherently classroom-level (L2) constructs, but applied researchers sometimes—inappropriately—represent them by student-level (L1) responses in single-level models rather than more appropriate multilevel models. Here we focus on important conceptual issues (distinctions between climate and contextual variables; use of classroom L2 rather than student-level L1 measures) and more appropriate multilevel models. To illustrate these issues, we consider the effects of two L2 classroom climate variables and one L2 classroom contextual variable on two L1 student-level outcomes for 2261 students in 128 classes. Through this example, we illustrate how to apply evolving doubly latent multilevel models to (a) evaluate the factor structure of L1 and L2 constructs based on multiple indicators of classroom climate and context measures, (b) control measurement error at L1 and L2, (c) control sampling error in the aggregation of L1 responses to form L2 constructs (the average of student-l...",0,1 +2617,Marginal maximum likelihood estimation of item parameters: Application of an EM algorithm,"Maximum likelihood estimation of item parameters in the marginal distribution, integrating over the distribution of ability, becomes practical when computing procedures based on an EM algorithm are used. By characterizing the ability distribution empirically, arbitrary assumptions about its form are avoided. The Em procedure is shown to apply to general item-response models lacking simple sufficient statistics for ability. This includes models with more than one latent dimension. © 1981 The Psychometric Society.",0,1 +2618,Information Processing Models Generating Lognormally Distributed Reaction Times,"Abstract The lognormal distribution has been fitted successfully to empirical reaction times (RTs), yet mechanisms that might generate lognormally distributed (RTs are unknown. Thus, the lognormal has the status of an ad-hoc distribution in RT research. In this paper we describe mechanisms that could generate the lognormal distribution and show how specific RT models can be constructed within the framework of general mathematical properties of the lognormal. It is demonstrated that various conceptually different mechanisms could produce lognormally distributed RTs.",0,1 +2619,"Apples and Oranges (and Pears, Oh My!): The Search for Moderators in Meta-Analysis","The purpose of this article is to review current practices with respect to detection and estimation of moderators in meta-analysis and to develop recommendations that are driven by the results of this review and previous research. The first purpose was accomplished through a review of the meta-analyses published in Journal of Applied Psychology from 1978 to 1997. Results show, first, that practices with respect to both the execution of and the reporting of results from searches for moderators are highly variable and, second, that findings relevant for detection of moderators (e.g., percentage variance attributable to artifacts, SDρ, etc.) are often highly inconsistent with what has been suggested in the past. These practices held regardless of time of publication, specificity of the question addressed in the paper, and content area. Detailed suggestions for modifications of current practices are offered.",0,1 +2620,Mediators of change for multisystemic therapy with juvenile sexual offenders.,"The mediators of favorable multisystemic therapy (MST) outcomes achieved at 12 months postrecruitment were examined within the context of a randomized effectiveness trial with 127 juvenile sexual offenders and their caregivers. Outcome measures assessed youth delinquency, substance use, externalizing symptoms, and deviant sexual interest/risk behaviors; hypothesized mediators included measures of parenting and peer relations. Data were collected at pretreatment, 6 months postrecruitment, and 12 months postrecruitment. Consistent with the MST theory of change and the small extant literature in this area of research, analyses showed that favorable MST effects on youth antisocial behavior and deviant sexual interest/risk behaviors were mediated by increased caregiver follow-through on discipline practices as well as decreased caregiver disapproval of and concern about the youth's bad friends during the follow-up. These findings have important implications for the community-based treatment of juvenile sexual offenders.",0,1 +2621,"Controlling pathological pain by adenovirally driven spinal production of the anti-inflammatory cytokine, interleukin-10","Gene therapy for the control of pain has, to date, targeted neurons. However, recent evidence supports that spinal cord glia are critical to the creation and maintenance of pain facilitation through the release of proinflammatory cytokines. Because of the ability of interleukin-10 (IL-10) to suppress proinflammatory cytokines, we tested whether an adenoviral vector encoding human IL-10 (AD-h-IL10) would block and reverse pain facilitation. Three pain models were examined, all of which are mediated by spinal pro-inflammatory cytokines. Acute intrathecal administration of rat IL-10 protein itself briefly reversed chronic constriction injury-induced mechanical allodynia and thermal hyperalgesia. The transient reversal caused by IL-10 protein paralleled the half-life of human IL-10 protein in the intrathecal space (t1/2 ∼ 2 h). IL-10 gene therapy both prevented and reversed thermal hyperalgesia and mechanical allodynia, without affecting basal responses to thermal or mechanical stimuli. Extra-territorial, as well as territorial, pain changes were reversed by this treatment. Intrathecal AD-h-IL10 injected over lumbosacral spinal cord led to elevated lumbosacral cerebrospinal fluid (CSF) levels of human IL-10, with far less human IL-10 observed in cervical CSF. In keeping with IL-10's known anti-inflammatory actions, AD-h-IL10 lowered CSF levels of IL-1, relative to control AD. These studies support that this gene therapy approach provides an alternative to neuronally focused drug and gene therapies for clinical pain control.",0,1 +2622,Psychometric Evaluation of the Overexcitability Questionnaire-Two Applying Bayesian Structural Equation Modeling (BSEM) and Multiple-Group BSEM-Based Alignment with Approximate Measurement Invariance,"The Overexcitability Questionnaire-Two (OEQ-II) measures the degree and nature of overexcitability, which assists in determining the developmental potential of an individual according to Dabrowski's Theory of Positive Disintegration. Previous validation studies using frequentist confirmatory factor analysis, which postulates exact parameter constraints, led to model rejection and a long series of model modifications. Bayesian structural equation modeling (BSEM) allows the application of zero-mean, small-variance priors for cross-loadings, residual covariances, and differences in measurement parameters across groups, better reflecting substantive theory and leading to better model fit and less overestimation of factor correlations. Our BSEM analysis with a sample of 516 students in higher education yields positive results regarding the factorial validity of the OEQ-II. Likewise, applying BSEM-based alignment with approximate measurement invariance, the absence of non-invariant factor loadings and intercepts across gender is supportive of the psychometric quality of the OEQ-II. Compared to males, females scored significantly higher on emotional and sensual overexcitability, and significantly lower on psychomotor overexcitability.",0,1 +2623,Item Selection and Ability Estimation Procedures for a Mixed-Format Adaptive Test,"In this study we compared five item selection procedures using three ability estimation methods in the context of a mixed-format adaptive test based on the generalized partial credit model. The item selection procedures used were maximum posterior weighted information, maximum expected information, maximum posterior weighted Kullback-Leibler information, and maximum expected posterior weighted Kullback-Leibler information procedures. The ability estimation methods investigated were maximum likelihood estimation (MLE), weighted likelihood estimation (WLE), and expected a posteriori (EAP). Results suggested that all item selection procedures, regardless of the information functions on which they were based, performed equally well across ability estimation methods. The principal conclusions drawn about the ability estimation methods are that MLE is a practical choice and WLE should be considered when there is a mismatch between pool information and the population ability distribution. EAP can serve as a viab...",0,1 +2624,Stochastic Dominance with Ordinal Variables: Conditions and a Test,"A re-emerging literature on robustness in multidimensional welfare and poverty comparisons has revived interest in multidimensional stochastic dominance. Considering the widespread use of ordinal variables in wellbeing measurement, and particularly in composite indices, I derive multivariate stochastic dominance conditions for ordinal variables. These are the analogues of the conditions for continuous variables (e.g., Bawa, 1975, and Atkinson and Bourguignon, 1982). The article also derives mixed-order-of-dominance conditions for any type of variable. Then I propose an extension of Anderson's nonparametric test in order to test these conditions for ordinal variables. In addition, I propose the use of vectors and matrices of positions in order to handle multivariate, multinomial distributions. An empirical application to multidimensional wellbeing in Peru illustrates these tests.",0,1 +2625,Bayesian Inference for Generalized Linear Mixed Model Based on the Multivariate t Distribution in Population Pharmacokinetic Study,"This article provides a fully bayesian approach for modeling of single-dose and complete pharmacokinetic data in a population pharmacokinetic (PK) model. To overcome the impact of outliers and the difficulty of computation, a generalized linear model is chosen with the hypothesis that the errors follow a multivariate Student t distribution which is a heavy-tailed distribution. The aim of this study is to investigate and implement the performance of the multivariate t distribution to analyze population pharmacokinetic data. Bayesian predictive inferences and the Metropolis-Hastings algorithm schemes are used to process the intractable posterior integration. The precision and accuracy of the proposed model are illustrated by the simulating data and a real example of theophylline data.",0,1 +2626,A hierarchical model for estimating response time distributions,"We present a statistical model for inference with response time (RT) distributions. The model has the following features. First, it provides a means of estimating the shape, scale, and location (shift) of RT distributions. Second, it is hierarchical and models between-subjects and within-subjects variability simultaneously. Third, inference with the model is Bayesian and provides a principled and efficient means of pooling information across disparate data from different individuals. Because the model efficiently pools information across individuals, it is particularly well suited for those common cases in which the researcher collects a limited number of observations from several participants. Monte Carlo simulations reveal that the hierarchical Bayesian model provides more accurate estimates than several popular competitors do. We illustrate the model by providing an analysis of the symbolic distance effect in which participants can more quickly ascertain the relationship between nonadjacent digits than that between adjacent digits.",0,1 +2627,Annual Research Review: Resilience and mental health in children and adolescents living in areas of armed conflict - a systematic review of findings in low- and middle-income countries,"Researchers focused on mental health of conflict-affected children are increasingly interested in the concept of resilience. Knowledge on resilience may assist in developing interventions aimed at improving positive outcomes or reducing negative outcomes, termed promotive or protective interventions.We performed a systematic review of peer-reviewed qualitative and quantitative studies focused on resilience and mental health in children and adolescents affected by armed conflict in low- and middle-income countries.Altogether 53 studies were identified: 15 qualitative and mixed methods studies and 38 quantitative, mostly cross-sectional studies focused on school-aged children and adolescents. Qualitative studies identified variation across socio-cultural settings of relevant resilience outcomes, and report contextually unique processes contributing to such outcomes. Quantitative studies focused on promotive and protective factors at different socio-ecological levels (individual, family-, peer-, school-, and community-levels). Generally, promotive and protective factors showed gender-, symptom-, and phase of conflict-specific effects on mental health outcomes.Although limited by its predominantly cross-sectional nature and focus on protective outcomes, this body of knowledge supports a perspective of resilience as a complex dynamic process driven by time- and context-dependent variables, rather than the balance between risk- and protective factors with known impacts on mental health. Given the complexity of findings in this population, we conclude that resilience-focused interventions will need to be highly tailored to specific contexts, rather than the application of a universal model that may be expected to have similar effects on mental health across contexts.",0,0 +2628,Profiling the Trauma Related Symptoms of Bosnian Refugees Who Have not Sought Mental Health Services,"The objective of this study was to profile trauma related psychiatric symptoms in a group of refugees not seeking mental health services and to consider the services implications. The study involved research assessments of two groups of Bosnian refugees: those who have not presented for mental health services and those who have. A total of 28 of 41 nonpresenters (70%) met symptom criteria for posttraumatic stress disorder (PTSD) diagnosis. All service presenters (N = 29) met symptom criteria for PTSD diagnosis. The group that did not present for services reported substantial but lower trauma exposure, PTSD symptom severity, and depression symptom severity. They had significant differences on all subscales of the MOS SF-36, indicating better health status. We concluded that those who do not seek services have substantial symptom levels, but their self-concept appears to be less oriented toward illness and help seeking. Innovative access, engagement, and preventive interventions are needed to address those who have symptoms but do not readily seek help for trauma mental health services.",0,0 +2629,"Acute panicogenic, anxiogenic and dissociative effects of carbon dioxide inhalation in patients with post-traumatic stress disorder (PTSD)","Increased anxiety and panic to inhalation of carbon dioxide (CO(2)) has been described in patients with anxiety disorders, especially panic disorder, compared to healthy subjects. Post-traumatic stress disorder (PTSD) has been hypothesised to resemble panic disorder and is currently classified as an anxiety disorder in DSM-IV. However, there are only very few data available about the sensitivity of patients with PTSD to CO(2).In 10 patients with PTSD, 10 sex- and age-matched healthy subjects and 8 patients with panic disorder we assessed anxiety, panic, dissociative and PTSD symptoms before and after a single vital capacity inhalation of 35% CO(2).Patients with PTSD showed an increased anxiety, panic and dissociative reaction to the inhalation of 35% CO(2) compared to healthy participants. PTSD subjects' responses were indistinguishable from those of panic patients. Additionally, PTSD-typical symptoms like post-traumatic flashbacks were provoked in patients with PTSD after the inhalation of CO(2).In our sample, PTSD was associated with an increased CO(2) reactivity, pointing to an increased susceptibility of PTSD patients to CO(2) challenge.",0,0 +2630,A Pooled Analysis of Gender and Trauma-Type Effects on Responsiveness to Treatment of PTSD With Venlafaxine Extended Release or Placebo,"To examine effects of gender and trauma type on response to treatment with venlafaxine extended release (ER) or placebo in patients with posttraumatic stress disorder (PTSD).Data were pooled from 2 flexible-dose, parallel-group, randomized, double-blind, placebo-controlled trials: a 12-week trial conducted in the United States (March 2001 to December 2002) and a 24-week trial conducted in 12 countries outside the United States (October 2001 to December 2003). Six hundred eighty-seven outpatients with DSM-IV-diagnosed PTSD and a 17-item Clinician-Administered PTSD Scale abbreviated 1-week Symptom Status version (CAPS-SX-17) score > or = 60 were randomly assigned to treatment with venlafaxine ER (37.5 mg/day-300 mg/day, N = 340) or placebo (N = 347). The primary efficacy end point was the CAPS-SX-17 total score at week 12. Secondary end points included CAPS-SX-17 cluster scores for reexperiencing, avoidance/numbing, and hyperarousal and scores on the Connor-Davidson Resilience Scale (CD-RISC), Clinical Global Impressions-Severity of Illness scale, Sheehan Disability Scale (SDS), and 17-item Hamilton Rating Scale for Depression (HAM-D-17). Analysis-of-covariance models were used to test for differences by gender and trauma type (accidental injury, combat, nonsexual abuse, adult sexual abuse, childhood sexual abuse, unexpected death, and other), treatment (venlafaxine ER vs. placebo), and the treatment-by-trauma-type interaction.Using last-observation-carried-forward analysis, significant effects of treatment with venlafaxine ER were found on the CAPS-SX-17 total score and on all CAPS-SX-17 cluster scores and most other secondary measures. No significant treatment-by-gender interactions were observed. Trauma type significantly affected treatment responsiveness on symptom-related disability (SDS, p = .0057) and resilience (CD-RISC, p = .0012), with a nearly significant effect on depression (HAM-D-17, p = .0625).Overall, there does not appear to be a significant effect of gender on the efficacy of venlafaxine ER in the treatment of PTSD. Trauma type may affect treatment outcome but seems to affect domains such as disability and resilience more than core PTSD symptoms.",0,0 +2631,Twelve-Month Use of Mental Health Services in the United States,"Dramatic changes have occurred in mental health treatments during the past decade. Data on recent treatment patterns are needed to estimate the unmet need for services.To provide data on patterns and predictors of 12-month mental health treatment in the United States from the recently completed National Comorbidity Survey Replication.Nationally representative face-to-face household survey using a fully structured diagnostic interview, the World Health Organization's World Mental Health Survey Initiative version of the Composite International Diagnostic Interview, carried out between February 5, 2001, and April 7, 2003.A total of 9282 English-speaking respondents 18 years and older.Proportions of respondents with 12-month DSM-IV anxiety, mood, impulse control, and substance disorders who received treatment in the 12 months before the interview in any of 4 service sectors (specialty mental health, general medical, human services, and complementary and alternative medicine). Number of visits and proportion of patients who received minimally adequate treatment were also assessed.Of 12-month cases, 41.1% received some treatment in the past 12 months, including 12.3% treated by a psychiatrist, 16.0% treated by a non-psychiatrist mental health specialist, 22.8% treated by a general medical provider, 8.1% treated by a human services provider, and 6.8% treated by a complementary and alternative medical provider (treatment could be received by >1 source). Overall, cases treated in the mental health specialty sector received more visits (median, 7.4) than those treated in the general medical sector (median, 1.7). More patients in specialty than general medical treatment also received treatment that exceeded a minimal threshold of adequacy (48.3% vs 12.7%). Unmet need for treatment is greatest in traditionally underserved groups, including elderly persons, racial-ethnic minorities, those with low incomes, those without insurance, and residents of rural areas.Most people with mental disorders in the United States remain either untreated or poorly treated. Interventions are needed to enhance treatment initiation and quality.",0,0 +2632,Rats exposed to traumatic stress bury unfamiliar objects — A novel measure of hyper-vigilance in PTSD models?,"Electric shocks lead to lasting behavioral deficits in rodents, and as such are often used to model post-traumatic stress disorder (PTSD) in the laboratory. Here we show that a single exposure of rats to 3 mA-strong shocks results in a marked social avoidance that lasts at least 28 days; moreover, the response intensifies over time. In an attempt to study the impact of cue reminders on the behavior of shocked rats, we administered shocks in the presence of a highly conspicuous, 10 cm-large object. This object was introduced into the home cage of rats 28 days after shock exposure. Shocked rats manipulated the object considerably less than controls. More importantly, however, the object was buried by shocked rats. This behavior was virtually absent in controls. The response strongly depended on the intensity of shocks, and was robust. Rats shocked with 3 mA currents spent 40% of time burying the object, which was often hardly visible at the end of the 5 min test. Subsequent experiments demonstrated that the response was not cue-specific as unfamiliar objects were also buried. Rats are well known to bury dangerous objects; the shock-prod burying test of anxiety is based on this response. Behavioral similarities with this test and the differences from the marble-burying behavior of mice suggest that traumatized rats bury unfamiliar objects in defense, and the response can be interpreted as a sign of hyper-vigilance. We further suggest that object burying can be used as a sign of hyper-vigilance in models of PTSD.",0,0 +2633,Trigeminal Nerve Stimulation for Comorbid Posttraumatic Stress Disorder and Major Depressive Disorder,"External stimulation of the trigeminal nerve (eTNS) is an emerging neuromodulation therapy for epilepsy and depression. Preliminary studies suggest it has an excellent safety profile and is associated with significant improvements in seizures and mood. Neuroanatomical projections of the trigeminal system suggest eTNS may alter activity in structures regulating mood, anxiety, and sleep. In this proof-of-concept trial, the effects of eTNS were evaluated in adults with posttraumatic stress disorder (PTSD) and comorbid unipolar major depressive disorder (MDD) as an adjunct to pharmacotherapy for these commonly co-occurring conditions.Twelve adults with PTSD and MDD were studied in an eight-week open outpatient trial (age 52.8 [13.7 sd], 8F:4M). Stimulation was applied to the supraorbital and supratrochlear nerves for eight hours each night as an adjunct to pharmacotherapy. Changes in symptoms were monitored using the PTSD Patient Checklist (PCL), Hamilton Depression Rating Scale (HDRS-17), Quick Inventory of Depressive Symptomatology (QIDS-C), and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q).Over the eight weeks, eTNS treatment was associated with significant decreases in PCL (p = 0.003; median decrease of 15 points; effect size d 1.5), HDRS-17 (p < 0.001; 42% response rate, 25% remission; d 2.1), and QIDS-C scores (p < 0.001; d 1.8), as well as an improvement in quality of life (Q-LES-Q, p < 0.01). eTNS was well tolerated with few treatment emergent adverse events.Significant improvements in PTSD and depression severity were achieved in the eight weeks of acute eTNS treatment. This novel approach to wearable brain stimulation may have use as an adjunct to pharmacotherapy in these disorders if efficacy and tolerability are confirmed with additional studies.",0,0 +2634,Military Resilience: A Concept Analysis,"Since the events surrounding September 11, 2011, and natural disasters, research on resilience has shifted from children to adult resilience. The military began to embrace the concept in 2008 in an effort to decrease the number of military service member (SM) suicides.The purpose of this article is to explain resilience as it relates to military SMs using the process for concept analysis outlined by Walker and Avant (2005).Adaptive coping, personal control, hardiness, and social support are the attributes that characterize psychological resilience in SMs. Antecedents for resilience are life events such as serious accidents, prior deployments where death is witnessed, and combat involvement. Consequences of high resilience include decreased mental health symptoms and career and personal success, while consequences of low resilience include increased mental health symptoms and participating in high-risk behaviors.Understanding resilience as it relates to SMs is critical. Nurses must be able to assess SMs and be equipped to refer them or their family members to the most appropriate care. As more is learned about resilience in the military community, there may be broader implications to the civilian community. Improved understanding of psychological resilience may lead to improved interventions appropriate for both civilians and military SMs.",0,0 +2635,Looking like the enemy: An interpretative phenomenological analysis of how race-related stressors in the military contribute to post traumatic stress disorder in Asian American and Pacific Islander Vietnam veterans,"Although significant evidence exists in the current literature about both the impact of race-related stressors on racial minority groups as well as the psychological impact of military-related stressors, there is very little research demonstrating the complexities of what a soldier may experience when a war is fought in a country where she/he resembles the enemy. This study explores how race-related stressors experienced in the military by Vietnam War veterans of Asian American and Pacific Islander (AAPI) ancestry contributed to the severity of post-traumatic stress disorder (PTSD) and other trauma-related psychiatric disorders. This topic has been explored by researchers out of the VA Pacific Islands Health Care System, National Center for PTSD in 1994 and their findings suggest that race-related stressors is a significant predictor of PTSD symptoms for Vietnam veterans of AAPI ancestry. Almost two decades since that study was conducted, this dissertation will examine, through the use of focus groups, if certain phenomenological themes have remained constant over time and also if new ones emerge. The generated hypothesis is that there will be phenomenological themes that abide over time related to the extended biopsychosocial effects of race-related stressors, particularly in the context of war. The second hypothesis posits that new themes will also surface as a result of the different political, social, and cultural climate these veterans currently reside in nearly two decades later. Clinical implications and suggestions for future research are also explored. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0,0 +2636,The North Sea Oil Rig Disaster,"Located halfway between the United Kingdom and Norway, the Ekofisk is the most highly developed of the oil fields of the North Sea. Approximately two dozen permanent and a few floating rigs are in operation there; some of them are interconnected by bridges. From the Ekofisk pipelines, crude oil is channeled to Teesside in England and gas to Emden in western Germany. The basic function of the Ekofisk fields is the supply of energy, made possible by the gigantic achievements of modern technology. Considerable attention has been given to safety issues, yet accidents and disasters have occurred.",0,0 +2637,The Use of Latent Trajectory Models in Psychopathology Research.,"Despite the recent surge in the development of powerful modeling strategies to test questions about individual differences in stability and change over time, these methods are not currently widely used in psychopathology research. In an attempt to further the dissemination of these new methods, the authors present a pedagogical introduction to the structural equation modeling based latent trajectory model, or LTM. They review several different types of LTMs, discuss matching an optimal LTM to a given question of interest, and highlight several issues that might be particularly salient for research in psychopathology. The authors augment each section with a review of published applications of these methods in psychopathology-related research to demonstrate the implementation and interpretation of LTMs in practice.",0,0 +2638,Anxiety sensitivity and post-traumatic stress reactions: Evidence for intrusions and physiological arousal as mediating and moderating mechanisms,"A growing body of research has implicated anxiety sensitivity (AS) and its dimensions in the development of post-traumatic stress disorder (PTSD). However, the mechanism(s) that may account for the association between AS and PTSD remains unclear. Using the ""trauma film paradigm,"" which provides a prospective experimental tool for investigating analog intrusion development, the present study examines the extent to which intrusions mediate the association between AS and the development of posttraumatic stress reactions. After completing a measure of AS and state mood, unselected participants (n = 45) viewed a 10 min film of graphic scenes of fatal traffic accidents and then completed a second assessment of state mood. Participants then kept a daily diary to record intrusions about the film for a one-week period. Post-traumatic stress reactions about the film were then assessed after the one-week period. The results showed that general AS and physical and cognitive concerns AS predicted greater post-traumatic stress reactions about the film a week later. Furthermore, the number of intrusions the day after viewing the traumatic film, but not fear and disgust in response to the trauma film, mediated the association between general AS (and AS specifically for physical and cognitive concerns) and post-traumatic stress reactions a week later. Subsequent analysis also showed that physiological arousal during initial exposure to the traumatic film moderated the association between general AS and the number of intrusions reported the day after viewing the film. The implications of these analog findings for conceptualizing the mechanism(s) that may interact to explain the role of AS in the development of PTSD and its effective treatment are discussed.",0,0 +2639,Trajectories of Exposure to Community Violence and Mental Health Symptoms Among Serious Adolescent Offenders,"The present study uses longitudinal data to investigate whether differences in exposure to community violence discriminate among serious juvenile offenders in terms of mental health symptomatology for depression, anxiety, posttraumatic stress, and hostility. Group-based modeling and moderation analyses are used to assess the influence of exposure to violence on mental health outcomes. The results demonstrate a moderating effect of psychosocial maturity and social support between exposure to community violence and adverse mental health consequences for youth on the stable low exposure trajectory. In addition, youth who experience stable high exposure to violence consistently suffer worse outcomes. The study contributes to the development of empirically derived profiles of serious youth offenders. While all of the youth in this study may face the stigma of being labeled as dangerous, some (particularly those on the chronic exposure trajectory) might find themselves in a situation where their psychological status exacerbates an already tenuous situation: reentry. Therefore, reentry services should better target the specific needs of this returning subgroup of serious youth offenders.",0,0 +2640,A spatial analysis of functional outcomes and quality of life outcomes after pediatric injury,"BackgroundChanges in health-related quality of life (HRQoL) are more regularly being monitored during the first year after injury. Monitoring changes in HRQoL using spatial cluster analysis can potentially identify concentrations of geographic areas with injury survivors with similar outcomes, thereby improving how interventions are delivered or in how outcomes are evaluated.MethodsWe used a spatial scan statistic designed for oridinal data to test two different spatial cluster analysis of very low, low, high, and very high HRQoL scores. Our study was based on HRQoL scores returned by children treated for injury at British Columbia Children’s Hospital and discharged to the Vancouver Metropolitan Area. Spatial clusters were assessed at 4 time periods – baseline (based on pre-injury health as reported prior to discharge from hospital), and one, four, and twelve months after discharge. Outcome data were measured used the PedsQL™ outcome scale. Outcome values of very low, low, high, and very high HRQoL scores were defined by classifying PedsQL™ scores into quartiles. In the first test, all scores were assessed for clustering without specifying whether the response score was from a baseline or follow-up response. In the second analysis, we built a space-time model to identify whether HRQoL responses could be identified at specific time points.ResultsAmong all participants, geographic clustering of response scores were observed globally and at specific time periods. In the purely spatial analysis, five significant clusters of ‘very low’ PedsQL physical and psychosocial health outcomes were identified within geographic zones ranging in size from 1 to 21 km. A space-time analysis of outcomes identified significant clusters of both ‘very low’ and ‘low’ outcomes between survey months within zones ranging in size from 3 to 5 km.ConclusionMonitoring patient health outcomes following injury is important for planning and targeting interventions. A common theme in the literature is that future prevention efforts may benefit from identifying those most a risk of developing ongoing problems after injury in effort to target resources to those most in need. Spatial scan statistics are tools that could be applied for identifying concentrations of poor recovery outcomes. By classifying outcomes as a categorical variable, clusters of ‘potentially low’ outcomes can also be mapped, thereby identifying populations whose recovery status may decrease.",0,0 +2641,Post-Traumatic Stress Diagnostic Scale (PDS),,0,0 +2642,ASSESSMENT OF COMA AND IMPAIRED CONSCIOUSNESS,"

Abstract

A clinical scale has been evolved for assessing the depth and duration of impaired consciousness and coma. Three aspects of behaviour are independently measured—motor responsiveness, verbal performance, and eye opening. These can be evaluated consistently by doctors and nurses and recorded on a simple chart which has proved practical both in a neurosurgical unit and in a general hospital. The scale facilitates consultations between general and special units in cases of recent brain damage, and is useful also in defining the duration of prolonged coma.",0,0 +2643,Frequency and predictors of post-traumatic stress disorder after stroke: A pilot study,"

Abstract

Objective

Few data exist about post-stroke symptoms of post-traumatic stress disorder (sPTSD) and none on DSM-IV formally diagnosed PTSD (fdPTSD). We investigated the frequency and predictors of sPTSD and fdPTSD 1–6months after a nondisabling ischemic stroke (IS) or transient ischemic attack (TIA).

Methods

Consecutive patients were assessed for sPTSD (Impact of Events Scale-Revised, IES-R, significant if >30) and fdPTSD (PTSD-Interview). We recorded sociodemographic factors, stroke features (including severity of the initial deficit, persistent disability, localization), associated mood changes, peritraumatic reactions during the stroke (Peritraumatic Distress Inventory (PDI) for fear and distress, Peritraumatic Dissociative Experience Questionnaire for cognitive appraisal), and psychiatric history. Patients with sPTSD and fdPTSD were compared to patients with IES-R<30.

Results

Among the 40 patients (65% male, mean age 52years) studied post-IS (n=30; mean initial NIHSS 4) or TIA, 25% had sPTSD, including 10% with fdPTSD. sPTSD was more frequent in women (p=0.02), patients with intense peritraumatic reactions especially on PDI (p=0.001) or identified prior depression and anxiety (p=0.007). No other demographic factors or stroke characteristics were associated with sPTSD. Forty percent of sPTSD patients were depressed versus none of the controls (p<0.002). All fdPTSD patients had ≥3 prior psychiatric co-morbidities.

Conclusions

After nondisabling IS or TIA, sPTSD is frequent, with fdPTSD for 10%. Patients with intense peritraumatic reactions, women, and those with prior psychiatric morbidity, require particular attention to detect sPTSD.",0,0 +2644,Child abuse and mental disorders in Canada,"Nationally representative Canadian data on the prevalence of child abuse and its relation with mental disorders are lacking. We used contemporary, nationally representative data to examine the prevalence of 3 types of child abuse (physical abuse, sexual abuse and exposure to intimate partner violence) and their association with 14 mental conditions, including suicidal ideation and suicide attempts.We obtained data from the 2012 Canadian Community Health Survey: Mental Health, collected from the 10 provinces. Respondents aged 18 years and older were asked about child abuse and were selected for the study sample (n = 23,395). The survey had a multistage stratified cluster design (household response rate 79.8%).The prevalence of any child abuse was 32% (individual types ranged from 8% to 26%). All types of child abuse were associated with all mental conditions, including suicidal ideation and suicide attempts, after adjustment for sociodemographic variables (adjusted odds ratios ranged from 1.4 to 7.9). We found a dose-response relation, with increasing number of abuse types experienced corresponding with greater odds of mental conditions. Associations between child abuse and attention deficit disorder, suicidal ideation and suicide attempts showed stronger effects for women than men.We found robust associations between child abuse and mental conditions. Health care providers, especially those assessing patients with mental health problems, need to be aware of the relation between specific types of child abuse and certain mental conditions. Success in preventing child abuse could lead to reductions in the prevalence of mental disorders, suicidal ideation and suicide attempts.",0,0 +2645,"Traumatic Brain Injury, Shell Shock, and Posttraumatic Stress Disorder in the Military—Past, Present, and Future","With preferential use of high explosives in modern warfare, traumatic brain injury (TBI) has become a common injury for troops. Most TBIs are classified as ""mild,"" although military personnel with these injuries can have persistent symptoms such as headache, memory impairment, and behavioral changes. During World War I, soldiers in the trenches, undergoing unrelenting artillery bombardment, suffered from similar symptoms, designated at the time as ""shell shock."" Dr Frederick Mott proposed studying the brains of deceased soldiers to elucidate the neuropathology of this clinical entity. Subsequent to a British government enquiry after World War I, the term ""shell shock"" was banned and further investigation into a possible organic cause for these symptoms was discontinued. Nevertheless, similar clinical entities, such as combat or battle fatigue and posttraumatic stress disorder, continue to be encountered by combatants in subsequent military conflicts. To this day, there exists a paucity of neuropathology studies investigating the effects of high explosives on the human brain. By analogy, studies have recently revealed that athletes with repeated head trauma can develop a neurodegenerative disease, chronic traumatic encephalopathy, who present with similar clinical features. Given current circumstance, we propose completing the work envisioned by Dr Mott almost 100 years ago.",0,0 +2646,Consumer involvement in consent document development: a multicenter cluster randomized trial to assess study participants' understanding,"Despite widespread agreement on the importance of informed consent in clinical research, uncertainty remains about the adequacy of current consent procedures and documentation.The objective of the study was to compare an informed consent document developed by a consumer group of potential study participants to one developed by the study investigators. The study was a cluster randomized, controlled study embedded in a 'parent' randomized controlled trial of 1092 participants with Gulf War veterans' illnesses recruited in 1999-2000 at 20 US medical centers. Centers were randomized to the investigator-developed or participant-developed consent document. The primary outcome measure was an Informed Consent Questionnaire-4 (ICQ-4), a validated four-item scale measuring self-reported participant understanding scored from 0 to 1. Secondary outcomes included the Client Satisfaction Questionnaire-8 and measures of study refusal and adherence to the parent trial protocol.There were no significant differences between consent documents on the ICQ-4 score overall or at any of the time points. Mean (95% CI) treatment differences ranged from +0.020 (-0.015, 0.055) (better understanding) at entry to -0.021 (-0.054, 0.012) (worse understanding) at three-months for the participant versus the investigator document group. There were also no significant differences in satisfaction, adherence to the protocol, or in the proportion of patients who refused to participate in the trial.The consumer group may not have been representative of the study participants and they did not suggest dramatic changes to the consent document. The outcome assessment questionnaire was not validated prior to the trial's initiation.Consumer modification of the consent document did not lead to either benefit or harm in understanding, satisfaction, or study refusal and adherence rates. This study did demonstrate, however, that embedding consent studies in a clinical trial is feasible and can address important questions about informed consent without disrupting the primary study.",0,0 +2647,"Epidemiology of multiple childhood traumatic events: child abuse, parental psychopathology, and other family-level stressors","Background: Multiple family-level childhood stressors are common and are correlated. It is unknown if clusters of commonly co-occurring stressors are identifiable. The study was designed to explore family-level stressor clustering in the general population, to estimate the prevalence of exposure classes, and to examine the correlation of sociodemographic characteristics with class prevalence. Method: Data were collected from an epidemiological sample and analyzed using latent class regression. Results: A six-class solution was identified. Classes were characterized by low risk (prevalence = 23%), universal high risk (7 %), family conflict (11 %), household substance problems (22 %), non-nuclear family structure (24 %), parent's mental illness (13 %). Conclusions: Class prevalence varied with race and welfare status, not gender. Interventions for childhood stressors are person-focused; the analytic approach may uniquely inform resource allocation. © Steinkopff Verlag 2004.",0,0 +2648,Optimization and characterization of an antagonist for vasopressin 1a (V1a) receptor,"Evidence from preclinical and human studies demonstrate that arginine vasopressin and vasopressin receptor 1a (V1a-R) play a crucial role in the pathophysiology of psychiatric disorders such as anxiety, depression and post-traumatic stress disorder (PTSD). The lack of selective, brain-penetrant and orally active V1a receptor antagonists has hampered the progress in our understanding of the precise/complete pharmacological role of V1a-R in central nervous system disorders and the development of novel treatments for these disorders. The optimization of promising V1a-R antagonist lead compounds and testing in known and relevant in vivo animal models will be a significant step forward in our understanding of the role of V1a-R in CNS disorders and in the development of novel treatments of anxiety, depression and PTSD. The lack of published data regarding brain-penetration and off-target selectivity, along with intellectual property barriers of the known V1a-R antagonists precludes their potential usefulness as CNS agents. As a result, there is a substantial need to discover centrally active V1a-R antagonists that are useful as in vivo tools to better understand the pharmacological role of V1a-R in CNS disorders with the potential as clinically therapeutic agents. The Scripps Research Institute Molecular Screening Center (SRIMSC), part of the Molecular Libraries Probe Production Centers Network (MLPCN), reports ML389 as a highly potent V1a-R antagonist with an IC50 of 40 nM, and high selectivity (selectivities vs. vasopressin 1b receptor, vasopressin 2 receptor, and the oxytocin receptor of >1250 fold). ML389 was identified by medicinal chemistry optimization of lead compounds. A set of pharmacokinetic analyses show that ML389 has good brain penetration, no significant activity at four human cytochrome P450 subtypes, high binding for human and rodent plasma protein, and an encouraging in vivo pharmacokinetic profile in mice. Broad selectivity screening data against a panel of receptors, transporters, and ion channels suggest that ML389 is generally inactive against a broad array of off targets and does not likely exert unwanted effects. ML389 serves as a novel V1a-R antagonist that can be developed as a therapeutic for the treatment of psychiatric disorders such as anxiety, depression and PTSD.",0,0 +2649,Evaluating Risk Factors and Possible Mediation Effects in Posttraumatic Depression and Posttraumatic Stress Disorder Comorbidity,"Objectives. On September 11, 2001 (9/11), attacks on the World Trade Center (WTC) killed 341 Fire Department of the City of New York (FDNY) firefighters and injured hundreds more. Previous WTC-related studies reported high rates of comorbid depression and posttraumatic stress disorder (PTSD), identifying disability retirement, alcohol use, and early arrival at the WTC site as correlates. However, those studies did not evaluate risk factors that could have mediated the observed comorbidity. We identified unique risk factors for each condition in an effort to better understand comorbidity. Methods. We screened retired WTC-exposed firefighters using self-administered questionnaires including the Center for Epidemiologic Studies Depression Scale, the Post Traumatic Stress Disorder Checklist, and the Alcohol Use Disorders Identification Test. We performed regression analyses to compare independent predictors of elevated depression and PTSD risk, and also tested a mediation hypothesis. Results. From December 2005 to July 2007, 23% and 22% of 1,915 retirees screened positive for elevated depression and PTSD risk, respectively, with comorbidity >70%. Controlling for comorbidity, we identified unique risk factors for (7) depression: problem alcohol use and (2) PTSD: early arrival at the WTC site. Conclusions. Our data support the premise that PTSD and depression are different responses to trauma with unique risk factors. The data also suggest a hypothesis that PTSD mediates the relationship between early WTC arrival and depression, while depression mediates the relationship between alcohol use and PTSD, a more complex relationship than shown in previous studies. Clinicians should consider these factors when evaluating patients for depression and PTSD.",0,0 +2650,Treating Multiple Incident Post-Traumatic Stress Disorder (PTSD) in an Inner City London Prison: The Need for an Evidence Base,"Background: Mental health problems have been found to be more prevalent in prison populations, and higher rates of post-traumatic stress disorder (PTSD) have been found in sentenced populations compared to the general population. Evidence-based treatment in the general population however has not been transferred and empirically supported into the prison system. Aims: The aim of this manuscript is to illustrate how trauma focused work can be applied in a prison setting. Method: This report describes a two-phased approach to treating PTSD, starting with stabilization, followed by an integration of culturally appropriate ideas from narrative exposure therapy (NET), given that the traumas were during war and conflict, and trauma-focused cognitive behavioural therapy (TF-CBT). Results : PTSD and scores on paranoia scales improved between start and end of treatment; these improvements were maintained at a 6-month follow-up. Conclusion : This case report 1 illustrates successful treatment of multiple incident PTSD in a prison setting using adaptations to TF-CBT during a window of opportunity when individuals are more likely to be free from substances and live in relative stability. Current service provision and evidence-based practice for PTSD is urgently required in UK prisons to allow individuals to engage in opportunities to reduce re-offending, free from mental health symptoms.",0,0 +2651,Stress-induced enhancement of fear conditioning activates the amygdalar cholecystokinin system in a rat model of post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD), a debilitating psychiatric disease characterized by invasive and persistent fear memories-induced stressful experience, is associated with numerous changes in neuroendocrine function. Here, we investigated whether PTSD-like symptoms are associated with changes in the cholecystokinin (CCK) system in the basolateral amygdala. We developed an animal model of PTSD using multiple foot shocks at 1.1 mA. The resulting conditioned fear response was severe (>80% freezing) and maintained for at least 28 days. The stress-associated neurotransmitters norepinephrine, dopamine, and corticotrophin-releasing hormone were elevated at 1 day after foot shock. CCK immunoreactivity and extracellular concentration as well as the expression of CCK receptors (CCK1R, CCK2R) increased progressively for 28 days following foot shock. Taken together, these results suggest that stress-induced activation of the CCK system in the BLA, which may contribute toward the development of PTSD-like symptoms.",0,0 +2652,"Female Domestic Violence Offenders: Their Attachment Security, Trauma Symptoms, and Personality Organization","Unlike male domestic violence offenders, female domestic violence offenders have traditionally been overlooked in research and theory, despite the fact that females also have high rates of domestic violence perpetration. Towards the aim of extending extant research on male and female pepetrators of domestic violence, we examined attachment style, trauma symptoms, and personality organization in 33 female offenders receiving mandated treatment for domestic violence. These offenders were compared to 32 nonoffending women receiving psychological treatment. The Experiences in Close Relationships Revised (ECR-Revised) was used to examine adult attachment, the Trauma Symptom Inventory (TSI) was used to examine trauma symptomology, and finally, the Millon Clinical Multiaxial Inventory III (MCMI-III) was used to examine cluster B personality traits. Analyses indicated that female domestic violence offenders reported less attachment security, more trauma-related symptoms, and more personality psychopathology (Antisocial, Borderline, and Dependent Subscales) than did nonoffender clinical comparison women. © 2007 Springer Publishing Company.",0,0 +2653,Identification of post traumatic stress disorder and risk factors in military first responders 6months after Wen Chuan earthquake in China,"Military personnel commonly serve as first responders to natural disasters. Our aim is to identify Post-Traumatic Stress Disorder (PTSD) and determine risk in military responders to the Wen Chuan earthquake.Analyses were carried out on 1056 of the 1125 soldiers enrolled. In addition to social demographic characteristics, the Davidson Trauma Scale (DTS) and an Earthquake exposure screening scale were administered.PTSD prevalence was 6.53% (69 cases). Logistic regression indicated that intensity of traumatic exposure (odds ratio 6.46, 95% CI 4.47-9.32, p<0.001), not having received psychological counseling (odds ratio 3.28, 95% CI 1.31-8.20, p<0.02) and regular drinking (odds ratio 2.42, 95% CI 1.04-5.62, p<0.05) were significant predictors of PTSD. Being a single-child, not being raised by both parents and regular smoking also independently predicted PTSD if intensity of earthquake traumatic exposure was not included in the model.The self-rated DTS was used to classify PTSD in this study and psychiatric co-morbidity outside of PTSD was not assessed in this sample.PTSD is a concern for Military disaster responders; to identify those with high risk of developing PTSD would be important and beneficial.",0,0 +2654,Therapeutic Effects of Melatonin Receptor Agonists on Sleep and Comorbid Disorders,"Several melatonin receptors agonists (ramelteon, prolonged-release melatonin, agomelatine and tasimelteon) have recently become available for the treatment of insomnia, depression and circadian rhythms sleep-wake disorders. The efficacy and safety profiles of these compounds in the treatment of the indicated disorders are reviewed. Accumulating evidence indicates that sleep-wake disorders and co-existing medical conditions are mutually exacerbating. This understanding has now been incorporated into the new Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Therefore, when evaluating the risk/benefit ratio of sleep drugs, it is pertinent to also evaluate their effects on wake and comorbid condition. Beneficial effects of melatonin receptor agonists on comorbid neurological, psychiatric, cardiovascular and metabolic symptomatology beyond sleep regulation are also described. The review underlines the beneficial value of enhancing physiological sleep in comorbid conditions.",0,0 +2655,Short-term psychiatric adjustment of children and their parents following meningococcal disease,"To assess short-term changes in child and parent psychiatric status following meningococcal disease.Prospective cohort study; 3-month follow-up using parent, teacher, and child questionnaires.Hospital admissions to three pediatric intensive care units and 19 general pediatric wards.Sixty children aged 3-6 yrs, 60 mothers, and 45 fathers.We administered measures of illness severity (Glasgow Meningococcal Septicaemia Prognostic Score, days in hospital) and psychiatric morbidity (Strengths and Difficulties Questionnaires, parent and teacher versions; Impact of Event scales; General Health Questionnaire-28).In children admitted to pediatric intensive care units, parental reports at 3-month follow-up showed a significant increase in emotional and hyperactivity symptoms and in related impairment; symptoms of posttraumatic stress disorder were present in four of 26 (15%) children >8 yrs old. Regarding the parents, 26 of 60 (43%) mothers in the total sample had questionnaire scores indicative of high risk for psychiatric disorder and 22 of 58 (48%) for posttraumatic stress disorder. In fathers there was high risk for psychiatric disorder in 11 of 45 (24%) and for posttraumatic stress disorder in 8 of 43 (19%). Severity of the child's physical condition on admission was significantly associated with hyperactivity and conduct symptoms at follow-up. Length of hospital admission was associated with psychiatric symptoms in the child and posttraumatic stress disorder symptoms in parents. There were also significant associations between psychiatric symptoms in children and parents.Admission of children to pediatric intensive care units for meningococcal disease is associated with an increase in and high levels of psychiatric and posttraumatic stress disorder symptoms in children and parents. Length of admission is associated with psychiatric symptoms in children and posttraumatic stress disorder symptoms in parents. Pediatric follow-up should explore psychiatric as well as physical sequelae in children and parents.",0,0 +2656,Biological and clinical framework for posttraumatic stress disorder,"Three decades of posttraumatic stress disorder (PTSD) research have placed it well on the map. PTSD is a young disorder that started being properly understood only from 1980 with incorporation in DSM-III, in which it was acknowledged that exposure to traumatic events can lead to long-term psychopathology. This chapter reviews the history and nosology of the disorder, epidemiology, and etiology, as well as the clinical features. It lists the diagnostic assessments and provides an overview of the biological framework of the disorder by addressing brain, neurohormonal, and transmitter alterations. Exposure to traumatic events is commonplace. The majority of exposed subjects are resilient, as this is still the rule rather than the exception. The reported prevalence of PTSD is twice as common in females compared to males. The A criterion in PTSD expressed the traumatic event, after which the symptom clusters are based on intrusions, avoidance, and irritability. Gene–environmental studies are needed, with a focus on specific, distinct endophenotypes and influences from environmental factors (e.g., traumatic early-life experiences, with abuse or neglect, as well as exposure to disasters or combat). PTSD is often accompanied by comorbid disorders, such as depression and other anxiety disorders, as well as drug and alcohol abuse and dependence. The disorder is heterogeneous, sometimes with complex features that focus on emotional dysregulation, attachment, and dissociation. Several validated trauma assessments are available that allow quantification of trauma symptomatology. The biological framework is based on the concepts of stress sensitization and fear conditioning as well as failure of inhibition. After the decade of the hippocampus we have seen a shift to the decade of the amygdala in the new millennium. Given the specific role of the prefrontal cortex in (neuro)psychological functions in patients with PTSD (i.e., attention and cognitive interference), interest in the role of the prefrontal cortex will increase significantly. Increased multidisciplinary involvement, with inclusion of genetics, endocrinology, immunology, (neuro)psychology, and psychopathology, is essential to find consistency between biological, emotional, and cognitive dysfunction in PTSD. A variety of effective psychological and pharmacological interventions can be used to treat PTSD. The mechanisms of exposure therapy and cognitive therapy in influencing neurobiological markers need to be further investigated. The same goes for emerging therapies such as eye movement desensitization and reprocessing, virtual reality exposure, internet therapy, and neurofeedback. There are no specific drugs for PTSD, except for the treatment of irritability and depressive features with selective serotonin reuptake inhibitors. Other options, such as specific serotonergic agents, e.g., 5-HT1A antagonists, norepinephrine blockers, corticotropin-releasing factor antagonists, glucocorticoid receptor antagonists, prazosin and α1-adrenergic blocker with nightmares, and use of beta-blockers early after trauma exposure, are investigated. New treatment options such as d-cycloserine and cortisol seem to offer opportunities to influence memory consolidation of traumatic experiences in timed relation to exposure. For health economy it is important to be aware that there is an economic burden associated with PTSD, and treatments require the use of scarce resources. They will ultimately provide tools to ascertain the relative efficiency of different treatment options and plan the availability of these for the affected population. This can be seen as the biggest challenge for the future evolution of the disorder.",0,0 +2657,"Child and Family Resilience: A Call for Integrated Science, Practice, and Professional Training","Science and practice focused on child resilience and family resilience have deep and intertwined roots, yet there have been surprisingly few efforts to systematically integrate the theory, findings, and implications of these two traditions of work. In this article, the authors discuss parallels in concepts and processes that link the sciences of child and family resilience and the potential of relational developmental systems theory to provide an integrative framework for understanding and promoting resilience in children and families. The authors describe components of an integrated approach to child and family resilience, highlighting examples from recent research, and discuss implications for research, practice, and professional training.",0,0 +2658,Resolution of Stressful Experiences as an Indicator of Coping Effectiveness in Young Adults: An Event History Analysis,"Coping research has been limited by an almost exclusivefocus on emotional distress as an indicator of coping effectiveness. The present study considers the role of stressful event duration as an indicator of coping effectiveness. The effects of specific coping strategies on the duration and resolution of different types of stressful experiences was examined in a cross-sectional, retrospective study of a large young adult sample (N = 829; age range = 21 to 26; 60% female; 94% Caucasian). Results revealed that use of coping strategies varied among different types of stressors, which included interpersonal problems, role strains, illnesses, and transitional experiences. Event history analyses indicated that avoidance and active cognitive coping were linked with longer duration, while active behavioral coping was linked with shorter duration. These coping differences did not account for the differences in duration across stressor domain. Finally, the impact of coping on duration varied as events progressed.",0,0 +2659,Prospective Study of Posttraumatic Stress Disorder and Depression Following Trauma,"OBJECTIVE: The purpose of this study was to prospectively evaluate the onset, overlap, and course of posttraumatic stress disorder (PTSD) and major depression following traumatic events. METHOD: The occurrence of PTSD and major depression and the intensity of related symptoms were assessed in 211 trauma survivors recruited from a general hospital's emergency room. Psychometrics and structured clinical interview (the Structured Clinical Interview for DSM-III-R and the Clinician-Administered PTSD Scale) were administered 1 week, 1 month, and 4 months after the traumatic event. Heart rate was assessed upon arrival at the emergency room for subjects with minor physical injury. Twenty-three subjects with PTSD and 35 matched comparison subjects were followed for 1 year. RESULTS: Major depression and PTSD occurred early on after trauma; patients with these diagnoses had similar recovery rates: 63 survivors (29.9%) met criteria for PTSD at 1 month, and 37 (17.5%) had PTSD at 4 months. Forty subjects (19.0%) met criteria for major depression at 1 month, and 30 (14.2%) had major depression at 4 months. Comorbid depression occurred in 44.5% of PTSD patients at 1 month and in 43.2% at 4 months. Comorbidity was associated with greater symptom severity and lower levels of functioning. Survivors with PTSD had higher heart rate levels at the emergency room and reported more intrusive symptoms, exaggerated startle, and peritraumatic dissociation than those with major depression. Prior depression was associated with a higher prevalence of major depression and with more reported symptoms. CONCLUSIONS: Major depression and PTSD are independent sequelae of traumatic events, have similar prognoses, and interact to increase distress and dysfunction. Both should be targeted by early treatment interventions and by neurobiological research.",0,0 +2660,Latent Variable Mixture Modeling,"This chapter discusses models with latent variables that are continuous and/ or categorical. It also gives an overview of modeling issues related to crosssectional analysis using latent class models, modeling of longitudinal data using latent class models, and modeling of longitudinal data using a combination of continuous and categorical latent variables (growth mixture models). A series of examples are presented. The analyses are carried out within a general latent variable modeling f\work shown in the appendix using the Mplus program (Muthen & Muthen, 1998). Mplus input specifications for these analyses can be obtained from www.statmodel.com. To introduce the analyses, a brief overview of modeling ideas is presented in Figs. 1.1 to 1.3.",0,0 +2661,"Olfactory identification dysfunction, aggression and impulsivity in war veterans with post-traumatic stress disorder","Background Due to neuropsychological conceptualizations of orbitoprefrontal cortex (OFC) dysfunction underpinning impulsive aggression and the incidence of such behaviour in post-traumatic stress disorder (PTSD), this study aimed to explore olfactory identification (OI) ability in war veterans with PTSD as a probe of putative OFC dysfunction; and to explore the utility of OI ability in predicting aggressive and impulsive behavior in this clinical population. Method Participants comprised 31 out-patient male war veterans with PTSD (mean=58.23 years, s.d .=2.56) recruited from a Melbourne Veterans Psychiatry Unit, and 31 healthy age- and gender-matched controls (mean=56.84 years, s.d .=7.24). All participants were assessed on clinical measures of PTSD, depression, anxiety, and alcohol misuse; olfactory identification; neurocognitive measures of dorsolateral prefrontal, lateral prefrontal and mesial temporal functioning; and self-report measures of aggression and impulsivity. Results War veterans with PTSD exhibited significant OI deficits (OIDs) compared to controls, despite uncompromised performance on cognitive measures. OIDs remained after covaring for IQ, anxiety, depression and alcohol misuse, and were significant predictors of aggression and impulsivity. Conclusions This research contributes to emerging evidence of orbitoprefrontal dysfunction in the pathophysiology underlying PTSD. This is the first study to report OIDs as a predictor of aggression and impulsivity in this clinical population. It prompts further exploration of the potential diagnostic utility of OIDs in the assessment of PTSD. Such measures may help delineate the clinical complexity of PTSD, and support more targeted interventions for individuals with a greater susceptibility to aggressive and impulsive behaviors.",0,0 +2662,The longitudinal course of posttraumatic stress disorder symptom clusters among war veterans.,"The aim of this study was to examine the long-term trajectories and interrelationships of posttraumatic stress disorder (PTSD) symptom clusters (intrusion, avoidance, and hyperarousal) in clinical and nonclinical groups of war veterans.Six hundred seventy-five Israeli veterans from the 1982 Lebanon War were assessed. The clinical group consisted of 369 who had combat stress reaction (CSR) during the war, and the nonclinical group consisted of 306 veterans with no antecedent CSR. The 2 groups were matched in age, education, military rank, and assignment. They were prospectively evaluated 1, 2, and 20 years after the war.The clinical group endorsed a higher number of symptoms than the nonclinical group, both cross-sectionally and across time. In both the clinical and nonclinical groups, the clusters of intrusion, avoidance, and hyperarousal were interrelated at any given point in time and across 20 years. In both groups, avoidance was found to be a particularly stable symptom cluster over time. Finally, hyperarousal levels 1 year after the war were found to play an important role in both groups, as they predicted future avoidance and intrusion symptoms.The findings of this study suggest that PTSD is not a monolithic disorder, as symptom clusters differ in several important aspects. Also, the course and severity of symptoms differ between clinical and nonclinical groups. Finally, practitioners are encouraged to focus on the identification and treatment of early hyperarousal due to its prominent role in the development of other PTSD symptoms.",0,0 +2663,The expansion of the field of research on ayahuasca: Some reflections about the ayahuasca track at the 2010 MAPS “Psychedelic Science in the 21st Century” conference,"A recent conference sponsored by the Multidisciplinary Assoiation for Psychedelic Studies (MAPS) in collaboration with the effter Research Institute, the Beckley Foundation and the Council n Spiritual Practices held fromApril 15th to 18th 2010, in San Jose, SA (MAPS, 2010) united 90 presenters and 1100 participantswith he goal of giving visibility to studies on the therapeutic potentials f psychedelics (psilocybin,MDMA, ibogaine, ayahuasca, etc.) in the reatment of often intractable ailments such as anxiety in terminal ancer patients, cluster headaches, obsessive–compulsive disorers, drug addiction, and post-traumatic stress disorders, as well s the role of these substances in human enhancement and welleing in general. MAPS was chartered in 1986, with the mission to evelop cannabis and psychedelics into prescription medicines to reat illnesses, tobuildanetworkof clinicswhere theseprescription edicines can be administered, and to provide public education n the harm and benefits of using psychedelics and cannabis. The nstitution has managed to get the permission of the DEA and FDA o conduct a number of clinical trials with psychedelics over the ears. Straddling the fence between establishment and counterculure, MAPS has generally been criticized by mainstream medicine or promoting the use of “dangerous drugs,” while other members f the psychedelic community have complained thatMAPS is either oo medically focused or too incendiary in its tactics with the US overnment. Ultimately,MAPS continues to enjoy the popular suport of many and occupy a leading position on the field, such as the evelopment, with the support of other important institutions, of he Psychedelic Science in the 21st Century conference The gathering was held in Silicon Valley, where psychedelics ave often, though quietly, been credited with helping to inspire",0,0 +2664,Refugee children in Sweden: Post-Traumatic Stress Disorder in Iranian preschool children exposed to organized violence,"Fifty preschool children from 47 Iranian families living as refugees in Sweden were assessed individually, simultaneously with parental interviews focusing on exposure to organized violence and post-traumatic stress symptomatology in the children. Information given by the children increased the prevalence of a Post-Traumatic Stress Disorder (PTSD) diagnosis (DSM-III-R) from 2% to 21% in the 42 children with traumatic exposure through war and political persecution. The amount of traumatic exposure was strongly related to the prevalence of PTSD. The stability of prevalence was high in a follow-up 2 and 1/2 years later; 23% of the children with traumatic exposure still met the full criteria of PTSD according to DSM-III-R.",0,0 +2665,Epigenetic mechanisms mediating vulnerability and resilience to psychiatric disorders,"The impact that stressful encounters have upon long-lasting behavioural phenotypes is varied. Whereas a significant proportion of the population will develop ""stress-related"" conditions such as post-traumatic stress disorder or depression in later life, the majority are considered ""resilient"" and are able to cope with stress and avoid such psychopathologies. The reason for this heterogeneity is undoubtedly multi-factorial, involving a complex interplay between genetic and environmental factors. Both genes and environment are of critical importance when it comes to developmental processes, and it appears that subtle differences in either of these may be responsible for altering developmental trajectories that confer vulnerability or resilience. At the molecular level, developmental processes are regulated by epigenetic mechanisms, with recent clinical and pre-clinical data obtained by ourselves and others suggesting that epigenetic differences in various regions of the brain are associated with a range of psychiatric disorders, including many that are stress-related. Here we provide an overview of how these epigenetic differences, and hence susceptibility to psychiatric disorders, might arise through exposure to stress-related factors during critical periods of development.",0,0 +2666,"Military blast exposure, ageing and white matter integrity","Mild traumatic brain injury, or concussion, is associated with a range of neural changes including altered white matter structure. There is emerging evidence that blast exposure-one of the most pervasive causes of casualties in the recent overseas conflicts in Iraq and Afghanistan-is accompanied by a range of neurobiological events that may result in pathological changes to brain structure and function that occur independently of overt concussion symptoms. The potential effects of brain injury due to blast exposure are of great concern as a history of mild traumatic brain injury has been identified as a risk factor for age-associated neurodegenerative disease. The present study used diffusion tensor imaging to investigate whether military-associated blast exposure influences the association between age and white matter tissue structure integrity in a large sample of veterans of the recent conflicts (n = 190 blast-exposed; 59 without exposure) between the ages of 19 and 62 years. Tract-based spatial statistics revealed a significant blast exposure × age interaction on diffusion parameters with blast-exposed individuals exhibiting a more rapid cross-sectional age trajectory towards reduced tissue integrity. Both distinct and overlapping voxel clusters demonstrating the interaction were observed among the examined diffusion contrast measures (e.g. fractional anisotropy and radial diffusivity). The regions showing the effect on fractional anisotropy included voxels both within and beyond the boundaries of the regions exhibiting a significant negative association between fractional anisotropy and age in the entire cohort. The regional effect was sensitive to the degree of blast exposure, suggesting a 'dose-response' relationship between the number of blast exposures and white matter integrity. Additionally, there was an age-independent negative association between fractional anisotropy and years since most severe blast exposure in a subset of the blast-exposed group, suggesting a specific influence of time since exposure on tissue structure, and this effect was also independent of post-traumatic stress symptoms. Overall, these data suggest that blast exposure may negatively affect brain-ageing trajectories at the microstructural tissue level. Additional work examining longitudinal changes in brain tissue integrity in individuals exposed to military blast forces will be an important future direction to the initial findings presented here.",0,0 +2667,Predator Stress-Induced CRF Release Causes Enduring Sensitization of Basolateral Amygdala Norepinephrine Systems that Promote PTSD-Like Startle Abnormalities,"The neurobiology of post-traumatic stress disorder (PTSD) remains unclear. Intense stress promotes PTSD, which has been associated with exaggerated startle and deficient sensorimotor gating. Here, we examined the long-term sequelae of a rodent model of traumatic stress (repeated predator exposure) on amygdala systems that modulate startle and prepulse inhibition (PPI), an operational measure of sensorimotor gating. We show in rodents that repeated psychogenic stress (predator) induces long-lasting sensitization of basolateral amygdala (BLA) noradrenergic (NE) receptors (α1) via a corticotropin-releasing factor receptor 1 (CRF-R1)-dependent mechanism, and that these CRF1 and NE α1 receptors are highly colocalized on presumptive excitatory output projection neurons of the BLA. A profile identical to that seen with predator exposure was produced in nonstressed rats by intra-BLA infusions of CRF (200 ng/0.5 μl), but not by repeated NE infusions (20 μg/0.5 μl). Infusions into the adjacent central nucleus of amygdala had no effect. Importantly, the predator stress- or CRF-induced sensitization of BLA manifested as heightened startle and PPI deficits in response to subsequent subthreshold NE system challenges (with intra-BLA infusions of 0.3 μg/0.5 μl NE), up to 1 month after stress. This profile of effects closely resembles aspects of PTSD. Hence, we reveal a discrete neural pathway mediating the enhancement of NE system function seen in PTSD, and we offer a model for characterizing potential new treatments that may work by modulating this BLA circuitry.The present findings reveal a novel and discrete neural substrate that could underlie certain core deficits (startle and prepulse inhibition) that are observed in post-traumatic stress disorder (PTSD). It is shown here that repeated exposure to a rodent model of traumatic stress (predator exposure) produces a long-lasting sensitization of basolateral amygdala noradrenergic substrates [via a corticotropin-releasing factor (CRF)-dependent mechanism] that regulate startle, which is exaggerated in PTSD. Moreover, it is demonstrated that the sensitized noradrenergic receptors colocalize with CRF1 receptors on output projection neurons of the basolateral amygdala. Hence, this stress-induced sensitization of noradrenergic receptors on basolateral nucleus efferents has wide-ranging implications for the numerous deleterious sequelae of trauma exposure that are seen in multiple psychiatric illnesses, including PTSD.",0,0 +2668,Resilience in the face of potential trauma: Clinical practices and illustrations,"Many persons exposed to loss or potentially traumatic events manage the stresses of these experiences with minimal to no impact on their daily functioning. The prevalence of this resilient capacity has surprised researchers and clinicians alike and refocused clinical practice. We review three key points about resilience: resilience is different from the process of recovery; resilience in the face of loss or potential trauma is common; and there are multiple and sometimes unexpected pathways to resilience. We then present six clinical practices informed by the study of resilience, illustrating key points with clinical vignettes. © 2006 Wiley Periodicals, Inc. J Clin Psychol: In Session 62: 971–985, 2006.",0,0 +2669,Novelty-evoked activity in open field predicts susceptibility to helpless behavior,"Learned helplessness in animals has been used to model disorders such as depression and post-traumatic stress disorder (PTSD), but there is a lack of knowledge concerning which individual behavioral characteristics at baseline can predict helpless behavior after exposure to inescapable stress. The first aim of this study was to determine behavioral predictors of helplessness using the novel and familiar open-field tests, sucrose consumption, and passive harm-avoidance tasks before learned helplessness training and testing. Individual differences in physiologic responses to restraint stress were also assessed. A cluster analysis of escape latencies from helplessness testing supported the division of the sample population of Holtzman rats into approximately 50% helpless and 50% non-helpless. Linear regression analyses further revealed that increased reactivity to the novel environment, but not general activity or habituation, predicted susceptibility to learned helplessness. During restraint stress there were no mean differences in heart rate, heart rate variability, and plasma corticosterone between helpless and non-helpless rats; however, a lower heart rate during stress was associated with higher activity levels during exploration. Our most important finding was that by using an innocuous screening tool such as the novel and familiar open-field tests, it was possible to identify subjects that were susceptible to learned helplessness.",0,0 +2670,"Use of a Frequency-Modulated System for Veterans with Blast Exposure, Perceived Hearing Problems, and Normal Hearing Sensitivity","Traumatic brain injury can impact the central auditory system leading to poor auditory recall and increased difficulties hearing in poor acoustic environments. In recent years, audiologists have increasingly encountered blast-exposed veterans who report speech understanding problems that are disproportionate to their essentially normal hearing sensitivity, and thus are thought to have an auditory processing disorder. In light of studies showing frequency-modulated (FM) systems to be effective rehabilitation for auditory processing difficulties, we examined the use of an FM system intervention for blast-exposed veterans with functional hearing problems in the presence of normal hearing sensitivity. The outcomes for three veterans who were provided with an FM system as part of a multisite randomized clinical trial are described. Data indicate that FM systems are beneficial for some patients reporting hearing problems in the presence of normal hearing sensitivity but factors other than audiometric profile and reported complaints influence outcome. These include understanding of speech in noise, patient communication demands, auditory lifestyle, and the presence of posttraumatic stress disorder or other mental health factors. Furthermore, education (and reeducation if necessary) of the patient and their spouse or family is critical to successful outcome.",0,0 +2671,Post-traumatic stress disorder in a Danish population of elderly bereaved,"The objectives of this study were to examine psychological sequalae of loss of a spouse in late life especially the occurrence of post-traumatic stress disorder (PTSD) and possible predictors of PTSD and symptom development. Fifty-four bereaved Danes (mean age 75 years) from five geographically different areas were studied by the Harvard Trauma Questionnaire (HTQ), the Trauma Symptom Checklist (TSC), and the Crisis Support Scale (CSS). One month after the loss, 27% of the subjects had PTSD. Six months after the loss, this number decreased to 17%; if the A2 criterion was dismissed, the number increased to 24%. Lack of expressive ability, numbing, fear of death or illness, and helplessness in relation to the loss predicted 73% of the variance of the HTQ-total scores. The study concluded that for a considerable number of elderly, losing a spouse in late life appeared to be a traumatic experience. Pre- and peritraumatic factors together with numbing were important predictors of traumatization. Research implications are discussed.",0,0 +2672,"The Effects of Disaster Exposure and Post-Disaster Critical Incidents on Intrusions, Avoidance Reactions and Health Problems Among Firefighters: A Comparative Study","Firefighters are at risk to be confronted with critical incidents and disasters. This study focused on the predictive value of these variables and their interaction effect for intrusions, avoidance reactions, and health problems among firefighters 18 months post-disaster (N = 639). Furthermore, the course of intrusions, avoidance reactions, and health problems in the period 2–3 weeks to 18 months post-disaster was assessed. Health problems were compared with those of non-affected firefighters (N = 132). Results showed that only disaster exposure and critical incidents accounted for a significant but small proportion of the variance (R 2 < .07) of intrusions, avoidance reactions and health problems among the affected firefighters. Health problems among affected firefighters did not decline in the period 2–3 weeks–18 months post-disaster, in contrast to intrusions and avoidance reactions. Health problems of both groups were comparable at T2. Results suggest that resilience in firefighters is rather high.",0,0 +2673,Quantitative somatosensory testing of subjects with chronic post-traumatic headache: Implications on its mechanisms,"Chronic headache is one of the most prominent symptoms among subjects with traumatic head injury (THI). Despite the relatively high prevalence of chronic post-traumatic headache (CPTHA) and its enormous effect on the already poor quality of life of subjects with THI, its mechanisms has not been studied in depth.To conducted quantitative somatosensory testing in THI subjects with and without chronic post-traumatic headache (CPTHA) in order to shed light on the yet, unknown pathophysiology of CPTHA.THI subjects with and without CPTHA and healthy controls underwent thermal and mechanical threshold measurements in painful and pain-free regions in the head and in their hands (a remote pain-free region) and filled out and the post-traumatic stress disorder (PTSD) inventory. In addition, the THI and CPTHA filled out the Mc'Gill pain questionnaire (MPQ).THI subjects with CPTHA had significantly higher thermal thresholds in both the head and hand indicating central damage to the pain and temperature system and in addition, a significantly lower pressure-pain threshold in the head as well as more severe PTSD symptomatology than the pain-free THI subjects and healthy controls.The sensory profile of subjects with CPTHA suggests that CPTHA may be a form of central pain. The cranial mechanical hyperalgesia may originate from peripheral tissue damage accompanying the THI. Psychological factors may contribute to the development, and maintenance of CPTHA in susceptible individuals.",0,0 +2674,No association between ADCYAP1R1 and post-traumatic stress disorder in two independent samples,"Presents a study which aims to replicate genetic association between single nucleotide polymorphisms rs2267735 and post-traumatic stress disorder (PTSD) in two independent samples. The first sample consisted of women from the Nurses' Health Study II (NHSII) and second sample contained 6074 individuals recruited for genetic studies of substance dependence at five US sites. The authors were unable to replicate the association between rs2267735 and PTSD in these two large independent samples. The findings do not, however, exclude the possibility that the pituitary adenylate cyclase-activating peptide-ligand type 1 receptor (PACAP-PACl1) receptor pathway has a role in the production of PTSD. Further research is needed to understand how selection factors, demographic characteristics and social context influence the role of the PACAP-PACl receptor pathway in PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +2675,Review of VA/DOD Clinical Practice Guideline on management of acute stress and interventions to prevent posttraumatic stress disorder,"This article summarizes the recommendations of the Department of Veterans Affairs (VA)/Department of Defense (DOD) VA/DOD Clinical Practice Guideline for Management of Post-Traumatic Stress that pertain to acute stress and the prevention of posttraumatic stress disorder, including screening and early interventions for acute stress states in various settings. Recommended interventions during the first 4 days after a potentially traumatic event include attending to safety and basic needs and providing access to physical, emotional, and social resources. Psychological first aid is recommended for management of acute stress, while psychological debriefing is discouraged. Further medical and psychiatric assessment and provision of brief, trauma-focused cognitive-behavioral therapy are warranted if clinically significant distress or functional impairment persists or worsens after 2 days or if the criteria for a diagnosis of acute stress disorder are met. Follow-up monitoring and rescreening are endorsed for at least 6 months for everyone who experiences significant acute posttraumatic stress. Four interventions that illustrate early intervention principles contained in the VA/DOD Clinical Practice Guideline are described.",0,0 +2676,Recruitment and Attrition Issues in Military Clinical Trials and Health Research Studies,"conducting long-term multidisciplinary research projects across a range of military health issues. The plethora of individually funded studies, program grants, and multisite military health research consortia speak to the considerable national investment in the well-being of the U.S. service member. In the context of the current economic situation, maximizing efficiency through optimal human subject participation is of paramount importance to research. A range of factors, however, can contribute to less-than-ideal levels of study participation. 5 Poor recruitment and high dropout rates are not only frustrating and costly, but they also pose a threat to the interpretation, integrity, and validity of research findings. A number of articles have reported obstacles to civilian study participation and have outlined strategies for overcoming those obstacles. 5‐11 However, to the best of our knowledge, none have been devoted to the unique challenges inherent to research with military service members. In this commentary, we review the civilian literature for recruitment and retention factors that potentially may also have relevance to military populations. We then examine research study recruitment and attrition in the U.S. military, highlighting militaryspecific issues that may impact study participation. Finally, we suggest strategies for improving research participation by service members.",0,0 +2677,"Depressive symptoms and psychological distress during the first five years after traumatic brain injury: Relationship with psychosocial stressors, fatigue and pain","To determine the prevalence of depressive symptoms among individuals with traumatic brain injury (TBI) and to identify predictors of depressive symptoms and psychological distress.A longitudinal study with assessments at 3 months, 1 year and 5 years after injury.A total of 118 individuals (29% females; mean age 32.5; range 16-55 years) with mild-to-severe TBI who were hospitalized in the Trauma Referral Centre from 2005 to 2007.Self-report assessments using the Hospital Anxiety- and Depression Scale, the Symptom Checklist 90-Revised and the Fatigue Severity Scale. Injury severity, trauma scores, pain, fatigue, substance abuse and demographic characteristics were also recorded.The prevalence of depressive symptoms was 18% at 3 months, 13% at 1 year and 18% at 5 years after injury. Only 4% had persistent depressive symptoms at all time-points. At 1 year post-injury, anxiety, age, ongoing stressors and employment status predicted depressive symptoms (R2 = 0.43, p < 0.001), and ongoing stressors, employment status, fatigue and pain predicted psychological distress (R2 = 0.45, p < 0.001).Psychosocial stressors and employment status contributed to depressive symptoms and psychological distress, whereas injury severity did not have any predictive value. The prevalence of depressive symptoms remained stable over time, emphasizing the importance of recognizing and treating depression early after the injury.",0,0 +2678,Mental Health Over Time in a Military Sample: The Impact of Alcohol Use Disorder on Trajectories of Psychopathology After Deployment,"To identify trajectories of depression and posttraumatic stress (PTS) symptom groups after deployment and determine the effect of alcohol use disorder on these trajectories, depression symptoms were modeled using the 9-item Patient Health Questionnaire in 727 Ohio National Guard members, and PTS symptoms were modeled using the PTSD Checklist in 472 Ohio National Guard members. There were 55.8% who were resistant to depression symptoms across the 4 years of study, and 41.5% who were resistant to PTS symptoms. There were 18.7% and 42.2% of participants who showed resilience (experiencing slightly elevated symptoms followed by a decline, according to Bonanno et al., 2002) to depression and PTS symptoms, respectively. Mild and chronic dysfunction constituted the smallest trajectory groups across disorders. Marital status, deployment to an area of conflict, and number of lifetime stressors were associated with membership into different latent groups for depression (unstandardized β estimates range = 0.69 to 1.37). Deployment to an area of conflict, number of lifetime traumatic events and education predicted membership into different latent groups for PTS (significant unstandardized β estimate range = 0.83 to 3.17). AUD was associated with an increase in both symptom outcomes (significant unstandardized β estimate range = 0.20 to 9.45). These results suggested that alcohol use disorder may have contributed substantially to trajectories of psychopathology in this population.",1,0 +2679,Health-related quality of life after burns,"Health-related quality of life (HRQOL) is an important parameter after medical treatments. Knowledge of (predictors of) diminished quality of life can help improve medical outcome. The aim of this study was to quantify health loss in patients with burns and to assess the contribution of injury extent, age, gender, and psychologic factors to HRQOL and speed of recovery. A multicenter prospective cohort design was used to address these aims.Data were obtained from 260 adults with burns. Patients completed the EQ-5D at 3 weeks, 3, 6, 9, and 18 months after burn and psychologic questionnaires during hospitalization. Patients' scores were compared with an age- and gender-weighted normpopulation.Patients suffered from substantial health losses at short term, but after 18 months the majority reached a HRQOL comparable with the norm population with the exception of patients requiring two or more surgeries. The best predictor of long-term HRQOL and the speed of recovery was the number of surgeries, followed by psychologic problems. Both predicted baseline and trajectories of improvement. Symptoms of traumatic stress were most debilitating over time.Both injury severity and psychologic problems play a pivotal role in reduced HRQOL and the speed of recovery. The number of surgeries seems to give a practically useful indication of the expected recovery speed that could aid in decision making and provides adequate information for patients in the aftermath of their initial surgical treatment. Screening for traumatic stress is recommended.",0,0 +2680,"A comparative study of fluoxetine, moclobemide, and tianeptine in the treatment of posttraumatic stress disorder following an earthquake","Abstract. Purpose Although antidepressant drugs have been proven as an effective treatment for posttraumatic stress disorder (PTSD), there are few comparative studies of antidepressants that are acting on different neurotransmitters. The main aim of this study is to compare the efficacy of different class of antidepressant drugs on the PTSD. Subjects/materials and methods. – In this open label study, the patients who met DSM-IV criteria for PTSD were randomly assigned to flexible doses of fluoxetine, moclobemide, or tianeptine. After the first assessment, consecutive assessments were performed at the end of weeks 2, 4, 8, and 12 using clinician administered PTSD scale (CAPS) and Clinical Global Impression of Severity (CGI-S). Changes in the total score of CAPS and sub-scale scores of symptom clusters (re-experience, avoidance, and hyperarousal) were the main output of efficacy. All statistics were based on intention-to-treat and last-observation-carried-forward (LOCF) principles. Results. Thirty-eight patients were assigned to fluoxetine, 35 patients were assigned to moclobemide, and 30 patients were assigned to tianeptine group. Gender distributions and mean ages of the treatment groups were not significantly different. Drop-out rates due to an adverse events or unknown reasons were not significantly different among fluoxetine (18.4%), moclobemide (14.3%), and tianeptine (20.0%) groups. All three treatments has led to a significant improvement in PTSD severity assessed with CAPS total score (ANOVA P < 0.001). Similarly, total scores of re-experiencing, avoidance, and hyperarousal clusters that are subscales of CAPS were significantly reduced by all three treatments (with ANOVA all P values < 0.001). There was not significant difference in terms of treatment effect between three groups. Discussion. – Treatment groups showed very similar improvement on all ratings scales. The findings support that fluoxetine, moclobemide, and tianeptine are all effective in the treatment of PTSD. Different mechanisms of action for these antidepressant drugs might result in the same common neurochemical end point. However, further studies using different classes of antidepressant drugs are needed.",0,0 +2681,Suicide Ideation and Deliberate Self-Harm among Ex-Prisoners of War,"The current study aims to assess the relations among war captivity, PTSD, suicidal ideation (SI), and deliberate self-harm (DSH) among former prisoners of war (ex-POWs). Israeli ex-POWs (N = 176) and a matched control group of combat veterans (controls; N = 118) were assessed using self-report measures. Ex-POWs with PTSD reported higher levels of both SI and DSH compared to ex-POWs and comparable veterans without PTSD. Furthermore, captivity-related variables as well as PTSD symptom clusters were positively related to both SI and DSH. However, only loss of emotional control in captivity and posttraumatic intrusion and emotional numbing symptoms, predicted SI. Ex-POWs with PTSD endorse high levels of SI and DSH. Among ex-POWs, both SI and DSH share similar captivity-related and posttraumatic symptoms correlates but only posttraumatic intrusion and emotional numbing symptoms predict SI.",0,0 +2682,"Examining cumulative victimization, community violence exposure, and stigma as contributors to PTSD symptoms among high-risk young women.","This study examines patterns of lifetime victimization within the family, community violence exposure, and stigma as contributors to posttraumatic stress disorder (PTSD) symptoms within a sample of 198 high-risk young women who are pregnant or parenting. We used cluster analysis to identify 5 profiles of cumulative victimization, based on participants' levels of witnessing intimate partner violence (IPV), physical abuse by an adult caregiver, and sexual victimization, all beginning by age 12. Hierarchical regression was used to examine these 5 clusters (ranging from a High All Victimization cluster characterized by high levels of all 3 forms of violence, to a Low All Victimization cluster characterized by low levels of all 3 forms), along with community violence exposure and stigma, as predictors of PTSD symptoms. We found that 3 of the cumulative victimization clusters, in comparison with Low All Victimization, were significant predictors of PTSD symptoms, as was stigma, while community violence exposure was not a significant predictor.",0,0 +2683,Post traumatic stress disorder: Insights from cat hair and catfish,"Post traumatic stress disorder (PTSD) is an anxiety disorder that develops in some, but not all, individuals following a traumatic experience. Established PTSD is difficult to treat, therefore prevention and early intervention is important to reduce prevalence. Identifying individuals susceptible to developing PTSD before trauma exposure and investigating neurophysiological processes that contribute to the disease will help develop better treatment and preventive methods. Limitations to such investigations in humans make animal models a necessary tool. Like humans, only some rats develop PTSD-like behavior after trauma but pre-trauma identification of these rats was not possible until now. We were able to reliably predict before trauma exposure which rats are susceptible (Susceptible) or resistant (Resistant) to developing two PTSD-like symptoms: impaired fear extinction and lasting elevation in acoustic startle responses. We hypothesized that Susceptible rats will have pre-existing alterations in plasticity-related responses in the hippocampus, a brain region whose altered size and function is associated with PTSD diagnosis. We also hypothesized that Susceptible rats will differ from Resistant rats in the acquisition of a traumatic event and tested this using Arc/H1a catFISH, a cellular imaging technique that detects neurons expressing plasticity-related immediate early genes (IEGs) during behavior. We found that, in Resistant rats a large proportion of the same dorsal CA1 (dCA1) neurons expressed IEGs during two identical explorations of the experimental box. This suggests that dCA1 responds to identical events with high fidelity. In Susceptible rats, however, different neuronal ensembles expressed IEGs during identical explorations suggesting a lack of fidelity in hippocampal response to identical events. In addition fewer ventral CA3 neurons expressed IEGs during the second exploration in Susceptible as compared to Resistant rats. We also examined the basolateral nucleus of the amygdala, but found no difference in IEG expression. Contrary to hypothesis, differences between Susceptible and Resistant rats during a foot shock paired exploration (traumatic event) were not pronounced. These findings show that rats susceptible to developing PTSD-like symptoms can be behaviorally identified and have altered hippocampal plasticity-related responses prior to the trauma. This study provides a frame-work for the investigation and remediation of susceptibilities. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +2684,"Sertraline Treatment of Children and Adolescents With Posttraumatic Stress Disorder: A Double-Blind, Placebo-Controlled Trial","The aim of this study was to evaluate the safety and efficacy of sertraline in children and adolescents who met Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for posttraumatic stress disorder (PTSD).Children and adolescents (6-17 years old) meeting DSM-IV criteria for PTSD were randomized to 10 weeks of double-blind treatment with sertraline (50-200 mg/day) or placebo. The primary efficacy measure was the University of California, Los Angeles Post-Traumatic Stress Disorder Index for DSM-IV (UCLA PTSD-I).A total of 131 patients met entry criteria and were randomized to sertraline (n = 67; female, 59.7%; mean age, 10.8; mean UCLA PTSD-I score, 43.8 ± 8.5) or placebo (n = 62; female, 61.3%; mean age, 11.2; mean UCLA PTSD-I score, 42.1 ± 8.8). There was no difference between sertraline and placebo in least squares (LS) mean change in the UCLA PTSD-I score, either on a completer analysis (-20.4 ± 2.1 vs. -22.8 ± 2.1; p = 0.373) or on an last observation carried forward (LOCF) end point analysis (-17.7 ± 1.9 vs. -20.8 ± 2.1; p = 0.201). Attrition was higher on sertraline (29.9%) compared to placebo (17.7%). Discontinuation due to adverse events occurred in a 7.5% treated with sertraline and 3.2% treated with placebo.Sertraline was a generally safe treatment in children and adolescents with PTSD, but did not demonstrate efficacy when compared to placebo during 10 weeks of treatment. ClinicalTrials.gov Identifier: NCT00150306.",0,0 +2685,Distinctiveness of prolonged grief disorder symptoms among survivors of the Great East Japan Earthquake and Tsunami,"Prolonged Grief Disorder (PGD) has been proposed for diagnostic classification as an independent psychiatric disorder. Previous research has investigated it in relation to other axis I disorders in order to determine whether it could be considered an independent nosological entity. The distinctiveness of this condition was apparent in cases of ordinary bereavement and in those following human-made disasters. However, this disorder may be expanded to include bereavement resulting from natural disasters. The present study aims to explore the differences between this disorder and posttraumatic stress disorder or major depressive disorder as experienced after the Great East Japan Earthquake and Tsunami. The subjects were 82 hospital workers. Each type of disorder was assessed by means of the Inventory of Complicated Grief, the Impact of Event Scale-Revised, and the Center for Epidemiological Studies Depression Scale. Exploratory factor analysis showed 3 dimensions, with PGD items independently clustering in the same dimension. Our findings support the uniqueness of PGD even in a post-natural disaster situation in a non-Western culture and warrant grief intervention for high-risk bereaved survivors.",0,0 +2686,Employment Status and Posttraumatic Stress Disorder Following Compensation Seeking in Victims of Violence,"The current study was developed to explore the associations between posttraumatic stress disorder (PTSD), level of compensation for pain and suffering, and employment status in a sample of victims of violence ( n = 226) who had held a full-time job at time of victimization and had filed a claim with the Dutch Victim Compensation Fund (DVCF) thereafter. Based on previous research, it was expected that PTSD would be associated with current unemployment. If a relationship between the two were to be found, the study would explore whether this should be ascribed to the presence of a sense of foreshortened future. Results confirmed this hypothesis and indicated that participants with PTSD were more prone to be currently unemployed than non-PTSDs. Additional analyses revealed that PTSD symptom severity and symptom cluster scores were also positively associated to higher unemployment rates. The observed relationships were not merely due to a high level of compensation for pain and suffering and failed to remain significant after adjusting for sense of foreshortened future. Implications for policy practice as well as strengths and limitations of the study were discussed.",0,0 +2687,"Trauma Exposure and Posttraumatic Stress Disorder Among Employees of New York City Companies Affected by the September 11, 2001 Attacks on the World Trade Center","Several studies have provided prevalence estimates of posttraumatic stress disorder (PTSD) related to the September 11, 2001 (9/11) attacks in broadly affected populations, although without sufficiently addressing qualifying exposures required for assessing PTSD and estimating its prevalence. A premise that people throughout the New York City area were exposed to the attacks on the World Trade Center (WTC) towers and are thus at risk for developing PTSD has important implications for both prevalence estimates and service provision. This premise has not, however, been tested with respect to DSM-IV-TR criteria for PTSD. This study examined associations between geographic distance from the 9/11 attacks on the WTC and reported 9/11 trauma exposures, and the role of specific trauma exposures in the development of PTSD.Approximately 3 years after the attacks, 379 surviving employees (102 with direct exposures, including 65 in the towers, and 277 with varied exposures) recruited from 8 affected organizations were interviewed using the Diagnostic Interview Schedule/Disaster Supplement and reassessed at 6 years. The estimated closest geographic distance from the WTC towers during the attacks and specific disaster exposures were compared with the development of 9/11-related PTSD as defined by the Diagnostic and Statistical Manual, Fourth Edition, Text Revision.The direct exposure zone was largely concentrated within a radius of 0.1 mi and completely contained within 0.75 mi of the towers. PTSD symptom criteria at any time after the disaster were met by 35% of people directly exposed to danger, 20% of those exposed only through witnessed experiences, and 35% of those exposed only through a close associate's direct exposure. Outside these exposure groups, few possible sources of exposure were evident among the few who were symptomatic, most of whom had preexisting psychiatric illness.Exposures deserve careful consideration among widely affected populations after large terrorist attacks when conducting clinical assessments, estimating the magnitude of population PTSD burdens, and projecting needs for specific mental health interventions.",0,0 +2688,The effect of strategies of personal resilience on depression recovery in an Australian cohort: A mixed methods study,"Strategies of personal resilience enable successful adaptation in adversity. Among patients experiencing depression symptoms, we explored which personal resilience strategies they find most helpful and tested the hypothesis that use of these strategies improves depression recovery. We used interview and survey data from the Diagnosis, Management and Outcomes of Depression in Primary Care 2005 cohort of patients experiencing depression symptoms in Victoria, Australia. A total of 564 participants answered a computer-assisted telephone interview question at 12 months follow-up, about what they found most helpful for their depression, stress or worries. Depressive disorder and severity were measured at annual follow-up using the Composite International Diagnostic Interview and the Patient Health Questionnaire self-rating questionnaire. Using interview responses, we categorised participants as users or not of strategies of personal resilience, specifically, drawing primarily on expanding their own inner resources or pre-existing relationships: 316 (56%) were categorised as primarily users of personal resilience strategies. Of these, 193 (61%) reported expanding inner resources, 79 (25%) drawing on relationships and 44 (14%) reported both. There was no association between drawing on relationships and depression outcome. There was evidence supporting an association between expanding inner resources and depression outcome: 25 per cent of users having major depressive disorder 1 year later compared to 38 per cent of non-users (adjusted odds ratio: 0.59, confidence interval: 0.36–0.97). This is the first study to show improved outcome for depression for those who identify as most helpful the use of personal resilience strategies. The difference in outcome is important as expanding inner resources includes a range of low intensity, yet commonly available strategies.",0,0 +2689,Vulnerability Factors for Disaster-Induced Child Post-Traumatic Stress Disorder: The Case for Low Family Resilience and Previous Mental Illness,"Objective: The aim of the present study was to investigate whether parent report of family resilience predicted children's disaster-induced post-traumatic stress disorder (PTSD) and general emotional symptoms, independent of a broad range of variables including event-related factors, previous child mental illness and social connectedness. Methods: A total of 568 children (mean age = 10.2 years, SD = 1.3) who attended public primary schools, were screened 3 months after Cyclone Larry devastated the Innisfail region of North Queensland. Measures included parent report on the Family Resilience Measure and Strengths and Difficulties Questionnaire (SDQ)–emotional subscale and child report on the PTSD Reaction Index, measures of event exposure and social connectedness. Results: Sixty-four students (11.3%) were in the severe–very severe PTSD category and 53 families (28.6%) scored in the poor family resilience range. A lower family resilience score was associated with child emotional problems on the SDQ and longer duration of previous child mental health difficulties, but not disaster-induced child PTSD or child threat perception on either bivariate analysis, or as a main or moderator variable on multivariate analysis (main effect: adjusted odds ratio (OR adj ) = 0.57, 95% confidence interval (CI) = 0.13–2.44). Similarly, previous mental illness was not a significant predictor of child PTSD in the multivariate model (OR adj = 0.75, 95%CI = 0.16–3.61). Conclusion: In this post-disaster sample children with existing mental health problems and those of low-resilience families were not at elevated risk of PTSD. The possibility that the aetiological model of disaster-induced child PTSD may differ from usual child and adolescent conceptualizations is discussed.",0,0 +2690,PTSD personality subtypes in women exposed to intimate-partner violence.,"There is considerable research implicating posttraumatic stress disorder (PTSD) as a common reaction to intimate-partner violence (IPV; Golding, 1999). PTSD is categorized as a single disorder; however, there is significant heterogeneity in its symptom-presentation patterns (Dickstein, Suvak, Litz, & Adler, 2010). Researchers have posited underlying personality characteristics as potentiating different expressions of PTSD (Miller, Greif, & Smith, 2003). Specifically, a model with 3 personality subtypes (i.e., externalizing, internalizing, and simple) has been proposed to explain PTSD symptom-pattern heterogeneity (Miller, 2003; Miller & Resick, 2007). The current study tested the PTSD personality-subtype model in a sample of 129 women exposed to a range of IPV experiences. Temperament patterns of women reporting clinically significant PTSD symptoms replicated the 3 personality-subtype patterns found in previous investigations (i.e., an externalizing subtype group characterized by high negative emotionality and low disinhibition, an internalizing subtype group characterized by high negative emotionality and low positive emotionality, and a simple subtype group characterized by midrange scores across the temperament variables; Miller et al., 2003; Miller, Kaloupek, Dillon, & Keane, 2004; Miller & Resick, 2007). Differences between personality-subtype groups and women without clinically significant PTSD symptoms were found (p < .05), with women reporting personality patterns consistent with the internalizing and externalizing subtype groups exhibiting higher comorbid personality pathology and psychological difficulties. Implications are discussed for personality as a risk or resiliency factor in PTSD and as contributing to explaining PTSD symptom heterogeneity.",0,0 +2691,"Substance abuse, memory, and post-traumatic stress disorder","• We discuss effects of nicotine, cocaine, and alcohol on memory. • We describe comorbidities for abuse of nicotine, cocaine, and alcohol with PTSD. • CPP We discuss how nicotine, cocaine, and alcohol may alter the course and treatment of PTSD. A large body of literature demonstrates the effects of abused substances on memory. These effects differ depending on the drug, the pattern of delivery (acute or chronic), and the drug state at the time of learning or assessment. Substance use disorders involving these drugs are often comorbid with anxiety disorders, such as post-traumatic stress disorder (PTSD). When the cognitive effects of these drugs are considered in the context of the treatment of these disorders, it becomes clear that these drugs may play a deleterious role in the development, maintenance, and treatment of PTSD. In this review, we examine the literature evaluating the cognitive effects of three commonly abused drugs: nicotine, cocaine, and alcohol. These three drugs operate through both common and distinct neurobiological mechanisms and alter learning and memory in multiple ways. We consider how the cognitive and affective effects of these drugs interact with the acquisition, consolidation, and extinction of learned fear, and we discuss the potential impediments that substance abuse creates for the treatment of PTSD.",0,0 +2692,"Emergency Workers’ Quality of Life: The Protective Role of Sense of Community, Efficacy Beliefs and Coping Strategies","This study, involving a sample of 764 emergency workers, investigates dimensions of quality of life at work (Compassion fatigue, Burnout and Compassion satisfaction), and their relationships with Coping strategies and some psychosocial variables (Sense of Community, Collective Efficacy and Self-efficacy). Results indicate the usefulness of distinguishing between positive and negative indicators of emergency workers’ quality of life. Compassion satisfaction is positively correlated with efficacy beliefs, Sense of Community and the use of Active coping strategies. Burnout and Compassion fatigue are especially correlated with the use of dysfunctional coping strategies like distraction and self-criticism. Volunteer emergency workers enjoy a higher well being than full-time professional workers. Results and their implications for interventions aimed at increasing rescue workers’ quality of life by enhancing psychosocial competences are discussed.",0,0 +2693,Forebrain-Specific CRF Overproduction During Development is Sufficient to Induce Enduring Anxiety and Startle Abnormalities in Adult Mice,"Corticotropin releasing factor (CRF) regulates physiological and behavioral responses to stress. Trauma in early life or adulthood is associated with increased CRF in the cerebrospinal fluid and heightened anxiety. Genetic variance in CRF receptors is linked to altered risk for stress disorders. Thus, both heritable differences and environmentally induced changes in CRF neurotransmission across the lifespan may modulate anxiety traits. To test the hypothesis that CRF hypersignaling is sufficient to modify anxiety-related phenotypes (avoidance, startle, and conditioned fear), we induced transient forebrain-specific overexpression of CRF (CRFOE) in mice (1) during development to model early-life stress, (2) in adulthood to model adult-onset stress, or (3) across the entire postnatal lifespan to model heritable increases in CRF signaling. The consequences of these manipulations on CRF peptide levels and behavioral responses were examined in adulthood. We found that transient CRFOE during development decreased startle habituation and prepulse inhibition, and increased avoidance (particularly in females) recapitulating the behavioral effects of lifetime CRFOE despite lower CRF peptide levels at testing. In contrast, CRFOE limited to adulthood reduced contextual fear learning in females and increased startle reactivity in males but did not change avoidance or startle plasticity. These findings suggest that forebrain CRFOE limited to development is sufficient to induce enduring alterations in startle plasticity and anxiety, while forebrain CRFOE during adulthood results in a different phenotype profile. These findings suggest that startle circuits are particularly sensitive to forebrain CRFOE, and that the impact of CRFOE may be dependent on the time of exposure.",0,0 +2694,"Depression, Anxiety, and Perinatal-Specific Posttraumatic Distress in Mothers of Very Low Birth Weight Infants in the Neonatal Intensive Care Unit","To compare the trajectories and determine the predictors of maternal distress defined as a continuous spectrum of symptomatology and elevated symptomatology, of depression, anxiety, and perinatal-specific posttraumatic stress (PPTS), in mothers of very low birth weight (VLBW) infants throughout the neonatal intensive care unit (NICU) hospitalization.Sixty-nine mothers completed psychological questionnaires within the first month of their infant's NICU hospitalization and again 2 weeks before NICU discharge. Multiple regression models determined maternal psychological, reproductive, sociodemographic, and infant medical predictors of maternal distress.Perinatal-specific posttraumatic stress remained stable throughout the NICU hospitalization, whereas other aspects of distress declined. Previous psychological history and infant medical variables predicted higher PPTS but no other aspects of distress. Reproductive variables predicted anxiety and PPTS; history of fetal loss initially predicted lower PPTS but throughout hospitalization primipara status emerged as a predictor of higher anxiety and PPTS. Sociodemographic variables predicated initial, but not later, depressive distress.Psychological screening is important in the NICU. The PPTS profile suggests it may require distinct treatment. Primiparas should be targeted for intervention.",0,0 +2695,Co-occurring posttraumatic stress and depression symptoms after sexual assault: A latent profile analysis,"Symptoms of posttraumatic stress disorder (PTSD) and depression frequently co-occur, but their distinctiveness following trauma remains unclear. We examined patterns of PTSD and depression symptoms after sexual assault to evaluate the extent to which assault survivors primarily reported symptoms of both disorders or whether there were meaningfully distinct subgroups with discordant PTSD and depression symptoms.Latent profile analysis was used to examine self-reported PTSD and depression symptoms among 119 female sexual assault survivors at 1-, 2-, 3-, and 4-months post-assault.At all time points, a 4-class solution fit the data best, revealing four subgroups with low, low-moderate, high-moderate, and severe levels of both PTSD and depression symptoms. Within each subgroup, PTSD symptom severity co-occurred with comparable depression symptom severity. At no time point were there reliable subgroups with discordant PTSD and depression symptom severities. Emotional numbing, hyperarousal, and overall PTSD symptom severity reliably distinguished each class from the others. Class membership at 1-month post-assault predicted subsequent class membership and functional impairment.Additional research is needed to evaluate predictors of class membership, temporal stability of classes, and generalizability to other trauma populations.Co-occurring and comparably severe PTSD and depression symptoms are pervasive among female sexual assault survivors. The absence of a distinct subset of individuals with only PTSD or depression symptoms suggests that PTSD and depression may be manifestations of a general posttraumatic stress response rather than distinct disorders after trauma. Integrated treatments targeting both PTSD and depression symptoms may therefore prove more efficient and effective.",0,0 +2696,"Prior trauma and PTSD among homeless mothers: Effects on subsequent stress appraisals, coping, posttraumatic growth, and health outcomes","There is much evidence that the experience of trauma is related to poorer subsequent outcomes, including mental health symptoms, poor physical health, and substance abuse. A high number of previous lifetime traumas and/or the experience of PTSD symptoms may contribute to difficulties adjusting to future life stress. However, some factors may protect individuals from the effects of posttraumatic stress and mediate the relationship between trauma exposure and adjustment outcomes. For instance, stress appraisals and coping behaviors may affect how an individual responds to stressful experiences. Furthermore, there is a growing interest in the potential for positive change following stressful life events (i.e., ""posttraumatic growth"" (PTG)). This longitudinal study investigated the effect of prior trauma history and PTSD symptoms on subsequent mental health, physical health, substance use, and posttraumatic growth in a sample of 70 homeless mothers. Participants' appraisals and coping behaviors with regard to a future life stressor and the contribution of these factors on adjustment outcomes were examined. The potential moderating effect of social support on appraisals, coping, and subsequent outcomes was also tested. A series of hierarchical regression analyses were conducted to test the effect of the proposed predictors on each adjustment outcome separately. Results indicated that the sample reported moderate to high levels of posttraumatic growth as a result of a recent life stressor. This is the first study to demonstrate that this phenomenon is observed in homeless mothers. Higher levels of PTSD symptomatology (but not number of prior traumas) and use of avoidant coping predicted greater subsequent mental health symptoms. Appraisals of a stressor as threatening and use of active coping contributed to posttraumatic growth. The examined variables did not significantly predict physical health or substance use outcomes in this sample. No significant moderating effect of social support on any of the outcomes was found. Implications for future research and for the development of interventions aimed at reducing the negative effects of trauma and facilitating posttraumatic growth in homeless women are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +2697,WHITE MATTER INTEGRITY AND ITS RELATIONSHIP TO PTSD AND CHILDHOOD TRAUMA-A SYSTEMATIC REVIEW AND META-ANALYSIS,"Recent reviews and meta-analyses reported structural gray matter changes in patients suffering from adult-onset posttraumatic stress disorder (PTSD) and in subjects with and without PTSD who experienced childhood trauma. However, it remains unclear if such structural changes are also affecting the white matter. The aim of this systematic review is to provide a comprehensive overview of all empirical investigations measuring white matter integrity in populations affected by PTSD and/or childhood trauma. To this end, results from different methodological approaches were included. Twenty-five articles are reviewed of which 10 pertained to pediatric PTSD and the effects of childhood trauma measured during childhood, seven to the effects of childhood trauma measured during adulthood, and eight to adult-onset PTSD. Overall, reductions in white matter volume were reported more often than increases in these populations. However, the heterogeneity of the exact locations indicates only a weak overlap across published studies. In addition, a meta-analysis was carried out on seven whole-brain diffusion tensor imaging (DTI) studies in adults. Significant clusters of both increases and decreases were identified in various structures, most notably the cingulum and the superior longitudinal fasciculus. Future research directions are discussed.",0,0 +2698,Neuropeptide receptor ligands as drugs for psychiatric diseases: the end of the beginning?,"The search for novel drugs for treating psychiatric disorders is driven by the growing medical need to improve on the effectiveness and side-effect profile of currently available therapies. Given the wealth of preclinical data supporting the role of neuropeptides in modulating behaviour, pharmaceutical companies have been attempting to target neuropeptide receptors for over two decades. However, clinical studies with synthetic neuropeptide ligands have been unable to confirm the promise predicted by studies in animal models. Here, we analyse preclinical and clinical results for neuropeptide receptor ligands that have been studied in clinical trials for psychiatric diseases, including agents that target the receptors for tachykinins, corticotropin-releasing factor, vasopressin and neurotensin, and suggest new ways to exploit the full potential of these candidate drugs.",0,0 +2699,Contemporary Longitudinal Methods for the Study of Trauma and Posttraumatic Stress Disorder,"Traditional methods for analyzing trends in longitudinal data have typically emphasized average group change over time. In this article, we propose multilevel, regression-based methods for examining inter-individual differences in intra-individual change and apply these methods to research in trauma and posttraumatic stress disorder (PTSD). The outcome or dependent variable of interest is reconceptualized as an index of dynamic change reflecting the trend or trajectory of an individual's PTSD symptom severity scores across time. A basic statistical model is presented, and analyses and findings are demonstrated with an existing database used in previously published studies. The methods offer promise for future study of the natural course of PTSD chronicity or recovery, risk and resilience factors that influence individual growth or decline, and critical timepoints for intervention.",0,0 +2700,"Traumatic brain injury, dissociation, and posttraumatic stress disorder in road traffic accident survivors","This study investigated the symptom profiles of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) in participants who did and did not sustain traumatic brain injury (TBI), following a road traffic accident. The participants were assessed at three time points: as soon as possible posttrauma as well as at 6 weeks and 3 months posttrauma. At the first assessment, fewer participants from the TBI group recalled feeling fear and helplessness at the time of the trauma, fewer TBI participants reported recurrent intrusive thoughts and images, and more TBI participants reported dissociation since the trauma, relative to the non-TBI group. At the second assessment, fewer participants from the TBI group recalled feeling intense helplessness at the time of the trauma. Fewer TBI participants also reported reliving and physiological reactions on trauma reminders relative to the non-TBI group. At 3 months posttrauma, there was no difference in PTSD symptom profile between non-TBI and TBI groups. Our findings indicate that the presence of TBI is likely to influence the distribution of certain symptoms, but need not be a significant barrier to diagnosing ASD and PTSD.",0,0 +2701,Relations among emotion regulation and DSM-5 symptom clusters of PTSD,"Abstract Emotion regulation has been implicated as a risk and maintaining factor for posttraumatic stress disorder (PTSD). Three aspects of emotion regulation have demonstrated the strongest relations with PTSD symptoms: experiential avoidance, rumination, and thought suppression. Given that emotion regulation has demonstrated differential relations with DSM-IV PTSD symptom clusters, the current study sought to examine these relations with the DSM-5 symptom clusters of PTSD. Participants were recruited via Amazon's Mechanical Turk (N = 403). All participants endorsed trauma exposure. Measures included the PTSD Checklist for DSM-5 (PCL-5), the Acceptance and Action Questionnaire-II (AAQ-II), the negative affect scale of the Positive and Negative Affect Schedule (PANAS-NA; included as a control variable), the Ruminative Responses Scale (RRS), and the White Bear Suppression Inventory (WBSI). A path analysis model in Mplus indicated that the AAQ-II demonstrated large effects with all four PTSD symptom clusters. Of those relations, the largest was observed for the AAQ-II and the Negative Alterations in Cognition and Mood cluster of PTSD. Results suggest that individual variation in PTSD symptoms may have implications for the salience of particular emotion regulation strategies.",0,0 +2702,Risk factors of posttraumatic stress disorder within emergency medical service personnel,"The current study examined the relationship between risk factors for posttraumatic stress disorder (PTSD) in Emergency Medical Service (EMS) personnel. It was hypothesized that EMS workers who were female; older; single; had less social support; reported more life stressors, depression, peritraumatic dissociation, history of trauma, negative cognitions; and experienced more life-threatening critical incidents would report a greater number of PTSD symptoms. The participants completed the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), the Center for Epidemiologic Studies Depression Scale (CES-D), the Posttraumatic Cognitions Inventory (PTCI), the Peritraumatic Dissociative Experiences Questionnaire (PDEQ), the Traumatic Events Questionnaire (TEQ), the Multidimensional Scale of Perceived Social Support (MSPSS), the Life Experiences Survey (LES), and a researcher-created EMS Demographic Questionnaire. To access predictor variables related to PTSD, all eight predictor variables were entered into a multiple regression in their continuous form. The criterion variable was the participants' score on the PCL-C. Preliminary Pearson product-moment correlations revealed that six of the eight predictor variables yielded statistically significant correlations with the PCL-C total score. Overall, these eight predictor variables were able to account for 64% of the variability in PTSD (adjusted R2 = .64, p < .001). Upon further examination, depression, traumatic events, negative cognitions, and sex all significantly contributed to the regression equation. The results of this study indicate that this combination of predictor variables is related to PTSD. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +2703,Influence of PTSD symptom clusters on smoking status among help-seeking Iraq and Afghanistan veterans,"Despite the strong association between smoking and posttraumatic stress disorder (PTSD), mechanisms influencing smoking in this population remain unclear. Previous smoking research has largely examined PTSD as a homogenous syndrome despite the fact that PTSD is composed of four distinct symptom clusters (i.e., reexperiencing, effortful avoidance, emotional numbing, and hyperarousal). Examination of the relationship between smoking and PTSD symptom clusters may increase understanding of mechanisms influencing comorbidity between smoking and PTSD. The goals of the present study were to (a) examine the influence of overall PTSD symptom severity on likelihood of smoking and smoking heaviness and (b) examine the influence of each PTSD symptom cluster on smoking.Participants (N = 439) were Operation Iraqi Freedom/Operation Enduring Freedom combat veterans referred to VA mental health services.Multinomial logistic regression was chosen to accommodate a three-level outcome, in which the likelihood of being a nonsmoker was compared with (a) light smoking (1-9 cigarettes/day), (b) moderate smoking (10-19 cigarettes/day), and (c) heavy smoking (> or =20 cigarettes/day). Results showed that veterans with higher levels of overall PTSD symptomatology were more likely to endorse heavy smoking (Wald = 4.56, p = .03, odds ratio [OR] = 1.65). Veterans endorsing high levels of emotional numbing were also more likely to endorse heavy smoking (Wald = 6.49, p = .01, OR = 1.81); all other PTSD symptom clusters were unrelated to smoking.The association between emotional numbing and heavy daily smoking suggests that veterans with PTSD may smoke to overcome emotional blunting following trauma exposure.",0,0 +2704,Gender differences in risk factors for trauma exposure and post-traumatic stress disorder among inner-city drug abusers in and out of treatment,"Over the past two decades there has been a growing awareness of the comorbidity between post-traumatic stress disorder (PTSD) and substance use disorders in the general population. The purpose of these analyses was to examine, in a population of drug users, the role of gender in (1) predicting the nature of the traumatic event and PTSD symptoms, (2) patterns of substance use disorders in relation to trauma exposure and PTSD symptoms, (3) comorbidity of other psychiatric disorders with trauma exposure and PTSD, and (4) the temporal association of substance use disorder, exposure to trauma, and PTSD. Drug abusers (n = 464) were interviewed using the Diagnostic Interview Schedule for DSM-III-R (DIS) and the Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM). Although more women than men met criteria for DSM-III-R PTSD, there were no gender differences on endorsement for a traumatic event. Adult antisocial behavior, affective disorder, schizophrenia, other anxiety disorder and polysubstance use predicted exposure to an event, whereas, only schizophrenia and other anxiety disorder predicted PTSD. In men, drug use preceded the exposure to an event, while in women, the onset age for both drug use and exposure to an event were nearly identical. This work suggests implications for gender-based education and prevention interventions.",0,0 +2705,Emotion dysregulation facets as mediators of the relationship between PTSD and alcohol misuse,"Posttraumatic stress disorder (PTSD) and alcohol misuse, which frequently co-occur among combat veterans, have been linked to emotion dysregulation. Emotion dysregulation may explain the link between PTSD and alcohol misuse, and this investigation tested emotion dysregulation as a mediator of that relationship.Correlations between PTSD symptoms and cluster symptoms, emotion dysregulation full and subscales, and alcohol misuse were examined in a sample of 139 combat Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans (45% African American; 89% men). Emotion dysregulation full scale and subscales were examined as mediators of the relationship between PTSD symptoms and alcohol misuse for the full sample and men only.PTSD symptoms and symptom clusters, emotion dysregulation, and alcohol misuse showed positive correlations for the full sample and men only. Neither the full scale of emotion dysregulation nor the facets of emotion dysregulation mediated the relationship between PTSD symptoms and alcohol misuse for the full sample; among men, the Impulse Control Difficulties when Upset and Lack of Emotional Clarity subscales were mediators of that relationship.Impulse control difficulties and lack of emotional clarity may play an important role in the link between PTSD and alcohol misuse for male veterans and should be an important target in treatment for individuals with both disorders. Addressing impulse control difficulties and lack of emotional clarity in those with PTSD and alcohol misuse may improve outcomes by helping individuals identify and describe upsetting emotions and develop healthy coping alternatives to alcohol misuse.",0,0 +2706,Comparison of two widely used PTSD-screening instruments: Implications for public mental health planning,"Epidemiological research serves a critical role in public mental health planning in the aftermath of disasters, particularly via estimation of the mental health burden and potential needs of affected communities. However, different measures are used across studies to assess mental health response, making cross-study comparison difficult. The National Women's Study Posttraumatic Stress Disorder module (NWS-PTSD) and PTSD Checklist (PCL) have been among the most widely used measures of PTSD in postdisaster research. Here, the authors used a sample of 233 New York City-area residents who were administered both the NWS-PTSD and PCL 4 months after the September 11, 2001 terrorist attacks. The PCL yielded higher prevalence estimates at the symptom, cluster, and diagnostic levels. Implications for the interpretation of epidemiological data are discussed.",0,0 +2707,Symptom-specific effects of fluoxetine in post-traumatic stress disorder,"The selective serotonin reuptake inhibitors have become a first line treatment for post-traumatic stress disorder (PTSD). In a recent double-blind study in civilians, fluoxetine produced clinically and statistically significant effects on all general measures of PTSD. We examined the specific effects of fluoxetine versus placebo in the above mentioned study of PTSD clusters and individual symptoms. Individuals were included if they met criteria for PTSD according to the Structured Clinical Interview for DSM-III-R (SCID). Symptoms were assessed at sequential time points by the Structured Interview for PTSD (SIP), a clinician interview based assessment, and a self-report scale, the Davidson Trauma Scale (DTS). A total of 53 patients were included in the analysis. On the SIP and DTS, fluoxetine was found to produce statistically significant changes on all clusters. Significant effects for fluoxetine were noted on 10 items of the DTS, and 8 items of the SIP. The SIP and DTS had 6 items in common that were significant. Fluoxetine exerts a broad spectrum effect in reducing all the symptom clusters of PTSD in this sample. The symptoms of being physically upset at reminders of the trauma, avoiding thoughts of the trauma, having difficulty enjoying things, feeling distant/estranged, having a sense of foreshortened future, and impaired concentration, were the symptoms most responsive to the effects of treatment with fluoxetine on both scales.",0,0 +2708,Latent classes of PTSD symptoms in Iraq and Afghanistan female veterans,"Recent studies have used latent class analysis (LCA) to identify subgroups of individuals who share similar patterns of PTSD symptom endorsement; however, further study is needed among female veterans, whose PTSD symptom expression may vary from that of their male counterparts. The current study examined latent PTSD symptom classes in female veterans who returned from recent military service in Iraq and Afghanistan, and explored military and demographic variables associated with distinct PTSD symptom presentations. A retrospective analysis was conducted using existing medical records from female Iraq and Afghanistan veterans who were new users of VA mental health outpatient (MHO) care, had received a PTSD diagnosis anytime during the post-deployment period, and completed the PTSD checklist within 30 days of their first MHO visit ( N =2425). The LCA results identified four latent classes of PTSD symptom profiles in the sample: High Symptom, Intermediate Symptom, Intermediate Symptom with High Emotional Numbing (EN), and Low Symptom. Race/ethnicity, age, time since last deployment, and distance from a VA facility emerged as predictors of PTSD symptom presentation. The current study was cross-sectional and utilized administrative data. The results may not be generalizable to female veterans from other service eras. Longer times between end of last deployment and initiation of MHO services were associated with more symptomatic classes. Exploration of PTSD symptom presentation may enhance our understanding of the service needs of female veterans with PTSD, and suggests potential benefits to engaging veterans in MHO soon after last deployment.",0,0 +2709,Symptom Patterns among Youth Exposed to Intimate Partner Violence,"Children and adolescents exposed to intimate partner violence display a broad range of symptoms. We sought to differentiate symptom patterns and predictors of these patterns using a person-oriented approach. Previous cluster analysis research of exposed youth was extended to include youth PTSD symptoms and trauma history. Participants were 74 mothers who had received a police call for domestic violence, and who had a child between 2 and 17 years old. Cluster analysis was used to identify four symptom patterns among exposed youth: Typical, Asymptomatic, General Distress, and Acute PTSD. These patterns were replicated in separate cluster analyses with younger and older participants. Symptom patterns were differentiated by maternal distress, maternal aggression, and youth trauma history, but not by male partner aggression. Implications for assessment and treatment of youth exposed to intimate partner violence, and suggestions for further research, are discussed. © 2008 Springer Science+Business Media, LLC.",0,0 +2710,The Psychological and Medical Sequelae of War in Central American Refugee Mothers and Children,"To investigate the physical and mainly psychological sequelae of exposure to war in Central American children and their mothers who immigrated to the United States on average 4 years before the study began.Interview study.Twenty-two immigrant Central American women caretakers and 1 of their children aged 5 to 13 years.Standardized and new measures were administered to assess children's physical and mental health symptoms and exposure to political violence.Eighteen of the 22 children had chronic health problems. Fifteen children and all of the adults had observed traumatic events, including bombings and homicides. Thirteen of the children showed mental health symptom profiles above established norms, although only 2 met the criteria for posttraumatic stress disorder according to their own reports. Many of the caretakers were unaware of their child's psychological distress. Four of the mothers exhibited posttraumatic stress disorder, and their symptoms predicted their child's mental health.Pediatricians are sometimes the first and only contacts these families have with health care providers. Caretakers' reports of children's mental health are often incomplete. It is therefore important for physicians to probe for ""hidden"" symptoms in refugee children. These family members may need referrals to social and psychological services, and pediatricians can open the gates to existing community networks of support. Because we found that maternal mental health influences the child's, the child's interests are well served when pediatricians also encourage the mother to contact services for herself if she confides that she is experiencing some of the severe psychological sequelae reported by the women in this study.",0,0 +2711,Hormone profiles in humans experiencing military survival training,"Clinical models of the human response to intense, acute stress have been limited to laboratory settings or cross sectional characterizations. As a result, data about the sensitivity of the human neuroendocrine activation to realistic stressors of varying magnitudes are limited. The U.S. Army survival course offers a unique opportunity to examine, in a controlled manner, the human response to acute, realistic, military stress.Salivary data were collected in 109 subjects at baseline during four stress exposure time points and at recovery. Serum data was collected at baseline and recovery in 72 subjects and at baseline and during stress exposure in a subgroup of subjects (n = 21).Cortisol significantly increased during the captivity experience and was greatest after subjects' exposure to interrogations. Cortisol remained significantly elevated at recovery. Testosterone was significantly reduced within 12 hours of captivity. Reductions of both total and free T4 and of total and free T3 were observed, as were increases in thyrotropin.The stress of military survival training produced dramatic alterations in cortisol, percent free cortisol, testosterone, and thyroid indices. Different types of stressors had varying effects on the neuroendocrine indices. The degree of neuroendocrine changes observed may have significant implications for subsequent responses to stress.",0,0 +2712,Interpersonal Subtypes and Therapy Response in Patients Treated for Posttraumatic Stress Disorder,"Interpersonal traits may influence psychotherapy success. One way of conceptualizing such traits is the interpersonal circumplex model. In this study, we analyse interpersonal circumplex data, assessed with the Inventory of Interpersonal Problems (Horowitz, Strauß, & Kordy, 1994) from a randomized study with 138 patients suffering from posttraumatic stress disorder after trauma in adulthood. The study compared cognitive processing therapy and dialogical exposure therapy, a Gestalt-based intervention. We divided the interpersonally heterogeneous sample according to the quadrants of the interpersonal circumplex. The division into quadrants yielded subgroups that did not differ in their general psychological distress, but the cold-submissive quadrant tended to exhibit higher posttraumatic stress disorder symptom severity and interpersonal distress than the other three. There was also a trend for patients in different quadrants to be affected differently by the treatments. Correlation analyses supported these results: in cognitive processing therapy, more dominant patients had more successful therapies, while in dialogical exposure therapy, success was not correlated with interpersonal style. Results indicate that especially patients with cold interpersonal styles profited differentially from the two treatments offered. Dividing samples according to the interpersonal circumplex quadrants seems promising. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message: Interpersonal traits may contribute to psychotherapy outcome. Dividing the sample according to the quadrants of the interpersonal circumplex, as opposed to cluster analysis, yielded promising results. Patients higher in dominance fared better with cognitive processing therapy, while interpersonal style had no correlations with therapy success in dialogical exposure therapy.",0,0 +2713,"Mental Health, Demographic, and Risk Behavior Profiles of Pregnant Survivors of Childhood and Adult Abuse","Our objective was to address the gap in knowledge about the extent to which perinatal mental health and risk behaviors are associated with childhood and adult experiences of abuse that arises because of barriers to screening and disclosure about past and current abuse. Survey data from an ongoing study of the effects of posttraumatic stress on childbearing were used to describe four groups of nulliparous women: those with no abuse history, adult abuse only, childhood abuse only, and abuse that occurred during both periods. The rates of abuse history disclosure were higher in the research context than in the clinical settings. Mental health morbidity and risk behaviors occurred in a dose-response pattern with cumulative abuse exposure. Rates of current posttraumatic stress disorder ranged from 4.1% among those never abused to 11.4% (adult only), 16.0% (childhood only), and 39.2% (both periods). Women abused during both periods also were more likely to be using tobacco (21.5%) and drugs (16.5%) during pregnancy. We conclude that mental health and behavioral risk sequelae affect a significant portion of both childhood and adult abuse survivors in prenatal care. The integration into the maternity setting of existing evidence-based interventions for the mental health and behavioral sequelae of abuse is needed.",0,0 +2714,"Combat, dissociation, and posttraumatic stress disorder in Australian Vietnam veterans","The specificity of various wartime stressors for different posttraumatic stress disorder (PTSD) symptoms is inconsistently reported in the literature. Combat, wounding, and peritraumatic dissociation have not been assessed together in their effects on each of the various PTSD symptom clusters. This cohort study of a random sample of male Australian Army Vietnam veterans yielded psychiatric assessments of 641 subjects. PTSD measures comprised symptom criteria for reexperiencing, numbing and avoidance, hyperarousal, and PTSD diagnosis both lifetime and current within the past month. Logistic regression is used to examine the effects of combat, wounding, and peritraumatic dissociation together on PTSD. Combat experiences comprised four components derived from a principal components analysis of combat experiences: direct combat exposure, exposure to death and injury, exposure to civilian death and injury, and exposure to mutilation. Each was differentially related to reexperiencing, avoidance, hyperarousal, and PTSD diagnosis. Being wounded was not related to lifetime or current PTSD and peritraumatic dissociation was related to all diagnostic components of PTSD in the presence of other variables.",0,0 +2715,Attachment insecurities and the processing of threat-related information: Studying the schemas involved in insecure people's coping strategies.,"In 6 studies we examined procedural, scriptlike knowledge associated with 2 different kinds of attachment insecurity: anxiety and avoidance. The studies examined associations between attachment insecurities, the cognitive accessibility of sentinel and rapid fight-flight schemas, and the extent to which these schemas guide the processing of threat-related information and actual behavior during an experimentally induced threatening event. Anxious attachment was associated with (a) greater accessibility of the sentinel schema in narratives of threatening events; (b) faster, deeper, and more schema-biased processing of information about components of the sentinel schema; and (c) quicker detection of a threat. Avoidant attachment was associated with greater accessibility of the rapid fight-flight schema in narratives of threatening events and faster, deeper, and more schema-biased processing of information about components of the schema. We discuss implications of the findings for understanding the cognitive aspects of insecure people's coping strategies in threatening situations, as well as the potential benefits of these strategies to the people who enact them and to the groups to which they belong.",0,0 +2716,A Typology of Psychiatric Reactions to Motor Vehicle Accidents,"Perhaps owing to their commonness, nonserious motor vehicle accidents, i.e. those not resulting in death or major bodily injury, have received scant systematic study in the psychiatric literature. However, patients presenting with lingering psychiatric distress following such accidents are seen commonly in practice. The authors reviewed the patterns of presentation and background circumstances in a series of 55 such cases, presenting at varying periods of time after the incident. They found such patients to cluster into four distinct groups. The most common presentation was that of a depressive syndrome, outnumbering those with features of posttraumatic stress disorder by 3:1.",0,0 +2717,Natural Course of Posttraumatic Stress Disorder: A 20-Month Prospective Study of Turkish Earthquake Survivors,"Objective: A 20-month prospective follow-up of survivors of the severe earthquake in Turkey in 1999 examined the natural course of posttraumatic stress disorder (PTSD) and the contribution of different symptom clusters to the emergence of PTSD. Method: Subjects were randomly sampled in a suburb of Istanbul that was severely affected by the earthquake. A total of 464 adults were assessed with a self-report instrument for PTSD symptoms on 3 consecutive surveys that were administered 1 to 3, 6 to 10, and 18 to 20 months following the earthquake. Results: The prevalence of PTSD was 30.2% on the first survey and decreased to 26.9% and 10.6% on the second and third surveys, respectively. Female subjects showed initially higher (34.8%) PTSD rates compared with male subjects (19.1%). However, gender differences disappeared by the time of the third survey due to high spontaneous remission rates in female subjects. Low levels of chronic and delayed-onset PTSD were observed. A major contribution of the avoidance symptoms to PTSD diagnosis was identified by statistical analysis. Conclusions: Initial PTSD following an earthquake may be as prevalent as in other natural disasters, but high rates of spontaneous remission lead to low prevalence 1.5 years following the earthquake. Initial avoidance characteristics play a major role in the emergence of PTSD.",0,0 +2718,"The relationship between sense of hope, family support and post-traumatic stress disorder among children: The case of young victims of rocket attacks in Israel","Post-traumatic stress disorder (PTSD) is diagnosed commonly in Israeli children following violent episodes of the ongoing Arab–Israeli conflict. Research has suggested that as many as 70% of war-affected children present symptoms of PTSD. This study examined two factors that may contribute to resiliency: perceived social support and sense of hope. The research participants (n = 311) were children who experienced the rocket attacks during Israel's Second Lebanon War and a control group of Israeli children from a town that was not affected directly by the 2006 war. It was hypothesized that a complex relationship would be demonstrated between presentation of symptoms of PTSD and perceived social support. It was hypothesized further that an inverse relationship would be measured between sense of hope and presentation of symptoms of PTSD in the children who experienced the rocket attacks and that those in the control group would show less symptoms of PTSD than those in the experimental group. Finally, females ...",0,0 +2719,Do compensation processes impair mental health? A meta-analysis,"Victims who are involved in a compensation processes generally have more health complaints compared to victims who are not involved in a compensation process. Previous research regarding the effect of compensation processes has concentrated on the effect on physical health. This meta-analysis focuses on the effect of compensation processes on mental health.Prospective cohort studies addressing compensation and mental health after traffic accidents, occupational accidents or medical errors were identified using PubMed, EMBASE, PsycInfo, CINAHL, and the Cochrane Library. Relevant studies published between January 1966 and 10 June 2011 were selected for inclusion.Ten studies were included. The first finding was that the compensation group already had higher mental health complaints at baseline compared to the non-compensation group (standardised mean difference (SMD)=-0.38; 95% confidence interval (CI) -0.66 to -0.10; p=.01). The second finding was that mental health between baseline and post measurement improved less in the compensation group compared to the non-compensation group (SMD=-0.35; 95% CI -0.70 to -0.01; p=.05). However, the quality of evidence was limited, mainly because of low quality study design and heterogeneity.Being involved in a compensation process is associated with higher mental health complaints but three-quarters of the difference appeared to be already present at baseline. The findings of this study should be interpreted with caution because of the limited quality of evidence. The difference at baseline may be explained by a selection bias or more anger and blame about the accident in the compensation group. The difference between baseline and follow-up may be explained by secondary gain and secondary victimisation. Future research should involve assessment of exposure to compensation processes, should analyse and correct for baseline differences, and could examine the effect of time, compensation scheme design, and claim settlement on (mental) health.",0,0 +2720,A Meta-Analysis of Risk Factors for Combat-Related PTSD among Military Personnel and Veterans,"Post-traumatic stress disorder (PTSD), a complex and chronic disorder caused by exposure to a traumatic event, is a common psychological result of current military operations. It causes substantial distress and interferes with personal and social functioning. Consequently, identifying the risk factors that make military personnel and veterans more likely to experience PTSD is of academic, clinical, and social importance. Four electronic databases (PubMed, Embase, Web of Science, and PsycINFO) were used to search for observational studies (cross-sectional, retrospective, and cohort studies) about PTSD after deployment to combat areas. The literature search, study selection, and data extraction were conducted by two of the authors independently. Thirty-two articles were included in this study. Summary estimates were obtained using random-effects models. Subgroup analyses, sensitivity analyses, and publication bias tests were performed. The prevalence of combat-related PTSD ranged from 1.09% to 34.84%. A total of 18 significant predictors of PTSD among military personnel and veterans were found. Risk factors stemming from before the trauma include female gender, ethnic minority status, low education, non-officer ranks, army service, combat specialization, high numbers of deployments, longer cumulative length of deployments, more adverse life events, prior trauma exposure, and prior psychological problems. Various aspects of the trauma period also constituted risk factors. These include increased combat exposure, discharging a weapon, witnessing someone being wounded or killed, severe trauma, and deployment-related stressors. Lastly, lack of post-deployment support during the post-trauma period also increased the risk of PTSD. The current analysis provides evidence of risk factors for combat-related PTSD in military personnel and veterans. More research is needed to determine how these variables interact and how to best protect against susceptibility to PTSD.",0,0 +2721,"Associations of adult separation anxiety disorder with conflict-related trauma, ongoing adversity, and the psychosocial disruptions of mass conflict among West Papuan refugees.","Refugees commonly experience traumatic events that threaten the self and close others, suggesting the possibility that they may experience overlapping symptoms of posttraumatic stress disorder (PTSD) and separation anxiety disorder (SAD). We examine this possibility among West Papua refugees (n = 230) displaced to Port Moresby, Papua New Guinea. We also examine associations between the combined PTSD-SAD construct and indices of past trauma exposure, ongoing adversity, and the psychosocial disruptions caused by mass conflict and displacement. We applied culturally adapted interview modules to assess symptoms of PTSD, SAD, traumatic events (TEs), ongoing adversity, and 5 psychosocial dimensions. Latent class analysis identified a PTSD class (23%), a posttraumatic (PT) SAD class (22%), and a low-symptom class (55%). Compared with the low-symptom class, both the PTSD and PT-SAD classes endorsed higher levels of exposure to all domains of TEs (conflict-related trauma, witnessing murder, childhood related adversities, traumatic losses, and health stress) and ongoing adversity (access to health care, displacement/separation, safety in the community, and access to basic needs), but the 2 comorbid groups did not differ on these indices. The PT-SAD class alone scored higher than the low-symptom reference class in relation to disruptions to the psychosocial domains (safety/security, bonds/network, access to justice, roles/identities, existential meaning) and higher than the PTSD class on safety/security, justice and roles/identities. Our findings suggest that the PT-SAD pattern may represent a response to the most severe forms of psychosocial disruptions of mass conflict among refugees. A focus on separation anxiety may enhance psychotherapies designed to treat PTSD in refugees. (PsycINFO Database Record",0,0 +2722,Childhood maltreatment is associated with distinct genomic and epigenetic profiles in posttraumatic stress disorder,"Childhood maltreatment is likely to influence fundamental biological processes and engrave long-lasting epigenetic marks, leading to adverse health outcomes in adulthood. We aimed to elucidate the impact of different early environment on disease-related genome-wide gene expression and DNA methylation in peripheral blood cells in patients with posttraumatic stress disorder (PTSD). Compared with the same trauma-exposed controls ( n = 108), gene-expression profiles of PTSD patients with similar clinical symptoms and matched adult trauma exposure but different childhood adverse events ( n = 32 and 29) were almost completely nonoverlapping (98%). These differences on the level of individual transcripts were paralleled by the enrichment of several distinct biological networks between the groups. Moreover, these gene-expression changes were accompanied and likely mediated by changes in DNA methylation in the same loci to a much larger proportion in the childhood abuse (69%) vs. the non-child abuse-only group (34%). This study is unique in providing genome-wide evidence of distinct biological modifications in PTSD in the presence or absence of exposure to childhood abuse. The findings that nonoverlapping biological pathways seem to be affected in the two PTSD groups and that changes in DNA methylation appear to have a much greater impact in the childhood-abuse group might reflect differences in the pathophysiology of PTSD, in dependence of exposure to childhood maltreatment. These results contribute to a better understanding of the extent of influence of differences in trauma exposure on pathophysiological processes in stress-related psychiatric disorders and may have implications for personalized medicine.",0,0 +2723,The Epidemiology of Post-Traumatic Stress Disorder after Disasters,"Traumatic experiences are relatively common. More than two thirds of persons in the general population may experience a significant traumatic event at some point in their lives, and up to one fifth of people in the United States may experience such an event in any given year (1–5). Although comparable international data are limited, large proportions of populations in many countries have been exposed to terrorism, forced relocation, and violence, which suggests that the overall prevalence of exposure to traumatic events worldwide may be even higher than that in the United States (6, 7). Disasters (e.g., floods, transportation accidents) are traumatic events that are experienced by many people and may result in a wide range of mental and physical health consequences (8). In one survey of US residents, 13 percent of the sample reported a lifetime exposure to natural or human-generated disaster (9). In the National Comorbidity Survey, 18.9 percent of men and 15.2 percent of women reported a lifetime experience of a natural disaster (4). Post-traumatic stress disorder (PTSD) is the most commonly studied and probably the most frequent and debilitating psychological disorder that occurs after traumatic events and disasters (8, 10). The growing threat of terrorism worldwide has heightened our awareness of disasters as a potentially important determinant of population health and suggests a pressing need both to identify key areas of consensus in postdisaster research and to highlight areas that require additional study (11). It is our purpose in this review to contribute to this overall goal by comprehensively and systematically assessing the epidemiologic evidence about PTSD after disasters.",0,0 +2724,The Role of Anxiety Control and Treatment Implications of Informant Agreement on Child PTSD Symptoms,"The goal of this study is to examine parent and child agreement of child posttraumatic stress disorder (PTSD) symptoms pre- and posttreatment, as well as potential moderators of agreement including treatment responder status, child anxiety control, and parent self-reported PTSD symptoms. We examined child self-reported and parent-reported child PTSD symptoms from the Diagnostic Interview Schedule for Children. Of the 141 parent-child pairs, the mean age of children was 12.72 (SD = 3.40), 53% were female, and 54% were Black. A subsample of participants (n = 47) was assessed after completion of a cognitive behavioral therapy treatment for PTSD. Moderate levels of agreement were found at baseline, though Criterion D (increased arousal) symptoms had lower levels of agreement than the other symptom clusters. Symptom agreement was lower at posttreatment. Treatment responders had higher levels of baseline informant agreement than treatment nonresponders. Child perceived anxiety control significantly moderated informant agreement, such that pairs with children who had high levels of perceived control of their anxiety had lower PTSD symptom agreement where children reported lower symptoms relative to their parents. Contrary to expectations, parent self-reported PTSD did not moderate parent-child symptom agreement. Factors associated with higher parent-child agreement of child PTSD symptoms were being a PTSD treatment responder and children with lower perceived anxiety control. These findings have potential implications for determining those who may benefit from greater symptom monitoring over the course of intervention and potential alternative intervention approaches.",0,0 +2725,Physiological Reactivity to Cognitive Stressors: Variations by Age and Socioeconomic Status,"The present study focused on age and SES differences in stress reactivity in response to cognitively challenging tasks. Specifically, we assessed within-person trajectories of cortisol, a steroid hormone released by the adrenal gland in response to stressors, before, during, and after exposure to cognitively challenging tasks. We extend the current literature by simultaneously examining age and SES differences in physiological reactivity. Findings suggest that age and SES both play an important role in reactivity, such that it was the older adults with higher SES who were the most physiologically reactive to cognitive stressors. Implications of these findings for cognitive aging research are discussed.",0,0 +2726,Multimodal PTSD characterization via the StartleMart game,"Computer games have recently shown promise as a diagnostic and treatment tool for psychiatric rehabilitation. This paper examines the potential of combining multiple modalities for detecting affective responses of patients interacting with a simulation built on game technology, aimed at the treatment of mental diagnoses such as post traumatic stress disorder (PTSD). For that purpose, we couple game design and game technology to create a game-based tool for exposure therapy and stress inoculation training that utilizes stress detection for the automatic profiling and potential personalization of PTSD treatments. The PTSD treatment game we designed forces the player to go through various stressful experiences while a stress detection mechanism profiles the severity and type of PTSD by analyzing the physiological responses to those in-game stress elicitors in two separate modalities: skin conductance (SC) and blood volume pulse (BVP). SC is often used to monitor stress as it is connected to the activation of the sympathetic nervous system (SNS). By including BVP into the model we introduce information about para-sympathetic activation, which offers a more complete view of the psycho-physiological experience of the player; in addition, as BVP is also modulated by SNS, a multimodal model should be more robust to changes in each modality due to particular drugs or day-to-day bodily changes. Overall, the study and analysis of 14 PTSD-diagnosed veteran soldiers presented in this paper reveals correspondence between diagnostic standard measures of PTSD severity and SC and BVP responsiveness and feature combinations thereof. The study also reveals that these features are significantly correlated with subjective evaluations of the stressfulness of experiences, represented as pairwise preferences. More importantly, the results presented here demonstrate that using the modalities of SC and BVP captures a more nuanced representation of player stress responses than using SC alone. We conclude that the results support the use of the simulation as a relevant treatment tool for stress inoculation training, and suggest the feasibility of using such a tool to profile PTSD patients. The use of multiple modalities appears to be key for an accurate profiling, although further research and analysis are required to identify the most relevant physiological features for capturing user stress.",0,0 +2727,Errors in self-report of post-traumatic stress disorder after severe traumatic brain injury,"Assessing PTSD by questionnaire can lead to false positive diagnosis after severe traumatic brain injury. Sumpter and McMillan, reported quantitative data on 34 people with severe TBI; 59% were PTSD 'cases' by questionnaire assessment, but only 3% using a structured interview. The present paper describes ways in which these individuals made errors on questionnaires. Some did not follow questionnaire instructions because of inattention and concrete thinking or instead reported effects of brain injury. Symptom overlap between TBI and PTSD, including insomnia, irritability and impaired concentration can cause errors. Brain injury can also provoke curiosity about loss of memory (during coma, retrograde and post-traumatic amnesia), decreased participation, social withdrawal and difficulty adjusting to injury that may be mistaken for fear-associated PTSD symptoms. Assessment of PTSD by questionnaire can lead to erroneous conclusions and factors related to brain injury must be carefully considered when investigating PTSD.",0,0 +2728,Dysregulation in microRNA Expression Is Associated with Alterations in Immune Functions in Combat Veterans with Post-Traumatic Stress Disorder,"While the immunological dysfunction in combat Veterans with post-traumatic stress disorder (PTSD) has been well documented, the precise mechanisms remain unclear. The current study evaluated the role of microRNA (miR) in immunological dysfunction associated with PTSD. The presence of peripheral blood mononuclear cells (PBMC) and various lymphocyte subsets in blood collected from PTSD patients were analyzed. Our studies demonstrated that the numbers of both PBMC and various lymphocyte subsets increased significantly in PTSD patients. When T cells were further analyzed, the percentage of Th1 cells and Th17 cells increased, regulatory T cells(Tregs) decreased, while Th2 cells remained unaltered in PTSD patients. These data correlated with increased plasma levels of IFN-γ and IL-17 while IL-4 showed no significant change. The increase in PBMC counts, Th1 and Th17 cells seen in PTSD patients correlated with the clinical scores. High-throughput analysis of PBMCs for 1163 miRs showed that the expression of a significant number of miRs was altered in PTSD patients. Pathway analysis of dysregulated miRs seen in PTSD patients revealed relationship between selected miRNAs and genes that showed direct/indirect role in immunological signaling pathways consistent with the immunological changes seen in these patients. Of interest was the down-regulation of miR-125a in PTSD, which specifically targeted IFN-γ production. Together, the current study demonstrates for the first time that PTSD was associated with significant alterations in miRNAs, which may promote pro-inflammatory cytokine profile. Such epigenetic events may provide useful tools to identify potential biomarkers for diagnosis, and facilitate therapy of PTSD.",0,0 +2729,Dopamine D2 receptor (DRD2) gene and susceptibility to posttraumatic stress disorder: A study and replication,"Subjects on an addiction treatment unit who had been exposed to severe combat conditions in Vietnam were screened for posttraumatic stress disorder (PTSD). Of 24 with PTSD, 58.3% carried the D2A1 allele. Of the remaining eight who did not meet PTSD criteria, 12.5% carried the D2A1 allele (p = 0.04). In a replication study of 13 with PTSD, 61.5% carried the D2A1 allele. Of the remaining 11 who did not meet criteria for PTSD, 0% carried the D2A1 allele (p = 0.002). For the combined group 59.5% of those with PTSD carried the D2A1 allele versus 5.3% of those who did not have PTSD (p = 0.0001). These results suggest that a DRD2 variant in linkage disequilibrium with the D2A1 allele confers an increased risk to PTSD, and the absence of the variant confers a relative resistance to PTSD.",0,0 +2730,"Incidence, clinical correlates and treatment effect of rage in anxious children","Episodic rage represents an important and underappreciated clinical feature in pediatric anxiety. This study examined the incidence and clinical correlates of rage in children with anxiety disorders. Change in rage during treatment for anxiety was also examined. Participants consisted of 107 children diagnosed with an anxiety disorder and their parents. Participants completed structured clinical interviews and questionnaire measures to assess rage, anxiety, functional impairment, family accommodation and caregiver strain, as well as the quality of the child's relationship with family and peers. Rage was a common feature amongst children with anxiety disorders. Rage was associated with a more severe clinical profile, including increased anxiety severity, functional impairment, family accommodation and caregiver strain, as well as poorer relationships with parents, siblings, extended family and peers. Rage was more common in children with separation anxiety, comorbid anxiety, attention deficit/hyperactivity disorder and behavioral disorders, but not depressive symptoms. Rage predicted higher levels of functional impairment, beyond the effect of anxiety severity. Rage severity reduced over treatment in line with changes in anxiety symptoms. Findings suggest that rage is a marker of greater psychopathology in anxious youth. Standard cognitive behavioral treatment for anxiety appears to reduce rage without adjunctive treatment.",0,0 +2731,Shortening the CES–D to improve its ability to detect cases of depression.,"Psychometric analyses evaluated how primary care patients with and without major depressive disorder endorsed individual response options on the Center for Epidemiologic Studies-Depression Scale (CES-D; L. S. Radloff, 1977). The analyses were then used to identify a subset of items that when appropriately weighted improved the efficiency with which depressed individuals were identified. Efficiency of the revised measure was evaluated relative to standard cutpoints used with the full scale. Results showed that some improvement in most indices of efficiency could be achieved with half as many items and a simplified scoring scheme, but great improvement in one measure was usually achieved only at the expense of other measures of efficiency. The efficiency of the CES-D can be improved with appropriate analytic techniques, but its limitations as a self-report screening measure persist.",0,0 +2732,Trauma amid ‘culture of avoidance’: Symptom profile of PTSD in Bedouin members of the Israel Defense Forces,"The appropriateness and cultural relevance of the construct of posttraumatic stress disorder (PTSD) has been questioned by previous studies of non-Western populations. The current study examined the symptom profile of PTSD in an ethnic minority group of Bedouin members of the Israel Defense Forces (N=317). Comparing individuals with PTSD to traumatized individuals without PTSD, we identified a pattern of symptoms that differed between the groups: while symptoms from the re-experiencing cluster were those most frequently reported by the PTSD group, avoidance symptoms were the most frequently reported by the traumatized group without PTSD. Our findings highlight the role of sociocultural considerations in the development of trauma-related problems and the special meaning of avoidant strategies for traumatized individuals from non-Western backgrounds.",0,0 +2733,Anxiety sensitivity taxon and trauma: discriminant associations for posttraumatic stress and panic symptomatology among young adults,"The present investigation examined whether the anxiety sensitivity (AS) taxon interacts with theoretically relevant traumatic types of aversive life events to show discriminant (concurrent) associations with posttraumatic stress symptoms, but not panic attacks or bodily vigilance among young adults. The interaction between the AS Taxon Scale and trauma exposure accounted for significant variance above and beyond negative affectivity and each of the main effects in terms of a posttraumatic stress disorder (PTSD) symptom-severity criterion variable, but not for posttraumatic-related thoughts and beliefs or either panic-relevant criterion variable. Thus, results suggest that although the AS taxon may function as a common cognitive diathesis for PTSD and panic outcomes, the AS taxon coupled with traumatic life events may confer emotional vulnerability that is specific to PTSD symptoms. These findings are discussed in terms of theoretical and clinical implications for PTSD and panic vulnerability.",0,0 +2734,A Brief Retrospective Method for Identifying Longitudinal Trajectories of Adjustment Following Acute Stress,"Research increasingly indicates that prototypical trajectories of resilience, recovery, delayed, and chronic distress characterize reactions to acute adversity. However, trajectory research has been limited by the practical and methodological difficulties of obtaining pre-event and longitudinal data. In two studies, we employed a novel method in which trained interviewers provided a graphical depiction of prototypical stress trajectories to participants and asked them to select the one that best described their experience. In Study 1, self-identified trajectories from 21 high-exposure survivors of the September 11th World Trade Center attacks distinguished variation in posttraumatic stress disorder and depression symptoms at 7 and 18 months, and were consistent with trajectories based on longitudinal outcomes and friend/relative ratings. In Study 2, we examined self-identified trajectories from 115 bereaved spouses at 1.5 to 3 years. Persons who identified a resilient trajectory, compared with recovery and chronic distress trajectories, had fewer interviewer-rated symptoms of grief, depression, and posttraumatic stress disorder were rated as functioning more effectively by friends, reported higher life satisfaction, and had fewer somatic complaints. The present results provide initial evidence for the construct validity of a cross-sectional and less demanding method for identifying acute stress trajectories.",0,0 +2735,Nonpathological response to ongoing traumatic stress.,"For individuals faced with ongoing traumatic stress, a range of adverse reactions are possible. Carrying over models from acute trauma, developed for soldiers suffering months and years after returning from combat, and for victims of rape and other community violence, most psychological literature emphasizes psychopathological syndromes, especially posttraumatic stress disorder (PTSD). The implicit assumption is that reactions that entail significant suffering must be explained by a diagnosable disorder. Ironically, this locates the mechanisms that explain ongoing suffering within the mind of the victim rather than in the stressful context in which s/he is forced to live. We present a description and venture theoretical consideration of an alternative phenomenon, which we refer to as ongoing traumatic stress response (OTSR). OTSR is not a diagnosis nor label, but an alternative framework through which to make sense of intense psychological suffering in the increasingly common situation of ongoing traumatic stress. In this article, we consider conceptual boundaries that distinguish pathologic reactions such as PTSD from nonpathologic reactions better captured by OTSR. We draw a distinction between PTSD, which is conceptualized as a disorder because it is driven primarily by internal psychological effects of a past trauma, and OTSR, which is determined by real and external environmental factors in the present. To illustrate these boundaries, we provide examples of how experiences and behaviors that may appear to reflect symptoms of PTSD or other disorders are actually adaptive and normative under extreme conditions, despite their causing clinical levels of distress. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +2736,Neurobiology of suicidal behavior in post-traumatic stress disorder,"Posttraumatic stress disorder (PTSD) is a frequent and severe disorder that can develop after exposure to a traumatic event. People with PTSD suffer from a range of symptoms that interfere with their capacities to enjoy normal life. Post-traumatic stress disorder is frequently comorbid with other psychiatric disorders. Multiple lines of evidence suggest an important relationship between PTSD and suicidal behavior. This association has been observed both in clinical and in general population samples, and is irrespective of the type of trauma that led to PTSD. High rates of suicidal behavior have been found among PTSD patients exposed to combat trauma, physical or sexual abuse, intimate partner violence and natural disasters. Neurobiological changes observed in PTSD include alterations in the hypothalamic–pituitary–adrenal axis, increased noradrenergic activity, and changes in the serotonergic and other neurotransmitter systems. Further studies of the role of the endocannabinoid system in the pathophysiology of PTSD may help to develop new modalities to treat PTSD and suicidal behavior in persons with PTSD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)",0,0 +2737,Race Differences in Depressive Symptoms: A Dynamic Perspective on Stress Exposure and Vulnerability,"The existence, nature, and strength of race differences in mental health remain unclear after several decades of research. In this research, we examine black-white differences in the relationship between acute stressors and depressive symptoms. We reframe the stress exposure and differential vulnerability hypotheses in the context of long-term trajectories of stress and depression, and we hypothesize that trajectories of stress growth will be associated with trajectories of depressive symptom growth. Using latent growth curve analysis of a sample of 1,972 older persons interviewed three times at three-year intervals, we test the hypotheses that (1) growth in exposure to loss-related events will predict growth in depressive symptoms, and (2) African Americans will experience greater stress growth than whites. Results support the hypotheses. Stress growth exhibited a linear increase for blacks but not for whites, and predicted depression growth for both races, but explained more variance for blacks than for whites.",0,0 +2738,Use of khat and posttraumatic stress disorder as risk factors for psychotic symptoms: A study of Somali combatants,"The chewing of the khat leaves, which contain the amphetamine-like cathinone, is a traditional habit in Somalia. Our objective was to explore the effects of khat use and Posttraumatic Stress Disorder (PTSD) on paranoid symptoms and to test a potential causal chain. We report on a cross-sectional study in Somalia that was conducted in 2003. Trained local staff interviewed 8723 personnel of armed groups in seven regional convenience samples. Of them, 8124 were included in the analysis. We assessed current khat use, PTSD symptoms, functional drug use and paranoid ideation using items from the Composite International Diagnostic Interview (CIDI) and the Somali version of the Posttraumatic Stress Diagnostic Scale (PDS). Applying the causal steps approach, in a series of logistic regression models, we used PTSD as independent and paranoia as outcome variable; the quantity of khat use was defined as mediator variable and functional drug use as moderator. The results showed that respondents with PTSD used khat more frequently. Khat chewers with PTSD reported a higher intake compared to khat chewers without PTSD. Among excessive khat chewers with PTSD, paranoia was most frequent. The greatest amount of khat use was among respondents with PTSD who indicated that they found drugs help them to forget war experiences. The proposed mediated moderation model was supported by the data, i.e. besides the direct effects of PTSD and functional drug use on paranoia, the amount of khat use appeared to be a mechanism, by which paranoia is caused. We conclude that in our data we have uncovered a relationship between khat, PTSD and paranoia. Khat is functionally used by respondents with PTSD. Findings support a dose effect: the more khat consumption and when a respondent has PTSD, the higher the odds for paranoid ideation. However, the proposed causal chain needs to be confirmed in longitudinal studies. Demobilization and reintegration programs in Somalia need to be prepared to deal with complex psychological problems.",0,0 +2739,Mitochondrial Gene Expression Profiles and Metabolic Pathways in the Amygdala Associated with Exaggerated Fear in an Animal Model of PTSD,"The metabolic mechanisms underlying the development of exaggerated fear in post-traumatic stress disorder (PTSD) are not well defined. In the present study, alteration in the expression of genes associated with mitochondrial function in the amygdala of an animal model of PTSD was determined. Amygdala tissue samples were excised from 10 non-stressed control rats and 10 stressed rats, 14 days post-stress treatment. Total RNA was isolated, cDNA was synthesized, and gene expression levels were determined using a cDNA microarray. During the development of the exaggerated fear associated with PTSD, 48 genes were found to be significantly upregulated and 37 were significantly downregulated in the amygdala complex based on stringent criteria (p < 0.01). Ingenuity pathway analysis revealed up- or downregulation in the amygdala complex of four signaling networks - one associated with inflammatory and apoptotic pathways, one with immune mediators and metabolism, one with transcriptional factors, and one with chromatin remodeling. Thus, informatics of a neuronal gene array allowed us to determine the expression profile of mitochondrial genes in the amygdala complex of an animal model of PTSD. The result is a further understanding of the metabolic and neuronal signaling mechanisms associated with delayed and exaggerated fear.",0,0 +2740,Posttraumatic stress disorder in veterans with spinal cord injury: Trauma-related risk factors,"Trauma-related risk factors for posttraumatic stress disorder (PTSD) were examined in a sample of 125 veterans with spinal cord injury. Category of injury was found to be the most consistent predictor of PTSD diagnosis and symptom severity with paraplegia predicting more PTSD symptoms than quadriplegia. The occurrence of a head injury at the time of the trauma was found to predict PTSD symptom severity measures, but not PTSD diagnosis. Trauma recency consistently predicted Impact of Event score (IES) and was found to be related to current PTSD severity and lifetime PTSD diagnosis in multiple but not simple regression models. Trauma severity was found to be significantly related to self-reported PTSD symptoms and lifetime PTSD diagnosis in simple but not in multiple regression analyses. Type of trauma, alcohol or other drug (AOD) use during the trauma and loss of consciousness (LOC) during the trauma were not consistently associated with PTSD symptom severity or diagnosis.",0,0 +2741,Epidemiological risk factors for trauma and PTSD.,,0,0 +2742,Elucidating the transdiagnostic dimensional structure of trauma-related psychopathology: Findings from VA cooperative study 504 – risperidone treatment for military service related chronic post traumatic stress disorder,"Three of the most common trauma-related mental disorders—posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD)—are highly comorbid and share common transdiagnostic symptom dimensions of threat (i.e., fear) and loss (i.e., dysphoria) symptomatology. However, empirical evaluation of the dimensional structure of component aspects of these disorders is lacking. Using structured clinical interview data from U.S. military veterans with chronic military-related PTSD, we evaluated the transdiagnostic dimensional structure of PTSD, MDD, and GAD symptoms. We then examined the relationship between the best-fitting transdiagnostic model of these symptoms, and measures of physical and mental functioning, and life satisfaction and well-being. Exploratory factor analysis revealed that a 3-factor transdiagnostic model comprised of loss (i.e., dysphoria), threat (i.e., anxious arousal, re-experiencing, and avoidance symptoms), and somatic anxiety (i.e., physiological manifestations of anxiety) symptoms provided the best representation of trauma-related PTSD, MDD, and GAD symptoms. Somatic anxiety symptoms were independently associated with physical functioning, while loss symptoms were independently associated with mental functioning and life satisfaction and well-being. Evaluation of study aims in a relatively homogeneous sample of veterans with chronic, military-related PTSD. Results of this study suggest that a 3-factor transdiagnostic model best characterizes the dimensional structure of PTSD, MDD, and GAD symptoms in military veterans with chronic military-related PTSD. This model evidenced external validity in demonstrating differential associations with measures of physical and mental functioning, and life satisfaction and well-being. Results provide support for emerging contemporary models of psychopathology, which emphasize transdiagnostic and dimensional conceptualizations of mental disorders. Such models may have utility in understanding the functional status of trauma survivors.",0,0 +2743,Psychopathology and resilience following traumatic injury: A latent growth mixture model analysis.,"To investigate trajectories of PTSD and depression following traumatic injury using latent class growth curve modeling.A longitudinal study of 330 injured trauma survivors was conducted and participants were assessed during hospitalization, and at 1, 3, and 6 months follow-up. Acute Stress Disorder (ASD) was assessed during hospitalization using the Acute Stress Disorder Interview (ASD-I), PTSD was measured at all follow-up with the Post-Traumatic Stress Diagnostic Scale (PDS) and depression was measured at hospitalization with the (BSI) and at follow-up with the Center for Epidemiologic Studies Depression Scale (CESDS). Covariates were explored, including coping self-efficacy, anger, education level, and mechanism of injury.Four latent classes were identified for PTSD and Depression symptoms: chronic distress, delayed distress, recovered, and resilience. When compared to the resilient group, individuals with chronic distress were more likely to have been assaulted, had higher levels of anger, and had less coping self-efficacy. The delayed distress group had lower education levels, higher levels of coping self-efficacy, and higher levels of anger. Individuals in the recovered group had fewer years of education, and higher levels of anger.The majority of the injured trauma sample demonstrated resiliency, with those exhibiting distress doing so as a delayed, chronic, or recovered trajectory. Coping self efficacy, education, assaultive trauma type, and anger were important covariates of depression and PTSD trajectories. These results are similar to studies of individuals who experienced a major health threat and with survivors from the World Trade Center attacks in the U.S.",1,0 +2744,"Severity, timing, and duration of reactions to trauma in the population: an example from Mexico","Normative data describing acute reactions to trauma are few. Of 2509 Mexican adults interviewed with the Composite International Diagnostic Interview, 1241 met trauma exposure criteria for index events occurring more than 1 year previously. The modal response, describing 45%, was a reaction to trauma that was mild (present but below levels of posttraumatic stress disorder symptom criteria), immediate (within the first month), and transient (over within a year). Nonetheless, 29% experienced immediate and serious reactions. Of these, 44% had chronic posttraumatic stress disorder symptoms. Those whose reactions were serious and chronic differed in many ways from those whose reactions were serious but transient. They had more traumatic events during their lives, and their index events were more likely to have occurred in childhood and to have involved violence. They had more symptoms and functional impairment after the trauma and higher levels of depressive and somatic symptoms when data were collected. Psychiatrically significant reactions to trauma persist often enough to justify their detection and treatment. Persons in need of acute intervention can be identified on the basis of the nature and severity of the initial response as well as characteristics of the stressor.",0,0 +2745,Positive symptoms of psychosis in posttraumatic stress disorder,"The possible presence of hallucinations and delusional thoughts in posttraumatic stress disorder (PTSD) was investigated. Other symptom clusters were also assessed in order to further clarify the nature of PTSD. Twenty combat veterans with PTSD were compared to 18 combat veterans without PTSD on symptom rating scales. The subjects with PTSD exhibited a greater degree of depression, anxiety, agitation, anhedonia, and positive symptoms of psychosis than the comparison group. Specifically, the PTSD group manifested increased hallucinations, delusions, and bizarre behavior. Some of these positive symptoms did not appear to be due to reexperiencing of the trauma. The groups were not significantly different on indices of mania, thought disorder, or inertia. The clinical and diagnostic implications of the results are discussed. A diagnosis of PTSD should be considered with patients who have positive symptoms in the absence of thought disorder.",0,0 +2746,The dynamics of cumulative trauma and trauma types in adults patients with psychiatric disorders: Two cross-cultural studies.,There is an intricate divide between three major valid paradigms in studying traumatic processes: The psychiatric paradigm that focused mostly on the survival types of traumas and on posttraumatic ...,0,0 +2747,Individual differences in posttraumatic stress disorder symptom profiles in Holocaust survivors in concentration camps or in hiding,"Symptom patterns were compared between Holocaust survivors in concentration camp (n = 70) and those who were in 'hiding' (n = 30) during the war. The impact of age at the time of the trauma, gender, and cumulative lifetime stress, and the effect of each of these variables controlling for the others, on posttraumatic stress disorder (PTSD) symptoms were also evaluated. A significant negative relationship between age at the time of the trauma and symptoms of psychogenic amnesia, hypervigilence and emotional detachment, and a positive correlation between age and intrusive thoughts, were observed. Cumulative lifetime stress was positively associated with symptoms of avoidance. The study provides the first empirical data regarding the factors that potentially explain individual differences in PTSD symptom patterns in Holocaust survivors.",0,0 +2748,Pharmacotherapy for post-traumatic stress disorder: Systematic review and meta-analysis,"Pharmacological treatment is widely used for post-traumatic stress disorder (PTSD) despite questions over its efficacy.To determine the efficacy of all types of pharmacotherapy, as monotherapy, in reducing symptoms of PTSD, and to assess acceptability.A systematic review and meta-analysis of randomised controlled trials was undertaken; 51 studies were included.Selective serotonin reuptake inhibitors were found to be statistically superior to placebo in reduction of PTSD symptoms but the effect size was small (standardised mean difference -0.23, 95% CI -0.33 to -0.12). For individual pharmacological agents compared with placebo in two or more trials, we found small statistically significant evidence of efficacy for fluoxetine, paroxetine and venlafaxine.Some drugs have a small positive impact on PTSD symptoms and are acceptable. Fluoxetine, paroxetine and venlafaxine may be considered as potential treatments for the disorder. For most drugs there is inadequate evidence regarding efficacy for PTSD, pointing to the need for more research in this area.",0,0 +2749,Resilience in highly stressed urban children: concepts and findings.,"The Rochester Child Resilience Project is a coordinated set of studies of the correlates and antecedents of outcomes relating to resilience among profoundly stressed urban children. The studies have been conducted over the course of the past decade. Based on child test data, parent, teacher, and self ratings of child adjustment, and in-depth individual interviews with parents and children, a cohesive picture has developed of child and family milieu variables that consistently differentiate children with resilient versus stress-affected outcomes within this highly stressed sample. Resilient children are characterized by an easy temperament and higher IQ; sound parent/child relationships; a parent's sense of efficacy; the parent's own wellness, especially mental health; and the child's perceived competence, realistic control, empathy, and social problem-solving.",0,0 +2750,A novel use for testosterone to treat central sensitization of chronic pain in fibromyalgia patients,"Fibromyalgia is a diffuse chronic pain condition that occurs predominantly in women and may be under-reported in men. Symptoms include a loss of feeling of well-being and generalized widespread flu-like muscle aches and pain that fail to resolve due to central sensitization of nociceptive neurons. It has commonalities with a myriad of other chronic pain conditions which include PTSD, ""Gulf War Syndrome"", and various stress-induced conditions caused, for example, by viral infection, emotional or physical stress, trauma, combat, accident or surgery. It is not understood why some individuals are susceptible to this condition and others are not. White et al., elsewhere in this issue, present a clinical feasibility study designed to test the hypothesis that 1) low or deficient testosterone serum levels are linked to a high risk for an inflamed nociceptive nervous system and resultant chronic pain states, and 2) a testosterone transdermal gel applied once a day by fibromyalgia patients can be an effective therapeutic against chronic pain. Here, a short profile of fibromyalgia is provided along with a brief summary of best practices currently recommended by clinical specialists. The link between testosterone and pain is then discussed, with an overview of scientific studies that lay the foundation for testosterone as a possible important additional therapeutic that has the potential to be safely administered and effective but also avoid the adverse effects of other therapeutics. Finally, novel mechanisms by which testosterone therapy is likely to down-modulate pain signaling are proposed.",0,0 +2751,A focus group study of the impact of trauma exposure in the 9/11 terrorist attacks,"Much of the mental health research that has emerged from the September 11 (9/11) attacks has been focused on posttraumatic stress disorder and its symptoms. To better understand the broader experience of individuals following a disaster, focus groups were conducted with individuals from affected companies both at Ground Zero and elsewhere in New York City.Twenty-one focus groups with a total of 140 participants were conducted in the second post-9/11 year. Areas of identified concern were coded into the following themes: Disaster Experience, Emotional Responses, Workplace Issues, Coping, and Issues of Public Concern.Discussions of focus groups included material represented in all five themes in companies both at Ground Zero and elsewhere. The emphasis and the content within these themes varied between the Ground Zero and other companies. Content suggesting symptoms of PTSD represented only a minority of the material, especially in the company groups not at Ground Zero.This study's findings revealed an array of psychosocial concerns following the 9/11 attacks among employees of companies in New York City that extended far beyond PTSD. This study's results provide further evidence that trauma exposure is central to individuals' post-disaster experience and focus, and to individuals' adjustment and experience after disaster.",0,0 +2752,Unsupervised Fuzzy Clustering Analysis Supports Behavioral Cutoff Criteria in an Animal Model of Posttraumatic Stress Disorder,"Unsupervised fuzzy clustering (UFC) analysis is a mathematical technique that groups together objects in the multidimensional feature space according to a specified similarity measurement, thereby yielding clusters of similar data points that can be represented by a set of prototypes or centroids.Since clinical studies of mental disorders distinguish between affected and unaffected individuals, we designed an inclusion/exclusion criteria (cutoff behavioral criteria [CBC]) approach for animal behavioral studies. The effect of classifying the study population into clearly affected versus clearly unaffected individuals according to behaviors on two behavioral paradigms was statistically significant.Here the raw data from previous studies were subjected to UFC algorithms as a means of objectively testing the validity of the concept of the CBC for our experimental model. The first UFC algorithm yielded two clearly discrete clusters, found to consist almost exclusively of the exposed animals in the one and unexposed animals in the other. The second algorithm yielded three clusters corresponding to animals designated as clearly affected, partially affected, and clearly unaffected. The algorithm for physiological data in addition to behavioral data failed to elicit discrete clusters.The UFC analysis yielded data that support the conceptual contention of the CBC and lends additional validity to our previous behavioral studies.",0,0 +2753,The 5-HTTLPR Polymorphism and Posttraumatic Stress Disorder: A Meta-Analysis,en,0,0 +2754,Prospective predictors of posttraumatic stress disorder symptoms: Direct and mediated relations.,"This study assessed the relations between pretrauma risk (neuroticism, negative affect, prior distress) and protective (self-esteem, optimism) factors and posttraumatic stress disorder (PTSD) symptoms and potential mediators (subjective event-related distress, unsupportive social interactions, perceived control) of those relations. Students (N = 1,528) at four U.S. universities completed online surveys assessing pretrauma risk and protective factors at Time 1 (T1); 84% (N = 1,281) completed a survey 2 months later (T2). PTSD symptoms and the three potential mediators were assessed among those who experienced potentially traumatic events between T1 and T2 (n = 264). PTSD symptoms related to prior traumas were controlled in all analyses. In structural equation modeling (SEM) analyses, the relation between risk factors and PTSD symptoms was mediated by unsupportive social interactions. Protective factors did not independently predict PTSD symptoms when risk factors also were included in the SEM models. Implications for research and practice are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +2755,Implicit and explicit memory in survivors of chronic interpersonal violence.,"We investigated the relationship of implicit and explicit memory to a range of symptoms in a sample of 27 women with exposure to chronic interpersonal violence (IPV). Participants viewed the first 3 letters (""stems"") of trauma-related, general threat, and neutral words; valenced words were matched with neutral words with the same stem. Free recall and a word-stem completion task were used to test explicit and implicit memory, respectively. Participants exhibited increased implicit memory for trauma-related words as compared with both general threat words and neutral ""match"" words. They also showed increased explicit memory for both general threat and trauma-related words. Finally, although neither implicit nor explicit memory was correlated with PTSD symptoms, implicit memory for trauma-related words was significantly correlated with symptoms associated with ongoing IPV. Interpersonal sensitivity, hostility, and alexithymia were significantly correlated with implicit, but not explicit, memory for trauma words. Somatization, dissociation, and alexithymia were negatively correlated with explicit, but not implicit, memory for general-threat words. These findings suggest that memory processes in survivors of IPV are closely related to the symptom profile associated with complex trauma. Exploring memory processes in survivors of IPV may lend unique insight into the development and maintenance of the symptom profile associated with IPV.",0,0 +2756,Gender Differences in Mental Health Diagnoses Among Iraq and Afghanistan Veterans Enrolled in Veterans Affairs Health Care,"Objectives. We examined gender differences in sociodemographic, military service, and mental health characteristics among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans. We evaluated associations between these sociodemographic and service characteristics and depression and posttraumatic stress disorder (PTSD) diagnoses. Methods. In a retrospective, cross-sectional study, we used univariate descriptive statistics and log binominal regression analyses of Department of Veterans Affairs (VA) administrative data on 329 049 OEF and OIF veterans seeking VA health care from April 1, 2002, through March 31, 2008. Results. Female veterans were younger and more likely to be Black and to receive depression diagnoses than were male veterans, who were more frequently diagnosed with PTSD and alcohol use disorders. Older age was associated with a higher prevalence of PTSD and depression diagnoses among women but not among men. Conclusions. Consideration of gender differences among OEF and OIF veterans seeking health care at the VA will facilitate more targeted prevention and treatment services for these newly returning veterans.",0,0 +2757,Household Survey of Psychiatric Morbidity in Cambodia,"Aims: To estimate the prevalence of psychiatric symptoms in the Kampong Cham province and to determine the association between these symptoms and an impaired social functioning. Methods: Cross-sectional cluster sample survey conducted among adults randomly selected within 50 clusters distributed over the province. Results: Of the respondents, 42.4% reported symptoms that met the Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria for depression, 53% displayed high anxiety symptoms and 7.3% met posttraumatic stress disorder (PTSD) criteria. Posttraumatic symptoms of intrusion and avoidance were present in 47.8% and 45.4% respectively. When reviewing comorbidities, 29.2% had depression and anxiety symptoms, 16.5% anxiety symptoms, 6.1% depression and 7.1% had triple comorbidity (PTSD, depression and anxiety). Regarding social functioning, 25.3% reported being socially impaired. Respondents with comorbid symptoms for depression, anxiety and PTSD were associated with an increased risk for social impairment compared with others. Being over 65 years and having experienced violent events were other factors associated with social impairment. Conclusion: Five years after the return of a more stable context in Cambodia, the prevalence of psychiatric symptoms in the community remains high. In addition, these symptoms are strongly associated with social impairment. This suggests that beyond psychosocial programs, the implementation of adapted clinical psychiatric care should be considered as a priority.",0,0 +2758,Psychosocial screening and outcome measurement in paediatric burns services in the UK,Rationale: The British Burn Association Psychosocial Special Interest Group convened a small working party to review available psychosocial screening tools and outcome measures that could be piloted in paediatric burn services across the UK. Psychosocial screening tools can be administered around the time of a child's admission to identify any pre-morbid psychosocial factors known to impact on treatment and/or recovery after a burn. Psychosocial outcome measures can be used to measure the key psychosocial domains shown to be important after a burn injury. Methods: The Working Party therefore made the following recommendations (subsequently endorsed by the wider BBA Psychosocial Special Interest Group membership): 1. Psychosocial screening tool: A wider pilot of a tool developed and piloted in Manchester be carried out. It is designed to be administered by nursing staff as part of the burns integrated care pathway and then reviewed by the psychology service on a weekly basis (or more often if required). It has proven useful in highlighting psychosocial need that support/intervention can then be directed towards. 2. Psychosocial outcome measures: A nullpacknull ofmeasures to be completed at particular time-points during inpatient and outpatient phases was identified. These cover the domains of: child well-being (PTSD; emotional and behavioural well-being and quality of life; pain; appearance concerns) and parental/family well-being. A number of burns services treating children across the UK agreed to pilot these tools and report back. Results: This paper presents the output of the Working Party and preliminary findings from this pilot. It explores: (i) progress around the practicalities of implementing these recommendations; (ii) the information gathered on the profile of the families of children that are being admitted to UK burn services; (iii) whether the screening tool is facilitating greater psychosocial care for families; and (iv) preliminary outcome data for this patient cohort. Conclusion: The paper concludes with lessons learned and recommendations for future directions.,0,0 +2759,"Recent Trends in the Sociodemographic, Clinical Profile and Psychiatric Comorbidity Associated with Posttraumatic Stress Disorder: A Study from Kashmir, India","To estimate the Prevalence of post-traumatic stress disorders (PTSD) among adults in field practise areas of Government Medical College, Srinagar, India.The present study was cross-sectional in nature and was conducted in field practice areas of Government Medical College Srinagar. Three blocks of field practise areas of Government Medical College, Srinagar comprising of various villages were selected. Further 10 per cent of these villages were selected by the method of randomization sampling and then 10 per cent of household were taken again by systemic random sampling. In the selected household all adult population (18 years and above) were selected and screened by using General health questionnaires(GHQ). The patients who screened positive for PTSD (post-traumatic stress Disorders) were assessed and diagnosed. From the line listing the positive cases, the prevalence rates were calculated.Of the total 3400 subjects (age≥18 years), the prevalence of posttraumatic stress disorders among general population was found to be 3.76%. Prevalence was found to be more in females (Chi-square test=2.086, p>0.05 (Insignificant). Most of cases were found to be in the age group 0-40 years. Most of the cases were unmarried, illiterate and belong to lower socioeconomic class. Death of near one comprised the major traumatic event. Acute onset Posttraumatic stress disorder was the commonest type, previous history of psychiatric illness was found in 12 % of patients and drug abuse was present in 22.6%.Our findings clearly indicates that posttraumatic stress disorders (PTSD) is a prevalent disorder in the developing world, especially in disaster prone regions and in areas of political unrest. Resilience to various traumatic events in Kashmir has developed over the years and this might explains the lower prevalence of Post-traumatic disorder (PTSD) in our study.",0,0 +2760,Family and individual factors associated with substance involvement and PTS symptoms among adolescents in greater New Orleans after Hurricane Katrina.,"This study examined the influence of hurricane impact as well as family and individual risk factors on posttraumatic stress (PTS) symptoms and substance involvement among clinically referred adolescents affected by Hurricane Katrina.A total of 80 adolescents (87% male; 13-17 years old; mean age = 15.6 years; 38% minorities) and their parents were interviewed at the adolescent's intake into substance abuse treatment, 16 to 46 months postdisaster. Independent measures included hurricane impact variables (initial loss/disruption and perceived life threat); demographic and predisaster variables (family income, gender, predisaster adolescent substance use, predisaster trauma exposure, and parental substance abuse); postdisaster family factors (parental psychopathology, family cohesion, and parental monitoring); and postdisaster adolescent delinquency.Hierarchical multivariate regression analyses showed that adolescent substance involvement was associated with higher family income, lower parental monitoring (adolescent report), and more adolescent delinquency. Adolescent-reported PTS symptoms were associated with greater hurricane-related initial loss/disruption, lower family cohesion (adolescent report), and more adolescent delinquency, whereas parent-reported adolescent PTS symptoms were associated with greater parental psychopathology, lower parental monitoring (adolescent report), and lower family cohesion (parent report).The results suggest that hurricane impact was related only to adolescent-reported PTS. However, certain postdisaster family and individual risk factors (low family cohesion and parental monitoring, more adolescent delinquency) were associated both with adolescent substance involvement and with PTS symptoms. Identification of these factors suggests directions for future research as well as potential target areas for screening and intervention with substance-abusing adolescents after disasters.",0,0 +2761,"Psychometric Properties of Darryl, a Cartoon Based Measure to Assess Community Violence-Related PTSD in Children","OBJECTIVE: To examine the reliability and validity of Darryl, a cartoon-based measure of PTSD symptoms and a screening tool for identifying children and adolescents with a PTSD diagnosis. METHOD: Exposure to community violence, PTSD symptoms and diagnostic status were assessed in a sample of 49 children and adolescents at an urban outpatient psychiatry clinic. RESULTS: Darryl has good internal consistency for the full scale and adequate reliability for each DSM-IV PTSD symptom cluster. Darryl correlates significantly (r = 0.64, P < 0.001) with the most frequently used measure for assessing PTSD in children (CPTSD-RI). As a screening tool, Darryl has excellent sensitivity and specificity in relationship to the KID-SCID. CONCLUSIONS: In comparison to other child PTSD measures, Darryl has comparable or better psychometric properties and assesses PTSD symptoms in a more developmentally appropriate manner, especially in the domain of community violence. The value of Darryl as a screening tool remains preliminary given the limited number of diagnosed cases of PTSD in the study sample. Full scale efforts at replication are warranted.",0,0 +2762,Phenomenology of Posttraumatic Stress Disorder and Acute Stress Disorder,"This chapter reviews how fear-conditioning models of posttraumatic stress disorder (PTSD) have been bolstered by our growing understanding of neurocircuitry involving the amygdala, hippocampus, and prefrontal cortex. It describes the reexperiencing, avoidant/numbing, and hyperarousal symptom clusters as well as other PTSD diagnostic criteria with specific reference to DSM-IV's changes in the A (A1 and A2) stressor criterion. Associated symptoms (e.g., danger to self or others, intolerance of ongoing stressors, capacity to acquire social support, and risk of reactivation and relapse) are briefly discussed. Longitudinal course, comorbidity, epidemiology, risk factors, and cross-cultural issues are also addressed. Other posttraumatic syndromes described include acute stress disorder, partial/subsyndromal PTSD, and complex PTSD. Finally, clinical issues in assessment are considered. © 2009 by Oxford University Press. All rights reserved.",0,0 +2763,Traumatic memories and pseudomemories in posttraumatic stress disorder,"Intrusive imagery was investigated in survivors of motor vehicle accidents with (a) posttraumatic stress disorder (PTSD) and accurate recall of the trauma, (b) PTSD and amnesia of the trauma, (c) no PTSD, or (d) control participants who simulated PTSD. Imagery was precipitated by presentation of an audiotape of a motor vehicle accident. Whereas the traumatic imagery of participants who had accurate recall of their trauma was consistent with third party accounts of the trauma, the imagery of amnesic participants was inconsistent with these accounts. Participants were then interviewed about cognitive and emotional aspects of their responses. All participants with PTSD and simulators reported similar levels of imagery detail, involuntariness, re-experiencing, and emotional response, and reported higher levels than participants with no PTSD. Findings are discussed in terms of cognitive and contextual factors that can mediate accurate and inaccurate traumatic imagery. © 1998 John Wiley & Sons, Ltd.",0,0 +2764,Effect of Eliminating Compensation for Pain and Suffering on the Outcome of Insurance Claims for Whiplash Injury,"The incidence and prognosis of whiplash injury from motor vehicle collisions may be related to eligibility for compensation for pain and suffering. On January 1, 1995, the tort-compensation system for traffic injuries, which included payments for pain and suffering, in Saskatchewan, Canada, was changed to a no-fault system, which did not include such payments. To determine whether this change was associated with a decrease in claims and improved recovery after whiplash injury, we studied a population-based cohort of persons who filed insurance claims for traffic injuries between July 1, 1994, and December 31, 1995.Of 9006 potentially eligible claimants, 7462 (83 percent) met our criteria for whiplash injury. The six-month cumulative incidence of claims was 417 per 100,000 persons in the last six months of the tort system, as compared with 302 and 296 per 100,000, respectively, in the first and second six-month periods of the no-fault system. The incidence of claims was higher for women than for men in each period; the incidence decreased by 43 percent for men and by 15 percent for women between the tort period and the two no-fault periods combined. The median time from the date of injury to the closure of a claim decreased from 433 days (95 percent confidence interval, 409 to 457) to 194 days (95 percent confidence interval, 182 to 206) and 203 days (95 percent confidence interval, 193 to 213), respectively. The intensity of neck pain, the level of physical functioning, and the presence or absence of depressive symptoms were strongly associated with the time to claim closure in both systems.The elimination of compensation for pain and suffering is associated with a decreased incidence and improved prognosis of whiplash injury.",0,0 +2765,Physiological Employment Standards III: physiological challenges and consequences encountered during international military deployments,"Modern international military deployments in austere environments (i.e., Iraq and Afghanistan) place considerable physiological demands on soldiers. Significant physiological challenges exist: maintenance of physical fitness and body composition, rigors of external load carriage, environmental extremes (heat, cold, and altitude), medical illnesses, musculoskeletal injuries, traumatic brain injuries, post-traumatic stress disorder, and environmental exposure hazards (i.e., burn pits, vehicle exhaust, etc.). To date there is very little published research and no comprehensive reviews on the physiological effects of deployments. The purpose of this paper is to overview what is currently known from the literature related mainly to current military conflicts with regard to the challenges and consequences from deployments. Summary findings include: (1) aerobic capacity declines while muscle strength, power and muscular endurance appear to be maintained, (2) load carriage continues to tax the physical capacities of the Soldier, (3) musculoskeletal injuries comprise the highest proportion of all injury categories, (4) environmental insults occur from both terrestrial extremes and pollutant exposure, and (5) post-deployment concerns linger for traumatic brain injury and post-traumatic stress disorder. A full understanding of these responses will assist in identifying the most effective risk mitigation strategies to ensure deployment readiness and to assist in establishment of military employment standards. © 2013 Springer-Verlag Berlin Heidelberg (outside the USA).",0,0 +2766,Escitalopram reversed the traumatic stress-induced depressed and anxiety-like symptoms but not the deficits of fear memory,"Rationale: Posttraumatic stress disorder (PTSD) is a trauma-induced mental disorder characterised by fear extinction dysfunction in which fear circuit monoamines are possibly associated. PTSD often coexists with depressive/anxiety symptoms, and selective serotonin reuptake inhibitors (SSRIs) are recommended to treat PTSD. However, therapeutic mechanisms of SSRIs underlying the PTSD fear symptoms remain unclear. Objectives: Using a rodent PTSD model, we examined the effects of early SSRI intervention in mood and fear dysfunctions with associated changes of monoamines within the fear circuit areas. Methods: A 14-day escitalopram (ESC) regimen (5 mg/kg/day) was undertaken in two separate experiments in rats which previously received a protocol of single prolonged stress (SPS). In experiment 1, sucrose preference and elevated T-maze were used to index anhedonia depression and avoidance/escape anxiety profiles. In experiment 2, the percentage of freezing time was measured in a 3-day fear conditioning paradigm. At the end of our study, tissue levels of serotonin (5-HT) in the medial prefrontal cortex, amygdala, hippocampus, and striatum were measured in experiment 1, and the efflux levels of infralimbic (IL) monoamines were measured in experiment 2. Results: In experiment 1, ESC corrected both behavioural (depression/anxiety) and neurochemical (reduced 5-HT tissue levels in amygdala/hippocampus) abnormalities. In experiment 2, ESC was unable to correct the SPS-impaired retrieval of fear extinction. In IL, ESC increased the efflux level of 5-HT but failed to reverse SPS-reduced dopamine (DA) and noradrenaline (NA). Conclusions: PTSD-induced mood dysfunction is psychopathologically different from PTSD-induced fear disruption in terms of disequilibrium of monoamines within the fear circuit areas. © 2016 Springer-Verlag Berlin Heidelberg",0,0 +2767,Does Opiate Use in Traumatically Injured Individuals Worsen Pain and Psychological Outcomes?,"Opiate use for chronic pain is becoming increasingly controversial. There has been a shift away from supporting the use of opiates for treatment of chronic pain. In addition to lack of effectiveness, concerns for adverse clinical outcomes, addiction, and death have provided the impetus for this change. The purpose of this study was to investigate the percent of trauma patients still using opiates, their pain levels, and psychological outcomes 4 months posttrauma. This was a study to evaluate chronic pain at 4 months posttrauma in 101 participants from a single level 1 trauma center. Eighty of the 101 participants developed chronic pain 4 months after their initial traumatic injury (79%). Of those who developed chronic pain, 27 (26%) were still using opiates. Those using narcotics at 4 months posttrauma had significantly more pain, life interference, depression, and anxiety. Posttraumatic stress disorder (PTSD) was not significantly influenced by narcotic use in this analysis. However, the mean associated with those using narcotics was higher and diagnostic for PTSD. Those taking opiates did not have significantly better relief from their pain using treatments or medications than those not using opiates (F = 8, P = .08). These findings bring into question the appropriate use of opiates for chronic pain and the possible exacerbating effects on pain and psychopathology in traumatically injured patients.This article identifies data that provide evidence that narcotic pain medication needs to be used carefully in traumatically injured patients with chronic pain, especially in those individuals with comorbid psychological pathology.",0,0 +2768,Male war-zone veterans' perceived relationships with their children: The importance of emotional numbing,"Despite growing recognition of substantial interpersonal impairment among many war-zone veterans with posttraumatic stress disorder (PTSD), little is known about the association between PTSD symptomatology and veterans' relationships with their children. This study examined the differential pattern of associations between the symptom clusters of PTSD and the perceived father-child relationships of 66 male Vietnam veterans. Analyses revealed that only the emotional numbing cluster was significantly related to perceived quality of all relationship domains. The association between emotional numbing and perceived relationship quality remained significant in regression analyses even after controlling for fathers' family-of-origin stressors, combat exposure, depression, and substance abuse. Findings suggest that emotional numbing may be the component of PTSD most closely linked to interpersonal impairment in war-zone veterans.",0,0 +2769,Noradrenergic Mechanisms in the Pathophysiology of Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) is a serious psychiatric illness that may develop in individuals after exposure to a traumatic event. Recent data suggest that trauma and/or long-term stressors can cause alterations in the functioning of neuroanatomical structures and neural networks throughout the central nervous system. Specifically, dysregulation in central and perhaps, peripheral noradrenergic neural networks has been implicated as the cause of specific symptom clusters in the pathophysiology of PTSD. In this review, both clinical and preclinical data are presented to highlight types of noradrenergic dysfunction observed in individuals with PTSD. Additionally, the role of noradrenaline dysregulation in the acquisition/initiation, and maintenance of hyperarousal and reexperiencing symptom clusters in PTSD will be addressed.",0,0 +2770,STATISTICAL SUPPORT FOR SUBTYPES IN POSTTRAUMATIC STRESS DISORDER: THE HOW AND WHY OF SUBTYPE ANALYSIS,"A number of researchers have argued for the existence of different subtypes of posttraumatic stress disorder (PTSD). In the current paper we present criteria by which to assess these putative subtypes, clarify potential pitfalls of the statistical methods employed to determine them, and propose alternative methods for such determinations. Specifically, three PTSD subtypes are examined: (1) complex PTSD, (2) externalizing/internalizing PTSD, and (3) dissociative/nondissociative PTSD. In addition, three criteria are proposed for subtype evaluation, these are the need for (1) reliability and clarity of definition, (2) distinctions between subtypes either structurally or by mechanism, and (3) clinical meaningfulness. Common statistical evidence for subtyping, such as statistical mean difference and cluster analysis, are presented and evaluated. Finally, more robust statistical methods are suggested for future research on PTSD subtyping.",0,0 +2771,The Rorschach and Traumatic Loss: Can the Presence of Traumatic Loss Be Detected From the Rorschach?,"Loss, an expected part of everyone's life, can be a catalyst promoting significant growth. But all losses are not the same or affect everyone in like manner. Some losses are of such magnitude and intensity that individuals cannot cope, and, therefore, they keep reliving them (posttraumatic stress syndrome) as if through repeated attempts (Freud, 1923-1922/1961) they might master what had been initially so overwhelming. This study, using an inpatient hospital sample, examines the Rorschach protocols of individuals who had experienced traumatic loss in childhood or early adolescence and compares them with a control group of individuals who appear to have no such history. Our hypotheses that victims of early trauma have a distinguishing Rorschach profile was validated in the exploratory study. Further study is needed to clarify whether factors other than traumatic loss may be contributing to this profile.",0,0 +2772,Should psychiatrists use atypical antipsychotics to treat nonpsychotic anxiety?,"There is neurobiologically based, theoretical support for the use of antipsychotic medications in the treatment of anxiety, and two first-generation neuroleptics are approved by the United States Food and Drug Administration for the treatment of nonpsychotic anxiety. However, neuroleptics are associated with a large side effect burden, which has limited their utility in the treatment of nonpsychotic disorders. Because of their somewhat improved safety profile, atypical antipsychotics are increasingly used for the treatment of nonpsychotic anxiety. The published literature describing the efficacy of atypical antipsychotics in randomized, controlled trials involving patients with anxiety disorders is briefly reviewed, and the safety of atypical antipsychotics in nonpsychotic disorders is discussed. There is moderately strong controlled evidence supporting the use of some atypical antipsychotics, either as adjunctive treatment or monotherapy, in the treatment of nonpsychotic anxiety; however, the side effect burden of some atypical antipsychotics probably outweighs their benefits for most patients with anxiety disorders. The evidence to date does not warrant the use of atypical antipsychotics as first-line monotherapy or as first- or second-line adjunctive therapy in the treatment of anxiety disorders. Rigorous, independently funded, long-term studies are needed to support the off-label use of atypical antipsychotics in the treatment of anxiety disorders. Nevertheless, some patients with highly refractory anxiety disorders may benefit from the judicious and carefully monitored use of adjunctive atypical antipsychotics. A careful risk-benefit assessment must be undertaken by the physician, on a case-by-case basis, with appropriate informed consent.",0,0 +2773,"Alcohol use motives among traumatic event-exposed, treatment-seeking adolescents: Associations with posttraumatic stress","The current study evaluated the linkage between posttraumatic stress symptoms and alcohol use motives among 49 traumatic event-exposed adolescents (M(age)=16.39 years). It was hypothesized that posttraumatic stress symptom levels would be positively associated with coping-related drinking motives specifically (cf., social, enhancement, or conformity motives) and that coping-related drinking motives would evidence associations with the hyperarousal and reexperiencing posttraumatic stress symptom types. Findings were consistent with hypotheses, suggesting traumatic event-exposed adolescents may be using alcohol to manage posttraumatic stress symptoms.",0,0 +2774,Life-Altering Outcomes after Lower Extremity Injury Sustained in Motor Vehicle Crashes,"Lower extremity injuries (LEIs) sustained in vehicular crashes result in physical problems and unexpected psychosocial consequences. Their significance is diminished by low Abbreviated Injury Scale scores.Drivers who sustained LEIs were identified as part of the Crash Injury Research and Engineering Network (CIREN) and interviewed during hospitalization, at 6 months, and at 1 year. All were occupants of newer vehicles with seatbelts and airbags.Sixty-five patients were followed for 1 year. Injuries included mild brain injury (43%), ankle/foot fractures (55%), and bilateral injuries (37%). One year post-injury, 46% reported limitations in walking and 22% with ankle/foot fractures were unable to return to work. Depression (39%), cognitive problems (32%), and post-traumatic stress disorder (18%) were significant in the mild brain injury group.Long-lasting physical and psychological burdens may impede recovery and alter the lifestyle of patients with LEI. These issues need to be addressed by trauma center personnel.",0,0 +2775,The Amygdala in Post-Traumatic Stress Disorder,"Over the past decade, neuroimaging studies have yielded important insights into the function of the amygdala in post-traumatic stress disorder (PTSD). The results of these studies are presented here. Because neurocircuitry models of PTSD also emphasize the role of the medial prefrontal cortex, findings regarding that brain region are discussed as well. The reviewed studies suggest that (1) the amygdala is hyperresponsive to both trauma-related and unrelated stimuli in PTSD, (2) amygdala activation is positively correlated with PTSD symptom severity and, in some studies, inversely correlated with medial prefrontal cortex function, (3) symptom reduction after treatment is associated with decreased amygdala activation and increased medial prefrontal cortex activation, and (4) medial prefrontal cortex is hyporesponsive in PTSD, perhaps reflecting diminished inhibitory control over the amygdala. All of this information suggests that the amygdala and medial prefrontal cortex play important roles in the pathogenesis or maintenance of this disorder. Limitations and future directions of this research are discussed.",0,0 +2776,Reassessing War Stress: Exposure and the Persian Gulf War,"Research has shown a clear association between war-zone exposure and psychological readjustment in soldiers. Newer findings suggest that certain event and person characteristics are especially influential in this process. The present article has the following goals: (a) to review existing parameters in the traditional measurement of war-zone exposure, (b) to consider conceptual and methodological limitations in these approaches, (c) to present empirical data from a cohort of Persian Gulf War veterans that support the utility of a broader conceptualization of war trauma, and (d) to examine how gender may be differentially associated with some dimensions of war-zone stress and psychological outcome following deployment. Data suggest that identifying diverse dimensions of war-zone stress may enhance efforts to understand veterans' initial and long-range wartime recovery.",0,0 +2777,Bushfire impact on youth,"The authors examined the association between disaster-related traumatic experiences and posttraumatic stress disorder (PTSD) symptoms in 155 youth, aged 8–18 years, from the Lower Eyre Peninsula of South Australia who were affected by January 2005 bushfires. Youth completed measures of PTSD symptoms and disaster experiences 11–5 months postdisaster. Many youth (27%) reported moderate to severe levels of PTSD symptoms; younger children reported greater PTSD symptom severity than older youth. Perceived personal life threat and ongoing loss/disruption were related to greater PTSD symptomatology. Following disasters, it may be helpful to identify young children and youth who perceived that their life was threatened and experienced more ongoing life disruption, as these youth may be at higher risk for persistent PTSD symptoms.",0,0 +2778,Identifying and Determining the Symptom Severity Associated With Polyvictimization Among Psychiatrically Impaired Children in the Outpatient Setting,"Polyvictimization involves experiencing multiple forms of maltreatment or other interpersonal victimization, and places children at risk for severe psychosocial impairment. Children with psychiatric problems are at risk for polyvictimization, and polyvictimized child psychiatric inpatients have been found to have particularly severe psychiatric symptoms. Cluster analysis was used to identify a polyvictimized subgroup (N = 22, 8%) among 295 outpatient admissions in 2007-2009 to a child psychiatry outpatient clinic, based on chart review of documented maltreatment, parental impairment (history of arrest, psychiatric illness, and substance use), and multiple out-of-home placements. Polyvictimization was associated with severe parent-reported externalizing problems and clinician-rated psychosocial impairment, independent of demographics and psychiatric diagnoses. Posttraumatic stress disorder (PTSD) was the only psychiatric diagnosis associated with polyvictimization. Polyvictimization merits further clinical and research assessment with child psychiatry outpatients. Evidence-based PTSD assessment and treatment for polyvictimized children with adaptations to address their severe impairment and externalizing problems also warrants empirical evaluation.",0,0 +2779,Family relationshipsembedded in United Statesmilitary culture,"United States military personnel and their families have made substantial sacrifices to protect and defend their country in the service of the post-9/11 global war on terrorism (MacDermid Wadsworth, 2010; Willerton, MacDermid Wadsworth, and Riggs, 2011). Service members, their romantic partners, and their children have handled the increased operational tempo of deployments resulting from both Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) with impressive resilience (Bonanno et al., 2012; Cozza, Chun, and Polo, 2005; Lester et al., 2010), although the challenges of war can take a substantial toll on people’s physical health (Badr, Barker, and Milbury, 2011; Gorman, Eide, and Hilse-Gorman, 2010), mental health (Mansfield et al., 2010; Milliken, Auchterlonie, and Hoge, 2007; Pfefferbaum et al., 2011), and relationship health (Adams, Durand, and Castro, 2006; Allen et al., 2010; Nelson Goff et al., 2007). One foundation of this resilience is undoubtedly the strong military identity that many families embrace. US military culture espouses the ideals of courage, fortitude, strength, fairness, discipline, loyalty, respect for authority, determination, and valor (Coll, Weiss, and Yarvis, 2011; Greene et al., 2010b; Ulmer, Collins, and Jacobs, 2000), and these qualities are the signature values of many active duty and reserve component military families (Hall, 2008). To be a US military family is to be proud, to be strong, and to be brave (Hall 2011a; 2011b; Park, 2011). Although military culture provides a pervasive backdrop for how service members and their families navigate domestic life (Hall 2008; 2011a; Sherman and Bowling, 2011), scholarship on the interpersonal functioning of military couples and families has not always been sensitive to the unique parameters at play. With some notable exceptions (Palmer, 2008; Pincus et al., 2001; Riggs and Riggs, 2011), scholars have tended to apply established theories of relationship functioning to the military context without fully taking into account the social circumstances that envelop military personnel, their romantic partners, and their children. The result is a body of work (including some of our own research) that underemphasizes the distinctive trademarks of military life. As Wiens and Boss (2006) noted, ""To understand how best to support today’s military families, it is essential to understand their contexts. What are the contextual sources of their stress and resiliency?"" (p. 25). This chapter takes up that question. © Cambridge University Press 2014.",0,0 +2780,Complicating Factors Associated with Mild Traumatic Brain Injury: Impact on Pain and Posttraumatic Stress Disorder Treatment,"The nature of combat in Iraq and Afghanistan has resulted in high rates of comorbidity among chronic pain, posttraumatic stress disorder (PTSD), and mild traumatic brain injury (mTBI) in Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF). Although separate evidence-based psychological treatments have been developed for chronic pain and PTSD, far less is known about how to approach treatment when these conditions co-occur, and especially when they co-occur with mTBI. To provide the best care possible for OEF/OIF Veterans, clinicians need to have a clearer understanding of how to identify these conditions, ways in which these conditions may interact with one another, and ways in which existing evidence-based treatments can be modified to meet the needs of individuals with mTBI. The purpose of the present paper is to review the comorbidity of pain, PTSD, and mTBI in OEF/OIF Veterans, and provide recommendations to clinicians who provide care to Veterans with these conditions. First, we will begin with an overview of the presentation, symptomatology, and treatment of chronic pain and PTSD. The challenges associated with mTBI in OEF/OIF Veterans will be reported and data will be presented on the comorbidity among all three of these conditions in OEF/OIF Veterans. Second, we will present recommendations for providing psychological treatment for chronic pain and PTSD when comorbid with mTBI. Finally, the paper concludes with a discussion of the need for a multidisciplinary treatment approach, as well as a call for continued research to further refine existing treatments for these conditions. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +2781,Psychological resilience in sport performers: a review of stressors and protective factors,"Psychological resilience is important in sport because athletes must utilise and optimise a range of mental qualities to withstand the pressures that they experience. In this article, we discuss psychological resilience in sport performers via a review of the stressors athletes encounter and the protective factors that help them withstand these demands. It is hoped that synthesising what is known in these areas will help researchers gain a deeper profundity of resilience in sport, and also provide a rigorous and robust foundation for the development of a sport-specific measure of resilience. With these points in mind, we divided the narrative into two main sections. In the first section, we review the different types of stressors encountered by sport performers under three main categories: competitive, organisational and personal. Based on our recent research examining psychological resilience in Olympics champions, in the second section we discuss the five main families of psychological factors (viz. positive personality, motivation, confidence, focus, perceived social support) that protect the best athletes from the potential negative effect of stressors. It is anticipated that this review will help sport psychology researchers examine the interplay between stressors and protective factors, which will, in turn, focus the analytical lens on the processes underlying psychological resilience in athletes.",0,0 +2782,"Psychosocial buffers of traumatic stress, depressive symptoms, and psychosocial difficulties in veterans of Operations Enduring Freedom and Iraqi Freedom: The role of resilience, unit support, and postdeployment social support","Little research has examined the role of protective factors such as psychological resilience, unit support, and postdeployment social support in buffering against PTSD and depressive symptoms, and psychosocial difficulties in veterans of Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF).A total of 272 OEF/OIF veterans completed a survey containing PTSD and depression screening measures, and questionnaires assessing resilience, social support, and psychosocial functioning.Lower unit support and postdeployment social support were associated with increased PTSD and depressive symptoms, and decreased resilience and psychosocial functioning. Path analyses suggested that resilience fully mediated the association between unit support and PTSD and depressive symptoms, and that postdeployment social support partially mediated the association between PTSD and depressive symptoms and psychosocial functioning.Generalizability of results is limited by the relatively low response rate and predominantly older and reserve/National Guard sample.These results suggest that interventions designed to bolster unit support, resilience, and postdeployment support may help protect against traumatic stress and depressive symptoms, and improve psychosocial functioning in veterans.",0,0 +2783,The Relationship Between PTSD Arousal Symptoms and Depression Among Mothers Exposed to the World Trade Center Attacks,"Posttraumatic stress disorder (PTSD) is associated with greater risk of developing comorbid depression. However, little is known about the relationship between specific PTSD symptom clusters and comorbid depression. Approximately 4 years after the World Trade Center (WTC) attacks, we examined the association between PTSD symptom clusters and depression severity among 64 mothers directly exposed to the WTC attacks. Severity scores were computed for each PTSD symptom cluster by summing symptom frequency. Partial correlations with depression severity were calculated separately for PTSD symptom clusters, controlling for demographic variables, time elapsed since the attacks, WTC attack exposure, meeting PTSD criterion A, and the other cluster scores. Higher arousal symptom cluster scores were significantly correlated with persistent depression, but the re-experiencing and avoidance symptom clusters were not. Subsequent analyses isolating shared symptoms of PTSD and depression from those unique to PTSD suggest a complex interrelationship among symptoms of arousal, numbing, and depression.",0,0 +2784,"Trauma, time and mental health: a study of temporal reintegration and Depressive Disorder among Southeast Asian refugees","Background. Prior research suggested that time splitting – suppressing the past and dissociating it from present and future – protected refugee mental health in the aftermath of catastrophe. The current study investigates temporal reintegration, defined as cognitive recapture of the past and reconnecting it with present and future, the mental health effects of temporal reintegration, and factors moderating the associated risk for Depressive Disorder. Method. A community sample of 608 Southeast Asian refugees, resettled in Vancouver British Columbia between 1979 and 1981, were interviewed on three separate occasions over a 10-year period. Participants performed a temporal orientation task and responded to questions about employment, social relations and mental health. Depressive Disorder, measured by a typology derived from Grade of Membership analysis of symptoms, constituted the dependent variable. Latent Growth Curve Analysis was used to examine both levels and rates of change in the probability of Depressive Disorder as predicted by changes in temporal reintegration, as well as the contribution of putative social and psychological moderators to explaining variations in growth parameters. Results. Time relatedness increased over the duration of the study. Temporal reintegration jeopardized mental health. Employment and relational stability each moderated the mental health effects of temporal reintegration. Conclusions. Although time splitting may be effective in coping with adversity over the short-term, eventual temporal reintegration is probably ineluctable. Stability in love and work are protective factors, mitigating the mental health vicissitudes of temporal reintegration. Implications for optimal timing of clinical interventions are discussed.",0,0 +2785,Early responding to traumatic events,"Summary How to respond optimally following traumatic events remains a Holy Grail. A number of early interventions lack evidence of effect. Practical, pragmatic support provided in an empathic manner is likely to be an appropriate initial response and complement the high levels of resilience shown by individuals exposed to traumatic events.",0,0 +2786,Sexual and Nonsexual Dating Violence Perpetration: Testing an Integrated Perpetrator Typology,"The present study tested the validity of an integrated sexual and nonsexual violence perpetrator typology outlined by Monson and Langhinrichsen-Rohling (1998) in a sample of 670 dating individuals. Two-hundred-and-sixty-five of the participants (87 men, 178 women) reported some act of sexual and/or physical dating violence perpetration in their lifetime. The data supported at least three perpetrator types, namely, the Relationship-only, Generally Violent/Antisocial, and Histrionic/Preoccupied types. Overall, these findings indicate that different factors may cause or maintain the intimate violence perpetrated within this heterogeneous population. There were important gender differences in perpetrator type membership, highlighting the differences in men's and women's use of violence. The implications of these findings are discussed with regard to the development of typologies, their application to men and women perpetrators, as well as their utility for the assessment and treatment of perpetrators.",0,0 +2787,Adverse Health Effects in African American Residents Living Adjacent to Chemical Industries,"The objective of the present study was to compare the physical and psychological health of three groups of African Americans (N = 310): acute sulfuric acid exposed, nonacute exposed, and unexposed controls. Instruments included a health questionnaire, a Toxic Symptom Checklist, the Profile of Mood States (POMS), the Post-Traumatic Stress and the Neurotoxic Anxiety scales of the MMPI-2, the Impact of Event Scale, the Symptom Check List 90-Revised (SCL 90-R), and several brief mood and personality scales. Blood pressure and pulse rates were also taken. Matching produced 51 three-way pairs. MANOVA results indicate significant effects for exposure. Significant univariate Fs (p < .05) were foundfor all the scales across the exposed groups exceptfor the Toxic Symptom category of memory/concentration, POMS depression, and 5 of the 9 SCL 90-R subscales. The t-test results using adjusted a = .0167 indicate both exposed groups had more mood and health symptoms than the controls. The acute were the most symptomatic, and both exposed groups had more respiratory problems, skin rashes, and allergies; results that are consistent with chemical exposure. Results also indicate all three groups had higher than average blood pressure, and the SCL 90-R scores for all three groups were higher than reported in the manual.",0,0 +2788,Association between flashbacks and structural brain abnormalities in posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) is reliably associated with reduced brain volume relative to healthy controls, in areas similar to those found in depression. We investigated whether in a PTSD sample brain volumes in these areas were related to reporting specific symptoms of PTSD or to overall symptom severity.Structural MRI scans were obtained from 28 participants diagnosed with PTSD according to DSM-IV-TR. Participants reported the extent of individual PTSD symptoms using the Posttraumatic Diagnostic Scale. Voxel-based morphometry applying the Dartel algorithm implemented within SPM5 was used to identify volumetric changes, related to PTSD total, symptom cluster, and individual symptom scores.Brain volume was unrelated to overall PTSD severity, but greater reexperiencing scores predicted reduced volumes in the middle temporal and inferior occipital cortices. Increased reports of flashbacks predicted reduced volume in the insula/parietal operculum and in the inferior temporal gyrus.The data illustrate the value of analyses at the symptom level within a patient population to supplement group comparisons of patients and healthy controls. Areas identified were consistent with a neurobiological account of flashbacks implicating specific abnormalities in the ventral visual stream.",0,0 +2789,Distinguishing Between Latent Classes and Continuous Factors with Categorical Outcomes: Class Invariance of Parameters of Factor Mixture Models,"Factor mixture models (FMM's) are latent variable models with categorical and continuous latent variables which can be used as a model-based approach to clustering. A previous paper covered the results of a simulation study showing that in the absence of model violations, it is usually possible to choose the correct model when fitting a series of models with different numbers of classes and factors within class. The response format in the first study was limited to normally distributed outcomes. The current paper has two main goals, firstly, to replicate parts of the first study with 5-point Likert scale and binary outcomes, and secondly, to address the issue of testing class invariance of thresholds and loadings. Testing for class invariance of parameters is important in the context of measurement invariance and when using mixture models to approximate non-normal distributions. Results show that it is possible to discriminate between latent class models and factor models even if responses are categorical. Comparing models with and without class-specific parameters can lead to incorrectly accepting parameter invariance if the compared models differ substantially with respect to the number of estimated parameters. The simulation study is complemented with an illustration of a factor mixture analysis of ten binary depression items obtained from a female subsample of the Virginia Twin Registry.",0,0 +2790,Posttraumatic stress symptom trajectories in children living in families reported for family violence,"The present study examined latent class trajectories of posttraumatic stress disorder (PTSD) and associations between demographics, prior trauma, and reason for referral on class membership. Children ages 7-18 (n=201) were recruited for participation in the Navy Family Study following reports to the U.S. Navy's Family Advocacy Program (FAP). Initial interviews were conducted 2-6 weeks following FAP referral, with follow-ups conducted at 9-12, 18-24, and 36-40 months. Growth mixture modeling revealed two latent class trajectories: a resilient class and a persistent symptom class. Relative to youth in the resilient class, participants in the persistent symptom class were more likely to be older and to report exposure to a greater number of trauma experiences at Time 1.",0,0 +2791,"PTSD symptom clusters, feelings of revenge, and perceptions of perpetrator punishment severity in victims of interpersonal violence","Feelings of revenge have often been found to correlate with symptoms of posttraumatic stress disorder (PTSD). Which PTSD symptom cluster prevails in this association is, however, unknown. Furthermore, previous studies suggest that revenge may be satisfied by perceptions of perpetrator punishment severity, but did not control for concurrent symptoms of PTSD. Therefore, this study explored associations between PTSD symptom clusters, feelings of revenge, and perceived perpetrator punishment severity in a sample of victims of interpersonal violence. Results indicated that the re-experiencing/intrusion symptom cluster was the only index of PTSD which was related to victims' feelings of revenge (n=207). Revenge correlated negatively with perceptions of punishment severity in victim who knew that the perpetrator had been sentenced, but not after adjustment for PTSD symptoms (n=96).",0,0 +2792,Understanding the pharmacokinetics of anxiolytic drugs,"Anxiety disorders are considered the most common mental disorders and they can increase the risk for comorbid mood and substance use disorders, significantly contributing to the global burden of disease. For this reason, anxiolytics are the most prescribed psychoactive drugs, particularly in the Western world.This review aims to analyze pharmacokinetic profile, plasma level variations so as the metabolism, interactions and possible relation to clinical effect of several drugs which are used primarily as anxiolytics. The drugs analyzed include benzodiazepines, anticonvulsants (pregabalin, gabapentin), buspirone, β-blockers and antihistamines (hydroxyzine). Regarding the most frequently used anxiolytic benzodiazepines, data on alprazolam, bromazepam, chlordesmethyldiazepam, chlordiazepoxide, clotiazepam, diazepam, etizolam, lorazepam, oxazepam, prazepam and clonazepam have been detailed.There is a need for a more balanced assessment of the benefits and risks associated with benzodiazepine use, particularly considering pharmacokinetic profile of the drugs to ensure that patients, who would truly benefit from these agents, are not denied appropriate treatment. An optimal pharmacological approach involving an integrative pharmacokinetic and pharmacodynamic optimization strategy would ensure better treatment and personalization of anxiety disorders. So it would be desirable for the development of new anxiolytic drug(s) that are more selective, fast acting and free from the unwanted effects associated with the traditional benzodiazepines as tolerance or dependence.",0,0 +2793,Quantifying Resilience to Enhance Individualized Training,"Resilience is the human ability to adapt in the face of tragedy, trauma, adversity, hardship, and ongoing life stressors. To date, experimental reports on this subject have focused on long-term trajectories (weeks to months) of resilience, with little or no focus on whether significant changes to resilience could be achieved by short-term interventions. Currently, an individual’s resilience is defined either by self-report or by behavioral changes such as the development of depression, post-traumatic stress disorder, or suicide. We propose that the quantification of an individual’s physiological and behavioral response to stress under controlled conditions is an indication of the individual’s level of resilience. To address such real-time resilience, we propose the first in a series of studies to evaluate real-time human resilience by exposing participants to controlled stressors while assessing the stress response. Activation of the hypothalamus-pituitary-adrenal cortex axis and sympathetic branch of the autonomic nervous system via monitoring of the pupil constriction, heart and respiration rate, muscle tonicity, salivary cortisol, and electrodermal activity will be assessed. Stress exposure will consist of virtual stressors presented using Virtual Battlespace 2 software-based scenarios, such as noise exposure, time pressure, and emotion-induction tasks, as well as external stressors such as socio-evaluative stress via the Trier social stress task, while evaluating decision-making and performance. The relationship between performance and the physiological stress response will be quantified, including the creation of a series of stress-performance trajectories based upon individual differences. Such an analysis is similar to probing for resilience in material testing, in which a load is applied to a candidate material, and the resulting forces and observable changes in dimension are quantified and reported via stress-strain curves. Ongoing studies will examine how this resilience measure may be integrated into a closed-loop training system to provide appropriate coping strategies to optimize resilience training. Such training programs, which take into account individual perceptions of stressors and physiological responses, are expected to be effective in helping trainees develop resiliency during high-stress operations.",0,0 +2794,Premorbid combat related ptsd in Huntington's disease - Case report.,"Huntington's disease (HD) is a neurodegenerative, autosomal dominant disease that manifests with a triad of symptom clusters including movement disorder, cognitive impairment and psychiatric symptoms. We present a patient with HD who, prior to developing neurological signs and symptoms, had been exposed to war trauma and had developed posttraumatic stress disorder. Fifteen years later he manifested with dysarthria, difficulties with swallowing and involuntary movement. What brought him to psychiatrist was a heteroanamnestically noticed change in personality with irritable mood, impulsivity, aggressive outbursts in behavior and delusional ideation. Therapy was stared with haloperidol, but patient developed severe extrapiramidal side effects. Subsequent treatment with olanzapine, diazepam and omega 3 fatty acids lead to mood stabilization and better impulse control with even some improvement in motoric symptoms. To our knowledge, this is the first case report on combat related PTSD as psychiatric disorder manifested prior to HD. We discuss a possible influence of psychological stress disorder on severity of psychiatric symptoms in the HD. The importance of personalized approach in both psychopharmacological and psychotherapeutical treatment of patients with HD is emphasized. If the influence of environmental stress on the psychiatric phenotype of the disease should be confirmed by clinical trials and further studies, both screening methods and interventions aimed to reduce psychological stress in carriers of Huntington gene could be considered.",0,0 +2795,[Sleep electroencephalography in depression and mental disorders with depressive comorbidity].,"Traditional scoring of sleep EEG in depressed patients shows abnormalities in sleep maintenance, sleep architecture, REM sleep, the distribution of slow wave and REM sleep during the night. Computerized analysis that comprises the period-amplitude analysis procedure and spectral analysis discloses changes in delta activity and distribution of delta activity. However, these methods of analysing EEG sleep are not able to distinguish the various concepts of depression: endogenous and non-endogenous depression, unipolar and bipolar depression, psychotic and non-psychotic depression. Polysomnographical data in patients with recurrent depression show alteration during remission suggesting trait-like abnormalities of sleep in depression illness. Shortened REM latency is not specific in depression. This sleep parameter is defined in many different ways explaining the heterogeneousness of study results and the failure of constituting a biological marker. Many sleep parameters are affected by several factors such as age, gender and severity. Several physiopathological hypotheses have been proposed to explain EEG sleep alterations. They refer either to circadian rhythms such as the two process model of Borbély, the phase advance hypothesis and the circadian amplitude hypothesis, or to neurotransmitter abnormalities such as the cholinergic hypothesis. None of them takes sufficient account of all the sleep abnormalities. Sleep abnormalities have also been described in other psychiatric disorders such as mania, panic and obsessional-compulsive disorders, generalized anxiety, phobias, post-traumatic stress disorder, eating disorders, borderline personality, schizophrenia and dementia. None of them have a particular sleep EEG profile which allows to differentiate between them. A concomitant episode of major depression cannot be uncovered by sleep recordings.",0,0 +2796,Traumatic Stress Disorders in Children and Adolescents,"Abstract Many children and adolescents who experience potentially traumatic events, such as natural disasters, acts of violence, physical injuries, child abuse, and life-threatening medical illnesses, display significant stress symptoms. In fact, these potentially traumatic events can lead to the development of acute stress disorder (ASD) and/or posttraumatic stress disorder (PTSD) and cause significant psychological impairment. In this chapter, we discuss the types of potentially traumatic events that lead to ASD or PTSD in youth, as well as various aspects of trauma exposure. We next review available evidence on the definition, prevalence, and course of ASD and PTSD in youth, and the risk factors associated with their development. To date, relatively few studies have examined ASD and existing evidence calls into question the validity of dissociative symptoms as part of the existing ASD diagnostic criteria for youth. In contrast, many studies have evaluated PTSD and its symptoms in youth exposed to trauma, although PTSD prevalence rates vary substantially depending on a host of factors, including the type of traumatic event experienced, the degree of exposure to the event, and the informant for PTSD symptoms, among other factors. We also discuss developmental considerations for the ASD and PTSD diagnoses and directions for future research. The chapter closes with a brief summary of proposed changes to the diagnostic criteria for ASD and PTSD in youth that are being considered for the DSM-5.",0,0 +2797,Improved Sleep in Military Personnel is Associated with Changes in the Expression of Inflammatory Genes and Improvement in Depression Symptoms,"Sleep disturbances are common in military personnel and are associated with increased risk for psychiatric morbidity, including posttraumatic stress disorder (PTSD) and depression, as well as inflammation. Improved sleep quality is linked to reductions in inflammatory bio-markers; however, the underlying mechanisms remain elusive.In this study, we examine whole genome expression changes related to improved sleep in 68 military personnel diagnosed with insomnia. Subjects were classified into the following groups and then compared: improved sleep (n = 46), or non-improved sleep (n = 22) following three months of standard of care treatment for insomnia. Within subject differential expression was determined from microarray data using the Partek Genomics Suite analysis program and the ingenuity pathway analysis (IPA) was used to determine key regulators of observed expression changes. Changes in symptoms of depression and PTSD were also compared.At baseline, both groups were similar in demographics, clinical characteristics, and gene-expression profiles. The microarray data revealed that 217 coding genes were differentially expressed at the follow-up-period compared to baseline in the participants with improved sleep. Expression of inflammatory cytokines were reduced including IL-1β, IL-6, IL-8, and IL-13, with fold changes ranging from -3.19 to -2.1, and there were increases in the expression of inflammatory regulatory genes including toll-like receptors 1, 4, 7, and 8 in the improved sleep group. IPA revealed six gene networks, including ubiquitin, which was a major regulator in these gene-expression changes. The improved sleep group also had a significant reduction in the severity of depressive symptoms.Interventions that restore sleep likely reduce the expression of inflammatory genes, which relate to ubiquitin genes and relate to reductions in depressive symptoms.",0,0 +2798,Surviving the ICU Does Not Mean That the War Is Over,,0,0 +2799,Television Exposure in Children after a Terrorist Incident,"This study examined the influence of bomb-related television viewing in the context of physical and emotional exposure on posttraumatic stress symptoms--intrusion, avoidance, and arousal--in middle school students following the 1995 Oklahoma City bombing. Over 2,000 middle school students in Oklahoma City were surveyed 7 weeks after the incident. The primary outcome measures were the total posttraumatic stress symptom score and symptom cluster scores at the time of assessment. Bomb-related television viewing in the aftermath of the disaster was extensive. Both emotional and television exposure were associated with posttraumatic stress at 7 weeks. Among children with no physical or emotional exposure, the degree of television exposure was directly related to posttraumatic stress symptomatology. These findings suggest that television viewing in the aftermath of a disaster may make a small contribution to subsequent posttraumatic stress symptomatology in children or that increased television viewing may be a sign of current distress and that it should be monitored. Future research should examine further whether early symptoms predict increased television viewing and/or whether television viewing predicts subsequent symptoms.",0,0 +2800,ESTIMATING UNKNOWN KNOTS IN PIECEWISE LINEAR-LINEAR LATENT GROWTH MIXTURE MODELS,"A piecewise linear-linear latent growth mixture model (LGMM) combines features of a piecewise linear-linear latent growth curve (LGC) model with the ideas of latent class methods all within a structural equation modeling (SEM) context. A piecewise linear-linear LGMM is an appropriate framework for analyzing longitudinal data that come from a mixture of two or more subpopulations (i.e., latent classes) where each latent class incorporates a separate growth trajectory corresponding to multiple growth phases from which repeated measurements arise. The benefit of the model is that it allows the specification of each growth phase to conform to a particular form of overall change process within each latent class thereby making these models flexible and useful for substantive researchers. There are two main objectives of this current study. The first objective is to demonstrate how the parameters of a piecewise linear-linear LGMM, including the unknown knot, can be estimated using standard SEM software. A series of Monte Carlo simulations empirically investigated the ability of piecewise linear-linear LGMMs to recover true (known) growth parameters of distinct populations. Specifically, the current research compared the performance of the piecewise linear-linear LGMM under different manipulated conditions of (1) sample size, (2) class mixing proportions, (3) class separation of location of knot, (4) the mean of the slope growth factor of the second phase, (5) the variance of the slope growth factor of the second phase, and (6) residual variance of the observed variables. The second objective is to address the issue of model mis-specification. It is important to analyze this issue because applied researchers have to make model selection decisions. Therefore, the current research examined the possibility of extracting spurious latent classes. To achieve this objective 1-, 2-, and 3-class piecewise linear-linear LGMMs were fit to data sets generated under different manipulated conditions using a 2-class piecewise linear-linear LGMM as a population model. The number of times the correct model (i.e., 2-class piecewise linear-linear LGMM) was preferred over incorrect models (i.e., 1- and 3-class piecewise linear-linear LGMMs) using the Bayesian Information Criterion (BIC) was examined. Results suggested that the recovery of model parameters, specifically, the variances of growth factors were generally poor. In addition, none of the manipulated conditions were systematically related to the outcome measures, parameter bias and variability index of parameter bias. Furthermore, among all the manipulated conditions, the residual variance of observed variable had the strongest statistically significant effect on both the model convergence rate and the model selection rate. Other manipulated conditions that had an impact on the model convergence rate and/or the model selection rate were the growth factor mean of slope of the second phase, the growth factor variance of slope of the second phase, and the class mixing proportion. The manipulated conditions whose levels had no influence on either the model convergence rate or the model selection rate were sample size and the class separation of location of knot. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +2801,d-Cycloserine administered directly to infralimbic medial prefrontal cortex enhances extinction memory in sucrose-seeking animals,"d-Cycloserine (DCS), a co-agonist at the N-methyl-D-aspartate (NMDA) receptor, has proven to be an effective adjunct to cognitive behavioral therapies that utilize extinction. This pharmacological-based enhancement of extinction memory has been primarily demonstrated in neuropsychiatric disorders characterized by pathological fear (e.g. posttraumatic stress disorder and various phobias). More recently, there has been an interest in applying such a strategy in the disorders of appetitive learning (e.g. substance abuse and other addictions), but these studies have generated mixed results. Here we first examined whether extinction memory encoding in a sucrose self-administration model is dependent on NMDA receptors. The NMDA antagonist (±)-3-(2-carboxypiperazin-4-yl)propyl-1-phosphonic acid (5mg/kg, i.p.) administered 2h prior to the first extinction training session effectively inhibited extinction memory recall 24h later, without affecting the expression of the conditioned sucrose-seeking response while the drug was on board. This profile of effects suggests a specific effect on extinction memory consolidation. Next, we sought to enhance extinction memory using the co-agonist DCS (10 μg/side) by infusion directly into infralimbic medial prefrontal cortex, a brain site implicated in extinction memory recall in conditioned fear models. Indeed, infusion of DCS immediately after the first extinction training session effectively enhanced extinction memory recall 24h later. Collectively, these data suggest that the neurobiological mechanisms and the neurocircuitry mediating extinction memory are similar regardless of the valence (aversive or appetitive) of the conditioned behavior, and that similar pharmacological strategies for treatment may be applied to neuropsychiatric disorders characterized by a failure to inhibit pathological emotional memories.",0,0 +2802,Incubation of conditioning-specific reflex modification: Implications for post traumatic stress disorder,"Incubation of fear has been used to account for the delayed manifestation of symptoms of fear and anxiety including the delayed onset of Post Traumatic Stress Disorder (PTSD). We have shown the utility of classical conditioning-specific modification of the rabbit nictitating membrane response (NMR) as a model of PTSD. This modification includes an exaggeration in the size and a change in the timing of the unconditioned NMR after several days of classical conditioning. To assess the effects of incubation on conditioning-specific modification, we measured changes in responding as a function of the time between classical conditioning and NMR testing. After just one day of classical conditioning resulting in modest levels of learning, increases in response size were an inverted-U shaped function of days of incubation with little if any change occurring one and ten days after training but significant change occurring after six days. The incubation effect persisted for a week. An unpaired control group showed no change in the size of the response confirming the incubation effect was associative. The results bear a striking resemblance to symptoms of PTSD that do not always occur immediately after trauma and become exacerbated over time and then persist. They point to a window when incubation can exacerbate symptoms and speak to the vulnerability of re-experiencing trauma too soon. This could be a serious problem for military or emergency personnel recalled to combat or a disaster site without sufficient time to deal with the effects of their initial experiences.",0,0 +2803,Increased response variability as a marker of executive dysfunction in veterans with post-traumatic stress disorder,"The stability of cognitive control processes over time can be indexed by trial-to-trial variability in reaction time (RT). Greater RT variability has been interpreted as an indicator of executive dysfunction, inhibitory inefficiency, and excessive mental noise. Previous studies have demonstrated that combat veterans with post-traumatic stress disorder (PTSD) show substantial impairments in inhibitory control, but no studies have examined response variability in this population. In the current experiment, RT variability in the Go/NoGo response inhibition task was assessed for 45 veterans with PTSD and 34 control veterans using the intra-individual coefficient of variation (ICV) and ex-Gaussian analysis of RT distributions. Despite having mean RTs that were indistinguishable from controls, the PTSD patients had significantly greater RT variability as measured by ICV. More variable RTs were in turn associated with a greater number of false alarm errors in the patients, suggesting that less consistent performers were less successful at inhibiting inappropriate responses. RT variability was also highly correlated with self-reported symptoms of PTSD, depression, and attentional impulsiveness. Furthermore, response variability predicted diagnosis even when controlling for PTSD symptom severity. In turn, PTSD severity was correlated with self-rated attentional impulsiveness. Deficits in the top-down cognitive control processes that cause greater response variability might contribute to the maintenance of PTSD symptomology. Thus, the distractibility issues that cause more variable reaction times might also result in greater distress related to the trauma.",0,0 +2804,Theoretical perspectives of traumatic stress and debriefings,"The purpose of this article was to attempt to identify and examine the core set of elements or factors which are germane to understanding the process and effects of traumatic stress and psychological debriefings. Before these factors are addressed, relevant questions regarding the nature, level of care, and implementation of debriefings are raised. A person-environment interactional model is used to explain the typologies of traumatic events and stressor dimensions. Factors considered fundamental to crisis response, goals common to debriefings, and the need to recognize the diversity of traumatic events are then reviewed.",0,0 +2805,A nationwide US study of post-traumatic stress after hospitalization for physical injury,"ABSTRACT Background Injured survivors of individual and mass trauma are at risk for developing post-traumatic stress disorder (PTSD). Few investigations have assessed PTSD after injury in large samples across diverse acute care hospital settings. Method A total of 2931 injured trauma survivors aged 18–84 who were representative of 9983 in-patients were recruited from 69 hospitals across the USA. In-patient medical records were abstracted, and hospitalized patients were interviewed at 3 and 12 months after injury. Symptoms consistent with a DSM-IV diagnosis of PTSD were assessed with the PTSD Checklist (PCL) 12 months after injury. Results Approximately 23% of injury survivors had symptoms consistent with a diagnosis of PTSD 12 months after their hospitalization. Greater levels of early post-injury emotional distress and physical pain were associated with an increased risk of symptoms consistent with a PTSD diagnosis. Pre-injury, intensive care unit (ICU) admission [relative risk (RR) 1·17, 95% confidence interval (CI) 1·02–1·34], pre-injury depression (RR 1·33, 95% CI 1·15–1·54), benzodiazepine prescription (RR 1·46, 95% CI 1·17–1·84) and intentional injury (RR 1·32, 95% CI 1·04–1·67) were independently associated with an increased risk of symptoms consistent with a PTSD diagnosis. White injury survivors without insurance demonstrated approximately twice the rate of symptoms consistent with a diagnosis of PTSD when compared to white individuals with private insurance. By contrast, for Hispanic injury survivors PTSD rates were approximately equal between uninsured and privately insured individuals. Conclusions Nationwide in the USA, more than 20% of injured trauma survivors have symptoms consistent with a diagnosis of PTSD 12 months after acute care in-patient hospitalization. Coordinated investigative and policy efforts could target mandates for high-quality PTSD screening and intervention in acute care medical settings.",0,0 +2806,The Interactive Effect of Worry and Intolerance of Uncertainty on Posttraumatic Stress Symptoms,"In this study, relations among worry, intolerance of uncertainty (IU), and posttraumatic stress symptoms (PTSS) were examined in N = 89 participants with a trauma history. Both worry and IU shared significant zero-order correlations with each of the three DSM-IV posttraumatic stress symptom clusters. Partial correlations, controlling for the overlap among the symptom clusters, suggested that both worry and IU shared unique associations only with hyperarousal. Finally, and consistent with predictions, IU moderated the relation between worry and PTSS. When examining each PTSS cluster separately, evidence of the moderating role of IU was found only in relation to hyperarousal. More specifically, simple effects revealed that worry had a significant positive association with PTSS and hyperarousal only at high levels of IU. These findings suggest a specific risk profile of high worry in conjunction with high IU for the development and maintenance of PTSS, with particular relevance to hyperarousal symptoms. Conceptual and practical implications of these findings regarding common PTSD treatment approaches are discussed. © 2012 Springer Science+Business Media New York.",0,0 +2807,Intolerance of Uncertainty and PTSD Symptoms: Exploring the Construct Relationship in a Community Sample with a Heterogeneous Trauma History,"Intolerance of uncertainty has received substantial empirical attention in recent years. The contribution of intolerance of uncertainty to the development and maintenance of anxiety disorders has become increasingly recognized by researchers; however, relationships between intolerance of uncertainty and symptoms of posttraumatic stress disorder remain largely unexplored. As part of a larger study, North American community members (n = 122, 81 % women) with a heterogeneous trauma history completed self-report measures assessing intolerance of uncertainty and its dimensions (inhibitory and prospective intolerance of uncertainty) and posttraumatic stress disorder symptoms (re-experiencing, avoidance, numbing, hyperarousal). Intolerance of uncertainty total scores accounted for statistically significant variance in each posttraumatic stress disorder symptom score except re-experiencing. Inhibitory intolerance of uncertainty scores accounted for statistically significant variance in each posttraumatic stress disorder symptom score except re-experiencing. Prospective intolerance of uncertainty scores did not account for statistically significant variance in any of the posttraumatic stress disorder symptom scores. Results suggest that intolerance of uncertainty relates differentially to posttraumatic stress disorder symptom clusters and inhibitory intolerance of uncertainty appears to be the main component of the relationship. © 2013 Springer Science+Business Media New York.",0,0 +2808,"Diagnostic, demographic, memory quality, and cognitive variables associated with acute stress disorder in children and adolescents.","To date, no studies have investigated factors associated with acute stress disorder (ASD) in children and adolescents. Relationships between ASD and a number of demographic, trauma, cognitive, and trauma memory variables were therefore investigated in a sample (N=93) of children and adolescents involved in assaults and motor vehicle accidents. Several cognitive variables and the quality of trauma memories, but not demographic or trauma variables, were correlated with ASD and also mediated the relationship between peritraumatic threat and ASD. Finally, nosological analyses comparing ASD with indexes of posttraumatic stress disorder in the month posttrauma revealed little support for the dissociation mandate that uniquely characterizes ASD. The results are discussed with respect to assessment and treatment for the acute traumatic stress responses of children and young people.",0,0 +2809,The Structure of Maladaptive Schemas: A Confirmatory Factor Analysis and a Psychometric Evaluation of Factor-Derived Scales,"One thousand and thirty-seven psychiatric patients and non-patients from six different sites completed the 205-item Young Schema Questionnaire or its shortended form, the 75-item Young Schema Questionnaire-S. Among 888 of the subjects, who all were patients, a confirmatory factor analysis (CFA) of the 75 items included in both forms of the questionnaire clearly yielded the 15 Early Maladaptive Schema (EMS) factors rationally developed by J. E. Young (1990). Confirmatory factor analyses, testing three models of the higher-order structure of the 15 EMSs, indicated that a four-factor model was the best alternative. The results slightly favored a correlated four second-order factor model over one also including a third-order global factor. The four factors or schema domains were Disconnection, Impaired Autonomy, Exaggerated Standards, and Impaired Limits. Scales derived from the four higher-order factors had good internal and test-retest reliabilities and were related to DSM-IV Cluster C personality traits, agoraphobic avoidance behavior, and depressive symptoms. (",0,0 +2810,[Less severe sexual child abuse and its sequelae: are there different psychic and psychosomatic symptoms in relation to various forms of sexual interaction?].,"A typology of less severe sexual encounters was used to analyze short and long term sequelae of sexual abuse via intimate skin contact. Well known theoretical approaches on the harmful effects of sexual abuse were tested. Do we find different peri- and posttraumatic reactions dependent upon varied forms of sexual interactions with children? A cluster analysis was calculated with symptom variables that were described in 141 child statements taken out of written expert opinions. Afterwards variance analyses of these symptom clusters were conducted in reference to six different abuse constellations. Different symptom profiles were found for these six abuse constellations. Panic symptoms, shame related feelings, avoidant behavior and physical reactions showed significant results. The sequelae to different forms of less severe sexual child abuse differ and depend more upon the situational dynamic than upon the kind of relationship between adult and child.",0,0 +2811,Pre-attack symptomatology and temperament as predictors of children's responses to the September 11 terrorist attacks,"The aims of this study were to assess the psychological response of children following the September 11, 2001 terrorist attacks in New York and Washington, DC and to examine prospective predictors of children's post-attack responses.Children's responses were assessed in a community sample of children in Seattle, Washington, participating in an ongoing study. Symptomatology and temperament assessed prior to the attacks were examined as prospective predictors of post-attack post-traumatic stress (PTS), anxiety, depression and externalizing problems.Children demonstrated PTS symptoms and worries at levels comparable to those in children directly experiencing disasters, with 77% of children reporting being worried, 68% being upset by reminders, and 39% having upsetting thoughts. The most common PTS symptom cluster was re-experiencing, and 8% of children met criteria consistent with PTSD. African-American children reported more avoidant PTS symptoms and being more upset by the attacks than European-American children. Girls reported being more upset than boys. Prior internalizing, externalizing, social competence and self-esteem were related to post-attack PTS; and child inhibitory control, assessed prior to the 9/11 attacks, demonstrated a trend towards an association with post-attack PTS symptoms controlling for prior levels of symptomatology. PTS predicted child-report anxiety and conduct problem symptoms at follow-up, approximately 6 months after 9/11.Children experiencing a major disaster at a distance or indirectly through media exposure demonstrated worries and PTS symptoms suggesting that communities need to attend to children's mental health needs in response to national or regional disasters. Pre-disaster symptomatology or low self-regulation may render children more vulnerable in response to a disaster, and immediate post-disaster responses predict subsequent symptomatology. These variables might be used in the identification of children in need of intervention.",0,0 +2812,Pavlovian eyeblink conditioning in combat veterans with and without post-traumatic stress disorder,"Several recent studies have investigated relationships between post-traumatic stress disorder (PTSD) and learning and memory problems. These reports have found in general that not only does PTSD affect trauma-related memories, but when patients with PTSD are compared with similar trauma patients without PTSD, general memory impairments have been found. The present paper reports a study in which associative learning, using Pavlovian eyeblink conditioning, was investigated in combat veterans with and without chronic PTSD, using interstimulus intervals of 500 and 1000 msec in two separate experiments. Although several recent reports suggest that larger-magnitude autonomic conditioned responses occur in patients with PTSD during Pavlovian conditioning, the present study found evidence of impaired Pavlovian eyeblink conditioning in combat veterans with and without PTSD, compared to non-combat veterans. Although these data suggest that combat leads to an impaired associative learning process regardless of whether PTSD is apparent, a group of community-dwelling combat veterans not under medical treatment showed normal conditioning, suggesting that variables other than prior combat must also be involved.",0,0 +2813,The role of alcohol misuse in PTSD outcomes for women in community treatment: a secondary analysis of NIDA's Women and Trauma Study.,"Individuals with comorbid substance use and posttraumatic stress disorder may differentially benefit from integrated trauma-focused interventions based on specific presenting characteristics such as substance use type and PTSD severity. The current study is a secondary analysis of a NIDA Clinical Trials Network study exploring the effectiveness of two interventions for women with comorbid PTSD and substance use disorders.Generalized estimating equations were used to examine the association of baseline alcohol misuse with PTSD outcome measures over time for all randomized participants.Women entering treatment with baseline alcohol misuse had higher Post Traumatic Stress Disorder Symptom Scale (PSS-SR) total scores (t=2.43, p<.05), cluster C (avoidance/numbing) scores (t=2.63, p<.01), and cluster D (hyper-arousal) scores (t=2.31, p<.05). For women with alcohol misuse, after treatment week 1, PSS-SR scores were significantly lower in the Seeking Safety intervention during treatment (chi(2)(1)=4.00, p<.05) and follow-up (chi(2)(1)=4.87, p<.05) compared to those in the health education intervention. Alcohol misusers in the Seeking Safety group who had higher baseline hyper-arousal severity improved more quickly than those with lower baseline hyper-arousal severity during treatment (chi(2)(1)=4.06, p<.05).These findings suggest that the type of substance abuse at treatment entry may inform treatment selection, predict treatment response among those with co-occurring PTSD and substance use disorders, and indicate a more severe clinical picture.",0,0 +2814,"The dimensional structure of posttraumatic stress symptomatology in 323,903 U.S. veterans","There is ongoing debate regarding the optimal dimensional structure of posttraumatic stress disorder symptomatology. A better understanding of this structure has significant implications, as it can provide more refined phenotypic measures for use in studies of the etiology and neurobiology of PTSD, as well as for use as endpoints in treatment studies of this disorder. In this study we analyzed the dimensional structure of PTSD symptomatology, as assessed using the PTSD Symptom Checklist-Military Version in 323,903 Veterans. Confirmatory factor analyses were used to compare two 4-factor models and a newly proposed 5-factor model to the 3-factor DSM-IV model of PTSD symptom dimensionality. To evaluate the external validity of the best-fitting model, we then conducted a structural equation model examining how the symptom dimensions of this model related to diagnoses of depression, anxiety, and substance use disorder. Results indicated that a newly proposed 5-factor ‘dysphoric arousal’ model comprised of separate re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal symptom clusters provided a significantly better fit to the data compared to the DSM-IV and the two alternative four-factor models. External validity analyses revealed that numbing symptoms were most strongly related to diagnoses of depression and substance use disorder, and that dysphoric arousal symptoms were most strongly related to a diagnosis of anxiety disorder. Thus the dimensional structure of PTSD may be best represented by five symptom dimensions. The clinical implications of these results and implications for further refinement of extant PTSD assessment instruments are discussed.",0,0 +2815,Increased Prefrontal Cortical Thickness Is Associated with Enhanced Abilities to Regulate Emotions in PTSD-Free Women with Borderline Personality Disorder,"Previous studies suggest that amygdala, insula and prefrontal cortex (PFC) disintegrity play a crucial role in the failure to adequately regulate emotions in Borderline Personality Disorder (BPD). However, prior results are confounded by the high rate of comorbidity with Posttraumatic Stress Disorder (PTSD), which itself has been associated with changes in frontolimbic circuitry. We thus scrutinized the link between PFC, amygdala, insula, and the ability to regulate emotions, contrasting 17 women with BPD without comorbid PTSD to 27 non-clinical control women and in addition to those with BPD and PTSD (n = 14). BPD women without PTSD, but not those with comorbid PTSD, had increased cortical thickness in the dorsolateral PFC (DLPFC) in comparison to control women. Furthermore, cortical thickness in the DLPFC of BPD women without PTSD positively correlated with emotion regulation scores and furthermore was positively associated with amygdala volume, as well as cortical thickness of the insula. Our findings highlight the importance of disentangling the impact of BPD and PTSD on the brain and suggest possible compensatory mechanisms for the impaired emotion regulation in BPD women without PTSD.",0,0 +2816,Aftermaths of combat stress reactions: A three-year study,"The current study provides an overview of a study assessing the psychological and somatic health adjustment of Lebanon War veterans one, two and three years after the war, comparing combat stress reactions (CSR) casualties with controls. Findings indicated that combat-related psychopathology was overwhelmingly more prevalent among CSR casualties than among their matched controls one, two and three years after war. In addition, the passage of time had no effect on the relative psychiatric symptomatology, social functioning, self-efficacy, and somatic complaints in either of the two study groups. This stable mental health status of the CSR casualty over the three years of the study contrasts with the observed decline in trauma-related distress in the third year. Results are discussed in terms of the emotional sequelae of war trauma.",0,0 +2817,"Posttraumatic stress disorder symptoms among low-income, African American women with a history of intimate partner violence and suicidal behaviors: Self-esteem, social support, and religious coping","There is a dearth of research on risk/protective factors for posttraumatic stress disorder (PTSD) among low-income African American women with a history of intimate partner violence (IPV), presenting for suicidal behavior or routine medical care in a large, urban hospital. We examined self-esteem, social support, and religious coping as mediators between experiences of child maltreatment (CM) and IPV and symptoms of PTSD in a sample (N = 134) of low-income African American women. Instruments used included the Index of Spouse Abuse, the Childhood Trauma Questionnaire, the Taylor Self-Esteem Inventory, the Multidimensional Profile of Social Support, the Brief Religious Coping Activities Scale, and the Davidson Trauma Scale. Both CM and IPV related positively to PTSD symptoms. Risk and resilience individual difference factors accounted for 18% of the variance in PTSD symptoms over and above IPV and CM, with self-esteem and negative religious coping making unique contributions. Both variables mediated the abuse-PTSD symptom link. In addition, we tested an alternate model in which PTSD symptoms mediated the relationship between abuse and both self-esteem and negative religious coping.",0,0 +2818,Police officers: a high-risk group for the development of mental health disturbances? A cohort study,"Policing is generally considered a high-risk profession for the development of mental health problems, but this assumption lacks empirical evidence. Research question of the present study is to what extent mental health disturbances, such as (very) severe symptoms of anxiety, depression and hostility are more prevalent among police officers than among other occupational groups.Multicomparative cross-sectional study using the data of several cross-sectional and longitudinal studies in the Netherlands.Two samples of police officers (N=144 and 503), employees of banks (N=1113) and employees of banks who were robbed (N=144); employees of supermarkets (N=335), and a psychiatric hospital (N=219), employees of a governmental social welfare organisation (N=76), employees who followed a training based on rational-motive therapy to strengthen their assertiveness (N=710), soldiers before deployment (N=278) and before redeployment (N=236) and firefighters (N=123). The numbers refer to respondents with complete data.Prevalence of severe (subclinical level) and very severe symptoms (clinical level) were computed using the Dutch norm tables (80th percentile and 95th percentile, respectively) of the Symptom Check List Revised (SCL-90-R). All comparisons were controlled for age, gender and education.Multivariate logistic regression and analyses showed that the prevalence of clinical and subclinical levels of symptoms of anxiety, depression and hostility among police officers were not significantly higher than among comparison groups. The same pattern was found for the other SCL-90-R subscales.We found no indications that self-reported mental health disturbances were more prevalent among police officers than among groups of employees that are not considered high-risk groups, such as employees of banks, supermarkets, psychiatric hospital and soldiers before deployment.",0,0 +2819,A Study of Symptoms of the Post-traumatic Stress Disorder and Its Related Factors in Adolescents after the Wenchuan Earthquake,"Objective:To investigate the related factors of post-traumatic stress disorder(PTSD) among adolescents in different areas after the Wenchuan Earthquake.Methods:With Revised Impact of Events Scale for Children(CRIES-13) and self made survey,1267 students in the extremely severe disaster areas in Mianzhu,Sichuan province and the severe disaster areas in Baoji,Shaanxi were tested.Results:The extent of disaster exposure in Mianzhu was significantly higher than that in Baoji.However,there was no difference in the extent of PTSD symptoms between the two areas(t=0.181,df=1265,P=0.857),but only significant difference in the incidence rate(χ2=8.766,df=1,P=0.003),and the incidence rate of PTSD in Mianzhu areas was significantly higher than that of Baoji areas.Conclusion:5·12 Wenchuan earthquake has caused severe post-traumatic response in adolescents both in the extremely severe disaster areas and the severe disaster areas,but the former is higher in the incidence rate of PTSD,and age,sex,getting trapped in the earthquake,having relatives and friends injured in the earthquake,witnessing death in the earthquake were all significant predictors for PTSD severity.",0,0 +2820,Differential roles of childhood adversities and stressful war experiences in the development of mental health symptoms in post-war adolescents in northern Uganda,"BackgroundPrevious studies have shown a relationship between stressful war experiences and mental health symptoms in children and adolescents. To date, no comprehensive studies on the role of childhood adversities have been conducted with war-exposed adolescents living in post-war, low-resource settings in Sub-Saharan Africa.MethodsA cross-sectional study of 551 school-going adolescents aged 13-21 years old was undertaken four years post-war in northern Uganda. Participants completed self-administered questionnaires assessing demographics, stressful war experiences, childhood adversities, posttraumatic stress disorder (PTSD), depression, and anxiety symptoms.ResultsOur analyses revealed a main effect of gender on all mental health outcomes except avoidance symptoms, with girls reporting higher scores than boys. Stressful war experiences were associated with all mental health symptoms, after adjusting for potential confounders. Childhood adversity was independently associated with depression symptoms but not PTSD, anxiety, and PTSD cluster symptoms. However, in situations of high childhood adversity, our analyses showed that stressful war experiences were less associated with vulnerability to avoidance symptoms than in situations of low childhood adversity.ConclusionsBoth stressful war experiences and childhood adversities are risk factors for mental health symptoms among war-affected adolescents. Adolescents with histories of high childhood adversities may be less likely to develop avoidance symptoms in situations of high stressful war experiences. Further exploration of the differential roles of childhood adversities and stressful war experiences is needed.",0,0 +2821,Physical Health and Posttraumatic Stress Disorder Symptoms in Women Experiencing Intimate Partner Violence,"This correlational-predictive study addresses the associations between intimate partner violence (IPV) and physical health and posttraumatic stress disorder (PTSD) symptoms, including: 1) detailed physical health symptoms reported and health care sought by women in intimate abusive relationships, 2) relationships between physical health symptoms, IPV, and PTSD, and 3) unique predictors of physical health symptoms. An ethnically diverse sample of 157 abused women was recruited from crisis shelters and the community. The women averaged almost 34 years of age and had been in the abusive relationship for slightly more than 5 years. The women experienced physical health symptoms falling into 4 groups: neuromuscular, stress, sleep, and gynecologic symptoms. Women experiencing more severe IPV reported more physical health and PTSD symptomatology. PTSD avoidance and threats of violence or risk of homicide uniquely predicted physical health. More than 75% of the women had sought treatment from a health care professional in the previous 9 months. Implications for practice are discussed.",0,0 +2822,An Expressive Arts Therapy Model with Groups for Post-Traumatic Stress Disorder.,"(from the chapter) This chapter sets forth a model of group treatment for children who have been impacted by abuse and neglect. This model of group therapy was developed for a population of children aged between 9 and 12. An overview of group therapy theory precedes a brief review of my integration of recent trauma research with direct clinical practice in the field. This research has served as a foundation for the treatment model as well as a rationale for the use of expressive arts and play therapy with children who have developed post-traumatic stress disorder symptoms (PTSD). A case example will be presented to demonstrate how theory and practice can be integrated. The remainder of the chapter focuses on the specifics of this particular treatment model. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +2823,"Psychological consequences of trauma in MVA perpetrators – Relationship between post-traumatic growth, PTSD symptoms and individual characteristics","The study explores two problems rarely discussed in literature. Firstly, it presents the psychological consequences of traumatic stress in perpetrators of motor vehicle accidents (MVAs). The attention of both clinicians and researchers is very seldom focused on this group of MVA participants, as in the natural way, people have a tendency to empathise with victims and distancing from those who make harm to others. MVA perpetrators usually feel no right to complain about experienced symptoms of poor well-being, and guilt prevent them against searching for any help. Such a situation may lead to further problems related to traffic safety, as persistent and untreated symptoms of PTSD or other anxiety disorders may negatively affect driving behaviour. Secondly, apart from post-traumatic psychopathology, the symptoms of post-traumatic growth (PTG) in MVA perpetrators together with factors related to them are analysed in the study. The examination results from the comprehensive sample of MVA perpetrators (n = 236) referred to Occupational Medicine Centres in the catchment area of Mazowieckie Voivodship, Poland, indicate that both PTSD and PTG symptoms are experienced by MVA perpetrators. The key predictors of PTG are neuroticism, conscientiousness, agreeableness and intensity of PTSD symptoms. Moreover, sex and perpetrators’ injuries during the accident seem to play a vital role in the process of post-traumatic growth. Those of subjects who were women or were injured generally declared more positive changes in their life as a consequences of the accident they caused.",0,0 +2824,Validity of the osu post-traumatic stress disorder scale and the behavior assessment system for children self-report of personality with child tornado survivors,"Tornadoes and other natural disasters can lead to anxiety and posttraumatic stress disorder (PTSD) in children. This study provides further validity for the Oklahoma State University Post-Traumatic Stress Disorder Scale–Child Form (OSU PTSDS-CF) by comparing it to the Behavior Assessment System for Children Self-Report of Personality (BASC-SRP). Correlations were significant at 0.01 between BASC-SRP scales of Anxiety, Atypicality, and Clinical Maladjustment, and at least 0.05 between OSU PTSDS-CF scales for Social Stress, Depression, Inadequacy, and Emotional Symptoms Index (ESI). Analyses of variance (ANOVAs) yielded significant differences at 0.01 between children with and without PTSD, based on OSU PTSDS-CF cut-off scores, for BASC-SRP Anxiety, Atypicality, and Clinical Maladjustment. ANOVAs were significant at 0.05 for Social Stress, Locus of Control, Relationship with Parents, and ESI. Results yielded moderate effect sizes, and BASC-SRP means were within normal limits for all groups. Practitioners are encouraged to supplement the BASC-SRP with PTSD measures in children who have experienced trauma. © 2008 Wiley Periodicals, Inc.",0,0 +2825,Systems Biology,"Genome sequences are now available that enable us to determine the biological components that make up a cell or an organism. The discipline of systems biology examines how these components interact and form networks, and how the networks generate whole cell functions corresponding to observable phenotypes. This 2006 textbook devoted to systems biology describes how to model networks, how to determine their properties, and how to relate these to phenotypic functions. The prerequisites are some knowledge of linear algebra and biochemistry. Though the links between the mathematical ideas and biological processes are made clear, the book reflects the irreversible trend of increasing mathematical content in biology education. Therefore to assist both teacher and student, in an associated web site Palsson provides problem sets, projects and Powerpoint slides, and keeps the presentation in the book concrete with illustrative material and experimental results.",0,0 +2826,Randomized Controlled Trial of Online Expressive Writing to Address Readjustment Difficulties Among U.S. Afghanistan and Iraq War Veterans,"We examined the efficacy of a brief, accessible, nonstigmatizing online intervention-writing expressively about transitioning to civilian life. U.S. Afghanistan and Iraq war veterans with self-reported reintegration difficulty (N = 1,292, 39.3% female, M = 36.87, SD = 9.78 years) were randomly assigned to expressive writing (n = 508), factual control writing (n = 507), or no writing (n = 277). Using intention to treat, generalized linear mixed models demonstrated that 6-months postintervention, veterans who wrote expressively experienced greater reductions in physical complaints, anger, and distress compared with veterans who wrote factually (ds = 0.13 to 0.20; ps < .05) and greater reductions in PTSD symptoms, distress, anger, physical complaints, and reintegration difficulty compared with veterans who did not write at all (ds = 0.22 to 0.35; ps ≤ .001). Veterans who wrote expressively also experienced greater improvement in social support compared to those who did not write (d = 0.17). Relative to both control conditions, expressive writing did not lead to improved life satisfaction. Secondary analyses also found beneficial effects of expressive writing on clinically significant distress, PTSD screening, and employment status. Online expressive writing holds promise for improving health and functioning among veterans experiencing reintegration difficulty, albeit with small effect sizes.",0,0 +2827,Prazosin for treatment of nightmares related to posttraumatic stress disorder,"The efficacy of prazosin for the treatment of posttraumatic stress disorder (PTSD)-related nightmares is reviewed.PTSD is an anxiety disorder that can occur after experiencing or witnessing a life-threatening event, such as military combat, natural disasters, terrorist attacks, serious accidents, or violent personal assaults. The event that induced PTSD is often relived through nightmares or flashbacks. Sleep disturbances affect approximately 70% of patients with PTSD. Several medications have been evaluated for reducing PTSD-related nightmares, with limited success. Prazosin is a centrally and peripherally acting alpha(1)-adrenergic antagonist whose mechanism of action, favorable adverse-effect profile, and low cost make it a promising agent for the treatment of PTSD. To date, two case reports, two chart reviews, three open-label trials, and two placebo-controlled trials have been published documenting the efficacy and safety of prazosin in the treatment of PTSD-related nightmares. Therapy with prazosin resulted in a reduction in nightmares in patients with both combat- and noncombat-related trauma. A therapeutic benefit occurred with prazosin dosages as low as 1 mg daily, and suppression of nightmare symptoms occurred within one week of prazosin initiation. The most frequently reported adverse event was orthostatic hypotension. The variability in the populations studied (e.g., combat, noncombat, recent traumatic experiences) leaves additional unanswered questions that must be addressed in large, randomized, controlled trials.Prazosin appears to be a promising and well-tolerated agent for the management of PTSD-related nightmares. Further well-designed trials are warranted to establish its place in the treatment of PTSD.",0,0 +2828,Neuroendocrine activity and memory-related impairments in posttraumatic stress disorder,"This article reviews memory-related impairments in trauma survivors with posttraumatic stress disorder and their possible association to neuroendocrine alterations seen in this disorder. The neuroendocrine profile in PTSD first described in chronically ill combat veterans is characterized by lower basal cortisol levels, higher glucocorticoid receptor number, enhanced sensitivity to exogenous steroids, and increased variation in basal cortisol levels over the diurnal cycle. The generalizability and time course of these neuroendocrine alterations are explored in longitudinal studies and studies in other traumatized populations. These studies suggest that at least some aspects of this neuroendocrine profile can also be seen in other populations, including women, children, and victims of childhood trauma. Additionally, the alterations may be present early in the course of illness, perhaps even in the immediate aftermath of trauma, and may continue to be manifest in elderly trauma survivors. The mechanisms by which these neuroendocrine alterations may influence the formation and processing of traumatic memories are discussed.",0,0 +2829,Identifying crime victims who are at high risk for post traumatic stress disorder: developing a practical referral instrument,"Objective To construct a practical instrument for the identification and referral of crime victims who are at high risk for post traumatic stress disorder (PTSD). Method: Crime victims filing a complaint at a police station were asked to fill out a questionnaire probing risk factors for PTSD (n=126). One and 3 months later, these victims filled out a self-report version of the PTSD Symptom Scale (PSS-SR). Results: The combination of four items predicted persistent PTSD with a sensitivity of 1.00 and a specificity of 0.62. The items were: being victims of a violent crime, knowing the perpetrator, experiencing the results of the crime as worse than was expected, and blaming oneself for the event. Only 25% of PTSD cases received emotional support from a victim assistance organization. Conclusion: This study demonstrates that early detection of high-risk victims and their referral to treatment is both necessary and possible.",0,0 +2830,"Violent communities, family choices, and children's chances: An algorithm for improving the odds","Abstract Data are presented concerning the early predictors of adaptational success and failure among 72 children attending their 1st years of elementary school in a violent Washington, D.C., neighborhood. Adaptational failures were defined as those children who were doing poorly or failing in school and rated by their parents as suffering clinically significant levels of behavior problems. Adaptational successes were defined as children whose performance as students was rated in the average to excellent range and whose parent-rated levels of behavior problems were within the normal range. Despite the fact that these children were being raised in violent neighborhoods, had been exposed to relatively high levels of violence in the community, and were experiencing associated distress symptoms, community violence exposure levels were not predictive of adaptational failure or success. Instead, adaptational status was systematically related to characteristics of the children's homes. More specifically, the children's chances of adaptational failure rose dramatically as a function of living in unstable and/or unsafe homes. Moreover, it was not the mere accumulation of environmental adversities that gave rise to adaptational failure in these children. Rather, it was only when such adversities contaminated or eroded the stability and/or safety levels of the children's homes that the odds of their adaptational failure increased. We argue that this erosion of the quality of the child's microsystem (i.e., family) by adversities and pressures in the exosystem (i.e., community) is not an inevitable process. Although not yet well understood, it is a process over which families have and must exercise control. The implications of these data for improving children's chances of physical, psychological, and academic survival in violent neighborhoods are considered.",0,0 +2831,"Predictors of Prolonged Grief, Resilience, and Recovery Among Bereaved Spouses","Most reactions to loss can be characterized by three prototypical trajectories of resilience, gradual recovery, and chronic distress (Bonanno, ). However, research on the factors that uniquely predict these trajectories of response has been limited. We examined theoretically relevant predictors of each of the trajectory patterns.We assessed 115 bereaved spouses at 1.5 to 3 years postloss and 74 married controls. To identify grief trajectory, we provided bereaved participants with a graphical depiction of the trajectories and asked them to select the one that best described their experience.Group comparisons revealed substantial differences between resilient and prolonged grievers, and almost no differences between resilient and married controls. Multivariate analyses indicated that prolonged grief, when compared to resilience, was uniquely associated with maladaptive dependency traits, difficulty accessing positive memories of the deceased, and higher recalled marital adjustment.The present results extend our understanding of factors associated with distinct trajectories of adjustment after loss.",0,0 +2832,Creatine kinase isoenzyme profiles in the plasma of the domestic fowl (Gallus domesticus): effects of acute heat stress,"Creatine kinase isoenzyme activities in extracts of plasma, skeletal muscle, heart and brain tissue of domestic fowls were separated by anion exchange chromatography and tissue specific distributions of the isoenzyme designated MM-CK, BB-CK1 and BB-CK2 were demonstrated. The muscle isoenzyme (MM-CK) was the predominant form in plasma (99 per cent) and its activity increased in response to an episode of acute heat stress.",0,0 +2833,Psychometric properties of the Posttraumatic Cognition Inventory within a Northern Ireland adolescent sample,"This study sought to investigate the psychometric properties of the Posttraumatic Cognitions Inventory (PTCI; Foa et al., 1999, Psychol. Assess., 11, 303) among a cohort of older adolescents and to determine the relationship between post-traumatic cognitions and a variety of psychological outcomes including depression, anxiety, stress, and loneliness.The PTCI was investigated among a large sample (N = 785) of Northern Irish adolescents. Confirmatory factor analysis and composite reliability analysis were conducted to assess the psychometric properties of the scale.The familiar three-factor solution of negative cognitions of self, negative cognitions of the world and others, and self-blame was supported; however, it was necessary to remove eight items from the original 33-item scale. The three-factor structure was subsequently demonstrated to be factorially invariant across gender and to possess satisfactory internal reliability. The three PTCI factors were found to correlate with depression, anxiety, stress, and three dimensions of loneliness.These results provide the first piece of evidence that older adolescents cognitively respond to trauma in a similar manner to adults, that the PTCI is factorially invariant between genders, and that trauma cognitions are correlated with feelings of loneliness. The contextual dependent nature of the structure of the PTCI factors is discussed in relation to future research efforts.The PTCI is a valid and reliable measure of trauma-related cognitions among adolescents and works equally well for male adolescents and female adolescents. Trauma cognitions are associated with a range of mental health problems beyond post-traumatic stress disorder including depression, anxiety, stress, and various aspects of loneliness. Reductions in trauma cognitions in survivors of trauma will have wide-scale clinical benefits to patient well-being. The exact structure and make-up of items in the PTCI may well be dependent on culture, context, and the nature of the trauma. The study is limited due to the fact that the authors could not assess the severity of the trauma experienced by the adolescent sample.",0,0 +2834,Dimensional complexity of the EEG in patients with posttraumatic stress disorder,"Recent electrophysiological studies have reported evidence of information processing abnormalities in patients with posttraumatic stress disorder (PTSD). The aim of this study is to examine dynamical complexity of the EEG in PTSD patients, which is thought to reflect information processing of the brain. Resting EEG recordings (32,800 data points acquired continuously from 82 s of an EEG record) were obtained in 16 channels of 27 patients with PTSD from a mixed civilian trauma population and 14 healthy subjects. The correlation dimension (D2) of the EEG was used to quantify the complexity of the cortical dynamics underlying the EEG signal. The PTSD patients were found to have lower D2 values than those of the healthy subjects in most channels (Fp1, F8, C4, P4, T3, T4, T5, T6, and O1), indicating that PTSD patients have globally reduced complexity in their EEG waveforms. This study supports the hypotheses that PTSD patients exhibit disturbed cortical information processing, and that non-linear dynamical analysis of the EEG can be a tool for detecting changes in neurodynamics of the brain in PTSD.",0,0 +2835,[Features of a short stay service facility for the severely motor and intellectually disabled persons in relation to the Niigata Chuetsu Prefecture earthquake in 2004].,"Twenty-four handicapped victims of the Niigata-Chuetsu earthquake have used our ""short-stay-service"" . We have summarized the characteristics of this utilization. Two prominent patterns were noted:1) The mean duration of the stays was clearly longer when compared to ordinary service, and correlated with the proximity of the victims to the focus of the earthquake, and 2) victims living near the epicenter took longer to start utilizing the short-stay service. The Niigata-Chuetsu earthquake has destroyed roads and highways at over 200 locations, preventing transportation, isolating the seismic center, and resulting in delayed rescue of the handicapped victims and their admittance to the institution. More of the 24 victims were from the severest region (on 7 of the Japanese seismic intensity scale) than from the violent region (scale 6). Unfortunately, the social and administrative network for supporting and protecting severely motor and intellectually disabled persons is still at an embryonic stages. Based of this experience, we propose the building and organization of a functional network for the disabled.",0,0 +2836,Observations on the Use of Growth Mixture Models in Psychological Research,"Psychologists are applying growth mixture models at an increasing rate. This article argues that most of these applications are unlikely to reproduce the underlying taxonic structure of the population. At a more fundamental level, in many cases there is probably no taxonic structure to be found. Latent growth classes then categorically approximate the true continuum of individual differences in change. This approximation, although in some cases potentially useful, can also be problematic. The utility of growth mixture models for psychological science thus remains in doubt. Some ways in which these models might be more profitably used are suggested.",0,0 +2837,Frequency and Content of Dreams Associated with Trauma,"Sleep disturbances and dream-related disorders play a prominent role in trauma victims' clinical profile. Although some progress has been made in understanding the impact of sleep mechanisms and nightmares in the development, maintenance, and treatment of posttraumatic stress disorder (PTSD), little is known about the actual content of trauma-related dreams beyond the more strictly defined PTSD nightmares. This article presents key methodological issues, reviews findings on dream recall frequency following trauma exposure, examines the incidence of dream-related disorders as a function of trauma characteristics and personality variables, and reviews findings on the relationship between dream content and specific types of traumas. It is concluded that greater clinical and research efforts should be directed at understanding the natural course and impact of dream-related disorders as well as normal dream processes in trauma victims.",0,0 +2838,Comorbid depressive symptoms in treatment-seeking PTSD outpatients affect multiple domains of quality of life,"No study has examined the impact of the comorbid Axis I conditions on the quality of life (QoL) of patients with a primary diagnosis of PTSD. Our goal was to investigate the influence of comorbid disorders on the QoL of treatment-seeking outpatients with PTSD.The diagnoses of PTSD and of the comorbid disorders were established using the SCID-I. The 54 volunteers also completed the Posttraumatic Stress Disorder Checklist - Civilian Version, the BDI, the BAI, the Trauma History Questionnaire, and a socio-demographic questionnaire. Quality of life was assessed by means of the WHOQOL-BREF, a 26-item self-administered scale that measures four domains of QoL: psychological, physical, social, and environmental. Multiple linear regression models were fitted to investigate the relationship between the severity of post-traumatic, mood, and anxiety symptoms; the presence of specific current comorbid disorders and of psychotic symptoms, the number of current comorbid conditions, and a history of child abuse for each of the four domains of QoL, after adjusting for the effect of socio-demographic characteristics.The severity of PTSD symptoms impacted negatively on the psychological and physical domains. The severity of depressive symptoms correlated negatively with QoL in all domains, independently of sex, age, occupation, and marital status. The psychotic symptoms impacted negatively on the environmental domain. A history of child abuse was negatively associated with the psychological and the social domains.The severity of comorbid depressive symptoms is one of the most important factors in the determination of the QoL in patients with PTSD.",0,0 +2839,Stressful life events and predictors of post-traumatic growth among high-risk early emerging adults,"Stressful life events (SLEs) may elicit positive psychosocial change among youth, referred to as Post-traumatic Growth (PTG). We assessed types of SLEs experienced, degree to which participants reported PTG, and variables predicting PTG across 24 months among a sample of high risk, ethnically diverse early emerging adults. Participants were recruited from alternative high schools (n = 564; mean age=16.8; 65% Hispanic). Multi-level regression models were constructed to examine the impact of environmental (SLE quantity, severity) and personal factors (hedonic ability, perceived stress, developmental stage, future time orientation) on a composite score of PTG. The majority of participants reported positive changes resulted from their most life-altering SLE of the past two years. Predictors of PTG included fewer SLEs, less general stress, having a future time perspective, and greater identification with the developmental stage of Emerging Adulthood. Findings suggest intervention targets to foster positive adaptation among early emerging adults who experience frequent SLEs.",0,0 +2840,Group-Based Trajectory Modeling in Clinical Research,"Group-based trajectory models are increasingly being applied in clinical research to map the developmental course of symptoms and assess heterogeneity in response to clinical interventions. In this review, we provide a nontechnical overview of group-based trajectory and growth mixture modeling alongside a sampling of how these models have been applied in clinical research. We discuss the challenges associated with the application of both types of group-based models and propose a set of preliminary guidelines for applied researchers to follow when reporting model results. Future directions in group-based modeling applications are discussed, including the use of trajectory models to facilitate causal inference when random assignment to treatment condition is not possible.",0,0 +2841,Posttraumatic stress disorder in children: The influence of developmental factors,"Despite the prevalence of childhood trauma, there are currently no developmentally oriented cognitive theories of posttraumatic stress disorder (PTSD). This paper outlines the definitional issues of PTSD in children, reviews the incidence of PTSD in children, and compares PTSD profiles in children and adults. We propose that a cognitive theory of childhood PTSD needs to accommodate developmental factors, including knowledge, language development, memory, emotion regulation, and social cognition, in addition to contextual factors such as family interactions. Implications of these developmental factors for assessment and treatment of traumatized children are discussed.",0,0 +2842,"Relations among posttraumatic stress disorder, comorbid major depression, and HPA function: A systematic review and meta-analysis","Exposure to traumatic stress is associated with increased risk for posttraumatic stress disorder (PTSD) and alterations of hypothalamic-pituitary-adrenocortical (HPA) function. Research linking traumatic stress with HPA function in PTSD has been inconsistent, however, in part due to (a) the inclusion of trauma-exposed individuals without PTSD (TE) in control groups and (b) a failure to consider comorbid major depressive disorder (MDD) and moderating variables. This meta-analysis of 47 studies (123 effect sizes, N=6008 individuals) revealed that daily cortisol output was lower for PTSD (d=-.36, SE=.15, p=.008) and PTSD+MDD (d=-.65, SE=.25, p=.008) groups relative to no trauma controls (NTC); TE and NTC groups did not differ significantly from each other. Afternoon/evening cortisol was lower in TE (d=-.25, SE=.09, p=.007) and PTSD (d=-.27, SE=.12, p=.021) groups and higher in PTSD+MDD groups (d=.49, SE=.24, p=.041) relative to NTC. Post-DST cortisol levels were lower in PTSD (d=-.40, SE=.12, p<.001), PTSD+MDD (d=-.65, SE=.14, p<.001), and TE groups (d=-.53, SE=.14, p<.001) relative to NTC. HPA effect sizes were moderated by age, sex, time since index event, and developmental timing of trauma exposure. These findings suggest that enhanced HPA feedback function may be a marker of trauma-exposure rather than a specific mechanism of vulnerability for PTSD, whereas lower daily cortisol output may be associated with PTSD in particular.",0,0 +2843,Impact of Exposure to Trauma on Posttraumatic Stress Disorder Symptomatology in Swedish Tourist Tsunami Survivors,"The aim was to examine long-term mental health and posttraumatic stress symptomatology in a Swedish tourist population after exposure to the 2004 Southeast Asian tsunami. Data from 4822 returned questionnaires 14 months after the disaster were analyzed. Respondents were categorized into 3 subgroups: (1) danger-to-life exposure group (having been caught or chased by the waves), (2) nondanger-to-life exposure group (exposed to other disaster-related stressors), and (3) low exposure group. Main outcome measures were General Health Questionnaire-12 and Impact of Event Scale-22-Revised. Danger-to-life exposure was an important factor in causing more severe posttraumatic stress symptoms and in affecting mental health. Female gender, single status, and former trauma experiences were associated with greater distress. Other factors related to more severe symptoms were loss of relatives, physical injuries, viewing many dead bodies, experiencing life threat, and showing signs of cognitive confusion. Disaster exposure has a substantial impact on survivors, which stresses the need for long-lasting support.",0,0 +2844,Post-traumatic stress symptoms in relatives in the first weeks after severe traumatic brain injury,"Severe traumatic brain injury (STBI) can cause psychological stress in proxies in the long-term. This study assessed post-traumatic stress (PTS) symptoms in proxies of survivors of STBI in the short-term and investigated stress-associated factors.Prospective cross-sectional study, conducted at three Swiss trauma centres over 1 year. Patient and proxy demographics, trauma data including Glasgow Coma Scale (GCS) and management data were collected. The proxies' PTS symptoms were assessed by applying the Impact of Event Scale-Revised (IES-R), once in the first month after the accident (median: 11 days).Sixty-nine proxies were included; 52 proxies were female (77.8%). Mean IES-R sum score for intrusions was 13.38 (SD=7.26), for avoidance 8.91 (SD=5.94), and for hyperarousal 9.07 (SD=6.75). Clinically significant PTS symptoms were observed in 36 proxies (52.2%); mean IES-R sum scores were significantly higher in women. IES-R sub-scale values were inversely related with GCS at the scene of the accident and on hospital admission.More than half of proxies had clinically significant PTS symptoms shortly after their relative's accident. More severe PTS symptoms were found in women and in proxies of patients with poorer initial GCS scores. Further research into risk groups in the short- and long-term and the long-term impact on patients of PTS syndrome in proxies is warranted.",0,0 +2845,"Trauma, Survival and Resilience in War Zones","This book, based upon a series of psychological research studies, examines Sierra Leone as a case study of a constructivist and narrative perspective on psychological responses to warfare, telling the stories of a range of survivors of the civil war. The authors explore previous research on psychological responses to warfare while providing background information on the Sierra Leone civil war and its context. Chapters consider particular groups of survivors, including former child soldiers, as well as amputee footballers, mental health service users and providers, and refugees. Implications of the themes emerging from this research are considered with respect to how new understandings can inform current models of trauma and work with its survivors. Amongst the issues concerned will be post-traumatic stress and post-traumatic growth; resilience; mental health service provision; perpetration of atrocities; and forgiveness. The book also provides a critical consideration of the appropriateness of the use of Western concepts and methods in an African context. Drawing upon psychological theory and rich narrative research, Trauma, Survival and Resilience in War Zones will appeal to researchers and academics in the field of clinical psychology, as well as those studying post-war conflict zones. © 2016 David A. Winter, Rachel Brown, Stephanie Goins and Clare Mason.",0,0 +2846,A Pilot Study of Interpersonal Psychotherapy for Posttraumatic Stress Disorder,"This article describes pilot testing of interpersonal psychotherapy adapted for posttraumatic stress disorder (PTSD). Unlike most psychotherapies for PTSD, interpersonal psychotherapy is not exposure-based, focusing instead on interpersonal sequelae of trauma.Fourteen consecutively enrolled subjects with chronic PTSD (DSM-IV) from various traumas received an open, 14-week interpersonal psychotherapy trial.Treatment was well tolerated: 13 subjects (93%) completed therapy. After 14 weeks, 12 of 14 subjects no longer met diagnostic criteria for PTSD, 69% responded (50% Clinician Administered PTSD Scale score decrement), and 36% remitted (score < or =20). Thirteen subjects reported declines in PTSD symptoms across all three symptom clusters. Depressive symptoms, anger reactions, and interpersonal functioning also improved.Treating interpersonal sequelae of PTSD appears to improve other symptom clusters. Interpersonal psychotherapy may be an efficacious alternative for patients who refuse repeated exposure to past trauma. This represents an exciting extension of interpersonal psychotherapy to an anxiety disorder.",0,0 +2847,Violent behaviour and post-traumatic stress disorder in US Iraq and Afghanistan veterans,"Background Violence towards others in the community has been identified as a significant problem for a subset of Iraq and Afghanistan veterans. Aims To investigate the extent to which post-traumatic stress disorder (PTSD) and other risk factors predict future violent behaviour in military veterans. Method A national, multiwave survey enrolling a random sample of all US veterans who served in the military after 11 September 2001 was conducted. A total of 1090 veterans from 50 US states and all military branches completed two survey waves mailed 1 year apart (retention rate = 79%). Results Overall, 9% endorsed engaging in severe violence and 26% in other physical aggression in the previous year, as measured at Wave 2. Younger age, financial instability, history of violence before military service, higher combat exposure, PTSD, and alcohol misuse at Wave 1 were significantly associated with higher severe violence and other physical aggression in the past year at Wave 2. When combinations of these risk factors were present, predicted probability of violence in veterans rose sharply. Veterans with both PTSD and alcohol misuse had a substantially higher rate of subsequent severe violence (35.9%) compared with veterans with alcohol misuse without PTSD (10.6%), PTSD without alcohol misuse (10.0%) or neither PTSD nor alcohol misuse (5.3%). Using multiple regression, we found that veterans with PTSD and without alcohol misuse were not at significantly higher risk of severe violence than veterans with neither PTSD nor alcohol misuse. There was a trend for other physical aggression to be higher in veterans with PTSD without alcohol misuse. Conclusions Co-occurring PTSD and alcohol misuse was associated with a marked increase in violence and aggression in veterans. Compared with veterans with neither PTSD nor alcohol misuse, veterans with PTSD and no alcohol misuse were not significantly more likely to be severely violent and were only marginally more likely to engage in other physical aggression. Attention to cumulative effects of multiple risk factors beyond diagnosis – including demographics, violence history, combat exposure, and veterans' having money to cover basic needs like food, shelter, transportation, and medical care – is crucial for optimising violence risk management.",0,0 +2848,Stockholm Syndrome and Child Sexual Abuse,"This article, based on an analysis of unstructured interviews, identifies that the emotional bond between survivors of child sexual abuse and the people who perpetrated the abuse against them is similar to that of the powerful bi-directional relationship central to Stockholm Syndrome as described by Graham (1994). Aspects of Stockholm Syndrome could be identified in the responses of adult survivors of child sexual abuse, which appeared to impact on their ability to criminally report offenders. An emotional bond, which has enabled the sexual abuse of children, has served to protect the offender long after the abuse has ceased. The implications of Stockholm Syndrome could offer valuable insights to those working in the field of child sexual abuse.",0,0 +2849,Posttraumatic Stress Disorder and Identification in Disaster Workers,"OBJECTIVE: Disaster workers who work with deceased victims are at increased risk of posttraumatic stress disorder (PTSD). Identification with the deceased has been proposed as one of the mechanisms in this stress-illness relationship. To examine this hypothesis, this study investigated three types of identification with the dead in a group of disaster workers: identification with the deceased as oneself, identification with the deceased as a friend, and identification with the deceased as a family member. METHOD: Fifty-four volunteer disaster workers who worked with the dead following an explosion on the USS Iowa naval ship were assessed 1, 4, and 13 months after the disaster. PTSD symptoms (measured with the DSMPTSD-IV scale), intrusive and avoidant disaster-related symptoms (measured with the Impact of Event Scale), somatization and general distress (measured with the SCL-90-R), and health care utilization were assessed. RESULTS: Disaster workers who reported identification with the deceased as a friend were more likely than those who did not to have PTSD, more intrusive and avoidant symptoms, and greater levels of other posttraumatic symptoms including somatization. Disaster workers who reported identification with the deceased as a family member had greater intrusive symptoms 1 month after the disaster than those who did not. There were no differences between those who did and did not identify with the deceased as self. Health care utilization was not associated with identification. CONCLUSIONS: Identification with the deceased is a risk factor for PTSD and posttraumatic symptoms in disaster workers exposed to the dead. Identification with the dead as a friend is specifically associated with higher risk for these workers.",0,0 +2850,"Posttraumatic stress disorder, poor physical health and substance use behaviors in a national trauma-exposed sample","Both experiencing a traumatic event and PTSD are related to physical health problems (e.g., Schnurr and Jankowski, 1999) and health-risk behavior (e.g., Stewart, 1996). Using structural equation modeling analyses, we examined the interrelationships among number of distinct traumatic event exposures, PTSD diagnosis, physical health, and substance use behavior using epidemiological data from the National Comorbidity Survey Replication (NCS-R; Kessler et al., 2004). Results provide some evidence that PTSD mediates the relationship between: (a) number of distinct traumatic event exposures and poor physical health defined by clusters of difficulties with gastrointestinal, musculoskeletal, and/or cardiovascular health, and (b) number of distinct traumatic event exposures and substance use behaviors. However, substance use behaviors did not significantly mediate the relationship between PTSD and poor physical health.",0,0 +2851,PTSD prevalence and symptom structure of DSM-5 criteria in adolescents and young adults surviving the 2011 shooting in Norway,"Diagnostic criteria for Posttraumatic Stress Disorder (PTSD) have been revised for DSM-5. Two key changes include alteration of the clustering of PTSD symptoms and new PTSD symptom criteria related to negative alterations in cognition and mood. In this study, we empirically investigated these changes.We interviewed 325 adolescents and young adults who survived the 2011 youth camp shooting at Utøya Island, Norway. The UCLA PTSD Reaction Index for DSM-IV was used to assess symptoms of PTSD. In addition, 11 questions were added to assess the four new symptom criteria within the new DSM-5 symptom categories.PTSD prevalence did not differ significantly whether DSM-IV (11.1%) or DSM-5 (11.7%) criteria were used and the Cohen׳s Kappa for consistency between the diagnoses was 0.061. Confirmatory factor analyses showed that the four-factor structure of the DSM-5 fit the data adequately according to the conceptual model outlined.The homogeneity of this sample of highly exposed subjects may preclude generalization to less severely exposed groups. Also, we did not assess criterion G in regard to symptoms causing clinically significant distress and functional impairment.The prevalence of PTSD was quite similar regardless of diagnostic system. The relatively low concordance between the diagnoses has implications for eligibility for a diagnosis of PTSD.",0,0 +2852,"Trauma Exposure, Posttraumatic Stress, and Psychiatric Comorbidity in Female Juvenile Offenders","To document the rate of posttraumatic stress disorder (PTSD) in female juvenile offenders and its relationship to trauma history, comorbid diagnoses, attributional style, and family functioning.The psychological profiles and trauma histories of 100 incarcerated female juvenile offenders (ages 13.5-19 years) were assessed using a semistructured interview. Two self-report measures were used to assess family functioning and attributional style.High rates of PTSD were reported by offenders (37%), with sexual abuse the precipitant in 70% of cases. Offenders with PTSD had significantly more comorbid diagnoses than those without (PTSD = 5.4, no PTSD = 3.1, p < .001). The majority (73%) of comorbid diagnoses appeared concurrently with or after PTSD onset. The presence of four or more psychiatric diagnoses (OR = 14.48, p < .001) and a history of sexual abuse (OR = 7.91, p < .001) were independently associated with a diagnosis of PTSD among female juvenile offenders.These results suggest a link among trauma, PTSD, and the development of further psychopathology in female juvenile offenders. This link highlights the importance of comprehensive diagnosis and treatment of this and other comorbid disorders to ensure the effectiveness of interventions designed to treat antisocial behavior.",0,0 +2853,Amygdala modulation of memory-related processes in the hippocampus: potential relevance to PTSD,"A key assumption in the study of stress-induced cognitive and neurobiological modifications is that alterations in hippocampal functioning after stress are due to an excessive activity exerted by the amygdala on the hippocampus. Research so far focused on stress-induced impairment of hippocampal plasticity and memory but an exposure to stress may simultaneously also result in strong emotional memories. In fact, under normal conditions emotionally charged events are better remembered compared with neutral ones. Results indicate that under these conditions there is an increase in activity within the amygdala that may lead to memory of a different quality. Studying the way emotionality activates the amygdala and the functional impact of this activation we found that the amygdala modulates memory-related processes in other brain areas, such as the hippocampus. However, this modulation is complex, involving both enhancing and suppressing effects, depending on the way the amygdala is activated and the hippocampal subregion examined. The current review summarizes our findings and attempts to put them in context with the impact of an exposure to a traumatic experience, in which there is a mixture of a strong memory of some aspects of the experience but impaired memory of other aspects of that experience. Toward that end, we have recently developed an animal model for the induction of predisposition to stress-related disorders, focusing on the consequences of exposure to stressors during juvenility on the ability to cope with stress in adulthood. Exposing juvenile-stressed rats to an additional stressful challenge in adulthood revealed their impairment to cope with stress and resulted in significant elevation of the amygdala. Interestingly, and similar to our electrophysiological findings, differential effects were observed between the impact of the emotional challenge on CA1 and dentate gyrus subregions of the hippocampus. Taken together, the results indicate that long-term alterations within the amygdala contribute to stress-related mnemonic symptoms and suggest that elucidating further these intra-amygdala alterations and their effects on modulating other brain regions is likely to be beneficial for the development of novel approaches to treat stress-related disorders.",0,0 +2854,Single-Prolonged Stress Induces Apoptosis by Activating Cytochrome C/Caspase-9 Pathway in a Rat Model of Post-traumatic Stress Disorder,"The purpose of this study was to provide a novel insight into the mechanism of how amygdala might participate in PTSD by investigating the changes of cytochrome c oxidase (COX), caspase-9, and caspase-3 in the amygdala of single-prolonged stress (SPS) rats. A total of 80 healthy, male Wistar rats were selected for this study. The models of post-traumatic stress disorder (PTSD) were created by SPS, which is an established animal model for PTSD. The change of COX was detected by light microscope and transmission electron microscopy (TEM). The expression of caspase-9 and caspase-3 in the basolateral amygdala was examined by immunofluorescence and reverse transcription-polymerase chain reaction (RT-PCR). SPS exposure resulted in a significant change of COX in the SPS model groups compared with the normal control group. Evaluation by enzymohistochemistry indicated translocation of COX from mitochondria to cytoplasm. The expression of both caspase-9 and caspase-3 significantly increased 1 day after SPS stimulation, then gradually increased and peaked at SPS 7d. This findings suggest changes of COX, caspase-9, and caspase-3 in the amygdala of SPS rats, which may play important roles in the pathogenesis of PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +2855,"Post Traumatic Stress, Context, and the Lingering Effects of the Hurricane Katrina Disaster among Ethnic Minority Youth","This study examined the stability of post traumatic stress disorder (PTSD) symptoms in a predominantly ethnic minority sample of youth exposed to Hurricane Katrina. Youth (n∈=∈191 grades 4th thru 8th) were screened for exposure to traumatic experiences and PTSD symptoms at 24 months (Time 1) and then again at 30 months (Time 2) post-disaster. PTSD symptoms did not significantly decline over time and were higher than rates reported at earlier time points for more ethnically diverse samples. Younger age, female sex, and continued disrepair to the child's home predicted stable elevated PTSD symptoms. Findings are consistent with predictions from contextual theories of disaster exposure and with epidemiological data from adult samples suggesting that the incidence of PTSD post Katrina is showing an atypical pattern of remittance. Theoretical, applied, and policy implications are discussed. © 2009 Springer Science+Business Media, LLC.",0,0 +2856,Psychosocial adjustment of directly exposed survivors 7 years after the Oklahoma City bombing,"Abstract Objective The aim of this study was to prospectively examine the long-term course of psychiatric disorders, symptoms, and functioning among 113 directly exposed survivors of the Oklahoma City bombing systematically assessed at 6 months and again nearly 7 years postbombing. Methods The Diagnostic Interview Schedule/Disaster Supplement was used to assess predisaster and postdisaster psychiatric disorders and symptoms and other variables of relevance to disaster exposure and outcomes. Results Total prevalence of posttraumatic stress disorder (PTSD) was 41%. Seven years postbombing, 26% of the sample still had active PTSD. Delayed-onset PTSD and new postdisaster alcohol use disorders were not observed. PTSD nonremission was predicted by the occurrence of negative life events after the bombing. Posttraumatic symptoms among survivors without PTSD decayed more rapidly than for those with PTSD, and symptoms remained at 7 years even for many who did not develop PTSD. Those with PTSD reported more functioning problems at index than those without PTSD, but functioning improved dramatically over 7 years, regardless of PTSD or remission from PTSD. No survivors had long-term employment disability based on psychiatric problems alone. Conclusions These findings have potentially important implications for anticipation of long-term emotional and functional recovery from disaster trauma.",0,0 +2857,Growth mixture modelling in developmental psychology: overview and demonstration of heterogeneity in developmental trajectories of adolescent antisocial behaviour,"Recent advances in statistical techniques for longitudinal data analysis have provided increased capabilities for elucidating individual differences in trajectories of change in child behaviours and abilities. However, most techniques still assume that there is a single underlying distribution with respect to changes over time, about which children are normally distributed. If there are multiple subgroups of youth following distinct developmental trajectories with unique predictors, however, the results of these statistical techniques may provide an incomplete analysis of the data. A newer class of statistical techniques, latent growth mixture modelling, provides a robust framework for examining heterogeneity in patterns of development. This paper illustrates the use of latent growth mixture modelling for examining heterogeneity in developmental trajectories of adolescent antisocial behaviour. Copyright © 2006 John Wiley & Sons, Ltd.",0,0 +2858,Dysfunction and Post-Traumatic Stress Disorder in Fracture Victims 50 Months after the Sichuan Earthquake,"This study aimed to evaluate the effectiveness of a rehabilitation intervention on physical dysfunction (PDF) and post-traumatic stress disorder (PTSD) in fracture victims 50 months after the Sichuan earthquake of 2008 and to identify risk factors for PTSD.This is a retrospective cohort study. Four hundred and fifty-nine earthquake-related fracture victims from Mianzhu city, Sichuan Province who did not qualify for disability pension participated. Two hundred and forty-five subjects received regular rehabilitation and 214 did not. Muscle strength, joint range of motion (ROM),sensory function, and sit-to-stand balance capacity were evaluated to assess PDF. The PTSD Checklist-Civilian Version (PCL-C) was administered to screen for PTSD. An ordinary least square regression was used to predict PTSD, and a logistic regression was used to predict PDF. In addition a Least Angle Regression (LARS) was carried out for PTSD to study the effects of rehabilitation and PDF at the same time.Unadjusted and adjusted group differences in physical dysfunction (p<0.01) and PTSD prevalence (p<0.05) were significant in favor of the rehabilitation group. In addition, being female, average or above family income, having witnessed death and fearfulness were found risk factors for PTSD symptoms 50 months after the earthquake. Both PDF and rehabilitation were selected predictors by LARS demonstrating opposite effects.PDF and PTSD were significantly reduced by the rehabilitation intervention. Future medical intervention strategies should consider rehabilitation in order to assist survivors in dealing with both physical and psychological effects of natural disaster.",0,0 +2859,Differentiating Overreporting and Extreme Distress: MMPI-2 Use With Compensation-Seeking Veterans With PTSD,"This purpose of this study was to examine overreporting on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) in compensation-seeking veterans with posttraumatic stress disorder (PTSD). A sample of veterans tested during a V.A. hospital compensation and pension exam were given the MMPI-2 and measures of PTSD, depression, and combat exposure. Veteran's MMPI-2s were only included in the analyses if their profile was extremely exaggerated, as measured by an F scale T score above 80, did not elevate the MMPI-2 VRIN and TRIN scales, and had a primary diagnosis of PTSD (n = 127). Using the Infrequency-Psychopathology, F(p), scale to distinguish overreporting from distress, it was found that 98 veterans elevated profiles due to distress, whereas 29 elevated due to overreporting, F(p) below and above 7, respectively. Differences between groups on MMPI-2 clinical scales and the other measures were assessed. Implications of these findings for assessing veteran response style and using the MMPI-2 with a PTSD population are discussed.",0,0 +2860,Feigning post-traumatic stress disorder on the PAI,"Multiscale personality inventories have been used to detect dissimulation of PTSD. The Personality Assessment Inventory (PAI) is a self-report inventory which has validity indicators that may be used to detect dishonest or biased self-report. The accuracy of these validity indicators was tested by comparing non-traumatized individuals instructed to fake PTSD with patients diagnosed as having PTSD and normal controls. Twenty-five individuals completed the PAI with the instruction to feign PTSD. The PAI results of these participants were compared to a cohort of 19 patients diagnosed as suffering from PTSD and 21 controls. Eleven of the 25 individuals instructed to fake PTSD on the PAI produced a profile consistent with this diagnosis. However, more than half of the faked profiles were correctly identified as feigned by the validity indicators. Specificity of the validity indicators was very high. The results of this study indicate that the PAI can be one useful source of information for the clinician when assessing for the possible distortion of PTSD symptoms. Copyright © 2000 John Wiley & Sons, Ltd.",0,0 +2861,Patterns of Maternal Distress Among Children With Cancer and Their Association With Child Emotional and Somatic Distress,"To identify patterns of distress among mothers of children with cancer over the initial 6 months of treatment and to examine these patterns as predictors of child somatic and emotional distress.Data were gathered regarding maternal perceived stress and affective distress from mothers of children (N = 65, mean age = 8.3 years) with cancer at 2 to 5 weeks postdiagnosis, then at 12 to 14 weeks and 22 to 24 weeks. Mothers and nurses provided indexes of child somatic and emotional distress at these assessments.Hierarchical and k-means cluster analyses revealed four distinct patterns of maternal distress: high, moderate, declining, and low. The high maternal distress group reported higher child emotional distress at all three points but higher child somatic distress only at the final assessment. Maternal distress group was unrelated to nurse-reported child distress.The identification of four empirically derived patterns of maternal distress may explain some of the variance in the literature regarding parental distress vis-à-vis pediatric cancer treatment and may have relevance to intervention efforts. Differences in the relations between maternal distress groups and mother- and nurse-reported child distress underscore the importance of collecting child distress data from multiple sources.",0,0 +2862,Early-life trauma is associated with rapid eye movement sleep fragmentation among military veterans,"The role of sleep in the relations between early-life trauma and the development of adverse psychological trajectories is relatively unknown and was the primary aim of the present study. Military veterans were evaluated for posttraumatic stress disorder, combat exposure, trauma history, sleep quality, disruptive nocturnal behaviors, and a subsample completed overnight polysomnography that yielded objectively measured sleep parameters. When relevant variables were controlled, increased earlier-life traumatic event exposure was associated with increased rapid-eye-movement sleep (REMs) fragmentation, and increased REMs fragmentation was associated with increased later-life disruptive nocturnal behaviors. REMs fragmentation carried an indirect relation between earlier-life trauma and later-life disruptive nocturnal behaviors. Objectively measured sleep parameters were used to describe REMs fragmentation physiology. The current findings elucidate the important role that earlier-life trauma exposure may have in the development of REM sleep physiology, and how this altered sleep physiology may have dynamic influences on subsequent posttraumatic stress symptoms in adulthood.",0,0 +2863,Comparing exposure metrics for classifying ‘dangerous heat’ in heat wave and health warning systems,"Heat waves have been linked to excess mortality and morbidity, and are projected to increase in frequency and intensity with a warming climate. This study compares exposure metrics to trigger heat wave and health warning systems (HHWS), and introduces a novel multi-level hybrid clustering method to identify potential dangerously hot days. Two-level and three-level hybrid clustering analysis as well as common indices used to trigger HHWS, including spatial synoptic classification (SSC), and the 90th, 95th, and 99th percentiles of minimum and relative minimum temperature (using a 10 day reference period), were calculated using a summertime weather dataset in Detroit from 1976 to 2006. The days classified as 'hot' with hybrid clustering analysis, SSC, minimum and relative minimum temperature methods differed by method type. SSC tended to include the days with, on average, 2.5 °C lower daily minimum temperature and 5.3 °C lower dew point than days identified by other methods. These metrics were evaluated by comparing their performance in predicting excess daily mortality. The 99th percentile of minimum temperature was generally the most predictive, followed by the three-level hybrid clustering method, the 95th percentile of minimum temperature, SSC and others. Our proposed clustering framework has more flexibility and requires less substantial meteorological prior information than the synoptic classification methods. Comparison of these metrics in predicting excess daily mortality suggests that metrics thought to better characterize physiological heat stress by considering several weather conditions simultaneously may not be the same metrics that are better at predicting heat-related mortality, which has significant implications in HHWSs.",0,0 +2864,A Multisite Study of Initial Respiration Rate and Heart Rate as Predictors of Posttraumatic Stress Disorder,"Fear-conditioning models posit that increased arousal at the time of trauma predicts subsequent posttraumatic stress disorder (PTSD). This multisite study evaluated the extent to which acute heart rate and respiration rate predict subsequent chronic PTSD.Traumatically injured patients admitted to 4 hospitals across Australia between April 2004 and February 2006 were initially assessed during hospital admission (N = 1105) and were reassessed 3 months later for PTSD by using the Clinician-Administered PTSD Scale-IV and for major depressive disorder (MDD) by using the Mini-International Neuropsychiatric Interview (English version 5.0.0) (N = 955). Heart rate, respiration rate, and blood pressure were assessed on the initial day of traumatic injury.Ninety patients (10%) met criteria for PTSD and 159 patients (17%) met criteria for MDD at the 3-month assessment. Patients with PTSD compared to those without PTSD had higher heart rate (90.16 +/- 18.66 vs. 84.84 +/-17.41, t = 2.74, p < .01) and respiration rate (20.24 +/- 5.16 vs. 18.58 +/- 4.29, t = 3.43, p < .001) immediately after injury. There were no heart rate or respiration rate differences between patients who did and did not develop MDD. Patients were more likely to develop PTSD at 3 months if they had a heart rate of at least 96 beats per minute (15% vs. 8%, OR = 2.12, 95% CI = 1.34 to 3.33) or respiration rate of at least 22 breaths per minute (18% vs. 8%, OR = 2.42, 95% CI = 1.48 to 3.94).Elevated heart rate and respiration rate are predictors of subsequent PTSD. These data underscore the need for future research into secondary prevention strategies that reduce acute arousal immediately after trauma and may limit PTSD development in some individuals.",0,0 +2865,"Attachment to therapist, the working alliance and emotional processing of traumatic material in session among veterans diagnosed with posttraumatic stress disorder","Title from PDF of title page (University of Missouri--Columbia, viewed on August 25, 2010).",0,0 +2866,Association of Posttraumatic Stress Disorder With Reduced In Vivo Norepinephrine Transporter Availability in the Locus Coeruleus,"Animal data suggest that chronic stress is associated with a reduction in norepinephrine transporter (NET) availability in the locus coeruleus. However, it is unclear whether such models are relevant to posttraumatic stress disorder (PTSD), which has been linked to noradrenergic dysfunction in humans.To use positron emission tomography and the radioligand [11C]methylreboxetine to examine in vivo NET availability in the locus coeruleus in the following 3 groups of individuals: healthy adults (HC group), adults exposed to trauma who did not develop PTSD (TC group), and adults exposed to trauma who developed PTSD (PTSD group) and to evaluate the relationship between NET availability in the locus coeruleus and a contemporary phenotypic model of PTSD symptoms.Cross-sectional positron emission tomography study under resting conditions at academic and Veterans Affairs medical centers among 56 individuals in the following 3 study groups: HC (n = 18), TC (n = 16), and PTSD (n = 22).The [11C]methylreboxetine-binding potential of NET availability in the locus coeruleus and the severity of PTSD symptoms assessed using the Clinician-Administered PTSD Scale.The PTSD group had significantly lower NET availability than the HC group (41% lower, Cohen d = 1.07). NET availability did not differ significantly between the TC and HC groups (31% difference, Cohen d = 0.79) or between the TC and PTSD groups (15% difference, Cohen d = 0.28). In the PTSD group, NET availability in the locus coeruleus was independently positively associated with the severity of anxious arousal (ie, hypervigilance) symptoms (r = 0.52) but not with any of the other PTSD symptom clusters.These results suggest that PTSD is associated with significantly reduced NET availability in the locus coeruleus and that greater NET availability in this brain region is associated with increased severity of anxious arousal symptoms in individuals with PTSD.",0,0 +2867,Trauma-informed sexuality education: recognising the rights and resilience of youth,"Experiences of maltreatment during childhood and the emergence of sexuality during adolescence are both critical developmental issues that intersect in meaningful ways, yet the two are often isolated from each other in practice. Despite the prevalence of childhood maltreatment, sexuality education does not accommodate young people with trauma histories. This results in curricula and content that ignore the particular needs and experiences of a proportion of students in sexuality education classrooms. Trauma interventions commit a similar oversight by neglecting the prospects for positive, growth-promoting sexual experiences and relationships among young people who have been abused. The failure to account for young people's resilience in the sexual domain results in treatment approaches that emphasise sexual risks (e.g. revictimisation) and problem behaviours to the exclusion of guidance in cultivating positive sexualities. Consequently, many forms of sexuality education and maltreatment interventions may ...",0,0 +2868,Factors discriminating among profiles of resilience and psychopathology in children exposed to intimate partner violence (IPV),"To evaluate the social and emotional adjustment of 219 children in families with varying levels of intimate partner violence (IPV) using a model of risk and protection. To explore factors that differentiate children with poor adjustment from those with resilience.Mothers who experienced IPV in the past year and their children ages 6-12 were interviewed. Standardized measures assessed family violence, parenting, family functioning, maternal mental health, and children's adjustment and beliefs.Using cluster analysis, all cases with valid data on the Child Behavior Checklist, Child Depression Inventory, General Self-Worth and Social Self-Competence measures were described by four profiles of children's adjustment: Severe Adjustment Problems (24%); children who were Struggling (45%); those with Depression Only (11%); and Resilient (20%) with high competence and low adjustment problems. Multinomial logistic regression analyses showed children in the Severe Problems cluster witnessed more family violence and had mothers higher in depression and trauma symptoms than other children. Resilient and Struggling children had mothers with better parenting, more family strengths and no past violent partner. Parents of children with Severe Problems were lacking these attributes. The Depressed profile children witnessed less violence but had greater fears and worries about mother's safety.Factors related to the child, to the mother and to the family distinguish different profiles of adjustment for children exposed to IPV who are living in the community. Resilient children have less violence exposure, fewer fears and worries, and mothers with better mental health and parenting skills, suggesting avenues for intervention with this population.Findings suggest that child adjustment is largely influenced by parent functioning. Thus, services should be targeted at both the child and the parent. Clinical interventions shaped to the unique needs of the child might also be tested with this population.",0,0 +2869,"The Bosnian version of the international self-report measure of posttraumatic stress disorder, the Posttraumatic Stress Diagnostic Scale, is reliable and valid in a variety of different adult samples affected by war","The aim of the present study was to assess the internal consistency and discriminant and convergent validity of the Bosnian version of a self-report measure of posttraumatic stress disorder (PTSD), the Posttraumatic Stress Diagnostic Scale (PTDS). The PTDS yields both a PTSD diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) and a measure of symptom severity.812 people living in Sarajevo or in Banja Luka in Bosnia-Herzegovina, of whom the majority had experienced a high number of traumatic war events, were administered the PTDS and other measures of trauma-related psychopathology. The psychometric properties of the instrument were assessed using Cronbach's alpha and principal components analysis, and its construct validity was assessed via Spearman correlation coefficients with the other instruments.The PTDS and its subscales demonstrated high internal consistency. The principal components revealed by an exploratory analysis are broadly consistent with the DSM-IV subscales except that they reproduce some previously reported difficulties with the ""numbing"" items from the avoidance subscale. The construct validity of the PTDS was supported by appropriate correlations with other relevant measures of trauma related psychopathology.The Bosnian version of the PTDS thus appears to be a time-economic and psychometrically sound measure for screening and assessing current PTSD. This self-report measure awaits further validation by interview methods.",0,0 +2870,"Resilience, internalized stigma, self-esteem, and hopelessness among people with schizophrenia: Cultural comparison in Austria and Japan","Resilience is becoming an important topic in people with schizophrenia since there is evidence that it increases the probability for long-term recovery. The current study investigated transcultural differences in resilience across schizophrenia patients from two different geographical regions, Austria and Japan. Another objective was to examine transcultural differences in internalized stigma, self-esteem, and hopelessness, which can be expected to be relevant in this context, as well as the interrelations between these subjective elements of recovery and symptom severity. To this end, patients from outpatient mental health services in Innsbruck, Austria (N=52) and Tokyo, Japan (N=60) as well as 137 healthy comparison subjects from both countries were included into this cross-sectional study. Notably, we detected a significant country effect with markedly lower resilience (F=74.4, p<0.001) and self-esteem scores (F=226.0, p<0.001) as well as higher hopelessness scores (F=37.4, p<0.001) among Japanese subjects in general. In addition, both Austrian and Japanese patients indicated significantly lower degrees of resilience (F=57.5, p<0.001), self-esteem (F=51.8, p<0.001), and hope (F=29.5, p<0.001) compared to healthy control subjects. The inter-correlations between subjective elements of recovery were comparable in size in the two patient samples, but the inter-correlations between these issues and residual symptoms of schizophrenia as objective domains of recovery were markedly higher in Austrian subjects. This suggests that schizophrenia patients from Western European and Japanese cultures may have different needs to achieve recovery. In conclusion, it will be critical to develop culture-specific psychosocial programs and to examine their feasibility and effectiveness among these patients.",0,0 +2871,Pilot study on prolonged exposure of Japanese patients with posttraumatic stress disorder due to mixed traumatic events,"This pilot study investigated the feasibility of Prolonged Exposure (PE) treatment for Japanese patients with posttraumatic stress disorder (PTSD) due to mixed traumatic events. Among 12 participants in this study, 9 women and 1 man completed between 9 and 15 weekly individual PE sessions; 2 female participants dropped out in early sessions. Among completers, the authors identified a significant reduction of symptom severity scores from pretreatment to posttreatment in terms of PTSD and depression on therapist-rated and self-rated measurements. Symptom levels remained low in 3- and 6-month follow-up assessments. Our findings suggest that PE is feasible and can be accepted for PTSD patients not only in Western countries, but also for those in Japan.",0,0 +2872,Hierarchical organization of axis I psychiatric disorder comorbidity through age 30,"Hierarchical models of psychopathology based on substantial numbers of lifetime diagnostic categories have not been sufficiently evaluated, even though such models have relevance for theories of disorder etiology, course, or prognosis. In this research, a hierarchical component model of 16 Axis I disorders is derived, and model elements are evaluated in terms of their ability to demonstrate distinct associations with several clinically-relevant variables. Participants were 816 randomly selected adolescents from the community who were repeatedly assessed for psychiatric disorders and associated risk and protective factors over a 14-year period. First-degree relatives were also interviewed to establish their lifetime psychiatric history. Patterns of lifetime comorbidity among 16 psychiatric disorders were described at five levels of organization. In addition to the broadest level that accounted for the most variance in disorder covariation, evidence was obtained at successive levels in the hierarchy for internalizing and externalizing broad-band domains that could be subdivided into more refined clusters. The validity and potential utility of the resultant hierarchical model were further supported by distinct associations that components at each level had with exposure to childhood adversities, psychiatric disorders among first-degree relatives, and psychosocial functioning at ~age 30. A large number of DSM Axis I disorders can be described within broad-band internalizing and externalizing domains, and further differentiation within these domains is possible and likely useful for some purposes. Implications of this research for conceptualizing relations among psychiatric disorders are discussed.",0,0 +2873,A Guide to Psychological Debriefing: Managing Emotional Decompression and Post-Traumatic Stress Disorder,"(from the cover) Traumatic events strike unexpectedly and can turn everyday life upside down. Frequently, people suffering trauma cannot get past the experience and develop Post-Traumatic Stress Disorder (PTSD). Psychological debriefing (PD) is a process commonly used to prevent an individual from developing PTSD, allowing them to re-examine the event in a safe and controlled environment. This book offers a practical introduction to PTSD and psychological debriefing, and outlines an enhanced model of PD: 'Emotional Decompression'. Structured like a deep-sea dive, it incorporates carefully planned safety stops for discussion and explanation on the way back to the 'surface' to avoid getting 'the bends'. The book presents a range of recovery models, from the 'simple' models developed by Williams and Horowitz to the more complex 'Snakes and Ladders' model developed by the author. This book is essential for health practitioners, counselors, psychologists and professionals working with clients suffering from PTSD, as well as students. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +2874,The role of ex-POWs’ PTSD symptoms and trajectories in wives’ secondary traumatization.,"Secondary traumatization describes the phenomenon whereby those in proximity to trauma survivors develop psychological symptoms similar to those experienced by the direct survivor. The current study examined secondary trauma (ST) and generalized distress symptoms (general psychiatric symptomatology, functional disability, and self-rated health) in wives of former prisoners of war (ex-POWs). The study compared wives of Israeli ex-POWs from the 1973 Yom Kippur War with wives of a matched control group of non-POW Yom Kippur War combat veterans (CVs). The wives also were divided into groups based on their husbands' current posttraumatic stress disorder (PTSD) status and PTSD trajectory (i.e., chronic, delayed), and their outcomes were compared with resilient CVs. We found that wives of ex-POWs with PTSD reported higher ST and generalized distress than wives of ex-POWs and non-POW CVs without PTSD. Wives of ex-POWs with chronic PTSD reported the highest levels of functional disability. We also found that the relationships between husbands' prior captivity, and wives' ST and general psychiatric symptomatology were fully mediated by the husbands' PTSD symptoms. These findings indicate that it is exposure to a partner with PTSD that leads to overall ST and other distress symptoms, and not simply to a trauma survivor. Furthermore, the more severe their husbands' PTSD, the more wives are at risk for ST and general psychiatric symptomatology. Wives of partners with PTSD should therefore be considered high-risk groups for ST and distress that may require targeted interventions.",0,0 +2875,"Community-building before, during, and after times of trauma: The application of the LINC model of community resilience in Kosovo.","A family's heritage and values have profound bearing on the stressors they encounter and how they cope. Socioeconomic change, natural and man-made disasters, and international migration are major influences on the integrity of society. In these times of global financial crisis, communities around the world are in danger of losing their intrinsic structure and protective factors. Connectedness or attachment to family and culture of origin correlate with reduced risk-taking behaviors and a reduction in family and societal violence, posttraumatic stress, addiction, depression, suicidality, sexual risk taking, and other chronic and/or life-threatening health problems and illnesses. Facilitating these families' cultural and community ties and enhancing their access to extended-family and community resources can thus be protective against trauma. These relationships foster resilience and reduce the short- and long-term effects of stress on families and communities. Targets of interventions may be individuals, families, or communities. Assessment of vulnerabilities, protective factors, goals, and resources encourages and facilitates collaboration across natural and artificial support systems. Such collaboration is important in building resilience rather than perpetuating vulnerability and long-term problems for individuals, their families, and the communities in which they live. The recent Kosovar experience in implementing the LINC Model of Community Resilience illustrates these principles, as applied in the context of substance abuse services and community rebuilding in the period soon after armed conflict.",0,0 +2876,Pharmacotherapy for post traumatic stress disorder (PTSD),"Post traumatic stress disorder (PTSD) is a prevalent and disabling disorder. Evidence that PTSD is characterised by specific psychobiological dysfunctions has contributed to a growing interest in the use of medication in its treatment.To assess the effects of medication for post traumatic stress disorder.We searched the Cochrane Depression, Anxiety and Neurosis Group specialised register (CCDANCTR-Studies) on 18 August 2005, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library issue 4, 2004), MEDLINE (January 1966 to December 2004), PsycINFO (1966 to 2004), and the National PTSD Center Pilots database. Reference lists of retrieved articles were searched for additional studies.All randomised controlled trials (RCTs) of pharmacotherapy for PTSD.Two raters independently assessed RCTs for inclusion in the review, collated trial data, and assessed trial quality. Investigators were contacted to obtain missing data. Summary statistics were stratified by medication class, and by medication agent for the selective serotonin reuptake inhibitors (SSRIs). Dichotomous and continuous measures were calculated using a random effects model, heterogeneity was assessed, and subgroup/sensitivity analyses were undertaken.35 short-term (14 weeks or less) RCTs were included in the analysis (4597 participants). Symptom severity for 17 trials was significantly reduced in the medication groups, relative to placebo (weighted mean difference -5.76, 95% confidence intervals (CI) -8.16 to -3.36, number of participants (N) = 2507). Similarly, summary statistics for responder status from 13 trials demonstrated overall superiority of a variety of medication agents to placebo (relative risk 1.49, 95% CI 1.28 to 1.73, number needed to treat = 4.85, 95% CI 3.85 to 6.25, N = 1272). Medication and placebo response occurred in 59.1% (N = 644) and 38.5% (628) of patients, respectively. Of the medication classes, evidence of treatment efficacy was most convincing for the SSRIs. Medication was superior to placebo in reducing the severity of PTSD symptom clusters, comorbid depression and disability. Medication was also less well tolerated than placebo. A narrative review of 3 maintenance trials suggested that long term medication may be required in treating PTSD.Medication treatments can be effective in treating PTSD, acting to reduce its core symptoms, as well as associated depression and disability. The findings of this review support the status of SSRIs as first line agents in the pharmacotherapy of PTSD, as well as their value in long-term treatment. However, there remain important gaps in the evidence base, and a continued need for more effective agents in the management of PTSD.",0,0 +2877,Psychological resilience and dysfunction among hospitalized survivors of the SARS epidemic in Hong Kong: A latent class approach.,"To examine trajectories of psychological functioning using latent class analysis on a sample of hospitalized survivors of the 2003 severe acute respiratory syndrome (SARS) epidemic in Hong Kong.A longitudinal study of 997 survivors, recruited from among 1,331 individuals hospitalized for SARS, were interviewed at 6, 12, and 18 months after hospitalization.Psychological and physical functioning at each time point was measured using the 12-item Medical Outcome Study Short-Form Health Survey (SF-12).Four latent classes were identified--chronic dysfunction, delayed dysfunction, recovery, and resilience. All groups had better physical health than the chronic group. Resilient and recovered individuals had greater social support and less SARS-related worry, and resilient individuals were more likely to be male. The resilient group also had greater social support than the delayed group and better physical functioning than the recovered group.This study demonstrated that longitudinal outcome trajectories following a major health-threat event in an Asian sample bear close resemblance to prototypical trajectories observed in trauma studies using Western samples. Unique predictors of the trajectories included factors observed in previous studies, such as social support, as well as factors of particular relevance to a major disease outbreak, such as SARS-related worry.",0,0 +2878,"Traumatic stress, oxidative stress and post-traumatic stress disorder: neurodegeneration and the accelerated-aging hypothesis","Post-traumatic stress disorder (PTSD) is associated with elevated risk for a variety of age-related diseases and neurodegeneration. In this paper, we review evidence relevant to the hypothesis that chronic PTSD constitutes a form of persistent life stress that potentiates oxidative stress (OXS) and accelerates cellular aging. We provide an overview of empirical studies that have examined the effects of psychological stress on OXS, discuss the stress-perpetuating characteristics of PTSD, and then identify mechanisms by which PTSD might promote OXS and accelerated aging. We review studies on OXS-related genes and the role that they may have in moderating the effects of PTSD on neural integrity and conclude with a discussion of directions for future research on antioxidant treatments and biomarkers of accelerated aging in PTSD.",0,0 +2879,Post-traumatic stress avoidance is attenuated by corticosterone and associated with brain levels of steroid receptor co-activator-1 in rats,"Individuals with post-traumatic stress disorder (PTSD) avoid trauma-related stimuli and exhibit blunted hypothalamic-pituitary-adrenal (HPA) axis activation at the time of stress. Our rodent model of stress mimics the avoidance symptom cluster of PTSD. Rats are classified as ""Avoiders"" or ""Non-Avoiders"" post-stress based on the avoidance of a predator-odor paired context. Previously, we found Avoiders exhibit an attenuated HPA stress response to predator odor. We hypothesized that corticosterone administration before stress would reduce the magnitude and incidence of stress-paired context avoidance. Furthermore, we also predicted that Avoiders would exhibit altered expression of glucocorticoid receptor (GR) signaling machinery elements, including steroid receptor co-activator (SRC)-1. Male Wistar rats (n = 16) were pretreated with corticosterone (25 mg/kg) or saline and exposed to predator-odor stress paired with a context and tested for avoidance 24 h later. A second group of corticosterone-naïve rats (n = 24) were stressed (or not), indexed for avoidance 24 h later, and killed 48 h post-odor exposure to measure phosphorylated GR, FKBP51 and SRC-1 levels in the paraventricular nucleus (PVN), central amygdala (CeA) and ventral hippocampus (VH), all brain sites that highly express GRs and regulate HPA function. Corticosterone pretreatment reduced the magnitude and incidence of avoidance. In Avoiders, predator-odor exposure led to lower SRC-1 expression in the PVN and CeA, and higher SRC-1 expression in the VH. SRC-1 expression in PVN, CeA and VH was predicted by prior avoidance behavior. Hence, a blunted HPA stress response may contribute to stress-induced neuroadaptations in central SRC-1 levels and behavioral dysfunction in Avoider rats.",0,0 +2880,Psychological Assessment of Patients with Dissociative Identity Disorder,"This article discusses how psychologic assessment can assist in the diagnosis of dissociative identity disorder (DID) and in planning treatment for patients who are dissociative. A battery of tests that can assess the extent of dissociation is outlined, the research on dissociation on various psychologic tests is reviewed, and new Rorschach data on severely dissociative patients that can be useful in planning treatment is presented. Diagnosing DID is a complex process and requires assessors to have knowledge of the assessment and treatment literature on posttraumatic stress disorder (PTSD), dissociative disorders, and personality disorders. The literature provides excellent reviews of assessment of posttraumatic states [1–4]. In addition to the complexity of assessing PTSD itself, assessment of DID requires the patient to reveal what is often a private, hidden world to a powerful stranger [5]. These challenges may be further compounded because many of the measures, particularly the projective tests, can open up emotional wounds and stir potentially painful memories, triggering dissociation and switching among dissociated states during the testing itself [5,6]. Clinicians must develop a collaborative relationship with patients who have DID before beginning the assessment to make the experience therapeutic rather than retraumatizing. A collaborative relationship will also help yield meaningful, rather than defended, test results.",0,0 +2881,Are lifestyle behavioral factors associated with health-related quality of life in long-term survivors of non-Hodgkin lymphoma?,"The objective of the current study was to determine whether survivors of non-Hodgkin lymphoma are meeting select American Cancer Society (ACS) health-related guidelines for cancer survivors, as well as to examine relationships between these lifestyle factors and health-related quality of life (HRQoL) and posttraumatic stress (PTS).A cross-sectional sample of 566 survivors of NHL was identified from the tumor registries of 2 large academic medical centers. Respondents were surveyed regarding physical activity, fruit and vegetable intake, body weight, tobacco use, HRQoL using the Medical Outcomes Study Short Form-36, and PTS using the Posttraumatic Stress Disorder CheckList-Civilian form. Lifestyle cluster scores were generated based on whether individuals met health guidelines and multiple linear regression analysis was used to evaluate relationships between lifestyle behaviors and HRQoL scores and PTS scores.Approximately 11% of participants met all 4 ACS health recommendations. Meeting all 4 healthy recommendations was related to better physical and mental QoL (standardized regression coefficient [β], .57 [P<.0001] and β, .47 [P = .002]) and to lower PTS scores (β, -0.41; P = .01).Survivors of NHL who met more ACS health-related guidelines appeared to have better HRQoL and less PTS. Unfortunately, many survivors are not meeting these guidelines, which could impact their overall well-being and longevity.",0,0 +2882,Heat stress deteriorates mitochondrial β-oxidation of long-chain fatty acids in cultured fibroblasts with fatty acid β-oxidation disorders,"Mitochondrial fatty acids beta-oxidation disorder (FAOD) has become popular with development of tandem mass spectrometry (MS/MS) and enzymatic evaluation techniques. FAOD occasionally causes acute encephalopathy or even sudden death in children. On the other hand, hyperpyrexia may also trigger severe seizures or encephalopathy, which might be caused by the defects of fatty acid beta-oxidation (FAO). We investigated the effect of heat stress on FAO to determine the relationship between serious febrile episodes and defect in beta-oxidation of fatty acid in children. Fibroblasts from healthy control and children with various FAODs, were cultured in the medium loaded with unlabelled palmitic acid for 96 h at 37 degrees C or 41 degrees C. Acylcarnitine (AC) profiles in the medium were determined by MS/MS, and specific ratios of ACs were calculated. Under heat stress (at 41 degrees C), long-chain ACs (C12, C14, or C16) were increased, while medium-chain ACs (C6, C8, or C10) were decreased in cells with carnitine palmitoyl transferase II deficiency, very-long-chain acyl-CoA dehydrogenase deficiency and mitochondrial trifunctional protein deficiency, whereas AC species from short-chain (C4) to long-chain (C16) were barely affected in medium-chain acyl-CoA dehydrogenase and control. While long-chain ACs (C12-C16) were significantly elevated, short to medium-chain ACs (C4-C10) were reduced in multiple acyl-CoA dehydrogenase deficiency. These data suggest that patients with long-chain FAODs may be more susceptible to heat stress compared to medium-chain FAOD or healthy control and that serious febrile episodes may deteriorate long-chain FAO in patients with long-chain FAODs.",0,0 +2883,Determinants of resource needs and utilization among refugees over time,"This study examined refugees' resource needs and utilization over time, investigated the relationships between pre-displacement/socio-demographic variables and resource needs and utilization, and explored the role of resource needs and utilization on psychiatric symptom trajectories.Iraqi refugees to the United States (N = 298) were assessed upon arrival and at 1-year intervals for 2 years for socio-demographic variables and pre-displacement trauma experiences, their need for and utilization of 14 different resources, and PTSD and depressive symptoms.Although refugees reported reduction of some needs over time (e.g., need for cash assistance declined from 99 to 71 %), other needs remained high (e.g., 99 % of refugees reported a need for health care at the 2-year interview). Generally, the lowest needs were reported after 2 years, and the highest utilization occurred during the first year post-arrival. Pre-displacement trauma exposure predicted high health care needs but not high health care utilization. Both high need for and use of health care predicted increasing PTSD and depressive symptoms. Specifically, increased use of psychological care across the three measurement waves predicted more PTSD and depression symptoms at the 2-year interview.Differences emerged between need for and actual use of resources, especially for highly trauma-exposed refugees. Resettlement agencies and assistance programs should consider the complex relationships between resource needs, resource utilization, and mental health during the early resettlement period.",0,0 +2884,Profiles of Adaptation Among Child Victims of Suspected Maltreatment,"This research seeks to identify profiles of adaptation among child victims of suspected maltreatment using a social-ecological framework. Data were drawn from the LONGSCAN multisite longitudinal study. Participants were 597 12-year-old children of diverse backgrounds (57% girls) with at least one Child Protective Services report of suspected maltreatment (M = 3.4 reports). Self-, caregiver-, and teacher-reports were collected to assess child competence, psychological and behavioral problems, and family and neighborhood characteristics. Latent Profile Analysis was used to classify individuals into empirically derived groups. The best-fitting model yielded five distinct profiles: consistent resilience; consistent maladaptation; posttraumatic stress problems; school maladaptation, family protection; and low socialization skills. Findings underscore the heterogeneity of child adaptation and reveal unique profiles of adaptation and contextual protection. Within-person variation in functioning suggests the need for comprehensive assessment across domains and contexts to address the clinical needs of maltreated youth.",0,0 +2885,Postdeployment Suicidal Ideations and Trajectories of Posttraumatic Stress Disorder in Danish Soldiers,"Article AbstractObjective: Suicidal ideation in veterans is of great concern. The objective of this study is to examine how heterogeneous posttraumatic stress disorder (PTSD) trajectories are associated with postdeployment suicidal ideation in veterans 2.5 years postdeployment to a combat zone in Afghanistan. If PTSD trajectories are associated with postdeployment suicidal ideations, then the accumulative knowledge on what characterizes veterans falling into different PTSD trajectories may provide better opportunities for early identification of suicidal high-risk veterans.Method: In this prospective study of 743 Danish soldiers deployed to Afghanistan from February to August in 2009, we collected data at 6 time points from 6 weeks before deployment to 2.5 years after homecoming (total for this study: 456). At all assessments, the soldiers responded to a comprehensive questionnaire including measures of PTSD (measured by the PTSD Checklist, Civilian Version) and other mental and physical health variables, demographics, and social and combat-related factors. Suicidal ideation was measured by an item from the European Parasuicide Study Interview Schedule II. In a previous study based on soldiers from this cohort, we identified 6 PTSD trajectories using latent growth mixture modeling, which we have extracted and applied as independent variables in this study. Adjusted multivariable logistic regression analyses were applied to examine whether deployed soldiers with certain PTSD symptom trajectories were more likely to report suicidal ideation 2.5 years after homecoming.Results: Two PTSD trajectories with high PTSD symptom level 2.5 years after return were significantly associated with suicidal ideation 2.5 years after homecoming. Thus, a relieved-worsening class, described by initial decreasing PTSD symptom levels followed by a steep increase in symptoms had higher risk of suicidal ideation (OR = 7.84; 95% CI, 1.68-36.6), which was also the case for a late-onset class (OR 5.2; 95% CI, 2.21-12.24) when compared to a low-stable class.Conclusions: Heterogeneous PTSD trajectories are associated with suicidal ideation in veterans 2.5 years after homecoming.",0,0 +2886,The descriptive epidemiology of internalizing and externalizing psychiatric dimensions,"Background: There is a growing recognition that comorbidity among individual mental disorders is best explained by the broad, psychiatric dimensions of internalization (sub-divided into distress and fear) and externalization. The aims of the current study were to examine the descriptive epidemiology of these psychiatric dimensions. Methods: Continuous measures of distress, fear and externalization dimensions were obtained from principal components analysis of 11 common ICD-10 mental disorders in a large (N = 10,641) community sample. The relationships between these three dimensions and sociodemographic, physical illness and personality disorder characteristics were determined using multivariate linear regression analyses. Results: The results suggest that the distress dimension is more strongly related to disadvantageous sociodemographic characteristics and physical health conditions than either the fear or externalizing dimensions. The results also demonstrate some specificity in profiles particularly with regard to the personality disorders. Conclusions: Greater emphasis should be placed on continuous psychiatric dimensions that are thought to underlie the expression of putatively independent mental disorders. \ \text",0,0 +2887,Post-traumatic stress disorder following disasters: a systematic review,"Background Disasters are traumatic events that may result in a wide range of mental and physical health consequences. Post-traumatic stress disorder (PTSD) is probably the most commonly studied post-disaster psychiatric disorder. This review aimed to systematically assess the evidence about PTSD following exposure to disasters. Method A systematic search was performed. Eligible studies for this review included reports based on the DSM criteria of PTSD symptoms. The time-frame for inclusion of reports in this review is from 1980 (when PTSD was first introduced in DSM-III) and February 2007 when the literature search for this examination was terminated. Results We identified 284 reports of PTSD following disasters published in peer-reviewed journals since 1980. We categorized them according to the following classification: (1) human-made disasters ( n =90), (2) technological disasters ( n =65), and (3) natural disasters ( n =116). Since some studies reported on findings from mixed samples (e.g. survivors of flooding and chemical contamination) we grouped these studies together ( n =13). Conclusions The body of research conducted after disasters in the past three decades suggests that the burden of PTSD among persons exposed to disasters is substantial. Post-disaster PTSD is associated with a range of correlates including sociodemographic and background factors, event exposure characteristics, social support factors and personality traits. Relatively few studies have employed longitudinal assessments enabling documentation of the course of PTSD. Methodological limitations and future directions for research in this field are discussed.",0,0 +2888,Posttraumatic Stress Symptomatology as a Mediator of the Association Between Military Sexual Trauma and Post-Deployment Physical Health in Women,"This study examined posttraumatic stress symptomatology (PSS) as a mediator of the association between military sexual trauma and post-deployment physical health. Relationships were examined in a sample of 83 female veterans of the first Gulf War (1990-1991) approximately 10 years post-deployment. Participants reported on the frequency of sexual harassment and sexual assault experienced during deployment. Physical health was measured using participants' self-reports of pre-deployment and post-deployment symptoms within 7 body systems. Sexual harassment exposure was not found to be associated with PSS-mediated associations with physical health symptoms. However, sexual assault during deployment was found to be associated with PSS and 4 of the 7 health symptom clusters assessed: gastrointestinal, genitourinary, musculoskeletal, and neurological symptoms. Furthermore, PSS was found to be a significant mediator of the sexual assault-physical health relationship in each of these domains, with the indirect path accounting for 74% to 100% of the relationship. The findings from the current study indicate that sexual assault has detrimental associations with physical health and that PSS plays a primary role in that relationship.",0,0 +2889,Exposure to Prolonged Socio-Political Conflict and the Risk of PTSD and Depression among Palestinians,"Little is known about the impact of traumatic experiences and stressful life conditions on people in low-income countries who live in conditions of ongoing political violence. In order to determine the prevalence and predictors of post-traumatic stress disorder (PTSD) and major depression (MD) among Palestinians subjected to chronic political violence and upheaval, we used a stratified multi-stage cluster random sampling strategy to interview a representative sample of 1,200 Palestinian adults living in Gaza, the West Bank, and East Jerusalem. Prevalence of PTSD/MD for men living in the West Bank, Gaza, and East Jerusalem was 25.4%/29.9%, 22.6%/27.6%, and 16.1%/16.1%, respectively. For women, the prevalence of PTSD/MD was 23.8%/29.0%, 23.9%/28.9%, and 19.7%/27.6%. Among men, PTSD was significantly positively associated with age group, two or more incidences of political violence (compared to none), greater intrapersonal resource loss, and loss of faith in government. MD was positively associated with experiencing exposure to one, or two or more, incidences of political violence (compared to none), and greater interpersonal and intrapersonal resource loss. Among women, PTSD was positively associated with greater interpersonal and intrapersonal resource loss, and MD was positively associated with death of a loved one, two or more socio-political stressors (compared to none) previous to the past year, one or more socio-political stressors (compared to none) in the past year, and greater interpersonal and intrapersonal resource loss. Interpersonal and intrapersonal resource losses were consistently associated with PTSD and MD, suggesting potential targets for intervention and prevention efforts and thus provide important keys to treatment in areas of ongoing conflict.",0,0 +2890,Psychosocial Factors Limit Outcomes after Trauma,"Psychological morbidity compromises return to work after trauma. We demonstrate this relationship and present methods to identify risks for significant psychological morbidity.Thirty-five adults were evaluated prospectively for return to functional employment after injury using demographic data, validated psychological and health measures, and the Michigan Critical Events Perception Scale. Evaluation was conducted at admission and at 1 and 5 months after injury.Poor return to work at 5 months was attributable to physical disability (p < 0.05) and psychological disturbance (p < 0.05) in a regression model that controlled for preinjury employment and psychopathologic factors as well as injury severity. A high score on the Impact of Events Scale administered during acute admission predicted development of acute stress disorder at 1 month (p < 0.01, odds ratio (OR) = 9.4) and posttraumatic stress disorder at 5 months (p < 0.05, OR = 6.7). Peritraumatic dissociation on the Michigan Critical Events Perception Scale was predictive for development of acute stress disorder (p < 0.05, OR = 5.8) at 1 month and posttraumatic stress disorder (p < 0.05, OR = 7.5) at 5 months.Psychological morbidity after injury compromises return to work independent of preinjury employment and psychopathologic condition, Injury Severity Score, or ambulation. A high Impact of Events Scale score or peritraumatic dissociation at admission predicts this morbidity.",0,0 +2891,The Equivalence of Traditional and Diagnostic Classification Model Approaches in Analyzing Empirical and Simulated Posttraumatic Stress Disorder Data,"The purpose of this study was to evaluate the performance of a log-linear cognitive diagnosis model (LCDM) as compared to three traditional scoring methods for the diagnosis of posttraumatic stress disorder (PTSD) as measured by the Posttraumatic Stress Disorder Checklist (PCL) civilian and military versions. Both civilian (empirical) and military (simulated) data were used in this study. Changes in the measurement and structure of PTSD have occurred over the years, especially as it related to military Veterans. Just recently in 2013, the diagnostic criteria for PTSD was changed to a four-dimensional diagnosis, although this study used the pre-2013 three-dimensional diagnosis due to the time period and instruments used to collect the empirical sample and the original samples used as parameters for the simulated data. Model parameters, respondent estimates, respondent classifications, and rates of agreement between the diagnostic methods were explored for both empirical and simulated data and further for sample size differences with the simulated data. The LCDM structural model was found to be comparable to the CFA model and the average item intercept -.539, showing that roughly 37% of respondents who were not positive for any PTSD clusters endorsed the item as being a problem they experienced. The average main effect parameter was 2.318, the size of which is relative to the size of the intercept where the lower intercepts and higher main effects showed more discrimination between those respondents who were ill or not ill with PTSD. Since posttraumatic stress disorder is both a compensatory and non-compensatory diagnosis the LCDM was evaluated on how well it was able to reflect these dimensions in the respondent estimates and classifications. Overall, the LCDM performed poorly compared to the traditional scoring, with the LCDM performing better at the symptom cluster level than at the diagnostic level. The potential utility of this feedback to a practicing clinician was found to be not yet suitable to clinical practice, but this study shows an opportunity to refine the PCL instrument to perform better in the LCDM framework, or to develop an instrument that is more discriminating and may be useful in differential diagnosis. (PsycINFO Database Record (c) 2015 APA, all rights reserved)",0,0 +2892,“Clinical brain profiling”: A neuroscientific diagnostic approach for mental disorders,"Clinical brain profiling is an attempt to map a descriptive nosology in psychiatry to underlying constructs in neurobiology and brain dynamics. This paper briefly reviews the motivation behind clinical brain profiling (CBP) and presents some provisional validation using clinical assessments and meta-analyses of neuroscientific publications. The paper has four sections. In the first, we review the nature and motivation for clinical brain profiling. This involves a description of the key aspects of functional anatomy that can lead to psychopathology. These features constitute the dimensions or categories for a profile of brain disorders based upon pathophysiology. The second section describes a mapping or translation matrix that maps from symptoms and signs, of a descriptive sort, to the CBP dimensions that provide a more mechanistic explanation. We will describe how this mapping engenders archetypal diagnoses, referring readers to tables and figures. The third section addresses the construct validity of clinical brain profiling by establishing correlations between profiles based on clinical ratings of symptoms and signs under classical diagnostic categories with the corresponding profiles generated automatically using archetypal diagnoses. We then provide further validation by performing a cluster analysis on the symptoms and signs and showing how they correspond to the equivalent brain profiles based upon clinical and automatic diagnosis. In the fourth section, we address the construct validity of clinical brain profiling by looking for associations between pathophysiological mechanisms (such as connectivity and plasticity) and nosological diagnoses (such as schizophrenia and depression). Based upon the mechanistic perspective offered in the first section, we test some particular hypotheses about double dissociations using a meta-analysis of PubMed searches. The final section concludes with perspectives for the future and outstanding validation issues for clinical brain profiling.",0,0 +2893,PREVENTING PTSD: THE VALUE OF INNER RESOURCEFULNESS AND A SENSE OF PERSONAL CONTROL OF A SITUATION. IS IT A MATTER OF PROBLEM-SOLVING OR ANXIETY MANAGEMENT?,"The accounts of five subjects who survived life threatening experiences without the development of PTSD were examined, focusing on the coping strategies and cognitions described in these situations. The study aimed to determine whether there was a common pattern of response amongst subjects in these situations similar to the cognitive patterns described by the senior author of the previous case study (Ness & Macaskill, 2000) who survived a near drowning experience without the development of PTSD. In the search for common coping strategies all five respondents in the study completed the Locus of Control Scale (Rotter, 1966) and the Self-Control Schedule (Fisher & Reason, 1988). All five respondents demonstrated the use of problem solving as their main cognitive strategy, utilizing specific information from their previous experience relevant to their life-threatening situation. Respondents did not appear to rely on coping strategies aimed at the management of acute anxiety symptomatology. There was no common pattern among respondents in profiles on the Self-Control Schedule or the Locus of Control Scale. The possible implications of this case series study are discussed in relation to opportunities for the prevention of PTSD, the use of debriefing and the treatment of post-traumatic stress.",0,0 +2894,The Multidimensional Inventory of Dissociation (MID): A Comprehensive Measure of Pathological Dissociation,"This article describes the development and validation of the Multidimensional Inventory of Dissociation (MID). The MID is a 218-item, self-administered, multiscale instrument that comprehensively assesses the phenomenological domain of pathological dissociation and diagnoses the dissociative disorders. The MID measures 14 major facets of pathological dissociation; it has 23 dissociation diagnostic scales that simultaneously operationalize (1) the subjective/ phenomenological domain of pathological dissociation and (2) the hypothesized dissociative symptoms of dissociative identity disorder (Dell, 2001a). The MID was designed for clinical research and for diagnostic assessment of patients who present with a mixture of dissociative, posttraumatic, and borderline symptoms. The MID demonstrated internal reliability, temporal stability, convergent validity, discriminant validity, and construct validity. The MID also exhibited incremental validity over the Dissociative Experiences Scale (DES) by predicting an additional 18% of the variance in weighted abuse scores on the Traumatic Experiences Questionnaire (TEQ). Confirmatory factor analysis (CFA) did not support a one-factor model of the MID's clinical scales (i.e., the 14 facets and the 23 diagnostic symptoms). In contrast, however, CFA of the MID's factor scales (Dell & Lawson, 2005) has strongly supported a one-factor model. It was concluded that both the MID's 168 dissociation items and the construct of pathological dissociation have a second-order, unifactorial structure.",0,0 +2895,Cognitive Model of the Maintenance and Treatment of Post-traumatic Stress Disorder Applied to Children and Adolescents,"The diagnosis of post-traumatic stress disorder (PTSD) has recently been established as a useful construct in children and adolescents, and is also now held to be a helpful framework when describing symptoms in refugees or survivors of war. This article reviews existing models of PTSD and existing evidence for treatment efficacy in both adults and children, and leads on to discuss the application of the Ehlers and Clark (2000) cognitive model to work with children and adolescents. The difference between techniques such as exposure and cognitive restructuring is examined. Two vignettes illustrate the practical details of working with young refugees with PTSD, including both exposure and cognitive restructuring in different phases of therapy, the importance of a collaborative formulation, and the importance of parental support during treatment as well as cultural and language factors specific to refugees.",0,0 +2896,Obsessive-Compulsive and Post Traumatic Avoidance Symptoms Influence the Response to Antihypertensive Therapy: Relevance in Uncontrolled Hypertension,"Aim: To investigate the association of uncontrolled hypertension with psychological factors associated with high cardiovascular morbidity and mortality (type D personality, depression, posttraumatic stress-related symptoms). Methods: 205 consecutive outpatient hypertensives completed three questionnaires evaluating Type D personality (DS 16), post traumatic symptoms (revised Impact of Events Scale), symptoms of anxiety, hostility, depression and obsessive-compulsive traits (subscales of the Symptom Checklist). Uncontrolled hypertension was diagnosed when clinic sitting blood pressure was above 140/90 mmHg (130/80 in the presence of diabetes or nephropathy), despite reported adherence to treatment with at least three antihypertensive medications, including a diuretic. Results: Uncontrolled hypertension (39%), was predicted by lower scores at Symptom Checklist obsessive-compulsive subscale and higher number of post traumatic avoidance symptoms, older age, diabetes, higher systolic pressure at first visit and longstanding hypertension. Type D personality correlated with depression, hostility, anxiety, compulsiveness, history of malignancy, and older age, but not with uncontrolled hypertension. Conclusions: Uncontrolled hypertension is associated with low obsessionality and avoidance symptoms, which reduce compliance to treatment. On the contrary, type D personality is not correlated with uncontrolled hypertension, as it includes compulsiveness, which improves compliance. A multidisciplinary approach to the hypertensive patient is mandatory to establish if the psychological profile affects compliance.",0,0 +2897,Do adverse childhood experiences increase the risk of postdeployment posttraumatic stress disorder in US Marines?,"BackgroundPosttraumatic stress disorder (PTSD) has been associated with combat intensity, lack of social support, and adverse childhood factors among military personnel in previous studies. It has not been well established if adverse childhood experiences reported predeployment are independently associated with postdeployment PTSD.MethodsData were evaluated from 8,391 male responders of the Recruit Assessment Program survey at Marine Corps Recruit Depot in San Diego who were deployed in support of military conflicts between September 2001 and June 2004. Using patient medical records to determine PTSD diagnoses, Cox proportional hazard modeling was performed to examine if adverse childhood experiences were independently associated with postdeployment PTSD.ResultsAfter adjustment, those who reported adverse childhood experiences in more than one category were significantly more likely to be diagnosed with postdeployment PTSD. Specifically, childhood physical neglect was mostly strongly associated with postdeployment PTSD.ConclusionsFindings suggest that Marines who experience multiple types of adverse childhood experiences may be at increased risk for postdeployment PTSD. It is possible, however, that these results indicate that men willing to report childhood adverse experiences are also more willing to seek care for PTSD.",0,0 +2898,Heterogeneity in signaled active avoidance learning: substantive and methodological relevance of diversity in instrumental defensive responses to threat cues,"Individuals exposed to traumatic stressors follow divergent patterns including resilience and chronic stress. However, researchers utilizing animal models that examine learned or instrumental threat responses thought to have translational relevance for Posttraumatic Stress Disorder (PTSD) and resilience typically use central tendency statistics that assume population homogeneity. This approach potentially overlooks fundamental differences that can explain human diversity in response to traumatic stressors. The current study tests this assumption by identifying and replicating common heterogeneous patterns of response to signaled active avoidance (AA) training. In this paradigm, rats are trained to prevent an aversive outcome (shock) by performing a learned instrumental behavior (shuttling between chambers) during the presentation of a conditioned threat cue (tone). We test the hypothesis that heterogeneous trajectories of threat avoidance provide more accurate model fit compared to a single mean trajectory in two separate studies. Study 1 conducted 3 days of signaled AA training (n = 81 animals) and study 2 conducted 5 days of training (n = 186 animals). We found that four trajectories in both samples provided the strongest model fit. Identified populations included animals that acquired and retained avoidance behavior on the first day (Rapid Avoiders: 22 and 25%); those who never successfully acquired avoidance (Non-Avoiders; 20 and 16%); a modal class who acquired avoidance over 3 days (Modal Avoiders; 37 and 50%); and a population who demonstrated a slow pattern of avoidance, failed to fully acquire avoidance in study 1 and did acquire avoidance on days 4 and 5 in study 2 (Slow Avoiders; 22.0 and 9%). With the exception of the Slow Avoiders in Study 1, populations that acquired demonstrated rapid step-like increases leading to asymptotic levels of avoidance. These findings indicate that avoidance responses are heterogeneous in a way that may be informative for understanding both resilience and PTSD as well as the nature of instrumental behavior acquisition. Characterizing heterogeneous populations based on their response to threat cues would increase the accuracy and translatability of such models and potentially lead to new discoveries that explain diversity in instrumental defensive responses.",0,0 +2899,Lessons from the 2004 Asian tsunami: Epidemiological and nosological debates in the diagnosis of post-traumatic stress disorder in non-Western post-disaster communities,"Background: The nosological validity of post-traumatic stress disorder (PTSD) remains controversial in non-Western communities. After natural disasters, epidemiological studies often overlook these conceptual debates and assess post-traumatic stress symptoms (PTSS) by short screening instruments. Such PTSS estimates are reported as inflated prevalence rates of PTSD in post-disaster settings. Aims: To discuss the prevalence and determinants of PTSS within the context of pertinent epidemiological and nosological debates. Methods: We assessed PTSS and grief symptoms of 643 survivors from five Indian villages struck by the Asian tsunami using the Impact of Events Scale – Revised and Complicated Grief Assessment Scale. We adopted a case control design and employed complex sample multiple logistic regression statistics to study the determinants of PTSS. Results: The prevalence of PTSS was 15.1% (95% CI 12.3%–17.9%). PTSS was significantly associated with traumatic grief, female gender, physical injury, death of children and financial losses, but not with functional disability ( p = .91). Conclusions: Although PTSS were common in this population, elevating them to a psychiatric construct of PTSD is questionable, when functional impairment and avoidance behaviours were absent. Grief reactions, socio-economic burden, and poor support systems contribute towards PTSS. We highlight the important issues regarding the nosological validity and epidemiology of PTSD in non-Western communities.",0,0 +2900,Treatment of concurrent PTSD and OCD: A commentary on the case of Howard,"The complexity inherent in treating patients diagnosed with multiple disorders often leaves clinicians feeling unsure of how best to encourage change, or even where to begin. The present commentary discusses the interplay between the symptoms of posttraumatic stress disorder and obsessive-compulsive disorder ( Kimble, 2000 ). Focusing on the need to assess the interplay of the two symptom clusters, the paper presents a model for understanding the etiological and functional relations that could link the symptoms of posttraumatic stress disorder and obsessive-compulsive disorder. Further, the paper discusses ways in which a clinician might approach such complex cases in order to address all of the client's needs in an effective and efficient manner.",0,0 +2901,Exploratory factor analysis of two measures of posttraumatic stress disorder (PTSD) symptoms in a non-clinical sample of college students,"This study investigated the psychometric structure of two widely utilized measures of posttraumatic symptoms in a primarily Caucasian non-clinical sample. Given the prevalence of trauma exposure in non-referred samples, measurement of resulting symptoms is a critical issue. Exploratory factor analysis was utilized to assess and compare the factor structure of the Impact of Event Scale [IES; Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: a measure of subjective stress. Psychosomatic Medicine, 41, 209-218] and the Mississippi Scale for Posttraumatic Stress Disorder, Civilian version [MIS-Civ; Vreven, D. L., Gudanowski, D. M., King, L. A., & King, D. W. (1995). The Civilian Version of the Mississippi PTSD Scale-a psychometric evaluation. Journal of Traumatic Stress, 8, 91-109] in a sample of college students reporting exposure to potentially traumatic events. The psychometric structure of the IES was largely consistent with the two-factor structure widely reported in the literature, while the structure of the MIS-Civ varied considerably in this sample. Notably, non-clinical samples tended to report fewer social and occupational dysfunction than clinical samples predominantly utilized in PTSD research. Implications for use of these instruments in screening samples are discussed.",0,0 +2902,Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study,"South Africa's unique history, characterised by apartheid, a form of constitutional racial segregation and exploitation, and a long period of political violence and state-sponsored oppression ending only in 1994, suggests a high level of trauma exposure in the general population. The aim of this study was to document the epidemiology of trauma and posttraumatic stress disorder (PTSD) in the South African general population.The South African Stress and Health Study is a nationally representative survey of South African adults using the WHO's Composite International Diagnostic Interview (CIDI) to assess exposure to trauma and presence of DSM-IV mental disorders.The most common traumatic events were the unexpected death of a loved one and witnessing trauma occurring to others. Lifetime and 12-month prevalence rates of PTSD were 2.3% and 0.7% respectively, while the conditional prevalence of PTSD after trauma exposure was 3.5%. PTSD conditional risk after trauma exposure and probability of chronicity after PTSD onset were both highest for witnessing trauma. Socio-demographic factors such as sex, age and education were largely unrelated to PTSD risk.The occurrence of trauma and PTSD in South Africa is not distributed according to the socio-demographic factors or trauma types observed in other countries. The dominant role of witnessing in contributing to PTSD may reflect the public settings of trauma exposure in South Africa and highlight the importance of political and social context in shaping the epidemiology of PTSD.",0,0 +2903,Resposta ao estresse: II. Resiliência e vulnerabilidade,"A crescente exposicao a estressores na vida cotidiana aumentou significativamente a investigacao da resposta ao estresse nas duas ultimas decadas. Embora associada a consequencias negativas, pois muitas patologias fisicas e mentais sao desencadeadas por exposicao cronica a estressores, esta resposta e indispensavel para sobrevivencia do individuo e e extremamente adaptativa quando ativada de forma aguda. Na parte I desta revisao foram abordados os conceitos de homestase e alostase e os sistemas fisiologicos ativados durante a resposta ao estresse. Na parte II serao discutidos fatores que modulam a resposta ao estresse tais como sexo, temperamento, periodos criticos do desenvolvimento e a presenca ou ausencia de suporte social. A interacao entre os fatores geneticos e ambientais gera os perfis da resposta psicofisiologica que caracterizam os fenotipos de susceptibilidade e resiliencia frente aos estressores e sua relacao com uma patologia mental cada vez mais presente na sociedade moderna, o transtorno de estresse pos-traumatico.",0,0 +2904,Psychogene Störungen bei deutschen Soldaten des Ersten und Zweiten Weltkrieges,"In the First and Second World War German soldiers frequently suffered from psychogenic disorders. By comparison a change in the prevalences can be noted: in the First World War dissociative disorders dominated the clinical impression (""shell shock""), in the Second World War they could rarely be seen but were replaced by somatoform and psychosomatic diseases. The discussion about numerous reasons for this development has not been completed yet and is still not free from political attitudes. To achieve a more scientific point of view, the perspective of psychotraumatology might be helpful. According to psychotraumatic research, dissociative and somatoform disorders can emerge in a close relation to a Posttraumatic Stress Disorder. The choice of symptoms depends on personality traits of the victim, but also on specific factors that characterise the situation in which the trauma appears. The mixture of pathogenetic and protective influences includes e. g. the possibility of flight- or fight reactions, feelings of trauma-associated guilt and group cohesion in the military unit. These factors can be useful to help explain the change of symptoms between both wars. In addition the analysis of situational conditions in former wars can give hints to actual planning and prophylaxis strategies in modern military psychiatry, that has to adjust to very different military operation fields.",0,0 +2905,Gastroesophageal Reflux Symptoms and Comorbid Asthma and Posttraumatic Stress Disorder Following the 9/11 Terrorist Attacks on World Trade Center in New York City,"Excess gastroesophageal reflux disease (GERD) was reported in several populations exposed to the September 11 2001 (9/11) terrorist attacks on the World Trade Center (WTC). We examined new onset gastroesophageal reflux symptoms (GERS) since 9/11 and persisting up to 5-6 years in relation to 9/11-related exposures among the WTC Health Registry enrollees, and potential associations with comorbid asthma and posttraumatic stress disorder (PTSD).This is a retrospective analysis of 37,118 adult enrollees (i.e., rescue/recovery workers, local residents, area workers, and passersby in lower Manhattan on 9/11) who reported no pre-9/11 GERS and who participated in two Registry surveys 2-3 and 5-6 years after 9/11. Post-9/11 GERS (new onset since 9/11) reported at first survey, and persistent GERS (post-9/11 GERS reported at both surveys) were analyzed using log-binomial regression.Cumulative incidence was 20% for post-9/11 GERS and 13% for persistent GERS. Persistent GERS occurred more often among those with comorbid PTSD (24%), asthma (13%), or both (36%) compared with neither of the comorbid conditions (8%). Among enrollees with neither asthma nor PTSD, the adjusted risk ratio (aRR) for persistent GERS was elevated among: workers arriving at the WTC pile on 9/11 (aRR=1.6; 95% confidence interval (CI) 1.3-2.1) or working at the WTC site > 90 days (aRR=1.6; 1.4-2.0); residents exposed to the intense dust cloud on 9/11 (aRR=1.5; 1.0-2.3), or who did not evacuate their homes (aRR=1.7; 1.2-2.3); and area workers exposed to the intense dust cloud (aRR=1.5; 1.2-1.8).Disaster-related environmental exposures may contribute to the development of GERS. GERS may be accentuated in the presence of asthma or PTSD.",0,0 +2906,Pathways for psychological adjustment in breast cancer: A longitudinal study on coping strategies and posttraumatic growth,"This longitudinal study examined the role of coping strategies and posttraumatic growth (PTG) on the psychological adjustment to breast cancer trajectory. The participants were 50 women assessed at the time of surgery (T1), during adjuvant treatment (T2) and six months after the end of treatment (T3). Women completed questionnaires assessing coping strategies, PTG and psychological adjustment (psychological quality of life, anxiety and depression). Results showed that the greatest impact of breast cancer on women's adjustment occurred at T1, when patients were significantly more anxious than in the other phases of the disease. The type of surgery and adjuvant treatment did not account for the course of PTG and adjustment. Coping through seeking social support and using cognitive strategies at T1 were linked to psychological quality of life and depression at T3 via PTG dimension of personal resources and skills at T2. Findings emphasise the value of promoting adaptive coping strategies and PTG in order to improve psychological adjustment in breast cancer patients.",0,0 +2907,A preliminary study of the association between traditional masculine behavioral norms and PTSD symptoms in Iraq and Afghanistan veterans.,"Studies identifying a high prevalence of posttraumatic stress disorder (PTSD) and low treatment utilization among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) Veterans reinforce the need for a greater understanding of the disorder in this population. Although traditional masculine norms have been found to relate to both help seeking and PTSD among civilians, little is known about their impact on war Veterans. The current study examined relationships between masculine behaviors, using the Masculine Behavior Scale (MBS), and PTSD symptoms in OEF/OIF Veterans, drawing on archival clinical data from 69 patients at an outpatient PTSD clinic. Despite a positive trend, total MBS scores were not correlated with overall PTSD severity. However, the MBS subscale Exaggerated Self-Reliance and Control positively predicted hyperarousal symptoms in a hierarchical regression model. Unexpectedly, the MBS subscale Success Dedication negatively predicted avoidance, suggesting that this masculine norm may serve a protective function against avoidance symptoms. Results suggest that elements of masculinity are related to specific PTSD symptom clusters in ways that may be both adaptive and maladaptive. Implications for PTSD treatment are discussed. © 2011 American Psychological Association.",0,0 +2908,Examination of the latent factor structure of the Alcohol Use Disorders Identification Test in two independent trauma patient groups using confirmatory factor analysis,"Recent research on the factor structure of the Alcohol Use Disorders Identification Test (AUDIT) provides support for two underlying factors: consumption and consequences. The current study sought to extend these findings to two independent and diverse trauma populations: traumatic injury patients and military veterans treated for posttraumatic stress disorder. The 2- and 3-factor solutions provided the best fit to the data, but there was a very high correlation between the second and third factors of the 3-factor solution. Parsimony suggests that the 2-factor solution is the preferred model. The 2-factor model has implications for alcohol screening using the AUDIT and supports the goal of screening to identify those with hazardous drinking and alcohol use disorders. An algorithm is proposed to inform alcohol screening protocols in a range of health settings for trauma-exposed patient groups.",0,0 +2909,Examination of the Content Specificity of Posttraumatic Cognitions in Combat Veterans With Posttraumatic Stress Disorder,"Cognitive theories have proposed the idea of content specificity, which holds that emotional disorders are associated with unique sets of negative cognitions. The existent research exploring the content specificity related to posttraumatic stress disorder (PTSD) and depression is sparse, and research is especially needed in veteran samples. The purpose of this study was to examine the associations of PTSD symptom clusters and comorbid depressive symptoms with posttraumatic cognitions.This study was cross-sectional in design, and the sample consisted of data from 150 male combat veterans with PTSD drawn from the baseline assessments of a large clinical trial. Analyses involved a series of separate and simultaneous linear regressions to examine the unique associations of comorbid depressive symptoms and PTSD symptom clusters with posttraumatic cognitions, as well as post hoc analyses to examine the mediational role of comorbid depressive symptoms.Findings demonstrated that posttraumatic negative cognitions about the self and self-blame were most strongly associated with comorbid depressive symptoms and the depression-related PTSD numbing cluster. Comorbid depressive symptoms also partially mediated nearly all the relationships between posttraumatic cognitions and PTSD symptom clusters.The findings of this study suggest that posttraumatic cognitions about the self and self-blame are not specific to PTSD but rather are more strongly related to symptoms of depression and negative affect. The results also suggest a potential pathway from posttraumatic cognitions to PTSD through the partially mediating influence of comorbid depression, and highlight the need to assess and treat comorbid depression in veterans with PTSD.",0,0 +2910,F Scale Elevation and PTSD MMPI Profiles,MMPI profiles for 87 PTSD veteran inpatients were classified and studied according to MMPI F Scale elevation. Mean MMPI profiles and frequency of high two-point code types were studied for different levels of F Scale elevation. Similar mean profile configurations were found for subgroups with F ≥ 70 with Scales 2 and 8 appearing as the two highest clinical scales. For F < 70 the configuration was different in that Scale 8 was not one of the two highest scales. The 2-8/8-2 high two-point code was the modal high two-point code for the total sample but the relative frequency of high two-point codes did vary somewhat within and across levels of F Scale elevation.,0,0 +2911,Relationship of Quality of Life and Perceived Control With Posttraumatic Stress Disorder Symptoms 3 to 6 Months After Myocardial Infarction,"This study examined whether psychological variables were associated with posttraumatic stress disorder (PTSD) symptoms 3 to 6 months after myocardial infarction.The sample included 52 patients with myocardial infarction. A structured interview was used to obtain information about PTSD symptoms, quality of life, and ratings of perceived control, danger, and predictability, as well as information about stressful events that occurred during hospitalization.Four patients (7.7%) met criteria for the diagnosis of PTSD. Elevated PTSD scores were associated with poorer quality of life (r = -0.32 to -0.79). Lower perceived control was associated with higher PTSD symptom scores (r = -0.30 to -0.52). Finally, PTSD scores were significantly correlated with the number of times patients were readmitted to the hospital (r = 0.35-0.57).Approximately 8% of patients experienced PTSD 3 to 6 months following MI. Increasing levels of PTSD symptoms were correlated with poorer quality of life. Perceived lack of control during the MI and multiple hospitalizations may be related to the severity of PTSD symptoms.",0,0 +2912,"Journalists, War, and Post Traumatic Stress Disorder *","(from the chapter) In this study of how war journalists deal with the stresses and physical dangers of their work, approximately one in five journalists was found to have ""probable"" Post Traumatic Stress Disorder (PTSD) while one in three showed evidence of psychological distress. Some of the large news organizations have belatedly discovered that war journalists are at risk for disorders such as PTSD. While confidential psychiatric help is now offered to war journalists within these organizations, the same does not apply to freelance journalists. The latter also lack the logistical back-up provided by the large organizations to their journalists in the field. Thus, the freelancer is potentially at greater risk for developing more frequent and enduring psychological difficulties. PTSD is potentially a chronic disorder. It also impacts on the quality of life and is known to affect the lives of family members too. For all these reasons, it behoves the news organizations to provide speedy access to therapy for their staff and any freelance journalists whom they may employ on a contract basis. It is equally important that no stigma be attached to those journalists requiring therapy. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +2913,Resilience to Loss and Potential Trauma,"Initial research on loss and potentially traumatic events (PTEs) has been dominated by either a psychopathological approach emphasizing individual dysfunction or an event approach emphasizing average differences between exposed and nonexposed groups. We consider the limitations of these approaches and review more recent research that has focused on the heterogeneity of outcomes following aversive events. Using both traditional analytic tools and sophisticated latent trajectory modeling, this research has identified a set of prototypical outcome patterns. Typically, the most common outcome following PTEs is a stable trajectory of healthy functioning or resilience. We review research showing that resilience is not the result of a few dominant factors, but rather that there are multiple independent predictors of resilient outcomes. Finally, we critically evaluate the question of whether resilience-building interventions can actually make people more resilient, and we close with suggestions for future research on resilience.",0,0 +2914,Mental health of children and adolescents with epilepsy: analysis of clinical and neuropsichological aspects,"Epilepsy compromises the development of cognitive and social skills and represents a risk of psychiatric comorbidity. Objective: To compare psychopathological symptoms in children with epilepsy and in a healthy group, and to correlate the results with neuropsychological and clinical variables. Method: Forty five children with idiopathic epilepsy and sixty five healthy controls underwent neuropsychological evaluation and their caregivers replied to a psychopathology questionnaire (Child Behavior Checklist – CBCL). Results: There were significant differences in CBCL, with poorer results showed mainly by patients with epilepsy. There was no significant association between any psychopathological symptom and disease duration or amount of antiepileptic drugs used. There was positive correlation between intelligence quocient and CBCL on items such as sluggish cognitive tempo, aggressive behavior, attention problems and activities and a negative relation between academic achievement, conduct and rule-breaking behavior. Conclusion: Children with epilepsy had the worse results in the psychopathology evaluation. Certain psychopathological variables are related to the cognitive profile, with no relation to clinical variables.",0,0 +2915,Childbirth-related post-traumatic stress disorder in couples: A qualitative study,"Previous research has established that women can develop childbirth-related post-traumatic stress disorder (PTSD), but the effect of this on a couple's relationship has not been examined. This study aimed to look at the experience and impact of childbirth-related PTSD in women and their partners.This was a qualitative interview study of six couples, where at least one partner had clinically significant symptoms of childbirth-related PTSD.Semi-structured interviews were conducted separately with each partner and interview transcripts subjected to thematic analysis.Analysis identified four themes with 18 subthemes as follows: (1) birth factors (pain, negative emotions in labour, perceived lack of control, lack of choice or lack of involvement in decision-making, restricted movement or physical restraint, and expectations not being met); (2) quality of care (information provision, staff factors, continuity of care and environment); (3) effects on relationship with partner (impact on physical relationship, communication within the relationship, negative emotions within the relationship, receiving or giving support from partner, coping together as a couple and overall effect on the relationship); and (4) effects on relationship with child (perceptions of the child and parent-baby bond).This study suggests that PTSD may have a negative impact on the couple's relationship and the parent-baby bond.",0,0 +2916,Epidemiology and Impact of Scarring After Burn Injury,"The purpose of this study was to perform a systematic review of the existing literature on the incidence of hypertrophic scarring and the psychosocial impact of burn scars. In a comprehensive literature review, the authors identified 48 articles published since 1965 and written in English which reported the incidence and risk factors for hypertrophic scarring or assessed outcomes related to scarring. Most studies had important methodological limitations limiting the generalizability of the findings. In particular, the absence of standardized valid measures of scarring and other outcome variables was a major barrier to drawing strong conclusions. Among studies on hypertrophic scarring, the prevalence rate varied between 32 and 72%. Identified risk factors included dark skin, female gender, young age, burn site on neck and upper limb, multiple surgical procedures, meshed skin graph, time to healing, and burn severity. With regard to psychosocial outcomes, two studies compared pediatric burn survivors with a nonburn comparison group on a body image measure; neither study found differences between groups. Across studies, burn severity and location had a modest relationship with psychosocial outcome variables. Psychosocial variables such as social comfort and perceived stigmatization were more highly associated with body image than burn characteristics. To advance our knowledge of the epidemiology of scars and the burden of scars, future studies need to implement more rigorous methodologies. In particular, standardized valid measures of scarring and other outcomes should be developed. This process could be facilitated by an international collaboration among burn centers.",0,0 +2917,The Phenomenology of Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) has been recognized for centuries, but has been named and formally characterized only recently. Criteria of PTSD in DSM-IV are a mixture of the new and old; some of the changes have far-reaching consequences. Acute stress disorder represents a new category that is long overdue. Even when well characterized, PTSD is an unusually broad condition with an uncertain epidemiology, a variable course, and a confused mixture of risk factors and vulnerabilities.",0,0 +2918,A Typological Analysis of Behavioral Profiles of Sexually Abused Children,"A cluster analysis is used to explore differential outcomes in 123 French Canadian children reporting sexual abuse contrasted with 123 control children. Mothers' reports of behavioral problems on the Child Behavior Checklist, abuse-related variables, personal factors, and family characteristics are used as potential variables discriminating clusters. Results reveal four clusters: (a) anxiety constellation group refers to children displaying behavior problems on a subset of scales, (b) the severe distress group refers to children showing a broader array of behavior problems, (c) victims of less severe sexual abuse (SA) group consists of children disclosing mostly extrafamilial SA, and (d) resilient children refers to children who, while disclosing severe abuse, rely less on avoidance coping. Findings underscore the need to go beyond abuse-related variables to orient treatment for children disclosing sexual abuse and for tailoring interventions to distinct subgroups.",0,0 +2919,Psychometric Properties of the German Version of the Child Post-Traumatic Cognitions Inventory (CPTCI-GER),"Dysfunctional trauma-related cognitions are associated with posttraumatic stress disorder (PTSD). The psychometric properties of the German version of the Child Post-Traumatic Cognitions Inventory (CPTCI-GER) were assessed in a sample of 223 children and adolescents (7-16 years) with a history of different traumatic events. Confirmatory factor analyses supported the original two-factor structure--permanent and disturbing change (CPTCI-PC) and fragile person in a scary world (CPTCI-SW). The total scale and both subscales showed good internal consistency. Participants with PTSD had significantly more dysfunctional trauma-related cognitions than those without PTSD. Dysfunctional posttraumatic cognitions correlated significantly with posttraumatic stress symptoms (PTSS; r = .62), depression (r = .71), and anxiety (r = .67). The CPTCI-GER has good psychometric properties and may facilitate evaluation of treatments and further research on the function of trauma-related cognitions in children and adolescents. (Partial) correlations provide empirical support for the combined DSM-5 symptom cluster negative alterations in cognitions and mood.",0,0 +2920,The role of offender profiling in classifying rapists: Implications for counselling,"Abstract The offender profiling process is an investigative technique used to identify the major personality and behavioural characteristics of the offender based upon an analysis of the crime(s) he or she has committed (Douglas & Burgess, 1986). Attempts have been made in both England and America to classify rapists into various subgroups. Instead of definitive groups of offenders a suggestion is made as to the formation of a dimensional typology of rapists. This would allow for the difficulties in defining boundaries for subgroups and accounting for individual differences and heterogeneity of both the rapist and the assault. The various criteria that attempt to distinguish the different types of offender are discussed including behavioural and motivational characteristics of the offender, lay theories of rape and the victim-offender relationship. The implications of the dimensional typology are outlined. There are indications that some factors may contribute to a longer and more complicated recovery pro...",0,0 +2921,Post-Weaning to Pre-Pubertal (‘Juvenile’) Stress: A Model of Induced Predisposition to Stress-Related Disorders,"Human studies suggest that childhood trauma predisposes individuals to develop stress-related disorders such as depression and post-traumatic stress disorder (PTSD). Recent years have witnessed growing interest in effectively modeling in animals the long-term effects of childhood emotional trauma on stress responses in adulthood. Most studies concerned with the impact of early-life stress on subsequent stress responses in adulthood in rodents have focused on the post-natal pre-weaning period. However, psychiatric studies often refer to human childhood rather than infancy when investigating the patients’ traumatic history of stress-related psychopathologies. In accordance with that, we have examined the consequences of stress exposure at a later early-life period, the post-weaning, pre-puberty (juvenile) period, which holds greater resemblance to human childhood. This review summarizes a series of studies examining the impact of exposure of rats to stressors during ‘juvenility’ (‘juvenile stress’) on the ability of these animals to cope with stress later in life. Exposure to relatively brief but significant stress experience during juvenility was found to impair the ability of animals to cope with stressful challenges in adulthood. These behavioral manifestations were associated with lasting alterations in limbic system brain regions of neuromodulatory pathways, such as alterations in the expression of cell adhesion molecules, GABAergic system functioning and alterations in levels of circulating corticosterone. Importantly, these studies have also demonstrated considerable individual and sex differences, which call for the development of adequate analysis approaches. The juvenile stress model combined with characterization of individual profiles is presented as a useful model to study in rodents different facets of stress-related disorders and neural mechanisms of vulnerability and resilience to stress.",0,0 +2922,Towards a post-traumatic subtype of obsessive–compulsive disorder,"We evaluated whether traumatic events are associated with a distinctive pattern of socio-demographic and clinical features of obsessive-compulsive disorder (OCD). We compared socio-demographic and clinical features of 106 patients developing OCD after post-traumatic stress disorder (PTSD; termed post-traumatic OCD), 41 patients developing OCD before PTSD (pre-traumatic OCD), and 810 OCD patients without any history of PTSD (non-traumatic OCD) using multinomial logistic regression analysis. A later age at onset of OCD, self-mutilation disorder, history of suicide plans, panic disorder with agoraphobia, and compulsive buying disorder were independently related to post-traumatic OCD. In contrast, earlier age at OCD onset, alcohol-related disorders, contamination-washing symptoms, and self-mutilation disorder were all independently associated with pre-traumatic OCD. In addition, patients with post-traumatic OCD without a previous history of obsessive-compulsive symptoms (OCS) showed lower educational levels, greater rates of contamination-washing symptoms, and more severe miscellaneous symptoms as compared to post-traumatic OCD patients with a history of OCS.",0,0 +2923,Prototypes of Student Veterans with Post Traumatic Stress Disorder and Traumatic Brain Injury among Faculty in Illinois Public Four-Year Universities.,"One of the primary reasons many college students with disabilities, and more specifically college student veterans with disabilities, do not seek support services is due to the stigma associated with disability, especially cognitive and mental health disabilities. The purpose of the present study was to explore how public university faculty in the state of Illinois perceive a college student veteran with the concurrent disabilities of post traumatic stress disorder (PTSD) and traumatic brain injury (TBI). This information was gleaned by means of a mixed-method, online survey. Through iterative, comparative, qualitative analysis, characteristics used to describe college student veterans with the PTSD and TBI were classified into six emergent prototypes. These prototypes included (1) the mature independent student; (2) the American hero; (3) the special needs student; (4) the isolated student; (5) the volatile student; and (6) the wounded warrior. Secondary analyses quantitatively examined the relationship between contact with a student veteran and the proportion of positive responses given for each participant as well as the relationship between contact with a student veteran and the proportion of negative responses given for each participant. Pearson correlation analysis indicated no significant relationship between prior contact factor scores and the proportion of positive responses given by faculty r(269) = .032, p = .597 nor was there a significant relationship detected between prior contact factor scores and the proportion of negative responses given by faculty r(269) = -.020, p= .745. Tertiary analysis examined the proportion of positive to negative perceptions by faculty. Overall, faculty responses were more negative than positive. Implications for best practices at the administration level as well as for faculty and students were discussed. Limitations to the study were also discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0,0 +2924,Investigating the MMPI–2 Trauma Profile in Treatment-Seeking Peacekeepers,"Most available research on MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) scores in combat veterans suffering from posttraumatic stress disorder (PTSD) has focused on Vietnam veterans. No data are available from peacekeepers suffering from PTSD. The aim of this study was to investigate the relationship between PTSD and the MMPI-2 in a sample of 120 treatment seeking peacekeeping veterans. Results show that relative to a non-PTSD reference group, veterans who screened positive for PTSD scored higher on Scales F, 2 (D), 4 (Pd), 6 (Pa), 7 (Pt), 8 (Sc), and 0 (Si) of the MMPI-2. Scales 2 (D), 7 (Pt), and 8 (Sc) were highest in the mean PTSD profile but no 2- or 3-point code type could be defined. Moderate correlations were found between a self-report measure for PTSD symptoms and scores on MMPI-2 clinical scales 1 (Hs), 2 (D), 6 (Pa), 7 (Pt), and 8 (Sc). The MMPI-2 proved to be useful in assessing the broad range of symptoms typically present in trauma populations as well as the severity of posttraumatic morbidity.",0,0 +2925,Trauma and post‐traumatic stress disorder (PTSD) in a high secure forensic learning disability population: future directions for practice,"Literature on trauma and post‐traumatic stress disorder (PTSD) has neglected the needs of people with intellectual disability, particularly those in forensic settings. The National Centre for High Secure Learning Disability Services at Rampton Hospital conducted a service evaluation on aspects of trauma experience and post‐trauma symptoms in the current population. File information and self‐reports indicated that most individuals had experienced a great deal of lifetime trauma, typically multiple types of abuse. A high rate of potentially trauma‐related symptoms was noted in files. However, file records of potentially traumatic events, including abuse, were often lacking in detail. There was limited information about the events themselves, and there was no information to suggest that any trauma‐specific assessments had been used to measure trauma exposure or symptoms. PTSD as a diagnosis was rarely considered, and there was little consideration of trauma‐specific interventions. While some individuals said that their experiences had resulted in a lot of distress, others could not talk about the past at all. This paper discusses the problem of assessing past trauma and response in a forensic intellectual disability population, and future directions for practice in forensic services. The service under study plans to address the needs of patients who have experienced trauma and abuse by conducting routine structured assessments, offering adapted evidence‐based psychological interventions where appropriate, and providing trauma‐specific education for staff to promote a compassionate approach.",0,0 +2926,Evaluation of Two Web-Based Alcohol Interventions in the U.S. Military,"The U.S. military has traditionally had high rates of alcohol misuse and alcohol-related problems, necessitating effective treatment programs that minimize participant burden. Web-based interventions have shown promise as efficient treatment options for college students and adults but have not been widely evaluated in the military. This study evaluated the efficacy of two web-based alcohol interventions originally created for civilians and then adapted for U.S. military personnel.Two web-based alcohol interventions, Alcohol Savvy and Drinker's Check-Up, were adapted for use among military populations. The interventions were evaluated using a convenience sample of 3,070 active-duty military personnel at eight installations. Following a baseline survey, participants were assigned to one of three treatment conditions: (a) Alcohol Savvy, (b) Drinker's Check-Up, or (c) control (no program participation). Follow-up surveys were completed by 1,072 participants 1 month following baseline and by 532 participants 6 months following baseline.At 1-month follow-up, participants who completed the Drinker's Check-Up intervention had significant reductions in multiple measures of alcohol use relative to controls. Positive outcomes were found for average number of drinks consumed per occasion, frequent heavy episodic drinker status, and estimated peak blood alcohol concentration. These reductions in alcohol use at the 1-month follow-up were maintained at the 6-month follow-up. There were no statistically significant changes in alcohol use for participants who completed Alcohol Savvy.This study expands the literature on the effectiveness of web-based treatment for alcohol misuse. Findings indicate that web-based programs (Drinker's Check-Up in particular) can significantly decrease several indicators of alcohol use in U.S. military personnel.",0,0 +2927,The impact of social support on psychological distress for U.S. Afghanistan/Iraq era veterans with PTSD and other psychiatric diagnoses,"This study aimed to examine the degree to which posttraumatic stress disorder (PTSD) affects the relationship between social support and psychological distress for U.S. Afghanistan/Iraq era veterans with and without co-occurring psychiatric disorders. Veterans (N=1825) were administered self-report questionnaires and a structured diagnostic interview as part of a multi-site study of post-deployment mental health through the Department of Veterans Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC). Main and interaction effects models assessed the association between psychological distress and social support for three comparisons conditions (Controls vs. PTSD-only, non-PTSD, and PTSD plus co-morbid diagnoses). Having PTSD was a critical factor in attenuating the strength of this association, more so than other diagnoses. Furthermore, those with PTSD plus co-morbid diagnoses did not demonstrate significantly larger attenuation in that association compared to the PTSD-only group, indicating that psychiatric comorbidity may be less important in considering the role of social support in PTSD. By understanding this relationship, new avenues for engaging and enhancing treatment outcomes related to social support for veterans of this cohort may be identified. Additional longitudinal research could help evaluate the effect of PTSD symptom clusters, social support type, and trauma exposure type on these relationships.",0,0 +2928,Corticotrophin-releasing hormone type 1 receptor gene (CRHR1) variants predict posttraumatic stress disorder onset and course in pediatric injury patients.,"Posttraumatic stress disorder (PTSD) is a common and disabling anxiety disorder that may occur in the aftermath of exposure to potentially traumatic life events. PTSD is moderately heritable, but few specific molecular variants accounting for this heritability have been identified. Genes regulating the hypothalamic-pituitary-adrenal (HPA) axis, such as corticotrophin-releasing hormone type 1 receptor gene (CRHR1), have been implicated in traumatic-stress related phenotypes but have yet to be studied in relation to PTSD. The present study sought to examine the relation between 9 single nucleotide polymorphisms (SNPs) in the CRHR1 gene and posttraumatic stress symptoms in a prospective study of pediatric injury patients (n=103) who were first assessed in the acute aftermath of their injury at the hospital. Results indicated that multiple SNPs were associated with acute symptoms at a univariate level, and after correction for multiple testing, rs12944712 was significantly related to acute PTSD symptoms. Longitudinal latent growth curve analyses suggest that rs12944712 is also related to both acute symptom level and trajectory of symptoms over time. The present study adds support for the role of CRHR1 in the stress response following potentially traumatic event exposure in youth. It should be noted that the sample size in this study was small, and therefore statistical power was low; following, results from this study should be considered preliminary. Although results are not definitive, the findings from this study warrant future replication studies on how variation in this gene relates to response to traumatic event exposure in youth.",0,0 +2929,An examination of the relation between combat experiences and combat-related posttraumatic stress disorder in a sample of Connecticut OEF–OIF Veterans,"Combat exposure is an important risk factor for posttraumatic stress disorder (PTSD). However, little research has examined specific combat experiences associated with PTSD and confirmatory factor analytically (CFA)-derived re-experiencing, avoidance, dysphoria, and hyperarousal symptom clusters.A total of 285 predominantly older National Guard/Reservist OEF-OIF Veterans completed an anonymous mail survey that assessed demographics and deployment history, a broad range of combat experiences, PTSD, and unit and postdeployment social support.Personally witnessing someone from one's unit or an ally unit being seriously wounded or killed (β = 0.22), and being exposed to ""friendly"" fire (β = 0.14) and land mines/traps (β = 0.13) were the only three combat experiences associated with severity of combat-related PTSD symptoms, after adjustment for age, relationship status, unit support, postdeployment social support, and other combat experiences. Differential patterns of associations were observed for specific combat experiences in relation to CFA-derived symptom clusters (e.g., experiencing ""friendly"" fire was associated with re-experiencing and dysphoria symptoms, but not avoidance and hyperarousal symptoms). Personally witnessing someone from one's unit or an ally unit being seriously wounded or killed (odds ratio [OR] = 4.34; 95% confidence interval [CI] = 1.62-11.61) and being exposed to ""friendly"" fire (OR = 2.94; 95%CI = 1.16-7.47) emerged as independent predictors of a positive screen for probable PTSD.Results of this study suggest that witnessing someone in one's unit or ally unit being seriously wounded or killed while in a combat zone and being exposed to ""friendly"" fire are most strongly associated with combat-related PTSD in this sample of OEF/OIF Veterans. Examination of the relation between specific combat experiences and combat-related PTSD in OEF/OIF Veterans may help inform etiologic models of PTSD, and guide prevention and treatment approaches in this population.",0,0 +2930,"Trajectories of psychological distress among low‐income, female survivors of Hurricane Katrina.","The purpose of this study was to investigate trajectories of psychological distress among low-income, primarily unmarried and African American women who survived Hurricane Katrina (N = 386). Data were collected in the year prior to the hurricane as well as approximately 1 and 3 years thereafter. Using Latent Class Growth Analysis (LCGA), we detected 6 distinct trajectory groups. Over half of the participants fit into a trajectory consistent with resilience; that is, they maintained low levels of psychological distress over the course of the study, but experienced an elevation in symptoms at the first predisaster time point followed by a return to predisaster levels. The other trajectories reflected a range of psychological responses to disasters and indicated that predisaster functioning had a major influence on postdisaster psychological outcomes. Degree of exposure to hurricane-related stressors, experiences of human and pet bereavement, perceived social support, and socioeconomic status were significant predictors of trajectory group membership. Implications for research and policy are discussed.",0,0 +2931,Borderline Personality Disorder and Posttraumatic Stress Disorder at Psychiatric Discharge Predict General Hospital Admission for Self-Harm,"We investigated whether posttraumatic stress disorder (PTSD) was predictor of suicidal behavior even when adjusting for comorbid borderline personality disorder (BPD) and other salient risk factors. To study this, we randomly selected 308 patients admitted to a psychiatric hospital because of suicide risk. Baseline interviews were performed within the first days of the stay. Information concerning the number of self-harm admissions to general hospitals over the subsequent 6 months was retrieved through linkage with the regional hospital registers. A censored regression analysis of hospital admissions for self-harm indicated significant associations with both PTSD (β = .21, p < .001) and BPD (β = .27, p < .001). A structural model comprising two latent BPD factors, dysregulation and relationship problems, as well as PTSD and several other variables, demonstrated that PTSD was an important predictor of the number of self-harm admissions to general hospitals(B = 1.52, p < .01). Dysregulation predicted self-harm directly (B = 0.28, p < .05), and also through PTSD [corrected]. These results suggested that PTSD and related dysregulation problems could be important treatment targets for a reduction in the risk of severe self-harm in high-risk psychiatric patients.",0,0 +2932,Posttraumatic Stress Disorder: A Primer for Trauma Surgeons,"In 1980, posttraumatic stress disorder (PTSD) officially became classified as an anxiety disorder in the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition. Since then, there has been increasing recognition that PTSD is a prevalent disorder that may have significant impact on the quality of life for survivors of traumatic events. More recently, methodologically sound research has begun to provide important insight into this disorder. The following review serves to provide the trauma surgeons information on PTSD in terms of its diagnosis, prevalence, risk factors, treatment strategies, and outcomes, with the goal of minimizing the sequelae of PTSD and maximizing postinjury quality of life.",0,0 +2933,Psycho-educational interventions designed to prevent deployment-related psychological ill-health in Armed Forces personnel: a review,"Background Employers such as the Armed Forces (AF) and emergency services, who predictably expose their staff to potentially traumatic events (PTEs), often provide psycho-educational briefings in an attempt to mitigate possible adverse psychological sequelae. Within the military, psycho-educational briefings are widely used, particularly following exposure to PTEs on operations. The aim of this review was to evaluate the efficacy of these interventions and make appropriate recommendations. Method A search of Medline, PsycINFO and EMBASE was conducted, bibliographies of retrieved articles were searched and experts in the field were consulted. Results Two surveys and seven intervention studies were identified for inclusion in the review. Only three studies were randomized controlled trials (RCTs). Overall, the review found some evidence of benefit of psycho-educational interventions but it was not consistent across studies or outcomes and effects were small. However, there was also little evidence to suggest that they caused harm. There was some evidence that the beneficial effects may be greater for those who have been exposed to a higher number of PTEs. Conclusions Given the high operational tempo currently faced by coalition forces personnel, there remains a pressing need to identify the most effective way of minimizing the impact of exposure to potentially traumatic deployment incidents. To date, few psycho-educational interventions designed to prevent deployment-related psychological ill-health have been evaluated systematically in methodologically robust studies. The review recommends that future interventions are theoretically based and evaluated in cluster RCTs that examine both process and outcome variables.",0,0 +2934,Environmental Hyperthermic Infant and Early Childhood Death,"Infant and early childhood death caused by environmental hyperthermia (fatal heat stroke) is a rare event, typically occurring in vehicles or beds. The aims of this study were to describe the demographics, circumstances, pathology, and manner of death in infants and young children who died of environmental hyperthermia and to compare these cases with those reported in the literature. Scene investigation, autopsy reports, and the microscopic slides of cases from three jurisdictions were reviewed. The subjects in 10 identified cases ranged in age from 53 days to 9 years. Eight were discovered in vehicles and 2 in beds. When the authors' cases were grouped with reported cases, the profile of those in vehicles differed from those in beds. The former were older, were exposed to rapidly reached higher temperatures, and often had more severe skin damage. The latter were mostly infants and were exposed to lower environmental temperatures. Hepatocellular necrosis and disseminated intravascular coagulation were reported in victims who survived at least 6 hours after the hyperthermic exposure. The consistent postmortem finding among nearly all victims was intrathoracic petechiae, suggesting terminal gasping in an attempt at autoresuscitation before death. The manner of death was either accident or homicide. Recommendations for the scene investigation are made.",0,0 +2935,Optimizing the Protection Against the Physiological Burden of CBRN Clothing,"Soldiers can wear chemical, biological, radiological and nuclear (CBRN) protective clothing to be protected against warfare agents. The disadvantage of that clothing is that higher protection introduces higher physiological burden. Therefore an optimum between comfort and protection must be found. Models of all relevant processes were created to find this optimum. The airflow profile around a cylinder with clothing-representing a dressed human body part-was modelled. This flow profile was used for calculating the agent vapour breakthrough through the clothing and for calculating the deposition of agents onto the skin (as indicators for protection). The flow profile was also used for calculating the temperature profile around the body part and the relative humidity underneath and in the clothing (as representative for physiological burden). As a result a tool was created, which can be used to identify the optimum properties of CBRN protective clothing, depending on the intended mission of the soldiers.",0,0 +2936,"[Post-traumatic stress, post-traumatic depression and major depressive episode: literature].","Although they are likely to add their effects, physical and psychic traumata (or traumas) can provoke in different ways the appearance of depressive symptoms sometimes common. Post-traumatic depression, reactional depression, major depressive disorder and post-traumatic stress disorder represent different clinical and nosographic disorders in despite of their occasionally common symptomatic core. Historically, it is interesting to note during the XXth century the true semantic change of the terms of trauma from the somatic field to the psychic sphere. Physical traumatism is often represented by a material shock for the subject and by its organic consequences. It is defined as an event that leaves its mark which itself inflicts and handicaps the vital trajectory of the subject. It primarily comprises brain and rachis injuries, whose evolution is frequently characterized by the occurrence/appearance of a depressive disorder, whose genesis rests on psychological but also neurobiologic and physical arguments. Thus major depressive disorders are often present in the course of various physical traumatisms mainly related to nervous system. In accordance with several studies, the prevalence of major depressive disorders ranges from 25% to 50%. These mood disorders occur in the year which follows the accidental event. Their average time of revelation is estimated at four months and their average duration lies between three and six months. Lastly, although these depressive illnesses present clinical symptoms comparable with those observed in other contexts, some nuances can be raised. Nonetheless, they confine sometimes with true clinical forms depending on the intensity, the form, the circumstances or the consequences of the trauma. Psychic traumatism doesn't have the same profile and rests for much dedicated with the reexperiencing. Thus for some authors, depression illness represents a disorder that occurs after a traumatic event whereas others see a differential diagnosis which exludes or which represents a comorbidity with post-traumatic stress disorder. The review of the literature allows us to emphasize the complexity of the links as well as the clinical and epidemiologic differences between stress disorder and major depressive disorder. From the clinical point of view, the major features of PTSD are articulated around a triad of symptoms. They include the reexperiencing symptoms of the traumatic event such as intrusive memories and recurrent nightmares, the protective reactions such as avoidance of the stimuli associated with the trauma and emotional numbing, and the arousal symptoms such as the startled response and hypervigilance. The complexity of this syndrom is due to the frequent combination of these symptoms with other nonspecific ones. As far as the mood is concerned (the mood symptoms are concerned), the regrouping of some of these symptoms allows the clinician to sometimes releave a depressive symptomatology without being able to assess the DSM diagnosis of major depressive disorder. Epidemiologic studies dealing with the risk of installation of a PTSD after a traumatic event reveal differences in the prevalence depending on the nature of the traumatic events: ranging from 1% in general population to 80% following some situations of extreme and durable psychic suffering. Between both poles, one finds a prevalence ranging between 20 and 50% following other events such as serious accidents, natural disasters or criminal assaults. The clinical features of depressive episodes comorbid or associated with PTSD have some characteristics making it possible to individualize various clinical forms as a function of traumatic event type: asthenic, characterial or with somatic symptoms. According to the majority of authors, the co-occurrence of post-traumatic stress disorder and major depressive disorder is high although differential diagnosis is sometimes difficult. However, conceptual differences remain and two conceptions are distinguished. For some authors, like Bleich and Shalev, there would not be true chronological evolution from PTSD to MDD. Moreover the presence of symptoms considered as pertaining to the mood register within the criteria of PTSD would be clearly predictive of the occurrence and the severity of the diagnosis but not of the chronicity. For others, there would be a continuity between post-traumatic stress disorder and major depressive disorder. It is the case in many studies of veterans but also for civilian traumatic events. It is also the case for the American national study of comorbidity in which Kessler concludes that for 78% of the subjects who present a comorbidity PTSD/MDD (comorbidity raised for 48% of the 5,877 subjects included), the mood disorder is secondary to PTSD. (ABSTRACT TRUNCATED)",0,0 +2937,Randomized Controlled Trial of Accelerated Resolution Therapy (ART) for Symptoms of Combat-Related Post-Traumatic Stress Disorder (PTSD),"Therapies for post-traumatic stress disorder (PTSD) endorsed by the Department of Defense and Veterans Administration are relatively lengthy, costly, and yield variable success. We evaluated Accelerated Resolution Therapy (ART) for the treatment of combat-related psychological trauma.A randomized controlled trial of ART versus an Attention Control (AC) regimen was conducted among 57 U.S. service members/veterans. After random assignment, those assigned to AC were offered crossover to ART, with 3-month follow-up on all participants. Self-report symptoms of PTSD and comorbidities were analyzed among study completers and by the intention-to-treat principle.Mean age was 41 ± 13 years with 19% female, 54% Army, and 68% with prior PTSD treatment. The ART was delivered in 3.7 ± 1.1 sessions with a 94% completion rate. Mean reductions in symptoms of PTSD, depression, anxiety, and trauma-related guilt were significantly greater (p < 0.001) with ART compared to AC. Favorable results for those treated with ART persisted at 3 months, including reduction in aggression (p < 0.0001). Adverse treatment-related events were rare and not serious.ART appears to be a safe and effective treatment for symptoms of combat-related PTSD, including refractory PTSD, and is delivered in significantly less time than therapies endorsed by the Department of Defense and Veterans Administration.",0,0 +2938,THE PERSONAL POLITICS OF DISASTER: NARRATIVES OF SURVIVORS OF A SOUTH AFRICAN SHANTY TOWN FIRE,"Despite the fact that natural disasters occur more commonly in low and middle income countries than in wealthier countries, we know relatively little about how these disasters are experienced in such contexts. South Africa presents an especially telling example in which it is clear that natural events are affected profoundly by sociopolitical factors, including the spatial design of the apartheid city. We report here on interviews with twenty survivors of the biggest shanty town fire in the history of Cape Town, South Africa. The narratives of participants demonstrate that in order to understand the human cost of such disasters it is as important to understand the politics of the precursors of the disaster as well as what occurred subsequent to the disaster. The South African case, like that of Hurricane Katrina, underscores the fact that disaster, far from being an acute event which happens to individuals, is better understood as part of a far longer sociopolitical process affecting individuals, groups, and, indeed, societies.",0,0 +2939,"Longitudinal study of PTSD, depression, and quality of life among adolescents after the Parnitha earthquake","To investigate the course of PTSD, depression, and current quality of life among adolescents 32-months after the 1999 Parnitha earthquake in Greece.The follow-up was conducted among 511 adolescents originally evaluated at 3-months post-earthquake using the UCLA PTSD Reaction Index (PTSD-RI), Depression Self-Rating Scale (DSRS), and Quality of Life Questionnaire (QOLQ).Mean PTSD scores for the whole sample had subsided to mild levels; however, 8.8% were still experiencing moderate to severe levels of symptoms, and 13.6% met criteria for clinical depression. Frequency of experiencing reminders of the earthquake in the past month best explained the variance (15%) in PTSD severity, followed by depression at 3-months (8%). The QOLQ domain scores were negatively correlated with PTSD and depression. Depression at 3-months was the best predictor of QOLQ at 32-months, explaining 16% of the variance.Self-report instruments were used; hence the responses may have been over- or under-estimated; also, the findings may not be generalizable to other ethnic groups.Ongoing screening is recommended after disaster to identify adolescents who continue to experience moderate to severe levels of PTSD and depressive symptoms. Specific interventions to reduce reactivity to earthquake-related reminders should be a component of post-disaster recovery programs. A quality of life measure can provide important information in addition to traditional scales for monitoring the course of recovery among adolescents after disasters.",0,0 +2940,"[Repeated amenorrhea in an adolescent girl in the course of flood disaster in Kłodzko Region, July 1997].","A natural disaster has been defined as a disruption of human ecology that exceeds the capacity of the community to function normally.After the flood disaster in Kłodzko Region, July 1997, the major problem in female adolescents was observed: secondary amenorrhea.17 female adolescents, aged 13-18, which injured from the flood disaster with secondary amenorrhea were investigated. A control random group consists of 17 girls diagnosed before oral contraception. Diagnostic work-up includes history, physical and psychological examinations, hormonal profiles, transvaginal ultrasonography, color Doppler analysis of utero-ovarian arterial blood flow.FSH, LH, E2 plasma levels and LH/FSH ratio were significantly lower in the amenorrheic group compared to normal girls. Prolactin serum levels after metoclopramid administration were significantly higher in the amenorrheic group. Lower impedance to blood flow in the intraovarian arteries have been shown. Psychosomatic disorders related to hypothalamic amenorrhoea were diagnosed.Psychosocial stress observed during the flood disaster caused hypogonadotropic hypogonadism amenorrhoea in the female adolescents.",0,0 +2941,Structural equation model trees.,"In the behavioral and social sciences, structural equation models (SEMs) have become widely accepted as a modeling tool for the relation between latent and observed variables. SEMs can be seen as a unification of several multivariate analysis techniques. SEM Trees combine the strengths of SEMs and the decision tree paradigm by building tree structures that separate a data set recursively into subsets with significantly different parameter estimates in a SEM. SEM Trees provide means for finding covariates and covariate interactions that predict differences in structural parameters in observed as well as in latent space and facilitate theory-guided exploration of empirical data. We describe the methodology, discuss theoretical and practical implications, and demonstrate applications to a factor model and a linear growth curve model.",0,0 +2942,Posttraumatic growth in the aftermath of a disaster: looking for the role of gender,"In the past 10 years, the literature on disasters and mental health has shifted from a focus on psychopathology, to an interest in documenting manifestations of resilience in the face of mass trauma. The Jin et al. study, published in this issue of the Journal, examines gender differences in the relationship between posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) in the aftermath of the Wenchuan Earthquake in China. The study suggests that the coping response to PTSD may differ between males and females, and raises interesting questions about the types of factors that contribute to the manifestation of high versus low PTG given high levels of PTSD. At the same time, this type of study highlights the need to investigate the long-term impact and meaning of PTG, and to examine whether it reflects an adaptive process with long-term benefits in the face of traumatic exposures, or an illusory type of posttraumatic response.",0,0 +2943,Posttraumatic Stress Disorder Following an Air Disaster: A Prospective Study,"OBJECTIVE: The purpose of this study was to determine predictors of posttraumatic stress disorder (PTSD) in health care workers exposed to a disaster, in order to facilitate early case identification and prevention of subsequent morbidity. METHOD: Following an air disaster, 355 military medical health care workers were studied over an 18-month follow-up period. Measures included assessment of peritraumatic reactions associated with the disaster, the frequency of other stressful events after the disaster, and standard PTSD rating scales at 6, 12, and 18 months. RESULTS: Multivariate logistic regression of data on health care workers who cared for victims of the air disaster showed that PTSD was more likely to develop in those who had not completed college, those who had worked with burn victims, those who had experienced more stressful life events in a period of approximately 6 months following the disaster, and those who experienced emotional numbness immediately after the disaster. CONCLUSIONS: Results suggest that lower levels of education, exposure to grotesque burn injuries, stressful life events following exposure, and feelings of numbness following exposure are useful predictors of subsequent development of PTSD. (Am J Psychiatry 1998; 155:934–938)",0,0 +2944,The Relationship between Cortisol Activity during Cognitive Task and Posttraumatic Stress Symptom Clusters,"The latest development in the dimensional structure of posttraumatic stress disorder (PTSD) is a novel 6-factor model, which builds on the newly released DSM-5. One notable gap in the literature is that little is known about how distinct symptom clusters of PTSD are related to hypothalamic-pituitary-adrenal (HPA) axis activity when people perform a relatively less stressful cognitive task. The purpose of this study was to investigate the relationship between cortisol activity when individuals perform cognitive tasks in the laboratory and a contemporary phenotypic model of posttraumatic stress symptomatology in earthquake survivors.Salivary cortisol while performing cognitive tasks was collected and analyzed in 89 adult earthquake survivors. The PTSD Checklist for the DSM-5 (PCL-5) was used to assess the severity of total PTSD as well as six distinct symptom clusters. Regression analyses were conducted to examine the associations between the six distinct PTSD symptom clusters and cortisol profiles.The results showed that the score of the negative affect symptom cluster, but not anhedonia or other clusters, was positively associated with cortisol levels before and during the cognitive tasks.The results showed that higher cortisol levels before and during cognitive tasks might be specifically linked to a distinct symptom cluster of PTSD-negative affect symptomatology. This suggests that a distinction should be made between negative affect and anhedonia symptom clusters, as the 6-factor model proposed.",0,0 +2945,The Trauma of Truth Telling: Effects of Witnessing in the Rwandan Gacaca Courts on Psychological Health,"Truth telling has come to play a pivotal role in postconflict reconciliation processes around the world. A common claim is that truth telling is healing and will lead to reconciliation. The present study applies recent psychological research to this issue by examining whether witnessing in the gacaca, the Rwandan village tribunals for truth and reconciliation after the 1994 genocide, was beneficial for psychological health. The results from the multistage, stratified cluster random survey of 1,200 Rwandans demonstrate that gacaca witnesses suffer from higher levels of depression and PTSD than do nonwitnesses, also when controlling for important predictors of psychological ill health. Furthermore, longer exposure to truth telling has not lowered the levels of psychological ill health, nor has the prevalence of depression and PTSD decreased over time. This study strongly challenges the claim that truth telling is healing and presents a novel understanding of the complexity of truth-telling processes in postconflict peace building.",0,0 +2946,Expressive and Defensive Behavior during Discourse on Unresolved Topics: A Single Case Study of Pathological Grief,"Both psychodynamic and social-cognitive theoretical domains have control process models of behavior but with different ideas about the purpose and loci of control. This study examines expressive and defensive behaviors associated with different topics of discourse in the time-limited psychotherapy of a woman treated for pathological grief. Conceptually the study is based on a model of defensive control processes that integrates states of mind and person schemas. Theoretically derived measures of discourse topics, verbal and nonverbal defensive behaviors, emotional disclosure, and states of mind were applied to transcripts and videotapes of the entire therapy. Evidence from combined cluster and factor analyses supported the existence of recurring emotionally significant states. Two of these are particularly interesting from a clinical perspective: One, a ""shimmering"" state of intense emotional expression with concurrent signs of avoidance, was associated with topics identified clinically as stressful, unresolved, and conflictual. The other, a state of more uniformly stifled emotionality, was characteristic of discourse thought of clinically as resistance.",0,0 +2947,Psychological Impact of Fire Disaster on Children and Their Parents,"Six weeks following a major wildfire, children's psychosocial functioning was examined. Employing a multimethod assessment approach, the short-term mental health consequences of the fire were evaluated. Individual adjustment was compared between families who reported high levels of loss as a result of the fire (high-loss group) and families who reported relatively low levels of loss resulting from the fire (low-loss group). Standardized assessment procedures were employed for children and adolescents as well as their parents. In general, high-loss participants reported slightly higher levels of post-traumatic stress disorder (PTSD) symptoms and significantly higher scores on the Impact of Events Scale. PTSD symptoms reported by parents were generally significantly correlated with (but not concordant with) PTSD symptoms reported by their children. The high-loss group scored significantly higher on the Resource Loss Index than did the low-loss group. Preexisting and comorbid disorders and previous stressors are described. A methodological framework for future studies in this area is discussed.",0,0 +2948,"Socio-demographic and Clinical Profile of Substance Abusers Attending a Regional Drug De-addiction Centre in Chronic Conflict Area: Kashmir, India.","The menace of substance abuse is not only a socially unacceptable reality, but in its entirety is a disease and emerging as a major public health challenge.To study the socio-demographic and clinical profile of patients attending the drug de-addiction centre.A descriptive study was undertaken in a drug de-addiction centre at the Police Hospital in Srinagar, and all patients (198) who were admitted during this period were interviewed.The mean (SD) age of patients was 26.8 years (SD 7.37), and over half (56%) belonged to the lower-middle social class. Poly-substance abuse was seen in 91.9%; medicinal opioids and cannabis were the most common substances abused. Most common age of initiation was 11-20 years (76.8%), with peer pressure and relief from a negative mood state being the most common reasons given for starting the drug(s). Prevalence of a co-morbid psychiatric disorder was high, on the order of 49.5%. A high rate of volatile substance use was observed among adolescents (54.5%).A pattern of poly-substance abuse was found to be quite common in patients, and use of volatile substances at a very young age emerged as a new trend. The dreadful repercussions of substance abuse justify the urgency to evolve a comprehensive strategy.",0,0 +2949,Faking PTSD From a Motor Vehicle Accident on the MMPI-2,"The MMPI-2 is often used to assess posttraumatic stress disorder (PTSD) in individuals who claim psychological injury as a result of a motor vehicle accident. There is concern that attorneys can coach plaintiffs to fake PTSD. The purpose of this study was to determine whether prior symptom knowledge increased one's ability to fake PTSD on the MMPI-2. Eighty-four female undergraduate students completed the MMPI-2 under either of two conditions, informed (given DSM-IV diagnostic criteria for PTSD prior to testing) or uninformed (no diagnostic criteria provided). It was hypothesized that the informed subjects would more accurately fake PTSD than the uninformed subjects. Results indicated that knowledge about the specific symptoms of PTSD did not create a more accurate profile, but rather was likely to produce more invalid (F>T89) profiles, detecting them as malingerers.",0,0 +2950,,"Dissociative responses to trauma have been hypothesized to be associated with long-term increases in psychopathology. The purpose of this study was to examine dissociative responses to premilitary, combat-related and postmilitary traumatic events and long-term psychopathology in Vietnam combat veterans with (n = 34) and without (n = 28) posttraumatic stress disorder (PTSD). PTSD patients reported higher levels of dissociative states at the time of combat-related traumatic events than non-PTSD patients. Higher levels of dissociative states persisted in PTSD patients in the form of higher levels of dissociative states in-response to postmilitary traumatic events. In addition, dissociative responses to combat trauma were associated with higher long-term general dissociative symptomatology as measured by scores on the Dissociative Experience Scale, as well as increases in the number of flashbacks since the time of the war. These findings are consistent with previous formulations that dissociation in the face of trauma is a marker of long-term psychopathology.",0,0 +2951,"PTSD as a mediator of sexual revictimization: The role of reexperiencing, avoidance, and arousal symptoms","Theory and research suggest that posttraumatic stress disorder (PTSD) may mediate the relationship between child sexual abuse and adult sexual assault. However, little empirical research has examined the mediational role of PTSD. In the present study, the authors use structural equation modeling to examine the degree to which the three symptom clusters that define PTSD (reexperiencing, avoidance, and hyperarousal) contribute to sexual revictimization. To assess PTSD symptomatology, undergraduate women completed questionnaires (N = 1,449), which detailed the history and severity of childhood and adult sexual assault experiences. Results indicated that PTSD mediated sexual revictimization. When PTSD symptom clusters were examined individually, only the hyperarousal cluster was a significant mediator. Results are discussed in terms of information-processing mechanisms that may underlie sexual revictimization.",0,0 +2952,Post-traumatic stress disorder in a person with a diagnosis of schizophrenia: Examining the efficacy of psychological intervention using single N methodology,"Psychological intervention for post-traumatic stress disorder (PTSD) in a person with a diagnosis of schizophrenia is presented using single N methodology. Psychological formulation and intervention were informed by psychological models of PTSD symptom persistence that focus on dual maintaining factors of (a) disturbance in the form of trauma autobiographical memory and (b) problematic trauma-related appraisals. Baseline assessment of difficulties related to intrusive memories, problematic trauma-related appraisals (e.g., responsibility appraisals) and associated negative emotions (e.g., anger) was followed by two phases of intervention: (1) written elaboration of the trauma memory and (2) cognitive restructuring of problematic trauma-related appraisals. Treatment produced reduction in ratings of distress in all domains and there were clinically significant reductions in PTSD symptomatology and co-morbid depression on standardized self-report measures. There were, however, differential effects of treatment components as evidenced during the sequential introduction of treatment components. These are discussed and directions for future research in the treatment of PTSD in persons with severe mental health problems are highlighted. Copyright © 2007 John Wiley & Sons, Ltd.",0,0 +2953,The Effects of Family and Community Violence on Children,"This review examines theoretical and empirical literature on children's reactions to three types of violence--child maltreatment, community violence, and interparental violence. In addition to describing internalizing and externalizing problems associated with exposure to violence, this review identifies ways that violence can disrupt typical developmental trajectories through psychobiological effects, post-traumatic stress disorder (PTSD), cognitive consequences, and peer problems. Methodological challenges in this literature include high rates of co-occurrence among types of violence exposure, co-occurrence of violence with other serious life adversities, heterogeneity in the frequency, severity, age of onset, and chronicity of exposure, and difficulties in making causal inferences. A developmental psychopathology perspective focuses attention on how violence may have different effects at different ages and may compromise children's abilities to face normal developmental challenges. Emphasis is placed on the variability of children's reactions to violence, on outcomes that go beyond diagnosable disorders, and on variables that mediate and moderate children's reactions to violence.",0,0 +2954,Psychopharmacology in Psycho-oncology,"Psychopharmacological intervention is a major clinical and research area in oncology and palliative care. Over the last 35 years, psychotropic drugs have been shown to have a number of important indications for the treatment of the most common psychiatric disorders, such as depression, anxiety, stress-related syndromes, severe adjustment disorders, sleep disorders and delirium, which combined affect at least 30-40% of patients with cancer and even a higher percentage of patients in an advanced phase of illness. The availability of new drugs, with less side-effects and safer pharmacological profiles, has been a major advance in clinical psycho-oncology. Interestingly, several drugs have also been found to be helpful for the adjuvant treatment of cancer-related symptoms, such as pain, hot flashes, pruritus, nausea and vomiting, fatigue, and cognitive impairment, making psychopharmacology an important tool for the improvement of cancer patients' quality of life. The aim of this paper is to summarize recent relevant data concerning the use of psychotropic drugs, namely antidepressants, anxiolytics, antipsychotics, anticonvulsants and psychostimulants in patients with cancer. © 2013 Springer Science+Business Media New York.",0,0 +2955,Mapping family stress: The application of family adaptation theory to post-traumatic stress disorder,Abstract This articel examines the role of interpersonal factors in the maintenance of Post-Traumatic Stress Disorder (PTSD) and suggests a need for clinicans to conceptualize PTSD within a family systems context. A case study illustrates the use of Family Adaptation Theory as a model for assessment and intervention.,0,0 +2956,"Non-Peptidic CRF1 Receptor Antagonists for the Treatment of Anxiety, Depression and Stress Disorders","Anxiety and depression are psychiatric disorders that constitute a major health concern worldwide, and new pharmacological approaches with the potential for improved efficacy and decreased side effect profiles relative to currently marketed drugs are desired. Since the identification of corticotropin releasing factor (CRF) by Vale and colleagues in 1981, an extensive research effort has solidified the importance of this 41 amino acid peptide in mediating the body's behavioral, endocrine, and autonomic responses to stress. The further identification of CRF receptor subtypes has provided compelling targets for novel pharmaceutical agents. The present review focuses on the potential of non-peptidic antagonists of the CRF(1) receptor subtype as a novel therapeutic approach for the treatment of anxiety and depression. The first section reviews preclinical and clinical evidence implicating CRF, in general, and CRF(1) receptors, in particular, in anxiety and depression. Clinical studies have demonstrated a dysfunctional hypothalamic-pituitary-adrenal (HPA) axis and/or elevated CRF levels in depression and in some anxiety disorders. Preclinical data utlilizing correlational methods, genetic models, and exogenous CRF administration techniques in rodents and non-human primates supports a link between hyperactive CRF pathways and anxiogenic and depressive-like symptoms. Studies employing the use of receptor knockouts and selective, non-peptidic antagonists of the CRF(1) receptor have demonstrated anxiolytic and antidepressant effects under certain types of laboratory conditions. A Phase II, open-label, clinical trial in major depressive disorder has reported that a CRF(1) receptor antagonist was safe and effective in reducing symptoms of anxiety and depression. In the second section, a topological approach is used to describe the design strategies employed to produce potent, non-peptidic CRF(1) receptor antagonists. Two main topologies, featuring a center core, a top side-chain, and a pending aromatic ring, can be used to characterize the vast majority of currently known CRF(1) receptor antagonists. By exploiting some of these structural elements, pharmacological, physicochemical, and pharmacokinetic properties can be modulated and optimized. However, as a result of a relatively conservative iteration process during the structural optimization, the chemical space presently defined by the existing CRF(1) receptor antagonists still remains fairly narrow. Expanding these structural and topological boundaries, while optimizing the ""drug-like"" properties of the CRF(1) receptor antagonists, seems to be a common objective across pharmaceutical companies to maximize the chances for a clinical success in the near future.",0,0 +2957,Age-Associated Epigenetic Upregulation of the FKBP5 Gene Selectively Impairs Stress Resiliency,"Single nucleotide polymorphisms (SNPs) in the FK506 binding protein 5 (FKBP5) gene combine with traumatic events to increase risk for post-traumatic stress and major depressive disorders (PTSD and MDD). These SNPs increase FKBP51 protein expression through a mechanism involving demethylation of the gene and altered glucocorticoid signaling. Aged animals also display elevated FKBP51 levels, which contribute to impaired resiliency to depressive-like behaviors through impaired glucocorticoid signaling, a phenotype that is abrogated in FKBP5-/- mice. But the age of onset and progressive stability of these phenotypes remain unknown. Moreover, it is unclear how FKBP5 deletion affects other glucocorticoid-dependent processes or if age-associated increases in FKBP51 expression are mediated through a similar epigenetic process caused by SNPs in the FKBP5 gene. Here, we show that FKBP51-mediated impairment in stress resiliency and glucocorticoid signaling occurs by 10 months of age and this increased over their lifespan. Surprisingly, despite these progressive changes in glucocorticoid responsiveness, FKBP5-/- mice displayed normal longevity, glucose tolerance, blood composition and cytokine profiles across lifespan, phenotypes normally associated with glucocorticoid signaling. We also found that methylation of Fkbp5 decreased with age in mice, a process that likely explains the age-associated increases in FKBP51 levels. Thus, epigenetic upregulation of FKBP51 with age can selectively impair psychological stress-resiliency, but does not affect other glucocorticoid-mediated physiological processes. This makes FKBP51 a unique and attractive therapeutic target to treat PTSD and MDD. In addition, aged wild-type mice may be a useful model for investigating the mechanisms of FKBP5 SNPs associated with these disorders.",0,0 +2958,Frail Elderly as Disaster Victims: Emergency Management Strategies,"To identify the vulnerabilities of elderly to disasters, and to develop strategies to address these vulnerabilities.A relevant literature search of journal articles, government training materials, news reports, and materials from senior organizations was conducted.The vulnerability of the elderly to disasters is related to their impaired physical mobility, diminished sensory awareness, chronic health conditions, and social and economic limitations that prevent adequate preparation for disasters, and hinder their adaptability during disasters. Frail elderly, those with serious physical, cognitive, economic, and psycho-social problems, are at especially high risk.This segment of the population is growing rapidly. Therefore, it is important that emergency management recognize the frail elderly as a special needs population, and develop targeted strategies that meet their needs. Several management strategies are presented and recommendations for further action are proposed.",0,0 +2959,Trazodone: properties and utility in multiple disorders,"Trazodone is an established antidepressant that is prescribed frequently as an off-label hypnotic with wide acceptance among psychiatrists. Owing to its atypical mixed serotonergic and adrenolytic pharmacology, trazodone has been investigated in a number of disorders besides depression and insomnia, including anxiety disorders, chronic pain, frontal cognitive dysfunctions, erectile dysfunction and others. Clinical studies using subjective and objective measures generally tend to support its efficacy as a hypnotic in depressed subjects. Various other attributes of trazodone, including interaction with adrenergic receptors, formation of an active metabolite with potent serotonergic activity, low abuse potential and putative utility in various disorders, warrant further exploration. The adverse effects of trazodone generally mirror its serotonergic activity and include sedation, headache, sweating, weight changes and gastrointestinal effects such as nausea and vomiting. Clinicians and patients should be cognizant of the risk for potential, but rare, cardiovascular adverse effects of trazodone. The safety and toxicology of trazodone should be examined under current standards of drug development before exposure to new patient populations. This article provides an overview of trazodone with a focus on its clinical pharmacology and opportunities, gaps and scientific strategies in developing it for new indications such as insomnia, anxiety disorders, chronic pain and frontal cognitive dysfunction. Modified release formulations, alternate forms of drug delivery and combination products are discussed as strategies to optimize the efficacy of trazodone and improve its safety profile.",0,0 +2960,PATTERNS OF LIFETIME PTSD COMORBIDITY: A LATENT CLASS ANALYSIS,"Posttraumatic stress disorder (PTSD) is associated with high rates of psychiatric comorbidity, most notably substance use disorders, major depression, and other anxiety disorders. However, little is known about how these disorders cluster together among people with PTSD, if disorder clusters have distinct etiologies in terms of trauma type, and if they confer greater burden over and above PTSD alone.Utilizing Latent Class Analysis, we tested for discrete patterns of lifetime comorbidity with PTSD following trauma exposure (n = 409). Diagnoses were based on the Structured Clinical Interview for DSM-IV (SCID). Next, we examined if gender, trauma type, symptom frequency, severity, and interference with everyday life were associated with the latent classes.Three patterns of lifetime comorbidity with PTSD emerged: a class characterized by predominantly comorbid mood and anxiety disorders; a class characterized by predominantly comorbid mood, anxiety, and substance dependence; and a relatively pure low-comorbidity PTSD class. Individuals in both high comorbid classes had nearly two and a half times the rates of suicidal ideation, endorsed more PTSD symptom severity, and demonstrated a greater likelihood of intimate partner abuse compared to the low comorbidity class. Men were most likely to fall into the substance dependent class.PTSD comorbidity clusters into a small number of common patterns. These patterns may represent an important area of study, as they confer distinct differences in risk and possibly etiology. Implications for research and treatment are discussed.",0,0 +2961,Genetic approaches to understanding post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) is increasingly recognized as both a disorder of enormous mental health and societal burden, but also as an anxiety disorder that may be particularly understandable from a scientific perspective. Specifically, PTSD can be conceptualized as a disorder of fear and stress dysregulation, and the neural circuitry underlying these pathways in both animals and humans are becoming increasingly well understood. Furthermore, PTSD is the only disorder in psychiatry in which the initiating factor, the trauma exposure, can be identified. Thus, the pathophysiology of the fear and stress response underlying PTSD can be examined and potentially interrupted. Twin studies have shown that the development of PTSD following a trauma is heritable, and that genetic risk factors may account for up to 30-40% of this heritability. A current goal is to understand the gene pathways that are associated with PTSD, and how those genes act on the fear/stress circuitry to mediate risk vs. resilience for PTSD. This review will examine gene pathways that have recently been analysed, primarily through candidate gene studies (including neuroimaging studies of candidate genes), in addition to genome-wide associations and the epigenetic regulation of PTSD. Future and on-going studies are utilizing larger and collaborative cohorts to identify novel gene candidates through genome-wide association and other powerful genomic approaches. Identification of PTSD biological pathways strengthens the hope of progress in the mechanistic understanding of a model psychiatric disorder and allows for the development of targeted treatments and interventions.",0,0 +2962,Exposure to dysfunctional parenting and trauma events and posttraumatic stress profiles among a treatment sample with coexisting depression and alcohol use problems,"Trauma exposure (including experiencing dysfunctional parenting when a child) and posttraumatic stress disorder (PTSD) frequently coexist with major depressive disorder (MDD) and alcohol use disorders (AUD), with the impact of this comorbidity usually studied as a dual disorder (i.e. PTSD-MDD or PTSD-AUD). This study explores trauma exposure (including to dysfunctional parenting), PTSD symptom severity and PTSD in people seeking treatment for coexisting depressive symptoms and alcohol use problems.Participants (n = 221) with current depression and alcohol use problems were recruited. Trauma exposure, PTSD symptoms and PTSD were assessed using the Posttraumatic Stress Diagnostic Scale. The Measure of Parenting Style assessed dysfunctional parenting (neglect/over-control/abuse) experienced as a child.Most participants experienced trauma (71.6%, n = 159), with more than one-third reaching DSM-IV criteria for current PTSD (38.0%, n = 84). Unique to this study was that there were no gender differences in rates of trauma exposure, number of traumatic events and PTSD. More severe PTSD symptoms and PTSD were associated with: childhood neglect; earlier depression onset; more severe depression and alcohol problems; and lower general functioning. More severe problems with alcohol were related to Intrusion and Avoidance symptoms, while severe alcohol dependence symptoms were related to hyperarousal.PTSD symptoms and PTSD are highly prevalent in those with coexisting depression and alcohol use problems and are associated with a history of childhood neglect and higher levels of comorbidity. Trauma, PTSD symptoms and PTSD should be assessed and addressed among people seeking treatment for coexisting depression and alcohol problems.",0,0 +2963,Does acute stress disorder predict post-traumatic stress disorder in traffic accident victims? Analysis of a self-report inventory,"The objective of this study was to account for acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) morbidity in a self-report survey of traffic accident victims and to evaluate the relationship between ASD and PTSD in this sample, and furthermore, to find both a model of independent variables accounting for variance in ASD and PTSD symptom level. Ninety patients, treated at an emergency ward after traffic accidents, participated in this longitudinal self-report survey. ASD was assessed using the Acute Stress Disorder Scale (ASDS) and PTSD was assessed at 6-8 months follow-up using the Posttraumatic Diagnostic Scale (PDS). Twenty-five patients (28%) met the cutoff scores for ASDS. Fifteen patients (17%) fulfilled criteria for PTSD according to the PDS. ASD was only able to predict 50% of patients who later developed high levels of PTSD symptomatology. A model of three variables explained 35% of the variance in ASD symptom level. Two variables explained 40% of the variance in PTSD symptom level. In both regression models, dissatisfaction with social support was associated with a higher symptom level. The results from this study reflect already voiced problems with the ASD diagnosis. The lack of precision in predicting who will develop PTSD is pronounced in this study. The acute traumatic symptom level explains a large part of the variance in PTSD symptom level. However, other variables also seem to play an important role. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +2964,Sequential Temporal Dependencies in Associations Between Symptoms of Depression and Posttraumatic Stress Disorder: An Application of Bivariate Latent Difference Score Structural Equation Modeling,"Depression and posttraumatic stress disorder (PTSD) are highly comorbid conditions that may arise following exposure to psychological trauma. This study examined their temporal sequencing and mutual influence using bivariate latent difference score structural equation modeling. Longitudinal data from 182 emergency room patients revealed level of depression symptom severity to be positively associated with changes in PTSD intrusion, avoidance, and hyperarousal over 3 time intervals, beginning shortly after the traumatic event. Higher scores on depression anticipated increases (or worsening) in PTSD symptom severity. The pattern of influence from PTSD symptom severity to change in depression symptom severity simply followed the general trend toward health and well-being. Results are discussed in terms of the dynamic interplay and associated mechanisms of posttrauma depression and PTSD symptom severity.",0,0 +2965,Social determinants of mid- to long-term disaster impacts on health: A systematic review,"Disasters cause a wide range of health impacts. Although there remains a need to understand and improve acute disaster management, a stronger understanding of how health is affected in the medium and longer term is also required to inform the design and delivery of measures to manage post-disaster health risks, and to guide actions taken before and during events which will also lead to reduction in health impact. Social determinants exert a powerful influence on different elements of risk, principally vulnerability, exposure and capacity, and thus, on people's health. As disaster health data and research has tended to focus on the short-term health impacts, no systematic assessment of the social determinants of the mid- to long-term health impacts of disasters has been identified. We assessed the chronic health impacts of disasters and explored the potential socioeconomic determinants of health impact through a systematic review. Our findings, based on 28 studies, highlighted that regardless of health outcomes and event types, the influence of disasters on chronic heath persists beyond the initial disaster period, affecting people's health for months to years. Using the World Health Organization's conceptual framework for the social determinants of health, we identified a total of 35 themes across the three conceptual domains (determinants related to the socioeconomic and political context, structural determinants, and intermediate determinants) as potentially influencing disaster impact. Investment to tackle modifiable underlying determinants could aid disaster risk management, improve medium and long-term health outcomes from disasters, and build community resilience.",0,0 +2966,Post-traumatic stress disorder predicts future weight change in the Millennium Cohort Study,"Objective To prospectively examine the association between post-traumatic stress disorder (PTSD) and weight change. Methods Longitudinal analysis techniques were used to examine data (2001–2008) from Millennium Cohort Study participants, consisting of U.S. service members and veterans. Using the PTSD Checklist–Civilian Version, PTSD was assessed as none, resolved, new onset, or persistent. Subsequent weight change was assessed as stable (≤3% loss or gain), >3% weight loss, >3% but <10% weight gain, and ≥10% weight gain. Results Of the 38,352 participants, 2391 (6.2%) had PTSD (838 resolved, 1024 new onset, and 529 persistent), and 11% of participants subsequently had ≥10% weight gain. In multivariable models, PTSD was associated with higher odds of ≥10% weight gain (new onset OR: 1.44 [95% CI: 1.20–1.73]; persistent OR: 1.51 [CI: 1.17–1.96]; resolved OR: 1.30 [CI: 1.05–1.60]) compared with those without PTSD. New-onset and persistent PTSD were also associated with higher odds of >3% weight loss (OR: 1.41 [CI: 1.17–1.71]; OR: 1.42 [CI: 1.09–1.86], respectively). Conclusions PTSD is independently associated with a higher risk of weight gain and loss, the former of which leads to a higher prevalence of overweight and obesity and a higher risk of comorbidities associated with excessive body adiposity.",0,0 +2967,Cognitive Behavioral Therapy for Posttraumatic Stress Disorder in Women,"

Context

The prevalence of posttraumatic stress disorder (PTSD) is elevated among women who have served in the military, but no prior study has evaluated treatment for PTSD in this population. Prior research suggests that cognitive behavioral therapy is a particularly effective treatment for PTSD.

Objective

To compare prolonged exposure, a type of cognitive behavioral therapy, with present-centered therapy, a supportive intervention, for the treatment of PTSD.

Design, Setting, and Participants

A randomized controlled trial of female veterans (n=277) and active-duty personnel (n=7) with PTSD recruited from 9 VA medical centers, 2 VA readjustment counseling centers, and 1 military hospital from August 2002 through October 2005.

Intervention

Participants were randomly assigned to receive prolonged exposure (n = 141) or present-centered therapy (n = 143), delivered according to standard protocols in 10 weekly 90-minute sessions.

Main Outcome Measures

Posttraumatic stress disorder symptom severity was the primary outcome. Comorbid symptoms, functioning, and quality of life were secondary outcomes. Blinded assessors collected data before and after treatment and at 3- and 6-month follow-up.

Results

Women who received prolonged exposure experienced greater reduction of PTSD symptoms relative to women who received present-centered therapy (effect size, 0.27;P = .03). The prolonged exposure group was more likely than the present-centered therapy group to no longer meet PTSD diagnostic criteria (41.0% vs 27.8%; odds ratio, 1.80; 95% confidence interval, 1.10-2.96;P = .01) and achieve total remission (15.2% vs 6.9%; odds ratio, 2.43; 95% confidence interval, 1.10-5.37;P = .01). Effects were consistent over time in longitudinal analyses, although in cross-sectional analyses most differences occurred immediately after treatment.

Conclusions

Prolonged exposure is an effective treatment for PTSD in female veterans and active-duty military personnel. It is feasible to implement prolonged exposure across a range of clinical settings.

Trial Registration

clinicaltrials.gov Identifier:NCT00032617",0,0 +2968,Studies on Genetics of Heat Tolerance in Dairy Cattle with Reduced Weather Information via Cluster Analysis,"The objective of this study was to explore the possibility of reducing the number of weather stations for studies on genetics of heat tolerance in dairy cattle. The similarity of information from 21 Georgia weather stations was analyzed by cluster analysis. Two major clusters have been found, separating Georgia along the NE and SW line. One weather station was selected for each of the clusters based on the minimal distance to all the remaining weather stations and on completeness of the weather information. The production dataset consisted of 114,751 first-parity test-day records for milk on 14,297 Holsteins from 120 herds in Georgia. Analyses using a model for daily milk yield with temperature-humidity index classes and several other fixed effects showed no increase in error sum of squares when using only two weather stations. The threshold of heat stress was different for each of the two regions but the rate of decline after the threshold was similar. After accounting for different thresholds, the genetic component of heat tolerance for milk was higher with the two-station model. Genetic studies on or evaluation for heat tolerance based on information from a few carefully selected weather stations can be as accurate as those based on information from numerous such stations.",0,0 +2969,An Introduction to Latent Variable Mixture Modeling (Part 2): Longitudinal Latent Class Growth Analysis and Growth Mixture Models,"Pediatric psychologists are often interested in finding patterns in heterogeneous longitudinal data. Latent variable mixture modeling is an emerging statistical approach that models such heterogeneity by classifying individuals into unobserved groupings (latent classes) with similar (more homogenous) patterns. The purpose of the second of a 2-article set is to offer a nontechnical introduction to longitudinal latent variable mixture modeling.3 latent variable approaches to modeling longitudinal data are reviewed and distinguished.Step-by-step pediatric psychology examples of latent growth curve modeling, latent class growth analysis, and growth mixture modeling are provided using the Early Childhood Longitudinal Study-Kindergarten Class of 1998-1999 data file.Latent variable mixture modeling is a technique that is useful to pediatric psychologists who wish to find groupings of individuals who share similar longitudinal data patterns to determine the extent to which these patterns may relate to variables of interest.",0,0 +2970,Loneliness Trajectories: The Role of Posttraumatic Symptoms and Social Support,"This study prospectively examines the longitudinal course of loneliness, social support, and posttraumatic symptoms (PTS) among Israeli war veterans. Two groups of veterans with and without antecedent combat stress reaction (CSR) were assessed at three points of time during a 20-year period. Veterans with CSR reported higher levels of loneliness compared with veterans without CSR. Loneliness remained stable among veterans with CSR but decreased among veterans without CSR. Baseline level of social support predicted the trajectory of change in loneliness. Finally, higher levels of PTS and lower levels of social support were associated with more loneliness among veterans with CSR.",0,0 +2971,Delayed-Onset Posttraumatic Stress Disorder: A Systematic Review of the Evidence,"Objective: Since the diagnosis of delayed-onset posttraumatic stress disorder (PTSD) was introduced in DSM-III, there has been controversy over its prevalence and even its existence. The authors sought to resolve discrepant findings concerning the prevalence of delayed-onset PTSD by conducting a systematic review of the evidence. Method: A literature search was conducted for case reports and group studies with adequate measurement of delayed-onset PTSD according to DSM criteria. Studies that met inclusion criteria were examined for the defined length of delay for delayed-onset PTSD, presence of symptoms before full diagnostic criteria were met, length of follow-up, prevalence estimates, and other variables. Studies were also examined for differences between immediate-onset PTSD, delayed-onset PTSD, and no-PTSD cases. Results: Ten case studies and 19 group studies met criteria for inclusion in the review. Studies consistently showed that delayed-onset PTSD in the absence of any prior symptoms was rare, whereas delayed onsets that represented exacerbations or reactivations of prior symptoms accounted on average for 38.2% and 15.3%, respectively, of military and civilian cases of PTSD. Conclusions: The discrepant findings in the literature concerning prevalence can be largely, but not completely, explained as being due to definitional issues. Little is known about what distinguishes the delayed-onset and immediate-onset forms of the disorder. Continuing scientific study of delayed-onset PTSD would benefit if future editions of DSM were to adopt a definition that explicitly accepts the likelihood of at least some prior symptoms.",0,0 +2972,Vinorelbine and gemcitabine vs vinorelbine and carboplatin as first-line treatment of advanced NSCLC. A phase III randomised controlled trial by the Norwegian Lung Cancer Study Group,"Platinum-based doublet chemotherapy is the standard first-line treatment for advanced non-small cell lung cancer (NSCLC), but earlier studies have suggested that non-platinum combinations are equally effective and better tolerated. We conducted a national, randomised study to compare a non-platinum with a platinum combination.Eligible patients had stage IIIB/IV NSCLC and performance status (PS) 0-2. Patients received up to three cycles of vinorelbine 60 mg m(-2) p.o.+gemcitabine 1000 mg m(-2) i.v. day 1 and 8 (VG) or vinorelbine 60 mg m(-2) p.o. day 1 and 8+carboplatin area under the curve=5 (Calvert's formula) i.v. day 1 (VC). Patients ≥75 years received 75% of the dose. Endpoints were overall survival, health-related quality of life (HRQoL), toxicity, and the use of radiotherapy.We randomised 444 patients from September 2007 to April 2009. The median age was 65 years, 58% were men and 25% had PS 2. Median survival was VG: 6.3 months; VC: 7.0 months, P=0.802. Vinorelbine plus carboplatin patients had more grade III/IV nausea/vomiting (VG: 4%, VC: 12%, P=0.008) and grade IV neutropenia (VG: 7%, VC: 19%, P<0.001). Infections, HRQoL and the use of radiotherapy did not differ significantly between the treatment groups.The two regimens yielded similar overall survival. The VG combination had only a slightly better toxicity profile.",0,0 +2973,Sustained Elevation of Serum Interleukin-6 and Relative Insensitivity to Hydrocortisone Differentiates Posttraumatic Stress Disorder with and Without Depression,"

Background

Elevated levels of proinflammatory cytokines, especially interleukin-6 (IL-6), can mediate the greater risk for cardiovascular disease in individuals with posttraumatic stress disorder (PTSD), particularly in those with comorbid major depressive disorder (MDD). However, IL-6 levels are not consistently elevated in either PTSD or MDD. Although PTSD is associated with supersensitivity to glucocorticoids; prior studies have not evaluated the effect of comorbid MDD.

Methods

Serum IL-6 levels were measured hourly between 7:00 pm and 7:00 am in individuals with PTSD with comorbid MDD (PTSD + MDD) (n = 9) and compared with those with PTSD without MDD (PTSD − MDD) (n = 9) and nontraumatized healthy control subjects (n = 14). Group differences in serum IL-6, plasma adrenocorticotropic hormone (ACTH), and plasma cortisol response to 30 mg of intravenous hydrocortisone were evaluated using linear mixed models.

Results

Only subjects with PTSD + MDD exhibited higher, overnight serum IL-6 levels compared with individuals with PTSD − MDD (p < .01) and healthy control subjects (p < .001). Peak overnight IL-6 levels positively correlated with severity of PTSD (r = .56, p < .01) and depressive symptoms (r = .54, p < .01). Hydrocortisone administration significantly reduced IL-6 levels in both PTSD groups; however, IL-6 levels in PTSD + MDD were higher than both PTSD − MDD (p < .05) and healthy control subjects (p < .01). Following hydrocortisone administration, there was a greater reduction in levels of ACTH in PTSD − MDD compared with control subjects (p < .01).

Conclusions

Sustained elevations of overnight IL-6 levels and relatively decreased sensitivity to hydrocortisone distinguish PTSD + MDD from PTSD − MDD. Novel strategies that decrease IL-6 levels offer a new direction in the prevention and treatment of PTSD and associated comorbid medical illnesses.",0,0 +2974,A three-year follow-up study of the psychosocial predictors of delayed and unresolved post-traumatic stress disorder in Taiwan Chi-Chi earthquake survivors,"To predict the longitudinal course of post-traumatic stress disorder (PTSD) in survivors three years following a catastrophic earthquake using multivariate data presented six months after the earthquake.Trained assistants and psychiatrists used the Disaster-related Psychological Screening Test (DRPST) to interview earthquake survivors 16 years and older and to assess current and incidental psychopathology. A total of 1756 respondents were surveyed over the three-year follow-up period.A total of 38 (9.1%) of the original 418 PTSD subjects and 40 of the original 1338 (3.0%) non-PTSD subjects were identified as having PTSD at the 3-year post-earthquake follow up. Younger age, significant financial loss, and memory/attention impairment were predictive factors of unresolved PTSD and delayed PTSD.The longitudinal course of PTSD three years after the earthquake could be predicted as early as six months after the earthquake on the basis of demographic data, PTSD-related factors, and putative factors for PTSD.",0,0 +2975,Distinctive Trajectory Groups of Mental Health Functioning among Assertive Community Treatment Clients: An Application of Growth Mixture Modelling Analysis,"Objective: Assertive community treatment (ACT) studies that have used conventional, statistical growth modelling methods have not examined different trajectories of outcomes or covariates that could influence different trajectories, even though heterogeneity in outcomes has been established in other research on severe mental illness. The purpose of our study was to examine the general trend in mental health functioning of ACT clients over a 2-year follow-up time period, to discover groups of ACT clients with distinctive longitudinal trajectories of mental health functioning, and to examine if some of the key sociodemographic and illness-related factors influence group membership. Method: A 2-year, prospective, within-subjects study of 216 ACT clients within southern Ontario, collected functional outcome data at baseline and 12 and 24 months using the Colorado Client Assessment Record. Baseline covariates included sex, primary diagnosis, number of comorbidities, hospitalization history, and duration of illness. Growth mixture modelling (GMM) was used to examine trajectories. Results: Clinical staff assessments of ACT clients showed a statistically significant improvement in functioning and 84% achieved successful community tenure. GMM analysis identified 2 classes of ACT clients: class 1 (79.63% of clients) experienced lower and stable overall functioning, and class 2 (20.37%) showed a better baseline functioning score and improvement in the overall functioning over time. Class membership was predicted by the number of comorbidities and diagnosis. Conclusions: Our study suggests general stability in overall functioning for the sampled ACT clients over 2 years, but significant heterogeneity in trajectories of functioning.",0,0 +2976,Heterogeneity of posttraumatic stress disorder symptoms in Croatian war veterans: retrospective study.,"To determine the relationship between the intensity of combat-related posttraumatic stress disorder (PTSD) and the intensity of predominating symptoms.The study included 151 veterans from 1992-1995 war in Croatia (aged 38.3+/-7.3 years) with PTSD. The veterans were psychologically tested with the Mississippi Scale for Combat-related PTSD (M-PTSD), Questionnaire on Traumatic Combat and War Experiences (USTBI-M), and Minnesota Multiphasic Personality Inventory-version 201 (MMPI-201).The discriminative analysis of the data revealed that the group with lower PTSD intensity had the highest scores on MMPI scales D (depression, T-score 98.3+/-5.6), Hs (hypochondriasis, 90.1+/-5.1), and Hy (hysteria, 89.5+/-4.9), whereas the group with higher PTSD intensity, besides these three scales (D=95.7+/-5.3; Hs=87.6+/-4.3; Hy=85.6+/-4.7), also had clinically significantly elevated Pt (psychastenia, 80.6+/-5.6), Sc (schizophrenia, 79.6+/-4.8), and Pa (paranoia, 85.6+/-5.4) scales, with the highest Pa scale.It was possible to differentiate study participants with different PTSD intensity on the basis of their MMPI profile. More intense PTSD was associated with externalized symptoms, such as aggression, acting-out, hostility, and mistrust, whereas less intensive PTSD was associated with mostly depressive symptoms. Our study showed that different intensity of PTSD has different symptom patterns.",0,0 +2977,Battle for the mind: World War 1 and the birth of military psychiatry,"

Summary

The 100th anniversary of the outbreak of World War 1 could be viewed as a tempting opportunity to acknowledge the origins of military psychiatry and the start of a journey from psychological ignorance to enlightenment. However, the psychiatric legacy of the war is ambiguous. During World War 1, a new disorder (shellshock) and a new treatment (forward psychiatry) were introduced, but the former should not be thought of as the first recognition of what is now called post-traumatic stress disorder and the latter did not offer the solution to the management of psychiatric casualties, as was subsequently claimed. For this Series paper, we researched contemporary publications, classified military reports, and casualty returns to reassess the conventional narrative about the effect of shellshock on psychiatric practice. We conclude that the expression of distress by soldiers was culturally mediated and that patients with postcombat syndromes presented with symptom clusters and causal interpretations that engaged the attention of doctors but also resonated with popular health concerns. Likewise, claims for the efficacy of forward psychiatry were inflated. The vigorous debates that arose in response to controversy about the nature of psychiatric disorders and the discussions about how these disorders should be managed remain relevant to the trauma experienced by military personnel who have served in Iraq and Afghanistan. The psychiatric history of World War 1 should be thought of as an opportunity for commemoration and in terms of its contemporary relevance—not as an opportunity for self-congratulation.",0,0 +2978,The clinical course over the first year of Whiplash Associated Disorders (WAD): pain-related disability predicts outcome in a mildly affected sample,"Different recovery patterns are reported for those befallen a whip-lash injury, but little is known about the variability within subgroups. The aims were (1) to compare a self-selected mildly affected sample (MILD) with a self-selected moderately to severely affected sample (MOD/SEV) with regard to background characteristics and pain-related disability, pain intensity, functional self-efficacy, fear of movement/(re)injury, pain catastrophising, post-traumatic stress symptoms in the acute stage (at baseline), (2) to study the development over the first year after the accident for the above listed clinical variables in the MILD sample, and (3) to study the validity of a prediction model including baseline levels of clinical variables on pain-related disability one year after baseline assessments.The study had a prospective and correlative design. Ninety-eight participants were consecutively selected. Inclusion criteria; age 18 to 65 years, WAD grade I-II, Swedish language skills, and subjective report of not being in need of treatment due to mild symptoms. A multivariate linear regression model was applied for the prediction analysis.The MILD sample was less affected in all study variables compared to the MOD/SEV sample. Pain-related disability, pain catastrophising, and post-traumatic stress symptoms decreased over the first year after the accident, whereas functional self-efficacy and fear of movement/(re)injury increased. Pain intensity was stable. Pain-related disability at baseline emerged as the only statistically significant predictor of pain-related disability one year after the accident (Adj r² = 0.67).A good prognosis over the first year is expected for the majority of individuals with WAD grade I or II who decline treatment due to mild symptoms. The prediction model was not valid in the MILD sample except for the contribution of pain-related disability. An implication is that early observations of individuals with elevated levels of pain-related disability are warranted, although they may decline treatment.",0,0 +2979,Schneiderian symptoms and childhood trauma in the general population,"The Dissociative Disorders Interview Schedule (DDIS) was administered to a sample of 502 adults in the city of Winnipeg, Manitoba, Canada. Findings indicate that Schneiderian symptoms are highly related to childhood trauma and other dissociative symptoms clusters in the general population, as they are in clinical populations. Implications of the findings are discussed.",0,0 +2980,Longitudinal study of probable post-traumatic stress disorder in firefighters exposed to the World Trade Center disaster,"Symptoms of post-traumatic stress disorder (PTSD) have been reported even years after the terrorist attacks of September 11, 2001 (9/11).We used screening tools to assess the prevalence of probable PTSD in 9/11-exposed firefighters at two time points, within 6 months of 9/11 (baseline) and 3-4 years post-disaster (follow-up).Five thousand six hundred fifty-six individuals completed assessments at both times. 15.5% reported probable PTSD post-9/11, 8.6% at baseline and 11.1% at follow-up, on average 2.9 (SD 0.5) years later. Analyses revealed that nearly half of all probable PTSD occurred as delayed onset (absent baseline, present follow-up). Compared with the resilient group (no probable PTSD at either time), probable PTSD at baseline, and delayed onset at follow-up were each associated with concomitant functional impairment (OR 19.5 and 18.9), respectively.Similar percentages of firefighters met criteria for baseline and delayed onset probable PTSD at follow-up, years later. Both were associated with substantial functional impairment. Early risk identification could provide opportunities for mental health interventions before symptoms compromise work and social relationships.",0,0 +2981,Research on injury compensation and health outcomes: ignoring the problem of reverse causality led to a biased conclusion,"This study highlights the serious consequences of ignoring reverse causality bias in studies on compensation-related factors and health outcomes and demonstrates a technique for resolving this problem of observational data.Data from an English longitudinal study on factors, including claims for compensation, associated with recovery from neck pain (whiplash) after rear-end collisions are used to demonstrate the potential for reverse causality bias. Although it is commonly believed that claiming compensation leads to worse recovery, it is also possible that poor recovery may lead to compensation claims--a point that is seldom considered and never addressed empirically. This pedagogical study compares the association between compensation claiming and recovery when reverse causality bias is ignored and when it is addressed, controlling for the same observable factors.When reverse causality is ignored, claimants appear to have a worse recovery than nonclaimants; however, when reverse causality bias is addressed, claiming compensation appears to have a beneficial effect on recovery, ceteris paribus.To avert biased policy and judicial decisions that might inadvertently disadvantage people with compensable injuries, there is an urgent need for researchers to address reverse causality bias in studies on compensation-related factors and health.",0,0 +2982,"Victimization Profiles, Non-Suicidal Self-Injury, Suicide Attempt, and Post-Traumatic Stress Disorder Symptomology","Few studies have incorporated multiple dimensions of victimization or examined whether victimization profiles differ by gender. Consequently, the present study sought to extend prior research by using latent class analysis (LCA) to identify naturally occurring subgroups of individuals who have experienced victimization, and to test for sex differences. Data from 4,016 females and 3,032 males in the Adult Psychiatric Morbidity Survey (APMS) were analyzed. Evidence of the existence of similar victimization subtypes for both males and females emerged, with a three-class solution providing the best fit to the data for both sexes. Furthermore, the classes were labeled “low victimization” (the baseline class; Class 3), the “high victimization class” (Class 1), and “the bullying and domestic violence class” (Class 2) for both males and females. Multinomial logistic regression was used to interpret the nature of the latent classes, or groups, by estimating the associations with post-traumatic stress disorder (PTSD) dimensions, suicide attempt, and non-suicidal self-injury. Although different constellations of victimization experiences did not emerge through the gender-specific analyses, the nature of the associations between class membership and external variables differed between males and females. Findings highlight the heterogeneity of victimization experiences and their relations to functioning, and have implications for policy and practice implications.",0,0 +2983,Efficacy of a Satyananda Yoga Intervention for Reintegrating Adults Diagnosed with Posttraumatic Stress Disorder,"The prevalence of posttraumatic stress disorder (PTSD) in ex-combatants from illegal armed groups in Colombia has been estimated at 37.4%. This high prevalence indicates a need to explore alternative and adjunctive therapies in the treatment of PTSD. A randomized controlled trial was undertaken to evaluate the efficacy and safety of a protocol based on Satyananda Yoga® in PTSD-diagnosed reintegrating adults in Colombia. One hundred reintegrating adults (n = 50 for each of the yoga and control arms) from Bogota and Medellin participated in this study. Yoga participants engaged in a Satyananda Yoga intervention for 16 weeks while the control group continued the regular demobilization program. The Posttraumatic Stress Disorder Checklist - Civilian Version (PCL-C) was used to evaluate the effects of the applied therapy. Outcomes were assessed before entry and after the treatment. T-tests revealed a treatment effect of d = 1.15 for the yoga group and a between-groups effect size of d = .73. The difference in improvement in PCL-C scores between both groups was 18.91% (p < 0.05). The highest percentage of improvement was observed in the re-experiencing symptom cluster (23.71%; p < 0.05), with a treatment effect of d = 1.40 for the yoga group and a between-groups effect size of d = 1.15. The data suggest that Satyananda Yoga methodology is an effective therapy for reintegrating adults diagnosed with PTSD. Further research is needed in order to evaluate prolonged effects of this alternative therapy.",0,0 +2984,Structural Validity of the Posttraumatic Stress Disorder Checklist Among College Students With a Trauma History,"The authors conducted confirmatory factor analyses to test three-factor and four-factor models of posttraumatic stress disorder (PTSD) using the PTSD Checklist with college students reporting a traumatic event history. The authors found support for the three-factor DSM-IV-based PTSD diagnostic model including reexperiencing, avoidance/numbing, and hyperarousal symptom factors, with slightly better support for a four-factor model separating the avoidance and numbing factors. Results further attest to the PTSD Checklist's construct validity, and to research finding that PTSD avoidance and numbing constructs are distinct.",0,0 +2985,Mental disorders and smoking trajectories: A 10-year prospective study among adolescents and young adults in the community,"Numerous studies have documented an association between mental disorders and onset of cigarette smoking. Yet, there is little understanding of the potential impact of mental disorders on trajectories of smoking over time. The objective of this study was to investigate this relationship among adolescents over a 10-year span. Data were drawn from the Early Developmental Stages of Psychopathology Study, a 10-year prospective investigation of youth in Germany. Growth mixture modeling was used to identify smoking trajectories and logistic regression analyses were used to examine relationships between mental disorders and subsequent trajectories. Four trajectories were identified: non-users; increasing use; decreasing use; persistent use. Alcohol/drug use disorders, stress disorders, anxiety disorders, somatoform disorder and nicotine dependence were associated with nicotine use (as compared to the non-smoker class). However, comparisons between trajectories of nicotine use showed that any stress disorder predicted only decreasing use compared to the other two trajectories; nicotine dependence, alcohol/illicit drug use disorders as well as panic disorder and somatoform disorders were inversely associated with increasing use; nicotine dependence and alcohol/drug use disorders were associated with persistent use. Several mental disorders appear to be non-specific markers of the range of smoking trajectories while others predict specific trajectories. Numerous disorders (e.g., alcohol/drug use disorders) do not appear to occur only prior to and predict increased smoking trajectory as had been previously suggested, but rather they also occur concurrently, with high levels of smoking and in some cases smoking persists at a steady level over time.",0,0 +2986,Posttraumatic stress disorders in children and adolescents,"Millions of children are exposed to traumatic experiences each year. Over 30% of these children develop a clinical syndrome with emotional, behavioral, cognitive, social, and physical symptoms called posttraumatic stress disorder. The symptoms of posttraumatic stress disorder fall into three clusters: reenactment of the traumatic event: avoidance of cues associated with the event or general withdrawal; and physiological hyperreactivity. Significant physical and medical problems in childhood, adolescence, and adulthood appear to be related to childhood trauma. Current treatment approaches include postacute psychoeducation, individual psychotherapy, pharmacotherapy, and cognitive-behavioral therapy. Despite increasing attention over the past 10 years, childhood posttraumatic stress disorder remains an understudied public health problem.",0,0 +2987,The World Trade Center Disaster and the Health of Workers: Five-Year Assessment of a Unique Medical Screening Program,"Approximately 40,000 rescue and recovery workers were exposed to caustic dust and toxic pollutants following the 11 September 2001 attacks on the World Trade Center (WTC). These workers included traditional first responders, such as firefighters and police, and a diverse population of construction, utility, and public sector workers.To characterize WTCrelated health effects, the WTC Worker and Volunteer Medical Screening Program was established. This multicenter clinical program provides free standardized examinations to responders. Examinations include medical, mental health, and exposure assessment questionnaires; physical examinations; spirometry; and chest X rays.Of 9,442 responders examined between July 2002 and April 2004, 69% reported new or worsened respiratory symptoms while performing WTC work. Symptoms persisted to the time of examination in 59% of these workers. Among those who had been asymptomatic before September 11, 61% developed respiratory symptoms while performing WTC work. Twenty-eight percent had abnormal spirometry; forced vital capacity (FVC) was low in 21%; and obstruction was present in 5%. Among nonsmokers, 27% had abnormal spirometry compared with 13% in the general U.S. population. Prevalence of low FVC among nonsmokers was 5-fold greater than in the U.S. population (20% vs. 4%). Respiratory symptoms and spirometry abnormalities were significantly associated with early arrival at the site.WTC responders had exposure-related increases in respiratory symptoms and pulmonary function test abnormalities that persisted up to 2.5 years after the attacks. Longterm medical monitoring is required to track persistence of these abnormalities and identify late effects, including possible malignancies. Lessons learned should guide future responses to civil disasters.",0,0 +2988,Ethical challenges with the left ventricular assist device as a destination therapy,"The left ventricular assist device was originally designed to be surgically implanted as a bridge to transplantation for patients with chronic end-stage heart failure. On the basis of the REMATCH trial, the US Food and Drug Administration and the US Centers for Medicare & Medicaid Services approved permanent implantation of the left ventricular assist device as a destination therapy in Medicare beneficiaries who are not candidates for heart transplantation. The use of the left ventricular assist device as a destination therapy raises certain ethical challenges. Left ventricular assist devices can prolong the survival of average recipients compared with optimal medical management of chronic end-stage heart failure. However, the overall quality of life can be adversely affected in some recipients because of serious infections, neurologic complications, and device malfunction. Left ventricular assist devices alter end-of-life trajectories. The caregivers of recipients may experience significant burden (e.g., poor physical health, depression, anxiety, and posttraumatic stress disorder) from destination therapy with left ventricular assist devices. There are also social and financial ramifications for recipients and their families. We advocate early utilization of a palliative care approach and outline prerequisite conditions so that consenting for the use of a left ventricular assist device as a destination therapy is a well informed process. These conditions include: (1) direct participation of a multidisciplinary care team, including palliative care specialists, (2) a concise plan of care for anticipated device-related complications, (3) careful surveillance and counseling for caregiver burden, (4) advance-care planning for anticipated end-of-life trajectories and timing of device deactivation, and (5) a plan to address the long-term financial burden on patients, families, and caregivers.Short-term mechanical circulatory devices (e.g. percutaneous cardiopulmonary bypass, percutaneous ventricular assist devices, etc.) can be initiated in emergency situations as a bridge to permanent implantation of ventricular assist devices in chronic end-stage heart failure. In the absence of first-person (patient) consent, presumed consent or surrogate consent should be used cautiously for the initiation of short-term mechanical circulatory devices in emergency situations as a bridge to permanent implantation of left ventricular assist devices. Future clinical studies of destination therapy with left ventricular assist devices should include measures of recipients' quality of end-of-life care and caregivers' burden.",0,0 +2989,Findings of Mild Traumatic Brain Injury in Combat Veterans With PTSD and a History of Blast Concussion,"Veterans with chronic posttraumatic stress disorder were evaluated for a history of blast concussion, controlling for confounding conditions. Electroencephalograms were analyzed by discriminant function for traumatic brain injury. A difference was found in discriminant scores between veterans with and without blast concussion. More members of the blast group had attentional symptoms and attentional dysfunction. Combat veterans with a remote history of blast injury have persistent electroencephalographic features of traumatic brain injury as well as attentional problems. The authors hypothesize that these constitute a type of chronic postconcussive syndrome that has cognitive and mood symptoms overlapping those of posttraumatic stress disorder.",0,0 +2990,Aged neuropeptide Y transgenic rats are resistant to acute stress but maintain spatial and non-spatial learning,"The behavioral phenotype of five-month-old rats overexpressing neuropeptide Y (NPY) has previously been described [Proc Natl Acad Sci USA 97 (2000) 12852]. In this transgenic rat model, there is central overexpression of prepro-NPY mRNA and NPY peptide in the hippocampus and hypothalamus and decreased Y1 binding sites within the hippocampus. These molecular and neurochemical events led to altered anxiety profile and learning abilities in NPY-overexpressing rats. In the present study, anxiety and learning/memory related behaviors were examined in one-year-old NPY-transgenic rats in order to assess any behavioral changes that may have occurred during the aging process. As observed in 5-month-old overexpressing rats, aged NPY-transgenic animals are resistant to acute physical restraint stress measured by the elevated-plus maze and demonstrate anxiolytic-like activity in the open field. However, in contrast to data in young rats, there was no significant difference between aged wildtype and NPY-transgenic animals in relation to spatial and non-spatial memory as indicated by the (allo- and ego-centric) Morris water maze and object recognition test. It would thus appear that the anxiolytic-like profile observed in young NPY-overexpressing rats is maintained in older animals providing further evidence for a role for NPY in anxious behaviors. However, the cognitive deficits observed in young rats do not appear to occur in older animals suggesting the existence of compensatory mechanisms leading to a reversal of the learning deficits noted in younger animals. These results also provide additional evidence for the mechanistic dissociation between anxiety and cognition-related behaviors modulated by NPY.",0,0 +2991,A Randomised Controlled Trial of a Cognitive-Behavioural Therapy Program for Managing Social Anxiety After Acquired Brain Injury,"Abstract Despite the prevalence of psychiatric illness in people with acquired brain injury (ABI), there are very few empirically validated studies examining the efficacy of treatments targeting commonly occurring disorders such as depression and anxiety. Using a randomised controlled trial, this study evaluated the efficacy of a cognitive behavioural intervention specifically designed for managing social anxiety following ABI. Twelve brain-injured participants were screened, randomly allocated to either treatment group (TG) or a wait list group (WLG), and proceeded through to the final stages of therapy. The TG received between 9 and 14 hourly, individual sessions of cognitive behavioural therapy. Repeated measures analyses revealed significant improvements in general anxiety, depression and a transient mood measure, tension-anxiety, for the TG when compared to the WLG at posttreatment. These treatment gains were maintained at one-month follow-up. Although in the predicted direction, postintervention improvements in social anxiety and self-esteem for the TG were not significant in comparison with the WLG. This study lends support to the small body of literature highlighting the potential of cognitive behavioural interventions for managing the psychological problems that serve as a barrier to rehabilitation following ABI.",0,0 +2992,The Impact of Event Scale-Revised: Psychometric properties in a sample of motor vehicle accident survivors,"This study examined the factor structure, internal consistency, concurrent validity, and discriminative validity of the Impact of Event Scale-Revised (IES-R, [Weiss, D. S. & Marmar, C. R. (1997). The Impact of Event Scale-Revised. In: J. P. Wilson & T. M. Keane (Eds.). Assessing psychological trauma and PTSD (pp. 399-411). New York: Guilford Press]) in a sample of 182 individuals who had experienced a serious motor vehicle accident. Results supported the three-factor structure of the IES-R, Intrusion, Avoidance, and Hyperarousal, with adequate internal consistency noted for each subscale. Support was obtained for the concurrent and discriminative validity, as well as the absence of social desirability effects. Although some differences were noted between the IES-R Avoidance subscale and diagnostically based measures of this cluster of symptoms, these differences do not necessarily signify measurement problems with the IES-R. The IES-R seems to be a solid measure of post-trauma phenomena that can augment related assessment approaches in clinical and research settings.",0,0 +2993,Identification of sexually abused female adolescents at risk for suicidal ideations: a classification and regression tree analysis.,"This study explored the clinical profiles of 77 female teenager survivors of sexual abuse and examined the association of abuse-related and personal variables with suicidal ideations. Analyses revealed that 64% of participants experienced suicidal ideations. Findings from classification and regression tree analysis indicated that depression, posttraumatic stress symptoms, and hopelessness discriminated profiles of suicidal and nonsuicidal survivors. The elevated prevalence of suicidal ideations among adolescent survivors of sexual abuse underscores the importance of investigating the presence of suicidal ideations in sexual abuse survivors. However, suicidal ideation is not the sole variable that needs to be investigated; depression, hopelessness and posttraumatic stress symptoms are also related to suicidal ideations in survivors and could therefore guide interventions.",0,0 +2994,Posttraumatic Stress Disorder (PTSD) and Posttraumatic Stress Symptoms (PTSS) in Families of Adolescent Childhood Cancer Survivors,"To describe rates and concordance of posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSS) in adolescent childhood cancer survivors and their mothers and fathers.Participants were 150 adolescent survivors of childhood cancer, 146 mothers, and 103 fathers who completed the Impact of Events Scale-Revised, the Posttraumatic Stress Disorder Reaction Index, and the PTSD module of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition.PTSS are common in families of childhood cancer survivors. Parents reported more symptomatology than former patients. Mothers and fathers had relatively equal rates of current PTSD and levels of PTSS. Nearly 30% of mothers met diagnostic criteria since their child's diagnosis, with 13.7% currently experiencing PTSD. Nearly 20% of families had at least one parent with current PTSD. Ninety-nine percent of the sample had at least one family member reexperiencing symptoms.Both PTSD and PTSS help in understanding the experience of adolescent cancer survivors and their families. Within families of childhood cancer survivors, it is likely that some member may be experiencing treatable bothersome memories, arousal, or avoidance specific to the cancer experience.",0,0 +2995,Trajectories of caregiver depressive symptoms while providing end-of-life care,"The course of caregivers' depressive symptoms may not be homogenous. This study identified trajectories of depressive symptoms among caregivers providing end-of-life care to cancer patients and profiled the unique characteristics of caregivers within each trajectory.Trajectories of depressive symptoms were explored in 447 caregivers who completed the Center for Epidemiological Studies Depression Scale over four periods close to the patient's death (1-30, 31-90, 91-180, and >180 days). Distinct trajectories were identified by latent class analysis.Four trajectories were identified as endurance, resilience, moderately symptomatic, and chronically distressed and contained 32.0%, 11.4%, 36.9%, and 19.7% of the sample, respectively. Caregivers in the endurance trajectory were relatively well-adjusted individuals with less education, adequate financial support, and ample psychological resources but provided care to older patients with greater symptom distress. They perceived less subjective caregiving burden than caregivers with moderate or chronic depressive symptoms. Caregivers in the resilience trajectory were in a more vulnerable position than those in other trajectories when they first transitioned into the caregiving role because they were more likely to be the patient's spouse, have greater educational attainment and insufficient finances, provide higher intensity assistance to a younger relative, and have weaker psychological resources. However, they were older, reported greater confidence in caregiving, and perceived less caregiving burden than caregivers in other trajectories. The moderately symptomatic and chronically distressed trajectories were differentiated only by the strength of psychological resources.Caregivers of terminally ill cancer patients follow distinct depressive-symptom trajectories while providing end-of-life care.",0,0 +2996,"Superior efficacy of St John's wort extract WS®5570 compared to placebo in patients with major depression: a randomized, double-blind, placebo-controlled, multi-center trial [ISRCTN77277298]","The aim of the current study was to assess the antidepressant efficacy and safety of Hypericum perforatum (St. John's wort) extract WS 5570 at doses of 600 mg/day in a single dose and 1200 mg/day in two doses.The participants in this double-blind, randomized, placebo-controlled, multi-center clinical trial were male and female adult out-patients with an episode of mild or moderate major depressive episode (single or recurrent episode, DSM-IV criteria). As specified by the relevant guideline, the study was preceded by a medication-free run-in phase. For the 6-week treatment, 332 patients were randomized: 123 to WS 5570 600 mg/day, 127 to WS 5570 1200 mg/day, and 82 to placebo. The primary outcome measure was the change in total score on the Hamilton Rating Scale for Depression (HAM-D, 17-item version) between baseline and endpoint. Additional measures included the number of responders, the number of patients in remission, and several other standard rating scales. Efficacy and safety were assessed after 2 and 6 weeks. The design included an interim analysis performed after randomization with the option of early termination.After 6 weeks of treatment, mean +/- standard deviation decreases in HAM-D total scores of 11.6 +/- 6.4, 10.8 +/- 7.3, and 6.0 +/- 8.1 points were observed for the WS 5570 600 mg/day, 1200 mg/day and placebo groups, respectively (endpoint analysis). Secondary measures of treatment efficacy also showed that both WS 5570 groups were statistically superior to placebo. Significantly more patients in the WS 5570 treatment groups than in the placebo group showed treatment response and remission. WS 5570 was consistently more effective than placebo in patients with either less severe or more severe baseline impairment. The number of patients who experienced remission was higher in the WS 5570 1200 mg/day group than the WS 5570 600 mg/day group. The incidence of adverse events was low in all groups. The adverse event profile was consistent with the known profile for Hypericum extract preparations.Hypericum perforatum extract WS 5570 at doses of 600 mg/day (once daily) and 1200 mg/day (600 mg twice daily) were found to be safe and more effective than placebo, with comparable efficacy of the WS 5570 groups for the treatment of mild to moderate major depression.",0,0 +2997,Lifetime Events and Posttraumatic Stress Disorder in 4 Postconflict Settings,"Little is known about the impact of trauma in postconflict, low-income countries where people have survived multiple traumatic experiences.To establish the prevalence rates of and risk factors for posttraumatic stress disorder (PTSD) in 4 postconflict, low-income countries.Epidemiological survey conducted between 1997 and 1999 among survivors of war or mass violence (aged >/=16 years) who were randomly selected from community populations in Algeria (n = 653), Cambodia (n = 610), Ethiopia (n = 1200), and Gaza (n = 585).Prevalence rates of PTSD, assessed using the PTSD module of the Composite International Diagnostic Interview version 2.1 and evaluated in relation to traumatic events, assessed using an adapted version of the Life Events and Social History Questionnaire.The prevalence rate of assessed PTSD was 37.4% in Algeria, 28.4% in Cambodia, 15.8% in Ethiopia, and 17.8% in Gaza. Conflict-related trauma after age 12 years was the only risk factor for PTSD that was present in all 4 samples. Torture was a risk factor in all samples except Cambodia. Psychiatric history and current illness were risk factors in Cambodia (adjusted odds ratio [OR], 3.6; 95% confidence interval [CI], 2.3-5.4 and adjusted OR,1.6; 95% CI, 1.0-2.7, respectively) and Ethiopia (adjusted OR, 3.9; 95% CI, 2.0-7.4 and adjusted OR, 1.8; 95% CI, 1.1-2.7, respectively). Poor quality of camp was associated with PTSD in Algeria (adjusted OR, 1.8; 95% CI, 1.3-2.5) and in Gaza (adjusted OR, 1.7; 95% CI, 1.1-2.8). Daily hassles were associated with PTSD in Algeria (adjusted OR, 1.6; 95% CI, 1.1-2.4). Youth domestic stress, death or separation in the family, and alcohol abuse in parents were associated with PTSD in Cambodia (adjusted OR, 1.7; 95% CI, 1.1-2.6; adjusted OR, 1.7; 95% CI, 1.0-2.8; and adjusted OR, 2.2; 95% CI, 1.1-4.4, respectively).Using the same assessment methods, a wide range of rates of symptoms of PTSD were found among 4 low-income populations who have experienced war, conflict, or mass violence. We identified specific patterns of risk factors per country. Our findings indicate the importance of contextual differences in the study of traumatic stress and human rights violations.",0,0 +2998,The Impact of Caregiver Distress on the Longitudinal Development of Child Acute Post-traumatic Stress Disorder Symptoms in Pediatric Injury Victims,The present study prospectively examined the development of child PTSD symptoms (PTSS) and the impact of caregiver PTSS on child PTSS following injury.One hundred and eighteen ED patients and their caregivers were interviewed in-hospital and 2- and 6-weeks posttrauma. Structural equation modeling and hierarchical linear regressions examined the development of PTSS.A model combining child and caregiver 2-week PTSS into one latent family PTSS variable provided the best fit to the data. Child in-hospital avoidance symptoms predicted higher levels of 2-week family PTSS. Two-week family PTSS predicted child 6-week PTSS. Post hoc analyses revealed an interaction between in-hospital caregiver avoidance symptoms and child reexperiencing symptoms in predicting 6-week child PTSS.Results highlight the dynamic development of child PTSS. Different symptom clusters may be related to higher PTSS at differing times posttrauma and may inform the development of time-sensitive methods of assessment and intervention for injury victims.,0,0 +2999,Course of posttraumatic stress symptoms over the 5 years following an industrial disaster: A structural equation modeling study,"The present study examined individual latent changes in posttraumatic stress disorder (PTSD) symptoms over a 60-month period after an industrial disaster. Participants were recruited from survivors of a factory explosion. Participants were assessed retrospectively for peritraumatic reactions and acute stress symptoms. Posttraumatic stress disorder symptoms were then assessed at 6, 15, and 60 months. Using structural equation modeling, the authors tested 3 hypotheses of individual latent change: stability of PTSD symptoms between 6, 15, and 60 months; change between 6 and 15 months; and change between 15 and 60 months. Only one model provided a good fit suggesting that PTSD symptoms evolved between 6 and 15 months after trauma exposure and remained stable at the individual level thereafter.",0,0 +3000,Examining the relationship between blast-induced mild traumatic brain injury and posttraumatic stress-related traits,"Emerging evidence suggests that mild traumatic brain injury (mTBI) resulting from blast exposure may contribute to the occurrence of posttraumatic stress disorder (PTSD) and related affective sequelae, such as anxiety and depression. Many studies have used survey techniques to describe blast exposure leading to comorbid mTBI and related persistent postconcussive symptoms (PPCS) with PTSD in military populations. Despite this, there is a lack of literature that examines possible biological mechanisms by which blast exposure contributes to the development of PTSD sequelae. This Mini-Review addresses the current literature on potential neurophysiological changes that may contribute to PTSD-like traits as a result of a single or multiple exposures to blast events. Evidence from clinical blast-induced mTBI populations and animal models of blast-induced mTBI was evaluated with an emphasis on behavioral and physiological symptoms similar to those seen in PTSD populations and models. From the analysis, we propose potential mechanisms that merit further investigation for better understanding of how blast exposures may produce a higher rate of comorbid PPCS, PTSD, and affective phenomena. An improved understanding of PTSD-like outcomes resulting from blast exposure will ultimately help facilitate the development of future treatments and contribute to a better understanding of PTSD sequelae that develop from physical trauma.",0,0 +3001,"Use of Prescription Pain Medications Among Medical Cannabis Patients: Comparisons of Pain Levels, Functioning, and Patterns of Alcohol and Other Drug Use","Management of chronic pain is one of the most common reasons given by individuals seeking medical cannabis. However, very little information exists about the concurrent use of cannabis and prescription pain medication (PPM). This study fills this gap in knowledge by systematically comparing medical cannabis users who use or do not use PPM, with an emphasis on understanding whether concurrent use of cannabis and PPM is associated with more serious forms of alcohol and other drug involvement.Data from this study were collected from a medical cannabis clinic in southwestern Michigan (N = 273). Systematic comparisons were made on measures of sociodemographics, reasons for substance use, pain, functioning, and perceptions of PPM and medical cannabis efficacy.PPM users tended to be older and reported higher levels of pain and lower levels of functioning. The overall sample exhibited higher lifetime and past-3-month rates of alcohol and other noncannabis drug use than did the general population. Approximately 40% of subjects reported combining cannabis with alcohol, but no significant difference was observed between PPM users and nonusers. PPM users and nonusers did not exhibit any difference in either lifetime or past-3-month use of other drugs, including cocaine, sedatives, street opioids, and amphetamines. PPM users rated the efficacy of cannabis higher than PPM for pain management and indicated a strong desire to reduce PPM usage.Use of PPM among medical cannabis users was not identified as a correlate for more serious forms of alcohol and other drug involvement. However, longitudinal study designs are needed to better understand the trajectories of alcohol and other drug involvement over time among medical cannabis users.",0,0 +3002,An Integrative Two-Factor Model of Post-Traumatic Stress,"(from the book) provides [a] macroanalytic integrative construction of post-traumatic stress wherein posttraumatic stress disorder (PTSD) is viewed as an epiphenomenon / [builds] an integrative 2-factor model wherein biological factors are inextricably intertwined with psychological factors to explain the posttraumatic stress phenomenon, (from the chapter) [suggests] that PTSD is an epiphenomenon undergirded by a core 2-factor phenomenology consisting of (1) subcortical neurological hypersensitivity and (2) psychological hypersensitivity / the neurobiology of PTSD was posited to be a combination of amygdalar-hippocampus neural networks with numerous and varied efferent projections (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +3003,Low emotional response to traumatic footage is associated with an absence of analogue flashbacks: An individual participant data meta-analysis of 16 trauma film paradigm experiments,"Most people will experience or witness a traumatic event. A common occurrence after trauma is the experience of involuntary emotional memories of the traumatic event, herewith ""flashbacks"". Some individuals, however, report no flashbacks. Prospective work investigating psychological factors associated with an absence of flashbacks is lacking. We performed an individual participant data meta-analysis on 16 experiments (n = 458) using the trauma film paradigm to investigate the association of emotional response to traumatic film footage and commonly collected baseline characteristics (trait anxiety, current depression, trauma history) with an absence of analogue flashbacks. An absence of analogue flashbacks was associated with low emotional response to the traumatic film footage and, to a lesser extent, low trait anxiety and low current depression levels. Trauma history and recognition memory for the film were not significantly associated with an absence of analogue flashbacks. Understanding why some individuals report an absence of flashbacks may aid preventative treatments against flashback development.",0,0 +3004,Fear and avoidance of internal experiences among patients with substance use disorders and PTSD: The centrality of anxiety sensitivity*,"This study evaluated anxiety sensitivity, cognitive avoidance, and alexithymia and their relationship to posttraumatic stress disorder (PTSD) and alcohol use indices concurrently and prospectively in an outpatient substance abuse treatment sample that screened positive for PTSD (N=58). Anxiety sensitivity accounted for substantial variance in the PTSD clusters, reexperiencing, avoidance, and hyperarousal, both concurrently and prospectively. Cognitive avoidance accounted for additional variance with concurrent PTSD avoidance symptoms. Anxiety sensitivity and cognitive avoidance were largely not associated with alcohol use indices. Alexithymia was largely redundant with cognitive avoidance and was, therefore, not included in the regression analyses. Theoretical and treatment implications of these findings are discussed in the context of individuals with dually diagnosed PTSD and substance abuse disorders.",0,0 +3005,Directions in Disaster Resilience Policy,"Currently, a range of common terms are being used differently within government and the emergency management community. This paper provides a foundation for an understanding of the term 'resilience' so that constructive discussion can emerge amongst those involved in disaster management policy and practice. In doing so, we provide a short review of how the term can be used differently within policy, as well as how it has come to be influential in emergency management policy.",0,0 +3006,Correlation between Genotypes and Behavioral Phenotypes in a Mouse Model simulating aspects of Human Post‐traumatic Stress Disorder (PTSD),"Biologically meaningful correlations between behavioral phenotypes and genotypes are evaluated in a modified ‘residentintruder’- type stress on mice. This model was established by housing male C57BL/6 naïve subject mice with an SJL aggressor (Agg) mouse without direct contact for 6 h/d for 10 d or 5 d, and then briefly pairing the C57BL/6 mice with the Agg mice for 3x/d. Controls (C), also housed without food/liquid during the 6hr session, did not experience direct physical contact with Agg. At time points of 24 hours or 6 wks after the last exposure, behaviors of C and aggressor-exposed (Agg-E) mice were studied using the partition test, which allows mutual exposure of only sensory cues without physical contact. Behavioral patterns (partition avoidance, freezing) of Agg-E mice suggested fear and social withdrawal, the reported traits of PTSD. Global gene expression profiling of three major stress-relevant brain regions, namely Hippocampus (HC), Amygdala (AY), and Medial Pre-Frontal Cortex (mPFC) shows a clear genotype distribution between the C and Agg-E in AY and not in HC which is a positive correlation with PTSD symptom severity. The cluster pattern of MPFC reflects similarity between the genotype profile and behavioral phenotype. Further comprehensive analysis can potentially lead to identifying diagnostic and therapeutic biomarkers that serve as internal indicators of the complex psycho-pathogenesis.",0,0 +3007,Posttraumatic stress and posttraumatic growth among low-income mothers who survived Hurricane Katrina.,"The purpose of the study was to explore the relationship between posttraumatic stress (PTS) and posttraumatic growth (PTG) after Hurricane Katrina, and the role of demographics, predisaster psychological distress, hurricane-related stressors, and psychological resources (optimism and purpose) in predicting each.Participants were 334 low-income mothers (82.0% non-Hispanic Black) living in the New Orleans area prior to Hurricane Katrina, who completed surveys in the year prior to the hurricane (T1 [Time 1]) and 1 and 3 years thereafter (T2 and T3).Higher T2 and T3 PTS full-scale and symptom cluster subscales (Intrusion, Avoidance, and Hyperarousal) were significantly associated with higher T3 PTG, and participants who surpassed the clinical cutoff for probable posttraumatic stress disorder at both T2 and T3 had significantly higher PTG than those who never surpassed the clinical cutoff. Older and non-Hispanic Black participants, as well as those who experienced a greater number of hurricane-related stressors and bereavement, reported significantly greater T3 PTS and PTG. Participants with lower T2 optimism reported significantly greater T3 intrusive symptoms, whereas those with higher T1 and T2 purpose reported significantly greater T3 PTG.Based on the results, we suggest practices and policies with which to identify disaster survivors at greater risk for PTS, as well as longitudinal investigations of reciprocal and mediational relationships between psychological resources, PTS, and PTG.",0,0 +3008,Clinical Presentation of PTSD in World War II Combat Veterans,"Clinicians have increasingly recognized posttraumatic stress disorder (PTSD) among Vietnam veterans, but the disorder may be easily overlooked among World War II combat veterans. The authors review recent studies of PTSD in older veterans and describe five cases that illustrate the diverse clinical presentations of PTSD in this population. Symptoms included anxiety, cognitive and somatic complaints, depression, alcohol dependence, and amnestic periods. Despite the varied presentations, a fairly consistent patient profile emerged. Patients avoided reminders of war, showed an exaggerated startle response, and experienced restless sleep and chronic anxiety. Factors associated with exacerbations of symptoms were retirement and reminders of war experiences. Although past studies have emphasized resuppression of the trauma, the authors encourage a flexible approach to treatment, including exploratory techniques.",0,0 +3009,Common genetic and environmental contributions to post-traumatic stress disorder and alcohol dependence in young women,"The few genetically informative studies to examine post-traumatic stress disorder (PTSD) and alcohol dependence (AD), all of which are based on a male veteran sample, suggest that the co-morbidity between PTSD and AD may be attributable in part to overlapping genetic influences, but this issue has yet to be addressed in females.MethodData were derived from an all-female twin sample (n=3768) ranging in age from 18 to 29 years. A trivariate genetic model that included trauma exposure as a separate phenotype was fitted to estimate genetic and environmental contributions to PTSD and the degree to which they overlap with those that contribute to AD, after accounting for potential confounding effects of heritable influences on trauma exposure.Additive genetic influences (A) accounted for 72% of the variance in PTSD; individual-specific environmental (E) factors accounted for the remainder. An AE model also provided the best fit for AD, for which heritability was estimated to be 71%. The genetic correlation between PTSD and AD was 0.54.The heritability estimate for PTSD in our sample is higher than estimates reported in earlier studies based almost exclusively on an all-male sample in which combat exposure was the precipitating traumatic event. However, our findings are consistent with the absence of evidence for shared environmental influences on PTSD and, most importantly, the substantial overlap in genetic influences on PTSD and AD reported in these investigations. Additional research addressing potential distinctions by gender in the relative contributions of genetic and environmental influences on PTSD is merited.",0,0 +3010,Deployment-related stress and trauma in Dutch soldiers returning from Iraq,"Some questionnaire studies have shown increased mental health problems, including probable post-traumatic stress disorder (PTSD), in soldiers deployed to Iraq.To test prospectively whether such problems change over time and whether questionnaires provide accurate estimates of deployment-related PTSD compared with a clinical interview.Dutch infantry troops from three cohorts completed questionnaires before deployment to Iraq (n=479), and about 5 months (n=382, 80%) and 15 months (n=331, 69%) thereafter. Post-traumatic stress disorder was evaluated by questionnaire and clinical interview.There were no group changes for general distress symptoms. The rates of PTSD for each cohort were 21, 4 and 6% based on questionnaires at 5 months. The deployment-related rates of PTSD based on the clinical interview were 4, 3 and 3%.There was a specific effect of deployment on mental health for a small minority. Questionnaires eliciting stress symptoms gave substantial overestimations of the rate of PTSD.",0,0 +3011,Heat Acclimation and Heat Stress Have Different Effects on Cholinergic Muscarinic Receptors,"In this brief report we have proved that membranal changes take place upon short-term heat acclimation. These changes may switch on a cascade of transient acclimatory compensatory responses as well as long-term processes. The changes observed in the MR profile are heat acclimation specific, and differ from those observed upon heat stress. These bring about functional changes in the signal transduction pathway for water secretion in the submaxillary salivary gland. A recovery period from heat stress, similar to STHA, leads to MR upregulation and decreased binding affinity. This response, however, is more pronounced than that observed upon STHA. The functional importance of the phenomenon is unclear. However, it could designate a novel component of the heat shock response.",0,0 +3012,Posttraumatic Stress Disorder and Posttraumatic Growth in Breast Cancer Patients: A Systematic Review,"Breast cancer, potentially a traumatic stressor, may be accompanied by negative outcomes, such as posttraumatic stress disorder or positive changes, such as posttraumatic growth. The authors reviewed 24 studies published from 1990 to 2010 that measured posttraumatic stress disorder and posttraumatic growth in women with breast cancer, in terms of frequency rates, factors associated with posttraumatic stress disorder and posttraumatic growth, and their interrelationships. A relatively small percentage of women experienced posttraumatic stress disorder, while the majority of them reported posttraumatic growth. Age, education, economic status, subjective appraisal of the threat of the disease, treatment, support from significant others, and positive coping strategies were among the most frequently reported factors associated with these phenomena. Moreover, posttraumatic stress disorder and posttraumatic growth were not related. Future research should shed more light on posttraumatic growth and posttraumatic stress disorder among women with breast cancer, the parameters that influence them, and their possible relationship.",0,0 +3013,Development of a depersonalization severity scale,"Our aim was to develop a clinician-rated scale assessing depersonalization severity for use in clinical trials of Depersonalization Disorder and trauma-related disorders in general. The 6-item Depersonalization Severity Scale (DSS) was administered to 63 participants with DSM-IV Depersonalization Disorder as diagnosed by the SCID-D, and its psychometric properties were examined. The sensitivity of the DSS and of the Dissociative Experiences Scale (DES) to treatment change was assessed in blinded, controlled settings. Individual items were widely distributed across the severity range. Interrater reliability was excellent and internal consistency was moderate. The DSS had high convergent and discriminant validity and was sensitive to treatment change. The DES was also sensitive to treatment change. We recommend piloting the DSS in future treatment trials of trauma-spectrum disorders.",0,0 +3014,Post-traumatic stress disorder in victims of traumatic events.,"The present study obtained data on frequency of Post-traumatic Stress Disorder (PTSD) symptoms, victims' gender and age, type of trauma and diagnostic comorbidity in a sample of 274 subjects (77 male and 197 female), victims of a severe traumatic event. The Checklist of Stressful and Traumatic Events, Trauma Assessment for Adults (TAA) Revised, Structured Interview for PTSD (SIP), Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) were used. Results indicated that 28% of the subjects met the criteria for Posttraumatic Stress Disorder, and that females were more likely than males to receive the PTSD classification. Significant differences were found in the PTSD diagnoses related to type of traumatic event and depression and anxiety symptoms.",0,0 +3015,Posttraumatic stress disorder and symptoms among American Indians and Alaska Natives: a review of the literature,"American Indians and Alaska Natives (AI/ANs) experience high rates of trauma and posttraumatic stress disorder (PTSD). We reviewed existing literature to address three interrelated questions: (1) What is the prevalence of PTSD and PTSD symptoms among AI/ANs? (2) What are the inciting events, risk factors, and co-morbidities in AI/ANs, and do they differ from those in the general U.S. population? (3) Are studies available to inform clinicians about the course and treatment of PTSD in this population?We searched the PubMed and Web of Science databases and a database on AI/AN health, capturing an initial sample of 77 original English-language articles published 1992–2010. After applying exclusion criteria, we retained 37 articles on prevalence of PTSD and related symptoms among AI/AN adults. We abstracted key information and organized it in tabular format.AI/ANs experience a substantially greater burden of PTSD and related symptoms than U.S. Whites. Combat experience and interpersonal violence were consistently cited as leading causes of PTSD and related symptoms. PTSD was associated with bodily pain, lung disorders, general health problems, substance abuse, and pathological gambling. In general, inciting events, risk factors, and co-morbidities appear similar to those in the general U.S. population.Substantial research indicates a strikingly high incidence of PTSD in AI/AN populations. However, inciting events, risk factors, and co-morbidities in AI/ANs, and how they may differ from those in the general population, are poorly understood. Very few studies are available on the clinical course and treatment of PTSD in this vulnerable population.",0,0 +3016,"Expression of intracellular cytokines, HSP72, and apoptosis in monocyte subsets during exertional heat stress in trained and untrained individuals","This study examined intracellular cytokine, heat shock protein (HSP) 72, and cellular apoptosis in classic and inflammatory CD14 + monocyte subsets during exertional heat stress (EHS). Subjects were divided into endurance-trained [TR; n = 12, peak aerobic power (V̇o 2peak ) = 70 ± 2 ml·kg lean body mass (LBM) −1 ·min −1 ] and sedentary-untrained (UT; n = 11, V̇o 2peak = 50 ± 1 ml·kg LBM −1 ·min −1 ) groups before walking at 4.5 km/h with 2% elevation in a climatic chamber (40°C, 30% relative humidity) wearing protective clothing until exhaustion (Exh). Venous blood samples at baseline and 0.5°C rectal temperature increments (38.0, 38.5, 39.0, 39.5, and 40.0°C/Exh) were analyzed for cytokines (TNF-α, IL-1β, IL-6, IL-1ra, and IL-10) in CD14 ++ CD16 − /CD14 + CD16 + and HSP72/apoptosis in CD14 Bri /CD14 Dim subsets. In addition, serum levels of extracellular (e)HSP72 were also examined. Baseline and Exh samples were separately stimulated with LPS (1 μg/ml) or heat shocked (42°C) and cultured in vitro for 2 h. A greater temperature-dependent increase in CD14 + CD16 + cells was observed in TR compared with UT subjects as well as a greater LPS tolerance following in vitro LPS stimulation. TNF-α and IL-1β cytokine expression was elevated in CD14 + CD16 + but not in CD14 ++ CD16 − cells. A greater induction of intracellular HSP72 and eHSP72 was observed in TR compared with UT subjects, which coincided with reduced apoptosis at Exh and following in vitro heat shock. Induced HSP in vitro was not uniform across CD14 + subsets. Findings suggest that circulating CD14 + CD16 + , but not CD14 ++ CD16 − monocytes, contribute to the proinflammatory cytokine profiles observed during EHS. In addition, the enhanced HSP72 response in endurance-trained individuals may confer improved heat tolerance through both anti-inflammatory and anti-apoptotic mechanisms.",0,0 +3017,Relationship of Trauma Symptoms to Amygdala-Based Functional Brain Changes in Adolescents,en,0,0 +3018,The Detection of Feigned Psychiatric Disorders Using the MMPI-2-RF Overreporting Validity Scales: An Analog Investigation,"Individuals who are motivated to feign psychological problems to achieve a desired outcome (e.g., insanity defense) may overreport symptoms of psychopathology, with type of pathology being dependent on the setting. In the current investigation, we examined the utility of the overreporting validity scales (infrequent responses [F-r], infrequent psychopathology responses [F P-r], infrequent somatic responses [Fs], and symptom validity [FBS-r]) on the Minnesota Multiphasic Personality Inventory-2-Restructured Form (Ben-Porath and Tellegen 2008) to detect research participants instructed to simulate one of three mental disorders: major depressive disorder (MDD), schizophrenia (SCH), or post-traumatic stress disorder (PTSD). The restructured clinical (RC) and overreporting validity scale scores of bona fide psychiatric patients with a primary diagnosis of either MDD, SCH, or PTSD were compared to two groups of simulators-naïve (i.e., undergraduate students with no training in mental disorders) and sophisticated (i.e., individuals with advanced training in psychopathology or personal experience with the disorder asked to overreport symptoms). Examination of the RC Scale profiles revealed that the sophisticated simulators produced symptom profiles more similar to the profiles of the psychiatric patients than did the naïve simulators. For the overreporting validity scales, the sophisticated simulators were less likely to be detected as feigning compared to the naïve simulators; overall, the validity scales were able to distinguish patients from simulators and accurately classify most of the simulators regardless of their level of ""symptom"" sophistication. Examination and comparison of the validity scales revealed that across disorders and level of research participant symptom sophistication, the F P-r scale best differentiated simulators from patients. © 2011 Springer Science+Business Media, LLC.",0,0 +3019,The buffering effect of resilience on depression among individuals with spinal cord injury: A structural equation model.,"To translate the theoretical constructs from a model of resilience into a structural equation model and evaluate relationships among the model's theoretical constructs associated with resilience and the occurrence of depressive symptoms.Quantitative descriptive research design using structural equation modeling (SEM).Two-hundred and fifty-five individuals with SCI recruited from the Canadian Paraplegic Association (CPA).Outcome was measured by the Center for Epidemiologic Studies-Depression Scale.The resilience model fit the data relatively well: χ² (200, N = 255) = 451.57, p < .001; χ²/df = 2.26; CFI = .92, RMSEA = 0.070 (90% CI: 0.062-0.079), explaining 77% of the variance in depressive symptomatology. Severity of SCI-related stressors significantly influenced perceived stress (β = .60) and perceived stress, in turn, affected depressive symptoms (β = .66), characteristics of resilience (β = -.43), and social support (β = -.26). The resilience characteristics had an inverse relationship with depressive symptoms (β = -.29). No direct relationship was found between severity of SCI-related stressors and depressive symptoms.Findings provide support for the resilience model and suggests characteristics of resilience ""buffer"" the perceptions of stress on depressive symptoms. The resilience model may be useful to guide clinical interventions designed to improve the mental health of individuals with SCI.",0,0 +3020,Post-traumatic stress disorder among adolescents with bipolar disorder and its relationship to suicidality,"The aims of this cross-sectional pilot study were to ascertain the rates of post-traumatic stress disorder (PTSD) among adolescents with bipolar disorder (BPD) and major depressive disorder (MDD) relative to a comparison group comprised of non-affectively ill patients, and to determine whether PTSD is related to suicidal ideation and attempts. The impetus for the study was born of clinical impressions derived in the course of routine clinical practice.Patients were screened by a single interviewer for BPD, MDD and PTSD, panic disorder, obsessive-compulsive disorder (OCD) and social phobia using the apposite modules from the Structured Clinical Interview for DSM-IV (SCID) and histories of suicidal ideation and attempts. The data were subjected to analysis using a logistic regression model.The database included 34 patients with BPD, 79 with MDD and 26 with a non-affective disorder. The risk for PTSD for a patient with BPD significantly exceeded that for a patient with MDD [odds ratio (OR) = 4.9, 95% confidence interval (CI) = 1.9-12.2, p = 0.001]. Patients with PTSD had an insignificantly increased risk for suicidal ideation (OR = 2.8, 95% CI = 0.9-8.9, p = 0.069), and a 4.5-fold significantly increased risk of having had a suicide attempt (OR = 4.5, 95% CI = 1.7-11.7, p = 0.002). The relationship between PTSD and suicide attempts remained significant even after controlling for the confounding effects of concurrent panic disorder, OCD and social phobia (OR = 3.4, 95% CI = 1.1-10.0, p = 0.023).Patients with BPD have a greater risk for PTSD than those with MDD. Post-traumatic stress disorder is significantly related to history of suicide attempts.",0,0 +3021,Factor Structure and Psychometric Properties of the Posttraumatic Stress Disorder (PTSD) Checklist and DSM-5 PTSD Symptom Set in a Long-Term Postearthquake Cohort in Armenia,"Psychometric properties of the Armenian-language posttraumatic stress disorder (PTSD) Checklist–Civilian version (PCL-C) and the DSM-5 PTSD symptom set were examined in a long-term cohort of earthquake survivors. In 2012, 725 survivors completed the instruments. Item-/scale-level analysis and confirmatory factor analysis (CFA) were performed for both scales. In addition, exploratory factor analysis (EFA) was conducted for DSM-5 symptoms. Also, the differential internal versus external specificity of PTSD symptom clusters taken from the most supported PTSD structural models was examined. Both scales had Cronbach’s alpha greater than .9. CFA of PCL-C structure demonstrated an excellent fit by a four-factor (reexperiencing, avoidance, numbing, and hyperarousal) model known as numbing model; however, a superior fit was achieved by a five-factor model (Elhai et al.). EFA yielded a five-factor structure for DSM-5 symptoms with the aforementioned four domains plus a negative state domain. This model achieved an acceptable fit during CFA, whereas the DSM-5 criteria-based model did not. The Armenian-language PCL-C was recommended as a valid PTSD screening tool. The study findings provided support to the proposed new classification of common mental disorders, where PTSD, depression, and generalized anxiety are grouped together as a subclass of distress disorders. Recommendations were made to further improve the PTSD diagnostic criteria.",0,0 +3022,Correlates of persisting posttraumatic symptoms in children and adolescents 18 months after a cyclone disaster,"Objective: To describe PTSD symptom persistence and resolution, including the potential phenomenon of late-onset PTSD, in children and adolescents 18 months after a cyclone disaster; and to investigate factors that predict longer-term symptom outcome. Method: 71 children and 191 adolescents who were screened three months after a Category 5 Cyclone were re-screened 18 months post-disaster. Child-report measures included the PTSD Reaction Index, measures of event exposure and social connectedness. Results: Approximately 1-in-5 children and 1-in-12 adolescents endorsed cyclone-related PTSD symptoms at the moderate to severe level 18 months post-disaster. Of these approximately one-half (44.8%) of children were in the ‘high-persister’ group at 18-month follow-up. Persistence of low symptoms was very common (97.6%) and late-onset PTSD was a rare phenomenon. This pattern was similar in adolescents: 25.0% were in the ‘high-persister’ group and few students experienced late-onset PTSD. In multivariate analysis, only initial severe to very severe PTSD category made a significant independent contribution to explaining persisting moderate to severe PTSD symptoms in primary school students (ORadj=8.33, 95% CI=1.45-47.84). There was a trend for a similar result in secondary students. Conclusion: A child or adolescent with few PTSD symptoms three months post-disaster is likely to remain so unless a further traumatic event occurs. However, if symptomatic at three months, there is approximately a 30-45% chance that the child or adolescent will still be symptomatic 18 months after the disaster. Given the high rate of students in the ‘resolver’ group, initial posttraumatic symptoms are a necessary but not sufficient condition for predicting chronic symptomatology. Other targets for predictive modelling include initial threat perception and high and low social connectedness.",0,0 +3023,Outcomes after ARDS: a distinct group in the spectrum of disability after complex and protracted critical illness.,"ARDS represents an important public health problem for patients, family caregivers and society. The last decade has seen a burgeoning literature focussed on the outcomes of this patient group and has informed important new knowledge about the devastating and often irreversible morbidity related to nerve, muscle and brain injury More recent studies have reinforced these robust themes of physical and neuropsychological morbidity in other patient groups and have shown that outcomes after ARDS are one segment of a spectrum of disability and may not be widely generalizable across older patients with multiple comorbidities and protracted length of stay in the critical care unit. Our literature has reached theme saturation in terms of morbidity and needs to identify and begin to address the research agenda for the next decade. Several of these themes will be addressed here and include the following: 1) to generate large diverse datasets to understand different outcome trajectories over time to facilitate risk stratification and inform development of rehabilitation programs; 2) to embrace mixed methodology as a new longitudinal study standard to facilitate detailed qualitative observations to augment insights from quantitative data; 3) to educate patients, families, colleagues and decision-makers about outcomes after critical illness to inform policy and decision-making; 4) to embrace family caregivers and provide intervention when needed and ongoing support across transitions of care; 5) prioritize functional outcome measures over those targeted at health-related quality of life for construction of more focussed rehabilitation interventions; 6) embrace translational research programs to elucidate the relationship between functional outcome and molecular mechanism to gain further insight into the pathophysiology of critical illness, muscle and brain injury and potential insights into novel therapeutic strategies.",0,0 +3024,Diagnostic efficacy of posttraumatic symptoms in children exposed to disaster,"Examined 5 conditional probability indices to determine the diagnostic efficacy of 48 symptoms associated with posttraumatic stress disorder (PTSD) in 5,687 children exposed to Hurricane Hugo, of whom 5.5% had a diagnosis of posttraumatic stress syndrome (PTSS). Moderate levels of sensitivity and high levels of specificity were obtained for most symptoms. Odds ratios more precisely demonstrated that some Diagnostic and Statistical Manual of Mental Disorders (DSM) symptoms of PTSD, especially when combined, were useful for identifying children with PTSS but that anxiety symptoms and some DSM symptoms of PTSD had poor diagnostic utility. Satisfying criteria for the DSM-III-R numbing/avoidance cluster and symptoms from the numbing/avoidance cluster had the highest diagnostic efficacy, suggesting that avoidance may be the hallmark of severe posttraumatic reactions. These results suggest which symptoms should be conceptualized as central versus peripheral to the disorder and which symptoms and symptom combinations clinicians should attend to most when diagnosing or screening PTSD in children.",0,0 +3025,Resilience and development: Contributions from the study of children who overcome adversity,"Abstract This article reviews the research on resilience in order to delineate its significance and potential for understanding normal development. Resilience refers to the process of, capacity for, or outcome of successful adaptation despite challenging or threatening circumstances. Three resilience phenomena are reviewed: (a) good outcomes in high-risk children, (b) sustained competence in children under stress, and (c) recovery from trauma. It is concluded that human psychological development is highly buffered and that long-lasting consequences of adversity usually are associated with either organic damage or severe interference in the normative protective processes embedded in the caregiving system. Children who experience chronic adversity fare better or recover more successfully when they have a positive relationship with a competent adult, they are good learners and problem-solvers, they are engaging to other people, and they have areas of competence and perceived efficacy valued by self or society. Future studies of resilience will need to focus on processes that facilitate adaptation. Such studies have the potential to illuminate the range and self-righting properties of, constraints on, and linkages among different aspects of cognitive, emotional, and social development.",0,0 +3026,Posttraumatic stress and symptom improvement in Norwegian tourists exposed to the 2004 tsunami – a longitudinal study,"Mental health consequences of disasters are frequently studied. However, few studies have investigated symptom improvement in victims after natural disasters. This study aimed to identify predictors of 6 months post-disaster stress symptoms and to study 6 months and 24 months course of symptoms among Norwegian tourists who experienced the 2004 tsunami.Norwegian tourists (≥ 18 years) who experienced the 2004 tsunami (n = 2468) were invited to return a postal questionnaire at two points of time. The first data set was collected at 6 months (T1, n = 899) and the second data set at 24 months post-disaster (T2, n = 1180). The population studied consisted of those who responded at both assessments (n = 674). Impact of Event Scale Revised (IES-R) was used to measure posttraumatic stress symptoms. IES-R score ≥ 33 (caseness) was used to identify various symptom trajectories from T1 to T2. Multiple linear regression was used to determine predictors of posttraumatic stress at T1 and to identify variables associated with symptom improvement from T1 to T2.The majority was identified as non-case at both assessments (57.7%), while 20.8% of the respondents were identified as case at both assessments. Symptoms at T1 were positively related to female gender, older age, unemployment, being chased or caught by the waves, witnessing death or suffering, loss of loved ones, experiencing intense fear during the disaster, low conscientiousness, neuroticism and low levels of social support. The IES-R sum score declined from 24.6 (SD = 18.5) at T1 to 22.9 (SD = 18.3) at T2, p < 0.001. Emotional stability and high IES-R scores at T1 were positively related to symptom improvement, while received social support was not. Being referred to a mental health specialist was negatively related to symptom improvement.A significant minority (20-30%) among Norwegian tourists developed enduring posttraumatic stress symptoms in the aftermath of the 2004 tsunami. Tsunami exposure, peritraumatic fear, neuroticism and low levels of social support were the strongest predictors of posttraumatic stress at 6 months post-disaster. Decrease in posttraumatic stress was related to emotional stability and higher symptom levels at T1. Being referred to a mental health specialist did not facilitate symptom improvement.",0,0 +3027,The structure and short-term stability of the emotional disorders: a dimensional approach,"Background Factor-analytic studies have found that depressive, bipolar, post-traumatic, obsessive–compulsive, and anxiety disorders – jointly referred to as the emotional disorders – form an internalizing spectrum that includes distress and fear subfactors. However, placement of some disorders is uncertain. Also, prior research analysed dichotomous interview-based diagnoses or dimensional self-report measures. We investigated this structure using a third-generation measure – the Interview for Mood and Anxiety Symptoms (IMAS) – that combines strengths of a clinical interview with dimensional assessment. Method The interview was administered to 385 students and 288 psychiatric out-patients. Participants were reinterviewed 2 months later. Results Exploratory and confirmatory factor analyses identified three factors: distress (depression, generalized anxiety, post-traumatic stress, irritability, and panic syndrome); fear (social anxiety, agoraphobia, specific phobia, and obsessive–compulsive); and bipolar (mania and obsessive–compulsive). The structure was consistent over time and across samples, except that panic and agoraphobia had higher factor loadings in patients. Longitudinal analyses revealed high temporal stability of the factors (test–retest r = 0.72 to 0.87), but also substantial disorder-specific stability. Conclusions This investigation – which bridges diagnostic and self-report studies – found three subfactors of internalizing psychopathology. It provided support for a new subfactor, clarified the placement of obsessive–compulsive and bipolar disorders, and demonstrated that this model generalizes across populations. The accumulating research suggests the need to recognize formally the close links among the emotional disorders, as well as empirical clusters within this spectrum. The IMAS demonstrated strong psychometric properties and can be useful for various research and clinical applications by providing dimensional, interview-based assessment of the emotional disorders.",0,0 +3028,"Longitudinal Relationships of Social Reactions, PTSD, and Revictimization in Sexual Assault Survivors","Sexual assault survivors receive various positive and negative social reactions to assault disclosures, yet little is known about the directionality of associations of social reactions to posttraumatic stress disorder (PTSD) symptoms over time. Data from a large, diverse sample of women who had experienced adult sexual assault was analyzed with hierarchical linear modeling (HLM) to examine how negative and positive reactions relate to PTSD symptoms over 3 years and to test the hypothesis that the relationship between negative social reactions and PTSD symptoms is reciprocal. We found that, as predicted, social reactions predicted subsequent PTSD symptoms, and in turn PTSD symptoms predicted subsequent social reactions. We also investigated the role of sexual revictimization by comparing women who suffered (vs. not) additional sexual victimization during the course of our study. Revictimized women had greater PTSD symptoms and more negative social reactions, but associations of social reactions with PTSD symptoms did not vary according to revictimization status. Implications for practice and suggestions for future research are discussed.",0,0 +3029,The Psychological Impact of Exposure to the 2008 Snowstorms on Migrant Workers in China,"This study aimed to estimate the prevalence of posttraumatic stress disorder (PTSD) and to identify associated risk factors among migrant workers 4 years after the 2008 snowstorm in China. A cross-sectional survey of 528 respondents was conducted to collect data in Changsha, the capital of Hunan Province. A multistage cluster sampling method was applied in selecting subjects from migrant workers’ gathering areas. Association between the independent variables and PTSD was analyzed using logistic regression analysis. The prevalence of PTSD was 17.42% among migrant workers in Changsha. Being male, being older than 35 years, being an electrician, having dependent children, suffering property damage, being without medical insurance, and having low social support were risk factors significantly related to the development of PTSD. Effective and sustainable mental health services should be directed particularly to the migrant workers, who are among the groups most vulnerable to the direct impact of snowstorms.",0,0 +3030,A Comparative Study of Trauma and Posttraumatic Stress Disorder Prevalence in Epilepsy Patients and Psychogenic Nonepileptic Seizure Patients,"This study tests the hypothesis that trauma histories, including histories of physical and sexual abuse, and posttraumatic stress disorder (PTSD) are more prevalent in psychogenic non-epileptic seizure (NES) patients than in epilepsy patients.Thirty-five inpatients with intractable seizures were evaluated for trauma history and PTSD. After these assessments, patients were diagnosed as having either epileptic or nonepileptic seizures through EEG monitoring.NES diagnosis correlated with PTSD and total number of lifetime traumas, adult traumas, and abuse traumas. Contrary to previous hypotheses, reported childhood sexual abuse (CSA) did not correlate significantly with NES diagnosis. However, CSA predicted PTSD in a discriminant analysis.We found evidence for the hypothesized relations between trauma, abuse, PTSD, and NES diagnosis. However, elevated levels in both seizure-disorder groups suggest that routine assessment for abuse, trauma, and PTSD might facilitate medical care and treatment for all intractable seizure patients.",0,0 +3031,Longitudinal modeling of population heterogeneity: Methodological challenges to the analysis of empirically derived criminal trajectory profiles,,0,0 +3032,A second look at comorbidity in victims of trauma: the posttraumatic stress disorder–major depression connection,"We examine whether traumatic events increase the risk for major depression independent of their effects on posttraumatic stress disorder (PTSD).Data come from the Epidemiologic Study of Young Adults in southeast Michigan (N = 1007). Retrospective and prospective data were used to estimate the risk of major depression in persons with PTSD and persons exposed to trauma with no PTSD, compared with persons who did not experience a trauma. National Comorbidity Survey data were used to evaluate the influence of trauma type.In the retrospective lifetime data, hazard ratios were, for first-onset major depression in exposed persons with PTSD, 2.8 and, in exposed persons with no PTSD, 1.3 (not significant), as compared with persons who were not exposed. Corresponding estimates from the prospective data were 11.7 and 1.4 (not significant). The difference in the risk for depression associated with PTSD versus exposure without PTSD is unlikely to be due to differences in trauma type.The findings of a markedly increased risk for major depression in persons with PTSD, but not in exposed persons without PTSD, do not support the hypothesis that PTSD and major depression in trauma victims are influenced by separate vulnerabilities.",0,0 +3033,Dimensionality of posttraumatic stress symptoms: a confirmatory factor analysis of DSM-IV symptom clusters and other symptom models,"Recent exploratory [Taylor, S., Kuch, K., Koch, W. J., Crockett, D. J., & Passey, G. (1998). The structure of posttraumatic stress symptoms. Journal of Abnormal Psychology, 107, 154-160.] and confirmatory [Buckley, T. C., Blanchard, E. B., & Hickling, E. J. (1998). A confirmatory factor analysis of posttraumatic stress symptoms. Behaviour Research and Therapy, 36, 1091-1099; King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998). Confirmatory factor analysis of the clinician-administered PTSD scale: evidence for the dimensionality of posttraumatic stress disorder. Psychological Assessment, 10, 90-96.] factor analytic investigations suggest that the three symptom clusters of posttraumatic stress disorder (PTSD) as defined in the Diagnostic and Statistical Manual [4th ed.; DSM-IV; American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.] may not provide the best conceptualization of symptom dimensionality. However, the alternative models have not been in agreement, nor have they been compared against each other or models based on the DSM-IV. The purpose of the present investigation was to test a series of dimensional models suggested by these recent factor analytic investigations and the DSM-IV. Using data collected with the PTSD Checklist--Civilian Version [Weathers, F. W., Litz, B. T., Huska, J. A., & Keane, T. M. (1994). PCL-C for DSM-IV. Boston: National Center for PTSD--Behavioral Science Division.] from 349 referrals to a primary care medical clinic, we used confirmatory factor analysis to evaluate a: (1) hierarchical four-factor model, (2) four-factor intercorrelated model, (3) hierarchical three-factor model, (4) three-factor intercorrelated model, and (5) hierarchical two-factor model. The hierarchical four-factor model (comprising four first-order factors corresponding to reexperiencing, avoidance, numbing, and hyperarousal all subsumed by a higher-order general factor) provided the best overall fit to the data; although, all models met some standards specified for good model fit. More research is needed to establish the dimensional nature of PTSD symptoms and to assess whether identified dimensions differ as a function of the trauma experience. Implications for assessment, diagnosis, and treatment are also discussed.",0,0 +3034,Sleep Disturbances in Posttraumatic Stress Disorder,"Sleep disturbances are common complaints among patients with posttraumatic stress disorder (PTSD), as well as intrusive recollection, avoidance of disturbing stimuli, difficulty in concentration, and depressive symptoms. Patients with PTSD frequently report difficulty falling or staying asleep and recurrent nightmares related to the traumatic events. These sleep disturbances are part of the diagnostic criteria for PTSD and are included in both the re-experiencing (Criterion B) and increased arousal (Criterion D) symptom cluster in the DSM-IV-TR. Despite these sleep complaints, polysomnographic studies have not provided consistent evidence of sleep disturbances, especially regarding non-rapid eye movement (REM) sleep. However, the characteristic sleep disturbances, in particular the repetitive, stereotypical nightmares may be relatively specific to PTSD. The presence of nightmares in PTSD has been hypothesized as a dysfunction of REM sleep mechanisms and investigators have reported various types of REM sleep abnormalities. Treatment studies also have shown that antidepressants, such as nefazodone, trazodone, fluvoxamine, and image rehearsal therapy are beneficial in the treatment of PTSD-related sleep disturbances as well as core symptoms of this anxiety disorder; however, these sleep disturbances may persist and impair the quality of life in PTSD patients for several decades. It is important, therefore, to understand the characteristics of sleep disturbances in PTSD and these treatments. In this review, we discuss the clinical features and objective findings of sleep disturbances in PTSD and these treatments based on the published literature, including our findings. © 2010 Nova Science Publishers, Inc. All rights reserved.",0,0 +3035,A meta-analysis of risk factors for post-traumatic stress disorder in children and adolescents,"Post-traumatic stress disorder (PTSD) is a complex and chronic disorder that causes substantial distress and interferes with social and educational functioning. Consequently, identifying the risk factors that make a child more likely to experience traumatic distress is of academic, clinical and social importance. This meta-analysis estimated the population effect sizes of 25 potential risk factors for PTSD in children and adolescents aged 6-18 years across 64 studies (N=32,238). Medium to large effect sizes were shown for many factors relating to subjective experience of the event and post-trauma variables (low social support, peri-trauma fear, perceived life threat, social withdrawal, comorbid psychological problem, poor family functioning, distraction, PTSD at time 1, and thought suppression); whereas pre-trauma variables and more objective measures of the assumed severity of the event generated small to medium effect sizes. This indicates that subjective peri-trauma factors and post-event factors are likely to have a major role in determining whether a child develops PTSD following exposure to a traumatic event. Such factors could potentially be assessed following a potentially traumatic event in order to screen for those most vulnerable to developing PTSD and target treatment efforts accordingly. The findings support the cognitive model of PTSD as a way of understanding its development and guiding interventions to reduce symptoms.",0,0 +3036,Dissociation and hypnotizability in posttraumatic stress disorder,"The authors compared the hypnotizability of 65 Vietnam veteran patients with posttraumatic stress disorder (PTSD) to that of a normal control group and four patient samples using the Hypnotic Induction Profile. The patients with PTSD had significantly higher hypnotizability scores than patients with diagnoses of schizophrenia (N = 23); major depression, bipolar disorder--depressed, and dysthymic disorder (N = 56); and generalized anxiety disorder (N = 18) and the control sample (N = 83). This finding supports the hypothesis that dissociative phenomena are mobilized as defenses both during and after traumatic experiences. The literature suggests that spontaneous dissociation, imagery, and hypnotizability are important components of PTSD symptoms.",0,0 +3037,Differences in the determinants of posttraumatic stress disorder and depression after a mass traumatic event,"Background: Hurricane Ike struck the Galveston Bay area of Texas on September 13, 2008, leaving substantial destruction and a number of deaths in its wake. We assessed differences in the determinants of posttraumatic stress disorder (PTSD) and depression after this event, including the particular hurricane experiences, including postevent nontraumatic stressors, that were associated with these pathologies. Methods: 658 adults who had been living in Galveston and Chambers counties, TX in the month before Hurricane Ike were interviewed 2–5 months after the hurricane. We collected information on experiences during and after Hurricane Ike, PTSD and depressive symptoms in the month before the interview, and socio-demographic characteristics. Results: The prevalence of past month hurricane-related PTSD and depression was 6.1 and 4.9%, respectively. Hurricane experiences, but not socio-demographic characteristics, were associated with Ike-related PTSD. By contrast, lower education and household income, and more lifetime stressors were associated with depression, as were hurricane exposures and hurricane-related stressors. When looking at specific hurricane-related stressors, loss or damage of sentimental possessions was associated with both PTSD and depression; however, health problems related to Ike were associated only with PTSD, whereas financial loss as a result of the hurricane was associated only with depression. Conclusions: PTSD is indeed a disorder of event exposure, whereas risk of depression is more clearly driven by personal vulnerability and exposure to stressors. The role of nontraumatic stressors in shaping risk of both pathologies suggests that alleviating stressors after disasters has clear potential to mitigate the psychological sequelae of these events. Depression and Anxiety, 2011. © 2011 Wiley-Liss, Inc.",0,0 +3038,PTSD Symptoms in Bosnian Refugees 1 Year After Resettlement in the United States,"The authors' goal was to describe the characteristics of posttraumatic stress disorder (PTSD) symptoms on resettlement in the United States and at 1-year follow-up among Bosnian refugees as well as possible factors affecting the PTSD symptom profile among these refugees.They used standardized instruments to assess 34 Bosnian refugees for PTSD at resettlement in the United States and 1 year later.Fifteen of the refugees were diagnosed with PTSD at 1-year follow-up, compared with 25 at initial assessment. The average PTSD severity score at follow-up was 12.5, compared with 20.6 at initial assessment. At 1-year follow-up, 25 of the refugees experienced a decrease in severity of PTSD symptoms, one remained the same, and eight experienced an increase in severity. Older refugees were significantly more likely to have PTSD than younger refugees, and older refugees had more severe symptoms.The level of PTSD diagnosis and symptoms in Bosnian refugees remained substantial 1 year after their resettlement in the United States, although there were notable overall decreases. Older refugees appeared to be at greater risk.",0,0 +3039,Anger regulation deficits in combat-related posttraumatic stress disorder,"We describe a typology of regulatory deficits associated with anger in combat-related posttraumatic stress disorder (PTSD). Cognitive, arousal, and behavioral domain deficits in anger regulation were observed clinically in PTSD patients with high levels of anger who were participating in a multi-year trial of a structured anger treatment. We also describe a category of patients whose anger type we have termed 'ball of rage'. These patients exhibit regulatory deficits in all three domains of anger regulation. We offer a conceptual framework to advance the understanding of anger associated with PTSD and to guide its effective treatment.",0,0 +3040,Role of postsynaptic density protein-95 in the maintenance of peripheral nerve injury-induced neuropathic pain in rats,"Our previous work has demonstrated that postsynaptic density protein-95, a molecular scaffolding protein that binds and clusters N-methyl-D-aspartate receptors at neuronal synapses, plays an important role in the development of peripheral nerve injury-induced neuropathic pain. The current study further investigated the possible involvement of postsynaptic density protein-95 in the maintenance of neuropathic pain. Mechanical and thermal hyperalgesia were induced within 3 days and maintained for 15 days or longer after unilateral injury to the fifth lumbar spinal nerve. The rats injected intrathecally with postsynaptic density protein-95 antisense oligodeoxynucleotide every 24 h for 4 days from day 7 to day 10 post-surgery exhibited not only a marked decrease in spinal cord postsynaptic density protein-95 protein expression but also a significant reduction in mechanical and thermal hyperalgesia on day 11 post-surgery. The rats injected with sense oligodeoxynucleotide did not display these changes. However, in the rats without nerve injury, postsynaptic density protein-95 antisense oligodeoxynucleotide given intrathecally every 24 h for 4 days did not affect responses to mechanical and thermal stimulation. In addition, postsynaptic density protein-95 antisense oligodeoxynucleotide did not change locomotor activity of experimental animals. Our results indicate that the deficiency of postsynaptic density protein-95 protein in the spinal cord significantly attenuates nerve injury-induced mechanical and thermal hyperalgesia during both the development and maintenance of chronic neuropathic pain. These results suggest that postsynaptic density protein-95 might be involved in the central mechanisms of chronic neuropathic pain and provide a novel target for development of new pain therapies.",0,0 +3041,Comparison of the PTSD symptom scale-interview version and the clinician-administered PTSD scale,"The Clinician-Administered PTSD Scale (CAPS) is one of the most frequently used measures of posttraumatic stress disorder (PTSD). It has been shown to be a reliable and valid measure, although its psychometric properties in nonveteran populations are not well known. One problem with the CAPS is its long assessment time. The PTSD Symptom Scale--Interview Version (PSS-I) is an alternative measure of PTSD severity, requiring less assessment time than the CAPS. Preliminary studies indicate that the PSS-I is reliable and valid in civilian trauma survivors. In the present study we compared the psychometric properties of the CAPS and the PSS-I in a sample of 64 civilian trauma survivors with and without PTSD. Participants were administered the CAPS, the PSS-I, and the Structured Clinical Interview for DSM-IV (SCID) by separate interviewers, and their responses were videotaped and rated by independent clinicians. Results indicated that the CAPS and the PSS-I showed high internal consistency, with no differences between the two measures. Interrater reliability was also high for both measures, with the PSS-I yielding a slightly higher coefficient. The CAPS and the PSS-I correlated strongly with each other and with the SCID. Although the CAPS had slightly higher specificity and the PSS-I had slightly higher sensitivity to PTSD, overall the CAPS and the PSS-I performed about equally well. These results suggest that the PSS-I can be used instead of the CAPS in the assessment of PTSD, thus decreasing assessment time without sacrificing reliability or validity.",0,0 +3042,The Effect of a Yoga Intervention on Alcohol and Drug Abuse Risk in Veteran and Civilian Women with Posttraumatic Stress Disorder,"Individuals with posttraumatic stress disorder (PTSD) often exhibit high-risk substance use behaviors. Complementary and alternative therapies are increasingly used for mental health disorders, although evidence is sparse.Investigate the effect of a yoga intervention on alcohol and drug abuse behaviors in women with PTSD. Secondary outcomes include changes in PTSD symptom perception and management and initiation of evidence-based therapies.The current investigation analyzed data from a pilot randomized controlled trial comparing a 12-session yoga intervention with an assessment control for women age 18 to 65 years with PTSD. The Alcohol Use Disorder Identification Test (AUDIT) and Drug Use Disorder Identification Test (DUDIT) were administered at baseline, after the intervention, and a 1-month follow-up. Linear mixed models were used to test the significance of the change in AUDIT and DUDIT scores over time. Treatment-seeking questions were compared by using Fisher exact tests.The mean AUDIT and DUDIT scores decreased in the yoga group; in the control group, mean AUDIT score increased while mean DUDIT score remained stable. In the linear mixed models, the change in AUDIT and DUDIT scores over time did not differ significantly by group. Most yoga group participants reported a reduction in symptoms and improved symptom management. All participants expressed interest in psychotherapy for PTSD, although only two participants, both in the yoga group, initiated therapy.Results from this pilot study suggest that a specialized yoga therapy may play a role in attenuating the symptoms of PTSD, reducing risk of alcohol and drug use, and promoting interest in evidence-based psychotherapy. Further research is needed to confirm and evaluate the strength of these effects.",0,0 +3043,PTSD symptom clusters are differentially related to substance use among community women exposed to intimate partner violence,"Women who experience intimate partner violence (IPV) have higher rates of posttraumatic stress disorder (PTSD) and substance abuse compared to women who do not experience IPV. However, the extent to which IPV-related PTSD symptoms are related to women's substance use involvement largely has been unexplored. The current study investigated PTSD symptomatology and substance use in a community sample of 212 IPV-exposed women. Drug-using women reported higher PTSD severity scores compared to women who reported no substance use or alcohol use only. Moreover, the reexperiencing, avoidance and numbing, and arousal clusters demonstrated unique associations with substance use involvement. Findings not only elucidate the associations among IPV-related PTSD symptoms and substance use, but they also can inform community-based preventive interventions.",0,0 +3044,Impact of physical injury on mental health after the 2004 Southeast Asia tsunami,"The risk of developing enduring post-traumatic stress reactions and mental health problems in the aftermath of disasters is substantial. However, there are inconsistencies regarding the contribution of physical injury as an independent risk factor for developing psychiatric morbidity after disasters.The aim was to assess whether physical injury was associated with post-traumatic stress reactions and general mental health after adjusting for perceived life-threat in the aftermath of the 2004 tsunami.A sample of 1501 highly exposed survivors from the 2004 Southeast Asia tsunami was selected from a cohort of Swedish survivors surveyed 14 and 36 months after the event. The impact of physical injury on post-traumatic stress and general mental health was assessed by regression models accounting for subjective life-threat.Physical injury was associated with higher levels of post-traumatic stress reactions and poorer general mental health. These associations were observed at both 14 and 36 months after the disaster.Physical injury has a specific contribution to the association between traumatic experience and both post-traumatic stress reactions and general mental health in victims of the 2004 tsunami. The effect is stable over several years.",0,0 +3045,Pain and neurological sequelae of cluster munitions on children and adolescents in South Lebanon,"This paper aims at evaluating the neurological repercussions arising from injuries sustained due to cluster munitions in children up to 18 years in South Lebanon following the 2006 conflict. Data on neurological and pain symptoms suffered during and after treatment because of sub-munitions in South Lebanon from August 2006 till late 2011 were prospectively recorded. Patients were divided into subcategories; children aged 12 and under and adolescents aged between 13 and 18. During the study period, there were 407 casualties, 122 (30 %) of which were aged 18 years or younger. There were 116 (95 %) males and six (5 %) females. Average age was 14 years. 10 (8.2 %), all males, died as a result of their injuries. 42 (34.4 %) were children and 80 (65.6 %) were adolescents. 112 had surgical treatments for their injuries. 83 out of 112 patients (74 %) with non-lethal injuries had amputations, 67 % children and 78 % adolescents. Among those who had amputations, 31 (37.4 %) suffered from phantom limb pain and 71 % suffered from stump/residual limb pain. 88 % of patients were diagnosed with post-traumatic stress disorder (44 % children and 77 % adolescents) and 41 % were diagnosed with post-concussion syndrome. Four patients (3.6 %) suffered from traumatic brain injuries, both penetrating and closed. Pain syndromes were found in all patients who had amputation. The injury related comorbidities together with many post-concussion syndrome cases, and fewer traumatic brain injuries lead into a high level of physical, psychosocial and economic burdens on the community. © 2013 Springer-Verlag Italia.",0,0 +3046,Group Exposure Therapy Treatment for Post-Traumatic Stress Disorder in Female Veterans,"The purpose of this study was to examine the application of a group exposure therapy model, the content of which consisted solely of repeated imaginal exposure during sessions, in a clinical sample of female veterans with post-traumatic stress disorder (PTSD). Establishing group delivery of exposure therapy will expand options, increase efficiency, and introduce group curative factors.Eighty-eight female veterans with PTSD completed a six-session exposure group, three participants per group, as a component of a larger treatment program. The PTSD symptom checklist (PCL) was used as the outcome measure and administered in each session.Pre/post-paired t-tests showed significant improvement in PTSD on the PCL, with 40% of completers showing at least a 10-point drop in the PCL scores. In addition, a repeated measures analysis of variance showed a significant main effect and a significant quadratic equation, with expected initial increases in the PCL followed by a decrease below baseline at session 6.The group exposure treatment protocol showed positive outcomes on PTSD symptoms in a real-world clinical sample of female veterans. The implications include an expansion of exposure treatment choices for veterans with PTSD and increased options for therapists.",0,0 +3047,Predictors of post-traumatic stress disorder following severe injury,"The chronicity and morbidity of established post-traumatic stress disorder (PTSD) has stimulated interest in recognizing and understanding the early development of the disorder. Acute stress disorder, a new diagnosis intended to facilitate early case detection, rests on the occurrence of dissociative reactions. It remains uncertain whether dissociation is a universal or unique early predictor of subsequent PTSD. Traumatic injury is an important and relatively understudied antecedent of PTSD. The objective of this study was to preliminarily identify which previously implicated early reactions and risk factors would apply to the prediction of PTSD following severe traumatic injury. Patients admitted to a regional Level I trauma center following life threatening events who had recall of the incident and did not have signs of traumatic brain injury or recent psychopathology were enrolled. Comprehensive assessments were conducted during hospitalization and after discharge approximately 2 months after the traumatic event. At follow-up, 24% of the available 50 subjects met full criteria for PTSD and an additional 22% met criteria for two of three symptom clusters. Early symptoms of heightened arousal and coping with disengagement were independent predictors of PTSD severity at follow-up. Relationships to initial dissociative reactions and a diagnosis of ASD were not significant. These early predictors found in a setting of severe injury only partially overlap findings from previous PTSD studies.",0,0 +3048,Predictors of PTSD and Delayed PTSD After Disaster,"In the present study we sought to identify factors associated with posttraumatic stress disorder (PTSD) following the World Trade Center Disaster (WTCD) and examine changes in PTSD status over time. Our data come from a two-wave, prospective cohort study of New York City adults who were living in the city on September 11, 2001. We conducted a baseline survey 1 year after the attacks (year 1), followed by a survey 1 year later (year 2). Overall, 2368 individuals completed the year 1 survey, and 1681 were interviewed at year 2. Analyses for year 1 indicated that being younger, being female, experiencing more WTCD events, reporting more traumatic events other than the WTCD, experiencing more negative life events, having low social support, and having low self-esteem increased the likelihood of PTSD. For year 2, being middle-aged, being Latino, experiencing more negative life events and traumas since the WTCD, and having low self-esteem increased the likelihood of PTSD. Exposure to WTCD events was not related to year 2 PTSD once other factors were controlled. Following previous research, we divided study respondents into four categories: resilient cases (no PTSD years 1 or 2), remitted cases (PTSD year 1 but not year 2), delayed cases (no PTSD year 1 but PTSD year 2), and acute cases (PTSD both years 1 and 2). Factors predicting changes in PTSD between year 1 and year 2 suggested that delayed PTSD cases were more likely to have been Latino, to have experienced more negative life events, and to have had a decline in self-esteem. In contrast, remitted cases experienced fewer negative life events and had an increase in self-esteem. We discuss these findings in light of the psychosocial context associated with community disasters and traumatic stress exposures.",0,0 +3049,Treatment of post-traumatic stress disorder in patients with severe mental illness: A review,"Although the prevalence of post-traumatic stress disorder (PTSD) is high among those with severe mental illness, little is known about the use of interventions to lessen the burden of PTSD in this population. Currently, there are limited data about safe and effective interventions to treat these individuals. This systematic published work review presents the scientific published work reporting studies of psychological treatment approaches for individuals with comorbid PTSD and severe mental illness. A secondary aim of this study was to identify the specific models implemented and tested, and their impact upon patient outcomes. A review of the published work from January 2001 through January 2012 of English-language publications retrieved from the Cumulative Index of Nursing and Allied Health Literature (CINAHL), MEDLINE, and the American Psychological Association generated abstracts (PsycINFO) databases was conducted. Six studies met the inclusion criteria for the review. The treatment programs described were cognitive-behavioural therapy, psychoeducation, exposure-based cognitive-behavioural therapy, and eye movement desensitization and reprocessing. Evidence of the effectiveness of these programs is examined. Data to support the use of these interventions are limited, indicating the need for further research and efficacy trials. Future areas of research and implications for nursing are discussed.",0,0 +3050,Attachment and Mental Health Symptoms Among U.S. Afghanistan and Iraq Veterans Seeking Health Care Services,"Attachment theory has become a primary framework for understanding adjustment to traumas. In a convenience sample of 157 U.S. service members from the Afghanistan and Iraq wars seeking health care services at a Veterans Administration (VA) hospital, this study examined (a) the impact of attachment characteristics on several key mental health symptoms in this new generation of veterans, (b) the relative frequencies of prominent attachment styles in the sample, and (c) how these higher order orientations related to study outcomes. First, with demographic and military background factors in the model, attachment-related anxiety and avoidance were each uniquely associated with posttraumatic stress symptoms (PTSS), psychiatric distress, and alcohol misuse, βs = .25 to .60. Second, latent class analysis highlighted the underrepresentation of avoidant veterans of a dismissive type in the sample. Third, of the different possible types of attachment insecurities, veterans with a fearful disorganized orientation were also shown to be particularly vulnerable to PTSS and other problems, even when compared to preoccupied-dependent persons. These findings yield further support for the protective benefit of attachment security, while also suggesting the importance of both attachment anxiety and avoidance in the context of postdeployment adjustment.",0,0 +3051,The Role of Hypnosis in the Detection of Psychogenic Seizures,"In this preliminary clinical investigation, hypnosis was used in the differential diagnosis of epileptic versus psychogenic seizures (PS). Eight patients with a clinical profile suggesting the presence of PS were given a hypnotic suggestion in which they had to go back in time to the exact moment of their last seizure. They were then asked to concentrate their attention on any unusual feeling or bodily sensation. All 8 patients presented a PS during the age regression protocol. In 6 cases, independent testimony from family members corroborated the morphological similarity of the induced attack and the ones presented in their natural environment. Also, the seizures ended abruptly after a command was given to stop them. A control group of 5 epileptic subjects did not present any signs of discomfort or seizure behavior during the hypnotic protocol. It is argued that a simple procedure as the one described in this investigation can be useful as a diagnostic tool in the differentiation of epileptic from PS attacks.",0,0 +3052,"The Impact of Previous Suicide Ideations, Traumatic Stress, and Gender on Future Suicide Ideation Trajectories Among Black American Adolescents: A Longitudinal Investigation","It has long been asserted that previous suicide behaviors (gestures and attempts) are a significant predictor of future suicide behaviors. Less is known about the extent to which this axiom applies to suicide ideations. The current investigation explored suicide ideations in a longitudinal sample of Black American adolescents (N = 977) aged 11 to 18. Logistic growth models were conducted with future suicide ideations as the dependent variable and the number of previous suicide ideations, traumatic stress, and gender as independent variables. Results show, first, that previous suicide ideations and traumatic stress are potent predictors of future suicide ideations. Second, the probability of future suicide ideations is higher when both the number of previous suicide ideations and traumatic stress levels increase, and this probability remains higher as the adolescent ages. These results demonstrate that the long-held proposition that previous suicide behaviors are predictive of future suicide behavior traje...",0,0 +3053,Glycine reuptake inhibitor RG1678: A pharmacologic characterization of an investigational agent for the treatment of schizophrenia,"Dysfunctional N-methyl-d-aspartate (NMDA) receptor neurotransmission has been implicated in the pathophysiology of schizophrenia. It is thought that this abnormal functioning can be corrected by increasing availability of the NMDA co-agonist glycine through inhibition of glycine transporter type 1 (GlyT1). Herein is described the pharmacologic profile of RG1678, a potent and noncompetitive glycine reuptake inhibitor. In vitro, RG1678 noncompetitively inhibited glycine uptake at human GlyT1 with a concentration exhibiting half-maximal inhibition (IC(50)) of 25 nM and competitively blocked [(3)H]ORG24598 binding sites at human GlyT1b in membranes from Chinese hamster ovary cells. In hippocampal CA1 pyramidal cells, RG1678 enhanced NMDA-dependent long-term potentiation at 100 nM but not at 300 nM. In vivo, RG1678 dose-dependently increased cerebrospinal fluid and striatal levels of glycine measured by microdialysis in rats. Additionally RG1678 attenuated hyperlocomotion induced by the psychostimulant d-amphetamine or the NMDA receptor glycine site antagonist L-687,414 in mice. RG1678 also prevented the hyper-response to d-amphetamine challenge in rats treated chronically with phencyclidine, an NMDA receptor open-channel blocker. In the latter experiment, a decrease in ex vivo striatal [(3)H]raclopride binding was also measured. These data demonstrate that RG1678 is a potent, noncompetitive glycine reuptake inhibitor that can modulate both glutamatergic and dopaminergic neurotransmission in animal experiments that model aspects of schizophrenia. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0,0 +3054,"Determinants of the development of post-traumatic stress disorder, in the general population","To assess (1) the lifetime prevalence of exposure both to trauma and post-traumatic stress disorder (PTSD); (2) the risk of PTSD by type of trauma; and (3) the determinants of the development of PTSD in the community.The Diagnostic Interview for Genetic Studies was administered to a random sample of an urban area (N = 3,691).(1) The lifetime prevalence estimates of exposure to trauma and PTSD were 21.0 and 5.0%; respectively, with a twice as high prevalence of PTSD in women compared to men despite a similar likelihood of exposure in the two sexes; (2) Sexual abuse was the trauma involving the highest risk of PTSD; (3) The risk of PTSD was most strongly associated with sexual abuse followed by preexisting bipolar disorder, alcohol dependence, antisocial personality, childhood separation anxiety disorder, being victim of crime, witnessing violence, Neuroticism and Problem-focused coping strategies. After adjustment for these characteristics, female sex was no longer found to be significantly associated with the risk of PTSD.The risk for the development of PTSD after exposure to traumatic events is associated with several factors including the type of exposure, preexisting psychopathology, personality features and coping strategies which independently contribute to the vulnerability to PTSD.",0,0 +3055,"Brain‐derived neurotropic factor polymorphisms, traumatic stress, mild traumatic brain injury, and combat exposure contribute to postdeployment traumatic stress","BACKGROUND: In addition to experiencing traumatic events while deployed in a combat environment, there are other factors that contribute to the development of posttraumatic stress disorder (PTSD) in military service members. This study explored the contribution of genetics, childhood environment, prior trauma, psychological, cognitive, and deployment factors to the development of traumatic stress following deployment. METHODS: Both pre- and postdeployment data on 231 of 458 soldiers were analyzed. Postdeployment assessments occurred within 30 days from returning stateside and included a battery of psychological health, medical history, and demographic questionnaires; neurocognitive tests; and blood serum for the D2 dopamine receptor (DRD2), apolipoprotein E (APOE), and brain-derived neurotropic factor (BDNF) genes. RESULTS: Soldiers who screened positive for traumatic stress at postdeployment had significantly higher scores in depression (d = 1.91), anxiety (d = 1.61), poor sleep quality (d = 0.92), postconcussion symptoms (d = 2.21), alcohol use (d = 0.63), traumatic life events (d = 0.42), and combat exposure (d = 0.91). BDNF Val66 Met genotype was significantly associated with risk for sustaining a mild traumatic brain injury (mTBI) and screening positive for traumatic stress. Predeployment traumatic stress, greater combat exposure and sustaining an mTBI while deployed, and the BDNF Met/Met genotype accounted for 22% of the variance of postdeployment PTSD scores (R (2) = 0.22, P CONCLUSION: These findings suggest predeployment traumatic stress, genetic, and environmental factors have unique contributions to the development of combat-related traumatic stress in military service members. Language: en",0,0 +3056,Double disadvantage: the influence of childhood maltreatment and community violence exposure on adolescent mental health,"Childhood maltreatment is a key risk factor for maladjustment and psychopathology. Although maltreated youth are more likely to experience community violence, both forms of adversity are generally examined separately. Consequently, little is known about the unique and interactive effects that characterize maltreatment and community violence exposure (CVE) on mental health.Latent Profile Analysis (LPA) was applied to data from a community sample of high-risk adolescents and young adults (n = 204, M = 18.85) to categorize groups of participants with similar patterns of childhood (i.e. past) maltreatment exposure. Associations between childhood maltreatment, CVE and mental health outcomes were then explored using multivariate regression and moderation analyses.Latent Profile Analysis identified three groups of individuals with low, moderate and severe levels of childhood maltreatment. Maltreatment was associated with more internalizing, externalizing, and trauma-related symptoms. By contrast, CVE showed independent associations with only externalizing and trauma-related symptoms. Typically, childhood maltreatment and CVE exerted additive effects; however, these forms of adversity interacted to predict levels of anger.Exposure to maltreatment and community violence is associated with increased levels of clinical symptoms. However, while maltreatment is associated with increased symptoms across a broad range of mental health domains, the impact of community violence is more constrained, suggesting that these environmental risk factors differentially impact mental health functioning.",0,0 +3057,"PTSD symptoms, life events, and unit cohesion in U.S. soldiers: Baseline findings from the neurocognition deployment health study","Relationships among a modifiable situational factor (unit cohesion), prior stressful life events, and posttraumatic stress disorder (PTSD) symptoms were assessed in 1,579 U.S. Army soldiers with no history of contemporary war zone deployment. It was predicted that unit cohesion would attenuate the dose-response relationship between past stressor exposures and PTSD symptoms at relatively moderate levels of exposure. Consistent with this hypothesis, regression analysis revealed that life experiences and unit cohesion strongly and independently predicted PTSD symptoms, and that unit cohesion attenuated the impact of life experiences on PTSD. Some military personnel reported significant predeployment, stress-related symptoms. These symptoms may serve as vulnerabilities that could potentially be activated by subsequent war-zone deployment. Higher predeployment unit cohesion levels appear to ameliorate such symptoms, potentially lessening future vulnerability.",0,0 +3058,Serotonin and Sensitivity to Trauma-Related Exposure in Selective Serotonin Reuptake Inhibitors-Recovered Posttraumatic Stress Disorder,"

Background

Selective serotonin reuptake inhibitors (SSRIs) are first-line treatments for posttraumatic stress disorder (PTSD). Serotonergic (5HT) attenuation of stress sensitivity is postulated from SSRIs' effects in other anxiety disorders, and we studied this in PTSD.

Methods

Ten patients with PTSD fully recovered on SSRIs (Clinical Global Impression Scale—I 1 and 2) were enrolled in the study. Patients were tested on two occasions 1 week apart; in each session, they received a drink containing large neutral amino acids (LNAAs) either with (sham tryptophan depletion [STD], control) or without (acute tryptophan depletion [ATD]) tryptophan. At 5.5 hours after the drink, subjects were exposed to a trauma-related exposure challenge. Self-reports of PTSD (visual analogue scales [VAS] and the Davidson Trauma Scale [DTS]), anxiety (Spielberger State Inventory [STAI] Form Y-1), and mood (Profile of Mood States [POMS]) were obtained. Heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure were also measured.

Results

The trauma-related exposure challenge induced anxiety on both days, with more marked responses on the ATD day according to VAS, DTS, POMS, and DBP (p < .05). A trend of significance (.1 > p > .05) was observed for STAI Form Y-1, HR, and SBP.

Conclusions

These data demonstrate that ATD accentuates responses to trauma-related stimuli in SSRI-recovered PTSD. They also suggest that SSRI-induced increases in serotonin function restrain PTSD symptoms, especially under provocation, supporting a role for serotonin in mediating stress resilience.",0,0 +3059,Evaluation of a corticotropin releasing hormone type 1 receptor antagonist in women with posttraumatic stress disorder: study protocol for a randomized controlled trial,"Pharmacologic treatment options for posttraumatic stress disorder (PTSD) are limited in number and effectiveness. Medications currently in use to treat PTSD were originally approved based on their efficacy in other disorders, such as major depression. Substantial research in PTSD suggests that increased activity of corticotropin releasing hormone (CRH)-containing circuits are involved in the pathophysiology of the disease. This Phase II trial aims to evaluate the efficacy of a CRH type 1 receptor (CRHR1) antagonist in the treatment of PTSD.Currently untreated adult women, ages 18 to 65 years, with a primary psychiatric diagnosis of PTSD of at least 3 months' duration, are being enrolled in a parallel-group, double-blind, placebo-controlled, randomized clinical trial evaluating the efficacy and safety of GSK561679, a novel CRHR1 receptor antagonist. GSK561679 (or matching placebo) is prescribed at a fixed dose of 350 mg nightly for six weeks. The primary trial hypothesis is that GSK561679 will reduce symptoms of PTSD, as measured by the Clinician-Administered PTSD Scale (CAPS), significantly more than placebo after six weeks of treatment. Putative biological markers of PTSD which may influence treatment response are measured prior to randomization and after five weeks' exposure to the study medication, including: fear conditioning and extinction using psychophysiological measures; variants of stress-related genes and gene expression profiles; and indices of HPA axis reactivity. In addition, the impact of PTSD and treatment on neuropsychological performance and functional capacity are assessed at baseline and after the fifth week of study medication. After completion of the six-week double blind treatment period, subjects enter a one-month follow-up period to monitor for sustained response and resolution of any adverse effects.Considerable preclinical and human research supports the hypothesis that alterations in central nervous system CRH neuronal activity are a potential mediator of PTSD symptoms. This study is the first to assess the efficacy of a specific antagonist of a CRH receptor in the treatment of PTSD. Furthermore, the biological and neuropsychological measures included in this trial will substantially inform our understanding of the mechanisms of PTSD.Clinicaltrials.gov Identifier: NCT01018992.Registered 6 November 2009. First patient randomized 14 January 2010.",0,0 +3060,"636,120 Ways to Have Posttraumatic Stress Disorder","In an attempt to capture the variety of symptoms that emerge following traumatic stress, the revision of posttraumatic stress disorder (PTSD) criteria in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has expanded to include additional symptom presentations. One consequence of this expansion is that it increases the amorphous nature of the classification. Using a binomial equation to elucidate possible symptom combinations, we demonstrate that the DSM-IV criteria listed for PTSD have a high level of symptom profile heterogeneity (79,794 combinations); the changes result in an eightfold expansion in the DSM-5, to 636,120 combinations. In this article, we use the example of PTSD to discuss the limitations of DSM-based diagnostic entities for classification in research by elucidating inherent flaws that are either specific artifacts from the history of the DSM or intrinsic to the underlying logic of the DSM's method of classification. We discuss new directions in research that can provide better information regarding both clinical and nonclinical behavioral heterogeneity in response to potentially traumatic and common stressful life events. These empirical alternatives to an a priori classification system hold promise for answering questions about why diversity occurs in response to stressors.",0,0 +3061,"Posttraumatic stress disorder, depression, and perceived needs for psychological care in older persons affected by Hurricane Ike","To examine the prevalence and correlates of disaster-related posttraumatic stress disorder (PTSD), depression, and needs for psychological care in older persons affected by Hurricane Ike.A total of 193 adults aged 60 or older who resided in the Galveston Bay area were interviewed 2-5 months following Hurricane Ike. Pre-, peri-, and post-disaster variables hypothesized to be related to PTSD and depressive symptoms, and perceived needs for psychological care were assessed.Weighted prevalences of past-month Ike-related PTSD and depression were 7.6% and 8.6%, respectively. Risk factors for Ike-related PTSD symptoms were predominantly peri-disaster in nature, with greater hurricane exposure, and peri-event dissociative and autonomic activation symptoms associated positively with these symptoms. Risk factors for depressive symptoms were predominantly pre-disaster in nature, with being married/living with partner associated negatively, and prior disaster exposure and pre-disaster PTSD or depression associated positively with these symptoms. 27.2% of the sample endorsed at least one of the perceived needs for psychological care assessed. A history of PTSD or depression, greater peri-event autonomic activation, and Ike-related PTSD and depressive symptoms were associated with greater need for psychological care.This study is limited by its cross-sectional design and employment of psychiatric screening instruments.A substantial proportion of older adults may have PTSD and depression, as well as perceived needs for psychological care, after a disaster. Assessment of disaster exposures, and peri-event dissociative and autonomic symptoms may help identify older adults at risk for disaster-related psychopathology. Older adults with a history of PTSD or depression, and greater peri-event autonomic activation and PTSD symptoms may be more likely to have needs for psychological care.",0,0 +3062,Emotional Processing Therapy for post traumatic stress disorder,"While prolonged exposure is considered one of the “gold standard” and recommended treatments for post traumatic stress disorder (PTSD), it has been poorly utilised in clinical practice. Individuals with PTSD often find it too distressing to confront memories, and therapists may be uncomfortable using the therapy. A new Emotional Processing Therapy is described in which an emotional approach to prolonged exposure provides individuals with a new insight into how trauma is processed. A conceptual analysis of exposure suggests that it is exposure to distressing emotional experiences which is a key element. Viewing it as an emotion-based therapy, allows the creative addition of new emotional elements. Through exploring the individual’s emotional processing style, previously learned and unhelpful patterns can be addressed, and the addition of an “emotional preparation” phase helps them understand why it is important to face emotionally distressing memories before exposure sessions begin. Emotional Processing Th...",0,0 +3063,The relation between multiple pains and mental disorders: Results from the World Mental Health Surveys,"It is unclear whether differences exist in the prevalence of mood, anxiety and alcohol use disorders among persons with multiple pain conditions compared with those with single pain problems. We conducted population surveys in 17 countries in Europe, the Americas, the Middle East, Africa, Asia, and the South Pacific. Participants were community-dwelling adults (N=85,088). Mental disorders were assessed with the Composite International Diagnostic Interview. Pain was assessed by self-report. Both multiple and single site pain problems were associated with mood and anxiety disorders, but not with alcohol abuse or dependence. In general, the prevalence of specific mood and anxiety disorders followed a linear pattern with the lowest rates found among persons with no pain, intermediate rates among those with one pain, and highest rates among those with multi-site pain problems. Relative to persons not reporting pain, the pooled estimates of the age-sex adjusted odds ratios were 1.8 (1.7-2.0) for mood disorders and 1.9 (1.8-2.1) for anxiety disorders for persons with single site pain; 3.7 (3.3-4.1) for mood disorders and 3.6 (3.3-4.0) for anxiety disorders among those with multi-site pain. Our results indicate that the presence of multiple pain conditions was strongly and comparably associated with mood and anxiety disorders in diverse cultures. This consistent pattern of associations suggests that diffuse pain and psychiatric disorders are generally associated, rather than diffuse pain representing an idiom for expressing distress that is specific to particular cultural settings or diffuse pain solely representing a form of masked depression.",0,0 +3064,"Hierarchical convergence of PTSD symptom clusters: A comparison of the numbing, dysphoria, and dysphoric arousal models of PTSD.","Previous research has found support for 3 intercorrelated models of posttraumatic stress disorder (PTSD): the Numbing model (King, Leskin, King, & Weathers, 1998), the Dysphoria model (Simms, Watson, & Doebbelling, 2002), and the Dysphoric Arousal model (Elhai et al., 2011). Researchers have not yet examined whether the symptom clusters represented by these 3 models would converge together in the same manner at the second-order level. The aim of the present study was to compare the efficiency of 1- and 2-factor hierarchical structures for each of the 3 PTSD models. Two large samples (total N = 3,178) of college students who reported a traumatic event completed a measure of PTSD. Confirmatory factor analysis showed that Elhai et al.'s (2011) Dysphoric Arousal model fit the data best at the first-order, intercorrelated level. Examination of the fit of the hierarchical structures showed important differences among the models: the Numbing model fit a 2-factor second-order structure more efficiently than it fit a single-factor hierarchical structure, whereas the Dysphoria model was better explained at the second-order level by a single-factor, General PTSD structure. The Dysphoric Arousal model showed poor fit statistics with both the 1- and 2-factor hierarchical structures, suggesting that Elhai et al.'s (2011) model does not fit either the General PTSD representation or a 2-factor hierarchical conception of PTSD. The differences in fit of the 3 models at the hierarchical level have implications for the measurement, theoretical understanding, and treatment of PTSD. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0,0 +3065,Interpersonal Processes in the Anxiety Disorders,"We examine the role of interpersonal processes in the anxiety disorders, a group of conditions characterized by excessive and incapacitating anxiety. The chapter begins with an empirical review that summarizes what is known about the interpersonal factors associated with social anxiety disorder, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. We then examine similarities and differences among the disorders as a first step toward establishing their unique interpersonal profiles. Despite limitations in extant studies, the literature as a whole supports the notion that interpersonal processes play a key role in these conditions. We end with suggestions for the way in which interpersonal theory might provide leads for future research. © 2011 John Wiley & Sons, Inc. All rights reserved.",0,0 +3066,Memory impairments in posttraumatic stress disorder are related to depression,"The present study focuses on verbal learning and memory alterations in refugees with posttraumatic stress disorder, and whether the alterations are related to attention, acquisition, storage, or retrieval. Twenty-one refugees exposed to war and political violence with chronic PTSD, were compared to an exposed control sample of 21 refugees without PTSD. No differences were found in attention span, but tests of verbal memory showed less efficient learning in the PTSD sample. Group differences in delayed recall could be explained by learning efficiency. No differences were seen in recognition memory. These results indicate that memory alterations in PTSD are related to impaired acquisition and less effective encoding of the memory material and not to impaired attention span and/or impaired retrieval. Controlling for specific PTSD symptom clusters and self-reported depression showed that the intrusion subscale and depressive reactions are the most important symptoms in understanding the memory alterations in PTSD.",0,0 +3067,Validation of a Tibetan Translation of the Hopkins Symptom Checklist–25 and the Harvard Trauma Questionnaire,"This study sought to translate and validate the Hopkins Symptom Checklist–25 (HSCL) and the Harvard Trauma Questionnaire (HTQ) in a Tibetan population. Translated questionnaires were administered to 57 Tibetan survivors of torture/human rights abuses living in the United States and receiving services in a torture treatment program. Participants were evaluated to determine if they met criteria for major depressive episode, generalized anxiety disorder, or posttraumatic stress disorder (PTSD). Coefficient alpha for the HSCL Anxiety subscale (.89), Depression subscale (.92), and the HTQ (.89) were high. Diagnostic accuracy using receiver operating characteristic curve analysis generated good classification accuracy for anxiety (.89), depression (.92), and PTSD (.83). However, although sensitivity and specificity for HSCL subscales were quite high, the HTQ generated low sensitivity (.33), partly because of a low rate of PTSD. Results support the reliability and validity of the HSCL but suggest further study of the HTQ with this population is required.",0,0 +3068,Post-traumatic stress disorder symptoms in emotionally distressed individuals referred for a depression prevention intervention: relationship to problem-solving skills,"Objectives This study examined the rates of syndromal and subthreshold post-traumatic stress disorder (PTSD) and PTSD symptom scores in participants with symptoms of emotional distress, subsyndromal depression, and a history of traumatic exposure. Participants had been referred to a study of an indicated depression prevention intervention using problem-solving therapy in primary care. We hypothesized that higher severity of PTSD symptom scores would predict poorer problem-solving skills. In addition, some reports have suggested that there are higher rates of PTSD in minority populations relative to Caucasians; thus we hypothesized that race would also predict problem-solving skills in these individuals. Methods We examined the rates of traumatic exposure, syndromal, and subthreshold PTSD. In those exposed to trauma, we performed a multiple linear regression to examine the effects of PTSD symptoms, depression symptoms, race, age, and gender on social problem-solving skills. Results Of the 244 participants, 64 (26.2%) reported a traumatic event; 6/234 (2.6%) had syndromal PTSD, and 14/234 (6.0%) had subthreshold PTSD. By way of regression analysis, higher PTSD symptom scores predicted poorer problem-solving skills. In addition, racial status (Caucasian vs. African American) predicted problem-solving skills; Caucasians exhibited lower levels of problem-solving skills. Conclusions Individuals presenting with subsyndromal depressive symptoms may also have a history of traumatic exposure, subthreshold and syndromal PTSD. Thus, screening these individuals for PTSD symptoms is important and may inform clinical management decisions because problem-solving skills are lower in those with more severe PTSD symptoms (even after adjusting for race, age, gender, and depressive symptoms). Copyright © 2011 John Wiley & Sons, Ltd.",0,0 +3069,"Prevalence of mental disorders among children exposed to war: a systematic review of 7,920 children","Worldwide, millions of children are affected by armed conflict. However, data on the prevalence of mental disorders among these children is sparse. We aimed to determine the prevalence of mental disorders among children affected by war using a systematic review and meta-regression analysis. We systematically reviewed existing literature to identify studies on prevalence of post-traumatic stress disorder (PTSD), anxiety, depression and psychosis among children exposed to armed conflict. We searched electronic databases and references listed in studies to obtain eligible studies. We pooled studies using the random-effects method and explored heterogeneity using meta-regression analysis. Seventeen studies met our inclusion criteria. Studies included 7,920 children. Sample sizes ranged from 22 to 2,976. Four studies were conducted during a conflict and others during post-conflict. All the studies reported PTSD as the primary outcome ranging from 4.5 to 89.3%, with an overall pooled estimate of 47% (9% CI: 35-60%, I2 = 98%). Meta-analysis heterogeneity was attributable to study location (OR 1.33, 95% CI: 1.27-1.41), method of measurement (OR 1.36, 95% CI: 1.29-1.44) and duration since exposure to war (coefficient 0.17, 95% CI: 0.94-0.25). In addition, four studies reported elevated depression that allowed pooling (43%, 95% CI: 31-55%) and three studies reported elevated anxiety disorders allowing pooling (27%, 95% CI: 21-33%). Our systematic review suggests a higher prevalence rate of mental disorders among children exposed to conflict than among the general population. Given the number of current conflicts, there is a paucity of information regarding mental disorders among children affected by war.",0,0 +3070,"Mental imagery, emotion and psychopathology across child and adolescent development","Mental imagery-based interventions are receiving increasing interest for the treatment of psychological disorders in adults. This is based on evidence that mental imagery potently influences the experience of emotion in non-clinical samples, and that a number of psychological disorders are marked by syndrome-specific, distressing abnormalities in mental imagery. During childhood and adolescence, neurocognitive development impacting mental imagery processes may moderate its relationship with clinically-relevant emotional symptoms at a number of potential loci. Crucially, these changes could impact vulnerability to distressing mental imagery and the efficacy of mental imagery-based clinical interventions. This review synthesises evidence pertaining to developmental changes in the role and content of mental imagery, and in the cognitive sub-processes required to generate and sustain mental images. Subsequently, we discuss implications for understanding the developmental relationship between mental imagery, emotion and psychopathology. Translational cognitive neuroscience research investigating the content, emotional impact and neurocognitive substrates of mental imagery across development may reveal insights into trajectories of vulnerability to symptoms of a number of psychological disorders. If proper consideration is given to developmental factors, techniques based on mental imagery may be valuable as part of a treatment armoury for child and adolescent clinical populations and those at risk of emotional disorders.",0,0 +3071,Functional outcome and quality of life in victims of terrorist explosions as compared to conventional trauma,"Background: Following trauma, the number of preventable deaths is low. Outcome should also be measured in terms of quality of life (QoL). Studies analyzing QoL in trauma patients have been published, but little is known about the long term QoL of victims of terrorist attacks. Methods: This is a case-control study of casualties of the March 11, 2004 attacks in Madrid. Patients treated for other trauma with similar age and Injury Severity Score (ISS), served as controls. Patients were assessed using the POLO-Chart (VAS, SF-36 and TOP). Results: Fifty-eight patients were included, 32 casualties admitted following the March 11, 2004 attacks and 26 controls. Both groups were comparable in age (average = 37), ISS (average = 23) and time from trauma (average = 1,770 days). Subjects demonstrated lower scores for the VAS, and the SF-36 clusters social functioning, role emotional and mental health. There was a tendency towards higher prevalence of symptoms associated to posttraumatic stress disorder (PTSD) in subjects (p = 0.056). Subjects suffered from higher residual pain in the head region (p = 0.032). Strong association was found between the presence of symptoms associated to depression, anxiety and PTSD and worse QoL (p < 0.001). Conclusion: Subjects present more emotional distortions, residual pain in the head region and a tendency towards a worsened perception of their own health and wellness. They also present symptoms associated to PTSD more frequently. The presence of symptoms associated to PTSD, depression or anxiety was an independent variable related to lower QoL in both groups. © 2010 Urban & Vogel.",0,0 +3072,Interaction between genetic variants and exposure to Hurricane Katrina on post-traumatic stress and post-traumatic growth: A prospective analysis of low income adults,"There is considerable variation in psychological reactions to natural disasters, with responses ranging from relatively mild and transitory symptoms to severe and persistent posttraumatic stress (PTS). Some survivors also report post-traumatic growth (PTG), or positive psychological changes due to the experience and processing of the disaster and its aftermath. Gene-environment interaction (GxE) studies could offer new insight into the factors underlying variability in post-disaster psychological responses. However, few studies have explored GxE in a disaster context.We examined whether ten common variants in seven genes (BDNF, CACNA1C, CRHR1, FKBP5, OXTR, RGS2, SLC6A4) modified associations between Hurricane Katrina exposure and PTS and PTG. Data were from a prospective study of 205 low-income non-Hispanic Black parents residing in New Orleans prior to and following Hurricane Katrina.We found a significant association (after correction) between RGS2 (rs4606; p=0.0044) and PTG, which was mainly driven by a cross-over GxE (p=0.006), rather than a main genetic effect (p=0.071). The G (minor allele) was associated with lower PTG scores for low levels of Hurricane exposure and higher PTG scores for moderate and high levels of exposure. We also found a nominally significant association between variation in FKBP5 (rs1306780, p=0.0113) and PTG, though this result did not survive correction for multiple testing.Although the inclusion of low-income non-Hispanic Black parents allowed us to examine GxE among a highly vulnerable group, our findings may not generalize to other populations or groups experiencing other natural disasters. Moreover, not all participants invited to participate in the genetic study provided saliva.To our knowledge, this is the first study to identify GxE in the context of post-traumatic growth. Future studies are needed to clarify the role of GxE in PTS and PTG and post-disaster psychological responses, especially among vulnerable populations.",0,0 +3073,The Dynamics of Posttraumatic Growth Across Different Trauma Types in a Palestinian Sample,"A Palestinian sample was used to explore the dynamics of posttraumatic growth (PTG) across different trauma types. Cumulative trauma, posttraumatic stress disorder, depression, anxiety, PTG, and stress-related growth (SRG) measures were administered. As predicted, only type I traumas were associated with PTG. Type II traumas were not associated with PTG, while type III collective identity traumas were negatively associated with PTG. Results indicated that PTG was not a significant predictor of any mental health symptoms and that PTG is different from SRG, which seems to describe growth in non-traumatic situations. The results suggest that it is important to analyze trauma profiles rather than single trauma.",0,0 +3074,Near-infrared spectroscopy analysis of frontal lobe dysfunction in schizophrenia,"Previous studies have shown that near-infrared spectroscopy (NIRS) has high temporal resolution, requires little restraint, and is suitable for examining the effect of psychological tasks on brain circulation. In the present study, frontal function in schizophrenic patients was analyzed by NIRS during random number generation (RNG), ruler-catching (RC), and sequential finger-to-thumb (SFT) tasks.Two sets of NIRS probes were attached to the foreheads of 13 schizophrenic patients and 10 control subjects approximately at Fp1-F7 and Fp2-F8. Near-infrared spectroscopy was conducted at a sampling rate of 1 Hz, with the pathlength being determined by time-resolved spectroscopy with differential pathlength factor measurements. The absolute changes in oxygenated (oxy-Hb) and deoxygenated (deoxy-Hb) hemoglobin concentrations in response to each task were measured, and total hemoglobin (total-Hb) concentration was calculated as the sum of the two.During RNG task, total- and oxy-Hb concentrations increased, and deoxy-Hb decreased, but the responses were significantly smaller in schizophrenic patients. During RC task, oxy-Hb in schizophrenic patients tended to decrease, in contrast to the mostly increasing response in control subjects. No group difference was observed during SFT task.Task-dependent profile of functional abnormalities was observed in schizophrenic frontal brain metabolism. These results support the usefulness of NIRS data in investigating frontal lobe dysfunction and evaluating psychopathologic condition in schizophrenic patients.",0,0 +3075,Reported rapes at a hospital rape centre: Demographic and clinical profiles,"2South Africa has one of the highest incidences of rape in the world and the most violent types of rape in the world, with gang rape and severe physical injury to rape victims commonly occurring. 3,4 Moreover, the consequences of rape potentially include many medical and psychological difficulties, such as unwanted pregnancy, risk of sexually transmitted infections (STIs), genital and physical injury, and psychological disturbance e.g. post-traumatic stress disorder, major depression, increased risk of suicidal ideation, and alcohol and drug abuse problems. 5,6 Rape survivors have specific health needs, ideally met by providing integrated and holistic post-rape services, including the provision of pregnancy testing and prevention, termination of pregnancy, testing and treatment of STIs and injuries, and psychosocial counselling. 7 Rape survivors strongly value the availability of HIV prophylaxis, an understanding health care provider, access to and receiving counselling, and thorough physical examination, emphasising the need for a holistic approach to post-rape care. 8,9 The Act aims to provide certain services to survivors of sexual assault to minimise or prevent further traumatisation, yet the only medical service conditionally provided to rape survivors is the provision of post-exposure prophylaxis (PEP). 2",0,0 +3076,A Socio-interpersonal Perspective on PTSD: The Case for Environments and Interpersonal Processes,"Post-traumatic stress disorder (PTSD) is a common reaction to traumatic experiences. We propose a socio-interpersonal model of PTSD that complements existing models of post-traumatic memory processes or neurobiological changes. The model adds an interpersonal perspective to explain responses to traumatic stress. The framework draws from lifespan psychology, cultural psychology and research into close relationships and groups. Additionally, clinical knowledge about PTSD is incorporated. This involves knowledge about shame, guilt, estrangement feelings and protective factors, such as social support and forgiveness. Three levels are proposed at which relevant interpersonal processes can be situated and should be adequately researched. First, the individual level comprises social affective states, such as shame, guilt, anger and feelings of revenge. Second, at the close relationship level, social support, negative exchange (ostracism and blaming the victim), disclosure and empathy are proposed as dyadic processes relevant to PTSD research and treatment. Third, the distant social level represents culture and society, in which the collectivistic nature of trauma, perceived injustice, and social acknowledgement are concepts that predict the response trajectories to traumatic stress. Research by the current authors and others is cited in an effort to promote future investigation based on the current model. Methodological implications, such as multi-level data analyses, and clinical implications, such as the need for couple, community or larger-level societal interventions, are both outlined.The socio-interpersonal model proposes an interpersonal view of the processes that occur in the aftermath of a traumatic experience. At the individual level, the model integrates the social affective phenomena that clinical research identifies in PTSD patients, including shame, guilt, anger, revenge and the urges or reluctance to disclose. At the level of close relationships, there is an emphasis on the role of the individuals' partner, family or social support in the development or maintenance of PTSD and its recovery. At the distant social level, societal and cultural factors, e.g., individualistic versus collectivistic or other human value orientations, are acknowledged as contributing to the severity and course of PTSD. Increasing attention should be given to new approaches of PTSD treatment that refer to an interpersonal view of PTSD, e.g., communication training, PTSD-specific couples' therapy or community programs.",0,0 +3077,Parent and child distress after war exposure,"The purpose of this study was to examine multiple distress symptoms (i.e., post-traumatic stress [PTS], anxiety, depression) among parents and children exposed to the Gulf Crisis in 1990-1991. Profiles of parent distress were identified, and the relationship between parent distress and specific child distress symptoms was examined.Parents and children were assessed at one time point.Participants included 151 children (Mage = 10.62 years; 51% female) and 140 parents (Mage = 40 years; 81% female).Utilizing latent profile analysis, three parallel profiles of parent distress were identified: low distress, moderate distress, and high distress. Parent distress was a risk factor for child depression, but it was not a risk factor for child PTS or anxiety.Findings support the importance of broadening the scope of research conducted after exposure to traumatic events to include the assessment of anxiety and depression, as well as PTS, among both parents and children. Additional implications for research and clinical work are discussed.Findings support the importance of screening for multiple distress symptoms among both children and parents after war exposure. Based on our findings, clinicians may want to consider including parents in therapy for children reporting psychological distress, especially depression symptoms, after exposure to traumatic events. This study was cross-sectional. Thus, we are not able to infer direction or causality. The generalizability of our study should be interpreted with caution, as findings will need to be replicated across other populations and other cultures.",0,0 +3078,Fluvoxamine,"Synopsis Fluvoxamine is a selective serotonin reuptake inhibitor which was initially developed as an antidepressant. Additional clinical research has identified several other disorders of the central nervous system in whichfluvoxamine has potential benefits, and which are the focus of this review. At present, the largest volume of data concerns the use of fluvoxamine in obsessive-compulsive disorder. Oral fluvoxamine at dosages of up to 300 mg/day is effective in alleviating, although not preventing, the symptoms of obsessivecompulsive disorder in 40 to 50% of patients, and limited data indicate that it is as effective as clomipramine. Encouraging initial data are also available regarding the efficacy of fluvoxamine in panic disorder. Further data are required to fully establish the efficacy of fluvoxamine in preventing panic attacks, and to investigate possible beneficial effects in the treatment of anxiety symptoms, bulimia nervosa, alcohol (ethanol )-induced amnesia, schizophrenia and several other psychiatric disorders, and pain states. Comparative and long term data in all disorders in which fluvoxamine shows potential are also required. Fluvoxamine is well tolerated by the majority of patients. Nausea is the most frequent adverse effect and can lead to withdrawal from treatment. However, nausea and most other adverse effects are generally mild to moderate in nature. Fluvoxamine induces less anticholinergic and sedative effects than tricyclic antidepressants, and does not appear to have cardiotoxic effects. In addition, as with many other antidepressants there is no evidence thatfluvoxamine induces suicidal behaviour. Compared with tricyclic antidepressants,fluvoxamine is relatively safe in overdose. Thus, studies available to date have demonstrated the efficacy offluvoxamine in obsessive-compulsive disorder. Efficacy in other central nervous system disorders has been indicated but further confirmatory data are required, as are comparative data in all disorders. The improved tolerability profile of fluvoxamine compared with many other agents used in these conditions will help to establish the agent as a useful alternative in obsessive-compulsive disorder, and in other conditions if preliminary efficacy findings are confirmed. Pharmacological Properties Fluvoxamine is a potent and selective inhibitor of serotonin reuptake. In addition to its lack of effects on other monoamine reuptake mechanisms, fluvoxamine has little or no effect on the neuronal function of other monoamines and has a low affinity for the receptors of a variety of neurotransmitters. While acute inhibition of serotonin reuptake by fluvoxamine is well documented, clinical response is slower and therefore is not readily explained by this acute effect. Studies in animals and humans have shown that fluvoxamine, unlike the tricyclic antidepressants, has relatively few cardiovascular or anticholinergic effects. In addition, fluvoxamine does not appear to have pro-convulsive or sedative effects, and does not impair cognition. Fluvoxamine has anxiolytic and anti-nociceptive activity in some animal models, and reduces alcohol (ethanol) intake in alcohol-preferring rats. Pain thresholds in healthy volunteers are increased by fluvoxamine. The pharmacokinetic properties of fluvoxamine are well established. The drug is almost completely absorbed following oral administration and the extent of absorption is not affected by the presence of food in the gastrointestinal tract. Maximum plasma concentrations are reached within 2 to 8 hours of administration and steady-state concentrations are achieved after 10 days. There is no drug accumulation after repeated administration. Fluvoxamine is extensively metabolised in the liver, with 11 pharmacologically inactive metabolites identified. Most of a dose offluvoxamineis excreted in the urine, with only about 3% as unchanged parent compound. Mean elimination half-life is 14 to 22 hours. Limited data suggest that the pharmacokinetic parameters of fluvoxamine are not affected by increased age, renal impairment or geneti polymorphism. However, elimination half-life is increased in patients with hepatic disease. Therapeutic Potential Fluvoxamine at oral dosages of 50 to 300 mg/day has been investigated in a number of non-depressive disorders. Positive results in 6 placebo-controlled trials support the efficacy of fluvoxamine in obsessive-compulsive disorder. At present, comparative data are limited but promising, with 2 trials showing that fluvoxamine is as effective as clomipramine. As with clomipramine, fluvoxamine reduces but does not eliminate obsessions and compulsions, is effective in only 40 to 50% of patients and has a delay in onset of action of approximately 4 weeks. Limited data indicate that fluvoxamine may also be effective in preventing panic attacks, although further placebo-controlled comparisons with standard agents are required. Encouraging preliminary results suggest that fluvoxamine may have potential in the treatment of anxiety symptoms, bulimia nervosa, alcohol- induced amnesia, schizophrenia and several other psychiatric disorders, and pain syndromes. Fluvoxamine does not appear to be effective in patients with dementia, post-traumatic stress disorder or menstrually related disorders, or in reducing body weight in obese patients. Tolerability Fluvoxamine is well tolerated in patients with depression or other central nervous system disorders at oral dosages of up to 300 mg/day for up to 12 weeks. Long term tolerability has not been fully established. A least 43% of patients experience at least 1 adverse effect, with the highest incidence of adverse effects being associated with the gastrointestinal tract (nausea, vomiting, abdominal pain) and central nervous system (somnolence, headache, insomnia). Asthenia is also a common adverse effect. The most common adverse effect is nausea, which can result in discontinuation of therapy. Most adverse effects are transient and of mild to moderate severity. No fluvoxamine-associated clinically significant changes in vital signs or laboratory parameters have been reported. Fluvoxamine produces fewer anticholinergic effects than tricyclic antidepressants, and is thought to have less epileptogenic potential than these agents. In addition, fluvoxamine does not appear to have any cardiotoxic effects. The adverse effects profile of fluvoxamine appears to be similar to that of other selective serotonin reuptake inhibitors. Fluvoxamine treatment has not been associated with an increase in suicidal behaviour, and the agent is considered less harmful than tricyclic antidepressants in overdose. Dosage and Administration For the treatment of non-depressive disorders, fluvoxamine has been administered at oral dosages of 50 to 300 mg/day. Dosages over 100 mg/day were most commonly used. Titration of the dosage in 50mg increments is recommended for the treatment of depression and a similar procedure should probably be used for other disorders. A starting dosage of 50 mg/day may reduce nausea. Dosage should not exceed 100 mg/day in patients with hepatic or renal impairment. While it does not seem necessary to reduce the dosage in elderly patients, slow titration of the dosage should be employed in these patients. Caution is recommended when administering fluvoxamine with agents with which it is known to interact, such as lithium, theophylline, tricyclic antidepressants or warfarin. In addition, cautious use is recommended when fluvoxamine is administered to patients with epilepsy or a medical condition that may be exacerbated by vomiting. Fluvoxamine should not be administered with or within 2 weeks of withdrawing a monoamine oxidase inhibitor, and a monoamine oxidase inhibitor should not be started within 1 week of stopping fluvoxamine. © 1994, Adis International Limited. All rights reserved.",0,0 +3079,Posttraumatic stress reactions among Rwandan youth in the second year after the genocide: Rising trajectory among girls.,"This study examines levels of traumatic stress reactions among youth attending school in the second year after the 1994 Rwandan genocide. From August to December 1995, the survey team visited 22 schools throughout Rwanda. The survey (n 942; youth aged 8 to 19 years) assessed exposure to wartime violence and symptoms of posttraumatic stress disorder (PTSD), as outlined in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM–IV; American Psychiatric Association, 2000). Mean symptom levels and the proportion of respondents meeting DSM–IV PTSD symptom criteria (“probable PTSD”) were examined for evidence of systematic decline over time. Multivariate analyses controlled for major confounders and the complex survey design. Overall, traumatic stress reactions increased among youth interviewed at successively later time points. For example, in the first third of the survey period, the “probable PTSD” rate was 48%; in the second, 54%; and in the third, 58%. The rise was confined to females. Among females, the adjusted odds of having “probable PTSD” in the last third of the study period was 2.71 (95% CI [1.66, 4.43]) fold higher than in the first. These results suggest that in planning health services in postconflict settings, humanitarian agencies should be alert to the possibility that traumatic stress reactions among youth may not decline with passage of time. Despite limitations in design, to date, this report represents the only formal structured evaluation of the mental health of youth living in the community, in the very early aftermath of catastrophic violence.",0,0 +3080,Neuroticism and post-traumatic stress disorder: a prospective investigation,"Background Neuroticism has been consistently correlated with the post-traumatic stress disorder (PTSD) response to traumatic events. Interpretation of these findings is limited by the retrospective nature of these findings: neuroticism was measured after the trauma had occurred. The prospective association of neuroticism with PTSD has not been examined (the relationship of neuroticism with PTSD symptoms was examined in a few prospective studies). We evaluate prospectively the relationship of neuroticism, measured at baseline, with the cumulative occurrence of PTSD during the subsequent 10 years, using data from a longitudinal epidemiological study of young adults. Method A sample of 1007 young adults randomly selected from the membership of a large health maintenance organization in southeast Michigan was assessed at baseline and followed up at 3, 5 and 10 years later. We conducted a series of multinomial logistic regressions to estimate the relative risk (RR) of exposure to trauma and PTSD by neuroticism at baseline, adjusting for history of major depression ( n = 990). Results During the 10-year follow-up, 50.2% of the sample experienced traumatic events and 5.2% developed PTSD. Neuroticism score at baseline increased significantly the RR of PTSD response to trauma. Additional analysis revealed that, among persons with history of major depression at baseline, RR for PTSD associated with neuroticism was equal to the null value of 1, but was increased significantly among those with no history of major depression. Conclusions The results confirm the role of neuroticism as diathesis in the PTSD response to traumatic experiences.",0,0 +3081,Derivation of a clinical prediction rule to identify both chronic moderate/severe disability and full recovery following whiplash injury,"Recovery following a whiplash injury is varied: approximately 50% of individuals fully recover, 25% develop persistent moderate/severe pain and disability, and 25% experience milder levels of disability. Identification of individuals likely to develop moderate/severe disability or to fully recover may help direct therapeutic resources and optimise treatment. A clinical prediction rule (CPR) is a research-generated tool used to predict outcomes such as likelihood of developing moderate/severe disability or experiencing full recovery from whiplash injury. The purpose of this study was to assess the plausibility of developing a CPR. Participants from 2 prospective, longitudinal studies that examined prognostic factors for poor functional recovery following whiplash injury were used to derive this tool. Eight factors, previously identified as predictor variables of poor recovery, were included in the analyses: initial neck disability index (NDI), initial neck pain (visual analogue scale), cold pain threshold, range of neck movement, age, gender, presence of headache, and posttraumatic stress symptoms (Posttraumatic Diagnostic Scale [PDS]). An increased probability of developing chronic moderate/severe disability was predicted in the presence of older age and initially higher levels of NDI and hyperarousal symptoms (PDS) (positive predictive value [PPV]=71%). The probability of full recovery was increased in younger individuals with initially lower levels of neck disability (PPV=71%). This study provides initial evidence for a CPR to predict both chronic moderate/severe disability and full recovery following a whiplash injury. Further research is needed to validate the tool, determine the acceptability of the proposed CPR by practitioners, and assess the impact of inclusion in practice.",0,0 +3082,Exploring posttraumatic stress disorder symptom profile among pregnant women,"Posttraumatic stress disorder (PTSD) is more prevalent in perinatal than general samples of women (6-8% vs. 4-5%). To explore potential causes, we examined the symptom profiles of women belonging to two separate samples: a perinatal clinic sample (n = 1581) and a subsample of women in a similar age range from the U. S. National Women's Study (NWS) (n = 2000). Within the perinatal sample, risk ratios were higher for all 17 PTSD symptoms among women with current PTSD compared with unaffected women, suggesting that higher rates are not likely due to measurement error. The younger age and greater social disadvantage in the perinatal clinic sample contributed only a small proportion of variance in symptom levels compared with extent of trauma exposure and pre-existing PTSD. Compared with the national study sample's symptom profile, the perinatal sample had higher rates of occurrence of five symptoms: detachment, loss of interest, anger and irritability, trouble sleeping, and nightmares. This analysis confirms that PTSD rates are higher in perinatal samples, which is likely due to exacerbation of pre-existing PTSD among women of a younger age and greater social disadvantage. Further elucidation is warranted, including identifying triggers and determining if there are needs for pregnancy-specific interventions.",0,0 +3083,Post-traumatic stress disorder is associated with poor health behaviors: Findings from the Heart and Soul Study.,"Posttraumatic stress disorder (PTSD) results in substantial disability, including increased risk of cardiovascular disease (CVD). Poor health behaviors are major risk factors for initial and recurrent CVD events. Therefore, this study investigated whether PTSD is associated with poor health behaviors in patients with CVD.Cross-sectional study of 1,022 men and women with CVD. PTSD was assessed with the Computerized Diagnostic Interview Schedule for DSM-IV. Physical activity, medication adherence and smoking history were determined by self-report questionnaires. Multivariate logistic and linear regression models were used to evaluate the association of PTSD with health behaviors.Of the 1,022 participants, 95 (9%) had PTSD. PTSD was associated with significantly higher rates of physical inactivity in terms of overall exercise (OR 1.6, 95% CI [1.0-2.6]; p = .049), light exercise (OR 1.7, 95% CI [1.0-2.9]; p = .045), and self-rated level of exercise compared to others of their age and sex (OR 1.8, 95% CI [1.0-3.0]; p = .047). Participants with PTSD were more likely to report medication nonadherence, including forgetting medications (OR 1.8, 95% CI [1.0-3.3]; p = .04) or skipping medications (OR 1.7, 95% CI [1.1-2.9]; p = .03). Participants with PTSD also reported a greater smoking history (β 6.4 pack years, 95% CI [1.8-10.9]; p = .006), which remained significant after adjustment for depression and income.Among patients with heart disease, those with PTSD were more likely to report physical inactivity, medication nonadherence and smoking. The majority of these associations were explained by adjustment for comorbid depression and lower income.",0,0 +3084,Incidence and Prediction of Post-Traumatic Stress Disorder at 6 Months After Motor Vehicle Accidents in Japan,"Incidence proportion of post-traumatic stress disorder (PTSD) after motor vehicle accidents (MVA) vary considerably across countries, and whether heart rate (HR) and respiratory rate (RR) immediately after MVA predict subsequent PTSD remains controversial. This study examined the incidence proportion of PTSD at 6 months after MVA in Japan, and the predictors of PTSD in MVA survivors.Patients with MVA-related injuries consecutively admitted to the intensive care unit of a teaching hospital in Tokyo were recruited. Six months after MVA, PTSD was diagnosed using the Clinician Administered Post-traumatic Stress Disorder Scale (CAPS).Of the 300 participants, 106 completed the assessments at 6 months after MVA and PTSD was diagnosed in 7.5% of the patients. Eight of the 300 participants (2.7%) were regarded as having PTSD after imputing their CAPS score at follow-up assessment for participants who dropped out. In multivariate regression analysis, no variables were shown to be independent predictors for PTSD. HR and RR did not predict PTSD in the analysis.The results suggested that the incidence proportion of PTSD following MVA in Japan was lower than that in most developed countries, and HR and RR might not be accurate screening tools despite their importance in a fear-conditioning model of the genesis of PTSD.",0,0 +3085,Trajectories of life satisfaction in the first 5 years following traumatic brain injury.,"The trajectories of life satisfaction for 609 individuals who sustained a traumatic brain injury (TBI) were studied. Hierarchical linear modeling analysis examined individual level growth trends over the first 5 years following TBI using gender, functional independence, age, and time to estimate life satisfaction trajectories.Participants completed the Functional Independence Measure and the Life Satisfaction Inventory at years 1, 2, 4, and 5 after sustaining TBI.Participants who reported higher functional independence at year 1 also had higher life satisfaction at year 1. Participants with lower functional independence across the 5-year period had life satisfaction trajectories that decreased at significantly greater rates than the individuals with more functional independence. The life satisfaction trajectory declined for the sample, but participants reporting lower cognitive and motor functional independence had significantly greater declines in life satisfaction trajectories. Age and gender were not significant factors in predicting life satisfaction trajectories following TBI.Individuals with greater cognitive and motor impairments following TBI are likely to experience significant declines in life satisfaction within 5 years of living with TBI.",0,0 +3086,War Exposure and Maternal Reactions in the Psychological Adjustment of Children from Bosnia-Hercegovina,,0,0 +3087,Neurobehavioral Mechanisms of Traumatic Stress in Post-traumatic Stress Disorder.,"Post-traumatic stress disorder (PTSD) is a debilitating psychiatric disorder that develops following trauma exposure. It is characterized by four symptom clusters: intrusion, avoidance, negative alteration in cognitions and mood, and alterations in arousal and reactivity. Several risk factors have been associated with PTSD, including trauma type and severity, gender and sexual orientation, race and ethnicity, cognitive reserve, pretrauma psychopathology, familial psychiatric history, and genetics. Great strides have been made in understanding the neurobiology of PTSD through animal models and human imaging studies. Most of the animal models have face validity, but they have limitations in the generalization to the human model of PTSD. Newer animal models, such as the ""CBC"" model, have better validity for PTSD, which takes into account the different components of its diagnostic criteria. To date, fear conditioning and fear extinction animal models have provided support for the hypothesis that PTSD is a dysregulation of the processes related to fear regulation and, especially, fear extinction. More research is needed to further understand these processes as they relate not only to PTSD but also to resilience. Further, this research could be instrumental in the development of novel effective treatments for PTSD.",0,0 +3088,Cross-Validation of the MMPI-2 in Detecting Malingered Posttraumatic Stress Disorder,"We attempted to cross-validate findings from a previous study (Elhai, Gold, Sellers, & Dorfman, in press) using a clinical sample of combat-related war veterans to distinguish genuine from malingered posttraumatic stress disorder (PTSD) on the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). The MMPI-2 scores of 124 male combat war veterans at the PTSD outpatient treatment program of a Veterans Affairs Medical Center were compared with those of 84 adult college students instructed and trained to malinger PTSD. MMPI-2 overreporting variables examined were F, F-Fb, F-K, F(p), Ds2, O-S, OT, and FBS. A stepwise discriminant analysis identified F. F-Fb, F-K, Ds2, O-S, and OT as the best malingering predictors. A predictive discriminant analysis yielded good hit rates for the model with impressive cross-validation results. We assessed cutting scores for the predictors of the model. We discuss clinical implications for using the MMPI-2 to distinguish malingered PTSD from combat-related PTSD.",0,0 +3089,Identifying longitudinal trajectories of emotional distress symptoms 5 years after traumatic brain injury,"To evaluate longitudinal trajectories of emotional distress symptoms after traumatic brain injury (TBI).Longitudinal study.Patients with mild-to-severe TBI, 118 patients participated at 3 months, 109 attended at 1-year and 89 attended the 5-year follow-up. Emotional distress was measured with the Impact of Event Scale-Revised. Patients were also assessed for coping style, anxiety, depression, substance abuse and trauma severity.Based on growth mixture modelling, four trajectories of emotional distress symptoms were identified: 73.5% of patients were characterized by a pattern of resilience, 6.8% by a pattern of delayed distress, 14.6% by recovery and 5.1% by chronic distress. Relative to the resilience trajectory, avoidant-coping style and psychiatric problems were related to recovery and chronic trajectories. The delayed trajectory was similar to the resilience trajectory, except for elevated depressive and anxiety symptoms at 1- and 5-years. Demographics and injury-related variables were not significantly associated with emotional distress trajectories.Resilience was the most common trajectory following TBI. Patients characterized by recovery and chronic trajectories required attention and long-term clinical monitoring of their symptoms. Future research would benefit from longitudinal studies to analyse emotional distress symptoms and the strength of resilience over time.",1,0 +3090,A critical evaluation of the complex PTSD literature: Implications for DSM-5,"Complex posttraumatic stress disorder (CPTSD) has been proposed as a diagnosis for capturing the diverse clusters of symptoms observed in survivors of prolonged trauma that are outside the current definition of PTSD. Introducing a new diagnosis requires a high standard of evidence, including a clear definition of the disorder, reliable and valid assessment measures, support for convergent and discriminant validity, and incremental validity with respect to implications for treatment planning and outcome. In this article, the extant literature on CPTSD is reviewed within the framework of construct validity to evaluate the proposed diagnosis on these criteria. Although the efforts in support of CPTSD have brought much needed attention to limitations in the trauma literature, we conclude that available evidence does not support a new diagnostic category at this time. Some directions for future research are suggested.",0,0 +3091,Use of the Personality Assessment Inventory in Assessment of Posttraumatic Stress Disorder in Women,"This study investigated the utility of the Personality Assessment Inventory (PAI) for the assessment of posttraumatic stress disorder (PTSD). Participants were 55 community-residing adult women who were administered a comprehensive battery that included the PAI and the Clinician-Administered PTSD Scale (CAPS). Participants were classified as either PTSD or non-PTSD based on the CAPS, and PAI profiles were compared between the two groups. Significant group differences were found for seven PAI clinical scales (Anxiety, Depression, Anxiety-Related Disorders, Somatic Complaints, Paranoia, Borderline Features, and Schizophrenia), one validity scale (Negative Impression), and two treatment scales (Nonsupport and Treatment Rejection). When all PAI scales and component subscales are considered, the largest group differences were found for the physiological subscale of the Depression scale (DEP-P) and the Traumatic Stress subscale of the Anxiety-Related Disorders scale (ARD-T). ARD-T and DEP-P also demonstrated excellent diagnostic utility. Finally, correlations between PAI scales and four CAPS symptom clusters provided additional validity evidence, in particular supporting a distinction between effortful avoidance and numbing. Taken together, these results support the use of the PAI in the assessment of PTSD. © 2005 Springer Science+Business Media, Inc.",0,0 +3092,"A comprehensive review of auditory verbal hallucinations: lifetime prevalence, correlates and mechanisms in healthy and clinical individuals","Over the years, the prevalence of auditory verbal hallucinations (AVHs) have been documented across the lifespan in varied contexts, and with a range of potential long-term outcomes. Initially the emphasis focused on whether AVHs conferred risk for psychosis. However, recent research has identified significant differences in the presentation and outcomes of AVH in patients compared to those in non-clinical populations. For this reason, it has been suggested that auditory hallucinations are an entity by themselves and not necessarily indicative of transition along the psychosis continuum. This review will examine the presentation of auditory hallucinations across the life span, as well as in various clinical groups. The stages described include childhood, adolescence, adult non-clinical populations, hypnagogic/hypnopompic experiences, high schizotypal traits, schizophrenia, substance induced AVH, AVH in epilepsy, and AVH in the elderly. In children, need for care depends upon whether the child associates the voice with negative beliefs, appraisals and other symptoms of psychosis. This theme appears to carry right through to healthy voice hearers in adulthood, in which a negative impact of the voice usually only exists if the individual has negative experiences as a result of their voice(s). This includes features of the voices such as the negative content, frequency, and emotional valence as well as anxiety and depression, independently or caused by voices presence. It seems possible that the mechanisms which maintain AVH in non-clinical populations are different from those which are behind AVH presentations in psychotic illness. For example, the existence of maladaptive coping strategies in patient populations is one significant difference between clinical and non-clinical groups which is associated with a need for care. Whether or not these mechanisms start out the same and have differential trajectories is not yet evidenced. Future research needs to focus on the comparison of underlying factors and mechanisms that lead to the onset of AVH in both patient and non-clinical populations.",0,0 +3093,Longitudinal Relationships between Posttraumatic Stress Symptoms and Sleep Problems in Adolescent Survivors following the Wenchuan Earthquake in China,"To examine the longitudinal relationships between Posttraumatic Stress Disorder (PTSD) and sleep problems among adolescent survivors in the Wenchuan earthquake, China.350 adolescent survivors were randomly selected from several primary and secondary schools in the counties of Wenchuan and Maoxian, the two areas most severely affected by the Wenchuan earthquake. Participants completed Revised Child PTSD Symptom Scale and Sleep Problems Subscale of Self-generated Child Behavior Problems Questionnaire at one year (T1), one-and-a-half years (T2), two years (T3) after the earthquake, respectively.There was a bidirectional relationship between intrusive symptom clusters of PTSD and sleep problems from T1 to T2, and this relationship became non-significant from T2 to T3. There was a one-way predictive relationship of avoidance symptom clusters of PTSD onto sleep problems from T1 to T3. The hyperarousal symptom clusters of PTSD had effects on sleep problems from T1 to T2 but not from T2 to T3, while sleep problems have no significant effect on hyperarousal symptom clusters of PTSD from T1 to T3. In addition, the relationships between three symptom clusters of PTSD and sleep problems weakened with time change.From 1 year to 1.5 years after the earthquake, all the three symptom clusters of PTSD could be important predictive factors for the development and maintenance of sleep problems, while sleep problems could only be risk factors for the intrusive symptom clusters of PTSD. From 1.5 years to 2 years, only the avoidance symptom clusters of PTSD were risk factors for sleep problems, and sleep problems had no significant effects on any symptom clusters of PTSD. Overall, the relationship between PTSD and sleep problems weakened with time change.",0,0 +3094,Training Resilience for High-risk Environments: Towards a Strength-based Approach within the Military,"In this chapter, we introduced the concept of resilience as especially relevant for soldiers as they nowadays operate in cumulative stressful environments. Resilience is different from traditional approaches to building, maintaining and restoring soldiers’ adaptation capabilities, because it focuses on positive adjustment besides the absence of pathology after a potentially traumatic event. We introduced the definition of military resilience the ability to maintain optimal performance during acute situations, positively recover afterwards, and sustain combat motivation under chronic stressful circumstances. Whether a soldier is resilient depends on the available internal and external resources. Several internal and external resources have been identified. However, not many studies have investigated the interplay between internal and external resources. More knowledge on the combined effects of these resources could provide valuable insights in how to best enhance military resilience. We discussed existing resilience interventions for personnel in high-risk occupations. Most interventions focused on individual resources and were based on cognitive principles that aim to enhance awareness and knowledge that will enable a soldier to better cope with stressful situations. Although these interventions addressed the positive adaptation perspective of resilience, the full range of resources has yet to be capitalized upon. In addition, only a few interventions explicitly aim to enhance resilience through external resources. Future interventions should include the positive adaptation perspective and address external resources to enhance effectiveness of resilience interventions.",0,0 +3095,Epigenetic and immune function profiles associated with posttraumatic stress disorder,"The biologic underpinnings of posttraumatic stress disorder (PTSD) have not been fully elucidated. Previous work suggests that alterations in the immune system are characteristic of the disorder. Identifying the biologic mechanisms by which such alterations occur could provide fundamental insights into the etiology and treatment of PTSD. Here we identify specific epigenetic profiles underlying immune system changes associated with PTSD. Using blood samples (n = 100) obtained from an ongoing, prospective epidemiologic study in Detroit, the Detroit Neighborhood Health Study, we applied methylation microarrays to assay CpG sites from more than 14,000 genes among 23 PTSD-affected and 77 PTSD-unaffected individuals. We show that immune system functions are significantly overrepresented among the annotations associated with genes uniquely unmethylated among those with PTSD. We further demonstrate that genes whose methylation levels are significantly and negatively correlated with traumatic burden show a similar strong signal of immune function among the PTSD affected. The observed epigenetic variability in immune function by PTSD is corroborated using an independent biologic marker of immune response to infection, CMV-a typically latent herpesvirus whose activity was significantly higher among those with PTSD. This report of peripheral epigenomic and CMV profiles associated with mental illness suggests a biologic model of PTSD etiology in which an externally experienced traumatic event induces downstream alterations in immune function by reducing methylation levels of immune-related genes.",0,0 +3096,Relief of serotonin selective reuptake inhibitor induced sexual dysfunction with low-dose mianserin in patients with traumatic brain injury,"Rationale: Serotonin selective reuptake inhibitors (SSRI) are commonly used in the treatment of many psychiatric disorders. Although possessing a relatively mild side effect profile, these drugs can cause a number of difficulties, including sexual dysfunction. A variety of strategies have been reported in the management of SSRI-induced sexual dysfunction, including dose reduction, drug holidays, substitution of another antidepressant drug, and various augmentation strategies, including use of sildenafil citrate (Viagra), buspirone, and others. Objectives: We aimed to examine the effect of adding another medication, mianserin, a mainly postsynaptic serotonin 2A agonist, to ongoing SSRI treatment in order to alleviate sexual side effects caused by SSRIs. Methods: The patients included in this study suffered from traumatic brain injury and from psychiatric complications that necessitated the use of SSRIs. Seventeen patients were included in this study, all were being treated with SSRIs, and all complained of sexual dysfunction. Mianserin was added to on-going treatment at low doses, 7.5-15 mg/day. Patients were followed for at least 3 months. Results: Fifteen of the 17 patients (88%) included in this study reported improvement in sexual dysfunction following this intervention. Ten (59%) reported that sexual function achieved pretreatment level. Five (29%) reported ""significant improvement,"" and two (12%) did not respond to this intervention and were given sildenafil citrate, with good results. Side effects were minimal and included dry mouth, drowsiness, headaches, and agitation. Conclusions: The use of low-dose mianserin as an add-on treatment to SSRIs appears to be an effective and well tolerated intervention for sexual dysfunction caused by SSRIs.",0,0 +3097,Assessing Long-Term Effects of Trauma: Diagnosing Symptoms of Avoidance and Numbing,"OBJECTIVE: This study compared the discovery of posttraumatic stress disorder (PTSD) symptoms by means of the Structured Clinical Interview for DSM-III-R (SCID) with a semistructured, psychodynamic clinical interview in a long-term follow-up of the survivors of the Buffalo Creek (W.Va.) flood. METHOD: Videotaped semistructured, psychodynamic clinical interviews of a small group of survivors (N=6) were compared with the results obtained in a prior group-level SCID investigation. RESULTS: Seventy-two percent of the total PTSD symptoms for the subjects studied were elicited exclusively by the psychodynamic clinical interview. PTSD cluster C symptoms of avoidance and numbing of general responsiveness were especially sensitive to discovery by this method. CONCLUSIONS: The psychodynamic clinical interview should be included in the design of studies that seek to investigate long-term effects of trauma, which are especially likely to be manifest in negative symptoms and subtle character change. (Am J Psychiatry 1999; 156:483–485)",0,0 +3098,La honte d’être soi. De l’intérêt de la psychothérapie à médiation artistique pour la réhabilitation des personnes en situation d’exclusion sociale,"Resume Dans le cadre d’un projet de recherche multi-annuel portant sur les relations entre les evenements biographiques traumatogenes, vecus depuis l’enfance, et le fonctionnement structurel de la personnalite a l’âge adulte, nous presentons les resultats d’une etude longitudinale. L’etude concerne l’evaluation d’ateliers d’art-therapie proposes a des personnes en situation de marginalisation et d’exclusion (n = 34). L’exploration du processus therapeutique est basee sur l’application de grilles d’analyse de contenu originales permettant d’utiliser la production artistique a titre de recherche. Des vignettes cliniques illustrent l’etre-au-monde singulier et l’angoisse existentielle des sujets qui se sentent discrimines et deracines et dont l’estime de soi est fortement ebranlee. La discussion porte sur la pertinence des resultats de l’etude, dans le cadre de la litterature actuelle concernant le psycho-traumatisme, la discrimination et la grande precarite, ainsi que sur la possibilite de degager de l’analyse de la production artistique quelques indices montrant une reprise du processus de subjectivation.",0,0 +3099,Associations between the SS variant of 5-HTTLPR and PTSD among adults with histories of childhood emotional abuse: Results from two African American independent samples,"Prior studies have found that the 5-HTTLPR polymorphism in the promoter region of the serotonin transporter gene (SLC6A4) interacts with stressful life events to increase general risk for PTSD, but this association has not extended to African American samples. Further, little is known about the effects of this interaction on specific PTSD symptom clusters, despite indications that clusters may have different biological substrates. The current study examined the interaction between exposure to childhood emotional abuse and 5-HTTLPR genotype on risk for PTSD symptom severity and severity of specific PTSD symptom clusters in two African American samples.Participants were 136 African American household residents from Detroit, MI and 546 African American patients recruited from waiting rooms in primary care clinics in Atlanta, GA. Participants reported emotional abuse exposure and PTSD symptom severity, and provided DNA for triallelic 5-HTTLPR genotyping. Analysis of covariance (ANCOVA) was used to examine main effects and interactions.In both African American samples, 5-HTTLPR genotype modified the effect of emotional abuse on PTSD symptom severity. Participants with the low-expression SS genotype who were exposed to emotional abuse had significantly lower reexperiencing and arousal symptom severity scores.The DNHS genetic sample size was small, and abuse data were assessed retrospectively.The SS variant of 5-HTTLPR appears to buffer against developing the reexperiencing and arousal symptoms of PTSD in two independent African American samples exposed to childhood emotional abuse. Findings also highlight the importance of considering emotional abuse experiences in patients with suspected PTSD.",0,0 +3100,Perceived Threat to Life Predicts Posttraumatic Stress Disorder after Major Trauma: Risk Factors and Functional Outcome,"The importance of psychological morbidity after major trauma, such as posttraumatic stress disorder (PTSD), is continuing to gain attention in trauma outcomes research. The Trauma Recovery Project is a large prospective epidemiologic study designed to examine multiple outcomes after major trauma, including quality of life (QoL) and PTSD. The specific objectives of the present report are to examine risk factors for PTSD and to assess the impact on QoL at the 6-, 12-, and 18-month follow-up time points in the Trauma Recovery Project population.Between December 1, 1993, and September 1, 1996, 1,048 eligible trauma patients triaged to four participating trauma center hospitals in the San Diego Regionalized Trauma System were enrolled in the study. The enrollment criteria for the study included age 18 years and older, admission Glasgow Coma Scale score of 12 or greater, and length of stay > 24 hours. QoL was measured after injury using the Quality of Well-being scale, a sensitive index to the well end of the functioning continuum (range, 0 = death to 1.000 = optimum functioning). Early symptoms of acute stress reaction (SASR) at discharge were assessed using the Impact of Events Scale (score > 30 = SASR). PTSD at 6-month follow-up was diagnosed using standardized Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, criteria. Patient outcomes were assessed at discharge and at 6, 12, and 18 months after discharge.PTSD was diagnosed in 32% (261 of 824) patients at 6-month follow-up. Perceived threat to life predicted PTSD onset (odds ratio [OR], 1.6; p < 0.01) and early SASR (OR, 2.2; p < 0.001). PTSD was more frequent in women (39%) than in men (29%) and in younger low-income patients. Other major risk factors were penetrating trauma (OR, 2.3; p < 0.001) and assaults (OR, 1.5; p < 0.05). PTSD had a major impact on QoL at 6-, 12-, and 18-month follow-up (Quality of Well-being scale score: 6 months, 0.576 vs. 0.658; 12 months, 0.620 vs. 0.691; 18 months, 0.620 vs. 0.700; p < 0.0001).These results provide new and provocative evidence that perceived threat to life and mechanism predict PTSD after major traumatic injury. PTSD had a prolonged and profound impact on short- and long-term outcome and QoL.",0,0 +3101,Characterizing Aggression and Its Association to Anger and Hostility Among Male Veterans With Post-Traumatic Stress Disorder,"The basis for the associations among anger, hostility, aggressive behavior, and post-traumatic stress disorder (PTSD) remains unclear. We suggest classifying aggressive behavior may elucidate the associations among these factors. On the basis of diagnostic and neurobiological similarities between impulsive aggression (IA) and PTSD, we proposed that IA was the predominant form of aggression in PTSD and that anger and hostility would not significantly predict PTSD when IA was also included as a predictor.We used cross-sectional self-report data obtained from two samples of male veterans (N = 136).Over 70% of veterans with PTSD reported IA compared to 29% of those without PTSD. IA, not anger, hostility, or premeditated aggression significantly predicted a diagnosis of PTSD.Associations between anger and PTSD may be unique to individuals with IA, and considering impulsive and premeditated aggressors separately may account for the heterogeneity found within samples of aggressive veterans with PTSD.",0,0 +3102,Whiplash following rear end collisions: a prospective cohort study,"The purpose of this study was to investigate the factors which predict neck pain initially and at 1 year following a rear end collision.All people who reported a rear end collision to the Devon and Cornwall Constabulary were identified and formed the basis of the cohort. People were excluded if they were under 18 years of age or had suffered a head injury. The main outcome measures were neck pain lasting for more than a week after the accident and neck pain at least 1 day a week at 1 year. Logistic regression was used to investigate associations between demographic and accident related variables and outcomes.A total of 1147 people reported rear end collisions to the police during the study period and 503 (44%) agreed to take part in the study. Of the respondents, 78% had neck pain lasting for more than a week and 52% still had pain at 1 year. Age (odds ratio, 95% confidence interval: 0.957, 0.942-0.972) and prior history of neck pain (8.32, 2.89-23.89) were the most important predictors of early neck pain. The most important predictors of pain at 1 year were the initial neck visual analogue scale (VAS) score (1.03, 1.01-1.05) and the presence of a compensation claim (4.09, 1.62-10.32). There was only weak evidence that measures of the severity of the impact were associated with outcomes.Demographic variables and the presence of a compensation suit show the strongest correlation with acute and chronic neck pain following rear end collisions.",0,0 +3103,Development and Initial Validation of Military Deployment-Related TBI Quality-of-Life Item Banks,"To investigate unique factors that affect health-related quality of life (QOL) in individuals with military deployment-related traumatic brain injury (MDR-TBI) and to develop appropriate assessment tools, consistent with the TBI-QOL/PROMIS/Neuro-QOL systems.Three focus groups from each of the 4 Veterans Administration (VA) Polytrauma Rehabilitation Centers, consisting of 20 veterans with mild to severe MDR-TBI, and 36 VA providers were involved in early stage of new item banks development. The item banks were field tested in a sample (N = 485) of veterans enrolled in VA and diagnosed with an MDR-TBI.Focus groups and survey.Developed item banks and short forms for Guilt, Posttraumatic Stress Disorder/Trauma, and Military-Related Loss.Three new item banks representing unique domains of MDR-TBI health outcomes were created: 15 new Posttraumatic Stress Disorder items plus 16 SCI-QOL legacy Trauma items, 37 new Military-Related Loss items plus 18 TBI-QOL legacy Grief/Loss items, and 33 new Guilt items. Exploratory and confirmatory factor analyses plus bifactor analysis of the items supported sufficient unidimensionality of the new item pools. Convergent and discriminant analyses results, as well as known group comparisons, provided initial support for the validity and clinical utility of the new item response theory-calibrated item banks and their short forms.This work provides a unique opportunity to identify issues specific to individuals with MDR-TBI and ensure that they are captured in QOL assessment, thus extending the existing TBI-QOL measurement system.",0,0 +3104,Pharmacotherapy for disordered sleep in post-traumatic stress disorder: a systematic review,"Sleep disorders, such as insomnia and nightmares, are common problems in post-traumatic stress disorder (PTSD), exert a strong negative influence on the quality of life and are a great challenge for clinical psychiatry. Several studies have reported on the efficacy of drugs for the treatment of PTSD-related sleep disorders. These studies have not been systematically reviewed. This is the first review on the effectiveness of sleep medication in PTSD. We performed a Medline, EMBASE and Cochrane Library Indexed search, using the keywords: PTSD, pharmacotherapy, therapy, sleep, nightmares, insomnia and review. From this database, English-language, human subject, data driven papers published after 1980 were selected. Forty eight articles are discussed. Open-label and case studies suggest efficacy for some antidepressants, anticonvulsants and atypical antipsychotics. Only a few placebo-controlled studies have been published. They show promising results for the atypical antipsychotic olanzapine, and the alpha1-adrenoceptor antagonist prazosin. In comparison to the incidence and impact of sleep complaints in PTSD, the pharmacotherapeutic armamentarium for PTSD-related sleep complaints remains poorly investigated. Some recent studies show promising results, especially for alpha1-adrenoceptor and 5-HT2 receptor antagonists. However, randomized controlled trials with larger populations need to be conducted.",0,0 +3105,Post-Traumatic Stress Disorder and Health Problems Among Medically Ill Canadian Peacekeeping Veterans,"Objective: The aim of the present study was to examine the relationship between post-traumatic stress disorder (PTSD) symptom severity and four significant health conditions (gastrointestinal disorders, musculoskeletal problems, headaches, and cardiovascular problems). Method: Participants included 707 Canadian peacekeeping veterans with service-related disabilities, from a random, national Canadian survey, who had been deployed overseas. Results: PTSD severity was significantly related to gastrointestinal disorders, musculoskeletal problems, and headaches, but not to cardiovascular problems. Controlling for demographic factors did not affect PTSD's relationships with the three significant health conditions. Conclusions: The present study supports previous work in finding consistent relations between PTSD severity and specific types of medical problems.",0,0 +3106,An Evaluation of the Relation Between Distress Tolerance and Posttraumatic Stress within a Trauma-Exposed Sample,"The present investigation examined the incremental associations between distress tolerance, or the perceived capacity to tolerate emotional distress, and global posttraumatic stress symptom severity as well as symptom cluster severity, beyond the variance accounted for by number of trauma exposure types and negative affectivity. The sample consisted of 140 adults (72 women; M(age)=25.9, SD=11.1) who endorsed exposure to traumatic life events, as defined by posttraumatic stress disorder diagnostic criterion A (American Psychiatric Association 2000). Participants did not meet diagnostic criteria for current axis I psychopathology. Distress tolerance demonstrated significant incremental associations with global posttraumatic stress symptom severity (p<.01) as well as re-experiencing (p<.05), avoidance (p=.05), and hyperarousal (p<.001) symptom cluster severity. Given the cross-sectional study design, causation cannot be inferred. Theoretical implications and future directions for better understanding associations between distress tolerance and posttraumatic stress are discussed.",0,0 +3107,Neural Correlates of Traumatic Recall in Posttraumatic Stress Disorder,"Functional activation studies of posttraumatic stress disorder (PTSD) using symptom provocation paradigms have implicated dysfunction in limbic and paralimbic brain regions. Increased or altered cerebral blood flow has been observed in amygdala and insula. Decreased or absent activity has been seen in medial prefrontal and anterior cingulate cortex (ACC). These brain regions comprise a neural circuit that has been demonstrated as important for emotional processing and emotional regulation. We studied combat veterans with PTSD (n=16), combat veterans without PTSD (combat controls, n=15), and age-matched healthy control subjects (n=15) with [O-15] H2O PET under a script-driven imagery paradigm of personalized traumatic/stressful and emotionally neutral events. Preliminary findings show that PTSD patients and combat controls had differential blood flow patterns during emotional recall in amygdala, insula and medial prefrontal cortex. Consistent with and extending prior findings, these preliminary results replicate differential patterns of activation in limbic and paralimbic regions of PTSD patients and trauma exposed controls suggesting that these neural substrates may be involved in the deficits in emotional processing in PTSD on one hand, and in resilience to trauma on the other.",0,0 +3108,A Web-Based Early Intervention Can Prevent Long-Term PTS Reactions in Children With High Initial Distress Following Accidental Injury,"The present study explored the targeting of a preventative information provision intervention delivered to children following accidental injury by assessing the impact of initial traumatic distress on response to treatment. Analyses were based on baseline and 6-month outcome of child traumatic stress in a control (n = 28) and an intervention group (n = 31). Moderation of treatment outcome by initial levels of child traumatic stress was assessed through multiple hierarchical regression analyses. Results indicated the interaction between treatment provision and initial level of posttraumatic stress significantly predicted 6-month outcome (β = -.42, p = .019). When initial distress was high, children in the control group demonstrated an increase in trauma symptoms, and had significantly higher trauma symptoms at follow-up than those in the treatment group (d = 0.94, p = .008). When initial distress was not elevated, no significant differences were noted between the groups. These results indicate that a preventative early intervention may be best targeted at children presenting with the specific risk factor of high initial distress.",0,0 +3109,Susceptibility of the Trauma Symptom Inventory to Malingering,"This study examined the sensitivity and specificity of the Trauma Symptom Inventory (TSI; Briere, 1995), a self-report measure of psychological sequelae of potentially traumatic events, to malingering. An optimal cutting score for a validity scale--Atypical Responding (ATR)--designed to identify exaggeration or other unusual response sets was developed in an analogue sample of 155 college students and subsequently applied to TSI profiles from several samples of patients with various psychiatric disorders. Use of a cross-validated T-score cutoff of 61 and below on the ATR scale produced good sensitivity (81%) and specificity (92%) rates in the analogue sample. Participants in the analogue sample who reported a history of traumatic experiences were no more able to successfully malinger trauma symptoms than were participants without such histories. Furthermore, false-positive rates in the clinical samples were generally low, suggesting that relatively few genuinely symptomatic individuals would be misclassified as malingering.",0,0 +3110,Heterogeneity in the response to rheumatoid arthritis (RA): The challenge of accounting for individual variability in the face of chronic disease,,0,0 +3111,Cluster analysis of obsessive-compulsive symptomatology: identifying obsessive-compulsive disorder subtypes.,"There is increasing evidence that obsessive-compulsive disorder (OCD) is a heterogeneous disorder. Different clinical subtypes may be characterized by differing pathophysiological mechanisms and treatment outcomes.A cluster analysis was performed on 45 items of the Yale-Brown Obsessive-Compulsive Symptoms Checklist (YBOCS-CL) for 261 patients with OCD. Cluster solutions emerging at different linkage distance levels, and the associations of identified clusters with demographic, clinical and relevant genetic variables, were investigated.A 6-cluster solution emerged at a linkage distance level of 1.5, and a 3-cluster solution emerged at a linkage distance level of 2.1. The 3 clusters in the latter solution were labeled I) Contamination / washing, II) Hoarding / symmetry / ordering, and III) Obsessional / checking. Increased Cluster III scores were associated with earlier age of OCD onset and the Met/Met (L/L) genotype of the COMT Val158Met polymorphism.The data here are consistent with previous work delineating the different symptom subtypes of OCD, also with previous work suggesting that the Met/Met (L/L) genotype of the COMT Val158Met polymorphism may be associated with anxiety symptoms, as well as with previous work suggesting that dopaminergic genes may be particularly important in early-onset OCD.",0,0 +3112,"Exploratory Factor Analysis of Diagnostic and Statistical Manual, 5th Edition, Criteria for Posttraumatic Stress Disorder","One change to the posttraumatic stress disorder (PTSD) nomenclature highlighted in the Diagnostic and Statistical Manual, 5th Edition (DSM-5; American Psychiatric Association, 2013) is the conceptualization of PTSD as a diagnostic category with four distinct symptom clusters. This article presents exploratory factor analysis to test the structural validity of the DSM-5 conceptualization of PTSD via an online survey that included the PTSD Checklist-5. The study utilized a sample of 113 college students from a large Midwestern university and 177 Amazon Mechanical Turk users. Participants were primarily female, Caucasian, single, and heterosexual with an average age of 32 years. Approximately 30% to 35% of participants met diagnostic criteria for PTSD based on two different scoring criteria. Results of the exploratory factor analysis revealed five distinct symptom clusters. The implications for the classification of PTSD are discussed.",0,0 +3113,Psychological Models in Rehabilitation Psychology,"Abstract Rehabilitation psychology depends upon a broad theoretical base incorporating frameworks, theories, models, and methodologies from many different areas of psychology, as well as from other professions invested in the health and rehabilitation of persons living with disabilities and chronic health conditions. This chapter considers some illustrative models that have been influential in rehabilitation psychology—both historically and in the present—including the biopsychosocial model, and psychological models derived from learning theory and behavior modification, psychoanalytic theory, social psychology, neuropsychology, and cognitive-behavioral theory. The current status of these models, their impact on current clinical practice, and future directions—including the role of dynamic models sensitive to differential trajectories of growth, adjustment, and development over time—will be discussed.",0,0 +3114,Post-traumatic growth in women after childbirth,"Childbirth is a complex event that leads to a variety of psychological outcomes. This cross-sectional study examined post-traumatic growth in women following childbirth (N = 219) using an online questionnaire, and explored associations between growth, support and control during birth, coping after birth and symptoms of post-traumatic stress disorder (PTSD). At least moderate degrees of growth were reported by 50.2% of women and average levels of growth were similar to those reported following accidents and assaults. Growth was positively related to approach coping and the avoidant strategy of seeking alternative rewards, but was unrelated to support and control during birth, other avoidant coping strategies after birth, and PTSD symptoms. It is concluded that growth does occur following childbirth. Further research is needed to clarify factors associated with growth in women following childbirth and to determine if growth is associated with psychological benefits in this population.",0,0 +3115,Posttraumatic Stress Disorder: Protective and Risk Factors in 18 Survivors of a Plane Crash,"The aim of this study is to identify protective and risk factors related to the development of posttraumatic stress disorder (PTSD) on a sample of survivors from a single plane crash. Eighteen survivors were examined 6 months following the event. The subjects all underwent psychiatric interviews, Clinician-Administered PTSD Scale structured interviews, personality and cognitive tests. Only 38.9% of them presented with all of the symptoms of PTSD; 22.2% showed no symptoms for PTSD; remaining survivors exhibited emotional/affective symptoms related to the event. In addition to the severity of the traumatic event itself, other risk factors identified were the loss of a relative, the manifestation of depressive symptoms, and the severity of physical injuries sustained. Low levels of hostility and high levels of self-efficacy represented protective factors against developing PTSD.",0,0 +3116,Glutamate and anxiety disorders,"Anxiety disorders are among the most prevalent psychiatric disorders, but they represent a particular challenge for treatment. The standard first-line treatments, including antidepressants, benzodiazepines, and buspirone, result in significant response rates for a majority of patients; however, unfavorable side effect profiles or risk for dependency for particular agents might limit their use by anxious patients, who often have low thresholds for medication discontinuation. Novel pharmacologic agents that modulate particular receptors, ion channels, or transporters relevant to glutamatergic neurotransmission may represent a new approach to the treatment of anxiety disorders, with generally more favorable side effect profiles. Although the role of glutamate in the pathophysiology of anxiety disorders is listill being elucidated, the use of these agents in treatment of anxiety disorders and commonly comorbid conditions such as substance abuse and mood disorders will continue to increase.",0,0 +3117,"Post-disaster stressful life events and WTC-related posttraumatic stress, depressive symptoms, and overall functioning among responders to the World Trade Center disaster","The current study examined contributions of post-disaster stressful life events in relation to the maintenance of WTC-related posttraumatic stress, depressive symptoms, and overall functioning among rescue, recovery, and clean-up workers who responded to the September 11, 2001 World Trade Center (WTC) terrorist attacks.Participants were 18,896 WTC responders, including 8466 police officers and 10,430 non-traditional responders (85.8% male; 86.4% Caucasian; M(age) = 39.5, SD = 8.8) participating in the WTC Health Program who completed an initial examination between July, 2002 and April, 2010 and who were reassessed, on average, 2.5 years later.Path analyses were conducted to evaluate contributions of life events to the maintenance of WTC-related posttraumatic stress, depressive symptoms, and overall functioning. These analyses were stratified by police and non-traditional responder groups and adjusted for age, sex, time from 9/11 to initial visit, WTC exposures (three WTC contextual exposures: co-worker, friend, or a relative died in the disaster; co-worker, friend, or a relative injured in the disaster; and responder was exposed to the dust cloud on 9/11), and interval from initial to first follow-up visit. In both groups, WTC-related posttraumatic stress, depressive symptoms, and overall functioning were stable over the follow-up period. WTC exposures were related to these three outcomes at the initial assessment. WTC-related posttraumatic stress, depressive symptoms, and overall functioning, at the initial assessment each predicted the occurrence of post-disaster stressful life events, as measured by Disaster Supplement of the Diagnostic Interview Schedule. Post-disaster stressful life events, in turn, were associated with subsequent mental health, indicating partial mediation of the stability of observed mental health.The present findings suggest a dynamic interplay between exposure, post-disaster stressful life events, and WTC-related posttraumatic stress, depressive symptoms, and overall functioning among WTC disaster responders.",0,0 +3118,Posttraumatic stress following childbirth: A review,"To assess the empirical basis of prevalence and risk factors of childbirth-related posttraumatic stress symptoms and PTSD in mothers, the relevant literature was critically reviewed. A MEDLINE and PSYCHLIT search using the key words ""posttraumatic stress"", ""PTSD"", ""childbirth"" and ""traumatic delivery"" was performed. The generated list of articles was supplemented by a review of their bibliographies. A total of 31 articles was selected. The primary inclusion criterion was report of posttraumatic stress symptoms or PTSD specifically related to childbirth. Case studies and quantitative studies on regular childbirth and childbirth by emergency cesarean section were identified. Consistency among studies was found with regard to development of posttraumatic stress symptoms as a consequence of traumatic delivery. Methodological issues concerning prevalence and risk factors were discussed. Case studies and quantitative studies confirm that childbirth may be experienced as so emotionally intense that it can lead to the development of posttraumatic stress symptoms or even a PTSD-profile. Among the identified risk factors were a history of psychological problems, trait anxiety, obstetric procedures, negative aspects in staff-mother contact, feelings of loss of control over the situation, and lack of partner support. The conclusion of the current review is twofold. First, traumatic reactions to childbirth are an important public health issue. Secondly, studying childbirth offers opportunity to prospectively study the development of posttraumatic stress reactions.",0,0 +3119,Oral administration of Bacillus subtilis strain BSB3 can prevent heat stress-related adverse effects in rats,"To determine the efficacy of Bacillus subtilis strain in prevention of heat stress-related complications in rats.Male Sprague-Dawley rats weighing 250-300 g were treated by oral gavage with B. subtilis BSB3 strain or PBS twice a day for 2 days. Half of the rats of each group were exposed to heat stress (45°C, relative humidity 55% for 25 min), while the remaining rats were placed at identical conditions but at 25°C. Bacterial translocation, histological changes in the intestine, cytokines profile, serum lipopolysaccharide level (LPS), as well as vesiculation of erythrocytes were analysed and compared between groups. Adverse effects of heat stress (morphological changes in intestine, bacterial translocation, elevated levels of LPS and IL-10, increased vesiculation of erythrocytes) were observed only in rats not protected with B. subtilis strain and exposed to heat. All registered parameters in rats pretreated with bacilli and exposed to heat were similar to control groups.Bacillus subtilis BS3B strain was effective in the prevention of complications related to heat stress in rats.This work will contribute towards better understanding of probiotics' mechanisms of action and will bring new approaches to characterize and use of beneficial bacteria.",0,0 +3120,"Physical Health Status of World Trade Center Rescue and Recovery Workers and Volunteers—New York City, July 2002–August 2004",,0,0 +3121,Stress and Cortisol in Disaster Evacuees: An Exploratory Study on Associations with Social Protective Factors,"Though cumulative emotional and physical effects of disasters may diminish evacuees’ short and long-term mental and physical health, social factors may buffer such consequences. We approached survivors of the October 2007 San Diego, California firestorms. We gathered data during the evacuation and 3 months afterward. Questionnaires measured social support as well as PTSD, depression, and anxiety symptoms. Saliva samples were used to assess the stress hormone, cortisol. Analyses, adjusting for age, gender, and socioeconomic status, showed PTSD symptoms were associated with flattening of the diurnal cortisol rhythm during evacuation. Secondary analyses showed those reporting a family emphasis on moral and religious values had lower psychological distress. Though anxiety symptoms had significantly decreased in the overall sample at follow-up, blunted cortisol rhythms persisted among those individuals with continued high anxiety. Results highlight a possible psychological, and perhaps a physiological, benefit of social and existential factors in disaster situations. Future work should explore the role of psychosocial factors and stress physiology in the development of long-term health concerns among individuals exposed to disaster. © 2015, Springer Science+Business Media New York.",0,0 +3122,Role of distinct PTSD symptoms in intimate partner reabuse: A prospective study,"This prospective study examines the impact of four posttraumatic stress disorder (PTSD) symptom clusters (hyperarousal, reexperiencing, numbing, and avoidance) on reabuse over 1 year among women exposed to intimate partner violence (IPV). The covariates include severity of IPV, a history of childhood violence, and characteristics of the abusive relationship. Although both hyperarousal and numbing symptoms were higher at baseline among women subsequently reabused, only numbing symptoms increased the odds of reabuse after controlling for the covariates. Greater IPV severity and shorter relationship duration also increased the risk of reabuse. Results indicate that specific symptoms of PTSD, especially numbing, need to be addressed to increase the safety of women seeking services for IPV.",0,0 +3123,"MMPI, MMPI-2 and PTSD: Overview of scores, scales, and profiles","A number of issues should be considered when applying profile interpretations and subscales derived from the original MMPI. These issues and the overall utility of the MMPI-2 for posttraumatic stress disorder (PTSD) evaluations are summarized. The Keane PTSD scale is found to be an effective tool for differential diagnosis when a cut-off score of 28 is used. The Schlenger PTSD scale warrants additional study. Various MMPI-2 validity scales are useful in detecting malingering, but concurrence regarding cut-off scores is lacking. The 2-8/8-2 MMPI PTSD profile does not emerge as consistently on the MMPI-2 as it did on the MMPI, due to the frequent elevation of scale 7 on the MMPI-2.",0,0 +3124,Coping strategies in civilians during air attacks,"Coping strategies may influence the psychological outcome after a stressful event, both as coping at the time of the event and as strategies of dealing with its consequences after the event. The aim of the study was to investigate coping strategies used by civilians during the air attacks in Yugoslavia in 1999, and their association with the level of exposure, gender and psychological symptoms 1 year later.The sample is a non-selective group of 139 medical students from the University of Belgrade, Yugoslavia. Open questions and content analysis were used to assess coping strategies. Symptoms of intrusion and avoidance were assessed, as well as general psychological symptoms.Content analysis of answers to open questions revealed nine categories of coping strategies (sport and walks, leisure activities, talking and gathering, humor, avoidance, philosophical approach, getting information, work, and substance abuse). A cluster analysis identified three groups of students with different styles of coping. Students that used dominantly 'talking and gathering' had the highest, and the ones that mostly used 'leisure activities' the lowest scores on intrusion. There were significant gender differences in how coping strategies were associated with intrusive symptoms.The type of coping strategies used during the air attacks may contribute to the level of intrusive symptoms 1 year after the event. Different coping strategies might be effective in men and women to reduce intrusive symptoms. Longitudinal and prospective studies are needed to draw definite conclusions on causal relationships between coping strategies and levels of posttraumatic stress.",0,0 +3125,The Parent Report Form of the CHIP–Child Edition,"Valid, comprehensive instruments to describe, monitor, and evaluate health from childhood through adolescence are almost nonexistent, but are critical for health resource planning, evaluation of policy, preventive, and clinical interventions, and understanding trajectories of health during this important period of life.The objectives of this study were to describe the development, testing, and final versions of the Parent Report Form of the Child Health and Illness Profile-Child Edition (CHIP-CE/PRF), designed to measure the health of children 6 to 11 years old from the caregiver perspective.Parents (N=1049) completed a version of the CHIP-CE/PRF in 4 locations in the United States, either in clinic waiting rooms or their homes. They differed in race/ethnicity, socioeconomic level, and native language.The Parent CHIP-CE is feasible; parents with a 5th-grade reading level complete the 76-item PRF in 20 minutes. Its domains (Satisfaction, Comfort, Risk Avoidance, Resilience, and Achievement) measure structurally distinct, interrelated aspects of health. Domain reliability is high: internal consistency=0.79-0.88; retest reliability (ICC)=0.71-0.85. Validity is supported. The scale scores are sensitive to predicted age, gender, and socioeconomic status differences in health.The CHIP-Child Edition/Parent Report Form is a psychometrically sound, conceptually based measure of child health that works well in diverse populations. It produces scores that parallel those of children on the CHIP-CE/CRF and adolescents on the CHIP-AE and allows health to be consistently assessed from childhood through adolescence. It should meet many needs for describing, monitoring, and understanding child health and evaluating outcomes of interventions.",0,0 +3126,Du pré-partum au post-partum : étude des profils et des symptomatologies maternelles,"Resume Objectifs Si les recherches sur les troubles psychiatriques en pre-partum sont nombreuses, il n’existe, a notre connaissance, aucune etude se focalisant sur les profils psychopathologiques des femmes en pre-partum. Le but de cette etude longitudinale est d’examiner les typologies de femmes en pre-partum et d’examiner si ces typologies se differencient au niveau des symptomes de troubles en post-partum immediat et a long terme. Participants, materiel et methode Quarante-six femmes ont rempli, entre le 8e et le 9e mois de grossesse (T1), des questionnaires mesurant la peur de l’accouchement et les symptomes de stress pretraumatique. Trois jours post-accouchement (T2), elles ont complete des mesures concernant l’experience et la douleur de l’accouchement et la detresse perinatale. A 6 semaines du post-partum (T3), des echelles mesurant les symptomes de depression postnatale et de stress post-traumatique ont egalement ete remplies. La symptomatologie anxio-depressive a egalement ete mesuree aux 3 temps de l’etude. Resultats Quatre typologies ont ete identifiees en pre-partum : le « groupe resilient » presentant une faible symptomatologie ; le « groupe peur » avec des symptomes averes de peur de l’accouchement ; le « groupe anxieux » rapportant une anxiete suspectee ; le « groupe stress pretraumatique-peur-anxiete-depression » avec des symptomes multiples. Nos resultats montrent egalement un impact des troubles en pre-partum sur les symptomatologies presentes en post-partum. Conclusion Les recherches sur les troubles en pre-partum et leurs etiologies sont a encourager afin de prevenir la formation de troubles secondaires.",0,0 +3127,Posttraumatic stress among children in Kurdistan,"To identify a posttraumatic stress disorder profile for the Child Behaviour Checklist.Checklist item scores for 806 school-aged children in Iraqi Kurdistan (201 randomly selected from the general population, 241 orphans, 199 primary medical care visitors and 165 hospital in-patients) were analysed against the Posttraumatic Stress Symptom Scale for Children (PTSS-C) scores, estimating not only stress diagnoses, but also nonstress-related, child-specific posttraumatic symptoms.Twenty checklist items, which revealed significant correlations with the stress diagnoses, formed the checklist-stress profile with acceptable reliability and validity, and significant correlation to the PTSS-C estimates.A child-specific stress profile for the checklist is recommended for use as a screening instrument.",0,0 +3128,"Negative Affect Predicts Adults’ Ratings of the Current, but Not Childhood, Impact of Adverse Childhood Events","Adverse childhood events (ACE's) have been empirically related to a wide range of negative health and mental health outcomes. However, not all individuals who experience ACE's follow a trajectory of poor outcomes, and not all individuals perceive the impact of ACE's as necessarily negative. The purpose of this study was to investigate positive and negative affect as predictors of adults' ratings of both the childhood and adult impact of their childhood adversity. Self-report data on ACE experiences, including number, severity, and 'impact' were collected from 158 community members recruited on the basis of having adverse childhood experiences. Results indicated that, regardless of event severity and number of different types of adverse events experienced, high levels of negative affect were the strongest predictor of whether the adult impact of the adverse childhood events was rated as negative. All individuals rated the childhood impact of events the same. Implications are discussed. © 2012 Springer Science+Business Media, LLC.",0,0 +3129,Effects of psychological and biomechanical trauma on brain and behavior,"The current conflicts in Iraq and Afghanistan have resulted in a large cohort of military personnel exposed to combat-related psychological trauma as well as biomechanical trauma, including proximity to blast events. Historically, the long-term effects of both types of trauma have been viewed as having different neural substrates, with some controversy over the proper attribution of such symptoms evident after each of the major conflicts of the last century. Recently, great effort has been directed toward distinguishing which neuropsychiatric sequelae are due to which type of trauma. Of interest, however, is that the chronic effects of exposure to either process are associated with a significant overlap in clinical symptoms. Furthermore, similar brain regions are vulnerable to the effects of either psychological or biomechanical trauma, raising the possibility that shared mechanisms may underlie the clinically observed overlap in symptom profile. This paper reviews the literature on the neural substrate of biomechanical and psychological injury and discusses the implications for evaluation and treatment of the neuropsychiatric sequelae of these processes.",0,0 +3130,Bullying boys: the traumatic effects of bullying in male adolescent learners,"This study investigated the nature and extent of the relationship between bullying and trauma among male adolescent learners. Trauma was operationalised through the multiple constructs of post-traumatic stress, anxiety, depression, dissociation and anger.In this quantitative study, two objective measures were administered (viz. the Olweus Bullying/ Victimisation Scale and the Trauma Symptom Checklist for children) to a sample of male adolescent learners between the ages of 12 and 17, from a South African male-only high school (n = 486).Statistical analysis (correlational analysis and MANOVA) produced evidence to suggest that there was a statistically significant relationship between bullying and trauma, and this was strongest for the victim role. The relationship between bullying and trauma was dependent on the frequency of bullying; as the frequency of being bullied increased so too did the mean scores of all the five trauma subscales. In general, the findings indicated that learners presented with elevated levels of internalising trauma outcomes. Depression demonstrated the highest correlation with the victim role, followed by Posttraumatic stress. In addition, 22.4% of learners could be clinically and sub-clinically diagnosed with post-traumatic stress and 21.0% with dissociation. Overall, the findings corroborate the argument that repetitive stressful events (such as bullying) are related to symptom-clusters of ongoing trauma.",0,0 +3131,"Circulating lymphocyte subsets, natural killer cell cytotoxicity, and components of hypothalamic-pituitary-adrenal axis in Croatian war veterans with posttraumatic stress disorder: cross-sectional study.","To determine peripheral blood lymphocyte subsets--T cells, helper T cells, cytotoxic T cells, B cells, and natural killer cells, natural killer cell cytotoxicity, serum cortisol concentration, and lymphocyte glucocorticoid receptor expression in Croatian combat veterans diagnosed with chronic posttraumatic stress disorder (PTSD); and to examine the relationship between the assessed parameters and the time passed since the traumatic experience.Well-characterized group of 38 PTSD patients was compared to a group of 24 healthy civilians. Simultaneous determination of lymphocyte subsets and the expression of intracellular glucocorticoid receptor was performed using three-color flow cytometry. Natural killer cell cytotoxicity was measured by (51)Cr-release assay and the serum cortisol concentration was determined by radioimmunoassay.We found higher lymphocyte counts in PTSD patients than in healthy controls (2294.7+/-678.0/microL vs 1817.2+/-637.0/microL, P=0.007) and a positive correlation between lymphocyte glucocorticoid receptor expression and the number of years that passed from the traumatic experience (r(s)=0.43, P=0.008). Lymphocyte glucocorticoid receptor expression positively correlated with serum cortisol concentration both in PTSD patients (r=0.46, P=0.006) and healthy controls (r=0.46, P=0.035).This study confirmed that the immune system was affected in the course of chronic PTSD. Our findings also indicated that the hypothalamic-pituitary-adrenal axis profile in PTSD was associated with the duration of the disorder. Due to the lack of power, greater sample sizes are needed to confirm the results of this study.",0,0 +3132,Levels of Trauma Among Women Inmates with HIV Risk and Alcohol Use Disorders: Behavioral and Emotional Impacts,"An increasing number of women are involved in the criminal justice system. Women in corrections are often of low socioeconomic status, medically underserved and exposed to a variety of traumatic events. Programs and services provided in correctional settings should be informed by the unique profiles and needs of these women. This study sought to identify distinct sub-groups (classes) of incarcerated women based on differences in their qualitative (types of trauma) and quantitative (number of) trauma experiences. Demographics, psychosocial and behavioral characteristics were measured in 149 women entering jail, who reported recent hazardous drinking and HIV sexual risk behavior. Two classes based on trauma exposure of women were identified through latent class analysis. The classes did not differ with respect to qualitative differences in trauma exposure (both classes reported all forms of trauma), but did differ with respect to quantitative differences (Class 2 reported more exposure to trauma in all categories than Class 1). The classes also differed significantly on current psychological functioning, alcohol treatment, problems, and consequences, drug histories, sexual risk, medical conditions, and social group characteristics. In all areas, members of Class 2 were significantly more likely to report higher levels of measured variables. Nearly all women in our sample reported levels of trauma exposure, suggesting a need for intervention and attention. Through identifying these separate classes, limited resources for trauma survivors in the correctional setting could be most appropriately allocated.",0,0 +3133,Borderline personality disorder and Axis I psychiatric and substance use disorders among women experiencing homelessness in three US cities,"In this study, we report prevalence rates of borderline personality disorder (BPD) and Axis I psychiatric and substance use disorders among randomly selected women who were experiencing episodes of homelessness in three US cities.The sample consists of 156 women, 79 from Omaha, NE, 39 from Pittsburgh, PA, and 38 from Portland, OR. It included 140 women from shelters and 16 women from meal locations. Latent class analysis was used to evaluate BPD symptoms.A large majority of the women (84.6 %) met criteria for at least one lifetime psychiatric disorder, about three-fourths (73.1 %) met criteria for a psychiatric disorder in the past year, and 39.7 % met past month criteria for a psychiatric disorder. Approximately three-fourths of the sample (73.7 %) met lifetime criteria for at least two disorders, about half (53.9 %) met criteria for at least three lifetime disorders, and approximately one-third (39.1 %) met criteria for four or more disorders. Latent class analyses indicated that 16.7 % of the women could be categorized as low self-harm BPD and 19.9 % high self-harm BPD.In shelters and in treatment settings, these women will present with complex histories of multiple serious psychiatric disorders. They are highly likely to manifest symptoms of BPD, post-traumatic stress disorder, and substance abuse disorders in addition to other psychiatric symptoms which will add to clinical complications.",0,0 +3134,Support for the mutual maintenance of pain and post-traumatic stress disorder symptoms,"Background Pain and post-traumatic stress disorder (PTSD) are frequently co-morbid in the aftermath of a traumatic event. Although several models attempt to explain the relationship between these two disorders, the mechanisms underlying the relationship remain unclear. The aim of this study was to investigate the relationship between each PTSD symptom cluster and pain over the course of post-traumatic adjustment. Method In a longitudinal study, injury patients ( n =824) were assessed within 1 week post-injury, and then at 3 and 12 months. Pain was measured using a 100-mm Visual Analogue Scale (VAS). PTSD symptoms were assessed using the Clinician-Administered PTSD Scale (CAPS). Structural equation modelling (SEM) was used to identify causal relationships between pain and PTSD. Results In a saturated model we found that the relationship between acute pain and 12-month pain was mediated by arousal symptoms at 3 months. We also found that the relationship between baseline arousal and re-experiencing symptoms, and later 12-month arousal and re-experiencing symptoms, was mediated by 3-month pain levels. The final model showed a good fit [χ 2 =16.97, df=12, p >0.05, Comparative Fit Index (CFI)=0.999, root mean square error of approximation (RMSEA)=0.022]. Conclusions These findings provide evidence of mutual maintenance between pain and PTSD.",0,0 +3135,"Anxiety, post-traumatic stress disorder and depression in Korean War veterans 50 years after the war","Background There has been no comprehensive investigation of psychological health in Australia's Korean War veteran population, and few researchers are investigating the health of coalition Korean War veterans into old age. Aims To investigate the association between war service, anxiety, post-traumatic stress disorder (PTSD) and depression in Australia's 7525 surviving male Korean War veterans and a community comparison group. Method A survey was conducted using a self-report postal questionnaire which included the PTSD Checklist, the Hospital Anxiety and Depression scale and the Combat Exposure Scale. Results Post-traumatic stress disorder (OR 6.63, P <0.001), anxiety (OR 5.74, P <0.001) and depression (OR 5.45, P <0.001) were more prevalent in veterans than in the comparison group. These disorders were strongly associated with heavy combat and low rank. Conclusions Effective intervention is necessary to reduce the considerable psychological morbidity experienced by Korean War veterans. Attention to risk factors and early intervention will be necessary to prevent similar long-term psychological morbidity in veterans of more recent conflicts.",0,0 +3136,Lamotrigine has an anxiolytic-like profile in the rat conditioned emotional response test of anxiety: a potential role for sodium channels?,"Rationale: Many anticonvulsants are used in disorders other than epilepsy. For example, lamotrigine is reported to be effective in post-traumatic stress disorder and mania. Objective: We assessed the effects of the anticonvulsants lamotrigine, valproate and carbamazepine in an animal model of anxiety. We assessed a wide range of pharmacological tools to delineate the mechanism of lamotrigine's anxiolytic effect. Methods: We assessed these compounds in the rat conditioned emotional response (CER) test of anxiety. Results: Lamotrigine (30-80 mg/kg) dose-dependently and reproducibly engendered an anxiolytic response in this test, with similar efficacy to benzodiazepines. Carbamazepine (20-40 mg/kg) and riluzole (10 mg/kg), which block Na+ channels by a similar mechanism as lamotrigine, were also anxiolytic. By contrast, valproate (100-600 mg/kg) was inactive and appears to differ in its interaction with Na+ channels. The SSRI paroxetine, the GABAA receptor positive modulator propofol, the NMDA antagonists memantine and (+)MK-801, and the Ca2+ channel antagonist nifedipine were all inactive in the CER test, suggesting these mechanisms may not mediate the anxiolytic effect of lamotrigine. More directly, we showed that the anxiolytic effect of lamotrigine could be blocked by co-administering rats with the Na+ channel activator veratrine (0.1 mg/kg). By contrast, neither the Ca2+ channel agonist BAYK8644 (0.5 mg/kg) nor the 5-HT1A or 5-HT 1/2 antagonists WAY100635 (0.3 mg/kg) and metergoline (3 mg/kg), respectively, were able to block the effect. Conclusion: Lamotrigine's anxiolytic effect in the CER test may be mediated via block of Na+ channels, and this may represent a target for the development of novel anxiolytics. (",0,0 +3137,Posttraumatic symptoms and suicide risk,"Abstract The relationship between traumatic events and suicide risk is well known. Most researches agree that Posttraumatic Stress Disorder (PTSD) plays a major role in this link. However, less is known about the specific posttraumatic symptom constellation that predicts suicide risk. In the current study we examined the posttraumatic symptom's profile which is associated with suicide risk, in a community sample of men with no known psychopathology. The research population included 103 men aged 25–45. They were administered the ‘Traumatic Event Questionnaire’, ‘PTSD Scale’, ‘Suicide Risk Scale’ (SRS) and the SCL-90. Results indicated that suicide risk was predicted by high levels of depression and hostility. High levels of arousal symptom and low levels of avoidance added a significant contribution to that prediction, suggesting that avoidance may serve as a buffer against suicide risk, while high levels of arousal may increase suicide risk. These findings may serve mental health professionals to identify high-risk persons also in a non-clinical population.",0,0 +3138,“War neurosis” and associated physical conditions: an exploratory statistical analysis,Abstract Records of the war service disability claims for Australian Vietnam veterans in Tasmania (n = 751) were analysed to establish patterns of interrelationships between categories of disability. The predicted relationship between psychiatric disability and stress related skin disabilities was strongly supported and relationships between psychiatric and other medical disabilities were found. An exploratory principal components analysis produced three independent components which accounted for 21.2 percent of total variance. Component 1 was interpreted as a general military service component and components 2 and 3 were labelled as stress components. The most likely interpretation of the two stress components was that they reflect differences in profiles of records for disability claims depending on the time when the disability presented. The relevance of the findings is discussed.,0,0 +3139,Efficacy of Psychoeducational Group Therapy in Reducing Symptoms of Posttraumatic Stress Disorder Among Multiply Traumatized Women,"Objective: The role of group therapy in treatment of posttraumatic stress disorder (PTSD) has been traditionally restricted to issues of self-esteem and interpersonal relationships, rather than primary symptoms of the disorder. In this study, the authors examined the effectiveness of a 16-week trauma-focused, cognitive-behavioral group therapy, named Interactive Psychoeducational Group Therapy, in reducing primary symptoms of PTSD in five groups (N=29) of multiply traumatized women diagnosed with chronic PTSD. Method: The authors made assessments at baseline, at 1-month intervals during treatment, at termination, and at 6-month follow-up by using self-report and structured interview measures of PTSD and psychiatric symptoms. The absence of a control group limits the conclusions drawn from the study.Results: At termination, subjects showed significant reductions in all three clusters of PTSD symptoms (i.e., reexperiencing, avoidance, and hyperarousal) and in depressive symptoms; they showed near-significant reductions in general psychiatric and dissociative symptoms, at termination. These improvements were sustained at 6-month follow-up.Conclusions: The role of group therapy in PTSD treatment should not be prematurely restricted to addressing self-esteem and interpersonal dimensions only. The use of structured, cognitive-behavioral elements within the group format may allow for more targeted treatment of core symptoms of the disorder. Am J Psychiatry 1998; 155: 1172-1177",0,0 +3140,Validation of the UCLA Child Post traumatic stress disorder-reaction index in Zambia,"Sexual violence against children is a major global health and human rights problem. In order to address this issue there needs to be a better understanding of the issue and the consequences. One major challenge in accomplishing this goal has been a lack of validated child mental health assessments in low-resource countries where the prevalence of sexual violence is high. This paper presents results from a validation study of a trauma-focused mental health assessment tool - the UCLA Post-traumatic Stress Disorder - Reaction Index (PTSD-RI) in Zambia.The PTSD-RI was adapted through the addition of locally relevant items and validated using local responses to three cross-cultural criterion validity questions. Reliability of the symptoms scale was assessed using Cronbach alpha analyses. Discriminant validity was assessed comparing mean scale scores of cases and non-cases. Concurrent validity was assessed comparing mean scale scores to a traumatic experience index. Sensitivity and specificity analyses were run using receiver operating curves.Analysis of data from 352 youth attending a clinic specializing in sexual abuse showed that this adapted PTSD-RI demonstrated good reliability, with Cronbach alpha scores greater than .90 on all the evaluated scales. The symptom scales were able to statistically significantly discriminate between locally identified cases and non-cases, and higher symptom scale scores were associated with increased numbers of trauma exposures which is an indication of concurrent validity. Sensitivity and specificity analyses resulted in an adequate area under the curve, indicating that this tool was appropriate for case definition.This study has shown that validating mental health assessment tools in a low-resource country is feasible, and that by taking the time to adapt a measure to the local context, a useful and valid Zambian version of the PTSD-RI was developed to detect traumatic stress among youth. This valid tool can now be used to appropriately measure treatment effectiveness, and more effectively and efficiently triage youth to appropriate services.",0,0 +3141,"Prevalence, Risk, and Correlates of Posttraumatic Stress Disorder Across Ethnic and Racial Minority Groups in the United States","We assess whether posttraumatic stress disorder (PTSD) varies in prevalence, diagnostic criteria endorsement, and type and frequency of potentially traumatic events (PTEs) among a nationally representative US sample of 5071 non-Latino whites, 3264 Latinos, 2178 Asians, 4249 African Americans, and 1476 Afro-Caribbeans.PTSD and other psychiatric disorders were evaluated using the World Mental Health-Composite International Diagnostic Interview (WMH-CIDI) in a national household sample that oversampled ethnic/racial minorities (n=16,238) but was weighted to produce results representative of the general population.Asians have lower prevalence rates of probable lifetime PTSD, whereas African Americans have higher rates as compared with non-Latino whites, even after adjusting for type and number of exposures to traumatic events, and for sociodemographic, clinical, and social support factors. Afro-Caribbeans and Latinos seem to demonstrate similar risk to non-Latino whites, adjusting for these same covariates. Higher rates of probable PTSD exhibited by African Americans and lower rates for Asians, as compared with non-Latino whites, do not appear related to differential symptom endorsement, differences in risk or protective factors, or differences in types and frequencies of PTEs across groups.There appears to be marked differences in conditional risk of probable PTSD across ethnic/racial groups. Questions remain about what explains risk of probable PTSD. Several factors that might account for these differences are discussed, as well as the clinical implications of our findings. Uncertainty of the PTSD diagnostic assessment for Latinos and Asians requires further evaluation.",0,0 +3142,Stress modulation of drug self-administration: Implications for addiction comorbidity with post-traumatic stress disorder,"Drug abuse and dependence present significant health burdens for our society, affecting roughly 10% of the population. Stress likely contributes to the development and persistence of drug use; for example, rates of substance dependence are elevated among individuals diagnosed with post-traumatic stress disorder (PTSD). Thus, understanding the interaction between stress and drug use, and associated neuroadaptations, is key for developing therapies to combat substance use disorders. For this purpose, many rodent models of the effects of stress exposure on substance use have been developed; the models can be classified according to three categories of stress exposure: developmental, adult nonsocial, and adult social. The present review addresses preclinical findings on the effect of each type of trauma on responses to and self-administration of drugs of abuse by focusing on a key exemplar for each category. In addition, the potential efficacy of targeting neuropeptide systems that have been implicated in stress responses and stress system neuroadaptation in order to treat comorbid PTSD and substance abuse will be discussed. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0,0 +3143,GAD65 haplodeficiency conveys resilience in animal models of stress-induced psychopathology,"GABAergic mechanisms are critically involved in the control of fear and anxiety, but their role in the development of stress-induced psychopathologies, including post-traumatic stress disorder (PTSD) and mood disorders is not sufficiently understood. We studied these functions in two established mouse models of risk factors for stress-induced psychopathologies employing variable juvenile stress and/or social isolation. A battery of emotional tests in adulthood revealed the induction of contextually generalized fear, anxiety, hyperarousal and depression-like symptoms in these paradigms. These reflect the multitude and complexity of stress effects in human PTSD patients. With factor analysis we were able to identify parameters that reflect these different behavioral domains in stressed animals and thus provide a basis for an integrated scoring of affectedness more closely resembling the clinical situation than isolated parameters. To test the applicability of these models to genetic approaches we further tested the role of GABA using heterozygous mice with targeted mutation of the GABA synthesizing enzyme GAD65 [GAD65(+/-) mice], which show a delayed postnatal increase in tissue GABA content in limbic and cortical brain areas. Unexpectedly, GAD65(+/-) mice did not show changes in exploratory activity regardless of the stressor type and were after the variable juvenile stress procedure protected from the development of contextual generalization in an auditory fear conditioning experiment. Our data demonstrate the complex nature of behavioral alterations in rodent models of stress-related psychopathologies and suggest that GAD65 haplodeficiency, likely through its effect on the postnatal maturation of GABAergic transmission, conveys resilience to some of these stress-induced effects.",0,0 +3144,Prevention of chronic PTSD with early cognitive behavioral therapy. A meta-analysis using mixed-effects modeling,"Post-traumatic stress disorder (PTSD) is of great interest to public health, due to the high burden it places on both the individual and society. We meta-analyzed randomized-controlled trials to examine the effectiveness of early trauma-focused cognitive-behavioral treatment (TFCBT) for preventing chronic PTSD. Systematic bibliographic research was undertaken to find relevant literature from on-line databases (Pubmed, PsycINFO, Psyndex, Medline). Using a mixed-effect approach, we calculated effect sizes (ES) for the PTSD diagnoses (main outcome) as well as PTSD and depressive symptoms (secondary outcomes), respectively. Calculations of ES from pre-intervention to first follow-up assessment were based on 10 studies. A moderate effect (ES = 0.54) was found for the main outcome, whereas ES for secondary outcomes were predominantly small (ES = 0.27-0.45). The ES for the main outcome decreased to small (ES = 0.34) from first follow-up to long-term follow-up assessment. The mean dropout rate was 16.7% pre- to post-treatment. There was evidence for the impact of moderators on different outcomes (e.g., the number of sessions on PTSD symptoms). Future studies should include survivors of other trauma types (e.g., burn injuries) rather than predominantly survivors of accidents and physical assault, and should compare early TFCBT with other interventions that previously demonstrated effectiveness.",0,0 +3145,Statistical and Substantive Checking in Growth Mixture Modeling: Comment on Bauer and Curran (2003).,This commentary discusses the D. J. Bauer and P. J. Curran (2003) investigation of growth mixture modeling. Single-class modeling of nonnormal outcomes is compared with modeling with multiple latent trajectory classes. New statistical tests of multiple-class models are discussed. Principles for substantive investigation of growth mixture model results are presented and illustrated by an example of high school dropout predicted by low mathematics achievement development in Grades 7-10.,0,0 +3146,Neurostructural imaging findings in children with post-traumatic stress disorder: Brief review,"Child maltreatment has been associated with different psychiatric disorders. Studies on both animals and humans have suggested that some brain areas would be directly affected by severe psychological trauma. The pathophsysiology of post-traumatic stress disorder (PTSD) appears to be related to a complex interaction involving genetic and environmental factors. Advanced neuroimaging techniques have been used to investigate neurofunctional and neurostructural abnormalities in children, adolescents, and adults with PTSD. This review examined structural brain imaging studies that were performed in abused and traumatized children, and discusses the possible biological mechanisms involved in the pathophysiology of PTSD, the implications and future directions for magnetic resonance imaging (MRI) studies. Published reports in refereed journals were reviewed by searching Medline and examining references of the articles related to structural neuroimaging of PTSD. Structural MRI studies have been performed in adults and children to evaluate the volumetric brain alterations in the PTSD population. In contrast with studies involving adults, in which hippocampus volumetric reduction was the most consistent finding, studies involving children and adolescents with PTSD have demonstrated smaller medial and posterior portions of the corpus callosum.",0,0 +3147,THE DISSOCIATIVE SUBTYPE OF PTSD: A REPLICATION AND EXTENSION,The nature of the relationship between dissociation and posttraumatic stress disorder (PTSD) has clinical and nosological importance. The aim of this study was to evaluate the evidence for a dissociative subtype of PTSD in two independent samples and to examine the pattern of personality disorder (PD) comorbidity associated with the dissociative subtype of PTSD.Latent profile analyses were conducted on PTSD and dissociation items reflecting derealization and depersonalization in two samples of archived data: Study 1 included 360 male Vietnam War Veterans with combat-related PTSD; Study 2 included 284 female Veterans and active duty service personnel with PTSD and a high base rate of exposure to sexual trauma.The latent profile analysis yielded evidence for a three-class solution in both samples: the model was defined by moderate and high PTSD classes and a class marked by high PTSD severity coupled with high levels of dissociation. Approximately 15% of the male sample and 30% of the female sample were classified into the dissociative class. Women (but not men) in the dissociative group exhibited higher levels of comorbid avoidant and borderline PD diagnoses.Results provide support for a dissociative subtype of PTSD and also suggest that dissociation may play a role in the frequent co-occurrence of PTSD and borderline PD among women. These results are pertinent to the on-going revisions to the DSM and suggest that consideration should be given to incorporating a dissociative subtype into the revised PTSD criteria.,0,0 +3148,A qualitative review of migrant women's perceptions of their needs and experiences related to pregnancy and childbirth,"A synthesis of the evidence of migrant women's perceptions of their needs and experiences in relation to pregnancy and childbirth.Despite the fact that all European Union member states have ratified human rights-based resolutions aimed at non-discrimination, there is a relationship between social inequality and access to pre-, intra-, and postpartum care.A qualitative systematic review of studies from European countries.A search was made for relevant articles published between January 1996-June 2010.Data were analysed by means of thematic synthesis.Sixteen articles were selected, analysed, and synthesized. One overall theme; 'Preserving one's integrity in the new country' revealed two key aspects; 'Struggling to find meaning' and 'Caring relationships'. 'Struggling to find meaning' comprised four sub-themes; 'Communication and connection', 'Striving to cope and manage', 'Struggling to achieve a safe pregnancy and childbirth', and 'Maintaining bodily integrity'. 'Caring relationships' was based on the following three sub-themes: 'Sources of strength', 'Organizational barriers to maternity care', and 'The nature and quality of caring relationships'.The results of this review demonstrate that migrant women are in a vulnerable situation when pregnant and giving birth and that their access to health services must be improved to better meet their needs. Research is required to develop continuity of care and improve integrated maternal care.",0,0 +3149,The development of a Clinician-Administered PTSD Scale,"Several interviews are available for assessing PTSD. These interviews vary in merit when compared on stringent psychometric and utility standards. Of all the interviews, the Clinician-Administered PTSD Scale (CAPS-1) appears to satisfy these standards most uniformly. The CAPS-1 is a structured interview for assessing core and associated symptoms of PTSD. It assesses the frequency and intensity of each symptom using standard prompt questions and explicit, behaviorally-anchored rating scales. The CAPS-1 yields both continuous and dichotomous scores for current and lifetime PTSD symptoms. Intended for use by experienced clinicians, it also can be administered by appropriately trained paraprofessionals. Data from a large scale psychometric study of the CAPS-1 have provided impressive evidence of its reliability and validity as a PTSD interview.",0,0 +3150,Five years later: Recovery from post traumatic stress and psychological distress among low-income mothers affected by Hurricane Katrina,"Hurricane Katrina, which struck the Gulf Coast of the United States in August 2005, exposed area residents to trauma and extensive property loss. However, little is known about the long-run effects of the hurricane on the mental health of those who were exposed. This study documents long-run changes in mental health among a particularly vulnerable group-low income mothers-from before to after the hurricane, and identifies factors that are associated with different recovery trajectories. Longitudinal surveys of 532 low-income mothers from New Orleans were conducted approximately one year before, 7-19 months after, and 43-54 months after Hurricane Katrina. The surveys collected information on mental health, social support, earnings and hurricane experiences. We document changes in post-traumatic stress symptoms (PTSS), as measured by the Impact of Event Scale-Revised, and symptoms of psychological distress (PD), as measured by the K6 scale. We find that although PTSS has declined over time after the hurricane, it remained high 43-54 months later. PD also declined, but did not return to pre-hurricane levels. At both time periods, psychological distress before the hurricane, hurricane-related home damage, and exposure to traumatic events were associated with PTSS that co-occurred with PD. Hurricane-related home damage and traumatic events were associated with PTSS without PD. Home damage was an especially important predictor of chronic PTSS, with and without PD. Most hurricane stressors did not have strong associations with PD alone over the short or long run. Over the long run, higher earnings were protective against PD, and greater social support was protective against PTSS. These results indicate that mental health problems, particularly PTSS alone or in co-occurrence with PD, among Hurricane Katrina survivors remain a concern, especially for those who experienced hurricane-related trauma and had poor mental health or low socioeconomic status before the hurricane.",0,0 +3151,The experience of traumatic events disrupts the measurement invariance of a posttraumatic stress scale,"Studies that include multiple assessments of a particular instrument within the same population are based on the presumption that this instrument measures the same construct over time. But what if the meaning of the construct changes over time due to one's experiences? For example, the experience of a traumatic event can influence one's view of the world, others, and self, and may disrupt the stability of a questionnaire measuring posttraumatic stress symptoms (i.e., it may affect the interpretation of items). Nevertheless, assessments before and after such a traumatic event are crucial to study longitudinal development of posttraumatic stress symptoms. In this study, we examined measurement invariance of posttraumatic stress symptoms in a sample of Dutch soldiers before and after they went on deployment to Afghanistan (N = 249). Results showed that the underlying measurement model before deployment was different from the measurement model after deployment due to invariant item thresholds. These results were replicated in a sample of soldiers deployed to Iraq (N = 305). Since the lack of measurement invariance was due to instability of the majority of the items, it seems reasonable to conclude that the underlying construct of PSS is unstable over time if war-zone related traumatic events occur in between measurements. From a statistical point of view, the scores over time cannot be compared when there is a lack of measurement invariance. The main message of this paper is that researchers working with posttraumatic stress questionnaires in longitudinal studies should not take measurement invariance for granted, but should use pre- and post-symptom scores as different constructs for each time point in the analysis.",0,0 +3152,A comparison of the SPRINT and CAPS assessment scales for posttraumatic stress disorder,"The Clinician-Administered PTSD Scale for DSM-IV (CAPS) is a widely used assessment tool for (posttraumatic stress disorder) (PTSD). However, a shorter assessment tool may be beneficial for clinical work. Here, we compare such a tool, the Short PTSD Rating Interview (SPRINT) to the CAPS. We found that the SPRINT rating scale performs similarly to the CAPS rating scale in the assessment of PTSD symptom clusters and total scores, and that the SPRINT takes significantly less time to administer than the CAPS.",0,0 +3153,Increased generalization of learned associations is related to re-experiencing symptoms in veterans with symptoms of post-traumatic stress,"One interpretation of re-experiencing symptoms in post-traumatic stress disorder (PTSD) is that memories related to emotional information are stored strongly, but with insufficient specificity, so that stimuli which are minimally related to the traumatic event are sufficient to trigger recall. If so, re-experiencing symptoms may reflect a general bias against encoding background information during a learning experience, and this tendency might not be limited to learning about traumatic or even autobiographical events. To test this possibility, we administered a discrimination-and-transfer task to 60 Veterans (11.2% female, mean age 54.0 years) self-assessed for PTSD symptoms in order to examine whether re-experiencing symptoms were associated with increased generalization following associative learning. The discrimination task involved learning to choose the rewarded object from each of six object pairs; each pair differed in color or shape but not both. In the transfer phase, the irrelevant feature in each pair was altered. Regression analysis revealed no relationships between re-experiencing symptoms and initial discrimination learning. However, re-experiencing symptom scores contributed to the prediction of transfer performance. Other PTSD symptom clusters (avoidance/numbing, hyperarousal) did not account for significant additional variance. The results are consistent with an emerging interpretation of re-experiencing symptoms as reflecting a learning bias that favors generalization at the expense of specificity. Future studies will be needed to determine whether this learning bias may pre-date and confer risk for, re-experiencing symptoms in individuals subsequently exposed to trauma, or emerges only in the wake of trauma exposure and PTSD symptom development.",0,0 +3154,Is mixed-handedness a marker of treatment response in posttraumatic stress disorder?: A pilot study,"Recent studies suggest that mixed-handedness is a risk factor for posttraumatic stress disorder (PTSD). This study examined whether mixed-handed veterans with combat-related PTSD respond more poorly to psychosocial treatment. Consistency of hand preference was assessed in 150 Vietnam combat veterans with PTSD using the Edinburgh Handedness Inventory (R. C. Oldfield, 1971). Growth modeling analyses using Mplus (L. K. Muthén & B. Muthén, 2002) identified that PTSD veterans with mixed-handedness reported significantly less treatment improvement on the PTSD Checklist (F. W. Weathers, B. T. Litz, D. S. Herman, J. A. Huska, & T. M. Keane, 1993) than did veterans with consistent handedness. These data suggest that mixed-handedness is associated with poorer PTSD treatment response. Several possible explanations for this finding are discussed.",0,0 +3155,Cell type-specific modifications of corticotropin-releasing factor (CRF) and its type 1 receptor (CRF1) on startle behavior and sensorimotor gating,"The corticotropin-releasing factor (CRF) family of peptides and receptors coordinates the mammalian endocrine, autonomic, and behavioral responses to stress. Excessive CRF production has been implicated in the etiology of stress-sensitive psychiatric disorders such as posttraumatic stress disorder (PTSD), which is associated with alterations in startle plasticity. The CRF family of peptides and receptors mediate acute startle response changes during stress, and chronic CRF activation can induce startle abnormalities. To determine what neural circuits modulate startle in response to chronic CRF activation, transgenic mice overexpressing CRF throughout the central nervous system (CNS; CRF-COE(CNS)) or restricted to inhibitory GABAergic neurons (CRF-COE(GABA)) were compared across multiple domains of startle plasticity. CRF overexpression throughout the CNS increased startle magnitude and reduced ability to inhibit startle (decreased habituation and decreased prepulse inhibition (PPI)), similar to previous reports of exogenous effects of CRF. Conversely, CRF overexpression confined to inhibitory neurons decreased startle magnitude but had no effect on inhibitory measures. Acute CRF receptor 1 (CRF1) antagonist treatment attenuated only the effects on startle induced by CNS-specific CRF overexpression. Specific deletion of CRF1 receptors from forebrain principal neurons failed to alter the effects of exogenous CRF or stress on startle, suggesting that these CRF1 expressing neurons are not required for CRF-induced changes in startle behaviors. These data indicate that the effects of CRF activation on startle behavior utilize an extensive neural circuit that includes both forebrain and non-forebrain regions. Furthermore, these findings suggest that the neural source of increased CRF release determines the startle phenotype elicited. It is conceivable that this may explain why disorders characterized by increased CRF in cerebrospinal fluid (e.g. PTSD and major depressive disorder) have distinct symptom profiles in terms of startle reactivity.",0,0 +3156,Abnormal serum lipid profile in Brazilian police officers with post-traumatic stress disorder,"To measure the serum lipid composition of a sample of Brazilian police officers with and without PTSD regularly exposed to potentially traumatic situations.A cross-sectional survey was conducted with 118 active duty male police officers. Serum concentrations for total cholesterol, LDL-C, HDL-C, and triglycerides were enzymatically determined. Body mass index (BMI) was obtained for each participant.Officers with PTSD exhibited significantly higher serum total cholesterol, LDL-C and triglycerides levels than those without PTSD. Total cholesterol and triglycerides, but not LDL-C, remained associated with PTSD diagnosis after controlling for confounding influences (i.e. socio-demographics, BMI, and tobacco, alcohol and medication use).The sample size was small. A nutritional interview was employed instead of established scales to assess alimentary habits, tobacco or alcohol consumption. A self-report screening tool was used to assess the prevalence of PTSD.The association between PTSD and abnormal serum lipid profile and a tendency to exhibit higher BMI suggests that individuals with PTSD may be at increased risk for developing metabolic syndrome, a condition that by itself could account for many of the most serious PTSD-related physical health problems.",0,0 +3157,Etiological factors in the development of posttraumatic stress disorder.,"(from the chapter) focuses on epidemiologic and descriptive studies in an effort to delineate specific factors that contribute to the development of posttraumatic stress disorder (PTSD) [primarily in veteran populations] / [review] noncombat-related trauma . . . as it relates to the generalizability of findings related to trauma / findings from studies at the West Haven Veterans Administration Medical Center (VAMC) on the role of dissociation in the etiology of PTSD are presented and discussed (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +3158,Anxiety sensitivity and aspects of alexithymia are independently and uniquely associated with posttraumatic distress,"Using a sample of adult survivors of physical trauma requiring hospitalization (N = 677), we examined the relationship of aspects of alexithymia and anxiety sensitivity to symptoms of posttraumatic distress (PTD). At the bivariate level, both aspects of alexithymia and anxiety sensitivity were positively associated with acute PTD symptomatology, but anxiety sensitivity was more strongly related to PTD symptoms. At the multivariate level, both anxiety sensitivity and aspects of alexithymia made unique and independent contributions to both total PTD symptoms and the majority of PTD symptom clusters. At the facet level, anxiety sensitivity-physical concerns and anxiety sensitivity-psychological concerns, and the alexithymic dimension of difficulty identifying feelings, were uniquely associated with acute PTD symptoms. Findings are discussed in terms of potential clinical implications.",0,0 +3159,Psychiatric morbidity following a natural disaster: An Australian bushfire,"This study investigated the prevalence of mental health problems after a major bushfire in Australia and examined the validity of the General Health Questionnaire (GHQ) (Goldberg 1978) against the Anxiety, Affective and Post-Traumatic Stress Disorder modules of the Diagnostic Interview Schedule (DIS; Robins et al. 1981). Study 1 was carried out 12 months after the Ash Wednesday bushfires and sought to include all the victims of the fires. Study 2 was conducted 20 months after the fires and included a sample of victims who had experienced major losses in the fires. Twelve months after the fires, 42% (n = 1,526) of the victims were defined as a potential psychiatric case using the GHQ. This rate indicated a significantly greater level of morbidity than found in communities that have not experienced a natural disaster. Twenty months after the fires, 23% (n = 43) were defined as ""cases"". The 28-item GHQ was found to be a valid instrument for defining the presence of psychiatric disorder in a disaster-effected community. The findings demonstrated that lasting psychiatric morbidity is associated with natural disasters.",0,0 +3160,Leg Extension Power Is a Pre-Disaster Modifiable Risk Factor for Post-Traumatic Stress Disorder among Survivors of the Great East Japan Earthquake: A Retrospective Cohort Study,"Post-traumatic stress disorder (PTSD) is a common psychological problem following natural disasters. Although pre-disaster risk factors are important for early detection and proactive support, the examination of such has been limited to sociodemographic factors, which were largely unaffected by the disasters. We examined the association between pre-disaster physical functioning and lifestyle and PTSD symptoms five months after the earthquake in the Great East Japan Earthquake survivors who were participating in a pre-existing cohort study.We designed a retrospective cohort study of a cooperative association in Sendai from August 2010 to August 2011. In 2010, lifestyle, physical condition, and sociodemographic factors were examined by self-reported questionnaires completed by 522 employees of this organization. We also measured the leg extension power of all the participants. PTSD symptoms were evaluated by the Japanese version of the Impact of Event Scale-Revised (IES-R-J) following the earthquake of 2011.In multivariate linear regression analysis, leg extension power (β = -0.128, P = 0.025), daily drinking (β = 0.203, P = 0.006), and depressive symptoms (β = 0.139, P = 0.008) were associated with total score of the IES-R-J among men. Moreover, for the IES-R-J subscale, leg extension power was also negatively associated with Intrusion (β = -0.114, P = 0.045) and Hyperarousal (β = -0.163, P = 0.004) after adjusting for all other significant variables. For women, hypertension (β = 0.226, P = 0.032) and depressive symptoms (β = 0.205, P = 0.046) were associated with the total score of the IES-R-J.Leg extension power is a potentially modifiable pre-disaster risk factor among men for attenuating the severity of PTSD symptoms associated with great disasters such as the Great East Japan Earthquake among men.",0,0 +3161,Post-traumatic stress disorder symptoms in first-time myocardial infarction patients: roles of attachment and alexithymia,"To explore the roles of attachment and alexithymia in the severity of post-traumatic stress disorder symptoms and to specify the relationship between sub-dimensions of attachment, alexithymia and posttraumatic stress disorder symptoms in patients with first-time myocardial infarction in mainland China.Patients experiencing myocardial infarction have a risk of developing post-traumatic stress disorder symptoms. However, there have been few studies on the roles of attachment and alexithymia.A cross-sectional survey design.Ninety-seven patients participated in the assessment of post-traumatic stress disorder symptoms, attachment and alexithymia from June-December in 2012. To assess post-traumatic stress disorder symptoms and their correlates, we administered the Post-traumatic Stress Disorder Checklist-Civilian Version, the 20-item Toronto Alexithymia Scale and the Experiences in Close Relationships Scale 5-17 days after the remission of first myocardial infarction attack.Twenty-five (25·77%) patients met the criteria of posttraumatic stress disorder symptoms. Greater attachment anxiety and avoidance were associated with more severe posttraumatic stress disorder symptoms. Except for externally oriented thinking, all dimensions of alexithymia were significantly correlated with post-traumatic stress symptoms. In the regression model, attachment anxiety and difficulties identifying feelings were found to be predictive and the total regression equation explained 24·2% variance of posttraumatic stress disorder symptoms among myocardial infarction patients.First-time myocardial infarction patients were at risk of developing posttraumatic stress disorder symptoms. Attachment anxiety and difficulties identifying feelings were positively associated with posttraumatic stress disorder symptoms in the early stage of myocardial infarction rehabilitation. It is essential to evaluate the causal relationship between attachment, alexithymia and posttraumatic stress disorder symptoms in longitudinal studies.",0,0 +3162,Post-traumatic stress disorder among people exposed to the Ventotene street disaster in Rome,"To test five hypotheses on Post-traumatic stress disorder (PTSD): 1) Is PTSD the most prevalent disorder after trauma? 2) Is the proximity to the disaster related to the risk of PTSD? 3) Is PTSD associated with child mourning or separation, previous stress, or familiarity for psychiatric disorders? 4) Does the exposition to trauma increase substance abuse or somatization? 5) Can episodic trauma cause long-lasting psychiatric morbidity?Clinical assessment of subjects exposed to an explosion in a building caused by a gas-leak. Best estimate clinical diagnoses were made according to DSM-IV-TR criteria. The Zung Depression Rating Scale, the Zung Anxiety Rating Scale, and the Clinician Administered Post Traumatic Stress Disorder Scale were used in the clinical assessment. Statistical analysis was performed by means of t-test with Bonferroni's correction on continuous variables and chi2 or Fisher test on categorical variables.PTSD was the most prevalent disorder after trauma, diagnosed in 32 (36.8%) subjects. The subjects who had not seen dead or injured people were more likely to receive no psychiatric diagnosis. Civil status, parenthood, death of relatives in the disaster, personal injuries, history of child mourning or separation, of previous stress, as well as familiarity for any psychiatric disorder or substance use disorder were not related with the rate of ascertained psychiatric diagnoses. Nearly two years after trauma, most of patients who had suffered PTSD still met PTSD criteria.The 1st and the 5th hypotheses were corroborated, the 3rd and the 4th hypotheses were not confirmed. The 2nd hypothesis was partially confirmed.",0,0 +3163,Mental health and resiliency following 44 months of terrorism: a survey of an Israeli national representative sample,"Israeli citizens have been exposed to intense and ongoing terrorism since September 2000. We previously studied the mental health impact of terrorism on the Israeli population (Bleich et al., 2002), however the long-term impact of ongoing terrorism has not yet been examined. The present study evaluated the psychological sequelae of 44 months of terrorism in Israel, and sought to identify factors that may contribute to vulnerability and resilience.This was a telephone survey using strata sampling of 828 households, which reached a representative sample of 702 adult Israeli residents (84.8% contact rate). In total, 501 people (60.5%) agreed to participate. The methodology was similar to that of our previous study. Exposure to terrorism and other traumatic events, number of traumatic stress-related symptoms (TSRS), percentage of respondents with symptom criteria for post-traumatic stress disorder (PTSD), traumatic stress (TS) resiliency and feelings of depression, anxiety, optimism, sense of safety, and help-seeking were the main outcome measures.In total, 56 participants (11.2%) were directly exposed to a terrorist incident, and 101 (20.2%) had family members or friends exposed. Respondents reported a mean +/- SD of 5.0 +/- 4.5 TSRS; 45 (9%) met symptom criteria for PTSD; and 72 (14.4%) were TS-resilient. There were 147 participants (29.5%) who felt depressed, 50 (10.4%) felt anxious, and almost half (235; 47%) felt life-threatening danger; 48 (9.7%) felt the need for professional help. Women and people of Arab ethnicity had more TSRS, more PTSD, and less TS resiliency. Injury following a life-threatening experience, a major stressful life event, and a major loss of income were associated with PTSD. Immigrant status, lower education, low sense of safety, low sense of social support, high societal distress, and injury following life-threatening experiences were associated with TSRS. TSRS did not increase with exposure severity. This study revealed less depression and functional impairment, similar rates of PTSD, increased help-seeking and poorer TSRS and TS resiliency than our initial study, 2 years previously.The response of people in Israel to 4 years of terrorism is heterogeneous. Vulnerability factors change over time; Arab ethnicity, immigrant status and less education, not found to be risk factors in our previous study, were found in the present study to contribute to trauma-related distress. Prior experience of highly stressful events increases vulnerability to adverse psychological effects of terror.",0,0 +3164,Toward an Empirical Definition of Pediatric PTSD: The Phenomenology of PTSD Symptoms in Youth,"To examine the frequency and intensity of posttraumatic stress disorder (PTSD) symptoms and their relation to clinical impairment, to examine the requirement of meeting all DSM-IV symptom cluster criteria (i.e., criteria B, C, D), and to examine the aggregation of PTSD symptom clusters across developmental stages.Fifty-nine children between the ages of 7 and 14 years with a history of trauma and PTSD symptoms were assessed with the Clinician-Administered PTSD Scale for Children and Adolescents.Data support the utility of distinguishing between the frequency and the intensity of symptoms in the investigation of the phenomenology of pediatric PTSD. Children fulfilling requirements for two symptom clusters did not differ significantly from children meeting all three cluster criteria with regard to impairment and distress. Reexperience (cluster B) showed increased aggregation with avoidance and numbing (cluster C) and hyperarousal (cluster D) in the later stages of puberty.Frequency and intensity of symptoms may both contribute to the phenomenology of pediatric PTSD. Children with subthreshold criteria for PTSD demonstrate substantial functional impairment and distress.",0,0 +3165,"Associations between Post-Traumatic Stress Symptoms, Stimulant Use, and Treatment Outcomes: A Secondary Analysis of NIDA's Women and Trauma Study","Background and Objectives To examine the associations between post-traumatic stress disorder (PTSD) symptoms, stimulant use, and treatment outcomes among dually diagnosed women. Methods Participants were 141 women who participated in a multisite clinical trial of group treatments for PTSD and addictions. Results Generalized linear models indicated Seeking Safety (SS; a cognitive-behavioral intervention) was significantly more effective than Women's Health Education (WHE; a control group intervention) in reducing stimulant use at follow-up among women who were heavy stimulant users at pre-treatment and who showed improvements in PTSD symptoms. There were no significant differences between the interventions among women who were light stimulant users at treatment entry. Conclusions and Scientific Significance These findings suggest that integrated treatment of co-occurring PTSD and addictions may be more effective than general health education approaches for heavy stimulant users. Assessment of frequency of stimulant use among individuals with PTSD symptoms may inform treatment selection for this population. (Am J Addict 2014;23:90–95)",0,0 +3166,The co-occurrence of PTSD and dissociation: differentiating severe PTSD from dissociative-PTSD,"A dissociative-posttraumatic stress disorder (PTSD) subtype has been included in the DSM-5. However, it is not yet clear whether certain socio-demographic characteristics or psychological/clinical constructs such as comorbid psychopathology differentiate between severe PTSD and dissociative-PTSD. The current study investigated the existence of a dissociative-PTSD subtype and explored whether a number of trauma and clinical covariates could differentiate between severe PTSD alone and dissociative-PTSD.The current study utilized a sample of 432 treatment seeking Canadian military veterans. Participants were assessed with the Clinician Administered PTSD Scale (CAPS) and self-report measures of traumatic life events, depression, and anxiety. CAPS severity scores were created reflecting the sum of the frequency and intensity items from each of the 17 PTSD and 3 dissociation items. The CAPS severity scores were used as indicators in a latent profile analysis (LPA) to investigate the existence of a dissociative-PTSD subtype. Subsequently, several covariates were added to the model to explore differences between severe PTSD alone and dissociative-PTSD.The LPA identified five classes: one of which constituted a severe PTSD group (30.5 %), and one of which constituted a dissociative-PTSD group (13.7 %). None of the included, demographic, trauma, or clinical covariates were significantly predictive of membership in the dissociative-PTSD group compared to the severe PTSD group.In conclusion, a significant proportion of individuals report high levels of dissociation alongside their PTSD, which constitutes a dissociative-PTSD subtype. Further investigation is needed to identify which factors may increase or decrease the likelihood of membership in a dissociative-PTSD subtype group compared to a severe PTSD only group.",0,0 +3167,Paranoia and post-traumatic stress disorder in the months after a physical assault: a longitudinal study examining shared and differential predictors,"Background Being physically assaulted is known to increase the risk of the occurrence of post-traumatic stress disorder (PTSD) symptoms but it may also skew judgements about the intentions of other people. The objectives of the study were to assess paranoia and PTSD after an assault and to test whether theory-derived cognitive factors predicted the persistence of these problems. Method At 4 weeks after hospital attendance due to an assault, 106 people were assessed on multiple symptom measures (including virtual reality) and cognitive factors from models of paranoia and PTSD. The symptom measures were repeated 3 and 6 months later. Results Factor analysis indicated that paranoia and PTSD were distinct experiences, though positively correlated. At 4 weeks, 33% of participants met diagnostic criteria for PTSD, falling to 16% at follow-up. Of the group at the first assessment, 80% reported that since the assault they were excessively fearful of other people, which over time fell to 66%. Almost all the cognitive factors (including information-processing style during the trauma, mental defeat, qualities of unwanted memories, self-blame, negative thoughts about self, worry, safety behaviours, anomalous internal experiences and cognitive inflexibility) predicted later paranoia and PTSD, but there was little evidence of differential prediction. Conclusions Paranoia after an assault may be common and distinguishable from PTSD but predicted by a strikingly similar range of factors.",0,0 +3168,Resilience in the Face of Potential Trauma,"Until recently, resilience among adults exposed to potentially traumatic events was thought to occur rarely and in either pathological or exceptionally healthy individuals. Recent research indicates, however, that the most common reaction among adults exposed to such events is a relatively stable pattern of healthy functioning coupled with the enduring capacity for positive emotion and generative experiences. A surprising finding is that there is no single resilient type. Rather, there appear to be multiple and sometimes unexpected ways to be resilient, and sometimes resilience is achieved by means that are not fully adaptive under normal circumstances. For example, people who characteristically use self-enhancing biases often incur social liabilities but show resilient outcomes when confronted with extreme adversity. Directions for further research are considered.",0,0 +3169,Comparison of long-term outcomes following traumatic injury: What is the unique experience for those with brain injury compared with orthopaedic injury?,"

Abstract

Objective

Whilst it has been well-demonstrated that traumatic brain injury (TBI) results in long-term cognitive, behavioural and emotional difficulties, less is understood about how these outcomes differ from those following traumatic orthopaedic injury (TOI). The aim of this study was to compare self-reported outcomes at 5–10 years post-injury for those with TBI, TOI, and uninjured controls. It was hypothesised that participants with TBI would have greater cognitive difficulties; participants with TOI and TBI would have similar functional and physical outcomes, both being poorer than controls; and participants with TBI would have poorer psychosocial outcomes than those with TOI.

Participants and methods

Eighty-eight individuals with complicated mild to severe TBI and 96 with TOI recruited during inpatient rehabilitation were followed up 5–10 years post-injury, together with 48 controls followed over a similar period. Self-report measures of global functioning (GOS-E), quality of life (SF-36), psychological wellbeing (SCL-90-R, HADS, PCL-S), psychosocial difficulties (SIP), cognitive difficulties (SF-36 COG), pain (BPI), and fatigue (FSS) were administered.

Results

Outcomes for individuals with TBI and TOI differed significantly from controls, with poorer global functioning, and greater psychological distress and interference from pain. Only participants with TBI reported greater cognitive difficulties and anxiety than controls, and were less likely to be employed or in a relationship. Participants with TBI reported greater anxiety, PTSD, psychological distress and psychosocial difficulties than those with TOI.

Conclusions

Both TOI and TBI cause long-term disability, interference from pain, and psychological distress. However, cognitive impairments, unemployment, lack of long-term relationships, anxiety and PTSD are more substantial long-term problems following TBI. Findings from this study have implications for managing risks associated with these injury groups and tailoring rehabilitation to improve long-term outcomes.",0,0 +3170,Subthreshold post traumatic stress disorder in the survivors of Marmara earthquake,"This study was conducted in order to determine the symptom profile and risk factors associated with subthreshold post traumatic stress disorder (PTSD). It was conducted in 1316 subjects who had experienced the Marmara Earthquake. The data collected included socio-demographic features, experiences during the earthquake and risk factors associated with trauma. The subjects who have at least one symptom in each of the B, C or D clusters in DSM-IV PTSD diagnostic criteria were accepted as ""subthreshold PTSD"". It was found that the prevalence of full PTSD and subthreshold PTSD was 13.8% and 28.0%, respectively. Female gender, excessive horror during the earthquake, damage to the home, being trapped under the rubble, loss of loved ones, and preexisting alcohol abuse were found to be the risk factors both for full PTSD and subthreshold PTSD. People with subthreshold PTSD seem to have similarities with full PTSD patients, as regards socio-demographic features, risk factors and functional impairment. It is concluded that the need for treatment of subthreshold PTSD patients should be considered. (",0,0 +3171,The younger sibling of PTSD: similarities and differences between complicated grief and posttraumatic stress disorder,"Just as traumatic experiences may lead to posttraumatic stress disorder (PTSD) in some individuals, grief may also be a serious health concern for individuals who have experienced bereavement. At present, neither the DSM-IV nor the ICD-10 recognizes any form of grief as a mental disorder. The aim of this review is to summarize recent advances in definition, assessment, prevention, and treatment of complicated grief disorder (CGD) and to compare CGD with PTSD. Four areas are identified to be of importance to clinicians and researchers: (a) the recently proposed consensus criteria of CGD for DSM-V and ICD-11, (b) available assessment instruments, (c) recent prevention and treatment techniques and related effectiveness studies, and (d) emerging disorder models and research on risks and protective factors. This review focuses on the similarities and differences between CGD and PTSD and highlights how a PTSD-related understanding aids the investigation and clinical management of CGD.",0,0 +3172,Increased Polysedative Use in Veterans with Posttraumatic Stress Disorder,"Posttraumatic stress disorder (PTSD) treatment is often complicated in veterans by co-occurring conditions including pain, insomnia, brain injury, and other mental disorders. Pharmacologic approaches to these conditions can produce an accumulation of sedating medications with potential for safety concerns.The objective of this study was to characterize polysedative prescribing among veterans with PTSD over an 8-year period.National Department of Veterans Affairs (VA) data were used to identify veterans with PTSD using International Classification of Diseases, Ninth Revision codes among regular medication users. Prescribing of benzodiazepines, hypnotics, atypical antipsychotics, opioids, and muscle relaxants was determined annually. Prevalence and incidence rates were determined for each medication class from 2004 through 2011. Polysedative use was determined from longitudinal refill patterns that indicated concurrent use across sedative classes.In 2004, 9.8% of veterans with PTSD concurrently received medications from three or more sedative classes. By 2011, the prevalence of concurrent use involving three or more classes increased to 12.1%. Polysedative use varied across demographic subgroups, with higher rates observed among women, rural residents, younger adults, Native Americans and Whites. The most common combination was an opioid plus a benzodiazepine, taken concurrently by 15.9% of veterans with PTSD.Important trends in polysedative use among veterans with PTSD illustrate the complexity of treating an intersecting cluster of symptoms managed by sedative medications. As the VA seeks to improve care by focusing on non-pharmacologic options, our findings emphasize the need for a comprehensive approach that encompasses overlapping conditions of relevance to veterans with PTSD.",0,0 +3173,Antipsychotic Medication Utilization Trends Among Texas Veterans: 1997–2002,"Background An antipsychotic utilization pattern has evolved substantially over the past 20 years or so due to the introduction of the second-generation antipsychotics (SGAs) and the increasing understanding of their adverse effect profile. Objective To understand antipsychotic utilization trends (including monotherapy, antipsychotic switching, and combination therapy) and to investigate factors associated with antipsychotic index medication selection (SGAs vs first-generation antipsychotics [FGAs]) among Texas veterans. Methods Data were taken from the Veterans Administration North Texas Health Care System (VANTHCS) and South Texas Veterans Health Care System (STVHCS) from January 1996 to December 2003. Adults with continuous enrollment (1 y before and after the Index date) who had newly initiated antipsychotic therapy were included. Prescriptions were followed for up to 12 months. Descriptive analyses examined utilization trends; logistic regression evaluated factors associated with antipsychotic index medication selection. Results: A total of 8096 patients were included in the study (VANTHCS n = 4477; STVHCS n = 3619), with the majority being male (93.6%) and white (62.6%) and nearly naif aged 55 years or older (44.1%). Between 1997 and 2002, antipsychotic prescriptions changed from primarily FGAs (1997:71.7%; 1999; 25.2%; 2002: 5.7%) to SGAs. Over the 6-year time frame, risperidone (31.0%) and olanzapine (30.7%) were most commonly prescribed. The overall combination therapy slightly increased over time (4.3%), switching to another antipsychotic remained stable (14.2%), and antipsychotic monotherapy remained dominant (81.5%). Hispanic and black patients were less likely than white patients to be initiated on SGAs. Patients who were older, had hypertension, and were in STVHCS were less likely to start on SGAs. Patients with dyslipidemia, bipolar disorder, and treatment in recent years were more likely to start on SGAs Conclusions: SGAs have replaced FGAs as first-line medications for patients with mental disorders. Race, age, physical comorbidities (ie, dyslipidemia, hypertension), and treatment initiation year were important factors in index medication selection.",0,0 +3174,Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis,"The WHO International Classification of Diseases, 11th version (ICD-11), has proposed two related diagnoses, posttraumatic stress disorder (PTSD) and complex PTSD within the spectrum of trauma and stress-related disorders.To use latent profile analysis (LPA) to determine whether there are classes of individuals that are distinguishable according to the PTSD and complex PTSD symptom profiles and to identify potential differences in the type of stressor and severity of impairment associated with each profile.An LPA and related analyses were conducted on 302 individuals who had sought treatment for interpersonal traumas ranging from chronic trauma (e.g., childhood abuse) to single-incident events (e.g., exposure to 9/11 attacks).THE LPA REVEALED THREE CLASSES OF INDIVIDUALS: (1) a complex PTSD class defined by elevated PTSD symptoms as well as disturbances in three domains of self-organization: affective dysregulation, negative self-concept, and interpersonal problems; (2) a PTSD class defined by elevated PTSD symptoms but low scores on the three self-organization symptom domains; and (3) a low symptom class defined by low scores on all symptoms and problems. Chronic trauma was more strongly predictive of complex PTSD than PTSD and, conversely, single-event trauma was more strongly predictive of PTSD. In addition, complex PTSD was associated with greater impairment than PTSD. The LPA analysis was completed both with and without individuals with borderline personality disorder (BPD) yielding identical results, suggesting the stability of these classes regardless of BPD comorbidity.Preliminary data support the proposed ICD-11 distinction between PTSD and complex PTSD and support the value of testing the clinical utility of this distinction in field trials. Replication of results is necessary.",0,0 +3175,Diagnostic utility and factor structure of the PTSD Checklist in older adults,"ABSTRACT Background: Little research has examined the diagnostic utility and factor structure of commonly used posttraumatic stress disorder (PTSD) assessment instruments in older persons. Methods: A total of 206 adults aged 60 or older (mean age = 69 years; range = 60–92), who resided in the Galveston Bay area when Hurricane Ike struck in September 2008, completed a computer-assisted telephone interview two–five months after this disaster. Using the PTSD Checklist (PCL), PTSD symptoms were assessed related both to this disaster and to participants’ worst lifetime traumatic event. Total PCL scores were compared to PCL-based, Diagnostic and Statistical Manual of Mental Disorders , 4th edition (DSM-IV)-derived probable diagnoses of PTSD to determine optimal cut scores. Confirmatory factor analyses (CFAs) were conducted to evaluate PTSD symptom structure. Results: Receiver operating characteristic analyses indicated that a PCL score of 39 achieved optimal sensitivity and specificity in assessing a PCL-based, algorithm-derived DSM-IV diagnosis of worst event-related PTSD; and that a score of 37 optimally assessed probable Ike-related PTSD. CFAs revealed that a recently proposed five-factor model – comprised of re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal factors – provided a better fitting representation of both worst event- and disaster-related PTSD symptoms than alternative models. Current Ike-related anxious arousal symptoms demonstrated a significantly stronger association with current generalized anxiety than depressive symptoms, thereby supporting the construct validity of this five-factor model of PTSD symptomatology. Conclusions: A PCL score of 37 to 39 may help identify probable PTSD in older persons. The expression of PTSD symptoms in older adults may be best characterized by a recently proposed five-factor model with distinct dysphoric arousal and anxious arousal clusters.",0,0 +3176,The looming maladaptive style predicts shared variance in anxiety disorder symptoms: further support for a cognitive model of vulnerability to anxiety,"Looming vulnerability pertains to a distinct cognitive phenomenology characterized by mental representations of dynamically intensifying danger and rapidly rising risk as one projects the self into an anticipated future [J. Pers. Soc. Psychol. 79 (2000) 837]. While looming appraisals can be experienced as state elicitation, some individuals are hypothesized to develop an enduring cognitive pattern of cross-situational looming appraisals, the looming maladaptive style (LMS), which functions as a cognitive vulnerability to anxiety. In the present study, we examined the extent to which the LMS predicts common variance in numerous anxiety disorder symptoms, independent of the potentially confounding effects of current depressive symptoms. Specifically, we hypothesized that controlling for depressive symptoms, LMS would predict shared variance in a latent factor comprised of indicators of five anxiety disorder symptoms: obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, social phobia, and specific phobic fears. Measures of these anxiety disorder symptoms, depressive symptoms, and looming vulnerability were administered to unselected college student population. Structural equations modeling analyses provided support for our hypothesis that LMS predicts shared variance in anxiety disorder symptoms and suggest that this cognitive style may be an overarching dimension of vulnerability to anxiety.",0,0 +3177,Post concussion syndrome ebb and flow: Longitudinal effects and management,"This research identified persistent post concussion symptoms (PCS) in a group of 20 adult subjects. PCS generally lasted for two years with a mean of 3.35 years. Typical symptoms included physical and cognitive fatigue, depressive behaviors, sensitivity to noise, social withdrawal, irritability, concentration and problem solving difficulties, loss of libido and much difficulty making decisions at even the simplest strategic level. They represented a hard core group for whom the original symptoms persisted well beyond the 6~month period. Participants identified their PCS according to sensory, somatic affective and cognitive items immediately following their trauma (01) and two years later (02). Counseling and psychotherapy intervention took place between 01 and 02. Items on the PCS schedules and the Beck Depression Inventory (II) demonstrated significant decline in the presence of overall symptoms most noticeably in reduction of agitation, irritability and suicidal wishes. However, subjects throughout generally experienced the feeling that they were being punished which equated with behaviors comparable with learned helplessness. The PCS group considered themselves to be different people after trauma. They had different goals, changing lifestyle, relationships and employment and were more often in a dependent state. Comparability with other conditions such as PTSD and chronic fatigue syndrome (CFS) was demonstrated by individuals who experienced persistent and invasive post concussion symptoms.",0,0 +3178,Trauma and victims: epidemiology of post-traumatic stress disorder,"Riassunto Scopo - Presentare una esaustiva review degli studi riguardanti l'epidemiologia del DPTS condotti nella popolazione generale, tra i soggetti a rischio, e, infine, tra gruppi clinicamente selezionati. Disegno - Attraverso Excepta Medica Psychiatry CD-ROM 1980-1993 (ottobre), utilizzando come parola chiave «Post-Traumatic Stress Disorder», sono stati identificati 1.057 articoli pubblicati nel periodo considerate Sono stati anche consultati altri data base della letteratura medica (MEDLINE CD-ROM 1988-1993); è stata quindi operata una ricerca manuale su tutti i numeri del Journal of Traumatic Stress. Risultati - In totale, 135 lavori che hanno soddisfatto i criteri di inclusione prescelti sono stati inclusi nella review. I due terzi (n = 86, 64%) di queste ricerche sono state condotte negli USA. Solo 8 (6%) sono le indagini effettivamente realizzate nei paesi del Terzo Mondo. L'ampiezza del campione varia da un minimo di 11 soggetti, numero riscontrato in due studi, sino ad un massimo di 22.436, per un campione medio di 500 e mediano di 108. Per quanto attiene ai metodi di valutazione, in un terzo degli studi (n = 45, 33%), i ricercatori hanno impiegato un questionario (auto- o etero- somministrato). In un altro terzo delle ricerche elencate (n = 44, 33%) e stata somministrata un'intervista strutturata (la DIS, la SCID, o la SADS), mentre nei rimanenti studi la valutazione diagnostica si è basata o su una procedura clinica non strutturata, o sulla somministrazione di altri strumenti specifici dai quali è possibile inferire una diagnosi di DPTS (M-PTSD, IES, SCL-90-R,o pochi altri). In 77 studi (57%) i ricercatori hanno basato la loro valutazione sui criteri diagnostici propri del DSM-III, mentre in altri 55 (41%) su quelli del DSM-III-R. La prevalenza del DPTS e analizzata quindi separatamente per le diverse popolazioni studiate. Conclusioni - Nell'arco di soli 13 anni, a partire cioe dalla definizione di criteri diagnostici operazionali ben definiti per il DPTS, sono stati condotti numerosi studi volti ad indagare la prevalenza, i fattori di rischio, la storia naturale, il decorso e l' esito di questo disturbo tra campioni diversi di popolazioni a rischio; inoltre, anche il livello qualitativo di queste ricerche, per quanto attiene alia sofisticazione metodologica, si è accresciuto sensibilmente in un tempo tutto sommato breve. Molte aree, pero', restano tuttora inesplorate, ed inoltre appare imperativo avviare ricerche estensive tra le popolazioni dei paesi in via di sviluppo, maggiormente esposte a disastri naturali o provocati dall'uomo.",0,0 +3179,Treatment of post traumatic stress disorder symptoms in emotionally distressed individuals,"Older individuals with emotional distress and a history of psychologic trauma are at risk for post traumatic stress disorder (PTSD) and major depression. This study was an exploratory, secondary analysis of data from the study ""Prevention of Depression in Older African Americans"". It examined whether Problem Solving Therapy-Primary Care (PST-PC) would lead to improvement in PTSD symptoms in patients with subsyndromal depression and a history of psychologic trauma. The control condition was dietary education (DIET). Participants (n=60) were age 50 or older with scores on the Center for Epidemiologic Studies-Depression scale of 11 or greater and history of psychologic trauma. Exclusions stipulated no major depression and substance dependence within a year. Participants were randomized to 6-8 sessions of either PST-PC or DIET and followed 2 years with booster sessions every 6 months; 29 participants were in the PST-PC group and 31 were in the DIET group. Mixed effects models showed that improvement of PTSD Check List scores was significantly greater in the DIET group over two years than in the PST-PC group (based on a group time interaction). We observed no intervention⁎time interactions in Beck Depression Inventory or Brief Symptom Inventory-Anxiety subscale scores.",0,0 +3180,Subtypes of Clinical Presentations in Malingerers of Posttraumatic Stress Disorder: An MMPI-2 Cluster Analysis,"This paper investigated subtypes of individuals trained and instructed to malinger Posttraumatic Stress Disorder (PTSD) through a cluster analysis of their Minnesota Multiphasic Personality Inventory-2 (MMPI-2) clinical and validity scales. Participants were 84 men and women college students at a community college in the southeastern United States. Two well fitting MMPI-2 cluster solutions were evaluated with discriminant analyses and multivariate analyses of variance (MANOVAs); a 2-cluster solution was deemed optimal. Significant between-cluster differences emerged in follow-up analyses on most of the content scales of the MMPI-2. Most demographic variables did not account for differences in cluster membership. Clusters differed in their reported clarity of the materials used to educate them about PTSD. Discriminant analyses yielded better correct classification rates than those from previous studies, when the more severely symptomatic cluster was compared with a sample of clinical combat-related PTSD veterans. Implications are considered in conducting future malingered PTSD investigations.",0,0 +3181,Risk Factors for Posttraumatic Stress Symptomatology in Police Officers: A Prospective Analysis,"This study examines internal and external risk factors for posttraumatic stress symptoms in 262 traumatized police officers. Results show that 7% of the entire sample had PTSD, as established by means of a structured interview; 34% had posttraumatic stress symptoms or subthreshold PTSD. Trauma severity was the only predictor of posttraumatic stress symptoms identified at both 3 and 12 months posttrauma. At 3 months posttrauma, symptomatology was further predicted by introversion, difficulty in expressing feelings, emotional exhaustion at time of trauma, insufficient time allowed by employer for coming to terms with the trauma, dissatisfaction with organizational support, and insecure job future. At 12 months posttrauma, posttraumatic stress symptoms were further predicted by lack of hobbies, acute hyperarousal, subsequent traumatic events, job dissatisfaction, brooding over work, and lack of social interaction support in the private sphere. Implications of the findings regarding organizational risk factors are discussed in the light of possible occupational health interventions.",0,0 +3182,Post-Traumatic Stress Disorder: Some Diagnostic and Clinical Issues,"The development of post-traumatic stress disorder (PTSD) in a group of 42 individuals exposed to a multiple homicide was examined. A comparison of DSM-III and DSM-III-R indicated that 74% qualified for a diagnosis of PTSD using DSM-III, but only 33% met the criteria outlined in DSM-III-R. The most commonly reported symptoms were found to be intrusive recollections of the event and exaggerated startle response. In general, those symptoms that are new additions in the revised version were the least frequently reported, whilst guilt, which has been excluded from DSM-III-R, was experienced by 38% of the sample. It is suggested that the new criteria may not cluster with the core syndrome of PTSD.",0,0 +3183,Risk and Protective Factors for Psychopathology Among Older versus Younger Adults After the 2004 Florida Hurricanes,"Previous research demonstrates increased resiliency to psychopathology after disasters among older adults. However, little is known about differences in age-based risk and protective factors for postdisaster mental illness.The authors used random-digit dialing methodology to survey 1,130 older adults (60+ years) and 413 younger adults residing in Florida counties directly affected by the 2004 hurricanes. Assessed risk and protective factors included demographics, social support, displacement, incurred dollar losses, perceived positive outcomes, and self-rated health status. Outcome variables included symptom counts of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-defined posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD).Older adults reported fewer symptoms of PTSD, MDD, and GAD. Explanatory risk variables accounted for large proportions of variance, but differed in meaningful ways across age groups.Although older adults are less symptomatic, their psychologic reactions appear more closely connected to economic consequences of disasters.",0,0 +3184,The Consequences of Violence on the Mental Health of the Elderly,"This chapter reviews the prevalence and risk factors associated with violence during the life course of the elderly, including its short and long-term consequences. As violence is highly prevalent in many societies individuals who have been exposed to violence have also grown old. There is limited knowledge about the long-term implications of early exposure into late life. Elder abuse has become a major issue in public health; however, the elderly are also victims to crime, war, atrocities in society, and trauma from disasters. The mental health implications of exposure to violence are reviewed, in particular post-traumatic stress disorder. Controlled studies on treatment of older individuals exposed to violence are rare. The findings suggest that exposure to violence in childhood, as a young adult or as an elder all have adverse effects on mental health in old age. The trajectory of these mental health outcomes suggests that the elderly may have a path of resilience. © Springer Science+Business Media Dordrecht 2015",0,0 +3185,"Post-traumatic stress disorder symptoms, underlying affective vulnerabilities, and smoking for affect regulation","Post-traumatic stress disorder (PTSD) is overrepresented among cigarette smokers. It has been hypothesized that those with PTSD smoke to alleviate negative affect and counteract deficient positive affect commonly associated with the disorder; however, limited research has examined associations between PTSD symptoms, smoking motives, and affective vulnerability factors. In the current study, we examined (1) whether PTSD symptoms were associated with positive reinforcement and negative reinforcement smoking motives; and (2) whether two affective vulnerability factors implicated in PTSD-anxiety sensitivity and anhedonia-mediated relationships between PTSD symptoms and smoking motives.Data were drawn from a community sample of non-treatment-seeking smokers recruited without regard for trauma history (N = 342; 10+ cig/day). We used the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) to assess overall PTSD symptom severity as well as individual PTSD subfactors.Overall, PTSD symptom severity was significantly associated with negative reinforcement, but not positive reinforcement, smoking motives. Variation in anxiety sensitivity significantly mediated the relation between PTSD symptom severity and negative reinforcement smoking motives, whereas anhedonia did not. Regarding PTSD subfactors, emotional numbing was the only PTSD subfactor associated with smoking rate, while re-experiencing symptoms were uniquely associated with both positive reinforcement and negative reinforcement smoking motives.Findings suggest that anxiety sensitivity may be an important feature associated with PTSD that enhances motivation to smoke for negative reinforcement purposes. Smoking cessation interventions that alleviate anxiety sensitivity and enhance coping with negative affect may be useful for smokers with elevated PTSD symptoms.",0,0 +3186,Review of sertraline and its clinical applications in psychiatric disorders,"Sertraline (Zoloft, Pfizer) has been shown in numerous controlled studies to have similar efficacy to other selective serotonin (5-HT) re-uptake inhibitors (SSRIs) in the treatment of depression and anxiety disorders. Further research is indicating that the efficacy of sertraline extends even beyond the treatment of depression and anxiety to include utility in eating disorders, premenstrual dysphoric disorder (PMDD) and possibly substance abuse treatment. Along with other SSRIs, sertraline offers several advantages over older antidepressants, including improved patient tolerability, low risk of lethality in overdose and no dependence potential. In head-to-head comparisons, sertraline appears to be at least as well-tolerated as other SSRIs and may even have a more favourable side effect profile. Low potential for pharmacokinetic drug interactions is another advantage of sertraline. Unlike fluoxetine, fluvoxamine and paroxetine, sertraline is not a potent inhibitor of any of the cytochrome P450 isoenzyme systems. As a result of its proven efficacy, good tolerability and lack of pharmacokinetic interactions, sertraline should be considered first-line in the treatment of anxiety and depressive disorders.",0,0 +3187,Pain Descriptors Used by Military Personnel Deployed to Iraq and Afghanistan Following Combat-Related Blast Experience,"Pain complaints are highly prevalent among military personnel of the combat operations in Iraq and Afghanistan, due, in part, to blast-related injuries. Further, pain often co-occurs with condition...",0,0 +3188,"Contribution of cognitive factors to the prediction of post-traumatic stress disorder, phobia and depression after motor vehicle accidents","Past research into the psychological consequences of traumatic events has largely focused on post-traumatic stress disorder (PTSD), although other anxiety disorders and depression are also common in the aftermath of trauma. Little is known about differential predictors of these conditions. The present study investigated the extent to which theoretically derived cognitive variables predict PTSD, phobias and depression after motor vehicle accidents. The cognitive predictors were compared to a set of established, mainly non-cognitive predictors. In addition, we tested how disorder-specific the cognitive predictors are. Participants (n=101) were interviewed within a year after having been injured in a motor vehicle accident. Diagnoses of PTSD, travel phobias and depression, symptom severities and predictor variables were assessed with self-report questionnaires and structured interviews. In multiple regression analyses, the sets of cognitive variables derived from disorder-specific models explained significantly greater proportions of the variance of the symptom severities than the established predictors (PTSD 76% vs. 45%, depression 72% vs. 46% and phobia 66% vs. 40%), and than cognitive variables derived from the models of the other disorders. In addition, the majority of individual cognitive variables showed the expected pattern of differences between diagnostic groups. The results support the hypothesis that disorder-specific sets of cognitive factors contribute to the development and maintenance of PTSD, phobias and depression following traumatic events.",0,0 +3189,Posttraumatic Stress Disorder in Patients With Burns,"Among 39 patients with burns evaluated a mean of 12 months after hospital discharge, 38% met DSM-III-R criteria for post-traumatic stress disorder (PTSD) for at least 1 month. With proposed DSM-IV criteria, 43% met criteria for past or current PTSD. Analysis of specific symptom clusters of PTSD revealed that 74% of patients had been affected by a reexperience symptom for at least 1 month, but only 30% were currently experiencing flashbacks. No correlation was found between several clinical correlates (TBSA, length of hospitalization, and age) and development of PTSD. There was no correlation between presence of a DSM-III-R psychiatric diagnosis at the time of hospitalization and later development of PTSD and no correlation between whether or not a psychiatric diagnosis emerged during hospitalization and later development of PTSD. Finally, patients who had injuries that they could not prevent were no more likely to experience PTSD.",0,0 +3190,Trauma Related Guilt Inventory – psychometric properties of the Polish adaptation (TRGI-PL),"AIM : Although various aspects of guilt are frequent problems of patients suffering from PTSD, they have been included into the diagnostic criteria for PTSD just in the present version DSM-5. Kubany proposed a cognitive conceptualization of guilt in PTSD followed by development of the Trauma Related Guilt Inventory (TRGI). The aim of the paper is to present psychometric properties of the Polish version of the inventory - the TRGI-PL.A Polish adaptation of the Trauma-Related Guilt Inventory was applied to a sample of 280 motor vehicle (MVA) participants (147 females, 133 males of age from 18 to 80 (M=34,93, SD=13,71) within 1-24 months after a MVA (M=10,18, SD=6,23). Validation of the Polish version was done by analyzing the internal structure of the instrument and comparing the emotional and cognitive aspects of guilt assessed by the TRGI with PTSD symptoms, post-traumatic cognitions and responsibility for MVA and subjective agreement with the judgment.The model with four latent factors: Distress, Hindsight-Bias/Responsibility, Wrongdoing and Insufficient Justification scales showed acceptable fit (Satorra-Bentler chi2=518,62, df=203, p<0,01, RMSEA=0,079, CFI=0,96, GFI=0,97), what confirms the four-factor structure of guilt, obtained in the studies on original TRGI version. Reliability coefficients are similar to original version. Correlations with other PTSD measures showed satisfactory convergent and discriminative validity.The Polish adaptation of the Trauma-Related Guilt Inventory is a reliable and valid tool for assessing guilt as a multidimensional phenomenon, comprising emotional and several cognitive characteristics, in trauma survivors.",0,0 +3191,Post-Traumatic Stress Disorder: A Comment on the Value of ‘Mixed Trauma’ Treatment Groups,"(1996). Post-Traumatic Stress Disorder: A Comment on the Value of ‘Mixed Trauma’ Treatment Groups. Australasian Psychiatry: Vol. 4, No. 5, pp. 258-259.",0,0 +3192,The effects of preterm birth on mother-infant interaction and attachment during the infant's first two years,"Abstract Objective. Early mother–infant relationships in preterm populations were evaluated in the context of a systematic review of the literature. Design and setting. A systematic search of three electronic databases (PsychINFO, PubMed and Cochrane Library) was undertaken. Three studies of maternal attachment, 18 studies of mother–preterm infant interaction and eight studies of infant attachment were included. Studies of preterm infant attachment were also evaluated using a meta-analysis. Results. Studies of mother–preterm infant interactions showed that the differences in maternal interaction behavior between mothers of preterm infants and mothers of full-term infants seem to be most evident during the first six months of life. Differences in the preterm infant's interaction behavior seem also to continue for six months after birth. However, five of 18 studies showed an equal or even higher quality of mother–infant interaction in groups of preterm compared to groups of full-term infants. Studies of maternal and infant attachment indicated that preterm infants and their mothers are not at higher risk of insecure attachment than full-term infants and their mothers. Conclusions. The mother–preterm infant relationship is complex, and some relational patterns forecast greater psychological risk than others. It is important to decrease maternal stress and early separation in every possible way during hospitalization as well as after discharge.",0,0 +3193,Personality Assessment Inventory profiles of veterans: Differential effects of mild traumatic brain injury and psychopathology,"Objective: Neuropsychiatric complaints often accompany mild traumatic brain injury (mTBI), a common condition in post-deployed Veterans. Self-report, multi-scale personality inventories may elucidate the pattern of psychiatric distress in this cohort. This study investigated valid Personality Assessment Inventory (PAI) profiles in post-deployed Veterans. Method: Measures of psychopathology and mTBI were examined in a sample of 144 post-deployed Veterans divided into groups: healthy controls (n = 40), mTBI only (n = 31), any mental health diagnosis only (MH; n = 25), comorbid mTBI and Posttraumatic Stress Disorder (mTBI/PTSD; n = 23), and comorbid mTBI, PTSD, and other psychological diagnoses (mTBI/PTSD/MDD+; n = 25). Results: There were no significant differences between the mTBI and the control group on mean PAI subscale elevation, or number of subscale elevations above 60T or 70T. The other three groups had significantly higher overall mean scores, and more elevations above 60 and 70T compared to both controls and mTBI only. The mTBI/PTSD/MDD+ group showed the highest and most elevations. After entering demographics, PTSD, and number of other psychological diagnoses into hierarchical regressions using the entire sample, mTBI history did not predict mean PAI subscale score or number of elevations above 60T or 70T. PTSD was the only significant predictor. There were no interaction effects between mTBI and presence of PTSD, or between mTBI and total number of diagnoses. Conclusions: This study suggests that mTBI alone is not uniquely related to psychiatric distress in Veterans, but that PTSD accounts for self-reported symptom distress. © 2015, Springer Science+Business Media New York (outside the USA).",0,0 +3194,Relationship between PTSD symptomatology and nicotine dependence severity in crime victims,"Smoking rates are higher and cessation rates are lower among individuals with posttraumatic stress disorder (PTSD) compared to the general population, thus understanding the relationship between PTSD and nicotine dependence is important. In a sample of 213 participants with a crime-related trauma (109 with PTSD), the relationship between PTSD status, smoking status (smoker vs. non-smoker), substance abuse diagnosis (SUD), PTSD symptoms, and sex was assessed. SUD diagnosis was significantly related to smoking status, but PTSD symptomatology and sex were not. Among smokers (n=117), increased nicotine dependence severity was associated with being male and with increased level of PTSD avoidance symptoms. Correlations indicated that PTSD avoidance and hyperarousal symptom clusters and total PTSD symptom scores were significantly related to nicotine dependence severity in males, while PTSD symptomatology in general did not correlate with dependence severity for females. The results suggest that level of PTSD symptomatology, particularly avoidance symptoms, may be important targets for smoking cessation treatment among male smokers who have experienced a traumatic event.",0,0 +3195,PTSD symptoms as risk factors for intimate partner violence revictimization and the mediating role of victims' violent behavior,"Apart from being a consequence of intimate partner violence (IPV), posttraumatic stress disorder (PTSD) can also be a risk factor for IPV revictimization. The current study examined how each of 4 PTSD symptom clusters (reexperiencing, arousal, avoidance, and numbing) related to revictimization in a sample of 156 female help-seeking victims of IPV, recruited from various victim support services in the Netherlands. In addition, we hypothesized that victim-perpetrated IPV would mediate the relation between PTSD symptomatology and IPV revictimization. Our results show that victims' PTSD reexperiencing symptoms predict revictimization of partner violence (d = .45 for physical IPV revictimization; d = .35 for psychological IPV revictimization); the other 3 PTSD symptom clusters were not related to IPV revictimization. Furthermore, victim-perpetrated psychological IPV was found to partially mediate the relation between victims' PTSD reexperiencing symptoms and IPV revictimization (Z = 2.339, SE = 0.044, p = .019 for physical IPV revictimization, and Z = 2.197, SE = 0.038, p = .028 for psychological IPV revictimization). Findings indicate that IPV victims with higher levels of PTSD reexperiencing symptoms may be more likely to perpetrate psychological IPV themselves, which may put them at greater risk for receiving IPV in return. Based on these results, a focus on individual PTSD symptom clusters and victim behaviors seems relevant for practice and may contribute to a decrease in victims' risk for future IPV.",0,0 +3196,Expanding the Science of Resilience: Conserving Resources in the Aid of Adaptation,In considering resilience to stress there are several key organizing principles that will aid both research and understanding. Understanding resilience is critical to illumination of the stress pro...,0,0 +3197,"What predicts psychological resilience after disaster? The role of demographics, resources, and life stress.","A growing body of evidence suggests that most adults exposed to potentially traumatic events are resilient. However, research on the factors that may promote or deter adult resilience has been limited. This study examined patterns of association between resilience and various sociocontextual factors. The authors used data from a random-digit-dial phone survey (N = 2,752) conducted in the New York City area after the September 11, 2001, terrorist attack. Resilience was defined as having 1 or 0 posttraumatic stress disorder symptoms and as being associated with low levels of depression and substance use. Multivariate analyses indicated that the prevalence of resilience was uniquely predicted by participant gender, age, race/ethnicity, education, level of trauma exposure, income change, social support, frequency of chronic disease, and recent and past life stressors. Implications for future research and intervention are discussed.",0,0 +3198,"Post-traumatic stress disorder, social anxiety disorder, and depression in survivors of the Kosovo War: Experiential avoidance as a contributor to distress and quality of life","Few studies have been conducted on psychological disorders other than post-traumatic stress disorder (PTSD) in war survivors. The aim of this study was to examine PTSD, social anxiety disorder (SAD), and major depressive disorder (MDD) and their associations with distress and quality of life in 174 Albanian civilian survivors of the Kosovo War. This included testing of conceptual models suggesting that experiential avoidance might influence associations between anxiety and mood disorders with psychological functioning. Each of the three psychiatric disorders was associated with greater experiential avoidance and psychological distress, and lower quality of life. Being a refugee was associated with a higher likelihood of having SAD and MDD. We found evidence for experiential avoidance as a partial mediator of the respective effects of SAD and PTSD on quality of life; experiential avoidance did not mediate the effects of disorders on global distress. We also found support for a moderation model showing that only war survivors without SAD and low experiential avoidance reported elevated quality of life; people with either SAD or excessive reliance on experiential avoidance reported compromised, low quality of life. This is the third independent study, each using a different methodology, to find empirical support for this moderation model [Kashdan, T. B., & Breen, W. E. (2008). Social anxiety and positive emotions: a prospective examination of a self-regulatory model with tendencies to suppress or express emotions as a moderating variable. Behavior Therapy, 39, 1-12; Kashdan, T. B., & Steger, M. F. (2006). Expanding the topography of social anxiety: an experience sampling assessment of positive emotions and events, and emotion suppression. Psychological Science, 17, 120-128]. Overall, we provided initial evidence for the importance of addressing PTSD, SAD, MDD, and experiential avoidance in primarily civilian war survivors.",0,0 +3199,Differential Effects of Subtypes of Trauma Symptoms on Couples' Hypothalamus-Pituitary-Adrenal (HPA) Axis Reactivity and Recovery in Response to Interpersonal Stress,"Abstract: This article examined the relation of five subtypes of trauma symptoms to hypothalamus-pituitary-adrenal (HPA) functioning as assessed with salivary cortisol before, during, and after an experimentally induced interpersonal conflict task in 194 heterosexual young adult couples. Trauma history and symptoms were assessed through structured clinical interviews and standardized self-report measures. Hierarchical linear modeling was used to analyze the effects of trauma symptoms on trajectories of cortisol reactivity to and recovery from the interpersonal stress. Trauma-related anxiety, depression, sleep disturbances, and dissociation significantly predicted cortisol reactivity and recovery. Trauma-related anxiety, sleep disturbances, and sexual problems significantly predicted partners' cortisol reactivity to interpersonal stress.",0,0 +3200,"Trauma and Posttraumatic Stress Disorder in an Urban Xhosa Primary Care Population: Prevalence, Comorbidity, and Service Use Patterns","Despite increased awareness of the prevalence and morbidity of psychiatric illnesses, relatively few studies have been undertaken in primary care settings in the African context. The authors determined the prevalence of trauma exposure and posttraumatic stress disorder (PTSD) in a South African township primary health care clinic and assessed associated demographic factors, comorbidity, service use, service satisfaction, and quality of life. Subjects were directly interviewed using translated, standardized instruments to assess variables described. Retrospective chart analysis assessed clinician case identification and psychotropic drug-prescribing habits. Of the 201 participants, 94% reported exposure to traumatic events (mean, 3.8). Trauma was associated with single status (p =.01), and PTSD was associated with poverty and single status (p =.04). Both sexes were equally likely to develop PTSD. PTSD (current; 19.9%), depression (37%), and somatization disorder (18.4%) were the most common diagnoses. Comorbidity with PTSD was high and included depression (75%, p <.01), somatization (35%, p <.01), and panic disorder (25%, p <.01). Levels of functional impairment were higher for subjects with PTSD, depression, and somatization than for those without (p <.05). PTSD comorbid with depression compounded impairment (p =.04). Levels of trauma, PTSD, and depression did not increase service use or dissatisfaction with services. Clinicians did not identify trauma (0%) or psychopathology (0%), and psychotropic medication was prescribed for only 1% of participants. In this population, trauma and PTSD were highly prevalent and associated with significant unidentified morbidity and comorbidity. Patients remain untreated for years in the current system of primary care consultations.",0,0 +3201,The impact of ecological momentary assessment on posttraumatic stress symptom trajectory,"Ecological momentary assessment includes continuous, real-time gathering of self-report data in a participant's natural environment. The current study evaluated the possible impact of this assessment strategy on severity of posttraumatic stress (PTS) in a sample of participants who reported experiencing a past traumatic event. Participants with clinically elevated PTS symptoms reported symptom severity at three time-points: during an initial screening, following an unmonitored period, and following two weeks of monitoring. During the monitoring period, participants carried an Android device which prompted them to report PTS symptoms and negative emotions six times daily. PTS severity scores were then compared across these three time-points. Results indicated that participating in the ecological momentary assessment protocol was associated with a significant reduction in PTS severity, whereas significant changes were not noted over the unmonitored control condition. The authors conclude that ecological momentary assessment may have therapeutic value even when not combined with formal intervention, and it may be a useful tool for improving the efficiency of a stepped-care approach to treating PTS symptoms.",0,0 +3202,Long-Term Positive and Negative Psychological Late Effects for Parents of Childhood Cancer Survivors: A Systematic Review,"Increasing survival rates in childhood cancer have yielded a growing population of parents of childhood cancer survivors (CCSs). This systematic review compiles the literature on positive and negative long-term psychological late effects for parents of CCSs, reported at least five years after the child's diagnosis and/or two years after the end of the child's treatment. Systematic searches were made in the databases CINAHL, EMBASE, PsycINFO, and PubMed. Fifteen studies, published between 1988 and 2010, from 12 projects were included. Thirteen studies used quantitative methodology, one quantitative and qualitative methodology, and one qualitative methodology. A total of 1045 parents participated in the reviewed studies. Mean scores were within normal ranges for general psychological distress, coping, and family functioning. However, a substantial subgroup reported a clinical level of general psychological distress, and 21-44% reported a severe level of posttraumatic stress symptoms. Worry, disease-related thoughts and feelings, marital strains, as well as posttraumatic growth was reported. Several factors were associated with the long-term late effects, such as parents' maladaptive coping during earlier stages of the childs disease trajectory and children's current poor adjustment. Quality assessments of reviewed studies and clinical implications of findings are discussed and recommendations for future research are presented.",0,0 +3203,Measuring the Severity of Negative and Traumatic Events,"We devised three measures of the general severity of events, which raters applied to participants' narrative descriptions: 1) placing events on a standard normed scale of stressful events, 2) placing events into five bins based on their severity relative to all other events in the sample, and 3) an average of ratings of the events' effects on six distinct areas of the participants' lives. Protocols of negative events were obtained from two non-diagnosed undergraduate samples (n = 688 and 328), a clinically diagnosed undergraduate sample all of whom had traumas and half of whom met PTSD criteria (n = 30), and a clinically diagnosed community sample who met PTSD criteria (n = 75). The three measures of severity correlated highly in all four samples but failed to correlate with PTSD symptom severity in any sample. Theoretical implications for the role of trauma severity in PTSD are discussed.",0,0 +3204,Treatment Outcome in Depressed Latinos Predicted by Concomitant Psychosislike Symptoms,"We compared treatment response (≥50 decrease in Nine-Item Patient Health Questionnaire total score) among 24 Latinos with major depressive disorder, presenting with and without specific psychosislike symptoms: A, hearing noises or house sounds, B, hearing voices calling one's name, C, seeing fleeting visions such as shadows, and D, symptoms more likely to be truly psychotic (e.g., poorly defined and short-lasting voices [other than B], fleeting paranoid ideation, or fleeting ideas of reference). 18 subjects (75%) endorsed symptoms of cluster A, 12 (50%) of cluster B, 10 (31%) of cluster C, and 12 (50%) of cluster D. Only subjects who reported symptoms from the D cluster exhibited significantly unfavorable depressive outcomes (compared to those with absence of D symptoms). The authors propose a phenomenological differentiation between benign psychosislike symptoms (clusters A-C) and the expression of the psychotic continuum (cluster D) in depressed Latinos.",0,0 +3205,Translational evidence for a role of endocannabinoids in the etiology and treatment of posttraumatic stress disorder,"• Endocannabinoids are involved in the etiology of PTSD . • They are linked to anxious arousal symptoms. • Enhancing endocannabinois function may specifically treat this symptom complex of PTSD. Posttraumatic stress disorder (PTSD) is a prevalent, chronic, and disabling anxiety disorder that may develop following exposure to a traumatic event. Despite the public health significance of PTSD, relatively little is known about the etiology or pathophysiology of this disorder, and pharmacotherapy development to date has been largely opportunistic instead of mechanism-based. Recently, an accumulating body of evidence has implicated the endocannabinoid system in the etiology of PTSD, and targets within this system are believed to be suitable for treatment development. Herein, we describe evidence from translational studies arguing for the relevance of the endocannabinoid system in the etiology of PTSD. We also show mechanisms relevant for treatment development. There is convincing evidence from multiple studies for reduced endocannabinoid availability in PTSD. Brain imaging studies show molecular adaptations with elevated cannabinoid type 1 (CB 1 ) receptor availability in PTSD which is linked to abnormal threat processing and anxious arousal symptoms. Of particular relevance is evidence showing reduced levels of the endocannabinoid anandamide and compensatory increase of CB 1 receptor availability in PTSD, and an association between increased CB 1 receptor availability in the amygdala and abnormal threat processing, as well as increased severity of hyperarousal, but not dysphoric symptomatology, in trauma survivors. Given that hyperarousal symptoms are the key drivers of more disabling aspects of PTSD such as emotional numbing or suicidality, novel, mechanism-based pharmacotherapies that target this particular symptom cluster in patients with PTSD may have utility in mitigating the chronicity and morbidity of the disorder.",0,0 +3206,Obesogenic Family Types Identified through Latent Profile Analysis,"Obesity may cluster in families due to shared physical and social environments.This study aims to identify family typologies of obesity risk based on family environments.Using 2007-2008 data from 706 parent/youth dyads in Minnesota, we applied latent profile analysis and general linear models to evaluate associations between family typologies and body mass index (BMI) of youth and parents.Three typologies described most families with 18.8% ""Unenriched/Obesogenic,"" 16.9% ""Risky Consumer,"" and 64.3% ""Healthy Consumer/Salutogenic."" After adjustment for demographic and socioeconomic factors, parent BMI and youth BMI Z-scores were higher in unenriched/obesogenic families (BMI difference = 2.7, p < 0.01 and BMI Z-score difference = 0.51, p < 0.01, respectively) relative to the healthy consumer/salutogenic typology. In contrast, parent BMI and youth BMI Z-scores were similar in the risky consumer families relative to those in healthy consumer/salutogenic type.We can identify family types differing in obesity risks with implications for public health interventions.",0,0 +3207,Risk and preventive factors of post-traumatic stress disorder (PTSD): alcohol consumption and intoxication prior to a traumatic event diminishes the relative risk to develop PTSD in response to that trauma,"Previous reports examined the effects of selected pre- (e.g. female gender, previous trauma), peri- (e.g. the horror of the trauma, threatened death) or post-exposure (e.g. the physical injury caused by the trauma) risk factors on the development of post-traumatic stress disorder (PTSD), an anxiety disorder associated with a traumatic event outside the range of usual human experience. We hypothesized that alcohol consumption prior to traumatic events may reduce the incidence rate of PTSD. The aim of this study was to examine the effects of the above risk factors and preventive factors, such as alcohol consumption, on the development of PTSD.An epidemiological cohort study was carried out on 127 victims trapped in a ballroom fire. Data were collected, 7-9 months after the traumatic event, by means of the Composite International Diagnostic Interview (CIDI) and structured interviews, aimed to assess the above pre-, peri- and post-exposure factors. Logistic regression analysis was used to examine the association of PTSD with the etiologic factors and to delineate those risk factors which contribute most to the development of PTSD.Female gender, the number of previous trauma, a past history of simple phobia, threatened death, trauma exposure, hospitalization for trauma-induced injuries and the presence of burns increased the odds of PTSD, whereas a sense of control during the trauma, and alcohol consumption and intoxication decreased the odds of PTSD. Six factors made independent contributions to the prediction of PTSD, i.e. the number of previous trauma, a past history of simple phobia, loss of control (increase the odds), a sense of control, alcohol consumption and alcohol intoxication (decrease the odds).The results of this study show that the development of PTSD is determined by the effects of pre-, peri- and post-exposure risk factors and may be prevented by the effects of peri-traumatic factors, such as sense of control, alcohol consumption and intoxication.",0,0 +3208,"The relationship between glucocorticoid receptor polymorphisms, stressful life events, social support, and post-traumatic stress disorder","It is debatable whether or not glucocorticoid receptor (GR) polymorphisms moderate susceptibility to PTSD. Our objective was to examine the effects of stressful life events, social support, GR genotypes, and gene-environment interactions on the etiology of PTSD.Three tag single nucleotide polymorphisms, trauma events, stressful life events, and social support were assessed in 460 patients with PTSD and 1158 control subjects from a Chinese Han population. Gene-environment interactions were analyzed by generalized multifactor dimensionality reduction (GMDR).Variation in GR at rs41423247 and rs258747, stressful life events, social support, and the number of traumatic events were each separately associated with the risk for PTSD. A gene-environment interaction among the polymorphisms, rs41423247 and rs258747, the number of traumatic events, stressful life events, and social support resulted in an increased risk for PTSD. High-risk individuals (a large number of traumatic events, G allele of rs258747 and rs41423247, high level stressful life events, and low social support) had a 3.26-fold increased risk of developing PTSD compared to low-risk individuals. The association was statistically significant in the sub-groups with and without childhood trauma.Our data support the notion that stressful life events, the number of trauma events, and social support may play a contributing role in the risk for PTSD by interacting with GR gene polymorphisms.",0,0 +3209,Children's reactions to a natural disaster: symptom severity and degree of exposure,"Abstract Self-report data for 5,687 children ranging in age from 9 to 19 years were collected approximately three months after Hurricane Hugo devastated the rural community where the children lived. Information about the children's perceptions of hurricane severity, degree of home damage suffered as a result of the hurricane, and hurricane-related parental job loss was used to categorize children into four levels of hurricane exposure. Reports of anxiety were obtained via the Revised Children's Manifest Anxiety Scale (RCMAS) and reports of posttraumatic stress disorder (PTSD) symptoms were obtained via the Reaction Index (RI). Significantly higher anxiety scores and significantly more PTSD symptomatology was found for children experiencing more or more severe exposure to the hurricane. Girls reported more anxiety and PTSD symptoms than boys, and black children were more likely than the white children to report PTSD symptomatology. Additionally, girls were more severely affected by increasing levels of hurricane exposure as indicated by their RI scores. These results indicate that, similar to adult and child victims of crime and adult victims of disaster, the development of PTSD symptoms in children exposed to a natural disaster is a function of the degree of exposure to the traumatic event. The results also suggest that children's trait negative affectivity may moderate the effects of exposure on the development of PTSD symptoms.",0,0 +3210,The structure of post-traumatic stress symptoms in young survivors of war,"Research on the dimensionality of post-traumatic stress disorder (PTSD) has generally failed to provide support for the three clusters of PTSD suggested in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). However, much research has been restricted to samples in North America and Western European countries. The aim of the current study was to test four alternative factor models among a relatively understudied population-young civilian survivors of war who had experienced war-related events as adolescents-in order to establish whether the factor structure of PTSD is consistent among various traumatized populations and age groups. Using the Posttraumatic Stress Diagnostic Scale, the results indicated that the four-factor model including intrusion, avoidance, hyperarousal, and numbing factors provided a better fit than the three-factor model suggested by the DSM-IV. The current study offers additional support from another population for a four-factor model of PTSD that implies a separation of avoidance and numbing items. Case conceptualization and treatment implications are discussed.",0,0 +3211,Post-traumatic stress disorder in partners of people with epilepsy,"The objectives of the present study were to examine whether living with an individual who suffered from epilepsy was a potentially traumatizing event and to identify predictive risk factors in developing post-traumatic stress disorder (PTSD).Six hundred fourteen respondents completed the Harvard Trauma Questionnaire, the Crisis Support Scale, the Hopkins Symptom Checklist-25, and the Dyadic Adjustment Scale. In addition, demographic variables were included in order to identify factors that might predict PTSD.The percentage of the participants that fulfilled the symptom criteria of PTSD was 7.7%, and an additional 43.9% reported a subclinical level of PTSD. Clinical and subclinical anxiety was unveiled in 9.3% of the respondents.Partners were at risk of PTSD when living with a patient with epilepsy. Identified variables that explained PTSD were frequency and types of seizures medication, side effects, and objective and subjective epilepsy severity, anxiety, and depression. High level of social support decreased the level of traumatic stress.",0,0 +3212,Post-traumatic stress and coping factors among search and recovery divers,"Irish search and recovery divers dive on a voluntary basis to recover missing persons. During these procedures, they encounter situations not typically part of ordinary human experience and might be expected to experience psychological effects as a result.To investigate the association of post-traumatic stress disorder (PTSD) symptoms with previous experience of missing person recovery among divers, and to investigate the coping mechanisms used.Self-administered questionnaires were distributed to all 206 active search divers in Ireland. A validated questionnaire, the Impact of Event Scale revised (IES-R), was used together with a coping questionnaire to compare the level of symptoms in divers with and without recovery experience, and to describe the main coping factors.One hundred and fifty-five questionnaires were returned, a response rate of 75%. Divers with prior missing person recovery experience scored lower on all three PTSD dimensions (avoidance, intrusion and hyper-arousal) with a significant difference for intrusion (P < 0.001). Coping mechanisms listed by the divers were search and recovery training, support from peers and search unit and sense of duty.The results do not support the hypothesis of an accumulation of traumatic experience in experienced divers but may indicate a survivor bias of the most resilient individuals, or a wearing off of vulnerability to traumatic events with experience.",0,0 +3213,Bullying: a source of chronic post traumatic stress?,"This study surveyed 165 care professionals on their experience of workplace bullying. The results showed that in a 2-year period 40% had been bullied and 68% had observed bullying taking place. Of the 67 care professionals that had been bullied 44% were experiencing high levels of PTSD symptoms based on the general factor of the IES-E. However, when these results were examined further it was found that the symptoms clustered rather differently to those of victims of other forms of trauma. In victims of bullying, the symptoms of arousal and re-experience formed a single cluster of symptoms with avoidance remaining as a separate cluster. These results are challenging in both the classification of Post Traumatic Stress Disorder and for the treatment of victims of bullying.",0,0 +3214,Parenting an infant with a congenital anomaly,"The present study examined psychological adjustment in parents of infants with congenital anomalies (CAs), focusing on the interval from the disclosure of the diagnosis to six months after the infant’s birth and considering the effects of the parent’s gender and the timing of diagnosis (pre- vs postnatal). Within-group diversity was also examined by identifying distinct patterns of individual adjustment over time. Parents of 43 infants (43 mothers and 36 fathers) with a pre- or postnatal diagnosis of a CA answered questionnaires assessing psychological distress and quality of life one month after the disclosure of the diagnosis and six months after the infant’s birth. Results showed a significant reduction in psychological distress and a significant increase in physical quality of life over time, for both parents, regardless of the timing of diagnosis. In all, 57% of parents presented a pattern of recovery from diagnosis to six months post birth and 26.6% presented a pattern of resilience. However, 15.2% of parents showed chronic adjustment difficulties. Findings suggest that most parents tend to adjust to their infant’s CA, although some experienced difficulties and should be targeted for specialised counselling. Both members of the couple should be acknowledged, as both experience similar patterns of adjustment.",0,0 +3215,The role of shame in distinguishing perpetrators of intimate partner violence in U.S. veterans,"Increasing attention is being paid to the fact that exposure to traumatic stressors in military combat may lead to perpetration of intimate partner violence (IPV). Because shame has been identified as a factor in posttraumatic stress disorder (PTSD), the current cross-sectional study examined the relationship in U.S. veterans between IPV and PTSD, depression, guilt, and shame. We hypothesized that shame would be the strongest correlate of perpetration of IPV and that shame would mediate the relationship between PTSD and IPV. Participants were 264 primarily male and Caucasian mixed-era veterans presenting for psychological treatment at a Veterans Affairs hospital. They completed standard measures of depression, PTSD symptoms, shame, and guilt and a local checklist was used to dichotomize the sample regarding IPV. Discriminant analysis indicated that shame contributed most (standardized canonical discriminant function coefficient = .44) to distinguishing perpetrators of IPV. In addition, the results were consistent with shame as a mediator of the relationship between PTSD and IPV. These results are in line with studies indicating that shame is linked to IPV perpetration in nonveteran samples (Harmon, 2002; Rand, 2004; Schibik, 2002) and suggests that shame may be an important aspect of the relationship between PTSD and IPV.",0,0 +3216,Postmigration Living Problems and Common Psychiatric Disorders in Iraqi Asylum Seekers in the Netherlands,"In a previous community-based, national study among Iraqi asylum seekers, a long asylum procedure was found to have a higher risk for common psychiatric disorders than adverse life events in Iraq. In the present article, the postmigration period is considered in more detail and evaluated in relationship with psychiatric disorders. Respondents were interviewed with fully structured, culturally validated, translated questionnaires. With the use of a Post- migration Living Problems questionnaire, worries about all kinds of problems were gathered. Psychiatric (DSM-IV) disorders were measured with the Composite International Diagnostic Interview 2.1. Factor analysis was done on the postmigration living problems, and in univariate and multivariate analyses, associations with psychopathology were calculated. Results show that clusters of postmigration living problems could be identified: family issues, discrimination, asylum procedure, socioeconomic living conditions, socioreligious aspects, and work-related issues. There was a significant relationship between all clustered postmigration living problems and psychopathology, except for socioreligious aspects. Multivariate logistic regression showed that lack of work, family issues, and asylum procedure stress had the highest odds ratios for psychopathology. The findings appeal to governments to shorten the asylum procedures, allow asylum seekers to work, and give preference to family reunion. Mental health workers should recognize the impact of postmigration living problems and consider focusing their treatment on coping with these problems instead of traumas from the past.",0,0 +3217,Psychometric properties of the Korean version of the Short Post-Traumatic Stress Disorder Rating Interview (K-SPRINT),"Aims: The Short Post-traumatic Stress Disorder (PTSD) Rating Interview (SPRINT) is a validated, eight-item, brief global assessment scale for PTSD. This report investigated the psychometric properties of the Korean version of the SPRINT (K-SPRINT). Methods: Eighty-seven PTSD patients, 47 other psychiatric patients, and 63 healthy control subjects were enrolled in the study. All subjects completed a psychometric assessment package that included the K-SPRINT and the Korean versions of the Clinician-Administered PTSD Scale (CAPS), the Beck Depression Inventory (BDI), and the State Trait Anxiety Inventory (STAI). Results: The K-SPRINT showed good internal consistency (Cronbach's α = 0.86) and test–retest reliability (r = 0.82). K-SPRINT showed moderatecorrelations with CAPS (r = 0.71). An exploratory factor analysis produced one K-SPRINT factor. The optimal diagnostic efficiency (91.9%) of the K-SPRINT was found at a total score of 15, at which point the sensitivity and specificity were 90.8% and 92.7%, respectively. Conclusions: The present findings demonstrate that the K-SPRINT had good psychometric properties and can be used as a reliable and valid instrument for the assessment of PTSD.",0,0 +3218,"Active Multimodal Psychotherapy in Children and Adolescents with Suicidality: Description, Evaluation and Clinical Profile","The aim of this study was to describe and evaluate the clinical pattern of 14 youths with presenting suicidality, to describe an integrative treatment approach, and to estimate therapy effectiveness. Fourteen patients aged 10 to 18 years from a child and adolescent outpatient clinic in Stockholm were followed in a case series. The patients were treated with active multimodal psychotherapy. This consisted of mood charting by mood-maps, psycho-education, wellbeing practice and trauma resolution. Active techniques were psychodrama and body—mind focused techniques including eye movement desensitization and reprocessing. The patients were assessed before treatment, immediately after treatment and at 22 months post treatment with the Global Assessment of Functioning Scale. The clinical pattern of the group was observed. After treatment there was a significant change towards normality in the Global Assessment of Functioning scale both immediately post-treatment and at 22 months. A clinical pattern, post trauma suicidal reaction, was observed with a combination of suicidality, insomnia, bodily symptoms and disturbed mood regulation. We conclude that in the post trauma reaction suicidality might be a presenting symptom in young people. Despite the shortcomings of a case series the results of this study suggest that a mood-map-based multimodal treatment approach with active techniques might be of value in the treatment of children and youth with suicidality.",0,0 +3219,Validation of the PTSD checklist-civilian version in survivors of bone marrow transplantation,"Life-threatening illness now qualifies as a precipitating stessor for posttraumatic stress disorder (PTSD). We examined the validity of the PTSD Checklist-Civilian Version (PCL-C; Weathers, Litz, Herman, Juska, & Keane, 1993), a brief 17-item inventory of PTSD-like symptoms, in a sample of 111 adults who had undergone bone marrow transplantation an average of 4.04 years previously. Exploratory factor analysis of the PCL-C identified four distinct patterns of symptom responses: Numbing-Hyperarousal, Dreams-Memories of the Cancer Treatment, General Hyperarousal, Responses to Cancer-Related Reminders and Avoidance-Numbing. Respondents meeting PTSD symptom criteria on the PCL-C had significantly lower physical, role, and social functioning, greater distress and anxiety, and significantly more intrusive and avoidant responses than individuals who did not meet PTSD symptom criteria.",0,0 +3220,South African adolescents with cystic fibrosis: a qualitative exploration of their bio-psychosocial fields,"This qualitative case study explored risk factors and protective factors in the bio-psychosocial fields of adolescents living with cystic fibrosis (CF).Semi-structured interviews were conducted with adolescents in the middle and late adolescent years (15-22 years) who had the defining characteristics of CF and were living in Gauteng province.Themes emerged from individual interviews. The fundamental human need to be understood and to understand was negatively affected as the illness affected socialisation and learning. Participants experienced an array of emotions including loss and bereavement linked to their illness and when friends with CF died. Constructive internal dialogue and positive thinking emerged as protective variables. Participants generally showed awareness of how they regulated their contact with the illness and how they self-regulate. Despite the severity of their symptoms and the taxing demands of managing CF, participants expressed hope for the future and could find some meaning in the illness.Adolescents with CF who participated in this study indicated that they felt different from their peers. Apart from the general developmental tasks typical to adolescence they faced the challenge of managing a severe chronic and potentially terminal illness.",0,0 +3221,Structural Model Analysis of HIV Risk Behaviors among Sexually Active Minority Adolescents,"Contents of this article are solely the responsibility of the authors and do not necessarily reflect the opinions, official policy or position of the U.S. Department of Health and Human Services, the Substance Abuse and Mental Health Services Administration or Centers for Mental Health Services and Substance Abuse Prevention.To evaluate an HIV risk profile in sexually active black and Hispanic adolescents using a structural equation model (SEM).Grantees from 15 states and Washington, DC, were selected to participate in the study. Black and Hispanic adolescents (N = 2,371) who completed the baseline instrument were required to have experienced vaginal, oral or anal sex in order to be included in this study. Total minority youths who self-reported as black but not Hispanic were n = 1,455 and for Hispanic n = 916.The hypothesized model fit moderately well (CFI = 0.940, TLI = 0.928, RMSEA = 0.039). The key significant direct effect was found (P < 0.05) for higher alcohol, tobacco and other drug use related to nonuse of condoms, more sex partners and use of substances before sex.Current findings underscore the need to incorporate culturally sensitive strategies in developing programs for minority youth. However, given that minority group members often report greater experiences of discrimination than whites, future research in this area should also include an examination of the role of other stressors such as racial disparities and their potential cumulative impact on minority youth and their risks for alcohol, tobacco and other drug use and HIV.",0,0 +3222,Recent Developments in Potential Anxiolytic Agents Targeting GABAA/BzR Complex or the Translocator Protein (18kDa) (TSPO),"Anxiety disorders are frequent and disabling disorders. For short-term treatment, benzodiazepines are useful due to their rapid onset of anxiolytic action. However, these compounds have sedative properties and may induce tolerance, abuse liability and withdrawal symptoms. First-line choices for the long-term treatment are selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors. The major disadvantage of these compounds is their delayed onset of action. It is obvious that there is a need for novel pharmacological approaches that combine a rapid anxiolytic efficacy with the lack of tolerance induction, abuse liability and withdrawal symptoms. A very important target for the development of such compounds is the -amino-butyric-acid (GABA)A receptor. Subtype specific benzodiazepines are being developed, but also phytotherapeutic agents experience a renaissance as GABAA receptor modulators. On the other hand, GABA related compounds, e.g. tiagabine, did not show pronounced anxiolytic efficacy. Neuroactive steroids such as allopregnanolone and tetrahydrodeoxycorticosterone (THDOC) are potent modulators of GABAA receptors. To date synthetic neuroactive steroids could not be established in the treatment of anxiety disorders. Regarding endogenous neurosteroidogenesis, recently the translocator protein (18kDa) (TSPO) has been identified as a potential novel target. TSPO is supposed to play an important role for the synthesis of neuroactive steroids. TSPO ligands may promote the synthesis of neuroactive steroids via induction of cholesterol translocation to the inner mitochondrial membrane. First clinical studies revealed promising results. In this review, we discuss putative compounds affecting the GABAergic system which may provide the basis for fast acting anxiolytics with a favorable side effect profile.",0,0 +3223,Longitudinal changes of telomere length and epigenetic age related to traumatic stress and post-traumatic stress disorder,"Several studies have reported an association between traumatic stress and telomere length suggesting that traumatic stress has an impact on ageing at the cellular level. A newly derived tool provides an additional means to investigate cellular ageing by estimating epigenetic age based on DNA methylation profiles. We therefore hypothesise that in a longitudinal study of traumatic stress both indicators of cellular ageing will show increased ageing. We expect that particularly in individuals that developed symptoms of post-traumatic stress disorder (PTSD) increases in these ageing parameters would stand out. From an existing longitudinal cohort study, ninety-six male soldiers were selected based on trauma exposure and the presence of symptoms of PTSD. All military personnel were deployed in a combat zone in Afghanistan and assessed before and 6 months after deployment. The Self-Rating Inventory for PTSD was used to measure the presence of PTSD symptoms, while exposure to combat trauma during deployment was measured with a 19-item deployment experiences checklist. These groups did not differ for age, gender, alcohol consumption, cigarette smoking, military rank, length, weight, or medication use. In DNA from whole blood telomere length was measured and DNA methylation levels were assessed using the Illumina 450K DNA methylation arrays. Epigenetic ageing was estimated using the DNAm age estimator procedure. The association of trauma with telomere length was in the expected direction but not significant (B=-10.2, p=0.52). However, contrary to our expectations, development of PTSD symptoms was associated with the reverse process, telomere lengthening (B=1.91, p=0.018). In concordance, trauma significantly accelerated epigenetic ageing (B=1.97, p=0.032) and similar to the findings in telomeres, development of PTSD symptoms was inversely associated with epigenetic ageing (B=-0.10, p=0.044). Blood cell count, medication and premorbid early life trauma exposure did not confound the results. Overall, in this longitudinal study of military personnel deployed to Afghanistan we show an acceleration of ageing by trauma. However, development of PTSD symptoms was associated with telomere lengthening and reversed epigenetic ageing. These findings warrant further study of a perhaps dysfunctional compensatory cellular ageing reversal in PTSD.",0,0 +3224,Outcomes of posttraumatic stress disorder.,"The typical reaction to a life-threatening experience is one of distress, anxiety, and fear. This is characteristic of the basic survival instinct; these emotions enhance the individual's memory of the traumatic experience and thus serve to help in the recognition and avoidance of similarly dangerous situations in the future. In a significant minority of individuals, however, the natural reaction to trauma becomes uncontrollably and disastrously intensified, resulting in the symptoms of posttraumatic stress disorder (PTSD). PTSD varies in severity and duration between individuals, often relating to personal characteristics and the nature of the trauma to which a person is subjected. However, several factors, namely, chronicity, impairment, comorbidity, and somatization, are significantly related to and can influence the course of PTSD and subsequent outcome. This article briefly reviews each of these factors.",0,0 +3225,Trauma and Posttraumatic Stress Disorder in the Community,"The study estimates the relative importance of specific types of traumas experienced in the community in terms of their prevalence and risk of leading to posttraumatic stress disorder (PTSD).A representative sample of 2181 persons in the Detroit area aged 18 to 45 years were interviewed by telephone to assess the lifetime history of traumatic events and PTSD, according to DSM-IV. Posttraumatic stress disorder was assessed with respect to a randomly selected trauma from the list of traumas reported by each respondent, using a modified version of the Diagnostic Interview Schedule, Version IV, and the World Health Organization Composite International Diagnostic Interview.The conditional risk of PTSD following exposure to trauma was 9.2%. The highest risk of PTSD was associated with assaultive violence (20.9%). The trauma most often reported as the precipitating event among persons with PTSD (31% of all PTSD cases) was sudden unexpected death of a loved one, an event experienced by 60% of the sample, and with a moderate risk of PTSD (14.3%). Women were at higher risk of PTSD than men, controlling for type of trauma.The risk of PTSD associated with a representative sample of traumas is less than previously estimated. Previous studies have overestimated the conditional risk of PTSD by focusing on the worst events the respondents had ever experienced. Although recent research has focused on combat, rape, and other assaultive violence as causes of PTSD, sudden unexpected death of a loved one is a far more important cause of PTSD in the community, accounting for nearly one third of PTSD cases.",0,0 +3226,Attributional style and anxiety sensitivity as maintenance factors of posttraumatic stress symptoms: A prospective examination of a diathesis–stress model,"Diathesis-stress models of posttraumatic stress disorder (PTSD) assert that traumatic events function as stressors that interact with vulnerabilities to influence the development of PTSD. The present study prospectively examined negative attributional style (NAS) and anxiety sensitivity (AS) as maintenance factors for PTSD in female adult sexual assault victims. A diathesis-stress model was tested by examining interactions between the vulnerabilities and negative life events. The present study included both the traditional three-factor model of PTSD (re-experiencing, avoidance and emotional numbing, and arousal) and the dysphoria four-factor model of PTSD (re-experiencing, avoidance, arousal, and dysphoria). Robust regression analyses revealed that negative life events at Time 2 significantly predicted increases in all clusters of the three-factor model (i.e., re-experiencing, avoidance and numbing, and arousal) and the re-experiencing, arousal, and dysphoria clusters of the four-factor model (but not avoidance). Neither NAS nor AS significantly independently predicted any of the symptom clusters for either model. Both NAS and AS interacted with negative life events to predict increases in the avoidance and numbing symptoms. However, examination of the dysphoria four-factor model of PTSD revealed that the NAS and AS interactions with negative life events only predicted dysphoria symptoms.",0,0 +3227,A controlled comparison of eye movement desensitization and reprocessing versus exposure plus cognitive restructuring versus waiting list in the treatment of post-traumatic stress disorder,"A total of 105 patients with post-traumatic stress disorder (PTSD) were randomly allocated to eye-movement desensitization and reprocessing (EMDR) (n = 39) versus exposure plus cognitive restructuring (E + CR) (n = 37) versus waiting list (WL) (n = 29) in a primary care setting. EMDR and E + CR patients received a maximum of 10 treatment sessions over a 10-week period. All patients were assessed by blind raters prior to randomization and at end of the 10-week treatment or waiting list period. EMDR and E + CR patients were also assessed by therapists at the mid-point of the 10-week treatment period and on average at 15 months follow-up. Patients were assessed on a variety of assessor-rated and self-report measures of PTSD symptomatology including the Clinician Administered PTSD Scale (CAPS), the Impact of Events Scale (IOE) and a self-report version of the SI-PTSD Checklist. Measures of anxiety and depression included the Montgomery Asberg Depression Rating Scale (MADRS), the Hamilton Anxiety Scale (HAM-A) and the Hospital Anxiety and Depression Scale (HADS). A measure of social function, the Sheehan Disability Scale was also used. Drop-out rates between the three groups were 12 EMDR, 16 E + CR and five WL. Treatment end-point analyses were conducted on the remaining 72 patients. Repeated measures analysis of variance of treatment outcome at 10 weeks revealed significant time, interaction and group effects for all the above measures. In general there were significant and substantial pre–post reductions for EMDR and E + CR groups but no change for the WL patients. Both treatments were effective over WL. The only indication of superiority of either active treatment, in relation to measures of clinically significant change, was a greater reduction in patient self-reported depression ratings and improved social functioning for EMDR in comparison to E + CR at the end of the treatment period and for fewer number of treatment sessions for EMDR (mean 4.2) than E + CR (mean 6.4) patients. At 15 months follow-up treatment gains were generally well-maintained with the only difference, in favour of EMDR over E + CR, occurring in relation to assessor-rated levels of clinically significant change in depression. However, exclusion of patients who had subsequent treatment during the follow-up period diminished the proportion of patients achieving long-term clinically significant change. In summary, at end of treatment and at follow-up, both EMDR and E + CR are effective in the treatment of PTSD with only a slight advantage in favour of EMDR. Copyright © 2002 John Wiley & Sons, Ltd.",0,0 +3228,Plasma neurotransmitters and cortisol in chronic illness: role of stress.,"We routinely measured plasma neurotransmitters and hormone levels in order to investigate the role of stress on many types of diseases. In this study, we present results obtained from patients with severe chronic diseases. The study sample consisted of 88 patients (asthmatics, ulcerative colitis, Crohn's disease, chronic active hepatitis, chronic relapsing hepatitis, multiple sclerosis, trigeminal neuralgia, systemic lupus erithematous, and rheumatoid arthritis), and their respective controls. Noradrenaline (NA), adrenaline (Ad), dopamine (DA), platelet-serotonin (pS), free-serotonin (fS), growth hormone (GH) and cortisol (CRT) were determined during both exacerbation and improvement periods. A profile compatible with uncoping stress disorder (raised NA-Ad-DA + fS + CRT as well as low pS and NA/Ad ratio) was found during exacerbation periods when compared with improvement, as seen in controls. However, during improvement periods the neurochemical profile remained significantly different from that of normal controls. The neurochemical plus hormonal plasma profiles registered in chronic illness, both during exacerbation and improvement periods, strongly suggest that an uncoping stress mechanism underlies diseases of these patients.",0,0 +3229,Children Exposed to Disaster: I. Epidemiology of Post-Traumatic Symptoms and Symptom Profiles,"To determine the range and severity of post-traumatic stress disorder (PTSD) symptoms exhibited by children after exposure to a natural disaster.Three months after Hurricane Hugo struck Berkeley County, South Carolina, 5,687 school-aged children were surveyed about their experiences and reactions related to the storm. Self-reports of PTSD symptoms were obtained by use of a PTSD Reaction Index.Significant variation in the prevalence of PTSD symptoms was found across race, gender, and age groups. Self-reported symptoms were used to derive a post-traumatic stress syndrome classification according to DSM-III-R guidelines for the diagnosis of PTSD. More than 5% of the sample reported sufficient symptoms to be classified as exhibiting this post-traumatic stress syndrome. Females and younger children were more likely to receive this classification. At the symptom level, females reported more symptoms associated with emotional processing and emotional reaction to the trauma. Males were more likely to report symptoms related to cognitive and behavioral factors. Younger children were more likely to report symptoms overall.Children exposed to a high magnitude natural disaster report sufficient symptoms to establish a DSM-III-R derived classification of a PTSD syndrome. Differences between gender, age, and race groups appear to be related to differential risk of exposure, reporting biases, as well as a differential risk for developing post-traumatic symptoms.",0,0 +3230,The Psychiatric Genomics Consortium Posttraumatic Stress Disorder Workgroup: Posttraumatic Stress Disorder Enters the Age of Large-Scale Genomic Collaboration,"The development of posttraumatic stress disorder (PTSD) is influenced by genetic factors. Although there have been some replicated candidates, the identification of risk variants for PTSD has lagged behind genetic research of other psychiatric disorders such as schizophrenia, autism, and bipolar disorder. Psychiatric genetics has moved beyond examination of specific candidate genes in favor of the genome-wide association study (GWAS) strategy of very large numbers of samples, which allows for the discovery of previously unsuspected genes and molecular pathways. The successes of genetic studies of schizophrenia and bipolar disorder have been aided by the formation of a large-scale GWAS consortium: the Psychiatric Genomics Consortium (PGC). In contrast, only a handful of GWAS of PTSD have appeared in the literature to date. Here we describe the formation of a group dedicated to large-scale study of PTSD genetics: the PGC-PTSD. The PGC-PTSD faces challenges related to the contingency on trauma exposure and the large degree of ancestral genetic diversity within and across participating studies. Using the PGC analysis pipeline supplemented by analyses tailored to address these challenges, we anticipate that our first large-scale GWAS of PTSD will comprise over 10 000 cases and 30 000 trauma-exposed controls. Following in the footsteps of our PGC forerunners, this collaboration-of a scope that is unprecedented in the field of traumatic stress-will lead the search for replicable genetic associations and new insights into the biological underpinnings of PTSD.",0,0 +3231,Risk factors for posttraumatic stress disorder,Introduction. Strategies to study risk for the development of PTSD. Epidemiological risk factors for trauma and PTSD. Genetic risk factors for PTSD: a twin study. Family studies of PTSD: a review. Parental PTSD as a risk factor for PTSD. Neurocognitive risk factors for PTSD. Psychophysiological expression of risk factors for PTSD. Risk factors for the acute biological and psychological response to trauma. Personality as a risk factor for PTSD. Risk factors for PTSD reflections and recommendations. Index.,0,0 +3232,Idioms of Distress Among Trauma Survivors: Subtypes and Clinical Utility,"In this introduction to the Special Issue on Trauma and Idioms of Distress, we provide an overview of the concept and typology of ""idioms of distress,"" focusing particularly on their clinical utility. This includes the role of idioms as indicators of trauma exposure, of various types of psychopathology and of levels of distress, risk and functioning. It likewise includes the fact that idioms of distress may profoundly influence the personal meaning of having a trauma-related disorder, may shape the interpersonal course of the disorder and may pattern help-seeking and self-treatment. Finally, it illustrates the fact that idioms may also help clinicians understand sufferers' views of the causes of their distress, constitute key therapeutic targets and help increase therapeutic empathy and treatment adherence. This special issue focuses on the role played by idioms of distress in the local trauma ontology, the associations between the idioms and psychiatric disorders occurring in the context of trauma and the mechanisms by which the idioms profoundly influence the personal and interpersonal course of trauma-related disorders.",0,0 +3233,Clinical efficacy of a Phaseolus vulgaris and Cynara scolymus mixture on satiety,"Rondanelli M, Giacosa A, Orsini F, Opizzi A, Villani S. Appetite control and glycaemia reduction in overweight subjects treated with a combination of two highly standardized extracts from Phaseolus vulgaris and Cynara scolymus. Phytother Res 2011; 25: 1275–82.",0,0 +3234,Posttraumatic stress disorder in school-age children exposed to domestic violence: An examination of emotion regulation and cognitive inhibition as predictors of PTSD symptomatology,"Exposure to the physical abuse of a parent can be a traumatic event for a child, leaving the child fearful, helpless, and horrified. Research results have documented that children exposed to domestic violence are at increased risk for developing trauma symptoms characteristic of Posttraumatic Stress Disorder (PTSD). This study examined how childhood developmental factors, specifically emotion regulation and inhibition, predict PTSD symptomatology in school-age children exposed to domestic violence. Based on Horowitz's (1986) Stress Response Theory of PTSD, this study was formulated on the premise that effective coping of trauma material requires a balance of mental processes. Child participants between the ages of 8 and 12 and their mothers were asked to complete a battery of assessment measures that included the following areas: posttraumatic stress symptoms, avoidance, emotion regulation, and inhibition. The current study extends the research literature regarding PTSD symptoms in children and the influence of developmental factors. Based on results from the current study, emotion regulation seems to function as a protective factor in children, and was predictive of lower levels of avoidance symptoms Children reported to have high emotion regulation skills varied on PTSD avoidance symptoms as a function of inhibitory control. Specifically, inhibitory control was a significant predictor of symptoms for children with high emotion regulation skills Inhibition was predictive of higher rates of PTSD symptoms (child reported) when using a child-report measure of thought suppression (WBSI). Maternal report of inhibitory control and maternal report of PTSD Total symptoms were negatively correlated, thus, as inhibitory control increases, PTSD avoidance symptoms decrease Finally, avoidance symptoms were found to be an important mediator of inhibition and the development of PTSD arousal and reexperiencing symptoms in children. Post Hoc analyses also revealed emotion regulation as a mediator of maternal report of inhibitory control skills on PTSD Total symptoms. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +3235,Factors associated with comorbidity patterns in full and partial PTSD: Findings from the PsyCoLaus study,"Subtypes of comorbid conditions and their associated trauma and clinical characteristics in full and partial PTSD were examined. Data from 289 subjects from the general population that met criteria for full or partial PTSD were analyzed. Latent class analyses (LCA) were performed to derive homogeneous patterns of DSM-IV Axis-I disorders and anti-social personality comorbid to PTSD. Logistic regression models were conducted to characterize these classes by trauma-related and clinical features. The LCA revealed three classes: (1) low comorbidity; (2) high comorbidity with primarily substance-related disorders and a higher proportion of males; and (3) more severe PTSD-symptomatology and higher comorbid anxiety disorders and depression, almost entirely represented by females. Exposure to sexual abuse was more likely in the substance-dependent class and contributed strongly to the distinction between classes. Affective disorders tended to precede the onset of PTSD in the substance-dependent class, whereas phobias were more likely to follow PTSD in the depressed-anxious class. Posttrauma onset of alcohol use disorders in the substance dependent class confirmed the self-medication hypothesis. The three classes of comorbidity and their sequence of onset with PTSD suggest different mechanisms involved in their development. Our findings suggest that PTSD-related comorbidity subtypes also apply to individuals with partial PTSD.",0,0 +3236,"PTSD symptoms, potentially traumatic event exposure, and binge drinking: A prospective study with a national sample of adolescents","Research demonstrates substantial comorbidity between PTSD and alcohol use disorders. Evidence for functional relationships between PTSD and problematic alcohol use has not always been consistent, and there have been few investigations with adolescent samples. Further, research has not consistently controlled for cumulative potentially traumatic event (PTE) exposure when examining prospective relationships between PTSD and problematic alcohol use (i.e., binge drinking). This study examines the prospective relationships between PTSD symptoms, problematic alcohol use, and cumulative PTE exposure measured at three time points over approximately three years among a nationally representative sample of adolescents exposed to at least one PTE (n=2399 and age range=12-17 at Wave 1). Results from parallel process latent growth curve models demonstrated that increases in cumulative PTE exposure over time positively predicted increases in both PTSD symptoms and binge drinking, whereas increases in PTSD symptoms and increases in binge drinking were not related when controlling for the effect of cumulative PTE exposure. Further analyses suggested that these relationships are specific to assaultive PTEs and are not found with non-assaultive PTEs. Theoretical implications are discussed.",0,0 +3237,The Posttraumatic Stress Disorder Diagnosis in Preschool- and Elementary School-Age Children Exposed to Motor Vehicle Accidents,"Increasingly, children are being diagnosed with psychiatric disorders, including preschool-age children. These diagnoses in young children raise questions pertaining to 1) how diagnostic algorithms for individual disorders should be modified for young age groups, 2) how psychopathology is best detected at an early stage, and 3) how to make use of multiple informants. The authors examined these issues in a prospective longitudinal assessment of preschool- and elementary school-age children who were exposed to a traumatic event.Participants were 114 children (age range: 2-10 years) who had experienced a motor vehicle accident. Parents and older children (age range: 7-10 years) completed structured interviews 2-4 weeks (initial assessment) and 6 months (6-month follow-up) after the traumatic event. A recently proposed alternative symptom algorithm for diagnosing posttraumatic stress disorder (PTSD) was utilized and compared with the standard DSM-IV algorithms for diagnosing PTSD and acute stress disorder.At the 2- to 4-week assessment, 11.5% of the children met conditions for a diagnosis of PTSD based on the alternative algorithm criteria per parent report, and 13.9% met criteria for this diagnosis at the 6-month follow-up. These percentages were much higher than those for DSM-IV diagnoses of acute stress disorder and PTSD. Among 7- to 10-year-old subjects, the use of combined parent- and child-reported symptoms to derive a diagnosis resulted in an increased number of children in this age group who were identified with psychiatric illness relative to the use of parent report alone. Agreement between parent and child on symptoms for 1) a diagnosis of PTSD based on the alternative algorithm criteria and 2) diagnoses of DSM-IV acute stress disorder and PTSD in this age group was poor. Among 2- to 6-year-old subjects, the alternative algorithm PTSD diagnosis per parent report was a more sensitive predictor of later onset psychopathology relative to a diagnosis of DSM-IV acute stress disorder or PTSD per parent report. However, among 7- to 10-year-old subjects, a combined symptom report (from both parent and child) was optimal in predicting posttraumatic psychopathology.These findings support the use of the proposed alternative algorithm for assessing PTSD in young children and suggest that the diagnosis of PTSD based on the alternative algorithm criteria is stable from the acute phase onward. When both parent- and child-reported symptoms are utilized for the assessment of PTSD among 7- to 10-year-old children, the alternative algorithm and DSM-IV criteria have broad comparable validity. However, in the absence of child-reported symptoms, the alternative algorithm criteria per parent report appears to be an optimal diagnostic measure of PTSD among children in this age group, relative to the standard DSM-IV algorithm for diagnosing the disorder.",0,0 +3238,Trajectory and predictors of depression in a 12-month prospective study after the Madrid March 11 terrorist attacks,"Few longitudinal studies have examined the trajectory of and the risk factors for depression in a representative sample of the population exposed to terrorism. A 12 month prospective study was conducted among a sample of Madrid city residents after the March 11, 2004 terrorist attacks. We aimed to document the trajectories of depressive symptoms and determine the risk factors associated with these trajectories.We conducted telephone surveys among a representative sample of Madrid citizens (N = 1589) to recruit baseline respondents approximately 1 month after the March 11 terrorist attacks. Participants were re-contacted at 6 and 12 months after baseline for further telephone interviews.Findings reveal heterogeneity in the longitudinal trajectories of depression ranging from the absence of depressive symptoms over time, to transient or chronic depression. Life and recent stressors, experiencing direct exposure to the attacks, personality traits, poor physical health and other psychological disorders were principally associated with a worse trajectory of depression after this event.Consistent with a stress diathesis model, ongoing stressors and intense event exposure are key drivers of a chronic depression trajectory after a mass traumatic event.",0,0 +3239,Treatment of post-traumatic stress disorder with eye movement desensitization and reprocessing: Outcome is stable in 35-month follow-up,"Post-traumatic stress disorder (PTSD) is an anxiety disorder that may follow major psychological trauma. The disorder is longstanding, even chronic, and there is a need for effective treatment. The most effective short-term treatments are cognitive behavioural therapy and eye movement desensitization and reprocessing (EMDR). Twenty subjects with chronic PTSD following occupational health hazards from “person under train” accidents or assault at work were treated with five sessions of EMDR. They were assessed with psychometric scales and diagnostic interviews before treatment, directly after treatment, at 8 months, and at 35 months after the end of Therapy. The primary outcome variable was full diagnosis of PTSD according to the DSM-IV diagnostic criteria. Results from interview-based and self-evaluation psychometric scales were used as secondary outcome variables. Immediately following treatment, the patients were divided up into two groups, initial remitters (12 of 20) and non-remitters (8 of 20). There were no drop-outs during therapy, but three patients withdrew during follow-up. The initial result was maintained at the 35-month follow-up. The secondary outcome variables also showed a significant immediate change towards normality that was stable during the long-term follow-up. After 3 years of follow-up, 83% of the initial remitters had full working capacity.",0,0 +3240,Therapy implications of child abuse in multi-risk families,"Objectives: Our aim is to critique Australian child maltreatment policy, outline abuse trends and provide data on family risk factors. Method: We identified policy gaps and reviewed family profiles within selective child maltreatment databases. Data sources included international and Australian literature, Queensland Department of Child Safety reports and a research clinical database. Results: Data reviewed suggest that a pattern of co-occurring complex multiple system family problems characterize substantiated abuse cases. Conclusions: The presence of multiple family problems suggests the need for a new treatment paradigm. Multisystemic Therapy for child physical abuse and neglect is an evidence-based intervention that matches the therapeutic needs of such families.",0,0 +3241,Risk factors for the development versus maintenance of posttraumatic stress disorder,"This study examined risk factors for posttraumatic stress disorder (PTSD) in Vietnam veterans: 68 women and 414 men of whom 88 were White, 63 Black, 80 Hispanic, 90 Native Hawaiian, and 93 Japanese American. Continuation ratio logistic regression was used to compare the predictive power of risk factors for the development versus maintenance of full or partial PTSD. The development of PTSD was related to premilitary, military, and postmilitary factors. The maintenance of PTSD was related primarily to military and postmilitary factors. Multivariate analyses identified different models for development and maintenance. We conclude that development of PTSD is related to factors that occur before, during, and after a traumatic event, whereas failure to recover is related primarily to factors that occur during and after the event.",0,0 +3242,A PILOT STUDY OF GROUP MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) FOR COMBAT VETERANS WITH POSTTRAUMATIC STRESS DISORDER (PTSD),"""Mindfulness-based"" interventions show promise for stress reduction in general medical conditions, and initial evidence suggests that they are accepted in trauma-exposed individuals. Mindfulness-based cognitive therapy (MBCT) shows substantial efficacy for prevention of depression relapse, but it has been less studied in anxiety disorders. This study investigated the feasibility, acceptability, and clinical outcomes of an MBCT group intervention adapted for combat posttraumatic stress disorder (PTSD).Consecutive patients seeking treatment for chronic PTSD at a VA outpatient clinic were enrolled in 8-week MBCT groups, modified for PTSD (four groups, n = 20) or brief treatment-as-usual (TAU) comparison group interventions (three groups, n = 17). Pre and posttherapy psychological assessments with clinician administered PTSD scale (CAPS) were performed with all patients, and self-report measures (PTSD diagnostic scale, PDS, and posttraumatic cognitions inventory, PTCI) were administered in the MBCT group.Intent to treat analyses showed significant improvement in PTSD (CAPS (t(19) = 4.8, P < .001)) in the MBCT condition but not the TAU conditions, and a significant Condition × Time interaction (F[1,35] = 16.4, P < .005). MBCT completers (n = 15, 75%) showed good compliance with assigned homework exercises, and significant and clinically meaningful improvement in PTSD symptom severity on posttreatment assessment in CAPS and PDS (particularly in avoidance/numbing symptoms), and reduced PTSD-relevant cognitions in PTCI (self blame).These data suggest group MBCT as an acceptable brief intervention/adjunctive therapy for combat PTSD, with potential for reducing avoidance symptom cluster and PTSD cognitions. Further studies are needed to examine efficacy in a randomized controlled design and to identify factors influencing acceptability and efficacy.",0,0 +3243,Nefazodone in post-traumatic stress disorder: results from six open-label trials,"Nefazodone, an antidepressant which blocks serotonin (5-HT)2 receptors and 5-HT reuptake, was evaluated in the treatment of post-traumatic stress disorder (PTSD) in six open-label studies involving both civilians and combat veterans. Our objective was to report this available pooled data to characterize the response of this drug in PTSD. Specifically, we looked at response rates using three different criteria, the effect of nefazodone on each PTSD cluster and individual symptoms and, lastly, variables that might predict response. One hundred and five outpatients with chronic PTSD were treated with nefazodone titrated up to 600 mg/day, 92 of whom were entered in an intent to treat analysis. We used the percentage drop in score between baseline and endpoint on main scale as a common measure to evaluate outcome. The response criterion of a drop in score of at least 30%, 40% and 50% revealed response rates of 46, 36 and 26%, respectively. Nefazodone showed a broad spectrum of action on PTSD symptoms. This profile might make nefazodone a useful drug to treat PTSD. Predictors of response include age, sex and trauma type. Double-blind, placebo-controlled clinical trials in PTSD are in progress to assess the utility of nefazodone as a treatment in this disorder.",0,0 +3244,Interpreting the WHOQOL-Brèf: Preliminary Population Norms and Effect Sizes,"Since publication use of the WHOQOL-Bref has rapidly risen. However, as yet no population norms have been published as a reference point against which researchers can interpret their findings. This study provides preliminary population norms for this purpose. Randomly sampled community residents from two studies were pooled and used to examine the properties of the WHOQOL-Bref by age group, gender and health status. The results showed that general norms for the WHOQOL-Bref domains were 73.5 (SD=18.1) for the Physical health domain, 70.6 (14.0) for Psychological wellbeing, 71.5 (18.2) for Social relationships and 75.1 (13.0) for the Environment domain. In general scores declined slightly by age group. For females scores were stable across the lifespan with an accelerated decline after the age of 60 years. Males exhibited a more consistent and even decline across the lifespan. There were significant differences in WHOQOL-Bref scores when reported by health status, with those in poor health obtaining scores that were up to 50% lower than those in excellent health. Effect sizes between different health status levels are reported. These preliminary norms and effect sizes may be used as reference points for interpreting WHOQOL-Bref scores. They provide additional information to the numerous national studies already reporting on the validity of the WHOQOL-Bref.",0,0 +3245,"""Sexual assault-characteristis effects of PTSD and psychosocial mediators: A cluster-analysis approach to sexual assault types"": Correction to Peter-Hagene and Ullman (2014).","Reports an error in ""Sexual Assault-Characteristics Effects on PTSD and Psychosocial Mediators: A Cluster-Analysis Approach to Sexual Assault Types"" by Liana C. Peter-Hagene and Sarah E. Ullman (Psychological Trauma: Theory, Research, Practice, and Policy, Advanced Online Publication, Aug 18, 2014, np). In the article, there was an error in the abstract. The second to last sentence should have read, ""The effect of assault-characteristics clusters on Time 2 PTSD was mediated by Time 1 self-blame and turning against social reactions."" (The following abstract of the original article appeared in record 2014-33772-001.) Using cluster analysis, we investigated the effects of assault characteristics (i.e., level of violence, subjective distress, alcohol consumption, perpetrator identity) on PTSD symptoms, and whether these effects are mediated by postassault social and psychological reactions. A large community sample of women sexual assault survivors completed 2 mail surveys at a 1-year interval. In line with prior research, cluster analyses revealed the existence of 3 general categories of sexual assault, which we described as ""high violence,"" ""alcohol-related,"" and ""moderate sexual severity."" Alcohol-related assaults resulted in fewer PTSD symptoms than high-violence assaults at Time 1, but not at Time 2. Alcohol-related and violent assaults resulted in more PTSD symptoms than moderate-severity assaults at both times. The effect of assault-characteristics clusters on Time 2 PTSD was mediated by Time 1 self-blame and turning against social reactions. The importance of considering effects of violence and alcohol consumption during the assault to better understand postassault PTSD, including implications for theory and practice, are discussed. (PsycINFO Database Record",0,0 +3246,Magnitude of Life Events and Seriousness of Illness,"A study investigating the relationship between the quantity of life change that patients have undergone during the 2 years before the onset of their illness, and the seriousness of that illness, is described in this report. The sample represented 42 disease items and 232 patients. Thirty-six percent",0,0 +3247,Posttraumatic disorders following injury: an empirical and methodological review,"Although there has been a marked increase in research on psychological disorders following physical injury in recent years, there are many discrepancies between the reported findings. This paper reviews the prevalence outcomes of recent studies of the mental health sequelae of physical injury with a focus on posttraumatic stress disorder (PTSD), acute stress disorder (ASD), and depression. The review critically outlines some of the methodological factors that may have contributed to these discrepancies. The phenomenological overlap between organic and psychogenic symptoms, the use of narcotic analgesia, the role of brain injury, the timing and content of assessments, and litigation are discussed in terms of their potential to confound findings with this population. Recommendations are proposed to clarify methodological approaches in this area. It is suggested that a clearer understanding of the psychological effects of physical injury will require the widespread adoption of more rigorous, standardized and transparent methodological procedures.",0,0 +3248,POST-TRAUMATIC STRESS DISORDER IS ASSOCIATED WITH INCREASED INCIDENCE OF INSULIN RESISTANCE AND METABOLIC SYNDROME,"Insulin resistance (IR) increases atherogenesis and atherosclerotic plaque instability and further increases risk of myocardial infarction, but its potential association with Post-traumatic stress disorder(PTSD) has not been evaluated. This study assessed the association of PTSD with incidence of IR",0,0 +3249,Women at War: Implications for Mental Health,"Few studies have investigated the impact of deployment stressors on the mental health outcomes of women deployed to Iraq in support of Operation Iraqi Freedom. This pilot study examined exposure to combat experiences and military sexual harassment in a sample of 54 active duty women and assessed the impact of these stressors on post-deployment posttraumatic stress disorder (PTSD) symptoms and depressive symptoms. Within 3 months of returning from deployment to Iraq, participants completed (a) the Combat Experiences Scale and the Sexual Harassment Scale of the Deployment Risk and Resilience Inventory, (b) the Primary Care PTSD Screen, and (c) an abbreviated version of the Center for Epidemiological Studies-Depression scale. Approximately three quarters of the sample endorsed exposure to combat experiences, and more than half of the sample reported experiencing deployment-related sexual harassment, with nearly half of the sample endorsing both stressors. Approximately one third of the sample endorsed clinical or subclinical levels of PTSD symptoms, with 11% screening positive for PTSD and 9% to 14% of the sample endorsing depressive symptoms. Regression analyses revealed that combat experiences and sexual harassment jointly accounted for significant variance in post-deployment PTSD symptoms, whereas military sexual harassment was identified as the only unique significant predictor of these symptoms. Findings from the present study lend support to research demonstrating that military sexual trauma may be more highly associated with post-deployment PTSD symptoms than combat exposure among female service members and veterans.",0,0 +3250,Analysis of Kinase Gene Expression in the Frontal Cortex of Suicide Victims: Implications of Fear and Stress†,"Suicide is a serious public health issue that results from an interaction between multiple risk factors including individual vulnerabilities to complex feelings of hopelessness, fear, and stress. Although kinase genes have been implicated in fear and stress, including the consolidation and extinction of fearful memories, expression profiles of those genes in the brain of suicide victims are less clear. Using gene expression microarray data from the Online Stanley Genomics Database and a quantitative PCR, we investigated the expression profiles of multiple kinase genes including the calcium calmodulin-dependent kinase (CAMK), the cyclin-dependent kinase, the mitogen-activated protein kinase (MAPK), and the protein kinase C (PKC) in the prefrontal cortex (PFC) of mood disorder patients died with suicide (N = 45) and without suicide (N = 38). We also investigated the expression pattern of the same genes in the PFC of developing humans ranging in age from birth to 49 year (N = 46). The expression levels of CAMK2B, CDK5, MAPK9, and PRKCI were increased in the PFC of suicide victims as compared to non-suicide controls (false discovery rate, FDR-adjusted p < 0.05, fold change >1.1). Those genes also showed changes in expression pattern during the postnatal development (FDR-adjusted p < 0.05). These results suggest that multiple kinase genes undergo age-dependent changes in normal brains as well as pathological changes in suicide brains. These findings may provide an important link to protein kinases known to be important for the development of fear memory, stress associated neural plasticity, and up-regulation in the PFC of suicide victims. More research is needed to better understand the functional role of these kinase genes that may be associated with the pathophysiology of suicide.",0,0 +3251,"Basic emotion profiles in healthy, chronic pain, depressed and PTSD individuals","To compare self-reports of five basic emotions across four samples: healthy, chronic pain, depressed and post-traumatic stress disorder (PTSD), and to investigate the extent to which basic emotion reports discriminate between individuals in healthy or clinical groups.In total, 439 participants took part in this study: healthy (n = 131), chronic pain (n = 220), depressed (n = 24) and PTSD (n = 64). The participants completed the trait version of the Basic Emotion Scale. Basic emotion profiles were compared both within each group and between the healthy group and each of the three other groups. Discriminant analysis was used to assess the extent to which basic emotions can be used to classify the participants as belonging to the healthy group or one of the clinical groups.In the healthy group, happiness was experienced more than any other basic emotion. This was not found in the clinical groups. In comparison to the healthy participants, the chronic pain group experienced more fear, anger and sadness, the depressed group reported more sadness and the PTSD group experienced all of the negative emotions more frequently. Discriminant analysis revealed that happiness was the most important variable in determining whether an individual belonged to the healthy group or one of the clinical groups. Anger was found to further discriminate between depressed and chronic pain individuals.The findings demonstrate that basic emotion profile analysis can provide a useful foundation for the exploration of emotional experience both within and between healthy and clinical groups.",0,0 +3252,The major symptoms of hysteria.,,0,0 +3253,Beacon: a web portal to high‐quality mental health websites for use by health professionals and the public,"Objective To describe the Beacon web portal, which lists and rates quality health websites, collects user characteristics and publishes user feedback; and to report summary data on Beacon's highest-rated (best evidence-based) sites for mental health. Data sources A systematic search was undertaken in February 2009 for potentially relevant websites through a review of research papers and a recently published book, an internet search of Open Directory Project medical categories, a review of material on a high-profile mental health portal, and a survey of international researchers. Selection criteria All sites were ranked on a 7-point scale from -1 to 5, with negative scores indicating evidence of no effect and scores of 2 or more indicating evidence of efficacy based on reports in the scientific literature. Results By March 2010, 183 sites had been identified, of which 122 focused on physical health or wellbeing, 40 targeted anxiety, and 23 targeted depression. Of the eight generalised anxiety disorder sites identified, four achieved ratings of 2 or above. Two social anxiety disorder sites achieved scores higher than 2. Ten panic disorder sites were identified, with three achieving ratings of 2 or above; and five post-traumatic stress disorder sites were identified, with two achieving ratings of 2 or above. Of the 23 identified depression sites, four achieved a rating of 2 or above. Conclusions There are a number of high-quality mental health websites on the internet, and Beacon provides a portal to enable the wide dissemination of these resources.",0,0 +3254,"Social Support, Stressors, and Frailty Among Older Mexican American Adults","There is little research on the effects of stressors and social support on frailty. Older Mexican Americans, in particular, are at higher risk of medical conditions, such as diabetes, that could contribute to frailty. Given that the Mexican American population is rapidly growing in the United States, it is important to determine whether there are modifiable social factors related to frailty in this older group.To address the influence of social support and stressors on frailty among older Mexican Americans, we utilized five waves of the Hispanic Established Populations for the Epidemiologic Study of the Elderly (Hispanic EPESE) to examine the impact of stressors and social support on frailty over a 12-year period. Using a modified version of the Fried and Walston Frailty Index, we estimated the effects of social support and stressors on frailty over time using trajectory modeling (SAS 9.2, PROC TRAJ).We first grouped respondents according to one of three trajectories: low, progressive moderate, and progressive high frailty. Second, we found that the effects of stressors and social support on frailty varied by trajectory and by type of stressor. Health-related stressors and financial strain were related to increases in frailty over time, whereas social support was related to less-steep increases in frailty.Frailty has been hypothesized to reflect age-related physiological vulnerability to stressors, and the analyses presented indicate partial support for this hypothesis in an older sample of Mexican Americans. Future research needs to incorporate measures of stressors and social support in examining those who become frail, especially in minority populations.",0,0 +3255,Latent classes of posttraumatic stress and growth,"Potentially traumatic events may lead to different patterns of posttraumatic stress symptoms and posttraumatic growth. The objective of the present study was to identify subgroups with different patterns of posttraumatic reactions, and to determine whether these subgroups differed in terms of personal and social resources and indicators of adjustment.This study used survey data collected 10 months after the 2011 Oslo bombing attack to investigate patterns of reactions among ministerial employees (N=1970).We applied latent class analyses with covariates to extract subgroups of individuals.Three classes of individual reactions were extracted, and these were similar among those who were and those who were not physically proximate to the bombing attack: ""High stress/high growth"" (27% and 11%, respectively), ""Low stress/high growth"" (74% and 42%, respectively), and ""Low stress/low growth"" (only among the not physically proximate: 47%). The classes differed in terms of gender, neuroticism, and social support as well as life satisfaction and daily functioning.Heterogeneous patterns of posttraumatic reactions were found. Physical proximity is not necessary to experience posttraumatic stress or growth after political violence. Among individuals with low stress, posttraumatic growth may not encompass higher life satisfaction or functioning.",0,0 +3256,"Functional associations among trauma, ptsd, and substance-related disorders","This review article presents several potential functional pathways which may explain the frequent co-occurrence of PTSD and substance abuse disorders in traumatized individuals. Emerging empirical studies which have examined these potential pathways are reviewed, including studies on relative order of onset, PTSD patients' perceptions of various drug effects, comparisons of PTSD patients with and without comorbid substance use disorders, and correlational studies examining the relations between severity of specific PTSD symptom clusters and substance disorder symptoms. Research on the acute and chronic effects of alcohol and other drugs on cognitive and physiological variables relevant to PTSD intrusion and arousal symptoms is reviewed to highlight ways in which these two sets of PTSD symptoms might be functionally interrelated with substance abuse. Finally, based on these findings, recommendations are made for the treatment of individuals with comorbid PTSD-substance use disorders.",0,0 +3257,Longitudinal Pathways Between Political Violence and Child Adjustment: The Role of Emotional Security about the Community in Northern Ireland,"Links between political violence and children’s adjustment problems are well-documented. However, the mechanisms by which political tension and sectarian violence relate to children’s well-being and development are little understood. This study longitudinally examined children’s emotional security about community violence as a possible regulatory process in relations between community discord and children’s adjustment problems. Families were selected from 18 working class neighborhoods in Belfast, Northern Ireland. Participants (695 mothers and children, M = 12.17, SD = 1.82) were interviewed in their homes over three consecutive years. Findings supported the notion that politically-motivated community violence has distinctive effects on children’s externalizing and internalizing problems through the mechanism of increasing children’s emotional insecurity about community. Implications are considered for understanding relations between political violence and child adjustment from a social ecological perspective.",0,0 +3258,A Review of Health-Related Quality of Life in Adult Traumatic Brain Injury Survivors in the Context of Combat Veterans,"Health-related quality of life (HRQOL) research in traumatic brain injury (TBI) populations is beginning to emerge in the literature. Because rehabilitation and reintegration issues are complex with TBI, especially with new combat veterans, it is critical that future HRQOL research be designed to consider these issues. Utilizing explicit definitions and a conceptual model of HRQOL can provide researchers with a holistic base on which to build interventions for successful patient outcomes. The conceptual model of HRQOL of C.E. Ferrans, J.J. Zerwic, J.E. Wilbur, and J.L. Larson (2005) is an exemplar model that presents clear definitions and encompasses domains of HRQOL relevant to TBI survivors and their families. This review was organized utilizing the model of HRQOL of Ferrans et al. The objective of this review was to identify gaps in current knowledge of HRQOL and TBI. These findings were then used to develop recommendations for future research with combat veterans who have sustained a TBI.",0,0 +3259,Rethinking First Response: Effects of the Clean Up and Recovery Effort on Workers at the World Trade Center Disaster Site,"We sought to describe the physical and mental health effects of the cleanup and recovery effort on workers at the World Trade Center disaster site.A mailed survey was sent to truck drivers, heavy equipment operators, laborers, and carpenters. It assessed work-related exposures and somatic and mental health symptoms. In one open-ended question, respondents shared any aspect of their experiences they wished; these 332 narrative responses were analyzed using qualitative techniques.Respondents reported suffering debilitating consequences of their work, including depression, drug use, and posttraumatic stress disorder. They felt poorly prepared to work in a disaster, lacked protective equipment and training, and felt overwhelmed by the devastation they faced.These workers' experiences were qualitatively similar to the experiences of the first responders. To protect workers in the future, the focus on preparing ""first"" responders should be reconsidered more broadly.",0,0 +3260,The symptom structure of posttraumatic stress disorder in the National Comorbidity Replication Survey,"Previous research has provided mixed findings for the validity of various three- and four-factor models of posttraumatic stress disorder (PTSD) symptomatology. However, much of this research has been restricted to clinical samples rather than nationally representative community-based samples. The current study employed confirmatory factor analysis to evaluate the validity of three competing models of PTSD symptom structure using the DSM-IV-based National Comorbidity Replication Survey (part II of the NCS-R: N=5692). Individuals with a lifetime diagnosis of PTSD (N=588) were selected and symptom assessment was based on the World Health Organization Composite International Diagnostic Interview. Strong support was found for both the DSM-IV three-factor model and a four-factor model of PTSD symptoms by King et al. [King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998). Confirmatory factor analysis of the clinician-administered PTSD scale: evidence for the dimensionality of posttraumatic stress disorder. Psychological Assessment,10, 90-96], a variation of the DSM-IV model in which avoidance and numbing are viewed as separate factors. There was some evidence, however, that the King et al. [King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998). Confirmatory factor analysis of the clinician-administered PTSD scale: evidence for the dimensionality of posttraumatic stress disorder. Psychological Assessment,10, 90-96] model demonstrated a significantly superior fit over the DSM-IV three-factor model. Because this study provided support for both the DSM-IV three-factor model and the King et al., four-factor model of PTSD symptoms, further research is still necessary to provide more definitive conclusions in this area.",0,0 +3261,Enhancing Resilience: Families and Communities as Agents for Change,"In this article, the Linking Human Systems (LINC) Community Resilience model, a theoretical framework for initiating and sustaining change in communities that have undergone rapid and untimely transition or loss, is presented. The model assumes that individuals, families, and communities are inherently competent and resilient, and that with appropriate support and encouragement, they can access individual and collective strengths that will allow them to transcend their loss. This competence can be nurtured by helping people regain a sense of connectedness with one another; with those who came before them; with their daily patterns, rituals, and stories that impart spiritual meaning; and with tangible resources within their community. Rather than imposing artificial support infrastructures, LINC interventions engage respected community members to act as natural agents for change. These ""community links"" provide a bridge between outside professionals, families, and communities, particularly in circumstances in which outside intervention may not be welcomed. The article illustrates how LINC interventions successfully have been used in communities around the world.",0,0 +3262,Laypersons' expectations of recovery and beliefs about whiplash injury: A cross-cultural comparison between Australians and Singaporeans,"Background Beliefs and expectations are thought to influence outcome following whiplash injury. Studies have proposed a link between rates of chronic whiplash and laypersons' expectations about outcome following a motor vehicle accident. The prevalence of chronic whiplash is relatively high in Australia and apparently low in Singapore. This study's objectives were to compare laypersons' beliefs and expectations of recovery of whiplash injury in Brisbane and Singapore and to assess the effect of demographic factors on whiplash beliefs. Methods A cross-sectional study using online surveys was conducted on adult Internet users in Brisbane (Australia) and Singapore. The 14-item whiplash beliefs questionnaire (WBQ) was used to evaluate whiplash beliefs. Two additional items assessed expectations of recovery. Individual items of WBQ, WBQ score and expectations of recovery were analysed. Stratified analysis was performed to adjust for sampling bias due to quota sampling. Results A total of 402 participants from Singapore and 411 participants from Brisbane, Australia, completed the survey. While participants from Singapore demonstrated slightly more negative whiplash beliefs than participants from Brisbane [t(811) = −5.72; p < 0.0001], participants from both samples were similar in their expectations of quick recovery and return to normal activities following whiplash injury. Only gender had a significant effect on whiplash beliefs [estimated marginal means of WBQ score for men = 21.5; standard error (SE) = 0.20; women = 22.5; SE = 0.20; F(1,810) = 11.2; p = 0.001]. Conclusions Laypersons' expectations of recovery and beliefs about whiplash injury in Brisbane and Singapore were generally similar and mostly positive. Our results demonstrate that cultural differences reflected by laypersons' beliefs may not reflect the differences in prevalence of chronic whiplash between countries.",0,0 +3263,The relationship between acute stress disorder and posttraumatic stress disorder in severely injured trauma survivors,"This prospective longitudinal study was designed to investigate the relationship between acute stress disorder (ASD) and the subsequent development of posttraumatic stress disorder (PTSD) in a population of severely injured hospitalised trauma survivors. Symptoms of ASD were assessed just prior to discharge in 307 consecutive admissions to a Level 1 Trauma Centre, with PTSD assessments completed at 3 and 12 months post-injury. A well-established structured clinical interview was adopted for both assessments. Only 1% of the sample met criteria for an ASD diagnosis (at a mean of 8 days post-injury), while the incidence of PTSD was 9% at 3 months and 10% at 12 months. Although all ASD symptom clusters contributed to the prediction of subsequent PTSD severity, logistic regression indicated that only re-experiencing and arousal predicted a categorical PTSD diagnosis. The dissociative symptoms that form the core of ASD were rarely endorsed and showed high specificity but low sensitivity, resulting in a high proportion of false negative diagnoses. Reducing the number of dissociative symptoms required for a diagnosis ameliorated, but did not resolve, the problem. In this particular population, the low sensitivity of the ASD diagnosis renders it a poor screening test for use in identifying high risk individuals for early intervention and prevention strategies.",0,0 +3264,"Epigenetics of Posttraumatic Stress Disorder: Current Evidence, Challenges, and Future Directions","Posttraumatic stress disorder (PTSD) is a stress-related psychiatric disorder that is thought to emerge from complex interactions among traumatic events and multiple genetic factors. Epigenetic regulation lies at the heart of these interactions and mediates the lasting effects of the environment on gene regulation. An increasing body of evidence in human subjects with PTSD supports a role for epigenetic regulation of distinct genes and pathways in the pathogenesis of PTSD. The role of epigenetic regulation is further supported by studies examining fear conditioning in rodent models. Although this line of research offers an exciting outlook for future epigenetic research in PTSD, important limitations include the tissue specificity of epigenetic modifications, the phenomenologic definition of the disorder, and the challenge of translating molecular evidence across species. These limitations call for studies that combine data from postmortem human brain tissue and animal models, assess longitudinal epigenetic changes in living subjects, and examine dimensional phenotypes in addition to diagnoses. Moreover, examining the environmental, genetic, and epigenetic factors that promote resilience to trauma may lead to important advances in the field.",0,0 +3265,Variations in emotional abuse experiences among multiply maltreated young adolescents and relations with developmental outcomes,"Based on the data obtained through Child Protective Services (CPS) case records abstraction, this study aimed to explore patterns of overlapping types of child maltreatment in a sample of urban, ethnically diverse male and female youth (n= 303) identified as maltreated by a large public child welfare agency.A cluster analysis was conducted on data for 303 maltreated youth. The overall categorization of four types of abuse (i.e., physical, sexual, emotional abuse and neglect) was used to provide a starting point for clustering of the 303 cases and then the subtypes of emotional abuse were broken down in the clusters. The different clusters of child maltreatment were compared on the multiple outcomes such as mental health, behavior problems, self-perception, and cognitive development.In this study, we identified four clusters of child maltreatment experiences. Three patterns involved emotional abuse. One cluster of children experienced all four types. Different clusters were differentially associated with multiple outcome measures. In general, multiply-maltreated youth fared worst, especially when the cluster involved sexual abuse. Also, sex differences were found in these associations. Boys who experienced multiple types of maltreatment showed more difficulties than girls.These results reiterate the importance of creating more complex models of child maltreatment. Children who have experienced various types of maltreatment are especially in need of more attention from professionals and resources should be allocated accordingly.",0,0 +3266,"The relationship among cognitive schemas, job-related traumatic exposure, and posttraumatic stress disorder in journalists","American newspaper journalists (N = 906) participated in a study examining a cognitive mediational model for explaining the relationship between exposure to work-related traumatic events and work-related posttraumatic stress disorder (PTSD). Results indicated (a) greater exposure to work-related traumatic events was associated with work-related PTSD symptoms, as well as negative cognitive schemas; (b) cognitive beliefs partially accounted for PTSD symptoms, but the full cognitive mediational model was not supported. Implications include targeting interventions for journalists who experience traumatic stress and modifying theories about PTSD symptoms in journalists.",0,0 +3267,Systematic Review and Meta-Analysis of Multiple-Session Early Interventions Following Traumatic Events,"The authors sought to determine the efficacy of multiple-session psychological interventions to prevent and treat traumatic stress symptoms beginning within 3 months of a traumatic event.Nine computerized databases were searched, and manual searches were conducted of reference lists of selected articles as well as two journals. In addition, key researchers in the field were contacted to determine whether they were aware of other relevant studies. The reviewers identified randomized controlled trials of multiple-session psychological treatments aimed at preventing or reducing traumatic stress symptoms in individuals within 3 months of exposure to a traumatic event. Details of the studies were independently extracted by two reviewers, and outcome data were entered into the Review Manager software package. Quality assessment was also conducted by two researchers independently.Twenty-five studies examining a range of interventions were identified. For treatment of individuals exposed to a trauma irrespective of their symptoms, there was no significant difference between any intervention and usual care. For treatment of traumatic stress symptoms irrespective of diagnosis, trauma-focused cognitive-behavioral therapy (CBT) was more effective than waiting list or supportive counseling conditions. The difference was greatest for treatment of acute stress disorder and acute posttraumatic stress disorder.Trauma-focused CBT within 3 months of a traumatic event appears to be effective for individuals with traumatic stress symptoms, especially those who meet the threshold for a clinical diagnosis.",0,0 +3268,"Displacement, Gender, and the Challenges of Parenting after Hurricane Katrina","In emergency situations and in the aftermath of disaster, parents are essential in caring for children. Yet very little has been written explicitly about the experiences of mothers and fathers - either as individuals or partners - in postdisaster contexts. With the understanding that parenting is a gendered endeavor that occurs in a society stratified by race and class, this article focuses on the responses of mothers and fathers to Hurricane Katrina. This article draws on data gathered in Louisiana through observations, focus groups, and in-depth interviews with parents and other adults responsible for the care of children. Through a qualitative analysis, this research examines the strategies that mothers and fathers used to deal with the challenges of parenting in the aftermath of Katrina, the role of advocates who worked on behalf of families, the importance of kin networks, and the uniqueness of New Orleans and what the city means for families struggling to recover after the storm.",0,0 +3269,"The Millennium Cohort Study: A 21-Year Prospective Cohort Study of 140,000 Military Personnel","Does military service, in particular operational deployment, result in a higher risk of chronic illness among military personnel and veterans? The Millennium Cohort Study, the largest Department of Defense prospective cohort study ever conducted, will attempt to answer this question. The probability-based sample of 140,000 military personnel will be surveyed every 3 years during a 21-year period. The first questionnaire, scheduled for release in summer 2001, will be sent to 30,000 veterans who have been deployed to southwest Asia, Bosnia, or Kosovo since August 1997 and 70,000 veterans who have not been deployed to these conflict areas. Twenty thousand new participants will be added to the group in each of the years 2004 and 2007 to complete the study population of 140,000. The participants will have the option of completing the study questionnaire either on the paper copy received in the mail or through the World Wide Web-based version, which is available at www.MillenniumCohort.org. This will be one of the first prospective studies ever to offer such an option. The initial survey instrument will collect data regarding demographic characteristics, self-reported medical conditions and symptoms, and health-related behaviors. Validated instruments will be incorporated to capture self-assessed physical and mental functional status (Short Form for Veterans), psychosocial assessment (Patient Health Questionnaire), and post-traumatic stress disorder (Patient Checklist-17). Information obtained from the survey responses will be linked with other military databases, including data on deployment, occupation, vaccinations, health care utilization, and disability. In addition to revealing changes in veterans' health status over time, the Millennium Cohort Study will serve as a data repository, providing a solid foundation upon which additional epidemiological studies may be constructed.",0,0 +3270,Stress and Health during Medical Humanitarian Assistance Missions,"The present research examined stress and health among service members deployed on a medical humanitarian assistance mission to Kazakstan. Team members were surveyed before and during their deployment. Team members underestimated how much stress they would experience in terms of isolation and inability to help the local population. Team members also used less adaptive coping mechanisms than anticipated and showed elevations in alcohol and cigarette consumption. Despite these negative experiences, reports of depression and physical symptoms did not increase during the deployment. This may have been a function of team members being personally involved in important and relevant work during the humanitarian operation.",0,0 +3271,Internal validity of an anxiety disorder screening instrument across five ethnic groups,"We tested the factor structure of the National Anxiety Disorder Screening Day instrument (n=14860) within five ethnic groups (White, Black, Hispanic, Asian, Native American). Conducted yearly across the US, the screening is meant to detect five common anxiety syndromes. Factor analyses often fail to confirm the validity of assessment tools' structures, and this is especially likely for minority ethnic groups. If symptoms cluster differently across ethnic groups, criteria for conventional DSM-IV disorders are less likely to be met, leaving significant distress unlabeled and under-detected in minority groups. Exploratory and confirmatory factor analyses established that the items clustered into the six expected factors (one for each disorder plus agoraphobia). This six-factor model fit the data very well for Whites and not significantly worse for each other group. However, small areas of the model did not appear to fit as well for some groups. After taking these areas into account, the data still clearly suggest more prevalent PTSD symptoms in the Black, Hispanic and Native American groups in our sample. Additional studies are warranted to examine the model's external validity, generalizability to more culturally distinct groups, and overlap with other culture-specific syndromes.",0,0 +3272,Life after Trauma: Personality and Daily Life Experiences of Traumatized People,"In this study, we explored differences in personality and daily life experiences of traumatized (n = 26) versus nontraumatized (n = 30) college students. Study participants completed a variety of personality measures as well as a 28-day experience sampling study assessing daily activities, emotions, and physical health. Although not differing on general demographics, traumatized individuals reported more trait anxiety and lower self-esteem than nontraumatized individuals. They scored higher on Neuroticism, were more introverted, and were less emotionally stable than nontraumatized participants. Traumatized individuals also reported more cognitive disturbances, emotional blunting, and interpersonal withdrawal. They did not report being more depressed, but did endorse cognitive styles associated with heightened risk for depression. Earlier age of trauma was associated with more pathological outcomes: lower self-esteem and psychological well-being, more anxiety, more pessimism, and emotional constriction of positive mood. We compare this symptom profile to that of posttraumatic stress disorder.",0,0 +3273,Exploring the Lived-Experience of Limerence: A Journey toward Authenticity,"Limerence is an acute onset, unexpected, obsessive attachment to one person, the Limerent Object, which is rarely reported in scientific literature. Presented here is an interpretative phenomenological analysis to explore the livedexperience of six international Limerent respondents. The condition's unique and common journey is conceptualised in a Limerence Trajectory, which is characterized by generally sequential yet overlapping super-ordinate themes. The themes primarily regard experiences of ruminative thinking, free floating anxiety and depression temporarily fixated and the disintegration of the self. These themes are further linked to an inclination to reintegrate unresolved past life(s) experiences and to progress to a state of greater authenticity (i.e., being truer to one's inner self). A paradigm shift is identified in the realization that both a real and idealized Limerent Object are involved which may relate to attachment anxieties. Symptomology relating to Obsessive Compulsive Disorder, addiction, separation anxiety and depression, Post Traumatic Stress Disorder, disassociated states and maladaptive fantasy are discussed. The study authors and respondents collective aim is to promote awareness, research and resources for Limerent Experiencers and those who seek to support them.",0,0 +3274,Religious meaning-making at the community level: The forced relocation from the Gaza Strip.,"The purpose of the current study was to describe the process of religious coping in a religious community that underwent a forced relocation. Whereas previous work on meaning-making processes has looked at individuals, we sought to understand what happens to the process of religious coping when an entire community experiences a shared stressful event. Using Park’s (2005) model of religion as a meaningmaking framework, we analyzed open-ended narratives of 230 former residents of Gush Katif who wrote about the ways in which they coped with their relocation, 8 to 10 months after it took place. The primary finding was that participants referred to the impact of the relocation on their religious beliefs and referred to it not only as individuals but also, and perhaps mostly, as members of a community. Analyzing the content of these answers revealed four pathways of religious coping: resilient (no change in religious belief), strengthening of belief, weakening of belief, and open crisis. The findings suggest that in collective events, and especially in communities, meaning-making processes take place at both individual and collective levels. We discuss the findings in light of existing theories of religious coping.",0,0 +3275,Treatment type and demographic characteristics as predictors for cancer adjustment: Prospective trajectories of depressive symptoms in a population sample.,"Prospectively identifying individuals at heightened risk for depression can alleviate the disease burden of distal physical and mental health consequences after cancer onset. Our objective was to identify heterogeneous trajectories of adjustment in cancer patients, using treatment-type as a predictor.Participants were followed for 6 years within the Health and Retirement Study (HRS), a prospective population-based cohort study. The sample consisted of 1,294 middle-aged participants who were assessed once before and 3 time points after their report of an initial cancer diagnosis. In addition to self-reported depressive symptoms, subjects indicated receipt of surgical, radiological, or chemical interventions as part of their usual oncological care.Four symptom trajectories were identified with Latent Growth Mixture Modeling: an increasing depression (10.5%), chronic depression (8.0%), depressed-improved (7.8%), and stable-low depression (73.7%). A conditional model using participants with available predictor data (n = 545) showed individuals in the emerging depression class were significantly more likely to have received chemo/medication therapy when compared with the remitting depression, stable-low, and chronic depression classes. Participants in the chronic and depressed-improved classes generally had worse baseline health, and the depressed-improved were also younger in age.Patients who exhibited increasing depressive symptoms had a greater probability of receiving chemo/medication therapy than any other adjustment trajectory group, although the majority of chemotherapy patients did not exhibit depressive symptom changes. These data underscore the diversity of ways that patients adjust to cancer, and suggest cancer treatment, baseline health, and age may influence long-term patterns of psychological adjustment.",0,0 +3276,"Children and war: Risk, resilience, and recovery","This article reviews and reflects on studies that have explored the effects of war on children around the world. Most are cross-sectional and based on self-reports. They describe a range of mental health problems, related to dose effects and to the negative impact of being a victim or witness of violent acts, threats to and loss of loved ones, prolonged parental absence, and forced displacement. The more recent the exposure to war, and the older the child, the higher was the likelihood of reported posttraumatic stress disorder symptoms. Especially vulnerable to long-term emotional distress were child soldiers, children who were raped, and children who had been forcibly displaced. In adulthood, war-traumatized children displayed significantly increased risks for a wide range of medical conditions, especially cardiovascular diseases. Among protective factors that moderated the impact of war-related adversities in children were a strong bond between the primary caregiver and the child, the social support of teachers and peers, and a shared sense of values. Among the few documented intervention studies for children of war, school-based interventions, implemented by teachers or locally trained paraprofessionals, proved to be a feasible and low-cost alternative to individual or group therapy. More longitudinal research with multiple informants is needed to document the trajectories of risk and resilience in war-affected children, to assess their long-term development and mental health, and to identify effective treatment approaches.",0,0 +3277,Additive Gene-Environment Effects on Hippocampal Structure in Healthy Humans,"Hippocampal volume loss has been related to chronic stress as well as genetic factors. Although genetic and environmental variables affecting hippocampal volume have extensively been studied and related to mental illness, limited evidence is available with respect to G × E interactions on hippocampal volume. The present MRI study investigated interaction effects on hippocampal volume between three well-studied functional genetic variants (COMT Val158Met, BDNF Val66Met, 5-HTTLPR) associated with hippocampal volume and a measure of environmental adversity (life events questionnaire) in a large sample of healthy humans (n = 153). All three variants showed significant interactions with environmental adversity with respect to hippocampal volume. Observed effects were additive by nature and driven by both recent as well as early life events. A consecutive analysis of hippocampal subfields revealed a spatially distinct profile for each genetic variant suggesting a specific role of 5-HTTLPR for the subiculum, BDNF Val66Met for CA4/dentate gyrus, and COMT Val158Met for CA2/3 volume changes. The present study underscores the importance of G × E interactions as determinants of hippocampal volume, which is crucial for the neurobiological understanding of stress-related conditions, such as mood disorders or post-traumatic stress disorder (PTSD).",0,0 +3278,Prevalence of post-traumatic stress disorder among adolescents after the Wenchuan earthquake in China,"Background The Wenchuan earthquake was a catastrophic earthquake in China. The aim of this study is to explore longitudinally the rates of post-traumatic stress disorder (PTSD) and depression in adolescents after the Wenchuan earthquake, and to identify independent predictors of PTSD. Method PTSD and depression symptoms among adolescents at 6, 12 and 18 months after the Wenchuan earthquake were investigated using the PTSD Checklist Civilian Version and the Beck Depression Inventory (BDI). Subjects in this study included 548 high school student survivors in a local boarding high school. Results The rates of PTSD symptoms were 9.7%, 1.3% and 1.6% at the 6-, 12- and 18-month follow-ups, respectively. BDI scores were found to be the best predictor of severity of PTSD at 6, 12 and 18 months. Gender was another variable contributing significantly to PTSD at 6 and 12 months after the earthquake. In the 12-month follow-up, home damage was found to be a predictor of severity of PTSD symptoms. Being a child with siblings was found to be a predictor of severity of PTSD symptoms at 12 and 18 months after the earthquake. Conclusions PTSD symptoms changed gradually at various stages after the earthquake. Depression symptoms were predictive of PTSD symptoms in the 18-month follow-up study. Other predictors of PTSD symptoms included female gender and being a child with siblings. The results of this study may be helpful for further mental health interventions for adolescents after earthquakes.",0,0 +3279,"Finding One's Way to ""a Place Where I Am Respected"": the Experiences of First-Generation Vietnamese Americans with Depression and/or Post-traumatic Stress Disorder","Despite the high prevalence of depression and post-traumatic stress disorder among first-generation Vietnamese Americans, their underutilization of mental health services continues to persist. The question of how culturally sensitive mental health services can be delivered to engage this population effectively in treatment has been a key issue for disparities research for the past several decades. Ample literature has identified individual, sociocultural and structural factors that influence mental health service use among this population, but very few studies have explored the perceptions of the clients themselves about mental illness or their pathways to care. Twenty-one individual, inductive, and qualitative one-on-one interviews were conducted to address three aims: 1) to explore the conceptualizations of health among first-generation Vietnamese Americans living with depression and/or PTSD, 2) to illustrate the pathways through which this population obtained outpatient mental health services, and 3) to describe their expectations and perceptions of outpatient mental health treatment. Constructivist grounded theory (GT) guided all aspects of this study. The participants were mostly female and ranged in age from 42 to 74 years. Two major themes, bounded within these four walls and finding one's way to a place where I am respected, emerged as overarching processes through which the participants described their experiences. Their rich stories portrayed journeys through losing, finding and reclaiming their self worth -- journeys marked with losses, sacrifices, disruptions, stigma, resilience, coming to terms with their conditions, and managing their illnesses. These men and women remained optimistic on the road to reclaiming their sense of self worth, despite being crippled by their legacies of war, trauma, and migration to the United States. Their stories offer a culturally nuanced understanding of how participants explained their emotional discomforts, how they found their various ways to agencies that could help ease these discomforts, and the unexpected resources and relationships they gained from outpatient mental health care. This study's findings provide strong implications for social work research, practice, and policy that can help empower these individuals to find purpose and hope in their lives.",0,0 +3280,Psychophysiology in the Study of Psychological Trauma: Where Are We Now and Where Do We Need to Be?,"Posttraumatic stress disorder (PTSD) is a major public health concern, which has been seeing increased recent attention partly due to the wars in Iraq and Afghanistan. Historically, research attempting to understand the etiology and treatment of PTSD has made frequent use of psychophysiological measures of arousal as they provide a number of advantages in providing objective, non-self-report outcomes that are closely related to proposed neurobiological mechanisms and provide opportunity for cross-species translation. Further, the ongoing shift in classification of psychiatric illness based on symptom clusters to specific biological, physiological, and behavioral constructs, as outlined in the US National Institute of Mental Health (NIMH) Research Domain Criteria project (RDoC), promises that psychophysiological research will continue to play a prominent role in research on trauma-related illnesses. This review focuses on the current state of the knowledge regarding psychophysiological measures and PTSD with a focus on physiological markers associated with current PTSD symptoms, as well as markers of constructs thought to be relevant to PTSD symptomatology (safety signal learning, fear extinction), and psychophysiological markers of risk for developing PTSD following trauma. Future directions and issues for the psychophysiological study of trauma including traumatic brain injury (TBI), treatment outcome studies, and new wearable physiological monitoring technologies are also discussed.",0,0 +3281,Psychometric properties of the Posttraumatic Stress Disorder Symptom Scale Interview for DSM–5 (PSSI–5).,"Changes to the diagnostic criteria for posttraumatic stress disorder (PTSD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) create a need for valid and reliable updated assessment tools. This study examined key psychometric properties (e.g., internal consistency, test-retest reliability, interrater reliability, and convergent and discriminant validity) of the PTSD Symptom Scale Interview for DSM-5 (PSSI-5), a modified version of the PSS-I (PTSD Symptom Scale)-Interview Version for the DSM-IV. Participants were 242 urban community residents, veterans, and college undergraduates, recruited from 3 study sites, who had experienced a DSM-5 Criterion A traumatic event. The PSSI-5 demonstrated good internal consistency (α = .89) and test-retest reliability (r = .87), as well as excellent interrater reliability for the total severity score (intraclass correlation = .98) and interrater agreement for PTSD diagnosis (κ = .84). The PSSI-5 also demonstrated convergent validity with 3 measures of PTSD (i.e., Clinician-Administered PTSD Scale for DSM-5, Posttraumatic Diagnostic Scale for DSM-5, and PTSD Checklist-Specific Version; all rs > .72) and discriminant validity with the Beck Depression Inventory-II and the State-Trait Anxiety Inventory-Trait scale. Receiver operating characteristic analysis yielded a cutoff score of 23 for identifying a probable PTSD diagnosis. Together, these findings indicate that the PSSI-5 is a valid and reliable instrument for assessing PTSD diagnosis and severity. (PsycINFO Database Record",0,0 +3282,Social Work Practice for Promoting Health and Wellbeing,,0,0 +3283,The Course of Posttraumatic Stress in Children: Examination of Recovery Trajectories Following Traumatic Injury,"Group-based trajectory modeling was used to identify patterns of posttraumatic stress symptom (PTSS) in children 6-16 years following accidental injury. The aims were to: (a) identify probable groups of children following distinct trajectories, and (b) identify risk factors affecting the probability of group membership.Children's Impact of Events Scale (n = 190) was used to assess PTSS up to 2 years post injury. Age, gender, type of injury, and preinjury behavior were assessed as risk factors.Three distinct trajectory groups were identified: resilient (57%), elevated stress symptoms which recovered quickly (33%), and chronic (10%). Younger children were more likely to be in the recovery group. Those with serious injuries were more likely to be in the chronic group. Preinjury child behavior problems were predictive of recovery and high chronic symptoms.Identification of distinct PTSS trajectory groups has implications for understanding the course and treatment of PTSS in children.",0,0 +3284,Models for pedestrian gap acceptance behaviour analysis at unprotected mid-block crosswalks under mixed traffic conditions,"Pedestrian safety is an important aspect while crossing the road and it can be explained by pedestrian gap acceptance behaviour. The statistical models such as multiple linear regression (MLR) is often used to model linear relationships between dependent variable (viz., pedestrian gap acceptance behaviour) and independent variables, due to their ability to quantitatively predict the effect of various factors on the dependent variable. However such linear models cannot consider the effect of several variables on the output variable, due to primary assumptions of normality, linear, homoscedasticity and multicollinearity. In this regard, the non-linear models based on the artificial neural network (ANN), which are free from assumptions of linear models, can be easily employed for obtaining the effect of several input variables on the pedestrian accepted gap size. However, researchers have rarely applied ANN modelling technique for predicting the pedestrian gap acceptance behaviour, as the pedestrian gap acceptance behaviour depends on several pedestrian, traffic and vehicular characteristics. The ANN based models would be quite useful in establishing relationship between these factors on the pedestrian gap acceptance behaviour at midblock crosswalks under mixed traffic conditions. In this direction, the present study adopts both MLR as well as ANN with different pedestrian, traffic and vehicular characteristics to assess the significant contributing factors for pedestrians’ gap acceptance behaviour at unprotected mid-block crosswalks under mixed traffic conditions. For this purpose, a video graphic survey was conducted at a six lane divided road at unprotected mid-block crossing in Mumbai, India. The data such as pedestrian (gender and age), vehicular, traffic and pedestrian behavioural characteristics were extracted to model pedestrian accepted gaps. The model results show that pedestrian rolling behaviour has a significant effect on pedestrian accepted gap size. The model results concluded that ANN has a better prediction with possibility to consider the effect of more number of variables on the pedestrian gap acceptance behaviour as compared to the MLR model under mixed traffic conditions. However, the quantification of significant contributing variables on pedestrian accepted gap size is easy by MLR model as compared to the ANN technique. So, both models have their own significant role in pedestrian gap acceptance analysis. The developed models may be useful to enhance the existing mid-block crosswalk facilities or planning new facilities by more accurate prediction of the pedestrian gap acceptance behaviour considering the influence of various factors under mixed traffic conditions.",0,0 +3285,Cognitive Debt and Alzheimer's Disease,"We propose the concept of Cognitive Debt to characterize thoughts and behaviors that increase vulnerability to symptomatic Alzheimer's disease (AD). Evidence indicates that depression, anxiety, sleep disorder, neuroticism, life stress, and post-traumatic stress disorder increase risk for AD, and we suggest they do so by increasing Cognitive Debt. Repetitive negative thinking (RNT), a behaviorally measurable process common to these factors, may drive Cognitive Debt acquisition. RNT transcends disorder-specific definition, encompasses rumination and worry, and is defined by perseverative, negative thought tendencies. Evidence of dysregulated stress responses supports the concept of Cognitive Debt, of RNT as its causal mechanism, and of an interaction with the APOE-ε4 genotype to increase vulnerability to clinical AD, independent from traditional AD pathology. Defining a more specific behavioral profile of risk would enable interventions to be targeted earlier and more precisely at individuals most vulnerable to developing AD. Additionally, modulating RNT could potentially reduce risk of clinical AD. Interventions to reduce RNT are discussed, as are suggestions for future research. For these reasons we submit that the Cognitive Debt model may aid understanding of the psychological mechanisms that potentially increase predisposition to AD.",0,0 +3286,The importance of secondary trauma exposure for post-disaster mental disorder,"Background. Interventions to treat mental disorders after natural disasters are important both for humanitarian reasons and also for successful post-disaster physical reconstruction that depends on the psychological functioning of the affected population. A major difficulty in developing such interventions, however, is that large between-disaster variation exists in the prevalence of post-disaster mental disorders, making it difficult to estimate need for services in designing interventions without carrying out a post-disaster mental health needs assessment survey. One of the daunting methodological challenges in implementing such surveys is that secondary stressors unique to the disaster often need to be discovered to understand the magnitude, type, and population segments most affected by post-disaster mental disorders. Methods. This problem is examined in the current commentary by analyzing data from the WHO World Mental Health (WMH) Surveys. We analyze the extent to which people exposed to natural disasters throughout the world also experienced secondary stressors and the extent to which the mental disorders associated with disasters were more proximally due to these secondary stressors than to the disasters themselves. Results. Lifetime exposure to natural disasters was found to be high across countries (4.4–7.5%). 10.7–11.4% of those exposed to natural disasters reported the occurrence of other related stressors (e.g. death of a loved one and destruction of property). A monotonic relationship was found between the number of additional stressors and the subsequent onset of mental disorders Conclusions. These results document the importance of secondary stressors in accounting for the effects of natural disasters on mental disorders. Implications for intervention planning are discussed.",0,0 +3287,Introduction to a Special Issue on Research with Youth Exposed to Disasters and Violence,,0,0 +3288,Missing data: Our view of the state of the art.,"Statistical procedures for missing data have vastly improved, yet misconception and unsound practice still abound. The authors frame the missing-data problem, review methods offer advice, and raise issues that remain unresolved. They clear up common misunderstandings regarding the missing at random (MAR) concept. They summarize the evidence against older procedures and, with few exceptions, discourage their use. They present, in both technical and practical language, 2 general approaches that come highly recommended: maximum likelihood (ML) and Bayesian multiple imputation (MI). Newer developments are discussed, including some for dealing with missing data that are not MAR. Although not yet in the mainstream, these procedures may eventually extend the ML and MI methods that currently represent the state of the art.",0,0 +3289,Posttraumatic Stress Disorder across Two Generations of Cambodian Refugees,"To examine the expression of war-related trauma as manifested by DSM-III-R rates of posttraumatic stress disorder (PTSD) and major depressive disorder in two generations of Cambodian refugees living in the western United States.A probability sample of 209 Khmer adolescents and one of their parents were interviewed using portions of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version and the PTSD section of the Diagnostic Interview for Children and Adolescents. Interviews were conducted in English by a master's-level clinician with a Khmer interpreter.PTSD was found to be significantly related across parent-child generations. A nonsignificant generational trend was also found for depressive disorders. A number of environmental variables measured in the study (amount of reported war trauma, loss, living arrangements, treatment received, socioeconomic status) were not related to these findings. Parents were more likely to report an earlier onset of PTSD symptoms.This study suggests that PTSD in refugees may cluster in families. Whether this phenomenon is caused by a genetic susceptibility to trauma awaits further research. PTSD and depressive disorders in refugee populations, while often comorbid, appear to follow different courses over time.",0,0 +3290,Acute psychophysiological arousal and posttraumatic stress disorder: A two-year prospective study,"This study investigated the role of acute arousal in the development of posttraumatic stress disorder (PTSD). Hospitalized motor vehicle accident survivors (n = 146) were assessed for acute stress disorder (ASD) within 1 month of the trauma, 6 months later, and reassessed for PTSD 2 years posttrauma (n = 87). Heart rates (HR) were assessed on the day of hospital discharge. Participants who had PTSD 2 years posttrauma had higher HR at hospital discharge than those without PTSD. A diagnosis of ASD or a resting HR of 95 beats per minute had moderate sensitivity (74%) and specificity (91%) in predicting PTSD. These findings suggest that caution is required in using acute HR as a predictor of longer-term PTSD following trauma.",0,0 +3291,The association of posttraumatic stress disorder and quality of life during the first year after acute coronary syndrome,"Acute coronary syndrome [ACS, including unstable angina (UA) or myocardial infarction (MI)] events can be psychologically traumatic experiences for patients given their unpredictable, sudden onset and life-threatening nature [1]. Although posttraumatic stress disorder (PTSD) is commonly associated with index events of war or assault, PTSD is also associated with life-threatening illness and in particular ACS with approximately 12% of patients developing PTSD [1,2].",0,0 +3292,Low early morning plasma cortisol in posttraumatic stress disorder is associated with co-morbid depression but not with enhanced glucocorticoid feedback inhibition,"Co-morbid major depressive disorder (MDD) in individuals with posttraumatic stress disorder (PTSD) confers a more severe clinical course and is associated with distinct biologic abnormalities. Although dysregulation in the hypothalamic pituitary adrenal (HPA) axis has been well established in PTSD, the impact of commonly co-occuring MDD has received scant attention.Overnight (7p.m. to 7a.m.) plasma cortisol, adrenocorticotropic hormone (ACTH), dehydroepiandrosterone sulphate (DHEA-S) were measured at 30 min intervals in 9 participants with PTSD with MDD (PTSD+MDD), 9 with PTSD without MDD (PTSD-MDD) and 16 non-traumatized healthy controls. A low-dose dexamethasone suppression test was administered to evaluate feedback sensitivity to glucocorticoids. Linear mixed models with body mass index (BMI) and age as covariates and Bonferroni corrected post hoc tests assessed group differences.Compared to healthy controls, subjects with PTSD+MDD, but not those subjects with PTSD-MDD, exhibited lower basal plasma cortisol levels between 1:30 a.m. and 3:30 a.m. and at 4:30 a.m. and 6:30 a.m. (effect size d=0.75). Despite similar plasma ACTH levels between the three groups, the ACTH/cortisol ratio was higher in PTSD+MDD patients compared to controls. We obtained similar results when the patient and control groups were re-studied 1 week later, and when men and current smokers were excluded. Basal plasma DHEA-S levels, and cortisol and ACTH response to a low-dose dexamethasone suppression test were similar in all three groups.Lower early morning plasma cortisol levels and a high ACTH/cortisol ratio in subjects with PTSD and co-morbid MDD may not be due to enhanced peripheral sensitivity to glucocorticoids. A central abnormality in glucocorticoid regulation could explain HPA axis dysfunction in this subgroup.",0,0 +3293,Posttraumatic Stress Disorder Among Israeli Ex-Prisoners of War 18 and 30 Years After Release,"Article AbstractBackground: The psychological responses to captivity were measured in a sample of former prisoners of war (POWs) 18 and 30 years after release from captivity. Method: 209 Israeli veterans of the 1973 Yom Kippur War (103 ex-POWs and 106 controls) who had taken part in a previous study conducted in 1991 participated in the current study conducted in 2003. The study assessed current rates of posttraumatic stress disorder (PTSD), changes in PTSD over time, and the contribution of captivity severity (objective and subjective), sociodemographic variables, and psychological appraisal and coping with captivity to predicting PTSD using standardized self-report questionnaires. Results: Twenty-three percent of the ex-POWs met PTSD criteria and were 10 times more likely than controls to experience deterioration in their psychological condition in the 12-year interval between the 2 assessments. Almost 20% of ex-POWs who did not meet PTSD criteria in 1991 met criteria in the current assessment, in comparison to almost 1% of the controls. Current PTSD was predicted by younger age at the time of captivity, by loss of emotional control and higher subjective appraisal of suffering in captivity, and by a greater number of PTSD symptoms in the 1991 assessment. Conclusion: It is important to follow up and offer treatment to former POWs. Special attention should be paid to those who lost emotional control in captivity and to those who felt that the conditions of their captivity were severe.",0,0 +3294,Shared and unique predictors of post-traumatic growth and distress,"This prospective longitudinal study compared pretraumatic, peritraumatic, and post-traumatic predictors of post-traumatic growth (PTG) and post-traumatic stress disorder (PTSD). A total of 103 Israeli former prisoners of the Yom Kippur War were followed over 30 years. Sociodemographic variables, trauma exposure, reactions in captivity, world assumptions, social support, and personality factors were assessed in 1991, and PTG and PTSD symptoms in 2003. Hierarchical regression modeling showed that although some predictors, namely, loss of control and active coping during captivity, predicted both PTG and PTSD, others predicted one outcome and not the other. Self-controllability predicted PTG while sociodemographic factors predicted PTSD when controlling for PTSD and PTG, respectively. The findings indicate that salutary and pathogenic trauma outcomes share some but not all precursors, underscoring their multifaceted relationship.",0,0 +3295,Associations between posttraumatic stress disorder symptom clusters and cigarette smoking.,"Understanding the relationship between Posttraumatic stress disorder (PTSD) and cigarette smoking has been difficult because of PTSD's symptomatic heterogeneity. This study examined common and unique lifetime cross-sectional relationships between PTSD symptom clusters [Re-experiencing (intrusive thoughts and nightmares about the trauma), Avoidance (avoidance of trauma-associated memories or stimuli), Emotional Numbing (loss of interest, interpersonal detachment, restricted positive affect), and Hyperarousal (irritability, difficulty concentrating, hypervigilance, insomnia)] and three indicators of smoking behavior: (1) smoking status; (2) cigarettes per day; and (3) nicotine dependence. Participants were adult respondents in the National Epidemiologic Survey of Alcohol and Related Conditions with a trauma history (n = 23,635). All four symptom clusters associated with each smoking outcome in single-predictor models (ps <. 0001). In multivariate models including all of the symptom clusters as simultaneous predictors, Emotional Numbing was the only cluster to retain a significant association with lifetime smoking over and above the other clusters, demographics, and Axis-I comorbidity (OR = 1.30, p < .01). While Avoidance uniquely associated with smoking status and nicotine dependence in multivariate models, these relations fell below significance after adjusting for demographics and comorbidity. No clusters uniquely associated with cigarettes per day. Hyperarousal uniquely related with nicotine dependence over and above the other clusters, demographics, and Axis-I comorbidity (OR = 1.51, p < .001). These results suggest the following: (a) common variance across PTSD symptom clusters contribute to PTSD's linkage with smoking in the American population; and (b) certain PTSD symptom clusters may uniquely associate with particular indicators of smoking behavior. These findings may clarify the underpinnings of PTSD-smoking comorbidity and inform smoking interventions for trauma-exposed individuals.",0,0 +3296,Trajectories of maternal depression over 7 years: Relations with child psychophysiology and behavior and role of contextual risks,"Abstract This study examines the relation between the longitudinal course of maternal depression during the child's early life and children's psychophysiology and behavior at age 6.5 years. One hundred fifty-nine children of depressed and nondepressed mothers were followed from infancy through age 6.5 years. Growth mixture modeling was used to identify classes of depressed mothers based on the longitudinal course of the mother's depression. School-aged children of chronically depressed mothers were found to have elevated externalizing behavior problems, decreased social competence, reduced frontal brain activation (EEG power), and higher respiratory sinus arrhythmia reactivity. Children of mothers with decreasing and stable mild depression were found to have increased hyperactivity and attention problems compared to children of nondepressed mothers. Contextual risk factors were found to mediate the relation between maternal depression and child behavioral outcomes.",0,0 +3297,Risk Factors for Depression After a Disaster,"Environmental stressors such as mass disasters may contribute to an increased prevalence of depression within the population affected. We examined the prevalence of probable major depression and risk factors for depression in the 6-month period after the September 11, 2001, attacks on the World Trade Center among New York City (NYC) metropolitan residents. A total of 2700 persons who were representative of the NYC metropolitan area were included in this cross-sectional telephone survey. The prevalence of probable major depression in the 6 months after the attacks was 9.4%. Multivariate logistic regression covariates associated with the likelihood of probable major depression included being directly affected by the attacks, having a perievent panic attack, experiencing multiple life stressors, and having been exposed to previous traumatic events. Mass traumatic event exposure appears to be an independent environmental risk factor for depression in the postdisaster context; specific reactions such as perievent panic attacks may have prognostic value.",0,0 +3298,Posttraumatic Stress Disorder Increases Risk of Criminal Recidivism Among Justice-Involved Persons With Mental Disorders,"Posttraumatic stress disorder (PTSD) is a potentially important, yet understudied, mental disorder to consider in models of criminal recidivism. The present study sought to address this gap in the literature with a large-scale secondary analysis of observational data from a sample of justice-involved persons with mental disorders. Administrative data were reviewed for 771 adult jail detainees with mental disorders. Hierarchical logistic regression models showed that PTSD was associated with a greater likelihood of general (arrest for any new charge) and serious (arrest for a new felony charge) recidivism during the year following the index arrest, after controlling for risk conferred by a recent history of arrest, demographic characteristics, and other mental disorders. Furthermore, risk of rearrest for new charges was comparable for PTSD and substance use disorders. Findings show that PTSD increases risk of both general and serious recidivism and suggest it should be considered in interventions to reduce justice-system involvement.",0,0 +3299,Association between traumatic events and post-traumatic stress disorder: results from the ESEMeD-Spain study,"The relative importance of traumatic events (TEs) in accounting for the social burden of post-traumatic stress disorder (PTSD) could vary according to cross-cultural factors. In that sense, no such studies have yet been conducted in the Spanish general population. The present study aims to determine the epidemiology of trauma and PTSD in a Spanish community sample using the randomly selected TEs method.The European Study of the Epidemiology of Mental Disorders (ESEMeD)-Spain is a cross-sectional household survey of a representative sample of adult population. Lifetime prevalence of self-reported TEs and lifetime and 12-month prevalence of PTSD were evaluated using the World Health Organization (WHO) Composite International Diagnostic Interview. Reports of PTSD associated with randomly selected TEs were weighted by the individual-level probabilities of TE selection to generate estimates of population-level PTSD risk associated with each TE.Road accident was the most commonly self-reported TE (14.1%). Sexual assault had the highest conditional risk of PTSD (16.5%). The TEs that contributed most to societal PTSD burden were unexpected death of a loved one (36.4% of all cases) and sexual assault (17.2%). Being female and having a low educational level were associated with low risk of overall TE exposure and being previously married was related to higher risk. Being female was related to high risk of PTSD after experiencing a TE.Having an accident is commonly reported among Spanish adults, but two TE are responsible for the highest burden associated with PTSD: the unexpected death of someone close and sexual assault. These results can help designing public health interventions to reduce the societal PTSD burden.",0,0 +3300,Abnormal recruitment of working memory updating networks during maintenance of trauma-neutral information in post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) is characterised by disturbances in concentration and memory, symptoms which are a source of further distress for patients. Related to this, abnormalities in underlying working memory (WM) systems have been identified [Clark, C.R., McFarlane, A.C., Morris, P., Weber, D.L., Sonkkilla, C., Shaw, M.E., Marcina, J., Tochon-Danguy, H.J., Egan, G.F., 2003. Cerebral function in posttraumatic stress disorder during verbal working memory updating: a positron emission tomography study. Biological Psychiatry 53, 474-481.], indicating dysfunction in left hemisphere brain regions. In this study, we performed functional magnetic resonance imaging (fMRI) in 13 patients with severe PTSD and matched non-traumatized Controls, during performance of visuo-verbal tasks that involved either maintenance or continual updating of word stimuli in WM. The PTSD group failed to show differential activation during WM updating, and instead appeared to show abnormal recruitment of WM updating network regions during WM maintenance. These regions included the bilateral dorsolateral prefrontal cortex (DLPFC) and the inferior parietal lobe (IPL). Several other regions were significantly more activated in Controls than in PTSD during WM updating, including the hippocampus, the anterior cingulate (AC), and the brainstem pons, key regions that are consistently implicated in the neurobiology of PTSD. These findings suggest compensatory recruitment of networks in PTSD normally only deployed during updating of WM and may reflect PTSD patients' difficulty engaging with their day-to-day environment.",0,0 +3301,Hostility is related to clusters of T-cell cytokines and chemokines in healthy men,"Hostility is a risk factor for adverse health outcomes as diverse as cardiovascular disease and post-traumatic stress disorder (PTSD). Cytokines have been suggested to mediate this relationship. We investigated whether in healthy men a relation existed between hostility and T-cell mitogen-induced cytokines and chemokines. Male Dutch military personnel (n=304) were included before deployment. Eleven cytokines and chemokines were measured in supernatants of T-cell mitogen-stimulated whole blood cultures by multiplex immunoassay. Factor analysis was used to identify clusters of cytokines and chemokines. In a regression analysis hostility was related to the cytokine/chemokine clusters, and the potential risk factors age, BMI, smoking, drinking, previous deployment, early life trauma and depression. Explorative factor analysis showed four functional clusters; a pro-inflammatory factor (IL-2, TNFalpha, IFNgamma), an anti-inflammatory factor (IL-4, IL-5, IL-10), IL-6/chemokine factor (IL-6, MCP-1, RANTES, IP-10), and MIF. Hostility was significantly related to decreased IL-6/chemokine secretion and increased pro- and anti-inflammatory cytokines. There was an inverse relation between age and hostility scores. Early life trauma and depression were positively and independently related to hostility as well. This study represents a novel way of investigating the relation between cytokines and psychological characteristics. Cytokines/chemokines clustered into functional factors, which were related to hostility in healthy males. Moreover this relation appeared to be independent of reported depression and early trauma.",0,0 +3302,Construct Validity of the Posttraumatic Stress Disorder Checklist in Cancer Survivors: Analyses Based on Two Samples.,"The measurement of posttraumatic stress disorder (PTSD) is critically important for the identification and treatment of this disorder. The PTSD Checklist (PCL; F. W. Weathers and J. Ford, 1996) is a self-report measure that is increasingly used. In this study, the authors investigated the factorial validity of the PCL with data from 236 cancer survivors who received a bone marrow or stem cell transplantation. The authors examined the fit of these data with the clinical model of 3 symptom clusters for PTSD, as proposed in the Diagnostic and Statistical Manual of Mental Disorders, and alternative models tested in prior research. By using confirmatory factor analysis the authors found that a 4-first-order-factor model of PTSD provided the best fit. The relations of PTSD symptoms with sociodemographic and medical variables were also explored.",0,0 +3303,Use of prescription drugs and future delinquency among adolescent offenders,"

Abstract

Non-medical use of prescription drugs (NMUPD) by adolescents is a significant public health concern. The present study investigated the profile of NMUPD in 1349 adolescent offenders from the Pathways to Desistance project, and whether NMUPD predicted future delinquency using longitudinal data. Results indicated that increased frequency and recency of NMUPD in adolescent offenders are related to some demographic factors, as well as increased risk for violence exposure, mental health diagnoses, other drug use, and previous delinquency, suggesting that severity of NMUPD is important to consider. However, ANCOVA analyses found that NMUPD was not a significant predictor of drug-related, non-aggressive, or aggressive delinquency 12months later beyond other known correlates of delinquency. Age, sex, exposure to violence, lower socioeconomic status, more alcohol use, and having delinquency histories were more important than NMUPD in predicting future delinquency. These findings suggest that although NMUPD is an important risk factor relating to many correlates of delinquency, it does not predict future delinquency beyond other known risk factors.",0,0 +3304,Financial and social circumstances and the incidence and course of PTSD in Mississippi during the first two years after Hurricane Katrina,"Hurricane Katrina was the most devastating natural disaster to hit the United States in the past 75 years. The authors conducted interviews of 810 persons who were representative of adult residents living in the 23 southernmost counties of Mississippi before Hurricane Katrina. The prevalence of posttraumatic stress disorder (PTSD) since Hurricane Katrina was 22.5%. The determinants of PTSD were female gender, experience of hurricane-related financial loss, postdisaster stressors, low social support, and postdisaster traumatic events. Kaplan-Meier survival curves suggest that exposure to both hurricane-related traumatic events and to financial and social stressors influenced the duration of PTSD symptoms. Postdisaster interventions that aim to improve manipulable stressors after these events may influence the onset and course of PTSD.",0,0 +3305,Post-traumatic amnesia and the nature of post-traumatic stress disorder after mild traumatic brain injury,"Abstract The prevalence and nature of post-traumatic stress disorder (PTSD) following mild traumatic brain injury (MTBI) is controversial because of the apparent paradox of suffering PTSD with impaired memory for the traumatic event. In this study, 1167 survivors of traumatic injury (MTBI: 459, No TBI: 708) were assessed for PTSD symptoms and post-traumatic amnesia during hospitalization, and were subsequently assessed for PTSD 3 months later ( N = 920). At the follow-up assessment, 90 (9.4%) patients met criteria for PTSD (MTBI: 50, 11.8%; No-TBI: 40, 7.5%); MTBI patients were more likely to develop PTSD than no-TBI patients, after controlling for injury severity (adjusted odds ratio: 1.86; 95% confidence interval, 1.78–2.94). Longer post-traumatic amnesia was associated with less severe intrusive memories at the acute assessment. These findings indicate that PTSD may be more likely following MTBI, however, longer post-traumatic amnesia appears to be protective against selected re-experiencing symptoms. ( JINS , 2009, 15 , 862–867.)",0,0 +3306,The PHQ-9,"While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity.The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as ""0"" (not at all) to ""3"" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients.As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples.In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.",0,0 +3307,Screening for substance abuse in individuals with traumatic brain injury,"To determine the utility of the CAGE, the Brief Michigan Alcohol Screening Test (BMAST) and the Substance Abuse Subtle Screening Inventory (SASSI-3) with individuals with traumatic brain injury (TBI), two studies were conducted examining the accuracy, sensitivity and specificity of these instruments.Data from self-report instruments were compared to a clinical interview, Structured Clinical Interview for DSM-IV (SCID), to determine the accuracy, sensitivity and specificity.Two studies were conducted. In study I, 100 individuals with TBI were screened for alcohol abuse using the CAGE and the resulting classifications were compared with those derived from the SCID. In study II, 223 individuals were screened for alcohol abuse and drug abuse using the BMAST and SASSI-3 and the results of these screenings were compared with diagnoses obtained by the SCID.The specificity of the self-report instruments was moderately high, ranging between 81-83%. The specificity of the CAGE for alcohol abuse both pre- and post-TBI was high, 96% and 86%, respectively. The sensitivity of the self-report instruments was most variable, ranging from 32-95%, with the SASSI face valid drug scale and the CAGE alcohol post-TBI indicating the most sensitivity, 95 and 91%, respectively.The findings suggest that the CAGE may be useful in screening for alcohol abuse and the face valid drug sub-scale of the SASSI-3 may be useful in screening for drug abuse in individuals with TBI.",0,0 +3308,Student-teacher relationship trajectories and mental health problems in young children,"This longitudinal study classified groups of children experiencing different trajectories of student-teacher relationship quality over the transition from preschool into school, and determined the strength of the association between different student-teacher relationship trajectories and childhood mental health problems in the second year of primary school.A community sample of 460 Australian children were assessed in preschool (age 4), the first school year (age 5), and second school year (age 6). Teachers at all three assessments reported on student-teacher relationship quality with the Student Teacher Relationship Scale. When the children were at preschool and in their second school year, parents and teachers rated children's mental health problems using the Strengths and Difficulties Questionnaire.Latent-class growth modelling identified two trajectories of student-teacher relationship quality: (1) a stable-high student-teacher relationship quality and (2) a moderate/declining student-teacher relationship quality trajectory. Generalised linear models found that after adjusting for family demographic characteristics, having a stable high quality student-teacher relationship trajectory was associated with fewer parent-rated and teacher-rated total mental health problems, and fewer conduct, hyperactivity, and peer problems, and greater prosocial behaviour at age 6. A stable high quality trajectory was also associated with fewer teacher-rated, but not parent-rated emotional symptoms. These effects remained after adjustment for levels of mental health problems at age 4.Findings suggest that early intervention and prevention strategies that focus on building stable high quality student-teacher relationships during preschool and children's transition into formal schooling, may help reduce rates of childhood mental health problems during the early school years.",0,0 +3309,Duties of a psychiatric-neurological consultation/ liaison service in a prison setting,"Demonstrated are standards for diagnostic and therapeutic competence deriving from the duties of a psychiatric-neurological consultation/liaison service maintained in a German prison over a 4-year period. Homogeneous age distribution (32.5 +/- 4.4 years) and the lower social status of the patients characterized the mental disorders observed in the male multinational group of patients investigated (n = 170). These included schizophrenic, affective, neurotic and psychosocial stress disorders, alcohol and drug dependence and specific personality disorders. Besides tendencies towards dissimulation, culture-bound differences in symptomatology, the phenomenon of malingering and the reluctance of prisoners, by reason of their status as such, to divulge personal information on relevant aspects of personal identity were factors complicating the diagnostic process. Epileptic syndromes and lesions of the peripheral nervous system dominated the profile of neurological diseases, mandating experience in all established technical examination procedures of neurology. Therapeutic competence in psychiatry and neurology has to satisfy not only the diversity of the manifest diseases and disorders, calling for cooperation with various medical specialists and hospitals, it must also recognize particularly the limitations of therapy in a prison setting (e.g. observation of suicidal patients). Confidentiality and transparency of medical behavior are absolute variables in the treatment of prisoners that can be rather easily realized in a consultation/liaison service.",0,0 +3310,Posttraumatic Growth in Populations with Posttraumatic Stress Disorder-A Systematic Review on Growth-Related Psychological Constructs and Biological Variables,"Posttraumatic growth (PTG) and Posttraumatic Stress Disorder (PTSD) are possible consequences of trauma. PTG is supposed to emerge from cognitive processes and can have functional and dysfunctional aspects. This systematic review aims to identify and evaluate publications assessing PTG in adults diagnosed with PTSD in order to analyse the relationship between both constructs, how PTG is related to specific psychological variables and if there are biological variables linked to PTG. This extended review evaluates the quality of measures applied and is the first to study PTG only in populations meeting full PTSD criteria. In addition, the relationship between PTG and other relevant constructs, such as openness, optimism and social support, is explored. Our systematic literature search identified 140 studies of which 19 fulfilled our inclusion criteria; most of them used the Post-Traumatic Growth Inventory. Results indicate that trauma survivors with PTSD exhibit more PTG than those without PTSD and that PTG can be intensified during the therapeutic process whereat it is unclear whether PTG is a desirable outcome of PTSD therapy. Positive correlations between PTG and PTSD are reported. For diagnosed populations, we could not find strong evidence of a quadratic relationship between PTG and PTSD, although some studies support this hypothesis. Findings regarding the association of PTG with psychological variables are heterogeneous. Only one study focused on PTG as well as on biological variables (salivary cortisol) but did not discuss possible links between these two so far unconnected research fields in PTSD. Copyright © 2015 John Wiley & Sons, Ltd.Trauma survivors with PTSD develop more PTG than those without PTSD, it remains unclear whether PTSD and PTG are curvilinearly related. PTG can be enhanced through PTSD therapy, nevertheless one must not assume that PTG is a favorable treatment outcome since we do not know if the development of PTG during therapy promotes the reduction of PTSD symptoms. It is unclear whether PTG in PTSD sufferers is a constructive outcome of cognitive processes or a positive illusion in favor of avoidance and denial. Results regarding the association of personality factors, social support and PTG are inconsistent, studies on biological aspects of PTG are lacking.",0,0 +3311,Broadening the etiological discourse on Alzheimer's disease to include trauma and posttraumatic stress disorder as psychosocial risk factors,"Biomedical perspectives have long dominated research on the etiology and progression of Alzheimer's disease (AD); yet these approaches do not solely explain observed variations in individual AD trajectories. More robust biopsychosocial models regard the course of AD as a dialectical interplay of neuropathological and psychosocial influences. Drawing on this broader conceptualization, we conducted an extensive review of empirical and theoretical literature on the associations of trauma, posttraumatic stress disorder (PTSD) and AD to develop a working model that conceptualizes the role of psychosocial stressors and physiological mechanisms in the onset and course of AD. The proposed model suggests two pathways. In the first, previous life trauma acts as a risk factor for later-life onset of AD, either directly or mediated by PTSD or PTSD correlates. In the second, de novo AD experiential trauma is associated with accelerated cognitive decline, either directly or mediated through PTSD or PTSD correlates. Evidence synthesized in this paper indicates that previous life trauma and PTSD are strong candidates as psychosocial risk factors for AD and warrant further empirical scrutiny. Psychosocial and neurological-based intervention implications are discussed. A biopsychosocial approach has the capacity to enhance understanding of individual AD trajectories, moving the field toward ‘person-centered’ models of care. • Alzheimer's disease is influenced by both neurological and psychosocial factors. • Trauma and PTSD are strong psychosocial risk factor candidates. • Earlier life trauma is associated with later-life Alzheimer's disease onset. • Alzheimer's disease experiential trauma associated with illness progression.",0,0 +3312,Reduced GABAA benzodiazepine receptor binding in veterans with post-traumatic stress disorder,"-aminobutyric acid (GABAA) receptors are thought to play an important role in modulating the central nervous system in response to stress. Animal data have shown alterations in the GABAA receptor complex by uncontrollable stressors. SPECT imaging with benzodiazepine ligands showed lower distribution volumes of the benzodiazepine-GABAA receptor in the prefrontal cortex of patients with post-traumatic stress disorder (PTSD) in one, but not in another study. The objective of the present study was to assess differences in the benzodiazepine-GABAA receptor complex in veterans with and without PTSD using [C]flumazenil and positron emission tomography (PET). Nine drug naive male Dutch veterans with deployment related PTSD and seven male Dutch veterans without PTSD were recruited, and matched for age, region and year of deployment. Each subject received a [C]flumazenil PET scan and a structural magnetic resonance imaging scan. Dynamic 3D PET scans with a total duration of 60 min were acquired, and binding in template based and manually defined regions of interest (ROI) was quantified using validated plasma input and reference tissue models. In addition, parametric binding potential images were compared on a voxel-by-voxel basis using statistical parametric mapping (SPM2). ROI analyses using both template based and manual ROIs showed significantly reduced [C]flumazenil binding in PTSD subjects throughout the cortex, hippocampus and thalamus. SPM analysis confirmed these results. The observed global reduction of [C]flumazenil binding in patients with PTSD provides circumstantial evidence for the role of the benzodiazepine-GABAA receptor in the pathophysiology of PTSD and is consistent with previous animal research and clinical psychopharmacological studies. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +3313,Neuropsychiatric diagnosis and management of chronic sequelae of war-related mild to moderate traumatic brain injury,"Soldiers with a traumatic brain injury (TBI) present with an array of neuropsychiatric symptoms that can be grouped into nosological clusters: (1) cognitive dysfunctions: difficulties in memory, attention, language, visuospatial cognition, sensory-motor integration, affect recognition, and/or executive function typically associated with neocortical damage; (2) neurobehavioral disorders: mood, affect, anxiety, posttraumatic stress, and psychosis, as well as agitation, sleep problems, and libido loss, that may have been caused by damage to the cortex, limbic system, and/or brain stem monoaminergic projection systems; (3) somatosensory disruptions: impaired smell, vision, hearing, equilibrium, taste, and somatosensory perception frequently caused by trauma to the sensory organs or their projections through the brain stem to central processing systems; (4) somatic symptoms: headache and chronic pain; and (5) substance dependence. TBI-related cognitive impairment is common in veterans who have served in recent conflicts in the Middle East and is often related to blasts from improvised explosive devices. Although neurobehavioral disorders such as depression and posttraumatic stress disorder commonly occur after combat, the presentation of such disorders in those with head injury may pass undetected with use of current diagnostic criteria and neuropsychological instruments. With a multidimensional approach (such as the biopsychosocial model) applied to each symptom cluster, psychological, occupational, and social dysfunction can be delineated and managed.",0,0 +3314,The Predictive Power of Peritraumatic Dissociation and Acute Stress Symptoms for Posttraumatic Stress Symptoms: A Three-Month Prospective Study,"The authors prospectively examined the power of peritraumatic dissociation and acute stress symptoms in predicting posttraumatic stress disorder (PTSD) symptoms.Thirty-five assault victims were assessed with the Peritraumatic Dissociative Experiences Questionnaire within 24 hours of the assault. Participants were reassessed 2 weeks after the trauma with the Stanford Acute Stress Reaction Questionnaire and 3 months after the trauma with the Clinician-Administered PTSD Scale and the Impact of Event Scale. Correlational analyses and a hierarchical multiple regression were conducted.Peritraumatic dissociation and acute stress symptoms were correlated with later PTSD symptoms and diagnosis. Together, peritraumatic dissociation and acute stress symptoms accounted for 33% of the variance in PTSD symptoms.These results support earlier findings that peritraumatic dissociative experiences and acute stress are robust predictors of PTSD. Such symptoms may be of use for identifying at an early stage individuals at highest risk of remaining symptomatic. Future studies should investigate the predictive power of specific peritraumatic and acute stress disorder symptom clusters.",0,0 +3315,Peritraumatic tonic immobility in a large representative sample of the general population: association with posttraumatic stress disorder and female gender,"Tonic immobility is an involuntary response to inescapable life-threatening events. Peritraumatic tonic immobility has been reported in convenience samples of female victims of sexual assault and in mixed-gender victims of different types of trauma. This study evaluated peritraumatic tonic immobility in a representative general population sample and its association with posttraumatic stress disorder (PTSD) and gender.3231 victims of traumatic events aged 15-75 years responded to the Tonic Immobility Scale. PTSD and traumatic events were assessed using the Composite International Diagnostic Interview (CIDI 2.1). We calculated the means and the standard deviations of Tonic Immobility Scale scores stratified by PTSD and gender. The association between tonic immobility scores and gender was explored controlling for potential confounders through a multiple linear regression model.Tonic immobility scores were more than double in those who met criteria for PTSD and were almost four points higher in women. Gender differences remained statistically significant even after adjustment for confounding variables.The cross-sectional and retrospective design may have given rise to recall bias. Results presented here may not apply to small and medium rural areas and the CIDI 2.1 can lead to a certain degree of misclassification.We have expanded the scope of previous investigations on peritraumatic tonic immobility which were based on convenience samples only, showing its occurrence in victims of traumatic events using a large representative sample of the general population. Furthermore, we confirmed in an unbiased sample the association between peritraumatic tonic immobility and PTSD and female gender.",0,0 +3316,"Symptoms of prolonged grief, depression, and adult separation anxiety: Distinctiveness and correlates","Research has shown that prolonged grief disorder (PGD) is a disorder distinct from other disorders including major depression and posttraumatic stress disorder (PTSD). This study aimed to extend this research by examining the distinctiveness of symptoms of PGD relative to symptoms of adult separation anxiety disorder, also taking into account depression. Data were available from 205 bereaved individuals who completed measures tapping these symptoms together with a complementary measure of mental and physical health. Findings showed that symptoms of PGD, depression, and adult separation anxiety disorder were better conceptualized as distinct dimensions instead of a unitary dimension of distress. Correlations between the three symptom clusters were moderate to large. Cause of loss was the single variable that was associated with all three symptom clusters with loss due to violent cause giving rise to more severe symptoms. All three symptom clusters were associated with lower concurrent mental and physical health.",0,0 +3317,"A Cross-Sectional, Randomized Cluster Sample Survey of Household Vulnerability to Extreme Heat among Slum Dwellers in Ahmedabad, India","Extreme heat is a significant public health concern in India; extreme heat hazards are projected to increase in frequency and severity with climate change. Few of the factors driving population heat vulnerability are documented, though poverty is a presumed risk factor. To facilitate public health preparedness, an assessment of factors affecting vulnerability among slum dwellers was conducted in summer 2011 in Ahmedabad, Gujarat, India. Indicators of heat exposure, susceptibility to heat illness, and adaptive capacity, all of which feed into heat vulnerability, was assessed through a cross-sectional household survey using randomized multistage cluster sampling. Associations between heat-related morbidity and vulnerability factors were identified using multivariate logistic regression with generalized estimating equations to account for clustering effects. Age, preexisting medical conditions, work location, and access to health information and resources were associated with self-reported heat illness. Several of these variables were unique to this study. As sociodemographics, occupational heat exposure, and access to resources were shown to increase vulnerability, future interventions (e.g., health education) might target specific populations among Ahmedabad urban slum dwellers to reduce vulnerability to extreme heat. Surveillance and evaluations of future interventions may also be worthwhile.",0,0 +3318,Does Comorbid Posttraumatic Stress Disorder Affect the Severity and Course of Psychotic Major Depressive Disorder?,"Major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) are commonly comorbid conditions that result in greater severity, chronicity, and impairment compared with either disorder alone. However, previous research has not systematically explored the potential effects of the psychotic subtyping of MDD and comorbid PTSD.The sample in this retrospective case-control study conducted from December 1995 to August 2006 consisted of psychiatric outpatients with DSM-IV-diagnosed psychotic MDD with PTSD, psychotic MDD without PTSD, or nonpsychotic MDD with PTSD presenting for clinic intake. Clinical indices of severity, impairment, and history of illness were assessed by trained diagnosticians using the Structured Clinical Interview for DSM-IV Axis I Disorders supplemented by items from the Schedule for Affective Disorders and Schizophrenia.In terms of current severity and impairment, the psychotic MDD with PTSD (n = 34) and psychotic MDD only (n = 26) groups were similar to each other, and both tended to be more severe than the nonpsychotic MDD with PTSD group (n = 263). In terms of history of illness, the psychotic MDD with PTSD group tended to show greater severity and impairment relative to either the psychotic MDD only or nonpsychotic MDD with PTSD groups. Furthermore, the psychotic MDD with PTSD patients had an earlier time to depression onset than patients with either psychotic MDD alone or nonpsychotic MDD with PTSD, which appeared to contribute to the poorer history of illness demonstrated in the former group.Future research should explore the possibility of a subtype of psychotic depression that is associated with PTSD, resulting in a poorer course of illness. The current findings highlight the need for pharmacologic and psychotherapeutic approaches that can be better tailored to psychotic MDD patients with PTSD comorbidity.",0,0 +3319,Posttraumatic Disorders Following Injury: Assessment and Other Methodological Considerations,"Physical injury in civilian populations is a frequent event. In 2000, 11% of the U.S. population (approximately 30 million people) were treated in emergency departments following nonfatal injuries (National Centre for Injury Prevention and Control-Electronic Database, 2000). Not only does injury occur frequently, but it often occurs at a severity to be classified as a traumatic event. Breslau et al. (1991) found that a lifetime prevalence of serious injury or serious motor vehicle crash was 41.9%, rating second in frequency of traumatic events. The conditional risk for developing Posttraumatic Stress Disorder (PTSD) following serious accidents and injury is relatively low (Kessler et al., 1995); that is, the risk of developing PTSD in all those who are exposed to traumatic injury is low relative to other traumatic events such as interpersonal violence (Breslau et al., 1998). Nevertheless, serious injury is a leading cause of PTSD because of the frequency with which injury occurs. For example, Breslau et al. (1998) found that serious injury accounted for nearly one-quarter of the PTSD cases in their community sample. This was also the case in both the National Comorbidity Survey (Kessler et al., 1995) and the equivalent Australian study (Creamer et al., 2001). Taken together, although the conditional risk of developing PTSD following serious injury is low, the substantial frequency with which injury occurs makes injury one of the most frequent causes of PTSD. This chapter aims to orient both practitioner and researcher to the current status of research regarding PTSD following injury. However, when evaluating this literature and when conducting assessments with injury survivors, researchers and practitioners alike must be cognizant of a number of key issues that may impact on the diagnosis of PTSD. These factors include the following: differentiating among the physical, psychological, and environmental origin of symptoms; head injury and how it complicates assessment; the impact of secondary stressors; the influence of medications on symptom presentation; and the role of litigation. Appropriate attention to these factors will help to optimize the reliability and consistency of mental health assessments following injury.",0,0 +3320,Signs of Mood and Anxiety Disorders in Chimpanzees,"In humans, traumatic experiences are sometimes followed by psychiatric disorders. In chimpanzees, studies have demonstrated an association between traumatic events and the emergence of behavioral disturbances resembling posttraumatic stress disorder (PTSD) and depression. We addressed the following central question: Do chimpanzees develop posttraumatic symptoms, in the form of abnormal behaviors, which cluster into syndromes similar to those described in human mood and anxiety disorders?In phase 1 of this study, we accessed case reports of chimpanzees who had been reportedly subjected to traumatic events, such as maternal separation, social isolation, experimentation, or similar experiences. We applied and tested DSM-IV criteria for PTSD and major depression to published case reports of 20 chimpanzees identified through PrimateLit. Additionally, using the DSM-IV criteria and ethograms as guides, we developed behaviorally anchored alternative criteria that were applied to the case reports. A small number of chimpanzees in the case studies met DSM-IV criteria for PTSD and depression. Measures of inter-rater reliability, including Fleiss' kappa and percentage agreement, were higher with use of the alternative criteria for PTSD and depression. In phase 2, the alternative criteria were applied to chimpanzees living in wild sites in Africa (n = 196) and chimpanzees living in sanctuaries with prior histories of experimentation, orphanage, illegal seizure, or violent human conflict (n = 168). In phase 2, 58% of chimpanzees living in sanctuaries met the set of alternative criteria for depression, compared with 3% of chimpanzees in the wild (p = 0.04), and 44% of chimpanzees in sanctuaries met the set of alternative criteria for PTSD, compared with 0.5% of chimpanzees in the wild (p = 0.04).Chimpanzees display behavioral clusters similar to PTSD and depression in their key diagnostic criteria, underscoring the importance of ethical considerations regarding the use of chimpanzees in experimentation and other captive settings.",0,0 +3321,"Posttraumatic Stress Symptoms, Intrusive Thoughts, Loss, and Immune Function after Hurricane Andrew","To examine the impact of and relationship between exposure to Hurricane Andrew, a severe stressor, posttraumatic stress symptoms and immune measures.Blood draws and questionnaires were taken from community volunteer subjects living in the damaged neighborhoods between 1 and 4 months after the Hurricane.The sample exhibited high levels of posttraumatic stress symptoms by questionnaire (33% overall; 76% with at least one symptom cluster), and 44% scored in the high impact range on the Impact of Events (IES) scale. A substantial proportion of variance in posttraumatic stress symptoms could be accounted for by four hurricane experience variables (damage, loss, life threat, and injury), with perceived loss being the highest correlate. Of the five immune measures studied Natural Killer Cell Cytotoxicity (NKCC) was the only measure that was meaningfully related (negatively) to both damage and psychological variables (loss, intrusive thoughts, and posttraumatic stress disorder (PTSD). White blood cell counts (WBCs) were significantly positively related with the degree of loss and PTSD experienced. Both NKCC (lower) and WBC were significantly related to retrospective self-reported increase of somatic symptoms after the hurricane. Overall, the community sample was significantly lower in NKCC, CD4 and CD8 number, and higher in NK cell number compared to laboratory controls. Finally, evidence was found for new onset of sleep problems as a mediator of the posttraumatic symptom-NKCC relationship.Several immune measures differed from controls after Hurricane Andrew. Negative (intrusive) thoughts and PTSD were related to lower NKCC. Loss was a key correlate of both posttraumatic symptoms and immune (NKCC, WBC) measures.",0,0 +3322,Full and Partial Post-Traumatic Stress Disorder among World War II Prisoners of War,"<i>Background:</i> The aim of the study is to evaluate the frequency and characteristics of full and partial post-traumatic stress disorder (PTSD) among 66 World War II Nazi prisoners of war, some of whom had been deported to death camps. <i>Methods:</i> The Structured Clinical Interview for DSM-IV was used to assess the presence of PTSD and major depression. The Dissociative Experiences Scale and the 58-item version of the Hopkins Symptom Checklist were also administered. Partial PTSD was defined as the presence of at least one symptom in each of the clusters defined by DSM-IV. <i>Results:</i> Forty-eight percent of the subjects have a partial PTSD, while 20% reported the full syndrome. When compared to subjects with full PTSD, those with partial PTSD showed a significantly lower frequency of comorbid depression and lower levels of psychological distress, as measured by the Symptom Checklist. No differences were found with regards to dissociative symptoms and help-seeking. <i>Conclusions:</i> The problem of definition of PTSD partial syndromes deserves more attention in the literature.",0,0 +3323,"Post-Traumatic Stress Disorder: Definition, Prevalence, and Risk Factors","In this chapter, we provide the definition and diagnostic criteria for post-traumatic stress disorder (PTSD). Next, the prevalence data for this disorder are reviewed, with a particular focus on how prevalence rates vary with demographic characteristics (e.g., gender) and trauma type. The literature on risk and resilience factors for the development and maintenance of PTSD is then discussed. The chapter concludes with a discussion of contemporary statistical methods that may be used to advance our knowledge and understanding of PTSD.",0,0 +3324,Early childhood behavior trajectories and the likelihood of experiencing a traumatic event and PTSD by young adulthood,"This study modeled children's trajectories of teacher rated aggressive-disruptive behavior problems assessed at six time points between the ages of 6 and 11 and explored the likelihood of being exposed to DSM-IV qualifying traumatic events and posttraumatic stress disorder (PTSD) in 837 urban first graders (71% African American) followed-up for 15 years. Childhood trajectories of chronic high or increasing aggressive-disruptive behavior distinguished males more likely to be exposed to an assaultive violence event as compared to males with a constant course of low behavior problems (OR(chronic high) = 2.8, 95% CI = 1.3, 6.1 and OR(increasing) = 4.5, 95% CI = 2.3, 9.1, respectively). Among females, exposure to traumatic events and vulnerability to PTSD did not vary by behavioral trajectory. The findings illustrate that repeated assessments of disruptive classroom behavior during early school years identifies more fully males at increased risk for PTSD-level traumatic events, than a single measure at school entry does.",0,0 +3325,Attachment Patterns and Working Alliance in Trauma Therapy for Victims of Political Violence,"We examined the development of alliance in therapy in different attachment groups in a naturalistic setting. The participants were 36 self-referred Palestinian political ex-prisoners, who were victims of torture and ill treatment and had sought psychotherapy. Their therapy lasted for 10-12 months. The analyses showed that the development of alliance during therapy followed different patterns across the attachment groups. Yet early alliance did not differ between the groups. For the autonomous individuals, alliance dropped in the middle of therapy, and increased back to its initial level by the end. Similarly, for the preoccupied individuals alliance decreased steeply in the middle of the therapy, and then increased even more steeply by the end. In contrast, for the dismissing individuals, alliance was approximately the same at the beginning and in the middle of the therapy, and then it decreased at the end.",0,0 +3326,Chronic Stress Increases the Plasmalemmal Distribution of the Norepinephrine Transporter and the Coexpression of Tyrosine Hydroxylase in Norepinephrine Axons in the Prefrontal Cortex,"Norepinephrine (NE) potently modulates the cognitive and affective functions of the prefrontal cortex (PFC). Deficits in NE transmission are implicated in psychiatric disorders, and antidepressant drugs that block the NE transporter (NET) effectively treat these conditions. Our initial ultrastructural studies of the rat PFC revealed that most NE axons (85–90%) express NET primarily within the cytoplasm and lack detectable levels of the synthetic enzyme tyrosine hydroxylase (TH). In contrast, the remaining 10–15% of PFC NE axons exhibit predominantly plasmalemmal NET and evident TH immunoreactivity. These unusual characteristics suggest that most PFC NE axons have an unrecognized, latent capacity to enhance the synthesis and recovery of transmitter. In the present study, we used dual-labeling immunocytochemistry and electron microscopy to examine whether chronic cold stress, a paradigm that persistently increases NE activity, would trigger cellular changes consistent with this hypothesis. After chronic stress, neither the number of profiles exhibiting NET labeling nor their size was changed. However, the proportion of plasmalemmal NET nearly doubled from 29% in control animals to 51% in stressed rats. Moreover, the expression of detectable TH in NET-labeled axons increased from only 13% of profiles in control rats to 32% of profiles in stressed animals. Despite the consistency of these findings, the magnitude of the changes varied across individual rats. These data represent the first demonstration of activity-dependent trafficking of NET and expression of TH under physiological conditions and have important implications for understanding the pathophysiology and treatment of stress-related affective disorders.",0,0 +3327,Coping with displacement from Hurricane Katrina: predictors of one-year post-traumatic stress and depression symptom trajectories,"Abstract This study examined predictors of symptom trajectories of 93 adult survivors of Hurricane Katrina who were displaced and relocated to Colorado. Survivors were interviewed within six months of the hurricane and then again six months later. Four symptom trajectories were identified for clinical levels of depression and post-traumatic stress: resilient, recovered, delayed onset, and chronic. High levels of adaptive coping and coping efficacy characterized the resilient groups and low levels of both characterized the chronic groups. The recovered groups were characterized by low levels of adaptive coping coupled with high coping efficacy, and the delayed groups were characterized by high secondary control coping in the presence of low primary control coping, though some symptom-specific differences were found for these two groups. African American (67%) participants did not differ from European American (28%) participants in terms of membership in trajectory groups, though analyses revealed that displacement stress and positive religious coping were especially relevant predictors for African American participants. The results are interpreted in light of the Conservation of Resources Theory (Hobfoll, 2001) and implications for treatment and preventive intervention are discussed.",0,0 +3328,Risk and Resilience Factors among Italian Municipal Police Officers Exposed to Critical Incidents,Police officers are exposed to critical events as part of their duty which can affect their well-being. The present study examines the relationships between risk and protective factors and health outcome following critical incident exposure among police officers. Person-oriented analyses were applied to questionnaire data from a sample of 509 Italian municipal police officers. Two groups with different patterns of risk and protective factors were found by cluster analysis. One group (resilient officers) had higher levels of protective factors such as self-esteem and social support and lower levels of risk factors such as peritraumatic distress and perceived threat in comparison to the other group (non resilient police officers). The resilient group reported fewer traumatic stress reactions than the non resilient group in spite of a similar degree of exposure to critical incidents and better health than expected in spite of severe abuse. The two groups differed according to sleeping pills use but not for alcohol and smoking habits. Risk and protective factors could offer an explanation of resilience as an outcome. (,0,0 +3329,The prevalence of long-term post-traumatic stress symptoms among adolescents after the tsunami in Aceh,"The aim of this study was to identify long-term post-traumatic stress disorder (PTSD) symptoms in Aceh 4.5 years after the tsunami and to examine whether certain factors affected the severity of PTSD symptoms among adolescents. The PTSD symptoms of 482 adolescents aged 11 to 19 years were assessed according to the Child Post-Traumatic Stress Reaction Index (CPTSD-RI). The severity of the disaster was identified by the Traumatic Exposure Severity Scale (TESS). Of the adolescents who completed the questionnaire, 54 (11.2%), 124 (25.7%), 196 (40.7%), 103 (21.4%) and 5 (1%), respectively, reported none, mild, moderate, severe and very severe symptoms on CPTSD-RI. Gender, loss of parents, somatic response and support level were significantly associated with the total score on CPTSD-RI (P < 0.05). The TESS-Occurrence Scale and CPTSD-RI were significantly correlated (r= 0.33, P < 0.05). The TESS-Distress Scale was significantly correlated with CPTSD-RI (r= 0.48, P < 0.05). The study indicated that the symptoms of PTSD, ranging from very severe to moderate, could persist for a long time after the tsunami and be affected by gender, loss of parents, somatic response, support level and severity of the disaster.",0,0 +3330,Long-term mental health outcome in post-conflict settings: Similarities and differences between Kosovo and Rwanda,"Background: Few studies investigated the long-term mental health outcome in culturally different post-conflict settings. This study considers two surveys conducted in Kosovo 8 years after the Balkans war and in Rwanda 14 years after the genocide. Methods: All participants ( n = 864 in Kosovo; n = 962 in Rwanda) were interviewed using the posttraumatic stress disorder (PTSD) and major depressive episode (MDE) sections of the Mini International Neuropsychiatric Interview (MINI) and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Results: Proportions of participants who met diagnostic criteria for either PTSD or MDE were 33.0% in Kosovo and 31.0% in Rwanda, with co-occurrence of both disorders in 17.8% of the Rwandan sample and 9.5% of the Kosovan sample. Among patients with PTSD, patterns of symptoms significantly differed in the two settings, with avoidance and inability to recall less frequent and sense of a foreshortened future and increased startle response more common in Rwanda. Significant differences were also observed in patients with MDE, with loss of energy and difficulties concentrating less frequent and suicidal ideation more common in Rwanda. Comorbid PTSD and MDE were associated with decreased SF-36 subjective mental and physical health scores in both settings, but significantly larger effects in Kosovo than in Rwanda. Conclusion: Culturally different civilian populations exposed to mass trauma may differ with respect to their long-term mental health outcome, including comorbidity, symptom profile and health perception.",0,0 +3331,Longitudinal mental health screening results among postdeployed U.S. soldiers preparing to deploy again,"Mental health concerns have been documented in soldiers postdeployed from Iraq or Afghanistan, but information is limited regarding individuals directed to deploy again. Routine screening assessed symptoms of posttraumatic stress disorder, depression, anxiety, panic, and hazardous alcohol consumption among 443 soldiers after returning from deployment and again before the next deployment. Initial rates for meeting screening criteria were under 9% with most around 5%. The average number of symptoms reported for depression, anxiety, and alcohol consumption decreased from first to second screening, as did the percentage of participants who met screening criteria for hazardous alcohol consumption. No change was observed on other screening measures. The findings suggest that mental health symptoms remain stable or decline for soldiers repeating deployment.",0,0 +3332,"Serum chemical profile of feeder pigs, as influenced by market stress and feeding regimen.","Two hundred eighty-eight crossbred feeder pigs were used in 2 trials to determine the effects of feed and/or water deprivation at an auction market, and the effects of restricting the intake of the receiving diet on their serum chemical profile. The study also was designed to assess the value of the serum chemical profile as a diagnostic data base for stress disorders in feeder pigs. Performance data indicated that feeder pigs provided water only at the auction facilities lost significantly more weight than did those provided feed and water. Feeder pigs deprived of both feed and water were not significantly different in body weight from either group. Several serum chemical values (creatinine, triglycerides, cholesterol, blood urea nitrogen, and lactate dehydrogenase) were significantly influenced by feed deprivation, but not by feed and water deprivation. However, only the serum creatinine values were significantly different after the 24-hour posttransport period. There were no significant differences in pig weight or serum chemical values 84 days after pigs had arrived at the finishing unit. The serum chemical profile, widely used in human medicine, appears not to provide a reliable marker for identification of short-term nutritional deprivation, nor for transport stress in feeder pigs.",0,0 +3333,Delayed recall of childhood sexual abuse memories and the awakening rise and diurnal pattern of cortisol,"Traumatic stress associated with childhood sexual abuse (CSA) may result in chronic alterations of stress-sensitive neurochemical systems (e.g., the hypothalamic-pituitary-adrenal axis and sympathetic-adrenal medullary activity). Some authors have suggested that these alterations might help explain why some individuals, after a period of inability to remember, demonstrate delayed recall of CSA memories (i.e., ""recovered"" memories). The present study is the first study that explored morning cortisol responses and circadian cortisol profiles among women with recovered (n=7), repressed (n=8), or continuous (n=6) memories of CSA and women without a history of CSA (n=9). Although there were group differences in current depression and post-traumatic stress symptoms, we found no differences in cortisol awakening response or daytime profile between women reporting recovered, repressed, or continuous memories of CSA as compared to women without a history of CSA. Implications for neurobiological models intended to explain the delayed recall of CSA are discussed.",0,0 +3334,Posttraumatic Stress Disorder Among Firearm Assault Survivors: Risk and Resiliency Factors in Recovery from Violent Victimization,"Firearm violence in the United States has reached epidemic proportions, and yet little is known about the psychosocial impact of firearm assault on its survivors. This study set out to: (1) determine the rate of chronic Posttraumatic Stress Disorder (PTSD), and (2) to identify pre-assault factors, assault characteristics, and factors in the post-assault recovery environment that serve as risk or protective factors for the development of PTSD in a sample of firearm assault survivors. In addition, a qualitative analysis drew upon in-depth interviews with six firearm assault survivors about their recovery experience. Fifty-five firearm assault survivors recruited from an urban trauma center completed a number of measures assessing pre-assault factors, assault characteristics, factors in the post-assault recovery environment, and PTSD symptomatology. Fifty-eight percent of the sample met full diagnostic criteria for PTSD 3 to 36 months post-assault. Hierarchical multiple regression analysis supported a model in which negative change of outlook, assault severity, and adopting safeguarding behaviors served as risk factors for the presence of PTSD after firearm assault; while social support operated as a resiliency factor protecting individuals from development of PTSD after severe violent victimization. Qualitative analysis revealed a number of commonalities in the recovery experience for both impaired and resilient survivors. The findings suggest that firearm assault survivors are at high risk for the development of chronic PTSD. Further, the use of a high-risk screening tool that assesses risk and protective factors for the development of chronic PTSD may have important clinical applications in identifying victims most in need of clinical intervention. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +3335,Impact of Traumatic Events on Posttraumatic Stress Disorder among Danish Survivors of Sexual Abuse in Childhood,"Childhood sexual abuse can be extremely traumatic and lead to lifelong symptomatology. The present study examined the impact of several demographic, abuse, and psychosocial variables on posttraumatic stress disorder severity among a consecutive sample of treatment-seeking, adult child sexual abuse survivors (N = 480). The child sexual abuse sample was characterized by severe trauma exposure, insecure attachment, and significant traumatization, with an estimated 77% suffering from posttraumatic stress disorder, more than twice the level of the comparison group. Regression analyses revealed risk factors associated with the development of posttraumatic stress disorder in which the strongest predictors being additional traumas, negative affectivity, and somatization. The findings add to existing research confirming the stressful nature of child sexual abuse and the variables that contribute to the development and severity of posttraumatic stress disorder.",0,0 +3336,Hypnotizability and trauma symptoms after burn injury,"This study investigated the association of trauma symptoms and hypnotizability in 43 hospitalized survivors of burn injury. Three to 17 days after the injury, participants rated the frequency of intrusive and avoidance symptoms and were interviewed with the posttraumatic stress disorder module of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-III-R. The Hypnotic Induction Profile was also administered at the postburn, hospital stage of recovery. Results indicated that when participants were divided into low, mid-range, and high hypnotizability categories, high hypnotizability was associated with more intrusive, avoidance, and arousal symptoms. Although causal relations cannot be assessed in this cross-sectional study, these results suggest that, as compared to the low and mid-range categories, high hypnotizables may experience a greater frequency of trauma symptoms after burn injury.",0,0 +3337,"The interrelationships between moral attitudes, posttraumatic stress disorder symptoms and mixed lateral preference in Israeli reserve combat troops","Background: Combat soldiers often encounter moral dilemmas during operational deployment, especially when an armed engagement is situated within a civilian setting. The study of moral dilemmas and posttraumatic stress disorder (PTSD) has mostly focused on the impact of war atrocities and moral injury. However, the relationship between moral attitudes and different combat-related pathologies has not been thoroughly addressed by quantitative studies. Aims: We aimed to assess the relationship between combatant’s moral attitudes, severity of PTSD symptoms and mixed lateral preference. Methods: Data on moral objection, PTSD severity and lateral preference were collected in a right-handed non-pathologic sample ( n = 147) of reserve combat troops in the Israel Defense Forces (IDF). Results: Nearly one-fifth (19.7%) of the reserve personnel who served in the occupied territories have reported high moral objection to the commands they were expected to act upon. This group of participants exhibited more PTSD symptoms and higher levels of mixed lateral preference. Multiple linear regression analyses revealed a mediating role of moral objection in the relationship between PTSD symptoms severity and lateral preference. Conclusions: Our findings suggest that moral objection has significant implications on combatant’s psychological and organic well-being. The findings highlight the need to include moral attitudes in research and clinical practice among combat personnel and veterans.",0,0 +3338,Psychological intimate partner violence: the major predictor of posttraumatic stress disorder in abused women,"Intimate partner violence (IPV) significantly impacts women mental and physical wellbeing and therefore represents a worldwide public health problem. A clear association between IPV and increased risk to develop posttraumatic stress disorder (PTSD) has been documented. However, few studies examined how different features of IPV (physical, psychological, sexual) interact with other traumatic stress experiences (physical, psychological and sexual childhood abuse and adulthood victimization by other/s than the partner) in determining PTSD. Women abused by the partner ( n =75) were compared with non-abused control women ( n =52). Information about sociodemographic profile and relevant personal characteristics was obtained through structured interviews. A comprehensive questionnaire was designed for a face-to-face interview in order to obtain detailed information about duration and frequency of the different types of violent acts above mentioned. The incidence and severity of symptoms of current PTSD were assessed with Echeburua's Severity of Symptom Scale of Posttraumatic Stress Disorder, a structured interview based on DSM-IV criteria. Women suffering from IPV had a significantly higher rate of PTSD symptomatology as compared to control women, whereas childhood abuse variables did not explain PTSD score variance. In addition, the severity of IPV was significantly and positively correlated with the intensity of PTSD symptoms. Women involved in an abusive relationship were more frequently exposed to other experiences of adulthood victimization, suggesting that their higher PTSD vulnerability could be a result of cumulative traumatic experiences. A relevant result of the correlation analysis was the strong, positive association between PTSD and each different type of IPV. In particular, the psychological component of intimate partner violence was the strongest predictor of posttraumatic stress disorder. This study underlines the importance of separating the effects of the different types of intimate partner abuse when taking into account its effects on women mental health.",0,0 +3339,"Men's Pathways to Risky Sexual Behavior: Role of Co-Occurring Childhood Sexual Abuse, Posttraumatic Stress Disorder, and Depression Histories","Recent reports of sexually transmitted infection-rate increases among men indicate the need for renewed study of male sexual risk behavior to aid development of updated and novel risk reduction interventions. Men who have childhood sexual abuse (CSA) histories consistently report frequent sexual risk behavior. The objective of this sturdy is to explore whether posttraumatic stress disorder (PTSD) and depression are moderators and/or mediators of the association between CSA and sexual risk in adult men. A cross-sectional survey study employing random digit dial recruitment was administered to men aged 18-49 years from Philadelphia County. Two hundred ninety eight men were recruited and screened for CSA history, administered items from the Posttraumatic Stress Diagnostic Scale (PDS) and Center for Epidemiologic Studies- Depression (CES-D), and asked to estimate their number of lifetime sexual partners (LSPs). Effects of sociodemographic characteristics, CSA, PTSD, and depression on the number of LSPs were modeled using Poisson regression. Results show that 197 (66%) men participated; 43 (22%) had CSA histories. CSA was significantly associated with PTSD/depression (P=.03). Four sociodemographic variables (age, race, sexual identity, and education), CSA (incidence rate ratio, IRR=1.47, P<.001), PTSD (IRR=1.19, P=.04), depression (IRR=1.29, P=.001), all 2-way interactions, and the 3-way CSA/PTSD/depression interaction (IRR=11.00, P<.001) were associated with the number of LSPs (R2=0.27). In conclusion, sexual partnership patterns unique to men with CSA histories and comorbid PTSD/depression appear to lead to substantially higher numbers of LSPs. Estimates of this relationship may have been biased toward the null by underreporting that can occur with phone surveys. Cross-sectional studies do not support causal inferences; however, the identification of a moderating and mediating influence of PTSD/depression on the relationship between CSA and sexual risk behavior is important and suggests the need for future studies with larger samples that examine trajectories for CSA, psychiatric illness, and sexual partnerships.",0,0 +3340,Cohort Profile: The Study of Health in Pomerania,"Henry Volzke, y Dietrich Alte,1y Carsten Oliver Schmidt, Dorte Radke, Roberto Lorbeer, Nele Friedrich, Nicole Aumann, Katharina Lau, Michael Piontek, Gabriele Born, Christoph Havemann, Till Ittermann, Sabine Schipf, Robin Haring, Sebastian E Baumeister, Henri Wallaschofski, Matthias Nauck, Stephanie Frick, Andreas Arnold, Michael Junger, Julia Mayerle, Matthias Kraft, Markus M Lerch, Marcus Dorr, Thorsten Reffelmann, Klaus Empen, Stephan B Felix, Anne Obst, Beate Koch, Sven Glaser, Ralf Ewert, Ingo Fietze, Thomas Penzel, Martina Doren, Wolfgang Rathmann, Johannes Haerting, Mario Hannemann, Jurgen Ropcke, Ulf Schminke, Clemens Jurgens, Frank Tost, Rainer Rettig, Jan A Kors, Saskia Ungerer, Katrin Hegenscheid, Jens-Peter Kuhn, Julia Kuhn, Norbert Hosten, Ralf Puls, Jorg Henke, Oliver Gloger, Alexander Teumer, Georg Homuth, Uwe Volker, Christian Schwahn, Birte Holtfreter, Ines Polzer, Thomas Kohlmann, Hans J Grabe, Dieter Rosskopf, Heyo K Kroemer, Thomas Kocher, Reiner Biffar,17,y Ulrich John20y and Wolfgang Hoffmann1y",0,0 +3341,An updated animal model capturing both the cognitive and emotional features of post-traumatic stress disorder (PTSD),"The new-released Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines post-traumatic stress disorder (PTSD) as a ""trauma and stressor-related disorder"". PTSD pathogenesis relies on paradoxical changes of emotional memory processing induced by the trauma exposure and associated with emotional dysfunction. Several animal models of PTSD have been validated and are currently used. Each one mimics a particular subset of the disorder with particular emphasis, mainly driven by the past classification of PTSD in the DSM-4, on the emotional features. In view of the recent update in the DSM-5, our aim was to develop, by using well-validated paradigms, a modified model of PTSD able to mimic at the same time both the cognitive and emotional features of the disease. We exposed male rats to either a piece of worn cat collar or to a series of inescapable footshocks paired with a PTSD risk factor, i.e., social isolation. Animals were subsequently re-exposed to the conditioned contexts at different time intervals in order to test memory retention for the stressors. In addition, footshock-exposed rats were tested in the elevated-plus-maze and social interaction tests. We found that rats exposed to a cat collar exhibited an acute fear response that did not lead to enduring memory retention. Conversely, footshock-exposed rats expressed a successful retention of the stressful experience at 1, 7, 14, 21 and 56 post-exposure days. Footshock-exposed rats displayed an anxious behavioral profile in the social interaction test and a significantly reduced locomotor activity in the elevated-plus-maze test. These dysfunctions were not observed when animals were socially housed, thus highlighting a social buffering effect in the development of the pathology. Our results underline the good validity of a footshock-based paradigm paired with social isolation as a PTSD animal model, able to mimic at the same time both some of the enduring cognitive and emotional facets of the pathology.",0,0 +3342,Power analyses for correlations from clustered study designs,"Power analysis constitutes an important component of modern clinical trials and research studies. Although a variety of methods and software packages are available, almost all of them are focused on regression models, with little attention paid to correlation analysis. However, the latter is arguably a simpler and more appropriate approach for modelling concurrent events, especially in psychosocial research. In this paper, we discuss power and sample size estimation for correlation analysis arising from clustered study designs. Our approach is based on the asymptotic distribution of correlated Pearson-type estimates. Although this asymptotic distribution is easy to use in data analysis, the presence of a large number of parameters creates a major problem for power analysis due to the lack of real data to estimate them. By introducing a surrogacy-type assumption, we show that all nuisance parameters can be eliminated, making it possible to perform power analysis based only on the parameters of interest. Simulation results suggest that power and sample size estimates obtained under the proposed approach are robust to this assumption.",0,0 +3343,Risk and resilience in canine search and rescue handlers after 9/11,"Research has suggested that rescue workers are at increased risk for psychological distress. To determine whether 9/11 deployment was a significant risk factor for canine search and rescue handlers, 82 deployed handlers were compared to 32 nondeployed handlers on measures of posttraumatic stress disorder (PTSD), depression, anxiety, acute stress, and clinical diagnoses. Deployed handlers reported more PTSD and general psychological distress 6 months after 9/11. Among deployed handlers, prior diagnoses and peritraumatic reactions were associated with psychological distress whereas social support and training were protective. Results suggest that more extensive screening and prophylactic interventions for individuals with a history of mental illness could be beneficial. Future research should examine identified risk/resilience factors prospectively, and training and intervention should be designed accordingly.",0,0 +3344,Coming to Our Senses: Appreciating the Sensorial in Medical Anthropology,"This article supports the call for the sensorially engaged anthropological study of healing modalities, popular health culture, dietary practices, drug foods and pharmaceuticals, and idioms of distress. Six concepts are of central importance to sensorial anthropology: embodiment, the mindful body, mimesis, local biology, somatic idioms of distress, and 'the work of culture'. Fieldwork in South and Southeast Asia and North America illustrates how cultural interpretations associate bodily sensations with passions (strong emotions) and anxiety states, and bodily communication about social relations. Lay interpretations of bodily sensations inform and are informed by local understanding of ethnophysiology, health, illness, and the way medicines act in the body. Bodily states are manipulated by the ingestion of substances ranging from drug foods (e.g., sources of caffeine, nicotine, dietary supplements) to pharmaceuticals that stimulate or suppress sensations concordant with cultural values, work demands, and health concerns. Social relations are articulated at the site of the body through somatic modes of attention that index bodily ways of knowing learned through socialization, bodily memories, and the ability to relate to how another is likely to be feeling in a particular context. Sensorial anthropology can contribute to the study of transformative healing and trajectories of healthcare seeking and patterns of referral in pluralistic healthcare arenas.",0,0 +3345,Psychopharmacological treatment with lithium and antiepileptic drugs: suggested guidelines from the Danish Psychiatric Association and the Child and Adolescent Psychiatric Association in Denmark,"A subcommittee under the Danish Psychiatric Association and the Child and Adolescent Psychiatric Association in Denmark have recently developed national guidelines for the psychopharmacological treatment with lithium and antiepileptic drugs, and the present translation aims at contributing to the international discussion on the development of proper guidelines for the treatment of bipolar disorder. Among the antiepileptic drugs, the report deals with valproate, carbamazepine and lamotrigine and to a lesser extent with oxcarbazepine, gabapentin and topiramate. The various drugs will be reviewed, outlining the scientific evidence for mood-stabilizing properties and discussing major side effects, the most important interactions with other drugs and practical use. Special considerations during pregnancy and lactation, during treatment of children and adolescents and during treatment of the elderly will also be presented. Antidepressants and antipsychotics are beyond the scope of the report, but due to the mood-stabilizing properties of at least some of the atypical antipsychotics, these agents will be brought into some focus in connection with the overall treatment guidelines for the different phases of bipolar disorder given at the end of this report.",0,0 +3346,Cost-utility analysis of different treatments for post-traumatic stress disorder in sexually abused children,"Post-traumatic stress disorder (PTSD) is diagnosed in 20% to 53% of sexually abused children and adolescents. Living with PTSD is associated with a loss of health-related quality of life. Based on the best available evidence, the NICE Guideline for PTSD in children and adolescents recommends cognitive behavioural therapy (TF-CBT) over non-directive counselling as a more efficacious treatment.A modelled economic evaluation conducted from the Australian mental health care system perspective estimates incremental costs and Quality Adjusted Life Years (QALYs) of TF-CBT, TF-CBT combined with selective serotonin reuptake inhibitor (SSRI), and non-directive counselling. The ""no treatment"" alternative is included as a comparator. The first part of the model consists of a decision tree corresponding to 12 month follow-up outcomes observed in clinical trials. The second part consists of a 30 year Markov model representing the slow process of recovery in non-respondents and the untreated population yielding estimates of long-term quality-adjusted survival and costs. Data from the 2007 Australian Mental Health Survey was used to populate the decision analytic model.In the base-case and sensitivity analyses, incremental cost-effectiveness ratios (ICERs) for all three active treatment alternatives remained less than A$7,000 per QALY gained. The base-case results indicated that non-directive counselling is dominated by TF-CBT and TF-CBT + SSRI, and that efficiency gain can be achieved by allocating more resources toward these therapies. However, this result was sensitive to variation in the clinical effectiveness parameters with non-directive counselling dominating TF-CBT and TF-CBT + SSRI under certain assumptions. The base-case results also suggest that TF-CBT + SSRI is more cost-effective than TF-CBT.Even after accounting for uncertainty in parameter estimates, the results of the modelled economic evaluation demonstrated that all psychotherapy treatments for PTSD in sexually abused children have a favourable ICER relative to no treatment. The results also highlighted the loss of quality of life in children who do not receive any psychotherapy. Results of the base-case analysis suggest that TF-CBT + SSRI is more cost-effective than TF-CBT alone, however, considering the uncertainty associated with prescribing SSRIs to children and adolescents, clinicians and parents may exercise some caution in choosing this treatment alternative.",0,0 +3347,"Future of brain stimulation: New targets, new indications, new technology","In the last quarter of a century, DBS has become an established neurosurgical treatment for Parkinson's disease (PD), dystonia, and tremors. Improved understanding of brain circuitries and their involvement in various neurological and psychiatric illnesses, coupled with the safety of DBS and its exquisite role as a tool for ethical study of the human brain, have unlocked new opportunities for this technology, both for future therapies and in research. Serendipitous discoveries and advances in structural and functional imaging are providing abundant ""new"" brain targets for an ever-increasing number of pathologies, leading to investigations of DBS in diverse neurological, psychiatric, behavioral, and cognitive conditions. Trials and ""proof of concept"" studies of DBS are underway in pain, epilepsy, tinnitus, OCD, depression, and Gilles de la Tourette syndrome, as well as in eating disorders, addiction, cognitive decline, consciousness, and autonomic states. In parallel, ongoing technological development will provide pulse generators with longer battery longevity, segmental electrode designs allowing a current steering, and the possibility to deliver ""on-demand"" stimulation based on closed-loop concepts. The future of brain stimulation is certainly promising, especially for movement disorders-that will remain the main indication for DBS for the foreseeable future-and probably for some psychiatric disorders. However, brain stimulation as a technique may be at risk of gliding down a slippery slope: Some reports indicate a disturbing trend with suggestions that future DBS may be proposed for enhancement of memory in healthy people, or as a tool for ""treatment"" of ""antisocial behavior"" and for improving ""morality.""",0,0 +3348,Psychological Distress of Rescue Workers Eight and One-Half Years After Professional Involvement in the Amsterdam Air Disaster,"This study examined specific and general psychological distress 8.5 years following the 1992 cargo aircraft crash in Amsterdam. Participants included 334 occupationally exposed fire fighters and 834 occupationally exposed police officers compared with reference groups of 194 fire fighters and 634 police officers who were exposed to duty-related stressors other than the disaster. On the standardized instruments of psychological distress, exposed fire fighters reported more somatic complaints and fatigue, while exposed police officers reported higher psychological distress on all aspects. The degree and type of exposure at the disaster site and other background factors were associated with several outcomes of psychological distress levels of exposed rescue workers. The disasters' aftermath of rumors about potential health consequences due to toxic exposure likely contributed to the long-lasting psychological distress of some of the rescue workers as well.",0,0 +3349,PTSD Symptoms Mediate the Effect of Attachment on Pain and Somatisation after Whiplash Injury,"Introduction: The development of persistent pain post-whiplash injury is still an unresolved mystery despite the fact that approximately 50% of individuals reporting whiplash develop persistent pain. There is agreement that high initial pain and PTSD symptoms are indicators of a poor prognosis after whiplash injury. Recently attachment insecurity has been proposed as a vulnerability factor for both pain and PTSD. In order to guide treatment it is important to examine possible mechanisms which may cause persistent pain and medically unexplained symptoms after a whiplash injury. Aim: The present study examines attachment insecurity and PTSD symptoms as possible vulnerability factors in relation to high levels of pain and somatisation after sub-acute whiplash injury. Methods: Data were collected from 327 patients (women = 204) referred consecutively to the emergency unit after acute whiplash injury. Within 1-month post injury, patients answered a questionnaire regarding attachment insecurity, pain, somatisation, and PTSD symptoms. Multiple mediation analyses were performed to assess whether the PTSD symptom clusters mediated the association between attachment insecurity, pain, and somatisation. Results: A total of 15% fulfilled the DSM-IV symptom cluster criteria for a possible PTSD diagnosis and 11.6% fulfilled the criteria for somatisation. PTSD increased the likelihood of belonging to the moderate-severe pain group three-fold. In relation to somatisation the likelihood of belonging to the group was almost increased four-fold. The PTSD symptom clusters of avoidance and hyperarousal mediated the association between the attachment dimensions, pain, and somatisation. Conclusion: Acknowledging that PTSD is part of the aetiology involved in explaining persistent symptoms after whiplash, may help sufferers to gain early and more suited treatment, which in turn may prevent the condition from becoming chronic.",0,0 +3350,"Trajectories of life satisfaction after traumatic brain injury: Influence of life roles, age, cognitive disability, and depressive symptoms.","(a) Identify life satisfaction trajectories after moderate to severe traumatic brain injury (TBI); (b) establish a predictive model for these trajectories across the first 5 years postinjury; and (c) describe differences in these life satisfaction trajectory groups, focusing on age, depressive symptoms, disability, and participation in specific life roles.Analysis of the longitudinal TBI Model Systems National Database was performed on data collected prospectively at 1-, 2-, and 5-years post-TBI. Participants (n = 3,012) had a moderate to severe TBI and were 16 years old and older.Four life satisfaction trajectories were identified across the first 5 years postinjury, including: stable satisfaction, initial satisfaction declining, initial dissatisfaction improving, and stable dissatisfaction. Age, depressive symptoms, cognitive disability, and life role participation as a worker, leisure participant, and/ or religious participant at 1-year postinjury significantly predicted trajectory group membership. Life role participation and depressive symptoms were strong predictors of life satisfaction trajectories across the first 5 years post-TBI.The previously documented loss of life roles and prevalence of depression after a moderate to severe TBI make this a vulnerable population for whom low or declining life satisfaction is a particularly high risk. Examining individual life role participation may help to identify relevant foci for community-based rehabilitation interventions or supports.",0,0 +3351,Individual and Community-Level Determinants of Mental and Physical Health After the Deepwater Horizon Oil Spill: Findings from the Gulf States Population Survey,"The 2010 Deepwater Horizon oil spill had enormous consequences on the environment. Prevalence of mental and physical health conditions among Gulf residents after the disaster, however, are still being assessed. The Gulf State Population Survey (GSPS) was a representative survey of 38,361 residents in four Gulf States and was conducted from December 2010 to December 2011. Analysis of the GSPS data showed that differences in individual characteristics and direct or indirect exposure to the disaster drove the individual-level variation in health outcomes (mental distress, physical distress, and depression). Direct exposure to the disaster itself was the most important determinant of health after this event. Selected county-level characteristics were not found to be significantly associated with any of our health indicators of interest. This study suggests that in the context of an overwhelming event, persons who are most directly affected through direct exposure should be the primary focus of any public health intervention effort. © 2014, National Council for Behavioral Health (outside the USA).",0,0 +3352,Age differences in the psychological consequences of Hurricane Hugo.,"At 12, 18, and 24 months after Hurricane Hugo, 831 adults were interviewed regarding their disaster-related stressors and present psychological state. The study's purposes were to assess whether age influenced one's vulnerability to postdisaster stress and to evaluate four different perspectives on disaster recovery that have been previously used to explain age differences. Regression analyses demonstrated that disaster exposure had substantial and pervasive psychological effects. The analyses also revealed a curvilinear interaction between disaster exposure and age. Younger people exhibited the most distress in the absence of disaster, but middle-aged people did so in its presence. Differential exposure, resources, and inoculation all failed to explain these differences, however, the burden perspective had considerable explanatory power.",0,0 +3353,"PTSD, Endophenotypes, the RDoC, and the DSM-5","The search for endophenotypes that stand between genetics and disease has been applied to the diagnostic entity of Posttraumatic Stress Disorder (PTSD). Advances are being made in understanding the pathway to disorder in PTSD in terms of brain regions, neuronal networks, stress-related systems (e.g., the hypothalamic-pituitary-adrenal (HPA) axis), and their underlying genetic and neurogenetic bases. The latter are affected by gene-environmental interactions and epigenetic effects, and the environment and context reciprocally interrelate with them, as well. Therefore, a primary focus on (neuro)pathophysiological intermediates in the disease pathway, as appears emphasized in the research domain criteria (RDoC) approach to etiology of psychiatric disorder, and to which the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) subscribes, might detract from a more inclusive biopsychosocial approach that would be more applicable in the case of PTSD. The paper undertakes a comprehensive review of the recent literature in the areas of endophenotypes, neurogenetics, epigenetics, neural networks, HPA axis, neuronal networks, pathways, the PTSD five-factor model, allostasis, and the RDoC criteria for psychiatric diagnosis, and then returns to the topic of endophenotypes. Neuronal networks constitute one integrating area that could help in arriving at an appropriate model of PTSD endophenotype. Pathway analysis provides a rich field for discerning individual differences in PTSD development, more so than the static approach of using DSM-5 symptom criteria. A model of endophenotypes is presented, which considers these factors in relation to PTSD. The paper concludes with implications for the DSM-5, for practice and for court, especially that it would be premature to seek individual biomarkers of PTSD given the current state of knowledge, even if it is burgeoning. © 2014 Springer Science+Business Media New York.",0,0 +3354,Social Information Processing in Anger Expression and Partner Violence in Returning U.S. Veterans,"We examined social information processing factors that could represent pathways through which posttraumatic stress disorder (PTSD) symptoms relate to anger expression and intimate partner violence (IPV) perpetration in returning U.S. veterans. The sample included 92 male Operation Enduring Freedom/Operation Iraqi Freedom veterans, primarily Caucasian (77.4%), with smaller numbers of African American, Asian, Hispanic or Latino, American Indian or Alaskan Native, and other minority participants (9.7%, 2.2%, 2.2%, 3.2%, and 5.3% respectively). The average age was 40.37 (SD = 9.63) years. Data were collected through self-report questionnaires (PTSD Checklist, State-Trait Anger Expression Scale, Revised Conflict Tactics Scales) and the Articulated Thoughts in Simulated Situations experimental protocol. Laboratory-based assessment of cognitive biases and hostile attributions were tested as mediators of associations between PTSD symptoms and anger expression and IPV. Among the PTSD symptom clusters, hyperarousal symptoms were most strongly associated with anger expression (r = .50) and IPV perpetration (r = .27). Cognitive biases mediated associations between PTSD total scores and 3 of 4 PTSD cluster scores as well as anger expression. Hostile attribution biases were also associated with IPV perpetration (r = .23). We discuss the implications of these findings for understanding social information processing mechanisms for the relationship between PTSD symptoms and aggression.",0,0 +3355,Cumulative trauma and symptom complexity in children: A path analysis,"Multiple trauma exposures during childhood are associated with a range of psychological symptoms later in life. In this study, we examined whether the total number of different types of trauma experienced by children (cumulative trauma) is associated with the complexity of their subsequent symptomatology, where complexity is defined as the number of different symptom clusters simultaneously elevated into the clinical range. Children's symptoms in six different trauma-related areas (e.g., depression, anger, posttraumatic stress) were reported both by child clients and their caretakers in a clinical sample of 318 children. Path analysis revealed that accumulated exposure to multiple different trauma types predicts symptom complexity as reported by both children and their caretakers.",0,0 +3356,Girls’ childhood trajectories of disruptive behavior predict adjustment problems in early adolescence,"It is widely recognized that early onset of disruptive behavior is linked to a variety of detrimental outcomes in males, later in life. In contrast, little is known about the association between girls' childhood trajectories of disruptive behavior and adjustment problems in early adolescence.This study used nine waves of data from the ongoing Pittsburgh Girls Study. A semiparametric group-based model was used to identify trajectories of disruptive behavior in 1,513 girls from age 6 to 12 years. Adjustment problems were characterized by depression, self-harm, Post Traumatic Stress Disorder (PTSD), substance use, interpersonal aggression, sexual behavior, affiliation with delinquent peers, and academic achievement at ages 13 and 14.Three trajectories of childhood disruptive behavior were identified: low, medium, and high. Girls in the high group were at increased risk for depression, self-harm, PTSD, illegal substance use, interpersonal aggression, early and risky sexual behavior, and lower academic achievement. The likelihood of multiple adjustment problems increased with trajectories reflecting higher levels of disruptive behavior.Girls following the high childhood trajectory of disruptive behavior require early intervention programs to prevent multiple, adverse outcomes in adolescence and further escalation in adulthood.",0,0 +3357,The course of PTSD symptoms among Gulf War veterans: A growth mixture modeling approach,"Relatively little is known about the course of PTSD symptoms over time following trauma exposure. Accordingly, this study utilized a specialized structural equation modeling approach, growth mixture modeling, to examine the trajectory of PTSD symptoms across three time points in a sample of Gulf War veterans (n at Time 1 = 2,949, n at Time 2 = 2,313, and n at Time 3 = 1,327). Results were most consistent with a two-group model suggesting that the course of PTSD symptoms following the Gulf War was best characterized by two distinct growth curves: (1) low levels of PTSD symptoms with little increase over time and (2) higher levels of initial symptoms with a significant increase over time. Thus, it appears that response to Gulf War experiences is not homogeneous, and that a subset of individuals may experience relatively more PTSD symptoms over time. In addition, men, Whites, those reporting more education, and those reporting less combat exposure had a significantly higher probability of being classified into the less symptomatic group.",1,0 +3358,Full and partial posttraumatic stress disorder: findings from a community survey,"Full and partial posttraumatic stress disorder (PTSD) following trauma exposure were examined in a community sample in order to determine their prevalence and their relative importance and functional significance.A standardized telephone interview with a series of trauma probes and a DSM-IV PTSD checklist was administered to a random sample of 1,002 persons in a midsized Midwestern Canadian city. The authors determined current (i.e., 1-months) prevalence rates of full PTSD, i.e., all DSM-IV criteria, and partial PTSD, i.e., fewer than the required number of DSM-IV criterion C symptoms (avoidance/numbing) or criterion D symptoms (increased arousal). Additional questions about interference with functioning were also posed.The estimated prevalence of full PTSD was 2.7% for women and 1.2% for men. The prevalence of partial PTSD was 3.4% for women and 0.3% for men. Interference with work or school was significantly more pronounced in persons with full PTSD than in those with only partial symptoms, although the latter were significantly more occupationally impaired than traumatized persons without PTSD.These findings in an epidemiologic sample underscore observations from patient and military groups that many traumatized persons suffer from a subsyndromal form of PTSD. These persons with partial PTSD, although somewhat less impaired than persons with the full syndrome, nonetheless exhibit clinically meaningful levels of functional impairment in association with their symptoms. This subthreshold form of PTSD may be especially prevalent in women. Additional study of partial PTSD is warranted.",0,0 +3359,Longitudinal linkages between perceived social support and posttraumatic stress symptoms: Sequential roles of social causation and social selection,"The authors examined social causation and social selection explanations for the association between perceptions of social support and psychological distress. Data came from a sample of 557 victims of natural disaster in Mexico. Structural equation modeling analyses indicated that social causation (more social support leading to less posttraumatic stress disorder [PTSD]) explained the support-to-distress relationship in the earlier postdisaster phase, 6 to 12 months after the impact. Both causal mechanisms emerged as significant paths in the midpoint of the study (12 and 18 months). Only social selection (more PTSD leading to less social support) accounted for the support-to-distress relationship at 18 to 24 months after the event. Interpersonal and social dynamics of disasters may explain why these two contrasting causal mechanisms emerged over time.",0,0 +3360,Health-Related Quality of Life After Aneurysmal Subarachnoid Hemorrhage: Profile and Clinical Factors,"Health-related quality of life has recently been suggested as a supplement to the traditional neurological outcome measures from the patient's perspective according to the World Health Organization model and may capture the effects of other factors such as posttraumatic stress disorder and neuroendocrine dysfunction.To explore the profile and clinical factors of quality of life after aneurysmal subarachnoid hemorrhage using the data we obtained from the recently completed Intravenous Magnesium Sulphate After Aneurysmal Subarachnoid Hemorrhage (IMASH) trial.This study was registered at www.strokecenter.org/trials and www.ClinicalTrials.gov (NCT00124150). Data from a patient cohort obtained with the Short Form-36 questionnaire completed at 6 months were used for analysis.Patients with aneurysmal subarachnoid hemorrhage demonstrated a decrease in quality of life according to the Short Form-36 at 6 months. The physical and mental health scores correlated with the Extended Glasgow Outcome Scale and had the potential to avoid the ceiling effect. Multiple regression analyses showed that the physical component scores were related to age, World Federation of Neurological Surgeons grade, and chronic hydrocephalus and that the mental component scores were not related to the traditional prognostic factors.Subarachnoid hemorrhage caused a decrease in quality of life. Chronic hydrocephalus is related to a decrease in physical health quality of life.",0,0 +3361,"Prevalence, comorbidity and predictors of anxiety disorders in children and adolescents in rural north-eastern Uganda","Child and adolescent anxiety disorders are the most prevalent form of childhood psychopathology. Research on child and adolescent anxiety disorders has predominantly been done in westernized societies. There is a paucity of data on the prevalence, comorbidity, and predictors of anxiety disorders in children and adolescents in non-western societies including those in sub-Saharan Africa. This paper investigates the prevalence, comorbidity, and predictors of anxiety disorders in children and adolescents in north-eastern Uganda.To determine the prevalence of DSM-IV anxiety disorders, as well as comorbidity patterns and predictors in children and adolescents aged 3 to 19 years in north-eastern Uganda.Four districts (Lira, Tororo, Kaberamaido and Gulu) in rural north-eastern Uganda participated in this study. Using a multi-stage sampling procedure, a sample of 420 households with children aged 3-19 years from each district was enrolled into the study. The MINI International Neuropsychiatric Interview for children and adolescents (MINI KID) was used to assess for psychiatric disorders in 1587 of 1680 respondents.The prevalence of anxiety disorders was 26.6%, with rates higher in females (29.7%) than in males (23.1%). The most common disorders in both males and females were specific phobia (15.8%), posttraumatic stress disorder (PTSD) (6.6%) and separation anxiety disorder (5.8%). Children below 5 years of age were significantly more likely to have separation anxiety disorder and specific phobias, while those aged between 14-19 were significantly more likely to have PTSD. Anxiety disorders were more prevalent among respondents with other psychiatric disorders; in respondents with two or more co-morbid psychiatric disorders the prevalence of anxiety disorders was 62.1%. Predictors of anxiety disorders were experience of war trauma (OR = 1.93, p < 0.001) and a higher score on the emotional symptom scale of the SDQ (OR = 2.58, p < 0.001). Significant socio-demograghic associations of anxiety disorders were found for female gender, guardian unemployment, living in permanent housing, living without parents, and having parents without education.The prevalence of anxiety disorders in children and adolescents in rural north-eastern Uganda is high, but consistent in terms of gender ratio and progression over time with a range of prior work in other contexts. Patterns of comorbidity and predictors of anxiety disorders in this setting are also broadly consistent with previous findings from western community studies. Both psychosocial stressors and exposure to war trauma are significant predictors of anxiety disorders.Prevention and treatment strategies need to be put in place to address the high prevalence rates of anxiety disorders in children and adolescents in Uganda.",0,0 +3362,Violence exposure in home and community: Influence on posttraumatic stress symptoms in Army recruits,"This study assessed the levels and types of violence exposure, levels of posttraumatic stress symptoms, and the relationship among exposure to violence, posttraumatic stress symptoms, and early discharge in U.S. Army recruits at Basic Combat Training (BCT). The study applied a modified ABCX model of family stress adaptation developed by McCubbin, Thompson, and McCubbin (1996). A sample of 779 BCT recruits were surveyed before training began. At the end of training, data was collected on those recruits who had been discharged before completion of training. Statistical measures of association were used to assess the relationship between the variables. Results supported all three of the hypotheses tested. Significant positive relationships were found between violence exposure and trauma symptoms, as well as levels of trauma symptoms and odds of early discharge. Patterns of association were found between types of exposure to community versus home violence and specific symptom clusters of traumatic stress.",0,0 +3363,Trauma Exposure and Health: The Role of Depressive and Hyperarousal Symptoms,"Posttraumatic stress disorder (PTSD) and depressive symptoms have been theorized to mediate the relationship between trauma exposure and physical health symptoms. Although empirical evidence supports this premise, studies conducted to date have employed statistical mediation analyses that are now broadly criticized. Furthermore, the mediating roles of both PTSD and depressive symptoms have seldom been examined concurrently, and it remains unclear which PTSD symptom clusters uniquely mediate this relationship. The aim of the present study was to examine the mediating role of reexperiencing, avoidance/numbing, hyperarousal, and depressive symptoms in the relationship between trauma exposure and physical health symptoms. Participants were 516 Spanish female undergraduate students. Physical health symptoms were compared between those who reported trauma exposure (n = 266) and those who did not (n = 250). Data from trauma-exposed participants were analyzed using regression models with bootstrapping to test mediation. Results of the analyses showed that the trauma-exposed group reported significantly more physical health symptoms (r2 = .035). Hyperarousal and depressive symptoms uniquely mediated the relationship between trauma exposure and physical health symptoms. Our findings clarify some of the mechanisms by which negative health consequences occur subsequent to trauma exposure.",0,0 +3364,Requiring both avoidance and emotional numbing in DSM-V PTSD: Will it help?,"The proposed DSM-V criteria for posttraumatic stress disorder (PTSD) specifically require both active avoidance and emotional numbing symptoms for a diagnosis. In DSM-IV, since both are included in the same cluster, active avoidance is not essential. Numbing symptoms overlap with depression, which may result in spurious comorbidity or overdiagnosis of PTSD. This paper investigated the impact of requiring both active avoidance and emotional numbing on the rates of PTSD diagnosis and comorbidity with depression.We investigated PTSD and depression in 835 traumatic injury survivors at 3 and 12 months post-injury. We used the DSM-IV criteria but explored the potential impact of DSM-IV and DSM-V approaches to avoidance and numbing using comparison of proportion analyses.The DSM-V requirement of both active avoidance and emotional numbing resulted in significant reductions in PTSD caseness compared with DSM-IV of 22% and 26% respectively at 3 and 12 months posttrauma. By 12 months, the rates of comorbid PTSD in those with depression were significantly lower (44% vs. 34%) using the new criteria, primarily due to the lack of avoidance symptoms.These preliminary data suggest that requiring both active avoidance and numbing as separate clusters offers a useful refinement of the PTSD diagnosis. Requiring active avoidance may help to define the unique aspects of PTSD and reduce spurious diagnoses of PTSD in those with depression.",0,0 +3365,HERITABILITY OF SOCIAL ANXIETY-RELATED CONCERNS AND PERSONALITY CHARACTERISTICS: A TWIN STUDY,"Negative evaluation fears figure prominently in the cognitive psychology of patients with social phobia. In this study, we examine the heritability of negative evaluation fears by using a twin sample. The authors also examine the relationships between negative evaluation fears and personality dimensions relevant to social phobia. Scores on the brief version of the Fear of Negative Evaluation Scale (BFNE) were examined in a sample of 437 (245 monozygotic and 192 dizygotic) twin pairs. Biometrical model fitting was conducted by using standard statistical methods. Genetic and environmental correlations with personality dimensions (from the Dimensional Assessment of Personality Pathology-Basic Questionnaire) were also calculated. Broad heritability estimate of the BFNE was 48%. Additive genetic effects and unique environmental effects emerged as the primary influences on negative evaluation fears. Genetic correlations between BFNE scores and the submissiveness, anxiousness, and social avoidance facets of the Dimensional Assessment of Personality Pathology-Basic Questionnaire were high (r(g) =.78 to.80). A cognitive dimension central to the phenomenology (and, perhaps, cause) of social phobia, the fear of being negatively evaluated, is moderately heritable. Moreover, the same genes that influence negative evaluation fears appear to influence a cluster of anxiety-related personality characteristics. Implications and limitations of these findings are discussed.",0,0 +3366,Gastrointestinal Symptoms and Altered Intestinal Permeability Induced by Combat Training Are Associated with Distinct Metabotypic Changes,"Physical and psychological stress have been shown to modulate multiple aspects of gastrointestinal (GI) physiology, but its molecular basis remains elusive. We therefore characterized the stress-induced metabolic phenotype (metabotype) in soldiers during high-intensity combat training and correlated the metabotype with changes in GI symptoms and permeability. In a prospective, longitudinal study, urinary metabotyping was conducted on 38 male healthy soldiers during combat training and a rest period using gas chromatography-mass spectrometry. The urinary metabotype during combat training was clearly distinct from the rest period (partial least-squares discriminant analysis (PLSDA) Q(2) = 0.581), confirming the presence of a unique stress-induced metabotype. Differential metabolites related to combat stress were further uncovered, including elevated pyroglutamate and fructose, and reduced gut microbial metabolites, namely, hippurate and m-hydroxyphenylacetate (p < 0.05). The extent of pyroglutamate upregulation exhibited a positive correlation with an increase in IBS-SSS in soldiers during combat training (r = 0.5, p < 0.05). Additionally, the rise in fructose levels was positively correlated with an increase in intestinal permeability (r = 0.6, p < 0.005). In summary, protracted and mixed psychological and physical combat-training stress yielded unique metabolic changes that corresponded with the incidence and severity of GI symptoms and alteration in intestinal permeability. Our study provided novel molecular insights into stress-induced GI perturbations, which could be exploited for future biomarker research or development of therapeutic strategies.",0,0 +3367,The association between post-traumatic stress disorder symptoms and the quality of life among Wenchuan earthquake survivors: the role of social support as a moderator,"Objective: To examine the role of the three types of social support as possible moderating factors between post-traumatic stress disorder (PTSD) and its relationship to two domains of the quality of life (QOL). Methods: A cross-sectional survey was done in a local area near the epicenter of the severe earthquake in Wenchuan. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), the standard Chinese 12-item Short Form (SF-12v2), and the Social Support Rating Scale (SSRS) were used to interview a total of 2,080 earthquake survivors in the one-year follow-up period. Multiple regressions were performed to evaluate the moderating role of social support on the relationship between PTSD and QOL. Results: Among survivors one-year after the Wenchuan earthquake, being a woman (p < 0.01), having a lower level of education (p < 0.01), having a lower level of income (p < 0.01), having a worse housing status (p < 0.05) and having a higher level of exposure (p < 0.05) were risk factors for a poorer QOL (DELTAR2 = 0.063). PTSD symptoms negatively influenced the QOL (DELTAR2 = 0.145), while social support positively influenced the QOL (DELTAR2 = 0.016). However, the interaction between social support and PTSD weakened the negative effect of PTSD on the QOL (DELTAR2 = 0.012). Subjective support and support availability moderated the association between PTSD and the QOL (DELTAR2 = 0.010). Conclusion: Subjective support and support availability are more useful strategies to improve the QOL of the earthquake survivors with PTSD symptoms. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +3368,"The Effects of Mild Traumatic Brain Injury, Post-Traumatic Stress Disorder, and Combined Mild Traumatic Brain Injury/Post-Traumatic Stress Disorder on Returning Veterans","United States veterans of the Iraqi (Operation Iraqi Freedom [OIF]) and Afghanistan (Operation Enduring Freedom [OEF]) conflicts have frequently returned from deployment after sustaining mild traumatic brain injury (mTBI) and enduring stressful events resulting in post-traumatic stress disorder (PTSD). A large number of returning service members have been diagnosed with both a history of mTBI and current PTSD. Substantial literature exists on the neuropsychological factors associated with mTBI and PTSD occurring separately; far less research has explored the combined effects of PTSD and mTBI. The current study employed neuropsychological and psychological measures in a sample of 251 OIF/OEF veterans to determine whether participants with a history of mTBI and current PTSD (mTBI+PTSD) have poorer cognitive and psychological outcomes than participants with mTBI only (mTBI-o), PTSD only (PTSD-o), or veteran controls (VC), when groups are comparable on intelligence quotient, education, and age. The mTBI+PTSD group performed more poorly than VC, mTBI-o, and PTSD-o groups on several neuropsychological measures. Effect size comparisons suggest small deleterious effects for mTBI-o on measures of processing speed and visual attention and small effects for PTSD-o on measures of verbal memory, with moderate effects for mTBI+PTSD on the same variables. Additionally, the mTBI+PTSD group was significantly more psychologically distressed than the PTSD-o group, and PTSD-o group was more distressed than VC and mTBI-o groups. These findings suggest that veterans with mTBI+PTSD perform significantly lower on neuropsychological and psychiatric measures than veterans with mTBI-o or PTSD-o. The results also raise the possibility of mild but persisting cognitive changes following mTBI sustained during deployment.",0,0 +3369,Post‐traumatic stress disorder related to birth: a prospective longitudinal study in a French population,"The objective of the current study is to determine the prevalence of post‐traumatic stress disorder (PTSD) following birth in a French sample, as well as to examine predictive variables. This study collected data from women at four different times: 48 h, 1 month, 4 months and 9 months post‐partum. PTSD symptoms were measured using the Impact of Events Scale‐Revised (IES‐R). Predictive variables were examined with four questionnaires: the Labor Agentry Scale (LAS), the Multidimensional Scale of Perceived Social Support (MSPSS), the Edinburgh Postnatal Depression Scale (EPDS) and a researcher‐designed personal information form. PTSD rates varied from 5% (1 month post‐partum) to 2.9% (9 months post‐partum). Primiparity, birth preparation classes, transfer to a tertiary care centre, perception of external control, feeling of pain during birth and depressive symptoms were significant predictors of the global IES‐R score. Results provide a basis for considering changes in healthcare delivery and prevention prog...",0,0 +3370,"Posttraumatic intrusion, avoidance, and social functioning: A 20-year longitudinal study.","The study assesses posttraumatic intrusion, avoidance, and social functioning among 214 Israeli combat veterans from the first Lebanon War with and without combat stress reaction (CSR) 1, 2, 3, and 20 years after the war. CSR veterans reported higher intrusion and avoidance than did non-CSR veterans. With time, there was a decline in these symptoms. In addition, intrusion and avoidance were associated with problems in social functioning on a given year, and they longitudinally predicted social dysfunction 2, 3, and 20 years after the war. CSR veterans presented stronger temporal covariations between intrusion-avoidance and social functioning. The findings suggest that CSR is a marker for future psychopathology and point to the role of avoidance in social dysfunction.",0,0 +3371,The Mental Health Impact of 9/11 on Inner-City High School Students 20 Miles North of Ground Zero,"To determine the rate of post-traumatic stress disorder (PTSD) after 9/11 in a sample of New York City high school students and associations among personal exposure, loss of psychosocial resources, prior mental health treatment, and PTSD.A total of 1214 students (grades 9 through 12) attending a large community high school in Bronx County, 20 miles north of ""Ground Zero,"" completed a 45-item questionnaire during gym class on one day eight months after 9/11. Students were primarily Hispanic (62%) and African American (29%) and lived in the surrounding neighborhood. The questionnaire included the PCL-T, a 17-item PTSD checklist supplied by the Office of Behavioral and Social Science Research of the National Institutes of Health (NIH). The PCL-T was scored following the DSM-IV criteria for PTSD requiring endorsement of at least one repeating symptom, two hyperarousal symptoms, and three avoidance symptoms. Bivariate analysis comparing PTSD with personal exposure, loss of psychosocial resources, and mental health variables was done and multiple logistic regression was used to identify significant associations.There were 7.4 % of students with the PTSD symptom cluster. Bivariate analysis showed a trend for females to have higher rates of PTSD (males [6%] vs. females [9%], p = .06] with no overall ethnic differences. Five of the six personal exposure variables, and both of the loss of psychosocial resources and mental health variables were significantly associated with PTSD symptom cluster. Multiple logistic regression analysis found one personal exposure variable (having financial difficulties after 9/11, odds ratio [OR] = 5.27; 95% confidence interval [CI] 2.9-9.7); both the loss of psychosocial resources variables (currently feeling less safe, OR = 3.58; 95% CI 1.9-6.8) and currently feeling less protected by the government, (OR = 4.04; 95% CI 2.1-7.7); and one mental health variable (use of psychotropic medication before 9/11, OR = 3.95; 95% CI 1.2-13.0) were significantly associated with PTSD symptom cluster.We found a rate of PTSD in Bronx students after 9/11 that was much higher than other large studies of PTSD in adolescents done before 9/11. Adolescents living in inner cities with high poverty and violence rates may be at high risk for PTSD after a terrorist attack. Students who still felt vulnerable and less safe eight months later and those with prior mental health treatment were four times more likely to have PTSD than those without such characteristics, highlighting the influence of personality and mental health on development of PTSD after a traumatic event.",0,0 +3372,Shifting the Odds of Lifelong Mental Illness Through an Understanding of the Profiles of Adolescents and Young Adults with Serious Mental Health Conditions,Every day families and mental health providers are called upon to make tough decisions in determining the best quality of care for adolescents and young adults with serious mental health conditions. This study profiles the behavioral and emotional needs and risk behaviors of adolescents and young adults seeking mental health services based on assessment of strengths and needs at program entry. © 2013 Springer Science+Business Media New York.,0,0 +3373,History of trauma and dissociative symptoms among patients with obsessive-compulsive disorder and social anxiety disorder,"We aimed to compare the history of trauma and the profile and severity of dissociative symptoms of patients with obsessive-compulsive disorder (OCD) to those of patients with social anxiety disorder (SAD). Patients with OCD (n = 34) and patients with SAD (n = 30) were examined with the following instruments: Trauma History Questionnaire (THQ), Dissociative Experience Scale (DES), Obsessive-Compulsive Inventory (OCI), Liebowitz Social Anxiety Scale (LSAS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Patients with OCD reported significantly lower rates of exposure to traumatic events. Nevertheless, the severity of dissociative symptoms was not significantly different between the groups. Regression analyses showed that, while the OCI scores better predicted the variance on DES scores in the OCD sample, the LSAS and the BAI better predicted the variance on the DES among patients with SAD. Patients with OCD are probably less vulnerable to some types of traumatic experiences. Dissociative symptoms may cut across different anxiety disorders. (",0,0 +3374,A Prospective Study of Heart Rate Response Following Trauma and the Subsequent Development of Posttraumatic Stress Disorder,"Physiological arousal during traumatic events may trigger the neurobiological processes that lead to posttraumatic stress disorder (PTSD). This study prospectively examined the relationship between heart rate and blood pressure recorded immediately following a traumatic event and the subsequent development of PTSD.Eighty-six trauma survivors who presented at the emergency department of a general hospital were followed up for 4 months. Heart rate and blood pressure were recorded on arrival at the emergency department. Heart rate, anxiety, depression, and PTSD symptoms were assessed 1 week, 1 month, and 4 months later. The clinician-administered PTSD scale defined PTSD status at 4 months.twenty subjects (23%) met PTSD diagnostic criteria at the 4-month assessment (PTSD group), and 66 (77%) did not (non-PTSD group). Subjects who developed PTSD had higher heart rates at the emergency department (95.5+/-13.9 vs 83.3+/-10.9 beats per minute, t=4.4, P<.001) and 1 week later (77.8+/-11.9 vs 72.0+/-9.5 beats per minute, t=2.25, P<.03), but not after 1 and 4 months. The groups did not differ in initial blood pressure measurement. Repeated-measures analysis of variance (ANOVA) for heart rate showed a significant group effect (P<.02), time effect (P<.001), and group x time interaction (P<.001). The time effect and group x time interaction remained significant when adjusted for sex, age, trauma severity, immediate response, and dissociation during the traumatic event.Elevated heart rate shortly after trauma is associated with the later development of PTSD.",0,0 +3375,Cultural bias in suicidal behaviour among refugees with post-traumatic stress disorder,"The study was primarily designed to assess the prevalence of suicidal behaviour among asylum applicants diagnosed as having post-traumatic stress disorder (PTSD) and the impact of cultural bias factors (such as religion and nationality) in suicidal dynamics. The traumatic stressors reported in the study included being subjected to or forced to witness war atrocities, imprisonment, torture, sexual violence, other's suicide, and summary or mock executions. The study included 64 PTSD patients who were examined as part of a diagnostic and suicidal risk assessment after referral. Suicide risk assessments were assisted with scores of the SAD PERSONS Scale. Most PTSD patients reported suicidal behaviour. Nearly half of the refugees with PSTD diagnoses had a history of suicide attempts. Religious proscription or nationality was not found to be a significant deterrent of suicidal behaviour, and no differences between the various religious groups were established on this point. Another noteworthy finding in the pre...",0,0 +3376,The role of work in the recovery of persons with psychiatric disabilities.,"This study explored the role of work in the recovery of employed and unemployed persons with psychiatric disabilities. Fourteen persons with psychiatric disabilities participated in semi-structured interviews. Content analysis revealed that the experience of recovery was based on six major dimensions: self-definition, empowerment, connections to others, meaning of work, vocational future, and meaning of recovery. Differences in these six dimensions led to the identification of three profiles of recovery: recovery as uncertain, recovery as a self-empowering experience, and recovery as a challenging experience. Each profile described a specific context in which participation in work or avoidance of work can be understood and vocational interventions can be designed.",0,0 +3377,Early identification of posttraumatic stress following military deployment: Application of machine learning methods to a prospective study of Danish soldiers,"Pre-deployment identification of soldiers at risk for long-term posttraumatic stress psychopathology after home coming is important to guide decisions about deployment. Early post-deployment identification can direct early interventions to those in need and thereby prevents the development of chronic psychopathology. Both hold significant public health benefits given large numbers of deployed soldiers, but has so far not been achieved. Here, we aim to assess the potential for pre- and early post-deployment prediction of resilience or posttraumatic stress development in soldiers by application of machine learning (ML) methods.ML feature selection and prediction algorithms were applied to a prospective cohort of 561 Danish soldiers deployed to Afghanistan in 2009 to identify unique risk indicators and forecast long-term posttraumatic stress responses.Robust pre- and early postdeployment risk indicators were identified, and included individual PTSD symptoms as well as total level of PTSD symptoms, previous trauma and treatment, negative emotions, and thought suppression. The predictive performance of these risk indicators combined was assessed by cross-validation. Together, these indicators forecasted long term posttraumatic stress responses with high accuracy (pre-deployment: AUC = 0.84 (95% CI = 0.81-0.87), post-deployment: AUC = 0.88 (95% CI = 0.85-0.91)).This study utilized a previously collected data set and was therefore not designed to exhaust the potential of ML methods. Further, the study relied solely on self-reported measures.Pre-deployment and early post-deployment identification of risk for long-term posttraumatic psychopathology are feasible and could greatly reduce the public health costs of war.",0,0 +3378,iMStrong: Deployment of a Biosensor System to Detect Cocaine Use,"Biosensor systems are increasingly promoted for use in behavioral interventions. Portable biosensors might offer advancement over self-report use and can provide improved opportunity for detection and intervention in patients undergoing drug treatment programs. Fifteen participants wore a biosensor wristband capable of detecting multiple physiologic markers of sympathetic nervous system (SNS) arousal for 30 days. Urine drug screening and drug use self-report were obtained twice per week. A parameter trajectory description method was applied to capture abrupt changes in magnitude of three measures of SNS activity: Electrodermal activity (EDA), skin temperature and motion. Drug use events detected by the biosensor were verified using a triad of parameters: the biosensor data, urine drug screens, and patient self-report of substance use. Twelve positive cocaine urine screens were identified. Thirteen self-reported episodes of cocaine use were recorded. Distinct episodes with biometric parameters consistent with cocaine use were identified on biosensor data. Eleven potential cocaine use episodes were identified by biosensors that were missed by both self-report and drug screening. Study participants found mobile biosensors to be acceptable, and compliance with the protocol was high. Episodes of cocaine use, as measured by supraphysiologic changes in biophysiometric parameters, were detected by analysis of biosensor data in instances when self-report or drug screening or both failed. Biosensors have substantial potential in detecting substance abuse, in understanding the context of use in real time, and in evaluating the efficacy of behavioral interventions for drug abuse.",0,0 +3379,"The cumulative effect of different childhood trauma types on self-reported symptoms of adult male depression and PTSD, substance abuse and health-related quality of life in a large active-duty military cohort","History of childhood trauma (CT) is highly prevalent and may lead to long-term consequences on physical and mental health. This study investigated the independent association of CT with symptoms of adult depression and posttraumatic stress disorder (PTSD), mental and physical health-related quality of life (HRQoL), as well as current tobacco consumption and alcohol abuse in a large homogenous cohort of 1254 never-deployed, young male Marines enrolled in the Marine Resiliency Study. Independent effects of CT history, number and type of CT on outcomes were analyzed using hierarchical multivariate logistic regression models. Our results suggested dose-dependent negative effect of an increasing number of trauma types of CT on depression, PTSD and HRQoL. Experience of single CT type demonstrated overall weak effects, while history of multiple CT types distinctively increased the likelihood of adult PTSD symptomology (OR: 3.1, 95% CI: 1.5-6.2), poor mental (OR: 2.3, 95% CI: 1.7-3.1) and physical HRQoL (OR: 1.4, 95% CI: 1.1-1.9). Risk for depression symptoms was similar for both single and multiple CT (OR: 2.2, 95% CI: 1.3-3.8 and OR: 2.1, 95% CI: 1.2-3.5 respectively). CT history had no effects on current tobacco use and alcohol abuse. Our study thus provides evidence for substantial additive effect of different CT types on adult mental and physical health with increasing levels of exposure.",0,0 +3380,Structure of Posttraumatic Stress Disorder Symptoms in Pain and Pain-Free Patients Scheduled for Major Surgery,"Factor-analytic studies of the structure of posttraumatic stress disorder (PTSD) symptoms have yielded inconsistent results. One of the reasons for the inconsistency may be that PTSD is highly comorbid with other disorders; the observed factor structure might depend on the particular comorbid disorder. One such disorder is chronic pain. The goal of the present study was to investigate whether PTSD symptom structure differs between pain and pain-free patients scheduled to undergo major surgery. Four hundred and forty-seven patients who were approached 7 to 10 days prior to scheduled surgery completed the PTSD Checklist-Civilian (PCL-C) Version and the Current Pain and Pain History Questionnaire; the latter was used to divide patients into pain (N = 175) and pain-free (N = 272) groups. Results showed that in pain-free patients, PTSD symptoms were best expressed as 2 symptom clusters (re-experiencing/avoidance; emotional numbing/hyperarousal) accounting for 52.4% of the variance. In pain patients, PTSD symptoms were best expressed as a single symptom cluster accounting for 51.1% of the variance. These results suggest different interrelationships among PTSD symptoms in these 2 populations. Results reflect the need for (1) controlling for pain in studies looking at PTSD-symptom expression and (2) further research on PTSD-symptom expression in pain populations.These results may have important implications for research on the comorbidity between PTSD and chronic pain, as well as for treatment of PTSD symptoms in patients presenting with pain problems.",0,0 +3381,"Distribution of Traumatic and Other Stressful Life Events by Race/Ethnicity, Gender, SES and Age: A Review of the Research","Much research has shown that reports of stressful life events are related to a wide variety of psychiatric and physical health outcomes. Relatively little research exists, however, on the distribution of the events according to gender, age, racial/ethnic background, and socioeconomic status (SES). Such information would help identify groups at greatest risk for further investigation. This paper presents a review of the relevant studies. We find that traumatic (e.g., life threatening) events appear to be more frequent for men, while men and women differ more consistently on types rather than on overall numbers of stressful events other than traumatic. Traumatic and other stressful events tend to be more frequent in low SES and racial/ethnic minorities groups, and finally, both traumatic and other stressful events are reported more by younger age groups in samples 18 years of age and older. The limitations and implications of these findings for further research and preventive interventions are discussed, especially the need for more detailed information about individual events.",0,0 +3382,Control theory and psychopathology: An integrative approach,"Perceptual control theory (PCT; Powers, 1973) is presented and adapted as a framework to understand the causes, maintenance, and treatment of psychological disorders. PCT provides dynamic, working models based on the principle that goal-directed activity arises from a hierarchy of negative feedback loops that control perception through control of the environment. The theory proposes that psychological distress arises from the unresolved conflict between goals. The present paper integrates PCT, control theory, and self-regulatory approaches to psychopathology and psychotherapy and recent empirical findings, particularly in the field of cognitive therapy. The approach aims to offer fresh insights into the role of goal conflict, automatic processes, imagery, perceptual distortion, and loss of control in psychological disorders. Implications for psychological therapy are discussed, including an integration of the existing work on the assessment of control profiles and the use of assertive versus yielding modes of control.",0,0 +3383,Kompleksowa opieka nad dzieckiem z zespołem stresu pourazowego,"The essential feature of posttraumatic stress disorder (PTSD) is the development of characteristic symptoms following exposure to a traumatic event that arouses - intense fear, helplessness, or horror, or in children - disorganized or agitated behaviour. Symptoms are categorized into three clusters: persistent re-experiencing of the stressor, persistent avoidance of reminders and emotional numbing, and persistent symptoms of increased arousal. Childhood PTSD confers increased risk for a number of problems in later childhood, adolescence and adulthood. Among psychotherapies there is convincing evidence that trauma-focused therapies, that is that specifically address the child's traumatic experiences, are superior to nonspecific or nondirective therapies in resolving PTSD symptoms. Among the trauma-focused psychotherapies, TF-CBT has received the most empirical support for the treatment of childhood PTSD. The first step in the psychotherapy for posttraumatic stress disorder in children is helping the child gain a sense of mastery over the trauma and helping the child to feel safe again. In older children, gaining a sense of mastery includes the ability to recall, relate, narrate, and reconsider the trauma without feeling overwhelmed and without dissociating. Relaxation training and medication may be helpful in enabling the child to do this. In younger children, play provides an opportunity to work through the trauma. The victims of domestic violence especially required long-term psychological and psychiatric treatment. © PSYCHIATR. PSYCHOL.",0,0 +3384,The Psychopathology of Posttraumatic Embitterment Disorders,"<i>Background:</i> The posttraumatic embitterment disorder (PTED) was introduced as a new subgroup of adjustment disorders. The trigger event in PTED is an exceptional, though normal negative life event that is experienced as a violation of basic beliefs and values. The predominant emotion in PTED is embitterment. This study presents first data on the psychopathological profile of PTED. <i>Method:</i> 48 inpatients were diagnosed by clinical judgment as suffering from PTED. Patients were then interviewed with the standardized Mini International Neuropsychiatric Interview (MINI) and an additional interview section on the diagnostic criteria for PTED. Patients also filled in the Symptom Checklist-90-Revision (SCL-90-R), and the Impact of Event Scale (IES-R). <i>Results:</i> According to the MINI68.8% of the patients fulfilled the criteria for adjustment disorders, 52.1% for major depression, 41.7% for dysthymia, and 35.4% for generalized anxiety disorders. 100% of patients reported that they were suffering from intrusive thoughts about the event. 97.9% of the patients complained about persistent negative mood, 91.7% about restlessness, 83.3% inhibition of drive and loss of interest, 77.1% phobic avoidance of places related to the event, and 75% resignation, but 91.7% reported normal mood when distracted. The SCL-90-R indicated a high load of general psychopathological complaints with an average positive symptom total score of 52.26. Characteristic were feelings of injustice (100%), embitterment (97.7%), and rage (91.7%). The IES-R scale indicated a high prevalence of posttraumatic stress, with an average total score of 3.23. The average duration of illness was 31.7 months. <i>Conclusions:</i> The PTED patients are suffering from severe, multiform, and disabling symptoms. Their clinical features pose difficult diagnostic problems. The predominant complaints about feelings of injustice, embitterment, and rage and the results of the IES speak for the importance of the critical event for the development and understanding of such disorders.",0,0 +3385,Postintensive care unit psychological burden in patients with chronic obstructive pulmonary disease and informal caregivers: A multicenter study,"To determine the prevalence and risk factors of symptoms of anxiety, depression, and posttraumatic stress disorder-related symptoms in patients with chronic obstructive pulmonary disease and their relatives after an intensive care unit stay.Prospective multicenter study.Nineteen French intensive care units.One hundred twenty-six patients with chronic obstructive pulmonary disease who survived an intensive care unit stay and 102 relatives.None.Patients and relatives were interviewed at intensive care unit discharge and 90 days later to assess symptoms of anxiety and depression using Hospital Anxiety and Depression Scale (HADS) and posttraumatic stress disorder-related symptoms using the Impact of Event Scale (IES). At intensive care unit discharge, 90% of patients recollected traumatic psychological events in the intensive care unit. At day 90, we were able to conduct telephone interviews with 53 patients and 47 relatives. Hospital Anxiety and Depression Scale scores indicated symptoms of anxiety and depression in 52% and 45.5% of patients at intensive care unit discharge and in 28.3% and 18.9% on day 90, respectively. Corresponding prevalence in relatives were 72.2% and 25.7% at intensive care unit discharge and 40.4% and 14.9% on day 90, respectively. The Impact of Event Scale indicated posttraumatic stress disorder-related symptoms in 20.7% of patients and 29.8% of relatives on day 90. Peritraumatic dissociation assessed using the Peritraumatic Dissociative Experiences Questionnaire was independently associated with posttraumatic stress disorder-related symptoms in the patients and relatives. Previous intensive care unit experience and recollection of bothersome noise in the intensive care unit predicted posttraumatic stress disorder-related symptoms in the patients.Psychiatric symptoms were found to be common in a group of 126 patients with chronic obstructive pulmonary disease who survived an intensive care unit stay and their relatives at intensive care unit discharge and 90 days later. Peritraumatic dissociation at intensive care unit discharge was found to independently predict posttraumatic stress disorder-related symptoms in this sample of patients and relatives.",0,0 +3386,Rationale for iloperidone in the treatment of posttraumatic stress disorder.,"Multiple controlled efficacy studies are available to support the use of psychotropic medications in the treatment of posttraumatic stress disorder symptoms. Iloperidone, a recently approved atypical antipsychotic, has yet to be evaluated in such a manner. This unique agent has the highest affinity of all antipsychotics toward alpha-1 receptors. Antagonism of central nervous system alpha-1 receptors has been implicated in certain aspects of posttraumatic stress disorder, as evidenced by the beneficial role of prazosin in treating nightmares. Additional reduction in hypervigilance may occur through blockade of dopamine receptor D2 and serotonin receptors in the 5-HT2 family. Further investigation of iloperidone is warranted in the treatment of patients with posttraumatic stress disorder due to its unique receptor binding profile.",0,0 +3387,Compassion Fatigue and Burnout Amongst Clinicians: A Medical Exploratory Study,"Compassion fatigue is a broad term comprising of two components - burnout and secondary traumatic stress. The current study is aimed at identifying 'burnout' and 'compassion fatigue' among clinicians involved in care of individuals suffering from medical illness.A total of 60 clinicians were included in the study. A semi-structured questionnaire was administered to gather information related to personal, professional, anthropometric, and metabolic profile of the study participants. Professional Quality of Life Scale (ProQoL Version V) was used to assess burnout, compassion satisfaction and secondary traumatic stress. Analysis was carried out using the SPSS version 19.0.The mean age of clinicians was 46.68±11.06 (range 26-67 years). Burnout score was significantly higher in those involved in diabetology practice. Similarly, compassion satisfaction score was greater among those with greater years of practice as well as among those in private practice. Clinicians who reported a poor working condition, as opposed to good, had more burnout and less compassion satisfaction.The current study suggests that it is important to find out ways of decreasing burnout and compassion fatigue among clinicians.",0,0 +3388,"Principles and neurobiological correlates of concentrative, diffuse, and insight meditation.","T he term meditation encompasses a broad variety of mental-training practices that vary between cultures and traditions, ranging from techniques designed to promote physical health, relaxation, and improved concentration, to exercises performed with farther-reaching goals, such as developing a heightened sense of well-being, cultivating altruistic behaviors, and, for some, attaining enlightenment. Meditation can be conceptualized as complex emotional and attentional regulatory practices in which mental and somatic events are affected by specific mental-training practices. Meditation is typically associated with a concurrent state of heightened vigilant awareness and reduced metabolic activity—which lead to improved physical health, psychological balance, and emotional stability. Not all meditation practices focus on the training of specific cognitive skills, and in those that do, the methodologies and outcomes often vary. It is therefore essential to be explicit about the type of meditation practice under investigation. Different types of meditation can be classified based on how the practitioner’s attentional processes are regulated and directed. In this article we focus on the two most common styles of meditation derived from Buddhist traditions: (1) concentrative, or focused-attention, meditation, and (2) diffuse, or open-monitoring, meditation. Concentrative meditation involves maintaining and continually refocusing attention on a chosen object, such as a body sensation, single point in space, color, object, sound, or affective state such as compassion. Open-monitoring meditation involves developing a present-centered and unattached/neutral mode of observation toward all sensational phenomena, including thoughts.",0,0 +3389,Clinical applications of electroconvulsive therapy and transcranial magnetic stimulation for the treatment of major depressive disorder: a critical review,"Depression is a common and debilitating psychiatric disorder that is often unable to be effectively treated with pharmacotherapeutic agents alone. Electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) are among several somatic therapies available for the treatment of major depression. The purpose of this article is to synthesize current information on ECT and repetitive TMS as treatments for pharmacotherapy-resistant major depression regarding its use in neuropsychiatric clinical practice. The current psychiatric literature indicates that both ECT and TMS are effective antidepressant treatments. ECT is a safe and highly effective treatment for depression. The literature also illustrates that TMS has a favorable side-effect profile, excellent tolerability and modest efficacy. To date, additional research is being conducted to further enhance ECT and TMS treatment, and to further define their role in treatment algorithms.",0,0 +3390,Emotional numbing and pain intensity predict the development of pain disability up to one year after lateral thoracotomy,"Little is known about the factors that predict the transition of acute, time limited pain to chronic pathological pain following postero-lateral thoracotomy. The aim of the present prospective, longitudinal study was to determine the extent to which (1) pre-operative pain intensity, pain disability, and post-traumatic stress symptoms (PTSS) predict post-thoracotomy pain disability 6 and 12 months later; and (2) if these variables, assessed at 6 months, predict 12 month pain disability. Fifty-four patients scheduled to undergo postero-lateral thoracotomy for intrathoracic malignancies were recruited before surgery and followed prospectively for one year. The incidence of chronic post-thoracotomy pain was 68.1% and 61.1% at the 6 and 12 month follow-ups, respectively. Multiple regression analyses showed that neither pre-operative factors nor acute movement-evoked post-operative pain predicted 6 or 12 month pain disability. However, concurrent pain intensity and emotional numbing, but not avoidance symptoms, made unique, significant contributions to the explanation of pain disability at each follow-up (total R(2)=76.3.0% and 63.9% at 6 and 12 months, respectively, both p<0.0009). The relative contribution of pain intensity decreased, while that of emotional numbing increased with time, indicating a progressive de-coupling of pain intensity and disability and a concomitant strengthening of the link between emotional numbing and disability. This suggests that pain may serve as a traumatic stressor which causes increased emotional numbing. The results also support recent suggestions that avoidance and emotional numbing constitute separate PTSS clusters. Further research is required to determine the source(s) of emotional numbing after postero-lateral thoracotomy and effective interventions.",0,0 +3391,Associations with duration of compensation following whiplash sustained in a motor vehicle crash,"Continued exposure to compensation systems has been reported as deleterious to the health of participants. Understanding the associations with time to claim closure could allow for targeted interventions aimed at minimising the time participants are exposed to the compensation system.To identify the associations of extended time receiving compensation benefits with the aim of developing a prognostic model that predicts time to claim closure.Prospective cohort study in people with whiplash associated disorder.Time to claim closure, in a privately underwritten fault based third party traffic crash insurance scheme in New South Wales, Australia.Cox proportional hazard regression modelling.Of the 246 participants, 25% remained in the compensation system longer than 24 months with 15% remaining longer than three years. Higher initial disability (Functional Rating Index≥25 at baseline) (HRR: 95% CI, 1.916: 1.324-2.774, p<0.001); and lower initial mental health as measured by SF-36 Mental Component Score (HRR: 95% CI, 0.973: 0.960-0.987, p<0.001) were significantly and independently associated with an increased time-to-claim closure. Shorter time to claim closure was associated with having no legal involvement (HRR: 95% CI, 1.911: 1.169-3.123, p=0.009); and, not having a prior claim for compensation (HRR: 95% CI, 1.523: 1.062-2.198, p=0.022).Health and insurance related factors are independently associated with time to claim closure. Both factors need to be considered by insurers in their assessment of complexity of claims. Interventions aimed at minimising the impact of these factors could reduce claimants' exposure to the compensation system. In turn insurers can potentially reduce claims duration and cost, while improving the health outcomes of claimants.",0,0 +3392,The impact of PTSD symptoms on physical and mental health functioning in returning veterans,"This study aimed to determine the unique impact of PTSD symptoms, beyond other frequently examined factors on physical and mental health functioning in a sample of returning veterans. Assessments of 168 returning OEF/OIF veterans conducted an average of six months following return from deployment included measures of emotional disorders and the Short Form (36) Health Survey. Hierarchical multiple regressions revealed significant, unique contribution of Clinician-Administered PTSD Scale (CAPS) score above all other predictors in the model (demographics, severity of trauma exposure, physical injury, substance abuse and depressive symptoms), for both the physical (8%) and mental (6%) health aggregate scores, along with significant prediction of physical health (4-10%) and mental health (3-7%) subscale scores. The only other significant predictors were age for physical health scores, and depressive symptoms for mental health scores. PTSD criterion B (re-experiencing) symptoms uniquely predicted reduced physical health functioning and higher experience of bodily pain, while criterion D (hyperarousal) symptoms uniquely predicted lower feelings of energy/vitality and poorer perceptions of emotional health.",0,0 +3393,The Effectiveness of the Personality Assessment Inventory With Feigned PTSD,"Malingered posttraumatic stress disorder (PTSD) poses a formidable clinical challenge because of the apparent ease in feigning PTSD. As an additional confound, some patients with genuine PTSD produce elevated profiles on feigning indicators that are difficult to distinguish from feigned PTSD. The current study utilized 109 inpatients from a trauma unit to examine whether the Personality Assessment Inventory and the Detailed Assessment of Posttraumatic Stress can effectively differentiate between genuine and feigned PTSD. As a primary focus, Resnick’s model of malingered PTSD was evaluated with its three subtypes: pure malingering, partial malingering, and false imputation. They were tested on their ability to (a) effectively simulate PTSD and (b) avoid being classified as feigning. The partial malingering group proved to be the best feigning group in achieving these two goals. Overall, the Personality Assessment Inventory Malingering Index and Negative Distortion Scale were the most effective at identifying feigning.",0,0 +3394,"Trajectories of posttraumatic stress symptoms (PTSS) after major war among Palestinian children: Trauma, family- and child-related predictors","Research shows great individual variation in changes in posttraumatic stress symptoms (PTSSs) after major traumas of terrorist attacks, military combat, and natural disasters. Earlier studies have identified specific mental health trajectories both in children and adults. This study aimed, first, to identify potential PTSS-related trajectories by using latent class growth analyses among children in a three-wave assessment after the 2008/2009 War on Gaza, Palestine. Second, it analyzed how family- and child related factors (e.g., attachment relations, posttraumatic cognitions (PTCs), guilt, and emotion regulation) associate with the trajectory class membership.The sample consisted of 240 Palestinian children (49.4% girls and 50.6% boys) of 10-13 years of age (M=11.29, SD=0.68), who completed PTSS (CRIES) assessments at 3 (T1), 5 (T2), and 11 (T3) months after the war. Children reported their personal exposure to war trauma, attachment style, cognitive trauma processing, and emotion regulation, and their parents reported family war trauma exposure and attachment style.Results revealed a three-trajectory solution, a majority of children belonging to the Recovery trajectory (n=183), and a minority belonged either to Resistant trajectory (n=29) or to Increasing symptoms trajectory (n=28). Low levels of negative posttraumatic cognitive appraisals, feelings of guilt and emotion regulation were characteristic of children in the Resistant trajectory as compared to Increasing symptoms trajectory. Father׳s attachment security was further associated with the Resistant trajectory membership. Children׳s attachment avoidance and high parental trauma were typical to children in Recovery trajectory (as compared to the Increasing symptoms trajectory).",1,0 +3395,Frequencies and predictors of barriers to mental health service use: a longitudinal study of Hurricane Ike survivors,"BackgroundThe majority of disaster survivors suffering from psychological symptoms do not receive mental health services. Research on barriers to service use among disaster survivors is limited by a lack of longitudinal studies of representative samples and investigations of predictors of barriers. The purpose of this study was to address these limitations through analysis of a three-wave population-based study of Hurricane Ike survivors (N = 658).MethodsFrequencies of preference, outcome expectancy, resource, and stigma barriers among participants with unmet mental health needs were documented and logistic regression using a generalized estimating equations approach explored predisposing (e.g., age), illness-related (e.g., posttraumatic stress) and enabling (e.g., insurance coverage) factors as predictors of each type of barrier.ResultsPreference barriers were most frequently cited at each wave, whereas stigma barriers were least frequently cited. Older age and higher emotional support predicted preference barriers; being a parent of a child under 18-years old at the time of the hurricane, higher generalized anxiety, and lack of insurance predicted resource barriers; and higher posttraumatic stress predicted stigma barriers.ConclusionsThese findings suggest that postdisaster practices targeting subpopulations most likely to have barriers to service use may be indicated.",0,0 +3396,"Outcome Evaluation of the Veterans Affairs Salt Lake City Integrative Health Clinic for Chronic Pain and Stress-Related Depression, Anxiety, and Post-Traumatic Stress Disorder","Objectives: The purpose of this longitudinal outcome research study was to determine the effectiveness of the Integrative Health Clinic and Program (IHCP) and to perform a subgroup analysis investigating patient benefit. The IHCP is an innovative clinical service within the Veterans Affairs Health Care System designed for nonpharmacologic biopsychosocial management of chronic nonmalignant pain and stress-related depression, anxiety, and symptoms of post-traumatic stress disorder (PTSD) utilizing complementary and alternative medicine and mind–body skills. Methods: A post-hoc quasi-experimental design was used and combined with subgroup analysis to determine who benefited the most from the program. Data were collected at intake and up to four follow-up visits over a 2-year time period. Hierarchical linear modeling was used for the statistical analysis. The outcome measures included: Health-Related Quality of Life (SF-36), the Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Subgroup comparisons included low anxiety (BAI < 19, n = 82), low depression (BDI < 19, n = 93), and absence of PTSD (n = 102) compared to veterans with high anxiety (BAI ≥ 19, n = 77), high depression (BDI > 19, n = 67), and presence of PTSD (n = 63). Results: All of the comparison groups demonstrated an improvement in depression and anxiety scores, as well as in some SF-36 categories. The subgroups with the greatest improvement, seen at 6 months, were found in the high anxiety group (Cohen's d = 0.52), the high-depression group (Cohen's d = 0.46), and the PTSD group (Cohen's d = 0.41). Conclusions: The results suggest IHCP is an effective program, improving chronic pain and stress-related depression, anxiety, and health-related quality of life. Of particular interest was a significant improvement in anxiety in the PTSD group. The IHCP model offers innovative treatment options that are low risk, low cost, and acceptable to patients and providers.",0,0 +3397,SKA2 methylation is associated with decreased prefrontal cortical thickness and greater PTSD severity among trauma-exposed veterans,"Methylation of the SKA2 (spindle and kinetochore-associated complex subunit 2) gene has recently been identified as a promising biomarker of suicide risk. Based on this finding, we examined associations between SKA2 methylation, cortical thickness and psychiatric phenotypes linked to suicide in trauma-exposed veterans. About 200 trauma-exposed white non-Hispanic veterans of the recent conflicts in Iraq and Afghanistan (91% male) underwent clinical assessment and had blood drawn for genotyping and methylation analysis. Of all, 145 participants also had neuroimaging data available. Based on previous research, we examined DNA methylation at the cytosine-guanine locus cg13989295 as well as DNA methylation adjusted for genotype at the methylation-associated single nucleotide polymorphism (rs7208505) in relationship to whole-brain cortical thickness, posttraumatic stress disorder symptoms (PTSD) and depression symptoms. Whole-brain vertex-wise analyses identified three clusters in prefrontal cortex that were associated with genotype-adjusted SKA2 DNA methylation (methylation(adj)). Specifically, DNA methylation(adj) was associated with bilateral reductions of cortical thickness in frontal pole and superior frontal gyrus, and similar effects were found in the right orbitofrontal cortex and right inferior frontal gyrus. PTSD symptom severity was positively correlated with SKA2 DNA methylation(adj) and negatively correlated with cortical thickness in these regions. Mediation analyses showed a significant indirect effect of PTSD on cortical thickness via SKA2 methylation status. Results suggest that DNA methylation(adj) of SKA2 in blood indexes stress-related psychiatric phenotypes and neurobiology, pointing to its potential value as a biomarker of stress exposure and susceptibility.",0,0 +3398,"Predicting symptom clusters of posttraumatic stress disorder (PTSD) in Croatian war veterans: the role of socio-demographics, war experiences and subjective quality of life.","Previous research has documented multiple chains of risk in the development of PTSD among war veterans. However, existing studies were mostly carried out in the West, while they also did not analyze specific symptom clusters of PTSD. The aim of this study was to examine the role of socio-demographic characteristics, war experiences and subjective quality of life in the prediction of three clusters of PTSD symptoms (i.e., avoidance, intrusion, hyperarousal).This study comprised 184 male participants who have survived war imprisonment during the Croatian Homeland War in the period from 1991 to 1995. The data was collected through several self-report measuring instruments: questionnaire on socio-demographic data, war experiences (Questionnaire on Traumatic Combat and War Experiences), subjective quality of life (WHO-Five Well-being Index), and PTSD symptoms (Impact of Events Scale - Revised).The level of three symptom clusters of PTSD was found to be moderate to high, as indicated by the scores on the IES-R. Results of the three hierarchical regression analyses showed the following: traumatic war experiences were significant predictors of avoidance symptoms; traumatic war experiences and subjective quality of life were significant predictors of hyperarousal symptoms; and traumatic war experiences, material status and subjective quality of life were significant predictors of intrusion symptoms.These findings support the widespread belief that the development of war-related PTSD is accounted for by multiple chains of risk, while traumatic war experiences seem to be the only predictor of all three symptom clusters. Future research should put more emphasis on specific PTSD symptom clusters when investigating the etiopathogenesis of this disorder among war-affected populations.",0,0 +3399,The Severity of Childhood Abuse and Neglect in Relationship to Post-Traumatic Stress Disorder Among Female Sex Workers in the Netherlands,"In this article, the relationship between childhood abuse and neglect and post-traumatic stress disorder (PTSD) in adulthood is examined in a sample of 123 female indoor sex workers in the Netherlands. It was hypothesized that the severity of childhood abuse and neglect is associated with the severity of PTSD. In this study, a substantial number of sex workers had experienced abuse, neglect, or both during childhood. Furthermore, a substantial number suffered from PTSD. Results show significant differences between sex workers suffering from PTSD and sex workers not suffering from PTSD, in the extent to which they have experienced abuse or neglect. Logistic regression analysis shows emotional abuse contributes significantly to the prediction of PTSD. Our findings suggest that the high rate of PTSD among sex workers might be partially related to childhood experiences, indicating that a number of sex workers might be traumatized before entering sex work.",0,0 +3400,A Pilot Study of Acute Stress Symptoms in Parents and Youth Following Diagnosis of Type I Diabetes,"The primary aims of this exploratory study were to determine the rate of occurrence of acute stress disorder (ASD) in children newly diagnosed with Type 1 diabetes and their parents, to examine relationships with demographic and psychosocial factors, and to examine the relationships between ASD symptom clusters and early adherence behavior (clinic attendance). The sample consisted of 102 parents of children ages 0-17 years and 40 youth ages 11-17 who were evaluated within three days of diabetes diagnosis. Eighteen percent of parents and 17% of youth reported subthreshold symptoms of ASD. Acute stress symptoms and demographic variables predicted clinic attendance, with a differential pattern evident in the responses of youth and their parents. These findings reinforce the importance of screening symptoms of ASD in youth with newly diagnosed diabetes and their parents to assist in identifying families who may be in need of additional support. © Springer Science+Business Media, LLC 2011.",0,0 +3401,"PTSD Is a Chronic, Fluctuating Disorder Affecting the Mental Quality of Life in Older Adults","Examine the longitudinal course of posttraumatic stress disorder (PTSD) in older adults and its influence on mental health quality of life (MHQoL).Evaluation performed at baseline, and 3 and 6 months postrandomization as part of a longitudinal trial.A total of 1,185 participants, with a mean (±SD) age of 73.53 (±5.98) years, at seven primary care sites (including five Veterans Affairs clinics), were divided into four groups, namely, no trauma (n = 661), trauma only (n = 319), partial PTSD (n = 114), and PTSD (n = 81), based on reports of trauma and associated PTSD symptoms.The prevalence of comorbid depression, anxiety, and alcohol use disorders, assessed using the Diagnostic and Statistical Manual, Fourth Edition, criteria and changes in MHQoL, as assessed by the Short Form-36 mental component score.At baseline, the PTSD group had higher frequencies of comorbid depression and anxiety disorders and worse MHQoL than the other groups. Both chronic (participants diagnosed with PTSD at all three assessments) and fluctuating (participants moving to or from one of the other groups) trajectories of course were observed during the follow-up period, which appeared to be separate from that of the comorbid disorders. Even after accounting for those comorbid disorders, PTSD had an independent association with poorer MHQoL at multiple time points, especially in men, whereas trauma without PTSD symptoms (trauma only) had better MHQoL.PTSD had chronic and fluctuating courses, with negative effects on MHQoL, while partial PTSD might represent a transitional state, underscoring the need to better identify and treat PTSD at any phase in later life.",0,0 +3402,Response of Post-Mortem Human Head Under Primary Blast Loading Conditions: Effect of Blast Overpressures,"Blast induced neurotrauma (BINT), and posttraumatic stress disorder (PTSD) are identified as the “signature injuries” of recent conflicts in Iraq and Afghanistan. The occurrence of mild to moderate traumatic brain injury (TBI) in blasts is controversial in the medical and scientific communities because the manifesting symptoms occur without visible injuries. Whether the primary blast waves alone can cause TBI is still an open question, and this work is aimed to address this issue. We hypothesize that if a significant level of intracranial pressure (ICP) pulse occurs within the brain parenchyma when the head is subjected to pure primary blast, then blast induced TBI is likely to occur. In order to test this hypothesis, three post mortem human heads are subjected to simulated primary blast loading conditions of varying intensities (70 kPa, 140 kPa and 200 kPa) at the Trauma Mechanics Research Facility (TMRF), University of Nebraska-Lincoln. The specimens are placed inside the 711 mm × 711 mm square shock tube at a section where known profiles of incident primary blast (Friedlander waveform in this case) are obtained. These profiles correspond to specific field conditions (explosive strength and stand-off distance). The specimen is filled with a brain simulant prior to experiments. ICPs, surface pressures, and surface strains are measured at 11 different locations on each post mortem human head. A total of 27 experiments are included in the analysis. Experimental results show that significant levels of ICP occur throughout the brain simulant. The maximum peak ICP is measured at the coup site (nearest to the blast) and gradually decreases towards the countercoup site. When the incident blast intensity is increased, there is a statistically significant increase in the peak ICP and total impulse (p<0.05). Even after five decades of research, the brain injury threshold values for blunt impact cases are based on limited experiments and extensive numerical simulations; these are still evolving for sports-related concussion injuries. Ward in 1980 suggested that no brain injury will occur when the ICP<173 kPa, moderate to severe injury will occur when 173 kPa<ICP<235 kPa and severe injury will occur when ICP>235 kPa for blunt impacts. Based on these criteria, no injury will occur at incident blast overpressure level of 70 kPa, moderate to severe injuries will occur at 140 kPa and severe head injury will occur at the incident blast overpressure intensity of 200 kPa. However, more work is needed to confirm this finding since peak ICP alone may not be sufficient to predict the injury outcome.",0,0 +3403,Reduction of Nightmares and Other PTSD Symptoms in Combat Veterans by Prazosin: A Placebo-Controlled Study,"Prazosin is a centrally active alpha(1) adrenergic antagonist. The authors' goal was to evaluate prazosin efficacy for nightmares, sleep disturbance, and overall posttraumatic stress disorder (PTSD) in combat veterans.Ten Vietnam combat veterans with chronic PTSD and severe trauma-related nightmares each received prazosin and placebo in a 20-week double-blind crossover protocol.Prazosin (mean dose=9.5 mg/day at bedtime, SD=0.5) was superior to placebo for the three primary outcome measures: scores on the 1) recurrent distressing dreams item and the 2) difficulty falling/staying asleep item of the Clinician-Administered PTSD Scale and 3) change in overall PTSD severity and functional status according to the Clinical Global Impression of change. Total score and symptom cluster scores for reexperiencing, avoidance/numbing, and hyperarousal on the Clinician-Administered PTSD Scale also were significantly more improved in the prazosin condition, and prazosin was well tolerated.These data support the efficacy of prazosin for nightmares, sleep disturbance, and other PTSD symptoms.",0,0 +3404,Substance Use And Misuse After Disasters:,"Introduction Exposure to various traumatic events, as well as resulting disturbances such as posttraumatic stress disorder (PTSD), is associated with increased substance use (Breslau, Davis, & Schultz, 2003; Feldner, Babson, & Zvolensky, 2007; McFarlane, 1998; Morissette, Tull, Gulliver, Kamholz, & Zimering, 2007; Stewart, 1996). In particular, studies have shown that alcohol and tobacco consumption increase through both initiation of and increasing use of these substances. It is, however, unclear whether this is also true in the aftermath of large-scale catastrophes or disasters. The distinction between individual traumatic experiences and collective experiences (e.g., disasters) may be sometimes unclear (Galea, Nandi, & Vlahov, 2005). Moreover, comorbidity profiles of PTSD and substance use and misuse, as well as the population under study, may differ between types of trauma (Deering, Glover, Ready, Eddleman, & Alarcon, 1996). Insight into substance use and misuse after disaster is important for several reasons. First, similar to PTSD and other mental health disturbances, understanding the prevalence of substance use and misuse after disasters is necessary in estimating the need for mental health services (see Cao, McFarlane, & Klimidis, 2003) and in organizing programs to prevent prolonged and increased use to minimize adverse affects on health and functioning. Second, information on comorbidity (e.g., PTSD, depression), correlates, and predictors of substance use may help to identify victims who are at risk for substance disorders and increased substance use in the short, medium and/or long term. © Cambridge University Press 2009.",0,0 +3405,Comorbid Chronic Pain and Posttraumatic Stress Disorder Across the Lifespan: A Review of Theoretical Models,"(from the chapter) The primary aim of this chapter is to provide a critical review and synthesis of the existing literature investigating the relationship between chronic pain and posttraumatic stress disorder (PTSD). The chapter begins with a presentation of the diagnostic criteria, prevalence, and theoretical models of chronic pain and PTSD. Research is then presented describing the co-occurrence of the two disorders, and several theoretical models are highlighted that may serve to explain the similar mechanisms by which these two disorders may be maintained. This chapter then addresses how comorbid chronic pain and PTSD may present differently in youth, with consideration of how theoretical models of the comorbidity of pain and PTSD may be modified to incorporate developmental factors. Furthermore, the chapter helps to explicate how the experience of comorbid chronic pain and PTSD can vary from childhood to adulthood. Finally, the chapter closes with a section on implications for treatment as well as a call for continued research to further refine the models reviewed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +3406,Interpersonal Conflict and Referrals to Counseling Among Married Soldiers Following Return From Deployment,"Deployment represents a significant potential strain on military families. The impact of postdeployment stresses may be increased if family coping resources are diminished by returning service members' physical injuries, mental health issues, or substance abuse. This article examines the health and mental health correlates of self-reported concerns regarding interpersonal conflict among married soldiers following return from deployment and the likelihood that soldiers acknowledging such concerns are referred to counseling services. Among 20,166 married Army soldiers completing Post-Deployment Health Reassessments, 18% reported having experienced serious interpersonal conflict with their spouse, family members, close friends, or coworkers. Results indicate that interpersonal conflict was more common among those who reported health problems, depression, post-traumatic stress disorder, and alcohol abuse. Among soldiers reporting interpersonal conflict and not already receiving services, 11% were referred to service. Findings support the need to communicate with soldiers and their spouses about the availability of services following return from deployment and to continue efforts to reduce stigma associated with seeking treatment.",0,0 +3407,A Second Look at Prior Trauma and the Posttraumatic Stress Disorder Effects of Subsequent Trauma,"Previous studies showed increased probability of a posttraumatic stress disorder (PTSD) effect of trauma in persons who had experienced prior trauma. The evidence comes chiefly from retrospective data on earlier events, obtained from trauma-exposed persons with and without PTSD. A generally overlooked major limitation is the failure to assess the PTSD response to the prior trauma.To estimate the risk of PTSD after traumas experienced during follow-up periods in relation to respondents' prior traumatic events and PTSD.A cohort study of young adults interviewed initially in 1989, with repeated assessments during a 10-year follow-up.The sample was randomly selected from a large health maintenance organization in Southeast Michigan, representing the geographic area.The relative risk of PTSD precipitated by traumatic events occurring during follow-up periods in relation to prior exposure and PTSD that had occurred during preceding periods, estimated by general estimating equations (n = 990).The conditional risk of PTSD during the follow-up periods was significantly higher among trauma-exposed persons who had experienced prior PTSD, relative to those with no prior trauma (odds ratio, 3.01; 95% confidence interval, 1.52-5.97). After adjustment for sex, race, education, and preexisting major depression and anxiety disorders, the estimates were only marginally revised. In contrast, the conditional risk of PTSD during follow-up among trauma-exposed persons who had experienced prior traumatic events but not PTSD was not significantly elevated, relative to trauma-exposed persons with no prior trauma. The difference between the 2 estimates was significant (P = .005).Prior trauma increases the risk of PTSD after a subsequent trauma only among persons who developed PTSD in response to the prior trauma. The findings suggest that preexisting susceptibility to a pathological response to stressors may account for the PTSD response to the prior trauma and the subsequent trauma.",0,0 +3408,The role of guilt in the development of post-traumatic stress disorder: A systematic review,"Post-traumatic stress disorder (PTSD) can be a debilitating condition associated with a myriad of emotions. Guilt is an important associated feature of PTSD that has received far less recognition than other symptoms often associated with fear and intense threat. The nature of the relationship between guilt and PTSD remains elusive and requires further clarification. The aim of the current paper was to review the extant literature regarding the link between guilt and PTSD.A systematic database search of PsycINFO, Medline, Embase and Web of Science identified articles that enabled examination of the guilt-PTSD relationship. A total of 27 articles met inclusion criteria for this review.There were cross-sectional relationships between guilt and PTSD symptomology with evidence of associations between PTSD symptoms and cognitions related to perceived wrong doing and self-blame. However, the direction of association between guilt and PTSD is unclear and possibly confounded by overlapping constructs such as shame.The review is constrained by the absence of longitudinal and experimental research and studies, which control for potential confounding variables. The reliability and validity of measures of guilt and PTSD is also not consistently reported.This review outlines four competing models of the guilt-PTSD relationship and examines existing evidence linking the two constructs. The current literature is too preliminary to offer any strong support for one model over the other. However, in critically appraising existing studies, this review helps to inform the design of future studies investigating the association between guilt and PTSD.",0,0 +3409,Suicide in the US Army,"Suicide in the US Army is a high-profile public health problem that is complex and poorly understood. Adding to the confusion surrounding Army suicide is the challenge of defining and understanding individuals/populations dying by suicide. Data from recent studies have led to a better understanding of risk factors for suicide that may be specifically associated with military service, including the impact of combat and deployment on increased rates of psychiatric illness in military personnel. The next steps involve applying these results to the development of empirically supported suicide prevention approaches specific to the military population. This special article provides an overview of suicide in the Army by synthesizing new information and providing clinical pearls based on research evidence.",0,0 +3410,Work-related quality of life and posttraumatic stress disorder symptoms among female veterans.,"Posttraumatic stress disorder (PTSD) can have pervasive, negative effects on multiple aspects of quality of life. We investigated the relationship between PTSD symptom clusters and work-related quality of life among female veterans. Although prior studies have shown that PTSD symptom clusters are differentially related to work-related quality of life, no study has assessed these relationships in women specifically.Participants were 253 female veterans with current PTSD. We assessed three components of work-related quality of life (employment status, clinician-rated occupational impairment, and self-rated occupational satisfaction) and performed analyses with and without adjusting for self-reported depression symptoms.None of the PTSD symptom clusters were associated with employment status. All PTSD symptom clusters had significant independent associations with occupational impairment. All PTSD symptom clusters except avoidance were significantly associated with lower occupational satisfaction, but none had independent associations with occupational satisfaction. No single PTSD symptom cluster emerged as most strongly associated with occupational outcomes. Symptoms of depression had substantial associations across all occupational outcomes, independent of PTSD symptoms.Knowledge about how PTSD relates to occupational outcomes in women veterans is important for addressing the needs of this growing segment of the VA patient population, in which PTSD is a prevalent condition. Because PTSD had differential relationships with the three components of work-related quality of life, measuring only one component, or using an aggregate measure, may obscure important distinctions. Resolving depression symptoms also may be integral to achieving meaningful recovery.",0,0 +3411,Treatment-related reductions in PTSD and changes in physical health symptoms in women,"This study examined the relationship between change in posttraumatic stress disorder (PTSD) symptoms over the course of PTSD treatment and the association with changes in general physical health symptoms. Both positive health habits (e.g., exercise) and negative (e.g., smoking), were examined to determine if they accounted for the association between changes in PTSD severity over time and changes in physical health. Participants were 150 women seeking treatment for PTSD. Latent growth curve modeling indicated a substantial relationship (R 2 = 34 %) between changes in PTSD and changes in physical health that occurred during and shortly following treatment for PTSD. However, there was no evidence to suggest that changes in health behaviors accounted for this relationship. Thus, PTSD treatment can have beneficial effects on self-reported physical health symptoms, even without direct treatment focus on health per se, and is not accounted for by shifts in health behavior. © 2013 Springer Science+Business Media New York (outside the USA).",0,0 +3412,A prospective investigation of the role of cognitive factors in persistent Posttraumatic Stress Disorder (PTSD) after physical or sexual assault,"The effectiveness of psychological treatments for PTSD is likely to be enhanced by improved understanding of the factors involved in maintaining the disorder. Ehlers and Clark [A cognitive model of persistent posttraumatic stem disorder Behav. Res. Ther. 38 (2000) 319-345] recently proposed a cognitive model of maintenance. The current study aimed to investigate several cognitive factors highlighted in Ehlers and Clark's model using a prospective design. Fifty-seven victims of physical or sexual assault participated in the study. Cognitive factors were assessed within 4 months of assault and victims were followed-up 6 and 9 months after the assault. Cognitive variables which significantly predicted PTSD severity at both follow-ups were: cognitive processing style during assault (mental defeat, mental confusion, detachment); appraisal of assault sequelae (appraisal of symptoms, perceived negative responses of others, permanent change); negative beliefs about self and world; and maladaptive control strategies (avoidance/safety seeking). Relationships between early appraisals, control strategies, and processing styles and subsequent PTSD severity remained significant after statistically controlling for gender and perceived assault severity. These findings support the cognitive model of PTSD proposed by Ehlers and Clark and suggest that effective treatment will need to address these cognitive factors.",0,0 +3413,Pharmacotherapy of post-traumatic stress disorder,"In the Diagnostic and Statistical Manual of Mental Disorders (DSM)-III, DSM-III-R and DSM-IV, the diagnosis of post-traumatic stress disorder (PTSD) requires the presence of three symptom clusters: re-experiencing, avoidance and hyperarousal. The selective serotonin reuptake inhibitors (SSRIs), in particular sertraline and paroxetine, have emerged as the treatment of choice for trauma victims experiencing these three symptom clusters. While not approved by the U.S. Food and Drug Administration, other pharmacological agents are often used, some for symptoms found in victims of early, chronic or extreme stress. Referred to as having type II trauma, complex PTSD, disorders of extreme stress and enduring personality change after catastrophic experience, these patients, with symptoms such as dissociation, somatization and self-injurious behavior, need to be recognized as suffering from a trauma-related disorder qualitatively different from that presently captured in the DSM-IV. In this paper we will refer to DSM-IV's construct as simple PTSD (sPTSD); to complex PTSD/disorders of extreme stress as cPTSD/DES; and to both as PTSD. We will review existing evidence for the efficacy of SSRIs in treating sPTSD as well as different pharmacological interventions that are necessary for the treatment of cPTSD/DES. In addition, since both sPTSD and cPTSD/DES frequently coexist with other mental disorders, treatment of comorbid PTSD will be addressed. Finally, given that existing rating scales are not designed to measure symptoms of cPTSD/DES, we will describe the Symptoms of Trauma Scale (SOTS), designed to measure symptoms of both sPTSD and cPTSD.",0,0 +3414,Beware of multiple traumas in PTSD assessment: the role of reactivation mechanism in intrusive and hyper-arousal symptoms,"Post-traumatic stress disorder (PTSD) is a major public health problem defined by three symptom clusters: intrusion thoughts, avoidance mechanisms and hyper-arousal. Several authors have emphasized, that some or all of these symptoms related to a past traumatic experience could be reactivated, even after long asymptomatic periods. This study investigates the role of an additional trauma in the reactivation of a childhood trauma among a group of former hidden children (n = 65), the Jewish youths who spent World War II in various hideaway shelters in Nazi-occupied Europe. They were compared with a control group.The presence or absence of an additional trauma in adulthood was assessed and PTSD symptoms were measured by using the Impact of Event Scale-Revised.An additional trauma reactivates PTSD symptoms of intrusion thoughts and, marginally, symptoms of hyper-arousal. At the opposite, symptoms of avoidance were not reactivated.Our results confirm the role of an additional trauma in the reactivation of traumatic memories, related to an earlier trauma, in later life. Clinical and theoretical implications are discussed and perspectives are proposed.",0,0 +3415,ACUTE POST-TRAUMATIC STRESS DISORDER IN PRISONERS OF WAR RELEASED FROM DETENTION CAMPS,"The aim of the present study was to assess acute psychiatric disturbances in Croatian prisoners of war (POWs) released after 6-9 months of detention. Immediately (1-3 days) after exchange with the other side, 47 prisoners of war were examined at the Zagreb University Clinic for Infectious Diseases by a team of medical professionals to assess their physical and psychological health, and therapeutic needs. The team consisted of a general practitioner, surgeon, infectious diseases specialist, psychiatrist and clinical psychologist. All prisoners were active soldiers from Vukovar, and were of similar age, social background, combat activity and duration of detention. All were severely physically and psychically maltreated in the detention camp. Sixteen (34%) had symptoms of current post-traumatic stress syndrome as assessed by the Watsons PTSD questionnaire. In a structured clinical interview, all POWs reported at least 2 (average 8-9) symptoms of psychological disturbance. All POWs ranked the withdrawal of information on their families and the situation in Croatia as the most painful experience during detention. Minnesota Multiphasic Personality Inventory (MMPI-201 version) profiles of the prisoners of war showed a significant difference between the POWs with and without diagnosed PTSD on the paranoia scale. In conclusion, although only one third of the POWs released after 6-9 months of detention and torture had manifest PTSD, most had several symptoms of psychological disturbances with dominating anxiotic-depressive and psychosomatic reactions. Careful follow-up is needed to asses the extent and late consequences of polytrauma experienced by this high-risk group.",0,0 +3416,Hurricane Andrew's Landfall in South Florida. Part II: Surface Wind Fields and Potential Real-Time Applications,"All available wind data associated with Hurricane Andrew’s passage were analyzed for periods corresponding to landfall south of Miami and emergence from southwest Florida. At landfall in southeast Florida, maximum sustained 1-min surface wind speeds VM1 reached just over 60 m s 01 in the northern eyewall over land; by the time Andrew exited the Florida peninsula, the peak value of VM1 over land decreased to 40 ‐ 45 m s 01 . Radar reflectivity observations from Tampa and Melbourne could not support an obvious correlation of convective cell development with coastal convergence during landfall on the southeast coast. On the southwest coast, however, convective cell development in the southern eyewall was supported by a coastal convergence maximum. Comparison of the wind swath with two independent Fujita-scale damage maps indicated that peak swath speeds compared well with damage-derived speed equivalents in the worst damaged areas but were higher than equivalents in moderately damaged areas. Comparison of the analysis maximum wind swath with an engineering survey of damaged homes suggests that homes exposed to a wide range of wind directions while subjected to high wind speeds suffered the most damage. Potential real-time applications of wind field products include warning dissemination, emergency management, storm surge and wave forecasting, and wind engineering. Development of damage assessment models for disaster mitigation is addressed from the viewpoint of an electrical utility.",0,0 +3417,Neuropathic Ocular Pain due to Dry Eye Is Associated With Multiple Comorbid Chronic Pain Syndromes,"Recent data show that dry eye (DE) susceptibility and other chronic pain syndromes (CPS) such as chronic widespread pain, irritable bowel syndrome, and pelvic pain, might share common heritable factors. Previously, we showed that DE patients described more severe symptoms and tended to report features of neuropathic ocular pain (NOP). We hypothesized that patients with a greater number of CPS would have a different DE phenotype compared with those with fewer CPS. We recruited a cohort of 154 DE patients from the Miami Veterans Affairs Hospital and defined high and low CPS groups using cluster analysis. In addition to worse nonocular pain complaints and higher post-traumatic stress disorder and depression scores (P < .01), we found that the high CPS group reported more severe neuropathic type DE symptoms compared with the low CPS group, including worse ocular pain assessed via 3 different pain scales (P < .05), with similar objective corneal DE signs. To our knowledge, this was the first study to show that DE patients who manifest a greater number of comorbid CPS reported more severe DE symptoms and features of NOP. These findings provided further evidence that NOP might represent a central pain disorder, and that shared mechanistic factors might underlie vulnerability to some forms of DE and other comorbid CPS.DE patients reported more frequent CPS (high CPS group) and reported worse DE symptoms and ocular and nonocular pain scores. The high CPS group reported symptoms of NOP that share causal genetic factors with comorbid CPS. These results imply that an NOP evaluation and treatment should be considered for DE patients.",0,0 +3418,Commentary: Women in combat and the risk of post-traumatic stress disorder and depression,"Studies among civilian populations have consistently shown that when compared with men, women have significantly higher prevalence rates of depression and anxiety disorders, including post-traumatic stress disorder (PTSD). Studies of general military populations in garrison have paralleled findings from civilian studies. Research on the gender differences associated with military deployment, such as Vietnam, Persian Gulf War, or peacekeeping operations, has found inconsistent results. These studies are not representative of current extended combat deployments in Iraq or Afghanistan, war zones that lack traditional front lines and in which women are serving in roles that put them at greater risk than in the past. Although women are excluded from serving in direct combat specialties, such as infantry or armour, and are therefore not at the same risk as male soldiers, they do serve in a variety of support positions where they travel outside military bases, work alongside combat soldiers, come under direct fire and may become casualties. These positions include military police, transportation, intelligence, pilots, medics, mechanics, civil affairs and other roles. Among the 3004 US fatalities from Iraq reported through 31 December 2006, 66 (2.2%) were women; among 127 UK fatalities, 3 (2.4%) were women. About two-thirds of these deaths involved hostile fire. In contrast, only one woman was reported to have died by hostile fire in Vietnam and five in the Persian Gulf War. An important unanswered question is whether there are gender differences in the risk of PTSD and other mental health problems among men and women exposed to similar levels of combat. The article by Dr Rona and colleagues is notable for being one of the first studies of gender differences in mental health concerns associated with deployment to the Iraq combat theatre. This study paves the way for future efforts to understand gender differences in the mental health impact of operations in Iraq and Afghanistan. The article reports a number of different findings among veterans of two wars and era controls that includes a trend analysis of changes in the health of UK military veterans between 1997 and 2005 in addition to the gender comparisons. The trend analysis is difficult to interpret due to the crosssectional design, lack of uniformity in the survey instruments (especially for the alcohol measure), demographic differences between the samples, differences in the prevalence of combat experiences and markedly different time frames for surveying following the return from deployment. Within the context of this larger effort, however, there are important comparisons of the prevalence of mental health concerns by gender for each cross-sectional deployed sample. Among the deployed Iraq War study group in the Rona et al. study, 26.7% of women compared with 19.8% of men reported high levels of psychological distress on the General Health Questionnaire (GHQ), a measure made up of questions pertaining mostly to depression. However, this difference in prevalence between men and women is considerably smaller than the differences found in most studies of civilian and non-deployed military populations. In terms of post-traumatic stress symptoms among Iraq War veterans, most notable was the lack of gender differences, which contrasts with the marked gender differences reported in many studies on PTSD in both civilian and military populations. In the study by Rona et al., 8.4% of women and 7.1% of men met the criteria for post-traumatic stress reaction and a smaller percentage met full criteria for PTSD. This finding suggests that combat deployment to Iraq is not associated with a higher risk of mental health problems among female compared with male service members, at least during the time frame that was measured, relatively proximal to homecoming. Some additional evidence from the United States supports the findings by Rona and colleagues regarding the minimal gender differences in mental health outcomes. All US troops receive a brief mental health assessment for depressive symptoms, posttraumatic stress symptoms, and concerns about family and relationship functioning when they return from deployment. Among the first 222 620 Army and Marine service members (10.6% of whom were women) who completed this assessment after returning from Iraq, 24% of the women reported some sort of mental health concern compared with 19% of the men, prevalences remarkably similar to the GHQ measures seen among UK–Iraq War service members. A more detailed survey was conducted among a sample of 2064 US soldiers (including 288 females) from infantry and combat support units during the middle of a year-long deployment to Iraq or Kuwait (August–October 2004). Among this sample, 13% of the male soldiers and 12% of the female y To accompany the article by Rona RJ, Fear NT, Hull L, Wessely S. ‘‘Women in novel occupational roles: mental health trends in the UK armed forces.’’",0,0 +3419,Symptoms of PTSD Associated With Painful and Nonpainful Vicarious Reactivity Following Amputation,"Although the experience of vicarious sensations when observing another in pain have been described postamputation, the underlying mechanisms are unknown. We investigated whether vicarious sensations are related to posttraumatic stress disorder (PTSD) symptoms and chronic pain. In Study 1, 236 amputees completed questionnaires about phantom limb phenomena and vicarious sensations to both innocuous and painful sensory experiences of others. There was a 10.2% incidence of vicarious sensations, which was significantly more prevalent in amputees reporting PTSD-like experiences, particularly increased arousal and reexperiencing the event that led to amputation (φ = .16). In Study 2, 63 amputees completed the Empathy for Pain Scale and PTSD Checklist-Civilian Version. Cluster analyses revealed 3 groups: 1 group did not experience vicarious pain or PTSD symptoms, and 2 groups were vicarious pain responders, but only 1 had increased PTSD symptoms. Only the latter group showed increased chronic pain severity compared with the nonresponder group (p = .025) with a moderate effect size (r = .35). The findings from both studies implicated an overlap, but also divergence, between PTSD symptoms and vicarious pain reactivity postamputation. Maladaptive mechanisms implicated in severe chronic pain and physical reactivity posttrauma may increase the incidence of vicarious reactivity to the pain of others.",0,0 +3420,Genome-wide Epigenetic Regulation by Early-Life Trauma,"Our genome adapts to environmental influences, in part through epigenetic mechanisms, including DNA methylation. Variations in the quality of the early environment are associated with alterations in DNA methylation in rodents, and recent data suggest similar processes in humans in response to early-life adversity.To determine genome-wide DNA methylation alterations induced by early-life trauma.Genome-wide study of promoter methylation in individuals with severe abuse during childhood. PATIENTS, SETTING, AND MAIN OUTCOME MEASURES: Promoter DNA methylation levels were profiled using methylated DNA immunoprecipitation followed by microarray hybridization in hippocampal tissue from 41 French-Canadian men (25 with a history of severe childhood abuse and 16 control subjects). Methylation profiles were compared with corresponding genome-wide gene expression profiles obtained by messenger RNA microarrays. Methylation differences between groups were validated on neuronal and nonneuronal DNA fractions isolated by fluorescence-assisted cell sorting. Functional consequences of site-specific promoter methylation were assessed by luciferase assays.We identified 362 differentially methylated promoters in individuals with a history of abuse compared with controls. Among these promoters, 248 showed hypermethylation and 114 demonstrated hypomethylation. Validation and site-specific quantification of DNA methylation in the 5 most hypermethylated gene promoters indicated that methylation differences occurred mainly in the neuronal cellular fraction. Genes involved in cellular/neuronal plasticity were among the most significantly differentially methylated, and, among these, Alsin (ALS2) was the most significant finding. Methylated ALS2 constructs mimicking the methylation state in samples from abused suicide completers showed decreased promoter transcriptional activity associated with decreased hippocampal expression of ALS2 variants.Childhood adversity is associated with epigenetic alterations in the promoters of several genes in hippocampal neurons.",0,0 +3421,Posttraumatic stress disorder: An exploratory study examining rates of trauma and PTSD and its effect on client outcomes in community mental health,"BackgroundRates of trauma and Posttraumatic Stress Disorder (PTSD) were examined in order to compare the profile in clients of an Australian Public Mental Health Service with that reported in the international literature for clients with major mental illness and to explore the effect of this on client health outcomes. Potential factors contributing to increased levels of trauma/PTSD in this group of clients and the issue of causality between PTSD and subsequent mental illness was also explored.MethodsA convenience sample of 29 clients was screened for trauma and PTSD using the Posttraumatic Stress Diagnostic Scale™ (PDS) and selected outcome measures. Paired and independent samples t-test and ANOVA were applied to the data.ResultsHigh levels of undocumented trauma and PTSD were found. Twenty clients, (74%) reported exposure to multiple traumatic events; 33.3% (9) met DSM IV diagnostic criteria for PTSD. Significant difference was found for PTSD symptomatology, severity and impairment and for client and clinician-rated scores of Quality of Life (QOL) outcomes in the PTSD group. No effect for PTSD symptomatology on the Working Alliance (WA) was found. Factors that may influence higher rates of PTSD in this group were identified and included issues associated with the population studied, the predominance of assaultive violence found, and vulnerability and risks factors associated with re-traumatisation within the social and treating environments.ConclusionA similar trauma and PTSD profile to that reported in the international literature, including greater levels of trauma and PTSD and a poorer QOL, was found in this small sample of clients. It is postulated that the increased levels of trauma/PTSD as reported for persons with major mental illness, including those found in the current study, are primarily related to the characteristics of the population that access public mainstream psychiatric services and that these factors have specific implications for service delivery, and raise issues of efficiency and effectiveness of resource use in achieving successful outcomes in public mental health services for clients with co-morbid PTSD. Further research with a more rigorous design is needed to test these preliminary findings within Australian Community Mental Health Services.",0,0 +3422,Stress-Induced Lipocalin-2 Controls Dendritic Spine Formation and Neuronal Activity in the Amygdala,"Behavioural adaptation to psychological stress is dependent on neuronal plasticity and dysfunction at this cellular level may underlie the pathogenesis of affective disorders such as depression and post-traumatic stress disorder. Taking advantage of genome-wide microarray assay, we performed detailed studies of stress-affected transcripts in the amygdala - an area which forms part of the innate fear circuit in mammals. Having previously demonstrated the role of lipocalin-2 (Lcn-2) in promoting stress-induced changes in dendritic spine morphology/function and neuronal excitability in the mouse hippocampus, we show here that the Lcn-2 gene is one of the most highly upregulated transcripts detected by microarray analysis in the amygdala after acute restraint-induced psychological stress. This is associated with increased Lcn-2 protein synthesis, which is found on immunohistochemistry to be predominantly localised to neurons. Stress-naïve Lcn-2(-/-) mice show a higher spine density in the basolateral amygdala and a 2-fold higher rate of neuronal firing rate compared to wild-type mice. Unlike their wild-type counterparts, Lcn-2(-/-) mice did not show an increase in dendritic spine density in response to stress but did show a distinct pattern of spine morphology. Thus, amygdala-specific neuronal responses to Lcn-2 may represent a mechanism for behavioural adaptation to psychological stress.",0,0 +3423,Posttraumatic Stress Symptom Profiles of Battered Women: A Comparison of Survivors in Two Settings,"This study sought to develop a profile of posttraumatic stress symptoms experienced by battered women and to explore differences among subsamples. Two groups of survivors from five states were compared: 159 who had obtained help at domestic violence programs (DVP) and 33 who had obtained help at other types of programs (NDVP). They completed three self-report measures of posttraumatic stress and a fear questionnaire. Sixty percent of the women in the DVP group and 62% in the NDVP group met criteria for a diagnosis of posttraumatic stress disorder (PTSD). The most common symptoms were: nightmares intrusive memories of the abuse, avoiding reminders of it, and hyperarousal, and nightmares. DVP women experienced a variety of symptoms more frequently. Group differences in PTSD symptomatology were not present after statistically controlling for severity and frequency of the violence and length of time since the abusive relationship.",0,0 +3424,"Measuring resilience after spinal cord injury: Development, validation and psychometric characteristics of the SCI-QOL Resilience item bank and short form","To describe the development and psychometric properties of the Spinal Cord Injury--Quality of Life (SCI-QOL) Resilience item bank and short form.Using a mixed-methods design, we developed and tested a resilience item bank through the use of focus groups with individuals with SCI and clinicians with expertise in SCI, cognitive interviews, and item-response theory based analytic approaches, including tests of model fit and differential item functioning (DIF).We tested a 32-item pool at several medical institutions across the United States, including the University of Michigan, Kessler Foundation, the Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital and the James J. Peters/Bronx Department of Veterans Affairs medical center.A total of 717 individuals with SCI completed the Resilience items.A unidimensional model was observed (CFI=0.968; RMSEA=0.074) and measurement precision was good (theta range between -3.1 and 0.9). Ten items were flagged for DIF, however, after examination of effect sizes we found this to be negligible with little practical impact on score estimates. The final calibrated item bank resulted in 21 retained items.This study indicates that the SCI-QOL Resilience item bank represents a psychometrically robust measurement tool. Short form items are also suggested and computer adaptive tests are available.",0,0 +3425,Social vs. environmental stress models of depression from a behavioural and neurochemical approach,"Major depression is a mental disorder often preceded by exposure to chronic stress or stressful life events. Recently, animal models based on social conflict such as chronic social defeat stress (CSDS) are proposed to be more relevant to stress-induced human psychopathology compared to environmental models like the chronic mild stress (CMS). However, while CMS reproduces specifically core depressive symptoms such as anhedonia and helplessness, CSDS studies rely on the analysis of stress-induced social avoidance, addressing different neuropsychiatric disorders. Here, we study comparatively the two models from a behavioural and neurochemical approach and their possible relevance to human depression. Mice (C57BL/6) were exposed to CMS or CSDS for six weeks and ten days. Anhedonia was periodically evaluated. A battery of test applied during the fourth week after the stress procedure included motor activity, memory, anxiety, social interaction and helplessness. Subsequently, we examined glutamate, GABA, 5-HT and dopamine levels in the prefrontal cortex, hippocampus and brainstem. CMS induced a clear depressive-like profile including anhedonia, helplessness and memory impairment. CSDS induced anhedonia, hyperactivity, anxiety and social avoidance, signs also common to anxiety and posttraumatic stress disorders. While both models disrupted the excitatory inhibitory balance in the prefrontal cortex, CMS altered importantly this balance in the brainstem. Moreover, CSDS decreased dopamine in the prefrontal cortex and brainstem. We suggests that while depressive-like behaviours might be associated to altered aminoacid neurotransmission in cortical and brain stem areas, CSDS induced anxiety behaviours might be linked to specific alteration of dopaminergic pathways involved in rewarding processes.",0,0 +3426,Cognitive Behavioral Therapy for PTSD: The Role of Complex PTSD on Treatment Outcome,"Posttraumatic stress disorder (PTSD) represents an often chronic and debilitating mental illness resulting from exposure to trauma. Although the most compelling evidence for the treatment of PTSD is cognitive behavioral therapy (CBT), many patients experience residual functional impairment, or relapse, suggesting that this approach does not work for all cases of PTSD. Repeated severe trauma, particularly during development, might increase the risk for a more intricate clinical profile, called complex PTSD (CPTSD), which might contribute to poorer treatment response. The following provides a comprehensive summary of the evidence examining whether CPTSD symptomatology is related to poorer treatment outcome of CBT, reviews the literature on the treatment of CPTSD, and offers insights into current issues and future directions of the construct.",0,0 +3427,SWiFT: A Rapid Triage Tool for Vulnerable Older Adults in Disaster Situations,"ABSTRACT Background: In 2005, Hurricane Katrina caused extensive damage to parts of Mississippi, Louisiana, and Alabama, causing many people, including vulnerable older adults, to evacuate to safe surroundings. Approximately 23,000 evacuees—many of them 65 years old or older, frail, and lacking family to advocate for their care—arrived at the Reliant Astrodome Complex in Houston, Texas. There was no method for assessing the immediate and long-term needs of this vulnerable population. Methods: A 13-item rapid needs assessment tool was piloted on 228 evacuees 65 years old and older by the Seniors Without Families Team (SWiFT), to test the feasibility of triaging vulnerable older adults with medical and mental health needs, financial needs, and/or social needs. Results: The average age of the individuals triaged was 66.1 ± 12.72 (mean ± standard deviation [SD]) years. Of these, 68% were triaged for medical and or mental health needs, 18% were triaged for financial assistance, and 4% were triaged for social assistance. More than half of the SWiFT-triaged older adults reported having hypertension. Conclusions: The SWiFT tool is a feasible approach for triaging vulnerable older adults and provides a rapid determination of the level of need or assistance necessary for vulnerable older people during disasters. The tool was only piloted, thus further testing to determine reliability and validity is necessary. Potentially important implications for using such a tool and suggestions for preparing for and responding to disaster situations in which vulnerable older adults are involved are provided. ( Disaster Med Public Health Preparedness . 2008;2(Suppl 1):S45–S50)",0,0 +3428,Personality-guided therapy for posttraumatic stress disorder.,"This practical resource sheds light on the role personality factors play in the genesis and treatment of Posttraumatic Stress Disorder (PTSD). Using Theodore Millon's personality-guided psychology as a framework, the authors provide insight into this challenging disorder. They discuss factors that can help protect against stress or increase vulnerability to stress. They also explore the biological foundations of PTSD and offer practical guidance on how to assess PTSD and how to incorporate an understanding of personality in the formation of the therapeutic alliance.",0,0 +3429,Gender differences in probable posttraumatic stress disorder among police responders to the 2001 World Trade Center terrorist attack,"Police responders to the 2001 World Trade Center (WTC) disaster were previously reported to have an increased prevalence of probable posttraumatic stress disorder (PTSD).Four thousand seventeen police responders (3,435 men and 582 women) were interviewed 2-3 years after 9/11/01 as part of the World Trade Center Health Registry. Demographic, occupational, and event-specific risk factors were evaluated for probable PTSD, determined by DSM-IV criteria using the Posttraumatic Stress Checklist (PCL).Overall prevalence of probable PTSD was 8.3% (women: 13.9%; men: 7.4%, P < 0.001). Risk factors for both genders included 9/11-related injury and older age. For men, specific risk factors were: presence in WTC Towers on 9/11 and Hispanic ethnicity; and for women, witnessing horror and education less than a college degree.Significantly higher prevalence of probable PTSD was found for female police responders. Although consistent with civilian populations, this finding contrasts with other studies of PTSD and WTC rescue and recovery workers, and police prior to 9/11.",0,0 +3430,"Self-reported cannabis use characteristics, patterns and helpfulness among medical cannabis users","Little research has investigated the demographic and symptom profile of medical cannabis users in states in the USA that have legalized cannabis use.In the present cross-sectional study, we investigated the demographic profile of 217 adults currently receiving medical cannabis, as well as differences in problematic use and perceived helpfulness in terms of (i) symptoms of psychological disorders and pain, and (ii) motives for use.Findings indicated that medical cannabis users (i) use and perceive cannabis to be beneficial for multiple conditions, some for which cannabis is not specifically prescribed or allowed at the state level; and (ii) report similar rates of disordered use as compared with population estimates among regular users. Furthermore, problematic cannabis use was predicted by several symptoms of psychological disorders (e.g. depression) and a variety of use motives (e.g. coping), while cannabis was reported as particularly helpful among those with several psychological symptoms (e.g. traumatic intrusions), as well as those reporting use for social anxiety reasons.Results are discussed in terms of future directions for research given the current debates regarding legalization of cannabis for medical purposes and, more generally, the lack of empirical data to inform such debates.",0,0 +3431,Discriminant analysis of posttraumatic stress disorder among a group of Viet Nam veterans,"The authors designed a study to identify those independent variables which would statistically discriminate between a group of Viet Nam veterans who were experiencing posttraumatic stress disorder and those who were not. DSM-III criteria for diagnosis were used to measure and operationally define posttraumatic stress disorder. Five variables distinguished between groups: veterans with the disorder reported a negative perception of their family's helpfulness on return home, a higher level of combat, a more immediate discharge after the war, an external locus of control, and a more supportive attitude toward the war before they entered the service. The authors discuss the implications and limitations of these findings.",0,0 +3432,Evidence-Based Treatment of Anxiety in Patients With Cancer,"Anxiety is a dynamic response to perceived threat that is common among patients with cancer and fluctuates at critical points in the disease trajectory. A substantial minority of patients may experience clinically significant anxiety resulting from a range of potential etiologic factors. This review summarizes evidence-based recommendations for treatment of anxiety in oncology settings. Recommendations are based on the nature and time course of anxiety and the results of meta-analyses, systematic reviews, and individual trials in cancer populations. The evidence-based literature supports the use of psychosocial and psychopharmacologic treatments to prevent or alleviate anxiety symptoms. Conclusions are tempered by study heterogeneity and methodologic limitations and a lack of trials that included patients with clinically significant anxiety. In oncology settings, accessibility and acceptability of evidence-based treatments vary, and patients may seek a variety of resources to manage cancer concerns. Treatment planning should incorporate contributing factors to anxiety and patient preferences for psychiatric care.",0,0 +3433,Perceived injustice in fibromyalgia: Psychometric characteristics of the Injustice Experience Questionnaire and relationship with pain catastrophising and pain acceptance,"To validate a Spanish version of the Injustice Experience Questionnaire (IEQ), a measure of perceived injustice, in a fibromyalgia sample and to examine its relationship with pain catastrophising and pain acceptance.The IEQ was administered along with the Pain Visual Analogue Scale, the Fibromyalgia Impact Questionnaire, the Hospital Anxiety and Depression Scale, the Pain Catastrophizing Scale (PCS) and the Chronic Pain Acceptance Questionnaire (CPAQ) to 250 primary care patients with fibromyalgia.The IEQ had good test-retest reliability (intraclass correlation coefficient=0.98) and internal consistency (Cronbach's α=0.92). The factor structure obtained was similar to the original validation study. The multiple regression analyses showed that perceived injustice (PI) accounted for significant pain-related outcomes after controlling pain intensity, PCS and CPAQ. Principal component analysis of both the IEQ and the CPAQ taken together showed that the two constructs do not represent opposite extremes of the same dimension.The IEQ is a reliable assessment tool for measuring PI among patients with fibromyalgia. PI seems to be distinct from catastrophising, although the two constructs are very similar. The factor analysis showed that PI and acceptance represent related constructs, and this entails relevant implications for therapy, as acceptance-based interventions would be appropriate.",0,0 +3434,Mild Transient Hypercapnia as a Novel Fear Conditioning Stimulus Allowing Re-Exposure during Sleep,"Studies suggest that sleep plays a role in traumatic memories and that treatment of sleep disorders may help alleviate symptoms of posttraumatic stress disorder. Fear-conditioning paradigms in rodents are used to investigate causal mechanisms of fear acquisition and the relationship between sleep and posttraumatic behaviors. We developed a novel conditioning stimulus (CS) that evoked fear and was subsequently used to study re-exposure to the CS during sleep.Experiment 1 assessed physiological responses to a conditioned stimulus (mild transient hypercapnia, mtHC; 3.0% CO2; n = 17)+footshock for the purpose of establishing a novel CS in male FVB/J mice. Responses to the novel CS were compared to tone+footshock (n = 18) and control groups of tone alone (n = 17) and mild transient hypercapnia alone (n = 10). A second proof of principle experiment re-exposed animals during sleep to mild transient hypercapnia or air (control) to study sleep processes related to the CS.Footshock elicited a response of acute tachycardia (30-40 bpm) and increased plasma epinephrine. When tone predicted footshock it elicited mild hypertension (1-2 mmHg) and a three-fold increase in plasma epinephrine. When mtHC predicted footshock it also induced mild hypertension, but additionally elicited a conditioned bradycardia and a smaller increase in plasma epinephrine. The overall mean 24 hour sleep-wake profile was unaffected immediately after fear conditioning.Our study demonstrates the efficacy of mtHC as a conditioning stimulus that is perceptible but innocuous (relative to tone) and applicable during sleep. This novel model will allow future studies to explore sleep-dependent mechanisms underlying maladaptive fear responses, as well as elucidate the moderators of the relationship between fear responses and sleep.",0,0 +3435,World Trade Center disaster and sensitization to subsequent life stress: A longitudinal study of disaster responders,"The current study examined the role of World Trade Center (WTC) disaster exposure (hours spent working on the site, dust cloud exposure, and losing friend/loved one) in exacerbating the effects of post-disaster life stress on posttraumatic stress disorder (PTSD) symptoms and overall functioning among WTC responders.Participants were 18,896 responders (8466 police officers and 10,430 non-traditional responders) participating in the WTC Health Program who completed an initial examination between July, 2002 and April, 2010 and were reassessed an average of two years later.Among police responders, there was a significant interaction, such that the effect of post-disaster life stress on later PTSD symptoms and overall functioning was stronger among police responders who had greater WTC disaster exposure (β's=.029 and .054, respectively, for PTSD symptoms and overall functioning). This moderating effect was absent in non-traditional responders. Across both groups, post-disaster life stress also consistently was related to the dependent variables in a more robust manner than WTC exposure.The present findings suggest that WTC exposure may compound post-disaster life stress, thereby resulting in a more chronic course of PTSD symptoms and reduced functioning among police responders.",0,0 +3436,Development of a Brief Coping Checklist for Use with Pediatric Populations,"Although the process of coping and utilization of coping strategies has received widespread attention in the adult literature, there is a relative dearth of information on these processes in children and adolescents. As the importance of assessing and teaching coping strategies becomes apparent in behavioral medicine with adults, such investigations need to be extended to pediatric populations. The present study describes the development of a brief coping checklist. Preliminary psychometric investigations conducted with healthy adolescents demonstrated adequate reliability at 3-day, 7-day, 14-day, and 10-week intervals and concurrent validity with previously established measures of coping. The utility of the checklist with pediatric patients and in particular chronically ill children is also examined.",0,0 +3437,Psychopathology Among New York City Public School Children 6 Months After September 11,"Children exposed to a traumatic event may be at higher risk for developing mental disorders. The prevalence of child psychopathology, however, has not been assessed in a population-based sample exposed to different levels of mass trauma or across a range of disorders.To determine prevalence and correlates of probable mental disorders among New York City, NY, public school students 6 months following the September 11, 2001, World Trade Center attack.Survey.New York City public schools.A citywide, random, representative sample of 8236 students in grades 4 through 12, including oversampling in closest proximity to the World Trade Center site (ground zero) and other high-risk areas.Children were screened for probable mental disorders with the Diagnostic Interview Schedule for Children Predictive Scales.One or more of 6 probable anxiety/depressive disorders were identified in 28.6% of all children. The most prevalent were probable agoraphobia (14.8%), probable separation anxiety (12.3%), and probable posttraumatic stress disorder (10.6%). Higher levels of exposure correspond to higher prevalence for all probable anxiety/depressive disorders. Girls and children in grades 4 and 5 were the most affected. In logistic regression analyses, child's exposure (adjusted odds ratio, 1.62), exposure of a child's family member (adjusted odds ratio, 1.80), and the child's prior trauma (adjusted odds ratio, 2.01) were related to increased likelihood of probable anxiety/depressive disorders. Results were adjusted for different types of exposure, sociodemographic characteristics, and child mental health service use.A high proportion of New York City public school children had a probable mental disorder 6 months after September 11, 2001. The data suggest that there is a relationship between level of exposure to trauma and likelihood of child anxiety/depressive disorders in the community. The results support the need to apply wide-area epidemiological approaches to mental health assessment after any large-scale disaster.",0,0 +3438,The Human Capacity to Thrive in the Face of Potential Trauma,"For decades, researchers have documented remarkable levels of resilience in children who were exposed to corrosive early environments, such as those in which poverty or chronic maltreatment were present; however, relatively little research has examined resilience in children or adults who were exposed to isolated and potentially traumatic events. The historical emphasis on psychological and physiologic dysfunction after potentially traumatic events has suggested that such events almost always produce lasting emotional damage. Recent research, however, has consistently shown that across different types of potentially traumatic events, including bereavement, serious illness, and terrorist attack, upward of 50% of people have been found to display resilience. Research has further identified substantial individual variation in response to potentially traumatic events, including 4 prototypical and empirically derived outcome trajectories: chronic dysfunction, recovery, resilience, and delayed reactions. Factors that promote resilience are heterogeneous and include a variety of person-centered variables (eg, temperament of the child, personality, coping strategies), demographic variables (eg, male gender, older age, greater education), and sociocontextual factors (eg, supportive relations, community resources). It is surprising that some factors that promote resilience to potentially traumatic events may be maladaptive in other contexts, whereas other factors are more broadly adaptive. Given the growing evidence that resilience is common, psychotherapeutic treatment should be reserved for those in genuine need.",0,0 +3439,Does Time Heal all Wounds? : A Longitudinal Study of Development of Posttraumatic Stress Symptoms in Parents of Children With Cancer,Does Time Heal all Wounds? : A Longitudinal Study of Development of Posttraumatic Stress Symptoms in Parents of Children With Cancer,0,0 +3440,Post-traumatic stress symptoms among mothers of children with leukemia undergoing treatment: a longitudinal study,"To assess post-traumatic stress symptoms (PTSS) in mothers of children over 2 years of leukemia treatment, to identify possible early family and child predictors of this symptomatology and to indicate the temporal trajectory of PTSS.Participants were 76 Italian mothers (mean age = 37.30 years; SD = 6.07) of children receiving treatment for acute lymphoblastic (n = 69) or myeloid (n = 7) leukemia. Mothers had 12.05 years of education (SD = 3.87), and their incomes were average (52.1%), high (26%) and low (21.9%) for Italian norms, never in poverty. The pediatric patients with leukemia were equally distributed by gender with their mean age of 7.10 years (SD = 4.18). Post-traumatic stress symptoms were measured by a 17-item checklist. Scales assessing anxiety, depression, physical (Brief Symptom Inventory 18) and cognitive functioning (Problem Scale), and life evaluation were also used. There were five assessment points: 1 week (T1), 1 month (T2), 6 months (T3), 12 months (T4) and 24 months post-diagnosis (T5).The main results indicated moderate presence of clinical PTSS (≥9 symptoms: 24% at T2, 18% at T3, 16% at T4 and 19% at T5) that remained stable across time points, whereas Brief Symptom Inventory 18 Global score decreased and life evaluation improved. A series of hierarchical regression models identified cognitive functioning early after the diagnosis as the best predictive factor of PTSS across time points.Specific psychological interventions could be devised for mothers at risk for short and long-term PTSS just after the diagnosis.",0,0 +3441,Trajectories of Posttraumatic Stress Symptoms in Significant Others of Patients With Severe Traumatic Brain Injury,"Long-term psychological distress has been reported among significant others of patients who sustained a traumatic brain injury (TBI). This study examined the course and potential predictors of posttraumatic stress symptoms in a relative sample (N = 135) drawn from a national cohort study on severe TBI in Switzerland. Latent growth mixture model analyses revealed two main groups: Across 3, 6, and 12 months after the accident, 63% of the sample indicated fairly low symptom severity (“resilient” course), whereas 37% showed persistence of “higher distress” as indicated by elevated scores on the Impact of Event Scale–Revised. Group membership was significantly associated with self-reported dysfunctional disclosure style. Implications for research and practice are discussed.",0,0 +3442,"Child Sexual Abuse, Post-Traumatic Stress Disorder, and Substance Use: Predictors of Revictimization in Adult Sexual Assault Survivors","This study examined the unique effects of child sexual abuse simultaneously with post-traumatic stress disorder symptom clusters, problem drinking, and illicit drug use in relation to sexual revictimization in a community sample of female adult sexual assault victims. Participants (N=555) completed two surveys a year apart. Child sexual abuse predicted more post-traumatic stress disorder symptoms in adult sexual assault victims. Posttraumatic stress disorder numbing symptoms directly predicted revictimization, whereas other post-traumatic stress disorder symptoms (reexperiencing, avoidance, and arousal) were related to problem drinking, which in turn predicted revictimization. Thus, numbing symptoms and problem drinking may be independent risk factors for sexual revictimization in adult sexual assault victims, particularly for women with a history of childhood sexual abuse.",0,0 +3443,"Characteristics of Successful Fakers versus Unsuccessful Fakers: Is Empathy, Intelligence, Or Personality Associated with Faking PTSD on the MMPI-2?","Moyer, Burkhardt, and Gordon found in 2002 that some individuals could fake PTSD on the MMPI-2. In light of these results, a follow-up study was conducted to assess whether attributes such as empathy, intelligence, subjectivity, or insightfulness influenced ability to fake a PTSD profile on the MMPI-2. 35 subjects from the previous study were divided into two groups, successful fakers and unsuccessful fakers. Analysis indicated no significant differences between groups on the measures of empathy or intelligence. However, a significant difference was found between groups on the Schizophrenia and Cynicism scales and falling just short of significance on the Hypochondriasis scale. These results suggested that individuals able to fake PTSD are more insightful and less subjective, which makes them better at role-playing.",0,0 +3444,"Cellular, molecular, and epigenetic mechanisms in non-associative conditioning: Implications for pain and memory","• Review behavioral sensitization in response to noxious stimulation or injury. • Review functional, synaptic, and cellular mechanisms of sensitization. • Review epigenetic mechanisms in learning- and pain-related sensitization. Sensitization is a form of non-associative conditioning in which amplification of behavioral responses can occur following presentation of an aversive or noxious stimulus. Understanding the cellular and molecular underpinnings of sensitization has been an overarching theme spanning the field of learning and memory as well as that of pain research. In this review we examine how sensitization, both in the context of learning as well as pain processing, shares evolutionarily conserved behavioral, cellular/synaptic, and epigenetic mechanisms across phyla. First, we characterize the behavioral phenomenon of sensitization both in invertebrates and vertebrates. Particular emphasis is placed on long-term sensitization (LTS) of withdrawal reflexes in Aplysia following aversive stimulation or injury, although additional invertebrate models are also covered. In the context of vertebrates, sensitization of mammalian hyperarousal in a model of post-traumatic stress disorder (PTSD), as well as mammalian models of inflammatory and neuropathic pain is characterized. Second, we investigate the cellular and synaptic mechanisms underlying these behaviors. We focus our discussion on serotonin-mediated long-term facilitation (LTF) and axotomy-mediated long-term hyperexcitability (LTH) in reduced Aplysia systems, as well as mammalian spinal plasticity mechanisms of central sensitization. Third, we explore recent evidence implicating epigenetic mechanisms in learning- and pain-related sensitization. This review illustrates the fundamental and functional overlay of the learning and memory field with the pain field which argues for homologous persistent plasticity mechanisms in response to sensitizing stimuli or injury across phyla.",0,0 +3445,"Baksbat (Broken Courage): The Development and Validation of the Inventory to Measure Baksbat, a Cambodian Trauma-based Cultural Syndrome of Distress","This article outlines the development and validation of an inventory measuring a Cambodian cultural syndrome of distress called 'baksbat' (broken courage). The inventory development phase involved ethnographic interviews with a preliminary group of 53 experts having knowledge or experience of baksbat. The initial ethnographically derived inventory with 32 items was developed and administered to a second group of 390 consecutive patients to assess factor loadings. The validation phase used confirmatory factor analysis (CFA) to test goodness-of-fit of four hypothesized factor models of the newly developed inventory in a third group of 159 participants. CFA confirms three-factor models that have the best goodness-of-fit, thus a 24-item baksbat inventory clustering of three-symptom categories was developed. Multiple regression, which assesses the relationship between the dependent variable (PTSD) and a subcluster of baksbat inventory (predictors), shows baksbat inventory accounts for 47 % of the total variance of symptoms in PTSD (R2 =.47). Of the three-symptom clusters, 'psychological distress' shows significant contribution to the total variance of symptoms in PTSD (β = .63, p < .001). Of significance, some symptoms of baksbat were independent from symptoms of PTSD with isolated symptoms that are culturally specific. These preliminary findings suggest that baksbat could be a potential Cambodian trauma-based syndrome with its own culturally validated inventory. © 2012 Springer Science+Business Media New York.",0,0 +3446,Alert but less alarmed: a pooled analysis of terrorism threat perception in Australia,"Previous Australian research has highlighted disparities in community perceptions of the threat posed by terrorism. A study with a large sample size is needed to examine reported concerns and anticipated responses of community sub-groups and to determine their consistency with existing Australian and international findings.Representative samples of New South Wales (NSW) adults completed terrorism perception questions as part of computer assisted telephone interviews (CATI) in 2007 (N = 2081) and 2010 (N = 2038). Responses were weighted against the NSW population. Data sets from the two surveys were pooled and multivariate multilevel analyses conducted to identify health and socio-demographic factors associated with higher perceived risk of terrorism and evacuation response intentions, and to examine changes over time.In comparison with 2007, Australians in 2010 were significantly more likely to believe that a terrorist attack would occur in Australia (Adjusted Odd Ratios (AOR) = 1.24, 95%CI:1.06-1.45) but felt less concerned that they would be directly affected by such an incident (AOR = 0.65, 95%CI:0.55-0.75). Higher perceived risk of terrorism and related changes in living were associated with middle age, female gender, lower education and higher reported psychological distress. Australians of migrant background reported significantly lower likelihood of terrorism (AOR = 0.52, 95%CI:0.39-0.70) but significantly higher concern that they would be personally affected by such an incident (AOR = 1.57, 95%CI:1.21-2.04) and having made changes in the way they live due to this threat (AOR = 2.47, 95%CI:1.88-3.25). Willingness to evacuate homes and public places in response to potential incidents increased significantly between 2007 and 2010 (AOR = 1.53, 95%CI:1.33-1.76).While an increased proportion of Australians believe that the national threat of terrorism remains high, concern about being personally affected has moderated and may reflect habituation to this threat. Key sub-groups remain disproportionately concerned, notably those with lower education and migrant groups. The dissonance observed in findings relating to Australians of migrant background appears to reflect wider socio-cultural concerns associated with this issue. Disparities in community concerns regarding terrorism-related threat require active policy consideration and specific initiatives to reduce the vulnerabilities of known risk groups, particularly in the aftermath of future incidents.",0,0 +3447,Examining the relation between posttraumatic stress disorder and suicidal ideation in an OEF/OIF veteran sample,"This study examined the relation between posttraumatic stress disorder (PTSD) and suicidal ideation among U.S. military veterans deployed during Operation Enduring Freedom and/or Operation Iraqi Freedom. Specific aims included investigation of (1) whether PTSD was associated with suicidal ideation after controlling for combat exposure and history of suicide attempt(s), (2) whether PTSD was associated with suicidal ideation absent a co-occurring depressive disorder (MDD) or alcohol use disorder (AUD), (3) whether co-occurring MDD or AUD increased risk of suicidal ideation among those with PTSD and (4) whether PTSD/MDD symptom clusters were differentially associated with suicidal ideation. Results pointed to unique effects associated with prior suicide attempt(s), PTSD and MDD. PTSD-diagnosed participants with co-occurring MDD or AUD were not significantly more likely to endorse suicidal ideation than PTSD-diagnosed participants without such comorbidity. The 'emotional numbing' cluster of PTSD symptoms and the 'cognitive-affective' cluster of MDD symptoms were uniquely associated with suicidal ideation.",0,0 +3448,"Second Generation Antipsychotics (SGAs) in children and adolescents: prescription, efficacy, safety and open questions","Objectives: In children and adolescents, antipsychotics are being used in large and increasing quantities for a wide range of disorders and psychopathology, including psychotic, mood, and disruptive behaviour disorders, as well as to treat irritability associated with autism, tic disorders, obsessive-compulsive disorder, posttraumatic stress disorder and aggression. Both in Europe and in the US, however, the majority of these clinical uses are off-label and they exceed the available database regarding efficacy and safety. Aim of this article is to succinctly review available data on antipsychotic efficacy and adverse effects in children and adolescents and provide a general guide for the evaluation and management of antipsychotic-related efficacy and adverse effects. Methods: Medline and PubMed (1970-2008) databases were searched for articles using keywords like child, adolescent, antipsychotics, clozapine, risperidone, paliperidone, olanzapine, quetiapine, ziprasidone, aripiprazole and the like; English language, humans and clinical trials were used as limits. Papers addressing double-blind studies were firstly considered as main source of information, open label studies and reviews only when appropriate. Results: Currently available evidence indicates an increase in the use of SGAs in paediatric population, with different antipsychotics showing similar efficacies (except clozapine for treatment-resistant early onset schizophrenia) with different tolerability/safetyprofiles (i.e., weight gain and metabolic syndrome with olanzapine, hyperprolactinaemia with risperidone). Although more data are needed, children and adolescents seem generally more susceptible than adults to develop sedation, acute EPSs, withdrawal dyskinesia, hyperprolactinaemia, and age-inappropriate weight gain with related metabolic abnormalities. Given the paucity of data (especially in the long term) it is difficult to conduct a careful risk-benefit assessment when choosing an antipsychotic treatment. Families and patients should be involved in the process of selecting appropriate treatments for each patient. Conclusions: Clinicians and researchers should use age appropriate side effect measures that also take severity and time course of adverse effects into account to help assessing and managing more comprehensively antipsychotic risks and benefits in a given individual. Safety and efficacy data should inform a careful antipsychotic selection that takes general probabilities and patient/family preferences into account. Adverse effects are generally more easily predicted than therapeutic efficacy and differences in efficacy between antipsychotics are generally smaller than those for adverse effects: initial treatment selection should be guided largely by varying adverse effect profiles across medications.",0,0 +3449,Initial reliability and validity of a new retrospective measure of child abuse and neglect,"This report presents initial findings on the reliability and validity of a new retrospective measure of child abuse and neglect, the Childhood Trauma Questionnaire.Two hundred eighty-six drug- or alcohol-dependent patients were given the Childhood Trauma Questionnaire as part of a larger test battery, and 40 of these patients were given the questionnaire again after an interval of 2 to 6 months. Sixty-eight of the patients were also given a structured interview for child abuse and neglect, the Childhood Trauma Interview, that was developed by the authors.Principal-components analysis of responses on the Childhood Trauma Questionnaire yielded four rotated orthogonal factors: physical and emotional abuse, emotional neglect, sexual abuse, and physical neglect. Cronbach's alpha for the factors ranged from 0.79 to 0.94, indicating high internal consistency. The Childhood Trauma Questionnaire also demonstrated good test-retest reliability over a 2- to 6-month interval (intraclass correlation = 0.88), as well as convergence with the Childhood Trauma Interview, indicating that patients' reports of child abuse and neglect based on the Childhood Trauma Questionnaire were highly stable, both over time and across type of instruments.These findings provide strong initial support for the reliability and validity of the Childhood Trauma Questionnaire.",0,0 +3450,Long-Term Outcome of Motor Vehicle Accident Injury,"To define the psychological outcome at 5 years of a sample of non-head-injured motor vehicle accident victims and identify baseline predictors.Self-report questionnaires were completed by 111 consecutive subjects who had been injured in a motor vehicle accident 5 years earlier and who had been assessed previously in a prospective 1-year study.Although most subjects reported a good outcome, a substantial minority described continuing social, physical, and psychological difficulties and a quarter of those studied suffered phobic anxiety about travel as a driver or passenger. There was little change in quality of life outcome and effects on travel between assessments at 3 months, 1 year, and 5 years. The prevalence of posttraumatic stress disorder remained approximately 10% throughout the follow-up; most early cases had remitted by 5 years, and a similar number of delayed new onsets had occurred between 1 year and 5 years. PTSD at 5 years was predicted by physical outcome and by postaccident intrusive memories and emotional distress. Compensation proceedings were initiated by 66 subjects and were often prolonged and a cause of distress. There were no significant associations with outcome. Trends for a poor outcome in claimants, especially those not settled at 5 years, may be due to their having more serious physical problems.Psychological complications are important and persistent after injury in a motor vehicle accident, are associated with adverse effects on everyday activities, and pose a challenge for consultation-liaison psychiatry.",0,0 +3451,Diagnosing posttraumatic stress disorder with the MMPI clinical scales: A review of the literature,"A review of the literature resulted in 21 published studies that reported mean MMPI profile patterns for PTSD patients. Of these, six (29%) reported that the mean 8-2 profile pattern significantly differentiated PTSD patients from non-PTSD patients. The majority of studies found additional PTSD profile patterns reflecting nearly all of the MMPI clinical scales. The data indicate some common group profile patterns for inpatient veterans, prisoner's of war, and inpatient veteran substance abusers. The results also support the hypothesis that there is a continuum from inpatient to outpatient and veteran to civilian populations that corresponds with both symptom and stressor severity. It is concluded that although there is some typicality in similar populations, clinicians should expect heterogeneous MMPI profiles from PTSD patients representing a diversity of clinical symptoms and styles.",0,0 +3452,Using Bayesian statistics for modeling PTSD through Latent Growth Mixture Modeling: implementation and discussion,"After traumatic events, such as disaster, war trauma, and injuries including burns (which is the focus here), the risk to develop posttraumatic stress disorder (PTSD) is approximately 10% (Breslau & Davis, 1992). Latent Growth Mixture Modeling can be used to classify individuals into distinct groups exhibiting different patterns of PTSD (Galatzer-Levy, 2015). Currently, empirical evidence points to four distinct trajectories of PTSD patterns in those who have experienced burn trauma. These trajectories are labeled as: resilient, recovery, chronic, and delayed onset trajectories (e.g., Bonanno, 2004; Bonanno, Brewin, Kaniasty, & Greca, 2010; Maercker, Gäbler, O'Neil, Schützwohl, & Müller, 2013; Pietrzak et al., 2013). The delayed onset trajectory affects only a small group of individuals, that is, about 4-5% (O'Donnell, Elliott, Lau, & Creamer, 2007). In addition to its low frequency, the later onset of this trajectory may contribute to the fact that these individuals can be easily overlooked by professionals. In this special symposium on Estimating PTSD trajectories (Van de Schoot, 2015a), we illustrate how to properly identify this small group of individuals through the Bayesian estimation framework using previous knowledge through priors (see, e.g., Depaoli & Boyajian, 2014; Van de Schoot, Broere, Perryck, Zondervan-Zwijnenburg, & Van Loey, 2015).We used latent growth mixture modeling (LGMM) (Van de Schoot, 2015b) to estimate PTSD trajectories across 4 years that followed a traumatic burn. We demonstrate and compare results from traditional (maximum likelihood) and Bayesian estimation using priors (see, Depaoli, 2012, 2013). Further, we discuss where priors come from and how to define them in the estimation process.We demonstrate that only the Bayesian approach results in the desired theory-driven solution of PTSD trajectories. Since the priors are chosen subjectively, we also present a sensitivity analysis of the Bayesian results to illustrate how to check the impact of the prior knowledge integrated into the model.We conclude with recommendations and guidelines for researchers looking to implement theory-driven LGMM, and we tailor this discussion to the context of PTSD research.",0,0 +3453,"Latent change in discrete data: Unidimensional, multidimensional, and mixture distribution Rasch models for the analysis of repeated observations.","A survey of unidimensional, multidimensional, and mixture distribution Rasch models is presented with a particular focus on model applications for the analysis of change in repeated measures designs. A mover-stayer mixed Rasch model is specified for modeling global change in one of two latent subpopulations and for modeling stability in the other latent subpopulation. The application of unidimensional, multidimensional, and mixture distribution Rasch models for the analysis of change is illustrated using data on the development of understanding and solving arithmetic word problems in 1,030 2nd-3rd grade school children. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +3454,Posttraumatic stress and physical health among adults: The role of coping mechanisms,"ABSTRACTThe purpose of the present study was to examine whether coping mechanisms predict physical health, after controlling for posttraumatic stress disorder (PTSD) symptom clusters in a non-clinical sample of adults. Data were collected from 483 adults through an online survey. Most of the participants (66.7%) reported lifetime exposure to at least one traumatic event. The final sample of this study included 319 trauma-exposed individuals. Results indicated that PTSD symptoms on the avoidance and hyperarousal clusters had significant positive relationships with self-reported physical health symptoms. After controlling for gender and PTSD, denial, behavioral disengagement, and self-blame significantly and positively predicted physical health symptoms.",0,0 +3455,Posttraumatic stress symptoms predict impaired neutrophil recovery in stem cell transplant recipients,"Objective Despite the potentially life-saving effects of stem cell transplant (SCT), many transplant patients experience traumatic stress reactions due to mortality threat, interpersonal isolation, financial and occupational loss, and invasive medical procedures. Emerging evidence suggests that trauma-related stress symptoms (TSS) predict significant health complications following SCT. The aim of the current prospective study was to examine TSS in the acute aftermath of SCT as a predictor of neutrophil recovery following SCT, a crucial component of immune defense against infection. Methods Fifty-one autologous SCT recipients were assessed for TSS 7 days after SCT. Patients' absolute neutrophil counts were collected from medical charts for the first 30 days following SCT. Hierarchical linear growth modeling was used to test the hypothesis that TSS at day 7 would be associated with delayed recovery of neutrophil counts from days 9 to 30 post SCT, that is, when neutrophil counts began to recover. Results As hypothesized, TSS measured 7 days after SCT was significantly associated with slower neutrophil recovery even after pre-existing TSS, depression, distress related to physical symptoms, and potential medical confounds were statistically controlled. Exploratory analyses showed that of the TSS symptom clusters, re-experiencing symptoms and hyperarousal symptoms predicted neutrophil recovery, whereas avoidance symptoms did not. Conclusion Though traumatic stress symptoms may be a normative response to SCT, our findings suggest that TSS following SCT may interfere with neutrophil recovery and overall health. These results provide further insight as to potential mechanisms by which traumatic stress translates to poor medical outcomes for SCT patients. Copyright © 2015 John Wiley & Sons, Ltd.",0,0 +3456,Reduced Anterior Cingulate and Orbitofrontal Volumes in Child Abuse–Related Complex PTSD,"Article AbstractObjective: Classic posttraumatic stress disorder (PTSD) is associated with smaller hippocampus, amygdala, and anterior cingulate cortex (ACC) volumes. We investigated whether child abuse-related complex PTSD—a severe form of PTSD with affect dysregulation and high comorbidity—showed similar brain volume reductions. Method: We used voxel-based morphometry to measure gray matter concentrations in referred outpatients with child abuse-related complex PTSD (n = 31) compared to matched healthy nontraumatized controls (n = 28). Complex PTSD was diagnosed using the Structured Clinical Interview for DSM-IV-TR and the Structured Clinical Interview for Disorders of Extreme Stress. All respondents were scanned on a 1.5-T magnetic resonance system at the VU Medical Center, Amsterdam, The Netherlands, between September 2005 and February 2006. Results: As was hypothesized, patients with child abuse-related complex PTSD showed reductions in gray matter concentration in right hippocampus (PSVC corrected = .04) and right dorsal ACC (PSVC corrected = .02) compared to controls. In addition, a reduction in gray matter concentration in the right orbitofrontal cortex (OFC) was found. Severity of child abuse and PTSD-hyperarousal correlated negatively with ACC volume. Impulsivity correlated negatively with hippocampus volume, and anger, with hippocampus and OFC volume. Comorbidity of borderline personality disorder—compared to comorbid cluster C personality disorder—accounted for more extensive reductions in the ACC and OFC volume. Conclusions: In complex PTSD, not only the hippocampus and the ACC but also the OFC seem to be affected, even in the absence of comorbid borderline personality disorder. These results suggest that neural correlates of complex PTSD are more severe than those of classic PTSD.J Clin PsychiatrySubmitted: September 26, 2008; accepted July 7, 2009. Online ahead of print: July 13, 2010 (doi:10.4088/JCP.08m04754blu). Corresponding author: Kathleen Thomaes, MD, GGZ Ingeest, Department of Psychiatry, VU University Medical Center, A J Ernststraat 887, 1081 HL Amsterdam, The Netherlands (k.thomaes@vumc.nl).",0,0 +3457,ACCIDENT LITIGANTS WITH NEUROTIC SYMPTOMS,"Experience gained from an examination of 750 consecutive litigants leads to the conclusion that the aetiology of neurotic symptoms after accidents is so complex that diagnostic labels implying single causation give a false and oversimplified picture. Terms such as compensation neurosis, traumatic neurosis, Mediterranean back, postconcussion syndrome and many others illustrate preconceived ideas of causation which are in most cases not warranted, and it is recommended that this group of patients be considered under the general label of sufferers from accident neurosis. The many symptoms which occur are discussed, and it is found that they present in such endless variety, and in varying severity from mild to completely disabling; they do not cluster in any consistent way to justify the delineating of discrete syndromes which are artificial and misleading; their existence confuses rather than clarifies our understanding of these unfortunate people. Language: en",0,0 +3458,Different clinical courses of children exposed to a single incident of psychological trauma: a 30-month prospective follow-up study,"We investigated the distinct longitudinal trajectories of posttraumatic stress symptoms in a sample of 167 children, who witnessed death of two mothers of their schoolmates.The cohort was followed-up at 2 days (T1), 2 months (T2), 6 months (T3), and 30 months (T4) after the traumatic event. The children's posttraumatic stress symptoms (T1-T4), depression (T1, T3 and T4), state anxiety (T1, T3 and T4), and quality of life (T4) were assessed, along with parental stress related to child rearing (T4). Different trajectory patterns of the children's posttraumatic stress symptoms were identified using growth mixture modeling (GMM).Four different patterns of symptom change were identified, which were consistent with the prototypical model, and were named Recovery (19.9%), Resilience (72.7%), Chronic Dysfunction (1.8%), and Delayed Reactions (5.6%). Significant differences were found in depression and anxiety scores, children's quality of life, and parental rearing stress according to the distinct longitudinal trajectories of posttraumatic stress symptoms.The present study suggests that individual differences should be taken into account in the clinical course and outcome of children exposed to psychological trauma. The two most common trajectories were the Resilience and the Recovery types, together suggesting that over 90% of children were evidenced with a favorable 30-month outcome. The latent classes were associated with significant mean differences in depression and anxiety scores, supporting the clinical validity of the distinct trajectories.",1,0 +3459,[Trauma and stressor-related disorders: diagnostic conceptualization in DSM-5].,"The Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) includes a distinct diagnostic group of trauma and stressor-related disorders that has been set apart from anxiety disorders. From a perspective of adult psychiatry this new disorder category includes posttraumatic stress disorder (PTSD), acute stress disorder (ASD), and adjustment disorders. The PTSD is based on narrower trauma criteria that focus on acute life-threatening situations, serious injury, or sexual violence by way of direct confrontation, witnessing or indirect confrontation. Indirect confrontation, however, is reserved only for violent or accidental events that occurred to close family members or friends. The former A2 criterion of an intense emotional reaction to trauma has been removed. A deliberately broad approach to clinical PTSD phenomenology has created an empirically driven new cluster of persistent negative alterations in cognition and mood due to experiencing traumatic events. The ASD has been reconceptualized as an intense stress syndrome with a clear need of acute treatment during the early course after traumatic exposure. Adjustment disorders continue to emphasize maladaptive emotional and behavioral responses to unspecific, non-traumatic stressors in an intensity that is beyond social or cultural norms. Neither complex PTSD nor prolonged grief disorders have received an independent diagnostic status within DSM-5. With respect to stress-related disorders major divergences between DSM-5 and the future International Classification of Diseases 11 (ICD-11) are to be expected. © 2014 Springer-Verlag.",0,0 +3460,Trajectories of psychological distress among Chinese women diagnosed with breast cancer,"Background: The distinct trajectories of psychological distress over the first year of the diagnosis with breast cancer (BC) and its determinants have not been explored. Methods: 285 of 405 Chinese women receiving surgery for BC were assessed at 5-day, 1-month, 4-month, and 8-month post-surgery on measures of psychological distress, optimism, treatment decision-making (TDM) difficulties, satisfaction with treatment outcome, satisfaction with medical consultation, and physical symptom distress. Latent growth mixture modelling identified trajectories of psychological response to BC. Multinominal logistic regression compared TDM difficulties, satisfaction with treatment outcome, satisfaction with medical consultation, optimism, and physical symptom distress, by distress pattern adjusted for age, education, employment status, and stage of disease. Results: Four distinct trajectories of distress were identified, namely, resilience (66%), chronic distress (15%), recovered (12%), and delayed-recovery (7%). TDM difficulties, optimism, satisfaction with consultation, and physical symptom distress predicted distress trajectories. Psychologically resilient women had less physical symptom distress at early post-surgery compared with women with other distress patterns. Compared with the resilient group, women in the recovered or chronic distress groups experienced greater TDM difficulties, whereas women in the delayed-recovery group reported greater dissatisfaction with the initial medical consultation. Women in the chronic distress group reported greater pessimistic outlook. Conclusion: Optimism and better early post-operative treatment outcomes predicted resilience to distress. Pre-operative interventions helping women to establish a realistic expectation of treatment outcome may minimize disappointment with treatment outcome and resultant distress, whereas post-operative rehabilitation should focus on symptom management. Copyright © 2009 John Wiley & Sons, Ltd.",0,0 +3461,Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study,"

Summary

Background

Plausible projections of future mortality and disability are a useful aid in decisions on priorities for health research, capital investment, and training. Rates and patterns of ill health are determined by factors such as socioeconomic development, educational attainment, technological developments, and their dispersion among populations, as well as exposure to hazards such as tobacco. As part of the Global Burden of Disease Study (GBD), we developed three scenarios of future mortality and disability for different age-sex groups, causes, and regions.

Methods

We used the most important disease and injury trends since 1950 in nine cause-of-death clusters. Regression equations for mortality rates for each cluster by region were developed from gross domestic product per person (in international dollars), average number of years of education, time (in years, as a surrogate for technological change), and smoking intensity, which shows the cumulative effects based on data for 47 countries in 1950–90. Optimistic, pessimistic, and baseline projections of the independent variables were made. We related mortality from detailed causes to mortality from a cause cluster to project more detailed causes. Based on projected numbers of deaths by cause, years of life lived with disability (YLDs) were projected from different relation models of YLDs to years of life lost (YLLs). Population projections were prepared from World Bank projections of fertility and the projected mortality rates.

Findings

Life expectancy at birth for women was projected to increase in all three scenarios; in established market economies to about 90 years by 2020. Far smaller gains in male life expectancy were projected than in females; in formerly socialist economies of Europe, male life expectancy may not increase at all. Worldwide mortality from communicable maternal, perinatal, and nutritional disorders was expected to decline in the baseline scenario from 17·2 million deaths in 1990 to 10·3 million in 2020. We projected that non-communicable disease mortality will increase from 28·1 million deaths in 1990 to 49·7 million in 2020. Deaths from injury may increase from 5·1 million to 8·4 million. Leading causes of disability-adjusted life years (DALYs) predicted by the baseline model were (in descending order): ischaemic heart disease, unipolar major depression, road-traffic accidents, cerebrovascular disease, chronic obstructive pulmonary disease, lower respiratory infections, tuberculosis, war injuries, diarrhoeal diseases, and HIV. Tobacco-attributable mortality is projected to increase from 3·0 million deaths in 1990 to 8·4 million deaths in 2020.

Interpretation

Health trends in the next 25 years will be determined mainly by the ageing of the world's population, the decline in age-specific mortality rates from communicable, maternal, perinatal, and nutritional disorders, the spread of HIV, and the increase in tobacco-related mortality and disability. Projections, by their nature, are highly uncertain, but we found some robust results with implications for health policy.",0,0 +3462,Altered brain structural connectivity in post-traumatic stress disorder: A diffusion tensor imaging tractography study,"Post-traumatic stress disorder (PTSD) is characterized by dysfunction of several discrete brain regions such as medial prefrontal gyrus with hypoactivation and amygdala with hyperactivation. However, alterations of large-scale whole brain topological organization of structural networks remain unclear.Seventeen patients with PTSD in motor vehicle accident survivors and 15 normal controls were enrolled in our study. Large-scale structural connectivity network (SCN) was constructed using diffusion tensor tractography, followed by thresholding the mean factional anisotropy matrix of 90 brain regions. Graph theory analysis was then employed to investigate their aberrant topological properties.Both patient and control group showed small-world topology in their SCNs. However, patients with PTSD exhibited abnormal global properties characterized by significantly decreased characteristic shortest path length and normalized characteristic shortest path length. Furthermore, the patient group showed enhanced nodal centralities predominately in salience network including bilateral anterior cingulate and pallidum, and hippocampus/parahippocamus gyrus, and decreased nodal centralities mainly in medial orbital part of superior frontal gyrus.The main limitation of this study is the small sample of PTSD patients, which may lead to decrease the statistic power. Consequently, this study should be considered an exploratory analysis.These results are consistent with the notion that PTSD can be understood by investigating the dysfunction of large-scale, spatially distributed neural networks, and also provide structural evidences for further exploration of neurocircuitry models in PTSD.",0,0 +3463,Specific Symptoms Predict Suicidal Ideation in Vietnam Combat Veterans with Chronic Post-Traumatic Stress Disorder,"Previous research documented the elevated risk of suicide and suicidal ideation among Vietnam veterans with post-traumatic stress disorder (PTSD). The aim of the current study was to examine which Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, PTSD symptom clusters are most associated with suicidal ideation in this population. Fifty Vietnam combat veterans enrolled in treatment for PTSD responded to the Beck Scale for Suicide Ideation and were interviewed with the Clinician-Administered PTSD Scale. In linear regression analysis, it was found that the reexperiencing symptom cluster was significantly associated with suicidal ideation but the other two symptom clusters (avoidance/numbing and increased arousal) were not. Furthermore, scores on a measure of severity of combat exposure were not found to be significantly related to PTSD symptoms or suicidal ideation. The results of this study suggest the importance of reexperiencing symptoms for predicting which individuals with combat-related PTSD are most at risk for suicidal ideation and behavior.",0,0 +3464,Severe paroxysmal hypertension (Pseudopheochromocytoma),"Paroxysmal hypertension always engenders a search for a catecholamine-secreting pheochromocytoma. Yet 98% of people with paroxysmal hypertension do not have this tumor. The cause and management of paroxysmal hypertension remain a mystery, and the subject of remarkably few papers. This review presents an approach to understanding and successfully treating this disorder. Patients experience symptomatic blood pressure surges likely linked to sympathetic nervous system stimulation. A specific personality profile associated with this disorder suggests a psychological basis, attributable to repressed emotion related to prior emotional trauma or a repressive (nonemotional) coping style. Based on this understanding, three forms of intervention, alone or in combination, appear successful: antihypertensive therapy with agents directed at the sympathetically mediated blood pressure elevation (eg, combined (alpha)- and (beta)-blockade or central (alpha)-agonists such as clonidine); psychopharmacologic interventions including anxiolytic and/or antidepressant agents; and psychological intervention, particularly reassurance and increased psychological awareness. An appropriately selected intervention can reduce or eliminate attacks in most patients.",0,0 +3465,Testimony Psychotherapy in Bosnian Refugees: A Pilot Study,"Objective:The authors sought to describe the use of the testimony method of psychotherapy in a group of traumatized adult refugees from genocide in Bosnia-Herzegovina. Method:The subjects were 20 Bosnian refugees in Chicago who gave written informed consent to participate in a case series study of testimony psychotherapy. All subjects received testimony psychotherapy, averaging six sessions, approximately 90 minutes, weekly or biweekly. Subjects received standardized instruments for posttraumatic stress disorder (PTSD), depression, traumatic events, global functioning, and prior psychiatric history. The instruments were administered before treatment, at the conclusion of the treatment, and at the 2- and 6-month follow-ups.Results:The posttreatment assessments demonstrated significant decreases in the rate of PTSD diagnosis, PTSD symptom severity, and the severity of reexperiencing, avoidance, and hyperarousal symptom clusters. Depressive symptoms demonstrated a significant decrease, and there was a significant increase in scores on the Global Assessment of Functioning Scale. Two-month and 6-month follow-up assessments demonstrated further significant decreases in all symptoms and an increase in scores on the Global Assessment of Functioning Scale. Conclusions:This pilot study provides preliminary evidence that testimony psychotherapy may lead to improvements in PTSD and depressive symptoms, as well as to improvement of functioning, in survivors of state-sponsored violence. Am J Psychiatry 1998; 155: 1720-1726",0,0 +3466,A Prospective Examination of Symptoms of Posttraumatic Stress Disorder in Victims of Nonsexual Assault,"Symptoms of posttraumatic stress disorder (PTSD) were examined prospectively in 84 non-sexual assault victims (53 women, 31 men) beginning shortly after the assault (mean = 18.68 days) and continuing weekly for 3 months. At the initial assessment, 71% of the women and 50% of the men met symptom criteria for PTSD. The incidence of PTSD decreased to 42% of the women and 32% of the men by the fourth assessment, and at the final assessment, 21% of the women but none of the men remained with PTSD. An examination of specific PTSD symptoms indicated that many subjects who were not diagnosed with PTSD at the final assessment retained significant symptoms of PTSD, particularly reexperiencing and arousal symptoms. The severity of PTSD did decrease significantly over the course of the study, but only in those groups who were not diagnosed with the disorder at the final assessment. Women who were diagnosed with PTSD at the final assessment did not show a significant decrease in symptom severity over the course of the study. The results are discussed with regard to implications for understanding the development and persistence of posttrauma pathology, and directions for future research are outlined.",0,0 +3467,Responses to civilian war experiences: Predictors of psychological functioning and coping,"This study investigated civilian war trauma in Central American refugees, focusing on the diagnosis of posttraumatic stress disorder (PTSD) as related to war experience and demographic characteristics. Sixty eight percent of the refugees met the diagnostic criteria for PTSD. Diagnosis was best predicted by number of war experiences, severity of war trauma and level of anxiety/depression. Higher numbers of war experiences predicted PTSD severity, as did involvement in the legalization process, parenthood, and being a citizen of El Salvador. In examining the PTSD symptom cluster scores, it was found that number of war experiences was a significant predictor in all clusters. These results are helpful in increasing our knowledge about the role of war experiences in civilian PTSD and the unique situation of the Central American refugees.",0,0 +3468,Posttraumatic stress symptoms and smoking among World Trade Center disaster responders: A longitudinal investigation,"The current longitudinal study examined posttraumatic stress disorder (PTSD) symptom severity in relation to smoking abstinence and reduction over time among responders to the World Trade Center (WTC) disaster.Participants were 763 police and 1881 non-traditional (e.g., construction workers) WTC responders who reported being smokers at an initial examination obtained between July 2002 and July 2011 at the WTC Health Program (WTC-HP). WTC responders were reassessed, on average, 2.5 years later.For police WTC responders, higher levels of WTC-related PTSD symptoms at the initial visit were associated with a decreased likelihood of smoking abstinence (OR=0.98, p=.002) and with decreased smoking reduction (β=-.06, p=.012) at the follow-up visit. WTC-related PTSD symptom severity was not related to likelihood of smoking abstinence or change in number of cigarettes smoked among non-traditional responders. Post hoc analyses suggested that for police, hyperarousal PTSD symptoms were predictive of decreased abstinence likelihood at the follow-up visit (OR=0.56, p=.006).The present findings suggest that PTSD symptoms may be differentially related to smoking behavior among police and non-traditional WTC responders in a naturalistic, longitudinal investigation. Future work may benefit from exploring further which aspects of PTSD (as compared to each other and to common variance) explain smoking maintenance.",0,0 +3469,The latent factor structure of acute stress disorder following bank robbery: Testing alternative models in light of the pending DSM-5,"Acute stress disorder (ASD) was introduced into the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) to identify posttraumatic stress reactions occurring within the first month after a trauma and thus help to identify victims at risk of developing posttraumatic stress disorder (PTSD). Since its introduction, research into ASD has focused on the prediction of PTSD, whereas only a few studies have investigated the latent structure of ASD. Results of the latter have been mixed. In light of the current proposal for the ASD diagnosis in the pending DSM-5, there is a profound need for empirical studies that investigate the latent structure of ASD prior to the DSM-5 being finalized.Based on previous factor analytic research, the DSM-IV, and the proposed DSM-5 formulation of ASD, four different models of the latent structure of ASD were specified and estimated.The analyses were based on a national study of bank robbery victims (N = 450) using the acute stress disorder scale.The results of the confirmatory factor analyses showed that the DSM-IV model provided the best fit to the data. Thus, the present study suggests that the latent structure of ASD may best be characterized according to the four-factor DSM-IV model of ASD (i.e., dissociation, re-experiencing, avoidance, and arousal) following exposure to bank robbery.The results are pertinent in light of the pending DSM-5 and add to the debate about the conceptualization of ASD. .",0,0 +3470,Caregiver—child mental health: a prospective study in conflict and refugee settings,"Background In humanitarian settings, family-level drivers of mental health are insufficiently documented; we examined the strength of caregiver—child associations with two-wave, family-level Afghan data. Methods We recruited a gender-balanced sample of 681 caregiver—child dyads (n = 1,362 respondents) using stratified random-sampling in government schools in Kabul (364 dyads) and refugee schools in Peshawar (317 dyads). One year after baseline, we re-interviewed 64% of Kabul and 31% of Peshawar cohorts (n = 331 dyads, 662 respondents), retaining fewer Peshawar families due to refugee repatriation. In multivariable analyses adjusted for baseline, we assessed the extent to which caregiver mental health (Self-Report Questionnaire, SRQ-20) was associated with child symptom scores of post-traumatic stress (Child Revised Impact of Events Scale, CRIES), depression (Depression Self-Rating Scale, DSRS), psychiatric difficulties, impact, and prosocial strength (Strength and Difficulties Questionnaire, SDQ). Results Caregiver mental health was prospectively associated with all eight measures of child mental health at follow-up, adjusted for baseline. For post-traumatic stress, caregiver mental health had a predictive impact comparable to the child experiencing one or two lifetime trauma events. For depression, caregiver mental health approached the predictive impact of female gender. Thus a one SD change in caregiver SRQ-20 was associated with a 1.04 point change on CRIES and a 0.65 point change in DSRS. For multi-informant SDQ data, caregiver—child associations were strongest for caregiver ratings. For child-rated outcomes, associations were moderated by maternal literacy, a marker of family-level dynamics. Both adults and children identified domestic violence and quality of home life as independent risk and protective factors. Conclusions In the context of violence and displacement, efforts to improve child mental health require a thoughtful consideration of the mental health cascade across generations and the cluster of adversities that impact family wellbeing. We identify culturally meaningful leverage points for building family-level resilience, relevant to the prevention and intervention agenda in global mental health.",0,0 +3471,The invention of post-traumatic stress disorder and the social usefulness of a psychiatric category,"A central assumption behind psychiatric diagnoses is that a disease has an objective existence in the world, whether discovered or not, and exists independently of the gaze of psychiatrists or anyone else. In other words, neolithic people had post-traumatic stress disorder as have people in all epochs since. However, the story of post-traumatic stress disorder is a telling example of the role of society and politics in the process of invention rather than discovery. The diagnosis is a legacy of the American war in Vietnam and is a product of the post-war fortunes of the conscripted men who served there. They came home to find that they were being blamed for the war. Epithets like “babykiller” and “psychopath” were thrown at them by some who had watched on television the US military's atrocities against defenceless peasants. This reception was a primary factor in the well publicised difficulties—such as antisocial behaviour—that some military personnel had in readjusting to their peacetime roles. Those who were seen by psychiatrists were diagnosed as having an anxiety state, depression, substance misuse, personality disorder, or schizophrenia; these diagnoses were later supplanted by post-traumatic stress disorder. Early proponents of the diagnosis of post-traumatic stress disorder were part of the antiwar movement in the United States; they were angry that military psychiatry was being used to serve the interests of the military rather than those of the soldier-patients. The proponents lobbied hard for veterans to receive specialised medical care under the new diagnosis, which became the successor to the older diagnoses of battle fatigue and war neurosis. The new diagnosis was meant to shift the focus of attention from the details of a soldier's background and psyche to the fundamentally traumatogenic nature of war. This was a powerful and essentially political transformation: Vietnam veterans were to be seen …",0,0 +3472,Posttraumatic stress disorder among Turkish veterans of the Southeast,"Objective: Traumatic events induced deliberately by humans such as terrorism causes posttraumatic stress disorder (PTSD) and other psychiatric disorders. Data analysis of the present study consists of two phases. At first phase, the prevalence of PTSD and depression comorbid to PTSD of veterans who were physically injured while doing their military service at South East Region was investigated. At the second phase, the role of risk factors of negative changes at the relationship with their environment and the need of psychological help on developing PTSD and depression comorbid to PTSD was examined. Methods: The study conducted with 247 southeast veterans. Age range of veterans is 24-49 (36.55±5.29). The years after the injury ranged from 2 to 28 years (15.35±5.3). All participants were evaluated with Demographic Information Questionnaire and Traumatic Stress Symptom Checklist (TSSC). Findings: The prevalence of PTSD was 29.6% (n=73), depression comorbid to PTSD 16.6% (n=41). There was a significant difference on PTSD and depression comorbid to PTSD among veterans who reported negative changes in the relationship with their environment and veterans who don’t reported negative changes in the relationship with their environment. Similarly, there was a significant difference on PTSD and depression comorbid to PTSD between veterans who need of psychological help and veterans who don’t need psychological help. However, there was no significant interaction effect among veterans who reported negative changes in the relationship with their environment and need of psychological help. Discussion: Southeast veterans are under the risk of direct death treat such as taking a part in battle or facing with mine explosion. Therefore, psychological and psychiatric services should be constituted to those who are physically injured and veterans who done military service at that region but not injured. Although it has been a long time, PTSD and depression comorbid to PTSD was found among southeast veterans who were exposed to frequent life-threatening traumatic experiences such as being in the middle of battle or stepping on mine. Since it is observed that both having a negative relationships with their surroundings and the need of psychological help increase the probability of PTSD and depression comorbid to PTSD, institutions which will provide psychological and psychiatric services to veterans deployed in the area should established. Key words:",0,0 +3473,"Hypnotizability, Posttraumatic Stress, and Depressive Symptoms in Metastatic Breast Cancer","This study assessed whether high hypnotizability is associated with posttraumatic stress and depressive symptoms in a sample of 124 metastatic breast cancer patients. Hypnotic Induction Profile Scores were dichotomized into low and high categories; posttraumatic intrusion and avoidance symptoms were measured with the Impact of Events Scale (IES); hyperarousal symptoms with items from the Profile of Mood States; and depressive symptoms with the Center for Epidemiologic Studies-Depression Scale. High hypnotizability was significantly related to greater IES total, IES intrusion symptoms, and depressive symptoms. A logistic regression model showed that IES total predicts high hypnotizability after adjusting for depressive symptoms and hyperarousal. The authors relate these results to findings in other clinical populations and discuss implications for the psychosocial treatment of metastatic breast cancer.",0,0 +3474,Psychological predictors of chronic posttraumatic stress disorder after motor vehicle accidents.,"A prospective longitudinal study assessed 967 consecutive patients who attended an emergency clinic shortly after a motor vehicle accident, again at 3 months, and at 1 year. The prevalence of posttraumatic stress disorder (PTSD) was 23.1% at 3 months and 16.5% at 1 year. Chronic PTSD was related to some objective measures of trauma severity, perceived threat, and dissociation during the accident, to female gender, to previous emotional problems, and to litigation. Maintaining psychological factors, that is, negative interpretation of intrusions, rumination, thought suppression, and anger cognitions, enhanced the accuracy of the prediction. Negative interpretation of intrusions, persistent medical problems, and rumination at 3 months were the most important predictors of PTSD symptoms at 1 year. Rumination, anger cognitions, injury severity, and prior emotional problems identified cases of delayed onset.",0,0 +3475,Disaster Resiliency,"Natural disasters in recent years have brought the study of disaster resiliency to the forefront. The importance of community preparedness and sustainability has been underscored by such calamities as Hurricane Katrina in 2005 and the Japanese tsunami in 2011. Natural disasters will inevitably continue to occur, but by understanding the concept of resiliency as well as the factors that lead to it, communities can minimize their vulnerabilities and increase their resilience. In this volume, editors Naim Kapucu, Christopher V. Hawkins, and Fernando I. Rivera gather an impressive array of scholars to provide a much needed re-think to the topic disaster resiliency. Previous research on the subject has mainly focused on case studies, but this book offers a more systematic and empirical assessment of resiliency, while at the same time delving into new areas of exploration, including vulnerabilities of mobile home parks, the importance of asset mapping, and the differences between rural and urban locations. Employing a variety of statistical techniques and applying these to disasters in the United States and worldwide, this book examines resiliency through comparative methods which examine public management and policy, community planning and development, and, on the individual level, the ways in which culture, socio-economic status, and social networks contribute to resiliency. The analyses drawn will lead to the development of strategies for community preparation, response, and recovery to natural disasters. Combining the concept of resiliency, the factors that most account for the resiliency of communities, and the various policies and government operations that can be developed to increase the sustainability of communities in face of disasters, the editors and contributors have assembled an essential resource to scholars in emergency planning, management, and policy, as well as upper-level students studying disaster management and policy. © 2013 Taylor & Francis.",0,0 +3476,Patterns of Distress in African-American Mothers of Preterm Infants,"To examine inter-relationships among stress due to infant appearance and behavior in the neonatal intensive care unit (NICU), parental role alteration stress in the NICU, depressive symptoms, state anxiety, posttraumatic stress symptoms, and daily hassles exhibited by African-American mothers of preterm infants and to determine whether there were subgroups of mothers based on patterns of psychological distress.One hundred seventy-seven African-American mothers completed questionnaires on their psychological distress at enrollment during infant hospitalization and 2, 6, 12, 18, and 24 months after term.Psychological distress measures were intercorrelated. There were four latent classes of mothers: the low distress class with low scores on all measures; the high NICU-related stress class with high infant appearance and parental role stress and moderate scores on other measures; the high depressive symptoms class with high depressive symptoms and state anxiety and moderately elevated scores on NICU-related stress and posttraumatic stress symptoms; the extreme distress class with the highest means on all measures. Infants in the high stress class were sicker than infants in the other classes. The extreme distress class mothers averaged the lowest educational level. The classes differed on distress measures, worry about the child, and parenting stress through 24 months with the extreme distress class having the highest values.Although different types of maternal psychological distress were substantially related, there were distinct subgroups of mothers that were identifiable in the NICU. Moreover, these subgroups continued to differ on trajectories of distress and on their perceptions of the infants and parenting through 24 months after term.",0,0 +3477,Characteristics of posttraumatic stress disorder in ex prisoners of war.,"Post Traumatic Stress Disorder is a frequent consequence of surviving the stress of the war. The majority of research studies confirm that the severity, duration and the proximity to the traumatic events have significant influence on the outcome of surviving psychological trauma. There is also evidence that the prisoners of war who have survived severe, repetitive traumatization will develop PTSD more frequently, and that the characteristics and the severity of symptoms is more serious compared with the veterans of war who did not survive imprisonment. This paper analyzes the presence of the symptoms of PTSD according to frequency in a group of former prisoners of war and a group of war veterans who did not experience imprisonment. The research sample is comprised of subjects who were selected by the method of randomized stratified sample and divided an experimental and control group. Experimental subgroup E1 consist of 50 former prisoners of war who have sought psychiatric help after being released from the prisons, and subgroup E2 consist of 50 former prisoners of war who never sought psychiatric assistance. Control group is divided in subgroup K1 that consist of 30 veterans of war who did not survive imprisonment, and who have occasionally sought psychiatric assistance after the war, and subgroup K2 that consist of 30 veterans of war who did not survive imprisonment and who never sought psychiatric assistance. All subjects were male, none of them had any prior psychiatric history. The instruments used in the study were the following: general and sociobiographic questionnaire designed by the authors, traumatic events questionnaire which is a modified version of the Harvard Trauma Questionnaire, PTSD questionnaire designed according to DSM IV diagnostic criteria. Results in relation to degree of traumatic experience demonstrate that there is a significant statistical difference (P<0.005) between the experimental and control group. PTSP is statistically significantly more represented among the former prisoners of war than among the war veterans who were not detained in camps (P<0.05). Average scores for all symptom clusters (fear and helplessness, re-experiencing symptoms, avoidance symptoms, and hyper-arousal symptoms) were higher in the experimental group than in a control group.",0,0 +3478,Differential changes in muscle composition exist in traumatic and nontraumatic neck pain.,"A population based cross-sectional study.To clarify relative constituents of viable muscle in 2-dimensional cross-sectional area (CSA) measures of ventral and dorsal cervical muscles in patients with chronic whiplash-associated disorders (WAD), idiopathic neck pain, and healthy controls.Previous data using T1-weighted magnetic resonance image demonstrated large amounts of neck muscle fat infiltration and increased neck muscle CSA in patients with chronic WAD but not in idiopathic neck pain or healthy controls.Magnetic resonance images were obtained for 14 cervical muscle regions in 136 females, including 79 with chronic whiplash, 23 with chronic idiopathic neck pain, and 34 healthy controls.Without fat removed, relative CSA of 7 of 14 muscle regions in the participants with chronic WAD was larger, 3 of 14 smaller and 4 of 14 similar to healthy individuals. When T1-weighted signal representing the lipid content of these muscles was removed, 8 of 14 relative muscle CSA in patients with whiplash were similar, 5 of 14 were smaller and only 1 of 14 was larger than those observed in healthy controls. Removal of fat from the relative CSA measurement did not alter findings between participants with idiopathic neck pain and healthy controls.These findings clarify that previous reports of increased relative CSA in patients with chronic whiplash represent cervical muscle pseudohypertrophy. Relative muscle CSA measures reveal atrophy in several muscles in both patients with WAD and idiopathic neck pain, which supports inclusion of muscle conditioning in the total management of these patients.3.",0,0 +3479,On the Horizon,"This review demonstrates that many advances have been made in burn care that have made dramatic differences in mortality, clinical outcomes, and quality of life in burn survivors; however, much work remains. In reality, the current standard of care is insufficient and we cannot be satisfied with the status quo. We must strive for the following goals: no deaths due to burn, no scarring, and no pain. These particular goals have only begun to be confronted.",0,0 +3480,Personality and Trauma: Adult Attachment and Posttraumatic Distress Among Former Political Prisoners.,"Attachment patterns are especially salient in facing danger and threats to one's life. Earlier research has suggested that secure persons are protected and insecure persons vulnerable in conditions of traumatic stress. We argued that the general view may not apply to the complex person-trauma interaction that is characteristic to torture and ill-treatment. Rather, as Crittenden maintains, each attachment pattern involves a unique strategy that is the most adaptive solution, depending on the nature of the trauma. We hypothesized that the general view of the secure attachment pattern being protective, and the insecure patterns being unprotective, would apply when political prisoners are exposed to physical torture and ill-treatment. Whereas, when exposed to psychological torture involving interpersonal cruelty, securely attached persons would be more vulnerable than insecure. The hypotheses were examined among 176 Palestinian male former political prisoners living in the Gaza Strip. Their mental health was ...",0,0 +3481,Plasma cortisol and neuropeptide Y in female victims of intimate partner violence,"The experience of intimate partner violence (physical and sexual violence) has been linked to psychiatric disorders such as posttraumatic stress disorder, yet data on the neuroendocrine profile in this population is sparse. This study sought to examine baseline plasma cortisol and neuropeptide Y (NPY) levels in female victims of intimate partner violence (IPV).Morning plasma samples were collected for cortisol and NPY determination in 22 women with histories of IPV (10 with current PTSD, 12 without current or lifetime PTSD) and 16 non-abused controls.Mean cortisol levels were significantly lower in IPV subjects compared with controls, but did not distinguish IPV subjects with and without PTSD. There were no significant differences in mean NPY levels between the groups. Neither cortisol nor NPY levels were significantly correlated with PTSD symptoms.These preliminary findings suggest that victims of IPV, like women traumatized by childhood abuse, may be characterized by alterations in hypothalamic-pituitary-adrenal axis functioning, however, further study is needed to identify specific stress system disturbances in this group.",0,0 +3482,A Diagnosis of Insomnia Is Associated With Differential Expression of Sleep-Regulating Genes in Military Personnel,"Sleep disturbance is a common and disturbing symptom in military personnel, with many individuals progressing to the development of insomnia, which is characterized by increased arousals, wakefulness after sleep onset, and distorted sleep architecture. The molecular mechanisms underlying insomnia remain elusive, limiting future therapeutic development to address this critical issue. We examined whole gene expression profiles associated with insomnia. We compared subjects with insomnia ( n = 25) to controls ( n = 13) without insomnia using microarray gene expression profiles obtained from peripheral samples of whole blood obtained from military personnel. Compared to controls, participants with insomnia had differential expression of 44 transcripts from 43 identified genes. Among the identified genes, urotensin 2 was downregulated by more than 6 times in insomnia participants, and the fold-change remained significant after controlling for depression, posttraumatic stress disorder, and medication use. Urotensin 2 is involved in regulation of orexin A and B activity and rapid eye movement during sleep. These findings suggest that differential expression of these sleep-regulating genes contributes to symptoms of insomnia and, specifically, that switching between rapid eye movement and nonrapid eye movement sleep stages underlies insomnia symptoms. Future work to identify therapeutic agents that are able to regulate these pathways may provide novel treatments for insomnia.",0,0 +3483,A Trial of Prazosin for Combat Trauma PTSD With Nightmares in Active-Duty Soldiers Returned From Iraq and Afghanistan,"The authors conducted a 15-week randomized controlled trial of the alpha-1 adrenoreceptor antagonist prazosin for combat trauma nightmares, sleep quality, global function, and overall symptoms in active-duty soldiers with posttraumatic stress disorder (PTSD) returned from combat deployments to Iraq and Afghanistan.Sixty-seven soldiers were randomly assigned to treatment with prazosin or placebo for 15 weeks. Drug was titrated based on nightmare response over 6 weeks to a possible maximum dose of 5 mg midmorning and 20 mg at bedtime for men and 2 mg midmorning and 10 mg at bedtime for women. Mean achieved bedtime doses were 15.6 mg of prazosin (SD=6.0) and 18.8 mg of placebo (SD=3.3) for men and 7.0 mg of prazosin (SD=3.5) and 10.0 mg of placebo (SD=0.0) for women. Mean achieved midmorning doses were 4.0 mg of prazosin (SD=1.4) and 4.8 mg of placebo (SD=0.8) for men and 1.7 mg of prazosin (SD=0.5) and 2.0 mg of placebo (SD=0.0) mg for women. Primary outcome measures were the nightmare item of the Clinician-Administered PTSD Scale (CAPS), the Pittsburgh Sleep Quality Index, and the change item of the Clinical Global Impressions Scale anchored to functioning. Secondary outcome measures were the 17-item CAPS, the Hamilton Depression Rating Scale, the Patient Health Questionnaire-9, and the Quality of Life Index. Maintenance psychotropic medications and supportive psychotherapy were held constant.Prazosin was effective for trauma nightmares, sleep quality, global function, CAPS score, and the CAPS hyperarousal symptom cluster. Prazosin was well tolerated, and blood pressure changes did not differ between groups.Prazosin is effective for combat-related PTSD with trauma nightmares in active-duty soldiers, and benefits are clinically meaningful. Substantial residual symptoms suggest that studies combining prazosin with effective psychotherapies might demonstrate further benefit.",0,0 +3484,Delivering a Victim Impact Statement: Emotionally effective or counter-productive?,"Although the delivery of a Victim Impact Statement (VIS) in court is assumed to contribute to the healing and recovery process of victims of violent crimes, its effectiveness to facilitate emotional recovery is widely debated. The current longitudinal study is the first to empirically examine the psychological effects of delivering a VIS in terms of the two most important emotional reactions after crime: anger and anxiety. It extends previous findings by showing that the debate concerning the effectiveness of delivering a VIS is not a ‘black and white’ matter. In this article, we argue that the question should not be whether delivering a VIS ‘works’ or ‘doesn’t work’ for the victim, but for whom, and under which conditions. We show that delivering a VIS does not give rise to direct ‘therapeutic’ effects. However, we found that feelings of anger and anxiety decrease for victims who experience more control over their recovery process and higher levels of procedural justice.",0,0 +3485,Persistent Pain in Adolescents Following Traumatic Brain Injury,"Traumatic brain injury (TBI) is a leading cause of pediatric disability. Although persistent pain has been recognized as a significant postinjury complication, there is a paucity of data concerning the postinjury pain experience of youth. This study aimed to examine the prevalence of persistent pain in adolescents after TBI, identify risk factors for pain, and evaluate the impact of pain on adolescent health-related quality of life. Participants included 144 adolescents with mild to severe TBI who were followed over 36 months after injury. At 3-, 12-, 24-, and 36-month assessments, measures of pain intensity, depression, posttraumatic stress disorder, and health-related quality of life were completed by adolescents. Findings demonstrated that 24.3% of adolescents reported persistent pain (defined as usual pain intensity ≥3/10) at all assessment points after TBI. Female sex (odds ratio = 2.73, 95% confidence interval = 1.12-6.63) and higher levels of depressive symptoms at 3 months after injury (odds ratio = 1.26, 95% confidence interval = 1.12-1.43) were predictors of persistent pain at 36 months. Furthermore, mixed linear models indicated that early pain experience at 3 months following TBI was associated with a significantly poorer long-term health-related quality of life.This is the first study to examine the prevalence of persistent pain over long-term follow-up in adolescents after TBI and its impact on health-related quality of life. These findings indicate that adolescents with TBI may benefit from timely evaluation and intervention to minimize the development and impact of pain.",0,0 +3486,C-39 * Resilience and Symptom Reporting following Mild Traumatic Brain Injury,"OBJECTIVE: The purpose of this study was to examine the relationship between resilience and symptom reporting following mild traumatic brain injury (mTBI). METHOD: Participants included 196 U.S. military service members (mean age = 29.2 years, SD = 8.4) who sustained a mTBI (78.8% 12 months post-injury). Three groups were derived based on self-reported resilience on the Response to Stressful Experiences Scale: low (n = 51), moderate (n = 71), and high (n = 74). Outcome measures included the Neurobehavioral Symptom Inventory (NSI) and PTSD Checklist-Civilian (PCL-C). RESULTS: There were significant main effects for all NSI and PCL-C total scores and symptom clusters (all p < .05). Pairwise comparisons revealed that the low resilience group reported greater symptomatology compared to the moderate and high resilience groups on the NSI and PCL-C total scores, NSI affective cluster, and PCL-C avoidance and hyperarousal clusters (all p < .005; d = .44-.83). Additionally, the low resilience group reported greater symptomatology compared to the high resilience group on the NSI somatic/sensory and cognitive clusters, and the PCL-C re-experiencing symptom cluster (all p < .05; d = .53-.75). Using logistic regression analyses, both the NSI and PCL-C total scores were significant predictors of high versus low resilience groups (both p < .01). However, the NSI and PCL-C total scores more reliably predicted the high resilience group (85.1% and 83.8% correctly classified, respectively) compared to the low resilience group (41.2% and 43.1% correctly classified). CONCLUSION(S): These results suggest that service members who have low resilience endorse greater symptomatology following mTBI compared to those who have high resilience.",0,0 +3487,"The co-occurrence of childhood sexual abuse, adult sexual assault, intimate partner violence, and sexual harassment: A mediational model of posttraumatic stress disorder and physical health outcomes.","This study examined the co-occurrence of childhood sexual abuse, adult sexual assault, intimate partner violence, and sexual harassment in a predominantly African American sample of 268 female veterans, randomly sampled from an urban Veterans Affairs hospital women's clinic. A combination of hierarchical and iterative cluster analysis was used to identify 4 patterns of women's lifetime experiences of violence co-occurrence. The 1st cluster experienced relatively low levels of all 4 forms of violence; the 2nd group, high levels of all 4 forms; the 3rd, sexual revictimization across the lifespan with adult sexual harassment; and the 4th, high intimate partner violence with sexual harassment. This cluster solution was validated in a theoretically driven model that examined the role of posttraumatic stress disorder (PTSD) as a mediator of physical health symptomatology. Structural equation modeling analyses revealed that PTSD fully mediated the relationship between violence and physical health symptomatology. Consistent with a bio-psycho-immunologic theoretical model, PTSD levels more strongly predicted pain-related physical health symptoms compared to nonpain health problems. Implications for clinical interventions to prevent PTSD and to screen women for histories of violence in health care settings are discussed.",0,0 +3488,Using mixture models with known class membership to address incomplete covariance structures in multiple-group growth models,"Multi-group latent growth modelling in the structural equation modelling framework has been widely utilized for examining differences in growth trajectories across multiple manifest groups. Despite its usefulness, the traditional maximum likelihood estimation for multi-group latent growth modelling is not feasible when one of the groups has no response at any given data collection point, or when all participants within a group have the same response at one of the time points. In other words, multi-group latent growth modelling requires a complete covariance structure for each observed group. The primary purpose of the present study is to show how to circumvent these data problems by developing a simple but creative approach using an existing estimation procedure for growth mixture modelling. A Monte Carlo simulation study was carried out to see whether the modified estimation approach provided tangible results and to see how these results were comparable to the standard multi-group results. The proposed approach produced results that were valid and reliable under the mentioned problematic data conditions. We also present a real data example and demonstrate that the proposed estimation approach can be used for the chi-square difference test to check various types of measurement invariance as conducted in a standard multi-group analysis.",0,0 +3489,History and Use of Relative Importance Indices in Organizational Research,"The search for a meaningful index of the relative importance of predictors in multiple regression has been going on for years. This type of index is often desired when the explanatory aspects of regression analysis are of interest. The authors define relative importance as the proportionate contribution each predictor makes to R 2 , considering both the unique contribution of each predictor by itself and its incremental contribution when combined with the other predictors. The purposes of this article are to introduce the concept of relative importance to an audience of researchers in organizational behavior and industrial/organizational psychology and to update previous reviews of relative importance indices. To this end, the authors briefly review the history of research on predictor importance in multiple regression and evaluate alternative measures of relative importance. Dominance analysis and relative weights appear to be the most successful measures of relative importance currently available. The authors conclude by discussing how importance indices can be used in organizational research.",0,0 +3490,Mild traumatic brain injury,"Mild traumatic brain injury (TBI) is common but accurate diagnosis and defining criteria for mild TBI and its clinical consequences have been problematic. Mild TBI causes transient neurophysiologic brain dysfunction, sometimes with structural axonal and neuronal damage. Biomarkers, such as newer imaging technologies and protein markers, are promising indicators of brain injury but are not ready for clinical use. Diagnosis relies on clinical criteria regarding depth and duration of impaired consciousness and amnesia. These criteria are particularly difficult to confirm at the least severe end of the mild TBI continuum, especially when relying on subjective, retrospective accounts. The postconcussive syndrome is a controversial concept because of varying criteria, inconsistent symptom clusters and the evidence that similar symptom profiles occur with other disorders, and even in a proportion of healthy individuals. The clinical consequences of mild TBI can be conceptualized as two multidimensional disorders: (1) a constellation of acute symptoms that might be termed early phase post-traumatic disorder (e.g., headache, dizziness, imbalance, fatigue, sleep disruption, impaired cognition), that typically resolve in days to weeks and are largely related to brain trauma and concomitant injuries; (2) a later set of symptoms, a late phase post-traumatic disorder, evolving out of the early phase in a minority of patients, with a more prolonged (months to years), sometimes worsening set of somatic, emotional, and cognitive symptoms. The later phase disorder is highly influenced by a variety of psychosocial factors and has little specificity for brain injury, although a history of multiple concussions seems to increase the risk of more severe and longer duration symptoms. Effective early phase management may prevent or limit the later phase disorder and should include education about symptoms and expectations for recovery, as well as recommendations for activity modifications. Later phase treatment should be informed by thoughtful differential diagnosis and the multiplicity of premorbid and comorbid conditions that may influence symptoms. Treatment should incorporate a hierarchical, sequential approach to symptom management, prioritizing problems with significant functional impact and effective, available interventions (e.g., headache, depression, anxiety, insomnia, vertigo).",0,0 +3491,VICTIMIZATION OF WOMEN AND ITS IMPACT ON ASSESSMENT AND TREATMENT IN THE PSYCHIATRIC EMERGENCY SETTING,"An understanding of victimization is critical to the practice of emergency psychiatry. Victimization histories are disturbingly common among women presenting to the PES, particularly among frequent service users. The sequelae of victimization are both psychological and physical and often impair health and functioning across numerous domains. PTSD, BPD, and substance-use disorders are often seen among women with victimization histories, which can be particularly challenging for PES providers. Screening for trauma on PES presentation or history should not be overlooked in any person, including severely mentally ill, homeless, disabled, or elderly women. PES clinicians should remember to ask about victimization and pose questions privately in a direct and an open-ended format while conveying empathic validation. Clinical assessment of women with victimization histories in the PES should be guided by the principles of standard emergency psychiatry and be informed by an understanding of trauma. This includes a working knowledge of trauma dynamics, adherence to sound professional boundaries, and care not to retraumatize patients or re-enact perpetrator-victim dynamics. Voyeurism and regression should be avoided, particularly when eliciting trauma history. The PES should be a place for screening and acute intervention, not for conducting intensive trauma therapy. In the PES, the focus should remain on triage and treatment priorities, those of safety and stabilization, and carefully evaluating for substance use and psychosis. The PES ideally provides a ""holding environment"" that affords a balance of nurturing, limits, consistency, and communication. A basic knowledge of cognitive-behavioral interventions affording ""crisis survival strategies,"" such as DBT, can be particularly useful to PES clinicians. Clinicians also need to monitor issues of countertransference and the potential to be dismissive to these women with complex, comorbid, and chronic problems and diseases. The role for the use of psychotropic medication in PES cohorts with victimization histories should target acute symptoms. Involving regular providers of these decisions is advised to coordinate care and minimize splitting and risks of polypharmacy. Although the SSRIs are effective in symptom management of disorders related to victimization, patients must be reminded of the side-effect profile, particularly sexual dysfunction and withdrawal and discontinuation syndromes.",0,0 +3492,Dissociative processes and symptoms of posttraumatic stress in Vietnam veterans,"The diagnostic taxonomy of posttraumatic stress disorder (PTSD) is a contentious issue. Commentators are divided as to whether PTSD should remain grouped with the anxiety disorders or conceptualized as a dissociative disorder. This study sought to clarify the issue by investigating the extent to which anxiety and dissociative processes differentially predict the severity of each of the three symptoms clusters in PTSD. Seventy-four Australian veterans of the Vietnam War were assessed on measures of dissociation, trait anxiety, and posttraumatic stress symptomatology. Multiple regression analyses showed that all three symptoms clusters were predicted by anxiety, but the clusters differed in the pattern of their relationship with dissociation variables. The failure of pathological dissociation to predict PTSD symptoms prompts a reconsideration of the point at which dissociative mechanisms may impact on this disorder. The findings are consistent with current classification of combat-related PTSD as an anxiety disorder.",0,0 +3493,The first president's pathway into ESTSS: memories and ideas for future issue. Patients as partners,"This article addresses Wolter De Loos' pathway into ESTSS that ended on 6th January 2004. His footsteps are still printed in the field of psychotraumatology as he showed the field how a physician was trying to integrate his working field with that of psychiatry, with a great passion for his patients. Erica M. Van der Schrieck-De Loos outlines the perspectives of her father as funding president of the ESTSS by using his Opening Address of the Fourth ESTSS Conference in 1995. This address emphasized that the mixture of righteousness and offence in warfare is ubiquitious and everlasting. The perspective of the first president's pathway has been integrated with the current vision of the author to show that the patient can be a partner of the healthcare team. A suggestion for ESTSS main objective number (8), contained within the ESTSS mission statement, is to involve patients as partners of the traumatic stress care team into accelerating traumatic stress care across Europe and beyond.",0,0 +3494,Impact of Event Scale-Revised,,0,0 +3495,The Posttraumatic Stress Disorder Checklist as a Screening Measure for Posttraumatic Stress Disorder in Rehabilitation After Burn Injuries,"To determine the profile of posttraumatic stress disorder (PTSD) among outpatients with burn injuries referred to psychology in a rehabilitation hospital, and the utility of the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) as a screening measure for PTSD.Retrospective psychological chart review.Outpatient burn clinic of a rehabilitation hospital.Outpatients (N=132) with burns referred to psychology between December 1999 and January 2010.Psychological evaluation and self-report questionnaires measuring PTSD and depression.The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition to assess clinical diagnosis of disorders, PCL-C to measure PTSD, and the Beck Depression Inventory-II to measure depression.Of 132 outpatients, 127 (96%) had work-related injuries, 116 (88%) were men, and 16 (12%) were women. Mean age ± SD at injury was 39.0±11.1 years. Mean time from injury to assessment was 15.7±42.7 months. Burn etiology included: electrical (46.2%), scald (28.0%), flame (16.7%), chemical (5.3%), and contact (3.8%). Most patients (75%) were diagnosed with PTSD, either clinical (39.4%) or subclinical (35.6%). PTSD (clinical or subclinical) was frequently diagnosed in the following etiology groups: scald (85.7%), flame (77.3%), and electrical (74.6%). There were significant relationships between PTSD and depression (P<.001), and between subclinical PTSD and adjustment disorder (P<.03). PCL-C mean scores ± SD in the clinical and subclinical PTSD groups were 59.7±8.9 and 43.5±15.6, respectively. A PCL-C total score of 50 or higher had a sensitivity of 90% and specificity of 79% for PTSD diagnosis.There was a high prevalence of PTSD (clinical or subclinical) among outpatients with burns referred to psychology. Prospective screening of psychological symptoms, clinical assessment, and intervention is warranted, especially for patients with work-related burn injuries. Our results suggest that PCL-C is a useful screening measure for PTSD in patients with burns.",0,0 +3496,Stress Induced Hypothalamus-Pituitary-Adrenal Axis Responses and Disturbances in Psychological Profiles in Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome,"Chronic pelvic pain in men has a strong relationship with biopsychosocial stress and central nervous system sensitization may incite or perpetuate the pain syndrome. We evaluated patients and asymptomatic controls for psychological factors and neuroendocrine reactivity under provoked acute stress conditions.Men with pain (60) and asymptomatic controls (30) completed psychological questionnaires including the Perceived Stress, Beck Anxiety, Type A behavior and Brief Symptom Inventory for distress from symptoms. Hypothalamic-pituitary-adrenal axis function was measured during the Trier Social Stress Test with serum adrenocorticotropin hormone and cortisol reactivity at precise times, before and during acute stress, which consisted of a speech and mental arithmetic task in front of an audience. The Positive and Negative Affective Scale measured the state of emotions.Patients with chronic pelvic pain had significantly more anxiety, perceived stress and a higher profile of global distress in all Brief Symptom Inventory domains (p <0.001), scoring in the 94th vs the 49th percentile for controls (normal population). Patients showed a significantly blunted plasma adrenocorticotropin hormone response curve with a mean total response approximately 30% less vs controls (p = 0.038) but no differences in any cortisol responses. Patients with pelvic pain had less emotional negativity after the test than controls, suggesting differences in cognitive appraisal.Men with pelvic pain have significant disturbances in psychological profiles compared to healthy controls and evidence of altered hypothalamic-pituitary adrenal axis function in response to acute stress. These central nervous system observations may be a consequence of neuropsychological adjustments to chronic pain and modulated by personality.",0,0 +3497,PROSPECTIVE INVESTIGATION OF MENTAL HEALTH FOLLOWING SEXUAL ASSAULT,"Comorbidity in psychological disorders is common following exposure to a traumatic event. Relatively little is known about the manner in which changes in the symptoms of a given type of psychological disorder in the acute period following a trauma impact changes in symptoms of another disorder. This study investigated the relationship between changes in posttraumatic stress disorder (PTSD), depression, and anxiety symptoms in the first 12 weeks following sexual assault.Participants were 126 women who had been sexually assaulted in the previous 4 weeks.Lower level mediation analyses revealed that changes in PTSD symptoms had a greater impact on changes in depression and anxiety than vice versa.The finding highlights the role of PTSD symptoms in influencing subsequent change in other psychological symptoms. These findings are discussed in the context of models detailing the trajectory of psychological disorders following trauma, and clinical implications are considered.",0,0 +3498,Prostatic epithelial polyp diagnosed in a bladder wash,"Prostatic epithelial polyps, also known as adenomatous polyps or papillary adenomas with prostatic type epithelium, are uncommon lesions. These lesions typically involve the adult male urethra, trigone, or bladder dome. Diagnosis is usually made by biopsy. Presence of clusters of benign columnar cells in urine cytologic material can suggest the presence of such polyps and must be included in the differential diagnosis.",0,0 +3499,Prospective Evaluation of Parent Distress Following Pediatric Burns and Identification of Risk Factors for Young Child and Parent Posttraumatic Stress Disorder,"Early childhood is a high-risk time for exposure to potentially traumatic medical events. We have previously reported that 10% of young children continue to have posttraumatic stress disorder (PTSD) 6 months after burn injury. This study aimed to 1) document the prevalence and prospective change in parental psychological distress over 6 months following their child's burn injury and 2) identify risk factors for posttraumatic stress symptoms (PTSS) in young children and their parents.Participants were 120 parents of 1-6-year-old children with unintentional burn injuries. Data were collected within 2 weeks, 1 month, and 6 months of burn injury using developmentally sensitive diagnostic interviews and questionnaires.Within the first month, ∼ 25% of parents had a probable PTSD diagnosis, and moderate to extremely severe levels of depression, anxiety, and stress. Distress levels decreased significantly over time; however, 5% of parents still had probable PTSD at 6 months. Hierarchical multiple regression and path analyses indicated that parent posttraumatic stress reactions contributed significantly to the development and maintenance of child PTSS. Other risk factors for child PTSS included premorbid emotional and behavioral difficulties and larger burn size. Risk factors identified for parent PTSS included prior trauma history, acute distress, greater number of child invasive procedures, guilt, and child PTSS.The findings from this study suggest that parents' responses to a traumatic event may play a particularly important role in a young child's psychological recovery. However, further research is needed to confirm the direction of the relationship between child and parent distress. This study identified variables that could be incorporated into screening tools or targeted by early intervention protocols to prevent the development of persistent child and parent PTSS following medical trauma.",0,0 +3500,Impact of short-term heat stress on physiological responses and expression profile of HSPs in Barbari goats,"Six, nonpregnant, Barbari goats aged 4–5 years were selected for the study. For the first 6 days, the animals were kept in psychrometric chamber at thermoneutral temperature for 6 h each day to make them acclimated to climatic chamber. On the 7th day, the animals were exposed to 41 °C temperature for 3 h and then to 45 °C for the next 3 h. Cardinal physiological responses were measured, and blood samples (3 ml) were collected at 1-h interval during the heat exposure period and then once after 6 h of the heat exposure. The rectal temperature (RT) and respiratory rate (RR) increased significantly (P < 0.05) during the heat exposure compared to pre- and postexposure. The relative messenger RNA (mRNA) expression of heat shock protein (HSP)60, HSP70, and HSP90 increased significantly (P < 0.05) within 1 h after exposure to heat stress at 41 and 45 °C and decreased significantly (P < 0.05) in next 2 h but remain significantly (P < 0.05) elevated from preexposure. HSP105/110 relative mRNA expression level remained unchanged during the first 4 h, and thereafter, it increased significantly (P < 0.05) and reached the peak at 6 h. Relative protein expression pattern of HSPs during exposure to heat stress showed similar trend as observed for the relative mRNA expression. Given the response sensitivity and intensity of HSP genes to environmental stresses, HSP70 was found to be the most sensitive to temperature fluctuation, and it could be used as an important molecular biomarker to heat stress in animals. © 2014, ISB.",0,0 +3501,Surveying Treatment Preferences in U.S. Iraq-Afghanistan Veterans With PTSD Symptoms: A Step Toward Veteran-Centered Care,en,0,0 +3502,Posttraumatic Stress Disorder Symptom Clusters and Perpetration of Intimate Partner Violence: Findings From a U.S. Nationally Representative Sample,"Associations between posttraumatic stress disorder (PTSD) and perpetration of intimate partner violence (IPV) have not been extensively studied in nonveteran samples. Secondary analysis was conducted using a nationally representative U.S. sample and limited to those who reported being in a relationship in the past year (N = 25,652). This sample was mostly White (72.0%), the majority had completed high school/ general educational development (GED; 87.8%), about half were female (49.2%), and the mean age was 46.44 years (SD = 15.92). We hypothesized that a diagnosis of PTSD in the past year would be associated with greater perpetration of IPV and that the arousal/reactivity and intrusion symptom clusters would evidence the strongest associations with IPV. Consistent with expectations, a PTSD diagnosis in the past year was associated with greater perpetration of IPV, OR = 2.07, 95% CI [1.89, 2.26]. Among those with a PTSD diagnosis in the past year (n = 1,742), arousal/reactivity symptom cluster scores were associated with greater perpetration of IPV for both men and women, AOR = 1.27, 95% CI [1.11, 1.44]; intrusion symptom cluster scores were associated with perpetration of IPV for men only, AOR = 1.56, 95% CI [1.20, 2.04]; whereas negative cognitions/mood symptom cluster scores were only significant among women, AOR = 1.12, 95% CI [1.01, 1.24]. Results suggested that theoretical and empirical work linking PTSD and perpetration of IPV in military samples extends to the general population.",0,0 +3503,Are avoidance and numbing distinct PTSD symptom clusters?,"We present the conceptual basis and empirical evidence for considering avoidance and numbing as distinct posttraumatic stress disorder (PTSD) symptom clusters. The majority of data from factor analytic studies supports the position that avoidance and numbing are distinct symptom clusters. As well, the available data suggest that (a) different treatment modalities have differential effects on reducing avoidance but not numbing, (b) patients with more severe pretreatment numbing have poorer treatment outcomes, (c) avoidance and numbing have different patterns of correlation with depression, and (d) they have different correlations with physiological indices of attention. We conclude that avoidance and numbing are distinct PTSD symptom clusters. This distinction has implications for revising current diagnostic criteria. The recognition of this distinction may lead to advances in understanding and treating PTSD.",0,0 +3504,Posttraumatic Stress and Posttraumatic Stress Disorder after Termination of Pregnancy and Reproductive Loss: A Systematic Review,"Objective . The aims of this systematic review were to integrate the research on posttraumatic stress (PTS) and posttraumatic stress disorder (PTSD) after termination of pregnancy (TOP), miscarriage, perinatal death, stillbirth, neonatal death, and failed in vitro fertilisation (IVF). Methods . Electronic databases (AMED, British Nursing Index, CINAHL, MEDLINE, SPORTDiscus, PsycINFO, PubMEd, ScienceDirect) were searched for articles using PRISMA guidelines. Results . Data from 48 studies were included. Quality of the research was generally good. PTS/PTSD has been investigated in TOP and miscarriage more than perinatal loss, stillbirth, and neonatal death. In all reproductive losses and TOPs, the prevalence of PTS was greater than PTSD, both decreased over time, and longer gestational age is associated with higher levels of PTS/PTSD. Women have generally reported more PTS or PTSD than men. Sociodemographic characteristics (e.g., younger age, lower education, and history of previous traumas or mental health problems) and psychsocial factors influence PTS and PTSD after TOP and reproductive loss. Conclusions . This systematic review is the first to investigate PTS/PTSD after reproductive loss. Patients with advanced pregnancies, a history of previous traumas, mental health problems, and adverse psychosocial profiles should be considered as high risk for developing PTS or PTSD following reproductive loss.",0,0 +3505,A Cross-Sectional Analysis of Clinical Outcomes Following Chiropractic Care in Veterans With and Without Post-Traumatic Stress Disorder,"This study was a cross-sectional analysis of clinical outcomes for 130 veteran patients with neck or low back complaints completing a course of care within the chiropractic clinic at the VA of Western New York in 2006. Multivariate analysis of variance (MANOVA) was utilized, comparing baseline and discharge scores for both the neck and low back regions and for those patients with and without post-traumatic stress disorder (PTSD). Patients with PTSD (n = 21) experienced significantly lower levels of score improvement than those without PTSD (n = 119) on self-reported outcome measures of neck and low back disability. These findings, coupled with the theorized relationships between PTSD and chronic pain, suggest that the success of conservative forms of management for veteran patients with musculoskeletal disorders may be limited by the presence of PTSD. Further research is warranted to examine the potential contributions of PTSD on chiropractic clinical outcomes with this unique patient population.",0,0 +3506,Post-traumatic stress symptoms 5 years after military deployment to Afghanistan,,0,0 +3507,Post-traumatic Growth Inventory: Psychometric properties of the Arabic version in Palestinian adults.,"In the current study, we investigated the psychometric properties of an Arabic version of the posttraumatic growth inventory in an adult group of Palestinians in Gaza. The internal consistency of the total scale, as well as its sub-scales, was satisfactory. Furthermore, the scale significantly correlated with stress related growth. The experience of posttraumatic growth was not related to Post Traumatic Stress Disorder, but was significantly related to cumulative trauma. Cumulative Trauma predicted post traumatic growth. Using confirmatory factor analysis, a five, three, two and one factor, as well as a hierarchical structure models were compared. While the five, the three, the one and the hierarchical models were relatively satisfactory, the two factor model had the best fit to the data. The Arabic version of the instrument appeared to be a sound measure for the experience of posttraumatic growth in Palestinian adults. Further, a modest to moderate degree of posttraumatic growth was found in the current multiply traumatized sample. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +3508,The correspondence of daily and retrospective PTSD reports among female victims of sexual assault.,"Research addressing the association between daily and retrospective symptom reports suggests that retrospective reports are typically inflated. The present study examined the association between daily posttraumatic stress disorder (PTSD) symptom reports over 1 month and a corresponding retrospective report (PTSD Checklist [PCL]; Weathers et al., 1993) for both total scores and symptom clusters. The authors hypothesized that greater PTSD symptom instability and greater depression would be associated with poorer agreement between daily and retrospective reports. Data were collected from 132 female college students who were sexually assaulted. Multilevel modeling indicated very strong agreement between mean daily and retrospective reports for total scores and symptom clusters, with pseudo-R2 ranging from .55 to .77. Depression symptoms did not moderate this association, but daily-retrospective agreement was lowest for the avoidance cluster, which was also the most unstable. Finally, retrospective recall for each symptom cluster showed acceptable specificity to the corresponding daily symptom clusters. Overall, these findings suggest that retrospective memories for global PTSD symptoms and symptom clusters, as assessed by the PCL, are consistent with daily reports over a 1-month period. Implications for clinical assessment methodology are discussed.",0,0 +3509,Are Selective Serotonin Reuptake Inhibitors Safe for Drivers? What is the Evidence?,"

Abstract

Background

Selective serotonin reuptake inhibitors (SSRIs) are widely used medications to treat several psychiatric diseases and, above all, depression. They seem to be as effective as older antidepressants but have a different adverse effect profile. Despite their favorable safety profile, little is known about their influence on traffic safety.

Objective

To conduct a literature review to summarize the current evidence on the role of SSRIs in traffic safety, particularly concerning undesirable effects that could potentially impair fitness to drive, experimental and pharmacoepidemiologic studies on driving impairment, 2 existing categorization systems for driving-impairing medications, and the European legislative procedures for assessing fitness to drive before issuing a driver's license and driving under the influence of medicines.

Methods

The article search was performed in the following electronic databases: MEDLINE, PsycINFO, ScienceDirect, and SafetyLit. The English-language scientific literature was searched using key words such as SSRIs and psychomotor performance, car crash or traffic accident, and adverse effects. For inclusion in this review, papers had to be full-text articles, refer to possible driving-related adverse effects, and be experimental or pharmacoepidemiologic studies on SSRIs and traffic accident risks. No restrictions concerning publication year were applied.

Results

Ten articles were selected as background information on driving-related adverse effects, and 15 articles were selected regarding experimental and pharmacoepidemiologic work. Regarding SSRI adverse effects, the most reported undesirable effects referring to driving impairment were anxiety, agitation, sleep disturbances, headache, increased risk of suicidal behavior, and deliberate self-harm. Regarding the remaining issues addressed in this article, inconsistencies were found between the outcomes of the selected experimental and epidemiologic studies and between the 2 existing categorization systems under evaluation. Some pitfalls of the current legislative scenario were identified as well.

Conclusions

Based on the current evidence, it was concluded that more experimental and epidemiologic research is needed to elucidate the relationship between SSRI use and traffic safety. Furthermore, a revision of the existing categorization systems and harmonized European legislation in the field of medication use and driving were highly recommended.",0,0 +3510,Traumatic Brain Injury in a Child Psychiatry Outpatient Clinic: A Controlled Study,"To demonstrate the similarity of children with a history of traumatic brain injury (TBI), particularly mild TBI, to matched children without such a history, within a child psychiatry outpatient clinic.This is a chart review of patients presenting to a child psychiatry outpatient clinic over a 3-year period. Children with TBI were matched by age, sex, race, and social class to children with no history of TBI. Axis I and II diagnoses, use of special education services, and IQ scores were compared.Seventy-four (5.6%) of 1,333 consecutive clinic cases had a definite TBI. Of these, 64 were mild. Only 3 of 59 comparisons that were made between TBI and control subjects were significant. A developmental communication disorder cluster was significantly more frequent in the TBI group. Autism and a pervasive developmental disorder cluster were significantly more frequent in the control group.In a child psychiatry clinic, patients with a history of TBI are virtually indistinguishable from matched children without TBI. Caution should be exercised before attributing the child's problems, especially long-term problems, to the TBI unless the injury was severe or the child is exhibiting related phobic or posttraumatic stress symptomatology.",0,0 +3511,Auricular Acupuncture: A Brief Introduction for Military Providers,"Injured veterans returning from Operation Iraqi Freedom and Operation Enduring Freedom often require long-term medical management for a variety of complex physical and mental health conditions. These conditions can be challenging to treat with conventional Western medicine practices alone. Recently, complementary and alternative medicine practices have been used within military settings, and have been well received by veterans. Auricular acupuncture is a practice that has provided veterans with a new approach to manage symptoms associated with a wide range of health conditions. This treatment has become an attractive treatment option because of its low cost, portability, minimal side effect profile, and ease of use in clinical and operational settings. Although formally trained Oriental medicine practitioners have historically performed these treatments, military health care providers are now receiving education and training to administer these treatments. This education and training allows military health care providers to expand their knowledge of acupuncture and provide this treatment to veterans across the continuum of care. The purpose of this article is to provide a fundamental description of auricular acupuncture and increase awareness of this treatment and its relevance to military settings.",0,0 +3512,Moderating Effects of a Postdisaster Intervention on Risk and Resilience Factors Associated With Posttraumatic Stress Disorder in Chinese Children,en,0,0 +3513,Healing with Plant Intelligence: A Report from Ayahuasca,"Numerous and diverse reports indicate the efficacy of shamanic plant adjuncts (e.g., iboga, ayahuasca, psilocybin) for the care and treatment of addiction, post-traumatic stress disorder, cancer, cluster headaches, and depression. This article reports on a first-person healing of lifelong asthma and atopic dermatitis in the shamanic context of the contemporary Peruvian Amazon and the sometimes digital ontology of online communities. The article suggests that emerging language, concepts, and data drawn from the sciences of plant signaling and behavior regarding “plant intelligence” provide a useful heuristic framework for comprehending and actualizing the healing potentials of visionary plant “entheogens” (Wasson 1971) as represented both through first-person experience and online reports. Together with the paradigms and practices of plant signaling, biosemiotics provides a robust and coherent map for contextualizing the often reported experience of plant communication with ayahuasca and other entheogenic plants. The archetype of the “plant teachers” (called Doctores in the upper Amazon) is explored as a means for organizing and interacting with this data within an epistemology of the “hallucination/perception continuum (Fischer 1975). “Ecodelic” is offered as a new linguistic interface alongside “entheogen” (Wasson 1971).",0,0 +3514,Trauma-Related Correlates of Alcohol Use in Recently Deployed OEF/OIF Veterans,"The co-occurrence of posttraumatic stress disorder (PTSD) and alcohol use disorders (AUDs) is well documented. Little is known about the factors that contribute to alcohol use and the development of AUDs among military personnel following deployment. The primary aim of this study was to examine trauma-related correlates of alcohol use in recently deployed Operation Enduring Freedom/Operation Iraqi Freedom veterans. Members of the Rhode Island National Guard and Army Reserves (N = 238) completed an in-person, initial assessment an average of 6 months postdeployment. Multiple regression analyses examined predictors of drinking outcomes (combat exposure, total PTSD symptoms, and PTSD symptom clusters) after accounting for gender, age, and history of AUD. Results indicated that total PTSD symptoms, but not combat exposure, significantly predicted alcohol use at the initial assessment. When PTSD symptom clusters were considered separately, reexperiencing symptoms (Cluster B) were the strongest predictor of total alcohol use (B = 3.58, p = .002) and heavy drinking episodes (B = 0.31, p = .005). Implications for these findings include early identification of risk factors that could lead to the development of AUDs, and the importance of integrated treatment approaches for co-occurring PTSD and AUD among veterans postdeployment.",0,0 +3515,The Effectiveness of Art Therapy Interventions in Reducing Post Traumatic Stress Disorder (PTSD) Symptoms in Pediatric Trauma Patients,"Although post traumatic stress disorder (PTSD) in children has been extensively studied during the past 15 years, little research exists regarding the efficacy of treatment interventions. This report describes an outcome-based art therapy research project currently conducted at a large urban hospital trauma center. Included are the theoretical rationale and overview of an art therapy treatment intervention called the Chapman Art Therapy Treatment Intervention (CATTI) designed to reduce PTSD symptoms in pediatric trauma patients. Used in this study, the CATTI was evaluated for efficacy in measuring the reduction of PTSD symptoms at intervals of 1 week, 1 month, and 6 months after discharge from the hospital. An early analysis of the data does not indicate statistically significant differences in the reduction of PTSD symptoms between the experimental and control groups. However, there is evidence that the children receiving the art therapy intervention did show a reduction in acute stress symptoms.",0,0 +3516,"Psychological symptoms of Turkish children and adolescents after the 1999 earthquake: Exposure, gender, location, and time duration",The authors describe their study of posttraumatic stress symptoms of children and adolescents after the 1999 earthquakes in Turkey. The rate of possible PTSD cases is also presented. The findings are reported as the results of two different studies. Location had a main effect on almost all of the dependent variables for both samples. The posttraumatic stress symptom scores for both groups significantly decreased 3 months after the initial assessment. The best predictors of the perceived posttraumatic stress symptoms for both children and adolescents were found to be perceived negative school performance and exposure.,0,0 +3517,Longitudinal trajectories of cigarette smoking following rape,"Although prior research has identified increases in cigarette smoking following trauma exposure, no studies have examined longitudinal trajectories of smoking following rape. The present investigation identified and characterized longitudinal (< 3 months, 3-6 months, and > 6 months post-assault) trajectories of smoking (N = 152) following a rape in a sample of 268 sexual assault victims participating in a forensic medical exam. Further, the authors examined acute predictors of subsequent smoking trajectories. Of participants endorsing smoking post-rape, a two-class solution was identified, with the majority of participants (74.6%) evidencing moderate smoking with a slight decrease over time and remaining participants showing heavy smoking with a slight increase over time. Having sustained an injury, minority status, and post-examination distress all predicted subsequent smoking trajectory.",0,0 +3518,The evaluation of Franco-Quebec victims of child sexual abuse and their mothers: The implementation of a standard assessment protocol,"There were two aims: first, to evaluate the feasibility of applying a standard assessment protocol to Franco-Quebec victims of child sexual abuse and nonoffending mothers; and second, to compare results from an initial sample with available data from English-speaking samples.A standard individual case study design was used for victims and mothers; and the satisfaction of the nine participating youth workers was assessed. Four self-report instruments for victims and five for mothers were chosen on the bases of workers' priorities, sensitivity to the impact of CSA, and the availability of published norms on English-speaking samples. Results are reported on 48 confirmed victims and 40 nonoffending mothers.The protocol was favorably received by the CPS workers, supervisors and all mothers and victims. Percentages of clinically distressed victims varied from highs of 68% on the externalization difficulties of the Child Behavior Checklist and 67% for 2- to 6-year-olds on the Child Sexual Behavior Inventory, to lows of 10% on hostility symptoms and 13% on the Dissociation Scale of the Trauma Symptom Check for Children. The rate of symptom-free children was lower (19%) and that of revictimization higher (30%) than most published estimates (Kendall-Tackett, Williams, & Finkelhor, 1993). Most mothers reported elevated emotional distress (depression, 59%) and symptoms of post-traumatic stress (intrusiveness, 67%). Although 87% of mothers believed the allegations, only 45% offered adequate emotional support.The implementation phase of this research was successful, given the positive reactions of workers and clients. Results on standard instruments from this French-speaking sample were similar to profiles of English-speaking victims and their mothers but firm conclusions on appropriate norms will require larger samples, cross cultural contrasts, and the evaluation of additional variables.",0,0 +3519,The Impact of Rape on Women's Sexual Health Risk Behaviors.,"This study used cluster analysis to identify three patterns of sexual health risk behaviors in a sample of adult rape survivors (N=102). Women in the 1st cluster (high risk) reported substantial increases from pre- to postrape in their frequency of sexual activity, number of sexual partners, infrequency of condom use, and frequency of using alcohol and/or drugs during sex. The 2nd cluster (moderate risk) reported increases in frequency of sexual activity and number of partners but mitigated that risk with increased condom use. Survivors in the 3rd cluster (low risk) indicated that their sexual health behaviors had become much less risky postrape. An ecological model predicting cluster membership revealed that individual-level and contextual factors predict patterns of risk behaviors.",0,0 +3520,Symptoms of Posttraumatic Stress Disorder and Borderline Personality Disorder in Veterans of Operation Desert Storm,"OBJECTIVE: The present report is part of a follow-along investigation focusing on the evolution of trauma-related symptoms in veterans of Operation Desert Storm. The goal of the current report was to examine three hypotheses on the relationship between severity of war-related trauma, symptoms of posttraumatic stress disorder (PTSD), and symptoms of borderline personality disorder with a mixed retrospective/prospective design. METHOD: Ninety-four National Guard reservists completed self-administered measures of combat-related trauma, PTSD symptoms, and borderline personality disorder features after their Gulf War duty. RESULTS: Consistent with study hypotheses, prewar features of borderline personality disorder predicted variability in postwar PTSD symptoms beyond that predicted by combat exposure, combat exposure predicted variability in postwar features of borderline personality disorder, and PTSD severity assessed shortly after combat exposure accounted for additional variability in subsequent features of borderline personality disorder. CONCLUSIONS: Taken together, the present findings suggest that trauma, symptoms of PTSD, and features of borderline personality disorder are related to one another in a complex fashion that may exceed simple linear models. Clinical and research implications for the relationships among trauma, PTSD, and borderline personality disorder are discussed.",0,0 +3521,Predicting fears of intimacy among individuals with post-traumatic stress symptoms by their sensory profile,"Introduction The purpose of the research was: (1) to compare fears of intimacy between people with post-traumatic stress symptoms and healthy controls; (2) to examine the relationships between sensory processing patterns and fears of intimacy among people with post-traumatic stress symptoms; (3) to examine the ability of post-traumatic stress symptoms and sensory processing patterns to predict fears of intimacy. Method The study consisted of 60 people between 24 and 62 years old. Thirty of the participants had post-traumatic stress symptoms and the other 30 were healthy controls. All participants were involved in an intimate relationship. Participants completed the Post-traumatic Stress Disorder Symptom Scale, the Adolescent/Adult Sensory Profile, and the Fear of Close Personal Relationship Questionnaire. Findings Higher prevalence of extreme sensory sensitivity, avoidance, and low registration was found among the study group. These patterns significantly correlated with impaired emotional responses associated with intimacy. Low registration and group membership predicted fears of intimacy. Conclusion Sensory processing difficulties may contribute to the impaired intimate relationships of people with post-traumatic stress symptoms. Occupational therapists may help people with post-traumatic stress symptoms to be aware of their sensory processing difficulties and their impact on social/intimate relationships. This awareness may contribute to the person's ability to cope with post-traumatic stress symptoms, enable better emotional performance, and elevate quality of life.",0,0 +3522,Exploring differences between the ICD-11 and DSM-5 models of PTSD: Does it matter which model is used?,"Alternative symptom profiles for posttraumatic stress disorder (PTSD) are presented in the DSM-5 and ICD-11. This study compared DSM-5 PTSD symptom profiles with ICD-11 PTSD symptom profiles among a large group of trauma-exposed individuals from Denmark. Covariates, and rates of co-occurrence with other psychiatric disorders were also investigated. A sample of treatment-seeking adult survivors of childhood sexual abuse (n=434) were assessed using self-report measures of PTSD and other psychiatric disorders. A significantly larger proportion of individuals met caseness for DSM-5 PTSD (60.0%) compared to ICD-11 PTSD (49.1%). This difference was largely attributable to low endorsement of the ICD-11 re-experiencing criteria. Replacement of the 'recurrent nightmares' symptom with the 'recurrent thoughts/memories' symptom seemed to balance the proportion of individuals meeting caseness for both taxonomies. Levels of co-occurrence with anxiety and thought disorder were higher for the DSM-5 model of PTSD compared to the ICD-11 model. Current results merit careful consideration in the selection of symptom indicators for the new ICD model of PTSD, particularly with respect to the re-experiencing symptom category.",0,0 +3523,"Rationale, Design, and Baseline Findings from a Randomized Trial of Collaborative Care for Chronic Musculoskeletal Pain in Primary Care","This article describes the rationale, design, and baseline findings from an ongoing study of collaborative care for chronic musculoskeletal pain and comorbid depression.Cluster randomized clinical trial.Forty-two clinicians and 401 patients from five Veterans Affairs primary care clinics.The intervention was based on the chronic care model, and included patient and provider activation and education, patient assessment, outcomes monitoring, and feedback to providers over 12 months. The intervention team consisted of a full-time psychologist care manager and a part-time physician internist. Approaches included goal setting emphasizing function, patient activation and educating about fear avoidance, and care management.Main outcomes are Roland-Morris Disability Questionnaire (RMDQ) score, depression severity (Patient Health Questionnaire-9), and pain severity (Chronic Pain Grade Severity subscale) at 6 and 12 months.Fifteen percent of primary care patients mailed a study advertisement letter requested screening for the study. The mean age of enrolled patients was 62. Back and neck or joint pain diagnoses were present in 67% and 65% of patients, respectively. Mean pain duration was 15 years, and mean RMDQ score (range 0-24) was 14.7 (standard deviation = 4.4). Sixty-five percent of patients were receiving disability. Eighteen percent of patients met criteria for major depression, 17% for posttraumatic stress disorder, and 9% for alcohol misuse. Thirty-nine percent of patients felt strongly that experiencing pain was a sign of damage, and 60% reported strong avoidance of painful activities.These baseline data support the rationale to develop a multifaceted approach to treat chronic pain in primary care that includes detection and treatment of psychiatric comorbidity.",0,0 +3524,Effectiveness of a Counseling Intervention after a Traumatic Childbirth: A Randomized Controlled Trial,"Adverse childbirth experiences can evoke fear and overwhelming anxiety for some women and precipitate posttraumatic stress disorder. The objective of this study was to assess a midwife-led brief counseling intervention for postpartum women at risk of developing psychological trauma symptoms.Of 348 women screened for trauma symptoms, 103 met inclusion criteria and were randomized into an intervention (n = 50) or a control (n = 53) group. The intervention group received face-to-face counseling within 72 hours of birth and again via telephone at 4 to 6 weeks postpartum. Main outcome measures were posttraumatic stress symptoms, depression, self-blame, and confidence about a future pregnancy.At 3-month follow-up, intervention group women reported decreased trauma symptoms, low relative risk of depression, low relative risk of stress, and low feelings of self-blame. Confidence about a future pregnancy was higher for these women than for control group women. Three intervention group women compared with 9 control group women met the diagnostic criteria for posttraumatic stress disorder at 3 months postpartum, but this result was not statistically significant.A high prevalence of postpartum depression and trauma symptoms occurred after childbirth. Although most women improved over time, the intervention markedly affected participants' trajectory toward recovery compared with women who did not receive counseling.A brief, midwife-led counseling intervention for women who report a distressing birth experience was effective in reducing symptoms of trauma, depression, stress, and feelings of self-blame. The intervention is within the scope of midwifery practice, caused no harm to participants, was perceived as helpful, and enhanced women's confidence about a future pregnancy.",0,0 +3525,Broad Clinical Phenotype and Facets of Emotion Regulation in Interpersonal Trauma Survivors,"This study examines broad-based psychopathology in a community sample of female survivors of interpersonal trauma. The extent to which facets of emotion regulation predict symptom presentation among this population is examined.Hierarchical cluster analysis examining symptoms of posttraumatic stress disorder, depression, somatization, and alcohol abuse was used to identify symptom clusters in an ethnically diverse sample (N = 205).Approximately 17% of the sample fell into a severe symptom group characterized by clinical levels of distress across all four disorders. The largest group (46%) was marked by subclinical distress across all four disorders, while the final group (37%) reported subclinical distress, but with a relative absence of alcohol abuse. Of the 6 emotion regulation subscales from the Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004), 2 consistently predicted group membership: nonacceptance and impulsivity.Cluster analyses revealed symptom clusters that may vary in their appropriateness for current posttrauma interventions. Implications for research and clinical practice are discussed.",0,0 +3526,Factors associated with chronicity in posttraumatic stress disorder: A prospective analysis of a national sample of women.,"The current study sought to identify factors associated with posttraumatic stress disorder (PTSD) chronicity over a 2-year time period in a national sample of adult women selected via random-digit dialing. Participants meeting diagnostic criteria for PTSD (n = 190) at the initial assessment were interviewed and certain baseline predictors of chronicity 2 years later were examined. Number of PTSD reexperiencing symptoms, rape history, and childhood history of physical assault were all predictive of chronicity at the follow-up assessment. No relationship emerged between remission status and treatment seeking, though approximately half who remitted did so without professional treatment. These risk factors for chronicity may help identify those individuals with PTSD who are most in need of intervention. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +3527,A Comparison Between Dually Diagnosed Inpatients with and without Axis II Comorbidity and the Relationship to Treatment Outcome,"The presence of a personality disorder (PD) has been associated with certain types of poor treatment outcomes in patients with substance use disorders (SUDs). The purpose of this study was to determine the prevalence of comorbid PDs in psychiatrically hospitalized adults with both non-SUD Axis I disorders and SUDs, and to assess the relationship between Axis II psychopathology and degree of pretreatment addiction severity and treatment outcome.One hundred consecutive inpatients admitted to a mixed dual diagnosis inpatient unit were assessed using semistructured interviews for SUDs, non-SUD Axis I disorders, and PDs. Pretreatment severity was assessed using a modified version of the Addiction Severity Index (ASI). Outcome measures were assessed both during hospitalization and at an initial follow-up appointment after discharge. Statistical analyses were performed comparing dually diagnosed patients with and without Axis II psychopathology.A significant number (53%) of the patients met criteria for at least one personality disorder. Of the PDs, Cluster B PDs were the most prevalent, particularly borderline personality disorder (74%) and antisocial personality disorder (66%). Dually diagnosed patients without an Axis II diagnosis had less severe pretreatment severity measures. During hospitalization, patients with Axis II disorders had higher levels of psychopathology on the Brief Symptom Inventory (BSI) subscales of sensitivity and hostility. However, there was no difference in overall degree of global improvement during hospitalization. During follow-up, patients with Axis II disorders were significantly less likely to be compliant in attending their initial follow-up appointment.Dual diagnosis inpatients with PDs appear to improve as much as patients without PDs during their inpatient hospitalizations; however, they appear to be less likely to be compliant with attending their initial follow-up appointment.",0,0 +3528,Neuroticism and self-criticism associated with posttraumatic stress disorder in a nationally representative sample,"Broad and specific psychological traits may uniquely differentiate trauma victims with PTSD from trauma victims without PTSD, but there is a need for representative, population-based research. We investigated elevated neuroticism and self-criticism in association with the presence versus absence of PTSD in a nationally representative sample of adults who experienced a traumatic stressor. Respondents were from the National Comorbidity Survey Part II (N=5877) (). Individuals who experienced one or more traumatic events were selected (N=3238). In separate regression analyses, elevated levels of neuroticism and self-criticism were each significantly associated with PTSD among men and women who had experienced one or more traumatic events. After controlling for types of traumas experienced and other previously identified factors (Bromet, Sonnega, & Kessler, 1998. American Journal of Epidemiology, 147, 353-361), neuroticism remained significantly associated with PTSD in women and both neuroticism and self-criticism remained significant in men. Evidence from this nationally representative sample of adults who experienced traumatic events suggests that self-criticism and especially the broad personality domain of neuroticism may represent robust psychological dimensions associated with the presence of PTSD.",0,0 +3529,Maternal posttraumatic stress disorder symptom trajectories following Hurricane Katrina: An initial examination of the impact of maternal trajectories on the well-being of disaster-exposed youth,"ObjectivesThis study examined trajectories of posttraumatic stress disorder symptoms in impoverished mothers impacted by Hurricane Katrina, as well as how predictive the maternal trajectories were for youth posttraumatic stress symptoms 2 years post-Katrina.Methods360 mother participants displaced by Hurricane Katrina completed self-report measures across four time points related to Hurricane exposure, trauma history, and posttraumatic stress symptoms. Additionally, the youth offspring completed a self-report measure of posttraumatic stress symptoms.ResultsLatent Class Growth Analysis demonstrated three primary trajectories emerged among females impacted by Katrina, namely, (1) chronic (4 %), (2) recovering (30 %), and (3) resilient (66 %), respectively. These trajectories were significantly impacted by prior trauma history, but not hurricane exposure. Additionally, data indicated that children whose parents fell into the chronic PTS trajectory also reported high levels of PTS symptoms.ConclusionsThis study identified three main trajectories typical of female PTS symptoms following disaster and was the first known study to document associations between PTS outcomes among adults and their offspring impacted by a large natural disaster. Future research is warranted and should explore additional risk and protective factors that impact both the parental and child outcomes.",1,0 +3530,Comparison of nefazodone and sertraline for the treatment of posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) is a prevalent condition that has been shown to be responsive to pharmacotherapy. Few head-to-head comparisons of medications used in the treatment of PTSD have been published. This 12-week, randomized, double-blind study compares the effectiveness, safety, and tolerability of nefazodone and sertraline for the treatment of PTSD. Thirty-seven male and female outpatients meeting DSM-IV criteria for PTSD were randomly assigned to receive nefazodone (maximum dose 600 mg/day; average dose 463 mg/day) or sertraline (maximum dose 200/day; average dose 153 mg/day). The primary outcome measures were the 17-item total severity score of the Clinician Administered PTSD Scale, Part 2 (CAPS-2) and the Clinical Global Impression Improvement Scale (CGI-I). Other assessments included the Davidson Trauma Scale (DTS), the Top-8 PTSD Rating Scale, Sheehan Disability Scale (SDS), Montgomery-Asberg Depression Rating Scale (MADRS), Hamilton Anxiety Scale (HAM-A), and Pittsburgh Sleep Quality Index (PSQI). Twenty-six subjects had at least one post-randomization CAPS-2 assessment and were therefore included in the data analysis. There were no statistically significant differences between treatment groups on any of the outcome measures. There was a significant effect for time in both groups, indicating an improvement in PTSD symptoms, depression, sleep, and quality of life over time. CAPS-2 scores for all of the PTSD symptom clusters decreased significantly over time. This study did not find significant differences in the effectiveness of nefazodone and sertraline for the treatment of PTSD. Larger trials are warranted.",0,0 +3531,Psychopharmacology of Pediatric Posttraumatic Stress Disorder,"To review the current knowledge of pharmacotherapy in the treatment of Post-traumatic Stress Disorder (PTSD) as it applies to children and adolescents and to provide a rational approach to medication use in Pediatric PTSD.The literature on the psychopharmacology of Pediatric PTSD is reviewed. Additionally, literature is reviewed on the neurobiological systems presumptively involved in trauma as well as studies in the pharmacology of adult PTSD, as they pertain to the treatment of Pediatric PTSD.There are too few studies in the current Pediatric PTSD literature to confirm treatment recommendations. Downward extrapolation from the adult literature combined with an understanding of the neurobiology of PTSD and its comorbid conditions may serve as the basis for a rational pharmacotherapy of PTSD in childhood. The effectiveness of targeting pharmacological agents at PTSD symptom clusters and associated comorbid conditions remains to be verified in controlled clinical trials.The state of psychopharmacology for Pediatric PTSD is in its earliest stages. While there are insufficient numbers of controlled pharmacological trials to make firm recommendations, the field requires a starting point for a rational psychopharmacological approach. Pharmacotherapy may provide symptom relief of both the debilitating primary symptoms and the comorbid conditions in children suffering from PTSD.",0,0 +3532,Physical Symptom Trajectories Following Trauma Exposure: Longitudinal Findings from the Normative Aging Study,"This study modeled physical symptom trajectories from ages 30 to 75 in 1079 older male military veterans who were assessed every 3 to 5 years since the 1960s. Combat exposure and noncombat trauma were used to define four groups: no trauma (N = 249), noncombat trauma only (N = 333), combat only (N = 152), and both combat and noncombat trauma (N = 345). Number of symptoms on the Cornell Medical Index physical symptom scale increased 29% per decade. Men who had experienced either combat or noncombat trauma did not differ from nonexposed men, but those who had experienced both combat and noncombat trauma had 16% more symptoms across all ages. There were no differences in age-related trajectories as a function of trauma history. In cross-sectional analysis, men with combat and noncombat trauma had more posttraumatic stress disorder symptoms, but not more depression symptoms, than men with either no trauma or noncombat trauma only. Discussion focuses on the importance of considering physical as well as psychological outcomes of exposure to traumatic events.",0,0 +3533,Use of Generic Versus Region-Specific Functional Status Measures on Patients With Cervical Spine Disorders,"Few data exist to support the use of functional status measures on patients with disorders of the cervical spine. This study was designed to compare the construct validity and sensitivity to change of the Neck Disability Index (NDI) and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36).Patients (N = 146) with a variety of disorders of the cervical spine completed the NDI and the SF-36 prior to treatment. Following discharge from treatment, 69 of these patients completed a second NDI and SF-36.There was evidence for the construct validity and sensitivity to change of the NDI and the physical and mental component scores of the SF-36. The ability of the NDI and SF-36 to detect change varied, depending on the construct tested. The SF-36 was superior in some instances, and the NDI was superior in other instances. The NDI appears to measure both mental and physical health-related factors.There appears to be substantial overlap between the 2 measures. The use of both measures, therefore, is probably not necessary. [Riddle DL, Stratford PW. Use of generic versus region-specific functional measures on patients with cervical spine disorders.",0,0 +3534,"Community Resilience as a Metaphor, Theory, Set of Capacities, and Strategy for Disaster Readiness","Communities have the potential to function effectively and adapt successfully in the aftermath of disasters. Drawing upon literatures in several disciplines, we present a theory of resilience that encompasses contemporary understandings of stress, adaptation, wellness, and resource dynamics. Community resilience is a process linking a network of adaptive capacities (resources with dynamic attributes) to adaptation after a disturbance or adversity. Community adaptation is manifest in population wellness, defined as high and non-disparate levels of mental and behavioral health, functioning, and quality of life. Community resilience emerges from four primary sets of adaptive capacities--Economic Development, Social Capital, Information and Communication, and Community Competence--that together provide a strategy for disaster readiness. To build collective resilience, communities must reduce risk and resource inequities, engage local people in mitigation, create organizational linkages, boost and protect social supports, and plan for not having a plan, which requires flexibility, decision-making skills, and trusted sources of information that function in the face of unknowns.",0,0 +3535,Mental Health Treatments In The Wake Of Disaster,"INTRODUCTION There is overwhelming evidence that disasters can lead to a range of posttraumatic mental health problems. The aim of this chapter is to review the evidence for psychological and pharmacological approaches to treating people with adverse psychological reactions after disaster; specifically, we focus on interventions that can be provided in the short and intermediate phases after disaster. First we review common postdisaster psychiatric disorders. We then turn to describing and outlining the evidence for psychological approaches to treatment. Next we review pharmacological treatments for posttraumatic conditions. Finally, we comment on factors that influence the management of psychological approaches in the acute postdisaster environment. PSYCHOLOGICAL EFFECTS OF DISASTERS There is convergent evidence that an array of psychiatric disorders arise after disasters. Posttraumatic stress disorder (PTSD) is the most commonly identified, and the disorder is characterized by three clusters of symptoms, including reexperiencing of the traumatic event, avoidance and numbing, and hyperarousal. Symptoms need to be present for at least 1 month and cause clinically significant distress or impairment in functioning to fulfill criteria for PTSD. Rates of PTSD were reported in 34% of survivors of the Oklahoma City bombing (North et al., 1999) and 53% after Australian bushfires (McFarlane, 1986). Across studies, the prevalence of PTSD is higher among direct victims (30%–40%) than rescue personnel (10%–20%; Neria, Nandi, & Galea, 2007). © Cambridge University Press 2009.",0,0 +3536,An event-related brain potential investigation of PTSD and PTSD symptoms in abused children,"We tested 186 children ranging in age from 6 years, 10 months to 13 years, 7 months; 174 suffered either physical and/or sexual abuse, and 12 were nonabused children. Abused subjects were grouped in four different ways. The primary grouping was based on whether subjects satisfied the DSM III-R criteria for posttraumatic stress disorder (PTSD). Secondary groupings were based upon the three symptom clusters used to make the PTSD diagnosis (arousal, avaidance, and reexperiencing). In each of these groupings three separate subgroups were formed with approximately 25 percent in the high and low symptom count subgroups and the remaining 50 percent in the middle symptom count subgroup.Subjects listened to four different intensity levels (65, 80, 95, and 102 dB) of a 1 KHz tone, pseudo-randomly ordered, while event-related brain potentials (ERPs) were recorded. Two separate blocks were used, one with short intervals (4±1 sec) between tones and the other with longer intervals (17±2 sec). PTSD subjects presented a greater P2-N2 ERP intensity gradient (i.e., a larger increase in the P2-N2 ERP component as tone intensity increased) than did abused subjects without PTSD. Abused subjects with the highest number of reexperiencing symptoms showed a similar P2-N2 augmenting effect when compared to those with the lowest number of reexperiencing symptoms. Subjects with the highest number of arousal symptoms showed a shallower intensity gradient for the N1-P2 ERP component than did those with fewer arousal symptoms. The results are discussed in relation to previous results reported on adults with PTSD and in terms of CNS processing of stimulus intensity information.",0,0 +3537,"The psychotherapeutic potential of MDMA (3,4-methylenedioxymethamphetamine): an evidence-based review","Aims and rationale: The purpose of this study was to review whether methylenedioxymethamphetamine (MDMA) has the appropriate pharmacodynamic profile to be a therapeutic agent. Materials and methods: Empirical descriptions of MDMA's subjective effects in humans will be reviewed to evaluate the proposal that MDMA has psychotherapeutic properties. The focus will be published evidence on its functional effects in therapeutic, medical, and other situations. Results: MDMA is a powerful central nervous system (CNS) stimulant which affects several neurotransmitter systems and intensifies a range of psychobiological functions. Its acute mood effects can be very positive and life enhancing, and the affirmative cognitions engendered during MDMA therapy may well endure afterwards. However, MDMA also has a number of potential anti-therapeutic characteristics. Acutely, it can also intensify negative cognitions, and these may similarly endure over time. Psychotherapists have found that setting, intention, and expectancy are crucial for a positive outcome, but these factors cannot be guaranteed. Post-MDMA, there is a period of neurotransmitter recovery when low moods predominate, and these may exacerbate psychiatric distress. The explanations proposed for MDMA-assisted therapy are all psychodynamic, and a neurochemical model needs to be outlined. It has been suggested that enduring therapeutic gains can follow a single session, but again, this lacks a clear psychopharmacological rationale. Finally, diathesis-stress models suggest that psychiatric individuals are more prone to acute and chronic abreactions to CNS stimulants such as MDMA. Conclusions: There are a number of issues which need to be addressed before it can be argued that MDMA might be clinically useful for psychotherapy. (",0,0 +3538,The effect of paternal heat stress on protein profiles of pre-implantation embryos in the mouse,"The study was undertaken to compare the protein profiles of [35S]-methionine-labelled control-sired embryos with heat-sired embryos at 7, 14 or 21 days after mature fertile B6CBF F1 male mice were kept at 36 +/- 0.3 degrees C and 62 +/- 2.7% relative humidity for 24 h. One-dimensional gel electrophoresis and autoradiographs were used to examine the protein profiles between the two-cell embryos and the blastocysts. The results obtained demonstrate that paternal heat stress 7 or 14 days earlier did not apparently affect protein patterns of two-cell embryos, four-cell to eight-cell embryos, morulae or blastocysts. However, 21 days earlier, there were changes in protein patterns of two-cell embryos and abnormal embryos, but not the morulae. To further support and extend these results, two-dimensional gel electrophoresis and phosphorimaging were employed and the results obtained show that paternal heat stress 21 days before mating affected protein profiles of two-cell embryos and morulae in the mouse. Together, these findings have indicated that paternal heat stress affects most but not all protein patterns of pre-implantation embryos, which strongly supports our previous results demonstrating that paternal heat stress significantly reduced the developmental proportion of pre-implantation embryos in the mouse.",0,0 +3539,Posttraumatic stress and sleep: Differential relations across types of symptoms and sleep problems,"Posttraumatic stress symptoms and self-reported sleep problems reliably covary. The current study investigated how posttraumatic stress symptom clusters (i.e., hyperarousal, avoidance, and reexperiencing) relate to trouble initiating and maintaining sleep and nightmares. Participants included traumatic event-exposed respondents from the NCS-R. Results suggested that posttraumatic stress symptom severity is related to trouble initiating and maintaining sleep and nightmares. Investigation of symptom clusters indicated that reexperiencing symptoms were related to trouble initiating and maintaining sleep and nightmares, while hyperarousal symptoms were related to trouble maintaining sleep and nightmares. Findings partially support both reexperiencing and hyperarousal-based models of the relation between sleep and posttraumatic stress.",0,0 +3540,Perceptual processing advantages for trauma-related visual cues in post-traumatic stress disorder,"Intrusive re-experiencing in post-traumatic stress disorder (PTSD) comprises distressing sensory impressions from the trauma that seem to occur 'out of the blue'. A key question is how intrusions are triggered. One possibility is that PTSD is characterized by a processing advantage for stimuli that resemble those that accompanied the trauma, which would lead to increased detection of such cues in the environment.We used a blurred picture identification task in a cross-sectional (n=99) and a prospective study (n=221) of trauma survivors.Participants with acute stress disorder (ASD) or PTSD, but not trauma survivors without these disorders, identified trauma-related pictures, but not general threat pictures, better than neutral pictures. There were no group differences in the rate of trauma-related answers to other picture categories. The relative processing advantage for trauma-related pictures correlated with re-experiencing and dissociation, and predicted PTSD at follow-up.A perceptual processing bias for trauma-related stimuli may contribute to the involuntary triggering of intrusive trauma memories in PTSD.",0,0 +3541,Investigating Differences in Truthful and Fabricated Symptoms of Traumatic Stress over Time,"False allegations of victimization typically are accompanied by malingered emotional symptomology to corroborate claims. This analog study was designed to compare truthful and fabricated symptom profiles on measures of post-traumatic stress (i. e., Revised Impact of Event Scale, Post-Traumatic Stress Disorder (PTSD) Checklist, Trauma Symptom Inventory) and levels of symptom consistency over time. Participants (undergraduate students) described their mental health symptoms for both traumas at time 1 (N=291), time 2 (N=252, 3 month), and time 3 (N=181, 6 months). Results indicated that fabricated traumas were associated with inflated symptom profiles. Validity scales were not effective at discerning symptom veracity, although reports could be discriminated somewhat by atypical responding and clinical scales. PTSD symptoms in malingerers also were reported more consistently over time. This research offers applicable information for identifying feigned traumatic stress. © 2010 Springer Science + Business Media, LLC.",0,0 +3542,Divalproex in the Treatment of Posttraumatic Stress Disorder,"To evaluate the efficacy of divalproex for the treatment of posttraumatic stress disorder (PTSD) hyperarousal symptom cluster.Under double-blind conditions, 85 US military veterans with PTSD were randomized to treatment with divalproex or placebo for 8 weeks. All patients who received at least 1 dose of medication and 1 postbaseline assessment (n = 82) were included in the efficacy population. The primary outcome measure was the hyperarousal subscale of the Clinician-Administered PTSD Scale.There were no significant intergroup differences in primary or secondary end points. The final mean (SD) divalproex dose and serum valproic acid level were 2309 +/- 507 mg/d and 82 +/- 30 mg/L, respectively.Divalproex monotherapy was not effective in the treatment of chronic PTSD in predominantly older male combat veterans. Further study is needed to determine the efficacy of divalproex in the management of PTSD in women or civilians or in combination with antidepressants.",0,0 +3543,Resilience and Distress: Israelis Respond to the Disengagement from Gaza and the Second Lebanese War,"Resilience and distress in Israeli society were assessed at three points in time: before and after the Israeli disengagement from Gaza, and after the second Lebanese war. A random sample of 366 Israelis was assessed for nation-related anxiety and hostility, personal resources and post-traumatic symptoms. The lowest levels of anxiety were observed at the second time point, after the disengagement. Respondents with high-resilience profiles showed lower levels of post-traumatic symptoms and higher levels of personal resources. The findings underscore Israelis' resilience and the importance of personal resources in ongoing nationally stressful situations. © 2011 Springer Science+Business Media, LLC.",0,0 +3544,The psychological treatment of Post Traumatic Stress Disorder (PTSD) in adult refugees: A review of the current state of psychological therapies,"Background: Large numbers of refugees flee their countries of origin each year. A proportion of these people will have witnessed or experienced traumatic events and may be suffering from psychological distress requiring intervention.Aims: The article aims to review the literature relating to the psychological treatment of Post Traumatic Stress Disorder (PTSD) in adult refugees. The clinical implications of existing research and specific challenges faced by health services in meeting the mental health needs of non-western individuals are discussed.Method: A literature search of English language journals was conducted using the Web of Science, Medline and PsycInfo databases.Findings: There is a dearth of research in this area and the majority of studies conducted have significant methodological limitations. Despite this, the psychotherapeutic studies to date indicate some potentially effective treatments with traumatized refugees and have attempted to employ innovative treatment elements taking into account issues of diversity.Conclusions: Research and practice in this area is in its infancy and further research is necessary. Culturally sensitive adaptations of CBT seem promising and further research is needed to clarify the value of such specific elements in therapy. The need for greater therapist awareness of issues of diversity raises issues for training and continual professional development.",0,0 +3545,Cultural differences in personal identity in post-traumatic stress disorder,"This study investigated cultural differences in goals, self-defining memories, and self-cognitions in those with and without post-traumatic stress disorder (PTSD).Trauma survivors with and without PTSD, from independent and interdependent cultures (N=106) provided major personal goals, self-defining memories, and self-cognitions.Trauma survivors with PTSD from independent cultures reported more goals, self-defining memories, and self-cognitions that were trauma-related than non-PTSD trauma survivors from independent cultures. In contrast, for those from interdependent cultures, there was no difference between trauma survivors with and without PTSD in terms of trauma-centred goals, self-defining memories, and self-cognitions.The results suggest cultural variability in the impact of trauma on memory and identity, and highlight the need for contemporary models of PTSD to more explicitly consider culture in their accounts of PTSD. Clinical implications of these findings, such as cultural considerations in assessment and treating trauma relevant self-schema in cognitive therapy for PTSD, are discussed.",0,0 +3546,A critique of the female sexual perpetrator research,"This paper critically reviewed the research literature on female sex-offenders based on all the identified studies with a sample exceeding 10 from 1989 to 2004. Thirteen studies were identified. Five exploratory studies were individually summarized and critiqued as a group. The eight comparative studies were individually discussed and critiqued. Strengths and weaknesses of the current research were discussed. Conclusions about the research and suggestions for future research were provided. Notable conclusions were: that female sex-offenders are more likely to have been sexually victimized than other populations, offended by themselves, and commit serious forms of sexual abuse. There are also some promising typologies for this heterogeneous population, but they need further replication.",0,0 +3547,Retrospective surveillance of metabolic parameters affecting reproductive performance of Japanese Black breeding cows,"This retrospective study was conducted to confirm the relationship between pre- and postpartum metabolic parameters and postpartum reproductive performance and to clarify seasonal characteristics of the metabolic parameters by using our metabolic profile test (MPT) database of Japanese Black breeding herds. In evaluation 1, MPT databases of blood samples from multiparous cows collected prepartum and postpartum were divided into two groups according to calving interval, and each MPT parameter was compared. In evaluation 2, the same MPT databases used in evaluation 1 were divided into two groups according to the sampling period. Significant differences were found in the prepartal total protein and postpartal γ-glutamyltransferase in evaluation 1. In evaluation 2, significant differences were found in the prepartal and postpartal total protein, albumin/globulin ratio, and glucose. Clear seasonal differences in MPT results emphasized the usefulness of the MPT in breeding cattle herds fed home-pasture roughage and suggest that unsatisfactory reproductive performance during hot periods reflects inadequate nutritional content of the diet and possible reduced feed intake due to heat stress.",0,0 +3548,The relationships between posttraumatic stress symptom clusters and marital intimacy among war veterans.,"This study examined (a) the relationships between posttraumatic stress disorder (PTSD) symptom clusters and marital intimacy among Israeli war veterans and (b) the role of self-disclosure and verbal violence in mediating the effects of PTSD avoidance and hyperarousal symptoms on marital intimacy. The sample consisted of 219 participants divided into 2 groups: ex-prisoners of war (ex-POWs; N = 125) and a comparison group of veterans who fought in the same war but were not held in captivity (N = 94). Ex-POWs displayed higher levels of PTSD symptoms and verbal violence and lower levels of self-disclosure than did controls. Although ex-POWs and controls did not differ in level of marital intimacy, they did, however, present a different pattern of relationships between PTSD clusters and intimacy. In ex-POWs, self-disclosure mediated the relations between PTSD avoidance and marital intimacy. Verbal aggression was also found via indirect effect of hyperarousal on marital intimacy. The results point to the importance of self-disclosure and verbal violence as interpersonal mechanisms for the relations between posttraumatic symptoms on marital intimacy of ex-POWs.",0,0 +3549,Predictors of the Development of Posttraumatic Stress Disorder Among Police Officers,"This retrospective study examined risk and protective factors for the development of posttraumatic stress disorder (PTSD) in a sample of 132 Canadian police officers. Structured interviews were conducted in order to assess the most distressing work-related traumatic events and determine diagnoses of full or partial PTSD. Participants completed self-administered questionnaires assessing several potential predictors. The results suggested that 7.6% of the participants developed full PTSD, whereas 6.8% had partial PTSD following an incident at work. A multiple logistic regression analysis indicated that the most potent risk factor for the development of full or partial PTSD was peritraumatic dissociation. Social support from colleagues during the event emerged as a significant protective factor. Clinical implications of the findings are discussed.",0,0 +3550,Children's Coping in the Context of Disasters and Terrorism,"Disasters and terrorism present significant and often overwhelming challenges for children and families worldwide. Individual, family, and social factors influence disaster reactions and the diverse ways in which children cope. This article links conceptualizations of stress and coping to empirical knowledge of children's disaster reactions, identifies limitations in our current understanding, and suggests areas for future study of disaster coping. Coping strategies, developmental trajectories influencing coping, and the interplay between parent and child coping represent critical areas for advancing the field and for informing programs and services that benefit children's preparedness and foster resilience in the face of mass trauma.",0,0 +3551,INTEGRATIVE ASSESSMENT OF BRAIN FUNCTION IN PTSD: BRAIN STABILITY AND WORKING MEMORY,"Posttraumatic Stress Disorder (PTSD) is characterized by symptoms of hyperarousal, avoidance and intrusive trauma-related memories and deficits in everyday memory and attention. Separate studies in PTSD have found abnormalities in electroencephalogram EEG, in event-related potential (ERP) and behavioral measures of working memory and attention. The present study seeks to determine whether these abnormalities are related and the extent to which they share this relationship with clinical symptoms. EEG data were collected during an eyes-open paradigm and a one-back working memory task. Behavioral and clinical data (CAPS) were also collected. The PTSD group showed signs of altered cortical arousal as indexed by reduced alpha power and an increased theta/alpha ratio, and clinical and physiological measures of arousal were found to be related. The normal relationship between theta power and ERP indices of working memory was not affected in PTSD, with both sets of measures reduced in the disordered group. Medication appeared to underpin a number of abnormal parameters, including P3 amplitude to targets and the accuracy, though not speed, of target detection. The present study helps to overcome a limitation of earlier studies that assess such parameters independently in different groups of patients that vary in factors such as comorbidity, medication status, gender and symptom profile. The present study begins to shed light on the relationship between these measures and suggests that abnormalities in brain working memory may be linked to underlying abnormalities in brain stability.",0,0 +3552,Factor analysis of the impact of event scale with children in war,"To evaluate the psychometric properties of the Impact of Event Scale (IES scale) in children a study was conducted on 1787 children exposed to the warfare in Croatia, Bosnia and Herzegovina. The study group comprised 877 girls and 910 boys ranging in age from 6 to 15 years attending 28 arbitrary selected schools in Zagreb. High levels of posttraumatic reactions were found in the group of children. The pattern of endorsement and the factor structure of the IES scale were similar to that found in other samples. This supports the use of the IES in the assessment of posttraumatic stress reactions in children. Two factors emerged from a Principal Component Analysis, labeled intrusion (9 items), and avoidance (4 items). As in other studies, this study documented problems with several items (items 2, 12 and 15), items that should be considered omitted from the IES. Girls reported significantly more distress on 13 out of the 15 items. Both the overall IES score as well as the intrusion and avoidance score were significantly higher in girls than boys. The factor structure for boys and girls were very similar, and the reliability of the scale was adequate across different age groups and for subgroups of displaced and refugee children.",0,0 +3553,Combat Experience and Postservice Psychosocial Status as Predictors of Suicide in Vietnam Veterans,"The authors examined potential risk factors for suicide among 38 Vietnam veterans using 46 Vietnam veterans who died from motor vehicle accidents as a comparison group. The veterans were selected from Los Angeles County Medical Examiner's file (1977-1982). Data for these veterans were obtained from military service records, the coroner's reports, and the psychological autopsy conducted with the decedents' family members. No military service factor was associated with suicide. The characteristics of Vietnam veteran suicide cases were not substantially different from non-Vietnam veteran suicide cases with respect to known demographic risk factors. The psychological profile of Vietnam veteran suicide cases are also similar to non-Vietnam veteran suicide cases in most instances. Symptoms related to posttraumatic stress disorder were observed more frequently among suicide cases than accident cases. However, suicides were not associated with specific combat experiences or military occupation. The extent of combat experience in Vietnam per se as measured in this study is not a good predictor of suicide death.",0,0 +3554,Trajectories of life satisfaction five years after medical discharge for traumatically acquired disability.,"We studied the predictive impact of family satisfaction, marital status, and functional impairment on the trajectories of life satisfaction over the first 5 years following medical treatment for traumatic spinal cord injury, burns, or interarticular fractures (total N = 662). It was anticipated that fewer functional impairments, being married, and greater family satisfaction would predict higher life satisfaction trajectories.The Functional Independence Measure, the Family Satisfaction Scale, and the Life Satisfaction Index were administered 12, 24, 48, and 60 months postdischarge.Trajectory modeling revealed that greater functional impairment significantly predicted lower life satisfaction, regardless of injury type. However, this association diminished when marital status and family satisfaction were entered into the models. Greater family satisfaction and being married predicted greater life satisfaction across time. Moreover, there was no evidence for increases in life satisfaction trajectories over time: Trajectories were stable across time for all injury groups.Results suggest that being married and greater family satisfaction promote life satisfaction among those who traumatically acquire disability, and these beneficial effects may be more salient than the degree of functional impairment imposed by the condition.",0,0 +3555,Behavioral and Emotional Profiles of Neglected Children,"This study explored the emotional and behavioral profiles of 41 neglected children, ages 6 to 12 years, who were compared with a control group of 41 children. The Achenbach System was used in order to describe emotional and behavioral profiles based on the Diagnostic Criteria of the DSM-IV [Diagnostic and Statistical Manual of Mental Disorders, 4th ed.]). Neglected children had more symptoms on DSM-IV Scales related to conduct or attention/hyperactivity problems. Based on the perceptions of teachers, children exposed to neglect showed more externalized and internalized problems as well as symptoms on DSM-IV Scales. Results supported the relevance of using the Diagnostic Criteria of the DSM-IV and the importance of getting the different perceptions of respondents to better understand the emotional and behavioral portrait of neglected children. © 2013",0,0 +3556,"Post-conflict mental health needs: a cross-sectional survey of trauma, depression and associated factors in Juba, Southern Sudan","The signing of the Comprehensive Peace Agreement in January 2005 marked the end of the civil conflict in Sudan lasting over 20 years. The conflict was characterised by widespread violence and large-scale forced migration. Mental health is recognised as a key public health issue for conflict-affected populations. Studies revealed high levels of post-traumatic stress disorder (PTSD) amongst populations from Southern Sudan during the conflict. However, no studies have been conducted on mental health in post-war Southern Sudan. The objective of this study was to measure PTSD and depression in the population in the town of Juba in Southern Sudan; and to investigate the association ofdemographic, displacement, and past and recent trauma exposure variables, on the outcomes of PTSD and depression.A cross-sectional, random cluster survey with a sample of 1242 adults (aged over 18 years) was conducted in November 2007 in the town of Juba, the capital of Southern Sudan. Levels of exposure to traumatic events and PTSD were measured using the Harvard Trauma Questionnaire (original version), and levels of depression measured using the Hopkins Symptom Checklist-25. Multivariate logistic regression was used to analyse the association ofdemographic, displacement and trauma exposure variables on the outcomes of PTSD and depression. Multivariate logistic regression was also conducted to investigate which demographic and displacement variables were associated with exposure to traumatic events.Over one third (36%) of respondents met symptom criteria for PTSD and half (50%) of respondents met symptom criteria for depression. The multivariate logistic regression analysis showed strong associations of gender, marital status, forced displacement, and trauma exposure with outcomes of PTSD and depression. Men, IDPs, and refugees and persons displaced more than once were all significantly more likely to have experienced eight or more traumatic events.This study provides evidence of high levels of mental distress in the population of Juba Town, and associated risk-factors. Comprehensive social and psychological assistance is urgently required in Juba.",0,0 +3557,Setting Apart the Affected: The Use of Behavioral Criteria in Animal Models of Post Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) affects about 20-30% of exposed individuals. Clinical studies of PTSD generally employ stringent criteria for inclusion in study populations, and yet in animal studies the data collection and analysis are generally expressed as a function of exposed vs nonexposed populations, regardless of individual variation in response. Prior data support an approach to animal models analogous to inclusion criteria in clinical studies. This series of studies sought to assess prevalence rates of maladaptive vs adaptive responses determined according to a more stringent approach to the concept of inclusion/exclusion criteria (cutoff behavioral criteria-CBC), consisting of two successive behavioral tests (elevated plus maze and acoustic startle response tests). The rats were exposed to stressors in two different paradigms; exposure to a predator and underwater trauma. The prevalence rates of maladaptive responses to stress in these two distinct models dropped over time from 90% in the acute phase to 25% enduring/maladaptive response at 7 days, to remain constant over 30 days. As setting the affected individuals apart from the unaffected approximates clinical studies, it might also help to clarify some of the pending issues in PTSD research.",0,0 +3558,Psychological factors after traumatic amputation in landmine survivors: The bridge between physical healing and full recovery,"Limb loss due to a landmine injury is sudden and devastating. The resulting disability makes life challenging in a world where physical ability is the 'norm'. In order to better understand the psychological adjustments individuals make in their recovery from a landmine injury, the Landmine Survivors Network conducted an exploratory qualitative study to determine factors that contribute to an individual's recovery. The study examined psychosocial aspects, coping strategies, and resilience characteristics of limb loss survivors across differing cultural, societal and economic backgrounds.Eighty-five participants (68 persons of limb loss, 10 family members, seven service providers) were interviewed using a semi-structured protocol in the USA and an open-ended format in six landmine affected countries. Data analysis was completed using grounded theory analytic strategies.Data indicated that the survivors' acceptance of limb loss and their state of psychological recovery were greatly influenced by the individual's resilience characteristics, social support, medical care, economic situation and societal attitudes toward people with disabilities.Recovery from traumatic amputation in landmine survivors needs to be comprehensive and coordinated, and requires addressing the individual's physical, psychological, economic and social needs within the context of family, community, and the socio-cultural environment in which they live.",0,0 +3559,Culture and Posttraumatic Stress Disorder (PTSD): A Proposed Conceptual Framework,"It is widely accepted that the understanding of any psychological disorder needs to be contextualised within cultural parameters. The notion that current diagnostic taxonomies are not always universally applicable does not mean that all symptoms are not applicable. We present a framework that is aimed at being a starting point from which to delineate universal and culture specific elements of PTSD. The framework follows the possible influence of cultural factors on (a) the formation of an intrusive memory, (b) an understanding of how such a memory becomes pathological, and (c) how symptoms are expressed from the intrusive memory core of PTSD. While the framework presents certain elements (e.g. intrusive memory and core schemas) as centrally important, the focus is on a heuristic framework that allows for the study of the dynamic interaction between potentially universal and cultural factors and how this interaction may produce the symptom profile generally seen with PTSD. Tentative recommendations are made for a research agenda and are presented after a brief exploration of the strengths and weaknesses of such a framework.",0,0 +3560,Providing Psychosocial Support to Children and Families in the Aftermath of Disasters and Crises,"Disasters have the potential to cause short- and long-term effects on the psychological functioning, emotional adjustment, health, and developmental trajectory of children. This clinical report provides practical suggestions on how to identify common adjustment difficulties in children in the aftermath of a disaster and to promote effective coping strategies to mitigate the impact of the disaster as well as any associated bereavement and secondary stressors. This information can serve as a guide to pediatricians as they offer anticipatory guidance to families or consultation to schools, child care centers, and other child congregate care sites. Knowledge of risk factors for adjustment difficulties can serve as the basis for mental health triage. The importance of basic supportive services, psychological first aid, and professional self-care are discussed. Stress is intrinsic to many major life events that children and families face, including the experience of significant illness and its treatment. The information provided in this clinical report may, therefore, be relevant for a broad range of patient encounters, even outside the context of a disaster. Most pediatricians enter the profession because of a heartfelt desire to help children and families most in need. If adequately prepared and supported, pediatricians who are able to draw on their skills to assist children, families, and communities to recover after a disaster will find the work to be particularly rewarding.",0,0 +3561,Crisis support and psychiatric symptomatology in adult survivors of the Jupiter cruise ship disaster,"The aim of the present study was to explore the relationship between crisis support and psychiatric symptomatology among adult survivors in the year following the Jupiter cruise ship disaster. Evidence is presented that support decreases over the following year, and that higher levels of crisis support are strongly related to better psychological outcome. Crisis support is shown to retain its association with symptomatology even when satisfaction with support is partialled out. These data are discussed with reference to the debate over the relative importance of received vs. perceived support.",0,0 +3562,Risk factors for psychological and physical health problems after a man-made disaster,"There are few prospective studies on risk factors for health problems after disasters in which actual pre-disaster health data are available.To examine whether survivors' personal characteristics, and pre-disaster psychological problems, and disaster-related variables, are related to their post-disaster health.Two studies were combined: a longitudinal survey using the electronic medical records of survivors' general practitioners (GPs), from 1 year before to 1 year after the disaster, and a survey in which questionnaires were filled in by survivors, 3 weeks and 18 months after the disaster. Data from both surveys and the electronic medical records were available for 994 survivors.After adjustment for demographic and disaster-related variables, pre-existing psychological problems were significantly associated with post-disaster self-reported health problems and post-disaster problems presented presented to the to the GP. This association was found for both psychological and physical post-disaster problems.In trying to prevent long-term health consequences after disaster, early attention to survivors with pre-existing psychological problems, and to those survivors who are forced to relocate or are exposed to many stressors during the disaster, appears appropriate.",0,0 +3563,Treatment of posttraumatic stress disorder with nefazodone,"Selective serotonin reuptake inhibitors are useful in the treatment of posttraumatic stress disorder (PTSD), but have a number of side-effects which limit their acceptability. A newer serotonergic compound, nefazodone, has a different side-effect profile, thus making it a potentially promising compound to study. Seventeen private practice patients with PTSD were treated with nefazodone up to 600 mg/day for a maximum total treatment period of 12 weeks. All subjects were civilians, and were monitored for efficacy and side-effects at weeks 1, 2, 4, 6, 8 and 12. Nefazodone was associated with statistically significant improvement in mean scores on all six rating scales used to assess change from baseline in PTSD symptoms. Additionally, statistically significant improvement from baseline were seen for the intrusive, avoidant/numbing, and hyperarousal clusters on a global PTSD scale. Early improvements in nightmares and general sleep disturbance were observed. Overall, there was a 43% response rate at endpoint, or 60% in treatment completers, by observer rating. Side-effects (assessed on the Medication Effects Scale) were generally benign. Nefazodone was associated with clinical improvement in this population, and now needs to be studied in double-blind, placebo controlled, protocols.",0,0 +3564,Variation in Mouse Basolateral Amygdala Volume is Associated With Differences in Stress Reactivity and Fear Learning,"A wealth of research identifies the amygdala as a key brain region mediating negative affect, and implicates amygdala dysfunction in the pathophysiology of anxiety disorders. Although there is a strong genetic component to anxiety disorders such as posttraumatic stress disorder (PTSD) there remains debate about whether abnormalities in amygdala function predispose to these disorders. In the present study, groups of C57BL/6 x DBA/2 (B x D) recombinant inbred strains of mice were selected for differences in volume of the basolateral amygdala complex (BLA). Strains with relatively small, medium, or large BLA volumes were compared for Pavlovian fear learning and memory, anxiety-related behaviors, depression-related behavior, and glucocorticoid responses to stress. Strains with relatively small BLA exhibited stronger conditioned fear responses to both auditory tone and contextual stimuli, as compared to groups with larger BLA. The small BLA group also showed significantly greater corticosterone responses to stress than the larger BLA groups. BLA volume did not predict clear differences in measures of anxiety-like behavior or depression-related behavior, other than greater locomotor inhibition to novelty in strains with smaller BLA. Neither striatal, hippocampal nor cerebellar volumes correlated significantly with any behavioral measure. The present data demonstrate a phenotype of enhanced fear conditioning and exaggerated glucocorticoid responses to stress associated with small BLA volume. This profile is reminiscent of the increased fear processing and stress reactivity that is associated with amygdala excitability and reduced amygdala volume in humans carrying loss of function polymorphisms in the serotonin transporter and monoamine oxidase A genes. Our study provides a unique example of how natural variation in amygdala volume associates with specific fear- and stress-related phenotypes in rodents, and further supports the role of amygdala dysfunction in anxiety disorders such as PTSD.",0,0 +3565,Trusted Information Sources Used During and After Superstorm Sandy: TV and Radio were Used More Often than Social Media,"Health and safety professionals and the public are interested in the best methods of providing timely information about disasters. The objective of this study was to examine information sources used for Superstorm Sandy with respect to the storm, evacuation routes, shelters, safety, and health issues. Respondents in central New Jersey and Jersey shore communities were differentially impacted by the storm. Jersey shore respondents had higher evacuation rates (47% vs. 13%), higher flood waters in homes, longer power outages (average 23 vs. 6 d), and longer periods without Internet (29 vs. 6 d). Electricity outages disrupted both sources and receivers of communication. Both groups obtained most of their information regarding safety from television, radio, friends, and Web/e-mail. Information sources on health varied by location, with central Jersey respondents using mainly TV and the Web, and Jersey shore respondents obtaining health information from the radio and TV (before the storm). For information on evacuation routes, Jersey shore respondents obtained information from many sources, while central Jersey respondents obtained it from TV. Information on mold was largely obtained from friends and the Web, since mold issues were dealt with several weeks after Sandy. The reliance on traditional sources of information (TV, radio, friends) found in this study suggests that the extreme power outages rendered Web, cell phones, and social media on cell phones less usable, and suggests the need for an integrated communication strategy with redundancies that takes into account prolonged power outages over large geographical areas.",0,0 +3566,Measures of endothelial dysfunction in plasma of patients with posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) confers an increased cardiovascular risk. In 14 otherwise healthy patients with PTSD and in 14 age- and gender-matched non-PTSD controls, we investigated whether the categorical diagnosis of PTSD and severity of PTSD symptom clusters (i.e. re-experiencing, avoidance, arousal, and overall score) would be associated with plasma concentrations of three markers of endothelial dysfunction [soluble tissue factor (sTF), von Willebrand factor (VWF), and soluble intercellular adhesion molecule (sICAM)-1]. Compared with controls, patients had significantly higher sTF; this difference became nonsignificant when controlling for psychological distress. VWF and sICAM-1 levels were not significantly different between patients and controls. In the entire sample virtually all PTSD symptom clusters correlated significantly and positively with sTF and VWF but not with sICAM-1. The correlation between symptoms of re-experiencing and sTF was significantly different between patients and controls. Controlling for symptoms of anxiety and depression (i.e. psychological distress) rendered most associations between PTSD symptom clusters and sTF nonsignificant, whereas controlling for age retained significance of associations with VWF. Posttraumatic stress showed a continuous relationship with sTF and VWF, with the former relationship being partly affected by psychological distress. This suggests one mechanism by which posttraumatic stress could contribute to atherosclerosis.",0,0 +3567,"The Impact of Clergy-Perpetrated Sexual Abuse: The Role of Gender, Development, and Posttraumatic Stress","The literature on clergy-perpetrated sexual abuse suggests that there are two modal populations of survivors: boys and adult women. We review what is known about trauma and post-traumatic stress disorder following sexual abuse and explore the different treatment needs for these two survivor groups. For children, clergy-perpetrated sexual abuse can catastrophically alter the trajectory of psychosocial, sexual, and spiritual development. Depending on the age at which abuse occurred, adult clients may present with clinical issues that are more appropriate for a younger developmental stage. Additionally, the symptoms of traumatic stress may be misunderstood when clients conceptualize their abuse as an ""affair"" or ""consensual"" relationship. We discuss empirically supported treatments for post-traumatic stress disorder and potential adaptations for the needs of clergy-perpetrated sexual abuse survivors.",0,0 +3568,"Community resilience: concepts, assessment, and implications for intervention","Although stress research has emphasized individual well-being, many types of stress are experienced collectively: the events bring harm, pain, and loss to large numbers of people simultaneously. Natural disasters, terrorist attacks, war, political oppression, epidemics, and economic recessions happen to whole communities and, sometimes, whole societies. This is not to say that all exposed individuals experience the event identically; in a disaster, one person may lose a loved one, while another loses a home, and another only a few possessions. Nor is this to say that all exposed individuals respond identically; a person’s psychological, social, and material resources powerfully shape his or her capacity to cope and function effectively. When stress pervades the community, however, these factors tell only part of the story. To have an ecologically valid understanding of mass trauma, we must recognize that survivors are connected and dependent upon one another’s coping strategies. Their attributions and actions reflect a host of social influences, social comparisons, and emergent norms. They help each other but also compete for scarce resources. Household preparedness is vital, but one household can no more prepare for disaster than it could, on its own, protect itself from crime or disease, educate its children, or keep the roads safe. Consequently, an individual’s resilience is inextricably linked to the community’s ability to prepare for, respond to, and adapt to adverse conditions. Simply put, when problems are shared, so must be solutions. In recognition of such interdependencies, “community resilience” has emerged as a key concept for disaster readiness, although by no means limited to this one goal (Norris et al., 2008). This chapter will explore the concept of community resilience in some depth. Broadly, the chapter is organized into four sections. The first section provides our perspective on the meaning of resilience, including definitions that work across levels of analysis (individual, family, organization, community, society). The second section describes the adaptive capacities theorized to yield community resilience. This is followed by an outline of measurement strategies and challenges in assessing capacities, including some of our own pilot work. The concluding section makes recommendations for intervention and raises issues that need to be addressed in future research. © Cambridge University Press 2011.",0,0 +3569,Social issues and post-disaster recovery: A qualitative study in an Iranian context,"The physical impacts of a disaster are usually the most obvious impacts, and they are easily measured. However, there is not sufficient in-depth understanding of social issues arising after disasters. This qualitative study explored three main concepts regarding social issues after an earthquake in an Iranian context: social vulnerability, social uncertainty and confusion, and ignorance of local social capital. Negligence of social issues after disasters leads to delays in returning back to normal life. Policymakers are encouraged to take a comprehensive plan into account which considers these issues and facilitates the process of returning to normal life after earthquakes.",0,0 +3570,Victimization and Posttraumatic Stress Disorder Among Homeless Adolescents,"To examine street victimization and posttraumatic stress symptoms among urban homeless adolescents and to test whether emotional numbing and avoidance represent distinct posttraumatic stress disorder (PTSD) symptom clusters.Structured, private interviews were conducted with homeless adolescents (N = 374) in the Seattle metropolitan area (95% response rate) from 1995 to 1998.Eighty-three percent of street youths were physically and/or sexually victimized after leaving home. Approximately 18% of these youths met research criteria for PTSD. Results from a confirmatory factor analysis suggest that disaggregating symptoms of avoidance from symptoms of emotional numbing provides a better fit of the data than the current DSM-IV model in which these symptoms are combined in one factor.Sexual and physical victimization are serious threats for homeless adolescents, and those who are victimized are at risk for PTSD. Results challenge the belief that symptoms of avoidance and numbing represent one unified cluster in this population.",0,0 +3571,Post-traumatic stress disorder: symptom profiles in men and women,"To investigate the symptom frequencies of a relatively large sample of post-traumatic stress disorder (PTSD) sufferers and compare male and female symptom profiles.A total of 103 consecutive attendees at a clinic for PTSD were examined using a checklist of DSM-IV PTSD characteristics. The presence and absence of all symptoms was evaluated in a research interview. Some additional symptoms were also routinely asked about, such as mood lability, substance use, sex drive or libido. Symptom profiles of male and female sufferers of PTSD were compared using the chi-squared statistical test.Structured interview using checklist of DSM-IV PTSD characteristics.Certain symptoms were present in more than 30% of sufferers. Symptom frequencies for anxiety, insomnia, distressing and recurrent dreams, flashback imagery and intrusive thoughts, irritability, poor concentration, avoidance behaviour and detachment all reached frequencies above 70%. Some symptoms (such as inability to recall parts of the trauma and restricted affect) occurred in no more than 35% of sufferers.Men are significantly more likely than women to suffer with irritability (p < 0.05) and to use alcohol to excess (p < 0.05). Symptoms tend to follow an acute stress reaction, occur early and persist for many months. A case is made for restricting the diagnosis to the most prevalent symptoms and for including some often overlooked symptoms in the diagnostic guidelines, namely low mood, mood lability, and impaired libido.",0,0 +3572,Exposure to Hurricane-Related Stressors and Mental Illness After Hurricane Katrina,"Uncertainty exists about the prevalence, severity, and correlates of mental disorders among people exposed to Hurricane Katrina.To estimate the prevalence and associations between DSM-IV anxiety-mood disorders and hurricane-related stressors separately among prehurricane residents of the New Orleans metropolitan area and the remainder of the areas in Alabama, Louisiana, and Mississippi affected by Katrina.Community survey.A probability sample of 1043 English-speaking prehurricane residents of the areas affected by Hurricane Katrina was administered via telephone survey between January 19 and March 31, 2006. The survey assessed hurricane-related stressors and screened for 30-day DSM-IV anxiety-mood disorders.The K6 screening scale of anxiety-mood disorders and the Trauma Screening Questionnaire scale for posttraumatic stress disorder (PTSD), both calibrated against blinded structured clinical reappraisal interviews to approximate the 30-day prevalence of DSM-IV disorders.Prehurricane residents of the New Orleans metropolitan area were estimated to have a 49.1% 30-day prevalence of any DSM-IV anxiety-mood disorder (30.3% estimated prevalence of PTSD) compared with 26.4% (12.5% PTSD) in the remainder of the sample. The vast majority of respondents reported exposure to hurricane-related stressors. Extent of stressor exposure was more strongly related to the outcomes in the New Orleans metropolitan area subsample than the remainder of the sample. The stressors most strongly related to these outcomes were physical illness/injury and physical adversity in the New Orleans metropolitan area subsample and property loss in the remainder of the sample. Sociodemographic correlates were not explained either by differential exposure or reactivity to hurricane-related stressors.The high prevalence of DSM-IV anxiety-mood disorders, the strong associations of hurricane-related stressors with these outcomes, and the independence of sociodemographics from stressors argue that the practical problems associated with ongoing stressors are widespread and must be addressed to reduce the prevalence of mental disorders in this population.",0,0 +3573,Bayesian Inference for Growth Mixture Models with Latent Class Dependent Missing Data,"Growth mixture models (GMMs) with nonignorable missing data have drawn increasing attention in research communities but have not been fully studied. The goal of this article is to propose and to evaluate a Bayesian method to estimate the GMMs with latent class dependent missing data. An extended GMM is first presented in which class probabilities depend on some observed explanatory variables and data missingness depends on both the explanatory variables and a latent class variable. A full Bayesian method is then proposed to estimate the model. Through the data augmentation method, conditional posterior distributions for all model parameters and missing data are obtained. A Gibbs sampling procedure is then used to generate Markov chains of model parameters for statistical inference. The application of the model and the method is first demonstrated through the analysis of mathematical ability growth data from the National Longitudinal Survey of Youth 1997 (Bureau of Labor Statistics, U.S. Department of Labor, 1997). A simulation study considering 3 main factors (the sample size, the class probability, and the missing data mechanism) is then conducted and the results show that the proposed Bayesian estimation approach performs very well under the studied conditions. Finally, some implications of this study, including the misspecified missingness mechanism, the sample size, the sensitivity of the model, the number of latent classes, the model comparison, and the future directions of the approach, are discussed.",0,0 +3574,Metabolic Syndrome: Relative Risk Associated with Post-Traumatic Stress Disorder (PTSD) Severity and Antipsychotic Medication Use,"In recent years, numerous lines of converging evidence have revealed an association between post-traumatic stress disorder (PTSD) and impaired physical health outcomes, including cardiovascular disease and metabolic syndrome. Although these findings have been interpreted as indicating a direct association of PTSD with metabolic syndrome and obesity, previous studies have not addressed the important confound of antipsychotic drug usage in this population. Second generation antipsychotic medications themselves are associated with metabolic syndrome and obesity, and it is unclear whether the common utilization of these drugs in PTSD may account for some if not all of the observed metabolic problems.The present study examined the relative contributions of PTSD severity and use of antipsychotic medications to risk of metabolic syndrome among veterans.Cross-sectional clinical data, including five factors representing metabolic syndrome, psychiatric diagnoses, and medications were gathered from 253 veterans enrolling in mental health services. We used a logistic regression model to measure the relative association of antipsychotic medication use and PTSD severity on risk of metabolic syndrome.We found that antipsychotic medication usage was not uniquely associated with elevated risk of metabolic syndrome (Wald = 0.30, ns) when PTSD severity and other sociodemographic, psychiatric, and behavioral variables were accounted for. Furthermore, PTSD severity continued to be a significant and unique predictor of risk for metabolic syndrome (Wald = 4.04, p < 0.05).These findings suggest that chronic and moderately severe PTSD, independent of antipsychotic medications, is associated with increased risk of metabolic syndrome.",0,0 +3575,A cognitive behaviour therapy (CBT) programme for anxiety following moderate–severe traumatic brain injury (TBI): Two case studies,"CBT is a potentially effective treatment for anxiety disorders following TBI; however, empirical evidence has mainly come from clients with mild TBI. This paper describes a CBT-based anxiety treatment programme adapted for clients with more severe injuries. Two case studies are provided to illustrate the implementation of the programme, as a step toward larger scale testing of the programme's feasibility.A manualised adapted CBT treatment manual was used to deliver CBT in a standardised manner to two clients, one with severe and one with moderate TBI. Outcome was evaluated using a single-subject design with repeated measures of anxiety, mood and coping style at pre- and post-CBT.The two clients demonstrated positive treatment response on either a measure of anxiety or a continuous measure of distress. Although neither demonstrated a clinically significant change according to the primary outcome measure (Hospital Anxiety and Depression Scale), they showed significant change in at least one corroborated measure of anxiety.This study suggests the potential utility of the adapted CBT programme for clients with moderate-severe TBI. Limitations of the single case studies were discussed, while noting how they would be addressed in a follow-up randomised controlled trial.",0,0 +3576,Recognizing and Responding to Post-Traumatic Stress Disorder in People With Cancer,"To describe post-traumatic stress disorder (PTSD) in patients with cancer and identify nursing assessment and intervention strategies.Discussion of recent research literature in relation to oncology nursing practice.4%-19% of patients with cancer experience symptoms of PTSD. When PTSD routinely is considered as a risk for patients with cancer, nurses can reframe intense psychological and physiologic reactions or patient distress as possible trauma reactions and implement appropriate interventions and referral.Patients with cancer may experience PTSD as a consequence of their cancer diagnosis, treatment, or a past traumatic episode. PTSD may interfere with patients' ability to tolerate treatment and return for crucial follow-up care. To date, no studies have explored interventions for PTSD in adult patients with cancer.Oncology nurses can help patients with PTSD by interpreting psychological symptoms with the possibility of PTSD in mind, screening for PTSD across the illness trajectory, providing emotional support, teaching coping strategies, and advocating for further assessment, medical treatment, and appropriate referral within the multidisciplinary care team.",0,0 +3577,Report from the CDC: Mental Health of Women in Postwar Afghanistan,"More than two decades of war and a culture that has denied women freedom of movement, access to healthcare, and education have affected the mental health status of Afghan women more than that of men. In 2002, the Centers for Disease Control and Prevention (CDC) conducted a national population-based mental health survey in Afghanistan. The prevalence of symptoms of depression was 73% (standard error [SE] 8.15) and 59% (SE 5.59), of symptoms of anxiety was 84% (SE 2.98) and 59% (SE 8.65), and of posttraumatic stress disorder (PTSD) was 48% (SE 6.19) and 32% (SE 4.22) for female and male respondents, respectively. Mean scores for social functioning were lower for women (52.00 [SE 2.77]) than for men (66.63 [SE 3.92]). Women had significantly lower mental health status and poorer social functioning than did men. Results of our survey underscore the need for financial donors and healthcare planners to address the current lack of mental healthcare resources, facilities, and trained mental healthcare professionals in Afghanistan and to establish mental health services directed at the specific needs of women. This study highlights the negative impact that war, restrictions in freedoms, and socioeconomic hardship have had on the mental health and social functioning of women in Afghanistan.",0,0 +3578,Exposure to Trauma and Posttraumatic Stress Disorder Symptoms in Older Veterans Attending Primary Care: Comorbid Conditions and Self-Rated Health Status,"OBJECTIVES: Assess the prevalence of posttraumatic stress disorder (PTSD) symptomatology and its association with health characteristics in a geriatric primary care population. DESIGN: Cross-sectional screening assessments during a multisite trial for the treatment of depression, anxiety, and at-risk drinking. SETTING: Department of Veterans Affairs (VA)-based primary care clinics across the United States. PARTICIPANTS: Seventeen thousand two hundred five veterans aged 65 and older. MEASUREMENTS: Sociodemographic information, the General Health Questionnaire (GHQ-12), questions about death wishes and suicidal ideation, quantity and frequency of alcohol use, smoking, exposure to traumatic events, and PTSD symptom clusters. RESULTS: Twelve percent (2,041/17,205) of participants screened endorsed PTSD symptoms. Veterans with PTSD symptoms from some (partial PTSD) or each (PTSD all clusters) of the symptom clusters were significantly more likely to report poor general health, currently smoke, be divorced, report little or no social support, and have a higher prevalence of mental distress, death wishes, and suicidal ideation than those with no trauma history or those with trauma but no symptoms. Group differences were most pronounced for mental distress and least for at-risk drinking. Presence of PTSD all clusters was associated with poorer outcomes on all of the above-mentioned health characteristics than partial PTSD. CONCLUSION: PTSD symptoms are common in a substantial minority of older veterans in primary care, and careful inquiry about these symptoms is important for comprehensive assessment in geriatric populations.",0,0 +3579,Trajectories of Attachment Insecurities Over a 17-Year Period: A Latent Growth Curve Analysis of the Impact of War Captivity and Posttraumatic Stress Disorder,"In this study, we assessed the 17-year trajectories of attachment insecurities (anxiety and avoidance) and examined their relations to having been a prisoner of war and suffering from Posttraumatic Stress Disorder (PTSD). The sample included two groups of Israeli veterans from the 1973 Yom Kippur war: ex-prisoners of war and comparable control individuals who had not been held captive. They completed self-report measures of anxious and avoidant attachment and PTSD at three time points: 18, 30, and 35 years after the war. Ex-POWs were less secure with respect to attachment than the controls at the initial assessment, and although the controls experienced a decline in attachment insecurity over the 17-year period, the anxiety and avoidance scores of the ex-POWs increased over time. We also found that PTSD was associated with higher attachment insecurity scores at each time point, beyond the effect of war captivity. Implications of the findings for both attachment theory and the psychological effects of trau...",0,0 +3580,"Resource loss, resource gain, and psychological resilience and dysfunction following cancer diagnosis: A growth mixture modeling approach.","This study investigated trajectories of psychological distress and their relationships with change in psychosocial resources in the year following cancer diagnosis.Chinese colorectal cancer (CRC) patients (n = 234) were assessed within 12 weeks of diagnosis (T1) and again at 3-month (T2) and 12-month (T3) follow-ups. Growth mixture modeling was used to analyze the longitudinal data.Psychological distress was measured at the three time-points using Hospital Anxiety and Depression Scale (HADS).Growth mixture models identified four classes: chronic distress (7-9%), delayed distress (10-13%), recovery (13-16%), and resilient (65-67%). People in chronic distress were more likely to demonstrate loss in physical functioning and social relational quality than those in delayed distress, and loss in physical functioning, optimism, and hope than those in recovery, but more likely to demonstrate stability/gain in optimistic personalities than those in delayed distress and resilient. People in resilient were more likely to report stability/gain in optimistic personalities than those in delayed distress but not those in recovery.Understanding differential outcome trajectories and associated change in coping resources has implications for developing ongoing psychological services for cancer patients during the diagnosis and treatment process.",1,0 +3581,Novel Approach to the Role of NMDA Receptors in Traumatic Brain Injury,"For more than two decades the intensive research effort on the role of NMDA receptors (NMDAR) in traumatic brain injury (TBI) and cerebral ischemia (stroke) was led by the observations that extracellular concentrations of glutamate and aspartate are elevated after the insult and play a major role in brain pathologies. Indeed, NMDAR antagonists were shown to improve post-injury recovery in animal models and subsequently, large scale placebocontrolled clinical trials in TBI and stroke were performed with NMDAR antagonists. However, all these trials have demonstrated either no benefit or even deleterious effects. The discrepancy between the animal and human studies prompted us to investigate the temporal changes of the NMDAR after brain insult in TBI and stroke mouse models. We found that the early hyperactivation of the NMDAR is followed by loss of functional NMDAR which persists for weeks. Such dynamic changes could well explain the discrepancies between the preclinical and clinical experience as well as suggest alternative modes of treatment, namely, activation, rather than blockade of the NMDAR in the sub-acute period after TBI and stroke. Stimulation of the glycine modulatory site of the glycine/NMDAR by the partial agonist Dcycloserine (DCS) when given at least 24 hrs after TBI or stroke was shown to improve recovery of neurobehavioral and cognitive functions. It was also shown to restore impaired hippocampal Long-Term potentiation (LTP) and induce expression of Brain Derived-Neurotrophic Factor (BDNF) in a TBI model and to improve somatosensory and cognitive function in a stroke model. Experiments to optimize the DCS treatment paradigm showed that similar benefits were demonstrated in TBI mice whether the drug was given as a single injection at 24 or 72 hrs post injury, or as double (24 and 48 hrs) or triple (24, 48 and 72 hrs) doses. Interestingly, beneficial effects of DCS were reported in a range of animal models of human diseases as well as in several clinical indications thought to involve disruptions in NMDAR function, such as drug addiction, post-traumatic stress disorder, Parkinson's disease, aging and psychiatric disorders. As DCS has a good safety profile, and is already in use in humans in several different indications, and based on studies with DCS in the mouse TBI model, a multi-center prospective randomized controlled clinical trial, aiming to assess the effect of a single dose of DCS on cognitive outcome in patients with moderate TBI has recently begun.",0,0 +3582,Degree of exposure and peritraumatic dissociation as determinants of PTSD symptoms in the aftermath of the Ghislenghien gas explosion,"This paper investigates risk factors for the development of posttraumatic stress symptoms in the different survivor groups involved in a technological disaster in Ghislenghien (Belgium). A gas explosion instantly killed five firefighters, one police officer and 18 other people. Moreover, 132 people were wounded among which many suffered severe burn injuries.In the framework of a large health survey of people potentially involved in the disaster, data were collected from 3,448 households, of which 7,148 persons aged 15 years and older, at 5 months (T1) and at 14 months (T2) after the explosion. Hierarchical regression was used to determine the significant predictors and to assess their proportion in variance accounted for.The degree of exposure to the disaster was a predictor of the severity of posttraumatic stress symptoms. Peritraumatic dissociation appeared to be the most important predictor of the development of posttraumatic stress symptoms at T1. But at T2, posttraumatic stress symptoms at T1 had become the most important predictor. Dissatisfaction with social support was positively linked to development of posttraumatic stress symptoms at T1 and to the maintenance of these symptoms at T2. Survivors who received psychological help reported significant benefits.In harmony with the findings from studies on technological disasters, at T1 6,0% of the respondents showed sufficient symptoms to meet all criteria for a full PTSD. At T2, 6,6% still suffered from posttraumatic stress symptoms. The symptoms of the different victim categories clearly indicated the influence of the degree of exposure on the development of posttraumatic stress symptoms. Problems inherent to retrospective scientific research after a disaster are discussed.",0,0 +3583,The Role of Emotion in PTSD: Two Preliminary Studies,"Background: Two studies are presented that highlight the role of emotion in PTSD in which we examine what emotions in addition to anxiety may be present. Aims: The first aim was to assess the overall emotion profile across the five basic emotions of anxiety, sadness, anger, disgust, and happiness in clients attending a stress clinic. A small pilot study was also carried out to see how the emotion profiles impacted on outcome for CBT. Method: In Study 1, 75 consecutive attenders at a trauma service who were diagnosed with PTSD were assessed with a number of measures that included the Basic Emotions Scale. Results: The results showed that less than 50% of PTSD cases presented with anxiety as the primary emotion, with the remainder showing primary emotions of sadness, anger, or disgust rather than anxiety. A second pilot study involved the follow-up across exposure-based CBT of 20 of the participants from Study 1. Conclusions: The results suggest that anxiety-based PTSD is more likely to benefit from exposure than is non-anxiety based PTSD. Implications both for the classification and the treatment of PTSD are considered.",0,0 +3584,"The association between post-traumatic stress-related symptoms, resilience, current stress and past exposure to violence: a cross sectional study of the survival of Quechua women in the aftermath of the Peruvian armed conflict","BackgroundThe long lasting resilience of individuals and communities affected by mass violence has not been given equal prominence as their suffering. This has often led to psychosocial interventions in post-conflict zones being unresponsive to local realities and ill-equipped to foster local strengths. Responding to the renewed interest in resilience in the field of violence and health, this study examines the resilience and post-traumatic responses of Indigenous Quechua women in the aftermath of the political violence in Peru (1980–2000).MethodsA cross-sectional study examined the relationship between resilience, post-traumatic responses, exposure to violence during the conflict and current life stress on 151 Quechua women participants. Purposive and convenience sampling strategies were used for recruitment in Ayacucho, the area most exposed to violence. The study instruments were translated to Quechua and Spanish and cross-culturally validated. Data was analyzed using hierarchical regression analysis. A locally informed trauma questionnaire of local idioms of distress was also included in the analysis.FindingsSixty percent of women (n = 91) were recruited from Ayacucho city and the rest from three rural villages; the mean age was 45 years old. Despite high levels of exposure to violence, only 9.3% of the sample presented a level of symptoms that indicated possible PTSD. Resilience did not contribute to the overall variance of post-traumatic stress related symptoms, which was predicted by past exposure to violence, current life stress, age, and schooling (R2 = .421). Resilience contributed instead to the variance of avoidance symptoms (Stand β = −.198, t = −2.595, p = 0.010) while not for re-experiencing or arousal symptoms.ConclusionsThese findings identified some of the pathways in which resilience and post-traumatic responses interrelate in the aftermath of violence; yet, they also point to the complexity of their relationship, which is not fully explained by linear associations, requiring further examination. Age and gender-sensitive health care is considered critical almost fifteen years after the end of the conflict. The notable resilience of Quechua women—despite exposure to a continuum of violence and social inequalities—also calls for enhanced recognition of women not only as victims of violence but also as complex social actors in the reconstruction of post-conflict societies.",0,0 +3585,The Relationship Between Dating Violence and Psychosocial Problems in a Sample of Adolescent Pregnancy Termination Patients,"The relationship between dating violence and 13 psychosocial problems, conceptually organized into three symptom clusters--depressive, family problem, and posttraumatic stress--was investigated in a sample of adolescent pregnancy termination patients, ages 14 to 21. Results of a multivariate multiple-regression analysis indicated that, after controlling for age, ethnicity, general aggression problems, and problems with peers, dating violence was significantly related with the symptoms clusters. At the univariate level, the results suggested that dating violence was significantly related with self-esteem problems, guilt, and suicidal thinking from the depressive symptoms cluster and with guilt and stress from the posttraumatic stress cluster. The implications of these findings are discussed.",0,0 +3586,Imagery rehearsal therapy: An emerging treatment for posttraumatic nightmares in veterans.,"Nightmares are a common complaint among service members exposed to traumatic events, but prevailing paradigms are disposed to a view that nightmares are a secondary phenomenon untreatable with direct therapeutic intervention. Imagery rehearsal therapy is a cognitive-imagery approach with proven efficacy in the treatment of nightmares in civilian trauma victims. Imagery rehearsal therapy not only has potential to reduce nightmare intensity and frequency, but controlled studies show clinically meaningful decreases in all clusters of posttraumatic stress disorder symptoms as well as insomnia. Limited data support its use with combat veterans. Directions for future research with combat veterans are recommended. © 2010 American Psychological Association.",0,0 +3587,A systematic review of the comorbidity between PTSD and alcohol misuse,"Purpose This systematic review aimed to assess (1) the level of comorbidity of post-traumatic stress disorder (PTSD) and alcohol misuse reported in research studies since 2007 and (2) any associations found between specific PTSD symptom clusters and alcohol misuse. Methods A literature search was carried out to capture any papers published from 2007 to the end of July 2012. Six hundred and twenty abstracts were identified and reviewed, and 42 papers were included in the final review after applying inclusion and exclusion criteria. Results The prevalence of comorbid alcohol misuse in those with PTSD ranged from 9.8 to 61.3 %. The prevalence of comorbid PTSD in those with alcohol misuse ranged from 2.0 to 63.0 %, and the majority of prevalence rates were over 10.0 %. Almost all of the odds ratios representing the strength of association between the conditions across a variety of populations were significant, and those ranged from 1.1 to 4.87. Of the different PTSD symptom clusters, this review found most evidence for associations between alcohol misuse and both avoidance/numbing symptoms and hyperarousal symptoms. Conclusions Given that comorbidity appears to be common, the evidence from this systematic review supports the use of routine screening for comorbidity in populations who are known to have PTSD or alcohol misuse. © 2014 Springer-Verlag Berlin Heidelberg.",0,0 +3588,Acute Stress Disorder Symptoms Predict All-Cause Mortality Among Myocardial Infarction Patients: a 15-Year Longitudinal Study,"Studies have recognized myocardial infarction (MI) as a risk for acute stress disorder (ASD), manifested in dissociative, intrusive, avoidant, and hyperarousal symptoms during hospitalization.This study examined the prognostic role of ASD symptoms in predicting all-cause mortality in MI patients over a period of 15 years.One hundred and ninety-three MI patients filled out questionnaires assessing ASD symptoms during hospitalization. Risk factors and cardiac prognostic measures were collected from patients' hospital records. All-cause mortality was longitudinally assessed, with an endpoint of 15 years after the MI.Of the participants, 21.8 % died during the follow-up period. The decedents had reported higher levels of ASD symptoms during hospitalization than had the survivors, but this effect became nonsignificant when adjusting for age, sex, education, left ventricular ejection fraction, and depression. A series of analyses conducted on each of the ASD symptom clusters separately indicated that-after adjusting for age, sex, education, left ventricular ejection fraction, and depression-dissociative symptoms significantly predicted all-cause mortality, indicating that the higher the level of in-hospital dissociative symptoms, the shorter the MI patients' survival time.These findings suggest that in-hospital dissociative symptoms should be considered in the risk stratification of MI patients.",0,0 +3589,A Systematic Review of Resilience in the Physically Ill,"Resilience is the capacity of individuals to maintain, or regain, their mental health in the face of significant adversity, including physical illness.We conducted a systematic review of resilience and related concepts in the physically ill to determine factors associated with predicting or promoting resilience.An electronic search of PsychInfo, Medline, and CINAHL databases between 1950 and May 2009 was performed using the terms resilience, and various types of physical illnesses. Inclusion criteria were broad and exclusion criteria were not published in English or not focused on resilience in physical illness.A total of 475 articles were retrieved and 52 articles met inclusion/exclusion criteria. Psychological factors associated with resilience were self-efficacy, self-esteem, internal locus of control, optimism, mastery, hardiness, hope, self-empowerment, acceptance of illness, and determination. Social support was highly predictive of, and associated with, resilience. Coping strategies such as positive cognitive appraisal, spirituality, active coping, and mastery were also associated with resilience. Resilience factors directly salient to physical illness such as self-care, adherence to treatment, health related quality of life, illness perception, pain perception, exercise adherence, and physical outcomes were also found.These findings need to be considered and when appropriate incorporated into the psychological and psychiatric care of physically ill individuals.",0,0 +3590,Antidepressant treatment of posttraumatic stress disorder.,"Recent large double-blind, placebo-controlled trials have indicated that sertraline is an effective and well-tolerated treatment for posttraumatic stress disorder (PTSD). The avoidance/numbing symptom cluster improved the most significantly with sertraline, but significant improvements were also noted for the intrusive/reexperiencing and arousal symptom clusters. Smaller double-blind, placebo-controlled trials have also indicated that fluoxetine is an effective treatment for PTSD. Multiple small, open studies with other selective serotonin reuptake inhibitors and newer antidepressants indicate that these medications show some promise. Older studies indicate some efficacy for tricyclic antidepressants, and monoamine oxidase inhibitors are a reasonable choice, particularly for intrusive/reexperiencing symptoms.",0,0 +3591,Posttraumatic stress disorder and posttraumatic growth among Israeli ex-pows,"In this article, the authors present a prospective study that dealt with pathological (posttraumatic stress disorder; PTSD) and salutary (posttraumatic growth; PTG) outcomes of captivity and the correlates of those outcomes among a sample of ex-prisoners of war (POWs) and a control group of combat veterans. Posttraumatic stress disorder and its correlates were assessed in 1991 and 2003, and PTG was assessed in 2003. The results indicate that ex-POWs exhibited higher levels of PTSD and PTG than did the controls. In addition, both linear and quadratic associations between PTSD and PTG were found. The authors discuss some unresolved issues related to assessment of PTG and salutary outcomes, and outline directions for future research.",0,0 +3592,"Inflammatory markers in post-traumatic stress disorder: a systematic review, meta-analysis, and meta-regression","Studies investigating inflammatory markers in post-traumatic stress disorder (PTSD) have yielded mixed results. The aim of our study was to compare concentrations of inflammatory markers in patients with PTSD compared with healthy controls.We did a meta-analysis and meta-regression of studies comparing inflammatory markers between patients with PTSD and healthy controls by searching PubMed, Embase, Scopus, Web of Science, and PsycINFO for articles published between Jan 1, 1960, and April 7, 2015. From eligible studies (ie, cross-sectional studies or baseline data from longitudinal studies of peripheral blood cytokine concentrations that compared adults with PTSD with healthy controls), we extracted outcomes of interest, such as mean and SD of peripheral blood cytokines, the time of day blood was collected, whether the study allowed patients with comorbid major depressive disorder in the PTSD group, whether patients were medication free, and severity of PTSD symptoms. We undertook meta-analyses whenever values of inflammatory markers were available in two or more studies. A random-effects model with restricted maximum-likelihood estimator was used to synthesise the effect size (assessed by standardised mean difference [SMD]) across studies.8057 abstracts were identified and 20 studies were included. Interleukin 6 (SMD 0.88; p=0.0003), interleukin 1β (SMD 1.42; p=0.045), and interferon γ (SMD 0.49; p=0.002) levels were higher in the PTSD group than in healthy controls. Subgroup meta-analysis of patients who were not given medication showed higher tumour necrosis factor α (TNFα; SMD 0.69, 95% CI 0.35-1.02; p<0.0001) in the PTSD group than the control group in addition to the aforementioned cytokines. TNFα (SMD 1.32, 0.13-2.50; p=0.003), interleukin 1β (SMD 2.35, 0.01-4.68; p=0.048), and interleukin 6 (SMD 1.75, 0.97-2.53; p<0.0001) levels remained increased in the PTSD group in a subgroup meta-analysis of studies that excluded comorbid major depressive disorder. Illness duration was positively associated with interleukin 1β levels (b=0.33, p<0.0001) and severity with interleukin 6 (b=0.02, p=0.042). A model composed of several variables-presence of comorbid major depressive disorder, use of psychotropic medications, assay used, and time of day blood was collected-explained the large amount of heterogeneity between interleukin 1β, interleukin 6, and C-reactive protein studies. Egger's linear regression test revealed a potential publication bias for interleukin 1β. Additionally, for most inflammatory markers, study heterogeneity was reported to be high (I(2)>75%).PTSD is associated with increased interleukin 6, interleukin 1β, TNFα, and interferon γ levels. This information might be useful for consideration of chronic low-grade inflammation as a potential target or biomarker in PTSD treatment. Use of psychotropic medication and presence of comorbid major depressive disorder were important moderators that might explain the inconsistency between results of previous studies. Our search strategy used a range of databases and we made exhaustive effort to acquire data by contacting the authors. Notably, high levels of between-study heterogeneity were recorded for most cytokine variables measured in our analysis. However, meta-regression analysis could explain a large amount of this heterogeneity.None.",0,0 +3593,Pressure Pain Threshold Testing Demonstrates Predictive Ability in People With Acute Whiplash,"Longitudinal cohort study.To determine whether pressure pain threshold (PPT), tested at 2 standardized sites, could provide additional prognostic ability to predict short-term outcomes in people with acute whiplash, after controlling for age, sex, and baseline pain intensity.PPT may be a valuable assessment and prognostic indicator for people with whiplash-associated disorder. The extent to which PPT can predict short-term disability scores has yet to be explored in people with acute (of less than 30 days in duration) whiplash-associated disorder in a clinical setting.Eligible patients were recruited from community-based physiotherapy clinics in Canada. Baseline measurements included PPT, as well as pain intensity, age, and sex. Neck-related disability was collected with the Neck Disability Index 1 to 3 months after PPT testing. Multiple linear regression models were constructed to evaluate the unique contribution of PPT in the prediction of follow-up disability scores.A total of 45 subjects provided complete data. A regression model that included sex, baseline pain intensity, and PPT at the distal tibialis anterior site was the most parsimonious model for predicting short-term Neck Disability Index scores 1 to 3 months after PPT testing, explaining 38.6% of the variance in outcome. None of the other variables significantly improved the predictive power of the model.Sex, pain intensity, and PPT measured at a site distal to the injury were the most parsimonious set of predictors of short-term neck-related disability score, and represented promising additions to assessment of traumatic neck pain. Neither age nor PPT at the local site was able to explain significant variance beyond those 3 predictors. Limitations to interpretation are addressed.",0,0 +3594,Catecholamine responses to virtual combat: implications for post-traumatic stress and dimensions of functioning,"Posttraumatic stress disorder (PTSD) symptoms can result in functional impairment among service members (SMs), even in those without a clinical diagnosis. The variability in outcomes may be related to underlying catecholamine mechanisms. Individuals with PTSD tend to have elevated basal catecholamine levels, though less is known regarding catecholamine responses to trauma-related stimuli. We assessed whether catecholamine responses to a virtual combat environment impact the relationship between PTSD symptom clusters and elements of functioning. Eighty-seven clinically healthy SMs, within 2 months after deployment to Iraq or Afghanistan, completed self-report measures, viewed virtual-reality (VR) combat sequences, and had sequential blood draws. Norepinephrine responses to VR combat exposure moderated the relationship between avoidance symptoms and scales of functioning including physical functioning, physical-role functioning, and vitality. Among those with high levels of avoidance, norepinephrine change was inversely associated with functional status, whereas a positive correlation was observed for those with low levels of avoidance. Our findings represent a novel use of a virtual environment to display combat-related stimuli to returning SMs to elucidate mind-body connections inherent in their responses. The insight gained improves our understanding of post-deployment symptoms and quality of life in SMs and may facilitate enhancements in treatment. Further research is needed to validate these findings in other populations and to define the implications for treatment effectiveness.",0,0 +3595,Professional Quality of Life and Clinical Competencies among Korean Nurses,"Clinical competence among nurses is an essential requirement for the provision of safe and effective patient care. This study aims to classify types of professional quality of life experienced by Korean nurses, and examine the relationship between demographic and professional characteristics and clinical competence among nurses experiencing each type.A total of 335 nurses completed questionnaires assessing professional quality of life, clinical competence, and demographic and professional characteristics. Following identification of the underlying factors of professional quality of life, we classified participants into three clusters.There were significant differences in age, marital status, religion, educational status, and position between clusters. Results also revealed that nurses with high compassion satisfaction and low compassion fatigue (burnout, secondary traumatic stress) tended to have higher clinical competence.This study demonstrated that it is possible to directly examine the relationship between professional quality of life level and clinical competence among nurses. Thus, interventions to increase nurses' compassion satisfaction and relieve compassion fatigue are needed, as professional quality of life may affect clinical competence.",0,0 +3596,Pharmacotherapy for post-traumatic stress disorder - a systematic review and meta-analysis.,"Post-traumatic stress disorder (PTSD) is a prevalent and disabling condition. Evidence that PTSD is characterized by specific psychobiological dysfunctions has contributed to a growing interest in use of medication in its treatment.To assess the effects of medication in the treatment of PTSD.Systematic review of randomised controlled trials (RCTs) following the Cochrane Collaboration guidelines. A more detailed version of the review is published in the Cochrane Database of Systematic Reviews.We searched the Cochrane Depression, Anxiety and Neurosis Group specialised register, the Cochrane Central Register of Controlled Trials (Cochrane Library issue 4, 2004), MEDLINE (January 1966 - December 2004), PsycINFO (1966 - 2004), the National PTSD Center Pilots database, and the meta register module of the Controlled Trials database. Reference lists of retrieved articles were searched for additional studies. Two raters independently assessed RCTs for inclusion in the review, collated trial data, and assessed trial quality. Investigators were contacted to obtain missing data. Summary statistics were stratified by medication class, and by medication agent for the selective serotonin re-uptake inhibitors (SSRIs). Dichotomous and continuous measures were calculated using a random effects model, heterogeneity was assessed, and subgroup/sensitivity analyses were done.Thirty-five short-term (14 weeks or less) RCTs were included in the analysis (4 597 participants). Symptom severity for 17 trials was significantly reduced in the medication groups, relative to placebo (weighted mean difference (WMD) = -5.76, 95% confidence interval (CI)-8.16 - -3.36, N = 2 507). Similarly, summary statistics for responder status from 13 trials demonstrated overall superiority of a variety of medication agents compared with placebo (relative risk (RR) = 1.49, 95% CI: 1.28, 1.73, number needed to treat (NNT) = 4.85, N = 1 272). Medication and placebo response occurred in 59.1% (N = 644) and 38.5% (N = 628) of patients, respectively. Of the medication classes, evidence of treatment efficacy was most convincing for the SSRIs. Medication was also effective in reducing the severity of the PTSD re-experiencing/intrusion, avoidance/numbing, and hyperarousal symptom clusters in 9 trials (N = 1 304). In addition, medication was superior to placebo in reducing comorbid depression and disability. Medication was also less well tolerated than placebo. A narrative review of the 3 maintenance trials suggested that long-term medication may be required in treating PTSD.Medication treatments can be effective in treating PTSD, acting to reduce its core symptoms, as well as associated depression and disability, and should be considered as part of the treatment of this disorder. The findings of this review support the status of SSRIs as first-line agents in the pharmacotherapy of PTSD, as well as their value in longterm treatment. However, there remain important gaps in the evidence base, and there is a continued need for more effective agents in the management of PTSD.",0,0 +3597,Resilience in developmental psychopathology: Contributions of the Project Competence Longitudinal Study,"Abstract Contributions of the Project Competence Longitudinal Study (PCLS) to resilience science and developmental psychopathology are highlighted in this article. Initiated by Norman Garmezy, the PCLS contributed models, measures, and methods, as well as working definitions of concepts like competence, developmental tasks, protective factors, and resilience. Findings from the study corroborated the feasibility of studying adaptation in a normative group of school children, identifying patterns of resilience, competence without major adversity, and maladaptive paths through life. Competence was multidimensional, showing continuity and change over time. Cascading effects across domains indicated that competence and problems spread over time. Thus, adult achievements in developmental tasks were rooted in childhood and adolescence. Young people who showed resilience had much in common with similarly successful peers who experienced less adversity over time, including high-quality relationships with parents and other adults, and good cognitive, as well as social–emotional, skills. Maladaptive youth in the study often faced high adversity with little adaptive capacity (internal or external) and tended to generate stressful experiences. Resilience often emerged in childhood and endured, but there also were late bloomers whose lives turned around in the transition to adulthood. The role of collaboration and mentorship in the PCLS is also discussed.",0,0 +3598,Profile of psychiatric patients presenting to a tertiary care emergency department of Karachi.,"This study reviewed the presentations of psychiatric patients admitted through the Emergency Department (ED), The Aga Khan University Hospital, Karachi. Psychiatric patients admitted through the ED to the psychiatry ward were compared to those admitted through the same units other than the psychiatry ward, from 2006 to 2010 using medical records. Psychiatric patients were defined as those in whom psychiatry consult was generated and 1127 cases were included in study. There were 550 (48.8%) female patients. Most common presentations in the ED were sleep-related problems (n=205, 15.9%) followed by aggressive behavior (n=191, 14.8%). Depression was the most common diagnosis made in the ED (n=331, 29.3%) and at the time of discharge from the hospital (n=354, 29.5%). Psychiatric patients presenting to the ED had signs and symptoms which one generally disregards. However, these minor indicators can lead to major events in a patient's life.",0,0 +3599,Post-traumatic stress disorder in Asian refugees,"This study profiles 127 cases of Vietnamese, Cambodian, Laotian and Chinese refugee outpatients diagnosed with post-traumatic stress disorder (PTSD). Traumatic etiologies included victims of wars such as political refugees, concentration camp prisoners and victims of rape, severe personal losses (property or human lives). These traumata were experienced by our subjects during the period between the end of the Vietnam war in April 1975 and recent times, when they finally arrived in the USA. Clinical symptoms of these subjects reflected many influences of their oriental culture background and are characterized by internalization that needs to be overcome for assessment as well as for therapy. Symptomatic treatment with psychopharmacology and supportive therapy are helpful while cultural approaches have been adopted by many patients to reach the inner self pathology that could be of both mental and organic in nature. These facts need to be taken into consideration in the future description of the PTSD clinical picture. Recommendations are made for future PTSD studies in Vietnam, Cambodia and Laos, and to promote a global movement for prevention of any socio-political situation that may generate PTSD.",0,0 +3600,Thiol supplementation in aged animals alters antioxidant enzyme activity after heat stress,"Declines in oxidative and thermal stress tolerance are well documented in aging systems. It is thought that these alterations are due in part to reductions in antioxidant defenses. Although intracellular thiols are major redox buffers, their role in maintaining redox homeostasis is not completely understood, particularly during aging, where the reliance on antioxidant enzymes and proteins may be altered. To determine whether thiol supplementation improved the antioxidant enzyme profile of aged animals after heat stress, young and old Fischer 344 rats were treated with N-acetylcysteine (NAC; 4 mmol/kg ip) 2 h before heat stress. Liver tissue was collected before and 0, 30, and 60 min after heat stress. Aging was associated with a significant decline in tissue cysteine and glutathione (GSH) levels. There was also an age-related decrease in copper-zinc superoxide dismutase activity. Heat stress did not alter liver GSH, glutathione disulfide, or antioxidant enzyme activity. With NAC treatment, old animals took up more cysteine than young animals as reflected in an increase in liver GSH and a corresponding decrease in glutamate cysteine ligase activity. Catalase activity increased after NAC treatment in both age groups. Copper-zinc superoxide dismutase activity did not change with heat stress or drug treatment, whereas manganese superoxide dismutase activity was increased in old animals only. These data indicate that GSH synthesis is substrate limited in old animals. Furthermore, aged animals were characterized by large fluctuations in antioxidant enzyme balance after NAC treatment, suggesting a lack of fine control over these enzymes that may leave aged animals susceptible to subsequent stress.",0,0 +3601,Pain and quality of life 1 year after admission to the emergency department: factors associated with pain,"Objectives: This study describes the prevalence of pain in trauma patients 1 year after hospital admission and investigates separately health-related quality of life (QoL) for patients suffering severe pain and for those without pain. Moreover, psychosocial factors are examined for their impact on pain. Methods: Patients were contacted 12 months after admission in order to complete the following questionnaires: Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), Trauma Outcome Profile (TOP), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Impact of Event Scale-Revised (IES-R) and additional questions concerning satisfaction, work and financial status. Relevant pain at follow-up was defined as <80 points on the pain subscale of the TOP. Results: Two hundred and twenty patients were included. The Injury Severity Score (ISS) ranged from 1 to 41. Fifty-three percent (53 %) of patients suffered a severe trauma (ISS > 15). One year after injury, 55 % of patients had relevant pain according to the TOP. Patients with pain were older (41.4 vs. 34.4 years, p = 0.003) and had slightly more severe injuries (ISS 17.1 vs. 14.9, p = 0.115). There were significant differences between pain and no-pain patients on all domains of QoL (p < 0.001) and on the BDI, STAI and IES-R (p < 0.001). Pain patients more often experienced a stressful event and job-related and financial difficulties. Multivariate logistic regression analysis revealed post-traumatic stress disorder (PTSD) as the strongest predictor for pain [odds ratio (OR): 4.38, p = 0.015], followed by a stressful life event (OR: 4.08, p = 0.001). Discussion: Pain is strongly associated with psychosocial complaints 1 year after trauma. For the treatment of pain following a traumatic event, social reintegration and emotional regulation by means of occupational rehabilitation and psychotherapy should receive more attention. © 2013 Springer-Verlag Berlin Heidelberg.",0,0 +3602,Analysis of prevalence of PTSD and its influencing factors among college students after the Wenchuan earthquake,"Abstract Background This study explored the prevalence and severity of post-traumatic stress disorder (PTSD) in college students who lived in earthquake center one year after the Wenchuan earthquake on May 12, 2008, the factors affecting the prevalence of PTSD was also investigated. Methods 2987 students studying at the senior normal school in Tibetan autonomous region which was one of the most devastated regions were selected for this study. The PTSD Checklist-Civilian Version (PCL-C) was used as a screening instrument. Results A total of 420 cases (14.1%) were diagnosed with PTSD, among which mild, moderate, severe and extreme symptoms were reported in 122, 185, 106 and 7 cases, respectively. The PTSD prevalence in college students lived in the severely affected area was significantly higher than that in the less severe area (P < 0.001). According to the multivariate logistic regression analysis, the students who were injured in the earthquake, those lost their first degree relative, and those confronted with dead bodies were more likely to express PTSD. Male students were more prone than female students to develop PTSD. However, the students who received psychological tutorship were less prone to express PTSD. Conclusions At one year after the earthquake, the PTSD rate in college students in the severely affected area was high. The social support, psychological help and rehabilitation project should be strengthened to improve their ability to cope with the trauma.",0,0 +3603,Posttraumatic stress after a motor vehicle accident: A six-month follow-up study utilizing latent growth modeling,"Features of posttraumatic stress disorder (PTSD) for 596 survivors of motor vehicle accidents were examined by self-report measures at 1 week, 1 month, 3 months, and 6 months after the motor vehicle accident (MVA). Latent growth modeling was utilized to study the trend and predictors of the level of distress. Results indicated that 5-20% of the participants reported to have a significant level of posttraumatic stress in one, two, or three of the PTSD symptom clusters within the period studied. Survivors with significant acute stress 1 week after the MVA had a higher risk for developing chronic posttraumatic stress. Although the severity of intrusive and hyperarousal symptoms decreased over time, the severity of avoidance symptoms remained unchanged. Factors predicting the course of PTSD after an MVA are identified.",0,0 +3604,Varenicline for tobacco dependence: panacea or plight?,"This review examines the postmarketing experience with varenicline, including case reports, newer clinical trials and secondary analyses of large clinical datasets.Varenicline has been shown to be an effective treatment in a broad range of tobacco users with medical, behavioral and diverse demographic characteristics. Recent studies finding excellent safety and efficacy in groups of smokers with diseases including chronic obstructive pulmonary disease are particularly encouraging and call for increased use of this medication for smoking cessation. Despite case reports of serious neuropsychiatric symptoms in patients taking varenicline, including changes in behavior and mood, causality has not been established. Recent analyses of large datasets from clinical trials have not demonstrated that varenicline is associated with more depression or suicidality than other treatments for smoking cessation.Now that additional clinical trials in specific populations and observational studies on treatment-seeking smokers outside of clinical trials have been published, we can be confident that varenicline remains the most efficacious monotherapy for smoking cessation and that its side-effect profile remains good. The risk-to-benefit ratio of receiving varenicline to quit smoking must include the increased chances of quitting smoking and avoiding the sizeable risks of smoked-caused disease and death that remain if tobacco addiction is not properly treated.",0,0 +3605,APA's resilience initiative.,"Resilience is the human ability to adapt in the face of tragedy, trauma, adversity, hardship, and ongoing significant life stressors. Focus groups conducted by the APA Practice Directorate after the terrorist attacks of September 11, 2001, found people to be experiencing a chronic sense of stress and uncertainty for which they wanted to be more resilient. In response, APA launched its public education campaign, “The Road to Resilience,” in August 2002. A key component of the campaign is community outreach by psychologists, in which psychologists around the country bring information about resilience directly into their communities. This has allowed psychologists to help their communities and to help communities better understand the value of psychology.",0,0 +3606,The role of high-density lipoprotein cholesterol in risk for posttraumatic stress disorder: Taking a nutritional approach toward universal prevention,"Abstract Several cross-sectional studies, but no prospective studies, have reported an association between an abnormal lipid profile and posttraumatic stress disorder (PTSD). We hypothesized that an abnormal lipid profile might predict risk for developing PTSD. In this prospective study, we analyzed data from 237 antidepressant-naïve severely injured patients who participated in the Tachikawa Cohort of Motor Vehicle Accident Study. High-density lipoprotein cholesterol (HDL-C) levels at baseline were significantly lower in patients with PTSD than those without PTSD at 6 months after motor vehicle accident (MVA) and were inversely associated with risk for PTSD. In contrast, triglycerides (TG) at baseline were significantly higher in patients with PTSD than in those without PTSD at 6 months post-MVA and were positively associated with risk for PTSD. There was no clear association between low-density lipoprotein cholesterol or total cholesterol and risk for PTSD. In conclusion, low HDL-C and high TG may be risk factors for PTSD. Determining lipid profiles might help identify those at risk for PTSD after experiencing trauma.",0,0 +3607,The Moderating Role of Distress Tolerance in the Relationship Between Posttraumatic Stress Disorder Symptom Clusters and Suicidal Behavior Among Trauma Exposed Substance Users in Residential Treatment,"The co-occurrence of posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) is associated with greater risk for suicidal behavior than either disorder alone. Research highlights the relevance of PTSD symptoms in particular to suicide risk within this population. Research has also provided support for an association between distress tolerance (DT) and both PTSD symptoms and suicidal behavior. This study examined the role of DT in the relationship between PTSD symptom severity and suicidal behavior in a sample of 164 SUD inpatients with a history of Criterion A traumatic exposure. Results indicated that DT moderated the relationship between PTSD symptoms (overall, re-experiencing, and hyperarousal) and medically attended suicide attempts, with the magnitude of the relationship increasing at higher levels of DT.",0,0 +3608,Reductions in traumatic stress following a coping intervention were mediated by decreases in avoidant coping for people living with HIV/AIDS and childhood sexual abuse.,"To examine whether (a) Living in the Face of Trauma (LIFT), a group intervention to address coping with HIV and childhood sexual abuse (CSA), significantly reduced traumatic stress over a 1-year follow-up period more than an attention-matched support group comparison intervention; and (b) reductions in avoidant coping over time mediated reductions in traumatic stress.In a randomized controlled trial, 247 participants completed measures of traumatic stress and avoidant coping at pre- and post intervention, and at 4-, 8-, and 12-month follow-ups. Latent growth curve modeling examined changes over the 5 time points; standardized path coefficients provide estimates of effects.As compared with the support intervention, the coping intervention led to a reduction in traumatic stress over time (b = -.20, p < .02). Participants in the coping intervention also reduced their use of avoidant coping strategies more than did participants in the support intervention (b = -.22, p < .05). Mediation analyses showed reductions in avoidant coping related to reductions in traumatic stress (b = 1.45, p < .001), and the direct effect of the intervention on traumatic stress was no longer significant (b = .04, ns), suggesting that changes in avoidant coping completely mediated intervention effects on traumatic stress.The LIFT intervention significantly reduced traumatic stress over time, and changes in avoidant coping strategies mediated this effect, suggesting a focus on current stressors and coping skills improvement are important components in addressing traumatic stress for adults living with HIV and CSA.",0,0 +3609,"Associations Between Prolonged Grief Disorder, Depression, Posttraumatic Stress Disorder, and Anxiety in Rwandan Genocide Survivors","A number of studies have demonstrated that symptoms of prolonged grief disorder (PGD) represent a symptom cluster distinct from bereavement-related depression, anxiety, and posttraumatic stress disorder (PTSD). The aim of the present study was to confirm and extend these findings using the most recent criteria defining PGD. The authors interviewed a total of 400 orphaned or widowed survivors of the Rwandan genocide. The syndromes were strongly linked to each other with a high comorbidity. Principal axis factoring resulted in the emergence of 4 different factors. The symptoms of depression, along with the cognitive, emotional, and behavioral symptoms of PGD, loaded on the first factor, symptoms of anxiety on the second factor, symptoms of PTSD on the third factor, and the separation distress symptoms of PGD on the fourth factor. This indicates that the concept of PGD includes symptoms that are conceptually related to depression. However, the symptom cluster of separation distress presents a grief-specific dimension that may surface unrelated to depressive symptoms.",0,0 +3610,The use of antidepressant drugs in dermatology.,"This paper provides an updated review of the use of antidepressant drugs in dermatology. Some of the psychiatric disorders that are usually comorbid with dermatological disorders and respond to antidepressants include major depressive disorder, obsessive compulsive disorder, body dysmorphic disorder, social phobia and post-traumatic stress disorder usually secondary to trauma and abuse during early life. Cutaneous symptoms may be the feature of a primary psychiatric disorder, e.g. cutaneous body image problems, dermatitis artefacta, neurotic excoriations and trichotillomania, or psychiatric syndromes may be comorbid with a primary dermatological disorder such as the association of major depressive disorder or social phobia with psoriasis and obsessive compulsive disorder with acne excoriee. Some of the salient pharmacological properties of the tricyclic antidepressants (TCAs) and the selective serotonin reuptake inhibitor (SSRI) antidepressants are reviewed. The review indicates that the SSRI antidepressants are potentially beneficial in the management of all the major psychiatric syndromes that are encountered in dermatological disorders. The generally more favourable side-effect profile of the SSRIs, such as lower cardiotoxicity in contrast to the TCAs, has made them the first-line agents for the treatment of depression. Furthermore, some of the pharmacological properties of the antidepressant agents that are not related to their antidepressant activity, such as the histamine H1 blocking effect of TCAs, such as doxepin, amitriptyline and trimipramine, are of benefit in dermatological conditions such as urticaria and pruritus. This paper reviews the general guidelines for use of antidepressants and salient drug-drug interactions resulting mainly from the inhibition of the cytochrome P450 (CYP) 2D6 and 3A3/4 isoenzymes by some of the SSRI antidepressants. Before prescribing an antidepressant agent, the specific guidelines, side-effect profile, drug-drug interactions and most current indications should always be obtained.",0,0 +3611,"Multisite Investigation of Traumatic Brain Injuries, Posttraumatic Stress Disorder, and Self-reported Health and Cognitive Impairments","Few large-scale, multisite investigations have assessed the development of posttraumatic stress disorder (PTSD) symptoms and health outcomes across the spectrum of patients with mild, moderate, and severe traumatic brain injury (TBI).To understand the risk of developing PTSD symptoms and to assess the impact of PTSD on the development of health and cognitive impairments across the full spectrum of TBI severity.Multisite US prospective cohort study.Eighteen level I trauma centers and 51 non-trauma center hospitals.A total of 3047 (weighted n = 10 372) survivors of multiple traumatic injuries between the ages of 18 and 84 years.Severity of TBI was categorized from chart-abstracted International Classification of Diseases, Ninth Revision, Clinical Modification codes. Symptoms consistent with a DSM-IV diagnosis of PTSD were assessed with the PTSD Checklist 12 months after injury. Self-reported outcome assessment included the 8 Medical Outcomes Study 36-Item Short Form Health Survey health status domains and a 4-item assessment of cognitive function at telephone interviews 3 and 12 months after injury.At the time of injury hospitalization, 20.5% of patients had severe TBI, 11.7% moderate TBI, 12.9% mild TBI, and 54.9% no TBI. Patients with severe (relative risk, 0.72; 95% confidence interval, 0.58-0.90) and moderate (0.63; 0.44-0.89) TBI, but not mild TBI (0.83; 0.61-1.13), demonstrated a significantly diminished risk of PTSD symptoms relative to patients without TBI. Across TBI categories, in adjusted analyses patients with PTSD demonstrated an increased risk of health status and cognitive impairments when compared with patients without PTSD.More severe TBI was associated with a diminished risk of PTSD. Regardless of TBI severity, injured patients with PTSD demonstrated the greatest impairments in self-reported health and cognitive function. Treatment programs for patients with the full spectrum of TBI severity should integrate intervention approaches targeting PTSD.",0,0 +3612,"Prevalence and trends of benzodiazepine use among Veterans Affairs patients with posttraumatic stress disorder, 2003–2010","Although the Veterans Affairs and Department of Defense (VA/DoD) clinical guidelines for management of posttraumatic stress disorder (PTSD) recommend against routine benzodiazepine use, little is known about the trends and clinical and prescription profiles of benzodiazepine use since these guidelines were released in 2004. This retrospective study included 64,872 patients with a PTSD diagnosis received from care at facilities in VA Northwest Veterans Integrated Service Network (VISN 20) during 2003–2010. Annual prevalence of any use was defined as any prescription for benzodiazepines, and long-term use was defined as >90 days’ supply, in a year. Gender-specific logistic regressions were fit to estimate any and long-term benzodiazepine use, test for linear trends over 8-years and explore factors associated with trends. The trend of age-adjusted benzodiazepine use over 8-years rose significantly from 25.0 to 26.8% among men and 31.2 to 38.8% among women. Long-term use in men and women increased from 15.4 to 16.4% and 18.0 to 22.7%, respectively. Comorbid psychiatric and alcohol use disorders (AUD) were associated with a greater increase in long-term use of benzodiazepines. In 2010, 61% of benzodiazepine users received >90 days’ supply. Among those prescribed benzodiazepines long-term, 11% had AUD and 47% were also prescribed opioids long-term. Despite VA/DoD clinical guidelines recommending against routine use of benzodiazepines for PTSD, the adjusted prevalence of long-term use increased among men and women with PTSD in VISN 20. Widespread concomitant use of benzodiazepines and opioids suggests risk management systems and research on the efficacy and safety of these medications are needed.",0,0 +3613,"The impact of the refugee decision on the trajectory of PTSD, anxiety, and depressive symptoms among asylum seekers: A longitudinal study","To examine prospectively the trajectory of trauma-related psychiatric symptoms and disability amongst asylum seekers over the course of the refugee determination process. To identify the direct impact of the refugee decision on psychiatric symptoms by adjusting for other variables, namely sociodemographic characteristics, past trauma, and ongoing postmigration stresses.A prospective cohort study of asylum seekers recruited from a random sample of immigration agents in Sydney, Australia.Consecutive asylum seekers were referred for interview by immigration agents. Interviews were undertaken after the initial application and on average, 3.8 months after the refugee decision.Measures assessed premigration trauma and postmigration stressors. Mental health status was assessed using the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist-25. Functional impairment was assessed with the Medical Outcomes Study-Short Form 12.Sixty-two of 73 asylum seekers were retained at follow-up. The accepted (16) and rejected (46) groups did not differ on premigration trauma or baseline psychiatric symptoms. Postdecision, the accepted group showed substantial improvements in posttraumatic stress disorder, anxiety, depression, and in mental health functioning, whereas the rejected group maintained high levels of symptoms on all psychiatric indices.Establishing secure residency status for asylum seekers may be important to their recovery from trauma-related psychiatric symptoms. The practical and theoretical implications are discussed.",0,0 +3614,"Gold mining on Mayan-Mam territory: Social unravelling, discord and distress in the Western highlands of Guatemala","This article examines the influence of a large-scale mining operation on the health of the community of San Miguel Ixtahuacán, Guatemala. An anti-colonial narrative approach informed by participatory action research principles was employed. Data collection included focus groups and one-on-one interviews from August to November of 2011. Over this period, we interviewed 15 Mam Mayan men and 41 women (n = 56) between the ages of 18 and 64 including health care workers, educators, spiritual leaders, agricultural workers and previous mine employees from 13 villages within the municipality. Participants' accounts pointed to community health experiences of social unravelling characterized by overlapping narratives of a climate of fear and discord and embodied expressions of distress. These findings reveal the interconnected mechanisms by which local mining operations influenced the health of the community, specifically, by introducing new threats to the safety and mental wellbeing of local residents.",0,0 +3615,"Factor Structure, Reliability, and Known Groups Validity of the German Version of the Childhood Trauma Questionnaire (Short-Form) in Swiss Patients and Nonpatients","The Childhood Trauma Questionnaire-Short Form is the most widely used instrument to assess childhood trauma and has been translated into 10 languages. However, research into validity and reliability of these translated versions is scarce. The present study aimed to investigate the factor structure, internal consistency, reliability, and known-groups validity of the German Childhood Trauma Questionnaire-Short Form (Bernstein & Fink, 1998). Six-hundred and sixty-one clinical and nonclinical participants completed the German Childhood Trauma Questionnaire-Short Form. A confirmatory factor analysis was conducted to assess the 5-factor structure of the original Childhood Trauma Questionnaire-Short Form. To investigate known-groups validity, the confirmatory factor analysis latent factor levels between clinical and nonclinical participants were compared. The original 5-factor structure was confirmed, with only the Physical Neglect scale showing rather poor fit. As a conclusion, the results support the validity and reliability of the German Childhood Trauma Questionnaire-Short Form. It is recommended to use the German Childhood Trauma Questionnaire-Short Form to assess experiences of childhood trauma.",0,0 +3616,A comparison of PTSD symptom patterns in three types of civilian trauma,"Posttraumatic stress disorder (PTSD) is assumed to be an equivalent syndrome regardless of the type of traumatic event that precipitated it. However, the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) and previous research suggest that the clinical presentation of PTSD varies by trauma type. This study compared PTSD symptom profiles in three types of civilian trauma: sexual assault (n = 86), motor vehicle accident (n = 162), and sudden loss of a loved one (n = 185). Groups differed in overall PTSD severity and displayed distinct PTSD symptom patterns. Results suggest that different trauma types lead to unique variants of the PTSD syndrome, which may result from different etiological factors and may require different treatment approaches.",0,0 +3617,Item order effects in the evaluation of posttraumatic stress disorder symptom structure.,"Factor analytic research has demonstrated consistently that the 3-factor DSM-IV model of posttraumatic stress disorder (PTSD) symptom structure provides a poorer fit than alternative 4- and 5-factor models. In the current study we examined whether order of item presentation accounts for these findings. In a large sample (N = 1,311) of trauma-exposed undergraduates we conducted a series of confirmatory factor analyses using the PTSD Checklist and Posttraumatic Stress Diagnostic Scale, which present symptom items in the same order as DSM-IV, and the Detailed Assessment of Posttraumatic Stress, which presents items in a different order. Across all 3 measures the 3-factor DSM-IV model provided a relatively worse fit and the 5-factor dysphoric arousal model provided a relatively better fit compared with other tested models. We also examined the distinctiveness of 2 pairs of symptom clusters that appear in the dysphoric arousal model--avoidance versus numbing and dysphoric arousal versus anxious arousal--by comparing their patterns of associations with external correlates. Avoidance and numbing demonstrated differential associations with external correlates, as did dysphoric arousal and anxious arousal. Taken together, results indicate that order effects are unlikely to account for differences in relative fit between leading models of PTSD symptom structure. We discuss the need for future research in this area, especially studies designed to evaluate order effects more directly.",0,0 +3618,On the viability of PTSD Checklist (PCL) short form use: Analyses from Mississippi Gulf Coast Hurricane Katrina survivors.,"One measure commonly used to assess posttraumatic stress disorder is the PTSD Checklist (PCL). Lang and Stein (2005) extracted 4 subsets of PCL items, validating 2 of them for possible use in screening in primary care settings. The viability of the 4 item subsets was evaluated psychometrically in the present study with a sample of Hurricane Katrina survivors (N = 337). Corrected item-total and corrected item-cluster correlations were calculated and compared with those obtained by Lang and Stein. In addition, the sensitivity, specificity, and overall correct classification of the 4 item subsets were evaluated. With methodology approximating Lang and Stein's work, the current data would lead to the development of different screening versions of the PCL. Although some psychometric support was achieved (e.g., high sensitivity), use of the Lang and Stein PCL item subsets for screening natural disaster survivors appears unjustified on the basis of the present data.",0,0 +3619,0429 Chronic Probable Posttraumatic Stress Disorder among Police Registrants in the World Trade Centre Health Registry Ten Years after 9/11/01,"

Objectives

The World Trade Centre Health Registry (WTCHR) prospectively follows a cohort of over 71 000 individuals who reported being directly exposed to the 9/11/01 terrorist attack. Among police registrants at Survey Wave 2, 5–6 years after 9/11/01, four unique trajectories of probable PTSD symptoms were identified: resilient (83%), recovered (2.5%), delayed onset (11.2%) and chronic (5.3%). The current study documents the longitudinal trajectories of PTSD in police officers exposed to the WTC attacks at Wave 3 (2011–2012), over 10 years since the WTC attack.

Method

We examined the prevalence of probable PTSD at the Wave 3 survey using a cut-off score of 44 or greater on the event-specific Posttraumatic Stress Disorder Checklist (PCL) and at least one re-experiencing symptom (DSM-IV criterion B), three avoidance or numbing symptoms (DSM-IV criterion C), and two hyperarousal symptoms (DSM-IV criterion D).

Results

Probable PTSD was 14.4% (95% CI 13.0–15.9%) at Wave 2 and 12.9% (95% CI, 11.6–14.3%) at Wave 3. Significant predictors of chronic probable PTSD 10 years post-disaster (n = 59/2241, 2.6%) include age 45–69 (aOR 3.16, 95% CI, 1.7–6.0), number of stressful events witnessed on 9/11/01 (aOR 3.00, 1.6–5.8), five or more stressful life events since 9/11/01 (aOR 5.42, 1.9–15.2), and unmet mental health care needs (aOR 6.86, 3.3–14.1). Protective factors include social support (aOR 0.34, 0.1–0.97) and number of close friends or relatives (aOR 0.92, 0.87–0.98).

Conclusions

Chronic probable PTSD among police responders continues to be a significant problem, associated both with intervening stressful life events and unmet mental health care needs.",0,0 +3620,Pharmacological inhibition of endocannabinoid degradation modulates the expression of inflammatory mediators in the hypothalamus following an immunological stressor,"The endocannabinoid system is an important regulator of the nervous, neuroendocrine, and immune systems, thus representing a novel therapeutic target for stress-related neuroinflammatory and psychiatric disorders. However, there is a paucity of data relating to the effects of endocannabinoids on neuroinflammatory mediators following an immune stress/challenge in vivo. This study investigated the effects of URB597, a selective inhibitor of fatty acid amide hydrolyase (FAAH), the enzyme that preferentially metabolizes anandamide, on lipopolysaccharide (LPS)-induced increases in the expression of immune mediators in the hypothalamus. Systemic administration of URB597 increased the levels of anandamide and the related N-acylethanolamines, N-palmitoylethanolamide, and N-oleoylethanolamide, but not 2-arachidonoyl glycerol, in the hypothalamus and spleen. URB597 attenuated the LPS-induced increase in interleukin (IL)-1β expression while concurrently augmenting the LPS-induced increase in suppressor of cytokine signalling (SOCS)-3 expression. In addition, URB597 tended to enhance and reduce the LPS-induced increase in IL-6 and IL-10 mRNA expression, respectively. LPS-induced increases in peripheral cytokine levels or plasma corticosterone were not altered by URB597. The present study provides evidence for a role for FAAH in the regulation of LPS-induced expression of inflammatory mediators in the hypothalamus. Improved understanding of endocannabinoid-mediated regulation of neuroimmune function has fundamental physiological and potential therapeutic significance in the context of stress-related disorders.",0,0 +3621,Neural Correlates of Psychotherapy in Anxiety and Depression: A Meta-Analysis,"Several studies have used neuroimaging methods to identify neural change in brain networks associated to emotion regulation after psychotherapy of depression and anxiety. In the present work we adopted a meta-analytic technique specific to neuroimaging data to evaluate the consistence of empirical findings and assess models of therapy that have been proposed in the literature. Meta-analyses were conducted with the Activation Likelihood Estimation technique, which evaluates the overlap between foci of activation across studies. The analysis included 16 studies found in Pubmed (200 foci of activation and 193 patients). Separate meta-analyses were conducted on studies of 1) depression, post-traumatic stress disorder and panic disorder investigated with rest state metabolism (6 studies, 70 patients); 2) depression, post-traumatic stress disorder and panic disorder investigated with task-related activation studies (5 studies, 65 patients); 3) the previous studies considered jointly; and 4) phobias investigated with studies on exposure-related activation (5 studies, 57 patients). Studies on anxiety and depression gave partially consistent results for changes in the dorsomedial prefrontal cortex and in the posterior cingulated gyrus/precuneus. Several areas of change in the temporal lobes were also observed. Studies on the therapy of phobia were consistent with a reduction of activity in medial temporal areas. The cluster of change in the prefrontal cortex may refer to increased recruitment of control processes, as hypothesized by influential models of emotion regulation changes due to psychotherapy. However, not all areas associated with controlled emotion regulation were detected in the meta-analysis, while involvement of midline structures suggested changes in self-related information processing. Changes in phobia were consistent with reduced reactivity to phobic stimuli.",0,0 +3622,"Comorbidity in pediatric bipolar disorder: Prevalence, clinical impact, etiology and treatment","Research on pediatric bipolar disorder (PBD) is providing a plethora of empirical findings regarding its comorbidity. We addressed this question through a systematic review concerning the prevalence, clinical impact, etiology and treatment of main comorbid disorders involved.A comprehensive database search was performed from 1990 to August 2014. Overall, 167 studies fulfilled the inclusion criteria.Bipolar youth tend to suffer from comorbid disorders, with highest weighted mean prevalence rate arising from anxiety disorders (54%), followed by attention deficit hyperactivity disorder (ADHD) (48%), disruptive behavior disorders (31%), and substance use disorders (SUD) (31%). Furthermore, evidence indicates that ADHD and anxiety disorders negatively affect the symptomatology, neurocognitive profile, clinical course and the global functioning of PBD. Likewise, several theories have been posited to explain comorbidity rates in PBD, specifically common risk factors, one disorder being a risk factor for the other and nosological artefacts. Lastly, randomized controlled trials highlight a stronger therapeutic response to stimulants and atomoxetine (vs. placebo) as adjunctive interventions for comorbid ADHD symptoms. In addition, research focused on the treatment of other comorbid disorders postulates some benefits from mood stabilizers and/or SGA.Epidemiologic follow-up studies are needed to avoid the risk of nosological artefacts. Likewise, more research is needed on pervasive developmental disorders and anxiety disorders, especially regarding their etiology and treatment.Psychiatric comorbidity is highly prevalent and is associated with a deleterious clinical effect on pediatric bipolarity. Different etiological pathways may explain the presence of these comorbid disorders among bipolar youth. Standardized treatments are providing ongoing data regarding their effectiveness for these comorbidities among bipolar youth.",0,0 +3623,"The assessment of psychological symptoms of patients referred to community mental health teams: distress, chronicity and life interference","Mental health trusts are concerned to allocate scarce resources to those patients requiring secondary care services, rather than to those who can be managed in the community. It is important therefore to gain insight into the types of patient being referred into community mental health teams. This study was undertaken to explore this question. 421 patients completed the General Health Questionnaire and a newly devised symptom checklist, which allows assessment of distress/severity, chronicity and interference with life of individual symptoms. 81% of patients met criteria for caseness on the GHQ and those who did not still had a number of chronic symptoms. In regard to specific symptom profiles referred patients endorsed a wide variety of symptoms, related to anxiety, depression and impulse control. The most common anxiety symptom related to adjustment reactions and possibly post-traumatic stress. The most common mood symptom was mood instability, followed by fatigue and sleep problems. The majority of patients believed that they had had their symptoms and problems for longer than a year, indicating that many of the referrals to community teams are not short-term crises. Data suggests that the vast majority of referrals are appropriate but also point to a need for specific forms of intervention for the most common symptoms. Copyright © 2004 John Wiley & Sons, Ltd.",0,0 +3624,Gender Differences in Posttraumatic Stress Symptoms Among OEF/OIF Veterans: An Item Response Theory Analysis,"Establishing whether men and women tend to express different symptoms of posttraumatic stress in reaction to trauma is important for both etiological research and the design of assessment instruments. Use of item response theory (IRT) can reveal how symptom reporting varies by gender and help determine if estimates of symptom severity for men and women are equally reliable. We analyzed responses to the PTSD Checklist (PCL) from 2,341 U.S. military veterans (51% female) who completed deployments in support of operations in Afghanistan and Iraq (Operation Enduring Freedom/Operation Iraqi Freedom [OEF/OIF]), and tested for differential item functioning by gender with an IRT-based approach. Among men and women with the same overall posttraumatic stress severity, women tended to report more frequent concentration difficulties and distress from reminders whereas men tended to report more frequent nightmares, emotional numbing, and hypervigilance. These item-level gender differences were small (on average d = 0.05), however, and had little impact on PCL measurement precision or expected total scores. For practical purposes, men's and women's severity estimates had similar reliability. This provides evidence that men and women veterans demonstrate largely similar profiles of posttraumatic stress symptoms following exposure to military-related stressors, and some theoretical perspectives suggest this may hold in other traumatized populations.",0,0 +3625,The role of executive function in posttraumatic stress disorder: A systematic review,"Although posttraumatic stress disorder (PTSD) has been associated with disturbances in verbal memory, studies examining executive functioning in PTSD show mixed results.A systematic review and meta-analysis were performed to compare executive functioning in patients with current PTSD and controls without any psychiatric disorder. Standard mean differences (SMD) in executive functioning scores were calculated using random-effects models. Covariates were added to examine whether differences exist between subgroups.Across 18 studies, 1080 subjects were included. In comparison with 431 exposed controls and 227 healthy controls, 422 people with PTSD showed significantly impaired executive functioning. Subgroup analyses revealed more pronounced differences between PTSD patients and exposed controls than healthy controls. Male gender, higher age, war trauma, and higher severity of co-morbid depressive symptoms were related to poorer executive functioning in PTSD patients compared to exposed controls.Due to insufficient data and heterogeneity, not all subgroup differences or characteristics could be taken into account.Overall, PTSD patients were found to show impaired executive functioning. Future research should further elucidate the subgroup effects and focus on clinical implications with regard to daily functioning and treatment outcome.",0,0 +3626,USING LATENT PROFILE MODELS AND UNSTRUCTURED GROWTH MIXTURE MODELS TO ASSESS THE NUMBER OF LATENT CLASSES IN GROWTH MIXTURE MODELING,"Growth mixture modeling has gained much attention in applied and methodological social science research recently, but the selection of the number of latent classes for such models remains a challenging issue. This problem becomes more serious when one of the key assumptions of this model, proper model-specification is violated. The current simulation study compared the performance of a linear growth mixture model in determining the correct number of latent classes against two less parametrically restricted options, a latent profile model and an unstructured growth mixture model. A variety of conditions were examined, both for properly and improperly specified models. Results indicate that prior to the application of linear growth mixture model, the unstructured growth mixture model is a promising way to identify the correct number of unobserved groups underlying the data by using most model fit indices across all the conditions investigated in this study. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +3627,Posttraumatic Stress Disorder Symptom Structure in Injured Children: Functional Impairment and Depression Symptoms in a Confirmatory Factor Analysis,"To examine the factor structure of posttraumatic stress disorder (PTSD) symptoms in children and adolescents who have experienced an acute single-incident trauma, associations between PTSD symptom clusters and functional impairment, and the specificity of PTSD symptoms in relation to depression and general distress.Examined PTSD symptom structure in two samples of children (8 to 17 years of age) assessed an average of 6 months after unintentional injury: (1) a combined dataset of 479 children assessed with a PTSD symptom checklist, and (2) a sample of 204 children assessed via a standardized clinical interview. We evaluated the fit of six alternative models for the factor structure of PTSD symptoms, and the association of PTS symptom clusters with indicators of functional impairment. We then evaluated three models for the structure of PTSD and depression symptoms jointly, to examine specificity of PTSD versus general distress or mood symptoms.In both samples, the DSM-IV 3-factor model fit the data reasonably well. Two alternative four-factor models fit the data very well: one that separates effortful avoidance from emotional numbing, and one that separates PTSD-specific symptoms from general emotional distress. Effortful avoidance and dysphoria symptoms were most consistently associated with impairment. The best-fitting model for PTSD and depression symptom clusters had three factors: PTSD-specific, depression-specific, and general dysphoria symptoms.The DSM-IV model for PTSD symptom categories was a reasonable fit for these child data, but several alternative models fit equally well or better, and suggest potential improvements to the current diagnostic criteria for PTSD in children.",0,0 +3628,"THE DISSOCIATIVE SUBTYPE OF POSTTRAUMATIC STRESS DISORDER: RATIONALE, CLINICAL AND NEUROBIOLOGICAL EVIDENCE, AND IMPLICATIONS","Background Clinical and neurobiological evidence for a dissociative subtype of posttraumatic stress disorder (PTSD) has recently been documented. A dissociative subtype of PTSD is being considered for inclusion in the forthcoming Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) to address the symptoms of depersonalization and derealization found among a subset of patients with PTSD. This article reviews research related to the dissociative subtype including antecedent, concurrent, and predictive validators as well as the rationale for recommending the dissociative subtype. Methods The relevant literature pertaining to the dissociative subtype of PTSD was reviewed. Results Latent class analyses point toward a specific subtype of PTSD consisting of symptoms of depersonalization and derealization in both veteran and civilian samples of PTSD. Compared to individuals with PTSD, those with the dissociative subtype of PTSD also exhibit a different pattern of neurobiological response to symptom provocation as well as a differential response to current cognitive behavioral treatment designed for PTSD. Conclusions We recommend that consideration be given to adding a dissociative subtype of PTSD in the revision of the DSM. This facilitates more accurate analysis of different phenotypes of PTSD, assist in treatment planning that is informed by considering the degree of patients’ dissociativity, will improve treatment outcome, and will lead to much-needed research about the prevalence, symptomatology, neurobiology, and treatment of individuals with the dissociative subtype of PTSD.",0,0 +3629,,"Empirical evidence was provided on the utility of the Screen for Adolescent Violence Exposure (SAVE) in assessing adolescent exposure to school, home, and community violence. The SAVE was empirically developed on 1,250 inner-city adolescents, and obtained excellent reliability and validity. Both exploratory and confirmatory factor analyses identified three factors: Traumatic Violence, Indirect Violence, and Physical/Verbal Abuse. The SAVE demonstrated utility in classifying high- and low-violence participants, and correlated significantly with both objective crime data and theoretically relevant constructs (anger, posttraumatic stress symptoms, and internalizing/externalizing problems). Thus, the SAVE provides measurement of the stressor criterion associated with posttraumatic stress disorder, and allows quantification of severity of violence exposure by setting.",0,0 +3630,The Role of Peritraumatic Dissociation and Gender in the Association Between Trauma and Mental Health in a Palestinian Community Sample,"This research focused on gender-specific trauma exposure and mental health symptoms among Palestinians living in conditions of military violence. It also examined the gender-specific role of peritraumatic dissociation in moderating the association between lifetime trauma and mental health.A random sample of 311 Palestinian women and 274 men ages 16-60 years from the Gaza Strip participated. The subjects were asked about lifetime trauma and peritraumatic dissociation during their most severe traumatic experience. Mental health was indicated by total scores and diagnostic variables of posttraumatic stress disorder (PTSD), anxiety, mood (depression), and somatization disorders. Symptoms of hostility were assessed as a total score.The women reported a lower level of lifetime trauma than the men, but exposure to trauma was associated with PTSD among both genders. Exposure to lifetime trauma was further associated with anxiety, mood, and somatoform disorders only among women but not among men. No gender differences were found in the level of peritraumatic dissociation. Analyses on moderating effects showed that peritraumatic dissociation made both men and women more vulnerable to symptoms of hostility and men to depressive symptoms when they were exposed to lifetime trauma.The results are consistent with previous studies in more peaceful conditions: men experience more traumatic events, whereas exposure is associated with more severe psychiatric disorders among women. Peritraumatic dissociation as an acute response to trauma constituted a risk for mental health symptoms in both genders.",0,0 +3631,Posttraumatic reactions to an earthquake: Multidimensional scaling profile analysis of adolescent survivors,"The current study examined the prototypical profiles of posttraumatic stress reactions among a sample of 282 adolescent survivors of the 2008 Wenchuan earthquake in China. Based on a dimensional perspective, the results of profile analysis via multidimensional scaling (PAMS) model revealed a two-dimensional solution corresponding to four profiles: intrusion, avoidance/arousal, partial avoidance, and hyperarousal. These profiles of posttraumatic stress symptoms equally manifested across gender. In addition, the Intrusion Profile was found to be associated with more elevated psychological distress symptoms. Results are discussed with respect to the typical posttraumatic stress symptoms following the earthquake.",0,0 +3632,Effects of childhood development on late-life mental disorders,"To explore recent findings bridging childhood development and common late-life mental disorders in the elderly.We addressed aging as a part of the developmental process in central nervous system, typical and atypical neurodevelopment focusing on genetic and environmental risk factors and their interplay and links between psychopathology from childhood to the elderly, unifying theoretical perspectives and preventive intervention strategies.Current findings suggest that childhood development is strictly connected to psychiatric phenotypes across the lifespan. Although we are far from a comprehensive understanding of mental health trajectories, some initial findings document both heterotypic and homotypic continuities from childhood to adulthood and from adulthood to the elderly. Our review also highlights the urgent need for investigations on preventive interventions in individuals at risk for mental disorders.",0,0 +3633,"Profiles of adult survivors of severe sexual, physical and emotional institutional abuse in Ireland","Adult survivors of institutional abuse were interviewed with a comprehensive assessment protocol which included the Childhood Trauma Questionnaire, the Institutional Child Abuse Processes and Coping Inventory, the Structured Clinical Interviews for DSM IV axis I disorders and personality disorders, the Trauma Symptoms Inventory, a Life Problems Checklist, the Experiences in Close Relationships Inventory and the Kansas Marital Satisfaction Scale. Profiles were identified for subgroups who described severe sexual (N=60), physical (N=102), or emotional (N=85) abuse as their worst forms of maltreatment. Survivors of severe sexual abuse had the most abnormal profile, which was characterized by higher rates of all forms of child maltreatment and higher rates of posttraumatic stress disorder, alcohol and substance abuse, antisocial personality disorder, trauma symptoms, and life problems",0,0 +3634,Predictive factors of chronic post-traumatic stress disorder 6 months after a road traffic accident,"This study sets out to identify risk factors for post-traumatic stress disorder (PTSD) after a road traffic accident with a view to improving prevention.The study used a prospective cohort of road traffic accident casualties. All subjects over 15 years of age were recruited in the course of an interview conducted while they were receiving care in a hospital of the Rhône area administrative département. Six months after their accident, they answered a self-administered postal questionnaire that included the Post-traumatic Check-List Scale (PCLS) in order to evaluate PTSD. Multivariate logistic regression analysis was conducted to compare those subjects with a PCLS score of 44 or over with those with a lower score, in order to identify factors that might be associated with PTSD.592 subjects (out of 1168) returned the 6-month questionnaire and 541 completed the PCLS test. One hundred subjects had a PCLS score ≥ 44, suggesting PTSD, and 441 subjects did not. The factors associated with PTSD were initial injury severity, post-traumatic amnesia, the feeling of not being responsible for their accident and persistent pain 6 months after it. A lower odds-ratio was associated with users of two-wheel than four-wheel motor vehicles (OR=0.4; 0.2-0.9).Besides predictive factors for PTSD (injury severity, post-traumatic amnesia and the feeling of not being responsible for their accident), our study suggested a reduced risk of PTSD among two-wheel motor vehicle users.",0,0 +3635,Trauma-related symptoms in veterans of Operation Desert Storm: a 2-year follow-up,"This study was a 2-year follow-up in an ongoing prospective examination of development of trauma-related symptoms over time in a community group of veterans of Operation Desert Storm.Sixty-two National Guard reservists, from one medical and one military police unit, completed the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder and a DSM-III-R-based posttraumatic stress disorder (PTSD) symptom scale 1 month, 6 months, and 2 years after returning from the Middle East. Differences in symptom severity over time were analyzed by using repeated measure analyses of variance.Scores on the Mississippi scale, but not the DSM-III-R PTSD scale, increased significantly over time. Symptoms of hyperarousal were more severe at all time points than were symptoms of reexperiencing or avoidance. Level of combat exposure, as reflected by the Desert Storm trauma questionnaire, was significantly associated with the score on the Mississippi scale at 2 years but not at 1 month or 6 months. All subjects who met the Mississippi scale's diagnostic criteria for PTSD at 1 or 6 months still met the criteria at 2 years.Although symptoms were relatively mild, there was an overall increase in PTSD symptoms over 2 years. The statistical relationship between level of combat exposure and PTSD symptoms at 2 years, and not before, suggests that it may take time for the consequences of traumatic exposure to become apparent. Moreover, degree of exposure may be important in predicting the eventual development of symptoms. Continued follow-up will address the evolution of PTSD symptoms in Gulf War veterans.",0,0 +3636,Intelligence and Other Predisposing Factors in Exposure to Trauma and Posttraumatic Stress Disorder,"Prospective data on standardized measures of early predispositions would allow a strong test of hypotheses about suspected risk factors of posttraumatic stress disorder (PTSD) and exposure to traumatic events.To prospectively examine the extent to which intelligence, anxiety disorders, and conduct problems in childhood influence the risk for PTSD and for exposure to traumatic events.A longitudinal study of a randomly selected sample assessed at age 6 years and followed up to age 17 years.Samples were randomly selected from the 1983-1985 newborn discharge lists of 2 major hospitals in southeast Michigan (N=823).Cohort members with follow-up data at age 17 years (n=713; 86.6% of the initial sample).Cumulative exposure up to age 17 years of qualifying traumatic events; DSM-IV PTSD among participants who have experienced 1 or more traumatic events.Youth with teacher ratings of externalizing problems above the normal range at age 6 years were at increased risk for exposure to assaultive violence (adjusted odds ratio, 2.6; 95% confidence interval, 1.4-4.9). Youth aged 6 years with an IQ greater than 115 had decreased risk for exposure to traumatic events (adjusted odds ratio for assaultive violence, 0.3; 95% confidence interval, 0.2-0.7); a decreased risk for nonassaultive trauma (adjusted odds ratio, 0.6; 95% confidence interval, 0.3-0.9); and a decreased conditional risk for PTSD (adjusted odds ratio, 0.2; 95% confidence interval, 0.1-0.9). The conditional risk for PTSD was increased for youth with anxiety disorders and teacher ratings of externalizing problems above the normal range at 6 years of age.The results of this prospective community study highlight the role of intelligence in avoidance of exposure to traumatic experiences and their PTSD effects. They underscore the need for investigating cognitive processes in persons' responses to traumatic experiences and the involvement of general intelligence in these processes.",0,0 +3637,A historical review of trauma-related diagnoses to reconsider the heterogeneity of PTSD,"Based on the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, there are 636,120 ways for an individual to qualify for a diagnosis of posttraumatic stress disorder (PTSD) (Galatzer-Levy & Bryant, 2013). To unravel this heterogeneity, we examine the historical trajectory of trauma-related diagnoses. Our review addresses four traumas (i.e., combat, natural disaster, life-threatening accident and sexual assault) that have contributed the most to conceptual models of PTSD. Although these trauma types are all subsumed under the same diagnostic label, our literature review indicates that the psychological consequences of different traumatic experiences are traditionally studied in isolation. Indeed, most research addresses hypotheses regarding specific trauma types using samples of individuals selected for their experience with that specific event. We consider the possibility that PTSD is not a single, unified construct and what this means for future research and clinical applications.",0,0 +3638,Trauma Typology as a Risk Factor for Aggression and Self-Harm in a Complex PTSD Population: The Mediating Role of Alterations in Self-Perception,"This study examined the role of prolonged, repeated traumatic experiences such as childhood and sectarian trauma in the development of posttraumatic aggression and self-harm. Forty-four adult participants attending therapy for complex trauma in Northern Ireland were obtained via convenience sampling. When social desirability was controlled, childhood emotional and physical neglect were significant correlates of posttraumatic hostility and history of self-harm. These relationships were mediated by alterations in self-perception (e.g., shame, guilt). Severity of sectarian-related experiences was not related to self-destructive behaviors. Moreover, none of the trauma factors were related to overt aggressive behavior. The findings have implications for understanding risk factors for posttraumatic aggression and self-harm, as well as their treatment.",0,0 +3639,"Profiles of childhood trauma: Betrayal, frequency, and psychological distress in late adolescence.","With an emphasis on betrayal trauma, this study used latent profile analysis to examine how childhood traumas co-occur and whether trauma patterns differentially predicted psychological distress.A community sample of 806 adolescents and young adults participated. Youths reported their trauma histories, and lifetime DSM-IV disorders were assessed using a structured diagnostic interview.Latent profile analysis yielded 5 profiles: high betrayal trauma physical violence and emotional abuse (HBTPE), high betrayal trauma sexual and emotional abuse (HBTSE), low betrayal trauma (LBT), parent death (PD), and a no/low trauma profile. Logistic regression analyses compared youths in the no/low trauma profile to those in the trauma profiles. Youths in the HBTPE profile were more likely to have moderate/severe major depressive disorder (odds ratio [OR] = 2.92, 95% CI [1.16, 7.32]), posttraumatic stress disorder (OR = 4.33, 95% CI [1.34, 14.03]), and hallucinations (OR = 5.03, 95% CI [2.00, 12.67]); youths in the HBTSE and LBT profiles were more likely to experience hallucinations (OR = 3.19, 95% CI [1.21, 8.39] and OR = 3.20, 95% CI [1.01, 10.19], respectively); and youths in the PD profile were more likely to have moderate/severe depression (OR = 2.42, 95% CI [1.07, 5.43]).Specific trauma types co-occurred when considering type, level of betrayal, and frequency. The emergence of the 2 high betrayal trauma profiles, with differing symptom presentations, suggests that experiences of high betrayal traumas are not homogenous and specific trauma-focused interventions may be more appropriate for differing trauma profiles.",0,0 +3640,Brittle diabetes: psychopathological aspects.,"The term ""brittle"" is used to described an uncommon subgroup of type I diabetics whose lives are disrupted by severe glycaemic instability with repeated and prolonged hospitalization. Psychosocial problems are the major perceived underlying causes of brittle behaviour. Aim of this study is a systematic psychopathological assessment of brittleness using specific parameters of general psychopathology and personality traits following the multiaxial format (axis I and II) of the current DSM-IV-TR diagnostic criteria for mental disorders.Patients comprised 21 brittle type I diabetics and a case-control group of 21 stable diabetics, matched for age, gender, years of education, and diabetes duration. General psychopathology and the DSM-IV-TR personality traits/disorders were assessed using the Syptom Checklist-90-R (SCL-90-R) and the Millon Clinical Multiaxial Inventory-III (MCMI-III).The comparison for SCL-90-R parameters exclusively revealed higher scores in ""Phobic Anxiety"" subscale in brittle diabetics. No differences in all the other SCL-90-R primary symptom dimensions and in the three SCL-90-R global distress indices were observed between the two diabetic groups, as well as in the all MCMI-III clinical syndrome categories corresponding to DSM-IV-TR specific psychiatric disorders. However, brittle patients presented lower scores in MCMI-III compulsive personality traits and higher scores in paranoid, schizoid, schizotypal, antisocial, borderline, narcissistic, avoidant, dependent, depressive, and passive-aggressive personality traits.In this study, brittle diabetics show no differencies in terms of global severity of psychopathological distress and axis I specific DSM-IV-TR diagnoses in comparison with non-brittle subjects (except for phobic anxiety). Differently, brittle diabetics are characterized from less functional and maladaptive personality features and suffer more frequently and intensively from specific pathological personality traits of all DSM-IV-TR clusters.",0,0 +3641,Relationships between hormonal profile and novelty seeking in combat-related posttraumatic stress disorder,"This study examines relationships between hormonal levels and novelty seeking in a group of 27 Vietnam veterans with combat-related posttraumatic stress disorder (PTSD). Novelty seeking in the veteran sample, measured by the Cloninger Tridimensional Personality Questionnaire (TPQ), was almost twice as high as previously published norms. A distinctive pattern of significant positive correlations was found between novelty seeking scores and serum total triiodothyronine (T3), free T3, the T3/free thyroxine (FT4) ratio, urinary norepinephrine and the norepinephrine/cortisol ratio, while a negative correlation was found between novelty seeking scores and urinary cortisol levels. The findings were confirmed by t test analyses of high vs low novelty seeking subgroups and do not appear to be related simply to the severity of PTSD. These preliminary findings indicate the need to include measures of characterological traits in psychoendocrine studies of PTSD and to investigate their possible usefulness in subtyping this disorder.",0,0 +3642,Ethnic differences in symptoms among female veterans diagnosed with PTSD,"Among U.S. male Vietnam veterans, Hispanics have been shown to have higher rates of posttraumatic stress disorder (PTSD) than African Americans and non-Hispanic Whites (Kulka et al., 1990). In terms of gender, Tolin and Foa's (2006) meta-analysis suggested women experience higher rates of PTSD than men. This study examined ethnic differences in PTSD and other symptomatology among 398 female veterans (63% non-Hispanic White, 28% Hispanic, 9% African American) seeking treatment for PTSD from 1995 to 2009 at a Veterans Administration (VA) behavioral health clinic. The following symptom clusters were examined: anxiety/PTSD, depression, anger/hostility, and psychotic/dissociative symptoms. Few differences were found among the groups, suggesting the 3 ethnic groups studied were more similar than different. African American female veterans, however, scored higher on measuring ideas of persecution/paranoia, although this may reflect an adaptive response to racism. These findings warrant further investigation to elucidate this relationship.",0,0 +3643,Less is more? Assessing the validity of the ICD-11 model of PTSD across multiple trauma samples,"In the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the symptom profile of posttraumatic stress disorder (PTSD) was expanded to include 20 symptoms. An alternative model of PTSD is outlined in the proposed 11th edition of the International Classification of Diseases (ICD-11) that includes just six symptoms.The objectives of the current study are: 1) to independently investigate the fit of the ICD-11 model of PTSD, and three DSM-5-based models of PTSD, across seven different trauma samples (N=3,746) using confirmatory factor analysis; 2) to assess the concurrent validity of the ICD-11 model of PTSD; and 3) to determine if there are significant differences in diagnostic rates between the ICD-11 guidelines and the DSM-5 criteria.The ICD-11 model of PTSD was found to provide excellent model fit in six of the seven trauma samples, and tests of factorial invariance showed that the model performs equally well for males and females. DSM-5 models provided poor fit of the data. Concurrent validity was established as the ICD-11 PTSD factors were all moderately to strongly correlated with scores of depression, anxiety, dissociation, and aggression. Levels of association were similar for ICD-11 and DSM-5 suggesting that explanatory power is not affected due to the limited number of items included in the ICD-11 model. Diagnostic rates were significantly lower according to ICD-11 guidelines compared to the DSM-5 criteria.The proposed factor structure of the ICD-11 model of PTSD appears valid across multiple trauma types, possesses good concurrent validity, and is more stringent in terms of diagnosis compared to the DSM-5 criteria.",0,0 +3644,Posttraumatic stress symptoms and structure among orphan and vulnerable children and adolescents in Zambia,"Background Scant information exists on posttraumatic stress disorder (PTSD) symptoms and structure in youth from developing countries. Methods We describe the symptom profile and exposure to trauma experiences among 343 orphan and vulnerable children and adolescents from Zambia. We distinguished profiles of posttraumatic stress symptoms using latent class analysis. Results Average number of trauma-related symptoms (21.6; range 0–38) was similar across sex and age. Latent class model suggested three classes varying by level of severity: low (31% of the sample), medium (45% of the sample), and high (24% of the sample) symptomatology. Conclusions Results suggest that PTSD is a continuously distributed latent trait.",0,0 +3645,Identifying Classes of Veterans With Multiple Risk Factors,"As researchers examine the efficacy of interventions that simultaneously target more than 1 symptom, it is important to identify ways to help guide research and program development. This study used electronic medical record data to examine the covariation of multiple risk factors regularly assessed among primary care patients. It also examined the health care utilization of those patients identifying where the health care system came in contact with them to help identify the ideal locations these interventions may be most often used. We obtained data for six risk factors, as well as the number of primary care, mental health, and emergency department visits, from Veteran patients with a primary care visit. There were three main groups of primary care patients, identified using latent class analysis and regression. Although the smallest group, the ""High Treatment Need"" group, had an increased probability of screening positive for all four risk factors, the post-traumatic stress disorder screen was a significant discriminator of this group from the others. Results show that this group had the greatest number of encounters in all health care locations suggesting significant opportunities for intervention. However, future research is needed to examine the current interventions offered and potential avenues where risk factors may be addressed simultaneously.",0,0 +3646,"Attachment styles, traumatic events, and PTSD: a cross-sectional investigation of adult attachment and trauma","The aim of the present study was to examine the association between post-traumatic stress disorder (PTSD) and adult attachment in a young adult population. A sample of 328 Danish students (mean age 29.2 years) from four different schools of intermediate education level were studied by the Harvard Trauma Questionnaire (HTQ), the Revised Adult Attachment Scale (RAAS), the Trauma Symptom Checklist (TSC), the Crisis Support Scale (CSS), the Coping Style Questionnaire (CSQ), and the World Assumption Scale (WAS). Attachment styles were associated with number of PTSD symptoms, negative affectivity, somatization, emotional coping, attributions, and social support. The distribution of attachment styles in relation to PTSD symptoms could be conceived as uni-dimensional.",0,0 +3647,The Posttraumatic Stress Disorder (PTSD) Family Workshop: A Pilot Study of Preliminary Outcomes and Effect Sizes of an Attachment-Based Intervention for Family Members of Veterans with Combat-Related PTSD,"Objective. Social support and secure attachment confer protection against the development of post traumatic stress disorder (PTSD) after trauma exposure. Yet there are few empirically-supported interventions for PTSD that address the impact on the family and significant relationships. This research is an intervention development study for ""The PTSD Family Workshop,"" an attachment-based group intervention for family members of veterans with combat-related PTSD. The study examines preliminary outcomes and treatment effect sizes and tests research hypotheses. Methods. Research hypotheses were tested through an adaptation of a partial crossover design. All research was conducted at the Stratton VA Medical Center and all participants were family members of veterans receiving treatment for combat-related PTSD. Intervention content includes PTSD psycho-education, a description of the impact of PTSD on their veterans and their important others and the factors that influence resilience and readjustment. Participants were recruited for participation in 4 group; each group being composed of an Immediate (n=17) and a Delay (n=11) condition. Participants completed standardized pre-test, post-delay and post-intervention assessments. Study domains included knowledge of PTSD, caregiver empathic concern, caregiver adaptive coping behavior and caregiver burden. Results. Data analyses revealed that participants who completed the PTSD Family Workshop reported a significant increase in their knowledge of PTSD, their empathic concern and their adaptive coping behaviors as compared to wait-list participants. Analyses of caregiver burden were not significant. Treatment effect sizes were calculated at d=1.66, d=.50 and d=.60 for knowledge of PTSD, caregiver empathic concern and caregiver adaptive coping behaviors respectively. Conclusion. Research findings support the development and study of innovative treatments for veterans with combat-related PTSD. Results are encouraging and suggest that brief intervention can be of benefit for family members of veterans with PTSD. Overall, this work increased access for psycho-education and support for family members of veterans in the VA system and provided preliminary data for a larger scale controlled study to test intervention efficacy and examine its relationship to outcomes for veterans. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +3648,Is implementation of the 2013 Australian treatment guidelines for posttraumatic stress disorder cost-effective compared to current practice? A cost-utility analysis using QALYs and DALYs,"Objective: To assess, from a health sector perspective, the incremental cost-effectiveness of three treatment recommendations in the most recent Australian Clinical Practice Guidelines for posttraumatic stress disorder (PTSD). The interventions assessed are trauma-focused cognitive behavioural therapy (TF-CBT) and selective serotonin reuptake inhibitors (SSRIs) for the treatment of PTSD in adults and TF-CBT in children, compared to current practice in Australia. Method: Economic modelling, using existing databases and published information, was used to assess cost-effectiveness. A cost-utility framework using both quality-adjusted life-years (QALYs) gained and disability-adjusted life-years (DALYs) averted was used. Costs were tracked for the duration of the respective interventions and applied to the estimated 12 months prevalent cases of PTSD in the Australian population of 2012. Simulation modelling was used to provide 95% uncertainty around the incremental cost-effectiveness ratios. Consideration was also given to factors not considered in the quantitative analysis but could determine the likely uptake of the proposed intervention guidelines. Results: TF-CBT is highly cost-effective compared to current practice at $19,000/QALY, $16,000/DALY in adults and $8900/QALY, $8000/DALY in children. In adults, 100% of uncertainty iterations fell beneath the $50,000/QALY or DALY value-for-money threshold. Using SSRIs in people already on medications is cost-effective at $200/QALY, but has considerable uncertainty around the costs and benefits. While there is a 13% chance of health loss there is a 27% chance of the intervention dominating current practice by both saving dollars and improving health in adults. Conclusion: The three Guideline recommended interventions evaluated in this study are likely to have a positive impact on the economic efficiency of the treatment of PTSD if adopted in full. While there are gaps in the evidence base, policy-makers can have considerable confidence that the recommendations assessed in the current study are likely to improve the efficiency of the mental health care sector.",0,0 +3649,Deciding on the Number of Classes in Latent Class Analysis and Growth Mixture Modeling: A Monte Carlo Simulation Study,"Mixture modeling is a widely applied data analysis technique used to identify unobserved heterogeneity in a population. Despite mixture models' usefulness in practice, one unresolved issue in the application of mixture models is that there is not one commonly accepted statistical indicator for deciding on the number of classes in a study population. This article presents the results of a simulation study that examines the performance of likelihood-based tests and the traditionally used Information Criterion (ICs) used for determining the number of classes in mixture modeling. We look at the performance of these tests and indexes for 3 types of mixture models: latent class analysis (LCA), a factor mixture model (FMA), and a growth mixture models (GMM). We evaluate the ability of the tests and indexes to correctly identify the number of classes at three different sample sizes (n = 200, 500, 1,000). Whereas the Bayesian Information Criterion performed the best of the ICs, the bootstrap likelihood ratio test ...",0,0 +3650,Too tired to care? The psychological effects of working with trauma,"This quantitative and qualitative longitudinal study was designed to examine the effects on caregivers working therapeutically with seriously traumatized people. The participants were 13 healthcare workers seconded into a trauma and recovery team (TRT) set up to help those traumatized by the Omagh bombing on 15 August 1998. Quantitative data were collected using the Compassion Satisfaction/Fatigue Test and the Life Status Review Questionnaire. Qualitative data regarding positive and negative aspects of working with traumatized individuals, as well as caregiver's experience leaving the TRT, were gathered using open-ended questions contained in the final data set. These questionnaires were completed at four points in time: August 1998, December 1998, August 1999 and February 2001. Ethical approval for the study was gained from the Sperrin Lakeland Trust research committee. Analysis of the quantitative data indicated that levels of compassion fatigue and burnout increased, respectively, from 18.85 to 34.46 and 22.38 to 29.69 over the first year. Levels of compassion satisfaction decreased from 87.62 to 80.15, while levels of satisfaction with life (53.85 to 40.38) and life status (11.23 to 5.62) also decreased. Findings also demonstrated that compassion satisfaction is possibly a protective factor against compassion fatigue and burnout, in that caregivers with high compassion satisfaction scores were less likely to have corresponding high compassion fatigue and burnout scores. Findings from the qualitative data generated, revealed that team spirit and camaraderie, along with the satisfaction of seeing clients recover, were the most positive aspects of working in the team. Media interest, coping with and containing anger shown by bereaved relatives and dealing with the content of client's stories were the most negative. Themes to emerge from leaving the team included lack of understanding and support from non-trauma managers and an underestimation of the impact on caregivers of finishing in the team. Strategies that were found to be beneficial in helping to alleviate the negative effects of working with trauma were also elicited. This research has implications for practice, management and education.",0,0 +3651,Characterizing the effects of sertraline in post-traumatic stress disorder,"Background. Sertraline has a proved efficacy in post-traumatic stress disorder (PTSD), but it is unknown which symptoms respond or in what sequence this occurs. Such information might be useful clinically and heuristically. Method. The study examined the effects of sertraline on the individual symptoms of PTSD. It also examined whether early changes in anger explained drug-induced change in other symptoms over time. Mixed models analysis was applied to datasets from two 12-week placebo-controlled trials of sertraline. A validated self-rating scale (DTS) was used to assess treatment efficacy. Results. Sertraline was superior to placebo on 15 of 17 symptoms, especially in the numbing and hyperarousal clusters. A strong effect was found on anger from week 1, which partly explained the subsequent effects of sertraline on other symptoms, some of which began to show significantly greater response to drug than to placebo at week 6 (emotional upset at reminders, anhedonia, detachment, numbness, hypervigilance) and week 10 (avoidance of activities, foreshortened future). Conclusions. Sertraline exercises a broad spectrum effect in PTSD. Effects are more apparent on the psychological rather than somatic symptoms of PTSD, with an early modulation of anger and, perhaps, other affects, preceding improvement in other symptoms.",0,0 +3652,The work compatibility improvement framework: preliminary findings of a case study for defining and measuring the human-at-work system,"Although researchers traditionally examined the 'risk' characteristics of work settings in health studies, few work models, such as the 'demand-control' and 'motivation-hygiene theory', advocated the study of the positive and the negative aspects of work for the ultimate improvement of work performance. The objectives of the current study were: (a) to examine the positive and negative characteristics of work in the machining department in a small manufacturing plant in the Midwest USA, and, (b) to report the prevalence of musculoskeletal and stress outcomes. A focus group consisting of worker experts from the different job categories in the machining department confirmed the management's concerns. Accordingly, 56 male and female workers, employed in three shifts, were surveyed on the demand/energizer profiles of work characteristics and self-reported musculoskeletal/stress symptoms. On average, one-fourth to one-third of the workers reported 'high' demand, and over 50% of the workers documented 'low' energizers for certain work domains/sub-domains, such as 'physical task content'/'organizational' work domains and 'upper body postural loading'/'time organization' work sub-domains. The prevalence of workers who reported 'high' musculoskeletal/stress disorder cases, was in the range of 25-35% and was consistent with the results of 'high' demands and 'low' energizers. The results of this case study confirm the importance of adopting a comprehensive view for work improvement and sustainable growth opportunities. It is paramount to consider the negative and positive aspects of work characteristics to ensure optimum organizational performance. The Work Compatibility Improvement Framework, proposed in the reported research, is an important endeavor toward the ultimate improvement and sustainable growth of human and organizational performance.",0,0 +3653,Post-traumatic Stress Disorder Symptoms in Children After the 1999 Marmara Earthquake in Turkey,"Objective: The aim of this study is to evaluate the symptoms of post-traumatic stress disorder in different age groups of children after the 1999 Marmara earthquake in Turkey. Method: The study included thirty-five patients, two to sixteen years old, who presented to the child and adolescent psychiatry department with symptoms of PTSD after the earthquake. An Earthquake Information Form and a Post-traumatic Stress Disorder Symptoms Checklist were filled out with clinical interviews of cases",0,0 +3654,Resilience in the initial year of caregiving for a family member with a traumatic spinal cord injury.,"Individuals who assume caregiving duties for a family member disabled in a traumatic injury often exhibit considerable distress, yet few studies have examined characteristics of those who may be resilient in the initial year of caregiving. Reasoning from the influential Pearlin model of caregiving (Pearlin & Aneshensel, 1994) and the resilience process model (Bonanno, 2005), we expected a significant minority of caregivers would be chronically distressed and another group would be resilient throughout the inaugural year of caregiving for a person with a traumatic spinal cord injury (SCI), and these groups would differ significantly in primary and secondary stress and in personal resources and mediators.Twenty men and 108 women who identified as caregivers for a family member who incurred a traumatic SCI consented to complete measures during the inpatient rehabilitation and at 1 month, 6 months, and 12 months postdischarge.Latent growth mixture modeling of depression symptoms over time revealed 3 groups of caregivers: chronic (24%), recovery (24%) and resilient (48%). The chronic group reported more anxiety, negative affect, and ill health than the other 2 groups throughout the year. The resilient group was best characterized by their enduring levels of positive affect and supportive social networks.A large percentage of individuals are resilient in the initial year of caregiving, and those who have problems adapting exhibit significant distress soon following the traumatic event. Early detection of and psychological interventions for individuals who have difficulty adjusting are indicated, as their distress is unlikely to abate untreated over the year.",0,0 +3655,Characteristics of the traumatic stressors experienced by rural first responders,"First responders routinely experience work-related events that meet the definition of a traumatic stressor. Despite the high exposure to traumatic events, prevalence rates of posttraumatic stress disorder (PTSD) are relatively low. This discrepancy points to the potential value of identifying factors that distinguish those traumatic stressors that produce ongoing traumatic stress symptoms from those that do not. The present study surveyed 181 first responders from rural settings. A repeated-measures design was used to compare characteristics of traumatic stressors that were or were not associated with ongoing PTSD symptoms. A factor analysis revealed that distressing events were characterized by chaos and resource limitations. Consistent with contemporary models, two mediational analyses revealed that each event characteristic predicted peritraumatic dissociation and posttraumatic cognitions, which in turn predicted PTSD symptoms. Moreover, the effect of each event characteristic on PTSD symptoms was partially mediated by these cognitive processes.",0,0 +3656,A longitudinal investigation of posttraumatic stress disorder in patients with ovarian cancer,"Exposure to the aggressive and life-threatening nature of ovarian cancer and its treatment is potentially traumatic. However, little is known about the occurrence of posttraumatic stress disorder (PTSD) in these patients.A total of 121 women newly diagnosed with ovarian cancer were recruited into a prospective longitudinal study of the course of PTSD and the factors that predict its development and persistence. Between 82 and 111 were assessed at each of the four time points subsequent to their diagnosis, and 63 women provided complete data from the beginning of chemotherapy treatment, midtreatment, end of treatment and 3-months follow-up on PTSD.Between 36% and 45% of the total sample experienced PTSD at some point, with a nonsignificant but progressive increase in prevalence over time. Of those women with complete data, only 30% never experienced PTSD at any time. Most of the women were intermittent cases of PTSD (57%, n=36), while 13% (n=8) were persistent cases. Younger women were at higher risk of experiencing PTSD.The prevalence of women newly diagnosed with ovarian cancer with persistent PTSD is relatively low (13%); however, our findings highlight that the trajectory of the illness and its associated stressors may constitute an enormous challenge and may be perceived as traumatic and stressful for most of the women in our sample at least once. Repetitive screening for PTSD and the provision of psychological treatments could ameliorate PTSD symptoms.",0,0 +3657,Effects of trauma on children: occupational therapy to support recovery,"Each year millions of the world's children witness, are victimized by or participate in traumatic events, placing them at risk for developing post-traumatic stress disorder. If this disorder is left untreated, a child's developmental trajectory can be compromised. Occupational therapists are in key positions to recognize the signs and symptoms of post-traumatic stress in children that interfere with functioning. Expressive therapies, long used in occupational therapy practice, are well suited to help children achieve an adaptive response to trauma. Two brief case studies are presented, describing the application of occupational therapy using expressive media with children who experienced post-traumatic stress disorders. The results of this preliminary investigation suggest that occupational therapists working in early intervention programmes can be helpful in identifying children in need and in providing treatment based on expressive therapies, stress management and cognitive-behavioural modalities. Further research is recommended to examine the efficacy of different occupational therapy frames of reference in treating children with post-traumatic stress disorder. Copyright © 1999 Whurr Publishers Ltd.",0,0 +3658,What is Posttraumatic Stress Disorder?,"Our understanding of posttraumatic stress disorder (PTSD) has increased significantly over the last 2 decades. Although the cause of the condition is usually easy to determine in individual patients, the symptoms of PTSD are diverse and a mixture of psychological processes are involved. This article presents a broad overview of PTSD, including its definition according to DSM-IV and ICD-10 diagnostic criteria, and its clinical course with reference to its association with depression and other mental disorders. The article also briefly reviews the assessment of patients and considers physiologic features such as responses to startle stimuli that appear to be useful in diagnosing PTSD and in differentiating it from other anxiety disorders and depression. Finally, a brief overview of the treatment of PTSD is given, including psychological and biological treatment options.",0,0 +3659,Post-traumatic Stress Disorder in an Emergency Department Population One Year after Hurricane Katrina,"Hurricane Katrina resulted in a significant amount of injury, death, and destruction.To determine the prevalence of, and risk factors for, symptoms of post-traumatic stress disorder (PTSD) in an emergency department (ED) population, 1 year after hurricane Katrina.Survey data including the Primary Care PTSD (PC-PTSD) screening instrument, demographic data, and questions regarding health care needs and personal loss were collected and analyzed.Seven hundred forty-seven subjects completed the survey. The PC-PTSD screen was positive in 38%. In the single variate analysis, there was a correlation with a positive PC-PTSD screen and the following: staying in New Orleans during the storm (odds ratio [OR] 1.73, 95% confidence interval [CI] 1.28-2.34), having material losses (OR 1.64, 95% CI 1.03-2.60), experiencing the death of a loved one (OR 1.96, 95% CI 1.35-1.87), needing health care during the storm (OR 2.01, 95% CI 1.48-2.73), and not having health care needs met during the storm (OR 2.00, 95% CI 1.26-3.18) or after returning to New Orleans (OR 2.29, 95% CI 1.40-3.73). In the multivariate analysis, the death of a loved one (OR 1.87, 95% CI 1.26-2.78), being in New Orleans during the storm (OR 1.69, 95% CI 1.22-2.33), and seeking health care during the storm (OR 1.69, 95% CI 1.22-2.35) were associated with positive PC-PTSD screens.There was a high prevalence of PTSD in this ED population surveyed 1 year after hurricane Katrina. By targeting high-risk patients, disaster relief teams may be able to reduce the impact of PTSD in similar populations.",0,0 +3660,Peace and War,"In the study reported here, we examined posttraumatic stress disorder (PTSD) symptoms in 746 Danish soldiers measured on five occasions before, during, and after deployment to Afghanistan. Using latent class growth analysis, we identified six trajectories of change in PTSD symptoms. Two resilient trajectories had low levels across all five times, and a new-onset trajectory started low and showed a marked increase of PTSD symptoms. Three temporary-benefit trajectories, not previously described in the literature, showed decreases in PTSD symptoms during (or immediately after) deployment, followed by increases after return from deployment. Predeployment emotional problems and predeployment traumas, especially childhood adversities, were predictors for inclusion in the nonresilient trajectories, whereas deployment-related stress was not. These findings challenge standard views of PTSD in two ways. First, they show that factors other than immediately preceding stressors are critical for PTSD development, with childhood adversities being central. Second, they demonstrate that the development of PTSD symptoms shows heterogeneity, which indicates the need for multiple measurements to understand PTSD and identify people in need of treatment.",1,0 +3661,Population Mental Health,,0,0 +3662,Pharmacotherapy of PTSD,,0,0 +3663,Standardized Self-Report Measures of Civilian Trauma and PTSD.,,0,0 +3664,Enhancing the Health Care Experiences of Adult Female Survivors of Childhood Sexual Abuse,"This article addresses the medical issues presented by women who were sexually abused in childhood and provides a detailed and direct link between the existing literature and its implications for the medical system. A profile of the sexual abuse survivor is given, including child sexual abuse (CSA) characteristics and sequelae that influence the adult female survivor's health. Post-traumatic Stress Disorder is outlined as part of a complex interplay of physiological and psychological symptomatology that can compromise the CSA survivor's ability to access health care treatment and forge a positive provider/patient relationship. This article emphasizes that effective treatment with sexual abuse survivors must include interdisciplinary collaboration among health care professionals. Management of the CSA patient, a case vignette illustrating salient themes, and finally, guidelines for the health care practitioner are presented.",0,0 +3665,Neuropsychological Dysfunction in Severe Accidental Electrical Shock: Two Case Reports,"There has been a relative absence of studies that have longitudinally examined the neuropsychological profiles of women who have sustained severe accidental electrical shocks. A case is reported of a college-educated woman who received an estimated 120-V electrical shock. Neuropsychological assessments conducted at 2 months, and at 1 and 2 years postinjury, revealed a diversity of deficits indicative of diffuse, mild to moderate neurocognitive dysfunction, as well as symptomatology consistent with depression and posttraumatic stress disorder. For comparison, a second case of a man who received a 69,000-Velectrical injury is also presented. Although only minimal neurocognitive deficits were observed in this individual, he exhibited a similar psychological profile. The results of this study are discussed in light of the contrasting neurocognitive findings but consistent psychological presentations across the two cases.",0,0 +3666,"Analysis of trauma exposure, symptomatology and functioning in Jewish Israeli and Palestinian adolescents","Background There has been no reported research comparing Jewish Israeli and Palestinian adolescents regarding the effect of ongoing political violence on adolescent psychosocial, family, post-traumatic stress disorder (PTSD) and aggression problems. Aims To compare Israeli and Palestinian responses regarding the relationship between exposure to traumatic events and psychosocial, behavioural, emotional and family problems. Method A cluster sample of youths aged 14–18 years, including 442 Jewish Israeli adolescents in Ariel, Haifa and Tel-Aviv, and 450 Palestinian adolescents in Gaza cities, villages and refugee camps were surveyed in 2006 using our Traumatic Events Questionnaire (TEV), the Brief Symptoms Inventory (BSI), the PTSD Symptom Scale – Interview (PSS–I), the Index of Peer Relations scale (IPR), Buss–Perry Aggression Questionnaire (BPAQ) and the MacMaster Family Assessment Device (FAD). Results Palestinian respondents had higher scores in the TEV, BSI, PSS–I and BPAQ questionnaires, and greater problems in functioning as revealed in the IPR and FAD. The social functioning of the adolescents with their peers predicted mental health symptoms and PTSD symptoms. Lower socioeconomic status predicted mental health symptoms, PTSD, pathology of participants' family functioning and the social functioning of the adolescents with their peers. Parents' education positively effected the FAD score and the avoidance item on the PSS–I, and religiosity improved the score on the FAD. Females reported more symptoms on the BSI and PSS–I than males, and males more symptoms on the FAD and IPR than females. Conclusions Both respondent groups had significant emotional and behavioural problems. Individual and community treatment, and community and social development, are likely to be useful for both populations, particularly Palestinians.",0,0 +3667,Personality heterogeneity in PTSD: Distinct temperament and interpersonal typologies.,"Researchers examining personality typologies of posttraumatic stress disorder (PTSD) have consistently identified 3 groups: low pathology, internalizing, and externalizing. These groups have been found to predict functional severity and psychiatric comorbidity. In this study, we employed Latent Profile Analysis to compare this previously established typology, grounded in temperament traits (negative emotionality; positive emotionality; constraint), to a novel typology rooted in interpersonal traits (dominance; warmth) in a sample of individuals with PTSD (n = 155). Using Schedule for Nonadaptive and Adaptive Personality (SNAP) traits to create latent profiles, the 3-group temperament model was replicated. Using Interpersonal Circumplex (IPC) traits to create latent profiles, we identified a 4-group solution with groups varying in interpersonal style. These models were nonredundant, indicating that the depiction of personality variability in PTSD depends on how personality is assessed. Whereas the temperament model was more effective for distinguishing individuals based on distress and comorbid disorders, the interpersonal model was more effective for predicting the chronicity of PTSD over the 10 year course of the study. We discuss the potential for integrating these complementary temperament and interpersonal typologies in the clinical assessment of PTSD.",0,0 +3668,"Coping with Chronic Social Stress in Mice: Hypothalamic-Pituitary-Adrenal/ Sympathetic-Adrenal-Medullary Axis Activity, Behavioral Changes and Effects of Antalarmin Treatment: Implications for the Study of Stress-Related Psychopathologies","The aim of this study was to analyze the individual differences that lead to the development of psychopathological changes in response to chronic social stress. We also assessed the ability of an antagonist of the corticotrophin-releasing hormone (CRH) receptors to reverse the effects of stress. Male adult mice were exposed to repeated defeat experiences for 21 days using a sensorial contact model. After 18 days of defeat, two groups of subjects were established (active and passive), according to their behaviors during social confrontation. Antalarmin treatment was given for 4 and 6 days. The results corroborated previous data indicating that subjects who adopted a passive coping strategy had higher corticosterone levels after 21 days of defeat and decreased resting levels 3 days later. Moreover, they showed higher resting expression levels of hypothalamic CRH than their active counterparts. On day 24, the experimental animals were subjected to another social defeat to determine whether the stress response remained. The increase in corticosterone and hypothalamic CRH levels was similar for all of the stressed subjects, but the passive subjects also had a greater CRH response in the amygdala. Passive subjects had decreased levels of adrenal dopamine β-hydroxylase, tyrosine hydroxylase and plasma adrenaline compared to the active subjects, and lower plasma noradrenaline levels than manipulated controls. The passive profile of physiological changes in both the hypothalamic-pituitary-adrenal and sympathetic-adrenal-medullary (SAM) axes has been associated with changes related to mood disorders, such as posttraumatic stress disorder and depression. The active coping profile is characterized by similar corticosterone resting levels to controls and increased SAM activity. Both profiles showed alterations in the novel palatable and forced swimming tests, with the passive profile being the most vulnerable to the effects of stress in this last test. Pharmacological treatment with antalarmin failed to reverse the effects of stress.",0,0 +3669,The Role of Craniocerebral Trauma in the Dynamics of Combat-Related Post-Traumatic Stress Disorder,"Study aim: To address the question of the dynamics of the clinical signs of post-traumatic stress disorder (PTSD) and the strength of their relationship with organic changes in the brain. Materials and methods: A longitudinal observations study of 87 combat veterans during the Karabakh war of 1992-1994 was performed in 2009-2011. Two groups of patients were identified. Group 1 consisted of 45 veterans who had sustained mild combat-related craniocerebral trauma followed by the development of PTSD; group 2 consisted of 42 veterans with organic brain damage of traumatic origin. Full general somatic and neurological investigations of patients were undertaken, along with assessment of the patients' status using a set of psychometric and other scales (including scales for assessment of post-traumatic reactions-the Clinician-Administered PTSD Scale (CAPS) and the Mississippi Scale for Combat-Related PTSD). Results and conclusions: Analysis of patients' status during the study and comparison with data relating to the time at which trauma was sustained showed that the groups of patients with PTSD were characterized, despite some reduction in post-traumatic symptomatology, by a higher level of severity of all PTSD symptoms during the whole of the 15-18 years of disease development, with simultaneous increases in organic mental changes. In patients with organic brain lesions, the corresponding symptomatology was more severe immediately after the traumatic event than at the time of the study. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0,0 +3670,"DEVELOPING AN INTEGRATED BRAIN, BEHAVIOR AND BIOLOGICAL RESPONSE PROFILE IN POSTTRAUMATIC STRESS DISORDER (PTSD)","The present study sought to determine a profile of integrated behavioral, brain and autonomic alterations in PTSD. Previous findings suggest that PTSD is associated with changes across electrophysiological (EEG and ERP), autonomic and cognitive/behavioral measures. In particular, PTSD has been associated with reduced cognitive performance, altered cortical arousal (measured by EEG), diminished late ERP component to oddball task targets (reduced P3 amplitude) and increased autonomic arousal relative to healthy controls. The present study examined measures of cognitive function, auditory oddball ERP components, autonomic function (heart rate and skin conductance) and EEG during resting conditions in 44 individuals with PTSD and 44 non-trauma-exposed controls, and predicted that an integrated profile of changes across a number of these measures would show a high level of sensitivity and specificity in discriminating PTSD from controls. Nine variables showing strongly significant (p < 0.002) between-group differences were entered into a discriminant function analysis. Four of these measures successfully discriminated the PTSD and non-PTSD groups: change in tonic arousal, duration of attention switching, working memory reaction time and errors of commission during visuospatial maze learning. Tonic arousal change contributed the most variance in predicting group membership. These results extend previous findings and provide an integrated biomarker profile that characterizes both PTSD and non-PTSD groups with a high degree of sensitivity and specificity. This outcome provides a platform for future studies to test how this profile of disturbances in autonomic and information processing may be unique to PTSD or may occur generically across clinical and/or other anxiety disorders.",0,0 +3671,Post-ICU consequences of patient wakefulness and sedative exposure during mechanical ventilation,"Objective: To determine the relationship between measures of critical illness (sedative/analgesic administration, wakefulness and organ dysfunction), intensive care unit (ICU) recall and symptoms of posttraumatic stress disorder. Design: Prospective, observational study with post-ICU follow-up. Setting: Medical and surgical ICUs at a teaching hospital. Patients: Two hundred seventy-seven subjects requiring > 36 h of mechanical ventilation were enrolled; 149 completed follow-up interviews 2 months later and 80 at 6 months. Interventions: None. Results: ICU recall was greater for events occurring at the end of critical illness; however, 18% of subjects had amnesia for the entire ICU course. Factual ICU recall was weakly associated with increased wakefulness during mechanical ventilation (r2 = 0.03-0.11, p< 0.05). Posttraumatic stress disorder prevalence was 17% at 2 months and 15% at 6 months. The avoidance-numbing cluster had the highest specificity (91%) for a formal diagnosis and the re-experiencing cluster had the lowest (69%). Recall of a delirious memory during critical illness was associated with more severe posttraumatic stress symptoms, but there was no association between posttraumatic stress symptoms and factual recall of ICU events. Neither ICU recall nor posttraumatic stress symptoms were associated with the intensity of sedative administration during mechanical ventilation. Posttraumatic stress symptoms were lowest in patients either the most awake during mechanical ventilation or the least awake. Conclusion: Wakefulness during mechanical ventilation has a greater influence on post-ICU recall and posttraumatic stress symptoms than sedative drug exposure or severity of illness. It is difficult to predict the future psychological consequences of an individual patient's critical illness. (",0,0 +3672,Estimating the Dimension of a Model,"The problem of selecting one of a number of models of different dimensions is treated by finding its Bayes solution, and evaluating the leading terms of its asymptotic expansion. These terms are a valid large-sample criterion beyond the Bayesian context, since they do not depend on the a priori distribution.",0,0 +3673,Does Mental Health Stigma Change Across the Deployment Cycle?,"Prior research on mental health stigma in military personnel has been cross-sectional. We prospectively examined the course of perceived mental health stigma in a cohort of deployed U.S. combat Marines.Participants (N = 768) were assessed 1 month before a 7-month deployment to Afghanistan, and again at 1, 5, and 8 months postdeployment. We also examined three predictors of the course of stigma: post-traumatic stress disorder symptom severity, vertical and horizontal unit cohesion, and mental health treatment utilization while deployed.Perceptions of stigma remained largely stable across the deployment cycle, with latent growth curve analyses revealing a statistically significant but small decrease in stigma over time. Lower post-traumatic stress disorder symptoms and greater perceived vertical and horizontal support predicted decreases in stigma over time, whereas mental health treatment utilization in theater did not predict the course of stigma.Perceived stigma was low and largely stable over time.",0,0 +3674,Omega-3 polyunsaturated fatty acids and anxiety disorders,"

Abstract

Anxiety disorders are a common group of psychiatric illnesses which have significant personal, family and societal costs. Current treatments have limited efficacy in many patients highlighting a need for new therapeutic approaches to be explored. Anxiety disorders exhibit marked comorbity with mood disorders suggesting the existence of mechanistic similarities. Such a notion is supported by observations that some conventional pharmacotherapies are both effective antidepressants and anxiolytics. As such, given that omega-3 PUFA supplementation may be effective in the treatment of major depressive disorder it is reasonable to propose that they may also possess anxiolytic properties. Experimental data in support of such a hypothesis is currently lacking although reduced abundance of omega-3 PUFA have been reported in patients with anxiety, while supplementation with omega-3 PUFA appears to inhibit activation of the HPA axis and can ameliorate some of the symptoms of anxiety. Clinical investigations carried out to date have, however, involved small numbers of participants. Larger trials using a variety of omega-3 PUFA species in clinically well-defined patients with anxiety will be required to demonstrate a therapeutic role for omega-3 PUFA in these disorders. Given the excellent side effect profile of omega-3 PUFA as well as their strong theoretical rationale, such future trials appear justified.",0,0 +3675,Measurement Properties of the Neck Disability Index: A Systematic Review,"Study Design Systematic review of clinical measurement. Objective To find and synthesize evidence on the psychometric properties and usefulness of the neck disability index (NDI). Background The NDI is the most commonly used outcome measure for neck pain, and a synthesis of knowledge should provide a deeper understanding of its use and limitations. Methods And Measures Using a standard search strategy (1966 to September 2008) and 4 databases (Medline, CINAHL, Embase, and PsychInfo), a structured search was conducted and supplemented by web and hand searching. In total, 37 published primary studies, 3 reviews, and 1 in-press paper were analyzed. Pairs of raters conducted data extraction and critical appraisal using structured tools. Ranking of quality and descriptive synthesis were performed. Results Horizon estimation suggested the potential for 1 missed paper. The agreement between raters on quality assessments was high (kappa = 0.82). Half of the studies reached a quality level greater than 70%. Failures to report clear psychometric objectives/hypotheses or to rationalize the sample size were the most common design flaws. Studies often focused on less clinically applicable properties, like construct validity or group reliability, than transferable data, like known group differences or absolute reliability (standard error of measurement [SEM] or minimum detectable change [MDC]). Most studies suggest that the NDI has acceptable reliability, although intraclass correlation coefficients (ICCs) range from 0.50 to 0.98. Longer test intervals and the definition of stable can influence reliability estimates. A number of high-quality published (Korean, Dutch, Spanish, French, Brazilian Portuguese) and commercially supported translations are available. The NDI is considered a 1-dimensional measure that can be interpreted as an interval scale. Some studies question these assumptions. The MDC is around 5/50 for uncomplicated neck pain and up to 10/50 for cervical radiculopathy. The reported clinically important difference (CID) is inconsistent across different studies ranging from 5/50 to 19/50. The NDI is strongly correlated (>0.70) to a number of similar indices and moderately related to both physical and mental aspects of general health. Conclusion The NDI has sufficient support and usefulness to retain its current status as the most commonly used self-report measure for neck pain. More studies of CID in different clinical populations and the relationship to subjective/work/function categories are required. J Orthop Sports Phys Ther 2009;39(5):400–417. doi:10.2519/jospt.2009.2930",0,0 +3676,Involvement of Anomalous Apoptosis in Impairments to Synaptic Plasticity in Post-Traumatic Stress Disorder,"Enzyme-linked immunosorbent assay was used to measure levels of apoptosis and synaptic plasticity marker proteins, i.e., annexin A5 and complexin 2 respectively, as well as the proinflammatory cytokine tumor necrosis factor alpha (TNF-alpha ), in serum from patients with post-traumatic stress disorder (PTSD) in comparison with healthy subjects. Correlations between these parameters were studied. The results obtained here showed that annexin A5 and complexin 2 concentrations in PTSD patients were significantly lower than normal, while TNF-alpha levels were higher. PTSD patients showed a positive correlation between annexin A5 and complexin 2 levels on the one hand, and a negative correlation between annexin A5 and TNF-alpha levels on the other. These data lead to the conclusion that the pathogenesis of PTSD is characterized by reduced apoptosis associated with defects in synaptic plasticity. It is suggested that anomalous apoptosis may also be among the factors supporting the development of the chronic inflammation typical of the pathogenesis of PTSD. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0,0 +3677,Self-Enhancement Among High-Exposure Survivors of the September 11th Terrorist Attack: Resilience or Social Maladjustment?,"The authors examined self-enhancing bias as a predictor of adjustment among individuals in or near the World Trade Center during the September 11, 2001, terrorist attacks. Resilience was defined from categorical and continuous analyses of both participant self-report and friend and relative ratings of adjustment. Self-enhancement was associated with a resilient outcome, ratings of better adjustment prior to September 11th, greater positive affect, and reduced perceptions of social constraints. Additional analyses indicated that self-enhancers' reduced symptom levels were fully mediated by their low perceived social constraints. However, consistent with previous evidence suggesting a social cost to self-enhancement, at 18 months post-September 11th, self-enhancers' friends and relatives also rated them as decreasing in social adjustment and as being less honest.",0,0 +3678,Does prior psychological health influence recall of military experiences? a prospective study,"In a prospective study, we evaluated pre- and postdeployment psychological health on recall of risk factors to assess recall bias. Measures of the General Health Questionnaire (GHQ), PTSD Checklist (PCL), and symptom clusters from the PCL were obtained from 681 UK military personnel along with information on traumatic and protective risk factors. Postdeployment psychological health was more important in explaining recall of traumatic experiences than predeployment psychological health. Predeployment intrusive cluster scores were highly associated with traumatic exposures. Postdeployment, but not predeployment GHQ showed small effects for most risk factors. With the exception of intrusive thoughts, there is insufficient evidence to suggest predeployment psychological status would be useful in correcting for recall bias in subsequent cross-sectional studies.",0,0 +3679,When the killer suffers: Post-traumatic stress reactions following homicide,"Objectives. The present study aimed to consider the extent to which post-traumatic stress disorder (PTSD) occurs after homicide and to examine characteristics of the offence and the offender which contribute to the development of these symptoms. It was proposed that type of violence (reactive versus instrumental) would be related to PTSD symptoms. Using Blackburn's typology of violent offenders, it was also hypothesized that primary and secondary psychopath, controlled and inhibited types would demonstrate differing forms of violence, prevalences and patterns of post-traumatic stress symptoms following the homicide. Method. Eighty homicide perpetrators were allocated equally to the four offender types based on their profiles on the Special Hospitals Assessment of Personality and Socialisation (SHAPS). Each offender completed the Post-Traumatic Stress Disorder Interview and the violence displayed during the index offence was classified as either reactive or instrumental. Results. Of the total sample, 52% met criteria for current PTSD. Reactive violence and reporting that the offence was traumatic were related to a current diagnosis of PTSD. Differing prevalences and patterns of PTSD symptoms were noted for Blackburn's offender types. Primary psychopaths showed instrumental violence and were the least traumatized. Secondary psychopaths were the most symptomatic, but not necessarily due to involvement in the homicide. Controlled and inhibited types both typically displayed reactive violence and had higher levels of current PTSD symptoms related to involvement in the offence itself. Conclusions. The extent to which PTSD follows homicide is a function of both personality type and form of violence. The results can be understood in terms of the cognitive model of Meichenbaum (1996) and also the defining dimensions of Blackburn's typology.",0,0 +3680,Behavioral markers of coping and psychiatric symptoms among sexually abused children,"The current study examined coping and psychiatric symptoms in a longitudinal sample of sexually abused children. Coping was behaviorally coded from children's forensic interviews in the aftermath of sexual abuse. Using principal components analysis, coping behaviors were found to cluster into 3 categories: avoidant, expressive, and positive affective coping. Avoidant coping had predictive utility for a range of psychiatric symptoms, including depressive, posttraumatic stress, anxiety, and dissociative symptoms as well as aggression and attention problems measured 8–36 months following the forensic interview. Specific behaviors, namely fidgetiness and distractibility, were also found to be associated with future symptoms. These findings suggest the predictive utility of avoidant behaviors in general, and fidgetiness and distractibility in particular, among sexually abused children.",0,0 +3681,Posttraumatic Stress Disorder Symptom Structure in Chinese Adolescents Exposed to a Deadly Earthquake,"This present study examined the structure of posttraumatic stress disorder (PTSD) symptoms in a large sample of Chinese adolescents exposed to a deadly earthquake. A total of 2,800 middle school students aged 12 to 18 years participated in the study 6 months after the ""Wenchuan Earthquake"". Results of confirmatory factor analysis indicated that a five-factor intercorrelated model composed of intrusion, avoidance, numbing, dysphoric arousal, and anxious arousal, fit data significantly better than both the four-factor numbing model King et al. (Psychological Assessment 10:90-96, 1998) and the four-factor dysphoria model Simms et al. (Journal of Abnormal Psychology 111:637-647, 2002). Further examination of the external convergent and discriminant validity revealed that except for the dysphoric arousal factor, the remaining four PTSD factors yielded significantly different correlations with external measures of anxiety vs. depression. The findings add to the limited literature on the factor structure of PTSD in youths and on the five-factor PTSD model. In addition, they provide more detail into the latent psychopathological processes of PTSD, and inform the forthcoming DSM-5. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +3682,A Population-Based Study of Familial and Individual-Specific Environmental Contributions to Traumatic Event Exposure and Posttraumatic Stress Disorder Symptoms in a Norwegian Twin Sample,"Objective: Posttraumatic stress disorder (PTSD) is one of the only disorders in the Diagnostic and Statistical Manual of Mental Disorders that requires an environmental exposure. The relationship between liability factors for trauma exposure and those for PTSD symptoms following exposure are unclear. Methods: Exposure to a trauma and resulting PTSD symptoms were assessed in a sample of 2,794 members of the Norwegian Institute of Public Health Twin Panel. Results: In the full sample, 737 twins experienced a trauma. A modified causal, contingent, common pathway model was used to examine trauma exposure and liability for PTSD. Genetic and common environmental factors could not be distinguished, so a model that included only familial and individual specific components was fit. The best-fitting model suggested that familial factors played an important role in liability for trauma exposure and for resulting PTSD symptoms, and that there was a modest transmission between trauma exposure and subsequent PTSD symptoms. Conclusions: One third of the variance in liability of PTSD symptoms is due to familial factors, and of this, approximately one fifth overlaps with the familial liability for trauma exposure while the other four fifths of the variance is specific to the risk of PTSD symptoms following exposure. The hypothesis that PTSD is etiologically similar to exposures to a traumatic event is not supported, suggesting that the factors that confer risk for trauma do not overlap completely with those that confer risk for PTSD.",0,0 +3683,"Pain and PTSD symptoms in female veterans⋆,⋆⋆","There has been growing empirical examination of the co-occurrence of pain and post-traumatic stress disorder (PTSD) symptoms, and existing evidence suggests that the symptoms associated with each have a close association. To date, however, the association has only been examined within samples of mostly male participants.In the present study, pain and PTSD symptoms were examined in a sample of 221 female veterans who utilised the VA Healthcare System between 1998 and 1999.Women who visited the clinic between 1998 and 1999 were mailed a self-report questionnaire package designed to elicit information regarding general health (including pain experiences), military and trauma history, childhood abuse and neglect, and PTSD symptoms. Analyses were conducted to identify differences in pain experience between those women classified as having PTSD, subsyndromal PTSD, and no PTSD. Analyses were also conducted to determine the degree to which pain-related (e.g., current pain, interference with activity) variables predicted PTSD symptom cluster scores.The three groups differed significantly on a number of pain-related variables. Analyses suggested that pain-related variables were significant predictors of PTSD symptom cluster scores.These results indicate that the association between pain and PTSD symptoms, previously observed in primarily male samples, is generalisable to females. Clinical implications and possible mechanisms of association are discussed.",0,0 +3684,Posttraumatic Stress Disorder Among Cuban Children and Adolescents After Release From a Refugee Camp,"The authors compared self-reported symptoms of posttraumatic stress disorder (PTSD) in a cohort of Cuban children and adolescents with assessments of internalizing and externalizing behaviors by the children's teachers.Eighty-seven children and adolescents who had left Cuba by sea in the summer of 1994 and who had been confined to refugee camps for up to eight months before arriving in the United States were evaluated four to six months later. Self-reported symptoms of PTSD were assessed with the Post-Traumatic Stress Disorder Reactive Index, and internalizing and externalizing behaviors were assessed with the Child Behavioral Check List-Teacher Report Form.A majority of the children reported moderate to severe PTSD symptoms. The most common symptom clusters were avoidance (67 percent), regressive behaviors (64 percent), reexperiencing the traumatic events (60 percent), somatic symptoms (52 percent), and hyperarousal (51 percent). Eighty-six percent of the children reported that the refugee experience had severely affected most of their peers. A statistically significant dose-effect relationship was found between the number of stressors and the severity of self-reported PTSD symptoms. There was a modest relationship between withdrawn behavior and children's feelings that they would die at sea and witnessing violence at the camps. Age and witnessing violence in the camps were moderately associated with PTSD. Teachers' overall ratings of externalizing and internalizing behaviors did not produce any clinically significant findings.PTSD symptoms among refugee children and adolescents who have been exposed to multiple and prolonged stressors may continue unabated after the stressors are removed. The symptoms are experienced subjectively and may go unnoticed by adults.",0,0 +3685,Systems of Care for Traumatized Children: The Example of a School-Based Intervention Model,"In this chapter we will describe the development of a system of care for children through educational systems. Providing a continuum of trauma services for Israeli school children during long periods of exposure to trauma focuses on an array of services ranging from prevention to intervention. The school-based intervention model incorporates principles of both community and clinical psychology. Traditionally, services have focused on those who have been identified as suffering from posttraumatic stress disorders or other clinical diagnoses. The continuum of trauma services model recognizes the importance of treating those who are suffering, while not overlooking the large, silent majority of the population who cope reasonably well through other trajectories. The provision of a range of services, from community interventions to clinical interventions within one system of care, forms one of the touchstones of this model. © Springer Science+Business Media New York 2015.",0,0 +3686,"Steroids, psychosis and poly-substance abuse","Objective To review consequences of the changing demographic profile of anabolic-androgenic steroid (AAS) use. Method Case report and review of key papers. Results We report here a case of a 19-year-old Irish male presenting with both medical and psychiatric side effects of methandrostenolone use. The man had a long-standing history of harmful cannabis use, but had not experienced previous psychotic symptoms. Following use of methandrostenolone, he developed rhabdomyolysis and a psychotic episode with homicidal ideation. Discussion Non-medical AAS use is a growing problem associated with medical, psychiatric and forensic risks. The population using these drugs has changed with the result of more frequent poly-substance misuse, potentially exacerbating these risks. Conclusion A higher index of suspicion is needed for AAS use. Medical personnel need to be aware of the potential side effects of their use, including the risk of violence. Research is needed to establish the magnitude of the problem in Ireland.",0,0 +3687,Post traumatic stress disorder: undiagnosed cases in a tertiary inpatient setting,"Objective: Post traumatic stress disorder (PTSD) is a common, debilitating anxiety disorder characterized by emotional and physical symptoms that may occur after exposure to a severely traumatic event. Since it occurs commonly as a comorbid diagnosis with other mood- and anxiety disorders, we postulated that this disorder may be under- diagnosed in therapeutic wards where anxiety and mood disorders are treated. The study thus sought to determine the prevalence of undiagnosed PTSD in an inpatient population, and to compare the demographic details and comorbid diagnoses of subjects with and without PTSD. Method: The Clinician-administered PTSD Scale for DSM-IV (CAPS) was administered to 40 subjects who were inpatients in a therapeutic ward of a large psychiatric hospital and who had never had a diagnosis of PTSD before. Results:16 (40%) subjects met the DSM-IV criteria for PTSD. We did not find significant clinical differentiating factors between subjects with and without PTSD; however subjects with PTSD were more likely to use cannabis. Conclusions: PTSD remains undiagnosed in many patients admitted to therapeutic units. Keywords: Stress Disorders, Post-Traumatic; Diagnosis; Inpatients;African Journal of Psychiatry Vol. 11 (2) 2008 pp. 119-122",0,0 +3688,Whiplash-associated disorder: musculoskeletal pain and related clinical findings,"The aim of this paper was to review the physical and psychological processes associated with whiplash-associated disorders. There is now much scientific data available to indicate the presence of disturbed nociceptive processing, stress system responses, muscle and motor changes as well as psychological factors in both acute and chronic whiplash-associated disorders. Some of these factors seem to be associated with the transition from acute to chronic pain and have demonstrated prognostic capacity. Further investigation is required to determine if these processes can be modified and if modification will lead to improved outcomes for this condition. The burden of whiplash injuries, the high rate of transition to chronicity, and evidence of limited effects of current management on transition rates demand new directions in evaluation and management. The understanding of processes underlying this condition is improving and this lays the foundation for the development of more effective management approaches.",0,0 +3689,Event-list construction and treatment of exposure data in research on political violence,"Event lists are commonly applied for measuring exposure to various kinds of potentially stressful and traumatizing life events. Before making general conclusions about the psychological effects of exposure to such events, problematic issues related to the use of event-list data need to be discussed and resolved. This article focuses on issues related to the construction and application of event lists for measuring exposure to political violence such as issues related to reliability, the applicability of the additive assumption, whether to weight event-list items, and the possible consequences of incomplete event lists. Alternative future approaches to these measurement issues are also discussed.",0,0 +3690,Neuroanatomy and Neuroimaging of Anxiety Disorders,"Neuroimaging methods can be used to examine functional brain differences between healthy individuals and those with anxiety disorders. After the brain regions implicated in the pathophysiology of anxiety disorders (e.g., amygdalo-cortical circuitry) are reviewed, neuroimaging studies of posttraumatic stress disorder (PTSD), social anxiety disorder (SAD), specific phobia (SP), and panic disorder (PD) that report activations in these regions are discussed. Studies of obsessive-compulsive disorder (OCD) implicate a distinct neurocircuitry profile (i.e., cortico-striatal-thalamic circuit) compared to the other anxiety disorders. Few neuroimaging studies of generalized anxiety disorder (GAD) have been conducted. In addition, results from functional connectivity analyses and the effects of treatment on neuroimaging findings are summarized.",0,0 +3691,Longitudinal Assessment of Dissociation in Holocaust Survivors With and Without PTSD and Nonexposed Aged Jewish Adults,"The trajectory of posttraumatic stress disorder (PTSD) and PTSD-related symptoms in relation to aging is not well understood. We previously observed higher levels of dissociation as measured by the Dissociative Experiences Scale (DES) among older Holocaust survivors with, compared to those without, PTSD, though scores on the DES in Holocaust survivors were markedly lower than those that had been reported for younger cohorts. We undertook a longitudinal evaluation of dissociation in Holocaust survivors. Twenty-six Holocaust survivors with current PTSD, 30 Holocaust survivors without current PTSD, and 19 nonexposed were evaluated at the initial evaluation and subsequently 8.11 years later. Repeated measures analysis of variance (ANOVA) on the DES scores from these times demonstrated a significant main effect for time and a significant group by time interaction, reflecting a marked decline in Holocaust survivors, particularly those with PTSD. Controlling for age obliterated the effect of time, but not the group by time interaction. A similar pattern was shown with The Clinician Administered PTSD Scale (CAPS) scores. Different symptoms related to PTSD show different trajectories of change with age, with dissociation appearing to be less prominent with age.",0,0 +3692,Posttraumatic Shame and Guilt,"Posttraumatic shame and guilt are important dimensions of posttraumatic syndromes, including simple and complex post-traumatic stress disorder (PTSD). The concepts of posttraumatic shame and guilt have received little theoretical or empirical investigation in the field of traumatology. It is proposed that there are acute and prolonged states of posttraumatic shame and guilt that can be compared in their consequences across eight psychosocial dimensions: (a) self-attribution processes, (b) emotional states and capacity for affect regulation, (c) appraisal and interpretation of actions, (d) the impact of states of shame and guilt on personal identity, (e) suicidality, (f) defensive patterns, (g) proneness to psychopathology and PTSD, and (h) the dimensions of the self-structure adversely affected by states of posttraumatic shame and guilt. The experience of posttraumatic states of shame and guilt are associated with compounded affective processesin PTSD, depression, and substance use disorders.",0,0 +3693,Offenders as victims: post-traumatic stress disorder and substance use disorder among male prisoners,"Background: Comorbid substance use disorder(s) and post-traumatic stress disorder (SUD-PTSD) is common among prisoners and linked to an increased risk of criminal recidivism; however, little is known about the characteristics of prisoners with this comorbidity. Aim: This study provides a preliminary examination of the clinical and criminal profile of male inmates with symptoms of SUD-PTSD, and examines whether this profile differs according to whether a person has experienced a trauma while in prison. Methods: Thirty male inmates from two correctional centres in Sydney, Australia, were recruited and assessed using a structured interview. Results: The sample reported extensive criminal, substance use and trauma histories. A history of substance dependence was almost universal (90%) and 56.7% met diagnostic criteria for PTSD with the remainder experiencing sub-threshold symptoms. Forty-three per cent reported a traumatic event while in prison. Those who had experienced trauma in prison, compared to those wh...",0,0 +3694,"Predictors of Intimate Partner Violence Revictimization: The Relative Impact of Distinct PTSD Symptoms, Dissociation, and Coping Strategies","Psychological distress and coping strategies following intimate partner violence (IPV) victimization may impact survivors' risk for future IPV. The current study prospectively examined the impact of distinct posttraumatic stress disorder (PTSD) symptom clusters (reexperiencing, avoidance, numbing, and hyperarousal), dissociation, and coping strategies (engagement and disengagement coping) on IPV revictimization among recently abused women. Women (N = 69) who were seeking services for IPV and experienced their most recent episode of physical IPV between 2 weeks and 6 months prior to study enrollment completed measures of physical IPV, psychological distress, and coping strategies at baseline and at 6-month follow-up. The women averaged 36 years of age and 67% of the sample was African American. Separate Poisson regression analyses revealed that PTSD hyperarousal symptoms, dissociation, engagement coping, and disengagement coping each significantly predicted physical IPV revictimization at the 6-month follow-up (with effect sizes ranging from a 1.20-1.34 increase in the likelihood of Time 2 physical IPV with a 1 SD increase in the predictor). When these significant predictors were examined together in a single Poisson regression model, only engagement and disengagement coping were found to predict physical IPV revictimization such that disengagement coping was associated with higher revictimization risk (1.29 increase in the likelihood of Time 2 physical IPV with one SD increase in disengagement coping) and engagement coping was associated with lower revictimization risk (1.30 decrease in the likelihood of Time 2 physical IPV with one SD increase in engagement coping). The current findings suggest that coping strategies are important and potentially malleable predictors of physical IPV revictimization.",0,0 +3695,[Insufficient cooperativeness in forensic neuropsychiatric assessment: prevalence estimates of negative response bias].,"In the context of independent medical examinations, negative response bias in patients is a problem of primary importance, especially in cases where self-reported symptoms cannot be directly verified by the examiner. Estimates of the prevalence of uncooperativeness in neuropsychological evaluations demonstrated that invalid test profiles are to be expected in a sizable minority of examinees. However, no estimates have ever been published in German-speaking countries. Symptom validity was checked in 235 patients who reported cognitive symptoms after suffering an accident and who underwent forensic neuropsychiatric assessment. Patient classification was based on the results obtained with the Word Memory Test (WMT) or the Medical Symptom Validity Test (MSVT). When applying the recommended cutoffs for these tests, 44.3 percent of the sample was found to be classified as suspect for insufficient effort. In a subsample of 47 patients with claims of posttraumatic stress disorder 51.1 percent were found to score below the cutoffs. These findings underline the importance of modern methods for assessment of symptom validity in forensic contexts. Cooperativeness of compensation claimants cannot be assumed solely on the basis of clinical impression.",0,0 +3696,All Symptoms Are Not Created Equal: The Prominent Role of Hyperarousal in the Natural Course of Posttraumatic Psychological Distress.,"This 3-wave longitudinal study examined the natural course of posttraumatic stress disorder symptoms using data collected from young adult survivors of community violence. Three key findings emerged. 1. Mean levels of distress for each symptom cluster decreased over time, with reexperiencing decreasing most rapidly. 2. Cross-lagged panel analysis revealed that hyperarousal strongly influences, but is not generally influenced by, other symptoms clusters. 3. Trajectory analysis demonstrated that respondents for whom hyperarousal was the most pronounced baseline symptom showed lower overall symptom improvement relative to trauma exposed counterparts for whom hyperarousal was a less prominent early symptom. Implications for theory, research, and clinical practice are discussed.",0,0 +3697,Traumatic Stress Symptomatology After Child Maltreatment and Single Traumatic Events: Different Profiles,"The sequelae of child maltreatment tend to extend current posttraumatic stress disorder (PTSD) symptoms. This study examined this assumption, hypothesizing that (a) PTSD and trauma-related symptoms are more severe after single trauma than after child maltreatment; (b) symptoms unrelated to trauma are more severe after child maltreatment than after single trauma; and (c) a comorbid association of clinical PTSD with trauma-related symptoms is more prevalent after single trauma, whereas a comorbid association of clinical PTSD with trauma unrelated symptoms is more prevalent after child maltreatment. The Trauma Symptom Checklist for Children (TSCC) assessed PTSD and trauma-related symptoms in 256 children (83 children exposed to single trauma, 173 to child maltreatment). The Strengths and Difficulties Questionnaire (SDQ) assessed trauma-unrelated symptoms. Single-trauma children reported significantly more severe PTSD and trauma-related symptoms. Significantly more severe trauma unrelated symptoms were reported after child maltreatment. A significant relation was found between clinical PTSD and more severe trauma-related symptoms in both samples. Likelihood of children meeting PTSD symptoms after trauma seems to decrease when traumatization becomes more complex. Findings support our assumption that symptomatology of maltreated children extends current PTSD symptoms.",0,0 +3698,Clinical Phenomenology of Childhood Abuse–Related Complex PTSD in a Population of Female Patients: Patterns of Personality Disturbance,"Complex posttraumatic stress disorder (PTSD) involves a variety of personality disturbances presumed to result from repeated interpersonal trauma such as child abuse. As Complex PTSD patients are a heterogeneous population, we searched for clinically relevant personality-based subtypes.This study used a cluster analysis of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), Axis II features within a sample of 71 female outpatients with systematically assessed child abuse-related Complex PTSD.Two main subtypes were found: adaptive and nonadaptive. The latter was further differentiated into withdrawn, alienated, suffering, and aggressive subtypes, characterized by different levels of introversion and disinhibition. Among the nonadaptive subtypes, the severity of Complex PTSD symptoms was lowest in the withdrawn (introverted only) subtype. The subtypes differed in their level of dissociation and depression but did not differ regarding PTSD symptoms, trauma history, or parental bonding characteristics.Confirming earlier findings, our study found personality-based Complex PTSD subtypes, which could implicate differential treatment needs and results.",0,0 +3699,Hippocampal volume in aging combat veterans with and without post-traumatic stress disorder: Relation to risk and resilience factors,"To examine whether there are post-traumatic stress disorder (PTSD) related differences in hippocampal volume in middle-aged and elderly veterans and to examine the relationship of neuroendocrine activity, memory performance, and measures of risk and resilience for PTSD to hippocampal volume in this cohort.Seventeen veterans with chronic PTSD and 16 veterans without chronic PTSD received an MRI scan followed by neuroendocrine assessment (24-h urinary cortisol excretion and the lysozyme IC(50-DEX), a measure of glucocorticoid receptor (GR) responsiveness), and cognitive testing.Veterans with PTSD did not differ from those without PTSD in hippocampal volume, but they did show significantly lower urinary cortisol levels, and poorer memory performance on the Wechsler Logical Memory test and Digit Span test. Smaller left hippocampal volumes were observed in veterans who developed PTSD in response to their first reported traumatic exposure, compared to veterans who had first experienced a traumatic event to which they did not develop PTSD, prior to experiencing a subsequent event that led to PTSD. In contrast, the two neuroendocrine measures were associated with risk factors related to early trauma exposure.Although hippocampal volume was not found to differ between subjects with and without PTSD, smaller hippocampal volumes in PTSD may be associated with specific risk and resilience factors. These may be distinct from vulnerability markers associated with increased responsiveness to glucocorticoids and/or other neuroendocrine measures that have been observed in combat-related PTSD.",0,0 +3700,"Memory deficits, postconcussive complaints, and posttraumatic stress disorder in a volunteer sample of veterans.","To better understand how memory impairment is related to postconcussive complaints and to posttraumatic stress disorder (PTSD) and whether these relationships remain after controlling for premorbid cognitive ability.We examined memory impairment, premorbid cognitive ability, postconcussive complaints, and symptoms of PTSD in 205 veterans, 135 of who gave a self-reported history of concussion and exposure to a traumatic life event. We limited our sample to those who gave good effort on cognitive testing according to a symptom validity measure.Although memory impairment was not associated with a history of concussion, it was associated with severity of postconcussive complaints. That association was no longer significant after controlling for premorbid IQ. A similar analysis yielded slightly different findings for PTSD. Memory impairment was associated with PTSD diagnosis, although it was not associated with severity of PTSD symptoms after controlling for premorbid ability.These data are consistent with multifactorial models of the etiology of postconcussion disorder and PTSD such as the ""burden of adversity hypothesis"" described by Brenner, Vanderploeg, and Terrio (2009). In such models, symptom severity and course of recovery are determined not only by trauma severity but (also) premorbid risk factors and postonset complications. (PsycINFO Database Record (c) 2013 APA, all rights reserved).",0,0 +3701,Association between posttraumatic stress disorder and inflammation: A twin study,"The association of posttraumatic stress disorder (PTSD) with cardiovascular disease risk may be mediated by inflammation. Our objective was to examine the association between PTSD and measures of inflammation and to determine whether these associations are due to shared familial or genetic factors. We measured lifetime history of PTSD using the Structured Clinical Interview for DSM-IV in 238 male middle-aged military veteran twin pairs (476 individuals), selected from the Vietnam Era Twins Registry, who were free of cardiovascular disease at baseline. We assessed inflammation using levels of high-sensitivity C-reactive protein (hsCRP), interleukin 6 (IL-6), fibrinogen, white blood cells, vascular cell adhesion molecule-1, and intercellular adhesion molecule-1 (ICAM-1). Geometric mean levels and percent differences by PTSD were obtained from mixed-model linear regression analyses with adjustment for potential confounders. Within-pair analysis was conducted to adjust for shared family environment and genetics (monozygotic pairs). Overall, 12.4% of participants had a lifetime history of PTSD. Adjusted mean levels of hsCRP and ICAM-1 were significantly higher among those with vs. without PTSD [hsCRP: 1.75 vs. 1.31mg/l (33% difference); ICAM-1: 319 vs. 293ng/ml (9% difference)]. Adjustment for depression rendered the association of PTSD with hsCRP non-statistically significant. For IL-6, no consistent association was seen. Within-pair analysis produced associations that were similar in direction for all three markers but lesser in magnitude for hsCRP and IL-6. There was no evidence of interaction by zygosity. Elevated hsCRP and ICAM-1 are associated with PTSD, and these associations may be confounded by shared non-genetic, antecedent familial and environmental factors.",0,0 +3702,Ecstasy and other club drugs: a review of recent epidemiologic studies,"This review highlights the epidemiologic research on club drug use in the past year, with a focus on clinical epidemiology, social epidemiology, new methodological approaches, and alternative explanations for drug use behaviors.Although 3,4-methylenedioxy-N-methylamphetamine (MDMA) or ecstasy is currently classified as a type of hallucinogen and its withdrawal is not recognized in the Diagnostic and Statistical Manual of Mental Disorders, there is evidence for the association of withdrawal symptoms with MDMA abstinence. Findings from latent class analysis indicate that MDMA users have a significantly higher risk of dependence than lysergic acid diethylamide users. Research on sociodemographic factors associated with club drug use continues to be a main focus worldwide. New epidemiologic research methods have been developed to enable researchers to monitor real-time drug use behaviors and to conduct surveys on sensitive issues in public places. In addition to traditional behavioral models, researchers began to examine the club drug phenomenon in the context of economic environment.Recent findings on MDMA use further question the current drug classification in the diagnostic systems. Despite the continuous growth in the club drug research literature, there is no study on the influence of genetic factors on club drug use. More research in this area is needed.",0,0 +3703,"Cognition and depression: the effects of fluvoxamine, a sigma-1 receptor agonist, reconsidered","Cognitive impairment is a primary feature of patients with major depressive disorder (MDD) and is characterised by stress-induced neural atrophy. Via alpha-adrenergic, anti-cholinergic and anti-histaminic activities, several antidepressants can cause significant counter-therapeutic cognitive impairment. Evidence is emerging of the involvement of sigma-1 receptor agonism in the mechanism of action of some antidepressants, notably fluvoxamine. Sigma-1 receptors are abundant in areas affected by depression/stress-induced cerebral atrophy and their ligands have a unique pharmacological profile; they may promote neurogenesis and initiate adaptive neural plasticity as a protection/reaction to stress. Fluvoxamine, as a potent sigma-1 receptor agonist, has shown ameliorating effects in animal models of psychosis, depression, stress, anxiety, obsessive-compulsive disorder (OCD) and aggression and has been shown to improve cognitive impairments. In humans, fluvoxamine may repair central nervous system (CNS) atrophy and restore cognitive function. The current review explores the mechanisms through which sigma-1 receptors can modulate cognitive function and examines how antidepressant therapy with fluvoxamine may help improve cognitive outcomes in patients with depression. Copyright © 2010 John Wiley & Sons, Ltd.",0,0 +3704,Intensive cognitive therapy for post-traumatic stress disorder: Case studies,"There is good evidence from randomized controlled trials that cognitive therapy (CT) for post-traumatic stress disorder (PTSD) (Ehlers et al., 2009) is an effective treatment (Duffy, Gillespie, & Clark, 2007; Ehlers, Clark, Hackmann, McManus, & Fennell, 2005; Ehlers et al., 2003). Furthermore, CT has been successfully disseminated to routine clinical settings in which, in contrast to randomized trials, no exclusion criteria are applied (Duffy et al., 2007; Gillespie, Duffy, Hackmann, & Clark, 2002). Finally, CT has been shown to work for acute and chronic PTSD following from one or two events (Ehlers et al., 2003, 2005), and for very chronic PTSD following multiple traumas (Duffy et al., 2007). The efficacy and effectiveness of CT for PTSD is in line with the finding from recent meta-analyses that trauma-focused cognitive behaviour therapy (CBT) is effective in the treatment of PTSD (e.g., Bisson et al., 2007). Other effective forms of trauma-focused CBT are Foa’s Prolonged Exposure (Foa & Rothbaum, 1998; Foa et al., 2005) and Resick’s Cognitive Processing Therapy (Resick & Schnicke, 1993).",0,0 +3705,PTSD in physically and sexually abused psychiatrically hospitalized children,"The history of sexual and physical abuse and the diagnosis of PTSD were examined in 98 psychiatrically hospitalized children. Relative to past studies, there was an increased incidence of abuse and of prevalence of PTSD. Specific instruments for assessing abuse and PTSD are suggested.",0,0 +3706,Childhood Sexual Abuse and Psychosomatic Symptoms in Irritable Bowel Syndrome,"Irritable bowel syndrome is characterized by chronic gastrointestinal symptoms without a demonstrable physical cause. In a subgroup of patients, irritable bowel syndrome may be part of a cluster of psychosomatic symptoms related to childhood sexual abuse. To investigate this possibility, the Dissociative Disorders Interview Schedule (DDIS), the Dissociative Experiences Scale (DES) and the Symptom Checklist-90 (SCL-90) were administered to 105 subjects with either irritable bowel syndrome, inflammatory bowel disease (Crohn's disease or ulcerative colitis), or other gastrointestinal disorders. The subjects in the three groups did not differ on the DES, the SCL-90 or most sections of the DDIS. However, subjects with irritable bowel syndrome reported much higher rates of childhood sexual abuse and psychosomatic symptoms.",0,0 +3707,The geography of post-disaster mental health: spatial patterning of psychological vulnerability and resilience factors in New York City after Hurricane Sandy,"Only very few studies have investigated the geographic distribution of psychological resilience and associated mental health outcomes after natural or man made disasters. Such information is crucial for location-based interventions that aim to promote recovery in the aftermath of disasters. The purpose of this study therefore was to investigate geographic variability of (1) posttraumatic stress (PTS) and depression in a Hurricane Sandy affected population in NYC and (2) psychological vulnerability and resilience factors among affected areas in NYC boroughs.Cross-sectional telephone survey data were collected 13 to 16 months post-disaster from household residents (N = 418 adults) in NYC communities that were most heavily affected by the hurricane. The Posttraumatic Stress Checklist for DSM-5 (PCL-5) was applied for measuring posttraumatic stress and the nine-item Patient Health Questionnaire (PHQ-9) was used for measuring depression. We applied spatial autocorrelation and spatial regimes regression analyses, to test for spatial clusters of mental health outcomes and to explore whether associations between vulnerability and resilience factors and mental health differed among New York City's five boroughs.Mental health problems clustered predominantly in neighborhoods that are geographically more exposed towards the ocean indicating a spatial variation of risk within and across the boroughs. We further found significant variation in associations between vulnerability and resilience factors and mental health. Race/ethnicity (being Asian or non-Hispanic black) and disaster-related stressors were vulnerability factors for mental health symptoms in Queens, and being employed and married were resilience factors for these symptoms in Manhattan and Staten Island. In addition, parental status was a vulnerability factor in Brooklyn and a resilience factor in the Bronx.We conclude that explanatory characteristics may manifest as psychological vulnerability and resilience factors differently across different regional contexts. Our spatial epidemiological approach is transferable to other regions around the globe and, in the light of a changing climate, could be used to strengthen the psychosocial resources of demographic groups at greatest risk of adverse outcomes pre-disaster. In the aftermath of a disaster, the approach can be used to identify survivors at greatest risk and to plan for targeted interventions to reach them.",0,0 +3708,Diagnostic alterations for post-traumatic stress disorder: examining data from the National Comorbidity Survey Replication and National Survey of Adolescents,"Background Two alternative models of post-traumatic stress disorder (PTSD) appear to represent the disorder's latent structure better than the traditional Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) three-factor PTSD model. The present study examines the impact of using these structural models for the diagnosis of lifetime PTSD while retaining the DSM-IV PTSD's six-symptom diagnostic requirement. Method Data were gathered from large-scale, epidemiological datasets collected with adults (National Comorbidity Survey Replication) and adolescents (National Survey of Adolescents). Two alternative, empirically supported four-factor models of PTSD were compared with the DSM-IV three-factor PTSD diagnostic model. Results Results indicated that the diagnostic alterations resulted in substantially improved structural validity, downward adjustments of PTSD's lifetime prevalence (roughly 1 percentage point decreases in adults, 1–2.5 percentage point decreases in adolescents), and equivalent psychiatric co-morbidity and sociodemographic associations. Conclusions Implications for modifying PTSD diagnostic criteria in future editions of DSM are discussed.",0,0 +3709,Remote stress detection using a visible spectrum camera,"Heart rate variability (HRV) can be an important indicator of several conditions that affect the autonomic nervous system, including traumatic brain injury, post-traumatic stress disorder and peripheral neuropathy. Recent work has shown that some of the HRV features can potentially be used for distinguishing a subject’s normal mental state from a stressed one. In all of these past works, HRV analysis is performed on the cardiac activity data acquired by conventional electrocardiography electrodes, which may introduce additional stress and complexity to the acquired data. In this paper we use remotely acquired time-series data extracted from the human facial skin reflectivity signal during rest and mental stress conditions to compute HRV driven features. We further apply a set of classification algorithms to distinguishing between these two states. To determine heart beat signal from the facial skin reflectivity, we apply Principal Component Analysis (PCA) for denoising and Independent Component Analysis (ICA) for source selection. To determine the signal peaks to extract the RR-interval time-series, we apply a threshold-based detection technique and additional peak conditioning algorithms. To classify RR-intervals, we explored classification algorithms that are commonly used for medical applications such as logistic regression and linear discriminant analysis (LDA). Goodness of each classifier is measured in terms of sensitivity/specificity. Results from each classifier are then compared to find the optimal classifier for stress detection. This work, performed under an IRB approved protocol, provides initial proof that remotely-acquired heart rate signal can be used for stress detection. This result shows promise for further development of a remote-sensing stress detection technique both for medical and deception-detection applications.",0,0 +3710,Long-Term Course of Post-Traumatic Stress Disorder (PTSD) in German Soldiers: Effects of Inpatient Eye Movement Desensitization and Reprocessing Therapy and Specific Trauma Characteristics in Patients with Non-Combat-Related PTSD,"In this study, we retrospectively evaluated a patient population of 89 German soldiers who received inpatient treatment for post-traumatic stress disorder at the German Armed Forces Hospital in Hamburg from 1998 to 2003.Patients were nonrandomly assigned to a treatment group who received eye movement desensitization and reprocessing and a comparison group with general hospital treatment and relaxation training. Follow-up information was obtained 29 months post-treatment. Trauma-related symptoms were assessed using the Impact of Event Scale and the Post-Traumatic Stress Scale (PTSS-10) as parameters of improvement.The Impact of Event Scale showed that inpatient trauma therapy with eye movement desensitization and reprocessing significantly improved the course of post-traumatic stress disorder. In addition, the Impact of Event Scale indicated a significantly poorer long-term outcome for patients who had been confronted with death during their traumatic experience. Other factors tested were of no significant influence.These results may influence further treatment strategies for traumatized German soldiers.",0,0 +3711,Involving Parents in Indicated Early Intervention for Childhood PTSD Following Accidental Injury,"Accidental injuries represent the most common type of traumatic event to which a youth is likely to be exposed. While the majority of youth who experience an accidental injury will recover spontaneously, a significant proportion will go on to develop Post-Traumatic Stress Disorder (PTSD). And yet, there is little published treatment outcome research in this area. This review focuses on two key issues within the child PTSD literature-namely the role of parents in treatment and the timing of intervention. The issue of parental involvement in the treatment of child PTSD is a question that is increasingly being recognized as important. In addition, the need to find a balance between providing early intervention to at risk youth while avoiding providing treatment to those youth who will recover spontaneously has yet to be addressed. This paper outlines the rationale for and the development of a trauma-focused CBT protocol with separate parent and child programs, for use with children and adolescents experiencing PTSD following an accidental injury. The protocol is embedded within an indicated intervention framework, allowing for the early identification of youth at risk within a medical setting. Two case studies are presented in order to illustrate key issues raised in the review, implementation of the interventions, and the challenges involved. © 2012 Springer Science+Business Media, LLC.",0,0 +3712,Positive and negative emotion prospectively predict trajectories of resilience and distress among high-exposure police officers.,"Responses to both potentially traumatic events and other significant life stressors have been shown to conform to discrete patterns of response such as resilience, anticipatory stress, initial distress with gradual recovery, and chronic distress. The etiology of these trajectories is still unclear. Individual differences in levels of negative and positive emotion are believed to play a role in determining risk and resilience following traumatic exposure. In the current investigation, we followed police officers prospectively from academy training through 48 months of active duty, assessing levels of distress every 12 months. Using latent class growth analysis, we identified 4 trajectories closely conforming to prototypical patterns. Furthermore, we found that lower levels of self-reported negative emotion during academy training prospectively predicted membership in the resilient trajectory compared with the more symptomatic trajectories following the initiation of active duty, whereas higher levels of positive emotion during academy training differentiated resilience from a trajectory that was equivalently low on distress during academy training but consistently grew in distress through 4 years of active duty. These findings emerging from a prospective longitudinal design provide evidence that resilience is predicted by both lower levels of negative emotion and higher levels of positive emotion prior to active duty stressor exposure.",0,0 +3713,Posttraumatic symptomatology in children exposed to war,"This study examines affective and behavioral symptomatology in two groups of school-age children who were traumatized to different degrees during the war in Croatia (N = 1034). Six self-reported questionnaires were used to assess the following: number and type of war experiences, PTSD symptoms, anxiety, depression, psychosomatic symptoms, and psychosocial adaptation. Canonical discriminant analysis yielded a significant discriminant function that indicates moderate differentiation between the two groups of children according to the assessed symptoms. The results of a 2 x 2 x 2 ANOVAs (gender x age x level of traumatization) indicate that the children's reactions to war traumata varied in respect to all factors, as well as their interaction. The results indicate that gender differences are more prominent in older children. Older girls report more posttraumatic stress reactions, anxiety and depression, but at the same time seem better adapted than boys. Younger children, particularly those who survived more war even report more PTSD symptoms than older children.",0,0 +3714,Is dissociation a multidimensional construct? Data from the Multiscale Dissociation Inventory,"The dimensionality of dissociation was examined in a combined sample of 1,326 general population, clinical, and university participants who completed the Multiscale Dissociation Inventory (MDI). Principal components analysis identified five moderately intercorrelated factors (mean r = .39): Disengagement, Identity Dissociation, Emotional Constriction, Memory Disturbance, and Depersonalization/Derealization. Differential relationships were found between individual MDI factors and demographics, trauma history, clinical status, posttraumatic stress, and scores on other dissociation measures. Surprisingly, after controlling for sex and age, trauma exposure accounted for only 3 to 7% of the variance in MDI factors. The notion of dissociation as a general trait was not supported. Instead, dissociation may represent a variety of phenomenologically distinct and only moderately related symptom clusters whose ultimate commonality is more theoretical than empirical.",0,0 +3715,Health-Related Quality of Life 2 Years to 7 Years After Burn Injury,"Knowledge concerning the trajectory and predictors of health-related quality of life (HRQoL) years after burn injury is fragmentary and these factors were therefore assessed using the EQ-5D questionnaire.Consecutive adult burn patients were included during hospitalization and assessed at 3 months, 6 months, and 12 months. In addition, an interview was performed at 2 years to 7 years postburn. Data concerning injury characteristics, sociodemographic variables, psychiatric disorders, and HRQoL were obtained.The EQ-5D dimension Mobility improved between hospitalization and 3 months, while Anxiety/Depression improved between 12 months and 2 years to 7 years. Other dimensions improved gradually. At 2 years to 7 years, only the dimensions Pain/Discomfort and Usual activities were lower than in the general population. In addition, overall HRQoL was lower than in the general population when measured by EQ VAS but not by EQ-5D index. EQ-5D index at 2 years to 7 years was predicted by EQ-5D index at 12 months and concurrent work status and pain. EQ VAS at 2 years to 7 years was predicted by previous assessments of work status, posttraumatic stress disorder and EQ VAS, and concurrent work status and substance abuse. Total amount of explained variance ranged between 17% and 57%.HRQoL after burn is conveniently screened by EQ VAS. Impairment after 2 years to 7 years is mainly reflected in the EQ dimensions Pain/Discomfort and Usual activities and can be predicted in part by information available before or at 12 months.",0,0 +3716,Drug-resistant chronic migraine: the Italian GON project,"Chronic daily headache is a major problem due to severe disability and high socio-economic costs. In the last years, some trials have shown potential benefit from new therapeutic approach by occipital neurostimulation techniques, already applied with some success for the treatment of chronic cluster headache. Due to the extremely heterogeneous population suffering from refractory chronic daily headaches, we propose a national multicenter experimental study involving Italian ANIRCEF Headache Centres with the aim to evaluate the efficacy of occipital neurostimulation in a selected group representative for the drug-resistant chronic migraine. Patients with chronic migraine according to Manzoni's modified IHS criteria-2011, with or without medication overuse headache, will be selected. Duration of illness should be at least 2 years and pharmacological refractoriness defined strictly for experimental-surgical purposes as those patients who have properly tried without success almost all available classes of prophylactic medications. Those presenting with medication overuse should have tried at least two previous detoxification treatments. A full psychopathological assessment will be performed by a psychiatrist, to exclude mainly psychotic disorder, ongoing severe status of an affective disorder, severe post traumatic stress disorder. Headache characteristics and abortive treatments used will be reported daily on a predisposed diary during 3-month baseline and continuously through the post implant follow up, while disability and QoL scale (MIDAS, SF-12) will be completed baseline, 6 and 12 months after implant. © Springer-Verlag 2012.",0,0 +3717,"Effects of traumatic brain injury and posttraumatic stress disorder on Alzheimer's disease in veterans, using the Alzheimer's Disease Neuroimaging Initiative","Both traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) are common problems resulting from military service, and both have been associated with increased risk of cognitive decline and dementia resulting from Alzheimer's disease (AD) or other causes. This study aims to use imaging techniques and biomarker analysis to determine whether traumatic brain injury (TBI) and/or PTSD resulting from combat or other traumas increase the risk for AD and decrease cognitive reserve in Veteran subjects, after accounting for age. Using military and Department of Veterans Affairs records, 65 Vietnam War veterans with a history of moderate or severe TBI with or without PTSD, 65 with ongoing PTSD without TBI, and 65 control subjects are being enrolled in this study at 19 sites. The study aims to select subject groups that are comparable in age, gender, ethnicity, and education. Subjects with mild cognitive impairment (MCI) or dementia are being excluded. However, a new study just beginning, and similar in size, will study subjects with TBI, subjects with PTSD, and control subjects with MCI. Baseline measurements of cognition, function, blood, and cerebrospinal fluid biomarkers; magnetic resonance images (structural, diffusion tensor, and resting state blood-level oxygen dependent (BOLD) functional magnetic resonance imaging); and amyloid positron emission tomographic (PET) images with florbetapir are being obtained. One-year follow-up measurements will be collected for most of the baseline procedures, with the exception of the lumbar puncture, the PET imaging, and apolipoprotein E genotyping. To date, 19 subjects with TBI only, 46 with PTSD only, and 15 with TBI and PTSD have been recruited and referred to 13 clinics to undergo the study protocol. It is expected that cohorts will be fully recruited by October 2014. This study is a first step toward the design and statistical powering of an AD prevention trial using at-risk veterans as subjects, and provides the basis for a larger, more comprehensive study of dementia risk factors in veterans.",0,0 +3718,The relation between parenting stress and adolescents' somatisation trajectories: A growth mixture analysis,"The impact of somatisation in adolescence is substantial. Knowledge on (predictors of) individual-level development of somatisation is necessary to develop tailored treatment. The current study assessed individual-level development of somatisation by means of latent mixed modelling. Parenting stress was included as a predictor of somatisation trajectory membership and within-trajectory variation.A total of 1499 adolescents and one of their parents (mostly the mother) agreed to participate. Questionnaires were administered when the adolescents were respectively 12-13 (T1), 13-14 (T2), and 14-15 (T3) years old. Adolescents reported on their somatisation, parents on their parenting stress.Four individual somatisation trajectories were found: increased, long-term low, long-term high, and decreased. Higher early parenting stress (T1) significantly predicted less favourable trajectory membership (increased and long-term high). The relation between later parenting stress (T2 and T3) and somatisation depended on trajectory membership. For adolescents in the long-term high and decreased somatisation trajectories, lower T2 and T3 parenting stress was related to higher somatisation, while for adolescents in the long-term low and increased trajectories, higher T2 and T3 parenting stress was related to higher somatisation.The results support a general recommendation to prevent the onset of high levels of parenting stress. In addition, for families in which high levels of parenting stress already exist, clinicians should be aware of natural fluctuations in parenting stress, its associated features (e.g., aspects of overall care, like looking for professional help) and of the consequences this might have for the adolescent.",0,0 +3719,Do gender and age moderate the symptom structure of PTSD? Findings from a national clinical sample of children and adolescents,"A substantial body of evidence documents that the frequency and intensity of posttraumatic stress disorder (PTSD) symptoms are linked to such demographic variables as female sex (e.g., Kaplow et al., 2005) and age (e.g., Meiser-Stedman et al., 2008). Considerably less is known about relations between biological sex and age with PTSD's latent factor structure. This study systematically examined the roles that sex and age may play as candidate moderators of the full range of factor structure parameters of an empirically supported five-factor PTSD model (Elhai et al., 2011). The sample included 6591 trauma-exposed children and adolescents selected from the National Child Traumatic Stress Network's Core Data Set. Confirmatory factor analysis using invariance testing (Gregorich, 2006) and comparative fit index difference values (Cheung and Rensvold, 2002) reflected a mixed pattern of test item intercepts across age groups. The adolescent subsample produced lower residual error variances, reflecting less measurement error than the child subsample. Sex did not show a robust moderating effect. We conclude by discussing implications for clinical assessment, theory building, and future research.",0,0 +3720,Factor analysis and AIC,,0,0 +3721,"Ecosystem services and urban heat riskscape moderation: water, green spaces, and social inequality in Phoenix, USA","Urban ecosystems are subjected to high temperatures--extreme heat events, chronically hot weather, or both-through interactions between local and global climate processes. Urban vegetation may provide a cooling ecosystem service, although many knowledge gaps exist in the biophysical and social dynamics of using this service to reduce climate extremes. To better understand patterns of urban vegetated cooling, the potential water requirements to supply these services, and differential access to these services between residential neighborhoods, we evaluated three decades (1970-2000) of land surface characteristics and residential segregation by income in the Phoenix, Arizona, USA metropolitan region. We developed an ecosystem service trade-offs approach to assess the urban heat riskscape, defined as the spatial variation in risk exposure and potential human vulnerability to extreme heat. In this region, vegetation provided nearly a 25 degrees C surface cooling compared to bare soil on low-humidity summer days; the magnitude of this service was strongly coupled to air temperature and vapor pressure deficits. To estimate the water loss associated with land-surface cooling, we applied a surface energy balance model. Our initial estimates suggest 2.7 mm/d of water may be used in supplying cooling ecosystem services in the Phoenix region on a summer day. The availability and corresponding resource use requirements of these ecosystem services had a strongly positive relationship with neighborhood income in the year 2000. However, economic stratification in access to services is a recent development: no vegetation-income relationship was observed in 1970, and a clear trend of increasing correlation was evident through 2000. To alleviate neighborhood inequality in risks from extreme heat through increased vegetation and evaporative cooling, large increases in regional water use would be required. Together, these results suggest the need for a systems evaluation of the benefits, costs, spatial structure, and temporal trajectory for the use of ecosystem services to moderate climate extremes. Increasing vegetation is one strategy for moderating regional climate changes in urban areas and simultaneously providing multiple ecosystem services. However, vegetation has economic, water, and social equity implications that vary dramatically across neighborhoods and need to be managed through informed environmental policies.",0,0 +3722,Compensation-Seeking and Extreme Exaggeration of Psychopathology Among Combat Veterans Evaluated for Posttraumatic Stress Disorder,"We extended the work of Smith and Frueh (1996) by evaluating whether combat veterans classified as ""extreme exaggerators"" were more likely to be compensation-seeking, and to report greater levels of psychopathology across self-report instruments than ""nonexaggerators."" Of 119 veterans who completed the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) at an outpatient posttraumatic stress disorder (PTSD) clinic, 26 (22%) and 17 (14%) were identified as extreme exaggerators using two MMPI-2 validity indicators with stringent cutoffs (F-K > or = 22; F(p) > or = 8). These veterans were much more likely to be compensation seeking and scored much higher on self-report measures of various psychological symptoms than nonexaggerators, despite having lower rates of PTSD diagnoses and similar rates of other comorbid diagnoses. Findings suggest that the validity indices of the MMPI-2 can play a critical role, as a screening instrument, in identifying veterans who may be exaggerating their psychopathology to gain disability compensation.",0,0 +3723,PTSD symptom severity and psychiatric comorbidity in recent motor vehicle accident victims: A latent class analysis,"We conducted a latent class analysis (LCA) on 249 recent motor vehicle accident (MVA) victims to examine subgroups that differed in posttraumatic stress disorder (PTSD) symptom severity, current major depressive disorder and alcohol/other drug use disorders (MDD/AoDs), gender, and interpersonal trauma history 6-weeks post-MVA. A 4-class model best fit the data with a resilient class displaying asymptomatic PTSD symptom levels/low levels of comorbid disorders; a mild psychopathology class displaying mild PTSD symptom severity and current MDD; a moderate psychopathology class displaying severe PTSD symptom severity and current MDD/AoDs; and a severe psychopathology class displaying extreme PTSD symptom severity and current MDD. Classes also differed with respect to gender composition and history of interpersonal trauma experience. These findings may aid in the development of targeted interventions for recent MVA victims through the identification of subgroups distinguished by different patterns of psychiatric problems experienced 6-weeks post-MVA.",0,0 +3724,Primary focal dystonia: evidence for distinct neuropsychiatric and personality profiles,"Primary focal dystonia (PFD) is characterised by motor symptoms. Frequent co-occurrence of abnormal mental conditions has been mentioned for decades but is less well defined. In this study, prevalence rates of psychiatric disorders, personality disorders and traits in a large cohort of patients with PFD were evaluated.Prevalence rates of clinical psychiatric diagnoses in 86 PFD patients were compared with a population based sample (n = 3943) using a multiple regression approach. Furthermore, participants were evaluated for personality traits with the 5 Factor Personality Inventory.Lifetime prevalence for any psychiatric or personality disorder was 70.9%. More specifically, axis I disorders occurred at a 4.5-fold increased chance. Highest odds ratios were found for social phobia (OR 21.6), agoraphobia (OR 16.7) and panic disorder (OR 11.5). Furthermore, an increased prevalence rate of 32.6% for anxious personality disorders comprising obsessive-compulsive (22.1%) and avoidant personality disorders (16.3%) were found. Except for social phobia, psychiatric disorders manifested prior to the occurrence of dystonia symptoms. In the self-rating of personality traits, PFD patients demonstrated pronounced agreeableness, conscientiousness and reduced openness.Patients with PFD show distinct neuropsychiatric and personality profiles of the anxiety spectrum. PFD should therefore be viewed as a neuropsychiatric disorder rather than a pure movement disorder.",0,0 +3725,A biopsychosocial deconstruction of “personality change” following acquired brain injury,"The judgement of personality change following acquired brain injury (ABI) is a powerful subjective and social action, and has been shown to be associated with a range of serious psychosocial consequences. Traditional conceptualisations of personality change (e.g., Lishman, 1998) have largely derived from individualist concepts of personality (e.g., Eysenck, 1967). These assume a direct link between neurological damage and altered personhood, accounting predominantly for their judgements of change. This assumption is found as commonly in family accounts of change as in professional discourse. Recent studies and perspectives from the overlapping fields of social neuroscience, cognitive approaches to self and identity and psychosocial processes following ABI mount a serious challenge to this assumption. These collectively identify a range of direct and indirect factors that may influence the judgement or felt sense of change in personhood by survivors of ABI and their significant others. These perspectives are reviewed within a biopsychosocial framework: neurological and neuropsychological deficits, psychological mechanisms and psychosocial processes. Importantly, these perspectives are applied to generate a range of clinical interventions that were not identifiable within traditional conceptualisations of personality changes following ABI.",0,0 +3726,Psychopathology in female juvenile offenders,"Background: The aim was to document the spectrum of present and lifetime psychological disorders in female juvenile offenders, and to examine the relations between mental health status and socio-demographic, family and trauma variables. Method: One hundred juvenile offenders were matched with a comparison group of 100 females on age and socioeconomic status (SES). Psychological profiles and trauma histories of both groups were assessed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime Version (K-SADS-PL) and family functioning was assessed with the Family Adaptability and Cohesion Scale II (FACES II) self-report measure. Results: Rates of psychopathology were higher for offenders than non-offenders (p < .001), with particularly high levels of conduct disorder (91% v.1%, p < .001), substance abuse disorders (85% v. 5%, p < .001), depression (55% v. 25%, p < .001) and posttraumatic stress disorder (37% v. 4%, p < .001). In the offenders, 78% met the criteria for three or more diagnoses. The number of psychiatric diagnoses was the most significant factor associated with offender status (OR = 21.26, p < .001). Conclusions: There is a high prevalence of psychological disorder in females in juvenile justice custody and this has a very strong association with offender status. Because these co-morbid disorders are treatable, there is a clear opportunity to intervene to decrease psychological distress.",0,0 +3727,The University of California at Los Angeles post-traumatic stress disorder reaction index,"Over the past decade, the University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index has been one of the most widely used instruments for the assessment of traumatized children and adolescents. This paper reviews its development and modifications that have been made as the diagnostic criteria for post-traumatic stress disorder have evolved. The paper also provides a description of standard methods of administration, procedures for scoring, and psychometric properties. The Reaction Index has been extensively used across a variety of trauma types, age ranges, settings, and cultures. It has been broadly used across the US and around the world after major disasters and catastrophic violence as an integral component of public mental health response and recovery programs. The Reaction Index forms part of a battery that can be efficiently used to conduct needs assessment, surveillance, screening, clinical evaluation, and treatment outcome evaluation after mass casualty events.",0,0 +3728,Theoretical Accounts of Gulf War Syndrome: From Environmental Toxins to Psychoneuroimmunology and Neurodegeneration,"Non-specific illness includes a wide variety of symptoms: behavioural (e.g., reduced food and water intake), cognitive (e.g., memory and concentration problems) and physiological (e.g., fever). This paper reviews evidence suggesting that such symptoms can be explained more parsimoniously as a single symptom cluster than as a set of separate illnesses such as Gulf War Syndrome (GWS) and chronic fatigue syndrome (CFS). This superordinate syndrome could have its biological basis in the activity of pro-inflammatory cytokines (in particular interleukin-1: IL-1), that give rise to what has become known as the 'sickness response'. It is further argued that the persistence of non-specific illness in chronic conditions like GWS may be (in part) attributable to a bio-associative mechanism (Ferguson and Cassaday, 1999). In the case of GWS, physiological challenges could have produced a non-specific sickness response that became associated with smells (e.g., petrol), coincidentally experienced in the Persian Gulf. On returning to the home environment, these same smells would act as associative triggers for the maintenance of (conditioned) sickness responses. Such associative mechanisms could be mediated through the hypothalamus and limbic system via vagal nerve innervation and would provide an explanation for the persistence of a set of symptoms (e.g., fever) that should normally be short lived and self-limiting. We also present evidence that the pattern of symptoms produced by the pro-inflammatory cytokines reflects a shift in immune system functioning towards a (T-helper-1) Th1 profile. This position contrasts with other immunological accounts of GWS that suggest that the immune system demonstrates a shift to a Th2 (allergy) profile. Evidence pertaining to these two contrasting positions is reviewed.",0,0 +3729,"Assessment and diagnosis of mild traumatic brain injury, posttraumatic stress disorder, and other polytrauma conditions: Burden of adversity hypothesis.","Military personnel returning from Iraq and Afghanistan have been exposed to physical and emotional trauma. Challenges related to assessment and intervention for those with posttraumatic stress disorder (PTSD) and/or history of mild traumatic brain injury (TBI) with sequelae are discussed, with an emphasis on complicating factors if conditions are co-occurring. Existing literature regarding cumulative disadvantage is offered as a means of increasing understanding regarding the complex symptom patterns reported by those with a history of mild TBI with enduring symptoms and PTSD.The importance of early screening for both conditions is highlighted. In addition, the authors suggest that current best practices include treating symptoms regardless of etiology to decrease military personnel and veteran burden of adversity.",0,0 +3730,Epigenetics in Posttraumatic Stress Disorder,"Reported exposure to traumatic event is relatively common within the general population (40–90%), but only a fraction of individuals will develop posttraumatic stress disorder (PTSD). Indeed, the lifetime prevalence of PTSD is estimated to range between 7% and 12%. The factors influencing risk or resilience to PTSD after exposure to traumatic events are likely both environmental, such as type, timing, and extent of trauma, and genetic. Recently, epigenetic mechanisms have been implicated in mediating altered risk for PTSD as they can reflect both genetic and environmental influences. In this chapter, we describe the accumulating evidences for epigenetic factors in PTSD highlighting the importance of sensitive periods as well as methodological aspects such as tissue availabilities for such studies. We describe studies using a candidate gene approach focusing mainly on key players in the stress hormone regulation that show epigenetic alterations both in humans and in animal models for PTSD. We also summarize the results of epigenome-wide studies reporting associations with PTSD. For the above, we focus on one epigenetic mechanism, DNA methylation, as it is so far the best studied for this disorder. Finally, we describe how epigenetic mechanisms could be responsible for the long-lasting effects of gene–environment interactions observed in PTSD.",0,0 +3731,"Peritraumatic distress, posttraumatic stress disorder symptoms, and posttraumatic growth in victims of violence","This study explored whether peritraumatic distress and posttraumatic stress disorder (PTSD) symptoms are curvilinearly related to posttraumatic growth in victims of violence several years after victimization (Time 1; n = 678) and 6 months later (Time 2, n = 205). At both time points, curve estimation revealed linear and quadratic associations between peritraumatic distress and posttraumatic growth and quadratic associations between PTSD symptoms and posttraumatic growth. In multivariate regressions controlling for background variables, the linear peritraumatic distress and quadratic PTSD symptom terms remained significant predictors of posttraumatic growth Time 1 scores. For Time 2, the linear peritraumatic distress term remained significant, though only prior to controlling for posttraumatic growth Time 1 scores. The results suggest that peritraumatic distress enables growth after substantial time has elapsed since victimization.",0,0 +3732,Classification of chronic pain patients with the Brief Symptom Inventory: Patient characteristics of cluster profiles.,"In this study, the psychological symptom patterns of individuals with chronic pain on the Brief Symptom Inventory (BSI) were cluster analyzed. Cluster analysis was initially performed on a large sample of people with chronic pain (n = 1,489) and then cross-validated on a smaller sample (n = 244). A 2-cluster solution was deemed most appropriate. The clusters reflected low- and high-profile elevations on all BSI subscales. Among persons in the smaller sample, high-profile participants were more likely to be involved in litigation, report a higher frequency of posttraumatic stress symptoms, and display poorer psychosocial functioning. The results suggest that the BSI subgroups are associated with psychosocial characteristics that may be important in terms of treatment planning and outcome.",0,0 +3733,Bias in longitudinal data analysis with missing data using typical linear mixed-effects modelling and pattern-mixture approach: An analytical illustration,"We analytically derive the fixed-effects estimates in unconditional linear growth curve models by typical linear mixed-effects modelling (TLME) and by a pattern-mixture (PM) approach with random-slope-dependent two-missing-pattern missing not at random (MNAR) longitudinal data. Results showed that when the missingness mechanism is random-slope-dependent MNAR, TLME estimates of both the mean intercept and mean slope are biased because of incorrect weights used in the estimation. More specifically, the estimate of the mean slope is biased towards the mean slope for completers, whereas the estimate of the mean intercept is biased towards the opposite direction as compared to the estimate of the mean slope. We also discuss why the PM approach can provide unbiased fixed-effects estimates for random-coefficients-dependent MNAR data but does not work well for missing at random or outcome-dependent MNAR data. A small simulation study was conducted to illustrate the results and to compare results from TLME and PM. Results from an empirical data analysis showed that the conceptual finding can be generalized to other real conditions even when some assumptions for the analytical derivation cannot be met. Implications from the analytical and empirical results were discussed and sensitivity analysis was suggested for longitudinal data analysis with missing data.",0,0 +3734,Long-term outcome of eight clinical trials of CBT for anxiety disorders: Symptom profile of sustained recovery and treatment-resistant groups,"Few clinical trials of cognitive behaviour therapy (CBT) for anxiety disorders have conducted follow-up beyond one year post-treatment. This paper summarises the long-term outcome of eight clinical trials of CBT for anxiety disorders in terms of diagnostic status, healthcare usage and symptom severity and compares the symptom profile of participants with the best and worst outcomes relative to chronic depression and the normal population.Follow-up at 2-14years with 396 patients (51% of those available to contact) employed structured diagnostic interview, assessment of healthcare usage and self-report measures of symptom severity. This paper concerns 336 participants who had either no disorder or at least one anxiety disorder and information on healthcare usage over the follow-up period.Only 38% recovered with little or no treatment over the follow-up period while 30% had a very poor outcome despite extensive treatment for anxiety over many years. The symptom profile of this 'treatment-resistant' group was comparable to 76 patients with chronic depression and significantly worse than normative data for psychiatric outpatients. Chronic anxiety disorder with co-morbid depression has a more severe symptom profile than chronic anxiety disorder alone.The follow-up sample, although broadly representative, may have a bias towards a more favourable picture of overall outcome.The long-term outcome of anxiety disorders, irrespective of diagnosis or active treatment, is diverse but with a tendency towards chronicity. Distinctions between acute and chronic presentations of common mental disorders are more important than distinctions between chronic anxiety and chronic depression.",0,0 +3735,The relationship between compensable status and long‐term patient outcomes following orthopaedic trauma,"OBJECTIVE: To determine the relationship between compensable status in a compensation scheme and long-term outcomes after orthopaedic trauma. DESIGN AND SETTING: Prospective cohort study within two adult Level 1 trauma centres in Victoria, Australia. PARTICIPANTS: Blunt trauma patients aged 18-64 years, admitted between September 2003 and August 2004 with orthopaedic injuries and funded by the no-fault compensation scheme for transport-related injury, or deemed non-compensable. MAIN OUTCOME MEASURES: 12-item Short Form Health Survey (SF-12) and return to work or study at 12 months after injury. RESULTS: Of 1033 eligible patients, 707 (68.8%) provided follow-up data; 450 compensable and 247 non-compensable patients completed the study. After adjusting for differences across the groups (age, injury severity, head injury status, injury group, and discharge destination) using multivariate analyses, compensable patients were more likely than non-compensable patients to report moderate to severe disability at follow-up for the physical (adjusted odds ratio [AOR], 2.0; 95% CI, 1.3-2.9), and mental (AOR, 1.6; 95% CI, 1.1-2.5) summary scores of the SF-12. Compensable patients were less likely than non-compensable patients to have returned to work or study, even after adjusting for injury severity, age, head injury status and discharge destination (AOR, 0.6; 95% CI, 0.3-0.9). CONCLUSIONS: Patients covered by the no-fault compensation system for transport-related injuries in Victoria had worse outcomes than non-compensable patients. Language: en",0,0 +3736,Cognitive predictors of posttraumatic stress disorder in children: results of a prospective longitudinal study,"The present study explored whether cognitive factors specified in the Ehlers and Clark model (Behav. Res. Ther. 38 (2000) 319) of posttraumatic stress disorder (PTSD) predict chronic PTSD in children who had experienced a road traffic accident. Children were assessed at 2 weeks, 3 months, and 6 months after the accident. Data-driven processing during the accident, negative interpretation of intrusive memories, alienation from other people, anger, rumination, thought suppression and persistent dissociation at initial assessment predicted PTSD symptom severity at 3 and 6 months. On the basis of sex and stressor severity variables, 14% of the variance of PTSD symptoms at 6 months could be explained. The accuracy of the prediction increased to 49% or 53% when the cognitive variables measured at initial assessment or 3 months, respectively, were taken into account.",0,0 +3737,Optimism and Consumption: Psychological Costs of Malaysia-Sulu Dispute,"This research aims to examine the moderating effect of optimism on the relationship between psychological cost and consumption level during disputes. Psychometric-based questionnaire was developed and distributed in March 2013 to find Sabahan had severe symptoms of stress. This stress level induced the consumption level and also leisure cost in attempts to overcome the dispute. Interestingly, those Sabahans who were more inclined to optimism-might rethink their consumption/spending decision making. In other words, there is a moderating effect of optimism on the relationship between stress level and consumption during disputes.",0,0 +3738,Posttraumatic stress disorder in parents of children with chronic illnesses: A meta-analysis.,"To estimate PTSD prevalence in parents of children with chronic illnesses or undergoing invasive procedures, and its association with higher risk of PTSD among parents.Sixteen studies reporting prevalence of PTSD in parents of children with chronic illnesses were identified through a systematic review in Pubmed, Web of Science, Pilots and PsycINFO databases.Pooled current PTSD prevalence was calculated for parents from these studies. Pooled PTSD prevalence ratios were obtained by comparing parents of children with chronic diseases with parents of healthy children. Meta-regression was used to identify variables that could account for the lack of homogeneity.Pooled PTSD prevalence was 19.6% in mothers, 11.6% in fathers, and 22.8% in parents in general (p < .001). Pooled prevalence ratio for the four studies reporting on mothers and comparison healthy groups was 4.2 (p < .001).The high prevalence of PTSD found in this population highlights the importance of promptly assessing and treating post-traumatic symptoms in parents of children with chronic diseases as a key step to prevent the negative consequences of PTSD and preserve their competency as caregivers.",0,0 +3739,On structural equation modeling with data that are not missing completely at random,"A general latent variable model is given which includes the specification of a missing data mechanism. This framework allows for an elucidating discussion of existing general multivariate theory bearing on maximum likelihood estimation with missing data. Here, missing completely at random is not a prerequisite for unbiased estimation in large samples, as when using the traditional listwise or pairwise present data approaches. The theory is connected with old and new results in the area of selection and factorial invariance. It is pointed out that in many applications, maximum likelihood estimation with missing data may be carried out by existing structural equation modeling software, such as LISREL and LISCOMP. Several sets of artifical data are generated within the general model framework. The proposed estimator is compared to the two traditional ones and found superior.",0,0 +3740,Vulnerability to post-traumatic stress disorder and psychological morbidity in aged holocaust survivors,"Objective Although high rates of post-traumatic stress disorder (PTSD) and psychological morbidity have been consistently reported in Holocaust survivors (HS), reports are inconsistent about which factors are associated with psychological morbidity. In a study of the oldest HS cohort yet reported, we aim to clarify why this variability exists by examining factors associated with PTSD and psychological morbidity, including for the first time measures of personality and defense mechanisms. Methods One hundred HS randomly selected from a convenience sample of 309 respondents to a survey of Jewish persons aged 60 years and older living in the community in Sydney were assessed using the following instruments: demographics, severity of trauma experienced, General Health Questionnaire (GHQ-28), PTSD diagnosis (DSM-IV), Brief Psychiatric Rating Scale, Impact of Events Scale, Defense Style Questionnaire, modified Eysenck Personality Inventory. Results Older age, experience of more severe trauma, use of immature defense mechanisms and higher neuroticism were associated with significant PTSD and psychological morbidity; severity of trauma was associated with PTSD and with more severe psychological morbidity. Conclusions A profile of survivors at-risk can be identified that may have application to survivors of more recent holocausts. Late life may be a period of vulnerability in the aftermath of severe trauma. Copyright © 2004 John Wiley & Sons, Ltd.",0,0 +3741,Psychoneuroendocrine assessment of posttraumatic stress disorder: Current progress and new directions,1. Studies in our laboratory have used the psychoendocrine strategy to explore differences in basal hormone levels between patients with posttraumatic stress disorder (PTSD) and other groups. This approach has allowed us to explore the relationship between hormone levels and specific psychological and biological processes which appear to develop following exposure to extreme trauma. 2. The concurrent assessment of several hormonal systems provides an opportunity to explore differences in hormonal patterns in various psychiatric disorders. PTSD appears to be characterized by a specific profile of hormonal changes that is distinct from that of other diagnostic groups and normal controls. These findings raise the possibility that the psychoendocrine approach may be useful in further exploring the pathophysiology and diagnosis of PTSD. 3. This paper reviews psychoendocrine changes in PTSD and describes updated multivariate methods that further elucidate psychological and neurochemical correlates of hormonal alterations in this disorder.,0,0 +3742,"Preventive Health Behaviors, Health-Risk Behaviors, Physical Morbidity, and Health-Related Role Functioning Impairment in Veterans with Post-Traumatic Stress Disorder","An examination of the relationships between health behaviors (preventive and risk-related), physician-diagnosed medical problems, role-functioning impairment because of physical morbidity, and post-traumatic stress disorder was conducted on a large cohort of consecutive treatment-seeking cases (N = 826) presenting to an outpatient Veterans Affairs post-traumatic stress disorder clinic. Results revealed that the sample rates of several medical conditions were markedly elevated when compared with general population rates for men of comparable age. The rates of smoking and other behavioral risk variables were greater than rates among men in the general population. Moreover, the majority of the sample did not engage in preventive health behaviors such as exercise and medical screening at levels consistent with health care guidelines. Physical role functioning indices of the SF-36 reveal greater role-functioning impairment because of physical morbidity in this psychiatric sample relative to the age adjusted general population norms. The health care implications of these data are discussed, as are areas for future research.",0,0 +3743,Behavioural psychopathology of child sexual abuse in schoolgirls referred to a tertiary centre: A North London study,"The sexually abused girls in this study were a sub-sample of a group of girls referred to a Regional Centre for Psychotherapy for the whole of London, North Thames. An inclusion criterion was that they were psychologically symptomatic and so it is likely that they were more problematic cases causing concern in their locality. The control clinical group consisted of referrals to local Child and Family consultation services, were an opt-in matched sample and not a total clinic referral sample. In addition, the reasons for referral covered both child disorder and family problems. It is, therefore, important to bear in mind the differences between these two groups. Certain clear cut findings have emerged from this study. No disorders specific to child sexual abuse in girls were identified but the extent and severity of the disturbance in the sexually abused sample was most striking. In these girls an event (CSA), together with referral because of emotional symptoms, was associated with enhanced severity of disorder and comorbidity particularly with reference to a cluster of disorders comprising post-traumatic stress disorder, depressive disorder, anxiety disorders (general and separation), social phobias and reactive attachment disorder. In the community clinic sample the identified disorders were mainly those of separation anxiety disorders and adjustment. Wide comorbidity was common in the sexual abuse sample and also severity of impairment was notable when compared to the clinic sample. However, because of the selected nature of the abuse group the findings are not generalisable beyond the population from which they emerged. The view is advanced that there are strong grounds for exploring the utility of psychodynamic psychotherapy in similar samples of sexually abused girls. These findings are discussed in the light of the current literature.",0,0 +3744,The Hospital Anxiety and Depression Scale,A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.,0,0 +3745,The Preeminence of Early Life Trauma as a Risk Factor for Worsened Long-Term Health Outcomes in Women,"Early life trauma (ELT) comprises an array of disturbingly common distressing experiences between conception and the beginning of adulthood with numerous and significant potential long-term, even transgenerational, health consequences of great public health concern, including depression, cardiovascular disease, and other psychiatric and medical disorders, and neurobiological, psychological, and behavioral effects which are sufficiently robust to confound many types of biomedical research. The impact of ELT on a woman’s health trajectory appears to vary with the specific characteristics of the ELT (e.g., type, number of different types, severity, and timing), the individual (e.g., age, genetics, epigenetics, personality, and cognitive factors), and the individual’s environment (e.g., level of social support and ongoing stressors) and to be mediated to a significant extent by persistent changes in a number of biological systems, dysregulation of those governing the stress response chief among them. Growing knowledge of the risk factors and pathophysiological mechanisms by which ELT confers diathesis to various poor health outcomes and the unique treatment–response profiles of women with ELT will lead to much needed improvements in prevention, diagnostic, and therapeutic efforts, including more effective psychotherapy and pharmacotherapy approaches, hopefully making strides toward improvements in the lives of women everywhere and ending countless cycles of intergenerational trauma-associated pathology. This article attempts to broadly summarize the current state of knowledge about the long-term sequelae of ELT for women’s health. © 2015, Springer Science+Business Media New York.",0,0 +3746,The neurobiology of abandonment homicide,"A review is made of the typical modus operandi and psychological profile of uxoricide (wife murder) perpetrators. Typically, most had traumatic childhood and have current personality disorders (PD; typically Dependent, Passive–Aggressive, or Borderline PD). The uxoricide occurred during attempted abandonment of the relationship by the female and was characterized by extreme violence and elements of disorganized behavior by the perpetrator. A review is also made of the neuroanatomy and neurobiology of aggression. It is found that the orbitofrontal cortex (OFC) is implicated in control of aggressive impulses. This cortical area matures during the critical “rapprochement subphase” of early development (1.5–2 years). Attachment dysfunction during this period may interfere with critical development. It is found that low levels of serotonin (5-HT) and high levels of norepinephrine (NE) are implicated in aggression. It is also found that low levels of 5-HT and high levels of NE are long-term neurobiological sequelae of trauma. Attachment trauma can occur during the rapprochement subphase. It is suggested that a biological basis may serve to connect early trauma experience with a specific rage response to abandonment and spousal homicide. Neural networks containing malignant memories may be the neural mechanism by which perceived abandonment generates such symbolic terror and rage.",0,0 +3747,Prediction of Outcome for Veterans with Post-Traumatic Stress Disorder Using Constructs from the Transtheoretical Model of Behaviour Change,"Post-traumatic stress disorder (PTSD) is a disabling condition, sometimes unresponsive to treatment. The aim of the present study was to examine the predictive utility of constructs from the transtheoretical model of behaviour change (TTM) known to predict outcome for other disorders.A sample of 50 veterans presenting for a PTSD treatment programme provided data for this longitudinal study. Variables were assessed at four time-points during the treatment programme. Multiple regression and mixed-effects regression were utilized to determine the predictive utility of variables from the TTM.Allocated stage of change at the time of a 2 day introduction programme predicted follow-up symptom severity, but changes therein during treatment did not predict changes in symptom severity. However, changes in the continuous readiness-to-change variable and behavioural processes of change were predictive of such changes.Despite some difficulties in the application of the TTM to PTSD, the model does appear to predict treatment outcome. Veterans who have increased readiness to change and who make more use of behavioural processes of change are likely to have improved outcomes.",0,0 +3748,Pathological Modes of Remembering,"The experience of a severe stressor can lead to involuntary and persistent recollections of the event in some affected individuals. These unwanted spontaneous memories are usually accompanied by intense emotions and psychological distress, leaving the individual unable to cope. The present chapter aims to give a comprehensible introduction to the pathological consequences that may arise from the exposure to traumatic stress. It is an attempt to provide some insight into what can be considered a traumatic event, which natural stress reactions can be expected, what we know about risk factors for the development of posttraumatic stress disorder, and which dysfunctional strategies may contribute to the maintenance of the disorder.",0,0 +3749,"Efficacy of Sertraline in Preventing Relapse of Posttraumatic Stress Disorder: Results of a 28-Week Double-Blind, Placebo-Controlled Study","The study examined the efficacy of sertraline, compared with placebo, in sustaining improvement and preventing relapse over 28 weeks in patients with posttraumatic stress disorder (PTSD) who had completed a 12-week double-blind, placebo-controlled acute treatment study and a subsequent 24-week open-label study of continuation treatment with sertraline.Ninety-six patients were randomly assigned, in a double-blind design, to 28 weeks of maintenance treatment with sertraline (50-200 mg, N=46; 78% were women) or placebo (N=50; 62% were women). Measures used in biweekly assessments included the Clinician-Administered PTSD Scale, the Impact of Event Scale, and the Clinical Global Impression severity and improvement ratings. Kaplan-Meier analyses were used to estimate time to discontinuation from the study due to relapse, relapse or study discontinuation due to clinical deterioration, and acute exacerbation.Continued treatment with sertraline yielded lower PTSD relapse rates than placebo (5% versus 26%). Patients who received placebo were 6.4 times as likely to experience relapse as were patients who received sertraline. Kaplan-Meier analyses confirmed the protective effect of sertraline in significantly extending time in remission. The ability of sertraline to sustain improvement was comparable across the three core PTSD symptom clusters (reexperiencing/intrusion, avoidance/numbing, and hyperarousal). A regression analysis found early response during acute treatment to be associated with a more than 16-fold reduced risk of relapse after placebo substitution. Sertraline, at a mean endpoint dose of 137 mg, was well tolerated, with no sertraline-related adverse events observed at a rate of 10% or higher.The results provide evidence for the ability of sertraline both to sustain improvement in PTSD symptoms and to provide prophylactic protection against relapse.",0,0 +3750,Post-traumatic stress disorder as a consequence of bullying at work and at school. A literature review and meta-analysis,"Bullying has been established as a prevalent traumatic stressor both in school and at workplaces. It has been claimed that the mental and physical health problems found among bullied persons resembles the symptomatology of Post Traumatic Stress Disorder (PTSD). Yet, it is still unclear whether bullying can be considered as a precursor to PTSD. Through a review and meta-analysis of the research literature on workplace- and school bullying, the aims of this study were to determine: 1) the magnitude of the association between bullying and symptoms of PTSD, and 2) whether the clinical diagnosis of PTSD applies to the consequences of bullying. Altogether 29 relevant studies were identified. All had cross-sectional research designs. At an average, 57% of victims reported symptoms of PTSD above thresholds for caseness. A correlation of .42 (95% CI: .36–.48; p < .001) was found between bullying and an overall symptom-score of PTSD. Correlations between bullying and specific PTSD-symptoms were in the same range. Equally strong associations were found among children and adults. Two out of the three identified clinical diagnosis studies suggested that bullying is associated with the PTSD-diagnosis. Due to a lack of longitudinal research and structural clinical interview studies, existing literature provides no absolute evidence for or against bullying as a causal precursor of PTSD. • Summarizes research literature on the associations between bullying and PTSD • The majority of victims reports symptoms of PTSD. • Exposure to bullying is cross-sectionally associated with symptoms of PTSD. • No longitudinal studies and few studies with clinical diagnosis • It is not possible to determine causal associations between bullying and PTSD based on existing literature.",0,0 +3751,Promoting Independent Task Performance by Persons with Severe Developmental Disabilities through a New Computer-Aided System,"This study involved two experiments. In Experiment 1, a computer-aided system for promoting task performance by 6 persons with severe developmental disabilities was compared with a card system. The computer-aided system was portable and presented pictorial task instructions (one instruction per step) and prompts. In Experiment 2, the same systemwas used, but the number of instruction occasions was reduced. In one condition, the system presented all the instructions used in Experiment 1 but mostly in clusters rather than individually. In another, the system presented part of the Experiment 1 instructions. Three Experiment 1 participants also served in Experiment 2. Experiment 1 results indicated all 6 participants had higher percentages of correct steps with the computer system and preferred it to the card system. Experiment 2 results indicated that the condition in which the instructions were clusteredwas more effective for maintaining correct task performance. Implications of the findings were discussed.",0,0 +3752,Family Violence: Clinical Indicators among Military and Post-Military Personnel,"Child and spouse abuse continues to be a critically important problem for the medical and mental health professions. Examined are recent clinical data and research addressing this most serious concern among military and post-military personnel. Criteria useful in the identification of risk persons and diagnosis and treatment of family violence are discussed. Specific attention is given to the diagnostic indicators, the abusing family profile, the traumatic process of abuse, and strategies relevant to psychiatric intervention. Guidelines for military mental health and medical professionals are explored.",0,0 +3753,Psychopathological comorbidities in medication-overuse headache: a multicentre clinical study,"In medication-overuse headache (MOH) patients, the presence of psychopathological disturbances may be a predictor of relapse and poor response to treatment. This multicentre study aimed to assess the occurrence of psychopathological disorders in MOH patients by comparing the incidence of psychopathological disturbances with episodic migraine (EM) patients and healthy controls (HC).The psychopathological assessment of patients and HC involved the administrations of the Beck Depression Inventory, the Beck Anxiety Inventory, the Modified Mini International Neuropsychiatric Interview (M-MINI), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Leeds Dependence Questionnaire.The MOH, EM and HC groups (88, 129 and 102 subjects, respectively) differed significantly from each other for the presence of moderate/severe anxiety, whereas mood disorder and depression were revealed in similar proportions for both MOH and EM patients. By stratifying the M-MINI questionnaire results according to the number of psychiatric disorders, it was found that MOH patients had a more complex profile of psychiatric comorbidity. Furthermore, clinically relevant obsessive-compulsive disturbances for abused drugs assessed by Y-BOCS appeared to be more represented in the MOH group, whilst the prevalence of this trait in the EM group was comparable to that of HC (12.5%, 0.8% and 0%, respectively).Our study indicates the multiple presence of psychopathological comorbidities in patients with MOH. In light of this, it is recommended that the assessment of the psychopathological profile be included in an evaluation of MOH patients, allowing the clinician to more rapidly start an appropriate behavioural treatment, which would greatly improve MOH management.",0,0 +3754,Treatment of Acute Stress Disorder,"Recent trauma survivors with acute stress disorder (ASD) are likely to subsequently develop chronic posttraumatic stress disorder (PTSD). Cognitive behavioral therapy for ASD may prevent PTSD, but trauma survivors may not tolerate exposure-based therapy in the acute phase. There is a need to compare nonexposure therapy techniques with prolonged exposure for ASD.To determine the efficacy of exposure therapy or trauma-focused cognitive restructuring in preventing chronic PTSD relative to a wait-list control group.A randomized controlled trial of civilians who experienced trauma and who met the diagnostic criteria for ASD (N = 90) seen at an outpatient clinic between March 1, 2002, and June 30, 2006.Patients were randomly assigned to receive 5 weekly 90-minute sessions of either imaginal and in vivo exposure (n = 30) or cognitive restructuring (n = 30), or assessment at baseline and after 6 weeks (wait-list group; n = 30).Measures of PTSD at the 6-month follow-up visit by clinical interview and self-report assessments of PTSD, depression, anxiety, and trauma-related cognition.Intent-to-treat analyses indicated that at posttreatment, fewer patients in the exposure group had PTSD than those in the cognitive restructuring or wait-list groups (33% vs 63% vs 77%; P = .002). At follow-up, patients who underwent exposure therapy were more likely to not meet diagnostic criteria for PTSD than those who underwent cognitive restructuring (37% vs 63%; odds ratio, 2.10; 95% confidence interval, 1.12-3.94; P = .05) and to achieve full remission (47% vs 13%; odds ratio, 2.78; 95% confidence interval, 1.14-6.83; P = .005). On assessments of PTSD, depression, and anxiety, exposure resulted in markedly larger effect sizes at posttreatment and follow-up than cognitive restructuring.Exposure-based therapy leads to greater reduction in subsequent PTSD symptoms in patients with ASD when compared with cognitive restructuring. Exposure should be used in early intervention for people who are at high risk for developing PTSD.",0,0 +3755,Prevalence of Depression–PTSD Comorbidity: Implications for Clinical Practice Guidelines and Primary Care-based Interventions,"Compared to those with depression alone, depressed patients with posttraumatic stress disorder (PTSD) experience more severe psychiatric symptomatology and factors that complicate treatment.To estimate PTSD prevalence among depressed military veteran primary care patients and compare demographic/illness characteristics of PTSD screen-positive depressed patients (MDD-PTSD+) to those with depression alone (MDD).Cross-sectional comparison of MDD patients versus MDD-PTSD+ patients.Six hundred seventy-seven randomly sampled depressed patients with at least 1 primary care visit in the previous 12 months. Participants composed the baseline sample of a group randomized trial of collaborative care for depression in 10 VA primary care practices in 5 states.The Patient Health Questionnaire-9 assessed MDD. Probable PTSD was defined as a Primary Care PTSD Screen > or = 3. Regression-based techniques compared MDD and MDD-PTSD+ patients on demographic/illness characteristics.Thirty-six percent of depressed patients screened positive for PTSD. Adjusting for sociodemographic differences and physical illness comorbidity, MDD-PTSD+ patients reported more severe depression (P < .001), lower social support (P < .001), more frequent outpatient health care visits (P < .001), and were more likely to report suicidal ideation (P < .001) than MDD patients. No differences were observed in alcohol consumption, self-reported general health, and physical illness comorbidity.PTSD is more common among depressed primary care patients than previously thought. Comorbid PTSD among depressed patients is associated with increased illness burden, poorer prognosis, and delayed response to depression treatment. Providers should consider recommending psychotherapeutic interventions for depressed patients with PTSD.",0,0 +3756,The Prevalence of Posttraumatic Stress Disorder Among Children and Adolescents Affected by Tsunami Disaster in Tamil Nadu,"The Asian earthquake and subsequent tsunami of December 2004, one of the largest natural disasters in recent history, resulted in the deaths of over 250,000 people and massive destruction in 8 countries. As with any disaster, children are at risk for developing short- and long-term psychological consequences, including posttraumatic stress disorder (PTSD). One area particularly affected by this disaster was southern India. Five hundred twenty-three juvenile survivors of the tsunami were studied to determine the prevalence of PTSD. The survey was conducted in 2 waves. Interviews were conducted by postgraduate psychiatric social work students, proficient in the local language of Tamil and trained in PTSD-related data collection. The Impact of Event Scale-8 items Tamil Version and Child Behaviour Checklist Post-traumatic Stress Disorder-Tamil Revised Version, with age-specific measures and validated for the local culture and language, were used for the study. Our study revealed a prevalence of 70.7% for acute PTSD and 10.9% for delayed onset PTSD. PTSD was more prevalent among girls and more severe among adolescents exposed to loss of life or property. These results indicate that PTSD is widely prevalent among the survivors of the tsunami, reinforcing the need to develop an effective, culturally sensitive outreach therapy strategy for them.",0,0 +3757,"The association of exposure, risk, and resiliency factors with PTSD among Jews and Arabs exposed to repeated acts of terrorism in Israel","Israel has faced ongoing terrorism since the beginning of the Al Aqsa Intifada in September 2000. The authors examined risk and resiliency factors associated with posttraumatic stress disorder (PTSD) among 1,117 Jews and 394 Arab adult citizens of Israel during August and September 2004 through telephone interviews. Probable PTSD was found among 6.6% of Jews and 18.0% of Arabs. Predictors of probable PTSD in a multivariate model for Jews were refusal to report income, being traditionally religious, economic and psychosocial resource loss, greater traumatic growth, and lower social support. For Arabs, predictors were low education and economic resource loss among those exposed to terrorism. Findings for only those directly exposed to terrorism were similar to those for the overall national sample.",0,0 +3758,Symptoms of post‐traumatic stress disorder in couples after birth: association with the couple's relationship and parent–baby bond,"Recent research suggests a proportion of women develop post-traumatic stress disorder (PTSD) after childbirth. To date, the effects of postnatal PTSD on the couple's relationship and the parent-baby bond have not been examined. In the present study, 64 couples completed questionnaires about the birth, symptoms of PTSD, the couple's relationship and parent-baby bond 9 weeks after childbirth. Results showed 5% of men and women had severe symptoms of PTSD. Symptoms were strongly associated within couples and were related to similar birth factors for men and women. PTSD symptoms were associated with neither the parent-baby bond nor couple's relationship. The mother-baby bond was not associated with any variables measured in this study. However, the father-baby bond was associated with the couple's relationship. It is concluded that men and women have comparable levels of PTSD symptoms 9 weeks after birth. Furthermore, these results suggest postnatal symptoms of PTSD have little association with the couple's relationship or the parent-baby bond in the short term. However, further research is needed to address methodological considerations.",0,0 +3759,Cross-Sectional Analysis of Dutch Repatriated Service Members From Southern Afghanistan (2003–2014),"A systematic analysis of the complete medical support organization of the Dutch Armed Forces regarding repatriated service members from Afghanistan has not been performed so far.All information were collated in a specifically designed electronic database and gathered from the archive of the Central Military Hospital for all Dutch service members receiving treatment for wounds or diseases sustained in the Afghan theater from July 2003 till January 2014.Traumatic injuries were the main cause (63%, 141/223) of repatriation, and improvised explosive devices the major (67%, 60/89) mechanism of injury in the battle casualty group. The mean time between injury and medical evacuation from Afghanistan was 8 days, and this was reduced to 3.6 days in case of polytrauma casualties (ISS > 15).Sixty percent of all Dutch medical evacuations from Afghanistan were not directly related to combat operations. A standard medical examination/endurance test in the predeployment phase could be useful as screening tool in reduction of the disease nonbattle injury casualty rate. Shorter transport intervals might improve morbidity and mortality of casualties, a timeframe of 48 to 72 hours for receiving definitive treatment seems feasible. Further research is necessary to identify delay factors and possible improvements in the medical support organization.",0,0 +3760,MMPI scales for diagnosing acute and chronic PTSD in civilians,"To develop new Minnesota Multiphasic Personality Inventory (MMPI) scales for diagnosing acute and chronic posttraumatic stress disorder (PTSD), 237 civilians with PTSD or panic disorder (controls) completed the MMPI-R. All 399 items were submitted to chi-square analysis to select those differentiating acute or chronic PTSD from controls. The analyses yielded an MMPI Acute PTSD scale (32 items) and a MMPI Chronic PTSD scale (41 items). Discriminating between acute PTSD and controls, the MMPI Acute PTSD scale had a hit rate of 83% and the MMPI Chronic PTSD scale produced a hit rate of 75% to 80%. Cross-validation produced similar hit rates. These scales scores were not substantially influenced by gender or types of traumatic events, and only the MMPI Acute PTSD scale seemed to not be sensitive to co-morbidity.",0,0 +3761,Taking care of staff: A comprehensive model of support for paramedics and emergency medical dispatchers.,"Following a brief overview of alternative Employee Assistance Programs (EAPs), this article proposes a comprehensive model of care for emergency service personnel. The pivotal element of the multilayered model is the Peer Support Officer (PSO) component providing early support to ambulance personnel following exposure to potentially traumatic events. After initial recruit training, peer supporters engage in professional supervision and annual psychological first aid education and counseling skill development workshops. The model is embedded within the workforce and is available to personnel for both work-related and personal matters. The success of the EAP relies on collaboration between the employer, professional counselors, and the trained peer support officers as well as extensive education and resilience building for employees. This article proposes that the model outlined offers high-profile, well-trained, and well-supervised peer support officers as an effective alternative to the more common approa...",0,0 +3762,"PTSD symptom increases in Iraq-deployed soldiers: Comparison with nondeployed soldiers and associations with baseline symptoms, deployment experiences, and postdeployment stress","This prospective study examined: (a) the effects of Iraq War deployment versus non-deployment on pre- to postdeployment change in PTSD symptoms and (b) among deployed soldiers, associations of deployment/postdeployment stress exposures and baseline PTSD symptoms with PTSD symptom change. Seven hundred seventy-four U.S. Army soldiers completed self-report measures of stress exposure and PTSD symptom severity before and after Iraq deployment and were compared with 309 soldiers who did not deploy. Deployed soldiers, compared with non-deployed soldiers, reported increased PTSD symptom severity from Time 1 to Time 2. After controlling for baseline symptoms, deployment-related stressors contributed to longitudinal increases in PTSD symptoms. Combat severity was more strongly associated with symptom increases among active duty soldiers with higher baseline PTSD symptoms.",0,0 +3763,Eye movement desensitization and reprocessing in posttraumatic stress disorder: A pilot study using assessment measures,"Spectacular claims have been made regarding the efficacy of eye movement desensitization and reprocessing (EMDR) in the treatment of posttraumatic stress disorder (PTSD), but almost entirely on the basis of patients' reports and without objective criteria. This study reports on the treatment of eight patients with a diagnosis of PTSD who received EMDR treatment over four sessions. Assessment measures included two structured interviews, three self-report inventories, and the electromyogram (EMG). Assessments were conducted pre and posttreatment, and at 3-month follow-up. Despite some residual pathology at posttreatment and follow-up, significant improvements were obtained on all measures and across all PTSD symptom clusters. Compared with other treatments of PTSD, change was achieved in far fewer sessions.",0,0 +3764,"P50 suppression, prepulse inhibition, and startle reactivity in the same patient cohort suffering from posttraumatic stress disorder","Psychophysiological alterations like impaired gating and increased startle have been reported in patients with posttraumatic stress disorder (PTSD). However, findings are inconsistent, and potential relationships to symptomatology remain unclear.The present study investigates two distinct operational measures of gating and startle reactivity within the same patients suffering from PTSD and their relationship to PTSD symptomatology.Prepulse inhibition of the acoustic evoked startle reflex, P50 suppression of auditory event related potentials, and startle reactivity were assessed in three distinct experiments in 27 PTSD patients and compared to 25 healthy control subjects.PTSD patients exhibited impaired P50 suppression and exaggerated startle. Lower P50 suppression was associated with higher levels of general psychopathology. Patients and control subjects did not differ in PPI.Some of the limitations include, that the control group compromised of non-trauma exposure subjects and menstrual cycle in female participants potentially affecting PPI was not controlled.Deficient P50 gating, not related to specific trauma or distinct symptom clusters reflects a robust finding in PTSD patients. In contrast, further research is needed to clarify whether PPI is affected in PTSD.",0,0 +3765,The HPA axis and perinatal depression: a hypothesis,"Episodes of depression and anxiety are as common during pregnancy as postpartum. Some start in pregnancy and resolve postpartum, others are triggered by parturition and some are maintained throughout. In order to determine any biological basis it is important to delineate these different subtypes. During pregnancy, as well as the rise in plasma oestrogen and progesterone there is a very large increase in plasma corticotropin releasing hormone (CRH), and an increase in cortisol. The latter reaches levels found in Cushing's syndrome and major melancholic depression. Levels of all these hormones drop rapidly on parturition. We here suggest that the symptoms of antenatal and postnatal depression may be different, and linked in part with differences in the function of the hypothalamic pituitary adrenal (HPA) axis. There are two subtypes of major depression, melancholic and atypical, with some differences in symptom profile, and these subtypes are associated with opposite changes in the HPA axis. Antenatal depression may be more melancholic and associated with the raised cortisol of pregnancy, whereas postnatal depression may be more atypical, triggered by cortisol withdrawal and associated with reduced cortisol levels. There is evidence that after delivery some women experience mild bipolar II depression, and others experience post traumatic stress disorder. Both of these are associated with atypical depression. It may also be that some women are genetically predisposed to depression of the melancholic type and some to depression of the atypical type. These women may be more or less vulnerable to depression at the different stages of the perinatal period. (",0,0 +3766,Political violence and mental health in Nepal: prospective study,"Background Post-conflict mental health studies in low-income countries have lacked pre-conflict data to evaluate changes in psychiatric morbidity resulting from political violence. Aims This prospective study compares mental health before and after exposure to direct political violence during the People's War in Nepal. Method An adult cohort completed the Beck Depression Inventory and Beck Anxiety Inventory in 2000 prior to conflict violence in their community and in 2007 after the war. Results Of the original 316 participants, 298 (94%) participated in the post-conflict assessment. Depression increased from 30.9 to 40.6%. Anxiety increased from 26.2 to 47.7%. Post-conflict post-traumatic stress disorder (PTSD) was 14.1%. Controlling for ageing, the depression increase was not significant. The anxiety increase showed a dose–response association with conflict exposure when controlling for ageing and daily stressors. No demographic group displayed unique vulnerability or resilience to the effects of conflict exposure. Conclusions Conflict exposure should be considered in the context of other types of psychiatric risk factors. Conflict exposure predicted increases in anxiety whereas socioeconomic factors and non-conflict stressful life events were the major predictors of depression. Research and interventions in postconflict settings therefore should consider differential trajectories for depression v. anxiety and the importance of addressing chronic social problems ranging from poverty to gender and ethnic/caste discrimination.",0,0 +3767,Youth offspring of mothers with posttraumatic stress disorder have altered stress reactivity in response to a laboratory stressor,"Parental Posttraumatic Stress Disorder (PTSD), particularly maternal PTSD, confers risk for stress-related psychopathology among offspring. Altered hypothalamic-pituitary-adrenal (HPA) axis functioning is one mechanism proposed to explain transmission of this intergenerational risk. Investigation of this mechanism has been largely limited to general stress response (e.g., diurnal cortisol), rather than reactivity in response to an acute stressor. We examined cortisol reactivity in response to a laboratory stressor among offspring of mothers with a lifetime diagnosis of PTSD (n=36) and age- and gender- matched control offspring of mothers without PTSD (n=36). Youth (67% girls; mean age=11.4, SD=2.6) participated in a developmentally sensitive laboratory stressor and had salivary cortisol assessed five times (one pre-stress, one immediate post-stress, and three recovery measures, spaced 15min apart). Results were consistent with the hypothesis that offspring of mothers with PTSD would exhibit a dysregulated, blunted cortisol reactivity profile, and control offspring would display the expected adaptive peak in cortisol response to challenge profile. Findings were maintained after controlling for youth traumatic event history, physical anxiety symptoms, and depression, as well as maternal depression. This finding contributes to the existing literature indicating that attenuated HPA axis functioning, inclusive of hyposecretion of cortisol in response to acute stress, is robust among youth of mothers with PTSD. Future research is warranted in elucidating cortisol reactivity as a link between maternal PTSD and stress-related psychopathology vulnerability among offspring.",0,0 +3768,The role of locus of control and coping style in predicting longitudinal PTSD-trajectories after combat exposure,"While longitudinal posttraumatic stress responses are known to be heterogeneous, little is known about predictors of those responses. We investigated if locus of control (LOC) and coping style are associated with long-term PTSD-trajectories after exposure to combat. Six hundred and seventy five Israeli soldiers with or without combat stress reaction (CSR) from the Lebanon war were assessed 1, 2, and 20 years after the war. Combat exposure, LOC, and coping style were then investigated as covariates of the trajectories of resilience, recovery, delayed onset, and chronicity. Symptomatic trajectories in the CSR and the non-CSR group were significantly associated to varying degrees with perceived life threat during combat (ORs: 1.76-2.53), internal LOC (0.77-0.87), emotional coping style (0.28-0.34), and low use of problem-focused coping (2.12-3.11). In conclusion, assessment of LOC and coping can aid prediction of chronic PTSD outcomes of combat exposure.",0,0 +3769,"Relationships between posttraumatic stress disorder (PTSD), dissociation, quality of life, hopelessness, and suicidal ideation among earthquake survivors","Researches have demonstrated that Posttraumatic stress disorder (PTSD) is one of the most common stress reactions in the face of disasters and significantly associated with a broad range of trauma-induced sequelaes including anxiety, depression, suicidality as well as functional impairments. To date, though many aspects of risk factors with respect to the development and maintenance of PTSD have been addressed, mediating role of dissociation has received relatively less attention. In the present study, we examined relations of PTSD with quality of life, hopelessness, suicidal ideation, and mediational effect of pathological dissociation in these connections. 583 subjects most of whom experienced a severe earthquake participated in the study after two years of the disaster. We found that being female, being single, earthquake exposure, and having greater suicidal ideation were significant predictors of PTSD symptom severity. Role-Physical, Bodily-Pain, General Health and Role-Emotional subscales of the SF-36 were inversely associated with PTSD symptom severity. Pathological dissociation significantly mediated the substantial associations between predictors and PTSD symptom clusters. Chronic dissociation appears to put trauma exposed individuals in jeopardy of prolonged posttraumatic reactions by mediating the negative influences of risk factors in the face of experienced earthquake.",0,0 +3770,Longitudinal Trajectories of Posttraumatic Stress Disorder Symptoms and Binge Drinking Among Adolescent Girls: The Role of Sexual Victimization,"Many studies have documented associations among sexual victimization (SV), posttraumatic stress disorder (PTSD) symptoms, and alcohol use; however, few have examined these associations longitudinally among adolescents. The present study evaluated the effect of SV on the longitudinal trajectory of PTSD symptoms and binge drinking (BD) among adolescent girls, a population known to have high rates of SV and alcohol use.Participants (N = 1,808 at wave 1) completed interviews regarding PTSD symptoms, BD, and SV experiences over approximately 3 years.Multilevel modeling revealed decreases in PTSD symptoms over the course of the study; however, compared with nonvictims, adolescents who were sexually victimized reported greater PTSD symptoms at wave 1 and maintained higher levels of PTSD symptoms over the course of the study after controlling for age. SV reported during the study also predicted an acute increase in PTSD symptoms at that occasion. BD increased significantly over the course of the study; however, SV did not predict initial BD or increases over time. SV reported during the study was associated with acute increases in BD at that occasion, although this effect diminished when participants reporting substance-involved rape were excluded.SV was associated with immediate and long-lasting elevations in PTSD symptoms, but not with initial or lasting elevations in BD over time, suggesting that adolescent victims have yet to develop problematic patterns of alcohol use to cope with SV. However, SV was associated with acute increases in PTSD symptoms and BD, suggesting a need for BD interventions to reduce alcohol-related SV.",0,0 +3771,Predictors of Suicidal Ideation in a Gender-Stratified Sample of OEF/OIF Veterans,"There is a growing concern about suicide among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans. We examined the role of postdeployment mental health in associations between deployment stressors and postdeployment suicidal ideation (SI) in a national sample of 2,321 female and male OEF/OIF veterans. Data were obtained via survey, and path analysis was used. For women and men, mental health symptoms largely accounted for associations between deployment stressors and SI; however, they only partly accounted for the sexual harassment and SI association among women. These findings enhance the understanding of the mental health profile of OEF/OIF veterans.",0,0 +3772,Prevalence and correlates of respiratory and non-respiratory panic attacks in the general population,"Panic attacks are heterogeneous with regards to symptom profile. Subtypes of panic attacks have been proposed, of which the most investigated is respiratory panic attacks (RPA). Limited information exists about RPA in the general population.The prevalence and correlates of RPA and non-respiratory panic attacks (NRPA) were examined in a subsample (n=8.796) of individuals participating in a cross-sectional survey of the adult general population of six European countries. Panic attacks, mental disorders, and chronic physical conditions were assessed with the Composite International Diagnostic Interview (CIDI) 3.0. Data on use of health services and disability were obtained.The lifetime prevalence of RPA was 6.77 and the 12-month prevalence was 2.26. No robust associations of RPA with sociodemographic characteristics, mental disorders or physical conditions were found as compared to NRPA. RPA were associated with increased use of health services but similar disability in comparison to NRPA.Few direct data are available on the validity of the CIDI to assess RPA. Other definitions of RPA exist in the literature.Our findings suggest that there are very few differences between RPA and NRPA and do not support the need of subtyping panic attacks in current classification systems.",0,0 +3773,Expression profiling associates blood and brain glucocorticoid receptor signaling with trauma-related individual differences in both sexes,"Significance Because posttraumatic stress disorder (PTSD) occurs in a subset of trauma-exposed persons, expression profiling in the context of an animal model that focuses on individual differences in stress response permits identification of the relevant signaling pathways that lead to sustained impairment or resilience. The inclusion of blood and brain samples from both sexes is important because it allows the detection of convergent susceptibility pathways and concomitant identification of blood-based biomarkers. The across tissue and sex involvement of glucocorticoid receptor signaling with exposure-related individual differences suggests that targeting this signaling pathway may lead to a promising therapeutic strategy in PTSD.",0,0 +3774,Heart rate measured in the acute aftermath of trauma can predict post-traumatic stress disorder: A prospective study in motor vehicle accident survivors,"To determine whether increased physiological arousal immediately after trauma or at emergency admission can predict post-traumatic stress disorder (PTSD) in motor vehicle accident (MVA) survivors with physical injuries.We included 119 MVA survivors with physical injuries. In this prospective cohort study, heart rate (HR) and blood pressure (BP) were assessed during ambulance transport (T1) and at hospital admission (T2). One and four months after the accident, we assessed patients for PTSD (Davidson trauma scale, confirmed with the structured clinical interview for DSM-IV axis I disorders). Multivariate logistic regression models assessed the relationship between HR or BP and PTSD.PTSD was diagnosed in 54 (45.4%) patients at 1 month and in 39 (32.8%) at 4 months. In the multivariate analysis, HR at T1 or at T2 predicted PTSD at 1 month (OR=1.156, 95% CI [1.094;1.221] p<0.0001). Only HR at T1 (not at T2) predicted PTSD at 4 months (OR=1.059, 95% CI [1.013; 1.108] p=0.012). Injury severity predicted PTSD at 4 months (OR=1.207, 95% CI [1.085; 1.342] p=0.001). A cut-off of 84 beats per minute yielded a sensitivity of 62.5% and a specificity of 75.0% for PTSD.HR measured at the scene of MVA and severity of injury predicted PTSD 4 months later.",0,0 +3775,Psychometric properties of the Impact of Event Scale—Revised,"This study investigated the psychometric properties of the Impact of Event Scale -- Revised (IES-R) in two samples of male Vietnam veterans: a treatment-seeking sample with a confirmed posttraumatic stress disorder (PTSD) diagnosis (N = 120) and a community sample with varying levels of traumatic stress symptomatolgy (N = 154). The scale showed high internal consistency (alpha = 0.96). Confirmatory factor analysis did not provide support for a three-factor solution corresponding to the three subscales of intrusion, avoidance, and hyperarousal. Exploratory factor analysis suggested that either a single, or a two-factor solution (intrusion/hyperarousal and avoidance), provide the best account of date. However, correlations among the subscales were higher in the community sample than in the treatment sample, suggesting that the IES-R may be sensitive to a more general construct of traumatic stress in those with lower symptom levels. The correlation between the IES-R and the PTSD Checklist was high (0.84) and a cutoff of 1.5 (equivalent to a total score of 33) was found to provide the best diagnostic accuracy.",0,0 +3776,Resource Loss as a Predictor of Posttrauma Symptoms Among College Women Following the Mass Shooting at Virginia Tech,"We examined risk factors for posttrauma symptomatology, 2 and 6 months following the April 2007 mass shooting at Virginia Tech. Using a conservation of resources framework and a Web-based survey methodology, we prospectively evaluated the relations among preshooting distress, social support, resource loss, and posttrauma symptomatology in a sample of 293 female students enrolled at the university at the time of the shootings. Structural equation modeling supported that preshooting social support and distress predicted resource loss postshooting. Resource loss predicted symptomatology 2 months and 6 months after the shooting. Implications of the results for research and intervention following mass trauma are discussed. © 2009 Springer Publishing Company.",0,0 +3777,Prevalence of post-traumatic stress disorder among patients with substance use disorder: it is higher than clinicians think it is,"This study had three objectives. Firstly, the prevalence of post-traumatic stress disorder (PTSD) and trauma exposure was compared between individuals with and without substance use disorder (SUD). Secondly, we compared self-rating of PTSD and clinical judgement. Thirdly, an analysis of the characteristics of SUD/PTSD patients was performed.The sample consisted of 423 patients with SUD and 206 healthy controls. All individuals were screened on PTSD using the self-rating inventory for PTSD.Significantly higher numbers of PTSD and trauma exposure were found in the SUD group (resp. 36.6 and 97.4%). PTSD went frequently unnoticed when relying on clinical judgement alone. Patients with SUD/PTSD were significantly more often unemployed and had a lower educational level. Axis I comorbidity and especially depressive disorders were more common in the SUD/PTSD group.It is concluded that patients with SUD/PTSD are a substantial and vulnerable subgroup in addiction treatment facilities and that a systematic screening for PTSD is required.",0,0 +3778,Anxiety sensitivity in traumatized Cambodian refugees: A discriminant function and factor analytic investigation,"We examined the psychometric properties and factor structure of a Cambodian translation of the Anxiety Sensitivity Index (ASI) and an Augmented ASI (the ASI supplemented with a 9-item addendum that assesses additional Cambodian concerns about anxiety-related sensations). Both the ASI and the Augmented ASI distinguished among three diagnostic groups: highest score, PTSD with panic disorder (PP group); next, panic disorder without PTSD (P group); and then, other disorders than PTSD or panic disorder (O group). In the discriminant function analysis using the Augmented ASI, the best classificatory predictor (PP vs. P vs. O) was an Addendum item (""It scares me when I stand up and feel dizzy""). The principal component analysis (oblimin rotation) of the ASI yielded a 3-factor solution (I, Weak Heart Concerns; II, Control Concerns; III, Social Concerns) and of the Augmented ASI, a 4-factor solution (I, Weak Heart Concerns; II, Control Concerns; III, Wind Attack Concerns; IV, Social Concerns). The item clustering within the factor solution of both the ASI and Augmented ASI illustrates the role of cultural syndromes in generating fear of mental and bodily events.",0,0 +3779,Longitudinal Assessment of Mental Health Problems Among Active and Reserve Component Soldiers Returning From the Iraq War,"To promote early identification of mental health problems among combat veterans, the Department of Defense initiated population-wide screening at 2 time points, immediately on return from deployment and 3 to 6 months later. A previous article focusing only on the initial screening is likely to have underestimated the mental health burden.To measure the mental health needs among soldiers returning from Iraq and the association of screening with mental health care utilization.Population-based, longitudinal descriptive study of the initial large cohort of 88 235 US soldiers returning from Iraq who completed both a Post-Deployment Health Assessment (PDHA) and a Post-Deployment Health Re-Assessment (PDHRA) with a median of 6 months between the 2 assessments.Screening positive for posttraumatic stress disorder (PTSD), major depression, alcohol misuse, or other mental health problems; referral and use of mental health services.Soldiers reported more mental health concerns and were referred at significantly higher rates from the PDHRA than from the PDHA. Based on the combined screening, clinicians identified 20.3% of active and 42.4% of reserve component soldiers as requiring mental health treatment. Concerns about interpersonal conflict increased 4-fold. Soldiers frequently reported alcohol concerns, yet very few were referred to alcohol treatment. Most soldiers who used mental health services had not been referred, even though the majority accessed care within 30 days following the screening. Although soldiers were much more likely to report PTSD symptoms on the PDHRA than on the PDHA, 49% to 59% of those who had PTSD symptoms identified on the PDHA improved by the time they took the PDHRA. There was no direct relationship of referral or treatment with symptom improvement.Rescreening soldiers several months after their return from Iraq identified a large cohort missed on initial screening. The large clinical burden recently reported among veterans presenting to Veterans Affairs facilities seems to exist within months of returning home, highlighting the need to enhance military mental health care during this period. Increased relationship problems underscore shortcomings in services for family members. Reserve component soldiers who had returned to civilian status were referred at higher rates on the PDHRA, which could reflect their concerns about their ongoing health coverage. Lack of confidentiality may deter soldiers with alcohol problems from accessing treatment. In the context of an overburdened system of care, the effectiveness of population mental health screening was difficult to ascertain.",0,0 +3780,"NEUROPHYSIOLOGICALLY-BASED MEAN-FIELD MODELLING OF TONIC CORTICAL ACTIVITY IN POST-TRAUMATIC STRESS DISORDER (PTSD), SCHIZOPHRENIA, FIRST EPISODE SCHIZOPHRENIA AND ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)","A recently developed quantitative model of cortical activity is used that permits data comparison with experiment using a quantitative and standardized means. The model incorporates properties of neurophysiology including axonal transmission delays, synaptodendritic rates, range-dependent connectivities, excitatory and inhibitory neural populations, and intrathalamic, intracortical, corticocortical and corticothalamic pathways. This study tests the ability of the model to determine unique physiological properties in a number of different data sets varying in mean age and pathology. The model is used to fit individual electroencephalographic (EEG) spectra from post-traumatic stress disorder (PTSD), schizophrenia, first episode schizophrenia (FESz), attention deficit hyperactivity disorder (ADHD), and their age/sex matched controls. The results demonstrate that the model is able to distinguish each group in terms of a unique cluster of abnormal parameter deviations. The abnormal physiology inferred from these parameters is also consistent with known theoretical and experimental findings from each disorder. The model is also found to be sensitive to the effects of medication in the schizophrenia and FESz group, further supporting the validity of the model.",0,0 +3781,Posttraumatic Stress Disorder: Memory and Learning Performance in Children and Adolescents,"Despite the wealth of information in adult posttraumatic stress disorder (PTSD) literature, few studies have explored the memory and learning performance of trauma-exposed youth. This study examined if memory deficits are associated with PTSD or with trauma exposure in the absence of PTSD.Youth exposed to traumatic incidents underwent clinical interviews to diagnose PTSD and exclude major comorbid disorders. Youth with conditions that could impede performance on a memory scale (e.g., limited intellectual functioning, current substance abuse, psychopharmacological treatment) were excluded. Three groups of participants were identified (PTSD positives [n = 29], traumatized PTSD negatives [n = 62], and nontraumatized control subjects [n = 40]). Participants completed the Wide Range Assessment of Memory and Learning (WRAML).Youth with PTSD evidenced significantly lower scores on the WRAML General Memory, Verbal Memory, and Learning indices compared with nontraumatized control subjects. With the exception of Verbal Memory, youth with and without PTSD performed comparably on all other indices. Nonsignificant differences were noted on the Visual Memory Index.General memory and verbal memory impairments as evidenced in adult populations were observed among this sample of youth. Given the developmental trajectory of memory capabilities, the implications of such early trauma exposure and memory deficits are considered.",0,0 +3782,Resource conservation as a strategy for community psychology,"Conservation of resources (COR) theory (Hobfoll, 1988, 1989) was applied to social intervention and research. COR theory depicts resource loss as disproportionately weighted in comparison to resource gain. COR theory further posits that to prevent resource loss or establish resources, other resources must be invested. Resources contribute to further resource gain, whereas lack of resources contributes to ongoing resource loss. Consequently, people, groups, or organizations that are endowed with strong personal or social resource reserves should better resist the deleterious effects of stress and withstand everyday challenges. One of the basic principles of the theory—that loss is disproportionately weighted compared to gain—was tested in two samples and strongly supported. Implications of the model for intervention were discussed.",0,0 +3783,"Traumatic bereavement, acute dissociation, and posttraumatic stress: 14 years after the MSEstoniadisaster",en,0,0 +3784,Overview and Clinical Presentation of Generalized Anxiety Disorder,"1. To distinguish GAD from panic disorder is not difficult if a patient has frequent, spontaneous panic attacks and agoraphobic symptoms, but many patients with GAD have occasional anxiety attacks or panic attacks. Such patients should be considered as having GAD. An even closer overlap probably exists between GAD and social phobia. Patients with clear-cut phobic avoidant behavior may be distinguished easily from patients with GAD, but patients with social anxiety without clear-cut phobic avoidant behavior may overlap with patients with GAD and possibly should be diagnosed as having GAD and not social phobia. The cardinal symptoms of GAD commonly overlap with those of social phobia, particularly if the social phobia is more general and not focused on a phobic situation. For example, free-floating anxiety may cause the hands to perspire and may cause a person to be shy in dealing with people in public, and thus many patients with subthreshold social phobic symptoms have, in the authors' opinion, GAD and not generalized social phobia. The distinction between GAD and obsessive-compulsive disorder, acute stress disorder, and posttraumatic stress disorder should not be difficult by definition. At times, however, it may be difficult to distinguish between adjustment disorder with anxious mood from GAD or anxiety not otherwise specified, particularly if the adjustment disorder occurs in a patient with a high level of neuroticism or trait anxiety or type C personality disorder. Table 2 presents features distinguishing GAD from other psychiatric disorders. 2. Lifetime comorbid diagnoses of other anxiety or depression disorders, not active for 1 year or more and not necessitating treatment during that time period, should not effect a diagnosis of current GAD. On the other hand, if concomitant depressive symptoms are present and if these are subthreshold, a diagnosis of GAD should be made, and if these are full threshold, a diagnosis of MDD should be made. 3. If GAD is primary and if no such current comorbid diagnosis, such as other anxiety disorders or MDD, is present, except for minor depression and dysthymia, or if only subthreshold symptoms of other anxiety disorders are present, GAD should be considered primary and treated as GAD; however, patients with concurrent threshold anxiety or mood disorders should be diagnosed according to the definitions of these disorders in the DSM-IV and ICD-10 and treated as such. 4. Somatization disorders are now classified separately from anxiety disorders. Some of these, particularly undifferentiated somatization disorder, may overlap with GAD and be diagnostically difficult to distinguish. The authors believe that, as long as psychic symptoms of anxiety are present and predominant, patients should be given a primary diagnosis of GAD. 5. Two major shifts in the DSM diagnostic criteria for GAD have markedly redefined the definition of this disorder. One shift involves the duration criterion from 1 to 6 months, and the other, the increased emphasis on worry and secondary psychic [table: see text] symptoms accompanied by the elimination of most somatic symptoms. This decision has had the consequence of orphaning a large population of patients suffering from GAD that is more transient and somatic in its focus and who typically present not to psychiatrists but to primary care physicians. Therefore, clinicians should consider using the ICD-10 qualification of illness duration of ""several months"" to replace the more rigid DSM-IV criterion of 6 months and to move away from the DSM-IV focus on excessive worry as the cardinal symptom of anxiety and demote it to only another important anxiety symptom, similar to free-floating anxiety. One also might consider supplementing this ICD-10 criterion with an increased symptom severity criterion as, for example, a Hamilton Anxiety Scale of 18. Finally, the adjective excessive, not used in the definition of other primary diagnostic criteria, such as depressed mood for MDD, should be omitted (Table 3). 6. One may want to consider the distinction of trait (chronic) from state (acute) anxiety, but whether the presence of some personality characteristics, particularly anxious personality or Cluster C personality and increased neuroticism, as an indicator of trait [table: see text] anxiety is a prerequisite for anxiety disorders; occurs independently of anxiety disorders; or is a vulnerability factor that, in some patients, leads to anxiety symptoms and, in others, does not, is unknown. 7. Symptoms that some clinicians consider cardinal for a diagnosis of GAD, such as extreme worry, obsessive rumination, and somatization, also are present in other disorders, such as MDD. (ABSTRACT TRUNCATED)",0,0 +3785,When the Foundations of Life have been Upset…. An Integrated Clinical and Experimental Study with Refugees and Asylum Seekers,"Aim of the study Recent research results in clinical psychology, health psychology and neurobiology underline the relationship between dissociative states, complex posttraumatic syndromes and borderline functioning . Our study is meant to investigate the traumatic hypothesis of borderline functioning and to develop appropriate psychotherapeutic measures based on artistic mediations. Subject or material and methods We undertook an integrated clinical and experimental study with a sample of 73 refugees and asylum seekers. In a second stage, those who suffered from PTSD or complex post-traumatic states were offered to attend arts psychotherapeutic sessions.. We combined a semi-structured biographical interview, a projective test, i.e. the Sentences Completion Test , for which we developed a new manner of interpretation , and psychometric scales, i.e. the HADS and the Index of Wellbeing . Furthermore, we analysed the artistic production with the help of original rating scales . Results With the help of non parametric multidimensional statistics, we extracted two profiles of personality functioning, linked either to repeated breaks, negligence and maltreatment from the beginning of life, or either to a recent external catastrophe, interrupting a continuous life course. Through the evaluation of the arts therapeutic sessions, we could note the first signs of resumption of the blocked process of subjectivation. Discussion The results of the study support the traumatogenic hypothesis of borderline functioning, as well as current clinical considerations concerning the defensive role of dissociation in complex posttraumatic states. Conclusions The study opens tracks for future research concerning an in depth investigation of the arts therapeutic process with traumatized people.",0,0 +3786,Psychometric Evaluation of the Moral Injury Events Scale,"Literature describing the phenomenology of the stress of combat suggests that war-zone experiences may lead to adverse psychological outcomes such as post-traumatic stress disorder not only because they expose persons to life threat and loss but also because they may contradict deeply held moral and ethical beliefs and expectations. We sought to develop and validate a measure of potentially morally injurious events as a necessary step toward studying moral injury as a possible adverse consequence of combat. We administered an 11-item, self-report Moral Injury Events Scale to active duty Marines 1 week and 3 months following war-zone deployment. Two items were eliminated because of low item-total correlations. The remaining 9 items were subjected to an exploratory factor analysis, which revealed two latent factors that we labeled perceived transgressions and perceived betrayals; these were confirmed via confirmatory factor analysis on an independent sample. The overall Moral Injury Events Scale and its two subscales had favorable internal validity, and comparisons between the 1-week and 3-month data suggested good temporal stability. Initial discriminant and concurrent validity were also established. Future research directions were discussed.",0,0 +3787,Voluntary exercise does not ameliorate context memory and hyperarousal in a mouse model for post-traumatic stress disorder (PTSD),"We investigated the effects of voluntary wheel running as model for intervention on the development of contextual fear and hyperarousal in a mouse model of post-traumatic stress disorder (PTSD). Physical exercise in general has been associated with improved hippocampus-dependent memory performance both in animals and humans. However, studies that have tried to link physical exercise and contextual conditioning in an animal model of PTSD, revealed mixed findings.Here we tested contextual fear conditioning, generalized fear response, acoustic startle response and emotionality in C57BL/6NCrl mice which had free access to a running wheel for 28 days, compared with control animals which did not run and mice which did not receive a shock during the conditioning phase.We found no significant effects of voluntary running on the above-mentioned variables, except for enhanced anxiety levels in the Dark-Light-Box and O-Maze tests of running mice.Our results suggest that running as a model for intervention does not ameliorate contextual aversive learning but has the potency to change emotional behaviours.",0,0 +3788,A Study of Posttraumatic Stress and Growth in Tsunami Relief Volunteers,"Twenty female relief volunteers who had participated in the post-tsunami relief operations in the coastal areas of Tamil Nadu, India, under the aegis of nongovernmental organizations and charitable trusts were assessed for posttraumatic stress, posttraumatic growth, and dissociative experiences. They also responded to a set of questions in order to determine the direction (upward-downward) of their counterfactual thoughts. The observed data were subjected to a multivariate analysis of variance and multiple discriminant analysis to identify the key underlying dimensions. The main effects of amnesia, depersonalization, percentage of dissociation, and family type were highly significant. Discriminant coefficients suggested the importance of relating to others and proactive coping. They also suggested the importance of intrusion, avoidance, and appreciation of life.",0,0 +3789,The prevalence of lifetime and partial post-traumatic stress disorder in Vietnam theater veterans,,0,0 +3790,‘Comparisons of traumatic and positive memories in people with and without PTSD profile’,"According to most post-traumatic stress disorder (PTSD) theories, memory mechanisms are involved in its development and maintenance. However, the specific memory characteristics responsible for this disorder are still not well known. In the present study, 210 participants having reported at least one traumatic experience were assigned to a PTSD or to a non-PTSD symptom profile group. Both groups rated their memories for their most traumatic and intense positive life events. We observed that the traumatic memories of PTSD profile participants were more clear, detailed and judged as significant compared with those of the non-PTSD profile group. However, participants in the first group acknowledged having more difficulties putting their traumatic memories into words and controlling these remembrances. These differences were absent in their positive memories. Additionally, clear relationships emerged between memory ratings and PTSD symptoms measures. Results are discussed according to fragmentation and superiority views of traumatic memories in PTSD. Copyright © 2006 John Wiley & Sons, Ltd. Language: en",0,0 +3791,Trajectory of Traumatic Stress Symptoms in the Aftermath of Extreme Natural Disaster,"This study investigated the trajectory of traumatic stress symptoms in the aftermath of the 2004 Southeast Asian earthquake-tsunami. A total of 265 adult Thai survivors were assessed at 2 weeks and 6 months following the earthquake-tsunami. The percentages of survivors reporting traumatic stress symptoms were 22% at 2 weeks and 30% at 6 months postdisaster. Four trajectories of traumatic stress symptoms were identified: 12% of survivors presented with chronic stress symptoms, 18% had a delayed onset, 10% showed improvement, and the remaining 60% maintained a stable emotional equilibrium. Among survivors, the chronic group was the oldest, the delayed group reported the lowest level of perceived government support, and the resilient group experienced the fewest postdisaster psychiatric symptoms. Results pointed to the need to broaden the conceptualization of postdisaster stress responding as well as to establish disaster psychiatry and related mental health activities in the region.",0,0 +3792,"A Diathesis-Stress Model of Posttraumatic Stress Disorder: Ecological, Biological, and Residual Stress Pathways","The symptoms captured within the contemporary diagnostic definition of posttraumatic stress disorder (PTSD) have been studied for more than 100 years. Yet, even with increasingly advanced discoveries regarding the etiology of PTSD, a comprehensive and up-to-date etiological model that incorporates both medical and psychological research has not been described and systematically studied. The diathesis-stress model proposed here consolidates existing medical and psychological research data on etiological factors associated with PTSD into 3 causal pathways: residual stress, ecological, and biological. In combination, these pathways illuminate how PTSD might develop and who might be at higher risk for developing the disorder. Research and treatment implications related to the diathesis-stress model are discussed.",0,0 +3793,Critically Evaluating Typologies of Internet Sex Offenders: A Psychological Perspective,"Understanding why indecent images of children are produced and collected involves issues beyond the legal definition of child pornography. An over-emphasis on a legal approach will not necessarily assist in the development of preventative and control strategies. This article provides a brief overview of the way in which the Internet can be misused for sexual gratification and has identified some of the issues that seem to be significant in understanding the nature and dimensions of Internet sexual offending. The main descriptive typologies that underpin research relating to Internet child sex offenders have been reviewed and critically evaluated. As discussed throughout this article, one of the most challenging issues continues to be the difficulty in placing Internet sex offenders into categories. The foregoing discussion indicates that Internet sex offenders comprise a heterogeneous population and that there appears to be a lack of a coherent and agreed framework for defining their activity.",0,0 +3794,Randomized Controlled Trial of Group Cognitive Behavioural Therapy for Post-Traumatic Stress Disorder in Children and Adolescents Exposed to Tsunami in Thailand,"Background: Post-traumatic stress disorder (PTSD) is a common and debilitating consequence of natural disaster in children and adolescents. Accumulating data show that cognitive behavioural therapy (CBT) is an effective treatment for PTSD. However, application of CBT in a large-scale disaster in a setting with limited resources, such as when the tsunami hit several Asian countries in 2004, poses a major problem. Aims: This randomized controlled trial aimed to test for the efficacy of the modified version of CBT for children and adolescents with PSTD. Method: Thirty-six children (aged 10–15 years) who had been diagnosed with PSTD 4 years after the tsunami were randomly allocated to either CBT or wait list. CBT was delivered in 3-day, 2-hour-daily, group format followed by 1-month posttreatment self-monitoring and daily homework. Results: Compared to the wait list, participants who received CBT demonstrated significantly greater improvement in symptoms of PTSD at 1-month follow-up, although no significant improvement was observed when the measures were done immediately posttreatment. Conclusions: Brief, group CBT is an effective treatment for PTSD in children and adolescents when delivered in conjunction with posttreatment self-monitoring and daily homework.",0,0 +3795,"Prevalence of War-Related Mental Health Conditions and Association With Displacement Status in Postwar Jaffna District, Sri Lanka","Nearly 2.7 million individuals worldwide are internally displaced (seeking refuge in secure areas of their own country) annually by armed conflict. Although the psychological impact of war has been well documented, less is known about the mental health symptoms of forced displacement among internally displaced persons.To estimate the prevalence of the most common war-related mental health conditions, symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression, and to assess the association between displacement status and these conditions in postwar Jaffna District, Sri Lanka.Between July and September 2009, a cross-sectional multistage cluster sample survey was conducted among 1517 Jaffna District households including 2 internally displaced persons camps. The response rate was 92% (1448 respondents, 1409 eligible respondents). Two percent of participants (n = 80) were currently displaced, 29.5% (n = 539) were recently resettled, and 68.5% (n = 790) were long-term residents. Bivariable analyses followed by multivariable logistic regression models were performed to determine the association between displacement status and mental health.Symptom criteria of PTSD, anxiety, and depression as measured by the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist-25.The overall prevalences of symptoms of PTSD, anxiety, and depression were 7.0% (95% confidence interval [CI], 5.1%-9.7%), 32.6% (95% CI, 28.5%-36.9%), and 22.2% (95% CI, 18.2%-26.5%), respectively. Currently displaced participants were more likely to report symptoms of PTSD (odds ratio [OR], 2.71; 95% CI, 1.28-5.73), anxiety (OR, 2.91; 95% CI, 1.89-4.48), and depression (OR, 4.55; 95% CI, 2.47-8.39) compared with long-term residents. Recently resettled residents were more likely to report symptoms of PTSD (OR, 1.96; 95% CI, 1.11-3.47) compared with long-term residents. However, displacement was no longer associated with mental health symptoms after controlling for trauma exposure.Among residents of Jaffna District in Sri Lanka, prevalence of symptoms of war-related mental health conditions was substantial and significantly associated with displacement status and underlying trauma exposure.",0,0 +3796,Posttraumatic growth and posttraumatic distress: A longitudinal study.,"This longitudinal study examined the course and bidirectional relation between posttraumatic distress and posttraumatic growth (PTG). A sample of Israeli ex-prisoners of war and matched controls were followed over 17 years. Participants’ posttraumatic stress disorder (PTSD), depression, and anxiety symptoms were measured at three time-points. PTG was assessed twice. Applying an autoregressive cross-lagged modeling strategy, initial PTSD predicted subsequent PTG above and beyond PTG stability, but not vice versa. Cross-lagged relations of PTG to depression and anxiety were not significant. Moreover, analysis of PTG trajectory revealed that individuals with PTSD reported higher PTG levels across times than those without PTSD. Thus, growth is facilitated and maintained by endorsement rather than absence of PTSD. The findings are discussed in the context of the illusionary versus adaptive notion of PTG.",0,0 +3797,Post-traumatic stress disorder and illness perceptions over time following myocardial infarction and subarachnoid haemorrhage,"This study investigated post-traumatic stress disorder (PTSD) symptoms and illness perceptions in people who suffered the acute medical trauma of a myocardial infarction (MI) or a subarachnoid haemorrhage (SAH). The study tested hypotheses regarding changes in PTSD symptoms and illness perceptions over time, associations between PTSD and illness perceptions and cognitive predictors of PTSD.The study employed a longitudinal design and measured the illness perceptions and PTSD symptoms of an MI group (N=17) and a SAH group (N=27). Data were collected within 2 weeks of admission (T1), 6 weeks after admission (T2) and 3 months after admission (T3). Statistical analysis was undertaken to examine associations between illness perceptions and PTSD and to examine cognitive predictors of PTSD.The prevalence of PTSD within the total acute medical trauma sample was 16% at 2 weeks, 35% at 6 weeks and 16% at 3 months. Illness perception factors of identity, timeline (acute/chronic), consequences and emotional representation were strongly correlated with PTSD at all three time points. PTSD symptoms and illness perceptions were shown to have changed over time. The results also showed that several illness perception factors are significant predictors of PTSD.Both PTSD symptoms and illness perceptions changed significantly over time following an MI or SAH. Illness perception factors are significant predictors of PTSD.",0,0 +3798,Mental Health Services Required after Disasters: Learning from the Lasting Effects of Disasters,"Disasters test civil administrations' and health services' capacity to act in a flexible but well-coordinated manner because each disaster is unique and poses unusual challenges. The health services required differ markedly according to the nature of the disaster and the geographical spread of those affected. Epidemiology has shown that services need to be equipped to deal with major depressive disorder and grief, not just posttraumatic stress disorder, and not only for victims of the disaster itself but also the emergency service workers. The challenge is for specialist advisers to respect and understand the existing health care and support networks of those affected while also recognizing their limitations. In the initial aftermath of these events, a great deal of effort goes into the development of early support systems but the longer term needs of these populations are often underestimated. These services need to be structured, taking into account the pre-existing psychiatric morbidity within the community. Disasters are an opportunity for improving services for patients with posttraumatic psychopathology in general but can later be utilized for improving services for victims of more common traumas in modern society, such as accidents and interpersonal violence.",0,0 +3799,State of psychiatry in Denmark,"Danish psychiatry has gone through profound changes over the past two to three decades, reducing inpatient-based treatment and increasing outpatient treatment markedly. The number of patients treated has almost doubled, and the diagnostic profile has broadened, now including a substantial number of common mental disorders, in particular depression and anxiety. Furthermore, 'new' diagnostic groups are represented in the treatment statistics with steeply increasing incidences, e.g. attention deficit hyperactivity disorder (ADHD) and eating disorders, especially in the outpatient part of the statistics. Over the same 30 years, the number of available beds has been reduced by 60-70%; however, as the length of stay of inpatients has been reduced markedly, the departments are still able to treat a high number of patients. The financial budgeting of psychiatry is not increasing equivalently to the somatic specialities, handicapping development in psychiatry. Action has been taken to increase research activity in psychiatry. This is facilitated by an increasing interest among medical students and young graduate physicians attracted by the neuropsychiatric paradigm, rapidly implemented in Danish psychiatry.",0,0 +3800,Has psychiatry tamed the “ketamine tiger?” Considerations on its use for depression and anxiety,"Ketamine has been available for approximately 50 years as an anesthetic agent. It is known to have potent effects on the central nervous system glutamatergic system, in particular blockade of N-methyl-D-aspartate (NMDA) receptors. Based upon pre-clinical evidence of involvement of the glutamatergic system in mood disorders, studies have been undertaken to test the antidepressant properties of ketamine. Several well-controlled studies, along with open-label case series, have established that ketamine can have rapid antidepressant effects. Additionally, data exist showing benefits of ketamine in post-traumatic stress disorder as well as obsessive compulsive disorder. However, improvements in these conditions tend to be short-lived with single infusions of ketamine. Of concern, ketamine has been associated with neurotoxicity in pre-clinical rodent models and is well-known to cause psychotomimetic effects and addiction in humans. While ketamine has been proven safe for use in sub-anesthetic doses administered once or a few times, the safety profile of prolonged use has not been established. Aspects of safety, possible mechanisms of action, and future directions of ketamine research are discussed in addition to the clinical literature on its use in psychiatric conditions.",0,0 +3801,Posttraumatic stress disorder in OEF/OIF veterans with and without traumatic brain injury,"Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) are presenting with high rates of co-occurring posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI). The purpose of this study was to compare the clinical presentations of combat-veterans with PTSD and TBI (N = 40) to those with PTSD only (N = 56). Results suggest that the groups present two distinct clinical profiles, with the PTSD + TBI group endorsing significantly higher PTSD scores, higher overall anxiety, and more functional limitations. The higher PTSD scores found for the PTSD + TBI group appeared to be due to higher symptom intensity, but not higher frequency, across PTSD clusters and symptoms. Groups did not differ on additional psychopathology or self-report of PTSD symptoms or executive functioning. Further analysis indicated PTSD severity, and not TBI, was responsible for group differences, suggesting that treatments implicated for PTSD would likely be effective for this population.",0,0 +3802,Summary of a National Institute of Mental Health workshop: developing animal models of anxiety disorders,"There exists a wide range of animal models and measures designed to assess anxiety or fearfulness. However, the relationship between these models and clinical anxiety symptoms and syndromes is unclear. The National Institute of Mental Health convened a workshop to discuss the relationship between existing behavioral models of anxiety and the clinical profile of anxiety disorders. A second goal of this workshop was to outline various approaches towards modeling components of anxiety disorders.To briefly describe epidemiological and behavioral manifestations of clinical anxiety syndromes and how they relate to commonly employed animal models of anxiety. To describe approaches and considerations for developing, improving, and adapting anxiety models to better understand the neurobiology of anxiety.Clinicians, psychiatrists and clinical and basic neuroscientists presented data exemplifying different approaches towards understanding anxiety and the role of animal models. Panel members outlined what they considered to be critical issues in developing and employing animal models of anxiety.This review summarizes the discussions and conclusions of the workshop including recommendations for improving upon existing models and strategies for developing novel models.The probability of developing comprehensive animal models that accurately reflect the relative influences of factors contributing to anxiety disorder syndromes is quite low. However, ample opportunity remains to better define and extend existing models and behavioral measures related to specific processes that may be disrupted in anxiety disorders and to develop new models that consider the impact of combined factors in determining anxious behaviors.",0,0 +3803,Obsessive-Compulsive Disorder and Posttraumatic Stress Disorder,"<i>Background: </i>Previous studies suggested an association between exposure to trauma or stressful life events and obsessive-compulsive disorder (OCD). This study investigates the hypothesis that traumatic events and posttraumatic stress disorders (PTSD) precede the onset of OCD. <i>Sampling and Methods:</i> 210 cases with OCD from university treatment facilities were compared with 133 sex- and age-matched controls from the adult general population. The data were derived from a German family study on OCD (GENOS). Direct interviews were carried out with the German version of the Schedule for Affective Disorders and Schizophrenia – Lifetime Version for Anxiety Disorders (DSM-IV). <i>Results:</i> Severe traumatization occurred in 6.2% of the OCD cases and in 8.3% of the controls. The lifetime prevalence rates of traumatization, PTSD and acute stress disorder were not different between the subjects with OCD and controls (p > 0.05). In 6 cases, acute stress disorder, subclinical or full PTSD preceded the onset of OCD, in 3 cases the trauma-related disorders and OCD occurred within the same year, in 5 other cases, the trauma-related disorders started after the onset of OCD. <i>Conclusion:</i> There is no significant association of traumatization or PTSD with OCD compared with controls. Given the low rate of trauma-related disorders occurring before (2.9%) or within (1.5%) the same year as the onset of OCD other factors than severe traumatic events determine the onset of OCD in most of the cases.",0,0 +3804,Self-Report of Psychological Function Among OEF/OIF Personnel Who Also Report Combat-Related Concussion,"MMPI-2 RF profiles of 128 U.S. soldiers and veterans with history of concussion were examined. Participants evaluated in forensic (n = 42) and clinical (n = 43) settings showed significantly higher validity and clinical elevations relative to a research group (n = 43). In the full sample, a multivariate GLM identified main effects for disability claim status and Axis I diagnosis across numerous MMPI-2 RF scales. Participants with co-morbid PTSD and concussion showed significant Restructured Clinical and Specific Problem scale elevations relative to those without Axis I diagnosis. Participants with PTSD and active disability claims were especially prone to elevate on FBS/FBS-r and RBS. Implications for neuropsychologists who routinely administer the MMPI-2/RF in the context of combat-related concussion are discussed.",0,0 +3805,Metabolite profiling in posttraumatic stress disorder,"Traumatic stress does not only increase the risk for posttraumatic stress disorder (PTSD), but is also associated with adverse secondary physical health outcomes. Despite increasing efforts, we only begin to understand the underlying biomolecular processes. The hypothesis-free assessment of a wide range of metabolites (termed metabolite profiling) might contribute to the discovery of biological pathways underlying PTSD.Here, we present the results of the first metabolite profiling study in PTSD, which investigated peripheral blood serum samples of 20 PTSD patients and 18 controls. We performed liquid chromatography (LC) coupled to Quadrupole/Time-Of-Flight (QTOF) mass spectrometry. Two complementary statistical approaches were used to identify metabolites associated with PTSD status including univariate analyses and Partial Least Squares Discriminant Analysis (PLS-DA).Thirteen metabolites displayed significant changes in PTSD, including four glycerophospholipids, and one metabolite involved in endocannabinoid signaling. A biomarker panel of 19 metabolites classifies PTSD with 85% accuracy, while classification accuracy from the glycerophospholipid with the highest differentiating ability already reached 82%.This study illustrates the feasibility and utility of metabolite profiling for PTSD and suggests lipid-derived and endocannabinoid signaling as potential biological pathways involved in trauma-associated pathophysiology.",0,0 +3806,Public Health Consequences of Terrorism on Maternal–Child Health in New York City and Madrid,"Past research provides evidence for trajectories of health and wellness among individuals following disasters that follow specific pathways of resilience, resistance, recovery, or continued dysfunction. These individual responses are influenced by event type and pre-event capacities. This study was designed to utilize the trajectories of health model to determine if it translates to population health. We identified terrorist attacks that could potentially impact population health rather than only selected individuals within the areas of the attacks. We chose to examine a time series of population birth outcomes before and after the terrorist events of the New York City (NYC) World Trade Center (WTC) attacks of 2001 and the Madrid, Spain train bombings of 2004 to determine if the events affected maternal-child health of those cities and, if so, for how long. For percentages of low birth weight (LBW) and preterm births, we found no significant effects from the WTC attacks in NYC and transient but significant effects on rates of LBW and preterm births following the bombings in Madrid. We did find a significant positive and sustained effect on infant mortality rate in NYC following the WTC attacks but no similar effect in Madrid. There were no effects on any of the indicator variables in the comparison regions of New York state and the remainder of Spain. Thus, population maternal-health in New York and Madrid showed unique adverse effects after the terrorist attacks in those cities. Short-term effects on LBW and preterm birth rates in Madrid and long-term effects on infant mortality rates in NYC were found when quarterly data were analyzed from 1990 through 2008/2009. These findings raise questions about chronic changes in the population's quality of life following catastrophic terrorist attacks. Public health should be monitored and interventions designed to address chronic stress, environmental, and socioeconomic threats beyond the acute aftermath of events.",0,0 +3807,Latent Trajectories of Trauma Symptoms and Resilience,"To identify trajectories of posttraumatic stress disorder (PTSD) symptoms from before to 2.5 years after deployment and to assess risk factors for symptom fluctuations and late-onset PTSD.743 soldiers deployed to Afghanistan in 2009 were assessed for PTSD symptoms using the PTSD Checklist (PCL) at 6 occasions from predeployment to 2.5 years postdeployment (study sample = 561). Predeployment vulnerabilities and deployment and postdeployment stressors were also assessed.Six trajectories were identified: a resilient trajectory with low symptom levels across all assessments (78.1%) and 5 trajectories showing symptom fluctuations. These included a trajectory of late onset (5.7%), independently predicted by earlier emotional problems (OR = 5.59; 95% CI, 1.57-19.89) and predeployment and postdeployment traumas (OR = 1.10; 95% CI, 1.04-1.17 and OR = 1.13; 95% CI, 1.00-1.26). Two trajectories of symptom fluctuations in the low-to-moderate range (7.5% and 4.1%); a trajectory of symptom relief during deployment, but with a drastic increase at the final assessments (2.0%); and a trajectory with mild symptom increase during deployment followed by relief at return (2.7%) were also found. Symptom fluctuation was predicted independently by predeployment risk factors (depression [OR = 1.27; 95% CI, 1.16-1.39], neuroticism [OR = 1.10; 95% CI, 1.00-1.21], and earlier traumas [OR = 1.09; 95% CI, 1.03-1.16]) and deployment-related stressors (danger/injury exposure [OR = 1.20; 95% CI, 1.04-1.40]), but not by postdeployment stressors.The results confirm earlier findings of stress response heterogeneity following military deployment and highlight the impact of predeployment, perideployment, and postdeployment risk factors in predicting PTSD symptomatology and late-onset PTSD symptoms.",1,0 +3808,"60,000 Disaster Victims Speak: Part II. Summary and Implications of the Disaster Mental Health Research","On the basis of the literature reviewed in Part I of this two-part series (Norris, Friedman, Watson, Byrne, Diaz, and Kaniasty, this volume), the authors recommend early intervention following disasters, especially when the disaster is associated with extreme and widespread damage to property, ongoing financial problems for the stricken community, violence that resulted from human intent, and a high prevalence of trauma in the form of injuries, threat to life, and loss of life. Meeting the mental health needs of children, women, and survivors in developing countries is particularly critical. The family context is central to understanding and meeting those needs. Because of the complexity of disasters and responses to them, inter-agency cooperation and coordination are extremely important elements of the mental health response. Altogether, the research demands that we think ecologically and design and test societal- and community-level interventions for the population at large and conserve scarce clinical resources for those most in need.",0,0 +3809,An examination of PTSD symptoms and relationship functioning in U.S. soldiers of the Iraq War over time,"We examined associations between overall posttraumatic stress disorder (PTSD) symptoms, symptom clusters of PTSD (reexperiencing, avoidance, dysphoria, and arousal), and relationship adjustment cross sectionally and longitudinally using self-report measures from a dyadic sample of U.S. National Guard soldiers from the Iraq war and their intimate partners (N = 49 couples). Results of multilevel modeling revealed that Time 1 PTSD symptom severity significantly predicted lower relationship adjustment as rated by partners at Time 2 after controlling for baseline relationship adjustment (β = −.20, p = .025). Total PTSD symptoms did not significantly predict soldiers' ratings of relationship adjustment at Time 2. For soldiers, the PTSD symptom cluster of dysphoria was uniquely and significantly related to relationship adjustment ratings both at Time 1 and at Time 2, controlling for Time 1 adjustment. For partners, none of the soldiers' PTSD symptoms clusters was uniquely associated with Time 1 relationship adjustment or with change in adjustment over time. In contrast, findings regarding the effect of relationship adjustment on changes in PTSD over time found that Time 1 relationship adjustment was not associated with changes in PTSD symptoms at Time 2.",0,0 +3810,"Exposure to war traumatic experiences, post-traumatic stress disorder and post-traumatic growth among nurses in Gaza","ACCESSIBLE SUMMARY: What is known on the subject? This study builds on existing research on war-related factors that may affect health-care staff by particularly focusing on trauma exposure in both professional and everyday life, as well as on correlates of later positive psychological changes. What this paper adds to existing knowledge? It shows that one in five nursing staff working in Gaza experienced post-traumatic stress symptoms within the clinical range, 2 years after an incursion on Gaza and after being exposed to substantial trauma during this period. Participants appeared to develop a variety of post-traumatic growth responses following trauma exposure. Although nurses experienced traumatic events both as civilians and in their health-care capacity, personal exposure was strongly associated with PTSD symptoms. What are the implications for practice? Support to nursing and other health-care professionals in war situations should entail different levels, remain available well after an acute conflict, and take into consideration both personal and practice-related traumatic events. Mental health nursing practitioners can play a pivotal role in this. ABSTRACT: Aim To establish the association between war traumatic experiences, post-traumatic stress disorder (PTSD) symptoms and post-traumatic growth among nurses in the Gaza Strip, 2 years after an incursion on Gaza, and during a period of ongoing trauma exposure. This study builds on existing evidence by considering exposure to personal and work-related traumatic events, and on factors associated with later positive psychological adaptation. METHODS The sample consisted of 274 randomly selected nurses in Gaza who completed the Gaza Traumatic Events Checklist, PTSD Checklist, and Posttraumatic Growth Inventory. RESULTS Of the nurses, 19.7% reported full PTSD. There was a significant relationship between traumatic events and PTSD scores; as well as between community-related traumatic events and post-traumatic growth. Participants reported a range of traumatic events, but PTSD and post-traumatic growth scores were more strongly associated with community rather than work-related traumas. DISCUSSION Nursing professionals experienced high levels of distress 2 years following an acute period of conflict, both as civilians and in their health-care capacity. Implications for Practice There is need for different levels of support for health-care staff in war-affected areas. Mental health nursing professionals have a central role in training, counselling and support to other health-care colleagues. Language: en",0,0 +3811,Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers,"PurposeWe sought to estimate the pooled current prevalence of posttraumatic stress disorder (PTSD) among rescue workers and to determine the variables implicated in the heterogeneity observed among the prevalences of individual studies.MethodsA systematic review covering studies reporting on the PTSD prevalence in rescue teams was conducted following four sequential steps: (1) research in specialized online databases, (2) review of abstracts and selection of studies, (3) review of reference list, and (4) contact with authors and experts. Prevalence data from all studies were pooled using random effects model. Multivariate meta-regression models were fitted to identify variables related to the prevalences heterogeneity.ResultsA total of 28 studies, reporting on 40 samples with 20,424 rescuers, were selected. The worldwide pooled current prevalence was 10%. Meta-regression modeling in studies carried out in the Asian continent had, on average, higher estimated prevalences than those from Europe, but not higher than the North American estimates. Studies of ambulance personnel also showed higher estimated PTSD prevalence than studies with firefighters and police officers.ConclusionsRescue workers in general have a pooled current prevalence of PTSD that is much higher than that of the general population. Ambulance personnel and rescuers from Asia may be more susceptible to PTSD. These results indicate the need for improving pre-employment strategies to select the most resilient individuals for rescue work, to implement continuous preventive measures for personnel, and to promote educational campaigns about PTSD and its therapeutic possibilities.",0,0 +3812,Gender and Comorbid Psychopathology in Adolescents With Alcohol Dependence,"Although several mental disorders have been shown to be common in adolescents with substance use disorders, prior studies have not specifically focused on alcohol dependence and have not had sufficient sample sizes to examine gender effects. This study contrasts mental disorder diagnoses and symptoms between a sample of adolescents with alcohol dependence and a community control sample of adolescents and incorporates gender analyses.Adolescents (aged 14 years 0 months to 18 years 0 months) with alcohol dependence (females: n = 55; males: n = 78) and community-dwelling control adolescents without substance use disorders (females: n = 44; males: n = 42) were assessed by means of a semistructured interview for DSM-III-R.While cannabis and hallucinogen use disorders were common in the alcohol dependence group, females and males had similar rates. Conduct disorder (CD), oppositional defiant disorder, attention-deficit hyperactivity disorder, major depression (MD), and posttraumatic stress disorder (PTSD) had significantly higher rates in the alcohol dependence than in the community control group. Depression and PTSD symptoms were more strongly associated with alcohol dependence in females than in males. A configural frequency analysis showed that CD and MD tended to occur together in both female and male adolescents with alcohol dependence.While alcohol-dependent females and males similarly exhibited more comorbid disorders than control adolescents, gender affects the relationship of alcohol dependence to MD and PTSD. Rather than reflecting distinct types, the comorbid disorders of CD and MD jointly characterize many adolescents with alcohol dependence.",0,0 +3813,MCMI and 16-PF With Vietnam Veterans: Profiles and Concurrent Validation of MCMI,"The issue of concurrent validation for the Millon Clinical Multiaxial Inventory (MCMI) is addressed. A carefully defined group of Vietnam veterans with posttraumatic stress disorder (PTSD) were identified (n = 60). They were given the MCMI and 16-PF Results showed that the passive—aggressive and avoidant personality styles (8-2) with schizoid and borderline features and symptoms of dysthymia and anxiety were characteristic of Vietnam veterans with PTSD on the MCMI. The 16-PF pattern of this group was one with low stens on Warmth, Emotional Stability, Happy-Go-Lucky, Boldness, Self-Discipline, and Extraversion; and high stens on Suspiciousness, Insecurity, Self-Sufficiency, and Anxiety. When each MCMI scale was inspected separately for correlates of the 16-PF, considerable concurrent validation resulted. Clinicians are encouraged to use these scales for the identification and personologic description of the PTSD disorder with veterans.",0,0 +3814,Neurocircuitry models of posttraumatic stress disorder and beyond: A meta-analysis of functional neuroimaging studies,"Over the past two decades a relatively large number of studies have investigated the functional neuroanatomy of posttraumatic stress disorder (PTSD). However, findings are often inconsistent, thus challenging traditional neurocircuitry models of PTSD. As evidence mounts that cognition and behavior is an emergent property of interacting brain networks, the question arises whether PTSD can be understood by examining dysfunction in large-scale, spatially distributed neural networks. We used the activation likelihood estimation quantitative meta-analytic technique to synthesize findings across functional neuroimaging studies of PTSD that either used a non-trauma (N=20) or trauma-exposed (N=19) comparison control group. In line with neurocircuitry models, our findings support hyperactive amygdala and hypoactive medial prefrontal regions, but suggest hyperactive hippocampi. Characterization of additional regions under a triple network model showed functional alterations that largely overlapped with the salience network, central executive network, and default network. However, heterogeneity was observed within and across the neurocircuitry and triple network models, and between results based on comparisons to non-trauma and trauma-exposed control groups. Nonetheless, these results warrant further exploration of the neurocircuitry and large-scale network models in PTSD using connectivity analyses.",0,0 +3815,Commentary: Developmental Trauma Disorder: A Missed Opportunity in DSM V.,"This is a commentary on the proposal of van der Kolk, et al. (2009) to include the diagnosis of developmental trauma disorder in the DSM V. As is now known, it was not accepted. Importantly, a commentary relating to this must include comments on both diagnosis and trauma in children. We will first comment on general issues of diagnostic systems in child psychiatry and then, if we are to use DSM V, why there should be a separate category for developmental trauma.",0,0 +3816,A psychological profile of Elian Gonzalez.,,0,0 +3817,Trends in mental illness and suicidality after Hurricane Katrina,"A representative sample of 815 pre-hurricane residents of the areas affected by Hurricane Katrina was interviewed 5–8 months after the hurricane and again 1 year later as the Hurricane Katrina Community Advisory Group (CAG). The follow-up survey was carried out to study patterns-correlates of recovery from hurricane-related post-traumatic stress disorder (PTSD), broader anxiety-mood disorders and suicidality. The Trauma Screening Questionnaire screening scale of PTSD and the K6 screening scale of anxiety-mood disorders were used to generate DSM-IV prevalence estimates. Contrary to results in other disaster studies, where post-disaster mental disorder typically decreases with time, prevalence increased significantly in the CAG for PTSD (20.9 vs 14.9% at baseline), serious mental illness (SMI; 14.0 vs 10.9%), suicidal ideation (6.4 vs 2.8%) and suicide plans (2.5 vs 1.0%). The increases in PTSD-SMI were confined to respondents not from the New Orleans Metropolitan Area, while the increases in suicidal ideation-plans occurred both in the New Orleans sub-sample and in the remainder of the sample. Unresolved hurricane-related stresses accounted for large proportions of the inter-temporal increases in SMI (89.2%), PTSD (31.9%) and suicidality (61.6%). Differential hurricane-related stress did not explain the significantly higher increases among respondents from areas other than New Orleans, though, as this stress was both higher initially and decreased less among respondents from the New Orleans Metropolitan Area than from other areas affected by the hurricane. Outcomes were only weakly related to socio-demographic variables, meaning that high prevalence of hurricane-related mental illness remains widely distributed in the population nearly 2 years after the hurricane.",0,0 +3818,Relationship of alexithymia and temperament and character dimensions with lifetime post-traumatic stress disorder in male alcohol-dependent inpatients,"Aims: The purpose of the present study was to evaluate the prevalence of lifetime post-traumatic stress disorder (PTSD) in male alcohol-dependent inpatients and to investigate the relationship of PTSD with alexithymia and temperament and character dimensions. Methods: Participants were 156 consecutively admitted male alcohol-dependent subjects. Patients were investigated using the Clinician-Administered PTSD Scale (CAPS), the Toronto Alexithymia Scale (TAS-20) and the Temperament and Character Inventory (TCI). Results: Among alcohol-dependent inpatients 32.1% were considered as having lifetime PTSD. Mean scores of alexithymia, novelty seeking (NS), harm avoidance (HA) and self-transcendence (ST) were higher in the PTSD group, whereas age and self-directedness (S) were lower. Among age and other factors of TAS-20, ‘difficulty in identifying feelings (DIF)’ predicted PTSD in a logistic regression model. When age and personality dimensions of TCI were taken as independent variables, S predicted PTSD in the logistic regression model. Finally, among subscales of TCI, ‘impulsiveness versus reflection’ (NS2) and ‘congruent second nature versus bad habits’ (S5) predicted PTSD. Conclusions: Alexithymia and personality traits, particularly high DIF and S scores are related with lifetime PTSD diagnosis, even when controlling for age among alcohol-dependent inpatients. Causal relationships between alexithymia, personality dimensions and PTSD, and their implications on treatment are not clear and should be evaluated in longitudinal studies.",0,0 +3819,Association of Posttraumatic Stress Disorder With Increased Prevalence of Metabolic Syndrome,"Few studies have compared prevalence rates of metabolic abnormalities in antipsychotic-treated patients with different psychiatric disorders, including posttraumatic stress disorder (PTSD). In this study, we examined components of metabolic syndrome among middle-aged and older patients with psychiatric disorders.In the study, 203 outpatients older than 40 years and with psychotic symptoms that needed antipsychotic treatment were enrolled. Among them, 65 had a diagnosis of schizophrenia, 56 had dementia, 49 had mood disorder, and 33 had PTSD. Clinical evaluations included medical history, use of psychotropic and other medications, adverse effects, physical examination, and clinical laboratory tests for metabolic profiles.Overall, the prevalence rates of metabolic syndrome were 72% in patients with PTSD, 60% in those with schizophrenia, 58% in those with mood disorder, and 56% in those with dementia. There were significant differences in body mass index, diastolic blood pressure, waist circumference, and high-density lipoprotein cholesterol among the 4 diagnostic groups. Posttraumatic stress disorder, schizophrenia, and mood disorder groups had significantly higher body mass indexes compared with the dementia group. The PTSD group also had significantly higher diastolic blood pressure compared with the dementia and mood disorder groups.Posttraumatic stress disorder may be associated with worsened metabolic profile. The overall frequency of metabolic syndrome and its components in patients with PTSD taking antipsychotics seemed to be at least equivalent, if not slightly worse, compared with that in patients with schizophrenia, dementia, or a mood disorder.",0,0 +3820,Posttraumatic stress predicting depression and social support among college students: Moderating effects of race and gender.,"More than half of the students entering college report a history of potentially traumatic events; however, little is known about the relationship of trauma exposure and posttraumatic stress disorder (PTSD) symptomatology to college students' mental health and access to social support or whether these relationships may show variations as a function of race and gender. The purpose of this study was to explore whether the relationships between PTSD symptoms and both depression and social support were moderated by gender and race. Data were collected from 631 African American (AA) and 299 European American (EA) freshmen students attending 2 universities in the Southeast. The majority of the students (74.3% of the AA and 68.2% of the EA sample) reported lifetime exposure to at least 1 traumatic event. PTSD symptomatology was significantly and positively associated with depression symptoms for all groups (i.e., AA and EA males and females); however, the relationship between these 2 variables was strongest for EA men. Similarly, the relationship between PTSD symptoms on the avoidance cluster and social support was stronger for EA males than other groups; avoidance symptoms did not significantly predict social support for AA men.",0,0 +3821,Burden of Medical Illness in Women With Depression and Posttraumatic Stress Disorder,"Depression and posttraumatic stress disorder (PTSD) are important women's health issues. Depression is known to be associated with poor physical health; however, associations between physical health and PTSD, a common comorbidity of depression, have received less attention.To examine number of medical symptoms and physical health status in women with PTSD across age strata and benchmark them against those of women with depression alone or with neither depression nor PTSD.A random sample of Veterans Health Administration enrollees received a mailed survey in 1999-2000 (response rate, 63%). The 30 865 women respondents were categorized according to whether a health care provider had ever told them that they had PTSD, depression (without PTSD), or neither. Outcomes were self-reported medical conditions and physical health status measured with the Veterans SF-36 instrument, a version of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) modified for use in veteran populations.Across age strata, women with PTSD (n = 4348) had more medical conditions and worse physical health status (physical functioning, role limitations due to physical problems, bodily pain, and energy/vitality scales from the Veterans SF-36) than women with depression alone (n = 7580) or neither (n = 18 937). In age-adjusted analyses, the Physical Component Summary score was on average 3.4 points lower in women with depression alone and 6.3 points lower in women with PTSD than in women with neither (P<.001).Posttraumatic stress disorder is associated with a greater burden of medical illness than is seen with depression alone. The presence of PTSD may account for an important component of the excess medical morbidity and functional status limitations seen in women with depression.",0,0 +3822,Sincerity of effort versus feigned movement control of the cervical spine in patients with whiplash-associated disorders and asymptomatic persons: a case-control study.,"Cross-sectional design.To investigate whether the Fly Test can be used to differentiate patients with whiplash-associated disorders (WAD) from asymptomatic persons who deliberately feign symptoms and from WAD patients exaggerating symptoms.The lack of valid clinical tests makes it difficult to detect a justifiable cause for compensation claims in traumatic neck-pain disorders.The Fly Test recorded the accuracy of neck movements in patients with WAD (n = 34) and asymptomatic persons (n = 31). The participants followed a moving ""Fly"" on a computer screen with a cursor from sensors mounted on the head. Two conditions were tested, sincere versus feigned efforts. In the former, the participants moved their neck as accurately as possible. In the latter, a short text was presented describing a fictitious accident (asymptomatic group) or imagining more intense pain/suffering (WAD group), and the test was performed as affected by these more serious conditions. Amplitude accuracy (AA), time on target (ToT) and jerk index (JI) were compared across patterns, conditions and groups.The sincere effort in the WAD group was significant compared to the feigned effort of the asymptomatic group (p < 0.001). For AA, correct categorization of 81.5% of the performances was made, where a mean score above 5.5 mm differentiated feigned versus sincere efforts in asymptomatic and WAD groups (sensitivity 79.4%, specificity 67.7%). For ToT, score above 11% indicated correctly categorized WAD patients (sensitivity 82.4%, specificity 64.5%).The Fly Test can provide clinicians a clue when patients with mild to moderate pain/disability are feigning or exaggerating symptoms.",0,0 +3823,Demoralization and the longitudinal course of PTSD following Hurricane Mitch,"Background and Objectives: Numerous studies of disasters have used measures of non-specific distress as outcome measures. The utility of these measures as predictive of the long-term outcome of disasters has remained unclear, in particular the relationship with PTSD. This study examines whether demoralization is predictive and a useful concept to examine the long-term outcome of disaster related PTSD. Methods: The 1998 Hurricane Mitch that impacted Honduras was examined two-months (n = 800) and two-years following the disaster in a longitudinal community-based sample of 604 adults. Respondents were selected from a stratified sample in Tegucigalpa based on exposure and social economic status. PTSD diagnosed using the CIDI module at both periods of time. Demoralization was measured using the PERI-D at 2-months post-disaster. Results: The PERI-D, increased demoralization, was significantly associated with PTSD at two-month and two-years. In addition, increased demoralization was associated with increased risk of PTSD chronicity. Decreased demoralization was associated with PTSD remission. New onset PTSD was associated increased demoralization; however, the finding was not appreciated after controlling for potential confounders. Conclusions: Demoralization can be measured using a simple screening questionnaire that may be a useful in identifying individuals who may be at increased risk for PTSD in the short-term, as well as in the long-term following a disaster.",0,0 +3824,The shaping of vulnerability factors including core cognitive beliefs and their subsequent role in posttraumatic stress disorder and general clinical psychopathology,"ABSTRACT The present study examines the role of core beliefs in posttraumatic outcome including the development and maintenance of PTSD and general clinical psychopathology in a non-treatment seeking college-age population. Although trauma and clinical PTSD literatures are replete with references concerning the potential impact that traumatic and/or uncontrollable stressor(s) may have on cognitive schemata and their role in negative posttraumatic adjustment, little empirical research exists that delineates potentially important differences in the nature and quality of core belief systems for which both trauma and PTSD history are controlled. Unique aspects of the present study include: 1) the inclusion of two domains of core belief measures (i.e., early maladaptive schemas via the Schema Questionnaire as proposed by Young (1994) and the three basic personal belief systems as measured by the World Assumptions Scale (WAS) that have been posited by Janoff-Bulman (1985) as centrally related to traumatization experiences; 2) the examination of these broad ranging core belief systems in relation to other factors that have been found or proposed to be significantly related to PTSD development and/or maintenance, including aspects of the traumatic event(s), dissociation, and related areas of clinical symptomatology; and 3) the use of four specific study groups that controlled for both level of traumatization and PTSD symptomatology (no trauma; trauma without past or current PTSD; PTSD in remission; and PTSD current) to enhance conclusions regarding the most potent predictors of PTSD symptomatology by analyzing these factors simultaneously across progressive (i.e., continuous) levels of PTSD symptomatology, as well as between the discrete diagnostic groups. Three main overarching hypotheses were generated in this study, and related to: 1) the detection of general between-group differences between the four study groups on important indices of PTSD se verity, core beliefs, and measures of clinical symptomatology; 2) specific core beliefs that would predict PTSD symptomatology to a equal or greater extent than other important factors that have been related to posttraumatic adjustment, irrespective of depression status; and 3) cognitive specificity of core belief systems between major domains of clinical symptomatology (i.e., anxiety and depression) as well as within specific clinical domains (i.e., within types of anxiety). The results largely supported these hypotheses, where specific subtypes of core beliefs were strongly associated with posttraumatic outcome. In particular, the core belief of vulnerability demonstrated a highly consistent relationship with PTSD severity, as well as all domains of anxiety assessed within the study (i.e., state anxiety, anxiety sensitivity, and worry). This finding is consistent with Beck’s (1967) hypothesis that vulnerability schemata underlie the anxiety disorders. Furthermore, evidence was found both for the specificity of core cognitive beliefs between major domains of…",0,0 +3825,Corrigendum to “The relative efficacy of bona fide psychotherapies for treating post-traumatic stress disorder: A meta-analysis of direct comparisons” [Clinical Psychology Review 28 (2008) 766–75],"Reports an error in ""The relative efficacy of bona fide psychotherapies for treating post-traumatic stress disorder: A meta-analysis of direct comparisons"" by Steven G. Benish, Zac E. Imel and Bruce E. Wampold (Clinical Psychology Review, 2008[Jun], Vol 28[5], 746-758). There are three errors in the original analysis that appear in Table 1: The effect size for all measures should be d=.40 for Foa et al. (1999), while all measures and PTSD measures for Devilly & Spence (1999) should be d=.43 and d=.57, respectively. In the original analysis, data from Resick et al. (1988) was erroneously included in lieu of Resick (2002) including the quotation. The correct effect size for Resick et al. (2002) all measures and PTSD measures should be d=.31 and d=.27, respectively. (The following abstract of the original article appeared in record 2008-05435-003.) Psychotherapy has been found to be an effective treatment of post-traumatic stress disorder (PTSD), but meta-analyses have yielded inconsistent results on relative efficacy of psychotherapies in the treatment of PTSD. The present meta-analysis controlled for potential confounds in previous PTSD meta-analyses by including only bona fide psychotherapies, avoiding categorization of psychotherapy treatments, and using direct comparison studies only. The primary analysis revealed that effect sizes were homogenously distributed around zero for measures of PTSD symptomology, and for all measures of psychological functioning, indicating that there were no differences between psychotherapies. Additionally, the upper bound of the true effect size between PTSD psychotherapies was quite small. The results suggest that despite strong evidence of psychotherapy efficaciousness vis-a-vis no treatment or common factor controls, bona fide psychotherapies produce equivalent benefits for patients with PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +3826,Social Bonds and Posttraumatic Stress Disorder,"Retrospective and prospective studies consistently show that individuals exposed to human-generated traumatic events carry a higher risk of developing Posttraumatic Stress Disorder (PTSD) than those exposed to other kinds of events. These studies also consistently identify perceptions of social support both before and after a traumatic event as an important factor in the determining vulnerability to the development of PTSD. We review the literature on interpersonal traumas, social support and risk for PTSD and integrate findings with recent advances in developmental psychopathology, attachment theory and social neuroscience. We propose and gather evidence for what we term the social ecology of PTSD, a conceptual framework for understanding how both PTSD risk and recovery are highly dependent on social phenomena. We explore clinical implications of this conceptual framework.",0,0 +3827,PTSD Symptoms in Urban Adolescent Girls: Compounded Community Trauma,"To describe the assessments for exposure to violent events and posttraumatic stress disorder (PTSD) symptoms in a population of urban adolescent girls.Seventy-nine urban adolescent girls attending an adolescent medicine clinic were assessed via clinician-assisted self-report measures called the Adolescent Self-Report Trauma Questionnaire. The questionnaire gathered information on demographics, exposure to community and domestic violent events, and PTSD symptoms.The adolescents experienced between 8 and 55 different types of community and domestic violent events, with the mean number of violent events being 28. Hyperarousal cluster symptoms were present in 90%, reexperiencing clusters symptoms in 89%, and avoidance cluster symptoms in 80%, while 67% met symptom criteria for PTSD. Increased number of types of violent events was positively correlated with meeting PTSD criteria (p = .01) and with increased PTSD severity scores (p = .001).These urban adolescent girls have experienced prolonged and repeated exposure to multiple types of community as well as domestic violent events, via multiple modalities of contact, over time. They reported a high percentage of PTSD symptoms across all three symptom clusters. The authors propose the concept of ""compounded community trauma"" and discuss its marked impact on female adolescent development.",0,0 +3828,"Ten-year follow-up study of PTSD diagnosis, symptom severity and psychosocial indices in aging holocaust survivors","We performed a longitudinal study of holocaust survivors with and without post-traumatic stress disorder (PTSD) by assessing symptoms and other measures at two intervals, approximately 10 years apart.The original cohort consisted of 63 community-dwelling subjects, of whom 40 were available for follow-up.There was a general diminution in PTSD symptom severity over time. However, in 10% of the subjects (n=4), new instances of delayed onset PTSD developed between time 1 and time 2. Self-report ratings at both assessments revealed a worsening of trauma-related symptoms over time in persons without PTSD at time 1, but an improvement in those with PTSD at time 1.The findings suggest that a nuanced characterization of PTSD trajectory over time is more reflective of PTSD symptomatology than simple diagnostic status at one time. The possibility of delayed onset trajectory complicates any simplistic overall trajectory summarizing the longitudinal course of PTSD.",0,0 +3829,Quantitative electroencephalogram (qEEG) in combat veterans with post-traumatic stress disorder (PTSD),"Only a small number of studies have used quantitative electroencephalography (qEEG) in research of the post-traumatic stress disorder (PTSD). The results are not consistent. The aim of the present investigation was to compare qEEG in combat veterans with and without PTSD. The hypothesis is that differences among qEEG characteristics will be found regarding the presence/absence of PTSD. Seventy-nine combat veterans with PTSD comprised the experimental group and 37 veterans without PTSD were included as controls. After the informed consent, they were investigated by the resting EEG recordings. The results demonstrate that PTSD veterans had decreased alpha power and increased beta power. These results suggest an altered neurobiology in PTSD. Various explanations have been offered for alpha activity decrease observed in PTSD veterans. Increased beta rhythm may play a role as a potential marker in differentiating subtypes of PTSD.",0,0 +3830,Research on psychedelics moves into the mainstream,"The backlash against the recreational use of psychedelic drugs in the 1960s had a negative effect on research into their potential therapeutic benefit. But now attitudes are changing and work in this area is being revitalised, with several early-stage trials underway. Kelly Morris reports.",0,0 +3831,Open Trial of Interpersonal Psychotherapy for Chronic Post Traumatic Stress Disorder,"Objective: The aim of this study was to investigate the feasibility of adapting group-based interpersonal psychotherapy (IPT-G) for patients with chronic post traumatic stress disorder (PTSD). Methods: Thirteen subjects with DSM-IV-defined PTSD, with symptom duration greater than 12 months, entered the study, an 8-week treatment programme conducted in a clinical setting using IPT-G modified for the treatment of PTSD. Data obtained were analysed qualitatively and quantitatively. Results: All 13 subjects completed the treatment programme and showed significant improvement in social functioning, general wellbeing and depressive symptoms. Treatment completers demonstrated a moderate reduction in the avoidant symptom cluster of PTSD. These improvements appeared stable at 3-month follow-up. Benefits appeared to be associated with perceived intra-therapy progress in resolving identified IPT problem areas. Qualitative analysis found that themes of ‘reconnection’ and ‘interpersonal efficacy’ were core parts of the experience of the treatment. Conclusion: IPT-G modified for PTSD appears to be of modest symptomatic benefit, but may lead to improvement in social functioning, general psychological wellbeing and enhanced interpersonal functioning. Further studies are indicated.",0,0 +3832,Influence of childhood adversity on health among male UK military personnel,"Background Exposure to childhood adversity may explain why only a minority of combatants exposed to trauma develop psychological problems. Aims To examine the association between self-reported childhood vulnerability and later health outcomes in a large randomly selected male military cohort. Method Data are derived from the first stage of a cohort study comparing Iraq veterans and non-deployed UK military personnel. We describe data collected by questionnaire from males in the regular UK armed forces ( n =7937). Results Pre-enlistment vulnerability is associated with being single, of lower rank, having low educational attainment and serving in the Army. Pre-enlistment vulnerability is associated with a variety of negative health outcomes. Two main factors emerge as important predictors of ill health: a ‘family relationships’ factor reflecting the home environment and an ‘externalising behaviour’ factor reflecting behavioural disturbance. Conclusions Pre-enlistment vulnerability is an important individual risk factor for ill health in military men. Awareness of such factors is important in understanding post-combat psychiatric disorder.",0,0 +3833,Polyvictimization: Latent profiles and mental health outcomes in a clinical sample of adolescents.,"Exposure to multiple traumatic events (polyvictimization) is a reliable predictor of deleterious health outcomes and risk behaviors in adolescence. The current study extends the literature on the prevalence and consequences of adolescent trauma exposure by (a) empirically identifying and characterizing trauma exposure profiles in a large, ethnically diverse, multi-site, clinical sample of adolescents, and (b) evaluating relations among identified profiles with demographic characteristics and clinical correlates.Data from the National Child Traumatic Stress Network Core Data Set were used to identify and characterize victimization profiles using latent class analysis in a sample of 3,485 adolescents (ages 13-18, 63% female, 35.7% White, 23.2% Black/African American, 35.0% Hispanic/Latino). Multiple measures of psychological distress and risk behaviors were evaluated as covariates of trauma exposure classes.Five trauma exposure classes, or profiles, were identified. Four classes-representing approximately half the sample-were characterized by polyvictimization. Polyvictimization classes were differentiated on number of trauma types, whether emotional abuse occurred, and whether emotional abuse occurred over single or multiple developmental epochs. Unique relations with demographic characteristics and mental health outcomes were observed.Results suggest polyvictimization is not a unidimensional phenomenon but a diverse set of trauma exposure experiences with unique correlates among youth. Further research on prevention of polyvictimization and mechanisms linking chronic trauma exposure, gender, and ethnicity to negative outcomes is warranted.",0,0 +3834,"Repeated administration of AC-5216, a ligand for the 18kDa translocator protein, improves behavioral deficits in a mouse model of post-traumatic stress disorder","Post-traumatic stress disorder (PTSD) is a severely disabling anxiety disorder that may occur following exposure to a serious traumatic event. It is a psychiatric condition that can afflict anyone who has experienced a life-threatening or violent event. Previous studies have shown that changes in 18 kDa translocator protein (TSPO) expression (or function), a promising target for treating neurological disorders without benzodiazepine-like side effects, may correlate with PTSD. However, few studies have investigated the anti-PTSD effects of TSPO ligands. AC-5216, a ligand for TSPO, induces anxiolytic- and anti-depressant-like effects in animal models. The present study aimed to determine whether AC-5216 ameliorates PTSD behavior in mice. Following the training session consisting of exposure to inescapable electric foot shocks, animals were administered AC-5216 daily during the behavioral assessments, i.e., situational reminders (SRs), the open field (OF) test, the elevated plus-maze (EPM) test, and the staircase test (ST). The results indicated that exposure to foot shocks induced long-term behavioral deficiencies in the mice, including freezing and anxiety-like behavior, which were significantly ameliorated by repeated treatment with AC-5216 but without any effect on spontaneous locomotor activity or body weight. In summary, this study demonstrated the anti-PTSD effects of AC-5216 treatment, suggesting that TSPO may represent a therapeutic target for anti-PTSD drug discovery and that TSPO ligands may be a promising new class of drugs for the future treatment of PTSD.",0,0 +3835,Long-term dynamic-oriented group psychotherapy of posttraumatic stress disorder in war veterans: prospective study of five-year treatment.,"To assess the effectiveness of the long-term group psychotherapy in the treatment of posttraumatic stress disorder (PTSD) in war veterans on the basis of clinical picture of PTSD, associated neurotic symptoms, and adopted models of psychological defense mechanisms.Prospective cohort study involved 59 war veterans who participated in dynamic-oriented supportive group psychotherapy for five years. The groups met once a week for 90 minutes. Forty-two veterans finished the program. The Clinician-Administered PTSD Scale structured interview was used to assess the intensity of PTSD. Crown-Crisp Index was used to evaluate other neurotic symptoms, and Life Style Questionnaire was used to assess the defense mechanisms. The assessments were done at the beginning of psychotherapy, after the second, and after the fifth year of treatment. Comorbid diagnoses, hospitalizations, and outpatient clinic treatments were also recorded.Long-term group psychotherapy reduced the intensity of PTSD symptoms in our patients (the difference between Clinician-Administered PTSD Scale score at the beginning and the end of treatment, F=9.103, P=0.001). Other neurotic symptoms and the characteristic profile of defense mechanisms did not change significantly during the course of treatment. Predominant defense mechanisms were projection (M=82.0-/+14.4) and displacement (M=69.0-/+16.8). None of the symptoms or defense mechanisms present at the beginning of the treatment changed significantly after two or five years of treatment. The number of diagnosed major depressive episodes, which increased after the second year of psychotherapy, decreased by the end of treatment.Psychotherapy can reduce the intensity of PTSD symptoms, but the changes in the personality of veterans with PTSD are deeply rooted. Traumatic experiences lead to the formation of rigid defense mechanisms, which cannot be significantly changed by long-term group psychotherapy.",0,0 +3836,Mental Health Symptoms Following War and Repression in Eastern Afghanistan,"Decades of armed conflict, suppression, and displacement resulted in a high prevalence of mental health symptoms throughout Afghanistan. Its Eastern province of Nangarhar is part of the region that originated the Taliban movement. This may have had a distinct impact on the living circumstances and mental health condition of the province's population.To determine the rate of exposure to traumatic events; estimate prevalence rates of symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety; identify resources used for emotional support and risk factors for mental health symptoms; and assess the present coverage of basic needs in Nangarhar province, Afghanistan.A cross-sectional multicluster sample survey of 1011 respondents aged 15 years or older, conducted in Nangarhar province during January and March 2003; 362 households were represented with a mean of 2.8 respondents per household (72% participation rate).Posttraumatic stress disorder symptoms and traumatic events using the Harvard Trauma Questionnaire; depression and general anxiety symptoms using the Hopkins Symptom Checklist; and resources for emotional support through a locally informed questionnaire.During the past 10 years, 432 respondents (43.7%) experienced between 8 and 10 traumatic events; 141 respondents (14.1%) experienced 11 or more. High rates of symptoms of depression were reported by 391 respondents (38.5%); anxiety, 524 (51.8%); and PTSD, 207 (20.4%). Symptoms were more prevalent in women than in men (depression: odds ratio [OR], 7.3 [95% confidence interval [CI], 5.4-9.8]; anxiety: OR, 12.8 [95% CI, 9.0-18.1]; PTSD: OR, 5.8 [95% CI, 3.8-8.9]). Higher rates of symptoms were associated with higher numbers of traumas experienced. The main resources for emotional support were religion and family. Medical care was reported to be insufficient by 228 respondents (22.6%).In this survey of inhabitants of Nangarhar province, Afghanistan, prevalence rates of having experienced multiple traumatic events and having symptoms of anxiety, depression, and PTSD were high. These findings suggest that mental health symptoms in this region should be addressed at the population and primary health care level.",0,0 +3837,Decreased Cerebrospinal Fluid Allopregnanolone Levels in Women with Posttraumatic Stress Disorder,"Alterations in the gamma-amino-butyric acid (GABA) neurotransmitter system have been identified in some populations with posttraumatic stress disorder (PTSD).To further investigate factors of relevance to GABAergic neurotransmission in PTSD, we measured cerebrospinal fluid (CSF) levels of allopregnanolone and pregnanolone combined (ALLO: congeners that potently and positively modulate effects of GABA at the GABA(A) receptor), 5alpha-dihydroprogesterone (5alpha-DHP: the immediate precursor for allopregnanolone), dehydroepiandrosterone (DHEA: a negative modulator of GABA(A) receptor function), and progesterone with gas chromatography, mass spectrometry in premenopausal women with (n = 9) and without (n = 10) PTSD. Subjects were free of psychotropic medications, alcohol, and illicit drugs; all were in the follicular phase of the menstrual cycle except three healthy and four PTSD subjects receiving oral contraceptives.There were no group differences in progesterone, 5alpha-DHP, or DHEA levels. The PTSD group ALLO levels were < 39% of healthy group levels. The ALLO/DHEA ratio correlated negatively with PTSD re-experiencing symptoms (n = -.82, p < 008; trend) and with Profile of Mood State depression/dejection scores (n = -0.70, p < 0008).Low CSF ALLO levels in premenopausal women with PTSD might contribute to an imbalance in inhibitory versus excitatory neurotransmission, resulting in increased PTSD re-experiencing and depressive symptoms.",0,0 +3838,A longitudinal study of the role of cortisol in posttraumatic stress disorder symptom clusters,"Research examining the role of cortisol in posttraumatic stress disorder (PTSD) has largely been cross-sectional studies and few studies have examined cortisol in relation to specific symptom clusters. Examining cortisol in relation to specific PTSD symptom clusters could aid in identifying candidates for symptom-specific treatments. Hence, cortisol was examined in relation to specific PTSD symptom clusters including reexperiencing, avoidance, numbing, and hyperarousal symptoms.A repeated-measures longitudinal design was utilized to predict PTSD symptom clusters.Mothers of children (N = 27) diagnosed with cancer completed a measure of PTSD, and they provided salivary cortisol samples at the time of their child's diagnosis as well as monthly for the following 12 months.Multi-level modeling analyses revealed that higher cortisol levels were significantly related to higher levels of numbing symptoms. Although numbing symptoms declined as cortisol levels declined across 12 months postcancer diagnosis, mothers with higher cortisol levels still reported more numbing symptoms. Reexperiencing, avoidance, and hyperarousal symptoms were not found to be related to cortisol level across time.The findings offer support for the role of cortisol in the manifestation of numbing symptoms. Further research is recommended with other trauma groups to maximize generalizations.",0,0 +3839,Counselling for post-traumatic stress disorder,"Post-traumatic stress disorder - definition, presentation and assessment a cognitive-behavioural conceptualization of post-traumatic stress disorder an overview of cognitive-behavioural counselling for PTSD/ counselling for acute PTSD - illustrative cases counselling for chronic PTSD - illustrative cases counselling for PTSD from prolonged duress (PDSD) - illustrative cases counselling for concurrent anxiety and depression counselling for concurrent irritability counselling for PTSD - service delivery.",0,0 +3840,Re-examination of the Controversial Coexistence of Traumatic Brain Injury and Posttraumatic Stress Disorder: Misdiagnosis and Self-Report Measures,"The coexistence of traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) remains a controversial issue in the literature. To address this controversy, we focused primarily on the civilian-related literature of TBI and PTSD. Some investigators have argued that individuals who had been rendered unconscious or suffered amnesia due to a TBI are unable to develop PTSD because they would be unable to consciously experience the symptoms of fear, helplessness, and horror associated with the development of PTSD. Other investigators have reported that individuals who sustain TBI, regardless of its severity, can develop PTSD even in the context of prolonged unconsciousness. A careful review of the methodologies employed in these studies reveals that investigators who relied on clinical interviews of TBI patients to diagnose PTSD found little or no evidence of PTSD. In contrast, investigators who relied on PTSD questionnaires to diagnose PTSD found considerable evidence of PTSD. Further analysis revealed that many of the TBI patients who were initially diagnosed with PTSD according to self-report questionnaires did not meet the diagnostic criteria for PTSD upon completion of a clinical interview. In particular, patients with severe TBI were often misdiagnosed with PTSD. A number of investigators found that many of the severe TBI patients failed to follow the questionnaire instructions and erroneously endorsed PTSD symptoms because of their cognitive difficulties. Because PTSD questionnaires are not designed to discriminate between PTSD and TBI symptoms or determine whether a patient's responses are accurate or exaggerated, studies that rely on self-report questionnaires to evaluate PTSD in TBI patients are at risk of misdiagnosing PTSD. Further research should evaluate the degree to which misdiagnosis of PTSD occurs in individuals who have sustained mild TBI.",0,0 +3841,Resilience after 9/11: Multimodal neuroimaging evidence for stress-related change in the healthy adult brain,"Exposure to psychological trauma is common and predicts long-term physical and mental health problems, even in those who initially appear resilient. Here, we used multimodal neuroimaging in healthy adults who were at different distances from the World Trade Center on 9/11/01 to examine the neural mechanisms that may underlie this association. More than 3 years after 9/11/01, adults with closer proximity to the disaster had lower gray matter volume in amygdala, hippocampus, insula, anterior cingulate, and medial prefrontal cortex, with control for age, gender, and total gray matter volume. Further analysis showed a nonlinear (first-order quadratic) association between total number of traumas in lifetime and amygdala gray matter volume and function in the whole group. Post hoc analysis of subgroups with higher versus lower levels of lifetime trauma exposure revealed systematic associations between amygdala gray matter volume, amygdala functional reactivity, and anxiety that suggest a nonlinear trajectory in the neural response to accumulated trauma in healthy adults.",0,0 +3842,Acute and Chronic Posttraumatic Stress Disorder in Motor Vehicle Accident Victims,"This study reports the rates of acute and chronic posttraumatic stress disorder (PTSD) in a suburban community study group of 122 victims of serious motor vehicle accidents and a comparison group of 42 (who had been involved in minor, non-motor-vehicle accidents) followed over 12 months.Motor vehicle accident victims were systematically recruited and examined with comparison subjects at 1, 3, 6, 9, and 12 months after the accident. The authors used the Structured Clinical Interview for DSM-III-R to assess DSM-III-R axis I disorders including PTSD.One month after the accident, 34.4% of the motor vehicle accident victims met criteria for PTSD (versus 2.4% of the comparison subjects). Similarly, at 3 and 6 months, rates of PTSD were higher (25.2% and 18.2%) in the motor vehicle accident victims than in the comparison group. Female victims were 4.64 times more likely than male victims to have PTSD at 1 month. Victims with a history of PTSD were 8.02 times more likely at 1 month and 6.81 times more likely at 3 months to have PTSD than those without a history of PTSD. Having an axis II disorder increased the risk for PTSD at 6 months. After adjustment for a history of PTSD and potentially confounding variables, women were 4.39 times more likely than men to develop PTSD at 1 month but did not have a higher risk for chronic PTSD; at 6 months, those with an axis II disorder were at greater risk of PTSD.Rates of PTSD are high in victims of serious motor vehicle accidents and remain high 9 months later. Female victims have an increased risk of acute but not chronic PTSD. Individuals with a history of PTSD are at risk of acute and chronic PTSD. An axis II disorder increases the risk for chronic but not acute PTSD.",0,0 +3843,Early Trajectory of Psychiatric Symptoms after Traumatic Brain Injury: Relationship to Patient and Injury Characteristics,"Psychiatric disturbance is common and disabling after traumatic brain injury (TBI). Few studies have investigated the trajectory of psychiatric symptoms in the first 6 months postinjury, when monitoring and early treatment might prevent persistent difficulties. The aim of this study was to examine the trajectory of psychiatric symptoms 1-6 months post-TBI, the patient/injury characteristics associated with changes, and characteristics predictive of persisting symptoms. A secondary analysis was performed on data from a clinical trial with three data collection points. Across eight centers, 872 participants with complicated mild to severe TBI were administered the Brief Symptom Inventory (BSI) at 30, 90, and 180 days postinjury. Mixed-effects models were used to assess longitudinal changes in the BSI Global Severity Index (GSI). Multi-variate logistic regression was used to assess predictors of clinically significant GSI elevations persisting to 6 months post-TBI. In general, GSI scores improved over time. Women improved faster than men; race/ethnicity was also significantly associated with rate of change, with Hispanics showing the most and African Americans the least improvement. Clinically significant psychiatric symptoms (caseness) occurred in 42% of the sample at 6 months, and more than one type of symptom was common. Significant predictors of caseness included African American race, age from 30 to 60 years, longer post-traumatic amnesia (PTA) duration, pre-TBI unemployment, and pre-TBI risky alcohol use. Findings indicate that psychiatric symptoms are common in the first 6 months post-TBI and frequently extend beyond the depression and anxiety symptoms that may be most commonly screened. Patients with longer PTA and preinjury alcohol misuse may need more intensive monitoring for symptom persistence.",0,0 +3844,Symptom structure of PTSD following breast cancer,"Identification of posttraumatic stress disorder (PTSD) symptoms and diagnoses in survivors of cancer is a growing area of research, but no published data exist regarding the symptom structure of PTSD in survivors of malignant disease. Findings from investigations of the PTSD symptom structure in other trauma populations have been inconsistent and have not been concordant with the re-experiencing, avoidance/numbing, and arousal symptom clusters specified in DSM-IV. The present study employed confirmatory factor analysis to evaluate the extent to which the implied second-order factor structure of PTSD was replicated in a sample of 142 breast cancer survivors. PTSD symptoms were measured using the PTSD Checklist--Civilian Version (PCL-C). Fit indices reflected a moderate fit of the symptom structure implied by the DSM-IV. These findings provide some tentative support for the DSM-IV clustering of PTSD symptoms and for the validity of cancer-related PTSD.",0,0 +3845,Reformulating PTSD forDSM-V: Life after Criterion A,"The diagnosis of posttraumatic stress disorder has been criticized on numerous grounds, but principally for three reasons (a) the alleged pathologizing of normal events, (b) the inadequacy of Criterion A, and (c) symptom overlap with other disorders. The authors review these problems along with arguments why the diagnosis is nevertheless worth retaining in an amended form. A proposal for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) is put forward that involves abolishing Criterion A, narrowing the B criteria to focus on the core phenomena of flashbacks and nightmares, and narrowing the C and D criteria to reduce overlap with other disorders. The potential advantages and disadvantages of this formulation are discussed.",0,0 +3846,Diagnostic and clinical profiles of treatment-seeking men with and without substance use disorders.,"This study compared treatment-seeking men with and without a history of substance use disorders (SUD), both lifetime and current, on diagnostic and clinical variables in order to elucidate their clinical profile. Analyses revealed that men with a history of SUD were more likely meet criteria for a cluster B personality disorder, particularly borderline and antisocial personality disorder, and for anxiety disorders, particularly posttraumatic stress disorder (PTSD). Men with lifetime and current SUD reported a significantly higher frequency of hospitalizations and had lower scores on global functioning. Despite the high prevalence of SUD in this sample, depressive and anxiety disorders were the leading reasons for treatment seeking in this large outpatient psychiatric clinic. Implications of the observed diagnostic and clinical correlates of lifetime SUD among treatment-seeking men are discussed. © 2010 American Psychological Association.",0,0 +3847,The structure of Pavlovian fear conditioning in the amygdala,"Do different brains forming a specific memory allocate the same groups of neurons to encode it? One way to test this question is to map neurons encoding the same memory and quantitatively compare their locations across individual brains. In a previous study, we used this strategy to uncover a common topography of neurons in the dorsolateral amygdala (LAd) that expressed a learning-induced and plasticity-related kinase (p42/44 mitogen-activated protein kinase; pMAPK), following auditory Pavlovian fear conditioning. In this series of experiments, we extend our initial findings to ask to what extent this functional topography depends upon intrinsic neuronal structure. We first showed that the majority (87 %) of pMAPK expression in the lateral amygdala was restricted to principal-type neurons. Next, we verified a neuroanatomical reference point for amygdala alignment using in vivo magnetic resonance imaging and in vitro morphometrics. We then determined that the topography of neurons encoding auditory fear conditioning was not exclusively governed by principal neuron cytoarchitecture. These data suggest that functional patterning of neurons undergoing plasticity in the amygdala following Pavlovian fear conditioning is specific to memory formation itself. Further, the spatial allocation of activated neurons in the LAd was specific to cued (auditory), but not contextual, fear conditioning. Spatial analyses conducted at another coronal plane revealed another spatial map unique to fear conditioning, providing additional evidence that the functional topography of fear memory storing cells in the LAd is non-random and stable. Overall, these data provide evidence for a spatial organizing principle governing the functional allocation of fear memory in the amygdala. (",0,0 +3848,Relationships between psychopathological and demographic variables and posttraumatic growth among Holocaust survivors.,"The relationship between posttraumatic growth and posttraumatic stress disorder (PTSD) symptoms, depression, anxiety, and vulnerability, as well as demographic differences in growth was examined in a group of 23 Holocaust survivors. The posttraumatic growth aspect of spiritual change was found to correlate positively and significantly with the PTSD symptom clusters of intrusion, avoidance, and hyperarousal. Numerous demographic variables were also found to relate to posttraumatic growth including survivors' age during the Holocaust; the nature of their Holocaust experiences; and whether they were ever alone, without family, during their Holocaust experiences as well as survivor support group membership.",0,0 +3849,Meta-analysis of dropout in treatments for posttraumatic stress disorder.,"Many patients drop out of treatments for posttraumatic stress disorder (PTSD); some clinicians believe that trauma-focused treatments increase dropout.We conducted a meta-analysis of dropout among active treatments in clinical trials for PTSD (42 studies; 17 direct comparisons).The average dropout rate was 18%, but it varied significantly across studies. Group modality and greater number of sessions, but not trauma focus, predicted increased dropout. When the meta-analysis was restricted to direct comparisons of active treatments, there were no differences in dropout. Differences in trauma focus between treatments in the same study did not predict dropout. However, trauma-focused treatments resulted in higher dropout compared with present-centered therapy (PCT), a treatment originally designed as a control but now listed as a research-supported intervention for PTSD.Dropout varies between active interventions for PTSD across studies, but variability is primarily driven by differences between studies. There do not appear to be systematic differences across active interventions when they are directly compared in the same study. The degree of clinical attention placed on the traumatic event does not appear to be a primary cause of dropout from active treatments. However, comparisons of PCT may be an exception to this general pattern, perhaps because of a restriction of variability in trauma focus among comparisons of active treatments. More research is needed comparing trauma-focused interventions to trauma-avoidant treatments such as PCT.",0,0 +3850,Mismatch of posttraumatic stress disorder (PTSD) symptoms andDSM-IV symptom clusters in a cancer sample: Exploratory factor analysis of the PTSD Checklist-Civilian Version,"The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994a) conceptualization of posttraumatic stress disorder (PTSD) includes three symptom clusters: reexperiencing, avoidance/numbing, and arousal. The PTSD Checklist-Civilian Version (PCL-C) corresponds to the DSM-IV PTSD symptoms. In the current study, we conducted exploratory factor analysis (EFA) of the PCL-C with two aims: (a) to examine whether the PCL-C evidenced the three-factor solution implied by the DSM-IV symptom clusters, and (b) to identify a factor solution for the PCL-C in a cancer sample. Women (N = 148) with Stage II or III breast cancer completed the PCL-C after completion of cancer treatment. We extracted two-, three-, four-, and five-factor solutions using EFA. Our data did not support the DSM-IV PTSD symptom clusters. Instead, EFA identified a four-factor solution including reexperiencing, avoidance, numbing, and arousal factors. Four symptom items, which may be confounded with illness and cancer treatment-related symptoms, exhibited poor factor loadings. Using these symptom items in cancer samples may lead to overdiagnosis of PTSD and inflated rates of PTSD symptoms.",0,0 +3851,"Symptoms of Posttraumatic Stress Disorder in Parents of Transplant Recipients: Incidence, Severity, and Related Factors","Objective. To examine the incidence, severity, and factors related to posttraumatic stress disorder (PTSD) symptoms in parents of pediatric solid organ transplant recipients. Method. A total of 170 caregivers of pediatric transplant recipients completed self-report measures of psychological functioning between 10 and 38 months after their child’s most recent transplant. Demographic data, child health variables, and ratings of medical attitudes and social functioning were also collected to help explain individual differences in psychological functioning. Results. Although caregivers of pediatric transplant recipients did not report elevated levels of depression or anxiety, they did report elevated levels of PTSD symptoms. Multiple regression analyses revealed that PTSD symptoms were most strongly associated with parent reports of child health, family impact of the transplant, and attitudes toward medical caregivers. Conclusions. PTSD seems to be relatively common in parents of pediatric transplant recipients and may be largely the result of how parents perceive and interpret the transplant experience.",0,0 +3852,The Evolution of Post-Traumatic Stress Disorder following Moderate-to-Severe Traumatic Brain Injury,"Increasing evidence indicates that post-traumatic stress disorder (PTSD) may develop following traumatic brain injury (TBI), despite most patients having no conscious memory of their accident. This prospective study examined the frequency, timing of onset, symptom profile, and trajectory of PTSD and its psychiatric comorbidities during the first 4 years following moderate-to-severe TBI. Participants were 85 individuals (78.8% male) with moderate or severe TBI recruited following admission to acute rehabilitation between 2005 and 2010. Using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Disorders (SCID-I), participants were evaluated for pre- and post-injury PTSD soon after injury and reassessed at 6 months, 12 months, 2 years, 3 years, and 4 years post-injury. Over the first 4 years post-injury, 17.6% developed injury-related PTSD, none of whom had PTSD prior to injury. PTSD onset peaked between 6 and 12 months post-injury. The majority of PTSD cases (66.7%) had a delayed-onset, which for a third was preceded by subsyndromal symptoms in the first 6 months post-injury. PTSD frequency increased over the first year post-injury, remained stable during the second year, and gradually declined thereafter. The majority of subjects with PTSD experienced a chronic symptom course and all developed one or more than one comorbid psychiatric disorder, with mood, other anxiety, and substance-use disorders being the most common. Despite event-related amnesia, post-traumatic stress symptoms, including vivid re-experiencing phenomena, may develop following moderate-to-severe TBI. Onset is typically delayed and symptoms may persist for several years post-injury.",0,0 +3853,"Child-adolescent posttraumatic stress disorder: Prevalence, risk factors, and comorbidity.","(create) This chapter explores prevalence, risk factors, and comorbidity issues in child-adolescent posttraumatic stress disorder (PTSD)., (from the chapter) Topics include: child-adolescent posttraumatic stress disorder (PTSD): prevalence and risk factors; epidemiology of child-adolescent exposure to traumatic events; PTSD prevalence rates among clinical samples of stress-exposed children and adolescents (crime-related PTSD, war-related PTSD, disaster-related PTSD); comorbidity; risk factors; and implications for future research. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +3854,Buffalo Creek survivors in the second decade: Stability of stress symptoms.,"A follow-up study of 120 adult survivors of the Buffalo Creek dam collapse of 1972 showed group changes 14 years after the event. Decreased symptoms were noted in all areas, although significant psychopathology remained in about one-quarter of the survivors. A small group with delayed onset of symptoms was identified.",0,0 +3855,Factor structure of posttraumatic stress disorder symptoms in OEF/OIF veterans presenting to a polytrauma clinic.,"A significant number of Operation Iraqi Freedom/Operation Enduring Freedom (OEF/OIF) veterans are returning from deployment and presenting to Veterans Health Administration (VHA) polytrauma clinics with elevated rates of posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). Inherent to the accurate assessment and treatment of this diagnostically complex group of veterans is the assumption that the construct of PTSD is the same in this population as in other trauma groups. To our knowledge, no previous study has examined the structure of PTSD in this relevant and fast-growing population of treatment-seeking OEF/OIF veterans. Evidence suggests that the latent structure of PTSD symptoms is best represented by a four-factor model, rather than the three-factor model found in the current DSM-IV-TR. Thus, we examined the three and four-factor models using the PTSD Check List-Civilian (PCL-C) in a sample of treatment-seeking OEF/OIF veterans seen through a VHA polytrauma clinic.A chart review was conducted for OEF/OIF veterans (N = 361) seen through a VHA outpatient polytrauma clinic from September 2007 through August 2008. Participants completed the PCL-C as part of a comprehensive polytrauma evaluation.Confirmatory factor analyses showed that the DSM-IV-TR three-factor model did not fit the data well. A direct comparison showed that the four-factor model provided a superior fit relative to the three-factor model.Results extend the generalizability of the four-factor model to OEF/OIF veterans presenting to Veterans Health Administration (VHA) polytrauma clinics.",0,0 +3856,Resting-state fMRI studies in epilepsy,"Epilepsy is a disease characterized by abnormal spontaneous activity in the brain. Resting-state functional magnetic resonance imaging (RS-fMRI) is a powerful technique for exploring this activity. With good spatial and temporal resolution, RS-fMRI is a promising approach for accurate localization of the focus of seizure activity. Although simultaneous electroencephalogram-fMRI has been performed with patients in the resting state, most studies focused on activation. This mini-review focuses on RS-fMRI alone, including its computational methods and its application to epilepsy.",0,0 +3857,Why verbal psychotherapy is not enough to treat Post Traumatic Stress Disorder: a Biosystemic approach to stress debriefing,"Clinical and common experience shows that the consequences of traumatic events (physical and sexual violence, natural or civil disasters, witnessing violent events, serious diseases or bereavements, etc.) on people's lives is one of the main causes of mental suffering. The prevalence of Post Traumatic Stress Disorder (PTSD) is estimated to be as low as 0.5–1% (Frans, Rimmo, Aberg, & Fredrikson, 2005) and as high as 9.5% (Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995). It is clear the important role psychotherapy plays in facing similar conditions and restoring a state of wellness; hence the need for specific methodologies of intervention based on scientific evidence. The purpose of this article is to illustrate how mind-body techniques may usefully be integrated into psychotherapy protocols and can be used in the prevention and treatment of symptoms related to PTSD. These techniques may empower the ‘body's innate intelligence’ and improve self-regulation when addressing factors such as trauma, mind/bod...",0,0 +3858,World Trade Center Disaster Exposure-Related Probable Posttraumatic Stress Disorder among Responders and Civilians: A Meta-Analysis,"The World Trade Center (WTC) disaster on September 11, 2001 was an unprecedented traumatic event with long-lasting health consequences among the affected populations in the New York metropolitan area. This meta-analysis aimed to estimate the risk of probable posttraumatic stress disorder (PTSD) associated with specific types of WTC exposures. Meta-analytical findings from 10 studies of 3,271 to 20,294 participants yielded 37 relevant associations. The pooled summary odds ratio (OR) was 2.05 (95% confidence interval (CI): 1.82, 2.32), with substantial heterogeneity linked to exposure classification, cohort type, data source, PTSD assessment instrument/criteria, and lapse time since 9/11. In general, responders (e.g. police, firefighters, rescue/recovery workers and volunteers) had a lower probable PTSD risk (OR = 1.61; 95% CI: 1.39, 1.87) compared to civilians (e.g. residents, office workers, and passersby; OR = 2.71, 95% CI: 2.35, 3.12). The differences in ORs between responders and civilians were larger for physical compared to psychosocial exposure types. We also found that injury, lost someone, and witnessed horror were the three (out of six) most pernicious exposures. These findings suggest that these three exposures should be a particular focus in psychological evaluation and treatment programs in WTC intervention and future emergency preparedness efforts.",0,0 +3859,Gender Differences in Posttraumatic Stress Disorder and Help Seeking in the U.S. Army,"Inconsistent findings between studies of gender differences in mental health outcomes in military samples have left open questions of differential prevalence in posttraumatic stress disorder (PTSD) among all United States Army soldiers and in differential psychosocial and comorbid risk and protective factor profiles and their association with receipt of treatment.This study assesses the prevalence and risk factors of screening positive for PTSD for men and women based on two large, population-based Army samples obtained as part of the 2005 and 2008 U.S. Department of Defense Surveys of Health Related Behaviors among Active Duty Military Personnel.The study showed that overall rates of PTSD, as measured by several cutoffs of the PTSD Checklist, are similar between active duty men and women, with rates increasing in both men and women between the two study time points. Depression and problem alcohol use were strongly associated with a positive PTSD screen in both genders, and combat exposure was significantly associated with a positive PTSD screen in men. Overall, active duty men and women who met criteria for PTSD were equally likely to receive mental health counseling or treatment, though gender differences in treatment receipt varied by age, race, social support (presence of spouse at duty station), history of sexual abuse, illness, depression, alcohol use, and combat exposure.The study demonstrates that the prevalence of PTSD as well as the overall utilization of mental health services is similar for active duty men compared with women. However, there are significant gender differences in predictors of positive PTSD screens and receipt of PTSD treatment.",0,0 +3860,Coping Strategies as Mediators of the Relations Among Perceived Control and Distress in Sexual Assault Survivors.,"Two studies assessed whether coping strategies mediate the relations among 2 forms of perceived control (past and present control) and postassault distress among female sexual assault survivors. In Study 1, longitudinal data were gathered from 2 weeks to 1 year postassault (N = 171). Past control (behavioral self-blame) was associated with more distress partly because it was associated with greater social withdrawal. Present control (control over the recovery process) was associated with less distress partly because it was associated with less social withdrawal and more cognitive restructuring. In Study 2, cross-sectional data were gathered from a community sample of nonrecent survivors of sexual assault (N = 131). Coping strategies again mediated the relations among the measures of past and present control and distress.",0,0 +3861,Posttraumatic Stress Disorder in Mothers of Pediatric Cancer Survivors,"Prevalence of posttraumatic stress disorder (PTSD) in 24 mothers of pediatric cancer survivors was compared with its prevalence among 23 mothers of healthy children. Significantly more mothers of pediatric cancer survivors were diagnosed with lifetime PTSD. Significant differences were also found in lifetime arousal, as well as current and lifetime reexperience and avoidance symptom clusters. Significant difference existed in the distribution of the number of prediagnosis high-magnitude events experienced by the mothers diagnosed with current PTSD as compared with the prediagnosis experience of the mothers who were not diagnosed with current PTSD. Illness severity, level of perceived family and extrafamilial social support, and Symptom Checklist-90-Revised global severity index scores did not significantly differ in the PTSD-positive and PTSD-negative groups.",0,0 +3862,"Prior health care utilization as a potential determinant of enrollment in a 21-year prospective study, the Millennium Cohort Study","Results obtained from self-reported health data may be biased if those being surveyed respond differently based on health status. This study was conducted to investigate if health, as measured by health care use preceding invitation, influenced response to invitation to a 21-year prospective study, the Millennium Cohort Study. Inpatient and outpatient diagnoses were identified among more than 68,000 people during a one-year period prior to invitation to enroll. Multivariable logistic regression defined how diagnoses were associated with response. Days spent hospitalized or in outpatient care were also compared between responders and nonresponders. Adjusted odds of response to the questionnaire were similar over a diverse range of inpatient and outpatient diagnostic categories during the year prior to enrollment. The number of days hospitalized or accessing outpatient care was very similar between responders and nonresponders. Study findings demonstrate that, although there are some small differences between responders and nonresponders, prior health care use did not affect response to the Millennium Cohort Study, and it is unlikely that future study findings will be biased by differential response due to health status prior to enrollment invitation.",0,0 +3863,"Attachment from Infancy to Early Adulthood in a High‐Risk Sample: Continuity, Discontinuity, and Their Correlates","This study explores the stability of attachment security and representations from infancy to early adulthood in a sample chosen originally for poverty and high risk for poor developmental outcomes. Participants for this study were 57 young adults who are part of an ongoing prospective study of development and adaptation in a high-risk sample. Attachment was assessed during infancy by using the Ainsworth Strange Situation (Ainsworth & Wittig) and at age 19 by using the Berkeley Adult Attachment Interview (George, Kaplan, & Main). Possible correlates of continuity and discontinuity in attachment were drawn from assessments of the participants and their mothers over the course of the study. Results provided no evidence for significant continuity between infant and adult attachment in this sample, with many participants transitioning to insecurity. The evidence, however, indicated that there might be lawful discontinuity. Analyses of correlates of continuity and discontinuity in attachment classification from infancy to adulthood indicated that the continuous and discontinuous groups were differentiated on the basis of child maltreatment, maternal depression, and family functioning in early adolescence. These results provide evidence that although attachment has been found to be stable over time in other samples, attachment representations are vulnerable to difficult and chaotic life experiences.",0,0 +3864,Trajectories of Response to Treatment for Posttraumatic Stress Disorder,"Research on the predictors of response to cognitive-behavioral treatments for PTSD has often produced inconsistent or ambiguous results. We argue this is in part due to the use of statistical techniques that explore relationships among the entire sample of participants rather than homogeneous subgroups. Using 2 large randomized controlled trials of Cognitive Processing Therapy (CPT), CPT components, and Prolonged Exposure, we employed growth mixture modeling to identify distinct trajectories of treatment response and to determine the predictors of those trajectories. We determined that the participants' trajectories could be best represented by 2 latent classes, which we subsequently labeled responders (87% of the sample) and nonresponders (13% of the sample). Notably, there was not a separate class for partial responders. Assignment to the nonresponder class was associated with receiving the written accounts (WA) component of CPT, a pretreatment diagnosis of major depression (MDD), and more pretreatment hyperarousal symptoms. Thus, it appears that some individuals do not benefit from merely writing about their trauma and processing it with the therapist; they may also need to engage in cognitive restructuring to successfully ameliorate their symptoms. Additionally, those who meet criteria for MDD or have high levels of hyperarousal at the onset of treatment might require additional treatment or support.",0,0 +3865,Chronic Multisymptom Illness Complex in Gulf War I Veterans 10 Years Later,"Prior research has demonstrated that shortly after the 1991 Gulf War (Gulf War I), chronic multisymptom illness (CMI) was more common among deployed veterans than among nondeployed veterans. The aims of the current study were to determine the prevalence of CMI among deployed and nondeployed veterans 10 years after Gulf War I, compare the distribution of comorbid conditions, and identify prewar factors associated with CMI. Cross-sectional data collected from 1,061 deployed veterans and 1,128 nondeployed veterans examined between 1999 and 2001 were analyzed. CMI prevalence was 28.9% among deployed veterans and 15.8% among nondeployed veterans (odds ratio = 2.16, 95% confidence interval: 1.61, 2.90). Deployed and nondeployed veterans with CMI had similarly poorer quality-of-life measures and higher prevalences of symptom-based medical conditions, metabolic syndrome, and psychiatric disorders. Diagnoses of prewar anxiety disorders (not related to post-traumatic stress disorder) and depression were associated with CMI among both deployed and nondeployed veterans. Nicotine dependence and veteran-reported physician-diagnosed infectious mononucleosis were associated with CMI among deployed veterans, and migraine headaches and gastritis were associated with CMI among nondeployed veterans. CMI continues to be substantially more prevalent among deployed veterans than among nondeployed veterans 10 years after Gulf War I, but it manifests similarly in both groups. It is likely to be a common, persistent problem among veterans returning from the current Gulf War.",0,0 +3866,Differential effects of prolonged exposure on posttraumatic stress disorder symptoms in female veterans.,"We compared the effect of Prolonged Exposure (PE) on posttraumatic stress disorder (PTSD) symptom clusters and individual symptoms relative to a nonspecific comparison therapy (present-centered therapy; PCT) to identify the unique benefits of PE. We used data from a 12-site randomized clinical trial that found PE to be more effective than PCT for reducing PTSD symptom severity.Participants were 284 female veterans and active duty soldiers with PTSD (M age = 44.8 years, range = 22-78; 45.4% non-White). Participants were randomized to 10 weekly sessions of PE or PCT and assessed before and after treatment and at 3- and 6-month follow-ups. The primary measure of PTSD symptoms and symptom clusters (reexperiencing, avoidance, numbing, and hyperarousal) was the Clinician-Administered PTSD Scale (CAPS; Weathers et al., 2001) but we also assessed self-reported PTSD using the PTSD Checklist-Specific Version (PCL; Weathers, Litz, Herman, Huska, & Keane, 1993).Almost all clinician-rated and self-reported symptoms improved from pre- to posttreatment in both conditions. In the analyses of clinician-rated PTSD, PE had greater benefit than PCT on avoidance and numbing clusters. PE also had greater benefit on most individual symptoms in these clusters as well as on distress related to reminders. In the analyses of self-reported PTSD, PE had greater benefit than PCT on all clusters and on most individual symptoms.PE may be especially helpful for individuals with significant avoidance and numbing. Giving patients information about how a treatment can help with the symptoms that create the greatest burden can facilitate choosing the treatment that is best for them.",0,0 +3867,General Growth Mixture Analysis with Antecedents and Consequences of Change,"Many studies of youth, adolescents, and adults related to delinquent, antisocial, and criminal offending, have utilized a language of trajectory typologies to describe individual differences in the behavioral course manifest in their longitudinal data. The two most common statistical methods currently in use are the semiparametric group-based modeling, also known as latent class growth analysis and general growth mixture analysis, with the latter method being the focus of this chapter. In concert with the growing popularity of these data-driven, group-based methods for studying developmental and life-course behavior trajectories have come active and spirited ontological discussions about the nature of the emergent trajectory groups resulting from the analyses. In this chapter, we presuppose that there are analytic, empirical, and substantive advantages inherent in using discrete components to (partially) describe population heterogeneity in longitudinal processes. Conceptually as well as empirically, we will discuss the use of auxiliary information in terms of antecedents and consequences of trajectory group membership. The inclusion of auxiliary information in growth mixture analysis is a necessary step in understanding as well as evaluating the fidelity and utility of the resultant trajectory profiles from a given study, regardless of one’s beliefs about the veracity of the method itself.",0,0 +3868,Validating the Primary Care Posttraumatic Stress Disorder Screen and the Posttraumatic Stress Disorder Checklist with soldiers returning from combat.,"The purpose of the research was to assess the diagnostic efficiency of the Primary Care Posttraumatic Stress Disorder Screen (PC-PTSD) and the Posttraumatic Stress Disorder Checklist (PCL) as clinical screening tools for active duty soldiers recently returned from a combat deployment. A secondary goal was to examine the item-level characteristics of both the PC-PTSD and the PCL. A validation study conducted with a sample of 352 service members showed that both the PC-PTSD and PCL had good diagnostic efficiency. The overall diagnostic efficiency assessed by the area under the curve (AUC) was virtually the same for both the PC-PTSD and PCL. The most efficient cutoff values for the PC-PTSD were either 2 or 3 ""yes"" responses with the latter favoring specificity. For the PCL, the most efficient cutoff values were between 30 and 34, mirroring recommended PCL cutoff values from some studies in primary care settings. The examination of item characteristics suggested a 4-item PCL with an AUC virtually identical to that of the full PCL. Item analyses also identified that the most discriminate item in both scales pertained to symptoms of avoidance. Implications and limitations are discussed.",0,0 +3869,Plasma brain-derived neurotrophic factor level may contribute to the therapeutic response to eye movement desensitisation and reprocessing in complex post-traumatic stress disorder: a pilot study,Plasma brain-derived neurotrophic factor level may contribute to the therapeutic response to eye movement desensitisation and reprocessing in complex post-traumatic stress disorder: a pilot study - Volume 24 Issue 6,0,0 +3870,Prognosis After Whiplash Injury,"Nonsystematic review and discussion of prognosis after whiplash injury.To summarize the research and identify a research agenda for improving prognostic models after whiplash injury.With up to 50% of individuals failing to fully recover after whiplash injury, the capacity to determine a precise estimate of prognosis will be important. Systematic reviews note inconsistencies and shortcomings of research in this area.A nonsystematic review and discussion.Most prognostic whiplash studies are phase 1 (exploratory) studies with few confirmatory or validation studies yet available. It is recognized that whiplash is a heterogeneous condition and clinicians require prognostic indicators for clinical use. Although the evidence is not sufficiently strong to make firm recommendations, there are some prognostic factors that have shown consistency across studies and could be considered as preliminary flags or guides to gauge patients potentially at risk of poor recovery. These include pain and/or disability levels, neck range of movement, cold and mechanical hyperalgesia and psychological factors of recovery beliefs/expectations, post-traumatic stress symptoms, depression, and pain catastrophizing. It is not known whether these factors can be modified or whether modification will improve outcomes, thus they should not be considered directives for management. Research priorities identified to develop improved predictive models include confirmation and validation of factors identified in phase 1 studies; investigation of the interaction between variables; investigation of the predictive value of changes in variables over time; the inclusion of validated outcomes including measures of pain and disability as well as perceived recovery and psychological outcomes.The current evidence is not sufficiently robust to be able to confidently predict outcome after whiplash injury. A preliminary set of consistent factors has been proposed to assist clinicians in identifying individuals at risk of poor recovery. Directions for the development of improved prognostic models are discussed.",0,0 +3871,Burn Rehabilitation,"ABSTRACTEsselman PC, Thombs BD, Magyar-Russell G, Fauerbach JA: Burn rehabilitation: State of the science. Am J Phys Med Rehabil 2006;85:383–413.",0,0 +3872,Cutaneous Vascular Responses to Hypercapnia During Whole-Body Heating,"Hypercapnia may be encountered in lung disease as well as during situations involving rebreathing of previously expired air (e.g., occupational diving). Inhibitory effects of elevated arterial carbon dioxide partial pressure on the central nervous system may result in impaired thermoregulation. This study tested the hypothesis that in heat-stressed subjects, cutaneous vascular responsiveness [expressed as cutaneous vascular conductance (CVC)] would be reduced during hypercapnic exposure.Four men and three women (mean - SD; age: 35 +/- 7 yr) rested supine while wearing a tube-lined suit perfused with 34 degrees C water (normothermia). Following normothermic data collection, 50 degrees C water was perfused through the suit to increase internal temperature approximately 1 degrees C (whole-body heating). In both thermal conditions, a normoxic-hypercapnic (5% CO2, 21% O2, balance N2) gas mixture was inspired while forearm skin blood flux (laser-Doppler flowmetry) was measured continuously and was used for calculation of CVC (skin blood flux/mean arterial pressure).End-tidal CO2 increased similarly throughout hypercapnic exposure during both normothermic and whole-body heating conditions (7.9 +/- 2.4 and 8.3 +/- 1.9 mmHg, respectively). However, CVC was not different between normocapnia and hypercapnia under either thermal condition (normothermia: 0.42 +/- 0.24 vs. 0.39 +/- 0.21 flux units/mmHg for normocapnia and hypercapnia, respectively; heat stress: 1.89 +/- 0.67 vs. 1.92 +/- 0.63 flux units/ mmHg for normocapnia and hypercapnia, respectively).Based on these findings, mild hypercapnia is unlikely to impair heat dissipation by reducing cutaneous vasodilation.",0,0 +3873,Post-traumatic stress disorder and color preference in released prisoners of war,"The Luscher Color Test was administered to a sample of 188 male ex-prisoners of war (aged 18-66 years), who underwent psychiatric and psychological examination. The aim of this study was to evaluate possible connections between PTSD symptom clusters and color preferences, and possible impact of post-war and post-imprisonment period on color choice. The obtained results showed a prevalence of 6.9% for full PTSD diagnosis and 38.8% for Partial PTSD diagnosis. Furthermore, we found increased preference for violet (dominantly in those with one symptom cluster) and green (dominantly in those with full PTSD or two symptom clusters) and decreased preference for red (all subgroups). The persistence of the post-trauma period influenced even more pronounced preference for green, and even lesser preference for red.",0,0 +3874,Post-traumatic stress behavioural responses in inbred mouse strains: can genetic predisposition explain phenotypic vulnerability?,"Clinical studies of twin pairs and families of post-traumatic stress disorder (PTSD) patients raise questions as to possible genetic predisposition to PTSD. Studies using isogenic animal populations exposed to a stress paradigm could elucidate the relative contributions of genotype and environment to endophenotypic expression. The prevalence of individuals displaying severely compromised behavioural responses to predator scent stress (PSS) was assessed in six inbred strains of mice in an animal model of PTSD that classifies individuals into groups according to the degree of their behavioural response. The choice of strains was based on the frequent use of these mice in transgenic research. The prevalence of extreme behavioural response in the elevated plus maze and the acoustic startle response paradigms, performed in sequence, was assessed at baseline and 7 d after PSS exposure between and within strains, and compared to differences in circulating corticosterone levels. Narrow-sense trait heritability was determined by comparing the between-strain variance to the total variance. Although strain-specific differences in anxiety-like behaviours were demonstrated, the results revealed a significant degree of individual variability in response patterns within each of the inbred strains, yielding a baseline heritability factor for anxiety-like behaviours of 30%, but only 10% for response to stress exposure. Baseline anxiety-like behaviours were found not to be predictive of post-exposure behavioural responses. The response of the individual to stress is multifactorial and environmental factors play a predominant role in characterizing the individual response to stress exposure, although there are significant genetic underpinnings.",0,0 +3875,Trajectories of PTSD risk and resilience in World Trade Center responders: an 8-year prospective cohort study,"Background Longitudinal symptoms of post-traumatic stress disorder (PTSD) are often characterized by heterogeneous trajectories, which may have unique pre-, peri- and post-trauma risk and protective factors. To date, however, no study has evaluated the nature and determinants of predominant trajectories of PTSD symptoms in World Trade Center (WTC) responders. Method A total of 10835 WTC responders, including 4035 professional police responders and 6800 non-traditional responders (e.g. construction workers) who participated in the WTC Health Program (WTC-HP), were evaluated an average of 3, 6 and 8 years after the WTC attacks. Results Among police responders, longitudinal PTSD symptoms were best characterized by four classes, with the majority (77.8%) in a resistant/resilient trajectory and the remainder exhibiting chronic (5.3%), recovering (8.4%) or delayed-onset (8.5%) symptom trajectories. Among non-traditional responders, a six-class solution was optimal, with fewer responders in a resistant/resilient trajectory (58.0%) and the remainder exhibiting recovering (12.3%), severe chronic (9.5%), subsyndromal increasing (7.3%), delayed-onset (6.7%) and moderate chronic (6.2%) trajectories. Prior psychiatric history, Hispanic ethnicity, severity of WTC exposure and WTC-related medical conditions were most strongly associated with symptomatic trajectories of PTSD symptoms in both groups of responders, whereas greater education and family and work support while working at the WTC site were protective against several of these trajectories. Conclusions Trajectories of PTSD symptoms in WTC responders are heterogeneous and associated uniquely with pre-, peri- and post-trauma risk and protective factors. Police responders were more likely than non-traditional responders to exhibit a resistant/resilient trajectory. These results underscore the importance of prevention, screening and treatment efforts that target high-risk disaster responders, particularly those with prior psychiatric history, high levels of trauma exposure and work-related medical morbidities.",1,0 +3876,Posttraumatic stress in children following acute physical injury,"To prospectively assess the presence of posttraumatic stress disorder (PTSD) in children hospitalized following acute physical injury. The focus was identification of the incidence of PTSD, PTSD symptoms, and exploration of factors associated with development of PTSD symptoms and disorder.Forty children ages 8-17 were interviewed approximately 1 month following a serious injury and assessed for PTSD, pretrauma behavior problems, levels of peritraumatic fear, and posttraumatic thought suppression.Twenty-two and a half percent of participants met DSM-IV diagnostic criteria for PTSD; 47.5% met criteria for at least two of the three PTSD symptom clusters. Greater thought suppression was associated with increased symptoms of PTSD, as were the child's peritraumatic fear response and pretrauma internalizing behaviors.Results suggest that many children who have been hospitalized for physical trauma may be experiencing clinically significant PTSD symptomatology and may benefit from psychological as well as medical intervention.",0,0 +3877,Deployment Risk and Resilience Inventory: A Collection of Measures for Studying Deployment-Related Experiences of Military Personnel and Veterans,This article describes the development of an inventory to assess key psychosocial risk and resilience factors for military personnel and veterans deployed to war zones or other hazardous environmen...,0,0 +3878,Stress disorders following traumatic injury: Assessment and treatment considerations,"Traumatic injury is a relatively common occurrence, with approximately 40 million injury-related visits to emergency departments in the United States per year. Psychiatric complications of physical injury are a public health concern. Approximately 12% to 16% of survivors of traumatic injury are diagnosed with acute stress disorder (ASD), and 30% to 36% warrant a diagnosis of posttraumatic stress disorder (PTSD) 12 months after the traumatic event. Phenomena related to injury, such as blood loss, pain, administration of narcotic analgesics, and traumatic brain injury, as well as high rates of premorbid psychiatric and substance abuse and/or dependence disorders, often overlap with stress-related symptoms of psychological origin. This complicates the assessment of dissociative processes required for the diagnosis of ASD, as well as the three core PTSD symptom clusters (re-experiencing of the trauma, avoidance and numbing, and hyperarousal). This article reviews specific aspects of stress disorders in the context of traumatic injury, with a focus on aspects of assessment. Psychopharmacologic and behavioral treatment recommendations are also reviewed.",0,0 +3879,"Neighborhood disadvantage, stress, and drug use among adults.","This paper explores the relationships among neighborhood disadvantage, stress, and the likelihood of drug use in a sample of adults (N = 1,101). Using the 1995 Detroit Area Study in conjunction with tract-level data from the 1990 census, we find a positive relationship between neighborhood disadvantage and drug use, and this relationship remains statistically significant net of controls for individual-level socioeconomic status. Neighborhood disadvantage is moderately associated with drug related behaviors, indirectly through increased social stressors and higher levels of psychological distress among residents of disadvantaged neighborhoods. A residual effect of neighborhood disadvantage remains, net of a large number of socially relevant controls. Finally, results from interactive models suggest that the relationship between neighborhood disadvantage and drug use is most pronounced among individuals with lower incomes.",0,0 +3880,Practical assessment and evaluation of mental health problems following a mass disaster.,"Almost all individuals who experience a severe trauma will develop symptoms of posttraumatic stress disorder (PTSD) shortly after the traumatic event. Although the natural history of PTSD varies according to the type of trauma, most people do not develop enduring PTSD, and, in many of those who do, it resolves within 1 year without treatment. To the extent that is possible, maintenance of normal daily activities is believed to help patients cope more successfully in the aftermath of major trauma. In the case of a disaster such as the Asian tsunami, the whole community is involved, and it is impossible to continue with normal daily activities. To improve overall outcome after trauma, it would be optimal to identify individuals at increased risk for developing PTSD. This article describes screening and assessment tools for posttrauma mental health problems, particularly PTSD, and examines in more detail instruments that can be used in rapid field assessment of individuals who may be affected or who have already been identified and require monitoring. Self-rated instruments are most appropriate, but the choice of instrument will depend on the local situation and availability of appropriately validated questionnaires. The article also addresses important aspects of training nonmedical personnel in screening and assessment.",0,0 +3881,Symptom profiles of patients with DSM-III anxiety disorders,"The authors used symptom profiles, demographic data, and other variables to compare 316 patients representing all specific DSM-III anxiety disorders except posttraumatic stress disorder to each other and to published norms for both an unselected psychiatric outpatient population and normal subjects. The results support the grouping of these disorders, with the possible exception of obsessive-compulsive disorder, into one general diagnostic category of ""anxiety disorders."" The distinction between the specific diagnoses of simple phobia and social phobia was also supported; however, the differentiation between panic disorder, agoraphobia, and generalized anxiety was only weakly supported.",0,0 +3882,"Economics of Disaster Risk, Social Vulnerability, and Mental Health Resilience","We investigate the relationship between exposure to Hurricanes Katrina and/or Rita and mental health resilience by vulnerability status, with particular focus on the mental health outcomes of single mothers versus the general public. We advance a measurable notion of mental health resilience to disaster events. We also calculate the economic costs of poor mental health days added by natural disaster exposure. Negative binomial analyses show that hurricane exposure increases the expected count of poor mental health days for all persons by 18.7% (95% confidence interval [CI], 7.44-31.14%), and by 71.88% (95% CI, 39.48-211.82%) for single females with children. Monthly time-series show that single mothers have lower event resilience, experiencing higher added mental stress. Results also show that the count of poor mental health days is sensitive to hurricane intensity, increasing by a factor of 1.06 (95% CI, 1.02-1.10) for every billion (U.S.$) dollars of damage added for all exposed persons, and by a factor of 1.08 (95% CI, 1.03-1.14) for single mothers. We estimate that single mothers, as a group, suffered over $130 million in productivity loss from added postdisaster stress and disability. Results illustrate the measurability of mental health resilience as a two-dimensional concept of resistance capacity and recovery time. Overall, we show that natural disasters regressively tax disadvantaged population strata.",0,0 +3883,Relationship BetweenToxoplasma gondiiand Mood Disturbance in Women Veterans,"Toxoplasma gondii is an intracellular protozoan parasite with zoonotic potential that causes acute and chronic diseases, which has been associated with schizophrenia, depression, bipolar disorder, and suicidal behavior. Military personnel may be at increased risk for exposure to the parasite when deployed to countries with high prevalence rates.Women Veterans were recruited to participate in the study at an event to recognize women Veterans and later through e-mails. Blood samples were collected from 70 women Veterans (mean age: 47 years) and analyzed for T. gondii IgG titer. Participants completed a demographic instrument, Center for Epidemiologic Studies Depression scale, Profile of Mood States (POMS), and Post-Traumatic Stress Disorder Checklist-Military.The infectivity rate was lower than the rate in the United States (11.4% [8 out of 70 were seropositive], but 6 of the 8 [75%] had been deployed outside the United States. Pearson correlations and t tests showed significant relationships between T. gondii seropositivity and Center for Epidemiologic Studies Depression score), POMS-depression, POMS-confusion, and POMS-anger subscale scores, and total mood disturbance score.This study is the first to describe biobehavioral relationships between chronic T. gondii infection, depression, and dysphoric moods in a military veteran population.",0,0 +3884,Preliminary Evidence for a Classroom Based Psychosocial Intervention for Disaster Exposed Children with Posttraumatic Stress Symptomatology,"Background: In 2004, a firework factory in a residential area of a large Danish city exploded. The children at the local school were screened for symptoms of posttraumatic stress disorder (PTSD) 16 months and 31/2 years after the incident. A large proportion of the children still suffered from a substantial number of symptoms 31/2 years after the incident. Thus, a treatment program designed to target PTSD symptoms in trauma-exposed children was established. Objectives: The first aim of this study was to provide preliminary evidence that a classroom-based psychosocial intervention program for children with posttraumatic stress would be associated with reductions in symptoms. The second aim was to evaluate the usefulness of the Darryl, a cartoon-based PTSD screening instrument. Methods: One hundred and eight children participated in the treatment program, all of whom fulfilled at least two out of the three DSM-IV PTSD symptom clusters. The children were screened for PTSD symptoms at baseline and 1 month after treatment using Darryl. Results: There was a statistically significant reduction in PTSD symptoms from pre-treatment to post-treatment. Furthermore, a logistic regression analysis revealed that being female, being young, and having a high PTSD score at baseline predicted a probable PTSD diagnosis post-treatment. Conclusion: The present study provides preliminary evidence of feasibility and that the treatment program described may help to alleviate PTSD symptoms children with chronic PTSD symptoms. Furthermore, the results indicated that the Darryl instrument is a useful screening tool for assessing PTSD symptoms in this sample of children. © 2013 Springer Science+Business Media New York.",0,0 +3885,Latent profiles of PTSD symptoms in women exposed to intimate partner violence,"Studies have utilized latent class analysis (LCA) and latent profile analysis (LPA) to examine posttraumatic stress disorder (PTSD) symptom profiles in a range of populations. Further study is needed to explore symptom profiles among women exposed to intimate partner violence (IPV). The current study examined latent symptom profiles in a sample of IPV-exposed women, and explored trauma-related cognitive appraisals associated with these PTSD symptom presentations.An LPA was conducted using cross-sectional data from a non-treatment seeking community sample of women recruited following a police-reported incident of IPV by a male perpetrator (N=229). Multinomial regression analyses determined associations between latent profile membership and trauma-related appraisals.The LPA identified five PTSD symptom profiles: Low Symptom (46% of the sample); Low Symptom with High Hypervigilance (17%); Intermediate Symptom (16%); Intermediate Symptom with High Hypervigilance (11%); and High Symptom (10%). Trauma-related appraisals, including fear, alienation, and self-blame, were the strongest independent predictors of PTSD symptom profile membership.The study focused on female victims of IPV by a male partner, and findings may not generalize to other gender configurations (e.g. same-sex couples, male victims, etc.). The LPA is cross-sectional, and the stability of these profiles over time warrants further study.These findings suggest the need for careful consideration of differences among IPV-exposed women within the larger context of PTSD research and clinical intervention. Identifying latent subgroups may provide an empirical basis for practitioners to design and implement PTSD intervention efforts that are tailored to specific symptom profiles.",0,0 +3886,Psychiatric outcomes after childbirth: can posttraumatic growth protect me from disordered eating symptoms?,"Purpose: While many studies on mood disorder and posttraumatic stress disorder (PTSD) following childbirth have been conducted, little is known regarding posttraumatic growth (PTG) and disordered eating in the postpartum period. This study aims to (a) identify the typology of women following childbirth based on anxiety, depressive, PTSD symptoms and level of PTG and (b) evaluate whether these profiles differ on disordered eating symptoms. Methods: Up to 2 years after childbirth, 306 French-speaking mothers [mean age (SD) = 29.4 (4.6) years] completed questionnaires assessing PTSD, depressive, anxiety and disordered-eating symptoms and level of posttraumatic growth. Results: Four profiles were highlighted: a first one labeled growing cluster (22.2  \% of the sample, n = 68), a second one labeled low level of symptoms cluster (37.6  \% of the sample, n = 115), a third one labeled vulnerable cluster (21.6  \% of the sample, n = 66) and a last one labeled anxious–depressed–traumatized cluster (18.6  \% of the sample, n = 57). Our findings also highlight an impact of these profiles on disordered eating symptoms, suggesting that disordered eating in postpartum would not be the result of pregnancy. Conclusion: Consistent with our expectation, our findings suggest a potential protective role of posttraumatic growth on the development of disordered eating symptoms. Further researches focusing on traumatic experience, disordered eating and posttraumatic growth in postpartum are warranted.",0,0 +3887,Heterogeneity in the latent structure of PTSD symptoms among Canadian veterans.,"The current study used factor mixture modeling to identify heterogeneity (i.e., latent classes) in 2 well-supported models of posttraumatic stress disorder's (PTSD) factor structure. Data were analyzed from a clinical sample of 405 Canadian veterans evaluated for PTSD. Results were consistent with our hypotheses. Each PTSD factor model was best represented by 2 latent classes of participants, differing with respect to PTSD symptom severity. Furthermore, classes were most strongly distinguished by factor scores related to emotional numbing or dysphoria. For both factor models, class membership was significantly predicted by age and depression diagnosis. Implications of these findings are discussed.",0,0 +3888,"Posttraumatic Stress, Anxiety, and Depression Symptoms Among Children After Hurricane Katrina: A Latent Profile Analysis","This study utilized Latent Profile Analysis to identify typologies of distress (i.e., patterns of posttraumatic stress, anxiety, and depression symptoms) among children exposed to Hurricane Katrina. Outcomes and risk factors for these pattern groups were examined. Participants were children (n = 353; ages 8-15 years) affected by Hurricane Katrina. Children were assessed at 3 - 7 months (Time 1) and 14 - 17 months (Time 2) post-Katrina. Results identified three pattern groups (No Disturbance, PTS Only, and Mixed Internalizing) at Time 1. Children in the No Disturbance group reported the lowest levels of internal distress, while the Mixed Internalizing group reported the highest levels of internal distress at Time 2. The Mixed Internalizing and the PTS Only groups reported greater school problems than the No Disturbance group at Time 2. Perceived life threat and community violence exposure were risk factors associated with higher likelihood of falling in the PTS Only and Mixed Internalizing groups, compared to the No Disturbance group. Immediate loss and disruption was also a risk factor associated with a higher likelihood of falling in the PTS Only group, compared to the No Disturbance group. Finally, social support from parents or a classmate/friend was a significant protective factor associated with a lower likelihood of falling into a symptomatic pattern group.",0,0 +3889,Symptom Overreporting in Combat Veterans Evaluated for PTSD: Differentiation on the Basis of Compensation Seeking Status,"We examined the role of compensation-seeking status on response patterns to self-report inventories of acute psychopathology and psychological distress in a group of 165 combat veterans evaluated for posttraumatic stress disorder (PTSD) at a Department of Veteran Affairs (VA) Medical Center. Veterans completed the Minnesota Multiphasic Personality Inventory-Revised, Beck Depression Inventory, Mississippi Scale for Combat-Related PTSD, a fixed-response format version of the Dissociative Experiences Scale, and Impact of Events Scale as part of a standard assessment battery. Results showed that compensation-seeking veterans endorsed dramatically higher levels of psychopathology across measures and produced sharply elevated ""fake-bad"" validity indices as compared to non-compensation-seeking veterans. Differences between the two groups on most scales and indices exceeded effect sizes of 1.0, even when effects of income, global assessment of functioning, and clinician-rated severity of PTSD were controlled for. It is suggested that the availability of VA disability compensation for combat-related PTSD impedes accurate initial assessment of veterans presenting for treatment and may impair estimation of long-term therapeutic outcome in this population.",0,0 +3890,Assessing the ‘true’ effect of active antidepressant therapy v. placebo in major depressive disorder: use of a mixture model,"Background There is controversy about the implications of relatively small average drug–placebo differences observed in randomised controlled trials of antidepressant medications. Aims To investigate whether efficacy is better understood as a large effect in a subgroup of patients. Method The mixture model was used to identify patient subgroups (patients benefiting or not benefiting from treatment) to directly model the skewness of Montgomery–åsberg Depression Rating Scale (MADRS) scores at week 8. Results The MADRS scores improved by 15.9 points (95% CI 15.2–16.6) among patients who benefited from treatment. The proportion of patients who benefited from escitalopram and not from placebo treatment was 19.5%, corresponding to a number needed to treat of 5. Conclusions This model gave a considerably better fit to the data than the analysis of covariance model in which all patients were assumed to benefit from treatment. The small average antidepressant–placebo difference obscures a much larger effect in a clinically meaningful subgroup of patients.",0,0 +3891,DSM–5’s Posttraumatic Stress Disorder with Dissociative Symptoms: Challenges and Future Directions,"The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, formally recognizes a dissociative subtype of posttraumatic stress disorder (PTSD; PTSD with dissociative symptoms). This nomenclative move will boost empirical and theoretical efforts to further understand the links between dissociation, trauma, and PTSD. This article examines the empirical literature showing that patients with PTSD can be divided into 2 different groups based on their neurobiology, psychological symptom profile, history of exposure to early relational trauma, and depersonalization/derealization symptoms. It then explores the conceptual and empirical challenges of conceiving 1 of these types as reflecting a ""dissociative"" type of PTSD. First, this classification is based on the presence of a limited subset of dissociative symptoms (i.e., depersonalization, derealization). This sets aside an array of positive and negative psychoform and somatoform dissociative symptoms that may be related to PTSD. Second, empirical evidence suggests heightened dissociation in PTSD compared to many other disorders, indicating that dissociation is relevant to PTSD more broadly rather than simply to the so-called dissociative subtype. This article sets out important issues to be examined in the future study of dissociation in PTSD, which needs to be informed by solid conceptual understandings of dissociation.",0,0 +3892,A new instrument to assess social functioning in mental health settings,"This article present a new social functioning self-report instrument in French language the Questionnaire de Fonctionnement Social (QFS), initially developed in order to assess social functioning in patients involved ingroup psychotherapy programs conducted in a specialist mental health setting. The psychometric analysis globally support the validity of the QFS and suggest that it performs similarly to other standardized measure of social functioning. Brief, easy to complete and score, the QFS seems to be an appropriate instrument for use not only in research protocols but also in clinical psychiatric settings. Within the often costly exercise of routine measurement, this short questionnaire should help identifying social dysfunctions otherwise not always recognized, making informed clinical decision and monitoring therapeutic responses. The QFS, while promising, needs further validation by study of its use namely in other settings (e.g. community mental health setting,...), with other patient groups (for instance, suffering from other mental disorders or chronic medical illnesses) and, more generally, with other non-clinical populations (e.g. pensioners, prisoners, refugees,...).",0,0 +3893,Trauma and stress-related disorders in German emergency physicians: the predictive role of personality factors.,"Emergency medical personnel (EMP) are repeatedly exposed to traumatic and stressful events with possible consequences on their mental wellbeing. Out of the group of EMP, we chose German Emergency Physicians (EP), because they represent a distinct group within the German pre-hospital emergency services. In this group, we studied the prevalence rates of posttraumatic stress disorder (PTSD), burnout and depression. We specifically focussed on the role of personality and other factors of vulnerability. Four hundred eighty-seven German EPs answered questionnaires with scales assessing probable PTSD, burnout, depression, and personality factors. Additionally, we asked for biographic, occupational and mental health information. More than 90% of the participants reported at least one traumatic event. We found low to moderate levels of stress-related disorders with 16.8% of participants meeting the criteria for probable PTSD, 4.1% for burnout, and 3.1% for clinical depression. We identified four clusters of personalities that were related to the prevalence of PTSD and depression. The type of personality seems to be more predictive of the development of trauma and stress-related disorders than the EPs' traumatic experiences.",0,0 +3894,Coping and Emotional Adjustment Following Traumatic Brain Injury,"To examine the association between coping style and emotional adjustment following traumatic brain injury.Thirty three individuals who had sustained a traumatic brain injury (mean duration of posttraumatic amnesia = 32 days) between 1(1/2) months and almost 7 years previously.Coping Scale for Adults, Hospital Anxiety and Depression Scale, Rosenberg Self-Esteem Scale, State-Trait Anger Expression Inventory, and the Sickness Impact Profile.Approximately 50% of the sample reported clinically significant levels of anxiety and depression. Coping characterized by avoidance, worry, wishful thinking, self-blame, and using drugs and alcohol was associated with higher levels of anxiety, depression, and psychosocial dysfunction and lower levels of self-esteem. Coping characterized by actively working on the problem and using humor and enjoyable activities to manage stress was associated with higher self-esteem. Lower premorbid intelligence (measured via the National Adult Reading Test) and greater self-awareness (measured via the Self-Awareness of Deficits Interview) were associated with an increased rate of maladaptive coping.The strong association between the style of coping used to manage stress and emotional adjustment suggests the possibility that emotional adjustment might be improved by the facilitation of more adaptive coping styles. It is also possible that improving emotional adjustment may increase adaptive coping. The development and evaluation of interventions aimed at facilitating adaptive coping and decreasing emotional distress represent important and potentially fruitful contributions to enhancing long-term outcome following brain injury.",0,0 +3895,Epidemiology ofDSM-5Drug Use Disorder,"Current information on the prevalence and sociodemographic and clinical profiles of individuals in the general population with DSM-5 drug use disorder (DUD) is limited. Given the present societal and economic context in the United States and the new diagnostic system, up-to-date national information is needed from a single uniform data source.To present nationally representative findings on the prevalence, correlates, psychiatric comorbidity, disability, and treatment of DSM-5 DUD diagnoses overall and by severity level.In-person interviews were conducted with 36,309 adults in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III, a cross-sectional representative survey of the United States. The household response rate was 72%; person-level response rate, 84%; and overall response rate, 60.1%. Data were collected April 2012 through June 2013 and analyzed from February through March 2015.Twelve-month and lifetime DUD, based on amphetamine, cannabis, club drug, cocaine, hallucinogen, heroin, nonheroin opioid, sedative/tranquilizer, and/or solvent/inhalant use disorders.Prevalences of 12-month and lifetime DUD were 3.9% and 9.9%, respectively. Drug use disorder was generally greater among men, white and Native American individuals, younger and previously or never married adults, those with lower education and income, and those residing in the West. Significant associations were found between 12-month and lifetime DUD and other substance use disorders. Significant associations were also found between any 12-month DUD and major depressive disorder (odds ratio [OR], 1.3; 95% CI, 1.09-1.64), dysthymia (OR, 1.5; 95% CI, 1.09-2.02), bipolar I (OR, 1.5; 95% CI, 1.06-2.05), posttraumatic stress disorder (OR, 1.6; 95% CI, 1.27-2.10), and antisocial (OR, 1.4; 95% CI, 1.11-1.75), borderline (OR, 1.8; 95% CI, 1.41-2.24), and schizotypal (OR, 1.5; 95% CI, 1.18-1.87) personality disorders. Similar associations were found for any lifetime DUD with the exception that lifetime DUD was also associated with generalized anxiety disorder (OR, 1.3; 95% CI, 1.06-1.49), panic disorder (OR, 1.3; 95% CI, 1.06-1.59), and social phobia (OR, 1.3; 95% CI, 1.09-1.64). Twelve-month DUD was associated with significant disability, increasing with DUD severity. Among respondents with 12-month and lifetime DUD, only 13.5% and 24.6% received treatment, respectively.DSM-5 DUD is a common, highly comorbid, and disabling disorder that largely goes untreated in the United States. These findings indicate the need for additional studies to understand the broad relationships in more detail; estimate present-day economic costs of DUDs; investigate hypotheses regarding etiology, chronicity, and treatment use; and provide information to policy makers about allocation of resources for service delivery and research. Findings also indicate an urgent need to destigmatize DUD and educate the public, clinicians, and policy makers about its treatment to encourage affected individuals to obtain help.",0,0 +3896,The relations between posttraumatic stress disorder symptoms and disorder of extreme stress (not otherwise specified) symptoms following war captivity.,"War captivity is a recognized pathogenic agent for both posttraumatic stress disorder (PTSD) symptoms and disorder of extreme stress not otherwise specified (DESNOS) symptoms, also known as Complex PTSD. However, the relationship between the two disorders remains unclear. While some scholars assume that the two diagnoses are overlapping and share the same predictors, others believe that the two diagnoses are relatively independent and differ in phenomenology and functional impairment. This study aims to assess both PTSD and DESNOS symptoms and their inter-relations among ex-prisoners of war (ex-POWs) and matched controls, 35 years after the end of the war.The sample included two groups of male Israeli veterans from the 1973 Yom Kippur War: ex-POWs (n = 176) and comparable veterans who had not been held captive (n = 118). PTSD and DESNOS symptoms, battlefield and captivity stressors, and ways of coping in captivity were assessed using self-report questionnaires in 2008.Ex-POWs reported a higher number of PTSD symptoms and higher rates of PTSD symptoms that fill criteria for the diagnosis of PTSD than controls. Furthermore, ex-POWs reported a higher number of DESNOS symptom clusters and higher rates of DESNOS symptoms that fill criteria for the diagnosis of DESNOS. Moreover, we found positive relationships between PTSD symptom clusters and DESNOS symptom clusters. Finally, weight loss and mental suffering in captivity, loss of emotional control and total number of DESNOS symptoms predicted total number of PTSD symptoms. However, only the total number of PTSD symptoms predicted the total number of DESNOS symptoms.This study demonstrated the heavy and extensive toll of war captivity, three decades after the ex-POWs' release from captivity. Importantly, approaching the publication of DSM-5, this study depicts both the high number of DESNOS symptom clusters alongside PTSD symptoms and highlights the complex relationship between the two diagnostic entities. Thus, DESNOS characteristics might be viewed as associated features of PTSD but also that the symptoms of PTSD are the core foundations of DESNOS.",0,0 +3897,A Brief Measure for Assessing Generalized Anxiety Disorder,"Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity.A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use.A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale.The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.",0,0 +3898,Rates of Major Depressive Disorder and Clinical Outcomes Following Traumatic Brain Injury,"Uncertainties exist about the rates, predictors, and outcomes of major depressive disorder (MDD) among individuals with traumatic brain injury (TBI).To describe MDD-related rates, predictors, outcomes, and treatment during the first year after TBI.Cohort from June 2001 through March 2005 followed up by structured telephone interviews at months 1 through 6, 8, 10, and 12 (data collection ending February 2006).Harborview Medical Center, a level I trauma center in Seattle, Washington.Five hundred fifty-nine consecutively hospitalized adults with complicated mild to severe TBI.The Patient Health Questionnaire (PHQ) depression and anxiety modules were administered at each assessment and the European Quality of Life measure was given at 12 months.Two hundred ninety-seven of 559 patients (53.1%) met criteria for MDD at least once in the follow-up period. Point prevalences ranged between 31% at 1 month and 21% at 6 months. In a multivariate model, risk of MDD after TBI was associated with MDD at the time of injury (risk ratio [RR], 1.62; 95% confidence interval [CI], 1.37-1.91), history of MDD prior to injury (but not at the time of injury) (RR, 1.54; 95% CI, 1.31-1.82), age (RR, 0.61; 95% CI, 0.44-0.83 for > or = 60 years vs 18-29 years), and lifetime alcohol dependence (RR, 1.34; 95% CI, 1.14-1.57). Those with MDD were more likely to report comorbid anxiety disorders after TBI than those without MDD (60% vs 7%; RR, 8.77; 95% CI, 5.56-13.83). Only 44% of those with MDD received antidepressants or counseling. After adjusting for predictors of MDD, persons with MDD reported lower quality of life at 1 year compared with the nondepressed group.Among a cohort of patients hospitalized for TBI, 53.1% met criteria for MDD during the first year after TBI. Major depressive disorder was associated with history of MDD and was an independent predictor of poorer health-related quality of life.",0,0 +3899,"Crisis support, attributional style, coping style, and post-traumatic symptoms","Abstract Although disaster is believed to be aetiological in the development of post-traumatic stress disorder, there exist large unexplained individual differences in the severity and chronicity of symptoms. For this reason, attention has begun to focus on those variables that might mediate between disaster and subsequent outcome. One such variable is crisis support. However, it has been suggested that associations between self-report measures of support and symptoms may be a function of attributional style and coping style. It is shown in the present study that crisis support is able to predict symptoms over and above attributional style and coping style.",0,0 +3900,Psychosocial Interventions and Therapeutic Support as a Standard of Care in Pediatric Oncology,"Research indicates that a subset of youths with childhood cancer and their parents will experience significant psychological distress throughout the course of their illness. Importantly, the existing literature indicates that psychosocial support is beneficial in decreasing symptoms of distress in these families. The aim of the current review is to determine the extent of the evidence to support a standard of psychosocial care for children and their families throughout the cancer trajectory; thus, we examined the research related to psychosocial outcomes in youth with cancer and their parents.",0,0 +3901,Posttraumatic stress disorder: the etiologic specificity of wartime stressors,"The authors examined the effects of wartime stressors in a sample of 69 Vietnam veterans who were psychiatric inpatients in a Veterans Administration hospital. Participation in atrocities and the cumulative exposure to combat stressors, each independently of the other, conferred a significant risk for posttraumatic stress disorder. In contrast, the effect of these war experiences on the onset of panic, major depression, and mania was not significant. The results indicate that extreme stressors are uniquely linked with posttraumatic stress disorder's characteristic cluster of symptoms but challenge DSM-III's implicit assumption that the reexperienced trauma is the stressor responsible for posttraumatic stress disorder.",0,0 +3902,The latent structure of acute stress disorder: A posttraumatic stress disorder approach.,"Acute stress disorder (ASD) was first included in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) to account for the psychological symptoms present during the one-month period between trauma exposure and a posttraumatic stress disorder (PTSD) diagnosis. The diagnostic criteria sets of both ASD and PTSD are similar; however, ASD includes additional dissociative items. Factor analytic research into ASD is rare, whereas there is a plethora of research on the factor structure of PTSD symptoms. This study tested whether the latent structure of ASD is similar to the latent structure of PTSD. Five models were tested by using data from Danish rape victims (N = 380); a unidimensional model, the DSM-IV 4-factor ASD model, a King, Leskin, King, and Weathers (1998) replication model, a Simms, Watson, and Doebbeling (2002) replication model, and a 3-factor model. Model fit was assessed by using a number of fit indices, including the root-mean-square error of approximation, comparative fit index, Tucker-Lewis index, and standardized root-mean-square residual. However, based on the fit indices, 3 models were deemed indistinguishable. Chi-square difference tests concluded that a 3-factor model and two 4-factor models did not differ in fit. Overall, the current 4-factor ASD latent structure proposed by the DSM-IV was not supported. A 3-factor structure was deemed preferential on the basis of parsimony. Furthermore, of all models, the unidimensional model provided the poorest fit to the data. These findings are pertinent given that the DSM-5 ASD task force is considering implementing either a 4-factor conceptualization or a unidimensional approach to the ASD diagnosis. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +3903,The role of DNA methylation in stress-related psychiatric disorders,"Epigenetic modifications in response to traumatic experience and stress are emerging as important factors in the long-term biological trajectories leading to stress-related psychiatric disorders, reflecting both environmental influences as well as individual genetic predisposition. In particular, recent evidence on DNA methylation changes within distinct genes and pathways but also on a genome-wide level provides new insights into the pathophysiology of stress related psychiatric disorders. This review summarizes current findings and concepts on DNA methylation changes in stress-related disorders with a focus on major depressive disorder and posttraumatic stress disorder (PTSD). We highlight studies of DNA methylation in animals and humans pertinent to these disorders, both focusing on candidate loci as well as genome-wide studies. We describe molecular mechanisms of how exposure to stress can induce long lasting changes in DNA methylation and how these may relate to the pathophysiology of depression and PTSD. We discuss data suggesting that DNA methylation, even in peripheral tissues, appears to be an informative reflection of environmental exposures on the genome and may have potential as a biomarker for the early prevention of stress-related disorders.",0,0 +3904,A history in-care predicts unique characteristics in a homeless population with mental illness,"Multiple studies of homeless persons report an increased prevalence of a history in-care, but there is a dearth of information on associated outcomes or relevant demographic profiles. This information is critical to understanding if certain individuals are at elevated risk or might benefit from specific intervention. Here, we investigate how a history in-care relates to demographics and multiple outcome measures in a homeless population with mental illness. Using the Mini International Neuropsychiatric Interview (MINI), the Short-Form 12, and a trauma questionnaire, we investigated baseline differences in demographics and length of homelessness in the At Home/Chez Soi Trial (N=504) Winnipeg homeless population with and without a history in-care. Approximately 50% of the homeless sample reported a history in-care. This group was significantly more likely to be young, female, married or cohabitating, of Aboriginal heritage, have less education, and have longer lifetime homelessness. Individuals of Aboriginal heritage with a history in-care were significantly more likely to report a familial history of residential school. Individuals with a history in-care experienced different prevalence rates of Axis 1 mental disorders. Those with a history in-care also reported significantly more traumatic events (particularly interpersonal). A distinctive high-risk profile emerged for individuals with a history in-care. Sociocultural factors of colonization and intergenerational transmission of trauma appear to be particularly relevant in the trajectories for individuals of Aboriginal heritage. Given the high prevalence of a history in-care, interventions and policy should reflect the specific vulnerability of this population, particularly in regards to trauma-informed services.",0,0 +3905,Differences in PTSD Prevalence and Associated Risk Factors Among World Trade Center Disaster Rescue and Recovery Workers,"This study compared the prevalence and risk factors of current probable posttraumatic stress disorder (PTSD) across different occupations involved in rescue/recovery work at the World Trade Center site.Rescue and recovery workers enrolled in the World Trade Center Health Registry who reported working at the World Trade Center site (N=28,962) were included in the analysis. Interviews conducted 2-3 years after the disaster included assessments of demographic characteristics, within-disaster and work experiences related to the World Trade Center, and current probable PTSD.The overall prevalence of PTSD among rescue/recovery workers was 12.4%, ranging from 6.2% for police to 21.2% for unaffiliated volunteers. After adjustments, the greatest risk of developing PTSD was seen among construction/engineering workers, sanitation workers, and unaffiliated volunteers. Earlier start date and longer duration of time worked at the World Trade Center site were significant risk factors for current probable PTSD for all occupations except police, and the association between duration of time worked and current probable PTSD was strongest for those who started earlier. The prevalence of PTSD was significantly higher among those who performed tasks not common for their occupation.Workers and volunteers in occupations least likely to have had prior disaster training or experience were at greatest risk of PTSD. Disaster preparedness training and shift rotations to enable shorter duration of service at the site may reduce PTSD among workers and volunteers in future disasters.",0,0 +3906,"Relationships Among Predeployment Risk Factors, Warzone-Threat Appraisal, and Postdeployment PTSD Symptoms","Previous research indicates a relationship between perceived fear for one's safety (i.e., threat appraisal) and posttraumatic stress disorder (PTSD). This prospective study examined relationships among deployment- and predeployment-related variables, threat appraisal, and postdeployment PTSD symptom severity. Prior to Iraq deployment, 774 U.S. Army soldiers completed self-report measures assessing previous life stressors, deployment history, current (predeployment) PTSD symptoms, deployment preparedness, and unit cohesion. Following deployment, participants completed self-report measures assessing combat intensity, deployment threat appraisal, and current (postdeployment) PTSD symptoms. Structural equation modeling revealed that predeployment PTSD symptom severity, prior warzone deployment, unit cohesion, and preparedness were each independently associated with deployment threat appraisal, even after taking into account combat intensity. Deployment threat appraisal was associated with postdeployment PTSD severity. Results indicated that predeployment PTSD symptom severity, history of warzone deployment, and preparedness-risk factors previously thought to influence PTSD outcomes directly-were either partially or fully mediated by threat appraisal. The model explained 15% of the variance in deployment threat appraisal and 50% of the variance in postdeployment PTSD severity. Helping service members cope with exposure to extreme stress during deployment by modifying certain prewar risk factors may facilitate reduction of PTSD symptoms following deployment.",0,0 +3907,Determining the Relative Importance of Predictors in Logistic Regression: An Extension of Relative Weight Analysis,"Techniques such as dominance analysis and relative weight analysis have been proposed recently to evaluate more accurately predictor importance in ordinary least squares (OLS) regression. Similar questions of predictor importance also arise in instances where logistic regression is the primary mode of analysis. This article presents an extension of relative weight analysis that can be applied in logistic regression and thus aids in the determination of predictor importance. We briefly review relative importance techniques and then discuss a new procedure for calculating relative importance estimates in logistic regression. Finally, we present a substantive example applying this new approach to an example data set.",0,0 +3908,Impact of combat and non-military trauma exposure on symptom reduction following treatment for veterans with posttraumatic stress disorder,"Military veterans with posttraumatic stress disorder (PTSD) frequently report exposure to multiple other traumas in addition to their military experiences. This study aimed to examine the impact of exposure-related factors for military veterans with PTSD on recovery after participation in a group-based treatment program. Subjects included 1548 military veterans with PTSD participating in specialist veterans' PTSD programs across Australia. The study included measures of PTSD, depression, anxiety and alcohol use. Analyses of variance found higher combat exposure was associated with more severe PTSD at intake. No differences in PTSD intake severity were evident in those with additional non-military trauma. Severity of combat exposure did not affect treatment outcomes, although those with low combat exposure and additional non-military trauma (which included high rates of molestation) did report reduced symptom improvement. These findings have implications for considerations of optimal interventions for those with lower levels of combat exposure and additional non-military trauma.",0,0 +3909,Mortality rates between treated post-traumatic stress disorder Israeli male veterans compared to non-diagnosed veterans,"The literature suggests that post-traumatic stress disorder (PTSD) is associated with increased mortality. However, to date, mortality rates amongst veterans diagnosed with post-traumatic stress disorder have not been reported for Israeli veterans, who bear a different profile than veterans from other countries. This study aims to evaluate age-adjusted mortality rates amongst Israeli Defense Forces veterans with and without PTSD diagnosis. The study was carried out in a paired sample design with 2457 male veterans with treated PTSD and 2457 matched male veterans without a PTSD diagnosis. Data on PTSD and non-PTSD veterans was collected from the Rehabilitation Division of the Israeli Ministry of Defense (MOD) and the Israeli Defense Forces' (IDF) special unit for treatment of combat stress reaction. Mortality data were collected from the Ministry of the Interior (MOI) computerized database. Comparison of mortality rates between PTSD and non-PTSD veterans was done using paired observations survival analysis by applying a proportional hazards regression model. Overall no statistically significant difference in mortality rates was found between veterans with treated PTSD and veterans without PTSD. These findings hold even when excluding veterans who died in battle and including non-PTSD veterans who died before their matched PTSD veteran was diagnosed. However, among pairs with similar military jobs PTSD group had significantly less mortality. The results of this large national cohort suggest that treated PTSD is not associated with increased mortality. We submit that the lack of this association represents the ""net"" pathophysiology of PTSD due to the unique characteristics of the sample.",0,0 +3910,Group-Based Trajectory Modeling (Nearly) Two Decades Later,"The Author(s) 2010. This article is published with open access at Springerlink.com Nearly two decades have passed since the publication of ‘‘Age, Criminal Careers, and Population Heterogeneity: Specification and Estimation of a Nonparametric Mixed Poisson Model’’ by Nagin and Land (1993). In that article Nagin and Land laid out a statistical method that has come to be called group-based trajectory modeling. The principle objective of the paper was to address issues related to the ‘‘hot topic’’ of the time—the criminal career debate—not to lay out a new statistical methodology. As described in the paper’s abstract, these issues were: ‘‘First, is the life course of individual offending patterns marked by distinctive periods of quiescence? Second, at the level of the individual, do offending rates vary systematically with age? In particular, is the age-crime curve single peaked or flat? Third, are chronic offenders different from less active offenders? Do offenders themselves differ in systematic ways?’’ Figure 1 reports Nagin’s (2005) updated version of the trajectories reported in Nagin and Land (1993). The analysis is based on the classic dataset assembled by Farrington and West (1990), which includes data on convictions from age 10 to 32 in a sample of over 400 males from a poor neighborhood in London, England. A four group model, analyzed using the zero-inflated Poisson modeling option, was found to best fit the data. The largest trajectory group accounted for 69.5% of the population, and was composed of individuals who generally had no convictions. The three offending trajectories included an adolescentlimited group (12.4% of the population), which peaked sharply in late adolescence, and then declined to a near zero rate of offending by age 20, a high chronic trajectory (5.9% of the population) with a high-humped shaped trajectory and a low rate chronic trajectory that accounted for the remaining 12.2% of the population. Also, shown in the figure are 95% confidence intervals around each trajectory. The dominant legacy of Nagin and Land (1993), however, was not its answers to the specific questions listed in the abstract but the methodology itself. A review of applications",0,0 +3911,Coping with Gulf War combat stress: Mediating and moderating effects.,,0,0 +3912,Thirty years of using a series of personality questionnaires constructed by computer.,"The series of personality questionnaires constructed using a computer was created on the basis of cybernetic theories of personality, which presupposes the existence of six conative control systems: a system for the regulation of defense responses, a system for the regulation of attack responses, a system for controlling physiological functions, a system for coordination of regulatory functions, system for integration of regulatory functions and system for regulation of activity. Six personality questionnaires measure the intensity of the following pathological personality tendencies: 1. neurasthenia and anxiety, 2. aggressiveness and impulsiveness, 3. conversive neurotic disorders, 4. psychotic dissociation, 5. psychotic regression and 6. extroversion-introversion.The sample consisted of 4368 persons: 3496 subjects without a diagnosis, and 872 patients with a psychiatric diagnosis. Participants had to fill in the six personality questionnaire. Data were collected anonymously, during psychological treatment at the Neuropsychiatric Hospital ""Dr. Ivan Barbot"" in Popovača, at the Department of Occupational Medicine and Transport and the Department of Mental Health and Addiction Prevention at Dr. Andrija Štampar Institute of Public Health and for the purpose of selection of candidates for employment in the period from 1984 until today. Basic metric characteristics were determined for all scales. Factor structure of the scales was determined using principal component analysis; as canonical discriminant analysis, polar taxons analysis and canonical correlation analysis are special cases of factor analysis, results of factor analysis were used for further processing.Results from earlier studies are replicated on much larger sample: metric characteristics of scales are very good, as in previous studies, similar structure of polar taxons was found and discrimination between healthy subjects ad those with psychiatric diagnoses was successful. Canonical correlation analysis showed interconnection of reactions on certain scales and extremely complex relationship between them which indirectly confirms the theoretical model on the basis of which the scales are formed.The usefulness of this scales is confirmed in clinical setting and in selection of candidates for employment.",0,0 +3913,Symptoms of post-traumatic stress disorder after non-traumatic events: evidence from an open population study,"Post-traumatic stress disorder (PTSD) is the only psychiatric condition that requires a specific event to have occurred for its diagnosis.To gather evidence from the adult general population on whether life events (e.g. divorce, unemployment) generate as many symptoms of post-traumatic stress as traumatic events (e.g. accidents, abuse).Data on demographic characteristics and history of stressful events were collected through a written questionnaire sent to a random sample of 2997 adults. Respondents also filled out a PTSD symptom checklist, keeping in mind their worst event. Mean PTSD scores were compared, controlling for differences between the two groups. Differences in item scores and in the distribution of the total PTSD scores were analysed.Of the 1498 respondents, 832 were eligible for inclusion in our analysis. For events from the past 30 years the PTSD scores were higher after life events than after traumatic events; for earlier events the scores were the same for both types of events. These findings could not be explained by differences in demographics, history of stressful events, individual item scores, or the distribution of the total PTSD scores.Life events can generate at least as many PTSD symptoms as traumatic events. Our findings call for further studies on the specificity of traumatic events as a cause of PTSD.",0,0 +3914,Family cohesion and posttraumatic intrusion and avoidance among war veterans: a 20-year longitudinal study,"Background: The bi-directional relationships between combat-induced posttraumatic symptoms and family relations are yet to be understood. The present study assesses the longitudinal interrelationship of posttraumatic intrusion and avoidance and family cohesion among 208 Israeli combat veterans from the 1982 Lebanon War. Methods: Two groups of veterans were assessed with self-report questionnaires 1, 3 and 20 years after the war: a combat stress reaction (CSR) group and a matched non-CSR control group. Results: Latent Trajectories Modeling showed that veterans of the CSR group reported higher intrusion and avoidance than non-CSR veterans at all three points of time. With time, there was a decline in these symptoms in both groups, but the decline was more salient among the CSR group. The latter also reported lower levels of family cohesion. Furthermore, an incline in family cohesion levels was found in both groups over the years. Most importantly, Autoregressive Cross-Lagged Modeling among CSR and non-CSR veterans revealed that CSR veterans' posttraumatic symptoms in 1983 predicted lower family cohesion in 1985, and lower family cohesion, in turn, predicted posttraumatic symptoms in 2002. Conclusions: The findings suggest that psychological breakdown on the battlefield is a marker for future family cohesion difficulties. Our results lend further support for the bi-directional mutual effects of posttraumatic symptoms and family cohesion over time. © 2012 Springer-Verlag.",0,0 +3915,Autonomic dysfunction in women with chronic pelvic pain,"We compared the Autonomic Symptom Profile results in 16 women with chronic pelvic pain (CPP) and 15 age-matched healthy subjects. Moderately severe generalized autonomic symptomology occurs in women with CPP, but not in controls. Further study including autonomic testing is needed to confirm results and explore the mechanism of dysfunction.",0,0 +3916,You want to measure coping but your protocol’ too long: Consider the brief cope,"Studies of coping in applied settings often confront the need to minimize time demands on participants. The problem of participant response burden is exacerbated further by the fact that these studies typically are designed to test multiple hypotheses with the same sample, a strategy that entails the use of many time-consuming measures. Such research would benefit from a brief measure of coping assessing several responses known to be relevant to effective and ineffective coping. This article presents such a brief form of a previously published measure called the COPE inventory (Carver, Scheier, & Wcintraub, 1989), which has proven to be useful in health-related research. The Brief COPE omits two scales of the full COPE, reduces others to two items per scale, and adds one scale. Psychometric properties of the Brief COPE arc reported, derived from a sample of adults participating in a study of the process of recovery after Hurricane Andrew.",0,0 +3917,Posttraumatic Concerns: A Patient-Centered Approach to Outcome Assessment After Traumatic Physical Injury,"Approximately 2.5 million Americans are admitted to the hospital after traumatic physical injury each year. Few investigations have elicited patients' perspectives regarding posttraumatic outcomes.To identify and categorize physically injured trauma survivors' posttraumatic concerns.Prospective longitudinal investigation; trauma survivors were interviewed during the post-injury hospitalization and again 1, 4, and 12 months after the trauma.Ninety-seven, randomly selected, English speaking, hospitalized survivors of motor vehicle-crashes or assaults.At the end of each interview patients were asked, ""Of all the things that have happened to you since you were injured, what concerns you the most?"" Using an iterative process and working by consensus, investigators categorized patient concerns in content domains. Concern domains were then compared with established measures of posttraumatic stress disorder (PTSD) symptoms and limitations in physical functioning.Seven categories of posttraumatic concerns were identified. During the course of the year, 73% of patients expressed physical health concerns, 58% psychological concerns, 53% work and finance concerns, 40% social concerns, 10% legal concerns, 10% medical concerns, and 20% uncodable concerns. Rater agreement on concern categorization was substantial (kappa = 0.72). The mean number of concerns expressed per patient gradually decreased over time (1 month mean = 1.51; 12 month mean = 1.26) and resembled the trajectories of PTSD symptoms and functional limitations.The concerns of physically injured trauma survivors are readily elicited and followed up during the course of the year after injury. Open-ended inquiry regarding posttraumatic concerns may complement standardized outcome assessments by identifying and contextualizing the outcomes of greatest importance to patients.",0,0 +3918,Child Mental Health in the Aftermath of Disaster: A Review of PTSD Studies,"INTRODUCTION Epidemiological investigations provide strong evidence that experiencing disaster-related traumatic events in childhood can have significant adverse psychopathological consequences (Hoven et al., 2005; La Greca, Silverman, Vernberg, & Prinstein, 1996; Lonigan, Shannon, Finch, Jr., Daugherty, & Taylor, 1991). Clearly, understanding how such exposure to disaster affects children's mental health and psychosocial development is important, both for elucidating vulnerabilities specific to children, and for informing and guiding appropriate responses, including treatment, which fosters resilience and speeds recovery. The greatest promise for advancing knowledge on this topic depends upon systematic assessment, using diagnostic-based measures in well-designed, longitudinal investigations of representative samples of children (in sufficient numbers) to allow for meaningful analyses. Unfortunately, to date, no study with children that includes all of these elements could be identified. As a nascent field of inquiry, disaster mental health research in children is now ideally poised to review its own recent research, including emphasis and approach, so as to determine a future trajectory. In an effort to stimulate and facilitate this process and to identify critical knowledge gaps, this chapter systematically examines the extant literature, focusing on methodological issues. In an effort to identify lacunae in our collective research agenda, we offer a conceptual typology, or classification schema, for reviewing the kinds of disasters that have been studied and the research methods employed. © Cambridge University Press 2009.",0,0 +3919,Community Resilience and the Principles of Mass Trauma Intervention,"Drawing upon literatures in several disciplines, Norris and colleagues (in press) concluded that the resilience of communities, and consequently the wellness of communities, rests upon a network of adaptive capacities, particularly Economic Development, Social Capital, Information and Communication, and Community Competence. There are numerous ways in which efforts to build community resilience might also achieve the five essential elements of mass trauma intervention explicated by Hobfoll and colleagues. Thus, it is argued here that efforts to reduce risk and resource inequities, engage local people in mitigation, create organizational linkages, boost and protect social supports, cultivate trusted and responsible information resources, and enhance decision–making skills will augment more specific intervention efforts to promote safety, calming, efficacy, hope, and connectedness in the aftermath of mass trauma. Many of these outcomes require systems and social changes that can be the target of intervention efforts before as well as after disasters.",0,0 +3920,NEO-PI profiles in PTSD as a function of trauma level,"One hundred Vietnam veterans with combat-related PTSD were administered the NEO Personality Inventory (NEO-PI) and the Combat Exposure Scale and were sorted into three groups based on trauma exposure level. Results indicate no significant differences among the personality profiles of the three trauma-exposed groups. A normative NEO-PI profile for persons diagnosed with combat-related PTSD is presented, characterized by an extremely high Neuroticism score (T > 75) and an extremely low Agreeableness score (T < 25).",0,0 +3921,Auditory Startle Response in Trauma Survivors With Posttraumatic Stress Disorder: A Prospective Study,"Previous studies have shown elevated autonomic responses to startling tones in trauma survivors with chronic posttraumatic stress disorder (PTSD). The origin of these abnormal responses is obscure. The present study attempted to clarify this issue by prospectively evaluating responses to sudden, loud tones in individuals who arrived at a hospital emergency room after psychologically traumatic events.By using a previously established protocol, autonomic and muscular responses to the tones were evaluated at 1 week, 1 month, and 4 months after the traumatic event. Structured diagnostic interviews performed at 4 months classified subjects into groups with (N=36) and without (N=182) PTSD, which were further subdivided according to the presence or absence of major depressive disorder as follows: neither PTSD nor depression (N=166), depression alone (N=16), PTSD alone (N=21), and both PTSD and depression (N=15).The groups showed comparable physiological responses to the tones at 1 week posttrauma. However, at 1 and 4 months posttrauma, the subjects with PTSD showed a greater heart rate response and required more stimulus trials to reach the criteria of skin conductance and orbicularis oculi electromyogram nonresponse. These findings were not significantly influenced by comorbid depression and were not explained by the severity of the traumatic event or by the intensity of the initial symptoms.Differences in physiological response to startling tones develop along with PTSD in the months that follow a traumatic event. This pattern supports the theories that associate PTSD with progressive neuronal sensitization.",0,0 +3922,"Post-traumatic stress symptom, metacognition, emotional schema and emotion regulation: A structural equation model","Abstract Objective The present study aimed to assess the direct and indirect impacts of the metacognition, emotional schema and emotion regulation in prediction of post-traumatic stress (PTS) symptom. Method Participants consisted of 678 high school students from earthquake-stricken areas of eastern Azerbaijan selected from Varzaghan, Ahar and Heris by multistage cluster sampling. PTSD Symptom Scale—Self Report (PSS-SR), Metacognition Questionnaire—Adolescent Version (MCQ-A), Leahy Emotional Schema Scale (LESS) and Difficulties in Emotion Regulation Scale (DERS) were utilized for data collection. SPSS software and LISREL software were used for data analysis. Results The results of SEM and path analysis indicated the direct and indirect (through emotion regulation) impacts of metacognition and also indirect (through emotion regulation) impact of emotional schema on PTS symptom. Model examination presented the good fitness of the proposed theoretical model. Conclusions Consistent with metacognitive model and also emotional schema model, results of this study indicated the impact of metacognition and emotional schema on post-traumatic stress symptom through emotion regulation. This finding emphasizes that both metacognitive and emotional factors are important in explanation of PTS symptom.",0,0 +3923,Five psychosocial variables related to the existence of Post-Traumatic Stress Disorder symptoms,"Sixty Vietnam veterans from a midwestern VA Medical Center were surveyed to determine the relationship between symptoms of Post-Traumatic Stress Disorder (PTSD) and five psychosocial variables: Intensity of combat experienced in Vietnam, current subjective impact of the previously experienced stress of Vietnam experiences, current level of life stress, extent and nature of social support available to the veteran during the first year of return from Vietnam, and pre-service psychosocial functioning. A stepwise discriminant function analysis revealed that combat intensity, current impact of the previously experienced events in Vietnam, and current level of life stress correctly classified 75% of the total cases. These findings were supported by other lines of analyses, including tests of correlation and stepwise regression analysis. Current levels of life stress, especially disruption in interpersonal relationships, also were associated significantly with PTSD symptoms. These findings are consistent with previous reports on the etiology and correlates of PTSD symptoms and suggest the existence of a quantifiable constellation of symptoms associated with psychological sequelae of severely stressful trauma.",0,0 +3924,Post traumatic stress disorder in armed robbery victims and ex-prisoners of war,"The aim of this study was to examine the prevalence of Post Traumatic Stress Disorder (PTSD) symptom clusters in 72 armed robbery victims (AR) at their work place. 19 were assaulted twice or three times, while 15 suffered mild or minor physical injury. Subjects were 47 female and 25 male employees who were having 1 to 11 months of sick leave period at the time of examination. According to psychiatric examination 38.9% fulfilled criteria for PTSD, while others had different combination of symptoms. Statistical analysis showed that the whole group dominantly expressed persistent re-experience of the event, followed by arousal symptoms. Those with full PTSD diagnosis did not differ from others in age, level of education, number of assaults, length of sick leave period or the fact that they had or had not been physically injured. No difference was found between those who suffered only one attack and those who were assaulted two or three times in a short period of time. The repetition of identical or very similar trauma situation did not contribute to the increased number of psychological problems measured by PTSD scales. Additionally we compared the structure of PTSD in AR victims and in a group of 100 male ex-prisoners of war (ex-POW). The results indicate greater occurrence of full PTSD in AR group, as well as re-experience and arousal symptoms combination in those with partial PTSD, while ex-POW group dominantly showed arousal symptoms as isolated cluster, followed by combination of re-experience and arousal symptoms.",0,0 +3925,Screening in special populations: A “case study” of recent vietnamese immigrants,"

Purpose

To determine how the medical and social profile of a particular special population, Vietnamese immigrants, should be used to tailor screening protocols that differ from those designed for the general population.

Patients and methods

A consecutive series of Vietnamese immigrants living in the United States for less than 6 months were evaluated by interviewer-administered standardized questionnaire and medical record review. A total of 99 new Vietnamese immigrants (47 women and 52 men) aged 19 to 71 years presenting for primary care to two neighborhood health centers between October 1994 and June 1995 were identified. Data collected included smoking status, alcohol use (CAGE questionnaire), depression (Vietnamese Depression Scale [VDS]), PPD status, stool ova and parasites, hepatitis B and syphilis serologies.

Results

Overall, 32% were smokers and significantly more men than women smoked (54% vs. 9%) (P <.00001). Although 24% of patients used alcohol, none responded positively to any of the CAGE questions. Using the VDS, 17% (17 of 99) were depressed; age 40 and older was the only sociodemographic factor associated with depression (P <.00001). Ova or parasites were found in 51% (41 of 80), and 63% of those infected (26 of 41) required treatment for pathogenic infections. Seventy percent (66 of 94) tested positive on the tuberculin skin test (PPD), and antituberculous medication was recommended in 39% (37 of 94). Eighty-three percent (80 of 96) had been exposed to hepatitis B, and 14% (13 of 96) were chronic hepatitis B carriers.

Conclusions

Caring for special populations provides an opportunity to institute appropriate unique screening tests not recommended for the general population. In the case of new Vietnamese immigrants, routine screening protocols should include the following: testing for tuberculosis by PPD, stool ova and parasite examinations, hepatitis B serologies, and assessment for depression and smoking status. The CAGE questionnaire may not be an effective instrument for detecting alcohol abuse in this particular population.",0,0 +3926,Procedural justice and quality of life in compensation processes,"There is considerable evidence that being involved in compensation processes has a negative impact on claimants' health. Previous studies suggested that this negative effect is caused by a stressful compensation process: claimants suffered from a lack of communication, a lack of information, and feelings of distrust. However, these rather qualitative findings have not been quantitatively investigated yet. This observational study aimed to fill this gap of knowledge, investigating the claimants' perceived fairness of the compensation process, the provided information, and the interaction with lawyers and insurance companies, in relation to the claimants' quality of life.Participants were individuals injured in traffic accidents, older than 18 years, who were involved in a compensation process in the Netherlands. They were recruited by three claims settlement offices. Outcome measures were procedural, interactional, and informational justice, and quality of life.Participants (n=176) perceived the interaction with lawyers to be fairer than the interaction with insurance companies (p<.001). The length of hospital stay was positively associated with procedural justice (β=.31, p<.001). Having trunk/back injury was negatively related to procedural justice (β=-.25, p=.001). Whiplash injury and length of time involved in the claim process were not associated with any of the justice scales. Finally, procedural justice was found to be positively correlated with quality of life (rs=.22, p=.004).The finding that the interaction with insurance companies was considered less fair than the interaction with lawyers may imply that insurers could improve their interaction with claimants, e.g. by communicating more directly. The result that claimants with mild injuries and with trunk/back injuries considered the compensation process to be less fair than those with respectively severe injuries and injuries to other body parts suggests that especially the former two require an attentive treatment. Finally, the fact that procedural justice was positively correlated with quality of life could implicate that it is possible to improve claimants' health in compensation processes by enhancing procedural justice, e.g. by increasing the ability for claimants to express their views and feelings and by involving claimants in the decision-making process.",0,0 +3927,Flooding and Mental Health: A Systematic Mapping Review,"Floods are the most common type of global natural disaster. Floods have a negative impact on mental health. Comprehensive evaluation and review of the literature are lacking.To systematically map and review available scientific evidence on mental health impacts of floods caused by extended periods of heavy rain in river catchments.We performed a systematic mapping review of published scientific literature in five languages for mixed studies on floods and mental health. PUBMED and Web of Science were searched to identify all relevant articles from 1994 to May 2014 (no restrictions).The electronic search strategy identified 1331 potentially relevant papers. Finally, 83 papers met the inclusion criteria. Four broad areas are identified: i) the main mental health disorders-post-traumatic stress disorder, depression and anxiety; ii] the factors associated with mental health among those affected by floods; iii) the narratives associated with flooding, which focuses on the long-term impacts of flooding on mental health as a consequence of the secondary stressors; and iv) the management actions identified. The quantitative and qualitative studies have consistent findings. However, very few studies have used mixed methods to quantify the size of the mental health burden as well as exploration of in-depth narratives. Methodological limitations include control of potential confounders and short-term follow up.Floods following extreme events were excluded from our review.Although the level of exposure to floods has been systematically associated with mental health problems, the paucity of longitudinal studies and lack of confounding controls precludes strong conclusions.We recommend that future research in this area include mixed-method studies that are purposefully designed, using more rigorous methods. Studies should also focus on vulnerable groups and include analyses of policy and practical responses.",0,0 +3928,Patterns of recovery from trauma: The use of intraindividual analysis.,"Patterns of recovery from sexual and nonsexual assault were examined. Two studies containing data from female victims of these assaults were analyzed. In Study 1, victims (N = 101) underwent 12 weekly assessments with measures of posttraumatic stress disorder (PTSD), depression, and state anxiety. In Study 2, victims (N = 108) underwent monthly assessments on the same measures. The authors examined the effects of type of trauma and time of peak reaction on long-term recovery using intraindividual analysis of change. In both studies, initial and peak reactions of rape victims were more severe than were those of nonsexual assault victims on all measures of psychopathology. Victims with delayed peak reaction exhibited more severe pathology at the final assessment than did victims with early peak reaction. Results of Study 2 indicated a slower recovery rate from sexual than nonsexual assault; in Study 1 a similar pattern of recovery emerged. The advantages of an individual-focused, longitudinal approach to recovery from a trauma are discussed.",0,0 +3929,Psychosocial care for seriously injured children and their families: A qualitative study among Emergency Department nurses and physicians,"Approximately one in five children who sustain a serious injury develops persistent stress symptoms. Emergency Department nurses and physicians have a pivotal role in psychosocial care for seriously injured children. However, little is known about staff's views on this role.Our aim was to investigate Emergency Department staff's views on psychosocial care for seriously injured children.We conducted semi-structured interviews with 20 nurses and physicians working in an Australian Paediatric Emergency Department. We used purposive sampling to obtain a variety of views. The interviews were transcribed verbatim and major themes were derived in line with the summative analysis method. We also mapped participants' strategies for child and family support on the eight principles of Psychological First Aid (PFA).Five overarching themes emerged: (1) staff find psychosocial issues important but focus on physical care; (2) staff are aware of individual differences but have contrasting views on vulnerability; (3) parents have a central role; (4) staff use a variety of psychosocial strategies to support children, based on instinct and experience but not training; and (5) staff have individually different wishes regarding staff- and self-care. Staff elaborated most on strategies related to the PFA elements 'contact and engagement', 'stabilization', 'connection with social supports' and least on 'informing about coping'.The strong notion of individual differences in views suggests a need for training in psychosocial care for injured children and their families. In addition, further research on paediatric traumatic stress and psychosocial care in the ED will help to overcome the current paucity of the literature. Finally, a system of peer support may accommodate wishes regarding staff care.",0,0 +3930,"Toward an integrative model of the spectrum of mood, behavioral and personality disorders based on fear and anger traits: I. Clinical implications","Current formal psychiatric approaches to nosology are plagued by an unwieldy degree of heterogeneity with insufficient appreciation of the commonalities of emotional, personality, behavioral, and addictive disorders. We address this challenge by building a spectrum model that integrates the advantages of Cloninger's and Akiskalian approaches to personality and temperament while avoiding some of their limitations. We specifically propose that ""fear"" and ""anger"" traits--used in a broader connotation than in the conventional literature--provide an optimum basis for understanding how the spectra of anxiety, depressive, bipolar, ADHD, alcohol, substance use and other impulse-control, as well as cluster B and C personality disorders arise and relate to one another. By erecting a bidimensional approach, we attempt to resolve the paradox that apparently polar conditions (e.g. depression and mania, compulsivity and impulsivity, internalizing and externalizing disorders) can coexist without cancelling one another. The combination of excessive or deficient fear and anger traits produces 4 main quadrants corresponding to the main temperament types of hyperthymic, depressive, cyclothymic and labile individuals, which roughly correspond to bipolar I, unipolar depression, bipolar II and ADHD, respectively. Other affective temperaments resulting from excess or deficiency of only fear or anger include irritable, anxious, apathetic and hyperactive. Our model does not consider schizophrenia. We propose that ""healthy"" or euthymic individuals would have average or moderate fear and anger traits. We further propose that family history, course and comorbidity patterns can also be understood based on fear and anger traits. We finally discuss the implications of the new derived model for clinical diagnosis of the common psychiatric disorders, and for subtyping depression and anxiety as well as cognitive and behavioral styles. We submit this proposed schema represented herein as a heuristic attempt to build bridges between basic and clinical science.",0,0 +3931,The two-factorial symptom structure of post-traumatic stress disorder: depression–avoidance and arousal–anxiety,"The first part of this study showed that the DSM-III-R symptom structure of post-traumatic stress disorder (PTSD), i.e. criteria B (reexperience), C (avoidance-numbing), and D (arousal), and, consequently the diagnosis of PTSD, could not be validated in fire and car-accident victims. The aims of this study were to: (i) determine the factors as well as their structure in the symptoms of PTSD; and (ii) develop a new classification or typology of PTSD. Exploratory and confirmatory factor analyses and cluster analyses were employed to: (i) examine the factors in PTSD symptomatology; and (ii) find and validate adequate diagnostic criteria for PTSD. The Composite International Diagnostic Interview (CIDI), PTSD Module, was used between 7 and 9 months after the traumatic event in a study group of 185 victims of two different traumatic events, i.e. 130 fire and 55 car-accident victims. Our findings support the existence of two factors, i.e. a first labeled 'depression-avoidance (DAV) dimension', as it contains items reminiscent of depression and avoidance, and a second labeled 'the anxiety-arousal (AA) dimension', as it contains symptoms reminiscent of anxiety and increased arousal. Cluster analysis yielded two clusters, i.e. a cluster of subjects with PTSD cases and another with non-cases. Our PTSD algorithm was significantly less restrictive than the DSM-III-R diagnosis of PTSD. There are only quantitative, but no qualitative, differences between the cluster analytically derived classes.PTSD is not a well-delineated clinical entity, as there is a clinical continuum from PTSD non-cases to cases with less and more severe DAV and AA symptoms. It is more appropriate to express PTSD in terms of general severity of PTSD and severity of the DAV and AA dimensions.",0,0 +3932,"Longitudinal linkages between posttraumatic stress disorder and posttraumatic growth in adolescent survivors following the Wenchuan earthquake in China: A three-wave, cross-lagged study","The aim of this study is to examine the longitudinal relationships between posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) among adolescent survivors of the 2008 Wenchuan earthquake in China. The participants in our study included 245 adolescent survivors who were randomly selected from several primary and secondary schools in the counties of Wenchuan, which are the areas most severely affected by the Wenchuan earthquake. Participants completed the Revised Child PTSD Symptom Scale and the Posttraumatic Growth Inventory (PTGI) at 3.5 years after the earthquake (T1), 4.5 years after the earthquake (T2), and 5.5 years after the earthquake (T3). The results found that PTSD reported in T1 and T2 predicted subsequent PTG reported at T2 and T3 and that PTG did not predict PTSD from T1 to T3. In addition, the cross-sectional correlation between PTSD and PTG weakened from T1 to T3. These results indicate that PTSD and PTG can coexist in individuals after a traumatic experience, and they further suggest that the reduction in PTSD does not indicate the appearance of PTG.",0,0 +3933,The Role of Emotional Numbing in Sexual Functioning Among Veterans of the Iraq and Afghanistan Wars,"Post-traumatic stress disorder (PTSD) negatively impacts sexuality, yet few studies have evaluated which component of PTSD contributes to this known association. The present study examined which of four PTSD clusters (numbing, avoidance, intrusiveness, and hyperarousal) was most closely linked to sexual problems in a sample of 197 veterans from the Iraq or Afghanistan wars. Newly registered veterans completed a packet of questionnaires including standardized measures of PTSD and questions regarding sexual functioning. A stepwise logistic regression was performed to examine the relationship between symptom cluster and sexual functioning. As predicted, only the numbing cluster was retained in the regression model. The numbing cluster appears to be intimately tied to sexual functioning, assessment of which should be part of a comprehensive evaluation during the postdeployment readjustment phase. Those exhibiting numbing symptoms should be thoroughly assessed for sexual functioning problems and referred for treatment as necessary.",0,0 +3934,Predictors of healthy behaviour in long-term survivors of childhood cancer,"Aim. The objective of this study was to examine the factors contributing to healthy behaviour in young adult long-term survivors of childhood cancer. Background. Young adult childhood cancer survivors can adopt more healthy behaviour than the general population as a way to minimize the adverse consequences, that is, late effects of cancer and its treatment. Knowledge about the predictors of healthy behaviour in childhood cancer survivors can help providers assist young adult survivors with minimizing late effects. Design and methods. A cross-sectional correlational design and convenience sampling were used. Data were collected by mailed survey. Study measures included an investigator-developed demographic and disease form, the Mishel Uncertainty in Illness Scale-Community, the Post-traumatic Stress Disorder Index and the Health Promoting Lifestyle Profile II. Fifty-one per cent (N = 46) of eligible survivors responded to the survey. Data from 45 participants were used in the analyses. Results. 43·3% of variance in healthy behaviour was explained by a model that included uncertainty (β = −0·37, p = 0·007), post-traumatic stress symptoms (β = −0·10, p = −0·44), interactions with primary care providers (β = 0·33, p = 0·01) and a history of special educational assistance (β = −0·23, p = 0·06). Conclusion. Young adult childhood cancer survivors who have higher levels of uncertainty, higher levels of symptoms of post-traumatic stress, lower frequency of primary healthcare interaction and poorer cognitive resources were more likely to report lower levels of healthy behaviour. Relevance to clinical practice. The findings can guide the clinical assessment of young adult survivors with regard to their health behaviours and needs they may have for education and supportive care. Findings also help inform the design of health promotion interventions for this specific group of cancer survivors.",0,0 +3935,"Differential diagnosis of PTSD, schizophrenia, and depression with the MMPI-2","This study used 102 male, veteran, psychiatric inpatients to describe patterns of MMPI-2 clinical and content scales that most accurately discriminate among patients diagnosed with PTSD, schizophrenia, and depression. Single scale accuracy classification using scales PK and PS was unacceptably low. Optimally weighted scales, including PK, Sc, BIZ, and ANX, correctly classified 70% of the patients. Suggestions for facilitating the use of formal decision rules are offered. © 1999 John Wiley & Sons, Inc. J Clin Psychol 55: 217–223, 1999.",0,0 +3936,[Psychopathological profile of battered women according to age].,"In this paper, differential psychopathological consequences in battered women according to age were analysed in a sample of 148 victims seeking psychological treatment in a Family Violence Centre. The younger victims exposed to intimate partner violence suffered more often from physical violence and were at higher risk for their lives than the older ones. The prevalence rate of posttraumatic stress disorder (PTSD) was higher (42%) in the younger victims than in the older ones (27%). Likewise, younger victims were affected by more depressive symptoms and lower self-esteem than the older ones. The severity of PTSD in the younger victims was related to the presence of forced sexual relationship but in the older ones, it was related to the perceived threat to their lives. Implications of this study for clinical practice and future research in this field are commented upon.",0,0 +3937,Anxiety disorders as early stages of malignant psychopathological long-term outcomes: results of the 10-years prospective EDSP Study,"Introduction: Epidemiological studies consistently evidence that anxiety, depressive and substance use disorders are the most frequent mental disorders in adults with high rates of comorbidity. Little long-term outcome research has examined the psychopathological developmental trajectories which would allow for conclusions regarding improved early identification and targeted intervention. Methods: A representative community sample (N = 3,021; age 14-24) was prospectively followed-up over 10 years. Mental disorders were assessed using a standardized diagnostic interview (DSM-IV/M-CIDI). Results: While anxiety disorders reveal the earliest onset in childhood and adolescents, the incidence for depressive and substance use disorders increases in adolescence and young adulthood. Two thirds of those with an anxiety, depressive, or substance use disorder reveal comorbidity with an average of 3.3 diagnoses (SD = 1.7). Among those with any comorbidity, 79.1% meet criteria for a substance use disorder, 52.8% for a depressive disorder, and 59.6% for an anxiety disorder. While anxiety disorders emerge temporally primary in the majority of comorbid cases (74.2%), substance use (67.5%) and depressive disorders (71.8%) are mostly secondary onset conditions. Circumscribed phobias (specific phobia, social phobia, phobia NOS) and panic attacks increase the risk for onset of comorbid - more complex - anxiety disorders (GAD, panic disorder, agoraphobia, OCD, PTSD) (Hazard Ratio (HR) = 2.5, p < .001). Survival analyses with Cox regressions revealed that the higher the overall number of anxiety diagnoses, the greater the risk for subsequent substance use disorders (HR1 vs 0 Anx = 1.5, HR2 vs 0 Anx = 2.3, HR3+ vs 0 Anx = 2.6; p < .001), depression (HR1 vs 0 Anx = 2.0,HR2 vs 0 Anx = 2.6,HR3+ vs 0 Anx = 3.6; p < .001), and suicidality (HR1 vs 0 Anx = 3.8,HR2 vs 0 Anx = 4.8,HR3+ vs 0 Anx = 21.8; p < .001). Conclusions: Childhood and adolescent anxiety syndromes and disorders are an important gateway for unfavourable long-term psychopathological outcomes. Findings support 'sequential comorbidity' or 'staging models of psychopathology' which suggest that an early cascade of anxiety conditions contributes to a substantial proportion of adult substance use and depressive disorders, possibly due to self-medication and demoralization. Such models are of potential usefulness for diagnostic and treatment planning purposes, emphasizing the need for early identification and targeted interventions to prevent the onset of anxiety disorders and a cascade of secondary psychopathology.",0,0 +3938,Coping effectiveness and coping diversity under traumatic stress.,"The effectiveness of different strategies of coping and the impact of coping diversity were tested under traumatic stress conditions. Participants were 632 U.S. soldiers stationed in Iraq (mean age = 27.7, 98% male). Results indicate that four of nine functional coping strategies (including some emotion-focused coping) as defined by the COPE scale were inversely related to psychological symptom, whereas five of six dysfunctional strategies were positively related. Overall, in comparison to the norm group, soldiers showed a depressed level of functional coping strategies. Hierarchical regression, used to control for demographics and coping strategy intercorrelations, indicated that positive reinterpretation, emotional social support, and humor were most strongly related to lower psychological symptoms, whereas venting emotions, denial, mental disengagement, behavioral disengagement, and alcohol and drug use were related to higher levels of psychological symptoms. Two indices of coping diversity were tested. The index more strongly related to higher psychological adjustment was the sum of deviations from the mean of specific coping strategies combined with the alignment of functional and dysfunctional strategy clusters. Implications for research and application were discussed.",0,0 +3939,Anxiety Sensitivity as a Moderator of the Relation Between Trauma Exposure Frequency and Posttraumatic Stress Symptomatology,"The present study tested if the global anxiety sensitivity construct and its constituent factors (i.e., physical, mental incapacitation, and social concerns) moderate the relation between traumatic event exposure frequency and posttraumatic stress symptomatology. Participants were 61 rural young adults who reported experiencing at least 1 lifetime traumatic event. Consistent with prediction, anxiety sensitivity total and subfactor levels moderated the relation between trauma exposure frequency and posttraumatic stress symptomatology. These moderating effects were above and beyond variance accounted for by the respective anxiety sensitivity and stress main effects as well as other theoretically relevant factors (e.g., negative affectivity). Findings are discussed in relation to better understanding cognitive-based individual difference factors associated with posttraumatic stress symptomatology.",0,0 +3940,On growth curves and mixture models,"The multilevel model of change and the latent growth model are flexible means to describe all sorts of population heterogeneity with respect to growth and development, including the presence of sub-populations. The growth mixture model is a natural extension of these models. It comes at hand when information about sub-populations is missing and researchers nevertheless want to retrieve developmental trajectories from sub-populations. We argue that researchers have to make rather strong assumptions about the sub-populations or latent trajectory classes in order to retrieve existing population differences. A simulated example is discussed, showing that a sample of repeated measures drawn from two sub-populations easily leads to the mistaken inference of three sub-populations, when assumptions are not met. The merits of methodological advises on this issue are discussed. It is concluded that growth mixture models should be used with understanding, and offer no free way to growth patterns in unknown sub-populations. Copyright © 2006 John Wiley & Sons, Ltd.",0,0 +3941,Predictors of chronic posttraumatic stress symptoms following burn injury: Results of a longitudinal study,"The authors' goal was to examine the course and predictors of posttraumatic stress symptoms among persons hospitalized for burns. A total of 301 participants completed self-report measures assessing peritraumatic mental state, anxiety related to pain, and posttraumatic stress symptoms. Twenty-six percent of the participants were suffering from posttraumatic stress symptoms at 2-3 weeks postburn and 15% of them at 12 months postburns. In general, a decrease in symptoms was observed over time, although a substantial part of the participants with acute stress symptoms suffers from chronic posttraumatic stress symptoms 1-year postburn. Symptoms were predicted by anxiety measures and objective factors, such as female gender, locus, and severity of injury.",0,0 +3942,"ADX71743, a Potent and Selective Negative Allosteric Modulator of Metabotropic Glutamate Receptor 7: In Vitro and In Vivo Characterization","Metabotropic glutamate receptor 7 (mGlu(7)) has been suggested to be a promising novel target for treatment of a range of disorders, including anxiety, post-traumatic stress disorder, depression, drug abuse, and schizophrenia. Here we characterized a potent and selective mGlu(7) negative allosteric modulator (NAM) (+)-6-(2,4-dimethylphenyl)-2-ethyl-6,7-dihydrobenzo[d]oxazol-4(5H)-one (ADX71743). In vitro, Schild plot analysis and reversibility tests at the target confirmed the NAM properties of the compound and attenuation of L-(+)-2-amino-4-phosphonobutyric acid-induced synaptic depression confirmed activity at the native receptor. The pharmacokinetic analysis of ADX71743 in mice and rats revealed that it is bioavailable after s.c. administration and is brain penetrant (cerebrospinal fluid concentration/total plasma concentration ratio at C(max) = 5.3%). In vivo, ADX71743 (50, 100, 150 mg/kg, s.c.) caused no impairment of locomotor activity in rats and mice or activity on rotarod in mice. ADX71743 had an anxiolytic-like profile in the marble burying and elevated plus maze tests, dose-dependently reducing the number of buried marbles and increasing open arm exploration, respectively. Whereas ADX71743 caused a small reduction in amphetamine-induced hyperactivity in mice, it was inactive in the mouse 2,5-dimethoxy-4-iodoamphetamine-induced head twitch and the rat conditioned avoidance response tests. In addition, the compound was inactive in the mouse forced swim test. These data suggest that ADX71743 is a suitable compound to help unravel the physiologic role of mGlu(7) and to better understand its implication in central nervous system diseases. Our in vivo tests using ADX71743, reported here, suggest that pharmacological inhibition of mGlu(7) is a valid approach for developing novel pharmacotherapies to treat anxiety disorders, but may not be suitable for treatment of depression or psychosis.",0,0 +3943,"The association between childhood trauma and lipid levels in an adult low-income, minority population","BACKGROUND: The objective of this study is to investigate the association between childhood trauma and lipid profiles in adults from a highly traumatized population at-risk for cardiovascular disease. METHOD: We recruited 452 participants, primarily African-American and of low socioeconomic status, from general medical clinics in a large urban hospital. We performed direct comparisons, univariate analysis of variance and regression analyses together and separated by sex, examining the associations of child abuse, body mass index, lipid lowering drug use, blood pressure, age, and substance use to HDL levels and HDL/LDL ratios. RESULTS: A history of moderate to severe levels of childhood trauma and abuse was associated with a significant decrease in HDL levels (P≤.01) and HDL/LDL ratios (P≤.001) relative to males with low levels of abuse. This relationship held when the status of lipid-lowering drugs was considered. When controlling for age, substance abuse, tobacco use, and adult trauma, the effects of childhood trauma remained significant. We found a significant child abuse by sex interaction on HDL/LDL ratios [F(1,369)=13.0, P≤.0005] consistent with a differential effect of trauma on dyslipidemia in male but not female subjects. CONCLUSIONS: Our data suggest that childhood trauma exposure, obtained with self-report measures, may contribute to increased risk of cardiovascular disease by way of stress-mediated alterations of lipid concentration and composition in male, but not female, subjects. Language: en",0,0 +3944,Profile of two cohorts: UK and US prospective studies of military health,"Abstract : In the United Kingdom and United States, these two independent cohort studies have been instituted to prospectively study the health of service personnel and veterans. From comparisons with baseline information, these studies are designed to better inform the military and the public on how best to protect the health of their armed forces and better understand the long-term risks of some occupational exposures that extend beyond military communities. In order to do this, these studies consider: 1) The underlying physical and mental health of the military populations before, during, and after military service; and 2) The specific effects of deployment, deployment-related exposures, and other occupational exposures upon personnel compared with unexposed subgroups. Whilst previous studies have attempted to address these topics, they have often been limited in their generalisability to all service branches and components of the military, or previous population-based methodologies have been largely limited to cross-sectional or retrospective methods. Although follow-up to the National Vietnam Veterans Readjustment Survey, called the National Vietnam Veterans Longitudinal Study, is still ongoing, this study is focused on a single deployment. Similarly, the Air Force Health study, a 20-year longitudinal study of approximately 20,000 Vietnam veterans, assessed potential health effects associated with exposure to aerial spraying of dioxins. Here, we present two prospective, longitudinal, multi-service studies of active duty and Reserve/National Guard personnel that will continue to follow participants even after they have left military service. We describe these two studies in detail, comparing study populations, methodology, and the published literature so far. Potential areas for future collaboration are also explored. By understanding the inherent similarities and differences between these two cohorts and leveraging each study?s unique strengths and strategies to minimize",0,0 +3945,"Associations between body mass index, post-traumatic stress disorder, and child maltreatment in young women","The objective of this study was to examine interrelationships between child maltreatment, post-traumatic stress disorder (PTSD) and body mass index (BMI) in young women. We used multinomial logistic regression models to explore the possibility that PTSD statistically mediates or moderates the association between BMI category and self-reported childhood sexual abuse (CSA), physical abuse (CPA), or neglect among 3,699 young women participating in a population-based twin study. Obese women had the highest prevalence of CSA, CPA, neglect, and PTSD (p<.001 for all). Although all three forms of child maltreatment were significantly, positively associated with overweight and obesity in unadjusted models, only CSA was significantly associated with obesity after adjusting for other forms of maltreatment and covariates (OR=2.21, 95% CI: 1.63, 3.00). CSA and neglect, but not CPA, were associated with underweight in unadjusted models; however, after adjusting for other forms of maltreatment and covariates, the associations were no longer statistically significant (OR=1.43, 95% CI: 0.90-2.28 and OR=2.16, 95% CI: 0.90-5.16 for CSA and neglect, respectively). Further adjustment for PTSD generally resulted in modest attenuation of effects across associations of child maltreatment forms with BMI categories, suggesting that PTSD may, at most, be only a weak partial mediator of these associations. Future longitudinal studies are needed to elucidate the mechanisms linking CSA and obesity and to further evaluate the role of PTSD in associations between child maltreatment and obesity.",0,0 +3946,"Relationships between explanatory style, posttraumatic growth and posttraumatic stress disorder symptoms among Chinese breast cancer patients","Many existing models posit that cognitive processing style is an important factor affecting self-perceived positive changes. In this study, the effects of explanatory style (the manner in which people cognitively process and explain why they experience good and bad events) on both posttraumatic growth (PTG) and posttraumatic stress disorder (PTSD) symptoms were examined among 90 Chinese women with breast cancer. It was found that explanatory style for good events, but not for bad events, was significantly associated with self-reported PTG. Women who attributed the causes of positive events to internal, global and stable factors tended to report more posttraumatic growth. In contrast, explanatory style for bad events, as opposed to good events, was significantly and positively correlated with PTSD symptoms. Among the three dimensions of explanatory style (internal, stable and global), the tendency to globalise the causes of good and bad events were the most important predictors of self-reported PTG and PTSD symptoms, respectively. While enhancing an optimistic explanatory style for bad events might reduce posttraumatic stress symptoms, cultivating an optimistic explanatory style for good events is likely to increase self-perceived positive changes after breast cancer diagnosis and treatment.",0,0 +3947,Post-traumatic stress symptoms in Guillain-Barré syndrome patients after prolonged mechanical ventilation in ICU: a preliminary report,"Thirty percent of Guillain-Barré syndrome (GBS) patients require mechanical ventilation (MV) in intensive care unit (ICU). Post-traumatic stress disorder (PTSD) is found in ICU survivors, and the traumatic aspects of intubation and MV have been previously reported as risk factors for PTSD after ICU. Our objective was to determine long-term PTSD or post-traumatic stress symptoms (PTSS) in GBS patients after prolonged MV in ICU. We assessed GBS patients who had MV for more than 2 months. PTSD was assessed using Horowitz Impact of Event Scale (IES), IES-Revisited (IES-R), and the Post-traumatic CheckList Scale; functional outcome using Rankin and Barthel scales; quality of life (QoL) using Nottingham Health Profile (NHP) and 36-Item Short Form Health Survey (SF-36) and depression using Hospital Anxiety and Depression Scale (HAD) and Beck questionnaire. Thirteen patients could be identified and analyzed. They had only mild disability. They were neither anxious nor depressed with an anxiety HAD at 5 (4-11.5), a depression HAD at 1 (0-3.5) and a Beck at 1 (0-5). QoL was mildly decreased in our population with a NHP at 78.5 (12.8-178.8) and mild decreased SF-36. Compared with the French population, the SF-36 sub-categories were, however, not statistically different. Twenty-two percentage of our 13 patients had PTSD and PTSS with a Horowitz IES at 12 (2-29), and an IES-R at 16 (2-34.5). Although severe GBS patients requiring prolonged MV had good functional recovery and no difference in QoL, they had a high incidence of PTSS.",0,0 +3948,Modelling Psychological Responses to the Great East Japan Earthquake and Nuclear Incident,"The Great East Japan (Tōhoku/Kanto) earthquake of March 2011 was followed by a major tsunami and nuclear incident. Several previous studies have suggested a number of psychological responses to such disasters. However, few previous studies have modelled individual differences in the risk perceptions of major events, or the implications of these perceptions for relevant behaviours. We conducted a survey specifically examining responses to the Great Japan earthquake and nuclear incident, with data collected 11-13 weeks following these events. 844 young respondents completed a questionnaire in three regions of Japan; Miyagi (close to the earthquake and leaking nuclear plants), Tokyo/Chiba (approximately 220 km from the nuclear plants), and Western Japan (Yamaguchi and Nagasaki, some 1000 km from the plants). Results indicated significant regional differences in risk perception, with greater concern over earthquake risks in Tokyo than in Miyagi or Western Japan. Structural equation analyses showed that shared normative concerns about earthquake and nuclear risks, conservation values, lack of trust in governmental advice about the nuclear hazard, and poor personal control over the nuclear incident were positively correlated with perceived earthquake and nuclear risks. These risk perceptions further predicted specific outcomes (e.g. modifying homes, avoiding going outside, contemplating leaving Japan). The strength and significance of these pathways varied by region. Mental health and practical implications of these findings are discussed in the light of the continuing uncertainties in Japan following the March 2011 events.",0,0 +3949,Prevalence of post-traumatic stress disorder in first-episode psychosis,"Psychosis can be considered one of the most severe stressors that an individual may face. Previous studies have suggested that the traumatic experience of psychotic symptoms and hospitalization may provoke a post-traumatic type reaction.The aim of this study was to establish the point prevalence of post-traumatic stress disorder (PTSD) among patients recovering from a first-episode of psychosis in Singapore, and to elucidate the factors associated with it.Patients from the Early Psychosis Intervention Programme in Singapore, who were recovering from their first psychotic episode, participated in this study. Diagnoses were made using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) - Text Revised Axis I Disorders. The Clinician-Administered PTSD Scale, an interviewer-rated semi-structured interview, was used to diagnose PTSD.Sixty-one patients (30 males, 31 females) were recruited. Twelve (19.7%) patients were diagnosed with PTSD. Hospitalization for treatment, whether compulsory or otherwise, did not increase the rate of PTSD. The Chinese ethnic group had lower risk of developing PTSD (adjusted odds ratio 0.14, P = 0.018).There was a high prevalence of PTSD in patients recovering from their first psychotic episode. This study raises awareness among clinicians and hopes to promote early recognition and treatment of PTSD so as to potentially improve outcome.",0,0 +3950,Childhood trauma increases the risk of post-traumatic stress disorder in response to first-episode psychosis,"Objective: To investigate the relationship between childhood trauma, post-traumatic stress symptoms due to the experience of childhood trauma, and post-traumatic stress symptoms due to the experience of psychosis. Method: The current study assessed childhood trauma and post-traumatic stress disorder (PTSD) symptoms as a result of both childhood trauma and psychosis using the Impact of Events Scale - Revised, in a group of 36 people with first-episode psychosis. Results: Reported rates of clinical level post-psychotic PTSD symptoms, childhood trauma and childhood trauma-related clinical level PTSD symptoms were 47% (95% CI 31–64%), 64% (95% CI 48–80%) and 39% (95% CI 23–55%), respectively. Reporting childhood trauma increased the risk of developing post-psychosis PTSD 27-fold (95% CI 2.96–253.80, p = 0.01). Having childhood trauma-related PTSD increased the risk of developing post-psychosis PTSD 20-fold (95% CI 3.38–123.25, p = 0.01). These risks were not explained by illness factors such as duration of untreated psychosis, age of onset or severity of psychotic symptoms. Those without post-psychotic PTSD symptoms at clinical levels were unlikely to report childhood trauma (6%; 95% CI 3–8%). Conclusions: These results suggest the cognitive, social and biological consequences of childhood trauma can prevent effective recovery from the trauma of acute first-episode psychosis resulting in post-psychotic PTSD. Treatment strategies for post-psychotic PTSD must address childhood trauma and related PTSD.",0,0 +3951,Associations between Pittsburgh Sleep Quality Index factors and health outcomes in women with posttraumatic stress disorder,"The Pittsburgh Sleep Quality Index (PSQI) is a widely used measure of subjective sleep disturbance in clinical populations, including individuals with posttraumatic stress disorder (PTSD). Although the severity of sleep disturbance is generally represented by a global symptom score, recent factor analytic studies suggest that the PSQI is better characterized by a two- or three-factor model than a one-factor model. This study examined the replicability of two- and three-factor models of the PSQI, as well as the relationship between PSQI factors and health outcomes, in a female sample with PTSD.The PSQI was administered to 319 women with PTSD related to sexual or physical assault. Confirmatory factor analyses tested the relative fit of one-, two-, and three-factor solutions. Bivariate correlations were performed to examine the shared variance between PSQI sleep factors and measures of PTSD, depression, anger, and physical symptoms.Confirmatory factor analyses supported a three-factor model with Sleep Efficiency, Perceived Sleep Quality, and Daily Disturbances as separate indices of sleep quality. The severity of symptoms represented by the PSQI factors was positively associated with the severity of PTSD, depression, and physical symptoms. However, these health outcomes correlated as much or more with the global PSQI score as with PSQI factor scores.These results support the multidimensional structure of the PSQI. Despite this, the global PSQI score has as much or more explanatory power as individual PSQI factors in predicting health outcomes.",0,0 +3952,Trajectories of PTSD and substance use disorders in a longitudinal study of personality disorders.,"This study investigated the co-occurrence of posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) in a sample (N = 668) recruited for personality disorders and followed longitudinally as part of the Collaborative Longitudinal Personality Disorders Study. The study both examined rates of co-occurring disorders at baseline and temporal relationships between PTSD and substance use disorders over 4 years. Subjects with a lifetime history of PTSD at baseline had significantly higher rates of SUDs (both alcohol and drug) than subjects without PTSD. Latent class growth analysis, a relatively novel approach used to analyze trajectories and identify homogeneous subgroups of participant on the basis of probabilities of PTSD and SUD over time, identified 6 classes, which were compared with respect to a set of functioning and personality variables. The most consistent differences were observed between the group that displayed low probabilities of both SUD and PTSD and the group that displayed high probabilities of both.",0,0 +3953,Dissociative Symptomatology in Posttraumatic Stress Disorder and Disorders of Extreme Stress,"ABSTRACT The present study was designed to assess differences in dissociative symptoms in adults with Posttraumatic Stress Disorder (PTSD) vs. PTSD plus Disorders of Extreme Stress Not Otherwise Specified (DESNOS). This study was done for two reasons: (1) to better understand the clinical profile of DESNOS clients in order to inform more effective treatment, and (2) to further empirical research on the validity of the DESNOS construct. To assess severity of dissociative symptoms, the authors administered the Dissociative Experiences Scale (DES) to 155 participants with PTSD. Using the Structured Interview for Disorders of Extreme Stress (SIDES), participants were divided into two groups: those who also met criteria for DESNOS and those who did not. DES means are provided for the two groups. Participants with PTSD plus DESNOS scored higher than participants with only PTSD on the measure of dissociative symptomatology, particularly on the DES scales that tap absorption/fantasy and depersonalization/derealization. The two groups did not differ on the amnesia subscale of the DES. Findings support the construct validity of the DESNOS concept and further delineate the clinical profiles of community-based PTSD with and without DESNOS, thus contributing to the knowledge base on the assessment of complex adaptations to trauma.",0,0 +3954,Psychological trauma exposure and trauma symptoms among individuals with high and low levels of dental anxiety,"This questionnaire-based study investigated the traumatic background and trauma-related symptomatology among 141 treatment-seeking individuals with high levels of dental anxiety and among a low-anxious reference group consisting of 99 regular dental patients. The highly anxious individuals reported a significantly higher number of traumatic events, both within and outside the dental or medical setting, than those in the reference group (73% vs. 21%). Horrific experiences in the dental setting were the most common traumatic events reported. Of the highly anxious individuals, 46.1% indicated suffering from one or more of the post-traumatic stress disorder (PTSD) symptom clusters (re-experiencing, avoidance, loss of interest, and insomnia), while in the reference group this percentage was 6%. Severity of dental anxiety was significantly associated with number of screening criteria for specific phobia and the extent to which the anxious subjects displayed symptoms of post-traumatic stress. Two variables were uniquely predictive for positive diagnostic screens for dental phobia and PTSD: having experienced a horrific dental treatment and having been a victim of a violent crime. In conclusion, post-traumatic symptoms are common accompaniments of severe forms of dental anxiety and are experienced even when dental treatment is not imminent.",0,0 +3955,"Development, Reliability, and Validity of a Dissociation Scale","Dissociation is a lack of the normal integration of thoughts, feelings, and experiences into the stream of consciousness and memory. Dissociation occurs to some degree in normal individuals and is thought to be more prevalent in persons with major mental illnesses. The Dissociative Experiences Scale (DES) has been developed to offer a means of reliably measuring dissociation in normal and clinical populations. Scale items were developed using clinical data and interviews, scales involving memory loss, and consultations with experts in dissociation. Pilot testing was performed to refine the wording and format of the scale. The scale is a 28-item self-report questionnaire. Subjects were asked to make slashes on 100-mm lines to indicate where they fall on a continuum for each question. In addition, demographic information (age, sex, occupation, and level of education) was collected so that the connection between these variables and scale scores could be examined. The mean of all item scores ranges from 0 to 100 and is called the DES score. The scale was administered to between 10 and 39 subjects in each of the following populations: normal adults, late adolescent college students, and persons suffering from alcoholism, agoraphobia, phobic-anxious disorders, posttraumatic stress disorder, schizophrenia, and multiple personality disorder. Reliability testing of the scale showed that the scale had good test-retest and good split-half reliability. Item-scale score correlations were all significant, indicating good internal consistency and construct validity. A Kruskal-Wallis test and post hoc comparisons of the scores of the eight populations provided evidence of the scale's criterion-referenced validity.(ABSTRACT TRUNCATED AT 250 WORDS)",0,0 +3956,Exposure of French EMS providers to violence,"Objectives: Evaluate the problem of violence in French EMS system and characterize assaults. Study design: Multicentric, descriptive, open study. Patients and methods: A questionnaire was given to a sample of prehospital care providers in Paris area. People were asked about assaults during their careers, typology of the assaults and consequences. Results are presented in percentage and means. Results: Two hundred seventy-six questionnaires were returned. One or more assaults were recounted by 23% (61/271) of the sample (median of 8 ± 7 years experience on the job). The injuries were bruises in 40% (17/43), wounds in 9% (4/43) and fractures in 2% (1/43). Only 4% of assaults were followed by sick leave, 15% by a complaint. After the assaults, 4% (2/45) reported having got therapy against post-traumatic stress disorder. Eighty-eight per cent reported verbal threat and 41% physical threat. Thirteen per cent (25/200) were threatened with a knife and 12% (23/200) with a gun. Only 9% (24/270) had a formal training for management of violence. Conclusion: Formal training in the management of violent encounters and prevention of post-traumatic stress should be developed.",0,0 +3957,Impact of pre-enlistment antisocial behaviour on behavioural outcomes among UK military personnel,"Purpose: Concern has been raised over alleged increases in antisocial behaviour by military personnel returning from the deployment in Iraq and Afghanistan. US-based research has shown that post-deployment violence is related not only to combat experience, but also to pre-enlistment antisocial behaviour (ASB). This study aimed to examine the association between pre-enlistment ASB and later behavioural outcomes, including aggression, in a large randomly selected UK military cohort. Methods: Baseline data from a cohort study of 10,272 UK military personnel in service at the time of the Iraq war in 2003 were analysed. The associations between pre-enlistment ASB and a range of socio-demographic and military variables were examined as potential confounders. Logistic regression analyses were performed to examine the relationship between pre-enlistment ASB and military behavioural outcomes such as severe alcohol use, violence/aggression and risk-taking behaviour, controlling for confounders. Results: 18.1% were defined as having displayed preenlistment ASB. Pre-enlistment ASB was significantly associated with factors such as younger age, low educational achievement, male gender, non-officer rank, Army personnel, being a regular, increasing time spent on the deployment and having a combat role. Pre-enlistment ASB was associated with increased risk of negative behavioural outcomes (severe alcohol misuse, outbursts of anger or irritability, fighting or assaultative behaviour and risk-taking behaviour), after controlling for confounders, suggesting that such background information may identify individuals who are more vulnerable to subsequent behavioural disturbance. Conclusion: The results of this study suggest that those already demonstrating ASB prior to joining the military are more likely to continue on this trajectory, thus emphasising the importance of considering pre-enlistment behaviour when exploring the aetiology of aggression in military personnel. © Springer-Verlag 2011.",0,0 +3958,A distinct neurochemical profile in WKY rats at baseline and in response to acute stress: implications for animal models of anxiety and depression,"Wistar-Kyoto (WKY) rats exhibit hyperresponsive neuroendocrine and behavioral responses to stress that exceed normal controls and are especially prone to develop stress-induced depressive disorder. Pharmacological studies indicate altered serotonin (5-HT), norepinephrine (NE) and dopamine (DA) systems functioning in WKY rats, yet no attempt has been made to provide a comprehensive assessment of the neurochemical profile for WKY rats as compared to the outbred progenitor controls, Wistar rats. To this end, male, WKY and Wistar rats (N=6/group) were exposed to an acute forced-swim stress or were left untreated as controls. The prefrontal cortex (PFCtx), striatum, nucleus accumbens (NAS), and amygdala were assayed for levels of NE, DA and 5-HT, as well as major metabolites, by high-pressure liquid chromatography (HPLC) with electrochemical detection. In a separate experiment, designed to assess baseline and stress-induced neuroendocrine activation, male, Wistar and WKY rats (N=6/group) were exposed to an acute forced-swim stress of 15 min or were left untreated as controls. Animals were killed immediately after the test (T=0), 30 min after the test (T=30) or 60 min after the test (T=60), and control animals were killed immediately after weighing. After decapitation, trunk blood was collected and plasma was isolated by centrifugation and analyzed for corticosterone by immunoassay. The neurochemical results demonstrate distinct patterns of baseline and stress-induced monoamine turnover in WKY rats, including alterations to DA and 5-HT turnovers in prefrontal cortex and nucleus accumbens, two critical brain areas implicated in anxiety, depression and drug reward. The neuroendocrine results indicate that WKY rats exhibited a sustained corticosterone response to acute stress, as compared to Wistar controls. Overall, these data are predicted to be useful for understanding the anxiety- and depressive-like behavioral phenotype exhibited by these animals and for increased understanding of the role genetic background in altering neurochemical function.",0,0 +3959,Mental Health Outcomes and Predictors of Chronic Disorders After the North Sea Oil Rig Disaster,"The present study examined long-term mental health outcomes following a major disaster, including the relative risks (RR) of developing psychiatric disorders. Trauma exposure and predisaster vulnerability factors were examined as predictors of chronic psychopathology. Standardized questionnaires measuring psychological distress were completed 5½ months, 14 months, 5 years, and 27 years after the disaster. Twenty seven years after the disaster, 48 (79%) survivors and a matched comparison group of 62 (78%) nondisaster-exposed controls were assessed using the Structured Clinical Interview for DSM-IV, axis I Disorders. The prevalence of posttraumatic stress disorder among the survivors was 6.1%, and the risk of having a psychiatric disorder was more than 3 times higher than in the comparison group (RR = 3.44, 95% confidence interval = 1.6-7.6). Disaster exposure and general neurotic personality predicted chronic psychopathology, which was reported by 20.9% of the participants. Findings from this study suggest that increased risk of psychopathology persists 27 years after disaster. Both disaster exposure and vulnerable personality are important predictors of chronic psychopathology.",0,0 +3960,Chemistry and Pharmacology of GABAB Receptor Ligands,"This chapter presents new clinical applications of the prototypic GABA(B) receptor agonist baclofen for the treatment of addiction by drugs of abuse, such as alcohol, cocaine, nicotine, morphine, and heroin, a novel baclofen prodrug Arbaclofen placarbil, the GABA(B) receptor agonist AZD3355 (Lesogabaran) currently in Phase 2 clinical trials for the treatment of gastroesophageal reflux disease, and four positive allosteric modulators of GABA(B) receptors (CGP7930, GS39783, NVP-BHF177, and BHFF), which have less propensity for the development of tolerance due to receptor desensitization than classical GABA(B) receptor agonists. All four compounds showed anxiolytic affects. In the presence of positive allosteric modulators the ""classical"" GABA(B) receptor antagonists CGP35348 and 2-hydroxy-saclofen showed properties of partial GABA(B) receptor agonists. Seven micromolar affinity GABA(B) receptor antagonists, phaclofen; 2-hydroxy-saclofen; CGP's 35348, 36742, 46381, 51176; and SCH50911, are discussed. CGP36742 (SGS742) showed statistically significant improvements of working memory and attention in a Phase 2 clinical trial in mild, but not in moderate Alzheimer patients. Eight nanomolar affinity GABA(B) receptor antagonists are presented (CGP's 52432, 54626, 55845, 56433, 56999, 61334, 62349, and 63360) that were used by pharmacologists for numerous in vitro and in vivo investigations. CGP's 36742, 51176, 55845, and 56433 showed antidepressant effects. Several compounds are also available as radioligands, such as [(3)H]CGP27492, [(3)H]CGP54626, [(3)H]CGP5699, and [(3)H]CGP62349. Three novel fluorescent and three GABA(B) receptor antagonists with very high specific radioactivity (>2,000 Ci/mmol) are presented. [(125)I]CGP64213 and the photoaffinity ligand [(125)I]CGP71872 allowed the identification of GABA(B1a) and GABA(B1b) receptors in the expression cloning work.",0,0 +3961,Children and war†,"Children bear disproportionate consequences of armed conflict. The 21st century continues to see patterns of children enmeshed in international violence between opposing combatant forces, as victims of terrorist warfare, and, perhaps most tragically of all, as victims of civil wars. Innocent children so often are the victims of high-energy wounding from military ordinance. They sustain high-energy tissue damage and massive burns - injuries that are not commonly seen in civilian populations. Children have also been deliberately targeted victims in genocidal civil wars in Africa in the past decade, and hundreds of thousands have been killed and maimed in the context of close-quarter, hand-to-hand assaults of great ferocity. Paediatricians serve as uniformed military surgeons and as civilian doctors in both international and civil wars, and have a significant strategic role to play as advocates for the rights and welfare of children in the context of the evolving 'Laws of War'. One chronic legacy of contemporary warfare is blast injury to children from landmines. Such blasts leave children without feet or lower limbs, with genital injuries, blindness and deafness. This pattern of injury has become one of the post-civil war syndromes encountered by all intensivists and surgeons serving in four of the world's continents. The continued advocacy for the international ban on the manufacture, commerce and military use of antipersonnel landmines is a part of all paediatricians' obligation to promote the ethos of the Laws of War. Post-traumatic stress disorder remains an undertreated legacy of children who have been trapped in the shot and shell of battle as well as those displaced as refugees. An urgent, unfocused and unmet challenge has been the increase in, and plight of, child soldiers themselves. A new class of combatant comprises these children, who also become enmeshed in the triad of anarchic civil war, light-weight weaponry and drug or alcohol addiction. The International Criminal Court has outlawed as a War Crime, the conscription of children under 15 years of age. Nevertheless, there remain more than 300000 child soldiers active and enmeshed in psychopathic violence as part of both civil and international warfare. The typical profile of a child soldier is of a boy between the ages of 8 and 18 years, bonded into a group of armed peers, almost always an orphan, drug or alcohol addicted, amoral, merciless, illiterate and dangerous. Paediatricians have much to do to protect such war-enmeshed children, irrespective of the accident of their place of birth. Only by such vigorous and maintained advocacy can the world's children be better protected from the scourge of future wars.",0,0 +3962,"Resilience and other stability concepts in ecology: notes on their origin, validity and usefulness","Resilience and other stability concepts in ecology: notes on their origin, validity and usefulness",0,0 +3963,Post-traumatic stress disorder among asylum seekers and refugees in Istanbul may be predicted by torture and loss due to violence,"Background: Turkey is both a source and target for asylum seekers seeking refugee status in countries of European Union. There is a scarcity of research on the mental health issues of asylum seekers and refugees residing in Turkey. Aims: This study aimed: 1) to provide clinical and demographic information on asylum seekers and refugees receiving mental health services from a non-governmental refugee support program in Istanbul between 2005 and 2007, and 2) to evaluate the differences between patients diagnosed with post-traumatic stress disorder (PTSD) with those who did not meet criteria. Methods: The study was conducted at the Mental Health Division of the Refugee Advocacy Support Group. Between July 2005 and February 2007, 1209 asylum seekers applied to the support group; 75 of these individuals (6.2%) were referred for psychiatric evaluation while 57 were diagnosed as having a psychopathology. The number of analyzed subjects was 57. Results: PTSD and major depressive disorder were the most common diagnoses (55.2% for both). The most common criteria of PTSD reported were problems in concentration and social isolation (97.3% for both). Suffering torture and losing a significant other due to violence were found to be associated with a diagnosis of PTSD. Conclusions: This study is the first of its kind to be conducted on a mixed refugee population residing in Turkey and focusing on their mental health problems. Our results should be tested within larger samples of refugees residing in different cities of Turkey.",0,0 +3964,Psychological resilience in OEF–OIF Veterans: Application of a novel classification approach and examination of demographic and psychosocial correlates,"A growing number of studies have examined the prevalence and correlates of psychopathology in Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF-OIF), but few have examined determinants of resilience in this population. This study employed a novel approach to classify psychological resilience in a cross-sectional sample of OEF-OIF Veterans. A total of 272 predominantly older reserve/National Guard OEF/OIF Veterans completed a mail survey that assessed combat exposure, psychopathology, psychosocial functioning, and aspects of social support. Cluster analysis of scores on measures of combat exposure and PTSD symptoms revealed that a three-group solution best fit the data: Controls (low combat exposure, low PTSD symptoms); PTSD (high combat exposure, high PTSD symptoms); and Resilient (high combat exposure, low PTSD symptoms). Compared to the PTSD group, the Resilient group was more likely to be in a relationship and active duty; they also scored lower on a measure of psychosocial dysfunction, and higher on measures of psychological resilience and postdeployment social support. Logistic regression analysis revealed that being in a relationship, having fewer psychosocial difficulties, and reporting greater perceptions of purpose/control and family support and understanding were significantly associated with resilient group membership. Results of this study demonstrate a novel approach to classifying psychological resilience and suggest that interventions to mitigate psychosocial difficulties, enhance perceptions of purpose and control, and bolster family support and understanding may help promote resilience to combat-related PTSD in OEF-OIF Veterans.",0,0 +3965,Head Injury as a PTSD Predictor Among Oklahoma City Bombing Survivors,"The aim of the Oklahoma City (OKC) bombing retrospective review was to investigate the relationship between physical injury, environmental contributors, and psychiatric disorders such as posttraumatic stress disorder (PTSD) in an event-based, matched design study focused on injury.The 182 selected participants were a random subset of the 1,092 direct survivors from the OKC bombing. Only 124 of these 182 cases had a full complement of medical/clinical data in the OKC database. These 124 cases were assessed to explore relationships among PTSD diagnoses, levels of blast exposure, and physical injuries. Associations among variables were statistically tested using contingency analysis and logistic regression.Comparison of the PTSD cases to symptoms/diagnoses reported in the medical records reveals a statistically significant association between PTSD and head/brain injuries associated with head acceleration. PTSD was not highly correlated with other injuries. Although blast pressure and impulse were highly correlated with head injuries, the correlation with PTSD was not statistically significant. Thus, a correlation between blast pressure and PTSD may exist, but higher fidelity pressure calculations are required to elucidate this potential relationship.This study provides clear evidence that head injury is associated with subsequent PTSD, giving caregivers' information on what physical injuries may suggest the development of psychologic disorders to aid them in developing a profile for the identification of future survivors of terrorist attacks and Warfighters with brain injuries and potential PTSD.",0,0 +3966,Resilience and symptom reporting following mild traumatic brain injury in military service members,"The purpose of this study was to examine the relationship between resilience and symptom reporting following mild traumatic brain injury (mTBI). It was hypothesized that, as resilience increases, self-reported symptoms would decrease.Cross-sectional design.Participants were 142 US military service members who sustained a mTBI, divided into three resilience groups based on participants' responses on the Response to Stressful Experiences Scale: Moderate (n = 42); High (n = 51); and Very High (n = 49). Participants completed the Neurobehavioral Symptom Inventory (NSI) and PTSD Checklist-Civilian Version (PCL-C) within 12 months following injury.There were significant main effects for the NSI total score, cognitive cluster and affective cluster, as well as for the PCL-C total score, avoidance cluster and hyperarousal cluster. Pairwise comparisons revealed that there was a negative relationship between resilience and self-reported symptoms overall. Specifically, participants with higher resilience reported fewer post-concussion and PTSD-related symptoms than participants with lower levels of resilience.These findings underscore the important role that resilience plays in symptom expression in military service members with mTBI and suggest that research on targeted interventions to increase resilience in the acute phase following injury is indicated.",0,0 +3967,Longitudinal Cluster Analysis with Applications to Growth Trajectories,"Longitudinal studies play a prominent role in health, social, and behavioral sciences as well as in the biological sciences, economics, and marketing. By following subjects over time, temporal changes in an outcome of interest can be directly observed and studied. An important question concerns the existence of distinct trajectory patterns. One way to discover potential patterns in the data is through cluster analysis, which seeks to separate objects (individuals, subjects, patients, observational units) into homogeneous groups. There are many ways to cluster multivariate data. Most methods can be categorized into one of two approaches: nonparametric and model-based methods. The first approach makes no assumptions about how the data were generated and produces a sequence of clustering results indexed by the number of clusters k=2,3,... and the choice of dissimilarity measure. The later approach assumes data vectors are generated from a finite mixture of distributions. The bulk of the available clustering algorithms are intended for use on data vectors with exchangeable, independent elements and are not appropriate to be directly applied to repeated measures with inherent dependence.Multivariate Gaussian mixtures are a class of models that provide a flexible parametric approach for the representation of heterogeneous multivariate outcomes. When the outcome is a vector of repeated measurements taken on the same subject, there is often inherent dependence between observations. However, a common covariance assumption is conditional independence---that is, given the mixture component label, the outcomes for subjects are independent. In Chapter 2, I study, through asymptotic bias calculations and simulation, the impact of covariance misspecification in multivariate Gaussian mixtures. Although maximum likelihood estimators of regression and prior probability parameters are not consistent under misspecification, they have little asymptotic bias when mixture components are well separated or if the assumed correlation is close to the truth even when the covariance is misspecified. I also present a robust standard error estimator and show that it outperforms conventional estimators in simulations and can provide evidence that the model is misspecified. The main goal of a longitudinal study is to observed individual change over time; therefore, observed trajectories have two prominent features: level and shape of change over time. These features are typically associated with baseline characteristics of the individual. Grouping by shape and level separately provides an opportunity to detect and estimate these relationships. Although many nonparametric and model-based methods have been adapted for longitudinal data, most fail to explicitly group individuals according to the shape of their repeated measure trajectory. Some methods are thought to group by shape, but the dissimilarity between trajectories is not defined in terms of any one specific feature of the data. Rather, the methods are based on the entire vector and cluster trajectories by the level because it tends to dominate the variability between data vectors. These methods discover shape groups only if level and shape are correlated. To fulfill the need for clustering based explicitly on shape, I propose three methods Chapter 4 that are adaptations of available algorithms. One approach is to use a dissimilarity measure based on estimated derivatives of functions underlying the trajectories. One challenge for this approach is estimating the derivatives with minimal bias and variance. The second approach explicitly models the variability in the level within a group of similarly shaped trajectories using a mixture model resulting in a multilayer mixture model. One difficulty with this method comes in choosing the number of shape clusters. Lastly, vertically shifting the data by subtracting the subject-specific mean directly removes the level prior to modeling. This non-invertible transformation can result in singular covariance matrixes, which makes parameter estimation difficult. In theory, all of these methods should cluster based on shape, but each method has shortfalls. I compare these methods with existing clustering methods in a simulation study in Chapter 5 and find that the vertical shifted mixture model outperforms the existing and other proposed methods. A subset of the clustering methods are then compared on a real data set of childhood growth trajectories from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) study in Chapter 6. Vertically shifting the data prior to fitting a mixture model results in groups based on the shape of their growth over time in contrast to the standard mixture model assuming either conditional independence or a more general correlation. The group means do not drastically change between methods for this data set, but group membership differs enough to impact inference about the relationship between baseline covariates and distinct groups.",0,0 +3968,"Childhood trauma and dissociation in patients with alcohol dependence, drug dependence, or both—A multi-center study","The aims of this study were to examine the level of dissociative symptoms in patients with different substance related disorders (alcohol dependence, drug dependence, and combined alcohol and drug dependence), and to investigate the influence of potentially traumatic events in childhood, age, gender, and posttraumatic stress disorder on the relationship between dissociative symptoms and type of substance abuse.Of the 459 participants (59.7% male) 182 (39.7%) were alcohol-dependent (A), 154 (33.6%) were drug-dependent (D), and 123 (26.8%) were dependent on both, alcohol and drugs (AD) based on the DSM-IV criteria for a current diagnosis. Participants completed the Childhood Trauma Questionnaire (CTQ) and the Dissociative Experiences Scale (DES). The International Diagnostics Checklist (IDCL) was administered to diagnose PTSD.Higher levels of dissociation were observed in patients with drug dependence as compared to patients with mere alcohol dependence (mean DES group A: 9.9+/-8.8; group D: 12.9+/-11.7; group AD: 15.1+/-11.3). However, when severity of potentially traumatic events in childhood, PTSD, age and gender were included in the analysis, the influence of the type of substance abuse did not prove to be statistically significant. The variable most strongly related to dissociative symptoms was severity of potentially traumatic events in childhood, in particular emotional abuse, even after controlling for PTSD and other potential confounders.It seems appropriate to screen SUD patients for dissociative symptoms, especially those with a more complex risk profile including (additional) drug abuse, female gender, younger age and most importantly a history of childhood trauma.",0,0 +3969,Discriminant validity and gender differences in DSM-5 posttraumatic stress disorder symptoms,"The posttraumatic stress disorder (PTSD) literature is replete with investigations of factor structure, however, few empirical studies have examined discriminant validity and the moderating role of gender on factor structure and symptom expression. This study aimed to address these gaps.An online, population-based study of 3175 Australian adults was conducted. This study analyzed data from 642 participants who reported a traumatic event. Overall, 10.2% (13.4% females, 7.6% males) met diagnostic criteria for current PTSD.Confirmatory factor analyses indicated that eight factor models provided excellent fit to the data. The DSM-5 model, anhedonia and hybrid models provided strong fit to the data, based on statistical fit indices and parsimony. The models' factors were significantly associated with a number of external correlates. Factor structure was gender invariant for the three models, albeit significant latent mean-level differences were apparent in relation to the intrusion/re-experiencing and alterations in arousal and reactivity factors. Bonferroni-adjusted Wald chi-square tests indicated significant gender differences in four DSM-5 PTSD symptoms: females reported significantly higher rates of negative beliefs, diminished interest, restricted affect and sleep disturbance symptoms compared to men.Response rate to the survey was low. However, the number of respondents who completed the survey was high and population weights were employed to account for self-selection biases and aid generalizability.The findings provide support for the DSM-5, anhedonia and hybrid models compared to alternative models based on DSM-5 symptoms. Discriminant validity analyses indicated similar patterns of significant associations with the transdiagnostic factors, potentially suggesting that all the PTSD factors are related to non-specific distress. Further research investigating how gender influences PTSD symptom expression is warranted, including possible gender differences in symptom item interpretation.",0,0 +3970,Test of the trauma outcome process assessment model: One model of individual and environmental factors to explain adjustment.,"The Trauma Outcome Process Assessment (TOPA) is a theoretical model, based on a large body of empirical research establishing key variables that consistently are associated with a range of outcomes...",0,0 +3971,Predicting post-traumatic stress disorder following first onset acute coronary syndrome: Testing a theoretical model,"This research identified which theoretically predicted factors (Joseph, Williams, & Yule, 1997) were associated with the severity of post-traumatic stress disorder (PTSD) symptoms 1 and 6 months following onset of acute coronary syndrome (ACS). Predictor variables included event factors, peri-traumatic distress; and maintaining factors including coping strategies, social support, re-appraisal of event threat, and beliefs about the nature of ACS. Associations with alexithymia were also explored.One hundred and fifty participants completed questionnaires in hospital and at 1- and 6-month follow-up.Hierarchical multiple regression including both baseline and contemporaneous variables explained 52 and 42% of the variance in PTSD symptoms at each follow-up. At 1-month follow-up, predictors of PTSD symptoms were as follows: peri-traumatic distress, concern over symptoms, illness comprehension, and lack of social support. At 6-month follow-up, predictors were: peri-traumatic distress, lack of social support, use of problem-focused coping, and continued symptoms.The Joseph et al. model was generally supported. The data allow some degree of prediction of high risk individuals and suggest some possible interventions.",0,0 +3972,Internalizing and externalizing personality styles and psychopathology in OEF-OIF veterans,"Previous research with other trauma populations demonstrated that internalizing and externalizing personality styles are associated with different PTSD comorbidities. The present study tested this association in two distinct Operation Enduring Freedom–Operation Iraqi Freedom (OEF/OIF) combat samples. Cluster analysis was used to categorize subtypes, which were compared on measures of PTSD, depression, anxiety, and substance use. Internalizers showed the highest rates of PTSD and depression. Externalizers had higher rates of alcohol problems in one sample only, whereas the other sample showed more substance misuse. In general, these findings suggest that this method of classifying trauma survivors is useful in OEF/OIF populations. Results suggest some differences across this population in terms of how substance use issues are expressed in externalizers.",0,0 +3973,In their own words: Trauma and substance abuse in the lives of formerly homeless women with serious mental illness.,"In-depth interviews were conducted with 13 formerly homeless mentally ill women to capture their individual life trajectories of mental illness, substance abuse, and trauma in their own words. Cross-case analyses produced 5 themes: (a) betrayals of trust, (b) graphic or gratuitous nature of traumatic events, (c) anxiety about leaving their immediate surroundings (including attending group treatment programs), (d) desire for one's own space, and (e) gender-related status loss and stigmatization. Findings suggest formerly homeless mentally ill women need (and want) autonomy, protection from further victimization, and assistance in restoring status and devalued identity. Avenues for intervention include enhanced provider training, addressing experiences of betrayal and trauma, and more focused attention to current symptoms rather than previous diagnoses.",0,0 +3974,A multidimensional spectrum approach to post-traumatic stress disorder: comparison between the Structured Clinical Interview for Trauma and Loss Spectrum (SCI-TALS) and the Self-Report instrument (TALS-SR),"Dimensional approaches to psychiatric disorders have shown an increased relevance in the ongoing debate for the forthcoming Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. In line with previously validated instruments for the assessment of different mood, anxiety, eating and psychotic spectra, we tested the validity and reliability of a newly developed Structured Clinical Interview for Trauma and Loss Spectrum (SCI-TALS). The instrument is based on a multidimensional approach to post-traumatic stress spectrum that includes a range of threatening or frightening experiences, as well as a variety of potentially significant losses, to which an individual can be exposed. Furthermore, it explores the spectrum of the peritraumatic reactions and post-traumatic symptoms that may ensue from either type of life events, targeting soft signs and subthreshold conditions, as well as temperamental and personality traits that may constitute risk factors for the development of the disorder. The aim of the present study is to describe the reliability of the self-report version of the SCI-TALS: the TALS-SR. Thirty patients with PTSD and thirty healthy control subjects were assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Half of the patients and controls received the TALS-SR first and the SCI-TALS after 15 days; for the other half of the sample, the order of administration was reversed. Agreement between the self-report and the interview formats was substantial. Intraclass correlation coefficients ranged from 0.934 to 0.994, always exceeding the threshold of 0.90. Our findings provide substantial support for the reliability of the TALS-SR questionnaire.",0,0 +3975,Multiple risk-behavior profiles of smokers with serious mental illness and motivation for change.,"Individuals with serious mental illness (SMI) are dying on average 25 years prematurely. The leading causes are chronic preventable diseases. In the context of a tobacco-treatment trial, this exploratory study examined the behavioral risk profiles of adults with SMI to identify broader interventional needs.Recruited from five acute inpatient psychiatry units, participants were 693 adult smokers (recruitment rate = 76%, 50% male, 45% Caucasian, age M = 39, 49% had income < $10,000) diagnosed with mood disorders (71%), substance-use disorders (63%), posttraumatic stress disorder (39%), psychotic disorders (25%), and attention deficit-hyperactivity disorder (25%). The Staging Health Risk Assessment, the primary measure used in this study, screened for risk status and readiness to change 11 health behaviors, referencing the period prior to acute hospitalization.Participants averaged 5.2 (SD = 2.1) risk behaviors, including smoking (100%), high-fat diet (68%), inadequate fruits/vegetables (67%), poor sleep (53%), physical inactivity (52%), and marijuana use (46%). The percent prepared to change ranged from 23% for tobacco and marijuana to 76% for depression management. Latent class analysis differentiated three risk groups: the global higher risk group included patients elevated on all risk behaviors; the global lower risk group was low on all risks; and a mood and metabolic risk group, characterized by inactivity, unhealthy diet, sleep problems, and poor stress and depression management. The global higher risk group (11% of sample) was younger, largely male, and had the greatest number of risk behaviors and mental health diagnoses; had the most severe psychopathologies, addiction-treatment histories, and nicotine dependence; and the lowest confidence for quitting smoking and commitment to abstinence.Most smokers with SMI engaged in multiple risks. Expanding targets to treat co-occurring risks and personalizing treatment to individuals' multibehavioral profiles may increase intervention relevance, interest, and impact on health.",0,0 +3976,"Efficacy and Safety of Topiramate Monotherapy in Civilian Posttraumatic Stress Disorder: A Randomized, Double-Blind, Placebo-Controlled Study","Objective: This double-blind, placebo-controlled trial assessed efficacy and safety of topiramate monotherapy in civilian posttraumatic stress disorder (PTSD). Method: Outpatients (18-64 years) with DSM-IV non-combat-related PTSD and Clinician-Administered PTSD Scale (CAPS) scores (greater-than or equal to) 50 were eligible. Topiramate was started at 25 mg/day and titrated by 25-50 mg/week to 400 mg/day or maximum tolerated dose. Data were collected between April 26, 2002, and February 4, 2004. Primary efficacy, change in total CAPS score, and secondary efficacy measures were assessed by analysis of covariance in the intent-to-treat (ITT) population with last observation carried forward. Results: The ITT population comprised 38 patients with mean (plus or minus) SD baseline total CAPS scores of 88.3 (plus or minus) 13.8 (topiramate, N = 19) and 91.1 (plus or minus) 13.7 (placebo, N = 19). Although a decrease in total CAPS score was noted (topiramate, -52.7; placebo, -42.0), this difference was not statistically significant (p = .232). Topiramate-treated patients exhibited significant reductions in reexperiencing symptoms (CAPS cluster B: topiramate, 74.9%; placebo, 50.2%; p = .038) and Treatment Outcome PTSD scale (topiramate, 68.0%; placebo, 41.6%; p = .025). Reductions approaching statistical significance, based on a nominal p value, were noted in mean total Clinical Global Impressions-Improvement Scale scores (topiramate, 1.9 (plus or minus) 1.2; placebo, 2.6 (plus or minus) 1.1; p = .055). Conclusion: These preliminary results suggest that further, adequately powered studies of topiramate for the treatment of civilian PTSD are warranted.",0,0 +3977,An evaluation of the DSM-5 factor structure for posttraumatic stress disorder in survivors of traumatic injury,"Confirmatory factor analytic studies of the latent structure of DSM-5 PTSD symptoms using self-report data (Elhai et al., 2012; Miller et al., 2013) have found that the four-factor model implied by the DSM-5 diagnostic criteria provided adequate fit to their data. However, the fit of this model is yet to be assessed using data derived from gold standard structured interview measures. This study evaluated the fit of the DSM-5 four-factor model and an alternative four-factor model in 570 injury survivors six years post-injury using the Clinician Administered PTSD Scale (Blake et al., 1990), updated to include items measuring new DSM-5 symptoms. While both four-factor models fitted the data well, very high correlations between the 'Intrusions' and 'Avoidance' factors in both models and between the 'Negative Alterations in Cognitions and Mood' and 'Arousal and Reactivity' factors in the DSM-5 model and the 'Dysphoria' and 'Hyperarousal' factors in the alternative model were evident, suggesting that a more parsimonious two-factor model combining these pairs of factors may adequately represent the latent structure. Such a two-factor model fitted the data less well according to χ(2) difference testing, but demonstrated broadly equivalent fit using other fit indices. Relationships between the factors of each of the four-factor models and the latent factors of Fear and Anxious-Misery/Distress underlying Internalizing disorders (Krueger, 1999) were also explored, with findings providing further support for the close relationship between the Intrusion and Avoidance factors. However, these findings also suggested that there may be some utility to distinguishing Negative Alterations in Cognition and Mood symptoms from Arousal and Reactivity symptoms, and/or Dysphoria symptoms from Hyperarousal symptoms. Further studies are required to assess the potential discriminant validity of the two four-factor models.",0,0 +3978,Developmental Patterns of Adverse Childhood Experiences and Current Symptoms and Impairment in Youth Referred For Trauma-Specific Services,"By the time children reach adolescence, most have experienced at least one type of severe adversity and many have been exposed to multiple types. However, whether patterns of adverse childhood experiences are consistent or change across developmental epochs in childhood is not known. Retrospective reports of adverse potentially traumatic childhood experiences in 3 distinct developmental epochs (early childhood, 0- to 5-years-old; middle childhood, 6- to 12-years-old; and adolescence, 13- to 18-years-old) were obtained from adolescents (N = 3485) referred to providers in the National Child Traumatic Stress Network (NCTSN) for trauma-focused assessment and treatment. Results from latent class analysis (LCA) revealed increasingly complex patterns of adverse/traumatic experiences in middle childhood and adolescence compared to early childhood. Depending upon the specific developmental epoch assessed, different patterns of adverse/traumatic experiences were associated with gender and with adolescent psychopathology (e.g., internalizing/externalizing behavior problems), and juvenile justice involvement. A multiply exposed subgroup that had severe problems in adolescence was evident in each of the 3 epochs, but their specific types of adverse/traumatic experiences differed depending upon the developmental epoch. Implications for research and clinical practice are identified.",0,0 +3979,Validation and Utility of a Self-report Version of PRIME-MD<SUBTITLE>The PHQ Primary Care Study</SUBTITLE>,"The Primary Care Evaluation of Mental Disorders (PRIME-MD) was developed as a screening instrument but its administration time has limited its clinical usefulness.To determine if the self-administered PRIME-MD Patient Health Questionnaire (PHQ) has validity and utility for diagnosing mental disorders in primary care comparable to the original clinician-administered PRIME-MD.Criterion standard study undertaken between May 1997 and November 1998.Eight primary care clinics in the United States.Of a total of 3000 adult patients (selected by site-specific methods to avoid sampling bias) assessed by 62 primary care physicians (21 general internal medicine, 41 family practice), 585 patients had an interview with a mental health professional within 48 hours of completing the PHQ.Patient Health Questionnaire diagnoses compared with independent diagnoses made by mental health professionals; functional status measures; disability days; health care use; and treatment/referral decisions.A total of 825 (28%) of the 3000 individuals and 170 (29%) of the 585 had a PHQ diagnosis. There was good agreement between PHQ diagnoses and those of independent mental health professionals (for the diagnosis of any 1 or more PHQ disorder, kappa = 0.65; overall accuracy, 85%; sensitivity, 75%; specificity, 90%), similar to the original PRIME-MD. Patients with PHQ diagnoses had more functional impairment, disability days, and health care use than did patients without PHQ diagnoses (for all group main effects, P<.001). The average time required of the physician to review the PHQ was far less than to administer the original PRIME-MD (<3 minutes for 85% vs 16% of the cases). Although 80% of the physicians reported that routine use of the PHQ would be useful, new management actions were initiated or planned for only 117 (32%) of the 363 patients with 1 or more PHQ diagnoses not previously recognized.Our study suggests that the PHQ has diagnostic validity comparable to the original clinician-administered PRIME-MD, and is more efficient to use.",0,0 +3980,Headache Diagnoses Among Iraq and Afghanistan War Veterans Enrolled in VA: A Gender Comparison,"To examine the prevalence and correlates of headache diagnoses, by gender, among Iraq and Afghanistan War Veterans who use Department of Veterans Affairs (VA) health care.Understanding the health care needs of recent Veterans, and how these needs differ between women and men, is a priority for the VA. The potential for a large burden of headache disorders among Veterans seeking VA services exists but has not been examined in a representative sample.We conducted a historical cohort study using national VA inpatient and outpatient data from fiscal year 2011. Participants were all (n = 470,215) Iraq and Afghanistan War Veteran VA users in 2011; nearly 13% were women. We identified headache diagnoses using International Classification of Diseases (ICD-9) diagnosis codes assigned during one or more VA inpatient or outpatient encounters. Descriptive analyses included frequencies of patient characteristics, prevalence and types of headache diagnoses, and prevalence of comorbid diagnoses. Prevalence ratios (PR) with 95% confidence intervals (CI) were used to estimate associations between gender and headache diagnoses. Multivariate models adjusted for age and race. Additional models also adjusted for comorbid diagnoses.In 2011, 56,300 (11.9%) Veterans received a headache-related diagnosis. While controlling for age and race, headache diagnoses were 1.61 times more prevalent (95% CI = 1.58-1.64) among women (18%) than men (11%). Most of this difference was associated with migraine diagnoses, which were 2.66 times more prevalent (95% CI = 2.59-2.73) among women. Cluster and post-traumatic headache diagnoses were less prevalent in women than in men. These patterns remained the same when also controlling for comorbid diagnoses, which were common among both women and men with headache diagnoses. The most prevalent comorbid diagnoses examined were depression (46% of women with headache diagnoses vs 40% of men), post-traumatic stress disorder (38% vs 58%), and back pain (38% vs 46%).Results of this study have implications for the delivery of post-deployment health services to Iraq and Afghanistan War Veterans. Migraine and other headache diagnoses are common among Veterans, particularly women, and tend to occur in combination with other post-deployment health conditions for which patients are being treated.",0,0 +3981,Short and longer-term psychological consequences of Operation Cast Lead: documentation from a mental health program in the Gaza Strip,"There is growing recognition of the psychological impact of adversity associated with armed conflict on exposed civilian populations. Yet there is a paucity of evidence on the value of mental health programs in these contexts, and of the chronology of psychological sequelae, especially in prolonged conflicts with repeated cycles of extreme violence. Here, we describe changes in the psychological profile of new patients in a mental health program after the military offensive Cast Lead, in the context of the prolonged armed conflict involving the Gaza Strip.This study analyses routinely collected program data from a Médecins Sans Frontières mental health program in the Gaza Strip spanning 2007-2011. Data consist of socio-demographic as well as clinical baseline and follow-up data on new patients entering the program. Comparisons were made through Chi square and Fisher's exact tests, univariate and multivariate logistic and linear regression.PTSD, depression and other anxiety disorders were the most frequent psychopathologies, with 21% having multiple diagnoses. With a median of nine sessions, clinical improvement was recorded for 83% (1122/1357), and more common for those with separation anxiety, acute and posttraumatic disorders as principal diagnosis (855/1005), compared to depression (141/183, p<0.01). Noted changes proximal to Operation Cast Lead were: a doubling in patient case load with a broader socio-economic background, shorter interval from an identified traumatic event to seeking care, and a rise in diagnoses of acute and posttraumatic stress disorders. Sustained changes included: high case load, more distal triggering events, and increase in diagnoses of other anxiety disorders (especially for children 15 years and younger) and depression (especially for patients 16 years and older).Evolving changes in patient volume, diagnoses and recall period to triggering events suggest a lengthy and durable effect of an intensified exposure to violence in a context of prolonged conflict. Our findings suggest that mental health related humanitarian relief in protracted conflicts might need to prepare for an increase in patients with changing profiles over an extended period following an acute flare-up in violence.",0,0 +3982,"The impact of being afforded a college education on posttraumatic growth, trauma resilience, and academic resilience in individuals exposed to trauma","Trauma resilience has many definitions and trajectories; however, theorists remain consistent on the idea that some individuals who endure trauma do not succumb to its impact, but instead flourish in its aftermath. Research that focuses on individuals who do exhibit symptoms, yet go on to achieve notable feats is important to understanding how various paths of resilience and growth interact and can be encouraged. The purpose of this study was to examine the factors associated with being provided a college education on trauma resilience, academic resilience, and posttraumatic growth in ""at risk"" students who have experienced a traumatic event. Participants included approximately 146 individuals (77 Males, 69 Females) named as Horatio Alger Association of Distinguished Americans' National Scholars who exemplify academic resiliency and were selected based on their ability to demonstrate integrity and perseverance in overcoming adversity. Participants were asked to complete an electronic survey designed to assess whether or not the participant meets criteria for Posttraumatic Stress Disorder (PTSD), shows posttraumatic growth as a result of facing adversity, and/or shows academic resilience. Qualitative questions were utilized to uncover themes or factors related to the student's ability to be resilient. Results indicated that as the number of events that the participants were exposed to increased, participants were less likely to meet criteria for a PTSD diagnosis. Second, there was not a significant relationship found between posttraumatic growth and academic resilience, but a significant relationship was found between posttraumatic growth and trauma resilience. Lastly, the most commonly supported theme reported by participants as being influential in their growth, ability to make meaning of their past adversities, and academic success was learning that there were other individuals who had been through similar adversities and had persevered. Recognizing the aspects of the program that were the most beneficial to the students can not only provide insight into why this group of at-risk students were resilient, but can also illuminate the needs of other at-risk students in their journeys towards resiliency. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +3983,Looking for resilience: Understanding the longitudinal trajectories of responses to stress,"Taking advantage of two large, population-based, and longitudinal datasets collected after the 1999 floods in Mexico (n=561) and the September 11, 2001 terrorist attacks in New York (n=1267), we examined the notion that resilience may be best understood and measured as one member of a set of trajectories that may follow exposure to trauma or severe stress. We hypothesized that resistance, resilience, recovery, relapsing/remitting, delayed dysfunction, and chronic dysfunction trajectories were all possible in the aftermath of major disasters. Semi-parametric group-based modeling yielded the strongest evidence for resistance (no or mild and stable symptoms), resilience (initially moderate or severe symptoms followed by a sharp decrease), recovery (initially moderate or severe symptoms followed by a gradual decrease), and chronic dysfunction (moderate or severe and stable symptoms), as these trajectories were prevalent in both samples. Neither Mexico nor New York showed a relapsing/remitting trajectory, and only New York showed a delayed dysfunction trajectory. Understanding patterns of psychological distress over time may present opportunities for interventions that aim to increase resilience, and decrease more adverse trajectories, after mass traumatic events.",1,0 +3984,Psychosocial Risk Factors in Women: Special Reference to Depression and Posttraumatic Stress Disorder,"Women have a higher susceptibility than men to a set of psychosocial factors that have been linked to increased risk of ischemic heart disease (IHD), such as depression, early life adversities, and posttraumatic stress disorder (PTSD). In this chapter we discuss the notion that these psychosocial risk factors, particularly if they are present at young age, may set a trajectory of increased IHD risk in women, even though clinical events may occur years later. Emerging data suggest that young women are uniquely susceptible to the adverse cardiovascular effects psychosocial stress, which can result in earlier onset of IHD or more adverse prognosis if the disease is already manifest. Women’s vulnerability to psychosocial stress could also play a role in sex differences in the pathophysiology of IHD; for example it could help explain their higher propensity to abnormal coronary vasomotion and micro-vascular disease, which has been described in women compared with men. Young women are severely under-represented in studies of cardiovascular disease. In future research, it will be crucial to study women earlier in their life to better understand the risk pathways linking psychosocial stress to IHD risk, in order to devise successful preventive and treatment strategies to ameliorate such risk. © Springer International Publishing Switzerland 2015.",0,0 +3985,Child and Adolescent Mental Health Research in the Context of Hurricane Katrina: An Ecological Needs-Based Perspective and Introduction to the Special Section,This article introduces the special section on child and adolescent mental health research in the context of Hurricane Katrina. We outline the purpose and intent of the special section and present an integrative perspective based on broad contextual theories of human development with which to think about the impact of disasters like Katrina. The perspective emphasizes multiple levels of influence on mental health and normal development through the impairment of multiple human needs. The perspective helps show the interconnections among the diverse theoretical and methodological paradigms that are utilized to understand the impact of disasters on youth and may help to guide future research.,0,0 +3986,Psychosocial Predictors of Distress in Parents of Children Undergoing Stem Cell or Bone Marrow Transplantation,"To examine psychosocial predictors of distress (mood disturbance, perceived stress, caregiver burden) in parents of children undergoing stem cell or bone marrow transplantation (BMT).Measures of prior illness experiences, premorbid child behavior problems, family environment, social support, and parental coping behavior were obtained from the resident parents of 151 children prior to the children's admission for BMT. Parents subsequently completed assessments of their mood disturbance, perceived stress, and caregiving burden on a weekly basis through week +6 post-BMT, and then monthly through month +6 post-BMT.Significant changes were observed in parental distress across the course of BMT. After correcting for demographic and medical factors, several significant predictors of parental distress trajectories were identified, including prior parent and patient illness-related distress, premorbid child internalizing behavior problems, the family relationship dimensions of the family environment, and parental avoidant coping behaviors. Multivariable models were developed using a hierarchical modeling approach. The best-fit model accounted for approximately 50% of the variance in parental global distress.Subgroups of parents at higher risk for increased distress during the acute phase of transplant have been identified. These findings can help target parents who may be in greater need of intervention aimed at reducing transplant-related distress.",0,0 +3987,A Twin Study of Genetic and Environmental Contributions to Liability for Posttraumatic Stress Symptoms,"We studied 4042 Vietnam era veteran monozygotic and dizygotic male twin pairs to determine the effects of heredity, shared environment, and unique environment on the liability for 15 self-reported posttraumatic stress disorder symptoms included in the symptom categories of reexperiencing the trauma, avoidance of stimuli related to the trauma, and increased arousal. Quantitative genetic analysis reveals that inheritance has a substantial influence on liability for all symptoms. Symptoms in the reexperiencing cluster and one symptom in the avoidance and numbing cluster are strongly associated with combat exposure, and monozygotic pairs are more highly concordant for combat exposure than dizygotic pairs. By fitting a bivariate genetic model, we show that there are significant genetic influences on symptom liability, even after adjusting for differences in combat exposure; genetic factors account for 13% to 30% of the variance in liability for symptoms in the reexperiencing cluster, 30% to 34% for symptoms in the avoidance cluster, and 28% to 32% for symptoms in the arousal cluster. There is no evidence that shared environment contributes to the development of posttraumatic stress disorder symptoms.",0,0 +3988,Children in Adoptive Families: Overview and Update,"To summarize the past 10 years of published research concerning the 2% of American children younger than 18 years old who are adoptees.Review recent literature on developmental influences, placement outcome, psychopathology, and treatment.Adoption carries developmental opportunities and risks. Many adoptees have remarkably good outcomes, but some subgroups have difficulties. Traditional infant, international, and transracial adoptions may complicate adoptees' identity formation. Those placed after infancy may have developmental delays, attachment disturbances, and posttraumatic stress disorder. Useful interventions include preventive counseling to foster attachment, postadoption supports, focused groups for parents and adoptees, and psychotherapy.Variables specific to adoption affect an adopted child's developmental trajectory. Externalizing, internalizing, attachment, and posttraumatic stress disorder symptoms may arise. Child and adolescent psychiatrists can assist both adoptive parents and children.",0,0 +3989,Developmental Trajectories and Predictors of Prosocial Behavior Among Adolescents Exposed to the 2008 Wenchuan Earthquake,"This longitudinal study examined the developmental trajectories of prosocial behavior and related predictors among adolescents exposed to the 2008 Wenchuan earthquake. At 6-, 18-, and 30-months postearthquake, we followed a sample of 1,573 adolescents. Self-report measures were used to assess earthquake exposure, postearthquake negative life events, prosocial behavior, symptoms of posttraumatic stress disorder, depression, anxiety, social support, and coping style. Data were analyzed using growth mixture modeling and multinomial logistic regressions. Four trajectories of postearthquake prosocial behavior were identified in the sample: (a) high/enhancing (35.0%), (b) high/stable (29.4%), (c) low/declining (33.6%), and (d) low/steeply declining (2.0%). Female gender, more social support, and greater positive coping were significant factors related to a higher probability of developing the high/enhancing trajectory. These findings may be helpful for us to identify adolescents with poor prosocial behavior after exposure to earthquakes so as to provide them with appropriate intervention.",0,0 +3990,Preclinical Perspectives on Posttraumatic Stress Disorder Criteria in DSM-5,"Posttraumatic stress disorder (PTSD) now sits within the newly created ""Trauma- and Stressor-Related Disorders"" section of the Diagnostic and Statistical Manual of Mental Disorders (fifth edition; DSM-5). Through the refinement and expansion of diagnostic criteria, the DSM-5 version better clarifies the broad and pervasive effects of trauma on functioning, as well as the impact of development on trauma reactions. Aggressive and dissociative symptoms are more thoroughly characterized, reflecting increasing evidence that reactions to trauma often reach beyond the domains of fear and anxiety (these latter domains were emphasized in DSM-IV). These revised criteria are supported by decades of preclinical and clinical research quantifying traumatic stress-induced changes in neurobiological and behavioral function. Several features of the DSM-5 PTSD criteria are similarly and consistently represented in preclinical animal models and humans following exposure to extreme stress. In rodent models, for example, increases in anxiety-like, helplessness, or aggressive behavior, along with disruptions in circadian/neurovegetative function, are typically induced by severe, inescapable, and uncontrollable stress. These abnormalities are prominent features of PTSD and can help us in understanding the pathophysiology of this and other stress-associated psychiatric disorders. In this article we examine some of the changes to the diagnostic criteria of PTSD in the context of trauma-related neurobiological dysfunction, and discuss implications for how preclinical data can be useful in current and future clinical conceptualizations of trauma and trauma-related psychiatric disorders.",0,0 +3991,Posttraumatic stress disorder symptoms in adolescents: risk factors versus resilience moderation,"Exposure to community violence and trauma, stress, and childhood abuse and neglect have been identified as risk factors for the development of posttraumatic stress disorder (PTSD) symptoms among adolescents. Although evidence suggests that resilience may moderate the relationship between some of these risk factors and PTSD symptoms, no studies to date have examined these risk factors collectively.Our first aim was to examine the relationship between exposure to community violence, childhood abuse and neglect, perceived stress, and PTSD symptoms. Our second aim was to examine the extent to which resilience moderated the relationship between risk factors and PTSD symptoms.A convenience sample of 787 participants was drawn from 5 public secondary schools in the Cape Town metropole of South Africa. The participants were invited to complete a battery of questionnaires on a single occasion.Of the participants, 48.3% were Black, 58.6% were female, and 31.6% were in grade 8. After controlling for covariates, we found that exposure to community violence, perceived stress, and childhood abuse and neglect together accounted for 33.4% of the variance in PTSD symptoms (F(8,778) = 71.06, P < .001). Nevertheless, resilience moderated the relationship between childhood abuse and symptoms of PTSD (beta = .09, t(786) = 2.88, P < .001), where the independent effect of childhood abuse and neglect on PTSD symptoms was significantly reduced with increasing resilience. Resilience did not, however, interact with exposure to community violence or perceived levels of stress to influence PTSD symptoms.High levels of exposure to community violence, perceived stress, and childhood abuse and neglect may contribute to the development of PTSD symptoms in South African adolescents. However, high levels of resilience may buffer the negative effects of childhood abuse and neglect.",0,0 +3992,Stepping Off the Hedonic Treadmill,"Theorists have long maintained that people react to major life events but then eventually return to a setpoint of subjective well-being. Yet prior research is inconclusive regarding the extent of interindividual variability. Recent theoretical models suggest that there should be heterogeneity in long-term stress responding ( Bonanno, 2004 ; Muthén & Muthén, 2000 ). To test this idea, we used latent growth mixture modeling to identify specific patterns of individual variation in response to three major life events (bereavement, divorce, and marriage). A four-class trajectory solution provided the best fit for bereavement and marriage, while a three-class solution provided the best fit for divorce. Relevant covariates predicted trajectory class membership. The modal response across events was a relatively flat trajectory (i.e., no change). Nevertheless, some trajectories diverged sharply from the modal response. Despite the tendency to maintain preevent levels of SWB, there are multiple and often divergent trajectories in response to bereavement, divorce, and marriage, underscoring the essential role of individual differences.",0,0 +3993,Negative affectivity as a transdiagnostic factor in patients with common mental disorders,"Screening and monitoring systems are increasingly used in psychotherapy, but it has been questioned whether outcome measurement using multiple questionnaires is warranted. Arguably, type and number of assessment instruments should be determined by empirical research. This study investigated the latent factor structure of a multi-dimensional outcome measurement strategy used in English services aligned to the Improving Access to Psychological Therapies (IAPT) programme.Factor analyses and structural equation models were performed on 11,939 intake assessments of outpatients accessing an IAPT service between 2008 and 2010. We examined whether three routinely employed instruments (PHQ-9 for depression, GAD-7 for anxiety, WSAS for functional impairment) assess empirically different dimensions.The instruments were found to assess mainly one general dimension and only some items of the GAD-7 and WSAS assess unique variance beyond this general dimension. In a structural equation model the disorder-specific factor scores were predicted by patients׳ diagnostic categories.Since a large naturalistic data base was used, missing data for diagnoses and scale items were encountered. Diagnoses were obtained with brief case-finding measures rather than structured diagnostic interviews.Although the items seem to address mostly one dimension, some variance is due to differences between individuals in anxiety and impairment. While this generally supports multi-dimensional assessment in a primary care population, the clinical upshot of the study is to concentrate attention on transdiagnostic factors as a target for treatment.",0,0 +3994,Serving within the British army: research into mental health benefits,"The mental health (MH) of soldiers remains extremely newsworthy and is regularly featured in high profile media forums that focus on post-traumatic stress disorder. However, the authors feel that there are distinct benefits to serving within the Army, and that it provides effective occupational medical, MH and welfare support. This research study explores potential benefits and stressors of being in the Army and provides an overview of Army mental health services (AMHS) through the perspectives of AMHS personnel, 84% of which were nurses. The study indicated that the Army can provide a protective community, sharing a bond based on common values and experiences. The Army can provide soldiers with career opportunities that are not available in civilian life, and there are opportunities to develop an employment profile, enhanced by internal and external educational training, and encapsulated within a progressive career pathway. The Army can also be seen to offer an escape route, preventing soldiers entering a life of crime, and supplying the stable family these soldiers had never experienced. The provision of leadership, within an environment where soldiers are valued and stigma is not tolerated can potentially shield against MH problems.",0,0 +3995,Sympathetic system modulation to treat post-traumatic stress disorder (PTSD): A review of clinical evidence and neurobiology,A review of clinical evidence and neurobiology on the effects of modulation of sympathetic system modulation to treat post-traumatic stress disorder (PTSD) is being presented . The review provides an overview of currently available treatments followed by efficacy of orally effective sympathetic blocking agents. The main focus of the review is the application of stellate ganglion blocks (SGBs) or a local anesthetic blockade of the sympathetic ganglion in the neck.,0,0 +3996,Dissociative experiences in obsessive-compulsive disorder and trichotillomania: Clinical and genetic findings,"A link between dissociation proneness in adulthood and self-reports of childhood traumatic events (including familial loss in childhood, sexual/physical abuse and neglect) has been documented. Several studies have also provided evidence for an association between dissociative experiences and trauma in patients with various psychiatric disorders, including post-traumatic stress disorder, borderline personality, dissociative identity and eating disorders. Based on the relative paucity of data on dissociation and trauma in obsessive-compulsive disorder (OCD) and trichotillomania (TTM), the primary objective of this study was to examine the relationship between trauma and dissociative experiences (DE) in these two diagnostic groups. Furthermore, the availability of clinical and genetic data on this sample allowed us to explore clinical and genetic factors relevant to this association. A total of 110 OCD and 32 TTM patients were compared with respect to the degree of dissociation (using the Dissociative Experiences Scale [DES]) and childhood trauma (using the Childhood Trauma Questionnaire [CTQ]). Patients were classified on the DES as either ""high"" (mean DES score >/= 30) or ""low"" (mean DES score < 30) dissociators. Additional clinical and genetic factors were also explored with chi-square and t tests as appropriate. A total of 15.8% of OCD patients and 18.8% of TTM patients were high dissociators. OCD and TTM groups were comparable on DES and CTQ total scores, and in both OCD and TTM groups, significant positive correlations were found between mean DES scores and mean CTQ subscores of emotional abuse, physical abuse, sexual abuse, and physical neglect. In the OCD group, high dissociators were significantly younger than low dissociators, and significantly more high dissociators than low dissociators reported a lifetime (current and past) history of tics (P <.001), Tourette's syndrome (P =.019), bulimia nervosa (P =.003), and borderline personality disorder (P =.027). In the TTM group, significantly more high dissociators than low dissociators reported (lifetime) kleptomania (P =.005) and depersonalisation disorder (P =.005). In the Caucasian OCD patients (n = 114), investigation of genetic polymorphisms involved in monoamine function revealed no significant differences between high and low dissociator groups. This study demonstrates a link between childhood trauma and DE in patients with OCD and TTM. High dissociative symptomatology may be present in a substantial proportion of patients diagnosed with these disorders. High dissociators may also be differentiated from low dissociators on some demographic features (e.g., lower age) and comorbidity profile (e.g., increased incidence of impulse dyscontrol disorders). Additional work is necessary before conclusions about the role of monoaminergic systems in mediating such dissociation can be drawn.",0,0 +3997,Short screening scales to monitor population prevalences and trends in non-specific psychological distress,"Background. A 10-question screening scale of psychological distress and a six-question short-form scale embedded within the 10-question scale were developed for the redesigned US National Health Interview Survey (NHIS). Methods. Initial pilot questions were administered in a US national mail survey ( N = 1401). A reduced set of questions was subsequently administered in a US national telephone survey ( N = 1574). The 10-question and six-question scales, which we refer to as the K10 and K6, were constructed from the reduced set of questions based on Item Response Theory models. The scales were subsequently validated in a two-stage clinical reappraisal survey ( N = 1000 telephone screening interviews in the first stage followed by N = 153 face-to-face clinical interviews in the second stage that oversampled first-stage respondents who screened positive for emotional problems) in a local convenience sample. The second-stage sample was administered the screening scales along with the Structured Clinical Interview for DSM-IV (SCID). The K6 was subsequently included in the 1997 ( N = 36116) and 1998 ( N = 32440) US National Health Interview Survey, while the K10 was included in the 1997 ( N = 10641) Australian National Survey of Mental Health and Well-Being. Results. Both the K10 and K6 have good precision in the 90th–99th percentile range of the population distribution (standard errors of standardized scores in the range 0·20–0·25) as well as consistent psychometric properties across major sociodemographic subsamples. The scales strongly discriminate between community cases and non-cases of DSM-IV/SCID disorders, with areas under the Receiver Operating Characteristic (ROC) curve of 0·87–0·88 for disorders having Global Assessment of Functioning (GAF) scores of 0–70 and 0·95–0·96 for disorders having GAF scores of 0–50. Conclusions. The brevity, strong psychometric properties, and ability to discriminate DSM-IV cases from non-cases make the K10 and K6 attractive for use in general-purpose health surveys. The scales are already being used in annual government health surveys in the US and Canada as well as in the WHO World Mental Health Surveys. Routine inclusion of either the K10 or K6 in clinical studies would create an important, and heretofore missing, crosswalk between community and clinical epidemiology.",0,0 +3998,Role of risk factors proximate to time of trauma in the course of PTSD and MDD symptoms following traumatic injury,"Questions exist regarding whether posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are unique sequelae of trauma or a manifestation of a single form of psychopathology. Using latent growth modeling, we examined the role of risk factors occurring within 48 hours of the time of trauma on the course of PTSD and MDD symptoms over an 8-month period in 163 participants recruited from a level 1 surgical trauma center. Both PTSD and MDD symptoms showed peak prevalence by 1 month and significantly decreased over 7 months. Greater postinjury pain and PTSD symptoms (measured within 48 hours of trauma) predicted higher rates of both PTSD and MDD symptoms at 1 month. Other predictors were unique to each disorder. Results suggest that PTSD and MDD are related consequences of trauma.",0,0 +3999,Post-traumatic stress disorder symptom clusters in Turkish child and adolescent trauma survivors,"This study identified post-traumatic stress disorder (PTSD) symptom clusters in Turkish children and adolescents who experienced the 1999 Marmara Earthquake, which was classified as one of the world's six deadliest earthquakes in the 20th century. Two hundred ninety three children and adolescents (152 females and 141 males between the ages of 8 and 15) living in Izmit, the epicenter of the earthquake, participated in this study. The Post-Traumatic Stress Disorder Reaction Index for Children (CPTSD-RI) was administered to assess PTSD symptoms. A confirmatory factor analysis (CFA), using data from the CPTSD-RI, was conducted to determine whether the DSM-IV-TR symptom structure of PTSD was valid in Turkish children and adolescents. The CFA model supported the three-symptom cluster model. Limitations and implications for future research studies are included in the discussion. (",0,0 +4000,Post traumatic stress psychopathology 8 years after a flooding in Italy,"Objective: Post Traumatic Stress Psychopathology (PTSP) was assessed among village's inhabitants 8 years after the 1996 Versilia flooding in Italy. Methods: The sample was formed by 61 subjects. The Davidson Trauma Scale (DTS) was used to evaluate PTSP. Gender and two class of age (young and old subjects) were considered as demographic characteristics. Results: No significant differences resulted on DTS total and factor scores between female and male subjects. On the contrary, significant differences emerged on Hyperarousal Total and Hyperarousal Frequency between young and old subjects. People considered having enough symptoms for full Post Traumatic Stress Disorder (PTSD) were 45.9% (N=28), while 35.8% (N=20) had subthreshold PTSD, and 21.3% (N=13) had no PTSD. In the full PTSD subgroup old subject had a mean Hyperarousal Frequency significantly higher than young subjects, while in the subthreshold PTSD subgroup old subjects have a mean score on Intrusion Frequency, Intrusion Severity, Total Intrusion, Total Frequency and Total score significantly higher than young subjects. Conclusion: This study confirms that the traumatic impact of a flooding on a population hit some years before is not time-limited, showing the persistence of a high level of PTSP 8 years later. Old subjects showed on Hyperarousal Total and Hyperarousal Frequency within the whole sample, on Hyperarousal Frequency within the full PTSD subgroup, and on all Intrusion clusters, Total Frequency and Total score in the subthreshold PTSD subgroup, significantly higher scores than young subjects. Further specific research is needed in the elderly, in order to facilitate a better understanding of PTSP that is present in this unique population.",0,0 +4001,Posttraumatic Stress Disorder and Work-Related Injury,"The literature indicates a substantial overlap between chronic pain and posttraumatic stress disorder (PTSD) symptoms in individuals who sustain accidental injury. To date, however, there have been no studies of PTSD symptoms in individuals who experience work-related injury. Consequently, we assessed 139 consecutive injured workers using the Modified PTSD Symptom Scale (Falsetti, Resnick, & Kirkpatrick, 1993), as well as a number of general measures of psychopathology. Most participants reported chronic pain and all were receiving workers compensation. Results indicated that 34.7% and 18.2% of the sample reported symptoms consistent with PTSD and partial PTSD, respectively. When PTSD symptom frequency and severity were considered criterion variables in multiple regression analyses, depression was found to be significantly associated with the former and anxiety sensitivity, social fears, and somatic focus with the later. Finally, these measures of general psychopathology correctly classified 78.6% of individuals with PTSD and 81.3% of those with no PTSD. These results suggest that a considerable proportion of injured workers display symptoms consistent with PTSD and that these symptoms are related to general negative affect. Implications, including the suggestion of clinical intake screening of PTSD in this population, are discussed.",0,0 +4002,Epigenetic findings for PTSD and lower respiratory symptoms in male WTC responders,"After the World Trade Center (WTC) attack on 9/11/2001, the CDC established a consortium of clinics (WTC-Health Programs) in the NY-metropolitan area to detect, monitor and treat WTC-related health problems occurring among responders to the disaster. More than 25% of these responders (∼30,000) have WTC-related post-traumatic stress disorder (PTSD) and lower respiratory symptoms. These two conditions are often co-morbid (OR = 2.5). Longitudinal findings indicate that WTC-PTSD is associated with an increased risk of new-onset respiratory disease (but not vice versa). One explanation for this finding is that PTSD can result in a chronic stress response, including immunologic dysregulation. Epigenetics is a promising approach to elucidating biological processes underlying the PTSD-lower respiratory symptoms link. To further our understanding of the association among responders, the current study investigated DNA methylation patterns in peripheral blood of WTC responders and examined associations between methylation, PTSD symptom severity (PTSD Checklist [PCL]), and lower respiratory symptoms. Participants were 224 male (mean/ SD age = 49.6/8.1), primarily Caucasian (78%) responders enrolled in the WTC Health Program. Methylation was assessed with HumanMethylation450 BeadChip. As expected, no CpG site reached genome-wide significance (lowest p-value: 10-6). However, a network-based approach revealed that PTSD symptoms are correlated with reduced methylation in CpG sites that belong to a cluster of highly interacting genes involved in regulation of NF-κB transcription factor activity (fdr < 2 × 10-2). NF-κB is a protein complex that plays a significant role in regulating the immune response. The observed effect was driven primarily by sites within immunoregulatory genes TLR9, DAB2IP, TAOK3, and TRAF3, with the strongest effect on cg16302310 in the promoter region of TLR9. This site correlated significantly both with PTSD symptoms (r = -0.29, p = 3.91 × 10-5) and lower respiratory symptoms (r = -0.18, p = 0.01), indicating that demethylation of TLR9 is associated with greater symptom severity. The association between PTSD symptoms and lower respiratory symptoms was reduced when controlling for cg16302310 (p =0.04), which suggests that methylation mediates the PTSD-lower respiratory symptoms link. These results are a promising step in understanding the biologicalmechanisms underlying PTSD, lower respiratory symptoms, and their comorbidity. Specifically, our data build upon previous work that has implicated NF-κB and TLR9 in PTSD and highlights a potential pathway from PTSD to lower respiratory symptoms. Future work is needed to assess the observed relations longitudinally to evaluate directionality and to investigate the downstream effects of these epigenetic differences.",0,0 +4003,Violence Exposure and PTSD Among Delinquent Girls,"This study focuses on the unique trauma histories of incarcerated girls. In particular, this study draws upon data obtained from 100 incarcerated adolescent girls, highlighting areas of similarity to and difference from incarcerated boys, including: overall levels of traumatic violence exposure, exposure to unique forms of traumatic violence, psychological symptomatology, and hypothesized trajectories of involvement in serious delinquent activity. In addition, a case example is presented to illustrate our hypotheses about the trajectories of adolescent girls' involvement in serious delinquent behavior, as well as the prominent role of early trauma histories and repeat victimization in these trajectories.",0,0 +4004,"Parent and Child Agreement for Acute Stress Disorder, Post-Traumatic Stress Disorder and other Psychopathology in a Prospective Study of Children and Adolescents Exposed to Single-Event Trauma","Examining parent-child agreement for Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorder (PTSD) in children and adolescents is essential for informing the assessment of trauma-exposed children, yet no studies have examined this relationship using appropriate statistical techniques. Parent-child agreement for these disorders was examined by structured interview in a prospective study of assault and motor vehicle accident (MVA) child survivors, assessed at 2-4 weeks and 6 months post-trauma. Children were significantly more likely to meet criteria for ASD, as well as other ASD and PTSD symptom clusters, based on their own report than on their parent's report. Parent-child agreement for ASD was poor (Cohen's kappa = -.04), but fair for PTSD (Cohen's kappa = .21). Agreement ranged widely for other emotional disorders (Cohen's kappa = -.07-.64), with generalised anxiety disorder found to have superior parent-child agreement (when assessed by phi coefficients) relative to ASD and PTSD. The findings support the need to directly interview children and adolescents, particularly for the early screening of posttraumatic stress, and suggest that other anxiety disorders may have a clearer presentation post-trauma.",0,0 +4005,Reliability and validity of the Korean version of the Impact of Event Scale-Revised,"The aim of this study was to explore the reliability and validity of the Impact of Event Scale-Revised Korean version (IES-R-K), a self-report scale for assessment of posttraumatic stress disorder (PTSD).The original Impact of Event Scale-Revised was translated into Korean, and the comparability of content was verified through back-translation procedures. This multicenter study included 93 patients with PTSD, 73 nonpsychotic psychiatric patients, and 88 healthy controls drawn from 18 hospitals across the country. The subjects were assessed using IES-R-K, Clinician-Administered PTSD Scale (CAPS), Beck Depression Inventory, and State Trait Anxiety Inventory (STAI; state anxiety subscale [STAI-S], trait anxiety subscale [STAI-T]) scales.In the reliability test, Cronbach alpha coefficient and test-retest reliability were .93 and 0.91, respectively, indicating that the IES-R-K has good internal consistency. One-way analysis of variance revealed significant differences in IES-R-K scores among the patients with PTSD, nonpsychotic psychiatric patients, and healthy controls (F = 139.1, P < .001). Duncan post hoc test showed the significant differences among the 3 groups. To assess the validity of the IES-R-K, correlation coefficient between the IES-R-K and CAPS, STAI-S, and STAI-T was calculated. We found that there was a relatively high degree of correlation between the IES-R-K and CAPS (r = 0.92, P < .001). However, there was a relatively less degree of correlation between STAI-S and STAI-T and IES-R-K (r = 0.30, P < .001). Taken these together, IES-R-K showed good discriminant validity.The IES-R-K showed good reliability and validity for the assessment of PTSD symptom severity. The IES-R-K is a useful instrument for assessing PTSD symptoms in Korea.",0,0 +4006,Posttraumatic stress symptoms in children after Hurricane Katrina: Predicting the need for mental health services.,"The purpose of this study was to examine factors related to the development of posttraumatic stress symptoms in children and adolescents after Hurricane Katrina. It was hypothesized that a positive correlation would exist between trauma exposure variables and symptoms indicating need for mental health services experienced 2 years after Hurricane Katrina. Specifically, the authors hypothesized that experiences associated with natural disaster including personal loss, separation from family and/or community, and lack of community support as well as previous loss or trauma would be related to increased symptomatology in both children and adolescents. This study included 7,258 children and adolescents from heavily affected Louisiana parishes. Measures included the Hurricane Assessment and Referral Tool for Children and Adolescents developed by the National Child Traumatic Stress Network (NCTSN, 2005). Results were generally supportive of our hypotheses, and specific exposure and demographic variables were found to be strongly related to posttraumatic stress symptoms in children and adolescents.",0,0 +4007,"Predictors of symptoms of post-traumatic stress disorder after the AZF chemical factory explosion on 21 September 2001, in Toulouse, France","To analyse in the general population the prevalence and predictors of symptomatology consistent with post-traumatic stress disorder (S-PTSD) 18 months after an industrial explosion.Cross-sectional survey.A random sample of 1191 city inhabitants, including an oversample of the immediate area (<3 km). S-PTSD was measured by the self-administered Impact of Event Scale-Revised. The relation between S-PTSD and individual vulnerability factors, immediate exposure and post-trauma factors was analysed by gender.S-PTSD was more prevalent in the immediate area than in the peripheral area (women 19% vs 8%; men 8% vs 2%, p<0.01). In the immediate area, S-PTSD was independently associated with birth outside France (men: OR(a) = 13.9, 95% CI 3.7 to 52.8; women: OR(a) = 2.1, 95% CI 1.0 to 4.2), age more than 40 years (men: OR(a) = 4.3, 95% CI 1.01 to 18.2; women: OR(a) = 2.3, 95% CI 1.1 to 4.5), previous psychotropic treatment (men: OR(a) = 11.5, 95% CI 2.4 to 53.6), proximity to the explosion (less educated men only) (OR(a) = 9.3, 95% CI 1.9 to 44.7), rescue efforts (men: OR(a) = 5.2, 95% CI 1.5 to 18.2), temporarily uninhabitable home (men: OR(a) = 5.8, 95% CI 1.9 to 18.1), personal injury (women: OR(a) = 3.7, 95% CI 1.7 to 8.4), financial difficulties (men: OR(a) = 17.4, 95% CI 4.2 to 72.1; women: OR(a) = 3.4, 95% CI 1.7 to 7.1) and inconvenience due to closure of public services (women: OR(a) = 4.1, 95% CI 1.6 to 9.9).Individual vulnerability, exposure and post-trauma factors were associated with S-PTSD. Vulnerable subgroups, defined by low socioeconomic characteristics may warrant focused screening after such disasters.",0,0 +4008,The predictive value of post-traumatic stress disorder symptoms for quality of life: a longitudinal study of physically injured victims of non-domestic violence,"Little is known about longitudinal associations between post-traumatic stress disorder (PTSD) and quality of life (QoL) after exposure to violence. The aims of the current study were to examine quality of life (QoL) and the predictive value of post-traumatic stress disorder (PTSD) for QoL in victims of non-domestic violence over a period of 12 months.A single-group (n = 70) longitudinal design with three repeated measures over a period of 12 months were used. Posttraumatic psychological symptoms were assessed by using the Impact of Event Scale, a 15-item self-rating questionnaire comprising two subscales (intrusion and avoidance) as a screening instrument for PTSD. The questionnaire WHOQOL-Bref was used to assess QoL. The WHOQOL-BREF instrument comprises 26 items, which measure the following broad domains: physical health, psychological health, social relationships, and environment. Results of the analysis were summarized by fitting Structural Equation Modelling (SEM).For each category of PTSD (probable cases, risk level cases and no cases), the mean levels of the WHOQOL-Bref subscales (the four domains and the two single items) were stable across time of assessment. Individuals who scored as probable PTSD or as risk level cases had significantly lower scores on the QoL domains such as physical health, psychological health, social relationships and environmental than those without PTSD symptoms. In addition, the two items examining perception of overall quality of life and perception of overall health in WHOQOL showed the same results according to PTSD symptoms such as QoL domains. PTSD symptoms predicted lower QoL at all three assessments. Similarly PTSD symptoms at T1 predicted lower QoL at T2 and PTSD symptoms at T2 predicted lower QoL at T3.The presence of PTSD symptoms predicted lower QoL, both from an acute and prolonged perspective, in victims of non-domestic violence. Focusing on the individual's perception of his/her QoL in addition to the illness may increase the treatment priorities and efforts.",0,0 +4009,Depression and Posttraumatic Stress Disorder Among Women with Vulvodynia: Evidence from the Population-Based Woman to Woman Health Study,"Psychological disorders may affect the pain experience of women with vulvodynia, but evidence remains limited. The present study aimed to describe the magnitude of the association of depression and posttraumautic stress disorder (PTSD) with the presence of vulvodynia in a nonclinical population from southeastern Michigan.Baseline data from 1,795 women participating in the Woman to Woman Health Study, a multiethnic population-based study, was used for this analysis. Validated screening questionnaires were conducted to assess vulvodynia, depression, and PTSD. Modified Poisson regression models with a robust variance estimation were used to estimate prevalence ratios (PR) and their 95% confidence intervals (CI) for the association between vulvodynia status and two mental health conditions, depression and PTSD.In the adjusted models, women who screened positive for depression had a 53% higher prevalence of having vulvodynia (PR=1.53; 95% CI: 1.12, 2.10) compared with women who screened negative for depression. Women who screened positive for PTSD had more than a two-fold increase in the prevalence of having vulvodynia (PR=2.37; 95% CI: 1.07, 5.25) compared with women who screened negative for PTSD.The increased prevalence of vulvodynia among those screening positive for depression or PTSD suggests that these disorders may contribute to the likelihood of reporting vulvodynia. Alternatively, vulvodynia, depression, and PTSD may have a common pathophysiological and risk profile. Prospective studies are needed to improve our understanding of the temporal relation between mental health conditions and vulvar pain.",0,0 +4010,Social acknowledgment as a victim or survivor: A scale to measure a recovery factor of PTSD,"The development and validation of a new measure of social acknowledgment as a victim or survivor is presented, whose items were derived from previous research on social recovery factors of post-traumatic stress disorder. The Social Acknowledgment Questionnaire (SAQ) was administered to nontreatment seeking traumatized persons—178 former political prisoners in East Germany and 151 recently traumatized interpersonal crime victims. Principal components analysis yielded three factors—Recognition as victim, General disapproval, and Family disapproval. The factors showed high internal consistency and good test-retest reliability; correlated moderately to strong with measures of PTSD severity, social support, and reluctance to talk about the trauma. In comparison to a conventional measure of social support, the SAQ predicted comparably better between persons with high- and low-PTSD severity.",0,0 +4011,Open Trial of Nefazodone for Combat-Related Posttraumatic Stress Disorder,"Because of its ability to block 5-HT2 receptors postsynaptically and inhibit 5-HT reuptake presynaptically and/or its enhancement of sleep quality, nefazodone may be useful for symptom management in posttraumatic stress disorder (PTSD) patients.Ten patients with combat-related DSM-IV posttraumatic stress disorder (PTSD) entered an open-label 12-week trial of nefazodone with a 4-week follow-up, beginning with 100 mg/day and increasing as necessary to achieve a maximal response or until reaching a maximum dosage of 600 mg/day.Nefazodone was well tolerated, and no significant changes in sexual function were reported. Based on Clinical Global Impressions-Improvement scores, all 10 patients were rated as much improved. All PTSD symptoms (except self-reported PTSD reexperiencing symptoms), sleep, and clinician-rated depression significantly improved at week 12. At follow-up, significant changes were maintained, and self-reported PTSD reexperiencing symptoms had also significantly improved. Effect sizes for all changed symptoms were moderate to large at week 12 and at follow-up. Self-reported and clinician-rated anger significantly improved. Self-reported depression failed to improve. Improvement in social and occupational functioning was minimal.These preliminary data suggest that nefazodone may be effective in reducing the 3 primary PTSD symptom clusters and may be particularly helpful in improving sleep and decreasing anger.",0,0 +4012,Neuropsychiatric profile of a case of post traumatic stress disorder following an electric shock.,"Exposure to extraordinary stressors or life-threatening events has been shown to result in negative cognitive, behavioural and emotional outcomes including the cluster of symptoms constituting Post Traumatic Stress Disorder (PTSD). This disorder has most often been studied in military veterans and victims of abuse who also show high rates of comorbid conditions. We report a case of PTSD following an electrical injury in a patient with no past psychiatric history. Implications for a full range of examinations including comprehensive neuropsychiatric testing are discussed. Results suggest that such approach addresses the complexity of a differential diagnosis between organic and psychiatric dysfunctions.",0,0 +4013,"Social interaction in the aftermath of conflict-related trauma experiences among women in Walungu Territory, Democratic Republic of Congo","The aim of this study was to understand the relative contribution of posttraumatic stress disorder (PTSD)- and non-PTSD-associated reductions in social interaction among a group of adult Congolese women (N = 701) who have experienced multiple and different traumatic events and are participating in a village livestock microfinance programme. The two main outcomes were frequency of (1) family/community members visiting women's homes and (2) women visiting family/community members in their home. Bivariate and multivariable linear regression was used to understand relationships between multiple and grouped trauma experiences, PTSD, depression and social interaction. The majority of women (51.6%) reported rarely or never visiting family/community members or having family/community members visit the woman's home (54.9%). In the multivariable model, material deprivation was significantly associated with fewer visits in the woman's home. Exposure to certain conflict-related traumas, but not material deprivation, was significantly associated with fewer visits to the homes of family/community members. Increased symptoms of PTSD were significantly associated with fewer visitors in woman's home and fewer visits to the homes of family/community members. A better understanding of the social effects of conflict on individuals and local communities is necessary to support rebuilding of local communities.",0,0 +4014,Awake/sleep cortisol levels and the development of posttraumatic stress disorder in injury patients with peritraumatic dissociation.,"Differences in the time of day that cortisol is sampled and failure to consider the impact of peritraumatic dissociation have been hypothesized as factors possibly contributing to the inconsistent findings in research examining associations between cortisol levels soon after trauma exposure and the subsequent development of posttraumatic stress disorder (PTSD). The present study examined associations between urinary cortisol levels during wake and sleep times soon after a serious injury and the subsequent development of PTSD in adult patients reporting low or high peritraumatic dissociative (PD) symptoms. Thirty-nine injury patients (20 with high and 19 with low PD symptoms) provided a 15-hour (6 PM to 9 AM) urine sample at 3-weeks post-injury and completed the Clinician Administered PTSD Scale at a 7-week follow-up. Participants collected their urine during wake and sleep times separately. Results showed that in the total sample and in the high PD group, wake, but not sleep, cortisol levels were lower in patients who developed PTSD compared to those who did not. A multiple linear regression analysis revealed a significant main effect of PD and a non-significant interaction between wake cortisol and PD in predicting PTSD symptom severity. In addition, results showed that PD was a better predictor of PTSD symptom severity than wake cortisol levels. These results were consistent with prior research indicating lower afternoon/evening cortisol levels in PTSD and strong associations between PD and PTSD, but did not support the existence of subgroups of PTSD patients (dissociators versus non-dissociators) who may differ in basal cortisol levels.",0,0 +4015,Differing psychotropic profiles of the anticonvulsants in bipolar and other psychiatric disorders,"Abstract Several compounds from the anticonvulsant category have played a major role in therapeutic approaches to bipolar illness, particularly carbamazepine, valproate, and lamotrigine. At the same time there is little evidence that covert seizures underlie the affective disorders, or that all anticonvulsants are effective acute antimanic or mood stabilizing agents. For example, recent FDA-approved anticonvulsants (gabapentin, the gamma-aminobutyric acid (GABA) re-uptake inhibitor tiagabine, and topiramate) that exert major effects on GABAergic systems and increase brain GABA in patients as measured by magnetic resonance spectroscopy, do not appear to be effective acute antimanic agents based on controlled clinical trials or detailed open observations. This raises the question as to what mechanistic properties within the anticonvulsant class are associated with positive effects in bipolar illness; candidates include blockade of sodium channels and decreased release of glutamate, decreased calcium influx through the NMDA receptor, increases in potassium efflux, as well as a variety of aminergic effects and effects on gene expression. With the exception of lamotrigine, mood stabilizers (including lithium, valproate, and carbamazepine) appear to be better acute and prophylactic antimanics than antidepressants, and preliminary data suggest this for zonisamide as well. Some of the anticonvulsants appear useful in targeting a variety of other syndromes and ones that are often comorbid with bipolar illness, including anxiety disorders, substance abuse disorders, migraine, eating disorders, and obesity. Gabapentin is effective in panic anxiety and social phobia as well as chronic pain syndromes, whereas a large range of anticonvulsants may be useful in the treatment of sleep disorders and paroxysmal components of posttraumatic stress disorder. Recent data indicate that topiramate has the ability to reduce alcohol intake and craving in patients with primary alcoholism compared with placebo, and both topiramate and zonisamide share the positive side effect of inducing weight loss of a magnitude similar to that achieved with the FDA-approved weight-loss drug sibutramine. Thus, while there is an apparent absence of seizures in bipolar illness, and anticonvulsant efficacy is not sufficient for classifying the psychotropic properties of these agents, some of the mechanisms that are pertinent to inhibiting paroxysmal discharges in the epilepsies may also be pertinent to the wide range of primary or adjunctive uses of the anticonvulsants in a range of neuropsychiatric disorders.",0,0 +4016,Does the evocation of traumatic memories confound subsequent working memory performance in posttraumatic stress disorder (PTSD)?,"The role of heightened arousal has been previously discussed as a contributor to neurocognitive impairment in posttraumatic stress disorder (PTSD). To investigate whether psychological effects (distraction, re-location of resources) elicited by the evocation of traumatic memories impact on subsequent cognitive performance in PTSD, two parallel versions of a working memory task were administered to 33 trauma-exposed participants (15 with and 18 without PTSD). Between first and second working memory assessment a trauma-related interview was conducted including the narration of the trauma. Levels of working memory impairment in PTSD patients remained unchanged. This study provides preliminary evidence that neurocognitive impairment is not secondary to psychological effects induced by the evocation of traumatic memories. Nevertheless, it is recommended that future PTSD research should devote more care to the order in which trauma-related and other dependent variables such as cognitive tests are presented to participants. Depression and Anxiety 25:175–179, 2008. © 2008 Wiley-Liss, Inc.",0,0 +4017,Use of the Hand Test in the Assessment of Combat-Related Stress,"This study investigated the effectiveness of the Hand Test in discriminating the differential symptomatology of posttraumatic stress (PTS) in Vietnam combat veterans (VCVs). Participants were 108 VCV outpatients, 85 of whom met the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) criteria for posttraumatic stress disorder (PTSD), and 23 patients that were found to meet some, but not the minimum criteria, required for a diagnosis of PTSD by the DSM-IV. The latter group of patients was classified into a subclinical PTSD, posttraumatic stress symptoms (PTSS) group. Results showed higher levels of overall psychopathology, a vulnerable capacity for coping, and a tendency for feelings of inadequacy and inferiority in the PTSD group. The PTSD group also exhibited more limited interaction with the world around them than the PTSS group, which may be indicative of withdrawal, apathy, or a lack of concern with environmental activities and goals. These findings are discussed in relation to the assessment, understanding, and treatment of PTS symptomatology and PTSD.",0,0 +4018,Recovery from PTSD following Hurricane Katrina,"We examined patterns and correlates of speed of recovery of estimated posttraumatic stress disorder (PTSD) among people who developed PTSD in the wake of Hurricane Katrina.A probability sample of prehurricane residents of areas affected by Hurricane Katrina was administered a telephone survey 7-19 months following the hurricane and again 24-27 months posthurricane. The baseline survey assessed PTSD using a validated screening scale and assessed a number of hypothesized predictors of PTSD recovery that included sociodemographics, prehurricane history of psychopathology, hurricane-related stressors, social support, and social competence. Exposure to posthurricane stressors and course of estimated PTSD were assessed in a follow-up interview.An estimated 17.1% of respondents had a history of estimated hurricane-related PTSD at baseline and 29.2% by the follow-up survey. Of the respondents who developed estimated hurricane-related PTSD, 39.0% recovered by the time of the follow-up survey with a mean duration of 16.5 months. Predictors of slow recovery included exposure to a life-threatening situation, hurricane-related housing adversity, and high income. Other sociodemographics, history of psychopathology, social support, social competence, and posthurricane stressors were unrelated to recovery from estimated PTSD.The majority of adults who developed estimated PTSD after Hurricane Katrina did not recover within 18-27 months. Delayed onset was common. Findings document the importance of initial trauma exposure severity in predicting course of illness and suggest that pre- and posttrauma factors typically associated with course of estimated PTSD did not influence recovery following Hurricane Katrina.",0,0 +4019,Posttraumatic Stress Disorder in Infants and Young Children Exposed to War-Related Trauma,"Although millions of the world's children are growing up amidst armed conflict, little research has described the specific symptom manifestations and relational behavior in young children exposed to wartime trauma or assessed factors that chart pathways of risk and resilience.Participants included 232 Israeli children 1.5 to 5 years of age, 148 living near the Gaza Strip and exposed to daily war-related trauma and 84 controls. Children's symptoms were diagnosed, maternal and child attachment-related behaviors observed during the evocation of traumatic memories, and maternal psychological symptoms and social support were self-reported.PTSD was diagnosed in 37.8% of war-exposed children (n = 56). Children with PTSD exhibited multiple posttraumatic symptoms and substantial developmental regression. Symptoms observed in more than 60% of diagnosed children included nonverbal representation of trauma in play; frequent crying, night waking, and mood shifts; and social withdrawal and object focus. Mothers of children with PTSD reported the highest depression, anxiety, and posttraumatic symptoms and the lowest social support, and displayed the least sensitivity during trauma evocation. Attachment behavior of children in the Exposed-No-PTSD group was characterized by use of secure-base behavior, whereas children with PTSD showed increased behavioral avoidance. Mother's, but not child's, degree of trauma exposure and maternal PTSD correlated with child avoidance.Large proportions of young children exposed to repeated wartime trauma exhibit a severe posttraumatic profile that places their future adaptation at significant risk. Although more resilient children actively seek maternal support, avoidance signals high risk. Maternal well-being, sensitive behavior, and support networks serve as resilience factors and should be the focus of interventions for families of war-exposed infants and children.",0,0 +4020,"Posttraumatic Stress Disorder: Etiology, Epidemiology, and Treatment Outcome","Posttraumatic stress disorder (PTSD) results from exposure to a traumatic event that poses actual or threatened death or injury and produces intense fear, helplessness, or horror. U.S. population surveys reveal lifetime PTSD prevalence rates of 7% to 8%. Potential reasons for varying prevalence rates across gender, cultures, and samples exposed to different traumas are discussed. Drawing upon a conditioning model of PTSD, we review risk factors for PTSD, including pre-existing individual-based factors, features of the traumatic event, and posttrauma social support. Characteristics of the trauma, particularly peritraumatic response and related cognitions, and posttrauma social support appear to confer the greatest risk for PTSD. Further work is needed to disentangle the interrelationships among these factors and elucidate the underlying mechanisms. Based upon existing treatment outcome studies, we recommend use of exposure therapies and anxiety management training as first-line treatment for PTSD. Among psychopharmacological treatments, selective serotonin reuptake inhibitors evidence the strongest treatment effects, yet these effects are modest compared with psychological treatments.",0,0 +4021,Content not quantity is a better measure of muscle degeneration in whiplash,"Whiplash associated disorder (WAD) represents an enormous economic, social and personal burden. Five out of 10 people with WAD never fully recover and up to 25% continue to have moderate to severe pain-related disability. Unfortunately, clear and definitive reasons as to why half of individuals with WAD recover uneventfully and the other half do not, remain elusive. Identifying the factors that can reliably predict outcome holds considerable importance for not only WAD, but arguably for other acute musculoskeletal traumas. The precise pathology present in WAD has been controversial and often biased by outdated models. Fortunately, a combination of new measurement technology that illuminates pain processing, physical and social functioning and post-traumatic stress responses (and possibly markers of altered muscle size/shape/physiology) is providing a clearer picture of the multisystem pathophysiology in individuals with persistent WAD. The aim of this professional issues paper is to illuminate the clinical and research communities with regards to the growing body of knowledge for determining the trajectory of a patient with whiplash.",0,0 +4022,Nitric oxide as inflammatory mediator in post-traumatic stress disorder (PTSD): evidence from an animal model,"Post-traumatic stress disorder (PTSD) is a severe anxiety disorder that may develop after experiencing or witnessing a traumatic event. Recent clinical evidence has suggested the involvement of neurodegenerative pathology in the illness, particularly with brain imaging studies revealing a marked reduction in hippocampal volume. Of greater significance is that these anatomical changes appear to be positively correlated with the degree of cognitive deficit noted in these patients. Stress-induced increases in plasma cortisol have been implicated in this apparent atrophy. Although not definitive, clinical studies have observed a marked suppression of plasma cortisol in PTSD. The basis for hippocampal neurodegeneration and cognitive decline therefore remains unclear. Stress and glucocorticoids increase glutamate release, which is recognized as an important mediator of glucocorticoid-induced neurotoxicity. Recent preclinical studies have also noted that glutamate and nitric oxide (NO) play a causal role in anxiety-related behaviors. Because of the prominent role of NO in neuronal toxicity, cellular memory processes, and as a neuromodulator, nitrergic pathways may have an important role in stress-related hippocampal degenerative pathology and cognitive deficits seen in patients with PTSD. This paper reviews the preclinical evidence for involvement of the NO-pathway in PTSD, and emphasizes studies that have addressed these issues using time-dependent sensitization - a putative animal model of PTSD.",0,0 +4023,A group therapy approach to treating combat posttraumatic stress disorder: Interpersonal reconnection through letter writing.,"Many who have served in a war zone carry deep emotional wounds that go beyond the typical symptom clusters of reexperiencing, avoidance/numbing, and hyperarousal that comprise a diagnosis of posttraumatic stress disorder (PTSD). Specifically, many combatants experience unresolved grief, guilt, and shame caused by losses and traumatic experiences suffered in war, called ""moral injury"" by some clinicians and researchers (e.g., Litz et al., 2009; Shay, 1994). We describe the aspects of human attachment that set the stage for grief, guilt, and shame, and outline the 3-phase group therapy model we have implemented in a clinical setting to foster the reconnection of severed human bonds. Special attention is paid to killing and related phenomena that are unique to combat PTSD. The program phases include psychoeducation, trauma-focused therapy, and aftercare, which focuses on assisting the veterans in reconnecting with their families and communities. The use of letter writing as an intervention is illustrated through case examples, and clinical outcomes are anecdotally described.",0,0 +4024,Post-acute polytrauma rehabilitation and integrated care of returning veterans: Toward a holistic approach.,"Throughout the history of war, exposure to combat has been associated with clusters of physical and psychological symptoms labeled in various ways, from ""hysteria"" to ""shell shock"" in World War I to ""polytrauma"" in Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF).To describe the historical conceptualizations of combat injury and the ways they are relevant to developing current rehabilitation strategies, discuss the symptom complex presented by OEF/OIF veterans, and describe key elements and principles of holistic, integrated care for post-acute OEF/OIF veterans.A conceptualization of rehabilitation recognizing a final common pathway of functional disability and suffering is proposed, and both systematic and treatment-specific aspects at the core of a veteran-centered holistic approach are discussed.",0,0 +4025,Cancer-Related Intrusive Thoughts as an Indicator of Poor Psychological Adjustment at 3 or More Years After Breast Surgery: A Preliminary Study,"Intrusive thoughts are one of the re-experiencing symptoms in posttraumatic stress disorder, and have been suggested as a predictor for the continuous presence of psychological distress in cancer survivors. The aim of this preliminary study was to examine the possibility of using cancer-related intrusive thoughts (CITs) as an indicator of psychological distress and adjustment after breast surgery. A consecutive series of ambulatory breast cancer survivors at 3 or more years after surgery were given the Structured Clinical Interview for DSM-IV (SCID) and self-report questionnaires, including Profile Of Mood States (POMS), Impact of Event Scale (IES) and Mental Adjustment to Cancer (MAC) scale, to measure psychological distress and/or adjustment. The SCID identified a history of CITs in 34 (46 \% ) of the 74 participants. No significant differences were found in the POMS and IES psychological distress scores between subjects with and without a history of CITs. Subjects with a history of CITs showed significantly higher levels of anxious preoccupation, one of the MAC subscale scores. The association continued to be significant after controlling for potential confounders such as social support, depression, avoidance, arousal, and neuroticism. The results indicated that CITs might be useful for indicating poor psychological adjustment, but not distress, in patients at 3 or more years after breast surgery.",0,0 +4026,Emotion regulation in relation to social functioning: An investigation of child self-reports,"Relations between child self-reports of specific aspects of emotion regulation and specific aspects of social functioning in school were studied in two samples (N = 129/135) of 8- to 9-year-old children. The newly developed child self-report measure had significant relations to parent (Sample 1) and teacher (Sample 2) ratings of emotion regulation. In line with expectations (Rydell, Berlin, & Bohlin, 2003), poor regulation of anger and exuberance was associated with externalizing problems in both samples, poor regulation of fear had associations with social anxiety or internalizing problems in the two samples and poor regulation of sadness had marginal relations to internalizing problems in one sample. In both samples, good regulation of all emotions except fear was associated with prosocial behaviour. In Sample 1, several independent effects of child self-reports of emotion regulation on outcomes were demonstrated after controlling for parent reports of emotion regulation.",0,0 +4027,Resilience to potential trauma: Toward a lifespan approach.,,0,0 +4028,Prevalence and predictors of stress disorders following two earthquakes,"Background: Studies about stress disorders following a disaster have mainly been based on single-event trauma with little emphasis on multiple traumas. Aims: This study investigated the prevalence and predictors of stress disorders following two earthquakes in China. Methods: Subjects were randomly sampled from 11 villages in rural China. A total of 624 subjects were administered with the 12-item General Health Questionnaire (GHQ-12), Symptom Checklist -90-R (SCL-90-R), Coping Style Scale and Social Support Rating Scale. This was followed by a structural clinical interview using the Chinese translation of the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV-TR axis 1 disorders (SCID-I-P) for acute stress disorder (ASD) and post-traumatic stress disorder (PTSD). Results: The prevalence of ASD and PTSD was 15% and 29%, respectively. Regression analysis indicated that high intensity of trauma exposure, lower educational level, subjective feeling of economic status and psychological stress after the first earthquake significantly predicted the outcome of PTSD. Conclusions: The study suggested that the prevalence of stress disorders in two earthquakes were higher than that experienced in a single disaster. The intensity of trauma exposure, low educational level, bad subjective feeling of economic status, and psychological stress after the first earthquake could be used to identify survivors at risk of developing PTSD in two earthquakes.",0,0 +4029,Social support barriers and mental health in terrorist attack survivors,"To expand our understanding of social support and mental health, we introduce a measure of social support barriers and investigate the relationship between these barriers, social support, mental health and gender in survivors of the terrorist attack on Utøya Island, Norway.Survivors (N=285) were interviewed face to face. We used confirmatory factor analysis (CFA) to assess the latent factor structure of the Social Support Barriers Scale and perceived social support (FSSQ), and linear regression analyses to investigate the associations between social support variables and mental health (PTSD-RI and HSCL-8).The CFA indicated that social support barriers and perceived social support were two separable latent constructs. Social support barriers were highly associated with posttraumatic stress reactions (adjusted regression coefficient=0.38, 95% CI=0.29-0.47. p<0.001) as well as with psychological distress (adjusted regression coefficient=0.35, 95% CI=0.26-0.43, p<0.001). In contrast, neither perceived social support nor gender was associated with mental health after adjustment for barriers.Most analyses were based on cross-sectional data. This is the first study to use a quantitative measure of social support barriers.Social support barriers may be a new opening to understand the relationship between social support and mental health and may have a role in explaining why women are at increased risk for mental health problems. Clinicians should explore not only perceived social support but also barriers to making use of these resources when consulting young people facing major life adversities.",0,0 +4030,Parental intimate partner homicide and its consequences for children: protocol for a population-based study,"The loss of a parent due to intimate partner homicide has a major impact on children. Professionals involved have to make far-reaching decisions regarding placement, guardianship, mental health care and contact with the perpetrating parent, without an evidence base to guide these decisions. We introduce a study protocol to a) systematically describe the demographics, circumstances, mental health and wellbeing of children bereaved by intimate partner homicide and b) build a predictive model of factors associated with children's mental health and wellbeing after intimate partner homicide.This study focuses on children bereaved by parental intimate partner homicide in the Netherlands over a period of 20 years (1993 - 2012). It involves an incidence study to identify all Dutch intimate partner homicide cases between 1993 and 2012 by which children have been bereaved; systematic case reviews to describe the demographics, circumstances and care trajectories of these children; and a mixed-methods study to assess mental health, wellbeing, and experiences regarding decisions made and care provided.Clinical experience and initial research suggest that the children involved often need long-term intensive mental health and case management. The costs of these services are extensive and the stakes are high. This study lays the foundation for an international dataset and evidence-informed decision making.",0,0 +4031,Examining the relationship between race-related stressors and post-traumatic stress disorder among African American male Vietnam veterans,"It is estimated that 1,700,000 Vietnam War veterans have experienced ""clinically serious stress reaction symptoms"" (National Center for Post Traumatic Stress Disorder, 2005). Of this figure, all ethnic minorities (except for Japanese) reported the greatest life time prevalence of posttraumatic stress disorder (PTSD) compared to Whites (Kulka, Schlenger, Fairbank, Hough, Jordan, Marmar, & Weiss, 1990). The National Vietnam Veterans Readjustment Study (NVVRS) found that African American Vietnam War veterans had greater exposure to war stressors and had more predisposing factors than Whites (Kulka et al., 1990). The Race-Related Stressor Scale (RRSS) is the only instrument that exists to measure race-related stressors that contribute uniquely and substantially to PTSD symptoms and generalized psychiatric distress in an ethnic minority Vietnam Veteran sample. A previous study found that race-related stressors account for a significant proportion of the variance in PTSD symptoms of Asian American Vietnam Veterans (Loo, Fairbank, Scurfield, Ruch, King, Adams, & Chemtob, 2001). Although African American Vietnam War veterans are one of the most frequently studied samples, no instrument exists to measure race-related exposure accounting for their PTSD symptoms. There are two purposes of this study: Primary is to adapt and validate the RRSS using an African American Vietnam Veteran sample, and secondary is to examine the amount of variability the adapted RRSS accounts for in PTSD and generalized psychiatric distress symptoms. This new measure will be called the Vietnam Racial Stressor Scale for African American Vietnam Veterans (VRSS). The construct validity of the adapted RRSS will be examined by investigating the relationship between the VRSS, PTSD, and general psychiatric distress symptoms, controlling for military rank and exposure to combat. The temporal stability of the VRSS will be assessed using Cronbach's Alpha method. Results of the temporal stability of the VRSS will be compared to Loo et al., (2001) RRSS temporal stability for Asian American Vietnam War veterans. A general discussion of the temporal stability comparisons between the RRSS and its adaptations will suggest the generalizability of the RRSS with other Vietnam War veteran ethnic groups. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4032,Children's Environmental Health in the Twenty-First Century,"In the twenty-first century, the global burden of disease trends are the result of complex interaction among rapid industrialization and urbanization, unsustainable use of natural resources, and population growth. In addition, global environmental changes due to climate change, ozone depletion, desertification/deforestation, loss of biodiversity, and increased used of some biotechnologies are having an important impact on human health. Many other factors also play an important role in the population's health response to global environmental threats, including poverty, malnutrition, poor sanitation, and infectious diseases. Worldwide, the burden of environmental disease is much higher for children than adults, especially in young children under 5 years of age. Quantification of the burden of diseases attributable to environment shows that environmental risk factors can contribute to more than one-third of the disease burden in children, a fraction of disease that could be prevented. Children are often exposed to multiple environmental threats combined with other behavioral, social, and economic risk factors. Many of the environmental health risk factors are shared among children's home, school, and community. Therefore, an integrated approach should be considered in order to create healthy environments for children. The promotion of safe environments for children has to involve decision makers, nongovernmental organizations (NGOs), families, and various sectors including health, education, housing, environment, agriculture, industry, transport, and energy. Multiple initiatives have been proposed from collection, evaluation, and dissemination of information on children's health and the potential environmental threats to research, monitoring, risk assessment, and policies to improve the environmental conditions and ultimately children's growth and development.",0,0 +4033,The relationship between cognitive control and posttraumatic stress symptoms,"Recently researchers have theorized that individual differences in cognitive control (i.e., the ability to complete goal-directed behavior by actively maintaining information while inhibiting irrelevant information) may elucidate processes involved in disorders characterized by intrusive thoughts and memories. By this account, the relationship between cognitive control and emotional disorders would be specific to symptoms associated with intrusive cognitions, such as re-experiencing symptoms of posttraumatic stress disorder (PTSD).In the present study, 77 undergraduate participants with a self-reported history of trauma exposure were administered assessments of cognitive control (working memory capacity; WMC), PTSD symptoms, trait anxiety, and depression. PTSD symptoms from each of the three symptom clusters (re-experiencing, avoidance, and hyperarousal) were predicted from trait anxiety, depression, and WMC performance scores using separate regression models.After controlling for trait anxiety and depression, there was a negative, statistically significant relationship between cognitive control and re-experiencing symptoms but not avoidance or hyperarousal symptoms.The study was completed cross-sectionally and did not include a diagnostic assessment of PTSD.Findings add to extant literature suggesting a relationship between cognitive control and intrusive cognitions. Moreover, the present study expands the current literature by demonstrating the specificity of this relationship within individuals with varying degrees of PTSD symptom severity.",0,0 +4034,Computerised Test Generation for Cross-National Military Recruitment: A Handbook,"“‘Computerised Test Generation for Cross-National Military Recruitment’ by Prof. Sidney H. Irvine is a handbook for use in occupational psychology, test construction and psychometrics. The book describes the development of the British Army Recruitment Battery (BARB) by Prof. Irvine and his colleagues at the University of Plymouth. BARB is a computer-administered selection battery that is still in use to this day and is capable of developing new parallel tests for every candidate in the recruitment process. In telling the story, Sidney Irvine describes not only the development of the battery itself, funded by the UK Ministry of Defence, but all the work that went on before and afterwards, in the United Kingdom, with European allies and in the United States. Prof. Irvine argues that judicious application of the current state-of-the art in psychometric selection tests can be used to maximise retention and minimise attrition. As such, this long-awaited book will be of great interest to psychologists, psychometricians, test developers, those involved in personnel selection and all with an interest in military history, in particular the history of military science. With a foreword and chapter introductions from a worldwide array of subject matter experts, the book also has a full subject index and an extensive bibliography. I commend it heartily.” — Professor Jamie Hacker Hughes CPsychol CSci FBPsS, Former Defence Consultant Advisor in Clinical Psychology, Ministry of Defence, United Kingdom. © 2014 The author and IOS Press. All rights reserved.",0,0 +4035,The association between latent depression subtypes and remission after treatment with citalopram: A latent class analysis with distal outcome,"The objectives were to characterize latent depression subtypes by symptoms, evaluate sex differences in and examine correlates of these subtypes, and examine the association between subtype and symptom remission after citalopram treatment.Latent class analysis was applied to baseline data from 2772 participants in the Sequenced Treatment Alternatives to Relieve Depression trial. Indicators were from the Quick Inventory of Depressive Symptomatology. Separate multinomial logistic models identified correlates of subtypes and the association between subtype and the distal outcome of remission.Four latent subtypes were identified: Mild (men: 37%, women: 27%), Moderate (men: 24%, women: 21%), Severe with Increased Appetite (men: 13%, women: 22%), and Severe with Insomnia (men: 26%, women: 31%). Generalized anxiety disorder, bulimia, and social phobia were correlated with Severe with Increased Appetite and generalized anxiety disorder, post-traumatic stress disorder, and social phobia with Severe with Insomnia. Relative to those with the Mild subtype, those with Severe with Increased Appetite (odds ratiomen (OR): 0.48; 95% confidence interval (CI): 0.25-0.92; OR women: 0.59; 95% CI: 0.41-0.86) and those with Severe Depression with Insomnia (ORmen: 0.65; 95% CI: 0.41-1.02; ORwomen: 0.45; 95% CI: 0.32-0.64) were less likely to achieve remission.The sample size limited exploration of higher order interactions.Insomnia and increased appetite distinguished latent subtypes. Sex and psychiatric comorbidities differed between the subtypes. Remission was less likely for those with the severe depression subtypes. Sleep disturbances, appetite changes, and other mental disorders may play a role in the etiology and treatment of depression.",0,0 +4036,A Test of Missing Completely at Random for Multivariate Data with Missing Values,"Abstract A common concern when faced with multivariate data with missing values is whether the missing data are missing completely at random (MCAR); that is, whether missingness depends on the variables in the data set. One way of assessing this is to compare the means of recorded values of each variable between groups defined by whether other variables in the data set are missing or not. Although informative, this procedure yields potentially many correlated statistics for testing MCAR, resulting in multiple-comparison problems. This article proposes a single global test statistic for MCAR that uses all of the available data. The asymptotic null distribution is given, and the small-sample null distribution is derived for multivariate normal data with a monotone pattern of missing data. The test reduces to a standard t test when the data are bivariate with missing data confined to a single variable. A limited simulation study of empirical sizes for the test applied to normal and nonnormal data suggests th...",0,0 +4037,The Brain and Propranolol Pharmacokinetics in the Elderly.,"Propranolol, a non-selective β-blocker, has been found to have a tremendous array of indications. Recent evidence has suggested that propranolol may be effective in patients suffering from post-traumatic stress disorder by suppressing activity in the amygdala and thereby inhibiting emotional memory formation. Dosage requirements have been well established in the pediatric and adult population, however, there has been no definitive geriatric dose recommended in the package inserts made available to the public. The aim of this paper is to use pharmacokinetic simulations in order to establish a pharmacokinetic profile dosage equivalent for the elderly as has been found in young patients. After completing the Monte-Carlo simulations for the elderly and young patients, a single 10mg dose in the elderly has shown comparable pharmacokinetic profiles as found in young patients administered a 40mg single dose.",0,0 +4038,Memory performance and dysfunctional cognitions in recent trauma victims and patients with post-traumatic stress disorder,"In order to investigate whether cognitive dysregulation contributed to memory impairment in trauma patients, recent trauma victims, post-traumatic stress disorder (PTSD) patients and healthy controls were compared with regard to verbal memory and dysfunctional cognitions. There were no significant group differences with regard to verbal memory. Concerning dysfunctional cognitions, recent trauma victims hardly differed from controls, unlike PTSD patients, who showed more negative appraisal, more dysfunctional thought control strategies and externality than controls. None of them were related to memory performance in the recent trauma group, and there was a negative correlation with distraction strategy in PTSD patients. In recent trauma victims, negative appraisal increased with time since the trauma. Copyright © 2007 John Wiley & Sons, Ltd.",0,0 +4039,The mutual prospective influence of child and parental post-traumatic stress symptoms in pediatric patients,"Previous studies found notable rates of post-traumatic stress symptoms (PTSS) and post-traumatic stress disorder (PTSD) in pediatric patients and their parents and suggest a significant association between child and parent PTSS. However, little is known about mutual influences between child and parental PTSS over time. This study prospectively examined the presence of PTSS and PTSD and the mutual influence of child and parental PTSS in a large sample of pediatric patients with different medical conditions. A total of 287 children (aged 6.5-16 years) and their mothers (n = 239) and fathers (n = 221) were assessed at 5-6 weeks and 1 year after an accident or a new diagnosis of cancer or diabetes mellitus type 1 in the child. At the first assessment 11.1% and at the second assessment 10.2% of the children had moderate to severe PTSS. At 5-6 weeks 29.3% of mothers and 18.6% of fathers met criteria for PTSD. At 1 year the rates were 14.6% for mothers and 7.9% for fathers. There were considerable differences of PTSS among different medical diagnostic groups in children and parents. Mothers were more vulnerable than fathers. Structural equation analysis revealed that initially high PTSS in mothers and fathers were longitudinally related to poorer recovery from PTSS in the child. Cross-lagged effects from the child to the parents and from one parent to the other were not significant. This study highlights the long-term influence of parental PTSS on the child's recovery after trauma and calls for a family systems approach and for early interventions in the treatment of traumatized pediatric patients.",0,0 +4040,Post-Traumatic Stress Disorder in Episodic and Chronic Migraine,"To assess and contrast the relative frequency of self-reported post-traumatic stress disorder (PTSD) in patients with episodic migraine and chronic/ transformed migraine.Several risk factors have been identified as risk factors for chronification of headache disorders. Childhood abuse has been suggested as a risk factor for chronic pain in adulthood. In addition depression, as well as several other psychiatric disorders, are co-morbid with migraine. Recent data suggest that PTSD may be more common in headache sufferers than in the general population.This was a prospective, pilot study conducted at a headache center. Adult subjects with episodic, chronic, or transformed migraine were included. Demographic information, depression history, body mass index (BMI), and headache characteristics were obtained. PTSD was assessed using the life events checklist (LEC) and the PTSD checklist, civilian version (PCL-C). We contrasted the data from episodicmigraineurs and chronic/transformed migraine participants (CM) and conducted multivariate analyses, adjusting for covariates.Of the 60 participants included, 91.7% were female with a mean age of 41.4+/-12.5 years old. EM was diagnosed in 53.3% and CM in 46.7%. The mean BMI was not significantly different between groups. In contrast, the relative frequency of depression was significantly greater in subjects with CM (55.2%) than EM (21.9%, P=.016). There was no significant difference in the percentage of participants reporting at least 1 significant traumatic life event (LE) or in the mean number of traumatic LEs between EM and CM participants. However, the relative frequency of PTSD reported on the PCL in CM (42.9%) was significantly greater as compared to EM (9.4%, P=.0059. After adjusting for depression and other potential confounders, the difference remained significant P=.023).PTSD is more common in CM than in episodic migraineurs. This suggests that PTSD may be a risk factor for headache chronification, pending longitudinal studies to test this hypothesis.",0,0 +4041,Posttraumatic Stress Disorder Symptom Severity and Socioeconomic Factors Associated with Veterans Health Administration Use among Women Veterans,"The Veterans Health Administration (VA) has historically focused on treating men. Although women veterans' VA use is increasing, they remain more likely than male veterans to receive their care in non-VA settings. To date, there is limited research on factors associated with VA use among women. We examined the relationship between demographic, civilian, military, and health-related variables with past-year VA use among women veterans.Women veterans were recruited over the internet to participate in an anonymous national survey (n = 617) in 2013. An empirically derived decision tree was computed using signal detection software for iterative receiver operator characteristics (ROC) to identify variables with the best sensitivity/specificity balance associated with past-year VA use.ROC analysis indicated that 85% of participants with high posttraumatic stress disorder (PTSD) and depressive symptoms and who were younger than 54 years of age used VA in the past year. Of those who were 54 years of age or older and had very high PTSD symptoms, 94% used the VA in the last year. By contrast, only 40% of participants with relatively lower PTSD symptoms had VA past-year use, although among these individuals, VA past-year use increased to 65% for those with a relatively lower income.Findings suggest that greater PTSD symptoms, depressive symptoms, and low income correlate with VA use, with very high PTSD symptoms in older groups, high PTSD symptoms coupled with high depressive symptoms in younger groups, and low income in those with lower PTSD symptoms each associated with greater past-year VA use. Ensuring PTSD assessment and treatment, and addressing socioeconomic factors, may be key strategies for health care delivered directly or through contract with VA facilities.",0,0 +4042,Identifying latent trajectories of personality disorder symptom change: Growth mixture modeling in the longitudinal study of personality disorders.,"Although previous reports have documented mean-level declines in personality disorder (PD) symptoms over time, little is known about whether personality pathology sometimes emerges among nonsymptomatic adults, or whether rates of change differ qualitatively among symptomatic persons. Our study sought to characterize heterogeneity in the longitudinal course of PD symptoms with the goal of testing for and describing latent trajectories. Participants were 250 young adults selected into two groups using a PD screening measure: those who met diagnostic criteria for a DSM-III-R PD (PPD, n = 129), and those with few PD symptoms (NoPD, n = 121). PD symptoms were assessed three times over a 4-year study using semistructured interviews. Total PD symptom counts and symptoms of each DSM-III-R PD were analyzed using growth mixture modeling. In the NoPD group, latent trajectories were characterized by stable, minor symptoms; the rapid or gradual remission of subclinical symptoms; or the emergence of symptoms of avoidant, obsessive-compulsive, or paranoid PD. In the PPD group, three latent trajectories were evident: rapid symptom remission, slow symptom decline, or a relative absence of symptoms. Rapid remission of PD symptoms was associated with fewer comorbid disorders, lower Negative Emotionality, and greater Positive Emotionality and Constraint, whereas emergent personality dysfunction was associated with comorbid PD symptoms and lower Positive Emotionality. In most cases, symptom change for one PD was associated with concomitant changes in other PDs, depressive symptoms, and anxiety. These results indicate that the longitudinal course of PD symptoms is heterogeneous, with distinct trajectories evident for both symptomatic and nonsymptomatic individuals. The prognosis of PD symptoms may be informed by an assessment of personality and comorbid psychopathology.",0,0 +4043,Diagnosis of Posttraumatic Stress Disorder (PTSD) by the Structured Clinical Interview SCID-I,"Cel Trafna i rzetelna diagnoza pourazowego zaburzenia stresowego jest ważna w praktyce klinicznej, orzecznictwie i badaniach naukowych. Celem badania było określenie właściwości psychometrycznych polskiej wersji ustrukturalizowanego wywiadu klinicznego SCID-I-PTSD, przeznaczonego do diagnozy pourazowego zaburzenia stresowego w oparciu o kryteria DSM-IV-TR. Metoda W badaniu uwzględniono dane od pięciuset dwudziestu sześciu uczestników wypadków drogowych. Podstawę diagnozy klinicznej stanowił wywiad SCID-I-PTSD. Osoby badane wypełniały także zestaw narzędzi samoopisowych służących do oceny objawów PTSD (PDS), depresji (BDI-II), lęku (STAI) i potraumatycznych przekonań (PTCI). Wyniki Pomiar za pomocą wywiadu cechuje wysoka rzetelność oraz trafność zbieżna i różnicowa. W porównaniu do narzędzia samoopisowego wywiad SCID-I-PTSD charakteryzuje się wyższą specyficznością. Pozycje wywiadu wykazują dobre własności psychometryczne (za wyjątkiem pozycji C3) oraz brak stronniczości w odniesieniu do płci. Analizy nie pozwoliły na jednoznaczne określenie struktury czynnikowej objawów PTSD. Wnioski Otrzymane wyniki pozwalają twierdzić, że ustrukturalizowany wywiad kliniczny SCID-I, część poświęcona badaniu PTSD, wchodząca w skład Modułu F (zaburzenia lękowe) stanowi trafne i rzetelne narzędzie diagnozy pourazowego zaburzenia stresowego.",0,0 +4044,"Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care","The current combat operations in Iraq and Afghanistan have involved U.S. military personnel in major ground combat and hazardous security duty. Studies are needed to systematically assess the mental health of members of the armed services who have participated in these operations and to inform policy with regard to the optimal delivery of mental health care to returning veterans.We studied members of four U.S. combat infantry units (three Army units and one Marine Corps unit) using an anonymous survey that was administered to the subjects either before their deployment to Iraq (n=2530) or three to four months after their return from combat duty in Iraq or Afghanistan (n=3671). The outcomes included major depression, generalized anxiety, and post-traumatic stress disorder (PTSD), which were evaluated on the basis of standardized, self-administered screening instruments.Exposure to combat was significantly greater among those who were deployed to Iraq than among those deployed to Afghanistan. The percentage of study subjects whose responses met the screening criteria for major depression, generalized anxiety, or PTSD was significantly higher after duty in Iraq (15.6 to 17.1 percent) than after duty in Afghanistan (11.2 percent) or before deployment to Iraq (9.3 percent); the largest difference was in the rate of PTSD. Of those whose responses were positive for a mental disorder, only 23 to 40 percent sought mental health care. Those whose responses were positive for a mental disorder were twice as likely as those whose responses were negative to report concern about possible stigmatization and other barriers to seeking mental health care.This study provides an initial look at the mental health of members of the Army and the Marine Corps who were involved in combat operations in Iraq and Afghanistan. Our findings indicate that among the study groups there was a significant risk of mental health problems and that the subjects reported important barriers to receiving mental health services, particularly the perception of stigma among those most in need of such care.",0,0 +4045,PTSD (Post-Traumatic Stress Disorder) in Later Life,"(from the chapter) Posttraumatic stress disorder (PTSD) is a stress reaction characterized by symptoms of reexperiencing, avoidance/numbing, and hyperarousal following 1 month or more an exposure to extreme trauma. Trauma at late life is plentiful and treatable. Data of the past two decades do not suggest that older adults are at greater risk than younger adults for poor psychosocial outcomes following exposure to trauma. There is simply insufficient evidence to conclude that trauma causes more negative psychosocial consequences in older adults. Empirically supported therapies that apply to younger groups have applicability to older groups as well. The six-step model proposed here, which incorporates key elements of traditional cognitive and behavioral therapies but also expands them to include a trauma focus, is a comprehensive treatment for acute or chronic PTSD. The model treats the whole person with PTSD problems. Memories are modified or transformed directly only as a last resort. Throughout, factors related specifically to aging, mourning for losses, giving meaning to experiences, reestablishing self-coherence and self-continuity, achieving ego integration, and culture and social support are integrated. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4046,"Bipolar Disorder Comorbidity in Anxiety Disorders: Relationship to demographic profile, symptom severity, and functional impairment","Background and Objectives: High rates of comorbidity between anxiety dis- orders and bipolar disorder (BD) have been reported. Studies on the impact of BD comor- bidity in individuals with a principal anxiety disorder have been limited. Methods: Individuals (N = 186) seeking anxiety disorder treatment completed ques- tionnaires and a diagnostic interview. Anxious individuals with comorbid BD were com- pared to anxious individuals with comorbid depression, and individuals with an anxiety disorder only. Results: Anxious individuals with BD were more likely to report being single, separated or divorced, and to present with greater substance abuse and comorbidity than individuals with an anxiety disorder only. Anxious individuals with BD also presented with lower household income than anxious individuals with depression, and individuals with anxiety only. Anxious individuals with either comorbid BD or comorbid depression reported greater functional impairment and more severe symptoms than individuals with anxiety only. Conclusions: Overall, the presence of comorbid BD was associated with demographic and clinical factors that have been previously shown to adversely affect treatment out- come in people with anxiety disorders.",0,0 +4047,Schizophrenia patients with and without Post-traumatic Stress Disorder (PTSD) have different mood symptom levels but same cognitive functioning,"Objective To investigate differences in cognitive function and level of psychopathology in patients with schizophrenia (SZ) with or without psychological traumatization/post-traumatic stress disorder (PTSD). We hypothesized that traumatized patients with or without PTSD would have more severe cognitive impairments because of the neuropathological changes associated with PTSD, and more severe psychopathology compared with non-traumatized SZ patients. Method Seventy-five SZ patients with traumatization and 217 SZ patients without traumatization were evaluated regarding the symptoms and cognitive functioning, using standard symptom scales (PANSS; CDSS) and a neuropsychological test battery (IQ, verbal memory, attention, working memory, psychomotor speed, and executive functioning). Results No significant differences were observed between the groups in cognitive test performance. The patients in the traumatized group with PTSD showed significantly more current depression than the non-traumatized group (P = 0.012). Conclusion The findings did not support the hypothesis that the presence of comorbid PTSD/traumatization in SZ is associated with increased cognitive impairment. The increase in current depression in SZ with comorbid traumatization suggests that more severe psychopathology is associated with traumatization.",0,0 +4048,Factors associated with risk of depression and relevant predictors of screening for depression in clinical practice: a cross-sectional study among HIV-infected individuals in Denmark,"Depression and psychiatric disorders are frequent among HIV-infected individuals. The aim of this study was to determine the prevalence of depression and describe the psychiatric history of HIV-infected individuals in an out-patient clinic in Denmark and to identify factors of clinical importance that may be used to identify patients at risk of depression.In 2013, 212 HIV-infected patients were included in a questionnaire study. We used the Beck Depression Inventory II (BDI-II) to assess the prevalence and severity of depressive symptoms. Patients with a BDI-II score ≥ 20 were offered a clinical evaluation by a consultant psychiatrist. Logistic regression was used to determine predictors associated with risk of depression.Symptoms of depression (BDI-II score ≥ 14) were observed in 75 patients (35%), and symptoms of moderate to major depression (BDI-II score ≥ 20) in 55 patients (26%). There was also a high prevalence of co-occurring mental illness. In a multivariate model, self-reported stress, self-reported perception that HIV infection affects all aspects of life, self-reported poor health, not being satisfied with one's current life situation, previous alcohol abuse, nonadherence to antiretroviral therapy and previously having sought help because of psychological problems were independently associated with risk of depression.Symptoms of depression and co-occurring mental illness are under-diagnosed and under-treated among HIV-infected individuals. We recommend that screening of depression should be conducted regularly to provide a full psychiatric profile to decrease the risk of depression and improve adherence and quality of life in this population.",0,0 +4049,Disaster preparedness and the chronic disease needs of vulnerable older adults.,"About 80% of older adults have at least one chronic condition that makes them more vulnerable than healthy people during a disaster. These chronic conditions - combined with the physiological, sensory, and cognitive changes experienced as part of aging - result in frail older adults having special needs during emergencies. Planning and coordination among public health and emergency preparedness professionals and professionals who provide services for the aging are essential to meet these special needs. Several tools and strategies already exist to help prepare these professionals to protect and assist older adults during a disaster. These include having professionals from diverse fields work and train in coalitions, ensuring that advocates for older adults participate in community-wide emergency preparedness, and using community mapping data to identify areas where many older adults live.",0,0 +4050,The PTSD Symptom Scale's latent structure: An examination of trauma-exposed medical patients,"Several studies have employed confirmatory factor analysis (CFA) to evaluate the latent structure of posttraumatic stress disorder (PTSD) assessment measures among various trauma-exposed populations. Findings have generally failed to support the current three-factor DSM-IV PTSD conceptualization, demonstrating the need to consider alternative models. The present study used CFA to evaluate seven models, including intercorrelated and hierarchical versions of two models with the most empirical support. Data were utilized from a heterogeneous trauma-exposed sample of general medical patients (n=252). Based on several indices, the three-factor DSM-IV PTSD model was shown to be inferior to alternative models. The strongest support was found for an intercorrelated four-factor model, separating avoidance and numbing symptoms into distinct factors. Validity for this model was partially supported by divergent relations between factors and external variables. Implications of the results are discussed, and a framework is proposed for resolving discrepant findings in the PTSD CFA literature.",0,0 +4051,Young Offenders' Experiences of Traumatic Life Events: A Qualitative Investigation,"This investigation aimed to look at how a group of young offenders attending an inner-city youth offending team experienced adverse and traumatic life events. A qualitative approach was used and semi-structured interviews were conducted with eight young offenders about their perceptions of difficult experiences and the effects of such events. The interviews were analysed using Interpretative Phenomenological Analysis (Smith, Jarman, & Osborn, 1999). Analysis of the accounts yielded a number of themes. Young offenders experienced violence at home, in the community and in custody. Instability and transitions emerged as important themes in relation to school and home. Deprivation was experienced both in terms of poverty and the literal and emotional absence of parents. A variety of cognitive, emotional and behavioural responses to adverse/traumatic experiences were identified, including a blocking out of painful experience and aggression to self and others. There were barriers to seeking or making use of professional support. Custody appeared to offer an opportunity to reflect on and re-evaluate life trajectory. The study concluded that greater consideration of trauma when carrying out assessments would enable ;at risk' young offenders to be identified using clinical interviewing along side standardized measures to aid assessment of the complexity and uniqueness of the response to trauma.",0,0 +4052,Prevalence and risk factors for posttraumatic stress disorder: a cross-sectional study among survivors of the Wenchuan 2008 earthquake in China,"Background: The impact of the May 2008 Wenchuan earthquake, measuring a massive 8.0 on the surface wave magnitude scale, on public health in China has been significant and multifaceted. In light of extant data on prevalence and risk factors for posttraumatic stress disorder (PTSD) after other natural diasters, we collected data from the Wenchuan earthquake survivors to estimate the prevalence of PTSD and to characterize a range of PTSD risk factors. Methods: A cross-sectional multicluster sample survey of 446 respondents (201 from the Qiang ethnic-minority group, 245 the majority Han Chinese group) was conducted in August 2008 in Beichuan county, Sichuan province, a region that was severely affected by the earthquake. In total, 240 households were represented, with a mean of 2.2 respondents per household. Data were collected from structured interviews and the Harvard Trauma Questionnaire (HTQ) and DSM-IV criteria were used to diagnose PTSD. Results: The prevalence of PTSD was 45.5% (203/446). Low household income, being from an ethnic minority, living in a shelter or temporary house, death in family, and household damage were factors significantly related to increased odds of PTSD. Conclusions: PTSD is common after a major disaster. Postdisaster mental health recovery programs that include early identification, ongoing monitoring, preventive and intervention programs, and sustained psychosocial support are needed for the highest-risk population, namely, the bereaved, people without incomes and those with serious household damage. These populations may also benefit from governmental and nongovernmental programs that provide social and economic support, as suggested by earlier studies. Depression and Anxiety, 2009. © 2009 Wiley-Liss, Inc.",0,0 +4053,Pre-trauma verbal ability at five years of age and the risk of post-traumatic stress disorder in adult males and females,"Previous studies have shown that high cognitive ability, measured in childhood and prior to the experience of traumatic events, is protective of PTSD development. Our aim was to test if the association between pre-trauma verbal ability ascertained at 5 years with DSM-IV lifetime post-traumatic stress disorder (PTSD) at 21 years was subject to effect modification by gender, trauma type or prior behaviour problems. Using a prospective birth cohort of young Australians, we found that both trauma type and behaviour problems did not change the association between cognitive ability and PTSD. During multivariate analysis, testing for the interactive effect of gender revealed that verbal ability was linearly and inversely associated with PTSD in females only, with those in the lowest verbal ability quintile having strongly increased odds of PTSD (OR=3.89: 95% CI; 1.50, 10.10) compared with those in the highest quintile. A graph of the interaction revealed lower verbal ability placed females, but not males, at an increased risk of PTSD. Our results indicate that lower verbal ability in early childhood is a vulnerability factor for PTSD in females but not in males, and may constitute a gender-specific risk factor responsible for part of the increased risk of PTSD found in females compared with males.",0,0 +4054,Adverse Childhood Events and the Risk for New-Onset Depression and Post-Traumatic Stress Disorder Among U.S. National Guard Soldiers,"This article examines the relationship between childhood adversity and postdeployment new-onset psychopathology among a sample of U.S. National Guard personnel deployed during Operation Iraqi Freedom and Operation Enduring Freedom with no history of post-traumatic stress disorder (PTSD) or depression. We recruited a sample of 991 Ohio Army National Guard soldiers and conducted structured interviews to assess traumatic event exposure, a history of childhood adversity, and postdeployment depression, and PTSD, consistent with the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition. We assessed childhood adversity by using questions from the Childhood Adverse Events Survey. In multivariable logistic models, a history of any childhood adversity was significantly associated with new-onset depression, but not PTSD, postdeployment. This finding suggests that a history of childhood adversity is predisposing for new-onset depression, among U.S. National Guard soldiers who were deployed with no prior history of PTSD or depression. This highlights the centrality of childhood experience for the production of mental health among soldiers.",0,0 +4055,[Heat health warning systems: possibilities of improvement].,"In the summer of 2003 the temperatures reached were responsible for a large number of deaths in Europe. A year after this fact, many countries had implemented some sort of plan of prevention against excessive temperatures. Plans that had already shown its ability to prevent a large proportion of avoidable mortality in other latitudes. Since then, a lot of papers have been published providing new data on health effects of a heat wave, which can help increase the efficiency of these prevention plans. Knowing the weather conditions at risk, defining ""heat wave"" or to take into account the time that the plan should be active from the study of the relationship between temperature and their effects on health, to identify weather patterns that modulate the relationship between temperature and mortality, locate the profile of people at risk or to develop protocols for action as accurately as possible and based on scientific knowledge are elements drawn from studies carried on in recent years that should be taken into account.",0,0 +4056,"PTSD Symptom Trajectories in Disaster Volunteers: The Role of Self-Efficacy, Social Acknowledgement, and Tasks Carried Out","Millions of volunteers respond after disasters, with a 24% to 46% risk of developing posttraumatic stress disorder (PTSD). It is unclear which symptom trajectories develop and how they differ between core (volunteering before the disaster) and noncore volunteers (joining after the disaster) and which factors predict trajectories. Symptoms of PTSD were assessed at 6-, 12-, and 18-months postearthquake in 449 volunteers in Indonesia. Demographics, previous mental health service use, self-efficacy, social acknowledgment, and type of tasks were assessed at 6 months. In both core and noncore volunteers, 2 PTSD symptom trajectories emerged: a resilient trajectory (moderate levels of symptoms with a slow decrease over time; 90.9%) and a chronic trajectory (higher levels of symptoms with an increase over time; 9.1%). In both trajectories, core volunteers had fewer symptoms than noncore volunteers. Core volunteers in the chronic trajectory were characterized by having sought prior mental help, reported lower levels of self-efficacy and social acknowledgment, and were more likely to have provided psychosocial support to beneficiaries (Cramér's V = .17 to .27, partial η(2) = .02 to .06). Aid organizations should identify and follow up chronic PTSD trajectories in volunteers, including the noncore, who may be out of sight to the organization after the acute response phase.",1,0 +4057,Hallmarks of Posttraumatic Stress: Symptom Z-Scores in a Tsunami-Affected Tourist Population,"<i>Background:</i> To date, little research has been published on the prominence of the various psychiatric symptoms that result from exposure to a natural disaster. In our study of stress-related symptoms among Norwegian tourists who were repatriated after the 2004 southeast Asian tsunami, we evaluated to what extent symptom scores differed between individuals who were exposed to the disaster and those who were not. <i>Methods:</i> Participants (n = 899) completed a questionnaire via post 6 months after the disaster. The participants were categorized according to their level of exposure to the disaster: danger exposed (caught or chased by the waves), nondanger exposed (other disaster-related stressors) and not exposed. Symptoms were assessed by the General Health Questionnaire (GHQ-28), the Post Traumatic Symptom Scale (PTSS-10), and the Impact of Event Scale – Revised (IES-R). We used z-transformation of symptom scores (Z-scores) to evaluate the extent to which symptom scores among disaster-exposed individuals differed from those in the nonexposed reference group. <i>Results:</i> The IES-R revealed the greatest differences between nonexposed and disaster-exposed individuals. Hyperarousal was the most prominent symptom cluster that related to disaster exposure, followed by intrusion and then avoidance. Symptoms of anxiety, social dysfunction, withdrawal, somatization and feelings of guilt were more closely linked to exposure than were symptoms of depression. <i>Conclusions:</i> Our results indicate that symptoms of hyperarousal may be more closely linked to acute exposure to a natural disaster such as a tsunami than other symptoms of psychological distress.",0,0 +4058,"Anxiety, cognition, and habit: A multiple memory systems perspective","Consistent with a multiple systems approach to memory organization in the mammalian brain, numerous studies have differentiated the roles of the hippocampus and dorsal striatum in ""cognitive"" and ""habit"" learning and memory, respectively. Additional research indicates that activation of efferent projections of the basolateral amygdala (BLA), a brain region implicated in mammalian emotion, modulates memory processes occurring in other brain structures. The present brief review describes research designed to link these general concepts by examining the manner in which emotional state may influence the relative use of multiple memory systems. In a dual-solution plus-maze task that can be acquired using either hippocampus-dependent or dorsal striatal-dependent learning, acute pre-training or pre-retrieval emotional arousal (restraint stress/inescapable foot shock, exposure to the predator odor TMT, or peripheral injection of anixogenic drugs) biases rats towards the use of habit memory. Moreover, intra-BLA injection of anxiogenic drugs is sufficient to bias rats towards the use of dorsal striatal-dependent habit memory. In single-solution plus-maze tasks that require the use of either cognitive or habit learning, intra-BLA infusions of anxiogenic drugs result in a behavioral profile indicating an impairing effect on hippocampus-dependent memory that effectively produces enhanced habit learning by eliminating competitive interference between cognitive and habit memory systems. It is speculated that the predominant use of habit memory that can be produced by anxious and/or stressful emotional states may have implications for understanding the role of learning and memory processes in various human psychopathologies, including for example post-traumatic stress disorder and drug addiction.",0,0 +4059,Testing the dimensionality of posttraumatic stress responses in young Chinese adult earthquake survivors: further evidence for “dysphoric arousal” as a unique PTSD construct,"This study investigated an alternative five-factor diagnostic model for posttraumatic stress disorder (PTSD) symptoms, and tested external convergent and discriminant validity of the model in a young Chinese sample of earthquake survivors.A total of 938 participants (456 women, 482 men) aged 15-20 years were recruited from a vocational school originally located in Beichuan County Town which was almost completely destroyed by the ""Wenchuan Earthquake."" The participants were administrated with the PTSD Checklist and the Hopkins Symptoms Checklist-25 12 months after the earthquake.The results of confirmatory factor analysis showed that the five-factor intercorrelated model (intrusion, avoidance, numbing, dysphoric arousal, and anxious arousal) fit the data significantly better than the four-factor numbing model proposed by King et al. (1998: Psychol Assess 10:90-96) and the four-factor dysphoria model proposed by Simms et al. (2002: J Abnorm Psychol 111:637-647). Further analyses indicated that four out of five PTSD factors yielded significantly different correlations with external measures of anxiety versus depression.The findings provide further empirical evidence in favor of the five-factor diagnostic model of PTSD, and carry implications for the upcoming DSM-5.",0,0 +4060,"Clinical and neuropsychological correlates of major depression following post-traumatic brain injury, a prospective study","Major depression disorder (MDD) is the most frequent psychiatric complication after traumatic brain injury (TBI), with a prevalence of 14-77%. The aim of this study was to analyse the psychiatric sequelae of TBI, and to identify the neuropsychological and psychopathological correlates of post-TBI MDD in order to highlight their differences from those of primary MDD.This was a longitudinal, prospective, case-control study. Sixteen patients with closed brain injury, and a lesion revealed by computed tomography (CT), were recruited and were evaluated one (T1), three (T3) and six (T6) months after discharge from Neurosurgery Department; the controls were six patients with MDD. The psychiatric symptoms were evaluated using brief psychiatric rating scale (BPRS), Hamilton depression rating scale (HRSD), Beck depression inventory scale (BDI), Hamilton anxiety rating scale (HRSA), global assessment of functioning (GAF) and instrumental activity of daily living (IADL). Neuropsychological profiles were assessed by using neuropsychological tests, focused on memory and frontal-executive functioning.At T1, MDD was observed in 10 cases (62.5%), a manic episode in 12.5%, and post-traumatic stress disorder in 6.5%. At T3 and T6, MDD was diagnosed in, respectively, eight (50%) and six cases (37.5%). Post TBI MDD had less severe depressive symptoms, showed greater social isolation and hostility and more cognitive deficits in comparison with the control group.MDD is a frequent TBI complication. Patients with post-TBI MDD have a specific psychopathological profile characterised by a less severe depressive symptomatology and a neuropsychological pattern that is significantly associated with greater deficits in cognitive functions than those with primary MDD.",0,0 +4061,Behavioral Problems and Service Utilization in Children with Chronic Illnesses Referred for Trauma-Related Mental Health Services,"Given its prevalence and impact on health and well-being, children's exposure to traumatic experiences is of growing importance to pediatricians and other medical providers. Little is known, however, about the traumatic experiences profiles, trauma-related sequelae, and service use patterns of youth with chronic or recurrent medical problems/disabilities. This study aimed to fill this research gap.Participants were children less than 18 years of age who were referred for assessment and/or treatment services at one of the 56 National Child Traumatic Stress Network centers from 2004 to 2010 across the United States and had experienced at least one of 13 types of traumatic experience(s) (n = 9885; mean = 11 years, SD = 4.3; 52.3% girls). Generalized linear mixed models were used to examine associations among types of trauma, emotional and behavioral problems, and rates of service utilization adjusting for treatment center-level random effects, demographic characteristics, and the total number of types of trauma exposures.Among children seeking treatment for traumatic stress, those with comorbid medical problems/disabilities had different demographic characteristics, different types of trauma exposure, and more service utilization in multiple sectors before trauma treatment entry than those without comorbid medical problems/disabilities. Those without comorbid medical problems/disabilities had higher levels of some types of traumatic exposures, associated symptoms, and higher levels of behavioral problems at home, school, or day care. Those with medical disorders/disabilities were at 30% to 40% higher odds of meeting clinical criteria for hyperarousal and re-experiencing posttraumatic stress disorder symptoms, used more medical and mental health services for trauma, and had more emotional and behavioral concerns.Given that pediatricians are more likely to see children with medical disabilities and concerns than those without, there is an opportunity to ask directly about traumatic exposures and associated symptoms and provide support and interventions to promote resilience. Integrating trauma screening and mental health services into medical care could be especially beneficial for children with chronic medical conditions.",0,0 +4062,Mindfulness-Based Stress Reduction for Veterans Exposed to Military Sexual Trauma: Rationale and Implementation Considerations,"Military sexual trauma (MST) represents a significant public health concern among military personnel and Veterans and is associated with considerable morbidity and suicide risk. It is estimated that 22% of Veteran women and 1% of Veteran men experienced sexual assault or repeated, threatening sexual harassment during their military service. Exposure to traumatic stress has detrimental effects on emotion regulation, which refers to a set of strategies used to modulate different components of emotion at different points on the trajectory of an emotional response. Mindfulness-based interventions offer approaches to health that focus on mind and body practices that can help regulate the experience and expression of difficult emotions. Mindfulness-based stress reduction (MBSR) is an evidence-based therapy shown to be effective for depression, anxiety, and post-traumatic stress disorder. This article discusses the rationale for providing MBSR to Veterans who have been exposed to MST. The article also discusses ways to facilitate implementation of this practice in the U.S. Department of Veterans Affairs health care system. We address potential barriers to care and ways to facilitate implementation at the patient, provider, organization/local, and policy levels. MBSR is likely to be an important component of a comprehensive approach to care for Veterans exposed to MST.",0,0 +4063,A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder.,"Posttraumatic stress disorder (PTSD) is associated with regional alterations in brain structure and function that are hypothesized to contribute to symptoms and cognitive deficits associated with the disorder. We present here the first systematic meta-analysis of neurocognitive outcomes associated with PTSD to examine a broad range of cognitive domains and describe the profile of cognitive deficits, as well as modifying clinical factors and study characteristics. This report is based on data from 60 studies totaling 4,108 participants, including 1,779 with PTSD, 1,446 trauma-exposed comparison participants, and 895 healthy comparison participants without trauma exposure. Effect-size estimates were calculated using a mixed-effects meta-analysis for 9 cognitive domains: attention/working memory, executive functions, verbal learning, verbal memory, visual learning, visual memory, language, speed of information processing, and visuospatial abilities. Analyses revealed significant neurocognitive effects associated with PTSD, although these ranged widely in magnitude, with the largest effect sizes in verbal learning (d = -.62), speed of information processing (d = -.59), attention/working memory (d = -.50), and verbal memory (d =-.46). Effect-size estimates were significantly larger in treatment-seeking than community samples and in studies that did not exclude participants with attention-deficit/hyperactivity disorder, and effect sizes were affected by between-group IQ discrepancies and the gender composition of the PTSD groups. Our findings indicate that consideration of neuropsychological functioning in attention, verbal memory, and speed of information processing may have important implications for the effective clinical management of persons with PTSD. Results are further discussed in the context of cognitive models of PTSD and the limitations of this literature.",0,0 +4064,Psychological interventions for post-traumatic stress disorder and comorbid substance use disorder: A systematic review and meta-analysis.,"Co-morbid post-traumatic stress disorder (PTSD) and substance use disorder (SUD) are common, difficult to treat, and associated with poor prognosis. This review aimed to determine the efficacy of individual and group psychological interventions aimed at treating comorbid PTSD and SUD, based on evidence from randomised controlled trials. Our pre-specified primary outcomes were PTSD severity, drug/alcohol use, and treatment completion. We undertook a comprehensive search strategy. Included studies were rated for methodological quality. Available evidence was judged through GRADE. Fourteen studies were included. We found that individual trauma-focused cognitive-behavioural intervention, delivered alongside SUD intervention, was more effective than treatment as usual (TAU)/minimal intervention for PTSD severity post-treatment, and at subsequent follow-up. There was no evidence of an effect for level of drug/alcohol use post-treatment but there was an effect at 5-7 months. Fewer participants completed trauma-focused intervention than TAU. We found little evidence to support the use of individual or group-based non-trauma-focused interventions. All findings were judged as being of low/very low quality. We concluded that there is evidence that individual trauma-focused psychological intervention delivered alongside SUD intervention can reduce PTSD severity, and drug/alcohol use. There is very little evidence to support use of non-trauma-focused individual or group-based interventions.",0,0 +4065,Flashbacks and post-traumatic stress disorder: the genesis of a 20th-century diagnosis,"It has been argued that post-traumatic stress disorder (PTSD) is a timeless condition, which existed before it was codified in modern diagnostic classifications but was described by different names such as 'railway spine' and 'shellshock'. Others have suggested that PTSD is a novel presentation that has resulted from a modern interaction between trauma and culture.To test whether one core symptom of PTSD, the flashback, has altered in prevalence over time in soldiers subjected to the intense stress of combat.Random selections were made of UK servicemen who had fought in wars from 1854 onwards and who had been awarded war pensions for post-combat disorders. These were studied to evaluate the incidence of flashbacks in defined, at-risk populations.The incidence of flashbacks was significantly greater in the most recent cohort, veterans of the 1991 Persian Gulf War; flashbacks were conspicuous by their absence in ex-servicemen from the Boer War and the First and Second World Wars.Although this study raises questions about changing interpretations of post-traumatic illness, it supports the hypothesis that some of the characteristics of PTSD are culture-bound. Earlier conflicts showed a greater emphasis on somatic symptoms.",0,0 +4066,"Effects of telephone health mentoring in community-recruited chronic obstructive pulmonary disease on self-management capacity, quality of life and psychological morbidity: a randomised controlled trial","To assess benefits of telephone-delivered health mentoring in community-based chronic obstructive pulmonary disease (COPD).Cluster randomised controlled trial.Tasmanian general practices: capital city (11), large rural (3), medium rural (1) and small rural (16).Patients were invited (1207) from general practitioner (GP) databases with COPD diagnosis and/or tiotropium prescription, response rate 49% (586), refused (176) and excluded (criteria: smoking history or previous study, 68). Spirometry testing (342) confirmed moderate or severe COPD in 182 (53%) patients.By random numbers code, block stratified on location, allocation by sequentially numbered, opaque and sealed envelopes.Health mentor (HM) group received regular calls to manage illness issues and health behaviours from trained community health nurses using negotiated goal setting: problem solving, decision-making and action planning.usual care (UC) group received GP care plus non-interventional brief phone calls.Measured at 0, 6 and 12 months, the Short Form 36 (SF-36) and St George's Respiratory Questionnaire (SGRQ, primary); Partners In Health (PIH) Scale for self-management capacity, Hospital Anxiety and Depression Scale (HADS), Center for Epidemiologic Studies-Depression (CES-D) questionnaire, Post-Traumatic Stress Disorder Checklist, Satisfaction with life and hospital admissions (secondary).182 participants with COPD (age 68±8 years, 62% moderate COPD and 53% men) were randomised (HM=90 and UC=92). Mixed model regression analysis accounting for clustering, adjusting for age, gender, smoking status and airflow limitation assessed efficacy (regression coefficient, β, reported per 6-month visit). There was no difference in quality of life between groups, but self-management capacity increased in the HM group (PIH overall 0.15, 95% CI 0.03 to 0.29; knowledge domain 0.25, 95% CI 0.00 to 0.50). Anxiety decreased in both groups (HADS A 0.35; 95% CI -0.65 to -0.04) and coping capacity improved (PIH coping 0.15; 95% CI 0.04 to 0.26).Health mentoring improved self-management capacity but not quality of life compared to regular phone contact, which itself had positive effects where decline is generally expected.",0,0 +4067,From prematurity to parenting stress: The mediating role of perinatal post-traumatic stress disorder,"Preterm delivery may lead to the emergence of symptoms of Post-Traumatic Stress disorder (PTSD), which may, in turn, affect the quality of the mother-child relationship. The aim of this study is to shed light on the development of parenting stress in mothers of preterm and full-term children. It is hypothesized that PTSD symptoms mediate the relationship between preterm/full-term birth and the levels of parenting stress. Perinatal PTSD, parenting stress and social support were assessed in 156 mothers of full-term children and 87 mothers of preterm children. Mothers of preterm children experienced more post-traumatic stress and parenting stress than mothers of full-term children. However, the relationship between preterm delivery and subsequent levels of parenting stress was mediated by PTSD symptoms. These findings suggest that the maternal perception of childbirth as a traumatic experience and the subsequent development of PTSD symptoms are pivotal in the emergence of parenting stress.",0,0 +4068,In the shadow of terror: Posttraumatic stress and psychiatric co-morbidity following bombing in Iraq: The role of shattered world assumptions and altered self-capacities,"Whilst research has looked at posttraumatic stress disorder (PTSD) and psychiatric co-morbidity among civilians exposed to bombing, there is a lack of longitudinal data on the development of these outcomes and the psychological factors associated with them, particularly among Iraqi civilians. This study aimed to: investigate 1) the trajectory of PTSD and psychiatric co-morbidity following bombing among civilians in Iraq and 2) the link between shattered world assumptions, altered self-capacities and identified health outcomes. One hundred and eighty (F = 90, M = 90) Iraqi civilians exposed to first time bombing were recruited approximately one month (time 1) after the bombing and five months (time 2) after the baseline assessment. A control group data (178, F = 91, M = 87) from people who were not exposed to bombing was also collected. They completed the Posttraumatic Stress Diagnostic Scale, the General Health Questionnaire-28, the World Assumptions Questionnaire and the Inventory of Altered Self-Capacities. The results showed that there was a significant decline in the proportion of people meeting the screening criteria for PTSD and psychiatric co-morbidity symptoms over time. For the cross-sectional analysis, controlling for demographic variables, regression analysis showed that severity of the bombing (β = .16), controllability of events (β = -.21), safety and vulnerability (β=.31) and affect dysregulation (β = .37) significantly predicted PTSD time 1. Controllability of events (β = -.20) and affect dysregulation (β = .37) also predicted psychiatric co-morbidity at time 1. For the prospective analysis, controlling for PTSD and psychiatric co-morbidity at time 1, none of these dimensions predicted PTSD and psychiatric co-morbidity at time 2. Findings are discussed in terms of individual resilience. It can be concluded that following bombing, civilians developed PTSD and psychiatric co-morbidity which declined over time. Civilians' perceptions of their ability to control events in the world and regulate their affect had a short term impact on the severity of these symptoms.",0,0 +4069,"Safety and efficacy of sildenafil citrate in treating erectile dysfunction in patients with combat-related post-traumatic stress disorder: a double-blind, randomized and placebo-controlled study","To evaluate the safety and efficacy of sildenafil citrate for treating erectile dysfunction (ED) in patients with combat-related post-traumatic stress disorder (PTSD).In all, 266 combat-exposed war veterans with ED (aged 37-59 years) were recruited. They met the Diagnostic and Statistical Manual of Mental Disorders-IV criteria for PTSD according to the Structured Clinical Interview for Patients, Investigator Version. The patients were also evaluated with the Clinician-Administered PTSD Scale, both to establish the diagnosis of PTSD and to measure symptom severity. Only patients with psychogenic ED were included in the study. Patients with comorbid conditions (diabetes mellitus, hypercholesterolaemia, hypertension, Peyronie's disease) and smokers of more than five cigarettes daily were excluded. The patients were randomly divided into a group of 133 who received 100 mg of on-demand sildenafil 0.75-2 h before sexual stimulation, and 133 who received placebo. Patients were asked to use > or =16 doses or attempts at home. The efficacy of the treatments was assessed every four attempts during treatment, and at the end of the study, using responses to the 15-question International Index of Erectile Function (IIEF), Sexual Encounter Profile diary questions 2 and 3, Erectile Dysfunction Inventory of Treatment Satisfaction questionnaire, patients' event logs of sexual activity, and a Global Assessment Question about erections.Sildenafil did not produce significantly and substantially greater improvement than placebo in each of the primary and secondary outcome measures (P = 0.08). A normal EF domain score (> or =26) at endpoint was reported by 13 (9.8%), and 11 (8.3%) of patients on the sildenafil and placebo regimens, respectively (P = 0.09). Patients treated with sildenafil had no statistically significantly greater improvement in the five sexual function domains of the IIEF questionnaire than those treated with placebo (P = 0.08). The incidences of treatment-emergent adverse events were significantly greater in the sildenafil arm than in the placebo group (P = 0.01).Sildenafil is no better than placebo in treating PTSD-emergent ED. Further randomized clinical trials are warranted in combat veterans and other populations with PTSD to better elucidate the role of phosphodiesterase type 5 inhibitors in treating PTSD-emergent ED.",0,0 +4070,Combat exposure severity as a moderator of genetic and environmental liability to post-traumatic stress disorder,"Background Twin studies of veterans and adults suggest that approximately 30–46% of the variance in post-traumatic stress disorder (PTSD) is attributable to genetic factors. The remaining variance is attributable to the non-shared environment, which, by definition, includes combat exposure. This study used a gene by measured environment twin design to determine whether the effects of genetic and environmental factors that contribute to the etiology of PTSD are dependent on the level of combat exposure. Method The sample was drawn from the Vietnam Era Twin Registry (VETR) and included 620 male–male twin pairs who served in the US Military in South East Asia during the Vietnam War era. Analyses were based on data from a clinical diagnostic interview of lifetime PTSD symptoms and a self-report measure of combat exposure. Results Biometric modeling revealed that the effects of genetic and non-shared environment factors on PTSD varied as a function of level of combat exposure such that the association between these factors and PTSD was stronger at higher levels of combat exposure. Conclusions Combat exposure may act as a catalyst that augments the impact of hereditary and environmental contributions to PTSD. Individuals with the greatest exposure to combat trauma were at increased risk for PTSD as a function of both genetic and environmental factors. Additional work is needed to determine the biological and environmental mechanisms driving these associations.",0,0 +4071,Prevention and Treatment of Post-Traumatic Stress Disorder in Adolescents,"(create) Post-Traumatic Stress Disorder (PTSD) has a significant negative impact on the biological, psychological, and social development of those youth who develop the disorder following exposure to a traumatic event (Pynoos, 1994). Given the frequency with which young people today experience traumatic events, the authors feel that it is important that we develop a model for primary prevention and health promotion in those youth who have experienced trauma. In this chapter the authors look at individual, family and social risk factors and protective factors related to PTSD; evidence-based treatment interventions; psychopharmacology for PTSD; and prevention of PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4072,Sex-related and non-sex-related comorbidity subtypes of tic disorders: a latent class approach,"Recent evidence suggests that there may be more than one Gilles de la Tourette syndrome (GTS)/tic disorder phenotype. However, little is known about the common patterns of these GTS/tic disorder-related comorbidities. In addition, sex-specific phenomenological data of GTS/tic disorder-affected adults are rare. Therefore, this community-based study used latent class analyses (LCA) to investigate sex-related and non-sex-related subtypes of GTS/tic disorders and their most common comorbidities.The data were drawn from the PsyCoLaus study (n = 3691), a population-based survey conducted in Lausanne, Switzerland. LCA were performed on the data of 80 subjects manifesting motor/vocal tics during their childhood/adolescence. Comorbid attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder, depressive, phobia and panic symptoms/syndromes comprised the selected indicators. The resultant classes were characterized by psychosocial correlates.In LCA, four latent classes provided the best fit to the data. We identified two male-related classes. The first class exhibited both ADHD and depression. The second class comprised males with only depression. Class three was a female-related class depicting obsessive thoughts/compulsive acts, phobias and panic attacks. This class manifested high psychosocial impairment. Class four had a balanced sex proportion and comorbid symptoms/syndromes such as phobias and panic attacks. The complementary occurrence of comorbid obsessive thoughts/compulsive acts and ADHD impulsivity was remarkable.To the best of our knowledge, this is the first study applying LCA to community data of GTS symptoms/tic disorder-affected persons. Our findings support the utility of differentiating GTS/tic disorder subphenotypes on the basis of comorbid syndromes.",0,0 +4073,Post traumatic stress disorder and adaptive capacity in victims of intimate partner violence,"The goal of this article was to identify the existing relationship between Post Traumatic Stress Disorder (PTSD) and the adaptive capacity in a group of victims of intimate partner violence residing in Medellin (Colombia). The sample consisted of 26 people, both male and female selected from different health and social centers. The instruments used were the PTSD Symptom Severity Scale and the Maladjustment Scale. Descriptive statistics and Pearson's Correlation Coefficient were used for data analysis. The results reinforce the initiative of considering PTSD as a diagnostic category unmistakably associated to intimate partner violence; 84.2% of the sample reported Post Traumatic Stress Disorder symptomatology, mainly avoidance and hyperarousal, as well as somatic manifestations. Maladjustment levels were highly elevated, 93.2% average, the areas with the lowest level of adaptive capacity were marital life and family life, while maladjustment levels exhibited significant associations with overall PTSD and hyperarousal (p <0.01). In general, the participants exhibited emotional affliction in their responses, characterized by the presence of somatic anxiety, an intense fear of re-experiencing the abuse situations and a marked response of increased arousal.",0,0 +4074,An Integration of American Nontraditional and Mesoamerican Traditional Approaches as a Treatment Model for Traumatic Stress and Post-Traumatic Stress Disorder (PTSD),"Traumatic stress and Post-Traumatic Stress Disorder (PTSD) are rampant in American culture, even within nuclear families. This may cause disorganization of attachment bonds and increase the likelihood of PTSD when exposed to future traumatic events. The objective of this study is to assess the similarities and differences among psychotherapeutic treatment modalities employed in the United States, Cognitive Behavioral Therapy (CBT); Eye Movement Desensitization and Reprocessing (EMDR); Structured Intervention for Trauma for Children, Adolescents and Parents (SITCAP); Hypnosis; and finally Curanderismo, a Mesoamerican traditional treatment modality with similar practices to those found in Transpersonal Psychology for the treatment of PTSD. This heuristic study consists of interviews with co-researchers gathered in urban settings in the United States; urban, rural, and jungle settings in Mexico; and the personal and professional experiences of the researcher with both modalities. This study includes description of the therapeutic use of the temazcal (a Mesoamerican sweat lodge); limpias (a ritualized clearing of the subtle energy field); the medicinal and spiritual applications of herbalism; shamanic ritual; and the platica (a specific and highly interpersonal counseling style employed by curanderos), and the significance of holism and equilibrium in the Mesoamerican healing paradigm. In addition to these, this discussion also presents the role of prayer and interpersonal touch related to healing traumatic stress, and PTSD. An analysis of the results produced the development of an integrated healing model to reflect the positive aspects of all researched modalities toward efficacious treatments for traumatic stress and PTSD. Finally, this research examines and discusses the implications, limitations, and future research of this model for trauma treatment and research. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4075,Cognitive–Behavioral Theory and Preparation for Professionals at Risk for Trauma Exposure,"Military personnel, emergency first responders, and others whose work environments include exposure to traumatic events are at risk for developing posttraumatic stress disorder (PTSD). To help prevent negative sequelae, there is a strong need to identify well-operationalized, empirically supported, theoretically framed models of healthy adaptation to potentially traumatic events. Cognitive–behavioral theories (CBTs) describe etiological factors in trauma, guide research that has identified risk for PTSD, and help develop interventions that can effectively reduce posttrauma symptomatology. In this article, the authors draw on CBT and empirical research on post-traumatic stress to propose possible cognitive–behavioral mechanisms in trauma adaptation. They then suggest directions for future research, including areas for prevention interventions for at-risk professionals.",0,0 +4076,Psychometric Properties and Confirmatory Factor Analysis of the Posttraumatic Stress Disorder Checklist for Chinese Survivors of Road Traffic Accidents,"Abstract Objectives: To examine the psychometric properties and factor structure of the Chinese version of the Posttraumatic Stress Disorder Checklist. Participants and Methods: A total of 481 survivors of road traffic accidents completed the Posttraumatic Stress Disorder Checklist, Impact of Event Scale-Revised, and General Health Questionnaire 1 week after a road traffic accident. Their responses were studied to investigate the factor structure and validity of the Posttraumatic Stress Disorder Checklist. To examine the diagnostic utility of the Checklist, an independent sample of 45 road traffic accident survivors completed the Posttraumatic Stress Disorder Checklist and the Clinician-administered Post-traumatic Disorder Scale 1 month after their road traffic accidents. Results: A hierarchical 4-factor model was identified as providing the best account of the data for the Posttraumatic Stress Disorder Checklist. The diagnostic efficiency of the mixed scoring criteria, using a minimum symptom score of 4 with either a total score of 44 or 50, was confirmed as a means of screening for post-traumatic stress disorder. Conclusions: The Chinese version of the Posttraumatic Stress Disorder Checklist was found to have satisfactory reliability and validity. Key words: Accidents, traffic; Life change events; Questionnaires; Stress disorders, post-traumatic ... (ProQuest: ... denotes formula omitted.) Introduction According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV),1 the prevalence of acute stress disorder in individuals exposed to trauma ranges from 14 to 33%. In the adult population the lifetime prevalence of post-traumatic stress disorder (PTSD) found in community-based studies is approximately 8%. However, there are few psychometrically sound Chinese language PTSD-related assessment instruments for clinical and research use. Although the Chinese version of the Impact of Event Scale-Revised (IES-R) has been proven a useful means of examining traumatic stress, the items included do not bear a direct reference to the diagnostic criteria in the DSM-IV.2-6 The PTSD Checklist (PCL)7 is a 17-item, selfreported rating scale instrument that parallels DSM-IV's diagnostic criteria B, C, and D for PTSD. Thus, the PCL may yield information that has greater predictive validity on a diagnostic level than the IES-R. The PCL's structure may also enable researchers to draw more precise comparisons with data derived from PTSD-relevant interviews such as the Clinician-administered PTSD Scale (CAPS).8 The PCL's diagnostic sensitivities and specificities in different languages have been demonstrated. This includes the English version,7,9,10 French version,11 and Spanish version.12 As it takes only a short period, roughly 5 minutes, to administer the PCL, it compares favourably with the 40 to 60 minutes needed for diagnostic interviews (e.g. CAPS), making the PCL a good candidate as a screening tool for PTSD. There is a need for PTSD-related assessment instruments in Chinese, so this study was conducted to investigate the psychometric properties of the Chinese version of the PCL and to provide preliminary results for guiding future use of the PCL as a valid and reliable PTSD assessment instrument in Chinese. This study aimed to examine the psychometric properties of the Chinese version of the PCL when applied to survivors of road traffic accidents (RTAs) attending accident and emergency (A&E) services. Data collected from 481 respondents 1 week after experiencing a RTA were used to study the internal consistency, reliability, and factor structure of the PCL. Given the personal impact, nature and recency of the event, data from RTA survivors at this point should enable us to understand the psychometric properties of the PCL. The concurrent validity of the PCL was examined by studying its relationship with self-reported measures of general psychological distress and posttraumatic stress, respectively. …",0,0 +4077,Understanding acute psychological distress following natural disaster,"A household probability sample of 229 adults was interviewed four to seven months after the Sierra Madre earthquake (June 28, 1991; Los Angeles County). The study predicted psychological distress from these variables: demographics, traumatic event history, low magnitude event history, earthquake related threat perceptions, and earthquake related resource loss. Based on the Conservation of Resources (COR) stress model, it was predicted that resource loss would be central in predicting psychological distress. Three major hypotheses were supported: (1) resource loss was positively associated with psychological distress; (2) resource loss predicted psychological distress when other predictors were statistically controlled; and (3) resource loss was associated with mild to moderate elevations in of psychological distress. The findings support COR stress theory. Theoretical and practical implications are discussed.",0,0 +4078,Risperidone ameliorates post-traumatic stress disorder-like symptoms in modified stress re-stress model,"The management for post-traumatic stress disorder (PTSD) involves chronic administration of drugs. We have modified the stress re-stress (SRS) model to study the effect of chronic administration of risperidone (RIS) after induction of PTSD in rats. On day-1 (D-1) rats underwent training session for elevated-plus maze (EPM) test. On D-2, rats were subjected to stress protocol of 2 h restraint and 20 min forced-swim test (FST) followed by halothane anesthesia. The rats were exposed to re-stress (FST) on D-8 and at six day intervals on D-14, D-20, D-26 and D-32. The rats were treated with RIS (0.01, 0.1 and 1.0 mg/kg; p.o. ) and standard drug, paroxetine (PAX; 10.0 mg/kg; p.o. ) from D-8 to D-32. RIS (0.1 mg/kg) and PAX ameliorated SRS-induced immobility. RIS in median dose reversed SRS-induced hypocorticosteronemia both in urine and plasma. RIS in median dose improved SRS-induced behavioral perturbations such as memory impairment and anxiety-like behavior in EPM and Y-maze tests. RIS (0.1 mg/kg) reversed SRS-induced increase in amygdalar serotonin level. RIS (0.1 mg/kg) increased the expression of hippocampal MR thereby reversing the SRS-induced decrease in MR/GR ratio. Pearson's analysis of data on D-32 showed that there was significant correlation of plasma corticosterone, amygdalar serotonin and hippocampal ratio of mineralocorticoid (MR)/glucocorticoid receptor (GR) with SRS-induced behavioral abnormalities. Hence, median dose of RIS shows anti-PTSD-like effect in the modified SRS model. PAX had earlier onset of action in ameliorating behavioral effects of PTSD compared to RIS. However, RIS showed anti-PTSD like effect in sub-therapeutic dose. The mode of anti-PTSD action of RIS seems to involve the HPA-axis and serotonergic system, whereas PAX did not show any significant action on these pathways. The effect of repeated treatment of drugs for PTSD can be evaluated using the modified SRS model. • Modified SRS showed PTSD related behavioral abnormalities. • RIS in median dose reversed SRS-induced hypocorticosteronemia in urine and plasma. • RIS improved SRS-induced behavioral abnormalities. • RIS reversed SRS-induced decrease in MR:GR in hippocampus. • Modified SRS can be used to evaluate repeated drug treatment schedules for PTSD.",0,0 +4079,Examining posttraumatic stress symptoms in a national sample of homicide survivors: Prevalence and comparison to other violence victims,en,0,0 +4080,Therapeutic Prospects of PPARs in Psychiatric Disorders: A Comprehensive Review,"Peroxisome Proliferator-Activated Receptors (PPARs) are a family of nuclear receptors whose activation modulates the gene expression that underlies both the glucid-lipid and the inflammation pathways. While many PPARs agonists have been used for years as medication for metabolic disorders, an increasing attention is being currently dedicated to these drugs for inflammation-related pathologies. Within the psychiatric field, it has recently appeared that inflammatory processes are highly suspected in the pathophysiology of several important disorders, such as schizophrenia and mood disorders. By their anti-inflammatory properties, PPARs might have a disease-modifying action that could help in improving the outcome of patients. Furthermore, recent data suggest that PPARs could also modulate the expression of some neurotransmission factors. Therefore, PPARs may directly modify the information processing, and have a potential symptomatic action on several psychiatric disorders. At last, PPARs action of metabolic regulation could have a role on corrective or even preventive strategies against the metabolic adverse events that are commonly observed with some current psychiatric medications, notably antipsychotics. This triple potential action profile of PPARs modulators is investigated in this article, successively for schizophrenia spectrum disorders and mood disorders. Theoretical involvements of PPARs are also discussed for the treatment of Post- Traumatic Stress Disorder and Personality Disorders. At the time of the emerging concept of psychoneuroimmunology, PPARs open original therapeutic prospects for the psychiatric research.",0,0 +4081,Children’s Disaster Reactions: the Influence of Family and Social Factors,"This review examines family (demographics, parent reactions and interactions, and parenting style) and social (remote effects, disaster media coverage, exposure to secondary adversities, and social support) factors that influence children’s disaster reactions. Lower family socioeconomic status, high parental stress, poor parental coping, contact with media coverage, and exposure to secondary adversities have been associated with adverse outcomes. Social support may provide protection to children in the post-disaster environment though more research is needed to clarify the effects of certain forms of social support. The interaction of the factors described in this review with culture needs further exploration. © 2015, Springer Science+Business Media New York.",0,0 +4082,Post-Traumatic Stress Disorder in the Military Veteran,"Post-traumatic stress disorder (PTSD) has followed in the wake of wars throughout history, even wars that have been brief and successful. Soldiers are at marked risk for chronic functional impairment as well as specific psychiatric conditions such as dysthymia, panic disorders, obsessive disorder, and others. Premilitary functioning and genetics play definite roles in the likelihood of developing PTSD, whereas long-term outcome depends upon a number of additional factors such as severity of combat exposure and chronic physical disabilities. Primary prevention, understandably, is both desirable and difficult, and secondary prevention is both attainable and effective. Likewise, treatment is significantly effective in some, but not all, veterans.",0,0 +4083,Changing for Better or Worse? Posttraumatic Growth Reported by Soldiers Deployed to Iraq,"There has been increased interest in self-perceived posttraumatic growth, but few longitudinal studies have focused on its relationship with posttraumatic stress. Self-perceived growth is generally thought to facilitate adjustment, but some researchers have proposed that it reflects a dysfunctional coping strategy that impedes adjustment and leads to posttraumatic stress. In this prospective longitudinal study, we examined the relationship between self-perceived posttraumatic growth and stress. Participants were soldiers deployed to Iraq. They were tested before their deployment ( N = 479) and again 5 months ( n = 382; 80%) and 15 months ( n = 331; 69%) after returning home. Cross-lagged panel analysis indicated that more perceived growth 5 months postdeployment was associated with more posttraumatic stress 15 months postdeployment, even after we controlled for stressor severity, posttraumatic stress at 5 months, and potential predeployment confounders (extraversion, neuroticism, and cognitive ability). Findings suggest that it may be counterproductive to promote perceived growth to enhance adjustment after traumatic events.",0,0 +4084,Prevalence of psychiatric disorders three years after the 1999 earthquake in Turkey: Marmara Earthquake Survey (MES),"Background: The objective of the study is to describe the community prevalence of psychiatric disorder, mainly posttraumatic stress disorder (PTSD) and Major Depressive Disorder (MDD) 3 years after a devastating earthquake. Methods: Three years after the Marmara Earthquake, 683 individuals from the epicentre were randomly selected to form a representative sample and were assessed with Composite International Diagnostic Interview (CIDI), General Health Questionnaire (GHQ), Traumatic Stress Symptom Checklist (TSSC) and Beck Depression Inventory (BDI). Results: The 36 months prevalence of PTSD and MDD after the Marmara Earthquake were 19.2% and 18.7% respectively. The current prevalence of PTSD and MDD in the affected community was found to be 11.7% and 10.5%, respectively. PTSD and MDD were the most prevalent disorders after the disaster and showed a decrease over time. However, only 38.9% of the PTSD cases identified at any time over the 3 years were in remission at the 3rd-year. The co-occurrence of MDD with PTSD resulted in a decrease in the rate of recovery from PTSD. MDD was also the most prevalent disorder accompanying PTSD. Of all the subjects 37.5% with PTSD still met the MDD criteria at the 3rd year postearthquake. Conclusions: In comparison with the data from pre-earthquake national mental health profile, the present study showed that the prevalence of MDD, panic disorder, OCD, GAD, social phobia and special phobias were still higher in the affected region 3 years after the earthquake. (",0,0 +4085,Effects of a formula of components from Shengmai Powder on glucocorticoid receptor in rats after thermal injury,"To investigate the effects of a formula of components from Shengmai Powder, a compound traditional Chinese herbal medicine, on glucocorticoid receptor (GR) in rats after thermal injury.A total of 32 male SD rats were randomly assigned into normal control group, untreated group, ginsenosides group and components group, with 8 rats in each group. Rats in the normal control group were intragastrically administered with normal saline (NS) at room temperature once daily. Rats in the untreated group were treated with NS before thermal injury, and rats in the components group and ginsenosides group were once daily treated with a mixture of aqueous extracts of Ophiopogonis Japoni, Fructus schizandrae Chinensis and ginsenosides and ginsenosides respectively. Rats were administered for one week. After the last administration, rats in the untreated group and treated groups underwent thermal injury for one hour, and then were sacrificed immediately by decapitation. Blood serum was collected, and the serum corticosterone (CS) and adrenocorticotropic hormone (ACTH) levels were determined with enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (RIA) respectively. The liver, lung and kidney homogenates were used to determine the GR binding capacity by radioligand receptor binding assay. The results were analyzed by one point analysis.GR binding capacities in liver, lung and kidney cytosols in the untreated group were obviously lower than those in the normal control group (P<0.01). The GR binding capacities in the liver and lung cytosols in the components group and the ginsenosides group were significantly higher than those in the untreated group (P<0.01), but no significant difference was found in kidney cytosol. Compared with the ginsenosides group, GR binding capacity in liver cytosol in the components group was increased (P<0.01), but there were no noticeable differences when compared with the GR binding capacities in lung and kidney cytosols. Serum CS and ACTH levels of the normal rats were (66+/-16)microg/L and (59+/-18) ng/L respectively. There were significant differences in CS and ACTH levels between the normal control group and the other groups (P<0.01), in which the serum CS and ACTH levels were (113+/-33)microg/L and (125+/-20) ng/L, (123+/-26) microg/L and (110+/-30) ng/L and (118+/-17) microg/L and (115+/-35) ng/L respectively. But there was no significant difference between the untreated group and the other treated groups.The formula of components from Shengmai Powder can enhance the effect of ginsenosides in up-regulating GR in rats after thermal injury.",0,0 +4086,Cognitive therapy for people with post-traumatic stress disorder to multiple events: Working out where to start,"(create) Many people presenting for help with post-traumatic stress disorder (PTSD) have re-experiencing symptoms relating to more than one traumatic event and this can be daunting to clinicians. Although there is now a substantial literature on working with single-incident PTSD, less is available to help clinicians working with those with PTSD to multiple events. Despite over 25 years of epidemiological research on the prevalence of traumatic events and PTSD, the proportion of this population with PTSD to more than one event remains unclear. Many clinicians have argued that the psychological effects of isolated traumatic events and repeated trauma are different and require different treatment. Herman (1992) proposed a phased model of treatment for people who have experienced multiple traumatic events. The first priority is ensuring safety. This includes reducing the risk of further trauma (e.g., organizing alternative accommodation for victims of domestic violence), reducing self-harm, improving affect-regulation, and controlling dissociation. The second phase, 'remembrance', involves providing a detailed account of the trauma so that it can be incorporated within an autobiographical narrative. In the third, 'reconnection' phase, a sense of self is (re-)established encompassing more than their identity as a trauma survivor. Most guidance for clinicians working with people with PTSD to multiple events refers to themes likely to be important, such as trust and intimacy, or describes particular treatment approaches, such as testimony or narrative exposure therapy. Advice regarding the order in which to work on memories relates to constructing a hierarchy of trauma memories and collaborative decision-making with clients (Hembree, Rauch, & Foa, 2003). Control over treatment and sensitive pacing of the work are, clearly, essential for clients whose control was taken away during the trauma. However, greater attention to the cognitive factors within the formulation and the relationship between the traumatic events assists with this process. It can help identify which re-experiencing symptoms can be treated most quickly, giving the client an early experience of success, which can hearten them to tackle even more distressing memories. People with PTSD to multiple traumatic events fall into different groups, which tend to have distinct presentations: (1) people with PTSD to multiple events in childhood, often physical or sexual abuse; (2) people with PTSD to multiple events in adulthood, including victims of domestic violence, people in high-risk occupational groups such as emergency personnel, and asylum-seekers and refugees; and (3) people with PTSD to traumatic events in both childhood and adulthood. The two cases presented in this chapter represent differing presentations of this third group. All aspects of treatment needed for PTSD to single events are also required for the treatment of PTSD to multiple events. The emphasis here is on additional elements useful with PTSD to multiple events. There are some issues particular to specific groups-those with histories of childhood abuse are likely to present with more dissociative symptoms, for example-but the same general principles apply across groups. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4087,The latent structure of posttraumatic stress disorder among adolescents,"Debate has arisen over whether posttraumatic stress disorder (PTSD) is most accurately conceptualized as representing a discrete clinical syndrome or an extreme reaction to traumatic life events. Recent taxometric research using predominantly adult samples appears to support a dimensional model of PTSD, raising questions about the utility of current psychiatric nosology which depicts PTSD as a distinct entity. The present study sought to use taxometric procedures to examine the latent structure of posttraumatic stress reactions among a national epidemiologic sample of 2,885 adolescents. Results were consistent with previous taxometric studies in supporting a dimensional model of posttraumatic stress reactions. The implications of these findings for public policy, as well as the etiology and assessment of posttraumatic stress reactions, are discussed.",0,0 +4088,Demoralisation syndrome does not explain the psychological profile of community-based asylum-seekers,"Demoralisation syndrome (DS) has been advanced as a construct that features hopelessness, meaninglessness, and existential distress. Demoralisation and DS have predominantly been considered secondary only to illness; hence there is scant research on demoralisation or DS in populations affected by extreme environmental stress.The current study aimed to determine the prevalence of demoralisation, its predictors, and the relevance of DS in a community-based forced-migrant population.A convenience sample of 131 adult asylum-seekers (n=98) and refugees (n=33) without recognised mental disorders in Melbourne, Australia, were assessed cross-sectionally on posttraumatic stress, anxiety, depression, post-migration stress, and demoralisation. Socio-demographic data were analysed with relevant clinical data. Predictive aims were investigated using bivariate statistical tests and exploratory aims were investigated using correlational and linear regression analyses.Seventy nine percent of the sample met criteria for demoralisation (asylum-seekers=83%; refugees=66%), with asylum-seekers being 2.55 (95% C.I.=1.03-6.32, Z=2.03, p=.04) times more likely to be demoralised than refugees. No relationship between demoralisation and time in the refugee determination process emerged. The regression model explained 47.5% of variance in demoralisation scores for the total sample F(9,111)=13.07, p<.0001, with MDD and anxiety score making unique significant contributions.Demoralisation was widespread through the asylum-seeker and refugee population and its prevalence was attributable to a range of social and psychiatric factors. However, DS had little explanatory power for psychiatric morbidity, which was more suggestive of a pan-distress symptom complex.",0,0 +4089,"Suicidality, Psychopathology, and Gender in Incarcerated Adolescents in Austria","Article AbstractObjective: Delinquent juveniles are at extreme risk for suicide with death rates 4 times higher than in the general population. Whereas psychopathologic risk factors for suicidal behavior in nonforensic adolescent populations are well defined, psychopathologies associated with suicidality in delinquent juveniles are not yet clear. The objective of this study was to determine gender-specific psychopathologic profiles associated with suicidality in detained juveniles. Method: The Massachusetts Youth Screening Instrument-Second Version, the Youth Self-Report, and the Mini-International Neuropsychiatric Interview for children and adolescents were used to investigate juveniles in an Austrian pretrial detention facility. The study sample consisted of all juveniles entering the system between March 2003 and January 2005. Of the 370 eligible participants, 319 completed the study (53 girls and 266 boys; age range, 14 to 21 years; mean = 16.67, SD = 1.45 years). Results: We found significantly higher prevalence rates of both current (p < .01) and lifetime (p < .001) suicidality in girls than in boys. Suicidal boys exhibited more psychopathology and a wider range of psychopathology compared to nonsuicidal boys. For suicidal girls, psychopathologies appeared more circumscribed (all relevant p values < .04). Using signal detection methods, major depressive disorder, attention-deficit/hyperactivity disorder, and social phobia identified boys athighest risk of suicidality, while a diagnosis of posttraumatic stress disorder identified girls at highest risk. Conclusions: Suicidality levels are high in delinquent adolescents, especially in girls. Psychopathologic risk factors seem to be gender specific in this population. Not only depression, but also psychopathologies that usually do not arouse strong suspicion for an association with suicidal behavior, i.e., social phobia and ADHD in boys and PTSD in girls, might increase suicide risk. Further research in other countries is needed to replicate our results with respect to sociocultural influences.",0,0 +4090,Minnesota Multiphasic Personality Inventory (MMPI)-derived psychopathology subtypes among former prisoners of war (POWs): Replication and extension,"Psychopathology and symptom patterns identified among former prisoners of war (POWs) by Sutker, Winstead, Goist, Malow, and Allain (1986) were replicated in an independent sample of 51 former POWs with similar personal backgrounds and military experiences. Data collection instruments included the Minnesota Multiphasic Personality Inventory (MMPI), self-report measures of anxiety and depression, and a structured clinical interview including a POW Trauma Index. Two prototypic MMPI profile patterns were identified using modal profile analysis (Skinner & Lei, 1980). Both were highly similar in shape and elevation to those reported in the previous investigation. Multiprofile-multisample analysis produced prototypic profile patterns which were accurate representations of profiles identified in separate analyses of the derivation and replication samples (r's ≥.96). Representing unique constellations of clinical features, profile subtypes were associated differentially with confinement stress severity, postservice adjustment, and nature and extent of stress-induced symptomatology. © 1988 Plenum Publishing Corporation.",0,0 +4091,Pharmacological Management of Mood and Anxiety Disorders in Headache Patients,"There is emerging evidence that treatment of comorbid mood and anxiety disorders can improve headache treatment outcome when implemented within a comprehensive program. Effective treatment for comorbid mood and anxiety disorders requires screening headache patients and accurately diagnosing specific psychiatric disorders when present. Specific dual-action antidepressant, anticonvulsant, and atypical antipsychotic medications can serve as dual agents that simultaneously treat both headaches and a mood or anxiety disorder. Serotonin reuptake inhibitors and most other antidepressant, anxiolytic, and mood-stabilizing medications are generally ineffective for headache prophylaxis. However, they can be safely added to a headache regimen for treatment of a comorbid psychiatric disorder. Treatment of comorbid psychiatric disorders in headache patients requires patient education about the psychiatric disorder, its treatment, possible side-effects, and expected benefits. Clinicians need to be sensitive to possible stigma that some patients fear from a psychiatric diagnosis or its treatment.",0,0 +4092,"Exposure, probable PTSD and lower respiratory illness among World Trade Center rescue, recovery and clean-up workers","Background Thousands of rescue and recovery workers descended on the World Trade Center (WTC) in the wake of the terrorist attack of September 11, 2001 (9/11). Recent studies show that respiratory illness and post-traumatic stress disorder (PTSD) are the hallmark health problems, but relationships between them are poorly understood. The current study examined this link and evaluated contributions of WTC exposures. Method Participants were 8508 police and 12 333 non-traditional responders examined at the WTC Medical Monitoring and Treatment Program (WTC-MMTP), a clinic network in the New York area established by the National Institute for Occupational Safety and Health (NIOSH). We used structural equation modeling (SEM) to explore patterns of association among exposures, other risk factors, probable WTC-related PTSD [based on the PTSD Checklist (PCL)], physician-assessed respiratory symptoms arising after 9/11 and present at examination, and abnormal pulmonary functioning defined by low forced vital capacity (FVC). Results Fewer police than non-traditional responders had probable PTSD (5.9% v . 23.0%) and respiratory symptoms (22.5% v . 28.4%), whereas pulmonary function was similar. PTSD and respiratory symptoms were moderately correlated ( r =0.28 for police and 0.27 for non-traditional responders). Exposure was more strongly associated with respiratory symptoms than with PTSD or lung function. The SEM model that best fit the data in both groups suggested that PTSD statistically mediated the association of exposure with respiratory symptoms. Conclusions Although longitudinal data are needed to confirm the mediation hypothesis, the link between PTSD and respiratory symptoms is noteworthy and calls for further investigation. The findings also support the value of integrated medical and psychiatric treatment for disaster responders.",0,0 +4093,The prevalence of PTSD following the violent death of a child and predictors of change 5 years later,"In this study, we examined the violent death bereavement trajectories of 173 parents by following them prospectively for 5 years after their children's deaths by accident, suicide, homicide, or undetermined causes. Using latent growth curve methodology, we examined how the initial level of PTSD and the rate of change over time were influenced by 9 predictors: the deceased children's causes of death, parents' gender, self-esteem, 3 coping strategies, perceived social support, concurrent levels of mental distress, and an intervention offered in early bereavement. Six of the nine factors predicted initial levels of PTSD; however, only parents' gender and perceived social support predicted change in PTSD over the 5-year time frame. Five years postdeath, 3 times as many study mothers (27.7%) met diagnostic criteria for PTSD and twice as many study fathers (12.5%) met diagnostic criteria for PTSD compared with the normative samples.",0,0 +4094,Traumatic brain injury and posttraumatic stress disorder: a preliminary investigation of neuropsychological test results in PTSD secondary to motor vehicle accidents,This study investigated the effect of traumatic brain injury on the development of posttraumatic stress disorder (PTSD). Subjects were 107 motor vehicle accident survivors including 38 individuals who were diagnosed with posttraumatic stress disorder (PTSD). Neuropsychological testing was administered to all subjects during an initial diagnostic evaluation. Results showed that subjects who had lost consciousness during their MVA had greater impairment on speed dependent tests and delayed recall of verbal material. Subjects who suffered traumatic brain injury (TBI) were also found to have developed PTSD as often as those who had not reported TBI. Implications for future research and clinical utility are discussed.,0,0 +4095,Validity of the Dissociative Experiences Scale in screening for multiple personality disorder: a multicenter study,"The Dissociative Experiences Scale has proved a reliable and valid instrument to measure dissociation in many groups, but its capacity to distinguish patients with multiple personality disorder from patients with other psychiatric disorders has not yet been conclusively tested.A discriminant analysis was performed to classify 1,051 subjects as having or not having multiple personality disorder. Another discriminant analysis was performed on a subgroup of 883 subjects more closely representing patients in a typical psychiatric facility in terms of base rates of dissociative disorders. A cutoff score of 30 was also used to classify subjects, and Bayes's theorem, which allows for the calculation of the positive predictive value and the negative predictive value of a screening test, was applied.According to discriminant analysis of the total study group, the scale's sensitivity was 76% and its specificity was also 76%; according to discriminant analysis of the more representative subgroup, the scale's sensitivity was 76% and its specificity was 85%. Use of the cutoff score of 30 produced similar results. Results of the application of Bayes's theorem showed that 17% of the subjects scoring 30 or higher would actually have multiple personality disorder and 99% of those scoring less than 30 would not have multiple personality disorder.These results indicate that the Dissociative Experiences Scale performs quite well as a screening instrument to identify subjects with multiple personality disorder. In addition, the consistency of responses to scale items across centers indicates that the symptoms reported by patients with multiple personality disorder are highly similar across diverse geographic centers. This consistency supports the reliability and validity of the diagnosis of multiple personality disorder across centers.",0,0 +4096,"Personality, posttraumatic stress and trauma type: factors contributing to posttraumatic growth and its domains in a Turkish community sample","Posttraumatic growth (PTG) is conceptualized as a positive transformation resulting from coping with and processing traumatic life events. This study examined the contributory roles of personality traits, posttraumatic stress (PTS) severity and their interactions on PTG and its domains, as assessed with the Posttraumatic Growth Inventory Turkish form (PTGI-T). The study also examined the differences in PTG domains between survivors of accidents, natural disasters and unexpected loss of a loved one.The Basic Personality Traits Inventory, Posttraumatic Diagnostic Scale, and PTGI-T were administered to a large stratified cluster community sample of 969 Turkish adults in their home settings.The results showed that conscientiousness, agreeableness, and openness to experience significantly related to the total PTG and most of the domains. The effects of extraversion, neuroticism and openness to experience were moderated by the PTS severity for some domains. PTG in relating to others and appreciation of life domains was lower for the bereaved group.Further research should examine the mediating role of coping between personality and PTG using a longitudinal design.",0,0 +4097,"Trauma memories, mental health, and resilience: a prospective study of Afghan youth","Background Studies of war-affected youth have not yet examined how trauma memories relate to prospective changes in mental health and to subjective or social experiences. Methods We interviewed a gender-balanced, randomly selected sample of Afghan child-caregiver dyads (n = 331, two waves, 1 year apart). We assessed lifetime trauma with a Traumatic Event Checklist, past-year events with a checklist of risk and protective events, and several child mental health outcomes including posttraumatic distress (Child Revised Impact of Events Scale, CRIES) and depression. We examined the consistency of trauma recall over time, identified mental health trajectories with latent transition modeling, and assessed the predictors of posttraumatic distress and depression trajectories with multinomial logistic regressions. Results From baseline to follow-up, reports of lifetime trauma significantly changed (p ≤ 0.01). A third of the cohort reported no trauma exposure; only 10% identified the same event as their most distressing experience. We identified four CRIES trajectories: low or no distress (52%), rising distress (15%), declining distress (21%), and sustained high distress (12%). Youth with chronic posttraumatic distress were more likely to be girls (OR = 5.78, p ≤ 0.01), report more trauma exposure at baseline (OR = 1.55, p ≤ 0.05) and follow-up (OR = 5.96, p ≤ 0.01), and experience ongoing domestic violence (OR = 4.84, p ≤ 0.01). The risks of rising distress and sustained distress showed a steady increase for youth recalling up to four traumatic experiences. Depression and CRIES trajectories showed weak comorbidity. Conclusions Memories of violent events are malleable, embedded in social experiences, and present heterogeneous associations with posttraumatic distress. Our study provides insights on resilience and vulnerability to multiple adverse childhood experiences, highlighting research and clinical implications for understanding trauma in conflict-affected youth.",0,0 +4098,"Mindfulness Skills, Anxiety Sensitivity, and Cognitive Reactivity in Patients with Posttraumatic Stress Disorder","In trauma-exposed individuals, those with relatively high levels of mindfulness skills tend to have lower levels of symptoms. Mindfulness has also been associated with decreased anxiety sensitivity and cognitive reactivity, and vulnerability factors related to posttraumatic and depressive symptom severity. In this cross-sectional study, our aim was to further investigate the associations among mindfulness skills, anxiety sensitivity, cognitive reactivity, and symptom severity in patients with posttraumatic stress disorder (PTSD). Outpatients with PTSD (N = 101) filled out questionnaires. All facets of mindfulness correlated negatively with reactivity measures and with symptom severity, except for the facet observe. In hierarchical multiple regression analysis, describe, non-judgment, and non-reactivity predicted PTSD symptom severity above and beyond anxiety sensitivity and trauma exposure severity. Describe, act with awareness, and non-judgment also predicted depressive symptom severity above and beyond cognitive reactivity and number of experienced traumatic events. In conclusion, mindfulness skills were indeed uniquely related to symptom severity and cognitive reactivity measures. Our results furthermore support a five-facet model of mindfulness. In addition, the outcomes are a cross-cultural contribution to research on the relevance of mindfulness skills in the treatment of PTSD. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0,0 +4099,Intranetwork and internetwork functional connectivity alterations in post-traumatic stress disorder,"A large number of previous neuroimaging studies have explored the functional alterations of post-traumatic stress disorder (PTSD). However, abnormalities in the functional architecture of resting-state networks in PTSD were rarely elucidated.This study used independent component analysis to explore the resting-state intranetwork and internetwork functional connectivity differences between 20 PTSD patients and 20 matched healthy controls (HCs).Selective alterations of intranetwork and internetwork intrinsic functional connectivities were found in the PTSD patients. Compared with HCs, the PTSD patients exhibited significantly decreased network connectivity within the anterior default mode network, posterior default mode network (pDMN), salience network (SN), sensory-motor network, and auditory network. Furthermore, the PTSD patients exhibited increased internetwork connectivity between SN and pDMN.This study lacked recruitment of trauma-exposed HCs, which limits our ability to determine whether the alterations are caused by PTSD or trauma exposure.The findings suggested that the PTSD patients exhibited abnormal functional connectivity at the brain network level. Notably, the enhanced internetwork connectivity between SN and pDMN in the PTSD patients may be associated with hyperarousal and heightened anxiety in PTSD.",0,0 +4100,Individual and Collective Traumatic Memories: A Qualitative Study of Post-Traumatic Stress Disorder Symptoms in Two Latin American Localities,"A qualitative analysis of material from a number of field trips to Peru and Colombia shows the diagnosis of post-traumatic stress disorder (PTSD) to be culture related. When a local community consists of collective, functional units, as in some Peruvian villages, people have a tendency to not react solely with conventional PTSD symptoms, or to have the attitude that traumatic memory should be treated with crisis intervention. This is in contrast to some villages in Colombia where people are more individualistically oriented and reactions to trauma are more concerned with guilt and shame. In Peru, psychosocial work is carried out mostly by strengthening the construction of the local community, whereas in Colombia, individual psychological interventions are more widely used and accepted. The study demonstrates that the concept of traumatic memory should be considered in both collective and individual aspects, depending on the nature of the underlying organisation of society and culture.",0,0 +4101,Frequent binge drinking five to six years after exposure to 9/11: Findings from the World Trade Center Health Registry,"Exposure to 9/11 may have considerable long-term impact on health behaviors, including increased alcohol consumption. We examined the association between frequent binge drinking, posttraumatic stress disorder (PTSD), and number of 9/11-specific experiences among World Trade Center Health Registry (Registry) enrollees five-to-six years after 9/11.Participants included 41,284 lower Manhattan residents, workers, passers-by, and rescue/recovery workers aged 18 or older without a pre-9/11 PTSD diagnosis who completed Wave 1 (2003-2004) and Wave 2 (2006-2007) interviews. Frequent binge drinking was defined as consuming five or more drinks on five or more occasions in the prior 30 days at Wave 2. Probable PTSD was defined as scoring 44 or greater on the PTSD Checklist. 9/11 exposure was measured as the sum of 12 experiences and grouped as none/low (0-1), medium (2-3), high (4-5) and very high (6+).Frequent binge drinking was significantly associated with increasing 9/11 exposure and PTSD. Those with very high and high exposures had a higher prevalence of frequent binge drinking (13.7% and 9.8%, respectively) than those with medium and low exposures (7.5% and 4.4%, respectively). Upon stratification, very high and high exposures were associated with frequent binge drinking in both the PTSD and no PTSD subgroups.Our findings suggest that 9/11 exposure had an impact on frequent binge drinking five-to-six years later among Registry enrollees. Understanding the effects of traumatic exposure on alcohol use is important to identify risk factors for post-disaster alcohol misuse, inform policy, and improve post-disaster psychological and alcohol screening and counseling.",0,0 +4102,AAGP Position Statement: Disaster Preparedness for Older Americans: Critical Issues for the Preservation of Mental Health,"The Disaster Preparedness Task Force of the American Association for Geriatric Psychiatry was formed after Hurricane Katrina devastated New Orleans to identify and address needs of the elderly after the disaster that led to excess health disability and markedly increased rates of hopelessness, suicidality, serious mental illness (reported to exceed 60% from baseline levels), and cognitive impairment. Substance Abuse and Mental Health Services Administration (SAMHSA) outlines risk groups which fail to address later effects from chronic stress and loss and disruption of social support networks. Range of interventions recommended for Preparation, Early Response, and Late Response reviewed in the report were not applied to elderly for a variety of reasons. It was evident that addressing the needs of elderly will not be made without a stronger mandate to do so from major governmental agencies (Federal Emergency Management Agency [FEMA] and SAMHSA). The recommendation to designate frail elderly and dementia patients as a particularly high-risk group and a list of specific recommendations for research and service and clinical reference list are provided.",0,0 +4103,Regularized Finite Mixture Models for Probability Trajectories,"Finite mixture models are widely used in the analysis of growth trajectory data to discover subgroups of individuals exhibiting similar patterns of behavior over time. In practice, trajectories are usually modeled as polynomials, which may fail to capture important features of the longitudinal pattern. Focusing on dichotomous response measures, we propose a likelihood penalization approach for parameter estimation that is able to capture a variety of nonlinear class mean trajectory shapes with higher precision than maximum likelihood estimates. We show how parameter estimation and inference for whether trajectories are time-invariant, linear time-varying, or nonlinear time-varying can be carried out for such models. To illustrate the method, we use simulation studies and data from a long-term longitudinal study of children at high risk for substance abuse.",0,0 +4104,Dimensional Structure of <em>DSM-5</em> Posttraumatic Stress Disorder Symptoms,"To evaluate the prevalence of DSM-5 posttraumatic stress disorder (PTSD) and factor structure of PTSD symptomatology in a nationally representative sample of US veterans and examine how PTSD symptom clusters are related to depression, anxiety, suicidal ideation, hostility, physical and mental health-related functioning, and quality of life.Data were analyzed from the National Health and Resilience in Veterans Study, a nationally representative survey of 1,484 US veterans conducted from September through October 2013. Confirmatory factor analyses were conducted to evaluate the factor structure of PTSD symptoms, and structural equation models were constructed to examine the association between PTSD symptom clusters and external correlates.12.0% of veterans screened positive for lifetime PTSD and 5.2% for past-month PTSD. A 5-factor dysphoric arousal model and a newly proposed 6-factor model both fit the data significantly better than the 4-factor model of DSM-5. The 6-factor model fit the data best in the full sample, as well as in subsamples of female veterans and veterans with lifetime PTSD. The emotional numbing symptom cluster was more strongly related to depression (P < .001) and worse mental health-related functioning (P < .001) than other symptom clusters, while the externalizing behavior symptom cluster was more strongly related to hostility (P < .001).A total of 5.2% of US veterans screened positive for past-month DSM-5 PTSD. A 6-factor model of DSM-5 PTSD symptoms, which builds on extant models and includes a sixth externalizing behavior factor, provides the best dimensional representation of DSM-5 PTSD symptom clusters and demonstrates validity in assessing health outcomes of interest in this population.",0,0 +4105,Understandings of Coping: A Critical Review of Coping Theories for Disaster Contexts,"This chapter addresses the behavior, thoughts, experiences, and feelings of individuals who have been exposed to strain and stress. First, we introduce the many different approaches associated with both psychological and broader social science-based understandings of coping. We then analyze the extent to which these approaches can be applied in a disaster-related context. In the first part of this chapter, we examine the person-centered coping models that dominate stress research in mainstream psychological approaches. These models are similar to the goal-based models of human nature in which the basic motivation of human beings is to move toward goals while avoiding threats. Depending on the model in question, the main focus lies either in the cognitive processes of appraisal and emotion regulation, attribution of meaning, and religious forms of coping or on the conceptualization as a mental health problem. In contrast, resource-oriented coping theories emphasize the social and material contexts of stress processes. Social contexts and interactions are also more central to the field of community psychology and in the research on social support. Sociology and related social sciences have even broader models in which community coping and resilience of communities are studied as a social or collective process. When considering community resilience, or the application of social capital or local knowledge, the coping resources of larger social units are of primary importance, as collective meanings, emotions, and agency come to the fore. © 2014 Springer Science+Business Media, LLC. All rights are reserved.",0,0 +4106,Developmental trajectories of adolescent popularity: A growth curve modelling analysis,"Growth curve modelling was used to examine developmental trajectories of sociometric and perceived popularity across eight years in adolescence, and the effects of gender, overt aggression, and relational aggression on these trajectories. Participants were 303 initially popular students (167 girls, 136 boys) for whom sociometric data were available in Grades 5-12. The popularity and aggression constructs were stable but non-overlapping developmental dimensions. Growth curve models were run with SAS MIXED in the framework of the multilevel model for change [Singer, J. D., & Willett, J. B. (2003). Applied longitudinal data analysis. Oxford, UK: Oxford University Press]. Sociometric popularity showed a linear change trajectory; perceived popularity showed nonlinear change. Overt aggression predicted low sociometric popularity but an increase in perceived popularity in the second half of the study. Relational aggression predicted a decrease in sociometric popularity, especially for girls, and continued high-perceived popularity for both genders. The effect of relational aggression on perceived popularity was the strongest around the transition from middle to high school. The importance of growth curve models for understanding adolescent social development was discussed, as well as specific issues and challenges of growth curve analyses with sociometric data.",0,0 +4107,Mental Health Consequences of Disasters,"We present in this review the current state of disaster mental health research. In particular, we provide an overview of research on the presentation, burden, correlates, and treatment of mental disorders following disasters. We also describe challenges to studying the mental health consequences of disasters and discuss the limitations in current methodologies. Finally, we offer directions for future disaster mental health research.",0,0 +4108,Validity of the Hospital Anxiety and Depression Scale to assess depression and anxiety following traumatic brain injury as compared with the Structured Clinical Interview for DSM-IV,"Rating scales are often used in the assessment of depression and anxiety in traumatic brain injury (TBI), but few have been validated for use with this population. Overlap of symptoms between such disorders and TBI may lead to under- or over-diagnosis of depression or anxiety.100 participants with mild to severe TBI, and 87 informants, were interviewed using the SCID-IV (Axis I). The HADS was administered at the same time.According to the SCID-IV, 34 participants were diagnosed with major depression and 36 with an anxiety disorder. Higher HADS scores were associated with a greater likelihood of depression and anxiety. However, the ""clinical"" categories of the HADS did not strongly correspond with the clinical diagnoses of depression and anxiety. Compared with SCID diagnoses, the depression subscale of the HADS had a sensitivity of 62% and a specificity of 92%. The anxiety subscale had a sensitivity of 75% and a specificity of 69%. Positive predictive and negative predictive values were calculated.This study included mostly moderate to severe TBI individuals, recruited from a rehabilitation hospital. Therefore, they may not necessarily be representative of the entire TBI population.The HADS was a reliable measure of emotional distress in this TBI sample; however the cut-off scores and categories were not useful in predicting caseness of depression and anxiety. Clinicians should be mindful of the sequelae of TBI that may confound the scores yielded in rating scales and should follow up with a psychiatric interview when diagnosis is unclear.",0,0 +4109,Neural Systems for Cognitive and Emotional Processing in Posttraumatic Stress Disorder,"Individuals with posttraumatic stress disorder (PTSD) show altered cognition when trauma-related material is present. PTSD may lead to enhanced processing of trauma-related material, or it may cause impaired processing of trauma-unrelated information. However, other forms of emotional information may also alter cognition in PTSD. In this review, we discuss the behavioral and neural effects of emotion processing on cognition in PTSD, with a focus on neuroimaging results. We propose a model of emotion-cognition interaction based on evidence of two network models of altered brain activation in PTSD. The first is a trauma-disrupted network made up of ventrolateral PFC, dorsal anterior cingulate cortex (ACC), hippocampus, insula, and dorsomedial PFC that are differentially modulated by trauma content relative to emotional trauma-unrelated information. The trauma-disrupted network forms a subnetwork of regions within a larger, widely recognized network organized into ventral and dorsal streams for processing emotional and cognitive information that converge in the medial PFC and cingulate cortex. Models of fear learning, while not a cognitive process in the conventional sense, provide important insights into the maintenance of the core symptom clusters of PTSD such as re-experiencing and hypervigilance. Fear processing takes place within the limbic corticostriatal loop composed of threat-alerting and threat-assessing components. Understanding the disruptions in these two networks, and their effect on individuals with PTSD, will lead to an improved knowledge of the etiopathogenesis of PTSD and potential targets for both psychotherapeutic and pharmacotherapeutic interventions.",0,0 +4110,Life Course Epidemiology of Trauma and Related Psychopathology in Civilian Populations,"Traumatic events are ubiquitous exposures that interact with life course events to increase risk of acute psychopathology and alter mental health trajectories. While the majority of persons exposed to trauma experience mild to moderate psychological distress followed by a return to pre-trauma health, many persons exposed to trauma experience substantial distress that lasts for several years. Therefore, in an effort to understand why exposure to trauma can provoke such a range of reactions, we apply a life course approach that considers the complex accumulation and interaction of life experiences that range from social to biological factors, which occur over the life span-from gestation to death and across generations. We present this evidence in three categories: genetics and biology, individual exposures, and community experiences, followed by discussing challenges in existing research and directions for future study.",0,0 +4111,Adolescent Survivors of “Ethnic Cleansing”: Observations on the First Year in America,"To describe the psychiatric assessments and trauma testimonies of 12 Bosnian adolescents newly resettled in America.Twelve Bosnian adolescents who experienced the massive psychic trauma of ""ethnic cleansing"" were assessed during the first year after their resettlement in the United States. Assessments consisted of systematic, trauma-focused, clinical interviews that included standard assessment scales of posttraumatic stress disorder (PTSD) and depression, as well as the opportunity to give testimony about their experiences.PTSD was diagnosed in 25% of subjects and depressive disorders in 17%. Reexperiencing cluster symptoms were present in 50%, avoidance cluster symptoms in 31%, and hyperarousal cluster symptoms in 29%.The relatively low rate of PTSD in this sample (in comparison with adult survivors of ""ethnic cleansing"" and with Cambodian adolescent survivors) may be attributable to normal prior development, time-limited adversity, lack of physical or sexual traumas, rejoining nuclear families, or insufficient time for the development of delayed-onset PTSD. It may also be a reflection of the resiliency of adolescence.",0,0 +4112,Fluvoxamine treatment in veterans with combat-related post-traumatic stress disorder,"This study was designed to investigate the efficacy of the antidepressant fluvoxamine in the treatment of combat-related post-traumatic stress disorder (PTSD). Fifteen veterans with combat-related PTSD and no other psychiatric diagnosis except depression were recruited to participate in a 14-week open-label study of fluvoxamine. Patients underwent a 30-day washout period and were rated with the Clinician Administered PTSD Scale (CAPS), Mississippi Scale, Beck Depression Inventory (BDI), Hamilton Rating Scale for Depression (HAM-D) and Hamilton Rating Scale for Anxiety (HAM-A) at baseline, and every 2 weeks until week 14. Three patients stopped fluvoxamine prematurely due to side effects and 7 withdrew consent before completing the 14-week trial. Eight patients completed at least 8 weeks of treatment. The total daily dose of fluvoxamine ranged from 100 to 300 mg with a mean daily dose of 150 mg at week 14. Intent-to-treat analysis revealed a significant improvement in total CAPS scores, and in the intrusion and the avoidance/numbing subscales. The CAPS hyperarousal scores did not change significantly. HAM-A score also improved significantly. No significant changes were seen on the Mississippi scale, HAM-D, or Beck Depression Inventory in the intent-to-treat analysis. In summary, our study shows that fluvoxamine appears to improve combat-related PTSD symptoms but not depressive symptoms. The high attrition rate and lack of a placebo group limits the conclusions of our study. Controlled studies of fluvoxamine in the treatment of PTSD are warranted. Depression and Anxiety 15:29–33, 2002. © 2002 Wiley-Liss, Inc.",0,0 +4113,Peritraumatic and Persistent Dissociation in the Presumed Etiology of PTSD,"Dissociative responses that occur at the time of a trauma (peritraumatic dissociation) have been described as a major risk factor for subsequent posttraumatic stress disorder (PTSD). The current study evaluated peritraumatic dissociation and PTSD from a multivariate perspective, along with a less-investigated phenomenon: trauma-specific dissociation that begins during or after an event and continues until the time of assessment (persistent dissociation).In two studies, 52 local community participants and 386 participants from the general population with histories of exposure to at least one traumatic event were assessed for the presence of PTSD and were administered measures of dissociation and peritraumatic distress.In both studies, peritraumatic dissociation, persistent dissociation, peritraumatic distress, and generalized dissociative symptoms were associated with PTSD by univariate analyses. However, multivariate analyses in both studies indicated that PTSD status was no longer related to peritraumatic dissociation once other variables (especially persistent and generalized dissociation) were taken into account. In contrast, persistent dissociation was a strong predictor at univariate and multivariate levels.Trauma-related persistent dissociation is a substantial predictor of PTSD, whereas peritraumatic dissociation ceases to predict PTSD at the multivariate level. These findings suggest that it is less what happens at the time of a trauma (e.g., disrupted encoding) that predicts PTSD than what occurs thereafter (i.e., persistent avoidance).",0,0 +4114,The role of childhood maltreatment in the altered trait and global expression of personality in cocaine addiction,"Drug addictions are debilitating disorders that are highly associated with personality abnormalities. Early life stress (ELS) is a common risk factor for addiction and personality disturbances, but the relationships between ELS, addiction, and personality are poorly understood.Ninety-five research participants were assessed for and grouped by ELS history and cocaine dependence. NEO-FFI personality measures were compared between the groups to define ELS- and addiction-related differences in personality traits. ELS and cocaine dependence were then examined as predictors of personality trait scores. Finally, k-means clustering was used to uncover clusters of personality trait configurations within the sample. Odds of cluster membership across subject groups was then determined.Trait expression differed significantly across subject groups. Cocaine-dependent subjects with a history of ELS (cocaine+/ELS+) displayed the greatest deviations in normative personality. Cocaine dependence significantly predicted four traits, while ELS predicted neuroticism and agreeableness; there was no interaction effect between ELS and cocaine dependence. The cluster analysis identified four distinct personality profiles: Open, Gregarious, Dysphoric, and Closed. Distribution of these profiles across subject groups differed significantly. Inclusion in cocaine+/ELS+, cocaine-/ELS+, and cocaine-/ELS- groups significantly increased the odds of expressing the Dysphoric, Open and Gregarious profiles, respectively.Cocaine dependence and early life stress were significantly and differentially associated with altered expression of individual personality traits and their aggregation as personality profiles, suggesting that individuals who are at-risk for developing addictions due to ELS exposure may benefit from personality centered approaches as an early intervention and prevention.",0,0 +4115,PTSD symptom clusters associated with physical health and health care utilization in rural primary care patients exposed to natural disaster,"This study investigated the influence of exposure to a tornado disaster and disaster-related posttraumatic stress disorder (PTSD) symptomatology on physical health complaints and primary health care utilization among rural medical patients. One-hundred five patients completed self-report measures assessing disaster exposure, PTSD symptoms, and self-reported physical health complaints. Objective rates of health care utilization were gathered by a review of medical records. Tornado disaster exposure and generalized psychological distress were associated with physical health complaints one year following the disaster. After controlling for age, gender, and levels of predisaster health care utilization, PTSD Cluster C (avoidance) symptoms were associated with increased rates of postdisaster health care utilization. Implications of these findings for interventions within the medical system are discussed.",0,0 +4116,Prevalence and duration of PTSD in survivors 6 years after a natural disaster,"The present study aimed to examine the prevalence of posttraumatic stress disorder (PTSD) in survivors with low levels of risk factors for PTSD. The sample included 142 adults (58% women, 54% university education, 93% employed/students/retired) on vacation in Southeast Asia during the 2004 Indian Ocean disaster. Semi-structured clinical interviews (SCID-I) were performed after 6 years including PTSD, depression, specific phobia, and alcohol abuse. The 6-year prevalence of PTSD was 11.3% and the current prevalence was 4.2%, with onset mainly within 1 month and remission within 3 years post-disaster. Suicidal ideation and comorbidity were common in PTSD cases. Lifetime prevalence of depression was 19%, specific phobia 7%, and alcohol abuse 4%. The findings suggest elevated levels of PTSD but not other disorders as compared with general population samples, but still lower levels than other disaster samples. Despite benign circumstances, however, the course and burden of PTSD were comparable to similar studies.",0,0 +4117,"Dimensions of trauma associated with posttraumatic stress disorder (PTSD) caseness, severity and functional impairment: a study of Bosnian refugees resettled in Australia","Refugee survivors of inter-ethnic warfare vary greatly in the extent and range of their trauma experiences. Discerning which experiences are most salient to generating and perpetuating disorders such as posttraumatic stress disorder (PTSD) is critical to the mounting rational strategies for targeted psychosocial interventions. In a sample of Bosnian Muslim refugees (n=126) drawn from a community centre and supplemented by a snowball sampling method, PTSD status and associated disability were measured using the clinician-administered PTSD Scale (CAPS) for DSM-IV. A principal components analysis (PCA) based on a pool of trauma items yielded four coherent trauma dimensions: Human Rights Violations, Threat to Life, Traumatic Loss and Dispossession and Eviction. A cluster analysis identified three subgroupings according to extent of trauma exposure. There were no differences in PTSD risk for the group most exposed to human rights violations (internment in concentration camps, torture) compared to the general war-exposed group. Logistic regression analysis using the dimensions derived from the PCA indicated that Threat to Life alone of the four trauma factors predicted PTSD status, a finding that supports the DSM-IV definition of a trauma. Both Threat to Life and Traumatic Loss contributed to symptom severity and disability associated with PTSD. It may be that human rights violations pose a more general threat to the survivor's future psychosocial adaptation in areas of functioning that extend beyond the confines of PTSD.",0,0 +4118,"INTERACTIONS OF IMMUNOLOGICAL, PSYCHOLOGICAL, HORMONAL, AND NUTRITIONAL ALTERATIONS IN WAR-RELATED CHRONIC STRESS","Background and purpose: Stress-induced effects on neuroendocrine and immune functions are well established. The nature of relations in these multidirectionally interacting allostatic systems is difficult to evaluate in humans. To assess the complex responses to war-related chronic stress we used multivariate statistical model analysis. Materials and methods: Twenty-nine detainees released from the concentration camp and 15 controls were included in the study. Psychological status was assessed by COR-NEX2 and Hamilton tests, nutritional status by serum albumin and total protein levels, and endocrine status by serum cortisol, (beta)-endorphin, prolactin, T3 and T4 levels. Immune status was estimated by flow cytometric enumeration of the lymphocyte subpopulations, NK and phagocytic activities and serum cytokines (IL-2, TNF, IFN) levels. To assess the relations between psychological, nutritional, endocrine and immune statuses representet by sets of several variables each, multivariate canonical correlation and cluster analysis were aplyed. Results: Although no causal relationship can be inferred from this study, multiple interactions were established between the statuses examined. Psychological and nutritional variables correlated with T lymphocyte activation and non-specific immune functions while hormonal and psychological statuses, being in correlation, contributed to the relation with immunofunctional variables. By cluster analysis, all variables employed were structured into four clusters, reflecting more or less the same relation among the psychological, endocrine, immune and nutritional statuses. Conclusion: The multivariate model analyses employed confirmed the prevailing influence of chronic stress on hormonal and immunological responses, although in order to arrive at a more reliable interpretation of such complex interactions, some other important variables and larger sample size should be employed.",0,0 +4119,Combat Stress Injury,,0,0 +4120,THE ANXIETY SPECTRUM AND THE REFLEX PHYSIOLOGY OF DEFENSE: FROM CIRCUMSCRIBED FEAR TO BROAD DISTRESS,"Guided by the diagnostic nosology, anxiety patients are expected to show defensive hyperarousal during affective challenge, irrespective of the principal phenotype. In the current study, patients representing the whole spectrum of anxiety disorders (i.e., specific phobia, social phobia, panic disorder with or without agoraphobia, obsessive-compulsive disorder, generalized anxiety disorder (GAD), posttraumatic stress disorder(PTSD)), and healthy community control participants, completed an imagery-based fear elicitation paradigm paralleling conventional intervention techniques. Participants imagined threatening and neutral narratives as physiological responses were recorded. Clear evidence emerged for exaggerated reactivity to clinically relevant imagery--most pronounced in startle reflex responding. However, defensive propensity varied across principal anxiety disorders. Disorders characterized by focal fear and impairment (e.g., specific phobia) showed robust fear potentiation. Conversely, for disorders of long-enduring, pervasive apprehension and avoidance with broad anxiety and depression comorbidity (e.g., PTSD secondary to cumulative trauma, GAD), startle responses were paradoxically diminished to all aversive contents. Patients whose expressed symptom profiles were intermediate between focal fearfulness and broad anxious-misery in both severity and chronicity exhibited a still heightened but more generalized physiological propensity to respond defensively. Importantly, this defensive physiological gradient--the inverse of self-reported distress--was evident not only between but also within disorders. These results highlight that fear circuitry could be dysregulated in chronic, pervasive anxiety, and preliminary functional neuroimaging findings suggest that deficient amygdala recruitment could underlie attenuated reflex responding. In summary, adaptive defensive engagement during imagery may be compromised by long-term dysphoria and stress-a phenomenon with implications for prognosis and treatment planning.",0,0 +4121,The factor structure of Posttraumatic Stress Disorder symptoms among bereaved individuals: A confirmatory factor analysis study,"Posttraumatic Stress Disorder (PTSD) is defined in DSM-IV as an anxiety disorder that encompasses symptom-clusters of reexperiencing, avoidance, and hyperarousal. Several studies have examined the factor structure of PTSD symptoms. To our knowledge, no studies have yet examined the factor structure of loss-related PTSD symptoms in samples exclusively comprised of bereaved individuals. Such an examination is important because it can advance our understanding of the stability of the structure of PTSD symptoms across groups confronted with different aversive life-events and of processes underlying the occurrence of PTSD symptoms after loss. In this study, five alternative models of the factor structure of PTSD symptoms were examined in a sample of 347 mourners. Results showed that, in this group, PTSD symptoms are best conceptualized as forming four factors: reexperiencing, avoidance, dysphoria, and hyperarousal. Patterns of correlations with depression and complicated grief supported the validity of the model.",0,0 +4122,Emotional processing of fear: Exposure to corrective information.,"In this article we propose mechanisms that govern the processing of emotional information, particularly those involved in fear reduction. Emotions are viewed as represented by information structures in memory, and anxiety is thought to occur when an information structure that serves as program to escape or avoid danger is activated. Emotional processing is denned as the modification of memory structures that underlie emotions. It is argued that some form of exposure to feared situations is common to many psychotherapies for anxiety, and that confrontation with feared objects or situations is an effective treatment. Physiological activation and habituation within and across exposure sessions are cited as indicators of emotional processing, and variables that influence activation and habituation of fear responses are examined. These variables and the indicators are analyzed to yield an account of what information must be integrated for emotional processing of a fear structure. The elements of such a structure are viewed as cognitive representations of the stimulus characteristic of the fear situation, the individual's responses in it, and aspects of its meaning for the individual. Treatment failures are interpreted with respect to the interference of cognitive defenses, autonomic arousal, mood state, and erroneous ideation with reformation of targeted fear structures. Applications of the concepts advanced here to therapeutic practice and to the broader study of psychopathology are discussed.",0,0 +4123,Complexities in Complex Posttraumatic Stress Disorder in Inpatient Women: Evidence From Cluster Analysis of MCMI-III Personality Disorder Scales,"Herman's (1992a) clinical formulation of complex posttraumatic stress disorder (PTSD) captures the extensive diagnostic comorbidity seen in patients with a history of repeated interpersonal trauma and severe psychiatric disorders. Yet the sheer breadth of symptoms and personality disturbance encompassed by complex PTSD limits its descriptive usefulness. This study employed cluster analysis of the MCMI-III (Millon, 1994) personality disorder scales to determine whether there is meaningful heterogeneity within a group of 227 severely traumatized women who were treated in a specialized inpatient program. The analysis distinguishes 5 clinically meaningful clusters, which we label alienated, withdrawn, aggressive, suffering, and adaptive. The study examined differences among these 5 personality disorder clusters on the MCMI-III clinical syndrome scales, as well as on the Brief Symptom Inventory (Derogatis, 1993), Dissociative Experiences Scale (E. M. Bernstein & Putnam, 1986), Adult Attachment Scale (Collins & Read, 1990), and Childhood Trauma Questionnaire (D.P. Bernstein, 1995). We present a classification-tree method for determining the cluster membership of new cases and discuss the implications of the findings for diagnostic assessment, treatment, and research.",0,0 +4124,Toward a lifespan approach to resilience and potential trauma,"As much as we might wish it otherwise, bad things happen: war, natural disaster, the death of close friends and relatives, serious accidents, senseless abuse or violence at the hand of others, and so on. Any of these things can and all too often do happen, and at every stage of life. Epidemiological data indicate that most adults experience at least one and usually several potentially traumatic events (PTE) during the course of their lives (Norris, 1992; Kessler et al., 1995; Breslau et al., 2000), and that most children are also exposed to such experiences (Copeland et al., 2007). It is important to note, however, that life event research typically relies on retrospective accounts, which more than likely underestimate the frequency of PTEs. Indeed, a recent study that measured life events among college students over a four-year period using a weekly internet survey reported an average of six PTEs per student (Lalande & Bonanno, 2011). Perhaps because acutely aversive events are so dreaded, both clinicians and the lay public tend to assume that they will almost always result in lasting emotional damage. The available evidence, however, suggests a more complex and far more encouraging picture. To emphasize the pronounced individual differences in the way people react to adversity, we emphasize that such events are only “potentially traumatic” (Norris, 1992; Bonanno, 2004), for the simple reason that not everyone experiences them as traumatic. Most people in fact cope with PTEs remarkably well (Bonanno, 2004, 2005; Bonanno & Mancini, 2008). Although some do, in fact, endure lasting emotional difficulties, the vast majority of people exposed to extreme adversity recover a semblance of their normal level of functioning within several months to several years after the event, and many if not most show little evidence of more than transient disruptions in functioning. © Cambridge University Press 2011.",0,0 +4125,Attachment-Related Consequences of War Captivity and Trajectories of Posttraumatic Stress Disorder: A 17-Year Longitudinal Study,"Attachment security contributes to resilience in times of stress, but it can be disrupted by traumatic events that shatter positive views of self and others. We followed Israeli ex-POWs of the Yom Kippur War over 17 years and examined associations between trajectories of posttraumatic stress disorder (PTSD) and disruptions in the regulatory functions of the attachment system. Fifty-nine ex-POWs and 39 control veterans from the same war who had reported on PTSD 18, 30, and 35 years after the war performed laboratory cognitive tasks assessing activation of mental representations of security in response to threat and the ability of these representations to color neutral stimuli with positive affect and reduce access to trauma-related thoughts. As compared to controls, ex-POWs with persistent PTSD over the 17-year period exhibited dramatic disruptions in the soothing and healing functions of attachment security representations. These disruptions were not evident among ex-POWs with a worsening PTSD trajectory or a stable resilience trajectory. The implications of attachment-system functioning for understanding posttraumatic processes are discussed.",0,0 +4126,Multisample cross-validation of a model of childhood posttraumatic stress disorder symptomatology,"This study is the latest advancement of our research aimed at best characterizing children's posttraumatic stress reactions. In a previous study, we compared existing nosologic and empirical models of PTSD dimensionality and determined the superior model was a hierarchical one with three symptom clusters (Intrusion/Active Avoidance, Numbing/Passive Avoidance, and Arousal; Anthony, Lonigan, & Hecht, 1999). In this study, we cross-validate this model in two populations. Participants were 396 fifth graders who were exposed to either Hurricane Andrew or Hurricane Hugo. Multisample confirmatory factor analysis demonstrated the model's factorial invariance across populations who experienced traumatic events that differed in severity. These results show the model's robustness to characterize children's posttraumatic stress reactions. Implications for diagnosis, classification criteria, and an empirically supported theory of PTSD are discussed.",0,0 +4127,"Race, age, and gender influences among clusters of african american and white patients with chronic pain","

Abstract

Racial and ethnic minorities, older people, and women are differentially affected by chronic pain. This study aimed to identify the experiences of adult African Americans and whites with chronic pain while identifying patient clusters on the basis of clinical characteristics as well as race, age, and gender influences within and between clusters. Three clusters of patients with chronic pain were identified within race, age, and gender categories: chronic pain syndrome, good pain control, and disability with mild syndrome. African American and younger patients experiencing chronic pain were more likely to present with chronic pain syndrome. African American patients presenting with chronic pain syndrome or disability with mild pain syndrome reported a higher disability than their counterparts. Older patients and women within the good pain control cluster reported a lower level of (1) pain and depression and (2) depression, respectively. Older patients presenting with a disability with mild syndrome also reported lower pain and depression. Despite similar physical, emotional, and pain characteristics, this study confirmed that the chronic pain experience differs across racial and age groups. Further study is necessary to evaluate how these factors influence pain services among an ethnically diverse population across the age continuum.

Perspective

This study found important racial and age-related variability in the symptom severity of patients with chronic pain presenting with similar physical, emotional, and pain characteristics to a tertiary care pain center. These findings have important clinical implications on chronic pain assessment and management.",0,0 +4128,Postdisaster PTSD over four waves of a panel study of Mexico's 1999 flood,"Samples of adults representative of Tezuitlán, Puebla and Villahermosa, Tobasco (combined N = 561), were interviewed 6, 12, 18, and 24 months after the devastating 1999 floods and mudslides in Mexico. Current DSM-IV PTSD and major depressive disorder (MDD) were assessed with the Composite International Diagnostic Interview. At Wave 1, PTSD was highly prevalent (24% combined), especially in Tezuitlán (46%), which had experienced mass casualties and displacement. Both linear and quadratic effects of time emerged, as PTSD symptoms initially declined but subsequently stabilized. Differences between cities lessened as time passed. Comorbidity between PTSD and MDD was substantial. The findings demonstrate that the international health community needs to be prepared for epidemics of PTSD when disasters strike developing areas of the world.",0,0 +4129,An Association Between Stress-Induced Disruption of the Hypothalamic-Pituitary-Adrenal Axis and Disordered Glucose Metabolism in an Animal Model of Post-Traumatic Stress Disorder,"Retrospective clinical reports suggesting that traumatic stress populations display an increased propensity for glucose metabolism disorders were examined in a controlled prospective animal model. Stress-induced behavioural and hypothalamic-pituitary-adrenal (HPA) axis response patterns were correlated to central and peripheral parameters of glucose metabolism and signalling, and to body measurements in Sprague–Dawley rats exposed to predator scent stress. Forty days post-exposure, fasting blood glucose and insulin levels, oral glucose tolerance test, body weight and white adipose tissue mass, systemic corticosterone levels and brain expression of insulin receptor (IR) and insulin-sensitive glucose transporter 4 (GLUT4) protein levels were evaluated. In a second experiment inbred strains with hyper- (Fischer) and hypo- (Lewis) reactive HPA axes were employed to assess the association of metabolic data with behavioural phenomenology versus HPA axis response profile. For data analysis, animals were classified according to their individual behavioural response patterns (assessed at day 7) into extreme, partial and minimal response groups. The exposed Sprague–Dawley rats fulfilling criteria for extreme behavioural response (EBR) (20.55%) also exhibited significant increases in body weight, abdominal circumference and abdominal white adipose tissue mass; a hyperglycaemic oral glucose tolerance test; and fasting hyperglycaemia, hyperinsulinaemia and hypercorticosteronemia, whereas minimal responders (MBR) and control animals displayed no such disturbances. Hippocampal and hypothalamic expression of IR and GLUT4 protein were significantly lower in EBR than in MBR and control rats. The inbred strains showed no metabolic differences at baseline. Exposed Fischer rats displayed hyperglycaemia and hyperinsulinaemia, whereas Lewis rats did not. A significant protracted disorder of glucose metabolism was induced by exposure to a stress paradigm. This metabolic response was associated with the characteristic pattern of HPA axis (corticosterone) response, which underlies the behavioural response to stress.",0,0 +4130,Cluster Analysis as a Method of Recovering Types of Intraindividual Growth Trajectories: A Monte Carlo Study,"There has been increased interest in and application of cluster analysis in longitudinal applications to identify distinctive developmental patterns of intraindividual change. This article used Monte Carlo experiments to evaluate the adequacy of cluster analysis to recover group membership based on simulated latent growth curve (LGC) models. The simulated LGC models were manipulated by varying growth parameters (e.g., elevation, dispersion, and shape) for subpopulation growth curves (e.g., linear and quadratic growth models). The evaluation of cluster analysis to recover individual membership in these growth curve subpopulations was completed via the Kappa statistics. Cluster analysis failed to recover adequately growth subtypes when the difference between growth curves was shape only. It was much more successful when the distance between initial mean levels was large (e.g., difference of two standard deviations), independent of difference in the shape of the growth curves. Tentative guidelines were proposed to facilitate the evaluation of the adequacy of a cluster analytic solution to recover subtype heterogeneity in longitudinal (intraindividual) growth curves.",0,0 +4131,A 6-Month Follow-Up Study of Posttraumatic Stress and Anxiety/Depressive Symptoms in Korean Children After Direct or Indirect Exposure to a Single Incident of Trauma,"Article AbstractObjectives: The aims of this study were to examine the symptoms of posttraumatic stress and anxiety/depression in Korean children after direct or indirect exposure to a single incident of trauma during a fire-escape drill and to assess the incidence of psychiatric disorders in this population.Method: A total of 1,394 students who attended the elementary school at which the traumatic event took place were evaluated using self-administered questionnaires (the Child Posttraumatic Stress Disorder-Reaction Index , State Anxiety Scale of the State-Trait Anxiety Inventory for Children , and Children's Depression Inventory ), as well as structured diagnostic interviews (Diagnostic Interview Schedule for Children, Version-IV ) at 2 days (time point 1), 2 months (time point 2), and 6 months (time point 3) after the incident. The 335 students who witnessed the accident were defined as the direct-exposure group, and the remaining students (n = 1,059) were defined as the indirect- exposure group. The study was conducted from May to November 2007.Results: At time point 1, the prevalence of severe posttraumatic stress disorder (PTSD), anxiety, and depressive symptoms was 18.2%, 5.5%, and 3.4%, respectively. The prevalence of severe PTSD symptoms, as measured by the CPTSD-RI, was significantly higher in the direct-exposure group than in the indirect-exposure group (36.6% vs 12.7%, respectively; P < .001). At time point 2, the prevalence of severe PTSD symptoms was 7.4% (14.0% in the direct- exposure group and 4.9% in the indirect-exposure group, P < .001). The mean total CPTSD-RI score was significantly higher (P < .001) in the direct-exposure group than in the indirect-exposure group. At time point 3, thirty-eight of the 58 subjects (65.5%) evaluated with the DISC-IV in the direct-exposure group had 1 or more of the 7 anxiety/depressive disorders assessed, including subthreshold diagnoses. Among the diagnoses meeting full DSM-IV criteria for each disorder, agoraphobia was the most prevalent (22.4%), followed by generalized anxiety disorder (13.8%), separation anxiety disorder (6.9%), PTSD (5.2%), and social phobia (5.2%). When the subthreshold diagnoses were considered along with the full syndrome diagnoses, separation anxiety disorder was the most common diagnosis (41.4%), followed by agoraphobia (34.5%), obsessive-compulsive disorder (22.4%), PTSD (20.7%), and social phobia (20.7%).Conclusions: The results of this study provide important evidence that various anxiety/depressive disorders, in addition to PTSD, might follow after direct or indirect exposure to trauma. Our findings highlight the importance of comprehensive screening for psychiatric problems in children exposed to trauma of any scale.Submitted: November 25, 2008; accepted February 11, 2009. Online ahead of print: June 16, 2009.Corresponding author: Dr Jae-Won Kim, Department of Child and Adolescent Psychiatry, College of Medicine, Seoul National University Hospital, 28 Yongon-Dong, Chongno-Gu, Seoul, Korea (adore412@paran.com).",0,0 +4132,Posttraumatic Stress Disorder and Impaired Autonomic Modulation in Male Twins,"Posttraumatic stress disorder (PTSD) has been linked to increased morbidity. An inflexibility of the autonomic nervous system might be the underlying mechanism. We aimed to assess whether PTSD and combat trauma exposure are associated with lower heart rate variability (HRV), a measure of autonomic function and a predictor of death.We measured HRV by power spectral analysis on 24-hour ambulatory electrocardiogram in 459 middle-aged veteran male twins. Combat trauma was assessed with the combat exposure scale, and current and remitted PTSD was assessed with the Structured Clinical Interview for Psychiatry Disorders. Mixed-effects regression models were used to test associations of PTSD and HRV between and within twin pairs.Of all twins, 211 had combat exposure, 31 had current PTSD, and 43 had remitted PTSD. Current PTSD was inversely associated with very-low-frequency and low-frequency HRV both in individual twins and within 20 pairs discordant for current PTSD. Twins with current PTSD had a 49% lower low-frequency HRV than their brothers without PTSD (p<.001). Remitted PTSD was not associated with HRV. Results were robust to adjustment for depression and other risk factors. Combat exposure was inversely associated with most HRV frequencies, but this association mostly diminished after adjustment for current PTSD.In middle-aged veteran men, combat exposure and current PTSD are associated with measures of autonomic inflexibility previously shown to have prognostic significance. The negative health impact of combat exposure on autonomic function is mediated largely through PTSD and might reverse with remission of PTSD.",0,0 +4133,Stress sensitization following a disaster: a prospective study,"Background According to the stress sensitization hypothesis, prior exposure to extreme stressors may lead to increased responsiveness to subsequent stressors. It is unclear whether disaster exposure is associated with stress sensitization and, if so, whether this effect is lasting or temporary. This study aimed to investigate the occurrence and duration of stress sensitization prospectively following a major disaster. Method Residents affected by a fireworks disaster ( n =1083) participated in surveys 2–3 weeks (T1), 18–20 months (T2) and almost 4 years (T3) after the disaster. Participants reported disaster exposure, including direct exposure, injury and damage to their home at T1, and also stressful life events (SLEs) at T2 and T3. Feelings of anxiety and depression, concentration difficulty, hostility, sleep disturbance, and intrusion and avoidance of disaster-related memories were used as indicators of distress. Results Residents whose home was completely destroyed responded with greater distress to SLEs reported 18–20 months following the disaster than residents whose home was less damaged. There were no differences in stress responsiveness almost 4 years after the disaster. Conclusions During the first years after a disaster, stress sensitization may occur in disaster survivors who experienced extreme disaster exposure. Stress sensitization may explain the persistence or progression of distress over time following extreme stressor exposure.",0,0 +4134,Treating Traumatized Children,"Ford, Pat-Horenczyk, Brom, Introduction. Layne, Beck, Rimmasch, Southwick, Moreno, Hobfoll, Promoting Resilient Posttraumatic Adjustment in Childhood and Beyond: Unpacking Life Events, Adjustment Trajectories, Resources, and Interventions. PART I: Risk and Protective Factors. Pat-Horenczyk, Rabinowitz, Rice, Tucker-Levin, The Search for Risk and Protective Factors in Childhood PTSD: From Variables to Processes. Cohen, Parenting in the Throes of Traumatic Events: Risks and Protection. Keren, Tyano, A Developmental Approach: Looking at the Specificity of Reactions to Trauma in Infants. Knight, Geltman, Ellis, Physical and Mental Health Functioning in Sudanese Unaccompanied Minors. Bifulco, Risk and Resilience in Young Londoners. PART II: Resilience. Brom, Kleber, Resilience as the Capacity for Processing Traumatic Experiences. Hobfoll, Horsey, Lamoureux, Resiliency and Resource Loss in Times of Terrorism and Disaster: Lessons Learned for Children and Families and Those Left Untaught. Tol, Jordans, Reis, Jong, Ecological Resilience: Working with child-related psychosocial resources in war-affected communities. Meichenbaum, Bolstering Resilience: Benefiting from Lessons Learned. PART III. Recovery: Empirically-based Systemic Interventions for Traumatized Children. Ford, Albert, Hawke, Prevention and Treatment Interventions for Traumatized Children: Restoring Children's Capacities for Self-Regulation. Van Horn, Lieberman, Using Dyadic Therapies to Treat Traumatized Young Children. DeRosa, Pelcovitz, Group Treatment for Chronically Traumatized Adolescents: Igniting SPARCS of Change. Saltzman, Babayon, Lester, Beardslee, Pynoos, Family-Based Treatment for Child Traumatic Stress: A Review and Report on Current Innovations. Kagan, Transforming Troubled Children into Tomorrow's Heroes. Pat-Horenzcyk, Ford, Brom, Toward A Developing Science and Practice of Childhood Traumatic Stress: Concluding Comments",0,0 +4135,Cognitive Changes During Prolonged Exposure Versus Prolonged Exposure Plus Cognitive Restructuring in Female Assault Survivors With Posttraumatic Stress Disorder.,"The authors report on changes in cognitions related to posttraumatic stress disorder (PTSD) among 54 female survivors of sexual and nonsexual assault with chronic PTSD who completed either prolonged exposure alone or in combination with cognitive restructuring. Treatment included 9-12 weekly sessions, and assessment was conducted at pretreatment, posttreatment, and a modal 12-month follow-up. As hypothesized, treatment that included prolonged exposure resulted in clinically significant, reliable, and lasting reductions in negative cognitions about self, world, and self-blame as measured by the Posttraumatic Cognitions Inventory. The hypothesis that the addition of cognitive restructuring would augment cognitive changes was not supported. Reductions in these negative cognitions were significantly related to reductions in PTSD symptoms. The addition of cognitive restructuring did not significantly augment the cognitive changes. Theoretical implications of the results are discussed.",0,0 +4136,The Use of Debriefing With Children,"The debate over the use of psychological debriefing in the early aftermath of a traumatic event has raged for decades, yet little attention has been paid to its use with perhaps the most vulnerable of victims, children and adolescents. While recommendations against the use of group debriefing with adults seem to have been made based on research of individual debriefing, recommendations regarding its use with children have been made based on the adult literature. In this review, we outline the possible mechanisms of harm and benefit of debriefing with a discussion of developmental concerns. The available empirical and nonempirical literature on the use of debriefing with youth is summarized. While research does not currently evidence harm in the use of debriefing with children, there is no strong support for its use either. We present both clinical considerations and research implications as they relate to debriefing as well as what this debate has taught us about the challenges to disseminating and evaluating early crisis interventions in general. © 2015, Springer Science+Business Media New York.",0,0 +4137,Development of the World Health Organization WHOQOL-BREF Quality of Life Assessment,"Background. The paper reports on the development of the WHOQOL-BREF, an abbreviated version of the WHOQOL-100 quality of life assessment. Method. The WHOQOL-BREF was derived from data collected using the WHOQOL-100. It produces scores for four domains related to quality of life: physical health, psychological, social relationships and environment. It also includes one facet on overall quality of life and general health. Results. Domain scores produced by the WHOQOL-BREF correlate highly (0·89 or above) with WHOQOL-100 domain scores (calculated on a four domain structure). WHOQOL-BREF domain scores demonstrated good discriminant validity, content validity, internal consistency and test–retest reliability. Conclusion. These data suggest that the WHOQOL-BREF provides a valid and reliable alternative to the assessment of domain profiles using the WHOQOL-100. It is envisaged that the WHOQOL-BREF will be most useful in studies that require a brief assessment of quality of life, for example, in large epidemiological studies and clinical trials where quality of life is of interest. In addition, the WHOQOL-BREF may be of use to health professionals in the assessment and evaluation of treatment efficacy.",0,0 +4138,"Post-traumatic stress disorder, depression, anxiety and quality of life in patients with traffic-related injuries","This paper reports a study to investigate and follow-up relationships between post-traumatic stress disorder, anxiety, depression and quality of life in patients after traffic-related injuries.Worldwide, traffic accidents kill 1.2 million people and injure 50 million people per year. Accidental injuries are fourth in the top five causes of death in Taiwan. For survivors, traffic accidents not only cause physical impairments, but also psychological trauma, such as post-traumatic stress disorder, depression and anxiety, all of which affect the quality of life.An exploratory, correlational design was used, and participants were recruited consecutively. Data were collected at 1 and 6 weeks post-injury for 64 patients from two major medical centres in Taiwan. Instruments were the New Injury Severity Scale, Post-traumatic Stress Disorder Reaction Index, Beck Depression Inventory, State Anxiety Inventory and Medical Outcomes Study Questionnaire. The data were collected in 2002.Statistically significant improvements occurred in depression, anxiety and the quality of life between week 1 and week 6 (P<0.05); high levels of post-traumatic stress disorder symptoms at week 1 (87.5%) and at week 6 (82.8%) showed no statistically significant improvement. There was a positive correlation between post-traumatic stress disorder and depression (r=0.70, P<0.001) and between post-traumatic stress disorder and anxiety (r=0.57, P<0.001), and a negative correlation between post-traumatic stress disorder and quality of life (r=-0.47, P<0.001). Depression was the most important variable to predict post-traumatic stress disorder at week 6, with depression levels at week 6 being a more powerful predictor than those at week 1. Regression analysis revealed that depression (19%) at week 1, depression at week 6 (45%), anxiety (3.8%) at week 6 and post-traumatic stress disorder (5.8%) explained a statistically significant amount of the variance at week 6.The findings suggest that traffic accidents have an impact on people's psychosocial wellbeing. Healthcare professionals need to implement interventions to decrease post-traumatic stress disorder, depression and anxiety to increase the quality of life for patients following traffic injuries.",0,0 +4139,Explosive anger as a response to human rights violations in post-conflict Timor-Leste,"Over several decades, clinicians have documented a pattern of explosive anger amongst survivors of gross human rights violations. Yet there is a dearth of epidemiological research investigating explosive anger in post-conflict countries. In the present study undertaken in Timor-Leste between March and November 2004, we identified an indigenous descriptor for explosive anger, including this index in the East Timor Mental Health Epidemiological Needs Study, a small area total population survey of 1544 adults living in an urban and a rural area. Other measures included indices of past trauma events, post-traumatic stress and general psychological distress, and socio-demographic variables. We found that 38% of the population reached the defined threshold of one attack of explosive anger a month (average=1 episode every 2-3 days). Only a minority of persons with explosive anger reached threshold scores for post-traumatic stress and general psychological distress. High levels of trauma exposure represented the strongest predictor of explosive anger. Latent class analysis identified three sub-groups with explosive anger: young trauma-affected adults living in the capital city who were unemployed; an older group, predominantly men, who had experienced extensive violence, including combat, assault and torture; and a less well characterized group of women. The findings offer support for a sequential model of explosive anger in which experiences of past persecution are compounded by frustrations in the post-conflict environment. The data provide a foundation for exploring further the role of trauma-induced anger in the cycles of violence that are prevalent in post-conflict countries.",0,0 +4140,ICD–11 Complex PTSD in U.S. National and Veteran Samples,"The 11th edition of the International Classification of Diseases ( ICD–11) is under development, and current proposals include major changes to trauma-related psychiatric diagnoses, including a heavily restricted definition of posttraumatic stress disorder (PTSD) and the addition of complex PTSD (CPTSD). We aimed to test the postulates of CPTSD in samples of 2,695 community participants and 323 trauma-exposed military veterans. CPTSD prevalence estimates were 0.6% and 13% in the community and veteran samples, respectively; one quarter to one half of those with PTSD met criteria for CPTSD. There were no differences in trauma exposure across diagnoses. A factor mixture model with two latent dimensional variables and four latent classes provided the best fit in both samples: Classes differed by their level of symptom severity but did not differ as a function of the proposed PTSD versus CPTSD diagnoses. These findings should raise concerns about the distinctions between CPTSD and PTSD proposed for ICD–11.",0,0 +4141,"Early PTSD Symptom Trajectories: Persistence, Recovery, and Response to Treatment: Results from the Jerusalem Trauma Outreach and Prevention Study (J-TOPS)","Uncovering heterogeneities in the progression of early PTSD symptoms can improve our understanding of the disorder's pathogenesis and prophylaxis.To describe discrete symptom trajectories and examine their relevance for preventive interventions.Latent Growth Mixture Modeling (LGMM) of data from a randomized controlled study of early treatment. LGMM identifies latent longitudinal trajectories by exploring discrete mixture distributions underlying observable data.Hadassah Hospital unselectively receives trauma survivors from Jerusalem and vicinity.Adult survivors of potentially traumatic events consecutively admitted to the hospital's emergency department (ED) were assessed ten days and one-, five-, nine- and fifteen months after ED admission. Participants with data at ten days and at least two additional assessments (n = 957) were included; 125 received cognitive behavioral therapy (CBT) between one and nine months.We used LGMM to identify latent parameters of symptom progression and tested the effect of CBT on these parameters. CBT consisted of 12 weekly sessions of either cognitive therapy (n = 41) or prolonged exposure (PE, n = 49), starting 29.8±5.7 days after ED admission, or delayed PE (n = 35) starting at 151.8±42.4 days. CBT effectively reduced PTSD symptoms in the entire sample.Latent trajectories of PTSD symptoms; effects of CBT on these trajectories.THREE TRAJECTORIES WERE IDENTIFIED: Rapid Remitting (rapid decrease in symptoms from 1- to 5-months; 56% of the sample), Slow Remitting (progressive decrease in symptoms over 15 months; 27%) and Non-Remitting (persistently elevated symptoms; 17%). CBT accelerated the recovery of the Slow Remitting class but did not affect the other classes.The early course of PTSD symptoms is characterized by distinct and diverging response patterns that are centrally relevant to understanding the disorder and preventing its occurrence. Studies of the pathogenesis of PTSD may benefit from using clustered symptom trajectories as their dependent variables.",1,0 +4142,Heightened pain perception in illicit substance–using patients in the ED: implications for management,"Substance users are commonly perceived to overstate their pain. Few data exist comparing pain intensity, perception, and related psychiatric comorbidities in the emergency department (ED) population. To compare pain severity, duration, interference with function, and psychiatric and mood disturbance in substance-using (SU) and non–substance-using (NSU) patients in the ED. This is a cross-sectional study. The setting is in an urban ED. Participants are SU and NSU patients in moderate to severe pain (numerical rating scale, 5-10). Outcome measures are as follows: pain intensity and duration, other painful conditions, pain-related functional interference (0-10), psychiatric disorders, and mood distress (profile of mood scale, 0-44). Of the 148 patients who enrolled, 28 (19%) reported recent illicit substance use (SU) and 120 (81%) did not (NSU). The SU patients' mean pain intensity was 8.96 (confidence interval [CI], 7.47-8.14) vs 7.81 (CI, 8.48-9.45) for NSU ( P = .003). The SU patients reported higher levels of pain interference. Fifty-four percent of SU patients vs 31% of NSU patients reported a psychiatric illness ( P = .02). Mean Profile of Mood State score was higher in SU (32.3; CI, 27.4-37.1) than in NSU (22.5; CI, 20.2-24.8; P < .001). Chronic pain was reported by 29% of SU patients vs 16% of NSU patients, and 75% of SU patients vs 58% of NSU patients reported another concurrent painful condition ( P = .10). The SU patients report more severe pain and functional interference, more psychiatric illness and mood distress, and more chronically painful conditions. Given the complex interplay between pain, substance use, and mood disorders, increased attention should be paid to identifying patients with these associated conditions and to facilitating appropriate referrals. Effective treatment of this challenging patient population requires treating the entirety of their medical, psychiatric, and addictive diseases.",0,0 +4143,The effectiveness of mirtazapine in the treatment of post-traumatic stress disorder: A 24-week continuation therapy,"Few studies for the long-term effects of antidepressants on post-traumatic stress disorder (PTSD) have been conducted. The aim of the present study was to investigate the effectiveness of mirtazapine during the 24-week continuation treatment in patients with PTSD. Out of 15 patients who participated in the previous 8-week short-term study, 12 patients completed 24-week continuation treatment with mirtazapine. The effectiveness was evaluated at week 12 and week 24 using Impact of Event Scale-Revised (IES-R), Short PTSD Rating Interview (SPRINT), Interviewer-Administered Structured Interview for PTSD (SIP) and Montgomery-Asberg Depression Rating Scale (MADRS). The tolerability of continuation treatment was also reported. The scores on the IES-R, SPRINT, SIP and MADRS were significantly reduced over time from baseline to week 24, the end-point (F=36.1, d.f.=4, P<0.001; F=106.3, d.f.=4, P<0.001; F=121.1, d.f.=4, P<0.001; F=198.9, d.f.=4, P<0.001). On post-hoc analysis, the scores of all four measures were significantly reduced at the end point since week 8. However, after Bonferroni's correction, that was statistically significant in SPRINT only. The number of patients whose scores were reduced over 50% in all four scales had a tendency of incremental increase from three at week 8 to eight at the end point (P=0.063). No serious drug-related side-effects occurred. These results suggest that the mirtazapine may be effective in the continuation treatment of PTSD as well as short-term treatment. Further and better-designed studies are necessary.",0,0 +4144,Impact of age on long-term cognitive function after traumatic brain injury.,"To examine the association of age and time postinjury with cognitive outcome 5-22 years following traumatic brain injury (TBI), in relation to matched uninjured controls.One hundred twelve participants with mild to very severe TBI, aged 16-81 years at the time of injury, were cognitively assessed on measures of processing speed and attention, verbal and visual memory, executive function, and working memory. Results were compared with those of 112 healthy controls individually matched for current age, gender, education, and estimated IQ.Older injured individuals performed worse than did younger injured individuals across all cognitive domains, after controlling for the performance of controls. In relation to matched controls, long-time survivors performed disproportionately worse than did more recently injured individuals, irrespective of age.After maximum spontaneous recovery from TBI, poorer cognitive functioning appears to be associated with both older age at the time of injury and increased time postinjury. These findings have implications for prognosis, early treatment recommendations, and long-term issues of differential diagnosis and management planning.",0,0 +4145,Dose-effect relationships of trauma to symptoms of depression and post-traumatic stress disorder among Cambodian survivors of mass violence,"The dose-effect relationships of cumulative trauma to the psychiatric symptoms of major depression and post-traumatic stress disorder (PTSD) in a community study of Cambodian survivors of mass violence were evaluated.In 1990, a survey of 1000 households was conducted in a Thai refugee camp (Site 2) using a multi-stage random sampling design. Trauma history and psychiatric symptoms were assessed for two time periods. Analysis used linear dose-response regression modelling.993 Cambodian adults reported a mean of 14 Pol Pot era trauma events and 1.3 trauma events during the past year. Symptom categories of depression, PTSD, dissociative and culturally dependent symptoms exhibited strong dose-effect responses with the exception of avoidance. All symptom categories, except avoidant symptoms, were highly correlated.Cumulative trauma continued to affect psychiatric symptom levels a decade after the original trauma events. The diagnostic validity of PTSD criteria, with the notable exception of avoidance, was supported. Inclusion of dissociative and culturally dependent symptoms increased the cultural sensitivity of PTSD.",0,0 +4146,Personalidad y resiliencia en un cuerpo especial de la Policía Nacional de España,"Resumen Se valora la relacion entre datos sociodemograficos, personalidad y resiliencia en una muestra de 348 policias masculinos de las unidades de intervencion policial (UIP) de Espana (N = 348) entre los 23 y los 38 anos (M = 26.88, DT = 3.12). Los resultados mostraron que la edad y el nivel educativo junto con la dominancia, la escrupulosidad, perseverancia, control de los impulsos y emociones estaban muy relacionados con la resiliencia. Ademas, el 66% de la varianza en resiliencia vendria dado por cuatro variables: la edad y el nivel academico y el teson y el control de las emociones. Se discute la importancia de algunas variables socio-demograficas y diferencias individuales como predictoras del nivel de resiliencia en profesionales especializados de la policia y se abren algunas vias de trabajo para el estudio de la resiliencia en otros colectivos profesionales expuestos de forma constante a situaciones de extrema adversidad.",0,0 +4147,Longitudinal trajectories and predictors of adolescent suicidal ideation and attempts following inpatient hospitalization.,"Remarkably little is known regarding the temporal course of adolescent suicidal ideation and behavior, the prediction of suicidal attempts from changes in suicidal ideation, or the prediction of suicidal attempts after accounting for suicidal ideation as a predictor. A sample of 143 adolescents 12-15 years old was assessed during psychiatric inpatient hospitalization and again at 3, 6, 9, 15, and 18 months postdischarge through a series of structured interviews and parent- and adolescent-reported instruments. Symptoms of depression, posttraumatic stress disorder, externalizing psychopathology, hopelessness, and engagement in several forms of self-injurious/suicidal behaviors (i.e., suicide threats/gestures, plans, nonsuicidal self-injury [NSSI]) were assessed. Latent growth curve analyses revealed a period of suicidal ideation remission between baseline and 6 months following discharge, as well as a subtle period of suicidal ideation reemergence between 9 and 18 months postdischarge. Changes in suicidal ideation predicted suicide attempts. After accounting for the effects of suicidal ideation, baseline suicide threats/gestures also predicted future suicide attempts. Higher adolescent-reported depressive symptoms, lower parent-reported externalizing symptoms, and higher frequencies of NSSI predicted weaker suicidal ideation remission slopes. Findings underscore the need for more longitudinal research on the course of adolescent suicidality.",0,0 +4148,Adapted Character Styles of Vietnam Veterans with Posttraumatic Stress Disorder,"A total of 189 male Vietnam veterans who were admitted to a specialized inpatient treatment program were evaluated using the Millon Clinical Multiphasic Personality Inventory to assess character styles. The veterans were assessed for Posttraumatic Stress Disorder by using a subscale of the Minnesota Multiphasic Personality Inventory (MMPI) and 72% of the patients were classified as having Posttraumatic Stress Disorder. The character styles of passive-aggressive, schizoid, avoidant, and borderline were significantly associated with these patients. The most common 2-point profile was passive-aggressive and avoidant (8-2 or 2–8) and was significantly related to the diagnosis. While drug and alcohol abuse were common problem areas for the entire sample, the profile of patients with Posttraumatic Stress was different from those of substance abusers. These results indicate that treating Vietnam veterans with this disorder requires adopting strategies which include a character style focus as well as a symptom focus.",0,0 +4149,"A pilot study on peritraumatic dissociation and coping styles as risk factors for posttraumatic stress, anxiety and depression in parents after their child's unexpected admission to a Pediatric Intensive Care Unit","To study the prevalence of posttraumatic stress disorder (PTSD), anxiety and depression in parents three months after pediatric intensive care treatment of their child and examine if peritraumatic dissocation and coping styles are related to these mental health problems.This is a prospective cohort study and included parents of children unexpectedly admitted to the Pediatric Intensive Care Unit (PICU) from January 2006 to March 2007. At three months follow-up parents completed PTSD (n = 115), anxiety and depression (n = 128) questionnaires. Immediately after discharge, parents completed peritraumatic dissocation and coping questionnaires. Linear regression models with generalized estimating equations examined risk factors for mental health problems.Over 10% of the parents were likely to meet criteria for PTSD and almost one quarter for subclinical PTSD. Respectively 15% to 23% of the parents reported clinically significant levels of depression and anxiety. Peritraumatic dissocation was most strongly associated with PTSD, anxiety as well as depression. Avoidance coping was primarily associated with PTSD.A significant number of parents have mental health problems three months after unexpected PICU treatment of their child. Improving detection and raise awareness of mental health problems is important to minimize the negative effect of these problems on parents' well-being.",0,0 +4150,Mental health diagnoses and counseling among pilots of remotely piloted aircraft in the United States Air Force.,"Remotely piloted aircraft (RPA), also known as drones, have been used extensively in the recent conflicts in Iraq and Afghanistan. Although RPA pilots in the U.S. Air Force (USAF) have reported high levels of stress and fatigue, rates of mental health (MH) diagnoses and counseling in this population are unknown. We calculated incidence rates of 12 specific MH outcomes among all active component USAF RPA pilots between 1 October 2003 and 31 December 2011, and by various demographic and military variables. We compared these rates to those among all active component USAF manned aircraft (MA) pilots deployed to Iraq/Afghanistan during the same period. The unadjusted incidence rates of all MH outcomes among RPA pilots (n=709) and MA pilots (n=5,256) were 25.0 per 1,000 person-years and 15.9 per 1,000 person-years, respectively (adjusted incidence rate ratio=1.1, 95% confidence interval=0.9-1.5; adjusted for age, number of deployments, time in service, and history of any MH outcome). Th ere was no significant difference in the rates of MH diagnoses, including post-traumatic stress disorder, depressive disorders, and anxiety disorders between RPA and MA pilots. Military policymakers and clinicians should recognize that RPA and MA pilots have similar MH risk profiles.",0,0 +4151,Psychopathology in Substance Abusing Women Reporting Childhood Sexual Abuse,"This study compared MMPI-2 profiles and evaluated the ability of the MMPI-2 and its two new post-traumatic stress scales (PK and PS) to discriminate women in outpatient substance abuse treatment reporting positive (n = 24) and negative (n = 69) child sexual abuse histories. T-tests revealed significantly higher mean scores for the sexual abuse group for the following scales: F, 1, 2, 3, 4, 6, 7, and 8. A discriminant analysis yielded a linear function of L, F, 3, 5, 8, and PK that correctly categorized 75% with positive histories and 77% with negative histories. The optimal cutoff PK score was 17, which correctly classified 75% and 46% of those reporting positive and negative abuse histories, respectively. These findings support early identification of abuse survivors among substance abusing women and suggests that the MMPI-2 may be useful in patient-treatment matching.",0,0 +4152,Historical trauma: Politics of a conceptual framework,"The concept of historical trauma (HT) is compelling: Colonialism has set forth cumulative cycles of adversity that promote morbidity and mortality at personal and collective levels, with especially strong mental health impacts. Yet as ongoing community-based as well as scholarly discussions attest, lingering questions continue to surround HT as a framework for understanding the relationships between colonialism and indigenous mental health. Through an overview of 30 recent peer-reviewed publications that aim to clarify, define, measure, and interpret how HT impacts American Indian and Alaska Native (AIAN) mental health, this paper examines how the conceptual framework of HT has circulated in ways shaped by interactions among three prominent research approaches: evidence-based, culturally relevant, and decolonizing. All define current approaches to AIAN mental health research, but each sets forth different conceptualizations of the connections between colonialism and psychological distress. The unfolding trajectory of research about HT reflects persistent tensions in how these frameworks interact, but also possibilities for better integrating them. These considerations aim to advance conversations about the politics of producing knowledge about AIAN mental health, and support ongoing calls for greater political pluralism in mental health research.",0,0 +4153,Adverse Psychological Impact of Operative Obstetric Interventions: A Prospective Longitudinal Study,"Objective: This paper reports the findings of a prospective longitudinal study of 272 nulliparous pregnant women, which investigated as one of its objectives the psychological sequelae of obstetric procedures. Method: Participants completed structured interviews and standardised, published psychometric questionnaires, including the Rosenberg Self-Esteem Scale and the Profile of Mood States late in pregnancy and again early in the postpartum period. Results: Little evidence was found to support the notion that the total number of obstetric interventions was linked to a deterioration in postpartum mood. Significant adverse psychological effects were associated with the mode of delivery. Those women who had spontaneous vaginal deliveries were most likely to experience a marked improvement in mood and an elevation in self-esteem across the late pregnancy to early postpartum interval. In contrast, women who had Caesarean deliveries were significantly more likely to experience a deterioration in mood and a diminution in self-esteem. The group who experienced instrumental intervention in vaginal deliveries fell midway between the other two groups, reporting neither an improvement nor a deterioration in mood and self-esteem. Conclusions: The findings of this study suggest that operative intervention in first childbirth carries significant psychological risks rendering those who experience these procedures vulnerable to a grief reaction or to posttraumatic distress and depression.",0,0 +4154,Investigating the dissociative subtype of posttraumatic stress disorder in a sample of traumatized detained youth.,"In this study, we tested the validity of a dissociative subtype in a sample of 225 detained adolescents (142 boys, 83 girls) likely meeting full or partial criteria for posttraumatic stress disorder (PTSD). Competing theories of dissociation pose controversy regarding dissociation as a taxon versus a continuum, and results of the current study contribute to this debate by providing evidence of distinct group differences between those high and low in dissociation. Mixture modeling revealed 2 groups of youth with differing levels of depersonalization/derealization dissociative symptoms. Differences between the 2 groups of youth were investigated regarding trauma exposure and several posttraumatic reactions: posttraumatic stress symptoms (PTSS), emotion dysregulation, and emotional numbing. Compared with youth classified in the low-dissociation group, youth who exhibited high levels of dissociation demonstrated higher levels of total PTSS, posttraumatic symptom clusters of emotional numbing, intrusion, and associated features, as well as reporting more difficulties with emotion dysregulation. To test theory regarding the factors that increase the likelihood of persistent dissociation, bootstrapped regression analyses were performed to examine the possibility of an indirect effect of peritraumatic dissociation. Results consistent with statistical mediation suggested that the presence of peritraumatic dissociation at the time of trauma may contribute to the continuation of dissociative symptoms as a more generalized pattern. The results of the current study have implications for clinical treatment with traumatized youth.",0,0 +4155,Over-time changes in PTSD and depression among children surviving the 1999 Istanbul earthquake,"Objective: To follow-up on child and adolescent victims with full criteria of PTSD and depression, and to examine the impact of treatment. Method: One to two months following a 7.4-magnitude quake in Turkey, 160 students were examined by self-report questionnaire, psychiatric interview, clinician-administered post-traumatic stress disorder scale (CAPS), and depression and anxiety inventories. At baseline, 96 students were diagnosed with PTSD, and 49 had comorbid depression with anxiety symptoms. After 18-20 months, 74 of 96 students were found and reassessed by psychiatric interview and CAPS; 25 had been treated with cognitive-behavioral therapy (CBT) and pharmocotherapy, and 49 did not have any treatment. Binary logistic regression was used to identify significant predictors of persistent PTSD. Variables entered included pre-quake, quake and post-quake factors, having co-morbid depression upon initial interview, receipt of drug therapy, and number of months of CBT. Results: At follow-up, many had symptoms of PTSD with anxiety, but only 14 subjects met the full criteria of PTSD, and four students had major depression with anxiety symptoms. Only one variable-having been in serious personal danger during the quake (e.g., trapped in the house or under rubble)-was significantly associated with being symptomatic at follow-up. Conclusion: Regardless of receipt of treatment, diagnoses of PTSD and depression were much reduced. More research is needed about resiliency factors. © 2009 Steinkopff Verlag Darmstadt.",0,0 +4156,Resilience and Trajectories of Posttraumatic Stress Among Youth Exposed to Disaster,"Multiple trajectories of posttraumatic stress (PTS) symptoms are hypothesized following disaster in a number of theoretical perspectives. Increasingly, those with rapidly declining, transient, or stable low symptoms are defined as resilient. This article examines trajectories to understand acute reactions to disaster, and explores the need to define resilience as more than just symptom trajectories.An urban school-based sample of youth exposed to both hurricanes Katrina and Gustav (n=141; grades 4 through 8) were assessed for PTS symptoms at 12 months and 6 months pre-Gustav (Times 1 and 2); and then again at 1 month post-Gustav (Time 3).Data indicated that there were significant decreases in mean PTS symptoms post-Gustav, but individual trajectories were identified consistent with theory. Whereas an ostensibly resilient group was identified (stable low symptoms), results suggest that the group was heterogeneous in terms of disaster experiences, and that those with low symptoms but relatively high Katrina disaster exposure had a unique coping style.Results provide prospective data to support theories of multiple trauma exposure trajectories, and highlight the importance of empirically identifying resilient youth in terms of both functioning and level of risk exposure in disaster samples.",0,0 +4157,MDMA assisted psychotherapy found to have a large effect for chronic post-traumatic stress disorder,"Comments on an article by Peter Oehen et al. (see record 2012-34703-005). Oehen et al. (2013) reported a well-designed, randomized, double-blind, active placebo controlled trial of MDMA assisted psychotherapy in a small sample (N=12) of participants with resistant, chronic post-traumatic stress disorder (PTSD). Given that the sample is small, the statistical power of the study using analysis of variance is low. A potential solution is to express the findings in terms of effect sizes using Cohen's d, which is a way of estimating the magnitude of the difference between two means that is independent of the sample size. In that case, a d value of 0.20 is considered to be a small effect, 0.50 a medium effect and 0.80 a large effect. Thus, given than the full dose group had higher baseline levels of both clinician-observed and self-reported PTSD symptoms than the active placebo group, authors can say that these subjects with resistant, chronic PTSD showed, on average, a substantial improvement in PTSD symptoms over the course of MDMA assisted psychotherapy. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +4158,,"Findings from a longitudinal study are presented on the relationships between the problems and stresses resulting from Hurricane Andrew and posthurricane minor deviant behavior. The sample (N = 4,978) included Hispanic, African-American, and White non-Hispanic middle school students enrolled in Dade County, Florida public schools. Two waves of data were collected prior to the hurricane; a third was obtained approximately 6 months following the storm. Results indicated that females were likely to report higher levels of hurricane-related stress symptoms than males. After controlling for prehurricane levels of minor deviance, family support, and race/ethnicity, hurricane stress symptom level remained a significant predictor of posthurricane minor deviant behavior. The findings lend support to stress theories of social deviance.",0,0 +4159,Risk Factors for Posttraumatic Stress Disorder in Haitian Students,"The aim of this study was to assess the prevalence of posttraumatic stress disorder (PTSD) in undergraduate students after the Haiti earthquake on January 12, 2010, as well as to identify the risk factors involved in the development of PTSD symptoms in this sample. Evaluations concerning depression, anxiety, risk and protective factors, and PTSD symptoms were conducted in 246 Haitian undergraduate students enrolled in a Dominican private university. Results indicate a prevalence of 36% for PTSD 2 years after the earthquake, with a high prevalence also of depression (31.7%) and anxiety (21.1%). Some of the risk factors identified are being female, a history of psychiatric treatment, and the amount of personal and material losses. The instauration of crisis management and follow-up protocols after traumatic events was deemed to be needed. Further research is necessary to study the long-term effects of this tragedy, not only in undergraduate students, but also in the working class Haitian immigrants living in the Dominican Republic.",0,0 +4160,Quantitative testing of pain perception in subjects with PTSD – Implications for the mechanism of the coexistence between PTSD and chronic pain,"Post-traumatic stress disorder (PTSD) often co-occurs with chronic pain. Neither the underlying mechanism of this comorbidity nor the nature of pain perception among subjects with PTSD is well defined. This study is the first systematic and quantitative evaluation of pain perception and chronic pain in subjects with PTSD. The study group consisted of 32 outpatients with combat- and terror-related PTSD, 29 outpatients with anxiety disorder and 20 healthy controls. Quantitative somatosensory testing included the measurement of warm, cold, light touch and heat-pain thresholds and responses to acute suprathreshold heat and mechanical stimuli. Chronic pain was characterized, and levels of PTSD and anxiety symptomatology were assessed by self-report questionnaires. Subjects with PTSD exhibited higher rates of chronic pain, more intense chronic pain and more painful body regions compared with the other two groups. PTSD severity correlated with chronic pain severity. Thresholds of subjects with PTSD were significantly higher than those of subjects with anxiety and healthy controls, but they perceived suprathreshold stimuli as being much more intense than the other two groups. These results suggest that subjects with PTSD exhibit an intense and widespread chronic pain and a unique sensory profile of hyposensitivity to pain accompanied by hyper-reactivity to suprathreshold noxious stimuli. These features may be attributed to the manner with which PTSD subjects emotionally interpret and respond to painful stimuli. Alternatively, but not mutually exclusive, the findings may reflect altered sensory processing among these subjects.",0,0 +4161,"Anger, PTSD, and the nuclear family: A study of Cambodian refugees","This study profiles the family-directed anger of traumatized Cambodian refugees, all survivors of the Pol Pot genocide (1975–1979), who were patients at a psychiatric clinic in Lowell, MA, USA. We focus on the nuclear family (NF) unit, the NF unit defined as the patient's “significant other” (i.e. spouse or boyfriend/girlfriend) and children. Survey data were collected from a convenience sample of 143 Cambodian refugee patients from October 2006 to August 2007. The study revealed that 48% (68/143) of the patients had anger directed toward a NF member in the last month, with anger directed toward children being particularly common (64 of the 143 patients, or 49% [64/131] of the patients with children). NF-type anger was severe, for example, almost always resulting in somatic arousal (e.g., causing palpitations in 91% [62/68] of the anger episodes) and often in trauma recall and fears of bodily dysfunction. Responses to open-ended questions revealed the causes of anger toward a significant other and children, the content of anger-associated trauma recall, and what patients did to gain relief from anger. A type of cultural gap, namely, a linguistic gap (i.e., the parent's lack of English language skills and the child's lack of Khmer language skills), seemingly played a role in generating conflict and anger. NF-type anger was associated with PTSD presence. The effect of anger on PTSD severity resulted in part from anger-associated trauma recall and fears of bodily dysfunction, with 54% of the variance in PTSD severity explained by that regression model. The study: 1) suggests that among traumatized refugees, family-related anger is a major clinical concern; 2) illustrates how family-related anger may be profiled and investigated in trauma-exposed populations; and 3) gives insights into how family-related anger is generated in such populations.",0,0 +4162,Sleep and anxiety disorders,"Sleep disturbances-particularly insomnia - are highly prevalent in anxiety disorders and complaints such as insomnia or nightmares have even been incorporated in some anxiety disorder definitions, such as generalized anxiety disorder and posttraumatic stress disorder. In the first part of this review, the relationship between sleep and anxiety is discussed in terms of adaptive response to stress. Recent studies suggested that the corticotropin-releasing hormone system and the locus ceruleus-autonomic nervous system may play major roles in the arousal response to stress. It has been suggested that these systems may be particularly vulnerable to prolonged or repeated stress, further leading to a dysfunctional arousal state and pathological anxiety states, Polysomnographic studies documented limited alteration of sleep in anxiety disorders. There is some indication for alteration in sleep maintenance in generalized anxiety disorder and for both sleep initiation and maintenance in panic disorder; no clear picture emerges for obsessive-compulsive disorder or posttraumatic stress disorder. Finally, an unequivocal sleep architecture profile that could specifically relate to a particular anxiety disorder could not be evidenced; in contrast, conflicting results are often found for the same disorder. Discrepancies between studies could have been related to illness severity, diagnostic comorbidity, and duration of illness. A brief treatment approach for each anxiety disorder is also suggested with a special focus on sleep.",0,0 +4163,Foundations of posttraumatic stress disorder: Does early life trauma lead to adult posttraumatic stress disorder?,"Abstract The effects of childhood abuse are diverse, and although pathology is not the only outcome, psychiatric illness, including posttraumatic stress disorder (PTSD), can develop. However, adult PTSD is less common among those who experienced single-event traumas as children than it is among those who experienced childhood abuse. In addition, PTSD is more common among adults than children who experienced childhood abuse. Such evidence raises doubt about the direct, causal link between childhood trauma and adult PTSD. The experience of childhood trauma, and in particular abuse, has been identified as a risk factor for subsequent development of PTSD following exposure to adult trauma, and a substantial literature identifies revictimization as a factor that plays a pivotal role in this trajectory. The literature on the developmental effects of childhood abuse and pathways to revictimization, when considered in tandem with the biological effects of early stress in animal models, may provide some explanations for this. Specifically, it seems possible that permanent sensitization of the hypothalamic–pituitary–adrenal axis and behavioral outcomes are a consequence of childhood abuse, and these combine with the impact of retraumatization to sustain, perpetuate, and amplify symptomatology of those exposed to maltreatment in childhood.",0,0 +4164,Outcomes and moderators of a preventive schoolbased mental health intervention for children affected by war in Sri Lanka: a cluster randomized trial,"We aimed to examine outcomes, moderators and mediators of a preventive school-based mental health intervention implemented by paraprofessionals in a war-affected setting in northern Sri Lanka. A cluster randomized trial was employed. Subsequent to screening 1,370 children in randomly selected schools, 399 children were assigned to an intervention (n=199) or waitlist control condition (n=200). The intervention consisted of 15 manualized sessions over 5 weeks of cognitive behavioral techniques and creative expressive elements. Assessments took place before, 1 week after, and 3 months after the intervention. Primary outcomes included post-traumatic stress disorder (PTSD), depressive, and anxiety symptoms. No main effects on primary outcomes were identified. A main effect in favor of intervention for conduct problems was observed. This effect was stronger for younger children. Furthermore, we found intervention benefits for specific subgroups. Stronger effects were found for boys with regard to PTSD and anxiety symptoms, and for younger children on pro-social behavior. Moreover, we found stronger intervention effects on PTSD, anxiety, and function impairment for children experiencing lower levels of current war-related stressors. Girls in the intervention condition showed smaller reductions on PTSD symptoms than waitlisted girls. We conclude that preventive school-based psychosocial interventions in volatile areas characterized by ongoing war-related stressors may effectively improve indicators of psychological wellbeing and posttraumatic stress-related symptoms in some children. However, they may undermine natural recovery for others. Further research is necessary to examine how gender, age and current war-related experiences contribute to differential intervention effects.",0,0 +4165,Genetic Association Analysis of 300 Genes Identifies a Risk Haplotype in SLC18A2 for Post-traumatic Stress Disorder in Two Independent Samples,"The genetic architecture of post-traumatic stress disorder (PTSD) remains poorly understood with the vast majority of genetic association studies reporting on single candidate genes. We conducted a large genetic study in trauma-exposed European-American women (N=2538; 845 PTSD cases, 1693 controls) by testing 3742 SNPs across more than 300 genes and conducting polygenic analyses using results from the Psychiatric Genome-Wide Association Studies Consortium (PGC). We tested the association between each SNP and two measures of PTSD, a severity score and diagnosis. We found a significant association between PTSD (diagnosis) and SNPs (top SNP: rs363276, odds ratio (OR)=1.4, p=2.1E-05) in SLC18A2 (vesicular monoamine transporter 2). A haplotype analysis of 9 SNPs in SLC18A2, including rs363276, identified a risk haplotype (CGGCGGAAG, p=0.0046), and the same risk haplotype was associated with PTSD in an independent cohort of trauma-exposed African-Americans (p=0.049; N=748, men and women). SLC18A2 is involved in transporting monoamines to synaptic vesicles and has been implicated in a number of neuropsychiatric disorders including major depression. Eight genes previously associated with PTSD had SNPs with nominally significant associations (p<0.05). The polygenic analyses suggested that there are SNPs in common between PTSD severity and bipolar disorder. Our data are consistent with a genetic architecture for PTSD that is highly polygenic, influenced by numerous SNPs with weak effects, and may overlap with mood disorders. Genome-wide studies with very large samples sizes are needed to detect these types of effects.",0,0 +4166,Examination of fatigue development in elite soccer in a hot environment: a multi-experimental approach,"The study examines fatigue in elite soccer played in hot conditions. High-profile soccer players (n=20) were studied during match play at ∼31 °C. Repeated sprint and jump performances were assessed in rested state and after a game and activity profile was examined. Additionally, heart rate (HR), blood lactate, muscle temperature and body mass changes were determined. Repeated sprint and jump performances were reduced (P<0.05) by 2.6% and 8.2%, respectively, after the game. The fatigue index in the repeated sprint test was 6.0±0.7% after the game compared with 1.7±1.0% at rest (P<0.05). High-intensity running was 57±4% lower (P<0.05) during the last 15-min interval of the game compared with the first 15-min period. No differences were observed in mean HR or blood lactates between halves. Muscle temperature was 40.5±0.4 °C after the first half, which was 0.8±0.2 °C higher (P<0.05) than after the second half. Net fluid loss during the game was >2% of the body mass. Correlations were observed between net-fluid loss and repeated sprint test fatigue index after the game (r=0.73, P<0.05) and Yo-Yo intermittent recovery, level 1 test performance and high-intensity running during the final 15 min of the game (r=0.51, P<0.05). The study provides direct evidence of compromised repeated sprint and jump performances induced by soccer match play and pronounced reduction in high-intensity running toward the end of an elite game played in a hot environment. This fatigue could be associated training status and hyperthermia/dehydration.",0,0 +4167,Traumatic Events and Mental Health in the Community: a New Zealand Study,"Background: Adverse mental health effects in response to a variety of distressing events in specific populations are well documented. However, comparatively little research has been conducted within large community samples outside North America. Aims: To assess the prevalence and psychological impact of specific traumatic events in a New Zealand community sample. Methods: Prevalence and psychological impact of 12 traumatic events was examined in a community sample of 1,500 New Zealand adults using a three-stage cluster sampling method. Traumatic events, psychological distress, psychological well-being, and post-traumatic stress disorder symptoms were assessed using modifi ed versions of the Traumatic Stress Schedule, Mental Health Inventory, and Civilian Mississippi Scale. The effects of age, gender and ethnicity were controlled for while assessing impact of traumatic events. Results: Sixty-one per cent of the sample experienced trauma events in their lifetime, with 9% experiencing events in the past year. Accident-related events were most common in the present sample. Violent crime produced the greatest impact. Tests of interactions involving age, gender, and ethnicity were not significant. Conclusions: New Zealand community-residing individuals experience post-traumatic stress symptoms, reduced psychological well-being, and increased psychological distress following the experience of violent crime and accidents specifically. Study limitations and suggestions for future research are discussed.",0,0 +4168,"Epidemiology of trauma, post-traumatic stress disorder (PTSD) and co-morbid disorders in Chile","Background. In this study we examined the prevalence rates of post-traumatic stress disorder (PTSD), types of trauma most often associated with PTSD, the co-morbidity of PTSD with other lifetime psychiatric disorders, which disorders preceded PTSD, and gender differences in PTSD and trauma exposure in a representative sample of Chileans. Method. The DSM-III-R PTSD and antisocial personality disorder modules from the Diagnostic Interview Schedule (DIS) and modules for a range of DSM-III-R diagnoses from the Composite International Diagnostic Interview (CIDI) were administered to a representative sample of 2390 persons aged 15 to over 64 years in three cities in Chile. Results. The lifetime prevalence of PTSD was 4·4% (2·5% for men and 6·2% for women). Among persons exposed to trauma, rape was most strongly associated with PTSD. Onset of PTSD significantly increased the risk of developing each of the 10 other tested disorders. Among those exposed to trauma, women were significantly more likely to develop PTSD, after controlling for assaultive violence. Conclusions. This study highlights the importance of investigating the prevalence of PTSD, patterns of co-morbidity of PTSD, and gender differences in PTSD in non-English-speaking countries.",0,0 +4169,Late and Long‐Term Effects of Breast Cancer Treatment and Surveillance Management for the General Practitioner,"To examine the most common long-term and late effects of breast cancer treatment, the American Society of Clinical Oncology guidelines for surveillance, and recommendations for the primary care provider's role in delivering breast cancer survivorship care.A comprehensive literature review was conducted using CINAHL, PubMed, Google Scholar, and hand searches using the search terms breast cancer, survivor, and long-term or late effects.Articles published in English from 2002 to 2012 that addressed the long-term or late effects of adults with breast cancer were included.Findings are discussed categorically, including the most common late and long-term psychosocial effects from relevant studies.Topics relevant to survivors included challenges to psychosocial, emotional, and cognitive well-being; satisfaction with life; sexuality; body image; anxiety; fear of recurrence and post-traumatic stress disorder; depression; cognitive dysfunction challenges to physical well-being; adverse cardiovascular events; fatigue; lymphedema; musculoskeletal symptoms; accelerated bone loss and fractures; pain; skin changes due to radiation; disease recurrence; and new breast cancers.With earlier detection methods and improvements in treatment options making breast cancer a highly survivable disease, there are more survivors of breast cancer than ever. The clinicians' role in survivorship care is more important than ever to manage the potential long-term and late effects of treatment, physical and emotional well-being, and recurrent disease surveillance. However, the clinician's role in cancer follow-up care is often poorly defined leading to a lack of awareness about the needs of survivors of breast cancer, suboptimal communication between providers and survivors, and an overall deficiency in quality care.",0,0 +4170,Self-injurious behaviors in posttraumatic stress disorder: An examination of potential moderators,"Despite increasing evidence for a relation between posttraumatic stress disorder (PTSD) and self-injurious behaviors (SIB), limited research has examined the factors that may moderate the associations between PTSD and both nonsuicidal SIB (deliberate self-harm; DSH) and suicidal SIB (suicide attempts). Nonetheless, research suggests that characteristics of the traumatic event, co-occurring borderline personality disorder (BPD), and emotion dysregulation may influence the relations between PTSD and SIB. Thus, the aim of this study was to examine the moderating role of these factors in the association between PTSD and SIB (including history and frequency of DSH and suicide attempts, and DSH versatility) among a sample of substance use disorder inpatients with ( n =116) and without ( n =130) a history of PTSD. Results from stepwise regression analyses indicate that sexual assault-related PTSD predicted suicide attempt frequency and DSH versatility among those with PTSD. Furthermore, results from hierarchical linear and logistic regression analyses suggest that co-occurring BPD moderates the relationship between PTSD and both DSH history and versatility and emotion dysregulation moderates the relationship between PTSD and DSH frequency. Specifically, the relations between PTSD and DSH outcomes were stronger among participants with co-occurring BPD and higher levels of emotion dysregulation. This study is limited by its reliance on cross-sectional, self-report data. Despite limitations, findings suggest distinct risk factors for suicide attempts and DSH, and highlight the importance of examining characteristics of the trauma and associated BPD and emotion dysregulation in assessing risk for SIB in PTSD.",0,0 +4171,Valoración psicológica en delitos de violencia de género mediante el Inventario Clínico y Multiaxial de Millon III (MCMI-III),"In this study, psychological assessment of 127 women presenting charges of gender-based violence (GVB) and 55 male suspects, were analyzed by the MCMI-III, as well as the influence of sociodemographic data and GVB features on these MCMI-III scores. Average age of women was 36.25 (SD = 10.48) and average age of men was 42.54 years old (SD = 12.93). Both groups were referred to the Legal Medicine Institute by the Woman Violence Court and all of them were administered the Millon Clinical Multiaxial Inventory III (MCMI-III). Differential profiles according to age, maltreatment duration and years of cohabitation were obtained. Women presented high scores in Social desirability, Compulsive personality, Anxiety, Dysthymia, Somatization and Depression. Men presented Narcissistic features, Depression and Substance abuse. As maltreatment extended in time, Schizoid, Depressive and Self-destructive features increased in women, as well as Dysthymia and PTSD, obtaining lower scores on Social desirability and Histrionic personality.",0,0 +4172,"Dynamics of in Vivo Release of Molt-Inhibiting Hormone and Crustacean Hyperglycemic Hormone in the Shore Crab, Carcinus maenas","Very little is known regarding the release patterns or circulating titers of neuropeptides in crustaceans, in particular those concerned with regulation of molting hormone (ecdysteroid) synthesis, molt-inhibiting hormone (MIH), and crustacean hyperglycemic hormone (CHH), which is also an adaptive hormone, centrally important in carbohydrate metabolism. Furthermore, the currently accepted model of molt control is founded on an untested hypothesis suggesting that molting can proceed only after decline in MIH titer. Accordingly, we measured simultaneous circulating neuropeptide profiles for both MIH and CHH by RIA of purified hemolymph during the molt cycle at fine temporal scale during day/night cycles and seasonally. For CHH we additionally determined release patterns after physiologically relevant stress. Results show that both hormones are released exclusively and episodically, rather than continuously, with notably short half-lives in circulation, suggesting dynamic and short-lived variations in levels of both hormones. During the molt cycle, there are no overt changes in MIH titer, except a massive and unprecedented increase in MIH during late premolt, just before ecdysis. The function of this hormone surge is unknown. Treatment with various stressors (hypoxia, temperature shock) showed that CHH release occurs extremely rapidly, within minutes of stress. Release of CHH after stressful episodes during premolt (when gut endocrine cells synthesize large quantities of CHH) is exclusively from the sinus gland: CHH from the gut is never involved in the stress response. The results show a hitherto unsuspected dynamism in release of MIH and CHH and suggest that currently accepted models of molt control must be reconsidered.",0,0 +4173,A causal model of post-traumatic stress disorder: disentangling predisposed from acquired neural abnormalities,"Discriminating neural abnormalities into the causes versus consequences of psychopathology would enhance the translation of neuroimaging findings into clinical practice. By regarding the traumatic encounter as a reference point for disease onset, neuroimaging studies of post-traumatic stress disorder (PTSD) can potentially allocate PTSD neural abnormalities to either predisposing (pre-exposure) or acquired (post-exposure) factors. Based on novel research strategies in PTSD neuroimaging, including genetic, environmental, twin, and prospective studies, we provide a causal model that accounts for neural abnormalities in PTSD, and outline its clinical implications. Current data suggest that abnormalities within the amygdala and dorsal anterior cingulate cortex represent predisposing risk factors for developing PTSD, whereas dysfunctional hippocampal-ventromedial prefrontal cortex (vmPFC) interactions may become evident only after having developed the disorder.",0,0 +4174,Analysis of a case series of workers with mobbing syndrome,"Mobbing represents nowadays a major challenge for Occupational Medicine. We examined, during the last seven years, 253 patients who asked medical assistance for psychopathological problems by them ascribed to mobbing in the working environment. All patients underwent occupational health visit, psychological counselling (including personality tests administration), and psychiatric evaluation. A clinical picture probably due to mobbing was diagnosed in 37 workers: 2 cases of Post-Traumatic Stress Disorder (PTSD), 33 of Adjustment Disorder (AD), and 2 of anxiety disorder. Regarding mobbing typology, we found 19 cases of vertical mobbing (by an employer/manager to employees), 14 cases of strategic mobbing, 3 cases of horizontal mobbing (among colleagues), and one non intentional mobbing. In conclusion, a pure mobbing syndrome was diagnosed in a lower proportion than that reported by other investigators. The described interdisciplinary approach appears useful for the diagnostic assessment of suspect mobbing cases, that in turn is crucial for prognosis and treatment, as well as in relation to medico-legal issues and work-related compensation claims.",0,0 +4175,Disasters and Depressive Symptoms in Children: A Review,"Background Disasters are destructive, potentially traumatic events that affect millions of youth each year.ObjectiveThe purpose of this paper was to review the literature on depressive symptoms among youth after disasters. Specifically, we examined the prevalence of depression, risk factors associated with depressive symptoms, and theories utilized in this research area.MethodsWe searched MEDLINE, PsycInfo, and PubMed electronic databases for English language articles published up to May 1, 2013. Reference lists from included studies were reviewed to capture additional studies. Only quantitative, peer reviewed studies, conducted with youth under the age of 18 years, that examined postdisaster depressive symptoms were included. Seventy-two studies met inclusion criteria. Prevalence of depressive symptoms, disaster type, correlates of depressive symptoms, and theories of depressive symptoms were reviewed.ResultsOnly 27 studies (38 %) reported on prevalence rates among youth in their sample. Prevalence rates of depression among youth postdisaster ranged from 2 to 69 %. Potential risk factors were identified (e.g., female gender, exposure stressors, posttraumatic stress symptoms). Theories were examined in less than one-third of studies (k = 21).ConclusionsGiven the variability in prevalence rates, difficulty identifying a single profile of youth at risk for developing depressive symptoms, and lack of a unifying theory emerging from the studies, recommendations for future research are discussed. Use of established batteries of assessments could enable comparisons across studies. Merging existing theories from children’s postdisaster and depression literatures could aid in the identification of risk factors and causal pathways.",0,0 +4176,Key determinants of the MMPI-PTSD subscale: Treatment considerations,"Seventy-five “in country” Vietnam combat psychiatric inpatients were given a battery of measures upon admission to the medical center. These included the MMPI, VETS Adjustment Scale, State-Trait Anxiety Scale, Rotter Locus of Control, Profile of Mood Scale, and a variation of the Figley Stress Scale that measures current stress. Post-traumatic stress disorder (PTSD) was determined by the MMPI-PTSD subscale. Ten of the battery variables were used as predictors for a multiple regression analysis on the MMPI-PTSD subscale. Results yielded a multiple R of .89 for two predictors, Figley Stress Scale and Rotter Locus of Control (external). Patients with PTSD, therefore, suffer most from perceived and experienced current stressors and a low sense of control. Arguments are made for more present-centered and interpersonal strategies in the treatment of PTSD combat veterans.",0,0 +4177,Understanding posttraumatic stress disorder: insights from the methylome,"Genome-wide association studies (GWAS) have identified numerous disease-associated variants; however, these variants have a minor effect on disease and explain only a small amount of the heritability of complex disorders. The search for the missing heritability has shifted attention to rare variants, copy number variants, copy neutral variants and epigenetic modifications. The central role of epigenetics, and specifically DNA methylation, in disease susceptibility and progression has become more apparent in recent years. Epigenetic mechanisms facilitate the response to environmental changes and challenges by regulating gene expression. This makes the study of DNA methylation in psychiatric disorders such as posttraumatic stress disorder (PTSD) highly salient, as the environment plays such a vital role in disease aetiology. The epigenome is dynamic and can be modulated by numerous factors, including learning and memory, which are important in the context of PTSD. Numerous studies have shown the effects of early life events, such as maternal separation and traumas during adulthood, on DNA methylation patterns and subsequent gene expression profiles. Aberrations in adaptive DNA methylation contribute to disease susceptibility when an organism is unable to effectively respond to environmental demands. Epigenetic mechanisms are also involved in higher order brain functions. Dysregulation of methylation is associated with neurodevelopmental and neurodegenerative cognitive disorders, affective disorders, addictive behaviours and altered stress responses. A thorough understanding of how the environment, methylome and transcriptome interact and influence each other in the context of fear and anxiety is integral to our understanding and treatment of stress-related disorders such as PTSD.",0,0 +4178,Functional significance of a novel 7-factor model of DSM-5 PTSD symptoms: Results from the National Health and Resilience in Veterans Study,"While posttraumatic stress disorder (PTSD) symptoms in the recently published Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are clustered into four factors, emerging confirmatory factor analytic studies suggest that this disorder is best characterized by seven symptom clusters, including re-experiencing, avoidance, negative affect, anhedonia, externalizing behaviors, and anxious and dysphoric arousal symptoms. To date, however, data are lacking regarding the relation between this novel model of DSM-5 PTSD symptoms and measures of clinical significance in this population (e.g., functioning).Using data from the National Health and Resilience in Veterans Study (NHRVS), a contemporary, nationally representative sample of 1484 U.S. veterans, we evaluated clinical and functional correlates of a novel 7-factor model of DSM-5 PTSD symptoms.Differential patterns of associations were observed between DSM-5 PTSD symptom clusters, and psychiatric comorbidities, suicidal ideation, hostility, and functioning and quality of life. Anhedonia symptoms, in particular, were strongly related to current depression, as well as reduced mental functioning and quality of life. Externalizing behaviors were most strongly related to hostility, supporting the convergent validity of this construct.Cross-sectional design and employment of self-report measures.These results suggest that a more refined 7-factor model of DSM-5 PTSD symptoms may provide greater specificity in understanding associations with comorbid psychopathology, suicidal ideation, and functioning and quality of life in U.S. veterans. They further suggest that prevention and treatment efforts that target distinct aspects of the PTSD phenotype may be more effective in mitigating key clinical and functional outcomes in this population.",0,0 +4179,Randomized controlled evaluation of an early intervention to prevent post-rape psychopathology,"A randomized between-group design was used to evaluate the efficacy of a video intervention to reduce post-traumatic stress disorder (PTSD) and other mental health problems, implemented prior to the forensic medical examination conducted within 72 h post-sexual assault. Participants were 140 female victims of sexual assault (68 video/72 nonvideo) aged 15 years or older. Assessments were targeted for 6 weeks (Time 1) and 6 months (Time 2) post-assault. At Time 1, the intervention was associated with lower scores on measures of PTSD and depression among women with a prior rape history relative to scores among women with a prior rape history in the standard care condition. At Time 2, depression scores were also lower among those with a prior rape history who were in the video relative to the standard care condition. Small effects indicating higher PTSD and Beck Anxiety Inventory (BAI) scores among women without a prior rape history in the video condition were observed at Time 1. Accelerated longitudinal growth curve analysis indicated a videoxprior rape history interaction for PTSD, yielding four patterns of symptom trajectory over time. Women with a prior rape history in the video condition generally maintained the lowest level of symptoms.",0,0 +4180,Facial asymmetry detection in patients with body dysmorphic disorder,"Cognitive-behavioral models of body dysmorphic disorder (BDD) propose that individuals with BDD may possess a better or more developed sense of aestheticality than do individuals without BDD. Evidence for this proposition, however, is limited. One perceptual process that could contribute to heightened aestheticality is the ability to detect differences in symmetry. In this experiment we tested whether individuals with BDD (n=20), relative to individuals with obsessive compulsive disorder (OCD; n=20) and healthy controls (n=20), show an enhanced ability to detect differences in the symmetry of others' faces, symmetry of dot arrays, and/or show a greater preference for symmetrical faces. Individuals with BDD were not significantly more accurate in detecting differences in facial symmetry or dot arrays relative to individuals with OCD and healthy controls. Individuals with OCD took longer to make facial symmetry judgments than did individuals in the other two groups. All participants, regardless of diagnostic group, preferred more symmetrical faces than nonsymmetrical ones. Taken together, our results do not support a heightened perceptual ability or evaluative preference for symmetry among individuals with BDD.",0,0 +4181,Peritraumatic and trait dissociation differentiate police officers with resilient versus symptomatic trajectories of posttraumatic stress symptoms,"Research has consistently demonstrated that stress reactions to potentially traumatic events do not represent a unified phenomenon. Instead, individuals tend to cluster into prototypical response patterns over time including chronic symptoms, recovery, and resilience. We examined heterogeneity in a posttraumatic stress disorder (PTSD) symptom course in a sample of 178 active-duty police officers following exposure to a life-threatening event using latent growth mixture modeling (LGMM). This analysis revealed 3 discrete PTSD symptom trajectories: resilient (88%), distressed-improving (10%), and distressed-worsening (2%). We further examined whether trait and peritraumatic dissociation distinguished these symptom trajectories. Findings indicate that trait and peritraumatic dissociation differentiated the resilient from the distressed-improving trajectory (trait, p < .05; peritraumatic, p < .001), but only peritraumatic dissociation differentiated the resilient from the distressed-worsening trajectory (p < .001). It is essential to explore heterogeneity in symptom course and its predictors among active-duty police officers, a repeatedly exposed group. These findings suggest that police officers may be a highly resilient group overall. Furthermore, though there is abundant evidence that dissociation has a positive linear relationship with PTSD symptoms, this study demonstrates that degree of dissociation can distinguish between resilient and symptomatic groups of individuals.",1,0 +4182,Selective blockade of 2-arachidonoylglycerol hydrolysis affects learning and memory performance while slowing down epileptogenesis in rodents,"Background: Endocannabinoids (eCBs) play a key neuromodulatory role in the central nervous system, regulating appetite, cognition, emotion, mood and pain by activation of cannabinoid (CB1) receptors. Alterations in the eCB system has been associated with disease in several major therapeutic areas. In particular, changes in tissue concentrations of their natural lipid ligands, N-arachidonoylethanolamine (anandamide) and 2-arachidonoyglycerol (2-AG) have been observed in neurological and psychiatric disorders, observations which have fueled considerable pharmaceutical interest in developing eCB-manipulating drugs to treat these conditions. These include compounds that act at CB1 receptors or inhibit anandamide degradation by fatty acid amide hydrolase (FAAH). Much less attention focused on the identification of drugs that modify 2-AG levels via manipulation of the serine hydrolase monoacylglycerol lipase (MAGL), its principal degradative enzyme. Here we report the pharmacological profile of a potent and selective MAGL inhibitor, Compound A. Methods: MAGL selectivity and activity of Compound A were determined in in vitro and ex vivo biochemical assays, followed by a pharmacokinetic study to measure its brain exposure in mice. The effects of Compound A were then evaluated using rodent models with a focus on cognition and epilepsy tests since there is recent evidence that the modulation of 2-AG levels affects cognitive processes and seizure activity. Results: Compound A behaves as a highly selective and competitive reversible inhibitor of mouse and human MAGL (IC50=29 and 3.8 nM, respectively). It does not affect the activities of other human serine hydrolases or interact with a panel of selected kinases, neurotransmitter transporters, ion channels and receptors, including the binding of a highaffinity ligand to CB1 and CB2 receptors. Ex vivo assays confirmed the degree of selectivity across eCBs as Compound A decreased MAGL activity (ID50=2.7mg/kg po), while increasing levels of 2-AG (MED=3mg/kg po) in the absence of effect on other serine hydrolase substrates. Compound A demonstrated excellent brain permeability in the mouse (brain/plasma 4.3 at 10 mg/kg po). In a preliminary experiment, Compound A was found to decrease in vitro long term potentiation in rat hippocampus. This finding is in line with those of behavioral experiments showing that Compound A affected learning performance in the novel object recognition task (NOR), the Y-maze (YM) and the Morris water maze test, suggesting alterations in episodic, working and spatial memory. The effects of Compound A in the NOR and YM were antagonized by rimonabant suggesting that they were mediated by CB1 receptors. It is noteworthy that no tolerance to the effects of the drug was observed in the latter test upon repeated administration for 5 days. Interestingly, the effects of Compound A in the NOR were similar to those observed following genetic deletion of MAGL, supporting further the role of 2-AG in the intrinsic modulation of cognitive processes. In acute seizure tests in mice, Compound A was inactive over a wide dose-range in the 6-Hz model and after the administation of the convulsants pentylenetetrazole and kainate. However, in the mouse corneal kindling model of partial epilepsy, repeated administration of Compound A for 2 weeks delayed the acquisition and decreased the expression of kindled seizures, suggesting antiepileptogenic and anticonvulsant activities. Conclusions: These findings demonstrate that selective pharmacological or genetic blockade of 2-AG hydrolysis affects memory performance, suggesting that MAGL inhibitors may be of limited utility as therapeutic agents for CNS disorders. However, it cannot be totally excluded that they may serve to treat psychopathologies hallmarked by an inability to extinguish maladaptive behaviors, such as posttraumatic stress syndrome and obsessive-compulsive disorder. Finally, our study reveals a previously unsuspected role of 2-AG in epileptogenesis process, a finding which deserves further investigation to determine t e therapeutic potential of MAGL inhibitors as antiepileptic drugs.",0,0 +4183,Does Language of Retrieval Affect the Remembering of Trauma?,"Semantic and episodic bilingual memory has been extensively researched. Research has also been conducted in the area of autobiographical memory. This study investigated traumatic bilingual memories. This study was a preliminary exploration of possible differences in the reporting of the intensity of 3 clusters of posttraumatic stress disorder symptoms and 5 specific characteristics of traumatic memory in the first versus second languages of bilingual (Spanish-English) individuals who sustained traumatic experiences in childhood. Participants were 19 Spanish-English coordinate bilingual individuals. A repeated measures design examined the prediction that, regardless of the order in which language was presented (whether Spanish-English or English-Spanish), bilingual participants would rate the intensity of specific symptoms and characteristics of traumatic memory higher in their first language. It is hypothesized that the first language is most closely connected to early experience between the self and the first other. Additionally, the relation between affect and first language is different from the relation between affect and second language. P. Janet (1919/1925) and current trauma research suggest that traumatic memories may be encoded differently from ordinary memories. Matching language at the time that traumatic memories were experienced with the later language of retrieval may significantly facilitate the healing process by allowing unique access to traumatic memories through the first language.",0,0 +4184,"Pretrauma problems, prior stressor exposure, and gender as predictors of change in posttraumatic stress symptoms among physically injured children and adolescents.","This study addressed predictors of change in posttraumatic stress symptoms (PTSS) among youths who had experienced physical injuries. The influences of pretrauma internalizing and externalizing problems, prior stressor exposure, and gender were investigated. Additionally, gender was examined as a moderator of the associations between internalizing problems and PTSS, externalizing problems and PTSS, and prior stressor exposure and PTSS.Participants were 157 children and adolescents (75% male; age M = 13.30 years, SD = 3.60; 44% Caucasian, 39% African American, 13% Hispanic, and 4% other) admitted to 2 hospitals for physical injuries. Youths and their parents completed measures of PTSS (Child Posttraumatic Stress Reaction Index), internalizing and externalizing problems (Child Behavior Checklist), and prior stressor exposure (Coddington Life Events Scale, Child) during the hospital stay; youths completed up to 3 additional PTSS assessments targeted at 3, 6, and 12 months postinjury.Multilevel regression analyses revealed a significant average decline in PTSS over time (p < .05) that followed a curvilinear trajectory. Externalizing problems, prior stressor exposure, and female gender predicted higher initial PTSS levels (p < .05). Gender moderated the influence of internalizing problems, externalizing problems, and prior stressor exposure on decline in PTSS over time (p < .05). Patterns of recovery for those with high and low levels of each characteristic differed for girls and boys.Findings suggest targets for clinical consideration, both with respect to identifying subgroups of children and adolescents that may warrant early assessment and monitoring and timing of more directed PTSS treatment intervention.",0,0 +4185,Patterns of psychological distress in mothers of preterm infants.,"Mothers of preterm infants experience significant psychological distress, with elevated levels of inter-correlated depressive, stress, anxiety and post-traumatic stress symptoms. In a sample of racially and ethnically diverse mothers of preterm infants, we identified differing patterns of psychological distress during infant hospitalization and examined the effect of these psychological distress patterns on longitudinal trajectories of each psychological distress measure and on maternal perceptions of the child over the first year of the infant's life. Mothers of preterm infants (N=232) completed five questionnaires assessing depressive symptoms, anxiety, post-traumatic stress symptoms, stress due to infant appearance, and stress due to parental role alteration during enrollment during the neonatal hospitalization, discharge, and at 2, 6, and 12 months of age adjusted for prematurity. Latent class analysis on the enrollment psychological distress variables allowed us to identify five sub-groups of mothers exhibiting similar patterns of psychological distress, differing primarily in degree and type: low distress, moderate distress, high NICU-related distress, high depressive and anxiety symptoms, and extreme distress. These classes continued to show different longitudinal trajectories for the psychological distress measures through 12 months corrected age. Mothers in the extreme distress class and, to a lesser degree, mothers in the high depressive and anxiety symptom class remained at risk of significant psychological distress one year after discharge and had less positive perceptions of their child (greater worry and higher perceptions of child vulnerability). In conclusion, distinctive sub-groups of mothers during hospitalization had different patterns of psychological distress throughout the 12-month period and may require different interventions in the NICU.",0,0 +4186,Posttraumatic stress disorder symptoms and functional impairment among OEF and OIF National Guard and Reserve veterans,"The aims of the present investigation were (a) to examine associations between posttraumatic stress disorder (PTSD; diagnosis and symptoms) and different aspects of functioning, severity, and subjective distress among Operation Iraqi Freedom and Operation Enduring Freedom National Guard and Reserve veterans, and (b) to examine the unique contribution of PTSD symptom clusters to different aspects of functioning and distress. Participants were 124 veterans who had returned from war-zone deployment. A PTSD diagnosis and PTSD symptoms were significantly associated with nearly all of the psychosocial functioning and distress measures, controlling for Axis I disorders and other covariates. Of the PTSD symptom clusters, numbing/avoidance symptoms were the strongest predictors of interpersonal and social functioning, and hyperarousal symptoms were the strongest predictors of overall severity and distress.",0,0 +4187,Specific Trauma Subtypes Improve the Predictive Validity of the Harvard Trauma Questionnaire in Iraqi Refugees,"Trauma exposure contributes to poor mental health among refugees, and exposure often is measured using a cumulative index of items from the Harvard Trauma Questionnaire (HTQ). Few studies, however, have asked whether trauma subtypes derived from the HTQ could be superior to this cumulative index in predicting mental health outcomes. A community sample of recently arrived Iraqi refugees (N = 298) completed the HTQ and measures of posttraumatic stress disorder (PTSD) and depression symptoms. Principal components analysis of HTQ items revealed a 5-component subtype model of trauma that accounted for more item variance than a 1-component solution. These trauma subtypes also accounted for more variance in PTSD and depression symptoms (12 and 10%, respectively) than did the cumulative trauma index (7 and 3%, respectively). Trauma subtypes provided more information than cumulative trauma in the prediction of negative mental health outcomes. Therefore, use of these subtypes may enhance the utility of the HTQ when assessing at-risk populations.",0,0 +4188,Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication,"Little is known about lifetime prevalence or age of onset of DSM-IV disorders.To estimate lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the recently completed National Comorbidity Survey Replication.Nationally representative face-to-face household survey conducted between February 2001 and April 2003 using the fully structured World Health Organization World Mental Health Survey version of the Composite International Diagnostic Interview.Nine thousand two hundred eighty-two English-speaking respondents aged 18 years and older.Lifetime DSM-IV anxiety, mood, impulse-control, and substance use disorders.Lifetime prevalence estimates are as follows: anxiety disorders, 28.8%; mood disorders, 20.8%; impulse-control disorders, 24.8%; substance use disorders, 14.6%; any disorder, 46.4%. Median age of onset is much earlier for anxiety (11 years) and impulse-control (11 years) disorders than for substance use (20 years) and mood (30 years) disorders. Half of all lifetime cases start by age 14 years and three fourths by age 24 years. Later onsets are mostly of comorbid conditions, with estimated lifetime risk of any disorder at age 75 years (50.8%) only slightly higher than observed lifetime prevalence (46.4%). Lifetime prevalence estimates are higher in recent cohorts than in earlier cohorts and have fairly stable intercohort differences across the life course that vary in substantively plausible ways among sociodemographic subgroups.About half of Americans will meet the criteria for a DSM-IV disorder sometime in their life, with first onset usually in childhood or adolescence. Interventions aimed at prevention or early treatment need to focus on youth.",0,0 +4189,"Intergenerational Transmission, Attitudes, and Post-Traumatic Stress Disorder in Times of War: A Comparison between Elderly People and Their Adult Offspring after the Second Lebanon War (2006) and Casting Lead Operation (2008)","Background: While the effects of war on individuals, age groups, and communities have been thoroughly studied, there has been relatively little mention in the literature regarding its differential effects on adult children and their elderly parents and grandparents. Methods: Three hundred thirty-eight participants (167 elderly parents and 171 adult offspring) living in the northern and southern regions of Israel, were interviewed after the Second Lebanon War (2006) and the Casting Lead Operation (2008). (A military operation took place at the Israeli southern border as a reaction to the 7 years of missiles bombing from the Gaza strip to the Israeli civilians.) The participants were sampled by a cluster sampling. Findings: Elderly population experiences higher levels of PTSD symptoms than their adult children do. Women experience higher levels of PTSD symptoms than men and Israeli Arabs and Druze more than Israeli Jews. Conclusions: A policy should be enacted among the local authorities and the governmental offices that would ensure accessibility to and the ability to provide proper care for the elderly population during times of war or terror events. In addition, it is important to setup local teams in every local community to deal with the level of mental and emotional preparedness of the home front and its inhabitants, in case the latter should again become part of the human casualties of the wars and terrorist events that occur in Israel.",0,0 +4190,"Traumatic experiences, alexithymia, and posttraumatic symptomatology: a cross-sectional population-based study in Germany","Previous studies have established an association between number of traumatic experiences and alexithymia. The present study examines this relationship in a large-scale representative sample of the German general population (N=2,507) and explores the potential mediating effects of posttraumatic symptomatology, particularly avoidance/numbing.Alexithymia was assessed with the German version of the Toronto Alexithymia Scale (TAS-20). Posttraumatic symptomatology was operationalized by the symptom score of the modified German version of the Posttraumatic Symptom Scale, and traumatic experiences were assessed with the trauma list of the Munich Composite International Diagnostic Interview. Two mediation analyses were conducted.Of the total sample, 24.2% (n=606) reported at least one traumatic experience, 10.6% (n=258) were classified as alexithymic, and 2.4% (n=59) fulfilled the criteria of posttraumatic stress disorder (PTSD). Participants who had survived five or more traumatic experiences had significantly higher alexithymia sum scores. The PTSD symptom cluster avoidance/numbing mediated the association between the number of traumatic experiences and alexithymia.Our findings illustrate an association between number of traumatic experiences and alexithymia and the influence of emotional avoidance and numbing within this relationship. The significant relationship between alexithymia and number of traumatic experiences in a general population sample further supports the concept of multiple and complex traumatization as associated with alexithymia. The results suggest the importance of further investigations determining the causal impact of alexithymia both as a potential premorbid trait and as consequence of traumatization. Lastly, future investigations are needed to clarify alexithymia as a distinct trauma-relevant characteristic for better diagnostics and specialized trauma-integrative therapy.",0,0 +4191,The Sensory Profile of People With Post-Traumatic Stress Symptoms,"Thirty participants with post-traumatic stress (PTS) symptoms and 30 healthy controls completed the Post-Traumatic Stress Disorder Symptom Scale (PSS-SR) and the Adolescent/Adult Sensory Profile (AASP). Participants with PTS symptoms vacillated between sensory sensitivity, sensation avoiding, and low registration. Sensation avoiding and low registration correlated with intrusive thoughts related to PTS. Discriminant Analysis classified 73% of the study group and 80% of the controls. PTS may be related to hypersensitivity and low registration. Further studies about the sensory profile of people with PTS symptoms may contribute to research and optimize evaluation and intervention for people with PTSD.",0,0 +4192,Disaster survivors in their third decade: Trajectories of initial stress responses and long-term course of mental health,en,1,0 +4193,Epidemiology of Hospitalizations and Deaths from Heat Illness in Soldiers,"Serious heat illness has received considerable recent attention due to catastrophic heat waves in the United States and Europe, the deaths of high-profile athletes, and military deployments.This study documents heat illness hospitalizations and deaths for the U.S. Army from 1980 through 2002. Hospitalization data were obtained from the Total Army Injury Health Outcomes Database (TAIHOD) coded according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). North Atlantic Treaty Organization Standardization Agreement codes were searched for heat injuries in an effort to detect cases that were not found during the ICD-9-CM search.Five-thousand two-hundred forty-six soldiers were hospitalized, and 37 died due to heat illness. Our results indicate: 1) approximately 60% reduction in hospitalization rates (fewer heat exhaustion cases) over the 22-yr period; 2) fivefold increase in heat stroke hospitalization rates (1.8 per 100,000 in 1980 to 14.5 per 100,000 in 2001); 3) heat stroke cases were associated with dehydration (17%), rhabdomyolysis (25%), and acute renal failure (13%); 4) lower hospitalizations rates among African and Hispanic Americans compared with Caucasians (incidence density ratio, 0.76 [95% confidence interval, 0.71-0.82]; 5) greater rates of hospitalizations and heat strokes among recruits from northern than southern states (incidence density ratio, 1.69 [95% confidence interval, 1.42-1.90]; and 6) greater rates of hospitalizations and heat strokes among women than men (incidence density ratio, 1.18 [95% confidence interval, 1.09-1.27]).Exertional heat illness continues to be a military problem during training and operations. Whereas the hospitalization rate of heat illness is declining, heat stroke has markedly increased.",0,0 +4194,Development and preliminary validation of a brief broad-spectrum measure of trauma exposure: The Traumatic Life Events Questionnaire.,"This article describes the development and preliminary validation of a brief questionnaire that assesses exposure to a broad range of potentially traumatic events. Items were generated from multiple sources of information. Events were described in behaviorally descriptive terms, consistent with Diagnostic and Statistical Manual of Mental Disorders IV posttraumatic stress disorder stressor criterion A1. When events were endorsed, respondents were asked if they experienced intense fear, helplessness, or horror (stressor criterion A2). In separate studies with college students, Vietnam veterans, battered women, and residents of a substance abuse program, most items possessed adequate to excellent temporal stability. In a study comparing questionnaire and structured-interview inquiries of trauma history, the 2 formats yielded similar rates of disclosure. Preliminary data on positive predictive power are also presented.",0,0 +4195,Sertraline in the Treatment of Co-occurring Alcohol Dependence and Posttraumatic Stress Disorder,"Background: Posttraumatic stress disorder (PTSD) frequently co-occurs with alcohol use disorders. This study investigated the use of sertraline, a serotonin reuptake inhibitor, in treating co-occurring symptoms of alcohol dependence and PTSD. Methods: A total of 94 individuals with current alcohol dependence and PTSD were randomly assigned to receive sertraline (150 mg/day) or placebo for 12 weeks. Post hoc cluster analysis of baseline characteristics was used to define subgroups of participants. Results: There was a significant decrease in alcohol use during the trial in both the sertraline and the placebo groups. Cluster analysis revealed significant medication group by cluster interactions for alcohol-related outcomes. Sertraline-treated participants with less severe alcohol dependence and early-onset PTSD had significantly fewer drinks per drinking day (p < 0.001). For participants with more severe alcohol dependence and later onset PTSD, the placebo group had significantly greater decreases in drinks per drinking day (p < 0.01) and average number of drinks consumed per day (p < 0.05). Conclusions: There may be subtypes of alcohol-dependent individuals who respond differently to serotonin reuptake inhibitor treatment. Further investigation of differential responders may lead to improvements in the pharmacological treatment of co-occurring alcohol dependence and PTSD.",0,0 +4196,What are the disruptive symptoms of behavioral disorders after traumatic brain injury? A systematic review leading to recommendations for good practices,"Behavioral disorders are major sequelae of severe traumatic brain injury. Before considering care management of these disorders, and in the absence of a precise definition for TBI-related behavioral disorder, it is essential to refine, according to the data from the literature, incidence, prevalence, predictive factors of commonly admitted disruptive symptoms. Systematic review of the literature targeting epidemiological data related to behavioral disorders after traumatic brain injury in order to elaborate good practice recommendations according to the methodology established by the French High Authority for Health. Two hundred and ninety-nine articles were identified. The responsibility of traumatic brain injury (TBI) in the onset of behavioral disorders is unequivocal. Globally, behavioral disorders are twice more frequent after TBI than orthopedic trauma without TBI (Masson et al., 1996). These disorders are classified into disruptive primary behaviors by excess (agitation 11–70%, aggression 25–39%, irritability 29–71%, alcohol abuse 7–26% drug abuse 2–20%), disruptive primary behaviors by default (apathy 20–71%), affective disorders – anxiety – psychosis (depression 12–76%, anxiety 0.8–24,5%, posttraumatic stress 11–18%, obsessive-compulsive disorders 1.2–30%, psychosis 0.7%), suicide attempts and suicide 1%. The improvement of care management for behavioral disorders goes through a first step of defining a common terminology. Four categories of posttraumatic behavioral clinical symptoms are defined: disruptive primary behaviors by excess, by default, affective disorders-psychosis-anxiety, suicide attempts and suicide. All these symptoms yield a higher prevalence than in the general population. They impact all of life's domains and are sustainable over time.",0,0 +4197,Perfusion deficits in patients with mild traumatic brain injury characterized by dynamic susceptibility contrast MRI,"Perfusion deficits in patients with mild traumatic brain injury (TBI) from a military population were characterized by dynamic susceptibility contrast perfusion imaging. Relative cerebral blood flow (rCBF) was calculated by a model-independent deconvolution approach from the tracer concentration curves following a bolus injection of gadolinium diethylenetriaminepentaacetate (Gd-DTPA) using both manually and automatically selected arterial input functions (AIFs). Linear regression analysis of the mean values of rCBF from selected regions of interest showed a very good agreement between the two approaches, with a regression coefficient of R = 0.88 and a slope of 0.88. The Bland-Altman plot also illustrated the good agreement between the two approaches, with a mean difference of 0.6 ± 12.4 mL/100 g/min. Voxelwise analysis of rCBF maps from both approaches demonstrated multiple clusters of decreased perfusion (p < 0.01) in the cerebellum, cuneus, cingulate and temporal gyrus in the group with mild TBI relative to the controls. MRI perfusion deficits in the cerebellum and anterior cingulate also correlated (p < 0.01) with neurocognitive results, including the mean reaction time in the Automated Neuropsychological Assessment Metrics and commission error and detection T-scores in the Continuous Performance Test, as well as neurobehavioral scores in the Post-traumatic Stress Disorder Checklist-Civilian Version. In conclusion, rCBF calculated using AIFs selected from an automated approach demonstrated a good agreement with the corresponding results using manually selected AIFs. Group analysis of patients with mild TBI from a military population demonstrated scattered perfusion deficits, which showed significant correlations with measures of verbal memory, speed of reaction time and self-report of stress symptoms.",0,0 +4198,EVIDENCE FOR A DISSOCIATIVE SUBTYPE OF PTSD BY LATENT PROFILE AND CONFIRMATORY FACTOR ANALYSES IN A CIVILIAN SAMPLE,"Dissociative symptoms are increasingly recognized in individuals with posttraumatic stress disorder (PTSD). The aim of this study was to investigate the prevalence of derealization and depersonalization symptoms via latent profile analyses (LPAs) in a civilian PTSD sample and examine the relationship between PTSD and dissociative symptoms via factor analytic methods.A civilian sample of individuals with PTSD predominantly related to childhood abuse (n = 134) completed a diagnostic interview for PTSD and comorbid psychiatric disorders. LPAs and confirmatory factor analyses (CFAs) were performed on the severity scores for PTSD, derealization, and depersonalization symptoms.LPAs extracted three groups, one of which was uniquely characterized by high derealization and depersonalization symptoms, and accounted for 25% of the sample. Individuals in the dissociative subgroup also showed a higher number of comorbid Axis I disorders and a more significant history of childhood abuse and neglect. CFAs suggested the acceptance of a five factor solution in which dissociative symptoms are distinct from but correlate significantly with the core PTSD symptom clusters.The results from LPAs and CFAs are concordant with the concept of a dissociative subtype in patients with PTSD and suggest that symptoms of derealization-depersonalization and the core symptoms of PTSD are positively correlated. Thought should be given to including a dissociative subtype of PTSD in the DSM-5.",0,0 +4199,Developmentally adapted cognitive processing therapy for adolescents and young adults with PTSD symptoms after physical and sexual abuse: study protocol for a randomized controlled trial,"Although childhood sexual and/or physical abuse (CSA/CPA) is known to have severe psychopathological consequences, there is little evidence on psychotherapeutic interventions for adolescents and young adults suffering from post-traumatic stress disorder (PTSD). Equally sparse are data on moderators of treatment response on PTSD-related epigenetic changes, health care costs and loss of productivity, alterations in cognitive processing, and on how successful interventions affect all of these factors. Early treatment may prevent later (co)morbidity. In this paper, we present a study protocol for the evaluation of a newly developed psychotherapeutic manual for PTSD after CSA/CPA in adolescents and young adults - the Developmentally Adapted Cognitive Processing Therapy (D-CPT).In a multicenter randomized controlled trial (RCT) D-CPT is compared to treatment as usual (TAU). A sample of 90 adolescent outpatients aged 14 to 21 years will be randomized to one of these conditions. Four assessments will be carried out at baseline, at end of treatment, and 3 and 6 months after end of therapy. Each time, patients will be assessed via clinical interviews and a wide range of questionnaires. In addition to PTSD symptoms and comorbidities, we will evaluate moderators of treatment response, epigenetic profiles, direct and indirect costs of this disorder, and neurophysiological processing of threat cues in PTSD and their respective changes in the course of these two treatments (D-CPT and TAU).The study will provide new insights in the understudied field of PTSD in adolescents and young adults. A newly developed intervention will be evaluated in this therapeutically underserved population. Results will provide data on treatment efficacy, direct and indirect treatment costs, as well as on associations of treatment outcome and PTSD intensity both to epigenetic profiles and to the neurobiological processing of threat cues. Besides, they will help to learn more about the psychopathology and possible new objective correlates of PTSD.Germanctr.de identifier: DRKS00004787.",0,0 +4200,Trajectories of stress reactions and somatization symptoms among war veterans: a 20-year longitudinal study,"Background There is considerable evidence that immediate and long-term stress reactions are associated with increased somatic symptomatology. However, because of the scarcity of long-term longitudinal studies, the trend of mutual change of these factors has not been assessed. This study examined the chronological inter-relationships between post-traumatic stress reactions and somatization symptoms among combatants over a 20-year period. Method Two groups of veterans were assessed 1, 2, 3 and 20 years after their participation in the 1982 Lebanon War: a clinical group of veterans who had been diagnosed with combat stress reaction (CSR) on the battlefield ( n =363), and a matched control group of veterans ( n =301). Results The CSR veterans reported higher initial levels of intrusion and avoidance and a steeper decline in those symptoms over time in comparison to the control group. The former also reported higher initial levels of somatization symptoms than the latter. In addition, over the years, stress reactions were positively associated with somatization symptoms. For both study groups, in the first years after the war, stress reaction symptoms predicted somatization symptoms. However, with time, the trend was reversed and somatization symptoms predicted stress reactions. Conclusions The findings suggest that CSR is a marker for future stress reactions and somatization symptoms, and indicate a long-term role for these symptoms in veterans' psychological distress.",0,0 +4201,Chronic Posttraumatic Stress Disorder and Diagnostic Comorbidity in a Disaster Sample,"Research has indicated significant comorbid psychopathology with chronic posttraumatic stress disorder (PTSD) in samples of war veterans. The present paper examines the issue of comorbidity in a disaster sample to learn whether findings from veterans generalized to this event. A total of 193 subjects exposed to the Buffalo Creek dam collapse of 1972 were examined 14 years later using diagnoses derived from the Structured Clinical Interview for DSM-III (SCID). Past and present PTSD was found in a significant portion of the sample. Major depression was the next most common diagnosis and was highly related to PTSD. Anxiety disorders were also common. The overlap with other diagnoses was quite similar to that found in a sample of Vietnam veterans we studied earlier, except that the disaster sample had fewer dysthymic disorders, substance abusers, and antisocial personality disorders. Possible explanations for comorbidity in chronic PTSD were discussed and it was suggested that the morphology of PTSD may be quite stable in at least some other nonveteran trauma populations.",0,0 +4202,Attending to the Mental Health of War-Affected Children: The Need for Longitudinal and Developmental Research Perspectives,,0,0 +4203,Mothers going to war: The role of nurse practitioners in the care of military mothers and families during deployment,"Purpose Many military women are being called to separate from their children to go to war. Most previous research has focused upon paternal, rather than, maternal, separation. The purpose of this article is to describe the experience of military mothers and their children during wartime deployments with clinical implications for nurse practitioners (NPs) in military or community settings. Data sources Using grounded theory methods, 37 active duty and reserve component military women participated in a one-time interview. Included were women who deployed for at least 4 months to Iraq or Afghanistan and had at least one child under the age of 12 during the separation. Conclusions Military families present unique challenges for NPs. Mother deployments offer opportunities for intervention and anticipatory guidance across the trajectory of the separation. Military women's emotional and physical health must be supported before, during, and following deployment. Implications for practice NPs are ideally positioned to support military families. During deployment, the NP's focus may shift to care of the children and their caregiver. Before and at reintegration, NPs are in a key position to intervene early for posttraumatic stress and support family readjustment.",0,0 +4204,Panic disorder following torture by suffocation is associated with predominantly respiratory symptoms,"Background. We previously reported that in panic disorder a history of near-suffocation is associated with predominantly respiratory panic attacks. It might be hypothesized that the near-suffocation experienced in certain kinds of torture is also associated with the development of predominantly respiratory panic attacks. Methods. A sample of patients who had experienced torture ( N =14) was drawn from an Anxiety Disorders Clinic in South Africa. Subjects were questioned about symptoms of panic disorder, post-traumatic stress disorder and depression. Results. Patients with a history of torture by suffocation were more likely than other patients to complain of predominantly respiratory symptoms during panic attacks. These patients also demonstrated higher levels of depressive symptoms. Conclusions. While various interpretations of the data can be made, it is possible that torture by suffocation is associated with a specific symptomatic profile. Were such an association to be replicated, this would perhaps support the suffocation alarm hypothesis of panic disorder and provide evidence that specific environmental factors play a role in the development of this alarm.",0,0 +4205,Wearable sensors can assist in PTSD diagnosis,Post-traumatic stress disorder (PTSD) currently is diagnosed via subjective reports of experiences related to the traumatic event. More objective measures are needed to assist clinicians in diagnosis. Physiological activity was recorded from 58 participants. Participants in the No Trauma/No PTSD group had no trauma exposure and no PTSD diagnosis. Trauma Exposed/No PTSD participants had experienced a traumatic event but did not have PTSD. PTSD participants had experienced a traumatic event and had PTSD. Baseline and emotionally evocative stimulus-related sensor data were collected. Features were extracted from each sensor stream and submitted to statistical analysis. Significant group differences were present during the viewing of two virtual reality videos. Features were submitted to discriminant function analysis to assess classification accuracy. Classification accuracy was between 89 and 92%. The results from this study suggest the utility of objective physiological measures obtained from wearable sensors in assisting with PTSD diagnosis.,0,0 +4206,"Traumatic events and post-traumatic stress disorder in the community: prevalence,risk factors and comorbidity","Lifetime and 12-month prevalence of traumatic events and DSM-IV post-traumatic stress disorder as well as risk factors and comorbidity patterns were investigated in a representative community sample (n = 3021, aged 14-24 years).Traumatic events and PTSD were assessed with the Munich Composite International Diagnostic Interview (CIDI).Although 26% of male subjects and 17.7% of female subjects reported at least one traumatic event, only a few qualified for a full PTSD diagnosis (1% of males and 2.2% of females). Traumatic events and PTSD were strongly associated with all other mental disorders examined. PTSD occurred as both a primary and a secondary disorder.The prevalence of PTSD in this young German sample is considerably lower than reported in previous US studies. However, the conditional probability for PTSD after experiencing traumas, risk factors and comorbidity patterns are quite similar. Traumatic events and full PTSD may increase the risk for other disorders, and vice versa.",0,0 +4207,Adult memories of childhood trauma: A naturalistic clinical study,"The clinical evaluations of 77 adult psychiatric outpatients reporting memories of childhood trauma were reviewed. A majority of patients reported some degree of continuous recall. Roughly half (53%) said they had never forgotten the traumatic events. Two smaller groups described a mixture of continuous and delayed recall (17%) or a period of complete amnesia followed by delayed recall (16%). Patients with and without delayed recall did not differ significantly in the proportions reporting corroboration of their memories from other sources. Idiosyncratic, trauma-specific reminders and recent life crises were most commonly cited as precipitants to delayed recall. A previous psychotherapy was cited as a factor in a minority (28%) of cases. By contrast, intrusion of new memories after a period of amnesia was frequently cited as a factor leading to the decision to seek psychotherapy. The implications of these findings are discussed with respect to the role of psychotherapy in the process of recovering traumatic memories.",0,0 +4208,Psychophysiological Response to Virtual Reality and Subthreshold Posttraumatic Stress Disorder Symptoms in Recently Deployed Military,"Subthreshold posttraumatic stress disorder (PTSD) has garnered recent attention because of the significant distress and functional impairment associated with the symptoms as well as the increased risk of progression to full PTSD. However, the clinical presentation of subthreshold PTSD can vary widely and therefore is not clearly defined, nor is there an evidence-based treatment approach. Thus, we aim to further the understanding of subthreshold PTSD symptoms by reporting the use of a virtual combat environment in eliciting distinctive psychophysiological responses associated with PTSD symptoms in a sample of subthreshold recently deployed US service members.Heart rate, skin conductance, electromyography (startle), respiratory rate, and blood pressure were monitored during three unique combat-related virtual reality scenarios as a novel procedure to assess subthreshold symptoms in a sample of 78 service members. The Clinician-Administered PTSD Scale was administered, and linear regression analyses were used to investigate the relationship between symptom clusters and physiological variables.Among the range of psychophysiological measures that were studied, regression analysis revealed heart rate as most strongly associated with Clinician-Administered PTSD Scale-based measures hyperarousal (R = 0.11, p = .035,) reexperiencing (R = 0.24, p = .001), and global PTSD symptoms (R = 0.17, p = .003).Our findings support the use of a virtual reality environment in eliciting physiological responses associated with subthreshold PTSD symptoms.",0,0 +4209,What are the risk factors for the comorbidity of posttraumatic stress disorder and depression in a war-affected population? a cross-sectional community study in South Sudan,"BackgroundLimited data exists on the association of war trauma with comorbid posttraumatic stress disorder (PTSD)-depression in the general population of low-income countries. The present study aimed to evaluate socioeconomic and trauma-related risk factors associated with PTSD, depression, and PTSD-depression comorbidity in the population of Greater Bahr el Ghazal States, South Sudan.MethodsIn this cross-sectional community study (n=1200) we applied the Harvard Trauma Questionnaire (HTQ) and MINI International Neuropsychiatric Interview (MINI) to investigate the prevalence of PTSD, depression, and PTSD-depression comorbidity. Multinomial logistic regression analyses were conducted to examine the association between these disorders, previous trauma exposure, sociodemographic, and socioeconomic factors.ResultsPTSD only was found in 331 (28%) and depression only in 75 (6.4%) of the study population. One hundred and twelve (9.5%) of the participants had PTSD-depression comorbid diagnosis. Exposure to traumatic events and socioeconomic disadvantage were significantly associated with having PTSD or PTSD-depression comorbidity but not with depression. Participants with a comorbid condition were more likely to be socioeconomic disadvantaged, have experienced more traumatic events, and showed higher level of psychological distress than participants with PTSD or depression alone.ConclusionsIn individuals exposed to war trauma, attention should be given to those who may fulfill criteria for a diagnosis of both PTSD and depression.",0,0 +4210,Posttraumatic stress symptoms mediate the relation between childhood sexual abuse and nonsuicidal self-injury.,"Prior research consistently has shown a strong relation between childhood abuse and nonsuicidal self-injury (NSSI), yet it is unclear why this relation exists. The authors examined 2 specific posttraumatic stress disorder (PTSD) symptom clusters as potential mechanisms through which childhood abuse may be related to NSSI. Participants were 86 adolescents (78% female, 22% male; 73% Caucasian, 27% other races/ethnicities; mean age = 17.03 years, range = 12-19 years) who completed measures of childhood abuse, Diagnostic and Statistical Manual of Mental Disorders (4th ed.) PTSD symptoms, and NSSI. Analyses revealed a significant relation between childhood sexual abuse in particular and the presence and frequency of NSSI. Moreover, data supported a theoretical model in which PTSD reexperiencing and avoidance/numbing symptoms independently mediate this relation. Future research must test the temporal relation between childhood sexual abuse, PTSD symptoms, and NSSI and identify additional pathways to engagement in NSSI.",0,0 +4211,A clinical profile of women with posttraumatic stress disorder and substance dependence.,"To assess the clinical characteristics of women with posttraumatic stress disorder (PTSD) and substance dependence, 28 women with both disorders were compared with 29 women with PTSD alone on a wide battery of lifetime and current clinical measures. The dual-diagnosis women consistently had a more severe clinical profile, including worse life conditions (e.g., physical appearance, opportunities in life), both as children and as adults; greater criminal behavior; a higher number of lifetime suicide attempts; a greater number having a sibling with a drug problem; and fewer outpatient psychiatric treatments. One discrepant finding, however, was their lower rate of major depression. Interestingly, the 2 groups did not differ in number or type of lifetime traumas, PTSD onset or severity, family history of substance use; coping style, functioning level, psychiatric symptoms, or sociodemographic characteristics. Treatment implications and methodological limitations are discussed.",0,0 +4212,Latent Class Analysis of Personality Disorders in Adults With Posttraumatic Stress Disorder,"Article AbstractObjective: To characterize predominant typologies of co-occurring personality disorders among adults with posttraumatic stress disorder (PTSD) and examine their relation to Axis I comorbidities, health-related quality of life, and course and treatment of PTSD. Method: Latent class analysis was conducted on the 10 DSM-IV personality disorders in a nationally representative sample of 2,463 adults with a lifetime diagnosis of PTSD from Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Results: Three latent classes of personality disorders were identified: a borderline-dysregulated class (11.4%), an obsessive-paranoid class (13.1%), and a no/low personality disorders class (75.5%). The borderline-dysregulated and obsessive-paranoid classes were more likely than the no/low personality disorder class to have a broad range of comorbid Axis I diagnoses and to have ever attempted suicide (ORs = 1.50-8.01), and they reported lower mental health-related quality of life. The borderline-dysregulated class was less likely than the no/low personality disorder class to have experienced remission of their most recent episode of PTSD (OR = 0.54; 95% CI, 0.38-0.75) and was more likely to have been prescribed medication for PTSD (OR = 1.65; 95% CI, 1.20-2.28) and to have used alcohol and drugs to mitigate their PTSD symptoms (OR = 2.77; 95% CI, 1.62-4.74). The obsessive-paranoid class was more likely than the no/low personality disorders class to report sexual assault as their worst trauma (OR = 2.22; 95% CI, 1.36-3.61) and had an earlier age at onset of PTSD symptoms compared to the other 2 classes. Conclusions: Among US adults with PTSD, the 10 DSM-IV personality disorders can be classified into 3 ""person-based"" typologies, which are differentially associated with comorbid Axis I disorders, mental health-related quality of life, and clinical and treatment characteristics of this disorder. These results suggest that comprehensive assessment of personality disorders may help inform etiologic models and treatment approaches for PTSD. J Clin Psychiatry © Copyright 2013 Physicians Postgraduate Press, Inc. Submitted: March 12, 2013; accepted July 15, 2013. Online ahead of print: December 10, 2013 (doi:10.4088/JCP.13m08466). Corresponding author: Jack Tsai, VA Connecticut Healthcare System, 950 Campbell Ave, 151D, West Haven, CT 06516 (Jack.Tsai@yale.edu).",0,0 +4213,"Stressful or traumatic life events, post-traumatic stress disorder (PTSD) symptoms, and HIV sexual risk taking among men who have sex with men","The present study assessed the presence of post-traumatic stress disorder (PTSD) symptoms in response to stressful or traumatic life events and their impact on HIV risk behaviors and associated psychosocial variables among men who have sex with men (MSM). Participants (n=189; 60% HIV-infected) who were recruited by notices posted in a community health clinic and via a modified respondent-driven sampling technique completed a behavioral assessment survey. Sixty percentage of participants screened positive for having PTSD symptoms using the startle, physiological arousal, anger, and numbness screening instrument. After controlling for race, sexual self-identification, and HIV status, multivariable logistic regression analyses revealed that screening in for having PTSD symptoms was significantly associated with having engaged in unprotected anal (insertive or receptive) sex in the past 12 months, over and above any effects of whether or not a traumatic/stressful event occurred during the year (adjusted odds ratio [OR] = 2.72; p<0.02; 95% confidence interval [CI] = 1.19-6.20). In addition, MSM with PTSD symptoms were more likely to have clinically significant depressive symptoms (adjusted OR = 3.50; p<0.001) and/or symptoms of social anxiety (adjusted OR = 2.87; p<0.01; 95% CI = 1.48-5.62). The current study, in the context of other research documenting the high rates of co-occurring psychosocial issues facing MSM, points to the importance of incorporating coping with these issues in HIV and sexually transmitted disease prevention and care interventions.",0,0 +4214,The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection.,"A 36-item short-form (SF-36) was constructed to survey health status in the Medical Outcomes Study. The SF-36 was designed for use in clinical practice and research, health policy evaluations, and general population surveys. The SF-36 includes one multi-item scale that assesses eight health concepts: 1) limitations in physical activities because of health problems; 2) limitations in social activities because of physical or emotional problems; 3) limitations in usual role activities because of physical health problems; 4) bodily pain; 5) general mental health (psychological distress and well-being); 6) limitations in usual role activities because of emotional problems; 7) vitality (energy and fatigue); and 8) general health perceptions. The survey was constructed for self-administration by persons 14 years of age and older, and for administration by a trained interviewer in person or by telephone. The history of the development of the SF-36, the origin of specific items, and the logic underlying their selection are summarized. The content and features of the SF-36 are compared with the 20-item Medical Outcomes Study short-form.",0,0 +4215,Interactive Stories for Health Interventions,"In recent years, there has been an increasing interest in exploring virtual environments and computer aided interactive stories as tools in developing health promotion and disease prevention interventions. Applications have been developed to address a range of health related conditions, including stress [1], risky behaviors [2] and post-traumatic stress disorder(PTSD) [3].",0,0 +4216,The Psychiatric Sequelae of Traumatic Injury,"Traumatic injury affects millions of people each year. There is little understanding of the extent of psychiatric illness that develops after traumatic injury or of the impact of mild traumatic brain injury (TBI) on psychiatric illness. The authors sought to determine the range of new psychiatric disorders occurring after traumatic injury and the influence of mild TBI on psychiatric status.In this prospective cohort study, patients were drawn from recent admissions to four major trauma hospitals across Australia. A total of 1,084 traumatically injured patients were initially assessed during hospital admission and followed up 3 months (N=932, 86%) and 12 months (N=817, 75%) after injury. Lifetime psychiatric diagnoses were assessed in hospital. The prevalence of psychiatric disorders, levels of quality of life, and mental health service use were assessed at the follow-ups. The main outcome measures were 3- and 12-month prevalence of axis I psychiatric disorders, levels of quality of life, and mental health service use and lifetime axis I psychiatric disorders.Twelve months after injury, 31% of patients reported a psychiatric disorder, and 22% developed a psychiatric disorder that they had never experienced before. The most common new psychiatric disorders were depression (9%), generalized anxiety disorder (9%), posttraumatic stress disorder (6%), and agoraphobia (6%). Patients were more likely to develop posttraumatic stress disorder (odds ratio=1.92, 95% CI=1.08-3.40), panic disorder (odds ratio=2.01, 95% CI=1.03-4.14), social phobia (odds ratio=2.07, 95% CI=1.03-4.16), and agoraphobia (odds ratio=1.94, 95% CI=1.11-3.39) if they had sustained a mild TBI. Functional impairment, rather than mild TBI, was associated with psychiatric illness.A significant range of psychiatric disorders occur after traumatic injury. The identification and treatment of a range of psychiatric disorders are important for optimal adaptation after traumatic injury.",0,0 +4217,Psychometric properties of the Posttraumatic Stress Checklist among young African-American men and women.,"Research has demonstrated the validity and reliability of the Posttraumatic Stress Checklist (PCL) in predominantly Caucasian samples. However, there has not been a study that examined the psychometric properties of the PCL specifically for African Americans. The present paper is an examination of the factor structure, internal stability, reliability, and predictive validity of the PCL among a sample of young African American men and women. Confirmatory factor analysis indicated better support for a two-factor model than for a three-factor model reflecting the three diagnostic symptom clusters of posttraumatic stress disorder. High internal consistency and marginal test-retest reliability were observed. The positive predictive power of the PCL in the present study was far lower than that observed in previous studies; several potential explanations for this finding are discussed. © 2011 American Psychological Association.",0,0 +4218,Psychosocial Adaptation to Disability Within the Context of Positive Psychology: Findings from the Literature,"Purpose This purpose of this article is to review of the trends of research that examined positive psychology constructs in the context of adapting to chronic illness and disability (CID). This article examines the empirical findings on the relationships between six selected positive psychology-associated constructs (optimism, hope, resilience, benefit-finding, meaning-making, and post-traumatic growth) and adaptation to disability. Methods Six positive psychology constructs were selected to represent the trends found in recent literature published on CID. The process of choosing these six variables included reviewing chapters on positive psychology and CID, reviewing the top rehabilitation journals that typically publish articles on psychosocial adaptation to CID, using search engines to find relevant journal articles published since the year 2000, and selecting the most important constructs based on the authors’ professional judgment. Conclusion The available evidence supports the unique benefits of these six positive psychology constructs in predicting successful adaptation to a range of disabling conditions. Based on the available findings, the authors offer four suggestions for occupational rehabilitation researchers. © 2015, Springer Science+Business Media New York (outside the USA).",0,0 +4219,Unconscious relational traumatic memory and its relevance to ‘everyday’ clinical psychiatry,"Objective: The aim of this paper is to demonstrate the relevance of the concept of unconscious relational traumatic memory to ‘everyday’ clinical psychiatry. Method: One clinical vignette and concepts from the Conversational Model of Psychotherapy are used to consider the potential relevance of this type of memory. Conclusions: The influence of modern classification systems and the dominance of the paradigm of ‘biological psychiatry’ over the last 30 years have together led to an emphasis on diagnosis and treatment by symptom cluster. This perspective may overlook both the patient’s current psycho-social context and their personal history. An understanding of unconscious relational traumatic memory may assist in both the conceptualisation and the treatment of many patients, particularly those adults who have been abused in childhood, where the link between the early experiences and the late manifestations are frequently lost.",0,0 +4220,Characteristics Associated With Use of Homeopathic Drugs for Psychiatric Symptoms in the General Population,"Abstract Objective To explore which patient characteristics are associated in naturalistic conditions with the lifetime use of homeopathic treatment for psychiatric symptoms. Method Lifetime use of psychotropic treatment was explored in a sample of 36,785 persons, participating in the Mental Health Survey in the General Population. Characteristics associated with use of homeopathic treatments, associated or not with conventional psychotropic drugs, were explored using multivariate analyses. Results Use of homeopathic treatment for psychiatric symptoms was reported by 1.3% of persons. Younger age, female gender and high educational level were associated with use of homeopathy. Half of homeopathy users presented at least one Mini International Neuropsychiatric Interview (MINI) diagnosis, most frequently anxiety disorders. Their diagnostic profile was similar to that of persons reporting use of anxiolytics or hypnotics. Compared to persons with no lifetime use of psychotropic drugs, persons using homeopathy were more likely to present with a diagnosis of mood disorder or anxiety disorder. Compared to those using conventional psychotropic drugs, they presented less frequently with psychiatric disorders, with the exception of anxiety disorders. Conclusion Homeopathic treatment for psychiatric symptoms appears to be used mainly to reduce anxiety symptoms in the general population.",0,0 +4221,"Prevalence of Mental Disorders in 6–16-Year-Old Students in Sichuan Province, China","To investigate the point prevalence of mental disorders in school students, multistage cluster stratified random sampling and two-phase survey methods were used to identify 40 primary and middle schools. The students were screened using the Chinese version of the Child Behavior Checklist and diagnosed using the Mini International Neuropsychiatric Interview. The prevalence of behavioral problems was 19.13%. The prevalence of behavioral problems significantly differed by sex, age, city of residence, and caretaker. The six-month prevalence of any mental disorder was 15.24% (95% CI: 15.49%-16.97%). Psychiatric disorders were more prevalent in boys (17.33%) relative to girls (13.11%; p < 0.01). The prevalence of mental disorders significantly differed by community and caretaker, and 36.46% of students exhibited comorbidity. Results demonstrated important mental health issues, with a high incidence of comorbidities, in this population. Students' mental health requires increased attention, particularly in poverty-stricken areas and left-behind children and adolescents.",0,0 +4222,BELONGING PROTECTS AGAINST POSTDEPLOYMENT DEPRESSION IN MILITARY PERSONNEL,"Depression among U.S. military personnel has received relatively little empirical attention compared to posttraumatic stress disorder, despite evidence that depression is associated with poor psychosocial outcomes and increased suicide risk. Even less is known about factors that protect against depression in military populations.A sample of 168 active duty Air Force convoy operators completed self-report measures of depression, posttraumatic stress, and sense of ""belonging"" before deploying to Iraq, and again at 1, 3, 6, and 12 months following their return. Linear growth modeling was used to test the associations of the variables over time.Mean depression scores remained low and stable across the deployment and 12-month follow-up period. Increased depression severity was significantly associated with low belonging (P < .001) and with posttraumatic stress symptoms (P < .001) at every time point.Relatively small, predominantly male sample utilizing self-report methods.A sense of belongingness may protect service members from depression at all stages of the deployment cycle, from predeployment preparations through deployment and postdeployment adjustment.",0,0 +4223,Impact of Event Scale: A Measure of Subjective Stress,"Clinical, field, and experimental studies of response to potentially stressful life events give concordant findings: there is a general human tendency to undergo episodes of intrusive thinking and periods of avoidance. A scale of current subjective distress, related to a specific event, was based on a list of items composed of commonly reported experiences of intrusion and avoidance. Responses of 66 persons admitted to an outpatient clinic for the treatment of stress response syndromes indicated that the scale had a useful degree of significance and homogeneity. Empirical clusters supported the concept of subscores for intrusions and avoidance responses.",0,0 +4224,Children exposed to warfare: A longitudinal study,"Following the 1991 Gulf War a group of 94 children in Iraq were interviewed at 6 months, 1 year, and 2 years after the war. The group was exposed to the bombing of a shelter where more than 750 were killed. Selected items from different inventories, including the Impact of Event Scale (IES) assessed children's reactions. Results reveal that children continue to experience sadness and remain afraid of losing their family. Although there was no significant decline in intrusive and avoidance reactions as measured by the IES from 6 months to 1 year following the war, reactions were reduced 2 years after the war. However, the scores were still high, indicating that symptoms persist, with somewhat diminished intensity over time.",0,0 +4225,“Dissociation in posttraumatic stress disorder part II: How theoretical models fit the empirical evidence and recommendations for modifying the diagnostic criteria for PTSD”: Correction to Dalenberg and Carlson (2012).,"Reports an error in ""Dissociation in Posttraumatic Stress Disorder Part II: How Theoretical Models Fit the Empirical Evidence and Recommendations for Modifying the Diagnostic Criteria for PTSD"" by Constance Dalenberg and Eve B. Carlson (Psychological Trauma: Theory, Research, Practice, and Policy, Advanced Online Publication, May 14, 2012, np). There was an error in the section, ""Models 5 and 5a: The Component and Subtype Models."" The paragraph that began, ""Taxometric studies of dissociation in PTSD are also relevant to the Subtype model . . ."" has been replaced with a paragraph that begins, ""One taxometric study of dissociation in PTSD is also relevant to the Subtype model . . ."" (The following abstract of the original article appeared in record 2012-12663-001.) The purpose of this article is to examine how closely six theoretical models fit the empirical evidence reviewed in Part 1 on the relationship between trauma and dissociation and to apply the resulting conclusions to make recommendations about diagnostic criteria for PTSD. We describe six models for the relationships among traumatic stress, dissociation, and PTSD, including models for fantasy-proneness, mediation, comorbidity, interactional comorbidity, component, and subtype. The research reviewed strongly supports component and subtype models of the relationship between dissociation and PTSD, and recommendations are made for including dissociative symptoms in the diagnostic criteria for PTSD in ICD-11 and DSM-5 and adding either a dissociative subtype or a complex PTSD diagnosis in both diagnostic systems. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4226,Co-morbid Post-traumatic Stress Disorder and Opioid Dependence Syndrome,"Post-traumatic stress disorder (PTSD) is common among patients with opioid dependence syndrome. The aim of this study was to find the prevalence of PTSD in patients with opioid dependence and to examine the relationship of PTSD with the severity of dependence on opioids in patients attending an outpatient clinic for drug treatment services. An interview using the Maudsley Addiction Profile, the Severity of Dependence Scale, the Impact of Events Scale, and ICD-10 clinical criteria was conducted in a large urban center for addiction treatment in the central United Kingdom. Seventy patients with opioid dependence syndrome were interviewed. On interview, 30% of the patients met ICD-10 criteria for PTSD. Clinically significant levels of intrusive (45.7%) and avoidant (65.7%) symptoms were reported. Participants with PTSD reported higher perceived rate of childhood threat to life including sexual abuse, physical abuse, and witnessing physical fights between parents. In adulthood, the main traumatic events were ...",0,0 +4227,Grief Counseling and Crisis Intervention in Hospital Trauma Units,"The demand for family counselors implementing crisis intervention and grief counseling in hospital trauma units continues to increase. Thus, this article provides a review of the nature of family counselors working with individuals and families affected by traumatic brain injury (TBI) and medical trauma in hospitals. Specifically, the article presents (a) unique aspects of crisis intervention and grief services provided in hospital trauma units, (b) effective rapport building strategies for family counselors working with families in crisis from TBI, (c) multidisciplinary collaboration in hospitals, (d) diagnostic approaches and common mental health disorders following TBI, (e) ethical issues working in hospitals, (f) family-focused grief therapy and stages of grief interventions, and (g) implications with a case example of a family counselor working with a family affected by TBI.",0,0 +4228,"Suicide-nearness assessed with PORT, the Percept-genetic Object-Relation Test: A replication and a reliability study","To determine the reliability and validity of a previously identified ""suicide cluster"" in the Percept-genetic Object-Relation Test (PORT), which test documents subliminal perception of object-relation pictures, 20 suicide attempters and 70 controls were investigated. The correspondence between scores assigned by two judges was 95%-100%. The suicide-cluster signs in PORT, notably ""lack of attachment relationships"" and ""Motor activity,"" were significant. Differences between the results of this and the previous study are discussed as is the role of psychiatric disorder in suicide.",0,0 +4229,Validation of the five-factor model of PTSD symptom structure among delinquent youth.,"This study compared the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM–IV–TR; American Psychiatric Association, 2000) diagnostic 3-factor structure of posttraumatic stress disorder (PTSD) symptoms with leading 4-factor models and the newly proposed 5-factor dysphoric arousal model in a sample of 1,363 juvenile-justice-involved adolescents (990 boys, 373 girls). Structural equation modeling suggested that the 5-factor dysphoric arousal model fit significantly better than each of the other models. The model fit better for girls than for boys, and girls evidenced stronger factor loadings for items on all but the Anxious Arousal factor. The factors of the 5-factor model were then tested as mediators of the association between interpersonal and noninterpersonal trauma and mental health problems. Interpersonal trauma was associated with PTSD symptoms for boys and girls, whereas noninterpersonal trauma exposure was only associated with PTSD symptoms for boys, despite equal levels of exposure across genders, suggesting that girls may be more sensitive to the effects of interpersonal, but not noninterpersonal, trauma. Patterns in mediation were moderated by gender, as girls’ data showed stronger paths leading to depression/anxiety, somatic complaints, and suicidal ideation through PTSD symptoms, whereas for boys, paths were stronger leading to anger/irritability symptoms. Mediation results suggested differential patterns of influence for dysphoric versus anxious arousal and also indicate the importance of numbing for delinquent youth. These results add to the evidence base supporting the 5-factor dysphoric arousal model in establishing developmentally sensitive criteria for the diagnosis of PTSD among traumatized youth.",0,0 +4230,A test of the assumptions of the transtheoretical model in a post-traumatic stress disorder population,"Prior reports suggest an ambivalence regarding treatment in individuals with Post-Traumatic Stress Disorder (PTSD). A model that accommodates such ambivalence is the Transtheoretical Model of Behavior Change (TTM, also known as the Stages-of-Change Model). Fifty veterans presenting for treatment completed self-report measures (94% response rate) that assessed disorder variables and constructs relating to the TTM. While the relationships between the components of each specific construct were found to be consistent with the findings of other studies and a number of predicted relationships between variables were confirmed, many results were inconsistent with the TTM. Notwithstanding questions about the suitability of the self-report measures, the unique characteristics of the veteran sample and the small sample size, the results suggest that the assumptions of the TTM were not met in veterans with PTSD. Copyright © 2005 John Wiley & Sons, Ltd.",0,0 +4231,Localization of Pain and Self-Reported Rape in a Female Community Sample,"Studies suggest that rape increases risk of medically unexplained pain in women. At present it is not clear whether rape is associated with pain at specific locations or at multiple locations. In this study we tested the hypothesis that rape was associated with a preferential increase in risk of pelvic pain that was not explained by pain at other sites.We relied on an existing community study that oversampled women with fibromyalgia and major depression. Localization was assessed by asking about pain at four sites: pelvic region; jaw/face; headache; and lower back. Three groups were identified using a structured telephone interview: Abuse Only (sexual/physical abuse excluding rape); Rape+Abuse (rape in addition to other sexual/physical abuse); and No Abuse.Compared with the No Abuse group, the Rape+Abuse group was eight times more likely to have pelvic pain and 3.7 times more likely to have jaw/face pain after we controlled for the effect of widespread pain. Rape was not associated with lower back pain or headache. The Abuse Only group did not show a preferential increase in risk of pain at any of the four locations that were assessed. After controlling for pain at other locations, we found that the Rape + Abuse group was 10 times more likely to report pelvic pain than the No Abuse group (P<0.005).In accord with the localization hypothesis, self-reported rape was uniquely associated with pelvic pain. Future efforts to account for pain in the aftermath of rape must specify a mechanism that can simultaneously cause widespread pain as well as increase risk of localized pain.",0,0 +4232,Diagnostic accuracy of the Posttraumatic Stress Disorder Checklist–Civilian Version in a representative military sample.,"This study aimed to assess the diagnostic accuracy of the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C; Weathers, Litz, Herman, Huska, & Keane, 1993) and to establish the most accurate cutoff for prevalence estimation of posttraumatic stress disorder (PTSD) in a representative military sample compared to a clinical interview. Danish soldiers (N = 415; 94.4% male, mean age 26.6 years) were assessed with the PCL-C and the Structured Clinical Interview for the DSM-IV (SCID; First, Spitzer, Gibbon, & Williams, 2002) 2.5 years after their return from deployment to Afghanistan. Diagnostic accuracy of the PCL-C was assessed through receiver operating characteristic curve analysis. The PCL-C displayed high overall accuracy (area under the curve = .95, confidence interval [.92, .98]) and performed well (sensitivity > .70 and specificity ≥ .90), with cutoff scores ranging from 37 to 44. When including sensitivity values a little below .70 (.69), the PCL-C performed well for cutoff levels up to 53. Prevalence of PTSD varied considerably with the application of different cutoff values and scoring methods. Our results show that the PCL-C is a relevant and valid tool for screening for probable PTSD in active military samples. However, it is of great importance that cutoff scores be chosen based on the sample and the purpose of the particular study or screening.",0,0 +4233,A college community's vicarious stress reaction to September 11th terrorism.,"This study examined the effects of vicarious exposure to the September 11 terrorist attacks in an academic community, just after the three-month period that delineates acute from chronic post-traumatic stress. An entire academic community of 1693 students, faculty, and staff was surveyed electronically regarding their perceived stress symptoms and coping behaviors. The survey yielded a 37 percent response rate. About 76 percent showed one or more substantial symptoms of stress, and 32 percent showed three or more. The most prominent symptom clusters involved persistent avoidance and persistent arousal. Respondents primarily relied on coping through optimism, reassessing priorities and relationships, giving and receiving support, and becoming better informed on terrorism-related topics. Differences in symptoms and coping preferences were found based on sex, group (student, faculty, staff), and exposure to previous crisis. This study indicates that despite time and distance from the site of the terrorism, all segments of a college community continue to experience some degree of distress. Such distress can interfere with academic performance, personal health, and relationship stability. Rather than rely on formal support service delivery, most appear to rely on established interpersonal relationships. This suggests that providing support to vicarious victims in the future might emphasize training for friends and family, rather than relying on established service delivery systems. Language: en",0,0 +4234,Physical Health Symptoms in Peacekeepers: Has the Role of Deployment Stress Been Overrated?,"Using a prospective design, physical health symptoms were examined in a sample of 198 peacekeepers. At pre-deployment, general life stressors and pre-deployment stress symptoms were significant predictors of physical health symptoms. At post-deployment, physical health symptoms were predicted by pre-existing physical health symptoms and stress symptoms reported before and after the mission; mission-related stressors were not associated with physical health symptoms. In addition, stress symptoms mediated the relationship between exposure and physical symptoms. Finally, the hyperarousal symptom cluster was a better predictor of physical health complaints than the other symptom clusters. Implications and limitations are discussed.",0,0 +4235,Exploring combat-related loss and behavioral health among OEF/OIF veterans with chronic PTSD and mTBI.,"While combat-related loss is likely to result in the development of lingering stress responses, little is known about its impact on behavioral health. The purpose of this study was to present preliminary results on war-related losses and behavioral health among Operations Enduring Freedom/Iraqi Freedomveterans. Veterans who suffered losses, to include noncombat losses (relationships back home) that occurred while the combatant was in the combat theater, reported more stress, depressive symptoms, and combat experiences. Outcomes were worse for veterans reporting two losses. Most notable was the decline in social support as losses increased. Also of note, avoidance and arousal symptom clusters were the most endorsed. While the pattern was more pronounced for those experiencing loss, results were consistent regardless of number of losses. Language: en",0,0 +4236,Typologies of Childhood Exposure to Violence: Associations With College Student Mental Health,"This study examined typologies of childhood violence exposure (CVE) and the associations of profiles with current demographic characteristics and mental health in emerging adulthood.The study evaluated a sample of college students from 2 US geographic regions (Midwest, n = 195; Southeast, n = 200).An online questionnaire (collected 2013-2014) assessed CVE and current mental health. Latent class analysis was used to identify typologies of CVE. Follow-up analyses were conducted to distinguish differences between typologies in demographic characteristics and mental health.Four distinct profiles emerged: High-Exposed, Domestic-Exposed, Community-Exposed, and Low-Exposed. High- and Domestic-Exposed groups were more likely to be first-generation college students and to experience symptoms of psychopathology.This study offers a unique presentation of CVE profiles and a nuanced interpretation of their differential relationship to current demographic characteristics and mental health. It may befit university mental health initiatives to engage first-generation students and utilize comprehensive assessments of previous victimization.",0,0 +4237,Post-traumatic stress disorder symptomatology among American Indian Vietnam veterans : mediators and moderators of the stress-illness relationship,"Results from the National Vietnam Veterans Readjustment Study (NVSRS) reported high rates of Post-traumatic Stress Disorder (PTSD) among Vietnam Theater veterans compared to rates in the Vietnam Era and others of the veterans' generation. Prevalence rates were even higher among minority groups, specifically Blacks and Hispanics. Results from the American Indian Vietnam Veterans Project (AIVVP) suggested that American Indian Vietnam veterans were also at increased risk for PTSD. However, not all American Indian veterans with high levels of trauma exposure developed PTSD, which suggests that other contributing factors specific to American Indian populations may also affect their vulnerability to PTSD outcomes. The objective of this study was to identify potential predictors of PTSD symptomatology across three military timeframes and to examine the relationships among personal resources, trauma, and PTSD symptomatology in American Indian Vietnam veterans. It was hypothesized that high levels of social support and ethnic identity may enhance one's psychosocial resilience to stress, resulting in positive health outcomes. This study was based on AIVVP data collected by the National Center for American Indian and Alaska Native Mental Health Research (NCAIANMHR) at the University of Colorado Health Sciences Center. Interviews with 621 American Indian Vietnam veterans living on or near their reservations assessed predisposing factors, characteristics of military service, military and nonmilitary trauma, personal resources, and PTSD symptomatology. The results of hierarchical linear regression analyses showed a strong relationship between social support and PTSD symptomatology across all time flames. Although results did not support the stress-buffering hypothesis, combat trauma and social support during the military interacted significantly. In addition, post-military social support appeared to mediate the relationship between trauma and PTSD symptomatology. Identifying a relationship between social support and PTSD has implications for the development of interventions used to treat PTSD in ethnic minorities. The impact of personal resources on PTSD symptomatology may be important for traumatic survivors and long-term strategies for victims of PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4238,Posttraumatic Stress Disorder and Functioning and Quality of Life Outcomes in a Nationally Representative Sample of Male Vietnam Veterans,"Although posttraumatic stress disorder (PTSD) is a highly prevalent and often chronic condition, the relationship between PTSD and functioning and quality of life remains incompletely understood.The authors undertook an archival analysis of data from the National Vietnam Veterans Readjustment Study. The study subjects consisted of the nationally representative sample of male Vietnam veterans who participated in the National Vietnam Veterans Readjustment Study. The authors estimated PTSD at the time of the interview with the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder. They examined the following outcomes: diminished well-being, physical limitations, bed day in the past 2 weeks, compromised physical health status, currently not working, and perpetration of violence. Logistic models were used to determine the association between PTSD and outcome; adjustment was made for demographic characteristics and comorbid psychiatric and other medical conditions.The risks of poorer outcome were significantly higher in subjects with PTSD than in subjects without PTSD in five of the six domains. For the outcome domains of physical limitations, not working, compromised physical health, and diminished well-being, these significantly higher risks persisted even in the most conservative logistic models that removed the shared effects of comorbid psychiatric and other medical disorders.The suffering associated with combat related-PTSD extends beyond the signs and symptoms of the disorder to broader areas of functional and social morbidity. The significantly higher risk of impaired functioning and diminished quality of life uniquely attributable to PTSD suggests that PTSD may well be the core problem in this group of difficult to treat and multiply afflicted patients.",0,0 +4239,Protecting Children from Violence,"Providing an evidence-based understanding of the causes and consequences of violence against children, experts in the field examine the best practices used to help protect children from violence. Various types of violence are reviewed including physical and sexual abuse, (cyber-)bullying, human trafficking, online predators, abductions, and war. In addition, it reviews the various perpetrators of such violence including parents and relatives, strangers, other children, and societal institutions. The possible outcomes of such violence including physical injuries, death, depression, anxiety, post-traumatic stress disorders, and damage to the social fabric of the local community are also explored. To enhance accessibility, each contributor addresses common themes: • Opening case studies dramatically illustrate the human cost of abuse and neglect • Empirically driven estimates of the scope of problem to better understand who is at risk and why • Empirically driven testing of interventions to maximize effectiveness of programs • How current research compares to public perception and the impact on public policy • The worldwide problem of violence against children • Evidence-based recommendations for reducing violence against children. The book opens with a review of the history of the problem, the methodological approaches used to study it, and current –best practice— prevention strategies. The methods used to identify peer victims are then explored. Next child eyewitness memory is examined including the most effective techniques for maximizing the retrieval of information. This is followed by the research on missing and abducted children including the effectiveness of recovery programs such as supermarket campaigns and forensic age profiles. Next how the Internet is used in the victimization of children is explored including tips to help protect children online. Public attitudes toward sex offender registration laws are then reviewed followed by vulnerabilities that include genetic, neuropsychological, temperamental, cognitive, perceptual and social factors. International perspectives on protecting children from violence and global health inequities are then addressed. The book concludes with recommendations for future research. Contributors are noted scholars from a broad range of disciplines. As such, the book appeals to researchers and advanced students in developmental, counseling, clinical, cognitive, evolutionary, and social psychology, as well as sociology, social work, criminal justice, education, and law enforcement. © 2010 by Psychology Press. All rights reserved.",0,0 +4240,Somatic symptoms and health-related quality of life among treatment-seeking Canadian Forces personnel with PTSD,"This study examined the association between somatic complaints and health-related quality of life (HR-QoL) in treatment-seeking Canadian military personnel with military-related Posttraumatic Stress Disorder (PTSD). Current and former Canadian Forces (CF) members attending the Parkwood Hospital Operational Stress Injury Clinic in London, Ontario (N=291) were administered self-report questionnaires assessing number and severity of somatic complaints, PTSD and depressive symptom severity, and mental and physical health-related quality of life (HR-QoL) prior to commencing treatment. Regression analyses were used to identify the role of somatic complaints on physical and mental HR-QoL, after controlling for PTSD symptom cluster and depressive symptom severity. Somatic symptom severity accounted for only a small amount of the variance in mental HR-QoL after accounting for PTSD symptom cluster and depressive symptom severity, but accounted for a larger proportion of the variance in physical HR-QoL after accounting for PTSD cluster and depressive symptom severity. Understanding the role of somatization in the symptom-presentation of military personnel with PTSD may provide additional avenues for treatment with this population.",0,0 +4241,Framing disaster resilience,"Purpose – To confront the increasingly devastating impacts of disasters and the challenges that climate change is posing to disaster risk management (DRM) there is an imperative to further develop DRM. The resilience approach is emerging as one way to do this, and in the last decade has been strongly introduced into the policy arena, although it is not new for DRM practitioners and researchers. Nevertheless, resilience is a highly contested issue, and there is no agreed definition of it, which has resulted in confusion for stakeholders when applying it to practice. Therefore, the purpose of this paper is to investigate how resilience is framed by researchers and DRM practitioners. Design/methodology/approach – The analytical framework used was Hajer's “social-interactive discourse theory”, combined with analysis of government documents, in-depth interviews with practitioners and observation of field and practices within the context of the Natural Disaster Resilience Program in Queensland, Australia. Findings – One of the key findings is that the idea of “bouncing back” is central to the resilience discourse but different interpretations of this idea results in real-world implications. Three different ways (storylines) in which practitioners construct the meaning of disaster resilience emerge from this study. Importantly the divergences between these storylines reveal possibilities for reframing to occur and these could lead to different policy options and practices. Originality/value – The results presented in this paper offer empirical evidence on how resilience is understood on the ground, contributing to extending resilience theory and informing DRM and resilience practice.",0,0 +4242,"Pain, coping, and adjustment in patients with burns: Preliminary findings from a prospective study","We prospectively examined the associations between procedural pain during hospitalization and coping and adjustment 1 month postdischarge in 43 patients treated at a major regional burn center for burns extensive enough to require at least 5 days of daily wound debridement procedures. Both patients and nurses provided ratings of patient pain, which were summarized and aggregated across a 5-day period. Results indicated that those subjects with higher pain scores also reported poorer adjustment as measured by scores on the Brief Symptoms Inventory and the Sickness Impact Profile. Moreover, these associations remained significant after partialling out the effects of preburn adjustment. Hierarchical regression analyses revealed evidence that seeking social support had a moderating effect on the association between pain and scores on a measure of posttraumatic stress disorder.",0,0 +4243,No PTSD-related differences in diurnal cortisol profiles of genocide survivors,"Posttraumatic stress disorder (PTSD) has been associated with reduced cortisol levels. Opposing results have been interpreted as resulting from methodological differences between studies. We investigated the diurnal profile of salivary cortisol in a population of highly traumatized adult males from Rwanda with and without PTSD, who spent the whole day of examination together under a maximally standardized schedule. Besides the detection of PTSD-related alterations in cortisol release we aimed at determining physiologically relevant effects of cumulative trauma exposure on HPA functioning in interaction with or independent of diagnosis. There were no differences in the diurnal pattern of cortisol release between subjects with and without PTSD. We observed an increasing prevalence of PTSD with increasing number of different traumatic event types experienced, replicating earlier results on a “building-block effect” of multiple traumatization. However, size of cumulative exposure was not related to any of the cortisol measures. The results suggest that besides methodological constraints also confounding factors not previously controlled for, e.g., sex differences or current life stress, might contribute to the diverging results of lowered, unchanged or enhanced cortisol secretion in PTSD. Future research should therefore closely monitor these possible confounds to optimize models for cortisol in research on stress-dependent illnesses.",0,0 +4244,"Post-traumatic stress disorder and traumatic brain injury: A review of causal mechanisms, assessment,and treatment","In this paper we explore the evidence for post-traumatic stress disorder (PTSD) after traumatic brain injury (TBI). We examine its possible mediating mechanisms after brain injury, the evidence for its occurrence, risk, and protective factors, and the implications for intervention and service demands. In the first section we review the current literature relevant to cause, maintenance, and treatment of PTSD in general, before addressing issues associated with the assessment and management of PTSD after TBI. It is argued that PTSD may occur after a brain injury, and can be, relatively, a common disorder. However, explanatory mechanisms for its occurrence may be speculative. In this context, we argue, assessment and treatment need to be carefully considered, and comprehensive.",0,0 +4245,"Prevalence of post-traumatic stress symptoms and associated factors in tuberculosis (TB), TB retreatment and/or TB–HIV co-infected primary public health-care patients in three districts in South Africa","High rates of tuberculosis (TB) and TB/HIV co-infection is often linked with mental health issues such as post-traumatic stress disorder (PTSD) symptoms, which is further associated with poor health outcomes. In a country such as South Africa where rates of these infectious diseases are high, it is concerning that there is limited/no data on prevalence rates of mental disorders such as PTSD and its associated factors. Therefore, the aim of this study was to establish the prevalence of PTSD symptoms and associated factors in TB, TB retreatment and/or TB-HIV co-infected primary public health-care patients in three districts in South Africa. Brief screening self-report tools were used to measure: PTSD symptoms, psychological distress (anxiety and depression) and alcohol misuse. Other relevant measures, such as adherence to medication, stressful life events and sexual risk-taking behaviours, were obtained through structured questions. A total of 4900 public primary care adult patients from clinics in high TB burden districts from three provinces in South Africa participated. All the patients screened positive for TB (either new or retreatment cases). The prevalence of PTSD symptoms was 29.6%. Patients who screened positive for PTSD symptoms and psychological distress were more likely to be on antidepressant medication. Factors that predicted PTSD symptoms were poverty, residing in an urban area, psychological distress, suicide attempt, alcohol and/or drug use before sex, unprotected sex, TB-HIV co-infected and the number of other chronic conditions. Health-care systems should be strengthened to improve delivery of mental health care, by focusing on existing programmes and activities, such as those which address the prevention and treatment of TB and HIV.",0,0 +4246,The Long-Term Impact of Physical and Emotional Trauma: The Station Nightclub Fire,"Survivors of physical and emotional trauma experience enduring occupational, psychological and quality of life impairments. Examining survivors from a large fire provides a unique opportunity to distinguish the impact of physical and emotional trauma on long-term outcomes. The objective is to detail the multi-dimensional long-term effects of a large fire on its survivor population and assess differences in outcomes between survivors with and without physical injury.This is a survey-based cross-sectional study of survivors of The Station fire on February 20, 2003. The relationships between functional outcomes and physical injury were evaluated with multivariate regression models adjusted for pre-injury characteristics and post-injury outcomes. Outcome measures include quality of life (Burn Specific Health Scale-Brief), employment (time off work), post-traumatic stress symptoms (Impact of Event Scale-Revised) and depression symptoms (Beck Depression Inventory). 104 fire survivors completed the survey; 47% experienced a burn injury. There was a 42% to 72% response rate range. Although depression and quality of life were associated with burn injury in univariate analyses (p<0.05), adjusted analyses showed no significant relationship between burn injury and these outcomes (p = 0.91; p = .51). Post-traumatic stress symptoms were not associated with burn injury in the univariate (p = 0.13) or adjusted analyses (p = 0.79). Time off work was the only outcome in which physical injury remained significant in the multivariate analysis (p = 0.03).Survivors of this large fire experienced significant life disruption, including occupational, psychological and quality of life sequelae. The findings suggest that quality of life, depression and post-traumatic stress outcomes are related to emotional trauma, not physical injury. However, physical injury is correlated with employment outcomes. The long-term impact of this traumatic event underscores the importance of longitudinal and mental health care for trauma survivors, with attention to those with and without physical injuries.",0,0 +4247,Psychologiczne reakcje członków rodzin chorych leczonych na oddziałach intensywnej terapii,"The environment of the intensive care unit (ICU) is burdensome to a patient and the patient's family. There is a higher risk of depression, anxiety and stress-related disorders in the ICU patients' family members. In relatives of critically ill patients, the cluster of adverse psychological reactions, such as: anxiety, acute stress disorder, posttraumatic stress disorder, depression and complicated grief, is called post-intensive care syndrome - family (PICS-F). These complications may affect the relatives' ability to perform the role of a caregiver and it can also hinder their daily functioning. Apart from negative psychological consequences experienced after a loved one's stay in the ICU, there are also some positive changes observed in patient's relatives called posttraumatic growth. In this review, the psychological repercussions in the ICU patient's family and the means to prevent their undesirable responses are discussed.",0,0 +4248,Rorschach Correlates of Sexual Abuse: Trauma Content and Aggression Indexes,"This study compared Rorschach records of nondissociative outpatients with histories of (a) definite sexual abuse (n = 22), (b) suspected but unconfirmed sexual abuse (n = 13), or (c) no sexual abuse (n = 43) on selected variables hypothesized to be associated with sexual abuse. As predicted, clients with definite sexual abuse scored significantly higher than clients known not to be sexually abused on Armstrong and Loewenstein's (1990) Trauma Content index (TC/R), with an effect size greater than 1 SD. Contrary to prediction, there was no significant difference in the frequency of their Aggressive Past (AgPast; Gacono & Meloy, 1994) scores. AgPast scores, however, did positively correlate with sexual abuse that was violent or sadistic. As a test of discriminant validity, we hypothesized that 2 Rorschach variables (PER and Sc) would be unrelated to sexual abuse. This was supported by our data. Although TC/R was strongly associated with the presence and severity of sexual abuse, it could not discriminate sexually abused from nonsexually abused clients with great accuracy. The TC/R score is 1 factor among many that can be used to assess the validity of clients' claims of past sexual abuse.",0,0 +4249,Former Combatants in Liberia: The Burden of Possible Traumatic Brain Injury Among Demobilized Combatants,"To provide a better understanding of any associations between Disarmament, Demobilization, and Reintegration, previous head injury, and mental health symptoms among former combatants in Liberia.A cluster-sampled national survey of the adult household-based Liberian population.Former combatants with reported head injury were more likely to experience major depressive disorder symptoms, suicidal ideation and attempts, and current substance abuse. Former combatants with head injury are 2.83 times more likely to have major depressive disorder symptoms, and those with suspected traumatic brain injury are five times more likely to have post-traumatic stress disorder.The poor mental health of former combatants in Liberia, both child and adult, might be mitigated if Disarmament, Demobilization, and Reintegration programming assessed participants for head trauma and traumatic brain injury using simple screening methods. The specific health and mental health needs of ex-combatants--a highly vulnerable group--will need to be addressed by Liberia. If left untreated, ex-combatants with high rates of suicidal ideation and post-traumatic stress disorder might be susceptible to re-recruitment into new conflicts in the region.",0,0 +4250,"Risk of lipid abnormality with haloperidol, olanzapine, quetiapine, and risperidone in a Veterans Affairs population","Second-generation antipsychotics can cause lipid elevations at a greater rate than older typical antipsychotics. This risk may not be equivalent amongst the second-generation antipsychotics. We conducted a computerized, retrospective, nonrandomized, case-control analysis of 6331 patients receiving antipsychotics. For each patient, the first prescription for at least 60 continuous days for four antipsychotics [haloperidol (HALD), olanzapine (OLANZ), quetiapine (QUET), or risperidone (RISP)] was analyzed for total cholesterol, low-density lipoprotein, high-density lipoprotein (HDL), and triglycerides (TGL). Mean HDL was lower during OLANZ treatment than with RISP (P = 0.03) or QUET (P = 0.001). TGL were higher during OLANZ (P = 0.0007) or QUET treatment (P = 0.006) than RISP. In dichotomous analyses, odds ratios on the percentage of participants having abnormal cholesterol (P = 0.0003), low-density lipoprotein (P = 0.001), or TGL (P = 0.0001) during medication were in the order: OLANZ > QUET > RISP > HALD. For HDL, the results were less robust but the percentage of participants were in the order: OLANZ>RISP = HALD = QUET. In treatment-emergent analyses of patients without lipid abnormalities during an unmedicated baseline period, there was a greater risk of developing new HDL abnormality with OLANZ than RISP (P<0.05). In conclusion, treatment with RISP or HALD was associated with a more favorable lipid profile than with OLANZ or QUET.",0,0 +4251,Longitudinal mental health impact among police responders to the 9/11 terrorist attack,"Background Among police responders enrolled in the World Trade Center Health Registry (WTCHR), Post-traumatic Stress Disorder (PTSD) was almost twice as prevalent among women as men 2–3 years after the 9/11 attacks. Methods Police participants in the WTCHR Wave 1 survey 2–3 years after 9/11/01, were reassessed for probable PTSD at Wave 2, 5–6 years after 9/11/01, using PCL DSM-IV criteria. Results Police participants in the Wave 2 survey included 2,527 men, 413 women. The prevalence of “Probable PTSD” was 7.8% at Wave 1 and 16.5% at Wave 2. Mean PCL scores increased from 25.1 to 29.9 for men and 28.6 to 32.2 for women. Prevalence of PTSD was higher for women than for men at Wave 1 (χ2 = 10.882, P = 0.002), but not Wave 2 (χ2 = 2.416, P = 0.133). Other risk factors included losing one's job after 9/11 and being disabled. Conclusions Prevalence of probable PTSD among police doubled between 2003–2004 and 2006–2007. After the 2-year time span, the gender difference was no longer significant; prevalence of PTSD symptoms increased and there was a substantial amount of co-morbidity with other mental health problems. Further development of prevention and intervention strategies for police responders with symptoms of PTSD is needed. The observed upward trend in PCL scores over time in police officers with PCL scores less than 44, suggests that PTSD prevention and intervention strategies should be applied to all police affected by the 9/11 attacks, not limited just to those with PTSD symptoms. Am. J. Ind. Med. 55:297–312, 2012. © 2011 Wiley Periodicals, Inc.",0,0 +4252,Trauma-related Structural Dissociation of the Personality,"Abstract Many traumatized individuals alternate between re-experiencing their trauma and being detached from, or even relatively unaware of the trauma and its effects. At first sight one may be inclined to conceptualize detachment from trauma and re-experiencing of trauma as mental states. However, on closer scrutiny it becomes apparent that in both cases a range or cluster of states rather than a singular state is involved. For example, being detached from trauma does not itself exclude being joyful, ashamed, sexually aroused, or curious at times, and re-experiencing trauma can encompass states such as fleeing, freezing, and being in pain or being analgesic. In this paper we relate detachment from trauma and re-experiencing trauma to emotional operating systems (Panksepp, 1998) and functional systems (Fanselow & Lester, 1988), briefly addressed as action systems. Action systems control a range of functions, but some are more complex than others. Reexperiencing trauma will be associated with the inborn and evolutionary derived defensive system that is evoked by severe threat, in particular threat to the integrity of the body. As a complex system, it encompasses various subsystems, such as flight, freeze, and fight. Detachment from trauma, in our view, is associated with several action systems (Panksepp, 1998), i.e., the ones that control functions in daily life (e.g., exploration of the environment, energy control), and the ones that are dedicated to survival of the species (e.g., reproduction, attachment to and care for offspring). In this context we will maintain that severe threat may provoke a structural dissociation of the premorbid personality (Van der Hart, 2000). In its primary form this dissociation is between the defensive system on one hand, and the systems that involve managing daily life and survival of the species on the other hand. To summarize the essence of the theory of structural dissociation of the personality, we argue (1) that traumatic experiences, especially when they occur early in life and involve severe threat to the integrity of the body, may activate psychobiological action systems that have been developed by evolution, and (2) that due to extreme stress levels and classical as well as evaluative conditioning to traumatic memories these systems may remain unintegrated to varying degrees.",0,0 +4253,Epidemiological investigation on major depressive disorder in the most heavily damaged areas from Wenchuan earthquake in 2008,"OBJECTIVE: To assess the prevalence, demographic characteristics, risk factors and protective factors on major depression disorder (MDD) among the affected people in the epicenter, 7 months after the 2008-earthquake in Wenchuan, China. METHODS: Stratified multistage cluster randomization was conducted to choose 14 503 subjects aged 15 years or over in the city of Dujiangyan, Beichuan county and Qingchuan county, Sichuan province. We used the general health questionnaire (GHQ-12) as the screening instrument, and the structured clinical interview for DSM-IV-TR axis I disorder-patient edition (SCID-I/P) as the tool for diagnosis. RESULTS: There were 180 persons diagnosed as MDD with other 13 asymptomatic ones. The point prevalence of MDD was 1.27% and the lifetime prevalence was 1.36%. Risk factors were including:being female (OR = 1.56, 95%CI: 1.136 ∼ 2.143, P 20 000 Yuan (OR = 2.54, 95% CI: 1.38 - 4.68, P Language: zh",0,0 +4254,Heterogeneity in clinical presentations of posttraumatic stress disorder among medical patients: Testing factor structure variation using factor mixture modeling,"The present study used factor mixture modeling to explore empirically defined subgroups of psychological trauma victims based on confirmatory factor analysis (CFA) and latent class analysis of posttraumatic stress disorder (PTSD) symptoms. We sampled 310 medical patients with a history of trauma exposure. Confirmatory factor analysis revealed that the 4-factor emotional numbing PTSD model yielded the best model fit. Using latent factor means derived from this model and the 4-factor dysphoria PTSD model (indexing severity on PTSD factors), 3 latent classes of participants were identified using factor mixture modeling. The 3-class model fit the data very well and was validated against external measures of anxiety and rumination.",0,0 +4255,The influence of pre-deployment cognitive ability on post-traumatic stress disorder symptoms and trajectories: The Danish USPER follow-up study of Afghanistan veterans,"New trajectories of PTSD symptoms have recently been identified in war exposed army veterans. The aim of this army veterans study was to examine whether pre-deployment cognitive ability is associated with the risk of developing PTSD symptoms or non-resilient PTSD trajectories.Follow up study in 428 Danish soldiers, deployed to Afghanistan in 2009, who were assessed at six occasions from pre-deployment to three years post-deployment. Pre-deployment vulnerabilities, deployment and homecoming stressors were measured. Pre-deployment cognitive test scores on Børge Priens Prøve (based on logical, verbal, numerical and spatial reasoning) were converted to a mean of 100 and with a standard deviation of 15.Higher pre-deployment cognitive ability scores were associated with lower risk of PTSD symptoms as assessed by the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) 2.5 years post-deployment (OR=0.97; 95% CI 0.95-1.00) after adjustment for educational length, baseline PCL-C score and perceived war-zone stress. Compared to a resilient trajectory, a non-resilient relieved-worsening trajectory (high baseline mental symptoms, being symptom free during deployment and a drastic increase in PTSD symptoms at the final assessments of PTSD symptoms) had significantly lower cognitive scores by a mean difference of 14.5 (95% CI 4.7-24.3). This trajectory (n=9) comprised 26.5% of soldiers with moderate-severe PTSD symptoms 2.5 years post-deployment.We confirmed an inverse association between pre-deployment cognitive ability and risk of PTSD symptoms, and observed significantly lower mean pre-deployment cognitive scores in one non-resilient PTSD trajectory. If replicated, this might inform relevant prevention efforts for soldiers at pre-deployment.",0,0 +4256,Conditioning and ethological models of anxiety disorders: stress-in-dynamic-context anxiety models.,"(from the chapter) argue that the central shortcoming of traditional behavioral models has been their failure to consider the dynamic context in which stressors occur in a person's life / by ignoring the powerful effect of dynamic contextual factors on the impact of those stressors, behavioral models have appeared to be much more simplistic than they need to be and to have far less explanatory power than we know they can have / refer to the more traditional models as Stress-in-Total-Isolation Anxiety models (SITIA models) / present an alternative model in which we show that stress must always be considered in a dynamic context rather than in isolation in determining the outcome of exposure to stress the relevant dynamic contextual factors that we will consider include constitutional factors such as temperament, past experiential history (including general factors such as a history of exposure to uncontrollable life events as well as specific factors such as prior traumatic conditioning events), current contextual factors at the time of a stressor (such as whether there are already reliable predictors of the stressor, or the nature of the conditioned stimulus relative to the nature of the unconditioned stimulus, or whether the stressor can be controlled), and future modification of the impact of the stressor (through processes such as forgetting and other memory modifications, as well as through later experiences with other stressors) / refer to these models as the Stress-in-Dynamic-Context Anxiety models (SIDCA models) specific phobias [vicarious conditioning of fears and phobias, sources of individual differences in the acquisition of fears and phobias, selective associations in the conditioning of fears and phobias, persistence of fears and phobias] / social phobia [preparedness and conditioning models of social phobia; direct traumatic conditioning, observational conditioning, and social phobia; temperamental variables and social phobia; uncontrollability and social phobia] / panic disorder and agoraphobia / generalized anxiety disorder / posttraumatic stress disorder (PTSD) / obsessive-compulsive disorder [animal models of compulsive behaviors, anxiety reduction theory, preparedness and the nonrandom distribution of obsessive thoughts and compulsive behaviors] (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4257,Anxiety and alcohol use disorders: comorbidity and treatment considerations.,"The co-occurrence of anxiety disorders and alcohol use disorders (AUDs) is relatively common and is associated with a complex clinical presentation. Sound diagnosis and treatment planning requires that clinicians have an integrated understanding of the developmental pathways and course of this comorbidity. Moreover, standard interventions for anxiety disorders or AUDs may need to be modified and combined in targeted ways to accommodate the unique needs of people who have both disorders. Optimal combination of evidence-based treatments should be based on a comparative balance that considers the advantages and disadvantages of sequential, parallel, and integrated approaches.",0,0 +4258,9/11: Mental Health in the Wake of Terrorist Attacks,"Does terrorism have a unique and significant emotional and behavioral impact among adults and children? In what way does the impact of terrorism exceed the individual level and affect communities and specific professional groups, and test different leadership styles? How were professional communities of mental health clinicians, policy-makers and researchers mobilized to respond to the emerging needs post disaster? What are the lessons learned from the work conducted after 9/11, and the implications for future disaster mental health work and preparedness efforts? Yuval Neria and his team are uniquely placed to answer these questions having been involved in modifying ongoing trials and setting up new ones in New York to address these issues straight after the attacks. No psychiatrist, mental health professional or policy-maker should be without this book.",0,0 +4259,"Factors impacting on psychological distress and recovery after the 2004 Niigata-Chuetsu earthquake, Japan: Community-based study","This study was undertaken 5 months after the 2004 Niigata-Chuetsu earthquake in Japan to assess factors that impacted on psychological distress and its recovery.Three thousand and twenty-six adult victims who lived in temporary shelter and in seriously damaged areas were evaluated by questionnaire. The questionnaire queried subject profile, degree of house damage, health status, and psychological distress using a 5-point scale before, immediately and 5 months after the earthquake.Immediately after the earthquake, 59.3% of the subjects had psychological distress. At 5 months after the earthquake, however, this percentage decreased to 21.8%. The psychological distress immediately after the earthquake was significantly serious in victims who: (i) were female; (ii) felt stronger fear of the earthquake and the aftershocks; (iii) lived at home or office after the earthquake; and (iv) were injured due to the earthquake or suffered from sickness after the earthquake. In contrast, the factors impairing psychological recovery 5 months after the earthquake were as follows: (i) being with unfamiliar member(s) during the night after the earthquake; (ii) serious house damage; (iii) living in temporary shelter or at a relative's home after the earthquake; and (iv) physical illness after the earthquake.Despite differences between disasters, these results were consistent with those in some previous studies and may be useful for long-term mental care support.",0,0 +4260,Prevalence of personality disorders among combat veterans with posttraumatic stress disorder,"Many combat veterans with PTSD have co-occurring symptoms of other forms of psychopathology; however, there have been limited studies examining personality disorders among this population. The few extant studies typically have assessed only two or three personality disorders or examined a small sample, resulting in an incomplete picture and scope of comorbidity. This study assessed all DSM-III-R personality disorders in 107 veterans in a specialized, inpatient unit. Using the Structured Clinical Interview for DSM-III-R Personality Disorders, 79.4% of the participants were diagnosed with at least one personality disorder: 29.9% received only one diagnosis, 21.5% had two, 15.9% had three, and 12.1% had four or more. The most frequent single diagnoses were Avoidant (47.2%), Paranoid (46.2%), Obsessive-Compulsive (28.3%), and Antisocial (15.1%) personality disorders.",0,0 +4261,Using Pattern Analysis Matching to Differentiate TBI and PTSD in a Military Sample,"Distinguishing between traumatic brain injury (TBI) residuals and the effects of posttraumatic stress disorder (PTSD) during neuropsychological evaluation can be difficult because of significant overlap of symptom presentation. Using a standardized battery of tests, an artificial neural network was used to create an algorithm to perform pattern analysis matching (PAM) functions that can be used to assist with diagnosis. PAM analyzes a patient's neuropsychological data and provides a best fit classification, according to one of four groups: TBI, PTSD, malingering/invalid data, or ""other"" (depressed/anxious/postconcussion syndrome/normal). The original PAM was modeled on civilian data; the current study was undertaken using a database of 100 active-duty army service personnel who were referred for neuropsychological assessment in a military TBI clinic. The PAM classifications showed 90% overall accuracy when compared with clinicians' diagnoses. The PAM function is able to classify detailed neuropsychological profiles from a military population with a high degree of accuracy and is able to distinguish between TBI, PTSD, malingering/invalid data, or ""other."" PAM is a useful tool to help with clinical decision-making.",0,0 +4262,Addictive profile in juvenile delinquents admitted to correctional institutions in relation to personality characteristics,"Introduction A strong correlation and connection has been observed between drug use and delinquency, as most youths in juvenile commitment programs are involved with drugs compared with nondelinquent youths. Aim of the study The aim of this study was to determine the relationship between substance use among delinquent adolescents and personality characteristics and its impact on mental health. Methods Fifty juvenile delinquent adolescents from among juveniles admitted to two correctional institutes as well as 50 control juveniles were selected. Informed consent was taken. Psychometric analyses were conducted using the Addiction Severity Index, the Eysenck Personality Questionnaire, and The Adolescent and Adult Psychological State Inventory. Results Of the juvenile delinquents, 28% were found to be using nicotine, 22% were using cannabis, and 24% were using polysubstances. They expressed more symptoms of adjustment disorder, generalized anxiety disorder, depression, phobia, post-traumatic stress disorder, attention deficiency hyperactivity disorder, and conduct disorder, and the difference was statistically significant between cases and controls. There were statistically significant differences between cases and controls as regards all the personality dimensions, including extraversion, neuroticism, and psychoticism. In all, 25% of juvenile delinquents suffered from moderate to severe problems with regard to employment, legal, psychiatric, and social problems, as assessed by the Addiction Severity Index. There were statistically significant differences between male and female delinquents as regards employment, psychiatric, and social problems as assessed by the Addiction Severity Index. Conclusion Community and correctional systems must be established to provide psychiatric services to the youth, as juvenile delinquents with psychiatric disorders pose a challenge for the juvenile justice system and, after their release, for the larger mental health system. © 2012 Okasha Institute of Psychiatry, Ain Shams University.",0,0 +4263,Randomized controlled trial of cognitive behaviour therapy for comorbid post-traumatic stress disorder and alcohol use disorders,"Aims This study aimed to test the efficacy of integrated cognitive behaviour therapy (CBT) for coexisting post traumatic stress disorder (PTSD) and alcohol use disorders (AUD). Setting Clinics across Sydney, Australia.Design Randomized controlled trial of 12 once-weekly individual sessions of either integrated CBT for PTSD and AUD(integrated therapy, IT; n = 33) or CBT for AUD plus supportive counselling (alcohol-support, AS; n = 29). Blind assessments were conducted at baseline and post-treatment and at 5 [standard deviation (SD) = 2.25] and 9.16(SD = 3.45) months post-treatment. Participants Sixty-two adults with concurrent PTSD and AUD. Measurements Outcomes included changes in alcohol consumption (time-line follow-back), PTSD severity [clinician-administered PTSD scale (CAPS)], alcohol dependence and problems, and depression and anxiety. Findings Reductions in PTSD severity were evident in both groups. IT participants who had received one or more sessions of exposure therapy exhibited a twofold greater rate of clinically significant change in CAPS severity at follow-up than AS participants [IT60%, AS 39%, odds ratio (OR): 2.31, 95% confidence interval (CI): 1.06, 5.01]. AS participants exhibited larger reductions than IT participants in alcohol consumption, dependence and problems within the context of greater treatment from other services during follow-up. Results lend support to a mutually maintaining effect between AUD and PTSD. Conclusions Individuals with severe and complex presentations of coexisting post-traumatic stress disorder(PTSD) and alcohol use disorders (AUD) can derive substantial benefit from cognitive behaviour therapy targeting AUD, with greater benefits associated with exposure for PTSD. Among individuals with dual disorders, these therapies can generate significant, well-maintained treatment effects on PTSD, AUD and psychopathology.",0,0 +4264,Substantial Symptom Changes in Naturalistic Recovery from Aversive Events,"Researchers have recommended examining trajectories of recovery from aversive events, including sudden gains and spikes. We examined rates, attributions for, and outcomes associated with substantial symptom improvements and brief exacerbations after aversive events.Sixty-three women completed questionnaire measures of mood, depression, and posttraumatic stress disorder symptoms. They used a Life History Calendar (LHC) to draw the trajectory of symptom levels from the event to the present, and were interviewed regarding the course of their symptoms. Based on the LHC and interview, we coded whether each participant experienced substantial improvements and/or brief exacerbations and reasons for them.Participants frequently experienced substantial improvements and brief exacerbations, most of which they attributed to external events. Substantial improvements-but not substantial brief exacerbations-were associated with significantly lower symptom levels.Substantial improvements are similar to sudden gains in therapy samples. Substantial improvements in avoidance and mood have positive, bidirectional effects on each other.",0,0 +4265,Post-traumatic growth in people living with a serious medical condition and its relations to physical and mental health: A systematic review,"The diagnosis of a life-threatening illness can be an extremely stressful, traumatic experience. However, many survivors report also various positive changes, referred in empirical literature as post-traumatic growth (PTG). Empirical studies that documented stress disorders and PTG in patients and survivors of life-threatening diseases are reviewed in three areas: Predictors of PTG, relationships between PTG and indicators of mental health and the impact of PTG on the process of convalescence.The literature review was completed by making use of three major databases - PsycINFO, PILOTS and Medline.The majority of the studies investigated PTG and its relationships to health indicators after the diagnosis of cancer, HIV/AIDS, cardiac disease, multiple sclerosis and rheumatoid arthritis. The review indicated that quality of social support, patients' coping strategies and several indicators of mental and physical health were consistently associated with post-traumatic growth. Associations between growth and health-related variables (e.g. physical deficits, pain, depression, anxiety) varied depending on different study design (cross-sectional versus longitudinal) and the sample composition (patients versus symptom-free survivors). Several findings are disease-specific.The results point to the potential adaptive significance of PTG. More research is needed to investigate specific disease-related profiles of PTG and the complex mechanisms, which underlie the relationships between PTG and the process of convalescence. This knowledge may help to foster the overall positive adjustment of chronically ill patients.",0,0 +4266,"Posttraumatic stress disorder, smoking, and cortisol in a community sample of pregnant women","The prevalence of posttraumatic stress disorder (PTSD) in the United States is higher among pregnant women than women generally. PTSD is related to adverse birth outcomes via physiological and behavioral alterations, such as smoking.We utilize salivary cortisol measures to examine how traumatic stress, smoking and the hypothalamic-pituitary-adrenal axis interact. Pregnant women (n=395) gave cortisol specimens as part of a cohort study of PTSD and pregnancy at three health systems in the Midwestern United States. Women were divided into three groups: nonsmokers, quitters (who stopped smoking during pregnancy), and pregnancy smokers. Mean cortisol values at three points, sociodemographics, trauma history, and PTSD were compared across groups. We assessed the association of smoking group and PTSD with late afternoon cortisol levels.Smokers, quitters, and nonsmokers differed on demographic risk factors and PTSD symptom load. Late afternoon and bedtime cortisol measures were significantly positively correlated with smoking in pregnancy, with smokers with PTSD presenting the highest cortisol levels. Regression analysis showed that smoking in pregnancy was associated with higher late afternoon cortisol in an additive manner with PTSD symptoms.Smoking appears to have a different relationship with cortisol level for those with and without PTSD. This is the first study to show additive effects of smoking and PTSD on cortisol levels in pregnant women. Since high cortisol, smoking, and PTSD have been shown to adversely affect perinatal outcomes, and since those continuing to smoke in pregnancy had the highest PTSD symptom load, PTSD-specific smoking cessation programs in maternity settings are warranted.",0,0 +4267,Alcohol use trajectories among adults in an urban area after a disaster: evidence from a population-based cohort study,"Alcohol use increased in the New York City (NYC) metropolitan area in the first months after the 11 September 2001 terrorist attacks.To investigate alcohol use trajectories in the NYC metropolitan area in the 3 years after 11 September and examine the relative contributions of acute exposure to the attacks and ongoing stressors to these trajectories.We used a population-based cohort of adults recruited through a random-digit-dial telephone survey in 2002; participants completed three follow-up interviews over 30 months.The NYC metropolitan area.A total of 2752 non-institutionalized adult residents of NYC.We used growth mixture models to assess trajectories in levels of total alcohol consumption and bingeing in the past 30 days, and predictors of these trajectories.We identified five trajectories of alcohol consumption levels and three bingeing trajectories. Predictors of higher levels of use over time included ongoing stressors, traumatic events and lower income. Ongoing exposure to stressors and low income also play a central role in bingeing trajectories.While point-in-time mass traumatic events may matter in the short term, their contribution subsides over time. Accumulated stressors and traumatic events, in contrast, lead to higher levels of consumption among respondents already vulnerable to high alcohol use. Interventions to mitigate post-disaster stressors may have substantial benefit in reducing alcohol abuse in the medium- to long term.",0,0 +4268,Expressive flexibility.,"Previous research has examined the consequences of either expressing or suppressing emotion using between-subjects designs. However, emotion theorists have argued that adaptation depends not so much on one regulatory process but rather on the ability to flexibly regulate emotion in accord with situational demands. To test this idea, Bonanno, Papa, Lalande, Westphal, and Coifman (2004) developed a within-subjects experimental paradigm to measure expressive flexibility (EF) and showed that EF predicted better self-reported adjustment over a 2-year period. The current investigation extends this research by (1) demonstrating the stability of EF across a 3-year period, (2) replicating the association between EF and positive adjustment using a more objective measure of adjustment (obtained from participants' close friends rather than based on self-report), and (3) by showing that the positive relation between EF and adjustment was particularly salient in the context of high levels of cumulative life stress when EF was measured under conditions of immediate threat (presence of a subliminal threat prime).",0,0 +4269,[Short-term psychological consequences of car accidents: an empirical study].,"AIM: Aim of this study is to investigate short-term (3 and 5 months) psychological consequences of severe motor-vehicle accidents. METHODS: The sample under investigation is composed of two groups: 8 survivors of severe motor-vehicle accidents with spinal cord injuries (SCI) hospitalized in a Spinal Cord Unit, and 6 survivors who did not require hospitalization. All subjects were assessed twice, three and five months after the accident, on a variety of measures including the CAPS and the BDI-SF. RESULTS: Prevalence of PTSD in the total sample was, 3 months after the accident, 14% with no significant differences between the two groups; some peculiarities in the symptomathological profile emerged as much as subjects with SCI experience avoidance of trauma-related stimuli more frequently. An overall decline in frequency and severity of post-traumatic symptoms between the two assessments was observed in the total sample, though some components (Criterion C symptoms) showed no relevant variations over time. Finally, depressive symptoms, which were characterized by higher severity in the SCI group, showed a significant decline between the two assessments. DISCUSSION: Our data, although based on a limited sample, might help in tailoring psychological interventions for prevention and treatment of PTSD in survivors of severe motor accidents. Language: it",0,0 +4270,A systematic review of probable posttraumatic stress disorder in first responders following man-made mass violence,"The current study was a systematic review examining probable posttraumatic stress disorder (PTSD) in first responders following man-made mass violence. A systematic literature search yielded 20 studies that fit the inclusion criteria. The prevalence rates of probable PTSD across all 20 studies ranged from 1.3% to 22.0%. Fifteen of the 20 articles focused on first responders following the September 11th terrorist attacks and many of the studies used the same participant recruitment pools. Overall, the results of the systematic review described here suggest that our understanding of PTSD in first responders following man-made mass violence is based on a very small set of articles that have focused on a few particular events. This paper is meant to serve as a call for additional research and to encourage more breadth in the specific incidents that are examined.",0,0 +4271,Predictors of PTSD trajectories following captivity: A 35-year longitudinal study,"Although war captivity is a potent pathogen for psychiatric illness, little is known about the long-term trajectories of post-traumatic stress disorder (PTSD) among ex-prisoners of wars (ex-POWs). This study aimed to assess the long-term trajectories of PTSD and their predictors following war captivity. Three follow-ups (1991, 2003, 2008) were conducted over 35 years of 164 Israeli ex-POWs and185 comparable combatants from the 1973 Yom Kippur War. Ex-POWs reported higher PTSD rates than controls at all three assessments. Four trajectories of PTSD were identified: chronic PTSD, delayed PTSD, recovery and resilience. The majority of POWs reported delayed PTSD, while the majority of controls were classified as resilient. While PTSD rates remained relatively stable over time among controls, a steep increase in rates was observed among POWs between 1991 and 2003, followed by stabilization in rates between 2003 and 2008. Finally, subjective experience of captivity was the variable that best distinguished between the resilience and PTSD groups of ex-POWs, followed by participation in previous wars and negative life events during childhood. War captivity carries long-lasting psychiatric implications, even decades after release. Aging processes, as well as unique stressors that exist in Israel, may account for the elevated PTSD rates found here.",0,0 +4272,Parenting Support and PTSD in Children of a War Zone,"The protective role of parenting factors on the mental well-being of children exposed to war trauma remains an under-researched area.To establish the relationship between perceived positive parenting support and post-traumatic stress disorder (PTSD) symptoms in children exposed to war trauma.A random sample of 412 children aged 12-16 years was selected from the Gaza Strip and was assessed using the Gaza Traumatic Events Checklist (GTEC), the SCID (DSM-IV) and the Perceived Parenting Support Scale (PPSS).Palestinian children were exposed to different types of war-traumatic events. The number of exposed traumatic events was independently associated with the severity of post-traumatic symptoms scores or the diagnosis of PTSD, while perceived parenting support was found to act as a protective factor in this association.Interventions in war zones need to ensure the minimal possible disruption to communities and family units, and to involve parents in preventive or treatment programmes for children exposed to trauma.",0,0 +4273,Single prolonged stress increases contextual freezing and the expression of glycine transporter 1 and vesicle-associated membrane protein 2 mRNA in the hippocampus of rats,"Rats subjected to single prolonged stress (SPS) show enhanced HPA negative feedback, exaggerated acoustic startle response, and enhanced contextual freezing 7 days after SPS, and accordingly, SPS is an animal model of PTSD. To elucidate the influence of contextual fear on gene expression in the hippocampus of SPS rats, we used cDNA microarray followed by real-time quantitative PCR analyses to compare the hippocampal gene expression profiles between rats that were or were not subjected to SPS during exposure to contextual fear. In the behavioral experiments, spontaneous locomotor activity was measured 7 days after SPS. Twenty-four hours after footshock conditioning (7 days after SPS), freezing behavior was measured during re-exposure to the chamber in which footshock was delivered. Based on the behavioral analysis, rats subjected to SPS exhibited a significant enhancement of contextual freezing compared to rats not subjected to SPS, without any changes in locomotor activity. Analyses using cDNA microarray and RT-PCR showed that the hippocampal levels of glycine transporter 1 (Gly-T1) and vesicle-associated membrane protein 2 (VAMP2) mRNA in rats subjected to SPS were significantly increased relative to sham-treated rats. Administration of SPS alone did not affect the expression of these 2 genes. These findings suggest that the upregulation of Gly-T1 and VAMP2 in the hippocampus may be, at least in part, involved in the enhanced susceptibility to contextual fear in rats subjected to SPS.",0,0 +4274,Sexual assault-characteristics effects on PTSD and psychosocial mediators: A cluster-analysis approach to sexual assault types.,"Using cluster analysis, we investigated the effects of assault characteristics (i.e., level of violence, subjective distress, alcohol consumption, perpetrator identity) on PTSD symptoms, and whether these effects are mediated by postassault social and psychological reactions. A large community sample of women sexual assault survivors completed 2 mail surveys at a 1-year interval. In line with prior research, cluster analyses revealed the existence of 3 general categories of sexual assault, which we described as ""high violence,"" ""alcohol-related,"" and ""moderate sexual severity."" Alcohol-related assaults resulted in fewer PTSD symptoms than high-violence assaults at Time 1, but not at Time 2. Alcohol-related and violent assaults resulted in more PTSD symptoms than moderate-severity assaults at both times. The effect of assault-characteristics clusters on Time 2 PTSD was mediated by Time 1 self-blame and turning against social reactions. The importance of considering effects of violence and alcohol consumption during the assault to better understand postassault PTSD, including implications for theory and practice, are discussed.",0,0 +4275,The SCID-II and DIB-R interviews: diagnostic association with poor outcome risk factors in Borderline Personality Disorder.,"This study assesses whether patients diagnosed with Borderline Personality Disorder (BPD) according to the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) or the Revised Diagnostic Interview for Borderlines (DIB-R) present differences in factors associated with risk of poor outcome. Three hundred fifty-two patients were evaluated with SCID-II and DIB-R. Patients diagnosed as BPD according to one or both instruments were compared in BPD poor outcome risk factors. The analysis was conducted on the participants who were assigned to SCID-II (n = 135) and SCID-II/DIB-R (n = 126) groups. The group diagnosed with BPD according the combined SCID-II/DIB-R interview showed a significantly greater association with risk of poor outcome predictors, such as total number of comorbid Axis II disorders, number of BPD criteria, presence of comorbid paranoid personality disorder, and worse occupational status. No differences between groups were found in the affective instability BPD criterion, self-reported impulsivity, post-traumatic stress disorder, major depressive disorder or presence of any cluster C comorbidity. The observed differences were large enough to advise caution in generalizing findings from studies without considering what measurement was used for the BPD diagnosis.",0,0 +4276,Commentary: Stalking risk profile.,"Paul Mullen and his colleagues have developed a Stalking Risk Profile that is the latest model for assessing and managing stalkers. The model includes an assessment of the nature of the relationship between the stalker and his victim; the stalker's motivations; the general psychological, psychopathological, and social realities of the stalker; the circumstances of the victim, and the legal and mental health context. The model is not an actuarial scale, but rather an assessment to be used on a case-by-case basis. It recommends certain standardized tests as part of the assessment. The Stalker Risk Profile is the most thorough risk assessment to date. It includes victim variables and provides specifics for assessment and specifics for treatment of the stalker.",0,0 +4277,Children and Disasters: Understanding Impact and Enabling Agency,"From a child rights perspective disaster impacts affect not only a child’s basic right to survival and development, but cut across their right to participate and for decisions to be made in their best interests. Child-centred approaches recognise the role and rights of children as citizens and agents of change, seeking to engage them in DRR/CCA (Disaster Risk Reduction/Climate Change Adaptation) decision-making and accountability processes and supporting child-centred community-based programmes of action. The research produced two papers, one on Undertanding Impacts of disasters on child welfare, and the second to identify the factors which create an enabling environment for children to engage in climate change and disaster risk reduction. This report synthesises the research outputs to produce a comprehensive report looking into the need both for child sensitive programmes to tackle disasters and climate change, but also at the need for child participation in programming and policy.",0,0 +4278,Salivary Oxytocin and Vasopressin Levels in Police Officers With and Without Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) is characterised by symptoms associated with maladaptive fear and stress responses, as well as with social detachment. The neuropeptides oxytocin (OT) and arginine vasopressin (AVP) have been associated with both regulating fear and neuroendocrine stress responsiveness and social behaviour. However, there is only limited evidence for dysregulated peripheral OT and AVP levels in PTSD patients. The present study aimed to investigate basal salivary OT and AVP levels in trauma-exposed male and female police officers with and without PTSD. Saliva samples were collected during rest and OT and AVP levels were determined using a radioimmunoassay. Men and women were analysed separately, having adjusted for differences in trauma history, and for hormonal contraception use in women. The results showed that male PTSD patients had lower basal salivary OT levels, and did not differ in AVP levels compared to male trauma-exposed healthy controls after adjusting for childhood emotional abuse. There were no significant differences in basal salivary OT and AVP levels in women. Our findings indicate potential dysfunctioning of the OT system in male PTSD patients. Future studies are needed to replicate these findings and to further unravel the relationship between the OT and AVP systems, sex, trauma history and PTSD.",0,0 +4279,Longitudinal measures of hostility in deployed military personnel,"Increases in anger and hostility are commonly found after military deployment. However, it is unknown how anger and hostility develop over time, and which veterans are more at risk for developing these complaints. Data of 745 veterans one month before deployment to Afghanistan and one, six, twelve and 24 months after deployment were analyzed in a growth model. Growth mixture modeling revealed four classes based on their growth in hostility. Most of the participants belonged to a low-hostile group or a mild-hostile group that remained stable over time. Two smaller groups were identified that displayed increase in hostility ratings after deployment. The first showed an immediate increase after deployment. The second showed a delayed increase between twelve and 24 months after deployment. No groups were identified that displayed a decrease of hostility symptoms over time. Multinomial logistic regression was applied to predict group membership by age, education, early trauma, deployment stressors and personality factors. This study gains more insight into the course of hostility over time, and identifies risk factors for the progression of hostility.",0,0 +4280,A pilot longitudinal study of hippocampal volumes in pediatric maltreatment-related posttraumatic stress disorder,"Adult posttraumatic stress disorder (PTSD) is associated with decreased hippocampal volumes; however, decreased hippocampal volumes were not seen in pediatric maltreatment-related PTSD. We examined hippocampal volumes longitudinally to determine if a history of childhood traumatic stress alters hippocampal growth during puberty.Magnetic resonance imaging was used to measure temporal lobes, amygdala, and hippocampal volumes in nine prepubertal maltreated subjects with pediatric maltreatment-related PTSD and nine sociodemographically matched healthy nonmaltreated yoked control subjects at baseline and after at least 2 years follow-up (during the later stages of pubertal development) using identical equipment and measurement methodology.Temporal lobe, amygdala and hippocampal volumes did not differ between groups at baseline, follow-up, or across time.Whereas these data are from a small sample, the results do not support hippocampal changes in pediatric maltreatment-related PTSD.",0,0 +4281,PTSD in Service Members and New Veterans of the Iraq and Afghanistan Wars: A Bibliography and Critique,,0,0 +4282,Investigating Subtypes of Child Development,"Two classification methods, latent class cluster analysis and cluster analysis, are used to identify groups of child behavioral adjustment underlying a sample of elementary school children aged 6 to 11 years. Behavioral rating information across 14 subscales was obtained from classroom teachers and used as input for analyses. Both the procedures and results were compared. The latent class cluster analysis uncovered three classes representing differing levels of children's behavioral adjustment (well adjusted, average adjustment, functionally impaired), whereas the cluster analysis uncovered seven groups of child behavior. Results show a high degree of overlap, and each procedure offers unique information toward classifying child behavior.",0,0 +4283,Deployment Risk Factors and Postdeployment Health Profiles Associated With Traumatic Brain Injury in Heavy Drinking Veterans,"Along with post-traumatic stress disorder (PTSD), mild traumatic brain injury (mTBI) is considered one of the ""signature wounds"" of combat operations in Iraq (Operation Iraqi Freedom [OIF]) and Afghanistan (Operation Enduring Freedom [OEF]), but the role of mTBI in the clinical profiles of Veterans with other comorbid forms of post-deployment psychopathology is poorly understood. The current study explored the deployment risk and postdeployment health profiles of heavy drinking OIF and OEF Veterans as a function of mTBI. Sixty-nine heavy-drinking OIF/OEF Veterans were recruited through a Veterans' Affairs Medical Center and completed questionnaires and structured interviews assessing war-zone experiences, postdeployment drinking patterns, and PTSD symptoms. Veterans with positive mTBI screens and confirmed mTBI diagnoses endorsed higher rates of combat experiences, including direct and indirect killing, and met criteria for PTSD at a higher rate than Veterans without a history of mTBI. Both PTSD and combat experiences independently predicted screening positive for mTBI, whereas only combat experiences predicted receiving a confirmed mTBI diagnosis. mTBI was not associated with any dimension of alcohol use. These results support a growing body of literature linking mTBI with PTSD.",0,0 +4284,Is legal status impacting outcomes of group therapy for posttraumatic stress disorder with male asylum seekers and refugees from Iran and Afghanistan?,"Abstract Background Legal status and other resettlement stressors are known to impact mental health of asylum seekers and refugees. However, the ways in which they interact with treatment of posttraumatic stress disorder (PTSD) with these populations is still poorly understood. The aim of this study was to examine whether legal status and other resettlement stressors influence outcomes of a trauma-focused group PTSD treatment within a day-treatment setting with asylum seekers and refugees. Methods Sixty six male Iranian and Afghan patients with PTSD residing in the Netherlands were assessed with self-rated symptom checklists for PTSD, anxiety and depression, and a demographic questionnaire one week before and two weeks after the treatment. Multivariate linear regression analysis was used to examine the impact of legal status and living arrangements on the treatment outcomes per symptom domain. Results The results suggest that both asylum seekers and refugees can be helped with their mental health complaints with a trauma-focused group therapy for PTSD regardless of their legal status. Obtaining a refugee status in a course of the treatment appears to improve the treatment outcomes. Conclusions Legal status is impacting outcomes of group therapy for PTSD with male asylum seekers and refugees. Asylum seekers may benefit from group treatment regardless of unstable living conditions.",0,0 +4285,Presence of Spontaneous Pain and Comorbid Pain Conditions Identifies Vulvodynia Subgroups,"The aims of the study were to define the heterogeneity of vulvodynia by determining data-driven subgroups within the vulvodynia diagnosis using exploratory cluster analysis and to characterize the subgroups identified.Included were participants in the longitudinal population-based study of vulvodynia in southeast Michigan who screened positive for vulvodynia at least once during the study. A cluster analysis using variables reflecting vulvar pain characteristics and comorbid pain conditions was conducted. Variables reflecting best separation of clusters were used to assign participants to subgroup categories. Demographic, psychiatric, general health, and other vulvar pain characteristics were summarized for each subgroup, followed by multinomial regression and pairwise comparisons of subgroups on these factors.Of 441 women screening positive for vulvodynia during the course of the study, 393 were eligible on the basis of data requirements. Cluster analysis suggested that best subgroup separation was based on the following 2 variables: (1) presence or absence of spontaneous vulvar pain and (2) presence or absence of other comorbid pain conditions. Subgroups did not differ by age or ethnicity. The subgroup having spontaneous pain and other comorbid conditions demonstrated greatest morbidity in general health measures, psychiatric disorders, and other vulvar pain measures. Primary versus secondary vulvodynia did not vary between subgroups and did not assist in subgroup separation in the cluster analysis.Subgroups based on exploratory cluster analysis demonstrated that presence of spontaneous pain and the presence of comorbid pain conditions resulted in best separation of groups. Presence of both spontaneous pain and other comorbid pain conditions identified the group with greatest morbidity.",0,0 +4286,Prevalence of Mental Health Symptoms in Dutch Military Personnel Returning from Deployment to Afghanistan: A 2-year Longitudinal Analysis,"Abstract Objective: Recent studies in troops deployed to Iraq and Afghanistan have shown that combat exposure and exposure to deployment-related stressors increase the risk for the development of mental health symptoms. The aim of this study is to assess the prevalence of mental health symptoms in a cohort of Dutch military personnel prior to and at multiple time-points after deployment. Methods: Military personnel ( n = 994) completed various questionnaires at 5 time-points; starting prior to deployment and following the same cohort at 1 and 6 months and 1 and 2 years after their return from Afghanistan. Results: The prevalence of symptoms of fatigue, PTSD, hostility, depression and anxiety was found to significantly increase after deployment compared with pre-deployment rates. As opposed to depressive symptoms and fatigue, the prevalence of PTSD was found to decrease after the 6-month assessment. The prevalence of sleeping problems and hostility remained relatively stable. Conclusions: The prevalence of mental health symptoms in military personnel increases after deployment, however, symptoms progression over time appears to be specific for various mental health symptoms. Comprehensive screening and monitoring for a wide range of mental health symptoms at multiple time-points after deployment is essential for early detection and to provide opportunities for intervention. Declaration of interest: This project was funded by the Dutch Ministry of Defence.",0,0 +4287,Adjustment disorders: prevalence in a representative nationwide survey in Germany,"ObjectivesThis is the first study to estimate the prevalence of adjustment disorder (AjD) in the general population. A new conceptualisation of AjD as a stress response syndrome was applied, which allowed AjD to be assessed directly from its symptom profile, including intrusive, avoidance and failure-to-adapt symptoms (Maercker et al., Psychopathology 40:135–146, 2007).MethodsPrevalence rates of distressing life events and AjD were estimated from a representative sample of the German general population (n = 2,512) with a broad age range (14–93 years). A questionnaire including a life events checklist and self-rating questions that assessed AjD symptoms and symptom duration were personally handed out by an interviewer.ResultsThe prevalence of AjD fulfilling the criterion of clinically significant impairment was 0.9%; a further 1.4% of the sample was diagnosed with AjD without fulfilling the impairment criterion. In ~72.5% of AjD cases, symptoms had developed 6–24 months prior to assessment. AjD was most often associated with acute events such as moving or chronic stressors such as serious illness, conflicts at the respondent’s job or with friends or neighbours (with ~5% conditional probability each).ConclusionsThe results correspond with the few other studies that have examined the prevalence of AjD, even though a new conceptualisation of the disorder was used. Explorative results regarding the duration of AjD syndromes and symptoms call for further redefinition and empirical investigation of this under-researched mental condition.",0,0 +4288,Exploring the Longitudinal Trajectories of Posttraumatic Stress Disorder in Injured Trauma Survivors,"Objective: The goal of this study was to examine the longitudinal trajectories of posttraumatic stress disorder (PTSD) symptoms in a sample of acutely injured hospitalized civilian trauma survivors who participated in a randomized clinical trial. Prior longitudinal descriptive research has shown that there are distinct trajectories of PTSD symptoms over time in trauma survivors. Limited clinical trial research exists that describes the patterns of the trajectories as well as the risk factors that influence the trajectories for seriously injured trauma-exposed patients. Method: Semiparametric, group-based approach trajectory modeling was used to examine four group trajectories of a subset of data obtained from a previous longitudinal clinical trial. Trajectories examined included resilience, recovery, relapsing/remitting, and chronic symptom patterns. One hundred and ninety-four patients who participated in the randomized clinical trial were assessed at baseline in the days and weeks after injury and then randomized. The associations between previously identified PTSD risk factors and the four trajectories were examined. Results: The risk factors of ethnocultural minority status, psychiatric history, additional life stressors, and depressive symptoms, as well as intervention versus control group status, were found to significantly affect the probability of trajectory group membership for PTSD symptom severity. Conclusions: These findings suggest that there is a need for early PTSD interventions that anticipate differences in injured patients' PTSD trajectory profiles. Stepped care intervention procedures may optimally address the diverse PTSD trajectory patterns observed in injured trauma survivors through the tailoring of intervention timing and dosing.",0,0 +4289,The association between posttraumatic stress symptoms and functional impairment during ongoing conflict in the Democratic Republic of Congo,"► Evaluated the impact of PTSD on perceived health and physical and social functioning. ► Data were collected from 93 adults living in Bunia, Eastern Democratic Republic of Congo. ► People with PTSD reported poor health and high disability scores compared to those without PTSD. ► Of the three PTSD symptom clusters, hyperarousal was most strongly associated with disability. ► People with PTSD had greater health problems, difficulty with social contact and functioning. The Democratic Republic of Congo (DRC) has suffered from a bloody conflict for more than a decade. More than 5,400,000 people died from war-related causes since 1998 and exposure to violence was wide-spread. This study investigated the impact of posttraumatic stress disorder (PTSD) symptoms on perceived health and physical and social functioning, filling an important gap in the current literature. Data were collected from a sample of 93 adults living in Bunia, Eastern Democratic Republic of Congo. Structured in-person interviews included the PTSD section of the Composite International Diagnostic Interview and the World Health Organization Disability Assessment Scale. Additional questions were included to assess social resources. Study recruitment was balanced to achieve equal representation of both sexes and each quarter of town. Forty percent met symptom criteria for probable PTSD. Individuals with PTSD reported poor perceived general health and had high disability scores compared to those without PTSD. Of the three PTSD symptom clusters, hyperarousal was most strongly associated with disability. Individuals with PTSD were significantly more emotionally affected by their health problems than those without PTSD (85% versus 41%), had more difficulties in activities involving social contact (54% versus 16%) and in doing their daily work (54% versus 20%). The impact of war-related violence on mental health is severe in the DRC. Psychosocial interventions developed in conflict areas might be best targeted primarily to supporting social functioning and reducing hyperarousal. Implications for clinical treatment and future directions are discussed.",0,0 +4290,Neuropsychological outcomes of army personnel following deployment to the Iraq war.,"The effects of war-zone deployment on neuropsychological health remain poorly understood. Neuropsychological performance deficits serve as sensitive measures of neural dysfunction and are often associated with psychosocial and occupational problems. Previous studies have not conducted objective neuropsychological assessments both before and after a major war-zone deployment.To examine objective neuropsychological outcomes of Iraq War deployment in a large military cohort.The Neurocognition Deployment Health Study, a prospective, cohort-controlled study conducted at military installations. This report centers on 961 male and female active-duty Army soldiers drawn from the larger cohort. Deploying Army soldiers (n = 654) were examined prior to deployment to Iraq (April-December 2003) and shortly after return (within a mean of 73 days [median, 75 days]; January-May 2005) from Iraq deployment. A comparison group of soldiers (n = 307) similar in military characteristics but not deploying overseas during the study was assessed in sessions timed to be as close as possible to the assessment of deployers. Military unit sampling procedures facilitated representation of combat, combat support, and combat service support functions among both deployers and nondeployers.Individually administered, performance-based neuropsychological tasks. Estimates (beta; the unstandardized parameter estimate) for the absolute differences in adjusted mean outcome scores between deployed and nondeployed groups were determined using generalized estimating equations.Multiple linear regression analyses adjusted for battalion membership revealed that Iraq deployment, compared with nondeployment, was associated with neuropsychological compromise on tasks of sustained attention (beta = 0.11; P<.001), verbal learning (beta = -1.51; P = .003), and visual-spatial memory (beta = -3.82; P<.001). Iraq deployment was also associated with increased negative state affect on measures of confusion (beta = 1.40; P<.001) and tension (beta = 1.24; P<.001). In contrast, deployment was associated with improved simple reaction time (beta = 4.30; P = .003). Deployment effects remained statistically significant after taking into account deployment-related head injury and stress and depression symptoms.Deployment to Iraq is associated with increased risk of neuropsychological compromise. Findings point to the need to investigate further the impact of deployment on neural functioning. Public health implications include consideration of neuropsychological compromise in health prevention and postdeployment clinical and occupational management.",0,0 +4291,Predictors of treatment response to an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder.,"Despite evidence for the efficacy of several treatments for deliberate self-harm (DSH) within borderline personality disorder (BPD), predictors of response to these treatments remain unknown. This study examined baseline demographic, clinical, and diagnostic predictors of treatment response to an adjunctive emotion regulation group therapy (ERGT) for DSH among women with BPD. A recent RCT provided evidence for the efficacy of this ERGT (relative to a treatment-as-usual only waitlist condition). Participants in this study include the full intent-to-treat sample who began ERGT (across treatment and waitlist conditions; n = 51). Baseline diagnostic and clinical data were collected at the initial assessment, and outcome measures of DSH and self-destructive behaviors, emotion dysregulation/avoidance, and BPD symptoms (among others) were administered at pretreatment, posttreatment, and 3- and 9-months posttreatment. Notably, both demographic variables and characteristics of participants' ongoing therapy in the community had minimal impact on treatment response. However, several indicators of greater severity in domains relevant to this ERGT (i.e., baseline emotion dysregulation and BPD criteria, lifetime and recent DSH, and past-year hospitalization and suicide attempts) predicted better responses during treatment and follow-up across the primary targets of treatment. Likewise, several co-occurring disorders (i.e., social phobia, panic disorder, and a cluster B personality disorder) predicted greater improvements in BPD symptoms during treatment or follow-up. Finally, although co-occurring generalized anxiety disorder, posttraumatic stress disorder, and cluster A and C personality disorders were associated with poorer treatment response during follow-up, most of these effects reflected a lack of continued improvements during this period (vs. worsening of symptoms).",0,0 +4292,Biomarkers of PTSD: Neuropeptides and immune signaling,"The biological underpinnings for participation of the immune system in the pathogenesis of Posttraumatic Stress Disorder (PTSD) include evidence for cross-talk between the stress and immune systems, as well as more recently discovered roles for immune system mediators in core behavioral functions such as adult neurogenesis, as well as in processes that underlay synaptic plasticity, such as learning and memory. This article reviews the expanding body of literature on immune system mediators in the periphery and the central nervous system (CNS) in chronic PTSD along with the evidence for increased peripheral inflammation, and excess morbidity and mortality. CNS inflammation has been implicated in the pathogenesis of depression. This literature is briefly reviewed, along with evidence for a possible role for CNS inflammation in PTSD symptoms, especially in individuals who have PTSD with co-morbid depression. Whether the immune system is involved in risk and resilience, or evolution of PTSD symptoms following a trauma event remains to be determined, although hypotheses have been advanced. This paper reviews the current evidence including the novel hypothesis that cellular immunity is implicated in PTSD risk and resilience. Potential research implications and directions are discussed. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0,0 +4293,An Overview of 9/11 Experiences and Respiratory and Mental Health Conditions among World Trade Center Health Registry Enrollees,"To date, health effects of exposure to the September 11, 2001 disaster in New York City have been studied in specific groups, but no studies have estimated its impact across the different exposed populations. This report provides an overview of the World Trade Center Health Registry (WTCHR) enrollees, their exposures, and their respiratory and mental health outcomes 2-3 years post-9/11. Results are extrapolated to the estimated universe of people eligible to enroll in the WTCHR to determine magnitude of impact. Building occupants, persons on the street or in transit in lower Manhattan on 9/11, local residents, rescue and recovery workers/volunteers, and area school children and staff were interviewed and enrolled in the WTCHR between September 2003 and November 2004. A total of 71,437 people enrolled in the WTCHR, for 17.4% coverage of the estimated eligible exposed population (nearly 410,000); 30% were recruited from lists, and 70% were self-identified. Many reported being in the dust cloud from the collapsing WTC Towers (51%), witnessing traumatic events (70%), or sustaining an injury (13%). After 9/11, 67% of adult enrollees reported new or worsening respiratory symptoms, 3% reported newly diagnosed asthma, 16% screened positive for probable posttraumatic stress disorder (PTSD), and 8% for serious psychological distress (SPD). Newly diagnosed asthma was most common among rescue and recovery workers who worked on the debris pile (4.1%). PTSD was higher among those who reported Hispanic ethnicity (30%), household income < $25,000 (31%), or being injured (35%). Using previously published estimates of the total number of exposed people per WTCHR eligibility criteria, we estimate between 3,800 and 12,600 adults experienced newly diagnosed asthma and 34,600-70,200 adults experienced PTSD following the attacks, suggesting extensive adverse health impacts beyond the immediate deaths and injuries from the acute event.",0,0 +4294,Symptoms of Trauma and Traumatic Memory Retrieval in Adult Survivors of Childhood Sexual Abuse,"We examined posttraumatic stress symptoms and the memory retrieval process in 2 groups of adult survivors of childhood sexual abuse: 29 participants who reported having memories of their abuse prior to entering therapy (PM) and 13 who reported no memories of abuse prior to therapy (NPM). Participants were asked to indicate on checklists symptoms of constriction, hyperarousal, and intrusion experienced (a) prior to entering therapy and (b) during the surfacing of a memory while in therapy. Overall, the findings indicate that for both groups the same cluster of posttraumatic stress symptoms occurred prior to therapy and during therapy and that there was a continuity of symptoms over time. Participants were also asked to fully describe details of their traumatic memories as these details emerged prior to and/or during therapy. We determined that (a) there were striking similarities in the detailed recall of trauma memories for both groups; (b) memories of abuse emerged in substantial perceptual, somatic, and emotional detail over time before developing into a narrative; (c) the amount of detail remembered increased in the PM group during therapy; (d) members of the NPM group were more kinesthetic than visual in their orientation to the world and may not have had access to the visual information that would associate their symptoms to their abuse; and (e) triggers of traumatic memories were largely the result of internal rather than external stimuli, and these triggers happened primarily outside of therapy sessions.",0,0 +4295,Impact of Evidence-Based Standardized Assessment on the Disability Clinical Interview for Diagnosis of Service-Connected PTSD: A Cluster-Randomized Trial,"Posttraumatic stress disorder (PTSD) is one of the fastest growing compensated medical conditions. The present study compared usual disability examiner practices for PTSD with a standardized assessment that incorporates evidence-based assessments. The design was a multicenter, cluster randomized, parallel-group study involving 33 clinical examiners and 384 veterans at 6 Veterans Affairs medical centers. The standardized group incorporated the Clinician Administered PTSD Scale and the World Health Organization Disability Assessment Schedule-II into their assessment interview. The main outcome measures were completeness and accuracy of PTSD diagnosis and completeness of functional assessment. The standardized assessments were 85% complete for diagnosis compared to 30% for nonstandardized assessments (p < .001), and, for functional impairment, 76% versus 3% (p < .001). The findings demonstrate that the quality of PTSD disability examination would be improved by using evidence-based assessment.",0,0 +4296,An analysis of the internalizing and externalizing behaviors of traumatized urban youth with and without PTSD.,"To test the differential validity of the posttraumatic stress disorder (PTSD) classification, 3 groups of youths (PTSD, traumatized PTSD negatives, and controls) were examined. Youth with major comorbid disorders were excluded. On the basis of an analysis of parent-derived Child Behavior Checklist (CBCL) ratings, significant variations in CBCL scores were associated with PTSD but not with exposure to exceptional stress in the absence of PTSD. The results also indicated that traumatic exposure without the development of PTSD was not associated with higher estimates of psychopathology.",0,0 +4297,MMPI-2 Patterns in Electrical Injury: A Controlled Investigation,"The psychological consequences of electrical injury (EI) are many. Depression, posttraumatic stress disorder, anxiety, and somatic preoccupation are often concomitant with this type of injury (Kelley, Pliskin, Meyer, & Lee, 1994). The present study utilized the MMPI-2 as a tool for characterizing profiles of psychological distress in EI. We examined MMPI-2 profiles in 79 EI patients and their relationship to both injury parameters (i.e., time since injury, LOC, voltage), and extra-diagnostic factors, such as litigation status. EI patient profiles were also compared to individuals with mild traumatic brain injury (TBI), and chronic pain sufferers (CP). Results indicated that in EI, clinical elevations (T > or = 65) were found on the Hs and Hy scales, and approached clinical levels on the D scale. The injury parameter of time since injury was predictive of a distinctive profile, with individuals in the post acute phase experiencing more distress. Compared to other clinical groups, MMPI-2 scores on the Hs and Hy scales were significantly higher within the EI cohort as compared with their CP peers, with higher scores on the Pd scale for CP than EI. No statistically significant differences emerged between the EI and TBI groups. However, TBI patients showed significant elevations on Hy and D compared to CP, and EI patients endorsed more somatic symptoms than CP patients. Implications of these findings and future directions will be discussed.",0,0 +4298,Abnormal Structure of Fear Circuitry in Pediatric Post-Traumatic Stress Disorder,"Structural brain studies of adult post-traumatic stress disorder (PTSD) show reduced gray matter volume (GMV) in fear regulatory areas including the ventromedial prefrontal cortex (vmPFC) and hippocampus. Surprisingly, neither finding has been reported in pediatric PTSD. One possibility is that they represent age-dependent effects that are not fully apparent until adulthood. In addition, lower-resolution MRI and image processing in prior studies may have limited detection of such differences. Here we examine fear circuitry GMV, including age-related differences, using higher-resolution MRI in pediatric PTSD vs healthy youth. In a cross-sectional design, 3 T anatomical brain MRI was acquired in 27 medication-free youth with PTSD and 27 healthy non-traumatized youth of comparable age, sex, and IQ. Voxel-based morphometry was used to compare GMV in a priori regions including the medial prefrontal cortex and amygdala/hippocampus. Compared with healthy youth, PTSD youth had reduced GMV but no age-related differences in anterior vmPFC (BA 10/11, Z=4.5), which inversely correlated with PTSD duration. In contrast, although there was no overall group difference in hippocampal volume, a group × age interaction (Z=3.6) was present in the right anterior hippocampus. Here, age positively predicted hippocampal volume in healthy youth but negatively predicted volume in PTSD youth. Within the PTSD group, re-experiencing symptoms inversely correlated with subgenual anterior cingulate cortex (sgACC, Z=3.7) and right anterior hippocampus (Z=3.5) GMV. Pediatric PTSD is associated with abnormal structure of the vmPFC and age-related differences in the hippocampus, regions important in the extinction and contextual gating of fear. Reduced anterior vmPFC volume may confer impaired recovery from illness, consistent with its role in the allocation of attentional resources. In contrast, individual differences in sgACC volume were associated with re-experiencing symptoms, consistent with the role of the sgACC in fear extinction. The negative relationship between age and hippocampal volume in youth with PTSD may suggest an ongoing neurotoxic process over development, which further contributes to illness expression. Future studies employing a longitudinal design would be merited to further explore these possibilities.",0,0 +4299,Factor analysis of treatment response in posttraumatic stress disorder,"Factor analysis is applied to the symptoms of posttraumatic stress disorder (PTSD) to reduce the multidimensional symptom space to 2 dimensions; 1 dimension strongly correlated with depressive symptoms and 1 independent dimension weakly correlated with depressive symptoms. These factors are used to assess whether the effectiveness of an antidepressant medication is due to its antidepressant effect. The treatment is shown to be effective in both dimensions. The factor analysis sheds light on the symptom structure of PTSD, supports PTSD as a distinct psychiatric disorder, and supports the current diagnostic criteria.",0,0 +4300,Using QMethodology to Identify Reasons for Distress in Burn Survivors Postdischarge,"Reasons for distress after burn injuries have not been codified based on any type of acceptable empirical or statistical technique. The unique design methodology proposed in this study can identify the most common reasons cited for causing distress in burn survivors after discharge. A Q-sort task was developed with the assistance of our burn advisory group. After identifying 50 possible reasons for distress after discharge, each reason was placed on a laminated game card. In compliance with Qmethodology, a game board was developed that allowed patients to rank order each reason from ""not causing distress"" to ""causing significant distress."" A total of 69 burn survivors were enrolled in the study at four different time points: 1 month, 6 months, 1 year and 2 years postdischarge. After factor analysis, four factors accounted for all of the participants across time points. This indicates that at least four distinct groups of people can be categorized according to themes raised in rating reasons for distress. This Q-sort technique allowed us to capture the complexity of conceptualizing human distress by categorizing clusters of reported problems into similar groups. This methodology shows great promise for developing interventions that target unique needs of burn survivors.",0,0 +4301,Guest Editorial—Introduction to the Special Issue,"This special issue in the Journal of Social Work Education is a forum for professional and scholarly discourse on military social work education initiatives developed to educate and train social work professionals and students for practice with military personnel, veterans, and their families across the micro–macro continuum. Special emphasis was given to educational and technological trends, innovations, and challenges related to educating the next generation of social workers to provide evidence-based services to a new generation of veterans that incorporate the CSWE’s (2010) advanced knowledge and practice behaviors in military social work and NASW’s (2012) practice standards. Additional focus was given to university–community and university–military partnerships, collaborations, and initiatives that involve community and military stakeholders. Quantitative, qualitative, mixed methods, and conceptual manuscripts from researchers, educators, and practitioners on military social work education and practice were solicited from the professional social work community. In this special issue we highlight select exemplars of the social work profession’s unique contributions to military social work education. The issue is divided into two sections: (1) discourse on the integration of military social work into professional social work education and (2) innovative military social work education and training programs for doctoral and master’s students, student veterans, and licensed social work professionals—many including program evaluation and other research components. Each section is described in following paragraphs, including a brief overview of representative manuscripts. Integration of Military Social Work Into Professional Social Work Education Four manuscripts highlight military social work as a field of practice requiring specialized knowledge and skills, teaching strategies based on the CSWE competencies and advanced practice behaviors in military social work, the inclusion of military and veteran culture in social work education curricula, and adapting social work field placements for training in military social work practice. Wooten presents a rationale for military social work as a specialized field of practice, the need for military social work education, and opportunities and challenges for professional social work education. She delineates foundation and advanced knowledge in military social work and concludes by proposing an integrated model of intellectual capital to guide strategic planning for professional military social work education in addition to professional infrastructure needed to develop intellectual capital in military social work. For social work educators unfamiliar with military and veteran culture, Daley provides examples of teaching strategies based on CSWE’s advanced practice behaviors in military social work for integration into social work courses, specifically focusing on their application to CSWE’s Educational Policy and Accreditation Standards (EPAS; CSWE, 2008). He identifies foundation and advanced year military social work educational goals based on EPAS 2.1.1 to 2.1.10 and suggests that the infusion of military social work across the social work curriculum will assist students and faculty in becoming more sensitive to the issues faced by military service members, veterans, and their families. Continuing the application of CSWE’s EPAS to military social work education, Canfield and Weiss proposes the inclusion of military-related material into the foundation courses of undergraduate and graduate social work education because social workers providing services in civilian settings not focused on military-related difficulties may encounter military personnel, veterans, and families who seek services outside of the DoD and VA. Key issues, military examples, and resources are recommended for the integration of military culture into human behavior in the social environment, generalist practice, research methods, and social policy core curricula. With a focus on field education as the signature pedagogy of social work education, Selber, Chavkin, and Biggs advance a promising field instruction model in military social work with the growing student veteran population on American campuses. This innovative approach to field education expands placement opportunities beyond the VA for professional training in service delivery to current and past military cohorts.",0,0 +4302,Clinical Presentation and Therapeutic Interventions for Posttraumatic Stress Disorder Post-Katrina,"It has been almost 2 years since Hurricane Katrina struck the Gulf Coast. These 2 years can be characterized by constant struggle and pain as the people try to reattain some semblance of life as they knew it before Katrina struck. Some have chosen to leave their ancestral homes, homes where they were raised and where they, in turn, raised their own families. Those who did leave are able, in some way, to reestablish some semblance of normality, but those who stayed showed manifestations of and dealt with psychological trauma. These manifestations include regression, inattentiveness, aggressiveness, somatic complaints, irritability, social withdrawal, nightmares, and crying. Longer lasting effects may include depression, anxiety, adjustment disorders, and interpersonal or academic difficulties. These postdisaster manifestations can linger or remain hidden until well after the traumatic event and could persist for years. This article presents issues about the effects of Katrina on the mental health of the people of New Orleans. It discusses the profile of posttraumatic stress disorder and presents evidence-based review of interventions the health care provider can implement to care for those who continue to suffer the effects of this horrific disaster.",0,0 +4303,Posttraumatic Stress Disorder and Motor Vehicle Accidents: A Multidisciplinary Overview,"Objective: Motor vehicle accidents (MVA) may result in intractable disability. This paper investigates posttraumatic stress disorder (PTSD) as a potential cause. Method: The literature was reviewed for recent studies on prevalence, symptom profile, and outcome of PTSD. Results: PTSD is prevalent in roughly 10% of survivors of MVAs during the first year. Comorbid depression and pain are common. Medical complications, psychophysiological reactivity, and possibly litigation may slow remission. Phobic symptoms can persist for years. Mood disturbance may augment the impact of pain on daily living and on self-perceived disability. Conclusion: Recently developed screening instruments, structured interviews, and behavioural approach tests yield quantitative and reliable assessments of symptom severity. Cognitive–behavioural intervention and antidepressants may improve coping, ease fear, and reduce the impact of pain.",0,0 +4304,Animal models of post-traumatic stress disorder and recent neurobiological insights,"Post-traumatic stress disorder (PTSD) is a complex psychiatric disorder characterized by the intrusive re-experiencing of past trauma, avoidant behavior, enhanced fear, and hyperarousal following a traumatic event in vulnerable populations. Preclinical animal models do not replicate the human condition in its entirety, but seek to mimic symptoms or endophenotypes associated with PTSD. Although many models of traumatic stress exist, few adequately capture the complex nature of the disorder and the observed individual variability in susceptibility of humans to PTSD. In addition, various types of stressors may produce different molecular neuroadaptations that likely contribute to the various behavioral disruptions produced by each model, although certain consistent neurobiological themes related to PTSD have emerged. For example, animal models report traumatic stress-induced and trauma reminder-induced alterations in neuronal activity in the amygdala and prefrontal cortex, in agreement with the human PTSD literature. Models have also provided a conceptual framework for the often-observed combination of PTSD and comorbid conditions such as alcohol use disorder. Future studies will continue to refine preclinical PTSD models in hope of capitalizing on their potential to deliver new and more efficacious treatments for PTSD and associated psychiatric disorders.",0,0 +4305,Assessing adolescent mental health in war-affected societies: the significance of symptoms,"To compare the use of self-report symptom checklists with qualitative methods for assessing adolescent psychological well-being in a war-affected society.A school-based sample of three hundred and thirty seven 13- to 15-year-olds from two communities on opposite sides of the Bosnian conflict (183 from Gorazde, 154 from Foca) completed the Hopkins Symptoms Checklist and the Harvard Trauma Questionnaire. A gender balanced sub-sample of 40 adolescents was selected on the basis of their combined checklist scores, including equal numbers of high and low scorers from each side. Over the following 6 months this sub-sample was assessed (blind to checklist scores) with qualitative methods that included narrative interviews of child and parent, and participant observation. School marks were taken as a measure of social function.QUALITATIVE: Some children identified as ""less well"" by qualitative methods denied having symptoms. Some children identified as ""well"" had symptoms with no pathological significance for them. The lifeline revealed that feeling ""less well"" could be more related to post-war circumstances than war events. QUANTITATIVE: The two symptom checklist items have shown good internal consistency and discriminant validity. However, comparison with the overall well being revealed that still in 9/40 of cases the reported presence or absence of symptoms did not correspond to the well being of the child. Items of the two questionnaires did not discriminate reliably between children identified as ""well"" and ""less well"" by other means.Self-report checklists may be useful as a public health measure to assess the prevalence of psychological distress in war affected areas, but they are not an adequate means of clinical screening. Checklists used in combination with other qualitative approaches make it possible to identify those in need and avoid unnecessary pathologizing.",0,0 +4306,Prior experience as a moderator of disaster impact on anxiety symptoms in older adults,"As participants in a panel study, 234 older adults were interviewed before, as well as after, serious flooding occurred in southeastern Kentucky. Floods are not uncommon in this area, but these were more widespread than most, and resulted in both previously exposed and newly exposed subsamples of disaster victims. Flood impact was measured at both personal and community levels. With preflood symptoms controlled, there were modest flood effects on both trait anxiety and weather-specific distress in older adults without prior flood experience, but no flood effects in older adults who had been in floods before. Thus, the study provides support for the ""inoculation hypothesis"" and other conceptualizations that emphasize the advantage of being familiar or experienced with a stressor that is at hand. An implication is that ""experienced"" victims could be a valuable resource in prevention efforts.",0,0 +4307,Assessment and treatment in polytrauma contexts: Traumatic brain injury and posttraumatic stress disorder.,"(from the chapter) Military personnel deployed to Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) return from combat with injuries that were fatal in previous wars. This is partially due to more rapid and sophisticated medical responses on the battlefield and partially to improved protective equipment, such as Kevlar vests (Sayer et al., 2008; Warden, 2006). Protective gear and armored vehicles protect soldiers from mortal internal injuries but not from bodily trauma or concussive brain injuries. Recent studies have found that the great majority of injuries were due to explosions, and many involve more than one area of the body (i.e., polytrauma; Sayer et al., 2008). Physical injury during deployment is associated with a higher prevalence of PTSD postdeployment (J. E. Kennedy et al., 2007; Stein & McAllister, 2009). In a recent survey, 9% of soldiers returning from deployment without physical injury screened positive for PTSD (Hoge et al., 2008); however, the rate was almost double (16%) among those reporting bodily injury during deployment. This rate is similar to an earlier study assessing the increased risk of PTSD due to combat-related injury (Koren, Norman, Cohen, Berman, & Klein, 2005). Finally, another postdeployment survey of veterans revealed that the incidence of PTSD increased with the number of injury mechanisms: 14% for one, 29% for two, and 51% for three or more (Schneiderman, Braver, & Kang, 2008). This chapter focuses on how to adapt the assessment and treatment of posttraumatic stress disorder (PTSD) to returning veterans with polytraumatic injuries, especially when the polytrauma involves a traumatic brain injury (TBI). We begin with a review of the empirical literature addressing the prevalence of PTSD in polytrauma populations and the degree to which polytrauma alters PTSD severity and treatment response. Although the evidence base regarding best models of clinical management of PTSD when accompanied by TBI is in its infancy, we present suggestions for assessment of polytrauma and outline techniques and tools useful in optimizing psychosocial and psychopharmacological PTSD treatment interventions in polytrauma contexts. (PsycINFO Database Record (c) 2015 APA, all rights reserved)",0,0 +4308,Mental health of Iraqi children,,0,0 +4309,Annual Research Review: Positive adjustment to adversity - trajectories of minimal-impact resilience and emergent resilience,"Background: Research on resilience in the aftermath of potentially traumatic life events (PTE) is still evolving. For decades, researchers have documented resilience in children exposed to corrosive early environments, such as poverty or chronic maltreatment. Relatively more recently, the study of resilience has migrated to the investigation of isolated PTE in adults. Methods: In this article, we first consider some of the key differences in the conceptualization of resilience following chronic adversity versus resilience following single-incident traumas, and then describe some of the misunderstandings that have developed about these constructs. To organize our discussion, we introduce the terms emergent resilience and minimal-impact resilience to represent trajectories of positive adjustment in these two domains, respectively. Results: We focused in particular on minimal-impact resilience, and reviewed recent advances in statistical modeling of latent trajectories that have informed the most recent research on minimal-impact resilience in both children and adults and the variables that predict it, including demographic variables, exposure, past and current stressors, resources, personality, positive emotion, coping and appraisal, and flexibility in coping and emotion regulation. Conclusions: The research on minimal-impact resilience is nascent. Further research is warranted with implications for a multiple levels of analysis approach to elucidate the processes that may mitigate or modify the impact of a PTE at different developmental stages.",0,0 +4310,Military Personnel With Traumatic Brain Injuries and Insomnia Have Reductions in PTSD and Improved Perceived Health Following Sleep Restoration: A Relationship Moderated by Inflammation,"Background: Up to one-third of deployed military personnel sustain a traumatic brain injury (TBI). TBIs and the stress of deployment contribute to the vulnerability for chronic sleep disturbance, resulting in high rates of insomnia diagnoses as well as symptoms of posttraumatic stress disorder (PTSD), depression, and declines in health-related quality of life (HRQOL). Inflammation is associated with insomnia; however, the impact of sleep changes on comorbid symptoms and inflammation in this population is unknown. Methods: In this study, we examined the relationship between reported sleep changes and the provision of the standard of care, which could include one or more of the following: cognitive behavioral therapy (CBT), medications, and continuous positive airway pressure (CPAP). We compared the following: (a) the group with a decrease in the Pittsburgh Sleep Quality Index (PSQI; restorative sleep) and (b) the group with no change or increase in PSQI (no change). Independent t tests and chi-square tests were used to compare the groups on demographic and clinical characteristics, and mixed between-within subjects analysis of variance tests were used to determine the effect of group differences on changes in comorbid symptoms. Linear regression models were used to examine the role of inflammation in changes in symptoms and HRQOL. Results: The sample included 70 recently deployed military personnel with TBI, seeking care for sleep disturbances. Thirty-seven participants reported restorative sleep and 33 reported no sleep changes or worse sleep. The two groups did not differ in demographic characteristics or clinical symptoms at baseline. The TBI + restored sleep group had significant reductions in PTSD and depression over the 3-month period, whereas the TBI + no change group had a slight increase in both PTSD and depression. The TBI + restored sleep group also had significant changes in HRQOL, including the following HRQOL subcomponents: physical functioning, role limitations in physical health, social functioning, emotional well-being, energy/fatigue, and general health perceptions. In a linear regression model using a forced entry method, the dependent variable of change in C-reactive protein (CRP) concentrations was significantly related to changes in PTSD symptoms and HRQOL in the TBI + restored sleep group, with R2 = 0.43, F33,3 = 8.31, p \textless .01. Conclusions: Military personnel with TBIs who have a reduction in insomnia symptoms following a standard-of-care treatment report less severe symptoms of depression and PTSD and improved HRQOL, which relate to decreased plasma concentrations of CRP. These findings suggest that treatment for sleep disturbances in this TBI + military population is associated with improvements in health and decreases in inflammation. The contributions of inflammation-induced changes in PTSD and depression in sleep disturbances in TBI + military personnel require further study. (PsycINFO Database Record (c) 2016 APA, all rights reserved)",0,0 +4311,Family functioning and posttraumatic stress disorder in adolescent survivors of childhood cancer.,"This study investigated family functioning and relationships between family functioning and posttraumatic stress disorder (PTSD) in adolescent survivors of childhood cancer. To assess family functioning, 144 adolescent cancer survivors 1 to 12 years post-cancer treatment (M = 5.3 years) and their parents completed the Family Assessment Device (FAD). To assess PTSD, adolescents were administered a structured diagnostic interview. Nearly half (47%) of the adolescents, one fourth (25%) of mothers, and one third (30%) of fathers reported poor family functioning, exceeding the clinical cutoff on 4 or more FAD subscales. Families in which the cancer survivor had PTSD (8% of the sample) had poorer functioning than other families in the areas of problem solving, affective responsiveness, and affective involvement. Three fourths of the adolescents with PTSD came from families with categorically poor family functioning. A surprisingly high rate of poor family functioning was reported in these families of adolescent cancer survivors. Adolescents with PTSD were more than 5 times as likely to emerge from a poorly functioning family compared with a well-functioning one. This study provides evidence that family functioning is related to cancer-related posttraumatic reactions in adolescent survivors.",0,0 +4312,Impaired psychological recovery in the elderly after the Niigata-Chuetsu Earthquake in Japan:a population-based study,"An earthquake measuring 6.8 on the Richter scale struck the Niigata-Chuetsu region of Japan at 5.56 P.M. on the 23rd of October, 2004. The earthquake was followed by sustained occurrence of numerous aftershocks, which delayed reconstruction of community lifelines. Even one year after the earthquake, 9,160 people were living in temporary housing. Such a devastating earthquake and life after the earthquake in an unfamiliar environment should cause psychological distress, especially among the elderly.Psychological distress was measured using the 12-item General Health Questionnaire (GHQ-12) in 2,083 subjects (69% response rate) who were living in transient housing five months after the earthquake. GHQ-12 was scored using the original method, Likert scoring and corrected method. The subjects were asked to assess their psychological status before the earthquake, their psychological status at the most stressful time after the earthquake and their psychological status at five months after the earthquake. Exploratory and confirmatory factor analysis was used to reveal the factor structure of GHQ12. Multiple regression analysis was performed to analyze the relationship between various background factors and GHQ-12 score and its subscale.GHQ-12 scores were significantly elevated at the most stressful time and they were significantly high even at five months after the earthquake. Factor analysis revealed that a model consisting of two factors (social dysfunction and dysphoria) using corrected GHQ scoring showed a high level of goodness-of-fit. Multiple regression analysis revealed that age of subjects affected GHQ-12 scores. GHQ-12 score as well as its factor 'social dysfunction' scale were increased with increasing age of subjects at five months after the earthquake.Impaired psychological recovery was observed even at five months after the Niigata-Chuetsu Earthquake in the elderly. The elderly were more affected by matters relating to coping with daily problems.",0,0 +4313,Topiramate in the treatment of trichotillomania: an open-label pilot study,"There is a need for an effective medication for the treatment of trichotillomania (TTM), which is an impulse control disorder characterized by chronic hair-pulling. Topiramate has shown promising results in the treatment of impulse-control disorders. The present open-label pilot study investigated the efficacy and safety of topiramate in 14 adults with TTM. Patients received 16 weeks of flexible dose treatment (50-250 mg/day), followed by a flexible dose taper over 2-4 weeks. The primary outcome measure was the Massachusetts General Hospital Hair-Pulling Scale (HPS), whereas secondary outcome measures were the Clinical Global Impression (CGI) Scale, the Montgomery-Asberg Depression Rating Scale, the Hamilton Rating Scale for Anxiety and the Disability Profile. A repeated measures analysis of variance on the intent-to-treat sample was implemented to evaluate treatment response. The primary outcome measure (HPS) indicated that the severity of hair-pulling in adults with TTM who completed the 16-week study (n=9) decreased significantly from baseline to the treatment endpoint (F=5.05; P=0.0002). Although the CGI-Improvement scores suggested that hair-pulling was not significantly reduced, six of nine trial completers were classified as responders. None of the other measures showed significant differences compared to baseline. Five patients dropped out owing to adverse effects. These results suggest that topiramate may be useful in the treatment of TTM. Future studies should investigate the efficacy of topiramate in an appropriately powered randomized placebo-controlled trial.",0,0 +4314,Detecting Alcoholism,,0,0 +4315,Subjective models of psychological disorders: Mental health professional's perspectives,"This exploratory study is an extension of previous studies which have applied personal construct theory (PCP) methodology toward a better understanding of the structure and dynamics of multidisciplinary mental (and physical) health care (Kirkcaldy and Pope, 1992; Kirkcaldy et al., 1993, 2000, 2005; Kirkcaldy and Siefen, 1999). In this study we wanted to use similar cluster statistical analyses, not unlike PCP analysis, to identify the diverse subjective models of psychological ailments such as anxiety, depression, psychosis, mania, obsessive compulsive disorder (OCD), post stress traumatic disorder (PTSD), etc., using not the idiosyncratic constructs generated by individual triadic element comparisons, but by selecting those constructs which have been clearly identified in various psychiatric and psychological rating scales (e.g. somatic preoccupation, social withdrawal, conceptual disorganization, hostility, disinhibition and controlling). Clinical experts (psychological psychotherapists, and medical psychotherapist and psychiatrist) each with over 25 years of clinical and research experience were required to complete the ratings of each disorder listed in terms of the pre-formulated behavioral, emotional and cognitive concepts. What emerged are several multivariate (grid) analyses based on mental health professionals' perception of diverse elements (disorders) and their interrelationship derived from the similarity of composite profiles of ill-related constructs. Overall, the analyses revealed clear associations between the subjective evaluations of psychological ailments suggesting some uniformity in mental health assessment of such disorders. The implications of these findings are discussed within the theoretical framework of improved mental health care.",0,0 +4316,PTSD onset and course following the World Trade Center disaster: findings and implications for future research,"We sought to identify common risk factors associated with posttraumatic stress disorder (PTSD) onset and course, including delayed, persistent, and remitted PTSD following a major traumatic exposure.Based on a prospective study of New York City adults following the World Trade Center disaster (WTCD), we conducted baseline interviews with 2,368 persons one year after this event and then at follow-up 1 year later to evaluate changes in current PTSD status based on DSM-IV criteria.Baseline analysis suggested that current PTSD, defined as present if this occurred in the past 12 months, was associated with females, younger adults, those with lower self-esteem, lower social support, higher WTCD exposure, more lifetime traumatic events, and those with a history of pre-WTCD depression. At follow-up, current PTSD was associated with Latinos, non-native born persons, those with lower self-esteem, more negative life events, more lifetime traumatic events, and those with mixed handedness. Classifying respondents at follow-up into resilient (no PTSD time 1 or 2), remitted (PTSD time 1, not 2), delayed (no PTSD time 1, but PTSD time 2), and persistent (PTSD both time 1 and 2) PTSD, revealed the following: compared to resilient cases, remitted ones were more likely to be female, have more negative life events, have greater lifetime traumatic events, and have pre-WTCD depression. Delayed cases were more likely to be Latino, be non-native born, have lower self-esteem, have more negative life events, have greater lifetime traumas, and have mixed handedness. Persistent cases had a similar profile as delayed, but were the only cases associated with greater WTCD exposures. They were also likely to have had a pre-WTCD depression diagnosis. Examination of WTCD-related PTSD at follow-up, more specifically, revealed a similar risk profile, except that handedness was no longer significant and WTCD exposure was now significant for both remitted and persistent cases.PTSD onset and course is complex and appears to be related to trauma exposure, individual predispositions, and external factors not directly related to the original traumatic event. This diagnostic classification may benefit from additional conceptualization and research as this relates to changes in PTSD status over time.",0,0 +4317,Use of antiepileptic drugs for nonepileptic conditions: Psychiatric disorders and chronic pain,"Antiepileptic drugs (AEDs) are commonly utilized for nonepileptic conditions, including various psychiatric disorders and pain syndromes. Evidence for their benefit in these nonepileptic conditions varies widely among different drugs, but there is, in general, a paucity of published multicenter randomized double-blind trials. Variable levels of evidence suggest that lamotrigine and the vagal nerve stimulator have antidepressant properties. Carbamazepine, valproate, lamotrigine, and oxcarbazepine appear to have mood stabilizing properties while gabapentin, pregabalin, and tiagabine have anxiolytic benefits. Barbiturates, topiramate, and possibly phenytoin may precipitate or exacerbate depression. Underlying depression and anxiety symptoms may be exacerbated by levetiracetam, while psychotic symptoms have rarely been reported with topiramate, levetiracetam, and zonisamide. Pregabalin, gabapentin, carbamazepine, and oxcarbazepine have been used to treat neuropathic pain such as postherpetic neuralgia, and diabetic polyneuropathy. Topiramate and divalproex sodium have utility in the prophylaxis or acute treatment of migraine. Further rigorous studies are needed to clarify the utility of AEDs in nonepileptic conditions.",0,0 +4318,Neurobehavioral sequelae of traumatic brain injury: evaluation and management,"Traumatic brain injury (TBI) is a worldwide public health problem. Over the last several decades, improvements in acute care have resulted in higher survival rates. Unfortunately, the majority of survivors of moderate and severe TBI have chronic neurobehavioral sequelae, including cognitive deficits, changes in personality and increased rates of psychiatric illness. These neurobehavioral problems are understandable in the context of the typical profile of regional brain damage associated with trauma. This paper presents an overview of the neurobehavioral sequelae of TBI and outlines issues to consider in the evaluation and management of these challenges.",0,0 +4319,Post-traumatic stress disorder: current status and future directions,"Provides an overview of current research in posttraumatic stress disorder (PTSD) to provide impetus for studies that will advance the understanding of the effects of high level stressors on individuals in society today. It is suggested that the most important factors that need to be studied in PTSD involve the biological, psychological, and social resources that interact with individuals' experiences of traumatic events. Research on reactions to different types of trauma and on other disorders that develop following exposure to extreme stress is reviewed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4320,Evaluation of an Early Risk Screener for PTSD in Preschool Children After Accidental Injury,"OBJECTIVES: To evaluate the effectiveness and most powerful selection of predictors of an early screening tool for posttraumatic stress disorder (PTSD) in a sample of 87 children ages 2 to 6 years after unintentional injury. METHODS: The examined screener was administered within 6 to 13 days post accident and consisted of an adapted version of the Pediatric Emotional Distress Scale (PEDS), the PEDS-ES (PEDS Early Screener), and questions on 5 additional risk factors (preexisting child behavioral problems, parental preexisting chronic mental or physical illness, pretraumatic life events in the family, parental feelings of guilt, parental posttraumatic stress). The PTSD Semi-structured Interview and Observational Record for Infants and Young Children served as criterion measure 6 months after the accident. A case was deemed positive when meeting criteria for full or partial PTSD. RESULTS: Use of the PEDS-ES without the additional risk factors performed best, with good sensitivity (85%) and moderate specificity (63%) for full or partial PTSD. CONCLUSIONS: The PEDS-ES allows for successful early screening of preschool-aged children after single accidental trauma. It may be used within a stepped-care model for early identification of individuals designated for possible secondary preventative interventions.",0,0 +4321,Latent Class Modeling with Covariates: Two Improved Three-Step Approaches,"Researchers using latent class (LC) analysis often proceed using the following three steps: (1) an LC model is built for a set of response variables, (2) subjects are assigned to LCs based on their posterior class membership probabilities, and (3) the association between the assigned class membership and external variables is investigated using simple cross-tabulations or multinomial logistic regression analysis. Bolck, Croon, and Hagenaars (2004) demonstrated that such a three-step approach underestimates the associations between covariates and class membership. They proposed resolving this problem by means of a specific correction method that involves modifying the third step. In this article, I extend the correction method of Bolck, Croon, and Hagenaars by showing that it involves maximizing a weighted log-likelihood function for clustered data. This conceptualization makes it possible to apply the method not only with categorical but also with continuous explanatory variables, to obtain correct tests using complex sampling variance estimation methods, and to implement it in standard software for logistic regression analysis. In addition, a new maximum likelihood (ML)—based correction method is proposed, which is more direct in the sense that it does not require analyzing weighted data. This new three-step ML method can be easily implemented in software for LC analysis. The reported simulation study shows that both correction methods perform very well in the sense that their parameter estimates and their SEs can be trusted, except for situations with very poorly separated classes. The main advantage of the ML method compared with the Bolck, Croon, and Hagenaars approach is that it is much more efficient and almost as efficient as one-step ML estimation.",0,0 +4322,"PTSD, depression, and their comorbidity in relation to suicidality: cross-sectional and prospective analyses of a national probability sample of women","A growing body of literature implicates major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) as risk factors for suicidal ideation (SI) and suicide attempts (SA), though research has not adequately examined their differential contributions to increasing suicide risk prospectively or cross-sectionally.The contribution of these disorders and their comorbidity to SI and SA was examined using a national household probability sample of women (N=3,085) and covarying for trauma history, substance abuse, and demographic variables.Cross-sectional analyses indicated that lifetime comorbidity of MDD and PTSD were associated with much higher prevalence of SI than either diagnosis alone; prevalence of SI was elevated and comparable for PTSD and MDD only. Comorbid diagnosis and PTSD only groups displayed greater prevalence of SA than those with MDD only. Lastly, a 2-year prospective analysis indicated that PTSD only at baseline was predictive of greater subsequent SI risk than MDD only, though comorbid diagnosis did not differ from either PTSD only or MDD only.PTSD appears to be a particularly strong predictor of SI and SA. Overall, only 16% of women with lifetime SA did not have a history of MDD or PTSD, highlighting the importance of assessing these variables when assessing suicide risk.",0,0 +4323,Mental Health Functioning in the Human Rights Field: Findings from an International Internet-Based Survey,"Human rights advocates play a critical role in promoting respect for human rights world-wide, and engage in a broad range of strategies, including documentation of rights violations, monitoring, press work and report-writing, advocacy, and litigation. However, little is known about the impact of human rights work on the mental health of human rights advocates. This study examined the mental health profile of human rights advocates and risk factors associated with their psychological functioning. 346 individuals currently or previously working in the field of human rights completed an internet-based survey regarding trauma exposure, depression, posttraumatic stress disorder (PTSD), resilience and occupational burnout. PTSD was measured with the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) and depression was measured with the Patient History Questionnaire-9 (PHQ-9). These findings revealed that among human rights advocates that completed the survey, 19.4% met criteria for PTSD, 18.8% met criteria for subthreshold PTSD, and 14.7% met criteria for depression. Multiple linear regressions revealed that after controlling for symptoms of depression, PTSD symptom severity was predicted by human rights-related trauma exposure, perfectionism and negative self-appraisals about human rights work. In addition, after controlling for symptoms of PTSD, depressive symptoms were predicted by perfectionism and lower levels of self-efficacy. Survey responses also suggested high levels of resilience: 43% of responders reported minimal symptoms of PTSD. Although survey responses suggest that many human rights workers are resilient, they also suggest that human rights work is associated with elevated rates of PTSD and depression. The field of human rights would benefit from further empirical research, as well as additional education and training programs in the workplace about enhancing resilience in the context of human rights work.",0,0 +4324,Axis-I Comorbidity in Female Patients With Dissociative Identity Disorder and Dissociative Identity Disorder Not Otherwise Specified,"The aim of this study was to investigate axis-I comorbidity in patients with dissociative identity disorder (DID) and dissociative disorder not otherwise specified (DDNOS). Using the Diagnostic Interview for Psychiatric Disorders, results from patients with DID (n = 44) and DDNOS (n = 22) were compared with those of patients with posttraumatic stress disorder (PTSD) (n = 13), other anxiety disorders (n = 14), depression (n = 17), and nonclinical controls (n = 30). No comorbid disorders were found in nonclinical controls. The average number of comorbid disorders in patients with depression or anxiety was 0 to 2. Patients with dissociative disorders averagely suffered from 5 comorbid disorders. The most prevalent comorbidity in DDNOS and DID was PTSD. Comorbidity profiles of patients with DID and DDNOS were very similar to those in PTSD (high prevalence of anxiety, somatoform disorders, and depression), but differed significantly from those of patients with depression and anxiety disorders. These findings confirm the hypothesis that PTSD, DID, and DDNOS are phenomenologically related syndromes that should be summarized within a new diagnostic category.",0,0 +4325,Prediction of the occurrence and intensity of post-traumatic stress disorder in victims 32 months after bomb attack,"Our objective was to identify factors that predict occurrence and severity of post-traumatic stress disorder (PTSD) after a terrorism attack.We evaluated 32 victims of a bomb attack in a Paris subway in December 1996 at 6 and 32 months.Sociodemographic characteristics, clinical data and physical injuries were used to predict PTSD occurrence and severity in 32 victims. The Watson's PTSD Inventory (PTSD-I) and the Impact of Event Scale (IES) by Horowitz were used to evaluate occurrence and severity of PTSD, respectively.Thirty-nine percent of participants met PTSD criteria at 6 months, 25% still had PTSD at 32 months. Women had PTSD 32 months after the bomb attack more frequently than men. Employment predicted PTSD severity at 32 months. PTSD scores assessed by PTSD-I at 6 months were significantly and positively associated with IES scores at 32-month follow-up (r = 0.55, P = 0.004). Psychotropic drug use before the bomb attack significantly predicted PTSD occurrence and severity at 6 and 32 months. In a linear regression model, physical injuries, employment status and psychotropic drug use before the bomb attack were independent predictors of severity of PTSD at 32 months.Bomb attack exposure resulted in persisting PTSD in a significant proportion of victims; the severity was predicted at 32 months by physical injuries and psychotropic drug use before the terrorism attack and by the PTSD score few months after the bomb attack.",0,0 +4326,"Association between posttraumatic stress, depression, and functional impairments in adolescents 24 months after traumatic brain injury","The degree to which postinjury posttraumatic stress disorder (PTSD) and/or depressive symptoms in adolescents are associated with cognitive and functional impairments at 12 and 24 months after traumatic brain injury (TBI) is not yet known. The current study used a prospective cohort design, with baseline assessment and 3-, 12-, and 24-month followup, and recruited a cohort of 228 adolescents ages 14-17 years who sustained either a TBI (n = 189) or an isolated arm injury (n = 39). Linear mixed-effects regression was used to assess differences in depressive and PTSD symptoms between TBI and arm-injured patients and to assess the association between 3-month PTSD and depressive symptoms and cognitive and functional outcomes. Results indicated that patients who sustained a mild TBI without intracranial hemorrhage reported significantly worse PTSD (Hedges g = 0.49, p = .01; Model R(2) = .38) symptoms across time as compared to the arm injured control group. Greater levels of PTSD symptoms were associated with poorer school (η(2) = .07, p = .03; Model R(2) = .36) and physical (η(2) = .11, p = .01; Model R(2) = .23) functioning, whereas greater depressive symptoms were associated with poorer school (η(2) = .06, p = .05; Model R(2) = .39) functioning.",0,0 +4327,An Examination of the CROPS and BASC-2-SRP-A among Adjudicated Youth,"This study explored the Behavior Assessment System for Children Second Edition Self Report of Personality-Adolescent (BASC-2-SRP-A) and the Child Report of Post-traumatic Stress (CROPS) profiles of a sample of adjudicated youth. Results were consistent with previous research, indicating that 56% of CROPS scores fell within the clinically significant range. Cronbach’s alpha indicated good internal consistency of the 26-item CROPS. In addition, Anxiety was found to contribute most to distinguishing between the clinically significant and clinically non-significant CROPS groups, followed by the Social Stress and Somatization subscales. Gender differences, implications, and future directions are discussed.",0,0 +4328,Emotion Regulation Difficulties in Trauma Survivors: The Role of Trauma Type and PTSD Symptom Severity,"Two different hypotheses regarding the relationship between emotion regulation and PTSD are described in the literature. First, it has been suggested that emotion regulation difficulties are part of the complex sequelae of early-onset chronic interpersonal trauma and less common following late-onset or single-event traumas. Second, PTSD in general has been suggested to be related to emotion regulation difficulties. Bringing these two lines of research together, the current study aimed to investigate the role of trauma type and PTSD symptom severity on emotion regulation difficulties in a large sample of trauma survivors (N=616). In line with the hypotheses, PTSD symptom severity was significantly associated with all variables assessing emotion regulation difficulties. In addition, survivors of early-onset chronic interpersonal trauma showed higher scores on these measures than survivors of single-event and/or late-onset traumas. However, when controlling for PTSD symptom severity, the group differences only remained significant for 2 out of 9 variables. The most robust findings were found for the variable ""lack of clarity of emotions."" Implications for future research, theoretical models of trauma-related disorders, and their treatment will be discussed.",0,0 +4329,Post-traumatic stress disorders in children and adolescents,"(from the chapter) Children and adolescents surviving a life-threatening disaster show a wide range of symptoms which tend to cluster around signs of re-experiencing the traumatic event, trying to avoid dealing with the emotions that this gives rise to, and a range of signs of increased physiological arousal. There may be considerable co-morbidity with depression, generalized anxiety or pathological grief reactions. Topics include: manifestations of stress reactions in children and adolescents; effects on younger children (risk and protective factors age, gender, ability and attainment, family factors, prevalence, single vs repeated or chronic stressors, objective factors, subjective factors, single vs multiple traumas, disorders of extreme stress not otherwise specified); developmental issues (case examples); assessing posttraumatic stress disorder (PTSD) in children; treatment of PTSD (critical incident stress debriefing, group treatments, individual treatment, contingency planning). (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4330,Portuguese version of the PTSD Checklist-Military Version (PCL-M)-I: Confirmatory Factor Analysis and reliability,"The PTSD Checklist-Military Version (PCL-M) is a brief self-report instrument widely used to assess Post-traumatic Stress Disorder (PTSD) symptomatology in war Veterans, according to DSM-IV. This study sought out to explore the factor structure and reliability of the Portuguese version of the PCL-M. A sample of 660 Portuguese Colonial War Veterans completed the PCL-M. Several Confirmatory Factor Analyses were conducted to test different structures for PCL-M PTSD symptoms. Although the respecified first-order four-factor model based on King et al.'s model showed the best fit to the data, the respecified first and second-order models based on the DSM-IV symptom clusters also presented an acceptable fit. In addition, the PCL-M showed adequate reliability. The Portuguese version of the PCL-M is thus a valid and reliable measure to assess the severity of PTSD symptoms as described in DSM-IV. Its use with Portuguese Colonial War Veterans may ease screening of possible PTSD cases, promote more suitable treatment planning, and enable monitoring of therapeutic outcomes.",0,0 +4331,Family Resilience Following a Physical Trauma and Efficient Support Interventions: A Critical Literature Review,"The concept of resilience was first associated with physics and engineering, but it has since held the interest of thinkers and researchers from many other fields, including ecology, economics, computer science, and social science. The definition has also been expanded to now include family and community. Thus, the concept of resilience has been modified according to the various contexts or fields of interest with which it is associated. From an etymological perspective, the term resilience is comprised of the prefix re, meaning again, and salire, meaning jump (Anaut, 2008; Poilpot, 2003). In physics, resilience refers to the capacity of a material to resist a shock (Murry, 2004), whereas in ecology, it refers to a species' or an ecosystem's capacity to return to normal functioning or development following a trauma (Holling, 1973). In economics, resilience is the capacity for an economy to get back on track following a crash or crisis (Richemond, 2003), and in computer science, it is the quality of a system that ensures it continues to function properly in spite of defects of one or several components (Collin, 2013). In psychology, individual resilience refers to the ability to succeed, live, and continue to grow despite adversity (Cyrulnik, 2002, 2003, 2006; Tisseron, 2007). Researchers in nursing, for their part, generally retain the same definition of resilience as those in psychology; specifically that individual resilience is the ability to successfully navigate changes and difficulties (Mandleco & Peery, 2000; Wagnild & Young, 1993). Definitions Several definitions of family resilience have been developed in the past few years, most of which seem to be inspired by individual resilience, but when studied in a family context the concept becomes more complex. For some authors, family resilience refers to the success of family members in overcoming difficulties in the wake of a trauma (Black & Lobo, 2008), or represents the strength a family taps into to change its dynamic in order to solve the problems encountered (Delage, 2004, 2008; Lee et al., 2004; McCubbin & McCubbin, 1988, Walsh, 2006). According to Michael Ungar (2010), family resilience necessarily includes interactions with the environment in which the family evolves. In other words, it is important to consider the family's environment when talking about resilience. Moreover, again according to Ungar (2010), family resilience is influenced by what transpired before, during, and after the trauma, hence the reference to a process. Recently, Genest (2012) studied the process of resilience, which she defined as complex and multidimensional, in order to develop a theoretical model of resilience in families grieving the loss of an adolescent who committed suicide. Genest defines family resilience as a process during which a family confronted with a traumatic situation, despite the psychological and physical suffering endured, overcame it. Without a doubt, the most important contribution of her research is its pragmatic aspect, which proposes intervention methods for health care professionals according to the different types of resilience observed in the families interviewed during this process. For his part, Gauvin-Lepage (2013) conducted an empirical study with the aim of co-constructing the elements of an intervention program that would support the resilience process of families of adolescents with a moderate or severe traumatic brain injury, involving both families and rehabilitation professionals. The research process allowed the author to define family resilience as: (...) a complex human process that is deployed when a family is confronted with a trauma. Thus, the family will undertake a fluctuating process of transformation, according to the meaning it ascribes to the situation. The interrelation of elements inherent to the family and its environment will influence this process, positively or negatively, to achieve a positive reconstruction of the life project. …",0,0 +4332,One Quintillion Ways to Have PTSD Comorbidity: Recommendations for the Disordered DSM-5,"Galatzer-Levy and Bryant (Perspect Psychol Sci 8:651-662, 2013) have calculated the number of ways that Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; American Psychiatric Association, 2013) posttraumatic stress disorder (PTSD) symptoms can be combined as over 600,000. They concluded that the amount is astounding and the category is rendered amorphous. PTSD often occurs in the context of polytrauma or comorbidity. The epidemiological literature indicates that the most common comorbid conditions in cases of PTSD include major depressive disorder (MDD), chronic pain, neurocognitive disorder due to traumatic brain injury (e.g., mild), and alcohol use disorder, with premorbid personality disorder possible, as well (which we consider as exacerbated due to the traumatic incident at issue, as in borderline personality disorder). We calculated the possible symptom combinations for each of these disorders and then in comorbid combination with PTSD (e.g., PTSD with MDD, but also when all six conditions are present). The number of symptom combinations in full polytrauma involving all six conditions listed is truly astounding, over one quintillion. Also, we reviewed the range of PTSD comorbidities, which adds to the symptom heterogeneity in cases. We make recommendations to prioritize symptoms in disorders as primary (e.g., unique, marker), secondary (e.g., core essential), and tertiary (e.g., common, cross-diagnostic). The latter tertiary type of symptoms in a disorder, if any, should be kept apart in its own criterion. This approach might help make the next version of the DSM more clinically useful both to clinicians and to court. © 2014 Springer Science+Business Media New York.",0,0 +4333,Which factors influence the development of post-traumatic stress disorder in patients with burn injuries? A systematic review of the literature,"This article aims to discover which variables influence the development of post-traumatic stress disorder in patients with burn injuries. It will also consider whether it is possible to predict which burns patients will develop PTSD.Post-traumatic stress disorder is an important psychopathology for burned patients as it can affect both physical outcomes and quality of life for those affected. Research states that PTSD may be identified in up to 30% of burns patients, making it relatively common.A systematic review of the literature was carried out using four databases. Eleven articles were identified from these searches, and were then analysed thematically to draw out common ideas.Gender, extraversion and neuroticism, attribution of blame, capacity for forgiveness, the event as a disaster or non-disaster, alcohol consumption and peri-traumatic emotional response were all found to influence burns patients' risk of developing PTSD.While it is possible to identify the factors that put burns patients are greater risk of developing PTSD, it is not possible to accurately predict who will go on to develop PTSD due to the interplay between variables and individual differences. Focus should instead be on screening for PTSD and timely recognition of intrusive symptoms.",0,0 +4334,Factors influencing social and health outcomes after motor vehicle crash injury: an inception cohort study protocol,"There is growing evidence that health and social outcomes following motor vehicle crash injury are related to cognitive and emotional responses of the injured individual, as well as relationships between the injured individual and the compensation systems with which they interact. As most of this evidence comes from other states in Australia or overseas, investigation is therefore warranted to identify the key determinants of health and social outcomes following injury in the context of the New South Wales motor accident insurance scheme.In this inception cohort study, 2400 participants, aged 17 years or more, injured in a motor vehicle crash in New South Wales will be identified though hospital emergency departments, general and physiotherapy practitioners, police records and a government insurance regulator database. Participants will be initially contacted through mail. Baseline interviews will be conducted by telephone within 28 days of the injury and participants will be followed up with interviews at 6, 12 and 24 months post-injury. Health insurance and pharmaceutical prescription data will also be collected.The study results will report short and long term health and social outcomes in the study sample. Identification of factors associated with health and social outcomes following injury, including related compensation factors will provide evidence for improved service delivery, post-injury management, and inform policy development and reforms.Australia New Zealand Clinical trial registry identification number--ACTRN12613000889752. Available at: ANZCTR Registered FISH Study.",0,0 +4335,"Childhood adversities: Social support, premorbid functioning and social outcome in first-episode psychosis and a matched case-control group","Objective: The establishment of childhood adversities as risk factors for non-affective psychosis has derived a need to consider alternative interpretations of several psychosis-related factors. This paper sought to examine premorbid adjustment trajectories and social outcome factors in relation to childhood adversities. Perceived support has been found to decrease the risk of post-traumatic stress disorder, and we wished to compare perceived support in people with first-episode psychosis to non-clinical control persons and explore its relation to childhood adversities. Method: Every individual presenting with a non-affective first-episode psychosis (F20–29, except F21) in Region Zealand over a 2-year period was approached for participation and the 101 consenting participants were matched to 101 people with no psychiatric disorders. Comprehensive demographic data were collected. Assessment instruments included the Premorbid Assessment Scale, the Global Assessment of Functioning scale and the Childhood Trauma Questionnaire. The latter represented the childhood adversities in addition to parental separation and institutionalization. Results: There were no associations between number of childhood adversities and different social or academic premorbid trajectories. Those with more adversities had lower global functioning the year prior to treatment start and reported lower rates of perceived support during childhood along with less current face-to-face contact with family members. Lack of peer support remained a significant predictor of psychosis when adversities were adjusted for; peer support diminished the risk of psychosis caused by childhood adversities by 10%. Conclusion: Childhood adversities may not predict specific premorbid trajectories, but have an effect on global functioning when the psychosis has begun. Perceived support, especially from peers, may be important in the development of psychosis, and those with more adversities may represent a vulnerable subgroup who need more assistance to increase and maintain supportive networks.",0,0 +4336,"Relationships Among Depression, PTSD, Methamphetamine Abuse, and Psychosis","Objective: Research suggests several possible associations among methamphetamine abuse, psychotic symptoms, depression, and posttraumatic stress disorder (PTSD), but the exact nature and clinical significance of these associations is unclear. Individuals who abuse methamphetamine increasingly present in hospital emergency rooms with acute psychiatric symptoms. The aim of this study was to identify patterns of depressive symptoms and explore predictors of acute versus sustained depressive symptoms in individuals who abuse methamphetamine and who have had psychotic symptoms. Methods: This longitudinal study, conducted in Vancouver, British Columbia, included 295 participants with methamphetamine use disorder who were seeking psychiatric help for depressive or psychotic symptoms, assessed at baseline and monthly for 6 months. Measures included substance use (including frequency, quantity, and route of administration), family history of psychosis and depression, trauma exposure, and PTSD symptoms. Results: Tr...",0,0 +4337,"Epigenetics and child abuse: Modern-day darwinism - The miraculous ability of the human genome to adapt, and then adapt again","It has long been recognized that early adversity can have life-long consequences, and the extent to which this is true is gaining increasing attention. A growing body of literature implicates Adverse Childhood Experiences, including physical, sexual, and emotional abuse, in a broad range of negative health consequences including adult psychopathology, cardiovascular, and immune disease. Increasing evidence from animal, clinical, and epidemiological studies highlight the critical role of epigenetic programing, such as DNA methylation and histone modification, in altering gene expression, brain structure and function, and ultimately life-course trajectories. This review outlines our developing insight into the interplay between our human biology and our changing environment, and explores the growing evidence base for how interventions may prevent and ameliorate damage inflicted by toxic stress in early life.",0,0 +4338,Numbing symptoms as predictors of unremitting posttraumatic stress disorder,"This prospective longitudinal study examined the ability of re-experiencing, avoidance, numbing, and hyperarousal symptoms to predict persistence of posttraumatic stress disorder (PTSD) in disaster workers followed for 2 years. Cluster analyses suggested that overall severity was the best predictor of PTSD at follow up, but for groups with PTSD of moderate severity, numbing symptoms were also associated with PTSD at the 2-year follow up. Regression analyses with all four symptom groups as independent variables found that only numbing and re-experiencing symptoms predicted PTSD at the 1 year follow up, and only numbing symptoms predicted PTSD at the 2-year follow up. Findings suggest that numbing symptom severity could be used as a risk index of very chronic PTSD, especially when the overall PTSD severity falls in the moderate range.",0,0 +4339,Discrepancy in Diagnosis and Treatment of Post-traumatic Stress Disorder (PTSD): Treatment for the Wrong Reason,"In primary care (PC), patients with post-traumatic stress disorder (PTSD) are often undiagnosed. To determine variables associated with treatment, this cross-sectional study assessed 592 adult patients for PTSD. Electronic medical record (EMR) review of the prior 12 months assessed mental health (MH) diagnoses and MH treatments [selective serotonin reuptake inhibitor (SSRI) and/or ≥1 visit with MH professional]. Of 133 adults with PTSD, half (49%; 66/133) received an SSRI (18%), a visit with MH professional (14%), or both (17%). Of those treated, 88% (58/66) had an EMR MH diagnosis, the majority (71%; 47/66) depression and (18%; 12/66) PTSD. The odds of receiving MH treatment were increased 8.2 times (95% CI 3.1-21.5) for patients with an EMR MH diagnosis. Nearly 50% of patients with PTSD received MH treatment, yet few had this diagnosis documented. Treatment was likely due to overlap in the management of PTSD and other mental illnesses.",0,0 +4340,"Linking Human Systems: Strengthening Individuals, Families, And Communities in the Wake of Mass Trauma","This article presents an overview of the philosophy and practical principles underlying the Linking Human Systems Approach based on the theory of resilience in individuals, families, and communities facing crisis, trauma, and disaster. The Link Approach focuses on tapping into the inherent strength of individuals and their families and emphasizes resilience rather than vulnerability. It has been successfully used in combating critical public health problems, such as addiction, HIV/AIDS, and recovery from major trauma or disaster. Also, three specific models of Link intervention aimed at the individual, family, and community levels are discussed, with special emphasis on the family-level intervention. These interventions are directed toward mobilizing resources for long-term physical, emotional, psychological, and spiritual healing.",0,0 +4341,Dimensions and Dissociation in PTSD in the DSM-5: Towards Eight Core Symptoms,"The article reviews the literature on the dimensional (factor) structure of posttraumatic stress disorder (PTSD) as presented in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; American Psychiatric Association, 2013). The DSM-5 PTSD diagnostic category contains 20 symptoms split into four factors. Also, the article considers the literature on the dissociative subtype, which is found in a minority of PTSD cases. The literature shows that the DSM (Diagnostic and Statistical Manual of Mental Disorders) over the years has moved from a three-dimensional structure in prior DSMs to one with four dimensions in the DSM-5. However, the research reviewed queries whether the DSM-5’s four dimensions are consistent with the empirical literature; in this regard, models with five and six dimensions were the first to suggest alternatives. Moreover, in the literature, the DSM-5 symptoms appear to group into as many as seven dimensions, which are as follows: re-experiencing, avoidance, negative affect, anhedonia, externalizing behavior, anxious arousal, and dysphoric arousal (Armour et al., Journal of Psychiatric Research 61: 106–113, 2015; Wang et al., Journal of Anxiety Disorders 31: 90–97, 2015). In particular, the two DSM-5 dimensions of negative alterations in cognitions and mood and alterations in arousal and reactivity appear to be subdivided into five dimensions. Generally, the 20 PTSD symptoms and their suggested factors that are found in the literature could prove unwieldy to clinicians. Moreover, they allow for much heterogeneity in symptom expression among PTSD cases. In response, the article presents a model of PTSD based on the seven-factor dimensional structure emerging in the literature, as well as another factor associated with the dissociation subtype, but with one core or primary symptom specified for each of the dimensions. The article considers forensic implications of the newer models on PTSD’s dimensional structure. © 2015, Springer Science+Business Media New York.",0,0 +4342,The List of Threatening Experiences: a subset of 12 life event categories with considerable long-term contextual threat,"In a survey of a random sample of the general population recent life events, collected and rated for long-term contextual threat according to the methods of Brown & Harris (1978), were also recorded where possible on an inventory of life event categories (Tennant & Andrews, 1977). Of the 82.5% of all events collected which were covered by the inventory, 12 of the 67 event categories accounted for 77% of life events with an aetiologicaly significant rating of marked or moderate long-term threat. Where practical and economic constraints oblige research workers to choose the inventory method, a brief list of event categories, such as the List of Threatening Experiences, is recommended in preference to much longer lists.",0,0 +4343,"Emotionality, emotion regulation, and adaptation among 5- to 8-year-old children.","This study investigated relations between emotionality, emotion regulation, and children's behavioral adaptation in a longitudinal design. Mothers rated emotionality and emotion regulation related to anger, fear, and positive emotions-exuberance for 151 children at age 5 and later at age 6 years 6 months. Emotionality and emotion regulation measures were modestly related. Preschool ratings at age 6 (n = 125), maternal ratings at age 6 years 6 months (n = 133), and elementary school ratings at age 8 (n = 135) of problems and competence were also collected. High anger emotionality and low regulation of positive emotions and exuberance predicted externalizing problem behavior and prosocial behavior. High fear emotionality and low fear regulation predicted internalizing problem behavior. There were few interactive effects of emotionality and regulation.",0,0 +4344,An examination of the structure of posttraumatic stress disorder in relation to the anxiety and depressive disorders,"The nature and structure of posttraumatic stress disorder (PTSD) has been the subject of much interest in recent times. This research has been represented by two streams, the first representing a substantive body of work which focuses specifically on the factor structure of PTSD and the second exploring PTSD's relationship with other mood and anxiety disorders. The present study attempted to bring these two streams together by examining structural models of PTSD and their relationship with dimensions underlying other mood and anxiety disorders. PTSD, anxiety and mood disorder data from 989 injury survivors interviewed 3-months following their injury were analyzed using a series of confirmatory factor analyses (CFA) to identify the optimal structural model. CFA analyses indicated that the best fitting model included PTSD's re-experiencing (B1-5), active avoidance (C1-2), and hypervigilance and startle (D4-5) loading onto a Fear factor (represented by panic disorder, agoraphobia and social phobia) and the PTSD dysphoria symptoms (numbing symptoms C3-7 and hyperarousal symptoms D1-3) loading onto an Anxious Misery/Distress factor (represented by depression, generalized anxiety disorder and obsessive compulsive disorder). The findings have implications for informing potential revisions to the structure of the diagnosis of PTSD and the diagnostic algorithm to be applied, with the aim of enhancing diagnostic specificity.",0,0 +4345,Differential responses to trauma: Migration-related discriminants of post-traumatic stress disorder among Southeast Asian refugees,"This study examined possible differentiating experiences between Post-Traumatic Stress Disorder (PTSD) and non-PTSD refugees, after matching them on certain demographic characteristics and exposure to trauma. Previous research on predictors of PTSD usually has not controlled for differences in trauma exposure between the comparison groups. By examining individuals who have had similar traumatic histories, this study more clearly identified some factors implicated in the development of PTSD among Southeast Asians. To increase comparability with previous PTSD research, all events were assessed with reference to three time frames involving premigration, migration, and postmigration periods. The role of anger reactions was also examined in view of previous findings from the veteranbased PTSD research. Finally, this study ascertained the influence of acculturation and cultural identity orientation because these variables often have been implicated in the adjustment of Asian Americans. Results from the present study indicate that respondents with PTSD appeared to experience and express much more anger and were more dependent on public assistance. They were also less engaged in maintaining their cultural traditions and ties. However, more life changes and a trend toward more separations and reunifications with family members were evidenced for those without PTSD. The implications of these findings in developing community intervention strategies for Southeast Asian refugees who have experienced trauma are discussed.",0,0 +4346,Early predictors of chronic post-traumatic stress disorder in assault survivors,"ABSTRACT Background Some studies suggest that early psychological treatment is effective in preventing chronic post-traumatic stress disorder (PTSD), but it is as yet unclear how best to identify trauma survivors who need such intervention. This prospective longitudinal study investigated the prognostic validity of acute stress disorder (ASD), of variables derived from a meta-analysis of risk factors for PTSD, and of candidate cognitive and biological variables in predicting chronic PTSD following assault. Method Assault survivors who had been treated for their injuries at a metropolitan Accident and Emergency (A&E) Department were assessed with structured clinical interviews to establish diagnoses of ASD at 2 weeks ( n =222) and PTSD at 6 months ( n =205) after the assault. Candidate predictors were assessed at 2 weeks. Results Most predictors significantly predicted PTSD status at follow-up. Multivariate logistic regressions showed that a set of four theory-derived cognitive variables predicted PTSD best (Nagelkerke R 2 =0·50), followed by the variables from the meta-analysis (Nagelkerke R 2 =0·37) and ASD (Nagelkerke R 2 =0·25). When all predictors were considered simultaneously, mental defeat, rumination and prior problems with anxiety or depression were chosen as the best combination of predictors (Nagelkerke R 2 =0·47). Conclusion Questionnaires measuring mental defeat, rumination and pre-trauma psychological problems may help to identify assault survivors at risk of chronic PTSD.",0,0 +4347,Increased Framingham 10-year risk of coronary heart disease in middle-aged and older patients with psychotic symptoms,"The Framingham 10-risk of coronary heart disease (CHD) has been a widely studied estimate of cardiovascular risk in the general population. However, few studies have compared the relative risk of developing CHD in antipsychotic-treated patients with different psychiatric disorders, especially in older patients with psychotic symptoms. In this study, we compared the 10-year risk of developing CHD among middle-aged and older patients with psychotic symptoms to that in the general population.We analyzed baseline data from a study examining metabolic and cardiovascular effects of atypical antipsychotics in patients over age 40 with psychotic symptoms. After excluding patients with prior history of CHD and stroke, 179 subjects were included in this study. Among them, 68 had a diagnosis of schizophrenia, 42 mood disorder, 38 dementia, and 31 PTSD. Clinical evaluations included medical and pharmacologic treatment history, physical examination, and clinical labs for metabolic profiles. Using the Framingham 10-year risk of developing CHD based on the Framingham Heart Study (FHS), we calculated the risk CHD risk for each patient, and then compared relative risk in each psychiatric diagnosis to the risks reported in the FHS.The mean age of entire sample was 63 (range 40-94) years, 68% were men. The Framingham 10-year risk of CHD was increased by 79% in schizophrenia, 72% in PTSD, 61% in mood disorder with psychosis, and 11% in dementia relative to the risk in general population from the FHS.In this sample of middle-aged and older patients with psychotic symptoms, we found a significantly increased 10-year risk of CHD relative to the estimated risk from FHS, with the greatest increased risk for patients with schizophrenia and PTSD. Development of optimally tailored prevention and intervention efforts to decrease different risk components in these patients could be an important step to help decrease the risks of CHD and overall mortality in this vulnerable population.",0,0 +4348,Aerobic Exercise Reduces Symptoms of Posttraumatic Stress Disorder: A Randomized Controlled Trial,"Evidence suggests aerobic exercise has anxiolytic effects; yet, the treatment potential for posttraumatic stress disorder (PTSD) and responsible anxiolytic mechanisms have received little attention. Emerging evidence indicates that attentional focus during exercise may dictate the extent of therapeutic benefit. Whether benefits are a function of attentional focus toward or away from somatic arousal during exercise remains untested. Thirty-three PTSD-affected participants completed two weeks of stationary biking aerobic exercise (six sessions). To assess the effect of attentional focus, participants were randomized into three exercise groups: group 1 (attention to somatic arousal) received prompts directing their attention to the interoceptive effects of exercise, group 2 (distraction from somatic arousal) watched a nature documentary, and group 3 exercised with no distractions or interoceptive prompts. Hierarchal linear modeling showed all groups reported reduced PTSD and anxiety sensitivity (AS; i.e., fear of arousal-related somatic sensations) during treatment. Interaction effects between group and time were found for PTSD hyperarousal and AS physical and social scores, wherein group 1, receiving interoceptive prompts, experienced significantly less symptom reduction than other groups. Most participants (89%) reported clinically significant reductions in PTSD severity after the two-week intervention. Findings suggest, regardless of attentional focus, aerobic exercise reduces PTSD symptoms.",0,0 +4349,Is Poor Sleep in Veterans a Function of Post-Traumatic Stress Disorder?,"Substantial research has demonstrated an association between post-traumatic stress disorder (PTSD) and quality of sleep, particularly in veteran populations. The exact nature of this relationship, however, is not clear. The possibility that poor sleep is a more general experience among veterans has not been explored to date, with most studies focusing only on veteran populations with PTSD. This pilot study aimed to explore whether sleep disturbance is common to veterans generally or simply those with PTSD. Data were collected from a community sample of 152 Australian Vietnam war veterans, 87 of whom did not meet criteria for PTSD. All those with PTSD and 90% of those without PTSD reported clinically significant sleep disturbance, indicating that serious sleep problems are common across the veteran population. Despite the limitations of this initial study, these results highlight the importance of ensuring that research into sleep disorders in veterans with PTSD pays attention to the potential etiological role of other military factors, including deployments.",0,0 +4350,A real-world study of the effectiveness of DBT in the UK National Health Service,"Objectives. Dialectical behavioral therapy (DBT) has gained widespread popularity as a treatment for borderline personality disorder (BPD), and its efficacy has been demonstrated in several trials. The aim of this study was to evaluate the effectiveness of DBT delivered by staff with a level of training readily achievable in National Health Service care settings for individuals with a Cluster B personality disorder. Design. Randomized control trial methodology was used to compare DBT to treatment as usual (TAU). Method. Forty-two participants entered the trial. Diagnostic and outcome measures were undertaken at assessment, at 6 months, and at 1 year. The clinical outcomes in routine evaluation – outcome measure (CORE-OM) were utilized as the primary outcome measure. Results. Both the DBT and TAU groups improved on the range of measures employed. The DBT group showed a slightly greater decrease in CORE-OM risk scores, suicidality, and post-traumatic stress disorder symptom severity. However, the TAU group showed comparable reductions in all measures and a larger decrease in para-suicidal behaviours and risk. Conclusions. DBT may be an effective treatment delivered by community outpatient services for individuals with a Cluster B personality disorder. Further studies are needed to consider the impact of experience and adherence to DBT in improving outcome.",0,0 +4351,Evidence-Based Practice with Women: Toward Effective Social Work Practice with Low-Income Women Evidence-based practice with women: Toward effective social work practice with low-income women,"This one-of-a-kind book presents evidence-based coverage of the assessment and treatment of the most common mental health disorders among women, particularly low-income women. For each disorder-depression, post-traumatic stress disorder and trauma (including sexual abuse), generalized anxiety disorder, substance use disorder, and borderline personality disorder-the authors include assessment instruments and detailed case examples that illustrate the assessment and treatment recommendations. © 2011 by SAGE Publications, Inc.",0,0 +4352,"Posttraumatic growth, posttraumatic stress disorder and resilience of motor vehicle accident survivors","Abstract Background Although some previous studies have suggested that posttraumatic growth (PTG) is comprised of several factors with different properties, few have examined both the association between PTG and posttraumatic stress disorder (PTSD) and between PTG and resilience, focusing on each of the factors of PTG. This study aimed to examine the hypothesis that some factors of PTG, such as personal strength, relate to resilience, whereas other factors, such as appreciation of life, relate to PTSD symptoms among Japanese motor vehicle accident (MVA) survivors. Methods This cross-sectional study was performed with 118 MVA survivors at 18 months post MVA. Data analyzed included self-reporting questionnaire scores on the Posttraumatic Growth Inventory (PTGI), the Impact of Event Scale- Revised (IES-R), and the Sense of Coherence (SOC) scale, which is one of the most widely used scales for measuring resilience. Correlations between scores on the PTGI and IES-R, the PTGI and SOC scale, and the IES-R and SOC scale were established by calculating Spearman's correlation coefficients. Results PTGI was positively correlated with both SOC and PTSD symptoms, in spite of an inverse relationship between SOC and PTSD symptoms. Relating to others, new possibilities, and personal strength on the PTGI were correlated positively with SOC, and spiritual change and appreciation of life on the PTGI were positively correlated with PTSD symptoms. Conclusions Some factors of PTG were positively correlated with resilience, which can be regarded as an outcome of coping success, whereas other factors of PTG were positively correlated with PTSD symptoms, which can be regarded as signifying coping effort in the face of enduring distress. These findings contribute to our understanding of the psychological change experienced by MVA survivors, and to raising clinicians' awareness of the possibility that PTG represents both coping effort coexisting with distress and outcome of coping success.",0,0 +4353,The traumatic stress response in child maltreatment and resultant neuropsychological effects,"Child maltreatment is a pervasive problem in our society that has long-term detrimental consequences to the development of the affected child such as future brain growth and functioning. In this paper, we surveyed empirical evidence on the neuropsychological effects of child maltreatment, with a special emphasis on emotional, behavioral, and cognitive process–response difficulties experienced by maltreated children. The alteration of the biochemical stress response system in the brain that changes an individual’s ability to respond efficiently and efficaciously to future stressors is conceptualized as the traumatic stress response. Vulnerable brain regions include the hypothalamic–pituitary–adrenal axis, the amygdala, the hippocampus, and prefrontal cortex and are linked to children’s compromised ability to process both emotionally-laden and neutral stimuli in the future. It is suggested that information must be garnered from varied literatures to conceptualize a research framework for the traumatic stress response in maltreated children. This research framework suggests an altered developmental trajectory of information processing and emotional dysregulation, though much debate still exists surrounding the correlational nature of empirical studies, the potential of resiliency following childhood trauma, and the extent to which early interventions may facilitate recovery.",0,0 +4354,Unique relations between counterfactual thinking and DSM–5 PTSD symptom clusters.,"Cognitive models of posttraumatic stress disorder (PTSD) propose that rumination about a trauma may increase particular symptom clusters. One type of rumination, termed counterfactual thinking (CFT), refers to thinking of alternative outcomes for an event. CFT centered on a trauma is thought to increase intrusions, negative alterations in mood and cognitions (NAMC), and marked alterations in arousal and reactivity (AAR). The theorized relations between CFT and specific symptom clusters have not been thoroughly investigated. Also, past work has not evaluated whether the relation is confounded by depressive symptoms, age, gender, or number of traumatic events experienced.The current study examined the unique associations between CFT and PTSD symptom clusters according to the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013) in 51 trauma-exposed treatment-seeking individuals.As predicted, CFT was associated with all PTSD symptom clusters. After controlling for common predictors of PTSD symptom severity (i.e., age, depressive symptoms, and number of traumatic life events endorsed), we found CFT to be significantly associated with the intrusion and avoidance symptom clusters but not the AAR or NAMC symptom clusters.Results from the present study provide further support for the role of rumination in specific PTSD symptom clusters above and beyond symptoms of depression, age, and number of traumatic life events endorsed. Future work may consider investigating interventions to reduce rumination in PTSD. (PsycINFO Database Record",0,0 +4355,"Posttraumatic stress disorder after a school shooting: effects of symptom threshold selection and diagnosis by DSM-III, DSM-III-R, or proposed DSM-IV","The purpose of the study was to investigate the effect of symptom threshold and criteria set selections on the diagnosis of posttraumatic stress disorder (PTSD) in adults and children exposed to a man-made disaster and determine how well DSM-III and its successors agree.Data gathered in the course of a voluntary clinical screening for PTSD in 66 adults and 64 children 6 to 14 months after exposure to a school shooting were analyzed according to DSM-III, DSM-III-R, and proposed DSM-IV criteria for PTSD diagnosis and cluster endorsement using liberal (occurring at least a little of the time), moderate (occurring at least some of the time), and conservative (occurring at least much or most of the time) symptom thresholds.Within DSM-III, DSM-III-R, and proposed DSM-IV, selection of liberal, moderate, and conservative symptom thresholds had robust effects on rates of diagnoses; liberal thresholds allowed the greatest frequencies of diagnosis. Compared with DSM-III and proposed DSM-IV, DSM-III-R generally diagnosed the fewest cases. Agreements between DSM-III-R and proposed DSM-IV were good, while agreements between DSM-III and its successors varied for children and adults.Diagnostic rates and agreements were complexly influenced by interactions among threshold and revisions in symptom clusters. The present study suggests that attempts to refine PTSD classification consider specification of symptom threshold intensity and supports the view that modification of criteria sets be undertaken with caution.",0,0 +4356,The General Self-Efficacy Scale: Multicultural Validation Studies,"General self-efficacy is the belief in one's competence to cope with a broad range of stressful or challenging demands, whereas specific self-efficacy is constrained to a particular task at hand. Relations between general self-efficacy and social cognitive variables (intention, implementation intentions, outcome expectancies, and self-regulation), behavior-specific self-efficacy, health behaviors, well-being, and coping strategies were examined among 1,933 respondents in 3 countries: Germany (n = 633), Poland (n = 359), and South Korea (n = 941). Participants were between 16 and 86 years old, and some were dealing with stressful situations such as recovery from myocardial events or tumor surgery. Perceived self-efficacy was measured by means of the General Self-Efficacy Scale (R. Schwarzer & M. Jerusalem, 1995). Meta-analysis was used to determine population effect sizes for four sets of variables. Across countries and samples, there is consistent evidence for associations between perceived self-efficacy and the variables under study confirming the validity of the psychometric scale. General self-efficacy appears to be a universal construct that yields meaningful relations with other psychological constructs.",0,0 +4357,"The relationship between anxiety and depression: A clinical comparison of generalized anxiety disorder, dysthymic disorder, panic disorder, and major depressive disorder","This study examined the relationship between the chronic disorders, generalized anxiety disorder (GAD) and dysthymic disorder (DD), and the more acute disorders, panic disorder (PD) and major depressive disorder (MDD) in 110 psychiatric outpatients with diagnoses of either PD, MDD, GAD, or DD. Pure, mixed, and early-/late-onset forms of the chronic disorders were compared with each other and then with PD and MDD on clinical measures and psychiatric history. Minimal differences were found between pure GAD and mixed GAD or between pure DD and mixed DD. The chronic disorders, DD and GAD, had distinct clinical symptom profiles when compared with each other and appeared more closely related to their parent disorders than to each other. However, despite these similarities, there were significant differences between DD and MDD in contrast to the minimal differences between GAD and PD, providing less support for GAD as a valid diagnostic category separate from PD. Comparisons of early-/late-onset DD and GAD showed more severe symptoms in late-onset DD, in contrast to more severe symptoms in early-onset GAD. These varying patterns of symptom severity may warrant study for further syndromal delineation.",0,0 +4358,Association of exposure to intimate-partner physical violence and potentially traumatic war-related events with mental health in Liberia,"Liberia's wars between 1989 and 2003 resulted in hundreds of thousands of casualties and millions of victims. Gender-based violence was widespread during the conflict. Since the end of the war, however, little attention has been paid to ongoing violence against women, especially within the household. This research examines the relationships between intimate-partner physical violence, war experiences, and mental health nearly ten years after the end of the war. The study is based on a nationwide cross-sectional, multistage stratified cluster random survey of 4501 adults using structured interviews during a six-week period in November and December 2010. The main outcome measures are prevalence of intimate-partner physical violence, exposure to potentially traumatic war-related events, symptoms of Post-Traumatic Stress Disorder (PTSD) and depression. Among adult women, 37.7% (95%CI, 34.9-40.5; n = 852/2196) reported lifetime exposure to intimate-partner physical violence and 24.4% (95%CI, 22.1-26.9; n = 544/2196) reported incidence of intimate-partner physical violence over a one-year recall period. Among men, 23.2% (95%CI, 20.8-25.9, n = 475/2094) reported having severely beaten their spouse or partner over their lifetime; the incidence over the one-year recall was 12.2% (95%CI, 10.4-14.2, n = 259/2094). Among adult residents in Liberia, 10.6% (95%CI, 9.5-11.7, n = 546/4496) met the criteria for symptoms of depression, and 12.6% (95% CI, 11.5-13.9, n = 608/4496) met the criteria for symptoms of PTSD. Intimate-partner physical violence as a victim and as a perpetrator was significantly associated with exposure to potentially traumatic war-related events, especially among men. Among women, experiencing intimate-partner physical violence was associated with symptoms of PTSD and depression. Among men, perpetrating intimate-partner physical violence was associated with symptoms of PTSD and depression after adjusting for exposure to potentially traumatic war-related events. These findings suggest that intimate-partner physical violence may be a continued stressor in post-war societies that needs to be recognized and addressed as part of the reconstruction effort.",0,0 +4359,Neuronal DNA Methylation Profiling of Blast-Related Traumatic Brain Injury,"Long-term molecular changes in the brain resulting from blast exposure may be mediated by epigenetic changes, such as deoxyribonucleic acid (DNA) methylation, that regulate gene expression. Aberrant regulation of gene expression is associated with behavioral abnormalities, where DNA methylation bridges environmental signals to sustained changes in gene expression. We assessed DNA methylation changes in the brains of rats exposed to three 74.5 kPa blast overpressure events, conditions that have been associated with long-term anxiogenic manifestations weeks or months following the initial exposures. Rat frontal cortex eight months post-exposure was used for cell sorting of whole brain tissue into neurons and glia. We interrogated DNA methylation profiles in these cells using Expanded Reduced Representation Bisulfite Sequencing. We obtained data for millions of cytosines, showing distinct methylation profiles for neurons and glia and an increase in global methylation in neuronal versus glial cells (p<10(-7)). We detected DNA methylation perturbations in blast overpressure-exposed animals, compared with sham blast controls, within 458 and 379 genes in neurons and glia, respectively. Differentially methylated neuronal genes showed enrichment in cell death and survival and nervous system development and function, including genes involved in transforming growth factor β and nitric oxide signaling. Functional validation via gene expression analysis of 30 differentially methylated neuronal and glial genes showed a 1.2 fold change in gene expression of the serotonin N-acetyltransferase gene (Aanat) in blast animals (p<0.05). These data provide the first genome-based evidence for changes in DNA methylation induced in response to multiple blast overpressure exposures. In particular, increased methylation and decreased gene expression were observed in the Aanat gene, which is involved in converting serotonin to the circadian hormone melatonin and is implicated in sleep disturbance and depression associated with traumatic brain injury.",0,0 +4360,"Attention-Deficit/Hyperactivity Disorder Diagnosis, Co-Morbidities, Treatment Patterns, and Quality of Life in a Pediatric Population in Central and Eastern Europe and Asia","Attention deficit/hyperactivity disorder (ADHD) is often poorly understood, and treatment practices are variable. This 12-month, prospective, observational study provides information about the diagnosis, co-morbidities, treatment patterns, and quality of life (QOL) of patients aged 6–17 years with ADHD symptoms from eastern Asia and central and eastern Europe. Here, we present baseline data for the 1068 enrolled and eligible patients in the study (median age 8 years, 82.2% male). Patients were grouped into two cohorts based on whether they were prescribed psycho- and/or pharmacotherapy (n = 794) or not (n = 274) at study entry. On average, patients receiving treatment were significantly older (9.1 vs. 8.4 years, p < 0.001), more severely ill (Clinical Global Impressions [CGI]-ADHD-S, 4.6 vs. 4.2, p < 0.001; Child Symptom Inventory-4 Parent Checklist (CSI-4) ADHD:C, 35.2 vs. 31.9, p < 0.001), and had significantly higher CSI-4 symptom severity scores relating to various co-morbidities than patients not receiving treatment. At study initiation, patient's health-related QOL was significantly impaired as measured on the Child Health and Illness Profile–Child Edition (CHIP-CE) rating scale, with significantly more impairment in the treated group of patients for the Comfort, Risks Avoidance, and Achievement domains. These results provide a description of ADHD and treatment practices in these regions and establish a baseline for gauging changes over time in the study sample.",0,0 +4361,Posttraumatic Stress Disorder and Posttraumatic Growth Among Adult Survivors of Wenchuan Earthquake After 1 Year: Prevalence and Correlates,"

Abstract

This study investigates the prevalence and predictors for posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) in adult survivors 1year after the 2008 Wenchuan earthquake. Questionnaires were used to collect the data. PTSD was assessed using the PTSD Check List-Civilian (PCL-C), and PTG was assessed using the Post Traumatic Growth Inventory (PTGI). A total of 2,300 individuals were involved in the survey with 2,080 completing the questionnaire, a response rate of 90.4%. The PTSD prevalence estimate in this study was found to be 40.1%, and the prevalence for PTG among the participants was measured at 51.1%. A bivariate correlation analysis indicated that there was a positive association between PTG and PTSD. In the conclusions, possible explanations for the findings and implications for future research are discussed.",0,0 +4362,Influences of Maternal and Paternal PTSD on Epigenetic Regulation of the Glucocorticoid Receptor Gene in Holocaust Survivor Offspring,"Differential effects of maternal and paternal posttraumatic stress disorder (PTSD) have been observed in adult offspring of Holocaust survivors in both glucocorticoid receptor sensitivity and vulnerability to psychiatric disorder. The authors examined the relative influences of maternal and paternal PTSD on DNA methylation of the exon 1F promoter of the glucocorticoid receptor (GR-1F) gene (NR3C1) in peripheral blood mononuclear cells and its relationship to glucocorticoid receptor sensitivity in Holocaust offspring.Adult offspring with at least one Holocaust survivor parent (N=80) and demographically similar participants without parental Holocaust exposure or parental PTSD (N=15) completed clinical interviews, self-report measures, and biological procedures. Blood samples were collected for analysis of GR-1F promoter methylation and of cortisol levels in response to low-dose dexamethasone, and two-way analysis of covariance was performed using maternal and paternal PTSD as main effects. Hierarchical clustering analysis was used to permit visualization of maternal compared with paternal PTSD effects on clinical variables and GR-1F promoter methylation.A significant interaction demonstrated that in the absence of maternal PTSD, offspring with paternal PTSD showed higher GR-1F promoter methylation, whereas offspring with both maternal and paternal PTSD showed lower methylation. Lower GR-1F promoter methylation was significantly associated with greater postdexamethasone cortisol suppression. The clustering analysis revealed that maternal and paternal PTSD effects were differentially associated with clinical indicators and GR-1F promoter methylation.This is the first study to demonstrate alterations of GR-1F promoter methylation in relation to parental PTSD and neuroendocrine outcomes. The moderation of paternal PTSD effects by maternal PTSD suggests different mechanisms for the intergenerational transmission of trauma-related vulnerabilities.",0,0 +4363,HIV-Related Posttraumatic Stress Disorder: Investigating the Traumatic Events,"This study examined the relationship between the experience of various HIV-related events (receiving the diagnosis, receiving treatment, experiencing physical symptoms, self-disclosing HIV positive status, and witnessing HIV-related death) and posttraumatic stress symptoms in a sample of 100 gay men living with HIV. Self-report data revealed that 65% met criteria for having experienced a traumatic event in accordance with the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR) posttraumatic stress disorder (PTSD) criterion A. The experience of shame, humiliation, or guilt during an event was measured but not found to be a significant indicator of having been traumatized. A total of 33% qualified for a PTSD diagnosis. Stepwise multiple regression analysis showed that receiving medical treatment, experiencing physical symptoms, and witnessing HIV-related death were most associated with HIV-related PTSD symptoms. Given that multiple HIV-related events are potentially traumatic, the screening, assessment and treatment for HIV-related PTSD may need to be considered by HIV services.",0,0 +4364,MACI Scores of African American Males in a Forensic Setting: Are We Measuring What We Think We Are Measuring?,"In this study, confirmatory factor analyses were used to examine scores on the Millon Adolescent Clinical Inventory (MACI) in adolescent, African American males in a forensic setting (N = 496; Mage = 15.96, SDage = 1.32). Results from the study do not support the model proposed by Millon and suggest the MACI may not yield valid or reliable scores in forensic populations of adolescent, African American males. Because MACI scores could be misleading in African American males, the authors argue that the MACI and other trait-scales not validated in this group be used with extreme caution—especially in settings where African Americans are disproportionately represented.",0,0 +4365,A Brief Overview of Traumatic Brain Injury (TBI) and Post-Traumatic Stress Disorder (PTSD) Within the Department of Defense,The current conflicts in the Middle East have yielded increasing awareness of the acute and chronic effect of traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). The increasing frequency of exposure to blast and multiple deployments potentially impact the probability that a service member may sustain one of these injuries. The 2008 International Conference on Behavioral Health and Traumatic Brain Injury united experts in the fields of behavioral health and traumatic brain injury to address these significant health concerns. This article summarizes current Department of Defense (DOD) initiatives related to TBI and PTSD.,0,0 +4366,Internalizing and externalizing classes in posttraumatic stress disorder: A latent class analysis,"Using latent class analysis (LCA) the typology of personality profiles of veterans with posttraumatic stress disorder (PTSD) was examined based on internalizing/externalizing dimensions of psychopathology. Latent class analysis on Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Personality Psychopathology-5 (PSY-5) scale data from 299 Australian combat veterans with PTSD supported the model, identifying an optimal 4-class solution, with PTSD externalizing class defined by aggressiveness and disconstraint, high and moderate internalizing classes differentiated on the extent of elevations in introversion and negative emotionality and elevation of psychoticism in the high internalizing class and a simple PTSD class with normal range scores. The model was validated using external self-report and psychiatric-interview-derived diagnoses. A second exploratory LCA using broader comorbidity indicators (MMPI-2 Restructured Clinical scales) demonstrated some support for, although limitations in, using nonpersonality measures to identify these classes directly.",0,0 +4367,Comorbidity of personality disorders and mental illnesses,"Abstract Mental illness and personality disorder often occur in the same person. Although concern has been expressed that this may be due to overlapping diagnostic criteria, many different studies have confirmed this finding. Various models have been proposed to explain the association, and it is likely that different models will be relevant to different associations. Associations between specific personality disorders and categories of mental illness include those between Cluster A personality disorders and schizophrenia, Cluster B personality disorders and substance misuse and post-traumatic stress disorder, and Cluster C personality disorders and depression, eating disorders and a number of neurotic disorders.",0,0 +4368,Distinct Hippocampal Expression Profiles of lncRNAs in Rats Exhibiting a PTSD-like Syndrome,"Posttraumatic stress disorder (PTSD) refers to a series of clinical syndromes, including symptoms such as nightmares, hallucinations, severe anxiety, fear, and trauma related to the environment. These symptoms tend to occur after intense psychological trauma or physiological stress. Long non-coding RNAs (lncRNAs) have been shown to play key roles in various biological processes, although it is unknown whether they have important functions in PTSD. Here, we present the first study exploring the connection between lncRNAs and a PTSD-like syndrome in rats. We find distinct expression profiles of lncRNAs between PTSD-like syndrome rats and a control group, which provides information for further research on the differentiation of PTSD and transdifferentiation between the PTSD-like syndrome and the control group. This information will be helpful for finding new therapeutic targets for the treatment of PTSD. © 2015 Springer Science+Business Media New York",0,0 +4369,Patterns of emotion regulation and psychopathology,"Emotion regulatory strategies such as higher expressive suppression and lower cognitive reappraisal may be associated with increased psychopathology (Gross & John, 2003). Yet, it is unclear whether these strategies represent distinct cognitive styles associated with psychopathology, such that there are individuals who are predominantly ""suppressors"" or ""reappraisers."" Using cluster analysis, we examined whether women with and without exposure to potentially traumatic events evidence distinct patterns of emotion regulation frequency, capacity, suppression, and cognitive reappraisal. Four patterns emerged: high regulators; high reappraisers/low suppressors; moderate reappraisers/low suppressors; and low regulators. Individuals who reported infrequently and ineffectively regulating their emotions (low regulators) also reported higher depression, anxiety, and posttraumatic stress disorder (PTSD). In contrast, individuals who reported frequently and effectively using reappraisal and low levels of suppression (high reappraisers/low suppressors) reported the lowest levels of these symptoms, suggesting that this specific combination of emotion regulation may be most adaptive. Our findings highlight that the capacity to regulate emotions and the ability to flexibly apply different strategies based on the context and timing may be associated with reduced psychopathology and more adaptive functioning.",0,0 +4370,Diagnostic Criteria for Postconcussional Syndrome After Mild to Moderate Traumatic Brain Injury,,0,0 +4371,Posttraumatic stress disorder and depressive symptoms: Joined or independent sequelae of trauma?,"The nature of co-morbidity between posttraumatic stress disorder (PTSD) and depression has been the subject of much controversy. This study addresses this issue by investigating associations between probable PTSD and depressive symptoms in a prospective, longitudinal sample of combat veterans. Symptoms of PTSD and depression were assessed at 3 points of time (i.e., 1991, 2003, 2008) over a period of 17 years utilizing the PTSD Inventory and the SCL-90 (Derogatis, 1977). Two groups of combat veterans, 275 former prisoners of war (ex-POWs) and 219 matched combatants (controls), were assessed. Data were analyzed using descriptive statistics, latent variable modeling, and confirmatory factor analysis. A series of χ 2 tests revealed that the prevalence proportions of depressive symptoms and probable PTSD were higher among ex-POWs compared to controls at all time points. The prevalence of depressive symptoms was higher than the prevalence of PTSD symptoms in both groups at the each of the times. Latent Trajectories Modeling (LTM) indicated that while ex-POWs' PTSD symptom severity increased over time, the severity of symptoms remained stable among controls. Parallel Process Latent Growth Modeling (PLGM) revealed a positive bi-directional relationship whereby PTSD symptoms mediated the affect of captivity on depressive symptoms and depressive symptoms mediated the affect of captivity on PTSD symptoms over time. Utilizing Confirmatory Factor Analysis (CFA), a single factor model emerged for depressive and PTSD symptoms. The findings suggest that while depression and PTSD seem to be different long-term manifestations of traumatic stress, accounted for in part by the severity of the trauma, they both may be parts of a common general traumatic stress construct. Clinical and theoretical implications of these findings are discussed.",0,0 +4372,A Practical Measure of Workplace Resilience,"To develop an effective measure of resilience at work for use in individual work-related performance and emotional distress contexts.Two separate cross-sectional studies investigated: (1) exploratory factor analysis of 45 items putatively underpinning workplace resilience among 397 participants and (2) confirmatory factor analysis of resilience measure derived from Study 1 demonstrating a credible model of interaction, with performance outcome variables among 194 participants.A 20-item scale explaining 67% of variance, measuring seven aspects of workplace resilience, which are teachable and capable of conscious development, was achieved. A credible model of relationships with work engagement, sleep, stress recovery, and physical health was demonstrated in the expected directions.The new scale shows considerable promise as a reliable instrument for use in the area of employee support and development.",0,0 +4373,Posttraumatic stress disorder symptom trajectories in Hurricane Katrina affected youth,"This study examined trajectories of posttraumatic stress disorder symptoms in Hurricane Katrina affected youth.A total of 426 youth (51% female; 8-16 years old; mean age=11 years; 75% minorities) completed assessments at 4 time points post-disaster. Measures included Hurricane impact variables (initial loss/disruption and perceived life threat); history of family and community violence exposure, parent and peer social support, and post-disaster posttraumatic stress symptoms.Latent class growth analysis demonstrated that there were three distinct trajectories of posttraumatic stress disorder symptoms identified for this sample of youth (resilient, recovering, and chronic, respectively). Youth trajectories were associated with Hurricane-related initial loss/disruption, community violence, and peer social support.The results suggest that youth exposed to Hurricane Katrina have variable posttraumatic stress disorder symptom trajectories. Significant risk and protective factors were identified. Specifically, youth Hurricane and community violence exposure increased risk for a more problematic posttraumatic stress disorder symptom trajectory, while peer social support served as a protective factor for these youth. Identification of these factors suggests directions for future research as well as potential target areas for screening and intervention with disaster exposed youth.The convenience sample limits the external validity of the findings to other disaster exposed youth, and the self-report data is susceptible to response bias.",1,0 +4374,Trajectory in obsessive-compulsive disorder comorbidities,"The main goal of this study is to contribute to the understanding of the trajectory of comorbid disorders associated with obsessive-compulsive disorder (OCD) according to the first manifested psychiatric disorder and its impact in the clinical course of OCD and subsequent psychiatric comorbidities. One thousand and one OCD patients were evaluated at a single time point. Standardized instruments were used to determine the current and lifetime psychiatric diagnoses (Structured Clinical Interview for DSM-IV Axis I and for impulse-control disorders) as well as to establish current obsessive-compulsive, depressive and anxiety symptom severity (Yale-Brown Obsessive-Compulsive Scale; Dimensional Yale-Brown Obsessive-Compulsive Scale, Beck Depression and Anxiety Inventories and the OCD Natural History Questionnaire). To analyze the distribution of comorbidities according to age at onset Bayesian approach was used. Five hundred eight patients had the first OC symptom onset till the age of 10 years old. The first comorbidity to appear in the majority of the sample was separation anxiety disorder (17.5%, n=175), followed by ADHD (5.0%, n=50) and tic disorders (4.4%, n=44). OCD patients that presented with separation anxiety disorder as first diagnosis had higher lifetime frequency of post-traumatic stress disorder (p=0.003), higher scores in the Sexual/Religious dimension (p=0.04), Beck Anxiety (p<0.001) and Depression (p=0.005) Inventories. OCD patients that initially presented with ADHD had higher lifetime frequencies of substance abuse and dependence (p<0.001) and worsening OCD course (p=0.03). OCD patients that presented with tic disorders as first diagnosis had higher lifetime frequencies of OC spectrum disorders (p=0.03). OCD is a heterogeneous disorder and that the presence of specific comorbid diagnoses that predate the onset of OCD may influence its clinical presentation and course over the lifetime.",0,0 +4375,"Conflict, violence, and health: Setting a new interdisciplinary agenda",,0,0 +4376,The Epidemiology of Post-traumatic Stress Disorder: A Focus on Refugee and Immigrant Populations,"(from the chapter) Despite of the great variability in study findings on rates and risks for posttraumatic stress disorder (PTSD) in general, PTSD has to be considered as a possible diagnosis in refugees and asylum seekers with suspected psychiatric symptoms, since these populations are particularly vulnerable groups which are more commonly and often repeatedly exposed to life's adversities preflight, while on flight and even after resettlement in another country, or when internally displaced in a stable part of the home country. The findings on prevalence rates of PTSD are quite heterogeneous and may also vary within the same population over time. Risk factors for PTSD may be more consistent over time and population group studied. Among the factors most frequently found to be associated with increased risk for PTSD is having a psychiatric history prior to the trauma. A meta-analysis by Brewin et al, (2000) also found childhood abuse and a family history of psychiatric disorders to be consistently associated with PTSD risk. The study further found low socioeconomic status, low level of education, low intelligence, life stress, lack of social support, trauma severity, adverse childhood and previous trauma to be consistently but to a differing degree related to an increased risk for PTSD. While protective effects of higher levels of intelligence have also been shown in a large prospective study in a cohort of adolescents independent of social and educational status, no explanatory model has yet been established. (PsycINFO Database Record (c) 2015 APA, all rights reserved)",0,0 +4377,Interfering with the reconsolidation of traumatic memory: sirolimus as a novel agent for treating veterans with posttraumatic stress disorder.,"Development of novel treatment approaches for combat-related posttraumatic stress disorder (PTSD) is critical, given the increasing prevalence of PTSD in veterans returning from war zone deployment. Established preclinical research using protein synthesis inhibitors (such as sirolimus) to interfere with fear memory reconsolidation provides a compelling rationale for investigation in humans.This double-blind, placebo-controlled translational pilot study examined the effects of pairing reactivation of a trauma memory with a single administration of sirolimus on the frequency and intensity of PTSD symptoms in male combat veterans.Primary analyses found no significant differences between treatment groups on any of the clinical or physiologic outcome measures. In an exploratory analysis of a subsample of post-Vietnam-era veterans who had more recent combat trauma, PTSD symptom scores fell significantly more in these veterans than in controls.The post-Vietnam-era veteran findings suggest that further investigation of this pairing of sirolimus with traumatic memory reactivation may be warranted. Theoretically, interference with the reconsolidation of fear memories could ameliorate military-related psychological trauma symptoms. Future research should focus on veterans of more recent eras whose traumatic memories may be less entrenched and more amenable to pharmacologic modification within this procedure.",0,0 +4378,Malignant Memories: PTSD in Children and Adults after a School Shooting,"Sixty-four children and 66 adults were screened for post-traumatic stress disorder 6 to 14 months after a school shooting. Although there were no differences in overall frequencies of DSM-III-R diagnoses or cluster endorsements, there were developmental influences. Post-traumatic stress disorder was associated more with emotional states recalled from the disaster than with proximity. Emotional states mediated the formation of malignant memories leading to symptomatology, suggesting that postdisaster intervention be offered on the basis of degree of emotional reaction as well as proximity.",0,0 +4379,Correlation between lipid profile and different types of aggressive behaviour in combatants,"Objectives At present there is a discussion whether cholesterol level, aggression and violence are connected for they are characteristic behavioral patterns in combatants suffering particularly from PTSD. Method With the help of the Aggressive Behaviour Assessment Scale we examined 337 combatants and 116 healthy people, also we held an additional investigation of serum concentration of lipid profile. Reliability of results was evaluated by the Mann-Whitney U-test. Also the correlation analysis (Spearman rank correlation coefficient) was carried out. Results Combatants showed an integrated overall index of aggression twice as much in comparison with the control group (2,44 ± 0,09 and 1,08 ± 0,08, Ð < 0,00001), impulsive aggression was five times greater (2,08 ± 0,12 and 0,39 ± 0,06, Ð < 0,00001), premeditated aggression was 1,7-fold (3,15 ± 0,11 and 1,78 ± 0,13, Ð < 0,00001). The highest points of emotional (impulsive, hostile) aggressive behaviour revealed negative links with concentrations of cholesterol (r = −0,109, Ð < 0,05), LDL total cholesterol (r = −0,109, Ð < 0,05), triglycerides (−0,137 ≥ r ≥ −0,108, Ð < 0,05). Certain positions of premeditated (instrumental) aggression positively correlated with level of total cholesterol (0,140 ≥ r ≥ 0,126, Ð < 0,01), LDL total cholesterol (0,141 ≥ r ≥ 0,161, Ð < 0,01). Conclusions Reduction of cholesterol level and its most atherogenic fractions increases intensity of impulsive aggression and diminishes instrumental aggression of aggressive behaviour whereas increase of lipid profile leads to opposite results. The obtained data can be of great importance for treatment and prophylaxis of cardio-vascular disorders which are so typical for combat veterans.",0,0 +4380,Diagnosis and management of post-traumatic stress disorder.,"Although post-traumatic stress disorder (PTSD) is a debilitating anxiety disorder that may cause significant distress and increased use of health resources, the condition often goes undiagnosed. The lifetime prevalence of PTSD in the United States is 8 to 9 percent, and approximately 25 to 30 percent of victims of significant trauma develop PTSD. The emotional and physical symptoms of PTSD occur in three clusters: re-experiencing the trauma, marked avoidance of usual activities, and increased symptoms of arousal. Before a diagnosis of PTSD can be made, the patient's symptoms must significantly disrupt normal activities and last for more than one month. Approximately 80 percent of patients with PTSD have at least one comorbid psychiatric disorder. The most common comorbid disorders include depression, alcohol and drug abuse, and other anxiety disorders. Treatment relies on a multidimensional approach, including supportive patient education, cognitive behavior therapy, and psychopharmacology. Selective serotonin reuptake inhibitors are the mainstay of pharmacologic treatment.",0,0 +4381,A lifespan perspective on terrorism: Age differences in trajectories of response to 9/11.,"A terrorist attack is an adverse event characterized by both an event-specific stressor and concern about future threats. Little is known about age differences in responses to terrorism. This longitudinal study examined generalized distress, posttraumatic stress responses, and fear of future attacks following the September 11, 2001 (9/11) terrorist attacks among a large U.S. national sample of adults (N = 2,240) aged 18-101 years. Individuals completed Web-based surveys up to 6 times over 3 years post 9/11. Multilevel models revealed different age-related patterns for distress, posttraumatic stress, and ongoing fear of future attacks. Specifically, older age was associated with lower overall levels of general distress, a steeper decline in posttraumatic stress over time, and less change in fear of future terrorist attacks over the 3 years. Understanding age differences in response to the stress of terrorism adds to the growing body of work on age differences in reactions to adversity.",0,0 +4382,Posttraumatic Stress Disorder and its Relationship with Attachment Styles and Dimensions,"Treatment studies for posttraumatic stress disorder (PTSD) consistently show a portion of participants with poor treatment outcomes. Bowlby.s attachment theory is one framework for understanding PTSD. Research has begun investigating relationships between PTSD and attachment and has found relationships between PTSD symptoms and attachment across attachment styles. The purpose of the current study was to extend this research by investigating relationships between a person.s own PTSD symptoms and attachment style and dimensions. The study used a correlational approach with a convenience sample of adults diagnosed with PTSD (N = 80). The research questions sought to (a) examine the relationships between a person.s predominating PTSD symptom cluster and their scores on the two attachment dimensions that combine to form attachment styles, and (b) accurately classify participants into their attachment style based on their three PTSD symptom cluster scores. Participants completed the Experiences in Close Relationships- Revised (ECR-R) and PTSD Checklist- Specific (PCL-S) via a secure website. MANOVA was used for the first research question and multiple discriminant analysis (MDA) for the second. MANOVA results were nonsignificant but MDA results classified participants at a greater-than-chance rate. The MDA classification results provide implications for positive social change by supplying preliminary evidence for relationships between a person.s own PTSD symptoms and attachment style, suggesting that personalizing PTSD treatment protocols according to a person.s attachment style may improve treatment outcomes for people with PTSD. More research is needed to determine mediating variables between these constructs as well as how attachment considerations may be most effectively implemented in treatment. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4383,Effects of Stress and MDMA on Hippocampal Gene Expression,"MDMA (3,4-methylenedioxymethamphetamine) is a substituted amphetamine and popular drug of abuse. Its mood-enhancing short-term effects may prompt its consumption under stress. Clinical studies indicate that MDMA treatment may mitigate the symptoms of stress disorders such as posttraumatic stress syndrome (PTSD). On the other hand, repeated administration of MDMA results in persistent deficits in markers of serotonergic (5-HT) nerve terminals that have been viewed as indicative of 5-HT neurotoxicity. Exposure to chronic stress has been shown to augment MDMA-induced 5-HT neurotoxicity. Here, we examine the transcriptional responses in the hippocampus to MDMA treatment of control rats and rats exposed to chronic stress. MDMA altered the expression of genes that regulate unfolded protein binding, protein folding, calmodulin-dependent protein kinase activity, and neuropeptide signaling. In stressed rats, the gene expression profile in response to MDMA was altered to affect sensory processing and responses to tissue damage in nerve sheaths. Subsequent treatment with MDMA also markedly altered the genetic responses to stress such that the stress-induced downregulation of genes related to the circadian rhythm was reversed. The data support the view that MDMA-induced transcriptional responses accompany the persistent effects of this drug on neuronal structure/function. In addition, MDMA treatment alters the stress-induced transcriptional signature.",0,0 +4384,The prevalence and latent structure of proposed DSM-5 posttraumatic stress disorder symptoms in U.S. national and veteran samples.,"The Diagnostic and Statistical Manual, Fourth Edition (DSM-IV) is currently undergoing revisions in advance of the next edition, DSM-5. The DSM-5 posttraumatic stress disorder workgroup has proposed numerous changes to the PTSD diagnosis. These include the addition of new symptoms, revision of existing ones, and a new four-cluster organization (Friedman, Resick, Bryant, & Brewin, 2011). We conducted two Internet-based surveys to provide preliminary information about how proposed changes might impact PTSD prevalence and clarify the latent structure of the new symptom set. We used a newly developed instrument to assess event exposure and lifetime and current DSM-5 PTSD symptoms among a nationally representative sample of American adults (N = 2,953) and a clinical convenience sample of U.S. military veterans (N = 345). Results from both samples indicated that the originally proposed DSM-5 symptom criteria (i.e., requiring 1 B, 1 C, 3 D, and 3 E symptoms) yielded considerably lower PTSD prevalence estimates compared with DSM-IV estimates. These estimates were more comparable when the DSM-V D and E criteria were relaxed to 2 symptoms each (i.e., the revised proposal). Confirmatory factor analyses (CFA) indicated that the factor structure implied by the four-symptom criteria provided adequate fit to the data in both samples, and a DSM-5 version of a dysphoria model (Simms, Watson, & Doebbeling, 2002) yielded modest improvement in fit. Item-response theory and CFA analyses indicated that the psychogenic amnesia and new reckless/self-destructive behavior symptom deviated from the others in their respective symptom clusters. Implications for final formulations of DSM-5 PTSD criteria are discussed.",0,0 +4385,Mood and anxiety disorders in females with the FMR1 premutation,"Fragile X syndrome (FXS) is a model for studying the relative contributions of genetic and environmental factors to psychiatric disorders in mothers of children with disabilities. Here, we examine the frequency and predictors of mood and anxiety disorders in mothers with the FMR1 premutation. Ninety-three females with the FMR1 premutation were in the study and were compared to 2,159 women from the National Comorbidity Survey Replication (NCS-R) dataset. Mood and anxiety disorders were assessed using the SCID-I. Our data reflect elevated lifetime major depressive disorder (MDD), lifetime panic disorder without agoraphobia and current agoraphobia without panic disorder in the FMR1 premutation sample. Also, we found a low frequency of lifetime social phobia, specific phobia, and post-traumatic stress disorders and current specific phobia in the FMR1 premutation sample. The profile of MDD in the FMR1 premutation sample was not episodic or comorbid with an anxiety disorder, as in the NCS-R dataset. Never having been married and smaller CGG repeat length were associated with increased likelihood of MDD while increased children with FXS in the family and greater child problem behaviors were associated with increased likelihood of an anxiety disorder in the FMR 1 premutation group. Major depression in females with the FMR1 premutation may not be characterized as an episodically chronic recurrent disorder as it is in community samples and may have a genetic basis given the relationship with CGG repeat length and lack of association with all child and most demographic factors.",0,0 +4386,Peritraumatic Distress Inventory as a predictor of post-traumatic stress disorder after a severe motor vehicle accident,"Aim: The aim of this study was to examine the utility of the Peritraumatic Distress Inventory (PDI) as a predictor of subsequent post-traumatic stress disorder (PTSD) in severe motor vehicle accident survivors. Methods: Patients consecutively admitted to the intensive care unit were assessed immediately and 1 month after accidents in this prospective study. The predictive value for post-traumatic stress symptoms at 1 month of the PDI at initial assessment was examined by using multivariate regression analysis. Moreover, the accuracy of the PDI as a predictor of PTSD was determined using receiver operator characteristic curve analysis. Post-traumatic stress symptoms were assessed using the Impact of Event Scale – Revised questionnaire, and PTSD was assessed using the Clinician-Administered PTSD Scale. Results: Seventy-nine patients completed the Impact of Event Scale – Revised questionnaire, and 64 patients participated in a structured interview. Of 64 patients, 13 met the diagnostic criteria of full or partial PTSD. The PDI was an independent predictor of post-traumatic stress symptoms (P = 0.003). The data indicated that a cut-off score of 23 maximized the balance between sensitivity (77%) and specificity (82%) in this study. Compared with negative predictive value (93%), positive predictive value was not high (53%). Conclusion: The study suggests the predictive usefulness of the PDI for subsequent PTSD in accident survivors. Its adequate usage should be further elaborated.",0,0 +4387,Fluvoxamine Reduces Physiologic Reactivity to Trauma Scripts in Posttraumatic Stress Disorder,"This study assessed the effect of open-label fluvoxamine treatment for posttraumatic stress disorder (PTSD), depressive symptoms, and physiologic arousal to trauma cues. Baseline psychometric ratings and physiologic assessments of heart rate and blood pressure responses to individualized, taped trauma scripts were determined for 16 patients with PTSD and 16 mentally healthy age- and gender-matched control subjects exposed to at least 1 serious trauma. Patients with PTSD had greater autonomic reactivity than control subjects at baseline, with physiologic measures correlating with the severity of the PTSD for the combined groups. Discriminant analyses indicated that systolic blood pressure best classified patients with PTSD (75% sensitivity) and control subjects (100% specificity), with a stepwise discriminant analysis showing that combined physiologic variables correctly classified 75% of patients with PTSD and 100% of control subjects. After 10 weeks of fluvoxamine treatment (100-300 mg/day), patients' PTSD, depression, and physiologic reactivity improved significantly. Medicated patients with PTSD could not be distinguished statistically from untreated control subjects in any physiologic measure. This dampening of autonomic reactivity after drug treatment corroborates subjective measures of improvement, validating the reported efficacy of fluvoxamine in this open trial.",0,0 +4388,Post-Traumatic Stress Disorder and Depression in Health Care Providers Returning from Deployment to Iraq and Afghanistan,"This study examines risk factors for post-traumatic stress disorder (PTSD), depression, and mental health care use among health care workers deployed to combat settings.Anonymous surveys were administered to previously deployed workers at a military hospital. PTSD and depression were assessed by using the PTSD Checklist and the Patient Health Questionnaire depression scale, respectively. Deployment exposures and perceived threats during deployment were also assessed.There were 102 respondents (36% response rate). Nine percent (n=9) met the criteria for PTSD and 5% (n=5) met the criteria for depression. Direct and perceived threats of personal harm were risk factors for PTSD; exposure to wounded or dead patients did not increase risk. Those who met the criteria for PTSD were more likely to seek mental health care after but not before their deployment.For health care workers returning from a warfare environment, threat of personal harm may be the most predictive factor in determining those with subsequent PTSD.",0,0 +4389,"Primary malignant brain tumours, psychosocial distress and the intimate partner experience: what do we know?","From the time of diagnosis of a primary malignant brain tumour (PMBT) and throughout the illness trajectory, the patient and intimate partner face many psychosocial challenges ranging from fear and uncertainty to hope and loss (Fox & Lantz, 1998; Janda et al., 2007; Kvale, Murthy, Taylor, Lee, & Nabors, 2009). While many patients diagnosed with cancer may go on to live with cancer as a chronic illness, this may not be said of individuals diagnosed with a PMBT, in particular those diagnosed with a glioma, the most common form of brain tumour (Gupta & Sarin, 2002). Gliomas are associated with a short disease trajectory and multiple deficits (functional, cognitive and psychiatric). What makes the PMBT experience unique from other cancers is that the intimate partner must not only deal with the diagnosis of cancer in their spouse, but also the accompanying personality, functional and behavioural changes wrought by the disease, as well as grieve the loss of the person they once knew (Sherwood et al., 2004). These multi-dimensional deficits are thought to place the intimate partner, as caregiver, at greater risk for adverse psychosocial effects such as anxiety, depression and post traumatic stress (Goebel, von Harscher, & Mehdorn, 2011; Keir, Farland, Lipp, & Friedman, 2009). The following discussion will provide an overview of the extant literature on the experience of living with a PMBT from the intimate partner (spouse) perspective with a particular emphasis on how intimate partners cope. The intimate partner is considered to be the heterosexual or same-sex, married or common-law partner of the patient. Highlights from the psychotherapy practice of the author will be used to further strengthen the need for more research, education and enhanced practice to more effectively meet the unique needs of this under-researched and supported population.",0,0 +4390,Posttraumatic stress disorder following traumatic injury: Narratives as unconscious indicators of psychopathology,"Current conventional assessment methodologies used to diagnose posttraumatic stress disorder (PTSD) rely heavily on symptom counts obtained from clinical interviews or self-report questionnaires. Such measures may underestimate the impact of traumatic events, particularly in individuals who deny or repress emotional distress. This case report illustrates the use of two methods of narrative analysis to assess unconscious representations of PTSD. Linguistic analysis and a computerized analysis of referential activity were able to capture unconscious aspects of the traumatic experience.",0,0 +4391,Patterns in Blame Attributions in Maltreated Youth: Association with Psychopathology and Interpersonal Functioning,"This investigation explored patterns of blame attributions in 128 youth, primarily (87%) female, with maltreatment histories. Second, the study also evaluated the relative variance in posttraumatic stress disorder (PTSD) symptom severity, emotional distress, and interpersonal functioning outcomes, accounted for by age, abuse characteristics, and blame attribution patterns. Cluster analyses revealed distinctive blame profiles: high perpetrator blame, moderate perpetrator blame, high self-blame, high perpetrator/high self-blame, and low perpetrator/low self-blame. Regression analyses yielded significant models, accounting for 15% to 34% of the variance of outcomes. Most notably, youth endorsing a high perpetrator/high self-blame (i.e., compounded blame) attribution pattern reported poorer outcomes as compared to youth presenting with other blame profiles. Maltreatment type and age differences were not demonstrated across clusters. Implications and limitations are discussed.",0,0 +4392,Loss and grief: the role of individual differences,"It is an unfortunate but inevitable fact of life that virtually all of us must face: people we are close to die. Despite this universality, researchers and theorists have long assumed that bereavement almost always results in significant, and sometimes incapacitating, distress. Curiously, the absence of distress after loss has itself been considered pathological and a likely harbinger of future difficulties (Middleton et al., 1993). When bereaved persons fail to display the expected distress reaction, some have maintained that they are suppressing their grief (Middleton et al., 1993) or lack an attachment to their spouse (Fraley & Shaver, 1999). Indeed, emotional expression following loss – particularly negative emotions – has long been considered cathartic, a necessary ingredient of healthy adjustment (Freud, 1957). Perhaps for this reason, bereaved people who appear outwardly resilient and who resume their lives with minimal disruptions have often been thought to possess extraordinary coping abilities. However, this idea has increasingly come under fire (Bonanno, 2004). In fact, most bereaved people experience relatively transient disruptions in their ability to function effectively. Furthermore, research increasingly shows that there is a marked diversity in how people respond to loss. Indeed, it appears that three primary patterns or trajectories adequately describe most people’s response to interpersonal loss. The largest category, usually from 50% to 60%, is characterized by stable, healthy levels of psychological and physical functioning relatively soon after a loss, or “resilience” (Bonanno, 2004; Mancini & Bonanno, 2006). A second category of bereaved persons (20–25%) displays more acute and persistent levels of distress but gradually they too recover their bearings and return to their former level of functioning. The most problematic reaction is found among those with a persistent syndrome of a sometimes incapacitating distress that may take years to resolve. This pattern, often described as “complicated grief” (Bonanno et al., 2007), is relatively rare, typically occurring in 10–15% of grievers (Bonanno & Kaltman, 2001). Two other types of bereavement response have also emerged recently, although they typically characterize only a small proportion of grievers. These include a chronic form of distress that predated the loss and is exacerbated in its aftermath (Bonanno et al., 2002; Mancini et al., 2011) and dramatic improvement following loss (A.D. Mancini, I. Galatzer-Levy, & G.A. Bonanno, unpublished data). Although each is quite uncommon (5–10%), these patterns have been confirmed using different methods and samples, suggesting that they are veridical. © Cambridge University Press 2011.",0,0 +4393,Classifying developmental trajectories over time should be done with great caution: a comparison between methods,"In the analysis of data from longitudinal cohort studies, there is a growing interest in the analysis of developmental trajectories in subpopulations of the cohort under study. There are different advanced statistical methods available to analyze these trajectories, but in the epidemiologic literature, most of those are never used. The purpose of the present study is to compare five statistical methods to detect developmental trajectories in a longitudinal epidemiological data set.All five statistical methods (K-means clustering, a ""two-step"" approach with mixed modeling and K-means clustering, latent class analysis [LCA], latent class growth analysis [LCGA], and latent class growth mixture modeling [LCGMM]) were performed on a real-life data set and two manipulated data sets. The first manipulated data set contained four different linear developments over time, whereas the second contained two linear and two quadratic developments.For the real-life data set, all five classification methods revealed comparable trajectories. Regarding the manipulated data sets, LCGA performed best in detecting linear trajectories, whereas none of the methods performed well in detecting a combination of linear and quadratic trajectories. Furthermore, the optimal solution for LCA and LCGA contained more classes compared with LCGMM.Although LCGA and LCGMM seem to be preferable above the more simple methods, all classification methods should be applied with great caution.",0,0 +4394,Narrative Focus Predicts Symptom Change Trajectories in Group Treatment for Traumatized and Bereaved Adolescents,"Growing evidence supports the effectiveness of Trauma and Grief Component Therapy for Adolescents (TGCT-A) in reducing posttraumatic stress disorder (PTSD) symptoms and maladaptive grief (MG) reactions. This pilot study explored whether the specific focus of students' narratives (i.e., focus on trauma vs. focus on loss) as shared by TGCT-A group members would predict initial pretreatment levels, as well as pre- to posttreatment change trajectories, of PTSD symptoms and MG reactions. Thirty-three adolescents from three middle schools completed a 17-week course of group-based TGCT-A. PTSD and MG symptoms were assessed at pretreatment, twice during treatment, and at posttreatment. The focus (trauma vs. loss) of each student's narrative was coded using transcripts of members' narratives as shared within the groups. The reliable change index showed that 61% of students reported reliable pre-post improvement in either PTSD symptoms or MG reactions. Students whose narratives focused on loss both reported higher starting levels and showed steeper rates of decline in MG reactions than students whose narratives focused on trauma. In contrast, students whose narratives focused on trauma reported higher starting levels of PTSD than students who narrated loss experiences. However, narrative focus was not significantly linked to the rate at which PTSD symptoms declined over the course of treatment. This study provides preliminary evidence that TGCT-A treatment components are associated with reduced PTSD symptoms and MG reactions. Loss-focused narratives, in particular, appear to be associated with greater decreases in MG reactions.",0,0 +4395,The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care.,"A method for comparing death rates of groups of injured persons was developed, using hospital and medical examiner data for more than two thousand persons. The first step was determination of the extent to which injury severity as rated by the Abbreviated Injury Scale correlates with patient survival. Substantial correlation was demonstrated. Controlling for severity of the primary injury made it possible to measure the effect on mortality of additional injuries. Injuries that in themselves would not normally be life-threatening were shown to have a marked effect on mortality when they occurred in combination with other injuries. An Injury Severity Score was developed that correlates well with survival and provides a numerical description of the overall severity of injury for patients with multiple trauma. Results of this investigation indicate that the Injury Severity Score represents an important step in solving the problem of summarizing injury severity, especially in patients with multiple trauma.",0,0 +4396,Treatment of nonepileptic seizures,"Studies on nonepileptic seizures (NES) provide dichotomous data sets: extensive observational findings, but a paucity of controlled treatment data. Psychosocial stressors, whose full impact may lie outside a patient's awareness, often underlie NES. These stressors, along with patient's learned patterns of coping, may bring forth or potentiate comorbid psychiatric disorders. Patients with NES often have dysfunction in emotion regulation and family dynamics, as well as unemployment/disability. High percentages of comorbid disorders such as major depressive disorder, post-traumatic stress disorder, and cluster B personality with impulsivity (all disorders associated with serotonin system function) also exist in the NES population. The preliminary observational evidence suggests that specific psychotherapies and pharmacotherapy directed at comorbid conditions may be the most effective treatment for NES.",0,0 +4397,Posttraumatic stress disorder in DSM-5: Estimates of prevalence and symptom structure in a nonclinical sample of college students,"We empirically investigated recent proposed changes to the posttraumatic stress disorder (PTSD) diagnosis for DSM-5 using a non-clinical sample. A web survey was administered to 585 college students using the Stressful Life Events Screening Questionnaire to assess for trauma exposure but with additions for the proposed traumatic stressor changes in DSM-5 PTSD. For the 216 subjects endorsing previous trauma exposure and nominating a worst traumatic event, we administered the original PTSD Symptom Scale based on DSM-IV PTSD symptom criteria and an adapted version for DSM-5 symptoms, and the Center for Epidemiological Studies-Depression Scale. While 67% of participants endorsed at least one traumatic event based on DSM-IV PTSD's trauma classification, 59% of participants would meet DSM-5 PTSD's proposed trauma classification. Estimates of current PTSD prevalence were .4-1.8% points higher for the DSM-5 (vs. the DSM-IV) diagnostic algorithm. The DSM-5 symptom set fit the data very well based on confirmatory factor analysis, and neither symptom set's factors were more correlated with depression.",0,0 +4398,,"Research has suggested that organized violence and torture have long-term psychological effects that persist throughout the lifespan. The present survey aimed at examining the prevalence of posttraumatic stress disorder (PTSD), and other disorders and symptoms, all present in old age, as long-term consequences of politically motivated violence in a comparison design.A group of former political detainees (N = 59, mean age 73.5 years) who had been arrested by the Romanian communist regime were compared to an age- and gender-matched control group (N = 39). PTSD was assessed using a structured clinical interview (CIDI). The investigation of the clinical profile was further accomplished by self-rating measures for anxiety, depression, and health-related functioning, as well as by clinician-administrated interviews for substance abuse, dissociation, and somatization symptoms.Lifetime prevalence of PTSD was 54%. In the case of participants left untreated, PTSD persisted, often over four decades, such that current PTSD was diagnosed still in a third of the survivors. Other clinical conditions such as somatization, substance abuse, dissociative disorders, and major depression were also common among the former political detainees and often associated with current PTSD.Our findings suggest that political detention may have long-term psychological consequences that outlast the changes in the political system.",0,0 +4399,Neural correlates of observation of disgusting images in subjects with first episode psychosis and post-traumatic stress disorder.,"The aim of this study was to analyze neural responses to disgusting images in individuals with first episode psychosis and post-traumatic stress disorder (PTSD). Although anhedonia is a common symptom in both disorders we expected that they would be associated with different neurophysiological abnormalities and patterns of activation. We recruited three groups of participants: 13 individuals with first episode psychosis, 10 individuals with PTSD who had survived the April 2009 L’Aquila earthquake and 25 healthy controls matched for age and education. All individuals participated in a functional imaging experiment in which they watched six alternating blocks of disgusting and scrambled images whilst undergoing scanning with a General Electric 1.5T whole-body scanner. We estimated individuals'’ beta-weights, extracting 22 clusters corresponding to 22 significant areas. Findings were consistent with other neuroimaging studies; the active areas (i.e. amygdala, insula, inferior and medial frontal gyrus) have consistently been associated with emotional experiences. Statistical analysis revealed important group differences in intensity and direction (positive or negative) of signal from baseline during disgusting condition. Although these results are preliminary they show that functional neuroimaging techniques may make a valuable contribution to differential diagnosis of first episode psychosis and PTSD.",0,0 +4400,Post-traumatic stress disorder symptoms following a head injury: does amnesia for the event influence the development of symptoms?,"There is controversy as to whether PTSD can develop following a brain injury with a loss of consciousness. However, no studies have specifically examined the influence of the memories that the individuals may or may not have on the development of symptoms.To consider how amnesia for the traumatic event effects the development and profile of traumatic stress symptoms.Fifteen hundred case records from an Accident and Emergency Unit were screened to identify 371 individuals with traumatic brain injury who were sent questionnaires by post. The 53 subsequent valid responses yielded three groups: those with no memory (n = 14), untraumatic memories (n = 13) and traumatic memories (n = 26) of the index event. The IES-R was used as a screening measure followed by a structured interview (CAPS-DX) to determine caseness and provide details of symptom profile.Groups with no memories or traumatic memories of the index event reported higher levels of psychological distress than the group with untraumatic memories. Ratings of PTSD symptoms were less severe in the no memory groups compared to those with traumatic memories.Psychological distress was associated with having traumatic or no memories of an index event. Amnesia for the event did not protect against PTSD; however, it does appear to protect against the severity and presence of specific intrusive symptoms.",0,0 +4401,The needs of primary care mental health service users: a Q-sort study.,"Background Within scientific and policy literature, the broader needs and preferences of the service user are usually described as being relatively homogenous for any particular condition. Additionally, despite common adult mental health problems being a huge burden to primary care services, there has been little research into the client's perspective of their needs regarding such difficulties. The aim of this research was thus to uncover the issues and preferences for this sample.Method The attitudes of 28 service users were explored through use of a Q-methodology approach. This procedure involves statistical analysis of the order that participants rank pertinent statements associated with the area of study.Results Five independent factors (clusters of preferences) were identified. These differed over issues associated with: relationships with service providers, access/barriers associated with services, information provision, stigma, choices associated with therapy and the care pathway, medication and complementary approaches, as well as social support.Discussion The study suggests that differing individual needs exist within diagnostic categories which, unless considered, may impede service engagement. Issues associated with the implications for service delivery for these differing clusters of perceived needs and viewpoints are outlined.",0,0 +4402,The Role of Temperament in the Development of Post-Traumatic Stress Disorder Amongst Journalists,"The literature indicates that journalists, who have been exposed to traumatic situations, risk developing Post-traumatic Stress Disorder (PTSD). Certain temperament traits, such as neuroticism and compulsiveness, have been found to increase vulnerability to the development of PTSD amongst police officers. Few research studies have investigated temperament and a sense of coherence as factors mediating occupational stress in journalists exposed to trauma. The aim of this study was to address this dearth by investigating whether differences in the experience of trauma, temperament traits and a sense of coherence amongst journalists will influence the degree of PTSD experienced. The Impact of Event Scale-Revised was used to divide journalists into three groups, namely, those with minor reactions ( n=10), moderate reactions ( n=24) and severe reactions of clinical importance ( n=16). Analyses of variance followed by Scheffé post hoc multiple comparisons technique indicated statistically significant differences between the three groups regarding experience of trauma as measured by the Trauma Questionnaire, temperament traits as measured by the Zuckerman-Kuhlman Personality Questionnaire and sense of coherence as measured by the Sense of Coherence Questionnaire. The results show that various factors could have an impact on how journalists deal with the traumatic stories they cover, as well as their personal outcomes after covering these stories. Journalists who develop severe PTSD differ in terms of their perceptions of the trauma, temperament profiles and sense of coherence, which impacts on their way of coping with the traumatic situations they face daily.",0,0 +4403,Acquisition of Resistance to Butyrate Enhances Survival after Stress and Induces Malignancy of Human Colon Carcinoma Cells,"Abstract Acquired resistance to apoptosis by tumor cells remains a major obstacle for cancer treatment, and hence the analysis of resistance to apoptosis constitutes a major goal in the development of antitumoral drugs. We have established a butyrate-resistant human colon adenocarcinoma cell line (BCS-TC2.BR2) from nontumorigenic BCS-TC2 cells to analyze whether the acquisition of such phenotype confers resistance to apoptosis and stress. Although BCS-TC2.BR2 cells exhibited a more differentiated phenotype than the parental BCS-TC2 cells, higher butyrate concentrations remained capable of additionally enhancing their differentiation without inducing apoptosis. Survival rates of BCS-TC2.BR2 cells after glucose deprivation and heat shock were higher than those of parental cells, revealing a stress-resistant phenotype. These findings were accompanied by key differences between parental and butyrate-resistant cells in gene expression profiles and the acquisition of in vivo tumorigenicity. In conclusion, cells gaining resistance to an endogenous physiological modulator of growth, differentiation, and apoptosis concurrently acquired resistance to other agents that influence cell survival.",0,0 +4404,Sertraline: the first SSRI to be approved for the specific treatment of post-traumatic stress disorder,"Sertraline is the first selective serotonin re-uptake inhibitor (SSRI) to be approved for the treatment of patients with post-traumatic stress disorder (PTSD). Sertraline 50 to 200mg once daily for 12 weeks has shown efficacy in 2 of 3 double-blind, placebo-controlled trials conducted in US civilians. Overall response rates were 53 and 60% for patients receiving sertraline compared with 32 and 39% for patients receiving placebo in the 2 positive studies. A post hoc analysis of these studies indicated that sertraline was effective at alleviating PTSD symptoms in women but efficacy in men was not clearly established. Sertraline also failed to show significant effects compared with placebo in 2 clinical trials conducted in patients with predominantly combat-induced PTSD. Sertraline is generally well tolerated showing an adverse event profile similar to other SSRIs. Adverse events occuring with greater frequency than placebo in controlled trials were insomnia, nausea and diarrhoea.",0,0 +4405,Effect of the Interplay between Trauma Severity and Trait Neuroticism on Posttraumatic Stress Disorder Symptoms among Adolescents Exposed to a Pipeline Explosion,"While numerous studies have explored relevant factors of posttraumatic stress disorder (PTSD) symptoms, there have been few joint investigations of trauma severity and trait neuroticism on the development of PTSD symptoms. This study aims to assess the involvement and interrelationship of trauma severity and neuroticism in the expression of PTSD symptoms among adolescents exposed to an accidental explosion.Six hundred and sixty-two adolescents were recruited from a junior middle school closest to the 2013 pipeline explosion site in China and were assessed using the Explosion Exposure Questionnaire, the NEO Five Factor Inventory-Neuroticism Subscale (FFI-N), and the PTSD Checklist-Civilian (PCL-C). A battery of hierarchical multiple regression analyses and two-way ANOVAs were performed to examine the effect of trauma severity and trait neuroticism on adolescent PTSD symptoms.Eighty-seven adolescents (13.1%) showed PTSD symptoms after the pipeline explosion. Correlation analysis showed that all the factors of explosion exposure and trait neuroticism were positively associated with adolescent PTSD symptoms. Being male and younger was linked to lower risk for PTSD symptoms. The regression models identified explosion exposure and neuroticism as independent risk factors for PTSD symptoms, and the interactions between trait neuroticism and trauma exposure (personal casualty, degree of influence, total traumatic severity) were related to PTSD symptoms.The results highlight the role of trauma exposure and trait neuroticism as risk factors for PTSD symptoms. Therefore, the combination of these two factors should be investigated in clinical settings due to an augmented risk for more severe PTSD symptoms.",0,0 +4406,Positive psychology in rehabilitation medicine: A brief report,"The field of positive psychology has grown exponentially within the last decade. To date, however, there have been few empirical initiatives to clarify the constructs within positive psychology as they relate to rehabilitation medicine. Character strengths, and in particular resilience, following neurological trauma are clinically observable within rehabilitation settings, and greater knowledge of the way in which these factors relate to treatment variables may allow for enhanced treatment conceptualization and planning.The goal of this study was to explore the relationships between positive psychology constructs (character strengths, resilience, and positive mood) and rehabilitation-related variables (perceptions of functional ability post-injury and beliefs about treatment) within a baseline data set, a six-month follow-up data set, and longitudinally across time points.Pearson correlations and supplementary multiple regression analyses were conducted within and across these time points from a starting sample of thirty-nine individuals with acquired brain injury (ABI) in an outpatient rehabilitation program.Positive psychology constructs were related to rehabilitation-related variables within the baseline data set, within the follow-up data set, and longitudinally between baseline positive psychology variables and follow-up rehabilitation-related data.These preliminary findings support relationships between character strengths, resilience, and positive mood states with perceptions of functional ability and expectations of treatment, respectively, which are primary factors in treatment success and quality of life outcomes in rehabilitation medicine settings. The results suggest the need for more research in this area, with an ultimate goal of incorporating positive psychology constructs into rehabilitation conceptualization and treatment planning.",0,0 +4407,Minnesota Multiphasic Personality Inventory-2 Validity Patterns: An Elucidation of Gulf War Syndrome,"The potential effects of psychological distress on physical symptoms observed in Persian Gulf War veterans were evaluated in 48 veterans using neuropsychological evaluation that included personality assessment (the Minnesota Multiphasic Personality Inventory-2). Cluster analysis of the validity scales resulted in a solution with two viable subgroups. Members of cluster 1 had significantly higher scores on five Minnesota Multiphasic Personality Inventory-2 clinical scales, a measure of trait anxiety, and a number of subjective complaints, as well as lower scores on a task of attention. Neuropsychological functioning did not otherwise differ between the groups, Contributions of personality style in coping with physical and mental health stressors were indicated. Experience of distress appeared to be attributable to individual differences rather than factors that have been associated with the elusive Gulf War syndrome. Persian Gulf War veterans' emotional reactions to clinical laboratory findings, perceptions of exposure risks, war experience, and stress may represent a variation of post-traumatic stress disorder.",0,0 +4408,The role of sleep disturbance in the relationship between post-traumatic stress disorder and suicidal ideation,"• PTSD symptoms indirectly predicted suicidal ideation via comorbid sleep disturbances, but had no direct effect. • Polyvictimization predicted sleep disturbances and suicidal ideation independently of PTSD or major depression . • No relationships were substantively altered after adjusting for comorbid major depression. We tested if the risk of suicidal ideation in individuals with PTSD symptoms was dependent on comorbid sleep disturbance. Our cross-sectional sample included 2465 participants with complete data from the 21 year follow-up of the Mater University Study of Pregnancy (MUSP), a birth cohort study of young Australians. Using structural equation modelling with indirect pathways we found that 12 month PTSD symptoms did not directly predict suicidal ideation at 21 when adjusting for major depression symptoms, polyvictimization and gender. However, PTSD symptoms had an indirect effect on suicidal ideation via past-month sleep disturbance. Our results suggest that increased suicidal ideation in those with PTSD may result from the fact that PTSD sufferers often exhibit other comorbid psychiatric conditions which are themselves known to predict suicidal behaviours. Sleep disturbance may be targeted in those who experience PTSD to help prevent suicidal ideation.",0,0 +4409,Optimism and Death,"The course of depression in relation to myocardial infarction (MI), commonly known as heart attack, and the consequences for mortality are not well characterized. Further, optimism may predict both the effects of MI on depression as well as mortality secondary to MI. In the current study, we utilized a large population-based prospective sample of older adults ( N = 2,147) to identify heterogeneous trajectories of depression from 6 years prior to their first-reported MI to 4 years after. Findings indicated that individuals were at significantly increased risk for mortality when depression emerged after their first-reported MI, compared with resilient individuals who had no significant post-MI elevation in depression symptomatology. Individuals with chronic depression and those demonstrating pre-event depression followed by recovery after MI were not at increased risk. Further, optimism, measured before MI, prospectively differentiated all depressed individuals from participants who were resilient.",0,0 +4410,Type and Severity of Abuse and Posttraumatic Stress Disorder Symptoms Reported by Women Who Killed Abusive Partners,"This study investigated the type, severity, and frequency of Posttraumatic Stress Disorder (PTSD) symptoms experienced by battered women prior to killing male partners. Eighteen women were assessed for frequency and severity of lifetime PTSD symptoms and type of abuse endured. Correlations were performed between clusters of PTSD symptoms and composites of violent experiences. It was found that before killing male partners, these battered women suffered moderate to high levels of PTSD symptom frequency and severity, except for an inability to recall important aspects of the trauma. Significant canonical correlations were found between the frequency and severity of PTSD symptoms and the severity of types of abuses inflicted.",0,0 +4411,Neuropsychological Effects of Self-Reported Deployment-Related Mild TBI and Current PTSD in OIF/OEF Veterans,"Current combat veterans are exposed to many incidents that may result in mild traumatic brain injury (mTBI) and/or posttraumatic stress disorder (PTSD). While there is literature on the neuropsychological consequences of PTSD only (PTSD-o) and mTBI alone (mTBI-o), less has been done to explore their combined (mTBI+PTSD) effect. The goal of this study was to determine whether Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) veterans with mTBI+PTSD have poorer cognitive and psychological outcomes than veterans with PTSD-o, mTBI-o, or combat exposure-only. The final sample included 20 OIF/OEF veterans with histories of self-reported deployment mTBI (mTBI-o), 19 with current PTSD (PTSD-o), 21 with PTSD and self-reported mTBI (mTBI+PTSD), and 21 combat controls (CC) (no PTSD and no reported mTBI). Groups were formed using structured interviews for mTBI and PTSD. All participants underwent comprehensive neuropsychological testing, including neurocognitive and psychiatric feigning tests. Results of cognitive tests revealed significant differences in performance in the mTBI+PTSD and PTSD-o groups relative to mTBI-o and CC. Consistent with previous PTSD literature, significant differences were found on executive (switching) tasks, verbal fluency, and verbal memory. Effect sizes tended to be large in both groups with PTSD. Thus, PTSD seems to be an important variable affecting neuropsychological profiles in the post-deployment time period. Consistent with literature on civilian mTBI, the current study did not find evidence that combat-related mTBI in and of itself contributes to objective cognitive impairment in the late stage of injury.",0,0 +4412,MCMI Characteristics of DSM-III Posttraumatic Stress Disorder in Vietnam Veterans,Compared the MCMI profiles of 25 veterans with a diagnosis of Posttraumatic Stress Disorder (PTSD) with those of 25 veterans carrying psychiatric disorders which typically cause problems in the differential diagnosis of PTSD. The PTSD group had higher elevations on nine of the 20 MCMI scales (all ps less than .05). Profiles were also significantly different in shape and scatter. A discriminant analysis accounted for 100% of the variance and correctly classified 88% of the patients. Resulting MCMI profiles appear to be consistent with DSM-III criteria for PTSD.,0,0 +4413,The Enhancement of Natural Resilience in Trauma Interventions,"Resilience following trauma is the rule, not the exception. The minority of individuals who go on to suffer chronic pathology such as posttraumatic stress disorder (PTSD) will likely benefit from a number of evidence-based treatments. The study of resilience provides a new framework to examine and build upon these existing therapies. This article outlines an evidence-based theoretical model for understanding psychotherapy for PTSD through the lens of resilience. Specifically, we explore three broad factors thought to underlie resilience: social support, returning to daily routine, and meaning making. We review the literature regarding the impact of these factors on natural recovery after a trauma as well as treatment response. We connect these processes to interventions and techniques used in several empirically supported therapies, highlighting compatibility and synergy with therapeutic goals. With this review, we aim to map our existing knowledge about resilience onto theoretical models of treatment efficacy to broaden our conceptualization of treatment mechanisms and spur new ideas to improve clinical outcomes for those suffering due to trauma.",0,0 +4414,Cortisol augmentation of a psychological treatment for warfighters with posttraumatic stress disorder: Randomized trial showing improved treatment retention and outcome,"Prolonged exposure (PE) therapy for post-traumatic stress disorder (PTSD) in military veterans has established efficacy, but is ineffective for a substantial number of patients. PE is also associated with high dropout rates. We hypothesized that hydrocortisone augmentation would enhance symptom improvement and reduce drop-out rates by diminishing the distressing effects of traumatic memories retrieved during imaginal exposure. We also hypothesized that in responders, hydrocortisone augmentation would be more effective in reversing glucocorticoid indices associated with PTSD than placebo augmentation.Twenty-four veterans were randomized to receive either 30 mg oral hydrocortisone or placebo prior to PE sessions 3-10 in a double-blind protocol. Glucocorticoid receptor sensitivity was assessed in cultured peripheral blood mononuclear cells (PBMC) using the in vitro lysozyme inhibition test and was determined before and after treatment. Intent-to-treat analysis was performed using latent growth curve modeling of treatment effects on change in PTSD severity over time. Veterans who no longer met diagnostic criteria for PTSD at post-treatment were designated as responders.Veterans randomized to hydrocortisone or placebo augmentation did not differ significantly in clinical severity or glucocorticoid sensitivity at pre-treatment. Hydrocortisone augmentation was associated with greater reduction in total PTSD symptoms compared to placebo, a finding that was explained by significantly greater patient retention in the hydrocortisone augmentation condition. A significant treatment condition by responder status interaction for glucocorticoid sensitivity indicated that responders to hydrocortisone augmentation had the highest pre-treatment glucocorticoid sensitivity (lowest lysozyme IC50-DEX) that diminished over the course of treatment. There was a significant association between decline in glucocorticoid responsiveness and improvement in PTSD symptoms among hydrocortisone recipients.The results of this pilot study suggest that hydrocortisone augmentation of PE may result in greater retention in treatment and thereby promote PTSD symptom improvement. Further, the results suggest that particularly elevated glucocorticoid responsiveness at pre-treatment may identify veterans likely to respond to PE combined with an intervention that targets glucocorticoid sensitivity. Confirmation of these findings will suggest that pharmacologic interventions that target PTSD-associated glucocorticoid dysregulation may be particularly helpful in promoting a positive clinical response to PTSD psychotherapy.",0,0 +4415,Enhanced cortisol suppression following administration of low-dose dexamethasone in first-episode psychosis patients,"Impaired regulation of the hypothalamic-pituitary-adrenal (HPA) axis and hyper-activity of this system have been described in patients with psychosis. Conversely, some psychiatric disorders such as post-traumatic stress disorder (PTSD) are characterised by HPA hypo-activity, which could be related to prior exposure to trauma. This study examined the cortisol response to the administration of low-dose dexamethasone in first-episode psychosis (FEP) patients and its relationship to childhood trauma.The low-dose (0.25 mg) Dexamethasone Suppression Test (DST) was performed in 21 neuroleptic-naïve or minimally treated FEP patients and 20 healthy control participants. Childhood traumatic events were assessed in all participants using the Childhood Trauma Questionnaire (CTQ) and psychiatric symptoms were assessed in patients using standard rating scales.FEP patients reported significantly higher rates of childhood trauma compared to controls (p = 0.001) and exhibited lower basal (a.m.) cortisol (p = 0.04) and an increased rate of cortisol hyper-suppression following dexamethasone administration compared to controls (33% (7/21) vs 5% (1/20), respectively; p = 0.04). There were no significant group differences in mean cortisol decline or percent cortisol suppression following the 0.25 mg DST. This study shows for the first time that a subset of patients experiencing their first episode of psychosis display enhanced cortisol suppression.These findings suggest there may be distinct profiles of HPA axis dysfunction in psychosis which should be further explored.",0,0 +4416,Functional status after intensive care: A challenge for rehabilitation professionals to improve outcome,"To examine restrictions in daily functioning from a rehabilitation perspective in patients one year after discharge from the intensive care unit, and to identify prognostic factors for functional status.Cross-sectional design.Consecutive patients who were admitted to the intensive care unit for more than 48 h (n = 255).One year after intensive care, functional status (Sickness Impact Profile) as primary outcome, and Quality of Life (SF-36), anxiety and depression (Hospital Anxiety Depression Scale), and post-traumatic stress disorder (Impact of Events Scale) were evaluated.Fifty-four percent of the patients had restrictions in daily functioning. Walking and social activities were most frequently restricted (30-60% of the patients). Quality of life was lower than the general Dutch population. Symptoms of anxiety and depression were found in 14%, and post-traumatic stress disorder in 18%. Severity of illness at admission and length of stay in the intensive care unit were identified as prognostic factors, although they explained only 10% of functional status.The high prevalence of long-lasting restrictions in physical, social and psychological functioning among patients who stayed in the intensive care unit for at least 2 days implies that these patients are a potential target population for rehabilitation medicine. Multidisciplinary therapies need to be developed and evaluated in order to improve outcome.",0,0 +4417,The importance of the peritraumatic experience in defining traumatic stress.,"In the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev., DSM-IV-TR; American Psychiatric Association, 2000), posttraumatic stress disorder (PTSD) Criterion A2 stipulates that an individual must experience intense fear, helplessness, or horror during an event that threatened the life or physical integrity of oneself or others to be eligible for the PTSD diagnosis. In considering this criterion, we describe its origins, review studies that have examined its predictive validity, and reflect on the intended purpose of the criterion and how it complements the mission of the DSM. We then assert that the predictive validity of Criterion A2 may not be an appropriate metric for evaluating its worth. We also note that the current Criterion A2 may not fully capture all the salient aspects of the traumatic stress response. To support this claim, we review empirical research showing that individuals adapt to extreme environmental events by responding in a complex and coordinated manner. This complex response set involves an individual's appraisal regarding the degree to which the event taxes his or her resources, as well as a range of other cognitions (e.g., dissociation), felt emotions (e.g., fear), physiological reactions (e.g., heart rate increase), and behaviors (e.g., tonic immobility). We provide evidence that these response components may be associated with the subsequent development of PTSD. We then describe the challenges associated with accurately assessing an individual's traumatic stress response. We conclude with a discussion of the need to consider the individual's immediate response when defining a traumatic stressor.",0,0 +4418,The coherence and correlates of intermittent explosive disorder amongst West Papuan refugees displaced to Papua New Guinea,"Questions remain about the nosological status of intermittent explosive disorder (IED) as a universal diagnosis. Cross-cultural studies are needed to establish whether IED symptoms form a coherent pattern and are distinguishable from other related symptom constellations. A study amongst a refugee population also allows further inquiry of the relationship between exposure to potentially traumatic events (PTEs) and other adversities with the IED constellation. In the present study amongst West Papuan refugees residing in Port Moresby, Papua New Guinea, we apply culturally adapted interview modules to assess symptoms of IED, post-traumatic stress disorder (PTSD), and depression, as well as the potentially traumatic events (PTEs) of conflict and ongoing adversity in the post-migration environment. Latent class analysis yielded a PTSD class (23%), a posttraumatic depressive class (14%), an IED class (12%), and a low/no symptom class (49%). Compared to the low/no-symptom class, the PTSD class had high levels of exposure to all PTE domains including childhood-related adversities, witnessing murder, human rights trauma, and traumatic losses, as well as ongoing adversity relating to displacement and separation from families, safety concerns, and lack of access to basic needs and health care. The posttraumatic depression class had greater exposure to traumatic losses and childhood-related adversities, higher levels of stress relating to material loss and deprivation, as well as to displacement and separation from families. In contrast, the IED class was distinguished only by the ongoing stress of displacement and separation from families in the homeland. Our findings provide support for the phenomenological distinctiveness of IED symptoms in this transcultural setting. Although not exclusive to IED, conditions of long-term displacement and separation appear to be a source of ongoing anger and explosive aggression amongst this population.",0,0 +4419,Cortisol Response to Social Stress in Parentally Bereaved Youth,"Parental bereavement is associated with increased risk for psychiatric illness and functional impairment in youth. Dysregulated hypothalamic-pituitary-adrenal (HPA) axis functioning may be one pathway through which bereaved children experience increased risk for poor outcomes. However, few studies have prospectively examined the association between parental bereavement and cortisol response while accounting for psychiatric disorders in both youth and their caregivers.One-hundred and eighty-one bereaved and nonbereaved offspring and their caregivers were assessed at multiple time points over a 5-year period after parental death. Offspring participated in an adaptation of the Trier Social Stress Task (TSST), and salivary cortisol samples were collected before and after exposure to social stressors. Mixed models for repeated measures were used to analyze the effects of bereavement status, psychiatric disorder in both offspring and caregiver, and demographic indices on trajectories of cortisol response.After controlling for demographic variables and offspring depression, bereaved offspring demonstrated significantly different trajectories of cortisol response compared with nonbereaved offspring, characterized by higher total cortisol output and an absence of cortisol reactivity to acute social stress. Within the bereaved group, offspring of parents who died by sudden natural death demonstrated significant cortisol reactivity to social stress compared with offspring whose parents died by suicide, who demonstrated more blunted trajectory of cortisol response.Parentally bereaved youth demonstrate higher cortisol output than nonbereaved youth but are less able to mount an acute response in the face of social stressors.",0,0 +4420,A factor analysis of the DSM-III post-traumatic stress disorder criteria,"The authors factor analyzed DSM-III-based post-traumatic stress disorder symptom ratings made on 131 Vietnam-veteran PTSD patients. Five factors--termed Intrusive Thoughts and Their Effects, Increased Arousal, Impoverished Relationships, Guilt, and Cognitive Interference--emerged. The factor structure gave more support to Laufer, Brett and Gallops' conceptualization of PTSD than to the Horowitz, DSM-III, or DSM-III-R systems. It also generated suggestions for future editions of the diagnostic manual.",0,0 +4421,A memory-based model of posttraumatic stress disorder: Evaluating basic assumptions underlying the PTSD diagnosis.,"In the mnemonic model of posttraumatic stress disorder (PTSD), the current memory of a negative event, not the event itself, determines symptoms. The model is an alternative to the current event-based etiology of PTSD represented in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000). The model accounts for important and reliable findings that are often inconsistent with the current diagnostic view and that have been neglected by theoretical accounts of the disorder, including the following observations. The diagnosis needs objective information about the trauma and peritraumatic emotions but uses retrospective memory reports that can have substantial biases. Negative events and emotions that do not satisfy the current diagnostic criteria for a trauma can be followed by symptoms that would otherwise qualify for PTSD. Predisposing factors that affect the current memory have large effects on symptoms. The inability-to-recall-an-important-aspect-of-the-trauma symptom does not correlate with other symptoms. Loss or enhancement of the trauma memory affects PTSD symptoms in predictable ways. Special mechanisms that apply only to traumatic memories are not needed, increasing parsimony and the knowledge that can be applied to understanding PTSD.",0,0 +4422,Psychological Resilience after Hurricane Sandy: The Influence of Individual- and Community-Level Factors on Mental Health after a Large-Scale Natural Disaster,"Several individual-level factors are known to promote psychological resilience in the aftermath of disasters. Far less is known about the role of community-level factors in shaping postdisaster mental health. The purpose of this study was to explore the influence of both individual- and community-level factors on resilience after Hurricane Sandy. A representative sample of household residents (N = 418) from 293 New York City census tracts that were most heavily affected by the storm completed telephone interviews approximately 13–16 months postdisaster. Multilevel multivariable models explored the independent and interactive contributions of individual- and community-level factors to posttraumatic stress and depression symptoms. At the individual-level, having experienced or witnessed any lifetime traumatic event was significantly associated with higher depression and posttraumatic stress, whereas demographic characteristics (e.g., older age, non-Hispanic Black race) and more disaster-related stressors were significantly associated with higher posttraumatic stress only. At the community-level, living in an area with higher social capital was significantly associated with higher posttraumatic stress. Additionally, higher community economic development was associated with lower risk of depression only among participants who did not experience any disaster-related stressors. These results provide evidence that individual- and community-level resources and exposure operate in tandem to shape postdisaster resilience.",0,0 +4423,[Application of the Children's Impact of Event Scale (Chinese Version) on a rapid assessment of posttraumatic stress disorder among children from the Wenchuan earthquake area].,"To explore the reliability and validity of the Children's Impact of Event Scale (Chinese version, CRIES-13) and to determine the value and the optimal cutoff point of the score of CRIES-13 in screening posttraumatic stress disorder (PTSD), so as to provide evidence for PTSD prevention and identify children at risk in Wenchuan earthquake areas.A total of 253 children experienced the Wenchuan earthquake were tested through Stratified random cluster sampling. The authors examined CRIES-13's internal consistency, discriminative validity and predictive value of the cut-off. PTSD was assessed with the DSM-IV criteria. Area under the curve while sensitivity, specificity and Youden index were computed based on the receiver operating characteristic curve analysis. Optimal cutoff point was determined by the maximum of Youden index.20.9% of the subjects were found to have met the DSM-IV criteria for PTSD 7 months after the Wenchuan earthquake accident. The Cronbach's coefficient of CRIES-13 was 0.903 and the mean inter-item correlation coefficients ranged from 0.283 to 0.689, the correlation coefficient of the three factors with the total scale scores ranged from 0.836 to 0.868 while the correlation coefficient among the three factors ranged from 0.568 to 0.718, PTSD cases indicated much higher scores than non-PTSD cases, the Youden index reached maximum value when the total score approached 18 in CRIES-13 with sensitivity and specificity as 81.1% and 76.5% respectively. Consistency check showed that there were no significant differences between the results of CRIES-13 score >/= 32 and clinical diagnosis (Kappa = 0.529) from the screening program.CRIES-13 appeared to be a reliable and valid measure for assessing the posttraumatic stress symptoms among children after the earthquake accident in the Wenchuan area. The CRIES-13 seemed to be a useful self-rating diagnostic instrument for survivors with PTSD symptoms as a clinical concern by using a 18 cut-off in total score. Consistency check showed that there was no significant difference between the screening result of CRIES-13 score >/= 32 and clinical diagnosis.",0,0 +4424,Decreased N-acetyl-aspartate levels in anterior cingulate and hippocampus in subjects with post-traumatic stress disorder: a proton magnetic resonance spectroscopy study,"The purpose of this study was to investigate the concentration of N-acetyl-aspartate (NAA) in the brain and its relationship with clinical characteristics in patients with post-traumatic stress disorder (PTSD). Proton magnetic resonance spectroscopy was performed in order to measure NAA concentrations in the anterior cingulate cortex (ACC) and bilateral hippocampus in 26 subjects with fire-related PTSD, who were survivors of a subway fire in South Korea, and 25 age- and sex-matched healthy comparison subjects. There were decreased NAA levels in the ACC (t = -3.88, d.f. = 49, P < 0.001) and bilateral hippocampus (right, t = -3.88, d.f. = 49, P < 0.001; left, t = -3.62, d.f. = 49, P < 0.001) in the PTSD group relative to the healthy comparison group. Also, NAA levels of the ACC (r = -0.43, n = 26, P = 0.027) and bilateral hippocampus (right, r = -0.48, n = 26, P = 0.013; left, r = -0.40, n = 26, P = 0.04) were negatively correlated with re-experience symptom scores in subjects with PTSD. In conclusion, our findings suggest that subjects with PTSD had decreased neuronal viabilities in the ACC and bilateral hippocampus, and that these deficits may play an important role in the pathophysiology of PTSD, especially regarding the re-experiencing of traumatic events.",0,0 +4425,Management of post traumatic stress disorder after childbirth: a review,"Prevalence and risk factors for the development of post traumatic stress disorder (PTSD) after childbirth is well described in the literature. However, its management and treatment has only begun to be investigated. The aim of this article is to describe the studies that examine the effects of interventions on PTSD after childbirth. MedLine, PILOTS, CINAHL and ISI Web of Science databases were systematically searched for randomised controlled trials, pilot studies and case studies using key words related to PTSD, childbirth, treatment and intervention. The reference lists of the retrieved articles were also used to supplement the search. A total of nine studies were retrieved. Seven studies that examined debriefing or counselling were identified; six randomised controlled trials and one pilot study. Also found were one case report describing the effects of cognitive behavioural therapy (CBT) on two women, and one pilot study of eye movement desensitisation and reprocessing (EMDR). Overall, there is limited evidence concerning the management of women with PTSD after childbirth. The results agree with the findings from the non-childbirth related literature: debriefing and counselling are inconclusively effective while CBT and EMDR may improve PTSD status but require investigation in controlled trials before conclusions could be drawn.",0,0 +4426,FACTORS ASSOCIATED WITH POSTTRAUMATIC STRESS DISORDER FOLLOWING MODERATE TO SEVERE TRAUMATIC BRAIN INJURY: A PROSPECTIVE STUDY,"This study prospectively examined the relationship between preinjury, injury-related, and postinjury factors and posttraumatic stress disorder (PTSD) following moderate to severe traumatic brain injury (TBI).Two hundred and three participants were recruited during inpatient admission following moderate to severe TBI. Participants completed an initial assessment soon after injury and were reassessed at 3, 6, and 12 months, 2, 3, 4, and 5 years postinjury. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-fourth edition was used to diagnose pre- and postinjury PTSD and other psychiatric disorders. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Inventory (QOLI) were used to evaluate functional and psychosocial outcome from 6 months postinjury.The frequency of PTSD ranged between 0.5 and 9.4% during the 5-year period, increasing throughout the first 12 months and declining thereafter. After controlling for other predictors, shorter posttraumatic amnesia duration (odds ratio = 0.96, 95% CI = 0.92-1.00), other concurrent psychiatric disorder (odds ratio = 14.22, 95% CI = 2.68-75.38), and lower GOSE (odds ratio = 0.38, 95% CI = 0.20-0.72) and QOLI scores (odds ratio = 0.97, 95% CI = 0.95-0.97) were associated with greater odds of having injury-related PTSD.The results of this study indicate that while shorter posttraumatic amnesia duration is associated with PTSD, greater TBI severity does not prevent PTSD from evolving. Patients with PTSD experienced high rates of psychiatric comorbidity and poorer functional and quality of life outcomes after TBI.There is a need to direct clinical attention to early identification and treatment of PTSD following TBI to improve outcomes.",0,0 +4427,Elevation of Urinary Norepinephrine/Cortisol Ratio in Posttraumatic Stress Disorder,"We have previously reported the unusual combination of low urinary free cortisol levels with high urinary norepinephrine excretion in posttraumatic stress disorder (PTSD) patients in comparison with four other patient groups: major depressive disorder, endogenous type; bipolar I, manic; paranoid schizophrenia; undifferentiated schizophrenia. Cortisol levels alone did not distinguish PTSD from paranoid schizophrenia patients and norepinephrine levels alone did not distinguish PTSD from bipolar I, manic, patients. In further consideration of these findings, we have found that combining the values for the two systems in a norepinephrine/cortisol (N/C) ratio provides a measure that significantly distinguishes PTSD from all the other patient groups throughout the hospitalization period. The N/C ratio was more than twice as high in the PTSD group than in all the other patient groups in the first sample following hospital admission, in the mean sample during hospitalization, and in the last sample before discharge. The mean N/C ratio for the PTSD group was 2.54, compared with a mean of .99 for the other four groups, which ranged from .81 to 1.18. The diagnostic sensitivity was 78% and the specificity was 94% for correct classification of PTSD in our sample. These preliminary findings yield further encouragement for exploring multivariate strategies, using hormonal ratios or profiles, in an effort to increase the diagnostic sensitivity of neuroendocrine criteria in the assessment of psychiatric patients.",0,0 +4428,Psychosocial adaptation to spinal cord injury as a function of time since injury,"The literature on the relationship between time since injury (TSI) and the clinical unfolding of psychosocial adaptation to disability has yielded mixed results. In this exploratory study we have attempted to compare two groups of people who sustained spinal cord injury (SCI)--namely, short-term TSI versus long-term TSI--on the patterns of psychosocial reactions to their medical condition. Using the initial pool of participants (n=317), two ""extreme'"" TSI groups were created (short-term TSI, composed of people whose injuries occurred within the last 4 years, and long-term TSI, comprising people whose injuries occurred 20 or more years ago). A two-group discriminant function analysis (DFA) applied to the eight subscales of the Reactions to Impairment and Disability Inventory (RIDI) yielded a significant function that was most closely associated with reactions of denial, shock and generalized anger, suggesting a non-acceptance of the condition among the more recently injured. Further analyses were then separately applied to the two groups of civilians and veterans with SCI. The resultant DFAs yielded functions suggesting somewhat different group patterns from the original one. Results are discussed within the context of the literature drawn from the fields of post-traumatic stress disorder (PTSD) and related traumatic experiences.",0,0 +4429,"Potentially Modifiable Pre-, Peri-, and Postdeployment Characteristics Associated With Deployment-Related Posttraumatic Stress Disorder Among Ohio Army National Guard Soldiers","To evaluate potentially modifiable deployment characteristics-- predeployment preparedness, unit support during deployment, and postdeployment support-that may be associated with deployment-related posttraumatic stress disorder (PTSD).We recruited a sample of 2616 Ohio Army National Guard (OHARNG) soldiers and conducted structured interviews to assess traumatic event exposure and PTSD related to the soldiers' most recent deployment, consistent with DSM-IV criteria. We assessed preparedness, unit support, and postdeployment support by using multimeasure scales adapted from the Deployment Risk and Resilience Survey.The prevalence of deployment-related PTSD was 9.6%. In adjusted logistic models, high levels of all three deployment characteristics (compared with low) were independently associated with lower odds of PTSD. When we evaluated the influence of combinations of deployment characteristics on the development of PTSD, we found that postdeployment support was an essential factor in the prevention of PTSD.Results show that factors throughout the life course of deployment-in particular, postdeployment support-may influence the development of PTSD. These results suggest that the development of suitable postdeployment support opportunities may be centrally important in mitigating the psychological consequences of war.",0,0 +4430,Mental health correlates of victimization classes among homeless youth,"Literature reports high rates of street victimization among homeless youth and recognizes psychiatric symptoms associated with such victimization. Few studies have investigated the existence of victimization classes that differ in type and frequency of victimization and how youth in such classes differ in psychiatric profiles. We used latent class analysis (LCA) to examine whether classes of homeless youth, based on both type and frequency of victimization experiences, differ in rates of meeting diagnostic criteria for major depressive episodes and posttraumatic stress disorder (PTSD) in a sample of homeless youth (N=601) from three regions of the United States. Results suggest youth who experience high levels of direct and indirect victimization (high-victimization class) share similarly high rates of depressive episodes and PTSD as youth who experience primarily indirect victimization only (witness class). Rates of meeting criteria for depressive episodes and PTSD were nearly two and three times greater, respectively, among the high victimization and witness classes compared to youth who never or rarely experienced victimization. Findings suggest the need for screening and intervention for homeless youth who report direct and indirect victimization and youth who report indirect victimization only, while prevention efforts may be more relevant for youth who report limited victimization experience.",0,0 +4431,Dissociative Depression Among Women with Fibromyalgia or Rheumatoid Arthritis,"The aim of this study was to inquire about the possible relations of childhood trauma, anger, and dissociation to depression among women with fibromyalgia or rheumatoid arthritis. Fifty female patients diagnosed as having fibromyalgia (n = 30) or rheumatoid arthritis (n = 20) participated in the study. The Childhood Trauma Questionnaire, Somatoform Dissociation Questionnaire (SDQ), Dissociation Questionnaire (DIS-Q), Beck Depression Inventory (BDI), Spielberger State-Trait Anger Expression Inventory, and Dissociative Disorders Interview Schedule were administered to all participants. Women with a lifetime diagnosis of depressive disorder had higher scores for somatoform and psychoform dissociation than the nondepressive patients. However, childhood trauma scores did not differ between the 2 groups. In regression analysis, current severity of depression (BDI) was predicted by psychoform dissociation (DIS-Q) and lower education, and lifetime diagnosis of major depression was predicted by somatoform dissociation (SDQ). Whereas childhood emotional neglect predicted somatoform dissociation, psychoform dissociation was predicted by childhood sexual abuse. Mental processing of anger seems to be 1 of the dimensions of psychodynamics in trauma-related depressive conditions. In the context of the perceived threat of loss of control due to expressed anger and mental disintegration, somatoform dissociation seems to contribute to overmodulation of emotions in dissociative depression. Among patients suffering from physical illness with possible psychosomatic dimensions, assessment of somatoform dissociation in addition to psychoform dissociation may be helpful to understand diverse psychopathological trajectories emerging in the aftermath of childhood adversities. The recently proposed category of ""dissociative depression"" (Sar, 2011) seems to be a promising concept for future research on psychosomatic aspects of traumatic stress.",0,0 +4432,"Trauma and women: course, predictors, and treatment.","Posttraumatic stress disorder (PTSD) resulting from aggravated assault, rape, or noncrime trauma affects over 4 million women in the United States, according to retrospective studies. Prospective studies reviewed here found that 3 months post assault the prevalence of PTSD was 48% in rape victims and 25% in nonsexual crime victims. Prolonged exposure treatment and stress inoculation training are both effective psychotherapeutic treatments for PTSD. Prolonged exposure involves having the patient relive the traumatic memory and recount the event in detail. This description is audiotaped and the patient is asked to listen to it as part of assigned homework. In vivo exposure to feared objects or situations is also assigned as homework. Stress inoculation training consists of teaching patients a variety of techniques for managing anxiety, including controlled breathing, deep muscle relaxation, thought-stopping, cognitive restructuring, preparation for stressors, covert modeling, and role-play. Both treatments have been proven to be effective alone and in combination in ameliorating chronic PTSD in women after traumatic sexual or nonsexual assault. This efficacy was maintained for 3 months of follow-up.",0,0 +4433,"The structure of acute posttraumatic stress symptoms: ‘Reexperiencing’, ‘Active avoidance’, ‘Dysphoria’, and ‘Hyperarousal’","Empirical data have challenged chronic posttraumatic stress disorder (PTSD) consisting of three dimensions. In the present study we aimed to determine the factor structure of acute posttraumatic symptoms in two recently traumatized samples. In sample 1, 203 civilian trauma survivors were administered the Davidson Trauma Scale (DTS) approximately 1 week posttrauma. In sample 2, 182 civilian treatment seeking trauma survivors completed the DTS at an average of 41.4 days posttrauma. Our confirmatory factor analyses indicated that a 4-factor intercorrelated model provided the best representation of the data in both samples. The four factors are best described as reexperiencing, active avoidance, dysphoria , and hyperarousal. For acute posttraumatic symptoms, the empirical data suggest to split the avoidance cluster into ‘Active avoidance’ and ‘Dysphoria’—confirming findings in studies on chronic PTSD. In future revisions of the DSM, the diagnostic criteria for PTSD may need to be adapted to fit the research findings.",0,0 +4434,"Reactions of Oklahoma City bombing survivors to media coverage of the September 11, 2001, attacks","This study explored the effects of media coverage of a terrorist incident in individuals remote from the location of a major attack who had directly experienced a prior terrorist incident.Directly-exposed survivors of the 1995 Oklahoma City bombing, initially studied six months after the incident, and indirectly-affected Oklahoma City community residents were assessed two to seven months after the September 11, 2001, attacks. Survivors were assessed for a diagnosis of bombing-related posttraumatic stress disorder (PTSD) at index and follow up, and emotional reactions and September 11 media behavior were assessed in all participants.Among the three investigated forms of media (television, radio, and newspaper), only television viewing was associated with 9/11-related posttraumatic stress reactions. Exposure to the Oklahoma City bombing was associated with greater arousal in relation to the September 11 attacks, and among survivors, having developed bombing-related PTSD was associated with higher scores on all three September 11 posttraumatic stress response clusters (intrusion, avoidance, and arousal). Although time spent watching television coverage of the September 11 attacks and fear-related discontinuation of media contact were not associated with Oklahoma City bombing exposure, discontinuing September 11 media contact due to fear was associated with avoidance/numbing in the full sample and in the analysis restricted to the bombing survivors.Surviving a prior terrorist incident and developing PTSD in relation to that incident may predispose individuals to adverse reactions to media coverage of a future terrorist attack.",0,0 +4435,Code Triage: Integrating the National Children's Disaster Mental Health Concept of Operations Across Health Care Systems,"This article describes the National Children's Disaster Mental Health Concept of Operations (“CONOPS”) model as a method to address discrepancies between research advances that have been made and the typical methods of providing mental health services to children after disasters. Three key CONOPS strategies are described: (1) the PsySTART Disaster Mental Health Triage System, (2) a child-focused Incident Action Plan (IAP), and (3) a continuum of risk stepped-care model that matches the level of evidence-based treatment interventions with the level of identified risk using a stepped-care framework. Together, these strategies provide an integrated “disaster systems of care” method for the needs of children. With the goal to strengthen the resilience of children, the CONOPS provides clear operational strategies to facilitate mental health care addressing the full continuum of risk and resilience in the child population. Adapting this tool to health care systems i s a vital step to improving mental health services and resilience outcomes for children after a disaster.",0,0 +4436,"Attachment typologies and posttraumatic stress disorder (PTSD), depression and anxiety: a latent profile analysis approach","Bartholomew (1990) proposed a four category adult attachment model based on Bowlby's (1973) proposal that attachment is underpinned by an individual's view of the self and others. Previous cluster analytic techniques have identified four and two attachment styles based on the Revised Adult Attachment Scale (RAAS). In addition, attachment styles have been proposed to meditate the association between stressful life events and subsequent psychiatric status.The current study aimed to empirically test the attachment typology proposed by Collins and Read (1990). Specifically, LPA was used to determine if the proposed four styles can be derived from scores on the dimensions of closeness/dependency and anxiety. In addition, we aimed to test if the resultant attachment styles predicted the severity of psychopathology in response to a whiplash trauma.A large sample of Danish trauma victims (N=1577) participated. A Latent Profile Analysis was conducted, using Mplus 5.1, on scores from the RAAS scale to ascertain if there were underlying homogeneous attachment classes/subgroups. Class membership was used in a series of one-way ANOVA tests to determine if classes were significantly different in terms of mean scores on measures of psychopathology.The three class solution was considered optimal. Class one was termed Fearful (18.6%), Class two Preoccupied (34.5%), and Class three Secure (46.9%). The secure class evidenced significantly lower mean scores on PTSD, depression, and anxiety measures compared to other classes, whereas the fearful class evidenced significantly higher mean scores compared to other classes.The results demonstrated evidence of three discrete classes of attachment styles, which were labelled secure, preoccupied, and fearful. This is in contrast to previous cluster analytic techniques which have identified four and two attachment styles based on the RAAS.In addition, Securely attached individuals display lower levels of psychopathology post whiplash trauma.",0,0 +4437,Is multi-impulsive bulimia a distinct type of bulimia nervosa: Psychopathology and EMA findings,"To determine if clinically defined multi-impulsive bulimia (MIB) can be validated using an empirical classification approach.One hundred and twenty-five women who met DSM-IV criteria for bulimia nervosa were interviewed and completed a two-week EMA protocol. Participants who reported at least three highly impulsive behaviors were compared to participants who did not report such impulsive behavior. Also, Latent Class Analysis (LCA) was conducted to determine if the MIB classification could be replicated empirically.LCA produced a two-class solution consistent with the traditional clinical approach to MIB classification. In both approaches, MIB was associated with higher levels of anxiety disorders, child abuse, and daily self-damaging behaviors than the non-MIB class.Clinical classification of MIB was empirically supported through LCA. Although the classes failed to differ in bulimic behavior, MIB appears to represent a group of bulimic individuals with significant trauma histories and associated psychopathology.",0,0 +4438,POSTTRAUMATIC STRESS DISORDER SYMPTOMS AND THEIR COMORBIDITY WITH OTHER DISORDERS IN ELEVEN TO SIXTEEN YEARS OLD ADOLESCENTS IN THE CITY OF BAM,"Objectives: The aim of this study was to assess the symptoms of Posttraumatic Stress Disorder (PTSD) and the comorbidity of depression, anxiety, anger and dissociation with PTSD based on gender difference between two groups of earthquake-stricken boys and girls in the city of Bam and comparing it with normal adolescents in Tehran. Method: One thousand 11-16 year old students (300 boys and 700 girls) in the city of Bam selected using multi-step cluster sampling in two educational levels as the experimental group, and 3042 eleven to sixteen year old students from Tehran as the control group were examined. Data were gathered using Syndrome Checklist for Children (form A) and Interview form of Post Trauma Stress Scale (interview form). Data were then analyzed using correlation, independent t, chi-square (2), and Kruskal Wallis. Results: Adolescents who had experienced the traumatic events showed higher levels of depression, anxiety, posttraumatic stress, anger and dissociation in comparison with normal adolescents (p < 0.01). In the group with PTSD, frequency of all PTSD symptoms except anger symptoms was higher in girls than in boys. However, the frequency of pathological syndromes (T > 65) was more evident in boys than in girls, but was non-significant. The prevalence of PTSD in the experimental group was 20%. Conclusion: There is a high comorbidity between symptoms of PTSD and other symptoms, which leads to a higher report of PTSD prevalence. Even though psychological vulnerability was higher in boys than in girls, it seems that gender role expectance in the expression of emotions and the method of describing the symptoms play a role in this issue. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0,0 +4439,[Intensification of post-traumatic stress disorder of Siberian deportees from the North-East region of Poland].,"AIM Presentation of Post-Traumatic Stress Disorder based on the approach of various authors concentrating, upon the concept of the American classification: DSM III (1980) and DSM IV (1994). We acknowledged the necessity of displaying empirical results of intensification of PTSD among the population in the region of North-East part of Poland. METHOD In our analysis, we stressed the importance of the distant in time, psychological consequences of dwelling in extremely difficult living conditions that often threatened the life of those who had been deported to Siberia between 1939 and 1956. 40 Siberian deportees (20 men and 20 women) were examined. The method of PTSD-Interview (PTSD-I) was used here in order to obtain, in each individual case, the indicatory number indispensable for the statistical analysis. RESULTS AND CONCLUSION An average result of PTSD intensification in the case of women reaches a very level and in the case of men it is even higher. The disparity between the average results of women and of men are statistically significant (p<0.05). This research has confirmed the assumptions that suffering from trauma in the early stage of development (within the age range of 8-15) leaves a permanent mark in the human psyche. Statistical analysis revealed a high level of intensification of PTSD among the population of the Siberian deportees from the North-East region of Poland.",0,0 +4440,Commonality and Specificity of Personality Disorder Profiles in Subjects with Trauma Histories,"Recently, attention has been drawn to a range of disturbances in personality functioning that commonly characterize individuals with a history of severe or prolonged trauma. Many of these features overlap with criteria for some of the Axis II personality disorders. The current study investigated the similarity of personality disorder features in different samples of patients with trauma histories, and specificity of such features compared to other psychiatric samples. Profiles of Axis II features, based on relative frequencies of individual disorder “diagnoses” derived from a common measure (Personality Diagnostic Questionnaire-Revised), were compared in three trauma samples: male Vietnam combat veterans with PTSD, female inpatients with a history of childhood sexual abuse, and female outpatients with a history of childhood sexual abuse. The PDQ-R derived profiles in each of the three trauma samples were then compared with similar PDQ-R derived profiles in published reports of psychiatric samples selected for other diagnoses. Each of the three Spearman rank correlations among the three trauma samples were significant, ranging from .72 to .94. There was a clear pattern of higher correlations within the trauma samples (average correlation of .81) than between the trauma and nontrauma samples (average correlations of. 11, .36, and .25 between the nontrauma samples and the combat sample, inpatient sexual abuse sample, and outpatient sexual abuse sample, respectively). The findings suggest that a pattern of personality disorder features may be distinctly associated with individuals with trauma histories, at least of the type examined here. Future studies using more clinically valid measures of personality features and including other types of trauma samples are needed to determine the generalizability of the current findings.",0,0 +4441,Psychosocial Effects of War Experiences Among Displaced Children in Southern Darfur,"This study focused on assessing the psychosocial effects of the long standing, high intensity, and guerrilla-style of warfare among displaced children in Southern Darfur. The goal was to better understand the etiology, prognosis, and treatment implications for traumatic reactions, depression, and grief symptoms in this population. Three hundred thirty-one children aged 6-17 from three IDP Camps were selected using a quota sampling approach and were administered a Demographic Questionnaire, Child Post Traumatic Stress Reaction Index, Child Depression Inventory, and the Expanded Grief Inventory. Forty-three percent were girls and 57% were boys. The mean age of the children was 12 years. Results found that children were exposed to a very large Dumber of war experiences with no significant differences between genders for types of exposure, including rape, but with older children (13-17 years) facing a larger number of exposures than younger children (6-12 years). Out of the 16 possible war experiences, the mean number was 8.94 (SD = 3.27). Seventy-five percent of the children met the DSM-IV criteria for PTSD, and 38% exhibited clinical symptoms of depression. The percentage of children endorsing significant levels of grief symptoms was 20%. Increased exposure to war experiences led to higher levels of: 1) traumatic reactions; 2) depression; and 3) grief symptoms. Of the 16 war experiences, abduction, hiding to protect oneself, being raped, and being forced to kill or hurt family members were most predictive of traumatic reactions. Being raped, seeing others raped, the death of a parent/s, being forced to fight, and having to hide to protect oneself were the strongest predictors of depressive symptoms. War experiences such as abduction, death of one's parent/s, being forced to fight, and having to hide to protect oneself were the most associated with the child's experience of grief. In addition to Total Grief, Traumatic Grief, Existential Grief, and Continuing Bonds were measured in these children, Although trauma, depression, and grief often exist as co-morbid disorders, the mechanisms and pathways of these is less understood. In this study we used Structural Equation Modeling to better understand the complex interaction and trajectories of these three symptoms evolving from war exposure and loss. This study is the first of its kind to assess the psychosocial effects of war experiences among children currently living in war zone areas within Sudan. It identifies some of the most prevalent war-related atrocities and their varying impact on the children's psychological well-being and overall adjustment. Implications for planning mental health interventions are discussed. (",0,0 +4442,Neuroendocrine response to CRF stimulation in veterans with and without PTSD in consideration of war zone era,"Alterations in hypothalamic–pituitary–adrenal (HPA) axis activity have been observed in Gulf War veterans with posttraumatic stress disorder (PTSD) which differ from those observed in other veteran groups, raising the possibility that there is a unique neuroendocrine profile in this group of veterans. This study seeks to further characterize the effects of PTSD, military cohort (Vietnam, 1991 Gulf War, Operations Enduring Freedom/Iraqi Freedom (OEF/OIF)), and their interaction on the neuroendocrine response to synthetic corticotrophin-releasing factor (CRF) stimulation. 51 male veterans were studied consisting of 21 from the Vietnam era, 16 from the Gulf War era, and 14 from the OEF/OIF era. 16 of these veterans were deployed to a war zone and had chronic PTSD (PTSD+), 25 were deployed to a war zone and did not have chronic PTSD (PTSD−), and 10 were not deployed to a war zone and did not have PTSD (non-exposed). The participants underwent the CRF stimulation test in the afternoon (approximately 2:00 p.m.), which measures the integrity and sensitivity of the pituitary–adrenal axis. Plasma cortisol and adrenocorticotropic hormone (ACTH) were measured at baseline and at intervals over a 2 h period following intravenous administration of 1 μg/kg of ovine CRF (o-CRF, max 100 μg). In a small subset of participants, dehydroepiandrosterone (DHEA) and cortisol binding globulin (CBG) were also assessed. There was a significant group by era interaction in the response of ACTH to CRF, in addition to a main effect of group (PTSD+, PTSD−, non-exposed). The interaction reflected that group differences were only evident in the Gulf War cohort; among Gulf War era veterans, the PTSD+ group had higher elevations in ACTH levels following CRF than the PTSD− group and the non-exposed group. Additionally, the peak change in ACTH was associated with a self-reported environmental exposure (pyridostigmine bromide ingestion) which has been found to be linked to the excess morbidity found in Gulf War veterans. Self-reported childhood trauma was greater in veterans of the Gulf War than Vietnam or OEF/OIF, but did not account for the observed differences. There was a significant effect of group on the cortisol response to CRF, reflecting greater responsivity in both of the deployed groups (PTSD+ and PTSD−) compared to the non-exposed group which could be accounted for by baseline differences in cortisol levels; unlike the ACTH response, the cortisol response did not differ by era. There were no effects of group, era, or their interaction on the DHEA and CBG response to CRF. A uniform pattern of PTSD-related alterations in the response to intravenous CRF was not found. Rather, PTSD-related alterations were found only in veterans of the 1991 Gulf War, and were characterized by an enhanced pituitary response to CRF which may reflect increased sensitivity of pituitary corticotrophs or CRF hyposecretion. Together with previous neuroendocrine findings, the data suggest the HPA axis is dysregulated in Gulf War veterans in unique ways which may reflect the long-term effects of environmental exposures in addition to disease effects. Further work is needed to characterize these effects and their impact on long-term psychological and medical outcomes.",0,0 +4443,The perceptions and experiences of people injured in motor vehicle crashes in a compensation scheme setting: a qualitative study,"The evidence that compensation related factors are associated with poor recovery is substantial but these measures are generic and do not consider the complexity of scheme design. The objectives of this study were to understand people's perceptions and experiences of the claims process after sustaining a compensable injury in a motor vehicle crash (including why people seek legal representation); and to explore ways to assist people following a compensable injury and improve their experience with the claims process.A qualitative study in a Compulsory Third Party (CTP) personal injury scheme covering the state of New South Wales (NSW), Australia. A series of five focus groups, with a total of 32 participants who had sustained mild to moderate injuries in a motor vehicle crash, were conducted from May to June 2011 with four to eight attendees in each group. These were audio-recorded and transcribed. The methodology was based on a grounded theory approach using thematic analysis and constant comparison to generate coding categories for themes. Data saturation was reached. Analyst triangulation was used to ensure credibility of the results.Five primary themes were identified: complexity of the claims process; requirement of legal representation; injury recovery expectations; importance of timely healthcare decision making; and improvements for injury recovery. Some participants struggled, finding the claims process stressful and subsequently sought legal advice; whilst others reported a straight forward recovery, helpful insurer interactions and no legal representation. Most participants were influenced by injury recovery expectations, and timely healthcare decision making. To assist with injury recovery, access to objective information about the claims process using online technology and social media was considered paramount.Participants had contrasting injury recovery experiences and their perceptions of the claims process differed and were influenced by injury recovery expectations, and timeliness of healthcare decision making. Improvements to the claims process are required, including: simplification or streamlining (possibly using online technology and/or social media to reduce paperwork); and providing access to objective information. There is a need to trial early interventions and new claims management policies that could improve injury recovery and satisfaction with the claims process.",0,0 +4444,"Coping and Personality as Predictors of Post-Traumatic Intrusions, Numbing, Avoidance and General Distress: A Study of Victims of the Perth Flood","Trauma symptoms, coping and personality were assessed in 44 victims of the Perth flood. The sample was characterized by high levels of intrusions, numbness, arousal and general emotional distress. General levels of symptomatology were predicted by two coping strategies: emotion-focused coping and thought suppression. Overall trauma symptoms and emotion-focused coping were associated with the personality trait of neuroticism. These data are consistent with the Wells and Matthews (1994a) model of affective disorders and stress. The model proposes that certain types of emotion-focused coping tend to lead to greater access to negative self-beliefs, and that thought suppression tends to prime subsequent intruding thoughts. A second personality trait, private self-consciousness, was associated with relatively greater levels of numbing symptoms, and relatively lower levels of arousal symptoms. This patterning of symptoms may result from use of ruminative coping strategies. Hence, intrusions of trauma-related material are not simply a function of automatic activation of a fear network, but are also influenced by the person's voluntary efforts to deal with the aftermath of the event.",0,0 +4445,Can We Influence the Trajectory of Psychological Consequences to Terrorism?,"This article makes two significant contributions to the field of disaster and emergency mental health. First, it contributes to the existing knowledge regarding response to, and recovery from, events involving large-scale trauma. It does so by confirming previous findings as well as adding new information. Second, the findings of the study raise both puzzling and intriguing challenges to the profession and the country as we struggle to expand our knowledge and come to grips with the “new normal” faced by the United States. In a field where research is not nearly as extensive and complete as it needs to be and where we are far too dependent on extrapolation from other types of traumatic events, any and all research directly on disasters and terrorism is welcome. Longitudinal studies, even with rather short periods between samples, are especially needed. This study contributes by replication earlier findings regarding such factors as exposure, the impact of status factors such as gender, and the importance of social support. Other findings are tantalizing in both what they tell us and what they do not. We learn for example that a significant number of people turn to alcohol, medications, or drugs to feel better. What we cannot know from the study is the extent to which this coping strategy is nonproblematic use or abuse. To what extent is the drug use licit or illicit? These distinctions are important not only from a scientific and intervention perspective but also from a public policy, program development, and funding perspective. The study also demonstrates a significant gap in the existing models of understanding and intervening with the largest of catastrophic events. The science, practice, and appreciation for the importance of emergency and disaster mental health response has, and continues, to grow. However, most of our models are based on events that are far more limited in scope than the psychosocial sequelae that this study tells us attend the events of September 11, 2001. We have models for natural disaster. We have models for smaller-scale violent events. We do not have models for understanding and providing response and recovery from national disasters. This study documents the national nature of fear, distress, and changed behavior brought on by these types of events. While we may Psychiatry 67(2) Summer 2004 164",0,0 +4446,"Anxious and Depressive Avoidance and Symptoms of Prolonged Grief, Depression, and Post-Traumatic Stress Disorder","Following loss, people can develop symptoms of depression, Post-Traumatic Stress Disorder (PTSD), or Complicated Grief (CG) – also termed Prolonged Grief Disorder (PGD). A recent cognitive-behavioural model has proposed that avoiding confrontation with the reality of the loss (called “anxious avoidance” [AA]) and refraining from activities that could foster adjustment (called “depressive avoidance” [DA]) both play a critical role in CG/PGD. The present study examined this assumption, using self-reported data from 161 mourners. Findings showed that items constituting AA and DA represented two distinct factors. Both factors were strongly correlated with other measures of bereavement-related avoidance and both accounted for a unique part of the explained variance in CG/PGD severity, beyond relevant background variables, negative cognitions, and concomitant symptom-levels of depression and PTSD. DA also explained unique variance in depression beyond these variables. Moreover, AA and DA mediated the linkages of neuroticism, attachment anxiety, and attachment avoidance with symptom-levels of CG/PGD.",0,0 +4447,Linking abuse and recovery through advocacy: an observational study,"Aims. High numbers of psychiatric service users experience domestic violence, yet limited interventions exist for these victims. We piloted a domestic violence intervention for community mental health services to explore the feasibility of a future cluster randomized controlled trial. Methods. Quasi-experimental controlled design within five Community Mental Health Teams (three intervention and two control teams). The intervention comprised domestic violence training for clinicians' and referral to domestic violence advocacy for service users. Clinicians' ( n = 29) domestic violence knowledge, attitudes and behaviours were assessed before and 6 months post-training. Service users' ( n = 34) safety behaviours, unmet needs, quality of life and frequency/severity of abuse were examined at baseline and 3 months follow-up. Process evaluation data were also collected. Results. Clinicians receiving the intervention reported significant improvements in domestic violence knowledge, attitudes and behaviours at follow-up ( p < 0.05). Service users receiving the intervention reported significant reductions in violence ( p < 0.001) and unmet needs at follow-up ( p < 0.05). Conclusions. Interventions comprising domestic violence training for clinicians and referral to domestic violence advocacy may improve responses of psychiatric services. Low rates of identification among teams not receiving training suggest that future trials using service user outcomes are unlikely to be feasible. Therefore, other methods of evaluation are needed.",0,0 +4448,Pharmaceuticals and personal care products: A critical review of the impacts on fish reproduction,"Research in environmental toxicology involving pharmaceuticals and personal care products (PPCPs) has increased greatly over the last 10-15 years. Much research has been focused on the endocrine-disrupting potential of PPCPs, as they relate to negative population impacts of aquatic organisms. This review assesses the current data on the reported effects of PPCPs on fish reproduction with an emphasis on fecundity, a predictor of population effects. Studies of both individual PPCPs and PPCP mixtures are presented. As the majority of individual PPCP studies reviewed demonstrate negative effects on fish fecundity, we relate these findings to detected surface water concentrations of these compounds. Very few studies involving PPCP mixtures have been conducted; however, the need for these types of studies is warranted as fish are most likely exposed to mixtures of PPCPs in the wild. In addition, laboratory and field assessments of wastewater treatment plant (WWTP) effluents, a major source of PPCPs, are reviewed. Much of the data provided from these assessments are variable and do not generally demonstrate negative impacts on reproduction, or the studies are unable to directly associate observed effects with WWTP effluents. Finally, future research considerations are outlined to provide an avenue into understanding how wild populations of fish are affected by PPCPs. These considerations are aimed at determining the adaptation potential of fish exposed to mixtures of PPCPs over multiple generations. As global use of PPCPs continually rises, the need to discern the effects of chronic exposure to PPCPs is greatly increased.",0,0 +4449,Problemas de Nervos: A Multivocal Symbol of Distress for Portuguese Immigrants,"This article outlines research on a previous unstudied form of suffering specific to the Portugese immigrant community: problemas de nervos. Thirty-two Portuguese immigrant women (in Waterloo, ON and Boston, MA) were interviewed and each completed a questionnaire. Cluster analysis demonstrated that problemas de nervos has many meanings. The study profiled symptoms, causes and therapies associated with four variations of this culture-specific form of distress: “ mal da cabeca” meaning problems with/in the head (e.g., lack of control, visions); “ aflição” meaning affliction (e.g., nervous attacks, heart problems); immigration stress (causing sleep disturbances); and, conflicts with others (resulting in pressure within the body). None of the symptom clusters reported matched criteria for a DSM-IV-TR diagnosis, suggesting that problemas de nervos represents an idiomatic rather than universal expression of distress.",0,0 +4450,Double-Blind Placebo-Controlled Pilot Study of Sertraline in Military Veterans With Posttraumatic Stress Disorder,"The efficacy of sertraline in the treatment of civilian posttraumatic stress disorder (PTSD) has been established by two large placebo-controlled trials. The purpose of the current pilot study was to obtain preliminary evidence of the efficacy of sertraline in military veterans suffering from PTSD. Outpatient Israeli military veterans with a DSM-III-R diagnosis of PTSD were randomized to 10 weeks of double-blind treatment with sertraline (50-200 mg/day; N = 23, 83% male, mean age = 41 years) or placebo (N = 19, 95% male, mean age = 38 years). Efficacy was evaluated by the Clinician-Administered PTSD Scale (CAPS-2) and by Clinical Global Impression Scale-Severity (CGI-S) and -Improvement (CGI-I) ratings. Consensus responder criteria consisted of a 30% or greater reduction in the CAPS-2 total severity score and a CGI-I rating of ""much"" or ""very much"" improved. The baseline CAPS-2 total severity score was 94.3 +/- 12.9 for sertraline patients, which is notably higher than that reported for most studies of civilian PTSD. On an intent-to-treat endpoint analysis, sertraline showed a numeric but not statistically significant advantage compared with placebo on the CAPS-2 total severity and symptom cluster scores. In the study completer analysis, the mean CGI-I score was 2.4 +/- 0.3 for sertraline and 3.4 +/- 0.3 for placebo (t = 2.55, df = 30, p = 0.016), CGI-I responder rates were 53% for sertraline and 20% for placebo (chi2 = 3.62, df = 1, p = 0.057), and combined CGI-I and CAPS-2 responder rates (>or=30% reduction in baseline CAPS-2 score) were 41% for sertraline and 20% for placebo (chi2 = 1.39, df = 1, p = 0.238). Sertraline treatment was well tolerated, with a 13% discontinuation rate as a result of adverse events. This pilot study suggests that sertraline may be an effective treatment in patients with predominantly combat-induced PTSD, although the effect size seems to be somewhat smaller than what has been reported in civilian PTSD studies. Adequately powered studies are needed to confirm these results and to assess whether continued treatment maintains or further improves response.",0,0 +4451,WFS1 gene as a putative biomarker for development of post-traumatic syndrome in an animal model,"Post-traumatic stress disorder (PTSD) is an anxiety disorder that may develop after the experiencing or witnessing of a life-threatening event. PTSD is defined by the coexistence of three clusters of symptoms: re-experiencing, avoidance and hyperarousal, which persist for at least 1 month in survivors of the event (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition). Using an established model of PTSD, we addressed the well-accepted clinical finding that only a minority (about 20%) of the individuals exposed to a traumatic event develop PTSD. Moreover, we followed individual rat behavior for up to a month, and then treated the PTSD-like animals with citalopram. Our data demonstrate high face (20% of rats exposed to a reminder of the stressor develop symptoms characteristic of PTSD) and predictive (response to citalopram) validities. Based on these validities we identified alterations in the Wolframin gene in the CA1 and amygdala regions, specifically in exposed PTSD-like rats, which were normalized after treatment with citalopram. We suggest the Wolframin gene as a putative biomarker for PTSD. Since Wolframin gene undergoes alternative splicing and has polymorphism in the population, it may serve a future marker for identification of the vulnerable population exposed to a traumatic event. © 2009 Nature Publishing Group All rights reserved.",0,0 +4452,Gender Differences in a Clinical Sample of Patients with Borderline Personality Disorder,"The aim of the study was to investigate gender differences and similarities in patients with borderline personality disorder (BPD) with respect to Axis I comorbidity, Axis II comorbidity, general psychopathology (Symptom Checklist 90-Revised), and dimensional personality traits (NEO-Personality-Inventory Revised [NEO-PI-R] and the Dimensional Assessment of Personality Profile Basic questionnaire [DAPP-BQ]). Fifty-seven men and 114 women with BPD were included in the study. Regarding Axis I and II disorders in an exploratory analysis, men with BPD more often fulfilled the diagnostic criteria for binge eating disorder, antisocial personality disorder, narcissistic personality disorder, and conduct disorder in childhood, whereas women had higher frequencies of bulimia nervosa, posttraumatic stress disorder, and panic disorder with agoraphobia. After correcting for multiple tests, only the gender differences in narcissistic and antisocial personality disorder remained significant. In the SCL-90-R profile, no significant gender differences could be identified. In the exploratory analysis of the dimensional personality traits, women showed higher rates on the NEO-PI-R main factors (Neuroticism and Agreeableness) compared to men. In the DAPP-BQ profile, men reached higher sores on the main factor, Dissocial Behavior. When correcting for multiple tests, gender differences still existed for Neuroticism and Dissocial Behavior. Our results argue for gender differences in Axis I and II comorbidity and dimensional personality traits in BPD. However, in general, more similarities than differences were shown in this study.",0,0 +4453,"The Course of PTSD, Major Depression, Substance Abuse, and Somatization After a Natural Disaster","Flood research has used a variety of methods, yielding inconsistent findings. Universal definitions of illness are paramount to the science of psychiatric epidemiology of disasters. St. Louis area survivors (N = 162) of the Great Midwestern Floods of 1993 received a structured diagnostic assessment at 4 and 16 months postdisaster, with 88% follow-up. The purpose of the assessment was to examine predisaster and postdisaster rates of disorders and symptoms. Flood-related posttraumatic stress disorder was diagnosed in 22% and 16% at index and follow-up, respectively. Comorbidity with major depression determined whether the posttraumatic stress disorder would have remitted by 1 year later. Nearly one half of the men in the sample had a pre-existing alcohol use disorder. Virtually no new substance abuse followed the floods, and hence, substance abuse did not develop in response to the disaster or as part of coping with its aftermath. Somatization disorder was not observed; new somatoform symptoms represented a fraction of postflood somatic complaints. Findings are inconsistent with causal attribution of floods in the etiology of alcohol abuse and somatization. Methodological differences may account for much of the apparent discrepancy of these findings, with recent reports of increased alcohol use and somatic symptoms observed after other disasters.",0,0 +4454,Children of Katrina: Lessons Learned About Postdisaster Symptoms and Recovery Patterns,"Trauma symptoms, recovery patterns, and life stressors of children between the ages of 9 and 18 (n = 387) following Hurricane Katrina were assessed using an adapted version of the National Child Traumatic Stress Network Hurricane Assessment and Referral Tool for Children and Adolescents (National Child Traumatic Stress Network, 2005). Based on assessments 2 and 3 years after the hurricane, most children showed a decrease in posttraumatic stress and depression symptoms over time. Students were also classified into outcome trajectories of stress resistant, normal response and recovery, delayed breakdown, and breakdown without recovery (A. S. Masten & J. Obradovic, 2008). Age, gender, and life stressors were related to these recovery patterns. Overall, the findings highlight the importance of building and maintaining supportive relationships following disasters.",0,0 +4455,Psychosocial profile of a sample of Egyptian children with rheumatic heart disease,"Objectives Early-onset physical morbidity is likely to affect the emotional balance and behavioral adaptation of children and adolescents. Few published studies have investigated psychological morbidity in children with rheumatic heart diseases (RHD). Our work aims to explore the psychiatric symptoms in addition to total competence and quality of life in a sample of Egyptian children with RHD in comparison with those with no RHD and with healthy controls. Participants and methods Children (age 6-18 years) with RHD (n=24), those with congenital or other heart diseases (non-RHD) (n=23), and healthy control children (n=28) were recruited. The Arabic version of the Child Behavior Checklist was completed by parents. Results After adjustment for different socioeconomic statuses, all children with heart diseases were found to show more internalizing problems and post-traumatic stress compared with healthy children. Non-RHD children showed more generalized and social anxiety, whereas those with RHD showed higher levels of obsessive-compulsive problems. Conclusion Children with heart diseases suffer from high internalizing psychological stress. More effort needs to be made for the early identification and management of psychological morbidity in children with RHD, especially for anxiety and obsessive compulsive symptoms. © 2015 Institute of Psychiatry, Ain Shams University.",0,0 +4456,"Normative Data for the Neurobehavioral Symptom Inventory (NSI) and Post-Concussion Symptom Profiles Among TBI, PTSD, and Nonclinical Samples","The Neurobehavioral Symptom Inventory (NSI) is a self-report measure of symptoms commonly associated with Post-Concussion Syndrome (PCS) that may emerge after mild traumatic brain injury (mTBI). Despite frequent clinical use, no NSI norms have been developed. Thus, the main objective of this study was to establish NSI normative data using the four NSI factors (i.e., vestibular, somatic, cognitive, and affective) identified by Vanderploeg, Silva, et al. ( 2014 ) among nonclinical epidemiological samples of deployed and non-deployed Florida National Guard members as well as a reference sample of Guard members with combat-related mTBI. In addition, NSI subscale profile patterns were compared across four distinct subgroups (i.e., non-deployed-nonclinical, deployed-nonclinical, deployed-mTBI, and deployed-PTSD). The deployed-nonclinical group endorsed greater PCS symptom severity than the non-deployed group, and the mTBI group uniformly endorsed more symptoms than both nonclinical groups. However, the PTSD group endorsed higher symptom severity relative to the other three subgroups. As such, this highlights the non-specificity of PCS symptoms and suggests that PTSD is associated with higher symptom endorsement than mTBI.",0,0 +4457,Post-Traumatic Stress Disorder (PTSD),"This article discusses the biomedical and the social constructionist models applied to response to trauma, presents the prevalence and the etiology of post-traumatic stress disorder (PTSD), and describes its biological and psychological correlates in children and adults. It concludes that future research might benefit from investigating factors that may protect people who have been exposed to an event likely to be traumatic from presenting with PTSD symptoms, and factors that may affect the longitudinal course of PTSD and treatment effectiveness.",0,0 +4458,Optimal Scoring of the Multidimensional Pain Inventory in a Chronic Pain Sample,"The Multidimensional Pain Inventory (MPI) is one of the most commonly used self-report instruments in pain settings. The MPI can be used to classify patients into three clusters or its nine scales can be treated as dimensions in efforts to understand patient heterogeneity. Previous research suggests the existence of a fourth cluster, whose members have been labeled 'repressors,' that emerges with the addition of a defensiveness scale to the MPI. The current paper compared the abilities of MPI cluster and dimensional models with and without a measure of defensiveness to capture variability in validating variables related to personality, psychopathology, physical functioning, and treatment outcome in a chronic pain sample. Results suggest that dimensional models consistently outperform cluster models in explaining variance in outcome variables, and that the addition of a measure of defensiveness increments the validity offered by the MPI scales. Implications for the assessment of pain patients are discussed. (",0,0 +4459,Altered cortisol awakening response in posttraumatic stress disorder,"An altered function of the hypothalamic-pituitary-adrenal axis is assumed to be characteristic for Posttraumatic Stress Disorder (PTSD), although there is inconsistent empirical evidence. Only few studies examined the awakening cortisol response and a daytime profile in PTSD. Salivary cortisol levels were measured at seven intervals from awakening until 8 PM in trauma-exposed subjects with (N=29) and without PTSD (N=19) and in 15 non-exposed controls. While the three groups did not differ with respect to their first cortisol level immediately after awakening, the expected cortisol increase to awakening 15-60 min later was significantly lower in PTSD patients compared to non-PTSD subjects and healthy controls. This effect remained stable when trauma-exposed subjects with comorbid major depression were excluded from the analysis. A significant negative correlation between the overall cortisol secretion (AUC(G)) and overall PTSD symptomatology and hyper-arousal symptoms was found. The findings are discussed in light of the hypothesis of a counterregulation of hyper-arousal symptoms and chronic stress in PTSD.",0,0 +4460,Concerns and perceptions immediately following Superstorm Sandy: ratings for property damage were higher than for health issues,"Governmental officials, health and safety professionals, early responders, and the public are interested in the perceptions and concerns of people faced with a crisis, especially during and immediately after a disaster strikes. Reliable information can lead to increased individual and community preparedness for upcoming crises. The objective of this research was to evaluate concerns of coastal and central New Jersey residents within the first 100 days of Superstorm Sandy's landfall. Respondents living in central New Jersey and Jersey shore communities were differentially impacted by the storm, with shore residents having higher evacuation rates (47% vs. 13%), more flood waters in their homes, longer power outages (average 23 vs. 6 days), and longer periods without Internet (29 vs. 6 days). Ratings of concerns varied both among and within categories as a function of location (central vs. coastal New Jersey), stressor level (ranging from 1 to 3 for combinations of power outages, high winds, and flooding), and demographics. Respondents were most concerned about property damage, health, inconveniences, ecological services, and nuclear power plants in that order. Respondents from the shore gave higher ratings to the concerns within each major category, compared to those from central Jersey. Four findings have implications for understanding future risk, recovery, and resiliency: (1) respondents with the highest stressor level (level 3) were more concerned about water damage than others, (2) respondents with flood damage were more concerned about water drainage and mold than others, (3) respondents with the highest stressor levels rated all ecological services higher than others, and (4) shore respondents rated all ecological services higher than central Jersey residents. These data provide information to design future preparedness plans, improve resiliency for future severe weather events, and reduce public health risk.",0,0 +4461,Clustering Asian and North African Countries According to Trend of Colon and Rectum Cancer Mortality Rates: an Application of Growth Mixture Models,"Colorectal cancer is the second most common cause of cancer death with half a million deaths per year. Incidence and mortality rates have demonstrated notable changes in Asian and African countries during the last few decades. In this study, we first aimed to determine the trend of colorectal cancer mortality rate in each Institute for Health Metrics and Evaluation (IHME) region, and then re-classify them to find more homogenous classes.Our study population consisted of 52 countries of Asia and North Africa in six IHME pre-defined regions for both genders and age-standardized groups from 1990 to 2010.We first applied simple growth models for pre-defined IHME regions to estimate the intercepts and slopes of mortality rate trends. Then, we clustered the 52 described countries using the latent growth mixture modeling approach for classifying them based on their colorectal mortality rates over time.Statistical analysis revealed that males and people in high income Asia pacific and East Asia countries were at greater risk of death from colon and rectum cancer. In addition, South Asia region had the lowest rates of mortality due to this cancer. Simple growth modeling showed that majority of IHME regions had decreasing trend in mortality rate of colorectal cancer. However, re-classification these countries based on their mortality trend using the latent growth mixture model resulted in more homogeneous classes according to colorectal mortality trend.In general, our statistical analyses showed that most Asian and North African countries had upward trend in their colorectal cancer mortality. We therefore urge the health policy makers in these countries to evaluate the causes of growing mortality and study the interventional programs of successful countries in managing the consequences of this cancer.",0,0 +4462,Post-traumatic stress disorder in children following road traffic accidents: a comparison of those with and without mild traumatic brain injury,"It is now recognized that post-traumatic stress disorder (PTSD) can occur following road traffic accidents, but controversy exists about the possibility of PTSD in people sustaining traumatic brain injury (TBI). The present investigation examined the frequency, course and comorbidity of PTSD in children with and without mild TBI after traffic accidents.Interviews were conducted with 43 children and their parents 6 weeks after a traffic accident,assessing PTSD and associated symptomatology. Fourteen children sustained mild TBI and 29 had no TBI. A sub-set (n=32) was re-interviewed 7 weeks later.Children both with and without TBI reported PTSD symptomatology, but no significant group differences were found. At initial assessment, 74% of children were classified as having clinically significant PTSD symptomatology (86% and 69% in groups with and without TBI, respectively), which was strongly associated with report of general anxiety. At follow-up, PTSD symptomatology decreased, but 44% remained symptomatic (38% and 46% for those with and without TBI, respectively). Child and parental report of PTSD symptomatology were not significantly correlated.Presence of mild TBI did not influence the likelihood of experiencing PTSD symptomatology following a traffic accident. Given that PTSD symptomatology is a common consequence of traffic accidents in children, there is a clear need for provision of systematic assessment and, where appropriate, the implementation of intervention strategies to treat children.",0,0 +4463,[Heat waves: health impacts].,"During the summer of 2003, record high temperatures were reported across Europe, causing thousands of casualties. Heat waves are sporadic recurrent events, characterised by intense and prolonged heat, associated with excess mortality and morbidity. The most frequent cause of death directly attributable to heat is heat stroke but heat waves are known to cause increases in all-cause mortality, specially circulatory and respiratory mortality. Epidemiological studies demonstrate excess casualties cluster in specific risk groups. The elderly, those with chronic medical conditions and the socially isolated are particularly vulnerable. Air conditioning is the strongest protective factor against heat-related disorders. Heat waves cause disease indirectly, by aggravating chronic disorders, and directly, by causing heat-related illnesses (HRI). Classic HRI include skin eruptions, heat cramps, heat syncope, heat exhaustion and heat stroke. Heat stroke is a medical emergency characterised by hyperthermia and central nervous system dysfunction. Treatment includes immediate cooling and support of organ-system function. Despite aggressive treatment, heat stroke is often fatal and permanent neurological damage is frequent in those who survive. Heat related illness and death are preventable through behavioural adaptations, such as use of air conditioning and increased fluid intake. Other adaptation measures include heat emergency warning systems and intervention plans and environmental heat stress reduction. Heat related mortality is expected to rise as a consequence of the increasing proportion of elderly persons, the growing urban population, and the anticipated increase in number and intensity of heat waves associated with global warming. Improvements in surveillance and response capability may limit the adverse health conditions of future heat waves. It is crucial that health professionals are prepared to recognise, prevent and treat HRI and learn to cooperate with local health agencies.",0,0 +4464,Conflict between current knowledge about posttraumatic stress disorder and its original conceptual basis,"The author's goal was to explore the historical, political, and social forces that have played a major role in the acceptance of the idea of trauma as a cause of the specific symptoms of posttraumatic stress disorder (PTSD) and to discuss the impact that current research findings have had on some of the initial conceptualizations of the disorder.The conceptual origins of PTSD are described, and the literature on the prevalence, longitudinal course, phenomenology, and neurobiology of PTSD is reviewed.Paradoxically, there are a series of findings that support the idea that PTSD is a distinct diagnostic entity, but these are different from those originally developed from psychosocial theory and stress research.PTSD has been a controversial diagnosis and is again at a vulnerable point. It is imperative that the field address how current findings challenge the original conceptualizations of this disorder so that the next generation of conceptual issues can be formulated.",0,0 +4465,Impaired fear inhibition learning predicts the persistence of symptoms of posttraumatic stress disorder (PTSD),"Recent cross-sectional studies have shown that the inability to suppress fear under safe conditions is a key problem in people with posttraumatic stress disorder (PTSD). The current longitudinal study examined whether individual differences in fear inhibition predict the persistence of PTSD symptoms. Approximately 2 months after deployment to Afghanistan, 144 trauma-exposed Dutch soldiers were administered a conditional discrimination task (AX+/BX-). In this paradigm, A, B, and X are neutral stimuli. X combined with A is paired with a shock (AX+ trials); X combined with B is not (BX- trials). Fear inhibition was measured (AB trials). Startle electromyogram responses and shock expectancy ratings were recorded. PTSD symptoms were measured at 2 months and at 9 months after deployment. Results showed that greater startle responses during AB trials in individuals who discriminated between danger (AX+) and safety (BX-) during conditioning, predicted higher PTSD symptoms at 2 months and 9 months post-deployment. The predictive effect at 9 months remained significant after controlling for critical incidents during previous deployments and PTSD symptoms at 2 months. Responses to AX+ or BX- trials, or discrimination learning (AX+ minus BX-) did not predict PTSD symptoms. It is concluded that impaired fear inhibition learning seems to be involved in the persistence of PTSD symptoms.",0,0 +4466,Childhood Adversity and Combat as Predictors of Depression and Post-Traumatic Stress in Deployed Troops,"Previous studies have shown a relationship between childhood adversity and health outcomes in adulthood. The military represents a segment of the young working population that faces unique hazards that may be worsened by previous adverse life experiences. To date, no comprehensive studies of childhood adversity have been conducted with military samples that have included combat troops before and after a combat deployment.Surveys were administered in 2003 to 4529 male soldiers who had not deployed to Iraq, and in 2004 to a separate group of 2392 male soldiers 3 months after returning from Iraq. The main predictor was adverse childhood experiences, an aggregated construct representing incremental exposure to six types of traumatic childhood experiences. This construct correlated with depression and post-traumatic stress disorder rates, as well as symptom scores. For the post-Iraq sample, analyses were conducted to assess whether individuals with childhood trauma were affected differently by exposure to combat.The likelihood of screening positive for depression and post-traumatic stress disorder was significantly higher for individuals reporting exposure to two or more categories of childhood adversity. Core analyses showed that adverse childhood experiences were a significant predictor of mental health symptoms, beyond the expected contribution of combat.This study confirms the high prevalence of adverse childhood experiences and the association of these experiences with key mental health outcomes. In addition, the results highlight the importance of considering pre-enlistment childhood traumatic experiences as well as the level of combat exposure in the treatment of military personnel returning from combat operations.",0,0 +4467,EMG biofeedback-assisted desensitization treatment for Vietnam combat veterans Post-Traumatic Stress Disorder.,"Employed an electromyogram (EMG) biofeedback-induced desensitization procedure (EMG-D) in the treatment of 8 Vietnam combat veterans with a 7-yr history of chronic post-traumatic stress disorder (PTSD) and frequent recurring nightmares and/or flashbacks that were anxiety-evoking events. 16 PTSD Ss (aged 29-42 yrs) were assigned to the EMG-D group or a control group. Analysis of forehead muscle tension over a 2 yr follow-up indicated that the Ss in the EMG-D condition had significantly reduced their muscle tension and showed continued improved functioning. Ss reported a few instances of recurrence of their nightmares and/or flashbacks; however, they were essentially anxiety-free episodes. No significant reduction in muscle tension, recurring nightmares, or flashbacks was found for Ss in the control group. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4468,"Atrocities exposure in Vietnam combat veterans with chronic posttraumatic stress disorder: Relationship to combat exposure, symptom severity, guilt, and interpersonal violence","Vietnam combat veterans (N = 151) with chronic posttraumatic stress disorder (PTSD) completed measures of atrocities exposure, combat exposure, PTSD symptom severity, guilt and interpersonal violence. PTSD symptom severity, guilt and interpersonal violence rates were similar to previously reported studies that examined treatment seeking combat veterans with PTSD. Controlling for combat exposure, endorsement of atrocities exposure was related to PTSD symptom severity, PTSD B (reexperiencing) symptoms, Global Guilt, Guilt Cognitions, and cognitive subscales of Hindsight-Bias/Responsibility and Wrongdoing. These results are discussed in the context of previous research conducted regarding atrocities exposure and PTSD.",0,0 +4469,Long-term mental health of Vietnamese refugees in the aftermath of trauma,"Background There is no long-term prospective study (> 20 years) of the mental health of any refugee group. Aims To investigate the long-term course and predictors of psychological distress among Vietnamese refugees in Norway. Method Eighty Vietnamese refugees, 57% of the original cohort previously interviewed in 1982 ( T 1 ) and 1985 ( T 2 ), completed a self-report questionnaire prior to a semi-structured interview. Mental health was measured using the Symptom Checklist–90–Revised (SCL–90–R). Results The SCL–90–R mean Global Severity Index (GSI) decreased significantly from T 1 to T 3 (2005–6), but there was no significant change in the percentage reaching threshold scores (GSI =1.00). Trauma-related mental disorder on arrival and the trajectory of symptoms over the first 3 years of resettlement predicted mental health after 23 years. Conclusions Although the self-reported psychological distress decreased significantly over time, a substantial higher proportion of the refugee group still remained reaching threshold scores after 23 years of resettlement compared with the Norwegian population. The data suggest that refugees reaching threshold scores on measures such as the SCL–90–R soon after arrival warrant comprehensive clinical assessment.",0,0 +4470,Trauma and posttraumatic stress symptoms predict alcohol and other drug consequence trajectories in the first year of college.,"College matriculation begins a period of transition into adulthood, one that is marked by new freedoms and responsibilities. This transition also is marked by an escalation in heavy drinking and other drug use as well as a variety of use-related negative consequences. Trauma and symptoms of posttraumatic stress disorder (PTSD) may affect alcohol and drug problems and, thus, may be a point of intervention. Yet, no studies have examined trauma, PTSD, and alcohol and drug problem associations during this developmental period. The present study provides such an examination.Matriculating college students (N = 997) completed surveys in September (Time 1) and at 5 subsequent time points (Time 2-Time 6) over their 1st year of college. With latent growth analysis, trajectories of alcohol- and drug-related consequences were modeled to examine how trauma (No Criterion A Trauma, Criterion A Only, No PTSD Symptoms) and PTSD (partial or full) symptom status predicted these trajectories.Results showed substantial risk for alcohol- and other drug-related negative consequences that is conferred by the presence of PTSD at matriculation. Those with both partial and full PTSD started the year with more alcohol and drug consequences. These individuals showed a steeper decrease in consequences in the 1st semester, which leveled off as the year progressed. Both alcohol and drug consequences remained higher for those in the PTSD group throughout the academic year. Hyperarousal symptoms showed unique effects on substance consequence trajectories. Risk patterns were consistent for both partial and full PTSD symptom presentations. Trajectories did not vary by gender.Interventions that offer support and resources to students entering college with PTSD may help to ameliorate problem substance use and may ultimately facilitate a stronger transition into college and beyond.",0,0 +4471,RORA and posttraumatic stress trajectories: main effects and interactions with childhood physical abuse history,"Longitudinal studies of posttraumatic stress (PTS) have documented environmental factors as predictors of trajectories of higher, versus lower, symptoms, among them experiences of childhood physical abuse. Although it is now well-accepted that genes and environments jointly shape the risk of PTS, no published studies have investigated genes, or gene-by-environment interactions (GxEs), as predictors of PTS trajectories. The purpose of this study was to fill this gap.We examined associations between variants of the retinoid-related orphan receptor alpha (RORA) gene and trajectory membership among a sample of predominantly non-Hispanic Black urban adults (N = 473). The RORA gene was selected based on its association with posttraumatic stress disorder (PTSD) in the first PTSD genome wide association study. Additionally, we explored GxEs between RORA variants and childhood physical abuse history.We found that the minor allele of the RORA SNP rs893290 was a significant predictor of membership in a trajectory of consistently high PTS, relatively to a trajectory of consistently low PTS. Additionally, the GxE of rs893290 with childhood physical abuse was significant. Decomposition of the interaction showed that minor allele frequency was more strongly associated with membership in consistently high or decreasing PTS trajectories, relative to a consistently low PTS trajectory, among participants with higher levels of childhood physical abuse.The results of the study provide preliminary evidence that variation in the RORA gene is associated with membership in trajectories of higher PTS and that these associations are stronger among persons exposed to childhood physical abuse. Replication and analysis of functional data are needed to further our understanding of how RORA relates to PTS trajectories.",0,0 +4472,Prevalence and Incidence of Traumatic Experiences Among Orphans in Institutional and Family-Based Settings in 5 Low- and Middle-Income Countries: A Longitudinal Study,"Policy makers struggling to protect the 153 million orphaned and separated children (OSC) worldwide need evidence-based research on the burden of potentially traumatic events (PTEs) and the relative risk of PTEs across different types of care settings.The Positive Outcomes for Orphans study used a 2-stage, cluster-randomized sampling design to identify 1,357 institution-dwelling and 1,480 family-dwelling orphaned and separated children in 5 low- and middle-income countries (LMICs) in sub-Saharan Africa and Asia. We used the Life Events Checklist developed by the National Center for Posttraumatic Stress Disorder to examine self-reported PTEs among 2,235 OSC ages 10-13 at baseline. We estimated prevalence and incidence during 36-months of follow-up and compared the risk of PTEs across care settings. Data collection began between May 2006 and February 2008, depending on the site.Lifetime prevalence by age 13 of any PTE, excluding loss of a parent, was 91.0% (95% confidence interval (CI) = 85.6, 94.5) in institution-dwelling OSC and 92.4% (95% CI = 90.3, 94.0) in family-dwelling OSC; annual incidence of any PTE was lower in institution-dwelling (23.6% [95% CI = 19.4, 28.7]) than family-dwelling OSC (30.0% [95% CI = 28.1, 32.2]). More than half of children in institutions (50.3% [95% CI = 42.5, 58.0]) and in family-based care (54.0% [95% CI = 50.2, 57.7]) had experienced physical or sexual abuse by age 13. Annual incidence of physical or sexual abuse was lower in institution-dwelling (12.9% [95% CI = 9.6, 17.3]) than family-dwelling OSC (19.4% [95% CI = 17.7, 21.3]), indicating statistically lower risk in institution-dwelling OSC (risk difference = 6.5% [95% CI = 1.4, 11.7]).Prevalence and incidence of PTEs were high among OSC, but contrary to common assumptions, OSC living in institutions did not report more PTEs or more abuse than OSC living with families. Current efforts to reduce the number of institution-dwelling OSC may not reduce incidence of PTEs in this vulnerable population. Protection of children from PTEs should be a primary consideration, regardless of the care setting.",0,0 +4473,Alterations in cognitive flexibility in a rat model of post-traumatic stress disorder,"Exposure to stressful or traumatic events is associated with increased vulnerability to post-traumatic stress disorder (PTSD). This vulnerability may be partly mediated by effects of stress on the prefrontal cortex (PFC) and associated circuitry. The PFC mediates critical cognitive functions, including cognitive flexibility, which reflects an organism's ability to adaptively alter behavior in light of changing contingencies. Prior work suggests that chronic or acute stress exerts complex effects on different forms of cognitive flexibility, via actions on the PFC. Similarly, PFC dysfunction is reported in PTSD, as are executive function deficits. Animal models that permit study of the effects of stress/trauma on cognitive flexibility may be useful in illuminating ways in which stress-linked cognitive changes contribute to PTSD. Here, we examined the behavioral effects of a rodent model of PTSD - single prolonged stress (SPS) - on performance of two forms of cognitive flexibility: reversal learning and strategy set-shifting. SPS did not impair acquisition of either a response or visual-cue discrimination but did cause slight impairments in the retrieval of the visual-cue rule. During response discrimination reversal, SPS rats made more perseverative errors. In comparison, during set-shifting from the visual-cue to response discrimination, SPS rats did not show enhanced perseveration, but did display increased never-reinforced errors, indicative of impairment in selecting a novel strategy. These data demonstrate that SPS leads to a complex and intriguing pattern of deficits in flexible responding and suggest that impairments in executive functioning associated with PTSD could, in part, be a neuro-cognitive consequence of trauma exposure.",0,0 +4474,"The impact of disaster work on community volunteers: The role of peri-traumatic distress, level of personal affectedness, sleep quality and resource loss, on post-traumatic stress disorder symptoms and subjective health","Disaster work has shown to cause PTSD symptoms and subjective health complaints in professional emergency personnel. However, very little is known about how disaster work affects community volunteers. This first time longitudinal study examined factors contributing to post-traumatic stress disorder symptoms (PTSD) and subjective health complaints in volunteers working in an earthquake setting. At six and eighteen months post disaster, a sample of 506 Indonesian Red Cross volunteers were assessed using the Impact of Event Scale-Revised and the Subjective Health Complaints Inventory. Factors analyzed in relation to the outcomes included: peri-traumatic distress, level of personal affectedness by the disaster, sleep quality and loss of resources as a consequence of the disaster. At 18 months post-disaster the findings showed high levels of PTSD symptoms and subjective health complaints. Quality of sleep was related to both outcomes but resource loss only to PTSD symptoms. Neither peri-traumatic distress nor level of affectedness by the disaster (external versus directly affected volunteers), were predictive of symptoms. This study indicates that characteristics of disaster work e.g. low quality of sleep, may be an important contributor to PTSD symptoms and subjective health complaints in volunteers.",0,0 +4475,Health concerns and perceptions of central and coastal New Jersey residents in the 100days following Superstorm Sandy,"Superstorm Sandy made landfall in New Jersey 29–30 October 2012 (130 km/h winds), and many residents were evacuated, were without power for days to several weeks, and suffered property damages or lost their homes. The objective of this study was to understand health concerns within 100 days of this devastating storm that might improve recovery, future preparedness, and resilience. We conducted a survey of New Jersey residents in central (N = 407) and shore communities (n = 347) about health concerns before, during, and after Superstorm Sandy . People were interviewed at public places, town hall and FEMA meetings, health and university centers, and other gathering places. 47% of shore and 13% of central Jersey respondents evacuated. Both populations were concerned about agents of destruction, survival needs, and possessions before and during the storm, but they were mainly concerned about survival needs thereafter. During the storm, medical issues were the greatest concern for shore respondents (23%) vs secure and safe food and water (29%) for central respondents. Medical concerns increased after the storm. In the future, 42% of shore respondents would prepare more, while 51% of central residents would buy more supplies; 20% (shore) and 11% (central) would heed future evacuation warnings. Before Sandy many residents did not heed warnings and evacuation orders, but worried about property damage, while during and after their major concerns were personal and community health. Prevention of future health and property impacts could be enhanced by stronger evacuation enforcement, better preparedness information, greater attention to the possibility of prolonged power outages, and more attention to medical needs during and after a storm. • Within 100 days of Superstorm Sandy 754 people in New Jersey were interviewed. • Nearly half of people living along the shore evacuated, and were without electricity for some time. • During the storm, the major concerns for shore residents were medical issues (23%). • Medical concerns increased following the storm for shore residents. • Stress, respiratory problems, and access to medications were major medical concerns.",0,0 +4476,Psychiatric Impairment Among Adolescents Engaging in Different Types of Deliberate Self-Harm,"This retrospective chart review study of 227 participants examined the psychiatric profiles of outpatient adolescents ages 12 to 19 years (M = 15.08 years, SD = 1.72 years) engaging in different types of deliberate self-harm (DSH) behaviors. Participants were divided into four groups: no deliberate self-harm (NoDSH; n = 119), nonsuicidal self-injury only (NSSI only; n = 30), suicide attempt only (n = 38), and suicide attempt plus NSSI (n = 40). Those who attempted suicide were more likely to have major depressive disorder and/or posttraumatic stress disorder than those who engaged in NSSI only. Those who engaged in any type of DSH were more likely to have features of borderline personality disorder than those who did not engage in DSH. The suicidal ideation levels of those in the NSSI group were similar to those in the NoDSH group. Findings offer empirical support for the importance of distinguishing between suicidal and nonsuicidal self-harm behaviors.",0,0 +4477,"Child physical abuse and neglect in Kenya, Zambia and the Netherlands: A cross-cultural comparison of prevalence, psychopathological sequelae and mediation by PTSS","This study compared the prevalence of self-reported childhood physical abuse and neglect and the associated psychopathological sequelae among Kenyan, Zambian, and Dutch university students. In addition, we sought to find out the differentiated role of posttraumatic stress symptoms (PTSS) in mediating the associations between childhood maltreatment experiences and psychopathology symptoms. The sample consisted of 862 university students from Kenya (n = 375), Zambia (n = 182), and The Netherlands (n = 305) who completed the Personal and Relationships Profile (PRP). Results showed that physical abuse was highly prevalent in Kenya (59%) and Zambia (40%), and that neglect was even more prevalent than physical abuse in Zambia and The Netherlands at 59%, 54%, and 42% for the Kenyan, Zambian, and Dutch samples respectively. Neglect was associated with psychopathological symptoms in all three samples, whereas physical abuse was associated with psychopathological sequelae in the Kenyan and Zambian samples only. PTSS mediated the association between neglect and psychopathology symptoms in the Dutch sample and between physical abuse and psychopathology symptoms in the Dutch and Kenyan samples. We conclude that physical abuse and neglect are associated with psychopathology symptoms independently of country and cultural context. However, the pathways through which physical abuse and neglect may lead to psychopathological sequelae may be dependent on perceptions of specific parental behavior in different sociocultural contexts.",0,0 +4478,Multiple session early psychological intervention to prevent and treat post-traumatic stress disorder,,0,0 +4479,Altered blood oxygen level-dependent signal variability in chronic post-traumatic stress disorder during symptom provocation,"Recent research suggests that variability in brain signal provides important information about brain function in health and disease. However, it is unknown whether blood oxygen level-dependent (BOLD) signal variability is altered in post-traumatic stress disorder (PTSD). We aimed to identify the BOLD signal variability changes of PTSD patients during symptom provocation and compare the brain patterns of BOLD signal variability with those of brain activation.Twelve PTSD patients and 14 age-matched controls, who all experienced a mining accident, underwent clinical assessment as well as fMRI scanning while viewing trauma-related and neutral pictures. BOLD signal variability and brain activation were respectively examined with standard deviation (SD) and general linear model analysis, and compared between the PTSD and control groups. Multiple regression analyses were conducted to explore the association between PTSD symptom severity and these two brain measures across all subjects as well as in the PTSD group.PTSD patients showed increased activation in the middle occipital gyrus compared with controls, and an inverse correlation was found between PTSD symptom severity and brain activation in the hippocampus and anterior cingulate cortex/medial prefrontal cortex. Brain variability analysis revealed increased SD in the insula, anterior cingulate cortex/medial prefrontal cortex, and vermis, and decreased SD in the parahippocapal gyrus, dorsolateral prefrontal cortex, somatosensory cortex, and striatum. Importantly, SD alterations in several regions were found in both traumatic and neutral conditions and were stratified by PTSD symptom severity.BOLD signal variability may be a reliable and sensitive biomarker of PTSD, and combining brain activation and brain variability analysis may provide complementary insight into the neural basis of this disorder.",0,0 +4480,Violent offending by UK military personnel deployed to Iraq and Afghanistan: a data linkage cohort study,"

Summary

Background

Violent offending by veterans of the Iraq and Afghanistan conflicts is a cause for concern and there is much public debate about the proportion of ex-military personnel in the criminal justice system for violent offences. Although the psychological effects of conflict are well documented, the potential legacy of violent offending has yet to be ascertained. We describe our use of criminal records to investigate the effect of deployment, combat, and post-deployment mental health problems on violent offending among military personnel relative to pre-existing risk factors.

Methods

In this cohort study, we linked data from 13 856 randomly selected, serving and ex-serving UK military personnel with national criminal records stored on the Ministry of Justice Police National Computer database. We describe offending during the lifetime of the participants and assess the risk factors for violent offending.

Findings

2139 (weighted 17·0%) of 12 359 male UK military personnel had a criminal record for any offence during their lifetime. Violent offenders (1369 [11·0%]) were the most prevalent offender types; prevalence was highest in men aged 30 years or younger (521 [20·6%] of 2728) and fell with age (164 [4·7%] of 3027 at age >45 years). Deployment was not independently associated with increased risk of violent offending, but serving in a combat role conferred an additional risk, even after adjustment for confounders (violent offending in 137 [6·3%] of 2178 men deployed in a combat role vs 140 (2·4%) of 5797 deployed in a non-combat role; adjusted hazard ratio 1·53, 95% CI 1·15–2·03; p=0·003). Increased exposure to traumatic events during deployment also increased risk of violent offending (violent offending in 104 [4·1%] of 2753 men with exposure to two to four traumatic events vs 56 [1·6%] of 2944 with zero to one traumatic event, 1·77, 1·21–2·58, p=0·003; and violent offending in 122 [5·1%] of 2582 men with exposure to five to 16 traumatic events, 1·65, 1·12–2·40, p=0·01; test for trend, p=0·032). Violent offending was strongly associated with post-deployment alcohol misuse (violent offending in 120 [9·0%] of 1363 men with alcohol misuse vs 155 [2·3%] of 6768 with no alcohol misuse; 2·16, 1·62–2·90; p<0·0001), post-traumatic stress disorder (violent offending in 25 [8·6%] of 344 men with post-traumatic stress disorder vs 221 [3·0%] of 7256 with no symptoms of post-traumatic stress disorder; 2·20, 1·36–3·55; p=0·001), and high levels of self-reported aggressive behaviour (violent offending in 56 [6·7%] of 856 men with an aggression score of six to 16 vs 22 [1·2%] of 1685 with an aggression score of zero; 2·47, 1·37–4·46; p=0·003). Of the post-traumatic stress disorder symptoms, the hyperarousal cluster was most strongly associated with violent offending (2·01, 1·50–2·70; p<0·0001).

Interpretation

Alcohol misuse and aggressive behaviour might be appropriate targets for interventions, but any action must be evidence based. Post-traumatic stress disorder, though less prevalent, is also a risk factor for violence, especially hyperarousal symptoms, so if diagnosed it should be appropriately treated and associated risk monitored.

Funding

Medical Research Council and the UK Ministry of Defence.",0,0 +4481,Effect of the incident at Columbine on students' violence- and suicide-related behaviors,This study examined the impact that the violent incident at Columbine High School may have had on reports of behaviors related to violence and suicide among U.S. high school students.Nationally representative data from the 1999 Youth Risk Behavior Survey (YRBS) were analyzed using logistic regression analyses.Students who completed the 1999 YRBS after the Columbine incident were more likely to report feeling too unsafe to go to school and less likely to report considering or planning suicide than were students who completed the 1999 YRBS before the incident.These results highlight how an extreme incident of school violence can affect students nationwide.,0,0 +4482,Subthreshold Posttraumatic Stress Disorder in the World Health Organization World Mental Health Surveys,"

Abstract

Background

Although only a few people exposed to a traumatic event (TE) develop posttraumatic stress disorder (PTSD), symptoms that do not meet full PTSD criteria are common and often clinically significant. Individuals with these symptoms sometimes have been characterized as having subthreshold PTSD, but no consensus exists on the optimal definition of this term. Data from a large cross-national epidemiologic survey are used in this study to provide a principled basis for such a definition.

Methods

The World Health Organization World Mental Health Surveys administered fully structured psychiatric diagnostic interviews to community samples in 13 countries containing assessments of PTSD associated with randomly selected TEs. Focusing on the 23,936 respondents reporting lifetime TE exposure, associations of approximated DSM-5 PTSD symptom profiles with six outcomes (distress-impairment, suicidality, comorbid fear-distress disorders, PTSD symptom duration) were examined to investigate implications of different subthreshold definitions.

Results

Although consistently highest outcomes for distress-impairment, suicidality, comorbidity, and PTSD symptom duration were observed among the 3.0% of respondents with DSM-5 PTSD rather than other symptom profiles, the additional 3.6% of respondents meeting two or three of DSM-5 criteria B–E also had significantly elevated scores for most outcomes. The proportion of cases with threshold versus subthreshold PTSD varied depending on TE type, with threshold PTSD more common following interpersonal violence and subthreshold PTSD more common following events happening to loved ones.

Conclusions

Subthreshold DSM-5 PTSD is most usefully defined as meeting two or three of DSM-5 criteria B–E. Use of a consistent definition is critical to advance understanding of the prevalence, predictors, and clinical significance of subthreshold PTSD.",0,0 +4483,Developmental trajectories of adiposity from birth until early adulthood and association with cardiometabolic risk factors,"Objective: To identify developmental trajectories of adiposity from birth until early adulthood, and to investigate how they relate with cardiometabolic risk factors at 21 years of age. Methods: Participants' weight and height measurements were obtained using the EPITeen cohort protocol at 13, 17 and 21 years of age, and extracted from child health books as recorded during health routine evaluations since birth. Blood pressure, triglycerides, cholesterol and insulin resistance (HOMA-IR) were assessed at 21 years. Trajectories were defined using 719 participants contributing 11 459 measurements. The individual growth curves were modelled using mixed-effects fractional polynomial, and the trajectories were estimated using normal mixture modelling for model-based clustering. Differences in cardiometabolic risk factors at 21 years according to adiposity trajectories were estimated through analysis of covariance (ANCOVA), and adjusted means are presented. Results: Two trajectories-'Average body mass index (BMI) growth' (80.7%) and 'Higher BMI growth' (19.3%)-were identified. Compared with those in 'Average BMI growth', 'Higher BMI growth' participants were more frequently delivered by caesarean section, mothers were younger and had higher BMI, and parental education was lower; and at 21 years showed higher adjusted mean systolic (111.6 vs 108.3mmHg, P < 0.001) and diastolic blood pressure (71.9 vs 68.4mmHg, P < 0.001), and lower highdensity lipoprotein cholesterol (53.3 vs 57.0 mg dl-1, P = 0.001). As there was a significant interaction between trajectories and sex, triglycerides and HOMA-IR were stratified by sex and we found significantly higher triglycerides, in males, and higher HOMA-IR in both sexes in 'Higher BMI growth' trajectory. All the differences were attenuated after adjustment for BMI at 21 years. Conclusions: In this long-term follow-up, we were able to identify two adiposity trajectories, statistically related to the BMI and cardiometabolic profile in adulthood. Our results also suggest that the impact of the adiposity trajectory on cardiometabolic profile is mediated by current BMI. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0,0 +4484,The Trauma Recovery Group: A Cognitive-Behavioral Program for Post-Traumatic Stress Disorder in Persons with Severe Mental Illness,"To address the problem of post-traumatic stress disorder (PTSD) in severe mental illness, the Trauma Recovery Group, a mixed gender cognitive-behavioral program, was developed and piloted at a community mental health center. The 21-week program includes breathing retraining, education about PTSD, cognitive restructuring, coping with symptoms, and making a recovery plan. Eighty clients were assessed at baseline and 41 provided follow-up data. Retention in the group was good: 59%. Treatment completers improved significantly in PTSD symptoms and diagnosis, depression, and post-traumatic cognitions, but dropouts did not. The results support the feasibility of the program and suggest it produces clinical benefits. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +4485,Pediatric Adverse Childhood Experiences: Implications for Life Course Health Trajectories,"lems have their origins early in life. 1 The timing, intensity, and cumulative burden of adversities, especially in the relative absence of protective factors, can affect gene expression, the conditioning of stress responses, and the development of immune system function. Individuals affected by a high burden of adverse experiences may adopt compensatory high-risk behaviors that can further erode their health and mental health. Not all adversity occurs in childhood(eg,military combat),but a highburden of cumulative intrafamilial (child maltreatment, domestic violence, impaired caregiving) and other adversities (income and food insecurity) in childhood can have profound lifelong effects unless mitigated by protective factors within the family or the community, or through specific interventions. Two of the articles in this issue indicate that the impact of intrafamilial adverse childhood experiences (ACEs) on health and mental health begin to manifest in childhood. Kerker et al 2 used the nationally representative longitudinal National Survey of Child and Adolescent Well-Being study toassessthe ACEscoresofchildrenunder theageof6years who remained at home after child protective investigation and found they were similar to those of children who were removed and placed in foster/kinship care. The authors also reported that higher ACE scores in this population were associated with more mental health (Child Behavior Checklist score >64) and chronic medical problems, and, for preschool children, lower social scores. Earlier studies of children informally placed with kinship caregivers after child welfare investigation showed a high prevalence of health problems, although fewer mental health problems, compared to children in nonrelative foster care, indicating that almost all children involved with child welfare are at high risk for poor outcomes that may be rooted in cumulative childhood trauma. 3 In a second article in this issue, Thompson et al 4 used LONGSCAN longitudinal data to",0,0 +4486,Modulation of stress by imidazoline binding sites: Implications for psychiatric disorders,"In this review, we present evidence for the involvement of imidazoline binding sites (IBS) in modulating responses to stress, through central control of monoaminergic and hypothalamo-pituitary-adrenal (HPA) axis activity. Pharmacological and physiological evidence is presented for differential effects of different IBS subtypes on serotoninergic and catecholaminergic pathways involved in control of basal and stress-stimulated HPA axis activity. IBS ligands can modulate behavioural and neuroendocrine responses in animal models of stress, depression and anxiety, and a body of evidence exists for alterations in central IBS expression in psychiatric patients, which can be normalised partially or fully by treatment with antidepressants. Dysfunction in monoaminergic systems and the HPA axis under basal and stress-induced activation has been extensively reported in psychiatric illnesses. On the basis of the literature, we suggest a potential therapeutic role for selective IBS ligands in the treatment of depression and anxiety disorders.",0,0 +4487,Factor structure of PTSD symptoms in opioid-dependent patients rating their overall trauma history,"The current standard for posttraumatic stress disorder (PTSD) diagnosis is a 3-factor model (re-experiencing, avoidance, and hyperarousal). Two 4-factor models of PTSD, the emotional numbing model (re-experiencing, avoidance, emotional numbing, and hyperarousal) and the dysphoria model (re-experiencing, avoidance, dysphoria, and hyperarousal), have considerable empirical support in the extant literature. However, a newer 5-factor model of PTSD has been introduced that is receiving interest. The 5-factor model differs from the four-factor models in its placement of three symptoms (irritability, sleep disturbance, and concentration difficulties) into a separate cluster termed dysphoric arousal. We empirically compared the theoretical factor structures of 3-, 4-, and 5-factor models of PTSD symptoms to find the best fitting model in a sample of opioid-dependent hospitalized patients.Confirmatory factor analyses were conducted on the 17 self-reported PTSD symptoms of the Posttraumatic Checklist - Civilian Version (PCL-C) in a sample of 151 men and women with opioid dependence.Both four-factor models fit the observed data better than the three-factor model of PTSD; the dysphoria model was preferred to the emotional numbing model in this sample. The recently introduced five-factor model fit the observed data better than either four factor model.PTSD is a heterogeneous disorder comprised of symptoms of re-experiencing, avoidance, numbing, and dysphoria. Three symptoms, irritability, sleep disturbance, and concentration difficulties, may represent a unique latent construct separate from these four symptom clusters in opioid-dependent populations who have experienced traumatic events.",0,0 +4488,A Longitudinal Examination of Overgeneral Memory and Psychopathology in Children Following Recent Trauma Exposure,"Summary This study represents the first longitudinal examination of the trajectory of overgeneral memory (OGM) in children and how this relates to psychopathology immediately after trauma exposure. We recruited fifty 7- to 17-year-olds who had experienced an accidental injury that resulted in hospital admission. Assessment of psychological symptoms, OGM and cognitive processes proposed to drive OGM was completed at three points over a 6-month period post-trauma. We found that OGM was not related to depressive symptoms and that time since trauma exposure moderated the relationship between post-traumatic stress disorder symptoms and OGM. Although no relationship was found in the first 3 months following trauma, OGM was protective against post-traumatic stress disorder symptoms at 6 months post-trauma. Despite models of OGM (e.g. Williams et al., 2007) emphasising the role of rumination and executive control in explaining OGM, we found no evidence that they were related to OGM. Copyright © 2014 John Wiley & Sons, Ltd.",0,0 +4489,Using Mental Health Indicators to Identify Postdisaster Gender-Based Violence among Women Displaced by Hurricane Katrina,"Assessment of gender-based violence (GBV) among internally displaced persons (IDPs) is at best difficult. In complex humanitarian disasters, GBV inquiry can sometimes be dangerous and may lead to underestimation of the true prevalence. We developed a method of identifying women who have greater odds of having been exposed to postdisaster GBV (PDGBV) using mental health indicators.We systematically random sampled IDPs living in travel trailer parks in Louisiana and Mississippi and interviewed respondents using a health needs assessment survey during an 8-week period in April and May 2006. Women (n = 194) were screened for GBV and symptoms of depression.Women were on average 43.3 years old (range 18-85). Of the nine symptoms assessed with the Patient Health Questionnaire-9 (PHQ-9), four were associated with PDGBV. Among women with sleep dysregulation, the odds of PDGBV were 2.5 times higher in comparison with women without sleep dysregulation (95% CI 1.2-5.1). Appetite dysregulation increased the odds by 3.8 (95% CI 1.4-10.3), low self-esteem increased the odds by 2.3 (95% CI 1.2-4.6), and suicidal ideation increased the odds by 2.7 (95% CI 1.1-6.7). The internal consistency reliability of this symptom cluster was higher among women with PDGBV. Women screening positive on all four symptoms were 2.7 times more likely to have experienced PDGBV (95% CI 1.03-7.1).Several but not all symptoms of depression indicated exposure to PDGBV. Sleeping dysregulation, appetite dysregulation, low self-esteem, and suicidal ideation should be considered secondary indicators useful for identifying the prevalence of PDGBV exposure among female IDPs. This model may be useful for identifying women with exposure to PDGBV in settings where direct questioning may not be safe and reliable.",0,0 +4490,Post-traumatic stress disorder moderates the relation between documented childhood victimization and pain 30 years later,"Cross-sectional designs and self-reports of maltreatment characterize nearly all the literature on childhood abuse or neglect and pain in adulthood, limiting potential for causal inference. The current study describes a prospective follow up of a large cohort of individuals with court-documented early childhood abuse or neglect (n=458) and a demographically matched control sample (n=349) into middle adulthood (mean age 41), nearly 30 years later, comparing the groups for risk of adult pain complaints. We examine whether Post-Traumatic Stress Disorder (PTSD) mediates or moderates risk of pain. Assessed prospectively across multiple pain measures, physically and sexually abused and neglected individuals generally showed a significant (p<.05) but notably small (η(2)=.01) increased risk of pain symptoms in middle adulthood. Although PTSD was associated with both childhood victimization (p<.01) and risk of middle adulthood pain (p<.001), it did not appear to mediate the relationship between victimization and pain. However, across all pain outcomes other than medically unexplained pain, PTSD robustly interacted with documented childhood victimization to predict adult pain risk: Individuals with both childhood abuse/neglect and PTSD were at significantly increased risk (p<.001, η(2) generally=.05-.06) of pain. After accounting for the combined effect of the two factors, neither childhood victimization nor PTSD alone predicted pain risk. Findings support a view that clinical pain assessments should focus on PTSD rather than make broad inquiries into past history of childhood abuse or neglect.",0,0 +4491,"[Influence of educational status, burn area and coping behaviors on the complication of psychological disorders in severely burned patients].","To discuss how the educational status, burn area and coping behaviors influence the psychological disorders in severely burned patients.Sixty-four severely burned patients hospitalized in Guangzhou Red Cross Hospital, Guangdong Provincial Work Injury Rehabilitation Center, and Guangdong General Hospital were enrolled with cluster random sampling method. Data of their demography and situation of burns were collected. Then their coping behavior, psychological disorders including anxiety, depression and post-traumatic stress disorder (PTSD) plus its core symptoms of flashback, avoidance, and hypervigilance were assessed by medical coping modes questionnaire, self-rating anxiety scale (SAS), self-rating depression scale (SDS), PTSD checklist-civilian version (PCL-C) respectively. Correlation was analyzed between demography, burn area, coping behavior and psychological disorders. The predictive powers of educational status, burn area and coping behaviors on the psychological disorders were analyzed. The qualitative variables were assigned values. Data were processed with t test, Spearman rank correlation analysis, and multiple linear regression analysis.(1) The patients scored (19.0 ± 3.4) points in confrontation coping behavior, which showed no statistically significant difference from the domestic norm score (19.5 ± 3.8) points (t = -1.13, P > 0.05). The patients scored (16.6 ± 2.4) and (11.0 ± 2.2) points in avoidance and resignation coping behaviors, which were significantly higher than the domestic norm score (14.4 ± 3.0), (8.8 ± 3.2) points (with t values respectively 7.06 and 7.76, P values both below 0.01). The patients' standard score of SAS, SDS, PCL-C were (50 ± 11), (54 ± 11), and (38 ± 12) points. Respectively 89.1% (57/64), 60.9% (39/64), 46.9% (30/64) of the patients showed anxiety, depression, and PTSD symptoms. (2) Four independent variables: age, gender, marital status, and time after burns, were correlated with the psychological disorders, but the correlativity was not statistically significant (with rs values from -0.089 to 0.245, P values all above 0.05). Educational status was significantly negatively correlated with anxiety, depression, PTSD and its core symptoms of flashback, avoidance (with rs values from -0.361 to -0.253, P values all below 0.05). Educational status was negatively correlated with hypervigilance, but the correlativity was not statistically significant (rs = -0.187, P > 0.05). Burn area was significantly positively correlated with the psychological disorders (with rs values from 0.306 to 0.478, P values all below 0.05). Confrontation coping behavior was positively correlated with the psychological disorders, but the correlativity was not statistically significant (with rs values from 0.121 to 0.550, P values all above 0.05). Avoidance coping behavior was correlated with the psychological disorders, but the correlativity was not statistically significant (with rs values from -0.144 to 0.193, P values all above 0.05). Resignation coping behavior was significantly positively correlated with the psychological disorder (with rs values from 0.377 to 0.596, P values all below 0.01). (3) Educational status had predictive power on the anxiety, PTSD and flash back symptoms of patients (with t values from -2.19 to -2.02, P values all below 0.05), but not on depression, avoidance and hypervigilance (with t values from -1.95 to -0.99, P values all above 0.05). Burn area had no predictive power on the psychological disorders (with t values from 0.55 to 1.78, P values all above 0.05). Resignation coping behavior had predictive power on the psychological disorders (with t values from 3.10 to 6.46, P values below 0.01). Confrontation and avoidance coping behaviors had no predictive power on the psychological disorders (with t values from 0.46 to 2.32 and -0.89 and 1.75 respectively, P values all above 0.05).The severely burned patients with lower educational status, larger burn area, and the more frequently adapted resignation coping behavior are more likely to suffer from anxiety, depression, and PTSD.",0,0 +4492,Quantitative forecasting of PTSD from early trauma responses: A Machine Learning application,"There is broad interest in predicting the clinical course of mental disorders from early, multimodal clinical and biological information. Current computational models, however, constitute a significant barrier to realizing this goal. The early identification of trauma survivors at risk of post-traumatic stress disorder (PTSD) is plausible given the disorder's salient onset and the abundance of putative biological and clinical risk indicators. This work evaluates the ability of Machine Learning (ML) forecasting approaches to identify and integrate a panel of unique predictive characteristics and determine their accuracy in forecasting non-remitting PTSD from information collected within 10 days of a traumatic event. Data on event characteristics, emergency department observations, and early symptoms were collected in 957 trauma survivors, followed for fifteen months. An ML feature selection algorithm identified a set of predictors that rendered all others redundant. Support Vector Machines (SVMs) as well as other ML classification algorithms were used to evaluate the forecasting accuracy of i) ML selected features, ii) all available features without selection, and iii) Acute Stress Disorder (ASD) symptoms alone. SVM also compared the prediction of a) PTSD diagnostic status at 15 months to b) posterior probability of membership in an empirically derived non-remitting PTSD symptom trajectory. Results are expressed as mean Area Under Receiver Operating Characteristics Curve (AUC). The feature selection algorithm identified 16 predictors, present in ≥ 95% cross-validation trials. The accuracy of predicting non-remitting PTSD from that set (AUC = .77) did not differ from predicting from all available information (AUC = .78). Predicting from ASD symptoms was not better then chance (AUC = .60). The prediction of PTSD status was less accurate than that of membership in a non-remitting trajectory (AUC = .71). ML methods may fill a critical gap in forecasting PTSD. The ability to identify and integrate unique risk indicators makes this a promising approach for developing algorithms that infer probabilistic risk of chronic posttraumatic stress psychopathology based on complex sources of biological, psychological, and social information.",0,0 +4493,"Traumatic Stress in Overview: Definition, Context, Scope, and Long-Term Outcomes","Trauma in the form of natural disasters, war, and other catastrophic events is ubiquitous. Exposure to traumatic events has been recognized as part of the human experience and has the potential to impact subsequent development across the life span, although individual responses to trauma vary widely. In this chapter, we discuss common sources of trauma and their long-term impacts from the perspective of conservation of resources (COR) theory. In brief, COR theory posits that traumatic stress is a dynamic psychological process that occurs in response to the rapid and often momentous loss of key valued resources. COR theory corollaries include the notions that loss is developmental and tends to occur in negative spirals, the impact of loss outweighs the positive impact of gain, and individuals with fewer reserves of resources are more sensitive to loss and gain (Hobfoll, Stress, culture, and community: The psychology and philosophy of stress, 2004). Common reactions to trauma such as posttraumatic stress disorder (PTSD) are introduced with an emphasis on how reactions unfold over time. Moreover, these reactions interact with the broader social context to produce cycles of loss observed at the individual, community, and cultural levels.",0,0 +4494,Stress and Disease: Is Being Female a Predisposing Factor?,"Does heightened stress sensitivity predispose an individual toward disease? Our Society for Neuroscience mini-symposium examines the link between stress and disease onset, exploring sex differences and whether there is an increased female predisposition. This session specifically addresses the",0,0 +4495,Protective factors for posttraumatic stress disorder symptoms in a prospective study of police officers,"Although police officers are frequently exposed to potentially traumatic incidents, only a minority will develop chronic posttraumatic stress disorder (PTSD). Identifying and understanding protective factors could inform the development of preventive interventions; however, few studies have examined this. In the present prospective study, 233 police officers were assessed during academy training and again following 2 years of police service. Caucasian race, less previous trauma exposure, and less critical incident exposure during police service as well as greater sense of self-worth, beliefs of greater benevolence of the world, greater social support and better social adjustment, all assessed during academy training, were associated with lower PTSD symptoms after 2 years of service. Positive personality attributes assessed during training with the NEO Five-Factor Personality Inventory were not associated with lower PTSD symptoms. In a hierarchical linear regression model, only Caucasian race, lower critical incident exposure during police service, greater assumptions of benevolence of the world and better social adjustment during training remained predictive of lower PTSD symptoms after 2 years of police service. These results suggest that positive world assumptions and better social functioning during training may protect police officers from critical incident related PTSD.",0,0 +4496,Intervening With Immigrant Families: An Integrative Systems Perspective,"Give me your tired, your poor,Your huddled masses yearning to breathe free.The wretched refuse of your teeming shore.Send these, the homeless, tempest-tossed to me.I lift my lamp beside the golden door!(Emma Lazarus, New Colossus, 1883; embossed on the plaque mounted inside the pedestal of the Statue of Liberty)One of the massive trends affecting a myriad of families that has accelerated around the world in the past three and a half decades is immigration—with scores of people leaving their homelands to move to countries they hope will be safer and provide a less turbulent environment in which to reside and raise their families. Such families often encounter enormous problems in their new and sometimes ethnocentric, uninviting, even to the point of hostile environments. In this article, some of the problems and issues encountered and ways therapists can enhance client families’ understanding of their situation, their feelings about it, and how better to cope and problem solve will be explored from an inte...",0,0 +4497,Longitudinal Analysis of Latent Classes of Psychopathology and Patterns of Class Migration in Survivors of Severe Injury,"Little research to date has explored the typologies of psychopathology following trauma, beyond development of particular diagnoses such as posttraumatic stress disorder (PTSD). The objective of this study was to determine the longitudinal patterns of these typologies, especially the movement of persons across clusters of psychopathology.In this 6-year longitudinal study, 1,167 hospitalized severe injury patients who were recruited between April 2004-February 2006 were analyzed, with repeated measures at baseline, 3 months, 12 months, and 72 months after injury. All patients met the DSM-IV criterion A1 for PTSD. Structured clinical interviews were used to assess psychiatric disorders at each follow-up point. Latent class analysis and latent transition analysis were applied to assess clusters of individuals determined by psychopathology. The Mini International Neuropsychiatric Interview (MINI) and Clinician-Administered PTSD Scale (CAPS) were employed to complete diagnoses.Four latent classes were identified at each time point: (1) Alcohol/Depression class (3 months, 2.1%; 12 months, 1.3%; and 72 months, 1.1%), (2) Alcohol class (3 months, 3.3%; 12 months, 3.7%; and 72 months, 5.4%), (3) PTSD/Depression class (3 months, 10.3%; 12 months, 11.5%; and 72 months, 6.4%), and (4) No Disorder class (3 months, 84.2%; 12 months, 83.5%; and 72 months, 87.1%). Latent transition analyses conducted across the 2 transition points (12 months and 72 months) found consistently high levels of stability in the No Disorder class (90.9%, 93.0%, respectively) but lower and reducing levels of consistency in the PTSD/Depression class (81.3%, 46.6%), the Alcohol/Depression class (59.7%, 21.5%), and the Alcohol class (61.0%, 36.5%), demonstrating high levels of between-class migration.Despite the array of psychiatric disorders that may develop following severe injury, a 4-class model best described the data with excellent classification certainty. The high levels of migration across classes indicate a complex pattern of psychopathology expression over time. The findings have considerable implications for tailoring multifocused interventions to class type, as well as flexible stepped care models, and for the potential development and delivery of transdiagnostic interventions targeting underlying mechanisms.",0,0 +4498,Does injury compensation lead to worse health after whiplash? A systematic review,"One might expect that injury would leave injured parties better off than they would otherwise have been, yet many believe that does more harm than good. This study systematically reviews the evidence on this compensation hypothesis in relation to compensable whiplash injuries. PubMed, CINAHL, EMBASE, PEDro, PsycInfo, CCTR, Lexis, and EconLit were searched from the date of their inception to April 2010 to locate longitudinal studies, published in English, comparing the health outcomes of adults exposed/not exposed to compensation-related factors. Studies concerning serious neck injuries, using claimants only, or using proxy measures of health outcomes were excluded. Eleven studies were included. These examined the effect of lawyer involvement, litigation, claim submission, or previous claims on pain and other health outcomes. Among the 16 results reported were 9 statistically significant negative associations between compensation-related factors and health outcomes. Irrespective of the compensation-related factor involved and the health outcome measured, the quality of these studies was similar to studies that did not find a significant negative association: most took some measures to address selection bias, confounding, and measurement bias, and none resolved the potential for reverse causality bias that arises in the relationship between compensation-related factors and health. Unless ambiguous causal pathways are addressed, one cannot draw conclusions from statistical associations, regardless of their statistical significance and the extent of measures to address other sources of bias. Consequently, there is no clear evidence to support the idea that and its related processes lead to worse health.",0,0 +4499,INTEGRATIVE ASSESSMENT OF BRAIN AND COGNITIVE FUNCTION IN POST-TRAUMATIC STRESS DISORDER,"The present study combined neuropsychological and electrophysiological measures to obtain a comprehensive profile of the everyday attentional and memory dysfunction reported in PTSD. The event-related potential (ERP) literature has consistently found abnormalities in late components (N2, P3) reflecting working memory (WM) function. However, the neuropsychological profile reported in the literature has considerable variation. The present study examined ERP activity in 33 PTSD participants and matched controls during a standard two-tone auditory oddball task. Neuropsychological assessment was carried out using a task battery assessing a wide range of cognitive functions. Consistent with previous work, the PTSD group showed delayed N2 latency and reduced P3 target amplitude, together with slower and less accurate target detection. Scalp topography provided evidence of widespread abnormality during WM function, but with strongest effects broadly over the left hemisphere. Neuropsychological testing found concomitant difficulties on factorial measures of verbal memory retention/access and sustained attention but enhanced performance on measures of immediate recall. This integrative pattern of effects reflects a specific impairment in the operation of working memory systems that guide ongoing, planned behavior and that facilitate the acquisition and retention of new memories.",0,0 +4500,HIV infection associated post-traumatic stress disorder and post-traumatic growth – A systematic review,"The phenomenon of post-traumatic stress has been well documented in the literature as a lasting mental health condition associated with exposure to traumatic life events. The diagnosis and experience of human immunodeficiency virus (HIV) disease may be such a trauma. On the other hand, the phenomenon of post-traumatic growth (PTG) has been described, whereby people show positive mental health growth in the face of such trauma. This systematic review was set out to explore post-traumatic stress disorder (PTSD) and PTG in people with HIV to monitor prevalence, measurement and efficacy of interventions to reduce stress and/or promote growth. Standardised review techniques were used to track reports on both PTSD and PTG. A total of 206 papers were retrieved from the PTSD and HIV searches, and 13 from the PTG and HIV searches. After reviewing the papers for inclusion according to adequacy and relevance criteria and to remove duplicates, 33 PTSD papers and three PTG were available for full coding. Prevalence of PTSD in HIV ranged from 5% to 74%, which were much greater than the 7-10% in the general population. Seven studies showed a relation between trauma and PTSD, while six showed a link between PTSD diagnosis and reduced antiretroviral treatment adherence. Women were more likely to be diagnosed with PTSD. Only three intervention reports were identified that fitted our inclusion criteria. All of these reported on psychological interventions for HIV+ individuals with trauma. The interventions utilised HIV education, training in coping techniques and support groups. Only coping interventions were shown to be effective. PTG was under researched but showed a promising avenue of study. There needs to be harmonised measurement and the evidence base would need strengthening in order to build on the understanding of the impact of PTSD and PTG over the course of HIV disease. There is good evidence to associate HIV diagnosis and experiences during the course of illness as traumatic. PTSD has been shown to be prevalent and there seems to be good evidence to incorporate standardised measures to track the course of the disorder. There is extremely limited evidence that interventions may affect the course of symptom experience. The evidence and insight into PTG show promise but is currently inadequate.",0,0 +4501,A Prospective Longitudinal Study of Posttraumatic Stress Disorder Symptom Trajectories After Burn Injury,"Psychologic problems are common after burns, and symptoms of posttraumatic stress disorder (PTSD) are some of the most prevalent. Risk factors for PTSD have been identified, but little is known about the onset and course of these symptoms. The objective was to investigate whether there are different PTSD symptom trajectories after burns.Ninety-five adults with burns were enrolled in a prospective study from in-hospital treatment until 12 months after burn. Symptoms of PTSD were assessed with the Impact of Event Scale-Revised and scores at 3, 6, and 12 months after the burn were used in a cluster analysis to detect trajectories. The trajectories were compared regarding known risk factors for PTSD using non-parametric analysis of variance.Four clusters were identified: (1) resilient, with low levels of PTSD symptoms that decreased over time; (2) recovery, with high levels of symptoms that gradually decreased; (3) delayed, with moderate symptoms that increased over time; and (4) chronic, with high levels of symptoms over time. The trajectories differed regarding several risk factors for PTSD including life events, premorbid psychiatric morbidity, personality traits, avoidant coping, in-hospital psychologic symptoms, and social support. The resilient trajectory consistently had fewer of the risk factors and differed the most from the chronic trajectory.There are subgroups among patients with burns that have different patterns of PTSD symptom development. These findings may have implications for clinical practice, such as the timing of assessment and the management of patients who present with these symptoms.",0,0 +4502,Amygdala response predicts trajectory of symptom reduction during Trauma-Focused Cognitive-Behavioral Therapy among adolescent girls with PTSD,"Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is the gold standard treatment for pediatric PTSD. Nonetheless, clinical outcomes in TF-CBT are highly variable, indicating a need to identify reliable predictors that allow forecasting treatment response. Here, we test the hypothesis that functional neuroimaging correlates of emotion processing predict PTSD symptom reduction during Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) among adolescent girls with PTSD. Thirty-four adolescent girls with PTSD related to physical or sexual assault were enrolled in TF-CBT, delivered in an approximately 12 session format, in an open trial. Prior to treatment, they were engaged in an implicit threat processing task during 3T fMRI, during which they viewed faces depicting fearful or neutral expressions. Among adolescent girls completing TF-CBT (n = 23), slopes of PTSD symptom trajectories during TF-CBT were significantly related to pre-treatment degree of bilateral amygdala activation while viewing fearful vs neutral images. Adolescents with less symptom reduction were characterized by greater amygdala activation to both threat and neutral images (i.e., less threat-safety discrimination), whereas adolescents with greater symptom reduction were characterized by amygdala activation only to threat images. These clinical outcome relationships with pre-treatment bilateral amygdala activation remained when controlling for possible confounding demographic or clinical variables (e.g., concurrent psychotropic medication, comorbid diagnoses). While limited by a lack of a control group, these preliminary results suggest that pre-treatment amygdala reactivity to fear stimuli, a component of neurocircuitry models of PTSD, positively predicts symptom reduction during TF-CBT among assaulted adolescent girls, providing support for an objective measure for forecasting treatment response in this vulnerable population.",0,0 +4503,Mental Health Problems in Juvenile Justice Populations,"The limited literature on mental health problems in juvenile justice population has reported that most youth in juvenile justice hold psychiatric pathology. Although conduct disorder and substance abuse are the most prevalent conditions in this population, many other diagnoses can be found at alarmingly high rates; research on other diagnoses (eg, autism, psychosis) is limited. This finding underscores the necessity of implementing adequate diagnostic assessment within forensic settings and of developing interventions programs that take into account the presence of psychiatric problems.",0,0 +4504,Factors associated with post-traumatic stress disorder and depression amongst internally displaced persons in northern Uganda,"The 20 year war in northern Uganda between the Lord's Resistance Army and the Ugandan government has resulted in the displacement of up to 2 million people within Uganda. The purpose of the study was to measure rates of post-traumatic stress disorder (PTSD) and depression amongst these internally displaced persons (IDPs), and investigate associated demographic and trauma exposure risk factors.A cross-sectional multi-staged, random cluster survey with 1210 adult IDPs was conducted in November 2006 in Gulu and Amuru districts of northern Uganda. Levels of exposure to traumatic events and PTSD were measured using the Harvard Trauma Questionnaire (original version), and levels of depression were measured using the Hopkins Symptom Checklist-25. Multivariate logistic regression was used to analyse the association of demographic and trauma exposure variables on the outcomes of PTSD and depression.Over half (54%) of the respondents met symptom criteria for PTSD, and over two thirds (67%) of respondents met symptom criteria for depression. Over half (58%) of respondents had experienced 8 or more of the 16 trauma events covered in the questionnaire. Factors strongly linked with PTSD and depression included gender, marital status, distance of displacement, experiencing ill health without medical care, experiencing rape or sexual abuse, experiencing lack of food or water, and experiencing higher rates of trauma exposure.This study provides evidence of exposure to traumatic events and deprivation of essential goods and services suffered by IDPs, and the resultant effect this has upon their mental health. Protection and social and psychological assistance are urgently required to help IDPs in northern Uganda re-build their lives.",0,0 +4505,A confirmatory factor analysis of the acute stress disorder interview,"Acute stress disorder (ASD) was introduced in 1994 to describe posttraumatic stress reactions that occur in the initial month after trauma exposure. Although it comprises the distinct symptom clusters of dissociation, reexperiencing, avoidance, and arousal, there have been no confirmatory factor analyses of the construct. In this study, 587 individuals admitted to five major hospitals after traumatic injury were administered the Acute Stress Disorder Interview. Forty-four participants met criteria for ASD. Confirmatory factor analysis based on the four symptom clusters described the Acute Stress Disorder Interview responses. These data provide the first confirmatory factor analysis of the ASD symptoms, and are discussed in terms of the 4-factor models repeatedly found in samples of chronic posttraumatic stress disorder.",0,0 +4506,Combat-Exposed War Veterans at Risk for Suicide Show Hyperactivation of Prefrontal Cortex and Anterior Cingulate During Error Processing,"Suicide is a significant public health problem. Suicidal ideation (SI) increases the risk for completed suicide. However, the brain basis of SI is unknown. The objective of this study was to examine the neural correlates of self-monitoring in individuals at risk for suicide. We hypothesized that combat veterans with a history of SI relative to those without such a history would show altered activation in the anterior cingulate cortex and related circuitry during self-monitoring.Two groups of combat-exposed war veterans (13 men with and 13 men without history of SI) were studied. Both the SI and non-SI participants had two or more of the following: a) current major depressive disorder, b) current posttraumatic stress disorder, and c) history of mild traumatic brain injury, and each subject performed a validated stop task during functional magnetic resonance imaging. Error-related activation was compared between the SI and non-SI groups.The SI group demonstrated more error-related activation of the anterior cingulate (8256 mm(3), t = 2.51) and prefrontal cortex (i.e., clusters >2048 mm(3), voxelwise p < .05). The SI and non-SI participants showed similar behavioral task performance (i.e., mean error rate, F values < 0.63, p values > .43; and mean reaction times, F = 0.27, p = .61).These findings suggest neural correlates of altered self-monitoring in individuals with a history of SI and may further suggest that functional magnetic resonance imaging could be used to identify individuals at risk for suicide before they engage in suicidal behavior.",0,0 +4507,The study of intensity and frequency of posttraumatic stress disorder (PTSD) resulting from war in Ilam city,"Post-traumatic stress disorder (PTSD) is a set of a person's reactions to stresses which are beyond one's mental capacity and precedes a severe stress. The aim of this Research was to study the intensity and frequency of posttraumatic stress disorder (PTSD) resulting from war in Ilam city. This descriptive- analytic study was investigated the PTSD among the residents of Ilam city who were involved directly or indirectly in the war issues. The sample size was 5110 people chosen through cluster sampling technique. Data were analyzed through statistical methods such as K2 test, t-test, linear regression test, and variance analysis in SPSS software. The results of the study revealed that 26 of the cases who had residence background in Ilam city during Iraqi war against Iran suffered from mental disorder (PTSD). Most of these patients were married, illiterate, or primary educated people and mostly the young and middle aged housewives. The war-induced posttraumatic stress disorder has had negative effects on different aspects of Ilam city residents' health. Therefore, identifying the vulnerable groups to apply medical treatment seemed important and necessary.",0,0 +4508,Predictors of Posttraumatic Stress Symptom Trajectories in Parents of Children Exposed to Motor Vehicle Collisions,"Following child trauma, parents are at risk of developing posttraumatic stress disorder (PTSD), either owing to their direct involvement or from hearing of their child's involvement. Despite the potential impact of a parent's development of PTSD on both the parent and child, little is known about what may place a parent at increased risk.PTSD symptoms were assessed ≤ 4 weeks, 6 months, and 3 years post-trauma, along with a range of potential risk factors, in a sample of parents of 2-10-year-old children who were involved in a motor vehicle collision.Two symptom trajectories were identified: Those parents whose symptoms remained low across all time points and those whose symptoms remained elevated at 6 months post-trauma and declined by 3 years. Subjective threat, thought suppression, and maladaptive cognitions about damage to the child were identified as key predictors of poorer outcomes.",1,0 +4509,Impact of Event Scale: psychometric properties,"Background For more than 20 years, the Impact of Event Scale (IES) has been widely used as a measure of stress reactions after traumatic events. Aims To review studies that evaluated the IES's psychometric properties. Method Literature review. Results The results indicated that the IES's two-factor structure is stable over different types of events, that it can discriminate between stress reactions at different times after the event, and that it has convergent validity with observer-diagnosed post-traumatic stress disorder. The use of IES in many psychopharmacological trials and outcome studies is supportive of the measure's clinical relevance. Conclusions The IES is a useful measure of stress reactions after a range of traumatic events, and it is valuable for detecting individuals who require treatment.",0,0 +4510,Psychophysiologic assessment of mental imagery of stressful events in israeli civilian posttraumatic stress disorder patients,"This study explored the physiological responses of posttraumatic stress disorder (PTSD) patients to reminders of a stressful event that had preceded the onset of their illness and was not related to its cause: the SCUD missile alarms of the Gulf War. A mental-imagery technique used in previous studies of PTSD was used. Three 30-second audiotapes were presented to each subject, including (1) the Gulf War's missile alarm, (2) a radio announcement of a terrorist attack, and (3) a standardized relaxing scene. Subjects were instructed to imagine each event as vividly as possible while heart rate (HR), skin conductance (SC), and left lateral frontalis electromyogram (EMG) responses were measured. The responses of 12 outpatients with PTSD were compared with those of panic disorder patients (n = 11), survivors of traumatic events who had not developed PTSD (n = 9), and mentally healthy subjects with no lifetime history of major trauma (n = 19). Multivariate analysis of variance (MANOVA) for the three physiological measures showed a significant group difference during imagery of the Gulf War alarm, with PTSD subjects showing higher SC and EMG responses than the others. The differences remained significant when age, level of distress during the war, and concurrent anxiety were controlled for. There were no group differences in responses to the other stimuli. We conclude that, PTSD patients may either acquire and maintain prolonged conditioned responses to various stressors during their life span or become sensitized to reminders of past traumata following the onset of their illness. Heightened conditionability may be expressed before the trauma in subjects who are liable to develop PTSD.",0,0 +4511,A Multisite Analysis of the Fluctuating Course of Posttraumatic Stress Disorder,"Delayed-onset posttraumatic stress disorder (PTSD) accounts for approximately 25% of PTSD cases. Current models do not adequately explain the delayed increases in PTSD symptoms after trauma exposure.To test the roles of initial psychiatric reactions, mild traumatic brain injury (MTBI), and ongoing stressors on delayed-onset PTSD.In this prospective cohort study, patients were selected from recent admissions to 4 major trauma hospitals across Australia. A total of 1084 traumatically injured patients were assessed during hospital admission from April 1, 2004, through February 28, 2006, and 785 (72.4%) were followed up at 3, 12, and 24 months after injury.Severity of PTSD was determined at each assessment with the Clinician-Administered PTSD Scale.Of those who met PTSD criteria at 24 months, 44.1% reported no PTSD at 3 months and 55.9% had subsyndromal or full PTSD. In those who displayed subsyndromal or full PTSD at 3 months, PTSD severity at 24 months was predicted by prior psychiatric disorder, initial PTSD symptom severity, and type of injury. In those who displayed no PTSD at 3 months, PTSD severity at 24 months was predicted by initial PTSD symptom severity, MTBI, length of hospitalization, and the number of stressful events experienced between 3 and 24 months.These data highlight the complex trajectories of PTSD symptoms over time. This study also points to the roles of ongoing stress and MTBI in delayed cases of PTSD and suggests the potential of ongoing stress to compound initial stress reactions and lead to a delayed increase in PTSD symptom severity. This study also provides initial evidence that MTBI increases the risk of delayed PTSD symptoms, particularly in those with no acute symptoms.",0,0 +4512,Posttraumatic Growth in Adolescent Survivors of Cancer and Their Mothers and Fathers,"To describe posttraumatic growth (PTG) following childhood cancer survival and its association with demographic and disease/treatment variables, perceived treatment severity and life threat, and posttraumatic stress symptoms (PTSS).Adolescent survivors of cancer (N = 150, ages 11-19), at least 1 year after treatment, and their mothers (N = 146) and fathers (N = 107) completed self-report measures of perceived treatment intensity and PTSS and a semistructured interview designed to identify posttraumatic responses and indicators of PTG including perceived positive changes for self, relationships, and life goals.A majority of adolescents and their mothers and fathers reported PTG. Greater perceived treatment severity and life threat, but not objective disease severity, was associated with PTG. PTG and PTSS were positively associated for the adolescent cancer survivors. Diagnosis after age 5 resulted in more perceived benefit and greater PTSS for adolescent survivors.Clarification of the concept and measurement of PTG after childhood cancer is warranted, as are prospective studies of the association of PTG and PTSS and the role of demographic variables and illness-specific appraisals.",0,0 +4513,Posttraumatic stress disorder and intimate relationship problems: A meta-analysis.,"The authors conducted a meta-analysis of empirical studies investigating associations between indices of posttraumatic stress disorder (PTSD) and intimate relationship problems to empirically synthesize this literature.A literature search using PsycINFO, Medline, Published International Literature on Traumatic Stress (PILOTS), and Dissertation Abstracts was performed. The authors identified 31 studies meeting inclusion criteria.True score correlations (ρ) revealed medium-sized associations between PTSD and intimate relationship discord (ρ = .38, N = 7,973, K = 21), intimate relationship physical aggression perpetration (ρ = .42, N = 4,630, K = 19), and intimate relationship psychological aggression perpetration (ρ = .36, N = 1,501, K = 10). The strength of the association between PTSD and relationship discord was higher in military (vs. civilian) samples, and when the study was conducted in the United States (vs. other country), and the study represented a doctoral dissertation (vs. published article). The strength of the association between PTSD and physical aggression was higher in military (vs. civilian) samples, males (vs. females), community (vs. clinical) samples, studies examining PTSD symptom severity (vs. diagnosis), when the physical aggression measure focused exclusively on severe violence (vs. a more inclusive measure), and the study was published (vs. dissertation). For the PTSD-psychological aggression association, 98% of the variance was accounted for by methodological artifacts such as sampling and measurement error; consequently, no moderators were examined in this relationship.Findings highlight a need for the examination of models explaining the relationship difficulties associated with PTSD symptomatology and interventions designed to treat problems in both areas.",0,0 +4514,Analysis of suicidal behaviour in Israeli veterans and terror victims with post-traumatic stress disorder by using the computerised Gottschalk–Gleser scales,"Abstract The primary objective of this study was to identify the vulnerability factors for suicide attempts in an Israeli sample, with the help of the Gottschalk–Gleser content analysis scales. The respondents were divided into four groups: suicide attempters; controls; post-traumatic stress disorder and depressed patients who did not report suicidal behaviour; and suicide ideators. The significant results represent conscious and unconscious psychological states, which suicide attempters have in common and can be seen as potential suicide risk factors. The main recurring risk-related themes are hopelessness, sickness, deterrents, frustrated dependency strivings, total anxiety and total depression.",0,0 +4515,Applications of Latent Growth Mixture Modeling and allied methods to posttraumatic stress response data,"Scientific research into mental health outcomes following trauma is undergoing a revolution as scientists refocus their efforts to identify underlying dimensions of health and psychopathology. This effort is in stark contrast to the previous focus which was to characterize individuals based on Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic status (Insel et al., 2010). A significant unresolved issue underlying this shift is how to characterize clinically relevant populations without reliance on the categorical definitions provided by the DSM. Classifying individuals based on their pattern of stress adaptation over time holds significant promise for capturing inherent inter-individual heterogeneity as responses including chronicity, recovery, delayed onset, and resilience can only be determined longitudinally (Galatzer-Levy & Bryant, 2013) and then characterizing these patterns for future research (Depaoli, Van de Schoot, Van Loey, & Sijbrandij, 2015). Such an approach allows for the identification of phenominologically similar patterns of response to diverse extreme environmental stressors (Bonanno, Kennedy, Galatzer-Levy, Lude, & Elfstom, 2012; Galatzer-Levy & Bonanno, 2012; Galatzer-Levy, Brown, et al., 2013; Galatzer-Levy, Burton, & Bonanno, 2012) including translational animal models of stress adaptation (Galatzer-Levy, Bonanno, Bush, & LeDoux, 2013; Galatzer-Levy, Moscarello, et al., 2014). The empirical identification of heterogeneous stress response patterns can increase the identification of mechanisms (Galatzer-Levy, Steenkamp, et al., 2014), consequences (Galatzer-Levy & Bonanno, 2014), treatment effects (Galatzer-Levy, Ankri, et al., 2013), and prediction (Galatzer-Levy, Karstoft, Statnikov, & Shalev, 2014) of individual differences in response to trauma.METHODological and theoretical considerations for the application of Latent Growth Mixture Modeling (LGMM) and allied methods such as Latent Class Growth Analysis (LCGA) for the identification of heterogeneous populations defined by their pattern of change over time will be presented (Van De Schoot, 2015). Common pitfalls including non-identification, over identification, and issues related to model specification will be discussed as well as the benefits of applying such methods along with the theoretical grounding of such approaches.LGMM and allied methods have significant potential for improving the science of stress pathology as well as our understanding of healthy adaptation (resilience).",0,0 +4516,Abuse and Neglect in Childhood: Relationship to Personality Disorder Diagnoses,"Childhood history of abuse and neglect has been associated with personality disorders and has been observed in subjects with lifetime histories of suicidality and self-injury. Most of these findings have been generated from inpatient clinical samples.This study evaluated self-rated indices of sustained childhood abuse and neglect in an outpatient sample of well-characterized personality disorder subjects (n=182) to determine the relative associations of childhood trauma indices to specific personality disorder diagnoses or clusters and to lifetime history of suicide attempts or gestures. Subjects met criteria for ~2.5 Axis II diagnoses and 24% reported past suicide attempts. The Childhood Trauma Questionnaire was administered to assess five dimensions of childhood trauma exposure (emotional, physical, and sexual abuse, and emotional and physical neglect). Logistic regression was employed to evaluate salient predictors among the trauma measures for each cluster, personality disorder, and history of attempted suicide and self-harm. All analyses controlled for gender distribution.Seventy-eight percent of subjects met dichotomous criteria for some form of childhood trauma; a majority reported emotional abuse and neglect. The dichotomized criterion for global trauma severity was predictive of cluster B, borderline, and antisocial personality disorder diagnoses. Trauma scores were positively associated with cluster A, negatively with cluster C, but were not significantly associated with cluster B diagnoses. Among the specific diagnoses comprising cluster A, paranoid disorder alone was predicted by sexual, physical, and emotional abuse. Within cluster B, only antisocial personality disorder showed significant associations with trauma scores, with specific prediction by sexual and physical abuse. For borderline personality disorder, there were gender interactions for individual predictors, with emotional abuse being the only significant trauma predictor, and only in men. History of suicide gestures was associated with emotional abuse in the entire sample and in women only; self-mutilatory behavior was associated with emotional abuse in men.These results suggest that childhood emotional abuse and neglect are broadly represented among personality disorders, and associated with indices of clinical severity among patients with borderline personality disorder. Childhood sexual and physical abuse are highlighted as predictors of both paranoid and antisocial personality disorders. These results help qualify prior observations of the association of childhood sexual abuse with borderline personality disorder.",0,0 +4517,Postconcussive Symptoms and Posttraumatic Stress Disorder after Mild Traumatic Brain Injury,"Postconcussive symptoms after mild traumatic brain injury (MTBI) may be exacerbated by anxiety associated with posttraumatic stress. The aim of this study was to investigate the relationship between postconcussive symptoms and posttraumatic stress disorder (PTSD) in an MTBI population. Survivors of motor vehicle accidents who either sustained an MTBI (N = 46) or no TBI (N = 59) were assessed 6 months posttrauma for PTSD and postconcussive symptoms. Postconcussive symptoms were more evident in MTBI patients with PTSD than those without PTSD, and in MTBI patients than non-TBI patients. Further, postconcussive symptoms were significantly correlated with PTSD symptoms. These findings indicate that postconcussive symptoms may be mediated by an interaction of neurological and psychological factors after MTBI.",0,0 +4518,PTSD SYMPTOMS ACROSS PREGNANCY AND EARLY POSTPARTUM AMONG WOMEN WITH LIFETIME PTSD DIAGNOSIS,"Little is known about trajectories of PTSD symptoms across the peripartum period in women with trauma histories, specifically those who met lifetime PTSD diagnoses prior to pregnancy. The present study seeks to identify factors that influence PTSD symptom load across pregnancy and early postpartum, and study its impact on postpartum adaptation.The current study is a secondary analysis on pregnant women with a Lifetime PTSD diagnosis (N = 319) derived from a larger community sample who were interviewed twice across pregnancy (28 and 35 weeks) and again at 6 weeks postpartum, assessing socioeconomic risks, mental health, past and ongoing trauma exposure, and adaptation to postpartum.Using trajectory analysis, first we examined the natural course of PTSD symptoms based on patterns across peripartum, and found four distinct trajectory groups. Second, we explored factors (demographic, historical, and gestational) that shape the PTSD symptom trajectories, and examined the impact of trajectory membership on maternal postpartum adaptation. We found that child abuse history, demographic risk, and lifetime PTSD symptom count increased pregnancy-onset PTSD risk, whereas gestational PTSD symptom trajectory was best predicted by interim trauma and labor anxiety. Women with the greatest PTSD symptom rise during pregnancy were most likely to suffer postpartum depression and reported greatest bonding impairment with their infants at 6 weeks postpartum.Screening for modifiable risks (interpersonal trauma exposure and labor anxiety) and /or PTSD symptom load during pregnancy appears critical to promote maternal wellbeing.",0,0 +4519,"Gender, victimization, and outcomes: Reconceptualizing risk.","Large-scale studies of gender differences in psychopathological reactions to victimization have focused on posttraumatic stress disorder, overlooking other trauma-related disorders. The present study expands this literature with a contextualized examination of interpersonal aggression exposure and sequelae. Using k-means cluster analysis on a sample of 16,000, the authors identified 8 distinct profiles of exposure to sexual violence, physical assault, stalking, and emotional abuse. Analyses of covariance then suggested links among victimization profile, gender, and mental and physical health. Results revealed no meaningful interactive effects of gender and interpersonal aggression on outcomes, once lifetime exposure to aggressive events was adequately taken into account. These findings argue against theories of female victims' greater vulnerability to pathological outcomes, instead linking risk to exposure history.",0,0 +4520,The Impact of Childhood Maltreatment on PTSD Symptoms Among Female Survivors of Intimate Partner Violence,"Objective: Intimate partner violence (IPV) survivors often report histories of childhood maltreatment, yet the unique contributions of childhood maltreatment on IPV survivors' distinct posttraumatic stress disorder (PTSD) symptoms remain inadequately understood. Method: Using interview and self-report measures, we examined IPV as a potential mediator of the association between childhood maltreatment and severity of PTSD symptom clusters (reexperiencing, avoidance, numbing, and hyperarousal) among a sample of 425 women seeking help for recent IPV. Results: Structural equation modeling demonstrated that while both childhood maltreatment and IPV were both positively associated with PTSD symptom clusters, IPV did not mediate the association between childhood maltreatment and severity of PTSD symptom clusters among acute IPV survivors. Conclusions: Childhood maltreatment has persistent effects on the PTSD symptoms of IPV survivors, suggesting that child maltreatment may need to be addressed in addition to IPV during PTSD treatment. © 2013 Springer Publishing Company.",0,0 +4521,Mental health pathways from interpersonal violence to health-related outcomes in HIV-positive sexual minority men.,"We examined mental health pathways between interpersonal violence (IPV) and health-related outcomes in HIV-positive sexual minority men engaged with medical care.HIV-positive gay and bisexual men (N = 178) were recruited for this cross-sectional study from 2 public HIV primary care clinics that treated outpatients in an urban setting. Participants (M age = 44.1 years, 36% non-White) filled out a computer-assisted survey and had health-related data extracted from their electronic medical records. We used structural equation modeling to test associations among the latent factors of adult abuse and partner violence (each comprising indicators of physical, sexual, and psychological abuse) and the measured variables: viral load, health-related quality of life (HRQOL), HIV medication adherence, and emergency room (ER) visits. Mediation was tested for the latent construct mental health problems, comprising depression, anxiety, symptomatology of posttraumatic stress disorder, and suicidal ideation.The final model demonstrated acceptable fit, chi(2)(123) = 157.05, p = .02, CFI = .95, TLI = .94, RMSEA = .04, SRMR = .06, accounting for significant portions of the variance in viral load (13%), HRQOL (41%), adherence (7%), and ER visits (9%), as well as the latent variable mental health problems (24%). Only 1 direct link emerged: a positive association between adult abuse and ER visits.Findings indicate a significant role of IPV and mental health problems in the health of people living with HIV/AIDS. HIV care providers should assess for IPV history and mental health problems in all patients and refer for evidence-based psychosocial treatments that include a focus on health behaviors.",0,0 +4522,Ten years follow-up of trauma-related psychological distress in a cohort of patients with acute traumatic hand injury,"Summary Though early psychological symptoms after an acute traumatic hand injury have been described, there remains a need for knowledge concerning the trajectory of the individual's response over time to the traumatic event. The purpose of this study was to describe psychological distress related to the traumatic experience in a cohort of patients with acute traumatic hand injury in a 10-year perspective. Patients were recruited consecutively at a hand surgery department. Data were collected by means of mailed questionnaires one week, three months, one year and 10years after the accident. Eighty-three patients participated in all four measurements. Their experience of psychological distress related to the trauma differed significantly during the 10years ( p",0,0 +4523,Psychiatric (axis I) and personality (axis II) disorders in patients with burning mouth syndrome or atypical facial pain,"Abstract Background and aims Burning mouth syndrome (BMS) and atypical facial pain (AFP) are often persistent idiopathic pain conditions that mainly affect middle-aged and elderly women. They have both been associated with various psychiatric disorders. This study examined current and lifetime prevalence of psychiatric axis I (symptom-based) and II (personality) disorders in patients with chronic idiopathic orofacial pain, and investigated the temporal relationship of psychiatric disorders and the onset of orofacial pain. Method Forty patients with BMS and 23 patients with AFP were recruited from Turku university hospital clinics. Mean age of the patients was 62.3 years (range 35–84) and 90% were female. BMS and AFP diagnoses were based on thorough clinical evaluation, and all patients had undergone clinical neurophysiological investigations including blink reflex and thermal quantitative tests. Current and lifetime DSM-IV diagnoses of axis I and II disorders were made on clinical basis with the aid of SCID-I and II-interviews. The detected prevalence rates and their 95% confidence intervals based on binomial distribution were compared to three previous large population-based studies. Results Of the 63 patients, 26 (41.3%) had had an axis I disorder that preceded the onset of orofacial pain, and 33 (52.4%) had had a lifetime axis I disorder. Rate of current axis I disorders was 36.5%, indicating that only about 16% of lifetime disorders had remitted, and they tended to run chronic course. The most common lifetime axis I disorders were major depression (30.2%), social phobia (15.9%), specific phobia (11.1%), and panic disorder (7.9%). Twelve patients (19.0%) had at least one cluster C personality disorder already before the emergence of orofacial pain. Patients with cluster C personality disorders are characterized as fearful and neurotic. None of the patients had cluster A (characterized as odd and eccentric) or B (characterized as dramatic, emotional or erratic) personality disorders. The most common personality disorders were obsessive–compulsive personality (14.3%), dependent personality (4.8%), and avoidant personality (3.2%). The majority of the patients (54%) had also one or more chronic pain conditions other than orofacial pain. In almost all patients (94%) they were already present at the onset of orofacial pain. Conclusions Our results suggest that major depression, persistent social phobia, and neurotic, fearful, and obsessive–compulsive personality characteristics are common in patients with chronic idiopathic orofacial pain. Most psychiatric disorders precede the onset of orofacial pain and they tend to run a chronic course. Implications We propose that the high psychiatric morbidity, and comorbidity to other chronic pain conditions, in chronic idiopathic orofacial pain can be best understood in terms of shared vulnerability to both chronic pain and specific psychiatric disorders, most likely mediated by dysfunctional brain dopamine activity.",0,0 +4524,The experience of chronic illness and post-traumatic stress disorder: the consequences of cumulative adversity,"In this paper the experiences of the chronically ill are examined to explore the impact of post-traumatic stress disorder (PTSD), accumulated burden of adversity and trauma spectrum disorder on subsequent illness and coping behaviors. Individuals experiencing chronic diseases have been studied with regard to depression, anxiety and a variety of coping maladaptions, but negligible attention has been given to the PTSD potential of chronic disease over the life course. Yet, growing evidence suggests that the traumatogenic potential of chronic diseases, some sudden and unexpected onsets, and the traumatogenic changes in life circumstance, may produce maladaptive illness coping over the life course. More importantly, attention needs to focus on the additive effect of co-morbid life events and the traumatic potential of invasive medical therapies. Consideration of PTSD and a continuum of cumulative adversity provide a more complex and fully drawn understanding of the circumstances surrounding chronic illness coping and reasons for maladaptive coping following invasive therapies and changes in the disease trajectory. The pathophysiology that produces a chronic diseases does not begin at symptom onset, and the psychosocial strategies to cope with a chronic illness, whether efficacious or maladaptive, also do not begin at symptom onset, but develops over the life course.",0,0 +4525,Patterns and Perceptions of Intimate Partner Violence Committed by Returning Veterans with Post-Traumatic Stress Disorder,"Data from a recent mixed-methods study conducted among Veterans of Iraq and Afghanistan diagnosed with Post-Traumatic Stress Disorder (PTSD) raise important questions regarding the occurrence of Intimate Partner Violence (IPV) in this population. Three case studies illustrate two main findings. First, Veterans and family members participating in the study described three patterns of partner violence-violence committed in anger; dissociative violence; and parasomniac/hypnopompic violence-suggesting that distinct patterns of IPV may emerge in relation to PTSD symptoms. Second, participants' descriptions suggest that common ideas about PTSD and war-related suffering can play an important role in influencing how Veterans and their partners respond to episodes of partner violence. It is important for those providing care to PTSD-diagnosed Veterans and their partners to understand when and how partner violence may occur, and how both parties may perceive and respond to it, in order to aid in developing appropriate plans for coping and safety-seeking. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +4526,Reactions to Rape: A Military Forensic Psychiatrist's Perspective,"Accusations of rape or sexual harassment are currently very high-profile in the military. This article discusses rape allegations in the military legal system from a psychiatric perspective. The original definition of ""rape trauma syndrome"" and subsequent psychiatric thinking about the diagnosis are briefly outlined. Common reactions seen in military victims in this era are described. A prototypical military case is presented. An adequate evaluation of an alleged victim is outlined. Credentials and preparation of an expert witness are also briefly discussed, with cautions about the use of expert testimony in cases of alleged sexual assault and rape trauma syndrome.",0,0 +4527,"Attachment, personality, and psychopathology among adult inpatients: Self-reported romantic attachment style versus Adult Attachment Interview states of mind","The present study examined self-reported romantic attachment style and Adult Attachment Interview (AAI) states of mind regarding early attachment relationships, personality dimensions, and psychopathology in a psychiatric sample of trauma survivors. Inpatients (N = 80) admitted to a hospital trauma treatment program were administered the Experiences in Close Relationships Scale, AAI, Millon Clinical Multiaxial Inventory-III, Dissociative Experiences Scale, and Dissociative Disorder Interview Schedule. Self-report and AAI attachment classifications were not related, and different results emerged for the two measures. Self-reported romantic attachment style was significantly associated with personality dimensions, with fearful adults showing the most maladaptive personality profiles. Findings suggested that self-report dimensions of self and other independently contribute to different forms of psychological dysfunction. AAI unresolved trauma was uniquely associated with dissociation and posttraumatic stress disorder, whereas unresolved trauma and unresolved loss jointly contributed to schizotypal and borderline personality disorder scores. The differences in findings between the two measures are discussed with a view toward the developmental and clinical implications.",0,0 +4528,Psychiatric morbidity and posttraumatic symptoms among earthquake victims in primary care clinics,"Three months after the devastating Chi-Chi earthquake (magnitude of 7.3 on the Richter scale) struck the central area of Taiwan, 663 victims were screened for psychiatric morbidity at a local general hospital in a community mental health program. The rate of psychiatric morbidity as defined by the 12-item Chinese Health Questionnaire as greater than 4, was 24.5%. Posttraumatic symptoms were still prevalent. The rate of posttraumatic stress disorder was 11.3%, and the rate of partial PTSD was 32.0%. Variables associated with the presence of psychiatric morbidity and posttraumatic symptoms included female gender, old age, financial loss, obsessive trait, and nervous trait. A disproportionate use of mental health services (18%) was found, suggesting an urgent need to deliver mental health care to disaster victims at local medical settings. In addition, health care professionals who work with the earthquake victims need to be promptly and efficiently trained in mental health crisis intervention.",0,0 +4529,Resilience and Other Reactions to Military Deployment: The Complex Task of Identifying Distinct Adjustment Trajectories,"of psychological resilience to the effects of military deployment and some insight into the factors underlying it. In addition, they present evidence of a wide array of other adjustment trajectories following military deployment. In relation to resilience, 78% of Danish soldiers experienced minimal posttraumatic stress disorder (PTSD) symptoms before deployment and up to 2.5 years after. These results are consistent with other recent investigations of soldiers’ capacity to weather the stress of war. For example, Bonanno and colleagues 2 found that 83% of American military personnel deployed to Iraq and Afghanistan showed low levels of posttraumatic stress symptoms both before and up to 5 years after their deployment. Similarly, Dickstein and colleagues, 3 in a longitudinal study of American peacekeepers in Kosovo, found that over 80% showed minimal PTSD symptoms before their deployment and no increase in distress after it. Indeed, there can be little doubt that the considerable majority of soldiers are able to return to their normal levels of functioning after deployment to a war zone. The human capacity to endure and even thrive under conditions of acute stress, once considered rare or a reflection of extraordinary coping abilities, is now increasingly recognized as normative, 4 the rule rather than the exception. In response to events as diverse as bereavement, traumatic injury, life-threatening disease, and even terrorist attack, 5 most people are able to",0,0 +4530,Insomnia and Symptoms of Post-traumatic Stress Disorder Among Women Veterans,"Women will account for 10% of the Veteran population by 2020, yet there has been little focus on sleep issues among women Veterans. In a descriptive study of 107 women Veterans with insomnia (mean age = 49 years, 44% non-Hispanic white), 55% had probable post traumatic stress disorder (PTSD) (total score ≥33). Probable PTSD was related to more severe self-reported sleep disruption and greater psychological distress. In a regression model, higher PTSD Checklist-Civilian (PCL-C) total score was a significant independent predictor of worse insomnia severity index score while other factors were not. Women Veterans preferred behavioral treatments over pharmacotherapy in general, and efforts to increase the availability of such treatments should be undertaken. Further research is needed to better understand the complex relationship between insomnia and PTSD among women Veterans.",0,0 +4531,Longitudinal associations between post-traumatic distress and depressive symptoms following a traumatic event: a test of three models,"Background Symptoms of post-traumatic stress disorder (PTSD) and depression are highly co-morbid following a traumatic event. Nevertheless, decisive evidence regarding the direction of the relationship between these clinical entities is missing. Method The aim of the present study was to examine the nature of this relationship by comparing a synchronous change model (PTSD and depression are time synchronous, possibly stemming from a third common factor) with a demoralization model (i.e. PTSD symptoms causing depression) and a depressogenic model (i.e. depressive symptoms causing PTSD symptoms). Israeli adult victims of single-event traumas ( n =156) were assessed on measures of PTSD and depression at 2, 4 and 12 weeks post-event. Results A cross-lagged structural equation modeling (SEM) analysis provided results consistent with the synchronous change model and the depressogenic model. Conclusions Depressive symptoms may play an important role in the development of post-traumatic symptoms.",0,0 +4532,Executive function and PTSD: Disengaging from trauma,"Neuropsychological approaches represent an important avenue for identifying susceptibility and resiliency factors relating to the development and maintenance of posttraumatic stress disorder (PTSD) symptoms post-trauma. This review will summarize results from prospective longitudinal and retrospective cross-sectional studies investigating executive function associated with PTSD. This research points specifically towards subtle impairments in response inhibition and attention regulation that may predate trauma exposure, serve as risk factors for the development of PTSD, and relate to the severity of symptoms. These impairments may be exacerbated within emotional or trauma-related contexts, and may relate to dysfunction within dorsal prefrontal networks. A model is presented concerning how such impairments may contribute to the clinical profile of PTSD and lead to the use of alternative coping styles such as avoidance. Further neuropsychological research is needed to identify the effects of treatment on cognitive function and to potentially characterize mechanisms of current PTSD treatments. Knowledge gained from cognitive and neuroscientific research may prove valuable for informing the future development of novel, more effective, treatments for PTSD. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0,0 +4533,Blood-based gene-expression predictors of PTSD risk and resilience among deployed marines: A pilot study,"Susceptibility to PTSD is determined by both genes and environment. Similarly, gene-expression levels in peripheral blood are influenced by both genes and environment, and expression levels of many genes show good correspondence between peripheral blood and brain. Therefore, our objectives were to test the following hypotheses: (1) pre-trauma expression levels of a gene subset (particularly immune-system genes) in peripheral blood would differ between trauma-exposed Marines who later developed PTSD and those who did not; (2) a predictive biomarker panel of the eventual emergence of PTSD among high-risk individuals could be developed based on gene expression in readily assessable peripheral blood cells; and (3) a predictive panel based on expression of individual exons would surpass the accuracy of a model based on expression of full-length gene transcripts. Gene-expression levels were assayed in peripheral blood samples from 50 U.S. Marines (25 eventual PTSD cases and 25 non-PTSD comparison subjects) prior to their deployment overseas to war-zones in Iraq or Afghanistan. The panel of biomarkers dysregulated in peripheral blood cells of eventual PTSD cases prior to deployment was significantly enriched for immune genes, achieved 70% prediction accuracy in an independent sample based on the expression of 23 full-length transcripts, and attained 80% accuracy in an independent sample based on the expression of one exon from each of five genes. If the observed profiles of pre-deployment mRNA-expression in eventual PTSD cases can be further refined and replicated, they could suggest avenues for early intervention and prevention among individuals at high risk for trauma exposure.",0,0 +4534,Personality and anxiety disorders,"Personality traits and most anxiety disorders are strongly related. In this article, we review existing evidence for ways in which personality traits may relate to anxiety disorders: 1) as predisposing factors, 2) as consequences, 3) as results of common etiologies, and 4) as pathoplastic factors. Based on current information, we conclude the following: 1) Personality traits such as high neuroticism, low extraversion, and personality disorder traits (particularly those from Cluster C) are at least markers of risk for certain anxiety disorders; 2) Remission from panic disorder is generally associated with partial ""normalization"" of personality traits; 3) Anxiety disorders in early life may influence personality development; 4) Anxiety disorders and personality traits are usefully thought of as spectra of common genetic etiologies; and 5) Extremes of personality traits indicate greater dysfunction in patients with anxiety disorders.",0,0 +4535,Beyond Categorical Classifications: The Importance of Identifying Posttrauma Symptom Trajectories and Associated Negative Outcomes,,0,0 +4536,"Posttraumatic Stress Disorder and Not Depression Is Associated with Shorter Leukocyte Telomere Length: Findings from 3,000 Participants in the Population-Based KORA F4 Study","A link between severe mental stress and shorter telomere length (TL) has been suggested. We analysed the impact of Posttraumatic Stress Disorder (PTSD) on TL in the general population and postulated a dose-dependent TL association in subjects suffering from partial PTSD compared to full PTSD.Data are derived from the population-based KORA F4 study (2006-2008), located in southern Germany including 3,000 individuals (1,449 men and 1,551 women) with valid and complete TL data. Leukocyte TL was measured using a quantitative PCR-based technique. PTSD was assessed in a structured interview and by applying the Posttraumatic Diagnostic Scale (PDS) and the Impact of Event Scale (IES). A total of 262 (8.7%) subjects qualified for having partial PTSD and 51 (1.7%) for full PTSD. To assess the association of PTSD with the average TL, linear regression analyses with adjustments for potential confounding factors were performed.The multiple model revealed a significant association between partial PTSD and TL (beta = -0.051, p = 0.009) as well as between full PTSD and shorter TL (beta = -0.103, p = 0.014) indicating shorter TL on average for partial and full PTSD. An additional adjustment for depression and depressed mood/exhaustion gave comparable beta estimations.Participants with partial and full PTSD had significantly shorter leukocyte TL than participants without PTSD. The dose-dependent variation in TL of subjects with partial and full PTSD exceeded the chronological age effect, and was equivalent to an estimated 5 years in partial and 10 years in full PTSD of premature aging.",0,0 +4537,Posttraumatic stress disorder's role in integrated substance dependence and depression treatment outcomes,"Posttraumatic stress disorder (PTSD) frequently co-occurs with depression and substance use disorder (SUD). This study investigates the impact of PTSD diagnosis on treatment outcomes of 178 veterans treated for depression and SUD, with Integrated Cognitive-Behavioral Therapy (ICBT) or 12-Step Facilitation Therapy (TSF). Percentage days abstinent (PDA) and Hamilton Depression Rating Scale total score (HDRS total) trajectories were created. PDA was similar through initial follow-up; however, by 18 months, ICBT participants without PTSD had better PDA (M = 91%) than those without PTSD in TSF (M = 76%) and those with PTSD in either group (M = 75%-77%). Across time, participants with PTSD had higher depression levels than those without PTSD but benefited similarly from treatment (main effect, p < .004). Both conditions demonstrated reductions in average HDRS at 18 months (M = 17%-29%). Findings highlight the need to assess for PTSD and to investigate how to treat concomitant SUD, depression, and PTSD.",0,0 +4538,Depletion of FKBP51 in Female Mice Shapes HPA Axis Activity,"Psychiatric disorders such as depressive disorders and posttraumatic stress disorder are a major disease burden worldwide and have a higher incidence in women than in men. However, the underlying mechanism responsible for the sex-dependent differences is not fully understood. Besides environmental factors such as traumatic life events or chronic stress, genetic variants contribute to the development of such diseases. For instance, variations in the gene encoding the FK506 binding protein 51 (FKBP51) have been repeatedly associated with mood and anxiety. FKBP51 is a negative regulator of the glucocorticoid receptor and thereby of the hypothalamic-pituitary-adrenal axis that also interacts with other steroid hormone receptors such as the progesterone and androgen receptors. Thus, the predisposition of women to psychiatric disorders and the interaction of female hormones with FKBP51 and the glucocorticoid receptor implicate a possible difference in the regulation of the hypothalamic-pituitary-adrenal axis in female FKBP51 knockout (51KO) mice. Therefore, we investigated neuroendocrine, behavioural and physiological alterations relevant to mood disorders in female 51KO mice. Female 51KOs and wild type littermates were subjected to various behavioural tests, including the open field, elevated plus maze and forced swim test. The neuroendocrine profile was investigated under basal conditions and in response to an acute stressor. Furthermore, we analysed the mRNA expression levels of the glucocorticoid receptor and corticotrophin release hormone in different brain regions. Overall, female 51KO mice did not display any overt behavioural phenotype under basal conditions, but showed a reduced basal hypothalamic-pituitary-adrenal axis activity, a blunted response to, and an enhanced recovery from, acute stress. These characteristics strongly overlap with previous studies in male 51KO mice indicating that FKBP51 shapes the behavioural and neuroendocrine phenotype independent of the sex of the individual.",0,0 +4539,Prospective Analysis of Factors Associated with Work Reentry in Patients with Accident-Related Injuries,"Introduction: The objective of this study was to investigate the influence of accidents, the physical and psychological consequences, the patient's predisposition as well as work-related cognitions on return to work (RTW) post accident. Despite the costs of time-off from work after accidental injuries, very few investigations have been carried out so far. Method: In a consecutive sample, 163 patients were investigated directly and 12 months after an accident. Results: 32% of the patients had a poor occupational integration 12 months after an accident. As predictors for return to work were found type of prior work: laborer (OR=4.34; 1.79-10.50 CI 95%), type of accident: recreational (OR=0.27; 0.11-0.69 CI 95%) and subjective perception of the accident severity (OR=0.98; 0.96-0.99 CI 95%). Conclusion: Laborers after a traffic or work accident, who estimate the accident as severe, are at greater risk of developping long-term disability. Future efforts should be conducted especially for this target group. © 2006 Springer Science+Business Media, Inc.",0,0 +4540,The Dissociative Subtype of PTSD Scale: Initial Evaluation in a National Sample of Trauma-Exposed Veterans,"The fifth edition of the Diagnostic and Statistical Manual includes a dissociative subtype of posttraumatic stress disorder, but no existing measures specifically assess it. This article describes the initial evaluation of a 15-item self-report measure of the subtype called the Dissociative Subtype of Posttraumatic Stress Disorder Scale (DSPS) in an online survey of 697 trauma-exposed military veterans representative of the U.S. veteran population. Exploratory factor analyses of the lifetime DSPS items supported the intended structure of the measure consisting of three factors reflecting derealization/depersonalization, loss of awareness, and psychogenic amnesia. Consistent with prior research, latent profile analyses assigned 8.3% of the sample to a highly dissociative class distinguished by pronounced symptoms of derealization and depersonalization. Overall, results provide initial psychometric support for the lifetime DSPS scales; additional research in clinical and community samples is needed to further validate the measure.",0,0 +4541,Early PTSD symptom sub-clusters predicting chronic posttraumatic stress following sexual assault.,"Contemporary models of PTSD disaggregate this disorder into sub-clusters that differentially impact functioning. Severity of different types of PTSD symptoms in the acute posttrauma period may be predictive of the course of PTSD over time. Few research studies, however, have examined the predictive utility of PTSD sub-clusters. This study sought to determine the relative predictive validity of 4 sub-clusters, namely reexperiencing, strategic avoidance, emotional numbing, and hyperarousal, assessed within 1 month of a sexual assault. Women (N=120) who had been sexually assaulted completed self-report measures at 1 and 4 months postassault. Linear regression analyses revealed that early reexperiencing and emotional numbing sub-clusters uniquely contributed to the prediction of PTSD symptoms at month 4 (strategic avoidance and hyperarousal did not). To help explain and contextualize these findings, we explored the extent to which posttraumatic cognitions mediated the relationship between acute reexperiencing and emotional numbing and later PTSD symptoms. Simultaneous multiple mediation analyses revealed that general negative cognitions about the self significantly mediated the relationship between both reexperiencing and emotional numbing and month 4 PTSD symptoms. These findings have significant clinical implications, pointing to the importance of targeting posttraumatic cognitions in the acute posttrauma phase.",0,0 +4542,A Realistic Perspective on Pattern Representation in Growth Data: Comment on Bauer and Curran (2003).,"D. J. Bauer and P. J. Curran (2003) cautioned that results obtained from growth mixture models may sometimes be inaccurate. The problem they addressed occurs when a growth mixture model is applied to a single, general population of individuals but findings incorrectly support the conclusion that there are 2 subpopulations. In an artificial sampling experiment, they showed that this can occur when the variables in the population have a nonnormal distribution. A realistic perspective is that although a healthy skepticism to complex statistical results is appropriate, there are no true models to discover. Consequently, the issue of model misspecification is irrelevant in practical terms. The purpose of a mathematical model is to summarize data, to formalize the dynamics of a behavioral process, and to make predictions. All of this is scientifically valuable and can be accomplished with a carefully developed model, even though the model is false.",0,0 +4543,Differentiating Post-Traumatic Stress Disorder (PTSD) from Major Depression (MDD) and Generalized Anxiety Disorder (GAD),"Questions about the differential diagnosis of Post-Traumatic Stress Disorder (PTSD) have been raised since this category was reformulated in DSM-III ( APA, 1980 ). Clinicians have reported difficulties distinguishing PTSD from other categories, particularly from Major Depressive and Generalized Anxiety Disorders (MDD and GAD). Diagnostic validity can be established in several ways (e.g., through clinical descriptive studies, laboratory experiments, family history studies, etc.). In this paper, we describe one approach to validation thus far not applied to PTSD: This approach centers directly on whether clinicians can distinguish PTSD from other diagnostic categories. Experienced clinicians were asked to rate the extent to which a common set of 90 symptom items characterized PTSD, MDD , and GAD. Ratings were analyzed with multivariate and univariate analyses of variance and covariance, multiple discriminant function analysis, and factor analysis; moreover, characteristics of raters were examined for possible influences. Results indicated that clinicians readily distinguish PTSD from MDD and GAD as well as MDD from GAD. Findings are presented in terms of univariate analyses, 34 best discriminating items, and factors specifying dimensions differentiating the syndromes of PTSD, MDD, and GAD. Rater characteristics did not influence diagnostic accuracy, although significant differences in magnitude of symptom intensity were found. © 1997 Elsevier Science Ltd",0,0 +4544,Reducing refugee mental health disparities: A community-based intervention to address postmigration stressors with African adults.,"Refugees resettled in the United States have disproportionately high rates of psychological distress. Research has demonstrated the roles of postmigration stressors, including lack of meaningful social roles, poverty, unemployment, lack of environmental mastery, discrimination, limited English proficiency, and social isolation. We report a multimethod, within-group longitudinal pilot study involving the adaptation for African refugees of a community-based advocacy and learning intervention to address postmigration stressors. We found the intervention to be feasible, acceptable, and appropriate for African refugees. Growth trajectory analysis revealed significant decreases in participants' psychological distress and increases in quality of life, and also provided preliminary evidence of intervention mechanisms of change through the detection of mediating relationships whereby increased quality of life was mediated by increases in enculturation, English proficiency, and social support. Qualitative data helped to support and explain the quantitative data. Results demonstrate the importance of addressing the sociopolitical context of resettlement to promote the mental health of refugees and suggest a culturally appropriate, and replicable model for doing so.",0,0 +4545,Assessing nonresponse bias at follow-up in a large prospective cohort of relatively young and mobile military service members,"BackgroundNonresponse bias in a longitudinal study could affect the magnitude and direction of measures of association. We identified sociodemographic, behavioral, military, and health-related predictors of response to the first follow-up questionnaire in a large military cohort and assessed the extent to which nonresponse biased measures of association.MethodsData are from the baseline and first follow-up survey of the Millennium Cohort Study. Seventy-six thousand, seven hundred and seventy-five eligible individuals completed the baseline survey and were presumed alive at the time of follow-up; of these, 54,960 (71.6%) completed the first follow-up survey. Logistic regression models were used to calculate inverse probability weights using propensity scores.ResultsCharacteristics associated with a greater probability of response included female gender, older age, higher education level, officer rank, active-duty status, and a self-reported history of military exposures. Ever smokers, those with a history of chronic alcohol consumption or a major depressive disorder, and those separated from the military at follow-up had a lower probability of response. Nonresponse to the follow-up questionnaire did not result in appreciable bias; bias was greatest in subgroups with small numbers.ConclusionsThese findings suggest that prospective analyses from this cohort are not substantially biased by non-response at the first follow-up assessment.",0,0 +4546,Assessment and validation of prognostic models for poor functional recovery 12 months after whiplash injury: A multicentre inception cohort study,"Uncertainty surrounds prognostic factors after whiplash injury. Previously we identified a prognostic model for 6-month pain-related disability in a cohort of 80 participants with acute whiplash. Predictors included initial disability, older age, decreased cold pain thresholds, decreased neck rotation movement, posttraumatic stress symptoms and decreased sympathetic vasoconstriction. The objective of this study was to externally validate this model. In a multicentre inception cohort study, 286 participants with acute whiplash (I, II or III) were assessed at <3 weeks and 12 months after injury. The Neck Disability Index (NDI) was the outcome. Observed and predicted NDI scores were generated using the published equation of the original model. Model discrimination between participants with no or mild disability from those with moderate to severe disability was examined by receiver operating characteristic curves. Initial NDI and cold pain threshold predicted current observed 12-month NDI scores (r(2) = 0.50, 95% confidence interval 0.42 to 0.58). There was a significant site effect, and the estimated marginal mean ± SE of 12-month NDI for Iceland (27.6 ± 1.79%) was higher than the other 3 sites (Melbourne 11.2 ± 5.03%, Canada 16.4 ± 2.36%, Brisbane 16.8 ± 1.17%). After adjusting for site, age and Impact of Events Scale scores regained significance (r(2) = 0.56, 95% confidence interval 0.48 to 0.64). The tested model was not precise in predicting NDI as a continuous variable. However, it found good accuracy to discriminate participants with moderate to severe disability at 12 months (area under the receiver operating characteristic curve 0.89 [95% confidence interval 0.84-0.94], P<.001) which is clinically useful.",0,0 +4547,Posttraumatic stress and depression symptoms as correlates of deliberate self-harm among community women experiencing intimate partnerviolence,"Deliberate self-harm (DSH) among women in the general population is correlated separately with posttraumatic stress, depression, and abuse during childhood and adulthood. The prevalence of these DSH correlates is particularly high among women exposed to intimate partner violence (IPV), yet few studies have examined DSH among this high-risk population and none have examined these correlates simultaneously. Two hundred and twelve IPV-victimized women in the community participated in a 2-h retrospective interview. One-third reported current or past DSH. Discriminant analysis was used to examine which posttraumatic stress and depression symptoms and types of current IPV and childhood abuse were uniquely associated with current DSH. Findings show that women who currently use DSH reported greater severity of posttraumatic stress numbing symptoms and more severe sexual IPV compared to women who used DSH only in the past. Examining factors that are associated with women's current DSH in this population is critical so that a focus on DSH can be integrated into the treatment plans of women who are receiving mental health care, but also so that women who are not receiving such care can be referred to adequate mental health services.",0,0 +4548,Routine Work Environment Stress and PTSD Symptoms in Police Officers,"This study examined the relationship between routine work environment stress and posttraumatic stress disorder (PTSD) symptoms in a sample of police officers (N = 180) who were first assessed during academy training and reassessed 1-year later. In a model that included gender, ethnicity, traumatic exposure prior to entering the academy, current negative life events, and critical incident exposure over the last year, routine work environment stress was most strongly associated with PTSD symptoms. We also found that routine work environment stress mediated the relationship between critical incident exposure and PTSD symptoms and between current negative life events and PTSD symptoms. Ensuring that the work environment is functioning optimally protects against the effects of duty-related critical incidents and negative life events outside police service.",0,0 +4549,Predictors of posttraumatic stress disorder among police officers: A prospective study.,"This prospective study examined risk and protective factors in the development of posttraumatic stress disorder (PTSD) in a sample of 83 police officers. Structured interviews were conducted in order to assess the most recent work-related traumatic event and establish diagnoses of acute stress disorder (ASD) and full or partial PTSD. Police officers were assessed between 5 and 15 days, and at 1 month, 3 months, and 12 months after the event. They also completed self-administered questionnaires assessing several potential predictors. Predictive analyses about the onset of PTSD were based on a 4-step nested random-effect linear regression. Overall, results showed that the modulation of PTSD symptomatology was associated with some pretraumatic (i.e., emotional coping strategies and number of children), peritraumatic (i.e., physical and emotional reactions and dissociation), and posttraumatic factors (i.e., ASD, depression symptoms, and seeking psychological help at the employee assistance program and at the police union between the event and Time 1). Clinical implications of these findings are discussed and key directions for future studies are proposed.",0,0 +4550,The Structure of Posttraumatic Stress Disorder,"Latent structure analysis of DSM-IV posttraumatic stress disorder (PTSD) can help clarify how persons who experience traumatic events might be sorted into clusters with respect to their symptom profiles. Classification of persons exposed to traumatic events into clinically homogeneous groups would facilitate further etiologic and treatment research, as well as research on the relationship of trauma and PTSD with other disorders.To examine empirically the structure underlying PTSD criterion symptoms and identify discrete classes with similar symptom profiles.Data on PTSD symptoms from trauma-exposed subsets of 2 community samples were subjected to latent class analysis. The resultant classes were studied in associations with trauma type and indicators of impairment.The first sample is from the Detroit Area Survey of Trauma (1899 trauma-exposed respondents with complete data) and the second is from a mid-Atlantic study of young adults conducted by The Johns Hopkins University Prevention Research Center, Baltimore, Md (1377 trauma-exposed respondents with complete data).Respondents in the 2 community samples who experienced 1 or more qualifying PTSD-level traumatic events.Number, size, and symptom profiles of latent classes.In both samples, analysis yielded 3 classes: no disturbance, intermediate disturbance, and pervasive disturbance. The classes also varied qualitatively, with emotional numbing distinguishing the class of pervasive disturbance, a class that approximates the subset with DSM-IV PTSD. Members of the pervasive disturbance class were far more likely to report use of medical care and disruptions in life or activities.The 3-class structure separates trauma-exposed persons with pervasive disturbance (a class that approximates DSM-IV PTSD) from no disturbance and intermediate disturbance, a distinction that also helps identify population subgroups with low risk for any posttrauma disturbance. The results suggest that the structure of PTSD is ordinal and configurational and that emotional numbing differentiates the class with pervasive disturbance. These results should motivate prospective research of persons who have experienced trauma to trace the emergence of posttrauma symptoms and the timing of emotional numbing relative to other symptoms.",0,0 +4551,The contribution of prior psychological symptoms and combat exposure to post Iraq deployment mental health in the UK military,"This study assessed the contribution of baseline psychological symptoms, combat exposure, and unit support in the etiology of posttraumatic stress disorder (PTSD), and psychological distress. From 2004-2006, 67% of a random sample of 2,820 participants who had been assessed for psychological symptoms in 2002 were reassessed. Baseline psychological symptoms, combat exposure, and unit support factors were associated with the outcomes and the effect sizes for combat exposure were marked for PTSD symptoms. Adjustment for baseline psychological symptoms did not modify the pattern of association of group cohesion and combat exposures. The authors concluded that combat exposure and group cohesion have an effect on mental health outcomes independent of previous mental health status, which explains why screening prior to deployment is ineffective.",0,0 +4552,Connectedness in the Lives of Children and Adolescents: A Call for Greater Conceptual Clarity,"Studies of the role of connectedness in the health and development of children and adolescents are accumulating rapidly. Although findings are uniformly consistent in documenting its correlation with a host of health indicators, the construct is in need of substantial conceptual clarification to maximize its research and applied utility. Current conceptualizations and operationalizations inconsistently span a wide spectrum of varied elements of social experience--including the quality of a relationship, the degree of liking an environment or relationship, the quality of performance in an environment or relationship, the possession of feelings or attitude states, and a combination of states and the behaviors that antecede them--resulting in an ability to adequately understand what the construct is and how, why, and when it is most protective. This paper documents this variability in an effort to sensitize researchers, practitioners, and policy makers to the complexity of the construct. It further describes one ongoing, multicultural research project that is currently informing international health initiatives as an illustration of one approach to addressing the complexity with goals of precision, parsimony, cultural sensitivity, and applied utility.",0,0 +4553,Asthma and Posttraumatic Stress Symptoms 5 to 6 Years Following Exposure to the World Trade Center Terrorist Attack,"The World Trade Center Health Registry provides a unique opportunity to examine long-term health effects of a large-scale disaster.To examine risk factors for new asthma diagnoses and event-related posttraumatic stress (PTS) symptoms among exposed adults 5 to 6 years following exposure to the September 11, 2001, World Trade Center (WTC) terrorist attack.Longitudinal cohort study with wave 1 (W1) enrollment of 71,437 adults in 2003-2004, including rescue/recovery worker, lower Manhattan resident, lower Manhattan office worker, and passersby eligibility groups; 46,322 adults (68%) completed the wave 2 (W2) survey in 2006-2007.Self-reported diagnosed asthma following September 11; event-related current PTS symptoms indicative of probable posttraumatic stress disorder (PTSD), assessed using the PTSD Checklist (cutoff score > or = 44).Of W2 participants with no stated asthma history, 10.2% (95% confidence interval [CI], 9.9%-10.5%) reported new asthma diagnoses postevent. Intense dust cloud exposure on September 11 was a major contributor to new asthma diagnoses for all eligibility groups: for example, 19.1% vs 9.6% in those without exposure among rescue/recovery workers (adjusted odds ratio, 1.5 [95% CI, 1.4-1.7]). Asthma risk was highest among rescue/recovery workers on the WTC pile on September 11 (20.5% [95% CI, 19.0%-22.0%]). Persistent risks included working longer at the WTC site, not evacuating homes, and experiencing a heavy layer of dust in home or office. Of participants with no PTSD history, 23.8% (95% CI, 23.4%-24.2%) reported PTS symptoms at either W1 (14.3%) or W2 (19.1%). Nearly 10% (9.6% [95% CI, 9.3%-9.8%]) had PTS symptoms at both surveys, 4.7% (95% CI, 4.5%-4.9%) had PTS symptoms at W1 only, and 9.5% (95% CI, 9.3%-9.8%) had PTS symptoms at W2 only. At W2, passersby had the highest rate of PTS symptoms (23.2% [95% CI, 21.4%-25.0%]). Event-related loss of spouse or job was associated with PTS symptoms at W2.Acute and prolonged exposures were both associated with a large burden of asthma and PTS symptoms 5 to 6 years after the September 11 WTC attack.",0,0 +4554,"Inflammation and Oxidative Stress Are Elevated in the Brain, Blood, and Adrenal Glands during the Progression of Post-Traumatic Stress Disorder in a Predator Exposure Animal Model","This study sought to analyze specific pathophysiological mechanisms involved in the progression of post-traumatic stress disorder (PTSD) by utilizing an animal model. To examine PTSD pathophysiology, we measured damaging reactive oxygen species and inflammatory cytokines to determine if oxidative stress and inflammation in the brain, adrenal glands, and systemic circulation were upregulated in response to constant stress. Pre-clinical PTSD was induced in naïve, male Sprague-Dawley rats via a predator exposure/psychosocial stress regimen. PTSD group rats were secured in Plexiglas cylinders and placed in a cage with a cat for one hour on days 1 and 11 of a 31-day stress regimen. In addition, PTSD group rats were subjected to psychosocial stress whereby their cage cohort was changed daily. This model has been shown to cause heightened anxiety, exaggerated startle response, impaired cognition, and increased cardiovascular reactivity, all of which are common symptoms seen in humans with PTSD. At the conclusion of the predator exposure/psychosocial stress regimen, the rats were euthanized and their brains were dissected to remove the hippocampus, amygdala, and pre-frontal cortex (PFC), the three areas commonly associated with PTSD development. The adrenal glands and whole blood were also collected to assess systemic oxidative stress. Analysis of the whole blood, adrenal glands, and brain regions revealed oxidative stress increased during PTSD progression. In addition, examination of pro-inflammatory cytokine (PIC) mRNA and protein demonstrated neurological inflammatory molecules were significantly upregulated in the PTSD group vs. controls. These results indicate oxidative stress and inflammation in the brain, adrenal glands, and systemic circulation may play a critical role in the development and further exacerbation of PTSD. Thus, PTSD may not be solely a neurological pathology but may progress as a systemic condition involving multiple organ systems.",0,0 +4555,Psychometric properties of an African symptoms check list scale: the Ndetei-Othieno-Kathuku scale,"To profile and quantify the psychometric properties of the NOK (Ndetei-Othieno-Kathuku) scale against internationally used Gold-standards and benchmarks for mild psychiatric disorders and post-traumatic stress disorders and to provide a potential easy to administer culture sensitive instrument for screening and assessing those with possible psychiatric disorders for the Kenyan and similar social-cultural situations.Cross-Sectional quantitative study.A psychiatric clinical consultation setting and Kyanguli Secondary School psychotrauma counselling clinical set-up.Survivors of the Nairobi USA Embassy bombing who were referred for psychiatric treatment and survivors of a fire disaster from a rural Kenyan school (Kyanguli School fire disaster) including students, parents of the diseased children and staff members.Positive correlation was found between the NOK and all the instruments. The highest correlations were between the NOK and the BDI and SCL-90 (r = 0.557 to 0.786). The differences between the NOK scores among the different groups were statistically significant (F ratio = 13.54 to 160.34, p < 0.01). The reliability coefficient (internal consistency) of the scale, alpha = 0.9733. Other item statistics and correlations of the scale are discussed.It is concluded that the NOK has high concurrent and discriminant validity as well as a high internal consistency and that it can be used for the rapid assessment of psychotrauma victims of all age groups; and stress in general in similar age groups in the local setting. It is culture appropriate and sensitive.",0,0 +4556,Shame-based identity and chronic post-traumatic stress disorder in help -seeking combat veterans,"The long-term effects of post-traumatic stress disorder (PTSD) have been previously investigated. However, developmental and identity issues around trauma and shame have been less extensively examined. For some combat veterans, relief from the primary symptoms of PTSD is a struggle for much of the postwar adjustment period. Moreover, secondary problems associated with living with trauma have substantial impact on veterans' sense of self, capacity for interpersonal relationships, and making meaning of their lives. The current investigation examined relationships between self-reported symptom distress and shame on postwar adjustment of combat veterans. Specifically, the study investigated how shame and sense of self were related to PTSD, depression, trait anxiety, vulnerability, self-handicapping, hope, and overall quality of life. This investigation used archival data that are part of a larger longitudinal study. Correlational, repeated measures, and multivariate analyses examined how symptom distress and resilience measures were related to premilitary, military, and postmilitary factors. Participants completed self-report symptom distress measures and family of origin and demographic questionnaires. Repeated measures on symptom distress were collected at baseline, 2 months, 6 months, and 12 months post-baseline. Twelve hypotheses were postulated regarding how chronic PTSD and shame were related to long term adjustment. Findings contributed substantive new information on relationships among shame, symptom distress, and psychological trauma. Correlational analyses showed significant and positive relationships between shame and symptom distress measures including depression, trait anxiety, vulnerability, PTSD, and self-handicapping. Shame was negatively associated with hope and quality of life. Longitudinal data showed chronic PTSD and shame were amenable to treatment. While treatment data showed initial improvement in all symptom distress measures, maintenance of treatment gains was difficult, with six and twelve month symptom measures returning to near baseline. Multivariate analyses yielded no differences on family factors of chaos, loss, and ethnicity. Socioeconomic status was associated with decreased hope and quality of life. Convergence among the findings indicated a reciprocal relationship between shame and PTSD which warrants continued empirical investigation. Implications for theory, research, and practice are discussed.",0,0 +4557,Characteristics of Patients with Multiple Personality and Dissociative Disorders on Psychological Testing,"We describe a new psychological testing procedure used on a consecutive series of 14 patients with multiple personality and dissociative disorders who met DSM-III-R and research criteria for dissociative disorders. Once dissociative phenomena were accounted for in testing, most patients displayed response patterns markedly different from those of schizophrenic and borderline patients. Patients showed striking variability on cognitive and projective tests, often related to posttraumatic intrusions. Rorschach protocols showed unusual thinking accompanied by psychological complexity and highly developed self-observing capacity. In contrast to classical conceptualizations about these patients, most subjects had personality profiles that were intellectualized, obsessive, and introversive, not histrionic or labile.",0,0 +4558,Partial posttraumatic stress disorder revisited,"It is thought that the decision rule for a positive diagnosis of Posttraumatic Stress Disorder (PTSD) may be too restrictive, leaving too many victims of a trauma out in the cold for care, compensation, etc. Several authors have proposed the concept of Subthreshold or Partial PTSD (PPTSD). This concept considers that a subject may present a number of symptoms below threshold for criteria C or D (subthreshold syndromes) and may even present without any symptom for one or more of the criteria B, C and D (partial syndromes).Data have been collected by means of the Composite International Diagnostic Interview (CIDI) PTSD-module, in a group exposed to two different traumatic events (130 fire victims and 55 car accident victims). The syndrome patterns has been assessed by means of hierarchical class analyses. Each of the criteria B, C and D has been analyzed separately, showing the symptom patterns as hierarchically order clusters.Depending on the threshold used for criterion C (i.e. 3 or 2 symptoms), 18.4 and 22.7% of the subjects respectively satisfy the criteria for PTSD. 8.7% of the subjects show subthreshold syndromes. 60.7% of the subjects show partial syndromes and 16.7% of the subjects have partial syndromes while fulfilling criterion F, i.e. a clinically significant impairment in functioning.The results show a considerable number of partial and subthreshold syndromes. It is argued that subthreshold syndromes and partial syndromes, which fulfill criterion F, should be regarded as specific nosological categories or as specified PTSD subcategories, i.e. subsyndromal or partial PTSD.",0,0 +4559,One-year trajectories of depression and anxiety symptoms in older patients presenting in general practice with musculoskeletal pain: A latent class growth analysis,"Distinguishing transient from persistent anxiety and depression symptoms in older people presenting to general practice with musculoskeletal pain is potentially important for effective management. This study sought to identify distinct post-consultation depression and anxiety symptom trajectories in adults aged over 50years consulting general practice for non-inflammatory musculoskeletal pain.Self-completion questionnaires, containing measures of anxiety and depressive symptoms, age, gender, pain status, coping and social status were mailed within 1week of the consultation and at 3, 6 and 12months. Latent class growth analysis was used to identify anxiety and depression symptoms trajectories, which were ascertained with cut-off score ≥8 on Hospital Anxiety and Depression Scale subscales. Associations between baseline characteristics and cluster membership were examined using multivariate multinomial logistic regression analysis (the 3-step approach).Latent class growth analyses determined a 3-cluster anxiety model (n=499) and a 3-cluster depression model (n=501). Clusters identified were: no anxiety problem (44.1%), persistent anxiety problem (33.9%) and transient anxiety symptoms (22.2%); no depression problem (74.1%), persistent depression problem (22.0%) and gradual depression symptom recovery (4.0%). Widespread pain, interference with valued activities, coping by increased behavioral activities, catastrophizing, perceived lack of instrumental support, age ≥70years, being female, and performing manual/routine work were associated with anxiety and/or depression clusters.Older people with non-inflammatory musculoskeletal pain are at high risk of persistent anxiety and/or depression problems. Biopsychosocial factors, such as pain status, coping strategies, instrumental support, performing manual/routine work, being female and age ≥70years, may help identify patients with persistent anxiety and/or depression.",0,0 +4560,Alexithymia and posttraumatic stress: subscales and symptom clusters,"This study examined the relationship between the emotion-regulating factor alexithymia and the occurrence of posttraumatic stress disorder (PTSD) after critical incidents in a nonclinical sample of 136 nurses and ambulance personnel working in military facilities. The results showed that alexythima accounts for variance in PTSD symptoms. Breaking PTSD into its 4 symptom clusters, alexithymia was found to predict numbing and hyperarousal symptoms but not avoidance or reexperiencing symptoms. Finally, the rarely investigated, but clinically relevant, distinctive subdimensions of alexithymia were examined in relation to the 4 PTSD clusters. The difficulty identifying feelings subscale contributed most to the numbing and hyperarousal PTSD subscales. Clinical implications and future research directions are discussed.",0,0 +4561,"Mental Health Status of World Trade Center Rescue and Recovery Workers and Volunteers—New York City, July 2002–August 2004","After the September 11, 2001, attacks on the World Trade Center (WTC), a comprehensive screening program was established to evaluate the physical and mental health of rescue and recovery workers and volunteers. Persons were eligible for this program if they participated in the WTC rescue or recovery efforts and met specific time criteria for exposure to the site. During July 16, 2002--August 6, 2004, the program evaluated 11,768 workers and volunteers. This report summarizes data analyzed from a subset of 1,138 of the 11,768 participants evaluated at the Mount Sinai School of Medicine during July 16--December 31, 2002. On the basis of one or more standardized screening questionnaires, approximately half (51%) of participants met threshold criteria for a clinical mental health evaluation. Continued surveillance is needed to assess the long-term psychological impact of the aftermath of the 9/11 attacks and to determine needs for continued treatment.",0,0 +4562,The Factor Structure of Traumatic Stress in Parents of Children With Cancer: A Longitudinal Analysis*,"To determine the factor structure of posttraumatic stress symptoms (PTSS) and assess its stability over time among parents of children diagnosed with cancer.Parents of children with cancer included in a longitudinal study completed the posttraumatic stress disorder (PTSD) Checklist-Civilian Version 2 weeks (n = 249) and 2 (n = 234) and 4 (n = 203) months after their child's diagnosis. Confirmatory factor analysis (CFA) was used to assess 3 models of the underlying dimensions of PTSD and invariance tests were used to assess stability over time.A longitudinal CFA with the factors reexperiencing, avoidance, dysphoria, and hyperarousal provided best fit to the data. Invariance testing suggested that the pattern and size of loadings were equivalent across the three assessments. Discussions Findings tentatively suggest that PTSS among parents of children with cancer consist of four factors. Implications for research and clinical practice are discussed.",0,0 +4563,The Child and Family Traumatic Stress Intervention: Secondary prevention for youth at risk of developing PTSD,"This pilot study evaluated the effectiveness of a four-session, caregiver-child Intervention, the Child and Family Traumatic Stress Intervention (CFTSI), to prevent the development of chronic posttraumatic stress disorder (PTSD) provided within 30 days of exposure to a potentially traumatic event (PTE).One-hundred seventy-six 7 to 17-year-old youth were recruited through telephone screening based on report of one new distressing posttraumatic stress symptom after a PTE. Of those, 106 youth were randomly assigned to the Intervention (n = 53) or a four-session supportive Comparison condition (N = 53). Group differences in symptom severity were assessed using repeated measures with mixed effects models of intervention group, time, and the interaction of intervention and time. Logistic regression analyses were performed to assess treatment condition and any subsequent traumas experienced as predictors for full and partial PTSD diagnosis at 3-month follow-up. An exploratory chi-square analysis was performed to examine the differences in PTSD symptom criteria B, C, and D at follow-up.At baseline, youth in both groups had similar demographics, past trauma exposures and symptom severity. At follow-up, the Intervention group demonstrated significantly fewer full and partial PTSD diagnoses than the Comparison group on a standardized diagnostic measure of PTSD. Also, there was a significant group by time interaction for Trauma Symptom Checklist for Children's Posttraumatic Stress and Anxiety Indices as the CFTSI group had significantly lower posttraumatic and anxiety scores than the Comparison group.The results suggest that a caregiver-youth, brief preventative early intervention for youth exposed to a PTE is a promising approach to preventing chronic PTSD.",0,0 +4564,Health and ill health of asylum seekers in Switzerland: an epidemiological study,"Although the focus of health care for people seeking asylum in Western European countries is usually on communicable diseases, there is little data about the general health care need of this population. In this study, we investigated the actual burden of disease among asylum seekers.Data were collected from a Swiss Health Maintenance Organisation (HMO; a type of managed care organization in which physicians act as gate keepers) that was set up specifically to provide health care for asylum seekers. The data included socio-demographic characteristics, international classification of diseases (ICD-10) diagnoses and number of clinic visits. Descriptive statistics were used to assess the types of health problems and the number of clinic visits. Logistic regression analysis was used to determine whether age, gender or country or region of origin was predictive in terms of incidence of disease as diagnosed by using ICD classifications.The total number of asylum seekers (mean age 22 years; 38% women) enrolled in the HMO from 2000 through 2003 was 979. Half of this group came from the former country of Yugoslavia. The remainder came primarily from sub-Saharan Africa, Turkey, Iraq and Sri Lanka. The most common health problems encountered in the population included musculoskeletal diseases, respiratory diseases, depression and post-traumatic stress disorder. The prevalence of all disease clusters was significantly associated with age. One-fifth of the population did not request health care at all during the time they were enrolled in the HMO. It is not known whether those who did not visit the medical clinic did not require health care or just chose not to request clinic services.The most frequent health problems encountered in the study population were chronic medical conditions, not communicable acute diseases. Although health care services provided to asylum seekers usually focus on episodic acute care, what this group actually needs is continuity of care.",0,0 +4565,Posttraumatic stress disorder and suicide in 5.9 million individuals receiving care in the veterans health administration health system,"Post-traumatic stress disorder (PTSD) confers risk for suicidal ideation and suicide attempts but a link with suicide is not yet established. Prior analyses of users of the Veterans health administration (VHA) Health System suggest that other mental disorders strongly influence the association between PTSD and suicide in this population. We examined the association between PTSD and suicide in VHA users, with a focus on the influence of other mental disorders.Data were based on linkage of VA National Patient Care Database records and the Centers for Disease Control and Prevention׳s National Death Index, with data from fiscal year 2007-2008. Analyses were based on multivariate logistic regression and structural equation models.Among users of VHA services studied (N=5,913,648), 0.6% (N=3620) died by suicide, including 423 who had had been diagnosed with PTSD. In unadjusted analysis, PTSD was associated with increased risk for suicide, with odds ratio, OR (95% confidence interval, 95% CI)=1.34 (1.21, 1.48). Similar results were obtained after adjustment for demographic variables and veteran characteristics. After adjustment for multiple other mental disorder diagnoses, PTSD was associated with decreased risk for suicide, OR (95% CI)=0.77 (0.69, 0.86). Major depressive disorder (MDD) had the largest influence on the association between PTSD and suicide.The analyses were cross-sectional. VHA users were studied, with unclear relevance to other populations.The findings suggest the importance of identifying and treating comorbid MDD and other mental disorders in VHA users diagnosed with PTSD in suicide prevention efforts.",0,0 +4566,Measuring post-traumatic stress: A psychometric evaluation of symptom- and coping questionnaires based on a Norwegian sample,"The purpose of this study was to evaluate the psychometric characteristics of the Norweigian versions of the Impact of Event Scale, the Post Traumatic Stress Scale-10 item version and General Coping Questionnaire-30 item version. A group of 40 male and 56 female medical students was tested one week and four months after having started dissection of cadavers for the first time. The results showed that all scales had good internal consistency and test-retest reliability. The student sample scored lower on the IES and PTSS-10 than comparable groups of traumatized subjects. A gender difference emerged, with female subjects scoring higher than male subjects. The factor analysis of the instruments indicated good construct validity for the symptom scales. The analysis of content validity related to DSM IV criteria indicated that the IES and PTSS-10 may have some limitations in their predictive validity of PTSD. Taken together, the three scales have shown good psychometric properties and could be used in future research and clinical work.",0,0 +4567,Meta-Analysis of the Efficacy of Treatments for Posttraumatic Stress Disorder,"Posttraumatic stress disorder (PTSD) is an important mental health issue in terms of the number of people affected and the morbidity and functional impairment associated with the disorder. The purpose of this study was to examine the efficacy of all treatments for PTSD.PubMed, MEDLINE, PILOTS, and PsycINFO databases were searched for randomized controlled clinical trials of any treatment for PTSD in adults published between January 1, 1980, and April 1, 2012, and written in the English language. The following search terms were used: post-traumatic stress disorders, posttraumatic stress disorder, PTSD, combat disorders, and stress disorders, post-traumatic.Articles selected were those in which all subjects were adults with a diagnosis of PTSD based on DSM criteria and a valid PTSD symptom measure was reported. Other study characteristics were systematically collected. The sample consisted of 137 treatment comparisons drawn from 112 studies.Effective psychotherapies included cognitive therapy, exposure therapy, and eye movement desensitization and reprocessing (g = 1.63, 1.08, and 1.01, respectively). Effective pharmacotherapies included paroxetine, sertraline, fluoxetine, risperidone, topiramate, and venlafaxine (g = 0.74, 0.41, 0.43, 0.41, 1.20, and 0.48, respectively). For both psychotherapy and medication, studies with more women had larger effects and studies with more veterans had smaller effects. Psychotherapy studies with wait-list controls had larger effects than studies with active control comparisons.Our findings suggest that patients and providers have a variety of options for choosing an effective treatment for PTSD. Substantial differences in study design and study participant characteristics make identification of a single best treatment difficult. Not all medications or psychotherapies are effective.",0,0 +4568,A Double-Blind Randomized Controlled Trial To Study the Efficacy of Topiramate in a Civilian Sample of PTSD,"To evaluate the efficacy and tolerability of topiramate in patients with posttraumatic stress disorder (PTSD).We conducted a 12-week double-blind, randomized, placebo-controlled study comparing topiramate to placebo. Men and women aged 18-62 years with diagnosis of PTSD according to DSM-IV were recruited from the outpatient clinic of the violence program of Federal University of São Paulo Hospital (Prove-UNIFESP), São Paulo City, between April 2006 and December 2009. Subjects were assessed for the Clinician-Administered Posttraumatic Stress Scale (CAPS), Clinical Global Impression, and Beck Depression Inventory (BDI). After 1-week period of washout, 35 patients were randomized to either group. The primary outcome measure was the CAPS total score changes from baseline to the endpoint.82.35% of patients in the topiramate group exhibited improvements in PTSD symptoms. The efficacy analysis demonstrated that patients in the topiramate group exhibited significant improvements in reexperiencing symptoms: flashbacks, intrusive memories, and nightmares of the trauma (CAPS-B; P= 0.04) and in avoidance/numbing symptoms associated with the trauma, social isolation, and emotional numbing (CAPS-C; P= 0.0001). Furthermore, the experimental group demonstrated a significant difference in decrease in CAPS total score (topiramate -57.78; placebo -32.41; P= 0.0076). Mean topiramate dose was 102.94 mg/d. Topiramate was generally well tolerated.Topiramate was effective in improving reexperiencing and avoidance/numbing symptom clusters in patients with PTSD. This study supports the use of anticonvulsants for the improvement of symptoms of PTSD.",0,0 +4569,Risk of stroke among patients with post-traumatic stress disorder: nationwide longitudinal study,"Background Previous evidence has shown positive associations between post-traumatic stress disorder (PTSD) and hypertension, dyslipidaemia and diabetes mellitus, which are all risk factors for stroke, but the role of PTSD in the subsequent development of stroke is still unknown. Aims To investigate the temporal association between PTSD and the development of stroke. Method Identified from the Taiwan National Health Insurance Research Database, 5217 individuals aged 18 years, with PTSD but with no history of stroke, and 20 868 age- and gender-matched controls were enrolled between 2002 and 2009, and followed up until the end of 2011 to identify the development of stroke. Results Individuals with PTSD had an increased risk of developing any stroke (hazard ratio (HR) 3.37, 95% CI 2.44–4.67) and ischaemic stroke (HR = 3.47, 95% CI 2.23–5.39) after adjusting for demographic data and medical comorbidities. Sensitivity tests showed consistent findings (any stroke HR = 3.02, 95% CI 2.13–4.28; ischaemic stroke HR = 2.89, 95% CI 1.79–4.66) after excluding the first year of observation. Conclusions Individuals with PTSD have an increased risk of developing any stroke and ischaemic stroke. Further studies are required to investigate the underlying mechanisms.",0,0 +4570,Multidimensional Personality Questionnaire profiles of veterans with traumatic combat exposure: Externalizing and internalizing subtypes.,"This study used the Multidimensional Personality Questionnaire (MPQ; A. Tellegen, in press) to identify personality-based subtypes of posttraumatic response. Cluster analyses of MPQs completed by combat veterans revealed subgroups that differed on measures relating to the externalization versus internalization of distress. The MPQ profile of the externalizing cluster was defined by low Constraint and Harmavoidance coupled with high Alienation and Aggression. Individuals in this cluster also had histories of delinquency and high rates of substance-related disorder. In comparison, the MPQ profile of the internalizing cluster was characterized by lower Positive Emotionality, Alienation, and Aggression and higher Constraint, and individuals in this cluster showed high rates of depressive disorder. These findings suggest that dispositions toward externalizing versus internalizing psychopathology may account for heterogeneity in the expression of posttraumatic responses, including patterns of comorbidity.",0,0 +4571,Cluster analysis of obsessive-compulsive spectrum disorders in patients with obsessive-compulsive disorder: clinical and genetic correlates,"Comorbidity of certain obsessive-compulsive spectrum disorders (OCSDs; such as Tourette's disorder) in obsessive-compulsive disorder (OCD) may serve to define important OCD subtypes characterized by differing phenomenology and neurobiological mechanisms. Comorbidity of the putative OCSDs in OCD has, however, not often been systematically investigated. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition , Axis I Disorders-Patient Version as well as a Structured Clinical Interview for Putative OCSDs (SCID-OCSD) were administered to 210 adult patients with OCD (N = 210, 102 men and 108 women; mean age, 35.7 ± 13.3). A subset of Caucasian subjects (with OCD, n = 171; control subjects, n = 168), including subjects from the genetically homogeneous Afrikaner population (with OCD, n = 77; control subjects, n = 144), was genotyped for polymorphisms in genes involved in monoamine function. Because the items of the SCID-OCSD are binary (present/absent), a cluster analysis (Ward's method) using the items of SCID-OCSD was conducted. The association of identified clusters with demographic variables (age, gender), clinical variables (age of onset, obsessive-compulsive symptom severity and dimensions, level of insight, temperament/character, treatment response), and monoaminergic genotypes was examined. Cluster analysis of the OCSDs in our sample of patients with OCD identified 3 separate clusters at a 1.1 linkage distance level. The 3 clusters were named as follows: (1) “reward deficiency” (including trichotillomania, Tourette's disorder, pathological gambling, and hypersexual disorder), (2) “impulsivity” (including compulsive shopping, kleptomania, eating disorders, self-injury, and intermittent explosive disorder), and (3) “somatic” (including body dysmorphic disorder and hypochondriasis). Several significant associations were found between cluster scores and other variables; for example, cluster I scores were associated with earlier age of onset of OCD and the presence of tics, cluster II scores were associated with female gender and childhood emotional abuse, and cluster III scores were associated with less insight and with somatic obsessions and compulsions. However, none of these clusters were associated with any particular genetic variant. Analysis of comorbid OCSDs in OCD suggested that these lie on a number of different dimensions. These dimensions are partially consistent with previous theoretical approaches taken toward classifying OCD spectrum disorders. The lack of genetic validation of these clusters in the present study may indicate the involvement of other, as yet untested, genes. Further genetic and cluster analyses of comorbid OCSDs in OCD may ultimately contribute to a better delineation of OCD endophenotypes.",0,0 +4572,Externalizing and Internalizing Subtypes of Posttraumatic Psychopathology and Anger Expression,"Subtypes of posttraumatic psychopathology were replicated and extended in 254 female veterans with posttraumatic stress disorder (PTSD). Cluster analyses on Minnesota Multiphasic Personality Inventory-2 and Personality Psychopathology Five scales (Harkness, McNulty, & Ben-Porath, ) yielded internalizing and externalizing psychopathology dimensions, with a third low psychopathology group (simple PTSD). Externalizers were higher than the internalizers and the simple PTSD groups on the antisocial, substance, and aggression scales; internalizers were higher on depression and anxiety scales. Further validation included an independent measure of psychopathology to examine anger (Buss-Durkee Hostility Inventory, [BDHI]; Buss & Durkee, ). Externalizers were higher on extreme behavioral anger scales (assault and verbal hostility); and externalizers and internalizers were higher than the simple PTSD subjects on other anger scales. Positive correlations between the BDHI scales and the PTSD symptom of ""irritability and anger outbursts"" were found across scales in the total sample (range: r = .19-.36), on the assault scale in externalizers (r = .59), and the verbal hostility scale in both internalizers (r = .30) and simple PTSD (r = .37) groups, suggesting the broad utility of the symptom in the diagnosis. The results demonstrate the generalizability of the internalizing/externalizing typology to the female veteran population and highlight clinically relevant distinctions in anger expression within PTSD.",0,0 +4573,Interdisciplinary rehabilitation of mild TBI and PTSD: A case report,"Prevalence of mild traumatic brain injury (mTBI) or concussion on the battlefield in Iraq/Afghanistan has resulted in its designation as a 'signature injury'. Civilian studies have shown that negative expectations for recovery may lead to worse outcomes. While there is concern that concussion screening procedures in the Veteran's Affairs Healthcare System and the Department of Defence could fuel negative expectations, leading to negative iatrogenic effects, it has been difficult to document this in clinical settings. The aim of this report is to describe the case of a veteran with comorbid mTBI/PTSD with persistent symptoms of unknown aetiology and the effects of provider communications on the patient's recovery.Case report of a veteran with reported mTBI, including provider communications, neuropsychological test results and report of functioning after changes in provider messages.Two-years post-mTBI, the patient attributed cognitive difficulties to his brain injury, but neuropsychological assessment found that his cognitive profile was consistent with psychological rather than neurological dysfunction. After providers systematically emphasized expectations of recovery, the patient's daily functioning improved.This case illustrates difficulties in mass screening for and treating mTBI. Recommendations for improvement include clinician training in effectively communicating positive expectations of recovery after concussion.",0,0 +4574,When a soldier returns home from Iraq and/or Afghanistan with post -traumatic stress disorder: The lived experience of the spouse,"This study takes a broad look at the effects of a soldier's post-traumatic stress disorder (PTSD) symptomology on the dependent spouse, including anger, emotional distancing, and sleep disturbances a discussed by the participants. Domestic violence in the relationship was suggested to be one of the major factors in the participant's decision-making process. This study can be used as a first step in the development of programs aimed at maintaining family unity as well as increasing the safety of family members. This study is designed to investigate feelings, experiences, and major decisions military dependent spouses make when their Army soldier returns from Iraq and/or Afganistan with PTSD. This study uses qualitative methodology to obtain rich descriptions of the feelings and experiences of military dependants due to the soldier's PTSD symptomology. This study is meant to give other researchers a foundation upon which to create treatment methods that will benefit the Army community. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4575,"The café fire on New Year's Eve in Volendam, the Netherlands: description of events","The café fire at Volendam occurred shortly after midnight on the first of January 2001 and resulted in one of the worst mass burn incidents in recent Dutch history. The aim of this study was to provide insight into medical and organisational requirements of a major burns incident.Shortly after the fire, two university hospitals and a burn center in the region of the accident developed a plan for evaluation of medical care given during and after this major burn incident. A multidisciplinary research group investigated the management of victims at the scene, in the emergency departments (ED) and during admission in the hospitals. All 245 casualties were included in this study.A brief severe fire occurred in a crowded cafe with around 350 young visitors on a small embankment of a relatively isolated town, resulting in a unusually high number of severely injured burn victims. Four died immediately. The ensuing rescue effort was hampered by poor access and chaotic circumstances. At the scene of the incident, mobile medical teams ensured orderly transport and treatment priority for the injured. There were 245 victims with a median total body surface area burned of 12%. Inhalation injury was present in 96 patients. A total of 182 victims were admitted, with 112 to intensive care. Ten patients died in the hospital. Seventy-eight patients were secondarily transported, many to specialised centers in the Netherlands and abroad. In total, 36 hospitals in three countries participated.An incident with high numbers of burn victims poses a challenge to any health care system. The difficult circumstances at the site demonstrated the need for robust organisational structures. The primary and secondary distribution of patients required coordination, general hospitals were able to provide initial medical care to these major burn casualties.",0,0 +4576,Lifetime manic–hypomanic symptoms in post-traumatic stress disorder: Relationship with the 18 kDa mitochondrial translocator protein density,"Initially explored in military settings, post-traumatic stress disorder (PTSD) has shown increasing prevalence in the general population. The high comorbidity rates between bipolar disorder (BD) and PTSD have raised the issue of whether some characteristics of BD could represent risk factors for PTSD. In combat-related PTSD, the 18 kDa mitochondrial translocator protein (TSPO), essential for steroid synthesis, was found to be decreased. Aims of the present study were: 1) the assessment of the TSPO mitochondrial density in lymphomonocytes from civilian patients with non-combat-related PTSD, without current or lifetime Axis I mood comorbidity, versus controls; 2) the exploration of the correlations between TSPO density and the presence of comorbid manic/hypomanic lifetime spectrum symptoms. Assessments included the Structured Clinical Interview for DSM-IV (SCID), the Impact of Event Scale (IES), and the lifetime Mood Spectrum Self-Report (MOODS-SR). Blood samples were processed to assess TSPO binding parameters in lymphomonocyte mitochondrial membranes. PTSD patients showed a significant decrease in TSPO density, without changes in mitochondrial citrate synthase activity. Further, TSPO density correlated with the number of lifetime manic/hypomanic spectrum symptoms. For the first time, TSPO density was found to be decreased in non-war-related PTSD and such decreases correlated with comorbid manic/hypomanic spectrum symptoms, indicating a possible role of sub-threshold bipolar comorbidity in PTSD-related neurobiological dysregulation.",0,0 +4577,A SAS Procedure Based on Mixture Models for Estimating Developmental Trajectories,"This article introduces a new SAS procedure written by the authors that analyzes longitudinal data (developmental trajectories) by fitting a mixture model. The TRAJ procedure fits semiparametric (discrete) mixtures of censored normal, Poisson, zero-inflated Poisson, and Bernoulli distributions to longitudinal data. Applications to psychometric scale data, offense counts, and a dichotomous prevalence measure in violence research are illustrated. In addition, the use of the Bayesian information criterion to address the problem of model selection, including the estimation of the number of components in the mixture, is demonstrated.",0,0 +4578,Initial Stress Responses in Relation to Outcome After Three Decades,"The present study aimed at predicting posttraumatic stress 5 and 27 years after the North Sea oil rig disaster. The predictions were based on the initial levels of stress responses and the early recovery as reported in 1980. The Posttraumatic Stress Scale (PTSS) was used at 3 measure points. From 1980, data from 69 survivors were used in latent growth modeling. Follow-up studies included 65 survivors and 85 matched unexposed oil-rig workers in 1985; and 47 and 62 in 2007. In 1985, the survivors had higher total PTSS scores and more frequent endorsements on most single PTSS-items than the comparison group. In 2007, a few single items remained different. The initial levels of stress responses and the early recovery rate predicted the long-term outcomes after 5 and 27 years. Initial screenings may be helpful in the early detection of posttraumatic stress in the very long-term perspective.",0,0 +4579,What Is the Typical Response to Sexual Assault? Reply to Bonanno (2013),"We respond to Bonanno's (2013) comment on our longitudinal evaluation of sexual assault survivors. Bonanno posits that minor disruption in functioning is the modal response to any stressor or trauma, yet most women we studied had marked initial symptoms in the immediate months following assault, which gradually improved over time. We argue that sexual violence is one example of intentional and malicious victimization, which differs from other experiences studied by Bonanno, such as spinal cord injury. Our study also differed from most previous studies in that it specifically examined the acute reactions period, which is the only period that can distinguish between resilience and recovery: Both trajectories ultimately involve good adaptation, but are distinguished by the degree of initial postevent disruption. We address Bonanno's contention that our results should be dismissed on methodological and statistical grounds. Our findings suggest that prior research about the frequency of resilience may in part be confounded by the degree and type of stress exposure.",0,0 +4580,The Dissociative Subtype of Posttraumatic Stress Disorder: Unique Resting-State Functional Connectivity of Basolateral and Centromedial Amygdala Complexes,"Previous studies point towards differential connectivity patterns among basolateral (BLA) and centromedial (CMA) amygdala regions in patients with posttraumatic stress disorder (PTSD) as compared with controls. Here we describe the first study to compare directly connectivity patterns of the BLA and CMA complexes between PTSD patients with and without the dissociative subtype (PTSD+DS and PTSD-DS, respectively). Amygdala connectivity to regulatory prefrontal regions and parietal regions involved in consciousness and proprioception were expected to differ between these two groups based on differential limbic regulation and behavioral symptoms. PTSD patients (n=49) with (n=13) and without (n=36) the dissociative subtype and age-matched healthy controls (n=40) underwent resting-state fMRI. Bilateral BLA and CMA connectivity patterns were compared using a seed-based approach via SPM Anatomy Toolbox. Among patients with PTSD, the PTSD+DS group exhibited greater amygdala functional connectivity to prefrontal regions involved in emotion regulation (bilateral BLA and left CMA to the middle frontal gyrus and bilateral CMA to the medial frontal gyrus) as compared with the PTSD-DS group. In addition, the PTSD+DS group showed greater amygdala connectivity to regions involved in consciousness, awareness, and proprioception-implicated in depersonalization and derealization (left BLA to superior parietal lobe and cerebellar culmen; left CMA to dorsal posterior cingulate and precuneus). Differences in amygdala complex connectivity to specific brain regions parallel the unique symptom profiles of the PTSD subgroups and point towards unique biological markers of the dissociative subtype of PTSD.",0,0 +4581,Understanding Resilience and Other Trajectories of Psychological Distress: a Mixed-Methods Study of Low-Income Mothers Who Survived Hurricane Katrina,"Recent longitudinal studies in the aftermath of natural disasters have shown that resilience, defined as a trajectory of consistently low symptoms, is the modal experience, although other trajectories representing adverse responses, including chronic or delayed symptom elevations, occur in a substantial minority of survivors. Although these studies have provided insight into the prototypical patterns of postdisaster mental health, the factors that account for these patterns remain unclear. In the current analysis, we aimed to fill this gap through a mixed-methods study of female participants in the Resilience in Survivors of Katrina (RISK) study. Latent class growth analysis identified six trajectories of psychological distress in the quantitative sample (n=386). Qualitative analysis of in-depth interviews with 54 participants identified predisaster, disaster-related and postdisaster experiences that could account for the trends in the quantitative data. In particular, preexisting and gains in psychosocial resources (e.g., emotion regulation, religiosity) and positive postdisaster impacts (e.g., greater neighborhood satisfaction, improved employment opportunities) were found to underlie resilience and other positive mental health outcomes. Conversely, experiences of childhood trauma, and pre and postdisaster stressors (e.g., difficulties in intimate partner relationships) were common among participants in trajectories representing adverse psychological responses. Illustrative case studies that exemplify each trajectory are presented. The results demonstrate the utility of mixed-methods analysis to provide a richer picture of processes underlying postdisaster mental health.",0,0 +4582,Short-term follow-up of post-traumatic stress symptoms in motor vehicle accident victims,"Ninety-eight victims of recent motor vehicle accidents (MVA), who sought medical attention as a result of the MVA, were followed up prospectively 6 months after the initial assessment, using Keller, Lavori, Friedman, Nielsen, Endicott, McDonald-Scott and Andreasen's (Archives of General Psychiatry, 44, 540-548, 1987) LIFE methodology so that month-by-month changes in post-traumatic stress disorder (PTSD) symptoms could be determined. For the 40 MVA victims who initially met the full criteria for PTSD, 10 no longer met the criteria 4 months after the initial assessment, a decrease significant at the P < 0.01 level, and 20 no longer met the full criteria at 6 months (P < 0.001). On a symptom-by-symptom basis, there were significant declines among the fraction of those who initially met the criteria for PTSD for all avoidance and numbing symptoms by the 6-month follow-up, whereas most of the hyperarousal symptoms did not show significant declines.",0,0 +4583,Chronicity of Psychological Strain in Occupational Settings and the Accuracy of the General Health Questionnaire.,"This article examines the proposition that the traditional scoring method of the General Health Questionnaire (GHQ) underestimates the number of respondents classified as ""cases."" A revised ""chronic"" scoring method (the CGHQ) is used and demonstrates superior construct validity and greater sensitivity. A comparison of the CGHQ and GHQ also shows the CGHQ to be a superior criterion measure. These claims are demonstrated by survey data gathered from 3 occupational samples (Ns=11,637, 2,253, and 2,124). Results show that the CGHQ is more appropriate as a screening instrument for psychological morbidity. Tests of construct validity also favor the CGHQ with only a slight advantage for predictive validity in terms of variance explained. The more desirable statistical properties of the CGHQ result in a reduction of significant interaction terms and are strongly recommended in future studies as a means of controlling Type I errors when tests of moderation are examined.",0,0 +4584,Clinical and Cognitive Correlates of Psychiatric Comorbidity in Delusional Disorder Outpatients,"Objectives: The aims of this study were to investigate the prevalence, as well as the clinical, cognitive, and functional correlates of psychiatric comorbidity in patients with delusional disorder (DD). Methods: Eighty-six outpatients with DSM-IV DD were evaluated for psychiatric comorbidity on Axis I disorders using the Mini International Neuropsychiatry Interview (MINI). The following instruments were administered: the Standardized Assessment of Personality (SAP), the Positive and Negative Symptom Scale (PANSS), the Montgomery-Asberg Depression Rating Scale (MADRS), a neuropsychological battery (consisting of measures for attention, verbal and working memory, and executive functions), the Sheehan Disability Inventory (SDI), and the Global Assessment of Functioning (GAF) scale. A socio-demographic and clinical questionnaire was also completed. Results: Forty-six percent of the subjects had at least one additional lifetime psychiatric diagnosis, the most common being depressive disorders (N = 16, 32.6%), followed by anxiety disorders (N = 8, 14%). DD with comorbid Axis I disorders (N = 40, 46.5%) was associated with a specific syndromic constellation (more common cluster C personality psychopathology, somatic delusions, olfactory and gustatory hallucinations, and suicide risk), and greater severity of the psychopathology, particularly as regards emotional dysregulation (total and general PANSS scales, MADRS, and perceived stress SDI scoring). In contrast, DD without psychiatric comorbidity – “pure” DD – (N = 46, 53.5%) was associated with worse overall neurocognitive performance, mainly in working memory. There were no differences in functionality between the two groups (as per the GAF and SDI total, work, social and family life disability scores). Conclusions: Our findings reveal one type of DD with associated psychiatric comorbidity with greater emotion-related psychopathology and another “pure” DD, without psychiatric comorbidity, related to worse global cognitive functioning. Treatment for DD should address both types of processes.",0,0 +4585,"Efficacy and Safety of Paroxetine Treatment for Chronic PTSD: A Fixed-Dose, Placebo-Controlled Study","This study evaluated the efficacy and safety of paroxetine for the treatment of patients with chronic posttraumatic stress disorder (PTSD).Outpatients with chronic PTSD according to DSM-IV criteria and a score of 50 or more on the Clinician-Administered PTSD Scale, part 2, were randomly assigned to take placebo (N=186), 20 mg/day of paroxetine (N=183), or 40 mg/day of paroxetine (N=182) for 12 weeks. Efficacy was assessed by examining the change in total score from baseline to endpoint on the Clinician-Administered PTSD Scale, part 2, and rates of response (""very much improved"" or ""much improved"") for global improvement on the Clinical Global Impression scale.Paroxetine-treated patients in both dose groups demonstrated significantly greater improvement on primary outcome measures compared to placebo-treated patients in the intent-to-treat analysis. Moreover, paroxetine treatment resulted in statistically significant improvement compared to placebo on all three PTSD symptom clusters (reexperiencing, avoidance/numbing, and hyperarousal), social and occupational impairment, and comorbid depression. Paroxetine was effective for both men and women. Treatment response did not vary by trauma type, time since trauma, or severity of baseline PTSD or depressive symptoms. Both doses were well tolerated.Doses of 20 and 40 mg/day of paroxetine are effective and well tolerated in the treatment of adults with chronic PTSD.",0,0 +4586,Systems biology approach to understanding post-traumatic stress disorder,This review paper presents known biological facts about PTSD and the mathematical/systems biology tools used to understand the underpinning molecular principles.,0,0 +4587,Personality Assessment Inventory internalizing and externalizing structure in veterans with posttraumatic stress disorder: Associations with aggression,"Posttraumatic stress disorder (PTSD) is associated with aggressive behavior in veterans, and difficulty controlling aggressive urges has been identified as a primary postdeployment readjustment concern. Yet only a fraction of veterans with PTSD commit violent acts. The goals of this study were to (1) examine the higher-order factor structure of Personality Assessment Inventory (PAI) scales in a sample of U.S. military veterans seeking treatment for PTSD; and (2) to evaluate the incremental validity of higher-order latent factors of the PAI over PTSD symptom severity in modeling aggression. The study sample included male U.S. Vietnam (n = 433) and Iraq/Afghanistan (n = 165) veterans who were seeking treatment for PTSD at an outpatient Veterans Affairs (VA) clinic. Measures included the Clinician Administered PTSD Scale, the PAI, and the Conflict Tactics Scale. The sample was randomly split into two equal subsamples (n's = 299) to allow for cross-validation of statistically derived factors. Parallel analysis, variable clustering analysis, and confirmatory factor analyses were used to evaluate the factor structure, and regression was used to examine the association of factor scores with self-reports of aggression over the past year. Three factors were identified: internalizing, externalizing, and substance abuse. Externalizing explained unique variance in aggression beyond PTSD symptom severity and demographic factors, while internalizing and substance abuse did not. Service era was unrelated to reports of aggression. The constructs of internalizing versus externalizing dimensions of PTSD may have utility in identifying characteristics of combat veterans in the greatest need of treatment to help manage aggressive urges. Aggr. Behav. 9999:XX-XX, 2014. Published 2014. This article is a U.S. Government work and is in the public domain in the USA. Language: en",0,0 +4588,Frequency and Severity of Comorbid Mood and Anxiety Disorders in Prescription Opioid Dependence,"Background and Objectives Comorbid substance use disorders and mood and anxiety disorders are associated with more severe psychiatric symptoms, social and occupational impairment, and economic burden. To date, the majority of research has focused on comorbidity in illicit drug users, rather than prescription drug users. To address this gap in the literature, the present cross-sectional study investigated the clinical profiles of individuals with prescription opioid dependence with or without comorbid mood and anxiety disorders. Methods Ninety individuals with prescription opioid use were recruited to participate in the study procedures. All participants completed a structured clinical interview and series of self-report measures. Results and Conclusions Of the 85 individuals with prescription opioid dependence, 47.1% (n = 40) were diagnosed with a comorbid mood or anxiety disorder. The findings showed that individuals with prescription opioid dependence and comorbid mood and anxiety disorders demonstrated significantly more severe alcohol use, psychiatric symptoms, and sleep impairment than individuals without comorbidity. Scientific Significance The findings highlight the frequency and severity of co-occurring mood and anxiety disorders in individuals with prescription opioid dependence and suggest that integrated interventions are needed to address these growing problems. (Am J Addict 2013; 22:261–265)",0,0 +4589,REM sleep behaviour disorder: Clinical profiles and pathophysiology,"Rapid eye movement (REM) sleep behaviour disorder (RBD) is a parasomnia characterized by the intermittent loss of electromyographic atonia normally present during REM sleep and the emergence of purposeful complex motor activity associated with vivid dreams. Rapid eye movement sleep behaviour disorder usually affects older males and can be either idiopathic or symptomatic of various underlying disorders, in particular neurodegenerative diseases; in the latter case, RBD may be a prodromal symptom of the neurological disease. Several brainstem regions have been implicated in RBD pathophysiology, although the exact mechanism of the disorder in humans remains to be clarified. On clinical grounds, differentiation of RBD should be made from several non-REM parasomnias and other aberrant behaviours occurring during sleep. Rapid eye movement sleep behaviour disorder can be diagnosed on the basis of a systematic medical, neurological and psychiatric evaluation of the patient, assisted by a standard polysomnographic recording that includes continuous overnight videotaping; a brain imaging study is mandatory when an underlying brain disease is being suspected. Clonazepam at bedtime is the treatment of choice for RBD; alternatively, melatonin or pramipexole can be administered when clonazepam is contraindicated.",0,0 +4590,Predictors of acute posttraumatic stress disorder symptoms following civilian trauma,"Posttraumatic stress disorder (PTSD) is associated with significant morbidity following injury. The incidence and risk factors for PTSD are not well described in the civilian trauma population. We proposed to screen all trauma patients in the outpatient trauma clinic for acute PTSD symptoms and identify risk factors for PTSD.We prospectively screened 1,386 injured patients who presented for follow-up in trauma clinic (January 2009 to September 2010) using an established PTSD screening test (PTSD Checklist-Civilian, PCL-C). A PCL-C score of ≥35, with a known sensitivity of >85% for PTSD, was considered screen-positive (PCL-C-POS). Backward stepwise logistic regression was used to determine independent risk factors for PCL-C-POS.Over 25% of trauma clinic patients met the threshold for positive PTSD screen (PCL-C-POS). The highest incidence (43%) was in patients who sustained assault (blunt or penetrating). Regression analysis revealed that age <55 years, female gender, motor vehicle collision, and assaultive mechanism (blunt or penetrating, excluding self-inflicted or accidental injury) were independent predictors of PCL-C-POS status. As the severity of symptoms increased (higher PCL-C scores), the risk associated with assaultive mechanism significantly increased in a dose-response fashion (p < 0.05).This study confirms the high incidence of acute PTSD symptoms in trauma patients and supports the feasibility of PTSD screening in the outpatient trauma clinic. Among all mechanisms of injury, patients who sustain interpersonal violence are at the highest risk of developing acute PTSD symptoms. These results suggest that PTSD screening in outpatient trauma clinic may allow early detection and referral of patients with PTSD.II.",0,0 +4591,[Factors affecting the diagnosis of post-traumatic stress disorder after a terrorist attack].,"On 3 January 2008 explosives placed in an automobile on a thoroughfare in Diyarbakir, southeastern Turkey exploded in a terrorist attack. The aim of this study was to determine the risk factors for the diagnosis of and the rate of post-traumatic stress disorder (PTSD) among individuals who were eye- or earwitnesses to the explosion 1 and 3 months after the explosion.Among the residents and workers in close proximity to the explosion site, 216 individuals who were eye- or earwitnesses to the explosion were included in the study. A sociodemographic data form and a traumatic stress symptom scale were administered to the participants 1 and 3 months following the explosion.In all, 12.5% of the participants were diagnosed with PTSD 1 month post-explosion versus 9.6% 3 months post-explosion. While history of psychiatric disorder and physical injury were risk factors for PTSD 1 month post-explosion, risk factors 3 months post-explosion was history of psychiatric disorder.PTSD occurs at high rates in individuals exposed to terrorist attacks. More studies following such events are required in Turkey. In light of these results it is advised that individuals at risk of PTSD receive therapeutic and preventive interventions provided by mental health professionals.",0,0 +4592,Identification of resilient individuals and those at risk for performance deficits under stress,"Human task performance is affected by exposure to physiological and psychological stress. The ability to measure the physiological response to stressors and correlate that to task performance could be used to identify resilient individuals or those at risk for stress-related performance decrements. Accomplishing this prior to performance under severe stress or the development of clinical stress disorders could facilitate focused preparation such as tailoring training to individual needs. Here we measure the effects of stress on physiological response and performance through behavior, physiological sensors, and subjective ratings, and identify which individuals are at risk for stress-related performance decrements. Participants performed military-relevant training tasks under stress in a virtual environment, with autonomic and hypothalamic-pituitary-adrenal axis (HPA) reactivity analyzed. Self-reported stress, as well as physiological indices of stress, increased in the group pre-exposed to socioevaluative stress. Stress response was effectively captured via electrodermal and cardiovascular measures of heart rate and skin conductance level. A resilience classification algorithm was developed based upon physiological reactivity, which correlated with baseline unstressed physiological and self-reported stress values. Outliers were identified in the experimental group that had a significant mismatch between self-reported stress and salivary cortisol. Baseline stress measurements were predictive of individual resilience to stress, including the impact stress had on physiological reactivity and performance. Such an approach may have utility in identifying individuals at risk for problems performing under severe stress. Continuing work has focused on adapting this method for military personnel, and assessing the utility of various coping and decision-making strategies on performance and physiological stress.",0,0 +4593,Direct and indirect predictors of traumatic stress and distress in orphaned survivors of the 1994 Rwandan Tutsi genocide,"Millions of children grow into adulthood having experienced severe war and ethnic conflict as children. One such group is orphaned child and adolescent survivors of the 1994 Rwandan Tutsi Genocide, in which one-seventh of the Rwandan population was murdered over the course of 100 days. After the genocide, many of these children took on the responsibility of caring and providing for other child survivors. Research has documented that child survivors of the genocide are at increased risk of mental health concerns (Dyregrov, Gupta, Gjestad, & Mukanoheli, 2000; Schaal & Elbert, 2006). However, differences in PTSD symptoms in Rwandan orphan survivors have not been fully explained by genocide exposure. This dissertation consists of two manuscripts that used path analysis to identify modifiable factors that contribute to mental health outcomes for orphaned heads of household (OHH) in Rwanda, over and above genocide exposure. Participants were 100 OHH who were members of a community organization. Data came from genocide testimonies that were given in 2002 and assessments of post-genocide mental health and risk factors that were collected in a 2008/2009 follow-up of 61 of the 100 original participants. The first manuscript used cognitive models of posttraumatic stress disorder (PTSD) as a framework for investigating whether linguistic components of genocide testimonies predict PTSD symptoms. Results were somewhat consistent with cognitive models and indicated that the way survivors described their genocide experiences predicted PTSD symptoms six years later. The second manuscript investigated whether post-genocide social-ecological risk factors predict distress and traumatic stress. Lack of education substantially predicted both distress and traumatic stress, lack of resources significantly predicted lower educational attainment, and social support predicted distress. After accounting for post-genocide risk factors, genocide experiences still directly predicted distress and traumatic stress. Implications for intervention and research are discussed. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +4594,"Trauma, posttraumatic stress disorder symptom clusters, and physical health symptoms in postabused women","The purpose of this retrospective, descriptive-correlational research was to examine the relationships between violent and nonviolent trauma, posttraumatic stress disorder (PTSD) and its symptom clusters of avoidance, intrusive/re-experiencing, and hyperarousal, and self-reported physical health symptoms in 50 postabused women. Results indicated: (1) PTSD hyperarousal and avoidance symptom clusters were positively associated with physical health symptoms, and (2) childhood physical abuse accounted for a significant and unique portion of the variance in physical health symptoms. The results highlight the need for health care practitioners in all settings to assess for a history of trauma in a woman's life.",0,0 +4595,Childhood maltreatment and post-traumatic stress disorder among incarcerated young offenders,"Young offenders have a high prevalence of mental illness and a large proportion report experiencing a number of traumatic events during childhood, but there is little research exploring this association. This study describes the prevalence of, and association between, child maltreatment and post-traumatic stress disorder (PTSD) among young offenders. The study uses data collected as part of the 2009 NSW Young People in Custody Health Survey which was conducted in nine juvenile detention centers. This paper reports on findings from the baseline questionnaires and 18-months of re-offending data. The analysis included 291 participants who were assessed for PTSD and child maltreatment. The sample was 88% male, 48% Aboriginal, with an average age of 17 years (range 13–21 years). One in five (20%) participants were diagnosed with PTSD, with females significantly more likely to have PTSD than males (40% vs. 17%, p < 0.05). Over half (60%) of young offenders reported any child abuse or neglect, with females nearly 10 times more likely to report three or more kinds of severe child maltreatment than males. The main correlate for a diagnosis of PTSD was having three or more kinds of severe child maltreatment (OR = 6.73, 95% CI: 1.06–42.92). This study provides evidence for the need to comprehensively assess child abuse and neglect among young offenders in order to provide appropriate treatment in custody and post-release.",0,0 +4596,A Longitudinal Analysis of PTSD Symptom Course: Delayed-Onset PTSD in Somalia Peacekeepers.,"Posttraumatic stress disorder (PTSD) typically follows an acute to chronic course. However, some trauma victims do not report significant symptoms until a period of time has elapsed after the event. Although originally dismissed as an artifact of retrospective methodologies, recent prospective studies document apparent instances of delayed-onset PTSD. Little is known currently about factors associated with the delayed onset of PTSD. This study was designed to examine the course of PTSD in a sample of 1,040 U.S. military peacekeepers who served in Somalia. A small but nontrivial subset of participants endorsed clinically significant levels of PTSD after a period of minimal distress, the magnitude of which cannot be ascribed to minor waxing and waning of symptoms. War-zone exposure and perceived meaningfulness of the mission, as rated by soldiers after returning to the United States, predicted symptom course over the next 18 months.",0,0 +4597,"Human rights, transitional justice, public health and social reconstruction","Mass violence, armed conflict, genocide, and complex humanitarian emergencies continue to create major social and public health disasters at the dawn of the 21st Century. Transitional justice, a set of policies designed to address the effects of war on traumatized communities and bring justice, lies at the nexus of public health, conflict, and social reconstruction. Despite the paucity of empirical evidence, advocates of transitional justice have claimed that it can alleviate the effects of trauma, deter future violence, and bring about social reconstruction in war-affected communities. Empirical evidence--including new data and analyses presented in this article--suggests a link between trauma, mental health and attitudes towards and responses to transitional justice programs, but there has been little theoretical discussion about the intersection between public health and transitional justice, and even less empirical research to generate discussion between these two fields. Yet, public health professionals have an important role to play in assessing the impact of transitional justice on communities affected by mass violence. In this paper, we offer a conceptual model for future research that seeks to examine the relationship between transitional justice programs and their potential value to the fields of medicine and public health and discuss the methodological issues and challenges to a comprehensive evaluation of this relationship. To illustrate the discussion, we examine new data and analyses from two cases of contemporary conflicts, eastern Democratic Republic of Congo (DRC) and northern Uganda.",0,0 +4598,Heart rate variability (HRV): an indicator of stress,"Heart rate variability (HRV) can be an important indicator of several conditions that affect the autonomic nervous system, including traumatic brain injury, post-traumatic stress disorder and peripheral neuropathy [3], [4], [10] & [11]. Recent work has shown that some of the HRV features can potentially be used for distinguishing a subject’s normal mental state from a stressed one [4], [13] & [14]. In all of these past works, although processing is done in both frequency and time domains, few classification algorithms have been explored for classifying normal from stressed RRintervals. In this paper we used 30 s intervals from the Electrocardiogram (ECG) time series collected during normal and stressed conditions, produced by means of a modified version of the Trier social stress test, to compute HRV-driven features and subsequently applied a set of classification algorithms to distinguish stressed from normal conditions. To classify RR-intervals, we explored classification algorithms that are commonly used for medical applications, namely 1) logistic regression (LR) [16] and 2) linear discriminant analysis (LDA) [6]. Classification performance for various levels of stress over the entire test was quantified using precision, accuracy, sensitivity and specificity measures. Results from both classifiers were then compared to find an optimal classifier and HRV features for stress detection. This work, performed under an IRB-approved protocol, not only provides a method for developing models and classifiers based on human data, but also provides a foundation for a stress indicator tool based on HRV. Further, these classification tools will not only benefit many civilian applications for detecting stress, but also security and military applications for screening such as: border patrol, stress detection for deception [3],[17], and wounded-warrior triage [12].",0,0 +4599,The influence of the dissociative subtype of posttraumatic stress disorder on treatment efficacy in female veterans and active duty service members.,"A dissociative subtype of posttraumatic stress disorder (PTSD) was recently added to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; American Psychiatric Association, 2013) and is thought to be associated with poor PTSD treatment response.We used latent growth curve modeling to examine data from a randomized controlled trial of prolonged exposure and present-centered therapy for PTSD in a sample of 284 female veterans and active duty service members with PTSD to test the association between the dissociative subtype and treatment response.Individuals with the dissociative subtype (defined using latent profile analysis) had a flatter slope (p = .008) compared with those with high PTSD symptoms and no dissociation, such that the former group showed, on average, a 9.75 (95% confidence interval [-16.94, -2.57]) lesser decrease in PTSD severity scores on the Clinician Administered PTSD Scale (Blake et al., 1995) over the course of the trial. However, this effect was small in magnitude. Dissociative symptoms decreased markedly among those with the subtype, though neither treatment explicitly addressed such symptoms. There were no differences as a function of treatment type.Results raise doubt about the common clinical perception that exposure therapy is not effective or appropriate for individuals who have PTSD and dissociation, and provide empirical support for the use of exposure treatment for individuals with the dissociative subtype of PTSD.",0,0 +4600,Age at onset in Canadian OCD patients: Mixture analysis and systematic comparison with other studies,"This study aimed to determine the distributions of the age at onset (AAO) using mixture analysis and better develop the understanding of AAO as a clinical feature of obsessive-compulsive disorder.Mixture analysis was used to identify sub-groups characterized by differences in AAO. Clinical features were analyzed for differences in AAO sub-groups using mixture analysis. Comparisons were made with AAO cut-offs used in previous studies using the 2-Sample Kolmogorov-Smirnov Test.Mixture analysis of our sample (n=196) yielded a combination of 2 normal theoretical distributions with means (SD) of 9.66 (3.12) for the early-onset sub-group and 21.1 (8.36) years for the late-onset sub-group. The sub-groups were divided by a cut-off of 15 years. As expected, a negative correlation was found between AAO and duration of illness. The early-onset subjects had significantly lower age at the time of the assessment and they tended to have more often panic attacks but were treated less often with benzodiazepines and other anti-anxiety medications. The comparison analysis showed significant difference in the AAO distribution between our sample and four other study samples.Our findings support the notion that different AAO sub-groups correspond with differences in clinical presentations of obsessive-compulsive disorder.",0,0 +4601,RESILIENCE AND RECOVERY IN AMERICAN SĀMOA: A CASE STUDY OF THE 2009 SOUTH PACIFIC TSUNAMI,"Case study methodology was used to explore the culturally situated response and recovery efforts following a tsunami in American Sāmoa. Data indicated that cultural mechanisms were effective in meeting physical needs but insufficient to manage the emotional trauma caused by such a large-scale event. Samoan cultural norms strongly discourage uncontrolled emotional expression outside of ritualized grieving events. Disruptions in social networks and activities, combined with a lack of available emotional support, resulted in significant psychological distress for many survivors. Sixteen months after the tsunami residents continued to exhibit numerous symptoms of posttraumatic stress. In response to this need for emotional support, some groups within American Sāmoa are setting an example of how their culture can adapt by forging new, culturally grounded methods for addressing emotional needs that arose in the wake of the tsunami. Findings are analyzed through the lens of the social support deterioration deterrence model and activity settings theory.",0,0 +4602,Mental Health and Health-Related Quality of Life Among Adult Latino Primary Care Patients Living in the United States With Previous Exposure to Political Violence,"Although political violence continues in parts of Central America, South America, and Mexico, little is known about its relationship to the health of Latino immigrants living in the United States.To determine (1) rates of exposure to political violence among Latino adult primary care patients who have immigrated to the United States from Central America, South America, and Mexico and its impact on mental health and health-related quality of life and (2) frequency of disclosure of political violence to primary care clinicians.Two-stage cluster design survey of a systematic sample of Latino immigrant adults in 3 community-based primary care clinics in Los Angeles, conducted from July 2001 to February 2002.Reports of exposure to political violence in home country before immigrating to the United States and communication with clinicians about political violence; self-reported measures of health-related quality of life using the Medical Outcomes Study Short Form 36 (MOS SF-36); symptoms of depression, anxiety, and alcohol disorders using the Primary Care Evaluation of Mental Disorders (PRIME-MD); and symptoms of posttraumatic stress disorder (PTSD) using the PTSD Checklist-Civilian Version (PCL-C).A total of 638 (69%) of 919 eligible patients participated. The nonresponse rates did not differ by age, sex, recruitment sites, or clinic sessions. In weighted analyses, 54% of participants reported political violence experiences in their home countries, including 8% who reported torture. Of those exposed to political violence, 36% had symptoms of depression and 18% had symptoms of PTSD vs 20% and 8%, respectively, among those not exposed to political violence. Controlling for age, sex, country, years lived in the United States, acculturation, income, health insurance status, and recruitment site in a subsample of 512 participants (56%), those who reported political violence exposure were more likely to meet symptom criteria for PTSD (adjusted odds ratio [AOR], 3.4; 95% confidence interval [CI], 1.4-8.4) and to have symptoms of depression (AOR, 2.8; 95% CI, 1.4-5.4) and symptoms of panic disorder (AOR, 4.8; 95% CI, 1.6-14.4) than participants not reporting political violence. Those exposed to political violence reported more chronic pain and role limitations due to physical problems, as well as worse physical functioning and lower perceptions of general health than those who were not exposed to political violence. Only 3% of the 267 patients who had experienced political violence reported ever telling a clinician about it after immigrating; none reported their current physician asking about political violence.Latino immigrants in primary care in Los Angeles have a high prevalence of exposure to political violence before immigrating to the United States and associated impairments in mental health and health-related quality of life.",0,0 +4603,Degrees of resilience: profiling psychological resilience and prospective academic achievement in university inductees,"University inductees may be increasingly vulnerable to stressors during transition into higher education (HE), requiring psychological resilience to achieve academic success. This study aimed to profile inductees' resilience and to investigate links to prospective end of year academic outcomes. Scores for resilience were based on a validated Connor Davison Resilience Scale (CD-RISC) drawn from 1534 inductees in a single UK university. A four-stage analysis revealed that incremental resilience was more facilitative of females' prospective academic attainment, but less functional and more convoluted for males. This large, distinctive study has implications for student support practices and highlights that the relationship between resilience and academic achievement requires further consideration in HE.",0,0 +4604,Post-traumatic stress symptoms among former child soldiers in Sierra Leone: follow-up study,"Background Former child soldiers are at risk of developing post-traumatic stress disorder (PTSD); however, the trajectory of symptoms has yet to be examined. Aims The risk and protective factors associated with PTSD symptom change among former child soldiers in Sierra Leone were investigated. Method Data from 243 former child soldiers (mean age 16.6 years, 30% female) were analysed. Results Self-reported rates of possible PTSD using standard cut-off points declined from 32% to 16% 4 years later ( P <0.05). Symptoms of PTSD at baseline were significantly associated with war experiences ( P <0.01) and post-conflict family abuse ( P <0.001). Reliable improvement in symptoms was reported by 30%. In growth models examining symptom change, worsening of symptoms was associated with death of a parent ( P <0.05) and post-conflict stigma ( P <0.001). Protective effects were observed for increases in family acceptance ( P <0.001). Conclusions The findings indicated improvement in PTSD symptoms among former child soldiers despite limited access to care. Family and community support played a vital part in promoting psychological adjustment.",0,0 +4605,Psychometric Properties of the Dissociative Experiences Scale,"The test-retest reliability of the Dissociative Experiences Scale (DES; Bernstein EM, Putnam FW [1986] Development, reliability, and validity of a dissociation scale. The Journal of Nervous and Mental Disease 174:727-735) in a clinical sample was found to be .93 for the total DES score and .95, .89, and .82 for the three subscale scores of amnesia, depersonalization-derealization, and absorption (dissociative identity disorder [DID], DSM-IV), respectively. Test-retest reliabilities within diagnostic groups of multiple personality disorder, dissociative disorder not otherwise specified, and a general other category of psychiatric diagnoses were obtained for total and subscale scores on the DES. These ranged from .78 to .96. Tests of mean scores across the two test sessions showed the total and subscale scores to be temporally stable. The DES was also found to be highly internally consistent: Cronbach's alphas of .96 and .97 were observed for the total DES scores taken at times 1 and 2, respectively. Construct validity of the DES was demonstrated by differentiation among the subscale scores in a repeated-measures analysis of variance (F[2,154] = 32.03, p < or = .001). Normality and general distribution issues were also addressed and provided a rationale for using the DES with parametric statistics. Reasons why the DES (as it was originally designed) is not appropriate as a dependent measure in outcome research are discussed, along with needed future research. Implications of the findings for the clinical usefulness of the DES as a diagnostic instrument are noted.",0,0 +4606,Posttraumatic stress disorder in the new zealand police: The moderating role of social support following traumatic stress,"It has been consistently demonstrated that social support affects psychological outcomes following the experience of trauma. Information processing theories of traumatic stress and empirical evidence suggest a model of social support and Posttraumatic Stress Disorder (PTSD) aetiology, in which emotional support and disclosure moderates the effects of trauma. This model was tested using survey data from 527 New Zealand Police officers. The results showed that all support variables had significant negative main effects on PTSD symptoms. Trauma was positively related to PTSD symptoms and this relationship was moderated by police officers' attitudes to expressing emotions at work and emotional support from peers. These results have implications for the provision of support for workers whose job places them at risk of experiencing multiple trauma.",0,0 +4607,Comorbidities and psychotic illness. Part 1: Philosophy and clinical consequences.,"This article aims at addressing the implications of defining 'comorbidity' within the field of psychiatry. We have looked at the standard definition of comorbidity and then discussed whether this definition can be applied to comorbidities in psychiatry. While comorbidities in physical illness are clearly the coexistence of two independent illnesses, Comorbidities in Mental illness are the result of the polygenic nature of mental illnesses, especially in psychotic illness whether schizophrenia or bipolar disorder. As a consequence, often the comorbidities of psychiatric illness are caused by two conditions which have in common the presence of particular single nucleotide polymorphisms (snps), which regulate the metabolism of neurotransmitters or the presence of neurotrophic factors . Thus inevitably, many such comorbidities are inextricably linked. We discuss the consequences of this form of comorbidity for the description, classification, and risk profile of mental illness.",0,0 +4608,"Trajectories of Boys' Physical Aggression, Opposition, and Hyperactivity on the Path to Physically Violent and Nonviolent Juvenile Delinquency","A semi-parametric mixture model was used with a sample of 1,037 boys assessed repeatedly from 6 to 15 years of age to approximate a continuous distribution of developmental trajectories for three externalizing behaviors. Regression models were then used to determine which trajectories best predicted physically violent and nonviolent juvenile delinquency up to 17 years of age. Four developmental trajectories were identified for the physical aggression, opposition, and hyperactivity externalizing behavior dimensions: a chronic problem trajectory, a high level near-desister trajectory, a moderate level desister trajectory, and a no problem trajectory. Boys who followed a given trajectory for one type of externalizing problem behavior did not necessarily follow the same trajectory for the two other types of behavior problem. The different developmental trajectories of problem behavior also led to different types of juvenile delinquency. A chronic oppositional trajectory, with the physical aggression and hyperactivity trajectories being held constant, led to covert delinquency (theft) only, while a chronic physical aggression trajectory, with the oppositional and hyperactivity trajectories being held constant, led to overt delinquency (physical violence) and to the most serious delinquent acts.",0,0 +4609,"Loss, Trauma, and Human Resilience: Have We Underestimated the Human Capacity to Thrive After Extremely Aversive Events?","Many people are exposed to loss or potentially traumatic events at some point in their lives, and yet they continue to have positive emotional experiences and show only minor and transient disruptions in their ability to function. Unfortunately, because much of psychology's knowledge about how adults cope with loss or trauma has come from individuals who sought treatment or exhibited great distress, loss and trauma theorists have often viewed this type of resilience as either rare or pathological. The author challenges these assumptions by reviewing evidence that resilience represents a distinct trajectory from the process of recovery, that resilience in the face of loss or potential trauma is more common than is often believed, and that there are multiple and sometimes unexpected pathways to resilience.",0,0 +4610,A qualitative analysis of posttraumatic stress among Mexican victims of disaster,"In unstructured interviews, 24 Mexicans described survivors' responses to disasters in Guadalajara, Jalisco (n = 9), Homestead, Florida (n = 6), and Puerto Angel, Oaxaca (n = 9). This analysis assessed the extent to which symptom descriptions corresponded to the 17 criterion symptoms of PTSD. Nineteen participants (79%) mentioned from 1 to 9 criterion symptoms. Event-related distress, hypervigilance, recurrent recollections, and avoiding reminders were described most often. Only 3 criterion symptoms were never described. Twenty participants (83%) provided 109 separate expressions that could not be classified specifically as criterion symptoms. These phrases were sorted by 9 independent Mexican volunteers and cluster analyzed. Clusters composed of ataques de nervios, depression, lasting trauma, and somatic complaints provided the best description of the data.",0,0 +4611,Longitudinal Interactions of Pain and Posttraumatic Stress Disorder Symptoms in U.S. Military Service Members Following Blast Exposure,"

Abstract

Military personnel returning from conflicts in Iraq and Afghanistan often endorse pain and posttraumatic stress disorder (PTSD) symptoms, either separately or concurrently. Associations between pain and PTSD symptoms may be further complicated by blast exposure from explosive munitions. Although many studies have reported on the prevalence and disability associated with polytraumatic injuries following combat, less is known about symptom maintenance over time. Accordingly, this study examined longitudinal interactive models of co-occurring pain and PTSD symptoms in a sample of 209 military personnel (mean age = 27.4 years, standard deviation = 7.6) who experienced combat-related blast exposure. Autoregressive cross-lagged analysis examined longitudinal associations between self-reported pain and PTSD symptoms over a 1-year period. The best-fitting covariate model indicated that pain and PTSD were significantly associated with one another across all assessment periods, χ2 (3) = 3.66, P = .30, Tucker-Lewis index = .98, comparative fit index = 1.00, root mean squared error of approximation = .03. PTSD symptoms had a particularly strong influence on subsequent pain symptoms. The relationship between pain and PTSD symptoms is related to older age, race, and traumatic brain injury characteristics. Results further the understanding of complex injuries among military personnel and highlight the need for comprehensive assessment and rehabilitation efforts addressing the interdependence of pain and co-occurring mental health conditions.

Perspective

This longitudinal study demonstrates that pain and PTSD symptoms strongly influence one another and interact across time. These findings have the potential to inform the integrative assessment and treatment of military personnel with polytrauma injuries and who are at risk for persistent deployment-related disorders.",0,0 +4612,Chronic Pain and Posttraumatic Stress Symptoms in Litigating Motor Vehicle Accident Victims,"There has been little research examining chronic pain and posttraumatic stress symptoms in persons injured in motor vehicle accidents. The purpose of this study was to evaluate differences in physical injury and impairment, psychological distress, and pain coping strategies in litigating chronic pain patients low and high in motor vehicle accident-related posttraumatic stress symptoms.A total of 160 consecutive chronic pain patients referred for psychological-legal assessment underwent semistructured interview and testing. The testing battery included the Minnesota Multiphasic Personality Inventory-2, the Multidimensional Pain Inventory, the Sickness Impact Profile, and the Coping Strategies Questionnaire. Using the sample-specific median split of 18 posttraumatic stress symptoms on the Minnesota Multiphasic Personality Inventory-2 Posttraumatic Stress Disorder scale, chronic pain patients were categorized as evidencing low or high levels of posttraumatic stress symptoms.The findings indicate that participants evidencing high posttraumatic stress symptoms had more physical impairment, psychological distress, and maladaptive pain coping strategies and were more likely to be treated with antidepressants, other medications, and psychological management than participants evidencing low posttraumatic stress symptoms. A discriminant function analysis was performed using the full combination of physical injury and impairment, psychological distress, and pain coping variables in the prediction of posttraumatic stress symptom-defined group membership. The resulting discriminant function accounted for 61% of the between-group variance and correctly classified 92% of participants who were low in posttraumatic stress symptoms and 88% of participants who were high in posttraumatic stress symptoms.Chronic pain and posttraumatic stress symptoms in litigating motor vehicle accident victims are associated with increased physical and psychological morbidity.",0,0 +4613,A Diathesis-Stress Approach to Post-Traumatic Stress Disorder Symptoms Associated with an HIV Diagnosis: Implications for Medication Non-adherence.,"Introduction. We fit a diathesis-stress model with childhood trauma and neuroticism as predictors of depressive and HIV-related PTSD symptomatology in a sample of HIV+ Latino men who have sex with men (MSM). We then examined the impact of depressive and HIV-related PTSD symptomatology on medication adherence. We hypothesized the primary stressor from the diathesis-stress model to be symptoms of dissociation at the time of being diagnosed with HIV. Method. We sampled 149 Latino adult MSM living with HIV at a local HIV treatment clinic in El Paso, Texas. We administered all surveys in paper-and-pencil form, with viral loads and CD4 cell counts extracted from medical charts. Specifically, data were collected on self-reported histories of childhood abuse, trait levels of neuroticism, acculturation to non-Latino culture, accumulated life stressors, depression, HIV and non HIV-related post-traumatic stress symptoms, resilience, functional impairment and medication adherence. All participants were interviewed in either English or Spanish and paid $30 for their participation. Interviews lasted approximately two hours. Results. We observed high levels of childhood sexual abuse (22%) and trauma overall, as well as high rates of mild-to-moderate symptoms of depression (30%). Self-reported medication adherence was high across all measures. We found support for our hypothesized path model as a test of the theoretical structure proposed by the diathesis-stress model. All fit indices were indicative of good model fit. In addition, we found support for the diathesis-stress interaction with dissociation symptoms at the time of diagnosis moderating the relationship between childhood trauma and HIV-related PTSD symptoms. As hypothesized, our regression analyses revealed depression to be negatively correlated with adherence. PTSD symptoms related to HIV were positively associated with adherence, the opposite direction of that hypothesized. Conclusion. The diathesis-stress framework adequately models the relationship among childhood trauma, current levels of psychological distress, and the stress of being diagnosed with HIV. Furthermore, psychological distress is negatively associated with adherence and overall quality of life. Implications for interventions are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0,0 +4614,"A 30-Month Prospective Follow-up Study of Psychological Symptoms, Psychiatric Diagnoses, and Their Effects on Quality of Life in Children Witnessing a Single Incident of Death at School","We explored the course of trauma-related psychological symptoms and psychiatric diagnoses in 167 children who, as fourth graders, witnessed death at school and assessed the long-term effects of their symptoms on quality of life and their parents' rearing stress.167 children were evaluated using diverse self-rating symptom scales at 2 days (T1: May 19, 2007), 2 months (T2: July 16, 2007), 6 months (T3: November 12-17, 2007), and 30 months (T4: November 16-21, 2009) after the accident. All children were interviewed with the Diagnostic Interview Schedule for Children-Version IV (DISC-IV) at T1. High-risk children were assessed with the DISC-IV at T3 and T4. Children's quality of life and parental stress were assessed in all children and parents using the Parenting Stress Index and the Child Health and Illness Profile at T4.The mean scores and prevalence of severe posttraumatic stress disorder (PTSD) and anxiety symptoms decreased significantly over time (P < .001), but depressive symptoms did not. Although the prevalence of DISC-IV-based diverse anxiety disorders decreased significantly over time, 45% of high-risk subjects evaluated with the DISC-IV met criteria for an anxiety or depressive disorder at T4. Linear and logistic regression analyses showed that depressive symptoms at 6 months predicted more severe parental stress (β = 0.51; odds ratio [OR] = 2.88), less satisfaction (β = -0.25; OR = 2.66), and lower achievement (β = -0.41; OR = 1.50) at 30 months. PTSD symptoms were not associated with parental stress or quality of life at T4.This study provides new evidence regarding the long-term course of trauma-related symptoms and diagnostic changes in children exposed to a single trauma. Children's depressive symptoms predicted lower children's quality of life and higher parental rearing stress after 2 years. Careful assessment and management of depressive symptoms can potentially reduce parental stress and improve quality of life of children.",0,0 +4615,Mild traumatic brain injury and posttraumatic stress disorder in returning veterans: Perspectives from cognitive neuroscience,"A significant proportion of military personnel deployed in support of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) has been exposed to war-zone events potentially associated with traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD). There has been significant controversy regarding healthcare policy for those service members and military veterans who returned from OEF/OIF deployments with both mild TBI and PTSD. There is currently little empirical evidence available to address these controversies. This review uses a cognitive neuroscience framework to address the potential impact of mild TBI on the development, course, and clinical management of PTSD. The field would benefit from research efforts that take into consideration the potential differential impact of mild TBI with versus without persistent cognitive deficits , longitudinal work examining the trajectory of PTSD symptoms when index trauma events involve TBI, randomized clinical trials designed to examine the impact of mild TBI on response to existing PTSD treatment interventions, and development and examination of potential treatment augmentation strategies.",0,0 +4616,The importance of looking credible: the impact of the behavioural sequelae of post-traumatic stress disorder on the credibility of asylum seekers,"Memory difficulties following traumatic experiences have been found to result in testimonial inconsistencies, which can affect credibility judgements in asylum decisions. No investigations have looked into how/whether the behavioural sequelae of post-traumatic stress disorder (PTSD) affect decisions. This study aimed to investigate this by looking at whether observable symptoms of PTSD can be confused with perceived cues to deception. An actor performed four versions of a fictional ‘asylum interview’ that contained differing levels of pre-defined ‘deception’ and ‘trauma’ behaviours. Four groups of students (total n = 118) each watched a different interview. They gave subjective ratings of credibility, plus quantitative and qualitative information about the factors that influenced their judgements. Despite the content of the interviews remaining the same, significant differences in credibility ratings were found between interviews; with the interview containing both ‘trauma’ and ‘deception’ behaviours bein...",0,0 +4617,"Clinical evaluation of paroxetine in post-traumatic stress disorder (PTSD): 52-week, non-comparative open-label study for clinical use experience","The present study was a 52-week, non-comparative, open-label study of flexible dose paroxetine (20-40 mg) in 52 Japanese post-traumatic stress disorder (PTSD) patients in order to obtain clinical experience regarding efficacy and safety in regular clinical practice.Efficacy was measured using the Clinician-Administered PTSD Scale One Week Symptom Status Version (CAPS-SX).The mean change from baseline in CAPS-SX total score was -19.1, -22.8 and -32.3 at weeks 4, 12 and 52, respectively, and that in the Clinical Global Impression (CGI) Severity of Illness score was -1.1 at week 12 and -1.7 at week 52. A total of 46.9% were CGI responders at week 12, while 67.3% were improved on the CGI at week 52. Of 52 subjects who entered into the drug treatment, 25 completed the study. Only one patient withdrew from the study due to lack of efficacy. In patients who were rated as 'moderately ill' or less at baseline, the proportion of CGI responders at end-point was higher at a dose of 20 mg/day than at higher doses, whereas in patients rated as 'markedly ill' or more, it was higher at 30 and 40 mg/day, suggesting that severely ill patients could benefit from higher doses.Paroxetine appeared generally tolerated in short- and long-term use, and the safety profile in this study was consistent with international trials and other Japanese populations (i.e. patients suffering from depression, panic disorder or obsessive-compulsive disorder). Although the study was not conducted in double-blind fashion, the current findings suggest that paroxetine may contribute to clinically meaningful improvement that is maintained during long-term use and is generally well tolerated.",0,0 +4618,Schutz- und Risikofaktoren für Traumafolgestörungen,"Theoretischer Hintergrund: Schutzfaktoren und Risikofaktoren tragen zur Prognose, Indikation und Interventionsplanung bei Menschen nach traumatischen Ereignissen bei. Bisherige systematische Reviews fassen die Befunde bis maximal 2007 zusammen und fokussieren auf Posttraumatische Belastungsstörungen. Fragestellung: Systematisches Review unter Einschluss der Befunde für die Jahre 2007 bis 2010 und Berücksichtigung weiterer Traumafolgestörungen. Methode: Analyse von 13 systematischen Reviews und 29 prospektiven Originalarbeiten zu Schutz- und Risikofaktoren für Traumafolgestörungen nach Typ-I-Traumata. Ergebnisse: Es werden Befunde zu prätraumatischen (Soziodemographie, Biographie, psychische Störungen, Persönlichkeitsfaktoren), peritraumatischen (Art und Schwere des Ereignisses, psychische Verfassung während des Ereignisses, peritraumatische Reaktion) und posttraumatischen Faktoren (akute psychische Symptome, Kognitionen, Coping, Vermeidungsverhalten, soziale Unterstützung, zusätzliche Stressoren) dargestellt. Schlussfolgerungen: Vor allem peri- und posttraumatische Schutz- und Risikofaktoren eignen sich für die Vorhersage von Traumafolgestörungen.",0,0 +4619,Identifying Trajectories of Depressive Symptoms for Women Caring for Their Husbands with Dementia,"To use an innovative statistical method, Latent Class Trajectory Analysis (LCTA), to identify and describe subgroups (called trajectories) of caregiver depressive symptoms in a national sample of wives providing informal care for their husbands with dementia.Longitudinal.Community.Respondents to the National Longitudinal Caregiver Survey were wife caregivers of veterans with dementia who were identified through Veterans Affairs hospitals nationally.Mean number of depressive symptoms as measured using the Center for Epidemiologic Studies Depression scale (CES-D, 20-item scale).Overall mean depressive symptoms of wife caregivers were 6.2 of 20, below the cutpoint (8 or 9/20) associated with clinical depression. Four distinct trajectories of caregiver depressive symptoms were identified. The trajectory with the highest number of symptoms (11.9 of 20), contained one-third of the sample. Another third had mean depressive symptoms virtually identical to the overall sample mean. The final third were divided between two trajectories, low depressive symptoms (mean CES-D, 3.0/20, 22% of sample) and very low (mean CES-D, 0.8/20, 14% of sample). Approximately two-thirds of the sample members were in a depressive symptom trajectory, with substantially higher or lower numbers of symptoms than the overall mean. Two subjective measures asked of wife caregivers (desire for more help, life satisfaction) were significantly associated with membership in the highest depressive symptom trajectory.LCTA identified important depressive symptom subgroups of wife caregivers. A population-averaging method identified a mean effect that was similar to the effect in one-third of the cases but substantially different from that in two-thirds of the cases.",0,0 +4620,Pharmacotherapy for Southeast Asian Psychiatric Patients,"Refugees have been demonstrated to be at high risk for developing major depressive and posttraumatic stress disorders, but are often not able to benefit from modern advances in psychopharmacology. Besides difficulties in cross-cultural psychiatric diagnosis, problems also arise from cultural differences in the expectation of drug effects and in compliance. Recent evidence has suggested that pharmacokinetic and pharmacodynamic profiles of various psychotropic medications may be different in Asians than in non-Asian patients, leading to differences in dosage requirements and side effect profiles. These issues and their relevance to the care of refugee patients are reviewed.",0,0 +4621,Growth Curve Trajectories of Distress in Burn Patients,"Psychological adjustment after a major burn injury is a significant concern to providers and patients alike. Although efforts have been made to identify associated risk factors, little is known about heterogeneity in the levels or trajectories of adjustment in this population. This study used a novel application of Growth Mixture Modeling to identify subgroups of patients based on their longitudinal self-reported distress using the Brief Symptom Inventory (BSI). Data were drawn from the database of the Burn Model Systems project, a prospective, multisite, cohort study of major burn injury survivors. The BSI was used to assess symptoms in-hospital and at 6, 12, and 24 months postburn. Participants' T scores on the BSIs Global Severity Index provided a continuous measure of psychological distress. Analyses were conducted using participants' Global Severity Index T scores to discern distinct classes of respondents with similar trajectories across the 2-year follow-up. Results from the Growth Mixture Modeling analysis produced an ordered four-class model of psychological recovery from a major burn. Groups represented the equivalent of high, subthreshold, mild, and minimal symptom severity. Covariates significantly affected the intercept and slope of each class, as well as prediction of group assignment. These analyses demonstrate differences between individual recoveries after a major burn. Psychological distress symptoms remain largely stable over time and highlight the psychological vulnerability of this patient population.",1,0 +4622,A process-based approach to characterizing the effect of acute alprazolam challenge on visual paired associate learning and memory in healthy older adults,"Objective Alprazolam is a benzodiazepine that, when administered acutely, results in impairments in several aspects of cognition, including attention, learning, and memory. However, the profile (i.e., component processes) that underlie alprazolam-related decrements in visual paired associate learning has not been fully explored. Methods In this double-blind, placebo-controlled, randomized cross-over study of healthy older adults, we used a novel, “process-based” computerized measure of visual paired associate learning to examine the effect of a single, acute 1-mg dose of alprazolam on component processes of visual paired associate learning and memory. Results Acute alprazolam challenge was associated with a large magnitude reduction in visual paired associate learning and memory performance (d = 1.05). Process-based analyses revealed significant increases in distractor, exploratory, between-search, and within-search error types. Analyses of percentages of each error type suggested that, relative to placebo, alprazolam challenge resulted in a decrease in the percentage of exploratory errors and an increase in the percentage of distractor errors, both of which reflect memory processes. Conclusions Results of this study suggest that acute alprazolam challenge decreases visual paired associate learning and memory performance by reducing the strength of the association between pattern and location, which may reflect a general breakdown in memory consolidation, with less evidence of reductions in executive processes (e.g., working memory) that facilitate visual paired associate learning and memory. Copyright © 2012 John Wiley & Sons, Ltd.",0,0 +4623,Trauma and post-traumatic stress disorder in a drug treatment community service,"Aims and method A cross-sectional study aiming to assess the prevalence of trauma and post-traumatic stress disorder (PTSD) in a community substitution treatment sample, and to assess and compare the characteristics of traumatic experience, substance use, and psychological and social factors in those with and without PTSD. All assessments were completed during the interview which took approximately 1.5 h. Results The prevalence for current PTSD was 26.2% and for lifetime PTSD 42.9%. Traumatic experiences were extremely common, with two or more reported by 92.9% of the sample. The two groups differed significantly on the majority of psychological functioning and social variables, with women experiencing higher rates of PTSD and the non-PTSD group having lower rates of psychological impairment. Clinical implications The research supported findings from previous studies. The very high incidence of traumatic experiences has not been reported before. Training and information about trauma and PTSD for substance misuse workers are therefore necessary so that PTSD can be more easily detected and treated.",0,0 +4624,"Psychological vulnerability, ventricular tachyarrhythmias and mortality in implantable cardioverter defibrillator patients: is there a link?","Implantable cardioverter defibrillator (ICD) therapy is the first-line treatment for the prevention of sudden cardiac death. Despite the demonstrated survival benefits of the ICD, predicting which patients will die from a ventricular tachyarrhythmia remains a major challenge. So far, psychological factors have not been considered as potential risk markers that might enhance the prediction of sudden cardiac death. This article evaluates the evidence for a link between psychological vulnerability, ventricular tachyarrhythmias and mortality and the pathways that might explain such a link. This review demonstrates that there is cumulative evidence supporting a link between psychological vulnerability and risk of ventricular tachyarrhythmias and mortality in ICD patients independent of disease severity and other biomedical risk factors. It may be premature to include psychological factors in risk algorithms, but information on the psychological profile of the patient may help to optimize the management and care of these patients in clinical practice.",0,0 +4625,Intervention effectiveness among war-affected children: A cluster randomized controlled trial on improving mental health,"We examined the effectiveness of a psychosocial intervention in reducing mental health symptoms among war-affected children, and the role of peritraumatic dissociation in moderating the intervention impact on posttraumatic stress symptoms (PTSS). School classes were randomized into intervention (n = 242) and waitlist control (n = 240) conditions in Gaza, Palestine. The intervention group participated in 16 extracurriculum sessions of teaching recovery techniques (TRT) and the controls received normal school-provided support. Participants were 10- to 13-year-old Palestinian girls (49.4%) and boys (50.6%). Data on PTSS, depressive symptoms, and psychological distress were collected at baseline (T1), postintervention (T2), and 6-month follow-up (T3). Peritraumatic dissociation was assessed only at baseline. Regression analyses that took regression to the mean and cluster sampling into account were applied. The results on intervention effectiveness were specific to gender and peritraumatic dissociation. At T2, the intervention significantly reduced the proportion of clinical PTSS among boys, and both the symptom level (R(2) = .24), and proportion of clinical PTSS among girls who had a low level of peritraumatic dissociation. The results have implications for risk-specific tailoring of psychosocial interventions in war conditions.",0,0 +4626,Psychosocial Stress in Marine Corps Officers,"Stress research in military populations has largely been devoted to specialized situations ""at risk"" for high levels of stress, such as combat, recruit training, sea duty, as well as post-traumatic stress in veterans. Though the armed forces continue to train for war during peacetime, military personnel also carry out administrative, executive, and technical job functions not directly related to combat preparations. Little data exists researching stress experienced in military non-combat environments. A study was conducted assessing levels of stress of 900 Marine Corps officers assigned to various headquarters and stations. Randomly selected participants completed the Derogatis Stress Profile (DSP). The study examined stress as a function of rank and the individual officer's perception of stress. Total stress levels of the subjects were compared to those used to norm the DSP.",0,0 +4627,Multi-disciplinary Care for the Elderly in Disasters: An Integrative Review,"Abstract Introduction Older adults are disproportionately affected by disaster. Frail elders, individuals with chronic diseases, conditions, or disabilities, and those who live in long-term care facilities are especially vulnerable. Purpose The purpose of this integrative review of the literature was to describe the system-wide knowledge and skills that multi-disciplinary health care providers need to provide appropriate care for the elderly during domestic-humanitarian and disaster-relief efforts. Data sources A systematic search protocol was developed in conjunction with a research librarian. Searches of PubMed, CINAHL, and PsycINFO were conducted using terms such as Disaster, Geological Processes, Aged, Disaster Planning, and Vulnerable Populations. Forty-six articles met criteria for inclusion in the review. Conclusions Policies and guidance regarding evacuating versus sheltering in place are lacking. Tenets of elderly-focused disaster planning/preparation and clarification of legal and ethical standards of care and liability issues are needed. Functional capacity, capabilities, or impairments, rather than age, should be considered in disaster preparation. Older adults should be included in disaster planning as population-specific experts. Implications for Practice A multifaceted approach to population-specific disaster planning and curriculum development should include consideration of the biophysical and psychosocial aspects of care, ethical and legal issues, logistics, and resources. Johnson HL , Ling CG , McBee EC . Multi-disciplinary care for the elderly in disasters: an integrative review . Prehosp Disaster Med . 2015 ; 30 ( 1 ): 1 - 8 .",0,0 +4628,A Longitudinal Study of Secondary Posttraumatic Growth in Wives of Ex-POWs.,"The current study aimed to investigate (a) ""secondary"" posttraumatic growth (PTG) in wives of former prisoners of war (ex-POWs) and its association to husbands' captivity, husbands' posttraumatic stress disorder (PTSD), and husbands' PTSD trajectories; and (b) the bidirectional relationships over time between wives' posttraumatic stress symptoms (PTSS) and PTG.The study compared 116 wives of Israeli ex-POWs from the 1973 Yom Kippur War with 56 wives of a matched control group of non-POW combat veterans. Wives were divided into groups according to husbands' captivity status, husbands' PTSD status, and husbands' PTSD trajectories; and ANOVAs and MANOVAs were conducted to assess group differences in PTSS and PTG, both cross-sectionally and longitudinally. Autoregressive cross-lag modeling was also used to assess bidirectional relationships between wives' PTSS and PTG over time.Wives of ex-POWs with PTSD reported significantly higher PTG compared with wives of ex-POWs without PTSD and wives of controls. While PTG and PTSS remained stable over time, importantly, the Time 1 (T1) level of PTG predicted avoidance symptoms at Time 2 (T2); the higher the wives' PTG at T1, the higher their avoidance symptoms at T2, but not vice versa.These findings support the notion that ""secondary PTG"" exists. They also strengthen the theory that growth and distress can co-occur. Finally, the finding that PTG predicted subsequent avoidance symptoms suggests that PTG does not prevent the future development of distress.",0,0 +4629,Coping with Missing Data,,0,0 +4630,Communication in Military Families Across the Deployment Cycle,,0,0 +4631,Post-traumatic stress symptoms in cancer survivors: relationship to the impact of cancer scale and other associated risk factors,"The purpose of this study was to determine the prevalence of post-traumatic stress symptoms in a sample of cancer survivors and to investigate their association with the impact of cancer, depressive symptoms, and social support.We administered a survey to participants in a cancer survivor registry. It included: Post-Traumatic Stress Disorder Checklist-Civilian version (PCL-C), Impact of Cancer Scale (IOC) v.2, and measures of social support, income, and long-term effects of cancer. We performed multivariate analyses to estimate associations between PCL-C and other variables. PCL-C score was examined as a continuous dependent variable and categorically.Responses were available from 162 cancer survivors. Mean age was 51 years (standard deviation (SD) 16); mean time since diagnosis was 11 years (SD 10). Mean PCL-C score was 27 (SD 9, range 17-64); 29% of the sample scored 30 and above, 13% scored 38 and above, 7% scored 44 and above. Linear regression indicated that PCL-C scores were significantly associated with the IOC negative impact summary scale (NIS) (p < 0.001), depressive symptoms (p = 0.003), less social support (p = 0.02), and lower income (p = 0.03). NIS subscale analyses showed that two subscales, life interference (LI) and worry (W), were significantly correlated with PCL-C score (LI: p < 0.001; W: p = 0.02).In this study, the IOC NIS was associated with endorsement of PTSD symptoms. Assessing survivors for PTSD symptoms with the PCL-C could detect those individuals in need of psychosocial support. The IOC may be useful for identifying target areas for interventions to reduce these symptoms among cancer survivors.",0,0 +4632,Quetiapine-induced peripheral edema,"Quetiapine fumarate is an atypical antipsychotic with relatively benign side-effect profile. Here we report a rare side-effect of quetiapine use. This is the second reported case of peripheral edema with quetiapine use. Unaware of this rare side-effect, patient had to endure extensive investigations.",0,0 +4633,"Post-traumatic stress disorder in children and adolescents one year after a super-cyclone in Orissa, India: exploring cross-cultural validity and vulnerability factors","It has been asserted that psychological responses to disasters in children and adolescents vary widely across cultures, but this has rarely been investigated. The objectives of the study were to clinically evaluate the construct of traumatic stress symptoms and disorder in children and adolescents after a super-cyclone in Orissa, India; to find out the prevalence at one year; compare the effect in high and low exposure areas and study the factors associated with it.Clinical examination of children and adolescents (n = 447) was done, supplemented by a symptoms checklist based on International Classification of Mental and Behavioural Disorders, Diagnostic Criteria for Research and a semi-structured questionnaire for disaster related experiences.A majority of children had post-traumatic symptoms. Post-traumatic stress disorder (PTSD) was present in 30.6% (95% confidence interval: 26.4 to 34.9), and an additional 13.6% had sub-syndromal PTSD. Parents or teachers reported mental health concerns in 7.2% subjects, who were a minor proportion (12.8%) of subjects with any syndromal diagnosis (n = 196). Significantly more (43.7%) children in high exposure areas had PTSD than that (11.2%) in low exposure areas (p < 0.001). Depression was significantly associated with PTSD. Binary logistic regression analysis indicated that high exposure, lower educational level and middle socioeconomic status significantly predicted the outcome of PTSD. Extreme fear and perceived threat to life during the disaster, death in family, damage to home, or staying in shelters were not significantly associated with PTSD.Following natural disaster PTSD is a valid clinical construct in children and adolescents in Indian set up; and though highly prevalent it may be missed without clinical screening. Its manifestation and associated factors resembled those in other cultures.",0,0 +4634,"Brain-derived neurotrophic factor in traumatic brain injury, post-traumatic stress disorder, and their comorbid conditions: role in pathogenesis and treatment","As US military service members return from the wars in Iraq and Afghanistan with elevated rates of traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD), attention has been increasingly focused on TBI/PTSD comorbidity, its neurobiological mechanisms, and novel and effective treatment approaches. TBI and PTSD, and their comorbid conditions, present with a spectrum of common clinical features such as sleep disturbance, depression, anxiety, irritability, difficulty in concentrating, fatigue, suicidality, chronic pain, and alterations in arousal. These TBI and PTSD disorders are also thought to be characterized by overlapping neural mechanisms. Both conditions are associated with changes in hippocampal, prefrontal cortical, and limbic region function because of alterations in synaptogenesis, dendritic remodeling, and neurogenesis. Neural changes in TBI and PTSD result from pathophysiological disturbances in metabolic, cytotoxic, inflammatory, and apoptic processes, amongst other mechanisms. Neurotrophins have well-established actions in regulating cell growth and survival, differentiation, apoptosis, and cytoskeleton restructuring. A body of research indicates that dysregulation of neural brain-derived neurotrophic factor (BDNF) is found in conditions of TBI and PTSD. Induction of BDNF and activation of its intracellular receptors can produce neural regeneration, reconnection, and dendritic sprouting, and can improve synaptic efficacy. In this review, we consider treatment approaches that enhance BDNF-related signaling and have the potential to restore neural connectivity. Such treatment approaches could facilitate neuroplastic changes that lead to adaptive neural repair and reverse cognitive and emotional deficits in both TBI and PTSD.",0,0 +4635,"The heritability of mental health and wellbeing defined using COMPAS-W, a new composite measure of wellbeing","Mental health is not simply the absence of mental illness; rather it is a distinct entity representing wellness. Models of wellbeing have been proposed that emphasize components of subjective wellbeing, psychological wellbeing, or a combination of both. A new 26-item scale of wellbeing (COMPAS-W) was developed in a cohort of 1669 healthy adult twins (18-61 years). The scale was derived using factor analysis of multiple scales of complementary constructs and confirmed using tests of reliability and convergent validity. Bivariate genetic modeling confirmed its heritability. From an original 89 items we identified six independent subcomponents that contributed to wellbeing. The COMPAS-W scale and its subcomponents showed construct validity against psychological and physical health behaviors, high internal consistency (average r=0.71, Wellbeing r=0.84), and 12-month test-retest reliability (average r=0.62, Wellbeing r=0.82). There was a moderate contribution of genetics to total Wellbeing (heritability h(2)=48%) and its subcomponents: Composure (h(2)=24%), Own-worth (h(2)=42%), Mastery (h(2)=40%), Positivity (h(2)=42%), Achievement (h(2)=32%) and Satisfaction (h(2)=43%). Multivariate genetic modeling indicated genetic variance was correlated across the scales, suggesting common genetic factors contributed to Wellbeing and its subcomponents. The COMPAS-W scale provides a validated indicator of wellbeing and offers a new tool to quantify mental health.",0,0 +4636,Posttraumatic stress disorder and psychiatric co-morbidity following stroke: The role of alexithymia,"More research is needed to further our understanding of posttraumatic stress disorder symptoms (PTSD) and psychiatric co-morbidity following stroke, especially the trajectories of such symptoms over time. Previous studies suggest that exposure to a traumatic experience such as stroke is not sufficient to explain the etiology of PTSD. Alexithymia may be involved, but its relationships with PTSD and psychiatric co-morbidity following stroke remains unclear. This study aims to address these knowledge gaps. While in hospital, stroke patients (n=90) completed questionnaires assessing PTSD symptoms, psychiatric co-morbidity, alexithymia and physical disability. PTSD symptoms and psychiatric co-morbidity were re-assessed approximately 3 months post-stroke (n=78). The severity of post-stroke PTSD did not change significantly over time, while psychiatric co-morbidity reduced significantly. Alexithymia, in particular difficulty in identifying feelings, was associated with severity of post-stroke PTSD and psychiatric co-morbidity at baseline, but after adjusting for these, there was no significance 3 months post-stroke. We suggest that patients' difficulty in identifying feelings had a role to play in influencing relatively short-term rather than long-term PTSD and co-morbid psychiatric symptoms. Alternatively, PTSD could be interpreted as driving the alexithymic characteristics.",0,0 +4637,Posttraumatic stress disorder symptom severity predicts aggression after treatment,"This study examined the relation between posttraumatic stress disorder (PTSD) severity and aggression (verbal, psychological, and physical aggression) in a longitudinal dataset. Participants were 175 males in PTSD residential treatment who were assessed at pre-treatment, post-treatment, and at 4-month follow-up. Post-treatment PTSD severity predicted aggression at post-treatment and 4-month follow-up, adjusting for age, pre-treatment PTSD severity, and pre-treatment aggression. When examining the relation between aggression and specific PTSD symptom clusters, post-treatment Reexperiencing, Avoidance/Numbing and Hyperarousal symptoms predicted aggression at posttreatment and 4-month follow-up. These results support the hypothesis that post-treatment PTSD severity may be an important marker of post-treatment aggression risk and may offer unique information important to clinicians and patients focused on the development and maintenance of adaptive, non-aggressive relationships after intensive PTSD treatment.",0,0 +4638,Paraphilia from a Dissociative Perspective,"A dissociative structural model of the psyche can account for a wide range of symptoms across many DSM-IV categories, including sexual compulsions and addictions. The model leads to a distinct overall plan of treatment and a set of operationalized interventions aimed at integration of the self, rather than suppression of impulses. The model could be tested first in epidemiological studies and later in treatment outcome studies.",0,0 +4639,Glucocorticoid Functioning in Male Combat Veterans with Posttraumatic Stress Disorder and Mild Traumatic Brain Injury,"Explored glucocorticoid functioning in male combat veterans with posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). Of the total sample of 122 male veterans, 32 reported one or more brain injuries with loss of consciousness lasting <10 min and were designated as having a history of mTBI. To evaluate the influence of PTSD and mTBI on neuroendocrine measures, a series of linear regression equations was estimated. Combat veterans with mTBI also tended to have less severe current and lifetime PTSD symptoms whether comorbid with PTSD or not. Veterans who reported a history of mTBI were rated as having lower current reexperiencing, hyperarousal, and total CAPS scores compared with veterans without prior history of mTBI. Follow-up analyses on the current CAPS intensity and frequency scores revealed that the lower reexperiencing and hyperarousal scores in people with mTBI were attributed to lower frequency, but not lower intensity. Insofar as PTSD has been shown to be associated with greater glucocorticoid sensitivity, the two conditions may have opposing effects when they are present in the same individual. Group contrasts comparing people with PTSD with people without PTSD on measures reflecting glucocorticoid receptor sensitivity may be diminished if the presence of TBI is not considered. (PsycINFO Database Record (c) 2015 APA, all rights reserved)",0,0 +4640,Psychosocial correlates of depression following spinal injury: A systematic review,"Spinal cord injury (SCI) studies have identified a range of psychosocial risk and protective factors for depression post-injury. This study presents the first systematic and quantitative review of this body of research.Twenty-four studies (N=3172 participants) were identified through electronic database searches. Studies were evaluated according to recommended guidelines on Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). The significance and magnitude of the relationships between standardised measures of depression and psychosocial outcome were examined using Pearson's effect size r, 95% confidence intervals and fail-safe Ns. Effect sizes were categorised according to the ICF psychosocial domains.STROBE ratings indicated discrepancies in procedural detail and statistical analyses. Individual personal variables including affective feelings, and thoughts and beliefs specific to SCI demonstrated the strongest relationship with depression self-ratings. Life satisfaction, disability acceptance, environmental supports and community participation had a medium to strong association, helping to reduce vulnerability to depression. Longitudinal studies revealed that symptoms of depression continued to impact on psychosocial outcome up to 10 years post-injury, although this was based on limited data.Assessment of psychosocial factors in the acute stages of SCI rehabilitation can inform evidence-based interventions to treat and manage depressive symptomatology in the short to longer-term. Future studies would benefit from adopting a unified approach to the measurement of depression post-SCI to help inform targeted treatment.",0,0 +4641,DO COGNITIVE AND EXPOSURE TREATMENTS IMPROVE VARIOUS PTSD SYMPTOMS DIFFERENTLY? A RANDOMIZED CONTROLLED TRIAL,"This study (part of a larger one whose main outcomes were reported by Marks, Lovell, Noshirvani, Thrasher, & Livanou, 1998) investigated the impact of exposure therapy and cognitive restructuring alone and combined on the individual symptoms of PTSD and on associated features. Exposure therapy was expected to act mainly on fear and avoidance, and cognitive restructuring mainly on detachment, restricted range of affect, and associated features of PTSD. Seventy-seven PTSD outpatients were randomly allocated to one of four treatments: 1) exposure alone; 2) cognitive restructuring alone; 3) combined exposure and cognitive restructuring; or 4) relaxation (placebo control). The active treatments were superior to relaxation in improving clusters of PTSD symptoms and associated features and some but not all individual symptoms and associated features of PTSD. Exposure and cognitive restructuring improved almost all individual symptoms similarly.",0,0 +4642,A prospective examination of delayed onset PTSD secondary to motor vehicle accidents.,"Seven participants who did not meet the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; American Psychiatric Association, 1987) criteria for posttraumatic stress disorder (PTSD) 1-4 months post- motor vehicle accident (MVA) and developed delayed onset PTSD during a 1-year follow-up interval were compared with 38 MVA controls who did not develop PTSD, as well as to 62 MVA participants who met criteria for acute onset PTSD on variables related to demographics, pre-MVA functioning, post-MVA functioning, and follow-up. The delayed onset participants were more symptomatic at the time of the initial interview than the controls. The delayed onset participants had poorer social support than the controls prior to and after the MVA. For the month prior to the MVA, the delayed onset participants had lower Global Assessment of Functioning scores than the controls.",0,0 +4643,Fluoxetine and norfluoxetine stereospecifically and selectively increase brain neurosteroid content at doses that are inactive on 5-HT reuptake,"It has recently become more clearly understood that in human brain pathophysiology, neurosteroids play a role in anxiety disorders, premenstrual syndrome, postpartum depression, posttraumatic stress disorder, and depression. In the treatment of major depression, recent clinical studies indicate that the pharmacological profiles of fluoxetine and fluvoxamine are correlated with the ability of these drugs to increase the brain and cerebrospinal fluid content of allopregnanolone (Allo), a potent positive allosteric modulator of gamma-aminobutyric acid (GABA) action at GABAA receptors. Thus, the neurosteroid-induced positive allosteric modulation of GABA action at GABA A receptors is facilitated by fluoxetine or its congeners (i.e., paroxetine, fluvoxamine, sertraline), which may not block 5-HT reuptake at the doses currently prescribed in the clinic. However, these doses are effective in the treatment of premenstrual dysphoria, anxiety, and depression. In socially isolated mice, we tested the hypothesis that fluoxetine, norfluoxetine, and other specific serotonin reuptake inhibitor (SSRI) congeners stereoselectively upregulate neurosteroid content at doses insufficient to inhibit 5-HT reuptake; although they potentiate pentobarbital-induced sedation and exert antiaggressive action. Very importantly, the inhibition of 5-HT reuptake lacks stereospecificity and requires fluoxetine and norfluoxetine doses that are 50-fold greater than those required to increase brain Allo content, potentiate the action of pentobarbital, or antagonize isolation-induced aggression. Based on these findings, it could be inferred that the increase of brain Allo content elicited by fluoxetine and norfluoxetine, rather than the inhibition selective of 5-HT reuptake, may be operative in the fluoxetine-induced remission of the behavioral abnormalities associated with mood disorders. Therefore, the term ""SSRI"" may be misleading in defining the pharmacological profile of fluoxetine and its congeners. To this extent, the term ""selective brain steroidogenic stimulants"" (SBSSs) could be proposed. (",0,0 +4644,Psychological Inflexibility and Psychopathology in 9-1-1 Telecommunicators,"Mental health in 9-1-1 telecommunicators has been understudied in comparison to other emergency responders. This study enrolled a sample of telecommunicators from across the United States (N = 808). As measured by self-report, the prevalence of current probable posttraumatic stress disorder (PTSD) was 17.6% to 24.6%; it was 23.9% for probable major depression. Structural equation modeling revealed a significant direct effect of psychological inflexibility on psychopathology (path coefficient = .32) when considered among duty-related distress and dissociation, neuroticism, anger, and emotion dysregulation. The results provided further evidence of the adverse psychological effects of duty-related trauma exposure, including exposure that is vicarious in nature. The results indicate a need for prevention and intervention in this population, with psychological inflexibility as a potential target in these efforts.",0,0 +4645,Post-traumatic stress disorder (PTSD) treatment experience in Bedford East - audit and reaudit.,"Post-traumatic stress disorder (PTSD) can develop following exposure to a stressful event of an exceptionally threatening or catastrophic nature. Symptoms experienced by PTSD suffers can include re-experiencing the trauma through intrusive 'flashbacks' and recurrent dreams or nightmares, avoidance of stimuli associated with the stressor, hyperarousal, emotional blunting and an inability to remember aspects of the period of exposure to the stressor. We performed an audit of the treatment of PTSD in patients under the care of the Bedford East Mental Health Team to examine the psychological and pharmacological treatments currently being used and compared these with data collected in 2008. In summary, in the last 2 years there has been an increase in the identification of PTSD patients in Bedford East. These patients are a group with high levels of comorbidities and risk factors, and are challenging to treat. As a result of this, a wide range of agents including antidepressants with augementation, mood stabilizers and antipsychotic agents are used in their treatment, many of which are outside of NICE guidelines. There appears to be less availability of psychological therapy in these patients than we would expect. We discuss reasons for this and suggest possible solutions.",0,0 +4646,Effects of the 1992 Los Angeles civil unrest: Post traumatic stress disorder symptomatology among law enforcement officers,"Abstract This study examined the psychological impact of the April 29, 1992 Los Angeles civil unrest on the stress levels of law enforcement officers. Levels of Post Traumatic Stress Disorder (PTSD) symptomatology in Los Angeles Police Department (LAPD) officers assigned to a major riot area were evaluated. Factors implicated in individual coping processes after a traumatic event were examined. Furthermore, police officers' perceptions of the event were examined. One hundred forty-one officers (123 males, 18 females) assigned to two South Central Los Angeles police precincts during the Los Angeles, April 1992 disturbances replied to the questionnaire. The questionnaire included four instruments: The Mississippi Scale for Combat-Related PTSD, Moos' Coping Responses Inventory, the Police Perception Survey, and a demographic survey. The results indicate that 17 percent of the officers who responded are experiencing stress symptomatology. Findings further indicate that these officers are twice as likely to use approximately twice the avoidance coping strategies than are their counterparts without symptomatology. Results indicate a positive relationship of PTSD symptomatology with cognitive avoidance, acceptance or resignation, and emotional discharge; and they suggest an inverse relationship between PTSD symptomatology and seeking support and information, and seeking alternative rewards.",0,0 +4647,Psychological morbidity associated with motor vehicle accidents,"Fifty victims of recent motor vehicle accidents (MVAs), who had sought medical attention after their accidents, were assessed for possible psychological morbidity as a result of the accident. Forty age, gender-matched controls were also assessed with the same instruments. Forty-six percent of the MVA victims met the criteria for current post-traumatic stress disorders (PTSD) as a result of the accident while 20% showed a sub-syndromal version (the reexperiencing symptom cluster plus either the avoidance/numbing cluster or the over-arousal cluster) of PTSD. Although all MVA victims showed some form of driving reluctance, only 1 S met the criteria for driving phobia. Those MVA victims who met the criteria for PTSD or sub-syndromal PTSD were significantly more likely to have experienced previous trauma, other than a serious MVA, and were more likely (P = 0.008) to have previously met the criteria for PTSD as a result of that trauma. Forty-eight percent of MVA victims who met the criteria for current PTSD also met the criteria for current major depression. Significantly more current MVA-PTSDs had suffered previous major depressive episodes.",0,0 +4648,"Children's risk and resilience following a natural disaster: Genetic vulnerability, posttraumatic stress, and depression","We examined children's risk and resilience following a natural disaster, evaluating the role of stress, social support, and two genetic markers: the short allele of the serotonin transporter gene (5-HTTLPR), and the met allele of the Brain-Derived Neurotrophic Factor (BDNF).Under high levels of hurricane exposure or hurricane-related stressors, we expected children displaying the markers would report greater symptoms of posttraumatic stress disorder (PTSD) and depression than children without these markers. Social support was explored as an additional moderating variable.Eight months after Hurricane Ike, 116 children (M age=8.85 years, SD=.89; 54% girls) residing in Galveston, Texas, provided saliva samples and completed measures of hurricane exposure and stress, and symptoms of PTSD and depression; 80 also completed a social support measure.For BDNF, analyses revealed several Gene by Environment interactions; greater stress was related to more symptoms of PTSD and depression, and this effect was stronger for children with the met allele. No findings emerged for 5-HTTLPR. Stressors and social support also were associated with children's PTSD and depressive symptoms.Findings should be tempered by the relatively small sample, especially for analysis that included social support.The met allele (BDNF) may play a role in children's disaster reactions. Further research should consider the complex interplay between genes, stressors, support, and psychological outcomes over time.",0,0 +4649,A Victim Typology of Sexual Harassment,"A clinical sample of 20 sexual harassment victims who were successful in obtaining damage awards for trauma through the judicial system were sources of this descriptive study. Ratings of physical coercion of the harassment, MMPI–2 scores, and ratings on DSM–IV symptoms were analyzed. The majority of subjects met the DSM–IV criteria of Post-Traumatic Stress Disorder. A cluster analysis identified four clusters of harassment victims, described as older-mature, younger-mature, anxious-guilty, and expressive-adaptive based on MMPI–2 scores and symptoms.",0,0 +4650,Post-traumatic stress disorder and medication adherence: Results from the Mind Your Heart Study,"Patients with post-traumatic stress disorder (PTSD) are at increased risk for adverse outcomes from comorbid medical conditions. Medication non-adherence is a potential mechanism explaining this increased risk.We examined the association between PTSD and medication adherence in a cross-sectional study of 724 patients recruited from two Department of Veterans Affairs Medical Centers between 2008 and 2010. PTSD was assessed using the Clinician Administered PTSD Scale. Medication adherence was assessed using a standardized questionnaire. Ordinal logistic regression models were used to calculate the odds ratios (ORs) for medication non-adherence in patients with versus without PTSD, adjusting for potential confounders.A total of 252 patients (35%) had PTSD. Twelve percent of patients with PTSD reported not taking their medications as prescribed compared to 9% of patients without PTSD (unadjusted OR 1.85, 95% CI 1.37-2.50, P<0.001). Forty-one percent of patients with PTSD compared to 29% of patients without PTSD reported forgetting medications (unadjusted OR 1.90, 95% CI 1.44-2.52, P<0.001). Patients with PTSD were also more likely to report skipping medications (24% versus 13%; unadjusted OR 2.01, 95% CI 1.44-2.82, P<0.001). The association between PTSD and non-adherence remained significant after adjusting for demographics, depression, alcohol use, social support, and medical comorbidities (adjusted OR 1.47, 95% CI 1.03-2.10, P=0.04 for not taking medications as prescribed and 1.95, 95% CI 1.31-2.91, P=0.001 for skipping medications).PTSD was associated with medication non-adherence independent of psychiatric and medical comorbidities. Medication non-adherence may contribute to the increased morbidity and mortality observed in patients with PTSD.",0,0 +4651,The Australian Vietnam Veterans Health Study: III. Psychological Health of Australian Vietnam Veterans and its Relationship to Combat,"Self-reported psychiatric status of Australian Vietnam war veterans was determined 20-25 years after the war and its relation to combat was investigated.A simple random sample of Australian Army Vietnam veterans was interviewed nationally using standardized interviews and self-completion tests to assess the prevalence of lifetime and current psychiatric illness and its relationship to combat. Army records were used to extract data on the cohort for use in regression-based adjustment for non-response.The conditions mainly affecting the Australian veterans were alcohol abuse or dependence, post-traumatic stress disorder, somatization disorder were significantly related to combat exposure but not with posting to a combat unit. Less than half of the current one-month diagnoses were related to combat, possibly because of low power conferred by the relative rarity of these conditions.The results confirm a range of psychological problems in former warriors may linger 20 or more years from their war exposure and may be directly affected by exposure to war trauma.",0,0 +4652,Predictors of General Health After Major Trauma,"Traumatic injury is a leading contributor to the global burden of disease, yet there has been little research on possible predictors of general health after major trauma. This study aims to explore possible predictors of general health after major physical trauma.A survey was performed of 731 surviving consecutive adult patients presenting to a major trauma center with accidental major trauma, between 1 year and 5 years postinjury. Data pertaining to general patient factors, injury severity factors, socioeconomic factors, and claim-related factors were abstracted from the hospital trauma database and the questionnaire. Multiple linear regression was used to develop a predictive model for the main outcome, the physical and mental component summaries of the SF-36 General Health Survey.One hundred and forty nine patients were excluded, 93 refused to participate, and 134 did not respond, leaving 355 participants. On multivariate analysis, better physical health was significantly associated with increasing time since the injury and lower Injury Severity Scores (p = 0.03 and 0.02, respectively). Having a settled compensation claim, having an unsettled compensation claim, and using a lawyer were independently associated with poor physical health (p = 0.02, 0.006, and <0.0001, respectively). Measures of injury severity or socioeconomic status were not associated with mental health. However, having an unsettled compensation claim was strongly associated with poor mental health (p < 0.0001).General health after major physical trauma is more strongly associated with factors relating to compensation than with the severity of the injury. Processes involved with claiming compensation after major trauma may contribute to poor patient outcomes.",0,0 +4653,Latent Class Growth Modelling: A Tutorial,The present work is an introduction to Latent Class Growth Modelling (LCGM). LCGM is a semi‐parametric statistical technique used to analyze longitudinal data. It is used when the data follows a pattern of change in which both the strength and the direction of the relationship between the independent and dependent variables differ across cases. The analysis identifies distinct subgroups of individuals following a distinct pattern of change over age or time on a variable of interest. The aim of the present tutorial is to introduce readers to LCGM and provide a concrete example of how the analysis can be performed using a real‐world data set and the SAS software package with accompanying PROC TRAJ application. The advantages and limitations of this technique are also discussed.,0,0 +4654,Reconsideration of Harm's Way: Onsets and Comorbidity Patterns of Disorders in Preschool Children and Their Caregivers Following Hurricane Katrina,"This study examined posttraumatic stress disorder (PTSD) and comorbid disorders in 70 preschool children (ages 3-6) and their caregivers following Hurricane Katrina. Children's rate of PTSD was 50.0% using age-modified criteria. The rate of PTSD was 62.5% for those who stayed in the city and 43.5% in those who evacuated. Of those with PTSD, 88.6% had at least one comorbid disorder, with oppositional defiant disorder and separation anxiety disorder being most common. Caregivers' rate of PTSD was 35.6%, of which 47.6% was new post-Katrina. No children and only 2 caregivers developed new non-PTSD disorders in the absence of new PTSD symptoms. Differences by race and gender were largely nonsignificant. Children's new PTSD symptoms correlated more strongly to caregivers with new symptoms compared to caregivers with old or no symptoms.",0,0 +4655,Alterations in the cortical thickness and the amplitude of low-frequency fluctuation in patients with post-traumatic stress disorder,"The core neuropsychological processes underlying post-traumatic stress disorder (PTSD) have yet to be elucidated, and the association between anatomical and functional deficits in PTSD remains largely unknown. The aim of our study was to investigate the alterations in cortical thickness and amplitude of low-frequency fluctuation (ALFF) in PTSD patients resulting from motor vehicle accidents (MVCs), and to explore the association of cortical thickness and ALFF with the severity of PTSD symptoms. A total of 20 PTSD patients and 20 healthy controls were recruited and examined by high-resolution structural MRI combined with resting-state fMRI. The results showed significant decrease in cortical thickness in the left BA10, BA32 and BA45 and the right superior temporal gyrus in PTSD patients. The ALFF value in PTSD patients increased significantly in the left BA10 and BA32 and the right cerebellum. Linear regression revealed that decreased cortical thickness and increased ALFF in the BA10 were associated with the increased PTSD scores. These findings suggest that the structural integrity and resting-state function in the BA10 play an important role in the pathogenesis of PTSD. ► PTSD patients had focal cortex thinning in the left BA10, BA32, BA45. ► PTSD patients had significantly increased ALFF in the left BA10, BA32 and right cerebellum. ► Cortical thickness and ALFF in the BA10 were associated with PTSD scores.",0,0 +4656,Cognitive–behavioral conjoint therapy for PTSD improves various PTSD symptoms and trauma-related cognitions: Results from a randomized controlled trial.,"Numerous studies document an association between posttraumatic stress disorder (PTSD) and impairments in intimate relationship functioning, and there is evidence that PTSD symptoms and associated impairments are improved by cognitive-behavioral conjoint therapy for PTSD (CBCT for PTSD; Monson & Fredman, 2012). The present study investigated changes across treatment in clinician-rated PTSD symptom clusters and patient-rated trauma-related cognitions in a randomized controlled trial comparing CBCT for PTSD with waitlist in a sample of 40 individuals with PTSD and their partners (N = 40; Monson et al., 2012). Compared with waitlist, patients who received CBCT for PTSD immediately demonstrated greater improvements in all PTSD symptom clusters, trauma-related beliefs, and guilt cognitions (Hedge's gs -.33 to -1.51). Results suggest that CBCT for PTSD improves all PTSD symptom clusters and trauma-related cognitions among individuals with PTSD and further supports the value of utilizing a couple-based approach to the treatment of PTSD.",0,0 +4657,"Effects of attribution of responsibility for motor vehicle accidents on severity of PTSD symptoms, ways of coping, and recovery over six months","In light of Delahanty et al.'s (1997) identification of attribution of responsibility for a motor vehicle accident (MVA) as a powerful determinant of initial level of distress from the trauma and of early remission of PTSD, we reexamined data from Blanchard and Hickling's (1997) prospective follow-up of 158 MVA survivors. Despite differences between the two samples (Delahanty sample recruited from hospitals 2-3 weeks post-MVA and predominantly male; our sample recruited from outpatient care 1-4 months post-MVA and predominantly female) we replicated Delahanty's findings: those with PTSD who blame themselves for the MVA are less symptomatic initially and recover more rapidly in the first 6 months than those with PTSD who blame another party for the accident.",0,0 +4658,"Outcome of occupational electrical injuries among French electric company workers: A retrospective report of 311 cases, 1996–2005","This study reviewed records of all electrical incidents involving work-related injury to employees Electricité de France (EDF) from 1996 through 2005 and analysed data for 311 incidents. The results are compared with 1231 electrical incidents that occurred during 1970-1979 and 996 incidents during 1980-1989. A total of 311 electrical incidents were observed. The medical consequences of electrical incident remain severe and particularly, the current fatality rate (3.2%) is similar to that recorded in the 1980s (2.7%) and 1970s (3.3%). Among individuals with non-fatal incidents, any change has occurred in the prevalence of permanent functional sequelae (23.6% in the 1970s vs. 27.6% in the 1980s and 32.5% currently). An increase in the incidence of neuropsychiatric sequelae (5.4% in the 1980s vs. 13% currently) has been observed and they are now the second most common type of sequelae after those directly related to burns. Among the neurological sequelae, peripheral nervous system disorders are the most common, as observed in the 1980s. Since the definition of post-traumatic stress disorder (PTSD) has changed between the two periods, we can only report that the current prevalence of PTSD is 7.6%. This study emphasises the need for specific management of neurological and psychological impairments after electrical injuries, including especially early recognition and initiation of effective treatment.",0,0 +4659,"Can physiologic assessment and side effects tease out differences in PTSD trials? A double-blind comparison of citalopram, sertraline, and placebo.","Effects of double-blind treatment of chronic posttraumatic stress disorder (PTSD) with 2 SSRIs and placebo on emotional symptoms and autonomic reactivity were assessed prospectively. PTSD subjects received citalopram (n=25), sertraline (n=23), or placebo (n=10) for 10 weeks, with psychophysiologic assessments performed before and after treatment. Intent-to-treat analysis showed that all treatment groups improved significantly in total symptoms of PTSD (as measured by the Clinician Administered PTSD Scale), all 3 PTSD symptom clusters, and sleep time. However, subtle differences in improvements in PTSD symptom clusters, physiologic reactivity, and reported adverse events were identified. Citalopram treated subjects significantly lowered systolic and diastolic blood pressures, while sertraline and placebo treated patients significantly lowered only systolic blood pressure reactivity to individualized trauma scripts. The sertraline group showed significantly more improvement in avoidance/numbing symptoms than both other groups. Considering side effects, subjects on sertraline reported more gastrointestinal problems, with early terminators having more insomnia. Early terminators on citalopram reported more fatigue and appetite changes than other treatment groups, with completers reporting more sexual dysfunction. Results support a class effect of SSRIs in treating PTSD symptoms, but suggest a possible differential effect of drugs on symptom clusters, physiologic parameters, and side effects that may have clinical relevance. Implications of symptom reduction noted in the smaller placebo group are discussed relative to recent concerns about increasing placebo response in clinical trials.",0,0 +4660,Neurobiological and clinical consequences of stress : from normal adaptation to post-traumatic stress disorder,"This groundbreaking volume is the most thorough and up-to-date exploration of the laboratory, clinical, and theoretical aspects of post-traumatic stress disorder (PTSD) and related stress disorders ever published. The book reviews the entire spectrum of stress responses--from normal to pathological reactions--and brings together the very latest results from basic and clinical research. It provides for the first time critical, authoritative information that will help in the diagnosis and treatment of PTSD. This comprehensive volume provides an invaluable historical and conceptual framework by which to understand post-traumatic stress disorder, emphasizing throughout the homology between the normal stress response and the pathophysiology of PTSD. The book is divided into four major sections that logically progress from basic neurobiological research on stress to neurobiological models of stress and PTSD to specific research on PTSD and clinical issues regarding diagnosis and treatment",0,0 +4661,Prolonged Exposure Therapy With Veterans and Active Duty Personnel Diagnosed With PTSD and Traumatic Brain Injury,"The present study used archival clinical data to analyze the delivery and effectiveness of prolonged exposure (PE) and ancillary services for posttraumatic stress disorder (PTSD) among Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans (N = 69) with histories of mild to severe traumatic brain injury (TBI). Data from standard clinical assessments of veterans and active duty personnel treated in both inpatient and outpatient programs at 2 Department of Veteran Affairs medical centers were examined. Symptoms were assessed with self-report measures of PTSD (PTSD Checklist) and depression (Beck Depression Inventory-II) before and throughout therapy. Mixed linear models were utilized to determine the slope of reported symptoms throughout treatment, and the effects associated with fixed factors such as site, treatment setting (residential vs. outpatient), and TBI severity were examined. Results demonstrated significant decreases in PTSD, B = -3.00, 95% CI [-3.22, -2.78]; t(210) = -13.5; p < .001, and in depressive symptoms, B = -1.46, 95% CI [-1.64, -1.28]; t(192) = -8.32; p < .001. The effects of PE treatment did not differ by clinical setting and participants with moderate to severe injuries reported more rapid gains than those with a history of mild TBI. The results provide evidence that PE may well be effective for veterans with PTSD and TBI.",0,0 +4662,"Post-traumatic Stress Disorder (PTSD), Life Satisfaction and Work Personality: Exploring the Relationship with Disability","This research focused on Post-traumatic Stress Disorder (PTSD) and its relationship to life satisfaction and developmental work personality. The participants were women of low socioeconomic status and consisted of three groups: women not seeking employment; women pursuing their GED prior to seeking employment; and women with disabilities in readiness to work programs. Significant correlations exist between both the Developmental Work Personality Scale (DWPS) and the Life Satisfaction Scale, and PTSD symptoms for the entire group. Separate analyses for each group indicated significant correlations for the women with disabilities between levels of PTSD symptoms, developmental work personality, and life satisfaction. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +4663,Expressed emotion and causal attributions in relatives of post-traumatic stress disorder patients,"This study investigates the relationship between expressed emotion (EE) and causal attributions in relatives of post-traumatic stress disorder (PTSD) patients, and examines the contributions of EE and attributions to patient outcomes. Thirty-eight relatives of patients with PTSD participating in a treatment trial were assessed on EE, causal attributions for patient problems and nature of attributions. Patients’ PTSD symptoms at 6 and 12 months were assessed. Criticism and hostility in relatives were associated with attributing problems to factors controllable by patients. Relatives with marked emotional over-involvement (EOI) had an attributional profile similar to low EE relatives. Deficits in normal behaviour (“negative symptoms”) were perceived as more controllable, internal and stable than were more obvious signs of an illness or mental health problem such as hypervigilance and intrusive thoughts and nightmares (“positive symptoms”). Irritability or anger was perceived as more controllable and personal than any other problem. Hostility was associated with less psychological understanding. EE (hostility) but not attributions was found to predict clinical outcome. The results are consistent with previous studies of relatives of schizophrenia patients. The study suggests a need for interventions, which focus on helping relatives to reappraise the impact of PTSD.",0,0 +4664,Pharmacology for sleep disturbance in PTSD,"Symptoms of sleep disturbance, particularly nightmares and insomnia, are a central feature of post-traumatic stress disorder (PTSD). Emerging evidence suggests that specific treatment of PTSD-related sleep disturbance improves other symptoms of the disorder, which in turn suggests that such disturbance may be fundamental to development and maintenance of the disorder. This mini-review focuses on pharmacological treatment of sleep disturbance in adult PTSD (specifically, studies testing the efficacy of antidepressants, adrenergic inhibiting agents, antipsychotics and benzodiazepine and non-benzodiazepine hypnotics). We conclude that only prazosin, an adrenergic inhibiting agent, has had its efficacy established by multiple randomised controlled trials. There is also high-level evidence supporting use of eszopiclone, as well as risperidone and olanzapine as adjunct therapy. Antidepressants such as sertraline, venlafaxine and mirtazapine, benzodiazepines such as alprazolam and clonazepam and non-benzodiazepine hypnotics such as zolpidem appear ineffective in treating PTSD-related sleep disturbance. Most studies that report reduced frequency of nightmares and insomnia also report decreases in overall symptom severity. Such findings suggest that (i) sleep disruption is central to PTSD; (ii) treating sleep disruption may be an effective way to address other symptoms of the disorder and (iii) PTSD symptoms tend to cluster together in predictable ways.",0,0 +4665,Verbal learning and memory impairments in posttraumatic stress disorder: The role of encoding strategies,"The present study examined mechanisms underlying verbal memory impairments in patients with posttraumatic stress disorder (PTSD). Earlier studies have reported that the verbal learning and memory alterations in PTSD are related to impaired encoding, but the use of encoding and organizational strategies in patients with PTSD has not been fully explored. This study examined organizational strategies in 21 refugees/immigrants exposed to war and political violence who fulfilled DSM-IV criteria for chronic PTSD compared with a control sample of 21 refugees/immigrants with similar exposure, but without PTSD. The California Verbal Learning Test was administered to examine differences in organizational strategies and memory. The semantic clustering score was slightly reduced in both groups, but the serial cluster score was significantly impaired in the PTSD group and they also reported more items from the recency region of the list. In addition, intrusive errors were significantly increased in the PTSD group. The data support an assumption of changed memory strategies in patients with PTSD associated with a specific impairment in executive control. However, memory impairment and the use of ineffective learning strategies may not be related to PTSD symptomatology only, but also to self-reported symptoms of depression and general distress.",0,0 +4666,Age differences in PTSD among Canadian veterans: age and health as predictors of PTSD severity,"ABSTRACT Background: To date, few studies have investigated age differences in posttraumatic stress disorder (PTSD) symptoms and none has examined age differences across symptom clusters: avoidance, re-experiencing, and hyperarousal. The first objective of this study was to investigate age differences in PTSD and its three symptom clusters. The second objective was to examine age and indices of health as predictors of PTSD symptom severity. Methods: Participants were 104 male veterans, aged 22 to 87 years, receiving specialized mental health outpatient services. Assessments included measures of health-related quality of life, pain severity, number of chronic health conditions, and symptoms of PTSD, both in total and on the symptom clusters. Results: There were significant age differences across age groups, with older veterans consistently reporting lower PTSD symptom severity, both in total and on each of the symptom clusters. Hierarchical regression analyses indicated that the inclusion of health indices accounted for significantly more variance in PTSD symptoms over and above that accounted for by age alone. Pain severity was a significant predictor of PTSD total and the three symptom clusters. Conclusions : This is the first study to report lower levels of PTSD severity among older veterans across symptom clusters. These findings are discussed in relation to age differences in the experiencing and processing of emotion, autobiographical memory, and combat experiences. This study also emphasizes the importance of assessing pain in those with symptoms of PTSD, particularly older veterans who are less likely to receive specialized mental healthcare.",0,0 +4667,"Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining ""whiplash"" and its management.",,0,0 +4668,"Stress Controversies: Post-Traumatic Stress Disorder, Hippocampal Volume, Gastroduodenal Ulceration*","Stress in mammals triggers a neuroendocrine response mediated by the hypothalamic-pituitary-adrenal axis and the autonomic nervous system. Increased activity of these two systems induces behavioural, cardiovascular, endocrine and metabolic cascades that enable the individual to fight or flee and cope with the stress. Our understanding of stress and stress-response mechanisms is generally robust. Here, however, we review three themes that remain controversial and perhaps deserve further scrutiny and investigation before they achieve canonical status. The themes are, first, hypocortisolaemia in post-traumatic stress disorder (PTSD). A reduction rather than a stress-induced increase in adrenal glucocorticoid levels, as seen in major depressive disorder (MDD), is puzzling and furthermore is not a consistent feature of PTSD. Overall, studies on PTSD show that glucocorticoid levels may be normal or higher or lower than normal. The second theme concerns the reduction in volume of the hippocampus in MDD attributed to the neurotoxicity of hypercortisolaemia. Again, as for hypocortisolaemia in PTSD, reduced hippocampal volume in MDD has been found in some but not all studies. Third, the discovery of a causal association between Helicobacter pylori and peptic ulcers apparently brought to an end the long-held view that peptic ulceration was caused predominantly by stress. However, recent studies suggest that stress can cause peptic ulceration in the absence of H. pylori. Predictably, the aetiological pendulum of gastric and duodenal ulceration has swung from 'all stress' to 'all bacteria' followed by a sober realisation that both factors may play a role. This raises the question as to whether stress and H. pylori interact, and if so how? All three controversies are of clinical significance, pose fundamental questions about stress mechanisms and offer important areas for future research.",0,0 +4669,Veterans’ PTSD symptoms and their partners’ desired changes in key relationship domains.,"There is a growing literature investigating the connection between veterans' posttraumatic stress disorder (PTSD) symptoms and intimate relationship problems. Little to no work, however, has examined the connection between veterans' PTSD symptoms and their partners' perceptions of specific relationship areas in need of change. We examined associations between overall PTSD symptoms and symptom cluster scores with partners' desired changes in the areas of intimacy, shared activities, and responsibilities. The sample consisted of 249 male veterans of different service eras and their female partners. Results indicated that veterans' PTSD symptoms were associated with greater desired changes from their partners in the veterans' intimacy behaviors and participation in shared activities. When examining the contribution of each symptom cluster individually, only the veterans' emotional numbing symptoms emerged as a significant unique predictor and were associated with partners' desired changes in intimacy. The findings suggest that intimacy and shared activities may be relevant areas to address in PTSD treatment for veterans and their partners and highlight the particular significance of emotional numbing symptoms to intimacy in veterans' relationships.",0,0 +4670,Undiagnosed post‐traumatic stress disorder following motor vehicle accidents,"OBJECTIVES: To determine the pattern of emergence of post-traumatic stress disorder (PTSD) among motor vehicle accident victims and to examine the influence of PTSD on subsequent levels of disability. DESIGN: A longitudinal study of motor vehicle accident victims one month and 18 months after the accident. SUBJECTS: Twenty-four motor vehicle accident victims admitted by the trauma team at the Royal Adelaide Hospital. A 52% response rate was achieved. MAIN OUTCOME MEASURES: Post-traumatic stress disorder as diagnosed by the Diagnostic Interview Schedule and disability as measured with the Sickness Impact Profile. RESULTS: Eighteen months after their accidents, six of the 24 subjects had clinically significant PTSD and one was considered borderline. None had been previously diagnosed or treated. The group with PTSD had higher scores on all measures of psychological distress one month after the accident and were more likely to use immature psychological defences. There was no association between physical outcome (measured with the modified Glasgow Outcome Scale) at six months and subsequent diagnosis of PTSD. However, the group with PTSD had higher levels of disability on assessment with the Sickness Impact Profile, particularly in the domain of social functioning. The results suggest PTSD was associated with work-related dysfunction equal to that associated with severe physical handicap. CONCLUSION: The data from this pilot study suggest that PTSD after motor vehicle accidents is an important cause of disability, which may also become the focus for damages in litigation. Thus, there is a need for further investigation of the early patterns of distress and to design preventive programs for victims of road accidents. Language: en",0,0 +4671,Trajectories of suicidal ideation and posttraumatic stress symptoms among former prisoners of war: A 17-year longitudinal study,"War captivity is one of the most severe human-inflicted traumatic experiences with wide and substantial long-term negative effects. However, only one retrospective study examined suicidal ideation (SI) among ex-prisoners of war (ex-POWs). This study aimed to prospectively assess SI among ex-POWs and its associations with posttraumatic stress disorder (PTSD) symptoms over a 17-year period. Two groups of male Israeli veterans from the 1973 Yom Kippur War were examined: ex-POWs and comparable veterans who were not taken captive. Both groups were assessed via self-report measures of SI and PTSD symptoms at three time points: T1 18 (1991), T2 30 (2003), and T3 35 (2008) years after the war. Latent growth curve modeling (LGM) results showed that ex-POWs reported higher levels of SI at T2 and T3 and a pattern of increase in SI levels trajectory over time, compared to control veterans. Furthermore, among ex-POWs, PTSD symptoms at T1 contributed to the increase in rate of change in SI overtime. In addition, PTSD symptoms affected SI at the same measurement, above and beyond above the trajectories of SI. Clinical implications of these findings for the relations between captivity trauma and suicidality are discussed.",0,0 +4672,Higher cerebrospinal fluid homovanillic acid levels in depressed patients with comorbid posttraumatic stress disorder,"Major depression and posttraumatic stress disorder (PTSD) are often comorbid, resulting in more impairment compared than with either diagnosis alone. Both major depression and PTSD are thought to be associated with monoamine transmitter abnormalities. This study compared clinical features and cerebrospinal fluid (CSF) monoamine metabolites in drug-free depressed subjects with a current major depressive episode (MDE) without comorbid PTSD, subjects with a current MDE and comorbid PTSD, and healthy volunteers. Depressed subjects with comorbid PTSD had higher CSF homovanillic acid (HVA) levels compared with depressed subjects without comorbid PTSD or healthy volunteers. Higher HVA was present after adjustment for sex, lifetime aggression severity and depression scores, alcoholism, tobacco smoking, comorbid cluster B personality disorder, reported childhood abuse, and psychosis. We found no group difference in CSF 5-hydroxyindolacetic acid (5-HIAA) and 3-methoxy-4-hydroxyphenylglycol (MHPG) levels. Higher dopaminergic activity may contribute to alterations in memory and other cognitive functions, anhedonia, and hypervigilance observed in PTSD.",0,0 +4673,"Comparison of Concussive Symptoms, Cognitive Performance, and Psychological Symptoms Between Acute Blast-Versus Nonblast-Induced Mild Traumatic Brain Injury","Blast-related head injuries are one of the most prevalent injuries among military personnel deployed in service of Operation Iraqi Freedom. Although several studies have evaluated symptoms after blast injury in military personnel, few studies compared them to nonblast injuries or measured symptoms within the acute stage after traumatic brain injury (TBI). Knowledge of acute symptoms will help deployed clinicians make important decisions regarding recommendations for treatment and return to duty. Furthermore, differences more apparent during the acute stage might suggest important predictors of the long-term trajectory of recovery. This study evaluated concussive, psychological, and cognitive symptoms in military personnel and civilian contractors (N = 82) diagnosed with mild TBI (mTBI) at a combat support hospital in Iraq. Participants completed a clinical interview, the Automated Neuropsychological Assessment Metric (ANAM), PTSD Checklist-Military Version (PCL-M), Behavioral Health Measure (BHM), and Insomnia Severity Index (ISI) within 72 hr of injury. Results suggest that there are few differences in concussive symptoms, psychological symptoms, and neurocognitive performance between blast and nonblast mTBIs, although clinically significant impairment in cognitive reaction time for both blast and nonblast groups is observed. Reductions in ANAM accuracy were related to duration of loss of consciousness, not injury mechanism.",0,0 +4674,Short communication: Genetic trends of milk yield under heat stress for US Holsteins,"Data included 90,242,799 test-day milk records from 5,402,484 Holstein cows in the first 3 parities and 9,326,754 animals in the pedigree. Additionally, daily temperature-humidity indexes from 202 weather stations were available. Analyses were done by a random regression model in which each parity was treated as a separate trait and that accounted for heat stress. The fixed effects included herd test-day, age at calving, milking frequency, and days in milk classes. Random effects included additive genetic, permanent environment, and herd-year effects, all fit as random regressions. Five covariates in the random regressions included linear splines with 4 knots at 5, 50, 200, and 305 DIM and a function of a temperature-humidity index (THI). Mixed model equations were solved by using an iteration on data approach with a preconditioned conjugate gradient algorithm. Genetic trends for daily milk yield in absence of heat stress (intercept) were 0.140 kg/yr, 0.172 kg/yr, and 0.168 kg/yr for the first, second, and third parity, respectively. Genetic trends for decline of milk yield at temperature of 5 degrees C THI over the threshold of sensitivity to heat stress were -0.002 kg/yr, -0.035 kg/yr, and -0.038 kg/yr, for first, second, and third parity, respectively. Genetic profiles were created by contrasting the 100 most and 100 least heat-tolerant bulls for the official proofs. The most heat-tolerant bulls transmitted lower production and dairy form but higher fertility, productive life, and type, especially udder and locomotion traits. In later parities, the type advantages were smaller. Test-day records capture only a fraction of information due to heat stress, and the real trends for heat stress may be stronger. Studies on heat stress for production should include records on later parities.",0,0 +4675,Psychopharmacological treatment in PTSD: a critical review,"Posttraumatic stress disorder (PTSD) is a prevalent psychiatric disorder that is heterogeneous in its nature, and often presents with other psychiatric comorbidities. As a result, empirical research on effective pharmacotherapy for PTSD has produced complex findings. This article reviews the existing research literature on pharmacological treatments for PTSD, identifies the most effective treatments, and where possible examines their mechanism of action with respect to the neurobiology of PTSD.We examined reports of clinical trials of psychotropic agents carried out with PTSD patients and published in peer-reviewed journals, as well as reports from presentations at scientific meetings between 1966 and 2001.Numerous medications are effective in treating PTSD. These include tricyclic antidepressants, monoamine oxidase inhibitors, and serotonin reuptake inhibitors. Considering reported overall efficacy and side effects profiles, selective serotonin reuptake inhibitors emerge as the preferred first line treatment for PTSD. Mood stabilizers, atypical neuroleptics, adrenergic agents, and newer antidepressants also show promise, but require further controlled trials to clarify their place in the pharmacopoeia for PTSD.There is clear evidence for effective pharmacotherapy of PTSD. Future improvements in the treatment of this disorder await further clinical trials and neurobiological research.",0,0 +4676,Peritraumatic Distress and the Course of Posttraumatic Stress Disorder Symptoms: A Meta-Analysis,"Objective: To examine how peritraumatic distress modulates the severity of posttraumatic stress disorder (PTSD) according to the timing of the PTSD symptom assessments. Method: A systematic literature review of English- and French-language studies having administered the Peritraumatic Distress Inventory (PDI) was conducted. Meta-analyses were performed on correlations relating PDI and PTSD symptom scores obtained from the sampled studies. The meta-analyses, which included calculations of regression slopes, took into consideration the time at which PTSD symptoms were assessed following the traumatic event and the timing of the PDI assessment. Results: The literature review yielded a total of 22 studies. The meta-analysis performed over all studies resulted in a pooled correlation coefficient of 0.55 between the PDI and PTSD symptom scores. Meta-regression analyses conducted over all data revealed no apparent decrease in the correlations according to the timing of the PTSD symptom assessments. However, there were numerical or statistically significant declines in regression slopes when the meta-regressions were separately conducted on studies having administered the PDI either within, or following, a 1-month period after a traumatic event. Conclusions: While PDI or PTSD symptom score correlations remain generally significant, they tend to decline as time elapses between the traumatic event and the PTSD assessment. This suggests there may be factors other than peritraumatic distress that increasingly account for the long-term trajectory PTSD symptoms.",0,0 +4677,Pharmacologic treatment of impulsive aggression with antiepileptic drugs,"Aggressive behavior is a major concern in mental health and criminal justice settings. Although pharmacotherapy is often used in the treatment of the violent individual, no medication is presently approved by the US Food and Drug Administration specifically for such use. In recent years, antiepileptic drugs (AEDs) have become increasingly popular for the management of impulsive (reactive) aggressive behavior. The research literature has implicated several neurobiologic deficits associated with impulsive aggression, including reduced central serotonergic functioning, executive dysfunction, and prefrontal deficits. It has been suggested that the neurobiologic deficits specific to impulsive aggressive behavior may serve as indicators of an ineffective behavioral control system. A review of the literature finds that AEDs, particularly those that block sodium channels and/or have GABA-related mechanisms of action, are effective in reducing the frequency and intensity of impulsive aggressive outbursts both when used as the primary agent of treatment and as an adjunct to ongoing pharmacotherapy. Strong evidence for efficacy in impulsive aggression exists from randomized controlled trials for most of the common AEDs (phenytoin, carbamazepine, oxcarbazepine, lamotrigine, valproate/ divalproex sodium, topiramate). Additional controlled studies are needed for tiagabine and gabapentin. Of the common AEDs, only levetiracetam has been shown to be ineffective in the treatment of impulsive aggression. It is important to note that the anti-aggressive effects seen with the AEDs appear to be specific to the impulsive form of aggression. Individuals who display premeditated aggression do not seem to benefit from this type of treatment. Clinically, we recommend phenytoin (initial dose 100 mg three times daily) as the AED of first choice for the treatment of impulsive aggressive outbursts. This recommendation is based on this drug's limited side effect profile (compared with the other AEDs) and the large amount of empiric data supporting its clinical efficacy in impulsive aggression. In the event that the impulsive aggressive individual does not respond to pharmacotherapy with phenytoin, carbamazepine (initial dose 150 mg three times daily) and valproate/divalproex sodium (initial dose 250 mg three times daily) have both proved to be effective secondary options. (",0,0 +4678,Anxio- depressive Syndrome – Biopsychosocial Model of Supportive Care,"Acute stress in patients experiencing cancer diagnosis and the post-traumatic stress disorder in cancer survivors results in impaired overall quality of life mainly due to associated psychological and physical alterations, including anxiety, depression, sleep disturbances, cognitive dysfunctions, fatigue, pain, cachexia and others. Recent studies revealed a new insight into molecular mechanisms contributing to the development of cancer-related co morbidities. It has been shown that adverse psychosomatic reactions including cancer depression to emotional cancer distress result from neuroendocrinne dysfunctions, disruption of the hypothalamus- pituitary-adrenal axis and sympathetic nervous system, serotonin-dopamine interactions and circadian sleep- wake rhythm disruption.The aim of the present study was to evaluate clinical studies oriented toward elucidation of the hypothesis that cancer-related anxio- depressive syndrome is the major disorder leading to the development of accompanying psychosomatic disruptions.The data of the biopsychosocial approach in the treatment of cancer presented in the current literature were collecting using appropriate electronic databases and were elaborated in the form of meta-analysis of 24 selected publications.According to relevant clinical studies, psychosocial interventions and psychopharmacological treatment has been shown to reduce cancer symptomatology and to improve the ability of patients to cope with the disease. Thus, one of the key pillars of supportive care in oncology is stress reduction. Cognitive- behavioral interventions and group psychosocial therapies have shown to reduce stress from the diagnosis and treatment, to palliate depression and to help in restoring the circadian rhythm. Psychopharamacological interventions are the most useful approaches in the reduction of stress-induced cancer comorbidities. In the presented study, a plausible role of stress reduction in the protection of cancer patients from posttraumatic and anxio- depressive syndrome, physical and psychical suffering, from decrease of patients quality of life, ability to cope with the disease and cooperate in cancer treatment has been analyzed.Implementation of the biopsychosocial model of cancer care needs further cooperation between behavioral scientists and clinical oncologists attempted to elucidate further possibilities of psychosocial and pharmacological interventions leading to the regulation of stress-induced alterations of the neurotransmitter system and neuroendocrinne dysfunctions reduction of cancer-related co morbidities and improvement of patients survival time.",0,0 +4679,Sex-based responses of plasma creatine kinase in broilers to thermoneutral constant and cyclic high temperatures,"1. The plasma creatine kinase (CK) activities of male and female broilers under different temperature regimens were studied to investigate the suitability of plasma CK as an indicator of muscle damage due to heat exposure (HE). 2. This study characterises the responses of plasma CK concentration of Arbor Acres broilers to thermoneutral (TN) constant (22°C) or warm cyclic (WC) temperatures (ranging from 27·9°C to 37·9°C). 3. The daily mean CK of the females tended to be higher than those of the males, and significant differences in plasma CK were observed between the genders during the first 5-d test period, namely 2-d TN constant and 3-d WC temperatures. 4. During a 5-d HE to the WC regimens, CK of both genders fluctuated with HE time but exhibited somewhat different profiles. Specifically, the daily mean CK of the females was significantly higher on d 5 of HE than any other daily means, whereas significant difference in daily CK of the males occurred on d 4 of HE. 5. Repetitive blood sampling over 5 d of HE had significant effects on the plasma CK of the females regardless of the number of repeated bleeding times. 6. Profiles of the plasma CK for each gender during d 1 of HE were similar to those under the TN condition, implying that heat stress affects the range of broiler plasma CK concentration but with a 1-d lag. 7. Plasma CK activities of female and male broilers showed a response to HE. However, both the gender and the time of blood sampling should be taken into account when plasma CK is used as an indicator of HE for market-size broilers.",0,0 +4680,Preliminary Evidence for the Effects of Morphine on Posttraumatic Stress Disorder Symptoms in One- to Four-Year-Olds With Burns,"This study tested the hypothesis that very young children who received more morphine for acute burns would have larger decreases in posttraumatic symptoms 3 to 6 months later. This has never before been studied in very young children, despite the high frequency of burns and trauma in this age group. Seventy 12- to 48-month-old nonvented children with acute burns admitted to a major pediatric burn center and their parents participated. Parents were interviewed at three time points: during their child's hospitalization, 1 month, and 3 to 6 months after discharge. Measures included the Child Stress Disorders Checklist - Burn Version (CSDC-B). Chart reviews were conducted to obtain children's morphine dosages during hospitalization. Mean equivalency dosages of morphine (mg/kg/d) were calculated to combine oral and intravenous administrations. Eleven participants had complete 3 to 6-month data on the CSDC. The correlation between average morphine dose and amount of decrease in posttraumatic stress disorder symptoms on the CSDC (r = -0.32) was similar to that found in studies with older children. The correlation between morphine dose and amount of decrease in symptoms on the arousal cluster of the CSDC was significant (r = -0.63, P < .05). Findings from the current study suggest that, for young children, management of pain with higher doses of morphine may be associated with a decreasing number of posttraumatic stress disorder symptoms, especially those of arousal, in the months after major trauma. This extends, with very young children, the previous findings with 6- to 16-year olds.",0,0 +4681,Predictors of Risk and Resilience for Posttraumatic Stress Disorder Among Ground Combat Marines: Methods of the Marine Resiliency Study,"The Marine Resiliency Study (MRS) is a prospective study of factors predictive of posttraumatic stress disorder (PTSD) among approximately 2,600 Marines in 4 battalions deployed to Iraq or Afghanistan. We describe the MRS design and predeployment participant characteristics. Starting in 2008, our research team conducted structured clinical interviews on Marine bases and collected data 4 times: at predeployment and at 1 week, 3 months, and 6 months postdeployment. Integrated with these data are medical and career histories from the Career History Archival Medical and Personnel System (CHAMPS) database. The CHAMPS database showed that 7.4% of the Marines enrolled in MRS had at least 1 mental health diagnosis. Of enrolled Marines, approximately half (51.3%) had prior deployments. We found a moderate positive relationship between deployment history and PTSD prevalence in these baseline data.",0,0 +4682,Confirmatory factor analysis of posttraumatic stress symptoms in Brazilian primary care patients: An examination of seven alternative models,"► The DSM-IV-TR postulates that PTSD symptoms are organized into 3 clusters. ► However, recent factor analytical studies tend to favor 4-factor, first-order models. ► 805 Brazilian primary care patients filled out the PCL-C and a CFA was conducted. ► A 4-factor, first-order solution including a numbing cluster provided the best fit. ► The results uphold the cross-cultural validity of the 4-factor, first-order model. The DSM-IV-TR postulates that PTSD symptoms are organized into 3 clusters. This assumption has been challenged by growing number of factor analytical studies, which tend to favor 4-factor, first-order models. Our objective was to investigate whether the clusters of PTSD symptoms identified in North American and European studies could be replicated in a Brazilian sample composed of 805 primary care patients living in hillside slums. Volunteers were asked to fill out the Brazilian version of the Posttraumatic Stress Disorder Checklist—Civilian Version and a confirmatory factor analysis of this scale was conducted with the software LISREL 8.80. Seven models were tested and a 4-factor, first-order solution including an emotional numbing cluster was found to provide the best fit. Although PTSD has been characterized by some critics as a Western culture-specific disorder lacking universal validity, our results seem to uphold the cross-cultural validity of the 4-factor, first-order model.",0,0 +4683,Longitudinal interplay between posttraumatic stress symptoms and coping self-efficacy: A four-wave prospective study,"Trauma-related coping self-efficacy (CSE), the perceived capability to manage one's personal functioning and the myriad environmental demands of the aftermath of potentially traumatic events (PTE), has been shown to affect psychological outcomes after these events. Aim of the present four-wave study was to examine the cross-lagged relationships between CSE and posttraumatic stress disorder (PTSD) symptoms following PTEs in order to examine direction of influence. Levels of CSE and PTSD symptoms were measured with 4-month intervals. In addition, prospectively assessed personality traits and general self-efficacy perceptions as well as peritraumatic distress were entered in the analyses. The study sample consists of adult respondents of a representative internet panel who experienced PTE in the six months before T1, and did not experience any new PTE or life event between T1 and T3 (N = 400). Respondents were administered the coping self-efficacy scale (CSE-7), impact of event scale (IES) and arousal items of IES-R at each wave (T1 through T3), as well as questions on peritraumatic stress and prospectively measured personality traits (T0). Results of structural equation modeling showed that the effect of CSE on subsequent PTSD symptom levels was dominant. CSE significantly predicted subsequent symptoms, over and above earlier symptom levels, with higher CSE associated with lower PTSD. Symptoms in turn, did not predict subsequent levels of CSE. Higher peritraumatic distress was associated with both higher initial PTSD symptoms and lower initial CSE levels. Higher levels of the personality traits of emotional stability and agreeableness were associated with higher initial CSE levels. This supports a model in which CSE perceptions play an important role in recovery from trauma.",0,0 +4684,Dimensional structure and course of post-traumatic stress symptomatology in World Trade Center responders,"Background Post-traumatic stress disorder (PTSD) in response to the World Trade Center (WTC) disaster of 11 September 2001 (9/11) is one of the most prevalent and persistent health conditions among both professional (e.g. police) and non-traditional (e.g. construction worker) WTC responders, even several years after 9/11. However, little is known about the dimensionality and natural course of WTC-related PTSD symptomatology in these populations. Method Data were analysed from 10 835 WTC responders, including 4035 police and 6800 non-traditional responders who were evaluated as part of the WTC Health Program, a clinic network in the New York area established by the National Institute for Occupational Safety and Health. Confirmatory factor analyses (CFAs) were used to evaluate structural models of PTSD symptom dimensionality; and autoregressive cross-lagged (ARCL) panel regressions were used to examine the prospective interrelationships among PTSD symptom clusters at 3, 6 and 8 years after 9/11. Results CFAs suggested that five stable symptom clusters best represent PTSD symptom dimensionality in both police and non-traditional WTC responders. This five-factor model was also invariant over time with respect to factor loadings and structural parameters, thereby demonstrating its longitudinal stability. ARCL panel regression analyses revealed that hyperarousal symptoms had a prominent role in predicting other symptom clusters of PTSD, with anxious arousal symptoms primarily driving re-experiencing symptoms, and dysphoric arousal symptoms primarily driving emotional numbing symptoms over time. Conclusions Results of this study suggest that disaster-related PTSD symptomatology in WTC responders is best represented by five symptom dimensions. Anxious arousal symptoms, which are characterized by hypervigilance and exaggerated startle, may primarily drive re-experiencing symptoms, while dysphoric arousal symptoms, which are characterized by sleep disturbance, irritability/anger and concentration difficulties, may primarily drive emotional numbing symptoms over time. These results underscore the importance of assessment, monitoring and early intervention of hyperarousal symptoms in WTC and other disaster responders.",0,0 +4685,Development of a brief cannabis use disorder screening tool: The CUDIT Short-Form,"Aims: The aim of the present study was to develop and test the diagnostic utility of a shortened 3-item version of the Cannabis Use Disorder Identification Test - Revised (CUDIT-R) for the purpose of brief and effective screening within primary care and other medical settings. Methods:Ashort form of the CUDIT-R was developed using Item Response Theory (IRT) and traditional statistical methods, with data from two community samples of cannabis users representing two countries. Four item selection methods (Rasch Regression, Test Characteristic Curve, Logistic Regression, Discriminant Function Analysis) were employed to identify the most optimal 3-item shortened version. The diagnostic ability of the short forms was evaluated using receiver operating characteristic curves. Results: Using a cut score of 2, the 3-item CUDIT-Short Form (reliability alpha = .66 sample 1; .80 sample 2) identified 78.26% of participants in sample 1 and 78.31% of participants in sample 2 who met DSM-5 criteria for CUD, with 98% agreement in sample 1 and 93% agreement in sample 2 with the full CUDIT-R on CUD classifications using a cut score of 13. Specificity was 76.70 and 78.00 in sample 1 and 2, respectively. Conclusions: The CUDIT-Short Form (CUDIT-SF) may be useful in busy clinical settings for a stepwise screening. Further validation of this shortened version with larger samples and in different settings is warranted.",0,0 +4686,Mental Health Among Reserve Component Military Service Members and Veterans,"Since 2001, the US military has increasingly relied on National Guard and reserve component forces to meet operational demands. Differences in preparation and military engagement experiences between active component and reserve component forces have long suggested that the psychiatric consequences of military engagement differ by component. We conducted a systematic review of prevalence and new onset of psychiatric disorders among reserve component forces and a meta-analysis of prevalence estimates comparing reserve component and active component forces, and we documented stage-sequential drivers of psychiatric burden among reserve component forces. We identified 27 reports from 19 unique samples published between 1985 and 2012: 9 studies reporting on the reserve component alone and 10 reporting on both the reserve component and the active component. The pooled prevalence for alcohol use disorders of 14.5% (95% confidence interval: 12.7, 15.2) among the reserve component was higher than that of 11.7% (95% confidence interval: 10.9, 12.6) among the active component, while there were no component differences for depression or post-traumatic stress disorder. We observed substantial heterogeneity in prevalence estimates reported by the reserve component. Published studies suggest that stage-sequential risk factors throughout the deployment cycle predicted alcohol use disorders, post-traumatic stress disorder and, to a lesser degree, depression. Improved and more standardized documentation of the mental health burden, as well as study of explanatory factors within a life-course framework, is necessary to inform mitigating strategies and to reduce psychiatric burden among reserve component forces.",0,0 +4687,Human brain evolution and the “Neuroevolutionary Time-depth Principle:” Implications for the Reclassification of fear-circuitry-related traits in DSM-V and for studying resilience to warzone-related posttraumatic stress disorder,"The DSM-III, DSM-IV, DSM-IV-TR and ICD-10 have judiciously minimized discussion of etiologies to distance clinical psychiatry from Freudian psychoanalysis. With this goal mostly achieved, discussion of etiological factors should be reintroduced into the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). A research agenda for the DSM-V advocated the “development of a pathophysiologically based classification system”. The author critically reviews the neuroevolutionary literature on stress-induced and fear circuitry disorders and related amygdala-driven, species- atypical fear behaviors of clinical severity in adult humans. Over 30 empirically testable/falsifiable predictions are presented. It is noted that in DSM-IV-TR and ICD-10, the classification of stress and fear circuitry disorders is neither mode-of-acquisition-based nor brain-evolution-based. For example, snake phobia (innate) and dog phobia (overconsolidational) are clustered together. Similarly, research on blood-injection-injury-type-specific phobia clusters two fears different in their innateness: 1) an arguably ontogenetic memory-trace-overconsolidation-based fear (hospital phobia) and 2) a hardwired (innate) fear of the sight of one's blood or a sharp object penetrating one's skin. Genetic architecture-charting of fear-circuitry-related traits has been challenging. Various, non-phenotype-based architectures can serve as targets for research. In this article, the author will propose one such alternative genetic architecture. This article was inspired by the following: A) Nesse's “Smoke-Detector Principle”, B) the increasing suspicion that the “smooth” rather than “lumpy” distribution of complex psychiatric phenotypes (including fear-circuitry disorders) may in some cases be accounted for by oligogenic (and not necessarily polygenic) transmission, and C) insights from the initial sequence of the chimpanzee genome and comparison with the human genome by the Chimpanzee Sequencing and Analysis Consortium published in late 2005. Neuroevolutionary insights relevant to fear circuitry symptoms that primarily emerge overconsolidationally (especially Combat related Posttraumatic Stress Disorder) are presented. Also introduced is a human-evolution-based principle for clustering innate fear traits. The “Neuroevolutionary Time-depth Principle” of innate fears proposed in this article may be useful in the development of a neuroevolution-based taxonomic re-clustering of stress-triggered and fear-circuitry disorders in DSM-V. Four broad clusters of evolved fear circuits are proposed based on their time-depths: 1) Mesozoic (mammalian-wide) circuits hardwired by wild-type alleles driven to fixation by Mesozoic selective sweeps; 2) Cenozoic (simian-wide) circuits relevant to many specific phobias; 3) mid Paleolithic and upper Paleolithic ( Homo sapiens -specific) circuits (arguably resulting mostly from mate-choice-driven stabilizing selection); 4) Neolithic circuits (arguably mostly related to stabilizing selection driven by gene–culture co-evolution). More importantly, the author presents evolutionary perspectives on warzone-related PTSD, Combat-Stress Reaction, Combat-related Stress, Operational-Stress, and other deployment-stress-induced symptoms. The Neuroevolutionary Time-depth Principle presented in this article may help explain the dissimilar stress-resilience levels following different types of acute threat to survival of oneself or one's progency (aka DSM-III and DSM-V PTSD Criterion-A events). PTSD rates following exposure to lethal inter-group violence (combat, warzone exposure or intentionally caused disasters such as terrorism) are usually 5–10 times higher than rates following large-scale natural disasters such as forest fires, floods, hurricanes, volcanic eruptions, and earthquakes. The author predicts that both intentionally-caused large-scale bioevent-disasters, as well as natural bioevents such as SARS and avian flu pandemics will be an exception and are likely to be followed by PTSD rates approaching those that follow warzone exposure. During bioevents, Amygdala-driven and locus-coeruleus-driven epidemic pseudosomatic symptoms may be an order of magnitude more common than infection-caused cytokine-driven symptoms. Implications for the red cross and FEMA are discussed. It is also argued that hospital phobia as well as dog phobia, bird phobia and bat phobia require re-taxonomization in DSM-V in a new “overconsolidational disorders” category anchored around PTSD. The overconsolidational spectrum category may be conceptualized as straddling the fear circuitry spectrum disorders and the affective spectrum disorders categories, and may be a category for which Pitman's secondary prevention propranolol regimen may be specifically indicated as a “morning after pill” intervention. Predictions are presented regarding obsessive-compulsive disorder (OCD) (e.g., female-pattern hoarding vs. male-pattern hoarding) and “culture-bound” acute anxiety symptoms (taijin-kyofusho, koro, shuk yang, shook yong, suo yang, rok-joo, jinjinia-bemar, karoshi, gwarosa, Voodoo death). Also discussed are insights relevant to pseudoneurological symptoms and to the forthcoming Dissociative-Conversive disorders category in DSM-V, including what the author terms fright-triggered acute pseudo-localized symptoms (i.e., pseudoparalysis, pseudocerebellar imbalance, psychogenic blindness, pseudoseizures, and epidemic sociogenic illness). Speculations based on studies of the human abnormal-spindle-like, microcephaly-associated ( ASPM ) gene, the microcephaly primary autosomal recessive ( MCPH ) gene, and the forkhead box p2 ( FOXP2 ) gene are made and incorporated into what is termed “The pre- FOXP2 Hypothesis of Blood-Injection-Injury Phobia.” Finally, the author argues for a non-reductionistic fusion of “distal (evolutionary) neurobiology” with clinical “proximal neurobiology,” utilizing neurological heuristics. It is noted that the value of re-clustering fear traits based on behavioral ethology, human-phylogenomics-derived endophenotypes and on ontogenomics (gene–environment interactions) can be confirmed or disconfirmed using epidemiological or twin studies and psychiatric genomics.",0,0 +4688,Soldier Dimensions and Operational Readiness in U.S. Army Forces Deployed to Kosovo,"Abstract : The impact of military deployments on soldiers has been assessed from combat to peacekeeping to humanitarian missions. In a recent study of U.S. Army units deployed to Kosovo in support of a multinational peacekeeping mission, soldier attitudes and health were surveyed on site, mid-way during a 6-month deployment. In all, 1,718 soldiers were surveyed, 53.0% were junior enlisted, 34.5% were non-commissioned officers, and 12.5% were officers. In addition, 15 focused soldier and leader interviews were conducted. Key findings included: (a) Soldiers in Kosovo experienced nearly four times the number of traumatic events had higher rates of depression, slept less and were under higher strain compared to soldiers who did not have such experiences. (b) Soldiers' attitude about peacekeeping missions and military deployments became more negative over the course of the Kosovo deployment. (c) Confidence in leadership was high, although it declined somewhat during the deployment. These findings indicate that deployments involving peacekeeping operations can impact readiness on a broad range of soldier dimensions. These effects, however, can be both positive and negative. Only by addressing and understanding both aspects of a deployment will we be able to ensure that soldier and unit readiness remains high.",0,0 +4689,"Mental Health Problems, Use of Mental Health Services, and Attrition From Military Service After Returning From Deployment to Iraq or Afghanistan","The US military has conducted population-level screening for mental health problems among all service members returning from deployment to Afghanistan, Iraq, and other locations. To date, no systematic analysis of this program has been conducted, and studies have not assessed the impact of these deployments on mental health care utilization after deployment.To determine the relationship between combat deployment and mental health care use during the first year after return and to assess the lessons learned from the postdeployment mental health screening effort, particularly the correlation between the screening results, actual use of mental health services, and attrition from military service.Population-based descriptive study of all Army soldiers and Marines who completed the routine postdeployment health assessment between May 1, 2003, and April 30, 2004, on return from deployment to Operation Enduring Freedom in Afghanistan (n = 16,318), Operation Iraqi Freedom (n = 222,620), and other locations (n = 64,967). Health care utilization and occupational outcomes were measured for 1 year after deployment or until leaving the service if this occurred sooner.Screening positive for posttraumatic stress disorder, major depression, or other mental health problems; referral for a mental health reason; use of mental health care services after returning from deployment; and attrition from military service.The prevalence of reporting a mental health problem was 19.1% among service members returning from Iraq compared with 11.3% after returning from Afghanistan and 8.5% after returning from other locations (P<.001). Mental health problems reported on the postdeployment assessment were significantly associated with combat experiences, mental health care referral and utilization, and attrition from military service. Thirty-five percent of Iraq war veterans accessed mental health services in the year after returning home; 12% per year were diagnosed with a mental health problem. More than 50% of those referred for a mental health reason were documented to receive follow-up care although less than 10% of all service members who received mental health treatment were referred through the screening program.Combat duty in Iraq was associated with high utilization of mental health services and attrition from military service after deployment. The deployment mental health screening program provided another indicator of the mental health impact of deployment on a population level but had limited utility in predicting the level of mental health services that were needed after deployment. The high rate of using mental health services among Operation Iraqi Freedom veterans after deployment highlights challenges in ensuring that there are adequate resources to meet the mental health needs of returning veterans.",0,0 +4690,"Genetic and environmental influences on the relationship among combat exposure, posttraumatic stress disorder symptoms, and alcohol use","The role of genetic and environmental influences on the relationship between combat exposure, posttraumatic stress disorder (PTSD) symptoms, and alcohol use were examined in 4072 male-male twin pairs who served in the United States military during the Vietnam era (1965-1975). Results indicate that the relationship between combat and alcohol use and between PTSD symptom factors and alcohol use were both substantially influenced by genetic factors. Findings are most consistent with a shared vulnerability model for the etiology of the association between PTSD symptoms and alcohol use. Specific unique environmental factors were more important than genetic factors for PTSD symptoms, and both factors were equally important for alcohol use. Further support is also found for the role of the unique environment in PTSD symptoms.",0,0 +4691,The course of mental health disorders after a disaster: Predictors and comorbidity,en,0,0 +4692,Post-traumatic stress disorder and the outcome of dialectical behaviour therapy for borderline personality disorder,"Individuals with borderline personality disorder (BPD) and comorbid post-traumatic stress disorder (PTSD) have a worse prognosis than individuals with BPD alone. A common view is that the emotional instability and impulsivity of BPD should be treated before attempting to address trauma. However, PTSD symptoms may interfere with patients' ability to benefit from such 'stabilizing' treatments.The effect of BPD-PTSD comorbidity on self-harm and BPD symptom outcomes was evaluated in 89 patients receiving dialectical behaviour therapy, using multilevel modelling.Patients with comorbid BPD-PTSD showed a trend towards elevated BPD symptoms throughout the treatment year (β = 2.12, 95% CI = -0.21-4.44, p = 0.07). There was a three-way interaction between PTSD comorbidity, treatment completion and time, whereby PTSD comorbidity was associated with less reduction in self-harm frequency over time, but only in those completing the full 12 months of treatment (incident risk ratio = 1.16, 95% CI = 1.04-1.30, p < 0.01).Patients with comorbid PTSD had a poorer outcome from dialectical behaviour therapy than those with BPD alone, possibly because of the negative impact of unaddressed trauma. The results provide further grounds for recently developed treatments targeting BPD traits and PTSD symptoms simultaneously.",0,0 +4693,Falling Forever: The Price of Chronic Shock,"Manifestations of chronic shock and annihilation anxiety-including autistic defenses, chaotic relationships, disorganized attachment, split-off affective states, and vulnerability to disintegration--exist side by side with apparent ego strength and high functioning, even in nonabused patients. Chronic shock stemming from uncontained distress and failed dependency during childhood can persist throughout the lifespan, creating ripples of dysfunction that mask as character distortion and contribute to therapeutic impasse. Patients rely on omnipotent defenses to provide a sense of ""having skin"" in the face of the fear of breakdown, striving to avoid vulnerability, and trying to insulate themselves from shock experience. Although the relinquishment of autistic defenses and subsequent integration of disowned affect states are overwhelming and painful, patients can emerge from this process with significant shifts in intrapsychic, interpersonal, and existential/spiritual functioning. Clinical material from one psychodynamic psychotherapy group tracks the group process and growth trajectories of seven group members struggling with chronic shock. The ability to recognize subtle dissociative states is a valuable tool in the repertoire of the group psychotherapist.",0,0 +4694,Heterogeneous depression responses to chronic pain onset among middle-aged adults: A prospective study,"Studies on depression response to chronic pain are limited by lack of clarification of different forms of response patterns and cross-sectional measures. The current study examined heterogeneous long-term patterns of depression response to chronic pain onset prospectively using the mixture modeling technique. Depression symptoms prior to and following pain onset over a course of six years were charted in a nationally representative middle-aged sample. Four distinct depression symptom trajectories emerged. The resilience (72.0%) trajectory describes a pattern of no/minimal depression symptoms prior to and following pain onset. The post-pain depression trajectory (11.4%) describes a pattern of low depression at baseline and increasing symptoms following pain onset. The chronic depression (6.8%) trajectory is characterized by persistently high depression symptoms irrespective of pain onset. The prior depression improved (9.8%) trajectory describes a pattern of high depression at baseline and gradually declining symptoms following pain onset. Self-rated health at both baseline and following pain onset predicted the resilience trajectory. Baseline self-rated health distinguished the post-pain depression and chronic depression trajectories. Individuals in the prior depression improved trajectory were older and had more chronic illnesses at baseline but fewer illnesses following pain onset, compared to those in the resilience or post-pain depression trajectory.",0,0 +4695,The Psychological Impact of a Catastrophic Earthquake,"Aim of the present study was to retrospectively assess the impact of a catastrophic earthquake in a sample of 121 survivors, 50 years after the event. Mean age +/- SD of the responders was 72.2 +/- 6.1 years. The majority of the victims (78%) acknowledged a strong overall impact of the earthquake on their lives, and almost all of them had intense recollection of the event at its anniversary. The most frequent symptom during the 6 months after the earthquake was persistent remembering or ""reliving"" of the event; women had considerably more often recurrent dreams of the earthquake and distress than did men. Women and young adults at the time of the earthquake appear to be the most vulnerable groups regarding the psychological effects of the event.",0,0 +4696,"Prolonged exposure therapy: past, present, and future","Depression and AnxietyVolume 28, Issue 12 p. 1043-1047 The Cutting Edge Prolonged exposure therapy: past, present, and future† Edna B. Foa Ph.D., Corresponding Author Edna B. Foa Ph.D. foa@mail.med.upenn.edu Center for the Treatment and Study of Anxiety, University of Pennsylvania, 3535 Market Street, 6th Floor, Philadelphia, PA 19104Center for the Treatment and Study of Anxiety, University of Pennsylvania, 3535 Market Street, 6th Floor, Philadelphia, PA 19104Search for more papers by this author Edna B. Foa Ph.D., Corresponding Author Edna B. Foa Ph.D. foa@mail.med.upenn.edu Center for the Treatment and Study of Anxiety, University of Pennsylvania, 3535 Market Street, 6th Floor, Philadelphia, PA 19104Center for the Treatment and Study of Anxiety, University of Pennsylvania, 3535 Market Street, 6th Floor, Philadelphia, PA 19104Search for more papers by this author First published: 01 December 2011 https://doi.org/10.1002/da.20907Citations: 157 † No conflict of interest was declared. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume28, Issue12December 2011Pages 1043-1047 RelatedInformation",0,0 +4697,An Increased Capacity for Adrenal DHEA Release is Associated with Decreased Avoidance and Negative Mood Symptoms in Women with PTSD,"We recently found increased adrenal cortisol responses to adrenocorticotropic hormone (ACTH)1-24 and increased pituitary ACTH and adrenal cortisol responses to corticotropin-releasing factor in premenopausal women with chronic post-traumatic stress disorder (PTSD) compared to healthy nontraumatized subjects. This pattern of hypothalamic-pituitary-adrenal axis (HPA) hyper-reactivity has been previously seen in healthy individuals treated with the antiglucocorticoid mifepristone. We therefore investigated whether endogenous plasma levels of antiglucocorticoids such as dehydroepiandrosteroine (DHEA) and progesterone were increased in premenopausal women with PTSD at baseline or in response to adrenal activation by ACTH1-24. The study revealed that DHEA responses to 250 microg ACTH1-24 were increased in 13 PTSD subjects compared to 13 healthy nontraumatized subjects, while DHEA levels were generally increased in the PTSD subjects compared to seven healthy traumatized subjects. Cortisol responses to ACTH1-24 were also higher in the women with PTSD, while progesterone levels and responses were not different among the three groups. In addition, among the PTSD subjects, the peak change in DHEA in response to ACTH1-24 was negatively correlated with the total Clinician Administered PTSD Scale score, while the peak DHEA to cortisol ratio was inversely associated with negative mood symptoms measured by the Profile of Mood States scale. This work suggests that an increased capacity for DHEA release in response to extreme adrenal activation may influence the pattern of HPA axis adaptation to extreme stress, as well as mitigate the severity of PTSD and negative mood symptoms in premenopausal women with PTSD.",0,0 +4698,A Constructivist Perspective on Post-Traumatic Stress in Children and Adolescents,"(from the chapter) It is clear from the extant literature that different types of trauma exposure can differentially impact children at different stages of development, and that professionals must take into account the full range of internalizing and externalizing symptoms that so often co-occur with symptoms of posttraumatic stress disorder (PTSD). Although symptom management and reduction are often a critical component of treatment, we agree with the propositions by Wood and colleagues that (1) trauma exposure and subsequent responses are best understood via a social/ecological framework, and (2) it is critical to conceptualize the exposure, reaction, and response as primarily disruptions to a child's sense of self-efficacy. Consistent with these propositions, we utilize a framework for approaching post-traumatic stress in children that allows the symptoms to be targeted while simultaneously addressing the child's disrupted identity and social embeddedness. In this chapter, we will present a constructivist framework for understanding and intervening with post-traumatic stress reactions in childhood and adolescence. Although we base much of our thinking on traditional personal construct psychology, the perspective has been extended and reformulated by other constructivist scholars, including ourselves. We will begin with a consideration of how personal constructs and personal identity develop in childhood. Next, we will consider adolescent development from a constructivist perspective. Then, we will turn attention to how traumatic experiences can serve to disrupt identity and personal functioning across these two developmental periods. Finally, we will present a constructivist approach to assisting children and adolescents in adapting to life after a traumatic disruption. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0,0 +4699,Pretraumatic Stress Reactions in Soldiers Deployed to Afghanistan,"Posttraumatic Stress Disorder is a diagnosis related to the past. Pre-traumatic stress reactions, as measured by intrusive involuntary images of possible future stressful events and their associated avoidance and increased arousal, have been overlooked in the PTSD literature. Here we introduce a scale that measures pre-traumatic stress reactions providing a clear future-oriented parallel to the posttraumatic stress reactions described in the diagnostic criteria for PTSD. We apply this pre-traumatic stress reactions checklist (PreCL) to Danish soldiers before, during, and after deployment to Afghanistan. The PreCL has good internal consistency and is highly correlated with a standard measure of PTSD symptoms. The PreCL as answered before the soldiers' deployment significantly predicted level of PTSD symptoms during and after their deployment, while controlling for baseline PTSD symptoms and combat exposure measured during and after deployment. The findings have implications for the conceptualization of PTSD, screening, and treatment.",0,0 +4700,From Postimpact to Reconstruction: Considerations When Treating Traumatized Child and Adolescent Clients,"Longitudinal data analyses have revealed that children and adolescents may encounter several distinct recovery stages and trajectories following exposure to a traumatic event. As recent dissemination efforts have increased the availability of training in various empirically-supported treatments, mental health service providers may struggle to identify among these approaches a treatment that is best suited to address the needs of an individual client. Treatment planning should take into consideration the severity of distress symptoms, as well as the timing, mode of delivery, and the setting of intervention. In this paper we provide an overview of assessment and emerging treatment approaches that can be used across various phases of recovery. We also identify a framework for making treatment decisions based on existing research. Finally, we propose next steps for research and practice in the area of treating traumatized children and adolescents.",0,0 +4701,Depression Subtypes in Pediatric Inflammatory Bowel Disease,"The association between inflammatory bowel disease (IBD) and depression provides a unique opportunity to understand the relation between systemic inflammation and depressive symptom profiles.Youth (n = 226) ages 9 to 17 years with comorbid IBD and depression underwent psychiatric assessment and evaluation of IBD activity. Latent profile analysis (LPA) identified depressive subgroups based on similar responses to the Children's Depression Rating Scale-Revised. Demographic factors, depression severity, anxiety, IBD activity, inflammatory markers, IBD-related medications, and illness perception were evaluated as predictors of profile membership.Mean age was 14.3 years; 75% had Crohn disease; 31% were taking systemic corticosteroids. Mean depressive severity was moderate, whereas IBD activity, which reflects inflammation, was mild. LPA identified 3 subgroups: Profile-1 (mild, 75%) had diverse low-grade depressive symptoms and highest quality of life; Profile-2 (somatic, 19%) had severe fatigue, appetite change, anhedonia, decreased motor activity, and depressed mood with concurrent high-dose steroid therapy and the highest IBD activity; and Profile-3 (cognitive, 6%) had the highest rates of self-reported depressive symptoms, ostomy placements, and anxiety with IBD symptoms in the relative absence of inflammation.Evidence was found for 3 depression profiles in youth with IBD and depression. Our analyses determined that patients with predominantly somatic or cognitive symptoms of depression comprised 25% of our cohort. These findings may be used to design subgroup-specific interventions for depression in adolescents with IBD and other physical illnesses associated with systemic inflammation.",0,0 +4702,"Building resiliency: a cross-sectional study examining relationships among health-related quality of life, well-being, and disaster preparedness","Worldwide, disaster exposure and consequences are rising. Disaster risk in New Zealand is amplified by island geography, isolation, and ubiquitous natural hazards. Wellington, the capital city, has vital needs for evacuation preparedness and resilience to the devastating impacts and increasing uncertainties of earthquake and tsunami disasters. While poor quality of life (QoL) is widely-associated with low levels of engagement in many health-protective behaviors, the relationships among health-related quality of life (HrQoL), well-being, and preparedness are virtually unknown.We hypothesized that QoL and well-being affect household evacuation preparedness. We performed a quantitative epidemiologic survey (cross-sectional design) of Wellington adults. Our investigation assessed health-promoting attributes that build resiliency, conceptualized as health-protective attitudes and behaviors. Multidimensional QoL variables were measured using validated psychometric scales and analyzed for associations with evacuation preparedness, and we determined whether age and gender affected these relationships.We received 695 survey responses (28.5% response rate; margin of error ±3.8%; 80% statistical power to detect true correlations of 0.11 or greater). Correlational analyses showed statistically significant positive associations with evacuation preparedness for spiritual well-being, emotional well-being, and life satisfaction. No associations were found for mental health, social well-being, or gender; physical health was weakly negatively associated. Evacuation preparedness increased with age. Regression analyses showed that overall health and well-being explained 4.6-6.8% of the variance in evacuation preparedness. Spiritual well-being was the only QoL variable that significantly and uniquely explained variance in preparedness.How well-being influences preparedness is complex and deeply personal. The data indicate that multidimensional readiness is essential, and meaningfulness is an important factor. Inadequate levels of tangible preparedness actions are accompanied by gaps in intangible readiness aspects, such as: 1) errors in perceived exposure to and salience of natural hazards, yielding circumscribed risk assessments; 2) unfamiliarity with the scope and span of preparedness; 3) underestimating disaster consequences; and 4) misinterpreting the personal resources required for self-managing disaster and uncertainty. Our results highlight that conceptualizing preparedness to include attitudes and behaviors of readiness, integrating well-being and meaningfulness into preparedness strategies, and prioritizing evacuation planning are critical for resiliency as a dynamic process and outcome.",0,0 +4703,"Alternate forms of adjustment in adult women survivors of CSA: The relationship between wellness, resilience, and post-traumatic growth","Women disproportionately experience victimization as children, with at least one in five women reporting a history of child sexual abuse. The short and long term effects, both physical and emotional, are significant, negative, and pervasive, making CSA a critical physical and mental health issue for a significant portion of women in the United States. However, while many survivors experience negative long-term effects, a significant portion do not. This study addressed the need for greater attention to factors which depathologize this population, particularly the experiences of survivorship and how these are expressed in terms of wellness, resilience and post-traumatic growth (PTG). A sample of 163 adult women survivors completed an online survey comprised of instruments measuring wellness, resilience, PTG, and post-traumatic stress. A series of correlations revealed positive relationships between wellness factors and resilience, and wellness factors and PTG. Negative correlations were found between PTS symptoms and Resilience, and PTS symptoms and Wellness. Resilience and PTG were negatively correlated, a finding contrary to the conceptualization in the literature. A MANOVA and a series of linear regressions analyzed factors that might contribute to the variance in the major constructs. The results of the MANOVA indicated that the relationship to the perpetrator only affected PTS symptoms: women abused by a relative had significantly higher PTS symptoms. The results of the linear regressions indicated that the variables (current age, additional childhood maltreatment, reported current impact of CSA, CSA severity, and age at onset of abuse) accounted for a very small percentage of the variance in Wellness (16%) and Resilience (10%), and a greater amount of variance in total PTS symptoms (39%). The variables did not account for a significant amount of variance in PTG. The largest contributor of the variance in Wellness, Resilience, and PTS symptoms was the current impact of CSA while CSA severity was a significant contributor to PTS symptoms. A series of t-tests were conducted to analyze the difference between the wellness of this sample and the wellness reported by the normative group. Results indicated that the women in this sample had significantly lower Creative Self, Social Self, and Essential Self wellness but had significantly higher Physical Self wellness. No significant difference was found for Total Wellness and Coping Self wellness. The results of the final analysis, a hierarchical linear regression, indicated that above and beyond demographic variables, Resilience by far, and PTG, to a much smaller degree, were significant predictors of the variance in wellness factors. Additional research is necessary in order to further explore the relationships between wellness factors, resilience, and PTG.",0,0 +4704,Psychophysiologic assessment of traumatic imagery in Israeli civilian patients with posttraumatic stress disorder,"This study used a script-driven imagery technique, previously used with combat veterans, to assess physiologic responses of Israeli survivors of noncombat traumas.Each subject had experienced an event meeting DSM-III-R criterion A for posttraumatic stress disorder (PTSD). The subjects were classified on the basis of the full DSM-III-R criteria into a current PTSD group (N = 13) and a non-PTSD group (N = 13). Thirty-second scripts describing each subject's personal traumatic event, as well as other events, were prepared. The scripts incorporated subjective visceral and muscular responses reported to have accompanied each experience. In the laboratory, the scripts were read one at a time to the subject, who was instructed to imagine each event portrayed as vividly as possible, while heart rate, skin conductance, and left lateral frontalis electromyogram levels were measured.Multivariate analysis of variance revealed that the physiologic responses of the PTSD subjects during imagery of their personal traumatic experiences were significantly greater than those of the non-PTSD subjects. This difference was not explained by age, gender, or rated severity of the traumatic event. A physiologic discriminant function derived from previously studied Vietnam veterans correctly classified nine of the 13 PTSD subjects (sensitivity = 69%) and 10 of the 13 non-PTSD subjects (specificity = 77%).These results replicate previous findings of heightened physiologic responses during personal combat imagery in male American war veterans and extend them to a group of male and female Israeli civilian victims of trauma, supporting the robustness of physiologic responding during personal traumatic imagery as a measure of PTSD.",0,0 +4705,"Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis","There has been debate regarding whether Complex Posttraumatic Stress Disorder (Complex PTSD) is distinct from Borderline Personality Disorder (BPD) when the latter is comorbid with PTSD.To determine whether the patterns of symptoms endorsed by women seeking treatment for childhood abuse form classes that are consistent with diagnostic criteria for PTSD, Complex PTSD, and BPD.A latent class analysis (LCA) was conducted on an archival dataset of 280 women with histories of childhood abuse assessed for enrollment in a clinical trial for PTSD.THE LCA REVEALED FOUR DISTINCT CLASSES OF INDIVIDUALS: a Low Symptom class characterized by low endorsements on all symptoms; a PTSD class characterized by elevated symptoms of PTSD but low endorsement of symptoms that define the Complex PTSD and BPD diagnoses; a Complex PTSD class characterized by elevated symptoms of PTSD and self-organization symptoms that defined the Complex PTSD diagnosis but low on the symptoms of BPD; and a BPD class characterized by symptoms of BPD. Four BPD symptoms were found to greatly increase the odds of being in the BPD compared to the Complex PTSD class: frantic efforts to avoid abandonment, unstable sense of self, unstable and intense interpersonal relationships, and impulsiveness.Findings supported the construct validity of Complex PTSD as distinguishable from BPD. Key symptoms that distinguished between the disorders were identified, which may aid in differential diagnosis and treatment planning.",0,0 +4706,Traumatic Stressors and Post-Traumatic Stress Disorder Symptoms in Headache Patients,"The aim of this study was to assess the prevalence of significant traumatic stressors and post-traumatic stress disorder (PTSD) symptoms in a headache population.Several recent publications have emphasized the relationship between life stressors and/or daily hassles and recurrent headaches. However, little is known about the prevalence and impact of major traumatic stressors in patients with recurrent headaches.Eighty patients with either migraine or tension-type headache completed a PTSD checklist. Data were compared with those from patients with chronic masticatory muscle pain of similar intensity and duration.Almost 64% of the headache patients reported one or more major traumatic stressors. This percentage was not significantly different from that of the comparison group, and fell within the broad range reported for exposure to traumatic stressors in epidemiologic studies with nonpatient populations. One out of 6 patients in the total headache sample, and 1 out of 4 of those reporting a traumatic stressor, reported symptoms suggestive of current PTSD. The prevalence of current PTSD-like symptomatology reported by the headache patients was comparable to that of the comparison group of the present study, but higher than that reported for the general population in the available literature printed in English. Traumatic stressors most often reported were not related to direct physical trauma, but rather associated with loss or serious illness of a loved one.Exposure to traumatic events in patients with a primary diagnosis of recurrent headaches is similar to that reported for chronic masticatory muscle pain patients or nonpatient populations. However, symptoms consistent with a diagnosis of current PTSD appear to be more frequent in patients with recurrent headaches than reported in the scientific literature printed in English for nonpatient populations. Screening for PTSD symptomatology is recommended as part of the routine clinical evaluation of headache.",0,0 +4707,"Acute Stress Disorder, Posttraumatic Stress Disorder, and Depression in Disaster or Rescue Workers","The events of Sept. 11, 2001, highlighted the importance of understanding the effects of trauma on disaster workers. To better plan for the health care of disaster workers, this study examined acute stress disorder, posttraumatic stress disorder (PTSD), early dissociative symptoms, depression, and health care utilization in disaster workers.Exposed disaster workers (N=207) and unexposed comparison subjects (N=421) were examined at 2, 7, and 13 months after an airplane crash.Exposed disaster workers had significantly higher rates of acute stress disorder, PTSD at 13 months, depression at 7 months, and depression at 13 months than comparison subjects. Those who were younger and single were more likely to develop acute stress disorder. Exposed disaster workers with acute stress disorder were 3.93 times more likely to be depressed at 7 months. Those with high exposure and previous disaster experience or who had acute stress disorder were more likely to develop PTSD. Similarly, those who were depressed at 7 months were 9.5 times more likely to have PTSD. Those who were depressed at 13 months were 7.96 times more likely to also meet PTSD criteria. More exposed disaster workers than comparison subjects obtained medical care for emotional problems at 2, 7, and 13 months. Overall, 40.5% of exposed disaster workers versus 20.4% of comparison subjects had acute stress disorder, depression at 13 months, or PTSD.Exposed disaster workers are at increased risk of acute stress disorder, depression, or PTSD and seek care for emotional problems at an increased rate.",0,0 +4708,Positive Psychological Factors are Associated with Lower PTSD Symptoms among Police Officers: Post Hurricane Katrina,"Following Hurricane Katrina, police officers in the New Orleans geographic area faced a number of challenges. This cross-sectional study examined the association between resilience, satisfaction with life, gratitude, posttraumatic growth, and symptoms of posttraumatic stress disorder in 84 male and 30 female police officers from Louisiana. Protective factors were measured using the Connor–Davidson Resilience scale, Satisfaction with Life Scale, the Gratitude Questionnaire, and the Posttraumatic Growth inventory. Symptoms of posttraumatic stress disorder were measured using the Posttraumatic Stress Disorder Checklist—Civilian (PCL-C). Potential associations were measured using linear regression and analysis of variance. Models were adjusted for age, sex, race, education, and alcohol. Mean PCL-C symptoms were 29.5 ± 14.5 for females and 27.8 ± 12.1 for males. Adjusted mean levels of PCL-C symptoms significantly decreased as quartiles of resilience (p < .001), satisfaction with life (p < .001), and gratitude (p < .001) increased. In contrast, PCL-C symptoms were not associated with posttraumatic growth in this sample. These results indicate that positive factors such as resilience, satisfaction with life, and gratitude may help mitigate symptoms of posttraumatic stress disorder. To further explore these relationships, longitudinal follow-up in a larger population would be of interest. Copyright © 2014 John Wiley & Sons, Ltd.",0,0 +4709,Diagnosis of probable psychogenic nonepileptic seizures in the outpatient clinic: Does gender matter?,"Psychogenic nonepileptic seizures (PNESs) are paroxysmal events of altered behavior that outwardly resemble epilepsy but are caused by psychiatric disease. The diagnosis of probable PNESs can be made in the outpatient clinic prior to video-EEG monitoring by identification of specific PNES predictors and specific elements of seizure semiology from the clinical history. Since psychiatric disease may have distinct mechanisms between women and men, the objective of this study was to determine if gender-specific differences exist in PNES predictors and PNES semiology. Such differences could be used to optimize the accuracy of outpatient diagnosis of probable PNESs. Medical records of male and female patients with video-EEG diagnosis of definite PNESs were retrospectively reviewed for occurrence of PNES predictors. In addition, PNES semiology was analyzed de novo from video-EEG records and categorized into previously established semiology clusters. Eighty-six patients were included in the analysis (59 women and 27 men). We found significantly lower rates of reported physical and sexual abuse, lower rates of previous psychiatric diagnosis, and lower rates of chronic pain in male patients with no significant differences in rates of other PNES predictors. Furthermore, we found no difference in PNES semiology between men and women, with both groups experiencing similar rates of major motor, minor motor, and nonmotor semiology. In conclusion, our results lend support to the idea that distinct risk factor criteria but similar semiology criteria should be used for the diagnosis of probable PNESs in the outpatient clinic in men and women.",0,0 +4710,MMPI Configural Interpretation as Applied to Posttraumatic Stress Disorder in Vietnam Veterans,"This study investigated the systems of Minnesota Multiphasic Personality Inventory (MMPI) configural interpretation of Skinner and Jackson (1978) and Kunce (1979) with Vietnam veterans with posttraumatic stress disorder (PTSD). MMPI profiles of four groups differing in combat exposure were compared on four MMPI configural variables from Kunce (1979) and Skinner and Jackson (1978). The four groups were (a) PTSD sufferers, (b) Vietnam combat veterans without PTSD, (c) Vietnam noncombat veterans, and (d) Vietnam era veterans. All groups were further divided into hospitalized versus nonhospitalized subgroups. Dependent variables were Skinner and Jackson's (a) sociopathic modal profile, (b) neurotic profile, (c) psychotic profile, and (d) Kunce's emotional expression (enthusiastic-reserved) dimension. Results indicated that hospitalized PTSD subjects had significantly higher scores on Skinner and Jackson's neurotic profile; both hospitalized and nonhospitalized PTSD subjects had higher scores on the psychotic profile and were more ""reserved"" on Kunce's emotional expression dimension. Results were interpreted in terms of configural MMPI interpretation systems and the adjustment of Vietnam veterans with PTSD. PTSD was viewed as exhibiting cognitive, somatic, and affective features.",0,0 +4711,PTSD severity and health perceptions in female victims of sexual assault,"In women with chronic posttraumatic stress disorder (PTSD), poor physical health may be related to their PTSD symptoms through an underlying negative affect or distress that accompanies the disorder, through the PTSD symptoms in general, or specifically through the chronic hyperarousal present in the disorder. The current study examined the relative contribution of these factors to reported physical symptoms in female victims of sexual assault. Seventy-six women with chronic PTSD were assessed, using measures of stressful life events, psychological difficulties, and perceived health. Negative life events, anger, depression, and PTSD severity were all related to self-reported physical symptoms; however, PTSD severity predicted self-reported physical symptoms beyond these other variables. Contrary to our hypothesis, the reexperiencing cluster of PTSD, and not the hyperarousal cluster, was related to self-reported physical symptoms.",0,0 +4712,What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study,"Concerns have been raised about the psychological effect of continued combat exposure and of repeated deployments. We examined the consequences of deployment to Iraq and Afghanistan on the mental health of UK armed forces from 2003 to 2009, the effect of multiple deployments, and time since return from deployment.We reassessed the prevalence of probable mental disorders in participants of our previous study (2003-05). We also studied two new randomly chosen samples: those with recent deployment to Afghanistan, and those who had joined the UK armed forces since April, 2003, to ensure that the final sample continued to be representative of the UK armed forces. Between November, 2007, and September, 2009, participants completed a questionnaire about their deployment experiences and health outcomes.9990 (56%) participants completed the study questionnaire (8278 regulars, 1712 reservists). The prevalence of probable post-traumatic stress disorder was 4.0% (95% CI 3.5-4.5; n=376), 19.7% (18.7-20.6; n=1908) for symptoms of common mental disorders, and 13.0% (12.2-13.8; n=1323) for alcohol misuse. Deployment to Iraq or Afghanistan was significantly associated with alcohol misuse for regulars (odds ratio 1.22, 95% CI 1.02-1.46) and with probable post-traumatic stress disorder for reservists (2.83, 1.23-6.51). Regular personnel in combat roles were more likely than were those in support roles to report probable post-traumatic stress disorder (1.87, 1.26-2.78). There was no association with number of deployments for any outcome. There was some evidence for a small increase in the reporting of probable post-traumatic stress disorder with time since return from deployment in regulars (1.13, 1.03-1.24).Symptoms of common mental disorders and alcohol misuse remain the most frequently reported mental disorders in UK armed forces personnel, whereas the prevalence of probable post-traumatic stress disorder was low. These findings show the importance of continued health surveillance of UK military personnel.UK Ministry of Defence.",0,0 +4713,Differential mediating effects of PTSD symptom clusters on alcohol use and sleep in university students with trauma experiences: A multi-group analysis,"This study investigates the differential mediating pathways of PTSD symptom clusters in the relationship between traumatic events and alcohol use or poor sleep quality in a sample of university students with traumatic life experiences using a path analysis. Gender difference was also examined using multi-group analysis. Male (N = 1471) and female (N = 528) university students completed an online mental health survey consisting of the Life Event Checklist, the Impact of Event Scale-Revised, the CAGE Questionnaire, and the Pittsburgh Sleep Quality Index. Results showed that traumatic events had a direct impact on both alcohol use and poor sleep quality. The indirect impact of traumatic events on alcohol use appeared to be through PTSD-avoidance, and the indirect impact of traumatic events on poor sleep quality appeared to be through PTSD-intrusion and PTSD-hyperarousal. A multi-group analysis showed that male students are 3.25 times more likely to use alcohol in response to traumatic stress than female students. Our findings suggest that there are differential mediating mechanisms of PTSD symptom clusters underlying alcohol use or poor sleep quality following traumatic events, indicating the importance of developing symptom-tailored therapeutic intervention.",0,0 +4714,Post-Traumatic Stress Disorder in Israeli Survivors of Childhood Cancer,"To investigate the prevalence, symptom severity, and risk factors associated with post-traumatic stress disorder (PTSD) in childhood cancer survivors.Descriptive, correlational study.Follow-up clinic in Petach Tikva, Israel.Convenience sample of 70 adult Israeli survivors of childhood cancer.Questionnaires (the Post-Traumatic Diagnostic Scale and the Multidimensional Scale of Perceived Social Support) were distributed to participants, and demographic and clinical data were obtained from medical records.Post-traumatic stress, social support, and clinical and demographic data.Twenty (29%) of the participants met the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for PTSD; 10% experienced mild, 40% moderate, and 50% moderate to severe symptoms. Only 16% of the sample did not experience any symptoms of PTSD. A statistically significant negative relationship was found between PTSD symptom scores and the current age of the respondent (r(s) = -0.27, p = 0.03) and time since medical treatment (r(s) = -0.34, p = 0.004) but not any other demographic or clinical variables or social support.Higher severity of PTSD symptoms was found, possibly because of local living conditions. Most clinical and demographic variables were not risk factors. This population should be studied further in an effort to prevent PTSD via early diagnosis.Oncology nurses should be aware of the potential risk factors (recent completion of treatment and younger current age) and the high prevalence and severity of PTSD among survivors of childhood cancer to identify patients at higher risk and develop programs that prevent, limit, and treat PTSD.",0,0 +4715,Dimensional structure of DSM-5 posttraumatic stress symptoms: Support for a hybrid Anhedonia and Externalizing Behaviors model,"Several revisions to the symptom clusters of posttraumatic stress disorder (PTSD) have been made in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Central to the focus of this study was the revision of PTSD's tripartite structure in DSM-IV into four symptom clusters in DSM-5. Emerging confirmatory factor analytic (CFA) studies have suggested that DSM-5 PTSD symptoms may be best represented by one of two 6-factor models: (1) an Externalizing Behaviors model characterized by a factor which combines the irritability/anger and self-destructive/reckless behavior items; and (2) an Anhedonia model characterized by items of loss of interest, detachment, and restricted affect. The current study conducted CFAs of DSM-5 PTSD symptoms assessed using the PTSD Checklist for DSM-5 (PCL-5) in two independent and diverse trauma-exposed samples of a nationally representative sample of 1484 U.S. veterans and a sample of 497 Midwestern U.S. university undergraduate students. Relative fits of the DSM-5 model, the DSM-5 Dysphoria model, the DSM-5 Dysphoric Arousal model, the two 6-factor models, and a newly proposed 7-factor Hybrid model, which consolidates the two 6-factor models, were evaluated. Results revealed that, in both samples, both 6-factor models provided significantly better fit than the 4-factor DSM-5 model, the DSM-5 Dysphoria model and the DSM-5 Dysphoric Arousal model. Further, the 7-factor Hybrid model, which incorporates key features of both 6-factor models and is comprised of re-experiencing, avoidance, negative affect, anhedonia, externalizing behaviors, and anxious and dysphoric arousal symptom clusters, provided superior fit to the data in both samples. Results are discussed in light of theoretical and empirical support for the latent structure of DSM-5 PTSD symptoms.",0,0 +4716,The Crisis Support Scale: psychometric qualities and further validation,"The objective of the present study was to provide a further validation of the Crisis Support Scale, which is a short scale for measuring social support after a crisis has occurred. The data from eleven trauma studies of 4213 subjects were used to investigate the psychometric properties of the scale and the differences that emerge due to age, gender, and type of trauma. The scale appears to be very robust. Some aspects of crisis support seem to decrease as time goes by while others increase. Women survivors report less support than men both right after the trauma and later on. The younger survivors tend to report the least support in the acute phase although this picture is reversed later on. The various types of trauma have different item profiles, which supports the concurrent validity of the scale.",0,0 +4717,"Post-traumatic Stress Disorder, Anxiety and Depression among the Elderly: A Survey of the Hard-hit Areas a Year after the Wenchuan Earthquake","Few studies to date have examined psychological sequelae of natural disasters among the elderly in China. The aim of this study was to investigate the prevalence rates of probable post-traumatic stress disorder (PTSD), anxiety and depression in the elderly survivors a year after the Wenchuan earthquake as well as to analyse related risk factors. The community-based sample of the study consisted of 284 elderly survivors (≥60 years). PTSD was assessed by the PTSD Checklist--Civilian version, and anxiety and depression were assessed by the Hopkins Symptoms Checklist. In total, the estimated prevalence rates of probable PTSD, anxiety and depression were 26.3%, 42.9% and 35.2%, respectively. Nearly a fifth of the elderly participants reported symptoms that meet the criteria for all three of these mental disorders. Results indicated that some factors associated with earthquake-exposure intensity, which included loss of livelihood, bereavement, injury and initial fear during the earthquake, were among the significant risk factors for these mental disorders. Women had a higher risk of suffering from probable anxiety as compared to men. Finally, the significance and limitations of this study were also discussed.",0,0 +4718,Chronic post-traumatic headache: clinical findings and possible mechanisms,"Chronic post-traumatic headache (CPTHA), the most frequent complaint after traumatic brain injury (TBI), dramatically affects quality of life and function. Despite its high prevalence and persistence, the mechanism of CPTHA is poorly understood. This literature review aimed to analyze the results of studies assessing the characteristics and sensory profile of CPTHA in order to shed light on its possible underlying mechanisms. The search for English language articles published between 1960 and 2013 was conducted in MEDLINE, CINAHL, and PubMed. Studies assessing clinical features of headache after TBI as well as studies conducting quantitative somatosensory testing (QST) in individuals with CPTHA and in individuals suffering from other types of pain were included. Studies on animal models of pain following damage to peripheral tissues and to the peripheral and central nervous system were also included. The clinical features of CPTHA resembled those of primary headache, especially tension-type and migraine headache. Positive and negative signs were prevalent among individuals with CPTHA, in both the head and in other body regions, suggesting the presence of local (cranial) mechanical hypersensitivity, together with generalized thermal hypoesthesia and hypoalgesia. Evidence of dysfunctional pain modulation was also observed. Chronic post-traumatic headache can result from damage to intra- and pericranial tissues that caused chronic sensitization of these tissues. Alternatively, although not mutually exclusive, CPTHA might possibly be a form of central pain due to damage to brain structures involved in pain processing. These, other possibilities, as well as risk factors for CPTHA are discussed at length.",0,0 +4719,Etiology of depression comorbidity in combat-related PTSD: A review of the literature,"Posttraumatic stress disorder is often diagnosed with other mental health problems, particularly depression. Although PTSD comorbidity has been associated with more severe and chronic symptomology, relationships among commonly co-occurring disorders are not well understood. The purpose of this study was to review the literature regarding the development of depression comorbid with combat-related PTSD among military personnel. We summarize results of commonly tested hypotheses about the etiology of PTSD and depression comorbidity, including (1) causal hypotheses, (2) common factor hypotheses, and (3) potential confounds. Evidence suggests that PTSD may be a causal risk factor for subsequent depression; however, associations are likely complex, involving bidirectional causality, common risk factors, and common vulnerabilities. The unique nature of PTSD-depression comorbidity in the context of military deployment and combat exposure is emphasized. Implications of our results for clinical practice and future research are discussed.",0,0 +4720,Sleep and post-traumatic stress disorder: A roadmap for clinicians and researchers,"The three reviews in this issue of Sleep Medicine Reviews present formulations based on emerging findings that relate to sleep disturbances in posttraumatic stress disorders (PTSD). This set of papers is a timely selection for Sleep Medicine Reviews. PTSD is now recognized to be a prevalent disorder that confers considerable distress and morbidity. Appreciation of the significance of the disorder is increasing in relation to recent and ongoing wars, acts of terrorism, and natural disasters. People who experience traumatic stress often have a strong and intuitive appreciation of the importance of sleep to their emotional adaptation and as a contributor to their distress. This awareness is conveyed to clinicians who treat PTSD who in turn recognize the importance of targeting disturbed sleep with their treatments. The past 20 years has seen burgeoning research in the neurobiology of PTSD with much of the emphasis being neuroendocrinology and brain imaging. Achieving a coherent characterization of sleep dysregulation in PTSD and its integration with models of PTSD pathogenesis has challenged the field. Progress toward these goals and the promise of achieving them are highlighted by these manuscripts. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4721,"Assessing posttraumatic stress disorder with or without reference to a single, worst traumatic event: Examining differences in factor structure.","The authors examined the effects of a methodological manipulation on the Posttraumatic Stress Disorder (PTSD) Checklist's factor structure: specifically, whether respondents were instructed to reference a single worst traumatic event when rating PTSD symptoms. Nonclinical, trauma-exposed participants were randomly assigned to 1 of 2 PTSD assessment conditions: referencing PTSD symptoms to their worst trauma (trauma-specific group, n = 218) or to their overall trauma history in general (trauma-general group, n = 234). A 3rd group of non-trauma-exposed participants (n = 464) rated PTSD symptoms globally from any stressful event. Using confirmatory factor analysis, the authors show that the 4-factor PTSD model proposed by D. W. King, G. A. Leskin, L. A. King, and F. W. Weathers (1998; separating effortful avoidance and emotional numbing) demonstrated the best model fit for trauma-general and non-trauma-exposed participants. The 4-factor PTSD model proposed by L. J. Simms, D. Watson, and B. N. Doebbeling (2002; emphasizing a general dysphoria factor) demonstrated the best model fit for trauma-specific participants. Measurement invariance testing revealed that non-trauma-exposed participants were different from both trauma-exposed groups on factor structure parameters, but trauma groups were not substantially different from each other.",0,0 +4722,Brief measure of posttraumatic stress reactions: Impact of Event Scale-6,"BACKGROUND: The Impact of Event Scale-revised (IES-R) is one of the most widely used measures of posttraumatic stress reactions. However, for some purposes, such as large epidemiological studies, there is a need for briefer instruments. The aim of this study was to develop and validate an abbreviated version of the IES-R that could capture the three current symptom clusters of posttraumatic stress disorder (PTSD). METHODS: Stepwise multiple regression was applied to abbreviate the IES-R in one sample. The abbreviated version was then tested in three separate samples of individuals exposed to different kinds of potentially traumatic events. Agreement with a reference measure of PTSD, the PTSD checklist (PCL), was calculated for the abbreviated and the full-scale versions of IES. RESULTS: The abbreviation procedure resulted in a subset of six items (the IES-6), which correlated highly (pooled correlation = 0.95) with the IES-R across samples. Correlations between the IES-6 and IES-R subscales were somewhat lower (r = 0.78-0.94). Both the IES-6 and IES-R were in high agreement with the PCL. CONCLUSION: The IES-6 appears to be a robust brief measure of posttraumatic stress reactions. It may be useful for research in epidemiological studies, and it may also have a role as a screening instrument in clinical practice.",0,0 +4723,The moderation of resilience on the negative effect of pain on depression and post-traumatic growth in individuals with spinal cord injury,"To determine the moderating effect of resilience on the negative effects of chronic pain on depression and post-traumatic growth.Community-dwelling individuals with SCI (n = 37) were recruited at short-term admission for yearly regular health examination. Participants completed self-rating standardized questionnaires measuring pain, resilience, depression and post-traumatic growth. Hierarchical linear regression analysis was performed to identify the moderating effect of resilience on the relationships of pain with depression and post-traumatic growth after controlling for relevant covariates.In the regression model of depression, the effect of pain severity on depression was decreased (β was changed from 0.47 to 0.33) after entering resilience into the model. In the final model, both pain and resilience were significant independent predictors for depression (β = 0.33, p = 0.038 and β = -0.47, p = 0.012, respectively). In the regression model of post-traumatic growth, the effect of pain severity became insignificant after entering resilience into the model. In the final model, resilience was a significant predictor (β = 0.51, p = 0.016).Resilience potentially mitigated the negative effects of pain. Moreover, it independently contributed to reduced depression and greater post-traumatic growth. Our findings suggest that resilience might provide a potential target for intervention in SCI individuals.",0,0 +4724,The Peritraumatic Behavior Questionnaire: development and initial validation of a new measure for combat-related peritraumatic reactions,"Abstract Background Posttraumatic stress disorder (PTSD) is one of the most commonly observed stress-related conditions following combat exposure and its effective prevention is a high health-care priority. Reports of peritraumatic reactions have been shown to be highly associated with PTSD among combat exposed service members. However, existing instruments measuring peritraumatic symptoms were not specifically developed to assess combat-related peritraumatic stress and each demonstrates a different peritraumatic focus. We therefore developed the Peritraumatic Behavior Questionnaire (PBQ), a new military-specific rating scale focused upon the wide range of symptoms suggestive of combat-related peritraumatic distress in actively deployed Service Members. This study describes the development of the PBQ and reports on the psychometric properties of its self-rated version (PBQ-SR). Methods 688 Marine infantry service members were retrospectively assessed by the PBQ-SR within the scope of the Marine Resiliency Study after their deployment to war zone. Participants have been additionally assessed by a variety of questionnaires, as well as clinical interviews both pre and post-deployment. Results The PBQ-SR demonstrated satisfactory internal consistency, convergent and discriminant validity, as well as high correlation with trait dissociation prior to deployment. Component analysis suggested a latent bi-dimensional structure separating a peritraumatic emotional distress and physical awareness factor. The PBQ-SR total score showed high correlation to general anxiety, depression, poorer general health and posttraumatic symptoms after deployment and remained a significant predictor of PTSD severity, after controlling for those measures. The suggested screening cut-off score of 12 points demonstrated satisfactory predictive power. Conclusions This study confirms the ability of the PBQ-SR to unify the underlying peritraumatic symptom dimensions and reliably assess combat-related peritraumatic reaction as a general construct. The PBQ-SR demonstrated promise as a potential standard screening measure in military clinical practice, while It’s predictive power should be established in prospective studies.",0,0 +4725,Longitudinal Course of Posttraumatic Stress Disorder and Posttraumatic Stress Disorder Symptoms in a Community Sample of Adolescents and Young Adults,"OBJECTIVE: Few studies have focused on the natural course of posttraumatic stress disorder (PTSD) and its determinants in samples of the general population. The authors examined determinants of remission and chronicity of PTSD and associations with other disorders in a prospective community sample. METHOD: The data were drawn from a prospective, longitudinal epidemiological study of adolescents and young adults (age 14–24 years) in Munich, Germany (N=2,548). The course of PTSD from baseline to follow-up 34–50 months later was studied in 125 respondents with DSM-IV PTSD or subthreshold PTSD at baseline. RESULTS: Although 52% of the PTSD cases remitted during the follow-up period, 48% showed no significant remission of PTSD symptoms. Respondents with a chronic course were more likely to experience new traumatic event(s) during follow-up (odds ratio=5.21, 95% confidence interval [CI]=1.95–13.92), to have higher rates of avoidant symptoms at baseline (odds ratio=10.16, 95% CI=1.73–59.51), and to report more help seeking (odds ratio=5.50, 95% CI=1.04–29.05), compared to respondents with remission. Rates of incident somatoform disorder (odds ratio=4.24, 95% CI=1.60–11.19) and other anxiety disorders (odds ratio=4.07, 95% CI=1.15–14.37) were also significantly associated with a chronic course. CONCLUSIONS: PTSD is often a persistent and chronic disorder. Specific symptom clusters—especially avoidant symptoms—might be associated with the course of PTSD. In addition, the occurrence of new traumatic events differentiates PTSD cases with a chronic course from those with remission.",0,0 +4726,Meta-analytical Comparison of Voxel-Based Morphometry Studies in Obsessive-Compulsive Disorder vs Other Anxiety Disorders,"Whether obsessive-compulsive disorder (OCD) is adequately classified as an anxiety disorder is a matter of considerable debate.To quantitatively compare structural brain changes in OCD and other anxiety disorders using novel voxel-based meta-analytical methods and to generate an online database to facilitate replication and further analyses by other researchers.The PubMed, ScienceDirect, and Scopus databases were searched between 2001 (the date of the first voxel-based morphometry study in any anxiety disorder) and 2009. All voxel-based morphometry studies comparing patients with any anxiety disorder and healthy controls were retrieved. Manual searches were also conducted. Authors were contacted soliciting additional data.Thirty-seven data sets were identified, of which 26 (including 639 patients with anxiety disorders and 737 healthy controls) met inclusion criteria.Coordinates were extracted from clusters of significant gray matter difference between patients and controls. Demographic, clinical, and methodological variables were extracted from each study or obtained from the authors.Patients with anxiety disorders (including OCD) showed decreased bilateral gray matter volumes in the dorsomedial frontal/anterior cingulate gyri. Individuals with OCD had increased bilateral gray matter volumes (vs healthy controls and vs individuals with other anxiety disorders) in the lenticular/caudate nuclei, while patients with other anxiety disorders (mainly panic and posttraumatic stress disorders) had decreased gray matter volumes in the left lenticular nucleus. The findings remained largely unchanged in quartile and jackknife sensitivity analyses. Controlling for potential confounders such as age or antidepressant medication had little impact on the results.The meta-analysis consistently revealed common as well as distinct neural substrates in OCD and other anxiety disorders. These results have implications for the current debate surrounding the classification of OCD in the DSM-V.",0,0 +4727,The contribution of psychological factors to recovery after mild traumatic brain injury: Is cluster analysis a useful approach?,"Outcomes after mild traumatic brain injury (MTBI) vary, with slow or incomplete recovery for a significant minority. This study examines whether groups of cases with shared psychological factors but with different injury outcomes could be identified using cluster analysis.This is a prospective observational study following 147 adults presenting to a hospital-based emergency department or concussion services in Christchurch, New Zealand. This study examined associations between baseline demographic, clinical, psychological variables (distress, injury beliefs and symptom burden) and outcome 6 months later. A two-step approach to cluster analysis was applied (Ward's method to identify clusters, K-means to refine results).Three meaningful clusters emerged (high-adapters, medium-adapters, low-adapters). Baseline cluster-group membership was significantly associated with outcomes over time. High-adapters appeared recovered by 6-weeks and medium-adapters revealed improvements by 6-months. The low-adapters continued to endorse many symptoms, negative recovery expectations and distress, being significantly at risk for poor outcome more than 6-months after injury (OR (good outcome) = 0.12; CI = 0.03-0.53; p < 0.01).Cluster analysis supported the notion that groups could be identified early post-injury based on psychological factors, with group membership associated with differing outcomes over time. Implications for clinical care providers regarding therapy targets and cases that may benefit from different intensities of intervention are discussed.",0,0 +4728,"Predictors of battered women's use of intimate partner violence (IPV): A focus on IPV exposure, post-traumatic stress disorder (PTSD) and threat appraisal (TA).","The purpose of this study was to examine the prevalence and motivations of battered women's use of intimate partner violence (IPV), as well as to identify predictors of battered women's use of IPV. Using logistic regressions, we examined the predictive utility of women's exposure to IPV, women's symptoms of post-traumatic stress disorder (PTSD) and women's threat appraisal (TA) in explaining women's use of IPV. Using a series of logistic regressions, we also examined PTSD and TA as mediators of the relationship between women's exposure to IPV and women's use of IPV. Women were recruited from various help-seeking sites, as part of a longitudinal study of battered women's experiences. Prevalence rates were reported for all women (n = 285) who completed the third follow-up interview, during which women's use of IPV was assessed. In addressing the hypotheses related to this study, the sample included responses form 152 women who continued to have contact with their abusive partners in the assessed three month period between the third and fourth follow-up interviews. Approximately 70% of women reported having used IPV at some point in their relationships, and approximately 90% of women cited self-defense as a motivation. Statistical analyses found that IPV exposure and TA predicted whether women used IPV, but PTSD was not a significant predictor. Further, TA was not found to mediate the relationship between women's exposure to IPV and women's use of IPV. Findings are discussed within the framework of social, legal and clinical implications. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4729,Posttraumatic stress disorder and major depression in veterans with spinal cord injury.,"Objective: To explore the relationship between posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) in veterans with spinal cord injury and to compare those results with results found in veterans who had sustained other traumatic injuries. Method: To investigate the relationship between PTSD and MDD in persons with spinal cord injury, the authors examined whether individuals endorsed overlapping items on measures of both disorders, evaluated the contribution of overlapping items to comorbid diagnosis, and conducted an exploratory factor analysis. Results: The overlapping symptoms between the 2 disorders did not fully explain the high rate of comorbidity, although participants who endorsed a symptom common to MDD and PTSD on 1 measure were likely to endorse the corresponding item on another measure. In both samples, items loaded on separate PTSD and MDD factors. Conclusion: MDD and PTSD appear to represent independent reactions to trauma in those individuals who had experienced either a nonspinal cord injury or a spinal cord injury. This research also provides an initial investigation of some of the possible ways that MDD and PTSD are related by addressing psychometric issues inherent in their measurement. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +4730,Predicting criminality from child maltreatment typologies and posttraumatic stress symptoms,"The associations between childhood abuse and subsequent criminality and posttraumatic stress disorder (PTSD) are well known. However, a major limitation of research related to childhood abuse and its effects is the focus on one particular type of abuse at the expense of others. Recent work has established that childhood abuse rarely occurs as a unidimensional phenomenon. Therefore, a number of studies have investigated the existence of abuse typologies.The study is based on a Danish stratified random probability survey including 2980 interviews of 24-year-old people. The sample was constructed to include an oversampling of child protection cases. Building on a previous latent class analysis of four types of childhood maltreatment, three maltreatment typologies were used in the current analyses. A criminality scale was constructed based on seven types of criminal behavior. PTSD symptoms were assessed by the PC-PTSD Screen.Significant differences were found between the two genders with males reporting heightened rates of criminality. Furthermore, all three maltreatment typologies were associated with criminal behavior with odds ratios (ORs) from 2.90 to 5.32. Female gender had an OR of 0.53 and possible PTSD an OR of 1.84.The independent association of participants at risk for PTSD and three types of maltreatment with criminality should be studied to determine if it can be replicated, and considered in social policy and prevention and rehabilitation interventions.",0,0 +4731,The effects of direct versus witnessed threat on emergency department healthcare workers: implications for PTSD criterion A.,"We compared post-traumatic stress disorder (PTSD) symptom severity and symptom cluster profiles in hospital emergency department (ED) medical staff (N=100) who experienced an emotionally distressing work event that presented either a direct threat to themselves or a witnessed threat to patients. The two groups displayed similar levels of PTSD symptoms, however, they differed on symptom profiles and work consequences. The direct threat group experienced significantly greater fear during the event, more ongoing arousal symptoms, and more job dissatisfaction than the witnessed threat group. The witnessed threat group was more likely to appraise their PTSD symptoms as reflecting personal weakness. Overall, the results point to the need for further research to identify distinctive features of responses to different types of traumatic stressors.",0,0 +4732,"The assessment of optimistic self-beliefs: Comparison of the Chinese, Indonesian, Japanese, and Korean versions of the general self-efficacy scale",,0,0 +4733,Fitting a linear–linear piecewise growth mixture model with unknown knots: A comparison of two common approaches to inference.,"A linear-linear piecewise growth mixture model (PGMM) is appropriate for analyzing segmented (disjointed) change in individual behavior over time, where the data come from a mixture of 2 or more latent classes, and the underlying growth trajectories in the different segments of the developmental process within each latent class are linear. A PGMM allows the knot (change point), the time of transition from 1 phase (segment) to another, to be estimated (when it is not known a priori) along with the other model parameters. To assist researchers in deciding which estimation method is most advantageous for analyzing this kind of mixture data, the current research compares 2 popular approaches to inference for PGMMs: maximum likelihood (ML) via an expectation-maximization (EM) algorithm, and Markov chain Monte Carlo (MCMC) for Bayesian inference. Monte Carlo simulations were carried out to investigate and compare the ability of the 2 approaches to recover the true parameters in linear-linear PGMMs with unknown knots. The results show that MCMC for Bayesian inference outperformed ML via EM in nearly every simulation scenario. Real data examples are also presented, and the corresponding computer codes for model fitting are provided in the Appendix to aid practitioners who wish to apply this class of models.",0,0 +4734,Functional correlates of military sexual assault in male veterans.,"Despite research findings that similar numbers of male and female veterans are affected by military sexual trauma (MST), there has been considerably less research on the effects of MST specific to male veterans. The aim of the present study was to provide preliminary data describing functional correlates of military sexual assault (MSA) among male Iraq/Afghanistan-era veterans to identify potential health care needs for this population. We evaluated the following functional correlates: posttraumatic stress disorder (PTSD) symptoms, depression symptoms, alcohol use, drug use, suicidality, social support, violent behavior in the past 30 days, incarceration, disability eligibility status, and use of outpatient mental health treatment. We compared 3 groups: (a) male veterans who endorsed a history of MSA (n = 39), (b) a general non-MSA sample (n = 2,003), and (c) a matched non-MSA sample (n = 39) identified by matching algorithms on the basis of factors (e.g., age, education, adult premilitary sexual trauma history, childhood sexual and physical trauma history, and race) that could increase veterans' vulnerability to the functional correlates examined. MSA in men was associated with greater PTSD symptom severity, greater depression symptom severity, higher suicidality, and higher outpatient mental health treatment, above and beyond the effects of vulnerability factors. These findings suggest that, for male veterans, MSA may result in a severe and enduring overall symptom profile requiring ongoing clinical management.",0,0 +4735,Grey matter reduction associated with posttraumatic stress disorder and traumatic stress,"In recent decades, many imaging studies have reported brain structural alterations in posttraumatic stress disorder (PTSD). However, due to differences in the selection of control subjects, it is difficult to conclude whether the observed alterations were related to disease or traumatic stress. The present study was to provide a quantitative voxelwise meta-analysis of grey matter (GM) changes in PTSD relative to either trauma-exposed controls without PTSD (TEC) or non-traumatised healthy controls (HC) separately and to conduct a systematic review of voxel-based morphometry (VBM) studies that compared trauma-exposed individuals with HC to explore the effect of traumatic stress. GM reduction was identified in the medial prefrontal cortex in PTSD compared to both TEC and HC. Additional GM reduction was also observed in PTSD in the left hippocampus, left middle temporal gyrus and right superior frontal gyrus compared with TEC. Additionally, GM decreased in the left occipital cortex in PTSD compared with HC. The present study delimited the significant differences among VBM results in PTSD research when different control groups were chosen.",0,0 +4736,Longitudinal course of anxiety sensitivity and PTSD symptoms in cognitive-behavioral therapies for PTSD,"Anxiety sensitivity (AS) has been conceptualized as trait-like vulnerability and maintenance factor for PTSD. Although recent literature has demonstrated its malleability during treatment, few have examined its influence on and effect from PTSD treatment. Using multilevel regression analyses we examined: (a) changes in AS during treatment and (b) whether pre-treatment AS predicted PTSD treatment response, in sample of female victims of interpersonal trauma receiving one of three treatments (cognitive processing therapy, cognitive processing therapy-cognitive, and written accounts). Participants exhibited reductions in total ASI scores from pre- to post-treatment. Growth curve modeling revealed slightly different trajectories of PTSD symptoms as a function of pre-treatment AS, and overall decreases in PTSD symptoms during treatment were not associated with pretreatment AS. Pretreatment AS dimensions impacted PTSD total scores and symptoms clusters differentially. Clinical and theoretical implications for these results are discussed.",0,0 +4737,Identification of gene markers based on well validated and subcategorized stressed animals for potential clinical applications in PTSD,"Post-traumatic stress disorder (PTSD) is a complex mental disorder that can develop in response to traumatic experiences. The molecular mechanisms underlying the pathology of PTSD are poorly understood, and this lack of knowledge hampers our ability to find superior therapeutic approaches to the treatment of this disorder. There are two main reasons for our lack of study in this area: here is no sufficiently validated animal model and lack of large-scale studies for the search of underlying molecular mechanisms. Thus, to promote research on PTSD (especially its molecular mechanisms) and to set molecular basis for searching novel medications of this disorder, large-scale, genome-wide interrogation of a significant amount of genes based upon a well validated animal model is demanded. We hypothesize that a significant number of genes are involved in PTSD. It is only with a large number of these genes identified in specific samples of PTSD-related population, and then it is possible for a sufficient understanding of the pathology at the molecular level of a PTSD, as well as for enhancing the PTSD's therapeutic and preventative strategies. Two prerequisites are needed for testing this hypothesis: (1) relative pure samples from a well validated animal model; and (2) genome-wide screening of PTSD molecular targets. For the animal model, we suggest to use the predator-exposure paradigm, in which rats are exposed to a predator, this model has previously been evaluated behaviorally well emulated the clinical symptoms of PTSD. For a better stringency, three criteria can be used to further validate this animal model: analogous (similarity of behavior), predictive (predictability of drug response) and biological mechanism (e.g., electrophysiological and pathological change in amygdala). For large-scale molecular target screening, the new microarray technology, which can profile expression of tens of thousands genes simultaneously, is the method of choice. The validity and practicability of this hypothesis and the strategy for its testing have been supported by our preliminary laboratory data.",0,0 +4738,Resilience in the aftermath of war trauma: a critical review and commentary,"The resilience construct has received a great deal of attention as a result of the long wars in Iraq and Afghanistan. The discourse about resilience, especially the promise of promoting it and mitigating risk for serious post-traumatic negative outcomes among service members and veterans, is hopeful and encouraging. Remarkably, most service members exposed to horrific war trauma are not incapacitated by the experience. Yet, resilience is elusive and fleeting for many veterans of war. In this paper, I address some of the complexities about resilience in the context of exposure to war stressors and I offer some assumptions and heuristics that stem from my involvement in the dialogue about resilience and from experiences helping prevent post-traumatic stress disorder among active-duty service members with military trauma. My goal is to use my observations and applied experiences as an instructive context to raise critical questions for the field about resilience in the face of traumatic life-events.",0,0 +4739,Posttraumatic Stress Disorder Comorbid With Major Depression: Factors Mediating the Association With Suicidal Behavior,"OBJECTIVE: The purpose of the study was to determine if patients with a history of major depressive episode and comorbid posttraumatic stress disorder (PTSD) have a higher risk for suicide attempt and differ in other measures of suicidal behavior, compared to patients with major depressive episode but no PTSD. In addition, to explore how PTSD comorbidity might increase risk for suicidal behavior in major depressive episode, the authors investigated the relationship between PTSD, cluster B personality disorder, childhood sexual or physical abuse, and aggression/impulsivity. METHOD: The subjects were 230 patients with a lifetime history of major depressive episode; 59 also had lifetime comorbid PTSD. The demographic and clinical characteristics of subjects with and without PTSD were compared. Multivariate analysis was used to examine the relationship between suicidal behavior and lifetime history of PTSD, with adjustment for clinical factors known to be associated with suicidal behavior. RESULTS: Patients with a lifetime history of PTSD were significantly more likely to have made a suicide attempt. The groups did not differ with respect to suicidal ideation or intent, number of attempts made, or maximum lethality of attempts. The PTSD group had higher objective depression, impulsivity, and hostility scores; had a higher rate of comorbid cluster B personality disorder; and were more likely to report a childhood history of abuse. However, cluster B personality disorder was the only independent variable related to lifetime suicide attempts in a multiple regression model. CONCLUSIONS: PTSD is frequently comorbid with major depressive episode, and their co-occurrence enhances the risk for suicidal behavior. A higher rate of comorbid cluster B personality disorder appears to be a salient factor contributing to greater risk for suicidal acts in patients with a history of major depressive episode who also have PTSD, compared to those with major depressive episode alone.",0,0 +4740,Dissociative Disorders,"The dissociative disorders, including “psychogenic” or “functional” amnesia, fugue, dissociative identity disorder (DID, also known as multiple personality disorder), and depersonalization disorder, were once classified, along with conversion disorder, as forms of hysteria. The 1970s witnessed an “epidemic” of dissociative disorder, particularly DID, which may have reflected enthusiasm for the diagnosis more than its actual prevalence. Traditionally, the dissociative disorders have been attributed to trauma and other psychological stress, but the existing evidence favoring this hypothesis is plagued by poor methodology. Prospective studies of traumatized individuals reveal no convincing cases of amnesia not attributable to brain insult, injury, or disease. Treatment generally involves recovering and working through ostensibly repressed or dissociated memories of trauma; at present, there are few quantitative or controlled outcome studies. Experimental studies are few in number and have focused largely on state-dependent and implicit memory. Depersonalization disorder may be in line for the next “epidemic” of dissociation.",0,0 +4741,Perceived cognitive impairment in Chinese patients with breast cancer and its relationship with post-traumatic stress disorder symptoms and fatigue,"Objective Clinical reports have shown that adjuvant chemotherapy has a negative impact on perceived cognitive impairment (PCI) of patients with breast cancer; however, evidence concerning the effects of psychological factors such as post-traumatic stress disorder (PTSD) symptoms on PCI is limited, especially in relation to Chinese patients with breast cancer. This research investigated the associations between psychological factors and PCI in Chinese women with breast cancer. Methods In total, 204 women with breast cancer were assessed for PCI, PTSD symptoms, fatigue, anxiety, and depression using self-report measures. Hierarchical linear regression was conducted to investigate the associations between the variables of interest and PCI. Results Two hundred and two women were included in the final analysis; two of those originally tested were excluded because of missing data. A univariate analysis showed that PCI was significantly related to education, PTSD symptoms (re-experience, avoidance, and hyperarousal), fatigue, depression, anxiety, and undergoing chemotherapy or radiotherapy. Hierarchical linear regression revealed that PTSD symptoms and fatigue (ΔR2 = 0.26, P < 0.001) independently accounted for PCI in Chinese women with breast cancer regardless of age, education level, chemotherapy and radiotherapy. Hyperarousal was the only contributing PTSD symptom to PCI (B = −1.24, SE = 0.33, β = −0.39, P < 0.001). Conclusions Besides chemotherapy, PTSD symptoms, especially hyperarousal, and fatigue are important risk factors for significant PCI and are therefore worthy of further investigation. Copyright © 2014 John Wiley & Sons, Ltd.",0,0 +4742,Anxiety Disorders of Childhood and Adolescence: A Critical Review,"The 1980s were a decade of advancement in the knowledge of anxiety disorders in children and adolescents; this sets the stage for research achievements in the 1990s. This review examines the anxiety disorders of childhood and adolescence (separation anxiety disorder, overanxious disorder, and avoidant disorder), including prevalence rates, demographic profiles, comparisons of clinical presentations in different developmental age groups, and comorbidity patterns. Fears and simple phobias, obsessive-compulsive disorder, post-traumatic stress disorder, and panic disorder in children and adolescents are also evaluated. The controversy of whether panic attacks occur in prepubertal children is addressed. A brief review of behavioral and pharmacological treatment studies is included. Future directions for research are suggested.",0,0 +4743,The influence of traumatic brain injury on acute stress disorder and post-traumatic stress disorder following motor vehicle accidents,"This study compared the acute stress disorder and post traumatic stress disorder PTSD symptom profiles in motor vehicle accident survivors who sustained a mild traumatic brain injury MTBI or no TBI. Consecutive adult patients who sustained a MTBI n=79 and no TBI n=92 were assessed for acute stress disorder within 1 month of their trauma and reassessed for PTSD MTBI: n=63; non TBI; n=72 6 months post trauma. Comparable rates of acute stress disorder and PTSD were reported in MTBI and non TBI patients. Intrusive memories and fear and helplessness in response to the trauma were reported less frequently by MTBI than non TBI patients at the acute phase. Six months post trauma fewer MTBI patients than non TBI reported fear and helplessness in response to the trauma. These findings suggest that, whereas impaired consciousness at the time of a trauma may reduce the frequency of traumatic memories in the initial month post trauma, MTBI does not result in a different profile of longer term PTSD.",0,0 +4744,Trajectories of post-traumatic stress disorder symptoms among youth exposed to both natural and technological disasters,"Theorists and researchers have demonstrated multiple trajectories of symptoms following disasters (Ecology and Society, 13, 2008, 9), highlighting the importance of obtaining more knowledge about exposed youth who demonstrate resilience as well as those who suffer chronic difficulties. This paper examines trajectories of post-traumatic stress disorder (PTSD) symptoms following exposure to hurricanes and the Deepwater Horizon Oil Spill to increase understanding of resilience and chronic reactions to both natural and technological disasters.A multiwave longitudinal design was used to follow N = 4,619 youth who were evaluated for PTSD symptoms, hurricane exposure, and oil spill exposure/stress at four time points over a period of 4 years. Trajectories were identified with cluster analyses and multilevel modeling.Individual trajectories were statistically identified consistent with theory. The largest group exhibited stable-low symptoms (52%), a second group showed steep declines following initial symptoms (21%), a third group exhibited increasing symptoms (18%), and a fourth group showed stable-high symptoms (9%). Both hurricane exposure and oil spill stress predicted trajectories and overall levels of PTSD symptoms.Results identified an effect of oil spill stress and hurricane exposure on symptom levels and trajectories of exposed youth. Results provide prospective data to support theories of multiple symptom trajectories following disasters and reinforce the importance of research that utilizes a developmental perspective to consider the long-term effects of disasters in youth. Findings highlight the importance of identifying symptoms and predictors of resilience as well as factors that contribute to resilience.",0,0 +4745,When Multiple Disasters Strike: Louisiana Fishers in the Aftermath of Hurricanes and the British Petroleum Deepwater Horizon Oil Spill,"Relatively few studies in the research literature on technological disasters include commercial fishers whose livelihood, culture, and way of life are all deeply tied to bayous and natural waterways for generations. In this chapter, we address the impact of the 2010 British Petroleum (BP) Deepwater Horizon oil spill on commercial fishers sampled from two coastal parishes (counties) in south Louisiana. The individuals who provided the qualitative interviews upon which this chapter is based were participants in a larger study on long-term recovery from Hurricanes Katrina and Rita that devastated the US Gulf Coast in 2005. All respondents were exposed to the 2005 Hurricanes Katrina and Rita, the 2008 Hurricanes Gustav and Ike, and most recently the 2010 BP oil spill. We begin with a brief review of the literature on the psychosocial impact of disasters and examine the related concept of cumulative adversity. Content analysis of qualitative data from interviews conducted at least 12 months after the oil spill yielded three emergent themes which we present here: (1) Troubled Present, Uncertain Future; (2) Environmental Devastation; and (3)The “Pileup” Effect After a Decade of Disasters. Implications for individuals and families who have been directly impacted by the BP oil spill are considered.",0,0 +4746,"Analyzing developmental trajectories: A semiparametric, group-based approach.","Carnegie Mellon UniversityA developmental trajectory describes the course of a behavior over age or time. Agroup-based method for identifying distinctive groups of individual trajectorieswithin the population and for profiling the characteristics of group members isdemonstrated. Such clusters might include groups of increasers. decreasers,and no changers. Suitably defined probability distributions are used to handle 3data types—count, binary, and psychometric scale data. Four capabilities are dem-onstrated: (a) the capability to identify rather than assume distinctive groups oftrajectories, (b) the capability to estimate the proportion of the population followingeach such trajectory group, (c) the capability to relate group membership probabil-ity to individual characteristics and circumstances, and (d) the capability to use thegroup membership probabilities for various other purposes such as creating profilesof group members.",0,0 +4747,"Examining the Overlap between Bipolar Disorder, Nonaffective Psychosis, and Common Mental Disorders Using Latent Class Analysis","While dimensional models of psychopathology have delineated two broad factors underlying common mental disorders--internalizing and externalizing--it is unclear where bipolar disorder and nonaffective psychoses fit in relation to this structure and to each other. Given their low prevalence rates in the general population, these disorders generally tend to be excluded from such models. The current study used the person-centered approach of latent class analysis (LCA) to evaluate this question.LCA of diagnostic data from an epidemiological sample, the National Comorbidity Survey (n = 5,877), was undertaken. Diagnoses utilized in analyses included mania, nonaffective psychoses, specific phobia, social phobia, agoraphobia, panic disorder, major depression, dysthymia, generalized anxiety disorder, post-traumatic stress disorder, alcohol dependence, drug dependence, and conduct disorder.Results indicated that a 5-class LCA model optimally fit the data. Four of the classes mirrored those found in dimensional models--a class with few disorders, and 3 others with primarily fear, distress, and externalizing disorders. However, the fifth class--which is not evident in dimensional models--was unique in that it was the only one in which individuals demonstrated significant probabilities of both manic episodes and nonaffective psychoses in addition to markedly high levels of internalizing and externalizing disorders.This finding has important implications for nosological classification of psychopathology.",0,0 +4748,Depression and Anxiety Among Coronary Heart Disease Patients: Can Affect Dimensions and Theory Inform Diagnostic Disorder-Based Screening?,"Objectives To examine the association between low positive affect, somatic anxiety and general distress with affective disorders, anxious misery, and visceral fear among coronary heart disease patients. Participants Patients awaiting a coronary revascularization procedure (N = 158; 20.9% female; median age = 65, interquartile range 58–73) underwent structured interview with the Mini-International Neuropsychiatric Interview. Patients completed a brief version of the Mood and Anxiety Symptom Questionnaire (i.e., Anxiety Depression Distress Inventory-27) and a measure of Type D personality. Results Somatic anxiety scores yielded an area under the curve (AUC) = .784 and 75.0% sensitivity and 68.5% specificity in relation to panic disorder. Low positive affect yielded AUC = .811 and 70.4% sensitivity and 77.1% specificity for major depression. General distress yielded AUC = .795 and 75.0% sensitivity and 72.5% specificity for generalized anxiety disorder. No affective dimension was optimally associated with the anxious misery or visceral fear cluster. Trait negative affect was not a suitable screener for any disorder. Conclusions The Anxiety Depression Distress Inventory-27 dimensions of low positive affect and somatic anxiety provided optimal detection of depression and panic disorder, respectively, as hypothesized, supporting discriminant validity.",0,0 +4749,"Some Thoughts on Trauma, Pain, Posttraumatic Stress Disorder and Traumatic Brain Injury","Aversive learning and memory processes are common in pain and post-traumatic stress disorder (PTSD) and involve some of the same brain areas such as the amygdala, the insula and the anterior cingulate cortex. It is very likely that the deficient extinction of fear or pain responses is the core deficit in these disorders rather than enhanced acquisition. There is a great need for comparative studies for these disorders and their combination and specifically for the analysis of neuropsychological and neurobiological mechanisms that may partially be overlapping between these disorders. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4750,Peritraumatic dissociation as a predictor of post-traumatic stress disorder: a critical review,"In psychiatric literature, dissociative reactions at the time of a traumatic event (i.e., peritraumatic dissociation) are considered to be risk factors for the development of post-traumatic stress disorder (PTSD). In this article, we critically review research concerned with the link between peritraumatic dissociation and PTSD. Our main point is that studies in this area heavily rely on retrospective reports of dissociative reactions during the trauma. We argue that this methodology has important limitations since people in general and PTSD patients in particular find it difficult to give accurate descriptions of past emotional states. Restrictive factors that play a role in this context have to do with forgetting, attribution, and malingering.",0,0 +4751,Risk factors for chronic post-traumatic stress disorder (PTSD) in SARS survivors,"Post-traumatic stress disorder (PTSD) is one of the most prevalent long-term psychiatric diagnoses among survivors of severe acute respiratory syndrome (SARS). The objective of this study was to identify the predictors of chronic PTSD in SARS survivors. PTSD at 30 months after the SARS outbreak was assessed by the Structured Clinical Interview for the DSM-IV . Survivors' demographic data, medical information and psychosocial variables were collected for risk factor analysis. Multivariate logistic regression analysis showed that female gender as well as the presence of chronic medical illnesses diagnosed before the onset of SARS and avascular necrosis were independent predictors of PTSD at 30 months post-SARS. Associated factors included higher-chance external locus of control, higher functional disability and higher average pain intensity. The study of PTSD at 30 months post-SARS showed that the predictive value of acute medical variables may fade out. Our findings do not support some prior hypotheses that the use of high dose corticosteroids is protective against the development of PTSD. On the contrary, the adversity both before and after the SARS outbreak may be more important in hindering recovery from PTSD. The risk factor analysis can not only improve the detection of hidden psychiatric complications but also provide insight for the possible model of care delivery for the SARS survivors. With the complex interaction of the biopsychosocial challenges of SARS, an integrated multidisciplinary clinic setting may be a superior approach in the long-term management of complicated PTSD cases.",0,0 +4752,End-of-Life Care and the Effects of Bereavement on Family Caregivers of Persons with Dementia,"Although family caregiving has been intensively studied in the past decade, little attention has been paid to the impact of end-of-life care on caregivers who are family members of persons with dementia or to the caregivers' responses to the death of the patient.Using standardized assessment instruments and structured questions, we assessed the type and intensity of care provided by 217 family caregivers to persons with dementia during the year before the patient's death and assessed the caregivers' responses to the death.Half the caregivers reported spending at least 46 hours per week assisting patients with activities of daily living and instrumental activities of daily living. More than half the caregivers reported that they felt they were ""on duty"" 24 hours a day, that the patient had frequent pain, and that they had had to end or reduce employment owing to the demands of caregiving. Caregivers exhibited high levels of depressive symptoms while providing care to the relative with dementia, but they showed remarkable resilience after the death. Within three months of the death, caregivers had clinically significant declines in the level of depressive symptoms, and within one year the levels of symptoms were substantially lower than levels reported while they were acting as caregivers. Seventy-two percent of caregivers reported that the death was a relief to them, and more than 90 percent reported belief that it was a relief to the patient.End-of-life care for patients with dementia was extremely demanding of family caregivers. Intervention and support services were needed most before the patient's death. When death was preceded by a protracted and stressful period of caregiving, caregivers reported considerable relief at the death itself.",0,0 +4753,Association of Trauma and PTSD Symptoms With Openness to Reconciliation and Feelings of Revenge Among Former Ugandan and Congolese Child Soldiers,"Tens of thousands of the estimated 250,000 child soldiers worldwide are abused or have been abused during the last decade in Africa's Great Lakes Region. In the process of rebuilding the war-torn societies, it is important to understand how psychological trauma may shape the former child soldiers' ability to reconcile.To investigate the association of posttraumatic stress disorder (PTSD) symptoms and openness to reconciliation and feelings of revenge in former Ugandan and Congolese child soldiers.Cross-sectional field study of 169 former child soldiers (aged 11-18 years) in rehabilitation centers in Uganda and the Democratic Republic of the Congo, conducted in 2005.Potentially traumatic war-related experiences assessed via a sample-specific events scale; PTSD symptoms assessed using the Child Posttraumatic Stress Disorder Reaction Index (CPTSD-RI), with a score of 35 or higher indicating clinically important PTSD symptoms; and openness to reconciliation and feelings of revenge assessed via structured questionnaires.Children participating in this study were a mean of 15.3 years old. These former child soldiers reported that they had been (violently) recruited by armed forces at a young age (mean [SD], 12.1 [2] years), had served a mean of 38 months (SD, 24 months), and had been demobilized a mean of 2.3 months before data collection (SD, 2.4 months). The children were exposed to a high level of potentially traumatic events (mean [SD], 11.1 [2.99]). The most commonly reported traumatic experiences were having witnessed shooting (92.9%), having witnessed someone wounded (89.9%), and having been seriously beaten (84%). A total of 54.4% reported having killed someone, and 27.8% reported that they were forced to engage in sexual contact. Of the 169 interviewed, 59 (34.9%; 95% confidence interval, 34.4%-35.4%) had a PTSD symptom score higher than 35. Children who showed more PTSD symptoms had significantly less openness to reconciliation (rho= -0.34, P < .001) and more feelings of revenge (rho= 0.29, P < .001).PTSD symptoms are associated with less openness to reconciliation and more feelings of revenge among former Ugandan and Congolese child soldiers. The effect of psychological trauma should be considered when these children are rehabilitated and reintegrated into civilian society.",0,0 +4754,"The structure of PTSD among two cohorts of returning soldiers: Before, during, and following deployment to Iraq.","Evidence suggests either a four-factor emotional numbing or dysphoria model likely reflects the underlying structure of posttraumatic stress disorder (PTSD). Questions remain as to which of these structures best represents PTSD, how the structure changes with time, the applicability of models to returning veterans, and the validity of the symptom clusters. The present study addresses these questions among two longitudinal samples of National Guard soldiers assessed prior to, during, and following a combat deployment to Iraq. Findings support a four-factor intercorrelated dysphoria model of PTSD that remains stable across samples and time points. Differential associations were observed among PTSD symptom clusters over time and between symptom clusters and both depression and combat exposure, supporting important distinctions between symptom clusters.",0,0 +4755,Risk factors for pediatric posttraumatic stress disorder after traumatic injury,"The purpose of this study was to identify risk factors that may be predictive of posttraumatic stress disorder (PTSD) in children after a traumatic injury. The study was a retrospective review of data collected from 337 pediatric trauma patients treated in a multidisicplinary outpatient clinic. Results from Chi-square and t-test analyses indicated that gender, ethnicity, age, and injury severity were not risk factors for PTSD. However, mechanism of injury, specifically a gun shot wound (p =.001), was associated with development of PTSD, as was body area of injury, specifically the abdomen (p =.001). Psychiatric screening of patients with gun shot wounds and wounds to the abdomen may help with the early identification and treatment of PTSD.",0,0 +4756,Health-related quality of life (HRQoL) in veterans with chronic posttraumatic stress disorder (PTSD) and tobacco dependence,"Posttraumatic Stress Disorder (PTSD) is a psychiatric condition in which the experience of a traumatic event results in symptoms including intrusive memories and/or nightmares related to the trauma, avoidance of stimuli associated with the trauma, emotional numbing, and increased vigilance and irritability from pre- to post-trauma. Health-Related Quality of Life (HRQoL) is a construct designed to measure the effect of disease on physical, social/role, psychological/emotional, and cognitive functioning. Tobacco use is associated with both PTSD and HRQoL. PTSD is associated with higher rates of smoking than the national average (45% versus 23%). Additionally, smokers have well-documented negative health outcomes, and smoking is a major predictor of poorer HRQoL in the general population across both physical and mental health domains. PTSD is not generally associated in the public opinion with negative health consequences in the way that cigarette smoking is. However, PTSD has been causally linked with negative health outcomes, namely cardiovascular disease and metabolic syndrome. There are a lack of studies that examine the relationship between tobacco dependence and HRQoL, specifically in a PTSD population. Studies examining the effect of quitting smoking on HRQoL in the chronic tobacco dependent, PTSD population are also lacking. The proposed study aimed to examine the effect of post-treatment smoking status on post-treatment HRQoL scores by testing whether the interaction between quitting smoking and changes in PTSD symptom severity and/or depression severity from pre- to post-treatment predicted improvement in physical HRQoL from pre- to post-treatment. Hypotheses were tested using hierarchical linear modeling. Results indicated that reductions in PTSD symptom severity, particularly the numbing and hyperarousal symptom clusters, from pre- to post-treatment predicted improvement in the SF-36 Vitality and General Health subscales from pre- to post-treatment. We also found that PTSD and depressive symptoms differentially predicted the SF-36 subscales, and achievement of prolonged abstinence was associated with higher physical HRQoL scores. Our findings provide further evidence of a strong relationship between PTSD, tobacco dependence, and poor physical health status and HRQoL. Clinically, it may be important to examine HRQoL as a PTSD and depression treatment outcome. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +4757,Traumatic Stress Disorder: Diagnostic and clinical issues in former prisoners of war,Examined are a variety of clinical issues in the diagnosis and treatment of Posttraumatic Stress Disorder (PTSD) of former prisoners of war (POWs). Difficulties and complexities in understanding and diagnosing PTSD in former POWs presenting symptomatic complaints associated with this disorder are explored. Data collected on former POWs complaining of PTSD and diagnosed by DSM-III-R criteria revealed Minnesota Multiphasic Personality Inventory (MMPI) and Millon Clinical Multiaxial Inventory (MCMI) clinical profiles appropriate for clinical application. Comparative data between German-held and Japanese-held POWs experiencing PTSD and adjustment-related stressors are discussed. Import on clinical strategies with diagnosed patients suggests both behavioral approaches to treatment and future directions in research.,0,0 +4758,Aripiprazole: A clinical review of its use for the treatment of anxiety disorders and anxiety as a comorbidity in mental illness,"Although anxiety disorders are common, optimal treatment is elusive. More than half of anxiety patients treated with an adequate course of antidepressants fail to fully improve: treatment resistance, residual symptoms, and recurrence/relapse remain a challenge. Recently, atypical antipsychotics have been considered for treatment-resistant anxiety disorders. This review will explore the available data for the role of aripiprazole in the treatment of anxiety.PubMed and conference abstracts were searched for randomized, double-blind studies that investigated the efficacy of aripiprazole in anxiety; its efficacy in bipolar disorder and depression was also explored for comparison.A number of studies have shown atypical antipsychotics to be effective in anxiety, and currently available data suggest that aripiprazole augmentation in patients with anxiety disorders is likely as effective as other atypical antipsychotic drugs. Although there have been no randomized, controlled trials, aripiprazole has been found to be effective in treating anxiety disorders in two open-label trials. This combined with the larger data base demonstrating its utility in bipolar disorder and depression, its safety profile and its unique mechanism of action, make aripiprazole for anxiety an intriguing avenue of exploration.Data from large randomized, controlled trials on the use of atypical antipsychotics for anxiety in general, and aripiprazole in particular, are currently lacking.The results of open-label trials of aripiprazole in anxiety provide enough support to warrant its further study. This, combined with a larger data base demonstrating its utility in bipolar disorder and depression, its safety profile and its unique mechanism of action, make aripiprazole for anxiety an intriguing avenue of exploration.",0,0 +4759,Traumatic Loss and Major Disasters: Strengthening Family and Community Resilience,"This article presents the core principles and value of a family and community resilience-oriented approach to recovery from traumatic loss when catastrophic events occur. In contrast to individually based, symptom-focused approaches to trauma recovery, this multisystemic practice approach contextualizes the distress in the traumatic experience and taps strengths and resources in relational networks to foster healing and posttraumatic growth. The intertwining of trauma and traumatic losses is discussed. Key family and social processes in risk and resilience in traumatic loss situations are outlined. Case illustrations, model programs, and intervention guidelines are described in situations of community violence and major disasters to suggest ways to foster family and community resilience.",0,0 +4760,Childhood trauma exposure in Iraq and Afghanistan war era veterans: Implications for posttraumatic stress disorder symptoms and adult functional social support,"This study examined the relationship among childhood trauma, posttraumatic stress disorder (PTSD) symptoms, and adult social support in a large sample of veterans who served in the military after 09/11/2001, with a specific focus on the potential role of the PTSD avoidance and numbing cluster as intervening in the association between childhood abuse and adult functional social support.Participants were 1,301 veterans and active duty soldiers who have served in the military since 09/11/2001; a subsample of these participants (n=482) completed an inventory of current functional social support. Analyses included linear regression and nonparametric bootstrapping procedures.After controlling for combat exposure, exposure to childhood trauma was associated with PTSD symptoms in adulthood. Further, PTSD symptoms, and particularly PTSD avoidance/numbing cluster symptoms, intervened in the relationship between childhood trauma and adult functional social support.Findings support the association of childhood trauma (both abuse related and other, non-abuse related trauma) with PTSD symptoms in military personnel and veterans, even after accounting for combat exposure. Additionally, the avoidance and numbing symptom cluster of childhood trauma-based PTSD may be particularly salient in compromising one's subsequent ability to garner functional social support in adulthood.",0,0 +4761,MPI Profile Classifications and Associated Clinical Findings Among Litigating Motor Vehicle Collision Patients,"The purpose of this study was to examine differences in precollision, pericollision, and postcollision clinical variables across litigating motor vehicle collision (MVC) patients who were classified as Dysfunctional (DYS), Interpersonally Distressed (ID), or Adaptive Copers (ACs) based on Multidimensional Pain Inventory (MPI) profile classifications.A sample of 240 MVC patients who sustained serious physical injuries and experienced MVC-related chronic pain completed the MPI and provided responses to a semistructured psycholegal interview designed to elicit injury-related and pain-related symptoms and treatments, determine the presence and impact of precollision experiences, and render psychiatric diagnoses and ratings of psychological disability.A significant multivariate effect of MPI profile group on postcollision variables was revealed, with the DYS and ID groups reporting more pain sites than the AC group and the DYS group receiving more recommendations for treatment than the AC group. Larger proportions of the DYS and ID groups were diagnosed as experiencing major depressive disorder than the AC group. A rating of total psychological disability was applied most often to members of the ID group, with partial psychological disability applied most often to members of the DYS group, and no psychological disability applied most often to members of the AC group.This study extends the MPI literature by establishing the usefulness of the measure in determining those reports of MVC-related pain and emotional distress that are most likely to be associated with postcollision psychological disability. The current study supports the usefulness of MPI profile classifications in identifying MVC patients who are likely to require and benefit from intensive psychological and other rehabilitative interventions.",0,0 +4762,Nonlinear developmental trajectory of fear learning and memory,"The transition into and out of adolescence is a unique developmental period during which neuronal circuits are particularly susceptible to modification by experience. Adolescence is associated with an increased incidence of anxiety disorders in humans, and an estimated 75% of adults with fear-related disorders met diagnostic criteria as children and adolescents. Conserved neural circuitry of rodents and humans has facilitated neurodevelopmental studies of behavioral and molecular processes associated with fear learning and memory that lie at the heart of many anxiety disorders. Here, we review the nonlinear developmental aspects of fear learning and memory during a transition period into and out of adolescence and provide a discussion of the molecular mechanisms that may underlie these alterations in behavior. We provide a model that may help to inform novel treatment strategies for children and adolescents with fear-related disorders.",0,0 +4763,Main and Interactive Effects of Mental Contamination and Tolerance of Negative Emotions in Relation to Posttraumatic Stress Symptoms Following Sexual Trauma,"Mental contamination, an internal sense of dirtiness that originates in the absence of physical contact with a stimulus, has been implicated in the exacerbation of posttraumatic stress (PTS) symptoms following sexual trauma. In addition, evidence suggests that associations between PTS-related risk factors and PTS symptoms may depend on the degree to which one can tolerate experiencing negative emotions. To better understand the association between mental contamination and PTS symptoms, we examined main and interactive effects of mental contamination and tolerance of negative emotions in relation to PTS symptoms, including specific symptom clusters, in a community sample of women who experienced sexual trauma (N = 101). Tolerance of negative emotions moderated the association between mental contamination and PTS symptoms (total symptom severity, intrusion cluster, and cognitive/mood alterations cluster). These results indicate that difficulties tolerating negative emotions may be a necessary condition for mental contamination to relate to PTS symptoms following sexual trauma.",0,0 +4764,Differential Patterns of HPA Activity and Reactivity in Adult Posttraumatic Stress Disorder and Major Depressive Disorder,"Despite a number of overlapping symptoms, individuals with posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) often display hypothalamic-pituitary-adrenal (HPA) profiles that appear quite different from one another. This review describes the patterns of HPA-axis activity and reactivity in healthy individuals compared to individuals with these two disorders. Measures of HPA-axis activity and reactivity include cortisol levels at rest, in response to the dexamethasone suppression test (DST), and in response to psychological stress. The research reviewed presents the possibility of diagnostic specificity with regard to HPA function. In particular, the differential response pattern to the DST suggests that, while it cannot be considered a pure diagnostic tool, it should be one measure taken into consideration during diagnosis.",0,0 +4765,Life outcomes influenced by war-related experiences during the Gulf crisis,"This study examined the life outcomes of children exposed to the Gulf crisis in 1990-1991. We expected war-trauma exposure and psychological distress symptoms to predict poorer educational and occupational outcomes. Participants were 151 Kuwaiti citizens who were assessed during childhood (in 1993; M age = 10.6 years), and who were reassessed 10 years later in young adulthood (in 2003; M age = 21.2 years). Participants completed measures of intelligence, war-trauma exposure, posttraumatic stress symptoms, anxiety symptoms, depressive symptoms, intervening life events, and life outcomes. Results indicated that war-trauma exposure negatively impacted children's educational and occupational outcomes as young adults. Boys with higher levels of war-trauma exposure were less likely to attend University. Posttraumatic stress and anxiety symptoms also predicted poorer educational and occupational outcomes. However, this relationship was not significant when we accounted for children's intelligence. Depressive symptoms were not predictive of children's educational or occupational outcomes. Results suggest that war-trauma exposure may have life-altering effects on children. Tailored, early interventions are needed for children exposed to war traumas.",0,0 +4766,"Psychological Distress among Adolescents in Chengdu, Sichuan at 1 Month after the 2008 Sichuan Earthquake","A devastating earthquake occurred on May 12, 2008 in Sichuan, China. This study investigated the prevalence and factors in association with psychological problems among secondary school students living in Chengdu (90 km away from the disaster epicenter) in June 2008. In a cross-sectional survey, 3,324 secondary students self-administered a structured questionnaire in classroom setting. Validated scales were used in this study. Among all respondents, 22.3% reported post-traumatic stress disorder (PTSD); 22.6% were probable depression cases; 10.6% reported suicidal ideation; and 14.1% would like to receive psychological counseling. No gender differences were found. While social/emotional support from teachers or peers (OR from 0.40 to 0.78) and exposure to positive news reports (OR from 0.59 to 0.62) were found protective, prior experience of severe mental distress (OR from 1.60 to 2.68) and corporal punishment (OR from 1.31 to 1.58), worry about future aftershocks (OR from 1.64 to 3.11), absence from school when it was not closed (OR from 1.38 to 1.48), exposures to scary or sorrowful disaster media coverage (OR from 1.39 to 2.07), post-disaster visits to affected sites (OR from 1.51 to 1.59), separation from parents (OR = 1.61), etc., were risk factors predictive of some of the aforementioned psychological problems. Negative mental health impacts were prevalent among the respondents. Teachers, parents, and the mass media are all important in maintaining good mental health among adolescents that are indirectly affected by the severe earthquake. The results have important implications for earthquake preparedness and relief work in the future.",0,0 +4767,"Lifetime experiences, the brain and personalized medicine: An integrative perspective","The aim of personalized medicine is to base medical prevention and therapy on the unique health and disease susceptibility profile of each individual. Starting from this idea, we briefly discuss the meaning of the word 'personalized' before analyzing the practical content of personalized healthcare. From a medical perspective, knowledge of a person encompasses both biological and biographical perspectives. The latter includes significant events and experiences throughout the person's lifespan, from conception to the present, in which epigenetic influences play an important role. In practice, we believe personalized medicine should emphasize the development and maintenance of a healthy nervous system. The neurobiological processes involved here depend heavily on the psychosocial environment, in particular the presence of responsible, caring adults and integration in a reasonably fair society. A healthy brain subsequently promotes good health throughout life, both through direct, favorable influences on the body's intrinsic biological pathways, and indirectly by enabling the person to engage in supportive relationships, make wise decisions and take good care of him/herself. From a public health perspective, we conclude that hi-tech personalized medicine based on detailed bio-molecular mapping, monitoring and tailored drug interventions holds promise only as part of a wider, socio-culturally informed approach to the person.",0,0 +4768,PTSD among Israeli former prisoners of war and soldiers with combat stress reaction: a longitudinal study,"The aim of this study was to assess the long-term impact of war captivity and combat stress reaction on rates of posttraumatic stress disorder (PTSD) in Israeli veterans of the 1973 Yom Kippur war.One hundred sixty-four former prisoners of war (POWs), 112 veterans who had had combat stress reaction, and 184 combat veteran comparison subjects filled out the PTSD Inventory, a self-report scale based on the DSM-III-R criteria for PTSD. The inventory diagnoses past and present PTSD, assesses its intensity, and provides a symptom profile.Thirty-seven percent of the veterans who had had combat stress reaction, 23% of the former POWs, and 14% of the comparison subjects had had diagnosable PTSD at some time in the past. The current rates were 13%, 13%, and 3%, respectively. The results showed different recovery rates over time: almost two-thirds of the veterans with combat stress reaction who had had PTSD in the past recovered, while less than one-half of the POW group showed this improvement.These findings indicate that small but significant proportions of the POWs and veterans with combat stress reaction were still suffering from PTSD almost two decades after the war. The different recovery rates in the two groups may reflect the differences in duration and severity of stressors, the impact of immediate intervention on long-term adjustment, or both.",0,0 +4769,Late-onset posttraumatic stress disorder following a disaster: A longitudinal study.,"In disaster survivors, the occurrence of mental health problems beyond the immediate aftermath of the disaster has repeatedly been reported. The aim of the present study was to evaluate the course of symptoms and mental health services (MHS) utilization in late-onset posttraumatic stress disorder (PTSD) four years following a disaster and to examine whether late-onset PTSD can be explained within a longitudinal framework of PTSD. Residents affected by a fireworks disaster (N 1083) participated in surveys 2–3 weeks (T1), 18 months (T2), and almost 4 years (T3) following the disaster. PTSD was assessed at T2 and T3. Participants endorsing disaster-related late-onset PTSD (PTSD at T3 only) were compared to participants endorsing persistent PTSD (at both T2 and T3), recovered PTSD (at T2 only), and no PTSD using latent growth modeling and multinomial logistic regression. Participants endorsing late-onset PTSD comprised 4% of the total sample. They reported high initial intrusion and avoidance and experienced progression of avoidance/numbing and hyperarousal symptoms. They were more likely than all other participants to use MHS at T3. Late-onset PTSD was associated with high education level, severe disaster exposure, number of reported stressful life events, and perceived lack of social support. These results suggest that individuals with late-onset PTSD are likely to endorse prodromal distress, but experience clinically relevant symptom progression leading to increased MHS utilization. Stressful life events and perceived lack of social support may contribute to PTSD symptom progression. Foreseeable stressors in the aftermath of a disaster may be a target for secondary prevention of late-onset PTSD.",0,0 +4770,The Impact of Adverse Life Events on Clinical Features and Interaction with Gene Variants in Mood Disorder Patients,"<b><i>Background:</i></b> Adverse life events are precipitating and maintenance factors for mood and anxiety disorders. However, the impact of such events on clinical features and treatment response is still unclear. <b><i>Sampling and Methods:</i></b> The aim of this study was to investigate whether specific adverse events (early parental loss and physical abuse) influence clinical features in a sample of 1,336 mood disorder patients, and whether genetic parameters interact with adverse events to influence treatment outcomes in a subsample of 252 subjects. Participants were collected in the context of a European multicenter study and treated with antidepressants at adequate doses for at least 4 weeks. We focused on two genes (BDNF and CREB1) due to prior evidence of association with treatment outcomes in the same sample. <b><i>Results:</i></b> Patients with a history of physical abuse had higher suicidal risk (including history of attempts), comorbid panic disorder, posttraumatic stress disorder and alcohol dependence compared to non-abused patients. Experience of early parental loss was a less detrimental type of life stressor. Treatment response was not affected by adverse events. No gene-environment interaction was found with genetic variations, using a corrected significance level. <b><i>Conclusions:</i></b> A limitation of the present study is that the subsample is too small for detecting gene-environment interactions. The clinical message of our findings is that mood disorder patients with a history of physical abuse showed a worse clinical profile, characterized by higher comorbid Axis I psychopathology and increased suicidal behavior.",0,0 +4771,"Association of trauma exposure with psychiatric morbidity in military veterans who have served since September 11, 2001","This study examined the association of lifetime traumatic stress with psychiatric diagnostic status and symptom severity in veterans serving in the US military after 9/11/01.Data from 356 US military veterans were analyzed. Measures included a standardized clinical interview measure of psychiatric disorders, and paper-and-pencil assessments of trauma history, demographic variables, intellectual functioning, posttraumatic stress disorder (PTSD) symptoms, depression, alcohol misuse, and global distress.Ninety-four percent of respondents reported at least one traumatic stressor meeting DSM-IV criterion A for PTSD (i.e., life threatening event to which the person responded with fear, helplessness or horror), with a mean of four criterion A traumas. Seventy-one percent reported serving in a war-zone, with 50% reporting occurrence of an event meeting criterion A. The rate of current psychiatric disorder in this sample was: 30% PTSD, 20% major depressive disorder, 6% substance abuse or dependence and 10% for the presence of other Axis I psychiatric disorders. After accounting for demographic covariates and combat exposure, childhood physical assault and accident/disasters were most consistently associated with increased likelihood of PTSD. However, PTSD with no comorbid major depressive disorder or substance use disorder was predicted only by combat exposure and adult physical assault. Medical/unexpected-death trauma and adult physical assault were most consistently associated with more severe symptomatology.Particular categories of trauma were differentially associated with the risk of psychiatric diagnosis and current symptom severity. These findings underscore the importance of conducting thorough assessment of multiple trauma exposures when evaluating recently post-deployed veterans.",0,0 +4772,Regional cerebral blood flow during auditory recall in 47 subjects exposed to assaultive and non–ssaultive trauma and developing or not posttraumatic stress disorder,"Objective: Psychological trauma leads to posttraumatic stress disorder (PTSD) in susceptible subjects. The aim of this study was to investigate the differences in regional cerebral blood flow (rCBF) between two groups of subjects exposed to different types of traumatic stressor either developing or not developing PTSD. Method: Twenty subjects developing (S) and 27 not developing (NS) PTSD after being exposed to either earlier person-under-the- train accident (NA) or being assaulted in the underground environment (A) were included in the study. 99mTc-HMPAO SPECT was performed and the uptake in 29 regions of the brain (VOIs), bilaterally, was assessed. rCBF distribution was compared, using analysis of variance (ANOVA), between groups (S/NS) and type (A/NA) during a situation involving an auditory evoked re-experiencing of the traumatic event. Discriminant analysis was applied to test the concordance between clinical diagnosis and SPECT findings. Results: In the general analyses significant differences were found between groups and types and there was a significant hemisphere null type interaction. S showed higher CBF than NS and so did A as compared to NA, particularly in the right hemisphere. Discriminant analysis correctly classified 66% of cases (p < 0001) in testing S/NS and 72% (p < 0001) in testing NA/A. Conclusions: Under recall of their traumatic experience we found higher relative CBF distribution values in S as compared to NS. CBF was higher in the right hemisphere and particularly in assaulted subjects. These findings underscore the role upon trauma recall of both the right hemisphere and the nature of the stressing event.",0,0 +4773,Frontal brain asymmetry in depression with comorbid anxiety: A neuropsychological investigation.,"The approach-withdrawal model posits that depression and anxiety are associated with a relative right asymmetry in frontal brain activity. Most studies have tested this model using measures of cortical brain activity such as electroencephalography. However, neuropsychological tasks that differentially use left versus right frontal cortical regions can also be used to test hypotheses from the model. In two independent samples (Study 1 and 2), the present study investigated the performance of currently depressed individuals with or without a comorbid anxiety disorder and healthy controls on neuropsychological tasks tapping primarily left (verbal fluency) or right (design fluency) frontal brain regions. Across both samples, results indicated that comorbid participants performed more poorly than depressed only and control participants on design fluency, while all groups showed equivalent performance on verbal fluency. Moreover, comorbid participants showed ""asymmetrical"" performance on these two tasks (i.e., poorer design [right frontal] relative to verbal [left frontal] fluency), whereas depressed only and control participants showed approximately symmetrical profiles of performance. Results from these two samples suggest an abnormal frontal asymmetry in neurocognitive performance driven primarily by right frontal dysfunction among anxious-depressed individuals and highlight the importance of considering comorbid anxiety when examining frontal brain functioning in depression.",0,0 +4774,Predictors of Posttraumatic Stress in Parents of Children Diagnosed with a Disorder of Sex Development,"The aims of the current study were twofold: (1) to assess the prevalence/severity of posttraumatic stress symptoms (PTSS) as well as cognitive and emotional responses in parents whose children were diagnosed with a disorder of sex development (DSD); and (2) to assess factors which contributed to PTSS. We hypothesized that parents would show elevated levels of PTSS and that negative cognitive and/or emotional responses would be predictive. Participants were parents of children diagnosed with a DSD. Thirty-six mothers and 11 fathers completed a measure of posttraumatic stress and reported difficulties in the domains of cognition (e.g.; confusion) and emotion (e.g.; grief). Using multiple regression, we determined factors contributing to parental PTSS. Reported PTSS was high: 31 % of mothers and 18 % of fathers met the threshold for caseness for Posttraumatic Stress Disorder. Regression included: child sex, parent sex, child age at diagnosis, years since diagnosis, genital ambiguity, father occupation, cognitive confusion, and emotional distress. Only cognitive confusion contributed significantly to variance in PTSS. Parents of children with DSD may experience the diagnosis as traumatic, evidenced by high rates of PTSS in the current report. Assessment of reactions to their children's diagnoses revealed that cognitive confusion, and not emotional distress, predicted PTSS. In this case, direct cognitive interventions may be applicable. Though psychological support is widely recommended, no detailed intervention has been offered. Our findings suggest that we may directly apply models successful in other areas of pediatrics, such as pediatric oncology. Future studies may assess the usefulness of such an intervention. © 2013 Springer Science+Business Media New York.",0,0 +4775,Memories of pain after burn injury—The patients’ experience,"Pain after burns is a major clinical problem and researchers continue to report that burn pain remains undertreated. Adequate pain management could contribute to the prevention of posttraumatic stress disorder and can give a growing sense of patient's self-confidence and strength. Freedom from pain might be unrealistic, but the objective should be to reduce pain as much as possible. The purpose of this study was to describe burn patient's experiences and memories of pain during burn care and to acquire a deeper understanding of how patients cope with the experience. The study method was qualitative and interviews were conducted with 12 adult burn patients (eight men and four women) 6 to 12 months postburn (mean = 7 months). The mean burn size for the group was 10.6% mean of TBSA and the mean stay in hospital was 16 days. The interviews were analyzed using Kvale's method for structuring analysis. The patient's experiences and memories of pain during the trajectory of care were clearly described by the informants during the interviews. Four themes were identified for pain: becoming aware of pain, allowing oneself to feel pain, different pain experiences, and fragile body surface. Four themes were identified for coping: pragmatic coping, allowing someone to care for you, carrying the pain, and perspectives on the trauma. Both good and bad memories were recorded during the care trajectory, and it is evident that the patient has to carry the pain experience by themselves to a large extent. © 2010 by the American Burn Association.",0,0 +4776,Post-traumatic stress disorder: A review for the general psychiatrist,"Post-traumatic stress disorder affects about one in every hundred of the population at any particular time. Aetiological factors include genetics, personality, a background of psychiatric problems, the personal meaning of the traumatic event, issues of proximity or intensity, childhood abuse, and the initial emotional response to stress. Many precipitants are known, ranging from combat through rape or torture to difficult parturition. Core symptoms are reflective of the traumatic precipitant. Prolonged symptoms are associated with prior psychiatric or physical problems, poverty, repeated assault, alcohol or drug abuse, and cultural factors. Co-morbidity is high, especially for depression, alcohol and drug misuse. Reduced hippocampal volume, corticosteroid abnormalities, and adrenergic overactivity have been described. The use of official criteria and specific measuring instruments help in differential diagnosis. Management needs to be tailored to the needs of the individual and the stage of the disorder, and includes psychotherapy, antidepressants, and the newer eye-movement desensitization and reprocessing approach. ( Int J Psych Clin Pract 2001; 5:11-18).",0,0 +4777,Assessing the Latent Factor Association Between the Dysphoria Model of PTSD and Positive and Negative Affect in Trauma Victims from India,"The recent release of the DSM-5 comes with the division of posttraumatic stress disorder (PTSD) symptoms across four symptom clusters (American Psychiatric Association, 2013). This division is based on the support garnered by two four-factor models; Emotional Numbing (King et al., 1998) and Dysphoria (Simms et al., 2002) and a five-factor model; Dysphoric Arousal (Elhai et al., 2011). Much debate centered on the validity of the Dysphoria factor as a non-specific factor of PTSD within the Dysphoria model. In line with this, we assessed relations between the four factors of the Dysphoria model (Simms et al., 2002) and positive (PA) and negative affect (NA) in natural disaster victims (N = 200) from Leh, India, using the PTSD checklist (PCL-S) and Positive and Negative Affect Schedule (PANAS short form). Confirmatory factor analysis was implemented to assess the best-fitting model for both the PCL (PTSD) and the PANAS (affect). Two optimal models (the Dysphoria model and a two-factor model for affect) were subsequently used to assess latent variable associations across constructs. It was hypothesized that differential associations between latent factors would be evident with the Dysphoria factor being highly correlated with negative affect compared to alternative PTSD factors. Significant correlations were found between factors of the Dysphoria model and NA (0.52-0.65, p < 0.001). Comparing the association of pairs of PTSD factors with NA and PA, Wald's tests revealed that no single PTSD factor was more related to NA than the other. Avoidance and Hyperarousal factors were correlated with PA. Results are discussed in line with literature questioning Dysphoria factor's unique association with general distress. © 2014 Springer Science+Business Media New York.",0,0 +4778,Attentional interference by threat and post-traumatic stress disorder: the role of thought control strategies.,"Attentional interference by threat is associated with PTSD, but the mechanisms of this relationship remain unclear. Attentional interference might be related to increased use of maladaptive thought control strategies, such as suppressing unwanted thoughts (thought suppression) or replacing threatening thoughts with everyday concerns (worry), which increase PTSD risk. Conversely, attentional interference might be associated with reduced use of adaptive strategies, such as talking about threatening thoughts (social control), which decrease PTSD risk. This study tested if thought control strategies mediate the relationship between attentional interference and PTSD. Sixty-one male Vietnam-era veterans completed measures of PTSD symptoms and thought control strategies. Participants also completed a Visual Search Task measuring attentional interference, which required participants to identify a target letter string among a group of threat or neutral words. Attentional interference by threat was related to PTSD symptoms, and mediation analyses revealed significant indirect effects of attentional interference through thought suppression and worry. Attentional interference was related to re-experiencing and avoidance, but not hyperarousal, symptom clusters. Thought suppression was a unique mediator for re-experiencing, whereas thought suppression and worry both mediated the relationship with avoidance. These results offer evidence for maladaptive thought control strategies as a mechanism linking attentional biases for threat to PTSD.",0,0 +4779,Antisocial behavior and the combat veteran. A review (with special reference to the Vietnam conflict).,"The popular image of the Vietnam veteran, reinforced by such movies as Rambo and sensational press reporting, is that of a poorly controlled, impulsively violent character with a criminal record and a history of heroin addiction and alcoholism. Such a profile has also been regularly described in clinical studies of veterans receiving psychiatric attention and is congruent with the prevailing attitude of suspicion and mistrust towards the returning warrior reported in the anthropological, psychoanalytic, and historical literatures. Defense lawyers have increasingly advanced allegedly war-caused psychiatric disturbances as a defense for their veteran-clients' criminal behaviors. However, there is now considerable evidence from controlled studies that Vietnam veterans' levels of drug addiction, alcoholism, violence, criminal convictions, and suicide are no different from those manifested by young men from similar socioeconomic backgrounds who have not seen military service. This paper reviews these studies and cautions that excessive attention paid by the medical and legal professions to the high profile deviant behavior of a small and atypical group of the veteran population will defect attention from the unobtrusive, but disabling, readjustment difficulties faced by many more of their peers.",0,0 +4780,Investigating the Construct of Trauma-Related Acquired Callousness Among Delinquent Youth: Differences in Emotion Processing,"This study tested theories regarding differences in emotion processing among youth characterized by primary versus acquired callous-unemotional (CU) traits in a sample of 417 detained adolescents (306 boys, 111 girls). Mixture modeling identified 2 groups of youth high in CU, but with different levels of posttraumatic stress symptoms consistent with theoretical conceptualizations of acquired CU as being linked to trauma. Differences between the 2 groups of youth were investigated regarding 3 dimensions of emotion processing: emotion regulation, numbing, and recognition. Compared to youth classified in the primary group, youth classified as acquired CU demonstrated greater difficulty with lack of clarity (OR = 0.53), and nonacceptance of emotions, (OR = 0.57), general numbing of emotions (OR = 0.87), and recognition of disgust (OR = 0.18). Differences in emotion processing reported by youth in the 2 groups are consistent with theories regarding acquired callousness as related to emotional detachment in the aftermath of posttraumatic distress. The results of the current study have implications for the classification of primary and acquired CU, as well as the clinical treatment of youth with these characteristics.",0,0 +4781,Symptom Profiles in Depersonalization and Anxiety Disorders: An Analysis of the Beck Anxiety Inventory,"Background: Depersonalization disorder (DPD) entails distressing alterations in self-experiencing. However, it has long been recognized that depersonalisation symptoms occur in other disorders, particularly anxiety and panic. One strand of research proposes that depersonalization phenomenology arises through altered autonomic arousal in response to stress. Sampling and Methods: We sought to examine profiles of anxiety symptoms through a secondary data analysis of individual items and factor subscales on the Beck Anxiety Inventory (BAI), comparing two relatively large patient samples with DPD or with a variety of anxiety conditions, respectively. The DPD sample (n = 106) had a lower overall BAI score than the combined anxiety disorders group (n = 525). Results: After controlling for this as well as for potential confounders such as age and gender, the DPD group presented significantly lower scores on the panic subscale, marginally lower scores on the autonomic subscale and significantly higher scores on the neurophysiological subscale of the BAI. Conclusions: These differences imply similarities between the cognitive components of DPD and anxiety disorders while physiological experiences diverge. The findings encourage future research looking at direct physiological measures and longitudinal designs to confirm the mechanisms underlying different clinical manifestations of anxiety.",0,0 +4782,Does Memory of a Traumatic Event Increase the Risk for Posttraumatic Stress Disorder in Patients With Traumatic Brain Injury? A Prospective Study,"The present study examined prospectively the relationship between memory of the traumatic event and subsequent development of posttraumatic stress disorder (PTSD). More specifically, the aims of this study were to 1) investigate the possibility that lack of memory of the traumatic event might be a protective factor; 2) assess whether memory of the traumatic event equally affects the three symptom clusters of PTSD: reexperiencing, avoidance, and hyperarousal; and 3) explore the predictive value of memory of the traumatic event for the development of subsequent PTSD in the immediate aftermath of the event.One hundred twenty subjects with mild traumatic brain injury who were hospitalized for observation were assessed immediately after the trauma and followed up 1 week, 3 months, and 6 months later. All participants underwent psychiatric evaluation and self-assessment of their memory of the traumatic event.Overall, 17 (14%) of the participants met full criteria for PTSD at 6 months. Subjects with memory of the traumatic event were significantly more likely to develop PTSD than those without memory of the traumatic event; the difference between the groups resulted primarily from the reexperiencing cluster. Logistic regression analysis revealed that memory of the traumatic event within the first 24 hours is a strong predictor of PTSD 6 months after the event.Our study indicated that memory of a traumatic event is a strong predictor and a potential risk factor for subsequent development of PTSD. Future studies are needed to show whether these findings can be generalized to other traumatic conditions.",0,0 +4783,Traumatic Stress after Childbirth: The Role of Obstetric Variables,"In a sample of 1550 recently delivered women, traumatic stress after childbirth was studied in relation to obstetric variables. A post-traumatic stress disorder (PTSD) symptom profile and traumatic stress symptoms were assessed by means of the Traumatic Event Scale (TES). Obstetric data comprised delivery mode, duration of the second stage of labor (the time from cervical dilation of 10 cm to partus) and the use of analgesia/anesthesia. Traumatic stress symptoms and having a PTSD symptom profile were both significantly related to the experience of an emergency cesarean section or an instrumental vaginal delivery. It is of clinical importance, however, that most women with a PTSD symptom profile were found in the normal vaginal delivery group (NVD). This implies that a normal vaginal delivery can be experienced as traumatic, just as an emergency cesarian section is not necessarily traumatic. Traumatic stress symptoms were neither substantially correlated to the duration of the second stage of labor, nor to the use of analgesia/anesthesia.",0,0 +4784,Attachment Bases of Emotion Regulation and Posttraumatic Adjustment.,,0,0 +4785,The Toronto General Hospital Transitional Pain Service: development and implementation of a multidisciplinary program to prevent chronic postsurgical pain,"Chronic postsurgical pain (CPSP), an often unanticipated result of necessary and even life-saving procedures, develops in 5-10% of patients one-year after major surgery. Substantial advances have been made in identifying patients at elevated risk of developing CPSP based on perioperative pain, opioid use, and negative affect, including depression, anxiety, pain catastrophizing, and posttraumatic stress disorder-like symptoms. The Transitional Pain Service (TPS) at Toronto General Hospital (TGH) is the first to comprehensively address the problem of CPSP at three stages: 1) preoperatively, 2) postoperatively in hospital, and 3) postoperatively in an outpatient setting for up to 6 months after surgery. Patients at high risk for CPSP are identified early and offered coordinated and comprehensive care by the multidisciplinary team consisting of pain physicians, advanced practice nurses, psychologists, and physiotherapists. Access to expert intervention through the Transitional Pain Service bypasses typically long wait times for surgical patients to be referred and seen in chronic pain clinics. This affords the opportunity to impact patients' pain trajectories, preventing the transition from acute to chronic pain, and reducing suffering, disability, and health care costs. In this report, we describe the workings of the Transitional Pain Service at Toronto General Hospital, including the clinical algorithm used to identify patients, and clinical services offered to patients as they transition through the stages of surgical recovery. We describe the role of the psychological treatment, which draws on innovations in Acceptance and Commitment Therapy that allow for brief and effective behavioral interventions to be applied transdiagnostically and preventatively. Finally, we describe our vision for future growth.",0,0 +4786,"Differentiating army suicide attempters from psychologically treated and untreated soldiers: A demographic, psychological and stress-reaction characterization","Suicide is the leading cause of death in most armies during peace-time. The recent dramatic rise in suicides in the US Army further focuses attention on the causes of suicidal behavior in the military.This study investigated demographic characteristics, psychological profile and stress-related risk factors associated with suicide attempts in Israelis aged 18-21 years, who served in the Army in 2009. Soldiers who attempted suicide (N=60) were compared to soldiers treated by a mental health professional, but reported no suicidal behavior (N=58), and to controls (N=50).Suicide attempters had lower socioeconomic status and less cognitive ability compared with treated soldiers and untreated control soldiers. Only 25% of the suicide attempters had received mental healthcare prior to the attempt. The majority of the attempts were non-lethal (86.2%), and only 5.2% used firearms. Attempters had more previous suicide attempts (37.9%) and deliberate selfharm incidents (19.3%), compared to almost no such behaviors in the other two groups. Following the suicide attempt, 77% were diagnosed with moderate to severe mental disorders, 44.8% personality disorders and 8.6% mood disorders. Attempters reported higher levels of general stress compared to their peers in the other two groups. Being away from home and obeying authority were especially more stressful in attempters.Young soldiers are less prone to seek mental health assistance, despite suffering from higher levels of stress. Screening is required to detect soldiers at risk for suicidal behavior and preventive intervention will require active outreach.",0,0 +4787,"Exposure therapy for post-traumatic stress disorder: Its relative efficacy, limitations and optimal application","Abstract Post-traumatic stress disorder (PTSD) is a very debilitating psychological disturbance that follows the experience of traumatic events. Exposure therapy has shown good treatment efficacy in earlier treatment outcome studies on PTSD. Only a few other behavioral treatments have shown equal effectiveness, and exposure is usually a necessary treatment component in the others. This paper presents a short review of controlled treatment outcome studies on PTSD. The relative efficacy of exposure therapy compared to other treatments is discussed and factors that can hinder and enhance its effectiveness are reviewed. In the discussion section some methodological pitfalls in the treatment outcome studies are discussed.",0,0 +4788,In-Person and Video-Based Post-Traumatic Stress Disorder Treatment for Veterans: A Location–Allocation Model,"Post-traumatic stress disorder (PTSD) is associated with poor health but there is a gap between need and receipt of care. It is useful to understand where to optimally locate in-person care and where video-based PTSD care would be most useful to minimize access to care barriers, care outside the Veterans Affairs system, and total costs. We developed a service location systems engineering model based on 2010 to 2020 projected care needs for veterans across New England to help determine where to best locate and use in-person and video-based care. This analysis determined specific locations and capacities of each type of PTSD care relative to patient home locations to help inform allocation of mental health resources. Not surprisingly Massachusetts, Connecticut, and Rhode Island are well suited for in-person care, whereas some rural areas of Maine, Vermont, and New Hampshire where in-patient services are infeasible could be better served by video-based care than external care, if the latter is even available. Results in New England alone suggest a potential $3,655,387 reduction in average annual total costs by shifting 9.73% of care to video-based treatment, with an average 12.6 miles travel distance for the remaining in-person care.",0,0 +4789,Elucidating dimensions of posttraumatic stress symptoms and their functional correlates in disaster-exposed adolescents,"The aim of this study was to elucidate the dimensional structure of posttraumatic stress disorder (PTSD) and potential moderators and functional correlates of this structure in disaster-affected adolescents. A population-based sample of 2000 adolescents aged 12-17 years (M = 14.5 years; 51% female) completed interviews on post-tornado PTSD symptoms, substance use, and parent-adolescent conflict between 4 and 13 months (M = 8.8, SD = 2.6) after tornado exposure. Confirmatory factor analyses revealed that all models fit well but a 5-factor dysphoric arousal model provided a statistically significantly better representation of adolescent PTSD symptoms compared to 4-factor dysphoria and emotional numbing models. There was evidence of measurement invariance of the dysphoric arousal model across gender and age, although girls and older adolescents aged 15-17 years had higher mean scores than boys and younger adolescents aged 12-14 years, respectively, on some PTSD dimensions. Differential magnitudes of association between PTSD symptom dimensions and functional correlates were observed, with emotional numbing symptoms most strongly positively associated with problematic substance use since the tornado, and dysphoric arousal symptoms most strongly positively associated with parent-adolescent conflict; both correlations were significantly larger than the corresponding correlations with anxious arousal. Taken together, these results suggest that the dimensional structure of tornado-related PTSD symptomatology in adolescents is optimally characterized by five separate clusters of re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal symptoms, which showed unique associations with functional correlates. Findings emphasize that PTSD in disaster-exposed adolescents is not best conceptualized as a homogenous construct and highlight potential differential targets for post-disaster assessment and intervention.",0,0 +4790,"AGE, CRIMINAL CAREERS, AND POPULATION HETEROGENEITY: SPECIFICATION AND ESTIMATION OF A NONPARAMETRIC, MIXED POISSON MODEL*","This article addresses three issues that are central to the criminal career debate. First, is the life course of individual offending patterns marked by distinctive periods of quiescence? Second, at the level of the individual, do offending rates vary systematically with age? In particular, is the age-crime curve single peaked or flat? Third, are chronic offenders different from less active offenders? Do offenders themselves differ in systematic ways? Using a new approach to the analysis of individual criminal careers—based on nested, mixed Poisson models in which the mixing distribution is estimated nonparametrically—we analyze a panel data set that tracks a sample of males for more than 20 years. Our results provide empirical evidence in support of some features of criminal propensity theory and some in support of conventional criminal careers theory. In support of latent-trait criminal propensity theory, the individual-level average offense rate (per unit of time) varies as a function of observable individual-level characteristics and unobservable heterogeneity among individuals, and the age trajectory of the offense rate is generally single peaked rather than flat. On the other hand, in support of conventional criminal careers theory, models that incorporate a parameter that permits periods of active as well as inactive offending across age have greater explanatory power than those that do not. In addition, the nonparametric, discrete approximation to the population distribution of unobservable heterogeneity in the individual-level mean offense rate facilitates identification of four classes of offenders—nonoffenders as well as individual-level characteristics that are unique to each group. Problems of theoretical explanation and empirical generalizability of these results are described.",0,0 +4791,Unmet mental health care need 10–11 years after the 9/11 terrorist attacks: 2011–2012 results from the World Trade Center Health Registry,"There is little current information about the unmet mental health care need (UMHCN) and reasons for it among those exposed to the World Trade Center (WTC) terrorist attacks. The purpose of this study was to assess the level of UMHCN among symptomatic individuals enrolled in the WTC Health Registry (WTCHR) in 2011-2012, and to analyze the relationship between UMHCN due to attitudinal, cost, and access factors and mental health symptom severity, mental health care utilization, health insurance availability, and social support.The WTCHR is a prospective cohort study of individuals with reported exposure to the 2001 WTC attacks. This study used data from 9,803 adults who completed the 2003-2004 (Wave 1) and 2011-2012 (Wave 3) surveys and had posttraumatic stress disorder (PTSD) or depression in 2011-2012. We estimated logistic regression models relating perceived attitudinal, cost and access barriers to symptom severity, health care utilization, a lack of health insurance, and social support after adjusting for sociodemographic characteristics.Slightly more than one-third (34.2%) of study participants reported an UMHCN. Symptom severity was a strong predictor of UMHCN due to attitudinal and perceived cost and access reasons. Attitudinal UMHCN was common among those not using mental health services, particularly those with relatively severe mental health symptoms. Cost-related UMHCN was significantly associated with a lack of health insurance but not service usage. Access-related barriers were significantly more common among those who did not use any mental health services. A higher level of social support served as an important buffer against cost and access UMHCN.A significant proportion of individuals exposed to the WTC attacks with depression or PTSD 10 years later reported an UMHCN, and individuals with more severe and disabling conditions, those who lacked health insurance, and those with low levels of social support were particularly vulnerable.",0,0 +4792,Parenting burn-injured children in India: A grounded theory study,"Burn injury is one of the major traumas that a child can experience. Parents of burn-injured children experience anxiety, depression, guilt and post traumatic stress disorders as they care for their burn-injured children. Such empirical evidence related to effects of burns on parents and parenting process is unavailable from low and middle income countries like India.The aim of the study was to discover the process of parenting burn-injured children in India. The objective of this paper is to present one of the substantive processes ""Enduring the Blame"" that emerged from the data.Constructivist grounded theory methodology was used to explore the experiences of parenting burn-injured children.The study was conducted through a tertiary hospital that provided advanced paediatric burn care in a town in South India.Nine mothers, nine fathers, three grandmothers and one aunt from 12 families of children who were 15 years or younger and had sustained greater than 20% total body surface burns were purposively included.Twenty-two semi structured individual or family interviews were conducted in Tamil over a period of one year. The interview started with an overview question and then was followed by trigger questions as the participants shared their experiences. Second interviews were conducted with three participants in three families for theoretical saturation purposes.Mothers and fathers encountered blame from family members, health professionals, strangers, and their burn-injured children along the burn injury trajectory. They suffered double trauma of their child's burn and the blame. Parenting their burn-injured child involved a process of ""Enduring the Blame."" Enduring the Blame included four stages: internalizing blame, submitting to blame, rising above blame, and avoiding blame.Encouraging and assisting parents in caring for their children instead of blaming is a vital component of paediatric burn care. Parents will benefit from ongoing assessment and psychological interventions that will provide emotional support. Studying the perceptions of health professionals and the burn-injured children will help in further clarification of blame related issues and developing a parenting theory.",0,0 +4793,Sex Differences in the Experience of Unwanted Sexual Attention and Behaviors During Childhood,"Girls receive considerable amounts of unwanted sexual attention (UWSA) and behaviors (UWSB). Less is known about boys' unwanted sexual experiences. The primary goal of this study was to obtain a descriptive profile of the types and perpetrators of childhood UWSA/B. Secondary goals were to examine sex differences in emotional reactions to UWSA/B and influence of perpetrator. As many as 100 male and 100 female undergraduates completed the Exposure to Sexual Attention Scale and the Emotional Reaction Checklist. Results indicated that the majority of participants experienced UWSA/B during childhood, with females reporting higher rates of UWSB than males. Sex differences were also observed regarding types of perpetrators and emotional reactions. Findings are discussed as they relate to the sociocultural norms in which children are reared.",0,0 +4794,Is prolonged grief distinct from bereavement-related posttraumatic stress?,"Prolonged grief disorder (PGD) (previously called complicated grief (CG)) is proposed as a distinct post loss syndrome, with its own core symptoms. A key issue concerning the diagnostic validity of PGD is whether it can reliably be distinguished from related psychiatric outcomes following bereavement. This study therefore sought to determine whether the core symptoms of PGD could be distinguished from those of bereavement-related anxiety, depression and posttraumatic stress disorder (PTSD). Data were derived from a community sample of 223 bereaved adults in Croatia. PGD symptomatology was measured using the Revised Inventory of Complicated Grief. Depression and anxiety symptoms were measured using the Beck Depression and Anxiety Inventories, respectively. The intrusion and avoidance symptoms of PTSD were assessed using the Revised Impact of Event Scale. The distinctiveness of the five symptom clusters was examined using principal component analysis (PCA). Symptoms of prolonged grief, depression, anxiety, PTSD-intrusion, and PTSD-avoidance clustered together into five distinct factors. These results support the phenomenological distinctiveness of prolonged grief symptoms, from those of bereavement-related anxiety, depression and, for the first time, PTSD.",0,0 +4795,Acute effects of trauma-focused research procedures on participant safety and distress,"The ethical conduct of research on posttraumatic stress disorder (PTSD) requires assessing the risks to study participants. Some previous findings suggest that patients with PTSD report higher distress compared to non-PTSD participants after trauma-focused research. However, the impact of study participation on participant risk, such as suicidal/homicidal ideation and increased desire to use drugs or alcohol, has not been adequately investigated. Furthermore, systematic evaluation of distress using pre- and post-study assessments, and the effects of study procedures involving exposure to aversive stimuli, are lacking. Individuals with a history of PTSD (n=68) and trauma-exposed non-PTSD controls (n=68) responded to five questions about risk and distress before and after participating in research procedures including a PTSD diagnostic interview and a behavioral task with aversive stimuli consisting of mild electrical shock. The desire to use alcohol or drugs increased modestly with study participation among the subgroup (n=48) of participants with current PTSD. Participation in these research procedures was not associated with increased distress or participant risk, nor did study participation interact with lifetime PTSD diagnosis. These results suggest some increase in distress with active PTSD but a participant risk profile that supports a favorable risk-benefit ratio for conducting research in individuals with PTSD.",0,0 +4796,Fully conditional specification in multivariate imputation,"The use of the Gibbs sampler with fully conditionally specified models, where the distribution of each variable given the other variables is the starting point, has become a popular method to create imputations in incomplete multivariate data. The theoretical weakness of this approach is that the specified conditional densities can be incompatible, and therefore the stationary distribution to which the Gibbs sampler attempts to converge may not exist. This study investigates practical consequences of this problem by means of simulation. Missing data are created under four different missing data mechanisms. Attention is given to the statistical behavior under compatible and incompatible models. The results indicate that multiple imputation produces essentially unbiased estimates with appropriate coverage in the simple cases investigated, even for the incompatible models. Of particular interest is that these results were produced using only five Gibbs iterations starting from a simple draw from observed marginal distributions. It thus appears that, despite the theoretical weaknesses, the actual performance of conditional model specification for multivariate imputation can be quite good, and therefore deserves further study. © 2006 Taylor & Francis.",0,0 +4797,Prevalence and correlates of heavy smoking in Vietnam veterans with chronic posttraumatic stress disorder,"A study was conducted to investigate smoking patterns in 445 Vietnam veterans with and without posttraumatic stress disorder (PTSD). Combat veterans with PTSD reported similar occurrence of smoking (53%) compared to combat veterans without PTSD (45%). For those who smoked, combat veterans with PTSD reported a significantly higher rate of heavy smoking (> or = 25 cigarettes daily): 28% of combat veterans without PTSD were heavy smokers and 48% of combat veterans with PTSD were heavy smokers. PTSD diagnosis and heavy smoking status were independently and differentially related to motives for smoking. In combat veterans with PTSD, heavy smoking status was positively related to total health complaints, lifetime health complaints, health complaints in the past year, negative health behaviors, total PTSD symptoms, DSM-IV C cluster (avoidance and numbing) and D cluster (hyperarousal) PTSD symptoms. Heavy smoking status was also associated with fewer positive health behaviors.",0,0 +4798,Posttraumatic stress disorder after motor vehicle accidents: 3-year follow-up of a prospective longitudinal study,"The paper presents a 3-year follow-up of a prospective longitudinal study of posttraumatic stress disorder (PTSD) after motor vehicle accidents (J. Abnormal Psychol., 107 (1998) 508). Participants were 546 patients who had been assessed when attending an emergency clinic shortly after a motor vehicle accident, and at 3 months and 1 year afterwards. The prevalence of posttraumatic stress disorder PTSD at 3 years was 11%. Maintaining psychological factors, i.e. negative interpretation of intrusions, rumination, thought suppression and anger cognitions, were important in predicting the persistence of PTSD at 3 years, as were persistent health and financial problems after the accident. Other predictors were female sex, hospital admission for injuries, perceived threat and dissociation during the accident, and litigation.",0,0 +4799,The trauma symptom inventory: Italian validation of an instrument for the assessment of post-traumatic symptoms,"Aim. The trauma symptom inventory (TSI; Briere, 1995) is a useful instrument for the assessment of post-traumatic and common trauma-related mental health symptoms. The purpose of the study was to validate the Italian version of the original TSI. Methods. Participants from non-clinical ( n = 285), clinical ( n = 110) and post-traumatic ( n = 30) samples completed the TSI as part of a battery that included self-report measures of trauma exposure [MMPI-2 PK scale and Impact of Event Scale-Revised (IES-R)] and of psychological symptoms [brief symptom inventory (BSI) and symptom questionnaire (SQ)]. TSI validity scales were compared with MMPI-2 validity scales in order to assess convergent validity. Results. The TSI Italian version showed adequate internal consistency reliability and a good convergent validity. Discriminant function analysis indicates a classification accuracy of TSI scales of 90% for true-positive and 91.4% for true-negative post-traumatic stress disorder (PTSD) cases. A revised three-factor structural model, which demonstrated an adequate and the best fit for the data, was proposed. Conclusions. The study extended the generalization and validity of TSI and provided some suggestions for eventually revisiting factorial structure of the questionnaire.",0,0 +4800,Sensitization and kindling: Implications for the evolving neural substrates of post-traumatic stress disorder.,"(from the chapter) suggest that some of the principles involved in laying down the differential memory traces of sensitization and kindling may be useful bridging structures for considering parallel processes in different neural substrates that could be occurring in the related processes of stress sensitization and memory ""branding"" in posttraumatic stress disorder (PTSD) / suggest that these [2 behavioral] models may provide a primitive template for considering how acute or repeated stressors may not only leave permanent memory traces, but also affect the biochemistry and microstructure of the brain, potentially by impacting immediate-early-gene and late-effector-gene expression / stress sensitization and kindling also have their own spatiotemporal unfolding of cascades of neurobiological events that may have important mechanistic and pharmacotherapeutic implications cocaine sensitization / kindling: evolving neural substrates revealed by in situ hybridization and pharmacology / implications of sensitization and kindling for development and evolution of PTSD (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4801,The Khmer ‘Weak Heart’ Syndrome: Fear of Death from Palpitations,"According to the Khmer conception, a person suffering ‘weak heart’ ( khsaoy beh daung) has episodes of palpitations on slight provocation (e.g. triggered by orthostasis, anger, a noise, worry, an odor or exercise) and runs the risk of dying of heart arrest during these periods of palpitations; too, the sufferer typically has other symptoms attributed to the purported cardiac dysfunction: fatigue, shortness of breath, and orthostatic dizziness. Many Khmer refugees suffer this cultural syndrome, an anxious–dysphoria ontology, most probably of French colonial provenance. The syndrome demonstrates considerable overlap with those Western illness categories that feature panic attacks, in particular post-traumatic stress disorder (PTSD) and panic disorder. In a psychiatric clinic survey, 60 percent (60/100) of those assessed believed themselves to currently suffer ‘weak heart’; 90 percent (54/60) of those considering themselves to suffer from ‘weak heart’ thought that palpitations (e.g., those resulting from a loud noise or orthostasis) might result in death. The article illustrates the profoundly culturally constructed nature of ‘cardiac sensations,’ located in a specific historical trajectory and episteme; too, the article suggests that trauma may result more in panic disorder than ‘PTSD’ when autonomic arousal symptoms (in the present case, palpitations) are considered potentially life-threatening.",0,0 +4802,Prevalence of and Factors Associated With Subclinical Posttraumatic Stress Symptoms and PTSD in Urban and Rural Areas of Montana: A Cross-Sectional Study,"Posttraumatic stress disorder (PTSD) is an important clinical problem, but little is known about PTSD in rural, nonclinical populations. To better understand PTSD in rural areas, we examined the prevalence and risk and protective factors in urban, rural, and highly rural communities in Montana for both subclinical posttraumatic stress symptoms (PTSS) and PTSD.We compared the prevalence of PTSS and PTSD in urban, rural, and highly rural communities in bivariate and multivariable regression analyses using self-reported cross-sectional survey data from the Montana Health Matters study (N = 3,512), a state-representative household-based survey done in 2010-2011. We also explore potential risk and protective factors for PTSS and PTSD and whether risk and protective factors for each differ by rurality.There were no differences in the level of PTSS by rurality in bivariate or multivariate models, and the bivariate relationship between rurality and PTSD became nonsignificant in a multivariate model. Only locus of control was predictive for PTSS; however, gender, age, marital status, income, employment status, community fit, locus of control, and religiosity were associated with PTSD. Some risk and protective factors operate differently by rurality.Although our findings are subject to weaknesses common to cross-sectional data and are based on questionnaire reports, it appears that there are different risk and protective factors for PTSS and PTSD, suggesting that PTSD may be qualitatively different from PTSS. Furthermore, differences in risk and protective factors across urban and rural communities suggest more attention is needed to understand PTSD in rural communities.",0,0 +4803,Personality-based latent classes of posttraumatic psychopathology: Personality disorders and the internalizing/externalizing model.,"Prior research using the Brief Form of the Multidimensional Personality Questionnaire (MPQ-BF; Patrick, Curtin, & Tellegen, 2002) has shown evidence of 3 temperament-based subtypes--termed internalizing, externalizing, and simple PTSD--among individuals with symptoms of posttraumatic stress disorder (PTSD; Miller, Greif, & Smith, 2003). This study sought to replicate and extend research in this area by conducting a latent profile analysis of higher order temperament scales from the MPQ-BF using a new sample of 208 veterans with symptoms of PTSD. Results suggest that a 3-class solution reflecting internalizing, externalizing, and simple subtypes of posttraumatic psychopathology provided the best fit to the data. The externalizing subtype was characterized by features of antisocial, borderline, histrionic, and narcissistic personality disorders on the International Personality Disorder Examination (Loranger, 1999) as well as low levels of constraint and high levels of negative emotionality on the MPQ-BF. In contrast, individuals in the internalizing class exhibited features of schizoid and avoidant personality disorders, low levels of positive emotionality, and high levels of negative emotionality. The simple subtype was defined by low levels of comorbid personality disorder features and relatively normal personality profiles. Findings support the reliability of this typology and support the relevance of the internalizing and externalizing model to the structure of personality disorders.",0,0 +4804,A Longitudinal Study of Emotional Distress Intolerance and Psychopathology Following Exposure to a Potentially Traumatic Event in a Community Sample,"This study focused on better understanding the association between anxiety sensitivity (AS), distress tolerance (DT), and psychopathology, including posttraumatic stress, depression, panic and suicidality, in the aftermath of a potentially traumatizing event. A community-based sample of 151 adults exposed to the Mount Carmel Forest Fire Disaster were assessed within 30-days of exposure (T1) and then at 3- (T2) and 6-month (T3) follow-up intervals. At T1, AS, DT, and psychopathology symptoms loaded on a single common latent factor reflecting Emotional Avoidance and Distress; whereas by T2 AS-DT and psychopathology symptoms diverged into distinct latent variables—Emotional Distress Intolerance and Distress Post-Trauma, respectively. Levels of Emotional Distress and Avoidance at T1 predicted levels of Emotional Distress Intolerance as well as Distress Post-Trauma at T2. Finally, levels of Emotional Intolerance at T2 predicted levels of Distress Post-Trauma at T3 above and beyond the strong stability effects of Distress Post-Trauma over time. Findings are discussed with respect to their theoretical and clinical implications for understanding and promoting resilience to, and recovery following, exposure to potentially traumatic events.",0,0 +4805,Posttraumatic Stress Disorder and the Risk of Respiratory Problems in World Trade Center Responders,"Posttraumatic stress disorder (PTSD) is associated with high medical morbidity, but the nature of this association remains unclear. Among responders to the World Trade Center (WTC) disaster, PTSD is highly comorbid with lower respiratory symptoms (LRS), which cannot be explained by exposure alone. We sought to examine this association longitudinally to establish the direction of the effects and evaluate potential pathways to comorbidity.18,896 responders (8466 police and 10,430 nontraditional responders) participating in the WTC-Health Program were first evaluated between 2002 and 2010 and assessed again 2.5 years later. LRS were ascertained by medical staff, abnormal pulmonary function by spirometry, and probable WTC-related PTSD with a symptom inventory.In both groups of responders, initial PTSD (standardized regression coefficient: β = 0.20 and 0.23) and abnormal pulmonary function (β = 0.12 and 0.12) predicted LRS 2.5 years later after controlling for initial LRS and covariates. At follow-up, LRS onset was 2.0 times more likely and remission 1.8 times less likely in responders with initial PTSD than in responders without. Moreover, PTSD mediated, in part, the association between WTC exposures and development of LRS (p < .0001). Initial LRS and abnormal pulmonary function did not consistently predict PTSD onset.These analyses provide further evidence that PTSD is a risk factor for respiratory symptoms and are consistent with evidence implicating physiological dysregulation associated with PTSD in the development of medical conditions. If these effects are verified experimentally, treatment of PTSD may prove helpful in managing physical and mental health of disaster responders.",0,0 +4806,Experiential Avoidance Mediates the Association Between Behavioral Inhibition and Posttraumatic Stress Disorder,"Despite the large body of research on the risk factors for posttraumatic stress disorder (PTSD), few studies have examined specific personality factors that may be associated with risk for PTSD or the potential mechanisms that may underlie the association between personality and PTSD. Thus, this study sought to examine the relation between the behavioral inhibition system (BIS), a motivational brain-based system associated with the experience of anxiety, and probable posttraumatic stress disorder (PTSD) status. Further, we examined the mediating role of experiential avoidance in the relation between BIS sensitivity and PTSD. Participants included 291 undergraduates who indicated they had experienced a potentially traumatic event at some point in their life. As expected, significant associations were found between BIS sensitivity, experiential avoidance, and probable PTSD status. Results indicated that BIS scores significantly predicted probable PTSD status above and beyond other relevant covariates, including anxiety symptom severity. Further, this association was found to be fully mediated by experiential avoidance. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +4807,"Further validation of the IDAS: Evidence of convergent, discriminant, criterion, and incremental validity.","The authors explicated the validity of the Inventory of Depression and Anxiety Symptoms (IDAS; D. Watson et al., 2007) in 2 samples (306 college students and 605 psychiatric patients). The IDAS scales showed strong convergent validity in relation to parallel interview-based scores on the Clinician Rating version of the IDAS; the mean convergent correlations were .51 and .62 in the student and patient samples, respectively. With the exception of the Well-Being Scale, the scales also consistently demonstrated significant discriminant validity. Furthermore, the scales displayed substantial criterion validity in relation to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) mood and anxiety disorder diagnoses in the patient sample. The authors identified particularly clear and strong associations between (a) major depression and the IDAS General Depression, Dysphoria and Well-Being scales, (b) panic disorder and IDAS Panic, (c) posttraumatic stress disorder and IDAS Traumatic Intrusions, and (d) social phobia and IDAS Social Anxiety. Finally, in logistic regression analyses, the IDAS scales showed significant incremental validity in predicting several DSM-IV diagnoses when compared against the Beck Depression Inventory-II (A. T. Beck, R. A. Steer, & G. K. Brown, 1996) and the Beck Anxiety Inventory (A. T. Beck & R. A. Steer, 1990).",0,0 +4808,Psychopathology in a sample of candidate patients for bariatric surgery,"The prevalence of morbid obesity and the popularity of bariatric surgery have grown in recent years. Many surgical protocols require that the candidates undergo a pre-operative psychological evaluation. We describe the psychopathological characteristics of both clinical syndromes (Axis I of the DSM-IV), as well as personality disorders (Axis II of the DSM-IV), in a sample of morbidly obese patients accepted as bariatric surgery candidates and who participate in a specific surgery preparatory programme, and we analyze its relationship with personality clusters.The Millon Clinical Multiaxial Inventory-III (MCMI-III) scores from 50 patients attending for bariatric surgery were cluster analyzed in hopes of identifying clinical subgroups corresponding to typical personality profiles.With regard to personality disorders, the highest prevalence was found in the histrionic disorder, followed by obsessive- compulsive disorder. Cluster analysis revealed three personality profiles, which were validated by examining demographics, morphological variables, scores on anxiety and depression psychometric scales, and MCMI-III clinical scales scores. Groups were different in virtually all the MCMI-III clinical scores, as well as in depression and trait anxiety, with Cluster 3 presenting the worst scores.These findings suggest that morbidly obese patients are heterogeneous in their psychological profiles, highlighting Cluster C disorders.",0,0 +4809,The Deepwater Horizon Oil Spill and the Mississippi Gulf Coast: Mental health in the context of a technological disaster.,"A significant percentage of disaster survivors experience negative psychological, physical, and social outcomes after a disaster. The current study advances the literature concerning the Deepwater Horizon Oil Spill (the Gulf Oil Spill) while addressing weaknesses of previous research. The current study includes a clinical sample of 1,119 adults receiving mental health services in the coastal counties of Mississippi after the Gulf Oil Spill. The levels of clinical symptoms reported on the Depression Anxiety Stress Scales (DASS-21) and PTSD Checklist (PCL-S) were examined in relation to other domains of functioning potentially affected by the spill (finances, social relationships, and physical health). Participants reported substantial worsening of their functioning across each life domain. Furthermore, chronic problems in living related to the Gulf Oil Spill were significantly associated with higher levels of psychological distress, although the pattern differed somewhat for persons living above and below the poverty line, with lower income individuals reporting a higher level of overall distress. These data support the perspective that the experience of the Gulf Oil Spill is strongly associated with a deleterious effect on mental health symptoms.",0,0 +4810,Co-occurring medical and mental illness and substance use disorders among veteran clinic users with spinal cord injury patients with complexities,"Longitudinal analysis of SCI registry merged with VHA administrative-data and Medicare claims files (FY1999-2002).To estimate the prevalence of mental illness (MI) and substance use disorders (SUDs) among veteran health administration (VHA) clinic users with spinal cord injuries (SCI) and examine subgroup variations by demographic, socioeconomic characteristics, and duration and level of SCI.VHA clinic users (N=8338) with SCI who were alive by the end of FY2002.ICD-9-CM codes were used to identify individual MI (anxiety disorders, bipolar, depressive disorders, psychoses, post-traumatic stress disorder (PTSD) and schizophrenia) and categories of SUDs (tobacco, alcohol and drug abuse). Chi-square tests and multinomial logistic regression were used to examine the demographic and socio-economic profile of VHA users with SCI and MI and/or SUD.Over a 2-year period, 46% VHA users with SCI had either a MI or SUDs: 20% had MI only; 12% had SUD only and 14% had both. The most common MI was depressive disorder (27%) and tobacco use was highly prevalent (19%). African-Americans (versus whites) were less likely to be diagnosed with MI only. Increased duration of SCI lowered the likelihood of MI and/or SUDs. Mood and anxiety disorders were highly prevalent in veterans with SCI with chronic physical conditions such as diabetes, heart disease, hypertension, and respiratory diseases.Mental illness and SUDs are highly prevalent in the VHA population with SCI and is complicated by the high rates of chronic physical conditions, presenting challenges in their healthcare management.",0,0 +4811,Comparability of Telephone and Face-to-Face Interviews in Assessing Patients with Posttraumatic Stress Disorder,"Structured clinical interviews are very important in the area of mental health research and services. Prior research comparing the reliability and validity of face-to-face and phone interviews has found high levels of agreement. This project compared the results of face-to-face and phone interviews for two widely used measures: The Clinician-Administered PTSD Scale (CAPS) for assessing posttraumatic stress disorder diagnostic status and symptom severity and the Hamilton Rating Scale for Depression (Ham-D) to determine the severity of major depressive disorder.Subjects were 34 veterans recruited from applicants to the PTSD Assessment and Intervention program at the Cincinnati VA Medical Center. Order of interview (in-person or phone) was determined using random assignment within a counterbalanced framework. After attaining satisfactory levels of interrater reliability, four clinicians independently and blindly evaluated the subjects.Pearson correlation coefficients between face-to-face and phone interviews revealed high consistency (CAPS r = 0.745, HAM-D r = 0.748). The level of agreement between the two methods was 82% for the CAPS and 85% for the HAM-D. Diagnostic thresholds for the CAPS and HAM-D, after adjusting for the interview order and time elapsed between interviews, did not differ between the two groups (p = 0.31 for the CAPS and p = 0.96 for the HAM-D). High levels of agreement were achieved between the two methods (kappa = 0.75 for the CAPS using a cutoff of 65 and 0.70 for the HAM-D). The high sensitivity, specificity, and predictive values support the reliability of the phone-interview method.Phone interviews are a reliable method of interviewing for use in assessing patients for posttraumatic stress disorder and major depressive disorder.",0,0 +4812,Losing the Symptoms: Weight Loss and Decrease in Posttraumatic Stress Disorder Symptoms,"Posttraumatic stress disorder (PTSD) has frequently been found to have an effect on the development of obesity, a relationship usually thought of as unidirectional. The purpose of this study was to examine whether the level of PTSD symptoms would decrease as a result of weight loss.In a repeated measures design, PTSD symptoms, depression symptoms, social support, and weight were assessed in obese participants during 16 weeks at a weight loss facility.The participants' body mass index decreased significantly, and concurrently, a significant decline in the level of PTSD symptoms and depression symptoms was observed.The beneficial effects of weight loss on depression are consistent with previous work. The decline in the level of PTSD symptoms simultaneously with weight loss is an important and positive effect that has not been reported previously.",0,0 +4813,The Aberfan disaster: 33-year follow-up of survivors,"Experiencing life-threatening events often contributes to the onset of such psychiatric conditions as post-traumatic stress disorder (PTSD). Children can develop PTSD; however, there is controversy over whether PTSD symptoms decrease or persist over time.To examine the long-term effects of surviving the 1966 Aberfan disaster in childhood.Survivors (n=41) were compared with controls (n=72) matched for age and background. All were interviewed using the Composite International Diagnostic Interview, measures of current health and social satisfaction, and the General Health Questionnaire. The survivor group also completed the Impact of Event Scale to assess current levels of PTSD.Nineteen (46%; 95% CI 31-61) survivors had had PTSD at some point since the disaster, compared with 12 (20%; 95% CI 10-30) controls (OR=3.38 (95% CI 1.40-8.47)). Of the survivors,12 (29%; 95% CI 15-43) met diagnostic criteria for current PTSD. Survivors were not at a significantly increased risk of anxiety, depression or substance misuse.Trauma in childhood can lead to PTSD, and PTSD symptoms can persist for as long as 33 years into adult life. Rates of other psychopathological disorders are not necessarily raised after life-threatening childhood trauma.",0,0 +4814,Longitudinal follow-up of the mental health of unaccompanied refugee minors,"Despite growing numbers of unaccompanied refugee minors (UMs) in Europe, and evidence that this group is at risk of developing mental health problems, there still remain important knowledge gaps regarding the development of UMs' mental health during their trajectories in the host country and, in particular, the possible influencing role of traumatic experiences and daily stressors therein. This study therefore followed 103 UMs from the moment they arrived in Belgium until 18 months later. Traumatic experiences (SLE), mental health symptoms (HSCL-37A, RATS) and daily stressors (DSSYR) were measured at arrival in Belgium, after 6 and 18 months. UMs reported generally high scores on anxiety, depression and post-traumatic stress disorder (PTSD). Linear mixed model analysis showed no significant differences in mental health scores over time, pointing towards the possible long-term persistence of mental health problems in this population. The number of traumatic experiences and the number of daily stressors leaded to a significant higher symptom level of depression (daily stressors), anxiety and PTSD (traumatic experiences and daily stressors). European migration policies need to reduce the impact of daily stressors on UMs' mental health by ameliorating the reception and care facilities for this group. Moreover, regular mental health screenings are needed, in combination with, if needed, adapted psychosocial and therapeutic care. © 2013 Springer-Verlag",0,0 +4815,Peritraumatic Heart Rate and Posttraumatic Stress Disorder in Patients With Severe Burns,"Previous studies have suggested a link between heart rate (HR) following trauma and the development of posttraumatic stress disorder (PTSD). This study expands on previous work by evaluating HR in burn patients followed longitudinally for symptoms of acute stress disorder (ASD) and PTSD.Data were collected from consecutive patients admitted to the Johns Hopkins Burn Center, Baltimore, Maryland, between 1997 and 2002. Patients completed the Stanford Acute Stress Reaction Questionnaire (n = 157) to assess symptoms of ASD. The Davidson Trauma Scale was completed at 1 (n = 145), 6 (n = 106), 12 (n = 94), and 24 (n = 66) months postdischarge to assess symptoms of PTSD. Heart rate in the ambulance, emergency room, and burn unit were obtained by retrospective medical chart review.Pearson correlations revealed a significant relationship between HR in the ambulance (r = 0.32, P = .016) and burn unit (r = 0.30, P = .001) and ASD scores at baseline. Heart rate in the ambulance was related to PTSD avoidance cluster scores at 1, 6, 12, and 24 months. In women, HR in the ambulance was correlated with PTSD scores at 6 (r = 0.65, P = .005) and 12 (r = 0.78, P = .005) months. When covariates (gender, β-blockers, Brief Symptom Inventory Global Severity Index score) were included in multivariate linear regression analyses, ambulance HR was associated with ASD and PTSD scores at baseline and 1 month, and the interaction of ambulance HR and gender was associated with PTSD scores at 6 and 12 months. Multivariate logistic regression results were similar at baseline and 12 months, which included an HR association yet no interaction at 6 months and a marginal interaction at 1 month.While peritraumatic HR is most robustly associated with PTSD symptom severity, HR on admission to burn unit also predicts the development of ASD. Gender and avoidance symptoms appear particularly salient in this relationship, and these factors may aid in the identification of subgroups for which HR serves as a biomarker for PTSD. Future work may identify endophenotypic measures of increased risk for PTSD, targeting subgroups for early intervention.",0,0 +4816,Examination of the trait facets of the five-factor model in discriminating specific mood and anxiety disorders,"Structural models of the mood and anxiety disorders postulate that each disorder has a shared component that can account for comorbidity and its own unique component that distinguishes it from others. The principal aim of the current study was to determine the extent to which the 30 facets of the Five-Factor Model (FFM), as measured by the Revised NEO Personality Inventory (NEO PI-R), contribute to the identification of the unique component in mood and anxiety disorders in treatment-seeking clinical samples. Participants (N=610) were psychiatric outpatients with principal DSM-IV diagnoses (Diagnostic and Statistical Manual-IV; American Psychiatric Association, 1994) diagnoses of major depressive disorder (MDD), post-traumatic stress disorder (PTSD), generalized social phobia (GSP), panic disorder with/without agoraphobia (PD; PD/A) or obsessive-compulsive disorder (OCD). Results suggest that approximately half of the variance in differences between these diagnoses is associated with specific characteristics represented by the FFM facets. Unique personality profiles for the MDD, GSP, PTSD and, to a lesser extent, OCD groups emerged. Broad traits of the FFM, when broken into more narrow components at the facet level, contribute significantly to the identification of unique aspects associated with specific mood and anxiety disorders. The integration of lower and higher levels of structural examination of the mood and anxiety disorders is discussed.",0,0 +4817,What determines post-traumatic stress disorder symptomatology for survivors of childhood sexual abuse?,"The aim of this paper was to ascertain which childhood abuse experiences are associated with post-traumatic stress disorder (PTSD) symptomatology for women survivors of childhood sexual abuse (CSA).Seventy-three women attending a Family Health Counselling Service's Sexual Abuse Program were invited to participate in a study looking at the effectiveness of sexual abuse counselling. Initially, the women completed a series of self-report questionnaires including a measure of PTSD symptoms, and were interviewed about childhood abuse experiences.PTSD symptoms were associated with higher levels of all psychopathology. However, more interestingly, the severity of PTSD symptoms was also associated with the extent of CSA which involved actual sexual intercourse. This association of repeated abuse involving sexual intercourse with PTSD symptoms was still significant (partial coefficient = .30, p, .000) even when controlling for general level of psychopathology.One of the long-term effects of child sexual abuse (CSA) is post-traumatic stress disorder (PTSD), and the women who reported multiple abusive episodes which involved sexual intercourse had increased symptoms of PTSD.",0,0 +4818,Chromatographic characterization of substance P endopeptidase in the rat brain reveals affected enzyme activity following heat stress,"This paper describes a study of substance P endopeptidase (SPE)-like activity in various regions of the brain from male rats subjected to heat stress (HS). The enzyme activity was found to be affected in several brain areas including cerebellum, cerebral cortex, hippocampus, hypothalamus[sol ]thalamus and the spinal cord following HS. Significant increases in SPE activity were observed in, for example, hippocampus and the spinal cord. SPE-containing extracts from hippocampus were pooled and subsequently purified by size exclusion chromatography (using a Superdex® 75 HR column) and by anion-exchange chromatography (using Resource Q® column). The gel permeation chromatography separated the SPE-like activity into two fractions, one of which was suggested to be identical to neutral endopeptidase owing to its molecular size and inhibitory profile. The other active enzyme fraction behaved in conformity with SPE, previously identified in human cerebrospinal fluid. The activity of the purified fraction of these two enzymes was found to be increased (27%) in HS-treated animals. Copyright © 2005 John Wiley & Sons, Ltd.",0,0 +4819,Twin studies of posttraumatic stress disorder: Differentiating vulnerability factors from sequelae,"Posttraumatic stress disorder (PTSD) is defined by one's response to an environmental event. However, genetic factors are important in determining people's response to that event, and even their likelihood of being exposed to particular traumatic events in the first place. Classical twin designs can decompose genetic and environmental sources of variance. Such studies are reviewed extensively elsewhere, and we cover them only briefly in this review. Instead, we focus primarily on the identical co-twin control design. This design makes it possible to resolve the ""chicken-egg"" dilemma inherent in standard case-control designs, namely, distinguishing risk from sequelae. Abnormalities that are present in both the twin with PTSD and the unaffected co-twin suggest pre-existing vulnerability indicators. These include smaller hippocampal volume, large cavum septum pellucidum, more neurological soft signs, lower general intellectual ability, and poorer performance in the specific cognitive abilities of executive function, attention, declarative memory, and processing of contextual cues. In contrast, abnormalities in a twin with PTSD that are not present in the identical co-twin suggest consequences of PTSD or trauma exposure. These include psychophysiological responding, higher resting anterior cingulate metabolism, event-related potential abnormalities associated with attentional processes, recall intrusions, and possibly some types of chronic pain. Most co-twin control studies of PTSD have been small and come from the same twin registry of middle-aged male veterans. Consequently, there is a great need for replication and extension of the findings, particularly in women and younger individuals. The creation of new twin registries would do much toward accomplishing this goal. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0,0 +4820,"Posttraumatic Stress Disorder, Gender, and Problem Profiles in Substance Dependent Patients","Patients with a chronic and severe substance-use disorder who also have a history of posttraumatic stress disorder (PTSD) are thought to have a unique set of problems. The present study assessed psychiatric disorders, psychosocial problems, and traumatic events with structured interviews in 747 men and 693 women enrolling in urban opioid substitution treatment programs from 1995 to 2001. Participants with versus without a history of PTSD were more likely to have a history of many other psychiatric disorders and demonstrated more current and historical medical, employment, family/social, and psychiatric problems. PTSD was generally unrelated to substance-use disorder severity or diagnoses, with the exception of an increased risk of alcohol dependence. Women were more likely than men to have experienced sexual assault, and less likely to have been physically assaulted, although these events precipitated PTSD at equivalent rates across gender. In contrast, witnessing or hearing about the death or injury of others was more likely to precipitate PTSD in women than men. Female gender, exposure to combat, sexual assault, or physical assault, and a history of major mood or anxiety disorder were the best predictors of PTSD in this group. Study limitations are noted.",0,0 +4821,Lessons learned about psychosocial responses to disaster and mass trauma: an international perspective,"At the 13th meeting of the European Society for Traumatic Stress Studies in 2013, a symposium was held that brought together international researchers and clinicians who were involved in psychosocial responses to disaster. A total of six disasters that occurred in five countries were presented and discussed. Lessons learned from these disasters included the need to: (1) tailor the psychosocial response to the specific disaster, (2) provide multi-dimensional psychosocial care, (3) target at-risk population groups, (4) proactively address barriers in access to care, (5) recognise the social dimensions and sources of resilience, (6) extend the roles for mental health professionals, (7) efficiently coordinate and integrate disaster response services, and (8) integrate research and evaluation into disaster response planning.",0,0 +4822,"Combat Experiences, Pre-Deployment Training, and Outcome of Exposure Therapy for Post-Traumatic Stress Disorder in Operation Enduring Freedom/Operation Iraqi Freedom Veterans","The association between exposure to multiple potentially traumatic events (PTEs) and subsequent increased risk of post-traumatic stress disorder (PTSD) is well established. However, less is known about the relation between exposure to numerous PTEs, as is typical with military service, and treatment outcome. Furthermore, there has been little research examining military specific protective factors, such as pre-deployment preparedness, on PTSD treatment response. The current study investigated combat exposure and potential moderators of treatment outcome for exposure therapy in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans with PTSD. One hundred and eleven OEF/OIF veterans diagnosed with PTSD participated in 8 weeks of exposure therapy. Results indicated that increased combat exposure was associated with a reduced rate of change in PTSD symptoms but not depression symptoms. These findings were consistent across two measures of combat exposure. There was preliminary support for the moderating effect of pre-deployment preparedness on the association between combat exposure and treatment response. Together, these findings suggest that increased combat exposure is associated with poor treatment response in veterans with PTSD; however, this can be reduced by elevated pre-deployment preparedness.",0,0 +4823,Identifying PTSD personality subtypes in a workplace trauma sample,"The authors sought to identify personality clusters derived from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Personality Psychopathology Five Scales in a sample of workplace claimants with posttraumatic stress disorder (PTSD). Three clusters—low pathology, internalizing, and externalizing were recovered similar to those obtained by M. W. Miller and colleagues (2003, 2004, 2007) in samples of combat veterans and sexual assault victims. Internalizers and externalizers scored comparably on measures of PTSD symptom severity, general distress, and negative affect. Internalizers were uniquely characterized by anhedonia and depressed mood; externalizers by antisocial behavior, substance abuse, and anger/aggression.",0,0 +4824,A novel locus in the oxidative stress-related gene ALOX12 moderates the association between PTSD and thickness of the prefrontal cortex,"Oxidative stress has been implicated in many common age-related diseases and is hypothesized to play a role in posttraumatic stress disorder (PTSD)-related neurodegeneration (Miller and Sadeh, 2014). This study examined the influence of the oxidative stress-related genes ALOX 12 and ALOX 15 on the association between PTSD and cortical thickness. Factor analyses were used to identify and compare alternative models of the structure of cortical thickness in a sample of 218 veterans. The best-fitting model was then used for a genetic association analysis in White non-Hispanic participants (n=146) that examined relationships between 33 single nucleotide polymorphisms (SNPs) spanning the two genes, 8 cortical thickness factors, and each SNP×PTSD interaction. Results identified a novel ALOX12 locus (indicated by two SNPs in perfect linkage disequilibrium: rs1042357 and rs10852889) that moderated the association between PTSD and reduced thickness of the right prefrontal cortex. A whole-cortex vertex-wise analysis showed this effect to be localized to clusters spanning the rostral middle frontal gyrus, superior frontal gyrus, rostral anterior cingulate cortex, and medial orbitofrontal cortex. These findings illustrate a novel factor-analytic approach to neuroimaging-genetic analyses and provide new evidence for the possible involvement of oxidative stress in PTSD-related neurodegeneration.",0,0 +4825,Correlates of post-traumatic stress symptoms and growth in cancer patients: a systematic review and meta-analysis,"Objective The aim of this study is to examine the relationships among demographic, medical, and psychosocial factors and post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG) in oncology populations. Method A systematic search identified k = 116 relevant studies published between 1990 and 2012. Meta-analyses synthesized results from studies that reported data on correlates of PTSS (k = 26) or PTG (k = 48). A meta-analysis was performed for k = 5 studies reporting the correlation between PTSS and PTG. Results Post-traumatic stress symptoms were associated with depression (r = 0.56), anxiety (r = 0.65), distress (r = 0.62), social support (r = −0.33), and physical quality of life (r = −0.44). PTG was associated with age (r = −0.08), gender (r = −0.15), distress (r = −0.16), depression (r = −0.06), social support (r = 0.30), optimism (r = 0.27), positive reappraisal (r = 0.46), spirituality (r = 0.33), and religious coping (r = 0.36). There was a small positive relationship between PTSS and PTG (r = 0.13). Conclusions Post-traumatic stress symptoms and PTG appear to be independent constructs, rather than opposite ends of a single dimension. This is reflected in a small relationship between these variables and different psychosocial correlates. PTSS were strongly associated with variables reflecting a general state of negative affect. Optimism, spirituality, and positive coping styles were associated with PTG. It remains unclear how they are associated with PTSS, given the lack of relevant studies. Longitudinal research is required to examine how psychosocial factors influence the relationship between PTSS and PTG. Copyright © 2014 John Wiley & Sons, Ltd.",0,0 +4826,The relative efficacy of bona fide psychotherapies for treating post-traumatic stress disorder: A meta-analysis of direct comparisons,"Psychotherapy has been found to be an effective treatment of post-traumatic stress disorder (PTSD), but meta-analyses have yielded inconsistent results on relative efficacy of psychotherapies in the treatment of PTSD. The present meta-analysis controlled for potential confounds in previous PTSD meta-analyses by including only bona fide psychotherapies, avoiding categorization of psychotherapy treatments, and using direct comparison studies only. The primary analysis revealed that effect sizes were homogenously distributed around zero for measures of PTSD symptomology, and for all measures of psychological functioning, indicating that there were no differences between psychotherapies. Additionally, the upper bound of the true effect size between PTSD psychotherapies was quite small. The results suggest that despite strong evidence of psychotherapy efficaciousness vis-à-vis no treatment or common factor controls, bona fide psychotherapies produce equivalent benefits for patients with PTSD.",0,0 +4827,Posttraumatic stress disorder and posttraumatic stress disorder-like symptoms and mild traumatic brain injury,"In this article, we review the literature on posttraumatic stress disorder (PTSD) and PTSD-like symptoms that can occur along with mild traumatic brain injury (TBI) and concussion, with specific reference to concussive injuries in the military. We address four major areas: (1) clinical aspects of TBI and PTSD, including diagnostic criteria, incidence, predictive factors, and course; (2) biological overlap between PTSD and TBI; (3) comorbidity between PTSD and other mental disorders that can occur after mild TBI; and (4) current treatments for PTSD, with specific considerations related to treatment for patients with mild TBI or concussive injuries.",0,0 +4828,Child anxiety symptoms related to longitudinal cortisol trajectories and acute stress responses: Evidence of developmental stress sensitization.,"Cross-sectional research suggests that individuals at risk for internalizing disorders show differential activation levels and/or dynamics of stress-sensitive physiological systems, possibly reflecting a process of stress sensitization. However, there is little longitudinal research to clarify how the development of these systems over time relates to activation during acute stress, and how aspects of such activation map onto internalizing symptoms. We investigated children's (n = 107) diurnal hypothalamic-pituitary-adrenal activity via salivary cortisol (morning and evening levels) across 29 assessments spanning 6+ years, and related longitudinal patterns to acute stress responses at the end of this period (age 9-10). Associations with child psychiatric symptoms at age 10 were also examined to determine internalizing risk profiles. Increasing morning cortisol levels across assessments predicted less of a cortisol decline following interpersonal stress at age 9, and higher cortisol levels during performance stress at age 10. These same profiles of high and/or sustained cortisol elevation during psychosocial stress were associated with child anxiety symptoms. Results suggest developmental sensitization to stress-reflected in rising morning cortisol and eventual hyperactivation during acute stress exposure-may distinguish children at risk for internalizing disorders.",0,0 +4829,"Depression, anxiety and major adverse cardiovascular and cerebrovascular events in patients following coronary artery bypass graft surgery: a five year longitudinal cohort study","Although depression and anxiety have been implicated in risk for major adverse cardiovascular and cerebrovascular events (MACCE), a theoretical approach to identifying such putative links is lacking. The objective of this study was to examine the association between theoretical conceptualisations of depression and anxiety with MACCE at the diagnostic and symptom dimension level.Before coronary artery bypass graft (CABG) surgery, patients (N = 158; 20.9 % female) underwent a structured clinical interview to determine caseness for depression and anxiety disorders. Depression and anxiety disorders were arranged into the distress cluster (major depression, dysthymia, generalized anxiety disorder, post-traumatic stress disorder) and fear cluster (panic disorder, agoraphobia, social phobia). Patients also completed the self-report Mood and Anxiety Symptom Questionnaire, measuring anhedonia, anxious arousal and general distress/negative affect symptom dimensions. Incident MACCE was defined as fatal or non-fatal; myocardial infarction, unstable angina pectoris, repeat revascularization, heart failure, sustained arrhythmia, stroke or cerebrovascular accident, left ventricular failure and mortality due to cardiac causes. Time-to-MACCE was determined by hazard modelling after adjustment for EuroSCORE, smoking, body mass index, hypertension, heart failure and peripheral vascular disease.In the total sample, there were 698 cumulative person years of survival for analysis with a median follow-up of 4.6 years (interquartile range 4.2 to 5.2 years) and 37 MACCE (23.4 % of total). After covariate adjustment, generalized anxiety disorder was associated with MACCE (hazard ratio [HR] = 2.79, 95 % confidence interval [CI] 1.00-7.80, p = 0.049). The distress disorders were not significantly associated with MACCE risk (HR = 2.14; 95 % CI .92-4.95, p = 0.077) and neither were the fear-disorders (HR = 0.24, 95 % CI .05-1.20, p = 0.083). None of the symptom dimensions were significantly associated with MACCE.Generalized anxiety disorder was significantly associated with MACCE at follow-up after CABG surgery. The findings encourage further research pertaining to generalized anxiety disorder, and theoretical conceptualizations of depression, general distress and anxiety in persons undergoing CABG surgery.",0,0 +4830,PTSD symptoms and marital adjustment among ex-POWs’ wives.,"This study prospectively assessed the implications of war captivity and former prisoners of war's (ex-POWs) posttraumatic stress disorder (PTSD) and PTSD trajectory on their wives' marital adjustment, adjusting for their secondary traumatization (ST). Results show that marital adjustment of the wives of ex-POWs with PTSD (N = 66) was lower compared to wives of ex-POWs (N = 37) and combat veterans (N = 55) without PTSD symptoms. Investigating the possible mechanism underlying the lower marital adjustment, via a mediating model, indicated that husbands' PTSD symptoms mediated the association between captivity and the wives' marital adjustment. Moreover, husbands' PTSD trajectories assessed over 17 years were implicated in their wives' marital adjustment; wives of ex-POWs with chronic PTSD reported lower marital adjustment compared to wives of resilient ex-POWs. The substantial novelty was revealed in prospective deterioration found in dyadic adjustment among wives of ex-POWs with delayed PTSD, but not for wives of chronic or resilient ex-POWs. Implications for research and practice are discussed.",0,0 +4831,Connecting combat-related mild traumatic brain injury with posttraumatic stress disorder symptoms through brain imaging,"Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) may share common symptom and neuropsychological profiles in military service members (SMs) following deployment; while a connection between the two conditions is plausible, the relationship between them has been difficult to discern. The intent of this report is to enhance our understanding of the relationship between findings on structural and functional brain imaging and symptoms of PTSD. Within a cohort of SMs who did not meet criteria for PTSD but were willing to complete a comprehensive assessment within 2 months of their return from combat deployment, we conducted a nested case-control analysis comparing those with combat-related mTBI to age/gender-matched controls with diffusion tensor imaging, resting state functional magnetic resonance imaging and a range of psychological measures. We report degraded white matter integrity in those with a history of combat mTBI, and a positive correlation between the white matter microstructure and default mode network (DMN) connectivity. Higher clinician-administered and self-reported subthreshold PTSD symptoms were reported in those with combat mTBI. Our findings offer a potential mechanism through which mTBI may alter brain function, and in turn, contribute to PTSD symptoms.",0,0 +4832,Community Assessment of Psychic Experiences (CAPE) and Trauma and Loss Spectrum (TALS) 12 months after an earthquake in Italy,"Methods Assessments included the Trauma and Loss Spectrum Self-Report and Community Assessment of Psychic Experiences (CAPE). Significant associations were seen between trauma-related measures and subclinical symptoms of psychosis and depression scores. Results Trauma related measures are associated with a weak increase in the subclinical positive and negative dimensions of psychosis, and a modest increase in the subclinical depressive dimension.",0,0 +4833,Rapastinel (GLYX-13) has therapeutic potential for the treatment of post-traumatic stress disorder: Characterization of a NMDA receptor-mediated metaplasticity process in the medial prefrontal cortex of rats,"Rapastinel (GLYX-13) is a NMDA receptor modulator with glycine-site partial agonist properties. It is a robust cognitive enhancer and shows rapid and long-lasting antidepressant properties in both animal models and in humans. Contextual fear extinction (CFE) in rodents has been well characterized and used extensively as a model to study the neurobiological mechanisms of post-traumatic stress disorder (PTSD). Since CFE is NMDA receptor modulated and neural circuitry in the medial prefrontal cortex (MPFC) regulates both depression and PTSD, studies were undertaken to examine the effects of rapastinel for its therapeutic potential in PTSD and to use rapastinel as a tool to study its underlying glutamatergic mechanisms. A 21-day chronic mild unpredictable stress (CUS) rat model was used to model depression and PTSD. The effects of CUS alone compared to No CUS controls, and the effects of rapastinel (3 mg/kg IV) on CUS-treated animals were examined. The effect of rapastinel was first assessed using CUS-treated rats in three depression models, Porsolt, sucrose preference, and novelty-induced hypophagia tests, and found to produce a complete reversal of the depressive-like state in each model. Rapastinel was then assessed in a MPFC-dependent positive emotional learning paradigm and in CFE and again a reversal of the impairments induced by CUS treatment was observed. Both synaptic plasticity and metaplasticity, as measured by the induction of long-term potentiation in rat MPFC slice preparations, was found to be markedly impaired in CUS-treated animals. This impairment was reversed when CUS-treated rats were administered rapastinel and tested 24 h later. Transcriptomic analysis of MPFC mRNA expression in CUS-treated rats corroborated the link between rapastinel's behavioral effects and synaptic plasticity. A marked enrichment in both the LTP and LTD connectomes in rapastinel-treated CUS rats was observed compared to CUS-treated controls. The effects of rapastinel on depression models, PEL, and most importantly on CFE demonstrate the therapeutic potential of rapastinel for the treatment of PTSD. Moreover, rapastinel appears to elicit its therapeutic effects through a NMDA receptor-mediated, LTP-like, metaplasticity process in the MPFC.",0,0 +4834,Long-term trajectories of PTSD or resilience in former East German political prisoners.,"Studies on the long-term consequences of traumatization found different diagnostic trajectories: chronic, recovered, delayed and resilient. This distinction, however, was never studied in victims of torture or severe political persecution. We aimed to verify the trajectory classes of PTSD empirically and to analyze potential predictors of such trajectories. Former political prisoners from East Germany, first interviewed in 1995, were re-assessed fourteen years later. In 1995, retrospective symptom reports dating back to shortly after the prisoners' release dates were assessed. Predictors of the four different trajectories were divided into pre-trauma, peri-trauma, and post-trauma factors. As a result, the four long-term trajectories were validated in the current sample with the following percentages: chronic (36%), resilient (27%), recovered (26%) and delayed (11%) trajectories. Trajectories were mainly distinguished by pre- and post-traumatic factors, e.g. pre-trauma education or post-trauma disclosure opportunities. We conclude that the four long-term trajectories of trauma sequelae deserve more attention to adequately deal with survivors of severe persecution. Furthermore, the specific predictors of long-term trajectory deserve more attention for re-integration or in rehabilitation.",0,0 +4835,Effects of a Behavioral Sleep Medicine Intervention on Trauma Symptoms in Adolescents Recently Treated for Substance Abuse,"This study tested whether improvement in sleep by an integrative, behavioral sleep intervention was associated with improvement in traumatic stress (TS) symptoms in a sample of 20 adolescents who were recently treated for substance abuse. Sleep was measured throughout the intervention via daily sleep diaries, and traumatic stress symptoms were assessed by the Global Appraisal of Individual Needs (GAIN) at baseline, post-intervention, 3-months post-intervention, and 12-months post-intervention. Individuals with more time in bed and more total sleep time at the beginning of the intervention had more improvement in TS symptom trajectories across the intervention and at the 12-month follow-up assessment. Interaction trends also emerged indicating that adolescents who, throughout the sleep intervention, went to bed later and fell asleep faster had greater improvements in TS symptoms over time. Overall, these results indicate that stimulus control, a therapy that encourages patients to attempt sleep only when they are sleepy, may be particularly helpful for adolescents with TS symptoms, sleep disturbances, and substance abuse histories.",0,0 +4836,What's in a name? The MMPI-2 PTSD scales,"The MMPI-2 post-traumatic stress disorder scales (PK and PS) were examined with a sample of 96 outpatient anxiety disorder and 97 outpatient traffic accident subjects. PK and PS correlated .96 and showed highly similar correlations with MMPI-2 validity, clinical, content and supplementary scales for both groups, which indicated that these scales are indices of MMPI first-factor variance. This was supported by separate principal components analyses for each group, in which PK and PS contributed the most variance to the first component. Although the groups showed different MMPI-2 mean profiles, neither PK nor PS contributed to discriminant function classification of group members. It is suggested that PK and PS are indices of general emotional distress and maladjustment; implications for their use in diagnosing post-traumatic stress disorder were discussed.",0,0 +4837,Neighborhoods and Violent Crime: A Multilevel Study of Collective Efficacy,"It is hypothesized that collective efficacy, defined as social cohesion among neighbors combined with their willingness to intervene on behalf of the common good, is linked to reduced violence. This hypothesis was tested on a 1995 survey of 8782 residents of 343 neighborhoods in Chicago, Illinois. Multilevel analyses showed that a measure of collective efficacy yields a high between-neighborhood reliability and is negatively associated with variations in violence, when individual-level characteristics, measurement error, and prior violence are controlled. Associations of concentrated disadvantage and residential instability with violence are largely mediated by collective efficacy.",0,0 +4838,Prevalence and factors associated with Posttraumatic Stress Disorder seven years after the conflict in three districts in northern Uganda (The Wayo-Nero Study),"Research on the prevalence of Posttraumatic Stress Disorder (PTSD) is still limited in low income countries yet PTSD can be a public health problem in post conflict areas. In order to respond to the burden of PSTD in northern Uganda, an area that experienced civil strife for over two decades, we need accurate data on its (PTSD) prevalence and the associated risk factors to facilitate public mental health planning.This study employed a cross-sectional study design and data collection was undertaken in three districts in northern Uganda: Gulu, Amuru and Nwoya. Respondents were aged 18 years and above and were randomly selected at community level. A total of 2400 respondents were interviewed using a structured questionnaire in the three study districts. In this study, multivariate logistic regression was employed to analyze the associations of socio-demographic factors, trauma related variables and the outcome of PTSD.The prevalence of Posttraumatic Stress Disorder (PTSD) in the study population was 11.8 % (95 % CI: 10.5 %, 13.1 %) with a prevalence of 10.9 % (95 % CI: 9.3 %, 12.5 %) among female respondents and 13.4 % (95 % CI: 11.2 %, 15.7 %) among male respondents. Quite a number of factors were strongly associated with PTSD. Overall, a respondent had experienced 9 negative life events. In a multivariate logistic regression, the factors that were strongly associated with PTSD were: exposure to war trauma events, childhood trauma, negative life events, negative copying style and food insecurity. The findings also indicate no association between sex, age and PTSD.The prevalence rate of PTSD in the study communities is unacceptably high. Quite a number of factors were associated with PTSD. Effective public mental health services are needed that combine treatment (medical) psychological and social welfare programs especially at community level to address the high burden of PTSD. Longitudinal studies are also recommended to continuously assess the trends in PTSD in the study communities and remedial action taken.",0,0 +4839,"Association of FKBP5, COMT and CHRNA5 polymorphisms with PTSD among outpatients at risk for PTSD","To the Editor: Several genetic components for posttraumatic stress disorder (PTSD) have been identified, including biologic pathways involving the hypothalamic–pituitary–adrenocortical, locus coeruleus/noradrenergic, and the limbic systems (Broekman, et al., 2007; Koenen, 2007; Rauch and Drevets, 2009). In our IRB-approved study, lifetime PTSD was assessed among adult outpatients with chronic, non-malignant pain, a condition commonly associated with PTSD (McFarlane, 2010). We assessed PTSD with an instrument widely used in previous epidemiologic studies (Boscarino et al., 2010). We examined genetic markers using a multivariate design that assessed single nucleotide polymorphisms (SNPs) located within the FK506 binding protein-5 (FKBP5), catechol-O-methyltransferase (COMT), and cholinergic receptor nicotinic alpha3/alpha-5 (CHRNA3/CHRNA5) gene clusters. SNPs were selected using agnostic LD tagging with consideration of prior evidence and functional annotation (Erlich, et al., 2010). The COMT gene is associated with anxiety disorders, psychosis, depression, and other conditions involving catecholamine pathway regulation (Craddock, et al., 2006; Montag et al., 2008). This gene is also associated with PTSD (Kolassa et al., 2010). The FKBP5 gene regulates glucocorticoid receptor sensitivity, is functionally involved in HPA stress axis activity, and is associated with PTSD (Binder, 2009; Gillespie, et al., 2009). The CHRNA3/5 gene cluster, which encodes components of the nicotinic acetylcholine receptor, is associated with nicotine dependence, smoking, and other substance misuse (Erlich, et al., 2010). PTSD is also associated with cigarette smoking and substance use (Boscarino et al., 2006; Fu et al., 2007). Using trained interviewers and following informed consent, we completed diagnostic interviews with 502 subjects and collected DNA to determine if FKBP5, COMT, and CHRNA3/5 SNPs were associated with PTSD (mean age = 55, S.D. = 13.4; PTSD = 15%, 95% CI = 11.7–18.1%). Non-Caucasian patients were excluded from this analysis. Genotyping was performed on an Applied BioSystems 7500 real-time PCR platform, using TaqMan kits. Using multivariate logistic regressions that included demographic (age, gender, income, education, and marital status) and environmental (trauma exposure, childhood adversity, and neuroticism) variables, 3 of 9 SNPs examined were associated with PTSD (p<0.05), including one within each of the FKBP5 (rs9470080), COMT (rs4680), and CHRNA5 (rs16969968) genes. A count of risk alleles in these 3 loci was also associated with PTSD (OR = 1.65, 95% CI = 1.25–2.16, p = 0.000426), suggesting that those with 4 or more PTSD risk alleles had ~ 7 times greater risk of PTSD, compared to those with no risk alleles (1.65 × 4 = 6.6). We also included opioid dependence, reported pain, number of pain prescriptions, and ancestry (Northern European, Eastern European, and Sothern European/Other) in the model as a final analysis step, but this did not alter the results. Examination of risk-allele counts by PTSD status suggested that the “AA” genotype of the rs16969968 (CHRNA5) and rs4680 (COMT), and the “TT” genotype of rs9470080 (FKBP5) are more common among PTSD cases. Since our logistic regression detected a complex interaction between allele count × trauma exposure × childhood adversity × neuroticism (p = 0.029), we used Answer Tree Chi-square Automatic Interaction Detection to examine these effects (SPSS, Chicago, IL). This confirmed interactions with risk-allele count, indicating that those with higher risk-allele counts and exposure to higher trauma, higher childhood adversity, and higher neuroticism, were at much greater risk for PTSD. Conversely, those with no risk alleles appeared highly resilient to PTSD, regardless of environmental exposures. This is the first study to report that SNP markers rs16969968, rs9470080, and rs4680, were each individually associated with PTSD and that a cumulative allele model using these SNPs was associated with higher PTSD risk. FKBP5 polymorphisms are known to regulate the cortisol-binding affinity and nuclear translocation of the glucocorticoid receptor and polymorphisms at this locus have been associated with PTSD. COMT polymorphisms have been found to affect fear extinction and are thought to play a role in anxiety disorders and PTSD. The CHRNA gene has been associated with nicotine dependence and PTSD is associated with cigarette smoking and other substance misuse. Additional research is recommended to confirm these findings. The involvement of the CHRNA gene in PTSD, fear circuitry, and stress regulation is biologically plausible and worthy of further investigation.",0,0 +4840,MMPI-2 As a Predictor of Change in PTSD Symptom Clusters: A Further Analysis of the Forbes et al. (2002) Data Set,"In this study, we reanalyzed the Forbes et al. (2002) data set to examine the Minnesota Multiphasic Personality Inventory (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) as a differential predictor of change across posttraumatic stress disorder symptom clusters following treatment in 141 Vietnam veterans. A series of partial correlation and linear multivariate regression analyses, controlling for initial symptom severity, identified several scales predictive of symptom change. None of the MMPI-2 scales, however, emerged as predictors of change in reexperiencing symptoms. Social alienation and marital distress were the most potent predictors for avoidance symptoms. Anger, alcohol use, and hypomania were the most potent predictors for the hyperarousal symptoms. Of the personality disorders, borderline personality was the strongest predictor of change in the avoidance and hyperarousal clusters. Further replication of the findings of this article and those reported by Forbes et al. (2002) is required.",0,0 +4841,Posttraumatic stress disorder in the emergency room: exploration of a cognitive model,"Ehlers and Clark (Behav. Res. Ther., 38 (2000) 319) recently proposed a cognitive model of posttraumatic stress disorder (PTSD). In this study, we examined two facets of this model, appraisal and peritraumatic dissociation, in the context of a hospital emergency room. Fifty-one emergency room personnel completed questionnaires measuring posttraumatic stress symptoms, interpretations of traumatic events experienced while working in the emergency room and subsequent intrusive recollections, and peritraumatic dissociation. Twelve percent of participants met formal diagnostic criteria for PTSD, and 20% met PTSD symptom criteria. As predicted, both negative appraisals of the trauma and of intrusive recollections were associated with increased PTSD severity. Although peritraumatic dissociation did not correlate with overall PTSD symptom severity, it was associated with the reexperiencing symptom cluster. Discussion focuses on the factors associated with PTSD in emergency room professionals and implications for intervention.",0,0 +4842,An Open-Label Study of Levetiracetam for the Treatment of Social Anxiety Disorder,"Social anxiety disorder is a disabling condition characterized by excessive fear and avoidance of social and performance situations. While a variety of effective pharmacotherapies exists, many patients do not fully respond to or tolerate available agents. Preclinical and early clinical experience with levetiracetam, a novel anticonvulsant agent, suggests that levetiracetam has anxiolytic properties and a favorable adverse event profile. Levetiracetam thus warrants systematic evaluation as a treatment option for anxiety disorders.Twenty adult outpatients who were recruited through advertisement and clinical referral and who met DSM-IV criteria for social anxiety disorder, generalized type, participated in this 8-week open-label, flexible-dose study from November 2002 to December 2003. Participants were required to have scores of >/= 50 on the Liebowitz Social Anxiety Scale (LSAS) and >/= 4 on the Clinical Global Impressions-Severity of Illness scale (CGI-S) at baseline. The presence of comorbid depression and anxiety disorders were permitted as long as social anxiety disorder was the primary disorder. Levetiracetam was initiated at 250 mg/day for the first week and flexibly titrated up to a maximum of 3000 mg/day (1500 mg b.i.d.). The primary outcome measure was change in the LSAS score at endpoint.There was a clinically significant 20.5-point decrease in LSAS scores in the intent-to-treat, last-observation-carried-forward analysis (t = 3.1; p <.01, N = 20). There were also significant reductions in CGI-S (p <.01) and Hamilton Rating Scale for Anxiety (p <.02) scores.This pilot study supports the safety and potential efficacy of a novel agent, levetiracetam, for the treatment of social anxiety disorder. Larger controlled trials are warranted to confirm these results.",0,0 +4843,Affective Dispositions and PTSD Symptom Clusters in Female Interpersonal Trauma Survivors,"Interpersonal trauma (IPT) against women can have dire psychological consequences including persistent maladaptive changes in the subjective experience of affect. Contemporary literature has firmly established heightened negative affect (NA) as a risk and maintenance factor for posttraumatic stress disorder (PTSD). However, the relationship between NA and PTSD symptoms is not well understood within IPT survivors, the majority of whom are female, as much of this research has focused on combat veterans. In addition, the connection between positive affect (PA) and PTSD symptoms has yet to be examined. With increased emphasis on ""negative alterations in cognitions and mood . . ."" as an independent symptom cluster of PTSD in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5), understanding the relationship between self-reported affectivity and the classic PTSD symptom clusters may be increasingly useful in differentiating symptom presentations of trauma-related psychopathology. The current study directly compared self-reported trait NA and PA with total severity and frequency cluster scores from the Clinician-Administered PTSD Scale (CAPS) in 54 female survivors of IPT who met criteria for PTSD. Results identify NA (but not PA) as a consistent predictor of total PTSD symptoms and, specifically, re-experiencing symptoms.",0,0 +4844,Transforming Trajectories for Traumatized Children,,0,0 +4845,Posttraumatic Stress in Survivors 1 Month to 19 Years after an Airliner Emergency Landing,"Posttraumatic stress (PTS) is common in survivors from life-threatening events. Little is known, however, about the course of PTS after life threat in the absence of collateral stressors (e.g., bereavement, social stigma, property loss) and there is a scarcity of studies about PTS in the long term. This study assessed the short- and long-term course of PTS, and the influence of gender, education and age on the level and course of PTS, in survivors from a non-fatal airliner emergency landing caused by engine failure at an altitude of 1 km. There were 129 persons on board. A survey including the Impact of Event Scale was distributed to 106 subjects after 1 month, 4 months, 14 months, and 25 months, and to 95 subjects after 19 years (response rates 64-83%). There were initially high levels of PTS. The majority of changes in PTS occurred from 1 to 4 months after the event. There were small changes from 4 to 25 months but further decrease in PTS thereafter. Female gender was associated with higher levels of PTS whereas gender was unrelated to the slope of the short- and long-term trajectories. Higher education was related to a quicker recovery although not to initial or long-term PTS. Age was not associated with PTS. The present findings suggest that a life-threatening experience without collateral stressors may produce high levels of acute posttraumatic stress, yet with a benign prognosis. The findings further implicate that gender is unrelated to trajectories of recovery in the context of highly similar exposure and few collateral stressors.",0,0 +4846,[The typology of chronic posttraumatic stress disorder].,"Psychopathological chronic posttraumatic stress disorder (PTSD) was studied in relation to clinical peculiarities of depression included in PTSD structure. One hundred and sixty-five patients, 124 men and 41 women, aged 25-48 years, were examined in general outpatient clinics. PTSD duration was from 6 to 24 months. A stress was caused by situations related to combat events (60.6%), close person's death (25.4%), assault with physical and moral violence (8.2%) and rape (5.8%). With regard to depression structure and dominating affect, 4 PTSD types--anxious (36.6%), dysphoric (26.1%), apathic (20%) and somatoform (17.7%), were distinguished. Also, their significance for the formation of patient's personality features is emphasized. A role of depression in syndrome formation in chronic PTSD is suggested.",0,0 +4847,Persistence of multiple illnesses in World Trade Center rescue and recovery workers: a cohort study,"More than 50,000 people participated in the rescue and recovery work that followed the Sept 11, 2001 (9/11) attacks on the World Trade Center (WTC). Multiple health problems in these workers were reported in the early years after the disaster. We report incidence and prevalence rates of physical and mental health disorders during the 9 years since the attacks, examine their associations with occupational exposures, and quantify physical and mental health comorbidities.In this longitudinal study of a large cohort of WTC rescue and recovery workers, we gathered data from 27,449 participants in the WTC Screening, Monitoring, and Treatment Program. The study population included police officers, firefighters, construction workers, and municipal workers. We used the Kaplan-Meier procedure to estimate cumulative and annual incidence of physical disorders (asthma, sinusitis, and gastro-oesophageal reflux disease), mental health disorders (depression, post-traumatic stress disorder [PTSD], and panic disorder), and spirometric abnormalities. Incidence rates were assessed also by level of exposure (days worked at the WTC site and exposure to the dust cloud).9-year cumulative incidence of asthma was 27·6% (number at risk: 7027), sinusitis 42·3% (5870), and gastro-oesophageal reflux disease 39·3% (5650). In police officers, cumulative incidence of depression was 7·0% (number at risk: 3648), PTSD 9·3% (3761), and panic disorder 8·4% (3780). In other rescue and recovery workers, cumulative incidence of depression was 27·5% (number at risk: 4200), PTSD 31·9% (4342), and panic disorder 21·2% (4953). 9-year cumulative incidence for spirometric abnormalities was 41·8% (number at risk: 5769); three-quarters of these abnormalities were low forced vital capacity. Incidence of most disorders was highest in workers with greatest WTC exposure. Extensive comorbidity was reported within and between physical and mental health disorders.9 years after the 9/11 WTC attacks, rescue and recovery workers continue to have a substantial burden of physical and mental health problems. These findings emphasise the need for continued monitoring and treatment of the WTC rescue and recovery population.Centers for Disease Control and Prevention and National Institute for Occupational Safety and Health.",0,0 +4848,Post-Traumatic Stress Disorder in Adults with Serious Mental Illness and Substance Abuse,"Post-Traumatic Stress Disorder continues to be under-diagnosed among individuals with severe mental illness and substance abuse. In a convenience sample of 64 patients with severe mental disorders being treated at an urban outpatient clinic, 24% met full criteria for PTSD based upon a comprehensive assessment protocol while only 3% were diagnosed with PTSD by clinicians in the medical record (Cochran's Q = 11.267, df 1, p <.001). In contrast, there was a high rate of diagnostic agreement for psychotic and affective illnesses as well as substance abuse. More attention needs to be given to systematically assessing PTSD among severely mentally ill and dually diagnosed individuals because even highly skilled diagnosticians miss the complex presentation of symptoms with which these patients present for treatment.",0,0 +4849,Different Neural Mechanisms Underlie Deficits in Mental Flexibility in Post-Traumatic Stress Disorder Compared to Mild Traumatic Brain Injury,"Mental flexibility is a core executive function that underlies the ability to adapt to changing situations and respond to new information. Individuals with post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) complain of a number of executive function difficulties, one of which is mental inflexibility or an inability to switch between concepts. While the behavioral presentation of mental inflexibility is similar in those with PTSD or mTBI, we hypothesized that the differences in their etiology would manifest as differences in their underlying brain processing. The neural substrates of mental flexibility have been examined with a number of neuroimaging modalities. Functional magnetic resonance imaging has elucidated the brain regions involved, whereas electroencephalography has been applied to understand the timing of the brain activations. Magnetoencephalography, with its high temporal and spatial resolution, has more recently been used to delineate the spatiotemporal progression of brain processes involved in mental flexibility and has been applied to the study of clinical populations. In a number of separate studies, our group has compared the source localization and brain connectivity during a mental flexibility set-shifting task in a group of soldiers with PTSD and civilians with an acute mTBI. In this article, we review the results from these studies and integrate the data between groups to compare and contrast differences in behavioral, neural, and connectivity findings. We show that the different etiologies of PTSD and mTBI are expressed as distinct neural profiles for mental flexibility that differentiate the groups despite their similar clinical presentations.",0,0 +4850,Full Information Estimation in the Presence of Incomplete Data,,0,0 +4851,Do People Turn to Religion in Times of Stress?,"This study examined the effect of health-related stress on changes in religiousness in a sample of elderly, medically ill patients. Patients admitted to Duke University Medical Center (N = 745) were interviewed at baseline and 3-month follow-up. Increases in illness severity (from baseline to follow-up) were associated with decreases in both organizational and private religiousness at follow-up. Effect of illness severity on organizational religiousness was statistically mediated by changes in physical activity, while its effect on private religiousness remained significant after controlling for physical activity. These findings encourage further research investigating causal relationships between stress and religion, as well as identifying measures of religiousness that may capture this construct in the medically ill population.",0,0 +4852,The mediating effect of self-efficacy in the relationship between social support and post-traumatic stress disorder symptoms among patients with central system tumors in China: a cross-sectional study,"Post-traumatic stress disorder (PTSD) is a disorder that can affect people following the experience of a traumatic event. Few studies have researched on PTSD symptoms of patients with central nervous system tumors. In this study, we aim to examine the association between social support and PTSD symptoms and to explore the mediating effect of self-efficacy in this relationship among patients with central nervous system tumors in China.Questionnaires consisting of the Post-traumatic Stress Checklist-Civilian Version, the Duke-UNC Functional Social Support Questionnaire, the General Self-Efficacy Scale, as well as demographic and clinical factors were used to collect information of patients with central nervous system tumors in Liaoning Province, China. A total of 222 patients (effective response rate of 66.1%) became our subjects. Hierarchical linear regression analyses were performed to explore the association between social support and PTSD symptoms and the mediating effect of self-efficacy.After adjusting for demographic characteristics and tumor type, social support was negatively associated with the total score of PTSD symptoms (β = -0.342, P < 0.01). Social support explained 8.8% of the variance in PTSD symptoms. Self-efficacy was found to partially mediate the relationship between social support and PTSD symptoms.Self-efficacy partially mediated the relationship between social support and PTSD symptoms. Interventions focusing on both social support and self-efficacy might be more useful than interventions only targeting either of them.",0,0 +4853,"Longitudinal analysis of the relationship between PTSD symptom clusters, cigarette use, and physical health-related quality of life","Purpose: Posttraumatic stress disorder (PTSD) symptoms, particularly numbing and hyperarousal symptoms, are related to poor physical health-related quality of life (HRQoL). Tobacco dependence is also associated with poor HRQoL, and individuals with PTSD may smoke at higher rates than the general population. Our study aimed to examine the impact of quitting smoking and changes in PTSD symptoms over time on changes in physical HRQoL. Methods: The study used archival data from enrollees (N = 943) in a smoking cessation clinical trial for veterans with PTSD (VA Cooperative study #519). Results: Two of the physical HRQoL domains were sensitive to changes in PTSD symptoms over time: General Health and Vitality. Conclusions: Our findings suggest that particular physical HRQoL domains may be subject to improvement if PTSD symptoms decrease over time. © 2012 Springer Science+Business Media Dordrecht.",0,0 +4854,Lifetime Victimization and Psychological Distress: Cluster Profiles of Out of Treatment Drug-Involved Women,K-means clustering techniques were used to identify four cluster profi les characterized by unique patterns of victimization and psychological distress and further differentiated by distinct patterns of risk and protection across multiple life domains among a sample of 149 crack-using women. Results of this study suggest that important differences exist in patterns of victimization and psychological distress among drug-involved women. Identifi cation of this variation can be used to tailor intervention strategies to the particular needs of different subgroups within the population of crack-using women. © 2010 Springer Publishing Company.,0,0 +4855,Elevated Risk for Autoimmune Disorders in Iraq and Afghanistan Veterans with Posttraumatic Stress Disorder,"Posttraumatic stress disorder (PTSD) is associated with endocrine and immune abnormalities that could increase risk for autoimmune disorders. However, little is known about the risk for autoimmune disorders among individuals with PTSD.We conducted a retrospective cohort study of 666,269 Iraq and Afghanistan veterans under age 55 who were enrolled in the Department of Veterans Affairs health care system between October 7, 2001, and March 31, 2011. Generalized linear models were used to examine if PTSD, other psychiatric disorders, and military sexual trauma exposure increased risk for autoimmune disorders, including thyroiditis, inflammatory bowel disease, rheumatoid arthritis, multiple sclerosis, and lupus erythematosus, adjusting for age, gender, race, and primary care visits.PTSD was diagnosed in 203,766 veterans (30.6%), and psychiatric disorders other than PTSD were diagnosed in an additional 129,704 veterans (19.5%). Veterans diagnosed with PTSD had significantly higher adjusted relative risk (ARR) for diagnosis with any of the autoimmune disorders alone or in combination compared with veterans with no psychiatric diagnoses (ARR = 2.00; 95% confidence interval, 1.91-2.09) and compared with veterans diagnosed with psychiatric disorders other than PTSD (ARR = 1.51; 95% confidence interval, 1.43-1.59; p < .001). The magnitude of the PTSD-related increase in risk for autoimmune disorders was similar in women and men, and military sexual trauma exposure was independently associated with increased risk in both women and men.Trauma exposure and PTSD may increase risk for autoimmune disorders. Altered immune function, lifestyle factors, or shared etiology may underlie this association.",0,0 +4856,"Nosological profile and prevalence of common mental disorders of patients seen at the Family Health Program (FHP) units in Petrópolis, Rio de Janeiro","OBJECTIVES: This study aims to detect the prevalence of common mental disorders among patients seen by doctors at family health program units in Petrópolis-RJ, and to establish their nosological profile. METHOD: The population of the study included all 18 to 65-year-old patient who attended any family health program units included in the study during a 30-day period, between August and December 2002 (n = 714). The prevalence of common mental disorders was assessed using the General Health Questionnaire, 12 item version. In order to establish the nosological profile, the Composite International Diagnostic Interview was administered to all common mental disorders positive patients who accepted to return (n = 215). RESULTS: At the cut-off point of 2/3 the common mental disorders prevalence was 56% and for 4/5, it was 33%. The most frequent nosological categories found among common mental disorders positive patients were depression and anxiety categories along with posttraumatic stress disorder, somatoform pain disorder and dissociative disorders. There was a high frequency of comorbidity, especially between anxiety, depression, somatoform and dissociative disorders. CONCLUSIONS: The common mental disorders prevalence and the nosological profile found in FHP were similar to those of other primary care studies in Brazil, but some disorders (posttraumatic stress disorder, somatoform pain disorder and dissociative disorders) that had not been previously studied in this context were also very frequent. The high common mental disorders prevalence found reinforces the urgent need for systematic inclusion of this level of care in mental health assistance planning.",0,0 +4857,Establishing a methodology to examine the effects of war-zone PTSD on the family: the family foundations study,"Military deployment may adversely affect not only returning veterans, but their families, as well. As a result, researchers have increasingly focused on identifying risk and protective factors for successful family adaptation to war-zone deployment, re-integration of the returning veteran, and the longer-term psychosocial consequences of deployment experienced by some veterans and families. Post-traumatic stress disorder (PTSD) among returning veterans may pose particular challenges to military and military veteran families; however, questions remain regarding the impact of the course of veteran PTSD and other potential moderating factors on family adaptation to military deployment. The Family Foundations Study builds upon an established longitudinal cohort of Army soldiers (i.e. the Neurocognition Deployment Health Study) to help address remaining knowledge gaps. This report describes the conceptual framework and key gaps in knowledge that guided the study design, methodological challenges and special considerations in conducting military family research, and how these gaps, challenges, and special considerations are addressed by the study.",0,0 +4858,Predictors of outcome following a short multimodal rehabilitation program for patients with whiplash associated disorders.,"Patients with whiplash associated disorders (WAD) may present with physical and psychological symptoms which persist long after the initial onset of pain. Several studies have shown that therapeutic exercise for motor and sensorimotor control combined with manual therapy in a multimodal rehabilitation (MMR) program is effective at improving pain and disability in patients with neck disorders. To date, no studies have investigated which self-reported physical or psychological symptoms are predictive of response to this MMR program.To determine which baseline features can predict outcome following a 3-week MMR program in patients with WAD.Observational prospective cohort study.Outpatient rehabilitation clinic.Thirty-seven patients aged >18 years with a diagnosis of WAD grade II or III.The MMR program included manual therapy, motor control and sensorimotor control training according to the clinical impairments of each patient. Patients were assessed before and after treatment for their physical and psychological symptoms by means of self-reported questionnaires. Regression models were estimated with pain intensity, disability and post-traumatic stress symptoms (PTSS) as outcomes.After treatment, patients exhibited significant improvements in all evaluated outcomes (all P<0.01). Regression models accounting for 35% and 36% of the variance in pain intensity outcomes included average pain intensity over the previous week and pain catastrophizing as significant predictors. Disability and pain catastrophizing were predictors of changes in disability following the MMR program explaining 49% of the variance in the model. Furthermore, higher PTSS at baseline was a significant predictor of PTSS after treatment, explaining 55% of the variance in the model.Improved outcomes on pain intensity, disability and PTSS following a MMR program could be partially predicted based on the patient's initial presentation.This knowledge may assist clinicians in predicting outcome following a MMR program inclusive of specific exercise therapy and manual therapy in patients with WAD.",0,0 +4859,Managing anger and aggression in patients with posttraumatic stress disorder.,"Posttraumatic stress disorder was categorized as a clinical entity in 1980 in response to assertions by trauma survivors (particularly Vietnam veterans) and their clinicians that existing diagnostic categories failed to adequately describe their symptoms. The diagnostic features of the current DSM-IV diagnosis have been expanded, and the concept of the disorder is still evolving. Posttraumatic stress disorder rarely occurs in ""pure"" form, and individuals suffering from the disorder commonly meet criteria for Axis I and Axis II disorders. Research is now emerging that supports the prevalence of aggression in posttraumatic stress disorder. Treatment approaches vary, but pharmacotherapy aimed at targeting individual symptoms or clusters can promote mood stabilization. This article discusses the evolving concept of posttraumatic stress disorder as a clinical entity, the association of anger and aggression with the disorder, and the psychopharmacologic approaches to treatment.",0,0 +4860,The Effect of Draft DSM-V Criteria on Posttraumatic Stress Disorder Prevalence,"This study was designed to examine the concordance of proposed DSM-V posttraumatic stress disorder (PTSD) criteria with DSM-IV classification rules and examine the impact of the proposed DSM-V PTSD criteria on prevalence.The sample (N = 185) included participants who were recruited for studies focused on trauma and health conducted at an academic medical center and VA medical center in the southeastern United States. The prevalence and concordance between DSM-IV and the proposed DSM-V classifications were calculated based on results from structured clinical interviews. Prevalence rates and diagnostic efficiency indices including sensitivity, specificity, area under the curve (AUC), and Kappa were calculated for each of the possible ways to define DSM-V PTSD.Ninety-five percent of the sample reported an event that met both DSM-IV PTSD Criterion A1 and A2, but only 89% reported a trauma that met Criterion A on DSM-V. Results examining concordance between DSM-IV and DSM-V algorithms indicated that several of the algorithms had AUCs above 0.90. The requirement of two symptoms from both Clusters D and E provided strong concordance to DSM-IV (AUC = 0.93; Kappa = 0.86) and a greater balance between sensitivity and specificity than requiring three symptoms in both Clusters D and E.Despite several significant changes to the diagnostic criteria for PTSD for DSM-V, several possible classification rules provided good concordance with DSM-IV. The magnitude of the impact of DSM-V decision rules on prevalence will be largely affected by the DSM-IV PTSD base rate in the population of interest.",0,0 +4861,Circulatory response to hyperthermia during acute normovolaemic haemodilution,"Cats anaesthetized with a mixture of chloralose and urethane were exposed to heat stress in two groups. In the first group (n=10) of control animals, the effect of heat stress on haemodynamic variables was recorded at control haematocrit (HCT) of 42.0±1.0%. In a second group, the effect of heat stress was studied after induction of acute normovolaemic haemodilution (HCT of 13.0±1.0%). Haemodilution was induced to a maximum of 60% replacement of blood with dextran (mol.wt. 150000). Heat stress was induced by surface heating and core body temperature was raised from 37° C to 42° C. The effect of heat stress and haemodilution on various haemodynamic variables, viz. left ventricular pressure (LVP), left ventricular contractility (LVdP/dtmax), heart rate (HR), cardiac output (CO), arterial blood pressure (ABP), right atrial pressure (RAP), and arterial blood PO2, PCO2 and pH was examined. Haemodilution produced significant (P<0.05) increases in HR and CO but there were no significant (P>0.05) changes in ABP, RAP, LVdP/dtmax and total peripherial resistance (TPR). Hyperthermia caused a significant fall (P<0.05) in TPR. However, the percentage fall in TPR was higher in the control group. On exposure to heat stress, there were significant (P<0.05I increases in HR and CO in both the groups; however, HR and CO values were significantly (P<0.05) higher in the haemodiluted group compared to the control. The latter findings could be due either to the higher basal values of these variables with the fall in HCT or to inefficient cardiovascular regulatory mechanisms. The lack of efficient regulatory control under such severe stress conditions makes the cardiovascular system of anaemic animals more vulnerable to heat stress. In conclusion, the results of the present study showed deleterious effects of heat stress in both the groups. The higher values of HR and CO in the haemodiluted group may be responsible for circulatory failure at low HCT values, indicating a higher risk in the haemodiluted group as compared to the control group. © ISB 1998.",0,0 +4862,The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories,"The psychometric properties of the Depression Anxiety Stress Scales (DASS) were evaluated in a normal sample of N = 717 who were also administered the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The DASS was shown to possess satisfactory psychometric properties, and the factor structure was substantiated both by exploratory and confirmatory factor analysis. In comparison to the BDI and BAI, the DASS scales showed greater separation in factor loadings. The DASS Anxiety scale correlated 0.81 with the BAI, and the DASS Depression scale correlated 0.74 with the BDI. Factor analyses suggested that the BDI differs from the DASS Depression scale primarily in that the BDI includes items such as weight loss, insomnia, somatic preoccupation and irritability, which fail to discriminate between depression and other affective states. The factor structure of the combined BDI and BAI items was virtually identical to that reported by Beck for a sample of diagnosed depressed and anxious patients, supporting the view that these clinical states are more severe expressions of the same states that may be discerned in normals. Implications of the results for the conceptualisation of depression, anxiety and tension/stress are considered, and the utility of the DASS scales in discriminating between these constructs is discussed.",0,0 +4863,Cross-sectional psychosocial evaluation of heart transplantation candidates,"Heart transplantation (HT) is a potentially life-saving procedure for people with terminal cardiac disease. In the last decades researchers of HT programs have attempted to identify the existence of psychosocial factors that might influence the clinical outcome before and after the transplantation. The main objective of this study was to describe epidemiological, psychiatric and psychological features of a large sample of HT candidates.Cross-sectional, observational and descriptive study. A psychiatric and psychological assessment of 125 adult patients was performed at the moment of being included in the HT waiting list, between 2006 and 2012. The assessment consisted in: Clinical, epidemiological and psychosocial form; Spanish version of Hospital Anxiety and Depression Scale; Structured Clinical Interview for DSM-IV axis I disorders; Coping questionnaire (COPE); Five Factors Inventory Revised (NEO-FFI-R); Apgar-Family questionnaire and the Multidimensional Health Locus of Control scale.Axis I diagnoses were present in a 30.4% of patients. COPE showed that this group of patients used most frequently engagement strategies. Personality factors profile of NEO-FFI-R were similar to general population and locus of control scale also presented similar scores compared with other chronic diagnostic groups. Statistically significant associations were found between personality factors and COPE scales/dimensions and psychopathology, mainly neuroticism and disengagement.This is the first study to assess systematically psychosocial factors in a large sample of HT candidates. We have found that around one third of these patients have a psychiatric disorder. Neuroticism and disengagement coping styles can serve as markers of emotional distress.",0,0 +4864,Identification of posttraumatic growth trajectories in the first year after breast cancer surgery,"Background Empirical studies of the relationship between posttraumatic growth (PTG) and adjustment outcomes reveal a fairly inconclusive picture. We argue that the inconsistent findings are likely due to the heterogeneity of the PTG experience over time. In this regard, we predicted that individuals with different PTG trajectories vary in the level of adjustment and the correlational patterns between PTG and adjustment. Methods Participants were 124 Taiwanese women who underwent surgery for breast cancer. Measures of PTG and adjustment variables, including positive affect, negative affect, mental and physical quality of life, anxiety, and depression, were assessed at 1 day and 3, 6, and 12 months after surgery. A group-based trajectory model was used to identify subpopulations of individuals who shared homogenous growth patterns. Then, we determined whether the trajectory predicted adjustment at 12 months after surgery. The correlations between PTG and adjustment outcomes were computed in each subpopulation across every time point. Results The patients were categorized into the following four groups, which showed very different patterns of PTG change over the first year after breast cancer surgery: stable high (27.4%), high decreasing (39.4%), low increasing (16.9%), and low decreasing (16.9%). Differences in the level of adjustment at 12 months and the patterns of the correlations across time were found among these latent subgroups Conclusions This study was the first longitudinal examination of PTG trajectories and their different levels of adjustment. The findings support our argument that identifying distinct PTG trajectories can better determine the nature of the relationship between PTG and adjustment. Copyright © 2014 John Wiley & Sons, Ltd.",0,0 +4865,Patterns of mental distress following the violent death of a child and predictors of change over time,"We observed 173 parents bereaved by the violent death of an adolescent or young adult child. Data were collected 4, 12, 24, and 60 months postdeath. Using latent growth modeling, we examined how initial levels of mental distress and the rate of change over time are influenced by nine predictors: parents' gender, self-esteem, three coping strategies, perceived social support, negative life stressors, posttraumatic stress disorder (PTSD) symptoms, and an intervention offered in the early bereavement period. The results support a multiple-risk and -protective factor model of loss accommodation. Parents' gender, self-esteem, and affective and repressive coping were predictive of changes in mental distress over time. Although parents' initial levels of PTSD were the best predictor of baseline mental distress, they did not predict reductions in distress 5 years later. Theoretical, empirical, and clinical implications are discussed.",0,0 +4866,PTSD symptom presentation across the deployment cycle,"Symptom-level variation in posttraumatic stress disorder (PTSD) has not yet been examined in the early post-deployment phase, but may be meaningful etiologically, prognostically, and clinically.Using latent class analysis (LCA), we examined PTSD symptom heterogeneity in a cohort of participants from the Marine Resiliency Study (MRS), a longitudinal study of combat Marines deployed to Iraq and Afghanistan (N=892). Typologies of PTSD symptom presentation were examined at one month pre-deployment and again one, five, and eight months post-deployment.Heterogeneity in PTSD symptom presentation was evident at each assessment point, and the degree of symptom heterogeneity (i.e., the number of classes identified) differed by time point. Symptom patterns stabilized over time from notable symptom fluctuations during the early post-deployment period to high, medium, and low symptom severity by eight months post-deployment. Hypervigilance and exaggerated startle were frequently endorsed by participants in the initial month post-deployment. Flashbacks, amnesia, and foreshortened future were infrequently endorsed. Greater combat exposure, lifespan trauma, and avoidant coping generally predicted worse outcomes.Data were self-report and may have limited generalizability due to our lack of women and inclusion of only combat Marines. Attrition and re-ranging of data resulted in significant missing data and affected the representativeness of the sample.Symptom-level variability is highest in the month following deployment and then stabilizes over time. Should post-deployment assessments occur too soon, they may capture common and transient early post-deployment reactions, particularly anxious arousal.",0,0 +4867,Longitudinal Study of Headache Trajectories in the Year After Mild Traumatic Brain Injury: Relation to Posttraumatic Stress Disorder Symptoms,"To examine headache trajectories among persons with mild traumatic brain injury (MTBI) in the year after injury and the relation of headache trajectory to posttraumatic stress disorder (PTSD) at 1 year postinjury.Prospective, longitudinal study.Participants were recruited through a university medical center and participated in follow-up assessments by telephone.Prospectively enrolled individuals (N=212) within 1 week of MTBI who were hospitalized for observation or other system injuries. Participants were assessed at baseline and 3, 6, and 12 months postinjury.Not applicable.Participants rated average headache pain intensity using the 0 to 10 numerical rating scale at each assessment period. The PTSD Checklist-Civilian Version was completed at 12 months postinjury.Latent class growth analysis produced a 4-trajectory group model, with groups labeled resolved, worsening, improving, and chronic. Multivariate regression modeling revealed that younger age and premorbid headache correlated with membership in the worse trajectory groups (worsening and chronic; P<.001). Univariate regression revealed a significant association between PTSD and membership in the worse trajectory groups (P<.001).Headache is common in the year after MTBI, with younger people, persons who previously had headaches, and persons with PTSD more likely to report chronic or worsening headache. Further research is needed to examine whether PTSD symptoms exacerbate headaches or whether problematic headache symptoms exacerbate PTSD.",0,0 +4868,Cognitive behaviour therapy for adolescent offenders with mental health problems in custody,"Many studies have identified high levels of mental health problems among adolescents in custody and there is increasing evidence that mental health problems in this population are associated with further offending and mental health problems into adulthood. Despite recent improvements in mental health provision within custodial settings there is little evidence of structured interventions being offered or of their effectiveness being evaluated. A cognitively based intervention was developed and offered to adolescents with a variety of mental health problems in different secure settings, and the outcomes compared with a control group. Although this small-scale study did not identify significant differences in outcomes for the two groups, both recruitment and retention in therapy were good, and potential candidates were not excluded on the basis of learning difficulties or co-morbidity. The study demonstrated the viability of a delivering cognitively based intervention for common mental health problems within secure settings.",0,0 +4869,Evaluation of a Bayesian Approach to Estimating Nonlinear Mixed-Effects Mixture Models,"The growth mixture model has become increasingly popular, given the willingness to acknowledge developmental heterogeneity in populations. Typically, linear growth mixture models, based on polynomials or piecewise functions, are used in substantive applications and evaluated quantitatively through simulation. Growth mixture models that follow inherently nonlinear trajectories, referred to as nonlinear mixed-effects mixture models, have received comparatively little attention—likely due to estimation complexity. Previous work on the estimation of these models has involved multistep routines (Kelley, 2008), maximum likelihood estimation (MLE) via the E-M algorithm (Harring, 2005, 2012), Taylor series expansion and MLE within the structural equation modeling framework (Grimm, Ram, & Estabrook, 2010), and MLE by adaptive Gauss–Hermite quadrature (Codd & Cudeck, 2014). This article proposes and evaluates the use of Bayesian estimation with OpenBUGS (Lunn, Spiegelhalter, Thomas, & Best, 2009), a free program, a...",0,0 +4870,Autism and Trauma: Autistic Post-traumatic Developmental Disorder,"(from the chapter) The author notes that autistic patients fall into natural sub-groupings with shared characteristics. The author's clinical attempts to reach these inaccessible children has led to conceptualizing sub-groupings on the basis of symptoms, which includes meta-psychological factors based on the author's experience of the way the children present. This chapter proposes an Autistic Post-Traumatic Developmental Disorder (APTDD) sub-group, drawing attention to a similarity between the nature of the symptomatology in a small sub-group of children with autism and the symptomatology of posttraumatic stress disorder (PTSD) in children who are not autistic. The author suggests that it is the impact of trauma in infancy which precipitates in an autistic withdrawal, leading to developmental delay, and thus proposes the term APTDD to describe the condition. Links are made to the work of neurobiologists, and clinical vignettes are given as illustrations, including those of 2 male children. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4871,"Poly-Victimization and Risk of Posttraumatic, Depressive, and Substance Use Disorders and Involvement in Delinquency in a National Sample of Adolescents","

Abstract

Purpose

Adolescents exposed to multiple forms of psychological trauma (""poly-victimization,"" Finkelhor et al. Child Abuse Negl 2007;31:7–26) may be at high risk for psychiatric and behavioral problems. This study empirically identifies trauma profiles in a national sample of adolescents to ascertain correlates of poly-victimization.

Methods

Latent Class analyses and logistic regression analyses were used with data from the National Survey of Adolescents to identify trauma profiles and each profile's risk of posttraumatic stress disorder, major depressive disorder, substance use disorders, and delinquency involvement and deviant peer group relationships. Poly-victimization classes were also compared to classes with trauma exposure of lesser complexity.

Results

Six mutually exclusive trauma profiles (latent classes) were identified. Four classes were characterized by high likelihood of poly-victimization, including abuse victims (8%), physical assault victims (9%), and community violence victims (15.5%). Poly-victimization class members, especially abuse and assault victims, were more likely than do youth traumatized by witnessing violence or exposure to disaster/accident trauma to have psychiatric diagnosis and (independent of psychiatric diagnoses or demographics) to be involved in delinquency with delinquent peers.

Conclusions

Poly-victimization is prevalent among adolescents and places youth at high risk for psychiatric impairment and for delinquency. Moreover, poly-victimized youths' risk of delinquency cannot be fully accounted for by posttraumatic stress disorder, depression, or substance use problems, suggesting that adolescent healthcare providers should consider poly-victimization as a risk for behavioral and legal problems even when PTSD, depression, or addiction symptoms are not clinically significant.",0,0 +4872,Aberrant EEG functional connectivity and EEG power spectra in resting state post-traumatic stress disorder: A sLORETA study,"The aim of the present study was to explore the modifications of EEG power spectra and EEG connectivity of resting state (RS) condition in patients with post-traumatic stress disorder (PTSD). Seventeen patients and seventeen healthy subjects matched for age and gender were enrolled. EEG was recorded during 5min of RS. EEG analysis was conducted by means of the standardized Low Resolution Electric Tomography software (sLORETA). In power spectra analysis PTSD patients showed a widespread increase of theta activity (4.5-7.5Hz) in parietal lobes (Brodmann Area, BA 7, 4, 5, 40) and in frontal lobes (BA 6). In the connectivity analysis PTSD patients also showed increase of alpha connectivity (8-12.5Hz) between the cortical areas explored by Pz-P4 electrode. Our results could reflect the alteration of memory systems and emotional processing consistently altered in PTSD patients.",0,0 +4873,"Predeployment, deployment, and postdeployment risk factors for posttraumatic stress symptomatology in female and male OEF/OIF veterans.","[Correction Notice: An erratum for this article was reported in Vol 120(4) of Journal of Abnormal Psychology (see record 2011-19996-001). In the article there was an error in the affiliation bylines for Rani Elwy and Susan Eisen. Their affiliations should have been listed as Edith Nourse Rogers Memorial Veterans Hospital and Department of Health Policy and Management, Boston University School of Public Health.] Prior research on risk factors for posttraumatic stress symptomatology (PTSS) in war-exposed Veterans has revealed both direct and indirect mechanisms of risk that span predeployment, deployment, and postdeployment timeframes. The aims of the present study were to identify the mechanisms through which previously documented risk factors contribute to PTSS in a national sample of 579 female and male Veterans deployed to Afghanistan for Operation Enduring Freedom (OEF) or to Iraq for Operation Iraqi Freedom (OIF), as well as to examine the extent to which results mirror associations observed among Vietnam Veterans (King, King, Foy, Keane, & Fairbank, 1999). Consistent with conservation of resources (COR) theory (Hobfoll, 1989, 2001), findings indicated that PTSS is accounted for by multiple chains of risk, many originating in predeployment experiences that place Veterans at risk for additional stress exposure, and foretell difficulty accessing resources in the face of subsequent stressors. Importantly, the majority of previously documented mechanisms were replicated in this study, suggesting key pathways through which risk factors may contribute to PTSS across different Veteran populations. Results also revealed a number of novel risk mechanisms for OEF/OIF female Veterans, particularly with respect to the role of deployment family relationships in risk for PTSS.",0,0 +4874,"Protocol for a prospective, longitudinal, cohort study of postconcussive symptoms in children: the Take C.A.Re (Concussion Assessment and Recovery Research) study","A substantial minority of children who sustain a concussion suffer prolonged postconcussive symptoms. These symptoms can persist for more than 1 month postinjury and include physical, cognitive, behavioural and emotional changes. Those affected can develop significant disability, diminishing their quality of life. The precise prevalence of postconcussive symptoms following child concussion is unclear, with heterogeneous and at times conflicting results published regarding factors that predict children at risk for developing long-lasting postconcussive symptoms. The aim of the Take C.A.Re (Concussion Assessment and Recovery Research) study is to provide an in-depth multidimensional description of the postconcussive recovery trajectories from a physical, neurocognitive and psychosocial perspective in the 3 months following concussion, with a focus on the early postconcussive period, and identification of factors associated with prolonged recovery.Take C.A.Re is a prospective, longitudinal study at a tertiary children's hospital, recruiting and assessing patients aged 5-<18 years who present to the emergency department with a concussion and following them at 1-4 days, 2 weeks, 1 month and 3 months postinjury. Multiple domains are assessed: postconcussive symptoms, balance and coordination, neurocognition, behaviour, quality of life, fatigue, post-traumatic stress symptoms, parental distress and family burden. 'Delayed recovery' is operationalised as the presence of ≥ 3 symptoms on the Post Concussive Symptoms Inventory rated as worse compared with baseline. Main analyses comprise analysis of variance (recovery trajectories, delayed vs normal recovery groups) and regression analyses of predictors of recovery (preinjury, acute and family factors).Ethical approval has been obtained through the Royal Children's Hospital Melbourne Human Research Ethics Committee (33122). We aim to disseminate the findings through international conferences, international peer-reviewed journals and social media.ACTRN12615000316505.",0,0 +4875,Before and after the 1999 Chi-Chi earthquake: Traumatic events and depressive symptoms in an older population,"Natural disasters, such as earthquakes, can have deleterious consequences for physical and psychological health. In this study, we investigate variability in resilience to depressive symptoms in the aftermath of a massive earthquake that struck Taiwan in 1999. We analyze data on 1160 older individuals from a national, longitudinal survey with interviews before and after the earthquake. This survey contains extensive information on physical and cognitive function, depressive symptoms, socio-demographic characteristics and earthquake-related exposure and experiences. We estimate regression models to identify risk factors associated with the presence of depressive symptoms after the disaster, controlling for health status and the presence of depressive symptoms beforehand. We pay special attention to how socio-demographic factors moderate the psychological impact of the earthquake. Results indicate that persons of low socioeconomic status (SES), socially isolated individuals, and women reported higher levels of depressive symptoms than their respective counterparts, as did persons who experienced damage to their homes. The psychological effects of damage were strongest among those aged 54-70. The findings suggest that people who experience damage to their home during a disaster are at risk of experiencing depressive symptoms, with the elderly being more resilient than the near-elderly.",0,0 +4876,Anger: Cause or Consequence of Posttraumatic Stress? A Prospective Study of Dutch Soldiers,"Many studies have shown that individuals with posttraumatic stress disorder (PTSD) experience more anger over time and across situations (i.e., trait anger) than trauma-exposed individuals without PTSD. There is a lack of prospective research, however, that considers anger levels before trauma exposure. The aim of this study was to prospectively assess the relationship between trait anger and PTSD symptoms, with several known risk factors, including baseline symptoms, neuroticism, and stressor severity in the model. Participants were 249 Dutch soldiers tested approximately 2 months before and approximately 2 months and 9 months after their deployment to Afghanistan. Trait anger and PTSD symptom severity were measured at all assessments. Structural equation modeling including cross-lagged effects showed that higher trait anger before deployment predicted higher PTSD symptoms 2 months after deployment (β = .36), with stressor severity and baseline symptoms in the model, but not with neuroticism in the model. Trait anger at 2 months postdeployment did not predict PTSD symptom severity at 9 months, and PTSD symptom severity 2 months postdeployment did not predict subsequent trait anger scores. Findings suggest that trait anger may be a pretrauma vulnerability factor for PTSD symptoms, but does not add variance beyond the effect of neuroticism.",0,0 +4877,Psychosocial predictors of chronic Post-Traumatic Stress Disorder in Sri Lankan tsunami survivors,"This study aimed to determine whether psychological factors associated with Post-Traumatic Stress Disorder (PTSD) identified in Western samples generalize to low Social-Economical-Status (SES) populations in an underdeveloped Asian country. The study included 113 survivors of the 2004-tsunami on the south coast of Sri Lanka, recruited from 4 preschools and 10 villages for displaced persons. With logistic regressions the relations between interview-based PTSD diagnosis and psychological factors were assessed, controlling for putative confounders. Fifteen months post-trauma the prevalence of PTSD was 52.2%. Multivariate analyses indicated that negative interpretation of tsunami-memories was significantly (P<0.005) related to PTSD. Of the putative confounders, gender and (non-replaced) lost work equipment were related to current PTSD (P<0.05). The results indicate that the relation between negative interpretation of trauma memories and PTSD is quite universal, suggesting that interventions focusing on this factor may be important in treatment of tsunami survivors who are suffering from chronic PTSD.",0,0 +4878,A Prospective Study of Posttraumatic Stress and Depressive Reactions Among Treated and Untreated Adolescents 5 Years After a Catastrophic Disaster,"This study evaluated 1) the natural course of posttraumatic stress and depressive reactions among untreated adolescents from two cities in an earthquake zone (Gumri and Spitak) and one at the periphery (Yerevan) who were differentially exposed to the 1988 Spitak earthquake in Armenia and 2) the effectiveness of brief trauma/grief-focused psychotherapy among adolescents from Gumri.One hundred twenty-five adolescents were assessed with the Child Posttraumatic Stress Disorder Reaction Index (CPTSD-RI) and the Depression Self-Rating Scale (DSRS) at 1.5 and 5 years postearthquake. At 1.5 years, trauma/grief-focused group and individual psychotherapy was provided over 6 weeks to a group of students in Gumri.CPTSD-RI scores among untreated adolescents from Gumri and Spitak subsided significantly but mildly at follow-up, with scores from Spitak, the city at the epicenter, remaining above the cutoff for a diagnosis of PTSD. DSRS scores increased mildly in both earthquake cities but only significantly in Gumri. Among treated adolescents in Gumri, improvement in CPTSD-RI scores was three times that of the untreated Gumri comparison group. The treated group also tended to improve on their DSRS scores, whereas these scores worsened significantly among untreated subjects.Untreated adolescents exposed to severe trauma are at risk for chronic PTSD and depressive symptoms. Brief trauma/grief-focused psychotherapy is effective in reducing PTSD symptoms and halting the progression of depression. This study supports the implementation of mental health intervention programs in schools after disasters to reduce trauma-related psychopathology.",0,0 +4879,Association Between Traumatic Brain Injury and Risk of Posttraumatic Stress Disorder in Active-Duty Marines,"Whether traumatic brain injury (TBI) is a risk factor for posttraumatic stress disorder (PTSD) has been difficult to determine because of the prevalence of comorbid conditions, overlapping symptoms, and cross-sectional samples.To examine the extent to which self-reported predeployment and deployment-related TBI confers increased risk of PTSD when accounting for combat intensity and predeployment mental health symptoms.As part of the prospective, longitudinal Marine Resiliency Study (June 2008 to May 2012), structured clinical interviews and self-report assessments were administered approximately 1 month before a 7-month deployment to Iraq or Afghanistan and again 3 to 6 months after deployment. The study was conducted at training areas on a Marine Corps base in southern California or at Veterans Affairs San Diego Medical Center. Participants for the final analytic sample were 1648 active-duty Marine and Navy servicemen who completed predeployment and postdeployment assessments. Reasons for exclusions were nondeployment (n = 34), missing data (n = 181), and rank of noncommissioned and commissioned officers (n = 66).The primary outcome was the total score on the Clinician-Administered PTSD Scale (CAPS) 3 months after deployment.At the predeployment assessment, 56.8% of the participants reported prior TBI; at postdeployment assessment, 19.8% reported sustaining TBI between predeployment and postdeployment assessments (ie, deployment-related TBI). Approximately 87.2% of deployment-related TBIs were mild; 250 of 287 participants (87.1%) who reported posttraumatic amnesia reported less than 24 hours of posttraumatic amnesia (37 reported ≥ 24 hours), and 111 of 117 of those who lost consciousness (94.9%) reported less than 30 minutes of unconsciousness. Predeployment CAPS score and combat intensity score raised predicted 3-month postdeployment CAPS scores by factors of 1.02 (P < .001; 95% CI, 1.02-1.02) and 1.02 (P < .001; 95% CI, 1.01-1.02) per unit increase, respectively. Deployment-related mild TBI raised predicted CAPS scores by a factor of 1.23 (P < .001; 95% CI, 1.11-1.36), and moderate/severe TBI raised predicted scores by a factor of 1.71 (P < .001; 95% CI, 1.37-2.12). Probability of PTSD was highest for participants with severe predeployment symptoms, high combat intensity, and deployment-related TBI. Traumatic brain injury doubled or nearly doubled the PTSD rates for participants with less severe predeployment PTSD symptoms.Even when accounting for predeployment symptoms, prior TBI, and combat intensity, TBI during the most recent deployment is the strongest predictor of postdeployment PTSD symptoms.",0,0 +4880,Risk of post-traumatic stress disorder following traumatic events in a community sample,"Aims. Post-traumatic stress disorder (PTSD) is typically associated with high-risk population groups, but the risk of PTSD that is associated with trauma experienced in the community, and effect of changes in diagnostic criteria in DSM-5 on prevalence in the general population, is unknown. Methods. Cross-sectional analysis of population-based data from 4558 adults aged 25–83 years resident in Caerphilly county borough, Wales, UK. Exposure to different traumatic events was assessed using categorisation of free-text descriptions of trauma. PTSD caseness was determined using items assessing Diagnostic and Statistical Manual IV (DSM-IV) and DSM-5 A criteria and the Traumatic Screening Questionnaire. Results. Of the 4558 participants, 1971 (47.0%) reported a traumatic event. The most common DSM-IV A1 qualifying trauma was life-threatening illnesses and injuries (13.6%). The highest risk of PTSD was associated with assaultive violence [34.1%]. The prevalence of PTSD using DSM-IV A criteria was 14.3% (95% confidence interval [CI] = 12.8, 15.9%). Using DSM-5 A criteria reduced the prevalence to 8.0 (95% CI = 6.9, 9.4%), primarily due to exclusion of DSM-IV A1 qualifying events, such as life-threatening illnesses. Conclusions. Nearly one-half of a general community sample had experienced a traumatic event and of these around one in seven was a DSM-IV case of PTSD. Although the majority of research has concentrated on combat, rape and assaultive violence, life threatening illness is a more common cause of PTSD in the community. Removal of this traumatic event in DSM-5 could reduce the number of cases of PTSD by around 6.0%.",0,0 +4881,"Development and utilization of a psychometric instrument for measuring quality of life in burn patients, 1976 to 1996.","Our Burn Specific Health Scale was initially developed in 1978. Using a number of existing health scales, including the sickness impact profile, a depression scale, and the activities of daily living scale, and a large number of burn specific items derived from staff and patients, we eventually developed an 80 item instrument. This instrument was divided into four domains each containing 20 items of equal weight. The instrument was validated sequentially with intrarater, interrater and global validation systems, and subsequently compared with a number of other health and mental scales during which it performed very well. We now have longitudinal data which link this measurement system of quality of life to pre-injury educational level, to post-injury, stress disorder and predictability of return to work. The results indicate that total burn size has little to do with quality of life after recovery, and that a number of other factors play a bigger role, which will be presented.",0,0 +4882,"Childhood Adversity, Mental Disorder Comorbidity, and Suicidal Behavior in Schizotypal Personality Disorder","Schizotypal personality disorder (SPD) is a serious and relatively common psychiatric disorder, yet remains understudied among the personality disorders. The current study examines the psychiatric correlates of SPD in a representative epidemiologic sample, utilizing data from the National Epidemiological Survey on Alcohol and Related Conditions (N = 34,653). Multiple logistic regression compared people with SPD to the general population across a broad range of childhood adversities, comorbid psychiatric disorders, and suicidal behavior. SPD was strongly associated with many adverse childhood experiences. After adjusting for confounding factors, SPD was independently associated with major depression and several anxiety disorders, including post-traumatic stress disorder. Interestingly, SPD was more strongly associated with borderline and narcissistic personality disorders than cluster A personality disorders. Individuals with SPD were also more likely to attempt suicide. As a whole, these results suggest that individuals with SPD experience significant morbidity and may be at increased risk of mortality.",0,0 +4883,Clinical Profile Differences Between PTSD-Diagnosed Military Veterans and Crime Victims,Few studies have conducted symptom comparisons across different trauma-exposed populations. Evidence linking different types of trauma to variations in clinical presentation would have potential implications for the assessment and treatment of trauma-related psychopathology. The current study evaluated whether military veterans (n = 187) and civilian crime victims (n = 47) diagnosed with posttraumatic stress disorder differ in their self-reported posttraumatic symptoms as measured by the Trauma Symptom Inventory. A multivariate profile analysis revealed that military-related trauma is associated with more severe posttraumatic symptoms than criminal victimization and suggested that these 2 types of trauma have statistically distinct symptom profiles. Some potential implications of these findings and considerations for future research are discussed.,0,0 +4884,Video Testimony of Long-Term Hospitalized Psychiatrically Ill Holocaust Survivors,"Many Holocaust survivors who have both psychotic disorders and residual symptoms of posttraumatic stress disorder (PTSD) remain chronically hospitalized in psychiatric institutions. This study investigated the clinical benefits of a therapeutic process facilitating a detailed videotaped account of traumatic experience (testimony method) in elderly long-term hospitalized Holocaust survivors.Twenty-four schizophrenia patients (mean age=72.2 years) who were chronically hospitalized in Israeli state psychiatric hospitals underwent assessment by blind rating with a battery of psychiatric rating scales before and 4 months after extensive videotaped interview. The rating scales included the Positive and Negative Syndrome Scale; Clinical Global Impression (CGI); Mini-Mental State Examination (MMSE); Clinician-Administered PTSD Scale, Form 2; and Structured Interview for Disorders of Extreme Stress. Full pre- and postinterview data were available for 21 patients.Thirty-eight percent of the patients met the criteria for PTSD at the first interview, compared with only 19% at the second interview. The patients had significant reductions in functional impairment and in the severity and intensity of all posttraumatic symptom clusters (intrusion, avoidance, hyperarousal); the avoidance cluster showed the most reduction. Eleven subjects had an improvement of 30% or more in total posttraumatic severity score. No differences in Positive and Negative Syndrome Scale, MMSE, Structured Interview for Disorders of Extreme Stress, and CGI total scores were noted postinterview or between the two preinterview evaluation batteries in the comparison group. Female patients had a higher prevalence of PTSD symptoms. Total Clinician-Administered PTSD Scale, Form 2, scores and total Positive and Negative Syndrome Scale scores were inversely correlated both at baseline and at follow-up.Study observations suggest clinical benefits of the testimony method in the alleviation of many posttraumatic symptoms, but not psychosis, in a cohort of psychiatrically ill Holocaust survivors, despite an interval of as many as 60 years since the traumatic events. The findings have implications for care and rehabilitation of patients many years after acute traumatic events.",0,0 +4885,The Influence of Posttraumatic Stress Disorder Numbing and Hyperarousal Symptom Clusters in the Prediction of Physical Health Status in Veterans With Chronic Tobacco Dependence and Posttraumatic Stress Disorder,"Smoking and PTSD are predictors of poor physical health status. This study examined the unique contribution of PTSD symptoms in the prediction of the SF-36 physical health status subscales accounting for cigarette smoking, chronic medical conditions, alcohol and drug use disorders, and depression. This study examined baseline interview and self-report data from a national tobacco cessation randomized, controlled trial (Veterans Affairs Cooperative Study 519) that enrolled tobacco-dependent veterans with chronic PTSD (N = 943). A series of blockwise multiple regression analyses indicated that PTSD numbing and hyperarousal symptom clusters explained a significant proportion of the variance across all physical health domains except for the Physical Functioning subscale, which measures impairments in specific physical activities. Our findings further explain the impact of PTSD on health status by exploring the way PTSD symptom clusters predict self-perceptions of health, role limitations, pain, and vitality.",0,0 +4886,Examining posttraumatic stress disorder's latent structure between treatment-seeking and non-treatment-seeking Filipinos,"The discourse of latent structure of posttraumatic stress disorder (PTSD) has been extensive in trauma literature. Although findings have been consistent in rejecting DSM-IV-TR's three-factor model, alternative models are still fervently argued. This study contributes to the discussion by examining and comparing PTSD factor structure of the three most validated models—numbing model (King et al., 1998), dysphoria model (Simms et al., 2002), and dysphoric arousal model (Elhai et al., 2011b)—and determining if these are generalizable across treatment-seeking and non-treatment-seeking Filipinos with exposure to trauma events.Filipino-Tagalog version of Harvard Trauma Questionnaire (HTQ; Mollica et al., 1992) was administered to a sample of 737 treatment-seeking (n=526) and non-treatment-seeking (n=211) Filipinos who experienced and witnessed varied trauma events. Confirmatory factor analysis (CFA) was conducted involving the three models in order to determine the best-fitting model and generalizability across samples.Results showed that all three models achieved excellent fit, with dysphoric arousal model slightly fitting better than numbing and dysphoria models in both treatment-seeking and non-treatment-seeking samples. Series of invariance testing, however, indicated that although dysphoric arousal model fits significantly better than dysphoria model, it did not significantly differ from numbing model. Results revealed that aside from the factor loadings, the two groups are noninvariant in all parameters. Treatment-seeking sample had larger intercepts, factor variances and covariances and factor means than non-treatment-seeking group.The findings strongly contribute to the literature by showing how the type of groupings (treatment-seeking vs. non-treatment-seeking) moderates PTSD latent structure. It affirms the suggestion of Biehn et al. (2012) to be cautious in concluding the generalizability of PTSD models in the context that type of participants moderates PTSD's factor structure.",0,0 +4887,Psychiatric and behavioral problems in aggressive drivers,"Motor vehicle accidents (MVAs) are a leading cause of accidental death and injury, and aggressive driving has been identified as a risk factor for MVAs. Assessing psychiatric and behavioral disturbances in aggressive drivers is germane to the development of prevention and intervention programs for this population. The present study compared the prevalence of psychiatric diagnoses and behavioral problems in young adult drivers with self-reported high driving aggression to that of drivers with low driving aggression. Aggressive drivers evidenced a significantly higher current and lifetime prevalence of Oppositional Defiant Disorder, Alcohol and Substance Use Disorders, and Cluster B Personality Disorders, and a significantly greater lifetime prevalence of Conduct Disorder, Attention-Deficit/Hyperactivity Disorder, and Intermittent Explosive Disorder. Aggressive drivers also had a significantly greater prevalence of self-reported problems with anger, as well as a greater family history of anger problems and conflict. The findings suggest that prevention and intervention programs designed to reduce aggressive driving may need to address the presence of psychiatric and behavioral problems that could potentially complicate treatment or impede responses to treatment.",0,0 +4888,A MULTIDIMENSIONAL APPROACH FOR EVALUATING VARIABLES IN ORGANIZATIONAL RESEARCH AND PRACTICE,"One of the most difficult tasks facing industrial-organizational psychologists is evaluating the importance of variables, especially new variables, to be included in the prediction of some outcome. When multiple regression is used, common practices suggest evaluating the usefulness of new variables by showing incremental validity beyond the set of existing variables. This approach assures that the new variables are not statistically redundant with this existing set, but this approach attributes any shared criterion-related validity to the existing set of variables and none to the new variables. More importantly, incremental validity alone fails to answer the question directly about the importance of variables included in a regression model—arguably the more important statistical concern for practitioners. To that end, the current article reviews 2 indices of relative importance, general dominance weights and relative weights, which may be used to complement incremental validity evidence and permit organizational decision makers to make more precise and informed decisions concerning the usefulness of predictor variables. We illustrate our approach by reanalyzing the correlation matrices from 2 published studies.",0,0 +4889,The vicarious experience of posttraumatic stress disorder or symptoms in family members of trauma patients: Differences between ICU and non-ICU families,"This dissertation is part of a larger study investigating the degree to which family members and trauma patients experience early symptoms of Posttraumatic Stress Disorder (PTSD/S). This data was gathered for a protocol approved by the Stanford University Medical Center Institutional Review Board, under the direction of principle investigator, Eve Carlson, PhD. This dissertation's primary question investigated the differences between family members of Intensive Care Unit (ICU) patients and family members of less critical inpatients with regard to Posttraumatic Stress Disorder symptoms (PTSD/S). Also examined were PTSD/S differences between males and females, those with advanced degrees and those without, those with happy childhoods and unhappy childhoods, and those who reported greater socioeconomic status and those who had less resources. Thirty-six family members of ICU patients and family members of less medically critical inpatients participated in this study. They completed self-report questionnaires; a demographic survey, the Posttraumatic Cognitions Inventory-revised (PTCI-R) and the Screen for Posttraumatic Stress Symptoms Questionnaire (SPTSS). Participants were not invited to participate if they were exceedingly distressed, did not speak English well enough to give or understand the consent form, or if their loved one was not expected to recover to pre-injury health. The main limitation for this dissertation was the small participant pool. Also the PTCI-R was revised again by the principle investigator, reducing generalizability from this sample to other groups. The data gathered pertaining to financial security, educational achievement, and childhood experiences came from the larger study's specific demographic questionnaire, and varied in sensitivity. Participants were assessed almost immediately after the traumatic event, making the term ""post traumatic stress"" somewhat inaccurate. More specific and valid measures may have been useful to increase the reliability of this dissertation's findings, as would multiple time points after the trauma. Clinical implications include the need for staff education about family members. ICU and non-ICU families endure similar levels of stress, despite vastly different medical prognoses of their loved ones. Also family history may be an important factor in individual resilience to acute stress. Future research in the field of vicarious trauma could benefit this and other previously overlooked populations exposed to traumas of others. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4890,Quantifying heterogeneity attributable to polythetic diagnostic criteria: Theoretical framework and empirical application.,"Heterogeneity within psychiatric disorders is both theoretically and practically problematic: For many disorders, it is possible for 2 individuals to share very few or even no symptoms in common yet share the same diagnosis. Polythetic diagnostic criteria have long been recognized to contribute to this heterogeneity, yet no unified theoretical understanding of the coherence of symptom criteria sets currently exists. A general framework for analyzing the logical and mathematical structure, coherence, and diversity of Diagnostic and Statistical Manual diagnostic categories (DSM-5 and DSM-IV-TR) is proposed, drawing from combinatorial mathematics, set theory, and information theory. Theoretical application of this framework to 18 diagnostic categories indicates that in most categories, 2 individuals with the same diagnosis may share no symptoms in common, and that any 2 theoretically possible symptom combinations will share on average less than half their symptoms. Application of this framework to 2 large empirical datasets indicates that patients who meet symptom criteria for major depressive disorder and posttraumatic stress disorder tend to share approximately three-fifths of symptoms in common. For both disorders in each of the datasets, pairs of individuals who shared no common symptoms were observed. Any 2 individuals with either diagnosis were unlikely to exhibit identical symptomatology. The theoretical and empirical results stemming from this approach have substantive implications for etiological research into, and measurement of, psychiatric disorders.",0,0 +4891,Differences on adolescent life goal profile scale between a clinical and non-clinical adolescent sample,"This study aimed to determine similarities and differences on perceived importance and perceived attainability of life goals between a clinical and non-clinical adolescent sample.244 students and 54 adolescent patients completed the Adolescent Life Goal Profile Scale (ALGPS). The ALGPS measures perceived importance and perceived attainability of four main life goal categories: Relations, Generativity, Religion, and Achievements. As a control, we used five measures of mental health, quality of life, and personality.There were no differences on perceived importance on the Generativity, Religion, and Achievement life goal factor, but patients perceived relation-oriented goals less important than non-patients. Perceived attainability of life goals factors was lower for patients on all life goals except for Generativity. Compared to non-patients, patients were less happy and satisfied and had lower sense of coherence and self-efficacy. Patients were also less emotionally stable, had lower conscientiousness, but higher intellect.Though patients appear less content with life in general than non-patients, chances are that they uphold their concern and care for others, remain devoted in their religious stand, and stay committed to their achievement-related goals. The lower perceived importance of relations within the patient group should be awarded clinical attention.",0,0 +4892,PTSD symptom trajectories: From early to chronic response,"This study aimed to identify posttraumatic stress disorder (PTSD) symptom trajectories across the first 12 months following traumatic injury. Three hundred and seven consecutively admitted injury survivors were assessed for severity of PTSD symptoms just prior to discharge, and at 3 and 12 months postinjury. Growth modeling was used to determine the curve that best fit the trajectory for each symptom cluster over the 12-month period. Individuals with 12-month PTSD showed significantly higher re-experiencing, arousal, and avoidance symptoms at eight days posttrauma relative to those without, and these symptoms escalated over time. Those without PTSD maintained their relatively low symptom levels. These findings highlight that individuals who will go onto develop PTSD have a distinctly different symptom course than those who recover.",0,0 +4893,Temporal Associations Among Chronic PTSD Symptoms in U.S. Combat Veterans,"The present study examined fluctuation over time in symptoms of posttraumatic stress disorder (PTSD) among 34 combat veterans (28 with diagnosed PTSD, 6 with subclinical symptoms) assessed every 2 weeks for up to 2 years (range of assessments = 13-52). Temporal relationships were examined among four PTSD symptom clusters (reexperiencing, avoidance, emotional numbing, and hyperarousal) with particular attention to the influence of hyperarousal. Multilevel cross-lagged random coefficients autoregression for intensive time series data analyses were used to model symptom fluctuation decades after combat experiences. As anticipated, hyperarousal predicted subsequent fluctuations in the 3 other PTSD symptom clusters (reexperiencing, avoidance, emotional numbing) at subsequent 2-week intervals (rs = .45, .36, and .40, respectively). Additionally, emotional numbing influenced later reexperiencing and avoidance, and reexperiencing influenced later hyperarousal (rs = .44, .40, and .34, respectively). These findings underscore the important influence of hyperarousal. Furthermore, results indicate a bidirectional relationship between hyperarousal and reexperiencing as well as a possible chaining of symptoms (hyperarousal → emotional numbing → reexperiencing → hyperarousal) and establish potential internal, intrapersonal mechanisms for the maintenance of persistent PTSD symptoms. Results suggested that clinical interventions targeting hyperarousal and emotional numbing symptoms may hold promise for PTSD of long duration.",0,0 +4894,Physical and emotional health of Gulf War veteran women.,"Numerous questions have been raised about the health consequences to veterans of the Gulf War but most particularly to issues concerning women, who were deployed in unprecedented numbers. Little is known about the health consequences to women of wartime stressors, in general, or the environmental and job-related exposures specific to the theater of the Gulf War.A stratified sample of 525 women participated in the study following the war and again in a follow-up study 2 yr later. The sampling frame was stratified on component of the U.S. Air Force (active, guard or reserve), deployment (in the theater or elsewhere), and parental status (parent or nonparent). Measures included items concerning general physical health, gender-specific health, the ""Gulf War Syndrome,"" and the emotional responses to war, including symptoms of post-traumatic stress disorder (PTSD).Multiple statistical analyses were used to describe women's physical and emotional health at two time points following the war. Women deployed to the theater reported significantly more general as well as gender-specific health problems than did women deployed elsewhere. A cluster of common health problems included: skin rash, cough, depression, unintentional weight loss, insomnia, and memory problems. Women serving in the theater also reported a significant increase in several gender-specific problems compared to women deployed elsewhere.Findings suggest the need for follow-up of a cluster of specific health effects, including those concerning gynecologic and reproductive health.",0,0 +4895,A Review of Transcranial Magnetic Stimulation as a Treatment for Post-Traumatic Stress Disorder,"Patients with post-traumatic stress disorder (PTSD) may fail to achieve adequate relief despite treatment with psychotherapy, pharmacotherapy, or complementary medicine treatments. Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation procedure that can alter neuronal activity through administration of various pulse sequences and frequencies. TMS may theoretically have promise in correcting alterations observed in patients with PTSD. While the precise treatment location and pulse sequences remain undefined, current evidence suggests two promising targets, the right dorsolateral prefrontal cortex and the medial prefrontal cortex. The beneficial effects may be due to the secondary or indirect regulation of other brain structures that may be involved in the mood regulatory network. TMS may be an effective part of a comprehensive treatment program for PTSD, although significant work remains to define optimal treatment parameters and clarify how it fits within a broader traditional treatment program.",0,0 +4896,Posttraumatic Stress Symptoms and Trajectories in Child Sexual Abuse Victims: An Analysis of Sex Differences Using the National Survey of Child and Adolescent Well-Being,"Very few studies have prospectively examined sex differences in posttraumatic stress symptoms and symptom trajectories in youth victimized by childhood sexual abuse. This study addresses that question in a relatively large sample of children, drawn from the National Survey of Child and Adolescent Well-Being, who were between the ages of 8-16 years and who were reported to Child Protective Services for alleged sexual abuse. Sex differences were examined using t tests, logistic regression, and latent trajectory modeling. Results revealed that there were not sex differences in victims' posttraumatic stress symptoms or trajectories. Whereas caseworkers substantiated girls' abuse at higher rates than boys' abuse and rated girls significantly higher than boys on level of harm, there were not sex differences in three more objective measures of abuse severity characteristics. Overall, higher caseworker ratings of harm predicted higher initial posttraumatic stress symptom levels, and substantiation status predicted shallower decreases in trauma symptoms over time. Implications for theory and intervention are discussed.",0,0 +4897,Prevalence and consequences of disaster-related illness and injury from hurricane ike.,"To explore the extent to which disasters may be a source of injury and disability in community populations, we examined the prevalence and short-term consequences of disaster-related illness and injury for distress, disability, and perceived needs for care.A random population survey was conducted 2-6 months after Hurricane Ike struck Galveston Bay on September 13, 2008.The sample was composed of 658 adults representative of Galveston and Chambers Counties, Texas.The prevalences of personal injury (4%) and household illness (16%) indicated that approximately 7,700 adults in the two-county area were injured, and another 31,500 adults experienced household-level illness. Risk for injury/illness increased with area damage and decreased with evacuation. In bivariate tests, injury or illness or both were related to all outcome measures. In multivariate analyses that controlled for co-occurring stressors representing trauma, loss, adversities, and community effects, injury or illness or both were associated with global stress, posttraumatic stress, dysfunction, days of disability, and perceived needs for care, but not with depression or anxiety.The associations of injury with distress and disability suggest that community programs should reach out to injured persons for early mental health and functional assessments and, where indicated, intervene in ways that reduce further disability and need for complex rehabilitative services. The results also point to the potential effectiveness of evacuation incentives with regard to the prevention of disaster-related injury and disability.",0,0 +4898,"Easy to remember, difficult to forget: The development of fear regulation","Fear extinction learning is a highly adaptive process that involves the integrity of frontolimbic circuitry. Its disruption has been associated with emotional dysregulation in stress and anxiety disorders. In this article we consider how age, genetics and experiences shape our capacity to regulate fear in cross-species studies. Evidence for adolescent-specific diminished fear extinction learning is presented in the context of immature frontolimbic circuitry. We also present evidence for less neural plasticity in fear regulation as a function of early-life stress and by genotype, focusing on the common brain derived neurotrophin factor (BDNF) Val66Met polymorphism. Finally, we discuss this work in the context of exposure-based behavioral therapies for the treatment of anxiety and stress disorders that are based on principles of fear extinction. We conclude by speculating on how such therapies may be optimized for the individual based on the patient's age, genetic profile and personal history to move from standard treatment of care to personalized and precision medicine.",0,0 +4899,Preface,"Humans are remarkably resilient in the face of crises, traumas, disabilities, attachment losses, and ongoing adversities. In fact, resilience to stress and trauma may be the norm rather than the exception. However, to date, most research in the field of traumatic stress has focused on neurobiological, psychological, and social factors associated with trauma-related psychopathology and deficits in psychosocial functioning. While much has been learned in these areas of research, particularly about post-traumatic stress disorder (PTSD), far less is known about resilience to stress and healthy adaptation to stress and trauma. The study of resilience is enormously challenging. The first hurdle involves definition. Currently, there is no single agreed-upon definition of resilience in the clinical or scientific literature. In a review of the published literature on risk, vulnerability, resistance, and resilience, Layne and colleagues (2007) described the lack of precision and numerous terminological inconsistencies in the meanings of these concepts, and identified at least eight distinct meanings for the term “resilience.” For example, definitions of resilience have ranged from symptom-free functioning following trauma exposure (Bonanno et al., 2006) to positive adaptation despite adversity (Garmezy, 1993), and even to enhanced psychobiological regulation of stress/fear-related brain circuitry, neurotransmitters, and hormones (Charney, 2004). The American Psychological Association (2010) has defined resilience as “the process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of threat.” © Cambridge University Press 2011.",0,0 +4900,Assessing Latent Level Associations Between PTSD and Dissociative Factors: Is Depersonalization and Derealization Related to PTSD Factors More So than Alternative Dissociative Factors?,"Posttraumatic stress disorder (PTSD) criteria in DSM-5 included a dissociative diagnostic subtype characterized by a depersonalization item and a derealization item. Researchers have queried whether this was too restrictive, as alternative dissociative symptomatology may also be characteristic of the subtype. The current study utilized data from 318 Northern Irish students, of which 165 were trauma exposed. Participants were assessed for PTSD symptomatology based on DSM-5 criteria via a modified version of the PTSD Symptom Scale-Self-Report (PSS-5) and dissociative experiences via the Dissociative Experiences Scale (DES). Confirmatory factor analysis of PTSD and DES models revealed an optimal four-factor DSM-5 PTSD model including reexperiencing, avoidance, negative alterations in mood and cognitions, and alterations in hyperarousal and reactivity factors, and an optimal three-factor DES model including absorption, amnesia, and depersonalization/derealization factors. When comparing the correlations between depersonalization/derealization and the four PTSD factors, significant Wald tests of parameter constraints revealed that depersonalization/derealization is more related to alterations in arousal and reactivity (r = .432) compared to avoidance (r = .289), χ 2 (1, N = 165) = 8.352, p = .004. We discuss whether the mechanism for comorbid PTSD and dissociation may be related to PTSD’s arousal factor.",0,0 +4901,Psychosocial outcomes of telephone-based counseling for adults with an acquired physical disability: A meta-analysis.,"The delivery of mental health services by telephone, referred to as telecounseling, has the potential to improve the health outcomes of adults with an acquired physical disability in a cost-effective way. However, the efficacy of this form of treatment requires further evaluation before it is used on a larger scale.This meta-analysis provides a critical and quantitative evaluation of the impact of telephone-administered psychological interventions on the psychosocial functioning of adults with an acquired physical disability caused by spinal cord injury, limb amputation, severe burn injury, stroke, or multiple sclerosis.A comprehensive search of eight electronic databases identified eight studies (N = 658 participants) that compared treatment efficacy to that of matched control groups. Differences in the psychosocial outcomes of treatment and control participants were examined using Cohen's d effect sizes. Fail-safe Ns and 95% confidence intervals were used to evaluate the significance of these results.Significant improvements in coping skills and strategies (overall d = 0.57), community integration (overall d = 0.45), and depression (overall d = 0.44) were observed immediately after telecounseling, with modest improvements in quality of life maintained at 12 months post-intervention (overall d = 0.37).The results suggest that telecounseling is an effective treatment modality for adults adjusting to a physical disability; however, further trials are needed to establish the long term psychosocial benefits.",0,0 +4902,Family Models of Posttraumatic Stress Disorder,"Abstract This chapter reviews the extant literature on the interpersonal aspects of posttraumatic stress disorder (PTSD), with a focus on couple and family models of PTSD. Topics include the association of PTSD with a variety of family relationship problems in a range of traumatized populations. The role of relevant interpersonal constructs in the development and maintenance of PTSD (e.g., social support, attachment) and the psychological effects of PTSD symptoms on family members and their relations are discussed. In addition, models that take into account a range of relationship variables and the likely bi-directional association between individual and family functioning in PTSD are presented. Future directions for theory and research, as well as the clinical implications of this work are outlined.",0,0 +4903,Confirmatory factor analysis of the PTSD Checklist and the Clinician-Administered PTSD Scale in disaster workers exposed to the World Trade Center Ground Zero.,"Although posttraumatic stress disorder (PTSD) factor analytic research has yielded little support for the DSM-IV 3-factor model of reexperiencing, avoidance, and hyperarousal symptoms, no clear consensus regarding alternative models has emerged. One possible explanation is differential instrumentation across studies. In the present study, the authors used confirmatory factor analysis to compare a self-report measure, the PTSD Checklist (PCL), and a structured clinical interview, the Clinician-Administered PTSD Scale (CAPS), in 2,960 utility workers exposed to the World Trade Center Ground Zero site. Although two 4-factor models fit adequately for each measure, the latent structure of the PCL was slightly better represented by correlated reexperiencing, avoidance, dysphoria, and hyperarousal factors, whereas that of the CAPS was slightly better represented by correlated reexperiencing, avoidance, emotional numbing, and hyperarousal factors. After accounting for method variance, the model specifying dysphoria as a distinct factor achieved slightly better fit. Patterns of correlations with external variables provided additional support for the dysphoria model. Implications regarding the underlying structure of PTSD are discussed.",0,0 +4904,Timing of Mental Health Treatment and PTSD Symptom Improvement Among Iraq and Afghanistan Veterans,"This study examined demographic, military, temporal, and logistic variables associated with improvement of posttraumatic stress disorder (PTSD) among Iraq and Afghanistan veterans who received mental health outpatient treatment from the U.S. Department of Veterans Affairs (VA) health care system. The authors sought to determine whether time between last deployment and initiating mental health treatment was associated with a lack of improvement in PTSD symptoms.The authors conducted a retrospective analysis of existing medical records of Iraq and Afghanistan veterans who enrolled in VA health care, received a postdeployment PTSD diagnosis, and initiated treatment for one or more mental health problems between October 1, 2007, and December 31, 2011, and whose records contained results of PTSD screening at the start of treatment and approximately one year later (N=39,690).At the start of treatment, 75% of veterans diagnosed as having PTSD had a positive PTSD screen. At follow-up, 27% of those with a positive screen at baseline had improved, and 43% of those with a negative screen at baseline remained negative. A negative PTSD screen at follow-up was associated with female gender, older age, white race, having never married, officer rank, non-Army service, closer proximity to the nearest VA facility, and earlier initiation of treatment after the end of the last deployment.Interventions to reduce delays in initiating mental health treatment may improve veterans' treatment response. Further studies are needed to test interventions for particular veteran subgroups who were less likely than others to improve with treatment.",0,0 +4905,Dissociative symptoms in acute stress disorder,"This study provides a profile of symptoms, and particularly dissociative symptoms, in the diagnosis of acute stress disorder (ASD) following motor vehicle accidents (MVAs). Consecutive adult non-brain-injured admissions to a major trauma hospital (N = 92) were assessed between 2 days and 4 weeks following an MVA. Presence of ASD was determined by a structured clinical interview. The occurrence of full and subsyndromal ASD was approximately 13% and 21%, respectively. The majority of those who met criteria for subsyndromal ASD did not meet the ASD criteria for dissociation. At least 80% of individuals who reported derealization also reported reduced awareness and depersonalization. This significant overlap between dissociative symptoms questions the discriminatory power and conceptual independence of the dissociative criteria. These findings suggest the need for a more refined conceptual and operational understanding of dissociative symptoms in the acute trauma stage.",0,0 +4906,Trajectories of trauma symptoms and resilience in deployed US military service members: Prospective cohort study,"Background Most previous attempts to determine the psychological cost of military deployment have been limited by reliance on convenience samples, lack of pre-deployment data or confidentiality and cross-sectional designs. Aims This study addressed these limitations using a population-based, prospective cohort of US military personnel deployed in support of the operations in Iraq and Afghanistan. Method The sample consisted of US military service members in all branches including active duty, reserve and national guard who deployed once ( n = 3393) or multiple times ( n = 4394). Self-reported symptoms of post-traumatic stress were obtained prior to deployment and at two follow-ups spaced 3 years apart. Data were examined for longitudinal trajectories using latent growth mixture modelling. Results Each analysis revealed remarkably similar post-traumatic stress trajectories across time. The most common pattern was low–stable post-traumatic stress or resilience (83.1% single deployers, 84.9% multiple deployers), moderate–improving (8.0%, 8.5%), then worsening–chronic posttraumatic stress (6.7%, 4.5%), high–stable (2.2% single deployers only) and high–improving (2.2% multiple deployers only). Covariates associated with each trajectory were identified. Conclusions The final models exhibited similar types of trajectories for single and multiple deployers; most notably, the stable trajectory of low post-traumatic stress pre- to post-deployment, or resilience, was exceptionally high. Several factors predicting trajectories were identified, which we hope will assist in future research aimed at decreasing the risk of post-traumatic stress disorder among deployers.",1,0 +4907,Coping and Social Support in Children Exposed to Mass Trauma,"The goal of this paper was to critically evaluate the literature on children coping with mass trauma published between the years 2011 and 2014 and to emphasize interesting and important findings with the aim of proposing a new comprehensive model for better understanding the process of coping with these events in this unique developmental stage. Using a variety of databases, 26 research papers were selected. The papers were divided into two main categories, natural and manmade disasters. The findings suggest that several areas in this context still lack foundational knowledge and should be further investigated. Thus, it has been suggested that future research should emphasize the developmental stage of the children, the cultural context and atmosphere in which the investigated children grow up and live, and the type of event (acute vs. chronic; natural vs. manmade). A more comprehensive coping model which addresses these omissions and combines main theories is suggested for use in future research as well. © 2015, Springer Science+Business Media New York.",0,0 +4908,Simulating Emotional Responses in Posttraumatic Stress Disorder: An fMRI Study,"This study tested the extent to which coached participants can simulate the neural responses of participants with posttraumatic stress disorder (PTSD) when they are presented with signals of fear. Functional magnetic resonance imaging (fMRI) was used to study blood oxygenation level-dependent signal during the presentations of fearful and neutral faces under both conscious and nonconscious (masked) conditions. Participants comprised 12 patients with PTSD and 12 trauma-exposed controls who were instructed to simulate PTSD. During conscious fear processing, simulators showed greater activation in the left amygdala and medial prefrontal cortex (MPFC) than PTSD participants. By contrast, during nonconscious processing, PTSD participants had greater MPFC activation than simulators. These findings suggest that coached simulators produce a profile of 'over-responding' to fear when controlled conscious processing is possible, but are not able to simulate the exaggerated medial prefrontal responses observed in PTSD participants under conditions of nonconscious processing. © 2010 Springer Science + Business Media, LLC.",0,0 +4909,"Locus of control and combat-related post-traumatic stress disorder: The intervening role of battle intensity, threat appraisal and coping","The study examined the role of control expectancies in the formation of posttraumatic stress disorder (PTSD) among Israeli soldiers combat stress reactions (battle shock) casualties of the Lebanon War (1982). A random sample of 104 soldiers who fought in the Lebanon War and were identified as combat stress reaction casualties were clinically interviewed and given a battery of self-report questionnaires a year after their participation in combat. In general, the components of Lazarus' stress-illness model were predictive of the severity of PTSD. Greater appraisal of threat, more negative emotions, and more emotion-focused coping were all found to predict a larger number of PTSD symptoms. Path analyses were performed separately for soldiers who reported that they were under high battle intensity and those who were under relatively low battle intensity. For low battle intensity, externals suffered more PTSD than internals. This relationship was due mainly to the indirect effects of locus of control via threat appraisal. These significant relationships were not found when battle intensity was high. The implications of the findings for the study of combat stress reactions and for the stress-illness model are discussed. The relative impact of generalized control expectancies and situational factors are examined for the various components of the model.",0,0 +4910,Childhood trauma among individuals with co-morbid substance use and post-traumatic stress disorder,"BACKGROUND: Little is known about the impact of childhood trauma (CT) on the clinical profile of individuals with co-occurring substance use disorder (SUD) and post traumatic stress disorder (PTSD). AIMS: To compare the clinical characteristics of individuals with SUD+PTSD who have a history of CT with SUD+PTSD individuals who have experienced trauma during adulthood only. METHOD: Data were collected on 103 individuals as part of a randomised controlled trial examining the efficacy of an integrated psychosocial treatment for SUD+PTSD. Participants were recruited from substance use treatment services, community referrals and advertising. Data were collected on demographic characteristics, substance use and treatment histories, lifetime trauma exposure, and current physical and mental health functioning. RESULTS: The vast majority (77%) of the sample had experienced at least one trauma before the age of 16, with 55% of those endorsing childhood sexual abuse. As expected individuals with a CT history, as compared to without, evidenced significantly longer duration of PTSD. Those with a CT history also had more extensive lifetime trauma exposure, an earlier age of first intoxication, and reported more severe substance use (e.g., a greater number of drug classes used in their lifetime, higher severity of dependence scores and greater number of drug treatment episodes). CONCLUSION: Individuals with co-morbid SUD+PTSD who have experienced CT present with a more severe and chronic clinical profile in relation to a number of trauma and substance use characteristics, when compared to individuals with adulthood only trauma histories. It is therefore important for SUD+PTSD treatment planning that CT be carefully assessed.",0,0 +4911,"Marital Status, Life Stressor Precipitants, and Communications of Distress and Suicide Intent in a Sample of United States Air Force Suicide Decedents","Life stressor precipitants and communications of distress and suicide intent were examined among a sample of United States Air Force (USAF) married versus unmarried suicide decedents. A total of 100 death investigations conducted by the Office of Special Investigations on active duty USAF suicides occurring between 1996 and 2006 were retrospectively reviewed. Married decedents were twice as likely 1) to have documented interpersonal conflict 24 hours prior to suicide and 2) to have communicated suicide intent to peers or professionals. Themes of distress communication for all decedents were intrapersonal (perceived stress, depression, psychological pain) and interpersonal (thwarted belongingness, rejection, loneliness). Suicide prevention programs and policies are encouraged to adapt efforts to the unique needs of married and unmarried individuals.",0,0 +4912,Patterns of comorbidity among mental disorders: a person-centered approach,"Abstract Objective Comorbidity poses a major challenge to conventional methods of diagnostic classification. Although dimensional models of psychopathology have shed some light on this issue, the reason for interrelationships among dimensions is unclear. The current study employed an alternative approach to characterizing patterns of comorbidity among common mental disorders by modeling them instead as clusters by using latent class analysis (LCA). Method Latent class analyses of Diagnostic and Statistical Manual of Mental Disorders diagnoses from two nationally representative epidemiological samples—the National Comorbidity Survey and National Comorbidity Survey–Replication datasets—were undertaken. Results Within each dataset, LCA yielded 5 latent classes exhibiting distinctive profiles of diagnostic comorbidity: a fear class (all phobias and panic disorder), a distress class (depression, generalized anxiety disorder, dysthymia), an externalizing class (alcohol and drug dependence, conduct disorder), a multimorbid class (highly elevated rates of all disorders), and a few-disorders class (very low probability of all disorders). Whereas some disorders were relatively specific to certain classes, others (major depression, posttraumatic stress disorder, social phobia) appeared to be evident across all classes. Profiles for the five classes were highly similar across the two samples. When bipolar I disorder was added to the LCA models, in both samples, it occurred almost exclusively in the multimorbid class. Conclusions Comorbidity among mental disorders in the general population appears to occur in a finite number of distinct patterns. This finding has important implications for efforts to refine existing diagnostic classification schemes, as well as for research directed at elucidating the etiology of mental disorders.",0,0 +4913,A Community Study of the Psychological Effects of the Omagh Car Bomb on Adults,"The main aims of the study were to assess psychological morbidity among adults nine months after a car bomb explosion in the town of Omagh, Northern Ireland and to identify predictors of chronic posttraumatic stress disorder symptoms.A questionnaire was sent to all adults in households in The Omagh District Council area. The questionnaire comprised established predictors of PTSD (such as pre-trauma personal characteristics, type of exposure, initial emotional response and long-term adverse physical or financial problems), predictors derived from the Ehlers and Clark (2000) cognitive model, a measure of PTSD symptoms and the General Health Questionnaire.Among respondents (n = 3131) the highest rates of PTSD symptoms and probable casesness (58.5%) were observed among people who were present in the street when the bomb exploded but elevated rates were also observed in people who subsequently attended the scene (21.8% probable caseness) and among people for whom someone close died (11.9%). People with a near miss (left the scene before the explosion) did not show elevated rates. Exposure to the bombing increased PTSD symptoms to a greater extent than general psychiatric symptoms. Previously established predictors accounted for 42% of the variance in PTSD symptoms among people directly exposed to the bombing. Predictors derived from the cognitive model accounted for 63%.High rates of chronic PTSD were observed in individuals exposed to the bombing. Psychological variables that are in principle amenable to treatment were the best predictors of PTSD symptoms. Teams planning treatment interventions for victims of future bombings and other traumas may wish to take these results into account.",0,0 +4914,"Trends in Probable PTSD in Firefighters Exposed to the World Trade Center Disaster, 2001–2010","ABSTRACT Objective: We present the longest follow-up, to date, of probable posttraumatic stress disorder (PTSD) after the 2001 terrorist attacks on the World Trade Center (WTC) in New York City firefighters who participated in the rescue/recovery effort. Methods: We examined data from 11 006 WTC-exposed firefighters who completed 40 672 questionnaires and reported estimates of probable PTSD by year from serial cross-sectional analyses. In longitudinal analyses, we used separate Cox models with data beginning from October 2, 2001, to identify variables associated with recovery from or delayed onset of probable PTSD. Results: The prevalence of probable PTSD was 7.4% by September 11, 2010, and continued to be associated with early arrival at the WTC towers during every year of analysis. An increasing number of aerodigestive symptoms (hazard ratio [HR] 0.89 per symptom, 95% confidence interval [CI] 0.86-.93) and reporting a decrease in exercise, whether the result of health (HR 0.56 vs no change in exercise, 95% CI 0.41-.78) or other reasons (HR 0.76 vs no change in exercise, 95% CI 0.63-.92), were associated with a lower likelihood of recovery from probable PTSD. Arriving early at the WTC (HR 1.38 vs later WTC arrival, 95% CI 1.12-1.70), an increasing number of aerodigestive symptoms (HR 1.45 per symptom, 95% CI 1.40–1.51), and reporting an increase in alcohol intake since September 11, 2001 (HR 3.43 vs no increase in alcohol intake, 95% CI 2.67-4.43) were associated with delayed onset of probable PTSD. Conclusions: Probable PTSD continues to be associated with early WTC arrival even 9 years after the terrorist attacks. Concurrent conditions and behaviors, such as respiratory symptoms, exercise, and alcohol use also play important roles in contributing to PTSD symptoms. ( Disaster Med Public Health Preparedness . 2011;5:S197-S203)",0,0 +4915,Post-Traumatic Stress Reactions in Victims of Motor Accidents,"This article assesses the incidence and types of PSTD, causes and symptoms of the condition, diagnosis and assessment, treatment and prediction of litigation as well as remission. Two questions of particular interest to the legal profession are considered: the length of time and other factors needed for the prediction of post-traumatic stress and the time elapsing before normal patterns of behaviour reoccur. Also discussed is the difference in the prevalence of PTSD in the sexes. Physical injuries both to the brain and to other parts of the body, specifically whiplash, are assessed. A number of case studies for post-traumatic stress are analysed and predictions for successfully applied treatment are provided. There is also a section dealing specifically with the effect of post-traumatic stress on children. (A)",0,0 +4916,“Black Saturday” and its Aftermath: Reflecting on Postdisaster Social Work Interventions in an Australian Trauma Hospital,"AbstractSocial workers at The Alfred, a major tertiary referral teaching hospital in Melbourne, Australia, played a key role in providing psychosocial support to patients and their families following the 2009 Black Saturday bushfires in the State of Victoria. Faced with the highest number of casualties ever admitted simultaneously, and the media and community involvement surrounding the national disaster, new practice challenges emerged that led to tensions when compared to everyday practice. This article examines three challenges identified in the team's critical reflections—managing privacy and publicity; negotiating the boundaries of professional practice; and managing the impact of the work. These practice challenges are considered in light of relevant trauma and disaster literature that addresses the importance of promoting self-efficacy, hope, and connectedness; forming collective narratives of survivorship and resilience; negotiating the ethical questions of service intimacy and intensity; and impl...",0,0 +4917,Social and ecological resilience: are they related?,"This article defines social resilience as the ability of groups or communities to cope with external stresses and disturbances as a result of social, political and environmental change. This definition highlights social resilience in relation to the concept of ecological resilience which is a characteristic of ecosystems to maintain themselves in the face of disturbance. There is a clear link between social and ecological resilience, particularly for social groups or communities that are dependent on ecological and environmental resources for their livelihoods. But it is not clear whether resilient ecosystems enable resilient communities in such situations. This article examines whether resilience is a useful characteristic for describing the social and economic situation of social groups and explores potential links between social resilience and ecological resilience. The origins of this interdisciplinary study in human ecology, ecological economics and rural sociology are reviewed, and a study of the impacts of ecological change on a resource-dependent community in contemporary coastal Vietnam in terms of the resilience of its institutions is outlined.",0,0 +4918,Posttraumatic stress disorder in elderly and younger adults after the 1988 earthquake in Armenia,"This study was undertaken 1 1/2 years after the 1988 earthquake in Armenia to assess the frequency and severity of posttraumatic stress reactions among elderly and younger adult victims and to assess the relation of exposure, age, sex, and death of a family member to these reactions.One hundred seventy-nine subjects of both sexes were evaluated with the Posttraumatic Stress Disorder (PTSD) Reaction Index. A subgroup of 60 individuals were also assessed for PTSD with the DSM-III-R criteria.There was a strong association between the presence of severe symptoms on the index and a DSM-III-R diagnosis of PTSD. Elderly and younger adult victims in cities closer to the epicenter (higher exposure) had significantly higher index scores than elderly and adult victims in more distant locations. In comparison with previous studies of natural disasters, much greater rates of chronic severe posttraumatic stress reactions were found among the highly exposed individuals. Although there was no difference in total mean score on the Posttraumatic Stress Disorder Reaction Index, a significant difference in symptom profile was found between the elderly and younger adults; the elderly scored higher on arousal symptoms and lower on intrusive symptoms. There was a positive correlation between loss of family members and severity of posttraumatic stress reaction.These findings indicate that after a major natural disaster with subsequent multiple adversities, a substantial proportion of the adult population may experience severe and chronic posttraumatic stress reactions. The risk factors identified in this study may prove useful in screening exposed individuals for appropriate treatment.",0,0 +4919,Post-traumatic stress disorder and depression co-occurrence: Structural relations among disorder constructs and trait and symptom dimensions,"Post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) in response to trauma co-occur at high rates. A better understanding of the nature of this co-occurrence is critical to developing an accurate conceptualization of the disorders. This study examined structural relations among the PTSD and MDD constructs and trait and symptom dimensions within the framework of the integrative hierarchical model of anxiety and depression.Study participants completed clinician-rated and self-report measures during a pre-treatment assessment.The sample consisted of 200 treatment-seeking individuals with a primary DSM-IV PTSD diagnosis. Structural equation modelling was used to examine the relationship between the constructs.The trait negative affect/neuroticism construct had a direct effect on both PTSD and MDD. The trait positive affect/extraversion construct had a unique, negative direct effect on MDD, and PTSD had a unique, direct effect on the physical concerns symptoms construct. An alternative model with the PTSD and MDD constructs combined into an overall general traumatic stress construct produced a decrement in model fit.These findings provide a clearer understanding of the relationship between co-occurring PTSD and MDD as disorders with shared trait negative affect/neuroticism contributing to the overlap between them and unique trait positive affect/extraversion and physical concerns differentiating them. Therefore, PTSD and MDD in response to trauma may be best represented as two distinct, yet strongly related constructs.In assessing individuals who have been exposed to trauma, practitioners should recognize that co-occurring PTSD and MDD appears to be best represented as two distinct, yet strongly related constructs. Negative affect may be the shared vulnerability directly influencing both PTSD and MDD; however, in the presence of both PTSD and MDD, low positive affect appears to be more specifically related to MDD and fear of physical sensations to PTSD, which is information that could be used by practitioners in the determination of treatment approach. Overall, these findings are clinically relevant in that they may inform assessment, treatment planning, and ultimately diagnostic classification.",0,0 +4920,Association of Sexual Violence and Human Rights Violations With Physical and Mental Health in Territories of the Eastern Democratic Republic of the Congo,"Studies from the Eastern Region of the Democratic Republic of the Congo (DRC) have provided anecdotal reports of sexual violence. This study offers a population-based assessment of the prevalence of sexual violence and human rights abuses in specific territories within Eastern DRC.To assess the prevalence of and correlations with sexual violence and human rights violations on residents of specific territories of Eastern DRC including information on basic needs, health care access, and physical and mental health.A cross-sectional, population-based, cluster survey of 998 adults aged 18 years or older using structured interviews and questionnaires, conducted over a 4-week period in March 2010.Sexual violence prevalence and characteristics, symptoms of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), human rights abuses, and physical and mental health needs among Congolese adults in specific territories of Eastern DRC.Of the 1005 households surveyed 998 households participated, yielding a response rate of 98.9%. Rates of reported sexual violence were 39.7% (95% confidence interval [CI], 32.2%-47.2%; n = 224/586) among women and 23.6% (95% CI, 17.3%-29.9%; n = 107/399) among men. Women reported to have perpetrated conflict-related sexual violence in 41.1% (95% CI, 25.6%-56.6%; n = 54/148) of female cases and 10.0% (95% CI, 1.5%-18.4%; n = 8/66) of male cases. Sixty-seven percent (95% CI, 59.0%-74.5%; n = 615/998) of households reported incidents of conflict-related human rights abuses. Forty-one percent (95% CI, 35.3%-45.8%; n = 374/991) of the represented adult population met symptom criteria for MDD and 50.1% (95% CI, 43.8%-56.3%; n = 470/989) for PTSD.Self-reported sexual violence and other human rights violations were prevalent in specific territories of Eastern DRC and were associated with physical and mental health outcomes.",0,0 +4921,Post-traumatic stress disorder in parents of children hospitalized in the neonatal intensive care unit (NICU): medical and demographic risk factors.,"Post-traumatic stress disorder (PTSD) among parents of neonates hospitalized in the Neonatal Intensive Care Units (NICU) stays an underestimated problem. We determined the incidence of PTSD in parents and pointed out medical and demographic risk factors for PTSD in neonates hospitalized in the NICU.The study involved 39 mothers and 27 fathers of 42 infants aged 1 to 16 months who were hospitalized in the NICU of a Children's University Hospital during the neonatal period. As a measure of PTSD we used the Polish version of the Impact of Event Scale-Revised (IES-R). The current level of stress was measured using the Perceived Stress Scale (PSS-10). The author's questionnaire contained demographic and medical information on the infants hospitalized in the NICU and their parents. Data were statistically analyzed.The incidence of PTSD and levels of stress did not differ in the group of mothers and fathers. There was a statistically significant difference in the severity of PTSD symptoms in general (p=0.006) and the severity of symptoms of intrusion (p=0.009) and arousal (p=0.015), which were more pronounced in mothers of children hospitalized in the NICU than in their fathers. In the multivariate models perceived stress was the only predictor that significantly affected the rate of PTSD symptoms in parents.Since PTSD is a very common problem in parents of children hospitalized in the NICU and estimating the risk of its occurrence on the basis of collected data is not possible, the parents of all those children should be considered at high risk.",0,0 +4922,A Bioecological Model of Deployment Risk and Resilience,"A deployment risk and resilience model is proposed to describe military service and deployment-related factors influencing post-deployment reintegration and post-deployment behavioral health. Adapted from the resiliency model, it is a multiphasic framework consistent with biopsychosocial and strengths-based perspectives by focusing on vulnerability, risk, and resilience resulting from military service, deployment experiences, and feedback loops that occur over the life course. The article is divided into three broad sections that discuss (1) theoretical underpinnings of the model, (2) key components of the model, and (3) future directions for military social work practice.",0,0 +4923,[The burn patient: factors associated with post-traumatic stress disorder and directions for intervention].,"AIM: Starting from the evidence that not all burn patients develop a post-traumatic stress disorder (PTSD), the aim of this overview was to describe variables, which favour the development of the disorder following to burn injury and to delineate directions for a treatment. METHODS: We searched articles in English related to PTSD in the population suffering from burns in the PubMed database, using the key word 'burn' in combination with: PTSD, traumatic event, trauma, ASD, and psychological factors. We concentrated our attention on articles published in the last decade (January 1998-March 2010). RESULTS: We found 32 articles. The risk factors concurring in the onset of PTSD are the presence of post-traumatic symptoms in the first following weeks to the burn, the avoidant coping, nevroticism, the presence of psychiatric disorder before the trauma, and the degree of disfigurement. The principal protective factors emerged from the review are the search of social or emotional support and extraversion. Information related to the treatment of these patients is scarce. CONCLUSIONS: The literature underlines the importance of the individual vulnerability to the development of PTSD in burn patients, besides the experience itself of a traumatic event. These patients must face peculiar and specific problems, therefore, with the purpose to odevelop a suitable intervention, it would be useful to appraise, besides the physical and psychosocial implications of the burn, the psychological characteristics of each patient, to articulate a treatment that may account for the complexity of the burn patient. Language: it",0,0 +4924,PTSD in the elderly: the interaction between trauma and aging,"ABSTRACT Background: Because an increasingly large cohort of individuals is approaching their elderly years, there is concern about how the healthcare system will cope with the greater demands placed upon it. One area of concern is the impact of trauma and post traumatic stress disorder (PTSD) in the aged. Although several reviews have highlighted the lack of knowledge and research on the topic, there still remain gaps in the literature. Nevertheless, some recent behavioral, endocrinological and neuroimaging studies may provide new insights into the discussion. The central aims of this paper are to summarize the etiological, epidemiological and clinical aspects of PTSD, trauma, and the elderly, and to integrate this knowledge with (i) what is known about PTSD in adults, and (ii) the behavioral, hormonal and cerebral changes associated with healthy aging. Methods: A comprehensive search was performed with ISI Web of Science and PubMed for articles pertinent to the psychology and biology of PTSD, trauma, and the elderly. Results: There exist both significant similarities and differences between adults and elderly with PTSD concerning cognitive and biological profile. Evidence suggests that PTSD in the elderly does not follow a simple clinical trajectory. Conclusions: PTSD in the elderly must be considered within the context of normal aging. Strong claims about an interaction between PTSD and aging are difficult to make due to sample heterogeneity, but it is clear that PTSD in this age group presents unique aspects not seen in younger cohorts. Further research must integrate their studies with the biological, psychological, and social changes already associated with the aging process.",0,0 +4925,Premenstrual Symptoms and Posttraumatic Stress Disorder in Japanese High School Students 9 Months after the Great East-Japan Earthquake,"On March 11, 2011, the Great East-Japan Earthquake occurred and a massive tsunami hit the northeastern coast of Japan. Catastrophic disasters such as earthquakes and war cause tremendous damage, not only physically but also mentally. Posttraumatic stress disorder (PTSD) is an anxiety disorder that occurs in the aftermath of a traumatic event. Premenstrual syndrome (PMS) is a cluster of psychological and somatic symptoms that are limited to the late luteal phase of the menstrual cycle. Premenstrual dysphoric disorder (PMDD) is considered a severe form of PMS. To determine the relationship between premenstrual symptoms and natural disaster-induced PTSD among Japanese adolescent girls, we conducted a cross-sectional study. Overall, 1489 high school students who belong to two high schools in Sendai, the largest city in northeastern Japan, were assessed 9 months after the earthquake. These schools are located inland, far from the seashore, and were not damaged by the tsunami. Premenstrual symptoms were assessed using the Premenstrual Symptoms Questionnaire, and PTSD symptoms were assessed using the Japanese-language version of Impact of Event Scale-Revised, which is a widely used self-assessment questionnaire about PTSD symptoms. We analyzed the data of 1,180 girls who completed the questionnaires and 118 girls (10.0%) were classified as having PTSD. The prevalence rates of PMDD and moderate to severe PMS increased according to the comorbidity of PTSD (p < 0.001), showing a correlation between the severity of PMS/PMDD and natural disaster-induced PTSD. The comorbidity of PMS/PMDD and PTSD may complicate the follow-up of both conditions.",0,0 +4926,"Trauma exposure characteristics, past traumatic life events, coping strategies, posttraumatic stress disorder, and psychiatric comorbidity among people with anaphylactic shock experience","This study investigated the interrelationship between trauma exposure characteristics, past traumatic life events, coping strategies, posttraumatic stress disorder (PTSD) symptoms, and psychiatric comorbidity among people after anaphylactic shock experience. The design was cross-sectional in that 94 people with anaphylactic shock experience responded to a postal survey. They completed the Posttraumatic Stress Disorder Checklist, the General Health Questionnaire 28, and the COPE Scale. They also answered questions on trauma exposure characteristics. The control group comprised 83 people without anaphylaxis. Twelve percent of people with anaphylactic shock experience fulfilled the diagnostic criteria for full PTSD. As a group, people with anaphylaxis reported significantly more past traumatic life events and psychiatric comorbidity than did the control. Partial least squares analysis showed that trauma exposure characteristics influenced postanaphylactic shock PTSD symptoms and psychiatric comorbidity, which, in turn, influenced coping strategies. People could develop PTSD and psychiatric comorbidity symptoms after their experience of anaphylactic shock. The way they coped with anaphylactic shock was affected by the severity of these symptoms. Past traumatic life events had a limited role to play in influencing outcomes.",0,0 +4927,Profiles of Connectedness: Processes of Resilience and Growth in Children With Cancer,"Identified patterns of connectedness in youth with cancer and demographically similar healthy peers.Participants included 153 youth with a history of cancer and 101 youth without a history of serious illness (8-19 years). Children completed measures of connectedness, posttraumatic stress symptoms (PTSS), and benefit-finding. Parents also reported on children's PTSS.Latent profile analysis revealed four profiles: high connectedness (45%), low connectedness (6%), connectedness primarily to parents (40%), and connectedness primarily to peers (9%). These profiles did not differ by history of cancer. However, profiles differed on PTSS and benefit-finding. Children highly connected across domains displayed the lowest PTSS and highest benefit-finding, while those with the lowest connectedness had the highest PTSS, with moderate PTSS and benefit-finding for the parent and peer profiles.Children with cancer demonstrate patterns of connectedness similar to their healthy peers. Findings support connectedness as a possible mechanism facilitating resilience and growth.",0,0 +4928,"Cumulative effect of multiple trauma on symptoms of posttraumatic stress disorder, anxiety, and depression in adolescents","Recent literature has indicated that exposure to multiple traumatic events in adults is associated with high levels of posttraumatic stress disorder (PTSD), anxiety, and depression. Against the backdrop of stressful life events and childhood abuse and neglect, we investigated the cumulative effect of multiple trauma exposure on PTSD, anxiety, and depression in an adolescent sample. One thousand one hundred forty 10th-grade learners from 9 Cape Town (South Africa) schools completed questionnaires on stressful life experiences; trauma exposure; and symptoms of anxiety, depression, and PTSD. Our population of interest for this study was adolescents between the ages of 14 and 18 years who had been exposed to serious, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition , qualifying traumatic events. The final sample size was thus 922. Rates of trauma exposure, PTSD, depression, and anxiety were high. Controlling for sex, stressful life experiences in the past year, and childhood adversity, we found an effect of cumulative trauma exposure effect on PTSD and depression, with an increase in the number of traumas linearly associated with an increase in symptoms of PTSD (F (4,912) = 7.60, P < .001) and depression (F (4,912) = 2.77, P < .05). We did not find a cumulative effect on anxiety. Our findings indicate that adolescents exposed to multiple traumas are more likely to experience more severe symptoms of PTSD and depression than those who experience a single event, with this effect independent of childhood adversity and everyday stressful life experiences. Exposure to multiple trauma, however, does not seem to be associated with more severe anxiety symptoms.",0,0 +4929,Different profiles of mental and physical health and stress hormone response in women victims of intimate partner violence,"To analyse the individual differences in the impact that intimate male partner violence (IPV) has on a woman's depressive and posttraumatic stress disorder (PTSD) symptomatology, and to determine the association of the different profiles of mental dysfunction with cortisol and dehydroepiandrosterone (DHEA) basal saliva levels as well as physical health symptoms. A cross-sectional study was carried out in which IPV victims ( n =73) and control non-abused ( n =31) women participated. Information was obtained through structured interviews and saliva samples were collected for hormonal assays under baseline conditions. There were three profiles of mental symptoms in IPV subjects: no symptoms ( n =19); with depressive symptoms ( n =36), and depressive/PTSD symptom ( n =18). None of the non-abused women had depressive or PTSD symptoms. The stress hormone response differed between groups. Only the IPV-depressive group had higher evening cortisol, and both morning and evening DHEA, but lower morning cortisol/DHEA ratio than non-abused women. Furthermore, there were differences between the IPV groups. The IPV-depressive group had lower morning cortisol and morning cortisol/DHEA ratio than the IPV-no symptoms and lower morning cortisol/DHEA ratio than the IPV-depressive/PTSD group. With respect to the physical symptoms there was an association between the mean of symptoms and the profile of mental health, the incidence being higher in the depressive/PTSD group than in the other groups. This study demonstrates that there are individual differences in the impact that IPV has on the stress response and health status in women victims.",0,0 +4930,Psychometric Properties of the Impact of Event Scale-Revised in Patients One Year After Burn Injury,"Burn injury can be a life-threatening and traumatic event. Despite considerable risk for psychological morbidity, few outcome measures have been evaluated. The aim of this study was to examine the psychometric properties of a Swedish version of the Impact of Event Scale-Revised (IES-R) in patients 1 year after burn injury (N = 147). A principal component analysis was performed, and the results supported the three-factor structure of the IES-R. High internal consistency and intelligible associations with concurrent psychological symptoms and known risk factors for distress after trauma indicate satisfactory psychometric properties. Thus, the study supports the use of the IES-R as a screening tool for measuring traumatic distress after burn.",0,0 +4931,Innovative Training with Virtual Patients in Transcultural Psychiatry: The Impact on Resident Psychiatrists’ Confidence,"Virtual patients are now widely accepted as efficient and safe training tools in medical education, but very little is known about their implementation in psychiatry, especially in transcultural clinical care of traumatized refugee patients.This study aimed at assessing the impact of training with a virtual patient on confidence in providing clinical care for traumatized refugee patients.The authors developed an educational tool based on virtual patient methodology portraying the case of ""Mrs. K"", a traumatized refugee woman with symptoms of PTSD and depression. A group (N=32) of resident psychiatrists tested the system and their confidence in different aspects of providing clinical care for this patient group was evaluated pre- and post-test by using a validated confidence questionnaire. Cronbach's α was calculated for all clusters. Changes between pre- and post-test were compared by using the matched-pair t-test, binomial distribution for exact significance test and a calculation of effect sizes (Cohen's d).A statistically significant improvement was exhibited in overall confidence (mean Δ: 0.34; p<0.0001; d: 0.89) as well as in four more specific domains of clinical care, with the area of identifying and evaluating trauma-related diagnoses and disability showing the most prominent improvement (mean Δ: 0.47; p<0.0001; d: 1.00).This VP-system can lead to physicians' improvement of confidence in providing transcultural clinical care for traumatized refugee patients. Further research is required to investigate improvement in actual performance and cognitive outcomes with several VPs and in a long-term effect perspective.",0,0 +4932,Time‐dependent Development of Social Stress Caused by Repeated Exposures to Aggressors Simulating Features of Post‐traumatic Stress Disorder (PTSD),"A utility criterion of a PTSD mouse model is recruiting a stressor with systematically variable intensity. An ideal stressor should maintain a 'dose-response relationship' with the subjects' behavioral shift. A typical PTSD model includes a brief exposure to foot or tail shock. We developed a model that involves repeated exposures (either 5-day or 10-day) to trained conspecific aggressors (Agg). A contextual reminder study evaluating a cluster of ethogram identified PTSD-like (acute- and persistent-) syndromes such as incubation, extinction and desensitization of fear responses. Pathophysiological consequences supported the model. This model reflects the combat-like situation where life-threatening events occur repeatedly and randomly. The direct relationship of PTSD-risk with deployment frequency further justifies the model. Agg induced stress intensity can only be elevated by prolonging the exposure. The risk of habituation can thereby defeat the 'dose-response' relationship. We addressed this concern by evaluating the time-dependent behavioral shift of the subject mice (C57BL/6j). Subsets of subject mice were withdrawn from the Agg-exposure (Agg-E) schedule at regular intervals and their psycho-patho-physiological characters were evaluated. A regression model elucidated the temporal relationship of Agg-E stress with the psychological alteration.",0,0 +4933,Comorbidity of personality disorders in anxiety disorders: A meta-analysis of 30 years of research,"A comprehensive meta-analysis to identify the proportions of comorbid personality disorders (PD) across the major subtypes of anxiety disorders (AD) has not previously been published.A literature search identified 125 empirical papers from the period 1980-2010 on patients with panic disorders, social phobia, generalised anxiety, obsessive-compulsive (OCD) and post-traumatic stress disorder (PTSD). Several moderators were coded.The rate of any comorbid PD was high across all ADs, ranging from .35 for PTSD to .52 for OCD. Cluster C PDs occurred more than twice as often as cluster A or B PDs. Within cluster C the avoidant PD occurred most frequently, followed by the obsessive-compulsive and the dependent PD. PTSD showed the most heterogeneous clinical picture and social phobia was highly comorbid with avoidant PD. A range of moderators were examined, but most were non-significant or of small effects, except an early age of onset, which in social phobia increased the risk of an avoidant PD considerably. Gender or duration of an AD was not related to variation in PD comorbidity.Blind rating of diagnoses was recorded from the papers as an indication of diagnostic validity. However, as too few studies reported it the validity of the comorbid estimates of PD was less strong.The findings provided support to several of the proposed changes in the forthcoming DSM-5. Further comorbidity studies are needed in view of the substantial changes in how PDs will be diagnosed in the DSM-5.",0,0 +4934,Post-traumatic stress disorder in DSM-5: Estimates of prevalence and criteria comparison versus DSM-IV-TR in a non-clinical sample of earthquake survivors,"The latest edition of DSM (DSM-5) introduced important revisions to PTSD symptomatological criteria, such as a four-factor model and the inclusion of new symptoms. To date, only a few studies have investigated the impact that the proposed DSM-5 criteria will have on prevalence rates of PTSD.An overall sample of 512 adolescents who survived the L'Aquila 2009 earthquake and were previously investigated for the presence of full and partial PTSD, using DSM-IV-TR criteria, were reassessed according to DSM-5 criteria. All subjects completed the Trauma and Loss Spectrum-Self Report (TALS-SR).A DSM-5 PTSD diagnosis emerged in 39.8% of subjects, with a significant difference between the two sexes (p<0.001), and an overall 87.1% consistency with DSM-IV-TR. Most of the inconsistent diagnoses that fulfilled DSM-IV-TR criteria but not DSM-5 criteria can be attributed to the subjects not fulfilling the new criterion C (active avoidance). Each DSM-5 symptom was more highly correlated with its corresponding symptom cluster than with other symptom clusters, but two of the new symptoms showed moderate to weak item-cluster correlations. Among DSM-5 PTSD cases: 7 (3.4%) endorsed symptom D3; 151 (74%) D4; 28 (13.7%) both D3 and D4; 75 (36.8%) E2.The use of a self-report instrument; no information on comorbidity; homogeneity of study sample; lack of assessment on functional impairment; the rates of DSM-IV-TR qualified PTSD in the sample was only 37.5%.This study provides an inside look at the empirical performance of the DSM-5 PTSD criteria in a population exposed to a natural disaster, which suggests the need for replication in larger epidemiological samples.",0,0 +4935,Review of sertraline in post-traumatic stress disorder,"Sertraline (Zoloft trade mark, Pfizer) is a selective serotonin re-uptake inhibitor (SSRI) with proven efficacy in the treatment of post-traumatic stress disorder (PTSD). PTSD is a serious, complex and often chronic mental illness that may follow exposure to a traumatic event. The high prevalence of traumatic events and PTSD in the general population and the resulting distress and dysfunction present a need for the systematic study of the efficacy and effectiveness of treatments for PTSD. Sertraline offers advantages over the older antidepressants, including demonstrated efficacy in PTSD, improved tolerability and low risk of lethality in overdose. Sertraline's efficacy, favourable tolerability profile and relatively weak effect on the cytochrome P450 system are factors that contribute to make it a first-line agent of choice in the treatment of PTSD.",0,0 +4936,Personality Assessment Inventory (PAI) Profiles of Male Veterans With Combat-Related Posttraumatic Stress Disorder,"The Personality Assessment Inventory (PAI; L. C. Morey, 1991) is a promising tool for the assessment of Posttraumatic Stress Disorder (PTSD), but few studies have examined the PAI profiles of individuals with the diagnosis. In this study, the PAI was administered to 176 combat veterans with PTSD. Results showed significant elevations on scales measuring depression, somatic complaints, anxiety, anxiety-related disorders, schizophrenia, and negative impression management. The Traumatic Stress subscale was the highest point in the mean score profile and was moderately correlated with several established measures of PTSD. Veterans with and without comorbid major depression differed on PAI scales assessing depression, anxiety, and warmth. Analysis of two-point codetypes for the PAI and the MMPI-2 revealed substantial heterogeneity in symptom endorsement on both instruments, suggesting that there may be no clear ""PTSD profile"" on either instrument. Results provide a reference point for future work with the PAI in PTSD samples. (",0,0 +4937,"The PTSD Checklist-Civilian Version: Reliability, Validity, and Factor Structure in a Nonclinical Sample","We examined the reliability, validity, and factor structure of the posttraumatic stress diorder (PTSD) Checklist-Civilian Version (PCL-C; Blanchard, Jones-Alexander, Buckley, & Forneris, 1996) among unselected undergraduate students.Participants were 471 undergraduate students at a large university in the Eastern United States and were not preselected based on trauma history or symptom severity.The PCL-C demonstrated good internal consistency and retest reliability. Compared with alternative measures of PTSD, the PCL-C showed favorable patterns of convergent and discriminant validity. In contrast to previous research using samples with known trauma exposure, we found support for both 1-factor and 2-factor models of PTSD symptoms.Overall, the PCL-C appears to be a valid and reliable measure of PTSD symptoms, even among nonclinical samples, and is superior to some alternative measures of PTSD. The factor structure among nonclinical samples may not reflect each of the PTSD symptom ""clusters"" (i.e., reexperiencing, avoidance/numbing, and hyperarousal).",0,0 +4938,Evidence for Response Set Effects in Structured Research Interviews,"The Addiction Severity Index and NIMH Diagnostic Interview Schedule data of 20 methadone-maintained subjects with ""fake bad"" invalid profiles on the Personality Assessment Inventory, 15 methadone-maintained subjects with ""fake good"" invalid profiles, and 158 methadone-maintained subjects with valid profiles were compared. The findings revealed a number of significant group differences on both measures with the highest scores for the fake bad subjects and lowest scores for the fake good subjects. These findings suggest that the response sets exhibited in response to the Personality Assessment Inventory questionnaire extended to performance during the two semi-structured interviews. There was no indication that interviewers were aware of misrepresentation. The limitations of the findings and alternative interpretations of the data are considered.",0,0 +4939,Profile of children investigated for sexual abuse: Association with psychopathology symptoms and services.,"Sexually abused children may have poor mental health because of their victimization as well as preexisting or co-occurring family problems. However, few studies consider psychopathology in relation to both abuse and other family experiences. This study uses data from the National Survey of Child and Adolescent Well-Being (NSCAW) to create latent subgroups of 553 children investigated for sexual abuse. The study investigates children's psychological symptoms and child welfare service (CWS) patterns to understand how children's needs relate to mental health services. Analyses were conducted by child age: 3-7, 8-11, and 12-14. Factor mixture modeling and regression analyses were used. Results show meaningful subgroups of children that relate to different symptom patterns. Among 3- to 7-year-olds, behavioral symptoms are associated with caregiver domestic violence and mental illness. Among 8- to 11-year-olds, depressive symptoms are associated with severe abuse and multiple family problems, whereas posttraumatic stress is associated with chronic, unresolved abuse. Although many children received mental health services, services are not well matched to children's needs--the substantiation status of the abuse explains services. Implications for CWS and mental health services are discussed.",0,0 +4940,Post Traumatic Stress Disorder: Cognitive Therapy with Children and Young People,"Post traumatic stress disorder develops after exposure to one or more terrifying events that have caused, or threatened to cause the sufferer grave physical harm. This book discusses how trauma-focused cognitive therapy can be used to help children and adolescents who suffer from post traumatic stress disorder. Cognitive therapy is frequently used to treat adults who suffer from PTSD with proven results. Post Traumatic Stress Disorder provides the therapist with instructions on how CT models can be used with children and young people to combat the disorder. Based on research carried out by the authors, this book covers: assessment procedures and measures formulation and treatment planning trauma focused cognitive therapy methods common hurdles. The authors provide case studies and practical tips, as well as examples of self-report measures and handouts for young people and their parents which will help the practitioner to prepare for working with this difficult client group. Post Traumatic Stress Disorder is an accessible, practical, clinically relevant guide for professionals and trainees in child and adolescent mental health service teams who work with traumatized children and young people.",0,0 +4941,The injury profile after the 2008 earthquakes in China,"The 8.0 magnitude earthquake that struck China on May 12, 2008, was the deadliest earthquake in 30 years. Most hospitals were destroyed and limited facilities were available for medical service in the earthquake regions. Over the first 5 days, three general hospitals and one children's hospital admitted 1770 injured individuals.We retrospectively collected data on 1770 injured subjects in three general hospitals (n=1723) and one children's hospital (n=47) in the quake-area during the first 5 days after the event. The diagnosis for the injuries was based on the final hospital diagnosis made by the physicians and classified by two-independent researchers using the International Statistical Classification of Diseases and Related Health Problems ICD-10 (WHO ICD-10 Code.1993). To ensure the accuracy of the information, any questionable data was reviewed by phone with hospital staff.In three general hospitals, 848 patients (48%) were male and 922 (52%) were female. Nine percent (n=84) of females and 8.8% (n=75) of males were over the age of 75. Four (0.4%) females and 5 (0.5%) males were less than 1-year old. The most common injuries were the injuries of the knee, lower leg, ankle and foot (36%), followed by head injuries (18%). In the children's hospital, 31 (65%) of the patients were males and 16 (35%) were females. 40% of the subjects were 10-14, while 21% were less than 1-year old. The most frequently seen injuries were also of the knee, lower leg, ankle or foot (19%), and of the abdomen, lower back, lumbar spine and pelvis, and hip and thigh (15%).We gathered information from resources in Chinese, which at the time contained more records on this event than any documents in English. The age of the patients ranged from 7 days to 84 years old. Subjects over age 75 and children between 10 and 14 were the largest population in their respective hospitals, indicating that these groups required the greatest medical resources. The injury profile presented here serves as a reference not only for present injury intervention but also for future earthquake disaster response.",0,0 +4942,Stressor characteristics and post-traumatic stress disorder symptom dimensions in war victims.,"To evaluate how the type of trauma is related to specific symptom patterns in patients with post-traumatic stress disorder (PTSD) according to the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) criteria.A total of 136 PTSD patients exposed to war-related traumatic experiences were divided in four groups: 79 veterans, 18 former prisoners (who witnessed or were subject to torture or frequent assaults), 15 victims of rape, and 24 refugees from Bosnia and Herzegovina. Each group was homogenous in regard to traumatic experiences.Significant inter-group differences were found in symptoms listed in the DSM-IV criteria, and under criteria C (avoidance) and D (arousal). No such differences were observed in symptoms listed under criterion B (intrusive symptoms). The results indicate that stressor characteristics may play a role not only in the variety of symptoms exhibited, but particularly in the number of avoidance and arousal symptoms. Victims of rape tended to present with more avoidance symptoms and fewer hyperarousal symptoms, whereas former prisoners and veterans tended to report more hyperarousal symptoms. Rape victims and former prisoners also reported more symptoms than the other groups.There is a strong indication that stressor characteristics influence the variety and number of exhibited intrusive, avoidance, and arousal symptoms. More research is needed to precisely define individual symptom dimensions possibly relating to particular stressor characteristics. Additional studies are needed to determine whether PTSD, as it is currently defined in the DSM-IV, is really a homogenous diagnostic category.",0,0 +4943,The Quality of Life of Young Children and Infants with Chronic Medical Problems: Review of the Literature,"The question ""what makes a good quality of life?"" is a philosophical one which could be thought immune to scientific investigations. However, over the last few decades there has been great progress in developing tools to quantify quality of life (QoL) to make comparisons between different health states, evaluate the effectiveness of medical interventions, and describe the life trajectories of individuals or groups. Using a series of vignettes, we explore and review the biomedical literature to demonstrate how QoL is affected by chronic health conditions in childhood, and how it evolves as individuals pass into adulthood. Individuals experiencing serious chronic illnesses generally have reduced health-related QoL: their health status has significant repercussions of their everyday life, but scores are usually much better than healthy individuals expect, and better than physicians predict. Global QoL is more than a health status concept. QoL is a complex relationship between objectivity and subjectivity; it requires substantial and valid facts, and it defines itself by an interpretation of health within different schemes of values: societal, medical, and those of the subject themselves. QoL is dynamic; purely physical influences diminish as individuals age, and psychosocial factors become much more important. Resilience frequently allows adaptation to adverse health states, leading to acceptable QoL for most children with disabilities.",0,0 +4944,Clarifying Heterogeneity of Daytime and Nighttime Symptoms of Posttraumatic Stress in Combat Veterans With Insomnia,"Daytime and nighttime symptoms of posttraumatic stress disorder (PTSD) are common among combat veterans and military service members. However, there is a great deal of heterogeneity in how symptoms are expressed. Clarifying the heterogeneity of daytime and nighttime PTSD symptoms through exploratory clustering may generate hypotheses regarding ways to optimally match evidence-based treatments to PTSD symptom profiles. We used mixture modeling to reveal clusters based on six daytime and nighttime symptoms of 154 combat veterans with insomnia and varying levels of PTSD symptoms. Three clusters with increasing symptom severity were identified (N1=50, N2=70, N3=34). These results suggest that, among veterans with insomnia, PTSD symptoms tend to exist on a continuum of severity, rather than as a categorical PTSD diagnosis. Hypotheses regarding possible targeted treatment strategies for veterans within each identified cluster, as well as ways to generalize these methods to other groups within the military, are discussed.",0,0 +4945,Using Longitudinal Complex Survey Data,"Common features of longitudinal surveys are complex sampling designs, which must be maintained and extended over time; measurement errors, including memory errors; panel conditioning or time-in-sample effects; and dropout or attrition. In the analysis of longitudinal survey data, both the theory of complex samples and the theory of longitudinal data analysis must be combined. This article reviews the purposes of longitudinal surveys and the kinds of analyses that are commonly used to address the questions these surveys are designed to answer. In it, I discuss approaches to incorporating the complex designs in inference, as well as the complications introduced by time-in-sample effects and by nonignorable attrition. I also outline the use and limitations of longitudinal survey data in supporting causal inference and conclude with some summary remarks.",0,0 +4946,Latent Growth Mixture Models to estimate PTSD trajectories,"No abstract available. (Published: 2 March 2015) Citation: European Journal of Psychotraumatology 2015, 6 : 27503 - http://dx.doi.org/10.3402/ejpt.v6.27503 This paper is part of the Special Issue: Estimating PTSD trajectories . More papers from this issue can be found at http://www.ejpt.net",0,0 +4947,"War exposure, daily stressors, and mental health in conflict and post-conflict settings: Bridging the divide between trauma-focused and psychosocial frameworks","This paper seeks to bridge the divisive split between advocates of trauma-focused and psychosocial approaches to understanding and addressing mental health needs in conflict and post-conflict settings by emphasizing the role that daily stressors play in mediating direct war exposure and mental health outcomes. The authors argue that trauma-focused advocates tend to overemphasize the impact of direct war exposure on mental health, and fail to consider the contribution of stressful social and material conditions (daily stressors). Drawing on the findings of recent studies that have examined the relationship of both war exposure and daily stressors to mental health status, a model is proposed in which daily stressors partially mediate the relationship of war exposure to mental health. Based on that model, and on the growing body of research that supports it, an integrative, sequenced approach to intervention is proposed in which daily stressors are first addressed, and specialized interventions are then provided for individuals whose distress does not abate with the repair of the social ecology.",0,0 +4948,Changes in PTSD symptomatology during acute and protracted alcohol and cocaine abstinence,"Previous research with substance users has demonstrated, across a variety of psychiatric disorders, significant decreases in psychological symptoms during early substance abstinence. To build on this literature, the current study prospectively assessed trauma symptomatology over 28 days during acute and protracted cocaine and alcohol abstinence. Participants were 162 male and female cocaine and/or alcohol dependent outpatients who reported a history of trauma. Trauma-related symptoms and substance use were assessed at 2, 5, 10, 14, 21, and 28 days following last substance use. For participants who were known to relapse, assessments began again after the last day of substance use. Latent growth modeling was employed to estimate changes in posttraumatic stress disorder (PTSD) symptoms. Consistent with studies of other psychiatric syndromes, PTSD symptoms declined across the 28-day study period regardless of withdrawal substance (i.e., cocaine or alcohol). The majority of change in trauma symptoms occurred within 2 weeks of last substance use. Moreover, while trauma symptoms for the PTSD participants were more severe than those reported by the non-PTSD participants, trauma symptoms declined across the study period at the same rate irrespective of PTSD status.",0,0 +4949,Behavioral couples therapy for comorbid substance use disorders and combat-related posttraumatic stress disorder among male veterans: An initial evaluation,"Outcomes after behavioral couples therapy (BCT) were compared for 19 dually diagnosed veterans with combat-related PTSD and a substance use disorder (SUD, primarily alcohol dependence) and 19 veterans with SUD only. Clients with and without comorbid PTSD had very similar pre-treatment clinical profiles on dimensions of substance misuse, relationship functioning, and psychological symptoms. Further, both PTSD and non-PTSD clients showed good compliance with BCT, attending a high number of BCT sessions, taking Antabuse, and going to AA. Finally, both PTSD and non-PTSD groups improved from before BCT to immediately after and 12 months after BCT. Specific improvements noted were increased relationship satisfaction and reductions in drinking, negative consequences of drinking, male-to-female violence, and psychological distress symptoms. Extent and pattern of improvement over time were similar whether the client had PTSD or not. The present results suggest that BCT may have promise in treating clients with comorbid SUD and combat-related PTSD.",0,0 +4950,Smallpox Vaccination: Comparison of Self-Reported and Electronic Vaccine Records in the Millennium Cohort Study,"In December 2002, the US Government implemented policy to immunize health workers, first responders, and military personnel against smallpox in preparation for a possible bioterrorist attack. Self-reported vaccination data are commonly used in epidemiologic research and may be used to determine vaccination status in a public health emergency. To establish a measure of reliability, the agreement between self-reported smallpox vaccination and electronic vaccination records was examined using data from the Millennium Cohort Study. Descriptive measures and a kappa statistic were calculated for data from 54,066 Millennium Cohort Study participants. Multivariable modeling adjusting for potential confounders was used to investigate vaccination agreement status and health metrics, as measured by the Short Form 36-Item Health Survey for Veterans (SF-36V) and hospitalization data. Substantial agreement (kappa =0.62) was found between self-report and electronic recording of smallpox vaccination. Of all participants with an electronic record of smallpox vaccination, 90% self-reported being vaccinated; and of all participants with no electronic record of vaccination, 82% self-reported not receiving a vaccination. There was no significant difference in hospitalization experience prior to questionnaire completion between vaccinated and unvaccinated participants. While overall scores on the SF-36V suggested a healthy population, participants whose self-reported vaccination status did not match electronic records had slightly lower adjusted mean scores for some scales. These results indicate strong reliability in self-reported smallpox vaccination and also suggest that discordant reporting of smallpox vaccination is not associated with substantial differences in health among Millennium Cohort participants.",0,0 +4951,Screening for Traumatic Exposure and Posttraumatic Stress Symptoms in Adolescents in the War-Affected Eastern Democratic Republic of Congo,"To explore adolescent mental health in the eastern Democratic Republic of Congo, scene of a complex emergency since 1996.Community cross-sectional data obtained using a cluster sample approach.From November 5, 2007, through February 5, 2008, we assessed 13 secondary schools in 4 selected health zones in the Ituri district.One thousand forty-six adolescents and young adults aged 13 to 21 years completed a self-report questionnaire.War-related traumatic events, posttraumatic stress symptoms, and sociodemographic variables.The Adolescent Complex Emergency Exposure Scale, specifically designed for this region, screened for exposure to potentially traumatic events, and the Impact of Event Scale-Revised measured symptoms of posttraumatic stress consistent with Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria.Among the 477 girls (45.6%) and 569 boys (54.4%) in the study, 95.0% reported at least 1 traumatic event. On average, adolescents were exposed to 4.71 traumatic events, with higher exposure rates reported in boys, older groups, rural and urban areas, and respondents whose mother or father was dead. Of 990 respondents, 52.2% met symptom criteria for posttraumatic stress disorder. Symptom scores were strongly related to cumulative trauma exposure; however, the strength of this relationship differed slightly across living area groups for girls.Adolescents in the eastern Democratic Republic of Congo are highly exposed to political violence, putting them at a considerable risk--mediated by living area and sex--to develop posttraumatic stress symptoms.",0,0 +4952,Acute Stress Disorder and Posttraumatic Stress Disorder in Children and Adolescents Involved in Assaults or Motor Vehicle Accidents,"OBJECTIVE: The authors investigated acute stress disorder and later posttraumatic stress disorder (PTSD) in children and adolescents who had been involved in assaults or motor vehicle accidents. METHOD: They interviewed 93 patients 10–16 years old who were seen in an emergency department for having been assaulted or involved in a motor vehicle accident within 4 weeks after the assault or accident to assess acute stress disorder. At 6 months, they reinterviewed 64 (68.8%) of the patients to assess PTSD. RESULTS: At initial interview, 18 (19.4%) of the 93 patients had acute stress disorder and 23 (24.7%) met all acute stress disorder criteria except dissociation. At 6 months, eight of the 64 patients (12.5%) had PTSD. Acute stress disorder and PTSD did not differ in prevalence between patients who had been assaulted and those who had been in accidents. Sensitivity and specificity statistics and regression modeling revealed that the diagnosis of acute stress disorder was a good predictor of later PTSD but that dissociation did not play a significant role. CONCLUSIONS: Acute stress disorder has merit as a predictor of later PTSD in children and adolescents, but dissociation has questionable utility.",0,0 +4953,Sexual Function Outcomes in Women Treated for Posttraumatic Stress Disorder,"This study examined dysfunctional sexual behavior and sexual concerns in women treated for posttraumatic stress disorder (PTSD). There were three objectives: to characterize the relationship between symptoms of PTSD and sexual outcomes, to examine the effect of treatment on sexual outcomes, and to examine the relationship between change in PTSD and change in sexual outcomes.Female veterans and active duty personnel with PTSD (n = 242), 93% of whom had experienced sexual trauma, were randomly assigned to receive 10 weekly sessions of either Prolonged Exposure or Present-Centered Therapy. PTSD and sexual outcomes were assessed before and after treatment and then 3 and 6 months later.At baseline, the reexperiencing, numbing, and hyperarousal symptom clusters were related to one or both sexual outcomes. Although prior analyses had shown that Prolonged Exposure resulted in better PTSD outcomes, there were no differences between treatments for either dysfunctional sexual behavior or sexual concerns. However, loss of PTSD diagnosis was associated with improvements in sexual concerns.The findings suggest that clinically meaningful improvements in PTSD are necessary in order to reduce sexual problems in traumatized women.",0,0 +4954,"Modeling PTSD Symptom Clusters, Alcohol Misuse, Anger, and Depression as They Relate to Aggression and Suicidality in Returning U.S. Veterans","Suicidal ideation and aggression are common correlates of posttraumatic stress disorder (PTSD) among U.S. Iraq and Afghanistan war veterans. The existing literature has established a strong link between these factors, but a more nuanced understanding of how PTSD influences them is needed. The current study examined the direct and indirect relationships between PTSD symptom clusters and suicidal ideation in general aggression (without a specified target) regarding depression, alcohol misuse, and trait anger. Participants were 359 (92% male) U.S. Iraq/Afghanistan war veterans. Path analysis results suggested that the PTSD numbing cluster was directly (β = .28, p < .01) and indirectly (β = .17, p = .001) related through depression. The PTSD hyperarousal cluster was indirectly related to suicidal ideation through depression (β = .13, p < .001). The PTSD reexperiencing cluster was directly related to aggression (β = .17, p < .05), whereas the PTSD numbing and hyperarousal clusters were indirectly related to aggression through trait anger (β = .05, p < .05; β = .20, p < .001). These findings indicate that adjunct treatments aimed at stabilizing anger, depression, and alcohol misuse may help clinicians ameliorate the maladaptive patterns often observed in veterans. These results also point to specific manifestations of PTSD and co-occurring conditions that may inform clinicians in their attempts to identify at risk veterans and facilitate preventative interventions.",0,0 +4955,"A selective neurokinin-1 receptor antagonist in chronic PTSD: A randomized, double-blind, placebo-controlled, proof-of-concept trial","The substance P-neurokinin-1 receptor (SP-NK(1)R) system has been extensively studied in experimental models of stress, fear, and reward. Elevated cerebrospinal fluid (CSF) SP levels were reported previously in combat-related PTSD. No medication specifically targeting this system has been tested in PTSD. This proof-of-concept randomized, double-blind, placebo-controlled trial evaluated the selective NK(1)R antagonist GR205171 in predominately civilian PTSD. Following a 2-week placebo lead-in, 39 outpatients with chronic PTSD and a Clinician-Administered PTSD Scale (CAPS) score ≥50 were randomized to a fixed dose of GR205171 (N=20) or placebo (N=19) for 8weeks. The primary endpoint was mean change from baseline to endpoint in the total CAPS score. Response rate (≥50% reduction in baseline CAPS) and safety/tolerability were secondary endpoints. CSF SP concentrations were measured in a subgroup of patients prior to randomization. There was significant improvement in the mean CAPS total score across all patients over time, but no significant difference was found between GR205171 and placebo. Likewise, there was no significant effect of drug on the proportion of responders [40% GR205171 versus 21% placebo (p=0.30)]. An exploratory analysis showed that GR205171 treatment was associated with significant improvement compared to placebo on the CAPS hyperarousal symptom cluster. GR205171 was well-tolerated, with no discontinuations due to adverse events. CSF SP concentrations were positively correlated with baseline CAPS severity. The selective NK(1)R antagonist GR205171 had fewer adverse effects but was not significantly superior to placebo in the short-term treatment of chronic PTSD. (ClinicalTrials.gov Identifier: NCT 00211861, NCT 00383786).",0,0 +4956,Symptom structure of posttraumatic stress disorder in a nationally representative sample,"Diagnostic criteria (e.g., Diagnostic and Statistical Manual of Mental Disorders , 4th ed.) for posttraumatic stress disorder (PTSD) posit three symptom clusters including reexperiencing, avoidance/numbing, and hyperarousal. Factor analytic studies have suggested several alternative models of PTSD symptomatology . It is uncertain whether these new models are widely generalizable as most studies have relied on relatively select treatment seeking samples (e.g., combat veterans). To address this limitation, confirmatory factor analysis was applied to symptom data from National Comorbidity Survey respondents with a lifetime history of PTSD ( n = 429). Several models were tested. The model comprised of four intercorrelated factors (reexperiencing, avoidance, numbing, and hyperarousal) received the strongest support, but did not meet all the goodness-of-fit criteria. A follow-up principal-components analysis yielded a four-factor solution, with factors representing dysphoria , cued reexperiencing and avoidance, uncued reexperiencing and hyperarousal, and trauma-related rumination. The theoretical and clinical implications of these findings are discussed.",0,0 +4957,Wagner's migraine and other stories . . .,,0,0 +4958,A Randomized Stepped Care Intervention Trial Targeting Posttraumatic Stress Disorder for Surgically Hospitalized Injury Survivors,"To test the effectiveness of a stepped care intervention model targeting posttraumatic stress disorder (PTSD) symptoms after injury.Few investigations have evaluated interventions for injured patients with PTSD and related impairments that can be feasibly implemented in trauma surgical settings.The investigation was a pragmatic effectiveness trial in which 207 acutely injured hospitalized trauma survivors were screened for high PTSD symptom levels and then randomized to a stepped combined care management, psychopharmacology, and cognitive behavioral psychotherapy intervention (n = 104) or usual care control (n = 103) conditions. The symptoms of PTSD and functional limitations were reassessed at 1, 3, 6, 9, and 12 months after the index injury admission.Regression analyses demonstrated that over the course of the year after injury, intervention patients had significantly reduced PTSD symptoms when compared with controls [group by time effect, CAPS (Clinician-Administered PTSD Scale): F(2, 185) = 5.50, P < 0.01; PCL-C (PTSD Checklist Civilian Version): F(4, 185) = 5.45, P < 0.001]. Clinically and statistically significant PTSD treatment effects were observed at the 6-, 9-, and 12-month postinjury assessments. Over the course of the year after injury, intervention patients also demonstrated significant improvements in physical function [MOS SF-36 PCS (Medical Outcomes Study Short Form 36 Physical Component Summary) main effect: F(1, 172) = 9.87, P < 0.01].Stepped care interventions can reduce PTSD symptoms and improve functioning over the course of the year after surgical injury hospitalization. Orchestrated investigative and policy efforts could systematically introduce and evaluate screening and intervention procedures for PTSD at US trauma centers. (clinicaltrials.gov identifier: NCT00270959).",0,0 +4959,The Role of Memory-related Gene WWC1 (KIBRA) in Lifetime Posttraumatic Stress Disorder: Evidence from Two Independent Samples from African Conflict Regions,"Posttraumatic stress disorder (PTSD) results from the formation of a strong memory for the sensory-perceptual and affective representations of traumatic experiences, which is detached from the corresponding autobiographical context information. Because WWC1, the gene encoding protein KIBRA, is associated with long-term memory performance, we hypothesized that common WWC1 alleles influence the risk for a lifetime diagnosis of PTSD.Traumatic load and diagnosis of current and lifetime PTSD were assessed in two independent African samples of survivors from conflict zones who had faced severe trauma (n = 392, Rwanda, and n = 399, Northern Uganda, respectively). Array-based single nucleotide polymorphism (SNP) genotyping was performed. The influence of WWC1 tagging SNPs and traumatic load on lifetime PTSD was estimated by means of logistic regression models with correction for multiple comparisons in the Rwandan sample. Replication analysis was performed in the independent Ugandan sample.An association of two neighboring SNPs in almost complete linkage disequilibrium, rs10038727 and rs4576167, with lifetime PTSD was discovered in the Rwandan sample. Although each traumatic event added to the probability of lifetime PTSD in a dose-dependent manner in both genotype groups, carriers of the minor allele of both SNPs displayed a diminished risk (p = .007, odds ratio = .29 [95% confidence interval = .15-.54]). This effect was confirmed in the independent Ugandan sample.This study reveals an association between two WWC1 SNPs and the likelihood of PTSD development, indicating that this memory-related gene might be involved in processes that occur in response to traumatic stress and influence the strengthening of fear memories.",0,0 +4960,Psychological distress in survivors of residential fires,This paper presents preliminary findings from an ongoing study of survivors of residential fires. The purpose of this study was to examine psychological distress and extent of loss in order to provide a psychological profile of survivors overtime. The sample (N = 69) was drawn consecutively from the database of residential fires available through the Philadelphia Fire Department. Levels of psychological distress were measured as well as reports of symptoms consistent with the diagnostic criteria for Post-traumatic Stress Disorder. The major findings indicate that residential fires caused significant and sustained distress. An agenda for further research and for services to survivors of these fires is presented.,0,0 +4961,"Post-traumatic stress is associated with verbal learning, memory, and psychomotor speed in HIV-infected and HIV-uninfected women","The prevalence of post-traumatic stress disorder (PTSD) is higher among HIV-infected (HIV+) women compared with HIV-uninfected (HIV-) women, and deficits in episodic memory are a common feature of both PTSD and HIV infection. We investigated the association between a probable PTSD diagnosis using the PTSD Checklist-Civilian (PCL-C) version and verbal learning and memory using the Hopkins Verbal Learning Test in 1004 HIV+ and 496 at-risk HIV- women. HIV infection was not associated with a probable PTSD diagnosis (17% HIV+, 16% HIV-; p = 0.49) but was associated with lower verbal learning (p < 0.01) and memory scores (p < 0.01). Irrespective of HIV status, a probable PTSD diagnosis was associated with poorer performance in verbal learning (p < 0.01) and memory (p < 0.01) and psychomotor speed (p < 0.001). The particular pattern of cognitive correlates of probable PTSD varied depending on exposure to sexual abuse and/or violence, with exposure to either being associated with a greater number of cognitive domains and a worse cognitive profile. A statistical interaction between HIV serostatus and PTSD was observed on the fine motor skills domain (p = 0.03). Among women with probable PTSD, HIV- women performed worse than HIV+ women on fine motor skills (p = 0.01), but among women without probable PTSD, there was no significant difference in performance between the groups (p = 0.59). These findings underscore the importance of considering mental health factors as correlates to cognitive deficits in women with HIV.",0,0 +4962,Trauma History and Psychopathology in War-Affected Refugee Children Referred for Trauma-Related Mental Health Services in the United States,"There is an increasing need to deliver effective mental health services to refugee children and adolescents across the United States; however, the evidence base needed to guide the design and delivery of services is nascent. We investigated the trauma history profiles, psychopathology, and associated behavioral and functional indicators among war-affected refugee children presenting for psychological treatment. From the National Child Traumatic Stress Network's Core Data Set, 60 war-affected refugee children were identified (51.7% males, mean age = 13.1 years, SD = 4.13). Clinical assessments indicated high rates of probable posttraumatic stress disorder (30.4%), generalized anxiety (26.8%), somatization (26.8%), traumatic grief (21.4%), and general behavioral problems (21.4%). Exposure to war or political violence frequently co-occurred with forced displacement; traumatic loss; bereavement or separation; exposure to community violence; and exposure to domestic violence. Academic problems and behavioral difficulties were prevalent (53.6% and 44.6%, respectively); however, criminal activity, alcohol/drug use, and self-harm were rare (all < 5.45%). These findings highlight the complex trauma profiles, comorbid conditions, and functional problems that are important to consider in providing mental health interventions for refugee children and adolescents. Given the difficulties associated with access to mental health services for refugees, both preventive and community-based interventions within family, school, and peer systems hold particular promise.",0,0 +4963,Psychiatric emergencies (part I): psychiatric disorders causing organic symptoms.,"Psychiatric emergencies are conditions that mostly destabilize the already frenetic activity of the Emergency Department. Sometimes the emergency is clearly referable to primitive psychiatric illness. Other times, psychiatric and organic symptoms can independently coexist (comorbidity), or develop together in different conditions of substance abuse, including alcohol and prescription drugs. Differentiating between substance induced and pre-existing psychiatric disorder (dual diagnosis) may be difficult, other than controversial issue. Finally, an organic disease can hide behind a psychiatric disorder (pseudopsychiatric emergency). In this review (part I), psychiatric disorders that occur with organic symptoms are discussed. They include: (1) anxiety, conversion and psychosomatic disorders, and (2) simulated diseases. The physiologic mechanisms of the stress reaction, divided into a dual neuro-hormonal response, are reviewed in this section: (1) activation of the sympathetic nervous system and adrenal medulla with catecholamine production (rapid response), and (2) activation of the hypothalamic-pituitary-adrenal axis with cortisol production (slow response). The concept of the fight-or-flight response, its adaptive significance and the potential evolution in paralyzing response, well showing by Yerkes-Dodson curve, is explained. Abnormal short- and long-term reactions to stress evolving toward well codified cluster of trauma and stressor-related disorders, including acute stress disorder, adjustment disorder and post-traumatic stress disorder, are examined. A brief review of major psychiatric disorder and related behaviour abnormalities, vegetative symptoms and cognitive impairment, according to DMS IV-TR classification, are described. Finally, the reactive psychic symptoms and behavioral responses to acute or chronic organic disease, so called ""somatopsychic disorders"", commonly occurring in elderly and pediatric patients, are presented. The specific conditions of post-operative and intensive care unit patients, and cancer and HIV positive population are emphasized.",0,0 +4964,How Prevalent Is Resilience Following Sexual Assault?: Comment on Steenkamp et al. (2012),"Steenkamp, Dickstein, Salters-Pedneault, Hofmann, and Litz (2012) analyzed latent trajectories of posttraumatic stress disorder (PTSD) symptoms on data obtained in the early months following a single-incident sexual assault. In contrast to previous studies of potentially traumatic events, they did not observe a trajectory of minimal symptoms or resilience, which they argued occurred because sexual assault involves more severe and direct trauma exposure than examined in previous studies. Although sexual assault is an aversive and challenging event, it seems highly unlikely that at least some sexual assault survivors would not be resilient. Steenkamp et al.'s failure to observe resilience can easily be explained on purely methodological grounds. Most notably, their findings were probably heavily influenced by sampling bias. Additionally, their sample size was too small and had too much missing data for the kinds of latent trajectory modeling they attempted.",0,0 +4965,Exploratory Factor Analysis of the Greek Adaptation of the PTSD Checklist—Civilian Version,"The Diagnostic and Statistical Manual of Mental Disorders (4th edition; DSM-IV) conceptualization of posttraumatic stress disorder (PTSD) includes three symptom clusters or sequelae: reexperiencing, avoidance/numbing, and hyperarousal. The PTSD Checklist–Civilian Version (PCL-C) is based on the DSM-IV criteria. In the current study, we conducted an exploratory factor analysis (EFA) of the PCL-C using a sample of 312 adults. We examined whether the Greek adaptation of the PCL-C evidenced the three-factor solution given by the DSM-IV symptom cluster or the four-factor solution implied in other studies. The EFA was used to extract three- and four-factor solutions. The EFA identified a three-factor solution that included reexperiencing, avoidance/numbing, and hyperarousal supporting the DSM-IV PTSD symptoms.",0,0 +4966,Therapeutic Action of Fluoxetine is Associated with a Reduction in Prefrontal Cortical miR-1971 Expression Levels in a Mouse Model of Posttraumatic Stress Disorder,"MicroRNAs (miRNA) are a class of small non-coding RNAs that have recently emerged as epigenetic modulators of gene expression in psychiatric diseases like schizophrenia and major depression. So far, miRNAs have neither been studied in patients suffering from posttraumatic stress disorder (PTSD) nor in PTSD animal models. Here, we present the first study exploring the connection between miRNAs and PTSD. Employing our previously established PTSD mouse model, we assessed miRNA profiles in prefrontal cortices (PFCs) dissected from either fluoxetine or control-treated wildtype C57BL/6N mice 74 days after their subjection to either a single traumatic electric footshock or mock-treatment. Fluoxetine is an antidepressant known to be effective both in PTSD patients and in mice suffering from a PTSD-like syndrome. Screening for differences in the relative expression levels of all potential miRNA target sequences of miRBase 18.0 by pairwise comparison of the PFC miRNA profiles of the four mouse groups mentioned resulted in identification of five miRNA candidate molecules. Validation of these miRNA candidates by reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) revealed that the therapeutic action of fluoxetine in shocked mice is associated with a significant reduction in mmu-miR-1971 expression. Furthermore, our findings suggest that traumatic stress and fluoxetine interact to cause distinct alterations in the mouse PFC miRNA signature in the long-term.",0,0 +4967,"Trends in Psychological/Psychiatric Injury and Law: Continuing Education, Practice Comments, Recommendations","This literature review of the major topics in the field of psychological/psychiatric injury and law is aimed at developing commentary for practice in the area. The field is a fast-developing one, with over ten major topics that it needs to integrate. In particular, the present review focuses current work on: law (evidence, tort); forensic psychology; assessment and testing; psychological injuries (posttraumatic stress disorder, chronic pain, traumatic brain injury, other); the APA DSM-5 draft (Diagnostic and statistical manual of mental disorders; American Psychiatric Association 2010); malingering; causality; multicultural considerations; disability; the American Medical Association (AMA) Guides to the evaluation of permanent impairment (Rondinelli et al. 2008); models; and treatment. At the end of each section of the article, practice comments introduce critical issues in applying the research to psychological work in the area. Whether undertaking tort evaluations, disability, and treatment plan assessments or treating individuals with psychological injuries, the professional needs state-of-the-art information in all the areas listed in order to remain scientifically informed, comprehensive, and impartial. The article concludes with recommendations for an integrated field in psychological/psychiatric injury and law, study in the field, research in its major areas, best practice policies, for example in assessment and treatment, and model building. © 2010 Springer Science + Business Media, LLC.",0,0 +4968,Anthrax Vaccination in the Millennium CohortValidation and Measures of Health,"Background In 1998, the United States Department of Defense initiated the Anthrax Vaccine Immunization Program. Concerns about vaccine-related adverse health effects followed, prompting several studies. Although some studies used self-reported vaccination data, the reliability of such data has not been established. The purpose of this study was to compare self-reported anthrax vaccination to electronic vaccine records among a large military cohort and to evaluate the relationship between vaccine history and health outcome data. Methods Between September 2005 and February 2006 self-reported anthrax vaccination was compared to electronic records for 67,018 participants enrolled in the Millennium Cohort Study between 2001 and 2003 using kappa statistics. Multivariable modeling investigated vaccination concordance as it pertains to subjective health (functional status) and objective health (hospitalization) metrics. Results Greater than substantial agreement (kappa=0.80) was found between self-report and electronic recording of anthrax vaccination. Of all participants with electronic documentation of anthrax vaccination, 98% self-reported being vaccinated; and of all participants with no electronic record of vaccination, 90% self-reported not receiving a vaccination. There were no differences between vaccinated and unvaccinated participants in overall measures of health. Only the subset of participants who self-reported anthrax vaccination, but had no electronic confirmation, differed from others in the cohort, with consistently lower measures of health as indicated by Medical Outcomes Study 36-Item Short Form Health Survey for Veterans (SF-36V) scores. Conclusions These results indicate that military members accurately recall their anthrax vaccinations. Results also suggest that anthrax vaccination among Millennium Cohort participants is not associated with self-reported health problems or broad measures of health problems severe enough to require hospitalization. Service members who self-report vaccination with no electronic documentation of vaccination, however, report lower measures of physical and mental health and deserve further research. In 1998, the United States Department of Defense initiated the Anthrax Vaccine Immunization Program. Concerns about vaccine-related adverse health effects followed, prompting several studies. Although some studies used self-reported vaccination data, the reliability of such data has not been established. The purpose of this study was to compare self-reported anthrax vaccination to electronic vaccine records among a large military cohort and to evaluate the relationship between vaccine history and health outcome data. Between September 2005 and February 2006 self-reported anthrax vaccination was compared to electronic records for 67,018 participants enrolled in the Millennium Cohort Study between 2001 and 2003 using kappa statistics. Multivariable modeling investigated vaccination concordance as it pertains to subjective health (functional status) and objective health (hospitalization) metrics. Greater than substantial agreement (kappa=0.80) was found between self-report and electronic recording of anthrax vaccination. Of all participants with electronic documentation of anthrax vaccination, 98% self-reported being vaccinated; and of all participants with no electronic record of vaccination, 90% self-reported not receiving a vaccination. There were no differences between vaccinated and unvaccinated participants in overall measures of health. Only the subset of participants who self-reported anthrax vaccination, but had no electronic confirmation, differed from others in the cohort, with consistently lower measures of health as indicated by Medical Outcomes Study 36-Item Short Form Health Survey for Veterans (SF-36V) scores. These results indicate that military members accurately recall their anthrax vaccinations. Results also suggest that anthrax vaccination among Millennium Cohort participants is not associated with self-reported health problems or broad measures of health problems severe enough to require hospitalization. Service members who self-report vaccination with no electronic documentation of vaccination, however, report lower measures of physical and mental health and deserve further research.",0,0 +4969,"Post-traumatic stress disorder, drug abuse and migraine: New findings from the National Comorbidity Survey Replication (NCS-R)","Post-traumatic stress disorder (PTSD) has been shown to be associated with migraine and drug abuse.This was an analysis of data from the National Comorbidity Survey Replication (NCS-R) to evaluate the association of PTSD in those with episodic migraine (EM) and chronic daily headache (CDH).Our sample consisted of 5,692 participants. Lifetime and 12-month prevalence rates of PTSD were increased in those with EM and CDH. After adjustments, the lifetime odds ratio (OR) of PTSD was greater in those with EM (OR 3.07 confidence interval [CI]: 2.12, 4.46) compared to those without headache; was greater in men than women with EM (men: OR 6.86; CI: 3.11, 15.11; women: OR 2.77; CI: 1.83, 4.21); and was comparable or greater than the association between migraine with depression or anxiety. The lifetime OR of PTSD was also increased in CDH sufferers. The OR of illicit drug abuse was not increased in those with EM or CDH unless co-occurring with PTSD or depression.The lifetime and 12-month OR of PTSD is increased in those with migraine or CDH, and is greater in men than women with migraine. The lifetime and 12-month OR of illicit drug abuse is not increased in those with migraine or CDH unless co-occurring with PTSD or depression.",0,0 +4970,Progress and Controversy in the Study of Posttraumatic Stress Disorder,"Research on posttraumatic stress disorder (PTSD) has been notable for controversy as well as progress. This article concerns the evidence bearing on the most contentious issues in the field of traumatic stress: broadening of the definition of trauma, problems with the dose-response model of PTSD, distortion in the recollection of trauma, concerns about “phony combat vets,” psychologically toxic guilt as a traumatic stressor, risk factors for PTSD, possible brain-damaging effects of stress hormones, recovered memories of childhood sexual abuse, and the politics of trauma.",0,0 +4971,Individual and Collective Dimensions of Resilience Within Political Violence,"Research has documented a link between political violence and the functioning of individuals and communities. Yet, despite the hardships that political violence creates, evidence suggests remarkable fortitude and resilience within both individuals and communities. Individual characteristics that appear to build resilience against political violence include demographic factors such as gender and age, and internal resources, such as hope, optimism, determination, and religious convictions. Research has also documented the protective influence of individuals’ connection to community and their involvement in work, school, or political action. Additionally, research on political violence and resilience has increasingly focused on communities themselves as a unit of analysis. Community resilience, like individual resilience, is a process supported by various traits, capacities, and emotional orientations toward hardship. This review addresses various findings related to both individual and community resilience within political violence and offers recommendations for research, practice, and policy.",0,0 +4972,Impact of Depression and Post-Traumatic Stress Disorder on Functional Outcome and Health-Related Quality of Life of Patients with Mild Traumatic Brain Injury,"The impact of disability following traumatic brain injury (TBI), assessed by functional measurement scales for TBI or by health-related quality of life (HRQoL), may vary because of a number of factors, including presence of depression or post-traumatic stress disorder (PTSD). The aim of this study was to assess prevalence and impact of depression and PTSD on functional outcome and HRQoL six and 12 months following mild TBI. We selected a sample of 1919 TBI patients who presented to the emergency department (ED) followed by either hospital admission or discharge to the home environment. The sample received postal questionnaires six and 12 months after treatment at the ED. The questionnaires included items regarding socio-demographics, the 36-item Short-Form Health Survey (SF-36), the Perceived Quality of Life Scale (PQoL), the Beck Depression Inventory, and the Impact of Event Scale. A total of 797 (42%) TBI patients completed the six-month follow-up survey. Depression and PTSD prevalence rates at both the six- and 12-month follow-up were 7% and 9%, respectively. Living alone was an independent predictor of depression and/or PTSD at six- and 12-month follow-up. Depression and PTSD were associated with a significantly decreased functional outcome (measured with Glasgow Outcome Scale Extended) and HRQoL (measured using the SF-36 and the PQoL). We conclude that depression and/or PTSD are relatively common in our sample of TBI patients and associated with a considerable decrease in functional outcome and HRQoL.",0,0 +4973,"Trajectories and associated factors of quality of life, global outcome, and post-concussion symptoms in the first year following mild traumatic brain injury","Purpose: To investigate the associated factors and change trajectories of quality of life (QoL), global outcome, and post-concussion symptoms (PCS) over the first year following mild traumatic brain injury (mTBI).Methods: This was a prospective longitudinal study of 100 participants with mTBI from neurosurgical outpatient departments in Chiayi County District Hospitals in Taiwan. The checklist of post-concussion syndromes (CPCS) was used to assess PCS at enrollment and at 1, 3, and 12 months after mTBI; the glasgow outcome scale extended (GOSE), the quality of life after brain injured (QOLIBRI), Chinese version, and the Short Form 36 Health Survey (SF-36), Taiwan version, were used to assess mTBI global outcome and QoL at 1, 3, and 12 months after mTBI.Results: Latent class growth models (LCGMs) indicated the change trajectories of QOLIBRI, PCS SF-36, MCS SF-36, GOSE, and PCS. Classes of trajectory were associated with age >40 years, unemployment at 1 month after injury, and educational level <12 years. Univariate analysis revealed that employment status at 1 month post-injury was correlated with the trajectories of QOLIBRI, PCS SF-36, MCS SF-36, and GOSE, but not PCS.Conclusions: Employment status was the most crucial associated factor for QoL in individuals with mTBI at the 1-year follow-up. Future studies should explore the benefits of employment on QoL of individuals with mTBI. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal abstract)",0,0 +4974,Select non-coding RNA in blood components provide novel clinically accessible biological surrogates for improved identification of traumatic brain injury in OEF/OIF Veterans.,"This study was designed to identify clinically accessible molecular biomarkers of mild traumatic brain injury (mTBI) that could be used to help identify returning Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) Veterans who are suffering from the effects of mTBI. While analyzing the expression profile of small non-coding RNAs in peripheral blood mononuclear cells (PBMCs) from an OEF/OIF veteran study cohort using a high throughput array chip platform, we identified 18 candidate small non-coding RNA biomarkers that are differentially regulated in PBMCs of mTBI compared to non-TBI control cases. Independent quantitative real-time polymerase chain reaction assays confirmed that 13 of these candidate small RNA biomarker species are, indeed, significantly down-regulated in PBMCs of mTBI compared to non-TBI control veteran cases. Based on unsupervised clustering analysis, we identified a 3-biomarker panel which was most able to distinguish mTBI from non-TBI control veteran cases with high accuracy, selectivity and specificity. The majority of mTBI cases in our biomarker study were co-morbid with Post-Traumatic Stress Disorder (PTSD), and thus our non-TBI control cases were selected to match PTSD diagnoses. Therefore, our identified panel of 3 small RNA biomarkers likely represents a biological index selective for mTBI. Outcomes from our studies suggest that additional applications of the clinically accessible small non-coding RNA biomarkers to current diagnostic criteria may lead to improved mTBI detection and more sensitive outcome measures for clinical trials. Future studies exploring the physiological relevance of mTBI biomarkers will also provide a better understanding of the biological mechanisms underlying mTBI and insights into novel therapeutic targets for mTBI.",0,0 +4975,"Affective personality type, post-traumatic stress disorder symptom severity and post-traumatic growth in victims of violence","The current study explored the differential association between affective personality type, post-traumatic stress disorder (PTSD) symptom severity, and post-traumatic growth (PTG) in victims of violence (N = 113). Relying on previous research, median cut off-scores on the Positive and Negative Affect Schedule Short Form were used to classify participants as high affective [i.e. high positive affectivity (PA) and high negative affectivity (NA)], self-actualizing (i.e. high PA and low NA), self-destructive (i.e. low PA and high NA) and low affective (i.e. low PA and low NA). Results indicated that the self-destructive and high affective personality styles were strongly associated with increased PTSD symptoms severity. High affective personality type was found to be the only significant predictor of PTG. Results, study limitations and directions for future research were discussed. Copyright © 2010 John Wiley & Sons, Ltd.",0,0 +4976,Assessing the psychometric properties of a supplementary PK Scale embedded in the Minnesota Multiphasic Personality Inventory -Adolescent (MMPI-A) in detecting post-traumatic stress disorder (PTSD),"This study explored the validity of the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A; Butcher et al., 1992) PK Scale (Cashel, Ovaert and Holliman, 2000) to assess symptoms of Post-Traumatic Stress Disorder (PTSD) within an inpatient adolescent sample. The present research sought to expand upon the Cashel et al. (2000) study by assessing the predictive and comparative validity of the MMPI-A PK Scale. Information was gathered from the archival data of 631 adolescents who were referred to the assessment service of Four Winds Hospital. Adolescents were 13-18 years old and predominantly female (57.9%). The MMPI-A PK Scale significantly related to the following self-reported traumas measured by the Children's Trauma Questionnaire (CTQ; Bernstein & Fink, 1998): emotional abuse (r = .31, p < .01), sexual abuse (r = .14, p < .01) and physical abuse (r = .08, p < .05), respectively. Significant negative relationships between emotional neglect (r = .23, p < .01) and physical neglect (r .09, p < .05) were also found. The MMPI-A PK Scale significantly related to the Trauma Content Index (TC/R; Armstrong & Loewenstein, 1990), which was applied to Rorschach protocols (r = .14, p < .01) scored using Exner's Comprehensive System (CS; Exner, 2003). The relationships between the MMPI-A PK Scale and features associated with the presence of trauma, as measured by the Trauma Symptom Checklist for Children (TSCC; Briere, 1996), were explored. The MMPI-A PK Scale correlated highest with the Depression (DEP) clinical scale of the TSCC (r = .69, p < .01). The relationship between the MMPI-A PK Scale and the Posttraumatic Stress (PTS) clinical scale of the TSCC (r = .59, p < .01) was also significant and indicative of a moderate correlation. As a measure of PTSD symptoms, the MMPI-A PK Scale evidenced low to typical predictive validity (AUC = .696) when compared to the PTS scale. Other significant relationships between the MMPI-A PK Scale and the clinical scales of the TSCC were discussed. The MMPI-A PK Scale, as a diagnostic measure, performed similarly to the PTS scale. ROC analyses compared both the MMPI-A PK Scale and the PTS to discharge chart diagnosis. Both measures evidenced low to typical predictive validity (AUC = .613 and AUC = .621, respectively). The sensitivity and specificity of the MMPI-A PK Scale was also reviewed and compared to the sensitivity and specificity of the other measures. Implications, limitations and additional directions for future research were discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4977,"Nursing students’ post-traumatic growth, emotional intelligence and psychological resilience","Accessible summary Nursing students in the present sample who have experienced childhood adversity have a certain level of post-traumatic growth. If introduced into nursing curricula, emotional intelligence interventions may increase emotional coping resources and enhance social skills for nurses, which may benefit their long-term occupational health. As researchers consider personal resilience a strategy for responding to workplace adversity in nurses, resilience building should be incorporated into nursing education. This is a preliminary study that may guide future investigations of the curvilinear relationship rather than linear relationship between post-traumatic growth and positive factors in the special sample of nursing students. Abstract Resilience, emotional intelligence and post-traumatic growth may benefit nursing students’ careers and personal well-being in clinical work. Developing both their emotional intelligence and resilience may assist their individual post-traumatic growth and enhance their ability to cope with clinical stress. To investigate the relationships among post-traumatic growth, emotional intelligence and psychological resilience in vocational school nursing students who have experienced childhood adversities, a cross-sectional research design with anonymous questionnaires was conducted and self-report data were analysed. The Childhood Adversities Checklist (Chinese version), Posttraumatic Growth Inventory, Emotional Intelligence Scale and the 10-item Connor–Davidson Resilience Scale were used. Survey data were collected from 202 Chinese vocational school nursing students during 2011. Post-traumatic growth was associated with emotional intelligence and psychological resilience. Results indicated a curvilinear relationship between emotional intelligence and post-traumatic growth, and between psychological resilience and post-traumatic growth. Moderate-level emotional intelligence and psychological resilience were most associated with the greatest levels of growth. The results imply that moderate resilience and emotional intelligence can help nursing students cope with adversity in their future clinical work. This study first provided preliminary data suggesting the curvilinear relationship rather than linear relationship between post-traumatic growth and positive factors in the sample of nursing students.",0,0 +4978,Biological studies of post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) is the only major mental disorder for which a cause is considered to be known: that is, an event that involves threat to the physical integrity of oneself or others and induces a response of intense fear, helplessness or horror. Although PTSD is still largely regarded as a psychological phenomenon, over the past three decades the growth of the biological PTSD literature has been explosive, and thousands of references now exist. Ultimately, the impact of an environmental event, such as a psychological trauma, must be understood at organic, cellular and molecular levels. This Review attempts to present the current state of this understanding on the basis of psychophysiological, structural and functional neuroimaging, and endocrinological, genetic and molecular biological studies in humans and in animal models.",0,0 +4979,Dissociation and post-traumatic stress disorder: two prospective studies of road traffic accident survivors,"Dissociative symptoms during trauma predict post-traumatic stress disorder (PTSD), but they are often transient. It is controversial whether they predict chronic PTSD over and above what can be predicted from other post-trauma symptoms.To investigate prospectively the relationship between dissociative symptoms before, during and after a trauma and other psychological predictors, and chronic PTSD.Two samples of 27 and 176 road traffic accident survivors were recruited. Patients were assessed shortly after the accident and followed at intervals over the next 6 months. Assessments included measures of dissociation, memory fragmentation, data-driven processing, rumination and PTSD symptoms.All measures of dissociation, particularly persistent dissociation 4 weeks after the accident, predicted chronic PTSD severity at 6 months. Dissociative symptoms predicted subsequent PTSD over and above the other PTSD symptom clusters. Memory fragmentation and data-driven processing also predicted PTSD. Rumination about the accident was among the strongest predictors of subsequent PTSD symptoms.Persistent dissociation and rumination 4 weeks after trauma are more useful in identifying those patients who are likely to develop chronic PTSD than initial reactions.",0,0 +4980,Early trauma-focused cognitive-behavioural therapy to prevent chronic post-traumatic stress disorder and related symptoms: A systematic review and meta-analysis,"Early trauma-focused cognitive-behavioural therapy (TFCBT) holds promise as a preventive intervention for people at risk of developing chronic post-traumatic stress disorder (PTSD). The aim of this review was to provide an updated evaluation of the effectiveness of early TFCBT on the prevention of PTSD in high risk populations.We performed a systematic literature search in international electronic databases (MEDLINE, EMBASE, PsycINFO, CENTRAL, CINAHL, ISI and PILOTS) and included randomised controlled trials comparing TFCBT delivered within 3 months of trauma, to alternative interventions. All included studies were critically appraised using a standardised checklist. Two independent reviewers selected studies for inclusion and assessed study quality. Data extraction was performed by one reviewer and controlled by another. Where appropriate, we entered study results into meta-analyses.Seven articles reporting the results of five RCTs were included. All compared TFCBT to supportive counselling (SC). The study population was patients with acute stress disorder (ASD) in four trials, and with a PTSD diagnosis disregarding the duration criterion in the fifth trial. The overall relative risk (RR) for a PTSD diagnosis was 0.56 (95% CI 0.42 to 0.76), 1.09 (95% CI 0.46 to 2.61) and 0.73 (95% CI 0.51 to 1.04) at 3-6 months, 9 months and 3-4 years post treatment, respectively. A subgroup analysis of the four ASD studies only resulted in RR = 0.36 (95% CI 0.17 to 0.78) for PTSD at 3-6 months. Anxiety and depression scores were generally lower in the TFCBT groups than in the SC groups.There is evidence for the effectiveness of TFCBT compared to SC in preventing chronic PTSD in patients with an initial ASD diagnosis. As this evidence originates from one research team replications are necessary to assess generalisability. The evidence about the effectiveness of TFCBT in traumatised populations without an ASD diagnosis is insufficient.",0,0 +4981,Risking connection with our clients: Implications for the current state of the therapeutic relationship.,"In response to Hansen, Lambert, and Forman (2002), we discuss major caveats for research in which quantitative research methodology is applied to psychotherapy outcome studies. First, quantitative methodology fits more easily into a medical/disease model of mental illness than a truly psychological model of mental health. Second, results from quantitative outcome research are often misused when the findings are overgeneralized to individuals whose psychological profiles and treatment needs are dissimilar to the research samples. Third, quantitative studies fail to consider the therapeutic alliance as a critical factor in psychotherapy outcome. We describe Risking Connection, a training curriculum we coauthored with colleagues at the Traumatic Stress Institute, that highlights the centrality of healing relationships in psychotherapy with adult trauma survivors.",0,0 +4982,"Promoting “resilient” posttraumatic adjustment in childhood and beyond: “Unpacking” life events, adjustment trajectories, resources, and interventions",,0,0 +4983,Chronic fatigue syndrome/fibromyalgia: a “stress-adaptation” model,"Background: A symptom cluster consisting of ‘medically-unexplained’ chronic fatigue, effort intolerance and widespread pain is a complex and still poorly understood condition. Purpose: To demonstrate the theoretical and clinical value of a biopsychosocially-oriented ‘stress-adaptation’ model for this multi-symptom illness. Methods: Clinical observation and review of the relevant literature. Results: Symptoms and functional limitations of these patients may reflect a loss of normal physical, mental and emotional adaptability, primarily based on stress system dysregulation. Conclusions: The proposed stress-adaptation model may facilitate diagnosis, defy dualistic causal thinking, and offer tailor-made treatment options to help patients find a better balance in their lives",0,0 +4984,The Duration of Deployment and Sensitization to Stress,,0,0 +4985,Spatial Typologies of Care: Understanding the Implications of the Spatial Distribution of Off-Base Civilian Behavioral Health Providers Who Accept TRICARE Prime to Service Persons and Their Dependents,"Over the last decade, demand for services from military treatment facilities (MTFs) has frequently exceeded capacity resulting in increased usage of off-base civilian Tricare providers (OCTP). This capacity shortage has been particularly acute for mental health care. At many installations, OCTPs are the main source of mental health care for military personnel and their families. Utilizing data on the location of mental health OCTPs and demographic data, we examine the spatial accessibility of mental health OCTPs around five military installations. Variation exists in the spatial accessibility of mental health OCTPs depending on the geographic context of an installation. There is a mild correlation between the number of mental health OTCPs proximate to a base and the beneficiaries enrolled in an MTF. There is a strong correlation between the size of the general population proximate to an installation and the number of mental health OCTMPs present. Installations located in densely populated areas had high ratios of mental health OCTPs to the MTF beneficiary population but not when the civilian demand on these providers was accounted for. This study's findings open several avenues for future research and policy aimed at increasing the effectiveness of the mental health OCTP network.",0,0 +4986,The role of stress sensitization in progression of posttraumatic distress following deployment,"Purpose: Military personnel exposed to combat are at risk for experiencing post-traumatic distress that can progress over time following deployment. We hypothesized that progression of post-traumatic distress may be related to enhanced susceptibility to post-deployment stressors. This study aimed at examining the concept of stress sensitization prospectively in a sample of Dutch military personnel deployed in support of the conflicts in Afghanistan. Method: In a cohort of soldiers (N = 814), symptoms of post-traumatic stress disorder (PTSD) were assessed before deployment as well as 2, 7, 14, and 26 months (N = 433; 53 %) after their return. Data were analyzed using latent growth modeling. Using multiple group analysis, we examined whether high combat stress exposure during deployment moderated the relation between post-deployment stressors and linear change in post-traumatic distress after deployment. Results: A higher baseline level of post-traumatic distress was associated with more early life stressors (standardized regression coefficient = 0.30, p < 0.001). In addition, a stronger increase in posttraumatic distress during deployment was associated with more deployment stressors (standardized coefficient = 0.21, p < 0.001). A steeper linear increase in posttraumatic distress post-deployment (from 2 to 26 months) was predicted by more post-deployment stressors (standardized coefficient = 0.29, p < 0.001) in high combat stress exposed soldiers, but not in a less combat stress exposed group. The group difference in the predictive effect of post-deployment stressors on progression of post-traumatic distress was significant (χ2(1) = 7.85, p = 0.005). Conclusions: Progression of post-traumatic distress following combat exposure may be related to sensitization to the effects of post-deployment stressors during the first year following return from deployment. © 2013 Springer-Verlag Berlin Heidelberg.",0,0 +4987,Abnormal frontal and parietal activity during working memory updating in post-traumatic stress disorder,"This study used event-related potentials (ERPs) to investigate the timing and scalp topography of working memory in post-traumatic stress disorder (PTSD). This study was designed to investigate ERPs associated with a specific working memory updating process. ERPs were recorded from 10 patients and 10 controls during two visual tasks where (a) targets were a specific word or (b) targets were consecutive matching words. In the first task, nontarget words are not retained in working memory. In the second task, as in delay-match-to-sample tasks, a non-target word defines a new target identity, so these words are retained in working memory. This working memory updating process was related to large positive ERPs over frontal and parietal areas at 400-800 ms, which were smaller in PTSD. Estimation of cortical source activity indicated abnormal patterns of frontal and parietal activity in PTSD, which were also observed in regional cerebral blood flow [Clark, C.R., McFarlane, A.C., Morris, P., Weber, D.L., Sonkkilla, C., Shaw, M., Marcina, J., Tochon-Danguy, H., Egan, G., 2003. Cerebral function in posttraumatic stress disorder during verbal working memory updating: a positron emission tomography study. Biological Psychiatry 53, 474-481]. Frontal and parietal cortex are known to be involved in distributed networks for working memory processes, interacting with medial temporal areas during episodic memory processes. Abnormal function in these brain networks helps to explain everyday concentration and memory difficulties in PTSD.",0,0 +4988,Prevalence and Impact of Posttraumatic Stress Disorder-Like Symptoms on Patients With Fibromyalgia Syndrome,"Traumatic events can result in a set of symptoms including nightmares, recurrent and intrusive recollections, avoidance of thoughts or activities associated with the traumatic event, and symptoms of increased arousal such as insomnia and hypervigilance. These posttraumatic stress disorder (PTSD)-like symptoms are frequently observed in persons with chronic pain syndromes. Little is known about how these two phenomena interact with one another. The present study evaluated PTSD-like symptoms in patients with fibromyalgia syndrome (FMS) and examined the relation between PTSD-like symptoms and problems associated with FMS.Ninety-three consecutive patients underwent a comprehensive FMS evaluation and completed self-report questionnaires measuring PTSD-like symptoms, disability, and psychosocial responses to their pain condition. Subjects were divided in two groups based on level of self-reported PTSD-like symptoms.Approximately 56% of the sample reported clinically significant levels of PTSD-like symptoms (PTSD+). The PTSD+ patients reported significantly greater levels of pain (p < 0.01), emotional distress (p < 0.01), life interference (p < 0.01), and disability (p < 0.01) than did the patients without clinically significant levels of PTSD-like symptoms (PTSD-). Over 85% of the PTSD+ patients compared with 50% of the PTSD- patients demonstrated significant disability. Based on response to the Multidimensional Pain Inventory, a significantly smaller percentage of PTSD+ patients were classified as adaptive copers (15%) compared with the PTSD- group (48.2%).Results suggest that PTSD-like symptoms are prevalent in FMS patients and may influence adaptation to this chronic illness. Clinicians should assess the presence of these symptoms, as the failure to attend to them in treatment may impede successful outcomes.",0,0 +4989,Combat veterans with PTSD after mild TBI exhibit greater ERPs from posterior-medial cortical areas while appraising facial features.,"Posttraumatic stress disorder (PTSD) worsens prognosis following mild traumatic brain injury (mTBI). Combat personnel with histories of mTBI exhibit abnormal activation of distributed brain networks-including emotion processing and default mode networks. How developing PTSD further affects these abnormalities has not been directly examined. We recorded electroencephalography in combat veterans with histories of mTBI, but without active PTSD (mTBI only, n=16) and combat veterans who developed PTSD after mTBI (mTBI+PTSD, n=16)-during the Reading the Mind in the Eyes Test (RMET), a validated test of empathy requiring emotional appraisal of facial features. Task-related event related potentials (ERPs) were identified, decomposed using independent component analysis (ICA) and localized anatomically using dipole modeling. We observed larger emotional face processing ERPs in veterans with mTBI+PTSD, including greater N300 negativity. Furthermore, greater N300 negativity correlated with greater PTSD severity, especially avoidance/numbing and hyperarousal symptom clusters. This correlation was dependent on contributions from the precuneus and posterior cingulate cortex (PCC). Our results support a model where, in combat veterans with histories of mTBI, larger ERPs from over-active posterior-medial cortical areas may be specific to PTSD, and is likely related to negative self-referential activity.",0,0 +4990,"Posttraumatic Stress Disorder and HIV Risk Among Poor, Inner-City Women Receiving Care in an Emergency Department","Objectives. We examined the associations between posttraumatic stress disorder (PTSD) and HIV risk behaviors among a random sample of 241 low-income women receiving care in an urban emergency department. Methods. We recruited participants from the emergency department waiting room during randomly selected 6-hour blocks of time. Multivariate analyses and propensity score weighting were used to examine the associations between PTSD and HIV risk after adjustment for potentially confounding sociodemographic variables, substance use, childhood sexual abuse, and intimate partner violence. Results. A large majority of the sample self-identified as Latina (49%) or African American (44%). Almost one third (29%) of the participants met PTSD criteria. Women who exhibited symptoms in 1 or more PTSD symptom clusters were more likely than women who did not to report having had sex with multiple sexual partners, having had sex with a risky partner, and having experienced partner violence related to condom use in the preceding 6 months. Conclusions. The high rate of PTSD found in this sample and the significant associations between PTSD symptom clusters and partner-related risk behaviors highlight the need to take PTSD into account when designing HIV prevention interventions for low-income, urban women.",0,0 +4991,"An empirical exploration of the dynamics of anorexia nervosa: Representations of self, mother, and father.","Extensive clinical reports and a few empirical investigations indicate that a disrupted relationship with mother and a distorted sense of self are central to Anorexia Nervosa (AN). The present study explores these observations further using the Differentiation–Relatedness Scale (D–RS) to compare AN patients’ descriptions of mother, father, and self with those of matched general psychiatric (PC) and nonclinical controls (NC). Results indicate that the AN group is distinguished from the PC group by significantly lower D–R (Differentiation–Relatedness) for mother, and significantly higher D–R for self, as well as a tendency for greater DEQ Self–Criticism (p .05, one–tailed). Stepwise discriminant analysis indicates that an equation of D–R Self, D-R Mother, and DEQ Neediness, as well as the interaction of D–R Mother and DEQ Neediness, significantly (p .0001) discriminates 80.5% of the total sample (66.7% of the AN, 73.3% of the PC, and 87.2%",0,0 +4992,Victim and crime factors associated with the development of crime-related post-traumatic stress disorder,"This study examined the relationships between the development of Crime-Related Post-Traumatic Stress Disorder (CR-PTSD) and selected victim and crime characteristics. The sample consisted of 391 adult female residents of Charleston County, South Carolina, of whom 294 were crime victims assessed for CR-PTSD. Comparisons of CR-PTSD positive (n=82) and CR-PTSD negative (n=212) groups found significant differences on the variables of current age, years since most recent crime, experiencing a completed rape, perceiving a life threat during a crime, and sustaining physical injury during a crime. No differences existed on other assessed victim or crime variables. Hierarchical multiple regression analysis found that life threat, physical injury, and completed rape each made significant individual contributions to explaining CR-PTSD. Hierarchical discriminant function analysis correctly classified 80.6% of the respondents. Rape, life threat, and physical injury had a synergistic effect on CR-PTSD in that victims whose crime history included all three elements were 8.5 times more likely to have developed CR-PTSD than those with none of the three elements. Rape was associated with CR-PTSD after controlling for the effects of violence and dangerousness, suggesting that rape has other elements important to the development of CR-PTSD.",0,0 +4993,Characterizing time in longitudinal trauma research,"Despite the proliferation of longitudinal trauma research, careful attention to timing of assessments is often lacking. Patterns in timing of assessments, alternative time structures, and the treatment of time as an outcome are discussed and illustrated using trauma data.",0,0 +4994,SLC6A4 methylation modifies the effect of the number of traumatic events on risk for posttraumatic stress disorder,"Background: Posttraumatic stress disorder (PTSD) is a common and debilitating mental disorder that occurs following exposure to a traumatic event. However, most individuals do not develop PTSD following even a severe trauma, leading to a search for new variables, such as genetic and other molecular variation, associated with vulnerability and resilience in the face of trauma exposure. Method: We examined whether serotonin transporter (SLC6A4) promoter genotype and methylation status modified the association between number of traumatic events experienced and PTSD in a subset of 100 individuals from the Detroit Neighborhood Health Study. Results: Number of traumatic events was strongly associated with risk of PTSD. Neither SLC6A4 genotype nor methylation status was associated with PTSD in main effects models. However, SLC6A4 methylation levels modified the effect of the number of traumatic events on PTSD after controlling for SLC6A4 genotype. Persons with more traumatic events were at increased risk for PTSD, but only at lower methylation levels. At higher methylation levels, individuals with more traumatic events were protected from this disorder. This interaction was observed whether the outcome was PTSD diagnosis, symptom severity, or number of symptoms. Conclusions: Gene-specific methylation patterns may offer potential molecular signatures of increased risk for and resilience to PTSD. Depression and Anxiety, 2011. © 2011 Wiley-Liss, Inc.",0,0 +4995,"Latent trajectory studies: the basics, how to interpret the results, and what to report","In statistics, tools have been developed to estimate individual change over time. Also, the existence of latent trajectories, where individuals are captured by trajectories that are unobserved (latent), can be evaluated (Muthén & Muthén, 2000). The method used to evaluate such trajectories is called Latent Growth Mixture Modeling (LGMM) or Latent Class Growth Modeling (LCGA). The difference between the two models is whether variance within latent classes is allowed for (Jung & Wickrama, 2008). The default approach most often used when estimating such models begins with estimating a single cluster model, where only a single underlying group is presumed. Next, several additional models are estimated with an increasing number of clusters (latent groups or classes). For each of these models, the software is allowed to estimate all parameters without any restrictions. A final model is chosen based on model comparison tools, for example, using the BIC, the bootstrapped chi-square test, or the Lo-Mendell-Rubin test.To ease the use of LGMM/LCGA step by step in this symposium (Van de Schoot, 2015) guidelines are presented which can be used for researchers applying the methods to longitudinal data, for example, the development of posttraumatic stress disorder (PTSD) after trauma (Depaoli, van de Schoot, van Loey, & Sijbrandij, 2015; Galatzer-Levy, 2015). The guidelines include how to use the software Mplus (Muthén & Muthén, 1998-2012) to run the set of models needed to answer the research question: how many latent classes exist in the data? The next step described in the guidelines is how to add covariates/predictors to predict class membership using the three-step approach (Vermunt, 2010). Lastly, it described what essentials to report in the paper.When applying LGMM/LCGA models for the first time, the guidelines presented can be used to guide what models to run and what to report.",0,0 +4996,Emotional and behavioural difficulties in children referred to an early intervention program following child sexual abuse,"Many children suffer emotional and behavioural difficulties following trauma, however, children are not at equal risk for developing such difficulties following abuse (e.g., Kendell-Tackett, Williams, & Finkelhor, 1993). A detailed review of the literature indicated the need for an empirical investigation into the occurrence of Post Traumatic Stress Symptoms (PTSS) and other psychopathology in children and adolescents following Child Sexual Abuse (CSA). This project investigated the occurrence of psychopathology in children who experienced CSA. In particular, it examined the degree to which children and adolescents experience PTSS following CSA. Further, the study endeavoured to identify caregiver-related variables, abuse details, parenting behaviour, family functioning, and child coping strategies which predicted maladjustment following CSA. The first study (Chapter 4) involved 175 children aged between 8 and 16 years, and their primary caregivers. The purpose of this study was to develop and assess the psychometric properties of a measure of parenting behaviour that could be used in subsequent studies. As parenting behaviour has been linked with the development of psychopathology in children, an economical, reliable and valid measure of the dimensions of parenting behaviour of interest (parental support and overcontrol) was required. Based on existing measures of parenting behaviour, the Parent Support-Control Questionnaire (PSCQ) was developed. It was hypothesised that two central dimensions, namely parental warmth/support and overcontrol/protection, would be supported by factor analysis. The results of this study supported this hypothesis: a two-factor solution offered the most parsimonious explanation. Adequate internal and test-retest reliability, and convergent and discriminant validity were identified. The second study (Chapter 5) was conducted with 92 children (19 boys; 73 girls) aged 6 - 15 years who were referred and accepted into an early intervention program following the experience of sexual abuse. Children were accepted for the program if they had experienced sexual abuse within the previous three years, if the abuse had been formally substantiated, and if they had a primary caregiver willing to participate in the program. Children were excluded from the study if they continued to have regular contact with the perpetrator, had an IQ less than 70, or had a diagnosis of psychosis or pervasive developmental disorder. Assessment of children's emotional and behavioural adjustment as reported by children and their caregivers revealed that a significant majority of children experienced difficulties in the clinical range following CSA. Recent literature and findings in the current thesis indicate that there is considerable variability in symptom expression after CSA. A range of behaviours in the clinical range, including anxiety, depression, dissociation and post traumatic stress symptoms, were reported by caregivers and children. Despite previous reports that approximately 30% of children present as symptom free at the time of first assessment (e.g., Finkelhor & Berliner, 1995), only 2.2% of children in this sample were asymptomatic at initial presentation. In addition to general psychopathology, 31.4% of the sample reported PTSS indicative of a DSM-IV diagnosis of Post Traumatic Stress Disorder (PTSD). The three symptom clusters in the DSM-IV diagnostic criteria for PTSD (i.e., re-experiencing, avoidance, and hypervigilance) were not supported in preliminary analyses. Instead, it is suggested that PTSD can best be conceptualised as existing on a continuum for children following sexual abuse, with children showing elevations across the full spectrum of PTSD symptoms. This finding is more consistent with a single-dimension conceptualisation of PTSD. A discussion is offered about the developmental trajectory after trauma. Controversy surrounding the DSM-IV diagnostic criteria for PTSD is discussed, and modification of these criteria for use with children is recommended. A transactional model, based on the work of Spaccarelli (1994) was outlined in the third study (Chapter 7), as a basis for understanding differences in the occurrence of psychopathology following CSA. Specifically, it was hypothesised that poor adjustment following CSA is associated with abuse of high severity, a caregiver who has a history of abuse in her own childhood and high levels of psychopathology, a family environment with high levels of dysfunction, parenting behaviour characterised by low levels of support and high levels of control, and the child's reliance on avoidant coping strategies. The results of the current investigation provide some support for the model. Caregiver-reported anxiety and family dysfunction were significantly associated with child adjustment. Further, family functioning mediated the influence of caregiver anxiety on child adjustment. Contrary to prediction, parenting behaviour characterised by low support and high control was not significantly related to poor adjustment. Child-reported adjustment data revealed that an avoidant coping style was significantly associated with poor outcome following sexual abuse. Interestingly, the nature of the abuse was not related to child or parent report of difficulties following CSA. The results indicate that, following the experience of CSA, a high proportion of children experience psychopathology in the clinical range. Since affected children can continue to experience difficulties in adolescence and adulthood, early intervention is paramount. Of great clinical relevance is the finding that the factors significantly associated with poor adjustment, are those factors that are more amendable to change (e.g., coping style) rather than the characteristics of the abuse itself (e.g., frequency and duration of abuse). Findings are discussed in terms of identification of risk factors for poor adjustment following CSA, and presented as a guide clinicians could use in the selection of treatment goals for a particular case and in designing an individualised treatment program. Limitations associated with the present program of research are discussed. Recommendations are made for future research.",0,0 +4997,Identifying profiles of recovery from reward devaluation in rats,"In humans and other mammals, the unexpected loss of a resource can lead to emotional conflict. Consummatory successive negative contrast (cSNC) is a laboratory model of reward devaluation meant to capture that conflict. In this paradigm, animals are exposed to a sharp reduction in the sucrose concentration of a solution after several days of access. This downshift in sucrose content leads to behavioral responses such as the suppression of consumption and physiologic responses including elevation of corticosterone levels. However, response heterogeneity in cSNC has yet to be explored and may be relevant for increasing the validity of this model, as humans demonstrate clinically meaningful heterogeneity in response to resource loss. The current analysis applied latent growth mixture modeling to test for and characterize heterogeneity in recovery from cSNC among rats (N=262). Although most animals exhibited recovery of consummatory behavior after a sharp drop in consumption in the first postshift trial (Recovery class; 83%), two additional classes were identified including animals that did not change their consumption levels after downshift (No Contrast class; 6%), and animals that exhibited an initial response similar to that of the Recovery class but did not recover to preshift consumption levels (No Recovery class; 11%). These results indicate heterogeneity in recovery from reward loss among rats, which may increase the translatability of this animal model to understand diverse responses to loss among humans.",0,0 +4998,The Association of Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate With Anxiety Sensitivity and Electronic Diary Negative Affect Among Smokers With and Without Posttraumatic Stress Disorder,"Posttraumatic stress disorder (PTSD) is associated with increased smoking initiation, maintenance, and relapse. Dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS) are neurosteroids that have been associated with mood measures as well as smoking status, and nicotine is associated with increased DHEA and DHEAS levels. Given the difficulties with mood experienced by smokers with PTSD, the purpose of the current study was to evaluate the association between negative affect and anxiety sensitivity with DHEA and DHEAS levels. Ninety-six smokers with and without PTSD provided blood samples for neurosteroid analyses and completed self-report measures of anxiety sensitivity and electronic diary ratings of negative affect. As expected, PTSD smokers reported higher levels of anxiety sensitivity (F(1,94) = 20.67, partial η2 = 0.18, P < 0.0001) and negative affect (F(1,91) = 7.98, partial η2 = 0.08, P = 0.006). After accounting for age and sex, DHEAS was significantly inversely associated with both anxiety sensitivity (F(3,92) = 6.97, partial η2 = 0.07, P = 0.01) and negative affect (F(3,87) = 10.52, partial η2 = 0.11, P = 0.002) across groups. Effect sizes indicated that these effects are moderate to high. No significant interactions of diagnosis and DHEA(S) levels with mood measures were detected. Given that nicotine is known to elevate DHEA(S) levels, these results suggest that DHEAS may serve as a biomarker of the association between mood and nicotine among smokers. Implications for the results include (1) the use of DHEAS measurement across time and across quit attempts and (2) the potential for careful use of DHEA supplementation to facilitate abstinence during smoking cessation.",0,0 +4999,The predictive validity of the PTSD Checklist in a nonclinical sample of combat-exposed National Guard troops.,"After returning from an extended combat deployment to Iraq, 348 National Guard soldiers were administered the PTSD Checklist (PCL-M), and the Beck Depression Inventory II (BDI-II) followed, on average, 3 months later by structured diagnostic interviews including the Clinician-Administered PTSD Scale (CAPS) for the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). There were 6.5% of the soldiers who met diagnostic criteria for posttraumatic stress disorder (PTSD) based on structured interview. The predictive validity of the PCL was examined and contrasted with the predictive validity of the BDI-II in identifying soldiers meeting CAPS diagnosis for PTSD. The best identified PCL cut scores produced between 65% and 76% false positive errors when used as the sole source for identification of enduring PTSD. Comparison of prediction between the PCL and the BDI-II in identifying PTSD suggested that both instruments may be operating through tapping generalized distress rather than specific aspects of the disorder.",0,0 +5000,"An Exploratory Study of Neuroimaging, Neurologic, and Neuropsychological Findings in Veterans With Traumatic Brain Injury and/or Posttraumatic Stress Disorder","Seventy-two veterans with traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), or both participated in assessment procedures to evaluate between group differences. Half the sample was randomly selected for magnetic resonance imaging (MRI). Neurologic examinations were conducted using the Neurologic Rating Scale (NRS). Neuropsychological measures included the Paced Auditory Serial Addition Test (PASAT), Rey Auditory Verbal Learning Test (RAVLT), Conners' Continuous Performance Test II (CPT II), and Halstead Impairment Index (HII) including the Booklet Category Test (BCT). Data were analyzed using linear regression. Participants with moderate/ severe TBI were significantly more likely to have trauma-related imaging findings, and more severe TBI predicted lower scores on the NRS. No significant between-group differences were identified on the HII, PASAT, RAVLT, or CPT II. TBI group performance was significantly better on the BCT. More severe TBI predicted abnormal imaging findings and lower NRS scores. Hypothesized between-group differences on neuropsychological measures were not supported.",0,0 +5001,Gender differences in victims of war torture: Types of torture and psychological consequences,"Background/Aim. Torture for political reasons is an extreme violence in interpersonal relations resulting in not only acute psychiatric disorders but also very often in very severe and far reaching negative consequences for the overall psychosocial functioning of a victim. The aim of this study was to investigate gender differences in types of torture and psychological consequences in subjects who experienced war torture. Methods. A sample (410 men and 76 women) included clients of 'Centre for rehabilitation of torture victims - IAN, Belgrade' who experienced torture in prisons and concentration camps during civil wars in ex-Yugoslavia 1991-1995 and 1999. Types of Torture Questionnaire with 81 items was used for collecting data about forms of torture. Symptom Checklist 90-Revised (SCL-90- R) was used for assessing type and intensity of psychological symptoms, and Impact of Event Scale (IES) was used to estimate posttraumatic complaints. Results. A gender difference was found for 33 types of torture: 28 more frequent in men, and 5 in women. Factor analysis of torture types revealed three factors explaining 29% of variance: 'common torture', 'sadistic torture', and 'sexual torture'. Discriminant analysis revealed significant gender difference concerning the factors. 'Common torture' and 'sadistic torture' were more prominent in men, and 'sexual torture' was more present in women. Higher scores on depression, anxiety, somatization, interpersonal sensitivity and obsessive-compulsive dimensions on SCL-90-R were found in women. General score and scores of subscales (intrusion and avoidance) on IES were significantly higher in women. Conclusion. Women exposed to war torture experienced less torture techniques and shorter imprisonment than men, but had more frequent and severe symptoms of posttraumatic stress disorder and other psychological symptoms. Gender differences in posttraumatic symptomatology can not be explained exclusively by gender differences in types of torture found in this study.",0,0 +5002,The Association of Trauma and PTSD with the Substance Use Profiles of Alcohol- and Cocaine-Dependent Out-of-Treatment Women,The association of trauma and posttraumatic stress disorder (PTSD) with alcohol and cocaine use is explored to determine if there is additive risk associated with dual dependence. Data were collected from out-of-treatment women enrolled in an HIV-prevention study. Women who experienced a DSM-IV qualifying event (n = 791) were stratified into four substance use groups based on lifetime alcohol and cocaine use. Women with lifetime comorbid alcohol and cocaine dependence experienced significantly more traumatic events and had a higher prevalence of violent events and lifetime diagnosis of PTSD and PTSD-related impairment. There is added risk for associated trauma and subsequent PTSD among women who have dual substance dependence.,0,0 +5003,Health-related quality of life two years after injury due to terrorism.,"During the past few decades, terrorist acts have been an unfortunate reality worldwide. There is a striking paucity of research investigating the multitude of long-term outcomes after severe physical injury due to terrorist attacks, a unique subgroup of trauma patients. The purpose of this study was to provide a profile of the long-term health-related quality of life (HR-QOL) after injury due to terrorist attacks and to explore the relationships between Post Traumatic Stress Disorder (PTSD), occupational status and injury severity with HR-QOL.We included 35 survivors of terrorist attacks living in the community, two years on average after the injury, mean age at follow-up = 32.1 (±13.8), mean Injury Severity Score (ISS) = 27 (±14.2). The subjects were recruited from consecutive admissions to a rehabilitation department in a tertiary care center between September 2000 - June 2004. Most of the subjects suffered multiple trauma. The main outcome measures were the Short-Form Health Survey (SF-36), Post Traumatic Diagnostic Scale and return to work rates.The mean scores on 6/8 of the SF-36 subscales were significantly lower among the survivors compared to normative population norms. Post Traumatic Stress Disorder (PTSD) was found in 39% of the sample and 43% did not resume their main occupation two years after the injury. Multivariate analysis of variance of PTSD and occupational status (returned vs. did not return to work) on quality of life scores revealed significant main effects for both PTSD (p=. 000) and occupational status (p=. 005) with no interaction effect (p=. 476). No significant correlations were found between injury severity and the SF-36 scores.This study demonstrated the long-term impact of injury due to terrorism. Results showed independent effects of PTSD and occupational status on health related quality of life, two years after injury. These findings suggest that this group may benefit from intervention focusing on their emotional and occupational status in order to improve their quality of life.",0,0 +5004,Harvard Trauma Questionnaire Urdu translation: the only cross-culturally validated screening instrument for the assessment of trauma and torture and their sequelae.,"Violence is on the increase all over the world. The method, manner and quantum of such actions remain little explored. The common man has clearly received the message of power through the barrel of a gun. In Pakistan the major battle field of ethnic, political, sectarian and communal conflicts was Sindh and Punjab. Trauma and torture leaves a permanent scar on the survivor. It has physical, psychological and social sequelae. The two major psychiatric illnesses associated with trauma and torture are your major Depression and post traumatic stress disorder. The Harvard Trauma Questionnaire (HTQ) measures symptoms associated with diagnostic criteria for post-traumatic stress disorder as defined by DSMIII R manual and symptoms. Obtaining accurate knowledge of traumatic event and symptoms and properly classifying them into a diagnostic system is fundamental for providing effective treatment and good therapeutic intervention. Therefore an attempt is made to translate the HTQ, the only cross-culturally validated screening instrument for the assessment of trauma and torture related to mass violence and their sequelae [corrected].",0,0 +5005,Parental Alcohol History Differentially Predicts Offspring Disorders in Distinct Subgroups in Israel,"Objective: The association between alcoholism in parents and related disorders in their offspring is well established in cultures with intermediate/high alcohol consumption, but not in those with low consumption, such as Israel. This study investigated differences in parental transmission of alcohol problems and related psychopathology between immigrants from the former Soviet Union (FSU) to Israel and other Israelis—two Israeli subgroups with differing alcohol consumption behaviors and social norms. Method: A total of 1,347 adults from a household sample were interviewed. Regression analyses were used to examine associations between parental alcohol problems and participant disorders: alcohol, nicotine, and cannabis use disorders (AUD, NUD, CUD); antisocial personality disorder (ASPD); major depressive disorder (MDD); and posttraumatic stress disorder (PTSD). We also examined the associations of parental alcohol problems with participant disorders characterized with two latent factors: externalizing (EXT: AUD, NUD, CUD, ASPD) and internalizing (INT: MDD, PTSD). Differential parental transmission of alcohol problems in FSU (n = 315) and non-FSU (n = 1,032) Israelis was examined with statistical interaction. Results: Among emigrants from the FSU, parental alcohol problems predicted AUD, NUD, CUD, ASPD, PTSD, EXT, and INT (mean ratios = 1.38–4.83). In non-FSU Israelis, parental alcohol problems predicted only ASPD and PTSD (mean ratios = 1.08–4.09). Significant interactions were observed for AUD, CUD, PTSD, and EXT; each relationship was stronger in FSU Israelis and null (AUD, CUD, EXT) or less robust (PTSD) in other Israelis. Conclusions: Parental alcohol problems were related to substance use and psychiatric disorders differently in FSU and other Israelis, two groups with different alcohol consumption levels and drinking norms. We propose that, in social contexts that vary in the degree to which they constrain alcohol behavior, underlying genetic predispositions may manifest as different disorders.",0,0 +5006,Post-traumatic stress disorder and suicidal behavior: A narrative review,"There is a large literature investigating the underlying mechanisms, risk factors and demographics of suicidal thoughts and behaviors across a number of psychiatric disorders, such as, major depression , anxiety and schizophrenia. However, less research has focused on the relationship between Post-Traumatic Stress Disorder (PTSD) and suicide. There were two broad aims of this review. The first was to assess the extent to which PTSD is associated with suicide, and the second was to determine the effects of co-morbid disorders on this relationship. Overall, there was a clear relationship between PTSD and suicidal thoughts and behaviors irrespective of the type of trauma experienced. Very few studies directly examined whether depression was a mediating factor in the relationships reported. However, where this was investigated, the presence of co-morbid depression appeared to boost the effect of PTSD on suicidality . It was noteworthy that hardly any studies had investigated concepts thought to be key in other domains of research into suicidality, such as, feelings of entrapment, defeat and hopelessness.",0,0 +5007,World assumptions and the role of trauma in borderline personality disorder,"The present study tested whether borderline personality disorder (BPD) is characterized by specific worldviews as hypothesized by cognitive models, using Janoff-Bulman's [(1989) Social Cognition, 7, 113-136] world assumptive model of negative effects of trauma. A second aim of this study was to investigate the role of trauma in the content of worldviews of BPD patients. Fifteen BPD patients, 14 patients with Cluster C personality disorders (PD), 19 patients with axis-I psychopathology and 21 non-patients filled out the World Assumptions Scale, the Personality Disorder Belief Questionnaire, a childhood trauma checklist (assessing physical, emotional and sexual abuse) and the BPD Checklist (severity of BPD psychopathology). BPD patients appear to view the world as malevolent and perceive less luck independent of trauma but dependent of BPD psychopathology. Furthermore, BPD patients have low self-worth and persist in specific beliefs independent of trauma or severity of BPD psychopathology. Pretzer's theory of BPD can be largely supported through Janoff-Bulman's world assumptive model. World assumptions of BPD patients can better be explained by the severity of BPD psychopathology than by the presence of trauma.",0,0 +5008,Diagnostic mistakes in Post-Traumatic Stress Disorder. The problem of symptom overlap with Depression,"Cel The overlap between symptoms of PTSD and MDD is substantial. PTSD symptoms arise after a traumatic experience and the trauma is present in all of the diagnostic clusters. In individuals who have experienced a trauma a long time previously, it is difficult to establish the exact moment of onset of their symptoms in relation to the trauma suffered. We proposed to raise awareness among operators who may encounter this problem, with the aim of providing them with valuable help in order to achieve a correct differential diagnosis. Metoda A sample of subjects suffering from PTSD without comorbidity was assessed to confirm the diagnosis and the severity of post-traumatic symptoms. The Kruskal-Wallis test was used to compare any modifications in the parameters analyzed through the Davidson Trauma Scale with the presence and severity of depressive symptoms as evaluated by the Hamilton-D scale. Wyniki Half of the PSTD patients recruited showed values of HAM-D > 18, although an active Major Depressive Episode was clinically excluded. Symptom of ""numbing"", despite being different from the apathy experienced in depression, is identified as a depressive symptom by the HAM-D. Wnioski Giving prevalence to depressive symptoms may be misleading for diagnosis and ultimately result in inappropriate treatment.",0,0 +5009,Planning for Burn Disasters: Lessons Learned From One Hundred Years of History,"The terrorist attacks of September 11th have prompted interest in developing plans to manage thousands of burn casualties. There is little actual experience in the United States in managing disasters of this magnitude. As an alternative, lessons may be learned from the historical experiences of previous civilian burn or fire disasters occurring in this country. A review of relevant medical, fire service, and popular literature pertaining to civilian burn or fire disasters occurring in the United States between the years 1900 and 2000 was performed. In the 20th century, 73 major U.S. fire or burn disasters have occurred. With each disaster prompting a strengthening of fire regulations or building codes, the number of fatalities per incident has steadily decreased. Detailed examination of several landmark fires demonstrated that casualty counts were great but that most victims had fatal injuries and died on the scene or within 24 hours. A second large cohort comprised the walking wounded, who required minimal outpatient treatment. Patients requiring inpatient burn care comprise a small percentage of the total casualty figure but consume enormous resources during hospitalization. Burn mass casualty incidents are uncommon. The number of casualties per incident decreased over time. In most fire disasters, the majority of victims either rapidly die or have minimal injuries and can be treated and released. As a result, most disasters produce fewer than 25 to 50 patients requiring inpatient burn care. This would be a rational point to begin burn center preparations for mass casualty incidents. A robust outpatient capability to manage the walking wounded is also desirable.",0,0 +5010,Disaggregating the Relationship Between Posttraumatic Stress Disorder Symptom Clusters and Chronic Orofacial Pain: Implications for the Prediction of Health Outcomes with PTSD Symptom Clusters,"Research has established a significant relationship between posttraumatic stress disorder (PTSD) symptoms and pain; however, very little research has examined the differential role of PTSD symptom clusters on pain outcomes.(a) To confirm the most appropriate PTSD symptom factor structure for an orofacial pain population and (b) to test a model of prediction of pain outcomes with PTSD symptom clusters.The study was a cross-sectional, retrospective case series of 411 female patients with orofacial pain (mean 41.0 years, SD 13.1). A series of structural equation modeling analyses were conducted to examine five competing models of PTSD symptom clusters.Two four-factor models of PTSD symptom clusters fit the data reasonably well, and differing PTSD symptom clusters predicted different components of pain.To increase predictive utility for pain and for a wide range of health disorders, researchers should examine the unique predictive power of PTSD symptom clusters rather than examining a one-factor model of PTSD symptoms.",0,0 +5011,Risk Factors for Multisymptom Illness in US Army Veterans of the Gulf War,"This research study examined the prevalence of symptoms and identified risk factors for reported symptoms among a group of Army Gulf War (GW) veterans. A survey was mailed to all members of the Ft. Devens cohort in 1997, representing the third assessment of a group that consisted of 2949 US Army soldiers deployed to the Gulf, and was studied initially in 1991. A total of 1290 subjects responded to the mailed survey; aggressive follow-up methods to address non-response bias were employed. Subjects were classified as having multisymptom illness if they reported symptoms from at least two of three symptom categories (fatigue, mood-cognition, musculoskeletal). Sixty percent of the respondents met criteria for multisymptom illness. Female gender, lower levels of education, psychological symptoms, self-reported use of a medical clinic in the Gulf, ingestion of anti-nerve gas pills (pyridostigmine bromide), anthrax vaccination, tent heaters, exposure to oil fire smoke, and chemical odors were significantly related to multisymptom illness in logistic regression analyses. Analyses in which subjects were stratified by level of psychological symptoms revealed different sets of GW-service environmental exposures and suggest that subgroups of GW veterans may have different sets of risk factors.",0,0 +5012,Complex trauma of war captivity: a prospective study of attachment and post-traumatic stress disorder,"Background Victims of war captivity sometimes suffer from complex post-traumatic stress disorder (PTSD), a unique form of PTSD that entails various alterations in personality. These alterations may involve changes in attachment orientation. Method The sample comprised two groups of veterans from the 1973 Yom Kippur War: 103 ex-prisoners of war (ex-POWs) and 106 comparable control veterans. They were assessed at two points in time, 18 years and 30 years after the war. Results Ex-POWs suffered from more post-traumatic symptoms than controls at both measurements points and these symptoms increased only among ex-POWs from Time 1 to Time 2. In addition, both attachment anxiety and attachment avoidance increased with time among ex-POWs, whereas they decreased slightly or remained stable among controls. Finally, the increases in attachment anxiety and avoidance were positively associated with the increase in post-traumatic symptoms among both study groups. Further analyses indicated that early PTSD symptoms predicted later attachment better than early attachment predicted later PTSD symptoms. Conclusions The results suggest that: (1) complex traumas are implicated in attachment orientations and PTSD symptoms even many years after captivity; (2) there is an increase in attachment insecurities (anxiety, avoidance) and an increase in PTSD symptoms decades after the captivity; (3) and post-traumatic stress symptoms predict attachment orientations better than attachment orientations predict an increase in PTSD symptoms.",0,0 +5013,Measurement Differences From Rating Posttraumatic Stress Disorder Symptoms in Response to Differentially Distressing Traumatic Events,"The authors explored differences in posttraumatic stress disorder (PTSD) symptoms as a result of rating symptoms from two separate, differentially distressing traumatic events. In an initial sample of 400 nonclinical participants, the authors inquired through a web survey about previous psychological trauma, instructing participants to nominate their most distressing and second most distressing traumatic events experienced. Using the PTSD Checklist, participants rated their PTSD symptoms separately from these worst and second worst events. Using the four-factor emotional numbing PTSD model in confirmatory factor analysis, results demonstrated evidence supporting separation of PTSD symptom rating sets from two differentially distressing traumas—specifically, the worst and second worst events. Measurement invariance tests revealed that factor loadings did not vary between the worst and second worst event PTSD ratings; item thresholds (indexing symptom severity) differed. Results generally support the recommended PTSD assessment protocol instructing participants to rate PTSD symptoms from a single, worst index event.",0,0 +5014,The Role of Psychopathology and Personality in Rage-Type Homicide: A Review,"This article reviews the role of psychopathology and personality in offenders who have committed acts of rage-type murder. The possible role of depression, PTSD, psychotic disorders, intellectual functioning and alcohol/drug abuse are critically considered. It is argued that although some forms of psychopathology may be indicated in some cases, these still remain in the minority. This seems to be consistent with findings that describe such offenders as ‘apparently normal’. In an attempt to explain this further, the character profile and psychodynamics of personality are reviewed. A pattern of overcontrol is isolated as a key theme that best explains the ‘apparent normality’ of the rage-type offender. The relevance of the DSM-IV classification system of personality disorders for understanding this kind of criminal is considered. It is argued that a particular type of borderline personality organisation, not isolated by the DSM-IV system, best explains this character pattern.",0,0 +5015,Acute Stress Disorder and Posttraumatic Stress Disorder in Victims of Violent Crime,"OBJECTIVE: In a group of crime victims recruited from the community, the authors investigated the ability of both a diagnosis of acute stress disorder and its component symptoms to predict posttraumatic stress disorder (PTSD) at 6 months. METHOD: A mixed-sex group of 157 victims of violent assaults were interviewed within 1 month of the crime. At 6-month follow-up 88% were reinterviewed by telephone and completed further assessments generating estimates of the prevalence of PTSD. RESULTS: The rate of acute stress disorder was 19%, and the rate of subsequent PTSD was 20%. Symptom clusters based on the DSM-IV criteria for acute stress disorder were moderately strongly interrelated. All symptom clusters predicted subsequent PTSD, but not as well as an overall diagnosis of acute stress disorder, which correctly classified 83% of the group. Similar predictive power could be achieved by classifying the group according to the presence or absence of at least three reexperiencing or arousal symptoms. Logistic regression indicated that both a diagnosis of acute stress disorder and high levels of reexperiencing or arousal symptoms made independent contributions to predicting PTSD. CONCLUSIONS: This exploratory study provides evidence for the internal coherence of the new acute stress disorder diagnosis and for the symptom thresholds proposed in DSM-IV. As predicted, acute stress disorder was a strong predictor of later PTSD, but similar predictive power may be possible by using simpler criteria. (Am J Psychiatry 1999; 156:360–366)",0,0 +5016,"The factor structure of psychiatric comorbidity among Iraq/Afghanistan-era veterans and its relationship to violence, incarceration, suicide attempts, and suicidality","The present research examined how incarceration, suicide attempts, suicidality, and difficulty controlling violence relate to the underlying factor structure of psychiatric comorbidity among a large sample of Iraq/Afghanistan-era veterans (N=1897). Diagnostic interviews established psychiatric diagnoses; self-report measures assessed history of incarceration, difficulty controlling violence, suicide attempts, and suicidality. A 3-factor measurement model characterized by latent factors for externalizing-substance-use disorders (SUD), distress, and fear provided excellent fit to the data. Alcohol-use disorder, drug-use disorder, and nicotine dependence were indicators on the externalizing-SUD factor. Posttraumatic stress disorder and depression were indicators on the distress factor. Panic disorder, social phobia, specific phobia, and obsessive-compulsive disorder were indicators on the fear factor. Incarceration was exclusively predicted by the externalizing-SUD factor. Difficulty controlling violence, suicidality, and suicide attempts were exclusively predicted by the distress factor. Contrary to hypotheses, the path from the externalizing/SUD factor to difficulty controlling violence was not significant. Taken together, these findings suggest that the distress factor of psychiatric comorbidity is a significant risk factor for suicidality, suicide attempts, and difficulty controlling violence and could help to explain the frequent co-occurrence of these critical outcomes among returning Iraq/Afghanistan veterans.",0,0 +5017,Personality Profile of Parents of Children with Attention Deficit Hyperactivity Disorder,"Objectives. The present study was carried out aiming to identify the personality profile of parents of children with Attention Deficit Hyperactivity Disorder (ADHD). Methods. This study is of a descriptive, analytic, cross-sectional type in which parents of 6–12-year-old children with ADHD who were referred to the Bozorgmehr Psychiatric Clinic, affiliated with Tabriz University of Medical Sciences, were enrolled. ADHD was diagnosed according to the criteria of DSM-IV-TR and a quasi-structured diagnostic interview (K-SADS-PL). The personality profile of the parents was assessed with the Millon Clinical Multiaxial Inventory-III (MCMI-III). Results. According to the findings of this study, the most common personality problems based on the assessment scales in the MCMI-III belonged to the clinical patterns of depressive personality in 43 persons (25.3%), histrionic personality in 34 persons (20%), and compulsive personality in 29 persons (17.1%). According to discriminant analysis, four scales of somatoform, sadistic, dependence, and though disorder were direct and antisocial scale was reverse significant predictors of membership in the women group. Conclusion. According to the findings of this pilot study, personality disorders are prevalent in parents of ADHD children and mothers suffer from personality disorders more than fathers.",0,0 +5018,"Violence and post-traumatic stress disorder in Sao Paulo and Rio de Janeiro, Brazil: the protocol for an epidemiological and genetic survey","violence is a public health major concern, and it is associated with post-traumatic stress disorder and other psychiatric outcomes. Brazil is one of the most violent countries in the world, and has an extreme social inequality. Research on the association between violence and mental health may support public health policy and thus reduce the burden of disease attributable to violence. The main objectives of this project were: to study the association between violence and mental disorders in the Brazilian population; to estimate the prevalence rates of exposure to violence, post-traumatic stress disorder, common metal disorder, and alcohol hazardous use and dependence: and to identify contextual and individual factors, including genetic factors, associated with the outcomes.one phase cross-sectional survey carried out in Sao Paulo and Rio de Janeiro, Brazil. A multistage probability to size sampling scheme was performed in order to select the participants (3000 and 1500 respectively). The cities were stratified according to homicide rates, and in Sao Paulo the three most violent strata were oversampled. The measurements included exposure to traumatic events, psychiatric diagnoses (CIDI 2.1), contextual (homicide rates and social indicators), and individual factors, such as demographics, social capital, resilience, help seeking behaviours. The interviews were carried between June/2007 February/2008, by a team of lay interviewers. The statistical analyses will be weight-adjusted in order to take account of the design effects. Standardization will be used in order to compare the results between the two centres. Whole genome association analysis will be performed on the 1 million SNP (single nucleotide polymorphism) arrays, and additional association analysis will be performed on additional phenotypes. The Ethical Committee of the Federal University of Sao Paulo approved the study, and participants who matched diagnostic criteria have been offered a referral to outpatient clinics at the Federal University of Sao Paulo and Federal University of Rio de Janeiro.",0,0 +5019,Conceptualizing a Better Understanding of Diagnosing and Treating Posttraumatic Stress Disorder: A Review of Two Case Studies,"Clinical and epidemiological studies have supported the belief that human beings exposed to stressful life events are vulnerable to the symptomatology consistent with posttraumatic stress disorder (PTSD). However, early detection of symptoms consistent with PTSD oftentimes does not occur within the medicolegal arena. The importance of an early and accurate diagnosis is emphasized. Fortunately, the diagnosis of PTSD has become more clearly conceptualized in the DSM-IV criteria. Many of the characteristics consistent with this diagnosis are measured through the use of relatively recently developed and refined psychometric measures including the Posttraumatic Stress Diagnostic Scale, the Trauma Symptom Inventory, and the Personality Assessment Inventory-2. Additional measures including the Computerized Response Bias Test, the Word Memory Test, and the Validity Indicator Profile can detect exaggeration of symptoms without using specific tests for symptom validity. These measures, as well as biochemical determinations, are reviewed and presented along with the over-all structured clinical interviews and mental status examinations of two patients for a better understanding of the multimethod approach which establishes the reliability of the PTSD diagnosis.",0,0 +5020,Occupational Preferences of People Who Have Experienced Sexual Assault,"This study explored how individuals who have experienced sexual assault engage in occupations that require touch. Fifty-seven participants who reported a history of sexual assault and 347 participants who did not report such a history responded to a pilot instrument which was created to analyze college students’ engagement in occupations. Results were categorized into indices to isolate different types of touch. Results suggest that there is a statistically significant difference in the way these two groups go about their daily routines of engaging in occupations, particularly those that involve passive, unexpected, social, and light touch.",0,0 +5021,Clinical approaches to addressing spiritual struggle in veterans with PTSD.,"Trauma survivors often face difficult spiritual challenges as they attempt to reconcile the experience of trauma with their spiritual/religious beliefs. Spirituality has been found to be associated with a range of indices of well-being, and it is a component of many clients' coping skills and treatment strategies. However, many clinicians do not routinely assess or incorporate this domain of functioning in psychological services. This article describes a model for conceptualizing how trauma can impact spirituality by reviewing the possible consequences of each posttraumatic stress disorder (PTSD) symptom cluster on clients' belief systems and spiritual practices. Specific implications for treatment are described for each symptom cluster. A case study highlights many of the spirituality issues and intervention options described in this model. Ethical issues surrounding addressing spiritual factors in trauma survivors are considered, and clinicians are encouraged to further explore this domain with their clients. © 2015 American Psychological Association.",0,0 +5022,"Uncertainty, Posttraumatic Stress, and Health Behavior in Young Adult Childhood Cancer Survivors","Young adult survivors of childhood cancer are at risk for medical late effects, some of which can be managed through health promotion behaviors. However, chronic uncertainty about the future can lead to the development of posttraumatic stress symptoms (PTSS) that can interfere with health promotion behaviors.To test a mediating model for the relationships among uncertainty, PTSS, and health promotion behaviors in young adult survivors of childhood cancer.The design was cross-sectional correlational. A convenience sample was used, and the data were collected using a mailed survey. Study measures included the Mishel Uncertainty in Illness Scale-Community Form, the Posttraumatic Stress Disorder Index, and the Health Promoting Lifestyle Profile II.Forty-six (51.1%) of the eligible survivors responded to the invitation to participate in the study. The analysis was based on data from 45 survivors. The results show that the relationship between PTSS and health promotion behaviors was mediated by uncertainty.Uncertainty is a suitable target for theory-based nursing interventions used to boost health promotion behaviors in young adult survivors of childhood cancer.",0,0 +5023,Longitudinal trajectories of World Trade Center (WTC)-related PTSD symptoms in police and non-traditional WTC responders,"Background: Tens of thousands of traditional and non-traditional first responders were involved in rescue and recovery operations following the September 11th terrorist attacks. These responders endured unprecedented hazardous working conditions and psychological stressors while working at Ground Zero and/or the Staten Island landfill. Previous cross-sectional studies have examined the prevalence of posttraumatic stress disorder (PTSD) in WTC responders; however, little is known about longitudinal trajectories of PTSD symptoms in this population. In this study, we evaluated longitudinal trajectories of World Trade Center (WTC)-related PTSD symptoms in more than 10,000 police and non-traditional WTC responders; we then identified pre-, peri-, and post-9/11 determinants of these trajectories. Methods: Latent growth mixture modeling (LGMM) was utilized to characterize the nature of WTC-related PTSD symptom trajectories amongst 10,835 WTC responders, including 4,035 police responders and 6,800 nontraditional responders, who attended monitoring visits at the CDCestablished WTC Health Program (WTC-HP) an average of 3, 6, and 8 years post-9/11. Multinomial logistic regression analyses were then conducted to assess determinants of the WTC-related PTSD symptom trajectories. Results: LGMM analyses revealed that a 4-class solution optimally characterized longitudinal PTSD symptoms in police WTC responders: resistant (77.8%), delayed-onset (8.5%), recovering (8.4%), and severe chronic (5.3%). In non-traditional WTC responders, a 6-class solution was optimal: resistant (58.0%), recovering (12.3%), severe chronic (9.5%), subsyndromal increasing (7.3%), delayed-onset (6.7%), and moderate chronic (6.2%). A greater proportion of police responders manifested a resilient trajectory (77.8%) compared to non-traditional responders (58.0%). In both police and non-traditional responder groups, increased severity of WTC exposure, prior psychiatric history, greater number of WTC-related medical conditions, and Hispanic ethnicity were strongly associated with symptomatic PTSD trajectories. Family and work social support while working at the WTC site was a protective factor for both groups, while early arrival was protective among nontraditional responders. Conclusion: This study is the first of which we are aware to examine longitudinal trajectories of WTC-related PTSD trajectories in WTC responders. A greater proportion of police responders manifested a resilient trajectory compared to non-traditional responders, which is likely attributable to their greater training and disaster preparedness. These results suggest that greater training in disaster preparedness, as well as peri-disaster familial and work support may help protect against deleterious psychological outcomes in disaster responders, particularly those with risk factors such as prior psychiatric history, Hispanic ethnicity, greater severity of traumatic exposure, and any disaster-related medical co-morbidities.",0,0 +5024,Objective Neuropsychological Deficits in Post-Traumatic Stress Disorder and Mild Traumatic Brain Injury: What Remains Beyond Symptom Similarity?,"This exploratory study intends to characterize the neuropsychological profile in persons with post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) using objective measures of cognitive performance. A neuropsychological battery of tests for attention, memory and executive functions was administered to four groups: PTSD (n = 25), mTBI (n = 19), subjects with two formal diagnoses: Post-traumatic Stress Disorder and Mild Traumatic Brain Injury (mTBI/PTSD) (n = 6) and controls (n = 25). Confounding variables, such as medical, developmental or neurological antecedents, were controlled and measures of co-morbid conditions, such as depression and anxiety, were considered. The PTSD and mTBI/PTSD groups reported more anxiety and depressive symptoms. They also presented more cognitive deficits than the mTBI group. Since the two PTSD groups differ in severity of PTSD symptoms but not in severity of depression and anxiety symptoms, the PTSD condition could not be considered as the unique factor affecting the results. The findings underline the importance of controlling for confounding medical and psychological co-morbidities in the evaluation and treatment of PTSD populations, especially when a concomitant mTBI is also suspected.",0,0 +5025,Biological and psychological monitoring of training status during an entire season in top kayakers.,"The aim of this study was to analyze changes in selected biological and psychological variables in a group of top level kayakers along a 42-week training season.Eight top junior sprint kayakers (age=16.8±2.1) (5 men and 3 women) with international competitive experience participated in the research. During the 42-wk season the subjects were tested in three occasions: (T1) in the second week of the general training period, (T2) at the beginning of the specific training period, (T3) at the beginning of the competitive training period. Firstly, subjects were asked to complete the Recovery-Stress Questionnaire for Athletes (RESTQ-Sport) and the Profile of Mood States (POMS) questionnaires, and Borg´s rate of perceived exertion scale (RPE). Immediately after, blood samples were collected and white blood cells, creatine kinase (CK), C-reactive protein (CRP), myeloperoxidase protein levels (MPO) and glutathione status were determined. ANOVA with repeated measures was used to determine the differences between tests.From the hematological and biochemical measures only total leukocytes changed significantly, increasing at T3 when compared to T1. There were no differences along the entire season in both RESTQ-Sport and POMS scores or indices. Concerning performance, the group improved their maximal strength (+17.4% in bench-press 1RM) and their specific-distance time (+9.8%). The main finding of the present study was that training was well-balanced between stress and recovery because while specific performance increased, signs of overtraining were not found.Training monitoring in athletes should be performed in a multilevel approach using measurements of performance as well as biological or psychological parameters.",0,0 +5026,A prospective study of the relation between posttraumatic stress and physical health symptoms,"This ex post facto prospective study investigated whether symptoms of posttraumatic stress disorder (PTSD) are associated with increased physical health problems, while controlling for base-rates of symptoms and individual differences in neuroticism. Dutch army soldiers completed standardized questionnaires before they were deployed to Iraq (n = 479), and about 5 months (n = 382; 80%) and 15 months (n = 331; 69%) after their return home. PTSD-symptoms were evaluated by questionnaires and clinical interviews. The results showed that, on average, participants with PTSD at 5 months reported increased physical problems after deployment. PTSD-symptoms at 5 months predicted coexisting physical symptoms, after controlling for demographic variables, military factors, injury sustained on deployment, war-zone exposure on deployment, baseline physical problems, baseline PTSD-symptoms, and neuroticism. PTSD-symptoms at 5 months also predicted physical problems at 15 months, while controlling for physical symptoms at 5 months. The results suggest that posttraumatic stress contributes to physical symptoms. Clinicians are advised to be attentive to PTSD when individuals present with physical symptoms, and to pay attention to physical symptoms in patients diagnosed with PTSD.",0,0 +5027,The role of frontal EEG asymmetry in post-traumatic stress disorder,"Frontal alpha asymmetry, a biomarker derived from electroencephalography (EEG) recordings, has often been associated with psychological adjustment, with more left-sided frontal activity predicting approach motivation and lower levels of depression and anxiety. This suggests high relevance to post-traumatic stress disorder (PTSD), a disorder comprising anxiety and dysphoria symptoms. We review this relationship and show that frontal asymmetry can be plausibly linked to neuropsychological abnormalities seen in PTSD. However, surprisingly few studies (k = 8) have directly addressed frontal asymmetry in PTSD, mostly reporting that trait frontal asymmetry has little (if any) predictive value. Meanwhile, preliminary evidence suggest that state-dependent asymmetry during trauma-relevant stimulation distinguishes PTSD patients from resilient individuals. Thus, exploring links between provocation-induced EEG asymmetry and PTSD appears particularly promising. Additionally, we recommend more fine-grained analyses into PTSD symptom clusters in relation to frontal asymmetry. Finally, we highlight hypotheses that may guide future research and help to fully apprehend the practical and theoretical relevance of this biological marker.",0,0 +5028,Effect of maternal heat-stress on follicular growth and oocyte competence in Bos indicus cattle,"The objective was to determine whether exposure of Gir (Bos indicus) cows to heat-stress (HS) causes immediate and delayed deleterious effect on follicular dynamics, hormonal profile and oocyte competence. The cows were kept in tie-stalls for an adaptive thermoneutral period of 28 days (Phase I, Days -28 to -1). In Phase II (Days 0-28) cows were randomly allocated into control (CG, n=5) and HS (HS, n=5) treatments. The HS cows were placed in an environmental chamber at 38 degrees C and 80% relative humidity (RH) during the day and 30 degrees C, 80% RH during the night for 28 days. The CG group was maintained in shaded tie-stalls (ambient temperature) for 28 days. During Phase III (Days 28-147) animals were placed in tie-stalls (Days 28-42) followed by pasture (Days 42-147) under thermoneutrality. In each phase, weekly ovum pick up (OPU) sessions were to evaluate follicular development, morphology of cumulus-oocyte complexes (COCs), and developmental competence after in vitro maturation, fertilization, and culture. Serum concentrations of progesterone (P(4)) and cortisol were evaluated by radioimmunoassay. Exposure of Gir cows to HS had no immediate effect on reproductive function, but exerted a delayed deleterious effect on ovarian follicular growth, hormone concentrations, and oocyte competence. Heat-stress increased the diameter of the first and second largest follicles from Days 28 to 49. Indeed, HS increased the number of >9 mm follicles (characterized as follicular codominance) during this phase. Cows exposed to HS had longer periods of non-cyclic activity (P(4)<1 ng/mL), as well as shorter estrous cycles. However, HS did not affect cortisol concentration as compared to CG. Although HS had no significant effect on cleavage rate, it reduced blastocyst development during Phase III. In conclusion, long-term exposure of B. indicus cattle to HS had a delayed deleterious effect on ovarian follicular dynamics and oocyte competence.",0,0 +5029,"A study on the relationship between posttraumatic stress disorder in flood victim parents and children in Hunan, China.","To explore the relationship between posttraumatic stress disorder (PTSD) in flood victim parents and children in Hunan, China.Using the method of multistage cluster random sampling, we conducted a retrospective investigation on 3,698 families in Hunan, China who suffered from flooding in 1998. Investigators held face-to-face interviews with the parents and children of the families. The diagnosis of PTSD was made according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. The comparison of rate of PTSD positive in the groups of children with different characteristics was done by chi-square test. In the evaluation of the impact of parent PTSD on PTSD in their children, we used a multivariable logistic regression model to re-estimate the adjusted Odds Ratio and its confidence interval. We did this after the possible confounding variables were adjusted for. Additionally, the Odds Ratio and its confidence interval were estimated under the condition of a single variable.A total of 4,327 children and the parents of 3,292 families were included for analysis; 203 (4.7%) of 4,327 children and 740 (11.2%) of 6,584 parents were diagnosed with PTSD. We found that the PTSD positive rate is significantly higher in the children with disaster-related experience. The rate of beating their children in PTSD positive fathers (54.9%) was higher than that of PTSD negative fathers (51.2%). No correlation was found between mothers' PTSD and beating their children. The risk of developing PTSD is higher for children living in the families with PTSD parents.The rate of PTSD in 7-14-year-old children is 4.7% in areas in Hunan, China, who suffered from flooding in 1998. The possibility for children to develop PTSD is increased in families with PTSD parents.",0,0 +5030,The Factor Structure of Posttraumatic Stress Disorder Symptoms in Patients With Traumatic Spinal Cord Injuries,"The current study investigated the factor structure of posttraumatic stress disorder (PTSD) symptoms in a sample of 256 patients with traumatic spinal cord injuries (SCI) in China. The confirmatory factor analysis results showed that a five-factor model composed of intrusion, avoidance, emotional numbing, dysphoric arousal, and anxious arousal fits the data significantly better than the tripartite DSM-IV model and the two well-supported four-factor models, and the C3 symptom (inability to recall important aspect of the trauma) loaded weakly on its corresponding factor. Implications and limitations for the results are discussed.",0,0 +5031,Posttraumatic stress disorder in children exposed to intimate partner violence: the clinical picture of physiological arousal symptoms,"ABSTRACTIn recent years, researchers have focused on acquiring a better understanding of the development of posttraumatic stress disorder (PTSD) in children under the age of six following exposure to chronic trauma, such as intimate partner violence (IPV). Despite a number of empirical studies on early childhood PTSD, few have examined how children differ in the clinical presentation of PTSD symptomatology. There may be wide variability in the presentation of symptoms within the four clusters of PTSD symptoms: re-experiencing, alterations in physiological arousal, negative alterations in cognitions and mood, and avoidance. Symptoms of physiological arousal may be particularly difficult for parents and therapists to identify and report on because many of these symptoms are internal sensations (e.g. racing heart beat), and they are most often evaluated out of context (e.g. in reports of past behaviour). Thus, little is known about the presentation of these symptoms in preschoolers. To better identify physio...",0,0 +5032,Probable Posttraumatic Stress Disorder and Disability in Cambodia,"Millions of Cambodians suffered profound trauma during the Khmer Rouge era (1975 to 1979). A joint United Nations-Cambodian tribunal (the ""Khmer Rouge trials"") was empanelled in 2006 to prosecute top Khmer Rouge leaders and began substantive hearings in March 2009.To establish the prevalence of probable posttraumatic stress disorder (PTSD) among adult Cambodians and to assess correlates of PTSD symptoms and disability with perceived justice, desire for revenge, and knowledge of and attitudes toward the trials.A national probability sample of 1017 Cambodians was assembled using a multistage, stratified cluster design, including 813 adults older than 35 years who had been at least 3 years old during the Khmer Rouge era and 204 adults aged 18 to 35 years who had not been exposed to the Khmer Rouge era. Face-to-face interviews were conducted between December 2006 and August 2007.Prevalence of probable PTSD using the PTSD Checklist, Civilian version (cutoff score of 44), and mental and physical disability using the Medical Outcomes Study 12-item Short Form Health Survey.The prevalence of current probable PTSD was 11.2% (95% confidence interval [CI], 8.6%-13.9%) overall and 7.9% (95% CI, 3.8%-12.0%) among the younger group and 14.2% (95% CI, 11.0%-17.3%) in the older group. Probable PTSD was significantly associated with mental disability (40.2% vs 7.9%; adjusted odds ratio [AOR], 7.80; 95% CI, 3.90-15.60) and physical disability (39.6% vs 20.1%; AOR, 2.60; 95% CI, 1.26-5.39). Although Cambodians were hopeful that the trials would promote justice, 87.2% (n = 681) of those older than 35 years believed that the trials would create painful memories for them. In multivariate analysis, respondents with high levels of perceived justice for violations during the Khmer Rouge era were less likely to have probable PTSD than those with low levels (7.4% vs 12.7%; AOR, 0.54; 95% CI, 0.34-0.86). Respondents with high levels of desire for revenge were more likely to have probable PTSD than those with low levels (12.0% vs 7.2%), but the difference was not statistically significant in the multivariate analysis (AOR, 1.76; 95% CI, 0.99-3.11).Probable PTSD is common and associated with disability in Cambodia. Although Cambodians had positive attitudes toward the trials, most were concerned that the trials would bring back painful memories. Now that the trials have begun, longitudinal research is needed to determine the impact of the trials on Cambodians' mental health.",0,0 +5033,Salivary cortisol among American Indians with and without posttraumatic stress disorder (PTSD): Gender and alcohol influences,"Disruptions in hypothalamic-pituitary-adrenal regulation and immunity have been associated with posttraumatic stress disorder (PTSD). We examined the association of PTSD with diurnal rhythms in salivary cortisol in a convenience sample from a population-based study of male and female American Indians. Subjects with and without PTSD were identified from American Indians living on/near a Northern Plains reservation as part of a larger study. Over two days diurnal saliva samples were collected by staff at the University of Colorado Denver Clinical Research Center at waking, 30min after waking, before lunch, and before dinner. Generalized estimating equations linear regression models investigated the influence of PTSD on cortisol over time. The association of a lifetime diagnosis of PTSD with salivary cortisol level was assessed in subjects with complete data (PTSD: n=27; no PTSD n=32) for age, gender, and alcohol consumption in the past month. Subject mean age was 44 years, and 71% were women. When stratified by gender, women with a lifetime diagnosis of PTSD had significantly higher mean cortisol levels throughout the day than women without PTSD (p=0.01); but there was no significant association between PTSD and cortisol levels in men (p=0.36). The cortisol awakening response - the difference in cortisol levels from waking to 30min after waking - was not associated with PTSD in men or women. A lifetime diagnosis of PTSD may influence diurnal cortisol among American Indian women. These effects were independent of influences of current alcohol use/abuse. The unexpected elevation in cortisol in American Indian women with a lifetime diagnosis of PTSD may reflect acute anxiety associated with experiencing a number of novel tests in a strange location (e.g., cardiac imaging, medical, dental exams, etc.), or concurrent depression.",0,0 +5034,Family functioning predicts outcomes for veterans in treatment for chronic posttraumatic stress disorder.,"A longitudinal framework was used to examine the competing hypotheses of (a) whether family functioning predicts changes in posttraumatic stress disorder (PTSD) symptoms or (b) whether PTSD symptoms predict changes in family functioning. Veterans (N = 311) admitted to a treatment program completed a series of questionnaires at 3 time points: at intake, from intake to completion of a treatment program, and at the 6-month follow-up. Alcohol use and general mental health symptoms were also measured at intake. A cross-lagged panel model using structural equation modeling analyses indicated that family functioning was a moderate predictor of PTSD symptoms at posttreatment and at the 6-month follow-up. PTSD was not a significant predictor of family functioning across time and alcohol use, and general mental health symptoms did not affect the overall findings. Further analyses of PTSD symptom clusters indicated that the avoidance symptom cluster was most strongly related to family functioning. Targeting family relationships for treatment may be important in the future for veterans with PTSD.",0,0 +5035,BRAIN ACTIVATION TO FACIAL EXPRESSIONS IN YOUTH WITH PTSD SYMPTOMS,"Objective This study examined activation to facial expressions in youth with a history of interpersonal trauma and current posttraumatic stress symptoms (PTSS) compared to healthy controls (HC). Design and analysis Twenty-three medication-naive youth with PTSS and 23 age- and gender-matched HC underwent functional magnetic resonance imaging (fMRI) while viewing fearful, angry, sad, happy, and neutral faces. Data were analyzed for group differences in location of activation, as well as timing of activation during the early versus late phase of the block. Using SPM5, significant activation (P < .05 FWE [Family-Wise Error] corrected, extent = 10 voxels) associated with the main effect of group was identified. Activation from selected clusters was extracted to SPSS software for further analysis of specific facial expressions and temporal patterns of activation. Results The PTSS group showed significantly greater activation than controls in several regions, including the amygdala/hippocampus, medial prefrontal cortex, insula, and ventrolateral prefrontal cortex, and less activation than controls in the dorsolateral prefrontal cortex (DLPFC). These group differences in activation were greatest during angry, happy, and neutral faces, and predominantly during the early phase of the block. Post hoc analyses showed significant Group × Phase interactions in the right amygdala and left hippocampus. Conclusions Traumatic stress may impact development of brain regions important for emotion processing. Timing of activation may be altered in youth with PTSS.",0,0 +5036,"Fear of recurrence, sense of coherence and posttraumatic stress disorder in haematological cancer survivors","The diagnosis and treatment of cancer has been shown to precipitate posttraumatic stress disorder (PTSD) in some cancer survivors. However few studies have considered the links between cancer-related PTSD and theoretical models of PTSD. This study considers a cognitive model of PTSD by examining the relationship between sense of coherence, and fear of recurrence to posttraumatic stress symptomatology (PTSS) in haematological cancer survivors. Thirty-six participants completed the PTSD Checklist-Civilian Version (PCL-C), the Impact of Events Scale-Revised (IES-R), the sense of coherence scale and two measures of fear of recurrence. Two measures of fear of recurrence were included as no fear of recurrence measures had previously been assessed for reliability and validity on British populations. Seventeen percent of the sample met DSM-IV diagnostic criteria for PTSD. Statistically significant relationships were found between sense of coherence and fear of recurrence and PTSS, raising questions about the possibility of using this construct as a screening measure for vulnerability to PTSD. A relationship was also found between fear of recurrence and PTSS suggesting that cancer-related PTSS may fit within the theoretical model of PTSD considered. Further examination of factors affecting the onset, maintenance and treatment of PTSD in this population is required.",0,0 +5037,The Trauma Symptom Inventory: Factors Associated with Invalid Profiles in a Sample of Combat Veterans with Post-Traumatic Stress Disorder,"The assessment of combat-related post-traumatic stress disorder (PTSD) relies upon self-reported symptoms and the need for indicators of valid reporting is critical. The Trauma Symptom Inventory (TSI) is a testing instrument specific to PTSD which includes validity scales. In a pilot study examining the use of the TSI with combat veterans, 50 male veterans diagnosed with PTSD were administered the TSI. Nineteen percent of the profiles were invalid, all but one based on the Atypical Response Scale. Differences between veterans with valid and invalid TSI profiles are examined in terms of demographic and historical factors, TSI profiles, and individual scale items. The model best able to predict invalid profiles included high scores on subscales measuring dissociative experiences and tension reduction behaviors. Implications for the interpretation of TSI validity scales in assessing combat-related PTSD are discussed.",0,0 +5038,Millennium Cohort: The 2001–2003 baseline prevalence of mental disorders in the U.S. military,"

Abstract

Objectives

The 12-month prevalence of common mental illnesses in the United States is estimated to be 26%, accounting for an increasing fraction of all disability in the general population. The U.S. military is a unique group involved in response and defense during times of conflicts and disasters. The mental health of service members affects organizational productivity and effectiveness and is of great importance to the health of U.S. military members and public health in general.

Study Design and Setting

In the present report, the authors describe the baseline prevalence of mental disorders in a large U.S. military cohort, the Millennium Cohort, established for a 22-year longitudinal study of the health effects of military service. Using crude and weighted prevalence and multivariable logistic regression, the mental health morbidity of the Millennium Cohort is reported for various demographics.

Results

These analyses suggest that although the cohort compares favorably to other populations, there are military subpopulations, including women, younger, less educated, single, white, short-term service, enlisted, and Army members, who are at greater odds for some mental disorders.

Conclusion

With ongoing U.S. involvement in combat operations around the world, these baseline data are essential to assessing long-term mental health morbidity in U.S. military service members.",0,0 +5039,MMPI-2 data for Australian Vietnam veterans with combat-related PTSD,"Considerable attention has been devoted to the MMPI in the assessment of combat-related PTSD. To date, published data have focused almost exclusively on American Vietnam veterans. This study investigated MMPI-2 profiles of 100 Australian Vietnam veterans admitted to an intensive PTSD treatment program. Comparisons with United States (U.S.) data suggested strong similarities between the American and Australian populations in terms of F-scale elevations and typical 3-point code types (8-7-2). However, the American samples showed relatively higher elevations of Scales 4 and 6, suggesting social alienation and a tendency to externalize, while a subgroup of Australian veterans showed a greater propensity for somatization (Scale 1). The results provide overall support for the generalizability of American MMPI data to an alternative cultural group of combat veterans.",0,0 +5040,"Trauma, resilience and saliostasis: effects of treatment in post-traumatic stress disorder","There has been growing interest in the concept of resilience and the question as to whether psychotropic medications or psychosocial treatments might have resilience-enhancing effects. This pilot study investigates resilience in a sample of patients with post-traumatic stress disorder (PTSD) before and after treatment. Effects of treatment with tiagabine, fluoxetine, sertraline alone, and sertraline with cognitive behavioural therapy on resilience were assessed using the Connor-Davidson Resilience Scale (CD-RISC). Changes in resilience after treatment were measured and response to treatment was predicted from demographic, resilience and baseline disability measures. Changes in resilience following treatment were statistically significant. Items that showed the greatest change related to confidence, control, coping, knowing where to turn for help and adaptability. Items showing the least change related to religious and existential aspects of resiliency, effort, acting on a hunch, decision-making and goals. In linear and logistic regression models, gender, baseline CD-RISC score, baseline Sheehan Disability Scale score and an individual item from the CD-RISC scale, 'Sense of Humor', were significant predictors of response to treatment. Treatment of PTSD significantly improved resilience and reduced symptoms in this sample. Further controlled studies are indicated.",0,0 +5041,A cluster analysis of symptom patterns and adjustment in Vietnam combat veterans with chronic posttraumatic stress disorder,"This study investigated whether a subgroup of veterans with malignant posttraumatic stress syndrome, as described by Rosenheck (1985) and Lambert et al. (1996), could be identified via cluster analysis within two samples of Vietnam veterans with combat-related posttraumatic stress disorder (PTSD). In the initial subsample (n = 157), four clusters were identified, including a subgroup that scored consistently higher on measures of interpersonal violence and current physical problems. Similar results were found in the cross-validation subsample (n = 156). These results provide support for the theoretical concept of malignant PTSD and suggest that veterans with chronic PTSD are not homogenous. Whereas some manifest extreme levels of both functional impairment and PTSD symptomatology, others exhibit markedly less functional impairment despite manifesting clinically significant levels of PTSD. Clinicians can consider this heterogeneity in their treatment decisions.",0,0 +5042,Prediction of posttraumatic stress symptoms in children after Hurricane Andrew.,"The authors used an integrative conceptual model to examine the emergence of posttraumatic stress disorder (PTSD) symptoms in 568 elementary school- age children 3 months after Hurricane Andrew. The model included 4 primary factors: Exposure to Traumatic Events, Child Characteristics, Access to Social Support, and Children's Coping. Overall, 62% of the variance in children's self-reported PTSD symptoms was accounted for by the 4 primary factors, and each factor improved overall prediction of symptoms when entered in the analyses in the order specified by the conceptual model. The findings suggest that the conceptual model may be helpful to organize research and intervention efforts in the wake of natural disasters.",0,0 +5043,"Trauma exposure, posttraumatic stress disorder and the effect of explanatory variables in paramedic trainees","Abstract Background Emergency healthcare workers, including trainees and individuals in related occupations are at heightened risk of developing posttraumatic stress disorder (PTSD) and depression owing to work-related stressors. We aimed to investigate the type, frequency, and severity of direct trauma exposure, posttraumatic stress symptoms and other psychopathology amongst paramedic trainees. In order to create a risk profile for individuals who are at higher occupational risk of developing PTSD, we examined risk and resilience factors that possibly contributed to the presence and severity of posttraumatic symptomatology. Methods Paramedic trainees (n = 131) were recruited from a local university. A logistic regression analysis was conducted using the explanatory variables age, gender, population group, trauma exposure, depression, alcohol abuse, alcohol dependence, resilience and social support. Results 94% of paramedic trainees had directly experienced trauma, with 16% meeting PTSD criteria. A high rate of depression (28%), alcohol abuse (23%) and chronic perceived stress (7%) and low levels of social support was found. The number of previous trauma exposures, depression, resilience and social support significantly predicted PTSD status and depression had a mediating effect. Conclusion There is a need for efficient, ongoing screening of depressive and PTSD symptomatology in trauma exposed high risk groups so that early psychological supportive interventions can be offered.",0,0 +5044,"Posttraumatic Stress Disorder Symptom Clusters, Alcohol Misuse, and Women's Use of Intimate Partner Violence","Exploring how PTSD and alcohol misuse relate to women's use of intimate partner violence (IPV) is vital to develop our understanding of why some women may engage in IPV, which can serve to maximize intervention efforts for women. This study examined the extent to which posttraumatic stress disorder (PTSD) symptom clusters are directly and indirectly related to women's use of IPV through pathways involving alcohol misuse while controlling for severity of women's IPV victimization. The sample was comprised of substance-using, low socioeconomic status community women (N = 143) currently experiencing IPV victimization. The majority of the sample was African American (n = 115, 80.42%). This sample had an average annual household income of $14,368.68 (SD = $12,800.68) and the equivalent of a high school education (11.94 years, SD = 1.32). Path analyses indicated that the strongest statistical relationship emerged between women's use of IPV and women's IPV victimization. PTSD reexperiencing and numbing symptom severity was related to women's use of psychological, minor physical, and severe physical IPV; however, these relationships were indirect through alcohol misuse. Findings lend preliminary support for the application of the self-medication hypothesis to the study of PTSD, alcohol misuse, and IPV among women.",0,0 +5045,Hippocampus Function Predicts Severity of Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) is often accompanied by memory problems and abnormal brain structure, particularly within the hippocampus. We implemented a cross-species, hippocampal-dependent task--the virtual Morris Water task--to assess hippocampal function in people with PTSD and age-matched controls during functional magnetic resonance imaging (fMRI). Performance on the task was equivalent between the groups. However, when correlating fMRI-derived hippocampal activity during this task with PTSD severity, we observe a -0.84 correlation, indicating that those with reduced hippocampal activity show more severe PTSD symptoms. This correlation is not explained by differences in task performance, IQ, duration since trauma, nor time with PTSD. Hence, PTSD severity is predicted by functionally assessing the hippocampus using the virtual Morris water task, suggesting that this task may be used to identify those at risk for developing PTSD following a trauma.",0,0 +5046,PTSD comorbidity and suicidal ideation associated with PTSD within the Ohio Army National Guard.,"To study the relation between posttraumatic stress disorder (PTSD) psychiatric comorbidity and suicidal ideation in a representative sample of Ohio Army National Guard soldiers.Using retrospective data collected on the telephone from a random sample of 2,616 National Guard soldiers who enrolled in a 10-year longitudinal study (baseline data collected November 2008-November 2009), we examined (1) the prevalence of other psychopathologies among those with DSM-IV-diagnosed PTSD compared to those without PTSD and (2) the association between PTSD comorbidity and suicidal ideation (reporting thoughts of being better off dead or hurting themselves). All analyses were carried out using logistic regression.Of guard members with PTSD in the last year, 61.7% had at least 1 other psychopathology; 20.2% had at least 2 other co-occurring conditions. The most common co-occurring psychopathology was depression. While those with PTSD overall were 5.4 (95% CI, 3.8-7.5) times more likely to report suicidality than those without PTSD, those who had at least 2 additional conditions along with PTSD were 7.5 (95% CI, 3.0-18.3) times more likely to report suicidal ideation at some point in their lifetime than those with PTSD alone.Soldiers with PTSD were at increased risk for suicidality, and, among those with PTSD, those with at least 2 additional conditions were at the highest risk of suicidal ideation. Future research should address the mechanisms that contribute to multimorbidity in this population and the appropriate treatment methods for this high-risk group.",0,0 +5047,Trauma and Posttraumatic Stress Disorder Among Substance-Using Women Entering Cook County Jail,"In the United States, the number of incarcerated women continues to rise each year, with African American women having the highest incarceration rates. Many women enter prisons and jails with an extensive trauma history, though little is known about the percentage of these individuals suffering from posttraumatic stress disorder (PTSD) and specific trauma exposures they have had based on factors such as homelessness, degree of substance problems, and race. The present study examines a largely African American substance-using population of incarcerated women to determine the impact of various factors on specific traumas reported. We found that individuals reporting symptoms meeting criteria for PTSD had experienced the highest average number of traumas, and those who had ever been homeless also experienced many and varied trauma exposures compared with those who had never been homeless. Higher substance problems were also associated with more trauma exposure. Fewer than 10 percent of the sample met full cr...",0,0 +5048,"Breaking Bad: Two Decades of Life-Course Data Analysis in Criminology, Developmental Psychology, and Beyond","Studies of human development require longitudinal data analysis methods that describe within- and between-individual variation in developmental and behavioral trajectories. This article reviews life-course data analysis methods for modeling these trajectories, as well as their application in studies of antisocial behavior and of crime in childhood, in adolescence, and throughout life. We set the stage by introducing growth curve (hierarchical linear) models. We focus our review on finite mixture models for life-course data, known as group-based trajectory and growth mixture models. We then discuss how these models are applied within criminology and developmental psychology, recent controversies over their substantive use and interpretation, and important issues of statistical practice and the challenges they raise. Building on the critical literature, we offer several recommendations for the applied users of the models. Finally, we present the most recent method of examining behavioral trajectories in criminology, the unimodal curve registration (UCR) approach. We briefly contrast the UCR model with growth curve and finite mixture models for life-course data analysis.",0,0 +5049,Change in posttraumatic stress disorder symptoms: Do clinicians and patients agree?,"This study assessed the longitudinal association between clinician and patient ratings of posttraumatic stress disorder (PTSD) symptoms over the course of 2 different randomized clinical trials of veterans with chronic PTSD. One trial, the Department of Veterans Affairs Cooperative Study 420 (CSP 420; N = 360) compared trauma-focused and present-centered group therapies, and the 2nd trial compared cognitive processing theory and a waitlist control condition (N = 60). Linear mixed effects modeling revealed significant associations between clinician ratings (Clinician-Administered PTSD Scale; CAPS; D. D. Blake et al., 1990) and patient ratings (Posttraumatic Stress Disorder Checklist; PCL; F. W. Weathers, B. T. Litz, J. A. Herman, J. A. Huska, & T. M. Keane, 1993) in total and symptom clusters of PTSD. Contrary to hypothesis, the amount of change on the CAPS ranged from .75 to .82 standard deviations for every 1 standard deviation change on the PCL. The CAPS and PCL were more closely associated in the trauma-focused vs. present-centered treatment condition in CSP 420, and especially regarding hyperarousal symptoms. When comparing categorization of clinically significant change on the CAPS and PCL, the authors found no differences in the percentages of agreement between clinicians and patients in improvement and exacerbation. The value of multimodal assessment of PTSD treatment outcomes is discussed.",0,0 +5050,,"BACKGROUND: Peritraumatic response, as currently assessed by Posttraumatic Stress Disorder (PTSD) diagnostic criterion A2, has weak positive predictive value (PPV) with respect to PTSD diagnosis. Research suggests that indicators of peritraumatic autonomic activation may supplement the PPV of PTSD criterion A2. We describe the development and factor structure of the STRS (Shortness of Breath, Tremulousness, Racing Heart, and Sweating), a one page, two-minute checklist with a five-point Likert-type response format based on a previously unpublished scale. It is the first validated self-report measure of peritraumatic activation of the autonomic nervous system. METHODS: We selected items from the Potential Stressful Events Interview (PSEI) to represent two latent variables: 1) PTSD diagnostic criterion A, and 2) acute autonomic activation. Participants (a convenience sample of 162 non-treatment seeking young adults) rated the most distressing incident of their lives on these items. We examined the factor structure of the STRS in this sample using factor and cluster analysis. RESULTS: Results confirmed a two-factor model. The factors together accounted for 68% of the variance. The variance in each item accounted for by the two factors together ranged from 41% to 74%. The item loadings on the two factors mapped precisely onto the two proposed latent variables. CONCLUSION: The factor structure of the STRS is robust and interpretable. Autonomic activation signs tapped by the STRS constitute a dimension of the acute autonomic activation in response to stress that is distinct from the current PTSD criterion A2. Since the PTSD diagnostic criteria are likely to change in the DSM-V, further research is warranted to determine whether signs of peritraumatic autonomic activation such as those measured by this two-minute scale add to the positive predictive power of the current PTSD criterion A2. Additionally, future research is warranted to explore whether the four automatic activation items of the STRS can be useful as the basis for a possible PTSD criterion A3 in the DSM-V.",0,0 +5051,The presence of post-traumatic stress disorder symptoms in earthquake survivors one month after a mudslide in southwest China,"The psychological impact of a mudslide on survivors of the Wenchuan earthquake in China and the risk factors for development of disaster-related post-traumatic stress disorder (PTSD) were investigated. The study design was cross-sectional and included 1321 survivors who had endured both an earthquake and a mudslide. Participants filled out a self-report questionnaire. One month after the mudslide, the rate of PTSD symptoms was 18.7%. Females, the elderly, those with lower educational levels, those that lacked social support, those who did not take precautionary measures, those living with children below 6 years of age, and those who had higher exposure to traumatic events experienced a higher level of PTSD symptoms. Results indicated that timely rescue, abundant material help, and mental rehabilitation after a disaster play important roles in recovery, and that there are still some high-risk groups that need attention, care, and effective intervention from healthcare professionals and society.",0,0 +5052,Personal and familial correlates of bipolar (BP)-I disorder in children with a diagnosis of BP-I disorder with a positive child behavior checklist (CBCL)-severe dysregulation profile: A controlled study,"Although the DSM-IV provides explicit criteria for the diagnosis of BP-I disorder, this is a complex diagnosis that requires high levels of clinical expertise. Previous work shows children with a unique profile of the CBCL of high scores (2SD) on the attention problems (AP), aggressive behavior (AGG), and anxious-depressed (AD) (A-A-A) subscales are more likely than other children to meet criteria for BP-I disorder in both epidemiological and clinical samples. However, since not all BP-I disorder children have a positive profile questions remain as to its informativeness, particularly in the absence of an expert diagnostician.Analyses were conducted comparing personal and familial correlates of BP-I disorder in 140 youth with a structured interview and an expert clinician based DSM-IV diagnosis of BP-I disorder with (N=80) and without (N=60) a positive CBCL- Severe Dysregulation profile, and 129 controls of similar age and sex without ADHD or a mood disorder. Subjects were comprehensively assessed with structured diagnostic interviews and wide range of functional measures. We defined the CBCL-severe dysregulation profile as an aggregate cut-off score of ≥ 210 on the A-A-A scales.BP-I probands with and without a positive CBCL-severe dysregulation profile significantly differed from Controls in patterns of psychiatric comorbidity, psychosocial and psychoeducational dysfunction, and cognitive deficits, as well as in their risk for BP-I disorder in first degree relatives.Because the sample was referred and largely Caucasian, findings may not generalize to community samples and other ethnic groups.A positive CBCL-severe dysregulation profile identifies a severe subgroup of BP-I disorder youth.",0,0 +5053,Psychiatric Sequelae of Posttraumatic Stress Disorder in Women,"The risk for first-onset major depression, anxiety, and substance use disorders associated with prior posttraumatic stress disorder (PTSD) was estimated in a sample of women.The National Institute of Mental Health Diagnostic Interview Schedule, revised according to DSM-III-R, was used to measure lifetime psychiatric disorders in a stratified random sample of 801 mothers of children, who participated in a study of cognitive and psychiatric outcomes by level of birth weight. Cox proportional hazards models with time-dependent covariates were used to calculate the hazards ratios of first onset of other disorders following PTSD.The lifetime prevalence of traumatic events was 40% and of PTSD, 13.8%. Posttraumatic stress disorder signaled increased risks for first-onset major depression (hazards ratio, 2.1) and alcohol use disorder (hazards ratio, 3.0). The risk for major depression following PTSD was of the same magnitude as the risk for major depression following other anxiety disorders. Women with preexisting anxiety and PTSD had significantly increased risk for first-onset major depression. Additional analysis showed that preexisting major depression increased women's vulnerability to the PTSD-inducing effects of traumatic events and risk for exposure to traumatic events.Posttraumatic stress disorder influences the risk for first-onset major depression and alcohol use disorder. The causal explanation of these temporally secondary disorders is unclear and might involve the effect of PTSD or underlying vulnerabilities exposed by the traumatic experience.",0,0 +5054,Heterogeneous Patterns of Stress Over the Four Years of College: Associations With Anxious Attachment and Ego-Resiliency,"Objective A growing body of literature suggests that college students display alarming rates of psychological distress. However, studies of responses to significant life stressors in other contexts have found that people respond in heterogeneous ways and that attachment style and ego-resiliency mitigate the effects of stressors on mental health. Method Individual differences in distress among a cohort of students (N = 157; Mean age = 18.8 years, 62.6% female) across the four years of college were analyzed using latent class growth analysis. Trajectories were then regressed on levels of anxious and avoidant attachment and ego-resiliency. Results Four discrete patterns emerged characterized by healthy and maladaptive patterns of stress response, indicating that students respond to college in heterogeneous ways. Several patterns showed significant variability in distress by semester. Low levels of anxious but not avoidant attachment predicted membership in the stable-low distress or resilient class while ego-resiliency predicted membership in both the resilient and moderate distress classes. Conclusions Findings indicate that low levels of anxious attachment and the ability to flexibly cope with adversity may be associated with better mental health throughout college. Implications from stress response and developmental perspectives are discussed.",0,0 +5055,RISK FACTORS FOR ANXIETY DISORDERS: COMMON AND SPECIFIC EFFECTS IN A NATIONAL SAMPLE,"Anxiety disorders and major depressive disorder (MDD) often co-occur and share a broad range of risk factors. The goal of this study was to examine whether the co-occurrence of anxiety disorders and MDD could be explained by an underlying latent factor and whether the risk factors exert their effect exclusively through this factor, directly on each disorder, or through a combination of effects at both levels.Data were drawn from a large, nationally representative sample. Confirmatory factor analysis was used to identify the latent structure of anxiety disorders. A multiple indicators multiple causes (MIMIC) approach was used to assess the common and specific effects of risk factors for anxiety disorders.A one-factor model provided a good fit to the co-occurrence of anxiety disorders. Low self-esteem, family history of depression, female sex, childhood sexual abuse, White race, years of education, number of traumatic experiences, and disturbed family environment increased the risk of anxiety disorders and MDD through their effect on the latent factor. There were also several direct effects of the covariates on the disorders, indicating that the effect of the covariates differed across disorders.Risk for anxiety disorders and MDD appears to be mediated partially by a latent variable underlying anxiety disorders and MDD, and partially by disorder-specific effects. These findings may contribute to account for the high rates of comorbidity among disorders, identify commonalities in the etiologies of these disorders, and provide clues for the development of unified preventive interventions.",0,0 +5056,Selecting the appropriate psychotherapies for individuals with traumatic brain injury: What works and what does not?,"When traditional psychotherapy is provided to patients with traumatic brain injuries (TBIs), the primary focus is on treating mood changes such as depression, anxiety or anger. However, traditional psychotherapeutic methods developed specifically for mood changes fall short when treating most TBI patients. In large part, this is because the psychological adjustment difficulties that most TBI patients face are linked to life-altering changes that are interwoven with permanent physical, cognitive, and social sequelae. In addition, mood changes in TBI patients are also caused by vocational and financial losses.The sudden onset of these unfamiliar and interdependent problems necessitates a psychotherapeutic approach that acknowledges the inherent challenges of coping with multiple life-altering changes. For patients who experience a shattered sense of self, interventions need to be explored to make life meaningful following a TBI.An existentially-oriented approach is introduced in the following steps: (1) identifying pre-injury future expectations, (2) examining how the TBI has altered these expectations, (3) grieving the loss of the expected future, and (4) developing a realistic future that is existentially meaningful.Pivotal gains are achieved when patients rebuild their lives according to their own core values.TBI patients can benefit from existential psychotherapy.",0,0 +5057,Partial least squares based gene expression analysis in posttraumatic stress disorder.,"Posttraumatic stress disorder (PTSD) is an adverse psychological response to traumatic events. Microarray technology for large-scale gene expression analysis facilitates the identification of signatures that underlie the pathogenesis of PTSD. Previous studies mostly used variance/regression analysis without considering array specific factors. We aim to investigate the underlying mechanism of PTSD through partial least squares (PLS) based analysis.With a gene expression profile data set for 17 chronic PTSD patients and 16 controls recovered from psychological trauma from the Gene Expression Omnibus (GEO) database, we performed Partial Least Square (PLS) based analysis.We acquired 230 down-regulated genes and 335 up-regulated genes. Significantly increased representations of dysregulated genes in immune, endocrine and nervous pathways were identified. Among the top 5 hub genes in the network, PRKCA has been reported to be related with PTSD before. Three other genes, TP53, EP300 and CALM1 might also contribute to the pathogenesis of PTSD since they are all related with other neuronal disorders.Our findings shed light on expression signatures of PTSD with the hope to give further theoretical supports for future therapeutic study.",0,0 +5058,A Longitudinal Study of Retirement in Older Male Veterans.,"In this study, the authors examined the effect of retirement on psychological and physical symptoms in 404 older male veterans who were taking part in an ongoing longitudinal study. Hierarchical linear modeling was used to analyze symptom trajectories from preretirement, peri-retirement, and postretirement periods in veterans with either lifetime full or partial posttraumatic stress disorder (PTSD), trauma exposure only, or no traumatic exposure. As expected, the PTSD group experienced greater increases in psychological and physical symptoms during retirement, relative to the other groups. Retirement due to poor health in the PTSD group did not account for the findings regarding physical symptoms. Results indicate that clinicians should recognize and address the potential for older individuals with PTSD to experience difficulties during retirement.",0,0 +5059,Using the Excess Heat Factor (EHF) to predict the risk of heat related deaths,"Extremes of climate are not uncommon in Australia and heatwaves are not infrequent. Periods of high ambient temperature may result in clusters of heat related deaths, which may place strain on forensic facilities. This paper describes the formulation of the Excess Heat Factor using meteorological data to provide a means of predicting death resulting from periods of extreme heat stress. The 2009 South Australian heatwave had the highest ranked Excess Heat Factor in Adelaide's records. There were 58 heat related deaths, with the bulk of the heat related deaths following the peak Excess Heat Factor value (144 °C(2)). The 2008 heatwave had a lower peak Excess Heat Factor value (36 °C(2)); there was only one heat related death, which followed the peak in the Excess Heat Factor. It is proposed that calculation of the Excess Heat Factor from meteorological data could provide a means to predict and identify heat related deaths resulting from extreme weather conditions.",0,0 +5060,Differential Effects of Anxiety Sensitivity Components in the Relation Between Emotional Non-Acceptance and Post-traumatic Stress Symptoms Among Trauma-Exposed Treatment-Seeking Smokers,"Anxiety sensitivity (AS), defined as the extent to which individuals believe anxiety and anxiety-related sensations have harmful consequences, may play an important explanatory role in the relation between emotional non-acceptance and the expression of traumatic stress symptoms among trauma-exposed smokers. This investigation examined whether lower-order dimensions of AS (cognitive, physical, and social concerns) differentially explain the relation between emotional non-acceptance and post-traumatic stress (PTS) symptom clusters (re-experiencing, avoidance, hyperarousal) among trauma-exposed daily smokers (N = 169, 46% female; Mage = 41, SD = 12.3). AS and its lower-order facets of cognitive and social concerns were found to mediate the relations between emotional non-acceptance and avoidance and hyperarousal PTS symptoms. Using a multiple mediation model, the mediational effect of AS cognitive concerns for the relation between emotional non-acceptance and post-traumatic avoidance symptoms was found to be uniquely evident relative to social and physical concerns. All observed AS effects were evident above and beyond the variance accounted for by gender, number of traumatic event exposure types, negative affectivity, number of cigarettes smoked per day, and alcohol use problems. The present findings suggest cognitive-based AS concerns may play a mechanistic role in the relation between emotional non-acceptance and certain PTS symptoms among trauma-exposed daily smokers.",0,0 +5061,The latent structure of posttraumatic stress disorder: Different models or different populations?,"Factor analytic studies of the structure of self-reported posttraumatic stress disorder (PTSD) symptoms have consistently supported two 4-factor models; the ""Dysphoria"" and the ""Emotional Numbing"" model. The fit of both models has been satisfactory; however, it has been difficult to unequivocally determine which model is best. This study aimed to test the hypothesis that there is no single ""correct"" model, but rather that the models represent different subpopulations. A confirmatory factor 2-class mixture model was specified with the Dysphoria model in one class and the Emotional Numbing model in the other. This model was tested using data from participants from 4 trauma groups. This model fitted the data better than 1 and 2-class models of the Dysphoria, Emotional Numbing, and cross-factor loading model. It was concluded that the search for the ""correct"" model of PTSD based on the assumption of a single homogenous population may not be a worthwhile research endeavor.",0,0 +5062,Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample.,"The factor structure, reliability, and validity of the Depression Anxiety Stress Scales (DASS; S. H. Lovibond & P. F. Lovibond, 1995) and the 21-item short form of these measures (DASS-21) were examined in nonclinical volunteers (n = 49) and patients with Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) diagnoses of panic disorder (n = 67), obsessive-compulsive disorder (n = 54), social phobia (n = 74), specific phobia (n = 17), and major depressive disorder (n = 46). This study replicates previous findings indicating that the DASS distinguishes well between features of depression, physical arousal, and psychological tension and agitation and extends these observations to the DASS-21. In addition, the internal consistency and concurrent validity of the DASS and DASS-21 were in the acceptable to excellent ranges. Mean scores for the various groups were similar to those in previous research, and in the expected direction. The implications of these findings are discussed.",0,0 +5063,Posttraumatic stress disorder and psychosocial functioning within two samples of MVA survivors,"To examine criterion F variables of PTSD, the psychosocial functioning of two samples of motor vehicle accident (MVA) survivors was investigated. Within each sample, comparisons between MVA survivors with and without PTSD were conducted on four psychosocial functioning indices at three time points. In addition, the relationships between specific PTSD symptom clusters and psychosocial functioning indices were examined. The study revealed that, in general, MVA survivors with PTSD evidenced poorer psychosocial functioning than did survivors without PTSD. The emotional numbing symptoms of PTSD emerged as the most consistent predictors of the psychosocial functioning indices. The implications of these findings to the comprehensive treatment of PTSD are discussed.",0,0 +5064,Psychological Sequelae of the September 11 Terrorist Attacks in New York City,"The scope of the terrorist attacks of September 11, 2001, was unprecedented in the United States. We assessed the prevalence and correlates of acute post-traumatic stress disorder (PTSD) and depression among residents of Manhattan five to eight weeks after the attacks.We used random-digit dialing to contact a representative sample of adults living south of 110th Street in Manhattan. Participants were asked about demographic characteristics, exposure to the events of September 11, and psychological symptoms after the attacks.Among 1008 adults interviewed, 7.5 percent reported symptoms consistent with a diagnosis of current PTSD related to the attacks, and 9.7 percent reported symptoms consistent with current depression (with ""current"" defined as occurring within the previous 30 days). Among respondents who lived south of Canal Street (i.e., near the World Trade Center), the prevalence of PTSD was 20.0 percent. Predictors of PTSD in a multivariate model were Hispanic ethnicity, two or more prior stressors, a panic attack during or shortly after the events, residence south of Canal Street, and loss of possessions due to the events. Predictors of depression were Hispanic ethnicity, two or more prior stressors, a panic attack, a low level of social support, the death of a friend or relative during the attacks, and loss of a job due to the attacks.There was a substantial burden of acute PTSD and depression in Manhattan after the September 11 attacks. Experiences involving exposure to the attacks were predictors of current PTSD, and losses as a result of the events were predictors of current depression. In the aftermath of terrorist attacks, there may be substantial psychological morbidity in the population.",0,0 +5065,Avoidance symptoms and delayed verbal memory are associated with post-traumatic stress symptoms in female victims of sexual violence,"Victimization by sexual violence is strongly associated with the development of posttraumatic stress disorder (PTSD). While several psychological and cognitive factors are known to be associated with PTSD prognosis, multivariable analysis is scarce. This study examined factors affecting the severity of PTSD symptoms in early stage of traumatic experience of sexual violence, including initial post-traumatic symptoms and cognitive characteristics.Participants were recruited from the center for women and children victims of violence in a university hospital. Thirty-four sexual assault victims were assessed at the baseline and the second visit one to five months after the baseline. At the baseline, an array of posttraumatic symptoms and cognitive functions were measured: at follow-up, PTSD symptoms were determined by Clinician Administered PTSD Scale.Stepwise multiple regression showed that avoidance symptoms (β = 0.551, P < 0.01) and delayed verbal memory (β = -0.331, P < 0.05) at early stage of trauma predicted the severity of PTSD symptoms one to five month later. The regression model, factoring in avoidance and delayed verbal memory, showed a 34.9% explanatory power regarding the PTSD symptom severity.This study suggests that avoidance symptoms and verbal memory at the early stage of trauma are associated with later PTSD symptoms. It is also suggested that early intervention targeting avoidance symptoms may be beneficial in decreasing PTSD symptoms.",0,0 +5066,Post-traumatic stress disorder among adult survivors of the Wenchuan earthquake in China: a repeated cross-sectional study.,"The objective of the study was to examine trends in the prevalence of Posttraumatic Stress Disorder (PTSD) in Wenchuan, China, over the four-year period following its 2008 earthquake, and to explore the risk factors related to current PTSD. Chi-square analysis and multivariate logistic regression analysis were used to assess PTSD morbidity and identify associated risk factors. The results indicated that the prevalence of PTSD was 58.2% at two months, 22.10% at 8 months, 19.8% at 14 months, 19.0% at 26 months, and 8.0% at about 44 months after the earthquake. Female gender, being married, low education, non-drinking, and poor self-perceived health status were significantly associated with PTSD during the early period following the earthquake. Depression was significantly associated with survivors' PTSD throughout the study period.",0,0 +5067,Neuroendocrinology and psychiatric illness,"Evidence for a role of neurohormones in psychiatric disease is greatest for illnesses in the affective disorder spectrum, which we argue includes melancholic and atypical depression, anorexia nervosa, bulimia nervosa, posttraumatic stress disorder, and panic disorder. These illnesses are associated with signs of hypothalamic dysfunction and have similar profiles of neuroendocrine dysregulation. In contrast, the data are much less clear for an intrinsic role of neuroendocrine dysregulation in schizophrenia, obsessive-compulsive disorder, or other anxiety disorders. This difference may reflect the fact that schizophrenia and obsessive-compulsive disorder represent more 'structural' abnormalities, or it may reflect greater diagnostic heterogeneity, which makes the elucidation of specific alterations in neurohormonal systems impossible.",0,0 +5068,Questioning Psychosocial Resilience After Flooding and the Consequences for Disaster Risk Reduction,"This paper questions George Bonanno’s concept of resilience as “relatively stable, healthy levels of psychological and physiological functioning” (Bonanno in Am Psychol 59(1):20–28, 2004) following potentially traumatic events (PTE). It agrees with Bonanno’s claim that significant numbers of people may suffer from mental disorders following a PTE, but disagrees that the majority of people are resilient. Furthermore it argues that we should not see PTEs as one event, but as involving a number of stressors and having a variety of consequences. Drawing on fieldwork carried out in Rajni village, Bihar following the 2008 Kosi River flooding, it documents, 18 months post flood, that flood onset gave rise to symptoms related to Post Traumatic Stress Disorder (primarily re-experiencing). The villagers’ primary concern was livelihood loss which, together with their lack of hope for the future, led to symptoms of depression. It argues that mental health issues should be fully integrated into Disaster Risk Reduction plans and policies, which are likely to be included in the Post-2015 Millennium Development Goals. In addition to supporting mental health interventions, the paper suggests that deep socio-cultural changes are necessary to ensure improvements in mental health.",0,0 +5069,The Importance of Being Flexible,"Researchers have documented the consequences of both expressing and suppressing emotion using between-subjects designs. It may be argued, however, that successful adaptation depends not so much on any one regulatory process, but on the ability to flexibly enhance or suppress emotional expression in accord with situational demands. We tested this hypothesis among New York City college students in the aftermath of the September 11th terrorist attacks. Subjects' performance in a laboratory task in which they enhanced emotional expression, suppressed emotional expression, and behaved normally on different trials was examined as a prospective predictor of their adjustment across the first two years of college. Results supported the flexibility hypothesis. A regression analysis controlling for initial distress and motivation and cognitive resources found that subjects who were better able to enhance and suppress the expression of emotion evidenced less distress by the end of the second year. Memory deficits were also observed for both the enhancement and the suppression tasks, suggesting that both processes require cognitive resources.",0,0 +5070,Posttraumatic stress disorder and retrospectively reported stressor exposure: A longitudinal prediction model.,"There has been recent concern about the degree to which posttraumatic stress disorder (PTSD) symptomatology influences reports of prior exposure to highly stressful life events. In this longitudinal study of 2,942 male and female Gulf War veterans, the authors documented change in stressor reporting across 2 occasions and the association between change and PTSD symptom severity. A regression-based cross-lagged analysis was used to examine the relationship between PTSD symptom severity and later reported stressor exposure. Shifts in reporting over time were modestly associated with PTSD symptom severity. The cross-lagged analysis revealed a marginal association between Time 1 PTSD symptom severity and Time 2 reported stressor exposure for men and suggested that later reports of stressor exposure are primarily accounted for by earlier reports and less so by earlier PTSD symptomatology.",0,0 +5071,The valence of attentional bias and cancer-related rumination in posttraumatic stress and posttraumatic growth among women with breast cancer,"Objective: To examine the effects of self-reported attentional bias on posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG) through the potential mediator of cancer-related rumination. Design: A cross-sectional survey design was used and women with breast cancer (N=170) were recruited. Measures: Attentional biases, cancer-related ruminations, PTSD symptoms, and PTG were assessed. Results: Negative attentional bias and negative cancer-related rumination were positively related to PTSD symptoms following cancer diagnosis and treatments, but they were not related to PTG. Positive attentional bias and positive cancer-related rumination were positively related to PTG, but positive attentional bias was not related to PTSD symptoms. Findings showed that negative cancer-related rumination partially mediated the relationship between negative attentional bias and PTSD symptoms, while positive cancer-related rumination partially mediated the relationship between positive attentional bias and PTG. Conclusion: Findings support that there are differential trajectories to PTSD symptoms and PTG with respect to different valence of habitual attentional style and cancer-related rumination. They may serve as potential therapeutic leverages in the alleviation of PTSD symptoms and facilitation of PTG following cancer diagnosis and treatments. Copyright © 2010 John Wiley & Sons, Ltd.",0,0 +5072,A synopsis of recent influential papers published in psychiatric journals (2010–2011) from the Arab World,"Six recent and influential papers that have appeared in the three leading psychiatry journals from the Arab region are summarized in this review. The first paper examined the prevalence of eating disorders (EDs) in rural and urban secondary school girls in Sharkia; more EDs were found among urban than rural population. The second study reported the high prevalence of Post Traumatic Stress Disorder (PTSD) in primary school children in Iraq in context of the present situation in Iraq dominated by violence creating a traumatizing atmosphere for the population, especially children. The third paper reported that substance dependent patients manifest elevated traits of impulsivity; emotionally driven impulsivity in particular predicted substance related problems. The fourth study reported significant cognitive impairments at illness onset in a large sample of patients with a first psychotic episode. The fifth paper, investigated the cultural imprint on symptom profile of mood disorders. Culture effect on mood disorder was more prominent in depression than in mania. The last article examined the relations between social circumstances, medical morbidity, locus of control and depression in elderly patients suffering from medical conditions. Overall, the papers describe a wide spectrum of research initiatives in the Arab World that are likely to have implications for global mental health.",0,0 +5073,A one-year follow-up of post-traumatic stress disorder (PTSD) symptoms and perceived social support in cancer,"Aims Diagnosis of post-traumatic stress disorder (PTSD) symptoms in cancer patients fluctuates over the course of cancer according to the timing of assessment. In this longitudinal study, the prevalence of PTSD symptoms and the association between PTSD symptoms and the buffering variable of perceived social support were examined at one year follow-up.",0,0 +5074,Antidepressants: update on new agents and indications.,"A number of antidepressants have emerged in the U.S. market in the past two decades. Selective serotonin reuptake inhibitors have become the drugs of choice in the treatment of depression, and they are also effective in the treatment of obsessive-compulsive disorder, panic disorder, and social phobia. New indications for selective serotonin reuptake inhibitors include post-traumatic stress disorder, premenstrual dysphoric disorder, and generalized anxiety disorder. Extended-release venlafaxine has recently been approved by the U.S. Food and Drug Administration for the treatment of generalized anxiety disorder. Mirtazapine, which is unrelated to the selective serotonin reuptake inhibitors, is unique in its action--stimulating the release of norepinephrine and serotonin. The choice of antidepressant drug depends on the agent's pharmacologic profile, secondary actions, and tolerability. Sexual dysfunction related to the use of antidepressants may be addressed by reducing the dosage, switching to another agent, or adding another drug to overcome the sexual side effects. Augmentation with lithium or triiodothyronine may be useful in patients who are partially or totally resistant to antidepressant treatment. Finally, tapering antidepressant medication may help to avoid discontinuation syndrome or antidepressant withdrawal.",0,0 +5075,Borderline personality disorder subtypes: A factor analysis of the DSM-IV criteria,"This study examined the underlying factor structure of the DSM-IV criteria to determine whether the diagnosis could be classified into subtypes. It also sought to enhance the clinical interpretation of any identified subtypes by examining their relation to comorbid axis I and II disorders. In 95 treatment-seeking adults (82 women, 13 men), attending a psychiatric outpatient clinic principle components analysis yielded support for three subtypes: ‘affect dysregulation’, ‘rejection sensitivity’ and ‘mentalization failure’. Results of logistic regression analyses indicated that the affect dysregulation subtype was associated with the comorbid diagnosis of generalized anxiety and panic disorder and other cluster B and C personality disorders. The mentalization failure subtype was found to be predictive of posttraumatic stress disorder and other cluster B personality disorders. With further research, confirmation of these subtypes may inform diagnostic revisions and appropriate treatment regimes that are individually designed to target the patients' core symptoms. Copyright © 2012 John Wiley & Sons, Ltd.",0,0 +5076,Chronicity in Posttraumatic Stress Disorder and Predictors of the Course of Posttraumatic Stress Disorder Among Primary Care Patients,"The present study examined the course of posttraumatic stress disorder (PTSD) in a sample of 84 primary care patients. More specifically, this study investigated the role of Axis I comorbidity, psychosocial impairment, and treatment participation in the maintenance of an episode of chronic PTSD and whether patients at follow-up met criteria for PTSD (full remission) or continued to exhibit residual PTSD symptoms and impairment (partial PTSD). Diagnostic structured interviews established all clinical diagnoses and information on the course of anxiety disorder symptoms, psychosocial functioning, and treatment status. Using a prospective, longitudinal design, this study found that during the first 2 years of follow-up, the probability of no longer meeting full DSM-IV criteria for PTSD was .69, and .18 for full remission from PTSD. The number of comorbid anxiety disorders and degree of psychosocial impairment at intake were significantly related to remission status (i.e., full and partial PTSD). This study suggests that, in a primary care setting, PTSD is a persistent illness, and that many subjects who have recovered from PTSD continue to suffer from subthreshold symptoms of PTSD.",0,0 +5077,"Acute stress disorder in hospitalised victims of 26/11-terror attack on Mumbai, India.","The 26/11 terror attacks on Mumbai have been internationally denounced. Acute stress disorder is common in victims of terror. To find out the prevalence and to correlate acute stress disorder, 70 hospitalised victims of terror were assessed for presence of the same using DSM-IV TR criteria. Demographic data and clinical variables were also collected. Acute stress disorder was found in 30% patients. On demographic profile and severity of injury, there were some interesting observations and differences between the victims who developed acute stress disorder and those who did not; though none of the differences reached the level of statistical significance. This study documents the occurrence of acute stress disorder in the victims of 26/11 terror attack.",0,0 +5078,Sleep events among veterans with combat-related posttraumatic stress disorder,"Sleep disturbances are important features of posttraumatic stress disorder (PTSD); however, the published data characterizing PTSD sleep phenomena are limited. The authors report on the phenomenology and physiological correlates of symptomatic sleep events in PTSD.The study data included survey results that addressed sleep symptoms during the past month in combat veterans with and without PTSD (N = 58), sleep diary records of awakenings from combat veterans with PTSD hospitalized on an inpatient rehabilitation unit (N = 52), and overnight polysomnography recordings obtained from 21 medication-free combat veterans with PTSD and eight healthy comparison subjects not exposed to combat.Recurrent awakenings, threatening dreams, thrashing movements during sleep, and awakenings with startle or panic features represented the most prevalently reported sleep-related symptoms. Laboratory findings of longer time awake, micro-awakenings, and a trend for patients to exhibit body and limb movements during sleep are consistent with the subjectively reported symptom profile. Prospectively assessed symptomatic awakenings featured startle or panic symptoms or anxiety related to threatening dreams. Laboratory findings revealed a trend for the symptomatic awakenings (with and without dream recall) to be disproportionately preceded by REM sleep, and the two recorded awakenings with objective physiological arousal were preceded by REM.PTSD features intrusions into sleep of more highly aroused behaviors and states, which appear partially conditioned to REM sleep.",0,0 +5079,Is Trauma a Causal Agent of Psychopathologic Symptoms in Posttraumatic Stress Disorder?,"Article Abstract Objective: The diagnosis of posttraumatic stress disorder (PTSD) is unique in that its criteria are embedded with a presumed causal agent, viz, a traumatic event. This assumption has come under scrutiny as a number of recent studies have suggested that many symptoms of PTSD may not necessarily be the result of trauma and may merely represent general psychiatric symptoms that would have existed even in the absence of a trauma event but are subsequently misattributed to it. The current study tests this hypothesis. Method: A case-control twin study conducted between 1996-2001 examined psychopathologic symptoms in a national convenience sample of 104 identical twin pairs discordant for combat exposure in Vietnam, with (n = 50) or without (n = 54) combat-related PTSD (DSM-IV-diagnosed) in the exposed twin. Psychometric measures used were the Symptom Checklist-90-Revised, the Clinician-Administered PTSD Scale, and the Mississippi Scale for Combat-Related PTSD. If a psychopathologic feature represents a factor that would have existed even without traumatic exposure, then there is a high chance that it would also be found at elevated rates in the non-trauma-exposed, identical cotwins of trauma-exposed twins with PTSD. In contrast, if a psychopathologic feature is acquired as a result of an environmental factor unique to the exposed twin, eg, the traumatic event, their cotwins should not have an increased incidence of the feature. Results: Combat veterans with PTSD demonstrated significantly higher scores (P < .0001) on the Symptom Checklist-90-Revised and other psychometric measures of psychopathology than their own combat-unexposed cotwins (and than combat veterans without PTSD and their cotwins). Conclusions: These results support the conclusion that the majority of psychiatric symptoms reported by combat veterans with PTSD would not have been present were it not for their exposure to traumatic events. J Clin Psychiatry Submitted: March 17, 2010; accepted July 8, 2010. Online ahead of print: September 7, 2010 (doi:10.4088/JCP.10m06121blu). Corresponding author: Mark W. Gilbertson, PhD, Department of Research Service, Manchester VA Medical Center, 718 Smyth Rd, Manchester, NH 03104 (mark.gilbertson@va.gov).",0,0 +5080,Psychological distress related to patterns of family functioning among Japanese childhood cancer survivors and their parents,"Family functioning appears to be a predictor of psychological distress among childhood cancer survivors and their family members; however, relatively little is known about patterns in those families that are psychologically at-risk. The purpose of this study was to identify distinct clusters of families that include childhood cancer survivors, and to evaluate differences between the clusters with respect to anxiety, depression, and post-traumatic stress symptoms (PTSS).Childhood cancer survivors and their parents (247 individuals: 88 adolescent cancer survivors, 87 mothers, and 72 fathers) completed self-report questionnaires. Perceptions of family functioning were assessed using the Family Relationship Index and its three dimensions (cohesiveness, expressiveness, and conflict), and individuals were classified into groups via a cluster analytic approach. State-trait anxiety, depression, and PTSS were assessed to all of the participants.The individuals were classified into three types: One cluster featured high cohesiveness, high expressiveness, and low conflict ('Supportive-type', n=102); a second cluster featured low cohesiveness, low expressiveness, and high conflict ('Conflictive-type', n=32); and a third cluster had moderate cohesiveness, moderate expressiveness, and moderate conflict ('Intermediate-type', n=113). Among the three types, an analysis of variance revealed that 'Conflictive-type' members had the highest levels of PTSS, depression, and state-trait anxiety.These findings suggest that perceptions of family functioning are related to psychological distress in family members of childhood cancer survivors. A family-focused intervention might be a useful approach to targeting emotional distress in these families, particularly for families with a 'Conflictive-type' family member.",0,0 +5081,Perpetration of gross human rights violations in South Africa: association with psychiatric disorders.,"A nationally representative study of psychiatric disorders in South Africa provided an opportunity to study the association between perpetration of human rights violations (HRVs) during apartheid and psychiatric disorder. Prior work has suggested an association between perpetration and post-traumatic stress disorder (PTSD), but this remains controversial.Subjects reported on their perpetration of human rights violations, purposeful injury, accidental injury and domestic violence. Lifetime and 12-month prevalence of DSM-IV (Diagnostic and Statistical Manual, 4th edition) disorders were assessed with Version 3.0 of the World Health Organization Composite International Diagnostic Interview (CIDI 3.0). Socio-demographic characteristics of these groups were calculated. Odds ratios for the association between the major categories of psychiatric disorders and perpetration were assessed.HRV perpetrators were more likely to be male, black and more educated, while perpetrators of domestic violence (DV) were more likely to be female, older, married, less educated and with lower income. HRV perpetration was associated with lifetime and 12-month anxiety and substance use disorders, particularly PTSD. Purposeful and DV perpetration were associated with lifetime and 12-month history of all categories of disorders, whereas accidental perpetration was associated most strongly with mood disorders.Socio-demographic profiles of perpetrators of HRV and DV in South Africa differ. While the causal relationship between perpetration and psychiatric disorders deserves further study, it is possible that some HRV and DV perpetrators were themselves once victims. The association between accidental perpetration and mood disorder also deserves further attention.",0,0 +5082,Tiagabine in anxiety disorders,"GABA has been implicated in both the aetiology and treatment of anxiety. Tiagabine is currently the only selective GABA reuptake inhibitor available in US markets; it exerts its action via GAT-1 transporter blockade presynaptically, facilitating GABA neurotransmission. Preclinical studies and current human studies suggest tiagabine possesses anxiolytic properties. The anxiolytic properties of tiagabine have also been suggested in a number of case series, open-label studies and placebo-controlled studies in patients with different anxiety disorders. Throughout these studies, tiagabine has been reasonably tolerated; the most commonly reported adverse events include dizziness, headache and nausea. Tiagabine may be a useful addition to currently available drugs for anxiety; however, the data from small open-label investigations remain to be confirmed in larger controlled studies.",0,0 +5083,The structure of post-traumatic stress disorder and complex post-traumatic stress disorder amongst West Papuan refugees,"The validity of applying the construct of post-traumatic stress disorder (PTSD) across cultures has been the subject of contention. Although PTSD symptoms have been identified across multiple cultures, questions remain whether the constellation represents a coherent construct with an interpretable factor structure across diverse populations, especially those naïve to western notions of mental disorder. An important additional question is whether a constellation of Complex-PTSD (C-PTSD) can be identified and if so, whether there are distinctions between that disorder and core PTSD in patterns of antecedent traumatic events. Our study amongst West Papuan refugees in Papua New Guinea (PNG) aimed to examine the factorial structure of PTSD based on the DSM-IV, DSM-5, ICD-10 and ICD-11 definitions, and C-PTSD according to proposed ICD-11 criteria. We also investigated domains of traumatic events (TEs) and broader psychosocial effects of conflict (sense of safety and injustice) associated with the factorial structures identified.Culturally adapted measures were applied to assess exposure to conflict-related traumatic events (TEs), refugees' sense of safety and justice, and symptoms of PTSD and C-PTSD amongst 230 West Papuan refugees residing in Port Morseby, PNG.Confirmatory factor analysis (CFA) supported a unitary construct of both ICD-10 and ICD-11 PTSD, comprising the conventional symptom subdomains of intrusion, avoidance, and hyperarousal. In contrast, CFA did not identify a unitary construct underlying C-PTSD. The interaction of witnessing murders and sense of injustice was associated with both the intrusion and avoidance domains of PTSD, but not with the unique symptom clusters characterizing C-PTSD.Our findings support the ICD PTSD construct and its three-factor structure in this transcultural refugee population. Traumatic experiences of witnessing murder associated with a sense of injustice were specifically related to the intrusion and avoidance domains of PTSD. The unitary nature of C-PTSD across cultures remains in question.",0,0 +5084,The Relationship Between Posttraumatic Stress Symptoms and Suicide Ideation Among Child Survivors Following the Wenchuan Earthquake,"The association between posttraumatic stress disorder (PTSD) symptoms and suicide ideation was examined in a sample of 2,298 child survivors of the Wenchuan earthquake. Results indicated that intrusion, avoidance, hyperarousal symptom clusters, and PTSD total score were significantly associated with suicide ideation. Except for intrusion, other measures of PTSD remained as statistically significant correlates of suicide ideation even after controlling for age, gender, direct exposure, indirect exposure, and depression. Furthermore, results showed that PTSD symptoms had an indirect influence on suicide ideation that was mediated by depression. The findings suggest that avoidance and hyperarousal symptom clusters of PTSD may be two important indicators of suicide ideation among child survivors of the Wenchuan earthquake. Implications of the results for intervention and prevention of suicide behavior are discussed.",0,0 +5085,Symptoms of the Anxiety Disorders in a Perinatal Psychiatric Sample,"Symptoms of anxiety are a central feature of perinatal mental health, yet the anxiety disorders have received considerably less attention than depression in both perinatal research and practice. The present investigation involved a retrospective review of the clinical records of 334 patients seen at a psychiatric day hospital program serving pregnant and postpartum women. We examined the frequency with which the patients in this setting reported symptoms of anxiety, clinical correlates of elevated anxiety, and patterns of diagnosis in the clinical record. The results suggest that anxiety symptoms are very common in this population and that the presence of anxiety is associated with a more severe clinical profile, including higher rates of suicidality and increased use of psychotropic medications during pregnancy and postpartum. Although anxiety symptom levels were markedly elevated in this sample, anxiety disorders were diagnosed at relatively low rates. Implications for clinical practice, including discharge and treatment planning, are discussed.",0,0 +5086,The Impact of Chronic Hepatitis C and Comorbid Psychiatric Illnesses on Health-related Quality of Life,"To determine the relative impact of chronic hepatitis C (CHC) and comorbid psychiatric illness on the health-related quality of life (HRQoL).Psychiatric conditions are more common among patients with CHC but their relative influence on HRQoL is not well understood.We identified 864 veterans who had previously completed a veteran-specific HRQoL questionnaire (SF-36V) as part of the 1999 VA Large Health Survey with known HCV antibody (anti-HCV) status before the survey. For 201 anti-HCV(+) and 663 anti-HCV(-) patients, we compared the HRQoL status and the prevalence of 6 major psychiatric diagnoses. We conducted multiple regression analyses to measure the effect of anti-HCV status and psychiatric comorbidity.Compared with the anti-HCV(-) group, anti-HCV(+) veterans were more likely to have alcohol dependence (P<0.001), depression (P=0.01), or posttraumatic stress disorder (PTSD) (P<0.004). The anti-HCV(+) group also reported lower HRQoL on 4 of the 8 SF-36V subscales (P<0.01) and the mental component summary scale (P<0.001). Even after adjusting for demographic variables and comorbid psychiatric illness, anti-HCV(+) patients reported a significantly lower mental component summary score (P<0.01) than did anti-HCV(-) patients. Multiple regression analysis found that depression and PTSD predicted lower HRQoL scores for all 8 HRQoL subscales (P<0.01) and both the physical (P<0.001) and mental component (P<0.03) summary scales independent of anti-HCV status.The HRQoL is significantly impaired in veterans with CHC, particularly the mental health components of HRQoL. In contrast, comorbid depression and PTSD are associated with both lower physical and mental components of HRQol, independent of CHC.",0,0 +5087,"Gulf Coast Resilience Coalition: An Evolved Collaborative Built on Shared Disaster Experiences, Response, and Future Preparedness","For close to a decade, the Gulf Coast of the United States has been in almost constant disaster recovery mode, and a number of lessons have been learned concerning disaster recovery and behavioral health. The purpose of this report was to describe the natural development of a Gulf Coast Resilience Coalition (GCRC).The GCRC methods began with state-specific recovery goals following Hurricane Katrina in 2005 and transitioned to a shared multistate and multidiscipline coalition. The coalition's effectiveness is demonstrated through continuation, procurement of funding to provide response services, and increased membership to ensure sustainability.The coalition has enhanced response, recovery, and resilience by providing strategic plans for dissemination of knowledge; post-disaster surveillance and services; effective relationships and communication with local, state, and regional partners; disaster response informed by past experience; a network of professionals and community residents; and the ability to improve access to and efficiency of future behavioral health coordination through an organized response.The GCRC can not only improve readiness and response, but work toward a shared vision of improved overall mental and behavioral health and thus resilience, with beneficial implications for the Gulf South and other communities as well.",0,0 +5088,Clinical characteristics of depressed outpatients previously overdiagnosed with bipolar disorder,"The diagnosis of bipolar disorder in depressed patients requires the ascertainment of prior episodes of mania and hypomania. Several research reports and commentaries have suggested that bipolar disorder is underrecognized and that many patients with nonbipolar major depressive disorder have, in fact, bipolar disorder. In a previous article from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we reported the opposite phenomenon-that bipolar disorder is often overdiagnosed in psychiatric outpatients. An important question that has not been previously examined is whether there is a particular clinical or demographic profile associated with bipolar disorder overdiagnosis among depressed patients. Forty psychiatric outpatients with current major depressive disorder reported having been previously diagnosed with bipolar disorder, which was not confirmed when interviewed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID). Psychiatric diagnoses, clinical and demographic variables were compared in these 40 patients and 233 depressed patients who were not diagnosed with bipolar disorder. Patients were interviewed by a highly trained diagnostic rater who administered the SCID for DSM-IV Axis I disorders, the Structured Interview for DSM-IV Personality for DSM-IV Axis II disorders, and the Schedule for Affective Disorders and Schizophrenia for clinical features of depression. The depressed patients who were overdiagnosed with bipolar disorder were diagnosed with a significantly higher number of Axis I disorders and were more likely to be diagnosed with specific phobia, posttraumatic stress disorder, and drug abuse/dependence. The patients overdiagnosed with bipolar disorder were also significantly more likely to be diagnosed with a current personality disorder and were more chronically ill with greater psychosocial impairment. Thus, the results suggest that depressed outpatients who had previously been overdiagnosed with bipolar disorder were more chronically and severely ill than depressed outpatients who had not been overdiagnosed.",0,0 +5089,"Urban teens: Trauma, posttraumatic growth, and emotional distress among female adolescents.","Urban teens face many traumas, with implications for potential growth and distress. This study examined traumatic events, posttraumatic growth, and emotional distress over 18 months among urban adolescent girls (N = 328). Objectives were to (a) describe types of traumatic events, (b) determine how type and timing of events relate to profiles of posttraumatic growth, and (c) prospectively examine effects of event type and posttraumatic growth on short- and long-term emotional distress with controls for pre-event distress. Results indicate that type of event was related to profiles of posttraumatic growth, but not with subsequent emotional distress. When baseline emotional distress was controlled, posttraumatic growth was associated with subsequent reductions in short- and long-term emotional distress. Implications for future research and clinical practice with adolescents are addressed.",0,0 +5090,Posttraumatic Response and Children Exposed to Parental Violence,"Summary In this article some of the literature on children's responses to natural and person-created trauma are discussed. In addition, data relevant to children's posttraumatic response as a result of exposure to interparental violence are presented. Using a factor analytic procedure, the study attempted to examine how the DSM-IV symptom clusters for Posttraumatic Stress Disorder come together for this sample of children. General suggestions are made regarding possible intervention with exposed children experiencing posttraumatic symptoms.",0,0 +5091,A systematic and conceptual review of posttraumatic stress in childhood cancer survivors and their parents,"Recent years have witnessed a rapid acceleration in the recognition and documentation of posttraumatic stress disorder (PTSD) and posttraumatic stress symptomatology (PTSS) in childhood cancer survivors and their parents. However, applicability of PTSD both diagnostically and conceptually to cancer-related traumatic responses remains poorly articulated within the current literature. Following an outline of childhood cancer and PTSD, this paper critically examines the applicability of such a diagnosis to this clinical population. It then systematically reviews the current evidence base (24 studies) on PTSD and PTSS in childhood cancer survivors and their parents. Prevalence of PTSD and PTSS, as well as associated predictors, in this clinical population varies widely. Findings are considered in the light of a number of contemporary theories of PTSD. Limitations within current conceptualizations of PTSD are highlighted with respect to the nature of cancer as a traumatic event and the specific features of traumatic stress manifestations in childhood cancer survivors and their parents. Finally, a number of pertinent research areas are elucidated which are argued to warrant further investigation.",0,0 +5092,Clinical features of patients with treatment-emergent suicidal behavior following initiation of paroxetine therapy,"Understanding suicidal behavior is an important component of assessing suicidality in psychiatric patients. GlaxoSmithKline (GSK) conducted a meta-analysis of randomized, placebo-controlled trials to compare suicidality in adult patients treated with paroxetine vs. placebo. The goal was to identify emergent clinical characteristics of patients with definitive suicidal behavior (DSB: preparatory act, suicide attempt, completed suicide).The dataset comprised 14,911 patients from 57 placebo-controlled paroxetine trials. Possible cases of suicidality were identified and were blindly reviewed by an expert panel, which categorized cases as suicidal or non-suicidal. DSB incidences were compared between paroxetine and placebo. Clinical narratives and case report forms for major depressive disorder (MDD) and anxiety disorder patients with DSB were reviewed. For MDD, rating scale items relating to suicidality, insomnia, agitation, and anxiety were examined.Overall (all indications) there were no differences between paroxetine and placebo for DSB (50/8958 [0.56%] vs. 40/5953 [0.67%], respectively; OR=1.2 [CI 0.8, 1.9]; p=0.483). However, in patients with major depressive disorder (MDD), the incidence of DSB was greater for paroxetine (11/3455 [0.32%] vs. 1/1978 [0.05%], OR=6.7 [CI 1.1, 149.4]; p=0.058). Review of the 11 paroxetine MDD cases revealed common clinical features: symptomatic improvement; younger age (18-30 years); psychosocial stressors; overdose as method; and absent/mild suicidal ideation at the visit prior to the event. There was no evidence for a consistent adverse event profile or onset of akathisia/agitation or a manic/mixed state. Anxiety disorder patients with DSB had a heterogeneous clinical picture.Limitations to the study include the relatively small number of cases and the retrospective nature of the study.DSB incidence was similar between paroxetine and placebo overall, but a higher frequency of DSB was found for paroxetine in MDD patients, driven by young adults aged < or =30 years. Most MDD patients with DSB improved prior to the attempt and experienced a psychosocial stressor. Patients should receive careful monitoring for suicidality during paroxetine therapy.",0,0 +5093,Five-year outcome after mild head injury: a prospective controlled study,"To study the prevalence of post-concussion symptoms (PCS) 5-7 years after mild head injury (MHI) and to investigate whether patients suffer from more symptoms than the normal population.We conducted a 5- to 7-year follow-up of patients (n = 89) with MHI. Post-concussion symptoms were quantified with the Rivermead Post Concussion Symptoms Questionnaire (RPQ) and health-related quality of life (HRQL) was measured with the EuroQol-5D (EQ-5D). We also quantified subjective general health state with the EuroQol Visual Analogue Scale (EQ-VAS). An age- and sex-matched, but otherwise randomly chosen control group of 89 persons was recruited from the National Population Registry for a cross-sectional comparison. Twenty-eight patients (30%) and 27 (30%) controls responded.Patients reported significantly (P = 0.017) more PCS (median RPQ score 10, 95% CI 2-20) than controls (median 2, 95% CI 0-4). They also reported significantly (P = 0.008) lower HRQL (median EQ-5D score 0.866, 95% CI 0.796-1.000) than controls (1.000, 95% CI 1.000-1.000), but there was no difference between the groups in their subjective ratings of general health state.Patients reported significantly more PCS and lower HRQL 5 to 7 years after MHI than age- and sex-matched controls from the normal population.",0,0 +5094,Developing a function impairment measure for children affected by political violence: a mixed methods approach in Indonesia,"Practitioners in political violence-affected settings would benefit from rating scales that assess child function impairment in a reliable and valid manner when designing and evaluating interventions. We developed a procedure to construct child function impairment rating scales using resources available in low- and middle-income countries.We applied a mixed methods approach. First, rapid ethnographic methods (brief participant observation, collection of diaries and a focus group with children) were used to select daily activities that best represented children's functioning. Second, rating scales based on these activities were examined for their psychometric properties. Construct validity was assessed through a confirmatory factor analysis procedure.Central Sulawesi, Indonesia.Qualitative data were collected for 53 children and psychometric testing was done with 403 children [average age: 9.9 (SD = 1.21), 49% girls] and 385 parents.Using locally available resources, we developed separate child-rated and parent-rated scales, both containing 11 items. The child-rated scale evidenced good internal, test-retest and inter-rater reliability and acceptable convergent and discriminant validity. Construct validity was confirmed by fit of the theorized factor structure-a social-ecological clustering of daily activities.The procedure resulted in a reliable and valid rating scale to assess child function impairment in the context of political violence. Practitioners can apply this procedure to develop new locally adequate rating scales to strengthen epidemiological surveys, baseline assessments, monitoring and evaluation and eventually, interventions. Further research should address the importance of gender differences and criterion-related validity.",0,0 +5095,Vulnerability Factors in the Explanation of Workplace Aggression: The Construction of a Theoretical Framework,"Although workplace aggression is a well-known problem, research on workplace aggression merely focuses on perpetrators' typologies, and workplace-related victim research remains under-represented. In this article, we theoretically explore possible associations between victims' coping strategies, type-D personality, negative childhood experiences, attention-deficit/hyperactivity disorder, and posttraumatic stress disorder and work-related victimization. Through an intensive literature study and the incorporation of existing theories, under which is the precipitation theory, we develop a theoretical framework of vulnerability factors for experiencing workplace violence. Future directions of this theoretical framework and practical implications of the results after empirically exploring the theoretical pathways are suggested.",0,0 +5096,Exploration of a Factor Mixture-Based Taxonic-Dimensional Model of Anxiety Sensitivity and Transdiagnostic Psychopathology Vulnerability Among Trauma-Exposed Adults,"The aim of this study was to evaluate the associations between a factor mixture-based taxonic-dimensional model of anxiety sensitivity (AS) and posttraumatic stress, panic, generalized anxiety, depression, psychiatric multimorbidity, and quality of life among a young adult sample exposed to traumatic stress (N = 103, n (females) = 66, M (age) = 23.68 years, SD (age) = 9.55). Findings showed support for the conceptual and operational utility of the AS taxonic-dimensional model with respect to concurrent transdiagnostic vulnerability among trauma-exposed adults. Specifically, relative to the low-AS group, the high-AS group demonstrated elevated levels of panic, depressive, and posttraumatic stress symptom severity as well as greater psychiatric multimorbidity and poorer quality of life. Furthermore, past-month MDD, GAD, PTSD, and panic attacks occurred nearly exclusively among the high-AS group. Continuous AS physical and psychological concerns scores were found to be significantly related to levels of panic and posttraumatic stress symptom severity, psychiatric multimorbidity as well as panic attack status only among the high-AS group and not among the low-AS group. Findings are discussed with respect to their implications for the conceptual and operational utility of the FMM-based taxonic-dimensional model of AS, related vulnerability for psychopathology in the context of trauma, and the clinical implications of these findings for assessment and intervention.",0,0 +5097,Psychometric detection of fabricated symptoms of combat-related post-traumatic stress disorder: A systematic replication,Vietnam veterans with post-traumatic stress disorder (n = 11) and two other groups of Vietnam veterans (n = 24) instructed to fabricate symptoms of post-traumatic stress disorder completed the MMPI. A discriminant function analysis that used scale F and the post-traumatic stress disorder subscale correctly classified 91% of the subjects. This systematic replication supports the utility of the MMPI as a component in evaluating the validity of self-reported symptoms of post-traumatic stress disorder in Vietnam veterans.,0,0 +5098,Latent class differences explain variability in PTSD symptom changes during cognitive processing therapy for veterans.,"Despite demonstrated effectiveness of cognitive-behavioral psychotherapies for posttraumatic stress disorder (PTSD), there is limited research on the trajectory of PTSD symptom change during the course of these therapies. In addition, existent findings are mixed, making it difficult to know how individuals' PTSD symptoms will change from week to week during psychotherapy. The study presented here uses general growth mixture modeling (GGMM) to test the hypothesis that multiple latent classes will explain individual differences in PTSD symptom change during the course of cognitive processing therapy (CPT). Participants were 207 U.S. military veterans with PTSD who received CPT through an outpatient Veterans Affairs PTSD treatment program. Participants were mostly male (89%), White (81%), and averaged 42 years old. The PTSD Checklist (PCL), Clinician-Administered PTSD Scale (CAPS), and the Beck Depression Inventory-II (BDI-II) were administered at pre- and posttreatment; the PCL was also administered weekly to assess PTSD symptom changes during CPT. GGMM showed that a quadratic growth model with three distinct latent classes best explained the trajectory of PTSD symptom reductions during CPT. The following variables significantly predicted latent class membership: age; ethnicity; having combat as the worst trauma; and pretreatment PCL, CAPS, and BDI-II scores. In turn, class membership significantly predicted posttreatment PCL, BDI-II, and CAPS scores. This study is novel in showing that latent class differences in PTSD symptom reductions are useful in explaining why individuals exhibit variable rates of PTSD symptom change during psychotherapy and differing outcomes after psychotherapy. These findings may improve the ability to more accurately anticipate individual differences in PTSD symptom changes and responses to psychotherapy. © 2012 American Psychological Association.",0,0 +5099,Mental Health and Psychosocial Support after the Great East Japan Earthquake,"Since the Great East Japan Earthquake, Keio University School of Medicine has, at the request of the Tokyo Metropolitan Government, provided mental health and psychosocial support to those living in Soma City in Fukushima Prefecture. This report covers the types of support provided in Soma City and discusses previous studies that were used as the model for current support practice and the results gained from actual performance. Also included is a summary of the objectives that were or were not achieved for medical support compared with recommendations from previous studies. Furthermore, future directions for medical support are also discussed.",0,0 +5100,Factual memories of ICU: recall at two years post-discharge and comparison with delirium status during ICU admission - a multicentre cohort study,"Aims and objective. To examine the relationship between observed delirium in ICU and patients’ recall of factual events up to two years after discharge. Background. People, the environment, and procedures are frequently cited memories of actual events encountered in ICU. These are often perceived as stressors to the patients and the presence of several such stressors has been associated with the development of reduced health-related quality of life or post-traumatic stress syndrome. Design. Prospective cohort study using interview technique. Method. The cohort was assembled from 152 patients who participated in a previously conducted multi-centre study of delirium incidence in Australian ICUs. The interviews involved a mixture of closed- and open-ended questions. Qualitative responses regarding factual memories were analysed using thematic analysis. A five-point Likert scale with answers from ‘always’ to ‘never’ was used to ask about current experiences of dream, anxiety, sleep problems, fears, irritability and/or mood swings. Scoring ranged from 6 to 30 with a mid-point value of 18 indicating a threshold value for the diagnosis of post-traumatic stress syndrome. A P-value of <0·05 was considered significant for all analyses. Results. Forty-one (40%) out of 103 potential participants consented to take part in the follow-up interview; 18 patients (44%) had been delirious and 23 patients (56%) non-delirious during the ICU admission. The non-participants (n = 62) formed a control group to ensure a representative sample; 83% (n = 34) reported factual memories either with or without recall of dreaming. Factual memories were significantly less common (66% cf. 96%) in delirious patients (OR 0·09, 95%CI 0·01–0·85, p = 0·035). Five topics emerged from the thematic analysis: ‘procedures’, ‘staff’, ‘comfort’, ‘visitors’, and ‘events’. Based on the current experiences, five patients (12%, four non-delirious and one delirious) scored ≥18 indicative of symptoms of post-traumatic stress syndrome; this did not reach statistical significance. Memory of transfer out of ICU was less frequent among the delirious patients (56%, n = 10) than among the non-delirious patients (87%, n = 20) (p = 0·036). Conclusion. Most patients have factual memories of their ICU stay. However, delirious patients had significantly less factual recall than non-delirious patients. Adverse psychological sequelae expressed as post-traumatic stress syndrome was uncommon in our study. Every attempt must be made to ensure that the ICU environment is as hospitable as possible to decrease the stress of critical illness. Post-ICU follow-up should include filling in the ‘missing gaps’, particularly for delirious patients. Ongoing explanations and a caring environment may assist the patient in making a complete recovery both physically and mentally. Relevance to clinical practice. This study highlights the need for continued patient information, re-assurance and optimized comfort. While health care professionals cannot remove the stressors of the ICU treatments, we must minimize the impact of the stay. It must be remembered that most patients are aware of their surroundings while they are in the ICU and it should, therefore, be part of ICU education to include issues regarding all aspects of patient care in this particularly vulnerable subset of patients to optimize their feelings of security, comfort and self-respect.",0,0 +5101,Enhanced Dexamethasone Suppression of Plasma Cortisol in Adult Women Traumatized by Childhood Sexual Abuse,"A study was undertaken to determine if female survivors of childhood and/or adolescent sexual abuse (CSA) would exhibit hypothalamic-pituitary-adrenal (HPA) axis abnormalities characteristic of patients with combat-related posttraumatic stress disorder (PTSD)--i.e., enhanced cortisol suppression to low-dose dexamethasone and increased density of lymphocyte glucocorticoid receptors. Nineteen women who reported experiencing severe CSA and 21 nonvictimized women participated in a low-dose (0.5 mg) dexamethasone suppression test and donated blood for measurement of lymphocyte glucocorticoid receptor binding. Women with CSA had significantly enhanced suppression of plasma cortisol in response to 0.5 mg dexamethasone compared to the nonvictimized women. These observations are consistent with findings in male veterans with combat-related PTSD. They suggest that this pattern of HPA axis dysfunction may be a characteristic sequel of psychiatric disorders that occur following a range of traumatic experiences. This HPA axis profile is different than that associated with acute stress or with major depressive disorder.",0,0 +5102,"Emotional Distress Intolerance, Experiential Avoidance, and Anxiety Sensitivity: The Buffering Effect of Attentional Control on Associations with Posttraumatic Stress Symptoms","A number of individual difference factors, including emotional distress intolerance (EDI), experiential avoidance (EA), and anxiety sensitivity (ASI), have been implicated in the development and maintenance of posttraumatic stress (PTS) symptomatology. Attentional control (AC) has been shown to serve as a protective factor against the development of maladaptive psychological outcomes across a number of studies, even among those with outcome-specific vulnerabilities. The purpose of the present study was to examine AC as a moderator of the relations between three constructs pertaining to the way that people relate to their internal experiences (i.e., EDI, EA, AS) and PTS symptoms among a trauma exposed community sample (N = 903). As predicted, AC moderated the relations between each individual difference factor and PTS symptoms, such that as attentional control decreased, the strength of the association between each individual difference factor and PTS symptoms increased. Study results suggest that AC abilities may be one factor that differentiates those who recover from trauma from those who do not, even among those who may be vulnerable for developing PTS symptomatology. Clinical implications and results of a PTS cluster level analysis will be discussed.",0,0 +5103,The 2003 Heat Wave in France: Dangerous Climate Change Here and Now,"In an analysis of the French episode of heat wave in 2003, this article highlights how heat wave dangers result from the intricate association of natural and social factors. Unusually high temperatures, as well as socioeconomic vulnerability, along with social attenuation of hazards, in a general context where the anthropogenic contribution to climate change is becoming more plausible, led to an excess of 14,947 deaths in France, between August 4 and 18, 2003. The greatest increase in mortality was due to causes directly attributable to heat: dehydration, hyperthermia, heat stroke. In addition to age and gender, combinatorial factors included preexisting disease, medication, urban residence, isolation, poverty, and, probably, air pollution. Although diversely impacted or reported, many parts of Europe suffered human and other losses, such as farming and forestry through drought and fires. Summer 2003 was the hottest in Europe since 1500, very likely due in part to anthropogenic climate change. The French experience confirms research establishing that heat waves are a major mortal risk, number one among so-called natural hazards in postindustrial societies. Yet France had no policy in place, as if dangerous climate were restricted to a distant or uncertain future of climate change, or to preindustrial countries. We analyze the heat wave's profile as a strongly attenuated risk in the French context, as well as the causes and the effects of its sudden shift into amplification. Research and preparedness needs are highlighted.",0,0 +5104,Epidemiology of Trauma and Posttraumatic Stress Disorder in Mexico.,"Prevalence rates of trauma and posttraumatic stress disorder (PTSD) were estimated from a probability sample of 2,509 adults from 4 cities in Mexico. PTSD was assessed according to Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) criteria using the Composite International Diagnostic Interview (CIDI; WHO, 1997). Lifetime prevalence of exposure and PTSD were 76% and 11.2%, respectively. Risk for PTSD was highest in Oaxaca (the poorest city), persons of lower socioeconomic status, and women. Conditional risk for PTSD was highest following sexual violence, but nonsexual violence and traumatic bereavement had greater overall impact because of their frequency. Of lifetime cases, 62% became chronic; only 42% received medical or professional care. The research demonstrates the importance of expanding the epidemiologic research base on trauma to include developing countries around the world.",0,0 +5105,EMOTION REGULATION IN MOTHERS AND YOUNG CHILDREN FACED WITH TRAUMA,"The present study investigated maternal emotion regulation as mediating the association between maternal posttraumatic stress symptoms and children's emotional dysregulation in a community sample of 431 Israeli mothers and children exposed to trauma. Little is known about the specific pathways through which maternal posttraumatic symptoms and deficits in emotion regulation contribute to emotional dysregulation. Inspired by the intergenerational process of relational posttraumatic stress disorder (PTSD), in which posttraumatic distress is transmitted from mothers to children, we suggest an analogous concept of relational emotion regulation, by which maternal emotion regulation problems may contribute to child emotion regulation deficits. Child emotion regulation problems were measured using the Child Behavior Checklist-Dysregulation Profile (CBCL-DP; T.M. Achenbach & I. Rescorla, 2000), which is comprised of three subscales of the CBCL: Attention, Aggression, and Anxiety/Depression. Maternal PTSD symptoms were assessed by the Posttraumatic Diagnostic Scale (E.B. Foa, L. Cashman, L. Jaycox, & K. Perry, 1997) and maternal emotion regulation by the Difficulties in Emotion Regulation Scale (K.L. Gratz & L. Roemer, 2004). Results showed that the child's emotion regulation problems were associated with both maternal posttraumatic symptoms and maternal emotion dysregulation. Further, maternal emotion regulation mediated the association between maternal posttraumatic symptoms and the child's regulation deficits. These findings highlight the central role of mothers' emotion regulation skills in the aftermath of trauma as it relates to children's emotion regulation skills. The degree of mothers' regulatory skills in the context of posttraumatic stress symptoms reflects a key process through which the intergenerational transmission of trauma may occur. Study results have critical implications for planning and developing clinical interventions geared toward the treatment of families in the aftermath of trauma and, in particular, the enhancement of mothers' emotion regulation skills after trauma.",0,0 +5106,Longitudinal trajectories of post-traumatic stress disorder symptoms among adolescents after the Wenchuan earthquake in China,"Background This study examines the patterns and predictors of post-traumatic stress disorder (PTSD) symptom trajectories among adolescent survivors following the Wenchuan earthquake in China. Method A total of 1573 adolescent survivors were followed up at 6, 12, 18 and 24 months post-earthquake. Participants completed the Posttraumatic Stress Disorder Self-Rating Scale (PTSD-SS), Adolescent Self-Rating Life Events Checklist, Social Support Rate Scale, and the Simplified Coping Style Questionnaire. Distinct patterns of PTSD symptom trajectories were established through grouping participants based on time-varying changes of developing PTSD (i.e. reaching the clinical cut-off on the PTSD-SS). Multivariate logistic regressions were used to examine predictors for trajectory membership. Results PTSD prevalence rates at 6, 12, 18 and 24 months were 21.0, 23.3, 13.5 and 14.7%, respectively. Five PTSD symptom trajectories were observed: resistance (65.3% of the sample), recovery (20.0%), relapsing/remitting (3.3%), delayed dysfunction (4.2%) and chronic dysfunction (7.2%). Female gender and senior grade were related to higher risk of developing PTSD symptoms in at least one time point, whereas being an only child increased the possibility of recovery relative to chronic dysfunction. Family members’ injury/loss and witness of traumatic scenes could also cause PTSD chronicity. More negative life events, less social support, more negative coping and less positive coping were also common predictors for not developing resistance or recovery. Conclusions Adolescents’ PTSD symptoms showed an anniversary reaction. Although many adolescents remain euthymic or recover over time, some adolescents, especially those with the risk factors noted above, exhibit chronic, delayed or relapsing symptoms. Thus, the need for individualized intervention with these adolescents is indicated.",0,0 +5107,Splintered memories or vivid landmarks? Qualities and organization of traumatic memories with and without PTSD,"SUMMARY One hundred and eighty-one students answered a standardized questionnaire on Post-Traumatic Stress Disorder (PTSD): 25 reported trauma(s) and indicated a pattern of after-effects that matched a PTSD symptom profile, whereas 88 indicated trauma(s) but no PTSD symptom profile. Both groups answered a questionnaire addressing the recollective quality, integration and coherence of the traumatic memory that currently affected them most. Participants with a PTSD symptom profile reported more vivid recollection of emotion and sensory impressions. They reported more observer perspective in the memory (seeing themselves ‘from the outside’), but no more fragmentation. They also agreed more with the statement that the trauma had become part of their identity, and perceived more thematic connections between the trauma and current events in their lives. The two groups showed different patterns of correlations which indicated different coping styles. Overall, the findings suggest that traumas form dysfunctional reference points for the organization of other personal memories in people with PTSD symptoms, leading to fluctuations between vivid intrusions and avoidance. Copyright # 2003 John Wiley & Sons, Ltd.",0,0 +5108,Complex posttraumatic stress disorder: evidence from the primary care setting,"Sexual abuse is a common problem among female primary care medical patients. There is a wide spectrum of long-term sequelae, ranging from mild to the complex symptom profiles consistent with the theories of a posttraumatic sense of identity. Generally, the latter occurs in the context of severe, chronic abuse, beginning in childhood and often compounded by the presence of violence, criminal behavior, and substance abuse in the family of origin. In this study we search for empirical evidence for the existence of a complex posttraumatic stress syndrome in 99 women patients at 3 family practice outpatient clinics who report a history of sexual abuse. A structured interview was administered by trained female interviewers to gather data on family history and psychiatric symptoms and diagnoses. Empirical evidence from cluster analysis of the data supports the theory of a complex posttraumatic syndrome. The severity gradient based on symptoms roughly parallels the severity gradient based on childhood abuse and sociopathic behavior and violence in the family of origin, with the most severely abused subjects characterized by symptom patterns that fit the description of a complex posttraumatic stress syndrome.",0,0 +5109,Virtual Reality Exposure Therapy for Vietnam Veterans With Posttraumatic Stress Disorder,"Virtual reality (VR) integrates real-time computer graphics, body-tracking devices, visual displays, and other sensory input devices to immerse a participant in a computer-generated virtual environment that changes in a natural way with head and body motion. VR exposure (VRE) is proposed as an alternative to typical imaginal exposure treatment for Vietnam combat veterans with posttraumatic stress disorder (PTSD).This report presents the results of an open clinical trial using VRE to treat Vietnam combat veterans who have DSM-IV PTSD. In 8 to 16 sessions, 10 male patients were exposed to 2 virtual environments: a virtual Huey helicopter flying over a virtual Vietnam and a clearing surrounded by jungle.Clinician-rated PTSD symptoms as measured by the Clinician Administered PTSD Scale, the primary outcome measure, at 6-month follow-up indicated an overall statistically significant reduction from baseline (p = .0021) in symptoms associated with specific reported traumatic experiences. All 8 participants interviewed at the 6-month follow-up reported reductions in PTSD symptoms ranging from 15% to 67%. Significant decreases were seen in all 3 symptom clusters (p < .02). Patient self-reported intrusion symptoms as measured by the Impact of Event Scale were significantly lower (p < .05) at 3 months than at baseline but not at 6 months, although there was a clear trend toward fewer intrusive thoughts and somewhat less avoidance.Virtual reality exposure therapy holds promise for treating PTSD in Vietnam veterans.",0,0 +5110,Behavior and the Law Reconsidered: Psychological Syndromes and Profiles,"Recently, a new concept of behavior and the law has emerged which looks beyond the defendant's satisfaction of the elements which define the charge. This formulation, which considers not simply the objective facts but motive, intent, and circumstance, has marked a legal shift from diminished capacity to diminished responsibility. Still in evolution, this trend has challenged the relationship between law and the behavioral sciences, and prompted serious reconsideration of the role of each. This paper examines the landmarks of the movement, considers its implications, and looks to the future.",0,0 +5111,The validity of the Hospital Anxiety and Depression Scale,"To review the literature of the validity of the Hospital Anxiety and Depression Scale (HADS).A review of the 747 identified papers that used HADS was performed to address the following questions: (I) How are the factor structure, discriminant validity and the internal consistency of HADS? (II) How does HADS perform as a case finder for anxiety disorders and depression? (III) How does HADS agree with other self-rating instruments used to rate anxiety and depression?Most factor analyses demonstrated a two-factor solution in good accordance with the HADS subscales for Anxiety (HADS-A) and Depression (HADS-D), respectively. The correlations between the two subscales varied from.40 to.74 (mean.56). Cronbach's alpha for HADS-A varied from.68 to.93 (mean.83) and for HADS-D from.67 to.90 (mean.82). In most studies an optimal balance between sensitivity and specificity was achieved when caseness was defined by a score of 8 or above on both HADS-A and HADS-D. The sensitivity and specificity for both HADS-A and HADS-D of approximately 0.80 were very similar to the sensitivity and specificity achieved by the General Health Questionnaire (GHQ). Correlations between HADS and other commonly used questionnaires were in the range.49 to.83.HADS was found to perform well in assessing the symptom severity and caseness of anxiety disorders and depression in both somatic, psychiatric and primary care patients and in the general population.",0,0 +5112,Post-Traumatic Stress Disorder in U.S. Soldiers With Post-Traumatic Headache,"To determine the impact of post-traumatic stress disorder (PTSD) on headache characteristics and headache prognosis in U.S. soldiers with post-traumatic headache.PTSD and post-concussive headache are common conditions among U.S. Army personnel returning from deployment. The impact of comorbid PTSD on the characteristics and outcomes of post-traumatic headache has not been determined in U.S. Army soldiers.A retrospective cohort study was conducted among 270 consecutive U.S. Army soldiers diagnosed with post-traumatic headache at a single Army neurology clinic. All subjects were screened for PTSD at baseline using the PTSD symptom checklist. Headache frequency and characteristics were determined for post-traumatic headache subjects with and without PTSD at baseline. Headache measures were reassessed 3 months after the baseline visit, and were compared between groups with and without PTSD.Of 270 soldiers with post-traumatic headache, 105 (39%) met screening criteria for PTSD. There was no significant difference between subjects with PTSD and those without PTSD with regard to headache frequency (17.2 vs 15.7 headache days per month; P = .15) or chronic daily headache (58.1% vs 52.1%; P = .34). Comorbid PTSD was associated with higher headache-related disability as measured by the Migraine Disability Assessment Score. Three months after the baseline neurology clinic visit, the number of subjects with at least 50% reduction in headache frequency was similar among post-traumatic headache cases with and without PTSD (25.9% vs 26.8%).PTSD is prevalent among U.S. Army soldiers with post-traumatic headache. Comorbid PTSD is not associated with more frequent headaches or chronic daily headache in soldiers evaluated at a military neurology clinic for chronic post-traumatic headache. Comorbid PTSD does not adversely affect short-term headache outcomes, although prospective controlled trials are needed to better assess this relationship.",0,0 +5113,Risk factors in combat stress reaction--a study of Israeli soldiers in the 1982 Lebanon war.,"Identification des variables demographiques, militaires et de personnalite susceptibles d'etre predicteur de reactions de stress au combat. Les comparaisons des donnees concernant les blessures physiques et les atteintes psychiques lors de la guerre du Liban en 1982 indiquent qu'il existe des degres variables de vulnerabilite au stress du combattant. On esquisse un profil composite type du soldat a haut risque",0,0 +5114,I'll be working my way back: A qualitative synthesis on the trauma experience of children.,"Children who experience some kind of traumatic event, such as losing a sibling, witnessing war, or being the victim of abuse or an accident, all have the need to process this event. Few theories exist about the development of posttraumatic stress disorder, specifically in traumatized children. Therefore, a synthesis of qualitative research is conducted in which the available qualitative studies on the children’s perspective on traumatic experiences are integrated. A total of 17 English-language peer-reviewed articles were selected and a thematic synthesis was carried out. The core themes in the findings pertain to three domains: the individual, the family, and the community. We found a qualitative synthesis beneficial for creating a complete picture of children dealing with trauma and for strengthening the emerging theory. (aut. ref.)",0,0 +5115,Risk factors predict post-traumatic stress disorder differently in men and women,"About twice as many women as men develop post-traumatic stress disorder (PTSD), even though men as a group are exposed to more traumatic events. Exposure to different trauma types does not sufficiently explain why women are more vulnerable.The present work examines the effect of age, previous trauma, negative affectivity (NA), anxiety, depression, persistent dissociation, and social support on PTSD separately in men and women. Subjects were exposed to either a series of explosions in a firework factory near a residential area or to a high school stabbing incident.Some gender differences were found in the predictive power of well known risk factors for PTSD. Anxiety predicted PTSD in men, but not in women, whereas the opposite was found for depression. Dissociation was a better predictor for PTSD in women than in men in the explosion sample but not in the stabbing sample. Initially, NA predicted PTSD better in women than men in the explosion sample, but when compared only to other significant risk factors, it significantly predicted PTSD for both men and women in both studies. Previous traumatic events and age did not significantly predict PTSD in either gender.Gender differences in the predictive value of social support on PTSD appear to be very complex, and no clear conclusions can be made based on the two studies included in this article.",0,0 +5116,Estimating post-traumatic stress disorder in the community: lifetime perspective and the impact of typical traumatic events,"Background. Community surveys have assessed post-traumatic stress disorder (PTSD) in relation to traumatic events designated by respondents as the worst they have ever experienced. An assessment of PTSD in relation to all reported traumas would impose too great a burden on respondents, a considerable proportion of whom report multiple traumas. The ‘worst event’ method is efficient for identifying persons with PTSD, but may overestimate the conditional probability of PTSD associated with the entire range of PTSD-level traumas. In this report, we evaluate this potential bias. Method. The Detroit Area Survey of Trauma ( n =2181) estimated the PTSD risk from two samples of traumas: (1) a representative sample of traumas formed by selecting a random trauma from each respondent's list of traumas; and (2) traumas designated by respondents as the worst (the standard method). Results. Both estimation methods converged on key findings, including identifying trauma types with the highest probability of PTSD and sex differences in the risk of PTSD. Compared to the random events, the ‘worst event’ method yielded a moderately higher conditional probability for PTSD (0·136 v . 0·092). The bias was due almost entirely to the deviation of the distribution of the worst events from expected values, if all event types had equal prior selection probabilities. Direct adjustment, setting the distribution equal to expected values and applying the observed probabilities of PTSD associated with individual event types brought the estimate close to the unbiased estimate, based on the randomly selected traumas. Conclusions. Only the ‘worst event’ method can be used as a short-cut to assessing all traumas. The bias in the estimated risk of PTSD is modest and is attenuated by direct adjustment.",0,0 +5117,The effectiveness of anticonvulsants in psychiatric disorders,"Anticonvulsant drugs are widely used in psychiatric indications. These include mainly alcohol and benzodiazepine withdrawal syndromes, panic and anxiety disorders, dementia, schizophrenia, affective disorders, bipolar affective disorders in particular, and, to some extent, personality disorders. A further area in which neurology and psychiatry overlap is pain conditions, in which some anticonvulsants, and also typical psychiatric medications such as antidepressants, are helpful. From the beginning of their psychiatric use, anticonvulsants have also been used to ameliorate specific symptoms of psychiatric disorders independently of their causality and underlying illness, eg, aggression, and, more recently, cognitive impairment, as seen in affective disorders and schizophrenia. With new anticonvulsants currently under development, it is likely that their use in psychiatry will further increase, and that psychiatrists need to learn about their differential efficacy and safety profiles to the same extent as do neurologists.",0,0 +5118,DEATH ANXIETY AS A PREDICTOR OF POSTTRAUMATIC STRESS LEVELS AMONG INDIVIDUALS WITH SPINAL CORD INJURIES,"Because the onset of a spinal cord injury may involve a brush with death and because serious injury and disability can act as a reminder of death, death anxiety was examined as a predictor of posttraumatic stress levels among individuals with disabilities. This cross-sectional study used multiple regression and multivariate multiple regression to examine whether death denial and death awareness predicted posttraumatic stress disorder (PTSD) among veterans and civilians with spinal cord injuries (N = 313). The results indicated that death anxiety (after controlling for demographic and disability-related variables) predicted a significant amount of the total levels of posttraumatic stress reactions among individuals with spinal cord injuries. Further, death awareness, pain level, and spiritual/religious coping significantly predicted the posttraumatic stress clusters of reexperiencing, avoidance, and hyperarousal. Death denial significantly predicted only hyperarousal. Because death anxiety predicts various aspects of PTSD reactions, one possible therapeutic implication is that addressing death-related topics may help to reduce PTSD reactions. Further research is needed to better ascertain the possible causality among these variables.",0,0 +5119,Coping style use predicts posttraumatic stress and complicated grief symptom severity among college students reporting a traumatic loss.,"Problem-focused coping, and active and avoidant emotional coping were examined as correlates of grief and posttraumatic stress disorder (PTSD) severity among 123 college students reporting the unexpected death of an immediate family member, romantic partner, or very close friend. The authors administered to participants, via the Internet, 5 survey instruments that measured demographic characteristics, traumatic event exposure (Stressful Life Events Screening Questionnaire; L. Goodman, C. Corcoran, K. Turner, N. Yuan, & B. L. Green, 1998), complicated grief (CG) severity (Inventory of Complicated Grief-Revised-Short Form; A. E. Latham & H. G. Prigerson, 2004; H. G. Prigerson & S. C. Jacobs, 2001), PTSD severity (PTSD Checklist; F. W. Weathers, B. T. Litz, D. S. Herman, J. A. Huska, & T. M. Keane, 1993), and coping style use (Brief COPE; C. S. Carver, 1997). Results demonstrated that CG and PTSD severity were both significantly positively correlated with problem-focused, and active and avoidant emotional coping styles. The authors used path analysis to control for time since the loss and trauma frequency and found that only avoidant emotional coping remained significant in predicting CG and PTSD severity. Results are discussed in terms of their clinical implications for treating individuals with traumatic losses.",0,0 +5120,Age and emotional response to the Northridge earthquake: A longitudinal analysis.,"Cross-sectional studies have found older adults to have lower levels of emotional distress after natural disasters. The maturation hypothesis suggests that older adults are less reactive to stress events, whereas the inoculation hypothesis argues that prior experience with disaster is protective. One hundred and sixty-six adults aged 30 to 102 were interviewed regarding the 1994 Northridge earthquake. Longitudinal data were available on depressed mood before and after the earthquake. The maturation hypothesis was generally not supported. The young-old were least depressed; however, this age difference was present prior to the earthquake. The old-old showed lowest levels of earthquake-specific rumination, but age did not buffer the relationship between damage exposure and rumination. The inoculation hypothesis was supported for depressed mood. Prior earthquake experience was related to lower postearthquake depression scores.",0,0 +5121,Blood pressure among immigrants to Israel from areas affected by the Chernobyl disaster.,"OBJECTIVES: To validate and analyze apparent association of hypertension with exposures to radiation at Chernobyl among immigrants to Israel from the contaminated areas. METHODS: Data were collected in 1991 and 1994 from two samples of persons who immigrated to Israel from the contaminated zone around the Chernobyl nuclear power plant. The first sample were self-referred for evaluation in a clinic by whole-body cesium measurement, physical examination, and questionnaire (N = 756, 328 from less exposed and 438 from more exposed areas). The second wave data were collected in 1994 during home interviews for evaluation of psychosocial factors associated with their experience (N = 708, 121 from more exposed and 253 from less exposed areas). In the second study a referent group was included (n = 334) who were matched by age, sex, and year of immigration who immigrated from other areas outside of the contaminated zone. Estimates of exposure were based on the IAEA map of ground-level cesium isotope (137Cs) contamination. RESULTS: In the 1991 sample, 21% from high exposure areas and 16% from less exposed areas had elevated systolic blood pressure (> 140 mmHg). Elevated diastolic blood pressure (> 90 mmHg) had a similar difference between more and less exposed groups (21% and 16%). Age- and sex-specific analyses showed that statistically different levels were found in the older age groups. In the 1994 sample, we confirmed a relationship between exposure and elevated blood pressure. 33% of those from the more exposed areas and 34% of those from less exposed areas had elevated systolic blood pressure, compared with 23% of the comparison group, with a similar trend found in diastolic blood pressure. The relationship between exposure and blood pressure was accentuated in the group of respondents who had high scores on PTSD symptoms. Of the psychological variables analyzed, systolic blood pressure was most strongly related to cancer-related anxiety and somatization. A discriminant function analysis showed that three variables: age, reporting a significant loss from the Chernobyl accident, and fear of cancer correctly differentiated 72% of those with normal and high blood pressure. CONCLUSIONS: There is a relationship between exposure to Chernobyl and high blood pressure, partly due to the psychological reactions to the accident.",0,0 +5122,Sleep disturbances predict later trauma-related distress: Cross-panel investigation amidst violent turmoil.,"Sleep disturbances, including trouble falling and remaining asleep and recurrent nightmares, are symptoms of posttraumatic stress. A growing body of literature indicates that sleep disturbance may also convey vulnerability for the continuation of other symptoms of posttraumatic stress, including fear, anxiety, and heightened arousal. However, longitudinal research, which could help understand how these relationships unfold over time, has been limited.The longitudinal relationships between sleep disturbance and posttraumatic stress were investigated in 779 Palestinian adults randomly selected and interviewed twice during the period from April 2008 to November 2008, amid ongoing violent political turmoil. The recruitment method produced a representative sample and excellent retention. Cross-panel structural equation modeling was used to examine relationships between sleep and distress across two study periods.Results indicated that initial sleep problems were associated with increased posttraumatic stress disorder (PTSD), depression, and intrapersonal resource loss at follow-up 6 months later, but initial PTSD, depression, and intrapersonal resource loss were not associated with increased sleep problems at follow-up.Sleep problems may confer vulnerability to longer-term distress in the presence of ongoing political violence. Future research should examine whether interventions targeting trauma-related sleep problems may improve prevention and treatment for PTSD and related disorders.",0,0 +5123,Trajectory of post-traumatic stress following traumatic injury: 6-year follow-up,"Background Traumatic injuries affect millions of patients each year, and resulting post-traumatic stress disorder (PTSD) significantly contributes to subsequent impairment. Aims To map the distinctive long-term trajectories of PTSD responses over 6 years by using latent growth mixture modelling. Method Randomly selected injury patients ( n = 1084) admitted to four hospitals around Australia were assessed in hospital, and at 3, 12, 24 and 72 months. Lifetime psychiatric history and current PTSD severity and functioning were assessed. Results Five trajectories of PTSD response were noted across the 6 years: (a) chronic (4%), (b) recovery (6%), (c) worsening/recovery (8%), (d) worsening (10%) and (e) resilient (73%). A poorer trajectory was predicted by female gender, recent life stressors, presence of mild traumatic brain injury and admission to intensive care unit. Conclusions These findings demonstrate the long-term PTSD effects that can occur following traumatic injury. The different trajectories highlight that monitoring a subset of patients over time is probably a more accurate means of identifying PTSD rather than relying on factors that can be assessed during hospital admission.",1,0 +5124,Screening for post-traumatic stress disorder in female Veteran’s Affairs patients: validation of the PTSD checklist,"We evaluated the screening validity of a self-report measure for post traumatic stress disorder (PTSD), the PTSD Checklist (PCL), in female Veterans Affairs (VA) patients. All women seen for care at the VA Puget Sound Health Care system from October 1996-January 1999 (n=2,545) were invited to participate in a research interview. Participants (n=282) completed the 17-item PCL, followed by a gold standard diagnostic interview for PTSD, the Clinician Administered PTSD Scale (CAPS). Thirty-six percent of the participants (n=100) met CAPS diagnostic criteria for current PTSD. Receiver Operating Characteristic (ROC) analysis was used to evaluate the screening performance of the PCL. The area under the ROC curve was 0.86 (95% CI 0.82-0.90). A PCL score of 38 optimized the performance of the PCL as a screening test (sensitivity 0.79, specificity 0.79). The PCL performed well as a screening measure for the detection of PTSD in female VA patients.",0,0 +5125,Trauma-Focused Cognitive Behavioural Therapy for Children and Parents,"Trauma-focused cognitive behavioural therapy (TF-CBT) for children and parents is an evidence based treatment approach for traumatised children. Evaluation of TF-CBT includes several randomised controlled trials, effectiveness studies and ongoing studies for children experiencing sexual abuse, domestic violence, traumatic grief, terrorism, disasters and multiple traumas. The model of TF-CBT described here is a flexible, components-based model that provides children and parents with stress management skills prior to encouraging direct discussion and processing of children's traumatic experiences. TF-CBT components are summarised by the acronym PRACTICE: Psychoeducation, Parenting skills, Relaxation skills, Affective modulation skills, Cognitive coping skills, Trauma narrative and cognitive processing of the traumatic event(s), In vivo mastery of trauma reminders, Conjoint child-parent sessions, and Enhancing safety and future developmental trajectory. Currently this model of TF-CBT is being adapted and implemented both within the USA and internationally.",0,0 +5126,A Preliminary Study of DSM–5 PTSD Symptom Patterns in Veterans by Trauma Type,"Posttraumatic stress disorder (PTSD) has a primary etiology in experiencing psychological trauma and the subsequent psychological sequelae ( American Psychiatric Association, 2013). There are multi...",0,0 +5127,The Child PTSD Symptom Scale: An update and replication of its psychometric properties.,"The psychometric properties of the child PTSD Symptom Scale (CPSS) were examined in 2 samples. Sample 1 (N = 185, ages 6-17 years) consisted of children recruited from hospitals after accidental injury, assault, and road traffic trauma, and assessed 6 months posttrauma. Sample 2 (N = 68, ages 6-17 years) comprised treatment-seeking children who had experienced diverse traumas. In both samples psychometric properties were generally good to very good (internal reliability for total CPSS scores = .83 and .90, respectively). The point-biserial correlation of the CPSS with posttraumatic stress disorder (PTSD) diagnosis derived from structured clinical interview was .51, and children diagnosed with PTSD reported significantly higher symptoms than non-PTSD children. The CPSS demonstrated applicability to be used as a diagnostic measure, demonstrating sensitivity of 84% and specificity of 72%. The performance of the CPSS Symptom Severity Scale to accurately identify PTSD at varying cutoffs is reported in both samples, with a score of 16 or above suggested as a revised cutoff.",0,0 +5128,Disability associated with exposure to traumatic events: results from a cross-sectional community survey in South Sudan,"BackgroundThere is a general lack of knowledge regarding disability and especially factors that are associated with disability in low-income countries. We aimed to study the overall and gender-specific prevalence of disability, and the association between exposure to traumatic events and disability in a post-conflict setting.MethodsWe conducted a cross-sectional community based study of four Greater Bahr el Ghazal States, South Sudan (n = 1200). The Harvard Trauma Questionnaire (HTQ) was applied to investigate exposure to trauma events. Disability was measured using the Washington Group Short Measurement Set on Disability, which is an activity-based scale derived from the WHO’s International Classification of Disability, Functioning and Health.ResultsThe estimated prevalence of disability (with severe difficulty) was 3.6% and 13.4% for disability with moderate difficulties. No gender differences were found in disability prevalence. Almost all participants reported exposure to at least one war-related traumatic event. The result of a hierarchical regression analysis showed that, for both men and women, exposure to traumatic events, older age and living in a polygamous marriage increased the likelihood of having a disability.ConclusionsThe finding of association between traumatic experience and disability underlines the precariousness of the human rights situation for individuals with disability in low-income countries. It also has possible implications for the construction of disability services and for the provision of health services to individuals exposed to traumatic events.",0,0 +5129,Childbirth-related post-traumatic stress disorder and its treatment,"Abstract The phenomenon of childbirth-related post-traumatic stress disorder (PTSD) has become more widely recognised in recent years following changes in 1994 to the DSM criteria regarding how a traumatic event was defined. Emerging literature has predominately focused on prevalence rates and risk factors associated with this condition and on the use of debriefing techniques as an attempt to reduce or prevent the development of postnatal PTSD. However, little is known about the efficacy of psychological interventions that have been used to treat PTSD among postnatal women. This review summarises the limited evidence supporting the use of such treatments and discusses the significant challenges in developing and implementing psychological interventions for childbirth-related PTSD.",0,0 +5130,Morphine after Combat Injury and Post-Traumatic Stress Disorder,"Comments on an article by T. L. Holbrook et al. (see record 2010-00923-002). As medical providers currently deployed in Iraq, we read the article by Holbrook et al. with great interest. If confirmed, the association of morphine use with reductions in post-traumatic stress disorder (PTSD) would provide another important indication for the administration of morphine to battlefield casualties. We note that the investigators analyzed morphine use in level 1 or 2 facilities and that the morphine was administered intravenously in 98% of recipients. First, clinicians would benefit from knowing whether morphine was associated with adverse outcomes among patients treated at the facilities studied. Second, it is standard training for Navy corpsmen and Army medics to administer morphine and oral transmucosal fentanyl to patients before they reach these facilities. In addition, the ""fragments from blast - NOS [not otherwise specified]"" mechanism of injury was independently and strongly associated with the absence of PTSD in both models 1 and 2. Although we acknowledge that the numbers of injuries incurred through this mechanism were small, knowledge of the circumstances surrounding these injuries might lead to testable hypotheses for research aimed at elucidating factors associated with PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5131,The role of major depression in neurocognitive functioning in patients with posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) frequently co-occur after traumatic experiences and share neurocognitive disturbances in verbal memory and executive functioning. However, few attempts have been made to systematically assess the role of a comorbid MDD diagnosis in neuropsychological studies in PTSD.The purpose of the current study is to investigate neurocognitive deficits in PTSD patients with and without MDD. We hypothesized that PTSD patients with comorbid MDD (PTSD+MDD) would have significantly lower performance on measures of verbal memory and executive functioning than PTSD patients without MDD (PTSD-MDD).Participants included in this study were 140 treatment-seeking outpatients who had a diagnosis of PTSD after various single traumatic events and participated in a randomized controlled trial comparing different treatment types. Baseline neuropsychological data were compared between patients with PTSD+MDD (n=84) and patients with PTSD-MDD (n=56).The PTSD+MDD patients had more severe verbal memory deficits in learning and retrieving words than patients with PTSD alone. There were no differences between the groups in recall of a coherent paragraph, recognition, shifting of attention, and cognitive interference.The results of this study suggest that a more impaired neurocognitive profile may be associated with the presence of comorbid MDD, with medium-sized group differences for verbal memory but not for executive functioning. From a clinical standpoint, being aware that certain verbal memory functions are more restricted in patients with comorbid PTSD and MDD may be relevant for treatment outcome of trauma-focused psychotherapy.",0,0 +5132,The impact of housing displacement on the mental health of low-income parents after Hurricane Katrina,"Previous studies in the aftermath of natural disasters have demonstrated relationships between four dimensions of displacement - geographic distance from the predisaster community, type of postdisaster housing, number of postdisaster moves, and time spent in temporary housing - and adverse psychological outcomes. However, to date no study has explored how these dimensions operate in tandem. The literature is further limited by a reliance on postdisaster data. We addressed these limitations in a study of low-income parents, predominantly non-Hispanic Black single mothers, who survived Hurricane Katrina and who completed pre and postdisaster assessments (N = 392). Using latent profile analysis, we demonstrated three profiles of displacement experiences within the sample: (1) returned, characterized by return to a predisaster community; (2) relocated, characterized by relocation to a new community, and (3) unstably housed, characterized by long periods in temporary housing and multiple moves. Using regression analyses, we assessed the relationship between displacement profiles and three mental health outcomes (general psychological distress, posttraumatic stress, and perceived stress), controlling for predisaster characteristics and mental health indices and hurricane-related experiences. Relative to participants in the returned profile, those in the relocated profile had significantly higher general psychological distress and perceived stress, and those in the unstably housed profile had significantly higher perceived stress. Based on these results, we suggest interventions and policies that reduce postdisaster housing instability and prioritize mental health services in communities receiving evacuees.",0,0 +5133,Children's predisaster functioning as a predictor of posttraumatic stress following Hurricane Andrew.,"This study examined (a) children's predisaster behavioral and academic functioning as a predictor of posttraumatic stress (PTS) following Hurricane Andrew and (b) whether children who were exposed to the disaster would display a worsening of prior functioning. Fifteen months before the disaster, 92 4th through 6th graders provided self-reports of anxiety; peers and teachers rated behavior problems (anxiety, inattention, and conduct) and academic skills. Measures were repeated 3 months postdisaster; children also reported PTS symptoms and hurricane-related experiences (i.e., exposure). PTS symptoms were again assessed 7 months postdisaster. At 3 months postdisaster, children's exposure to the disaster, as well as predisaster ratings of anxiety, inattention, and academic skills, predicted PTS symptoms. By 7 months, only exposure, African American ethnicity, and predisaster anxiety predicted PTS. Prior anxiety levels also worsened as a result of exposure to the disaster. The findings have implications for identifying and treating children at risk for stress reactions following a catastrophic disaster.",0,0 +5134,Mental Health Problems Among Adults in Tsunami-Affected Areas in Southern Thailand,"On December 26, 2004, an undersea earthquake occurred off the northwestern coast of Sumatra, Indonesia. The tsunami that followed severely affected all 6 southwestern provinces of Thailand, where 5395 individuals died, 2991 were unaccounted for, and 8457 were injured.To assess the prevalence of symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression among individuals residing in areas affected by the tsunami in southern Thailand as part of a public health emergency response and rapid assessment.A multistage, cluster, population-based mental health survey was conducted from February 15 to 22, 2005, of random samples of displaced (n = 371) and nondisplaced persons in Phang Nga province (n = 322) and nondisplaced persons in the provinces of Krabi and Phuket (n = 368). Data were collected using an interviewer-administered questionnaire on handheld computers. A surveillance follow-up survey of the displaced persons (n = 371) and nondisplaced persons (n = 322) in Phang Na was conducted in September 2005.Medical Outcomes Study-36 Short-Form Health Survey SF-36 to assess self-perceived general health, bodily pain, and social and emotional functioning; the Harvard Trauma Questionnaire to assess tsunami-specific traumatic events; and the Hopkins Checklist-25 to detect symptoms of anxiety and depression.Participation rates for displaced and nondisplaced persons in the rapid assessment survey were 69% and 58%, respectively. Symptoms of PTSD were reported by 12% of displaced and 7% of nondisplaced persons in Phang Nga and 3% of nondisplaced persons in Krabi and Phuket. Anxiety symptoms were reported by 37% of displaced and 30% of nondisplaced persons in Phang Nga and 22% of nondisplaced persons in Krabi and Phuket. Symptoms of depression were reported by 30% of displaced and 21% of nondisplaced persons in Phang Nga and 10% of nondisplaced persons in Krabi and Phuket. In multivariate analysis, loss of livelihood was independently and significantly associated with symptoms of all 3 mental health outcomes (PTSD, anxiety, and depression). In the 9-month follow-up surveillance survey of 270 (73%) displaced and 250 (80%) nondisplaced participants in Phang Nga, prevalence rates of symptoms of PTSD, anxiety, and depression among displaced persons decreased to 7%, 24.8%, and 16.7%, respectively, and among nondisplaced persons, prevalence rates decreased to 2.3%, 25.9%, and 14.3%, respectively.Among survivors of the tsunami in southern Thailand, elevated rates of symptoms of PTSD, anxiety, and depression were reported 8 weeks after the disaster, with higher rates for anxiety and depression than PTSD symptoms. Nine months after the disaster, the rates of those reporting these symptoms decreased but were still elevated. This information is important for directing, strengthening, and evaluating posttsunami mental health needs and interventions.",0,0 +5135,"Suffering, hope, and entrapment: Resilience and cultural values in Afghanistan","A critical health-related issue in war-affected areas is how people make sense of adversity and why they show resilience in a high-risk environment. In Afghanistan, the burden of poor mental health arises in contexts of pervasive poverty, social inequality, and persistent violence. In 2006, we conducted face-to-face interviews with 1011 children (age 11-16) and 1011 adult caregivers, randomly selected in a school-based survey in three northern and central areas. Participants narrated their experiences as part of a systematic health survey, including an open-ended questionnaire on major life stressors and solutions to mitigate them. Responses were analysed using an inductive thematic approach and categorised for quantitative presentation, producing a conceptual model. For adults, the primary concern is repairing their ""broken economy,"" the root of all miseries in social, educational, governance, and health domains. For students, frustrations focus on learning environments as well as poverty, as education is perceived as the gateway to upward social and economic mobility. Hope arises from a sense of moral and social order embodied in the expression of key cultural values: faith, family unity, service, effort, morals, and honour. These values form the bedrock of resilience, drive social aspirations, and underpin self-respect and dignity. However, economic impediments, social expectations, and cultural dictates also combine to create entrapment, as the ability to realise personal and social aspirations is frustrated by structural inequalities injurious to health and wellbeing. This study contributes to a small but growing body of work on resilience in public health and conflict settings. It demonstrates that culture functions both as an anchor for resilience and an anvil of pain, and highlights the relevance of ethnographic work in identifying what matters most in formulating social and public health policies to promote a hopeful future.",0,0 +5136,Gender Differences in the Associations of PTSD Symptom Clusters With Relationship Distress in U.S. Vietnam Veterans and Their Partners,"Research has consistently linked symptoms of posttraumatic stress disorder (PTSD) with relationship distress in combat veterans and their partners. Studies of specific clusters of PTSD symptoms indicate that symptoms of emotional numbing/withdrawal (now referred to as negative alterations in cognition and mood) are more strongly linked with relationship distress than other symptom clusters. These findings, however, are based predominantly on samples of male veterans. Given the increasing numbers of female veterans, research on potential gender differences in these associations is needed. The present study examined gender differences in the multivariate associations of PTSD symptom clusters with relationship distress in 465 opposite-sex couples (375 with male veterans and 90 with female veterans) from the National Vietnam Veterans Readjustment Study. Comparisons of nested path models revealed that emotional numbing/withdrawal symptoms were associated with relationship distress in both types of couples. The strength of this association, however, was stronger for female veterans (b = .46) and female partners (b = .28), compared to male veterans (b = .38) and male partners (b = .26). Results suggest that couples-based interventions (e.g., psychoeducation regarding emotional numbing symptoms as part of PTSD) are particularly important for both female partners of male veterans and female veterans themselves.",0,0 +5137,Polysomnographically measured sleep abnormalities in PTSD: A meta-analytic review,"Although sleep complaints are common among patients with Posttraumatic stress disorder (PTSD), polysomnographic studies examining sleep abnormalities in PTSD have produced inconsistent results. To clarify discrepant findings, we conducted a meta-analytic review of 20 polysomnographic studies comparing sleep in people with and without PTSD. Results showed that PTSD patients had more stage 1 sleep, less slow wave sleep, and greater rapid-eye-movement density compared to people without PTSD. We also conducted exploratory analyses aimed at examining potential moderating variables (age, sex, and comorbid depression and substance use disorders). Overall, studies with a greater proportion of male participants or a low rate of comorbid depression tended to find more PTSD-related sleep disturbances. These findings suggest that sleep abnormalities exist in PTSD, and that some of the inconsistencies in prior findings may be explained by moderating variables.",0,0 +5138,Transitional Life Events and Trajectories of Cigarette and Alcohol Use During Emerging Adulthood: Latent Class Analysis and Growth Mixture Modeling,"Emerging adulthood (ages 18-25 years) has been associated with elevated substance use. Transitional life events (TLEs) during emerging adulthood in relation to substance use are usually examined separately, rather than as a constellation. The purposes of this study were (a) to explore distinct subgroups experiencing various TLEs during emerging adulthood, (b) to identify heterogeneous trajectories of cigarette and alcohol use during emerging adulthood, and (c) to examine the association of TLEs with cigarette and alcohol use trajectories.Five waves of longitudinal data (mean age range: 19.5-26.0 years) were used from a community-based drug prevention program (n = 946, 49.9% female). Distinct subgroups of emerging adults who experienced various TLEs were identified using latent class analysis. Cigarette and alcohol use were examined using a latent growth mixture model.A three-class model fit the data best in identifying TLE subgroups (new family, college attenders [NFCA]; uncommitted relationships, college attenders [URCA]; hibernators [HBN]). Three-trajectory models fit the data best for cigarette and alcohol use during emerging adulthood. The TLE categories were significantly associated with the cigarette (p < .05) and alcohol use groups (p < .001); specifically, the URCA and HBN groups were significantly more likely to be classified as accelerating cigarette users, relative to NFCA (ps < .05). The NFCA and HBN groups were significantly more likely to be classified as accelerating alcohol users, relative to URCA (ps < .01).To characterize an ""at-risk"" emerging adult group for cigarette and alcohol use over time, a range of life events during emerging adulthood should be considered. Interventions tailored to young adulthood may benefit from targeting the absence of these life events typifying ""independence"" as a potential marker for underlying substance use problems and provide supplemental screening methods to identify young adults with similar issues.",0,0 +5139,Risk Factors and Health Profiles of Recent Migrant Women Who Experienced Violence Associated with Pregnancy,"Background: Violence associated with pregnancy is a major public health concern, but little is known about it in recent migrant women. This study looked at (1) risk factors for violence associated with pregnancy among newly arrived migrant women in Canada and (2) if those who experienced violence associated with pregnancy had a different health profile or use of healthcare services for themselves or their infants during pregnancy and up to 4 months postpartum compared to other childbearing migrant women. Methods: Pregnant migrant women in Canada <5 years were recruited in 12 hospitals in 3 large cities between 2006 and 2009 and followed to 4 months postpartum. Data were collected on maternal background, migration history, violence associated with pregnancy, maternal and infant physical and mental health, and services used. Results: Of a total of 774 pregnant migrant women, 59 (7.6%) women reported violence associated with pregnancy. Migrant women who experienced violence, compared to those who did not, were at increased risk of violence if they lived without a partner, were asylum seekers, migrated <2 years ago, or had less than high school education. Women who reported violence were less likely to have up-to-date vaccinations, take folic acid before pregnancy, more likely to commence prenatal care after 3 months gestation and to not use contraceptives after birth. They were also more likely to have a history of miscarriage and report more postpartum pain and increased bleeding. They were also more likely to have inadequate social support and report more depression, anxiety, somatization, and posttraumatic stress disorder (PTSD) on standardized tests. No differences were found in the health status of the infants of women who experienced violence compared to those who did not. Conclusions: Clinicians should sensitively ask recent migrant women (asylum seekers, refugees, and nonrefugee immigrants) about violence associated with pregnancy and appropriately assess, treat, and refer them.",0,0 +5140,Police suicide--a Web surveillance of national data,"Considerable research has been done on suicide in police work. It appears that the volume of literature on this topic has led to considerable controversy concerning the accuracy and validity of police suicide rates. This topic has given rise to a wide variety of speculative, often wildly exaggerated figures being circulated in the law enforcement community and media, much of which is not based on verifiable research or gathered in an organized, useful manner that can be shared and scrutinized. Such figures have been taken at face value, translated into widely varying rates and profiles that, because they lack any substantiation, do little to help and much to impede the meaningful development of programs that can address the problems of police stress, trauma, posttraumatic stress, suicide, and the promotion of improved general health in the law enforcement community. This paper represents an empirical attempt to gather descriptive police suicide data from all fifty states in the U.S. for one year--2008--and record it in a cohesive manner that may be useful to researchers, police agencies, and program developers.",0,0 +5141,Going to war does not have to hurt: preliminary findings from the British deployment to Iraq,"We carried out a brief longitudinal mental health screen of 254 members of the UK's Air Assault Brigade before and after deployment to Iraq last year. Analysis of General Health Questionnaire (GHQ-28) scores before and after deployment revealed a lower score after deployment (mean difference=0.93, 95% CI 0.35-1.52). This indicated a highly significant relative improvement in mental health (P < 0.005). Moreover, only 9 of a larger sample of 421 (2%) exceeded cut-off criteria on the Trauma Screening Questionnaire. These findings suggest that war is not necessarily bad for psychological health.",0,0 +5142,Potential of eye movement desensitization and reprocessing therapy in the treatment of post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) continues to attract both empirical and clinical interest due to its complex symptom profile and the underlying processes involved. Recently, research attention has been focused on the types of memory processes involved in PTSD and hypothesized neurobiological processes. Complicating this exploration, and the treatment of PTSD, are underlying comorbid disorders, such as depression, anxiety, and substance use disorders. Treatment of PTSD has undergone further reviews with the introduction of eye movement desensitization and reprocessing (EMDR). EMDR has been empirically demonstrated to be as efficacious as other specific PTSD treatments, such as trauma-focused cognitive behavioral therapy. There is emerging evidence that there are different processes underlying these two types of trauma treatment and some evidence that EMDR might have an efficiency advantage. Current research and understanding regarding the processes of EMDR and the future direction of EMDR is presented.",0,0 +5143,Prevalence and Risk Factors of Posttraumatic Stress Disorder in Older Adults,"Posttraumatic stress disorder (PTSD) has scarcely been researched in the elderly. There is no population-based information on prevalence and risk factors in older persons. Patients with PTSD are often not recognized or incorrectly diagnosed. As the disorder has great implications for the quality of life, a correct diagnosis and treatment are crucial. Increased knowledge on vulnerability factors for PTSD can facilitate diagnostic procedures and health management in the elderly.PTSD cases were found following a two-phase sampling procedure: a random selection of 1,721 subjects were screened and in 422 subjects a psychiatric diagnostic interview was administered. Prevalence of PTSD and subthreshold PTSD were calculated. Vulnerability factors regarding demographics, physical health, personality, social factors, recent distress and adverse events in early childhood were assessed.6-month prevalence of PTSD and of subthreshold PTSD was 0.9 and 13.1%, respectively. The strongest vulnerability factors for both PTSD and subthreshold PTSD were neuroticism and adverse events in early childhood.This is the first population-based study on PTSD in older persons. With a 6-month prevalence of almost 1% the disease is not rare. Comparisons with younger populations suggest some accumulation of cases among older people reflecting the chronic risk factors, which are found in this study: neuroticism and adverse events in early childhood.",0,0 +5144,Psychogenic Lowering of Urinary Cortisol Levels Linked to Increased Emotional Numbing and a Shame-Depressive Syndrome in Combat-Related Posttraumatic Stress Disorder,"The purpose of the study was to search for the intrapsychic correlates of individual differences in cortisol levels in male Vietnam combat veterans with posttraumatic stress disorder.The study involved measurement of urinary cortisol levels and clinical assessment with a broad profile of psychometric tests during a single 48-hour period in 30 inpatients.The main finding by both correlation and t test analyses was a significant inverse relationship between urinary cortisol levels and a symptom complex composed of two closely interrelated clinical subgroupings, ""disengagement"" (principally involving emotional numbing) and ""shame-laden depression.""The findings support the concept that cortisol levels reflect the ongoing balance between the undifferentiated emotional arousal state of engagement (associated with higher cortisol levels) and opposing antiarousal disengagement defense mechanisms (associated with lower cortisol levels). It appears that the low cortisol levels often seen in patients with posttraumatic stress disorder are psychogenic and reflect a dominating effect of disengagement coping strategies, which represent secondary compensatory adaptations during the chronic course of this disorder to counteract primary arousal symptoms, especially those related to an intractable shame-laden depressive syndrome. The psychoendocrine findings suggest that the relatively inconspicuous clinical feature of shame resulting from both the primary and secondary traumatizations is a particularly powerful, preoccupying, and overwhelming source of emotional engagement. Shame may represent a ""sleeper"" that is worthy of greater attention in both research and clinical efforts to understand the pathogenesis and psychopathology of this devastating stress-related disorder.",0,0 +5145,Meaning-making appraisals relevant to adjustment for veterans with spinal cord injury.,"The purpose of the present study was to conduct a mixed-methods investigation of meaning-making appraisals generated from spinal cord injury survivors' narratives of their injury experience. The sample consisted of 79 participants from an urban midwestern Veterans Affairs facility. The study design was cross-sectional and incorporated semistructured, face-to-face interviews, taking approximately 1 hr to complete. Measures of posttraumatic stress disorder, depression, psychological well-being, and purpose in life were completed as part of the interview. A data analytic approach based on grounded theory that allowed qualitative themes to be transformed to quantitative data was employed. Seven salient meaning-making themes were identified. Significant relationships were identified between certain meaning-making themes (e.g., identity integration positively related to positive growth), and certain themes were also significantly related to postinjury psychological health and distress separately (e.g., perceived burden on others was significantly related to greater depression scores). Findings are discussed within the context of clinical interventions that foster positive posttrauma outcomes.",0,0 +5146,Hurt people who hurt people: Violence amongst individuals with comorbid substance use disorder and post traumatic stress disorder,"The association between substance use disorder (SUD) and the perpetration of violence has been well documented. There is some evidence to suggest that the co-occurrence of post traumatic stress disorder (PTSD) may increase the risk for violence. This study aims to determine the prevalence of violence perpetration and examine factors related to violence amongst individuals with comorbid SUD and PTSD.Data was collected via interview from 102 participants recruited to a randomised controlled trial of an integrated treatment for comorbid SUD and PTSD.The interview addressed demographics, perpetration of violent crime, mental health including aggression, substance use, PTSD, depression, anxiety and borderline personality disorder.Over half of participants reported committing violence in their lifetime and 16% had committed violence in the past month. Bivariate associations were found between violence perpetration and trait aggression, higher levels of alcohol and cannabis use, lower levels of other opiate use, and experiencing more severe PTSD symptoms, particularly in relation to hyperarousal. When entered into a backward stepwise logistic regression however, only higher levels of physical aggression and more severe PTSD hyperarousal symptoms remained as independent predictors of violence perpetration.These findings highlight the importance of assessing for PTSD amongst those with SUD particularly in forensic settings. They also indicate that it is the hyperarousal symptoms of PTSD specifically that need to be targeted by interventions aimed at reducing violence amongst individuals with SUD and PTSD.",0,0 +5147,A Village Possessed by “Witches”: A Mixed-Methods Case–Control Study of Possession and Common Mental Disorders in Rural Nepal,"In Nepal, spirit possession is a common phenomenon occurring both in individuals and in groups. To identify the cultural contexts and psychosocial correlates of spirit possession, we conducted a mixed-method study in a village in central Nepal experiencing a cluster of spirit possession events. The study was carried out in three stages: (1) a pilot study consisting of informal interviews with possessed individuals, observations of the possession spells, and video recording of possession events; (2) a case–control study comparing the prevalence of symptoms of common mental disorders in women who had and had not experienced possession; and (3) a follow-up study with focus group discussions and in-depth interviews with possessed and non-possessed men and women, and key informants. Quantitative results indicated that possessed women reported higher rates of traumatic events and higher levels of symptoms of mental disorder compared to non-possessed women (Anxiety 68 vs. 18 %, Depression 41 vs. 19 %, and PTSD 27 vs. 0 %). However, qualitative interviews with possessed individuals, family members, and traditional healers indicated that they did not associate possession states with mental illness. Spirit possession was viewed as an affliction that provided a unique mode of communication between humans and spirits. As such, it functioned as an idiom of distress that allowed individuals to express suffering related to mental illness, socio-political violence, traumatic events, and the oppression of women. The study results clearly indicate that spirit possession is a multi-dimensional phenomenon that cannot be mapped onto any single psychiatric or psychological diagnostic category or construct. Clinical and public health efforts to address spirit possession must take the socio-cultural context and systemic dynamics into account to avoid creating iatrogenic illness, undermining coping strategies, and exacerbating underlying social problems.",0,0 +5148,Links between child and adolescent trauma exposure and service use histories in a national clinic-referred sample.,"The National Child Traumatic Stress Network (NCTSN) is a federally funded child mental health service initiative designed to raise the standard of care and increase access to evidence-based services for traumatized children and their families across the United States. As part of the quality improvement goal, a Core Data Set (CDS) was established to standardize data collection and examine treatment outcomes across participating centers. This paper describes baseline demographic characteristics, prevalence of trauma exposure, and service use for children and adolescents served by a broad range of NCTSN service delivery centers. Data were collected from children 0–18 years (52% girls, 82% were 6–18 years old) who reported exposure to at least one trauma and who received trauma-related services (n 11,104). Approximately half the sample was White; more than three quarters reported exposure to multiple types of trauma. Sixty-three percent were eligible for state- or federally funded insurance. The two most commonly reported traumatic events were traumatic loss/separation/bereavement and domestic violence. Number and type of trauma exposure varied by gender and age. Type and number of services utilized prior to entering an NCTSN center varied by number of trauma exposures. Systematically assessing children’s trauma exposure provides clinically useful information, particularly for those exposed to multiple types of traumatic events. Identifying subgroups, and markers of risk for trauma-related sequelae, may inform policies, programs, and best practices to meet specific needs of children and families. Future research may clarify high-risk trauma profiles for coordinated utilization of systems of care.",0,0 +5149,Physiotherapy management of whiplash-associated disorders (WAD),[Sterling M (2014) Physiotherapy management of whiplash-associated disorders (WAD). Journal of Physiotherapy 60: 5–12],0,0 +5150,"Selecting a linear mixed model for longitudinal data: Repeated measures analysis of variance, covariance pattern model, and growth curve approaches.","With increasing popularity, growth curve modeling is more and more often considered as the 1st choice for analyzing longitudinal data. Although the growth curve approach is often a good choice, other modeling strategies may more directly answer questions of interest. It is common to see researchers fit growth curve models without considering alterative modeling strategies. In this article we compare 3 approaches for analyzing longitudinal data: repeated measures analysis of variance, covariance pattern models, and growth curve models. As all are members of the general linear mixed model family, they represent somewhat different assumptions about the way individuals change. These assumptions result in different patterns of covariation among the residuals around the fixed effects. In this article, we first indicate the kinds of data that are appropriately modeled by each and use real data examples to demonstrate possible problems associated with the blanket selection of the growth curve model. We then present a simulation that indicates the utility of Akaike information criterion and Bayesian information criterion in the selection of a proper residual covariance structure. The results cast doubt on the popular practice of automatically using growth curve modeling for longitudinal data without comparing the fit of different models. Finally, we provide some practical advice for assessing mean changes in the presence of correlated data.",0,0 +5151,Mental Health in Sumatra After the Tsunami,"Objectives. We assessed the levels and correlates of posttraumatic stress reactivity (PTSR) of more than 20000 adult tsunami survivors by analyzing survey data from coastal Aceh and North Sumatra, Indonesia. Methods. A population-representative sample of individuals interviewed before the tsunami was traced in 2005 to 2006. We constructed 2 scales measuring PTSR by using 7 symptom items from the Post Traumatic Stress Disorder (PTSD) Checklist–Civilian Version. One scale measured PTSR at the time of interview, and the other measured PTSR at the point of maximum intensity since the disaster. Results. PTSR scores were highest for respondents from heavily damaged areas. In all areas, scores declined over time. Gender and age were significant predictors of PTSR; markers of socioeconomic status before the tsunami were not. Exposure to traumatic events, loss of kin, and property damage were significantly associated with higher PTSR scores. Conclusions. The tsunami produced posttraumatic stress reactions across a wide region of Aceh and North Sumatra. Public health will be enhanced by the provision of counseling services that reach not only people directly affected by the tsunami but also those living beyond the area of immediate impact.",0,0 +5152,Urinary Catecholamine Excretion and Severity of PTSD Symptoms in Vietnam Combat Veterans,"In the present study, we replicated and extended our previous findings of increased 24-hour urinary catecholamine excretion in posttraumatic stress disorder (PTSD). Dopamine, norepinephrine, and epinephrine concentrations were measured in 22 male patients with PTSD (14 inpatients and eight outpatients) and in 16 nonpsychiatric normal males. The PTSD inpatients showed significantly higher excretion of all three catecholamines compared with both outpatients with PTSD and normal controls. Dopamine and norepinephrine, but not epinephrine, levels were significantly correlated with severity of PTSD symptoms in the PTSD group as a whole. In particular, these catecholamines seemed related to intrusive symptoms. None of the catecholamines were correlated with severity of depression. The findings support the hypothesis of an enhanced sympathetic nervous system activation in PTSD, and suggest that increased sympathetic arousal may be closely linked to severity of certain PTSD symptom clusters.",0,0 +5153,Reactions of Police Officers to Body-Handling after a Major Disaster a Before-and-After Comparison,"This study reports the results of an unusual opportunity to follow up a group of police officers who were involved in body-handling duties following the Piper Alpha disaster, and for whom there were available data from pre-disaster assessments. In addition, after these duties, the officers were compared with a matched control group of officers who had not been involved in such work. The comparisons failed to demonstrate high levels of post-traumatic distress or psychiatric morbidity. The results are interpreted in terms of issues such as the officers' own coping strategies, and major organisational and managerial factors.",0,0 +5154,"Well-being, posttraumatic growth and benefit finding in long-term breast cancer survivors","This study evaluates posttraumatic growth, benefit finding and well-being, and their mutual association in a random sample of disease-free 10-year breast cancer survivors. The population-based Eindhoven Cancer Registry (ECR) was used to select all women diagnosed with breast cancer in 1993 in six hospitals. Of the 254 breast cancer survivors, 183 (72%) returned a completed questionnaire. Measures included the Posttraumatic Growth Inventory (posttraumatic growth), the Perceived Disease Impact Scale (benefit finding) and the CentERdata Health monitor (life satisfaction, health status and psychological well-being). Self-reported health status and psychological well-being were similar in survivors compared to general population norms, whereas life satisfaction was significantly higher among survivors. In addition, posttraumatic growth was seen in the following domains: relationships with others, personal strength and appreciation of life. The number of patients reporting benefit finding was high (79%, N = 145). Benefit finding showed a moderately positive correlation with posttraumatic growth. In addition, women who stated that their satisfaction with life was high reported higher levels of posttraumatic growth in comparison to women who did not. Radiotherapy was negatively associated with posttraumatic growth. Women with a higher tumour stage at diagnosis experienced less benefit finding in comparison to women with a lower tumour stage at diagnosis. The above results can help to identify those patients who will probably experience posttraumatic growth and benefit finding after cancer. However, it is important to be aware that the positive effects of cancer on a patient's life do not occur in all cancer patients and all phases of the disease trajectory.",0,0 +5155,Cluster analysis of MCMI and MCMI-II on chronic PTSD victims,"A cluster analysis was used to identify groups of inpatients with confirmed post-traumatic stress disorder (PTSD) due to combat. In Study 1 the MCMI was administered to 256 subjects, in addition to the MMPI, PTSD measures, and background variables. Three clusters resulted: a Traumatic Personality (8-2), Schizoid Influence (8-2-1), and Antisocial Influence (8-6). Comparison on the MCMI symptom scales, MMPI, and PTSD scales showed that the Antisocial Influence cluster was ""healthier"" on all measures. The Schizoid Influence was most psychopathological. In Study 2 the MCMI-II was administered to 136 new subjects who met the same criteria as in Study 1. Four clusters resulted: Global (1-2-6A-6B-8A-8B), Subclinical (1), Aggressive (6A-6B-8A), and Detached/Self-defeating (1-2-8A-8B).",0,0 +5156,Affective and anxiety comorbidity in post-traumatic stress disorder treatment trials of sertraline,"Comorbidity of mood and anxiety disorders is common in patients suffering from post-traumatic stress disorder (PTSD). The current study evaluated the efficacy and tolerability of sertraline in a subgroup of PTSD patients suffering from anxiety or depression comorbidity. Two multicenter, 12-week, double-blind, flexible-dose US studies of adult outpatients from the general population with a DSM-III-R diagnosis of PTSD evaluated the safety and efficacy of sertraline (50 to 200 mg/d) compared to placebo in the treatment of PTSD. The total severity score of the Clinician-Administered PTSD Scale (CAPS-2) and the Davidson Trauma Scale (DTS) were used to examine the effect of comorbidity on treatment outcome. Among the combined 395 subjects enrolled in the two trials, 32.9% had a comorbid depressive diagnosis (no anxiety diagnosis), 6.3% had a comorbid anxiety disorder diagnosis (no depression), 11.4% had both a depression and anxiety disorder diagnosis, and 49.4% had no comorbidity. The correlation, at baseline, between Hamilton Depression Rating Scale (HAM-D) total score and the three CAPS-2 clusters was 0.37 for the re-experiencing/intrusion cluster, 0.52 for the avoidance/numbing cluster, and 0.45 for the hyperarousal cluster. Patients suffering from PTSD complicated by a current diagnosis of both depression and an anxiety disorder showed the highest baseline CAPS-2 cluster score severity. Patients treated with sertraline improved significantly (P <.05) compared to placebo on both the CAPS-2 and DTS whether or not they had a comorbid depressive or anxiety disorder. Sertraline was well tolerated. The presence of comorbidity was associated with a modest and mostly nonspecific increase in the side effect burden of approximately 10% to 20% on both study treatments. Patients suffering from dual depression and anxiety disorder comorbidity benefited from somewhat higher doses (147 mg v 125 mg; P =.08). Similarly, the presence of dual comorbidity resulted in a modest but nonsignificant increase in the mean time to response from 4.5 weeks to 5.5 weeks. We conclude that sertraline (50 to 200 mg/d) is effective and well tolerated in the treatment of PTSD for patients suffering from a current, comorbid depressive or anxiety disorders.",0,0 +5157,"Posttraumatic growth and its relationship to pre-, peri-, and post-surgical psychological factors","Depression and posttraumatic stress have been found to be important factors following cardiac surgery. Posttraumatic growth (PTG), however, has not been investigated following cardiac surgery, although it has been assessed regarding other health conditions. The current study assessed PTG at 3 to 6 years post coronary artery bypass graft (CABG) surgery among 31 participants (mean age 68.6, SD 10.9; 58.1% male and 41.9% female), and compared to data collected at the time of surgery (pre-surgical depression, trauma history, and posttraumatic stress; peri-surgical appraisals of fear, helplessness, and life-threat). PTG was also assessed among the full sample of 39 participants in relation to their post-surgical depression and surgery-related posttraumatic stress. Differences in the Post Traumatic Growth Inventory scores were compared to presurgical, peri-surgical, and post-surgical psychological factors. Participants with High PTG had higher levels of depression prior to heart surgery ( F (1, 29) = 4.20, p <.05). Participants with High PTG reported more fearfulness and perceived life threat in relation to the change in their cardiac condition (F (1, 28) = 4.49, p <.05) and (F (1, 28) = 4.97, p <.05), respectively. No differences were found between High and Low PTG groups on presurgical posttraumatic stress, nor were group differences found in regard to post-surgical depression or traumatic stress. Through investigation of a previously neglected population with regard to PTG, the current study supports previous findings that those with moderate psychological resources may have the most to gain from experiencing a traumatic event (McMillen et al., 1997) as well as findings that individuals who perceive more potential for harm develop more PTG (Linley and Joseph, 2004). (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5158,Posttraumatic Headache: A Review,"There has been intense controversy about postconcussion syndrome (PCS) since Erichsen's publication in 1866 on railway brain and spine. Headache as a result of trauma is one of the most common secondary headache types. Posttraumatic headache (PTH) remains a very controversial disorder, particularly with relation to chronic PTH following mild closed-head injury. PTH is one of several symptoms of PCS, and therefore may be accompanied by additional cognitive, behavioral, and somatic problems. PTH also is an important public health issue due to its associated disability and often refractory clinical course. While current awareness of PTH has become more prominent due to increased scrutiny given to both combat-related and sports-related head injuries, directed treatment remains a difficult challenge for physicians. Because of the frequently associated medicolegal aspects, PTH is one of physicians' least favorite types to treat. The article reviews both PCS and PTH.",0,0 +5159,"Returning home: forced conscription, reintegration, and mental health status of former abductees of the Lord's Resistance Army in northern Uganda","BackgroundSince the late 1980s, the Lord's Resistance Army (LRA), a spiritualist rebel group in northern Uganda, has killed and mutilated thousands of civilians and abducted an estimated 52,000 to 75,000 people to serve as soldiers, porters, and sex slaves for its commanders. This study examines the types of violence to which former abductees have been exposed and the extent to which these acts have affected their psychological well-being.MethodsThis is a cross-sectional study of 2,875 individuals selected through a multi-stage stratified cluster sampling design conducted in 8 districts of northern Uganda. Multivariate logistic regressions were performed with symptoms for Post-traumatic Stress Disorder (PTSD) and depression as the main outcome measures.ResultsOne-third of the respondents (33%) self-reported having experienced abduction (49% among the Acholi, the largest tribal group in northern Uganda). Over half (56%) of all the respondents and over two-thirds of those who experienced abduction met the criteria for symptoms of post-traumatic stress disorder (PTSD). Multivariate analysis shows that several factors increased the risk of former LRA abductees developing symptoms of PTSD. These factors included gender (females were more susceptible than males), being a member of the Acholi ethnic group, participating in or witnessing a cumulative number of traumatic events, and encountering difficulties re-integrating into communities after abduction. Factors associated with increased risk of meeting criteria for symptoms of depression included older age of males at the time of abduction, lower score on social relationship scale, high incidence of general traumatic event exposure, high incidence of forced acts of violence, and problems reintegrating into communities after abduction.ConclusionAbduction and forced conscription of civilians has affected the psychological well-being of a significant number of northern Ugandans. The sources of psychological trauma are multiple, ranging from witnessing to being forced to commit violent acts, and compounded by prolonged exposure to violence, often for months or years. Community-based mental health care services and reintegration programs are needed to facilitate the reintegration of former abductees back into their communities.",0,0 +5160,Two subjective factors as moderators between critical incidents and the occurrence of post traumatic stress disorders: Adult attachment and perception of social support,"This paper presents the result of a research which investigated the influence of the subjective factors ‘adult attachment style’ and ‘perception of social support’ in the occurrence of post traumatic stress disorders (PTSD) in a population of 544 subjects working for a security company and the Belgian Red Cross. The analysis of the results suggests that ‘adult attachment style’ and ‘perception of social support’ moderate between a critical incident and the occurrence of a PTSD. In other words, these independent variables differentiate between individuals who are more, and who are less prone, to suffer from a PTSD after having experienced a critical incident. The results of this research shed light on subjective risk factors related to PTSD. The findings can also suggest guidelines for the treatment of individuals suffering from a PTSD.",0,0 +5161,The Effect of Financial Compensation on Health Outcomes following Musculoskeletal Injury: Systematic Review,"The effect of financial compensation on health outcomes following musculoskeletal injury requires further exploration because results to date are varied and controversial. This systematic review identifies compensation related factors associated with poorer health outcomes following musculoskeletal injury. Searches were conducted using electronic medical journal databases (Medline, CINAHL, Embase, Informit, Web of Science) for prospective studies published up to October 2012. Selection criteria included: prognostic factors associated with validated health outcomes; six or more months follow up; and multivariate statistical analysis. Studies solely measuring return to work outcomes were excluded. Twenty nine articles were synthesised and then assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology to determine evidence levels. The results were mixed. There was strong evidence of an association between compensation status and poorer psychological function; and legal representation and poorer physical function. There was moderate evidence of an association between compensation status and poorer physical function; and legal representation and poorer psychological function. There was limited evidence of an association between compensation status and increased pain. In seven studies the association depended on the outcome measured. No studies reported an association between compensation related factors and improved health outcomes. Further research is needed to find plausible reasons why compensation related factors are associated with poorer health following musculoskeletal injury.",0,0 +5162,The validation of a self-report measure of posttraumatic stress disorder: The Posttraumatic Diagnostic Scale.,"The present article reports on the development and validation of a self-report measure of posttraumatic stress disorder (PTSD), the Posttraumatic Diagnostic Scale (PTDS), that yields both a PTSD diagnosis according to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994; DSM-IV) criteria and a measure of PTSD symptom severity. Two-hundred forty-eight participants who had experienced a wide variety of traumas (e.g., accident, fire, natural disaster, assault, combat) were administered the PTSD module of the Structured Clinical Interview (SCID; Spitzer, Williams, Gibbons, & First, 1990), the PTDS, and scales measuring trauma-related psychopathology. The PTDS demonstrated high internal consistency and test-retest reliability, high diagnostic agreement with SCID, and good sensitivity and specificity. The satisfactory validity of the PTDS was further supported by its high correlations with other measures of trauma-related psychopathology. Therefore, the PTDS appears to be a useful tool for screening and assessing current PTSD in clinical and research settings.",0,0 +5163,Traumatic Brain Injury in a Child Psychiatry Inpatient Population: A Controlled Study,"To extend our findings from child psychiatry outpatients to child psychiatry inpatients regarding the similarity of children with a history of traumatic brain injury (TBI), particularly mild TBI, to matched children without such a history.This is a chart review of patients consecutively admitted to a child psychiatry inpatient unit over a 5-year period. Children with TBI were matched by age, sex, race, and social class to children with no history of TBI. Axis I and II diagnoses and diagnostic clusters and use of special education services and IQ scores were compared.Fifty-six (8.1%) of 694 consecutive patients admitted had a definite TBI. Not one of more than 50 variables compared between TBI and control subjects was significantly different.In a child psychiatry inpatient unit, patients with a history of TBI were virtually indistinguishable from matched children without TBI. Caution should be exercised before attributing the child's problems, especially long-term problems, to the TBI unless the injury was severe or the child is exhibiting related phobic or posttraumatic stress symptomatology.",0,0 +5164,Disaster research methods: Past progress and future directions,"Published results for 225 disaster studies were coded on methodological variables, severity of effects, and event year. Methods varied greatly, but cross-sectional, after-only designs, convenience sampling, and small samples were modal. Samples that were assessed before the disaster, selected for reasons of convenience, or were large tended to show less severe effects than other samples. Developing countries were underrepresented overall, but not in recent years. Certain desirable study characteristics (longitudinal designs, representative samples) have been decreasing in prevalence over time, whereas others (early first assessment) have been increasing. Innovations such as latent trajectory modeling or hierarchical linear modeling might advance the field's ability to capture the complexity of disasters, but the field still needs to attend to the fundamentals of sound epidemiologic research.",0,0 +5165,To lump or to split? Comparing individuals with traumatic and nontraumatic limb loss in the first year after amputation.,"To compare individuals with traumatic (TE) vs. nontraumatic (NTE) amputation etiology on pain, psychological, and social variables over the first 12 months postamputation, and to explore changes in mean levels of and correlations between these variables over time.There were 111 adults with newly acquired limb loss.A VA medical center and a Level I trauma hospital in a large metropolitan area.Characteristic Pain Severity, Pain Interference, Patient Health Questionnaire depression module, Posttraumatic Stress Disorder Checklist, Social Constraints Scale, Aversive Emotional Support Scale, Centers for Disease Control and Prevention single item Social Support measure, single item loneliness measure.The NTE group was significantly older, had lower income, and had greater medical comorbidity, preamputation pain, and physical disability. The etiology groups did not differ significantly in mean levels of outcome variables except that the TE group reported greater aversive emotional support at 6 and 12 months. The TE group demonstrated a quadratic change in pain interference, with highest levels at 6 months and a linear increase in social constraints. Both etiology groups showed a linear increase in PTSD symptoms over time. Correlations between physical, psychological, and social distress were observed earlier in the year for the NTE group.Despite significant demographic and preamputation experience differences, few differences in outcomes emerged by etiology group in the first year after amputation. Findings suggest that the year after amputation may be a time of greater change for those with traumatic amputation compared to those with nontraumatic amputation.",0,0 +5166,Anger in the UK Armed Forces,"We assessed the strength of the association of several mental health problems, childhood difficulties, and combat role with anger, as well as the contribution of these factors to explain anger assessed by population attributable fraction (PAF). A total of 9885 UK service personnel, some of them deployed to Iraq and Afghanistan, participated in the study. There was a strong or intermediate association between cases and subthreshold cases of symptoms of posttraumatic stress disorder, psychological distress, multiple physical symptoms and alcohol misuse, having a combat role, childhood adversity, and childhood antisocial behavior with anger. The PAF for any mental health problem and combat role and childhood difficulties was 0.64 (95% confidence interval [CI], 0.56-0.70) and increased to 0.77 (95% CI, 0.69-0.83) if subthreshold cases were included. Anger is a frequent component of mental disorders; health care professionals need to be aware of the interference of anger in the management of mental illness and that anger infrequently presents as an isolated phenomenon.",0,0 +5167,The challenges of reintegration for service members and their families.,"The ongoing wars in Afghanistan and Iraq have posed a number of reintegration challenges to service members. Much of the research focuses on those service members experiencing psychological problems and being treated at the VA. In this article, we contend that much of the distress service members experience occurs following deployment and is a consequence of the difficulties encountered during their efforts to successfully reintegrate into their families and communities. We propose a new conceptual framework for intervening in this reintegration distress that is psycho-educational in nature as well as a new delivery model for providing such services. An example of this new intervention framework is presented.",0,0 +5168,Prevalence of Delayed-Onset Posttraumatic Stress Disorder in Military Personnel,"Delayed-onset posttraumatic stress disorder (PTSD) is defined as onset at least 6 months after a traumatic event. This study investigates the prevalence of delayed-onset PTSD in 1397 participants from a two-phase prospective cohort study of UK military personnel. Delayed-onset PTSD was categorized as participants who did not meet the criteria for probable PTSD (assessed using the PTSD Checklist Civilian version) at phase 1 but met the criteria by phase 2. Of the participants, 3.5% met the criteria for delayed-onset PTSD. Subthreshold PTSD, common mental disorder (CMD), poor/fair self-reported health, and multiple physical symptoms at phase 1 and the onset of alcohol misuse or CMD between phases 1 and 2 were associated with delayed-onset PTSD. Delayed-onset PTSD exists in this UK military sample. Military personnel who developed delayed-onset PTSD were more likely to have psychological ill-health at an earlier assessment, and clinicians should be aware of the potential comorbidity in these individuals, including alcohol misuse. Leaving the military or experiencing relationship breakdown was not associated.",0,0 +5169,Killing and latent classes of PTSD symptoms in Iraq and Afghanistan veterans,"Our goal was to better understand distinct PTSD symptom presentations in Iraq and Afghanistan Veterans ( N =227) and to determine whether those who killed in war were at risk for being in the most symptomatic class. We used latent class analysis of responses to the PTSD checklist and logistic regression of most symptomatic class. We found that a four-class solution best fit the data, with the following profiles emerging: High Symptom (34% of participants), Intermediate Symptom (41%), Intermediate Symptom with Low Emotional Numbing (10%), and Low Symptom (15%). The largest group of individuals who reported killing (45%) was in the High Symptom class, and those who killed had twice the odds of being in the most symptomatic PTSD class, compared to those who did not kill. Those who endorsed killing a non-combatant ( OR =4.56, 95% CI [1.77, 11.7], p<0.01) or killing in the context of anger or revenge ( OR =4.63, 95% CI =[1.89, 11.4], p<0.001) were more likely to belong to the most symptomatic PTSD class, compared to those who did not kill. The study was retrospective and cross-sectional. The results may not generalize to veterans of other wars. Killing in war may be an important indicator of risk for developing frequent and severe PTSD symptoms. This has implications for the mental healthcare of veterans, providing evidence that a comprehensive evaluation of returning veterans should include an assessment of killing experiences and reactions to killing.",0,0 +5170,"60,000 Disaster Victims Speak: Part I. An Empirical Review of the Empirical Literature, 1981–2001","Results for 160 samples of disaster victims were coded as to sample type, disaster type, disaster location, outcomes and risk factors observed, and overall severity of impairment. In order of frequency, outcomes included specific psychological problems, nonspecific distress, health problems, chronic problems in living, resource loss, and problems specific to youth. Regression analyses showed that samples were more likely to be impaired if they were composed of youth rather than adults, were from developing rather than developed countries, or experienced mass violence (e.g., terrorism, shooting sprees) rather than natural or technological disasters. Most samples of rescue and recovery workers showed remarkable resilience. Within adult samples, more severe exposure, female gender, middle age, ethnic minority status, secondary stressors, prior psychiatric problems, and weak or deteriorating psychosocial resources most consistently increased the likelihood of adverse outcomes. Among youth, family factors were primary. Implications of the research for clinical practice and community intervention are discussed in a companion article (Norris, Friedman, and Watson, this volume).",0,0 +5171,Evidence of symptom profiles consistent with posttraumatic stress disorder and complex posttraumatic stress disorder in different trauma samples,"The International Classification of Diseases, 11th version (ICD-11), proposes two related stress and trauma-related disorders, posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). A diagnosis of CPTSD requires that in addition to the PTSD symptoms, an individual must also endorse symptoms in three major domains: (1) affective dysregulation, (2) negative self-concepts, and (3) interpersonal problems. This study aimed to determine if the naturally occurring distribution of symptoms in three groups of traumatised individuals (bereavement, sexual victimisation, and physical assault) were consistent with the ICD-11, PTSD, and CPTSD specification. The study also investigated whether these groups differed on a range of other psychological problems.Participants completed self-report measures of each symptom group and latent class analyses consistently found that a three class solution was best. The classes were ""PTSD only,"" ""CPTSD,"" and ""low PTSD/CPTSD."" These classes differed significantly on measures of depression, anxiety, dissociation, sleep disturbances, somatisation, interpersonal sensitivity, and aggression. The ""CPTSD"" class in the three samples scored highest on all the variables, with the ""PTSD only"" class scoring lower and the ""low PTSD/CPTSD"" class the lowest.This study provides evidence to support the diagnostic structure of CPTSD and indicted that CPTSD is associated with a broad range of other psychological problems.",0,0 +5172,Parental Response to Child Injury: Examination of Parental Posttraumatic Stress Symptom Trajectories Following Child Accidental Injury,Trajectory analyses were used to empirically differentiate patterns of posttraumatic stress symptoms in parents following child accidental injury and explore the relationship between parent and child recovery patterns.Parent (n = 189) self-reported symptoms from acute to 2 years post accident were examined to (1) identify distinct parent symptom trajectories; (2) identify risk factors; and (3) explore the patterns of children and parents together.Analysis revealed three distinct symptom trajectory groups for parents: resilient (78%); clinical level acute symptoms that declined to below clinical level by 6 months (recovery 8%); and chronic subclinical (14%). Children of resilient parents were most likely to be resilient. Half of the children of parents with chronic subclinical trajectories were likely to have chronic trajectories.Clinicians cannot rely only on clinical level symptoms in parents to identify high risk families but include families where the parent has subclinical level symptoms.,1,0 +5173,Origin of chordate peptides by horizontal protozoan gene transfer in early metazoans and protists: Evolution of the teneurin C-terminal associated peptides (TCAP),"► The teneurin C-terminal associated peptides (TCAP) are a highly conserved signaling peptide family. ► TCAP and the teneurin–proprotein system play a major role in neurological development, processing and regulation of stress. ► The TCAP-teneurin system originated in the metazoan by a horizontal gene transfer event in a choanoflagellate. The teneurin C-terminal associated peptides (TCAP) are found at the extracellular face in C-terminal region of the teneurin transmembrane proteins. One of these peptides, TCAP-1 is independently transcribed as a smaller bioactive peptide that possesses a number of stress response-attenuating activities. The teneurin-TCAP system appears to be the result of a horizontal gene transfer from a prokaryotic proteinaceous polymorphic toxin to a choanoflagellate. In a basal metazoan, the TCAP region has been modified from a toxin to a soluble intercellular signaling system. New studies indicate that the teneurin-TCAP system form a complex signaling system associated with adhesion, cytoskeletal regulation and intracellular signaling. TCAP-1 is highly conserved in all vertebrates and in mammals, inhibits corticotropin-releasing factor (CRF)-associated stress. Using the TCAP-teneurin system as a model, it is likely that numerous peptide systems in the Chordata began as a result of horizontal gene transfer from prokaryotes early in metazoan ancestry.",0,0 +5174,Power of Latent Growth Curve Models to Detect Piecewise Linear Trajectories,"Latent curve models (LCMs) have been used extensively to analyze longitudinal data. However, little is known about the power of LCMs to detect nonlinear trends when they are present in the data. This simulation study was designed to investigate the Type I error rates, rates of nonconvergence, and the power of LCMs to detect piecewise linear growth and mean differences in the slopes of the 2 joined longitudinal processes represented by the piecewise model. The impact of 7 design factors was examined: number of time points, growth magnitude (slope mean), interindividual variability, sample size, position of the turning point, and the correlation of the intercept and the second slope as well between the 2 slopes. The results show that previous results based on linear LCMs cannot be fully generalized to a nonlinear model defined by 2 linear slopes. Interestingly, design factors specific to the piecewise context (position of the turning point and correlation between the 2 growth factors) had some effects on th...",0,0 +5175,Assessment of Accurate Self-Knowledge,"Despite ongoing theoretical interest in the accuracy of self-knowledge and its implications for mental health, few researchers have yet to tackle this topic directly. This may be due, in part, to several factors that make assessing individual differences in accurate self-knowledge especially difficult. In this article, we present a method for the assessment of accurate self-knowledge that relies on information gathered from the self, knowledgeable others, and observations of behavior in the laboratory, and we provide psychometric support for this newly developed assessment procedure. Specifically, we present evidence for internal consistency reliability, convergent and discriminant validity, and criterion-related validity. Other researchers interested in studying the accuracy of self-knowledge might wish to adopt this procedure in their own research endeavors.",0,0 +5176,Salivary Cortisol Lower in Posttraumatic Stress Disorder,"Altered cortisol has been demonstrated to be lower in those with posttraumatic stress disorder (PTSD) in most studies. This cross-sectional study evaluated salivary cortisol at waking and 30 minutes after, and at bedtime in 51 combat veterans with PTSD compared to 20 veterans without PTSD. It also examined the relationship of cortisol to PTSD symptoms using 2 classifications: the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV; American Psychiatric Association, 1994) and the more recent 4-factor classification proposed for DSM-5. The PTSD group had lower cortisol values than the control group, F(6, 69) = 3.35, p = .006. This significance did not change when adding age, body mass index, smoking, medications affecting cortisol, awakening time, sleep duration, season, depression, perceived stress, service era, combat exposure, and lifetime trauma to the model. Post hoc analyses revealed that the PTSD group had lower area-under-the-curve ground and waking, 30 min, and bedtime values; the cortisol awakening response and area-under-the-curve increase were not different between groups. The 4-factor avoidance PTSD symptom cluster was associated with cortisol, but not the other symptom clusters. This study supports the finding that cortisol is lower in people with PTSD.",0,0 +5177,Comorbidity and Labor Force Activity Among People With Psychiatric Disorders,"Comorbidity among people with psychiatric disorders with respect to other health conditions is extensive yet is rarely explored in-depth in occupational studies. We investigated how other ICD-10 comorbidity impacted on the labor force activity of people with psychiatric disorders.A secondary analysis of data files was conducted provided by the Australian Bureau of Statistics (ABS) from a 2003 population survey (N = 36,088). The reference group was working age community residents without long-term health conditions.Comorbidity with a broad range of ICD-10 health conditions can be characterized by both type and extent of comorbidity. Both dimensions are needed to explain impacts on labor force activity.Health professionals, policymakers, and administrators can utilize these results to identify people with psychiatric disorders and comorbidity profiles most likely to need more intensive vocational services.",0,0 +5178,Neurogenetics of emotional reactivity to stress in animals,"There is much evidence for the involvement of central monoaminergic systems, the key targets of stress, in the regulation of mood. Animal and human findings indicate that genetics play a role in the etiology of mood disorders, and so we selected divergent inbred rat strains according to their anxiety-related behaviors on exposure to novel environments. We compared these strains for psychoneuroendocrine response to stressors and/or antidepressants. Molecular genetic studies were also performed to localize the genomic regions associated with these strain-dependent anxiety profiles. We then examined human results indicating that allelic variations in the serotonin transporter (5-HTT) may play a role in the etiology of neuroticism and depression. Thus, we compared inbred rat strains for the 5-HTT, with regard to central and peripheral (platelet) protein expression and function, and the consequences of local application of a selective serotonin reuptake inhibitor (SSRI) on extracellular serotonin (5-HT) levels. Our results indicate that spontaneously hypertensive rats and Lewis rats (LEW) selectively diverge in terms of anxiety-related behaviors and that this divergence is located on chromosome 4. The use of social defeat in LEW and the analysis of its psychoneuroendocrine consequences strongly suggest that such a paradigm, which is sensitive to repeated SSRI treatment, models posttraumatic stress disorder. The Wistar-Kyoto rat may be an adequate model to study the consequences of a genetically driven hypersensitivity to stress and noradrenergic antidepressants. Our most recent findings show that the Fischer 344 and LEW strains differ in protein expression and function of hippocampal and platelet 5-HTT; the divergence in protein expression is not due to allelic variations in the gene-coding sequences and leads to marked differences in extracellular 5-HT levels under basal conditions or SSRI. These examples illustrate how the use of inbred rat strains may complement our knowledge on the genetics of behavior, in the same way as the use of transgenic mice.",0,0 +5179,"The impact of a natural disaster: under- and postgraduate nursing education following the Canterbury, New Zealand, earthquake experiences","While natural disasters have been reported internationally in relation to the injury burden, role of rescuers and responders, there is little known about the impact on education in adult professional populations. A 7.1 magnitude earthquake affected the Canterbury region of New Zealand on 4 September 2010 followed by more than 13,000 aftershocks in the three years to September 2013. As part of a larger study, a mixed method survey was used to explore factors impacting nurses engaged in education through polytechnic and university courses. This paper presents factors that were self-identified by students as supporting their ability to continue with education. Participants were recruited from three nursing settings: undergraduate nursing students, Registered Nurses (RNs) engaged in post-registration education and RNs engaged in postgraduate courses. A total of 290 participants took part in the study. A number of factors identified by participants could be addressed in pre-disaster course planning and curricu...",0,0 +5180,Integrating fragmented evidence by network meta-analysis: relative effectiveness of psychological interventions for adults with post-traumatic stress disorder,"Background. To summarize the available evidence on the effectiveness of psychological interventions for patients with post-traumatic stress disorder (PTSD). Method. We searched bibliographic databases and reference lists of relevant systematic reviews and meta-analyses for randomized controlled trials that compared specific psychological interventions for adults with PTSD symptoms either head-to-head or against control interventions using non-specific intervention components, or against wait-list control. Two investigators independently extracted the data and assessed trial characteristics. Results. The analyses included 4190 patients in 66 trials. An initial network meta-analysis showed large effect sizes (ESs) for all specific psychological interventions (ESs between −1.10 and −1.37) and moderate effects of psychological interventions that were used to control for non-specific intervention effects (ESs −0.58 and −0.62). ES differences between various types of specific psychological interventions were absent to small (ES differences between 0.00 and 0.27). Considerable between-trial heterogeneity occurred ( τ 2 = 0.30). Stratified analyses revealed that trials that adhered to DSM-III/IV criteria for PTSD were associated with larger ESs. However, considerable heterogeneity remained. Heterogeneity was reduced in trials with adequate concealment of allocation and in large-sized trials. We found evidence for small-study bias. Conclusions. Our findings show that patients with a formal diagnosis of PTSD and those with subclinical PTSD symptoms benefit from different psychological interventions. We did not identify any intervention that was consistently superior to other specific psychological interventions. However, the robustness of evidence varies considerably between different psychological interventions for PTSD, with most robust evidence for cognitive behavioral and exposure therapies.",0,0 +5181,Conceptual and methodological issues in developmental psychopathology research,,0,0 +5182,Use of Family Management Styles in Family Intervention Research,Family management styles (FMSs) explain some of the complexities embedded in a family with a child who has chronic illness. The FMS typologies provide descriptions of family adjustment and management of care. These 5 distinct patterns may be valuable in tailoring and evaluating family interventions in research.,0,0 +5183,Attitudes to emotional expression and personality in predicting post-traumatic stress disorder,"To test hypotheses derived from a suggestion of Williams (1989) that negative attitudes towards emotional expression act as a predisposing or maintaining factor for post-traumatic stress reactions following a traumatic event.The study employed a prospective design in which attitudes to emotional expression, the 'Big Five' personality factors (Costa & McCrae, 1992a) and initial symptoms and injury severity within 1 week of a road traffic accident were used to predict the development of post-traumatic stress disorder 6 weeks post-accident.Sixty victims of road traffic accidents randomly selected from attenders at a large A&E department were assessed by questionnaire and interview. Measures comprised a 4-item scale relating to emotional expression, standardized scales for intrusion and avoidance features of traumatic experiences, and for anxiety and depression and the NEO-FFI Five Factor Personality Inventory. Forty-five of these participants responded to a postal questionnaire follow-up. In this survey the battery was repeated and also included a self-report diagnostic measure of post-traumatic stress disorder (PTSD).The percentage of the sample meeting DSM-IV diagnostic criteria for PTSD at 6 weeks post-trauma was 30.8%. A small but significant relationship was found for negative attitudes to emotional expression at 1 week to predict intrusive symptoms and diagnosis at 6 weeks, over and above the independent relationships of initial symptoms, initial injury severity, personality and coping. The emotional expression measure was largely stable between the two points of measurement. More negative attitudes to emotional expression were related to less openness, extraversion and agreeableness personality domains.Some support for the hypotheses was found in relation to the development of PTSD and for the status of attitudes to emotion as a stable trait related to personality factors. The potential importance of attitudes to emotional expression in therapy and other work is discussed.",0,0 +5184,Parenting Stress and Parental Post-traumatic Stress Disorder in Families After Pediatric Heart Transplantation,"There has been little research on the stress experienced by parents of children who have undergone heart transplantation.Parents of 52 consecutive pediatric heart transplant recipients completed questionnaires assessing illness-related parenting stress and post-traumatic stress symptoms at a routine clinic visit. Medical charts were reviewed retrospectively to gather peri- and post-operative information.The average age of patients at transplant was 12 years (range 1 to 18 years), and participation occurred 3 months to 10 years post-transplant (median 2.5 years). Nearly 40% of parents indicated moderately severe to severe post-traumatic stress symptoms. Ten of the 52 participating parents met DSM-IV-TR clinical diagnostic criteria for current post-traumatic stress disorder. Parents also identified significant levels of illness-related parenting stress in the areas of communication around the child's illness, emotional distress, managing the child's medical care, and balancing role functions.Illness-related parenting stress and post-traumatic stress symptoms are significant concerns among parents of pediatric heart transplant patients. Parents' psychologic functioning post-transplant should be routinely assessed and addressed by transplant teams.",0,0 +5185,Associations of postdeployment PTSD symptoms with predeployment symptoms in Iraq-deployed Army soldiers.,"Prior to deployment, military personnel may experience a range of symptoms typically associated with posttraumatic stress disorder (PTSD); however, the relationship of specific preexisting symptoms characteristic of PTSD to postdeployment PTSD symptoms is not well understood. This prospective study examined (a) pre- to postdeployment changes in reexperiencing, avoidance, numbing, and hyperarousal symptoms among Iraq-deployed military personnel, and (b) pre- to postdeployment associations among these symptom groupings. Seven-hundred and seventy-four U.S. Army soldiers completed the PTSD Checklist pre- and postdeployment to Iraq. Participants demonstrated increases in reexperiencing, avoidance, and hyperarousal symptom severity but not in severity of numbing symptoms from pre- to postdeployment. Predeployment numbing was positively correlated with all postdeployment symptom clusters, and predeployment hyperarousal was positively correlated with postdeployment hyperarousal, reexperiencing, and numbing. Findings highlight the role of preexisting numbing and hyperarousal symptoms in the evolution of PTSD symptoms following trauma exposure. © 2012 American Psychological Association.",0,0 +5186,"The impact of gender, non-military trauma and combat exposure on the development of Post-Traumatic Stress Disorder (PTSD) in the Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MA-MIRECC)","Post-Traumatic Stress Disorder (PTSD) is a significant public health concern, both in the United States and internationally, as well as in civilian populations and among those who serve their country in the military. Those who are exposed to a number of different kinds of potentially traumatic events are at risk of developing Post-Traumatic Stress Disorder. A number of factors, however, have been identified that may put certain people at an increased risk for developing Post-Traumatic Stress Disorder. These factors include, but are not limited to, female gender, having been exposed to multiple traumatic events throughout one's life, being exposed to certain types of potentially traumatic events, and being exposed to military combat. The present study was a secondary analyses of a sample of veterans returning from serving in Operation Iraqi Freedom/Operation Enduring Freedom/Operation New Dawn, who were surveyed as part of the multisite Department of Veterans Affairs Mid-Atlantic VISN-6 Mental Illness Research, Education and Clinical Centers (MIRECC). The present study examined the role of gender in the development of Post-Traumatic Stress Disorder, whether those who have been exposed to potentially traumatic non-combat events, and combat, are more likely to experience Post-Traumatic Stress Disorder, and whether gender and non-combat trauma act synergistically in predicting Post-Traumatic Stress Disorder. When examined along with demographic factors, including age, race, marital status, working status, and education status, gender did not add to the prediction of PTSD above the contribution of demographic variables such as age race, marital status. When controlling for non-combat trauma and combat exposure, gender was found to significantly predict PTSD. And while these three variables independently predicted PTSD, the interaction of non-combat trauma and combat exposure did not vary meaningfully according to gender. Finally, when considering different levels of combat exposure, gender did not significantly predict PTSD based on the extent of combat experienced. Given the lack of consensus in the broader literature, the present study's findings have important implications regarding clarifying the relationship between gender and Post-Traumatic Stress Disorder and may increase understanding regarding the mechanisms behind any gender differences in Post-Traumatic Stress Disorder. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0,0 +5187,"If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans.","The notion that chronic stress fosters disease by activating the hypothalamic-pituitary-adrenocortical (HPA) axis is featured prominently in many theories. The research linking chronic stress and HPA function is contradictory, however, with some studies reporting increased activation, and others reporting the opposite. This meta-analysis showed that much of the variability is attributable to stressor and person features. Timing is an especially critical element, as hormonal activity is elevated at stressor onset but reduces as time passes. Stressors that threaten physical integrity, involve trauma, and are uncontrollable elicit a high, flat diurnal profile of cortisol secretion. Finally, HPA activity is shaped by a person's response to the situation; it increases with subjective distress but is lower in persons with posttraumatic stress disorder.",0,0 +5188,Relationship Between Acute Stress Disorder and Posttraumatic Stress Disorder Following Mild Traumatic Brain Injury,"The aim of this study was to index the frequency of occurrence of acute stress disorder following mild traumatic brain injury and to determine its utility in predicting posttraumatic stress disorder (PTSD).Consecutive adult patients who sustained a mild traumatic brain injury following a motor vehicle accident (N = 79) were assessed for acute stress disorder within 1 month of their trauma with the Acute Stress Disorder Inventory, a structured clinical interview based on DSM-IV criteria. Patients were followed up 6 months after the trauma (N = 63) and were administered the PTSD module of the Composite International Diagnostic Interview.Acute stress disorder was diagnosed in 14% of patients, and at follow-up 24% satisfied criteria for PTSD. Six months after the trauma PTSD was diagnosed in 82% of patients who had been diagnosed with acute stress disorder and in 11% of those who had not been diagnosed with acute stress disorder.These findings point to the frequency of PTSD following mild traumatic brain injury. While the criteria for acute stress disorder are useful in identifying those individuals who are at risk of developing chronic PTSD, the findings suggest that current criteria require modification in order to optimally predict PTSD following mild traumatic brain injury.",0,0 +5189,Postcancer Experiences of Childhood Cancer Survivors: How Is Posttraumatic Stress Related to Posttraumatic Growth?,"Understanding posttraumatic growth (PTG) and the factors associated with PTG among cancer survivors is important to improve their quality of life. This study examined PTG among 225 Korean adolescents and young adults between 15 years and 39 years of age who survived childhood cancer (58.5% males and 41.5% females). We explored the relationships between PTG and several sociodemographic and medical variables, and whether the relationships between PTG and posttraumatic stress disorder (PTSD) symptoms were linear or curvilinear. The Posttraumatic Stress Diagnostic Scale (PDS) and the Posttraumatic Growth Inventory (PTGI) were used to assess PTSD symptoms and PTG, respectively. In addition to the effects of sociodemographic and medical variables, there were linear effects of PDS on PTGI (R(2) change = .03, p = .008). No evidence of a curvilinear relationship between PDS and PTGI was found. Higher PDS scores were associated with lower PTGI scores (β = -.18). Older age (β = .41) and shorter time since diagnosis (β = -.42) were associated with greater PTGI. Understanding the factors that were associated with PTG among Korean adolescent and young adult survivors of cancer adds to the knowledge on PTG and may help develop services to promote PTG in this group.",0,0 +5190,A Cross-sectional Study on the Current Prevalence of Post-traumatic Stress Disorder in Adults Orphaned by Tangshan Earthquake in 1976,"Objectives:To investigate the current prevalence and risk factors of post-traumatic stress disorder in people orphaned by Tangshan earthquake in 1976.Methods:Two hundreds and sixty adults orphaned by the earthquake were interviewed to determine whether they were suffering from PTSD according to Chinese Classification and Diagnostic Criteria for Mental Disorder,the third Revised Edition(CCMD-3).All the subjects were divided into two groups,PTSD group and normal group.The assessed variables included subjective traumatic experiences during the earthquake,post-traumatic reactions,and current mental health status.Logistic regression analysis was conducted to identify risk factors of PTSD.Results:32(12.00%) cases were diagnosed as PTSD among 260 orphans.In comparison with orphans without PTSD,orphans with PTSD had significantly higher SAS(47.8±14.5/40.3±10.3),SDS(53.0±12.0/45.2±11.7)and SCL-90 total score(156.6±65.5/127.9±41.0),P0.05.In a stepwise logistic regression model,six risk factors were significantly correlated with the development of PTSD including age at the time of the earthquake(OR=4.5),EPQ-N score(OR=0.2),EPQ-E score(OR=5.5),strong posttraumatic spiritual pain(OR=3.5),recurrent nightmare(OR=5.4),and negative coping style(OR=3.9).Conclusions:30 years later the prevalence of PTSD in those orphaned survivors is still high and PTSD were significantly correlated with adolescence,severity of traumatic events,stressful reaction post earthquake,personality characteristics as well as negative coping style.",0,0 +5191,Diagnostic profiles of offenders in substance abuse treatment programs,"This study examined the association of Axis I and Axis II disorders among offenders who were in prison-based substance abuse treatment in a national multi-site study. Participants (N = 280) received a psychosocial assessment and a structured diagnostic interview in two separate sessions. Logistic regression models examined the association between lifetime mood and anxiety disorders with two personality disorders, and the relationship of Axis I and Axis II disorders (alone and in combination) to pre-treatment psychosocial functioning. Over two-thirds of the sample met criteria for at least one mental disorder. Borderline personality disorder was strongly associated with having a lifetime mood disorder (odds ratio = 7.5) or lifetime anxiety disorder (odds ratio = 8.7). Individuals with only an Axis II disorder, or who had both Axis I and Axis II disorders, had more severe problems in psychosocial functioning than those without any disorder. Clinical treatment approaches need to address this heterogeneity in diagnostic profiles, symptom severity, and psychosocial functioning.",0,0 +5192,Deployment stressors and physical health among OEF/OIF veterans: The role of PTSD.,"There is a large body of literature documenting the relationship between traumatic stress and deleterious physical health outcomes. Although posttraumatic stress disorder (PTSD) symptoms have been proposed to explain this relationship, previous research has produced inconsistent results when moderating variables such as gender or type of traumatic stressor are considered. Within a large sample of Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) Veterans, the current study examined if deployment stressors (i.e., combat stress, harassment stress) contributed unique variance to the prediction of physical health symptoms (i.e., pain, nonpain) beyond the effects of PTSD symptoms.A total of 2,332 OEF/OIF Veterans, with equal representation of women and men, completed a series of self-report measures assessing deployment stressors, PTSD symptoms, and physical health symptoms.RESULTS revealed that harassment, but not combat stress, added unique variance in the prediction of pain and nonpain symptoms after accounting for PTSD symptoms.This study extends the existing literature by demonstrating the unique influence of harassment stress on physical health outcomes. Specifically, the relationship between combat stress and physical health symptoms appears to be explained mainly by an individual's experience of PTSD symptoms, whereas the relationship between harassment stress and physical health symptoms is not fully explained by PTSD symptoms, suggesting that other variables may be involved in the pathway from harassment stress to physical health symptoms.",0,0 +5193,Mindfulness-Based Stress Reduction Among Breast Cancer Survivors: A Literature Review and Discussion,"To evaluate and discuss existing studies of mindfulness-based stress reduction (MBSR) among breast cancer survivors.Articles published from 1987-2009 were retrieved using MEDLINE®, CINAHL®, Ovid, and Scopus. Key words, including mindfulness-based stress reduction and mindfulness meditation, were combined with breast cancer.The search resulted in 26 articles that were narrowed down to 16 by selecting only quantitative studies of MBSR conducted with breast cancer (n = 7) or heterogeneous types of cancer in which the predominant cancer was breast cancer (n = 9). Most studies were one-group pre- and post-test design and examined the effect of MBSR on psychological outcomes. Overall, the studies had large effect sizes on perceived stress and state anxiety and medium effect sizes on symptoms of stress and mood disturbance. Four studies measured biologic outcomes and had small effect sizes, except cytokine production, which showed a large effect size at 6- and 12-month follow-ups.Future studies using randomized, control trials and longitudinal, repeated-measures designs are needed. Studies conducted with heterogeneous types of cancer and gender should be analyzed and the results reported separately.The comprehensive summary and critical discussion of existing studies of MBSR usage among breast cancer survivors provide essential information that can be used by nurses and others working in the healthcare setting.",0,0 +5194,Media exposure and dimensions of anxiety sensitivity: Differential associations with PTSD symptom clusters,"The present investigation examined the impact of anxiety sensitivity (AS) and media exposure on posttraumatic stress disorder (PTSD) symptoms. Reactions from 143 undergraduate students in Hamilton, Ontario were assessed in the Fall of 2003 to gather information on anxiety, media coverage, and PTSD symptoms related to exposure to a remote traumatic event (September 11th). Regression analyses revealed that the Anxiety Sensitivity Index (ASI; [Peterson, R. A., & Reiss, S. (1992). Anxiety Sensitivity Index manual, 2nd ed. Worthington, Ohio: International Diagnostic Systems]) and State-Trait Anxiety Inventory trait form (STAI-T; [Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970). State-trait anxiety inventory. Palo Alto, California: Consulting Psychologists Press]) total scores were significant predictors of PTSD symptoms in general. The ASI total score was also a significant predictor of hyperarousal and avoidance symptoms. Subsequent analyses further demonstrated differential relationships based on subscales and symptom clusters. Specifically, media exposure and trait anxiety predicted hyperarousal and re-experiencing symptoms, whereas the ASI fear of somatic sensations subscale significantly predicted avoidance and overall PTSD symptoms. Implications and directions for future research are discussed.",0,0 +5195,Pharmacokinetics and Metabolism of SRX246: A Potent and Selective Vasopressin 1a Antagonist,"SRX246 is a potent, highly selective, orally bioavailable vasopressin 1a receptor antagonist that represents a novel mechanism of action for the treatment of mood disorders. The compound previously showed efficacy in animal models of mood disorders and excellent safety and tolerability in healthy volunteers in phase I clinical trials. In this study, SRX246 was further characterized in rats and dogs. In vitro determinations of permeability, protein binding, hepatocyte metabolism, and cytochrome P450 enzyme inhibition and in vivo assessments of pharmacokinetics were conducted. In parallel artificial membrane permeability assay (PAMPA) and PAMPA-blood-brain barrier models, SRX246 was comparable to highly permeable, orally active pharmaceuticals. SRX246 hydrochloride salt was 95.5 ± 1.7%, 95.9 ± 1.3%, and 98.6 ± 0.4% bound to rat, dog, and human serum proteins, respectively, and was stable in serum after a 4 h incubation at 37°C. P450 enzyme inhibition results showed a very low potential for drug-drug interactions. Metabolism in primary hepatocytes demonstrated that SRX246 was stable in humans and moderately metabolized in dogs and rats. Plasma pharmacokinetics findings showed a half-life (T½ ) of 2 and 6 h in rat and dog, respectively. Rat brain levels following a single oral dose were approximately 20% of plasma values with a T½ of 6 h. The observed profile for SRX246 supports further development.",0,0 +5196,Post-traumatic stress symptoms and trauma exposure in youth with first episode bipolar disorder,"To examine the prevalence of trauma exposure as well as the rates and effects of post-traumatic stress disorder (PTSD) in adolescents with bipolar disorder following a first manic episode.Adolescents (12-18 years) with DSM-IV bipolar I disorder and experiencing their first manic or mixed episode were recruited. Participants underwent structured diagnostic interviews, completed the Trauma Symptom Checklist for Children (TSCC), and were prospectively evaluated using diagnostic, symptomatic and functional assessments over the course of 12 months.Seventy-six adolescents (14.9 +/- 1.7 years) completed the TSCC and 66% (50 individuals) reported exposure to traumatic events. Two (3%) subjects met DSM-IV criteria for PTSD, 11 (14%) had post-traumatic stress t-scores > or = 65, the threshold for clinically significant symptoms. Subjects with and without post-traumatic stress t-scores > or = 65 did not differ in demographic characteristics. When compared by t-score, TSCC subscores of the first episode bipolar adolescents were similar to normative data. Regression models incorporating TSCC subcomponents, did not predict syndromic recovery or recurrence or symptomatic recovery.Rates of PTSD were lower in this sample of bipolar adolescents at the time of their first hospitalization compared with rates in samples of bipolar adults. These differences coupled with the low incidence of PTSD and trauma symptoms in this young sample suggests that bipolar disorder may be a risk factor for the development of PTSD later in the course of illness or following recurrent affective episodes.",0,0 +5197,Emotion regulation difficulties and posttraumatic stress disorder symptom cluster severity among trauma-exposed college students.,"The present investigation examined the role of emotion regulation difficulties in predicting severity of the 3 posttraumatic stress disorder (PTSD) symptom clusters (i.e., reexperiencing, hyperarousal, avoidance) in a sample of undergraduates who reported exposure to at least 1 DSM-IV-TR Criterion A traumatic event (n = 297; 77.1% female, Mage = 20.46, SD = 4.64, range = 18-50 years). Results indicated that greater difficulties with emotional acceptance significantly predicted greater avoidance and hyperarousal symptom severity above and beyond the effects of number of trauma types endorsed and negative affect. Emotion regulation difficulties were not significantly predictive of reexperiencing symptom severity. Results from an exploratory analysis indicated that greater difficulties with emotional acceptance and greater difficulties accessing effective emotion regulation strategies when upset significantly predicted the DSM-5 negative alterations in cognitions and mood symptom cluster. These findings suggest that difficulties accepting one's emotional responses, in particular, may heighten emotional responding to and avoidance of trauma-related cues. Thus, individuals who experience such difficulties may be more likely to experience negative outcomes after experiencing a traumatic event.",0,0 +5198,Treatment of complex PTSD: Results of the ISTSS expert clinician survey on best practices,"This study provides a summary of the results of an expert opinion survey initiated by the International Society for Traumatic Stress Studies Complex Trauma Task Force regarding best practices for the treatment of complex posttraumatic stress disorder (PTSD). Ratings from a mail-in survey from 25 complex PTSD experts and 25 classic PTSD experts regarding the most appropriate treatment approaches and interventions for complex PTSD were examined for areas of consensus and disagreement. Experts agreed on several aspects of treatment, with 84% endorsing a phase-based or sequenced therapy as the most appropriate treatment approach with interventions tailored to specific symptom sets. First-line interventions matched to specific symptoms included emotion regulation strategies, narration of trauma memory, cognitive restructuring, anxiety and stress management, and interpersonal skills. Meditation and mindfulness interventions were frequently identified as an effective second-line approach for emotional, attentional, and behavioral (e.g., aggression) disturbances. Agreement was not obtained on either the expected course of improvement or on duration of treatment. The survey results provide a strong rationale for conducting research focusing on the relative merits of traditional trauma-focused therapies and sequenced multicomponent approaches applied to different patient populations with a range of symptom profiles. Sustained symptom monitoring during the course of treatment and during extended follow-up would advance knowledge about both the speed and durability of treatment effects.",0,0 +5199,Childhood sexual abuse: Effects on female sexual function and its treatment,"For many woman survivors of childhood sexual abuse, there are long-term sexual sequelae, such as hypersexual activity and avoidance, although the trajectory to each type of response remains unclear. Female survivors of childhood sexual abuse have problems with intimate relationships and some survivors may also complain of multiple health problems and use emergency room services at a higher rate than women who were not sexually abused. Although the health care provider is in a position to screen for childhood sexual abuse, care must be taken to maintain trust if referring the survivor for psychotherapy, specifically sex therapy, which can be the treatment of choice. This article reviews the effect of childhood sexual abuse in female sexual function and provides general treatment recommendations.",0,0 +5200,"Exploring the roles of emotional numbing, depression, and dissociation in PTSD","Some researchers consider emotional numbing a cardinal feature of posttraumatic stress disorder (PTSD). Others view numbing symptoms as representing an overlap between PTSD, depression, and dissociation. In this study, we examined the ability of early emotional numbing, depression, and dissociation symptoms to predict PTSD. One-hundred sixty-one women who were recent victims of sexual or nonsexual assault were assessed prospectively for 12 weeks. Emotional numbing, depression, and dissociation were each associated with initial PTSD severity. Notably, regression analyses revealed that after depression and dissociation were accounted for, early numbing contributed to the prediction of later PTSD.",0,0 +5201,Body Mass Index and Quality of Life: Examining Blacks and Whites With Chronic Pain,"Obesity contributes to several chronic pain conditions, negatively affecting quality of life (QOL). However, obesity's relationship with chronic pain is poorly understood. This prospective survey study examines obesity's role in chronic pain and subsequent impact on QOL. Black and white patients with chronic pain (N = 183, 18-50 years of age, 64% women, 50% black) were studied to determine predictors for the presence of body mass index (BMI) information in medical records, group BMI differences, and how BMI and pain contribute to mental/physical outcomes. BMI was calculated by using medical records nearest the enrollment date. Sociodemographic data, sleep, pain, functioning, disability, and depression were measured. BMI data were available for 143 subjects (78%), with blacks having a higher BMI (P = .002). Black (P = .08), people with higher pain (P < .01), affective distress (P < .01), and post-traumatic stress disorder scores (P = .07) were less likely to have their BMI recorded. Path analysis tested relationships between sociodemographics, BMI and pain with functioning, depression, and disability. BMI was positively associated with black race and age and predicted poorer physical functioning and greater disability. Pain was not predicted by race or age but was associated with all outcomes. These findings support assessing BMI when managing chronic pain and its negative impact on QOL, especially for minority patients.This study examines the relationships among sociodemographic factors, BMI, and QOL in chronic pain. Our results demonstrate significant racial disparity among chronic pain patients in assessing BMI and quality of pain care. These findings support obesity's negative impact on overall health and the importance of measuring BMI in patients with chronic pain, especially racial and ethnic minorities.",0,0 +5202,Functional independence in pediatric-onset spinal cord injury: Two levels of mediation.,"To test 3 models that examine the relationship of posttraumatic stress (PTS), family functioning (FF), and level of spinal cord injury (SCI) to functional independence (FI) among patients with pediatric-onset SCI.Participants were 109 pediatric spinal cord injury patients, ages 11-24 years, from 2 surgical and rehabilitation hospitals. Data from 2 previous cross-sectional studies included the Posttraumatic Diagnostic Scale, the Family Assessment Device, and the Pediatric Orthopedic Surgeons of North America Pediatric Musculoskeletal Functional Health Questionnaire. Path analyses were used to test 3 hypothesized models: that PTS would mediate the relationship between FF and FI, that PTS Avoidance symptoms would mediate the relationship between other PTS symptom clusters and FI, and that these 2 models would show adequate fit to the data when integrated into an overarching model to depict the interrelationship of level of SCI (tetraplegia v. paraplegia), FF, PTS symptom clusters, and FI.Results from the first model indicated that PTS mediated the relationship between FF and FI. In addition, the Avoidance symptom cluster of PTS mediated the relationships between PTS Reexperiencing symptoms and FI and between the PTS Arousal symptom cluster and FI. A third model integrated the previous 2 models and supported these 2 levels of mediation.Level of SCI related directly to FI, and PTS mediated the relationship between FF and FI; PTS Avoidance mediated the relationships between Intrusive Reexperiencing and FI and between PTS Arousal and FI.",0,0 +5203,"Associations Between Coerced Anal Sex and Psychopathology, Marital Distress and Non-Sexual Violence","There is a dearth of scientific data on anal intercourse in heterosexual relationships. Likewise, anal sex within marital relationships has yet to be fully explored.Among a representative sample of married women in the Iranian capital, Tehran, we aimed to determine the association of self-reported coerced anal sex with: (i) self-reported coerced vaginal sex; (ii) self-reported non-sexual violence; (iii) psychopathology; and (iv) marital attitude.The data presented here were obtained from the Family Violence Survey conducted in Tehran in 2007. A total of 230 married Iranian women were selected via a multi-cluster sampling method from four different randomized regions. The subjects' sociodemographic data, psychological distress (Symptom Check List; SCL-90-R), personality, and relationship characteristics (Personal and Relationships Profile), and marital attitude (Marital Attitude Survey) were gathered. In addition, the participants' self-reported histories of lifetime victimization through all types of violence by the husband, including coerced anal and vaginal sex as well as psychological and physical assault (Conflict Tactic Scales-Revised; CTS-2), were collected.There were associations between self-reported victimization through coerced anal and vaginal sex (P < 0.001), psychological (P < 0.001), and physical aggression (P < 0.001). Those reporting to have been forced into anal intercourse cited higher rates of paranoid and psychotic features, jealousy, attribution of problems to one's own behavior, conflict, and male dominance, as well as lower expectations of improvement in one's marital relationship.In marital relationships, women are at a higher risk of coerced anal sex if subjected to other types of sexual or non-sexual violence. Higher rates of psychopathology and poorer marital relationships are also allied to self-reported anal sexual coercion.",0,0 +5204,A prospective analysis of trauma exposure: The mediating role of PTSD symptomatology,"Trauma exposure has been associated with increased risk of exposure to additional traumatic events. Reactions to trauma exposure, specifically PTSD symptomatology, may mediate the link between trauma exposure and later traumatic events. Data from a longitudinal sample of Gulf War veterans (N = 2,949) were analyzed using a series of regression models. Higher levels of combat exposure were related to increased reports of PTSD symptomatology immediately upon return as well as increased reports of traumatic events in the 2 years following the Gulf War. PTSD symptomatology partially mediated the link between combat exposure and later trauma. Symptom clusters were also analyzed separately as potential mediators. Implications for the treatment of PTSD and prevention of exposure to multiple traumas are discussed.",0,0 +5205,"Attachment, Personality Characteristics, and Posttraumatic Stress Disorder in U.S. Veterans of Iraq and Afghanistan","U.S. veterans of Iraq and/or Afghanistan (N = 116) completed an Internet survey with questions related to attachment style in intimate relationships, personality factors, and posttraumatic stress disorder (PTSD). Participants completed the PTSD Checklist-Military, Experiences in Close Relationships Scale-Short Form, and the International Personality Item Pool Big Five Short Form Questionnaire. Most participants were male and Caucasian. Hierarchical linear regression analysis results indicated that emotional stability (β = −.46, p < .001) and attachment avoidance (β = .20, p < .05) were associated with PTSD symptom severity (adjusted R2 = .63). An interaction between conscientiousness and attachment anxiety was found (β = −.26, p < .001; ΔR2 = .06), with secure attachment moderating the relationship between conscientiousness and PTSD symptom severity. Results of this study indicate that emotional stability, conscientiousness, and secure relationship attachment styles (low attachment anxiety and avoidance) are important for postcombat mental health.",0,0 +5206,Comparison of the MMPI-PTSD subscale with PTSD and substance abuse patient populations,"War-related PTSD frequently presents as a dual disorder. Questions have been raised about whether the MMPI-PTSD subscale developed by Keane. Malloy, and Fairbank (1984) is identifying a separate PTSD syndrome or is a measure of generalized distress common to various diagnostic categories, including substance abuse. In this study, veterans with PTSD with and without substance abuse were compared to veterans with substance abuse only on the MMPI-PTSD subscale (n = 22 in each of the four categories). Results support the ability of the test to distinguish between groups of veterans with PTSD and those with substance abuse only. The findings lend indirect support to the validity of a distinct PTSD symptom cluster.",0,0 +5207,Function after Motor Vehicle Accidents: A Prospective Study of Mild Head Injury and Posttraumatic Stress,"Relationships among mild traumatic brain injury (MTBI), posttraumatic stress (PTS), and function were examined in 99 motor vehicle accident (MVA) admissions: 64 in an MTBI group and 35 in a no-MTBI comparison group. Assessments occurred within the first month and at 6 to 9 months. At follow-up, the sample was moderately disabled on the Sickness Impact Profile (SIP), 71% satisfied on the Reintegration of Normal Living Index (RNL), and 42% had returned to work. Only the SIP Psychosocial score was significantly different for MTBI groups; 24% of the sample showed definite symptoms of PTS. This group was significantly more disabled on the SIP, less satisfied on the RNL, and less likely to return to work. The proportion of variance in outcome explained in each model ranged from 32% (Physical SIP) to 44% (RNL). Results suggest the need for clinicians to be more aware of the strong influence of PTS on functional outcomes.",0,0 +5208,"Mental disorders, treatment response, mortality and serum cholesterol: a new holistic look at old data.","The importance of cholesterol for physical and psychological well-being has been recognized for several decades. Changes in serum cholesterol levels may have a direct impact on mental performance, behavior, treatment response, survival and expected lifetime duration.To examine the association between various mental disorders (schizophrenia, bipolar disorder, depression, generalized anxiety disorder, panic disorders, post-traumatic stress disorder and other mental disorders) and cholesterol levels, and to discuss the possible treatment implications.A MEDLINE search, citing articles from 1966 onward, supplemented by a review of bibliographies, was conducted to identify relevant studies. Criteria used to identify studies included (1) English language, (2) published studies with original data in peer-reviewed journals.Clinical investigations of cholesterolemia in patients with major mental disorders have produced very conflicting results. Hypercholesterolemia has been reported in patients with schizophrenia, obsessive-compulsive disorders, panic disorder, generalized anxiety disorder, PTSD. Low cholesterol level has been reported in patients with major depression, dissociative disorder, antisocial personality disorder, borderline personality disorder. It seems that both high and low serum total cholesterol may be associated with a higher risk of the premature death.Our current knowledge on the relation between cholesterolemia and mental disorders is poor and controversial. No definite or reliable insight into a pathophysiological link between cholesterol levels and mental disorders, treatment response and mortality rate is available. The lipoprotein profile, rather than total cholesterol levels, seems to be important.",0,0 +5209,"Unique Patterns of Substance Misuse Associated With PTSD, Depression, and Social Phobia","OBJECTIVES: This study investigated the relations between post-trauma psychopathology and substance abuse in a sample of trauma-exposed college students (n = 136) assigned to four groups based on primary diagnosis: posttraumatic stress disorder, depression, social phobia, or well-adjusted (participants who had low levels of distress). Groups were compared on a series of dimensions of substance use/abuse. RESULTS: Participants in the PTSD group evidenced greater substance use and abuse than those in the social phobia and well-adjusted groups on several dimensions and greater alcohol consumption than the depressed group. Correlation analyses suggested that most dimensions of substance abuse were related more strongly to avoidance and numbing (cluster C) symptoms than to reexperiencing and hyperarousal. CONCLUSIONS: The present findings suggest that trauma-related psychopathology may be associated with a more hazardous pattern of substance use than depression and social phobia.",0,0 +5210,Humiliation: the invisible trauma of war for Palestinian youth,"To investigate the influence of exposure to humiliation in war-like conditions on health status in 10th- and 11th-grade students living in the Ramallah District, West Bank, Occupied Palestinian Territory.A stratified single-stage cluster sample of 3415 students from cities, towns, villages and refugee camps of the Ramallah District.Survey questions were derived from the World Health Organization's Health Behaviour in School-aged Children Survey, the Gaza Community Mental Health Programme Traumatic Event Checklist, and focus group discussions with young people. The survey questionnaire was completed by students in their classrooms, under the supervision of a trained field worker.There was a significant association between a high number of subjective health complaints and demographic variables, particularly for females compared with males, and refugee camp dwellers compared with village dwellers. In addition, exposure to humiliation was significantly associated with an increased number of subjective health complaints. Students experiencing three forms of humiliation were found to be 2.5 times more likely to report a high number of subjective health complaints compared with those who had never been exposed to humiliation (52% vs 21%), while those experiencing four forms of humiliation were three times more likely to report a high number of subjective health complaints (62% vs 21%). A multiple logistic regression model revealed that humiliation was significantly associated with a high number of subjective health complaints, even after adjusting for sex, residence and other measures of exposure to violent events. The odds ratio of reporting a high number of subjective health complaints increased as the number of forms of humiliation increased, with values of 1.69, 2.67, 4.43 and 7.49 for reporting a high number of subjective health complaints when exposed to one, two, three or four forms of humiliation, respectively, compared with those who had never been exposed to humiliation.The results of this study demonstrate that humiliation induced by conflict and war-like conditions constitutes an independent traumatic event that is associated with negative health outcomes in its own right, regardless of exposure to other violent/traumatic events. Based on these findings, it is proposed that humiliation should be included as an indicator of mental health status in research that investigates the consequences of war and conflict on the health of populations.",0,0 +5211,"Tasco®, a Product of Ascophyllum nodosum, Imparts Thermal Stress Tolerance in Caenorhabditis elegans","Tasco(®), a commercial product manufactured from the brown alga Ascophyllum nodosum, has been shown to impart thermal stress tolerance in animals. We investigated the physiological, biochemical and molecular bases of this induced thermal stress tolerance using the invertebrate animal model, Caenorhabiditis elegans. Tasco(®) water extract (TWE) at 300 μg/mL significantly enhanced thermal stress tolerance as well as extended the life span of C. elegans. The mean survival rate of the model animals under thermal stress (35 °C) treated with 300 μg/mL and 600 μg/mL TWE, respectively, was 68% and 71% higher than the control animals. However, the TWE treatments did not affect the nematode body length, fertility or the cellular localization of daf-16. On the contrary, TWE under thermal stress significantly increased the pharyngeal pumping rate in treated animals compared to the control. Treatment with TWE also showed differential protein expression profiles over control following 2D gel-electrophoresis analysis. Furthermore, TWE significantly altered the expression of at least 40 proteins under thermal stress; among these proteins 34 were up-regulated while six were down-regulated. Mass spectroscopy analysis of the proteins altered by TWE treatment revealed that these proteins were related to heat stress tolerance, energy metabolism and a muscle structure related protein. Among them heat shock proteins, superoxide dismutase, glutathione peroxidase, aldehyde dehydrogenase, saposin-like proteins 20, myosin regulatory light chain 1, cytochrome c oxidase RAS-like, GTP-binding protein RHO A, OS were significantly up-regulated, while eukaryotic translation initiation factor 5A-1 OS, 60S ribosomal protein L18 OS, peroxiredoxin protein 2 were down regulated by TWE treatment. These results were further validated by gene expression and reporter gene expression analyses. Overall results indicate that the water soluble components of Tasco(®) imparted thermal stress tolerance in the C. elegans by altering stress related biochemical pathways.",0,0 +5212,When Epidemiology Meets the Internet: Web-based Surveys in the Millennium Cohort Study,"Almost 60% of American households were connected to the Internet in 2001, when the Millennium Cohort Study, the largest longitudinal study ever undertaken by the Department of Defense, was launched. To facilitate survey completion, increase data integrity, and encourage cohort retention while maintaining the highest standards of participant privacy, an online questionnaire was made available on the World Wide Web in addition to a traditional paper questionnaire sent via US mail. Over 50% of 77,047 participants chose to enroll in the study via the Web, affording substantial cost savings to the project. Using multivariable logistic regression, the authors compared the demographic and health characteristics of Web responders with those of paper responders. Web responders were slightly more likely to be male, to be younger, to have a high school diploma or college degree, and to work in information technology or another technical occupation. Web responders were more likely to be obese and to smoke more cigarettes and were less likely to be problem alcohol drinkers and to report occupational exposures. Question completion rates were 98.3%, on average, for both Web and paper responders. Web responders provided more complete contact information, including their e-mail addresses. These results demonstrate the value of survey research conducted over the Internet in concert with traditional mail survey strategies.",0,0 +5213,Post-traumatic stress disorder among patients with chronic pain and chronic fatigue,"Fibromyalgia (FM), a chronic pain condition of unknown aetiology often develops following a traumatic event. FM has been associated with post-traumatic stress disorder (PTSD) and major depression disorder (MDD).Patients seen in a referral clinic (N=571) were evaluated for FM and chronic fatigue syndrome (CFS) criteria. Patients completed questionnaires, and underwent a physical examination and a structured psychiatric evaluation. Critical components of the diagnostic criteria of FM (tender points and diffuse pain) and CFS (persistent debilitating fatigue and four of eight associated symptoms) were examined for their relationship with PTSD.The prevalence of lifetime PTSD was 20% and lifetime MDD was 42%. Patients who had both tender points and diffuse pain had a higher prevalence of PTSD (OR=3.4, 95% CI 2.0-5.8) compared with those who had neither of these FM criteria. Stratification by MDD and adjustment for sociodemographic factors and chronic fatigue revealed that the association of PTSD with FM criteria was confined to those with MDD. Patients with MDD who met both components of the FM criteria had a three-fold increase in the prevalence of PTSD (95% CI 1.5-7.1); conversely, FM patients without MDD showed no increase in PTSD (OR=1.3, 95% CI 0.5-3.2). The components of the CFS criteria were not significantly associated with PTSD.Optimal clinical care for patients with FM should include an assessment of trauma in general, and PTSD in particular. This study highlights the importance of considering co-morbid MDD as an effect modifier in analyses that explore PTSD in patients with FM.",0,0 +5214,Post-traumatic stress disorder in brain injury patients,"In the absence of the recognition of the emotional sequelae following traumatic brain injury (TBI), many patients are deprived of adequate treatment. The purpose of the current study is to evaluate the prevalence of post-traumatic stress disorder (PTSD) and explore the clinical picture among TBI patients. Twenty four outpatients with diagnosed head injuries following various traumas filled out standardized questionnaires, assessing post-traumatic residuals. Thirty-three per cent of these patients met criteria for PTSD diagnosis. The clinical picture of PTSD following TBI is somewhat distinguished from those following other traumatic events. Issues concerning the specific nature of the syndrome following TBI, and the difficulties in differentiating between PTSD and postconcussive syndrome, are discussed.",0,0 +5215,Posttraumatic stress disorder in DSM‐5: New criteria and controversies.,"The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) featured extensive changes to the posttraumatic stress disorder (PTSD) diagnosis. PTSD was moved out of the anxiety disorders into a new class of “trauma- and stressor-related disorders,” and the definition of what constitutes a traumatic experience was revised. Three new symptoms were added, existing ones were modified, and a new four-cluster organization and diagnostic algorithm were introduced. Finally, a new dissociative subtype was added to the diagnosis. We review these changes, discuss some of the controversies surrounding them, and then introduce a new debate involving a radically different conceptualization of PTSD proposed for International Classification of Diseases, 11th edition.",0,0 +5216,Trauma Reactions in Mothers and Fathers After Their Infant's Cardiac Surgery,"To investigate the prevalence and nature of trauma symptoms in mothers and fathers of infants who had cardiac surgery.Parents of infants who underwent cardiac surgery before 3 months of age were recruited at the time of surgery. 77 mothers and 55 fathers completed the Acute Stress Disorder Scale 1 month after their infant was discharged from hospital.26 of 77 (33.8%) mothers and 10 of 55 (18.2%) fathers satisfied criteria for acute stress disorder. For all symptom clusters, except dissociation, mothers had significantly higher mean scores (and therefore higher levels of symptoms) than did fathers, ps = .01, -.02. 83 percent of parents endorsed at least 1 trauma symptom and 11.4% endorsed only 1 symptom at a clinical level. Symptoms of dissociation were the most commonly endorsed by both parents, with each symptom in that cluster being endorsed at a clinical level by at least 26% of parents.Consistent with our hypotheses, approximately one-third of parents overall, as well as one-third of mothers and close to one-fifth of fathers, experienced trauma symptoms consistent with a diagnosis of acute stress disorder. Most parents experienced at least one symptom at a clinical level, with symptoms of dissociation being the most commonly endorsed symptom cluster. These findings highlight the need for clinical supports for parents.",0,0 +5217,Identification of anxiety sensitivity classes and clinical cut-scores in a sample of adult smokers: Results from a factor mixture model,"Anxiety sensitivity (AS), a multidimensional construct, has been implicated in the development and maintenance of anxiety and related disorders. Recent evidence suggests that AS is a dimensional-categorical construct within individuals. Factor mixture modeling was conducted in a sample of 579 adult smokers (M age=36.87 years, SD=13.47) to examine the underlying structure. Participants completed the Anxiety Sensitivity Index-3 and were also given a Structured Clinical Interview for DSM-IV-TR. Three classes of individuals emerged, a high AS (5.2% of the sample), a moderate AS (19.0%), and a normative AS class (75.8%). A cut-score of 23 to identify high AS individuals, and a cut-score of 17 to identify moderate-to-high AS individuals were supported in this study. In addition, the odds of having a concurrent anxiety disorder (controlling for other Axis I disorders) were the highest in the high AS class and the lowest in the normative AS class.",0,0 +5218,Occurrence of delayed-onset post-traumatic stress disorder: a systematic review and meta-analysis of prospective studies,"Post-traumatic stress disorder (PTSD) develops according to consensus criteria within the first 1-6 months after a horrifying traumatic event, but it is alleged that PTSD may develop later. The objective was to review the evidence addressing occurrence of PTSD with onset >6 months after a traumatic event (delayed-onset PTSD).Through a systematic search in PubMed, EMBASE, and PsycINFO, we identified 39 studies with prospective ascertainment of PTSD. A meta-analysis was performed in order to obtain a weighted estimate of the average proportion of delayed-onset PTSD cases, and meta-regression was used to examine effects of several characteristicsDelayed-onset PTSD was reported in all studies except one, and the average prevalence across all follow-up time was 5.6% [95% confidence interval (95% CI) 4.3-7.3%]. The proportion with delayed-onset PTSD relative to all cases of PTSD was on average 24.5% (95% CI 19.5-30.3%) with large variation across studies. In six studies with sub-threshold symptom data, delayed-onset PTSD seemed most likely an aggravation of early symptoms. The proportion with delayed-onset PTSD was almost twice as high among veterans and other professional groups compared to non-professional victims.Descriptive follow-up data suggest that PTSD may manifest itself >6 months after a traumatic event, delayed-onset PTSD most often, if not always, is preceded by sub-threshold PTSD symptoms, and a higher proportion of PTSD cases are delayed among professional groups. Contextual factors and biased recall may inflate reporting of PTSD and a cautious interpretation of prevalence rates seems prudent.",0,0 +5219,Are Effort Measures Sensitive to Cognitive Impairment?,"The basic premise of symptom validity tests (SVTs) is that appropriate effort can be assessed because the designs of SVT measures are thought to be insensitive to all but the most extreme forms of impairment of memory. In patients with mild traumatic brain injury in particular, it is thought that failure on effort measures consistently reflects poor effort or even conscious exaggeration of symptoms. This study examines the issue of SVT failure as a reflection of cognitive impairment and/or neuropsychiatric impairment by presenting cases of three patients who were given full neuropsychological batteries but in each case failed the Word Memory Test (WMT), a verbal recognition SVT measure. One patient who failed the WMT was probably in the early stages of dementia. The WMT fit the ""Genuine Memory Impaired Profile"". Two mild traumatic brain injury patients failed the WMT but their patterns of performance suggested that cognitive deficits influenced WMT performance. In determining the validity of neuropsychological test data in the individual case, it is recommended that the examiner consider whether cognitive impairment could affect performance on effort measures and the recommended cut score. Also, it is recommended that examiners use multiple indicators of effort.",0,0 +5220,Prevention of Heat Stress Disorders in the Workplace,"The intensive summer heat in Japan led to the death of 47 workers due to incidence of heat stroke in 2010. A notable cluster was observed during the first three days after the start of working in a hot environment. The construction industry accounted for 64% of all lethal cases, and the Wet Bulb Globe Temperature (WBGT) of 28°C or higher demonstrated an increasing tendency for lost workdays due to heat stress disorders. Lack of specific symptoms and signs strengthens the importance of prevention. Obedience to orders from employers in uncontrollable hot, humid environments requires thermoregulation dependent on sweating. Loss of lowconcentrated sodium in sweat causes temporary hypernatremia, followed by a shift in interstitial fluid to serum and secretion of arginine-vasopressin to adjust osmolarity; however, massive water intake sometimes leads to excessive serum dilution causing temporary hyponatremia, expressed as heat cramps. The complex risk of heat stroke in the workplace can be categorized into four principal causes: physical labor, hot and humid environment, long hours of work and short break times, and protective clothing. The Labour Standards Bureau, Ministry of Health, Labour and Welfare of Japan, noticed WBGT standard values based on ISO 7243 and ACGIH TLVs",0,0 +5221,Propranolol and central nervous system function: potential implications for paediatric patients with infantile haemangiomas,"Given its improved safety profile compared with systemic corticosteroids, propranolol has become the mainstay treatment of infantile haemangioma (IH) worldwide. There is evidence, mainly from adult volunteer studies, that propranolol use is associated with central nervous system (CNS) effects. Impairment to short- and long-term memory, psychomotor function, sleep quality and mood with relatively low doses and durations of treatment have been reported. The exact magnitude of CNS effects resulting from propranolol use, especially in the early developmental stages and for prolonged periods of use, is not currently known. These effects may not be readily recognizable and require specialized assessment of cognitive function not routinely performed. Furthermore, there may be a delay between exposure and cognitive defects. The evidence to date provides a strong rationale to proceed with caution when prescribing propranolol for IH: treatment should be used only when indicated (in the presence of ulceration, impairment of a vital function or risk of permanent disfigurement) and for a limited duration, and the benefits of treatment should be weighed carefully against potential adverse events before treatment is initiated. This narrative review describes the evidence for an effect of propranolol use on CNS function from volunteer and patient studies, including IH.",0,0 +5222,Familial vulnerability factors to post-traumatic stress disorder in male military veterans,"The question has been frequently raised about whether there are emotional disorders that predispose to post-traumatic stress disorder (PTSD). We do know that those with PTSD do have many comorbid disorders, but due to the difficulty in performing prospective studies it is hard to tell what is cause and what is effect. This study bypassed the problem caused by comorbidity by examining family history of four proband groups: PTSD, mixed anxiety disorders, coexisting anxiety and depressive disorders, and screened normal controls. Two questions were examined. First, whether family history predicted who experienced combat situations and second, whether the proband groups could be distinguished by family history. Logistic regression identified two variables that predicted the experience of combat: major depression (odds ratio 2.17) and the DSM-III dramatic personality disorder cluster (odds ratio 1.36). Although there was considerable overlap, family history variables distinguished PTSD from other proband groups. Overall, the pattern of psychopathology in the families of the PTSD probands most closely resembled that in the families of the coexisting anxiety and depressive disorders probands. We conclude that family history methods may be an addition to possible variables that predict who will be exposed to combat and also that family history variables may be able to distinguish a PTSD population from some other types of emotional disorders.",0,0 +5223,Epigenetic profiles associated with psychopathology in a community-based epidemiologic sample,"Background: Recent work suggests epigenetic differences may contribute to the etiology of psychiatric disorders. Here, we investigate whether methylation profiles can distinguish between individuals with and without lifetime psychopathology in a community-based epidemiologic sample. Methods: Using whole blood-derived genomic DNA from a subset (n = 100) of participants in the Detroit Neighborhood Health Study, we assessed genome-wide methylation microarray profiles in individuals affected by lifetime PTSD (n = 23) and lifetime depression (n = 33), respectively. Bioinformatic analyses were performed on the genes uniquely methylated and unmethylated in each group. Results: Individuals with PTSD showed epigenomic profiles characterized by decreased methylation in immune system-related genes and increased methylation in gene clusters involved in neurogenesis and sensory perception of sound. Among individuals with depression, epigenomic profiles were characterized by decreased methylation in lipoprotein-related gene sets and increased methylation in gene sets involved in brain development and tryptophan metabolism. For both disorders, epigenomic profiles were associated with disease classes predominated by psychopathologic conditions among the unmethylated gene sets identified from PTSD-and depression-free individuals, respectively, suggesting that individuals with these conditions possess higher methylation levels in these psychopathology-associated gene sets. Conclusion: Genome-wide methylation profiles distinguish individuals affected by psychopathology in a manner consistent with functions previously implicated in the etiology of these disorders.",0,0 +5224,"Longitudinal Evaluation of the Relationship Between Mindfulness, General Distress, Anxiety, and PTSD in a Recently Deployed National Guard Sample","Mindfulness has increasingly been shown to be a resilience-promoting factor against the negative effects of stress and anxiety. While there is considerable literature evidencing that higher levels of mindfulness are associated with decreased stress and anxiety in civilian cross-sectional studies, fewer studies have examined this relationship utilizing longitudinal designs with recently deployed National Guard soldiers. The present study examined the resilience-promoting effects of mindfulness on symptoms of post-traumatic stress disorder (PTSD), anxiety, and general distress with members of Aviation (N = 52) and Infantry (N = 146) battalions of the Army National Guard who recently returned from deployment. Each study participant completed measures at two time points (3 and 12 months post-deployment) to examine whether mindfulness predicted symptom reporting over time. Overall, findings suggest that time 1 mindfulness is a significant predictor of time 2 general distress, anxiety, and the hyperarousal symptom cluster, but not time 2 total PTSD. Consistent with previous studies, these findings suggest that mindfulness measures may be useful for identifying soldiers at risk and resilient for post-deployment psychological distress. The implications for different diagnostic frameworks and criteria are considered. © 2015, Springer Science+Business Media New York.",0,0 +5225,Minnesota multiphasic personality inventory profiles of Vietnam combat veterans with posttraumatic stress disorder and their children,"Forty children of 28 fathers who are Vietnam veterans with posttraumatic stress disorder (PTSD) completed the Minnesota Multiphasic Personality Inventory. Each of the fathers had at least one elevated clinical scale. Fathers averaged eight elevated clinical scales, and compared to more recent norms, fathers averaged seven elevated clinical scales. Seventy-eight percent of the children had at least one clinically elevated scale (averaging three elevated clinical scales). Compared to contemporary normal adolescents and adults, 65% of children had at least one clinically elevated scale (still averaging three elevated clinical scales). No consistent MMPI profile patterns emerged within or across the two groups. No gender differences were detected among child MMPI profiles. Forty percent of the children reported illegal drug use, and 35% reported behavior problems. Fifteen percent of children reported previous violent behavior. Eighty-three percent of the children reported elevated Cook-Medley hostility scores as compared to an age-matched national normative sample. Children with higher PK scores were also significantly more likely to report higher Cook-Medley hostility scores. Forty-five percent of children reported significant elevations on the PTSD/PK subscales.",0,0 +5226,Prevalence and trajectory of psychopathology among child and adolescent survivors of disasters: a systematic review of epidemiological studies across 1987–2011,"Aims: The goal of this paper was to systematically review evidence on (1) the potential magnitude of the psychopathological impacts of community-wide disasters on child and adolescent survivors, and (2) the long-term course or trajectory of disaster-induced psychopathology among children and adolescents. Methods: The PubMed/MEDLINE and PsycINFO databases were searched from their respective inception through December 2011. All of the resulting epidemiological studies of child and adolescent survivors following community-wide disasters were examined. Results: Sixty cross-sectional studies and 25 longitudinal or long-term follow-up studies were identified. The estimated rates of posttraumatic stress disorder (PTSD) and depression among child and adolescent survivors varied greatly across the included studies, ranging from 1.0 to 95 % and 1.6 to 81 %, respectively, while the reported rates of diagnosable PTSD according to the DSM-IV criteria and diagnosable depression ranged from 1.0 to 60 % and 1.6 to 33 %, respectively. The long-term courses of psychopathology among youthful survivors were summarized. Methodological issues with those studies were discussed. Conclusions: The empirical findings summarized in this review highlight the importance of psychosocial intervention at early postdisaster stages for child and adolescent survivors. The methodological flaws revealed by this review indicate the need for continued attempts to better understand the epidemiology and trajectory of psychopathological problems among youthful survivors. © 2013 Springer-Verlag Berlin Heidelberg.",0,0 +5227,Evaluation of the Efficacy of Pharmacotherapy and Psychotherapy in Treatment of Combat-Related Post-Traumatic Stress Disorder: A Meta-Analytic Review of Outcome Studies,"A meta-analysis was conducted to examine the relative effectiveness of the broad-based treatments for combat-related post-traumatic stress disorder (PTSD). The analysis includes 13 pharmacotherapy studies and 12 psychotherapy studies obtained from a PsychINFO database search and a reference search. Studies of pharmacotherapy treatment efficacy demonstrated a significantly greater decrease in reducing PTSD symptoms, t (22) = -2.74, p = 0.01, d = 0.05. A random coefficient analysis supports this finding with significance determined at p < 0.001 for the fixed effects in the models. A limited examination of depression as a frequently comorbid disorder indicated pharmacotherapy also demonstrated a significantly greater decrease than psychotherapy in depression symptoms, t (15.77) = -2.26, p = 0.04, d = 0.16. Differences between treatments are discussed as potentially reflective of assignment to treatments and assessment techniques as well as therapeutic effects.",0,0 +5228,Analysis of longitudinal data using latent variable models with varying parameters.,"Lt-fwt Latent Variable Growth Modeling with Multilevel Data Bengt Muthen * Graduate School of Education z B r y k & Raudenbush, 1992; Goldstein, 1987), less work has been done i n the area of latent variables. T h i s paper was presented at the U C L A conference Latent Variable Modelling with Applications to Causality, March 19-20, 1994. T h e research was supported by a grant from the Office of Educa- tional Research and Improvement, Department of Education to the National Center for Research on Evaluation, Standards, and Student Testing ( C R E S S T ) and grant A A 08651-01 from N 1 A A A . I thank Siek-Toon K h o o , Guanghan L i u , and Ginger Nelson GofT for helpful assistance. Ua^TdeU M^obJb^ l(",0,0 +5229,Probable Post-Traumatic Stress Disorder and Its Predictors in Disaster-Bereaved Survivors: A Longitudinal Study After the Sichuan Earthquake,"This study examined the trajectory of probable PTSD prevalence and severity, and analyzed the predictors for PTSD severity in bereaved survivors at 6 months and 18 months after the 2008 Sichuan earthquake. This was a longitudinal study with 226 bereaved survivors sampled at 6 months and 18 months post-earthquake. The instrument used in the study was the revised version of the Impact of Event Scale. The results showed that the prevalence of probable PTSD in bereaved survivors decreased significantly from 38.9% at 6 months to 16.8% at 18 months post-earthquake. Loss of a child, being directly exposed to the death of family members and property loss during the earthquake, and mental health services utilization after the earthquake were significant predictors for PTSD severity at both assessments. These findings can contribute to post-disaster psychological rescue work. The bereaved survivors at high risk for more severe PTSD should be particularly targeted.",0,0 +5230,Biological Factors Associated with Susceptibility to Posttraumatic Stress Disorder,"Because only a proportion of persons exposed to traumatic events develop posttraumatic stress disorder (PTSD), it has become important to elucidate the factors that increase the risk for the development of PTSD following trauma exposure as well as the factors that might serve to protect individuals from developing this condition. Putative risk factors for PTSD may describe the index traumatic event or characteristics of persons who experience those events. Recent data have implicated biological and familial risk factors for PTSD. For example, our recent studies have demonstrated an increased prevalence of PTSD in the adult children of Holocaust survivors, even though these children, as a group, do not report a greater exposure to life-threatening (Diagnostic and Statistical Manual of Mental Disorders [DSM-IV] Criterion A) events. These studies are reviewed. It is difficult to know to what extent the increased vulnerability to PTSD in family members of trauma survivors is related to biological or genetic phenomena, as opposed to experiential ones, because of the large degree of shared environment in families. In particular, at-risk family members, such as children, may be more vulnerable to PTSD as a result of witnessing the extreme suffering of a parent with chronic PTSD rather than because of inherited genes. But even if the diathesis for PTSD were somehow “biologically transmitted” to children of trauma survivors, the diathesis is still a consequence of the traumatic stress in the parent. Thus, even the most biological of explanations for vulnerability must at some point deal with the fact that a traumatic event has occurred.",0,0 +5231,Cognitive Transformation as a Marker of Resilience,"Individuals often report positive, transformative changes in response to adversity. Cognitive transformation involves a turning point in a person's life characterized by: (1) the recognition that coping with adversity resulted in new opportunities; and, (2) the reevaluation of the experience from one that was primarily traumatic or threatening to one that is growth-promoting. Cognitive transformation often signifies enhanced adaptation to adverse circumstances, and thus, is a marker of resilience. The present study examined the relationship of cognitive transformation to indicators of resilience among 35 acutely bereaved young adults and a nonbereaved comparison group. Findings strongly supported the hypothesis that transformation predicts resilience, and may reduce one's risk trajectory to enhance adaptation. Results are discussed in terms of their implications for research on resilience, and on recovery from acute or chronic adverse circumstances, including addiction.",0,0 +5232,Different profiles of acute stress disorder differentially predict posttraumatic stress disorder in a large sample of female victims of sexual trauma.,"This study aimed to test the dimensional structure of acute stress disorder (ASD). Latent profile analysis was conducted on scores from the Acute Stress Disorder Scale (Bryant, Moulds, & Guthrie, 2000) using a large sample of female victims of sexual trauma. Four distinct classes were found. Two of the classes represented high and low levels of ASD, and the high ASD class was associated with a high probability of subsequent posttraumatic stress disorder (PTSD). There were 2 intermediate classes that were differentiated by the number of arousal symptoms, and the class with high levels of arousal symptoms had a higher risk of PTSD. The results suggested that ASD is best described by qualitatively and quantitatively differing subgroups in this sample, whereas previous research has assumed ASD to be dimensional. This may explain the limited success of using ASD to predict subsequent PTSD. (PsycINFO Database Record (c) 2014 APA, all rights reserved).",0,0 +5233,Assessment of dysregulated children using the Child Behavior Checklist: A receiver operating characteristic curve analysis.,"Disorders of self-regulatory behavior are common reasons for referral to child and adolescent clinicians. Here, the authors sought to compare 2 methods of empirically based assessment of children with problems in self-regulatory behavior. Using parental reports on 2,028 children (53% boys) from a U.S. national probability sample of the Child Behavior Checklist (CBCL; T. M. Achenbach & L. A. Rescorla, 2001), the receiver operating characteristic curve analysis was applied to compare scores on the Posttraumatic Stress Problems Scale (PTSP) of the CBCL with the CBCL Dysregulation Profile (DP), identified using latent class analysis of the Attention Problems, Aggressive Behavior, and Anxious/Depressed scales of the CBCL. The CBCL-PTSP score demonstrated an area under the curve of between .88 and .91 for predicting membership in the CBCL-DP profile for boys and for girls. These findings suggest that the CBCL-PTSP, which others have shown does not uniquely identify children who have been traumatized, does identify the same profile of behavior as the CBCL-DP. Therefore, the authors recommend renaming the CBCL-PTSP the Dysregulation Short Scale and provide some guidelines for the use of the CBCL-DP scale and the CBCL-PTSP in clinical practice.",0,0 +5234,What can we learn from the first community-based epidemiological study on stalking in Germany?,"There is a lack of community-based studies on prevalence rates of stalking and the impact of stalking on victims in continental European countries. The authors published the first community-based epidemiological study on stalking in Germany. The purpose of this paper is to discuss possible implications of these epidemiological data for the mental health system, forensic psychiatry and legal regulations in Germany. For these reasons some data of our epidemiological study are outlined and reanalyzed. To examine lifetime and point prevalence rates of stalking, behavioural and psychological consequences for victims and the impact of stalking on current psychological well-being in a German community sample, a postal survey was conducted with 2000 inhabitants randomly selected from Mannheim (response rate 34.2%, n=679). The survey included a stalking questionnaire and the WHO-5 well-being scale. Almost 12% of the respondents reported having been stalked. This study identified a high lifetime prevalence of stalking in the community. Effects on victims' psychological health were significant and there was a high rate of physical (31%) and sexual (19%) violence in the context of stalking. Our data suggest that the phenomenon deserves more attention in future forensic psychiatric research and practice. Implications for forensic psychiatric assessment and treatment of stalkers as well as for management of stalking victims are discussed.",0,0 +5235,Mitochondrial peripheral-type benzodiazepine receptor and DHEAS levels in patients with post-traumatic stress disorder and combat complications,"Introduction: Post-Traumatic Stress Disorder (PTSD) is an highly invalidating anxiety disorder, which onset is related to the exposure to a traumatic event. First explored in military contexts, this disorder has recently shown increasing prevalence in the general population. In the last years, neurosteroids showed to be implicated in many psychiatric disorders, such as anxiety disorders. The Peripheral Benzodiazepine Receptor (PBR) is a mitochondrial protein that takes part in the constitution of a pore in the membrane, which opening has a crucial role in the regulation of neurosteroids synthesis. In stressful conditions, alterations in the levels of PBR expression and of some steroids were highlighted, particularly in patients with chronic PTSD combat related. Methods: Aim of the present study was to assess mitochondrial PBR density and serum neurosteroid DHEAS levels, in a sample of patients with PTSD or Traumatic Grief (LT) vs. healthy controls. All subjects were enrolled at the Clinica Psichiatrica 2(degrees) of the University of Pisa and assessed by SCID, Inventory of Complicated Grief and Impact of Event Scale. Results: Results of the present study show a significant reduction in lymphocyte PBR density in patients with PTSD vs. controls (p < 0.01). Reduced DHEAS levels, with respect to controls, were found in PTSD and TG subjects (in these latest p < 0.05). Conclusions: These data suggest PBR involvement in chronic PTSD related to non combat trauma. Moreover, patients with LT show a different PBR density profile with respect to that of patients with PTSD, suggesting a nosographic autonomy of these two clinical entities. The statistically significant alterations in serum DHEAS levels found in LT patients, vs. both PTSD patients and controls, further support this hypothesis.",0,0 +5236,Psychological Resilience Building in Disaster Risk Reduction: Contributions from Adult Education,"This article discusses three questions: What opportunities exist to enhance psychological resilience in adults? Why should psychological resilience promotion be considered an important disaster risk reduction strategy? What contribution can adult education make to such a strategy? Psychological resilience is presented as relational and somewhat malleable, even in adulthood. Although psychological resilience building is often overlooked in social-level disaster risk reduction efforts, it is a key strategy for social resilience building. Questions regarding the extent to which mental resilience can be improved and the techniques with which to do so may be answered by research in the field of adult education. Basic learning and teaching research fundamentals are suggested to create psychological resilience-building strategies in adults.",0,0 +5237,Offering the opportunity for family to be present during cardiopulmonary resuscitation: 1-year assessment,"Purpose: To evaluate the psychological consequences among family members given the option to be present during the CPR of a relative, compared with those not routinely offered the option. Methods: Prospective, cluster-randomized, controlled trial involving 15 prehospital emergency medical services units in France, comparing systematic offer for a relative to witness CPR with the traditional practice among 570 family members. Main outcome measure was 1-year assessment included proportion suffering post-traumatic stress disorder (PTSD), anxiety and depression symptoms, and/or complicated grief. Results: Among the 570 family members [intention to treat (ITT) population], 408 (72 %) were evaluated at 1 year. In the ITT population (N = 570), family members had PTSD-related symptoms significantly more frequently in the control group than in the intervention group [adjusted odds ratio, 1.8; 95 % confidence interval (CI) 1.1-3.0; P = 0.02] as did family members to whom physicians did not propose witnessing CPR [adjusted odds ratio, 1.7; 95 % CI 1.1-2.6; P = 0.02]. In the observed cases population (N = 408), the proportion of family members experiencing a major depressive episode was significantly higher in the control group (31 vs. 23 %; P = 0.02) and among family members to whom physicians did not propose the opportunity to witness CPR (31 vs. 24 %; P = 0.03). The presence of complicated grief was significantly greater in the control group (36 vs. 21 %; P = 0.005) and among family members to whom physicians did not propose the opportunity to witness resuscitation (37 vs. 23 %; P = 0.003). Conclusions: At 1 year after the event, psychological benefits persist for those family members offered the possibility to witness the CPR of a relative in cardiac arrest. © 2014 Springer-Verlag.",0,0 +5238,The role of social support in well-being and coping with self-reported stressful events in adolescents,"This study investigated the role that social support plays in well-being and in coping after a stressful event in a group of non-clinical adolescents. Furthermore, this study aimed at replicating the finding that adolescents who reported sexual abuse reported more symptoms and less adequate coping strategies than adolescents who reported another type of stressful event or no stressful episode.Eight hundred and twenty adolescents between 12 and 18 years of age filled out questionnaires assessing social support (Social Support Questionnaire, Sarason, Shearin, Pierce, & Sarason, 1987), trauma-related symptoms (Trauma Symptom Checklist for Children, Briere, 1996), behavior problems (Youth Self-Report, Achenbach, 1991), and coping (How I Cope Under Pressure Scale, Ayers, Sandler, West, & Roosa, 1996).42% of the adolescents reported a stressful experience, and 4.4% reported sexual abuse. Sexually abused adolescents reported more stress-related symptoms and used more avoidance and fewer support-seeking coping strategies than the other adolescents. The main-effect hypothesis of social support was sustained, but social support did not moderate the relation between a stressful event and coping. Yet, a trend was found suggesting that high support from the family was associated with less avoidance coping and more support-seeking in adolescents who reported a non-sexually abusive, stressful event.Our findings show that a highly perceived availability of social support is directly associated with fewer trauma-related symptoms, especially in adolescents who are non-sexually abused. For adolescents who reported a sexual or another type of stressful event, social support did not play a different role in coping.",0,0 +5239,"Posttraumatic Stress Symptoms, Aggression, and Substance Use Coping among Young Adults","This study examined how the symptom clusters of posttraumatic stress disorder (PTSD) were related to substance use and self-reported aggression in a college sample. There were 358 participants (ages 18–24) who completed surveys to assess PTSD symptoms, substance use as coping, and aggression. Hierarchical regressions tested for the effects of PTSD symptoms (total symptoms as well as cluster symptoms) on self-reported aggression, along with the main and interaction effects of substance use coping on these relationships. The hyperarousal cluster of PTSD was the only group of symptoms significantly related to aggression. There was an interaction between avoidance symptoms and substance use coping on aggression such that under conditions of high substance use coping, aggression increased regardless of avoidance symptoms; however, the relationship between avoidance and aggression was stronger under conditions of low substance use coping, with greater aggression as avoidance symptoms and low substance use copin...",0,0 +5240,"Acute Post-Rape Plasma Cortisol, Alcohol Use, and PTSD Symptom Profile among Recent Rape Victims",This study presents the acute post-rape plasma cortisol alcohol use and post-traumatic stress disorder (PTSD) symptom profile among 37 recent female rape victims. Subjects were victims of rape who reported the crime to the police and who received forensic medical examinations within 72 hours post-rape. A total of 15 (41%) women reported alcohol use not related to PTSD status. Cortisol was significantly negative associated with the time of post-rape. A nonsignificant association was seen for the main effect of alcohol use and in the interaction of alcohol use and prior history of assault. The association of history for assault with lower cortisol levels showed a significant effect for the history of assault. Apparent levels were found among newly assaulted women using alcohol. Women with assault histories irrespective of alcohol use showed low levels of cortisol. About 22 (71%) women met the cutoff criteria for PTSD. A main effect was observed in the presence of crime-related PTSD associated with cortisol showing a higher cortisol level. Basing from the results it can be concluded that alcohol use is associated with high levels of cortisol in women with no rape history. Moreover cortisol levels were lower in both alcohol users and nonusers which have been victimized.,0,0 +5241,School-Based Mental Health Intervention for Children Affected by Political Violence in Indonesia,"Little is known about the efficacy of mental health interventions for children exposed to armed conflicts in low- and middle-income settings. Childhood mental health problems are difficult to address in situations of ongoing poverty and political instability.To assess the efficacy of a school-based intervention designed for conflict-exposed children, implemented in a low-income setting.A cluster randomized trial involving 495 children (81.4% inclusion rate) who were a mean (SD) age of 9.9 (1.3) years, were attending randomly selected schools in political violence-affected communities in Poso, Indonesia, and were screened for exposure (> or = 1 events), posttraumatic stress disorder, and anxiety symptoms compared with a wait-listed control group. Nonblinded assessment took place before, 1 week after, and 6 months after treatment between March and December 2006.Fifteen sessions, over 5 weeks, of a manualized, school-based group intervention, including trauma-processing activities, cooperative play, and creative-expressive elements, implemented by locally trained paraprofessionals.We assessed psychiatric symptoms using the Child Posttraumatic Stress Scale, Depression Self-Rating Scale, the Self-Report for Anxiety Related Disorders 5-item version, and the Children's Hope Scale, and assessed function impairment as treatment outcomes using standardized symptom checklists and locally developed rating scales.Correcting for clustering of participants within schools, we found significantly more improvement in posttraumatic stress disorder symptoms (mean change difference, 2.78; 95% confidence interval [CI], 1.02 to 4.53) and maintained hope (mean change difference, -2.21; 95% CI, -3.52 to -0.91) in the treatment group than in the wait-listed group. Changes in traumatic idioms (stress-related physical symptoms) (mean change difference, 0.50; 95% CI, -0.12 to 1.11), depressive symptoms (mean change difference, 0.70; 95% CI, -0.08 to 1.49), anxiety (mean change difference, 0.12; 95% CI, -0.31 to 0.56), and functioning (mean change difference, 0.52; 95% CI, -0.43 to 1.46) were not different between the treatment and wait-listed groups.In this study of children in violence-affected communities, a school-based intervention reduced posttraumatic stress symptoms and helped maintain hope, but did not reduce traumatic-stress related symptoms, depressive symptoms, anxiety symptoms, or functional impairment.isrctn.org Identifier: ISRCTN25172408.",0,0 +5242,Children's symptoms of posttraumatic stress and depression after a natural disaster: Comorbidity and risk factors,"The current study examined rates of comorbidity among children's symptoms of posttraumatic stress (PTS) and depression after a natural disaster, Hurricane Ike. We also compared children with comorbid symptoms to children without comorbid symptoms, examining recovery, severity of symptoms, and risk factors.Children (n=277; 52% girls; 38% Hispanic, 28% White, 19% Black; grades 2-4) were assessed at 8 and 15 months postdisaster. Children completed measures of PTS and depressive symptoms at both time points and measures of exposure and recovery stressors at 8 months postdisaster.At 8 months postdisaster, 13% of children reported elevated PTS-only, 11% depression-only, and 10% comorbid symptoms of PTS and depression. At 15 months postdisaster, 7% of children reported elevated PTS-only, 11% depression-only, and 7% comorbid symptoms of PTS and depression. Children with comorbid symptoms of PTS and depression had poorer recovery, more severe symptoms, and they reported greater exposure and recovery stressors.We lacked information on children's predisaster functioning and diagnostic interview of psychological distress symptoms.Children with comorbid symptoms need to be identified early postdisaster. Levels of stressors should be monitored postdisaster, as highly stressed youth have difficulties recovering and may need help. Interventions should be tailored for children with comorbid symptoms of PTS and depression.",0,0 +5243,An Open-Label Study of Guanfacine Extended Release for Traumatic Stress Related Symptoms in Children and Adolescents,"The purpose of this open-label pilot study was to investigate the effectiveness and tolerability of guanfacine extended release (GXR) 1-4 mg given in the evening, on the symptoms of traumatic stress (reexperiencing, avoidance, overarousal), generalized anxiety, and functional impairment in children and adolescents with a history of traumatic stress with or without posttraumatic stress disorder (PTSD). As many of our sample had associated attention-deficit/hyperactivity disorder (ADHD) symptoms, we also assessed whether the presence of traumatic stress symptoms impaired the effectiveness of GXR in the treatment of comorbid ADHD symptoms.Participants were 19 children and adolescents 6-18 years of age, with current traumatic stress symptoms. In an 8 week open-label design, each patient's scores on parent-, child-, and clinician-reported symptom rating scales assessing traumatic stress symptoms, generalized anxiety, ADHD symptoms, functional impairment, and global symptom severity and improvement (n=17) were evaluated off and on GXR using χ(2) goodness-of-fit tests, paired t tests, and repeated measures analyses of variance (ANOVAs). To examine patterns of change in outcome measures across treatment, MPlus software was used to conduct linear growth curves modeled with individual-varying times of observation (i.e., random slopes).Using an average GXR daily dose of 1.19 mg±0.35 mg and an average weight-adjusted daily dose of 0.03 mg/kg±0.01 mg/kg, significant differences were found on all symptom severity measures. Parent reported UCLA Reaction Index scores assessing cluster B (reexperiencing), C (avoidant), and D (overarousal) symptoms significantly improved. In the presence of PTSD symptoms, children with ADHD experienced significantly improved ADHD symptom scores, suggesting that comorbidity does not attenuate an ADHD symptom response to GXR therapy. Medication was generally well tolerated.Within the limits of an open-label, hypothesis-generating pilot study, our results suggest that the α2A-adrenoceptor agonist GXR may have therapeutic effects in the treatment of PTSD symptoms in traumatically stressed children and adolescents. The effective dose may be lower than that found for ADHD. Our pilot study supports the need for further controlled research on the effects of GXR and other α2A-adrenoceptor agonists in pediatric disorders of traumatic stress.",0,0 +5244,Traumatisme psychique des victimes d’agressions sexuelles avec possible soumission chimique. Prise en charge UMJ,"Resume Chaque annee, de nombreuses personnes portent plainte pour agression sexuelle avec suspicion de soumission chimique. Les circonstances sont souvent les memes : un contexte festif avec une forte alcoolisation, puis une amnesie avec un reveil difficile et les stigmates d’une activite sexuelle. Les victimes attendent que l’examen effectue aux UMJ apporte la preuve de l’agression et de l’administration de produits a leur insu. Selon une etude menee aux UMJ de l’Hotel-Dieu, dans la majorite des cas, seule l’alcoolisation massive est responsable des symptomes, ce qui entraine un grand sentiment de culpabilite chez les plaignants. La plupart d’entre eux presentent une forte anxiete et des symptomes de psycho-traumatisme. La prise de conscience d’une certaine forme de responsabilite dans le deroulement des faits accroit leur desarroi. Chez les personnes rendues vulnerables par des antecedents traumatiques, le risque de passage a l’acte suicidaire peut etre accru. Une prise en charge empathique et chaleureuse des soignants des UMJ, ainsi qu’une plus juste repartition des responsabilites peuvent aider a la reconstruction des personnes qui seront alors orientees vers les professionnels du reseau pour une prise en charge globale medico-psycho-sociale.",0,0 +5245,Investigating the psychosocial determinants of child health in Africa: The Drakenstein Child Health Study,"Early life psychobiological and psychosocial factors play a key role in influencing child health outcomes. Longitudinal studies may help elucidate the relevant risk and resilience profiles, and the underlying mechanisms that impact on child health, but there is a paucity of birth cohort data from low and middle-income countries (LMIC). We describe the rationale for and present baseline findings from the psychosocial component of the Drakenstein Child Health Study (DCHS).We review the psychosocial measures used in the DCHS, a multidisciplinary birth cohort study in a peri-urban area in South Africa, and provide initial data on psychological distress, depression, substance use, and exposure to traumatic stressors and intimate partner violence (IPV). These and other measures will be assessed longitudinally in mothers in order to investigate associations with child neurodevelopmental and health outcomes.Baseline psychosocial data is presented for mothers (n=634) and fathers (n=75) who have completed antenatal assessments to date. The sample of pregnant mothers is characterized by multiple psychosocial risk factors, including a high prevalence of psychological distress and depression, high levels of substance use, and high exposure to traumatic stressors and IPV.These data are consistent with prior South African studies which have documented a high prevalence of a multitude of risk factors during pregnancy. Further longitudinal assessment of mothers and children may clarify the underlying psychobiological and psychosocial mechanisms which impact on child health, and so inform clinical and public health interventions appropriate to the South African and other LMIC contexts.",0,0 +5246,Animal model for PTSD: From clinical concept to translational research,"In humans, the diagnosis of PTSD is made only if an individual exhibits a certain number of symptoms from each of three quite well defined symptom clusters over a certain period of time. Animal behavioral studies, however, have generally tended to overlook this aspect and have commonly regarded the entire group of animals subjected to certain study conditions as homogeneous. Thus, in an attempt to develop animal models of long-term chronic behavioral responses to stress (i.e. PTSD) in a comparable manner to human diagnosis, we applied cut-off inclusion/exclusion criteria to behavioral data for a cohort of animals exposed to a stress paradigm. This grouped them as behaviorally affected or unaffected by the stress. This model takes into account the variability in degree of the individual's response to the stress paradigm, thereby modeling the fact that not all humans exposed to traumatic stress respond with affective disorder. This article will present and discuss findings from a series of studies employing a model of individual behavioral response classification. This article will discuss the concept of the model and its background and present a selection of studies employing and examining the model, alongside the underlying translational rationale of each. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0,0 +5247,Posttraumatic Stress Disorder and Cocaine Dependence: Order of Onset,"To investigate differences between patients whose posttraumatic stress disorder (PTSD) preceded their cocaine dependence and vice versa, 33 patients with comorbid PTSD and cocaine dependence were divided into two groups: one in which the traum and PTSD occurred before onset of cocaine dependence (primary PTSD) and one in which the PTSD occurred after cocaine dependence was established (primary cocaine). In the primary-PTSD group, the trauma was generally childhood abuse. In the primary-cocaine group, the trauma was generally associated with the procurement and use of cocaine. In the primary PTSD group, there were significantly more women, more other Axis I diagnoses, more Cluster B and C Axis II diagnoses, and more benzodiazepine and opiate use. In the primary-cocaine group, there was a trend toward more cocaine use in the previous month. Significant clinical differences between these two groups may warrant different types of treatment or differing treatment emphasis.",0,0 +5248,Effects of psychotherapy on hippocampal volume in out-patients with post-traumatic stress disorder: a MRI investigation,"Background. Magnetic resonance imaging (MRI) studies have especially reported smaller hippocampal volume in patients with post-traumatic stress disorder (PTSD), most of them war or sexual abuse victims. The present study compares the hippocampal volumes of out-patients with PTSD who had low co-morbidity rates to those of trauma-exposed control subjects without PTSD, and measures hippocampal volume changes in these patients after brief eclectic psychotherapy. We hypothesized that smaller hippocampal volumes are specific to PTSD and that hippocampal volume changes after effective psychotherapy would be measurable. Method. Eighteen patients with PTSD and 14 traumatized control subjects were examined with MRI. In a randomized clinical trial, the PTSD patients were assigned to treatment ( n =9) or waiting-list group ( n =9). After the former received psychotherapy for 4 months, the MRI was repeated on both PTSD groups. Three temporal lobe structures were manually segmented: hippocampus, amygdala, and parahippocampal gyrus. Volumetric analysis was used to measure grey matter, white matter, and cerebrospinal fluid. Results. PTSD patients had significantly smaller hippocampal volumes at baseline (total 13·8%, right 13·5%, left 14·1%) compared to the control subjects. After effective psychotherapy, however, no volume changes were found in the smaller hippocampi. Conclusions. We confirmed previous findings of smaller hippocampal volume in PTSD in a new population made up of out-patients who experienced different types of traumas, reducing co-morbidity to a minimum. Smaller hippocampal volumes did not change after effective psychotherapy, even while symptoms resolved.",0,0 +5249,MMPI-2 Assessment of Differential Post-Traumatic Stress Disorder Patterns in Combat Veterans and Sexual Assault Victims,"This study compared MMPI-2 profiles and trauma-specific subscales of the MMPI-2 in groups of combat veterans and sexual assault victims. Analyses indicated a trend toward externalizing symptoms for combat veterans and internalizing symptoms for sexual assault survivors. For diagnostic classification purposes, the PS scale was found to best differentiate post-traumatic stress disorder (PTSD) cases from non-PTSD cases for the combat group, whereas the F-2-8 standard decision rule best differentiated the sexual trauma group from comparisons. These results suggest that type of trauma experienced is a key variable in understanding the patient and dictates the need for different therapeutic focuses. In addition, the results suggest that the MMPI-2 PTSD scales provide a reasonable classification of PTSD status.",0,0 +5250,Factor Structure of the PTSD Checklist for DSM-5,"Scarce data are available regarding the dimensional structure of Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) posttraumatic stress disorder (PTSD) symptoms and how factors relate to external constructs. We evaluated six competing models of DSM-5 PTSD symptoms, including Anhedonia, Externalizing Behaviors, and Hybrid models, using confirmatory factor analyses in a sample of 412 trauma-exposed college students. We then examined whether PTSD symptom clusters were differentially related to measures of anger and impulsivity using Wald chi-square tests. The seven-factor Hybrid model was deemed optimal compared with the alternatives. All symptom clusters were associated with anger; the strongest association was between externalizing behaviors and anger (r = 0.54). All symptom clusters, except re-experiencing and avoidance, were associated with impulsivity, with the strongest association between externalizing behaviors and impulsivity (r = 0.49). A seven-factor Hybrid model provides superior fit to DSM-5 PTSD symptom data, with the externalizing behaviors factor being most strongly related to anger and impulsivity.",0,0 +5251,Prospective Trajectories of Posttraumatic Stress in College Women Following a Campus Mass Shooting,"In a sample with known levels of preshooting posttraumatic stress (PTS) symptoms, we examined the impact of a campus mass shooting on trajectories of PTS in the 31 months following the shooting using latent growth mixture modeling. Female students completed 7 waves of a longitudinal study (sample sizes ranged from 812 to 559). We identified 4 distinct trajectories (n = 660): (a) minimal impact-resilience (60.9%), (b) high impact-recovery (29.1%), (c) moderate impact-moderate symptoms (8.2%), and (d) chronic dysfunction (1.8%). Individuals in each trajectory class remained at or returned to preshooting levels of PTS approximately 6 months postshooting. The minimal impact-resilience class reported less prior trauma exposure (η(2) = .13), less shooting exposure (η(2) = .07), and greater emotion regulation skills than all other classes (η(2) > .30). The chronic dysfunction class endorsed higher rates of experiential avoidance prior to the shooting than the minimal-impact resilient and high impact-recovery classes (η(2) = .15), as well as greater shooting exposure than the high impact-recovery class (η(2) = .07). Findings suggest that preshooting functioning and emotion regulation distinguish between those who experience prolonged distress following mass violence and those who gradually recover.",1,0 +5252,The Prevalence of PTSD across War Eras and the Effect of Deployment on PTSD:a Systematic Review and Meta-analysis,,0,0 +5253,Women’s experiences of symptoms of posttraumatic stress disorder (PTSD) after traumatic childbirth: a review and critical appraisal,"This paper critically analyses nine studies on postnatal posttraumatic stress disorder (PTSD) following traumatic childbirth, in order to find common themes of PTSD symptoms, using the cognitive model of PTSD as a guide; it critically appraised one of the studies in depth and it attempted to explain the lived experience of women suffering from postnatal PTSD following traumatic childbirth and the suitability of cognitive behavioural therapy (CBT) for postnatal PTSD. This paper found that women following traumatic childbirth do experience postnatal PTSD; postnatal PTSD symptoms are similar to PTSD symptoms of other events and that CBT for PTSD of other events is just as effective for postnatal PTSD. Future recommendations include more qualitative studies with interpretative phenomenological approach in order to establish evidence-based CBT treatment for this client group, and more referrals need to be sent to the psychological services for CBT intervention.",0,0 +5254,Development of Child Posttraumatic Stress Disorder in Pediatric Trauma Victims: The Impact of Initial Child and Caregiver PTSD Symptoms on the Development of Subsequent Child PTSD,"Following a child's traumatic injury, both the child and his/her parents often report significant levels of posttraumatic stress disorder (PTSD) symptoms. Although many studies have identified predictors of PTSD at varying times post-trauma, few have longitudinally examined mechanisms through which child PTSD symptoms (PTSS) develop over time. Additionally, there is limited research on the interaction between caregiver and child PTSS. Determination of initial acute responses in both the caregiver and child that predict increased risk for persistent child PTSD will allow for greater specificity in identifying at-risk families and will inform the design of novel family-focused interventions. One hundred and eighteen child traumatic injury victims aged 8-18 years and their primary caregivers were interviewed in-hospital and at 2- and 6-weeks post-trauma to assess the development and maintenance of child PTSS. At each time point, depressive and PTSD symptomatology of both the child and caregiver were measured. Results revealed that child in-hospital levels of hyperarousal predicted child 2-week PTSS; however, child in-hospital levels of avoidance were found to predict child PTSS at 6-weeks post-trauma. Furthermore, post-hoc analyses revealed that high levels of child in-hospital re-experiencing symptoms and high levels of caregiver in-hospital avoidance symptoms significantly interacted to predict child 6-week PTSS, particularly in girls. The results of the current study underscore the importance of examining specific symptoms of PTSD and focus on the impact of familial distress on child post-traumatic adjustment. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5255,Psychobiology of posttraumatic stress disorder.,"(from the introduction) This volume summarizes the major findings and themes in the psychobiology of posttraumatic stress disorder (PTSD). One of the major points highlighted in this volume concerns the biological or pathophysiological differences between PTSD, stress, and other psychiatric disorders. The 1st section of this volume deals with the epidemiological and phenomenological studies that objectified the important clinical observations on the prevalence of trauma and its manifestations. The 2nd section represents the core of the psychobiological studies of chronic PTSD in adults. The 3rd section introduces an important framework that is becoming increasingly recognized in trauma studies-the developmental perspective. The 4th section deals with the biology of normal and traumatic memories in both animals and humans. The 5th section provides theoretical models to explain the way that traumatic experiences might be potentiated to pathological states. The 6th section provides an analysis of the influences of biological studies on the treatment of PTSD., (from the book) This volume is a result of a conference entitled Psychobiology of Posttraumatic Stress Disorder sponsored by the New York Academy of Sciences and held on September 7-10, 1996 in New York, New York. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5256,Prescribing Trends in Veterans With Posttraumatic Stress Disorder,"The revised Department of Veterans Affairs (VA) and Department of Defense Clinical Practice Guideline for Management of Post-Traumatic Stress recommends against long-term use of benzodiazepines to manage posttraumatic stress disorder (PTSD). An analysis of recent trends among veterans receiving care for PTSD in the VA noted a decreasing proportion receiving benzodiazepines. The authors examined prescribing patterns for other medications to better understand the general context in which the changes in benzodiazepine prescribing have occurred in the VA.Administrative VA data from fiscal years 1999 through 2009 were used to identify veterans with PTSD using ICD-9 codes extracted from inpatient discharges and outpatient encounters. Prescribing of antidepressants, antipsychotics, and hypnotics was determined for each fiscal year using prescription drug files.The proportion of veterans receiving either of the 2 Clinical Practice Guideline-recommended first-line pharmacotherapy treatments for PTSD, selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, increased from 49.7% in 1999 to 58.9% in 2009. In addition to reduced benzodiazepine prescriptions, the overall frequency of antipsychotic use declined 6.1%, from 20.0% in 1999 to 13.9% in 2009. Nonbenzodiazepine hypnotic prescribing tripled when zolpidem was added to the VA national formulary in 2008. Buspirone prescribing decreased steadily, while prazosin prescribing expanded nearly 7-fold.This work highlights several clinically important trends in prescribing over the past decade among veterans with PTSD that are generally consistent with the revised VA/Department of Defense Clinical Practice Guideline recommendations. However, the findings illustrate the limitations of administrative data and point to a need to supplement this work with a qualitative examination of PTSD prescribing from interviews with providers to better understand the strategies used to make medication management decisions.",0,0 +5257,PTSD and depression after the Madrid March 11 train bombings,"The March 11, 2004, train bombings in Madrid, Spain, caused the largest loss of life from a single terrorist attack in modern European history. We used a cross-sectional random digit dial survey of Madrid residents to assess the prevalence of posttraumatic stress disorder (PTSD) and major depression in the general population of Madrid 1 to 3 months after the March 11 train bombings. Of respondents 2.3% reported symptoms consistent with PTSD related to the March 11 bombings and 8.0% of respondents reported symptoms consistent with major depression. The prevalence of PTSD was substantially lower, but the prevalence of depression was comparable to estimates reported after the September 11 attacks in Manhattan. The findings suggest that across cities, the magnitude of a terrorist attack may be the primary determinant of the prevalence of PTSD in the general population, but other factors may be responsible for determining the population prevalence of depression.",0,0 +5258,Cannabinoids Prevent the Effects of a Footshock Followed by Situational Reminders on Emotional Processing,"Posttraumatic stress disorder (PTSD) can develop following exposure to a traumatic event. Hence, what we do in the first few hours after trauma exposure may alter the trajectory of PTSD. We examined whether cannabinoids can prevent the effects of a single footshock followed by situational reminders (SRs) on emotional processing. Rats were exposed to a footshock (1.5 mA, 10 s) on day 1 followed by exposure to SRs of the shock on days 3 and 5. The CB1/2 receptor agonist WIN55,212-2 or vehicle were injected intraperitoneally 2 h after the shock. After 1 week, PTSD-like symptoms were examined. Exposure to SRs exacerbated the effects of the shock as rats exposed to shock and SRs, but not shock alone, showed impaired extinction of the traumatic event, impaired plasticity in the hippocmapal-accumbens pathway, enhanced latency to startle, and altered expression of CB1 receptors (CB1r) and glucocorticoid receptors (GRs) in the CA1, basolateral amygdala (BLA) and prefrontal cortex (PFC). WIN55,212-2 prevented the effects of the shock and SRs on extinction, plasticity, and startle response. WIN55,212-2 normalized the shock/SR-induced upregulation in CB1r in the PFC, and CA1 and GRs in the CA1, with no effect on BLA downregulation of CB1r and GRs. Shock and SRs caused lasting (1 week) alterations in emotional processing associated with changes in GR and CB1r expression in brain areas related to PTSD. WIN55,212-2 administered after trauma exposure prevented these alterations via PFC- and CA1-CB1r and CA1-GRs.",0,0 +5259,Health-Related Outcomes Associated with Patterns of Risk Factors in Primary Care Patients,"It is important to find ways to identify prevalent co-occurring health risk factors to help facilitate treatment programming. One method is to use electronic medical record (EMR) data. Funderburk et al. (J Behav Med 31:525-535, 2008) used such data and latent class analysis to identify three classes of individuals based on standard health screens administered in Veterans Affairs primary care clinics. The present study extended these results by examining the health-related outcomes for each of these identified classes. Follow-up data were collected from a subgroup of the original sample (N = 4,132). Analyses showed that class assignment predicted number of diagnoses associated with the diseases that the health screens target and number of primary care behavioral health, and emergency room encounters. The findings illustrate one way an EMR can be used to identify clusters of individuals presenting with multiple health risk factors and where the healthcare system comes in contact with them. © 2013 Springer Science+Business Media New York (outside the USA).",0,0 +5260,"Mental Health, Social Functioning, and Attitudes of Kosovar Albanians Following the War in Kosovo","The 1998-1999 war in Kosovo had a direct impact on large numbers of civilians. The mental health consequences of the conflict are not known.To establish the prevalence of psychiatric morbidity associated with the war in Kosovo, to assess social functioning, and to identify vulnerable populations among ethnic Albanians in Kosovo.Cross-sectional cluster sample survey conducted from August to October 1999 among 1358 Kosovar Albanians aged 15 years or older in 558 randomly selected households across Kosovo.Nonspecific psychiatric morbidity, posttraumatic stress disorder (PTSD) symptoms, and social functioning using the General Health Questionnaire 28 (GHQ-28), Harvard Trauma Questionnaire, and the Medical Outcomes Study Short-Form 20 (MOS-20), respectively; feelings of hatred and a desire for revenge among persons surveyed as addressed by additional questions.Of the respondents, 17.1% (95% confidence interval [CI], 13.2%-21.0%) reported symptoms that met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for PTSD; total mean score on the GHQ-28 was 11.1 (95% CI, 9.9-12.4). Respondents reported a high prevalence of traumatic events. There was a significant linear decrease in mental health status and social functioning with increasing amount of traumatic events (PAbstract

Background

Research has examined how physical and sexual intimate partner violence (IPV) victimization increases sexual risk behavior, yet research is lacking on 1) the effect of psychological IPV on sexual risk behavior and 2) factors through which psychological IPV may be linked to sexual risk behavior.

Methods

The current study examined the relationship between psychological IPV and sexual risk behavior controlling for other forms of IPV (i.e., physical and sexual) in a sample of 186 human immunodeficiency virus (HIV)-negative community women currently experiencing IPV. Further, this study examined the potential mediating effects of four posttraumatic stress disorder (PTSD) symptom severity clusters (i.e., re-experiencing, avoidance, numbing, and hyperarousal) on this relationship.

Findings

Results revealed that greater severity of psychological IPV was uniquely and directly related to greater sexual risk behavior. Additionally, of the four PTSD symptom severity clusters, only avoidance symptom severity mediated the relationship between psychological IPV and sexual risk behavior.

Conclusion

Implications for addressing psychological IPV and PTSD to improve women's sexual health outcomes are discussed.",0,0 +5270,Resilience in the face of coping with a severe physical injury: A study of trajectories of adjustment in a rehabilitation setting.,"Despite the popularity of the concept of resilience, little research has been conducted on populations in physical rehabilitation settings. Our purpose was to identify three trajectories of psychological adjustment to an acquired severe physical injury characterized by resilience, recovery, or distress in a longitudinal design.Eighty inpatients with a severe injury at a rehabilitation hospital. The participants had spinal cord injury or multiple traumas.Classification into the three trajectories was based on symptoms of psychological distress (posttraumatic stress disorder, depression, anxiety, and negative affect) and participants' level of positive affect at admission to and discharge from the rehabilitation hospital.The most common trajectory was the resilience trajectory (54%), followed by the recovery trajectory (25%) and the distress trajectory (21%). The most interesting differences between the trajectories were the result of optimism, affect, social support, and pain. Trait negative and positive affect predicted classification into the trajectories.An adaptation pattern characterized by resilience was found to be the most common response to an acquired severe injury, and trait affect predicts the outcome pattern. Interventions based on resilience are discussed.",0,0 +5271,Military Personnel with Chronic Symptoms Following Blast Traumatic Brain Injury Have Differential Expression of Neuronal Recovery and Epidermal Growth Factor Receptor Genes,"Approximately one-quarter of military personnel who deployed to combat stations sustained one or more blast-related, closed-head injuries. Blast injuries result from the detonation of an explosive device. The mechanisms associated with blast exposure that give rise to traumatic brain injury (TBI), and place military personnel at high risk for chronic symptoms of post-concussive disorder (PCD), post-traumatic stress disorder (PTSD), and depression are not elucidated.To investigate the mechanisms of persistent blast-related symptoms, we examined expression profiles of transcripts across the genome to determine the role of gene activity in chronic symptoms following blast-TBI. Active duty military personnel with (1) a medical record of a blast-TBI that occurred during deployment (n = 19) were compared to control participants without TBI (n = 17). Controls were matched to cases on demographic factors including age, gender, and race, and also in diagnoses of sleep disturbance, and symptoms of PTSD and depression. Due to the high number of PCD symptoms in the TBI+ group, we did not match on this variable. Using expression profiles of transcripts in microarray platform in peripheral samples of whole blood, significantly differentially expressed gene lists were generated. Statistical threshold is based on criteria of 1.5 magnitude fold-change (up or down) and p-values with multiple test correction (false discovery rate <0.05).There were 34 transcripts in 29 genes that were differentially regulated in blast-TBI participants compared to controls. Up-regulated genes included epithelial cell transforming sequence and zinc finger proteins, which are necessary for astrocyte differentiation following injury. Tensin-1, which has been implicated in neuronal recovery in pre-clinical TBI models, was down-regulated in blast-TBI participants. Protein ubiquitination genes, such as epidermal growth factor receptor, were also down-regulated and identified as the central regulators in the gene network determined by interaction pathway analysis.In this study, we identified a gene-expression pathway of delayed neuronal recovery in military personnel a blast-TBI and chronic symptoms. Future work is needed to determine if therapeutic agents that regulate these pathways may provide novel treatments for chronic blast-TBI-related symptoms.",0,0 +5272,Genital heat stress in men of barren couples: a prospective evaluation by means of a questionnaire,"Exposure to genital heat stress among men of barren couples was evaluated in a prospective study. Five hundred and forty-two consecutive patients referred for andrological examination were asked to complete a specific questionnaire at their first visit. For 449 patients who answered all questions, the individual score values could be calculated by scoring each answer with points. Patients with 'idiopathic' oligoasthenoteratozoospermia had significantly higher score values when compared with men showing normozoospermia (P < 0.01), 'symptomatic' oligoasthenoteratozoospermia as a result of defined andrological disorders (P < 0.01), cryptozoospermia (P < 0.01) or other pathological semen profiles (P < 0.05). These data support the hypothesis that patients with 'idiopathic' oligoasthenoteratozoospermia are more exposed to genital heat stress than normozoospermic men. Moreover, in patients with a varicocele impairment semen quality was associated with significantly higher score values compared with the subgroup of men with normal semen profiles (P < 0.05). In contrast, the score values did not significantly differ between equivalent subgroups of men with a history of a retractile testis. Our observations indicate that the questionnaire used in the present study allows an integrative assessment of genital heat stress, which is superior to single factor analysis. Notably, the group of men with 'idiopathic' oligoasthenoteratozoospermia showed the highest mean score values for 10 of the 18 questions compared with the other groups. Prolonged sitting in a vehicle represented the only single factor with significantly different score values in patients with 'idiopathic' oligoasthenoteratozoospermia and those with normozoospermia (P < 0.05).",0,0 +5273,Advances in Group-Based Trajectory Modeling and an SAS Procedure for Estimating Them,"This article is a follow-up to Jones, Nagin, and Roeder (2001), which described an SAS procedure for estimating group-based trajectory models. Group-based trajectory is a specialized application of finite mixture modeling and is designed to identify clusters of individuals following similar progressions of some behavior or outcome over age or time. This article has two purposes. One is to summarize extensions of the methodology and of the SAS procedure that have been developed since Jones et al. The other is to illustrate how group-based trajectory modeling lends itself to presentation of findings in the form of easily understood graphical and tabular data summaries.",0,0 +5274,Paroxetine: current status in psychiatry,"Paroxetine is a selective serotonin reuptake inhibitor (SSRI) with antidepressant and anxiolytic properties. It is commercially available in both an immediate-release (paroxetine) and a controlled-release formulation (paroxetine CR). The latter product was developed to improve gastrointestinal tolerability. Paroxetine is the most potent inhibitor of the reuptake of serotonin among the available SSRIs. It has approved indications for the treatment of major depression, obsessive-compulsive disorder, panic disorder, generalized anxiety disorder, post-traumatic stress disorder and social phobia in adults. Paroxetine CR is approved for the treatment of major depression, social anxiety disorder, panic disorder and premenstrual dysphoric disorder in adults. While the overall efficacy of paroxetine appears to be comparable with other SSRIs in the treatment of major depression, it is approved for use in a wider variety of anxiety disorders than any other antidepressant. Long-term data suggest that paroxetine is effective in preventing relapse or recurrence of depression for up to 1 year. Limited data show that paroxetine maintains a therapeutic response over 1 year in obsessive-compulsive disorder and up to 6 months in panic disorder. The side-effect profile of paroxetine is largely similar to that of the other SSRIs, although paroxetine tends to be more sedating and constipating in some patients, perhaps due to its anticholinergic activity. The potential for discontinuation syndrome and weight gain appears to be slightly higher with paroxetine than with other SSRIs. This review focuses on the immediate release and controlled-release formulations of paroxetine. It summarizes the efficacy and tolerability data for both formulations, with a particular emphasis on paroxetine CR which was introduced in 2002. It also discusses emerging evidence in other clinical areas and recent data that have led to modifications in the safety profile of paroxetine.",0,0 +5275,"Psycho-Trauma, Psychosocial Adjustment, and Symptomatic Post-Traumatic Stress Disorder among Internally Displaced Persons in Kaduna, Northwestern Nigeria","In April 2011, a post election violent conflict in Northern Nigeria led to resettlement of internally displaced persons (IDPs) in a camp in Kaduna, the worst affected state. We set out to determine prevalence and socio-demographic factors associated with post-traumatic stress disorder (PTSD) among IDPs. We also determined types of psycho-trauma experienced by the IDPs and their psychosocial adjustment.Cross-sectional systematic random sampling was used to select 258 adults IDPs. We used Harvard trauma questionnaire to diagnose ""symptomatic PTSD,"" composite international diagnostic interview (CIDI) for diagnosis of depression, and communal trauma event inventory to determine exposure to psycho-trauma. We assessed social adjustment using social provision scale. Multiple logistic regression analysis was used to determine independent predictors of PTSD.Of the 258 IDPs, 109 (42.2%) had a diagnosis of PTSD, 204 (79.1%) had poor living conditions, and only 12 (4.7%) had poor social provision. The most frequent psycho-traumas were destruction of personal property (96.1%), been evacuated from their town (96%) and witnessing violence (88%). More than half (58%) of IDPs had experienced 11-15 of the 19 traumatic events. Independent predictors of PTSD among respondents were having a CIDI diagnosis of depression (adjusted odds ratios 3.5, 95% confidence interval 1.7-7.5; p = 0.001) and witnessing death of a family member (3.7, 1.2-11.5; p = 0.0259).We concluded that exposure to psycho-trauma among IDPs in Kaduna led to post conflict PTSD. Death of a family member and co-morbid depression were independent predictors of PTSD among IDPs. Though their living condition was poor, the IDPs had good psychosocial adjustment. We recommended a structured psychosocial intervention among the IDP targeted at improving living condition and dealing with the psychological consequences of psycho-trauma.",0,0 +5276,Posttraumatic stress disorder in primary care with special reference to personality disorder comorbidity.,"Posttraumatic stress disorder (PTSD) is a common and disabling disturbance in primary care. Few studies have been carried out in primary care samples and none have taken into consideration the association between PTSD and personality disorder.To describe prevalence and risk factors of PTSD and its comorbidity with personality disorder.General practice centre in Valencia (Spain).Patients who had experienced at least one traumatic event in their lives were selected from a random sample attending a primary healthcare centre in Valencia and blindly assessed by trained professionals. Patients suffering from PTSD were compared with those who were not. PTSD and personality disorder diagnoses were established using CIDI and SCID-II interviews respectively. Sex, age at the time of experiencing trauma, frequency, multiplicity and type of trauma, dissociative symptoms, personality disorder and severity of PTSD were subjected to multivariate analysis to estimate the probability of developing PTSD and its duration.Life prevalence rate was 14% and current prevalence 9%. Dissociative symptoms and personality disorder were significantly associated with PTSD. Cluster analysis based on age, frequency and type of trauma revealed the existence of one subgroup composed mainly of women who had experienced frequent body-contact trauma at an early age, developed severe PTSD and suffer from a variety of personality disorders, particularly paranoid personality disorder. Time to the complete disappearance of symptoms was only explained by the initial severity of PTSD.PTSD is a frequent disorder in general practice and it is often associated with personality disorder. Women who experienced high frequency body-contact traumatic events at an early age often suffer from personality disorder and present a particularly severe form of PTSD deserving referral to specialised care.",0,0 +5277,Post-traumatic stress disorder in serious accidental injury: 3-year follow-up study,"Background Long-term data on post-traumatic stress disorder (PTSD) following accidents are scarce. Aims To assess and predict PTSD in people 3 years after severe accidental injury. Method Severely injured patients were recruited consecutively from the intensive care unit ( n =121) and assessed within 1 month of the trauma. Follow-up interviews were conducted 6 months, 12 months and 36 months later; 90 patients participated in all four interviews. Symptoms were assessed using the Clinician-Administered PTSD Scale. Results Post-traumatic stress disorder was diagnosed in 6% of patients 2 weeks after the accident, in 2% after 1 year and in 4% after 3 years. Robust predictors of later PTSD symptom level were intrusive symptoms shortly after the accident and biographical risk factors. There were individual changes over time between the categories PTSD, sub-threshold PTSD and no PTSD. Whereas PTSD symptom severity was low or decreased for most of the patients, some of them showed an increase or a delayed onset. Patients with persisting PTSD symptoms at 6 months and patients with delayed onset of symptoms are at risk of long-term PTSD. Conclusions The prevalence of PTSD was low over the whole period of 3 years.",0,0 +5278,"The Harvard Trauma Questionnaire. Validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees.","There are no valid and reliable cross-cultural instruments capable of measuring torture, trauma, and trauma-related symptoms associated with the DSM-III-R diagnosis of posttraumatic stress disorder (PTSD). Generating such standardized instruments for patients from non-Western cultures involves particular methodological challenges. This study describes the development and validation of three Indochinese versions of the Harvard Trauma Questionnaire (HTQ), a simple and reliable screening instrument that is well received by refugee patients and bicultural staff. It identifies for the first time trauma symptoms related to the Indochinese refugee experience that are associated with PTSD criteria. The HTQ's cultural sensitivity may make it useful for assessing other highly traumatized non-Western populations.",0,0 +5279,Formation of an Anxious-Depressive State in an Experimental Model of Post-Traumatic Stress Disorder in Prenatally Stressed Female Rats,"The characteristics of the formation of a pathological state in an experimental model of post-traumatic stress disorder (PTSD) in adult female rats born to mothers subjected to daily restraint stress during the last third of pregnancy were studied. Both control and prenatally stressed female rats developed a pathological state after severe combined stress and subsequent restress, with long-lasting increases in anxiety and enhanced fast feedback inhibition of stress-related hypophyseal-adrenocortical system (HAS) activity. However, while development of the pathological state in control animals progressed to the anxiety type, prenatally stressed animals developed not only anxiety, but also increased depression-like behavior, i.e., an anxiety-depression disorder developed. These data are interpreted in the light of the interaction between the characteristics of HAS activity in prenatally stressed females and the predisposition of these animals to developing poststress pathology. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +5280,"Posttyphoon prevalence of posttraumatic stress disorder, major depressive disorder, panic disorder, and generalized anxiety disorder in a Vietnamese sample","In 2006, typhoon Xangsane struck Vietnam and disrupted a large-scale mental health needs analysis in the Da Nang province of Vietnam. Recruitment of new participants was halted, and the design of study was altered to that of a pre-/post-event investigation in which 798 of the original 4,982 participants were re-interviewed. This produced the first pre-post disaster epidemiological study. Specifically, risk and protective factors were evaluated with respect to probable mental health ""caseness"" on the bases of the World Health Organization Short Response Questionnaire (SRQ-20) 7/8 cutoff (i.e., scores of 8 or more). Caseness prevalence was 20.7% pre-disaster and 27.1% post-disaster. Specific risk factors associated with mental health caseness included poor health, extreme peri-disaster fear, and experienced injury. Religious affiliation appeared to be a protective factor. In contrast to US samples, gender was not predictive of outcome.",0,0 +5281,Coping Strategies in Daily Life as Protective and Risk Factors for Post Traumatic Stress in Motor Vehicle Accident Survivors,"To investigate the role of a general coping style in the development and maintainance of PTSD-like symptoms, we investigated 44 survivors of severe motor vehicle accidents. Coping was assessed using a German instrument. We also included personality traits such as neuroticism and extraversion, peritraumatic and cognitive factors that are linked to both PTSD and coping in daily life. Stepwise regressions were computed to explain overall PTSD symptoms and symptom clusters (intrusion, avoidance, hyperarousal). Extraversion and neuroticism, cognitive factors, and subjective trauma characteristics predicted total PTSD severity and the symptom clusters, respectively. Additionally, the results indicate that the coping of a person in daily life plays a role in the development and maintenance of PTSD symptoms. We identified both protective factors such as situation control and self-aggrandizement and risk factors such as avoidance and self-blame.",0,0 +5282,"Recurrent headache and interpersonal violence in adolescence: the roles of psychological distress, loneliness and family cohesion: the HUNT study","Recurrent headache is the most common and disabling pain condition in adolescence. Co-occurrence of psychosocial adversity is associated with increased risk of chronification and functional impairment. Exposure to interpersonal violence seems to constitute an important etiological factor. Thus, knowledge of the multiple pathways linking interpersonal violence to recurrent headache could help guide preventive and clinical interventions. In the present study we explored a hypothetical causal model where the link between exposure to interpersonal violence and recurrent headache is mediated in parallel through loneliness and psychological distress. Higher level of family cohesion and male sex is hypothesized to buffer the adverse effect of exposure to interpersonal violence on headache.The model was assessed using data from the cross-sectional, population-based Young-HUNT 3 study of Norwegian adolescents, conducted from 2006-2008. A cohort of 10 464 adolescents were invited. The response rate was 73% (7620), age ranged from 12 and 20 years, and 50% (3832) were girls. The study comprised self-report measures of exposure to interpersonal violence, loneliness, psychological distress and family cohesion, in addition to a validated interview on headache, meeting the International Classification of Headache Disorders criteria. Recurrent headache was defined as headache recurring at least monthly during the past year, and sub-classified into monthly and weekly headache, which served as separate outcomes.In Conditional Process Analysis, loneliness and psychological distress consistently posed as parallel mediating mechanisms, indirectly linking exposure to interpersonal violence to recurrent headache. We found no substantial moderating effect of family cohesion or sex.Loneliness and psychological distress seem to play crucial roles in the relationship between exposure to interpersonal violence and recurrent headache. To facilitate coping and recovery, it may be helpful to account for these factors in preventive and clinical interventions. Trauma-informed, social relationship-based interventions may represent a major opportunity to alter trajectories of recurrent headache.",0,0 +5283,Bereavement and Mental Health after Sudden and Violent Losses: A Review,"This paper reviews the literature on the psychological consequences of sudden and violent losses, including disaster and military losses. It also reviews risk and resilience factors for grief and mental health and describes the effects and possible benefit of psychosocial interventions. The review shows gaps in the literature on grief and bereavement after sudden and violent deaths. Still, some preliminary conclusions can be made. Several studies show that a sudden and violent loss of a loved one can adversely affect mental health and grief in a substantial number of the bereaved. The prevalence of mental disorders such as post-traumatic stress disorder (PTSD), major depressive disorder (MDD), and prolonged grief disorder (PGD, also termed complicated grief) varies widely, however, from study to study. Also, mental health disorders are more elevated after sudden and violent losses than losses following natural deaths, and the trajectory of recovery seems to be slower. Several factors related to the circumstances of the loss may put the bereaved at heightened risk for mental distress. These factors may be differentially related to different outcomes; some increase the risk for PTSD, others for PGD. Given the special circumstances, bereavement following sudden and violent death may require different interventions than for loss from natural death. Recommendations for future research and clinical implications are discussed.",0,0 +5284,A New Vulnerable Population? The Health of Female Partners of Men Recently Released from Prison,"Abstract Background Despite a growing literature on the consequences of having a romantic partner incarcerated on women's risk of contracting sexually transmitted infections, little research considers the broader health profile of the female partners of ever-imprisoned men. Methods We use data from the Relate Project ( n  = 332), a unique cross-sectional survey of recently released men and their female partners (2009–2011), to demonstrate that the female partners of recently released men suffer from a variety of health risks and conditions. We also examine the health conditions of females by their own incarceration history. Findings We find that these women engage in poor health behaviors including smoking, drug use, and excessive alcohol consumption and have high levels of health conditions including asthma, hypertension, anxiety, and depression. The vulnerability of women who had themselves been incarcerated in jails or prisons was especially acute. The number of risky background characteristics such as dropping out of high school (45%) and spending time in foster care or a group home (36%) were staggeringly high for ever-imprisoned women, as were their rates of anxiety (50%), depression (59%), and posttraumatic stress disorder (45%). Conclusions Results reveal that the health of the female partners of recently released men is at least as poor as that of their male partners, suggesting a degree of vulnerability that has yet to be considered in the medical or public health literature and a population that desperately needs medical attention with the full rollout of the Affordable Care Act in 2014.",0,0 +5285,Community integration after deployment to Afghanistan: a longitudinal investigation of Danish soldiers,"Methods: In a prospective, longitudinal study of Danish soldiers deployed to Afghanistan in 2009 (N = 743), we assessed community reintegration difficulties 2.5 years after home coming (study sample: N = 454). Furthermore, symptoms of posttraumatic stress disorder (PTSD) were assessed before, during, and after deployment. Trajectories of PTSD symptoms from a previously published latent growth mixture modeling analysis were used to address whether community reintegration difficulties differ as a result of course and level of PTSD symptoms. Objective: In the years following military deployment, soldiers may experience problems integrating into the community. However, little is known about the nature and prevalence of these problems and if they relate to posttraumatic symptomatology. Results: Between 3.6 and 18.0 % reported to have some, a lot, or extreme difficulties in reintegration domains such as interpersonal functioning, productivity, community involvement, and self-care. Mean level of reintegration difficulties differed significantly across six PTSD symptom trajectories (range 6.35–36.00); with more symptomatic trajectories experiencing greater community reintegration difficulties. Conclusions: Reintegration difficulties after deployment are present in less than 20 % of Danish soldiers who return from Afghanistan. Difficulties are greater in individuals who follow symptomatic PTSD trajectories in the first years following deployment than in those who follow a low-stable trajectory with no or few symptoms.",0,0 +5286,MMPI-2 profiles of Gulf and Vietnam combat veterans with chronic posttraumatic stress disorder,"The current study examined service era differences in a sample of 172 Gulf and Vietnam outpatient veterans with combat-related posttraumatic stress disorder (PTSD). Participants completed the MMPI-2 and several additional self-report measures of symptom severity (PTSD, depression, anxiety, hostility, and health complaints). Results indicated that MMPI-2 profiles differed significantly according to service era with Vietnam veterans scoring higher on scales 2, 8, and 0 and lower on scale 9 than did Gulf veterans. Examination of group means derived from parametric analysis of MMPI-2 data suggested a mean two-point code type of 2-8/8-2 for Vietnam veterans and 1-8/8-1 for Gulf veterans. In contrast, when the data were examined using descriptive techniques based on frequency counts of individual MMPI-2 profiles, the most frequently occurring two-point codetype was 7-8/8-7 for Vietnam veterans, and 6-8/8-6 for Gulf veterans. In addition, Gulf veterans reported a greater number of total health complaints than Vietnam veterans, whereas Vietnam veterans reported a greater number of physician-diagnosed physical conditions. Potential advantages of incorporating descriptive approaches versus parametric methods when examining profile data are also presented.",0,0 +5287,A clinical profile of 103 patients with secondary movement disorders: correlation of etiology with phenomenology,"Studying patients with secondary movement disorders (SMD) provides a unique opportunity to determine the correlation between the etiology and phenomenology of movement disorders.This was a prospective study of 103 patients (43 women, 60 men; age=28.7±17.3 years; range=2-70 years) with SMD, in a tertiary hospital over 4 years.The mean age of onset of SMD was 24.3±19.7 years, and duration of symptoms was 4.3±7.1 years (42 days to 40 years). Patients with pure tremor, pure dystonia (DYS), or a combination of tremor with dystonia had longest latency (10.9-18.5 months), whereas those with parkinsonism (PAR) and hemiballismus (HMB) had shorter latency (2.7-3.0 weeks). Pure dystonia was most prevalent (30.1%) followed by dystonia plus (13.6%), tremor (12.6%), PAR (11.7%), HMB (8.7%), mixed SMD (7.8%), tremor with dystonia (6.8%), myoclonus (5.8%), and chorea (2.9%). In approximately 60% of patients, the underlying etiologies were vascular (VAS), infections, and space-occupying lesions (SOL), and 25% had SMD following trauma or hypoxia (HYP). With reference to specific etiologies, the most frequent SMDs were tremor following SOL (46%), post-traumatic syndromes (25%), dystonia following HYP (56%), VAS lesions (50%), and infections (28%). With reference to specific SMDs, the most common etiologies were VAS for dystonia (39%), SOL for tremor (67%), and PAR (31%), and both SOL and trauma (37.5% each) for tremor with dystonia.Our study highlights the spectrum of SMDs and the lack of correlation between types of SMDs and underlying etiologies. Preventable causes such as infections, HYP, trauma, and kernicterus still play a major role in pathogenesis of SMD.",0,0 +5288,"Significant Improvements in Cognitive Performance Post-Transcranial, Red/Near-Infrared Light-Emitting Diode Treatments in Chronic, Mild Traumatic Brain Injury: Open-Protocol Study","This pilot, open-protocol study examined whether scalp application of red and near-infrared (NIR) light-emitting diodes (LED) could improve cognition in patients with chronic, mild traumatic brain injury (mTBI). Application of red/NIR light improves mitochondrial function (especially in hypoxic/compromised cells) promoting increased adenosine triphosphate (ATP) important for cellular metabolism. Nitric oxide is released locally, increasing regional cerebral blood flow. LED therapy is noninvasive, painless, and non-thermal (cleared by the United States Food and Drug Administration [FDA], an insignificant risk device). Eleven chronic, mTBI participants (26-62 years of age, 6 males) with nonpenetrating brain injury and persistent cognitive dysfunction were treated for 18 outpatient sessions (Monday, Wednesday, Friday, for 6 weeks), starting at 10 months to 8 years post- mTBI (motor vehicle accident [MVA] or sports-related; and one participant, improvised explosive device [IED] blast injury). Four had a history of multiple concussions. Each LED cluster head (5.35 cm diameter, 500 mW, 22.2 mW/cm(2)) was applied for 10 min to each of 11 scalp placements (13 J/cm(2)). LEDs were placed on the midline from front-to-back hairline; and bilaterally on frontal, parietal, and temporal areas. Neuropsychological testing was performed pre-LED, and at 1 week, and 1 and 2 months after the 18th treatment. A significant linear trend was observed for the effect of LED treatment over time for the Stroop test for Executive Function, Trial 3 inhibition (p=0.004); Stroop, Trial 4 inhibition switching (p=0.003); California Verbal Learning Test (CVLT)-II, Total Trials 1-5 (p=0.003); and CVLT-II, Long Delay Free Recall (p=0.006). Participants reported improved sleep, and fewer post-traumatic stress disorder (PTSD) symptoms, if present. Participants and family reported better ability to perform social, interpersonal, and occupational functions. These open-protocol data suggest that placebo-controlled studies are warranted.",0,0 +5289,Ethnic Differences in Personality Disorder Patterns among Women Veterans Diagnosed with PTSD,"Personality Disorders (PDs) impair the ability to function socially and occupationally. PD prevalence rates among veterans who have also been diagnosed with posttraumatic stress disorder (PTSD) range from 45%-79%. This study examined ethnic differences in PDs assessed with the Millon Clinical Multiaxial Inventory-III in 260 non-Hispanic white (64%), Hispanic (27%), and African American (9%), mostly single, women veterans in treatment for PTSD. After adjusting for covariates including number and sexual-nature of trauma, findings revealed the adjusted odds ratio of having a cluster A PD was almost three times higher for African Americans (p = 0.046) then the other two ethnic groups, which may be driven by the paranoid PD scale and potentially reflects an adaptive response to racial discrimination. In cluster designation analysis, the odds were twice as high of having a cluster B PD with childhood trauma (p = 0.046), and a cluster C PD with sexual trauma (p = 0.004), demonstrating the significance of childhood and sexual trauma on long-term chronic personality patterns in women veterans. These results highlight the importance of using instruments with demonstrated diagnostic validity for minority populations.",0,0 +5290,When range of motion is not enough: Towards an evidence-based approach to medico-legal reporting in whiplash injury,Whiplash injury medico-legal reporting has traditionally been focused upon identifying restrictions in range of motion and identifying the presence of tender areas in the cervical spine in an effort both to diagnose the condition and to offer a prognosis. There have been considerable advances in this field over the last decade however that calls into question such a diminutive approach. This paper reviews the contemporary evidence base for the medico-legal assessment of whiplash injury and identifies a body of literature that strongly implicates a Claimant's physiological and psychological stress response as a key medico-legal marker in predicting prognosis following whiplash injury.,0,0 +5291,Long-term psychological outcomes in older adults after disaster: relationships to religiosity and social support,"Natural disasters are associated with catastrophic losses. Disaster survivors return to devastated communities and rebuild homes or relocate permanently, although the long-term psychological consequences are not well understood. The authors examined predictors of psychological outcomes in 219 residents of disaster-affected communities in south Louisiana.Current coastal residents with severe property damage from the 2005 Hurricanes Katrina and Rita, and exposure to the 2010 British Petroleum Deepwater Horizon oil spill were compared and contrasted with former coastal residents and an indirectly affected control group. Participants completed measures of storm exposure and stressors, religiosity, perceived social support, and mental health.Non-organizational religiosity was a significant predictor of post-traumatic stress disorder (PTSD) in bivariate and multivariate logistic regressions. Follow-up analyses revealed that more frequent participation in non-organizational religious behaviors was associated with a heightened risk of PTSD. Low income and being a coastal fisher were significant predictors of depression symptoms in bivariate and multivariate models. Perceived social support had a protective effect for all mental health outcomes, which also held for symptoms of depression and GAD in multivariate models.People who experienced recent and severe trauma related to natural and technological disasters are at risk for adverse psychological outcomes in the years after these events. Individuals with low income, low social support, and high levels of non-organizational religiosity are also at greater risk. Implications of these data for current views on the post-disaster psychological reactions and the development of age-sensitive interventions to promote long-term recovery are discussed.",0,0 +5292,"Transcranial LED therapy for cognitive dysfunction in chronic, mild traumatic brain injury: two case reports","Two chronic, traumatic brain injury (TBI) cases are presented, where cognitive function improved following treatment with transcranial light emitting diodes (LEDs). At age 59, P1 had closed-head injury from a motor vehicle accident (MVA) without loss of consciousness and normal MRI, but unable to return to work as development specialist in internet marketing, due to cognitive dysfunction. At 7 years post-MVA, she began transcranial LED treatments with cluster heads (2.1” diameter with 61 diodes each – 9x633nm, 52x870nm; 12-15mW per diode; total power, 500mW; 22.2 mW/cm 2 ) on bilateral frontal, temporal, parietal, occipital and midline sagittal areas (13.3 J/cm 2 at scalp, estimated 0.4",0,0 +5293,AN INTERGENERATIONAL PERSPECTIVE ON RISK AND PROTECTIVE FACTORS IN MULTI-PROBLEM POOR FAMILES LIVING IN CAPE TOWN,At the time of the research the first author was employed as a social worker at a welfare organisation in the Cape Peninsula with a case load of over 300 clients. About 30 of these cases were multi-problem families who had been receiving social work services over at least three generations. The concern was that these multi-problem poor families seemed to be immobilised and found it difficult to break out of the cycle of poverty and welfare dependency,0,0 +5294,Prevalence and co-morbidity of psychiatric disorders 1–4 years after burn,"Currently, little is known about psychiatric disorders in the period following on the first year after burn. We examined the prevalence of DSM-IV Axis I disorders in burn patients 1-4 years after burn, using a standardized structured clinical interview and comparing findings with a representative general population sample.Ninety patients admitted to five burn centres were assessed with the 12-month Composite International Diagnostic Interview. Results were compared to an age and gender matched nation based norm group.Twelve-month prevalence for any DSM-IV study disorder was 39%. Prevalence for any after burn onset disorder was 28%. Most prevailing were major depression (10%), generalized anxiety disorder (10%), and PTSD (7%). The comorbidity-proportions for PTSD and generalized anxiety disorder where the highest. Fifty-seven percent of all burn onset disorders started within 1 year after the trauma and 21% within the next year. Burn patients had significantly higher prevalence rates for DSM-IV disorders than people from the general population sample.Psychiatric morbidity among burn patients, 1-4 years after burn, is considerable and higher than what may be expected in the general population. A 2-year follow-up for anxiety and depression disorder is warranted.",0,0 +5295,Genetic Components of Days Open Under Heat Stress,"A reaction norm approach was used to estimate the genetic parameters of days open (DO) with a model that accounted for heat stress. Data included DO records for Georgia, Tennessee, and North Carolina in the Southeastern United States. A fixed effect model included herd-year, month of calving (MOC), age of cow, and a regression on 305-d milk yield. The reaction norm model additionally included the effect of animal with random regression on a heat stress index (HI), calculated as the standardized solutions to MOC derived from the fixed effect model; the residual variance was assumed to be a function of the HI. The shape of the distribution of the HI was close to a sinusoidal function with the highest value in March/April and the lowest value in September. Genetic and residual variances and heritabilities were highest for spring calvings and lowest for fall calvings. The variance associated with the random regression of the highest level of HI was 33% of the genetic variance of the regular animal genetic effect. Genetic correlation between these effects was 0.67. As a validation, DO data were grouped into 4 seasons of calving and treated as different traits. A 4-trait mixed linear model that included the fixed effects listed above except MOC, was used to analyze the grouped data. In general, the estimates of genetic and residual variances of the multiple trait analyses followed those of the reaction norm model. Genetic correlations of spring with summer, and fall with winter were both 0.90. Genetic correlations between spring/summer and fall/winter were around 0.80. The reaction norm model for DO allows inexpensive genetic evaluation of fertility under heat stress. Results of such an evaluation may strongly depend on editing criteria and model specifications.",0,0 +5296,Target Identification for Stereotactic Thalamotomy Using Diffusion Tractography,"Stereotactic targets for thalamotomy are usually derived from population-based coordinates. Individual anatomy is used only to scale the coordinates based on the location of some internal guide points. While on conventional MR imaging the thalamic nuclei are indistinguishable, recently it has become possible to identify individual thalamic nuclei using different connectivity profiles, as defined by MR diffusion tractography.Here we investigated the inter-individual variation of the location of target nuclei for thalamotomy: the putative ventralis oralis posterior (Vop) and the ventral intermedius (Vim) nucleus as defined by probabilistic tractography. We showed that the mean inter-individual distance of the peak Vop location is 7.33 mm and 7.42 mm for Vim. The mean overlap between individual Vop nuclei was 40.2% and it was 31.8% for Vim nuclei. As a proof of concept, we also present a patient who underwent Vop thalamotomy for untreatable tremor caused by traumatic brain injury and another patient who underwent Vim thalamotomy for essential tremor. The probabilistic tractography indicated that the successful tremor control was achieved with lesions in the Vop and Vim respectively.Our data call attention to the need for a better appreciation of the individual anatomy when planning stereotactic functional neurosurgery.",0,0 +5297,Factor structure of posttraumatic stress among Western New York undergraduates following the September 11th terrorist attack on the World Trade Center,"The structure of posttraumatic stress is of both theoretical and clinical interest. In the present study, seven models of posttraumatic stress were compared using confirmatory factor analysis. A sample of 528 Western New York undergraduate students was assessed 1 and 3 months after the September 11th, 2001 terrorist attacks. At the Month 1 assessment, the current three-factor Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) model, which consists of Intrusions, Avoidance/Numbing, and Hyperarousal, did not provide a good fit to the data; however, a four-factor model consisting of factors labeled Intrusions, Avoidance, Dysphoria, and Hyperarousal did fit the data well and provided better fit than the three-factor model and other competing models. Importantly, Dysphoria spans symptoms from the traditional DSM Numbing and Hyperarousal clusters. The four-factor model continued to fit the data well at Month 3. These findings parallel the results of earlier studies which suggest that a four-factor model better reflects the nature of posttraumatic stress than do simpler models, including the DSM. The present work is consistent with a dimensional model of stress responses and calls for further longitudinal work in this area.",0,0 +5298,Cerebrospinal fluid and plasma β-endorphin in combat veterans with post-traumatic stress disorder,"Opioid-mediated analgesia develops in experimental animals following traumatic stress and increased opioid-mediated analgesia has been observed in combat veterans with post-traumatic stress disorder (PTSD). These observations have led to the hypothesis that increased central nervous system (CNS) opioidergic activity exists in patients with PTSD. However, direct CNS data on opioid peptide concentrations and dynamics in patients with PTSD are lacking. We withdrew cerebrospinal fluid (CSF) via a flexible, indwelling subarachnoid catheter over a 6-h period and determined hourly CSF concentrations of immunoreactive beta-endorphin (ir beta END) in 10 well-characterized combat veterans with PTSD and nine matched normal volunteers. Blood was simultaneously withdrawn to obtain plasma for ir beta END. PTSD symptom clusters, as measured by the CAPS, were correlated with neuroendocrine data. Mean CSF ir beta END was significantly greater in patients with PTSD compared with normals and there was a negative correlation between the ir beta END and PTSD intrusive and avoidant symptoms of PTSD. No intergroup difference between plasma ir beta END was found, nor was there a significant correlation between CSF and plasma ir beta END. Immunoreactive beta-lipotropin (ir beta LPH) and pro-opiomelanocortin (irPOMC), both precursors of beta END, were much more plentiful in human CSF than was beta-endorphin itself, as has been previously reported. It remains to be determined whether the increased CNS opioid concentrations predate traumatic stress, thereby conferring a vulnerability to dissociative states and PTSD itself, or result from the trauma. The negative correlation between CSF ir beta END and avoidant and intrusive symptoms suggests that CNS hypersecretion of opioids might constitute an adaptive response to traumatic experience. Poor correlation between CSF and plasma ir beta END limits use of plasma measures to assess CNS opioid activity.",0,0 +5299,Symptoms of posttraumatic stress disorder in young males diagnosed with testicular or lymphatic cancer,"Testicular and lymphatic cancers (Hodgkin's and non-Hodgkin's disease) are among the most common cancers in young males aged 18 to 45. It has recently been acknowledged that symptoms of posttraumatic stress disorder (PTSD) may be present following a cancer diagnosis, with incidence varying between 1.9% to 35.1% (Kangas, Henry & Bryant, 2002). This project aimed to explore the cancer related symptoms of PTSD and distress, to determine the frequency of PTSD symptoms in young male cancer patients, to establish a timeline for PTSD symptoms in the first year following a cancer diagnosis, to identify risk factors that were predictive of PTSD symptoms, and to report on the coping and posttraumatic growth experienced by survivors. In study 1, verbatim accounts of 22 survivors of either testicular or lymphatic cancer were collected retrospectively. Qualitative data was analyzed according to the Miles and Huberman (1984) approach. Survivors' appraisal of their diagnosis as a being a shock and a threat were common, as were and anxious anticipation, avoidance, and denial. In the treatment phase, despair and discouragement were most common. In the long-term, PTSD symptoms (increased presence of intrusions and avoidance) and delayed emotional reactions were reported. Optimism was common in early coping and many reported posttraumatic growth in the long-term survival phase. These findings were consistent with the social-cognitive transition model of adjustment (Brennan, 2001). In study 2, newly diagnosed cancer patients (n=92) and community controls (n=88) were recruited and followed prospectively over a period of 12 months. Severe PTSD symptoms were observed in up to 14.3% of cancer patients in the first year following diagnosis, compared to 5.7% of controls. Repeated measure analyses of variance (ANOVAs) revealed that cancer patients had higher levels of PTSD symptoms, at time 2 and 4 on the IES, at times 2, 3 and 4 on the PCL-C, at time 2 for depression, and at times 1 and 2 for anxiety than controls, but were not different in perceived stress, nor in quality of life. Furthermore, there was a significant increase in PTSD symptoms over time. Initial scores of PTSD were the only significant predictor of PTSD at time 4. Furthermore, there was a significant increase in PTSD symptoms over time for the cancer group, but not for controls. Taken together these results suggest that distress in the form of depression and anxiety was elevated but tended to diminish over time. Moreover, early manifestations of PTSD strongly predict later PTSD symptoms and there was an increase in PTSD symptoms over time. Avoidance and denial were common at the time of diagnosis, but intrusions gradually became more important. This may indicate that a form of cognitive processing of the stressful experience is taking place and allows some survivors to revisit their existing life assumptions and experience differing levels of posttraumatic growth. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5300,Psychometric Status and Clinical Utility of the MAYSI-2 with Girls and Boys in Juvenile Detention,"This study replicates and extends studies of the Massachusetts Youth Screening Instrument, Version 2 (MAYSI-2) in a sample of 479 urban, rural, and suburban 12-16 year old youths (68% boys; 41% African American, 23% Latino) consecutively admitted to juvenile detention centers. Six principal components replicated the MAYSI-2 factor-analytically-derived subscales except for Depression/Anxiety, and suggested modifications of specific items in each sub-scale. Findings supported the internal consistency and validity of the modified MAYSI-2 sub-scales. Few gender differences emerged, except that girls reported higher levels of hopelessness and trauma than boys. Five sub-groups were identified based on component profiles: (1) non-clinical, (2) addiction, somatic problems, and suicidality, (3) anger problems, (4) thought disturbance, and (5) addiction and traumatic stress. The findings support the validity of the MAYSI-2 for juvenile justice mental health screening while highlighting possible refinements in scoring in order to identify delinquent youths with distinctive psychosocial risks and needs. © 2007 Springer Science+Business Media, LLC.",0,0 +5301,"Complex trauma and intimate relationships: The impact of shame, guilt and dissociation","This study examined dissociation, shame, guilt and intimate relationship difficulties in those with chronic and complex PTSD. Little is known about how these symptom clusters interplay within the complex PTSD constellation. Dissociation was examined as a principle organizing construct within complex PTSD. In addition, the impact of shame, guilt and dissociation on relationship difficulties was explored.Sixty five treatment-receiving adults attending a Northern Irish service for conflict-related trauma were assessed on measures of dissociation, state and trait shame, behavioral responses to shame, state and trait guilt, complex PTSD symptom severity and relationship difficulties.Ninety five percent (n=62) of participants scored above cut-off for complex PTSD. Those with clinical levels of dissociation (n=27) were significantly higher on complex PTSD symptom severity, state and trait shame, state guilt, withdrawal in response to shame and relationship preoccupation than subclinical dissociators (n=38). Dissociation and state and trait shame predicted complex PTSD. Fear of relationships was predicted by dissociation, complex PTSD and avoidance in response to shame, while complex PTSD predicted relationship anxiety and relationship depression.The study was limited to a relatively homogeneous sample of individuals with chronic and complex PTSD drawn from a single service.Complex PTSD has significant consequences for intimate relationships, and dissociation makes an independent contribution to these difficulties. Dissociation also has an organizing effect on complex PTSD symptoms.",0,0 +5302,"A multivariate contextual analysis of torture and cruel, inhuman, and degrading treatments: Implications for an evidence-based definition of torture.","Current thinking on what constitutes torture in a detention/interrogation setting focuses solely on particular procedures, without regard for contextual factors that mediate traumatic stress. The present study examined stressor interactions that determined severity and psychological impact of captivity stressors in 432 torture survivors in former Yugoslavia countries and Turkey. A principal components analysis of 46 captivity stressors measured by an Exposure to Torture Scale identified meaningful stressor clusters, which suggested that multiple detention procedures were used in combination to maximize their impact. Perceived torture severity related to 'cruel, inhuman, and degrading' treatments (CIDT) but not to physical torture. Posttraumatic stress disorder related to war-related captivity, deprivation of basic needs, sexual torture, and exposure to extreme temperatures, isolation, and forced stress positions but not to physical torture. CIDT increased posttraumatic stress disorder risk by 71%. Fear- and helplessness-inducing effects of captivity and CIDT appear to be the major determinants of perceived severity of torture and psychological damage in detainees. Considerations on what constitutes torture need to take into account the contextual processes in a captivity setting that mediate these effects.",0,0 +5303,Clusters of Low18F-Fluorodeoxyglucose Uptake Voxels in Combat Veterans with Traumatic Brain Injury and Post-Traumatic Stress Disorder,"Individuals with mild traumatic brain injury (TBI) show diminished metabolic activity when studied with positron emission tomography (PET) with (18)F-fluorodeoxyglucose (FDG). Since blast injury may not be localized in the same specific anatomical areas in every patient or may be diffuse, significance probability mapping may be vulnerable to false-negative detection of abnormalities. To address this problem, we used an anatomically independent measure to assess PET scans: increased numbers of contiguous voxels that are 2 standard deviations below values found in an uninjured control group. We examined this in three age-matched groups of male patients: 16 veterans with a history of mild TBI, 17 veterans with both mild TBI and post-traumatic stress disorder (PTSD), and 15 veterans without either condition. After FDG administration, subjects performed a modified version of the California Verbal Learning Task. Clusters of low uptake voxels were identified by computing the mean and standard deviation for each voxel in the healthy combat veteran group and then determining the voxel-based z-score for the patient groups. Abnormal clusters were defined as those that contained contiguous voxels with a z-score <-2. Patients with mild TBI alone and patients with TBI+PTSD had larger clusters of low uptake voxels, and cluster size significantly differentiated the mild TBI groups from combat controls. Clusters were more irregular in shape in patients, and patients also had a larger number of low-activity voxels throughout the brain. In mild TBI and TBI+PTSD patients, but not healthy subjects, cluster volume was significantly correlated with verbal learning during FDG uptake.",0,0 +5304,Is there a recognizable post-incarceration syndrome among released “lifers”?,"It has been suggested that released prisoners experience a unique set of mental health symptoms related to, but not limited to, post-traumatic stress disorder. We sought to empirically assess whether there is a recognizable post-incarceration syndrome that captures the unique effects of incarceration on mental health. We conducted in-depth life interviews with 25 released ""lifers"" (individuals serving a life sentence), who served an average of 19 years in a state correctional institution. We assessed to what extent the symptoms described by the participants overlapped with other mental disorders, most notably PTSD. The narratives indicate a specific cluster of mental health symptoms: In addition to PTSD, this cluster was characterized by institutionalized personality traits, social-sensory disorientation, and alienation. Our findings suggest that post-incarceration syndrome constitutes a discrete subtype of PTSD that results from long-term imprisonment. Recognizing Post-Incarceration Syndrome may allow for more adequate recognition of the effects of incarceration and treatment among ex-inmates and ultimately, successful re-entry into society.",0,0 +5305,Predictors of the long-term course of comorbid PTSD: A naturalistic prospective study,"The study examined the long-term course of posttraumatic stress disorder (PTSD) by analyzing rates of recurrence and the predictive value of comorbid psychiatric disorders and psychosocial functioning.This study is based on diagnostic assessments administered at intake and subsequent follow-up interviews over a period of 15 years in a sample of 90 anxiety-disordered patients with comorbid PTSD who participated in the Harvard Brown Anxiety Research project (HARP). Kaplan-Meier life table analysis revealed a 0.20 probability of full remission during the 15 years of follow-up.Latent growth model (LGM) analysis revealed that the number of trauma exposures was a predictor of a worse course of PTSD but only during some intervals of the 15-year follow-up. Subjects with full social phobia were more likely to experience worsening of PTSD over time in comparison with subjects with less severe social phobia. Role functioning in the areas of household and employment was a significant predictor of a declining course of PTSD.These findings revealed the dynamic nature of the predictive value of traumatic experiences, the deleterious effect of social phobia and the long term effect of psychosocial functioning on the course of PTSD. Implications for treatment planning and development of interventions for PTSD are discussed.",0,0 +5306,Comorbidity of posttraumatic stress disorder and mild closed head injury in war veterans: Endocrinological and psychological profiles,"To determine the degree of psychological and endocrinological changes in war veterans with the diagnosis of Chronic Posttraumatic Stress Disorder (PTSD) regarding presence/absence of comorbid mild closed head injury (mCHI) caused by explosive devices.Two groups of PTSD inpatients, with (n = 37), and without (n = 86) sustained blast trauma followed by mCHI were formed during the psychiatric treatment. Participants were interviewed by experienced clinicians who used the PTSD Interview (PTSD-I). In addition, patients completed the Symptom Checklist-90-Revised (SCL-90-R). Serum levels of ten hormones were assessed: triiodothyronine, thyroxine, thyrotropin-stimulating hormone, prolactin, luteinizing hormone, follicle-stimulating hormone, and insulin, by radioimmunoassays and hydrocortisone, growth hormone and testosterone by fluoroimmunoassays.Veterans with comorbid mCHI and PTSD showed significantly higher level of amnesia for traumatic event as well as of somatization on the SCL-90-R. Significant differences of hormone levels were not found.The results didn't support the hypothesis on specific PTSD subgroup characterized by history of mCHI and consecutive postconcussion syndrome. The absence of differences in levels of hormones indicated the dominant role of psychogenic trauma in the etiology of hormone disbalance in chronic PTSD. Amnesia for traumatic event in war veterans with comorbid PTSD and mCHI was easily explained by neurogenic peritraumatic amnesia due to the blast trauma, but it did not affect either quality of intensity or posttraumatic symptoms as well as endocrinological parameters.",0,0 +5307,Factors Influencing Outcome After Orthopedic Trauma,"Background: Some recent studies have suggested that certain types of orthopedic trauma result in ongoing disability and that factors other than injury severity or location may influence outcome. This study aimed to evaluate outcome 12 months and 2 years after severe orthopedic trauma, as measured on the Short Form (SF)-36 Health Survey, relative to a control group, to examine change over time and to examine which demographic, injury-related and psychological factors are associated with persisting disability. Methods: One hundred thirteen orthopedic trauma patients, recruited during rehabilitation, and 61 demographically similar uninjured controls were followed up at 1 and 2 years postinjury. Measures included the SF-36 Health Survey, Symptom Checklist-90-R, Brief Pain Inventory, Hospital Anxiety and Depression Scales, and Posttraumatic Stress Disorder Checklist-Specific. Results: Results indicated presence of significant ongoing disability in all SF-36 physical and mental health domains, significant ongoing psychologic adjustment problems, including posttraumatic stress disorder (PTSD) symptoms, and pain, with little or no improvement between 1 and 2 years postinjury. The presence of ongoing pain, anxiety, depression or PTSD symptoms were the strongest predictors of outcome on most variables, with older age also contributing to negative outcomes. Injury severity and type did not predict outcome, although those with lower limb fractures had greater pain and poorer physical outcomes that those with fractures in other locations. Conclusions: This study has highlighted pain and PTSD symptoms as frequent and disabling factors after othropedic trauma. There is clearly a need to focus on alleviating these problems as part of the rehabilitation process.",0,0 +5308,Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples,"The psychometric properties of the Depression Anxiety Stress Scales (DASS) were evaluated in two studies using large clinical samples (N = 437 and N = 241). In Study 1, the three scales comprising the DASS were shown to have excellent internal consistency and temporal stability. An exploratory factor analysis (principal components extraction with varimax rotation) yielded a solution that was highly consistent with the factor structure previously found in nonclinical samples. Between-groups comparisons indicated that the DASS distinguished various anxiety and mood disorder groups in the predicted direction. In Study 2, the conceptual and empirical latent structure of the DASS was upheld by findings from confirmatory factor analysis. Correlations between the DASS and other questionnaire and clinical rating measures of anxiety, depression, and negative affect demonstrated the convergent and discriminant validity of the scales. In addition to supporting the psychometric properties of the DASS in clinical anxiety and mood disorders samples, the results are discussed in the context of current conceptualizations of the distinctive and overlapping features of anxiety and depression.",0,0 +5309,The structure of PTSD symptoms: A test of alternative models using confirmatory factor analysis,"This study aimed to examine the structure of self-reported post-traumatic stress disorder (PTSD) symptoms.Based on previous factor analytic findings and the DSM-IV formulation, six confirmatory factor models were specified and estimated that reflected different symptom clusters.The analyses were based on responses from 1116 participants who had suffered whiplash injuries and screened for full or subclinical PTSD using the Harvard Trauma Questionnaire.A correlated four-factor model with re-experiencing, avoidance, dysphoria and arousal factors fitted the data very well. Correlations with criteria measures showed that these factors were associated with other trauma related variables in a theoretically predictable way and showed evidence of unique predictive utility.These results concur with previous research findings using different trauma populations but do not reflect the current DSM-IV symptom groupings.",0,0 +5310,Analyzing developmental trajectories of distinct but related behaviors: A group-based method.,"This article presents a group-based method to jointly estimate developmental trajectories of 2 distinct but theoretically related measurement series. The method will aid the analysis of comorbidity and heterotypic continuity. Three key outputs of the model are (a) for both measurement series, the form of the trajectory of distinctive subpopulations; (b) the probability of membership in each such trajectory group; and (c) the joint probability of membership in trajectory groups across behaviors. This final output offers 2 novel features. First, the joint probabilities can characterize the linkage in the developmental course of distinct but related behaviors. Second, the joint probabilities can measure differences within the population in the magnitude of this linkage. Two examples are presented to illustrate the application of the method.",0,0 +5311,Real-World Barriers to Assessing and Treating Mental Health Problems With IPV Survivors,"Barriers to assessing and treating mental health problems with intimate partner violence (IPV) survivors were identified with qualitative responses from 62 IPV helping professionals who participated in an online survey question. Data were analyzed using a concept mapping approach, which resulted in following eight distinct clusters: (a) unsure, (b) limited IPV specific resources, (c) barriers to access, (d) systems-taboos, (e) immediate crisis needs, (f) fear-stigma, (g) offender’s control and (h) cultural concerns. The opinions expressed in these clusters help to better explain logistic, relational, and intrapersonal obstacles that can limit women IPV survivors’ ability to receive care for mental health conditions. Extending previous quantitative work by the authors (Simmons, Whalley, & Beck, 2014), the current portion of this project generates new ways of looking at barriers to service delivery, which can be used to develop theory and guide further research.",0,0 +5312,Posttraumatic stress disorder: Characteristics and pharmacological response in the veteran population,Abstract A retrospective chart review was conducted on all patients with the primary diagnosis of posttraumatic stress disorder (PTSD) admitted over a one-year period to a Veterans Administration Medical Center. The data base consisted of 14 Vietnam veterans and one World War II veteran. The purpose of the review was to compare the symptom profile of combat veterans to the established DSM III criteria for PTSD and to evaluate the efficacy of pharmacotherapy. The veterans' symptomatology was much more complex than described in DSM III and the currently employed drug therapy appears to be generally inadequate in treating combat-related PTSD.,0,0 +5313,The Mind Does Matter: Psychological and Physical Recovery After Musculoskeletal Trauma,"Posttraumatic psychopathology (PTP) is important to the orthopedic surgeon because it appears to be much more common than might have been suspected and may complicate the recovery from musculoskeletal injury. We have investigated the relationship between physical and psychological recovery in victims of musculoskeletal trauma.A prospective cohort of 200 patients with musculoskeletal injuries were studied, correlating development of psychopathology (measured by the General Health Questionnaire) and functional outcome (measured by Short Form-36, Sickness Impact Profile, and Musculoskeletal Function Assessment) 2 and 6 months after their injuries.Pre-existing psychological disturbance was found in 11% of our patients; this figure rose to 46% of patients at 2 months but fell to 22% at 6 months. The posttraumatic disturbance correlated strongly with impaired functional outcome as measured by all three outcomes measures (total and category scores) (p < 0.05).The strong correlation of PTP with impaired functional outcome after musculoskeletal trauma stresses that it is a significant problem. Further research is required to determine whether an approach that combines physical and psychological treatment can improve patient outcomes.",0,0 +5314,A short form of the metacognitions questionnaire: properties of the MCQ-30,"The metacognitions questionnaire (MCQ) measures individual differences in a selection of metacognitive beliefs, judgments and monitoring tendencies considered important in the metacognitive model of psychological disorders. The development and properties of a shortened 30-item version of the MCQ, the MCQ-30, are reported. Construct validity was evaluated by confirmatory and exploratory factor analysis. Overall, the fit indices suggested an acceptable fit to a five-factor model consistent with the original MCQ. Exploratory factor analysis supported a five-factor structure, which was almost identical to the original solution obtained in previous studies with the full MCQ. The five factors are cognitive confidence, positive beliefs about worry, cognitive self-consciousness, negative beliefs about uncontrollability of thoughts and danger, and beliefs about need to control thoughts. The MCQ-30 showed good internal consistency and convergent validity, and acceptable to good test–retest reliability. Positive relationships between metacognitions and measures of worry and obsessive–compulsive symptoms provided further support for the validity of the measure and the metacognitive theory of intrusive thoughts. The psychometric properties of MCQ-30 suggest that the instrument is a valuable addition to the assessment of metacognitions that has the advantage of being more economical to use compared with the original MCQ.",0,0 +5315,Immediate and Sustained Psychological Impact of an Emerging Infectious Disease Outbreak on Health Care Workers,"Objective: To assess the immediate and sustained psychological health of health care workers who were at high risk of exposure during the severe acute respiratory syndrome (SARS) outbreak. Methods: At the peak of the 2003 SARS outbreak, we assessed health care workers in 2 acute care Hong Kong general hospitals with the Perceived Stress Scale (PSS-10). One year later, we reassessed these health care workers with the PSS-10, the 21-Item Depression and Anxiety Scale (DASS-21), and the Impact of Events Scale-Revised (IES-R). We recruited high-risk health care workers who practised respiratory medicine and compared them with nonrespiratory medicine workers, who formed the low-risk health care worker control group. Results: In 2003, high-risk health care workers had elevated stress levels (PSS-10 score = 17.0) that were not significantly different from levels in low-risk health care worker control subjects (PSS-10 score = 15.9). More high-risk health care workers reported fatigue, poor sleep, worry about health, and fear of social contact, despite their confidence in infection-control measures. By 2004, however, stress levels in the high-risk group were not only higher (PSS-10 score = 18.6) but also significantly higher than scores among low-risk health care worker control subjects (PSS-10 score = 14.8, P < 0.05). In 2004, the perceived stress levels in the high-risk group were associated with higher depression, anxiety, and posttraumatic stress scores ( P < 0.001). Posttraumatic stress scores were a partial mediator of the relation between the high risk of exposure to SARS and higher perceived stress. Conclusions: Health care workers who were at high risk of contracting SARS appear not only to have chronic stress but also higher levels of depression and anxiety. Front-line staff could benefit from stress management as part of preparation for future outbreaks.",0,0 +5316,Narrative Methods in a Study of Trauma Recovery,"Multiple narrative perspectives can guide narrative research. The complexity of health narratives presents a significant challenge. Trauma recovery accounts are health narratives demonstrating successes as well as struggles. In this article, I describe a large-scale narrative study in which specific qualitative methods were combined to fit research aims, stories elicited, and emergent questions in the analysis process. Under my direction, an interdisciplinary team conducted this constructivist, feminist, narrative study describing the trauma recovery process. The study was focused on success or thriving in women surviving childhood maltreatment. I took an advocacy stance in favor of participants’ interests, as is commensurate with a critical feminist standpoint. Through initial analyses the research team constructed a trauma recovery process termed “becoming resolute.” Subanalyses were focused on key relationships, life trajectories, self-strategies, and perceptual changes. My purpose is to explain the various kinds and levels of analysis used here to provide options for others studying recovery narratives.",0,0 +5317,Posttraumatic growth in adolescence: Examining its components and relationship with PTSD,"To address gaps in the literature, this study examined the components of posttraumatic growth, and the relationship between growth and posttraumatic stress disorder (PTSD). Participants were from a pooled sample of 4,054 Israeli adolescents exposed to terror of whom 210 (5.5%) met criteria for PTSD. Measures included the Child Post-Traumatic Stress Reaction Index and Posttraumatic Growth Inventory. Principal components analysis showed two correlated components of outward and intrapersonal growth. Regression modeling showed that the relationship between the growth and PTSD measures was linear and curvilinear (inverted-U). These results replicated accounting for heterogeneity in PTSD, exposure and subsamples. Collectively, the results imply that posttraumatic growth in adolescence is characterized by two robust components, and is greatest at moderate posttraumatic stress levels.",0,0 +5318,Posttraumatic stress reactions among children following the Athens earthquake of September 1999,"The objective of the present study was to assess symptoms of posttraumatic stress disorder (PTSD), depression and anxiety among children 6 months after they had been exposed to an earthquake (EQ) affecting the north-western suburbs of Athens in September 1999. A total of 115 children attending two elementary schools located at the epicentre of the EQ were assessed. A group of 48 children not affected by the EQ attending a school not affected by the EQ were used as controls. The children and their parents completed a number of questionnaires. Overall, there was a high rate (78%) of severe to mild PTSD symptoms in the EQ exposed group. Additionally, a substantial proportion of these children scored above criteria (32%) for depression compared to the control group (12.5%). Severe or moderate symptoms of PTSD were associated with high scores of depression (p = 0.002). The relationship between PTSD symptoms and anxiety was limited to the ""avoidance"" factor of the anxiety questionnaire (p = 0.029). Those who were most likely to be affected were children alone at the time of the EQ, and children who sustained injuries. In summary, countries where EQs are frequent should be prepared to offer psychological support to a substantial proportion of children presenting with PTSD and depressive symptoms and should educate and prepare children to cope with these events.",0,0 +5319,Nonresponse to a population-based postdisaster postal questionnaire study,"We examined nonparticipation in a 2-year postdisaster mail survey of Norwegian tourists evacuated from countries affected by the 2004 tsunami. One hundred seventy-one persons out of a random sample of 330 nonparticipants were telephone interviewed concerning disaster exposure, current posttraumatic stress reactions, and reasons for not participating. Fewer nonparticipants than participants had been in a place directly affected by the tsunami. Nonparticipants reported less perceived threat of death and lower levels of posttraumatic stress reactions. Reasons for not participating were “lack of interest or time” (39.2%), “lack of relevant experiences” (32.2%), and “too personal or emotionally disturbing” (15.2%). Our findings suggest that postdisaster studies may be biased in the direction of more severe disaster exposure and pronounced posttraumatic stress reactions.",0,0 +5320,"Acceptance and Mindfulness Techniques as Applied to Refugee and Ethnic Minority Populations With PTSD: Examples From ""Culturally Adapted CBT""","Abstract In this article we illustrate how we utilize acceptance and mindfulness techniques in our treatment (Culturally Adapted CBT, or CA-CBT) for traumatized refugees and ethnic minority populations. We present a Nodal Network Model (NNM) of Affect to explain the treatment's emphasis on body-centered mindfulness techniques and its focus on psychological flexibility. We explain the definition of mindfulness that guides our treatment, and we outline a typology of mindfulness states and show how many of the techniques in our treatment can be analyzed by these categories. We argue that acceptance and mindfulness are therapeutic for refugees and minority populations for several reasons. These include their increasing psychological flexibility, decreasing somatic distress, decreasing rumination, serving as emotion regulation techniques, decreasing the attentional bias to threat, and forming part of a new adaptive processing mode (which in CA-CBT centers on psychological flexibility). We describe the specific ways we teach acceptance and mindfulness with Latino and Southeast Asian refugee populations and present case examples of the treatment of a traumatized Latino and Cambodian patient.",0,0 +5321,Effects of Schedule I drug laws on neuroscience research and treatment innovation,"Many psychoactive drugs are used recreationally, particularly by young people. This use and its perceived dangers have led to many different classes of drugs being banned under national laws and international conventions. Indeed, the possession of cannabis, 3,4.methylenedioxy-.N.methylamphetamine (MDMA; also known as ecstasy) and psychedelics is stringently regulated. An important and unfortunate outcome of the controls placed on these and other psychoactive drugs is that they make research into their mechanisms of action and potential therapeutic uses - for example, in depression and post-.traumatic stress disorder - difficult and in many cases almost impossible. © 2013 Macmillan Publishers Limited. All rights reserved.",0,0 +5322,"Hurricane-related exposure experiences and stressors, other life events, and social support: Concurrent and prospective impact on children's persistent posttraumatic stress symptoms.","We investigated the influence of hurricane exposure, stressors occurring during the hurricane and recovery period, and social support on children's persistent posttraumatic stress (PTS).Using a 2-wave, prospective design, we assessed 384 children (54% girls; mean age = 8.74 years) 9 months posthurricane, and we reassessed 245 children 21 months posthurricane. Children completed measures of exposure experiences, social support, hurricane-related stressors, life events, and PTS symptoms.At Time 1, 35% of the children reported moderate to very severe levels of PTS symptoms; at Time 2, this reduced to 29%. Hurricane-related stressors influenced children's persistent PTS symptoms and the occurrence of other life events, which in turn also influenced persistent PTS symptoms. The cascading effects of hurricane stressors and other life events disrupted children's social support over time, which further influenced persistent PTS symptoms. Social support from peers buffered the impact of disaster exposure on children's PTS symptoms.The effects of a destructive hurricane on children's PTS symptoms persisted almost 2 years after the storm. The factors contributing to PTS symptoms are interrelated in complex ways. The findings suggest a need to close the gap between interventions delivered in the immediate and short-term aftermath and those delivered 2 years or more postdisaster. Such interventions might focus on helping children manage disaster-related stressors and other life events as well as bolstering children's support systems.",0,0 +5323,Sleep Quality Among Low-Income Young Women in Southeast Texas Predicts Changes in Perceived Stress Through Hurricane Ike,"To document the time course of perceived stress among women through the period of a natural disaster, to determine the effect of sleep quality on this time course, and to identify risk factors that predict higher levels of perceived stress.Longitudinal study from 2006-2012.Community-based family planning clinics in southeast Texas.There were 296 women aged 18-31 y who experienced Hurricane Ike, September 2008.Cohen Perceived Stress Scale (PSS) was administered every 2 mo from 6 mo before to 12 mo after Hurricane Ike. Sleep quality was assessed 1 mo after Hurricane Ike using the Pittsburg Sleep Quality Index (PSQI). Good sleep was defined as a PSQI summary score < 5, and poor sleep as a score ≥ 5. Hurricane Ike stressors (e.g., property damage, subjective stressors) and pre-Ike lifetime major life events and emotional health (e.g., emotional dysregulation, self-control) were also assessed.Over the entire period of 18 mo (6 mo before and 12 mo after the hurricane), perceived stress was significantly higher among poor sleepers compared to good sleepers, and only good sleepers showed a significant decrease in perceived stress after Hurricane Ike. In addition, a higher level of perceived stress was positively associated with greater Ike damage among poor sleepers, whereas this correlation was not observed among good sleepers. In the final multivariate longitudinal model, Ike-related subjective stressors as well as baseline major life events and emotional dysregulation among poor sleepers predicted higher levels of perceived stress over time; among good sleepers, additional factors such as lower levels of self-control and having a history of a psychiatric disorder also predicted higher levels of perceived stress.Sleep quality after Hurricane Ike, an intense natural disaster producing substantial damage, impacted changes in perceived stress over time. Our findings suggest the possibility that providing victims of disasters with effective interventions to improve sleep quality could help to reduce their perceived stress over time.",0,0 +5324,Identification of Child Sexual Abuse Survivor Subgroups Based on Early Maladaptive Schemas: Implications for Understanding Differences in Posttraumatic Stress Disorder Symptom Severity,"Cognitive models have informed understanding of the development, maintenance, and treatment of posttraumatic stress disorder (PTSD). Limited research, however, has examined the relationship of early maladaptive schemas (EMS; Young in Cognitive therapy for personality disorders: A schema-focused approach (rev. ed.). Professional Resource Press, Sarasota, 1994) to PTSD among trauma survivors. The current study, using a sample of 127 female child sexual abuse (CSA) survivors, applied a model-based clustering procedure (Mclust; Fraley and Raftery in MCLUST Version 3 for R: Normal Mixture Modeling and Model-based Clustering, Technical Report No. 504, Department of Statistics, University of Washington, 2006) to the 15 subscales of the Young Schema Questionnaire-Short Form (YSQ-S; Young and Brown in Young Schema Questionnaire- short form. Cognitive Therapy Center, New York, 1994) and revealed three clusters differentiated primarily by level of schema elevation. Women in the cluster characterized by the highest schema scores reported the most severe PTSD symptoms. A discriminant analysis indicated that schemas of Mistrust/ Abuse, Vulnerability to Harm, and Emotional Deprivation contributed most to distinguishing women differentiated on the basis of presumptive PTSD diagnostic status. Results underscore the importance of cognitive factors in the development and/or maintenance of PTSD symptoms and suggest possible treatment targets for cognitive therapy with CSA survivors. ©Springer Science+Business Media, LLC 2011.",0,0 +5325,"The structure of distress following trauma: Posttraumatic stress disorder, major depressive disorder, and generalized anxiety disorder.","The current report used confirmatory factor analysis to examine the latent structures of both key features and associated symptoms of three disorders that commonly develop following a traumatic event: posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD). Participants were 228 motor-vehicle accident survivors who sought treatment for emotional difficulties. PTSD, MDD, and GAD were assessed with a combination of self-report and interview-based measures. The results of construct level analyses suggested that PTSD, MDD, and GAD are distinguishable but highly correlated disorders following a traumatic event. Symptom level analyses supported a model where the Reexperiencing, Avoidance, and Hypervigilance factors were subsumed under the PTSD construct. However, in this model the Dysphoria factor was a higher order construct correlated with the PTSD, MDD, and GAD factors, suggesting that the Dysphoria cluster may not be unique to PTSD. Diagnostic and theoretical implications of these results are discussed.",0,0 +5326,A meta-analysis of prevalence rates and moderating factors for cancer-related post-traumatic stress disorder.,e20557 Background: Systematic reviews highlight a broad range of PTSD prevalence estimates in cancer survivors. This meta-analysis was conducted to provide a general prevalence estimate of signific...,0,0 +5327,Prazosin in the Treatment of PTSD,"Posttraumatic stress disorder (PTSD) often follows a chronic course, and the disorder is resistant to treatment with antidepressants and cognitive-behavioral therapy in a proportion of patients. Prazosin, an a1-adrenoceptor blocker, has shown some promise in treating chronic PTSD. A review of this literature was conducted via a search of MEDLINE and SUMMON, using keywords such as PTSD, prazosin, treatment, and resistance. At least 10 clinical studies of prazosin in the treatment of PTSD, including open-label and randomized controlled trials, have been published. All of these studies support the efficacy of prazosin either for treating nightmares and improving sleep or for reducing the severity of PTSD. Treatment of PTSD with prazosin is usually initiated at a dose of 1 mg, with monitoring for hypotension after the first dose. The dose is then gradually increased to maintenance levels of 2-6 mg at night. Studies of military patients with PTSD have used higher doses (e.g., 10-16 mg at night). Prazosin has also been studied in younger and older adults with PTSD and in patients with alcohol problems, in whom it was found to reduce cravings and stress responses. Prazosin offers some hope for treating resistant cases of PTSD in which recurrent nightmares are problematic, with a relatively rapid response within weeks. It is suggested that large-scale civilian trials of prazosin be done, as well as studies concerning the use of prazosin in acute PTSD and as a potential preventive agent.",0,0 +5328,Posttraumatic growth and PTSD symptomatology among colorectal cancer survivors: a 3-month longitudinal examination of cognitive processing,"The experience of cancer can be understood as a psychosocial transition, producing both positive and negative outcomes. Cognitive processing may facilitate psychological adjustment.Fifty-five post-treatment, colorectal cancer survivors (M=65.9 years old; SD=12.7), an average of 13 months post-diagnosis, were recruited from a state cancer registry and completed baseline and 3-month questionnaires assessing dispositional (social desirability), cognitive processing (cognitive intrusions, cognitive rehearsal), and psychological adjustment variables (posttraumatic growth (PTG), posttraumatic stress disorder (PTSD) symptomatology, depression, anxiety, positive affectivity).PTSD symptomatology was positively associated with depression, anxiety, and negatively associated with positive affectivity. In contrast, PTG scores were unrelated to PTSD symptomatology, depression, anxiety, and positive affectivity. In addition, PTG was independent of social desirability. Notably, after controlling for age at diagnosis and education, multiple regression analyses indicated that cognitive processing (intrusions, rehearsal) was differentially predictive of psychological adjustment. Baseline cognitive intrusions predicted 3-month PTSD symptomatology and there was a trend for baseline cognitive rehearsal predicting 3-month PTG.Additional research is needed to clarify the association between PTG and other indices of psychological adjustment, further delineate the nature of cognitive processing, and understand the trajectory of PTG over time for survivors with colorectal cancer.",0,0 +5329,The Use of Transdermal Therapeutic Systems in Psychiatric Care: A Primer on Patches,"Numerous currently available medications that act in the central nervous system can be delivered transdermally. Such medications include cholinesterase inhibitors for dementia, methylphenidate (MPH) for attention-deficit hyperactivity disorder, monoamine oxidase inhibitors (MAOIs) for depression, dopamine agonists for Parkinson disease and restless leg syndrome, and clonidine for attention-deficit hyperactivity disorder and impulse-control disorders.This article aims to review the literature related to transdermal delivery systems from the perspective of clinical practice and research related to their use in the treatment of psychiatric conditions.Most of the currently available transdermal systems have psychotropic properties or utility in the behavioral health arena and, therefore, are of clinical relevance to consultation-liaison psychiatrists or practitioners of psychosomatic medicine. We discuss their efficacy and safety profiles. We provide a table of these agents and their uses.Transdermal delivery (i.e., patches) for medicines with psychotropic properties allows mental health providers to customize therapy for patients by altering the duration of therapy, minimizing first-pass metabolism and the potential for drug-drug interactions, and decreasing the risk for gastrointestinal irritation.",0,0 +5330,Are psychodynamic and psychoanalytic therapies effective? A review of empirical data,"There is a need for empirical outcome research in psychodynamic and psychoanalytic therapy. However, both the approach of empirically supported therapies (EST) and the procedures of evidence-based medicine (EBM) have severe limitations making randomised controlled trials (RCTs) an absolute standard. After a critical discussion of this approach, the author reviews the empirical evidence for the efficacy of psychodynamic psychotherapy in specific psychiatric disorders. The review aims to identify for which psychiatric disorders RCTs of specific models of psychodynamic psychotherapy are available and for which they are lacking, thus providing a basis for planning further research. In addition, results of process research of psychodynamic psychotherapy are presented. As the methodology of RCTs is not appropriate for psychoanalytic therapy, effectiveness studies of psychoanalytic therapy are reviewed as well. Studies of psychodynamic psychotherapy published between 1960 and 2004 were identified by a computerised search using Medline, PsycINFO and Current Contents. In addition, textbooks and journal articles were used. Twenty-two RCTs were identified of which 64% had not been included in the 1998 report by Chambless and Hollon. According to the results, for the following psychiatric disorders at least one RCT providing evidence for the efficacy of psychodynamic psychotherapy was identified: depressive disorders (4 RCTs), anxiety disorders (1 RCT), post-traumatic stress disorder (1 RCT), somatoform disorder (4 RCTs), bulimia nervosa (3 RCTs), anorexia nervosa (2 RCTs), borderline personality disorder (2 RCTs), Cluster C personality disorder (1 RCT), and substance-related disorders (4 RCTs). According to results of process research, outcome in psychodynamic psychotherapy is related to the competent delivery of therapeutic techniques and to the development of a therapeutic alliance. With regard to psychoanalytic therapy, controlled quasi-experimental effectiveness studies provide evidence that psychoanalytic therapy is (1) more effective than no treatment or treatment as usual, and (2) more effective than shorter forms of psychodynamic therapy. Conclusions are drawn for future research.",0,0 +5331,Acute versus chronic post-traumatic stress disorder,"A photographic lens and filter model is presented which outlines six steps between a person’s perception of stressful life events and their possible eventual development of an illness. Persons developing acute post-traumatic stress disorder differ markedly in their processing of early steps in the model compared to those who go on to suffer from chronic post-traumatic stress disorder. Persons with the acute disorder, with high likelihood of recovery, generally have had enriching early life experiences, use psychological defenses to a moderate degree, and demonstrate ample coping capabilities. Those going on to the chronic disorder, who frequently don’t recover, often report impoverished early life experiences, employ psychological defenses to an extreme degree, and show a paucity of coping skills. These differences are illustrated by histories from survivors of a terrorist bombing and by observations made by the author of returned prisoners of war and civilian hostages.",0,0 +5332,Effects of Stress Hormones on Traumatic Memory Formation and the Development of Posttraumatic Stress Disorder in Critically Ill Patients,"A majority of patients after intensive care treatment report traumatic memories from their stay in the intensive care unit (ICU). Traumatic memories can be associated with the development of posttraumatic stress disorder (PTSD) in a subpopulation of these patients. In contrast to other patient populations at risk for PTSD, patients in the ICU often receive exogenously administered stress hormones like epinephrine, norepinephrine, or cortisol for medical reasons and are extensively monitored. ICU patients therefore represent a suitable population for studying the relationship between stress hormones, traumatic memories, and the development of PTSD. Studies in long-term survivors of ICU treatment demonstrated a clear and vivid recall of different categories of traumatic memory such as nightmares, anxiety, respiratory distress, or pain with little or no recall of factual events. The number of categories of traumatic memory recalled increased with the total administered dosages of stress hormones (both catecholamines and cortisol), and the evaluation of these categories at different time points after discharge from the ICU showed better memory consolidation with higher dosages of stress hormones administered. However, the administration of stress doses of cortisol to critically ill patients resulted in more complex findings as it caused a significant reduction in PTSD symptoms measured after recovery. This effect can possibly be explained by a differential influence of cortisol on memory. Increased serum cortisol levels not only result in consolidation of emotional memory but are also known to cause a temporary impairment in memory retrieval which appears to be independent of glucocorticoid effects on memory formation. Disrupting retrieval mechanisms with glucocorticoids during critical illness may therefore act protectively against the development of PTSD by preventing recall of traumatic memories. Our findings indicate that stress hormones influence the development of PTSD through complex and simultaneous interactions on memory formation and retrieval. Our studies also demonstrate that animal models of aversive learning are useful in analyzing and predicting clinical findings in critically ill humans.",0,0 +5333,The common link between functional somatic syndromes may be central sensitisation,"Functional somatic syndromes are common and disabling conditions that all include chronic pain, and which may be related to central nervous system sensitisation. Here, we address the concept of central sensitisation as a physiological basis for the functional somatic syndromes.A narrative review of the current literature on central sensitisation and physiological studies in the functional somatic syndromes.Central sensitisation may be a common neurophysiological process that is able to explain non-painful as well as painful symptoms in these disorders. Furthermore, central sensitisation may represent an endophenotypic vulnerability to the development of these syndromes that potentially explains why they cluster together.Further research is needed to verify these findings, including prospective studies and the standardisation of combined methods of investigation in the study of central sensitisation in functional somatic syndromes. In turn, this may lead to new explanatory mechanisms and treatments being evaluated. Our conclusions add to the debate over the nomenclature of these syndromes but importantly also provide an explanation for our patients.",0,0 +5334,Heterogeneity in threat extinction learning: substantive and methodological considerations for identifying individual difference in response to stress,"Pavlovian threat (fear) conditioning (PTC) is an experimental paradigm that couples innate aversive stimuli with neutral cues to elicit learned defensive behavior in response to the neutral cue. PTC is commonly used as a translational model to study neurobiological and behavioral aspects of fear and anxiety disorders including Posttraumatic Stress Disorder (PTSD). Though PTSD is a complex multi-faceted construct that cannot be fully captured in animals PTC is a conceptually valid model for studying the development and maintenance of learned threat responses. Thus, it can inform the understanding of PTSD symptomatology. However, there are significant individual differences in posttraumatic stress that are not as of yet accounted for in studies of PTC. Individuals exposed to danger have been shown to follow distinct patterns: some adapt rapidly and completely (resilience) others adapt slowly (recovery) and others failure to adapt (chronic stress response). Identifying similar behavioral outcomes in PTC increases the translatability of this model. In this report we present a flexible methodology for identifying individual differences in PTC by modeling latent subpopulations or classes characterized by defensive behavior during training. We provide evidence from a reanalysis of previously examined PTC learning and extinction data in rats to demonstrate the effectiveness of this methodology in identifying outcomes analogous to those observed in humans exposed to threat. By utilizing Latent Class Growth Analysis (LCGA) to test for heterogeneity in freezing behavior during threat conditioning and extinction learning in adult male outbred rats (n = 58) three outcomes were identified: rapid extinction (57.3%), slow extinction (32.3%), and failure to extinguish (10.3%) indicating that heterogeneity analogous to that in naturalistic human studies is present in experimental animal studies strengthening their translatability in understanding stress responses in humans.",0,0 +5335,Potential Mediators of Post-Traumatic Stress Disorder in Child Witnesses to Domestic Violence,"The aim was to examine variables that might mediate the incidence of Post-Traumatic Stress Disorder (PTSD) in child witnesses to domestic violence. These variables included age, gender, locus of control, self-blame, perception of threat, active versus palliative coping style, maternal emotional health plus aspects of the violence witnessed (intensity, frequency, age of child when first witnessing violence, and time since the last violent episode).Following screening for other PTSD inducing experiences, a sample of 20 child witnesses to domestic violence, 15 matched control children, and their mothers were assessed using the following tools: The Straus Conflict Tactics Scale; the Child Post-Traumatic Stress Reaction Index; the Nowicki-Strickland Locus of Control Scale; the General Health Questionnaire, and a Screening Questionnaire designed to elicit qualitative information from both children and mothers including data about any other potential PTSD inducing stressor the subject child may have been exposed to.None of the factors under examination were found to contribute significantly to the severity levels of Post-Traumatic Stress Disorder in relation to witness status.The small sample size of the study necessitates that the results be interpreted with caution. Nevertheless the findings indicate that the impact of witnessing domestic violence, in terms of PTSD, is not mediated by factors such as maternal emotional well-being, age and gender of the child, or the child's style of coping with parental conflict. Evidence that variables specifically related to the violence witnessed did not mediate the impact suggests that all domestic violence may have severe and long-term impact on child witnesses.",0,0 +5336,"The relationship between post-traumatic stress disorder, depression and cardiovascular disease in an American Indian tribe","Background. Empirical findings suggest that psychiatric illness is associated with cardiovascular disease (CVD). The purpose of this study was to compare the strength of the association of lifetime post-traumatic stress disorder (PTSD) and lifetime major depression on CVD among Northern Plains American Indians. Method. A total of 1414 participants aged 18–57 years completed a structured interview that assessed psychiatric diagnoses, alcohol abuse/dependence, self-reported CVD, and traditional CVD risk factors including age, sex, education, diabetes, high blood pressure, and smoking. Logistic regression analyses compared the odds ratios of CVD in participants with and without diagnosed PTSD or major depression. Results. The rates of lifetime PTSD and major depression were 15% and 8% respectively. CVD was more commonly reported by participants with PTSD than by those without PTSD (12% v . 5%, p [les ]0·01). Likewise, more participants with major depression reported CVD than did their non-depressed counterparts (14% v . 6%, p [les ]0·05). PTSD was significantly associated with CVD even after controlling for traditional CVD risk factors and major depression (odds ratio 2·0, confidence interval 1·1–3·8). In contrast, the association of major depression with CVD was not significant after accounting for both traditional risk factors and PTSD. Conclusions. Rates of PTSD are high in American Indian communities. Rising CVD rates in this population may be better understood if PTSD is considered along with other traditional risk factors. Future research should examine the association and mechanisms of PTSD and CVD prospectively. Such data could lead to more effective CVD prevention efforts for American Indians.",0,0 +5337,Latent Variable Analysis: Growth Mixture Modeling and Related Techniques for Longitudinal Data,,0,0 +5338,Predictors of rape: Findings from the National Survey of Adolescents,"The current report examines data for 872 female adolescents obtained during the initial and follow-up interviews of the National Survey of Adolescents, a nationally representative sample. Lifetime prevalence of violence exposure reported was 12% and 13% for sexual assault, 19% and 10% for physical assault/punishment, and 33% and 26% for witnessing violence at Waves I and II, respectively. Racial/ethnic status, posttraumatic stress disorder (PTSD), childhood sexual abuse (CSA), and family drug problems emerged as significant predictors of new rape. Each of the PTSD symptom clusters significantly predicted new rape and analyses supported the mediational role of PTSD between CSA and new rape. African American or other racial identity was associated with lower risk.",0,0 +5339,Preliminary Examination of the Impact of Traumatic Brain Injury and Posttraumatic Stress Disorder on Self-Regulated Learning and Academic Achievement Among Military Service Members Enrolled in Postsecondary Education,"Delineate the effects of self-reported traumatic brain injury (TBI) or posttraumatic stress disorder (PTSD) on self-regulated learning and academic achievement for university-enrolled military Service members.Students (N = 192) from 8 regionally diverse universities, representing an estimated 6% of Service members enrolled across schools.Public universities that are members of the Servicemember Opportunity College consortium.Cross-sectional study evaluating the relationships between self-reported TBI, PTSD, and self-regulated learning variables and their contribution to academic achievement.Self-report of military service; symptoms of TBI and PTSD; self-regulation strategies including effort, time/environment regulation, and academic self-efficacy; and grade point average (GPA).There was no effect of self-reported TBI or PTSD on GPA, effort regulation, or time/environment regulation strategies; however, participants with TBI or PTSD reported significantly lower academic self-efficacy. Multiple regression analysis revealed self-efficacy was the strongest predictor of GPA among all participants, followed by military rank.The sample consisted of high achieving students responsive to a university administrator, which raises the possibility of sampling bias. Because of the low recruitment rate for this study and lack of published research on this subject, replicating the results is necessary before drawing generalizable conclusions about the population.",0,0 +5340,Sense of Coherence as a Determinant of Psychological Well-Being Across Professional Groups of Aid Workers Exposed to War Trauma,"The present study aims to test whether sense of coherence (SOC) acts as a determinant of positive psychological functioning in aid workers directly exposed to warfare. Specifically, we performed multiple regression analyses to compare different groups of aid workers in terms of the effects of SOC and cumulative trauma on their psychological distress. Palestinian helpers, both professional and non-professional ( N = 159) completed three self-reported measures: the General Health questionnaire, Sense of Coherence Scale, and Impact of Events Scale. The findings bear out the predictive power of SOC and posttraumatic stress disorder (PTSD) in relation to mental health across different professional groups. In particular, volunteers without a specific professional profile, psychiatrists, medical doctors, and less markedly counselors seemed to protect their mental health through a SOC. Clinical implications and recommendations for training and supervision are discussed.",0,0 +5341,Pain and post traumatic stress disorder – Review of clinical and experimental evidence,"Pain and Post Traumatic Stress Disorder (PTSD) are highly comorbid conditions. Patients with chronic pain have higher rates of PTSD. Likewise, patients with PTSD are often diagnosed with numerous chronic pain conditions. Despite the high pain-PTSD comorbidity, the neurobehavioral mechanisms underlying this phenomenon are incompletely understood and only recently researchers have started investigating it using experimental models. In this article, we systematically review the substantial clinical evidence on the co-occurrence of pain and PTSD, and the limited experimental evidence of pain processing in this disorder. We provide a detailed overview of the psychophysical and brain imaging experiments that compared somatosensory and pain processing in PTSD and non-PTSD populations. Based on the presented evidence, an extensive body of literature substantiates the clinical coexistence of pain and PTSD in patients but the limited experimental data show inconsistent results highlighting the need for well-controlled future studies. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0,0 +5342,Psychiatric Diagnoses in Historic and Contemporary Military Cohorts: Combat Deployment and the Healthy Warrior Effect,"Research studies have identified heightened psychiatric problems among veterans of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). However, these studies have not compared incidence rates of psychiatric disorders across robust cohorts, nor have they documented psychiatric problems prior to combat exposure. The authors' objectives in this study were to determine incidence rates of diagnosed mental disorders in a cohort of Marines deployed to combat during OIF or OEF in 2001-2005 and to compare these with mental disorder rates in two historical and two contemporary military control groups. After exclusion of persons who had been deployed to a combat zone with a preexisting psychiatric diagnosis, the cumulative rate of post-OIF/-OEF mental disorders was 6.4%. All psychiatric conditions except post-traumatic stress disorder occurred at a lower rate in combat-deployed personnel than in personnel who were not deployed to a combat zone. The findings suggest that psychiatric disorders in Marines are diagnosed most frequently during the initial months of recruit training rather than after combat deployment. The disproportionate loss of psychologically unfit personnel early in training creates a ""healthy warrior effect,"" because only those persons who have proven their resilience during training remain eligible for combat.",0,0 +5343,"Smoking patterns, symptoms of PTSD and depression: Preliminary findings from a sample of severely battered women","Intimate partner violence (IPV) is a public health problem that significantly impacts the physical and emotional well-being of women. In addition to the health risk associated with violence exposure, female victims of IPV are at increased risk of engaging in damaging health behaviors, including cigarette smoking. The present study examined patterns of cigarette smoking, using the Fagerström Test for Nicotine Dependence (FTND), and explored its association with sociodemographic factors, characteristics of physical, psychological, and sexual forms of IPV, symptoms of posttraumatic stress disorder (PTSD), and depression within 62 female victims of severe battering. Fifty-eight percent of the total sample reported that they were current smokers. Within the group of current smokers, women who evidenced greater symptoms of nicotine-related physical dependence (NRPD) were more likely to be unemployed, have less education, experience more recent violence, more severe IPV-related sexual coercion, more IPV-related dominance/isolation, and more severe symptoms of PTSD and depression. In addition, greater symptoms of NRPD were significantly and positively associated with PTSD clusters of reexperiencing and arousal. Implications for these preliminary findings were discussed and directions for future research were detailed.",0,0 +5344,"Social Support, Discrimination, and Coping as Predictors of Posttraumatic Stress Reactions in Youth Survivors of Hurricane Katrina","This study examined the influence of aspects of the post–Hurricane Katrina recovery environment (i.e., discrimination, social support) and coping behaviors on children's posttraumatic stress reactions (symptoms of posttraumatic stress disorder [PTSD], anxiety, and depression). Data corresponding to 46 youth (M = 11.43 years; 39% girls; 33% African American, 67% European American) revealed that greater helpfulness from extrafamilial sources of social support predicted lower levels of child-rated symptoms of PTSD, anxiety, and depression. A positive predictive relation was found between helpfulness from professional support sources and PTSD, perhaps suggesting that parents whose children were experiencing higher PTSD symptom levels sought professional support and reported it to be helpful. Youths' avoidant coping behaviors predicted both PTSD and anxiety symptoms. Discrimination, active coping, and familial support did not predict any of the posttraumatic stress reactions assessed in this study.",0,0 +5345,An examination of the construct validity of posttraumatic stress disorder with veterans using a revised criterion set,"Ongoing concerns exist in the literature regarding the construct of posttraumatic stress disorder (PTSD) and how to best conceptualize and measure this disorder. We compared the traditional DSM-IV PTSD symptom criteria (i.e., symptoms from clusters B, C, and D) to a revised criterion set that omits overlapping mood and other anxiety symptoms on PTSD prevalence, PTSD diagnostic caseness, associated psychiatric comorbidity, functional status, and structural validity using a cross-sectional, multi-site primary care sample of 747 veterans. After removing items theorized to overlap with mood and other anxiety disorders, PTSD prevalence was identical using both criterion sets (i.e., 12%). Overall, there were few statistically significant differences in PTSD caseness, associated psychiatric comorbidity, functional status, and structural validity across the two diagnostic criterion sets. These data provide further support that removing items that overlap with other psychiatric disorders does not significantly impact the prevalence of PTSD, its associated comorbidity and functional impairment, or its structural validity. Although the revised criterion set represents a more parsimonious model, the current study findings generally support the strong construct validity of PTSD. The implications of these study findings for research and clinical practice are discussed.",0,0 +5346,"Relationships among trauma exposure, chronic posttraumatic stress disorder symptoms, and self-reported health in women: Replication and extension","Fifty-two women who served during the Vietnam era were assessed for war-zone exposure, traumatic life events, post-traumatic stress disorder (PTSD), and self-reported health status. Symptoms of PTSD were examined as mediators in the relationship between traumatic exposure and subsequent reports of health problems. Results showed that PTSD symptoms accounted significantly for variance in health problems reported by women with prior traumatic stressor exposure. When the cardinal symptom domains of PTSD (re-experiencing, numbing, avoidance, hyper-arousal) were analyzed separately, the symptom cluster representing hyper-arousal accounted uniquely for the variance associated with health complaints, beyond that contributed by other symptom clusters. Discussion of the results focuses on mechanisms underlying the relationship between specific symptoms of PTSD and self-reported health. Implications for intervention within the medical system are also considered.",0,0 +5347,Cognitive Approaches to Posttraumatic Stress Disorder: The Evolution of Multirepresentational Theorizing.,"The evolution of multirepresentational cognitive theorizing in psychopathology is illustrated by detailed discussion and analysis of a number of prototypical models of posttraumatic stress disorder (PTSD). Network and schema theories, which focus on a single, explicit aspect/format of mental representation, are compared with theories that focus on 2 or more explicit representational elements. The author argues that the latter theories provide a more complete account of PTSD data, though are not without their problems. Specifically, it is proposed that at least 3 separate representational elements-associative networks, verbal/propositional representations, and schemas-are required to generate a comprehensive cognitive theory of PTSD. The argument that the development of multirepresentational cognitive theory in PTSD is a paradigm case for the development of similar theories in other forms of psychopathology is elaborated, and a brief agenda is proposed promoting 2 levels of theorizing-deep, formal theory alongside more localized, applied theory.",0,0 +5348,"Configurations of early risk and their association with academic, cognitive, emotional and behavioural outcomes in middle childhood","PURPOSE: Risk factors for children's development are multifarious and co-occur, having cumulative as well as individual impacts. Yet common configurations of early childhood risks remain little understood. The current study aimed to identify patterns of early risk exposure and to examine their relationship with diverse outcomes in middle childhood. METHODS: Using latent class analysis in a large, community-based, UK sample (N = 13,699), we examined 13 putative risk factors to identify patterns of exposure. RESULTS: Four risk configurations were identified: low (65 %), socio-demographic (14 %), family dysfunction (12 %), and multiple (9 %) risk classes. As expected, children in the low risk group fared best on all outcome measures, and those with multiple risk, worst. Importantly, specificity in associations with outcomes emerged, such that cognitive outcomes were predominantly linked with socio-demographic adversities, emotional difficulties with family dysfunction, and conduct problems increased across risk classes. CONCLUSIONS: Better understanding of configurations of childhood risk exposures may help to target resources for children in need.",0,0 +5349,Are cortisol profiles a stable trait during child development?,"Exposure to stressful experiences can increase vulnerability to adverse health outcomes. A potential neuroendocrine mechanism mediating the link between stress and health is the hypothalamic-pituitary-adrenal (HPA) system, with a key role attributed to the glucocorticoid hormone cortisol. Retrospective and cross sectional clinical studies of humans and experimental studies with nonhuman primates and rodents suggest that traumatic experiences during critical periods in development may have permanent effects on HPA regulation, which in turn can have deleterious effects on health. Here I report results from a continuous 20-year study (1988-2009) of children in a rural community on Dominica. Sequential data on cortisol levels, social stressors, and health in naturalistic, everyday conditions are examined to assess developmental trajectories of HPA functioning. Saliva aliquots were assayed for cortisol in concert with monitoring of growth, morbidity, and social environment. Analyses here include data from 1989 to 1999 for 147 children aged 3-16 years with >100 saliva samples each. Cortisol values were standardized by elapsed time since wake-up. Results do not support the hypothesis that traumatic stress during childhood causes permanent general elevation of cortisol levels.",0,0 +5350,Elucidating Posttraumatic Stress Symptom Profiles and Their Correlates Among Women Experiencing Bidirectional Intimate Partner Violence,"This study employed latent class analysis to identify profiles of women experiencing intimate partner violence (IPV) based on the severity of posttraumatic stress disorder (PTSD) symptoms.Self-report data from a sample of 369 women experiencing bidirectional IPV was used.A 3-class solution comprising low, moderate, and high PTSD severity profiles best fit the data. Profiles were differentially related to whether IPV victimization was considered traumatic (PTSD criterion A); whether functioning was impaired as a result of PTSD symptoms (PTSD criterion F); whether the woman met full diagnostic criteria for PTSD; depression symptom severity; and severity of psychological, physical, and sexual IPV victimization and use of IPV. An extremely high percentage of women in the high (96%) and moderate (88%) severity classes experienced functional impairment, although many did not meet full diagnostic criteria for PTSD.Findings support the need for interventions individually tailored to one's treatment needs based on the nature of one's traumatic stressor and the impact of PTSD on daily functioning.",0,0 +5351,Morphometric and Psychometric Comparisons between Non-Substance-Abusing Patients with Posttraumatic Stress Disorder and Normal Controls,"<i>Background:</i> Hippocampal decrease in size in response to posttraumatic stress disorder (PTSD) is still a subject of controversy. The aims of this study were to: (1) confirm previous hippocampus findings in PTSD patients compared to controls, using ethnically similar study groups where alcohol and drug abuse were non-existent; (2) test influence of disease duration as well as depression scores on possible morphological changes; (3) test whether the voxel-based morphometry (VBM) data confirm the group differences seen in the region of interest (ROI) analysis, and (4) test the associations between the cognitive test scores and the morphological changes. <i>Methods:</i> VBM and ROI-based analysis were applied in 23 patients and 17 healthy controls. Culture-neutral cognitive tests were used. <i>Results:</i> The ROI-based method showed significantly decreased gray matter volumes for global hippocampal volume, as in a separate analysis of left and right sides in the PTSD group. Total volume of the hippocampus was significantly decreased on the left side, as in the global assessment. A multiple regression VBM model showed significant voxel clusters for group affiliation in the right hippocampus, modelling lowering of gray matter associated with the PTSD group. Disease duration was shown to be negatively correlated to bilateral hippocampal volume and high depression score to bilateral gray matter parahippocampal volume. No significant correlations were found between hippocampal or parahippocampal volumes and cognitive functions. <i>Conclusion:</i> The present and previous studies showed that morphologic differences do not appear to be due to drug or alcohol abuse. The VBM data partially confirm the group differences seen in the ROI-based method in the medial temporal lobe. The fact that the significantly lower score on the short-term memory test in the PTSD group is not correlated to hippocampal volume may suggest a more general basis for such memory impairment.",0,0 +5352,The validity of the DSM-IV PTSD criteria in children and adolescents: A review,"Objective: DSM-V is on its way and doubts have been raised regarding the validity of pediatric PTSD. It is the goal of the current review to critically review the empirical literature on PTSD in youth. Method: A search of PsycINFO, PubMed and reference lists was conducted. Empirical information considered relevant regarding the validity of the criteria was collected. Results/Conclusions: The validity of the symptom criteria and clusters varies, with the Avoidance/Numbing cluster outperforming the Re-experiencing—and Arousal cluster. Factor analytic findings suggest that Arousal criterion D4 should be placed within the Re-experiencing cluster, and that the Avoidance/Numbing cluster should be split up. Some non-DSM-IV PTSD symptoms, among which guilt, have considerable validity in trauma-exposed youth and their inclusion in DSM-V PTSD should be considered. As for preschool children, alternative criteria are recommended that are more developmentally sensitive.",0,0 +5353,Feigning Combat-Related Posttraumatic Stress Disorder on the Personality Assessment Inventory,"This study examined whether individuals who were instructed on the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) criteria for posttraumatic stress disorder (PTSD) could feign PTSD on the Personality Assessment Inventory (PAI; Morey, 1991). The study also investigated whether PAI indexes of symptom exaggeration, the Negative Impression Management (NIM) scale and the Malingering index, could identify individuals feigning PTSD. The diagnostic rule for PTSD (Morey, 1991, 1996) was applied to the profiles of a group of 23 veterans with combat-related PTSD and 23 male undergraduates instructed to malinger PTSD. Seventy percent of the student malingerers produced profiles that received diagnostic consideration for PTSD. The NIM cutting score (> or = 8) was highly effective in detecting simulation of PTSD but resulted in the misclassification of a large number of true PTSD cases. There were no significant differences in the overall efficiency of the test with various validity criteria. We discuss the implications of these findings for the use of the PAI in the diagnosis of combat-related PTSD.",0,0 +5354,Use of self-report measures of crime-related posttraumatic stress disorder with substance use disordered patients,"Researchers have documented that approximately three-quarters of all patients in treatment for a substance use disorder (SUD) report a history of sexual or physical assault and that at least 25% of treatment-seeking SUD patients suffer from crime-related posttraumatic stress disorder (CR-PTSD). To address the pressing need to accurately evaluate symptoms associated with victimization, a battery of self-report instruments and a semi-structured interview were administered to 114 SUD patients. More than 90% of the SUD patients reported some type of victimization and approximately 38% met criteria for current CR-PTSD. The self-report battery correctly classified CR-PTSD status in 79% of the respondents with a sensitivity rate of 82% and a specificity rate of 74%. The results indicate that: (a) there is a high prevalence of CR-PTSD in SUD patients, (b) CR-PTSD should be evaluated in every SUD patient, and (c) the self-report battery utilized in the present study may serve as a valid tool for an initial CR-PTSD screening or to supplement a clinical interview.",0,0 +5355,Involvement in High-Profile Child Sexual Abuse Controversies: Costs and Benefits,"The costs and benefits associated with participation in conflicts around child sexual abuse are explored. Using qualitative data from interviews with 40 high-profile participants, findings suggest that professionals experience both positive and negative consequences as a result of their involvement. Costs identified include attacks and misrepresentations, harm to health or emotional well-being, and career losses or changes. Benefits included personal growth, a sense of personal satisfaction, and career enhancement. Women were found to have experienced more impacts overall than men. Psychological theories about stress and coping and sociological theories about social movement participation are used to explore why people remain committed despite the risks associated with participation. Material rewards, commitment to change, the development of a highly salient identity, and the support of social networks may be contributing factors.",0,0 +5356,Neuropsychiatric Disturbances Associated with Traumatic Brain Injury: A Practical Approach to Evaluation and Management,"Traumatic brain injury (TBI) causes a wide variety of neuropsychiatric disturbances associated with great functional impairments and low quality of life. These disturbances include disorders of mood, behavior, and cognition, and changes in personality. The diagnosis of specific neuropsychiatric disturbances can be difficult because there is significant symptom overlap. Systematic clinical evaluations are necessary to make the diagnosis and formulate a treatment plan that often requires a multipronged approach. Management of TBI-associated neuropsychiatric disorders should always include nonpharmacological interventions, including education, family involvement, supportive and behavioral psychotherapies, and cognitive rehabilitation. Pharmacological treatments include antidepressants, anticonvulsants, antipsychotics, dopaminergic agents, and cholinesterase inhibitors. However, evidence-based treatments are extremely limited, and management relies on clinical empiricism and resemblance of TBI neuropsychiatric symptom profiles with those of idiopathic psychiatric disorders. Although the understanding of TBI-associated neuropsychiatric disorders has improved in the last decade, further research is needed including prospective, longitudinal studies to explore biomarkers that will assist with management and prognosis as well as randomized-controlled studies to validate pharmacological and nonpharmacological treatments. The current review summarizes the available literature in support of a structured, systematic evaluation approach and treatment options as well as recommendations for further research directions.",0,0 +5357,Frequency and severity approaches to indexing exposure to trauma: The Critical Incident History Questionnaire for police officers,"The Critical Incident History Questionnaire indexes cumulative exposure to traumatic incidents in police by examining incident frequency and rated severity. In over 700 officers, event severity was negatively correlated (r(s) = -.61) with frequency of exposure. Cumulative exposure indices that varied emphasis on frequency and severity-using both nomothetic and idiographic methods-all showed satisfactory psychometric properties and similar correlates. All indices were only modestly related to posttraumatic stress disorder (PTSD) symptoms. Ratings of incident severity were not influenced by whether officers had ever experienced the incident. Because no index summarizing cumulative exposure to trauma had superior validity, our findings suggest that precision is not increased if frequency is weighted by severity.",0,0 +5358,Toward rational pharmacotherapy for posttraumatic stress disorder: an interim report,"There is growing evidence that medication can alleviate symptoms associated with posttraumatic stress disorder (PTSD). Recent research also suggests that PTSD has a unique biological profile consisting of alterations in sympathetic arousal, the neuroendocrine system, and the sleep/dream cycle. This profile distinguishes PTSD from both major depression and panic disorder. Medication appears to alleviate PTSD symptoms associated with sympathetic hyperarousal and intrusive recollections of the trauma but seems ineffective against avoidant symptoms. Pharmacotherapy alone is rarely sufficient to provide complete remission of PTSD. Symptom relief provided by medication facilitates the patient's participation in individual, behavioral, or group psychotherapy.",0,0 +5359,Acute episodes of predator exposure in conjunction with chronic social instability as an animal model of post-traumatic stress disorder,"People who are exposed to horrific, life-threatening experiences are at risk for developing post-traumatic stress disorder (PTSD). Some of the symptoms of PTSD include persistent anxiety, exaggerated startle, cognitive impairments and increased sensitivity to yohimbine, an alpha(2)-adrenergic receptor antagonist. We have taken into account the conditions known to induce PTSD, as well as factors responsible for long-term maintenance of the disorder, to develop an animal model of PTSD. Adult male Sprague-Dawley rats were administered a total of 31 days of psychosocial stress, composed of acute and chronic components. The acute component was a 1-h stress session (immobilization during cat exposure), which occurred on Days 1 and 11. The chronic component was that on all 31 days the rats were given unstable housing conditions. We found that psychosocially stressed rats had reduced growth rate, reduced thymus weight, increased adrenal gland weight, increased anxiety, an exaggerated startle response, cognitive impairments, greater cardiovascular and corticosterone reactivity to an acute stressor and heightened responsivity to yohimbine. This work demonstrates the effectiveness of acute inescapable episodes of predator exposure administered in conjunction with daily social instability as an animal model of PTSD.",0,0 +5360,Oxytocin improves compassion toward women among patients with PTSD,"Although impairments in social skills, including empathic abilities, are common in post-traumatic stress disorder (PTSD), the ability to feel compassion-a pro-social behavior that is based on empathy and drives us to help others-has never been assessed among these patients. The first aim of this study was to examine whether patients with PTSD suffer from deficits in compassion and to examine the association between the clusters of PTSD symptoms and these deficits. Furthermore, given that intranasal oxytocin (OT) has been suggested to possibly modulate social behaviors, the second aim of this study was to investigate whether intranasal OT may enhance compassion in these patients. Using a randomized, double-blind, placebo-controlled crossover design, we administered 24 IU of OT and placebo at a one-week interval to 32 patients with PTSD and to 30 matched healthy control participants. The results indicate that patients with PTSD exhibit deficits in compassion and that the numbing cluster emerged as the key predictor of those deficits. Moreover, the results indicate that a single intranasal dose of OT enhances compassion toward women (but not towards men), both in patients with PTSD and in controls. These results offer support for recent suggestions that intranasal OT may potentially be an effective pharmacological intervention for patients with PTSD.",0,0 +5361,Doing and Being Well (for the Most Part): Adaptive Patterns of Narrative Self-Evaluation During Bereavement,"Narrative self-evaluation patterns were studied in relation to longitudinal measures of adaptation to the death of a spouse in midlife. Narrative self-evaluations, identified in open-ended interview transcripts at 6 months post-loss, were coded as either positive or negative and as either doing-based (evaluations of ""what one does"") or being-based (evaluations of ""what one is""). These narrative variables were then compared with separate, clinical-interview measures of grief at 6, 14, and 25 months post-loss. Results confirmed 3 predictions. First, participants who made an optimal proportion of positive to negative self-evaluations (approximately a 5:1 positive-to-negative ratio) had lower grief levels over time than did those who made either higher or lower proportions. Second, the tendency to focus on evaluations of what one does rather than what one is predicted lower grief levels over time. Third, participants who directly integrated doing-based and being-based self-evaluations had lower grief levels over time than those who did not link the 2 evaluations. Implications for the narrative construction of personal meaning and identity in relation to adaptation are discussed.",0,0 +5362,Relationships between dissociation and posttraumatic stress disorder,"(from the chapter) A review of the relationship between dissociation and PTSD is discussed by Simeon in Chapter 4. She suggests that four models can be identified to account for the association. The first model (comorbidity) views PTSD and dissociation as separate entities that may co-occur because of the nosological link to a common etiological factor (i.e., traumatic stress). The second model (shared risk factors) suggests that the link between PTSD and dissociation is through a common psychological and/or biological vulnerability (i.e., a diathesis). The third model (shared pathogenesis) posits that PTSD and dissociation have common pathogenetic mechanisms that are activated by trauma. The final model (same disorder) suggests that PTSD and dissociation are inseparable, with the current nosology unnecessarily creating artificial distinctions between them. While acknowledging that no model effectively accounts for the relationship between PTSD and dissociation, Simeon concludes that the first model, comorbidity, best captures the current data. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5363,"Identifying trajectory clusters in breast cancer survivors’ supportive care needs, psychosocial difficulties, and resources from the completion of primary treatment to 8 months later","Purpose: This study aimed to chart patterns of simultaneous trajectories over 8 months in breast cancer survivors’ (BCS) supportive care needs, psychological distress, social support, and posttraumatic growth. Clusters of BCS among these trajectories were identified and characterized. Methods: Of 426 BCS study participants, 277 (65 %) provided full assessments in the last week of primary cancer treatment and 4 and 8 months later. Latent trajectories were obtained using growth mixture modeling for patients who responded to all scores for at least one time point (n = 348). Then, classification of BCS was performed by hierarchical agglomerative clustering on axes derived from a multiple factor analysis of trajectory assignments. Self-esteem, attachment security, and satisfaction with care were assessed at baseline. Results: Four trajectory clusters were identified, including two BCS subgroups (63 %) with low needs and low psychological distress. Two others (37 %) exhibited high or increasing needs and concerning levels of psychological distress. These latter clusters were characterized by higher insecure attachment, lower satisfaction with care, and either lower education or younger age, and having undergone chemotherapy. Conclusion: More than a third of BCS present unfavorable patterns in supportive care needs over 8 months after primary cancer treatment. Identified psychosocial and cancer care characteristics point to targets for enhanced BCS supportive care.",0,0 +5364,Dialectical Behaviour Therapy for Post-traumatic Stress Disorder after Childhood Sexual Abuse in Patients with and without Borderline Personality Disorder: A Randomised Controlled Trial,"<b><i>Background:</i></b> Post-traumatic stress disorder (PTSD) with co-occurring severe psychopathology such as borderline personality disorder (BPD) is a frequent sequel of childhood sexual abuse (CSA). CSA-related PTSD has been effectively treated through cognitive-behavioural treatments, but it remains unclear whether success can be achieved in patients with co-occurring BPD. The aim of the present study was to determine the efficacy of a newly developed modular treatment programme (DBT-PTSD) that combines principles of dialectical behaviour therapy (DBT) and trauma-focused interventions. <b><i>Methods:</i></b> Female patients (n = 74) with CSA-related PTSD were randomised to either a 12-week residential DBT-PTSD programme or a treatment-as-usual wait list. About half of the participants met the criteria for co-occurring BPD. Individuals with ongoing self-harm were not excluded. The primary outcomes were reduction of PTSD symptoms as assessed by the Clinician-Administered PTSD Scale (CAPS) and by the Posttraumatic Stress Diagnostic Scale (PDS). Hierarchical linear models were used to compare improvements across treatment groups. Assessments were carried out by blinded raters at admission, at end of treatment, and at 6 and 12 weeks post-treatment. <b><i>Results:</i></b> Under DBT-PTSD the mean change was significantly greater than in the control group on both the CAPS (33.16 vs. 2.08) and the PDS (0.70 vs. 0.14). Between-group effect sizes were large and highly significant. Neither a diagnosis of BPD nor the severity or the number of BPD symptoms was significantly related to treatment outcome. Safety analyses indicated no increase in dysfunctional behaviours during the trial. <b><i>Conclusion: </i></b>DBT-PTSD is an efficacious treatment of CSA-related PTSD, even in the presence of severe co-occurring psychopathology such as BPD.",0,0 +5365,Trauma and Stressor-Related Disorders,"This chapter focuses on gender differences in trauma exposure and the development of posttraumatic sequelae over the life course. First, we review the prevalence of trauma exposure and posttraumatic sequelae with particular attention to comorbidity and disability or impairment. Second, we review psychobiological processes that explain risk for various types of posttraumatic sequelae with a focus on gender and comorbidity. Third, we review the DSM-5 diagnostic criteria for various disorders associated with trauma exposure. Fourth, we review the best available instruments designed to assess these disorders. Fifth, we review the current best practices for treatment of these conditions including psychopharmacology, psychotherapy, and combined approaches designed to treat comorbid conditions. We conclude that despite a large body of research documenting gender differences in trauma exposure and trauma-related disorders much work remains to be done in this area. © Springer International Publishing Switzerland 2015.",0,0 +5366,"A mental health intervention for rural, foster children from methamphetamine-involved families: Experimental assessment with qualitative elaboration","Abstract This mixed method study describes the cultural adaptation, implementation and impact of a mental health intervention for individual rural children aged 7–17 from methamphetamine-involved families who are in foster care. Features of the culturally-shaped intervention include: 1) close collaboration with local professionals who provide the intervention over a seven month period; 2) provision of the intervention in and around children's homes; and 3) the use of local storytelling traditions in a narrative- and relationship-based intervention. As a group, children (N = 15) showed problematic levels of Childhood Behavior Checklist (CBCL) externalizing and total problem behaviors and symptoms of PTSD/dissociation during the pretest. Children were randomly assigned to an experimental group who received the intervention immediately (n = 8), or a wait-list control group (n = 7) who received the intervention at the end of the study. There was a significant interaction effect of time (pre and post test) and group on externalizing behavior with the trajectory of the experimental group improving while that of the control group worsened. Gains made by the experimental group were maintained over a seven month follow-up period. Comparative case studies, individual qualitative interviews and open-ended questionnaires provided rich elaboration of participants' experiences and illuminated complexities and challenges of the intervention.",0,0 +5367,Post-traumatic stress symptoms 5 years after military deployment to Afghanistan: an observational cohort study,"Deployment can put soldiers at risk of developing post-traumatic stress symptoms. Despite several longitudinal studies, little is known about the timing of an increase in post-traumatic stress symptoms relative to pre-deployment. Longitudinal studies starting pre-deployment, in which participants are repeatedly measured over time, are warranted to assess the timing of an increase in symptoms to ultimately assess the timing of an increase in treatment demand after deployment.In this large observational cohort study, Dutch military personnel who were deployed to Afghanistan as part of the International Security Assistance Forces between March, 2005, and September, 2008, were assessed for post-traumatic stress symptoms with the Self-Rating Inventory for Post-traumatic Stress Disorder (SRIP) questionnaire. Participants were assessed 1 month before deployment and followed up at 1 month, 6 months, 12 months, 2 years, and 5 years after deployment, with changes in SRIP scores compared with pre-deployment using a mixed model analysis. The primary outcome was the total score of post-traumatic stress symptoms measured with SRIP at pre-deployment and the five follow-up assessments, with a score of 38 used as the cutoff to indicate substantial post-traumatic stress symptoms.Between March, 2005, and September, 2008, 1007 participants were recruited to this study. The results show two important effects of deployment on post-traumatic stress symptoms. A short-term symptom increase within the first 6 months after deployment (symptom increase coefficient for SRIP score vs pre-deployment [β] 0·99, 95% CI 0·50-1·48); and a long-term symptom increase at 5 years after deployment (β 1·67, 1·14-2·20).This study underlines the importance of long-term monitoring of the psychological health of soldiers after deployment because early detection of symptoms is essential to early treatment, which is related to improved psychological health.Dutch Ministry of Defense.",1,0 +5368,Skin Conductance Response during Laboratory Stress in Combat Veterans with Post Traumatic Stress Disorder,"The primary objective was to assess skin conductance response (SCR) to a laboratory stressor in combat veterans with posttraumatic stress disorder (PTSD) compared to controls. The secondary objective was to evaluate the relationship between SCR and PTSD symptom clusters.15 combat/ PTSD, 15 combat/no PTSD, 15 no combat/no PTSD veterans had their SCR recording during aversive pictures from the International Affective Picture Scale.The groups had similar demographics and medical history (all p>.05). SCR was different between groups (F(2,42) = 4.34, p=.02). The combat/PTSD group had the highest response compared to both control groups. Numbing-avoiding was predictive of SCR (F(1,42)=12.72, p=.001), while re-experiencing and hyper-arousal were not (p's>.05).Increased SCR in the PTSD group validates previous studies. Numbing-avoiding PTSD cluster scores correlated with SCR values. These findings support current PTSD therapies that reduce avoidance behaviors.",0,0 +5369,Clinical presentations in combat veterans diagnosed with posttraumatic stress disorder,"This article investigated subtypes of symptom patterns among male combat veterans diagnosed with posttraumatic stress disorder (PTSD) through a cluster analysis of their Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Graham, Ben-Porath, Tellegen, Dahlstrom, & Kaemmer, 2001) clinical and validity scales. Participants were 126 veterans seeking outpatient treatment for combat-related PTSD at a Veterans Affairs Medical Center. Two well-fitting MMPI-2 cluster solutions (a four-cluster solution and a three-cluster solution) were evaluated with several statistical methods. A four-cluster solution was determined to best fit the data. Follow-up analyses demonstrated between-cluster differences on MMPI-2 ""fake bad"" scales and content scales, the Beck Depression Inventory (BDI; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961), Dissociative Experiences Scale (DES; Bernstein & Putnam, 1986), Mississippi Combat PTSD scale (M-PTSD; Keane, Caddall, & Taylor, 1988), and Clinician-Administered PTSD Scale (CAPS-1; Blake et al., 1990). Clusters also were different in disability-seeking status, employment status, and income. Implications for research and clinical practice using the MMPI-2 with combat veterans presenting with PTSD are briefly addressed.",0,0 +5370,"Prevalence of post-traumatic stress disorder in Sichuan Province, China after the 2008 Wenchuan earthquake","To estimate the prevalence of post-traumatic stress disorder (PTSD) and assess the associated risk factors among earthquake survivors in different areas after the Wenchuan earthquake in China.Cross-sectional multicluster sample surveys were employed using data collected from two counties.Surveys were conducted separately in Beichuan and Langzhong Counties in Sichuan Province, with a total of 1002 respondents. Beichuan County was damaged more severely than Langzhong County during the earthquake in May 2008. A total of 426 households were represented in the data, with a mean of 2.2 respondents per household. Data were collected using structured interviews and the Harvard Trauma Questionnaire.The prevalence of suspected PTSD was 45.5% (n=203) in Beichuan County (heavily damaged) and 9.4% (n=52) in Langzhong County (moderately damaged). Household income, living conditions (settlements), deaths in families and household damage were significantly related to the prevalence of suspected PTSD in heavily damaged areas.Interventions designed to reduce PTSD among populations affected by the May 2008 earthquake should focus on individuals with no household income, those living in shelters or temporary houses, those with damaged households, and those who experienced a death in the family. Governments should support income-generating activities and improve living conditions. Trained field personnel can assist with PTSD assessments and referrals, and existing rural healthcare services should be used to provide treatment for common psychiatric disorders.",0,0 +5371,"Remission in post-traumatic stress disorder (PTSD): effects of sertraline as assessed by the Davidson Trauma Scale, Clinical Global Impressions and the Clinician-Administered PTSD scale","Rates of remission were examined in two controlled 12-week studies of sertraline and placebo for post-traumatic stress disorder (PTSD). The performance of three scales was evaluated: the self-rated Davidson Trauma Scale (DTS), and two interviewer scales: the Clinician Administered PTSD Scale (CAPS) and Clinical Global Impressions (CGI). Sertraline proved significantly superior to placebo with respect to remission on all three ratings. Rates of remission were very similar for all scales, ranging from 23.1-26.3% for sertraline and 13.9-14.9% for placebo. Traditional thresholds for the CAPS and DTS were tested relative to the CGI and to each other. The CAPS and DTS thresholds of < 20 and < 18 were found to be valid.",0,0 +5372,The locomotor and behavioral patterns following both a singleinjection and double-injection rat model of subarachnoid hemorrhage,"Background and Goals of Study: Subarachnoid hemorrhage (SAH) has been described in humans to be associated with depression, anxiety and post-traumatic stress disorder. Yet, possibly due to the lack of experimental studies, little is known of the mechanism for post-SAH emotional and behavioral disturbances. Therefore, there is a great need for the development of animal models for post-SAH behavioral abnormalities. This study describes the neuro-behavioral profile of rats following both a single-injection and double-injection model of SAH. Materials and Methods: SAH was induced in 48 rats by 0.3 ml injection of autologous arterial blood into the cisterna magnum (single-injection model). Post-SAH vasospasm was induced in 24 of these rats by a second injection of blood into the cisterna magnum after 24 hours (double-injection model). 0.3 ml of saline was injected into the cisterna magnum of 24 additional rats (sham group). Neurological performance was measured at 24, 48 hours, 1, 2 and 3 weeks following SAH. 3 weeks after SAH, four behavioral tests were performed for the duration of 6 consequent days: open field test, sucrose preference test, elevated plus maze test and swimming test. Results and Discussion: There was impaired neurological performance by 24 hours following SAH (P< 0.0001). For the open field test, the double-injection model was associated with less total travel distance (P< 0.005), reduced mean velocity (P< 0.005), and less travel distance and time spent in the central part of the field (P< 0.05). Sucrose preference was impaired after SAH (P< 0.01). For the plus maze test, the single-injection model was associated with less open arm entries (P< 0.005), decreased time spent in open arms (P< 0.0005), decreased closed arm entries (P< 0.01), and decreased platform entries (P< 0.005). There was decreased time spent on the platform in rats after SAH (P< 0.005). There was more immobility time during the swimming test in both the single-injection (P< 0.005) and double-injection (P< 0.05) groups compared to the control group. Conclusions: The main finding of this study was that both, the single and double injection rat models of SAH, were associated with considerable behavioral disturbances including locomotor abnormalities, increased anxiety and depressive behavior.",0,0 +5373,Resilience Intervention for Young Adults With Adverse Childhood Experiences,"BACKGROUND: Adverse childhood experiences (ACEs) are correlated with risk behaviors of smoking, disordered eating, and alcohol and substance abuse. Such behaviors can lead to significant public health problems of chronic obstructive pulmonary disease, obesity, liver disease, and hypertension, yet some individuals do not appear to suffer negative consequences but rather bounce back. OBJECTIVE: To pilot the feasibility and potential efficacy of the Empower Resilience Intervention to build capacity by increasing resilience and health behaviors and decreasing symptoms and negative health behaviors with young adults in an educational setting who have had ACEs. DESIGN: A two-group pre–post repeated measures design to compare symptoms, health behaviors, and resilience and written participant responses. RESULTS: There was a statistically significant cohort by time interaction for physical activity in the intervention group. There was no significant change in risk behaviors or resilience score by cohort. Young adults in the intervention group reported building strengths, reframing resilience, and creating support connections. CONCLUSIONS: An increase in health behavior is theoretically consistent with this strengths-based intervention. Evaluating this intervention with a larger sample is important. Interrupting the ACE to illness trajectory is complex. This short-term empower resilience intervention, however, holds promise as an opportunity to reconsider the negative effects of the trauma of the past and build on strengths to develop a preferred future.",0,0 +5374,Heat acclimation and cross-tolerance against novel stressors: genomic–physiological linkage,"Heat acclimation (AC) is a ""within lifetime"" reversible phenotypic adaptation, enhancing thermotolerance and heat endurance via a transition to ""efficient"" cellular performance when acclimatory homeostasis is reached. An inseparable outcome of AC is the development of cross-tolerance (C-T) against novel stressors. This chapter focuses on central plasticity and the molecular-physiological linkage of acclimatory and C-T responses. A drop in temperature thresholds (T-Tsh) for activation of heat-dissipation mechanisms and an elevated T-Tsh for thermal injury development imply autonomic nervous system (ANS) and cytoprotective network involvement in these processes. During acclimation, the changes in T-Tsh for heat dissipation are biphasic. Initially T-Tsh drops, signifying the early autonomic response, and is associated with perturbed peripheral effector cellular performance. Pre-acclimation values return when acclimatory homeostasis is achieved. The changes in the ANS suggest that acclimatory plasticity involves molecular and cellular changes. These changes are manifested by the activation of central peripheral molecular networks and post-translational modifications. Sympathetic induction of elevated HSP 72 reservoirs, with faster heat shock response, is only one example of this. The global genomic response, detected using gene-chips and cluster analyses imply upregulation of genes encoding ion channels, pumps, and transporters (markers for neuronal excitability) in the hypothalamus at the onset of AC and down regulation of metabotrophic genes upon long term AC. Peripherally, the transcriptional program indicates a two-tier defense strategy. The immediate transient response is associated with the maintenance of DNA and cellular integrity. The sustained response correlates with long-lasting cytoprotective-signaling networks. C-T is recorded against cerebral hypoxia, hyperoxia, and traumatic brain injury. Using the highly developed ischemic/reperfused heart model as a baseline, it is evident that C-T stems via protective shared pathways developed with AC. These comprise constitutive elevation of HIF 1alpha and associated target pathways, HSPs, anti-apoptosis, and antioxidative pathways. Collectively the master regulators of AC and C-T are still enigmatic; however, cutting-edge investigative techniques, using a broad molecular approach, challenge current ideas, and the data accumulated will pinpoint novel pathways and provide new perspectives.",0,0 +5375,Effects of a dolphin interaction program on children with autism spectrum disorders – an exploratory research,"Interaction programs involving dolphins and patients with various pathologies or developmental disorders (e.g., cerebral palsy, intellectual impairment, autism, atopic dermatitis, post-traumatic stress disorder, depression) have stimulated interest in their beneficial effects and therapeutic potential. However, the true effects observed in different clinical and psycho-educational setups are still controversial.An evaluation protocol consisting of the Childhood Autism Rating Scale (CARS), Psychoeducational Profile-Revised (PEP-R), Autism Treatment Evaluation Checklist (ATEC), Theory of Mind Tasks (ToM Tasks) and a custom-made Interaction Evaluation Grid (IEG) to evaluate behavioural complexity during in-pool interactions was applied to 10 children diagnosed with Autism Spectrum Disorders. The ATEC, ToM Tasks and CARS results show no benefits of the dolphin interaction program. Interestingly, the PEP-R suggests some statistically significant effects on 'Overall development score', as well as on their 'Fine motor development', 'Cognitive performance' and 'Cognitive verbal development'. Also, a significant evolution in behavioural complexity was shown by the IEG.This study does not support significant developmental progress resulting from the dolphin interaction program.",0,0 +5376,Clinical evaluation of the Trauma Outcome Profile (TOP) in the longer-term follow-up of polytrauma patients,"No sufficiently validated disease-specific instrument is available to assess patient outcome after polytrauma. The aim of this investigation was to test the recently published Trauma Outcome Profile (TOP) in the longer-term outcome of multiply injured patients.Single centre validation study on the TOP in comparison with objective and subjective measures of patient, injury or treatment characteristics and longer-term outcome (e.g. medical outcomes study Short Form-36, SF-36; Nottingham Health Profile, NHP; working capacity), at least 2 years following trauma in 117 survivors of polytrauma (injury severity score, ISS>16), using comparative analysis and correlation testing of prospectively collected data.Patients' mean weighted self-rating with regard to the 10 single TOP dimensions of Health Related Quality of Life (HRQoL, 0-100) ranged from lowest values for mental functioning (52.6+33.5) to highest values for daily activities (79.0+27.5). The rate of persons who indicated an abnormal level of function or pain increased significantly from pre-injury status (2% and 5%, resp.) to 46% for both values at longer-term follow-up (p<0.001). Observed associations between single dimensions or TOP component summary scores with the corresponding values from general HRQol instruments, such as the SF-36, resulted in R (Pearson) up to 0.85. Survivors of polytrauma who presented with a reduced working capacity (RWC) at longer-term follow-up in all TOP dimensions included a significantly higher rate of patients conspicuous for a relevantly reduced outcome compared with those with a non reduced working capacity (NRWC) (posttraumatic stress disease, PTSD: p<0.05; all other dimensions: p<0.001). Patients with a RWC were characterised by an almost fivefold probability of reduced outcome with regard to the TOP dimensions 'social interaction' or 'satisfaction' (odds ratio, OR 12.4 (95% CI 5.1-30.1) and 12.5 (4.0-39.0), resp.).This first clinical and methodological evaluation in a well defined cohort of polytrauma patients found the TOP to be a reliable and well discriminating score covering both relevant general and trauma-specific aspects of longer-term outcome. Despite these promising primary results, until further validation, the TOP should be used together with already accepted HRQoL measures to allow adequate international comparison of data in the future.",0,0 +5377,Effect of trauma on quality of life as mediated by mental distress and moderated by coping and social support among postconflict displaced Ethiopians,"Objective: An understanding of how quality of life is affected by severe trauma and mental distress may facilitate better intervention strategies for postconflict internally displaced persons, by identifying mediators, moderators, and independent risk factors. We investigate the pathways involved in this process and also study the moderating roles of coping strategies and perceived social support. Method: A random sample of 1193 (62% women) internally displaced Ethiopian adults living in shelters in Addis Ababa were interviewed with instruments capturing the relevant concepts, including SCL-90-R and WHOQOL-BREF. Path analysis was employed to elaborate the mediating and moderating effects. Self-reported living conditions were also assessed. Results: Mental distress increased and quality of life decreased with age. Mental distress mediated the effects of trauma in reducing the quality of life, and some trauma also reduced quality of life directly. These effects remained after adjusting for living conditions. Living conditions were related to quality of life also on their own. Coping strategies and perceived social support influenced mental distress and quality of life directly as well as indirectly by moderation, in part gender specific. Conclusions: Intervention strategies aimed at reducing mental distress, modifying coping strategies, and encouraging social support may turn out to be useful in increasing the overall quality of life in postconflict situations, and are worth considering as complements to strategies that improve the living conditions. © 2007 Springer Science+Business Media B.V.",0,0 +5378,Two-Year Prospective Evaluation of the Relationship Between Acute Stress Disorder and Posttraumatic Stress Disorder Following Mild Traumatic Brain Injury,"To assess the ability of acute stress disorder to predict posttraumatic stress disorder (PTSD), the relationship between acute stress disorder and PTSD over the 2 years following mild traumatic brain injury was determined.Survivors of motor vehicle accidents who sustained mild traumatic brain injuries were assessed for acute stress disorder within 1 month of the trauma (N=79) and for PTSD at 6 months (N=63) and 2 years (N=50) posttrauma.Acute stress disorder was diagnosed in 14% of the patients. Among the patients who participated in all three assessments, 80% of the subjects who met the criteria for acute stress disorder were diagnosed with PTSD at 2 years. Of the total initial group, 73% of those diagnosed with acute stress disorder had PTSD at 2 years.This study provides further support for the utility of the acute stress disorder diagnosis as a predictor of PTSD but indicates that the predictive power of the diagnostic criteria can be increased by placing greater emphasis on reexperiencing, avoidance, and arousal symptoms.",0,0 +5379,"Epidemiologic Studies of Trauma, Posttraumatic Stress Disorder, and other Psychiatric Disorders","This paper reviews recent epidemiologic studies of posttraumatic stress disorder (PTSD) in the general population. Estimates of the prevalence of exposure to traumatic events vary with the method used to ascertain trauma exposure and the definition of the stressor criterion. Changes in the DSM-IV definition of ""stressor"" have increased the number of traumatic events experienced in the community that can be used to diagnose PTSD and thus, the number of PTSD cases. Risk factors for PTSD in adults vary across studies. The 3 factors identified as having relatively uniform effects are 1) preexisting psychiatric disorders, 2) a family history of disorders, and 3) childhood trauma. In civilian populations, women are at a higher risk for PTSD than are men, following exposure to traumatic events. Most community residents have experienced 1 or more PTSD-level traumas in their lifetime, but only a few succumb to PTSD. Trauma victims who do not succumb to PTSD are not at an elevated risk for the subsequent onset of major depression or substance use disorders, compared with unexposed persons.",0,0 +5380,Testing alternative factor models of PTSD and the robustness of the dysphoria factor,"This study first aimed to examine the structure of self-reported posttraumatic stress disorder (PTSD) symptoms using three different samples. The second aim of the paper was to test the robustness of the factor analytic model when depression scores were controlled for.Based on previous factor analytic findings and the DSM-IV formulation, six confirmatory factor models were specified and estimated that reflected different symptom clusters. The best fitting model was subsequently re-fitted to the data after including a depression variable.The analyses were based on responses from 973 participants across three samples. Sample 1 consisted of 633 parents who were members of 'The National Association of Infant Death' and who had lost a child. Sample 2 consisted of 227 victims of rape, who completed a questionnaire within 4 weeks of the rape. Each respondent had been in contact with the Centre for Rape Victims (CRV) at the Aarhus University Hospital, Denmark. Sample 3 consisted of 113 refugees resident in Denmark. All participants had been referred to a treatment centre which focused on rehabilitating refugees through treatment for psychosocial integration problems (RRCF: Rehabliterings og Revliderings Centre for Flygtninge). In total 500 participants received a diagnosis of PTSD/sub-clinical PTSD (Sample 1, N=214; 2, N=176; 3, N=110).A correlated four-factor model with re-experiencing, avoidance, dysphoria, and arousal factors provided the best fit to the sample data. The average attenuation in the factor loadings was highest for the dysphoria factor (M=-.26, SD=.11) compared to the re-experiencing (M=-.14, SD=.18), avoidance (M=-.10, SD=.21), and arousal (M=-.09, SD=.13) factors.With regards to the best fitting factor model these results concur with previous research findings using different trauma populations but do not reflect the current DSM-IV symptom groupings. The attenuation of dysphoria factor loadings suggests that dysphoria is a non-specific component of PTSD.",0,0 +5381,Investigation of the Relation Between PTSD Symptoms and Self-Compassion: Comparison Across DSM IV and DSM 5 PTSD Symptom Clusters,Self-compassion is posited to protect against posttraumatic stress disorder (PTSD) symptoms after exposure to traumatic events. Prior work has suggested self-compassion may only be related to avoidance symptoms using DSM IV criteria. Changes to the diagnosis in DSM 5 may have changed these relations. The current study examined the relation between self-compassion and PTSD symptoms using DSM IV and DSM 5 criteria. PTSD symptoms and self-compassion were evaluated in two trauma-exposed samples using measures that corresponded to DSM IV and DSM 5 criteria. Self-compassion was negatively correlated with aggregated PTSD symptoms for DSM IV and DSM 5. Self-compassion was correlated with avoidance symptoms for DSM IV but was correlated with all symptom clusters for the DSM 5. These results suggest that self-compassion may protect against PTSD symptoms using the most recent diagnostic criteria.,0,0 +5382,The Detection of Malingered Posttraumatic Stress Disorder with MMPI-2 Fake Bad Indices,"This investigation explored the effect of posttraumatic stress disorder (PTSD) simulation on Minnesota Multiphasic Personality Inventory-2 (MMPI-2) responses, to detect malingered from genuine PTSD. Sixty-four adult PTSD outpatients at a child sexual abuse (CSA) survivor treatment program were compared with 85 adult college students instructed and trained to malinger PTSD. MMPI-2 overreporting indices examined were F, F-Fb, F-K, F(p), Ds2, O-S, OT, and FBS. A stepwise discriminant analysis identified F(p), F-K, and O-S as the best malingering predictors. A predictive discriminant analysis yielded good hit rates for the model, with impressive cross-validation results. Cutoff scores were assessed for the model's predictors. Clinical implications for detecting malingered PTSD using the MMPI-2 are discussed.",0,0 +5383,"Posttraumatic stress disorder, hypnotizability, and imagery","Twenty-six Vietnam veterans were studied to determine the relationship between posttraumatic stress disorder and hypnotizability. The intensity of their posttraumatic stress disorder was measured by a self-report. Their hypnotizability scores, vividness of imagery scores, and symptomatic profiles were also ascertained. Veterans with low or no posttraumatic stress disorder scores had normal hypnotizability scores and normal imagery scores, whereas those with high posttraumatic stress disorder scores had high hypnotizability scores and high imagery scores. The authors conclude that either combat traumas enhanced hypnotic potential in some veterans or that veterans with excellent hypnotic potential to begin with were more susceptible to posttraumatic stress.",0,0 +5384,"Psychometric Properties of the Mobility Inventory for Agoraphobia: Convergent, Discriminant, and Criterion-Related Validity","Aims of this study were (a) to summarize the psychometric literature on the Mobility Inventory for Agoraphobia (MIA), (b) to examine the convergent and discriminant validity of the MIA's Avoidance Alone and Avoidance Accompanied rating scales relative to clinical severity ratings of anxiety disorders from the Anxiety Disorders Interview Schedule (ADIS), and (c) to establish a cutoff score indicative of interviewers' diagnosis of agoraphobia for the Avoidance Alone scale. A meta-analytic synthesis of 10 published studies yielded positive evidence for internal consistency and convergent and discriminant validity of the scales. Participants in the present study were 129 people with a diagnosis of panic disorder. Internal consistency was excellent for this sample, α=.95 for AAC and .96 for AAL. When the MIA scales were correlated with interviewer ratings, evidence for convergent and discriminant validity for AAL was strong (convergent r with agoraphobia severity ratings=.63 vs. discriminant rs of .10-.29 for other anxiety disorders) and more modest but still positive for AAC (.54 vs. .01-.37). Receiver operating curve analysis indicated that the optimal operating point for AAL as an indicator of ADIS agoraphobia diagnosis was 1.61, which yielded sensitivity of .87 and specificity of .73.",0,0 +5385,Suppressed monocyte gene expression profile in men versus women with PTSD,"There have been several attempts to use gene microarrays from peripheral blood mononuclear cells to identify new biological pathways or targets for therapy in Posttraumatic Stress Disorder (PTSD). The few studies conducted to date have yielded an unclear pattern of findings, perhaps reflecting the use of heterogeneous samples of circulating immune cells for analysis. We used gene microarrays on a homogeneous sample of circulating monocytes to test the hypothesis that chronic PTSD would be associated with elevated inflammatory activity and to identify new pathways dysregulated in the disorder. Forty-nine men (24 PTSD+ and 25 age-matched trauma-exposed PTSD- controls) and 18 women (10 PTSD+ and 8 age-matched PTSD- controls) were recruited. Gene expression microarray analysis was performed on CD14+ monocytes, immune cells that initiate and respond to inflammatory signaling. Male subjects with PTSD had an overall pattern of under-expression of genes on monocytes (47 under-expressed versus 4 over-expressed genes). A rigorous correction for multiple comparisons and verification with qPCR showed that of only 3 genes that were differentially expressed, all were under-expressed. There was no transcriptional evidence of chronic inflammation in male PTSD+ subjects. In contrast, preliminary data from our pilot female PTSD+ subjects showed a relatively balanced pattern of increased and decreased expression of genes and an increase in activity of pathways related to immune activation. The results indicate differential patterns of monocyte gene expression in PTSD, and the preliminary data from our female pilot subjects are suggestive of gender dimorphism in biologic pathways activated in PTSD. Changes in immune cell gene expression may contribute to medical morbidity in PTSD.",0,0 +5386,The Psychometric Properties of the Korean Version of the Verbal Abuse Questionnaire in University Students,"The aim of the present study was to examine the psychometric properties of the Korean Verbal Abuse Questionnaire (K-VAQ) that consists of 15 items related with life-time verbal aggression exposure.A total of 5814 university students who agreed to take part in the study completed the K-VAQ, the Korean version of the Life Event CheckList (LEC-K) and Impact of Event Scale-Revised (K-IES-R). Internal consistency was checked by using item-total item correlation and Cronbach's alpha coefficient. Exploratory and confirmatory factor analyses were performed, and convergent and concurrent validity levels were examined. Finally, a cluster analysis was conducted to verify the validity of the cutoff point of the K-VAQ.The Cronbach's alpha correlation coefficient was 0.9. The K-VAQ showed a single factor structure which explained 55.34% of the total variance. The K-VAQ was significantly associated with the LEC-K (r=0.24) and K-IES-R (r=0.28), indicating good convergent validity and concurrent validity. The cluster analysis provided four clusters of trauma experiences: high, moderate, low, and minimal, with K-VAQ ranges of 43-81, 20-42, 7-19, and 0-6, respectively. In a further investigation, a K-VAQ score of 40 was found to be the appropriate cutoff point to delineate the highly verbally abused group, as used in the previous studies. A sum of 36.5% of the highly verbally abused group reported to show substantial symptoms of PTSD (K-IES-R score >22).The present findings suggest that the K-VAQ has good psychometric properties for assessing verbal aggression among the Korean population.",0,0 +5387,The Children's Revised Impact of Event Scale (CRIES): Validity as a Screening Instrument for PTSD,"The Children's Revised Impact of Event Scale (CRIES) is a brief child-friendly measure designed to screen children at risk for Posttraumatic Stress Disorder (PTSD). It has good face and construct validity, a stable factor structure, correlates well with other indices of distress, and has been used to screen very large samples of at-risk-children following a wide range of traumatic events. However, few studies have examined the scale's validity against a structured diagnostic interview based on the DSM-IV criteria for PTSD. In the present study, the CRIES and the PTSD section of the Anxiety Disorders Interview Schedule-Child and Parent Version (ADIS-CP) were administered to a sample of children and adolescents ( n =63) recruited from hospital accident and emergency rooms and the validity of the CRIES as a screening tool evaluated. Cutoff scores were chosen from this sample with a low base-rate of PTSD (11.1%) to maximize sensitivity and minimize the likelihood that children with a diagnosis of PTSD would fail to be identified. Cutoff scores were then cross-validated in a sample of 52 clinically referred children who had a high base-rate of PTSD (67.3%). A cutoff score of 30 on the CRIES-13 and a cutoff score of 17 on the CRIES-8 maximized sensitivity and specificity, minimized the rate of false negatives, and correctly classified 75–83% of the children in the two samples. The CRIES-8 (which lacks any arousal items) worked as efficiently as the CRIES-13 (which includes arousal items) in correctly classifying children with and without PTSD. Results are discussed in light of the current literature and of the need for further development of effective screens for children at-risk of developing PTSD.",0,0 +5388,Olfactory anhedonia and negative olfactory alliesthesia in depressed patients,"The present study aimed to investigate olfactory anhedonia and olfactory negative alliesthesia in depressed patients. Two odorants, one with pleasant (vanillin), and one with unpleasant (butyric acid) hedonic valence were evaluated by 30 depressed inpatients and 30 controls (healthy subjects, matched by age and gender). Participants explored the hedonic valence, intensity (discrimination) and perceived quality (identification) of 16 different stimuli (3 concentrations of odorants, their 9 combinations, and 1 control containing distilled water). The hedonic perception showed that patients perceived the unpleasant odorant as significantly more unpleasant than controls (olfactory negative alliesthesia). Concerning the intensity ratings, controls were able to discriminate between all concentrations of odorants, while patients discriminated between the different concentrations only for the unpleasant component and not for the vanillin (olfactory anhedonia). Regarding the identification task in an iso-intense unmixed odorants mixture, patients perceived significantly less the pleasant odorant than the unpleasant one (olfactory anhedonia), whereas controls perceived both odorants equally well. These results support the notion of an olfactory perception impairment in depression. Further studies are needed to replicate these findings and to confirm that such olfactory anhedonia or/and olfactory negative alliesthesia could be a state or a trait of depression.",0,0 +5389,Growth mixture models in longitudinal research,"Latent growth curve models as structural equation models are extensively discussed in various research fields (Curran and Muthén in Am. J. Community Psychol. 27:567-595, 1999; Duncan et al. in An introduction to latent variable growth curve modeling. Concepts, issues and applications, 2nd edn., Lawrence Earlbaum, Mahwah, 2006; Muthén and Muthén in Alcohol. Clin. Exp. Res. 24(6):882-891, 2000a; in J. Stud. Alcohol. 61:290-300, 2000b). Recent methodological and statistical extension are focused on the consideration of unobserved heterogeneity in empirical data. Muthén extended the classic structural equation approach by mixture components, i. e. categorical latent classes (Muthén in Marcouldies, G. A., Sckumacker, R. E. (eds.), New developments and techniques in structural equation modeling, pp. 1-33, Lawrance Erlbaum, Mahwah, 2001a; in Behaviometrika 29(1):81-117, 2002; in Kaplan, D. (ed.), The SAGE handbook of quantitative methodology for the social sciences, pp. 345-368, Sage, Thousand Oaks, 2004). The paper discusses applications of growth mixture models with data on delinquent behavior of adolescents from the German panel study Crime in the modern City (CrimoC) (Boers et al. in Eur. J. Criminol. 7:499-520, 2010; Reinecke in Delinquenzverläufe im Jugendalter: Empirische Überprüfung von Wachstums- und Mischverteilungsmodellen, Institut für sozialwissenschaftliche Forschung e. V., Münster, 2006a; in Methodology 2:100-112, 2006b; in van Montfort, K., Oud, J., Satorra, A. (eds.), Longitudinal models in the behavioral and related sciences, pp. 239-266, Lawrence Erlbaum, Mahwah, 2007). Observed as well as unobserved heterogeneity will be considered with growth mixture models. Special attention is given to the distribution of the outcome variables as counts. Poisson and negative binomial distributions with zero inflation are considered in the proposed growth mixture models variables. Different model specifications will be emphasized with respect to their particular parameterizations. © 2011 Springer-Verlag.",0,0 +5390,Post-traumatic stress disorder following childbirth: an update of current issues and recommendations for future research,"Objective: This paper aimed to report the current status of research in the field of post-traumatic stress disorder following childbirth (PTSD FC), and to update the findings of an earlier 2008 paper. Background: A group of international researchers, clinicians and service users met in 2006 to establish the state of clinical and academic knowledge relating to PTSD FC. A paper identified four key areas of research knowledge at that time. Methods: Fourteen clinicians and researchers met in Oxford, UK to update the previously published paper relating to PTSD FC. The first part of the meeting focused on updating the four key areas identified previously, and the second part on discussing new and emerging areas of research within the field. Results: A number of advances have been made in research within the area of PTSD FC. Prevalence is well established within mothers, several intervention studies have been published, and there is growing interest in new areas: staff and pathways; prevention and early interven...",0,0 +5391,"Uses and abuses of the resilience construct: Loss, trauma, and health-related adversities",,0,0 +5392,"Social Support, Posttraumatic Stress, and Postpartum Depressive Symptomatology among Japanese Women","Background: In Japan, 13% of new mothers suffered from elevated postpartum depressive symptomatology (PPDS), and one-third of women had posttraumatic stress (PTS) symptoms following birth. Western researchers reported that women with elevated PPDS often had more PTS symptoms following birth. Although the importance of social support to alleviate PTS or PPDS has been reported, the role of social support in the relationship between PTS and PPDS is not known. Understanding how social support affects the relationship between PTS and PPDS is necessary to develop effective interventions to prevent elevated PPDS. Purpose: To examine the role of social support in the relationship between PTS and PPDS among Japanese women. Design and Methods: This study was a cross-sectional secondary data analysis. The study sample consisted of 207 Japanese women between one and three months after giving birth. Based on the Stress Process Model, two conceptual models (moderation and mediation), consisting of four study concepts (PPDS, PTS, social support, and maternal background factors) were examined, as well as the prediction model to examine the direct effect of each predictor on PPDS. PPDS was measured with the Postpartum Depression Screening Scale Short Form. PTS was measured with two items of posttraumatic stress disorder symptoms. Social support (by a partner/others) was measured with the adaptation of the Medical Outcomes Study Social Support Survey. Both multiple linear regressions and path analyses were used to examine the proposed models. Results: Ninety-seven (46.9%) women had elevated PPDS. One hundred two (49.3%) women experienced at least one PTS symptom. PTS following birth ( = .24), health promotion behaviors ( = -.31), partner support ( = -.15), others' support ( = - .14), physical health problems ( = .14), and parity ( = -.13) had significant direct effects on PPDS (R2 = .30). However, neither a moderating effect of social support on the relationship between PTS and PPDS nor a mediating effect of PTS on the relationship between social support and PPDS was supported in this study. Conclusions: Mental health care focusing on PTS following birth will contribute to preventing depressive symptoms. From the current study results, alternative moderation and mediation models that include coping or self-concepts are suggested for future study. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0,0 +5393,Regional homogeneity and resting state functional connectivity: Associations with exposure to early life stress,"Early life stress (ELS) confers risk for psychiatric illness. Previous literature suggests ELS is associated with decreased resting-state functional connectivity (rs-FC) in adulthood, but there are no studies of resting-state neuronal activity in this population. This study investigated whether ELS-exposed individuals demonstrate resting-state activity patterns similar to those found in PTSD. Twenty-seven adults (14 with at least moderate ELS), who were medication-free and without psychiatric or medical illness, underwent MRI scans during two 4-minute rest periods. Resting-state activity was examined using regional homogeneity (ReHo), which estimates regional activation patterns through indices of localized concordance. ReHo values were compared between groups, followed by rs-FC analyses utilizing ReHo-localized areas as seeds to identify other involved regions. Relative to controls, ELS subjects demonstrated diminished ReHo in the inferior parietal lobule (IPL) and superior temporal gyrus (STG). ReHo values were inversely correlated with ELS severity. Secondary analyses revealed decreased rs-FC between the IPL and right precuneus/posterior cingulate, left fusiform gyrus, cerebellum and caudate in ELS subjects. These findings indicate that ELS is associated with altered resting-state activity and connectivity in brain regions involved in trauma-related psychiatric disorders. Future studies are needed to evaluate whether these associations represent potential imaging biomarkers of stress exposure.",0,0 +5394,Prevalence and risk factors for posttraumatic stress disorder among chemically dependent adolescents,"OBJECTIVE: This study ascertained the prevalence of posttraumatic stress disorder (PTSD) among chemically dependent adolescents and identified factors that influence the risk of PTSD after a qualifying trauma. METHOD: The study group consisted of 297 adolescents aged 15-19 years who met the DSM-III-R criteria for dependence on alcohol or other drugs and who were receiving treatment in seven publicly funded Massachusetts facilities. PTSD and other axis I diagnoses were assessed by the Diagnostic Interview Schedule. Data on risk factors were collected by a specially constructed interview schedule. RESULTS: The lifetime prevalence of PTSD was 29.6% (24.3% for males and 45.3% for females), and the current prevalence was 19.2% (12.2% for males and 40.0% for females). These prevalences reflect a high occurrence of traumatic exposures and a high case rate among those who experienced trauma. The risk of PTSD varied with the nature of the trauma, the number of traumas experienced, psychiatric comorbidity, and familial characteristics. The higher rate of PTSD among females was due to a greater frequency of rape, which carries a high risk of PTSD development, and to a high rate of comorbid conditions. CONCLUSIONS: The lifetime prevalence of PTSD among these chemically dependent adolescents is five times that reported for a community sample of adolescents. This extremely high rate provides new understanding of the etiologic connection between PTSD and chemical dependence and has implications for their treatment.",0,0 +5395,Resilience to natural hazards: How useful is this concept?,"Resilience is widely seen as a desirable system property in environmental management. This paper explores the concept of resilience to natural hazards, using weather-related hazards in coastal megacities as an example. The paper draws on the wide literature on megacities, coastal hazards, hazard risk reduction strategies, and resilience within environmental management. Some analysts define resilience as a system attribute, whilst others use it as an umbrella concept for a range of system attributes deemed desirable. These umbrella concepts have not been made operational to support planning or management. It is recommended that resilience only be used in a restricted sense to describe specific system attributes concerning (i) the amount of disturbance a system can absorb and still remain within the same state or domain of attraction and (ii) the degree to which the system is capable of self-organisation. The concept of adaptive capacity, which has emerged in the context of climate change, can then be adopted as the umbrella concept, where resilience will be one factor influencing adaptive capacity. This improvement to conceptual clarity would foster much-needed communication between the natural hazards and the climate change communities and, more importantly, offers greater potential in application, especially when attempting to move away from disaster recovery to hazard prediction, disaster prevention, and preparedness.",0,0 +5396,Understanding implantable cardioverter defibrillator shocks and storms: Medical and psychosocial considerations for research and clinical care,"The experience of shock is the distinguishing feature for patients with implantable cardioverter defibrillators (ICDs) and is associated with diminished psychological functioning and quality of life. Multiple shocks and ICD storm are a relatively common event among patients with ICDs (10-20%) and may present specific challenging medical and psychological management for the attending health care providers. This paper examines the medical and psychological aspects of ICD shocks and storms and describes a model of biopsychosocial management for patients following the experience of ICD storm. Successful management of patients post shock includes the use of antiarrhythmic medications and careful attention to the causality of the shocks via stored electrograms. The psychological management includes specific attention to debriefing post-shock feelings and attributions, preventing avoidance behavior, and facilitating positive ""return to life"" actions. Preliminary research examining formal psychosocial treatment supports a cognitive behavioral strategy to reduce psychological distress and facilitate quality of life. Collectively, these data suggest that interdisciplinary management of patients with multiple ICD shocks or the experience of ICD storm is advised, and routine psychological consultation may be indicated for the patient post ICD storm to reduce the possibility of symptoms of post-traumatic stress.",0,0 +5397,Validity of PTSD in a sample of refugee children: can a separate diagnostic entity be justified?,"The objective of this study was to examine the construct validity of PTSD in a sample of refugee children from the Middle East – more specifically, to assess whether associations between traumatic events and specific PTSD symptoms were more outspoken than (1) the associations of PTSD symptoms with non-traumatic exposures, and (2) the associations of violent exposures with symptoms other than PTSD-symptoms. Parents of 311 refugee children from the Middle East were interviewed concerning their children's traumatic experiences and mental health symptoms. The specific PTSD symptoms did not cluster in a factor analysis. The PTSD symptom complex was significantly predicted not only by violent exposures (mother tortured, OR 8.2, p < 0.005; father disappeared OR 3.2, p < 0.05) but also by indicators of family interaction and parents' occupational situation. The two identified violent exposures had significant independent associations with a series of symptoms including symptoms other than those of PTSD (rs ranging from 0.25 to 0.44, p < 0.001). Thus it does not seem sufficient to focus solely on PTSD symptomatology when assessing the mental health needs of refugee children. Copyright © 2006 John Wiley & Sons, Ltd.",0,0 +5398,Factor Structure of the PTSD Checklist in a Sample of OEF/OIF Veterans Presenting to Primary Care: Specific and Nonspecific Aspects of Dysphoria,"Although DSM-IV-TR diagnostic criteria for posttraumatic stress disorder (PTSD) include three primary symptom clusters, recent evidence from confirmatory factor analyses suggest that the latent structure of PTSD is better represented by four factors, which will likely be reflected in the upcoming DSM-5. Given this likely transition from three to four clusters, the present study sought to examine specific and non-specific aspects of dysphoria in the factor structure of PTSD symptoms in a sample of OEF/OIF combat veterans presenting to a Veterans Affairs primary care clinic. PTSD symptoms were assessed using the PCL-M (Weathers et al. 1993). Results from confirmatory factor analyses suggested that a dysphoria factor involving a number of non-specific distress symptoms may be an important part of the PTSD symptom profile. After controlling for variance due to general psychological distress, we further found that factor loadings on the dysphoria factor were attenuated but continued to significantly load onto the factor, suggesting that dysphoria may be a specific part of the PTSD symptom constellation.",0,0 +5399,Consistent impaired verbal memory in PTSD: A meta-analysis,"Qualitative review papers have indicated that verbal memory impairment is found to be the most consistent cognitive impairment related to PTSD. These review papers have used qualitative methods to describe the effects, and consequently they have not been able to estimate the strength of the memory-PTSD association. This meta-analysis of 28 studies examined the empirical evidence for this relationship, and factors affecting the results. Overall, the results showed medium effect sizes in patients with PTSD compared to controls on verbal memory across studies. Marked impairment was found in the patient groups compared to healthy controls, while modest impairment was found compared to exposed non-PTSD controls. Meta-analyses found strongest effects in war veterans compared to sexual and physical assault related PTSD. Rather unexpectedly no effect was found for the sexually abused PTSD groups compared to exposed controls. The analyses further showed that the effect was dependent on the test procedures used. The studies using WMS and AVLT had stronger effects than studies using CVLT. Insufficient data were available to analyze a more complete attention–memory profile. This meta-analysis confirms that verbal memory impairment is present in adults with PTSD, and they are consistent across studies. This impairment should be the focus of work in clinical settings.",0,0 +5400,Acute Stress Disorder as a Predictor of Post-Traumatic Stress Disorder in Physical Assault Victims,"The authors’objective was to examine the ability of acute stress disorder (ASD) and other trauma-related factors in a group of physical assault victims in predicting post-traumatic stress disorder (PTSD) 6 months later. Subjects included 214 victims of violence who completed a questionnaire 1 to 2 weeks after the assault, with 128 participating in the follow-up. Measures included the Harvard Trauma Questionnaire, the Trauma Symptom Checklist, and the Crisis Support Scale. Twenty-two percent met the full PTSD diagnosis and 22% a subclinical PTSD diagnosis. Previous lifetime shock due to a traumatic event happening to someone close, threats during the assault, and dissociation explained 56% of PTSD variance. Inability to express feelings, hypervigilance, impairment, and hopelessness explained another 15% of PTSD variance. The dissociative, the reexperiencing, the avoidant, and the arousal criteria of the ASD diagnosis correctly classified 79% of the subsequent PTSD cases.",0,0 +5401,Individual and Group Factors that Affect Resilience and Mediate the Relationship between Resilience and the Development of Posttraumatic Stress Disorder in ICU Nurses,"The purpose of this research was to determine the significant individual and group characteristics that affected resilience in intensive care unit (ICU) nurses and whether those significant characteristics had a direct or indirect effect on the development of posttraumatic stress disorder (PTSD) mediated through resilience. An adaptation of the Nurse as Wounded Healer (N-WH) theory was also tested, which added resilience as a concept to facilitate self-healing, transformation and transcendence of trauma experienced in the ICU. This was a secondary database analysis that included 744 ICU nurses from around the United States. Participants were mailed a self-report survey that included demographic, anxiety, depression, PTSD and resilience measures. The factors that significantly affected resilience included: whether the ICU nurse had children, the number of years practicing, type of nursing degree, generational cohort affiliation, and type of unit the nurse was working in. Structural equation modeling (SEM) in MplusTM was used to model the direct and indirect effects of the significant variables on the development of PTSD mediated through resilience. Children and years practicing as an ICU nurse had direct effects on the development of PTSD. When compared with the medical ICU (MICU), the cardiac ICU, cardiothoracic surgery ICU and other ICUs had significant indirect effects on the development of PTSD mediated through the Personal Competence sub-scale of resilience. ICU nurses with a graduate degree had a significant indirect effect on the development of PTSD mediated through the Leadership sub-scale of resilience, when compared to ICU nurses with a bachelor degree of science in nursing (BSN). The results supported the adapted version of the NWH theory. Based on the findings of this research, having children, years practicing, type of nursing degree and ICU unit type had significant direct or indirect effects on the development of PTSD mediated through the Personal Competence and Leadership subscales of resilience. Future research is needed to describe the potentially unique characteristics of each unit type and to identify modifiable individual and organizational factors to help inform tailored resilience interventions in the ICU. (PsycINFO Database Record (c) 2015 APA, all rights reserved)",0,0 +5402,The relationship between response inhibition and posttraumatic stress symptom clusters in adolescent earthquake survivors: An event-related potential study,"Posttraumatic stress disorder (PTSD) patients experience impaired response inhibition. Little is known about the relationship between response inhibition abnormalities and distinct PTSD symptom clusters. This study investigated the relationship between response inhibition processing and a five-factor model of posttraumatic stress symptomatology in adolescents. The event-related potentials of 54 unmedicated adolescent earthquake survivors (age 15-18 years) were recorded as they completed a Go/NoGo task. The PTSD Checklist-Specific Stressor Version (PCL-S) was used to assess PTSD symptoms. Regression analyses were conducted to examine the associations between the five symptom-cluster model and response inhibition processing. The results revealed that the avoidance symptom cluster score, but not the numbing or other clusters' scores, was positively associated with NoGo-P3 latency. These results suggest that a specific PTSD symptom cluster--avoidance--has a distinct association with the slowed speed of the late step of response inhibition processing, i.e., decision or success of response inhibition in adolescent earthquake survivors.",0,0 +5403,DAILY CHARTING OF POSTTRAUMATIC STRESS SYMPTOMS: A PILOT STUDY,"This pilot study describes a prospective life-charting method for posttraumatic stress (PTS) symptoms. This method summarizes daily symptoms, functional impairment, life events, substance use, and treatment. Findings include experience with 17 cases over periods lasting from 3 to 25 months, with a description of 4 case examples that are characteristic of the pilot sample. People with posttraumatic stress disorder (PTSD) can complete day charting of their symptoms over an extended period of time. Some people reported that day charting distressed them mildly as they analyzed daily thoughts or feelings that they ordinarily avoided or pushed from awareness. Nonetheless, most people reported that they learned and benefited from daily symptom charting. In addition to enhancing patient self-understanding (or ""insight""), the method may prove useful in assessing treatments for PTSD. Finally, these preliminary findings have suggested hypotheses regarding the clinical phenomenology and course of PTSD. For example, PTS symptom cluster exacerbation, severity, and duration appear to be highly consistent within any given patient, but highly variable across patients. Daily charting of PTS symptoms over prolonged periods is feasible. This prospective PTSD symptom charting method may have therapeutic, clinical, and research potential for understanding individual and group patterns in PTSD over time.",0,0 +5404,Post-traumatic stress disorder in young people with intellectual disability,"Post-traumatic stress disorder (PTSD) is common and treatable. There is extensive research on people of average intelligence yet little on individuals with developmental disabilities.We report two people with intellectual disability (ID) who experienced PTSD. The relevance of their developmental difficulties, social and communication profiles, attentional skills, and causes of these, to their presentations is discussed.Both individuals have fragile X syndrome and severe ID. One has Diagnostic and Statistical Manual - 4th Edition (DSM-IV) autistic disorder; the other DSM-IV attention deficit-hyperactivity disorder. They experienced developmental and psychological regressions, new challenging behaviours and exacerbations of existing ones coincident with emotional trauma. PTSD symptoms and phenomena were identifiable despite intellectual and communicatory impairments.Presentation of PTSD is influenced by degree and cause of ID, social circumstances, social and communicatory skills, nature and timing of traumatic experience and subsequent management. The paucity of literature suggests it is missed frequently in individuals with ID who risk having problems misattributed to other causes with potential for inappropriate interventions.",0,0 +5405,Predictors of Psychosocial Adaptation Among People With Spinal Cord Injury or Disorder,"To examine the influence of disability-related medical and psychologic variables on psychosocial adaptation to spinal cord injury or disorder (SCI/D).A structural equation modeling design linking 3 sets of predictive variables to an outcome measure of adaptation.Two outpatient SCI clinics (1 veteran, 1 civilian) in Texas.Veterans (n=181) and civilians (n=132) with SCI/D.Not applicable.The adaptation outcome was measured by 2 subscales (acknowledgment, adjustment) of the Reactions to Impairment and Disability Inventory (RIDI) and by the Quality of Life Scale. The predictive variables were measured by a demographic questionnaire, 3 subscales (intrusion, re-experiencing, hyperarousal) of the Purdue Posttraumatic Stress Disorder-Revised scale, the McMordie-Templer Death Anxiety Scale, and 3 subscales (anxiety, depression, denial) of the RIDI.Goodness-of-fit indices suggested that a revised model of adaptation was a moderately good fit to the data. The revised model of adaptation indicated that there were medium total effects (direct plus indirect) on psychosocial adaptation by 2 latent variables (disability severity and impact, negative affectivity) and small total effects on psychosocial adaptation by disengagement coping. The latent factor of disengagement coping had the strongest direct effect on adaptation (although not statistically significant). Disability severity and impact had medium indirect effects and negative affectivity had small indirect effects on psychosocial adaptation. All of the aforementioned effects had a negative coefficient.Negative emotional responses (eg, depression, anxiety) to SCI/D, disengagement-type coping (eg, disability denial, avoidance), and the severity and impact of disability were related to lower levels of adaptation to SCI/D.",0,0 +5406,Posttraumatic stress disorder in an urban population of young adults: risk factors for chronicity,"Despite progress in epidemiologic research on posttraumatic stress disorder (PTSD), little is known about factors that distinguish chronic from nonchronic PTSD. In a previous report, the authors identified a set of personal predispositions associated with PTSD following traumatic events in a general population sample of young adults. The purpose of this analysis was to identify characteristics of chronic PTSD and examine whether any of the suspected risk factors for PTSD was associated specifically with chronic PTSD.A random sample of 1,007 21- to 30-year-old members of a large health maintenance organization in the Detroit area was interviewed, using the National Institute of Mental Health Diagnostic Interview Schedule (DIS), revised for DSM-III-R. The analysis was performed on data from 394 respondents who reported traumatic events, of whom 93 met criteria for PTSD. Chronic PTSD was defined as duration of symptoms for 1 year or more.Persons with chronic PTSD (N = 53) had, on the average, a significantly higher total number of PTSD symptoms and higher rates of overreactivity to stimuli that symbolized the stressor and interpersonal numbing than persons with nonchronic PTSD. The rates of one or more additional anxiety or affective disorders and a variety of medical conditions were higher in persons with chronic than nonchronic PTSD. Family history of antisocial behavior and female sex were associated specifically with chronic PTSD.The findings suggest that chronic PTSD may be associated with specific risk factors and clinical features. Longitudinal data on the course of PTSD are needed to determine whether the distinct features and the medical and psychiatric histories of persons with chronic PTSD are complications attendant on a chronic course or coexisting disturbances that inhibit recovery.",0,0 +5407,[Post-traumatic stress disorder (PTSD): the syndrome with multiple faces].,"We choose to discuss from the PTSD's point of view because this diagnostic reference is commonly used. We wish outline its restrictive sight which could prevent the professional from having a diagnosis of PTSD. We don't want to say there is a PTSD everywhere but it appears to us that a traumatic reading can be a precious advantage for the clinician to establish a real therapeutic relation with some patients. Post-traumatic syndrome differs from the majority of other diagnostic categories as it includes in its criteria the presumptive cause of the trauma (criterion A). In the case that this syndrome originates in war experiences, the presumed cause presents itself as an exceptional event overcoming the individual's resources. The notion of war traumatisation has been extended to other events such as catastrophes, physical attacks, rapes, child and wife battering, and sexual abuses. But the events which cause PTSD (Post-Traumatic Stress Disorder) are significantly more numerous. It can be seen that medical events such as giving birth, miscarriage, heart attack, cancer, or hospitalisation following resuscitation may give rise to PTSD. Further, people experiencing prolonged periods of distress may equally develop a post-traumatic syndrome without any particular event having occurred to surpass their defences. It's the case of the Prolonged Duress Stress Disorder (PDSD). The series of discontinuous stress ""waste"" the psychic balance and may give rise, at one moment, to posttraumatic symptoms described in DSM, without any specific stressful event. The existence of criterion A is therefore not a necessary prerequisite in establishing a diagnosis of PTSD. It is, in fact, very difficult to predict which events could cause a PTSD, and this, especially, as the subjective aspects count at least as much as the objective aspects. The clinician should have to carefully explore how the patient experienced the event or, how he apprehended the event itself and it's outcome, if he wants get the traumatic range of a life event. The feeling of deep distress, the feeling of being trapped, the loss of control, the collapse of basic beliefs, the feeling that one's life is in jeopardy, that the physical integrity is (really or in one's imagination) threatened, the feeling of helplessness, are quite as much clues for a possible PTSD which hides behind others clinical manifestations either psychological or somatic. Furthermore, the ""pure"" form described in the DSM and grouping together three further criteria (reliving events, avoiding stimuli associated with the trauma, hyper-reactivity) is extremely rare in the chronic form. An untreated post-traumatic syndrome evolves with time and may present, initially, with very different pathological symptoms giving rise to equally varied diagnoses. Different etiopathogenic models propose to account for the PTSD 's heterogeneous appearance and instability with time. The comorbidity concept sees the PTSD as an independent entity other independent pathologies coexist with. The typologic concept suggests that the PTSD is an independent entity which shows different clinical appearances based on symptomatic descriptions. The ""cascade"" concept suggests to see the PTSD as an independent entity which offers, with time, different symptomatic appearances, in evolution, because of events caused by after effects, in different areas of the PTSD itself. All of these concepts outline the transnosologic appearance of the PTSD which makes it hardly recognizable. The ""chronic"" syndrome is rarely diagnosed forming a real challenge to prevention. In effect, the present authors insist on the crucial nature of early detection of PTSD since the greater the time elapsed the more difficult it becomes due to the evolutionary aspect of the syndrome, which initially has more readily recognizable symptoms. The consequences of an unrecognised PTSD are serious and affect both the individual and his immediate family and friends, contributing further to the aggravation of the problems. When a PTSD is diagnosed, it can allow the clinician to further a more global care which will help the patient to get a better recovery. With patients who suffered an infarct, the treatment of PTSD which prevents their recovery will help to go back to the way they lived before the event. It has been showed how important could be the PTSD detection on the severe burned people's pain control. Thus it seems to be crucial for the clinician to keep this diagnosis in mind alongside any other.",0,0 +5408,The Role of Endogenous Opioids in the Placebo Effect in Post-Traumatic Stress Disorder,"The concept of the placebo effect has received a considerable attention over the past several decades. The placebo effect has been observed in different psychiatric disorders, including post-traumatic stress disorder (PTSD), a chronic and severe disorder precipitated by exposure to a psychologically distressing event. The placebo response rates in patients with PTSD range from 19% to 62%. A considerable number of research publications suggest that endogenous opioids are involved in the mechanisms of the placebo effect. Endogenous opioid peptides play an important role in stress response and in the pathophysiology of PTSD. Therefore, endogenous opioids may be involved in the neurobiology of the placebo effect in PTSD. Possibly, the endogenous opioid system mediates the effect of placebo on all 3 PTSD symptom clusters (re-experiencing symptoms, avoidance and numbing, and physiologic arousal). The placebo effect-related activation of the endogenous opioid system may result in an improvement in intrusive symptomatology and symptoms of increased arousal because the administration of exogenous opioids improve these symptoms. The placebo effect-related activation of the endogenous opioid system may have a mood-enhancing effect, and, consequently, diminish avoidance and numbing. Multiple neurotransmitter and neuroendocrine pathways may be involved in the mechanisms of the placebo effect in PTSD. Further studies of the neurobiology of the placebo effect on patients with PTSD and other psychiatric disorders may produce interesting and important results.",0,0 +5409,Latent Structure of the Mississippi Scale for Combat-Related Post-Traumatic Stress Disorder: Exploratory and Higher-Order Confirmatory Factor Analyses,"A series of factor analyses evaluated the dimensionality of the Mississippi Scale for Combat-Related Post-Traumatic Stress Disorder. Over 2,200 Vietnam theater and era veterans were divided into three random subsamples, each of which was used in a separate stage of analysis. Initial exploratory factor analyses suggested an underlying single-factor solution. In the second subsample, a second-order solution comprised of a general factor subsuming several first-order factors was supported using chi-square difference testing. This model was successfully replicated with the third subsample. Cumulative evidence suggests that the latent structure of the Mississippi Scale is best represented as an umbrella Post-Traumatic Stress Disorder (PTSD) factor leading to four subsidiary facets or dimensions.",0,0 +5410,The effect of intranasal oxytocin treatment on conditioned fear extinction and recall in a healthy human sample,"To improve outcomes for patients undergoing extinction-based therapies (e.g., exposure therapy) for anxiety disorders such as post-traumatic stress disorder (PTSD), there has been interest in identifying pharmaceutical compounds that might facilitate fear extinction learning and recall. Oxytocin (OT) is a mammalian neuropeptide that modulates activation of fear extinction-based neural circuits and fear responses. Little is known, however, about the effects of OT treatment on conditioned fear responding and extinction in humans.The purpose of the present study was to assess the effects of OT in a fear-potentiated startle task of fear conditioning and extinction.A double-blind, placebo-controlled study of 44 healthy human participants was conducted. Participants underwent a conditioned fear acquisition procedure, after which they were randomized to treatment group and delivered OT (24 IU) or placebo via intranasal (IN) spray. Forty-five minutes after treatment, participants underwent extinction training. Twenty-four hours later, subjects were tested for extinction recall.Relative to placebo, the OT group showed increased fear-potentiated startle responding during the earliest stage of extinction training relative to placebo; however, all treatment groups showed the same level of reduced responding by the end of extinction training. Twenty-four hours later, the OT group showed significantly higher recall of extinction relative to placebo.The current study provides preliminary evidence that OT may facilitate fear extinction recall in humans. These results support further study of OT as a potential adjunctive treatment for extinction-based therapies in fear-related disorders.",0,0 +5411,Factor mixture model of anxiety sensitivity and anxiety psychopathology vulnerability,"The purpose of the present study was to shed light on the latent structure and nature of individual differences in anxiety sensitivity (AS) and related risk for psychopathology.The present study evaluated the latent structure of AS using factor mixture modeling (FMM; Lubke and Muthén, 2005) and tested the relations between the observed FMM-based model of AS and psychopathology in a large, diverse adult clinical research sample (N=481; 57.6% women; M(SD)(age)=36.6(15.0) years).Findings showed that a two-class three-factor partially invariant model of AS demonstrated significantly better fit than a one-class dimensional model and more complex multi-class models. As predicted, risk conferred by AS taxonicity was specific to anxiety psychopathology, and not to other forms of psychopathology.The sample was not epidemiologic, self-report and psychiatric interview data were used to index AS and psychopathology, and a cross-sectional design limited inference regarding the directionality of observed relations between AS and anxiety psychopathology.Findings are discussed with respect to the nature of AS and related anxiety psychopathology vulnerability specifically, as well as the implications of factor mixture modeling for advancing taxonomy of vulnerability and psychopathology more broadly.",0,0 +5412,A Longitudinal Comparison of Posttraumatic Stress Disorder and Depression Among Military Service Components,"The purpose of this study was to longitudinally investigate PTSD and depression between Reserve, National Guard, and active duty continuously and dichotomously. The study consisted of Millennium Cohort Study participants and used self-reported symptoms. Repeated measures modeling assessed PTSD and depression continuously and dichotomously over time. A subanalysis among only recently deployed personnel was conducted. Of the 52,653 participants for the PTSD analysis, the adjusted PCL-C means were 34.6 for Reservists, 34.4 for National Guardsmen, and 34.7 for active duty members, respectively. Of the 53,073 participants for depression analysis, the adjusted PHQ-9 means were 6.8, 6.7, and 7.2, respectively. In dichotomous models, Reservists and National Guardsmen did not have a higher risk of PTSD or depression compared with active duty members. Among deployers, Reservists and National Guardsmen had higher odds (odds ratio = 1.16, 95% confidence limit [CL] [1.01, 1.34] and OR = 1.19, 95% CL [1.04, 1.36], resp...",0,0 +5413,Prevalence of Mental Health Problems and Functional Impairment Among Active Component and National Guard Soldiers 3 and 12 Months Following Combat in Iraq,"A growing body of literature has demonstrated the association of combat in Iraq and Afghanistan with postdeployment mental health problems, particularly posttraumatic stress disorder (PTSD) and depression. However, studies have shown varying prevalence rates of these disorders based on different case definitions and have not assessed functional impairment, alcohol misuse, or aggressive behavior as comorbid factors occurring with PTSD and depression.To (1) examine the prevalence rates of depression and PTSD using several case definitions including functional impairment, (2) determine the comorbidity of alcohol misuse or aggressive behaviors with depression or PTSD, and (3) compare rates between Active Component and National Guard soldiers at the 3- and 12-month time points following their deployment to Iraq.Population-based, cross-sectional study.United States Army posts and National Guard armories.A total of 18 305 US Army soldiers from 4 Active Component and 2 National Guard infantry brigade combat teams.Between 2004 and 2007, anonymous mental health surveys were collected at 3 and 12 months following deployment.Current PTSD, depression, functional impairment, alcohol misuse, and aggressive behavior.Prevalence rates for PTSD or depression with serious functional impairment ranged between 8.5% and 14.0%, with some impairment between 23.2% and 31.1%. Alcohol misuse or aggressive behavior comorbidity was present in approximately half of the cases. Rates remained stable for the Active Component soldiers but increased across all case definitions from the 3- to 12-month time point for National Guard soldiers.The prevalence rates of PTSD and depression after returning from combat ranged from 9% to 31% depending on the level of functional impairment reported. The high comorbidity with alcohol misuse and aggression highlights the need for comprehensive postdeployment screening. Persistent or increased prevalence rates at 12 months compared with 3 months postdeployment illustrate the persistent effects of war zone service and provide important data to guide postdeployment care.",0,0 +5414,Opioid Receptor Antagonists in Psychiatry,"Naltrexone has proved useful in a variety of psychopathological states, Mainly it has been used in long term therapy of heroin addicts. More recently it has been addressed to the treatment of alcoholics, Anecdoctical observations and research data suggest its use also in the field of Mental Illnesses (Eating disorders, Gilles de la Tourette syndrome and Obsessive Compulsive Disorder, Schizophrenia, Self Injuring Behaviours, Autism, Tricotillomania, Post-traumatic stress disorder). In this paper we will briefly discuss the use of opioid antagonists in drug addicts and then we will review the evidence for future development for other psychiatric illnesses. Examined data suggest that opioid antagonists be effective on symptomathologic clusters common to different clinical entities.",0,0 +5415,Patterns of Posttraumatic Stress Symptoms in Parents of Childhood Cancer Survivors.,"Posttraumatic stress (PTS) symptoms have been reported in mothers and fathers of childhood cancer survivors; however, little is known about patterns of PTS in these families. Cluster analysis was applied to the Posttraumatic Stress Disorder (PTSD) Reaction Index scores of 98 couples parenting adolescent childhood cancer survivors to describe patterns of PTS in families, yielding the following 5 clusters: Minimal PTS, Mothers Elevated, Disengaged, Fathers Elevated, and Elevated PTS. The clusters were validated using data from a structured psychiatric interview, an additional self-report measure of PTS, and an index of family functioning. These clinically meaningful patterns reveal that a majority of families had at least one parent with moderate to severe PTS, which supports development of family-based interventions for this population.",0,0 +5416,Predicting time to emergency department return for anxiety disorders and acute stress reactions in children and adolescents: a cohort study,"Purpose: While studies indicate that few children with anxiety disorders receive specialized mental health care, significant knowledge gaps exist for the mental health care trajectory outside of specialized care. We examined whether physician-based care after an emergency department (ED) visit for mental health care predicted time to ED return. Methods: We conducted a retrospective cohort study using administrative data from Alberta, Canada. Included in the cohort were 8075 children <18 years discharged from an ED (104 EDs in total), April 2002–September 2010, following a visit for an anxiety disorder or acute stress reaction. We used a multivariable Cox proportional hazards model to estimate time to ED return for mental health care (censored at 90 days). The variables of interest were: number and type of physician visits 30 days after index visit. We adjusted for sociodemographics, clinical acuity, comorbidity, and recent history of ED mental health care in the model. Results: Within 30 days of ED discharge, multiple physician follow-up visits were associated with shorter return time (adjusted HR 1.24, 95 % CI 1.08–1.43). A single physician follow-up visit was associated with longer return time (adjusted HR 0.68, 95 % CI 0.58–0.79). Physician follow-up visits for mental health care were associated with shorter return time (adjusted HR 2.5, 95 % CI 2.21–2.83). Conclusions: Following an index visit, ED return by children with anxiety disorders or acute stress reactions is associated with specific characteristics of subsequent physician visits. Improving physician use of evidence-based treatment and family access to coordinated services may reduce costly hospital-based care. © 2015, Springer-Verlag Berlin Heidelberg.",0,0 +5417,Typologies of posttraumatic stress disorder in treatment-seeking older adults,"ABSTRACT Background: While it is well known that posttraumatic stress disorder (PTSD) is characterized by heterogeneous symptom clusters, little is known about predominant typologies of PTSD symptoms in older adults. Methods: Latent profile analyses (LPAs) were employed to evaluate predominant typologies of PTSD symptoms in a sample of 164 treatment-seeking older adults with childhood war-related trauma. Multinomial logistic regressions were conducted to evaluate predictors of class membership. Results: LPAs revealed that a 3-class solution best fit the data. These included an Intermediate Disturbance class (50.0%) and two Pervasive Disturbance classes, which differed with respect to severity of avoidance symptoms (Pervasive Disturbance-Low Avoidance: 33.5%, Pervasive Disturbance-High Avoidance: 16.5%). A greater number of traumatic events predicted membership in the Pervasive Disturbance classes. The Pervasive Disturbance-Low Avoidance class had a higher level of education than the Pervasive Disturbance-High Avoidance class. Compared to the Intermediate Disturbance class, the Pervasive Disturbance classes had the highest levels of depression, anxiety and somatization symptoms. Conclusion: These results suggest that PTSD in treatment-seeking older adults may be characterized by three predominant typologies, which are differentiated by overall severity and avoidance symptoms, lifetime trauma burden, education level, and comorbid depression, anxiety, and somatization symptoms. These results underscore the importance of considering heterogeneity in the phenotypic presentation of PTSD in assessment and treatment approaches for this disorder in older adults.",0,0 +5418,"A preliminary examination of the relationships between posttraumatic stress symptoms and crack/cocaine, heroin, and alcohol dependence","High rates of co-occurrence between posttraumatic stress (PTS) and substance use disorders (SUDs) have led to the suggestion that substance use among individuals experiencing PTS symptoms might serve a self-medication function. However, research is still needed to provide a more comprehensive evaluation of the unique associations between PTS symptom clusters and substances (licit and illicit) with both anxiolytic/depressant and stimulant properties. Consequently, this study examined the relationship between severity of different PTS symptom clusters and heroin, crack/cocaine, and alcohol dependence among 48 treatment-seeking SUD patients with a history of traumatic exposure. No evidence was found for a relationship between PTS symptom clusters and crack/cocaine or alcohol dependence; however, results suggested a relationship between hyperarousal and avoidance (inversely related) symptoms and heroin dependence. Results are discussed in terms of their implications for understanding motivations underlying the substance of choice among individuals with PTS symptoms, as well as the development of treatments for co-occurring PTS and SUDs.",0,0 +5419,Low-Dose Risperidone as Adjunctive Therapy for Irritable Aggression in Posttraumatic Stress Disorder,"Increased aggressive behavior can occur in association with posttraumatic stress disorder (PTSD). This study tested the hypothesis that low-dose risperidone reduces aggression and other PTSD-related symptoms in combat veterans. Subjects were male combat veterans with PTSD who scored 20 or higher on cluster D (hyperarousal) of the Patient Checklist for PTSD-Military Version (PCL-M). Subjects were randomly assigned to either risperidone or placebo treatment groups. Drugs were administered over a 6-week treatment period in a double-blind manner. Subjects received either risperidone (0.5 mg/day; n = 7) or matched placebo (n = 8) tablets during the first 2 weeks of the treatment period. The dose of risperidone could then be increased up to 2.0 mg/day on the basis of response. Prerandomization psychotropic regimens were continued. Subjects were evaluated with the PCL-M and the Overt Aggression Scale-Modified for Outpatients (OAS-M). In comparison with placebo treatment, reductions in scores between baseline and the last week of treatment were significantly greater for OAS-M irritability and PCL-M cluster B (intrusive thoughts) subscales and on the PCL-M total scale. These results suggest that low-dose risperidone administration reduces irritability and intrusive thoughts in combat-related PTSD.",0,0 +5420,Psychological consequences of war trauma and postwar social stressors in women in Bosnia and Herzegovina.,"To assess the consequences of psychotrauma in civilian women in Herzegovina who were exposed to prolonged and repetitive traumatic war events and postwar social stressors.The study included a cluster sample of 367 adult women, divided into two groups. One group (n=187) comprised women from West Mostar who were exposed to serious war and posttraumatic war events. The other group (n=180) comprised women from urban areas in Western Herzegovina who were not directly exposed to war destruction and material losses, but experienced war indirectly, through military drafting of their family members and friends. Demographic data on the women were collected by a questionnaire created for the purpose of this study. Data on trauma exposure and posttraumatic stress disorder (PTSD) symptoms were collected by Harvard Trauma Questionnaire (HTQ)--Bosnia-Herzegovina version. General psychological symptoms were determined with Symptom Check List-90-revised (SCL-90-R). Data on postwar stressors were collected by a separate questionnaire.In comparison with the control group, women from Western Mostar experienced significantly more traumatic events (mean+/-standard deviation [SD], 3.3+/-3.2 vs 10.1+/-4.9, respectively, t=15.91; P<0.001) and had more posttraumatic symptoms (12.3+/-10.3 vs 21.2+/-10.9, respectively, t=8.42; P<0.001). They also had significantly higher prevalence of PTSD (4.4% vs 28.3%, respectively; chi(2)=52.56; P<0.001). The number of traumatic events experienced during the war was positively associated with postwar stressful events both in the West Mostar group (r=0.223; P=0.002) and control group (r=0.276; P<0.001). Postwar stressful events contributed both to the number and intensity of PTSD symptoms and all general psychological symptoms measured with SCL-90 questionnaire, independently from the number of experienced traumatic war events.Long-term exposure to war and postwar stressors caused serious psychological consequences in civilian women, with PTSD being only one of the disorders in the wide spectrum of posttraumatic reactions. Postwar stressors did not influence the prevalence of PTSD but they did contribute to the intensity and number of posttraumatic symptoms.",0,0 +5421,Post-traumatic stress disorder symptom clusters predicting substance abuse in adolescents,"The majority of studies exploring the mental health disorders, post-traumatic stress disorder (PTSD) and substance use disorders (substance abuse (SA) and dependence), have shown high co-morbidity rates in adolescents, indicating a well-established relationship. However, only a few studies have attempted to examine the functional mechanisms believed to underlie this common form of co-morbidity, and no studies have been carried out in adolescent samples. Knowledge is thus lacking on how specific PTSD symptom clusters may account for the development of specific types of problematic substance use in adolescents. Therefore, we studied this issue in relation to alcohol abuse (AA) and drug abuse (DA) in a probability sample of Danish 15–18-year-olds (n = 1988) in the form of an online survey using self-report questionnaires following the Diagnostic and statistical manual of mental disorders, fourth edition [DSM-IV; APA. (1994). Washington, DC: Author]. After demographic and substance-related variables were cont...",0,0 +5422,Characteristics of Heart Rate Variability in War Veterans with Post-Traumatic Stress Disorder after Myocardial Infarction,"The goal of the study was to evaluate differences in heart rate variability (HRV) among post-myocardial infarction (MI) patients, depending on their participation in the Croatian war and on established diagnoses of post-traumatic stress disorder (PTSD).The study included 34 male war veterans with diagnosed PTSD who had suffered a first MI and 34 age-matched post-MI patients without PTSD. Cardiac autonomic balance was evaluated through HRV analysis.There were no differences in the mean R-R interval or overall HRV between the analyzed groups. Post-MI patients with PTSD had lower values for the square root of the mean of squared successive differences in R-R intervals (p = 0.02), the percentage of R-R intervals that were > or =50 milliseconds different from the previous interval (p = 0.03), and the high-frequency component (p = 0.03) but had higher values for the low-frequency component (p = 0.01) and the low-frequency/high-frequency ratio (p = 0.02), compared with post-MI patients without PTSD.Post-MI patients with PTSD have higher sympathetic and lower parasympathetic heart rate modulation activity, compared with patients with MI and no PTSD.",0,0 +5423,Measurement Invariance of the Brief Symptom Inventory in Survivors of Torture and Trauma,"The United States accepts more refugees than any other industrialized nation. As refugee populations grow, mental health professionals must implement culturally and ethnically appropriate strategies to assess and treat individuals from diverse backgrounds. Culture can exert a powerful and often misunderstood influence on psychological assessment, and few structured measures have been demonstrated to have adequate cross-cultural validity for use with diverse and vulnerable populations such as survivors of torture. This study examined the factor structure and equivalency of underlying construct(s) of psychological distress as measured by the Brief Symptom Inventory (BSI) in three samples who had survived torture and other severe trauma from Tibet, West Africa and the Punjab region of India. Confirmatory factor analyses provided support for configural invariance of a two-factor model across the three samples, suggesting that the two latent factors of Complex Dysphoria and Somatic Distress were present in each subgroup. The data provide additional support for the strict invariance model in the West African–Tibetan dyad suggesting that scores are comparable across those two groups. Implications for research and treatment are discussed.",0,0 +5424,Daytime Prazosin Reduces Psychological Distress to Trauma Specific Cues in Civilian Trauma Posttraumatic Stress Disorder,"Persons with posttraumatic stress disorder (PTSD) whose trauma-related nightmares improve or resolve with bedtime administration of the alpha-1 adrenergic antagonist prazosin often continue to experience PTSD symptoms during the day. This study addressed whether daytime prazosin compared to placebo would alleviate psychological distress provoked experimentally by a trauma-related word list included in the emotional Stroop (E-Stroop) paradigm.Eleven persons with civilian trauma PTSD who continued to experience daytime PTSD symptoms despite a stable bedtime prazosin dose that suppressed trauma-related nightmares were studied. Prazosin and placebo were administered on two different occasions in the early afternoon followed two hours later by the E-Stroop. Effects of drug on psychological distress were assessed by the Profile of Mood States (POMS).POMS total score and an ""emotional distress"" POMS subscale score following trauma-related words were significantly lower in the prazosin than placebo condition. There were no treatment effects on E-Stroop completion time. In 10 subjects who continued open label daytime prazosin, there was a reduction in global PTSD illness severity at 2-week follow-up.Daytime prazosin pretreatment reduced psychological distress specifically to trauma cues. Adding daytime prazosin to bedtime prazosin may further reduce overall PTSD illness severity and distress.",0,0 +5425,A Qualitative Study of Mental Health Problems among Children Displaced by War in Northern Uganda,"While multiple studies have found that children affected by war are at increased risk for a range of mental health problems, little research has investigated how mental health problems are perceived locally. In this study we used a previously developed rapid ethnographic assessment method to explore local perceptions of mental health problems among children and adults from the Acholi ethnic group displaced by the war in northern Uganda. We conducted 45 free list interviews and 57 key informant interviews. The rapid assessment approach appears to have worked well for interviewing caretakers and children aged 10-17 years. We describe several locally defined syndromes: two tam/par/kumu (depression and dysthymia-like syndromes), ma lwor (a mixed anxiety and depression-like syndrome), and a category of conduct problems referred to as kwo maraco/gin lugero. The descriptions of these local syndromes were similar to western mood, anxiety and conduct disorders, but included culture-specific elements.",0,0 +5426,Post-traumatic stress disorder and traumatic brain injury,"Disentangling the effects of ""organic"" neurologic damage and psychological distress after a traumatic brain injury poses a significant challenge to researchers and clinicians. Establishing a link between traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) has been particularly contentious, reflecting difficulties in establishing a unique diagnosis for conditions with overlapping and sometimes contradictory symptom profiles. However, each disorder is linked to a variety of adverse health outcomes, underscoring the need to better understand how neurologic and psychiatric risk factors interact following trauma. Here, we present data showing that individuals with a TBI are more likely to develop PTSD, and that individuals with PTSD are more likely to develop persistent cognitive sequelae related to TBI. Further, we describe neurobiological models of PTSD, highlighting how patterns of neurologic damage typical in TBI may promote or protect against the development of PTSD in brain-injured populations. These data highlight the unique course of PTSD following a TBI and have important diagnostic, prognostic, and treatment implications for individuals with a dual diagnosis.",0,0 +5427,Treatment Improves Symptoms Shared by PTSD and Disordered Eating,"Eating disorders and posttraumatic stress disorder (PTSD) are debilitating conditions that frequently co-occur. Although the two disorders have different clinical presentations, they share associated features, including cognitive disturbances, emotion dysregulation, dissociation, and impulsivity. We hypothesized that reductions in PTSD symptoms following cognitive processing therapy (CPT) and its treatment components (CPT without the written account or the written account only) would be associated with improvements in symptoms common to PTSD and eating disorders. Participants in the current investigation included women with PTSD (N = 65) who reported a history of rape or physical assault, were in a randomized dismantling study of CPT, and completed the Eating Disorder Inventory-2 (EDI-2) at pre- and posttreatment. Latent growth modeling results indicated that decreases in PTSD symptom scores were significantly associated with reductions in the Impulse Regulation, Interoceptive Awareness, Interpersonal Distrust, Ineffectiveness, and Maturity Fears subscales of the EDI-2. Thus, PTSD treatment affected symptoms shared by PTSD and eating disorders. Currently, there are no clear guidelines for treatment of comorbid PTSD and eating disorders. Traditional CPT may impact symptoms common to both, but additional therapy may be needed for specific disordered eating attitudes and behaviors.",0,0 +5428,Predicting the development of posttraumatic stress disorder from the acute response to a traumatic event,"Posttraumatic stress disorder (PTSD) is a psychiatric condition that is directly precipitated by an event that threatens a person's life or physical integrity and that invokes a response of fear, helplessness, or horror. In recent years it has become clear that only a proportion of those exposed to fear-producing events develop or sustain PTSD. Thus, it seems that an important challenge is to elucidate aberrations in the normal fear response that might precipitate trauma-related psychiatric disorder. This paper summarizes the findings from recent studies that examined the acute and longer term biological response to traumatic stress in people appearing to the emergency room immediately following trauma exposure. In the aggregate, these studies have demonstrated increased heart rate and lower cortisol levels at the time of the traumatic event in those who have PTSD at a follow-up time compared to those who do not. In contrast, certain features associated with PTSD, such as intrusive symptoms and exaggerated startle responses, are only manifest weeks after the trauma. The findings suggest that the development of PTSD may be facilitated by an atypical biological response in the immediate aftermath of a traumatic event, which in turn leads to a maladaptive psychological state.",0,0 +5429,"Risk of trauma exposure and posttraumatic stress disorder: An examination of the separate and combined effects of race, gender, and social context","Posttraumatic Stress Disorder (PTSD) is a debilitating psychiatric disorder that affects approximately 7.7 million U.S. adults. A central criterion of a PTSD diagnosis is an exposure to an external traumatic stressor. Yet, surprisingly little research has focused on the role of the larger social context that shapes these exposures. Most PTSD research focuses on the separate effects of individual-level risk factors like gender and race, while the effects of macro-level factors like poverty are primarily used as control variables in regression models. Little is known about how the larger structural environment, and factors like racial residential and economic segregation impact PTSD risk, or whether examining the combined effects of risk factors like race, gender, and poverty might shift our understanding. The primary aims of this dissertation were two-fold: First, a stratified analysis was conducted to provide a fundamental understanding of race differences in trauma exposure/PTSD risk by examining within-group effects of gender, race, and poverty status, both alone and in combination, and testing for between-group differences in these effects. Second, discrete-time analysis and life-tables were used to examine the relationship between PTSD risk and incarceration, an exposure chosen to capture the effects of the U.S. macro-level social context due to its differential impact on the Black population. Study results showed the expected gender differences in PTSD risk. However, considerable variation in the pattern of risk was observed when the effects of race and gender were considered together, finding that African American females experienced greater disorder risk, and that non-Hispanic White males experienced greater risk when poverty status was considered. Prison exposure was found to be a significant predictor of lifetime PTSD, after accounting for the effects and timing of a comprehensive list of traumatic exposures. Race differences in the effect of incarceration exposure on PTSD risk were not found. These dissertation findings have implications for future PTSD research. Notably, these findings suggest that a better accounting of social contextual factors and the combined effects of sociodemographic and socioeconomic factors can improve our understanding of the disorder and those who are at most risk. (PsycINFO Database Record (c) 2015 APA, all rights reserved)",0,0 +5430,Compensation claim lodgement and health outcome developmental trajectories following whiplash injury: A prospective study,"This study aimed to identify distinctive trajectories for pain/disability and posttraumatic stress disorder (PTSD) symptoms following whiplash injury and to examine the effect of injury compensation claim lodgement on the trajectories. In a prospective study, 155 individuals with whiplash were assessed at <1month, 3, 6 and 12months post injury. Outcomes at each time point were Neck Disability Index (NDI) and the Posttraumatic Stress Diagnostic Scale (PDS). Group-based trajectory analytical techniques were used to identify outcome profiles. The analyses were then repeated after including third party compensation claim lodgment as a binary time-changing covariate. Three distinct NDI trajectories were determined: (1) Mild: mild or negligible pain/disability for the entire 12 months (45%), (2) Moderate: initial moderate pain/disability that decreased to mild levels by 3 months (39%) and (3) Chronic-severe: severe pain/disability persisting at moderate/severe levels for 12 months (16%). Three distinct PTSD trajectories were also identified: (1) Resilient: mild symptoms throughout (40%), (2) Recovering: initial moderate symptoms declining to mild levels by 3months (43%) and (3) Chronic moderate-severe: persistent moderate/severe symptoms throughout 12 months (17%). Claim submission had a detrimental effect on all trajectories (p<0.001) except for the Chronic-severe NDI trajectory (p=0.098). Following whiplash injury, there are distinct pathways of recovery for pain/ disability and PTSD symptoms. Management of whiplash should consider the detrimental association of compensation claim with psychological recovery and recovery of those with mild to moderate pain/disability levels. However, claim lodgement has no significant association with a more severe pain and disability trajectory.",1,0 +5431,Quality of life in Croatian Homeland war (1991-1995) veterans who suffer from post-traumatic stress disorder and chronic pain,"The aim of this study was to investigate the quality of life in Croatian homeland war veterans who suffer from post-traumatic stress disorder and chronic low back pain (LBP).A total of 369 participants were included, classified in four study groups: those with post-traumatic stress disorder (PTSD; N = 59), those with both PTSD and lower back pain (PTSD+LBP; N = 80), those with isolated LBP (N = 95) and controls (N = 135). WHOQOL-BREF survey was used in the estimation of quality of life. The data were analysed using statistical methods and hierarchical clustering.The results indicated a general pattern of lowering quality of life in participants with both psychological (PTSD) and physical (LBP) burden. The average overall quality of life was 2.82 ± 1.14 for the PTSD+LBP group, 3.29 ± 1.28 for the PTSD group, 4.04 ± 1.25 for the LBP group and 4.48 ± 0.80 for the controls (notably, all the pair-wise comparisons were significantly different at the level of P < 0.001, except for the pair LBP-controls, which was insignificant). This result indicated that quality of life was reduced for 9.9% in patients with LBP, 26.6% in patients with PTSD and 37.1% in PTSD+LBP, suggesting strong synergistic effect of PTSD and LBP. The analysis also identified several clusters of participants with different pattern of quality of life related outcomes, reflecting the complex nature of this indicator.The results of this study reiterate strong impact of PTSD on quality of life, which is additionally reduced if the patient also suffers from LBP. PTSD remains a substantial problem in Croatia, nearly two decades after the beginning of the 1991-1996 Homeland war.",0,0 +5432,Predictors of temporal patterns of psychiatric distress during 10 years following the nuclear accident at Three Mile Island,"The present study examines psychiatric symptom levels during a 10-year period in a community sample of mothers of young children. All were identified in the early aftermath of the 1979 Three Mile Island nuclear accident, and followed through the accident's 1989 anniversary. Cluster analysis was used to identify long-term distress profiles during the study period; women's temporal profiles were found to be either (a) stable and at low, clinically nonsignificant levels of distress across all measurement points or (b) at consistently elevated, clinically significant levels that varied with the timing of postaccident events such as the restart of the undamaged reactor and the 10th anniversary. Subsequent multivariate analyses indicated that preaccident characteristics, as well as parameters reflecting respondents' initial involvement with, and reactions to the accident, were important for distinguishing between women within the two temporal profile groups. Implications of the results for both policy formulation and continued research on significant environmental stressors is discussed.",0,0 +5433,Post-Traumatic Stress Disorder (PTSD) after Childbirth,"Background There has been discussion about the possible occurrence of post-traumatic stress disorder (PTSD) in mothers after difficult childbirth. Method Four cases with a symptom profile suggestive of PTSD commencing within 48 hours of childbirth are presented. Results The PTSD was in each case associated with the delivery. In each case, there was an associated depressive illness. All four had persistent disorders, and two had difficulties with mother/infant attachment. Conclusion As confirmed by other reports, the prevalence of PTSD associated with childbirth is a matter of concern.",0,0 +5434,Symptoms and Subjective Quality of Life in Post-Traumatic Stress Disorder: A Longitudinal Study,"Evidence suggests that post-traumatic stress disorder (PTSD) is associated with substantially reduced subjective quality of life (SQOL). This study aimed to explore whether and how changes in the levels of PTSD symptom clusters of intrusion, avoidance and hyperarousal are associated with changes in SQOL.Two samples with PTSD following the war in former Yugoslavia were studied, i.e. a representative sample of 530 people in five Balkan countries and a non-representative sample of 215 refugees in three Western European countries. They were assessed on average eight years after the war and re-interviewed one year later. PTSD symptoms were assessed on the Impact of Event Scale - Revised and SQOL on the Manchester Short Assessment of Quality of Life. Linear regression and a two-wave cross lagged panel analysis were used to explore the association between PTSD symptom clusters and SQOL.The findings in the two samples were consistent. Symptom reduction over time was associated with improved SQOL. In multivariable analyses adjusted for the influence of all three clusters, gender and time since war exposure, only changes in hyperarousal symptoms were significantly associated with changes in SQOL. The two-wave cross-lagged panel analysis suggested that the link between hyperarousal symptoms and SQOL is bidirectional.Low SQOL of patients with war-related PTSD is particularly associated with hyperarousal symptoms. The findings suggest a bidirectional influence: a reduction in hyperarousal symptoms may result in improved SQOL, and improvements in SQOL may lead to reduced hyperarousal symptoms.",0,0 +5435,Trauma Signature Analysis of the Great East Japan Disaster: Guidance for Psychological Consequences,"Abstract Objectives On March 11, 2011, Japan experienced the largest earthquake in its history. The undersea earthquake launched a tsunami that inundated much of Japan's eastern coastline and damaged nuclear power plants, precipitating multiple reactor meltdowns. We examined open-source disaster situation reports, news accounts, and disaster-monitoring websites to gather event-specific data to conduct a trauma signature analysis of the event. Methods The trauma signature analysis included a review of disaster situation reports; the construction of a hazard profile for the earthquake, tsunami, and radiation threats; enumeration of disaster stressors by disaster phase; identification of salient evidence-based psychological risk factors; summation of the trauma signature based on exposure to hazards, loss, and change; and review of the mental health and psychosocial support responses in relation to the analysis. Results Exposure to this triple-hazard event resulted in extensive damage, significant loss of life, and massive population displacement. Many citizens were exposed to multiple hazards. The extremity of these exposures was partially mitigated by Japan's timely, expert-coordinated, and unified activation of an evidence-based mental health response. Conclusions The eastern Japan disaster was notable for its unique constellation of compounding exposures. Examination of the trauma signature of this event provided insights and guidance regarding optimal mental health and psychosocial responses. Japan orchestrated a model response that reinforced community resilience. ( Disaster Med Public Health Preparedness . 2013;0:1-14)",0,0 +5436,DSM–5 posttraumatic stress disorder symptoms associated with suicide behaviors in veterans.,"A connection between suicidality and posttraumatic stress disorder (PTSD) has been consistently demonstrated; however, the underlying relationship between suicidality and PTSD remains unclear. The aim of this study was to examine patterns of DSM-5 PTSD symptom endorsement that differentiated veteran participants with and without a history of suicide behaviors. We enrolled 95 veterans, 32 of whom reported no suicide ideation (SI) or suicide attempts (SA). The 63 remaining participants reported a history of SI, with 28 of the 63 also reporting a historical SA. Participants completed a standardized diagnostic interview (Structured Clinical Interview for DSM-IV-TR; First, Spitzer, Gibbon, & Williams, 2002), structured interview of suicidal behaviors (Columbia-Suicide Severity Rating Scale; Posner et al., 2011), and selected clinical measures. Veterans who reported SI and/or SA were more likely to meet criteria for PTSD on DSM-5 than were veterans who reported neither SI nor SA. Participants who reported SA were more likely to meet criteria for clusters C and D. Finally, at the symptom level, those who reported SI were more likely to report experiencing feelings of alienation. Those who reported a SA were more likely to report avoidance of thoughts and feelings, inability to recall an important aspect of their trauma, persistent negative beliefs, diminished interest, and feelings of alienation. These findings suggest that targeting specific symptoms of PTSD may aid in treatment of suicidal thoughts and behaviors associated with PTSD.",0,0 +5437,Service use patterns and mental health symptoms among adolescents exposed to multiple types of trauma,"Few studies have explored how different trauma experiences influence service use. This study explores patterns of service use amongst 6483 adolescents aged between 13 and 18, and examines if such patterns are associated with trauma profiles, demographic variables, and mental health disorders. Data from the National Comorbidity Survey--Adolescent Supplement (NCS-A) were used. A latent class analysis identified four adolescent trauma sub-groups: 'high risk', 'sexual risk' 'non-sexual risk', and 'low risk'. Regression analysis was used to explore the relationship between service use, trauma classes, and mental health outcomes. Significant relationships were found between service use, trauma sub-groups, demographics and mental health outcomes. Despite the effectiveness of mental health services, only a minority of adolescents exposed to different traumas use such resources. However, this study may go some way towards providing an understanding of the trauma backgrounds, demographic predictors and mental health disorders associated with service use.",0,0 +5438,Exposure to Political Conflict and Violence and Posttraumatic Stress in Middle East Youth: Protective Factors,"We examine the role of family- and individual-level protective factors in the relation between exposure to ethnic-political conflict and violence and posttraumatic stress among Israeli and Palestinian youth. Specifically, we examine whether parental mental health (lack of depression), positive parenting, children's self-esteem, and academic achievement moderate the relation between exposure to ethnic-political conflict/violence and subsequent posttraumatic stress (PTS) symptoms. We collected three waves of data from 901 Israeli and 600 Palestinian youths (three age cohorts: 8, 11, and 14 years old; approximately half of each gender) and their parents at 1-year intervals. Greater cumulative exposure to ethnic-political conflict/violence across the first 2 waves of the study predicted higher subsequent PTS symptoms even when we controlled for the child's initial level of PTS symptoms. This relation was significantly moderated by a youth's self-esteem and by the positive parenting received by the youth. In particular, the longitudinal relation between exposure to violence and subsequent PTS symptoms was significant for low self-esteem youth and for youth receiving little positive parenting but was non-significant for children with high levels of these protective resources. Our findings show that youth most vulnerable to PTS symptoms as a result of exposure to ethnic-political violence are those with lower levels of self-esteem and who experience low levels of positive parenting. Interventions for war-exposed youth should test whether boosting self-esteem and positive parenting might reduce subsequent levels of PTS symptoms.",0,0 +5439,"Resilience, Trauma, Context, and Culture","This article reviews the relationship between factors associated with resilience, and aspects of the individual’s social ecology (environment) that promote and protect against the negative impact of exposure to traumatic events. It is shown that the Environment × Individual interactions related to resilience can be understood using three principles: (1) Resilience is not as much an individual construct as it is a quality of the environment and its capacity to facilitate growth (nurture trumps nature); (2) resilience looks both the same and different within and between populations, with the mechanisms that predict positive growth sensitive to individual, contextual, and cultural variation (differential impact); and (3) the impact that any single factor has on resilience differs by the amount of risk exposure, with the mechanisms that protect against the impact of trauma showing contextual and cultural specificity for particular individuals (cultural variation). A definition of resilience is provided that highlights the need for environments to facilitate the navigations and negotiations of individuals for the resources they need to cope with adversity. The relative nature of resilience is discussed, emphasizing that resilience can manifest as either prosocial behaviors or pathological adaptation depending on the quality of the environment.",0,0 +5440,Predicting Posttraumatic Distress in Hospitalized Trauma Survivors With Acute Injuries,"Each year approximately 2.5 million Americans are hospitalized after sustaining traumatic physical injuries. Few investigations have comprehensively screened for posttraumatic symptomatic distress or identified predictors of posttraumatic stress disorder (PTSD) in representative samples of surgical inpatients.The subjects were 101 randomly selected survivors of motor vehicle crashes or assaults who were interviewed while hospitalized and 1, 4, and 12 months after injury. In the surgical ward, inpatients were screened for PTSD, depressive, and dissociative symptoms, for prior trauma, for pre-event functioning, and for alcohol and drug intoxication. Patient demographic and injury characteristics were also recorded. Random coefficient regression models were used to assess the association between these clinical, injury, and demographic characteristics and PTSD symptom levels over the year after the injury.Of the 101 surgical inpatients, 73% screened positive for high levels of symptomatic distress and/or substance intoxication. At 1, 4, and 12 months after the injury, 30%-40% reported symptoms consistent with a diagnosis of PTSD. High ward PTSD symptom levels were the strongest and most parsimonious predictor of persistent symptoms over the course of the year. Greater prior trauma, stimulant intoxication, and female gender were also associated with higher symptom levels. Increasing injury severity, however, was not associated with higher PTSD symptom levels.Clinical and demographic characteristics readily identifiable at the time of surgical inpatient hospitalization predict PTSD symptoms over the year after injury. Effectiveness trials that test screening and intervention procedures for at-risk inpatients should be developed.",0,0 +5441,Sexual Orientation and Gender Identity/Expression Related Peer Victimization in Adolescence: A Systematic Review of Associated Psychosocial and Health Outcomes,"This article reviews research on psychosocial and health outcomes associated with peer victimization related to adolescent sexual orientation and gender identity or expression. Using four electronic databases and supplementary methods, we identified 39 relevant studies. These studies were published between 1995 and 2012 and conducted in 12 different countries. The studies were diverse in terms of their approaches to sampling participants, assessing participants' sexual orientation, operationalizing peer victimization, and with regard to the psychosocial and health outcomes studied in relation to peer victimization. Despite the methodological diversity across studies, there is fairly strong evidence that peer victimization related to sexual orientation and gender identity or expression is associated with a diminished sense of school belonging and higher levels of depressive symptoms; findings regarding the relationship between peer victimization and suicidality have been more mixed. Peer victimization related to sexual orientation and gender identity or expression is also associated with disruptions in educational trajectories, traumatic stress, and alcohol and substance use. Recommendations for future research and interventions are discussed.",0,0 +5442,Turn on and tune in to evidence-based psychedelic research,"For many people, words such as psychedelic and LSD (lysergic acid diethylamide) refer only to dangerous drugs of abuse. Less well known is that tens of thousands of patients were treated effectively with psychedelic drugs in the 1950s and 1960s,1 and that these drugs had almost become part of mainstream medicine by the time they became demonised and research was halted for 40 years.",0,0 +5443,Psychometric properties of the PTSD checklist (PCL),"The psychometric properties of the PTSD Checklist (PCL), a new, brief, self-report instrument, were determined on a population of 40 motor vehicle accident victims and sexual assault victims using diagnoses and scores from the CAPS (Clinician Administered PTSD Scale) as the criteria. For the PCL as a whole, the correlation with the CAPS was 0.929 and diagnostic efficiency was 0.900 versus CAPS. Examination of the individual items showed wide ranging values of individual item correlations ranging from 0.386 to 0.788, and with diagnostic efficiencies of 0.700 or better for symptoms. We support the value of the PCL as a brief screening instrument for PTSD.",0,0 +5444,Longitudinal investigation of interpersonal trauma exposure and alcohol use trajectories,"The current longitudinal study examined associations between interpersonal potentially traumatic events (PTEs; i.e., sexual or physical assault) and changes in alcohol consumption among incoming college students.1197 students (68% female) participating in a university-wide research study were included in analyses. Assessments were administered at three time-points and included measures of alcohol use, PTEs (Life Events Checklist), and a screener for possible PTSD symptoms (abbreviated Primary Care PTSD Screen). Linear growth curve models were fit to the three repeated measures of alcohol quantity and frequency to determine the role of pre-college and college-onset interpersonal PTEs and possible PTSD symptoms on patterns of alcohol use.Pre-college interpersonal PTE was associated with greater baseline alcohol use for female but not male students. College-onset interpersonal PTE predicted greater alcohol use at concurrent and future assessments for women but not men, beyond the effects of pre-college PTE. Pre-college possible PTSD symptoms did not predict baseline or change in alcohol use.There may be a stronger and longer-lasting impact of interpersonal PTE for college women compared to men on alcohol phenotypes, although replication in studies oversampling men endorsing interpersonal PTE is needed.",0,0 +5445,"Posttraumatic Stress Disorder in Adults: Impact, Comorbidity, Risk Factors, and Treatment","During the last 30 years, there has been a substantial increase in the study of posttraumatic stress disorder (PTSD). Several high-profile traumatic events, such as the wars in Afghanistan and Iraq, and the terrorist attacks of September 11 on the World Trade Center, have led to a greater public interest in the risk and protective factors for PTSD. In this In Review paper, I discuss some of the important advances in PTSD. The paper provides a concise review of the evolution of PTSD diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, impact of PTSD in the community, an overview of the established risk factors for developing PTSD, and assessment and treatment. Throughout the paper, controversies and clinical implications are discussed.",0,0 +5446,Exposure to high stress in the intensive care unit may have negative effects on health-related quality-of-life outcomes after cardiac surgery,"Up to 20% of patients do not show improvements in health-related quality of life (HRQL) after cardiac surgery, despite apparently successful surgical procedures. We sought to determine whether failed improvements in HRQL after cardiac surgery are associated with the development of traumatic memories and chronic stress states as a result of high perioperative stress exposure.Prospective cohort study.A 10-bed cardiovascular intensive care unit of a tertiary care university hospital.A total of 148 cardiac surgical patients.None.The patients were evaluated for traumatic memories from postoperative treatment in the cardiovascular intensive care unit (defined as the subjective recollection of pain, respiratory distress, anxiety/panic, and nightmares), symptoms of chronic stress, including those of posttraumatic stress disorder, and HRQL preoperatively (at baseline) and at 6 months after cardiac surgery. A state of chronic stress was defined as the development of posttraumatic stress disorder at 6 months after surgery. Factors predicting the decline in HRQL were determined by multivariable linear regression. Twenty-seven patients (18.2%) had posttraumatic stress disorder at 6 months after cardiac surgery; seven of these patients (4.8%) had evidence of preexisting posttraumatic stress disorder before undergoing cardiac surgery. Patients with new posttraumatic stress disorder at 6 months after cardiac surgery had a significantly higher number of traumatic memories from postoperative treatment in the cardiovascular intensive care unit (p =.01). A multiple regression model included the number of traumatic memories from the intensive care unit and stress symptom scores at 6 months after heart surgery as predictors for variations in physical HRQL outcome scores (R2 =.30, p <.04). Stress symptom scores were the most significant predictors of mental health HRQL outcomes (R2 =.52, p <.01).Exposure to high stress in the cardiovascular intensive care unit can have negative effects on HRQL outcomes of cardiac surgery.",0,0 +5447,Ten years after the genocide: Trauma confrontation and posttraumatic stress in Rwandan adolescents,"A decade after the 1994 Rwandan genocide, we interviewed a total of 68 Rwandan orphans about their war experiences and posttraumatic stress disorder (PTSD) symptoms. The two samples comprised youth living either in a child-headed household (CHH) or in an orphanage. All had been exposed to extreme levels of violence and 41% had witnessed the murder of their own mother or father. Of the sample, 44% had PTSD. PTSD vulnerability was greater for youth who at the time of the study lived in CHH than those in an orphanage; it was also higher in those aged 8 to 13 during the outbreak of the genocide than those aged 3 to 7 at the time. Furthermore, a significant relationship was found between the number of traumatic experiences and subsequent stress responses.",0,0 +5448,COMMUNITY NEEDS AMONG SERVICE MEMBERS AFTER RETURN FROM COMBAT DEPLOYMENT,"To build on research concerning the development of postdeployment community-based programs, we surveyed active duty soldiers from two Brigade Combat Teams (N = 693; N = 1,385) after return from a combat deployment. The Brigade Combat Teams were located on different installations in rural areas representing 2 large military communities. The survey included an assessment about a range of community services (social events, cultural integration opportunities, family, chaplain, and mental health services, etc.). We also examined whether ratings of services varied as a function of Posttraumatic Stress Disorder symptoms, deployment experiences, organizational leadership and support, and attitudinal variables related to mental health. Differences in ratings between the 2 communities suggest the measure detected perceptions of community needs that are idiosyncratic to the particular community, and may be useful for informing program planning and service needs.",0,0 +5449,Mental Health Care Needs among Recent War Veterans,"Fifteen percent or more of some populations of veterans of the Vietnam War and the 1991 Gulf War have received diagnoses of post-traumatic stress disorder (PTSD).1,2 Given this history and the fact that U.S. troops in Iraq and Afghanistan are serving for prolonged periods in a hazardous combat environment, we expect the mental health care needs of our newest veterans to be great. In a survey of 3671 Army soldiers and Marines who were involved in combat in Iraq and Afghanistan, up to 17 percent of those returning reported symptoms consistent with major depression, generalized anxiety, or PTSD.3 Since . . .",0,0 +5450,"Commentary: Key Issues, Concluding Thoughts, and Future Directions for the Study of Trauma and Child Health","Although the majority of children experience at leastone potentially traumatic event (PTE) by adolescence(Copeland, Keeler, Angold, & Costello, 2007;Costello, Erkanli, Fairbank, & Angold, 2002), previ-ous research offered little empirical foundation or con-ceptual guidance regarding relationships betweentrauma and child health. The papers included in thisSpecial Issue collectively offer informed directions andillustrate excellent examples of programs of researchseeking to elucidate the complex associations betweenchild traumatic stress and physical health. Preliminaryfindings and theoretical advances presented through-out this Special Issue underscore the importance ofcontinued efforts on this front.In the sections below, we consider each group ofstudies in this Special Issue, highlighting their key con-tributions. We also reflect on this Special Issue and of-fer recommendations for advancing science andpractice in this important area of child health.Maltreatment and VictimizationThe consequences of child maltreatment and victimiza-tion are a serious public health concern. Millions ofchildren experience maltreatment and victimization ev-ery year. Over 679,000 cases of abuse were confirmedin the United States in 2013 alone (U.S. Department ofHealth and Human Services & on Children, 2013), androughly 15–30% of youth report experiencing peer vic-timization (i.e., receiving physical or psychologicalharm from peers; Dinkes, Cataldi, Lin-Kelly, S Luxenberg, Limber, & Olweus, 2014).The considerable negative mental health consequencesof maltreatment and victimization are well documented(Banyard, Williams & Siegel, 2001; De Bellis et al.,2002; Landoll et al., 2015; Widom, Czaja, Wilson,Allwood, & Chauhan, 2013), but the impact of mal-treatment and victimization on child health are only be-ginning to be understood (Sachs-Ericsson, Blazer, Plant,A Springer, Sheridan, Kuo, & Carnes,2007). Several articles in this Special Issue build on thisimportant literature and reflect considerable progress inunderstanding key relationships between maltreatmentand victimization and child health.Importantly, it is currently unclear when adversephysical health effects of childhood maltreatment andvictimization emerge. Research has primarily focusedon the relationship between maltreatment and victimi-zation and adult health conditions (Afifi, Mota,MacMillan, & Sareen, 2013, Goodwin, Hoven,Murison, & Hotopf, 2003; Springer et al., 2007;seeArias, 2004 for a review). In a rare exception, in this is-sue, Gooding, Milliren, Austin, Sheridan, andMcLaughlin (2015) compared arterial pressure and cir-culation in adolescents who reported abuse with thosewho did not, and found that abused youth had higherresting diastolic blood pressure and blunted diastolicand systolic blood pressure reactivity to laboratorystressors. This study contributes to a growing body ofliterature documenting that the health effects of mal-treatment and victimization are evident in childhood(McLaughlin, Sheridan, Alves, & Mendes, 2014).An important next step is to understand whetherspecific types of maltreatment and victimization placeyouth at differential risk for adverse health outcomes.Past research has largely focused on the general impact",0,0 +5451,Changes in trauma-potentiated startle with treatment of posttraumatic stress disorder in combat Veterans,"Emotional Processing Theory proposes that habituation to trauma-related stimuli is an essential component of PTSD treatment. However, the mechanisms underlying treatment-related habituation are not well understood. We examined one psychophysiological measure that holds potential for elucidating the biological processes involved in treatment response: trauma-potentiated startle response. Seventeen OEF/OIF combat Veterans participated in the study and completed three assessments using a trauma-potentiated startle paradigm over PTSD treatment. Results revealed different patterns of trauma-potentiated startle across treatment for responders and nonresponders, but no differences in within task habituation. Responders showed an increase followed by a decrease in trauma-potentiated startle, whereas nonresponders showed a relatively flat response profile. Results suggested that PTSD patients who engage with emotional content as demonstrated by greater startle reactivity may be more likely to respond to PTSD treatment. Furthermore, trauma-potentiated startle shows promise as an objective measure of psychophysiological responses involved in PTSD recovery.",0,0 +5452,Support for a novel five-factor model of posttraumatic stress symptoms in three independent samples of Iraq/Afghanistan veterans: A confirmatory factor analytic study,"A large body of confirmatory factor analytic studies of posttraumatic stress disorder (PTSD) symptoms has demonstrated the superiority of 4-factor dysphoria and emotional numbing models over the DSM-IV model. Recently, a novel 5-factor model, which separates the DSM-IV hyperarousal symptom cluster into distinct dysphoric and anxious arousal clusters, has been identified. However, little research has evaluated the best-fitting representation of PTSD symptoms in veterans of the Iraq and Afghanistan wars.Confirmatory factor analyses were used to examine the factor structure of the PTSD Checklist in three independent samples of Iraq/Afghanistan veterans, including two community samples and a treatment-seeking sample.In all three samples, a novel model with five correlated factors reflecting symptoms of re-experiencing, avoidance, emotional numbing, dysphoric arousal, and anxious arousal provided a significantly better representation of PTSD symptoms than the DSM-IV, dysphoria, and numbing models. This model also showed evidence of ""excellent fit"" in the community samples according to empirically-defined benchmarks.These findings suggest that PTSD symptomatology in both community and treatment-seeking Iraq/Afghanistan veterans may be best represented by a 5-factor model that separates the DSM-IV PTSD hyperarousal symptom cluster into distinct dysphoric arousal and anxious arousal clusters.",0,0 +5453,Effects of early life trauma on affective executive control and white matter integrity in veterans with and without PTSD,"Background: Prior studies have illustrated the impact of early life trauma (ELT) and adult onset PTSD on affective executive control. We aimed at examining the interaction between a history of ELT and current PTSD diagnosis on performance on an affective executive control task and white matter integrity. Methods: 225 Veterans from TRACTS of the VABHS were grouped for current PTSD diagnosis (PTSD+ = 134 / PTSD- = 91) and for a history of ELT (ELT+ = 65, ELT- = 160). All subjects performed the Affective Go/No-Go task of the CANTAB and errors, as well as reaction time, were the variables of interest. Participants also underwent a diffusion-tensor imaging scan. Results: There was no significant interaction between ELT and PTSD on AGN. ELT+ subjects showed a significantly greater number of errors on the AGN [F (1,219) = 8.46, p. < .004]. There was no main effect of ELT on FA, however there was a significant interaction (p. <.05, corrected) between ELT and reaction time on FA for both positive (widespread clusters) and negative targets (left cingulate bundle). Conclusions: PTSD diagnosis is not associated with impaired performance in our study, though individuals with a history of ELT showed greater number of errors across both positive and negative valence. The interaction between FA and reaction time in the ELT group suggests altered neurodevelopmental trajectories leading to potential deficits in behavior. This may constitute a risk factor for later psychopathology.",0,0 +5454,Suicidality and posttraumatic stress disorder (PTSD) in adolescents: a systematic review and meta-analysis,"Purpose: There is growing evidence in the literature that a diagnosis of Posttraumatic Stress Disorder (PTSD) is an important contributory factor to suicidality in adolescents. However, there is no existing review of the literature examining the relationship between PTSD and suicidality in adolescents. This study aims to provide the first systematic review and meta-analysis of the association between PTSD and suicidality in adolescents. Methods: Five bibliographic databases (Medline, EMBASE, PsycINFO, Web of Science and PILOT) were screened for suitable articles. Twenty-eight studies (which provided 28 independent samples) were included in the review. The overall meta-analyses of the association between PTSD and suicidality were followed by subgroup and meta-regression analyses. Results: A highly significant positive association was found between PTSD and suicidality (d = 0.701, 95 % CI 0.555-0.848). The subgroup and meta-regression analyses showed that the association between PTSD and suicidality persisted whilst adjusting for various sources of between-study heterogeneity, such as, different levels of severity of suicidality, target groups, and methodological quality of the studies. Conclusions: Suicidality in adolescents with PTSD is a major problem which requires further research effort. The implications of these results are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0,0 +5455,"Conditioned Fear Associated Phenotypes as Robust, Translational Indices of Trauma-, Stressor-, and Anxiety-Related Behaviors","Posttraumatic stress disorder (PTSD) is a heterogeneous disorder that affects individuals exposed to trauma (e.g., combat, interpersonal violence, and natural disasters). It is characterized by hyperarousal, intrusive reminders of the trauma, avoidance of trauma-related cues, and negative cognition and mood. This heterogeneity indicates the presence of multiple neurobiological mechanisms underlying the development and maintenance of PTSD. Fear conditioning is a robust, translational experimental paradigm that can be employed to elucidate these mechanisms by allowing for the study of fear-related dimensions of PTSD (e.g., fear extinction, fear inhibition, and generalization of fear) across multiple units of analysis. Fear conditioning experiments have identified varying trajectories of the dimensions described, highlighting exciting new avenues of targeted, focused study. Additionally, fear conditioning studies provide a translational platform to develop novel interventions. The current review highlights the versatility of fear conditioning paradigms, the implications for pharmacological and non-pharmacological treatments, the robustness of these paradigms to span an array of neuroscientific measures (e.g., genetic studies), and finally the need to understand the boundary conditions under which these paradigms are effective. Further understanding these paradigms will ultimately allow for optimization of fear conditioning paradigms, a necessary step towards the advancement of PTSD treatment methods.",0,0 +5456,A Pilot Trial of Telephone-Based Collaborative Care Management for PTSD Among Iraq/Afghanistan War Veterans,"Collaborative care and care management are cornerstones of Primary Care-Mental Health Integration (PC-MHI) and have been shown to reduce depressive symptoms. Historically, the standard of Veterans Affairs (VA) collaborative care was referring patients with posttraumatic stress disorder (PTSD) to specialty care. Although referral to evidence-based specialty care is ideal, many veterans with PTSD do not receive such care. To address this issue and reduce barriers to care, VA currently recommends veterans with PTSD be offered treatment within PC-MHI as an alternative. The current project outlines a pilot implementation of an established telephone-based collaborative care model-Translating Initiatives for Depression into Effective Solutions (TIDES)-adapted for Iraq/Afghanistan War veterans with PTSD symptoms (TIDES/PTSD) seen in a postdeployment primary care clinic.Structured medical record extraction and qualitative data collection procedures were used to evaluate acceptability, feasibility, and outcomes.Most participants (n=17) were male (94.1%) and white (70.6%). Average age was 31.2 (standard deviation=6.4) years. TIDES/PTSD was successfully implemented within PC-MHI and was acceptable to patients and staff. Additionally, the total number of care manager calls was positively correlated with number of psychiatry visits (r=0.63, p<0.05) and amount of reduction in PTSD symptoms (r=0.66, p<0.05). Overall, participants in the pilot reported a significant reduction in PTSD symptoms over the course of the treatment (t=2.87, p=0.01).TIDES can be successfully adapted and implemented for use among Iraq/Afghanistan veterans with PTSD. Further work is needed to test the effectiveness and implementation of this model in other sites and among veterans of other eras.",0,0 +5457,Enhancing self-report assessment of PTSD: Development of an item bank,"The authors report results of work to enhance self-report posttraumatic stress disorder (PTSD) assessment by developing an item bank for use in a computer-adapted test. Computer-adapted tests have great potential to decrease the burden of PTSD assessment and outcomes monitoring. The authors conducted a systematic literature review of PTSD instruments, created a database of items, performed qualitative review and readability analysis, and conducted cognitive interviews with veterans diagnosed with PTSD. The systematic review yielded 480 studies in which 41 PTSD instruments comprising 993 items met inclusion criteria. The final PTSD item bank includes 104 items representing each of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association [APA], 1994), PTSD symptom clusters (reexperiencing, avoidance, and hyperarousal), and 3 additional subdomains (depersonalization, guilt, and sexual problems) that expanded the assessment item pool.",0,0 +5458,"The natural history of recovery for the healthcare provider ""second victim"" after adverse patient events","When patients experience unexpected events, some health professionals become ""second victims"". These care givers feel as though they have failed the patient, second guessing clinical skills, knowledge base and career choice. Although some information exists, a complete understanding of this phenomenon is essential to design and test supportive interventions that achieve a healthy recovery.The purpose of this article is to report interview findings with 31 second victims. After institutional review board approval, second victim volunteers representing different professional groups were solicited for private, hour-long interviews. The semistructured interview covered demographics, participant recount of event, symptoms experienced and recommendations for improving institutional support. After interviews, transcripts were analyzed independently for themes, followed by group deliberation and reflective use with current victims.Participants experienced various symptoms that did not differ by sex or professional group. Our analysis identified six stages that delineate the natural history of the second victim phenomenon. These are (1) chaos and accident response, (2) intrusive reflections, (3) restoring personal integrity, (4) enduring the inquisition, (5) obtaining emotional first aid and (6) moving on. We defined the characteristics and typical questions second victims are desperate to have answered during these stages. Several reported that involvement in improvement work or patient safety advocacy helped them to once again enjoy their work.We now believe the post-event trajectory is largely predictable. Institutional programs could be developed to successfully screen at-risk professionals immediately after an event, and appropriate support could be deployed to expedite recovery and mitigate adverse career outcomes.",0,0 +5459,The longitudinal course of PTSD among disaster workers deployed to the World Trade Center following the attacks of September 11th,"This study examined the long-term mental health outcomes of 2,960 nonrescue disaster workers deployed to the World Trade Center site in New York City following the September 11, 2001 (9/11) terrorist attacks. Semistructured interviews and standardized self-report measures were used to assess the prevalence of posttraumatic stress disorder (PTSD) and other psychopathology 4 and 6 years after the attacks. Clinician-measured rates of PTSD and partial PTSD 4-years posttrauma were 8.4% and 8.9%, respectively, in a subsample of 727 individuals. Rates decreased to 5.8% and 7.7% for full and partial PTSD 6 years posttrauma. For the larger sample, self-report scores revealed probable PTSD and partial PTSD prevalence to be 4.8% and 3.6% at 4 years, and 2.4% and 1.8% at 6 years. Approximately 70% of workers never met criteria for PTSD. Although PTSD rates decreased significantly over time, many workers remained symptomatic, with others showing delayed-onset PTSD. The strongest predictors of ongoing PTSD 6 years following 9/11 were trauma history (odds ratio (OR) = 2.27, 95% confidence interval (CI) [1.06, 4.85]); the presence of major depressive disorder 1-2 years following the trauma (OR = 2.80, 95% CI [1.17, 6.71]); and extent of occupational exposure (OR = 1.31, 95% CI [1.13, 1.51]). The implications of the findings for both screening and treatment of disaster workers are discussed.",0,0 +5460,Resiliencia en adultos: una revisión teórica,"The objective of this study is to make a theoretical review on resilience in adults between the year 2000 and 2011. A search of papers published in the databases Scopus, PsycInfo, Psicodoc, Web of Science and summaries Dialnet and ISOC (Social Sciences and Humanities) was performed. In total, 418 items were found that met the inclusion criteria. We conclude that in the studies published between 200 and 2011 on resilience in adults prevail cross-sectional studies, published in English, quantitative, and using samples from USA. Resilience is related psychological disorders. It is emphasized the need to include resilience in health education programs to improve ways of coping in the context of risk and adversity.",0,0 +5461,PTSD Symptom Patterns Following Traumatic and Nontraumatic Events,"This study extends research examining posttraumatic stress disorder symptoms following different types of potentially traumatic events. Specifically, the study examined and compared the symptom patterns observed in those who suffered a major accident, the unexpected death of a loved one, or sexual assault. Based on recent findings, this project also examines those who reported nontraumatic (but stressful) events, as well as comparing symptom patterns across gender. Findings suggest different types of traumas might be associated with differences in severity and patterns of symptoms for women (but not for men), suggesting symptom patterns manifest differently in men and women. Results also call into question the assumption that traumatic events demonstrate different symptom patterns than other types of events.",0,0 +5462,Unique PTSD Clusters Predict Intention to Seek Mental Health Care and Subsequent Utilization in US Veterans with PTSD Symptoms,"Many veterans return from deployment with posttraumatic stress disorder (PTSD), but most attend only a limited number of mental health care visits. Although global PTSD relates to seeking mental health care, it is unclear whether specific features of PTSD inform the low rates of mental health care utilization. This study examined PTSD cluster severities of avoidance, reexperiencing, dysphoria, and hyperarousal as predictors of intention to seek mental health care and prospective treatment utilization. US veterans with at least subthreshold PTSD (N = 189) completed a PTSD symptom measure and indicated whether they intended to seek mental health care. Prospective Department of Veterans Affairs mental health care utilization was extracted from the medical record. At the bivariate level, each cluster was positively associated with a positive intention to seek mental health care and prospective treatment utilization. In multivariate models, however, dysphoria severity (OR = 1.16, 95% CI [1.06, 1.26]) was uniquely and positively correlated with intention to seek mental health care, whereas higher avoidance severity (IRR = 0.86, 95% CI [0.76, 0.98]) predicted lower treatment utilization, and higher reexperiencing severity (IRR = 1.07, 95% CI [1.01, 1.14]) predicted greater treatment utilization. It is critical to tailor interventions to target specific features of PTSD and to meet patients where they are.",0,0 +5463,Association of Symptoms Following Mild Traumatic Brain Injury With Posttraumatic Stress Disorder vs Postconcussion Syndrome,"A proportion of patients experience long-lasting symptoms following mild traumatic brain injury (MTBI). The postconcussion syndrome (PCS), included in the DSM-IV, has been proposed to describe this condition. Because these symptoms are subjective and common to other conditions, there is controversy whether PCS deserves to be identified as a diagnostic syndrome.To assess whether persistent symptoms 3 months following head injury are specific to MTBI or whether they are better described as part of posttraumatic stress disorder (PTSD).We conducted a prospective cohort study of injured patients recruited at the adult emergency department of the University Hospital of Bordeaux from December 4, 2007, to February 25, 2009.At 3-month follow-up, we compared the prevalence and risk factors for PCS and PTSD. Multiple correspondence analyses were used to assess clustering of symptoms and their associations with the type of injury.We included 534 patients with head injury and 827 control patients with other nonhead injuries. Three months following the trauma, 21.2% of head-injured and 16.3% of nonhead-injured patients fulfilled the DSM-IV diagnosis of PCS; 8.8% of head-injured patients fulfilled the diagnostic criteria for PTSD compared with 2.2% of control patients. In multivariate analysis, MTBI was a predictor of PTSD (odds ratio, 4.47; 95% CI, 2.38-8.40) but not of PCS (odds ratio, 1.13; 95% CI, 0.82-1.55). Correspondence analysis suggested that symptoms considered part of PCS behave similarly to PTSD symptoms in the hyperarousal dimension. None of these 22 symptoms showed any pattern of clustering, and no clear proximity with head or nonhead injury status could be found.Persistent subjective symptoms frequently reported 3 months after MTBI are not specific enough to be identified as a unique PCS and should be considered part of the hyperarousal dimension of PTSD.",0,0 +5464,The social readjustment rating scale,"IN PREVIOUS studies [l] it has been established that a cluster of social events requiring change in ongoing life adjustment is significantly associated with the time of illness onset. Similarly, the relationship of what has been called ‘life stress,’ ‘emotional stress,’ ‘object loss,’ etc. and illness onset has been demonstrated by other investigations [2-131. It has been adduced from these studies that this clustering of social or life events achieves etiologic significance as a necessary but not sufficient cause of illness and accounts in part for the time of onset of disease. Methodologically, the interview or questionnaire technique used in these studies has yielded only the number and types of events making up the cluster. Some estimate of the magnitude of these events is now required to bring greater precision to this area of research and to provide a quantitative basis for new epidemiological studies of diseases. This report defines a method which achieves this requisite. METHOD",0,0 +5465,Psychophysiology of structural imagery in post-traumatic stress disorder.,"Discusses psychophysiological symptoms associated with posttraumatic stress disorder (PTSD), noting that an approach to PTSD involving a brain model can account for the paradoxical nature of disconnections of cognitive and affective processing in response to severe stress. The structural-imagery approach to PTSD capitalizes on the natural capacity of the equilibrium and nonequilibrium seeking processes of the unconscious brain and conscious mind to overcome the functional disconnection syndromes associated with extreme stress. A case example of a male accident victim suffering from an acute post-traumatic stress reaction is presented. (33 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5466,Psychiatry of whiplash neck injury,"The psychiatric outcome of whiplash neck injury is controversial.To describe outcomes and predictors as compared with other types of road accident injury.Consecutive emergency department attenders (n=1148; whiplash 278) assessed by self-report at baseline, 3 months, 1 year and 3 years.Moderate to severe pain was reported by 27% of whiplash sufferers at 1 year and by 30% at 3 years. Psychiatric consequences were common and persistent. Whiplash victims and those with bony injury were more likely to seek compensation. Accident and early post-accident psychosocial variables predicted the pain at 1 year. Claiming compensation at 3 months predicted the pain at 1 year for those with whiplash or bony injury.There is no special psychiatry of whiplash neck injury. Psychological variables and consequences are important following whiplash in a similar manner to other types of injury.",0,0 +5467,Helium Inhalation in Adolescents: Characteristics of Users and Prevalence of Use,"Although helium-related fatalities and concerns about potentially harmful effects of helium use have increased in recent years, virtually nothing is known about the epidemiology of helium inhalation in adolescents. This exploratory investigation examined the prevalence and correlates of helium inhalation in a large sample of at-risk youth. Study participants were 723 Missouri adolescents (M age = 15.5, SD = 1.2) in residential treatment for delinquent behavior. More than one-in-nine (N = 81, 11.5%) adolescents had inhaled helium with the intention of getting high, and one-third (N = 27, 34.2%) of helium users reported they actually did get high when they inhaled helium. Helium users were significantly more likely to be Caucasian, to live in rural/small town areas, and to have histories of mental illness, auditory hallucinations, and alcohol and marijuana use than nonusers. Helium users also reported significantly more current psychiatric distress, suicidality, traumatic life experiences, and antisocial attitudes, traits, and behaviors than nonusers. Helium inhalation was prevalent in this sample and many such users reported getting high while using helium. Helium users had psychosocial profiles similar to those of volatile solvent users, suggesting that they may be at substantial risk for a variety of adverse health outcomes.",0,0 +5468,"PTSD and TBI co-morbidity: Scope, clinical presentation and treatment options","Primary objective: To summarize the literature on post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) and their co-morbidity, focusing on diagnosis, clinical symptoms and treatment issues relevant to the clinician.Research design: Review of the literature.Methods and procedures: Pubmed searches were performed using the terms post-traumatic stress disorder, traumatic brain injury, sleep, cognitive, depression, anxiety, treatment and combinations of these terms. Those articles relevant to the objective were included.Main outcomes and results: This study presents pathophysiological, neuroimaging and clinical data on co-morbid PTSD and TBI. It reviews associated conditions, emphasizing the impact of cognitive and sleep problems. It summarizes the emerging literature on treatment effectiveness for co-morbid PTSD and TBI, including psychotherapy, pharmacotherapy and cognitive rehabilitation.Conclusions: Both PTSD and TBI commonly occur in the general population, both share some pathophysiological characteristics and both are associated with cognitive impairment and sleep disruption. PTSD and TBI present with a number of overlapping symptoms, which can lead to over-diagnosis or misdiagnosis. Both conditions are associated with co-morbidities important in diagnosis and treatment planning. More research is needed to elucidate what treatments are effective in PTSD and TBI co-morbidity and on factors predictive of treatment success.",0,0 +5469,Working memory training with tDCS improves behavioral and neurophysiological symptoms in pilot group with post-traumatic stress disorder (PTSD) and with poor working memory,"This pilot study investigated the feasibility of treating people suffering from both post-traumatic stress disorder (PTSD) and poor working memory by employing a combination of computerized working memory training and transcranial direct current stimulation (tDCS). After treatment, all four participants showed clinically significant improvements on a range of cognitive and emotional performance measures. Moreover, these improvements were accompanied by theoretically significant neurophysiological changes between pre- and post-treatment electroencephalographic (EEG) recordings. Specifically, the P3a component of participants' event related potentials (ERP) in response to novelty stimuli, characteristically abnormal in this clinical population, shifted significantly toward database norms. So, participants' initially slow alpha peak frequency (APF), theorized to underlie impaired cognitive processing abilities, also increased in both frequency and amplitude as a result of treatment. On the basis of these promising results, more extensive controlled studies are warranted.",0,0 +5470,The impact of maternal childhood abuse on maternal and infant HPA axis function in the postpartum period,"Early life trauma, particularly child abuse, has been associated with aberrations in hypothalamic–pituitary–adrenal (HPA) axis functioning in adulthood. However, the relationship of early abuse and later adult neuroendocrine changes may be moderated by additional factors such as comorbid psychopathology and recent life stress. Parental exposure to child abuse may have transgenerational effects, with offspring of abuse victims showing similar neuroendocrine profiles as their mothers. The majority of previous studies in this area focus on adult offspring, and the degree to which the effects of parental child abuse can be detected earlier in the development of the offspring remains obscure. The current study utilized a clinical sample of women with a history of MDD ( N = 126), to examine the effects of maternal early life sexual and physical abuse (Childhood Trauma Questionnaire (CTQ)) on both maternal and infant salivary cortisol levels during a laboratory stress paradigm at 6 months postpartum. Maternal child abuse was associated with steeper declines in cortisol in the mothers and lower baseline cortisol in their infants. Comorbid maternal PTSD, current maternal depressive symptoms, and recent life stressors were significant moderators of maternal cortisol change. Maternal abuse history was associated with increases in cortisol levels in those mothers who experienced these additional stressors. Similarly, a history of early maternal abuse and comorbid PTSD was associated with greater increases in infant cortisol levels. Maternal childhood abuse was associated with HPA axis function in both the mother and the infant during the postpartum period.",0,0 +5471,Does Posttraumatic Stress Disorder Affect Post-Treatment Methamphetamine Use?,"Although trauma is a well-established risk factor for substance use disorders, little is known about the association between posttraumatic stress disorder (PTSD) and treatment outcomes among methamphetamine users. In the present study, we examine the relationship between PTSD and post-treatment methamphetamine use outcomes, hospitalizations, and overall psychiatric impairment.Using data from 526 adults in the largest psychosocial clinical trial of methamphetamine users conducted to date, this study examined: (1) treatment outcomes of methamphetamine users with concomitant PTSD three years after psychosocial treatment for methamphetamine dependence; and (2) PTSD symptom clusters as risk factors for post-treatment relapse to methamphetamine use.PTSD was associated with poorer methamphetamine use outcomes; methamphetamine use frequency throughout the 3-year follow-up was significantly greater among individuals with a PTSD diagnosis, and those with PTSD had more than five times the odds of reporting methamphetamine use in the 30 days prior to the follow-up interview, OR= 5.2, 95% CI [2.0-13.3]. Additionally, higher levels of other Axis I psychopathology were observed among methamphetamine users with PTSD. Avoidance and arousal symptoms predicted post-treatment methamphetamine use.Addressing these high risk PTSD symptoms and syndromes in methamphetamine users may be helpful as a means of improving treatment outcomes in this population.",0,0 +5472,1H NMR based metabolomics approach to study the toxic effects of herbicide butachlor on goldfish (Carassius auratus),"Butachlor, one of the most widely used herbicides in agriculture, has been reported with high ecotoxicity to aquatic plants and animals. In this study, a (1)H NMR based metabolomics approach combined with histopathological examination and biochemical assays was applied to comprehensively investigate the toxic effects of butachlor on four important organs (gill, brain, liver and kidney) of goldfish (Carassius auratus) for the first time. After 10 days' butachlor exposure at two dosages of 3.2 and 0.64 μmol/L, fish tissues (gill, brain, liver and kidney) and serum were collected. Histopathological inspection revealed severe impairment of gill filaments and obvious cellular edema in livers and kidneys. The increase of glutathione peroxidase (GSH-Px) activity in gill and methane dicarboxylic aldehyde (MDA) level in four tissues reflected the disturbance of antioxidative system in the intoxicated goldfish. Serum lactate dehydrogenase (LDH) activity and creatinine (CRE) level were increased in butachlor exposure groups, suggesting liver and kidney injuries induced by butachlor. Orthogonal signal correction partial least-squares discriminant analysis (OSC-PLS-DA) of NMR profiles disclosed metabolic changes that were related to the toxic effects of butachlor including oxidative stress, disorder of energy metabolism and amino acids metabolism, and disturbance of neurotransmitter balance in butachlor exposed goldfish. This integrated metabolomics approach provided a molecular basis underlying the toxicity of butachlor and demonstrated that metabolomics was a powerful and highly effective approach to elucidate the toxicity and underlying mechanisms of herbicides and pesticides, applicable for their risk assessment.",0,0 +5473,Feasibility of a Screening Program for At-Risk Children Following Accidental Injury,en,0,0 +5474,Profile of 50 Women with Midlife-Onset Eating Disorders,"The aim of this study was to present a detailed profile of 50 women eating disorder (ED) inpatients who reported first ED onset at age 40 or above. We assessed patients' sociodemographics, severity-of-illness, comorbid diagnoses, personality profiles, and short-term treatment outcomes. Compared to patients of more traditional young adult ages, results revealed unique features of midlife-onset ED inpatients, including less severe and less common self-reported ED symptomology measured by the EDI-2; a predominance of pure restricting behaviors and rarity of bulimia; similar rates of co-occurring depression and anxiety but of less severity; fewer substance use disorders with a predominance of sedating/calming substance usage; many fewer Cluster C diagnoses on Axis II; substantially greater histories of sexual abuse; and different MMPI-2 profiles emphasizing much greater denial. The corresponding needs among midlife-onset ED inpatients for specialized assessment and treatment interventions are considered.",0,0 +5475,Psychopharmacology of topiramate: from epilepsy to bipolar disorder,"Topiramate (TPM) is one of the novel antiepileptic drugs and exhibits a wide range of mechanisms of action. Efficacy of TPM has been demonstrated in partial-onset seizures and primary generalized seizures in adults and children, as both monotherapy and adjunctive therapy. More recently, TPM has been proposed as an add-on treatment for patients with lithium-resistant bipolar disorder, especially those displaying rapid-cycling and mixed states. This paper reviews the multiple mechanisms of action and the tolerability profile of TPM in the light of its therapeutic potential in affective disorders. Studies of TPM in bipolar disorder are evaluated, and the efficacy and tolerability issues as a mood stabilizing agent are discussed.",0,0 +5476,Psychological Resilience in the Face of Terrorism,,0,0 +5477,Gender Group Differences in Coping with Chronic Terror: The Israeli Scene,"Gender group differences in terror-stress, cognitive appraisals, ways of coping with terror, and stress reactions were explored in a sample of Israeli adults following prolonged exposure to political violence. Data were gathered at the height of the Al-Aqsa Intifada uprising (May/July 2002) from a sample of 707 adult participants (60% women and 40% men) residing in Haifa and northern Israel. Israeli women reported that they were more distressed by political violence than the men did, and they also appraised the crisis situation as more threatening and less manageable. Women reported using more problem-focused as well as emotion-focused coping than men did; both men and women used a mixture of coping strategies. Compared to men, women reported that they experienced more somatic symptoms and more frequent posttraumatic stress symptoms than men did. Negative affectivity was found to mediate gender differences in appraisals, coping, and outcomes. Overall, the nexus of relations among key variables was found to be highly similar for men and women. These data suggest that women may be more reactive to chronic political violence situations than men are. The data are discussed and explicated in the context of stress and coping theory and prior research on political violence and community disasters. © 2006 Springer Science+Business Media, Inc.",0,0 +5478,"Regional economic resilience: concepts, empirics and a critical review","Abstract Regional (economic) resilience and resilient thinking have gained considerable attention in recent years. My aim with this work is to throw light on some of the underlying aspects of regional economic resilience and resilient thinking. In the current study I give an overview of the notion, key concepts, main empirical results and planning tasks concerning regional (economic) resilience as well as outlining some of the criticisms. Finally, I provide some suggestions for studies in resilience and resilient thinking for future research agendas. The main results of the study is my own belief in the concept of regional economic resilience, and an overview and comparison of regional (economic) resilience literature and empirics that lead me to highlight some of the shortcomings of the research topic.",0,0 +5479,Risk factors for post-traumatic stress disorder among UK Armed Forces personnel,"Background There is considerable interest in understanding further the factors that increase the risk of post-traumatic stress disorder (PTSD) for military personnel. This study aimed to investigate the relative contribution of demographic variables; childhood adversity; the nature of exposure to traumatic events during deployment; appraisal of these experiences; and home-coming experiences in relation to the prevalence of PTSD ‘caseness’ as measured by a score of ⩾50 on the PTSD Checklist (PCL) in UK Armed Forces personnel who have been deployed in Iraq since 2003. Method Data were drawn from the first stage of a retrospective cohort study comparing UK military personnel who were deployed to the 2003 Iraq War with personnel serving in the UK Armed Forces on 31 March 2003 but who were not deployed to the initial phase of war fighting. Participants were randomly selected and invited to participate. The response rate was 61%. We have limited these analyses to 4762 regular service individuals who responded to the survey and who have been deployed in Iraq since 2003. Results Post-traumatic stress symptoms were associated with lower rank, being unmarried, having low educational attainment and a history of childhood adversity. Exposure to potentially traumatizing events, in particular being deployed to a ‘forward’ area in close contact with the enemy, was associated with post-traumatic stress symptoms. Appraisals of the experience as involving threat to one's own life and a perception that work in theatre was above an individual's trade and experience were strongly associated with post-traumatic stress symptoms. Low morale and poor social support within the unit and non-receipt of a home-coming brief (psycho-education) were associated with greater risk of post-traumatic stress symptoms. Conclusions Personal appraisal of threat to life during the trauma emerged as the most important predictor of post-traumatic stress symptoms. These results also raise the possibility that there are important modifiable occupational factors such as unit morale, leadership, preparing combatants for their role in theatre which may influence an individual's risk of post-traumatic stress symptoms. Therefore interventions focused on systematic preparation of personnel for the extreme stress of combat may help to lessen the psychological impact of deployment.",0,0 +5480,The Relationship Between Quality of Life and Psychiatric Impairment for a Taiwanese Community Post-Earthquake,"This purpose of this study was to investigate the relationship between quality of life and psychiatric impairment in a Taiwanese community located near the epicenter of the 1999 earthquake, as assessed four to six months after the natural catastrophe. Trained assistants interviewed the 4223 respondents using the disaster-related psychological screening test (DRPST), an instrument specifically designed and validated by senior psychiatrists for assessment of psychiatric impairment after natural catastrophe. Additionally, the 36-Item Short-Form Health Survey (SF-36) was used to evaluate quality of life. The collected results were analyzed using Windows SPSS 10.0 software. Psychiatric impairment rated moderate to severe was assessed for 1448 (34.3%) of the responding residents. The 4223 respondents were divided into 4 psychiatric-impairment groups based on DPRST score: healthy (n = 952); mild impairment (n = 1823); moderate impairment (n = 1126); and, severe impairment (n = 322). The four groups were compared for a number of salient factors, including gender, age, current marital status and psychiatricimpairment score, to determine impact on quality of life. Respondents assessed as psychiatrically impaired tended to be older, female, divorced/widowed, and less educated, and they were more likely to have experienced major familial financial loss as an immediate consequence of the earthquake. Further, the greater the severity of the psychiatric impairment, the lower the scores for quality of life, for both the physical and mental aspects of this important general indicator.",0,0 +5481,Dissociative tendencies and dissociative disorders.,"Although dissociative disorders are relatively rare, dissociative experiences are rather common in everyday life. Dissociative tendencies appear to be modestly related to other dimensions of personality, such as hypnotizability, absorption, fantasy proneness, and some facets of openness to experience. These dispositional variables may constitute diathesis, or risk factors, for dissociative psychopathology, but more complex models relating personality to psychopathology may be more appropriate. The dissociative disorders raise fundamental questions about the nature of self and identity and the role of consciousness and autobiographical memory in the continuity of personality.",0,0 +5482,Genome-wide association study of posttraumatic stress disorder in a cohort of Iraq–Afghanistan era veterans,"Posttraumatic stress disorder (PTSD) is a psychiatric disorder that can develop after experiencing traumatic events. A genome-wide association study (GWAS) design was used to identify genetic risk factors for PTSD within a multi-racial sample primarily composed of U.S. veterans.Participants were recruited at multiple medical centers, and structured interviews were used to establish diagnoses. Genotypes were generated using three Illumina platforms and imputed with global reference data to create a common set of SNPs. SNPs that increased risk for PTSD were identified with logistic regression, while controlling for gender, trauma severity, and population substructure. Analyses were run separately in non-Hispanic black (NHB; n = 949) and non-Hispanic white (NHW; n = 759) participants. Meta-analysis was used to combine results from the two subsets.SNPs within several interesting candidate genes were nominally significant. Within the NHB subset, the most significant genes were UNC13C and DSCAM. Within the NHW subset, the most significant genes were TBC1D2, SDC2 and PCDH7. In addition, PRKG1 and DDX60L were identified through meta-analysis. The top genes for the three analyses have been previously implicated in neurologic processes consistent with a role in PTSD. Pathway analysis of the top genes identified alternative splicing as the top GO term in all three analyses (FDR q < 3.5 × 10(-5)).No individual SNPs met genome-wide significance in the analyses.This multi-racial PTSD GWAS identified biologically plausible candidate genes and suggests that post-transcriptional regulation may be important to the pathology of PTSD; however, replication of these findings is needed.",0,0 +5483,Introduction to Part I: Trauma and Juvenile Delinquency: Dynamics and Developmental Mechanisms,"This article introduces the first part of a two-part special issue featuring new directions in research on traumatized youth in the juvenile justice system. The articles in this issue focus on research devoted to investigating the underlying development mechanisms accounting for the associations among exposure to traumatic events, posttraumatic stress reactions, and delinquent behavior. The articles in this issue advance our understanding of these questions by expanding the scope of research to include the study of complex trauma as well as the differentiation between primary psychopathic traits among youth versus secondary psychopathy borne of trauma. In addition, studies are included targeting specific theoretically-derived mediators of the relations between childhood adversity and delinquency, including depressive cognitions, as well as specific symptom clusters of posttraumatic stress. The remaining articles shed light on the differential roles that trauma and demographic factors play in predicting recidivism and mental health functioning among youth involved in the juvenile justice system, including gender, ethnicity, age, and sexual minority status. Taken together, these studies suggest important directions for the development of effective interventions to target trauma-related sequelae among troubled youth and their families. © 2012",0,0 +5484,History and Future of the Multidisciplinary Association for Psychedelic Studies (MAPS),"This article describes the teenage vision of the founder of the Multidisciplinary Association for Psychedelic Studies (MAPS) that humanity's future would be aided by the therapeutic and spiritual potential of psychedelic substances. The article traces the trajectory of MAPS from inception in 1986 to its present, noting future goals with respect to research, outreach, and harm reduction. MAPS was created as a non-profit psychedelic pharmaceutical company in response to the 1985 scheduling of 3,4-methylenedioxymethamphetamine (MDMA). Overcoming many hurdles, MAPS developed the first double-blind, placebo-controlled trial of MDMA-assisted psychotherapy for posttraumatic stress disorder (PTSD) and plans for FDA prescription approval in 2021. MAPS' program of research expanded to include a trial of lysergic acid diethylamide (LSD)-assisted psychotherapy for anxiety when facing life-threatening illness, observational studies of ibogaine in the treatment of addiction, and studies of MDMA for social anxiety in people with autism spectrum disorders. MAPS meets the challenges of drug development through a clinical research team led by a former Novartis drug development professional experienced in the conduct, monitoring, and analysis of clinical trials. MAPS' harm-reduction efforts are intended to avoid backlash and build a post-prohibition world by assisting non-medical users to transform difficult psychedelic experiences into opportunities for growth.",0,0 +5485,Stress hormones and post-traumatic stress disorder in civilian trauma victims: a longitudinal study. Part II: The adrenergic response,"The aim of the study was to prospectively evaluate the association between the occurrence of post-traumatic stress disorder (PTSD) and the adrenergic response to the traumatic event, and additionally, to explore the link between PTSD and the initial norepinephrine:cortisol ratio. Plasma levels and urinary excretion of norepinephrine (NE) were measured in 155 survivors of traumatic events during their admission to a general hospital emergency room (ER) and at 10 d, 1 month and 5 months later. Symptoms of peri-traumatic dissociation, PTSD and depression were assessed in each follow-up session. The Clinician-Administered PTSD Scale (CAPS) conferred a diagnosis of PTSD at 5 months. Trauma survivors with (n=31) and without (n=124) PTSD had similar levels of plasma NE, urinary NE excretion, and NE:cortisol ratio in the ER. Plasma NE levels were lower in subjects with PTSD at 10 d, 1 month, and 5 months. There was a weak but significant positive correlation between plasma levels of NE in the ER and concurrent heart rate, and a negative correlation between NE in the ER and dissociation symptoms. Peripheral levels of NE, shortly after traumatic events, are poor risk indicators of subsequent PTSD among civilian trauma victims. Simplified biological models may not properly capture the complex aetiology of PTSD.",0,0 +5486,MMPI Scores of Female Victims,"Samples of MMPIs of women who were victims of abuse or manifested a Posttraumatic Stress Disorder were drawn from two private practice settings, one urban and one in a small town. Each PTSD sample included 21 persons. For comparison, two contrast samples of 15 persons each were drawn from the same populations. A cut-off point of T = 65 for PK yielded a 69% hit rate for classifying PTSD and contrast subjects. Since scores on PS and PK were so highly correlated, no independent analyses were warranted. Although the PTSD group yielded a more elevated mean profile, there were no characteristic 2-point codes. Therefore, PK is more useful in identifying Posttraumatic Stress Disorder than either profile elevation or configuration.",0,0 +5487,Peritraumatic dissociation and experiential avoidance as prospective predictors of posttraumatic stress symptoms.,"Peritraumatic dissociation (PD) and experiential avoidance (EA) have been implicated in the etiology of posttraumatic stress symptomatology (PTSS); however, the function of these two factors in the onset and maintenance of PTSS following a potentially traumatic event is unclear. The temporal relationships between EA, PD, and the four clusters of PTSS proposed by the Simms/Watson dysphoria model (Simms, Watson, & Doebbeling, 2002) were examined in a three-wave prospective investigation of 532 undergraduate women participating in an ongoing longitudinal study at the time of a campus shooting. Path analyses indicated that preshooting EA predicted greater PD, intrusions, and dysphoria symptoms approximately one month postshooting. PD was associated with increased symptomatology across all four clusters 1-month postshooting, while 1-month postshooting EA was associated with higher dysphoria and hyperarousal symptoms eight months postshooting. PD had a significant indirect effect on all four PTSS clusters eight months postshooting via 1-month postshooting symptom reports. The results suggest that both EA and PD show unique influences as risk factors for PTSS following a potentially traumatic event.",0,0 +5488,Aggression in war veterans suffering from posttraumatic stress disorder with co-morbid alcoholism.,"For thousands of years it has been known that aggression as a symptom appears in numerous psychiatric disorders and diseases. During the last decade the appearance of the aggressive behavior related to the posttraumatic stress disorder (PTSD) has been frequently investigated, often associated with war trauma. The goal of this study is to analyze the impact of alcoholism on a way war veterans suffering from chronic PTSD express and control aggression. The sample included 240 war veterans with chronic PTSD. The subjects were divided in two groups. PTSD group (n=147) and controlled group composed of those suffering from alcoholism in addition to PTSD (n=93). In this study, the following psychological instruments were used: The Harvard trauma questionnaire for PTSD diagnosis (HTQ); the questionnaire for self-evaluation of aggression (STAXI); The Profile Index Emotion (PIE); questionnaire for auto-diagnosis of alcoholism (CAGE). The obtained results indicate that subjects who have PTSD with co-morbid alcoholism are more deprived, aggressive (p < 0.001) and oppositional (p < 0.05) in comparison to subjects whose PTSD is not combined with alcoholism (PIE). The aggression is statistically more expressed in subjects with PTSD who have also been diagnosed with alcoholism on all subscales in comparison to subjects with PTDS who have not been diagnosed with alcoholism: the current state of aggression, the general state of aggression, aggression towards an unfair treatment, aggression directed inwards and outwards (p < 0.001); aggression towards nonspecific provocation and a general way of expressing aggression (p < 0.05) (STAXI). Subjects that had PTSD combined with alcoholism show a higher degree of aggression in comparison to subjects with PTDS who are not diagnosed with alcoholism.",0,0 +5489,Posttraumatic stress disorder: the burden to the individual and to society.,"Little is known about the total population prevalence and societal costs of posttraumatic stress disorder (PTSD); this report reviews relevant literature on these topics.A literature search of computerized databases for published reports on trauma and PTSD was conducted. This literature was reviewed to find data on general population exposure to trauma, conditional risk of PTSD among those exposed to trauma both in focused samples of trauma victims and in general population samples, and the adverse consequences of PTSD.PTSD was found to be a commonly occurring disorder that often has a duration of many years and is frequently associated with exposure to multiple traumas. The impairment associated with PTSD in U.S. samples, where the majority of research on these consequences has been carried out, is comparable to, or greater than, that of other seriously impairing mental disorders. Risk of suicide attempts is particularly high among people with PTSD. Available evidence suggests that the prevalence of PTSD and the adverse emotional and psychological consequences of PTSD are much greater in the many countries around the world that are in the midst of armed conflicts involving political, racial, or ethnic violence.PTSD is a highly prevalent and impairing condition. Only a minority of people with PTSD obtain treatment. Early and aggressive outreach to treat people with PTSD could help reduce the enormous societal costs of this disorder.",0,0 +5490,Posttraumatic stress disorder and major depressive disorder is common in parents of children with epilepsy,"The purpose of the study was to determine the prevalence of posttraumatic stress disorder (PTSD), posttraumatic stress symptoms (PTSS), and major depressive disorder (MDD) in parents of children with epilepsy.Parents (77 mothers and 3 fathers) of children with epilepsy were administered the Structured Clinical Interview for DSM-IV (SCID), PTSD and MDD modules, and the General Health Questionnaire (GHQ).The prevalence of both PTSD and MDD was 31.5%. Fifty-six percent (n = 14) of the participants with PTSD had a diagnosis of MDD. PTSD symptom clusters were very prevalent in the parents of children with epilepsy. Reexperiencing and arousal symptom clusters were more frequent (88.8 and 80% respectively) than the avoidance and numbing symptom cluster (32.5%).These findings suggest that a significant proportion of parents of children with epilepsy experience PTSD and MDD. Increased awareness of the clinical presentations of these disorders may help clinicians to develop preventive and intervention strategies for parents of children with epilepsy.",0,0 +5491,Longitudinal epigenetic variation of DNA methyltransferase genes is associated with vulnerability to post-traumatic stress disorder,"Epigenetic differences exist between trauma-exposed individuals with and without post-traumatic stress disorder (PTSD). It is unclear whether these epigenetic differences pre-exist, or arise following, trauma and PTSD onset.In pre- and post-trauma samples from a subset of Detroit Neighborhood Health Study participants, DNA methylation (DNAm) was measured at DNA methyltransferase 1 (DNMT1), DNMT3A, DNMT3B and DNMT3L. Pre-trauma DNAm differences and changes in DNAm from pre- to post-trauma were assessed between and within PTSD cases (n = 30) and age-, gender- and trauma exposure-matched controls (n = 30). Pre-trauma DNAm was tested for association with post-trauma symptom severity (PTSS) change. Potential functional consequences of DNAm differences were explored via bioinformatic search for putative transcription factor binding sites (TFBS).DNMT1 DNAm increased following trauma in PTSD cases (p = 0.001), but not controls (p = 0.067). DNMT3A and DNMT3B DNAm increased following trauma in both cases (DNMT3A: p = 0.009; DNMT3B: p < 0.001) and controls (DNMT3A: p = 0.002; DNMT3B: p < 0.001). In cases only, pre-trauma DNAm was lower at a DNMT3B CpG site that overlaps with a TFBS involved in epigenetic regulation (p = 0.001); lower pre-trauma DNMT3B DNAm at this site was predictive of worsening of PTSS post-trauma (p = 0.034). Some effects were attenuated following correction for multiple hypothesis testing.DNAm among trauma-exposed individuals shows both longitudinal changes and pre-existing epigenetic states that differentiate individuals who are resilient versus susceptible to PTSD. These distinctive DNAm differences within DNMT loci may contribute to genome-wide epigenetic profiles of PTSD.",0,0 +5492,A person-centred approach to modelling population experiences of trauma and mental illness,"Background: Exposure to traumatic events has been implicated in the onset and development of a range of psychiatric disorders. People can be exposed to multiple traumatic events and previous research suggests that traumatic experiences may cluster at the individual level. Methods: This study aimed to examine the distribution of traumatic experiences in a large nationally representative sample using latent class analysis, and estimate the relationship between these classes and a number of demographic and clinical variables. Data from the National Comorbidity Survey was used. Results: Four latent classes, each representative of a range of traumatic experiences were identified. The classes were labelled 'high risk' (class 1), 'exposure to non-sexual adult interpersonal/non-interpersonal trauma' (class 2), 'intermediate risk/sexual abuse' (class 3), and 'low risk' (class 4). Each of the latent classes was predicted by several of the demographic variables. In addition, membership of classes 1, 2, and 3 increased the risk of each of the clinical variables. Conclusions: The findings have clinical implications for the assessment of trauma histories across a range of psychiatric diagnoses. © 2010 Springer-Verlag.",0,0 +5493,Disaster severity and emotional disturbance: implications for primary mental health care in developing countries,"ABSTRACT Two months following the 1987 earthquakes in Ecuador, 150 patients in the primary health care clinics of the area were screened for emotional problems; 40% of them were emotionally distressed. Risk factors included not being married, reporting poor physical or emotional health, and having ill-defined physical complaints. The findings from this research are discussed in relation to a disaster of much greater intensity, whose victims were studied by the authors, utilizing the same instrument and research design. The comparison between these 2 groups of disaster victims revealed that: 1) the prevalence of emotional distress was smaller among the Ecuador victims, but the frequency of symptoms among the distressed was similar for both groups; 2) the symptom profiles were remarkably similar; and 3) the most frequent symptoms and the strongest predictors of emotional distress were very similar. These findings support a focused training of health care workers on selected emotional problems that are regularly present among victims of different disasters.",0,0 +5494,Implementation of integrated therapies for comorbid post-traumatic stress disorder and substance use disorders in community substance abuse treatment programs,"The high prevalence of trauma and post-traumatic stress disorder (PTSD) in individuals with substance use disorders (SUDs) presents a number of treatment challenges for community treatment providers and programs in the USA. Although several evidence-based, integrated therapies for the treatment of comorbid PTSD/SUD have been developed, rates of utilisation of such practices remain low in community treatment programs.The goal of this article was to review the extant literature on common barriers that prevent adoption and implementation of integrated treatments for PTSD/SUD among substance abuse community treatment programs.Organisational, provider-level and patient-level factors that drive practice decisions were discussed, including organisational philosophy of care policies, funding and resources, as well as provider and patient knowledge and attitudes related to implementation of new integrated treatments for comorbid PTSD and SUD.Understanding and addressing these community treatment challenges may facilitate use of evidence-based integrated treatments for comorbid PTSD and SUD.",0,0 +5495,Normal Grief and Complicated Bereavement Among Traumatized Cambodian Refugees: Cultural Context and the Central Role of Dreams of the Dead,"This article profiles bereavement among traumatized Cambodian refugees and explores the validity of a model of how grief and post-traumatic stress disorder (PTSD) interact in this group to form a unique bereavement ontology, a model in which dreams of the dead play a crucial role. Several studies were conducted at a psychiatric clinic treating Cambodian refugees who survived the Pol Pot genocide. Key findings included that Pol Pot deaths were made even more deeply disturbing owing to cultural ideas about “bad death” and the consequences of not performing mortuary rites; that pained recall of the dead in the last month was common (76 % of patients) and usually caused great emotional and somatic distress; that severity of pained recall of the dead was strongly associated with PTSD severity (r = .62); that pained recall was very often triggered by dreaming about the dead, usually of someone who died in the Pol Pot period; and that Cambodians have a complex system of interpretation of dreams of the deceased that frequently causes those dreams to give rise to great distress. Cases are provided that further illustrate the centrality of dreams of the dead in the Cambodian experiencing of grief and PTSD. The article shows that not assessing dreams and concerns about the spiritual status of the deceased in the evaluation of bereavement results in “category truncation,” i.e., a lack of content validity, a form of category fallacy.",0,0 +5496,Posttraumatic Stress and Depressive Reactions Among Nicaraguan Adolescents After Hurricane Mitch,"This study determined the severity of posttraumatic stress and depressive reactions among Nicaraguan adolescents after Hurricane Mitch and the relationship of these reactions to objective and subjective features of hurricane exposure, death of a family member, forced relocation, and thoughts of revenge.Six months after the hurricane, 158 adolescents from three differentially exposed cities were evaluated by using a hurricane exposure questionnaire, the Child Posttraumatic Stress Disorder Reaction Index, and the Depression Self-Rating SCALE:Severe levels of posttraumatic stress and depressive reactions were found among adolescents in the two most heavily affected cities. Severity of posttraumatic stress and depressive reactions and features of objective hurricane-related experiences followed a ""dose-of-exposure"" pattern that was congruent with the rates of death and destruction across cities. Level of impact (city), objective and subjective features, and thoughts of revenge accounted for 68% of the variance in severity of posttraumatic stress reaction. Severity of posttraumatic stress reaction, death of a family member, and sex accounted for 59% of the variance in severity of depression.After a category 5 hurricane, adolescents in heavily affected areas with extreme objective and subjective hurricane-related traumatic features of exposure experience severe and chronic posttraumatic stress and comorbid depressive reactions. The recovery of the severely affected Nicaraguan adolescents is vital to the social and economic recovery of a country ravaged by years of political violence and poverty. These findings strongly indicate the need to incorporate public mental health approaches, including systematic screening and trauma/grief-focused interventions, within a comprehensive disaster recovery program.",0,0 +5497,Substance Use and Mental Health Trends Among U.S. Military Active Duty Personnel: Key Findings From the 2008 DoD Health Behavior Survey,"Examine substance use and mental health issues among U.S. military personnel.Data were from the 2008 (and before) population-based Department of Defense Health Related Behavior Surveys. The sample size for the 2008 survey was 28,546 (70.6% response rate).Analyses examined substance use, stress, depression, post-traumatic stress disorder (PTSD), suicidal ideation and attempts, deployment, and job satisfaction. Trends show reductions in tobacco use and illicit drug use, but increases in prescription drug misuse, heavy alcohol use, stress, PTSD, and suicidal attempts. Deployment exacerbated some of these behavior changes. Despite the demanding lifestyle, job satisfaction was high.The military has shown progress in decreasing cigarette smoking and illicit drug use. Additional emphasis should be placed on understanding increases in prescription drug misuse, heavy alcohol use, PTSD, and suicide attempts, and on planning additional effective interventions and prevention programs. Challenges remain in understanding and addressing military mental health needs.",0,0 +5498,On Freedom and Induction,"Traumatizing events and traumatizing conflicts may lead to defense mechanisms which in the course of time become part of character formation. In psychosomatic medicine much attention has been paid in the past to the so-called psychosomatic character profiles. Though discussions about psychosomatic specificity have remained controversial, it still seems advisable to take into account the power of induction of specific defense strategies. In this paper special attention is paid to the fact that asthmatics, patients suffering from hypertension or coronary heart disease, as well as patients suffering from other psychosomatic syndromes, and even patients suffering from carcinoma may induce their own defense strategies in interviewers and therapists, who usually are not sufficiently aware of the fact of such transference phenomena. A distortion of the normal psychotherapeutic process is more often a result of induction processes than has been thought of.",0,0 +5499,Eficacia del MMPI-A en casos forenses de acoso escolar: Simulación y daño psicológico,"The efficacy of forensic evaluation of the psychological injury based on the MMPI-2 and a clinical interview has been continuously supported by literature. Nevertheless, there is no evidence of the efficacy of the MMPI for adolescents (MMPI-A) for bullying cases. To contrast the efficacy of the MMPI-A in bullying cases, 107 adolescents ranged from 14 to 18 years old (M = 14.85) endorsed the Spanish adaptation of the MMPI-A under standard and malingering instructions. The results showed a high adolescent ability (91.6% for posttraumatic stress disorder, ranging from 60 to 90% for comorbid posttraumatic stress disorders) to malinger both the direct (posttraumatic stress disorder) and indirect (depression, anxiety, psychosomatic problems, problems in interpersonal relationships) psychological injury. Four malingering strategies were identified in malingering protocols: indiscriminate symptom endorsement, symptom severity, obvious symptoms, and infrequent symptoms. The F, F1, F2 and K standard validity scales discriminated significantly and with a large effect size between genuine and malingered responding. Likewise, the F-K index and the L and K < 45 and F < 80 profile discriminated significantly and with a large effect size between genuine and malingered responding. The study of cases revealed excellent classification rates of the standard validity scales (K < 40) and indices for malingered (true positives) and honest (false positives) responding. Implications for forensic practice are discussed.",0,0 +5500,Childhood Maltreatment and Cluster B Personality Pathology in Female Serious Offenders,"The authors examined early maltreatment among serious female offenders at a maximum-security correctional facility, contrasting the maltreatment histories of inmates with and without Cluster B personality pathology. Women were interviewed regarding the frequency of 13 indicators of psychological or physical abuse perpetrated by maternal or paternal caregivers and the frequency of 10 types of sexual abuse perpetrated by persons at least 5 years older. Reports were based on inmates' recollected worst years of maltreatment before age 16. Women in both diagnostic groups reported substantial early maltreatment. Cluster B inmates reported higher levels and a greater variety of maternal and paternal physical and psychological abuse but were not distinguished from non—Cluster B inmates on levels of childhood sexual abuse. Inmates reported more physical and psychological abuse from maternal than paternal caregivers. The results document the high levels of childhood maltreatment of female prisoners and the relevance of this history to personality pathology.",0,0 +5501,Mindful Awareness and Non-judging in Relation to Posttraumatic Stress Disorder Symptoms,"The objective of this cross-sectional study was to assess group differences between veterans with and without posttraumatic stress disorder (PTSD) in mindful awareness and mindful non-judging. The relationships between mindfulness and PTSD symptom clusters were also evaluated. Three age and gender-matched groups, (1) 15 combat veterans with PTSD, (2) 15 combat veterans without PTSD, and (3) 15 non-combat veterans without PTSD, completed the Mindful Attention Awareness Scale and the Accept without Judgment Scale. PTSD status was determined with the Clinician Administered PTSD Scale and excluded disorders screened with the Structured Clinical Interview for DSM-IV. Mindfulness scale group differences were assessed with analysis of variance. Mindfulness and the PTSD symptom clusters relationships were assessed with hierarchical regression analysis. There were group differences on mindful non-judging (F(2,44) = 7.22, p = .002) but not mindful awareness (p > .05). Combat exposure accounted for significant variation in PTSD symptoms (hyper-arousal 47%; numbing-avoiding 32%; re-experiencing 23%). Mindfulness accounted for a significant percentage variance of PTSD symptoms (re-experiencing 32%; numbing-avoiding 19%, hyper-arousal 16%), beyond combat exposure effects, although only mindful non-judging was significant in the model. This study confirms in a clinical sample that mindful non-judging is associated with PTSD symptoms and could represent a meaningful focus for treatment.",0,0 +5502,Alcohol Use and Alcohol-Related Problems Before and After Military Combat Deployment,"High rates of alcohol misuse after deployment have been reported among personnel returning from past conflicts, yet investigations of alcohol misuse after return from the current wars in Iraq and Afghanistan are lacking.To determine whether deployment with combat exposures was associated with new-onset or continued alcohol consumption, binge drinking, and alcohol-related problems.Data were from Millennium Cohort Study participants who completed both a baseline (July 2001 to June 2003; n=77,047) and follow-up (June 2004 to February 2006; n=55,021) questionnaire (follow-up response rate = 71.4%). After we applied exclusion criteria, our analyses included 48,481 participants (active duty, n = 26,613; Reserve or National Guard, n = 21,868). Of these, 5510 deployed with combat exposures, 5661 deployed without combat exposures, and 37 310 did not deploy.New-onset and continued heavy weekly drinking, binge drinking, and alcohol-related problems at follow-up.Baseline prevalence of heavy weekly drinking, binge drinking, and alcohol-related problems among Reserve or National Guard personnel who deployed with combat exposures was 9.0%, 53.6%, and 15.2%, respectively; follow-up prevalence was 12.5%, 53.0%, and 11.9%, respectively; and new-onset rates were 8.8%, 25.6%, and 7.1%, respectively. Among active-duty personnel, new-onset rates were 6.0%, 26.6%, and 4.8%, respectively. Reserve and National Guard personnel who deployed and reported combat exposures were significantly more likely to experience new-onset heavy weekly drinking (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.36-1.96), binge drinking (OR, 1.46; 95% CI, 1.24-1.71), and alcohol-related problems (OR, 1.63; 95% CI, 1.33-2.01) compared with nondeployed personnel. The youngest members of the cohort were at highest risk for all alcohol-related outcomes.Reserve and National Guard personnel and younger service members who deploy with reported combat exposures are at increased risk of new-onset heavy weekly drinking, binge drinking, and alcohol-related problems.",0,0 +5503,Peripartum depression and anxiety as an integrative cross domain target for psychiatric preventative measures,"Exposure to high levels of early life stress has been identified as a potent risk factor for neurodevelopmental delays in infants, behavioral problems and autism in children, but also for several psychiatric illnesses in adulthood, such as depression, anxiety, autism, and posttraumatic stress disorder. Despite having robust adverse effects on both mother and infant, the pathophysiology of peripartum depression and anxiety are poorly understood. The objective of this review is to highlight the advantages of using an integrated approach addressing several behavioral domains in both animal and clinical studies of peripartum depression and anxiety. It is postulated that a greater focus on integrated cross domain studies will lead to advances in treatments and preventative measures for several disorders associated with peripartum depression and anxiety.",0,0 +5504,Symptoms of Post-Traumatic Stress Disorder in Bereaved Children and Adolescents: Factor Structure and Correlates,"This study investigated the factor structure and correlates of posttraumatic stress-disorder (PTSD) symptoms among children and adolescents confronted with the death of a loved one. Three hundred thirty-two bereaved children and adolescents (aged 8-18; 56.9 % girls) who all received some form of psychosocial support after their loss, completed self-report measures of PTSD, together with measures tapping demographic and loss-related variables, depression, prolonged grief, and functional impairment. Parent-rated indices of impairment were also collected. We first evaluated the fit of six alternative models of the factor structure of PTSD symptoms, using confirmatory factor analyses. Outcomes showed that the 4-factor numbing model from King et al. (Psychological Assessment 10, 90-96, 1998), with distinct factors of reexperiencing, avoidance, emotional numbing, and hyperarousal fit the data best. Of all participants, 51.5 % met DSM-IV criteria for PTSD. PTSD-status and scores on the PTSD factors varied as a function of age and gender, but were unrelated to other demographic and loss-related variables. PTSD-status and scores on the PTSD factors were significantly associated symptom-levels of depression, prolonged grief, and functional impairment. Findings complement prior evidence that the DSM-IV model of the factor structure of PTSD symptoms may not represent the best conceptualization of these symptoms and highlight the importance of addressing PTSD symptoms in children and adolescents seeking help after bereavement. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +5505,Analyzing small data sets using Bayesian estimation: the case of posttraumatic stress symptoms following mechanical ventilation in burn survivors,"Background : The analysis of small data sets in longitudinal studies can lead to power issues and often suffers from biased parameter values. These issues can be solved by using Bayesian estimation in conjunction with informative prior distributions. By means of a simulation study and an empirical example concerning posttraumatic stress symptoms (PTSS) following mechanical ventilation in burn survivors, we demonstrate the advantages and potential pitfalls of using Bayesian estimation. Methods : First, we show how to specify prior distributions and by means of a sensitivity analysis we demonstrate how to check the exact influence of the prior (mis-) specification. Thereafter, we show by means of a simulation the situations in which the Bayesian approach outperforms the default, maximum likelihood and approach. Finally, we re-analyze empirical data on burn survivors which provided preliminary evidence of an aversive influence of a period of mechanical ventilation on the course of PTSS following burns. Results : Not suprisingly, maximum likelihood estimation showed insufficient coverage as well as power with very small samples. Only when Bayesian analysis, in conjunction with informative priors, was used power increased to acceptable levels. As expected, we showed that the smaller the sample size the more the results rely on the prior specification. Conclusion : We show that two issues often encountered during analysis of small samples, power and biased parameters, can be solved by including prior information into Bayesian analysis. We argue that the use of informative priors should always be reported together with a sensitivity analysis.",0,0 +5506,"An Overview of SSR149415, a Selective Nonpeptide Vasopressin V1b Receptor Antagonist for the Treatment of Stress-Related Disorders","Vasopressin (AVP) and corticotropin-releasing factor (CRF) are key mediators in the organism's neuro-adaptive response to stress. Through pituitary and central vasopressin V(1b) receptors, AVP participates in the control of the hypothalamic-pituitary-adrenal axis (HPA) and is involved in various emotional processes. SSR149415 is the first selective, orally active vasopressin V(1b) receptor antagonist yet described. It is a competitive antagonist with nanomolar affinity for animal and human V(1b) receptors and displays a highly selective profile with regard to a large number of receptors or enzymes. In vitro, SSR149415 potently antagonizes functional cellular events associated with V(1b) receptor activation by AVP, such as intracellular Ca(2+) increase or proliferation in various cell systems. Pharmacological studies, performed by measuring ACTH secretion induced by various stimulants such as hormones (AVP or AVP + CRF) or physical stress (restraint or forced swimming stress and dehydration) in conscious rats or mice, confirm the antagonist profile of SSR149415 and its efficacy in normalizing ACTH secretion in vivo. SSR149415 is active by the oral route, at doses from 3 mg/kg, it potentiates CRF effect and displays a long-lasting oral effect in the different models. At 10 mg/kg p.o. its duration of action is longer than 4 h. This molecule also decreases anxiety and exerts marked antidepressant-like activity in several predictive animal models. The anxiolytic effects of SSR149415 have been demonstrated in various Generalized Anxiety Disorders (GAD) models (four-plate, punished drinking, elevated plus-maze, light dark, mouse defense test battery, fear-potentiated startle and social interaction tests). It is as effective as the benzodiazepine diazepam in the acute stress exposure test. SSR149415 has similar efficacy to the reference antidepressant drug, fluoxetine, in acute (forced-swimming) and chronic (chronic mild stress and subordination stress) situations in rodents. SSR149415 also reduces offensive aggression in the resident-intruder model in mice and hamsters. Depending on the model, the minimal effective doses are in the range of 1-10 mg/kg i.p. or 3-10 mg/kg p.o. SSR149415 is devoid of adverse effects on motor activity, sedation, memory or cognitive functions and produces no tachyphylaxis when administered repeatedly. It is well-tolerated in animals and humans and exhibits an adequate ADME profile. Thus, SSR149415 is a new dual anxiolytic/antidepressant compound, which appears to be free of the known side effects of classical anxiolytic/antidepressant drugs. Clinical trials are in progress, they will hopefully demonstrate its therapeutical potential for treating stress-related disorders.",0,0 +5507,Early fear as a predictor of avoidance in a rat model of post-traumatic stress disorder,"Exposure of humans and animals to an intensely fearful experience can lead to an enduring behavioral profile involving fear and avoidance. The present study examined if rats that show more fear to a novel tone one day after exposure to footshocks exhibit more avoidance-like responses over a 4-week period. Rats were exposed to an episode of moderately intense footshock (5×2s episodes of 1.5mA presented randomly over 3min). Shock rats that exhibited a high level of fear (HR) to a novel tone one day after the shock exposure showed more avoidance of open spaces and novel rats when compared to shock rats that exhibited a lower level of fear to the novel tone (LR). Similarly, HR emitted more ultrasonic vocalization in the dysphoric range (20-30kHz) when placed in a novel chamber or the chamber in which shock was given. This study highlights the importance of early fear as a contributing factor for the development of lasting changes in avoidance. These results also support the view that the presence of an intense peritraumatic stress response may be a predictor of the subsequent development of a lasting negative emotional state in humans exposed to trauma.",0,0 +5508,Post-traumatic stress disorder and smoking: A systematic review,"We conducted a systematic review of what is known about the relationship between post-traumatic stress disorder (PTSD) and smoking to guide research on underlying mechanisms and to facilitate the development of evidence-based tobacco treatments for this population of smokers. We searched Medline, PsychINFO, and the Cochrane Central Register of Controlled Trials and identified 45 studies for review that presented primary data on PTSD and smoking. Smoking rates were high among clinical samples with PTSD (40%-86%) as well as nonclinical populations with PTSD (34%-61%). Most studies showed a positive relationship between PTSD and smoking and nicotine dependence, with odds ratios ranging between 2.04 and 4.52. Findings also suggest that PTSD, rather than trauma exposure itself, is more influential for increasing risk of smoking. A small but growing literature has examined psychological factors related to smoking initiation and maintenance and the overlapping neurobiology of PTSD and nicotine dependence. Observational studies indicate that smokers with PTSD have lower quit rates than do smokers without PTSD. Yet a few tobacco cessation treatment trials in smokers with PTSD have achieved quit rates comparable with controlled trials of smokers without mental disorders. In conclusion, the evidence points to a causal relationship between PTSD and smoking that may be bidirectional. Specific PTSD symptoms may contribute to smoking and disrupt cessation attempts. Intervention studies that test behavioral and pharmacological interventions designed specifically for use in patients with PTSD are needed to reduce morbidity and mortality in this population.",0,0 +5509,"The relationship between neuroticism, pre-traumatic stress, and post-traumatic stress: a prospective study","Abstract The personality trait of Neuroticism has been repeatedly associated with symptoms of post-traumatic stress disorder (PTSD). However, the nature of this relationship is unclear. There are at least two possible interpretations: neuroticism might be a risk factor for PTSD symptoms, or, alternatively, the relationship might be based on content overlap in arousal symptoms. With a prospective design, this study tested both possibilities. About 1370 women volunteers completed questionnaires early in pregnancy, measuring neuroticism and ‘baseline’ arousal symptoms, and for every 2 months thereafter until 1 month after the due date of birth. Of these, 126 had a pregnancy loss, and most of them were assessed for PTSD symptoms 1 month later. The results showed that pre-trauma neuroticism strongly predicted PTSD symptoms, and particularly PTSD arousal symptoms, after pregnancy loss. However, neuroticism was also strongly related to pre-trauma arousal. After statistically controlling for pre-trauma arousal symptoms, the relationship between neuroticism and PTSD symptoms after pregnancy loss was no longer significant. In other words, neuroticism did not predict rises in these symptoms from pre to post-trauma. This suggests that PTSD arousal symptoms tap a specific aspect of neuroticism, and that content-overlap largely accounts for the relationship between neuroticism and PTSD symptoms.",0,0 +5510,Posttraumatic Stress Disorder Symptoms and Precombat Sexual and Physical Abuse in Desert Storm Veterans,"The purpose of this research was to study the association between precombat sexual and physical abuse and combat-related posttraumatic stress disorder (PTSD) symptoms in a clinical sample of male and female Desert Storm veterans. Two hundred ninety-seven veterans provided data on precombat sexual and physical abuse, precombat psychiatric problems, sociodemographics, Desert Storm combat exposure, and PTSD symptomatology using the Mississippi Scale. Men reported significantly higher levels of combat exposure, and women described significantly more frequent precombat abuse. Precombat-abused veterans reported more frequent precombat psychiatric histories. Analysis of covariance revealed that gender significantly modified the impact of precombat abuse on combat-related and other PTSD symptomatology after adjusting for precombat psychiatric history and level of combat exposure. Specifically, females describing precombat abuse reported much greater PTSD symptomatology than did females denying precombat abuse. These results in conjunction with previous research suggest that a relationship between precombat abuse and combat-related PTSD may exist. Prospective, longitudinal studies of both men and women are needed.",0,0 +5511,Post-traumatic stress disorder among recently diagnosed patients with HIV/AIDS in South Africa,"This study examined the prevalence of and factors associated with post-traumatic stress disorder in recently diagnosed HIV/AIDS patients in South Africa. One hundred and forty-nine (44 male, 105 female) recently diagnosed HIV/AIDS patients (mean duration since diagnosis = 5.8 months, SD = 4.1) were evaluated. Subjects were assessed using the MINI International Neuropsychiatric Interview (MINI), the Carver Brief COPE coping scale and the Sheehan Disability Scale. In addition, previous exposures to trauma and past risk behaviours were assessed. Twenty-two patients (14.8%) met criteria for PTSD. Current psychiatric conditions more likely to be associated with PTSD included major depressive disorder (29% in PTSD patients versus 7% in non-PTSD patients, p = 0.004), suicidality (54% versus 11%, p = 0.001) and social anxiety disorder (40% versus 13%, p = 0.04). Further patients with PTSD reported significantly more work impairment and demonstrated a trend towards higher usage of alcohol as a means of coping. Discriminant function analysis indicated that female gender and a history of sexual violation in the past year were significantly associated with a diagnosis of PTSD. Patients whose PTSD was a direct result of an HIV/AIDS diagnosis (8/22) did not differ from other patients with PTSD on demographic or clinical features. In the South African context, PTSD is not an uncommon disorder in patients with HIV/AIDS. In some cases, PTSD is secondary to the diagnosis of HIV/AIDS but in most cases it is seen after other traumas, with sexual violation and intimate partner violence in women being particularly important.",0,0 +5512,Traumatic events and post-traumatic stress disorder,"(from the chapter) Examines the role of traumatic events in the development of anxiety disorders in children, particularly posttraumatic stress disorder (PTSD), differentiating between single acute events and chronic and/or repeated ones. The relationships is placed between traumatic event and stress reaction within a developmental psychopathological context by looking at risk and protective factors in the etiology and maintenance of stress reactions. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5513,Relationship Between Peer Victimization and Posttraumatic Stress Among Primary School Children,"Peer victimization is a common stressor experienced by children. Although peer victimization has been studied extensively, few studies have examined the potential link between peer victimization and posttraumatic stress disorder (PTSD), and no studies of which we are aware have examined this link among children in primary school. The paucity of studies examining the link between PTSD and peer victimization in primary school is surprising because peer victimization occurs more frequently and is more likely to be physical among 7- and 8-year-old children. This study assessed the relationship between peer victimization and PTSD in a sample of 358 elementary school children (ages 6-11 years). Results indicated that peer victimization accounted for 14.1% of PTSD symptom severity among boys and 10.1% among girls. Additionally, we found gender differences in the types of peer victimization that were most associated with PTSD symptom severity (d = 0.38). The long-term developmental consequences that may be associated with peer victimization-linked PTSD symptomatology are discussed.",0,0 +5514,Development and validation of the Computerized Clinician Administered Post-Traumatic Stress Disorder Scale-1-Revised,"Synopsis A computer administered version of the clinician administered post-traumatic stress disorder (PTSD) scale-1 was developed to assess PTSD in subjects presenting with psychological symptoms following exposure to a traumatic event. Both forms were administered to 40 subjects who met the Diagnostic and Statistical Manual, third edition, revised (DSM-III-R) criteria for exposure to a significantly traumatic stressor. Inter-observer reliability was demonstrated with a kappa statistic of 0·90. The computer version had a sensitivity of 0·95 and a specificity 0·95. A correlation of 0·95 was found between the two versions and the mean score difference was non-significant. The computer form demonstrated adequate internal reliability and test–retest reliability. Overall results suggest the computer version is a valid and reliable measure of PTSD.",0,0 +5515,Prospective investigation of a PTSD personality typology among individuals with personality disorders,"This study investigated the replicability of a previously proposed personality typology of posttraumatic stress disorder (PTSD, and explored stability of cluster membership over a 6-month period. Participants with current PTSD (n = 156) were drawn from the Collaborative Longitudinal Personality Disorders Study (CLPS). The CLPS project tracked a large sample of individuals who met criteria for 1 of 4 target diagnoses (borderline, schizotypal, avoidant, and obsessive-compulsive) and a contrast group of individuals who met criteria for depression but no personality disorder. A cluster analysis using scales from the Schedule of Nonadaptive and Adaptive Personality yielded 3 clusters: ""internalizing,"" ""externalizing,"" and ""low pathology."" Using K-means cluster analysis, the results did not replicate previous work. Using Ward's method, the hypothesized 3-cluster structure was confirmed at baseline but did not demonstrate temporal stability at 6 months.",0,0 +5516,Relationship Between Post-traumatic Stress Disorder and Pain in Two American Indian Tribes,"To estimate the association of lifetime post-traumatic stress disorder (PTSD) and pain in American Indians, and determine if tribe, sex, cultural and psychosocial factors, or major depression influence the magnitude of this association.A cross-sectional probability sample survey completed between 1997 and 2000. A structured interview was conducted by trained, tribal members to gather information on demographic and cultural features, physical health status, psychiatric disorders, and functional status.General community.A total of 3,084 individuals randomly selected from the tribal rolls of a Southwestern (N = 1,446) and a Northern Plains (N = 1,638) tribal group who were 15-54 years of age and lived on or within 20 miles of their reservations.Bodily pain subscale of the Short Form-36. Linear regression models were fit to examine the association between lifetime PTSD and pain, adjusting for demographic, cultural, psychosocial features, painful medical conditions, and major depression.The prevalence of lifetime PTSD was 16% in the Southwestern and 14% in the Northern Plains; women were nearly twice as likely as men to have lifetime PTSD in both tribes. The final adjusted model demonstrated that mean Short Form-36 bodily pain subscale scores were lower (indicating more pain) among individuals with lifetime PTSD than those without lifetime PTSD. Effect modification by tribe, sex, and depression was not observed.Lifetime PTSD was strongly associated with bodily pain in this rural sample of American Indians. Clinicians should be aware of, and address, the link between physical pain syndromes and PTSD.",0,0 +5517,A Prospective Study of Coping After Exposure to a Mass Murder Episode,"In a study of 136 survivors of a mass murder spree, multidimensional scaling identified clusters of responses mapping from 75 coping behaviors described by victims. This powerful method identified three coping dimensions: (a) Active Outreach versus Passive Isolation, (b) Informed Pragmatism versus Abandonment of Control, and (c) Reconciliation/Acceptance versus Evading the Status Quo. These coping dimensions were used to predict change in psychiatric status prospectively assessed with structured diagnostic interviews at index 3-4 months after the event and follow-up assessments 1 and 3 years later. Statistically significant changes in the positive direction on each of the three dimensions in this study were associated with reductions of 47-79% of the odds for acute postdisaster major depression, posttraumatic stress disorder (PTSD), and any non-PTSD disorder. These findings suggest mechanisms for development of therapeutic techniques capitalizing on encouraging active outreach, informed focus and pragmatism, and reconciliation and acceptance, and reduction of passive and isolative behaviors, resignation of control, and avoidance of realities of the postdisaster situation.",0,0 +5518,"Event Trauma in Early Childhood: Symptoms, Assessment, Intervention","Expanding research over the last two decades has documented that very young children's responses to an event trauma will involve the same three basic categories of posttraumatic symptomatology observed in older children and adults that is, reexperiencing, numbing/avoidance, and hyperarousal. The ways in which these three symptom clusters will be manifested in very young children and recent progress in the establishment of developmentally sensitive and reliable criteria for the diagnosis of posttraumatic stress disorder (PTSD) in this age group are described. In addition to PTSD symptomatology, three additional factors that differentiate young children's responses to a trauma from those of older children and adults-their cognitive immaturity, their developmental vulnerability, and the relational context of early trauma given young children's dependence on caregivers-also are discussed. Principles of assessment and treatment are then described. These discussions emphasize the importance of normalizing traumatic responses, supporting the parent-child relationship and restoring trust, desensitizing the child's distress to traumatic reminders, helping the child and parents to process and develop a meaningful narrative of the traumatic event through expressive therapeutic techniques, and promoting effective strategies of restoration and repair.",0,0 +5519,The mental health of unaccompanied refugee minors on arrival in the host country,"Despite increasing numbers of unaccompanied refugee minors (UM) in Europe and heightened concerns for this group, research on their mental health has seldom included the factor ""time since arrival."" As a result, our knowledge of the mental health statuses of UM at specific points in time and over periods in their resettlement trajectories in European host countries is limited. This study therefore examined the mental health of UM shortly after their arrival in Norway (n = 204) and Belgium (n = 103) through the use of self-report questionnaires (HSCL-37A, SLE, RATS, HTQ). High prevalence scores of anxiety, depression and posttraumatic stress disorder (PTSD) symptoms were found. In addition, particular associations were found with the number of traumatic events the UM reported. The results indicate that all UM have high support needs on arrival in the host country. Longitudinal studies following up patterns of continuity and change in their mental health during their trajectories in the host country are necessary.",0,0 +5520,Evaluation of the Psychological Status in Chronic Low Back Pain: Comparison with General Population,"Multiple studies have documented a strong association between chronic low back pain and psychopathology including personality disorders, depressive disorders, anxiety, and somatoform disorders along with non-specific issues such as emotion, anger and drug dependency. However, depression, anxiety and somatization appear to be crucial. There are no controlled trials in interventional pain management settings. This study was designed to evaluate 40 individuals without pain or psychotherapeutic drug therapy, Group I, control group; and Group II, chronic low back pain group with 40 chronic low back pain patients. All the participants were tested utilizing Pain Patient Profile (P3). Significant differences were found among various clinical syndromes with generalized anxiety disorder, somatoform disorder, and depression, with 0% vs 20%, 0% vs 20%, and 5% vs 30% in Group I and Group II consecutively. This evaluation showed that clinical syndromes were seen in a greater proportion of patients with chronic low back pain emphasizing the importance of evaluation of the patients for generalized anxiety disorder, somatoform disorder, and for depression.",0,0 +5521,Rape-related psychotraumatic syndromes,"This study took place in a forensic center for rape victims. Our aims were: first, to explore the longitudinal course of post-traumatic stress disorder (PTSD) and prevalence of disorders over the 6-month period following rape, then second, to group these disorders into syndromes related to chronic PTSD whilst remaining distinct from it, and third, to establish some predictive factors for chronic PTSD.92 rape victims consecutively admitted to the center were regularly interviewed over a 6-month period by a psychiatrist.The paper confirms that rape leads to a high proportion of PTSD. Generally speaking, the psychopathology following rape is severe. PTSD at 6 months is associated with phobic and dissociative disorders. It is further associated with a cluster of symptoms arising after rape that we term borderline-like. Incestuous rape is a predictive factor for PTSD at 6 months.In the aftermath of rape several semiologically distinct psychotraumatic syndromes exist.",0,0 +5522,The Treatment of Post-Traumatic Stress Disorder Using Redecision Therapy,"This article describes the use of redecision therapy in the treatment of post-traumatic stress disorder. In traumatic situations, people make decisions that appear to increase their possibility of ...",0,0 +5523,Examining the dimensionality of combat-related posttraumatic stress and depressive symptoms in treatment-seeking OEF/OIF/OND veterans,"This study examined the factor structure of two of the most commonly used screening measures of posttraumatic stress disorder and depression in 164 treatment-seeking veterans who served in Operations Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND).Exploratory factor analysis was used to assess the dimensionality of items from the Posttraumatic Stress Disorder Checklist-Military Version (PCL-M) and the Patient Health Questionnaire-9 (PHQ-9). Regression analyses were then conducted to examine associations between factor scores of the resulting factor solution and measures of alcohol use, cognitive coping, psychological resilience, social support, and healthcare utilization.A four-factor solution was found that consisted of clusters of symptoms reflecting reexperiencing/avoidance, detachment/numbing, hopelessness/depression, and bodily disturbance. Scores on the detachment/numbing factor were uniquely related to alcohol use, whereas scores on the hopelessness/depression factor was uniquely associated with emergency room visits. Compared to conventional PCL-M and PHQ-9 total scores, the four-factor solution explained 2 to 10% more variance in scores on measures of alcohol use, cognitive coping, psychological resilience, social support, and healthcare utilization.This study was limited by a small sample size and cross-sectional design.Combat-related posttraumatic stress disorder and depressive symptoms in treatment-seeking OEF/OIF/OND veterans may be better conceptualized by four dimensions of reexperiencing/avoidance, detachment/numbing, hopelessness/depression, and bodily disturbance symptoms. This symptom structure may provide greater utility when examining other outcomes of interest in this population.",0,0 +5524,What predicts post-traumatic stress following spinal cord injury/,"Spinal cord injury (SCI) is a severe, traumatic event and recently research into the role of post-traumatic stress disorder (PTSD) subsequent to the injury has become of increasing interest. This study has been conducted in order to investigate potential risk factors for the development of post-traumatic stress disorder symptoms in those with SCI.This cross-sectional study used multiple regression analysis to look for associations between post-traumatic stress symptom severity, SCI-related factors and previously identified risk factors for PTSD such as dysfunctional cognitions, demographic factors and personality predispositions (neuroticism, alexithymia).A total of 102 participants with SCI completed measures of post-traumatic stress severity, acceptance of injury, post-traumatic cognitions, social support, neuroticism and alexithymia. In addition, information about type, level and cause of the SCI was assessed.High levels of post-traumatic stress symptoms were found. Potential risk factors for the development of PTSD were negative cognitions of self and neuroticism. Variables that added to the variance explained by the models included time since injury and difficulty identifying feelings. Acceptance of injury was mediated by negative cognitions of the self and neuroticism.The study highlights the need for services to be aware of the psychological difficulties experienced by this client group. An important finding is that the acceptance of the injury is mediated by negative cognitions of the self which need to be identified as potential risk factors in order to prevent the development of post-traumatic symptoms in this population.",0,0 +5525,Prospective Longitudinal Evaluation of the Effect of Deployment-Acquired Traumatic Brain Injury on Posttraumatic Stress and Related Disorders: Results From the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS),"Traumatic brain injury (TBI) is increasingly recognized as a risk factor for deleterious mental health and functional outcomes. The purpose of this study was to examine the strength and specificity of the association between deployment-acquired TBI and subsequent posttraumatic stress and related disorders among U.S. Army personnel.A prospective, longitudinal survey of soldiers in three Brigade Combat Teams was conducted 1-2 months prior to an average 10-month deployment to Afghanistan (T0), upon redeployment to the United States (T1), approximately 3 months later (T2), and approximately 9 months later (T3). Outcomes of interest were 30-day prevalence postdeployment of posttraumatic stress disorder (PTSD), major depressive episode, generalized anxiety disorder, and suicidality, as well as presence and severity of postdeployment PTSD symptoms.Complete information was available for 4,645 soldiers. Approximately one in five soldiers reported exposure to mild (18.0%) or more-than-mild (1.2%) TBI(s) during the index deployment. Even after adjusting for other risk factors (e.g., predeployment mental health status, severity of deployment stress, prior TBI history), deployment-acquired TBI was associated with elevated adjusted odds of PTSD and generalized anxiety disorder at T2 and T3 and of major depressive episode at T2. Suicidality risk at T2 appeared similarly elevated, but this association did not reach statistical significance.The findings highlight the importance of surveillance efforts to identify soldiers who have sustained TBIs and are therefore at risk for an array of postdeployment adverse mental health outcomes, including but not limited to PTSD. The mechanism(s) accounting for these associations need to be elucidated to inform development of effective preventive and early intervention programs.",0,0 +5526,"Comparative analysis of trends in paediatric trauma outcomes in New South Wales, Australia","

Abstract

Paediatric trauma centres seek to optimise the care of injured children. Trends in state-wide paediatric care and outcomes have not been examined in detail in Australia. This study examines temporal trends in paediatric trauma outcomes and factors influencing survival and length of stay. A retrospective review was conducted using data from the NSW Trauma Registry during 2003–2008 for children aged 15 years and younger who were severely injured (injury severity score>15). To examine trauma outcomes descriptive statistics and multivariable logistic and linear regression were conducted. There were 1138 children severely injured. Two-thirds were male. Road trauma and falls were the most common injury mechanisms and over one-third of incidents occurred in the home. Forty-eight percent of violence-related injuries were experienced by infants aged less than 1 year. For the majority of children definitive care was provided at a paediatric trauma centre, but less than one-third of children were taken directly to a paediatric trauma centre post-injury. Children who received definitive treatment at a paediatric trauma centre had between 3 and 6 times higher odds of having a survival advantage than if treated at an adult trauma centre. The number of severe injury presentations to the 14 major trauma centres in NSW remains constant. It is possible that injury prevention measures are having a limited effect on severe injury in NSW. This research provides stimulus for change in the provision and co-ordination in the delivery of trauma care for injured children.",0,0 +5527,Geographies of health and climate change,"Climate change presents significant challenges for human health and well-being and geography is contributing a growing field of knowledge relating to these processes. We outline here key dimensions of the debate, pointing to areas where human geographers can make a particularly strong contribution. These include: issues of adaptation and resilience; sustainability; environmental justice and socially unequal impacts of climate change; and psychological as well as physical impacts of environment on health. Key themes in the emerging research agenda include the significance of affect and emotion for the perception and communication of hazard and risk associated with the health impacts of climate change. Also, understanding exposure to health risks of climate change requires knowledge of complex and individually variable daily action spaces and residential mobility over the lifecourse. We argue for research that considers complex processes operating at various geographical scales, linking arguments about ‘global health’ with the more local and individual processes that contribute to health determinants. Much of the literature on health impacts of climate change demonstrates socially and geographically unequal effects, which often exacerbate existing health disparities. This highlights the links between this field of health geography and other geographical research concerned with sustainability and environmental justice.",0,0 +5528,Early Symptom Predictors of Chronic Distress in Gulf War Veterans,"Although there is evidence that specific early hyperarousal, avoidance, and emotional numbing symptoms are associated with later posttraumatic stress disorder (PTSD) symptomatology among veterans, little is known about predictors of later non-PTSD-related psychological symptoms. One and 2 years after serving in the Gulf War, 348 military reservists were assessed for severity of war zone stress, PTSD, psychological distress, and stress-mediated physical complaints. Overall PTSD symptomatology and emotional numbing and hyperarousal symptom clusters increased over time, whereas re-experiencing and avoidance symptoms showed no change. Emotional numbing and hyperarousal symptoms at 1 year predicted generalized distress, depression, anxiety, hostility, and somatic symptoms at 2 years, whereas re-experiencing and avoidance symptoms did not. Findings highlight the importance of targeting early emotional numbing and hyperarousal symptom clusters to reduce longer-term psychological distress.",0,0 +5529,Post-traumatic Stress Disorder (Traumatic War Neurosis) and Concurrent Psychiatric illness Among Australian Vietnam Veterans. A Controlled Study,"Depression, anxiety, irritability with unpredictable explosions of aggressive behaviour, impulsivity, suicidal actions and substance abuse have been repeatedly observed among ex-servicemen from World War II in psychiatric treatment settings. In the most recent American Psychiatric Association classification of mental disorders the category of Post Traumatic Stress Disorder (PTSD) was introduced, replacing the earlier Traumatic War Neurosis and the above cluster of symptoms were included as associated features of this disorder. Two recent uncontrolled studies on U.S. Vietnam veterans receiving psychiatric care supported the linkage of PTSD with these abnormalities. However, the present controlled study found these associated features occurred with equal frequencies among one group of psychiatrically hospitalised Australian Vietnam veterans with PTSD and another group not so afflicted. Reservations, then, should be harboured about ascribing all the presented psychopathology and behavioural abnormalities of ex-servicemen to the stress of their war service.",0,0 +5530,Genetics of glucocorticoid regulation and posttraumatic stress disorder—What do we know?,"CASTRO-VALE, I., E.F.C. van Rossum, J.C. Machado, R. Mota-Cardoso and D. Carvalho. Genetics of glucocorticoid regulation and posttraumatic stress disorder-What do we know? NEUROSCI. BIOBEHAV. REV. 43 (1) XXX-XXX, 2014 - Posttraumatic stress disorder (PTSD) develops in a small proportion of those who have been exposed to a traumatic event. Genetic factors are estimated to be responsible for 30% of the variance in PTSD risk. Dysfunction of the hypothalamic-pituitary-adrenal (HPA)-axis in PTSD has been found, particularly hypersensitivity of the glucocorticoid receptor (GR). In this review we aim to understand the genetic factors that influence glucocorticoid function in PTSD. Glucocorticoid action is regulated by a corticotrophin-releasing hormone, arginine vasopressin (AVP)/oxytocin pathway, GR, and regulators such as co-chaperone FKBP5. Single nucleotide polymorphisms (SNPs) in the GR gene, CRHR1 gene and FKBP5 gene affect HPA-axis sensitivity. The GR gene SNP BclI has been associated with hypersensitivity to glucocorticoids and PTSD symptoms. FKBP5 gene SNPs interacted with childhood adversity to moderate PTSD risk and in particular, the rs9470080 SNP was independently associated with lifetime PTSD. SNPs in the CRHR1 gene were also associated with PTSD risk. Gene-environment interaction studies have highlighted the importance of multifactorial vulnerability in PTSD, with epigenetic mechanisms contributing to the equation.",0,0 +5531,Post-Traumatic Stress Disorder and Suicide Risk: A Systematic Review,"There is a gap in the literature regarding suicide risk among traumatized individuals with post-traumatic stress disorder (PTSD) and this article aims to systematically review literature on the relationship between PTSD and suicidal behavior and ideation. A meta-analysis of 50 articles that examined the association between PTSD and past and current suicidal ideation and behavior was conducted. There was no evidence for an increased risk of completed suicide in individuals with PTSD. PTSD was associated with an increased incidence of prior attempted suicide and prior and current suicidal ideation. Controlling for other psychiatric disorders (including depression) weakened, but did not eliminate, this association. The evidence indicates that there is an association between PTSD and suicidality with several factors, such as concurrent depression and the pre-trauma psychiatric condition, possibly mediating this relationship. There are significant clinical implications of the reported relationship for suicide risk assessment and therapy, and further studies might help to understand the mediating pathways between PTSD and increased suicide risk.",0,0 +5532,Response to Psychotherapy for Posttraumatic Stress Disorder,"Neuropsychological studies have consistently demonstrated impaired verbal memory in posttraumatic stress disorder (PTSD). Trauma-focused treatment for PTSD is thought to rely on memory, but it is largely unknown whether treatment outcome is influenced by memory performance. The aim of the study, therefore, was to examine the relationship between verbal memory performance and treatment response to trauma-focused psychotherapy.Participants were referred to our outpatient clinic and recruited between December 2003 and January 2009 upon diagnosis of PTSD according to DSM-IV. Secondary analyses of a randomized controlled trial comparing eye movement desensitization and reprocessing therapy (n = 70) and brief eclectic psychotherapy (n = 70), a cognitive-behavioral intervention, are reported. Response to treatment was measured by self-reported PTSD symptom severity (Impact of Event Scale-Revised) over 17 weeks. Pretreatment verbal memory measures (California Verbal Learning Test, Rivermead Behavioral Memory Test) were included in the mixed linear model analyses in order to investigate the influence of memory on treatment outcome.Pretreatment encoding, short-term retrieval, long-term retrieval, and recognition performance were significantly associated with treatment response in terms of self-reported PTSD symptom severity for both treatments (P ≤ .013). Receiver operating characteristic curves predicting treatment response with pretreatment memory indices showed that 75.6% of the patients could be correctly classified as responder.Poor verbal memory performance represents a risk factor for worse treatment response to trauma-focused psychotherapy. Memory measures can be helpful in determining which patients are unable to benefit from trauma-focused psychotherapy. Future research should explore how treatment perspectives of patients with poor verbal memory can be improved.ISRCTN.com identifier: ISRCTN64872147.",0,0 +5533,EFFICACY OF A COGNITIVE-BEHAVIORAL TREATMENT FOR INSOMNIA AMONG AFGHANISTAN AND IRAQ (OEF/OIF) VETERANS WITH PTSD,"EFFICACY OF A COGNITIVE-BEHAVIORAL TREATMENT FOR INSOMNIA AMONG AFGHANISTAN AND IRAQ (OEF/OIF) VETERANS WITH PTSD By Skye Ochsner Margolies, M.A. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2011. Major Director: Scott Vrana, Ph.D. Professor Department of Psychology Sleep disturbances are a core and salient feature of PTSD and can maintain or exacerbate associated symptoms. Recent research demonstrates that cognitive-behavioral sleep-focused interventions improve sleep disturbances as well as PTSD symptoms. The present study is a randomized controlled trial comparing Cognitive Behavioral Therapy for Insomnia (CBT-I) to a waitlist control group. Conducted at a Veterans Affairs Medical Center, the study: 1) compared subjective outcome measures of sleep amongst veterans assigned to either a treatment group (CBT-I) or a waitlist control group; (2) examined the influence of the intervention on measures of PTSD, general mood and daytime functioning, comparing veterans in a treatment group to those in a waitlist control group and (3) examined the effect of the CBT-I intervention using objective measures of sleep for veterans included in the treatment arm of the study. Study participants were (n = 40) combat veterans who served in Afghanistan and/or Iraq (OEF/OIF). Participants were randomized to either a CBT-I treatment group or a waitlist control group. Those in the treatment condition participated in four CBT-I sessions over six weeks. CBT-I included sleep restriction, stimulus control, cognitive restructuring, sleep education, sleep hygiene and imagery rehearsal therapy. All participants completed subjective and objective measures at baseline and post-treatment. At six weeks post treatment, veterans who participated in CBT-I reported improved sleep, a reduction in PTSD symptom severity and PTSD-related nightmares, as well as a reduction in depression and distressed mood compared to veterans in the waitlist control group. When controlling for current participation in evidence-based PTSD treatment, veterans in the CBT-I group reported a reduction in PTSD symptom severity while their waitlist counterparts demonstrated an increase in these PTSD symptoms. Veterans in the treatment group also reported improved objectively measured sleep quality between baseline and posttreatment. These data suggest that CBT-I is an effective treatment for insomnia, nightmares and PTSD symptoms in OEF/OIF veterans with combat related PTSD and should be used as an adjunctive therapy to standard PTSD treatment.",0,0 +5534,Children's well-being after the war in Kosovo: survey in 2000.,"To assess special health and psychosocial needs of Albanian children in Kosovo shortly after the dramatic ethnic conflict in this part of former Yugoslavia in 1999.The survey included representative samples of school-age children (n=813), parents (n=41), and teachers (n=31) from six public schools in Prishtina and surrounding area. The measuring instruments included a standardized inventory of children's coping behavior in stressful situations (Ryan-Wegner Coping Style Inventory, SCSI), and survey questionnaires for children, parents, and school teachers, which were also used in a parallel study in Bosnia and Herzegovina (Sarajevo) on comparable survey samples. The study was accomplished in April 2000, ie, only a few months after the crisis in Kosovo.At the time of the survey, many children in Prishtina and surrounding area lived in unhealthy and dangerous physical environment. There were frequent lack of electricity (74%), lack of safe drinking water (68%), garbage on the streets (63%), and firearms, explosive devices, and mine fields in close environment (45%). Many of them showed signs and symptoms of ill health, including frequent headaches (60%), stomach ache (41%), frequent high fever (32%), and sleeplessness (18%). Most of them felt unsafe on the streets (61%). Many of them had rather unhealthy eating habits, such as not having breakfast regularly (16%) or not having a morning snack (60%). Three major groups of stressors were identified as having impact on children's health and psychosocial well-being in Kosovo, as follows: 1) lack of cultural and social security resources at home and in the community at large (20% of common variance explained); 2) poor physical and mental health conditions (14% of common variance); and 3) school-related stressors (11% of common variance). Similarly, parents and teachers also lived and worked under stressful life conditions. Many parents feared the impact of traumatic war experiences on children's health (54%), and school teachers noticed high rates of children's learning and behavioral disorders (84%). Factor analysis of the SCSI proved the hypothesis that in stressful situations children tend to use two major coping strategies: either active, ie, object-focused coping (13% of variance explained) or passive, ie, self-focused coping (10% of variance explained), the later being more typical for younger children. The pattern of stressors and coping behaviors were similar to stressors impacting physical and mental health of children in Sarajevo, although there were a number of culture-specific differences.Environmental, educational, and social conditions must be respected in assessing impact of war and conflict on children. Promotion of solidarity, tolerance, and mutual support among children from different ethnic and cultural backgrounds should be encouraged.",0,0 +5535,Baseline functioning among individuals with posttraumatic stress disorder and alcohol dependence,"Comorbid posttraumatic stress disorder (PTSD) and alcohol dependence (AD) may lead to a complicated and potentially severe treatment profile. Our study examined 167 individuals with both PTSD and AD compared with 105 individuals with PTSD without an alcohol use disorder (AUD) and 240 individuals with AD without PTSD on baseline psychosocial functioning. We hypothesized that individuals with PTSD/AD would be more socially and functionally impaired than individuals with only one disorder. Results indicated that participants with PTSD/AD were more likely to be unemployed, have less education, and report less income and were less likely to live with a partner than the participants with only a single disorder. However, they did not differ on symptom severity within these disorders (drinking frequency/quantity, PTSD, and anxiety symptoms) with the exception of depression and alcohol craving. This contradicts clinical lore that comorbid patients are more impaired at treatment initiation and adds support for concurrent treatment as not only feasible but also possibly ideal for these patients.",0,0 +5536,Cigarette Smoking and Military Deployment,"The stress of military deployment may compound occupational stress experienced in the military and manifest in maladaptive coping behaviors such as cigarette smoking. The current study describes new smoking among never-smokers, smoking recidivism among past smokers, and change in daily smoking among smokers in relation to military deployment.The Millennium Cohort is a 21-year longitudinal study. The current analysis utilized participants (N=48,304) who submitted baseline data (July 2001-June 2003) before the current conflicts in Iraq and Afghanistan and follow-up data (June 2004-January 2006) on health measures. New smoking was identified among baseline never-smokers, smoking recidivism among baseline past smokers, and increased or decreased daily smoking among baseline smokers. Analyses were conducted March 2007-April 2007.Among never-smokers, smoking initiation was identified in 1.3% of nondeployers and 2.3% of deployers. Among past smokers, smoking resumption occurred in 28.7% of nondeployers and 39.4% of those who deployed. Smoking increased 44% among nondeployers and 57% among deployers. Those who deployed and reported combat exposures were at 1.6 times greater odds of initiating smoking among baseline never-smokers (95% CI=1.2, 2.3) and at 1.3 times greater odds of resuming smoking among baseline past smokers when compared to those who did not report combat exposures. Other deployment factors independently associated with postdeployment smoking recidivism included deploying for >9 months and deploying multiple times. Among those who smoked at baseline, deployment was not associated with changes in daily amount smoked.Military deployment is associated with smoking initiation and, more strongly, with smoking recidivism, particularly among those with prolonged deployments, multiple deployments, or combat exposures. Prevention programs should focus on the prevention of smoking relapse during or after deployment.",0,0 +5537,Patterns of Multiple Victimization Among Maltreated Children in Navy Families,"The current study examined the cumulative risk associated with children's exposure to multiple types of parent-inflicted victimization. The sample was comprised of 195 children who were 7 to 17 years old (64.1% female and 48.2% non-White) at the time of referral to the United States Navy's Family Advocacy Program due to allegations of sexual abuse, physical abuse, or parental intimate partner violence. We conducted an exploratory latent class analysis to identify distinct subgroups of children based on lifetime victimization. We hypothesized that at least 2 classes or subgroups would be identified, with 1 characterized by greater victimization and poorer outcomes. Results indicated that 3 classes of children best fit the data: (a) high victimization across all 3 categories, (b) high rates of physical abuse and witnessing intimate partner violence, and (c) high rates of physical abuse only. Findings indicated that the high victimization class was at greatest risk for alcohol and substance use, delinquent behavior, and meeting criteria for posttraumatic stress disorder (PTSD) and/or depression 1 year later (odds ratio = 4.53). These findings highlight the serious mental health needs of a small but significantly high-risk portion of multiply victimized children entering the child welfare system.",0,0 +5538,"Distress, Coping, and Social Support Among Rural Women Recently Diagnosed with Primary Breast Cancer","This study examined distress, coping, and group support among a sample of rural women who had been recently diagnosed with breast cancer. We recruited 100 women who had been diagnosed with primary breast cancer at one of two time points in their medical treatment: either within a window up to 3 months after their diagnosis of breast cancer, or within 6 months after completing medical treatment for breast cancer. Their mean age was 58.6 years (SD = 11.6), and 90% were of white/European American ethnicity. Women completed a battery of demographic and psychosocial measures prior to being randomized into a psychoeducational intervention study, and then again 3 months later at a follow-up assessment. The focus of this article is on the women's self-reported psychosocial status at baseline. Many of the women experienced considerable traumatic stress regarding their breast cancer. However, this distress was not reflected in a standard measure of mood disturbance that is frequently used in intervention research (the Profile of Mood States). The average woman considered her diagnosis of breast cancer to be among the four most stressful life events that she had ever experienced. Also, women on average reported a high level of helplessness/hopelessness in coping with their cancer. On average, women felt that they ""often"" (but not ""very often"") received instrumental assistance, emotional support, and informational support. Women varied considerably in which kind of social group provided them with the most support, with as many reporting that they found the greatest support in spiritual/church groups or within their family units as with breast or general cancer groups. These results suggest that among these rural women with breast cancer, distress with the diagnosis of breast cancer must be carefully assessed, as women who are highly distressed about their breast cancer may not report general mood disturbance. Furthermore, the kinds of groups that rural women with breast cancer experience as most supportive need to be identified so that psychosocial interventions can be matched to breast cancer patients' individual needs.",0,0 +5539,Event-related potential patterns associated with hyperarousal in Gulf War illness syndrome groups,"An exaggerated response to emotional stimuli is one of the several symptoms widely reported by veterans of the 1991 Persian Gulf War. Many have attributed these symptoms to post-war stress; others have attributed the symptoms to deployment-related exposures and associated damage to cholinergic, dopaminergic, and white matter systems. We collected event-related potential (ERP) data from 20 veterans meeting Haley criteria for Gulf War Syndromes 1-3 and from 8 matched Gulf War veteran controls, who were deployed but not symptomatic, while they performed an auditory three-condition oddball task with gunshot and lion roar sounds as the distractor stimuli. Reports of hyperarousal from the ill veterans were significantly greater than those from the control veterans; different ERP profiles emerged to account for their hyperarousability. Syndromes 2 and 3, who have previously shown brainstem abnormalities, show significantly stronger auditory P1 amplitudes, purported to indicate compromised cholinergic inhibitory gating in the reticular activating system. Syndromes 1 and 2, who have previously shown basal ganglia dysfunction, show significantly weaker P3a response to distractor stimuli, purported to indicate dysfunction of the dopaminergic contribution to their ability to inhibit distraction by irrelevant stimuli. All three syndrome groups showed an attenuated P3b to target stimuli, which could be secondary to both cholinergic and dopaminergic contributions or disruption of white matter integrity.",0,0 +5540,Spotlight on Paroxetine in Psychiatric Disorders in Adults*,"Paroxetine is a selective serotonin reuptake inhibitor (SSRI), with antidepressant and anxiolytic activity. In 6- to 24-week well designed trials, oral paroxetine 10 to 50 mg/day was significantly more effective than placebo, at least as effective as tricyclic antidepressants (TCAs) and as effective as other SSRIs and other antidepressants in the treatment of major depressive disorder. Relapse or recurrence over 1 year after the initial response was significantly lower with paroxetine 10 to 50 mg/day than with placebo and similar to that with imipramine 50 to 275 mg/day. The efficacy of paroxetine 10 to 40 mg/day was similar to that of TCAs and fluoxetine 20 to 60 mg/day in 6- to 12-week trials in patients aged (greater-than or equal to)60 years with major depression. Paroxetine 10 to 40 mg/day improved depressive symptoms to an extent similar to that of TCAs in patients with comorbid illness, and was more effective than placebo in the treatment of dysthymia and minor depression. Paroxetine 20 to 60 mg/day was more effective than placebo after 8 to 12 weeks' treatment of obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder (social phobia), generalised anxiety disorder (GAD) and post-traumatic stress disorder (PTSD). Improvement was maintained or relapse was prevented for 24 weeks to 1 year in patients with OCD, panic disorder, social anxiety disorder or GAD. The efficacy of paroxetine was similar to that of other SSRIs in patients with OCD and panic disorder and similar to that of imipramine but greater than that of 2'chlordesmethyldiazepam in patients with GAD. Paroxetine is generally well tolerated in adults, elderly individuals and patients with comorbid illness, with a tolerability profile similar to that of other SSRIs. The most common adverse events with paroxetine were nausea, sexual dysfunction, somnolence, asthenia, headache, constipation, dizziness, sweating, tremor and decreased appetite. In conclusion, paroxetine, in common with other SSRIs, is generally better tolerated than TCAs and is a first-line treatment option for major depressive disorder, dysthymia or minor depression. Like other SSRIs, paroxetine is also an appropriate first-line therapy for OCD, panic disorder, social anxiety disorder, GAD and PTSD. Notably, paroxetine is the only SSRI currently approved for the treatment of social anxiety disorder and GAD, which makes it the only drug of its class indicated for all five anxiety disorders in addition to major depressive disorder. Thus, given the high degree of psychiatric comorbidity of depression and anxiety, paroxetine is an important first-line option for the treatment of major depressive disorder, OCD, panic disorder, social anxiety disorder, GAD and PTSD.",0,0 +5541,"Low-frequency, Repetitive Transcranial Magnetic Stimulation for the Treatment of Patients with Posttraumatic Stress Disorder: a Double-blind, Sham-controlled Study","Several studies have suggested that repetitive transcranial magnetic stimulation (rTMS) of the right prefrontal cortex may be useful in the treatment of posttraumatic stress disorder (PTSD). The aim of this study was to compare the effect of rTMS on the right prefrontal cortex with that of sham stimulation among patients with PTSD.In total, 18 patients with PTSD were randomly assigned to the 1-Hz low-frequency rTMS group or the sham group for 3 weeks. Primary efficacy measures were the Clinician-Administered PTSD Scale (CAPS) and its subscales, assessed at baseline and at 2, 4, and 8 weeks.All CAPS scores improved significantly over the study period. We found significant differences in the re-experiencing scores (F=7.47, p=0.004) and total scores (F=6.45, p=0.008) on the CAPS. The CAPS avoidance scores showed a trend toward significance (F=2.74, p=0.055), but no significant differences in the CAPS hyperarousal scores were observed.The present study showed low-frequency rTMS to be an effective and tolerable option for the treatment of PTSD. Trials using variable indices of rTMS to the right prefrontal cortex and explorations of the differences in the effects on specific symptom clusters may be promising avenues of research regarding the use of rTMS for PTSD.",0,0 +5542,"Indirect associations of combat exposure with post-deployment physical symptoms in U.S. soldiers: Roles of post-traumatic stress disorder, depression and insomnia","To characterize the indirect associations of combat exposure with post-deployment physical symptoms through shared associations with post-traumatic stress disorder (PTSD), depression and insomnia symptoms.Surveys were administered to a sample of U.S. soldiers (N = 587) three months after a 15-month deployment to Iraq. A multiple indirect effects model was used to characterize direct and indirect associations between combat exposure and physical symptoms.Despite a zero-order correlation between combat exposure and physical symptoms, the multiple indirect effects analysis did not provide evidence of a direct association between these variables. Evidence for a significant indirect association of combat exposure and physical symptoms was observed through PTSD, depression, and insomnia symptoms. In fact, 92% of the total effect of combat exposure on physical symptoms scores was indirect. These findings were evident even after adjusting for the physical injury and relevant demographics.This is the first empirical study to suggest that PTSD, depression and insomnia collectively and independently contribute to the association between combat exposure and post-deployment physical symptoms. Limitations, future research directions, and potential policy implications are discussed.",0,0 +5543,Effect of Sertraline on Glucocorticoid Sensitivity of Mononuclear Leukocytes in Post-Traumatic Stress Disorder,"This study examined the effects of sertraline (SER) on glucocorticoid sensitivity in mononuclear leukocytes (MNL) from eight subjects with current post-traumatic stress disorder (PTSD) and nine comparison subjects. In all, 60 ml of blood was withdrawn by venipuncture at 0800, and MNL were isolated from blood and divided into two portions: the first contained live cells incubated with a series of concentrations of dexamethasone (DEX); the second contained cells incubated with similar concentrations of DEX+2 muM SER. Group difference in the concentrations of DEX required to inhibit lysozyme activity by 50% were evaluated under conditions of DEX-only and DEX+SER using analysis of covariance (ANCOVA). A significant Group x Condition interaction reflected that SER altered the lysozyme IC(50-DEX) in the direction of decreasing sensitivity to glucocorticoids in PTSD while having no uniform effect in cells from comparison subjects. The data provide support for the idea that glucocorticoid receptors might be more responsive to antidepressants in PTSD than in persons without PTSD. Insofar as increased sensitivity to glucocorticoids has been linked with PTSD, the actions of SER on the lysozyme IC(50-DEX) suggest that this medication may target a biologic alteration associated with PTSD pathophysiology.",0,0 +5544,Genetic Polymorphisms Influence Recovery from Traumatic Brain Injury,"Traumatic brain injury (TBI) is a major public health concern in both civilian and military populations. Recently, genetics studies have begun to identify individual differences in polymorphisms that could affect recovery and outcome of cognitive and social processes following TBI. This review considers the potential for polymorphisms to influence six specific cognitive and social functions, which represent the most prominent domains of impairment following TBI: working memory, executive function, decision making, inhibition and impulsivity, aggression, and social and emotional function. Examining the influence of polymorphisms on TBI outcome has the potential to contribute to an understanding of variations in TBI outcome, aid in the triaging and treatment of TBI patients, and ultimately lead to targeted interventions based on genetic profiles.",0,0 +5545,"A Decade Later, How Much of Rwanda's Musculoskeletal Impairment Is Caused by the War in 1994 and by Related Violence?","In 1994 there was a horrific genocide in Rwanda following years of tension, resulting in the murder of at least 800,000 people. Although many people were injured in addition to those killed, no attempt has been made to assess the lasting burden of physical injuries related to these events. The aim of this study was to estimate the current burden of musculoskeletal impairment (MSI) attributable to the 1994 war and related violence.A national cross-sectional survey of MSI was conducted in Rwanda. 105 clusters of 80 people were selected through probability proportionate to size sampling. Households within clusters were selected through compact segment sampling. Enumerated people answered a seven-question screening test to assess whether they might have an MSI. Those who were classed as potential cases in the screening test were examined and interviewed by a physiotherapist, using a standard protocol that recorded the site, nature, cause, and severity of the MSI. People with MSI due to trauma were asked whether this trauma occurred during the 1990-1994 war or during the episodes that preceded or followed this war. Out of 8,368 people enumerated, 6,757 were available for screening and examination (80.8%). 352 people were diagnosed with an MSI (prevalence=5.2%, 95% CI=4.5-5.9%). 106 cases of MSI (30.6%) were classified as resulting from trauma, based on self-report and the physiotherapist's assessment. Of these, 14 people (13.2%) reported that their trauma-related MSI occurred during the 1990-1994 war, and a further 7 (6.6%) that their trauma-related MSI occurred during the violent episodes that preceded and followed the war, giving an overall prevalence of trauma-related MSI related to the 1990-1994 war of 0.3% (95% CI=0.2-0.4%).A decade on, the overall prevalence of MSI was relatively high in Rwanda but few cases appeared to be the result of the 1994 war or related violence.",0,0 +5546,"Exposure to traumatic events, prevalence of posttraumatic stress disorder and alcohol abuse in Aboriginal communities","Generations of Aboriginal people have been exposed to strings of traumatic events with devastating psychosocial health consequences, including psychiatric morbidities and mortalities, and medical complications. Posttraumatic Stress Disorder (PTSD) is a psychiatric morbidity directly linked to traumatic events. Despite research findings indicating traumatic exposure and resultant PTSD in Indigenous communities, little attention has been given to this condition in mental healthcare delivery. Consequently, clinical and psychosocial interventions are misguided and failed to deliver positive outcomes. The objective of this study is to explore the relationship between exposure to traumatic events, prevalence of PTSD and alcohol abuse in remote Aboriginal communities in Western Australia.A combination of structured clinical interview and multiple survey questionnaires - Composite International Diagnostic Interview (CIDI), and Impact of Events Scale (IES), Alcohol Use Disorder Identification Test (AUDIT) and Indigenous Trauma Profile (ITP) - were administered to 221 Indigenous participants aged 18 to 65 years.The overwhelming majority, 97.3% (n=215) of participants were exposed to traumatic events. Analysis of CIDI results using DSM-IV diagnostic criteria shows a life time prevalence of 55.2% (n=122) for PTSD, 20% (n=44) for major depression (recurrent) and 2.3% (n=5) for a single episode. A total of 96% (n=212) participants reported consuming a drink containing alcohol and 73.8% (n=163) met diagnostic criteria for alcohol use related disorders, abuse and dependence. Of participants who met the PTSD diagnostic criteria, 91% (n=111) met diagnostic criteria for alcohol use related disorders. Other impacts of trauma such as other anxiety disorders, dysthymic disorder and substances abuses were also identified.The rate of exposure to traumatic events and prevalence of PTSD are disproportionately higher in the communities studied than the national average and one of the highest recorded in survivors of specific traumatic events in the world. A very high rate of alcohol abuse and dependence in participants who met diagnostic criteria for PTSD demonstrates correlation between alcohol abuse and PTSD. It also suggests that alcohol is used as self-medication.",0,0 +5547,Hopefulness predicts resilience after hereditary colorectal cancer genetic testing: a prospective outcome trajectories study,"Genetic testing for hereditary colorectal cancer (HCRC) had significant psychological consequences for test recipients. This prospective longitudinal study investigated the factors that predict psychological resilience in adults undergoing genetic testing for HCRC.A longitudinal study was carried out from April 2003 to August 2006 on Hong Kong Chinese HCRC family members who were recruited and offered genetic testing by the Hereditary Gastrointestinal Cancer Registry to determine psychological outcomes after genetic testing. Self-completed questionnaires were administered immediately before (pre-disclosure baseline) and 2 weeks, 4 months and 1 year after result disclosure. Using validated psychological inventories, the cognitive style of hope was measured at baseline, and the psychological distress of depression and anxiety was measured at all time points.Of the 76 participating subjects, 71 individuals (43 men and 28 women; mean age 38.9 +/- 9.2 years) from nine FAP and 24 HNPCC families completed the study, including 39 mutated gene carriers. Four patterns of outcome trajectories were created using established norms for the specified outcome measures of depression and anxiety. These included chronic dysfunction (13% and 8.7%), recovery (0% and 4.3%), delayed dysfunction (13% and 15.9%) and resilience (76.8% and 66.7%). Two logistic regression analyses were conducted using hope at baseline to predict resilience, with depression and anxiety employed as outcome indicators. Because of the small number of participants, the chronic dysfunction and delayed dysfunction groups were combined into a non-resilient group for comparison with the resilient group in all subsequent analysis. Because of low frequencies, participants exhibiting a recovery trajectory (n = 3 for anxiety and n = 0 for depression) were excluded from further analysis. Both regression equations were significant. Baseline hope was a significant predictor of a resilience outcome trajectory for depression (B = -0.24, p < 0.01 for depression); and anxiety (B = -0.11, p = 0.05 for anxiety).The current findings suggest that hopefulness may predict resilience after HCRC genetic testing in Hong Kong Chinese. Interventions to increase the level of hope may be beneficial to the psychological adjustment of CRC genetic testing recipients.",0,0 +5548,The Moderating Effects of Maternal Psychopathology on Children's Adjustment Post–Hurricane Katrina,This study investigated the role of maternal psychopathology in predicting children's psychological distress in a disaster-exposed sample. Participants consisted of 260 children (ages 8-16) recruited from public schools and their mothers. These families were displaced from New Orleans because of Hurricane Katrina in 2005. Assessment took place 3 to 7 months postdisaster. Hierarchical regression analyses revealed that global maternal psychological distress and maternal posttraumatic stress disorder moderated the relation between child hurricane exposure and mother-reported child internalizing and externalizing symptoms.,0,0 +5549,Identifying latent profiles of posttraumatic stress and major depression symptoms in Canadian veterans: Exploring differences across profiles in health related functioning,"Posttraumatic stress disorder (PTSD) has been consistently reported as being highly comorbid with major depressive disorder (MDD) and as being associated with health related functional impairment (HRF). We used archival data from 283 previously war-zone deployed Canadian veterans. Latent profile analysis (LPA) was used to uncover patterns of PTSD and MDD comorbidity as measured via the PTSD Checklist-Military version (PCL-M) and the Patient Health Questionnaire-9 (PHQ-9). Individual membership of latent classes was used in a series of one-way ANOVAs to ascertain group differences related to HRF as measured via the Short-Form-36 Health Survey (SF-36). LPA resulted in three discrete patterns of PTSD and MDD comorbidity which were characterized by high symptoms of PTSD and MDD, moderate symptoms, and low symptoms. All ANOVAs comparing class membership on the SF-36 subscales were statistically significant demonstrating group differences across levels of HRF. The group with the highest symptoms reported the worst HRF followed by the medium and low symptom groups. These findings are clinically relevant as they demonstrate the need for continual assessment and targeted treatment of co-occurring PTSD and MDD.",0,0 +5550,"Clinical expression profiles of complex regional pain syndrome, fibromyalgia and a-specific repetitive strain injury: More common denominators than pain?","To systematically evaluate and compare the clinical manifestations, disease course, risk factors and demographic characteristics of Complex Regional Pain Syndrome type 1 (CRPS), fibromyalgia (FM) and a-specific Repetitive Strain Injury (RSI).A literature search was performed using terms related to the aforementioned topics and diseases. Only original clinical studies that included at least 20 subjects were eligible.Fifty-nine studies on CRPS, 73 on FM and 7 on a-specific RSI were identified. The diseases show similarities in age distribution, male-female ratio, pain characteristics and sensory signs and symptoms. Motor, autonomic and trophic changes are frequently reported in CRPS, but only occasionally in FM and RSI. Systemic symptoms are found in patients with CRPS and FM, and in a subgroup of patients with RSI. In all three disorders, symptoms usually start locally, but may spread to other body regions later, which, in the case of FM, is a prerequisite for diagnosis. Disease onset is always, usually, or occasionally of traumatic origin in RSI, CRPS and FM, respectively. Anxiety and depression are more frequent in patients compared to controls, but probably not very different from patients with other pain conditions or chronic diseases.Apart from some obvious differences between CRPS, FM and RSI, the similarities are conspicuous. The common features of CRPS, FM and a-specific RSI may suggest that a common pathway is involved, but until patients with these type of symptoms are assessed with a uniform assessment procedure, a thorough comparison cannot be made. A systematic evaluation of patients with a suspected diagnosis of CRPS, FM or RSI, may lead to a better appreciation of the differences and similarities in these diseases and help to unravel the underlying mechanisms.",0,0 +5551,Distinguishing between treatment efficacy and effectiveness in post-traumatic stress disorder (PTSD): Implications for contentious therapies,Research psychologists often complain that practitioners disregard research evidence whilst practitioners sometimes accuse researchers of failing to produce evidence with sufficient ecological validity. We discuss the tension that thus arises using the specific illustrative examples of two treatment methods for post-traumatic stress disorder: eye movement desensitisation and reprocessing and exposure-based interventions. We discuss the contextual reasons for the success or failure of particular treatment models that are often only tangentially related to the theoretical underpinnings of the models. We discuss what might be learnt from these debates and develop recommendations for future research.,0,0 +5552,Birth Outcomes in a Disaster Recovery Environment: New Orleans Women After Katrina,"To examine how the recovery following Hurricane Katrina affected pregnancy outcomes.308 New Orleans area pregnant women were interviewed 5-7 years after Hurricane Katrina about their exposure to the disaster (danger, damage, and injury); current disruption; and perceptions of recovery. Birthweight, gestational age, birth length, and head circumference were examined in linear models, and low birthweight (<2500 g) and preterm birth (<37 weeks) in logistic models, with adjustment for confounders.Associations were found between experiencing damage during Katrina and birthweight (adjusted beta for high exposure = -158 g) and between injury and gestational age (adjusted beta = -0.5 days). Of the indicators of recovery experience, most consistently associated with worsened birth outcomes was worry that another hurricane would hit the region (adjusted beta for birthweight: -112 g, p = 0.08; gestational age: -3.2 days, p = 0.02; birth length: -0.65 cm, p = 0.06).Natural disaster may have long-term effects on pregnancy outcomes. Alternately, women who are most vulnerable to disaster may be also vulnerable to poor pregnancy outcome.",0,0 +5553,Latent profile analysis and principal axis factoring of the DSM-5 dissociative subtype,"A dissociative subtype has been recognized based on the presence of experiences of depersonalization and derealization in relation to DSM-IV posttraumatic stress disorder (PTSD). However, the dissociative subtype has not been assessed in a community sample in relation to the revised DSM-5 PTSD criteria. Moreover, the 20-item PTSD Checklist for DSM-5 (PCL-5) currently does not assess depersonalization and derealization.We therefore evaluated two items for assessing depersonalization and derealization in 557 participants recruited online who endorsed PTSD symptoms of at least moderate severity on the PCL-5.A five-class solution identified two PTSD classes who endorsed dissociative experiences associated with either 1) severe or 2) moderate PTSD symptom severity (D-PTSD classes). Those in the severe dissociative class were particularly likely to endorse histories of childhood physical and sexual abuse. A principal axis factor analysis of the symptom list identified six latent variables: 1) Reexperiencing, 2) Emotional Numbing/Anhedonia, 3) Dissociation, 4) Negative Alterations in Cognition & Mood, 5) Avoidance, and 6) Hyperarousal.The present results further support the presence of a dissociative subtype within the DSM-5 criteria for PTSD.",0,0 +5554,Evolution of secure services for women in England,"Summary Patients detained at high and medium security reveal significant gender differences in the presentation of psychopathology, mental disorder and social and offending profiles. However, secure mental health services in England, like prisons, generally fail to recognise the core importance of the differing biopsychosocial development in women and the impact of life experiences on women's subsequent biopsychosocial functioning. As a consequence, women are often inadequately provided for in services dictated by the identified needs, risks and responsiveness of men. The lack of clinically appropriate facilities for women may account for the increased frequency with which women are readmitted to medium security and for their longer admissions to both high and medium secure care. New tertiary services are developing as a result of the lessons learnt while providing gender-blind care. However, further development is required to ensure that women receive services of the same quality, range and nature of those received by men.",0,0 +5555,Prolonged grief among traumatically bereaved relatives exposed and not exposed to a tsunami,"Numerous studies on the mental health consequences of traumatic exposure to a disaster compare those exposed to those not exposed. Relatively few focus on the effect of the death of a close relative caused by the disaster-suffering a traumatic bereavement. This study compared the impact on 345 participants who lost a close relative in the 2004 Indian Ocean tsunami, but who were themselves not present, to 141 who not only lost a relative, but also were themselves exposed to the tsunami. The focus was on psychological distress assessed during the second year after the sudden bereavement. Findings were that exposure to the tsunami was associated with prolonged grief (B = 3.81) and posttraumatic stress reactions (B = 6.65), and doubled the risk for impaired mental health. Loss of children increased the risk for psychological distress (prolonged grief: B = 6.92; The Impact of Event Scale-Revised: B = 6.10; General Health Questionnaire-12: OR = 2.34). Women had a higher frequency of prolonged grief. For men, loss of children presented a higher risk for prolonged grief in relation to other types of bereavement (B = 6.36 vs. loss of partner). Further long-term follow-up could deepen the understanding of how recovery after traumatic loss is facilitated.",0,0 +5556,Mobilizing Victim Services: The Role of Reporting to the Police,"Victim assistance programs have grown dramatically in response to the victim's rights movement and concern over difficulty navigating victim services. Evidence, however, indicates that very few victims seek assistance. The present study examined factors associated with victim service use including reporting to the police, the victim's demographic characteristics, the victim's injury, offender's use of a weapon, the victim's relationship to the offender, and the victim's mental and physical distress. Data came from a subset of the National Crime Victimization Survey 2008-2011 (N = 4,746), a stratified multistage cluster sample survey of persons age 12 years and older in the United States. Logistic regression models indicated that fewer than 10% of victims of violent crime sought help from victim services. Reporting to the police increased the odds of seeking services by 3 times. In addition, the odds of victims attacked by an intimate partner seeking services were 4.5 times greater than victims attacked by strangers. Findings suggest that additional exploratory work is needed in uncovering the mechanism of police involvement in linking victims to services. Specifically, do police understand what services are available to victims and why are police more likely to inform some types of victims about services more than others?",0,0 +5557,Workplace Violence: A Primer for Critical Care Nurses,"This review illustrates the various types of workplace violence nurses can encounter in critical care settings. Lack of a clear definition of workplace violence impedes research on the topic; however, the typology offered by the UIIPRC provides a framework to guide further studies of physical and nonphysical workplace violence. Further investigation of individual and organizational factors will assist nurses and agencies in identifying effective methods to manage, prevent, educate, and respond to each type of workplace violence. Fear, burnout, anxiety, depression, and acute and posttraumatic stress disorders are some of the sequelae that can occur after an incident of workplace violence. Debriefing strategies should be a fundamental component of workplace violence policies to prevent the development of longterm consequences. Additional research is needed on all types of workplace violence, as well as research addressing the needs of specialized setting, such as critical care unit. Critical care nurses have valuable insights regarding the risks they face on their units and should be part of a multidisciplinary team developing policies and workplace violence prevention and education programs.",0,0 +5558,Assessing the fit of the Dysphoric Arousal model across two nationally representative epidemiological surveys: The Australian NSMHWB and the United States NESARC,"Since the initial inclusion of PTSD in the DSM nomenclature, PTSD symptomatology has been distributed across three symptom clusters. However, a wealth of empirical research has concluded that PTSD's latent structure is best represented by one of two four-factor models: Numbing or Dysphoria. Recently, a newly proposed five-factor Dysphoric Arousal model, which separates the DSM-IV's Arousal cluster into two factors of Anxious Arousal and Dysphoric Arousal, has gathered support across a variety of trauma samples. To date, the Dysphoric Arousal model has not been assessed using nationally representative epidemiological data. We employed confirmatory factor analysis to examine PTSD's latent structure in two independent population based surveys from American (NESARC) and Australia (NSWHWB). We specified and estimated the Numbing model, the Dysphoria model, and the Dysphoric Arousal model in both samples. Results revealed that the Dysphoric Arousal model provided superior fit to the data compared to the alternative models. In conclusion, these findings suggest that items D1-D3 (sleeping difficulties; irritability; concentration difficulties) represent a separate, fifth factor within PTSD's latent structure using nationally representative epidemiological data in addition to single trauma specific samples.",0,0 +5559,Prognostic factors of whiplash-associated disorders: a systematic review of prospective cohort studies,"We present a systematic review of prospective cohort studies. Our aim was to assess prognostic factors associated with functional recovery of patients with whiplash injuries. The failure of some patients to recover following whiplash injury has been linked to a number of prognostic factors. However, there is some inconsistency in the literature and there have been no systematic attempts to analyze the level of evidence for prognostic factors in whiplash recovery. Studies were selected for inclusion following a comprehensive search of MEDLINE, EMBASE, CINAHL, the database of the Dutch Institute of Allied Health Professions up until April 2002 and hand searches of the reference lists of retrieved articles. Studies were selected if the objective was to assess prognostic factors associated with recovery; the design was a prospective cohort study; the study population included at least an identifiable subgroup of patients suffering from a whiplash injury; and the paper was a full report published in English, German, French or Dutch. The methodological quality was independently assessed by two reviewers. A study was considered to be of 'high quality' if it satisfied at least 50% of the maximum available quality score. Two independent reviewers extracted data and the association between prognostic factors and functional recovery was calculated in terms of risk estimates. Fifty papers reporting on twenty-nine cohorts were included in the review. Twelve cohorts were considered to be of 'high quality'. Because of the heterogeneity of patient selection, type of prognostic factors and outcome measures, no statistical pooling was able to be performed. Strong evidence was found for high initial pain intensity being an adverse prognostic factor. There was strong evidence that for older age, female gender, high acute psychological response, angular deformity of the neck, rear-end collision, and compensation not being associated with an adverse prognosis. Several physical (e.g. restricted range of motion, high number of complaints), psychosocial (previous psychological problems), neuropsychosocial factors (nervousness), crash related (e.g. accident on highway) and treatment related factors (need to resume physiotherapy) showed limited prognostic value for functional recovery. High initial pain intensity is an important predictor for delayed functional recovery for patients with whiplash injury. Often mentioned factors like age, gender and compensation do not seem to be of prognostic value. Scientific information about prognostic factors can guide physicians or other care providers to direct treatment and to probably prevent chronicity.",0,0 +5560,A clinical handbook/practical therapist manual for assessing and treating adults with post-traumatic stress disorder (PTSD).,"(from the preface) This ""Therapist Handbook/Manual"" arose out of a 7 yr intensive period during which [the author had] been deeply involved in work with clients (adults, adolescents, and children) who have been traumatized by natural and technological disasters and due to traumatic events of intentional human design. [The author's assessment and treatment of clients who experience posttraumatic stress disorder (PTSD) and in training both inpatient and outpatient mental health staff constitutes] the basis of the present manual on work with adults. . . . Each Section has a statement of objectives, section summaries, ""how to"" guidelines, critical evaluations of the field as well as a test of [one's] level of ""expertise."" (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5561,Treatment of Intimate Partner Violence Perpetration Among Male Veterans: An Example of a Comprehensive Approach,"Intimate partner violence (IPV) is a significant and enduring public health problem, affecting as many as 5 million women annually in the United States. As a microcosm of society, military families experience such violence at rates equal to or higher than civilian counterparts. IPV is a complex problem often fueled by an equally complex mixture of risk factors, including substance abuse, childhood abuse and trauma, PTSD, depression, personality disorders, and various other stressors. The United States Department of Veterans Affairs provides healthcare to nearly nine million Veterans annually, including for IPV and the related risk factors. This article describes the risk factors for IPV, as well as the challenges associated with effectively treating it. Given the complexity of the problem, the need for an interdisciplinary, comprehensive approach to treatment is emphasized. An example of such a program is described. © 2015, Springer Science+Business Media New York.",0,0 +5562,Validation of the French Version of the Brief Pain Inventory in Canadian Veterans Suffering from Traumatic Stress,"Although pain is a significant clinical problem in individuals suffering from post-traumatic stress disorder (PTSD), reliable and valid measures of pain for this population are lacking. The goal of this study was to validate the Brief Pain Inventory (BPI) in French-speaking veterans suffering from PTSD (n=130). We administered the BPI, as well as measures of PTSD, health status, quality of life, and social desirability, to veterans being assessed or treated for PTSD at a Veterans Affairs Canada clinic. The BPI showed strong internal consistency, as evidenced by Cronbach's alphas of 0.90 and 0.92 for the severity and interference subscales, respectively. Similar to previous findings, a two-factor structure (pain severity and pain interference) was found using an exploratory factor analysis. The two factors explained nearly 73% of the variance of the instrument. The BPI was also strongly correlated with health status and quality of life in the physical domain. In this veteran sample, nearly 87% of the veterans suffered from significant current pain. Veterans in our sample reported rates of pain severity that were similar to or higher than most of those reported by cancer patients and others with significant physical disability/illness. Overall, the French version of the BPI is a reliable, valid measure of pain in PTSD-suffering populations. Pain is a major issue in veterans with PTSD, and should be screened for with instruments such as the BPI.",0,0 +5563,From Memory Impairment to Posttraumatic Stress Disorder-Like Phenotypes: The Critical Role of an Unpredictable Second Traumatic Experience,"Arousal and stress critically regulate memory formation and retention. Increasing levels of stress produce an inverted U-shaped effect on cognitive performance, including the retention of explicit memories, and experiencing a severe stress during a traumatic event may lead to posttraumatic stress disorder (PTSD). The molecular mechanisms underlying the impairing effect of a severe stress on memory and the key contribution of traumatic experiences toward the development of PTSD are still unknown. Here, using increasing footshock intensities in an inhibitory avoidance paradigm, we reproduced the inverted U-shaped curve of memory performance in rats. We then show that the inverted U profile of memory performance correlates with an inverted U profile of corticosterone level in the circulation and of brain-derived neurotrophic factor, phosphorylated tropomyosin-receptor kinase B, and methyl CpG binding protein in the dorsal hippocampus. Furthermore, training with the highest footshock intensity (traumatic experience) led to a significant elevation of hippocampal glucocorticoid receptors. Exposure to an unpredictable, but not to a predictable, highly stressful reminder shock after a first traumatic experience resulted in PTSD-like phenotypes, including increased memory of the trauma, high anxiety, threat generalization, and resistance to extinction. Systemic corticosterone injection immediately after the traumatic experience, but not 3 d later, was sufficient to produce PTSD-like phenotypes. We suggest that, although after a first traumatic experience a suppression of the corticosterone-dependent response protects against the development of an anxiety disorder, experiencing more than one trauma (multiple hits) is a critical contributor to the etiology of PTSD.",0,0 +5564,"Posttraumatic Stress Disorder, Alcohol Use, and Perceived Safety After the Terrorist Attack on the Pentagon","The authors examined posttraumatic stress disorder (PTSD), alcohol use, and perceptions of safety in a sample of survivors of the September 11, 2001, terrorist attack on the Pentagon.Analyses were conducted to examine the effect of past traumatic experience, trauma exposure, initial emotional response, and peritraumatic dissociation on probable PTSD, substance use, and perceived safety among 77 survivors seven months after the attack.Eleven respondents (14 percent) had PTSD. Those with PTSD reported higher levels of initial emotional response and peritraumatic dissociation. Ten respondents (13 percent) reported increased use of alcohol. Women were more than five times as likely as men to have PTSD and almost seven times as likely to report increased use of alcohol. Persons with higher peritraumatic dissociation were more likely to develop PTSD and report increased alcohol use. Those with lower perceived safety at seven months had higher initial emotional response and greater peritraumatic dissociation and were more likely to have PTSD, to have increased alcohol use, and to be female.The association of perceived safety with gender, the presence of PTSD, and increased alcohol use among survivors of the terrorist attack on the Pentagon warrants further study.",0,0 +5565,Trajectories of perceived social support among low-income female survivors of Hurricane Katrina,"The purpose of this study was to explore trajectories of perceived social support among low-income women who survived Hurricane Katrina, and were surveyed prior to the hurricane and approximately one and four years thereafter ( N = 562). Latent class growth analysis provided evidence of the following four trajectories of perceived support: High Increasing (35.9%), High Decreasing (20.3%), Low Stable (41.1%), and Low Decreasing (2.7%). Bereavement was significantly predictive of membership in the Low Stable trajectory, relative to the High Increasing and High Decreasing trajectories. Higher psychological distress and indicators of greater social network size, density, and closeness were significantly predictive of membership in the Low Decreasing trajectory, relative to the High Increasing and High Decreasing trajectories.",0,0 +5566,Long-term effects of acute perinatal asphyxia on rat maternal behavior,"In this study we used a rat model of graded perinatal asphyxia to study the long-term consequences of this manipulation on rat maternal behavior at adulthood. Rats were delivered by cesarean (C) section and the pups, still in the uterus horns, were placed into a water bath at 37 degrees C for periods of 0 (controls) or 20 min (asphyxia). Subsequently, female pups were given to surrogate mothers, weaned at 21 days postnatally and then left undisturbed until adulthood, when they were mated. Once they gave birth, on postnatal days (Pnds) 1, 3, 5, 7, 9, 11 and 13 they were observed in the home cage five times per day to assess their maternal behavior in an undisturbed condition. In addition, maternal behavior was observed for 30 min in a novel cage on Pnds 4 and 8. Perinatal asphyxia affected maternal behavior in the home cage, hypoxic females being more often found outside the nest area and performing more often behaviors such as self-grooming. Principal component analysis confirmed a more 'active' behavioral profile for hypoxic females. Hypoxic mothers were characterized by a longer latency to perform on-nest behavior and by a reduced frequency of pup retrieval and licking in the novel cage. No significant differences in corticosterone secretion in response to an acute stressor were found in dams belonging to the different treatments or in the body weights of the offspring. These results are suggestive of an arousal deficit due to perinatal hypoxia and point to the dopaminergic system as a potential neurochemical target for an early hypoxic insult.",0,0 +5567,Assessment of social support among veterans with military-related post- traumatic stress disorder : a study of the Social Support Questionnaire,"Numerous studies in the past 20 years have found an inverse correlation between social support and post-traumatic stress disorder (PTSD). However, the social support literature is encumbered by a wide-spread inconsistency of social support measurement, with many studies not using existing validated measures. Identifying a valid social support measure with clinical utility among veterans diagnosed with war-related (PTSD) would be a helpful resource for clinicians. Using data from 689 veterans seeking treatment from a VA PTSD program, the reliability, factor structure, and construct validity of the Social Support Questionnaire (SSQ; Sarason, Levine, Basham, & Sarason, 1983) were evaluated. The hypothesis of this study was based on the theoretical assumption that social support (as measured by the SSQ), would be inversely correlated with severity of PTSD symptoms (as measured by the Mississippi Scale for War-related PTSD; Keane, Caddell & Taylor, 1988) and depression (as measured by the Beck Depression Inventory; Beck, 1961). In this study, the SSQ scores were found to inversely correlate at a low, but statistically significant level, with both PTSD and depression scores. Principal axes factor analysis found that the two subscales of the SSQ were each measuring one factor. The correlation between the SSQ ""N"" scores and ""S"" scores suggest that these subscales are measuring different components of social support. Numerous implications for research and clinical practice are discussed. This study is the first to psychometrically evaluate a measure of current social support for use among war veterans diagnosed with PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5568,A person-centered analysis of posttraumatic stress disorder symptoms following a natural disaster: Predictors of latent class membership,"The present study applied latent class analysis to a sample of 810 participants residing in southern Mississippi at the time of Hurricane Katrina to determine if people would report distinct, meaningful PTSD symptom classes following a natural disaster. We found a four-class solution that distinguished persons on the basis of PTSD symptom severity/pervasiveness (Severe, Moderate, Mild, and Negligible Classes). Multinomial logistic regression models demonstrated that membership in the Severe and Moderate Classes was associated with potentially traumatic hurricane-specific experiences (e.g., being physically injured, seeing dead bodies), pre-hurricane traumatic events, co-occurring depression symptom severity and suicidal ideation, certain religious beliefs, and post-hurricane stressors (e.g., social support). Collectively, the findings suggest that more severe/pervasive typologies of natural disaster PTSD may be predicted by the frequency and severity of exposure to stressful/traumatic experiences (before, during, and after the disaster), co-occurring psychopathology, and specific internal beliefs.",0,0 +5569,Subgroups of musculoskeletal pain patients and their psychobiological patterns – The LOGIN study protocol,"Pain conditions of the musculoskeletal system are very common and have tremendous socioeconomic impact. Despite its high prevalence, musculoskeletal pain remains poorly understood and predominantly non-specifically and insufficiently treated.The group of chronic musculoskeletal pain patients is supposed to be heterogeneous, due to a multitude of mechanisms involved in chronic pain. Psychological variables, psychophysiological processes, and neuroendocrine alterations are expected to be involved. Thus far, studies on musculoskeletal pain have predominantly focused on the general aspects of pain processing, thus neglecting the heterogeneity of patients with musculoskeletal pain. Consequently, there is a need for studies that comprise a multitude of mechanisms that are potentially involved in the chronicity and spread of pain. This need might foster research and facilitate a better pathophysiological understanding of the condition, thereby promoting the development of specific mechanism-based treatments for chronic pain. Therefore, the objectives of this study are as follows: 1) identify and describe subgroups of patients with musculoskeletal pain with regard to clinical manifestations (including mental co-morbidity) and 2) investigate whether distinct sensory profiles or 3) distinct plasma levels of pain-related parameters due to different underlying mechanisms can be distinguished in various subgroups of pain patients.We will examine a population-based chronic pain sample (n = 100), a clinical tertiary care sample (n = 100) and pain-free patients with depression or post-traumatic stress disorder and pain-free healthy controls (each n = 30, respectively). The samples will be pain localisation matched by sex and age to the population-based sample. Patients will undergo physical examination and thorough assessments of mental co-morbidity (including psychological trauma), perceptual and central sensitisation (quantitative sensory testing), descending inhibition (conditioned pain modulation, the diffuse noxious inhibitory control-like effect), as well as measurement of the plasma levels of nerve growth factor and endocannabinoids.The identification of the underlying pathophysiologic mechanisms in different subgroups of chronic musculoskeletal pain patients will contribute to a mechanism-based subgroup classification. This will foster the development of mechanism-based treatments and holds promise to treat patients more sufficient.",0,0 +5570,Fear of Hypoglycemia and Self Reported Posttraumatic Stress in Adults with Type I Diabetes Treated by Intensive Regimens,"This study investigated the prevalence of hypoglycemic fear (FH) and hypoglycemia-specific posttraumatic stress (PTS) among individuals with Type I diabetes. Over 25% of participants met diagnostic criteria for current PTSD. High percentages of participants endorsed PTS symptom clusters, suggesting that individuals may be experiencing distress without necessarily meeting diagnostic criteria. Hierarchical multiple regression analyses revealed that perceived threat of death from hypoglycemia and FH were significantly related to PTS. Number of recent hypoglycemic episodes did not predict PTS/PTSD. Depression and nonspecific anxiety did not contribute to the statistical prediction of PTSD, suggesting that symptomatology endorsed represents hypoglycemia-specific anxiety rather than global psychological distress. The hypothesis that greater PTS symptomatology would relate to poorer glycemic control was unsubstantiated. Perceived death-threat from hypoglycemia and nonspecific anxiety were the only variables that contributed to prediction of glycemic control, suggesting that PTS did not represent a significant barrier for glycemic control in this sample. © Springer Science+Business Media, LLC 2007.",0,0 +5571,"Trajectories of resilience, depression, and anxiety following spinal cord injury.","To investigate longitudinal trajectories of depression and anxiety symptoms following spinal cord injury (SCI) as well as the predictors of those trajectories.A longitudinal study of 233 participants assessed at 4 time points: within 6 weeks, 3 months, 1 year, and 2 years from the point of injury. Data were analyzed using latent growth mixture modeling to determine the best-fitting model of depression and anxiety trajectories. Covariates assessed during hospitalization were explored as predictors of the trajectories.Analyses for depression and anxiety symptoms revealed 3 similar latent classes: a resilient pattern of stable low symptoms, a pattern of high symptoms followed by improvement (recovery), and delayed symptom elevations. A chronic high depression pattern also emerged but not a chronic high anxiety pattern. Analyses of predictors indicated that compared with other groups, resilient patients had fewer SCI-related quality of life problems, more challenge appraisals and fewer threat appraisals, greater acceptance and fighting spirit, and less coping through social reliance and behavioral disengagement.Overall, the majority of SCI patients demonstrated considerable psychological resilience. Models for depression and anxiety evidenced a pattern of elevated symptoms followed by improvement and a pattern of delayed symptoms. Chronic high depression was also observed but not chronic high anxiety. Analyses of predictors were consistent with the hypothesis that resilient individuals view major stressors as challenges to be accepted and met with active coping efforts. These results are comparable to other recent studies of major health stressors.",0,0 +5572,"A comparison of gains after treatment at a psychiatric outpatient clinic in patients with cluster A+B, or cluster C personality disorders, and non-psychotic axis I disorders","Few studies exist on the outcome of patients with personality disorders (PDs) treated at ordinary outpatient clinics. This study examines the gains of such patients 2 years after treatment start at an outpatient clinic. Three patient groups were sampled: cluster A + B PDs, cluster C PDs and axis I disorders. Fifty-eight patients (53%) were amenable to follow-up, and they did not show less psychopathology than the non-compliers. All patients had structured interviews and filled in questionnaires. Patients in the PDs cluster A + B group showed considerable gains, while that was not found for the PDs cluster C and Axis I disorder groups. Since almost all patients received long-term psychotherapy sometimes combined with antidepressant drugs, the finding that such a treatment mainly shows gains in more severely disturbed PDs patients should be replicated in larger samples at ordinary psychiatric outpatient clinics.",0,0 +5573,Prevalence of epilepsy and comorbidity of psychiatric disorders in Iran,"To determine the lifetime prevalence of self- and other relative informants-reported epilepsy in nationwide study among Iranian adults of aged 18 years and over and to study the association of epilepsy with lifetime history of the psychiatric disorders.Twenty-five thousand one hundred and eighty individual were selected through a randomized clustered sampling method from all the Iranian households; interviewed and used epilepsy questionnaire face-to-face at home in year 2001. From 12,398,235 households residing in Iran, 7795 families selected from 1559 clusters, 997 clusters were in urban and 582 were in rural areas, each cluster with 5 households were studied. The response rate was 90%.The prevalence of epilepsy was 1.8%. Epilepsy was more common in females, unemployed and higher educational level. It was not significantly associated with the age group, marital status and residential areas. The most common psychiatric disorders in subjects with epilepsy were major depressive disorder and obsessive compulsive disorder. The rate of lifetime suicidal attempt was 8.1%.Lifetime prevalence of epilepsy in Iran is not low. As the other communities, it is more common in females and unemployed. However, in contrast with the other studies, it was not more common among some age groups and unmarried and low educated subjects.",0,0 +5574,Adverse childhood experiences in relation to mood and anxiety disorders in a population-based sample of active military personnel,"Background Although it has been posited that exposure to adverse childhood experiences (ACEs) increases vulnerability to deployment stress, previous literature in this area has demonstrated conflicting results. Using a cross-sectional population-based sample of active military personnel, the present study examined the relationship between ACEs, deployment related stressors and mood and anxiety disorders. Method Data were analyzed from the 2002 Canadian Community Health Survey – Canadian Forces Supplement (CCHS-CFS; n = 8340, age 18–54 years, response rate 81%). The following ACEs were self-reported retrospectively: childhood physical abuse, childhood sexual abuse, economic deprivation, exposure to domestic violence, parental divorce/separation, parental substance abuse problems, hospitalization as a child, and apprehension by a child protection service. DSM-IV mood and anxiety disorders [major depressive disorder, post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic attacks/disorder and social phobia] were assessed using the Composite International Diagnostic Interview (CIDI). Results Even after adjusting for the effects of deployment-related traumatic exposures (DRTEs), exposure to ACEs was significantly associated with past-year mood or anxiety disorder among men [adjusted odds ratio (aOR) 1.34, 99% confidence interval (CI) 1.03–1.73, p < 0.01] and women [aOR 1.37, 99% CI 1.00–1.89, p = 0.01]. Participants exposed to both ACEs and DRTEs had the highest prevalence of past-year mood or anxiety disorder in comparison to those who were exposed to either ACEs alone, DRTEs alone, or no exposure. Conclusions ACEs are associated with several mood and anxiety disorders among active military personnel. Intervention strategies to prevent mental health problems should consider the utility of targeting soldiers with exposure to ACEs.",0,0 +5575,Emotion-specific and emotion-non-specific components of posttraumatic stress disorder (PTSD): implications for a taxonomy of related psychopathology,"Many cognitive theories of posttraumatic stress disorder (PTSD), including our own SPAARS model, propose that one basis of the disorder is the cognitive system’s persistent failure to resolve discrepancies between trauma-related information and the content of pre-existing mental representations, such as schemas. This leads to the characteristic PTSD symptom pattern of re-experiencing and avoidance of trauma-related material. Furthermore, the nature of this unresolved discrepancy revolves around appraisals of threat and the corresponding emotion profile in PTSD is therefore predominantly intense fear and anxiety. This paper argues that this general framework can be extended to discrepancies around other appraisal dimensions such as loss, and consequently to other emotions such as sadness. A localized taxonomy is therefore proposed comprising emotional disorders that resemble PTSD in their basic patterns of re-experiencing and avoidance symptoms—what we call their ‘emotion-non-specific component’—but that differ from PTSD in terms of the core emotions involved—what we call their ‘emotion-specific component’. The clinical and nosological implications of this argument are discussed.",0,0 +5576,Interleukin-6 and soluble interleukin-6 receptor levels in posttraumatic stress disorder: Associations with lifetime diagnostic status and psychological context,"This study correlated lifetime PTSD diagnostic status with interleukin-6 (IL-6) and soluble IL-6 receptor (sIL-6R) levels, and tested whether these correlations are sensitive to psychological context. Midlife women attended two research visits where blood was drawn (beginning of visits) and saliva and oral mucosal transudate were collected (beginning and end of visits) to measure IL-6 and sIL-6R. Women were classified as PTSD-/- (past and current symptoms below subsyndromal levels), PTSD+/- (past symptoms at or above subsyndromal levels), or PTSD+/+ (past and current symptoms at or above subsyndromal levels). PTSD+/+ women, compared to the other women, showed more negative emotion at the beginning of the visits, higher salivary IL-6 levels at the beginning versus end of visits, and positive correlations between negative emotion, salivary IL-6, and plasma sIL-6R. Their plasma sIL-6R levels exceeded those of the PTSD+/- women. Overall, IL-6 sensitivity to anticipation and to negative emotions, and higher sIL-6R levels, differentiated persistent versus remitted PTSD.",0,0 +5577,Is DSM-IV criterion A2 associated with PTSD diagnosis and symptom severity?,"The diagnostic criteria for posttraumatic stress disorder (PTSD) have received significant scrutiny. Several studies have investigated the utility of Criterion A2, the subjective emotional response to a traumatic event. The American Psychiatric Association (APA) has proposed elimination of A2 from the PTSD diagnostic criteria for DSM-5; however, there is mixed support for this recommendation and few studies have examined A2 in samples at high risk for PTSD such as veterans. In the current study of 908 veterans who screened positive for a traumatic event, A2 was not significantly associated with having been told by a doctor that the veteran had PTSD. Those who endorsed A2, however, reported greater PTSD symptom severity in the 3 DSM-IV symptom clusters of reexperiencing (d = 0.45), avoidance (d = 0.61), and hyperarousal (d = 0.44), and A2 was significantly associated with PTSD symptom severity for all 3 clusters (R2 = .25, .25, and .27, respectively) even with trauma exposure in the model. Thus, although A2 may not be a necessary criterion for PTSD diagnosis, its association with PTSD symptom severity warrants further exploration of its utility.",0,0 +5578,Effects of melatonin on anxiety- like behaviors induced by post–traumatic stress disorder in rat,"Introduction: Post traumatic stress disorder (PTSD) is an anxiety disorder. This study was aimed to evaluate the effect of multiple injections of melatonin on anxiety like behaviors induced by PTSD. Materials and methods: PTSD induced in 60 male wistar rats, by combining the shock and single-prolonged stress method (S&SPS). Animals received electric shock (1 mA, 2s) for 5 days, and then on the day 6 they underwent three stages of SPS (restrained for 2 hours, forced swimming for 20 minutes and anesthetized by diethyl ether for 15 minutes). Seven days after PTSD induction, elevated plus maze (EPM) and open field tests were performed to measure anxiety profile. Animals received multiple subcutaneous injections of melatonin (5, 10, 15 mg/kg) or saline, within the 7 days after PTSD. Results: The control (saline) and treated (melatonin) groups showed significant differences in the percentage of time spent in open arms of the EPM. Melatonin, at dose of 15mg/kg, significantly increased the time spent in open arms of the EPM than the corresponding control group. Animals who received 10mg/kg melatonin showed a significant increase in crossing behavior in open field test than the corresponding control group. Conclusion: Our study showed that melatonin is able to reduce PTSD-induced anxiety-like behaviors in rats.",0,0 +5579,Response to Fergusson and Boden: The psychological impact of major disasters,,0,0 +5580,DSM-5 personality traits discriminate between posttraumatic stress disorder and control groups,"The relevance of personality traits to the study of psychopathology has long been recognized, particularly in terms of understanding patterns of comorbidity. In fact, a multidimensional personality trait model reflecting five higher-order personality dimensions-negative affect, detachment, antagonism, disinhibition, and psychoticism-is included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and represented in the Personality Inventory for DSM-5 (PID-5). However, evaluation of these dimensions and underlying personality facets within clinical samples has been limited. In the present study, we utilized the PID-5 to evaluate the personality profile elevation and composition of 150 control veterans and 35 veterans diagnosed with posttraumatic stress disorder (PTSD). Results indicated that veterans with PTSD endorsed significantly more personality pathology than control veterans, with scores on detachment and psychoticism domains most clearly discriminating between the two groups. When personality domain scores were considered as parts of each subject's personality profile, a slightly different picture emerged. Specifically, the PTSD composition was primarily characterized by detachment and negative affect, followed by disinhibition, psychoticism, and antagonism in that order of relative importance. The profile of the control group was significantly different, mostly accounted for differences in antagonism and psychoticism. Using these complementary analytic strategies, the findings demonstrate the relevance of personality pathology to PTSD, highlight internalizing features of PTSD, and pave the way for future research aimed at evaluating the role of shared maladaptive personality traits in underlying the comorbidity of PTSD and related disorders.",0,0 +5581,"Racial Discrimination, Post Traumatic Stress, and Gambling Problems among Urban Aboriginal Adults in Canada","Little is known about risk factors for problem gambling (PG) within the rapidly growing urban Aboriginal population in North America. Racial discrimination may be an important risk factor for PG given documented associations between racism and other forms of addictive behaviour. This study examined associations between racial discrimination and problem gambling among urban Aboriginal adults, and the extent to which this link was mediated by post traumatic stress. Data were collected via in-person surveys with a community-based sample of Aboriginal adults living in a mid-sized city in western Canada (N = 381) in 2010. Results indicate more than 80 % of respondents experienced discrimination due to Aboriginal race in the past year, with the majority reporting high levels of racism in that time period. Past year racial discrimination was a risk factor for 12-month problem gambling, gambling to escape, and post traumatic stress disorder (PTSD) symptoms in bootstrapped regression models adjusted for confounders and other forms of social trauma. Elevated PTSD symptoms among those experiencing high levels of racism partially explained the association between racism and the use of gambling to escape in statistical models. These findings are the first to suggest racial discrimination may be an important social determinant of problem gambling for Aboriginal peoples. Gambling may be a coping response that some Aboriginal adults use to escape the negative emotions associated with racist experiences. Results support the development of policies to reduce racism directed at Aboriginal peoples in urban areas, and enhanced services to help Aboriginal peoples cope with racist events. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +5582,Prediction of posttraumatic stress disorder among adults in flood district,"Flood is one of the most common and severe forms of natural disasters. Posttraumatic stress disorder (PTSD) is a common disorder among victims of various disasters including flood. Early prediction for PTSD could benefit the prevention and treatment of PTSD. This study aimed to establish a prediction model for the occurrence of PTSD among adults in flood districts.A cross-sectional survey was carried out in 2000 among individuals who were affected by the 1998 floods in Hunan, China. Multi-stage sampling was used to select subjects from the flood-affected areas. Data was collected through face-to-face interviews using a questionnaire. PTSD was diagnosed according to DSM-IV criteria. Study subjects were randomly divided into two groups: group 1 was used to establish the prediction model and group 2 was used to validate the model. We first used the logistic regression analysis to select predictive variables and then established a risk score predictive model. The validity of model was evaluated by using the model in group 2 and in all subjects. The area under the receiver operation characteristic (ROC) curve was calculated to evaluate the accuracy of the prediction model.A total of 2336 (9.2%) subjects were diagnosed as probable PTSD-positive individuals among a total of 25,478 study subjects. Seven independent predictive factors (age, gender, education, type of flood, severity of flood, flood experience, and the mental status before flood) were identified as key variables in a risk score model. The area under the ROC curve for the model was 0.853 in the validation data. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of this risk score model were 84.0%, 72.2%, 23.4%, and 97.8%, respectively, at a cut-off value of 67.5 in the validation data.A simple risk score model can be used to predict PTSD among victims of flood.",0,0 +5583,Consistency of retrospective reporting about exposure to traumatic events,"Lifetime exposure to traumatic events was assessed by means of a multimethod protocol applied to 76 male military veterans. Consistency of retrospective reporting was determined for physical and sexual assault and abuse, accidents, disasters, combat and warzone experiences, serious illness or injury, and hazardous duty. Findings demonstrate that respondents are generally consistent in reporting traumatic events, although the majority report more events upon reevaluation. Reporting about traumatic events shows some variation as a function of the life epoch in which events occurred, whether they were directly or indirectly experienced, and the type of trauma involved. Discussion addresses memory-related processes triggered by trauma evaluation or tied to characteristics of events themselves as potential sources of inconsistency.",0,0 +5584,Factors associated with outcome of cognitive-behavioural treatment of chronic post-traumatic stress disorder,"The study examined factors that were associated with outcome in the treatment of PTSD. A trial of cognitive therapy compared to imaginal exposure of chronic PTSD showed that although clinical improvements were obtained after treatment and at 6 month follow-up one type of treatment was not significantly superior to the other. Characteristics of the patient, the trauma and treatment and of pretreatment clinical measures were investigated as predictors of PTSD outcome. Eleven variables were significantly associated with the pre- to post-treatment change in CAPS severity scores. Of these, three (duration of therapy, gender and suicide risk) were selected into a step-wise multiple regression equation to explain 36.5% of the outcome. Similarly, nine variables were significant associated with the pretreatment to follow-up change with three variables (number of missed therapy sessions, residential status and co-morbid GAD) being selected into the equation and explaining 36.9% of the outcome. The best predictor of outcome was inconsistent attendance at therapy.",0,0 +5585,The course of PTSD in naturalistic long-term studies: High variability of outcomes. A systematic review,"With a lifetime prevalence of 8% posttraumatic stress disorder (PTSD) is one of the most common mental disorders; nevertheless, its longitudinal course is largely unknown.Our aim was to conduct a systematic review summarizing available findings on the prospective, naturalistic long-term course of PTSD and its predictors.Databases MEDLINE and PsycINFO were searched. Main selection criteria were: 1) naturalistic cohort study with a follow-up period of at least 3 years, 2) adult participants with observer-rated or probable PTSD at baseline.Twenty-four cohorts (25 studies) were retrieved (14 with observer-assessed, 10 with probable PTSD). In total, they comprised about 10,500 participants with PTSD at baseline that were included in the long-term follow-ups. Studies investigating patient populations with observer-assessed PTSD found that between 18% and 50% of patients experienced a stable recovery within 3-7 years; the remaining subjects either facing a recurrent or a more chronic course. Outcomes of community studies and studies investigating probable PTSD varied considerably (remission rates 6-92%). Social factors (e.g. support) as well as comorbid physical or mental health problems seem to be salient predictors of PTSD long-term course and special focus should be laid on these factors in clinical settings.Included studies differed notably with regard to applied methodologies. The resulting large variability of findings is discussed. More standardized systematic follow-up research and more uniformed criteria for remission and chronicity are needed to gain a better insight into the long-term course of PTSD.",0,0 +5586,Benzodiazepines in clinical practice: consideration of their long-term use and alternative agents.,"Despite increasing focus on the use of antidepressants and other agents for the treatment of anxiety, benzodiazepines have remained a mainstay of anxiolytic pharmacotherapy due to their robust efficacy, rapid onset of therapeutic effect, and generally favorable side effect profile. In this article, we examine issues related to the long-term use of benzodiazepines, including concerns about the development of therapeutic tolerance, dose escalation, and adverse cognitive effects. We also consider currently available alternatives to benzodiazepines and novel mechanisms of action that may prove fruitful in the development of future generations of anxiolytics.",0,0 +5587,Familial Linkage between Neuropsychiatric Disorders and Intellectual Interests,"From personality to neuropsychiatric disorders, individual differences in brain function are known to have a strong heritable component. Here we report that between close relatives, a variety of neuropsychiatric disorders covary strongly with intellectual interests. We surveyed an entire class of high-functioning young adults at an elite university for prospective major, familial incidence of neuropsychiatric disorders, and demographic and attitudinal questions. Students aspiring to technical majors (science/mathematics/engineering) were more likely than other students to report a sibling with an autism spectrum disorder (p = 0.037). Conversely, students interested in the humanities were more likely to report a family member with major depressive disorder (p = 8.8×10(-4)), bipolar disorder (p = 0.027), or substance abuse problems (p = 1.9×10(-6)). A combined PREdisposition for Subject MattEr (PRESUME) score based on these disorders was strongly predictive of subject matter interests (p = 9.6×10(-8)). Our results suggest that shared genetic (and perhaps environmental) factors may both predispose for heritable neuropsychiatric disorders and influence the development of intellectual interests.",0,0 +5588,ApoE isoform-dependent deficits in extinction of contextual fear conditioning,"The three major human apoE isoforms (apoE2, apoE3 and apoE4) are encoded by distinct alleles (ϵ2, ϵ3 and ϵ4). Compared with ϵ3, ϵ4 is associated with increased risk to develop Alzheimer's disease (AD), cognitive impairments in Parkinson's disease (PD), and other conditions. In contrast, a recent study indicated an increased susceptibility to the recurring and re-experiencing symptom cluster of Post-Traumatic Stress Disorder (PTSD), as well as related memory impairments, in patients carrying at least one ϵ2 allele. Contextual fear conditioning and extinction are used in human and animal models to study this symptom cluster. In this study, acquisition (day 1, training), consolidation (day 2, first day of re-exposure) and extinction (days 2–5) of conditioned contextual fear in human apoE2, apoE3 and apoE4 targeted replacement and C57BL/6J wild-type (WT) mice was investigated. Male and female apoE2 showed acquisition and retrieval of conditioned fear, but failed to exhibit extinction. In contrast, WT, apoE3 and apoE4 mice showed extinction. While apoE2 mice exhibited lower freezing in response to the context on day 2 than apoE3 and apoE4 mice, this cannot explain their extinction deficit as WT mice exhibited similar freezing levels as apoE2 mice on day 2 but still exhibited extinction. Elevating freezing through extended training preserved extinction in controls, but failed to ameliorate extinction deficits in apoE2 animals. These data along with clinical data showing an association of apoE2 with susceptibility to specific symptom clusters in PTSD supports an important role for apoE isoform in the extinction of conditioned fear.",0,0 +5589,Psychosocial Consequences of Bone Marrow Transplantation in Donor and Nondonor Siblings,"We investigated the psychosocial effects of bone marrow transplantation (BMT) on siblings of transplant recipients. We asked how donor siblings compared with nondonor siblings on quantitative measures of behavior, psychological distress, and sense of self. Participants included 44 siblings (21 donors and 23 nondonors, ages 6-18 yr) of surviving pediatric BMT patients. On self-report measures, donors reported significantly more anxiety and lower self-esteem than nondonors. On teacher-rated scales, donors showed significantly more adaptive skills in school. On these same scales, nondonors showed significantly more school problems than donors. One-third of the siblings in each group reported a moderate level of post-traumatic stress reaction. Exploratory multiple regression analyses point to factors that might influence sibling adjustment and suggest counseling strategies and avenues for future research.",0,0 +5590,Sudden Unexpected Versus Violent Death and PTSD Symptom Development,"Changes to posttraumatic stress disorder (PTSD) trauma criterion in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) have been an area of much scrutiny and debate. One of the proposed changes included removing sudden unexpected death (SUD) from the list of potentially traumatic events. This study tested the extent to which unexpected death differed from violent death and other traumas as measured by PTSD symptoms. Our results indicated a significant difference in symptom development between those experiencing sudden violent death and sudden unexpected, but nonviolent, death. Additional analyses at the DSM–IV symptom cluster level, as well as with Simms, Watson, and Doebbeling’s (2002) factor structure of PTSD symptoms, suggested further distinctions between event types and symptom development. The extent to which SUD should be included in the trauma criterion is considered.",0,0 +5591,Risk Factors Associated with Posttraumatic Stress Disorder Symptomatology in HIV-Infected Women,"This study examined risk factors for posttraumatic stress disorder (PTSD) symptomatology in a sample of 102 HIV-positive women. The magnitude of HIV-related PTSD symptoms was associated with a greater number of HIV-related physical symptoms, more extensive history of pre-HIV trauma, less perceived availability of social support, greater degree of perceived stigma, and greater degree of negative life events. Hierarchical multiple regression analysis revealed three individual predictors of PTSD symptomatology: total impact of negative life events, total stigma score, and total number of present symptoms. Stigma emerged as the strongest individual predictor. Social support failed to moderate relationships between PTSD symptomatology and HIV-related physical symptoms and negative life events. These findings may inform helping professionals about risk factors associated with PTSD symptomatology in HIV-positive women.",0,0 +5592,Life Threat and Posttraumatic Stress in School-age Children,"One hundred fifty-nine children (14.5% of the student body) were sampled after a fatal sniper attack on their elementary school playground. Systematic self-reports of posttraumatic stress disorder (PTSD) symptoms were obtained by use of a child PTSD Reaction Index. Analysis of variance revealed significant differences by exposure but not by sex, ethnicity, or age. Additional analyses were conducted of individual item response, overall severity of PTSD reaction, symptom grouping, and previous life events. The results provide strong evidence that acute PTSD symptoms occur in school-age children with a notable correlation between proximity to the violence and type and number of PTSD symptoms. Sampling at approximately one month after the trauma provided adequate delineation among exposure groups. The symptom profile of highly exposed children lends validity to the diagnosis of acute PTSD in childhood.",0,0 +5593,"A randomized, double-blind, placebo-controlled trial on the efficacy and tolerability of sertraline in Iranian veterans with post-traumatic stress disorder","Background Unlike civilian post-traumatic stress disorder (PTSD), the efficacy of sertraline for the treatment of combat-related PTSD has not yet been proven. The present study aimed to evaluate the clinical efficacy of sertraline against combat-related PTSD in a randomized, double-blind, placebo-controlled trial. Method Seventy Iranian veterans of the Iran–Iraq war who met the DSM-IV criteria for diagnosis of PTSD were randomized to receive either flexibly dosed sertraline (50–200 mg/day) ( n =35, completers=32) or placebo ( n =35, completers=30) for 10 weeks. Efficacy was evaluated by the Impact of Event Scale – Revised (IES-R) and the Clinical Global Impression scale – Severity (CGI-S) and Improvement (CGI-I) ratings. Responder criteria were defined as a ⩾30% reduction in the IES-R total score plus a CGI-I rating of ‘much’ or ‘very much’ improved. Results On both intention-to-treat (ITT) and per protocol (completer) methods of analysis, the mean reductions in the IES-R total and subscale (re-experiencing/intrusion, avoidance/numbing and hyperarousal) scores ( p <0.001) and also in the CGI-S score ( p <0.01) were significantly greater in the sertraline group than in the placebo group. For the CGI-I, the mean endpoint score was significantly lower in the sertraline group than in the placebo group ( p ⩽0.001). The number of responders in the sertraline group was significantly higher than in the placebo group (44% v . 3%, p ⩽0.001). Sertraline was well tolerated, with a 6% discontinuation rate as a result of adverse reactions. Conclusions The results of this study suggest that sertraline can be an effective, safe and tolerable treatment for combat-related PTSD in Iranian veterans.",0,0 +5594,"Mental health, educational and social needs of young offenders in custody and in the community","The purpose of this review is to highlight recent findings from research on mental health, educational and social needs of young offenders and the implications for key agencies that commission or provide services.Young offenders have high levels of morbidity in a number of areas, including mental health. A substantial number of young offenders have learning disabilities, which has implications for educational provision and delivering interventions. Other learning problems, such as low reading and comprehension ages, also have consequences for society in a number of areas, including occupational functioning and the associated development of a skilled workforce. There is some evidence that female offenders and persistent offenders are particularly at risk of psychosocial problems. Need is often unmet due to the lack of adequate assessment. Other reasons include inaccessibility of services and difficulties experienced in engaging young people in treatment. Young offenders in the community and those from ethnic minorities are particularly at risk of having poor access to services.Providing services for young offenders requires investment from all the agencies in prioritising their needs. Research can continue to contribute by informing policy and practice, although further understanding of the developmental trajectories of high-risk groups is still needed.",0,0 +5595,High hopes,"Psychedelic drugs fell from grace in the 1960s. Now, scientists are rediscovering them as potential treatments for a range of illnesses.",0,0 +5596,"Common Heritable Contributions to Low-Risk Trauma, High-Risk Trauma, Posttraumatic Stress Disorder, and Major Depression","Understanding the relative contributions of genetic and environmental factors to trauma exposure, posttraumatic stress disorder (PTSD), and major depressive disorder (MDD) is critical to developing etiologic models of these conditions and their co-occurrence.To quantify heritable influences on low-risk trauma, high-risk trauma, PTSD, and MDD and to estimate the degree of overlap between genetic and environmental sources of variance in these 4 phenotypes.Adult twins and their siblings were ascertained from a large population-based sample of female and male twin pairs on the basis of screening items for childhood sexual abuse and physical abuse obtained in a previous assessment of this cohort.Structured psychiatric telephone interviews.Total sample size of 2591: 996 female and 536 male twins; 625 female and 434 male nontwin siblings.Lifetime low- and high-risk trauma exposure, PTSD, and MDD.In the best-fitting genetic model, 47% of the variance in low-risk trauma exposure and 60% of the variance in high-risk trauma exposure was attributable to additive genetic factors. Heritable influences accounted for 46% of the variance in PTSD and 27% of the variance in MDD. An extremely high degree of genetic overlap was observed between high-risk trauma exposure and both PTSD (r = 0.89; 95% CI, 0.78-0.99) and MDD (r = 0.89; 95% CI, 0.77-0.98). Complete correlation of genetic factors contributing to PTSD and to MDD (r = 1.00) was observed.The evidence suggests that almost all the heritable influences on high-risk trauma exposure, PTSD, and MDD, can be traced to the same sources; that is, genetic risk is not disorder specific. Individuals with a positive family history of either PTSD or MDD are at elevated risk for both disorders and should be closely monitored after a traumatic experience for symptoms of PTSD and MDD.",0,0 +5597,Heat stress-responsive transcriptome analysis in heat susceptible and tolerant wheat (Triticum aestivum L.) by using Wheat Genome Array,"Abstract Background Wheat is a major crop in the world, and the high temperature stress can reduce the yield of wheat by as much as 15%. The molecular changes in response to heat stress are poorly understood. Using GeneChip ® Wheat Genome Array, we analyzed genome-wide gene expression profiles in the leaves of two wheat genotypes, namely, heat susceptible 'Chinese Spring' (CS) and heat tolerant 'TAM107' (TAM). Results A total of 6560 (~10.7%) probe sets displayed 2-fold or more changes in expression in at least one heat treatment ( f alse d iscovery r ate, FDR, α = 0.001). Except for heat shock protein (HSP) and heat shock factor (HSF) genes, these putative heat responsive genes encode transcription factors and proteins involved in phytohormone biosynthesis/signaling, calcium and sugar signal pathways, RNA metabolism, ribosomal proteins, primary and secondary metabolisms, as well as proteins related to other stresses. A total of 313 probe sets were differentially expressed between the two genotypes, which could be responsible for the difference in heat tolerance of the two genotypes. Moreover, 1314 were differentially expressed between the heat treatments with and without pre-acclimation, and 4533 were differentially expressed between short and prolonged heat treatments. Conclusion The differences in heat tolerance in different wheat genotypes may be associated with multiple processes and mechanisms involving HSPs, transcription factors, and other stress related genes. Heat acclimation has little effects on gene expression under prolonged treatments but affects gene expression in wheat under short-term heat stress. The heat stress responsive genes identified in this study will facilitate our understanding of molecular basis for heat tolerance in different wheat genotypes and future improvement of heat tolerance in wheat and other cereals.",0,0 +5598,Post-traumatic stress and age variation in amygdala volumes among youth exposed to trauma,"Theoretically, normal developmental variation in amygdala volumes may be altered under conditions of severe stress. The purpose of this article was to examine whether posttraumatic stress moderates the association between age and amygdala volumes in youth exposed to traumatic events who are experiencing symptoms of post-traumatic stress disorder (PTSD). Volumetric imaging was conducted on two groups of youth aged 9-17 years: 28 with exposure to trauma and PTSD symptoms (boys = 15, girls = 13) and 26 matched (age, IQ) comparison youth (Controls; boys = 12, girls = 14). There was a significant group by age interaction in predicting right amygdala volumes. A positive association between age and right amygdala volumes was observed, but only in PTSD youth. These associations with age remained when controlling for IQ, total brain volumes and sex. Moreover, older youth with PTSD symptoms had relatively larger right amygdala volumes than controls. Findings provide evidence that severe stress may influence age-related variation in amygdala volumes. Results further highlight the importance of utilizing age as an interactive variable in pediatric neuroimaging research, in so far as age may act as an important moderator of group differences.",0,0 +5599,Combat veterans' symptoms of PTSD and partners' distress: The role of partners' perceptions of veterans' deployment experiences.,"Romantic partners of combat veterans with posttraumatic stress disorder (PTSD) report elevated relationship and psychological distress. One recent study suggests that this association may be weaker when partners perceive that veterans experienced higher levels of traumatic deployment events, but such results have not yet been replicated. We replicated and extended these findings in a sample of 206 National Guard service members who deployed overseas since 2001 and their partners. We used multivariate structural equation models to explore whether partners' perceptions of service members' deployment experiences moderated the associations of severity of service members' overall PTSD and specific PTSD clusters with partners' psychological and relationship distress. The significant association of overall PTSD symptom severity with partners' distress was not moderated by partners' perceptions. When examining PTSD symptoms at the cluster level, only the numbing/withdrawal cluster was significantly associated with distress. However, this association was moderated by partners' perceptions of service members' deployment experiences, such that the associations weakened as these perceptions increased. These results are in line with research indicating that the avoidance cluster of PTSD symptoms is particularly detrimental for partners of those with PTSD. Furthermore, they indicate that such symptoms are associated with less distress in partners who perceive that service members experienced high levels of potentially traumatic deployment events. Such perceptions may be linked with external attributions for symptoms, which suggests that psychoeducation regarding the causes of PTSD and the totality of PTSD symptoms may be useful in intervening with such partners.",0,0 +5600,Predictors of trait aggression in bipolar disorder,"Although aggressive behavior has been associated with bipolar disorder (BD), it has also been linked with developmental factors and disorders frequently found to be comorbid with BD, making it unclear whether or not it represents an underlying biological disturbance intrinsic to bipolar illness. We therefore sought to identify predictors of trait aggression in a sample of adults with BD.Subjects were 100 bipolar I (n = 73) or II (n = 27) patients consecutively evaluated in the Bipolar Disorders Research Program of the New York Presbyterian Hospital-Payne Whitney Clinic. Diagnoses were established using the Structured Clinical Interview for the DSM-IV (SCID-I) and Cluster B sections of the SCID-II. Mood severity was rated by the Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS). Histories of childhood maltreatment were assessed via the Childhood Trauma Questionnaire (CTQ), while trait aggression was measured by the Brown-Goodwin Aggression Scale (BGA).In univariate analyses, significant relationships were observed between total BGA scores and CTQ total (r = 0.326, p = 0.001), childhood emotional abuse (r = 0.417, p < 0.001), childhood physical abuse (r = 0.231, p = 0.024), childhood emotional neglect (r = 0.293, p = 0.004), post-traumatic stress disorder (t = -2.843, p = 0.005), substance abuse/dependence (t = -2.914, p = 0.004), antisocial personality disorder (t = -2.722, p = 0.008) and borderline personality disorder (t = -5.680, p < 0.001) as well as current HDRS (r = 0.397, p < 0.001) and YMRS scores (r = 0.371, p < 0.001). Stepwise multiple regression revealed that trait aggression was significantly associated with: (i) diagnoses of comorbid borderline personality disorder (p < 0.001); (ii) depressive symptoms (p = 0.001); and (iii) manic symptoms (p < 0.001).Comorbid borderline personality disorder and current manic and depressive symptoms each significantly predicted trait aggression in BD, while controlling for confounding factors. The findings have implications for nosologic distinctions between bipolar and borderline personality disorders, and the developmental pathogenesis of comorbid personality disorders as predisposing to aggression in patients with BD.",0,0 +5601,A Multilevel Approach To Social Support As A Key Determinant Of Post-Traumatic Stress Disorder Onset And Trajectories After A Mass Traumatic Event,"Types of social support and the meaning attributed to each type vary across individuals, contexts and time. Widely studied across disciplines is the role of social support during periods of distress. Factors at multiple levels of social support (individual, network, and community) are often important predictors of psychopathology, including post-traumatic stress disorder (PTSD), in the aftermath of such events. The trajectory of PTSD after traumatic event exposure, in turn, varies markedly between individuals, differing with regards to onset, symptom patterns, recurrence, comorbidity, response to intervention, and recovery. Recent literature has considered how each of these levels may influence the development and persistence of PTSD. This dissertation is an attempt to bring together substantively overlapping, but disciplinarily siloed discussions related to how individual, network, and community levels of social support contribute to mental health functioning in the aftermath of a population-level disaster. The data demonstrate a clear association between individual (and not network) level social support covariates and PTSD onset as well as resilience/recovery and chronic PTSD. Delayed onset PTSD, on the other hand, was equally associated with network-level variables. Community level variables were excluded from the analyses as they did not show a robust pattern of association with PTSD trajectories in preliminary analyses. Given these findings, it is arguable that the history of defining social support simply as one's actual network or how one perceives of his/her network fails to capture the relational nature of social support as an exchange of resources between two or more unique individuals that can prove beneficial or harmful to the functioning of the recipient. Moreover, this paper argues that individual level social support, which includes individual characteristics and behaviors, is central to the successful exchange of resources (interpersonal and professional) and subsequently to health. Keywords: social support, posttraumatic stress disorder, resources, distress, disaster, trauma (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0,0 +5602,Factor Structure of the State-Trait Anger Expression Inventory for Middle-Aged Men and Women,"Recently, Forgays, Forgays, and Spielberger (in press) reported the first exploratory factor analysis of the total 44-item State-Trait Anger Expression Inventory (STAXI) by gender. The analyses were based on a sample of over 700 male and female university students and identified quite well six of the original STAXI scales and subscales. In addition, a seventh factor, ""Feel-Like-Expressing-Anger,"" emerged for women. In the present study, we examined the STAXI responses from a middle-aged adult population. Exploratory factor analyses replicated the majority of the original structure of the STAXI measure including a Feel-Like-Expressing-Anger factor for men and women. In addition, we employed confirmatory factor analyses and cross-validation procedures to test the validity of Spielberger's (1988) AHA! model. Based on these procedures, we found (a) that a seven-factor model provided a better fit than a six-factor solution for each gender and (b) evidence of robust gender differences for two factors: Feel-Like-Expressing Anger and State Anger. These gender differences are consistent with the social costs for anger expression in women and the social benefits for men.",0,0 +5603,The detection of psychiatric illness by questionnaire,,0,0 +5604,Predicting DSM‐III-R Disorders From the Youth Self‐Report: Analysis of Data From a Field Study,"To predict DSM-III-R diagnoses from Youth Self-Report (YSR) scores.The Diagnostic Interview Schedule for Children Version 2.1c (DISC-2.1c) and YSR were administered to 289 homeless adolescents. Stepwise discriminant analysis identified YSR scales contributing to predictions of DSM-III-R disorders. Paper-and-pencil prediction rules based on YSR ""borderline"" or ""clinical"" scores were evaluated.Statistically significant discriminant functions for disruptive disorders, depressive disorders, manic disorders, attention-deficit hyperactivity disorder, schizophrenia, and posttraumatic stress disorder, each based on a unique pair of YSR scales, produced overall hit rates of 0.66 to 0.90. Paper-and-pencil predictions produced comparable results. The weakest overall predictions were for the disruptive behaviors; the best rule (""IF Aggressive OR Delinquent is at least borderline THEN predict oppositional defiant disorder or conduct disorder"") produced a 0.72 hit rate. The strongest overall predictions were for schizophrenia; the best prediction rule (""IF [Thought Problems AND Delinquent are at least borderline] AND [at least one is clinical] THEN predict schizophrenia"") produced a 0.87 hlt rate.While the success rates reported here are specific to this sample, it appears that the YSR has good ability to predict DSM-III-R diagnoses as determined by the DISC. Furthermore, it was demonstrated that categorical diagnoses can be treated as locations or cluster sectors in a multidimensional space.",0,0 +5605,Psychiatric morbidity and comorbidity following accidental man-made traumatic events: incidence and risk factors,"The aims of this study were to examine the incidence and risk factors of major depression, bipolar disorder, psychoactive substance use, psychotic and anxiety disorders in relation to post-traumatic stress disorders (PTSD) in a study group exposed to two different traumatic events, i. e. 128 fire and 55 motor vehicle accident victims. Data have been collected 7–9 months after the traumatic event. The diagnosis of axis-I diagnoses, other than PTSD, was made according to DSM-III-R criteria using the Structured Interview according to the DSN-III-R. The incidence of new-onset major depression was 13.4%, generalised anxiety disorder (GAD) 12.6%, agoraphobia 10.2% and psychoactive substance use disorders 6%. Simple phobia, panic disorder and obsessive compulsive disorder had a much lower incidence (< 2.0%). Fifty-one percent of the victims with PTSD had one or more addition axis-I diagnoses, major depression (26.2%), agoraphobia (21.0%) and generalised anxiety disorder (24.6%) being the most common. Physical injury was the single best predictor for major depression. The best predictors for the development of new-onset anxiety disorders, other than PTSD, were: type and horror of the trauma, the extent of physical injury, the loss of control during the traumatic event, contextual stimuli, younger age and female sex. In conclusion: comorbid disorders, such as depression, GAD and agoraphobia, commonly occur within the first few months after man-made accidental traumata. Trauma variables, which are known to be related to the development of PTSD, are also related to the occurrence of these comorbid disorders.",0,0 +5606,Treatment of post-traumatic stress disorder in children using cognitive behavioural writing therapy,"This study evaluated the effectiveness of Cognitive Behavioral Writing Therapy (CBWT) in 23 children (age 8-18 years) in the Netherlands, who experienced a range of single and recurrent traumatic experiences. CBWT uses exposure, cognitive restructuring and social sharing.At pre-test, post-test and follow-up, post-traumatic stress disorder (PTSD) symptoms, depressive symptoms, trauma-related cognitions and general behavioural problems were assessed.At post-test there was a significant reduction of all symptoms, and this effect was maintained at 6 months follow-up. The mean amount of treatment sessions needed was 5.5.This study shows that short-term CBWT is a potentially effective intervention for clinically referred traumatized children. There is now a clear need of establishing the effectiveness of CBWT in a randomized, controlled trial.This first study indicates CBWT is a promising treatment, which can easily be used in clinical practice.",0,0 +5607,Post-traumatic stress and disability,"Post-traumatic stress is thought to account for significant disability. It is also known to be highly comorbid with other psychiatric conditions such as depression and alcohol dependence.To determine the relationship between post-traumatic stress, depression, alcohol dependence and disability.Seventy armed services personnel were assessed for DSM-IV diagnoses of post-traumatic stress disorder, major depressive disorder and alcohol dependence, and with continuous measures of symptoms of post-traumatic stress, depression and alcohol dependence following a traumatic event. These variables, as predictors of disability (using the Sheehan Disability Scale), were analysed using multivariate analysis of variance, analysis of covariance and multiple regression backward elimination models.No significant interaction was found for the diagnostic variables even after controlling for the continuous symptom measures. In the regression models, symptoms of depression were a significant predictor of total disability (R(2)=0.39). Symptoms of alcohol dependence and post-traumatic stress did not significantly predict disability.Since post-traumatic stress was not found to be associated with disability, its clinical importance may be questionable.",0,0 +5608,Neuropsychology and Psychology of MCS,"Neurological symptoms are frequently reported by patients with multiple chemical sensitivities (MCS). Methods to compare the psychiatric, personality, and neuropsychological function of patients with MCS, chronic fatigue syndrome (CFS), and normal controls are described. Increased rates of Axis I psychiatric diagnoses are observed in the literature for MCS and CFS subjects relative to controls. Findings on the MMPI-2 and the Toronto Alexithymia Scale reveal prof iles consistent with the tendency to report somatic rather than emotional symptoms in response to stress. However, many of the reported somatic symptoms also coincide with those found in neurologic disorders. The overall neuropsychological prof ile for MCS subjects does not reflect cognitive impairment. Relative to normal controls, the only difference in neuropsychological performance observed is reduced recognition of nontarget designs on a visual memory task. More fruitful areas for future psychological research will include measurement of the interaction between behavioral response styles and attentional processes in cognition, as well as observations under controlled challenge conditions.",0,0 +5609,Post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD), which is characterized by intrusive memories, marked avoidance of trauma reminders, affective numbing, and hyperarousal following a traumatic experience was introduced into the diagnostic nomenclature in 1980 with the publication by the American Psychiatric Association of DSM-III. Since then, a large body of research on the presentation and treatment of PTSD has been assembled. A number of efficacious cognitive–behavioral therapies (CBTs) are now offered, such as prolonged exposure and cognitive processing therapy (CPT; [3]), and the rates of successful treatment in a variety of populations are improving. Symptoms and diagnostic criteria In the DSM-IV-TR, there are six diagnostic criteria (Criterion A-F) that must be present for a diagnosis of PTSD. First, the individual must have experienced a traumatic event (Criterion A) during which: (1) the person experienced or witnessed an event or events that involved actual threatened death or serious injury, or a threat to the physical integrity of oneself or others; and (2) the person's reaction involved intense fear, helplessness, or horror (in children this may present as agitated or disorganized behavior). Examples of traumatic events include serious threats to life or physical integrity such as military combat, sexual assault, motor vehicle accidents, physical assault, natural or human-made disasters, or witnessing violence or severe human suffering. The symptoms of PTSD are categorized into three clusters in DSM-IV (Criterion B, C, and D): intrusive recollection, avoidance and numbing, and hyperarousal symptoms. © Cambridge University Press 2010.",0,0 +5610,"Resilience, traumatic brain injury, depression, and posttraumatic stress among Iraq/Afghanistan war veterans.","We examined the prospective influence of the resilient, undercontrolled, and overcontrolled personality prototypes on depression and posttraumatic stress disorder (PTSD) symptoms among Iraq/Afghanistan war veterans. After accounting for the possible influence of combat exposure, we expected that the resilient prototype would predict lower depression and PTSD over time and would be associated with adaptive coping strategies, higher social support, lower psychological inflexibility, and higher self-reported resilience relative to overcontrolled and undercontrolled prototypes, independent of traumatic brain injury (TBI) status.One hundred twenty-seven veterans (107 men, 20 women; average age = 37) participated in the study. Personality was assessed at baseline, and PTSD and depression symptoms were assessed 8 months later. Path analysis was used to test the direct and indirect effects of personality on distress.No direct effects were observed from personality to distress. The resilient prototype did have significant indirect effects on PTSD and depression through its beneficial effects on social support, coping and psychological inflexibility. TBI also had direct effects on PTSD.A resilient personality prototype appears to influence veteran adjustment through its positive associations with greater social support and psychological flexibility, and lower use of avoidant coping. Low social support, avoidant coping, and psychological inflexibility are related to overcontrolled and undercontrolled personality prototypes, and these behaviors seem to characterize veterans who experience problems with depression and PTSD over time. A positive TBI status is directly and prospectively associated with PTSD symptomology independent of personality prototype. Implications for clinical interventions and future research are discussed.",0,0 +5611,Pain symptomatology and pain medication use in civilian PTSD,"The comorbidity of pain syndromes and trauma-related syndromes has been shown to be high. However, there have been limited data, especially in civilian medical populations, on the role of trauma-related disorders such as posttraumatic stress disorder (PTSD) on chronic pain and pain medication use. We analyzed 647 general hospital patients in primary care and obstetrics and gynecological waiting rooms for the experience of trauma and PTSD-related stress disorders. PTSD symptoms were found to be significantly positively correlated with pain ratings (r=.282, P<0.001) and pain-related functional impairment (r=0.303, P<0.001). Those with a current PTSD diagnosis had significantly higher subjective pain and pain-related impairment ratings than those with no PTSD. Furthermore, those with a current diagnosis of PTSD were significantly more likely to have used opioid analgesics for pain control compared to those without a diagnosis of PTSD (χ(2)=8.98, P=0.011). When analyzing the separate PTSD symptom subclusters (re-experiencing, avoidance, and hyperarousal), all symptom clusters were significantly related to pain and pain-related impairment ratings, but only the avoidance cluster was significantly related to prior opioid pain medication use. We conclude that PTSD and trauma-related disorders are common in impoverished medical populations and that their presence should be examined in patients with pain syndromes. Furthermore, these data suggest that PTSD and pain may share a vulnerability pathway, including the endogenous opioid neurotransmission systems.",0,0 +5612,Habituation to stress and dexamethasone suppression in rats with selective basal forebrain cholinergic lesions,"Previous studies suggest a role for basal forebrain cholinergic neurons in enhancing the inhibitory influence of the hippocampus and medial prefrontal cortex (mPFC) on glucocorticoid stress responses mediated by the hypothalamic-pituitary-adrenocortical (HPA) axis. An inhibitory action of the basal forebrain cholinergic (BFC) system may occur through facilitation of stress-related information processing and maintenance of glucocorticoid receptor (GR) expression and negative feedback signaling in these target regions. The current study investigated the possibility that BFC input to the hippocampus contributes to habituation of the glucocorticoid response following repeated exposure to a stressor. Cholinergic lesions were made by microinjections of the immunotoxin 192 IgG-saporin into the medial septum/vertical limb of the diagonal band, and 3 weeks later rats were subjected to six daily sessions of restraint stress. Blood samples taken before, during and after acute stress revealed a significant increase in peak activation and protracted elevation of corticosterone in cholinergic lesioned rats. After 5 days of repeated stress, however, both groups habituated to the stressor, as indicated by similarly low corticosterone profiles throughout both the response and recovery period. Against that habituated background, rats were administered a dexamethasone challenge on day 6, so that feedback status could be examined. Dexamethasone-induced suppression of endogenous corticosterone before, during, and after stress was significantly attenuated in lesioned rats. The profile of dysfunction in glucocorticoid regulation after selective cholinergic lesions in young animals may be relevant to the adrenocortical hyperactivity and negative feedback deficits seen in conditions such as normal aging and Alzheimer's dementia, in which integrity of the basal forebrain cholinergic system is compromised. © 2004 Wiley-Liss, Inc.",0,0 +5613,Predictors of response in anxiety disorders,"Anxiety disorder variables such as duration, severity of illness, and comorbidity with other anxiety or mood disorders appear to identify individuals who are at the greatest risk of treatment nonresponse. Conversely, in accord with clinical experience, shorter periods of illness, less severe illness, being treatment naive, and the absence of comorbidity tend to identify patients who are likely to respond robustly to medication management. Symptom clusters in OCD and PTSD are promising as a means of stratifying those more likely to respond to standard pharmacologic treatment. The presence of hoarding or sexual obsessions seems to presage poorer response in OCD, while the presence of dissociative symptoms in PTSD has been linked to high nonspecific treatment response rates to placebo. Genotyping individuals with respect to genes that are thought to have an important role in the underlying disease process, such as the work with the 5HTTL-PR allele, is exciting and is perhaps the first glimmer of using genotyping to identify treatment strategies or to predict the likelihood or speed of response. The use of neuroimaging as a means of identifying individuals who may respond favorably to pharmacologic or neurosurgical intervention is still in its infancy. As a strategy, it may help combine symptom severity and response variables into a clear neurobiologic vulnerability model of illness. In the future, it may be possible to identify specific treatment interventions for specific patterns of abnormal metabolic rates in certain areas of the brain. However, it should be emphasized that such an approach has not been empirically demonstrated in a rigorous experimental context at this time.",0,0 +5614,"Neurocircuitry Models of Posttraumatic Stress Disorder and Extinction: Human Neuroimaging Research—Past, Present, and Future","The prevailing neurocircuitry models of anxiety disorders have been amygdalocentric in form. The bases for such models have progressed from theoretical considerations, extrapolated from research in animals, to in vivo human imaging data. For example, one current model of posttraumatic stress disorder (PTSD) has been highly influenced by knowledge from rodent fear conditioning research. Given the phenomenological parallels between fear conditioning and the pathogenesis of PTSD, we have proposed that PTSD is characterized by exaggerated amygdala responses (subserving exaggerated acquisition of fear associations and expression of fear responses) and deficient frontal cortical function (mediating deficits in extinction and the capacity to suppress attention/response to trauma-related stimuli), as well as deficient hippocampal function (mediating deficits in appreciation of safe contexts and explicit learning/memory). Neuroimaging studies have yielded convergent findings in support of this model. However, to date, neuroimaging investigations of PTSD have not principally employed conditioning and extinction paradigms per se. The recent development of such imaging probes now sets the stage for directly testing hypotheses regarding the neural substrates of fear conditioning and extinction abnormalities in PTSD.",0,0 +5615,Predictors of susceptibility and resilience in an animal model of posttraumatic stress disorder.,"Animal models of posttraumatic stress disorder (PTSD) are based on fear conditioning where innocuous cues elicit reactions that originally occur to traumatic events--a core feature of PTSD. Another core feature is hyperarousal--exaggerated reactions to stressful events. One limitation of animal models of PTSD is that group effects do not model the sporadic incidence of PTSD. We developed an animal model of PTSD in which rabbit nictitating membrane responses become exaggerated as a function of classical conditioning to a tone conditioned stimulus (CS) paired with a shock unconditioned stimulus (US). Exaggerated responses to the US are a form of hyperarousal termed conditioning-specific reflex modification (CRM) and occur in the absence of the CS. Inspecting data across several experiments, we determined 25% of our rabbits exhibit strong CRM despite all subjects having high levels of conditioning. To determine how prone rabbits were to CRM (susceptibility) or how resistant (resilience), we examined data from 135 rabbits analyzing for factors during CS-US pairings and during US prescreening that would predict CRM. We found the magnitude of CRM was correlated with the onset latency and area of conditioned responding during CS-US pairings and with the peak latency of a response during US pretesting. In an animal model of PTSD that more accurately reflects clinical prevalence, we can begin to predict susceptibility not only during responding to a stressful conditioning situation but also during a screening process before the stressful situation takes place. The results suggest relatively innocuous testing may help detect PTSD after trauma and screen for it before trauma occurs.",0,0 +5616,"A twin study of generalized anxiety disorder symptoms, panic disorder symptoms and post-traumatic stress disorder in men","Generalized anxiety disorder (GAD), panic disorder (PD) and post-traumatic stress disorder (PTSD) often co-occur. We investigated whether and to what degree genetic and environmental contributions overlap among symptoms of GAD, symptoms of PD and PTSD. Subjects were 3327 monozygotic and dizygotic male-male twin pair members of the Vietnam Era Twin Registry who participated in a 1992 telephone administration of the Diagnostic Interview Schedule Version 3 Revised (DIS3R). Genetic model fitting was performed to estimate the magnitude of genetic and environmental contributions to the lifetime co-occurrence of GAD symptoms, PD symptoms and PTSD. The liability for GAD symptoms was due to a 37.9% additive genetic contribution common to PD symptoms and PTSD. Liability for PD symptoms was due to a 20.7% additive genetic contribution common to GAD symptoms and PTSD, and a 20.1% additive genetic influence specific to PD symptoms. Additive genetic influences common to symptoms of GAD and PD accounted for 21.3% of the genetic variance in PTSD. Additive genetic influences specific to PTSD accounted for 13.6% of the genetic variance in PTSD. Remaining variance for all three disorders was due to unique environmental factors both common and specific to each phenotype. These results suggest that these disorders each have etiologically distinct components and also have significant genetic and unique environmental contributions in common.",0,0 +5617,"Comparison of Response to a Selective Serotonin Reuptake Inhibitor in Children, Adolescents, and Adults with Posttraumatic Stress Disorder","Although the pathophysiology of posttraumatic stress disorder (PTSD) is considered multifactorial, empirical evidence suggests that serotonergic dysregulation may characterize the disorder. The efficacy of the selective serotonin reuptake inhibitors (SSRIs) in treating essential symptoms (re-experiencing, avoidance, numbing, hyperarousal) in both adults and children is likely to involve potentiation of this neurotransmitter.This study compared outcome in an 8-week open trial of citalopram (an SSRI) in children/adolescents and adults with a Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnosis of PTSD.Twenty-four children/adolescents and 14 adults assessed for PTSD severity at baseline were followed up on citalopram treatment (20-40 mg/day) at two-weekly intervals over 8 weeks. The Clinician-Adminstered PTSD Scale (CAPS) and the Clinical Global Improvement Scale (CGI) were used as outcome measures.Although there were no significant differences in outcome measures between children/adolescents (n = 24) and adults (n = 14), both groups had significant reductions in mean CAPS total scores, symptom cluster scores, and CGI ratings at endpoint.Although the SSRIs have established efficacy and safety in the treatment of adult PTSD, literature on their use in child and adolescent PTSD is sparse. Controlled data are needed to support the clinical perception that SSRIs are agents of choice in the treatment of pediatric PTSD.",0,0 +5618,Personality disorders in treatment-seeking combat veterans with posttraumatic stress disorder,"Many patients with posttraumatic stress disorder (PTSD) appear to have co-occurring symptoms of character pathology; however, to date there have been no empirical studies of comorbid clinician-rated axis II personality disorders in war veterans with chronic PTSD. The authors' objective was to assess DSM-III-R personality disorders in treatment-seeking combat veterans with PTSD.They used the Personality Disorder Examination, a standardized diagnostic interview for DSM-III-R axis II disorders, to assess DSM-III-R personality disorders in 34 patients with PTSD; 18 of the subjects were inpatients and 16 were outpatients.A high rate of character pathology was observed in both inpatient and outpatient groups. The most frequent disorders for which criteria were met were borderline, obsessive-compulsive, avoidant, and paranoid personality disorders. Inpatients had a higher rate of nearly every personality disorder than did outpatients. Inpatients were significantly more likely to meet diagnostic criteria for paranoid, schizotypal, avoidant, and self-defeating personality disorders.War-related PTSD in treatment-seeking Vietnam veterans is often accompanied by diffuse, debilitating, and enduring impairments in character. Subtyping patients with PTSD on the basis of specific axis II profiles may aid in the selection of more specific and effective treatments.",0,0 +5619,Disentangling Mild Traumatic Brain Injury and Stress Reactions,"The study by Hoge and colleagues in this issue of the Journal provides an important profile of the sequelae of mild traumatic brain injury in military personnel after combat.1 The findings demonstrate that mild traumatic brain injury results in increased rates of psychological, health, and functional problems. Although the study provides strong evidence for impairments in military personnel serving in Iraq and Afghanistan, it also raises a number of critical questions concerning the impairments that may be attributed to mild traumatic brain injury. One striking finding from this study is that although mild traumatic brain injury predicted a range of . . .",0,0 +5620,Compulsive sexual behavior among male military veterans: Prevalence and associated clinical factors,"Compulsive sexual behavior (CSB) is highly prevalent among men, often co-occurring with psychiatric disorders and traumatic experiences. Psychiatric disorders and trauma are highly prevalent among military veterans, yet there is a paucity of research on CSB among military samples. The aim of this study was to examine the prevalence of and factors associated with CSB among male military veterans.Surveys were administered to veterans of Operations Iraqi Freedom, Enduring Freedom, or New Dawn at baseline (n = 258), 3 months(n = 194), and 6 months (n = 136). Bivariate analyses and Generalized Estimating Equations were utilized to estimate associations between CSB and the following variables: psychiatric co-morbidity, childhood physical or sexual trauma, pre- and post-deployment experiences, TV/ Internet usage, and sociodemographics. Associations between CSB and specific PTSD symptom clusters were also examined.CSB was reported by 16.7% of the sample at baseline. Several variables were associated with CSB in bivariate analyses; however, only PTSD severity, childhood sexual trauma, and age remained significant in multivariable GEE models. The PTSD symptom cluster re-experiencing was most strongly associated with CSB.This exploratory study suggests that CSB is prevalent amongst veterans returning from combat and is associated with childhood trauma and PTSD, particularly re-experiencing.Further study is needed to identify the mechanisms linking PTSD and CSB, define the context and severity of CSB in veterans, and examine the best ways to assess and treat CSB in VA clinical settings.",0,0 +5621,Evidence for low-grade systemic proinflammatory activity in patients with posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) may increase cardiovascular risk but the psychophysiological mechanisms involved are elusive. We hypothesized that proinflammatory activity is elevated in patients with PTSD as diagnosed by the Clinician Administered PTSD Scale (CAPS) interview. Plasma levels of proinflammatory C-reactive protein (CRP), interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α, and of anti-inflammatory IL-4 and IL-10 were measured in 14 otherwise healthy PTSD patients and in 14 age- and gender-matched healthy non-PTSD controls. Levels of TNF-α ( p = 0.038; effect size Cohen’s d = 0.58) and of IL-1β ( p = 0.075, d = 0.68) were higher in patients than in controls. CRP ( d = 0.10), IL-6 ( d = 0.18), IL-4 ( d = 0.42), and IL-10 ( d = 0.37) were not significantly different between groups. Controlling for traditional cardiovascular risk factors, mood, and time since trauma revealed lower IL-4 in patients than in controls ( p = 0.029) and rendered group differences in TNF-α and IL-1β insignificant. In all subjects, TNF-α correlated with total (frequency and intensity) PTSD symptom cluster of re-experiencing ( r = 0.49, p = 0.008), avoidance ( r = 0.37, p = 0.050), and hyperarousal ( r = 0.42, p = 0.026), and with PTSD total symptom score ( r = 0.37, p = 0.054). Controlling for time since trauma attenuated these associations. The correlation between IL-1β and total avoidance symptoms ( r = 0.42, p = 0.028) became insignificant when controlling for anxiety and depression. IL-4 correlated with total hyperarousal symptoms ( r = −0.38, p = 0.047), and after controlling for systolic blood pressure and smoking status, with PTSD total symptom score ( r = −0.41, p = 0.035). PTSD patients showed a low-grade systemic proinflammatory state, which, moreover, was related to PTSD symptom levels suggesting one mechanism by which PTSD could contribute to atherosclerotic disease.",0,0 +5622,Enduring sensorimotor gating abnormalities following predator exposure or corticotropin-releasing factor in rats: A model for PTSD-like information-processing deficits?,"A deficit in prepulse inhibition (PPI) can be one of the clinically observed features of post-traumatic stress disorder (PTSD) that is seen long after the acute traumatic episode has terminated. Thus, reduced PPI may represent an enduring psychophysiological marker of this illness in some patients. PPI is an operational measure of sensorimotor gating and refers to the phenomenon in which a weak stimulus presented immediately before an intense startling stimulus inhibits the magnitude of the subsequent startle response. The effects of stress on PPI have been relatively understudied, and in particular, there is very little information on PPI effects of ethologically relevant psychological stressors. We aimed to develop a paradigm for evaluating stress-induced sensorimotor gating abnormalities by comparing the effects of a purely psychological stressor (predator exposure) to those of a nociceptive physical stressor (footshock) on PPI and baseline startle responses in rats over an extended period of time following stressor presentation. Male Sprague-Dawley rats were exposed (within a protective cage) to ferrets for 5 min or left in their homecage and then tested for PPI immediately, 24 h, 48 h, and 9 days after the exposure. The effects of footshock were evaluated in a separate set of rats. The effects seen with stressor presentation were compared to those elicited by corticotropin-releasing factor (CRF; 0.5 and 3 μg/6 μl, intracerebroventricularly). Finally, the effects of these stressors and CRF administration on plasma corticosterone were measured. PPI was disrupted 24 h after ferret exposure; in contrast, footshock failed to affect PPI at any time. CRF mimicked the predator stress profile, with the lowdose producing a PPI deficit 24 h after infusion. Interestingly, the high dose also produced a PPI deficit 24 h after infusion, but with this dose, the PPI deficit was evident even 9d later. Plasma corticosterone levels were elevated acutely (before PPI deficits emerged) by both stressors and CRF, but returned to normal control levels 24 h later, when PPI deficits were present. Thus, predator exposure produces a delayed disruption of PPI, and stimulation of CRF receptors recapitulates these effects. Contemporaneous HPA axis activation is neither necessary nor sufficient for these PPI deficits. These results indicate that predator exposure, perhaps acting through CRF, may model the delayed-onset and persistent sensorimotor gating abnormalities that have been observed clinically in PTSD, and that further studies using this model may shed insight on the mechanisms of information-processing deficits in this disorder. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0,0 +5623,Posttraumatic Stress and Stigma in Active-Duty Service Members Relate to Lower Likelihood of Seeking Support,"Posttraumatic stress disorder (PTSD) is a common mental health concern for returning service members. Social support is a robust predictor of resiliency and recovery from PTSD; however, barriers to seeking support are understudied. PTSD and anticipated enacted stigma from family and friends were explored as correlates of the likelihood of seeking support among 153 Iraq/Afghanistan U.S. service members. Results showed that PTSD (r = -.31, p < .001) and anticipated enacted stigma (r = -.22, p ≤ .01) were negatively associated with likelihood of seeking support. Post hoc analyses showed that only dysphoria (r = -.32, p < .001) was significantly related to the likelihood of seeking support after accounting for anticipated enacted stigma and other PTSD clusters. Implications of these findings and ways to increase likelihood of seeking support are discussed.",0,0 +5624,"Post-traumatic stress disorder, emotional processing and Inappropriate Implantable Cardioverter-Defibrillator Shocks: clinical consideration by a single case report","Introduction. Even though an overwhelming amount of evidence supports the clinical efficacy and safety of the implantable cardioverter defibrillator (ICD), inappropriate shocks for atrial arrhythmias with rapid ventricular conduction or for abnormal sensing results in multiple adverse effects Presentation. In this study we present the case of a 59- year-old woman who was admitted to hospital for ICD implantation with a past medical history that was positive for non-ischemic dilated cardiomyopathy, congestive heart failure (NYHA class III), atrial fibrillation, essential hypertension and a recent episode of syncope. Since in the 18 months follow-up the patient suffered many inappropriate shocks, we investigated the association of the presence of a PTSD (Post- Traumatic-Stress-Disorder) prior to implantation and a specific profile of cognitive processing emotions, with the effectiveness of the ICD. Emotional distress states and cognitive thoughts preceding ICD shock inappropriate episode were recorded by structured mobile diary (eMotional-ICDiary©). We outlined how the presence of a highly traumatic event which had occurred 6 years previously was related to a recurrence of a combination of moderate distress and cognitive thoughts, associated with episodes of Inappropriate Shock. A psycho-diagnostic examination and the administration of the Emotional Processing Scale (EPS-25) and Emotional Regulation Questionnaire (ERQ) outlined that the patient presented a profile of cognitive processing of emotions characterized by elevated levels of unprocessed emotions, low appraisal and high suppression emotional regulation strategy. Conclusion. The observations gathered in this single case are a good starting point for further research in order to check if the post-traumatic stress disorder and a specific cognitive profile connected to the processing of emotions are associated with the presence of inappropriate ICD shocks. Further larger sample studies are required in this area.",0,0 +5625,"PTSD in Vietnamese Americans following Hurricane Katrina: Prevalence, patterns, and predictors","One year after Hurricane Katrina devastated New Orleans, we assessed 82 adults from a population-based sample of the Vietnamese American community who had participated in a larger study of immigration weeks before the disaster. Although 21% met criteria for partial posttraumatic stress disorder (PTSD), only 5% of the sample met all PTSD criteria. Avoidance/numbing symptoms did not form a coherent cluster and were seldom confirmed, but intrusion, arousal, and interference were common. Severity of exposure to the floodwaters, property loss, and subjective trauma were independently related to PTSD symptoms. Symptoms were highest among participants who were low in acculturation or who had high Katrina exposure in combination with prolonged stays in transition camps during emigration.",0,0 +5626,Long-Term Adjustment of Survivors of Ovarian Cancer Treated for Advanced-Stage Disease,"This study described the long-term adjustment of 42 ovarian cancer survivors diagnosed with advanced-stage disease with no evidence of recurrence, a mean of 6.1 years postdiagnosis. 64% of survivors' mental health was at or above the norm of medical outpatients (Mental Health Inventory-17). No patients reported post-traumatic stress disorder at a diagnosable level (Post-Traumatic Stress Disorder (PTSD) Checklist-Civilian). The majority of survivors (> or = 75%) reported a positive impact of cancer on their lives (Impact of Cancer Scale) and excellent social support (Medical Outcomes Study Social Support Survey). However, a subset of survivors reported needing more help than was received regarding emotional problems (28.9%).",0,0 +5627,"Psychological and health problems in a geographically proximate population time-sampled continuously for three months after the September 11th, 2001 terrorist incidents","This study assessed the mental and physical health status and psychological problems related to the September 11th terrorist incidents among a representative sample of adults living near New York City, using continuously time-sampled data collected throughout 2001. Prevalence estimates for poor mental or physical health after September 11th (October through December) were comparable to those for the entire year of 2001 (i.e. approximately 33%). Psychological problems related to the terrorist incidents were reported by more than half of the respondents, and appeared to peak in prevalence approximately two to three months following the incidents, followed by a decline in the next month and subsequent year. Poor mental health, female gender, media re-exposure, and ongoing or increased alcohol use were risk factors for psychological problems, while older age (65+ years old) and being married were protective factors. Risk factors for poor physical and mental health or psychological problems were generally stable over the three-month period following September 11th, but some changes were identified consistent with stage models of post-disaster psychological adjustment. Implications are discussed for using continuous time-sampling as a strategy to research patterns of relatively acute stress-related sequelae of terrorism in populations whose members are affected despite primarily not having been at the disaster epicenter.",0,0 +5628,Course and prognostic factors of whiplash: A systematic review and meta-analysis ☆,"We conducted a systematic review and meta-analysis of prospective cohort studies of subjects with acute whiplash injuries. The aim was to describe the course of recovery, pain and disability symptoms and also to assess the influence of different prognostic factors on outcome. Studies were selected for inclusion if they enrolled subjects with neck pain within six weeks of a car accident and measured pain and/or disability outcomes. Studies were located via a sensitive search of electronic databases; Medline, Embase, CINAHL, Cochrane database, ACP Journal club, DARE and Psychinfo and through hand-searches of relevant previous reviews. Methodological quality of all studies was assessed using a six item checklist. Sixty-seven articles, describing 38 separate cohorts were included. Recovery rates were extremely variable across studies but homogeneity was improved when only data from studies of more robust methodological quality were considered. These data suggest that recovery occurs for a substantial proportion of subjects in the initial 3 months after the accident but after this time recovery rates level off. Pain and disability symptoms also reduce rapidly in the initial months after the accident but show little improvement after 3 months have elapsed. Data regarding the prognostic factors associated with poor recovery were difficult to interpret due to heterogeneity of the techniques used to assess such associations and the way in which they are reported. There was also wide variation in the measurement of outcome and the use of validated measures would improve interpretability and comparability of future studies.",0,0 +5629,Anatomical and neuropsychological effects of cluster munitions,"The aim of this article is to investigate the effects of cluster munitions on the different environmental, anatomical and neuropsychological levels. We conducted a study to explore the effects of sub-munitions on Lebanese victims. The study included a total of 407 cases that have been subjected to the detonation of unexploded sub-munitions in Lebanon, between 2006 and 2011. In our series, 356 casualties were injured and 51 were dead. 382 were males and 25 were females. We recorded 83 cases of amputations, and injuries involving cranio-facial regions, thorax, abdomen, and upper and lower extremities. These injuries lead to loss of function, body disfiguration, and chronic pain caused by the injuries or the amputations, as well as post-traumatic stress disorder. The peripheral nervous system was mostly affected and patients suffered from significant psychosocial tribulations. Cluster munitions harm human beings and decrease biodiversity. Survivors suffer from physical and psychological impairments. Laws should be passed and enforced to ban the use of these detrimental weapons that have negative effects on ecosystem and societal levels. © 2013 Springer-Verlag Italia.",0,0 +5630,The Mental Health Status of Women in the Navy and Marine Corps: Preliminary Findings from the Perceptions of Wellness and Readiness Assessment,"The 1995 Perceptions of Wellness and Readiness Assessment was designed to provide baseline health and risk-factor information on the physical and mental health status of women in the U.S. Navy and Marine Corps and to make comparisons both within military subpopulations and with civilian populations. A population-based, multi-stage, cluster sample of 782 active duty Navy and Marine Corps women and men were administered a structured computerized telephone interview to make Diagnostic and Statistical Manual-III-R psychiatric diagnoses. Estimates were 40 and 21% for overall lifetime and 1-year prevalence of psychiatric disorders, respectively. Women had about five times the risk of experiencing post-traumatic stress disorder than men and about twice the risk of a major depressive episode. Of all personnel meeting diagnostic criteria for an active mental disorder, only 19% sought mental health care in the last year. Women generally sought treatment more readily than men.",0,0 +5631,"[The relationship between depression, anxiety and heart disease - a psychosomatic challenge].","Depressive and cardiological disorders present a major comorbidity. Their manifold interrelations may be best analysed within a biopsychosocial model of disease.A systematic research was done on empirical studies published during the last 15 years and dealing with epidemiological, etiopathogenetic and therapeutic dimensions of the comorbidity of depression, anxiety and heart disease.From an epidemiological perspective recurrent depressions are associated with a significantly increased risk of coronary heart disease. Depressive disorders play a major role in triggering critical cardiac events, e.g. myocardial infarction. The prevalence rates of depressive disorders in various cardiological conditions are significantly higher than the frequencies that can be expected in healthy general population. Depression shows a negative impact on the somatic morbidity and mortality during the further course of illness. Anxiety and posttraumatic stress disorders seem to be interrelated with cardiological conditions in quite a similar way, probably contributing even more negatively to critical and lethal cardiological events than depression. From an etiopathogenetic perspective some clusters of depressive symptoms seem to be linked to cardiotoxicity more closely than other, vital exhaustion, anhedonia, and hopelessness probably mediating a special risk. In any case, postmyocardial infarct depression that proves treatment-resistent indicates a negative prognosis of the prevailing cardiological condition. On a level of psychological and psychosocial constructs type-A personality, anger/hostility, type-D personality, and alexithymia have been explored regarding its proper pathogenetic role. Psychological and psychopathological variables have to be set into a context of psychosocial stressors on the one hand, and have to be simultaneously analysed with various underlying psycho- and neurobiological variables on the other. Above all, HPA- and sympathicomedullary dysfunctions, reduced heart rate variability, altered functions of thrombocytes, and increased proinflammatory processes have to be recognized as significantly contributing to the pathophysiology both of depression and of heart condition. Neurobiological aspects of anxiety and posttraumatic stress disorders must be interlinked with these underpinnings of depression. Differential effects on critical cardiological events must be supposed. From a therapeutic perspective several RCTs demonstrate that SSRIs may safely and efficiently treat depressive disorders in cardiological conditions, and may even improve the general somatic prognosis. Cognitive-behavioural psychotherapies have been empirically validated in treating depression and anxiety with cardiological patients. So far, however, a differential indication of psychopharmacological versus psychotherapeutic approaches has not been proved yet.Depression and anxiety disorders in patients with heart disease paradigmatically define a psychosomatic-somatopsychic challenge to any health delivery system. A psychosomatic perspective may best be practised within a Consultation-Liaison psychiatric service that cooperates continuously and closely with cardiological departments and experts.",0,0 +5632,The role of early pharmacotherapy in the development of posttraumatic stress disorder symptoms after traumatic injury: an observational cohort study in consecutive patients,"Pharmacological intervention during traumatic memory consolidation has been suggested to prevent posttraumatic stress disorder (PTSD). The aim of this study was to examine the association between prescription of early pharmacotherapy and the risk of developing PTSD symptoms following traumatic injury.The use of opiate analgesics, beta-adrenergic blockers, corticosteroids and benzodiazepines within 48 h postinjury was documented based on hospital charts for 629 Level 1 trauma center patients. PTSD symptoms were assessed using structured clinical interviews. Primary outcome was 6-week PTSD symptoms. Secondary outcomes were PTSD diagnoses at 6 weeks and during 1 year posttrauma.Linear regression analyses showed that opiate administration within 48 h was negatively associated with PTSD symptoms at 6 weeks (β=-0.14, P=.009) after controlling for demographic and injury-related characteristics and concurrent pharmacotherapy. Fewer patients with opiates had a PTSD diagnosis at 6 weeks (P=.047) and during 1 year posttrauma (P=.013) than patients with none of the specified pharmacotherapies. Low prescription frequency of beta-blockers (3.8%), corticosteroids (2.2%) and benzodiazepines (7.8%) precluded further examination of their role in the development of PTSD symptoms because of limited statistical power.This study suggests a possible beneficial influence of opiate administration within 48 h posttrauma on the development of PTSD symptoms. Future studies may evaluate the effectiveness of inhospital opiate analgesics compared to placebo in preventing PTSD and may focus on the mechanisms underlying the effect of opiates in preventing PTSD.",0,0 +5633,"Neurobehavioral, neuropathological and biochemical profiles in a novel mouse model of co-morbid post-traumatic stress disorder and mild traumatic brain injury","Co-morbid mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) has become the signature disorder for returning combat veterans. The clinical heterogeneity and overlapping symptomatology of mTBI and PTSD underscore the need to develop a preclinical model that will enable the characterization of unique and overlapping features and allow discrimination between both disorders. This study details the development and implementation of a novel experimental paradigm for PTSD and combined PTSD-mTBI. The PTSD paradigm involved exposure to a danger-related predator odor under repeated restraint over a 21day period and a physical trauma (inescapable footshock). We administered this paradigm alone, or in combination with a previously established mTBI model. We report outcomes of behavioral, pathological and biochemical profiles at an acute timepoint. PTSD animals demonstrated recall of traumatic memories, anxiety and an impaired social behavior. In both mTBI and combination groups there was a pattern of disinhibitory like behavior. mTBI abrogated both contextual fear and impairments in social behavior seen in PTSD animals. No major impairment in spatial memory was observed in any group. Examination of neuroendocrine and neuroimmune responses in plasma revealed a trend towards increase in corticosterone in PTSD and combination groups, and an apparent increase in Th1 and Th17 proinflamatory cytokine(s) in the PTSD only and mTBI only groups respectively. In the brain there were no gross neuropathological changes in any groups. We observed that mTBI on a background of repeated trauma exposure resulted in an augmentation of axonal injury and inflammatory markers neurofilament L and ICAM-1. Our observations thus far suggest that this novel stress-trauma-related paradigm may be a useful model for investigating further the overlapping and distinct spatio-temporal and behavioral/biochemical relationship between mTBI and PTSD experienced by combat veterans.",0,0 +5634,Quality of Life after Traumatic Injury: A Latent Trajectory Modeling Approach,"<b><i>Background:</i></b> It is largely unknown how quality of life (QoL) changes following accidental injuries. Equally, the mechanisms underlying such changes have not yet been identified in detail. This study of injured accident survivors aimed to: (1) detect a model of change which best explains the observed course of QoL, and (2) identify potential predictor variables. <b><i>Methods:</i></b> 323 injured accident survivors were interviewed within 2 weeks of the trauma, and followed up at 6 and 12 months. Latent trajectory modeling was used to analyze the fit of three potential trajectories regarding the observed course of general QoL as measured by the Questions on Life Satisfaction questionnaire. <b><i>Results:</i></b> The trajectory model adopting a negative square-root change fitted the observed data best, meaning that shortly after the accident, general QoL decreased strongly with diminishing negative changes occurring later on. Early and prolonged QoL impairment was largely attributable to the initial level of posttraumatic stress as measured by the Clinician-Administered PTSD Scale. To a lesser extent, depressive symptoms also predicted change in subjective QoL, while injury severity showed no direct effect; rather, its impact on QoL was mediated by initial posttraumatic stress. By contrast, reduced occupational functioning was attributable to injury severity rather than psychopathology. <b><i>Conclusions:</i></b> When treating injured accident survivors, clinicians should consider symptoms of posttraumatic stress and comorbid depression in order to prevent or mitigate negative changes in QoL.",0,0 +5635,Behavioral inhibition in childhood predicts smaller hippocampal volume in adolescent offspring of parents with panic disorder,"Behavioral inhibition (BI) is a genetically influenced behavioral profile seen in 15-20% of 2-year-old children. Children with BI are timid with people, objects and situations that are novel or unfamiliar, and are more reactive physiologically to these challenges as evidenced by higher heart rate, pupillary dilation, vocal cord tension and higher levels of cortisol. BI predisposes to the later development of anxiety, depression and substance abuse. Reduced hippocampal volumes have been observed in anxiety disorders, depression and posttraumatic stress disorder. Animal models have demonstrated that chronic stress can damage the hippocampal formation and implicated cortisol in these effects. We, therefore, hypothesized that the hippocampi of late adolescents who had been behaviorally inhibited as children would be smaller compared with those who had not been inhibited. Hippocampal volume was measured with high-resolution structural magnetic resonance imaging in 43 females and 40 males at 17 years of age who were determined to be BI+ or BI- based on behaviors observed in the laboratory as young children. BI in childhood predicted reduced hippocampal volumes in the adolescents who were offspring of parents with panic disorder, or panic disorder with comorbid major depression. We discuss genetic and environmental factors emanating from both child and parent that may explain these findings. To the best of our knowledge, this is the first study to demonstrate a relationship between the most extensively studied form of temperamentally based human trait anxiety, BI, and hippocampal structure. The reduction in hippocampal volume, as reported by us, suggests a role for the hippocampus in human trait anxiety and anxiety disorder that warrants further investigation.",0,0 +5636,Traumatic brain injury and PTSD screening efforts evaluated using latent class analysis.,"To empirically identify latent classes of service members according to persistent postconcussive symptom patterns and to characterize the identified classes relative to other postdeployment variables including posttraumatic stress disorder (PTSD) and mild traumatic brain injury (TBI) screening results. Such comparisons may directly inform policy regarding these routine assessments and translate to improved treatment decisions.Self-report data were obtained for 12,581 combat-exposed male U.S. Navy and Marine Corps personnel who returned from deployment in 2008-2009 and completed a Post-Deployment Health Assessment (PDHA) and an associated Post-Deployment Health Reassessment (PDHRA). Persistent postconcussive symptoms indicated on the PDHRA were used as manifest variables in a latent class analysis yielding 4 distinct classes: systemic, cognitive/behavioral, comorbid, and nonpresenting.Although the nonpresenting class endorsed few or no postconcussive symptoms, the systemic and cognitive/behavioral classes displayed elevated likelihoods of neurological and mental health symptoms, respectively. Members of the comorbid class had an increased probability of reporting a wide range of symptoms across both domains. Characterization of identified classes suggested that class membership may indicate the presence or absence of persistent conditions resulting from head injury and/or mental health issues. Under this assumption, estimated class membership probabilities implied a rate of probable neurological injury among this sample to be 17.9%, whereas the standard assessments aimed at identifying repercussions of mild TBI reported a positive screening rate of only 13.1%.Findings suggest that the routinely administered PDHA and PDHRA appear to underestimate the true prevalence of service members experiencing postdeployment health problems. Supplemental items or an alternative screening algorithm incorporating persistent postconcussive symptoms may enable identification of additional cases requiring treatment following return from deployment.",0,0 +5637,Resilience and Variability Following Oil Spill Disasters,"© 2012 Guilford Publications, Inc. George A. Bonanno, Ph.D., is Professor of Clinical Psychology in the Department of Counseling and Clinical Psychology at Columbia University in New York City. Address correspondence to George Bonanno, Deparatment of Counseling and Clinical Psychology, Teachers College Box 218, Columbia University, 525 W. 120th Street, New York, NY 10027. E-mail: Gab38@columbia.edu Commentary on “Lessons Learned from the Exxon Valdez Oil Spill” Bonanno",0,0 +5638,Peritraumatic dissociation and posttraumatic stress in male Vietnam theater veterans,"The aim of this study was to determine the reliability and validity of a proposed measure of peritraumatic dissociation and, as part of that effort, to determine the relationship between dissociative experiences during disturbing combat trauma and the subsequent development of posttraumatic stress disorder (PTSD).A total of 251 male Vietnam theater veterans from the Clinical Examination Component of the National Vietnam Veterans Readjustment Study were examined to determine the relationship of war zone stress exposure, retrospective reports of dissociation during the most disturbing combat trauma events, and general dissociative tendencies with PTSD case determination.The total score on the Peritraumatic Dissociation Experiences Questionnaire--Rater Version was strongly associated with level of posttraumatic stress symptoms, level of stress exposure, and general dissociative tendencies and weakly associated with general psychopathology scales from the MMPI-2. Logistic regression analyses supported the incremental value of dissociation during trauma, over and above the contributions of level of war zone stress exposure and general dissociative tendencies, in accounting for PTSD case determination.These results provide support for the reliability and validity of the Peritraumatic Dissociation Experiences Questionnaire--Rater Version and for a trauma-dissociation linkage hypothesis: the greater the dissociation during traumatic stress exposure, the greater the likelihood of meeting criteria for current PTSD.",0,0 +5639,Gender differences in posttraumatic stress disorder.,"One of the most consistent findings in the epidemiology of posttraumatic stress disorder (PTSD) is the higher risk of this disorder in women. Explanations reviewed within a psychobiological model of PTSD suggest that women's higher PTSD risk may be due to the type of trauma they experience, their younger age at the time of trauma exposure, their stronger perceptions of threat and loss of control, higher levels of peri-traumatic dissociation, insufficient social support resources, and greater use of alcohol to manage trauma-related symptoms like intrusive memories and dissociation, as well as gender-specific acute psychobiological reactions to trauma. This review demonstrates the need for additional research of the gender differences in posttraumatic stress. Recommendations are made for clinical practice.",0,0 +5640,"Work-related critical incidents in hospital-based health care providers and the risk of post-traumatic stress symptoms, anxiety, and depression: A meta-analysis","This meta-analysis reviewed existing data on the impact of work-related critical incidents in hospital-based health care professionals. Work-related critical incidents may induce post-traumatic stress symptoms or even post-traumatic stress disorder (PTSD), anxiety, and depression and may negatively affect health care practitioners' behaviors toward patients. Nurses and doctors often cope by working part time or switching jobs. Hospital administrators and health care practitioners themselves may underestimate the effects of work-related critical incidents. Relevant online databases were searched for original research published from inception to 2009 and manual searches of the Journal of Traumatic Stress, reference lists, and the European Traumatic Stress Research Database were conducted. Two researchers independently decided on inclusion and study quality. Effect sizes were estimated using standardized mean differences with 95% confidence intervals. Consistency was evaluated, using the I(2)-statistic. Meta-analysis was performed using the random effects model. Eleven studies, which included 3866 participants, evaluated the relationship between work-related critical incidents and post-traumatic stress symptoms. Six of these studies, which included 1695 participants, also reported on the relationship between work-related critical incidents and symptoms of anxiety and depression. Heterogeneity among studies was high and could not be accounted for by study quality, character of the incident, or timing of data collection. Pooled effect sizes for the impact of work-related critical incidents on post-traumatic stress symptoms, anxiety, and depression were small to medium. Remarkably, the effect was more pronounced in the longer than in the shorter term. In conclusion, this meta-analysis supports the hypothesis that work-related critical incidents are positively related to post-traumatic stress symptoms, anxiety, and depression in hospital-based health care professionals. Health care workers and their supervisors should be aware of the harmful effects of critical incidents and take preventive measures.",0,0 +5641,The relationship between substance use and posttraumatic stress disorder in a methadone maintenance treatment program,"Posttraumatic stress disorder (PTSD) is frequently linked with substance abuse. The self-medication hypothesis suggests that some people may use illicit substances in an attempt to self-treat psychiatric symptoms. This study explores the relationship between substance abuse and PTSD symptom clusters in a methadone maintenance population.Clients of a methadone maintenance program at a public Drug and Alcohol Service were invited to complete the PTSD Checklist-Civilian Version, a screening tool for PTSD. Information about their history of substance use was also collected.Eighty clients (43 female, 37 male), aged 35 ± 8.0 years (mean ± SD), participated in the study, of which 52.7% screened positive for PTSD. Severity of marijuana use was significantly associated with a number of reexperiencing and hyperarousal symptoms and with overall severity of PTSD symptoms. Opiate, amphetamine, and benzodiazepine use did not appear to be related to PTSD symptoms.In this sample, marijuana may be used to self-treat certain PTSD symptoms, supporting the self-medication hypothesis. Further research is required to confirm the association between a diagnosis of PTSD and substance use. Given the high prevalence of PTSD in the substance-using population, routine PTSD screening in the substance abuse treatment setting may be justified.",0,0 +5642,Evidence for a psychotic posttraumatic stress disorder subtype based on the National Comorbidity Survey,"Purpose This study assessed the distribution of posttraumatic stress disorder (PTSD) symptoms and psychosis indicators among a large sample of individuals with a lifetime diagnosis of PTSD. The identification of a psychotic PTSD subtype was also predicted. Method Using data from the National Comorbidity Survey a latent class analysis was conducted on the PTSD symptoms of intrusion, avoidance, and hyperarousal and the psychosis hallucination and delusion indicators. Results Results indicated four latent classes, two of which had relatively high probabilities of endorsing the hallucination and delusion indicators. These classes were associated with a broad range of traumatic experiences. One particular class had high probabilities of endorsing both the psychosis indicators and the PTSD symptoms and was associated with a broad range of comorbid psychiatric disorders. Conclusion There was a candidate class that met the characteristics expected to be evident in a psychotic PTSD subtype. © Springer-Verlag 2010.",0,0 +5643,L'automatisme psychologique,,0,0 +5644,"Prenatal stress induces long term stress vulnerability, compromising stress response systems in the brain and impairing extinction of conditioned fear after adult stress","Stress is a risk factor for the development of affective disorders, including depression, post-traumatic stress disorder, and other anxiety disorders. However, not all individuals who experience either chronic stress or traumatic acute stress develop such disorders. Thus, other factors must confer a vulnerability to stress, and exposure to early-life stress may be one such factor. In this study we examined prenatal stress (PNS) as a potential vulnerability factor that may produce stable changes in central stress response systems and susceptibility to develop fear- and anxiety-like behaviors after adult stress exposure. Pregnant Sprague-Dawley rats were immobilized for 1 h daily during the last week of pregnancy. Controls were unstressed. The male offspring were then studied as adults. As adults, PNS or control rats were first tested for shock-probe defensive burying behavior, then half from each group were exposed to a combined chronic plus acute prolonged stress (CAPS) treatment, consisting of chronic intermittent cold stress (4 °C, 6 h/d, 14 days) followed on day 15 by a single session of sequential acute stressors (social defeat, immobilization, cold swim). After CAPS or control treatment, different groups were tested for open field exploration, social interaction, or cued fear conditioning and extinction. Rats were sacrificed at least 5 days after behavioral testing for measurement of tyrosine hydroxylase (TH) and glucocorticoid receptor (GR) expression in specific brain regions, and plasma adrenocorticotropic hormone (ACTH) and corticosterone. Shock-probe burying, open field exploration and social interaction were unaffected by any treatment. However, PNS elevated basal corticosterone, decreased GR protein levels in hippocampus and prefrontal cortex, and decreased TH mRNA expression in noradrenergic neurons in the dorsal pons. Further, rats exposed to PNS plus CAPS showed attenuated extinction of cue-conditioned fear. These results suggest that PNS induces vulnerability to subsequent adult stress, resulting in an enhanced fear-like behavioral profile, and dysregulation of brain noradrenergic and hypothalamic-pituitary-adrenal axis (HPA) activity.",0,0 +5645,Flying therapy for flying phobia.,"Optimum treatment for aircrew who have developed anxiety associated with flight includes a flying phase for desensitization. However, standardized flight profiles are not found in the literature. In this study, a method of desensitization flying, which may increase the probability of a return to productive flying, was devised and assessed.Seven aircrew were referred for flying desensitization. Behavioral therapy (relaxation training, imaginary flying, and thought switching) was usually continued by the Medical Officer (Pilot) (MOP). These aircrewmen flew 2-16 sorties in the RAF IAM Hawk or Hunter aircraft with the MOP. Each flight was structured with three purposes: to approach by increments the flight conditions in each victim's anxiety hierarchy, to regulate the amount of low workload, anxiety-vulnerable time during each sortie, and to practice relaxation techniques in the air.In all referred aircrewmen, anxiety was controllable in flight at IAM. Somatic signs diminished and no sortie was terminated early. All returned to operational flying. Anxiety recurred in one fast jet pilot while flying solo, and in one navigator, both of whom requested a change to transports. A transport pilot had recurrent uncontrollable anxiety at high altitude and is grounded. At 9-24 months follow-up, 5/7 were flying comfortably with rare, controllable anxiety. We conclude that actual exposure to flying is usually necessary for aircrew to recover from anxiety associated with flight.",0,0 +5646,Comparative Study of Trauma-Related Phenomena in Subjects With Pseudoseizures and Subjects With Epilepsy,"The purpose of this study was to examine potential differences in measures of trauma-related phenomena between subjects with pseudoseizures and subjects with intractable epilepsy.Thirty-one adult subjects with pseudoseizures and 32 subjects with intractable epilepsy (confirmed by video-EEG) were recruited from the epilepsy unit of a tertiary care hospital. Each participant completed the Impact of Event Scale, the Davidson Trauma Scale, the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (PTSD), the Dissociative Experience Scale, and the Pittsburgh Sleep Quality Index, as well as demographic, seizure history, and family functioning measures.Subjects with pseudoseizures had significantly higher mean scores on the Davidson Trauma Scale, Mississippi Scale for Combat-Related PTSD, Impact of Event Scale, and Pittsburgh Sleep Quality Index than subjects with epilepsy. In addition, a significantly higher percentage of subjects with pseudoseizures had scores above the clinical cutoff level of 30 on the Dissociative Experience Scale.Subjects with pseudoseizures exhibited trauma-related profiles that differed significantly from those of epileptic comparison subjects and closely resembled those of individuals with a history of traumatic experiences. Interventions aimed at trauma-related issues may be beneficial for patients with pseudoseizures.",0,0 +5647,Non-termination of sickness behavior as precipitating factor for mental disorders,"Sickness behavior can be defined as a combination of coordinated behavioral and physiological changes that develop in response to any condition that elicits pro-inflammatory activity. It is an adaptational homeostasis initiated by the influence of pro-inflammatory cytokines on central nervous system neurohormonal functioning. This paper introduces the concept of non-termination of sickness behavior as a potential threat to mental health. In view of the similarities between the behavioral symptoms, the neuroendocrine and the cytokine profiles of sickness behavior and that of a number of mental disorders it is hypothesized that the inappropriate continuation of sickness behavior, (i.e., non-termination), after recovery from the initial disease, could form the basis for mental disturbances. This would be particularly relevant in individuals with alterations in stress vulnerability (altered activation threshold and impaired negative feedback), which may occur due to the combination of genetic disposition and priming by early life experiences.",0,0 +5648,"Prison Therapeutic Community Treatment for Female Offenders: Profiles and Preliminary Findings for Mental Health and Other Variables (Crime, Substance Use and HIV Risk)","ABSTRACT This random assignment study compared women in a prison Therapeutic Community (TC) program with those in a cognitive-behavioral intervention. Over two thirds of study subjects received a lifetime diagnosis of severe mental disorder, nearly one-half received a diagnosis of PTSD, and virtually all reported exposure to trauma. Preliminary analysis (n = 314) found significantly better six-month post-prison outcomes for the TC group on measures of mental health, criminal behavior and HIV-risk behavior. These findings suggest the short-term effectiveness of prison TC treatment for female offenders with substance use disorders, and underscore the importance of adapting treatment to address mental health.",0,0 +5649,Psychiatric disorders following return from combat duty during the twenty-first century,"Knowledge of the psychiatric consequences of combat deployment expanded rapidly during the late 20th century as large numbers of Vietnam veterans experienced substantial difficulties with readjustment upon return from deployment. Current warfare in Afghanistan and Iraq has resulted in the longest period of sustained combat exposure for United States forces since Vietnam. This article compares the nature of conflict, composition of deployed forces, combat exposures, and injuries in these deployment settings compared to late 20th century conflicts. It also reviews early findings on rates of psychiatric disorders among returning troops and compares these findings with those of studies of troops returning from prior conflicts. Evaluation and treatment approaches to posttraumatic stress disorder in combat veterans are then provided. Preliminary findings suggest that early assessment of veterans may not represent the long-term psychiatric needs of returning veterans and that ongoing surveillance and availability of psychiatric care will be needed for this population.",0,0 +5650,Associations Between Dimensions of Anxiety Sensitivity and PTSD Symptom Clusters in Active‐Duty Police Officers,"Prior studies have shown that anxiety sensitivity (AS) plays an important role in posttraumatic stress disorder (PTSD) symptom severity. The purpose of this study was to evaluate associations between empirically supported PTSD symptom clusters (i.e. reexperiencing, avoidance, numbing, hyperarousal) and AS dimensions (i.e. psychological concerns, social concerns, somatic concerns). Participants were 138 active-duty police officers (70.7% female; mean age = 38.9 years; mean time policing = 173.8 months) who, as a part of a larger study, completed measures of trauma exposure, PTSD symptoms, AS, and depressive symptoms. All participants reported experiencing at least one event that they perceived as traumatic, and 44 (31.9%) screened positive for PTSD. Officers with probable PTSD scored significantly higher on AS total as well as the somatic and psychological concerns dimensional scores than did those without PTSD. As well, a higher percentage of officers with probable PTSD scored positively on the AS-derived Brief Screen for Panic Disorder (Apfeldorf et al., 1994) compared with those without PTSD. A series of regression analyses revealed that depressive symptoms, number of reported traumas, and AS somatic concerns were significant predictors of PTSD total symptom severity as well as severity of reexperiencing. Avoidance was predicted by depressive symptoms and AS somatic concerns. Only depressive symptoms were significantly predictive of numbing and hyperarousal cluster scores. These findings contribute to understanding the nature of association between AS and PTSD symptom clusters. Implications for the treatment of individuals having PTSD with and without panic-related symptomatology are discussed.",0,0 +5651,"Current visual scanpath research: a review of investigations into the psychotic, anxiety, and mood disorders","The human visual system is comprised of an array of complex organs, which jointly decode information from visible light to construct a meaningful representation of the surrounding environment. The study of visual scanpaths transpired in a bid to enhance our understanding of the role of eye movements underpinning adaptive functioning as well as psychopathology and was further aided by the advent of modern eye-tracking techniques. This review provides a background to the nature of visual scanpaths, followed by an overview and critique of eye movement studies in specific clinical populations involving the psychotic, anxiety, and mood disorders, and concludes with suggested directions for future research. We performed a Medline and PsycInfo literature search, based on variations of the terms ""visual scanpath,"" ""eye-tracking,"" and ""eye movements,"" in relation to articles published from 1986 to the present. Eye-tracking studies in schizophrenia mostly concurred with the existence of a ""restricted"" scanning strategy, characterized by fewer number of fixations of increased durations, with shorter scanpath lengths, and a marked avoidance of salient features, especially in relation to facial emotion perception. This has been interpreted as likely reflecting dual impairments in configural processing as well as gestalt perception. Findings from the anxiety and mood disorders have conversely failed to yield coherent results, with further research warranted to provide corroborating evidence and overcome identified methodological limitations. Future studies should also look toward applying similar techniques to related disorders as well as conducting parallel neuroimaging investigations to elucidate potential neurobiological correlates.",0,0 +5652,The Role of Generalized Explicit and Implicit Guilt and Shame in Interpersonal Traumatization and Posttraumatic Stress Disorder,"Posttraumatic stress disorder (PTSD) and interpersonal traumatization are frequently associated with trauma-related guilt and shame. However, research on generalized guilt and shame in PTSD is lacking. The aim of this study was to investigate generalized explicit and implicit guilt and shame in interpersonal traumatization and PTSD. Interpersonally traumatized women either with PTSD (n = 28) or without PTSD (n = 32) and 32 nontraumatized women completed the Test of Self-Conscious Affect-3 and the Implicit Association Test to measure explicit and implicit guilt and shame. Explicit guilt and shame were significantly higher in women with PTSD than in traumatized women without PTSD. Traumatized women without PTSD showed significantly higher levels of explicit guilt and shame than nontraumatized women did. PTSD was associated with implicit guilt but not implicit shame. In addition to trauma-related guilt and shame, generalized explicit guilt and shame and implicit guilt seem to play a crucial role in PTSD.",0,0 +5653,Life events (Loss and traumatic) and emotional responses to them in acute catastrophe survivors and long-lasting heroin use disorder patients never exposed to catastrophic events,"Background. Symptoms of PTSD denote alterations in several neurobiological systems, including the opioid system. In a previous study on methadone-treated heroin use disorder (HUD) patients, we demonstrated strong correlations between the severity and progression of HUD and the subsequently greater severity of PTSD spectrum symptoms, so suggesting a unitary perspective. Methods. A comparative cross-sectional study was carried out to evaluate post-traumatic spectrum reactivity to loss and traumatic events in three groups: acute catastrophic event survivors experiencing (N=77) and the same number not experiencing PTSD (N=77), and a third group, of long-lasting HUD subjects who had never been exposed to catastrophic events (N=77). Results. To obtain an index of the magnitude of emotional response to losses and traumatic events, we conducted a preliminary ROC analysis on the TALS-SR total scores observed in our L’Aquila 2009 earthquake database, after having classified subjects as PTSD and No-PTSD (according to the SCID-questionnaire). That analysis determined the cut-off value required to ensure the best balance between sensitivity and specificity. The percentage of subjects who were over the threshold in the HUD group proved to be very similar to that observed in the PTSD earthquake survivors group [51 (66.2%) vs 56 (72.7%), Chi-square=0.49, p=.484], whereas it turned out to be significantly higher than that observed in the No-PTSD earthquake survivors group [51 (66.2%) vs 11 (14.3%), Chisquare= 41.07, p<.001]. Furthermore, the discriminant analysis utilizing TALS-SR domain scores as predictive variables failed to discriminate between the HUD group and the PTSD earthquake group, whereas it appears to clearly differentiate the No-PTSD earthquake group from the other two. Conclusions. This study, besides providing evidence of similarities in the type of reaction shown to loss and to traumatic events between HUD patients and earthquake survivors with PTSD, also supports the probable implication of the opioid system in the aetio(patho)logy of PTSD.",0,0 +5654,Intraclass correlations: Uses in assessing rater reliability.,"Reliability coefficients often take the form of intraclass correlation coefficients. In this article, guidelines are given for choosing among six different forms of the intraclass correlation for reliability studies in which n target are rated by k judges. Relevant to the choice of the coefficient are the appropriate statistical model for the reliability and the application to be made of the reliability results. Confidence intervals for each of the forms are reviewed.",0,0 +5655,"Predictors of emotional numbing, revisited: A replication and extension","Litz et al. (1997), theorizing that emotional numbing (EN) is the result of emotional depletion caused by chronic hyperarousal, demonstrated that a cluster of hyperarousal symptoms was a robust predictor of EN symptoms. In the present study, these findings were replicated and extended in two multiple regression analyses of data from a large, multisite investigation (T. M. Keane et al., 1998) of psychophysiological responding by male combat veterans. The arousal (D) cluster of symptoms was again the most robust predictor of EN symptoms, whereas physiological indices of arousal and reactivity accounted for negligible amounts of variance in both regression equations. These findings underscore the possible link between disturbances related to arousal and the capacity of traumatized individuals to express and experience pleasant feelings.",0,0 +5656,Psycho-oncology in Underserved and Minority Populations,,0,0 +5657,Post-traumatic stress disorder in childhood,"In the past two decades, post-traumatic stress disorder (PTSD) after exposure to a variety of traumatic or particularly threatening experiences has gained recognition as a significant contributor to morbidity in children. The basic features involve the development of impairing stress symptoms, including re-experiencing of the event in the form of “flashbacks” (distressing images, thoughts or perceptions) or nightmares, avoidance of thinking or talking about the event, of places or people associated with the event and of things that remind one of the event. Hyperarousal, or feeling on edge, irritability and exaggerated “startle” responses to stimuli, and emotional numbing (sufferers feeling cut off and detached) have also been described. PTSD in children was originally described after particularly traumatic events such as physical and sexual abuse1–3 and the witnessing of violence.4 It has been recognised following both natural5,6 and man-made7,8 disasters, and extensively documented in refugees,9,10 war situations11 and in response to terrorism-induced trauma.12 More recently, attention has focused on PTSD occurring as a consequence of a variety of paediatric conditions, some life threatening, including cancer,13 head injury14 and motor vehicle accidents15,16 as well as mild to moderate paediatric trauma,17 acute illnesses resulting in admission to paediatric intensive care units,18 children who undergo organ transplantation19 and after diagnosis of diabetes mellitus type 1.20 Stressful experiences related to serious paediatric illness in children may be expected to affect parents psychologically. Accordingly, high levels of symptoms of PTSD have been reported in parents of children with a variety of problems such as meningococcal infections requiring admission to paediatric intensive care units,21 in family members of adolescent cancer survivors22 and of children with newly diagnosed type 1 diabetes.23 Early identification and appropriate referral …",0,0 +5658,Risk and Protective Factors for Traumatic Stress Disorders,"Abstract This chapter provides an overview of risk and protective factors that may account for posttraumatic responses. In addition to risk and protective factors specifically for posttraumatic stress disorder (PTSD), the outcomes of resilience and posttraumatic growth are considered. Emphasis is placed on the importance of a longitudinal and especially a lifespan developmental framework to understand both the short- and long-term implications of trauma exposure and the factors that influence its consequences. A brief introduction to methodological approaches for documenting longitudinal change is presented, followed by suggestions for future research.",0,0 +5659,Trajectories of PTSD Symptoms and Predictive Factors of Trajectory Membership: A Step Toward Identifying Veterans at Risk,,0,0 +5660,The latent structure of post-traumatic stress disorder: tests of invariance by gender and trauma type,"Background Measurement invariance of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) post-traumatic stress disorder (PTSD) criterion symptoms was tested by gender and trauma type, assaultive and non-assaultive. Method Analysis was conducted using latent class analysis (LCA), based on findings that the three-class LCA model from Breslau et al . ( Archives of General Psychiatry 2005, 62 , 1343–1351) fits the data across the four groups best. The classes represent three levels of PTSD-related disturbance: no disturbance, intermediate disturbance and pervasive disturbance, with the last one approximating the DSM-IV PTSD diagnosis. Results Analysis of measurement invariance showed that, with respect to gender, there was no evidence of differential symptom reporting within the same disturbance class. DSM-IV symptom indicators represent the latent structure of PTSD equally in males and females. We found that more female than male victims of assaultive violence experienced pervasive disturbance. In the absence of measurement variability associated with gender, the finding is likely to reflect a gender difference in susceptibility. The analysis of measurement invariance detected evidence of variability associated with trauma type. Victims of assaultive violence in the pervasive disturbance class report more severe distress (especially emotional numbing) than do victims of non-assaultive violence in the same class. Conclusions The finding of measurement bias associated with type of trauma raises questions about the applicability of a single definition for PTSD associated with assaultive violence and PTSD associated with traumatic events of lesser magnitude.",0,0 +5661,Illegal Drugs Laws: Clearing a 50-Year-Old Obstacle to Research,"The United Nations drug control conventions of 1960 and 1971 and later additions have inadvertently resulted in perhaps the greatest restrictions of medical and life sciences research. These conventions now need to be revised to allow neuroscience to progress unimpeded and to assist in the innovation of treatments for brain disorders. In the meantime, local changes, such as the United Kingdom moving cannabis from Schedule 1 to Schedule 2, should be implemented to allow medical research to develop appropriately.",0,0 +5662,Post-traumatic stress disorder among Syrian refugees in Turkey: A cross-sectional study,"Refugees have had major challenges to meet their health care needs throughout history especially in war zones and natural disaster times. The health care needs of Syrian refugees have been becoming an increasingly important issue. We aimed to examine the prevalence of post-traumatic stress disorder (PTSD) and explore its relation with various socioeconomic variables among Syrian refugees, who sought asylum in Turkey.This cross-sectional study was conducted in a tent city. Sample size calculation yielded 352 and the participants of the study were determined randomly. Experienced and native Arabic speaking, psychiatrist evaluated the participants.The frequency of PTSD was 33.5%. Through the binary logistic regression analysis, we calculated that the probability of having PTSD among Syrian refugees in our sample was 71%, if they had the following features: with female gender; being diagnosed with psychiatric disorder in the past; having a family history of psychiatric disorder; and experiencing 2 or more traumas.The findings of our study suggest that PTSD among Syrian refugees in Turkey might be an important mental health issue in refugee camps especially among female refugees, who were exposed to 2 or more traumatic events and had a personal or family history of psychiatric disorder.",0,0 +5663,"Relationship between Early Abuse, Posttraumatic Stress Disorder, and Activity Levels in Prepubertal Children","To examine the relationship between early physical and sexual abuse, posttraumatic stress disorder (PTSD), major depression, and activity levels in prepubertal children.Nineteen unmedicated children with documented abuse (9.4 +/- 2.3 years; 6 girls, 13 boys) were compared with 15 healthy controls (8.3 +/- 1.9 years; 6 girls, 9 boys). Diagnoses were derived from structured interviews (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version). Motionlogger actigraphs collected activity data for 72 continuous hours in 1-minute epochs.Overall, abused children were 10% more active than normal children (p < .05) and displayed a paucity of periods of low-level daytime activity (p < .01). Abused children with PTSD were largely responsible for the increase in activity. Abused children with PTSD had a robust and normal circadian activity rhythm. Abused children in whom PTSD failed to develop had an attenuated circadian amplitude compared with subjects with PTSD (101% versus 93%, p < .01) and were phase-delayed by 61 minutes versus controls (p = .01). Early onset of abuse was significantly associated with greater likelihood of the development of PTSD and hyperactivity. Later age of abuse was associated with circadian dysregulation.These preliminary observations indicate that abused children with PTSD have activity profiles similar to those of children with attention-deficit hyperactivity disorder, while abused children without PTSD have activity profiles more similar to those of depressed children.",0,0 +5664,Childhood abuse and sexual revictimization in a female Navy recruit sample,"To examine effects of childhood abuse on adult rape, 1,887 female Navy recruits were surveyed. Overall 35% of recruits had been raped and 57% had experienced childhood physical abuse (CPA) and/or childhood sexual abuse (CSA). Controlling for CPA, rape was significantly (4.8 times) more likely among women who had experienced CSA than among women who had not. In contrast, CPA (controlling for CSA) was unrelated to likelihood of adult rape. Alcohol problems and number of sex partners were examined as mediators. Although both variabies predicted rape, their effects were independent of the effects of CSA. Finally, despite ethnic group differences in the prevalence of victimization, the predictors of rape did not differ significantly across ethnic groups.",0,0 +5665,The impact of sudden gains in cognitive behavioral therapy for posttraumatic stress disorder,"This study investigated sudden gains, i.e., rapid and stable improvements, in posttraumatic stress disorder (PTSD) symptoms that may occur in cognitive-behavioral therapy. Twenty-nine of 72 participants (39.2%) experienced a sudden gain during treatment. Mixed model ANOVAs analyzed sudden gains impact on clinician-rated PTSD symptom severity, patient-rated PTSD symptom severity, and patient-rated depressive symptom severity. Sudden gains in PTSD symptomology were associated with greater reductions in PTSD symptom severity for the avoidance/numbing and hyperarousal symptom clusters at posttreatment. By 6-month follow-up, the sudden gains group had maintained those reductions in symptoms, but the nonsudden gains group had achieved equal reductions in symptom severity. Participants experiencing sudden gains on PTSD measures had lower depression severity at posttreatment and follow-up.",0,0 +5666,Structure of posttraumatic stress disorder symptoms and psychosocial functioning in Veterans of Operations Enduring Freedom and Iraqi Freedom,"Posttraumatic stress disorder (PTSD) is one of the most prevalent psychiatric conditions in Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF-OIF), but little is known about the structure of PTSD symptoms, and associations between PTSD symptom clusters and psychosocial functioning in this population. A total of 272 OEF-OIF Veterans in Connecticut completed a mail survey containing measures of psychopathology, resilience, and psychosocial functioning. Confirmatory factor analyses revealed that the 4-factor dysphoria model, which is comprised of separate re-experiencing, avoidance, dysphoria, and hyperarousal symptom clusters, provided the best representation of PTSD symptom structure in this sample. Dysphoria symptoms were independently associated with a broad range of psychosocial measures, even after controlling for age, combat exposure, and other PTSD symptom clusters. Re-experiencing symptoms were associated with alcohol use problems, and avoidance symptoms were associated with increased psychosocial difficulties and decreased perceptions of postdeployment social support. These results suggest that dysphoria symptoms were strongly related to a broad range of psychosocial measures in this sample of OEF-OIF Veterans. Dysphoria symptoms may deserve special attention in the assessment and treatment of symptomatic OEF-OIF Veterans.",0,0 +5667,Finding patterns and groupings: II. Introduction to latent profile analysis and finite mixture models,"An latent class analysis (LCA) is a particular kind of mixture analysis. If we take the LCA concept and change it so that the dataset now comprises observed continuous variables; and the classes differ in their means on one or more variables; then the resulting model is called latent profile analysis (LPA). As with LCA, the model assumes that classes explain associations so that within classes the observed variables are now modeled as uncorrelated. A similar looking model to LPA, one which does not make the assumption of zero within-class correlations, is the finite mixture model (FMM) model, which tries to find underlying clusters of distributed data-univariate if there is only one variable, multivariate if there are two or more. The FMM typically assumes the data have a normal distribution. Depending on which assumptions you include it is easy to move between an LPA and an FMM and indeed obtain quite similar looking answers, but keep in mind that the conceptual models behind these are quite different. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +5668,Resilience in the Context of Chronic Stress and Health in Adults,"Over the past several decades, stress research has experienced a broadening of its pathologic focus to encompass the concept of resilience. There is a wealth of research on resilience but no general consensus regarding its conceptualization. Some define resilience as attaining eventual favorable outcomes following exposure to adversity. Others define it as specific relatively short-term responses characterized by a return to homeostasis after initial disruption due to a stressor, and still others refer to resilience as resources that enable the individual to withstand or recover from major stressors. Many of the existing conceptualizations of resilience are not applicable in the context of chronic stress which is particularly harmful to health. How do adults who experience chronic stress survive, manage, and thrive, and what resources enable them to do so? In this paper, we consider these questions by reviewing traditions of research and definitions of resilience in order to inform an understanding of resilience in general, and for the study of chronic stress in adults. Based on a review of the literature, we developed a taxonomy of resilience resources that can be applied broadly, and guide future research.",0,0 +5669,Traumatic Stress Symptoms in Adolescent Organ Transplant Recipients,"Symptoms of posttraumatic stress disorder (PTSD) after life-threatening medical illness have been found to predict poor outcome in preliminary studies of adults and children. However, these symptoms are rarely recognized in general medical or pediatric settings. Here we report on the first large investigation to assess prevalence and correlates of self-reported symptoms of posttraumatic stress in a nonreferred sample of adolescent liver, heart, and kidney transplant recipients.One hundred four adolescents, ages 12 to 20 years (mean: 15.7; SD: 2.1), completed and returned the University of California, Los Angeles, PTSD Index for the Diagnostic and Statistical Manual of Mental Disorders. All participants were at least 1 year post-initial transplant and were fluent speakers of English and/or Spanish.More than 16% of the adolescents met all symptom criteria for PTSD, and an additional 14.4% met 2 of 3 symptom-cluster criteria. Regression analysis indicated no effect of gender, ethnicity, age at interview, organ type, time since transplant, or age at transplant.As has been found with other life-threatening pediatric conditions, solid organ transplantation can precipitate symptoms of posttraumatic stress. Symptoms are not predicted by what would be considered objective factors increasing life threat, suggesting a greater salience of subjective appraisal of threat, as has been seen in studies of childhood cancer survivors.",0,0 +5670,"The impact of HIV status, HIV disease progression, and post-traumatic stress symptoms on the health-related quality of life of Rwandan women genocide survivors","We examined whether established associations between HIV disease and HIV disease progression on worse health-related quality of life (HQOL) were applicable to women with severe trauma histories, in this case Rwandan women genocide survivors, the majority of whom were HIV-infected. Additionally, this study attempted to clarify whether post-traumatic stress symptoms were uniquely associated with HQOL or confounded with depression.The Rwandan Women's Interassociation Study and Assessment was a longitudinal prospective study of HIV-infected and uninfected women. At study entry, 922 women (705 HIV+ and 217 HIV-) completed measures of symptoms of post-traumatic stress and HQOL as well as other demographic, clinical, and behavioral characteristics.Even after controlling for potential confounders and mediators, HIV+ women, in particular those with the lowest CD4 counts, scored significantly worse on HQOL and overall quality of life (QOL) than did HIV- women. Even after controlling for depression and HIV disease progression, women with more post-traumatic stress symptoms scored worse on HQOL and overall QOL than women with fewer post-traumatic stress symptoms.This study demonstrated that post-traumatic stress symptoms were independently associated with HQOL and overall QOL, independent of depression and other confounders or potential mediators. Future research should examine whether the long-term impact of treatment on physical and psychological symptoms of HIV and post-traumatic stress symptoms would generate improvement in HQOL.",0,0 +5671,Variations in Therapeutic Interventions for Cambodian and Chilean Refugee Survivors of Torture and Trauma: A Pilot Study,"The treatment of refugee survivors of torture and trauma has attracted increasing clinical attention. The present study surveyed therapists concerning the emphasis that was placed on disclosure of previous traumatic experiences in therapy with refugees from Chile and Cambodia. Significant differences were found between the two groups with trauma story discussion being judged by therapists to be more important to treatment outcome in Chilean patients. The problem of potential therapist bias limits definitive conclusions, however we suggest that differences in cultural preparedness for psychotherapy aimed at uncovering previous traumatic experiences may be the main reason for variations in styles of therapy offered to these distinctive ethnic groups. Other possible explanations are differences in diagnostic profiles and types of previous traumatic experiences.",0,0 +5672,Shaping the renaissance of psychedelic research,"Psychedelic drugs have a rich and vibrant history as clinical aids for psychiatry. For two decades after the discovery of lysergide (LSD) in the 1940s, psychedelics were extensively studied and clinical progress was good.1 But research collapsed rapidly in 1966 when LSD was made illegal, and there was a subsequent hiatus of psychedelic research. After 40 years, this pause is now coming to an end, with many new studies and a refreshing approach to the research of psychedelic drugs.2",0,0 +5673,Course and Prognostic Factors for Neck Pain in Whiplash-Associated Disorders (WAD),"Best evidence synthesis.To perform a best evidence synthesis on the course and prognostic factors for neck pain and its associated disorders in Grades I-III whiplash-associated disorders (WAD).Knowledge of the course of recovery of WAD guides expectations for recovery. Identifying prognostic factors assists in planning management and intervention strategies and effective compensation policies to decrease the burden of WAD.The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders (Neck Pain Task Force) conducted a critical review of the literature published between 1980 and 2006 to assemble the best evidence on neck pain and its associated disorders. Studies meeting criteria for scientific validity were included in a best evidence synthesis.We found 226 articles related to course and prognostic factors in neck pain and its associated disorders. After a critical review, 70 (31%) were accepted on scientific merit; 47 of these studies related to course and prognostic factors in WAD. The evidence suggests that approximately 50% of those with WAD will report neck pain symptoms 1 year after their injuries. Greater initial pain, more symptoms, and greater initial disability predicted slower recovery. Few factors related to the collision itself (for example, direction of the collision, headrest type) were prognostic; however, postinjury psychological factors such as passive coping style, depressed mood, and fear of movement were prognostic for slower or less complete recovery. There is also preliminary evidence that the prevailing compensation system is prognostic for recovery in WAD.The Neck Pain Task Force undertook a best evidence synthesis to establish a baseline of the current best evidence on the course and prognosis for WAD. Recovery of WAD seems to be multifactorial.",0,0 +5674,Virtual Natural Environments for Restoration and Rehabilitation in Healthcare,"AbstractFor over two decades, research and clinical projects have exploited Virtual Reality technologies in the treatment of numerous human conditions, from desensitisation régimes combating phobias to the use of distraction and exposure therapies for burns victims and those suffering from post-traumatic stress disorders. In contrast to previous “high-tech” interface and combat-oriented approaches to using VR in the psychological rehabilitation process, the present chapter advocates the use of virtual restorative environments (VREs)—the recreation of locations and scenes that, by virtue of their natural beauty and peacefulness, can significantly help to reduce the body’s reactivity to stress and restore cognitive or attentional capacities. The chapter also argues that VREs, suitably enhanced with more interactive and dynamic features, could offer significant benefits to patients in physical rehabilitation programmes. This is especially the case for amputees, for example, who, whilst awaiting the fitting of prosthetic limbs, could undertake competitive and motivational “virtual exercises”, thereby avoiding muscle atrophy and related reductions in residual limb capabilities. The report concludes that the exploitation of simulation technologies in psychological therapies is worthy of continued investigation, especially in the pursuit of enhancing patients’ recovery profiles following surgical procedures, from intensive care to the hospital recovery ward. VREs possess a range of important qualities, not least significant of which is real-time interaction and ease-of-editing, supporting the cost-effective generation of engaging and distributable scenarios that can be tailored relatively easily to meet the needs of individual patients.KeywordsVirtual realityRehabilitationRestorationHealthcareHuman factors",0,0 +5675,"Childhood maltreatment, juvenile disorders and adult post-traumatic stress disorder: a prospective investigation","Background We examine prospectively the influence of two separate but potentially inter-related factors in the etiology of post-traumatic stress disorder (PTSD): childhood maltreatment as conferring a susceptibility to the PTSD response to adult trauma and juvenile disorders as precursors of adult PTSD. Method The Dunedin Multidisciplinary Health and Development Study (DMHDS) is a birth cohort ( n = 1037) from the general population of New Zealand's South Island, with multiple assessments up to age 38 years. DSM-IV PTSD was assessed among participants exposed to trauma at ages 26–38. Complete data were available on 928 participants. Results Severe maltreatment in the first decade of life, experienced by 8.5% of the sample, was associated significantly with the risk of PTSD among those exposed to adult trauma [odds ratio (OR) 2.64, 95% confidence interval (CI) 1.16–6.01], compared to no maltreatment. Moderate maltreatment, experienced by 27.2%, was not associated significantly with that risk (OR 1.55, 95% CI 0.85–2.85). However, the two estimates did not differ significantly from one another. Juvenile disorders (ages 11–15), experienced by 35% of the sample, independent of childhood maltreatment, were associated significantly with the risk of PTSD response to adult trauma (OR 2.35, 95% CI 1.32–4.18). Conclusions Severe maltreatment is associated with risk of PTSD response to adult trauma, compared to no maltreatment, and juvenile disorders, independent of earlier maltreatment, are associated with that risk. The role of moderate maltreatment remains unresolved. Larger longitudinal studies are needed to assess the impact of moderate maltreatment, experienced by the majority of adult trauma victims with a history of maltreatment.",0,0 +5676,Posttraumatic Stress Disorder Symptoms Mediate the Relationship Between Traumatic Experiences and Drinking Behavior Among Women Attending Alcohol Serving Venues in a South African Township,"South Africa has high rates of traumatic experiences and alcohol abuse or dependence, especially among women. Traumatic experiences often result in symptoms of posttraumatic stress disorder (PTSD), and PTSD has been associated with hazardous drinking. This article examines the relationship between traumatic events and hazardous drinking among women who patronized alcohol-serving venues in South Africa and examines PTSD as a mediator of this relationship.A total of 560 women were recruited from a Cape Town township. They completed a computerized assessment that included alcohol consumption, history of traumatic events, and PTSD symptoms. Mediation analysis examined whether PTSD symptoms mediated the relationship between the number of traumatic event categories experienced (range: 0-7) and drinking behavior.The mean Alcohol Use Disorders Identification Test score in the sample was 12.15 (range: 0-34, SD = 7.3), with 70.9% reaching criteria for hazardous drinking (AUDIT > 8). The mean PTSD score was 36.32 (range: 17-85, SD = 16.3),with 20.9% meeting symptom criteria for PTSD (PTSD Checklist with 20.9% meeting symptom criteria for PTSD (PTSD Checklist-Civilian Version ≥ 50). Endorsement of traumatic experiences was high, including adult emotional (51.8%), physical (49.6%), and sexual (26.3%) abuse; childhood physical (35.0%) and sexual (25.9%) abuse; and other types of trauma (83%). All categories of traumatic experiences, except the ""other"" category, were associated with hazardous drinking. PTSD symptoms mediated 46% of the relationship between the number of traumatic categories experienced and drinking behavior.Women reported high rates of hazardous drinking and high levels of PTSD symptoms, and most had some history of traumatic events. There was a strong relationship between traumatic exposure and drinking levels, which was largely mediated by PTSD symptoms. Substance use interventions should address histories of trauma in this population, where alcohol may be used in part to cope with past traumas.",0,0 +5677,Missed bipolarity and psychiatric comorbidity in women with postpartum depression,"To investigate the diagnostic profile of women referred for postpartum depression.Fifty-six women seen consecutively with the referral diagnosis of postpartum depression were administered structured instruments to gather information about their DSM-IV Axis I diagnoses.In terms of frequency of occurrence, the primary diagnoses in this sample were: major depressive disorder (46%), bipolar disorder not otherwise specified (29%), bipolar II disorder (23%), and bipolar I disorder (2%). A current comorbid disorder, with no lifetime comorbidity, occurred among 32% of the sample; by contrast, lifetime comorbidity alone (i.e., with no currently comorbid disorder) was found among 27%. Both a lifetime and a current comorbidity were found among 18% of the women, and 23% had no comorbid disorder. The most frequently occurring current comorbid disorder was an anxiety disorder (46%), with obsessive-compulsive disorder (62%) being the most common type of anxiety disorder. For lifetime comorbidity, substance use (20%) and anxiety disorders (12%) were the two most common. Over 80% of patients who scored positive on either the Highs Scale or the Mood Disorder Questionnaire met the diagnostic criteria for a bipolar disorder.The results suggest that postpartum depression is a heterogeneous entity and that misdiagnosis of bipolar disorder in the postpartum period may be quite common. The findings have important clinical implications, which include the need for early detection of bipolarity through the use of reliable and valid assessment instruments, and implementation of appropriate prevention and treatment strategies.",0,0 +5678,Alcohol and stress in the military.,"Although research has independently linked stress experienced by military personnel to both alcohol use and posttraumatic stress disorder, more recently researchers have noted that there also is a significant overlap between stress reactions and alcohol use in veterans and active-duty service members. This overlap seems to be most understood in individuals who have experienced combat or military sexual trauma. This article will provide a brief review of some potential causal mechanisms underlying this relationship, including self-medication and genetic vulnerability models. It also addresses the possible implications for assessment and treatment of military personnel with co-occurring disorders.",0,0 +5679,The Challenge of Living On: Psychopathology and Its Mediating Influence on the Readjustment of Former Child Soldiers,"Current civil wars are characterized by the increasing involvement of civilian populations and the systematic employment of child soldiers. An example of such wars was the conflict in Northern Uganda, where the war-affected population is still challenged by the reintegration of formerly abducted children and youths. A cross-sectional, population-based survey, using a multistage cluster sampling approach of 1,113 Northern Ugandans aged between 12 and 25 in camps for internally displaced persons and locally validated instruments was conducted to assess symptoms and diagnoses of Posttraumatic Stress Disorder (PTSD) and probable Depression in war-affected, as well as formerly abducted individuals. Further objectives were to determine predictors of psychopathology and to relate indicators of maladjustment (i.e., impairments in daily and community functioning, somatic complaints, suicidality, aggressiveness and discrimination) to abduction, level of exposure to violence and psychopathology. 43% of the sample reported abduction by the rebel army. Exposure to violence among this group was higher than for non-abducted youths (t = 28.05; p<.001). PTSD point prevalence rates were 25% among former child soldiers and 7% among the comparison group. High suicidal ideation was present in 16% and 6% respectively. A higher amount of experienced and witnessed event-types (β = . 32. p<.001), loss of first-degree relatives (β = .13. p<.001) and the number of event-types involving forced perpetration (β = .23. p<.001) were identified as risk factors of PTSD symptoms in former child soldiers. The associations between abductee-status and indicators of maladjustment were fully mediated by level of trauma exposure and psychopathology. Results show that child soldiering and its psychological sequelae affect a substantial proportion of children and youths. After release or flight, their readjustment depends at least partly on their level of mental traumatization.",0,0 +5680,Patterns of psychological responses in parents of children that underwent stem cell transplantation,"Hematopoietic stem cell transplantation (HSCT) is curative in several life-threatening pediatric diseases but may affect children and their families inducing depression, anxiety, burnout symptoms, and post-traumatic stress symptoms, as well as post-traumatic growth (PTG). The aim of this study was to investigate the co-occurrence of different aspects of such responses in parents of children that had undergone HSCT.Questionnaires were completed by 260 parents (146 mothers and 114 fathers) 11-198 months after HSCT: the Hospital Anxiety and Depression Scale, the Shirom-Melamed Burnout Questionnaire, the post-traumatic stress disorders checklist, civilian version, and the PTG inventory. Additional variables were also investigated: perceived support, time elapsed since HSCT, job stress, partner-relationship satisfaction, trauma appraisal, and the child's health problems. A hierarchical cluster analysis and a k-means cluster analysis were used to identify patterns of psychological responses.Four clusters of parents with different psychological responses were identified. One cluster (n = 40) significantly differed from the other groups and reported levels of depression, anxiety, burnout symptoms, and post-traumatic stress symptoms above the cut-off. In contrast, another cluster (n = 66) reported higher levels of PTG than the other groups did.This study shows a subgroup of parents maintaining high levels of several aspects of distress years after HSCT. Differences between clusters might be explained by differences in perceived support, the child's health problems, job stress, and partner-relationship satisfaction.",0,0 +5681,Post traumatic stress disorder reactions in children of war: a longitudinal study,"To establish rates of posttraumatic stress disorder (PTSD) reactions and general mental health problems in children who had experienced war trauma.A longitudinal study in the Gaza strip with 234 children aged 7 to 12 years, who had experienced war conflict, at 1 year after the initial assessment, that is, during the peace process. Children completed the Child Post Traumatic Stress Reaction Index (CPTS-RI), while the Rutter A2 and B2 Scales were completed by parents and teachers.The rate of children who reported moderate to severe PTSD reactions at follow-up had decreased from 40.6% (N = 102) to 10.0% (N = 74). 49 children (20.9%) were rated above the cut-off for mental health problems on the Rutter A2 (parent) Scales, and 74 children (31.8%) were above the cut-off on the Rutter B2 (teacher) Scales. The total scores on all three measures had significantly decreased during the 1-year period. The total CPTS-RI score at follow-up was best predicted by the number of traumatic experiences recalled at the first assessment.PTSD reactions tend to decrease in the absence of further stressors, although a substantial proportion of children still present with a range of emotional and behavioral problems. Cumulative previous experience of war trauma constitutes a risk factor for continuing PTSD symptoms.",0,0 +5682,Patterns of treatment response in chronic posttraumatic stress disorder: An application of latent growth mixture modeling,"This study attempts to differentiate groups of individuals who exhibit different patterns of recovery following treatment for chronic posttraumatic stress disorder (PTSD) and describes these groups in terms of relevant characteristics at program intake. A sample of 2,219 Vietnam veterans who had completed a 12-week treatment program was followed up at 6, 12, and 24 months post admission using self-report measures. With change in PTSD symptoms over time as the focus, latent growth mixture modeling was used to assign individual veterans to subgroups. A three-group solution provided the best account of the data. Two groups showed moderate and consistent improvement over time although the larger group (n = 1,380) began treatment with more PTSD symptoms and improved more quickly over time. The smallest group (n = 87) showed a substantially different trajectory, with almost no net change in symptom levels over the 24-month period. The groups also varied significantly in terms of their characteristics, with symptom severity and improvements over time reflecting greater comorbidity and younger age. The results have both research and clinical implications.",0,0 +5683,"Trends and Risk Factors for Mental Health Diagnoses Among Iraq and Afghanistan Veterans Using Department of Veterans Affairs Health Care, 2002–2008","We sought to investigate longitudinal trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans.We determined the prevalence and predictors of mental health diagnoses among 289,328 Iraq and Afghanistan veterans entering Veterans Affairs (VA) health care from 2002 to 2008 using national VA data.Of 289,328 Iraq and Afghanistan veterans, 106,726 (36.9%) received mental health diagnoses; 62,929 (21.8%) were diagnosed with posttraumatic stress disorder (PTSD) and 50 432 (17.4%) with depression. Adjusted 2-year prevalence rates of PTSD increased 4 to 7 times after the invasion of Iraq. Active duty veterans younger than 25 years had higher rates of PTSD and alcohol and drug use disorder diagnoses compared with active duty veterans older than 40 years (adjusted relative risk = 2.0 and 4.9, respectively). Women were at higher risk for depression than were men, but men had over twice the risk for drug use disorders. Greater combat exposure was associated with higher risk for PTSD.Mental health diagnoses increased substantially after the start of the Iraq War among specific subgroups of returned veterans entering VA health care. Early targeted interventions may prevent chronic mental illness.",0,0 +5684,Mental Health Screening Outcomes Among Justice-Involved Youths Under Community Supervision,"The DISC Predictive Scales was administered to 812 New York City youths aged 10–19 placed under community supervision. Approximately half were indicated for possible mental health problems, most frequently mania and posttraumatic stress disorder. Girls were more likely than boys to flag on most disorders. Hierarchical Classes analysis produced five clusters: disruptive behavior, relational distress, marijuana, emotional dysregulation, and specific phobia. Posttraumatic stress disorder and mania were comorbid with all clusters except marijuana. Emotional dysregulation predicted higher, but relational distress predicted lower, risk for rearrest. Marijuana predicted failure to appear in court and receiving a final disposition of placement.",0,0 +5685,Development and validation of the Child Post-Traumatic Cognitions Inventory (CPTCI),"Negative trauma-related cognitions have been found to be a significant factor in the maintenance of post-traumatic stress disorder (PTSD) in adults. Initial studies of such appraisals in trauma-exposed children and adolescents suggest that this is an important line of research in youth, yet empirically validated measures for use with younger populations are lacking. A measure of negative trauma-related cognitions for use with children and adolescents, the Child Post-Traumatic Cognitions Inventory (CPTCI), is presented. The measure was devised as an age-appropriate version of the adult Post-Traumatic Cognitions Inventory (Foa et al., 1999).The CPTCI was developed and validated within a large (n = 570) sample, comprising community and trauma-exposed samples of children and adolescents aged 6-18 years.Principal components analysis suggested a two-component structure. These components were labelled 'permanent and disturbing change' and 'fragile person in a scary world', and were each found to possess good internal consistency, test-retest reliability, convergent validity, and discriminative validity. The reliability and validity of these sub-scales was present regardless of whether the measure was completed in the acute phase or several months after a trauma. Scores on these sub-scales did not vary with age.The CPTCI is a reliable and valid measure that is not specific to the type of trauma exposure, and shows considerable promise as a research and clinical tool. The structure of this measure suggests that appraisals concerning the more abstract consequences of a trauma, as well as physical threat and vulnerability, are pertinent factors in trauma-exposed children and adolescents, even prepubescent children.",0,0 +5686,Self-Embedding Behavior: A New Primary Care Challenge,"OBJECTIVE: The goal of this study was to define self-embedding behavior (SEB), develop a clinical profile of adolescents who engage in SEB, and emphasize the importance of rapid, targeted, and effective identification and intervention. METHODS: As part of a retrospective study with a database evaluating 600 patients percutaneously treated for soft-tissue foreign body removal, adolescents were identified with self-embedded soft-tissue foreign bodies. We describe patients' gender, age, and psychiatric diagnoses; SEB age of onset, frequency, and self-reported reasons; and the number, type, location of, and removal technique for objects. RESULTS: Eleven patients (9 females) who engaged in SEB were identified. Ten of the 11 patients were members of a group home or psychiatric facility at the time they engaged in SEB. All patients had previous and multiple psychiatric diagnoses. SEB mean age-of-onset was 16 years, and mean number of SEB episodes per patient was 1.9. The most common self-reported purpose for SEB was suicidal ideation (6 of 8 [75%]) versus nonsuicidal ideation (2 of 8 [25%]), with 3 cases lacking this documentation. The mean number of objects embedded in a single episode was 2.4, usually composed of metal and embedded in the arm. Seventy-six foreign bodies were percutaneously removed (using ultrasound or fluoroscopic guidance), including metal, glass, wood, plastic, graphite, and crayon. CONCLUSIONS: SEB is an extreme form of self-injury requiring aggressive and timely interdisciplinary assessment and treatment. An understanding of SEB allows medical professionals to pursue rapid, targeted, and effective intervention to interrupt the cycle of self-harm and institute appropriate long-term therapy.",0,0 +5687,The comparative effectiveness of levels of training and years of work experience in firefighters as determining factors in the development of posttraumatic stress disorder,"Posttraumatic Stress Disorder (PTSD) has been known by other names and not well studied prior to returning Vietnam veterans who suffered psychological dysfunction. However, the term PTSD became part of the Diagnostic and Statistical Manual for Mental Disorders in 1981. Since that time PTSD has been researched extensively in veterans. However, little attention has been given to firefighters who encounter trauma on a daily basis compared to veterans who may have experienced traumatic events during war or intermittently. Since firefighters are vital to society for rescue and recovery, it is salient that they remain mentally as well as physically fit for duty. PTSD can be debilitating and even result in early retirement or the change of occupation. Hence, determining the risk and resilience factors against the development of PTSD in firefighters may prevent premature retirement or job change. Although some form of brief intervention may be offered to firefighters after a traumatic event, more extensive counseling may be necessary. Knowing the risk factors prior to facing a distressful event may prompt additional counseling subsequent to trauma and ultimately prevent severe or chronic PTSD that may interfere with the duties of these emergency workers. This research compared levels of training and work experience in 127 male firefighters who ranged in age from 21 to 57 who were primarily Caucasian (63.8%). African-Americans comprised 26.8%, Asians 1.6%, Hispanics 1.6%, and Puerto Rican 0.8%. The researcher investigated the relationship between levels of training and work experience on self-efficacy and ultimately the effect self-efficacy has on the manifestation of PTSD symptoms. This study extends previous research that shows when self-efficacy increases, psychological dysfunctioning decreases (Heinrichs, Wagner, Schoch, Soravia, Hellhammer, & Ehlert, 2005). A retrospective causal-comparative design also referred to as an ex post facto design was employed to examine years of training and work experience and their association to self-efficacy. Next, self-efficacy was investigated to look at its effects on symptoms of PTSD. Findings from the study found no significant difference in the relationships between levels of training and self-efficacy or between years of work experience and self-efficacy. However, the study did support prior research that showed a statistical negative correlation between self-efficacy and symptoms of PTSD. Hence, when self-efficacy increased, symptoms of PTSD decreased. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5688,The clinical and cost effectiveness of group art therapy for people with non-psychotic mental health disorders: a systematic review and cost-effectiveness analysis,"The majority of mental health problems are non-psychotic (e.g., depression, anxiety, and phobias). For some people, art therapy may be a more acceptable alternative form of psychological therapy than standard forms of treatment, such as talking therapies. This study was part of a health technology assessment commissioned by the National Institute for Health Research, UK and aimed to systematically appraise the clinical and cost-effective evidence for art therapy for people with non-psychotic mental health disorders. Comprehensive literature searches for studies examining art therapy in populations with non-psychotic mental health disorders were performed in May 2013. A quantitative systematic review of clinical effectiveness and a systematic review of studies evaluating the cost-effectiveness of group art therapy were conducted. Eleven randomised controlled trials were included (533 patients). Meta-analysis was not possible due to clinical heterogeneity and insufficient comparable data on outcome measures across studies. The control groups varied between studies but included: no treatment/wait-list, attention placebo controls and psychological therapy comparators. Art therapy was associated with significant positive changes relative to the control group in mental health symptoms in 7 of the 11 studies. A de novo model was constructed and populated with data identified from the clinical review. Scenario analyses were conducted allowing comparisons of group art therapy with wait-list control and group art therapy with group verbal therapy. Group art-therapy appeared cost-effective compared with wait-list control with high certainty although generalisability to the target population was unclear; group verbal therapy appeared more cost-effective than art therapy but there was considerable uncertainty and a sizeable probability that art therapy was more cost effective. From the limited available evidence art therapy was associated with positive effects compared with control in a number of studies in patients with different clinical profiles. The included trials were generally of poor quality and are therefore likely to be at high risk of bias. Art therapy appeared to be cost-effective versus wait-list but further studies are needed to confirm this finding in the target population. There was insufficient evidence to make an informed comparison of the cost-effectiveness of group art therapy with group verbal therapy. HTA project no. 12/27/16; PROSPERO registration no. CRD42013003957 .",0,0 +5689,Internet-Based Early Intervention to Prevent Posttraumatic Stress Disorder in Injury Patients: Randomized Controlled Trial,"Posttraumatic stress disorder (PTSD) develops in 10-20% of injury patients. We developed a novel, self-guided Internet-based intervention (called Trauma TIPS) based on techniques from cognitive behavioral therapy (CBT) to prevent the onset of PTSD symptoms.To determine whether Trauma TIPS is effective in preventing the onset of PTSD symptoms in injury patients.Adult, level 1 trauma center patients were randomly assigned to receive the fully automated Trauma TIPS Internet intervention (n=151) or to receive no early intervention (n=149). Trauma TIPS consisted of psychoeducation, in vivo exposure, and stress management techniques. Both groups were free to use care as usual (nonprotocolized talks with hospital staff). PTSD symptom severity was assessed at 1, 3, 6, and 12 months post injury with a clinical interview (Clinician-Administered PTSD Scale) by blinded trained interviewers and self-report instrument (Impact of Event Scale-Revised). Secondary outcomes were acute anxiety and arousal (assessed online), self-reported depressive and anxiety symptoms (Hospital Anxiety and Depression Scale), and mental health care utilization. Intervention usage was documented.The mean number of intervention logins was 1.7, SD 2.5, median 1, interquartile range (IQR) 1-2. Thirty-four patients in the intervention group did not log in (22.5%), 63 (41.7%) logged in once, and 54 (35.8%) logged in multiple times (mean 3.6, SD 3.5, median 3, IQR 2-4). On clinician-assessed and self-reported PTSD symptoms, both the intervention and control group showed a significant decrease over time (P<.001) without significant differences in trend. PTSD at 12 months was diagnosed in 4.7% of controls and 4.4% of intervention group patients. There were no group differences on anxiety or depressive symptoms over time. Post hoc analyses using latent growth mixture modeling showed a significant decrease in PTSD symptoms in a subgroup of patients with severe initial symptoms (n=20) (P<.001).Our results do not support the efficacy of the Trauma TIPS Internet-based early intervention in the prevention of PTSD symptoms for an unselected population of injury patients. Moreover, uptake was relatively low since one-fifth of individuals did not log in to the intervention. Future research should therefore focus on innovative strategies to increase intervention usage, for example, adding gameplay, embedding it in a blended care context, and targeting high-risk individuals who are more likely to benefit from the intervention.International Standard Randomized Controlled Trial Number (ISRCTN): 57754429; http://www.controlled-trials.com/ISRCTN57754429 (Archived by WebCite at http://webcitation.org/6FeJtJJyD).",0,0 +5690,Latent Classes of PTSD Symptoms in Vietnam Veterans,"The authors examined heterogeneity in posttraumatic stress disorder (PTSD) symptom presentation among veterans ( n = 335) participating in the clinical interview subsample of the National Vietnam Veterans Readjustment Study. Latent class analysis was used to identify clinically homogeneous subgroups of Vietnam War combat veterans. Consistent with previous research, three classes emerged from the analysis, namely, veterans with no disturbance (61.4% of the cohort), intermediate disturbance (25.6%), and pervasive disturbance (12.5%). The authors also examined physical injury, war-zone stressor exposure, peritraumatic dissociation, and general dissociation as predictors of class membership. The findings are discussed in the context of recent conceptual frameworks that posit a range of posttraumatic outcomes and highlight the sizable segment of military veterans who suffer from intermediate (subclinical) PTSD symptoms.",0,0 +5691,Postconcussive Symptoms After Blast and Nonblast-Related Mild Traumatic Brain Injuries in Afghanistan and Iraq War Veterans,"Blast injury is common in current warfare, but little is known about the effects of blast-related mild traumatic brain injury (mTBI). Profile analyses were conducted investigating differences in self-reported postconcussive (PC) symptoms in 339 veteran outpatients with mTBI histories reporting current symptoms based on mechanism of injury (blast only, nonblast only, or both blast and nonblast), number of blast injuries, and distance from the blast. Veterans with any blast-related mTBI history were younger and reported higher posttraumatic stress symptoms than veterans with nonblast-related mTBI histories, with a marginally significant difference in posttraumatic stress symptom report between veterans reporting blast-related mTBI only and those reporting nonblast-related mTBI. The groups did not differ in terms of PC symptom severity or PC symptom cluster profiles. Among veterans with blast-related mTBI histories, PC symptom report did not vary by number of blast-related mTBIs or proximity to blast. Overall, posttraumatic stress symptoms accounted for a substantial portion of variance in PC symptom report. In veteran outpatients with remote mTBI histories who have enduring symptom complaints related to the mTBI, mechanism of injury did not clearly contribute to differential PC symptom severity or PC symptom cluster profile. Proximal rather than distal factors may be important intervention targets in returning symptomatic veterans with mTBI histories.",0,0 +5692,Expression profile of mRNAs from rat hippocampus and its application to microarray,"Stress refers to physiological or psychological stimuli that disrupt homeostasis and induce pathophysiological conditions due to maladaptive response, sometimes resulting in mental disorders including depression and post-traumatic stress disorder. Severe stress has been shown to induce neuronal atrophy and apoptosis, especially in the hippocampus, which is thought to be a region of the brain important in stress-related disorders. We have analyzed gene expression in rat hippocampus comprehensively to clarify the molecular mechanism of stress-related disorders. In the present study, we identified and catalogued 13,660 partial complementary DNA sequences (expressed sequence tags (ESTs)) of randomly selected clones from a cDNA library of rat hippocampus. Sequence analysis showed that these clones cluster into 7173 non-redundant sequences comprising 1794 clusters and 5379 singletons. As a result of nucleotide and peptide database search, 2594 were found to represent known rat sequences. Of the remaining 4579 genes, 599 non-redundant ESTs represent rat homologs of genes identified in other species or new members of structurally related families. In addition, we illustrate the use of these clone sets by constructing a cDNA microarray focused on genes categorized into ""cell/organism defense"". These ESTs and our own microarray thus provide an improved genomic source for molecular studies of animal models of stress-related disorders.",0,0 +5693,The way I make you feel: Social exclusion enhances the ability to manage others' emotions,"Abstract Original conceptions of social exclusion focused upon the negative impact of exclusion on intelligent thought (Baumeister, Twenge, & Nuss, 2002). We propose that although exclusion may impair cognitive forms of intelligence, exclusion should enhance more socially relevant forms of intelligence, such as emotional intelligence. Specifically, we examined whether exclusion would enhance performance in one branch of emotional intelligence: the ability to manage others' emotions. Social exclusion heightened the number and breadth of strategies that participants used for managing others' emotions when responding to hypothetical scenarios (Study 1) and when responding to online pen pals (Studies 3 and 4). Furthermore, excluded participants were more effective at energizing an interaction partner in a face-to-face coaching interaction (Study 2) and were rated as more effective at managing their pen pal's emotions in an online pen pal exchange (Studies 3 and 4). Although exclusion heightened the number and breadth of emotion management strategies generated in a social task, exclusion did not heighten the number or breadth of nonsocial strategies (creative uses for common household items) generated in a comparison task (Study 4). Lastly, we found preliminary evidence suggesting that this enhanced emotion management after exclusion may serve to facilitate reconnection; excluded participants were liked more by their interaction partners (Study 2) and were rated to be more likable by objective coders (Studies 3 and 4). Altogether, these findings suggest that individuals may be more effective at managing others' emotions following social exclusion, and this greater effectiveness may promote reconnection.",0,0 +5694,Psychological theories of posttraumatic stress disorder,"We summarize recent research on the psychological processes implicated in posttraumatic stress disorder (PTSD) as an aid to evaluating theoretical models of the disorder. After describing a number of early approaches, including social-cognitive, conditioning, information-processing, and anxious apprehension models of PTSD, the article provides a comparative analysis and evaluation of three recent theories: Foa and Rothbaum's [Foa, E. B. & Rothbaum, B. O. (1998). Treating the trauma of rape: cognitive behavioral therapy for PTSD. New York: Guilford Press] emotional processing theory; Brewin, Dalgleish, and Joseph's [Psychological Review 103 (1996) 670] dual representation theory; Ehlers and Clark's [Behaviour Research and Therapy 38 (2000) 319] cognitive theory. We review empirical evidence relevant to each model and identify promising areas for further research.",0,0 +5695,PTSD scale of the child behavior checklist: Concurrent and discriminant validity with non-clinic-referred sexually abused children,"Several assessment instruments include measures that are purported to assess characteristics of posttraumatic stress disorder (PTSD). Although these measures are used often by researchers and clinicians, few are supported by extensive validity data. The PTSD scale of the Child Behavior Checklist (CBCL) is one that has not yet encountered significant challenges to its validity. We examine the concurrent and discriminant validity of the CBCL-PTSD scale. Participants included 63 non-clinic-referred sexually abused (SA) children, 60 non-SA psychiatric outpatient children, and 61 non-SA, non-clinic-referred schoolchildren. Results revealed questionable concurrent validity for this scale, and suggest poor discriminant validity between SA children and non-SA psychiatric outpatients.",0,0 +5696,THE METHAMPHETAMINE AND PSYCHOSIS STUDY (MAPS) – INDIVIDUAL PROFILES AND TREATMENT NEEDS,"Background: Multiple studies are investigating the impact of substance abuse on early psychosis. Stimulants such as methamphetamines (MA), while known to precipitate psychosis, are understudied. The prevalence of MA abuse in young individuals showing signs of early psychosis is dramatically high in Western North America, as is the prevalence of psychosis in young MA abusers. MA lifetime use by youth diagnosed with psychosis ranges from 21-33%. Common reasons for drug misuse in first episode clients range from increased pleasure, reduced depression and anxiety, and enhanced social facilitation. Individuals who abuse drugs, particularly stimulants such as MA, tend to have their first hospitalization earlier than non-misusing peers with schizophrenia, present with more severe symptoms, and have more problems in areas of interpersonal relationships, motivation, role functioning and activities. For many people, the substance abuse may precede the onset of the illness, whereas for others MA abuse may coincide with the onset, or even follow the onset of psychosis. Sixty-90% of first episode psychosis youth have abused drugs prior to their first psychiatric contact, suggesting a strong connection between psychosis and substances. Recent studies suggest that MA users with psychosis are much more likely to experience psychotic symptoms again if they use MA, and are also more likely to have a psychotic relapse when confronted with stressful situations, even years after cessation of MA use. MA users with persistent or recurrent psychotic symptoms become vulnerable to stress and may benefit from antipsychotic medication the same way individuals with schizophrenia do. Method: Our study aimed at describing the profiles of individuals with MA abuse and psychotic symptoms. We also wished to determine patterns of abuse and psychotic symptoms over time. 295 participants were interviewed following at least one episode of acute psychotic symptoms linked to MA abuse, and followed with monthly measures of substance abuse and psychiatric symptoms for six months. Results: Most participants lived in transitional housing or were homeless. Only 13% had no family history of mental illness or substance abuse. Close to 70% had a previous diagnosis of a mental illness. Antisocial personality disorder (68%), depression (67%), and post-traumatic stress disorder (49%) were highly prevalent. Risk factors and trajectories of substance abuse and psychotic symptoms will also be presented. Treatment: Integrated dual-disorder treatment, where the mental health team works in collaboration with the substance abuse counsellors, is considered the evidenced-based treatment for individuals presenting with co-occurring substance abuse and severe mental illness. Such treatments include step-wise interventions, often using CBT and motivational interviewing components, and can be found in various settings, including assertive community treatments. However, only some of the difficulties presented by participants in our study are addressed in these programs. Our team is currently working on developing modular programs for people with early psychosis and various concurrent disorders. Some examples of these treatment modules will be presented.",0,0 +5697,Social cognition in borderline personality disorder,"Many typical symptoms of borderline personality disorder (BPD) occur within interpersonal contexts, suggesting that BPD is characterized by aberrant social cognition. While research consistently shows that BPD patients have biases in mental state attribution (e.g., evaluate others as malevolent), the research focusing on accuracy in inferring mental states (i.e., cognitive empathy) is less consistent. For complex and ecologically valid tasks in particular, emerging evidence suggests that individuals with BPD have impairments in the attribution of emotions, thoughts, and intentions of others (e.g., Preißler et al., 2010). A history of childhood trauma and co-morbid PTSD seem to be strong additional predictors for cognitive empathy deficits. Together with reduced emotional empathy and aberrant sending of social signals (e.g., expression of mixed and hard-to-read emotions), the deficits in attribution might contribute to behavioral problems in BPD. Given the importance of social cognition on the part of both the sender and the recipient in maintaining interpersonal relationships and therapeutic alliance, these impairments deserve more attention.",0,0 +5698,Effects of Sensory-Enhanced Yoga on Symptoms of Combat Stress in Deployed Military Personnel,"Abstract OBJECTIVE. We examined the effects of sensory-enhanced hatha yoga on symptoms of combat stress in deployed military personnel, compared their anxiety and sensory processing with that of stateside civilians, and identified any correlations between the State–Trait Anxiety Inventory scales and the Adolescent/Adult Sensory Profile quadrants. METHOD. Seventy military personnel who were deployed to Iraq participated in a randomized controlled trial. Thirty-five received 3 wk (≥9 sessions) of sensory-enhanced hatha yoga, and 35 did not receive any form of yoga. RESULTS. Sensory-enhanced hatha yoga was effective in reducing state and trait anxiety, despite normal pretest scores. Treatment participants showed significantly greater improvement than control participants on 16 of 18 mental health and quality-of-life factors. We found positive correlations between all test measures except sensory seeking. Sensory seeking was negatively correlated with all measures except low registration, which was insignificant. CONCLUSION. The results support using sensory-enhanced hatha yoga for proactive combat stress management.",0,0 +5699,The role of environmental hazard in mothers’ beliefs about appropriate supervision,"Understanding factors that influence mothers’ beliefs about appropriate levels of supervision for their children may assist in efforts to reduce child injury rates. This study examined the interaction of child (i.e. age, gender, and injury risk behavior) and maternal perception of environmental hazard (i.e. hazard level, injury likelihood, and potential injury severity) variables in predicting mothers’ beliefs about appropriate levels of supervision for their children. Participants were 58 mothers of 2- to 8-year-old community children who were interviewed about their beliefs regarding child injury risk and appropriate supervision. Results indicated that perceived environmental hazard level interacted with child age, gender, and injury risk behavior to predict mothers’ beliefs about supervision. Perceived injury likelihood also interacted with child injury risk behavior to predict beliefs about supervision. Findings underscore the complexity of factors influencing mothers’ beliefs about appropriate supervision and indicate the importance of environmental hazard level in such beliefs.",0,0 +5700,Outcome management in in-patient psychiatric care,"To delineate methods and to describe patient appraisal as well as effect of outcome management in in-patient psychiatric care.Two hundred and ninety-four adults with mental illness receiving in-patient treatment at a psychiatric hospital in rural Bavaria gave informed consent to participate in this cluster-randomised trial. Participants were asked to provide information on treatment outcome via weekly computerised standardised assessments. Patients and clinicians in the intervention group received continuous feedback of outcome.Patients were willing and able to regularly provide outcome data and valued feedback. However, use of feedback in conversations between patient and clinician was rare. Outcome management failed to impact on patient-rated outcome during in-patient treatment.Outcome management is feasible in people receiving in-patient psychiatric care, but failed to show an overall short-term effect. Strategies need to be developed to improve active use of routinely collected treatment outcome data in mental health care.",0,0 +5701,Considering PTSD from the perspective of brain processes: A psychological construction approach,"Posttraumatic stress disorder (PTSD) is a complex psychiatric disorder that involves symptoms from various domains that appear to be produced by the combination of several mechanisms. The authors contend that existing neural accounts fail to provide a viable model that explains the emergence and maintenance of PTSD and the associated heterogeneity in the expression of this disorder (cf. Garfinkel & Liberzon, 2009). They introduce a psychological construction approach as a novel framework to probe the brain basis of PTSD, where distributed networks within the human brain are thought to correspond to the basic psychological ingredients of the mind. The authors posit that it is the combination of these ingredients that produces the heterogeneous symptom clusters in PTSD. Their goal is show that a constructionist approach has significant heuristic value in understanding the emergence and maintenance of PTSD symptoms, and leads to different and perhaps more useful conjectures about the origins and maintenance of the syndrome than the traditional hyperreactive fear account.",0,0 +5702,The development and maintenance of post-traumatic stress disorder (PTSD) in civilian adult survivors of war trauma and torture: A review,"This review provides a comprehensive and critical summary of the literature as to the development and maintenance of post-traumatic stress disorder (PTSD) following civilian war trauma and torture. Prevalence rates are reviewed and predictors are discussed in terms of risk factors, protective factors, and factors that maintain PTSD. Most epidemiologically sound studies found relatively low rates of PTSD. There is good evidence of a dose-response relationship between cumulative war trauma and torture and development and maintenance of PTSD. There is also some evidence that female gender and older age are risk factors in development of PTSD. Some refugee variables may exacerbate symptoms of PTSD and contribute to their maintenance. Preparedness for torture, social and family support, and religious beliefs may all be protective against PTSD following war trauma and torture. Applicability of the concept of PTSD to non-western populations and areas for much needed further study are discussed.",0,0 +5703,Trajectories of PTSD symptoms following sexual assault: Is resilience the modal outcome?,"Theoretical frameworks positing qualitatively distinct trajectories of posttrauma outcome have received initial empirical support, but have not been investigated in cases of severe interpersonal trauma. To address this limitation, we conducted latent class growth analysis with longitudinal data collected from 119 female sexual assault survivors at 1-, 2-, 3-, and 4-months postassault. Participants' mean age was 33 years; 63% were White. We hypothesized that given the severity of exposure associated with sexual assault, resilience would not be the modal course of adaptation. Four distinct PTSD growth trajectories, representing unique latent classes of participants, best fit the data: a high chronic trajectory, a moderate chronic trajectory, a moderate recovery trajectory, and a marked recovery trajectory. Contrary to previous studies and recent theoretical models, resilience and resistance trajectories were not observed, as high levels of distress were evident in nearly all participants at 1-month postassault. These results suggest that theoretical models of posttrauma response positing resilience as the modal outcome may not generalize to cases of sexual assault.",1,0 +5704,Diseases among men 20 years after exposure to severe stress: Implications for clinical research and medical care,"OBJECTIVE Epidemiologic studies have linked exposure to severe environmental stress, such as natural disasters and combat operations, to the onset of specific psychiatric disorders. Some research also suggests that these exposures may be associated with the onset of chronic diseases as well. However, these chronic disease outcome studies often have been obscured by bias and confounding. METHOD The medical histories of 1399 male Vietnam veterans approximately 20 years after combat exposure (mean years = 17) were analyzed by lifetime posttraumatic stress disorder (PTSD) status (lifetime PTSD = 332 cases). These men were included in a national, random in-person study of United States Army veterans of the Vietnam War (study completion rate = 65%). RESULTS After controlling for preservice, in-service, and postservice factors (including intelligence, race, region of birth, enlistment status, volunteer status, Army marital status, Army medical profile, hypochondriasis, age, smoking history, substance abuse, education, and income), associations were found for reported circulatory [odds ratio (OR) = 1.62, p = .007], digestive (OR = 1.47, p = .036), musculoskeletal (OR = 1.78, p = .008), endocrine-nutritional-metabolic (OR = 1.58, p = .10), nervous system (OR = 2.47, p < .001), respiratory (OR = 1.54, p = .042), and nonsexually transmitted infectious diseases (OR = 2.14, p < .004) after military service. CONCLUSION Although this study has some limitations, it suggests that there is a direct link between severe stress exposures and a broad spectrum of human diseases. In the future, medical researchers and clinicians should focus more on the medical consequences of exposure to severe environmental stress and seek to better integrate psychobiologic models of disease pathogenesis.",0,0 +5705,Pretraumatic prolonged elevation of salivary MHPG predicts peritraumatic distress and symptoms of post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) is associated with elevated catecholamines and increased sympathetic arousal. However, it is unknown whether this condition is a pre-existing vulnerability factor for PTSD or an acquired result of either trauma exposure or the development of PTSD symptoms. We sought to examine if salivary 3-methoxy-4-hydroxy-phenylglycol (MHPG) in response to a laboratory stressor prior to critical incident exposure predicts the development of PTSD symptoms and if early childhood trauma influences this relationship. In a prospective cohort study, 349 urban police officers were assessed during academy training (baseline) and 243 were reassessed 12 months after the start of active duty (follow-up). At baseline, participants observed a video consisting of police critical incidents. Salivary MHPG was measured before and immediately after the challenge, and after 20min recovery. At follow-up, peritraumatic distress and PTSD symptoms were assessed in relationship to the worst critical incident during the past year. Participants with childhood trauma showed a trend towards higher MHPG increase to the challenge. Higher MHPG levels after 20min recovery were associated with both higher levels of peritraumatic distress and PTSD symptoms at follow-up. In a path analysis, elevated MHPG levels predicted higher peritraumatic distress which in turn predicted higher levels of PTSD symptoms while the direct effect of elevated MHPG levels on PTSD symptoms was no longer significant. Prolonged elevation of salivary MHPG in response to a laboratory stressor marks a predisposition to experience higher levels of peritraumatic distress and subsequently more PTSD symptoms following critical incident exposure.",0,0 +5706,What is the profile of post-traumatic reactions within medical literature? A survey of eight journals,"Abstract Objectives: The importance of traumatic events is recognised by the public but the profile of psychological sequelae such as Post-traumatic Stress Disorder (PTSD) within psychiatry and medicine is unclear. We aimed to establish the profile of PTSD within high impact medical journals and within psychiatric journals based in America and the United Kingdom, since the initial classification of PTSD in DSM-III in 1980 and, before and after classification of PTSD in ICD-10 in 1992. Method: A survey of all articles on post-traumatic reactions published in eight journals between 1980 and 2000. Results: The proportion of articles on PTSD was less in UK based psychiatric journals than their counterparts based in America. The proportion of articles published after the classification of PTSD in ICD-10 has increased in both psychiatric and medical journals. Conclusions: In UK based journals, there is an under-representation of articles on PTSD compared with disorders of similar prevalence.",0,0 +5707,Potential treatment mechanisms of counseling for children in Burundi: A series of n = 1 studies.,"Little is known about the impact and treatment processes of psychosocial counseling in low-income countries. This study aimed to generate hypotheses on key working mechanisms of counseling in Burundi. The authors carried out 11 empirically grounded n=1 studies with children (11-14years) screened for depression and anxiety who received counseling. The authors used quantitative (symptom scales) and qualitative instruments (treatment content and perceptions). Weekly measurements were taken preintervention (4 time points), during the intervention period (8-10 time points), and postintervention (4 time points). Five treatment mechanisms continua appeared associated with outcome trajectories: client centeredness, therapeutic alliance, active problem solving, trauma-focused exposure, and family involvement. Higher levels appeared associated with better outcomes. Contrarily, cases that demonstrated no change were characterized by a heavy focus on counselors' norms, containment and self-control, unstructured retelling and explicit avoidance, advice-oriented problem solving, and noninclusion of family members, respectively. The authors found a distinct clustering of outcome trends per therapist. The findings suggest that integrative counseling, which combines universal therapist variables with active use of specific therapeutic techniques and a systemic perspective, may be an adequate strategy to treat mental health symptoms of children in Burundi.",0,0 +5708,Association of Comorbid Posttraumatic Stress Disorder and Major Depression With Greater Risk for Suicidal Behavior,"Posttraumatic stress disorder (PTSD) increases the risk of suicidal behavior; a major depressive episode also increases the risk for suicidal behavior. The authors' goal was to examine the effect of comorbid PTSD and major depressive episode on suicidal behavior.Inpatients with a diagnosis of major depressive episode (N=156) were assessed for PTSD, suicidal behavior, and clinical risk factors for suicidal acts.Patients with comorbid major depressive episode and PTSD were more likely to have attempted suicide, and women with both disorders were more likely to have attempted suicide than men with both disorders. Cluster B personality disorder and PTSD were independently related to history of suicide attempts.The greater rate of suicide attempts among patients with comorbid PTSD and major depressive episode was not due to differences in substance use, childhood abuse, or cluster B personality disorders.",0,0 +5709,An Alternative AI Breeding Protocol for Dairy Cows Exposed to Elevated Ambient Temperatures before or after Calving or Both,"Our objective was to determine if a timed artificial insemination (AI) protocol (Ovsynch) might produce greater pregnancy rates than AI after a synchronized, detected estrus during summer. Lactating Holstein cows (n = 425) were grouped into breeding clusters and then assigned randomly to each of two protocols for AI between 50 and 70 days in milk. All cows were treated with GnRH followed 7 d later by PGF2alpha. Ovsynch cows then were treated with a second injection of GnRH 48 h after PGF2alpha and inseminated 16 to 19 h later. Controls received no further treatment after PGF2alpha and were inseminated after detected estrus. Pregnancy was diagnosed once by transrectal ultrasonography (27 to 30 d after AI) and again by palpation (40 to 50 d). Based on concentrations of progesterone in blood collected before each hormonal injection, only 85.4% of 425 cows were considered to be cycling. Although conception rates were not different between protocols at d 27 to 30, AI submission rates and pregnancy rates were greater after Ovsynch (timed AI) than after detected estrus. A temperature-humidity index > or = 72 was associated with fewer controls detected in estrus with lower conception than for controls detected in estrus when index values were < 72, whereas the reverse was true for cows after the Ovsynch protocol. We concluded that a timed AI protocol increased pregnancy rates at d 27 to 30 because its success was independent of either expression or detection of estrus. However, because of poorer embryonic survival in Ovsynch cows during heat stress only (39.5 vs. 69.2% survival for Ovsynch and control, respectively), pregnancy rates were not different by d 40 to 50 after timed AI.",0,0 +5710,Neurocognitive profiles of people with borderline personality disorder,"This review summarizes recent neurocognitive research to better delineate the nosology, prognostication and cause underlying borderline personality disorder (BPD).BPD had marked clinical heterogeneity with high comorbidity. Executive dysfunction in this disorder was linked to suicidality and treatment adherence, and may serve as an endophenotype. BPD was also characterized by cognitive distortions such as risky decision-making, deficient feedback processing, dichotomous thinking, jumping to conclusion, monocausal attribution and paranoid cognitive style. Social cognition deficits recently described in BPD include altered social inference and emotional empathy, hypermentalization, poorer facial emotional recognition and facial expressions. In electrophysiological studies, BPD was found to have predominantly right hemispheric deficit in high-order cortical inhibition. Reduced left orbitofrontal activity by visual evoked potential and magnetoencephalography correlated with depressive symptoms and functional deterioration. Brain structures implicated in BPD include the hippocampus, dorsolateral prefrontal cortex and anterior cingulate cortex. Abnormal anatomy and functioning of frontolimbic circuitry appear to correlate with cognitive deficits.Frontolimbic structural and functional abnormalities underlie the broad array of cognitive abnormalities in BPD. Further research should espouse broader considerations of effects of comorbidity and clinical heterogeneity, and include community samples and, possibly, longitudinal designs.",0,0 +5711,"Beginnings, Second Edition","Utilizing a decade’s worth of clinical experience gained since its original publication, Mary Jo Peebles builds and expands upon exquisitely demonstrated therapeutic approaches and strategies in this second edition of Beginnings. The essential question remains the same, however: How does a therapist begin psychotherapy? To address this delicate issue, she takes a thoughtful, step-by-step approach to the substance of those crucial first sessions, delineating both processes and potential pitfalls in such topics as establishing a therapeutic alliance, issues of trust, and history taking. Each chapter is revised and expanded to include the latest treatment research and modalities, liberally illustrated with rich case material, and espouse a commitment to the value of multiple theoretical perspectives. Frank and sophisticated, yet eminently accessible, this second edition will be an invaluable resource for educators, students, and seasoned practitioners of any therapeutic persuasion. © 2012 by Taylor & Francis Group, LLC.",0,0 +5712,Interpersonal Factors in Understanding and Treating Posttraumatic Stress Disorder,"Exposure to reminders of trauma underlies the theory and practice of most treatments for post-traumatic stress disorder (PTSD), yet exposure may not be the sole important treatment mechanism. Interpersonal features of PTSD influence its onset, chronicity, and possibly its treatment. The authors review interpersonal factors in PTSD, including the critical but underrecognized role of social support as both protective posttrauma and as a mechanism of recovery. They discuss interpersonal psychotherapy (IPT) as an alternative treatment for PTSD and present encouraging findings from two initial studies. Highlighting the potential importance of attachment and interpersonal relationships, the authors propose a mechanism to explain why improving relationships may ameliorate PTSD symptoms.",0,0 +5713,The Multidimensional Scale of Perceived Social Support,"The development of a self-report measure of subjectively assessed social support, the Multidimensional Scale of Perceived Social Support (MSPSS), is described. Subjects included 136 female and 139 male university undergraduates. Three subscales, each addressing a different source of support, were identified and found to have strong factorial validity: (a) Family, (b) Friends, and (c) Significant Other. In addition, the research demonstrated that the MSPSS has good internal and test-retest reliability as well as moderate construct validity. As predicted, high levels of perceived social support were associated with low levels of depression and anxiety symptomatology as measured by the Hopkins Symptom Checklist. Gender differences with respect to the MSPSS are also presented. The value of the MSPSS as a research instrument is discussed, along with implications for future research.",0,0 +5714,Emotion Regulation Strategy Use and Posttraumatic Stress Disorder: Associations Between Multiple Strategies and Specific Symptom Clusters,"A growing literature suggests that emotion regulation (ER) is associated with posttraumatic stress disorder (PTSD). However, most of the studies in this literature have one or more important limitations, including examining only a single ER strategy (e.g., thought suppression) rather than multiple strategies simultaneously, examining PTSD at the syndrome level rather than by symptom cluster, and failing to control for negative affect. The present study sought to address these limitations by using latent variable modeling to examine the associations between multiple ER strategies and individual PTSD symptom clusters while controlling for negative affect. Of the four measurement models of ER strategy use examined, the best-fitting model allowed items corresponding to each included strategy to load onto their independent factors. Of the four measurement models of PTSD symptoms examined, the best-fitting model was the five-factor dysphoric arousal model. Results of structural models indicated that thought suppression and experiential avoidance were associated with most PTSD symptom clusters, even after controlling for negative affect. However, most other included ER strategies were not associated with any symptom clusters. A number of issues regarding measurement of ER and PTSD are discussed, and several suggestions for future research are provided.",0,0 +5715,Relationship Distress in Partners of Combat Veterans: The Role of Partners’ Perceptions of Posttraumatic Stress Symptoms,"Partners of combat veterans with posttraumatic stress disorder report elevated relationship and psychological distress, but little is known about the mechanisms by which such distress develops. In two separate samples, we examined partners' perceptions of veterans' PTSD symptoms, with a specific focus on the simultaneous associations of partners' distress with their perceptions of veterans' reexperiencing, withdrawal/numbing, and hyperarousal symptom clusters. The first sample consisted of 258 partners of Operation Enduring- and Iraqi Freedom-era veterans who completed questionnaires. The second sample consisted of 465 partners of Vietnam-era veterans who completed interviews as part of the National Vietnam Veterans Readjustment Study. In both samples, path analyses revealed that, when examined simultaneously, partners' perceptions of withdrawal/numbing symptoms were associated with greater distress, but perceptions of reexperiencing symptoms were unrelated to psychological distress and significantly associated with lower levels of relationship distress. Given the cross-sectional nature of the data in both samples, there are multiple plausible interpretations of the results. However, the pattern is consistent with an attributional model of partner distress, whereby partners are less distressed when symptoms are more overtly related to an uncontrollable mental illness. Potential clinical implications are discussed.",0,0 +5716,Posttraumatic stress symptom clusters associations with psychopathology and functional impairment,"We examined posttraumatic stress symptom clusters associations with psychopathology and functional impairment in 899 Norwegian survivors of the 2004 South-East Asia tsunami six months post-disaster. Posttraumatic stress symptoms were assessed with the Impact of Event Scale-Revised (IES-R) with intrusion, avoidance, and hyper-arousal subscales. For criterion variables, we used 10 indicators of psychopathology and functional impairment, e.g. having mental health problems, seeing mental health professionals, and use of medication or sick leave. Hyper-arousal had stronger correlations than avoidance with all criterion variables (p values<0.001) and stronger correlations than intrusion with seven of the 10 criterion variables (p values<0.01). Also, intrusion had stronger correlations than avoidance with seven of 10 criterion variables (p values<0.05). Thus, our findings indicate that symptoms of hyper-arousal may be more closely linked to psychopathology and functional impairment than other symptoms of posttraumatic stress following a sudden onset, short duration, natural disaster event.",0,0 +5717,Open trial of citalopram in adults with post-traumatic stress disorder,"The selective serotonin reuptake inhibitors (SSRIs) are rapidly emerging as preferred first-line drugs in the pharmacological management of post-traumatic stress disorder (PTSD). Citalopram, an SSRI with highly potent and selective serotonin reuptake inhibition, may be a useful agent for treating the intrusive, avoidance, and arousal symptoms that characterize PTSD. Fourteen adult subjects (12 with civilian-related post-traumatic stress disorder, and 2 with combat-related post-traumatic stress disorder) were entered into an 8 wk, open- label, fixed-dose trial of citalopram, commencing with 20 mg/d, and increasing to 40 mg/d after 2 wk. Eleven subjects completed 8 wk treatment and were included in the data analysis. Based on the Clinician-Administered Post-traumatic Stress Disorder Scale (CAPS-2), there was significant reduction in all core PTSD symptoms (re-experiencing, hyperarousal, and avoidance) by week 8. Nine of the 11 completers were classified as 'responders' on Clinical Global Impression Improvement scores. Secondary measures of depression (Montgomery-Asberg Depression Rating Scale) and anxiety (Hamilton Anxiety Scale) also improved significantly by week 8. Citalopram was tolerated well, and there were no dropouts due to adverse effects. Data from this preliminary open trial suggests that citalopram, an SSRI, may be effective for reducing the key symptoms of PTSD, however, these findings need confirmation in double-blind, placebo-controlled trials.",0,0 +5718,No evidence of sleep disturbance in post-traumatic stress disorder: a polysomnographic study in injured victims of traffic accidents.,"Disturbed sleep is a common complaint among patients with PTSD. This complaint can be found in both the reexperiencing and hyperarousal symptom clusters in the DSM-IV. However, laboratory studies of sleep in PTSD have provided inconsistent evidence of objective sleep disturbances. Shortened REM latency, reduced sleep efficiency, restless sleep and increased prevalence of sleep apnea have been reported, but were not confirmed by all. A major shortcoming of most previous studies is the fact that they were done retrospectively in patients with chronic PTSD, often complicated by psychiatric comorbidity and drug abuse. Thus, little is known about the development of sleep disturbances in recently traumatized subjects.Eight injured victims of traffic accidents with PTSD and 6 injured victims without PTSD participated in a 3-night polysomnographic study one year after the accident.No significant differences between PTSD and non-PTSD patients were noted on any of the PSG measures. In addition, the two groups did not differ significantly from each other with respect to awakening thresholds during REM sleep.Considering that the present sample was free of active psychiatric comorbidity at the time of trauma and free of hypnotic medications, these results strengthen previous PSG studies suggesting that altered sleep perception, rather than sleep disturbance per se, may be the key problem in PTSD. More research is needed in order to examine whether this problem is specific to sleep or generalizes to other domains as well.",0,0 +5719,Prosocial coping by youth exposed to violence,"Chronic exposure to violence encourages youth to cope with challenges via a mixture of asocial, depressive and antisocial, aggressive tactics rather than prosocially in ways that benefit self without harming others. Youth exposed to violence are, therefore, not only at high risk for posttraumatic stress disorder (PTSD) but also for externalizing and internalizing behavior problems, school dropout, teen pregnancy, substance abuse, and delinquency. Despite violence exposure, high-risk youth may cope prosocially with controllable and uncontrollable life challenges if supported at school by a prosocial coping-skills program (PCS) that takes place each week for 45 minutes in small groups (6-8, members) with equal numbers of members skilled (competent) and less skilled (high-risk) at prosocial coping. Each PCS session: begins with information exchange among members about feelings, thoughts, and experiences; is structured by group rules that promote prosocial coping during sessions; includes activities that assess and rehearse prosocial coping with real-life emotional, social, and achievement challenges; is data driven and tailored to members' diverse skill levels. PCS may enable school-based prevention of behavior problems and adverse life outcomes from first grade through high school. © 1994 Human Sciences Press, Inc.",0,0 +5720,Psychiatric Comorbidity and PTSD in Addicted Prostitutes,"In the city of Rotterdam prostitution used to take place not only in sexclubs but also in and around a designated prostitution street-zone in the harbor area outside the city center. The group of sexworkers at this street-zone consisted primarily of severely addicted women. For a long period of time the harm reduction approach had been the major intervention for this socially marginalized group of women. From January 2003 to December 2004 184 of them could be interviewed and diagnosed according to DSM IV. Nearly all of them were addicted to heroin and cocaine and most of them also were dependent on alcohol and benzodiazepines. Psychiatric comorbidity was almost 100 %. Co-morbid conditions existed of cluster B and C personality disorders, psychotic disorders (26 %), affective disorders (31 %), acute PTSD (9 %) and adult-ADHD (8%). In 2006 the government had closed the prostitution street-zone and many of the women could be placed in therapeutic and protected homes. Now, 2 years later, we reinvestigate these women with respect to their actual social situation, their quality of life, psychiatric comorbidity and persisting (acute and chronic) PTSD. During the interviews we use the WHO Quality of life questionnaire and the KIP (clinical interview for PTSD). It is an ongoing study and the (preliminary) results will be presented during the symposium.",0,0 +5721,Treating post-traumatic stress disorder in the ‘real world’: evaluation of a specialist trauma service and adaptations to standard treatment approaches,"Aims and Method To evaluate the effectiveness of treatment at the Traumatic Stress Service (TSS) by comparing pre- and post-treatment scores on patient self-report measures. Through a questionnaire survey, to explore therapists' views of problems presenting in addition to post-traumatic stress disorder (PTSD) and how, as a result, they adapted their approach to trauma work. Results Therapists reported that their patients present with a range of complex problems, and self-report measures show that patients suffer particularly high levels of psychopathology. Therapists identified a number of adaptations to trauma-focused work to deal with these additional problems. Of the 112 patients who completed therapy, 43% filled in pre- and post-treatment questionnaire measures. Analysis showed clinically and statistically significant improvements in levels of PTSD, depression and social functioning. Clinical Implications The typical presentation of trauma survivors is often not ‘simple’ PTSD, but PTSD resulting from chronic and multiple traumas and complicated by additional psychological and social difficulties. Adaptations to trauma-focused work can successfully treat such ‘complex’ PTSD.",0,0 +5722,Prevalence and risk factors of post-traumatic stress disorder among adult survivors six months after the Wenchuan earthquake,"Exposure to earthquake has been associated with psychological distress, in particular, the development of posttraumatic stress disorder (PTSD). The aims of this study were to estimate the prevalence of PTSD, explore the associated risk factors among adult survivors 6 months after the Wenchuan earthquake in China, and compare the findings in our study to other studies about the Wenchuan earthquake and other earthquakes that occurred in the past. Multistage stratified random sampling methods were conducted in three severely affected areas in the Wenchuan earthquake. In this study, 14,798 individuals were identified with simple random selection methods at the sampling sites, 14,207 individuals were screened with the 12-item General Health Questionnaire(GHQ-12), and 3692 individuals were administered a Chinese version of the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV axis I disorders (SCID-I/P) by 180 psychiatrists. The prevalence of PTSD was 15.57%. The risk factors for PTSD included old age, female gender, living alone, buried in the earthquake, injured in the earthquake, operated on after the earthquake, witnessing someone get injured in the earthquake, witnessing someone get buried in the earthquake, witnessing someone die in the earthquake (P < 0.05, 95% CI). PTSD is common after a major disaster. Risk factors help people to identify the potential victims after disasters in time. Post-disaster mental health recovery interventions include early identification, sustained psychosocial support, governmental programs that provide social and economic support.",0,0 +5723,Perceived military organizational support and peacekeeper distress: A longitudinal investigation.,"Many professions vital to the safety of society require workers to face high magnitude and potentially traumatizing events. Because this routine exposure can cause high levels of stress in workers, it is important to investigate factors that contribute to both risk of posttraumatic stress disorder (PTSD), and healthy responses to stress. Although some research has found social support to mitigate the effects of posttraumatic stress symptoms, scant research has investigated organizational support. The aim of the present study is to investigate the temporal relationship between stress symptoms and perceived organizational support in a sample of 1,039 service members deployed to the peacekeeping mission to Kosovo. Participants completed self-report measures of stress symptoms and perceived organizational support at 4 study time points. Bivariate latent difference score structural equation modeling was utilized to examine the temporal relationship among stress and perceived organizational support. In general, across the 4 time points, latent PCL scores evidenced a salient and negative relationship to subsequent POS latent difference scores. However, no significant relationship was found between latent POS variables and subsequent PCL latent difference scores. Findings suggest that prior stress symptoms are influencing service member's perceptions of the supportiveness of their organization such that increased prior stress is associated with worsening perceptions of support. These results illustrate that targeting stress directly may potentiate the positive influence of organizational support and that institutional support programs should be adapted to better account for the negative biases increased distress may encourage.",0,0 +5724,Air Medical Evacuations from a Developing World Conflict Zone,"Somalia has been without effective government for close to two decades, with more than 1 million people internally displaced. The political unrest persists, with United Nations–backed African Union peacekeeping forces supporting the Transitional National government of Sharif Ahmed, struggling to maintain control of central Mogadishu from Islamist extremist groups, such as the reportedly Al-Qaeda–backed Al-Shabab. The African Union force of 5,000 troops is predominantly of Ugandan and Burundian origin, making up the African Mission in Somalia (AMISOM) effort. However, its mandate is limited to operations only in Mogadishu, and it is unauthorized to actively pursue insurgents. As with other ongoing high-profile conflicts, African Union troops face an enemy that blends into the civilian populace, fighting with a lethal mixture of improvised explosive devices and suicide bombers.",0,0 +5725,Predicting Posttraumatic Stress Following Pediatric Injury: A Systematic Review,"To review the recent empirical literature concerning development of posttraumatic stress symptoms following pediatric injury and summarize risk and predictive factors that will inform clinical practice and research.A systematic search of online databases such as PsycInfo, PILOTS, MedLine, and PubMed was performed. Further studies were identified through the reference lists of selected articles.Pre-injury psychological problems, the child's subjective experience of trauma severity/life threat, elevated heart rate immediately following the trauma, beliefs regarding initial symptoms, active thought suppression, and parental posttraumatic stress appear to be consistent predictors of persisting posttraumatic stress in children following injury.Specific variables may be useful in predicting posttraumatic stress following injury, which are discussed in terms of existing models of pediatric traumatic stress. Methodologies of included studies are also discussed.",0,0 +5726,Overgeneral autobiographical memory predicts changes in depression in a community sample,"This study investigated whether overgeneral autobiographical memory (OGM) predicts the course of symptoms of depression and anxiety in a community sample, after 5, 6, 12 and 18 months. Participants (N=156) completed the Autobiographical Memory Test and the Depression Anxiety Stress Scales-21 (DASS-21) at baseline and were subsequently reassessed using the DASS-21 at four time points over a period of 18 months. Using latent growth curve modelling, we found that OGM was associated with a linear increase in depression. We were unable to detect changes over time in anxiety. OGM may be an important marker to identify people at risk for depression in the future, but more research is needed with anxiety.",0,0 +5727,Ambulatory Medical Assistance - After Cancer (AMA-AC): A model for an early trajectory survivorship survey of lymphoma patients treated with anthracycline-based chemotherapy,"Cancer survivorship has emerged as an important aspect of oncology due to the possibility of physical and psychosocial complications. The purpose of this study was to assess the feasibility of the Ambulatory Medical Assistance for After Cancer (AMA-AC) procedure for monitoring lymphoma survivorship during the first year after chemotherapy.AMA-AC is based on systematic general practitioner (GP) consultations and telephone interventions conducted by a nurse coordinator (NC) affiliated to the oncology unit, while an oncologist acts only on demand. Patients are regularly monitored for physical, psychological and social events, as well as their health-related quality of life (HRQoL). Inclusion criteria were patients newly diagnosed with non-Hodgkin or Hodgkin lymphomas, who had been treated with anthracycline-based chemotherapy and were in complete remission after treatment.All 115 patients and 113 collaborating GPs agreed to participate in the study. For patients who achieved one year of disease-free survival (n = 104) their assessments (438 in total) were fully completed. Eleven were excluded from analysis (9 relapses and 2 deaths). The most frequent complications when taking into account all grades were arthralgia (64.3%) and infections (41.7%). About one third of patients developed new diseases with cardiovascular complications as the most common. Psychological disorders such as anxiety, depression and post-traumatic stress disorder were diagnosed in 42.6% of patients. The data collected showed that Hodgkin lymphoma patients, females, and patients with lower HRQoL (mental component) at study entry were at greater risk for developing at least one psychological disorder.This study showed that AMA-AC is a feasible and efficient procedure for monitoring lymphoma survivorship in terms of GP and patient participation rates and adherence, and provides a high quality of operable data. Hence, the AMA-AC procedure may be transferable into clinical daily practice as an alternative to standard oncologist-based follow-up.",0,0 +5728,A cross-sectional study of psychological complaints and quality of life in severely injured patients,"PurposeThe purpose of this study was to examine the incidence of psychological complaints and the relationship of these complaints with the quality of life (QOL) and accident- and patient-related factors among severely injured patients after the rehabilitation phase.MethodsPatients of 18 years or older with an injury severity score above 15 were included 15–53 months after their accident. Accident and patient characteristics were obtained from questionnaires and the trauma registry. Several questionnaires (Hospital Anxiety and Depression Scale, Impact of Events Scale, and Cognitive Failure Questionnaire) were used to determine the symptoms of psychological problems (anxiety or depression, post-traumatic stress disorder, or subjective cognitive complaints, respectively). The World Health Organization Quality of Life-Bref was used to determine QOL. A reference group of the Dutch general population was used for comparison of QOL scores.ResultsThe participation rate was 62 % (n = 173). At the time of the study, 30.1 % (n = 52) of the investigated patients had psychological complaints. No relation between psychological complaints and somatic severity or type of injury was found. Patients who were employed before the accident or resumed working reported less psychological complaints. Use of any medication before the accident and treatment for pre-accidental psychological problems were positively related to psychological complaints afterwards. QOL of severely injured patients was impaired in comparison with the general Dutch population, but only for those with psychological complaints.ConclusionsPsychological complaints seem to be an important and underestimated factor for a decreased QOL among severely injured patients.",0,0 +5729,Up Close and Personal: Temporal Variability in the Drinking of Individual College Students During Their First Year.,"Surveys have documented excessive drinking among college students and tracked annual changes in consumption over time. This study extended previous work by examining drinking changes during the freshman year, using latent growth curve (LGC) analysis to model individual change, and relating risk factors for heavy drinking to growth factors in the model. Retrospective monthly assessments of daily drinking were used to generate weekly estimates. Drinking varied considerably by week, apparently as a function of academic requirements and holidays. A 4-factor LGC model adequately fit the data. In univariate analyses, gender, race/ethnicity, alcohol expectancies, sensation seeking, residence, and data completeness predicted growth factors (ps <.05); gender, expectancies, residence, and data completeness remained significant when covariates were tested simultaneously. Substantive, methodological, and policy implications are discussed.",0,0 +5730,Trajectories of depression following spousal and child bereavement: A comparison of the heterogeneity in outcomes,"Our understanding of how individuals react to the loss of a close loved one comes largely from studies of spousal bereavement. The extent to which findings are relevant to other bereavements is uncertain. A major methodological limitation of current studies has been a reliance on retrospective reporting of functioning and use of samples of individuals who have self-selected for participant in grief research. To address these limitations, in the current study we applied Latent Growth Mixture Modelling (LGMM) in a prospective population-based sample to identify trajectories of depression following spousal and child bereavement in later life. The sample consisted of 2512 individual bereaved adults who were assessed once before and three times after their loss. Four discrete trajectories were identified: Resilience (little or no depression; 68.2%), Chronic Grief (an onset of depression following loss; 13.2%), Depressed-Improved (high pre-loss depression that decreased following loss; 11.2%), and Pre-existing Chronic Depression (high depression at all assessments; 7.4%). These trajectories were present for both child and spousal loss. There was some evidence that child loss in later life was associated more strongly with the Chronic Grief trajectory and less strongly with the Resilience trajectory. However these differences disappeared when covariates were included in the model. Limitations of the analyses are discussed. These findings increase our understanding of the variety of outcomes following bereavement and underscore the importance of using prospective designs to map heterogeneity of response outcomes.",0,0 +5731,Critical Body Temperature Profile as Indicator of Heat Stress Vulnerability,"Extreme climatic heat is a major health concern among workers in different occupational pursuits. People in the regions of western India confront frequent heat emergencies, with great risk of mortality and morbidity. Taking account of informal occupational groups (foundry and sheet metal, FSM, N=587; ceramic and pottery, CP, N=426; stone quarry, SQ, N=934) in different seasons, the study examined the body temperature profiling as indicator of vulnerability to environmental warmth. About 3/4th of 1947 workers had habitual exposure at 30.1-35.5°C WBGT and ~10% of them were exposed to 38.2-41.6°C WBGT. The responses of FSM, CP and SQ workers indicated prevailing high heat load during summer and post-monsoon months. Local skin temperatures (T(sk)) varied significantly in different seasons, with consistently high level in summer, followed by post-monsoon and winter months. The mean difference of T(cr) and T(sk) was ~5.2°C up to 26.7°C WBGT, and ~2.5°C beyond 30°C WBGT. Nearly 90% of the workers had T(cr) within 38°C, suggesting their self-adjustment strategy in pacing work and regulating T(cr). In extreme heat, the limit of peripheral adjustability (35-36°C T(sk)) and the narrowing down of the difference between T(cr) and T(sk) might indicate the limit of one's ability to withstand heat exposure.",0,0 +5732,Evaluation of the Atypical Response scale of the Trauma Symptom Inventory-2 in detecting simulated posttraumatic stress disorder,"This investigation evaluated the Atypical Response (ATR) scale of the Trauma Symptom Inventory - 2nd edition (TSI-2) in terms of its ability to distinguish genuine symptoms of posttraumatic stress disorder (PTSD) from simulated PTSD. Seventy-five undergraduate students were trained to simulate PTSD and were given monetary incentives to do so. Their responses on the PTSD Checklist (PCL), TSI-2 ATR, and Personality Assessment Inventory (PAI) validity scales were compared to responses of 49 undergraduate students with genuine symptoms of PTSD instructed to respond honestly on testing. Results indicate that the revised version of the ATR is superior to the original version in detecting malingered PTSD. Discriminant Function Analyses revealed correct classification of 75% of genuinely distressed individuals and 74% of PTSD simulators.",0,0 +5733,A role for cannabinoid CB1 receptors in mood and anxiety disorders,"Mood and anxiety disorders, the most prevalent of the psychiatric disorders, cause immeasurable suffering worldwide. Despite impressive advances in pharmacological therapies, improvements in efficacy and side-effect profiles are needed. The present literature review examines the role that the endocannabinoid system may play in these disorders and the potential value of targeting this system in the search for novel and improved medications. Cannabis and its major psychoactive component (-)-trans-delta9-tetrahydrocannabinol, have profound effects on mood and can modulate anxiety and mood states. Cannabinoid receptors and other protein targets in the central nervous system (CNS) that modulate endocannabinoid function have been described. The discovery of selective modulators of some of these sites that increase or decrease endocannabinoid neurotransmission, primarily through the most prominent of the cannabinoid receptors in the CNS, the CB1 receptors, combined with transgenic mouse technology, has enabled detailed investigations into the role of these CNS sites in the regulation of mood and anxiety states. Although data point to the involvement of the endocannabinoid system in anxiety states, the pharmacological evidence seems contradictory: both anxiolytic- and anxiogenic-like effects have been reported with both endocannabinoid neurotransmission enhancers and blockers. Due to advances in the development of selective compounds directed at the CB1 receptors, significant progress has been made on this target. Recent biochemical and behavioural findings have demonstrated that blockade of CB1 receptors engenders antidepressant-like neurochemical changes (increases in extracellular levels of monoamines in cortical but not subcortical brain regions) and behavioural effects consistent with antidepressant/antistress activity in rodents.",0,0 +5734,Differential accounts of refugee and resettlement experiences in youth with high and low levels of posttraumatic stress disorder (PTSD) symptomatology: A mixed-methods investigation.,"In recent years there has been increased debate and critique of the focus on psychopathology in general, and posttraumatic stress disorder (PTSD) in particular, as a predominant consequence of the refugee experience. This study was conducted to broaden the conceptualization and examination of the outcomes of the refugee experience by jointly examining how adaptive processes, psychosocial factors, and psychopathology are implicated. A mixed-methods approach was used to specifically examine whether adolescents' (N = 10) accounts of their refugee and resettlement experiences differed according to their level, ""high"" or ""low,"" of PTSD symptomatology. The superordinate themes of cultural belongingness and identification, psychological functioning, family unit functioning and relationships, and friendships and interpersonal processes, were identified as having particular relevance for the study's participants and in distinguishing between participants with high and low levels of PTSD symptomatology. Findings were characterized by marked differences between adolescents' accounts according to their symptomatology levels, and may thereby inform important avenues for future research as well as clinical prevention and intervention programs with refugee youth.",0,0 +5735,An Examination of the Latent Structure of the Difficulties in Emotion Regulation Scale,"The Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer, Journal of Psychopathology and Behavioral Assessment 26:41-54, 2004) is a popular multidimensional self-report measure of emotion regulation. The present study sought to examine the latent factor structure of the DERS. An examination of latent factor intercorrelations and a higher-order confirmatory factor analysis (CFA) suggested that the DERS-AWARENESS dimension may not represent the same higher-order emotion regulation construct as the other five DERS dimensions. Furthermore, findings supported the adequacy of a revised five-factor model of the DERS in which the AWARENESS dimension was removed. This revised DERS total scale did not diminish concurrent relations between the DERS and outcomes relevant to the emotion regulation domain (i.e., depression, anxiety, posttraumatic stress symptoms). Implications for the conceptualization and assessment of emotion regulation are discussed. © Springer Science+Business Media, LLC 2012.",0,0 +5736,"Mental health, social functioning, and feelings of hatred and revenge of Kosovar Albanians one year after the war in Kosovo","A cross-sectional cluster sample survey was conducted in June 2000 in Kosovo to assess the prevalence of mental health problems associated with traumatic experiences, feelings of hatred and revenge, and the level of social functioning among Kosovar Albanians approximately 1 year after the end of the war. Findings of the second cross-sectional survey were compared with those from our 1999 mental health survey in Kosovo. Included in the survey were 1399 Kosovar Albanians aged 15 years or older living in 593 randomly selected households across Kosovo. Twenty-five percent of respondents reported PTSD symptoms, compared with 17.1% in 1999. The MOS-20 social functioning score improved to 69.8 from 29.5 in 1999. In the 2000 survey 54% of men felt hatred toward the Serbs, compared with 88.7% in 1999.",0,0 +5737,An examination of a two-factor model of rumination and its impact on the relationship between posttraumatic growth and Posttraumatic Stress Disorder (PTSD),"Research indicates that over half the US population will experience a trauma at some point during their lifetime (Kessler et al., 1995). Following traumatic events, individuals frequently experience a range of intrusion, avoidance, and arousal symptoms that fall on a continuum and can occur with such frequency and intensity that they meet the criteria for Posttraumatic Stress Disorder (PTSD; American Psychiatric Association, 2001). However, though many people experience traumas, only a small percentage develop PTSD. Research shows that many trauma survivors actually report benefit finding, or posttraumatic growth, after trauma. Currently, there is no clear understanding of the relationship between PTSD symptoms and posttraumatic growth. The current study hypothesized that two very different types of cognitive processing - reflection and brooding - would moderate the relationship between PTSD symptoms and posttraumatic growth, with reflection strengthening the relationship (making it more positive), and brooding weakening the relationship. 270 University undergraduate students completed self-report questionnaires asking about their trauma history, PTSD symptoms, their use of reflection and brooding, and their perceptions of posttraumatic growth. Although reflection and brooding both moderated the relationship between PTSD symptoms and posttraumatic growth, both had the same antagonistic effects, switching the relationship between PTSD symptoms and posttraumatic growth from positive to negative. The current study concludes that: (1) Future studies should investigate the role of third variables in attempting to understand the relationship between PTSD symptoms and posttraumatic growth; (2) Cognitive processing variables appear to be excellent sources of information in this relationship; (3) Brooding and reflection may represent one way to investigate distinctions between adaptive and maladaptive forms of cognitive processing after trauma, if measurement tools are improved. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5738,Subgroups of US IRAQ and Afghanistan veterans: associations with traumatic brain injury and mental health conditions,"U. S. veterans of Iraq and Afghanistan are known to have a high prevalence of traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), and depression, which are often comorbid and share many symptoms. Attempts to describe this cohort by single diagnoses have limited our understanding of the complex nature of this population. The objective of this study was to identify subgroups of Iraq and Afghanistan veterans (IAVs) with distinct compositions of symptoms associated with TBI, PTSD, and depression. Our cross-sectional, observational study included 303,716 IAVs who received care in the Veterans Health Administration in 2010-2011. Symptoms and conditions were defined using International Classification of Diseases, Ninth Revision codes and symptom-clusters were identified using latent class analysis. We identified seven classes with distinct symptom compositions. One class had low probability of any condition and low health care utilization (HCU) (48 %). Other classes were characterized by high probabilities of mental health comorbidities (14 %); chronic pain and sleep disturbance (20 %); headaches and memory problems (6 %); and auditory problems (2.5 %). Another class had mental health comorbidities and chronic pain (7 %), and the last had high probabilities of most symptoms examined (3 %). These last two classes had the highest likelihood of TBI, PTSD, and depression and were identified as high healthcare utilizers. There are subgroups of IAVs with distinct clusters of symptom that are meaningfully associated with TBI, PTSD, depression, and HCU. Additional studies examining these veteran subgroups could improve our understanding of this complex comorbid patient population.",0,0 +5739,POSTTRAUMATIC STRESS DISORDER IS ASSOCIATED WITH HIGHER C-REACTIVE PROTEIN LEVELS,"Background: Posttraumatic stress disorder (PTSD) has been linked to cardiovascular disease. Increased inflammation, through disruption of neuroendocrine systems, could be implicated, but limited data are available on the link between PTSD and inflammation. In a twin study of military veterans we tested the hypothesis that twins with PTSD had higher plasma levels of inflammatory biomarkers than their twin brothers without PTSD after adjusting for cardiovascular and behavioral factors. Methods: We examined 510 monozygotic and dizygotic middle-aged male twins (255 pairs), mean age 55 yr (range 47-61) from the Vietnam Era Twin Registry. PTSD and other psychiatric diagnoses were assessed with the Structured Clinical Interview for DSM-IV. Plasma levels of C-reactive protein (CRP) and interleukin-6 (IL-6), and cardiovascular risk factors were measured. Analyses were conducted on log-transformed biomarker data using mixed effects regression to account for pair cluster and to separate between- and within-pair effects. Results: Of 510 twins, 69 had a lifetime diagnosis of PTSD and 35 had current PTSD. PTSD was associated with increasing CRP levels. Mean CRP levels were lowest in twins with no diagnosis of PTSD (2.5 mg/L) and highest in those with current PTSD (5.1 mg/L); those with lifetime, but no current PTSD, had a intermediate mean CRP level (3.7 mg/L) (p=0.005). Differences were attenuated but remained significant (p=0.02) after adjustment for traditional CVD risk factors, BMI, previous CVD, major depression, and history of substance abuse. Within 29 pairs discordant for current PTSD, after adjusting for the same factors, the twins with current PTSD had 69% higher CRP than their brother without PTSD (p=0.02). Results did not differ significantly by zygosity. There were no differences in IL-6 levels based on PTSD status. Conclusion: PTSD, particularly a current episode, is associated with elevated CRP. Enhanced inflammation may be a mechanism for increased risk of somatic disorders, including CVD, in persons with PTSD.",0,0 +5740,Acute Stress Masking the Biochemical Phenotype of Partial Androgen Insensitivity Syndrome in a Patient with a Novel Mutation in the Androgen Receptor,"Hypogonadism has traditionally been classified as either hypogonadotropic or hypergonadotropic based on serum gonadotropin levels. However, when hypothalamic suppression of GnRH secretion occurs, it can mask an underlying hypergonadotropic state. In this report we document the unusual case of a 61-yr-old man with androgen insensitivity and coincidental functional hypogonadotropic hypogonadism (HH). Although functional HH is not a well-recognized entity in the male, major stress has been reported to cause transient suppression of the hypothalamic-pituitary-gonadal axis in men. The patient in question was noted to have undervirilization, minimal pubertal development, hypogonadal testosterone, and low gonadotropin levels consistent with congenital HH during a hospital admission for myocardial infarction. However, the patient had also had surgery for hypospadias, a clinical feature not typically part of the phenotypic spectrum of congenital HH. We therefore hypothesized that the combination of acute stress and chronic glucocorticoid administration for temporal arteritis induced transient HH in a patient with a disorder of sexual differentiation in whom gonadotropin levels would have otherwise been elevated. Using clinical, molecular, and genetic studies, the patient was found to have partial androgen insensitivity syndrome (PAIS) caused by a novel mutation (Ser(740)Cys) in the ligand-binding domain of the androgen receptor. Subsequent studies of the patient confirmed the characteristic gonadotropin and sex steroid abnormalities of PAIS. We describe for the first time a patient with PAIS presenting with a reversible hypogonadotropic biochemical profile triggered by an acute illness and corticosteroid therapy. This case highlights the necessity for caution when interpreting gonadotropin levels during acute stress.",0,0 +5741,Information Processing in Posttraumatic Stress Disorder,"Abstract The chapter reviews the contribution of information processing models to understanding the development and maintenance of posttraumatic stress disorder. Individual differences in cognitive processing during the trauma and basic memory mechanism, such as priming and associative learning, may help explain why people with PTSD involuntarily re-experience parts of the trauma in a wide range of situations. Individual differences in how people remember traumatic events may influence the likelihood of developing PTSD. Attentional bias to trauma-related cues and threatening interpretations of the trauma or its aftermath help explain why people with PTSD have many symptoms of anxiety even though the trauma is over. Cognitive strategies people use to deal with memories of the trauma, such as effortful suppression of trauma memories and rumination, help explain why some develop chronic PTSD whereas many recover from trauma. Finally, there may be cognitive vulnerability factors that increase the probability of developing PTSD in response to trauma. Directions for future research are outlined.",0,0 +5742,The structure of post-traumatic stress disorder symptoms in three female trauma samples: A comparison of interview and self-report measures,"Empirical research increasingly suggests that post-traumatic stress disorder (PTSD) is comprised of four factors: re-experiencing, avoidance, numbing, and hyperarousal. Nonetheless, there remains some inconsistency in the findings of factor analyses that form the bulk of this empirical literature. One source of such inconsistency may be assessment measure idiosyncrasies. To examine this issue, we conducted confirmatory factor analyses of interview and self-report data across three trauma samples. Analyses of the interview data indicated a good fit for a four-factor model across all samples; analyses of the self-report data indicated an adequate fit in two of three samples. Overall, findings suggest that measure idiosyncrasies may account for some of the inconsistency in previous factor analyses of PTSD symptoms.",0,0 +5743,Psychometric Properties of the Life Events Checklist,"The Life Events Checklist (LEC), a measure of exposure to potentially traumatic events, was developed at the National Center for Posttraumatic Stress Disorder (PTSD) concurrently with the Clinician Administered PTSD Scale (CAPS) to facilitate the diagnosis of PTSD. Although the CAPS is recognized as the gold standard in PTSD symptom assessment, the psychometric soundness of the LEC has never been formally evaluated. The studies reported here describe the performance of the LEC in two samples: college undergraduates and combat veterans. The LEC exhibited adequate temporal stability, good convergence with an established measure of trauma history—the Traumatic Life Events Questionnaire (TLEQ)— and was comparable to the TLEQ in associations with variables known to be correlated with traumatic exposure in a sample of undergraduates. In a clinical sample of combat veterans, the LEC was significantly correlated, in the predicted directions, with measures of psychological distress and was strongly associated with PTSD symptoms.",0,0 +5744,Gender differences in the correlates of hazardous drinking among Iraq and Afghanistan veterans,"Despite increasing numbers of women veterans from the Iraq and Afghanistan conflicts, few studies have examined hazardous drinking in this group. The present study examined the prevalence of and risk and protective factors for hazardous drinking in a community-based sample of men and women veterans of Operations Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND).Veterans completed a structured survey that assessed hazardous drinking using the Alcohol Use Disorders Identification Test (AUDIT), and a broad range of demographic, life history, and psychopathology variables. Correlations and multivariate logistic regression analyses were conducted to examine risk and protective factors associated with hazardous drinking.A total 30.2% of male veterans and 16.3% of female veterans screened positive for hazardous drinking. In a multivariate analysis in male veterans, younger age, lifetime exposure to assaultive trauma, and conflict in interpersonal relationships were independently associated with hazardous drinking (p<.05). Among women veterans, younger age and posttraumatic stress disorder (PTSD) symptoms were independently associated with hazardous drinking in a multivariate analysis (p<.05). Secondary analyses of PTSD symptom clusters revealed that emotional numbing symptoms were independently related to hazardous drinking in women veterans (p<.05).Results of this study suggest that hazardous drinking is prevalent in both men and women OEF/OIF/OND veterans and is more likely to occur at younger ages. In addition, results indicate gender differences in the association between hazardous drinking and lifetime trauma history, PTSD symptoms, and interpersonal conflict, which may have important implications for the treatment of alcohol problems in men and women veterans.",0,0 +5745,Pre-traumatic personality as a predictor of post-traumatic stress disorder among undergraduate students exposed to a terrorist attack: A prospective study in Israel,"The present study addresses the issue of the role played by the pre-traumatic personality, as evaluated by Cloninger’s Tridimensional Personality Theory (1987), in predicting post-traumatic stress disorder (PTSD) following traumatic exposure. The initial sample consisted of 185 undergraduate students evaluated for a different aim two weeks prior to a terrorist explosion on a bus heading to their university. One week after the explosion, the sample was assessed to determine actual exposure: 81 reported being exposed and thus constituted the final cohort, re-evaluated at six months after the exposure both in terms of personality profile and to determine formal diagnosis of PTSD. A logistic regression analysis showed that age and the harm-avoidance personality dimension (i.e., avoiding novel stimuli) were positively associated with the risk for developing PTSD, and that the novelty-seeking dimension (i.e., seeking novel stimuli of excitement) was negatively associated with this risk.",0,0 +5746,Caught in a Web of Multiple Jeopardy: Post-Traumatic Stress Disorder and HIV-Positive Asylum Seekers in Scotland,"Many HIV-positive asylum seekers have experienced multiple traumas and human rights violations—circumstances that engender posttraumatic stress disorder (PTSD). This qualitative study examines the impact of PTSD symptoms among HIV-positive asylum seekers in Scotland. Data were collected from 19 participants, using open-ended interviews, and narrative analysis was used to develop significant themes. All respondents had significant traumatic experiences, such as physical and sexual assault, witnessing the beating and death of a loved one, and being forced to participate in the sex trade. Many experienced multiple symptoms of PTSD, including re-experiencing of intrusive thoughts, flashbacks, avoidance, and arousal. These symptoms met the duration and impairment requirements for DSM-5 diagnosis of PTSD. Their symptoms impacted their ability to tell their stories convincingly when interviewed by immigration officials. Legal processes for asylum seeking require individuals to tell their stories but ignore the impact of trauma on their ability to do so, thus increasing the likelihood of their applications being rejected. The findings indicate the need for asylum seekers to have routine assessment and treatment for PTSD and the provision of appropriate therapeutic and advocacy services.",0,0 +5747,PTSD symptom clusters in relationship to alcohol misuse among Iraq and Afghanistan war veterans seeking post-deployment VA health care,"Demographic factors, characteristics of military service, PTSD, and depression were examined as predictors of alcohol misuse in Iraq and Afghanistan War Veterans (N=287) presenting for post-deployment Veteran Affairs (VA) health care. Results indicated that alcohol misuse was more common among younger male Veterans who served in the Army or Marine Corps. Accounting for demographic factors and characteristics of service, Veterans who screened positive for PTSD or depression were two times more likely to report alcohol misuse relative to Veterans who did not screen positive for these disorders. The examination of specific PTSD symptom clusters suggested that emotional numbing symptoms were most strongly associated with alcohol misuse. The implications for interventions for alcohol misuse in returning Veterans are discussed.",0,0 +5748,Comparison of immediate-onset and delayed-onset posttraumatic stress disorder in military veterans.,"Differences in symptoms, trauma exposure, dissociative and emotional reactions to trauma, and subsequent life stress in war veterans reporting immediate-onset or delayed-onset posttraumatic stress disorder (PTSD) or no PTSD were investigated. The role of life stress in delayed-onset PTSD was also studied. Retrospective interviews were conducted with 142 United Kingdom veterans receiving a war pension for PTSD or physical disability. Immediate-onset and delayed-onset PTSD were similar in the number and type of symptoms reported at onset, but the delayed-onset group differed in showing a gradual accumulation of symptoms that began earlier and continued throughout their military career. They were more likely to report major depressive disorder and alcohol abuse prior to PTSD onset. Both groups described similar amounts of trauma exposure, but those in the delayed-onset group reported significantly less peritraumatic dissociation, anger, and shame. Veterans with delayed onsets were more likely than veterans with no PTSD to report the presence of a severe life stressor in the year before onset. In conclusion, the results suggest that delayed onsets involve a more general stress sensitivity and a progressive failure to adapt to continued stress exposure.",0,0 +5749,"Risk pathways among traumatic stress, posttraumatic stress disorder symptoms, and alcohol and drug problems: A test of four hypotheses.","The present study utilized longitudinal data from a community sample (n = 377; 166 trauma-exposed; 54% males; 73% non-Hispanic Caucasian; 22% Hispanic; 5% other ethnicity) to test whether pretrauma substance use problems increase risk for trauma exposure (high-risk hypothesis) or posttraumatic stress disorder (PTSD) symptoms (susceptibility hypothesis), whether PTSD symptoms increase risk for later alcohol/drug problems (self-medication hypothesis), and whether the association between PTSD symptoms and alcohol/drug problems is attributable to shared risk factors (shared vulnerability hypothesis). Logistic and negative binomial regressions were performed in a path analysis framework. Results provided the strongest support for the self-medication hypothesis, such that PTSD symptoms predicted higher levels of later alcohol and drug problems, over and above the influences of pretrauma family risk factors, pretrauma substance use problems, trauma exposure, and demographic variables. Results partially supported the high-risk hypothesis, such that adolescent substance use problems increased risk for assaultive violence exposure but did not influence overall risk for trauma exposure. There was no support for the susceptibility hypothesis. Finally, there was little support for the shared vulnerability hypothesis. Neither trauma exposure nor preexisting family adversity accounted for the link between PTSD symptoms and later substance use problems. Rather, PTSD symptoms mediated the effect of pretrauma family adversity on later alcohol and drug problems, thereby supporting the self-medication hypothesis. These findings make important contributions to better understanding the directions of influence among traumatic stress, PTSD symptoms, and substance use problems.",0,0 +5750,Post-traumatic stress disorder: diagnostic issues and epidemiology in adult survivors of traumatic events,This paper presents a review of the issues surrounding the diagnosis and epidemiology of post-traumatic stress disorder in adult survivors of traumatic events. The paper is presented in two section...,0,0 +5751,Reliability and validity of a brief instrument for assessing post-traumatic stress disorder,"This study examines the psychometric properties of two versions of the PTSD Sympton Scale (PSS). The scale contains 17 items that diagnose PTSD according to DSM-III-R criteria and assess the severity of PTSD symptoms. An interview and self-report version of the PSS were administered to a sample of 118 recent rape and non-sexual assault victims. The results indicate that both versions of the PSS have satisfactory internal consistency, high test-retest reliability, and good concurrent validity. The interview version yielded high interrater agreement when administred separately by two interviewers and excellent convergent validity with the SCID. When used to diagnose PTSD, the self-report version of the PSS was somewhat more conservative than the interview version.",0,0 +5752,Do Peritraumatic Emotions Differentially Predict PTSD Symptom Clusters? Initial Evidence for Emotion Specificity,"This study investigated whether specific peritraumatic emotions differentially predict PTSD symptom clusters in individuals who have experienced stressful life events. Hypotheses were developed based on the SPAARS model of PTSD. It was predicted that the peritraumatic emotions of anger, disgust, guilt, and fear would significantly predict re-experiencing and avoidance symptoms, while only fear would predict hyperarousal. Undergraduate students ( N = 144) participated in this study by completing a packet of self-report questionnaires. Multiple regression analyses were conducted with PCL-S symptom cluster scores as dependent variables and peritraumatic fear, guilt, anger, shame, and disgust as predictor variables. As hypothesized, peritraumatic anger, guilt, and fear all significantly predicted re-experiencing. However, only fear predicted avoidance, and anger significantly predicted hyperarousal. Results are discussed in relation to the theoretical role of emotions in the etiology of PTSD following the experience of a stressful life event.",0,0 +5753,"Outcome from Injury: General Health, Work Status, and Satisfaction 12 Months after Trauma","We evaluated outcomes 12 months after trauma in terms of general health, satisfaction, and work status.Two hundred forty-seven patients without severe neurotrauma were evaluated by interview during admission and by mailed self-report 6 and 12 months after trauma. Data were obtained from the Trauma Registry, interviews, and survey instruments. Baseline assessment was obtained with the Short Form 36 (SF36) and the Sickness Impact Profile (SIP) work scale. Outcome measures were the SF36, SIP work scale, Brief Symptom Inventory (BSI) depression scale, the Civilian Mississippi Scale for Posttraumatic Stress Disorder (PTSD), and a satisfaction questionnaire. Three regressions were determined for outcome. The dependent variables were general health and work status (linear) and satisfaction (logistic). Each regression controlled for baseline status and mental health, Injury Severity Score (ISS), and 12-month SF36 physical function before evaluating the effect of outcome mental health.Follow-up data were available for 75% of the patients at 6 months and 51% at 12 months. The mean age of patients was 37.2 +/- 0.9 years (+/-SEM), and 73% were male. Their average ISS was 13.9 +/- 0.6. Seventy percent of injuries were blunt force, 13.5 % were penetrating, and 16.5 % were burn injuries (mean total body surface area, 13.3 +/- 1.5%). Sixty-four percent of the patients had returned to work at 12 months. Follow-up SF36 mental health was associated with the dependent outcome in each regression. After controlling for baseline status and mental health, ISS, and outcome SF36 physical function, outcome mental health was associated with outcome SF36 general health (p < 0.001), SIP work status (p = 0.017), and satisfaction with recovery (p = 0.005). Outcome SF36 mental health was related to baseline mental health, 12-month PTSD and BSI depression scores, and increased drug and alcohol use.Twelve months after trauma, patients' work status, general health, and overall satisfaction with recovery are dependent on outcome mental health. This dependency persists despite measured baseline status, ISS, or physical recovery. The mental disease after trauma is attributable to poor mental health, the development of symptoms of PTSD and depression, and increased substance abuse. Trauma centers that fail to recognize, assess, and treat these injury-related mental health outcomes are not fully assisting their patients to return to optimal function.",0,0 +5754,Loss as a determinant of PTSD in a cohort of adult survivors of the 1988 earthquake in Armenia: implications for policy,"To study the relationship of post-traumatic stress disorder (PTSD) to severity of the disaster experience.A sample of 1785 adult participants of an epidemiological study initiated in the immediate aftermath of the 1988 earthquake in Armenia were interviewed about 2 years following the disaster based on the NIMH DIS-Disaster Supplement. All 154 cases of pure PTSD were compared with 583 controls without symptoms satisfying psychiatric diagnoses of interest.PTSD cases included more persons from areas with the worst destruction. Having the highest level of education compared to lowest (OR 0.6 [95% CI 0.4-0.9]), being accompanied at the moment of the earthquake (OR 0.6 [95% CI 0.4-0.9]) and making new friends after the earthquake (OR 0.6 [95% CI 0.5-0.8]) were protective for PTSD. PTSD risk increased with the total amount of loss to the family (OR for highest level of loss 4.1 [95% CI 2.3-7.5]).Based on this large population sample, we believe that early support to survivors with high levels of loss may reduce PTSD following earthquakes.",0,0 +5755,Blood-based gene-expression biomarkers of post-traumatic stress disorder among deployed marines: A pilot study,"The etiology of post-traumatic stress disorder (PTSD) likely involves the interaction of numerous genes and environmental factors. Similarly, gene-expression levels in peripheral blood are influenced by both genes and environment, and expression levels of many genes show good correspondence between peripheral blood and brain tissues. In that context, this pilot study sought to test the following hypotheses: (1) post-trauma expression levels of a gene subset in peripheral blood would differ between Marines with and without PTSD; (2) a diagnostic biomarker panel of PTSD among high-risk individuals could be developed based on gene-expression in readily assessable peripheral blood cells; and (3) a diagnostic panel based on expression of individual exons would surpass the accuracy of a model based on expression of full-length gene transcripts. Gene-expression levels in peripheral blood samples from 50 U.S. Marines (25 PTSD cases and 25 non-PTSD comparison subjects) were determined by microarray following their return from deployment to war-zones in Iraq or Afghanistan. The original sample was carved into training and test subsets for construction of support vector machine classifiers. The panel of peripheral blood biomarkers achieved 80% prediction accuracy in the test subset based on the expression of just two full-length transcripts (GSTM1 and GSTM2). A biomarker panel based on 20 exons attained an improved 90% accuracy in the test subset. Though further refinement and replication of these biomarker profiles are required, these preliminary results provide proof-of-principle for the diagnostic utility of blood-based mRNA-expression in PTSD among trauma-exposed individuals.",0,0 +5756,CINP 2000 - Collegium Internationale Neuro-Psychopharmacologicum 22nd Congress.,"At this large and varied meeting on neuropharmacotherapy, progress was reported on the newer more selective antipsychotics. The selective D(2) dopamine receptor partial agonist, aripiprazole (Otsuka Pharmaceutical Co Ltd) was recently proved effective over the medium term. The atypical antipsychotics generally, such as clozapine, have a good side effect profile and better patient compliance, even in Parkinson's disease (PD). Reboxetine (Pharmacia & Upjohn AB), having a far greater selectivity for norepinephrine reuptake inhibition than for serotonin or dopamine reuptake, is of particular value in treating depression. Paroxetine (Novo Nordisk A/S), a selective serotonin reuptake inhibitor (SSRI), has just completed a multicenter clinical trial, being effective in about 50% of cases of post-traumatic stress disorder. A meta-analysis of trials of other uptake inhibitors showed that ability to block serotonin (rather than norepinephrine) uptake correlated well with efficacy. Bipolar and other disorders were hoped to benefit from more selective agents in the future, the potential for which has been revealed through basic neurobiology, with, for example, only non-alpha7 nicotinic receptor subunits being expressed by those interneurons mediating nicotinic responses. An open label, 30-day study of a pyrrolopyrimidine, the corticotrophin releasing factor (CRF) type 1 receptor inhibitor, NBI-30775 (Neurocrine Biosciences Inc/Janssen Pharmaceutica NV) produced good antidepressant effects, but has had to be abandoned as a product due to indications of potential liver damage. Similarly, although glial-derived neurotrophic factor (GDNF) had proved ineffective in a 1999 trial for PD, due to failure to access the striatum, there was however much evidence to suggest that small molecule agonists of the TRK-B receptor should be effective. Of these, quinones such as L-783281 (Merck Research Laboratories) appear to activate all TRK subtypes by a common intracellular, rather than receptormediated action, which may limit their usefulness. Although such agents would have many potential applications, it is likely that highly selective receptor activation will be needed.",0,0 +5757,Post-traumatic growth in parents after a child’s admission to intensive care: maybe Nietzsche was right?,"OBJECTIVE: The aim of this prospective study was to establish the degree to which parents report post-traumatic growth after the intensive care treatment of their child. DESIGN: Prospective cross-sectional cohort study. SETTING: Paediatric Intensive Care Unit (PICU). SUBJECTS: A total of 50 parents of children, admitted to PICU for >12 h. MEASUREMENTS AND RESULTS: Parents provided stress ratings as their child was discharged from PICU and, 4 months later, completed postal questionnaires rating their anxiety, depression, post-traumatic stress and post-traumatic growth. As much as 44 parents (88%) indicated on the Posttraumatic Growth Inventory (PTGI) [1] that they had experienced a positive change to a great degree as a result of their experiences in PICU. Parents of children who were ventilated (P = 0.024) reported statistically higher post-traumatic growth as did parents of older children (P = 0.032). PTGI scores were positively correlated with post-traumatic stress scores at 4 months (P = 0.021), but on closer inspection this relationship was found to be curvilinear. CONCLUSIONS: Post-traumatic growth emerged as a salient concept for this population. It was more strongly associated with moderate levels of post-traumatic stress, than high or low levels.",0,0 +5758,Survey of domestic violence among young adolescents in Slovenia,"OBJECTIVE: It has been estimated that domestic violence is wide spread in Slovenia, but the lack of empirical data of domestic violence prevalence and its consequences, aggravate the precise knowledge on the extension of the phenomenon. The aim of the study was to assess the extensiveness and characteristics of domestic violence in the group of Slovenian adolescents. SUBJECTS: 1297 young adolescents (age 13-15 years) from 65 Slovenian primary schools participated in the study. METHODS: A questionnaire for domestic violence experience and help seeking screening, McMaster Family Functioning Scale, Buss/Perry Aggression Questionnaire and Trauma Symptom Checklist for Childrentrade mark (TSCCtrade mark) have been applied. RESULTS: 18.7% of participants experienced violence in their own family (38.3% males and 61.7% females). Different patterns of verbal violence, irritability and indirect violence predominated. In the most cases of domestic violence the adolescent's parents were involved as perpetrators and their close relatives (brothers, sisters). Victims displayed a significant profile that could be linked with their violence experience: dysfunctional family environmental, aggressiveness, anxiety, depression, anger and posttraumatic stress symptoms. CONCLUSIONS: Presented study confirmed that the phenomenon of domestic violence and abused adolescents is quite widespread in Slovenia and that in the future more attention on research and policy making level should be given to this phenomenon. Particularly the perceived gap between attitudes towards support and the actually given help could be the orientation for developing a better prevention strategies and screening procedures for domestic violence. A proper intervention and protection of the adolescent victims could effectively prevent the outburst of depression, suicide, behavioural problems and, spreading the aggressive behaviour patterns to the future generations. Language: en",0,0 +5759,Tailoring therapeutic strategies for treating posttraumatic stress disorder symptom clusters,"According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, posttraumatic stress disorder (PTSD) is characterized by three major symptom clusters following an event that elicited fear, helplessness, or horror. This review will examine each symptom cluster of PTSD separately, giving case study examples of patients who exhibit a preponderance of a given symptom domain. We use a translational approach in describing the underlying neurobiology that is relevant to particular symptoms and treatment options, thus showing how clinical practice can benefit from current research. By focusing on symptom clusters, we provide a more specific view of individual patient's clinical presentations, in order to better address treatment needs. Finally, the review will also address potential genetic approaches to treatment as another form of individualized treatment.",0,0 +5760,Unique patterns of comorbidity in posttraumatic stress disorder from different sources of trauma,"While there are many studies of comorbidity in combat veterans with posttraumatic stress disorder (PTSD), studies of PTSD from other sources of trauma (e.g., disasters, crimes, and civil violence) are just beginning to emerge. This is the first formal review comparing patterns of comorbidity in PTSD from different sources of trauma. Specific attention is given to the relative frequencies of substance abuse, depression, generalized anxiety, phobic, panic, somatization, psychotic, and personality disorders. The findings reveal that although similarities exist, the comorbidity profiles differ according to the type of trauma experienced and the population studied. Additionally, the evidence suggests that the associated psychiatric disorders are not truly comorbid, but are interwoven with the PTSD.",0,0 +5761,Assessing post-traumatic stress symptoms in a Latino prison population,"Purpose – The purpose of this paper is to assess the reliability and validity of the Spanish version of the Davidson trauma scale (DTS-S) and to determine the prevalence and correlates of post-traumatic stress disorder (PTSD) symptoms in a non-clinical random sample of prison inmates. Design/methodology/approach – Probabilistic samples of 1,179 inmates from 26 penal institutions in Puerto Rico were selected using a multistage sampling design. Population estimates and correlations were obtained for PTSD, generalized anxiety and depression. The reliability, factor structure, and convergent validity of the DTS-S were assessed. Cross-validation was employed to confirm the results of the factor analyses. Findings – Using the cut-offs adopted by the scale's author, 136 (13.4 percent) of the inmates are likely to have current PTSD and 117 (11.6 percent) reach the cut-off for sub-threshold PTSD. Confirmatory factor analysis generated two factors explaining 53 percent of the variance. High reliabilities were obtained for the total scale (α=0.95) and for the frequency and severity scales (α=0.90 and 0.91). Significantly higher DTS-S scores were found for females ( t =2.26, p <0.025), for inmates diagnosed with depression or anxiety ( t =2.02, p <0.05), and those reporting suicide attempts ( t =4.47, p <0.0001). Originality/value – Findings support that the DTS-S is a reliable and valid measure to assess PTSD symptoms in Latino inmate populations and to identify individuals at risk for the disorder that require confirmatory diagnosis and clinical interventions.",0,0 +5762,Reduced autobiographical memory specificity predicts depression and posttraumatic stress disorder after recent trauma.,"In this prospective longitudinal study, the authors examined the relationship between reduced specificity in autobiographical memory retrieval and the development of depression, posttraumatic stress disorder (PTSD), and specific phobia after injury in an assault. Assault survivors (N = 203) completed the Autobiographical Memory Test (J. M. G. Williams & K. Broadbent, 1986) at 2 weeks after the trauma as well as structured clinical interviews at 2 weeks and 6 months. Participants with acute stress disorder or major depression at 2 weeks, but not those with phobia, retrieved fewer specific autobiographical memories than those without the respective disorder. Reduced memory specificity at 2 weeks also predicted subsequent PTSD and major depression at 6 months over and above what could be predicted from initial diagnoses and symptom severity. Moderator analyses showed that low memory specificity predicted later depression in participants with prior episodes of major depression but not in those without prior depression. Mediation analyses suggested that rumination partly mediated and perceived permanent change fully mediated the effects of low memory specificity on posttrauma psychopathology at follow-up.",0,0 +5763,An examination of the structural link between post-traumatic stress symptoms and chronic pain in the framework of fear-avoidance models,"The tendency to respond with fear and avoidance can be seen as a shared vulnerability contributing to the development of post-traumatic stress disorder (PTSD) and chronic pain. Although several studies have examined which specific symptoms of PTSD (re-experiencing, avoidance, emotional numbing and hyperarousal) are associated with chronic pain, none has considered this association within the framework of fear-avoidance models.Seven hundred fourteen patients with chronic musculoskeletal pain were assessed. Of these, 149 patients were selected for the study based upon the following inclusion criteria: exposure to a traumatic event before the onset of pain (with scores equal to or higher than 8 points on the fear and hopelessness scales of the Stressful Life Event Screening Questionnaire Revised) and scores equal to or higher than 30 on the Davidson Trauma Scale.Structural equation modelling was used to test the association between PTSD symptoms and pain outcomes (pain intensity and disability) using the mediating variables considered in the fear-avoidance models. The results show that emotional numbing and hyperarousal symptoms, but neither re-experiencing nor avoidance, affected pain outcome via anxiety sensitivity (AS), catastrophizing and fear of pain. PTSD symptoms increased the levels of AS, which predisposes to catastrophizing and, in turn, had an effect on the tendency of pain patients to respond with more fear and avoidance.This study provides empirical support for the potential role of PTSD symptoms in fear-avoidance models of chronic pain and suggests that AS is a relevant variable in the relationship between both disorders.",0,0 +5764,Mental and physical disability after sepsis.,"Sepsis remains a major cause of admissions to Intensive Care Units (ICU) and has a high mortality rates and significant morbidity in survivors. There are physical, cognitive and psychological sequelae from severe sepsis that have a negative effect on the patients' health related quality of life in the longer term and a social care and humanitarian impact. Although muscle mass loss during the septic period happens very quickly, recovery takes a considerable time and requires the patient to commit to exercising and eating well to rebuild. Where cognitive impairment has resulted from the septic illness the patients' ability to look after themselves may be affected and this has financial and family implications for future care. Patients may also develop psychological problems such as anxiety, depression or post traumatic stress disorder (PTSD), which can have a profound effect on their everyday functioning and the possibility of returning to work. As yet there are no published studies of rehabilitation with patients surviving severe sepsis, although there is one in progress at the moment. The use of techniques such as ICU diaries to help patients to understand their illness and deal with delusional memories they may have from their ICU stay has been shown to aid psychological recovery in general ICU patients, a percentage of whom will have suffered from sepsis. The use of a self-guided manualised 6 week rehabilitation program, the ICU Recovery Manual, has been shown to accelerate physical recovery in general ICU patients. Considerable amounts of money are spent treating patients with severe sepsis in ICU and not completing the job of returning them to as close as possible to their normal functioning does not make financial sense.",0,0 +5765,"Stress doses of hydrocortisone, traumatic memories, and symptoms of posttraumatic stress disorder in patients after cardiac surgery: a randomized study","Traumatic experiences associated with cardiac surgery (CS) can result in traumatic memories and posttraumatic stress disorder (PTSD). Because it is known that subjects who develop PTSD often show sustained reductions in circulating cortisol concentrations, we performed a prospective, randomized study to examine whether exogenously administered stress doses of hydrocortisone during the perioperative period of CS reduces the long-term incidence of chronic stress and PTSD symptoms.Patients (n = 91) were prospectively randomized to receive either stress doses of hydrocortisone or standard treatment during the perioperative period of CS. Of 48 available patients at 6 months after CS, 26 had received stress doses of hydrocortisone and 22 standard treatment. Traumatic memories and PTSD symptoms were diagnosed with previously validated questionnaires.As compared with patients after standard therapy, patients from the hydrocortisone group had significantly lower chronic stress symptom scores (p <.05). There was no significant difference regarding the number or type of traumatic memories between the hydrocortisone and the standard treatment groups.Stress doses of hydrocortisone in patients undergoing CS are associated with a lower intensity of chronic stress and PTSD symptoms at 6 months after CS.",0,0 +5766,Traumatic experiences and post-traumatic stress disorder in Kurdistanian children and their parents in homeland and exile: An epidemiological approach,"The prevalence and correlates of post-traumatic stress disorder (PTSD) were assessed in random samples of school-aged Kurdistanian children and their parents in homeland and exile. Of the 376 eligible children at the two sites, 312 children and their parents (293 mothers and 248 fathers) completed the Harvard-Uppsala Trauma Questionnaire and Posttraumatic Stress Symptom interviews for children, and Harvard Trauma Questionnaire for parents. Unlike their children, fathers showed significantly higher PTSD frequencies in exile than in the homeland. The fathers' PTSD negatively correlated with the living standard and fathers' education, while child PTSD mostly correlated with maternal education and living in exile. Living in exile seems to have a negative impact on fathers' post-traumatic reactions, despite its positive influence on children. High drop-outs in exile limit the conclusions.",0,0 +5767,Complexities in Understanding the Role of Compensation-Related Factors on Recovery From Whiplash-Associated Disorders,"Focused discussion.To present some of the complexities in conducting research on the role of compensation and compensation-related factors in recovery from whiplash-associated disorders (WAD) and to suggest directions for future research.There is divergence of opinion, primary research findings, and systematic reviews on the role of compensation and/or compensation-related factors in WAD recovery.The topic of research of compensation/compensation-related factors was discussed at an international summit meeting of 21 researchers from diverse fields of scientific enquiry. This article summarizes the main points raised in that discussion.Traffic injury compensation is a complex sociopolitical construct, which varies widely across jurisdictions. This leads to conceptual and methodological challenges in conducting and interpreting research in this area. It is important that researchers and their audiences be clear about what aspect of the compensation system is being addressed, what compensation-related variables are being studied, and what social/economic environment the compensation system exists in. In addition, summit participants also recommended that nontraditional, sophisticated study designs and analysis strategies be employed to clarify the complex causal pathways and mechanisms of effects.Care must be taken by both researchers and their audiences not to overgeneralize or confuse different aspects of WAD compensation. In considering the role of compensation/compensation-related factors on WAD and WAD recovery, it is important to retain a broad-based conceptualization of the range of biological, psychological, social, and economic factors that combine and interact to define and determine how people recover from WAD.",0,0 +5768,"Longitudinal Relationships Between Neuroticism, Avoidant Coping, and Posttraumatic Stress Disorder Symptoms in Adolescents Following the 2008 Wenchuan Earthquake in China","The Wenchuan earthquake, which occurred in southwestern China in May 2008, was a source of severe psychological distress to adolescents. This study explored the developmental trajectory of posttraumatic stress disorder (PTSD) symptoms and the longitudinal relationships between neuroticism, avoidant coping, and PTSD symptoms measured at three time points: 1 year (T1), 1.5 years (T2), and 2 years (T3) after the earthquake. The participants included 636 adolescents from several high schools located in the areas that were most severely affected by the earthquake. Structural equation modeling results revealed bidirectional effects between neuroticism, avoidant coping, and PTSD symptoms. More severe PTSD symptoms predicted higher levels of avoidant coping at T1–T2 and T2–T3 but only predicted higher levels of neuroticism at T1–T2. Higher levels of neuroticism at T1 predicted more severe PTSD symptoms at T1–T2, while higher levels of avoidant coping at T1 predicted more severe PTSD symptoms at T2–T3.",0,0 +5769,Neurobehavioral Outcome of Children's Mild Traumatic Brain Injury,"Brain damage is underestimated as a public health and personal problem. The common belief in a good prognosis for childhood brain damage is unsubstantiated. It is based on lack of rigorous study and examiner satisfaction with a low response level. Occult brain trauma plagues victims into maturity. Above a rather low threshold of injury (even without focal neurologic findings), cognitive, personality, and adaptive dysfunctions are common and impairing. Child abuse signals were described. Brain lesions impair both matured functions and those expressed later. Dysfunctions were discussed for these neurobehavioral systems: consciousness, attention and tonic motor level; sensorimotor and body schema; neurophysiologic; cerebral personality; intelligence; memory; language; information processing; posttraumatic stress and mood; identity and insight; adaptivity in the community. Outcome evolves from complex pathologic, neurologic, anatomic, and personality parameters, the postinjury interval and child's age, the maturity and developmental trajectory of the function, social support, and emotional reaction to impairment. Assessment should study the entire range of functions, utilizing records, collaterals, observation, and qualitative and psychometric measurement. Complex, challenging, and ecologically relevant tasks are appropriate. There are several patterns of outcome: immediate permanent deficits; improvement through compensatory mechanisms, but with subclinical deficits; and initial progress with delayed expression (premature plateau of cognitive and personality maturity; physiologic developmental deficits). Confirmation of mild TBI may require several years of observation to determine late dysfunctions and deviation from preinjury or postinjury performance or expected level of development.",0,0 +5770,Post-traumatic stress disorder caused in mentally disordered offenders by the committing of a serious violent or sexual offence,"The aim of the study was to measure in a sample of mentally disordered offenders the frequency of post-traumatic stress disorder (PTSD) symptoms related to the committing of an offence and to consider what factors might be contributory to the onset and maintenance of these symptoms. The study was the first to investigate the incidence of PTSD in a primarily mentally ill population. A sample of 37 mentally disordered offenders was assessed for PTSD according to the Diagnostic and Statistical Manual of Mental Disorders (DSM III-R; American Psychiatric Association, 1987) and the Impact of Events Scale (IES; Horowitz, Wilner and Alvarez, 1979). Of this sample, 33% met diagnostic criteria for PTSD and 54% had significant PTSD symptomatology as indexed by the IES. The IES scores were greater in those who had committed violent offences than in those who had committed sexual offences, and in those who had an affective diagnosis. Frequency of PTSD symptoms was greater in those offenders who now felt regret for their actions. The high frequency of PTSD symptoms in this population may serve as a significant stressor and may exacerbate co-morbid psychiatric illness and contribute to poor treatment response and relapse. Many mental illnesses are exacerbated by stress and the presence of untreated PTSD symptoms may serve to prevent treatment gains for the primary mental disorder. If risk of future dangerous-ness is associated with unstable mental state, as is often the case in a mentally disordered population, then the development of PTSD post-offence may serve to prolong or increase risk of harm to both self and others.",0,0 +5771,Lifetime trauma and associated mental health symptoms in homeless women: Impulsivity as a feature of posttraumatic stress disorder and addiction,"This study aimed to provide a comprehensive assessment of the lifetime traumatic experiences of homeless women, and to explore the linkage between trauma, posttraumatic stress disorder (PTSD), and substance use problems. One hundred adult homeless women were assessed. Descriptive data on trauma histories show that three-quarters of the sample experienced some form of childhood trauma, and 58% experienced childhood sexual trauma. Trauma in childhood was predictive of trauma in adulthood. As hypothesized, indirect evidence of the self-medication hypothesis was provided by a path analysis showing a linear relationship between trauma and substance use consequences that was mediated by PTSD symptoms. Measures of future time perspective, and self-report and behavioral measures of impulsivity did not converge to indicate a single shared common factor, though the self-report measure of trait impulsivity was predictive of both PTSD and substance use consequences. This study suggests that homeless women have extensive trauma histories that often begin in childhood, they likely use substances to cope, and that trait impulsivity may itself represent a common factor of both PTSD and SUD. Clinical implications are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5772,"Trauma, attempted suicide, and morning cortisol in a community sample of adolescents","Individuals exposed to trauma or who have attempted suicide may show abnormal cortisol profiles; those exposed to significant trauma show reduced, while those who attempt suicide show increased cortisol output, although the evidence is inconsistent. This study explores the associations between morning cortisol, trauma, and suicide attempts or ideation among young people. In a community-based sample of 501 15-year-olds, using data from a DSM-IV-compatible interview on suicidal-behavior/ideation, trauma, and morning cortisol, we found no association between these factors and morning cortisol. A significant gender interaction was found for those threatened with a weapon-men showing a negative and women a positive association, suggesting that any cortisol/trauma association may be partially explained by coexisting behavioral problems and gender.",0,0 +5773,Developing and Implementing Randomized Effectiveness Trials in General Medical Settings.,"This article discusses the development of two mental health services research programs: one targeting depression treatment in primary care and the other early intervention for posttraumatic stress disorders in acute care. Both programs have used the randomized effectiveness trial to assess the delivery of empirically supported psychotherapeutic and psychopharmacologic interventions in these general medical settings. This article explores the fellowship training, clinical experiences, and conceptual frameworks that have informed the progression of the two research programs. Specific modifications to the traditional randomized clinical trial design employed in the effectiveness trials are discussed. This article concludes with reflection on intervention development trajectories and interdisciplinary team compositions that may facilitate the development of mental health interventions that both derive from the best scientific evidence and can be feasibly delivered in real-world treatment settings.",0,0 +5774,Effects of exogenous glucocorticoid on combat-related PTSD symptoms.,"Very few systematic human studies focus on changing the underlying traumatic memory after posttraumatic stress disorder (PTSD) has been established. Evidence from animal and human studies indicates that cortisol can be used to address traumatic memories. This translational pilot study is based on our previous rodent research in which extinction of fear memories was enhanced by glucocorticoids. The current study aims to assess the effectiveness of glucocorticoids in augmenting memory extinction and reducing clinical symptoms in veterans with combat-related PTSD.In a double-blind, placebo-controlled study, veterans with combat-related PTSD were exposed to a memory reactivation task using well established imagery and psychophysiology assessment technique followed by administration of either glucocorticoid or placebo.One week after glucocorticoid or placebo administration, participants who received the study medication showed significant PTSD-related symptom (cluster C) improvement compared with control participants who received placebo only. However, reduction of symptoms degraded at a 1-month postadministration assessment.These findings are consistent with a glucocorticoid-mediated enhancement of extinction to ameliorate PTSD symptoms. The use of traumatic memory reactivation temporally paired with glucocorticoid administration holds potential for developing a viable therapeutic option.",0,0 +5775,The unfairness of it all: Exploring the role of injustice appraisals in rehabilitation outcomes.,"A fundamental principle of rehabilitation psychology is that individual appraisals of the social and physical environment-including injury itself-have profound consequences for coping and adjustment. When core assumptions of a just and predictable world are violated and accompanied by ostensibly undeserved suffering and loss, perceptions of injustice can arise. Given the role of appraisal processes in adjustment to disability, mounting empirical support, and absence of targeted interventions, the current article considers perceptions of injustice regarding personal injury/disability as a fundamental appraisal affecting rehabilitation outcomes.The authors review theory underpinning the relevance of injustice appraisals and critically examine existing literature regarding the impact of perceived injustice and related constructs (i.e., attribution of blame, anger, and belief in a just world) on adjustment following injury.The authors bring attention to perceptions of injustice regarding personal injury/disability as a fundamental appraisal affecting rehabilitation outcomes. Dimensions of the social environment that have not received substantial attention in current research on condition-related injustice appraisals are highlighted.Perceived injustice is a potentially central appraisal process to physical and psychological outcomes in the context of rehabilitation. Research regarding the role of perceived injustice, related constructs, and potential social/environmental modulators of injustice perception is still in its infancy. Guided buy its foundational principles, the field of rehabilitation psychology can broaden and shape inquiry regarding perceived injustice. This article aims to guide future research, offer concepts for key areas of discourse, and consider potential interventions in the rehabilitation psychology domain.",0,0 +5776,Changes in Social Adjustment With Cognitive Processing Therapy: Effects of Treatment and Association With PTSD Symptom Change,"The current study sought to determine if different spheres of social adjustment, social and leisure, family, and work and income improved immediately following a course of cognitive processing therapy (CPT) when compared with those on a waiting list in a sample of 46 U.S. veterans diagnosed with posttraumatic stress disorder (PTSD). We also sought to determine whether changes in different PTSD symptom clusters were associated with changes in these spheres of social adjustment. Overall social adjustment, extended family relationships, and housework completion significantly improved in the CPT versus waiting-list condition, η(2) = .08 to .11. Hierarchical multiple regression analyses revealed that improvements in total clinician-rated PTSD symptoms were associated with improvements in overall social and housework adjustment. When changes in reexperiencing, avoidance, emotional numbing, and hyperarousal were all in the model accounting for changes in total social adjustment, improvements in emotional numbing symptoms were associated with improvements in overall social, extended family, and housework adjustment (β = .38 to .55). In addition, improvements in avoidance symptoms were associated with improvements in housework adjustment (β = .30), but associated with declines in extended family adjustment (β = -.34). Results suggest that it is important to consider the extent to which PTSD treatments effectively reduce specific types of symptoms, particularly emotional numbing and avoidance, to generally improve social adjustment.",0,0 +5777,Female Students and Cultures of Violence in Cities,,0,0 +5778,Epigenetics of Stress-Related Psychiatric Disorders and Gene × Environment Interactions,"A deeper understanding of the pathomechanisms leading to stress-related psychiatric disorders is important for the development of more efficient preventive and therapeutic strategies. Epidemiological studies indicate a combined contribution of genetic and environmental factors in the risk for disease. The environment, particularly early life severe stress or trauma, can lead to lifelong molecular changes in the form of epigenetic modifications that can set the organism off on trajectories to health or disease. Epigenetic modifications are capable of shaping and storing the molecular response of a cell to its environment as a function of genetic predisposition. This provides a potential mechanism for gene-environment interactions. Here, we review epigenetic mechanisms associated with the response to stress and trauma exposure and the development of stress-related psychiatric disorders. We also look at how they may contribute to our understanding of the combined effects of genetic and environmental factors in shaping disease risk.",0,0 +5779,"Compensation and Pension Evaluations: Psychotic, Neurotic, and Post-Traumatic Stress Disorder Millon Clinical Multiaxial Inventory II Profiles","The purpose of the present work was to provide an examination of the three major VA adjudication classifications (post-traumatic stress disorder [PTSD], psychotic, and neurotic) through objective psychological testing. During routine follow-up compensation and pension evaluations, 143 patients were given the Millon Clinical Multiaxial Inventory II (MCMI-II). Additionally, their current disability diagnoses as well as their current percentage of disability were coded. Discriminant function analysis revealed that the pivotal discriminatory variables were alcohol abuse for the PTSD patients, thought disorder for the psychotics, and anxiety for the neurotics. This is remarkably consistent with general clinical expectations. This should allow for more specific use of the MCMI-II in compensation and pension examinations by Department of Veterans' Affairs psychologists.",0,0 +5780,Childhood and Current Determinants of Heavy Drinking in Early Adulthood,"To explore the association of parental education, childhood living conditions and several adversities with heavy drinking in early adulthood, and to analyze the effect of the respondent's current circumstances on these associations.The analyses were conducted in a sample of 1234 adults aged 18-29 years participating in the Finnish Health 2000 Survey (65% of the original representative two-stage cluster sample, N = 1894). The outcome measure was heavy drinking measured by g/week for pure alcohol (for men >or=280 g/week and for women >or=140 g/week).8% of young adult men and 5% of women were heavy drinkers. In both genders, parental alcohol problems and other childhood adversities, poor own education, and unemployment status increased the risk of heavy drinking. The impact of childhood on heavy drinking was partly independent and partly mediated by adult characteristics, in particular, for both genders, low level of education.Childhood adversities are associated with heavy drinking in early adulthood among both genders. Childhood social circumstances as well as low educational level and unemployment should be taken into account in planning preventive policies to tackle the harms caused by excessive alcohol use at the individual and population level.",0,0 +5781,Cytokine production as a putative biological mechanism underlying stress sensitization in high combat exposed soldiers,"Combat stress exposed soldiers may respond to post-deployment stressful life events (SLE) with increases in symptoms of posttraumatic stress disorder (PTSD), consistent with a model of stress sensitization. Several lines of research point to sensitization as a model to describe the relations between exposure to traumatic events, subsequent SLE, and symptoms of PTSD. Based on previous findings we hypothesized that immune activation, measured as a high in vitro capacity of leukocytes to produce cytokines upon stimulation, underlies stress sensitization.We assessed mitogen-induced cytokine production at 1 month, SLE at 1 year, and PTSD symptoms from 1 month up to 2 years post-deployment in soldiers returned from deployment to Afghanistan (N=693). Exploratory structural equation modeling as well as latent growth models were applied.The data demonstrated significant three-way interaction effects of combat stress exposure, cytokine production, and post-deployment SLE on linear change in PTSD symptoms over the first 2 years following return from deployment. In soldiers reporting high combat stress exposure, both high mitogen-stimulated T-cell cytokine production and high innate cytokine production were associated with increases in PTSD symptoms in response to post-deployment SLE. In low combat stress exposed soldiers as well as those with low cytokine production, post-deployment SLE were not associated with increases in PTSD symptoms.High stimulated T-cell and innate cytokine production may contribute to stress sensitization in recently deployed, high combat stress exposed soldiers. These findings suggest that detecting and eventually normalizing immune activation may potentially complement future strategies to prevent progression of PTSD symptoms following return from deployment.",0,0 +5782,The Millennium Cohort Family Study: a prospective evaluation of the health and well-being of military service members and their families,"The need to understand the impact of war on military families has never been greater than during the past decade, with more than three million military spouses and children affected by deployments to Operations Iraqi Freedom and Enduring Freedom. Understanding the impact of the recent conflicts on families is a national priority, however, most studies have examined spouses and children individually, rather than concurrently as families. The Department of Defense (DoD) has recently initiated the largest study of military families in US military history (the Millennium Cohort Family Study), which includes dyads of military service members and their spouses (n > 10,000). This study includes US military families across the globe with planned follow-up for 21+ years to evaluate the impact of military experiences on families, including both during and after military service time. This review provides a comprehensive description of this landmark study including details on the research objectives, methodology, survey instrument, ancillary data sets, and analytic plans. The Millennium Cohort Family Study offers a unique opportunity to define the challenges that military families experience, and to advance the understanding of protective and vulnerability factors for designing training and treatment programs that will benefit military families today and into the future.",0,0 +5783,Assessing possible DSM-5 ASD subtypes in a sample of victims meeting caseness for DSM-5 ASD based on self-report following multiple forms of traumatic exposure,"Acute stress disorder (ASD) was introduced into the DSM-IV to recognize early traumatic responses and as a precursor of PTSD. Although the diagnostic criteria for ASD were altered and structured more similarly to the PTSD definition in DSM-5, only the PTSD diagnosis includes a dissociative subtype. Emerging research has indicated that there also appears to be a highly symptomatic subtype for ASD. However, the specific nature of the subtype is currently unclear. The present study investigates the possible presence of ASD subtypes in a mixed sample of victims meeting caseness for DSM-5 ASD based on self-report following four different types of traumatic exposure (N=472). The results of latent profile analysis revealed a 5-class solution. The highly symptomatic class was marked by high endorsement on avoidance and dissociation compared to the other classes. Findings are discussed in regard to its clinical implications including the implications for the pending the ICD-11 and the recently released DSM-5.",0,0 +5784,Post-Traumatic Stress Disorder in Turkish Child and Adolescent Survivors Three Years after the Marmara Earthquake,"The study investigated the emergence of post-traumatic stress disorder (PTSD) symptoms in child and adolescent survivors in Turkey three years after the 1999 Marmara Earthquake, with consideration of the severity of exposure and the survivors' gender and age. A representative sample of 293 young earthquake survivors (152 female and 141 male between the ages of 8 and 15) participated in the study. Participants' scores on the Post-Traumatic Stress Disorder Reaction Index for Children indicated that 31.4% reported moderate, 24.2% reported severe, and 3.8% reported very severe traumatic stress reactions. Analysis of the Revised Impact of Events Scale for Children scores revealed that 56% reported severe PTSD symptoms. While severity of exposure and gender were significantly associated with severity of PTSD symptoms, age was not related to PTSD symptoms. The results indicated a high need for addressing the mental health problems of the child and adolescent trauma survivors in Turkey.",0,0 +5785,"Five years after the accident, whiplash casualties still have poorer quality of life in the physical domain than other mildly injured casualties: analysis of the ESPARR cohort","This study aims to compare health status and quality of life five years after a road accident between casualties with whiplash versus other mild injuries, to compare evolution of quality of life at 1 and 5 years after the accident, and to explore the relation between initial injury (whiplash vs. other) and quality of life.The study used data from the ESPARR cohort (a representative cohort of road accident casualties) and included 167 casualties with ""pure"" whiplash and a population of 185 casualties with other mild injuries (MAIS-1). All subjects with lesions classified as cervical contusion (AIS code 310402) or neck sprain (AIS code 640278) were considered as whiplash casualties. Diagnosis was made by physicians, at the outset of hospital care, based on interview, clinical findings and X-ray. Whiplash injuries were then classified following the Quebec classification (grades 1 and 2). Quality of life was assessed on the WHOQoL-Bref questionnaire. Correlations between explanatory variables and quality of life were explored by Poisson regression and variance analysis.Between 1 and 5 years, global QoL improved for both whiplash and non-whiplash casualties; but, considering the two whiplash groups separately, improvement in grade 2 was much less than in grade 1. At 5 years, grade-2 whiplash casualties were more dissatisfied with their health (39.4%; p < 0.05) than non-whiplash (24.3%) or grade-1 whiplash casualties (27.0%). Deteriorated quality of life in the mental, social and environmental domains was mainly related to psychological and socioeconomic factors for both whiplash and other mildly injured road-accident casualties. While PTSD was a major factor for the physical domain, whiplash remained a predictive factor after adjustment on PTSD; unsatisfactory health at 5 years, with deteriorated quality of life in the physical domain, was observed specifically in the whiplash group, pain playing a predominant intermediate role.Deteriorated quality of life in the physical domain remained 5 years after the accident, specifically in the grade-2 whiplash group, pain playing a predominant intermediate role, which may be in line with the hypothesis of neuropathic pain.",0,0 +5786,Towards a multifaceted understanding of revenge and forgiveness,"Abstract We focus on two aspects: First, we argue that it is necessary to include implicit forgiveness as an additional adaptive behavioral option to the perception of interpersonal transgressions. Second, we present one possible way to investigate the cognitive-affective underpinnings of revenge and forgiveness: a functional MRI (fMRI) approach aiming at integrating forgiveness and revenge mechanisms into a single paradigm.",0,0 +5787,Assessing the co-occurrence of intimate partner violence domains across the life-course: relating typologies to mental health,"The inter-generational transmission of violence (ITV) hypothesis and polyvictimisation have been studied extensively. The extant evidence suggests that individuals from violent families are at increased risk of subsequent intimate partner violence (IPV) and that a proportion of individuals experience victimisation across multiple rather than single IPV domains. Both ITV and polyvictimisation are shown to increase the risk of psychiatric morbidity, alcohol use, and anger expression.The current study aimed to 1) ascertain if underlying typologies of victimisation across the life-course and over multiple victimisation domains were present and 2) ascertain if groupings differed on mean scores of posttraumatic stress disorder (PTSD), depression, alcohol use, and anger expression.University students (N=318) were queried in relation to victimisation experiences and psychological well-being. Responses across multiple domains of IPV spanning the life-course were used in a latent profile analysis. ANOVA was subsequently used to determine if profiles differed in their mean scores on PTSD, depression, alcohol use, and anger expression.Three distinct profiles were identified; one of which comprised individuals who experienced ""life-course polyvictimisation,"" another showing individuals who experienced ""witnessing parental victimisation,"" and one which experienced ""psychological victimisation only."" Life-course polyvictims scored the highest across most assessed measures.Witnessing severe physical aggression and injury in parental relationships as a child has an interesting impact on the ITV into adolescence and adulthood. Life-course polyvictims are shown to experience increased levels of psychiatric morbidity and issues with alcohol misuse and anger expression.",0,0 +5788,Traumatische Erfahrungen in der älteren deutschen Bevölkerung,"Background: World War II (WWII) is probably the most distressing and fatal historical event in Europe's recent past. Research on mental and physical health sequelae of these traumatic experiences from WWII has only started recently. Objectives: An overview on the findings from several population-based studies investigating the mental and physical health outcomes of traumatic experiences in the German elderly (born prior to 1946), especially from WWII, is given. Material and methods: The results presented here are based on several population-based representative studies regarding several aspects of mental and physical health in the elderly. Results: About 40-50 % of the elderly German population report at least one traumatic event, mostly from WWII. Traumatic experiences are related to higher rates of depressive and somatoform disorders, posttraumatic stress disorder, and physical morbidity, which are associated with increased health care utilization. Conclusion: The findings underline that the negative effects on health are long-term, manifold, and serious. Some of the elderly need psychotherapeutic interventions. Thus, a specific internet-based psychotherapeutic approach (ITT) is briefly presented. However, the majority of the elderly generally use other kinds of medical care, such as primary care, inpatient care, and geriatric care. It seems useful and necessary to pay more attention to the historical and biographical backgrounds of the patients to see and understand the current symptoms from this aspect. © 2014 Springer-Verlag Berlin Heidelberg.",0,0 +5789,Risperidone Treatment of Preschool Children with Thermal Burns and Acute Stress Disorder,"Pharmacologic treatment of acute stress disorder (ASD) is a novel area of investigation across all age groups. Very few clinical drug trials have been reported in children and adolescents diagnosed with ASD. Most of the available, potentially relevant, data are from studies of adults with posttraumatic stress disorder (PTSD). The atypical antipsychotic agents have been reported to be effective as an adjunctive treatment for adults with PTSD. There have been a limited number of studies published regarding atypical antipsychotic treatment of PTSD in children and adolescents, and there is no current literature available on the use of these agents for children with ASD. This report describes the successful treatment of three preschool-aged children with serious thermal burns as a result of physical abuse or neglect. Each of these children was hospitalized in a tertiary-care children's hospital and was diagnosed with ASD. In all cases, risperidone provided rapid and sustained improvement across all symptom clusters of ASD at moderate dosages. Minimal to no adverse effects were reported. These cases present preliminary evidence for the potential use of risperidone in the treatment of ASD in childhood.",0,0 +5790,Specificity of abnormal brain volume in major depressive disorder: A comparison with borderline personality disorder,"Abnormal brain volume has been frequently demonstrated in major depressive disorder (MDD). It is unclear if these findings are specific for MDD since aberrant brain structure is also present in disorders with depressive comorbidity and affective dysregulation, such as borderline personality disorder (BPD). In this transdiagnostic study, we aimed to investigate if regional brain volume loss differentiates between MDD and BPD. Further, we tested for associations between brain volume and clinical variables within and between diagnostic groups.22 Females with a DSM-IV diagnosis of MDD, 17 females with a DSM-IV diagnosis of BPD and without comorbid posttraumatic stress disorder, and 22 age-matched female healthy controls (HC) were investigated using magnetic resonance imaging. High-resolution structural data were analyzed using voxel-based morphometry.A significant (p<0.05, cluster-corrected) volume decrease of the anterior cingulate cortex (ACC) was found in MDD compared to HC, as opposed to volume decreases of the amygdala in BPD compared to both HC and MDD. Sensitivity and specificity of regional gray matter volume for a diagnosis of MDD were modest to fair. Amygdala volume was related to depressive symptoms across the entire patient sample.Potential limitations of this study include the modest sample size and the heterogeneous psychotropic drug treatment.ACC volume reduction is more pronounced in MDD with an intermediate degree of volume loss in BPD compared to HC. In contrast, amygdala volume loss is more pronounced in BPD compared to MDD, yet amygdala volume is associated with affective symptom expression in both disorders.",0,0 +5791,Modeling of Community Integration Trajectories in the First Five Years after Traumatic Brain Injury,"The aims of this study were to assess the trajectories of community integration in individuals with traumatic brain injury (TBI) through one, two, and five years post-injury and to examine whether those trajectories could be predicted by demographic and injury characteristics. A longitudinal cohort study was conducted with 105 individuals with moderate-to-severe TBI admitted to a trauma referral center in 2005-2007. Demographics and injury-related factors were extracted from medical records. At the one-, two- and five-year follow-ups, community integration was measured by the Community Integration Questionnaire (CIQ). A hierarchical linear model (HLM) examined whether longitudinal trajectories of community integration could be predicted by: time, sex, age, relationship status, education, employment status, occupation, acute Glasgow Coma Scale score, cause of injury, days in post-traumatic amnesia (PTA), computed tomography Marshall Score, and Injury Severity Score. CIQ scores improved across the three time-points (p<0.001). Additionally, higher trajectories of community integration were predicted by being single at the time of injury (p<.001), higher level of education (p=0.006), employment (p<0.001), and a shorter length of PTA (p<0.001). In a follow-up HLM with interaction terms, time*PTA was statistically significant (p<0.001), suggesting that participants with longer PTA increased in community integration more rapidly than those with shorter PTA. The longitudinal course of community integration described in this study may help rehabilitation professionals to plan more extensive follow-ups and targeted rehabilitation programs in the early stage of recovery for patients with specific demographic and injury characteristics.",0,0 +5792,Latent growth mixture models: an important new tool for developmental researchers,"This manuscript by Connell and Frye (Infant Child Dev 2006; 15(6): 609–621) provides a clear example of the application of latent growth mixture models (LGMM) to the development of antisocial behaviour in adolescence. The LGMM approach is discussed in the context of this example, and factors influencing the results achieved with these methods are highlighted. Overall, developmental psychologists have much to gain from the use of these new approaches. Copyright © 2006 John Wiley & Sons, Ltd.",0,0 +5793,The role of anger and ongoing stressors in mental health following a natural disaster,"Objective: Research has established the mental health sequelae following disaster, with studies now focused on understanding factors that mediate these outcomes. This study focused on anger, alcohol, subsequent life stressors and traumatic events as mediators in the development of mental health disorders following the 2009 Black Saturday Bushfires, Australia’s worst natural disaster in over 100 years. Method: This study examined data from 1017 (M = 404, F = 613) adult residents across 25 communities differentially affected by the fires and participating in the Beyond Bushfires research study. Data included measures of fire exposure, posttraumatic stress disorder, depression, alcohol abuse, anger and subsequent major life stressors and traumatic events. Structural equation modeling assessed the influence of factors mediating the effects of fire exposure on mental health outcomes. Results: Three mediation models were tested. The final model recorded excellent fit and observed a direct relationship between disaster exposure and mental health outcomes (b = .192, p < .001) and mediating relationships via Anger (b = .102, p < .001) and Major Life Stressors (b = .128, p < .001). Each gender was compared with multiple group analyses and while the mediation relationships were still significant for both genders, the direct relationship between exposure and outcome was no longer significant for men ( p = .069), but remained significant (b = .234, p < .001) for women. Conclusions: Importantly, anger and major life stressors mediate the relationship between disaster exposure and development of mental health problems. The findings have significant implications for the assessment of anger post disaster, the provision of targeted anger-focused interventions and delivery of government and community assistance and support in addressing ongoing stressors in the post-disaster context to minimize subsequent mental health consequences.",0,0 +5794,Resilience as process,"Abstract Resilience, the development of competence despite severe or pervasive adversity, is examined using data from a longitudinal study of high-risk children and families. The study is guided by an organizationaldevelopmental perspective. Resilience is conceived not as a childhood given, but as a capacity that develops over time in the context of person-environment interactions. Factors related to resilience in our study are examined in terms of this transactional process. From our studies, we have found emotionally responsive caregiving to mediate the effects of high-risk environments and to promote positive change for children who have experienced poverty, family stress, and maltreatment. The implications of these findings are discussed.",0,0 +5795,Family Presence during Cardiopulmonary Resuscitation,"The effect of family presence during cardiopulmonary resuscitation (CPR) on the family members themselves and the medical team remains controversial.We enrolled 570 relatives of patients who were in cardiac arrest and were given CPR by 15 prehospital emergency medical service units. The units were randomly assigned either to systematically offer the family member the opportunity to observe CPR (intervention group) or to follow standard practice regarding family presence (control group). The primary end point was the proportion of relatives with post-traumatic stress disorder (PTSD)-related symptoms on day 90. Secondary end points included the presence of anxiety and depression symptoms and the effect of family presence on medical efforts at resuscitation, the well-being of the health care team, and the occurrence of medicolegal claims.In the intervention group, 211 of 266 relatives (79%) witnessed CPR, as compared with 131 of 304 relatives (43%) in the control group. In the intention-to-treat analysis, the frequency of PTSD-related symptoms was significantly higher in the control group than in the intervention group (adjusted odds ratio, 1.7; 95% confidence interval [CI], 1.2 to 2.5; P=0.004) and among family members who did not witness CPR than among those who did (adjusted odds ratio, 1.6; 95% CI, 1.1 to 2.5; P=0.02). Relatives who did not witness CPR had symptoms of anxiety and depression more frequently than those who did witness CPR. Family-witnessed CPR did not affect resuscitation characteristics, patient survival, or the level of emotional stress in the medical team and did not result in medicolegal claims.Family presence during CPR was associated with positive results on psychological variables and did not interfere with medical efforts, increase stress in the health care team, or result in medicolegal conflicts. (Funded by Programme Hospitalier de Recherche Clinique 2008 of the French Ministry of Health; ClinicalTrials.gov number, NCT01009606.).",0,0 +5796,Methodological Challenges in Studying the Mental Health Consequences of Disasters,,0,0 +5797,Theoretical and empirical issues in the treatment of post-traumatic stress disorder in Vietnam veterans,"This article reviews the current status of research on the treatment of combat-related post-traumatic stress disorder (PTSD) in Vietnam veterans. Dynamic, behavioral, and biochemical models of treatment are presented, along with the findings of relevant treatment outcome studies. Examination of the treatment procedures employed in available studies revealed that direct therapeutic exposure to the memories of trauma emerged as the PTSD treatment technique common to all three theoretical models. The need for controlled investigations of the clinical efficacy of exposure-based interventions for combat-related PTSD is discussed. In addition, several other issues relevant to PTSD treatment research are presented and discussed, including the potential utility of studying untrained coping behavior in combat veterans; the effects of using heterogeneous subject samples in PTSD treatment research; and issues related to the measurement of treatment outcome.",0,0 +5798,Exposure to Political Violence and Political Extremism,"Exposure to political violence can lead to various political and psychological outcomes. Using the protracted Israeli-Palestinian conflict as a natural laboratory, we explore the way in which exposure to conflict violence leads to changes in citizens’ political attitudes and behavior, offering a model for a stress-based process of political extremism. This model encapsulates three basic components in a causal chain leading to political extremism: exposure to political violence, psychological distress, and enhanced perceptions of threat. We find that prolonged exposure to political violence increases psychological distress, which in turn evokes stronger perceptions of threat that foment political attitudes eschewing compromise and favoring militarism. This causal chain fuels a destructive cycle of violence that is hard to break. Understanding these psychological and political consequences of exposure to political violence can help to shed light on the barriers that too often stymie peacemaking efforts and contribute to the deterioration of intractable conflicts around the globe. Thus, this review offers insights applicable to conflict zones around the world and suggests policy implications for therapeutic intervention and potential pathways to conflict resolution.",0,0 +5799,The Role of Injury and Trauma-Related Variables in the Onset and Course of Symptoms of Posttraumatic Stress Disorder,"Posttraumatic stress disorder (PTSD) affects a minority of trauma-exposed persons and is associated with significant impairment. This longitudinal study examined risk factors for PTSD. We tested whether the presence of injuries resulting from trauma exposure predicted the course of PTSD symptoms. In addition, we tested whether gender, trauma type, perceived life threat, and peritraumatic dissociation predicted the onset of PTSD symptoms. 236 trauma-exposed civilians were assessed for PTSD symptoms with a structured interview at four occasions during 6 months posttrauma. Path analysis showed that a model in which the female gender, assault, perceived life threat, and peritraumatic dissociation predicted PTSD severity at 1 week, and injury predicted PTSD severity 8 weeks after the traumatic event showed the best fit. However, a similar model without injury showed comparable fit. It is concluded that injuries have a negligible effect on the course of PTSD. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0,0 +5800,Variation in the Profile of Anxiety Disorders in Boys with an ASD According to Method and Source of Assessment,"To determine any variation that might occur due to the type of assessment and source used to assess them, the prevalence of 7 anxiety disorders were investigated in a sample of 140 boys with an Autism spectrum disorder (ASD) and 50 non-ASD (NASD) boys via the Child and Adolescent Symptom Inventory and the KIDSCID Clinical Interview. Boys with an ASD were significantly more anxious than their NASD peers. Data collected from the boys with an ASD themselves showed differences in the severity and diagnostic criterion of anxiety disorders to data collected from the boys’ parents. There were age-related variations to the pattern of anxiety disorder differences across reports from the boys with an ASD and reports from their parents.",0,0 +5801,"On the Pervasiveness of Event-Specific Alcohol Use, General Substance Use, and Mental Health Problems as Risk Factors for Intimate Partner Violence","The aim of this study was to evaluate the role of demographic, mental health, and substance use as risk factors for intimate partner violence (IPV). Data were derived from Wave II of the National Epidemiological Survey on Alcohol and Related Conditions (2004-2005). Eligible participants ( N = 25,778) reported having an intimate partner 1 year before the survey. Clustered survey multivariate multinomial regression methods were used to assess risk factors for episodes of IPV. IPV victimization, perpetration, and both victims/perpetrators were assessed. Bivariate analyses indicated that African Americans, Hispanics, and women were more likely to be victims, perpetrators, or victim/perpetrators as compared with men and Whites. Multivariate analyses suggested that having a marijuana use disorder was strongly associated with IPV victimization (odds ratio [OR] = 2.61) and victim/perpetration (OR = 2.65). Post-traumatic stress disorder was consistently associated with all IPV typologies. Depression was associated with victimization (OR = 2.00) and IPV victim/perpetration (OR = 1.74). Antisocial Personality Disorder and Mania were both related to IPV perpetration (ORs = 2.53 and 2.32) and victim/perpetration (ORs = 3.15 and 2.31). Results also indicated that alcohol use during episodes of IPV is common (i.e., 35% of those who reported IPV also reported that alcohol was involved). Results indicate several substance- and mental health–related correlates of IPV. In addition, findings indicate that alcohol use by the victim and/or perpetrator is common during IPV events. Policy implications and directions for future research are discussed.",0,0 +5802,Neurobiological Models of Posttraumatic Stress Disorder,"(from the chapter) Focuses on two neurobiological systems that are critical for survival-the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis (HPA). Though most neurobiological research in posttraumatic stress disorder (PTSD) concentrates on these two systems, it is asserted that numerous other neurobiological systems are also involved in acute and chronic responses to stress, although far less is known about them as they relate to PTSD. Several new neurobiological models of PTSD are presented in an attempt to understand the current body of trauma-related neurobiological research. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5803,"Stress risk factors and stress-related pathology: Neuroplasticity, epigenetics and endophenotypes","This paper highlights a symposium on stress risk factors and stress susceptibility, presented at the Neurobiology of Stress workshop in Boulder, CO, in June 2010. This symposium addressed factors linking stress plasticity and reactivity to stress pathology in animal models and in humans. Dr. J. Radley discussed studies demonstrating prefrontal cortical neuroplasticity and prefrontal control of hypothalamo-pituitary-adrenocortical axis function in rats, highlighting the emerging evidence of the critical role that this region plays in normal and pathological stress integration. Dr. M. Kabbaj summarized his studies of possible epigenetic mechanisms underlying behavioral differences in rat populations bred for differential stress reactivity. Dr. L. Jacobson described studies using a mouse model to explore the diverse actions of antidepressants in brain, suggesting mechanisms whereby antidepressants may be differentially effective in treating specific depression endophenotypes. Dr. R. Yehuda discussed the role of glucocorticoids in post-traumatic stress disorder (PTSD), indicating that low cortisol level may be a trait that predisposes the individual to development of the disorder. Furthermore, she presented evidence indicating that traumatic events can have transgenerational impact on cortisol reactivity and development of PTSD symptoms. Together, the symposium highlighted emerging themes regarding the role of brain reorganization, individual differences, and epigenetics in determining stress plasticity and pathology.",0,0 +5804,Predictive factors of chronic Post-Traumatic Stress Disorder in rape victims,"This study aimed to investigate the psychological disorders following rape as well as the course of Post-Traumatic Stress Disorder (PTSD), and to determine clinical factors predictive of chronic PTSD. Seventy-three rape victims were observed in a systematic follow-up study over 1 year following rape using structured interview schedules. The frequency of PTSD was massive. The early disorders predicting PTSD 1 year after rape included somatoform and dissociative disorders, agoraphobia and specific phobias as well as depressive and gender identity disorders and alcohol abuse. Through stepwise logistic regressions, the following were found to be good models of prediction of chronic PTSD 1 year after rape: for the characteristics of the traumas, intrafamily rape, being physically assaulted outside rape, and added physical violence during rape; for the early psychological and behavioural attitudes, low self-esteem, permanent feelings of emptiness and running away; and for early mental disorders, agoraphobia and depressive disorders. Finally, among all these predictive factors, added physical violence during rape, low self-esteem, permanent feelings of emptiness and agoraphobia were shown to constitute a strong model of predictors. People presenting features such as the predictive factors of chronic PTSD found in the study should be asked about a history of rape and symptoms of PTSD.",0,0 +5805,The impact of resource loss and traumatic growth on probable PTSD and depression following terrorist attacks,"The authors interviewed by phone 2,752 randomly selected individuals in New York City within 6 to 9 months after the attacks of September 11, 2001 on the World Trade Center, and 1,939 of these were reinterviewed at a 12- to 16-month follow-up. It was hypothesized that resource loss would significantly predict probable posttraumatic stress disorder (PTSD) and probable depression since September 11, and that resource loss's impact would be independent of previously identified predictors relating to individuals' demographic characteristics, history of stressful event exposure, prior trauma history, peritraumatic experience, and social support. Second, it was predicted that reported traumatic growth would be related to greater, not lesser, psychological distress. The authors' findings supported their hypotheses for resource loss, but traumatic growth was unrelated to psychological outcomes when other predictors were controlled.",0,0 +5806,Patterns of DSM-5 posttraumatic stress disorder and depression symptoms in an epidemiological sample of Chinese earthquake survivors: A latent profile analysis,"Posttraumatic stress disorder (PTSD) and depression are highly comorbid in association with serious clinical consequences. Nevertheless, to date, no study using latent class or latent profile analysis (LCA/LPA) has examined patterns of co-occurring PTSD and depression symptoms among natural disaster survivors, nor has the distinctiveness of DSM-5 PTSD and depression symptoms been clarified in the aftermath of trauma. This study was primarily aimed at filling these gaps.LPA was used to examine self-reported PTSD and depression symptoms in an epidemiological sample of 1196 Chinese earthquake survivors.A 4-class solution characterized by low symptoms (53.9%), predominantly depression (18.2%), predominantly PTSD (18.9%) and combined PTSD-depression (9.0%) patterns fit the data best. Demographic characteristics and earthquake-related exposures were specifically or consistently associated with the non-parallel profiles varying in physical health impairment.A sample exposed to specific traumatic events was assessed by self-report measures.The distinctiveness of DSM-5 PTSD and depression symptoms following an earthquake suggests that PTSD and depression may be independent sequelae of psychological trauma rather than a manifestation of a single form of psychopathology. The current findings support the distinction between PTSD and depression constructs, and highlight the need for identifications of natural disaster survivors at high risk for PTSD and/or depression, and interventions individually tailored to one's symptom presentations.",0,0 +5807,"Trajectories of memory decline in preclinical Alzheimer's disease: results from the Australian Imaging, Biomarkers and Lifestyle Flagship Study of Ageing","Memory changes in preclinical Alzheimer's disease (AD) are often characterized by heterogenous trajectories. However, data regarding the nature and determinants of predominant trajectories of memory changes in preclinical AD are lacking. We analyzed data from 333 cognitively healthy older adults who participated in a multicenter prospective cohort study with baseline and 18-, 36-, and 54-month follow-up assessments. Latent growth mixture modeling revealed 3 predominant trajectories of memory change: a below average, subtly declining memory trajectory (30.9%); a below average, rapidly declining memory trajectory (3.6%); and an above average, stable memory trajectory (65.5%). Compared with the stable memory trajectory, high Αβ (relative risk ratio [RRR] = 2.1), and lower Mini-Mental State Examination (RRR = 0.6) and full-scale IQ (RRR = 0.9) scores were independently associated with the subtly declining memory trajectory; and high Αβ (RRR = 8.3), APOE ε4 carriage (RRR = 6.1), and greater subjective memory impairment (RRR = 1.2) were independently associated with the rapidly declining memory trajectory. Compared with the subtly declining memory trajectory group, APOE ε4 carriage (RRR = 8.4), and subjective memory complaints (RRR = 1.2) were associated with a rapidly declining memory trajectory. These results suggest that the preclinical phase of AD may be characterized by 2 predominant trajectories of memory decline that have common (e.g., high Αβ) and unique (e.g., APOE ε4 genotype) determinants.",0,0 +5808,Gender differences in childhood onset conduct disorder,"The present study tested several predictions related to the theory that girls with conduct disorder (CD) follow a single delayed onset pathway. The following hypotheses were tested among a high-risk, stratified random sample of youth who used public services during a 6-month period: boys will be more likely to have childhood onset CD (COCD) than girls; girls with COCD will be less common than girls with adolescent onset CD (AOCD); COCD girls. AOCD girls, and COCD boys will be similar in terms of risk profiles and AOCD boys will have a less severe risk profile than COCD girls; and risk factors that differentiate between COCD and AOCD among males will not differentiate between COCD and AOCD among females. Among those youth who met the criteria for CD, males were significantly more likely to have COCD than females. However, close to half of females with CD met the criteria for the COCD subtype. Of the seven risk factors that were examined, girls with COCD scored higher than COCD boys on three factors and higher than AOCD girls on four factors; however, only one significant difference was found between AOCD girls and COCD boys. Finally, risk factors appeared to differentiate between COCD and AOCD groups in a similar way among males and females. These findings suggest that COCD is not rare among females in public service sectors, COCD girls can be distinguished from AOCD girls in terms of risk factors, and risk factors for COCD among males are also relevant to females.",0,0 +5809,Expert opinions about the ICD-10 category of enduring personality change after catastrophic experience,"The inclusion of enduring personality change after catastrophic experience (EPCACE) as a diagnostic category in the ICD-10 represents a turning point in the evolution of the nosology of traumatic stress syndromes, yet many aspects of the diagnosis remain contentious. Given the absence of published research concerning this category, an exploratory survey of international experts was conducted using a questionnaire focusing on key aspects of the category, namely whether respondents used the diagnosis of EPCACE in their practice; which features were most salient in making a diagnosis of posttraumatic personality change; the types and characteristics of traumatic events that were judged to be most likely to cause EPCACE; and the possible limitations of the ICD-10 diagnosis. A response rate of 56.3% was obtained. A substantial portion of trauma experts working in the field of human-engendered violence recognize the possibility that certain traumas can result in personality change. However, questions were raised about the specificity of the criteria proposed for the category of EPCACE in ICD-10. A composite profile of proposed additional features suggests that a more comprehensive array of adaptational changes are recognized than are encompassed by EPCACE.",0,0 +5810,Gender differences in patients with posttraumatic stress disorder in a general psychiatric practice.,"This report examined gender differences in the clinical manifestations of current posttraumatic stress disorder (PTSD) in treatment-seeking patients.Outpatients with PTSD (N=138) were interviewed with the Structured Clinical Interview for DSM-IV.Compared with male patients, female patients experienced more reexperiencing symptoms and were more likely to meet criteria for current PTSD and to report sexual trauma as their index trauma. Men with PTSD were more likely than women with PTSD to meet criteria for a substance use disorder and for antisocial personality disorder. No gender differences were found in the frequency of other types of comorbid disorders, the number of comorbid disorders, or the presence of PTSD as a primary disorder.Overall, male and female patients with current PTSD present with fairly comparable clinical profiles.",0,0 +5811,Risk factors for PTSD and other diagnoses in a general sample of Vietnam veterans,"This study examined the contribution of premilitary, military, and postmilitary risk factors to posttraumatic stress disorder (PTSD) and other postwar diagnoses in a sample of Vietnam veterans. PTSD was explained primarily by war stressors, including threat to life and exposure to grotesque death, but premilitary and postmilitary factors also contributed to the likelihood of a current diagnosis of PTSD. Panic disorder was also highly predicted by war experiences, whereas prewar functioning played a stronger role in several non-PTSD diagnoses. The study supported the notion that PTSD is specifically linked to intense stressors. Mechanisms for interactions among risk factors are discussed.",0,0 +5812,Minimally adequate mental health care and latent classes of PTSD symptoms in female Iraq and Afghanistan veterans,"Female veterans of Operations Enduring and Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND) represent a growing segment of Department of Veterans Affairs (VA) health care users. A retrospective analysis used national VA medical records to identify factors associated with female OEF/OIF/OND veterans' completion of minimally adequate care (MAC) for PTSD, defined as the completion of at least nine mental health outpatient visits within a 15-week period or at least twelve consecutive weeks of medication use. The sample included female OEF/OIF/OND veterans with PTSD who initiated VA health care between 2007-2013, and were seen in outpatient mental health (N=2183). Multivariable logistic regression models examined factors associated with completing MAC for PTSD, including PTSD symptom expression (represented by latent class analysis), sociodemographic, military, clinical, and VA access factors. Within one year of initiating mental health care, 48.3% of female veterans completed MAC. Race/ethnicity, age, PTSD symptom class, additional psychiatric diagnoses, and VA primary care use were significantly associated with completion of MAC for PTSD. Results suggest that veterans presenting for PTSD treatment should be comprehensively evaluated to identify factors associated with inadequate completion of care. Treatments that are tailored to PTSD symptom class may help to address potential barriers.",0,0 +5813,Risk of False Positives When Identifying Malingered Profiles Using the Trauma Symptom Inventory,"The Trauma Symptom Inventory (TSI; Briere, 1995) is a 100-item self-report measure of posttraumatic symptomatology that includes an Atypical Response (ATR) validity scale designed to differentiate honest from malingered profiles. In this study, using an analogue design to experimentally manipulate honest and malingered responses on the TSI, we found that proposed ATR cut scores produce a significant risk of false positives. Furthermore, the functioning of proposed cut scores worsened when we used posttraumatic stress disorder relevant samples and low estimates of malingering base rates. In light of these findings, the TSI should be used with caution when assessing claims of posttraumatic stress in forensic or disability settings.",0,0 +5814,"Trauma, PTSD and personality: the relationship between prolonged traumatization and personality impairments","Chronic post-traumatic stress disorder (PTSD) has been associated with personality impairments involving externalized and internalized psychopathology. This study has explored the association between PTSD symptoms as consequences of prolonged torture experiences or early childhood trauma exposure and personality traits.One hundred and sixty-one men were included: 36 Iraqi men refugees (mean age = 43.9, SD = 8.7) who had longstanding torture experiences as adults; 42 Swedish prisoners (mean age = 33.8, SD = 7), with early childhood trauma exposure; 31 Arab men refugees (mean age = 41.8, SD = 8.9) without self-reported torture or violence experiences; 52 non-traumatized Swedish males (mean age = 39.3, SD = 5.5). They were assessed for symptoms of PTSD or PTSD hypothetical clusters. Personality profile was assessed by the Karolinska Scales of Personality (KSP). Factor analysis with varimax rotation was conducted and yielded three factors: externalized, internalized and avoidance domains.Individuals who suffered prolonged torture experiences or had early childhood trauma exposure showed impaired personality profiles in internalized and externalized domains. Individuals with or without PTSD showed significant differences p < 0.05 concerning: internalized, externalized and avoidance. ANOVA and post-hoc analysis according to Scheffé showed that the prolonged torture group > early childhood trauma exposure > nontraumatized group.Prolonged torture experiences or early trauma exposure may impair personality formation by enhancing the effects of cognitive, affective and behavioural vulnerabilities.",0,0 +5815,Comorbidity in posttraumatic stress disorder: a structural equation modelling approach,"Posttraumatic stress disorder (PTSD) is associated with high rates of psychiatric comorbidity. Existing theories consider comorbidity as a consequence of PTSD (model 1), PTSD and comorbidity as a consequence of shared factors of vulnerability (model 2), and comorbidity as a consequence of trauma-type specific mechanisms (model 3).To compare the explanatory value of these models, we assessed PTSD (model 1), sense of coherence (model 2) and satisfaction with health (model 3) and symptoms of anxiety and depression as indicators of comorbidity 5 days (t1) and 6 months (t2) postaccident in 225 injured accident survivors. Structural equation models representing models 1 to 3 were tested separately and combined.Combined, models 1 and 3 explained 82% of the variance of comorbid symptoms at t2. Posttraumatic stress disorder and satisfaction with health (t2) exerted strong influences on comorbid symptoms.Comorbidity besides PTSD is best described by an integration of competing explanatory models.",0,0 +5816,"Posttraumatic stress disorder symptoms, physiological reactivity, alcohol problems, and aggression among military veterans.","This study examined the association between posttraumatic stress disorder (PTSD) symptomatology and aggressive behavior among a sample of male Vietnam veterans (N = 1,328). Results indicated that the hyperarousal PTSD symptom cluster evidenced the strongest positive association with aggression at the bivariate level when compared with the other PTSD symptom clusters. When the PTSD symptom clusters were examined together as predictors, hyperarousal symptoms evidenced a significant positive relationship with aggression, and avoidance/numbing symptoms were negatively associated with aggression. Examination of potential mediators indicated that hyperarousal symptoms were directly associated with aggression and indirectly related to aggression via alcohol problems. Reexperiencing symptoms were associated with aggression only indirectly and through their positive association with physiological reactivity and negative association with alcohol problems. Study results highlight the complexity of the relationship between PTSD symptoms and aggression, and suggest possible mechanisms explaining this association.",0,0 +5817,Binary partitioning for continuous longitudinal data: categorizing a prognostic variable,"We investigate a binary partitioning algorithm in the case of a continuous repeated measures outcome. The procedure is based on the use of the likelihood ratio statistic to evaluate the performance of individual splits. The procedure partitions a set of longitudinal data into two mutually exclusive groups based on an optimal split of a continuous prognostic variable. A permutation test is used to assess the level of significance associated with the optimal split, and a bootstrap confidence interval is obtained for the optimal split.",0,0 +5818,Expression of locus coeruleus mineralocorticoid receptor and glucocorticoid receptor in rats under single-prolonged stress,"The pathogenesis of the post-traumatic stress disorder (PTSD) may involve dysfunction of several brain structures, such as the amygdala, locus coeruleus, hippocampus, noradrenergic system as well as the hypothalamic- pituitary-adrenal (HPA) axis. The cortisol and locus coeruleus dysfunction may affect the secretion of corticosterone. The present study was designed to examine the expression of mineralocorticoid receptor (MR) and glucocorticoid receptor (GR) in the locus coeruleus in the rats treated with single-prolonged stress (SPS). The results showed that the expression of MR had a sharp decline on day 1, but gradually increased on days 4, 7, 14, and 28. The expression of GR gradually increased on days 1, 4, and 7, but decreased on days 14 and 28, respectively.MR and GR in the locus coeruleus may have a role in the development of long-term persistent neuropsychological sequelae in PTSD. © 2011 Springer-Verlag.",0,0 +5819,Resilience to loss and chronic grief: A prospective study from preloss to 18-months postloss.,"The vast majority of bereavement research is conducted after a loss has occurred. Thus, knowledge of the divergent trajectories of grieving or their antecedent predictors is lacking. This study gathered prospective data on 205 individuals several years prior to the death of their spouse and at 6- and 18-months postloss. Five core bereavement patterns were identified: common grief, chronic grief, chronic depression, improvement during bereavement, and resilience. Common grief was relatively infrequent, and the resilient pattern most frequent. The authors tested key hypotheses in the literature pertaining to chronic grief and resilience by identifying the preloss predictors of each pattern. Chronic grief was associated with preloss dependency and resilience with preloss acceptance of death and belief in a just world.",0,0 +5820,Smoking status and exercise in relation to PTSD symptoms: A test among trauma-exposed adults,"The present investigation examined the interactive effect of cigarette smoking status (i.e., regular smoking versus non-smoking) and weekly exercise (i.e., weekly metabolic equivalent) in terms of posttraumatic stress (PTSD) symptom severity among a community sample of trauma-exposed adults. Participants included 86 trauma-exposed adults (58.1% female; Mage = 24.3). Approximately 59.7% of participants reported regular (≥ 10 cigarettes per day) daily smoking over the past year. The interactive effect of smoking status by weekly exercise was significantly associated with hyperarousal and avoidance symptom cluster severity (p ≤ .05). These effects were evident above and beyond number of trauma types and gender, as well as the respective main effects of smoking status and weekly exercise. Follow-up tests indicated support for the moderating role of exercise on the association between smoking and PTSD symptoms, such that the highest levels of PTSD symptoms were observed among regular smokers reporting low weekly exercise levels. Theoretical and clinical implications of the findings are discussed.",0,0 +5821,Latent profiles of DSM-5 PTSD symptoms and the “Big Five” personality traits,"Typologies of DSM-5 PTSD symptoms and personality traits were evaluated in regard to coping styles and treatment preferences using data from 1266 trauma-exposed military veterans of which the majority were male (n=1097; weighted 89.6%). Latent profile analyses indicated a best-fitting 5-class solution; PTSD asymptomatic and emotionally stable (C1); predominant re-experiencing and avoidance symptoms and less emotionally stable (C2); subsyndromal PTSD (C3); predominant negative alterations in mood/cognitions and combined internalizing-externalizing traits (C4); and high PTSD severity and combined internalizing-externalizing traits (C5). Compared to C5, C1 members were less likely to use self-distraction, denial, and substance use and more likely to use active coping; C2 and C4 members were less likely to use denial and more likely to use behavioral disengagement; C3 members were less likely to use denial and instrumental coping and more likely to use active coping; most classes were less likely to seek mental health treatment. Compared to C1, C2 members were more likely to use self-distraction, substance use, behavioral disengagement and less likely to use active coping; C3 members were more likely to use self-distraction, and substance use, and less likely to use positive reframing, and acceptance; and C4 members were more likely to use denial, substance use, emotional support, and behavioral disengagement, and less likely to use active coping, positive reframing, and acceptance; all classes were more likely to seek mental health treatment. Emotional stability was most distinguishing of the typologies. Other implications are discussed.",0,0 +5822,The characteristics of a cohort who tamper with prescribed and diverted opioid medications,"To describe the methods and baseline characteristics of a cohort of people who tamper with pharmaceutical opioids, formed to examine changes in opioid use following introduction of Reformulated OxyContin®.Participants were 606 people from three Australian jurisdictions who reported past month injecting, snorting, chewing or smoking of a pharmaceutical opioid and had engaged in these practices at least monthly in the past 6 months. Baseline interviews were conducted prior to introduction of Reformulated OxyContin® in April 2014. Patterns of opioid use and cohort characteristics were examined according to whether participants were prescribed opioid medications, or exclusively used diverted medication.The cohort reported high levels of moderate/severe depression (61%), moderate/severe anxiety (43%), post-traumatic stress disorder (42%), chronic pain or disability (past 6 months, 54%) and pain (past month, 47%). Lifetime use of oxycodone, morphine, opioid substitution medications and codeine were common. Three-quarters (77%) reported ICD-10 lifetime pharmaceutical opioid dependence and 40% current heroin dependence. Thirteen percent reported past year overdose, and 70% reported at least one past month opioid injection-related injury or disease. The cohort displayed complex clinical profiles, but participants currently receiving opioid substitution therapy who were also prescribed other opioids particularly reported a wide range of risk behaviors, despite their health service engagement.Findings highlight the heterogeneity in the patterns and clinical correlates of opioid use among people who tamper with pharmaceutical opioids. Targeted health interventions are essential to reduce the associated harms.",0,0 +5823,Post-Traumatic Stress Disorder and Functioning and Quality of Life Outcomes in Female Vietnam Veterans,"This investigation assessed whether current post-traumatic stress disorder (PTSD) was associated with impaired functioning in a nationally representative sample of female Vietnam veterans.Logistic models were used to determine the association between PTSD and outcome while adjusting for demographic characteristics and medical and psychiatric co-morbidities.PTSD was associated with significantly elevated odds of poorer functioning in five of the six outcome domains; only the association between perpetration of violence in the past year and PTSD did not achieve statistical significance. After adjusting for demographics and medical and psychiatric co-morbidities, PTSD remained associated with significantly elevated odds of bed days, poorer physical health, and currently not working.Among female Vietnam veterans PTSD is associated with a broad profile of functional impairment. The significantly increased odds of impaired functioning and diminished quality of life suggest that PTSD may be the core problem of the set of problems afflicting female Vietnam veterans.",0,0 +5824,The structure of posttraumatic psychopathology in veterans attending primary care,"This study attempted to extend research indicating that posttraumatic stress disorder (PTSD) factors of Re-experiencing, Avoidance and Hyperarousal are more related to Fear/phobic disorders, while PTSD Dysphoria is more related to Anxious-Misery disorders. Trauma exposure, PTSD and comorbidity data for 668 veteran patients were analysed using confirmatory factor analyses and relative strengths of the relationships between PTSD factors and the Fear and Anxious-Misery factors were assessed. Combining Simms, Watson, and Doebbeling's (2002) model of PTSD symptoms and Krueger's (1999) Fear/Anxious Misery model of mood and anxiety disorders fit the data well. Contrary to previous research, PTSD Re-experiencing, Avoidance and Hyperarousal did not correlate more with the Fear factor; nor did PTSD Dysphoria correlate more with Anxious-Misery. Hyperarousal was more closely related to Fear than was Re-experiencing; however, Avoidance was not. Dysphoria was more closely related to the Anxious-Misery factor than all other PTSD factors.",0,0 +5825,Influence of the Severity and Location of Bodily Injuries on Post-Concussive and Combat Stress Symptom Reporting after Military-Related Concurrent Mild Traumatic Brain Injuries and Polytrauma,"Traumatic brain injuries (TBI) sustained in combat frequently co-occur with significant bodily injuries. Intuitively, more extensive bodily injuries might be associated with increased symptom reporting. In 2012, however, French et al. demonstrated an inverse relation between bodily injury severity and symptom reporting. This study expands on that work by examining the influence of location and severity of bodily injuries on symptom reporting after mild TBI. Participants were 579 US military service members who sustained an uncomplicated mild TBI with concurrent bodily injuries and who were evaluated at two military medical centers. Bodily injury severity was quantified using a modified Injury Severity Score (ISSmod). Participants completed the Neurobehavioral Symptom Inventory (NSI) and the Posttraumatic Stress Disorder Checklist (PCL-C), on average, 2.5 months post-injury. There was a significant negative association between ISSmod scores and NSI (r=-0.267, p<0.001) and PCL-C (r=-0.273, p<0.001) total scores. Using linear regression to examine the relation between symptom reporting and injury severity across the six ISS body regions, three body regions were significant predictors of the NSI total score (face; p<0.001; abdomen; p=0.003; extremities; p<0.001) and accounted for 9.3% of the variance (p<0.001). For the PCL-C, two body regions were significant predictors of the PCL-C total score (face; p<0.001; extremities; p<0.001) and accounted for 10.5% of the variance. There was an inverse relation between bodily injury severity and symptom reporting in this sample. Hypothesized explanations include underreporting of symptoms, increased peer support, disruption of fear conditioning because of acute morphine use, or delayed expression of symptoms.",0,0 +5826,Childhood Post-Traumatic Stress Disorder: An Overview,"This article presents an overview of post-traumatic stress disorder (PTSD) as it relates to children and adolescents. The authors provide a critical review of the pediatric PTSD literature regarding the definition, epidemiology, clinical presentation, assessment, neurobiologic foundation, and treatment of PTSD. The importance of developmental and neurobiologic factors and the uniqueness of these factors to children are emphasized.",0,0 +5827,Female combat amputees have higher rates of posttraumatic stress disorder disability.,"The civilian trauma literature suggests that the sexes differ in physical and mental health outcomes following traumatic injury. In order to determine if the reaction to combat injury is different between the sexes in a specific war wounded population, service members with amputations, we examined the disability profiles of male and female amputees.All US combatants who sustained a major extremity amputation between October 2001 and July 2011 were examined for demographic and injury information from the Department of Defense Trauma Registry and for disability outcomes in the service specific Physical Evaluation Boards. The proportions of women versus men with various disabling conditions were compared using Fisher's Exact Test and the mean disability ratings for each condition were compared using student's t tests.Among 1,107 amputees, 21 were female. There was no difference in the average age, military rank, or Injury Severity Score between the sexes. While the most common military occupation of male amputees was infantry service, the most common occupation for the female amputee was military police. The overall disability ratings between females and males were not different (82% for females, 75% for males). Female amputees had more frequent disability from posttraumatic stress disorder (PTSD, 8/21 [38%] vs 168/818 [17%]). Disability ratings from PTSD tended to also be higher in women.Outside of variable occupational descriptions, both male and female amputees were exposed to explosions resulting in their injuries. Consistent with many civilian trauma and veterans' population studies, female amputees have higher frequencies of disability from PTSD. These results support the need for additional effort and attention directed towards optimizing physical and mental fitness following deployment in order to reduce disability and promote return to duty. Because certain conditions, such as PTSD, may be more or less common in men versus women veterans, postdeployment fitness may need to be tailored in a gender specific way.",0,0 +5828,Multiple Vantage Points on the Mental Health Effects of Mass Shootings,"The phenomenon of mass shootings has emerged over the past 50 years. A high proportion of rampage shootings have occurred in the United States, and secondarily, in European nations with otherwise low firearm homicide rates; yet, paradoxically, shooting massacres are not prominent in the Latin American nations with the highest firearm homicide rates in the world. A review of the scientific literature from 2010 to early 2014 reveals that, at the individual level, mental health effects include psychological distress and clinically significant elevations in posttraumatic stress, depression, and anxiety symptoms in relation to the degree of physical exposure and social proximity to the shooting incident. Psychological repercussions extend to the surrounding affected community. In the aftermath of the deadliest mass shooting on record, Norway has been in the vanguard of intervention research focusing on rapid delivery of psychological support and services to survivors of the “Oslo Terror.” Grounded on a detailed review of the clinical literature on the mental health effects of mass shootings, this paper also incorporates wide-ranging co-author expertise to delineate: 1) the patterning of mass shootings within the international context of firearm homicides, 2) the effects of shooting rampages on children and adolescents, 3) the psychological effects for wounded victims and the emergency healthcare personnel who care for them, 4) the disaster behavioral health considerations for preparedness and response, and 5) the media “framing” of mass shooting incidents in relation to the portrayal of mental health themes. © 2014, Springer Science+Business Media New York.",0,0 +5829,Social support and Quality of Life: a cross-sectional study on survivors eight months after the 2008 Wenchuan earthquake,"Abstract Background The 2008 Wenchuan earthquake resulted in extensive loss of life and physical and psychological injuries for survivors. This research examines the relationship between social support and health-related quality of life for the earthquake survivors. Methods A multistage cluster sampling strategy was employed to select participants from 11 shelters in nine counties exposed to different degrees of earthquake damage, for a questionnaire survey. The participants were asked to complete the Short Form 36 and the Social Support Rating Scale eight months after the earthquake struck. A total of 1617 participants returned the questionnaires. The quality of life of the survivors (in the four weeks preceding the survey) was compared with that of the general population in the region. Multivariate logistic regression analysis and canonical correlation analysis were performed to determine the association between social support and quality of life. Results The earthquake survivors reported poorer quality of life than the general population, with an average of 4.8% to 19.62% reduction in scores of the SF-36 (p < 0.001). The multivariate logistic regression analysis showed that those with stronger social support were more likely to have better quality of life. The canonical correlation analysis found that there was a discrepancy between actual social support received and perceived social support available, and the magnitude of this discrepancy was inversely related to perceived general health (rs = 0.467), and positively related to mental health (rs = 0.395). Conclusion Social support is associated with quality of life in the survivors of the earthquake. More attention needs to be paid to increasing social support for those with poorer mental health.",0,0 +5830,Childhood Posttraumatic Stress Disorder and Efforts to Cope After Hurricane Floyd,"The authors report on the level of posttraumatic stress disorder (PTSD) experienced by fourth-grade children 6 months after Hurricane Floyd and describe the children's efforts to cope with their stress. All of the children they studied were directly affected by the hurricane, secondary to the destruction of their school by floodwaters. The homes of 37% of these children were also flooded. Ninety-five percent of the children experienced at least mild symptoms of PTSD, and 71% had symptoms that were moderate to very severe. Children who reported that their homes were flooded were 3 times more likely to report symptoms than those whose homes were not flooded, and the girls were twice as likely as the boys to report symptoms. The high PTSD prevalence rates are comparable to findings from other studies involving violence in which 94% of the victims reported experiencing symptoms. For further analyses, the authors used symptom clusters of hyperarousal, numbing/avoidance, and reexperiencing symptoms.",0,0 +5831,Efficacy of group treatment for posttraumatic stress disorder symptoms: A meta-analysis.,"This study conducted a meta-analysis of published randomized clinical group trials for adult survivors of trauma to examine the efficacy of the group format. Effect sizes for posttraumatic stress disorder (PTSD) severity outcome were examined. Sixteen studies were included, with a total of 1686 participants. Results of a random effects model meta-analysis indicated that group treatments are associated with significant preto posttreatment reduction in PTSD symptom severity (within treatment d .71, 95% CI [.51, .91]), and result in superior treatment effects relative to a wait list comparison condition (d .56, 95% CI [.31, .82]). However, no significant findings were obtained for group interventions relative to active treatment comparison conditions (d .09, 95% CI [ .03, .22]). Moderator analyses also indicated that gender and type of trauma moderated treatment effects for PTSD outcome, with smaller effect sizes associated with males relative to females and combined gender samples, and smaller effect sizes for combat and child sexual assault trauma samples relative to mixed-trauma sample studies. Taken together, group treatment for trauma symptoms is better than no treatment but not better relative to comparison conditions that control for nonspecific benefits of therapy. Additional work is needed to identify effective group treatments for PTSD, especially for patients with repeated or chronic traumatization.",0,0 +5832,Race and Incarceration in an Aging Cohort of Vietnam Veterans in Treatment for Post-Traumatic Stress Disorder (PTSD),"Cross sectional studies have addressed the incarceration of Vietnam veterans with post-traumatic stress disorder (PTSD), but no studies have examined changes in incarceration as they age. This study examines patterns of incarceration among Vietnam veterans treated in specialized veterans affairs (VA) intensive PTSD programs over time. Data was drawn from admission data from the initial episode of treatment of Caucasian and African American Vietnam veterans entering VA specialized intensive PTSD programs between 1993 and 2011 (N = 31,707). Bivariate correlations and logistic regression were used to examine associations among race and incarceration over time and the potentially confounding influence of demographic and clinical covariates on this relationship. Rates of reported incarceration declined from 63 to 43 %. Over time, African American veterans were 34 % more likely than Caucasian veterans to have a lifetime history of incarceration while interaction analysis showed steeper declines for Caucasians than African Americans. Rates of incarceration among these Vietnam veterans declined as they aged. Furthermore, African American veterans were substantially more likely than Caucasian veterans to have been incarcerated and showed less decline as the cohort aged. While reduced, needs for clinical PTSD services remain among aging combat veterans. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0,0 +5833,Tolerating Distress After Trauma: Differential Associations Between Distress Tolerance and Posttraumatic Stress Symptoms,"Distress tolerance has been implicated in disorders of emotional regulation, such as eating disorders and borderline personality disorder; however, much less attention has been given to distress tolerance in the context of posttraumatic stress (PTS). Several conceptual linkages between distress tolerance and PTS exist. Low distress tolerance may increase negative appraisals, reducing an individual's propensity to deal with distressing mental symptoms immediately after a trauma. Relatedly, a perceived inability to cope with the distress brought on by trauma-related memories and cues may engender maladaptive coping strategies. The few published studies examining the relationship between distress tolerance and PTS have demonstrated that lower distress tolerance was associated with increased PTS symptomatology, including increased avoidance, hyperarousal, and re-experiencing. The current study sought to replicate and extend the emerging empirical base by examining the relationship between distress tolerance and the four distinct PTS symptom clusters, while controlling for time since the index trauma and depressive symptoms. Results indicated that distress tolerance accounted for significant unique variance in re-experiencing and avoidance but not negative emotionality and hyperarousal symptoms. There was also a strong positive association between the number of traumas endorsed by participants, depression, and PTS symptoms. Findings suggest that distress tolerance is associated with PTS, lending further support to the putative relationship between PTS and distress tolerance. Accordingly, developing treatment protocols designed to increase distress tolerance in individuals affected by PTS may reduce symptom severity and increase coping abilities. © 2014 Springer Science+Business Media.",0,0 +5834,Does repressive coping promote resilience? Affective-autonomic response discrepancy during bereavement.,"Traditional theories of coping emphasize the value of attending to and expressing negative emotion while recovering from traumatic life events. However, recent evidence suggests that the tendency to direct attention away from negative affective experience (i.e., repressive coping) may promote resilience following extremely aversive events (e.g., the death of a spouse). The current study extends this line of investigation by showing that both bereaved and nonbereaved individuals who exhibited repressive coping behavior--as measured by the discrepancy between affective experience and sympathetic nervous system response--had fewer symptoms of psychopathology, experienced fewer health problems and somatic complaints, and were rated as better adjusted by close friends than those who did not exhibit repressive coping. Results are discussed in terms of recent developments in cognitive and neuroimaging research suggesting that repressive coping may serve a protective function.",0,0 +5835,Best Practice in Responding to Critical Incidents and Potentially Traumatic Experience within an Organisational Setting,"This chapter addresses best practice for organisational support after critical incidents and traumatic events within social work. Critical incidents are situations and incidents within workplace settings or roles, which, whilst able to be anticipated and planned for, have the potential to create a sense of emergency, crisis, and extreme stress, or have a traumatic impact on those directly or indirectly affected. Alongside the notion of critical incidents are concepts of debriefing, psychological debriefing, Critical Incident Stress Debriefing (CISD), and Critical Incident Stress Management (CISM). Debate about debriefing models has concerned their effectiveness and safety; the terms being loaded with meaning and tensions between scientific and holistic paradigms and between academic and practitioner perspectives. The chapter suggests areas of research and exploration for agency managers and senior practitioners wishing to make sense of the debates and enables the reader to consider best practice for critical incident response within organisational settings.",0,0 +5836,"Physiotherapists' Beliefs About Whiplash‐associated Disorder: A Comparison Between Singapore and Queensland, Australia","Healthcare providers' beliefs may play a role in the outcome of whiplash-associated disorders (WAD), a condition which is proposed to be culturally dependent. Clinical practice guidelines recommend an active approach for the management of WAD, which is often delivered by physiotherapists. However, there is no data on physiotherapists' whiplash beliefs. Our primary objective was to determine physiotherapists' beliefs from Queensland (Australia) and Singapore, two cultures with differing prevalence of chronic musculoskeletal pain and chronic WAD.A pen and paper survey of musculoskeletal physiotherapists practicing in Queensland and Singapore was conducted. Participants completed questionnaires consisting of patient vignettes and statements inquiring knowledge and attitudes towards WAD. Chi-square tests of significance were used to compare the responses of physiotherapists from both samples.Ninety-one (response rate 45%) Queensland-based and 94 (response rate 98%) Singapore-based physiotherapists participated in the study. The beliefs in the management strategies for the patient vignettes were generally consistent with practice guidelines. A higher proportion of Queensland-based physiotherapists expected permanent disabilities for the patient vignette depicting chronic WAD (Queensland: 55% Singapore: 28% Pearson chi-sq 18.76, p < 0.005).Up to 99% of the physiotherapists from both samples believed in encouragement of physical activity, the effectiveness of exercise and multimodal physiotherapy for WAD. Significantly higher proportions of Singapore-based physiotherapists believed in ordering radiographs for acute WAD (Pearson chi-sq 41.98, p < 0.001) and also believed in a psychogenic origin of chronic WAD (Pearson chi-sq 22.57, p 0.001).The majority of beliefs between physiotherapists in Queensland and Singapore were similar but there were specific differences. Physiotherapists' whiplash beliefs in Queensland and Singapore did not clearly reflect the difference in prevalence of chronic musculoskeletal pain or chronic WAD in Queensland and Singapore.",0,0 +5837,Anger problem profiles among partner violent men: Differences in clinical presentation and treatment outcome.,"Cluster analysis of 139 partner violent men's self-reports on the State-Trait Anger Expression Inventory identified profiles reflecting pathological anger (PA), low anger control (LAC), and normal anger (NA). The PA group self-reported higher pretreatment partner abuse, interpersonal dysfunction, distress, and substance abuse and had lower treatment attendance than the NA and LAC groups. Collateral (victim) partners reported higher pretreatment abuse by the PA and LAC groups than the NA group. At posttreatment and 6-month follow-up, the PA group had the highest levels of physical assault and injury. The LAC group exceeded the NA group in physical assault at posttreatment and psychological aggression at posttreatment and follow-up. The recognition of distinct anger problem profiles may lead to new strategies for research and practice.",0,0 +5838,"The Comorbidity of Self-Reported Chronic Fatigue Syndrome, Post-Traumatic Stress Disorder, and Traumatic Symptoms","Background Data from primary care and community samples suggest higher rates of post-traumatic stress disorder (PTSD) among individuals with chronic fatigue syndrome (CFS). Objective This study investigated the co-occurrence of CFS, PTSD, and trauma symptoms and assessed the contribution of familial factors to the association of CFS with lifetime PTSD and current traumatic symptoms. Method Data on lifetime CFS and PTSD, as measured by self-report of a doctor's diagnosis of the disorder, and standardized questionnaire data on traumatic symptoms, using the Impact of Events Scale (IES), were obtained from 8544 female and male twins from the community-based University of Washington Twin Registry. Results Lifetime prevalence of CFS was 2% and lifetime prevalence of PTSD was 4%. Participants who reported a history of PTSD were over eight times more likely to report a history of CFS. Participants with scores ≥ 26 on the IES were over four times more likely to report CFS than those who had scores ≤ 25. These associations were attenuated but remained significant after adjusting for familial factors through within-twin pair analyses. Conclusion These results support similar findings that a lifetime diagnosis of CFS is strongly associated with both lifetime PTSD and current traumatic symptoms, although familial factors, such as shared genetic and environmental contributions, played a limited role in the relationship between CFS, PTSD, and traumatic symptoms. These findings suggest that future research should investigate both the familial and the unique environmental factors that may give rise to both CFS and PTSD.",0,0 +5839,Systematic Review: A Reevaluation and Update of the Integrative (Trajectory) Model of Pediatric Medical Traumatic Stress,"The objective of this systematic review is to reevaluate and update the Integrative Model of Pediatric Medical Traumatic Stress (PMTS; Kazak et al., 2006), which provides a conceptual framework for traumatic stress responses across pediatric illnesses and injuries.Using established systematic review guidelines, we searched PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and PubMed (producing 216 PMTS papers published since 2005), extracted findings for review, and organized and interpreted findings within the Integrative Model framework.Recent PMTS research has included additional pediatric populations, used advanced longitudinal modeling techniques, clarified relations between parent and child PMTS, and considered effects of PMTS on health outcomes. Results support and extend the model's five assumptions, and suggest a sixth assumption related to health outcomes and PMTS.Based on new evidence, the renamed Integrative Trajectory Model includes phases corresponding with medical events, adds family-centered trajectories, reaffirms a competency-based framework, and suggests updated assessment and intervention implications.",0,0 +5840,Factor structure of posttraumatic stress disorder symptoms in the Australian general population,"The tripartite model of posttraumatic stress disorder (PTSD) articulated in DSM-IV has received limited empirical support. Over the past decade, a burgeoning literature on PTSD symptom structure has accumulated suggesting several alternative models. Elucidating the latent structure of PTSD has important clinical and theoretical implications. This paper presents the first confirmatory factor analytic investigation of PTSD symptoms in an epidemiologically based trauma-exposed sample from Australia. Data from a subsample of respondents from the 2007 National Survey of Mental Health and Wellbeing (NSMHWB; n=2677) were submitted to confirmatory factor analysis and several alternative conceptual models were tested. Empirical support was found for an intercorrelated four-factor model reflecting re-experiencing, avoidance, dysphoria, and hyperarousal symptoms. Given that the DSM is currently under revision, research addressing structural validity concerns is especially timely. The present findings renew calls in the structural literature suggesting that the structure of PTSD should be revised in DSM-V.",0,0 +5841,Posttraumatic Stress Disorder and Other Psychological Sequelae Among World Trade Center Clean Up and Recovery Workers,"We assessed the health of workers exposed to the World Trade Center (WTC) site and of a comparison group of unexposed workers, by means of a mail survey. Exposed workers reported higher frequency of symptoms consistent with posttraumatic stress disorder (PTSD), depression, anxiety, and other psychological problems, approximately 20 months after the disaster. PTSD was positively associated with traumatic on-site experiences and with respiratory problems. These findings may have important clinical and public health implications.",0,0 +5842,"Beyond fear, helplessness, and horror: Peritraumatic reactions associated with posttraumatic stress symptoms among traumatized delinquent youth.","This study investigated associations among peritraumatic reactions, including the triad of fear, helplessness, and horror specified in Criterion A2 of the DSM-IV-R, and posttraumatic stress disorder (PTSD) diagnostic status and symptom severity among a sample of 555 juvenile justice-involved adolescents (188 girls and 367 boys). Results of hierarchical and logistic regression analyses indicated that, with the exception of helplessness, peritraumatic reactions beyond the DSM-IV-R triad, particularly disorganized behavior and confusion, were more strongly associated with PTSD diagnosis and symptoms among these youth than were the A2 criteria. Gender differences also emerged in the pattern of results, with disorganized behavior and dissociation associated more strongly with PTSD symptom levels among girls than boys. In addition, investigation of the relations between peritraumatic reactions and the recently proposed 5-factor model of PTSD symptom clusters showed that peritraumatic disorganization was the most consistently associated with PTSD symptoms, whereas peritraumatic helplessness was uniquely associated with Numbing among boys and Dissociation among girls. These results have implications for informing the DSM-5 as well as adding to the evidence base for deriving developmentally sensitive criteria for the diagnosis of PTSD among youth exposed to trauma.",0,0 +5843,Neuropsychological functioning of combat veterans with posttraumatic stress disorder and mild traumatic brain injury,"This study examined the neuropsychological performance of 125 outpatient Operation Enduring Freedom/Operation Iraqi Freedom combat veterans with posttraumatic stress disorder (PTSD) and nonacute mild traumatic brain injury (TBI) (n = 66) and PTSD (n = 59) across multiple cognitive domains to determine whether mild TBI results in greater impairment among those with PTSD. Profile analyses revealed that veterans with PTSD and mild TBI did not differ significantly from those with just PTSD across domains, suggesting that comorbid mild TBI does not result in an additive effect. A norms-based comparison also revealed that neither group demonstrated impaired performance on any of the objective neuropsychological measures examined. However, both groups endorsed moderately elevated symptoms of depression and anxiety, indicating that comorbid psychopathology may contribute to subjective cognitive complaints.",0,0 +5844,Second-generation structural equation modeling with a combination of categorical and continuous latent variables: New opportunities for latent class–latent growth modeling.,,0,0 +5845,Posttraumatic Stress Disorder and Psychosocial Functioning after Severe Traumatic Brain Injury,"The aim of this study was to investigate the influence of posttraumatic stress disorder (PTSD) on rehabilitation after severe traumatic brain injury (TBI). Ninety-six patients with severe TBI patients were assessed 6 months after hospital discharge with the Posttraumatic Stress Disorder Interview, the Functional Assessment Measure (FAM), the Community Integration Questionnaire (CIQ), the Overt Aggression Scale (OAS), the General Health Questionnaire (GHQ), the Beck Depression Inventory (BDI), and the Satisfaction with Life Scale (SWL). PTSD was diagnosed in 27% of patients. Patients with PTSD reported higher scores on the GHQ and BDI, and lower scores on the FAM, CIQ, OAS, and SWLS than those without PTSD. Effective rehabilitation after severe TBI may be enhanced by management of PTSD.",0,0 +5846,Responsivity to Stress in Chronic Posttraumatic Stress Disorder Due to Childhood Sexual Abuse,"The purpose of this study was to investigate psychological, cardiovascular, and neuroendocrine reactivity to standardized stress tests (orthostatic challenge, Stroop Color Word Test) in drug-free adult women with chronic PTSD due to repetitive childhood sexual abuse. At baseline, the 11 patients showed significantly higher mean scores on the Symptom Check List-90 and the Profile of Mood States than 13 healthy female controls, whereas baseline cardiovascular or hormonal parameters showed no differences between the groups. Also, no significant differences were found between the two groups in cardiovascular and hormonal responsivity to the stress tests. Thus, in the presence of robust psychological differences, the patients with chronic PTSD due to childhood sexual abuse did not show alterations in baseline values of neurobiological parameters, nor did they react differently to a physical and mental stress test when compared to healthy controls.",0,0 +5847,Mental health following traumatic injury: Toward a health system model of early psychological intervention,"In 2005, over 2 million people in the United States of America were hospitalised following non-fatal injuries. The frequency with which severe injury occurs renders it a leading cause of posttraumatic stress disorder and other trauma-related psychopathology. In order to develop a health system model of early psychological intervention for this population, we review the literature that pertains to mental health early intervention. The relevant domains include prevalence of psychopathology following traumatic injury, the course of symptoms, screening, and early intervention strategies. On the basis of available evidence, we propose a health system model of early psychological intervention following traumatic injury. The model involves screening for vulnerability within the hospital setting, follow-up screening for persistent symptoms at one month posttrauma, and early psychological intervention for those who are experiencing clinical impairment. Recommendations are made to facilitate tailoring early intervention psychological therapies to the special needs of the injury population.",0,0 +5848,Evaluation of the Dimensions of Anger Reactions-5 (DAR-5) Scale in combat veterans with posttraumatic stress disorder,"After a traumatic event many people experience problems with anger which not only results in significant distress, but can also impede recovery. As such, there is value to include the assessment of anger in routine post-trauma screening procedures. The Dimensions of Anger Reactions-5 (DAR-5), as a concise measure of anger, was designed to meet such a need, its brevity minimizing the burden on client and practitioner. This study examined the psychometric properties of the DAR-5 with a sample of 163 male veterans diagnosed with Posttraumatic Stress Disorder. The DAR-5 demonstrated internal reliability (α=.86), along with convergent, concurrent and discriminant validity against a variety of established measures (e.g., HADS, PCL, STAXI). Support for the clinical cut-point score of 12 suggested by Forbes et al. (2014, Utility of the dimensions of anger reactions-5 (DAR-5) scale as a brief anger measure. Depression and Anxiety, 31, 166-173) was observed. The results support considering the DAR-5 as a preferred screening and assessment measure of problematic anger.",0,0 +5849,MOSAIC (MOthers' Advocates In the Community): protocol and sample description of a cluster randomised trial of mentor mother support to reduce intimate partner violence among pregnant or recent mothers,"Intimate partner violence (IPV) is prevalent globally, experienced by a significant minority of women in the early childbearing years and is harmful to the mental and physical health of women and children. There are very few studies with rigorous designs which have tested the effectiveness of IPV interventions to improve the health and wellbeing of abused women. Evidence for the separate benefit to victims of social support, advocacy and non-professional mentoring suggested that a combined model may reduce the levels of violence, the associated mental health damage and may increase a woman's health, safety and connection with her children. This paper describes the development, design and implementation of a trial of mentor mother support set in primary care, including baseline characteristics of participating women.MOSAIC (MOtherS' Advocates In the Community) was a cluster randomised trial embedded in general practice and maternal and child health (MCH) nursing services in disadvantaged suburbs of Melbourne, Australia. Women who were pregnant or with infants, identified as abused or symptomatic of abuse, were referred by IPV-trained GPs and MCH nurses from 24 general practices and eight nurse teams from January 2006 to December 2007. Women in the intervention arm received up to 12 months support from trained and supported non-professional mentor mothers. Vietnamese health professionals also referred Vietnamese women to bilingual mentors in a sub-study. Baseline and follow-up surveys at 12 months measured IPV (CAS), depression (EPDS), general health (SF-36), social support (MOS-SF) and attachment to children (PSI-SF). Significant development and piloting occurred prior to trial commencement. Implementation interviews with MCH nurses, GPs and mentors assisted further refinement of the intervention. In-depth interviews with participants and mentors, and follow-up surveys of MCH nurses and GPs at trial conclusion will shed further light on MOSAIC's impact.Despite significant challenges, MOSAIC will make an important contribution to the need for evidence of effective partner violence interventions, the role of non-professional mentors in partner violence support services and the need for more evaluation of effective health professional training and support in caring for abused women and children among their populations.ACTRN12607000010493.",0,0 +5850,"Abuse‐Related Post‐Traumatic Stress, Coping, and Tobacco Use in Pregnancy","pregnancy cessation PTSD abuse coping ABSTRACT Objective: To examine the relationship between trauma history, posttraumatic stress disorder (PTSD), coping, and smoking in a diverse sample of pregnant women, some of whom are active smokers. Design: Secondary analysis from a prospective study on PTSD and pregnancy outcomes. Setting: Maternity clinics at three health systems in the midwestern United States. Participants: Women age 18 or older (1,547) interviewed at gestational age fewer than 28 weeks. Methods: Participants were classified at nonsmokers, quitters (stopped smoking during pregnancy), and pregnancy smokers. Demographic, trauma, and pregnancy factors, substance use, and use of tobacco to cope were compared across groups. Logistic regression assessed the influence of these factors on being a smoker versus a nonsmoker and a quitter versus a pregnancy smoker. Results: Smokers differed from nonsmokers on all demographic risk factors (being African American, being preg- nant as a teen, having lower income and less education, and living in high-crime areas), had higher rates of current and lifetime PTSD, and were more likely to report abuse as their worst trauma. Pregnancy smokers had lower levels of education, were more likely to classify their worst trauma as ''extremely troubling,'' and were more likely to exhibit PTSD hyperarousal symptoms. In regression models, smoking ''to cope with emotions and problems'' doubled the odds of continuing to smoke while pregnant even after accounting for several relevant risk factors.",0,0 +5851,Personality Profiles of Intimate Partner Violence Offenders With and Without PTSD,"Intimate partner violence (IPV) is a serious forensic and clinical problem throughout the United States. Research aimed at defining and differentiating subgroups of IPV offenders using standardized personality instruments may eventually help with matching treatments to specific individuals to reduce recidivism. The current study used a convenience sample of court-ordered IPV offenders to explore whether the presence of posttraumatic stress disorder (PTSD) can reliably differentiate this population in terms of personality characteristics and clinical symptoms. Profile analysis showed meaningful differences between PTSD (n = 22), non-PTSD (n = 43), and nontrauma (n = 13) groups on a variety of Millon Clinical Multiaxial Inventory and Personality Assessment Inventory personality and clinical scales. The PTSD group reported significantly less IPV than the non-PTSD and nontrauma groups, as well as endorsing greater overall distress, greater symptoms of anxiety, and greater symptoms of depression across instrum...",0,0 +5852,Symptom experience during acute coronary syndrome and the development of posttraumatic stress symptoms,"There is growing evidence for the development of posttraumatic stress symptoms as a consequence of acute cardiac events. Acute coronary syndrome (ACS) patients experience a range of acute cardiac symptoms, and these may cluster together in specific patterns. The objectives of this study were to establish distinct symptom clusters in ACS patients, and to investigate whether the experience of different types of symptom clusters are associated with posttraumatic symptom intensity at six months. ACS patients were interviewed in hospital within 48 h of admission, 294 patients provided information on symptoms before hospitalisation, and cluster analysis was used to identify patterns. Posttraumatic stress symptoms were assessed in 156 patients at six months. Three symptom clusters were identified; pain symptoms, diffuse symptoms and symptoms of dyspnea. In multiple regression analyses, adjusting for sociodemographic, clinical and psychological factors, the pain symptoms cluster (β = .153, P = .044) emerged as a significant predictor of posttraumatic symptom severity at six months. A marginally significant association was observed between symptoms of dyspnea and reduced intrusive symptoms at six months (β = -.156, P = .061). Findings suggest acute ACS symptoms occur in distinct clusters, which may have distinctive effects on intensity of subsequent posttraumatic symptoms. Since posttraumatic stress is associated with adverse outcomes, identifying patients at risk based on their symptom experience during ACS may be useful in targeting interventions.",0,0 +5853,Psychosocial treatment of posttraumatic stress disorder,"A review of the psychosocial treatment research literature indicates that several forms of therapy appear to be useful in reducing the symptoms of posttraumatic stress disorder (PTSD). Strongest support is found for the treatments that combine cognitive and behavioral techniques. Hypnosis, psychodynamic, anxiety management, and group therapies may also produce short-term symptom reduction. Still unknown is whether any approach produces lasting effects. Imaginal exposure to trauma memories and hypnosis are techniques most likely to affect the intrusive symptoms of PTSD, whereas cognitive and psychodynamic approaches may better address the numbing and avoidance symptom cluster. Treatment should be tailored to the severity and type of presenting PTSD symptoms, to the type of trauma experience, and to the many likely comorbid diagnoses and adjustment problems. © 1997 John Wiley & Sons, Inc.",0,0 +5854,Dissociation and Posttraumatic Stress Disorder: A Latent Profile Analysis,"The fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, ) contains a dissociative subtype for posttraumatic stress disorder (PTSD) characterized by significant depersonalization and derealization. In this study the PTSD dissociative subtype was examined using latent profile analysis in a sample of 541 trauma-exposed college students. Items from the PTSD Checklist and Multiscale Dissociation Inventory were used as latent class indicators. Results supported a 3-class solution including a well-adjusted class, a PTSD class, and a PTSD/dissociative class characterized by elevated symptoms of PTSD, depersonalization, and derealization. Significant class differences were found on a number of measures of related psychopathology with Cohen's d effect size estimates ranging from 0.04 to 1.86. Diagnostic and treatment implications regarding the dissociative subtype are discussed.",0,0 +5855,Epigenetic Signatures May Explain the Relationship between Socioeconomic Position and Risk of Mental Illness: Preliminary Findings from an Urban Community-Based Sample,"Low socioeconomic position (SEP) has previously been linked to a number of negative health indicators, including poor mental health. The biologic mechanisms linking SEP and mental health remain poorly understood. Recent work suggests that social exposures influence DNA methylation in a manner salient to mental health. We conducted a pilot investigation to assess whether SEP, measured as educational attainment, modifies the association between genomic methylation profiles and traumatic stress in a trauma-exposed sample. Results show that methylation × SEP interactions occur preferentially in genes pertaining to nervous system function, suggesting a plausible biological pathway by which SEP may enhance sensitivity to stress and, in turn, risk of posttraumatic stress disorder.[Supplementary materials are available for this article. Go to the publisher's online edition of Biodemography and Social Biology for the following free supplemental resource: Supplementary tables of full model and functional annotation clustering results.].",0,0 +5856,Ontogenetic Perspectives on the Neurobiological Basis of Psychopathology Following Abuse and Neglect,"Introduction The US Federal Child Abuse Prevention and Treatment Act defines child abuse and neglect as the recent act or failure of parents and caretakers resulting in physical or emotional injury, sexual exploitation, and/or death. According to national statistics on the prevalence of childhood abuse and neglect in the United States, 905,000 people under 18 years of age were victimized during 2006. Of these, 64.1% were neglected; 16.0% were physically abused; and 15.1% suffered abandonment, threats of harm, congenital drug addiction, or other forms of maltreatment. Furthermore, 8.8% were sexually abused; 6.6% were either emotionally or psychologically maltreated; and 2.2% were medically neglected. Childhood maltreatment is a major risk factor for the development of depression, drug and alcohol abuse, posttraumatic stress disorder (PTSD), bipolar disorder (BPD), personality disorders, and aggression. Depending on an individual's sex, genetic makeup, and age at insult, chronic childhood traumatic stress (CTS) alters the endocrine profile and gene-expression pattern, as well as the functional activity, hemispheric integration, and morphology of the brain. In this chapter, we offer a holistic portrayal of the pathways between maltreatment and adverse psychiatric outcomes, arguing that the impact of abuse and neglect is best understood in the context of normal ontogenetic processes relating to trajectories of brain development. Neuropsychiatric Effects Of Trauma Several studies have documented the consequences of exposure to CTS. One of the most compelling is the Adverse Childhood Experience (ACE) Study, led by Vincent Felitti and Robert Anda (Felitti et al., 1998). © Cambridge University Press 2010.",0,0 +5857,Long term course of chronic posttraumatic stress disorder in traffic accident victims: a three-year prospective follow-up study,"The purpose of the present study was to gather prospective longitudinal data on the long-term course and outcome of chronic posttraumatic stress disorder (PTSD). The target population for this study was 74 injured traffic accident victims who had been previously followed-up for one year after the trauma. Nineteen of the original 24 PTSD subjects (79%) and 39 of the original 50 Non-PTSD subjects (78%) were available for this study, which took place during the fourth year after the accident. Our results show that 10 (53%) of the 19 patients with PTSD at one-year still suffered from PTSD after another two-year follow-up interval, while 9 recovered from PTSD during this follow-up period. Only 2 of the 39 without PTSD at one year developed delayed onset PTSD. The best predictor of recovery from chronic PTSD was the initial level of posttraumatic reaction immediately after the accident. These results demonstrate that spontaneous recovery from PTSD can occur even among patients who are currently considered chronic. Severity of initial reaction to the trauma appears to be a major risk factor for non-remitting chronic PTSD.",0,0 +5858,A comparison of posttraumatic stress disorder and posttraumatic growth in *American and Israeli war veterans,"Over 50% of people experience a traumatic event during their lifetimes (Del, Kevin, Scotti, & Chen, 2006). These traumas may include, rape, a car accident, diagnosis of a chronic illness or military combat (Tedeschi & Calhoun, 2004). The trauma may have no impact on the individual, a negative effect, known as posttraumatic stress disorder (PTSD) or a positive effect, known as posttraumatic growth (PTG). The research has shown that positive and negative responses to a trauma may co-exist (Tedeschi & Calhoun 1995). Extensive research has been conducted examining the negative impact war has on veterans (Elder & Clipp, 1989; Erbes, Dikel, & Eberly, 2006; Solomon & Mikulincer, 1987). However, little research has focused on the positive outcomes veterans may exhibit due to their war experience. The purpose of the current study was to determine if there were significant differences in PTSD and PTG between war veterans in the United States of America and Israel. The current study focused on differences between the value systems of the two cultures and the amount of perceived social support within the two cultures as possible variables contributing to the differences in PTSD and PTG. Additionally, the current study examined veteran type, age, sex, marital status, branch of military served, years of military experience and employment status as possible predictor variables in the experience of PTSD and PTG. A total of 137 war veterans (70 America and 67 Israeli) participated in this study. Each participant completed several self-report questionnaires. The following measures were included: a demographics questionnaire, the Posttraumatic Stress Disorder Checklist-Military (PCL-M; Weathers, Litz, Herman, Huska & Keane, 1993), the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996), the Multidimensional Scale of Perceived Social Support (MSPSS; Zimet, Dahlem, Zimet, & Farley, 1988), and the Schwartz Value Scale (SVS; Schwartz, 1992). It was hypothesized that there would be a significant difference in the cultural values exhibited between American war veterans and Israeli war veterans. Results supported this hypothesis. However, further analyses demonstrated that veteran type (American or Israeli) was not a significant predictor in the experience of PTSD or PTG. In addition, perceived social support did not mediate the relationships between veteran type and PTSD and veteran type and PTG. Additional findings provided evidence for the experience of PTG in Israel in the same five-factor model found in the United States. Results indicated that within this study younger veterans were more likely to report higher levels of PTSD than older veteran and veterans with more years of military service were more likely to report higher levels of PTSD than veterans with less years of military service. Further, results demonstrated that female veterans were more likely to report higher levels of PTG than male veterans and that married veterans were more likely to report higher levels of PTG than single veterans. Results indicated veterans from the Air Force were less likely to experience PTSD and PTG than veterans from the other branches of military. Implications, limitations and directions for future research were presented. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5859,Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis.,,0,0 +5860,"Political violence, health, and coping among Palestinian women in the West Bank.","Political violence poses a considerable threat to the health of individuals. Protective factors, however, may help people to build resilience in the face of political violence. This study examined the influence of lifetime and past 30-day experiences of political violence on the mental and physical health of adult Palestinian women from the West Bank (N = 122). Two hypotheses were examined: (a) Reports of political violence exposure would be related to reports of poorer physical and mental health and (b) several coping variables (proactive coping; self-reliance; reliance on political, family, and religious support; and political or civic engagement) would function as moderators of the effects of political violence, buffering or weakening its effects on physical and mental health outcomes. Both lifetime and past 30-day measures of political violence were positively correlated with posttraumatic stress disorder symptoms. Proactive coping, reliance on self, and political or civic engagement significantly interacted with political violence to affect health in a counterintuitive direction; those with higher scores on these more internalized and individualistic coping strategies demonstrated worse health as political violence increased. Reliance on religious support, and, in particular, support from and participation in activities of religious institutions, emerged as a significant protective factor. Results underscore the importance of looking not only at whether political violence affects health, but also at how the relationships between political violence and health might occur, including the potential protective influence of resources within people's social environments.",0,0 +5861,Red/near-infrared light-emitting diode therapy for traumatic brain injury,"This invited paper reviews our research with scalp application of red/near-infrared (NIR) light-emitting diodes (LED) to improve cognition in chronic, traumatic brain injury 1. Application of red/NIR light improves mitochondrial function (especially hypoxic/compromised cells) promoting increased ATP, important for cellular metabolism. Nitric oxide is released locally, increasing regional cerebral blood flow. Eleven chronic, mTBI participants with closed-head injury and cognitive dysfunction received 18 outpatient treatments (MWF, 6 Wks) starting at 10 Mo. to 8 Yr. post-mTBI (MVA, sports-related, IED blast injury). LED therapy is non-invasive, painless, non-thermal (FDA-cleared, non-significant risk device). Each LED cluster head (2.1 diameter, 500mW, 22.2mW/cm2) was applied 10 min (13J/cm2) to 11 scalp placements: midline, from front-to-back hairline; and bilaterally on dorsolateral prefrontal cortex, temporal, and parietal areas. Testing performed pre- and post-LED (+1 Wk, 1 and 2 Mo post- 18th treatment) showed significant linear trend for LED effect over time, on improved executive function and verbal memory. Fewer PTSD symptoms were reported. New studies at VA Boston include TBI patients treated with transcranial LED (26J/cm2); or treated with only intranasal red, 633nm and NIR, 810nm diodes placed into the nostrils (25 min, 6.5mW, 11.4J/cm2). Intranasal LEDs are hypothesized to deliver photons to hippocampus. Results are similar to Naeser et al. (2014). Actigraphy sleep data show increased sleep time (average, +1 Hr/night) post-18th transcranial or intranasal LED treatment. LED treatments may be self-administered at home (Naeser et al., 2011). A shamcontrolled study with Gulf War Illness Veterans is underway.",0,0 +5862,A different kind of comorbidity: Understanding posttraumatic stress disorder and chronic pain.,"Many traumatic events leave lingering physical injuries and chronic pain in their wake, in addition to trauma-related psychopathology. In this review, we provide an overview of developments in the recent literature on co-morbid posttraumatic stress disorder (PTSD) and chronic pain. Starting with the conceptual models presented by Sharp and Harvey (2001) and Asmundson, Coons, Taylor, and Klatz (2002), this review summarizes newer studies that examine prevalence of these co-morbid conditions. Additionally, we present an updated synthesis of research on factors that may maintain both chronic physical pain and PTSD in trauma survivors. Consideration of the impact of this co-morbidity on psychosocial assessment and treatment also is discussed, with particular attention to issues that warrant additional research.",0,0 +5863,Growth Curve Analysis in Contemporary Psychological Research,"The term “growth curve” is used to describe data where: (1) the same entities are repeatedly observed, (2) the same procedures of measurement and scaling of observations are used, and (3) the timing of the observations is known. Growth curves are now common in many areas of psychological research, and some of these are presented here. The term “growth curve analysis” denotes the processes of describing, testing hypotheses, and making scientific inferences about the growth and change patterns in a wide range of time-related phenomena. In this sense, growth curve analyses are a specific form of the larger set of developmental and longitudinal research methods, but the unique features of growth data permit unique kinds of analyses. Formal models for the analysis of growth curves which have been developed in many different substantive domains are described here in five sections: (1) An introduction to growth curves, (2) linear models of growth, (3) multiple groups in growth curve models, (4) aspects of dynamic theory for growth models, and (5) multiple variables in growth curve analyses. We conclude with a discussion of future issues raised by the current growth models.",0,0 +5864,Tobacco use trajectories among a large cohort of treated smokers with posttraumatic stress disorder,"This study identified distinct tobacco use trajectories across 18months in 943 veteran smokers with posttraumatic stress disorder (PTSD) in order to describe quit and relapse patterns, examine associations between trajectory groups on baseline characteristics and cessation service utilization, and explore group differences in mental health outcomes.Veterans who participated in a multisite, randomized trial of integrated smoking cessation care were grouped using k-means clustering based on reported daily tobacco use between baseline and 18months. Four trajectory clusters were identified: no reduction (62%), temporary reduction (11%), late sustained reduction (9%) and early sustained reduction (18%).Median quit times in the early, late, temporary, and no reduction groups were 451, 141.5, 97, and 2days, respectively. Compared to the early reduction group, the temporary reduction group exhibited higher baseline depression (p<0.01) and anxiety (p<0.01), but did not differ in treatment received, with both groups attending significantly more cessation visits (p<0.001) and more likely to receive recommended pharmacotherapy (p<0.001) than the no reduction group between baseline and 6months. The early reduction group exhibited lower depression relative to the no reduction (p<0.01) and temporary reduction (p<0.01) groups across all assessments between baseline and 18months. Differences were not observed between groups in depressive or PTSD symptom change over time between baseline and 18months.Tobacco use trajectories among treated smokers with PTSD vary distinctly. Characteristics of identified subgroups may lead to targeted interventions among smokers with PTSD and potentially other psychiatric disorders.",0,0 +5865,Psychosocial Functioning and Health-Related Quality of Life Associated with Posttraumatic Stress Disorder in Male and Female Iraq and Afghanistan War Veterans: The VALOR Registry,"Iraq and Afghanistan war veterans suffer from high rates of posttraumatic stress disorder (PTSD). Given the growing number of women in the military, there is a critical need to understand the nature and extent of potential gender differences in PTSD-associated psychosocial functioning and health-related quality of life (HRQOL) in Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) veterans, which has not been studied to date.We used data from a gender-balanced national patient registry of warzone-deployed OEF/OIF veterans (Project VALOR: Veterans After-Discharge Longitudinal Registry) to determine the impact of gender on PTSD-related psychosocial functioning and HRQOL in 1,530 United States Iraq and Afghanistan war veterans (50% female) with and without PTSD. Overall psychosocial functioning was assessed with the Inventory of Psychosocial Functioning (IPF) and mental and physical HRQOL with the Veterans RAND 12-item Health Survey (VR-12) Mental and Physical Component Summary scores, respectively. Stratified linear regression models estimated gender-specific associations, controlling for demographic, deployment, and postdeployment factors. Interaction models tested for significant effect moderation by gender.In gender-stratified models, PTSD was strongly associated with higher IPF scores (greater functional impairment), with similar associations by gender. PTSD was also associated with lower Mental Component Summary scores (lower mental HRQOL) in both men and women, with no evidence of effect moderation by gender. PTSD was associated with lower Physical Component Summery scores in women but not men in adjusted models; however, interactions were not significant.PTSD among warzone-deployed OEF/OIF veterans is associated with significant impairments in both overall psychosocial functioning and HRQOL, with associations that are largely similar by gender. Findings support the need for thorough and continuous assessment of functional impairment and HRQOL during treatment of PTSD for both male and female OEF/OIF veterans.",0,0 +5866,Psychiatric and Cognitive Effects of War in Former Yugoslavia,"Although impunity for those responsible for trauma is widely thought to be associated with psychological problems in survivors of political violence, no study has yet investigated this issue.To examine the mental health and cognitive effects of war trauma and how appraisal of redress for trauma and beliefs about justice, safety, other people, war cause, and religion relate to posttraumatic stress responses in war survivors.A cross-sectional survey conducted between March 2000 and July 2002 with a population-based sample of 1358 war survivors who had experienced at least 1 war-related stressor (combat, torture, internal displacement, refugee experience, siege, and/or aerial bombardment) from 4 sites in former Yugoslavia, accessed through linkage sampling. Control groups at 2 study sites were matched with survivors on sex, age, and education.Semi-structured Interview for Survivors of War, Redress for Trauma Survivors Questionnaire, Emotions and Beliefs After War questionnaire, Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).The mean (SD) age was 39 (12) years, 806 (59%) were men, and 339 (25%) had high school or higher level of education. Participants reported experiencing a mean of 12.6 war-related events, with 292 (22%) and 451 (33%) having current and lifetime posttraumatic stress disorder (PTSD), respectively, and 129 (10%) with current major depression. A total of 1074 (79%) of the survivors reported a sense of injustice in relation to perceived lack of redress for trauma. Perceived impunity for those held responsible for trauma was only one of the factors associated with sense of injustice. Relative to controls, survivors had stronger emotional responses to impunity, greater fear and loss of control over life, less belief in benevolence of people, greater loss of meaning in war cause, stronger faith in God, and higher rates of PTSD and depression. Fear and loss of control over life were associated with PTSD and depression (odds ratio [OR], 2.91; 95% CI, 2.27-3.74 and OR, 2.30; 95% CI, 1.75-3.03, respectively), and emotional responses to impunity showed a relatively weaker association with PTSD (OR, 1.53; 95% CI, 1.16-2.02) and depression (OR, 1.39; 95% CI, 1.02-1.91). Appraisal of redress for trauma was not associated with PTSD or depression.PTSD and depression in war survivors appear to be independent of sense of injustice arising from perceived lack of redress for trauma. Fear of threat to safety and loss of control over life appeared to be the most important mediating factors in PTSD and depression. These findings may have important implications for reconciliation efforts in postwar countries and effective interventions for traumatized war survivors.",0,0 +5867,The burden of full and subsyndromal posttraumatic stress disorder among police involved in the World Trade Center rescue and recovery effort,"This study examined the prevalence, correlates, and perceived mental healthcare needs associated with subsyndromal PTSD in police involved in the World Trade Center (WTC) rescue and recovery effort.A total of 8466 police completed an interview/survey as part of the WTC Medical monitoring and Treatment Program an average of four years after 9/11/2001.The past month prevalence of full and subsyndromal WTC-related PTSD was 5.4% and 15.4%, respectively. Loss of someone or knowing someone injured on 9/11 (odds ratios [ORs]=1.56-1.86), pre-9/11 stressors (ORs=1.30-1.50), family support (ORs=0.83-0.94), and union membership (ORs=0.50-0.52) were associated with both full and subsyndromal PTSD. Exposure to the dust cloud (OR=1.36), performing search and rescue work (OR=1.29), and work support (OR=0.89) were additionally associated with subsyndromal PTSD. Rates of comorbid depression, panic disorder, and alcohol use problems (ORs=3.82-41.74), and somatic symptoms and functional difficulties (ORs=1.30-1.95) were highest among police with full PTSD, with intermediate rates among police with subsyndromal PTSD (ORs=2.93-7.02; and ORs=1.18-1.60, respectively). Police with full and subsyndromal PTSD were significantly more likely than controls to report needing mental healthcare (41.1% and 19.8%, respectively, versus 6.8% in trauma controls).These results underscore the importance of a more inclusive and dimensional conceptualization of PTSD, particularly in professions such as police, as operational definitions and conventional screening cut-points may underestimate the psychological burden for this population. Accordingly, psychiatric clinicians should assess for disaster-related subsyndromal PTSD symptoms in disaster response personnel.",0,0 +5868,Children’s Disaster Reactions: the Influence of Exposure and Personal Characteristics,"This paper reviews children's reactions to disasters and the personal and situational factors that influence their reactions. Posttraumatic stress disorder (PTSD) and posttraumatic stress reactions are the most commonly studied outcomes, though other conditions also occur including anxiety, depression, behavior problems, and substance use. More recently, traumatic grief and posttraumatic growth have been explored. New research has delineated trajectories of children's posttraumatic stress reactions and offered insight into the long-term consequences of their disaster experiences. Risk factors for adverse outcomes include pre-disaster vulnerabilities, perception of threat, and loss and life disruptions post-disaster. Areas in need of additional research include studies on the timing and course of depression and anxiety post-event and their interactions with other disorders, disaster-related functional and cognitive impairment, positive outcomes, and coping.",0,0 +5869,The presence of resilience is associated with a healthier psychological profile in intensive care unit (ICU) nurses: Results of a national survey,"ICU nurses are repeatedly exposed to work related stresses resulting in the development of psychological disorders including posttraumatic stress disorder and burnout syndrome. Resilience is a learnable multidimensional characteristic enabling one to thrive in the face of adversity. In a national survey, we sought to determine whether resilience was associated with healthier psychological profiles in intensive care unit nurses.Surveys were mailed to 3500 randomly selected ICU nurses across the United States and included: demographic questions, the Posttraumatic Diagnostic Scale, Hospital Anxiety and Depression Scale, Maslach Burnout Inventory and the Connor-Davidson Resilience Scale.Overall, 1239 of the mailed surveys were returned for a response rate of 35%, and complete data was available on a total of 744 nurses. Twenty-two percent of the intensive care unit nurses were categorized as being highly resilient. The presence of high resilience in these nurses was significantly associated with a lower prevalence of posttraumatic stress disorder, symptoms of anxiety or depression, and burnout syndrome (<0.001 for all comparisons). In independent multivariable analyses adjusting for five potential confounding variables, the presence of resilience was independently associated with a lower prevalence of posttraumatic stress disorder (p<0.001), and a lower prevalence of burnout syndrome (p<0.001).The presence of psychological resilience was independently associated with a lower prevalence of posttraumatic stress disorder and burnout syndrome in intensive care unit nurses. Future research is needed to better understand coping mechanisms employed by highly resilient nurses and how they maintain a healthier psychological profile.",0,0 +5870,Mild Traumatic Brain Injury and Posttraumatic Stress Disorder: Clinical and Conceptual Complexities,"The wars in Iraq and Afghanistan have raised public con-sciousness of traumatic brain injury (TBI) and posttraumaticstress disorder (PTSD), two of the most common healthconsequences of contemporary military deployment. TBI andPTSD may each in their own right exert a toll on affectedindividuals. Within the war zone, however, brain injury oftenoccurs within a broader context of extreme psychologicalstress (i.e., traumatic stress). Th e same dangerous circumstances(e.g., combat, encounters with improvised explosive devices)that lead to increased risk of TBI also place service membersat increased risk for PTSD. Therefore, the prevalence ofPTSD in returning war-zone veterans who have a history ofdeployment-related TBI are elevated, especially when thebrain injury falls at the milder end of the severity range,as is the case with the majority of deployment-relatedTBIs. For example, a RAND study estimated that almost20% of a representative sample of Operation EnduringFreedom/Operation Iraqi Freedom veterans screened positivefor history of mild TBI (mTBI), and that of those reportinga deployment mTBI, approximately 34% also screenedpositive for PTSD (Tanielian & Jaycox, 2008).The comorbidity of mTBI and PTSD is not limited, however,to war-zone veterans. Civilian events such as motor vehicleaccidents and interpersonal ass ault may also be associated withboth TBI and psychological traum a sufficiently severe to lead toPTSD. The prevalence of comorbid mTBI and PTSD is notwell-documented in civilians, but mTBI and/or PTSD eachaffect many civilians. The Centers for Disease Control andPrevention (2010) estimate that over 1.7 million people sustaina TBI each year, and that over 75% of these injuries are mild.A U.S. population-based survey estimated the prevalenceof PTSD in the general population to be at 7–8% (Kessler,Sonnega, Bromet, Hughes, & Nelson, 1995).Despite the relatively high rates of mTBI and PTSD inat-risk populations, much remains unknown about the clinicalconsequences in individuals who have both incurred anmTBI and experience PTSD. The sequelae of mTBI are oftenreferred to as post traumatic or post concussive symptoms.Some post traumatic symptoms (e.g., irritability, neurocog-nitive complaints) overlap with PTSD symptoms, makingdifferential diagnosis difficult. Other conditions commonlyco-occurring with TBI history and PTSD, such as chronicpain, depression, and substance abuse, may further complicatethe clinical presentation of patients with both history of mTBIand PTSD. As a result, considerablechallengesarise inregardsto both the assessment and clinical management of patientswith co-morbid mTBI and PTSD.The field of neuropsychology is well-positioned to tacklemany of the clinical and conceptual challenges posed bycomorbid mTBI and PTSD. This virtual special issue of theJournal of the International Neuropsychological Society (JINS)compiles eight papers on the topic of TBI and/or PTSD thatwere previously published in regular issues of JINS. The papersare for the first time grouped together with the goal of collec-tively addressing the issues con fronting clinicians who assessand care for patients with history of mTBI and PTSD.",0,0 +5871,Global Perspectives on Resilience in Children and Youth,"Global concerns about the consequences of disasters, political violence, disease, malnutrition, maltreatment, and other threats to human development and well-being have sparked a surge of international interest in resilience science. This article highlights progress and issues in research that aims to understand variations in human adaptation to adverse experiences. Two key questions are considered: Why is a new wave of global research on resilience important for developmental science? and Why is developmental science important for global resilience? The conclusion calls for developmental scientists to engage in international efforts to promote resilience.",0,0 +5872,Complex Comorbidity Clusters in OEF/OIF Veterans,"A growing body of research on US Veterans from Afghanistan and Iraq [Operations Enduring and Iraqi Freedom, and Operation New Dawn (OEF/OIF)] has described the polytrauma clinical triad (PCT): traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), and pain. Extant research has not explored comorbidity clusters in this population more broadly, particularly co-occurring chronic diseases.The aim of the study was to identify comorbidity clusters among diagnoses of deployment-specific (TBI, PTSD, pain) and chronic (eg, hypertension, diabetes) conditions, and to examine the association of these clusters with health care utilization and adverse outcomes.This was a retrospective cohort study.The cohort comprised OEF/OIF Veterans who received care in the Veterans Health Administration in fiscal years (FY) 2008-2010.We identified comorbidity using validated ICD-9-CM code-based algorithms and FY08-09 data, followed by which we applied latent class analysis to identify the most statistically distinct and clinically meaningful patterns of comorbidity. We examined the association of these clusters with process measures/outcomes using logistic regression to correlate medication use, acute health care utilization, and adverse outcomes in FY10.In this cohort (N=191,797), we found 6 comorbidity clusters. Cluster 1: PCT+Chronic Disease (5%); Cluster 2: PCT (9%); Cluster 3: Mental Health+Substance Abuse (24%); Cluster 4: Sleep, Amputation, Chronic Disease (4%); Cluster 5: Pain, Moderate PTSD (6%); and Cluster 6: Relatively Healthy (53%). Subsequent health care utilization patterns and adverse events were consistent with disease patterns.These comorbidity clusters extend beyond the PCT and may be used as a foundation to examine coordination/quality of care and outcomes for OEF/OIF Veterans with different patterns of comorbidity.",0,0 +5873,Sleep Problems Among Adolescent Survivors Following the 2008 Wenchuan Earthquake in China: A Cohort Study,"Objective: To examine sleep problems and associated risk factors among adolescent survivors following the 2008 Wenchuan earthquake, the deadliest earthquake to strike China in 30 years. Method: A cohort of students (N = 1,573) in the 7th and 10th grades from Dujiangyan City, 21 kilometers from the epicenter, was followed up periodically for 2 years. Participants were assessed at 12 months (n = 1,398; May 18-22, 2009), 18 months (n = 1,288; November 23-27, 2009), 24 months (n = 1,313; May 17-21, 2010), and 30 months (n = 1,038; November 22-26, 2010) after the earthquake. Adolescents were asked to complete the Pittsburgh Sleep Quality Index (PSQI; cutoff for sleep problems: total score of ≥ 8), Post-Traumatic Stress Disorder Self-Rating Scale (cutoff for probable posttraumatic stress disorder: ≥ 50), Depression Self- Rating Scale for Children (cutoff for depressive disorder: ≥ 15), Screen for Child Anxiety Related Emotional Disorders (cutoff for clinical anxiety: ≥ 25), Social Support Rate Scale, and Adolescent Self-Rating Life Events Checklist and provide demographic information. Trajectory analysis was used to examine sleep disturbance changes and associated risk factors. Results: Twelve months after the earthquake, 48.90% of participants reported sleeping less than 7 hours per night, 27.68% disclosed difficulties initiating sleep, 8.82% experienced problems staying sleep, 22.60% felt their sleep quality was poor, and 40.01% had difficulties functioning during daytime hours. Overall sleep problems, as assessed by the PSQI global scale, were stable from 18 months to 30 months following the earthquake, and the prevalence rates were between 28.79% and 30.18%. The risk of sleep issues was significantly increased in senior high school students (OR = 2.29) and in those who witnessed the tragic events directly (OR = 1.21). Depression (OR = 1.69), anxiety (OR = 1.57), poor social support (OR = 1.83), and negative life events (OR = 2.62) were also associated with increased risk and persistence of sleep problems. Conclusions: Sleep disturbances are common and persistent in adolescent earthquake survivors. Multiple demographic, psychosocial, and earthquake-related factors are associated with the increased risk of sleep difficulties. © 2012",0,0 +5874,Event-related potential dysfunction in posttraumatic stress disorder: the role of numbing,"The purpose of this study was to examine the relationship between disturbance in event-related potentials (ERPs) and symptom clusters in posttraumatic stress disorder (PTSD). ERPs were recorded in 17 unmedicated civilian PTSD patients and 17 age- and sex-matched controls during a conventional auditory oddball task. PTSD symptom clusters (re-experiencing, active avoidance, numbing, hyperarousal) were correlated with ERP measures. The PTSD group showed ERP disturbances to target stimuli (reduced P200 and P300 and increased N200 amplitude, increased N200 and P300 latency) and reduced P200 amplitude to common stimuli compared to the control group. A significant negative correlation was found between the intensity of numbing symptoms and parietal P300 amplitude. This study replicates findings of disturbed N200 and P300 components in PTSD, reflecting impairments in stimulus discrimination and attention. The finding that numbing was associated with reduced attention processing (P300) is consistent with models positing a relationship between disordered arousal and attention in PTSD.",0,0 +5875,Altered functional connectivity in posttraumatic stress disorder with versus without comorbid major depressive disorder: a resting state fMRI study.,"Posttraumatic stress disorder (PTSD) is an anxiety disorder that is often diagnosed with comorbid depressive disorder. Therefore, neuroimaging studies investigating PTSD typically include both patients with and without comorbid depression. Differences in activity of the anterior cingulate cortex (ACC) and insula have been shown to differentiate PTSD patients with and without major depressive disorder (MDD). Whether or not comorbid MDD affects resting state functional connectivity of PTSD patients has not been investigated to our knowledge. Here, resting state functional connectivity of PTSD patients with (PTSD+MDD; n=27) and without (PTSD-MDD; n=23) comorbid MDD was investigated. The subgenual ACC and insula were investigated as seed regions. Connectivity between the subgenual ACC and perigenual parts of the ACC was increased in PTSD+MDD versus PTSD-MDD. Reduced functional connectivity of the subgenual ACC with the thalamus was found in the PTSD+MDD group versus the PTSD-MDD group. These results remained significant after controlling for PTSD severity. In addition, the PTSD+MDD group showed reduced functional connectivity of the insula with the hippocampus compared to the PTSD-MDD group. However, this cluster was no longer significantly different when controlling for PTSD severity. Thus, resting state functional connectivity of the subgenual ACC may distinguish PTSD+MDD from PTSD-MDD. As PTSD patients with comorbid MDD are more treatment resistant, this result may be important for treatment development.",0,0 +5876,Evaluation of Cortical Thickness after Traumatic Brain Injury in Military Veterans,"Military service members frequently sustain traumatic brain injuries (TBI) while on active duty, a majority of which are related to explosive blasts and are mild in severity. Studies evaluating the cortical gray matter in persons with injuries of this nature remain scarce. The purpose of this study was to assess cortical thickness in a sample of military veterans with chronic blast-related TBI. Thirty-eight veterans with mild TBI and 17 veterans with moderate TBI were compared with 58 demographically matched healthy civilians. All veterans with TBI sustained injuries related to a blast and were between 5 and 120 months post-injury (M = 62.08). Measures of post-traumatic stress disorder (PTSD) and depression were administered, along with a battery of neuropsychological tests to assess cognition. The Freesurfer software package was used to calculate cortical thickness of the participants. Results demonstrated significant clusters of cortical thinning in the right hemispheric insula and inferior portions of the temporal and frontal lobe in both mild and moderate TBI participants. The TBI sample from this study demonstrated a high incidence of comorbid PTSD and depression symptoms, which is consistent with the previous literature. Cortical thickness values correlated with measures of PTSD, depression, and post-concussive symptoms. This study provides evidence of cortical thinning in the context of chronic blast-related mild and moderate TBI in military veterans who have comorbid psychiatric symptoms. Our findings provide important insight into the natural progression of long-term cortical change in this population and may have implications for future clinical evaluation and treatment.",0,0 +5877,Discrepancies between clinical needs and helpseeking behaviors in co-occurring posttraumatic stress and alcohol use disorders,"The aim of the study was to compare subjects dually diagnosed with posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) to those with only one or none of these conditions regarding helpseeking needs and behaviors.Data from a large community sample (N=3694) were used to assess the associations among lifetime PTSD and AUD, other psychiatric disorders, clinical characteristics and lifetime helpseeking behaviors derived from a semi-structured interview.Comorbid individuals had more severe clinical profiles and were more impaired than individuals with either PTSD or AUD alone or those with no/other psychiatric conditions. However, they did not differ in overall helpseeking behavior from any other group. Those with comorbid PTSD/AUD were even less likely than the other groups to seek help for depression and anxiety disorders through specific treatment facilities or the use of prescribed psychotropic drugs.Despite a greater need for treatment the comorbid group did not seek more help than the others. Their lower use of prescribed drugs supports the self-medication hypothesis, suggesting that those individuals relieve their symptoms through higher alcohol use instead. Our findings underline the need for health care facilities to encourage helpseeking behavior in the aftermath of stressful life events.",0,0 +5878,Consensus Document on European Brain Research,"Psychiatric and neurological diseases combined represent a considerable social and economic burden in Europe. A recent study conducted by the European Brain Council (EBC) quantified the 'cost and burden' of major brain diseases in Europe, amounting to €386bn per year. Considering that these costs will increase exponentially in the years to come due to ageing of the European population, it is necessary to act now in order to curb this increase and possibly reverse the trend. Thus, establishing a strong European platform supporting basic and clinical research in neuroscience is needed to confront the economic and social challenge posed by management of brain diseases in European countries. To setup a platform for discussion, EBC published in 2006 a Consensus Document on European Brain Research, describing needs and achievements of research in Europe and presenting proposals for future research programs. Since 2006, European research in neuroscience has advanced tremendously. The present document represents an update elaborated to reflect changes in research priorities and advances in brain research that have taken place since 2006. The same approach and format have been used here as in the previous version. Multinational and multidisciplinary teams have once again come together to express their views, not only on the current strengths in European research, but also on what needs to be done in priority, hoping that this update will inspire policy makers and stakeholders in directing funding for research in Europe.",0,0 +5879,Dream Dome: Do dreams shield the psyche in times of continuous stress?,"Results of analysis of 531 dreams, collected from 44 women living near the Gaza Strip in Israel under continuous rocket attacks, are presented. The most frequent themes found are 'Togetherness,' 'Being active,' 'Stress-related situation,' 'Fear and anxiety,' 'Helplessness,' and 'Masochism.' The participants were divided into 3 age groups-Young, Intermediate, and Old-and differences between the occurrence of dream themes in each group were examined. Results indicated high incidence of 'Togetherness' and 'Stress-related situation' themes in the young age group, whereas 'Symbolic' and 'No escape' themes were found to be significantly low in the same age group. On an unconscious level, the young age group seems to be the most vulnerable to the stress-related situation, the old age group is the least influenced by it, and the intermediate group makes the most psychological efforts at coping with it. © 2015 American Psychological Association.",0,0 +5880,Clinical Needs of In-treatment Pregnant Women with Co-occurring Disorders: Implications for Primary Care,"We investigated social vulnerability and behavioral health clinical profiles (symptom severity) of pregnant women with co-occurring disorders, defined as substance abuse, mental illness, and trauma at treatment entry compared to their nonpregnant counterparts and the role of interpersonal abuse in clinical presentation among pregnant women. Our objective was to provide primary health care providers with insight into the needs of pregnant patients with high behavioral health risks to serve them better during the critical window of opportunity for long-term impact. We conducted cross-sectional secondary analysis of baseline data from women enrolled in treatment programs in the Women, Co-occurring Disorders and Violence Study from nine sites across the United States. We used analysis of variance and Cochran-Mantel-Haenszel statistical analyses to compare means and frequencies of social vulnerability indicators and baseline Addiction Severity Index, Brief Symptom Inventory of mental health, and Posttraumatic Stress Diagnostic Scale scores between 152 pregnant and 2,577 nonpregnant women, and between pregnant women with and without current interpersonal abuse. Compared to nonpregnant women, pregnant women evidenced more social vulnerability but better behavioral health clinical profiles at treatment entry. Current interpersonal abuse was associated with increased mental health and trauma symptomatology but not with alcohol or drug abuse severity among pregnant women. The prenatal period is an important time for screening and intervention for factors such as social vulnerability and co-occurring disorders, known to affect pregnancy and infant outcomes; social and behavioral health services are particularly essential among pregnant women with co-occurring disorders. © 2014 Springer Science+Business Media New York.",0,0 +5881,Protective factors for intergenerational transmission of trauma among second and third generation Holocaust survivors.,"The current study explored whether differentiation of self and family communication styles were protective factors of secondary traumatic stress (STS). A sample of 215 Jewish Americans/Canadians whose families emigrated from Europe prior to or after World War II completed an online survey consisting of self-report measures. Four groups were created based on the participants’ Holocaust background and demographics: Second generation (2G; n 77) and third generation (3G; n 52), who self identified as having at least one parent or grandparent, respectively, who is/was a Holocaust survivor, and a matched control group for each generation (n 50; n 36, respectively) consisting of Jewish Americans/Canadians of European descent with no direct relatives who were Holocaust survivors. 2G and 3G referenced the Holocaust as the traumatic event on the STS measure, while the control group referenced non-Holocaust events. Results showed that levels of STS were generally within the normal range for all groups; however, 2G and 3G reported significantly higher levels of STS, lower levels of differentiation of self, and poorer family communication compared to their control groups. Greater differentiation of self and better family communication were associated with lower levels of STS. Differences between groups were consistent with other studies suggesting a mixture of resilience and vulnerability factors among 2G and 3G.",0,0 +5882,Classification of trauma and stressor-related disorders in DSM-5,"This review examines the question of whether there should be a cluster of disorders, including the adjustment disorders (ADs), acute stress disorder (ASD), posttraumatic stress disorder (PTSD), and the dissociative disorders (DDs), in a section devoted to abnormal responses to stress and trauma in the DSM-5. Environmental risk factors, including the individual's developmental experience, would thus become a major diagnostic consideration. The relationship of these disorders to one another is examined and also their relationship to other anxiety disorders to determine whether they are better grouped with anxiety disorders or a new specific grouping of trauma and stressor-related disorders. First how stress responses have been classified since DSM-III is reviewed. The major focus is on PTSD because it has received the most attention, regarding its proper placement among the psychiatric diagnoses. It is discussed whether PTSD should be considered an anxiety disorder, a stress-induced fear circuitry disorder, an internalizing disorder, or a trauma and stressor-related disorder. Then, ASD, AD, and DD are considered from a similar perspective. Evidence is examined pro and con, and a conclsion is offered recommending inclusion of this cluster of disorders in a section entitled ""Trauma and Stressor-Related Disorders."" The recommendation to shift ASD and PTSD out of the anxiety disorders section reflects increased recognition of trauma as a precipitant, emphasizing common etiology over common phenomenology. Similar considerations are addressed with regard to AD and DD.",0,0 +5883,Functional neuroimaging of emotionally intense autobiographical memories in post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) affects regions that support autobiographical memory (AM) retrieval, such as the hippocampus, amygdala and ventral medial prefrontal cortex (PFC). However, it is not well understood how PTSD may impact the neural mechanisms of memory retrieval for the personal past. We used a generic cue method combined with parametric modulation analysis and functional MRI (fMRI) to investigate the neural mechanisms affected by PTSD symptoms during the retrieval of a large sample of emotionally intense AMs. There were three main results. First, the PTSD group showed greater recruitment of the amygdala/hippocampus during the construction of negative versus positive emotionally intense AMs, when compared to controls. Second, across both the construction and elaboration phases of retrieval the PTSD group showed greater recruitment of the ventral medial PFC for negatively intense memories, but less recruitment for positively intense memories. Third, the PTSD group showed greater functional coupling between the ventral medial PFC and the amygdala for negatively intense memories, but less coupling for positively intense memories. In sum, the fMRI data suggest that there was greater recruitment and coupling of emotional brain regions during the retrieval of negatively intense AMs in the PTSD group when compared to controls.",0,0 +5884,Complex mental health sequelae of psychological trauma among women in prenatal care.,"Pregnancy is a critical time to identify and address maternal mental health problems, for the health of both mother and child. Pregnant women with histories of exposure to interpersonal psychological trauma may experience a range of mental health problems including but not limited to posttraumatic stress disorder (PTSD). In a community sample of 1,581 pregnant women, 25% reported symptoms consistent with at least one of six syndromes, including PTSD, major depressive disorder (MDD), generalized anxiety disorder (GAD), or clinically significant dissociation, somatization, or affect dysregulation. Six sub-groups with distinct mental health problem profiles were identified by cluster analysis. Controlling for sociodemographic risk factors, women with histories of interpersonal trauma were over-represented in four sub-groups characterized by: (1) PTSD comorbid with depression (childhood sexual abuse), (2) PTSD comorbid with affect/interpersonal dysregulation (childhood physical or emotional abuse), (3) somatization (adult abuse), and (4) GAD (foster/adoptive placement). Findings suggest risk relationships warranting further study between different types of interpersonal trauma exposure and psychiatric outcomes in pregnant women, including PTSD with two types of comorbidity.",0,0 +5885,"Posttraumatic Stress Symptom Clusters, Trauma History, and Substance Use among College Students","Previous research found associations between experiencing specific posttraumatic stress disorder (PTSD) symptom clusters and use of specific substances among combat veterans, women exposed to domestic violence, and an inpatient sample; however, research has not utilized a college sample when considering this association. This study assessed trauma history, PTSD symptoms, alcohol use, and nonexperimental use of depressants, stimulants, opioids, cannabinoids, hallucinogens, inhalants, and steroids in college students. Results indicate unique associations between the PTSD symptom cluster of reexperiencing and use of depressants, avoidance/numbing with use of depressants and opiates, and hyperarousal with use of opiates. Further, the individual subclusters of behavioral avoidance and emotional numbing were associated with use of depressants and avoidance was associated with hallucinogen use. Implications are discussed.",0,0 +5886,Validation of a Swedish version of the Impact of Event Scale-Revised (IES-R) in patients with burns,"The Impact of Event Scale (IES) and the Impact of Event Scale-Revised (IES-R) are often used as self-report instruments for symptoms of post-traumatic stress disorder (PTSD). However, there are few validations of the IES and the IES-R against structured clinical interviews. In this study the two scales, together with the three subscales of the IES-R, were assessed for their agreement with a diagnosis of PTSD in patients with burns 1 year after injury. Sixty patients with burns were evaluated 1 year after injury using the Structured Clinical Interview for the DSM-IV Axis I (SCID-I) psychiatric disorders and a Swedish version of the IES-R. The total score of the IES-R had the best discriminant ability (0.89) with a sensitivity of 1.0 and a specificity of 0.78. In conclusion, the total IES-R had good properties as a screening tool for PTSD and subsyndromal PTSD 1 year after burn injury.",0,0 +5887,Posttraumatic stress disorder in women,"This chapter discusses posttraumatic stress disorder (PTSD) in women. The clinical presentation in both men and women is often complex, with high levels of depression, anxiety, and substance use. Several epidemiological studies have indicated that, while men are more likely than women to be exposed to traumatic events, the prevalence of PTSD within the community is approximately twice as high for women. Few studies have investigated psycho physiological differences between men and women in acute reactions to threat that may serve as potential mediators for PTSD vulnerability. A mounting body of empirical research has supported the efficacy of certain types of psychotropic medication in the treatment of PTSD. Finally, while women may be at greater risk for the development of psychiatric sequelae following trauma, preliminary findings from treatment outcome studies indicate that they may benefit from PTSD interventions to a greater extent than men.",0,0 +5888,"Prevalence and predictors of posttraumatic stress symptoms in utility workers deployed to the World Trade Center following the attacks of September 11, 2001","Recent attention has begun to be focused on the effects of disaster recovery work on nonrescue workers. The goal of this study was to assess the prevalence and predictors of posttraumatic stress disorder (PTSD) and related symptoms in a population of utility workers deployed to the World Trade Center (WTC) site in the aftermath of 9/11.Utility workers deployed to the WTC site were screened at their place of employment between 10 and 34 months following the WTC attacks, utilizing both structured interviews and self-report measures. PTSD symptoms were assessed by the CAPS and the PCL; co-morbid disorders were also assessed. 2,960 individuals with complete CAPS and PCL data were included in the analyses.Eight percent of participants had symptoms consistent with full PTSD, 9.3% with subthreshold PTSD, 6% with MDD, 3.5% with GAD, and 2.5% with panic disorder. Although risk factors included psychiatric and trauma history, 51% of individuals with probable PTSD had neither; subjective perception of threat to one's life was the best predictor of probable PTSD. Extent of exposure predicted 89% of PTSD cases in those without a psychiatric or trauma history, but only 67% of cases among those with both.Nonrescue workers deployed to a disaster site are at risk for PTSD and depression. Extent of exposure affected the most vulnerable workers differently than the least vulnerable ones. These results suggest that the relationship among predictors of PTSD may be different for different vulnerability groups, and underscore the importance of screening, education, and prevention programs for disaster workers.",0,0 +5889,Brain-derived neurotrophic factor plasma levels in patients suffering from post-traumatic stress disorder,"In both animals and humans, stress has been demonstrated to reduce the expression of the Brain-Derived Neurotrophic Factor (BDNF), a neurotrophin (NT) which promotes the proliferation, survival and differentiation of neurons. Although traumatic events have been found to be associated with lower BDNF plasma levels in affective disorders, no study has explored this parameter in patients with post-traumatic stress disorder (PTSD). We, therefore, measured BDNF plasma level in 18 patients with PTSD and in 18 healthy control subjects. Diagnoses were assessed by the Structured Clinical Interview for DSM-IV, while the specific symptoms were examined in the patients by means of the Impact of Event Scale for PTSD and the traumas experienced were assessed by using the Life Events Checklist. BDNF plasma levels were evaluated by means of a standardized Elisa method. The results, while showing significantly lower BDNF levels in PTSD patients, as compared with those of healthy subjects (p=0.001), although obtained in a small sample size, would suggest that this NT may be involved in the pathophysiology of PTSD.",0,0 +5890,Personality disorder symptomatology among Vietnam veterans with combat-related PTSD.,"This research examined self-report personality profiles of 42 Vietnam veterans with combat-related posttraumatic stress disorder (PTSD) evaluated at an outpatient Veteran's Administration hospital PTSD clinic. Assessment was via the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev; DSM-III-R) Personality Disorders-II (SCID-II) self-report. Self-reported personality disorder symptomatology of PTSD patients was contrasted with that of 51 outpatients with a primary diagnosis of an anxiety disorder other than PTSD and with 16 patients with a primary diagnosis of major depressive disorder (MDD). Symptomatology from each of the 11 DSM-III-R categories and from the three personality disorder ""clusters"" was calculated in terms of percentage of possible traits endorsed, thus creating personality ""profiles"" for the three groups. PTSD veterans endorsed more traits overall than did both the mixed anxiety and MDD groups, particularly on the Cluster A, avoidant, and borderline scales. Results suggest a PTSD-related personality profile characterized by emotional lability/poor anger control, paranoia/suspiciousness, identity disturbance/confusion, social withdrawal/avoidance, and feelings of emptiness and boredom.",0,0 +5891,Factor Structure and Risk Factors for the Health Status of Homeless Veterans,"Homeless veterans have numerous health problems that have been previously characterized as falling into four major subgroups; addiction, psychosis, vascular disorders, and generalized medical and psychiatric illness. Comorbid conditions are common, often involving a combination of psychiatric and medical disorders. Using data from the same survey of homeless veterans that was used to establish these subgroups with cluster analysis, the present study examined the structure of these subgroup patterns through the use of factor analysis. This analysis yielded a five factor solution. They were named ""Cardiac"", Mood, Stress, Addiction, and Psychosis factors. Factor scores were computed and an odds ratio analysis was accomplished to determine the association between obtaining a high score on a given factor with a number of sociodemographic and homelessness related variables. It was concluded that health status of homeless veterans is a complex condition, but has a clear latent structure demonstrated by factor analysis. Scoring high or low on a particular factor is associated with numerous historical and sociodemographic considerations, notably age, ethnicity, and employment status. (",0,0 +5892,[Post-traumatic condition and psychological distress/well-being in a sample of inmates: a cluster analytic approach].,"AIM Researchers addressing the mental health needs of inmates reported that post-traumatic stress disorder (PTSD) was one of the most common disorders. This study examined the patterns of PTSD symptoms and their relation to the self-reported level of distress and psychological wellbeing in a sample of Italian inmates. METHODS Fifty inmates, 90% male, 54% aged 31-50 years, 70% awaiting trial, completed a battery of tests including the Davidson Trauma Scale (DTS), the Symptom Questionnaire (SQ), and the Psychological Well-Being Scales (PWBS). RESULTS Cluster analysis revealed three distinct clusters of respondents, which presents varying combination of PTSD symptoms, as measured with the three subscales of the DTS. Accordingly, these clusters were labeled Cluster 1--Traumatized (n = 18), Cluster 2--Non-traumatized (n = 18), and Cluster 3--Seriously traumatized (n = 14). Findings indicated that the three groups differed consistently across all the domains of the SQ and on the environmental mastery scale of the PWBS. Those in the Traumatized clusters, as compared to the Nontraumatized, demonstrated higher overall psychological distress and lower perceived environmental mastery. Moreover, independent of posttraumatic level, inmates showed poorer psychological wellbeing and higher distress than the normative population. DISCUSSION The patterns manifested in clusters 1 and 3 could become the focus of attention to deliver specific intervention aimed at reducing inmates' distress and encouraging their adjustment to prison life.",0,0 +5893,Multi-tier mental health program for refugee youth.,"We sought to establish that refugee youths who receive a multi-tiered approach to services, Project SHIFA, would show high levels of engagement in treatment appropriate to their level of mental health distress, improvements in mental health symptoms, and a decrease in resource hardships.Study participants were 30 Somali and Somali Bantu refugee youths in the English language learner classroom in a middle school in New England. Project SHIFA is a multi-tiered program including prevention and community resilience building for the community at large, school-based early intervention groups for at-risk students, and direct intervention using an established trauma model (trauma systems therapy) for those with significant psychological distress. Data were collected from students at time of enrollment, 6-month follow-up, and 12-month follow-up. Measures used were the War Trauma Screening Scale, Adolescent Post-War Adversities Scale-Somali version, UCLA PTSD Reaction Index for DSM-IV (Revision 1), and the Depression Self-Rating Scale.Students across all tiers of the program demonstrated improvements in mental health and resources. Resource hardships were significantly associated with symptoms of posttraumatic stress disorder over time, and the stabilization of resource hardships coincided with significant improvements in symptoms of depression and posttraumatic stress disorder for the top tier of participants.Project SHIFA is a promising model of treatment for young refugees.",0,0 +5894,New approaches to combining pharmacotherapy and psychotherapy for posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) is a complex disorder associated with an intricate biological and psychological symptom profile and various common comorbidities. Despite an existing myriad of evidence-based and experimental treatments, PTSD is often difficult to treat. This reality necessitates a discussion of the potential of emerging treatments.A literature search using PubMed and PsychInfo was done using the following keywords: randomized clinical trials, treatment guidelines, pharmacotherapy and psychotherapy, all in addition to PTSD. A comprehensive treatment review establishes that early intervention approaches have not yet been found to prevent PTSD in trauma survivors. However, psychotherapy research provides substantial support for cognitive behavioral therapies and eye movement desensitization and reprocessing for chronic PTSD, and psychopharmacological approaches are myriad - although at present there is FDA approval only for sertraline and paroxetine. However, the efficacy of these treatments varies and, unfortunately, not everyone will achieve remission.So far, the mental health field has tended to focus on either biological or psychological targets. We propose that maximizing treatment success may require an integrated approach that does not dichotomize biological and psychological aspects. Exciting new developments reflecting this perspective include psychopharmacologic augmentation strategies that enhance the mechanisms of psychotherapy.",0,0 +5895,Preclinical Evidence on the Psychotropic Profile of Fluvoxamine,"Serotonin (5-HT) reuptake inhibitors (SSRIs) such as fluvoxamine are interesting compounds. Initially launched as antidepressants, they have been found to be active in various psychiatric disorders besides depression, including obsessive-compulsive disorder, panic disorder, and eating disturbances. Preliminary data suggest their efficacy in alcohol and drug abuse, aggression, and posttraumatic stress disorder as well. Along with those clinical findings, new preclinical data have emerged. For example, fluvoxamine has demonstrated activity in various models of anxiety in rodents. Its anxiolytic activity can be clearly discriminated from that of the benzodiazepines. In the DRL 72-sec paradigm, fluvoxamine exhibits a good antidepressant profile, similar to those of imipramine and flesinoxan. Studies have shown that fluvoxamine does not down-regulate beta-adrenoceptors; apparently, that property is not a conditio sine qua non for antidepressant activity. Results of studies of the mechanism of action of fluvoxamine in which drug discrimination tests were performed with rats and pigeons suggest that the fluvoxamine stimulus is not (or is only to a very limited degree) dependent on activation of 5-HT1A receptors or 5-HT1B/1D receptors, or both. Experimentation is ongoing in those animal models.",0,0 +5896,Toward Animal Models of Post-Traumatic Stress Disorder,"(from the chapter) The development of animal models for PTSD and other traumatic stress related brain changes is an important part of advancing our neurobiological understanding of the disease process as well as recovery, resilience, and possible therapeutic targets. Although animal models for PTSD are limited to the assessment of measurable and observable behavioral parameters and cannot assess complex psychological symptoms such as intrusive thoughts, meaning and dreams, valid and reliable animal models offer a means for researching biomolecular, pathophysiological, and pharmacological features of the disorder in ways that are not feasible in human studies. Trauma/stress-based Models were developed in an attempt to induce in the animal a state similar to PTSD by exposing animals to an equivalent of a traumatic experience. Mechanism-based models were developed considering potential brain mechanisms that may underlay the disorder. The most studied are enhanced fear conditioning, impaired extinction and more recently, impaired contextualization. Another important line of research addresses the question of additional factors that contribute to the susceptibility to develop PTSD. Genetic background and environmental factors have been studied and have led to the recognition of the importance of individual differences in susceptibility to develop the disorder. This chapter presents and discusses findings from various animal models, with the understanding that no single model encompasses in full the complexity of the disorder but that each of these models contributes to our understanding of PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5897,PSYCHIATRIC AND PHYSICAL HEALTH RAMIFICATIONS OF TRAUMATIC EVENTS IN WOMEN,"All individuals are at some risk of experiencing a traumatic event and developing posttraumatic stress disorder (PTSD); however some individuals are at higher risk due to individual and environmental factors. This critical literature review focuses on women, as they are twice as likely as men to develop PTSD in their lifetimes. Should a woman develop PTSD, she is then at risk of developing psychiatric and physical health comorbidities that can further impact her quality of life. The strengths and limitations of current studies regarding this topic are discussed as are directions for future research and issues for nurses treating traumatized individuals.",0,0 +5898,Psychophysiological investigations of posttraumatic stress disorder imagery.,"Physiological responses to self-generated imagery of past traumatic combat experiences were assessed in medication-free Vietnam combat veterans, classified on the basis of DSM-III-R (American Psychiatric Association 1987) criteria into posttraumatic stress disorder (PTSD, n = 25), non-PTSD anxiety disorder (Anxious, n = 7), or no-mental-disorder (Healthy, n = 15) groups. ""Scripts"" describing each subject's combat experiences were read to him in the laboratory, and he was instructed to imagine the events the scripts portrayed, while heart rate, skin conductance, and frontalis electromyogram (EMG) were recorded. PTSD subjects' responses to their combat imagery were significantly higher than those of both control groups. A discriminant analysis identified 64 percent of PTSD subjects as physiological responders, and 100 percent of Anxious and 94 percent of Healthy subjects as nonresponders. A pilot study of imaginal flooding in three PTSD and two Healthy pilot subjects suggested that more prolonged, therapist-assisted imagery might increase the sensitivity of psychophysiological measures to PTSD, and that motor and endocrinological measures might also be of value in characterizing the disorder.",0,0 +5899,"Disentangling the Directions of Influence among Trauma Exposure, Posttraumatic Stress Disorder Symptoms, and Alcohol and Drug Problems","The present study utilized longitudinal data from a high-risk community sample (n= 377; 166 trauma-exposed; 54% males; 52% children of alcoholics; 73% non-Hispanic/Latino Caucasian; 22% Hispanic/Latino; 5% other ethnicity) to test a series of hypotheses that may help explain the risk pathways that link traumatic stress, posttraumatic stress disorder (PTSD) symptomatology, and problematic alcohol and drug use. Specifically, this study examined whether pre-trauma substance use problems increase risk for trauma exposure (the high-risk hypothesis) or PTSD symptoms (the susceptibility hypothesis), whether PTSD symptoms increase risk for later alcohol/drug problems (the self-medication hypothesis), and whether the association between PTSD symptoms and alcohol/drug problems is due to shared risk factors (the shared vulnerability hypothesis). This study also examined the roles of gender and ethnicity in these pathways. A series of logistic and negative binomial regressions were performed in a path analysis framework. A composite pre-trauma family adversity variable was formed from measures of family conflict, family life stress, parental alcoholism, and other parent psychopathology. Results provided the strongest support for the self-medication hypothesis, such that PTSD symptoms predicted higher levels of later alcohol and drug problems among non-Hispanic/Latino Caucasian participants, over and above the influences of pre-trauma family adversity, pre-trauma substance use problems, trauma exposure, and demographic variables. Results partially supported the high-risk hypothesis, such that adolescent substance use problems had a marginally significant unique effect on risk for assaultive violence exposure but not on overall risk for trauma exposure. There was no support for the susceptibility hypothesis, as pre-trauma adolescent substance use problems did not significantly influence risk for PTSD diagnosis/symptoms over and above the influence of pre-trauma family adversity. Finally, there was little support for the shared vulnerability hypothesis. Neither trauma exposure nor preexisting family adversity accounted for the link between PTSD symptoms and later substance use problems. These results add to a growing body of literature in support of the self-medication hypothesis. Findings extend previous research by showing that PTSD symptoms may influence the development of alcohol and drug problems over and above the influence of trauma exposure itself, preexisting family risk factors, and baseline levels of substance use. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +5900,Course of post-traumatic stress disorder following war in the Balkans: 1-year follow-up study,"Prevalence rates of post-traumatic stress disorder (PTSD) following the experience of war have been shown to be high. However, little is known about the course of the disorder in people who remained in the area of conflict and in refugees. Method We studied a representative sample of 522 adults with war-related PTSD in five Balkan countries and 215 compatriot refugees in three Western European countries. They were assessed on average 8 years after the war and reinterviewed 1 year later. We established change in PTSD symptoms, measured on the Impact of Events Scale - Revised (IES-R), and factors associated with more or less favourable outcomes.During the 1-year period, symptoms decreased substantially in both Balkan residents and in refugees. The differences were significant for IES-R total scores and for the three subscales of intrusions, avoidance and hyperarousal. In multivariable regressions adjusting for the level of baseline symptoms, co-morbidity with depression predicted less favourable symptom change in Balkan residents. More pre-war traumatic events and the use of mental health services within the follow-up period were associated with less improvement in refugees.Several years after the war, people with PTSD reported significant symptom improvement that might indicate a fluctuating course over time. Co-morbid depression may have to be targeted in the treatment of people who remained in the post-conflict regions whereas the use of mental health services seems to be linked to the persistence of symptoms among refugees.",0,0 +5901,"Rumination, post-traumatic growth, and distress: structural equation modelling with cancer survivors","Objective: Theoretical models of post-traumatic growth (PTG) have been derived in the general trauma literature to describe the post-trauma experience that facilitates the perception of positive life changes. To develop a statistical model identifying factors that are associated with PTG, structural equation modelling (SEM) was used in the current study to assess the relationships between perception of diagnosis severity, rumination, social support, distress, and PTG. Method: A statistical model of PTG was tested in a sample of participants diagnosed with a variety of cancers (N=313). Results: An initial principal components analysis of the measure used to assess rumination revealed three components: intrusive rumination, deliberate rumination of benefits, and life purpose rumination. SEM results indicated that the model fit the data well and that 30% of the variance in PTG was explained by the variables. Trauma severity was directly related to distress, but not to PTG. Deliberately ruminating on benefits and social support were directly related to PTG. Life purpose rumination and intrusive rumination were associated with distress. Conclusions: The model showed that in addition to having unique correlating factors, distress was not related to PTG, thereby providing support for the notion that these are discrete constructs in the post-diagnosis experience. The statistical model provides support that post-diagnosis experience is simultaneously shaped by positive and negative life changes and that one or the other outcome may be prevalent or may occur concurrently. As such, an implication for practice is the need for supportive care that is holistic in nature. Copyright © 2010 John Wiley & Sons, Ltd.",0,0 +5902,Postconcussive Symptom Complaints and Potentially Malleable Positive Predictors,"The purpose of this study was to examine the relationship between postconcussion symptom complaint (PCS) severity and positive coping factors (knowledge, self-efficacy, and attributions) in a sample of individuals who have sustained a mild TBI, above and beyond the demographic and psychiatric predictors that have been most commonly examined. Ninety-one people with a history of reported mild TBI were surveyed. Hierarchical regression analyses revealed that demographic variables and psychiatric symptom severity predicted PCS severity. Consistent with our hypotheses, knowledge, self-efficacy, and attributions, when taken together, made an independent and significant contribution to prediction of PCS severity (21% of additional variance). The most potent factor was attribution, or the extent to which one attributes symptoms to mild TBI versus other causes. Those who attribute their symptoms to TBI are more likely to report greater symptom severity overall. Taken together, knowledge, self-efficacy, and attributions contribute independently to PCS severity. Additional research is needed to determine if these factors are amenable to intervention.",0,0 +5903,"Anxiolytic-like effects of YL-IPA08, a potent ligand for the translocator protein (18 kDa) in animal models of post-traumatic stress disorder","Recently, the translocator protein (18 kDa) (TSPO), previously called peripheral benzodiazepine receptor (PBR) and both the starting point and an important rate-limiting step in neurosteroidogenesis, has received increased attention in the pathophysiology of post-traumatic stress disorder (PTSD) because it affects the production of neurosteroids, reinforcing the hypothesis that selective TSPO ligands could potentially be used as anti-PTSD drugs. As expected, we showed that chronic treatment with YL-IPA08 [N-ethyl-N-(2-pyridinylmethyl)-2-(3,4-ichlorophenyl)-7-methylimidazo [1,2-a] pyridine-3-acetamide hydrochloride], a potent and selective TSPO ligand synthesized by our institute, caused significant suppression of enhanced anxiety and contextual fear induced in the inescapable electric foot-shock-induced mouse model of PTSD and the time-dependent sensitization (TDS) procedure. These effects were completely blocked by the TSPO antagonist PK11195. Furthermore, YL-IPA08 could increase the level of allopregnanolone in the prefrontal cortex and serum of post-TDS rats, and these effects were antagonized by PK11195. In summary, the findings from the current study showed that YL-IPA08, a potent and selective TSPO ligand, had a clear anti-PTSD-like effect, which might be partially mediated by binding to TSPO and the subsequent synthesis of allopregnanolone.",0,0 +5904,The Association Between Childhood Physical and Sexual Abuse and Functioning and Psychiatric Symptoms in a Sample of U.S. Army Soldiers,"We examined associations between abusive childhood experiences and functioning and psychiatric symptoms in an active duty sample of U.S. Army soldiers.Cross-sectional survey of 204 soldiers stationed at a southern U.S. Army facility.Forty-six percent of individuals reported childhood physical abuse alone, whereas 25% reported both childhood physical and sexual abuse. Soldiers' work, role, and social functioning; physical functioning; depression severity; and severity of alcohol misuse did not differ significantly with childhood abuse status (p > 0.22 for all). However, individuals who reported both childhood physical and sexual abuse reported severer posttraumatic stress disorder symptoms than did soldiers who reported no childhood abuse or childhood physical abuse only (p = 0.007).Although abusive childhood experiences were common, soldiers with such experiences reported functioning as well as those soldiers without such experiences. Posttraumatic stress disorder symptoms were significantly elevated only in those who reported both childhood physical and sexual abuse.",0,0 +5905,Role of Zolpidem in the Management of Insomnia,"Insomnia is a common condition that affects one's ability to sleep comfortably and consequently to work effectively. Its etiology is multifactorial and involves plethora of risk factors. Consequences can vary from mild sleepiness to more sever psychiatric disturbances and ischemic stroke. Despite several diagnostic criteria it is poorly diagnosed and less often treated. Benzodiazepines formed the mainline therapy for many years till the advent of newer nonbenzodiazepine group of drugs including zolpidem. Zolpidem is an imidazo-pyridine compound that enhances the GABA(A) receptor function by interaction with Omega-1 receptor subtype. Its pharmacokinetic profile allows the patients to use it later in the night when having trouble falling asleep without any residual cognitive impairment the next morning. It has rapid onset of action, improves total sleep duration, and reduces night-time awakenings. Its adverse effect profile is satisfactory as it appears to have low addiction potential. This review will focus on the current role of zolpidem in the management of insomnia.",0,0 +5906,"Longitudinal Study of Posttraumatic Stress Disorder, Depression, and Changes in Traumatic Memories Over Time in Bosnian Refugees","This longitudinal study examined traumatic memory consistency over a 3-year period among a sample of highly traumatized Bosnian refugees, focusing on demographic factors, types of trauma, and posttraumatic stress disorder (PTSD) and depression. In 1996 and 1999, 376 Bosnian refugees were interviewed about 54 wartime trauma and torture events, and symptoms of PTSD and depression. Reports were compared for both time periods, and changed responses were analyzed for significance. Overall, there was consistency in reporting over time; when change occurred it was in the direction of decreased reports at follow-up. This downward trend was not associated with any particular diagnosis. However, PTSD alone, without comorbid symptoms of depression, was uniquely associated with the group that exhibited an upward trend. This implies that increased reporting is related specifically to the presence of PTSD symptoms, and that PTSD may be distinctly associated with the failed extinction of traumatic memories.",0,0 +5907,Psychological and Sleep Quality Differences between Chronic Daily Headache and Temporomandibular Disorders Patients,"The aim of this study was to investigate whether chronic daily headache (CDH) and temporomandibular disorders (TMD) patients present with different psychological and sleep quality characteristics. Sixty-seven patients diagnosed with CDH, according to classification criteria from Silberstein et al., were matched by age and sex with 67 patients who had a primary diagnosis of myofascial pain (MP) and 67 patients with a primary diagnosis of TMJ intracapsular pain (IC) according to the Research Diagnostic Criteria for TMD. The CDH group was comprised of three mutually exclusive diagnostic groups: chronic migraine ( n = 35); chronic tension-type headache ( n = 26); ‘other CDH’ ( n = 6). All patients completed a battery of psychological and sleep quality questionnaires. All CDH subgroups showed similar psychological and sleep quality profiles. Pain intensity and duration were controlled in the multivariate analyses (MANCOVA) by treating them as covariates. The CDH and MP groups revealed higher levels of psychological distress than the IC group on most psychological domains. The MP group also revealed numerically higher levels of psychological distress in most psychological domains than the CDH group, although these differences were generally not significant. We did not find significant differences between the three groups on post traumatic stress symptoms either. Sleep quality was significantly worse in the MP group than in the CDH and IC groups. These results are discussed in the context of multimodal patient evaluation and treatments that are often necessary for successful clinical management.",0,0 +5908,Prospective Risk Factors for Adolescent PTSD: Sources of Differential Exposure and Differential Vulnerability,"There are two types of risk factors for developing PTSD: factors that increase the likelihood of experiencing a potentially traumatizing event and factors that increase the likelihood of developing symptoms following such events. Using prospective data over a two-year period from a large, diverse sample of urban adolescents (n = 1242, Mean age = 13.5), the current study differentiates these two sources of risk for developing PTSD in response to violence exposure. Five domains of potential risk and protective factors were examined: community context (e.g.; neighborhood poverty), family risk (e.g.; family conflict), behavioral maladjustment (e.g.; internalizing symptoms), cognitive vulnerabilities (e.g.; low IQ), and interpersonal problems (e.g.; low social support). Time 1 interpersonal violence history, externalizing behaviors, and association with deviant peers were the best predictors of subsequent violence, but did not further increase the likelihood of PTSD in response to violence. Race/ethnicity, thought disorder symptoms, and social problems were distinctly predictive of the development of PTSD following violence exposure. Among youth exposed to violence, Time 1 risk factors did not predict specific event features associated with elevated PTSD rates (e.g.; parent as perpetrator), nor did interactions between Time 1 factors and event features add significantly to the prediction of PTSD diagnosis. Findings highlight areas for refinement in adolescent PTSD symptom measures and conceptualization, and provide direction for more targeted prevention and intervention efforts. © 2012 Springer Science+Business Media, LLC.",0,0 +5909,Sleep Complaints as Early Predictors of Posttraumatic Stress Disorder: A 1-Year Prospective Study of Injured Survivors of Motor Vehicle Accidents,"Disturbed sleep is a common complaint among patients with posttraumatic stress disorder (PTSD) that appears in the reexperiencing and hyperarousal symptom clusters in DSM-IV. The causal relationship between sleep complaints and PTSD is unclear.Self-reported insomnia and excessive daytime sleepiness were assessed in 102 victims of motor vehicle accidents and 19 comparison subjects 1 week and 1, 3, 6, and 12 months after the trauma. At 12 months the Structured Clinical Interview for DSM-III-R was administered to determine diagnoses of PTSD.Twenty-six of the accident victims but none of the comparison subjects met the criteria for PTSD. Logistic regression models indicated that sleep complaints from 1 month on were significant in predicting PTSD at 1 year.These results suggest that on the basis of sleep complaints as early as 1 month after the trauma, it is possible to detect subjects who will later develop chronic PTSD.",0,0 +5910,Mental Preparedness as a Pathway to Police Resilience and Optimal Functioning in the Line of Duty,"The idea of fostering ‘resilience’ among police and military personnel is a topic of growing interest (Andersen et al., 2015a; Cornum, Matthews, & Seligman, 2011; Reivich, Seligman, & McBride, 2011). This topic is particularly timely in light of recent media depictions of questionable use-of-force actions by police and the subsequent public retaliations against the police",0,0 +5911,Acclimatory-phase specificity of gene expression during the course of heat acclimation and superimposed hypohydration in the rat hypothalamus,"The induction of the heat-acclimated phenotype involves reprogramming the expression of genes encoding both constitutive and inducible proteins. In this investigation, we studied the global genomic response in the hypothalamus during heat acclimation, with and without combined hypohydration stress. Rats were acclimated for 2 days (STHA) or for 30 days (LTHA) at 34°C. Hypohydration (10% decrease in body weight) was attained by water deprivation. 32 P-labeled RNA samples from the hypothalamus were hybridized onto cDNA Atlas array (Clontech no. 1.2) membranes. Clustering and functional analyses of the expression profile of a battery of genes representing various central regulatory functions of body homeostasis demonstrated a biphasic acclimation profile with a transient upregulation of genes encoding ion channels, transporters, and transmitter signaling upon STHA. After LTHA, most genes returned to their preacclimation expression levels. In both STHA and LTHA, genes encoding hormones and neuropeptides, linked with metabolic rate and food intake, were downregulated. This genomic profile, demonstrating an enhanced transcription of genes linked with neuronal excitability during STHA and enhanced metabolic efficiency upon LTHA, is consistent with our previously established integrative acclimation model. The response to hypohydration was characterized by an upregulation of a large number of genes primarily associated with the regulation of ion channels, cell volume, and neuronal excitability. During STHA, the response was transiently desensitized, recovering upon LTHA. We conclude that hypohydration overrides the heat acclimatory status. It is notable that STHA and hypohydration gene profiles are analogous with the physiological profile described in the response to various types of brain injury.",0,0 +5912,Genomics and Pharmacogenomics of Brain Disorders,"CNS disorders are the third major problem of health in developed countries, with approximately 10% of direct costs associated with a pharmacological treatment of doubtful cost-effectiveness. There is an alarming abuse of psychotropic drugs worldwide and only 20-30% of patients with CNS disorders appropriately respond to conventional drugs. The pathogenesis of most CNS disorders is the result of the interplay of genetic and epigenetic factors with environmental factors leading to post-transcriptional changes and proteomic and metabolomic dysfunctions. It is estimated that genetics accounts for 20% to 95% of variability in drug disposition and pharmacodynamics, and about 25-60% of the Western population is defective in genes responsible for drug metabolism. In the European population only 25% of subjects are pure extensive metabolizers for the trigenic cluster integrated by the CYP2D6, CYP2C19 and CYP2C9 genes. About 50% of adverse drug events in CNS disorders might be attributed to pharmacogenomic factors. The rationale for practical pharmacogenomics and personalized therapeutics based on individual genomic profiles implies the management of different types of genes and their products including (i) genes associated with the mechanism of action of psychotropic drugs (neurotransmitters, receptors, transporters), (ii) genes encoding enzymes responsible for drug metabolism (phase I, phase II reactions), (iii) disease-specific genes associated with a particular pathogenic cascade, and (iv) pleiotropic genes with multilocative effects in metabolomic networks. The incorporation of genomic medicine procedures and pharmacogenomics into clinical practice, together with educational programs for the correct use of medication, must help to optimize therapeutics in CNS disorders.",0,0 +5913,White Matter Integrity in Highly Traumatized Adults With and Without Post-Traumatic Stress Disorder,"Prior structural imaging studies of post-traumatic stress disorder (PTSD) have observed smaller volumes of the hippocampus and cingulate cortex, yet little is known about the integrity of white matter connections between these structures in PTSD samples. The few published studies using diffusion tensor imaging (DTI) to measure white matter integrity in PTSD have described individuals with focal trauma rather than chronically stressed individuals, which limits generalization of findings to this population; in addition, these studies have lacked traumatized comparison groups without PTSD. The present DTI study examined microstructural integrity of white matter tracts in a sample of highly traumatized African-American women with (n=25) and without (n=26) PTSD using a tract-based spatial statistical approach, with threshold-free cluster enhancement. Our findings indicated that, relative to comparably traumatized controls, decreased integrity (measured by fractional anisotropy) of the posterior cingulum was observed in participants with PTSD (p<0.05). These findings indicate that reduced microarchitectural integrity of the cingulum, a white matter fiber that connects the entorhinal and cingulate cortices, appears to be associated with PTSD symptomatology. The role of this pathway in problems that characterize PTSD, such as inadequate extinction of learned fear, as well as attention and explicit memory functions, are discussed.",0,0 +5914,Medical Comorbidity of Full and Partial Posttraumatic Stress Disorder in US Adults,"This study examined associations between lifetime trauma exposures, PTSD and partial PTSD, and past-year medical conditions in a nationally representative sample of US adults.Face-to-face interviews were conducted with 34,653 participants in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression analyses evaluated associations of trauma exposure, PTSD, and partial PTSD with respondent-reported medical diagnoses.After adjustment for sociodemographic characteristics and comorbid Axis I and II disorders, respondents with full PTSD were more likely than traumatized respondents without full or partial PTSD (comparison group) to report diagnoses of diabetes mellitus, noncirrhotic liver disease, angina pectoris, tachycardia, hypercholesterolemia, other heart disease, stomach ulcer, human immunodeficiency virus seropositivity, gastritis, and arthritis (odds ratios [ORs] = 1.2-2.5). Respondents with partial PTSD were more likely than the comparison group to report past-year diagnoses of stomach ulcer, angina pectoris, tachycardia, and arthritis (ORs = 1.3-1.6). Men with full and partial PTSD were more likely than controls to report diagnoses of hypertension (both ORs = 1.6), and both men and women with PTSD (OR = 1.8 and OR = 1.6, respectively) and men with partial PTSD (OR = 2.0) were more likely to report gastritis. The total number of lifetime traumatic event types was associated with many assessed medical conditions (ORs = 1.04-1.16), reducing the magnitudes and rendering some of the associations between PTSD status and medical conditions nonsignificant.Greater lifetime trauma exposure and PTSD are associated with numerous medical conditions, many of which are stress-related and chronic, in US adults. Partial PTSD is associated with intermediate odds of some of these conditions.",0,0 +5915,Psychological Resilience After Disaster,"Research on adult reactions to potentially traumatic events has focused almost exclusively on post-traumatic stress disorder (PTSD). Although there has been relatively little research on the absence of trauma symptoms, the available evidence suggests that resilience following such events may be more prevalent than previously believed. This study examined the prevalence of resilience, defined as having either no PTSD symptoms or one symptom, among a large (n = 2,752) probability sample of New York area residents during the 6 months following the September 11th terrorist attack. Although many respondents met criteria for PTSD, particularly when exposure was high, resilience was observed in 65.1% of the sample. Resilience was less prevalent among more highly exposed individuals, but the frequency of resilience never fell below one third even among the exposure groups with the most dramatic elevations in PTSD.",0,0 +5916,Clinical utility of the selective serotonin reuptake inhibitors in the spectrum of anxiety,"The selective serotonin reuptake inhibitors (SSRIs) are now being employed in the treatment of the full spectrum of anxiety disorders. In comparative trials, the SSRIs are proving to be equal or superior in efficacy to traditional antianxiety medications. Due to their favorable side effect profile, safety, and tolerability, they are rapidly replacing older agents in the treatment of anxiety. Neuroanatomical pathways that may be important in the antianxiety effect of the SSRIs are outline and discussed, followed by a review of the clinical evidence supporting the efficacy of this class of medications in the treatment of anxiety disorders.",0,0 +5917,Trajectories of posttraumatic growth and depreciation after two major earthquakes.,"This study examined trajectories of posttraumatic growth or depreciation (i.e., positive or negative life change) in personal strength and relationships after 2 major earthquakes in Canterbury, New Zealand using group-based trajectory modeling. Participants completed questionnaires regarding posttraumatic growth or depreciation in personal strength and relationship domains 1 month after the first earthquake in September 2010 (N = 185) and 3 months (n = 156) and 12 months (n = 144) after the more severe February 2011 earthquake. Three classes of growth or depreciation patterns were found for both domains. For personal strength, most of the participants were grouped into a ""no growth or depreciation"" class and smaller proportions were grouped into either a ""posttraumatic depreciation"" or ""posttraumatic growth"" class. The 3 classes for relationships all reported posttraumatic growth, differing only in degree. None of the slopes were significant for any of the classes, indicating that levels of growth or depreciation reported after the first earthquake remained stable when assessed at 2 time points after the second earthquake. Multinomial logistic regression analyses examining pre- and postearthquake predictors of trajectory class membership revealed that those in the ""posttraumatic growth"" personal strength class were significantly younger and had significantly higher pre-earthquake mental health than those in the ""posttraumatic depreciation"" class. Sex was the only predictor of the relationship classes: No men were assigned to the ""high posttraumatic growth"" class. Implications and future directions are discussed.",0,0 +5918,A longitudinal study of changes in psychological responses to continuous terrorism.,"The impact of ongoing terror over time has received little attention. This study assesses longitudinally prevalence and predictors of posttraumatic stress symptoms' trajectories, namely resistance, resilience, late-onset and chronicity in the course of intensive and ongoing terror.Two surveys were performed at a two-year interval among 153 Jewish Israeli adults.Results show probable PTSD prevalence, number of traumatic stress related symptoms (TSRS), and rate of severe posttraumatic symptomatology (PTSS) to increase over time (from 18.2% to 31.2%). With this, many (66.7% of those with PTSD and 39.3% of those with PTSS at wave 1) recovered. Late-onset of severe PTSS (19.6% of the sample) was predicted by income reduction, a major lifetime traumatic event, sense of threat, dissociation, coping via disengagement and low mood. Chronicity was predicted by sense of threat, pessimism, dissociation and disengagement.Continuous exposure to terror has a strong negative impact on mental health. Secondly, even within a chronic situation of terror, a large proportion of individuals with elevated levels of posttraumatic symptomatology recover over time; third, prolonged exposure to terror may also exacerbate symptomatology, but not per-se trigger new PTSD cases.",0,0 +5919,The significance of experiences of war and migration in older age: long-term consequences in child survivors from the Dutch East Indies,"ABSTRACT Background: This study examines late consequences of war and migration in both non-clinical and clinical samples of child survivors of World War II. This is one of the very few studies on the mental health of children who were subjected to internment in camps, hiding, and violence under Japanese occupation in the Far East. It provides a unique case to learn about the significance of experiences of war and migration in later life. Methods: Long-term sequelae of the Japanese persecution in the Dutch East Indies (DEI) in child survivors were studied by analyzing sets of standardized questionnaires of 939 persons. Instruments dealt with post-traumatic responses, general health, and dissociation. Participants were recruited through community services and registers of clinical services. Discriminant analyses were conducted to evaluate the significance of early experiences in determining group belonging. Results: Compared with age-matched controls that lived through the German occupation in the Netherlands during World War II, the child survivors from the DEI reported both more trauma-related experiences and mental health disturbances in later life. In particular, the number of violent events during the war, among which especially internment in a camp, contributed to the variation among groups, in support of the significance of these disruptive experiences at older age. Conclusion: The results underline the long-term significance of World War II-related traumatic experiences in the population of elderly child survivors who spent their childhood in the former DEI.",0,0 +5920,"Effects of the CRF1 receptor antagonist, CP 154,526, in the separation-induced vocalization anxiolytic test in rat pups","CRF(1) receptor antagonists have been proposed as novel pharmacological treatments for depression, anxiety and stress disorders. The primary goal of the present study was to evaluate the effects of the CRF(1) receptor antagonist, CP 154,526, in the separation-induced vocalization (SIV) model of anxiety. Nine- to 11-day-old rat pups were separated from their litter and the effects of intraperitoneally administered test compounds on the elicited ultrasonic vocalizations were measured. Side-effect potential was assessed using a modified inclined plane test ('time on an inclined plane', or TIP), and using negative geotaxis. SIV was reduced by CP 154,526 at doses that did not affect TIP or negative geotaxis, a profile like that of the 5-HT(1A) partial agonist buspirone. The benzodiazepine anxiolytic, diazepam, decreased SIV but also produced significant side effects at one to three-fold higher doses. Additional pharmacological characterization of SIV demonstrated anxiolytic-like effects of the atypical antipsychotic, clozapine, but not the typical antipsychotic, haloperidol, and of the serotonin reuptake inhibitor, zimelidine, but not the norepinephrine reuptake inhibitor, desipramine. In summary, the data support the conclusion that selective CRF(1) receptor antagonists may have utility in anxiety and stress disorders. The data further support the use of separation-induced vocalizations for identifying mechanistically diverse compounds with anxiolytic actions in man.",0,0 +5921,Association between age of onset and mood in bipolar disorder: Comparison of subgroups identified by cluster analysis and clinical observation,"This study compared subgroups identified by cluster analysis and clinical observation by evaluating the association between the age of onset of bipolar disorder and self-reported daily mood ratings.Two hundred and seventy patients with bipolar disorder provided daily self-reported mood ratings for about 6 months returning 55,188 days of data. The age of onset subgroups were determined both using previously defined cutoff values based upon clinical observation (≤12 years, 13-19 years, 20-29 years, >29 years), and model-based cluster analysis. Demographic characteristics were compared in the age of onset subgroups. Univariate general linear models with age of onset subgroups and other demographic variables as fixed factors and covariates were used to analyze the percent of days depressed, euthymic and hypomanic/manic.Using the predetermined subgroups, demographic differences were found between the four subgroups in the diagnosis of bipolar I/II, years of illness, age and use of lamotrigine. Post-hoc pairwise comparison found that patients with an age of onset less ≤ 12 years spent more days hypomanic/manic: 16.4 percent versus 8.0 for patients with an age of onset between 13 and 19 years (p=0.006) and 8.2 percent for patients with an age of onset between 20 and 29 years (p = 0.031). The majority of the additional days of hypomania/mania occurred outside of an episode. Model-based cluster analysis found a mixture of 2 distributions of onset with peaks at age 15.1 years (SD = 4.7) and 27.5 years (SD = 10.2). Analysis of these two subgroups detected no significant differences in demographic characteristics or mood ratings.Age of onset subgroups arising from clinical observation may be more useful than those determined by cluster analysis.",0,0 +5922,Current status on behavioral and biological markers of PTSD: A search for clarity in a conflicting literature,"Extensive research has identified stereotypic behavioral and biological abnormalities in post-traumatic stress disorder (PTSD), such as heightened autonomic activity, an exaggerated startle response, reduced basal cortisol levels and cognitive impairments. We have reviewed primary research in this area, noting that factors involved in the susceptibility and expression of PTSD symptoms are more complex and heterogeneous than is commonly stated, with extensive findings which are inconsistent with the stereotypic behavioral and biological profile of the PTSD patient. A thorough assessment of the literature indicates that interactions among myriad susceptibility factors, including social support, early life stress, sex, age, peri- and post-traumatic dissociation, cognitive appraisal of trauma, neuroendocrine abnormalities and gene polymorphisms, in conjunction with the inconsistent expression of the disorder across studies, confounds attempts to characterize PTSD as a monolithic disorder. Overall, our assessment of the literature addresses the great challenge in developing a behavioral and biomarker-based diagnosis of PTSD.",0,0 +5923,Traumatic stress reactivity promotes excessive alcohol drinking and alters the balance of prefrontal cortex-amygdala activity,"Post-traumatic stress disorder (PTSD) and alcoholism are highly comorbid in humans and have partially overlapping symptomatic profiles. The aim of these studies was to examine the effects of traumatic stress (and stress reactivity) on alcohol-related behaviors and neuronal activation patterns. Male Wistar rats were trained to respond for alcohol, were exposed to predator odor (bobcat urine) paired with context and were tested for short- and long-term avoidance of the predator odor-paired context, alcohol self-administration and compulsivity of alcohol responding. Rats were re-exposed to the odor-paired context for western blot analysis of ERK phosphorylation in subregions of the medial prefrontal cortex (mPFC) and the amygdala. Rats that avoided the predator-paired chamber (Avoiders) exhibited persistent avoidance up to 6 weeks post conditioning. Avoiders exhibited increases in operant alcohol responding over weeks, as well as more compulsive-like responding for alcohol adulterated with quinine. Following re-exposure to the predator odor-paired context, Avoiders and Non-Avoiders exhibited unique patterns of neuronal activation in subregions of the mPFC and the amygdala, which were correlated with changes in avoidance and alcohol drinking. Furthermore, activity of upstream regions was differentially predictive of downstream regional activity in the Avoiders versus Non-Avoiders. An animal model for assessing the effect of traumatic stress on alcohol drinking reveals individual differences in neuronal activation patterns associated with re-exposure to traumatic stress-related stimuli, and may provide insight into the neural mechanisms underlying excessive alcohol consumption in humans with PTSD.",0,0 +5924,"Relationships among Dispositional Attributional Style, Trauma-Specific Attributions, and PTSD Symptoms","The learned helplessness model and its various revisions suggest that causal attributions influence responses to events. This study examined relationships among the 3-factor symptom clusters of posttraumatic stress disorder (PTSD) represented in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–IV; American Psychiatric Association, 1994) and the individual dimensions of dispositional attributional style and trauma-specific attributions (i.e., internal–external, stable–unstable, global–specific). Relationships among attributions and clusters of PTSD symptoms represented by the 4-factor dysphoria model were also examined. Trauma-specific attributions were most predictive of PTSD symptoms, with higher associations for avoidance and numbing symptoms compared to arousal symptoms in the three-factor model and higher associations for dysphoria symptoms compared to arousal and avoidance symptoms in the four-factor dysphoria model. Results suggest that cognitive vulnerabilities coul...",0,0 +5925,Brief Symptom Inventory symptom profiles of outpatients with borderline intellectual functioning and major depressive disorder or posttraumatic stress disorder: Comparison with patients from regular mental health care and patients with Mild Intellectual Disabilities,"In most countries, people with borderline intellectual functioning (BIF) are not considered a separate group in mental health care. There is little to no research on the impact of BIF on the presentation, nature and severity of mental health problems. The aim of the present exploratory study was to compare, in a naturalistic setting of patients referred to secondary care, symptom profiles of patients with BIF diagnosed with either major depressive disorder (MDD) or posttraumatic stress disorder (PTSD) to patients from regular mental health care (RMHC) and patients with Mild ID diagnosed with the same disorders.We used a cohort of adolescent and adult outpatients (aged 16-88) with or without BIF diagnosed with a primary diagnosis MDD or PTSD. Primary outcome was the nature and severity of psychopathological symptoms assessed at baseline using the Brief Symptom Inventory. All outcomes were adjusted for gender and age.Results showed that BIF patients with a primary diagnosis MDD reported less severe symptoms on BSI Total and the subscales Depression, Obsession-Compulsion and Psychoticism than patients from regular mental health care (RMHC). There were no statistically significant differences in reported symptom severity on BSI Total and the different BSI subscales between BIF patients with PTSD and either patients from RMHC or patients with Mild ID. Patients Mild ID, did report significantly less severe symptoms on the subscale Depression and on the subscale Psychoticism than patients from RMHC.Since there were no other published studies into symptom profiles in patients with BIF compared to either patients with higher or lower levels of cognitive functioning, the study was mainly exploratory in nature, providing direction for future research. Results indicate that symptom profiles did not widely differ, but that there might be some characteristics unique to patients BIF separating them as a group from both patients from RMHC and patients with Mild ID.",0,0 +5926,A meta-analytic clarification of the relationship between posttraumatic growth and symptoms of posttraumatic distress disorder,"Traumatic experiences can have a powerful impact on individuals and communities but the relationship between perceptions of beneficial and pathological outcomes are not known. Therefore, this meta-analysis examined both the strength and the linearity of the relationship between symptoms of posttraumatic stress disorder (PTSD) and perceptions of posttraumatic growth (PTG) as well as identifying the potential moderating roles of trauma type and age. Literature searches of all languages were conducted using the ProQuest, Wiley Interscience, ScienceDirect, Informaworld and Web of Science databases. Linear and quadratic (curvilinear) rs as well as βs were analysed. Forty-two studies (N = 11,469) that examined both PTG and symptoms of PTSD were included in meta-analytic calculations. The combined studies yielded a significant linear relationship between PTG and PTSD symptoms (r = 0.315, CI = 0.299, 0.331), but also a significantly stronger (as tested by Fisher's transformation) curvilinear relationship (r =0.372, CI = 0.353, 0.391). The strength and linearity of these relationships differed according to trauma type and age. The results remind those working with traumatised people that positive and negative post-trauma outcomes can co-occur. A focus only on PTSD symptoms may limit or slow recovery and mask the potential for growth.",0,0 +5927,A prospective study of leukocyte telomere length and risk of phobic anxiety among women,"We prospectively examined the relation of relative telomere lengths (RTLs), a marker of biological aging, to phobic anxiety in later-life. RTLs in peripheral blood leukocytes were measured among 3194 women in the Nurses' Health Study who provided blood samples in 1989/90. The Crown-Crisp Phobic Index (CCI, range=0–16) was assessed in 1988 and 2004. Only participants with CCI≤3 (consistent with no meaningful anxiety symptoms) in 1988 were included. We related baseline RTLs to odds ratios (ORs) of incident high phobic anxiety symptoms (CCI≥6). To enhance clinical relevance, we used finite mixture modeling (FMM) to relate baseline RTLs to latent classes of CCI in 2004. RTLs were not significantly associated with high phobic anxiety symptoms after 16 years of follow-up. However, FMM identified 3 groups of phobic symptoms in later-life: severe, minimal/intermediate, and non-anxious. The severe group had non-significantly shorter multivariable-adjusted mean RTLs than the minimal/intermediate and non-anxious groups. Women with shorter telomeres vs. longest telomeres had non-significantly higher likelihood of being in the severe vs. non-anxious group. Overall, there was no significant association between RTLs and incident phobic anxiety symptoms. Further work is required to explore potential connections of telomere length and emergence of severe phobic anxiety symptoms during later-life.",0,0 +5928,Postdisaster psychological intervention since 9/11.,"A wealth of research and experience after 9/11 has led to the development of evidence-based and evidence-informed guidelines and strategies to support the design and implementation of public mental health programs after terrorism and disaster. This article reviews advances that have been made in a variety of areas, including development of improved metrics and methodologies for conducting needs assessment, screening, surveillance, and program evaluation; clarification of risk and resilience factors as these relate to varying outcome trajectories for survivors and inform interventions; development and implementation of evidence-based and evidence-informed early, midterm, and late interventions for children, adults, and families; adaptation of interventions for cultural, ethnic, and minority groups; improvement in strategies to expand access to postdisaster mental health services; and enhancement of training methods and platforms for workforce development among psychologists, paraprofessionals, and other disaster responders. Continuing improvement of psychologists' national capacity to respond to catastrophic events will require more systematic research to strengthen the evidence base for postdisaster screening and interventions and effective methods and platforms for training. Policy decisions are clearly needed that enhance federal funding to increase availability and access to services, especially for longer term care. Traumatic bereavement represents a critical area for future research, as much needs to be done to clarify issues related to reactions and adaptation to a traumatic death.",0,0 +5929,Different Types of Postpartum Luteal Activity Affected by the Exposure of Heat Stress and Subsequent Reproductive Performance in Holstein Lactating Cows,"The aim of the present study was to determine the effect of heat stress on postpartum (PP) luteal activity and subsequent reproductive performance in lactating cows. Thirty Holstein-Friesian (HF, >or=75%) cows (hot season, n = 15 and cool season, n = 15) were studied over 60 days after calving. The changes of temperature-humidity index (THI) were monitored within both seasons. Body condition scores (BCS), uterine involution and the ovarian structures were recorded. Plasma samples were obtained three times a week for the analysis of progesterone (P4) and prostaglandin F(2 alpha) metabolite (PG metabolite). Subsequent reproductive performance of the cows, calved within the same period was also evaluated. The means of THI for hot and cool seasons varied between 84-87 and 78-83 respectively. A drop of the mean BCS was recorded at 5 weeks PP in the cows during hot season (p < 0.01), however a delay of uterine involution during early PP period in hot season was not clearly seen. The cows with normal PP ovarian cyclicity during hot and cool seasons were 4/15 (26.7%) and 9/15 (60.0%) respectively. A higher percentage of abnormal luteal activity was found in the cows during hot season (p = 0.07) and delayed luteal cyclicity/anovulation was the most pronounced atypical P4 profile. The levels of PG metabolite were not different between groups and the relationship between the levels of PG metabolite and the time of uterine involution was not evident (p > 0.05). The heat detection rates and the pregnancy rates were higher in the cows during cool season (p < 0.05). Additionally, the higher first AI conception rates during cool season were recorded (p = 0.06). In conclusion, heat stress conditions had negative effects on BCS and altered a normal process of ovarian resumption PP, consequently resulted in lower reproductive performance in a tropical dairy herd.",0,0 +5930,Does comorbid anxiety or depression affect clinical outcomes in patients with post-traumatic stress disorder and alcohol use disorders?,"Post-traumatic stress disorder (PTSD) is commonly comorbid with other psychiatric disorders, including substance use disorders. In spite of this, pharmacologic treatment trials for PTSD often exclude individuals with significant psychiatric comorbidity. This study is a post hoc analysis of a 12-week double-blind placebo-controlled trial investigating sertraline in the treatment of patients with comorbid PTSD and an alcohol use disorder. Individuals with additional anxiety and affective disorders were included. Patients (N = 93) were stratified into four groups depending on presence or absence of additional anxiety or depressive disorders and evaluated for the effects of comorbidity on PTSD symptoms, depressive symptoms, and drinking behaviors. We hypothesized that additional comorbidity would be associated with poorer outcomes. Patients in all four subgroups showed marked and clinically significant improvement in alcohol drinking behaviors over the course of the study. For the entire sample, over the course of the 12 weeks, mean drinks per drinking day fell from 13.0 +/- 8.4 (SD) to 3.0 +/- 5.0 (SD); t = 10.2, df = 92, P <.000. There were, however, no significant differences among groups. Patients in all four groups showed moderate improvement in Hamilton Depression Rating Scale (HAMD) scores and Clinician-Administered PTSD scale (CAPS) scores at endpoint. For the entire sample, mean CAPS scores fell from 59.3 +/- 19.4 (SD) to 40.8 +/- 26.0, t = 8.9, df = 92, P <.000. Mean HAMD scores fell from 17. 9 +/- 6.7 (SD) at baseline to 11.8 +/- 9.4 (SD) at endpoint; t = 6.7, df = 92, P <.000. There were, however, no significant differences among groups for change in HAM-D or CAPS scores. Hence, contrary to our hypothesis, having additional anxiety or mood disorder comorbidity did not decrease treatment response in individuals with comorbid PTSD and an alcohol use disorder.",0,0 +5931,Treatment of psychosis during pregnancy – a case report and a mini-review,"Nielsen RE. Treatment of psychosis during pregnancy – a case report and a mini-review. Objective: Describe clinical problems in treating a patient with psychotic symptoms during pregnancy by presenting a case report, and review the current evidence on antipsychotic drugs during pregnancy. Methods: The review consists of a non-systematic clinical review of current data on treatment with antipsychotics during pregnancy. The case, a 27 year old female initially diagnosed with posttraumatic stress disorder (PTSD) after a rape and emotionally unstable personality disorder, illustrates some of the common challenges a clinician meets. The patient initially discontinues all treatment as she is unsure if the drugs could have a teratogenic effect and is changed to a treatment that is regarded as safe during pregnancy. Results: The current data supports treatment with chlorpromazine although there is a risk of side effects, e.g. extrapyramidal symptoms and hypotension, but also treatment with olanzapine and risperidone. If the patient is currently treated with clozapine, this treatment should be continued, due to clozapines unique efficacy profile. Blood monitoring for six months after birth is recommended when the newborn has been exposed to clozapine treatment. Conclusion: Current evidence on treatment with antipsychotics during pregnancy is sparse, but not treating is associated with increased risks compared to treatment.",0,0 +5932,Examining factors that contribute to the process of resilience following spinal cord injury,"Cross-sectional survey.To examine factors that contribute to the process of positive adjustment, or resilience, in an adult community sample with spinal cord injury (SCI).South Australian Spinal Cord Injury Service, Hampstead Rehabilitation Centre, South Australia, AustraliaA postal survey comprising standardised measures of resilience (Connor-Davidson Resilience Scale-10 item), self-efficacy (Moorong Self-Efficacy Scale), locus of control (Locus of Control of Behaviour Scale) and psychological distress (Depression Anxiety Stress Scale--21 item).Of 60 respondents, 58% reported moderate to high levels of resilience. Resilience correlated significantly with high self-efficacy (r=0.68, P<0.01), internal locus of control (r=-0.52, P<0.01) and low psychological distress (depression r=-0.68, P<0.01; anxiety r=-0.55, P<0.01; stress r=-0.67, P<0.01). In comparison, resilience was not significantly influenced by degree of neuropathic pain (r=-0.23, P>0.05), time since injury (r=-0.14, P>0.05), gender (t(58)=-0.92, P>0.05), lesion completeness (t(57)=-0.86, P>0.05), or SCI diagnosis (t(58)=-1.21, P>0.05). A multiple regression indicated that psychological distress and self-efficacy were the only two variables that uniquely contributed to resilient behaviour.Resilience is an important psychological process in the longer-term management of SCI which can be promoted by targeting rehabilitation interventions towards mood management in addition to self efficacy beliefs. Larger-scale research will help to validate these results.",0,0 +5933,Residential Treatment for Combat-Related Posttraumatic Stress Disorder: Identifying Trajectories of Change and Predictors of Treatment Response,"Combat-related posttraumatic stress disorder (PTSD) can be a difficult condition to treat and has been associated with serious medical and economic issues among U.S. military veterans. Distinguishing between treatment responders vs. non-responders in this population has become an important public health priority. This study was conducted to identify pre-treatment characteristics of U.S. veterans with combat-related PTSD that might contribute to favorable and unfavorable responses to high value treatments for this condition.This study focused on 805 patients who completed a VHA PTSD residential program between 2000 and 2007. These patients completed the PTSD Clinical Checklist at pre-treatment, post-treatment, and a four-month follow-up assessment. Latent growth curve analysis (LCGA) was incorporated to determine trajectories of changes in PTSD across these assessments and whether several key clinical concerns for this population were associated with their treatment responses.LCGA indicated three distinct trajectories in PTSD outcomes and identified several clinical factors that were prospectively linked with changes in veterans' posttraumatic symptomatology. When compared to a group with high PTSD symptom severity that decreased over the program but relapsed at follow-up (41%), the near half (48.8%) of the sample with an improving trajectory had less combat exposure and superior physical/mental health. However, when compared to a minority (10.2%) with relatively low symptomatology that also remained somewhat stable, patients in the improving group were younger and also reported greater combat exposure, poorer physical/mental health status, and more problems with substance abuse before the start of treatment.Findings suggest that veterans are most likely to benefit from residential treatment in an intermediate range of symptoms and risk factors, including PTSD symptom severity, history of combat exposure, and comorbid issues with physical/mental health. Addressing these factors in an integrative manner could help to optimize the effectiveness of treatments of combat-related PTSD in many cases.",0,0 +5934,Predicting Posttraumatic Stress Disorder from Acute Reactions,"There is much interest in identifying people shortly after trauma exposure who will subsequently develop posttraumatic stress disorder (PTSD). This review outlines recent developments in early identification of trauma-exposed people who are at high risk for PTSD development, including the rationale, evidence, and limitations of the acute stress diagnosis as a predictor of chronic PTSD. The potential role of acute dissociative responses mediating development of PTSD is also reviewed. The available evidence suggests that whereas acute dissociation is an important factor in the acute stress response, many people develop PTSD in the absence of dissociative symptoms. The evidence suggests that dissociation needs to be considered in the context of other factors in the aftermath of trauma if optimal identification of high-risk individuals is to be achieved.",0,0 +5935,Psychosocial recovery after serious injury,"The 2010 iteration of the Global Burden of Disease statistics (Murray et al., 2012) points to the growing impact of injury and highlights the mounting burden of psychiatric disorder. It is essential to examine the intersection between these two contributors to disease burden.The Australian Injury Vulnerability Study collected data of over 1,000 injury patients from their initial hospitalization to 6 years post-injury. Structured clinical interviews were used to diagnose psychiatric disorder and self-report measures for disability and symptom severity.A wide range of psychiatric disorders developed following injury, which included posttraumatic stress disorder, agoraphobia, depression, and substance use disorders (Bryant, O'Donnell, Creamer, Silove, & McFarlane, 2010). Although prevalence rates for these disorders were generally consistent over time, examination of trajectory data showed that different people had the disorders at different times. Importantly, the data showed that early anxiety, depression, and PTSD symptoms played a significant role in the development of long term disability after injury (Carty, O'Donnell, Evans, Kazantzis, & Creamer, 2011; O'Donnell et al., 2013).These data support the view that transdiagnostic models for early intervention may be required to address the complex psychiatric disorder trajectories that develop after injury.",0,0 +5936,A meta‐analysis of prevalence rates and moderating factors for cancer‐related post‐traumatic stress disorder,"Objective Systematic reviews highlight a broad range of cancer-related post-traumatic stress disorder (CR-PTSD) prevalence estimates in cancer survivors. This meta-analysis was conducted to provide a prevalence estimate of significant CR-PTSD symptoms and full diagnoses to facilitate the psychological aftercare of cancer survivors. Methods A systematic literature search was conducted for studies using samples of cancer survivors by using validated clinical interviews and questionnaires to assess the prevalence of CR-PTSD (k = 25, n = 4189). Prevalence estimates were calculated for each assessment method using random-effects meta-analysis. Mixed-effects meta-regression and categorical analyses were used to investigate study-level moderator effects. Results Studies using the PTSD Checklist—Civilian Version yielded lower event rates using cut-off [7.3%, 95% confidence intervals (CI) = 4.5–11.7, k = 10] than symptom cluster (11.2%, 95% CI = 8.7–14.4, k = 9). Studies using the Structured Clinical Interview for Diagnostic and Statistical Manual, Fourth Edition (SCID), yielded low rates for lifetime (15.3%, 95% CI = 9.1–25, k = 5) and current CR-PTSD (5.1%, 95% CI = 2.8–8.9, k = 9). Between-study heterogeneity was substantial (I2 = 54–87%). Studies with advanced-stage samples yielded significantly higher rates with PTSD Checklist—Civilian Version cluster scoring (p = 0.05), and when assessing current CR-PTSD on the SCID (p = 0.05). The effect of mean age on current PTSD prevalence met significance on the SCID (p = 0.05). SCID lifetime prevalence rates decreased with time post-treatment (R2 = 0.56, p < 0.05). Discussion The cancer experience is sufficiently traumatic to induce PTSD in a minority of cancer survivors. Post-hoc analyses suggest that those who are younger, are diagnosed with more advanced disease and recently completed treatment may be at greater risk of PTSD. More research is needed to investigate vulnerability factors for PTSD in cancer survivors. © 2014 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.",0,0 +5937,"Screening of Current Post-Traumatic Stress Disorder in Patients with Substance Use Disorder Using the Depression, Anxiety and Stress Scale (DASS-21): A Reliable and Convenient Measure","<b><i>Background:</i></b> Several instruments have been developed and validated as screens for post-traumatic stress disorder (PTSD) in substance use disorder (SUD) patients. Unfortunately, many of these instruments have one or several disadvantages (e.g. low specificity, low sensitivity or high costs). No research has been conducted on instruments that screen simultaneously for other psychiatric disorders, which would be a potentially time-saving and cost-effective approach. In the current study we tested the psychometric properties of the Depression, Anxiety and Stress Scale (DASS) as a screen for PTSD. <b><i>Methods:</i></b> The DASS was assessed in an inpatient facility during intake with 58 patients and again 4 weeks after admission. Another 138 patients were assessed 4 weeks after admission only. The results were compared to the Clinician-Administered PTSD Scale (CAPS) that was also administered after 4 weeks of abstinence. <b><i>Results:</i></b> ROC curve analyses showed an area under the curve of 0.84 for the DASS at intake and 0.78 for the DASS after 4 weeks' abstinence. <b><i>Conclusion:</i></b> The DASS is therefore a reliable and convenient measure to use as a screen for PTSD in SUD patients.",0,0 +5938,Which symptoms of post-traumatic stress disorder are associated with suicide attempts?,"Individuals with post-traumatic stress disorder are at increased risk for suicide attempts. The present study aimed to determine which of the specific DSM-IV symptoms of post-traumatic stress disorder (PTSD) are independently associated with suicide attempts. Data came from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The NESARC has a sample size of N = 34653. The full sample size included in analyses was 2322 individuals with PTSD. Among individuals with lifetime PTSD, after adjusting for sociodemographic factors, as well as any mood, substance, personality, or anxiety disorder (excluding PTSD), increasing numbers of re-experiencing and avoidance symptoms were significantly correlated with suicide attempts. Of the specific symptoms, having physical reactions by reminders of the trauma, being unable to recall some part of it, and having the sense of a foreshortened future, were all associated with suicide attempts. These findings will help extend our understanding of the elevated risk for suicide attempts in individuals with PTSD.",0,0 +5939,Mediators and moderators of a psychosocial intervention for children affected by political violence.,"The authors examined moderators and mediators of a school-based psychosocial intervention for children affected by political violence, according to an ecological resilience theoretical framework.The authors examined data from a cluster randomized trial, involving children aged 8-13 in Central Sulawesi, Indonesia (treatment condition n = 182, waitlist control condition n = 221). Mediators (hope, coping, peer/emotional/play social support) and moderators (gender, age, family connectedness, household size, other forms of social support, exposure to political violence, and displacement) of treatment outcome on posttraumatic stress symptoms and function impairment were examined in parallel process latent growth curve models.Compared with the waitlist group, those receiving treatment showed maintained hope, increased positive coping, maintained peer social support, and increased play social support. Of these putative mediators, only play social support was found to mediate treatment effects, such that increases in play social support were associated with smaller reductions in posttraumatic stress disorder (PTSD) symptoms. Furthermore, the authors identified a number of moderators: Girls showed larger treatment benefits on PTSD symptoms; girls, children in smaller households, and children receiving social support from adults outside the household showed larger treatment benefits on function impairment.Findings provide limited evidence for an ecological resilience theoretical framework. On the basis of these findings, the authors recommend a stronger separation between universal prevention (e.g., resilience promotion through play) and selective/indicated prevention (e.g., interventions aimed at decreasing posttraumatic stress symptoms). Play-based interventions should be careful to exclude children with psychological distress. In addition, treatment effects may be augmented by selecting girls and socially vulnerable children.",0,0 +5940,Early and Delayed Onset of Response to Antidepressants in Individual Trajectories of Change During Treatment of Major Depression,"The timing and rate of improvement after the initiation of an antidepressant has implications for establishing the mechanism of antidepressant action and for answering the clinically relevant question of how long an appropriate trial of antidepressant medication should be. We explore the individual trajectories of relative change in depression severity to establish what proportion of individuals experience early and late onset of improvement.Longitudinal latent class analysis was applied in a secondary analysis of data obtained from the Genome-Based Therapeutic Drugs for Depression (GENDEP) study. In the GENDEP trial, conducted in 9 European academic psychiatry centers from July 2004 to June 2008, 811 treatment-seeking adult subjects with DSM-IV major depression received escitalopram or nortriptyline for 12 weeks. Montgomery-Asberg Depression Rating Scale measurements were taken weekly. The secondary analysis reported in this article was conducted in 2010.A model with 9 latent classes provided a good description of the individual trajectories of symptom change over time. These classes included 3 nonresponder classes, 3 classes with varying degrees of improvement concentrated in the first 3 weeks (early improvement), and 3 classes with varying degrees of improvement that was more prominent in the second 3 weeks than in the first 3 weeks (delayed improvement). More than half of the subjects who eventually reached remission showed a pattern of delayed improvement, and their eventual outcome could not be predicted from early time points. Early marked response occurred more frequently in subjects treated with nortriptyline than in those treated with escitalopram (12.9% vs 7.5%, χ² = 6.29, P = .01). Delayed complete remission occurred more frequently in subjects treated with escitalopram than in those treated with nortriptyline (13.6% vs 6.1%, χ² = 11.52, P = .0007).Both early and delayed improvement are common. Although early changes are maintained, the eventual outcome of 12-week antidepressant treatment can be accurately predicted only after 8 weeks.http://www.controlled-trials.com Identifier: ISRCTN03693000.",0,0 +5941,"Trajectories of Scores on a Screening Instrument for PTSD Among World Trade Center Rescue, Recovery, and Clean-Up Workers","The longitudinal course of posttraumatic stress disorder (PTSD) over 8-9 years was examined among 16,488 rescue and recovery workers who responded to the events of September 11, 2001 (9/11) at the World Trade Center (WTC; New York, NY), and were enrolled in the World Trade Center Health Registry. Latent class growth analysis identified 5 groups of rescue and recovery workers with similar score trajectories at 3 administrations of the PTSD Checklist (PCL): low-stable (53.3%), moderate- stable (28.7%), moderate-increasing (6.4%), high-decreasing (7.7%), and high-stable (4.0%). Relative to the low-stable group, membership in higher risk groups was associated with 9/11-related exposures including duration of WTC work, with adjusted odds ratios ranging from 1.3 to 2.0, witnessing of horrific events (range = 1.3 to 2.1), being injured (range = 1.4 to 2.3), perceiving threat to life or safety (range = 2.2 to 5.2), bereavement (range = 1.6 to 4.8), and job loss due to 9/11 (range = 2.4 to 15.8). Within groups, higher PCL scores were associated with adverse social circumstances including lower social support, with B coefficients ranging from 0.2 to 0.6, divorce, separation, or widowhood (range = 0.4-0.7), and unemployment (range = 0.4-0.5). Given baseline, exposure-related, and contextual influences that affect divergent PTSD trajectories, screening for both PTSD and adverse circumstances should occur immediately, and at regular intervals postdisaster.",1,0 +5942,Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis,"Background It is unclear how many children and adolescents develop post-traumatic stress disorder (PTSD) after trauma. Aims To determine the incidence of PTSD in trauma-exposed children and adolescents as assessed with well-established diagnostic interviews and to examine potential moderators of the estimate. Method A systematic literature search identified 72 peer-reviewed articles on 43 independent samples ( n = 3563). Samples consisting only of participants seeking or receiving mental health treatment were excluded. Main analyses involved pooled incidence estimates and meta-analyses of variance. Results The overall rate of PTSD was 15.9% (95% CI 11.5–21.5), which varied according to the type of trauma and gender. Least at risk were boys exposed to non-interpersonal trauma (8.4%, 95% CI 4.7–14.5), whereas girls exposed to interpersonal trauma showed the highest rate (32.9%, 95% CI 19.8–49.3). No significant difference was found for the choice of assessment interview or the informant of the assessment. Conclusions Research conducted with the best available assessment instruments shows that a significant minority of children and adolescents develop PTSD after trauma exposure, with those exposed to interpersonal trauma and girls at particular risk. The estimates provide a benchmark for DSM-5 and ICD-11.",0,0 +5943,New insights into secondary prevention in post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) is unique amongst psychiatric disorders in two ways. Firstly, there is usually a very clear point of onset- the traumatic event The second unique feature of PTSD is that it is characterized by a failure of the normal response to resolve. Given these two characteristics, PTSD appears a good candidate for secondary prevention, ie, interventions immediately after the trauma. Evidence available starting from current concepts and contemporary research of potential secondary prevention interventions are presented. Common practices in the aftermath of trauma such as debriefing and benzodiazepines need to be carefully considered, taking into account their potential harm to the spontaneous recovery process, and the trajectory of PTSD, and not only judging them according to their immediate (comforting) effects. A discussion of the balance required between aiding recovery but not interfering with the potent natural resolution of symptoms (that is expected in most cases), along with potential avenues of future research, are presented. Results of a small pilot study with a single intervention of hydrocortisone immediately after trauma appear to be promising, and clearly indicate the need for further studies.",0,0 +5944,Are traumatic events necessary to elicit symptoms of posttraumatic stress?,"A diagnosis of posttraumatic stress disorder (PTSD) has been conceptualized as being precipitated by a particularly traumatic (e.g., combat exposure, rape, and violent assault). Recent research suggests that common stressful events (e.g., relational problems, divorce, and expected death of a loved one) may also be capable of eliciting posttraumatic symptomatology. The current study replicated and extended these previous findings, examining three groups of exposure: those who reported experiencing only traumatic events in the past year, those who reported experiencing only significant stressful life events in the last year, and those who experienced both types of events. Consistent with previous findings, we found that all three groups of exposure, including those experiencing only stressful life events, experienced similar amounts of PTSD symptomatology across symptom clusters. These data add to the growing literature that suggests that the type of events that cause symptoms of PTSD may be broader than the current diagnostic criteria indicate, and as such calls for more rigorous research in this area to better understand the diagnostic implications of these findings. Since the formal inclusion of posttraumatic stress disorder (PTSD) into the Diagnostic and Statistical Manual of Mental Disorders (3rd ed.; DSM-III; American Psychiatric Association (APA), 1980), controversy has arisen with the diagnosis, much of it centered on Criterion A1 (the stressor criterion). In DSM-III, this criterion held that an individual had to experience an event that is outside the range of usual human experience and that would be markedly distressing to almost anyone (APA, 1980). One of the first critiques of PTSD came from Breslau and Davis (1987), who claimed that the connection between this criterion and the symptom constellation of the PTSD diagnosis had not been adequately tested in an empirical manner. An additional criticism of this early criterion concerned the definition of a traumatic as one that occurred rarely in the population. Epidemiological studies have shown that traumatic stressors are relatively common, with most people experiencing at least one traumatic within their lifetime (Breslau, Davis, Andreski, & Peterson, 1991). In addition to these early criticisms of PTSD as a construct, several research studies have documented that events not necessarily considered traumatic elicit the symptom constella- tion thought to be associated with PTSD, raising questions con- cerning the disorder's symptom specificity. A study conducted by Joseph, Mynard, and Mayall (2000) on English adolescents found a relationship between high scores on measures of posttraumatic stress symptoms and stressful life events that normally would not be classified as traumatic by the current PTSD inclusion criteria (e.g., parental separation, trouble with the police, and family member with a drug or alcohol prob- lem). Additionally, Mol and colleagues (2005) used a general population sample to examine whether stressful events could gen- erate symptoms of PTSD and found that those who identified a stressful life as their worst subjective experience endorsed higher levels of PTSD symptoms than did those whose worst experience was a traumatic event. Similarly, Gold, Marx, Soler- Baillo, and Sloan (2005) divided college undergraduate partici- pants into two groups: those who endorsed a traumatic consistent with the A1 criterion of PTSD and those who experi- enced a negative life not consistent with that criterion. Consistent with previous research, individuals who reported expe- riencing negative life events not consistent with the traumatic nature of the A1 criterion showed equal, if not more, posttraumatic symptomatology than did those who indicated the experience of a traumatic in their life. A more recent study using structured clinical interviews found similar results in a sample of people seeking treatment for major depression (Bodkin, Pope, Detke, & Hudson, 2007). These recent findings underscore a perceived problem with the construct of PTSD and the criterion that has received increased attention as we move closer to the release of DSM (5th ed.). These studies also highlight the importance of additional research in this area to further explore the A1 criterion of PTSD and the stressors that can lead to a posttraumatic stress symptom constellation.",0,0 +5945,Tachykinin Receptors as Therapeutic Targets in Stress-Related Disorders,"The first report demonstrating the therapeutic efficacy of an orally applied neurokinin-1 (NK1) receptor antagonist in depression was published 10 years ago. Although there were difficulties to reproduce this particular finding, a huge amount of data has been published since this time, supporting the potential therapeutic value of various tachykinin ligands as promising novel tools for the management of stress-related disorders including anxiety disorders, schizophrenia and depression. The present review summarizes evidence derived from anatomical, neurochemical, pharmacological and behavioral studies demonstrating the localization of tachykinin neuropeptides including substance P (SP), neurokinin A, neurokinin B and their receptors (NK1, NK2, NK3) in brain areas known to be implicated in stress-mechanisms, mood/anxiety regulation and emotion-processing; their role as neurotransmitters and/or neuromodulators within these structures and their interactions with other neurotransmitter systems including dopamine, noradrenaline and serotonin (5-hydroxytryptamine, 5-HT). Finally, there is clear functional evidence from animal and human studies that interference with tachykinin transmission can modulate emotional behavior. Based on these findings and on evidence of upregulated tachykinin transmission in individuals suffering from stress-related disorders, several diverse tachykinin receptor antagonists, as well as compounds with combined antagonist profile have been developed and are currently under clinical investigation revealing evidence for anxiolytic, antidepressant and antipsychotic efficacy, seemingly characterized by a low side effect profile. However, substantial work remains to be done to clarify the precise mechanism of action of these compounds, as well as the potential of combining them with established and experimental therapies in order to boost efficacy.",0,0 +5946,The psychological impact of the Israel–Hezbollah War on Jews and Arabs in Israel: The impact of risk and resilience factors,"Although there is abundant evidence that mass traumas are associated with adverse mental health consequences, few studies have used nationally representative samples to examine the impact of war on civilians, and none have examined the impact of the Israel-Hezbollah War, which involved unprecedented levels of civilian trauma exposure from July 12 to August 14, 2006. The aims of this study were to document probable post-traumatic stress disorder (PTSD), determined by the PTSD Symptom Scale and self-reported functional impairment, in Jewish and Arab residents of Israel immediately after the Israel-Hezbollah War and to assess potential risk and resilience factors. A telephone survey was conducted August 15-October 5, 2006, following the cessation of rocket attacks. Stratified random sampling methods yielded a nationally representative population sample of 1200 adult Israeli residents. The rate of probable PTSD was 7.2%. Higher risk of probable PTSD was associated with being a woman, recent trauma exposure, economic loss, and higher psychosocial resource loss. Lower risk of probable PTSD was associated with higher education. The results suggest that economic and psychosocial resource loss, in addition to trauma exposure, have an impact on post-trauma functioning. Thus, interventions that bolster these resources might prove effective in alleviating civilian psychopathology during war.",0,0 +5947,Follow-up of young road accident victims,The aim of this study was to follow-up a group of children and young people previously examined for psychological sequelae following road traffic accidents. The group was assessed 18-month postaccident to assess the severity of continuing symptoms and examine any emergence of delayed onset of posttraumatic stress reactions. Participants (N = 31) completed the Revised Impact of Event Scale and the Child Posttraumatic Stress Reaction Index. Parents completed the Child Behavior Check-List and participated in a semistructured interview. Symptoms of PTSD were noted in a quarter of participants as was delayed onset of symptoms. The role of avoidance in symptom reporting and continuing disorder is discussed.,0,0 +5948,Parental Stress Response to Sexual Abuse and Ritualistic Abuse Of Children in Day-Care Centers,"The purpose of this study was to examine the stress responses of parents to the sexual and ritualistic abuse of their children in day-care centers. Sixty-five mothers and 46 fathers of children sexually abused in day-care centers completed the Symptom Checklist-90-Revised (SCL-90-R), a measure of psychological distress. These scores were compared with a carefully matched comparison group of parents of 67 nonabused children. Parents of abused children also completed the Impact of Event Scale (IES), a measure which indexes symptoms that characterize posttraumatic stress disorder. Parents of sexually abused children reported significantly more psychological distress than parents of nonabused children, with parents of ritually abused children displaying the most severe psychological distress. Parents of abused children reported symptom profiles on the SCL-90-R and IES consistent with posttraumatic stress disorder.",0,0 +5949,Traumatic stress and psychopathology: experiences of a trauma clinic,"Objective: The study was undertaken to investigate the profile of individuals referred to the psychiatrist for assessment in terms of their demographic features, trauma experienced, diagnosis according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV), and recommendations made by the psychiatrist. Method: The trauma clinic, a key component of the Victim Empowerment Programme (VEP) of the Centre for the Study of Violence and Reconciliation (CSVR) in Johannesburg, South Africa is a multidisciplinary unit offering counselling and debriefing services to victims/survivors of violence. The staff consists of trained therapists (clinical, research and educational psychologists), social workers and a psychiatric nurse. Since 1998, a psychiatrist has been consulting at the clinic as well. A retrospective case review of all intake notes and progress notes of the clients was undertaken. The period of the survey was 1999-2002. Results: Of 3668 individuals presenting to the centre, 127 were referred to the resident psychiatrist for assessment. 119 were assessed. The majority were in the age range 15-45, unmarried and unemployed. Children under the age of 15 and refugees constituted 9.9% and 30% respectively. Major Depression was the most commonly diagnosed psychiatric condition (17.6%), with Post Traumatic Stress Disorder (PTSD), diagnosed less than expected (5.9%). Co- morbidity was common. Medication was prescribed for 66.4% of the sample, with a further 5.9% hospitalised. Conclusion: Not all individuals exposed to trauma develop PTSD, with mood disorders possibly being more common.",0,0 +5950,Quality of Life and Its Predictors in Adolescents after General Traumatic Injury,"Background: Injury is a leading cause of morbidity in adolescents in the United States, with almost 4 million 12- to 18-year olds experiencing non-fatal injury in 2009 alone. As survival rates improved, negative psychosocial outcomes were noted, including reduced health-related quality of life (HRQOL). Several variables have been investigated for association with worse HRQOL outcomes. However, no study has reported on the broader construct of quality of life (QOL) in this setting. The current project studied QOL in adolescents after general traumatic injury, specifically investigating whether it differed from a comparison group or changed over the year after injury. Factors potentially associated with poorer QOL outcomes were also evaluated, as they might serve as potential targets for intervention. Method: One-hundred eight 12- to 18-year-olds admitted to a level 1 trauma center after injury participated in this prospective cohort study with a population-based sampling frame. Data were collected within 30 days of injury and 2, 5, and 12 months after injury. The comparison sample was 116 12- to 18-year-olds without disability, mental health diagnosis or chronic illness. Adolescent posttraumatic stress disorder symptoms (PTSS), depressive symptoms, traumatic or stressful life events and parental PTSS were all considered for potential relationship to adolescent QOL. Analyses included descriptive statistics, paired comparisons, ANOVAs, mixed-model and linear regression and mediation analysis. Results: In general, injured adolescents reported normative QOL at injury and 2 months later and significantly better QOL at 5 and 12 months after injury. However, posttraumatic stress disorder was associated with significantly poorer QOL, and those with a higher number of postinjury traumatic or stressful life events had poorer QOL 1 year after injury. Depressive symptoms were also significantly correlated with lower QOL. Parental PTSS did not mediate the relationship between adolescent PTSS and QOL. Conclusions: Findings suggest points of intervention to improve QOL after adolescent injury. They further highlight a need for close communication between trauma center staff and primary care practitioners as well as education for primary providers. Future directions include attention to preinjury mental health and family functioning, investigations with younger children, and longer follow-up. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5951,"Relationship between anger, alcoholism and symptoms of posttraumatic stress disorders in war veterans","Purpose: Studies among veterans indicate that veterans with posttraumatic stress disorder (PTSD) express anger, hostility and aggression as well as alcohol and substance abuse more then veterans without PTSD. The aim of this study was to analyze the relationship between anger, use of alcohol and symptoms of PTSD in war veterans in Bosnia and Herzegovina (B&H). Method: Comparing a group of veterans (n=54) with PTSD who use alcohol and a group of veterans (n=46) who do not use alcohol, the analyzed were dimensions of anger related to PTSD symptoms and alcohol usage. Medical records of patients treated at the Department for Psychiatry in Tuzla, B&H, Harvard Trauma Questionnaire (HTQ) – version for Bosnia and Herzegovina, State-Trait Anger Expression Inventory (STAXI), Structured Clinical Diagnostic Interview (SCID-I) were used in this study. The basic socio-demographic data were also collected. Results: A significant correlation is found between alcohol usage, and state and trait of anger (P",0,0 +5952,Prenatal Excess Glucocorticoid Exposure and Adult Affective Disorders: A Role for Serotonergic and Catecholamine Pathways,"Fetal glucocorticoid exposure is a key mechanism proposed to underlie prenatal ‘programming’ of adult affective behaviours such as depression and anxiety. Indeed, the glucocorticoid metabolising enzyme 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2), which is highly expressed in the placenta and the developing fetus, acts as a protective barrier from the high maternal glucocorticoids which may alter developmental trajectories. The programmed changes resulting from maternal stress or bypass or from the inhibition of 11β-HSD2 are frequently associated with alterations in the hypothalamic-pituitary-adrenal (HPA) axis. Hence, circulating glucocorticoid levels are increased either basally or in response to stress accompanied by CNS region-specific modulations in the expression of both corticosteroid receptors (mineralocorticoid and glucocorticoid receptors). Furthermore, early-life glucocorticoid exposure also affects serotonergic and catecholamine pathways within the brain, with changes in both associated neurotransmitters and receptors. Indeed, global removal of 11β-HSD2, an enzyme that inactivates glucocorticoids, increases anxiety- and depressive-like behaviour in mice; however, in this case the phenotype is not accompanied by overt perturbation in the HPA axis but, intriguingly, alterations in serotonergic and catecholamine pathways are maintained in this programming model. This review addresses one of the potential adverse effects of glucocorticoid overexposure in utero, i.e. increased incidence of affective behaviours, and the mechanisms underlying these behaviours including alteration of the HPA axis and serotonergic and catecholamine pathways.",0,0 +5953,Dynamic resolution of functionally related gene sets in response to acute heat stress,"Using a gene clustering strategy we determined intracellular pathway relationships within skeletal myotubes in response to an acute heat stress stimuli. Following heat shock, the transcriptome was analyzed by microarray in a temporal fashion to characterize the dynamic relationship of signaling pathways.Bioinformatics analyses exposed coordination of functionally-related gene sets, depicting mechanism-based responses to heat shock. Protein turnover-related pathways were significantly affected including protein folding, pre-mRNA processing, mRNA splicing, proteolysis and proteasome-related pathways. Many responses were transient, tending to normalize within 24 hours.In summary, we show that the transcriptional response to acute cell stress is largely transient and proteosome-centric.",0,0 +5954,Assessing acute stress disorder: Psychometric properties of a structured clinical interview.,"This study presents the development ofa structured clinical interview to diagnose acute stress disorder (ASD). The Acute Stress Disorder Interview (ASDI) is a 19-item, dichotomously scored interview schedule that is based on criteria from the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). It was validated against clinician-based diagnoses of ASD on 65 trauma survivors assessed between 1 and 3 weeks posttrauma. It possessed good internal consistency (r = .90), sensitivity (91%), and specificity (93%). Test-retest reliability was evaluated on 60 trauma survivors between 1 and 3 weeks posttrauma, with a readministration interval of 2 to 7 days. Test-retest reliability of ASDI severity scores was strong (r = .88), and diagnostic agreement for presence (88%) and absence (94%) of ASD diagnosis was high. The ASDI appears to be a useful tool to identify those individuals who suffer ASD and are at risk of long-term posttraumatic stress disorder.",0,0 +5955,Group-Based Trajectory Analysis Applications for Prognostic Biomarker Model Development in Severe TBI: A Practical Example,"Over the last decade, biomarker research has identified potential biomarkers for the diagnosis, prognosis, and management of traumatic brain injury (TBI). Several cerebrospinal fluid (CSF) and serum biomarkers have shown promise in predicting long-term outcome after severe TBI. Despite this increased focus on identifying biomarkers for outcome prognostication after a severe TBI, several challenges still exist in effectively modeling the significant heterogeneity observed in TBI-related pathology, as well as the biomarker-outcome relationships. Biomarker data collected over time are usually summarized into single-point estimates (e.g., average or peak biomarker levels), which are, in turn, used to examine the relationships between biomarker levels and outcomes. Further, many biomarker studies to date have focused on the prediction power of biomarkers without controlling for potential clinical and demographic confounders that have been previously shown to affect long-term outcome. In this article, we demonstrate the application of a practical approach to delineate and describe distinct subpopulations having similar longitudinal biomarker profiles and to model the relationships between these biomarker profiles and outcomes while taking into account potential confounding factors. As an example, we demonstrate a group-based modeling technique to identify temporal S100 calcium-binding protein B (S100b) profiles, measured from CSF over the first week post-injury, in a sample of adult subjects with TBI, and we use multivariate logistic regression to show that the prediction power of S100b biomarker profiles can be superior to the prediction power of single-point estimates.",0,0 +5956,White Matter Compromise in Veterans Exposed to Primary Blast Forces,"OBJECTIVE:: Use diffusion tensor imaging to investigate white matter alterations associated with blast exposure with or without acute symptoms of traumatic brain injury (TBI). PARTICIPANTS:: Forty-five veterans of the recent military conflicts included 23 exposed to primary blast without TBI symptoms, 6 having primary blast with mild TBI, and 16 unexposed to blast. DESIGN:: Cross-sectional case-control study. MAIN MEASURES:: Neuropsychological testing and diffusion tensor imaging metrics that quantified the number of voxel clusters with altered fractional anisotropy (FA) radial diffusivity, and axial diffusivity, regardless of their spatial location. RESULTS:: Significantly lower FA and higher radial diffusivity were observed in veterans exposed to primary blast with and without mild TBI relative to blast-unexposed veterans. Voxel clusters of lower FA were spatially dispersed and heterogeneous across affected individuals. CONCLUSION:: These results suggest that lack of clear TBI symptoms following primary blast exposure may not accurately reflect the extent of brain injury. If confirmed, our findings would argue for supplementing the established approach of making diagnoses based purely on clinical history and observable acute symptoms with novel neuroimaging-based diagnostic criteria that look below the surface for pathology. Language: en",0,0 +5957,Identification of Traumatic Stress Reactions in Women at Increased Risk for Breast Cancer,"It has been shown that the diagnosis and treatment of cancer may constitute a traumatic event that generates in patients and some of their family members traumatic reactions that are consistent with the symptom profile of posttraumatic stress disorder (PTSD). The present study was conducted to establish the degree to which women at increased familial risk for breast cancer showed such traumatic reactions and to establish which demographic or psychological variables may contribute to the experience of such traumatic reactions in at-risk individuals. Seventy-three women from the Revlon UCLA Breast Center High Risk Clinic were assessed for traumatic reactions that might be consistent with the DSM-IV criteria for PTSD. The results showed that women at increased risk for breast cancer exhibited traumatic responses similar to those reported by cancer patients. When the authors used a self-report instrument that maps onto DSM-IV criteria, 4% of the study subjects reported symptoms consistent with criteria for a potential diagnosis of PTSD, and an additional 7% of the subjects reported symptoms consistent with potentially subclinical levels of PTSD, according to DSM-IV criteria.",0,0 +5958,A voice-based automated system for PTSD screening and monitoring.,"Comprehensive evaluation of PTSD includes diagnostic interviews, self-report testing, and physiological reactivity measures. It is often difficult and costly to diagnose PTSD due to patient access and the variability in symptoms presented. Additionally, potential patients are often reluctant to seek help due to the stigma associated with the disorder. A voice-based automated system that is able to remotely screen individuals at high risk for PTSD and monitor their symptoms during treatment has the potential to make great strides in alleviating the barriers to cost effective PTSD assessment and progress monitoring. In this paper we present a voice-based automated Tele-PTSD Monitor (TPM) system currently in development, designed to remotely screen, and provide assistance to clinicians in diagnosing PTSD. The TPM system can be accessed via a Public Switched Telephone Network (PSTN) or the Internet. The acquired voice data is then sent to a secure server to invoke the PTSD Scoring Engine (PTSD-SE) where a PTSD mental health score is computed. If the score exceeds a predefined threshold, the system will notify clinicians (via email or short message service) for confirmation and/or an appropriate follow-up assessment and intervention. The TPM system requires only voice input and performs computer-based automated PTSD scoring, resulting in low cost and easy field-deployment. The concept of the TPM system was supported using a limited dataset with an average detection accuracy of up to 95.88%.",0,0 +5959,Effect of DHA Supplementation During Pregnancy on Maternal Depression and Neurodevelopment of Young Children,"Uncertainty about the benefits of dietary docosahexaenoic acid (DHA) for pregnant women and their children exists, despite international recommendations that pregnant women increase their DHA intakes.To determine whether increasing DHA during the last half of pregnancy will result in fewer women with high levels of depressive symptoms and enhance the neurodevelopmental outcome of their children.A double-blind, multicenter, randomized controlled trial (DHA to Optimize Mother Infant Outcome [DOMInO] trial) in 5 Australian maternity hospitals of 2399 women who were less than 21 weeks' gestation with singleton pregnancies and who were recruited between October 31, 2005, and January 11, 2008. Follow-up of children (n = 726) was completed December 16, 2009.Docosahexaenoic acid-rich fish oil capsules (providing 800 mg/d of DHA) or matched vegetable oil capsules without DHA from study entry to birth.High levels of depressive symptoms in mothers as indicated by a score of more than 12 on the Edinburgh Postnatal Depression Scale at 6 weeks or 6 months postpartum. Cognitive and language development in children as assessed by the Bayley Scales of Infant and Toddler Development, Third Edition, at 18 months.Of 2399 women enrolled, 96.7% completed the trial. The percentage of women with high levels of depressive symptoms during the first 6 months postpartum did not differ between the DHA and control groups (9.67% vs 11.19%; adjusted relative risk, 0.85; 95% confidence interval [CI], 0.70-1.02; P = .09). Mean cognitive composite scores (adjusted mean difference, 0.01; 95% CI, -1.36 to 1.37; P = .99) and mean language composite scores (adjusted mean difference, -1.42; 95% CI, -3.07 to 0.22; P = .09) of children in the DHA group did not differ from children in the control group.The use of DHA-rich fish oil capsules compared with vegetable oil capsules during pregnancy did not result in lower levels of postpartum depression in mothers or improved cognitive and language development in their offspring during early childhood.anzctr.org.au Identifier: ACTRN12605000569606.",0,0 +5960,Posttraumatic Stress Disorder after Traumatic Brain Injury and Interpersonal Relationships: Contributions from Object-Relations Perspectives,"Posttraumatic stress disorder (PTSD) has been identified in survivors of traumatic brain injury (TBI), sustained from road traffic accidents, assaults, or industrial accidents. This article reviews the small literature on this population, which is predominantly characterized by integrations of cognitive neuropsychology and cognitive behavior therapy. While these perspectives have been applied to identify etiological processes and treatment options, one insufficiently specified domain in this literature is the role of interpersonal relationships. This includes interpersonal etiological mechanisms and social outcomes, but also therapeutic process for PTSD after TBI. In response, object-relations psychoanalytic concepts of symbolizing (Segal, 1957) and containing–contained (Bion, 1962) mechanisms are applied. These concepts are used to consider the aforementioned factors while permitting close conceptual links to neurological and cognitive vulnerabilities for this clinical group. This article finishes with a...",0,0 +5961,The Influences of Event Centrality in Memory Models of PTSD,"Summary The consequences of events for well-being are influenced by individual and situational factors that are often studied in isolation. In the research reported here, a large (N = 489) nonclinical sample of college students reported their most traumatic event, posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, personality traits, and characteristics of their event memory. This study achieved three major goals. First, we identified the highest types of stress event types in this population as disruptions of interpersonal relationships, homicides/assaults on others, and assaults/accidents involving themselves. Second, we established that the effects of memory characteristics such as vividness, belief, and impact on PTSD symptoms are mediated by the centrality of the event to identity. Third, we affirmed the hypothesis that a structural model of the influence of personality factors on PTSD symptoms has a higher level of concurrent validity if event centrality is included as a mediator of those influences. Copyright © 2015 John Wiley & Sons, Ltd.",0,0 +5962,THE ROLE OF SOCIAL SUPPORT ON MENTAL HEALTH AFTER MULTIPLE WILDFIRE DISASTERS,"Disasters can erode mental health (MH), even if it does not reach mental illness. This study explored the direct or moderating role of social support on MH after multiple wildfires, with attention to evacuation status and participant sex. Participants (N = 402) responded to a random digit dial telephone survey about their disaster exposure, current MH, MH at the time of the fire, social support, and life stressors since the disaster. For the evacuated, social support moderated the relation of fire stress to MH at the time of the fire, with those with high social support having better MH. For current MH, social support had a direct relation to MH, and moderated the influence of life stressors since the disaster for the evacuated and women. For those with a life stressor, current MH was better with high social support, but worse under average or low social support. Social support had a relation to current MH for women, but not men.",0,0 +5963,Traumatic stress in parents of children admitted to the pediatric intensive care unit,"To measure the prevalence of parental acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) and to examine the relationship between ASD symptoms and PTSD symptoms in parents of infants and children admitted to the pediatric intensive care unit (PICU). To examine the correlation between parental perceptions of illness severity and objective measures. To assess the association among demographic, situational, and illness factors and the severity of ASD and PTSD.Prospective cohort study.Thirty-eight bed PICU at an urban children's hospital.The parents of 272 children admitted to the PICU for >48 hrs.ASD symptoms were assessed using the Acute Stress Disorder Scale during the child's admission. PTSD symptoms were assessed using the PTSD Checklist at least 2 months after discharge. The severity of illness was measured using the Pediatric Risk of Mortality (PRISM III) score.Of the 272 parents completing the initial assessment, 87 (32%) met symptom criteria for ASD. Of the 161 parents completing follow-up, 33 (21%) met symptom criteria for PTSD. PTSD symptoms at follow-up were associated with ASD symptoms assessed in the PICU, unexpected admission, parent's degree of worry that the child might die, and the occurrence of another hospital admission or other traumatic event subsequent to the index admission. Neither ASD nor PTSD responses were associated with objective measures of a child's severity of illness (PRISM III score).Traumatic stress symptoms are common among parents in the PICU and may persist long after discharge. There is strong support from these data for continued attention to supporting parents both during and after a child's PICU admission.",0,0 +5964,"Prevalence and Determinants of Intimate Partner Violence Against Women in Kazeroon, Islamic Republic of Iran","The aim of this study was to screen for and estimate the prevalence of intimate partner violence (IPV) among women in Kazeroon, Iran. In November 2007, multistage cluster sampling was employed to recruit 702 women to participate in the study. A descriptive, cross-sectional design was employed. The prevalence of physical, psychological, and sexual abuse against women was 43.7%, 82.6%, and 30.9%, respectively, and there was a significant relationship between IPV and family income, education level, and level of religious commitment in both women and husbands. The study suggests that major strategies for prevention of IPV are empowering women and improving their status in the society by promoting of sexual equality in all rights, especially in employment and education.",0,0 +5965,Nefazodone in the treatment of patients with post-traumatic stress disorder,"Post-traumatic stress disorder occurs in patients who have undergone a traumatic experience and manifests itself through a cluster of symptoms, including re-experiencing, avoidance and hyperarousal. Post-traumatic stress disorder is commonly found among veterans of war and victims of sexual trauma, natural disasters and accidents. Nefazodone is a medication that has an FDA-approved indication for treating depression. Nefazodone has also been reported to be efficacious in treating post-traumatic stress disorder. Despite recent reports of hepatotoxicity, when used appropriately, nefazodone is generally as well-tolerated as the medications currently FDA-indicated for post-traumatic stress disorder, the selective serotonin reuptake inhibitors. Through its mechanism inhibiting neuronal uptake of serotonin and norepinephrine and as a potent postsynaptic serotonergic antagonist, nefazodone has proven to be effective in treating post-traumatic stress disorder in several open-label trials. The results of such trials warrant its study in larger, double-blind, placebo-controlled clinical trials.",0,0 +5966,"The Impact of Repression, Hostility, and Post-Traumatic Stress Disorder on All-Cause Mortality: A Prospective 16-Year Follow-up Study","A common assumption is that repression of traumatic memories is harmful to health. To assess this, we examined all-cause mortality among a national random sample of 4462 male US Army veterans evaluated in 1985 and followed up in 2000. Our hypothesis was that repression on the Welsh R scale would be associated with increased future mortality. We also expected to find a repression x post-traumatic stress disorder (PTSD) interaction effect. Multivariate Cox regression results for all veterans and for theater veterans (Vietnam service) and era veterans (no Vietnam service) separately, revealed that while PTSD was significant in all models, no main or interaction effect was found for repression. In addition, for era veterans, higher repression symptoms were protective for future mortality (HR = 0.95, p = 0.03). For hostility symptoms, although no interaction effect was found by PTSD, a positive main effect was detected for hostility, but only for theater veterans (HR = 1.04, p = 0.034). Disease-specific results were nonsignificant. Similar to a recent study, we also found that repression symptoms were negatively correlated with PTSD symptoms (r = -0.109, p < 0.001), suggesting repression might be protective. Our study found no evidence that repression had an adverse health impact on men exposed to psychological trauma. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +5967,Post-Traumatic Stress Symptoms in Long-Term Non-Hodgkin's Lymphoma Survivors: Does Time Heal?,"Little is known about the trajectory of post-traumatic stress disorder (PTSD) symptoms in cancer survivors, despite the fact that such knowledge can guide treatment. Therefore, this study examined changes in PTSD symptoms among long-term survivors of non-Hodgkin's lymphoma (NHL) and identified demographic, clinical, and psychosocial predictors and correlates of PTSD symptomatology.Surveys were mailed to 682 NHL survivors who participated in an earlier survey and now were at least 7 years postdiagnosis. Information was obtained regarding PTSD symptoms, positive and negative perceptions of the cancer experience (ie, impact of cancer), and other potential correlates of PTSD.A total of 566 individuals participated (83% response rate) with a median of 12.9 years since diagnosis; respondents were 52% female and 87% white. Although half (51%) of the respondents reported no PTSD symptoms and 12% reported a resolution of symptoms, more than one-third (37%) reported persistence or worsening of symptoms over 5 years. Survivors who reported a low income, stage ≥ 2 at diagnosis, aggressive lymphoma, having received chemotherapy, and greater impact of cancer (both positive and negative) at the initial survey had more PTSD symptoms at follow-up. In multivariable analysis, income and negative impacts of cancer were independent predictors of PTSD symptoms.More than one-third of long-term NHL survivors experience persisting or worsening PTSD symptoms. Providers should be aware of enduring risk; early identification of those at prolonged risk with standardized measures and treatments that target perceptions of the cancer experience might improve long-term outcomes.",0,0 +5968,Can Psychosocial Intervention Improve Peer and Sibling Relations Among War-affected Children? Impact and Mediating Analyses in a Randomized Controlled Trial,"Social resources are considered important protectors in traumatic conditions, but few studies have analyzed their role in psychosocial interventions among war-affected children. We examined (1) whether a psychosocial intervention (teaching recovery techniques, TRT) is effective in improving peer and sibling relations, and (2) whether these potentially improved relations mediate the intervention's impacts on children's mental health. Participants were 428 Palestinian children [10–13 (mean = 11.29, standard deviation SD = .68)-year-old girls (49.4 percent) and boys (50.6 percent)], who were cluster-randomized into the TRT and wait-list control groups. They reported the quality of peer (friendship and loneliness) and sibling (intimacy, warmth, conflict, and rivalry) relations, and posttraumatic stress, depressive and psychological distress symptoms, as well as psychosocial well-being at baseline (T1), postintervention (T2), and six month follow-up (T3). Results showed gender-specific TRT intervention effects: Loneliness in peer relations reduced among boys and sibling rivalry reduced among girls. The TRT prevented the increase in sibling conflict that happened in the control group. The mediating hypothesis was partially substantiated for improved peer relations, and beneficial changes in sibling relations were generally associated with improved mental health.",0,0 +5969,Changes in mental disorder prevalence among conflict-affected populations: a prospective study in Sri Lanka (COMRAID-R),"BackgroundLongitudinal data are lacking on mental health trajectories following conflict resolution and return migration. COMRAID-R is a follow-up study of Muslims displaced by conflict from Northern Sri Lanka 20 years ago who are now beginning to return.MethodsOf 450 participants in displacement interviewed in 2011, 338 (75.1%) were re-interviewed a year later, and a supplementary random sample (n = 228) was drawn from return migrants with a comparable displacement history. Common mental disorder (CMD; Patient Health Questionnaire) and post-traumatic stress disorder (CIDI-subscale) were measured.ResultsA CMD prevalence of 18.8% (95%CI 15.2–22.5) at baseline had reduced to 8.6% (5.6–11.7) at follow-up in those remaining in displacement, and was 10.3% (6.5–14.1) in return migrants. PTSD prevalences were 2.4%, 0.3% and 1.6% respectively.ConclusionsWe observed a substantial decrease in CMD prevalence in this population over a short period, which may reflect the prospect of return migration and associated optimism following conflict resolution.",0,0 +5970,Military trauma and its sequel in families of Bedouin servicemen,"Posttraumatic responses of veterans have an adverse impact on the family unit. These impacts include a variety of psychiatric, emotional, and behavioral problems in the veteran's partner and children. Despite the increased attention given today to the central role of the family in the aftermath of trauma, studies in families of non-Western minority servicemen almost do not exist. The current study examined the associations between veterans’ posttraumatic symptoms and familial distress in an ethnic minority sample of 112 families of Bedouin members of the Israeli Defense Forces. Specifically, we have studied the relationship between the men's posttraumatic symptoms, wife's psychological symptoms, and maternal reports about children's wellbeing. Results showed that while fathers’ posttraumatic symptoms were related to their wives’ psychological distress, they were not related to maternal reports about children's problems. However, mothers with higher levels of depression and anxiety tended to report more em...",0,0 +5971,"Efficacy and acceptability of atypical antipsychotics for the treatment of post-traumatic stress disorder: A meta-analysis of randomized, double-blind, placebo-controlled clinical trials","As some evidences demonstrated that atypical antipsychotics (AA) may be efficacious in treating post-traumatic stress disorder (PTSD), we preformed a meta-analysis of randomized, double-blind, placebo-controlled clinical trials (RCTs) of AAs for the treatment of PTSD. Two hundred and fifty one papers were searched and screened. Eight RCTs met the inclusion criteria. AAs may be superior to placebo in the treatment of PTSD, as indicated by the changes in Clinician Administered PTSD Scale (CAPS) total scores (weighted mean differences (WMD)=−5.89, 95% confidence interval (CI) [−9.21, −2.56], P =0.0005) and also in CAPS subscale intrusion (WMD=−2.58, 95% CI[−3.83, −1.33], P <0.0001 ) and subscale hyperarousal (WMD=−2.94, 95% CI[−5.45, −0.43], P =0.02). The acceptability measured by dropout rates between AAs and placebo showed no statistical difference (OR=1.24, 95%CI [0.78, 1.97], P =0.36). PTSD symptom cluster, especially in intrusion and hyperarousal. However, we should be careful to generalize the conclusion because of the small number of included trails. We expect more RCTs will be done in the future so as to clarify the specific value of AAs for PTSD.",0,0 +5972,Collective efficacy and the contingent consequences of exposure to life-threatening violence.,"Neighborhood research has increasingly emphasized the potential for contextual characteristics to moderate the effects of youths' experiences on their outcomes. Drawing on collective efficacy theory, we examine the variable consequences of youths' exposures to life-threatening violence across neighborhoods. We argue that strong community normative orientations supporting the control of violence diminish the negative effect of exposure to severe violence on subsequent mental health among urban youth. We also consider the extent to which the consequences of exposure to violence vary by gender. Employing data from the Project on Human Development in Chicago Neighborhoods, we estimate a series of multivariate, multilevel linear models of internalizing and externalizing symptoms. Results indicate that, for girls, exposure to life-threatening violence (witnessing someone being attacked with a weapon or shot) increases both internalizing and externalizing symptoms. However, this effect achieves statistical significance only for girls who reside in neighborhoods with lower collective efficacy. For boys, our analyses offered weaker evidence of violence exposure effects on mental health. Implications for research on the social context of mental health are discussed.",0,0 +5973,Post-traumatic stress disorders,"When … you Think of Things, you find sometimes that a Thing which seemed very Thingish inside you is quite different when it gets out into the open and has other people looking at it. ([Winnie the Pooh] Milne, 2004; p. 99) Introduction Adjusting to a significant life event can be difficult for children and adults alike. A sudden bereavement, or bearing witness to violence or a tragic accident are experiences likely to be accompanied by complex, even debilitating feelings of fear or sadness. For the young child, making sense of traumatic events is complicated by limited life experiences, naïve understandings of the world and reliance on those around them. Their interpretation of events may be hindered by child-like language and reasoning. This chapter seeks to describe the impact of such events on children and portray the application of a model that can be used both to understand such reactions and guide interventions intended to help children by enabling them to confront their experiences, formulate a narrative and develop a helpful meaning of the event. Diagnosis Traumatic events can lead to a variety of psychological problems such as anxiety, depression, behavioural problems, substance abuse, self-harm and post-traumatic stress disorder (PTSD) (Perrin et al., 2000). In clinical practice, children’s reactions to traumatic events may be complex; those with symptoms of PTSD, who fail to meet the strict criteria for a diagnosis according to the current Diagnostic and Statistical Manual of Mental Disorders (DSM–IV–TR; American Psychiatric Association, 2000), may still be suffering from substantial distress and impairment (Carrion et al., 2002), which may respond to intervention. At the time of writing, the fifth edition of the DSM is in preparation and new criteria are likely to be introduced. © Cambridge University Press 1998, 2005, 2013.",0,0 +5974,Posttraumatic stress symptoms in OIF/OEF service members with blast-related and non-blast-related mild TBI,"To examine the proportion and severity of stress-related symptoms in U.S. service members with mild traumatic brain injuries (mTBI) received during deployment to Operation Iraqi Freedom (OIF) or Operation Enduring Freedom (OEF). Stress-related symptoms reported by service members with mTBI from explosive munitions are compared to symptoms reported by those with mTBI received from other mechanisms (i.e. falls, motor vehicle accidents).Posttraumatic stress, as measured by scores on the Posttraumatic Stress Disorder Checklist (PCL-C), for a sample of 586 OIF/OEF service members with blast-related mTBI was compared to a sample of 138 OIF/OEF service members with non-blast mTBI selected from retrospective review of research records.Re-experiencing symptoms such as flashbacks and nightmares were higher for the blast mTBI group than for the non-blast mTBI group. Symptoms on other PTSD clusters and total score did not significantly differ between groups. Equivalent proportions of the blast and non-blast groups endorsed severe PTSD symptoms, with total PCL-C scores greater than or equal to 50.Consistent with prior reports, high levels of posttraumatic stress symptoms occur in a substantial proportion of service members who experienced deployment-related blast and non-blast mTBI. Results suggest that the psychological rehabilitation of OIF/OEF service members with mTBI from explosive blast should include particular attention to addressing re-experiencing symptoms.",0,0 +5975,Acute posttraumatic stress symptoms but not generalized anxiety symptoms are associated with severity of exposure to war trauma: A study of civilians under fire,"Posttraumatic stress (PTSS) and generalized anxiety symptoms (GAS) may ensue following trauma. While they are now thought to represent different psychopathological entities, it is not clear whether both GAS and PTSS show a dose-response to trauma exposure. The current study aimed to address this gap in knowledge and to investigate the moderating role of subjects' demographics in the exposure-outcome associations. The sample included 249 civilian adults, assessed during the 2014 Israel-Gaza military conflict. The survey probed demographic information, trauma exposure, and symptoms. PTSS but not GAS was associated with exposure severity. Women were at higher risk for both PTSS and GAS than men. In addition, several demographic variables were only associated with PTSS levels. PTSS dose-response effect was moderated by education. These findings are in line with emerging neurobiological and cognitive research, suggesting that although PTSS and GAS have shared risk factors they represent two different psychopathological entities. Clinical and theoretical implications are discussed.",0,0 +5976,An Animal Model for Studying Therapeutic Drugs against Post-Traumatic Stress Disorder,"An animal model for the evolvement of post-traumatic stress disorder (PTSD) was developed by simulating the hormonal consequences of prolonged stress via the continuous administration of corticosterone by subcutaneously implanted sustained-release pellets. Behavioral, morphological, and biochemical effects were recorded and analyzed. This model has shown cognitive deficits as well as hippocampal damage in the rat similar to those found in PTSD patients. The model was also used to test a therapeutic treatment against stress-induced brain damages. Concomitant treatment with the L-type calcium channel blocker, nimodipine, protected young rats from corticosterone-induced morphological brain changes but not cognitive impairments. The proposed animal model may be useful for testing the efficacy of various neuroprotective drugs. Development of an effective drug treatment for use after a traumatic event and through the trauma period might prevent permanent brain damage and the development of PTSD.",0,0 +5977,"The DSM-5 dissociative-PTSD subtype: Can levels of depression, anxiety, hostility, and sleeping difficulties differentiate between dissociative-PTSD and PTSD in rape and sexual assault victims?","The DSM-5 currently includes a dissociative-PTSD subtype within its nomenclature. Several studies have confirmed the dissociative-PTSD subtype in both American Veteran and American civilian samples. Studies have begun to assess specific factors which differentiate between dissociative vs. non-dissociative PTSD. The current study takes a novel approach to investigating the presence of a dissociative-PTSD subtype in its use of European victims of sexual assault and rape (N=351). Utilizing Latent Profile Analyses, we hypothesized that a discrete group of individuals would represent a dissociative-PTSD subtype. We additionally hypothesized that levels of depression, anger, hostility, and sleeping difficulties would differentiate dissociative-PTSD from a similarly severe form of PTSD in the absence of dissociation. Results concluded that there were four discrete groups termed baseline, moderate PTSD, high PTSD, and dissociative-PTSD. The dissociative-PTSD group encompassed 13.1% of the sample and evidenced significantly higher mean scores on measures of depression, anxiety, hostility, and sleeping difficulties. Implications are discussed in relation to both treatment planning and the newly published DSM-5.",0,0 +5978,"Coping Flexibility, Potentially Traumatic Life Events, and Resilience: A Prospective Study of College Student Adjustment","College has been shown to be a particularly stressful time both due to unique emergent stressors and because of increased vulnerability for exposure to potentially traumatic events (PTEs). Both of these conditions are associated with heightened risk for the development of stress-related pathology. However, while this period may be particularly challenging, previous work shows most students adapt in a number of heterogeneous ways that result in little or no stress-related symptomatology over the four years of college. There is indication from the coping literature that the ability to flexibly move between multiple coping behaviors may foster resilient outcomes. In this study, we examined trajectories of distress, using Latent Growth Mixture Modeling, and whether flexible coping aids in adaption. Results showed that trajectories were not influenced by exposure to a PTE and that the common outcome was little or no distress over the four years of college. Flexible coping was strongly associated with a resilie...",0,0 +5979,Factors influencing outcome following mild traumatic brain injury in adults,"This study aimed to investigate outcome in adults with mild traumatic brain injury (TBI) at 1 week and 3 months postinjury and to identify factors associated with persisting problems. A total of 84 adults with mild TBI were compared with 53 adults with other minor injuries as controls in terms of postconcussional symptomatology, behavior, and cognitive performance at 1 week and 3 months postinjury. At 1 week postinjury, adults with mild TBI were reporting symptoms, particularly headaches, dizziness, fatigue, visual disturbance, and memory difficulties. They exhibited slowing of information processing on neuropsychological measures, namely the WAIS-R Digit Symbol subtest and the Speed of Comprehension Test. By 3 months postinjury, the symptoms reported at 1 week had largely resolved, and no impairments were evident on neuropsychological measures. However, there was a subgroup of 24% of participants who were still suffering many symptoms, who were highly distressed, and whose lives were still significantly disrupted. These individuals did not have longer posttraumatic amnesia (PTA) duration. They were more likely to have a history of previous head injury, neurological or psychiatric problems, to be students, females, and to have been injured in a motor vehicle accident. The majority were showing significant levels of psychopathology. A range of factors, other than those directly reflecting the severity of injury, appear to be associated with outcome following mild TBI.",0,0 +5980,Distributional Assumptions of Growth Mixture Models: Implications for Overextraction of Latent Trajectory Classes.,"Growth mixture models are often used to determine if subgroups exist within the population that follow qualitatively distinct developmental trajectories. However, statistical theory developed for finite normal mixture models suggests that latent trajectory classes can be estimated even in the absence of population heterogeneity if the distribution of the repeated measures is nonnormal. By drawing on this theory, this article demonstrates that multiple trajectory classes can be estimated and appear optimal for nonnormal data even when only 1 group exists in the population. Further, the within-class parameter estimates obtained from these models are largely uninterpretable. Significant predictive relationships may be obscured or spurious relationships identified. The implications of these results for applied research are highlighted, and future directions for quantitative developments are suggested.",0,0 +5981,The Historic Origins of Military and Veteran Mental Health Stigma and the Stress Injury Model as a Means to Reduce It,,0,0 +5982,Cognitive impairment and functioning in PTSD related to intimate partner violence,"Abstract Posttraumatic stress disorder (PTSD) has been associated with neuropsychological impairments across multiple domains, but consensus regarding the cognitive profile of PTSD has not been reached. In this study of women with PTSD related to intimate partner violence ( n = 55) and healthy, demographically similar comparison participants (NCs; n = 20), we attempted to control for many potential confounds in PTSD samples. All participants were assessed with a comprehensive neuropsychological battery emphasizing executive functioning, including inhibition, switching, and abstraction. NCs outperformed PTSD participants on most neuropsychological measures, but the differences were significant only on speeded tasks (with and without executive functioning components). The PTSD group’s mean performance was within the average range on all neuropsychological tests. Within the PTSD group, more severe PTSD symptoms were associated with slower processing speed, and more severe dissociative symptoms were associated with poorer reasoning performance. These results suggest that women with PTSD related to intimate partner violence demonstrate slower than normal processing speed, which is associated with the severity of psychiatric symptoms. We speculate that the cognitive slowing seen in PTSD may be attributable to reduced attention due to a need to allocate resources to cope with psychological distress or unpleasant internal experiences. ( JINS , 2009, 15 , 879–887.)",0,0 +5983,Germ Cell Origins of Posttraumatic Stress Disorder Risk: The Transgenerational Impact of Parental Stress Experience,"Altered stress reactivity is a predominant feature of posttraumatic stress disorder (PTSD) and may reflect disease vulnerability, increasing the probability that an individual will develop PTSD following trauma exposure. Environmental factors, particularly prior stress history, contribute to the developmental programming of the hypothalamic-pituitary-adrenal stress axis. Critically, the consequences of stress experiences are transgenerational, with parental stress exposure impacting stress reactivity and PTSD risk in subsequent generations. Potential molecular mechanisms underlying this transmission have been explored in rodent models that specifically examine the paternal lineage, identifying epigenetic signatures in male germ cells as possible substrates of transgenerational programming. Here, we review the role of these germ cell epigenetic marks, including posttranslational histone modifications, DNA methylation, and populations of small noncoding RNAs, in the development of offspring stress axis sensitivity and disease risk.",0,0 +5984,Emotional ambivalence and post-traumatic stress disorder (PTSD) in soldiers during military operations.,"This pilot study examined the extent to which a specific mechanism of emotion regulation - namely, ambivalence concerning the expressiveness of German soldiers' emotions - affects the severity of PTSD symptoms after a military operation.A survey was conducted at three points in time among 66 soldiers deployed on military crisis operations. The Harvard Trauma Questionaire (HTQ), the Ambivalence over Emotional Expressiveness Questionnaire (AEQ-G18), and a questionnaire on the particular stress of German soldiers during military operations were used.The study showed a significant correlation between emotional ambivalence and traumatization. Furthermore, it was shown that the subjective stress of soldiers leading up to deployment is more pronounced when emotional ambivalence is stronger in the context of military operations. This particular stress is greater before and during the military operation than after. Compared to a male control sample, the average AEQ-G18 scores of the soldier sample examined here are considerably lower.This pilot study clearly indicates that the AEQ-G18 could be a suitable predictor of the psychological burden on soldiers. The correlations between emotional ambivalence on the one hand and the particular and post-traumatic stressors on the other hand are not only statistically significant in the present pilot study, but may also be relevant as risk factors. It is, therefore, necessary to conduct more extensive studies on soldiers participating in military operations to verify the results of this pilot study.Zielsetzung: In dieser Pilotstudie wurde untersucht, inwiefern sich ein spezifischer Mechanismus der Emotionsregulation, nämlich die Ambivalenz gegenüber der Expressivität eigener Emotionen bei deutschen Soldaten auf die Ausprägung der Symptome einer PTBS nach dem Einsatz auswirkt.Methodik: Es wurde eine Befragung mit 66 Soldaten im Kriseneinsatz an drei Zeitpunkten durchgeführt. Dabei kamen neben dem Harvard Trauma Questionaire (HTQ), der Ambivalence over Emotional Expressiveness Questionnaire (AEQ-G18) sowie ein Fragebogen zur speziellen Belastung von Bundeswehrangehörigen in Kriseneinsätzen zum Einsatz.Ergebnisse: In der Studie zeigte sich ein signifikanter Zusammenhang zwischen emotionaler Ambivalenz und Traumatisierung. Des Weiteren konnte gezeigt werden, dass bei stärkerem Auftreten emotionaler Ambivalenz im Kontext von militärischen Einsätzen die subjektiven Belastungen von Soldaten zum militärischen Einsatz hin ausgeprägter sind. Diese speziellen Belastungen sind vor und während des Kriseneinsatzes höher als nach dem Kriseneinsatz, Im Vergleich zu einer männlichen Vergleichsstichprobe liegen die Mittelwerte bei dem AEQ-G18 der vorliegenden Soldatenstichprobe erheblich niedriger.Fazit: Die Pilotstudie weist deutlich darauf hin, dass die Diagnostik mit dem AEQ-G18 geeignet sein könnte, die psychischen Belastungen bei Soldaten vorherzusagen. Die Zusammenhänge zwischen emotionaler Ambivalenz einerseits und den speziellen sowie posttraumatischen Belastungen andererseits sind in der vorgelegten Pilotstudie nicht nur statistisch signifikant, sondern können als Risikofaktoren relevant sein. Daher ist es erforderlich weitere umfangreiche Studien bei Soldaten in Kriseneinsätzen durchzuführen, um die Ergebnisse der Pilotstudie zu überprüfen.",0,0 +5985,The contribution of childhood emotional abuse to teen dating violence among child protective services-involved youth,"For child protective services (CPS) youth who may have experienced more than one form of maltreatment, the unique contribution of emotional abuse may be over-looked when other forms are more salient and more clearly outside of accepted social norms for parenting. This study considers the unique predictive value of childhood emotional abuse for understanding adolescent post-traumatic stress disorder (PTSD) symptomatology and dating violence. Further, PTSD symptomatology is assessed as an explanatory bridge in the emotional abuse-teen dating violence link.A random sample of 402 youth from the active caseload of a large urban CPS catchment area participated as part of a larger longitudinal study on adolescent health behaviors. Mid-adolescent youth across types of CPS status were targeted. CPS youth reported on lifetime maltreatment experiences, PTSD symptomatology, and past year dating experiences, using published scales.Over 85% of CPS youth had begun dating. For dating youth, some level of dating violence was common: over half of females (63-67%) and nearly half of males (44-49%). Taking into account other forms of maltreatment, emotional abuse emerged as a significant predictor of both PTSD symptomatology and dating violence among males and females. PTSD symptomatology was a significant mediator of the male emotional abuse-perpetration and the female emotional/physical abuse-victimization links, indicating a gendered patterning to findings.These results indicate that: (1) CPS youth are a high priority group for dating violence and PTSD-linked intervention; and (2) CPS youth continue to experience the unique negative impact of childhood emotional abuse in their adolescent adjustment. All CPS children should be evaluated for emotional abuse incurred, and appropriate intervention attention be given as to how it specifically impacts on the child's approach to relating to themselves and to others.The present study directs practice implications in regards to: (1) the problem of teen dating violence, (2) the salience of childhood emotional abuse; and (3) the importance of targeting PTSD symptomatolgy among CPS youth. A substantial number of CPS youth report early engagement in violent romantic relationships and require support towards attaining the non-coercive relationship experiences of their non-CPS-involved age mates. The topic of dating, healthy dating relationships, and dating violence may need to be part of the regular casework, with a view towards supporting youths' conceptualization of and skill set for healthy, close relationships. Further, this knowledge needs to be translated to foster parents and group home staff. With regard to the impact of childhood emotional abuse, CPS workers need to be sensitive to its potential for long-term, unique impact impairing relationship development. Emotional abuse is (a) unique among genders (i.e., for females, it clusters with physical abuse) and (b) uniquely predictive of PTSD symptoms and dating violence. Finally, as is consistent with theory and biopsychosocial evidence, PTSD symptomatology is a key causal candidate for understanding maltreatment-related impairment. Attention to targeting PTSD symptoms may be preventative for dating violence; attention to targeting emotional abuse experiences may be preventative for PTSD symptoms. CPS youth are an important population to involve in research, as their inclusion adds to the evidence-base to achieve evidence-informed practice and policy within child welfare.",0,0 +5986,Reactive Aggression and Posttraumatic Stress in Adolescents Affected by Hurricane Katrina,"The current study tests a theoretical model illustrating a potential pathway to reactive aggression through exposure to a traumatic event (Hurricane Katrina) in 166 adolescents (61% female, 63% Caucasian) recruited from high schools on the Gulf Coast of Mississippi. Results support an association between exposure to Hurricane Katrina and reactive aggression via posttraumatic stress disorder (PTSD) symptoms and poorly regulated emotion. The proposed model fits well for both boys and girls; however, results suggest that minority youth in this sample were more likely to experience emotional dysregulation in relation to posttraumatic stress than Caucasian youth. Further, results indicate that hurricane exposure, PTSD symptoms, and poorly regulated emotion are associated with reactive aggression even after controlling for proactive aggression. These findings have implications for postdisaster mental health services. Researchers examining mental health problems in youth after a significant disaster have traditionally focused on the presence of internalizing problems such as anxiety, depression, and posttraumatic stress disorder (PTSD) symptoms, with very little empirical attention paid to the incidence of post-disaster externalizing problems such as aggression. Specific types of aggressive responses, particularly those that involve poorly regulated emotion (i.e., reactive aggression), have been shown to be associated with a history of trauma and thus may be especially common following a traumatic event such as a hurricane.",0,0 +5987,Urinary Catecholamine Excretion in Sexually Abused Girls,"The objective of this study was to examine urinary catecholamine excretion in a self-selected sample of sexually abused and demographically matched control girls recruited from a prospective, longitudinal study.Twenty-four--hour urinary catecholamine and metabolite concentrations of epinephrine, norepinephrine, dopamine, 3-methoxy-4-hydroxyphenylglycol, metanephrine, normetanephrine, vanillylmandelic acid, 3,4-dihydroxyphenylacetic acid, and homovanillic acid were measured in 12 sexually abused and 9 control girls, aged 8 to 15 years. Psychiatric profiles also were obtained.The abused subjects excreted significantly greater amounts of metanephrine, vanillylmandelic acid, homovanillic acid, and total catecholamine synthesis as measured by the sum of epinephrine, norepinephrine, dopamine, and their metabolites compared to values from control subjects. When the means of all significant biochemical measures were adjusted by the covariate effect of height, only homovanillic acid and group interaction remained significant. There were positive trends toward significantly higher urinary excretion of metanephrine, vanillylmandelic acid, and total catecholamine synthesis. Sexually abused girls also had a greater incidence of suicidal ideation, suicide attempts, and dysthymia than control girls.These findings support the idea that sexually abused girls show evidence of higher catecholamine functional activity compared with controls. The clinical significance of these findings in their similarity to the psychobiology of both post-traumatic stress disorder and major depressive disorder. Results from this pilot study may be of value in understanding the mechanisms of depressive and anxiety disorders and in the clinical treatment of maltreated children.",0,0 +5988,Safety of a New Oral Contraceptive Containing Drospirenone,"New chemical entities must undergo rigorous, and preferably independent, safety and efficacy assessments before entry into the market. This is also true for oral contraceptives (OCs) given their extensive usage by healthy women and the safety concerns highlighted by the so-called 'third generation pill scare' in Europe a decade ago. This scare heightened patient and physician awareness of the increased risk of thromboembolic complications (mainly venous thromboembolism [VTE]) associated with OC use. Yasmin(registered trademark) (ethinylestradiol 30(mu)g/drospirenone 3mg [EE/DRSP]) is a novel OC that was demonstrated in clinical phase I-III studies to be highly effective in preventing pregnancy and to have a good safety profile. Nonetheless, clinical trials are not usually sufficiently powered to detect rare adverse events such as VTE to enable comparison with other OCs, which could allay fears and concerns about their inherent risks. Therefore, an extensive assessment of the VTE risk associated with EE/DRSP has been undertaken by reviewing data from the clinical development programme, postmarketing surveillance and spontaneous worldwide reporting, as well as information from other sources. Spontaneous worldwide reporting has revealed a VTE reporting rate of 5.1/100 000 women-years with EE/DRSP use. In contrast, 3-year interim results from a large, controlled, prospective postmarketing surveillance study suggest a VTE rate of 61/100 000 women-years for EE/DRSP, which is similar to the rates of 60/100 000 and 73/100 000 women-years for levonorgestrel-containing OCs and other OCs, respectively. When placed in context with potential biases and confounding factors that would inflate the perceived risk of VTEs with a novel OC, the VTE rate with EE/DRSP does not highlight any safety concerns. Furthermore, the risk of VTE with EE/DRSP or other OCs is far less than that associated with pregnancy and delivery (up to 800/100 000 women-years) or than other risks of daily living. Available data indicate that EE/DRSP is not associated with any increased risk of other serious adverse events such as hyperkalaemia, cardiac arrhythmia or birth defects. Nonetheless, caution should be exerted in prescribing EE/DRSP to women with conditions that predispose to hyperkalaemia. Overall, the safety data with EE/DRSP and other OCs indicate that these products have no negative impact on the risk of VTE (and other adverse events) in women who receive OCs for contraception.",0,0 +5989,Profile Analyses of the Personality Assessment Inventory Following Military-Related Traumatic Brain Injury,"Personality Assessment Inventory (PAI) profiles were examined in 160 U.S. service members (SMs) following mild-severe traumatic brain injury (TBI). Participants who sustained a mild TBI had significantly higher PAI scores than those with moderate-severe TBI on eight of the nine clinical scales examined. A two-step cluster analysis identified four PAI profiles, heuristically labeled ""High Distress"", ""Moderate Distress"", ""Somatic Distress,"" and ""No Distress"". Postconcussive and posttraumatic stress symptom severity was highest for the High Distress group, followed by the Somatic and Moderate Distress groups, and the No Distress group. Profile groups differed in age, ethnicity, rank, and TBI severity. Findings indicate that meaningful patterns of behavioral and personality characteristics can be detected in active duty military SMs following TBI, which may prove useful in selecting the most efficacious rehabilitation strategies.",0,0 +5990,Post-traumatic growth as outcome of a cognitive-behavioural therapy trial for motor vehicle accident survivors with PTSD,"Treatment effects on post-traumatic growth (PTG) and its subdomains were investigated together with predictors of the Janus-face model of PTG.Effects were investigated within a randomized controlled trial of cognitive-behavioural therapy (CBT) for post-traumatic stress disorder (PTSD).Forty motor vehicle accident survivors were randomly assigned to a treatment or waiting condition. PTG was measured by the Post-traumatic Growth Inventory and complemented by its possible predictors (optimism, openness).The CBT treatment proved to be highly effective in terms of PTSD symptom reduction. In contrast to previous findings, however, there was no treatment effect on PTG in general. The CBT group showed, however, increases in PTG subdomains 'new possibilities' and 'personal strength'.The results of this study caution researchers to naively expect PTG as a uniformly positive outcome to evaluate treatment effectiveness.",0,0 +5991,A national population-based assessment of 2007–2008 election-related violence in Kenya,"Abstract Background Following the contested national elections in 2007, violence occurred throughout Kenya. The objective of this study was to assess the prevalence, characteristics, and health consequences of the 2007–2008 election-related violence. Methods A cross-sectional, national, population-based cluster survey of 956 Kenyan adults aged ≥ 18 years was conducted in Kenya in September 2011 utilizing a two-stage 90 x 10 cluster sample design and structured interviews and questionnaires. Prevalence of all forms of violence surrounding the 2007 election period, symptoms of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), and morbidity related to sexual and physical violence were assessed. Results Of 956 households surveyed, 916 households participated (response rate 95.8%). Compared to pre-election, election-related sexual violence incidents/1000 persons/year increased over 60-fold (39.1-2370.1; p < .001) with a concurrent 37-fold increase in opportunistic sexual violence (5.2-183.1; p < .001). Physical and other human rights violations increased 80-fold (25.0-1987.1; p < .001) compared to pre-election. Overall, 50% of households reported at least one physical or sexual violation. Households reporting violence were more likely to report violence among female household members (66.6% vs. 58.1%; p = .04) or among the Luhya ethnic group (17.0% vs. 13.8%; p = 0.03). The most common perpetrators of election-related sexual violence were reported to be affiliated with government or political groups (1670.5 incidents/1000 persons per year); the Kalenjin ethnic group for physical violations (54.6%). Over thirty percent of respondents met MDD and PTSD symptom criteria; however, symptoms of MDD (females, 63.3%; males, 36.7%; p = .01) and suicidal ideation (females, 68.5%; males, 31.5%; p = .04) were more common among females. Substance abuse was more common among males (males, 71.2%; females, 28.8%; p < .001). Conclusion On a national level in Kenya, politically-motivated and opportunistic sexual and physical violations were commonly reported among sampled adults with associated health and mental health outcomes.",0,0 +5992,An evidence-based approach to evaluating and managing suicidal emergencies,"This article presents a framework for making suicide risk estimations, as well as recommendations for the management of suicidal emergencies, that are useful to the practitioner. It provides a review of existing empirical data concerning factors significantly related to acute suicidal behaviors within high-risk diagnoses. Findings across studies are categorized into risk profiles (as proposed by Clark & Fawcett, 1992) that are meant to aid the clinician in the application of recent research. The profiles are intended as templates in development and clearly require continual updating and clarification as new studies are completed. The article then addresses related management issues such as the importance of viewing risk factors within a comprehensive suicide assessment and the impact of possible negative therapist reactions when working with high-risk patients.",0,0 +5993,"Suicidality, aggression, and other treatment considerations among pregnant, substance-dependent women with posttraumatic stress disorder","Posttraumatic stress disorder (PTSD) and other Axis I comorbidity among women with substance use disorders (SUDs) appear similarly prevalent and are associated with comparable negative clinical profiles and treatment outcomes. The relative contribution of comorbid PTSD vs other Axis I psychiatric disorders to clinical characteristics is largely unexamined, however, despite theory and empirical data indicating that PTSD and SUDs may have a unique relationship that confers specific risk for clinical severity and poor treatment outcome. In a sample of pregnant, opioid- and/or cocaine-dependent women entering substance abuse treatment, women with PTSD (SUD-PTSD; n = 23) were compared to those with other Axis I comorbidity (SUD-PSY; n = 45) and those without Axis I comorbidity (SUD-only; n = 37). Data were collected via face-to-face interviews and urinalysis drug assays. Although the study groups had similar substance use severity, the SUD-PTSD group was more likely to report suicidality, aggression, and psychosocial impairment than both the SUD-PSY and SUD-only groups. Findings indicate treatment considerations for substance-dependent women with PTSD are broader and more severe than those with other Axis I conditions or substance dependence alone.",0,0 +5994,Does “subthreshold” posttraumatic stress disorder have any clinical relevance?,"The present report examined the extent to which subthreshold posttraumatic stress disorder (PTSD) (without lifetime PTSD) and full PTSD are associated with impairment or distress, controlling for comorbidity (i.e., major depression and panic disorder) in a sample of treatment-seeking psychiatric patients. Patients were administered diagnostic interviews and assessed for psychosocial impairment and whether or not they desired treatment for their PTSD symptoms. No significant differences were found between patients with full PTSD (N = 156) and those with subthreshold PTSD (N = 56) in degree of impairment (i.e., social and work functioning, as well as number of suicide attempts). In contrast, those with full PTSD had significantly more psychiatric hospitalizations and worse global functioning and were more likely to want treatment for their PTSD symptoms compared to those with subthreshold PTSD, albeit the majority of patients with subthreshold PTSD wanted treatment for their PTSD symptoms. These findings, like past research, suggest that subthreshold PTSD is associated with levels of social and work morbidity comparable to full PTSD. However, the report also underscores the difficulties in identifying a set of clinical criteria that clearly delineates between full PTSD and subthreshold PTSD.",0,0 +5995,Comparison of Outcome between Homogeneous and Heterogeneous Treatment Environments in Combat-Related Posttraumatic Stress Disorder,"This study compared treatment outcome at discharge, and 4, 8, and 12 month follow-up between an inpatient program consisting of a mixture of Vietnam combat veterans with posttraumatic stress disorder (PTSD) and general psychiatric patients (N = 42), and the same program at a later period, consisting of only Vietnam combat veterans with PTSD (N = 33). Veterans rated the homogeneous environment higher in satisfaction, support, order, clarity, and amount of discussion of combat, and lower in hostility, than the heterogeneous condition. However, veterans showed no improvement in condition at 12 month follow-up, with the exception of decreased violence, replicating earlier studies. No differences in outcome were found between homogeneous or heterogeneous treatment environments. This study underscores the enduring nature of chronic posttraumatic stress disorder in the veteran population.",0,0 +5996,Associations between lifetime PTSD symptoms and current substance use disorders using a five-factor model of PTSD,"This paper aimed to extend the existing knowledge on the association between PTSD symptoms, alcohol use disorders (AUD) and nicotine dependence (ND) by distinguishing between anxious and dysphoric arousal PTSD symptoms and by considering the putative contribution of additional comorbidity. Data stem from a cross-sectional study in a stratified, representative sample of 1483 recently deployed soldiers using standardized diagnostic interviews. All lifetime PTSD symptom clusters (occurrence of any symptom and number of symptoms) were associated with current AUD and ND in crude models except that anxious arousal was not related to AUD. Associations were reduced in magnitude when controlling for comorbidity. Current ND was related to the occurrence of any emotional numbing and to the number of re-experiencing symptoms above the contribution of other symptom clusters and comorbidity. In conclusion, associations between PTSD symptoms, AUD and ND may be partially attributable to additional comorbidity. Findings also yield further evidence for a role of emotional numbing and re-experiencing symptoms in the comorbidity between PTSD and ND and for a distinction between dysphoric and anxious arousal PTSD symptoms.",0,0 +5997,"Cognitive Function, Mental Health, and Health-related Quality of Life after Lung Transplantation","Cognitive and psychiatric impairments are threats to functional independence, general health, and quality of life. Evidence regarding these outcomes after lung transplantation is limited.Determine the frequency of cognitive and psychiatric impairment after lung transplantation and identify potential factors associated with cognitive impairment after lung transplantation.In a retrospective cohort study, we assessed cognitive function, mental health, and health-related quality of life using a validated battery of standardized tests in 42 subjects post-transplantation. The battery assessed cognition, depression, anxiety, resilience, and post-traumatic stress disorder (PTSD). Cognitive function was assessed using the Montreal Cognitive Assessment, a validated screening test with a range of 0 to 30. We hypothesized that cognitive function post-transplantation would be associated with type of transplant, cardiopulmonary bypass, primary graft dysfunction, allograft ischemic time, and physical therapy post-transplantation. We used multivariable linear regression to examine the relationship between candidate risk factors and cognitive function post-transplantation.Mild cognitive impairment (score, 18-25) was observed in 67% of post-transplant subjects (95% confidence interval [CI]: 50-80%) and moderate cognitive impairment (score, 10-17) was observed in 5% (95% CI, 1-16%) of post-transplant subjects. Symptoms of moderate to severe anxiety and depression were observed in 21 and 3% of post-transplant subjects, respectively. No transplant recipients reported symptoms of PTSD. Higher resilience correlated with less psychological distress in the domains of depression (P < 0.001) and PTSD (P = 0.02). Prolonged graft ischemic time was independently associated with worse cognitive performance after lung transplantation (P = 0.001). The functional gain in 6-minute-walk distance achieved at the end of post-transplant physical rehabilitation (P = 0.04) was independently associated with improved cognitive performance post-transplantation.Mild cognitive impairment was present in the majority of patients after lung transplantation. Prolonged allograft ischemic time may be associated with cognitive impairment. Poor physical performance and cognitive impairment are linked, and physical rehabilitation post-transplant and psychological resilience may be protective against the development of long-term impairment. Further study is warranted to confirm these potential associations and to examine the trajectory of cognitive function after lung transplantation.",0,0 +5998,Relationship between emotional experience and resilience: An fMRI study in fire-fighters,"Resilience refers to the capacity to cope effectively in stressful situations or adversity. It may involve the ability to experience emotions matching the demands of environmental circumstances. The brain mechanisms underlying resilience remain unclear. In this study, we aim to investigate the relationship between the neural basis of emotional experience and resilience. Thirty-six fire-fighters were included. They performed an fMRI script-driven paradigm comprising relaxing and trauma-related scripts to evaluate the cerebral substrate of emotional experience (p<0.05, FDR-corrected). Correlations were examined between fMRI activations and the resilience DRS15 scale (p<0.05). Resilience was positively correlated with the right amygdala and left orbitofrontal activations when performing the contrast of trauma vs. relaxing script. The present study provides neural data on the mechanisms underlying resilience and their relationship with emotional reactivity, suggesting that appropriate emotional response in stressful situations is essential for coping with aversive events in daily life.",0,0 +5999,The combined effect of gender and age on post traumatic stress disorder: do men and women show differences in the lifespan distribution of the disorder?,"The aim of the study was to examine the combined effect of gender and age on post traumatic stress disorder (PTSD) in order to describe a possible gender difference in the lifespan distribution of PTSD.Data were collected from previous Danish and Nordic studies of PTSD or trauma. The final sample was composed of 6,548 participants, 2,768 (42.3%) men and 3,780 (57.7%) women. PTSD was measured based on the Harvard Trauma Questionnaire, part IV (HTQ-IV).Men and women differed in lifespan distribution of PTSD. The highest prevalence of PTSD was seen in the early 40s for men and in the early 50s for women, while the lowest prevalence for both genders was in the early 70s. Women had an overall twofold higher PTSD prevalence than men. However, at some ages the female to male ratio was nearly 3:1. The highest female to male ratio was found for the 21 to 25 year-olds.The lifespan gender differences indicate the importance of including reproductive factors and social responsibilities in the understanding of the development of PTSD.",0,0 +6000,Review of A clinical handbook/practical therapist manual for assessing and treating adults with post-traumatic stress disorder (PTSD).,"Reviews the book, A clinical handbook/practical therapist manual for assessing and treating adults with post-traumatic stress disorder (PTSD) by Donald Meichenbaum (see record 1995-97286-000). This text is a much needed addition in the burgeoning field that is coming to be called ""psychotraumatology,"" including critical incident debriefing and related phenomena. Few fields of psychopathology have been fortunate enough to attract the attention of practitioners with the level of skill that Don Meichenbaum shows in this Manual, and his sobering, careful analysis of the traumatology literature in several very controversial areas deserves kudos. The reality is that this Handbook/Manual is in fact both a relatively comprehensive overview of the Post-Traumatic Stress Disorder literature, as well as a guidebook for treatment intervention strategies. Moreover, it is replete with appropriate cautions about variables that can interfere with treatment progress, together with strategic suggestions for overcoming that interference. The Manual is not only tremendously diverse, but is exceptional in its standards of scholarship and its careful application of those scholarly standards even to the most controversial topics. The author is also extremely credible in his treatment of potential harm from clinical techniques, and the Manual is replete with several examples of documented pitfalls, whether from comorbidity, relapse with substance-abusing populations, or the potential for harm to some individuals from simple repetitions of traumatic experiences. All in all, the reviewer strongly encourages Psychotherapy readers to avail themselves of this extremely well-written and thoughtful text. Both the book itself and the topic of PTSD deserve the excellent coverage devoted to them by this outstanding psychotherapy clinician and researcher. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6001,Correlates of comorbid anxiety and externalizing disorders in childhood obsessive compulsive disorder,"The present study examines the influence of diagnostic comorbidity on the demographic, psychiatric, and functional status of youth with a primary diagnosis of obsessive compulsive disorder (OCD). Two hundred and fifteen children (ages 5-17) referred to a university-based OCD specialty clinic were compared based on DSM-IV diagnostic profile: OCD without comorbid anxiety or externalizing disorder, OCD plus anxiety disorder, and OCD plus externalizing disorder. No age or gender differences were found across groups. Higher OCD severity was found for the OCD + ANX group, while the OCD + EXT group reported greater functional impairment than the other two groups. Lower family cohesion was reported by the OCD + EXT group compared to the OCD group and the OCD + ANX group reported higher family conflict compared to the OCD + EXT group. The OCD + ANX group had significantly lower rates of tic disorders while rates of depressive disorders did not differ among the three groups. The presence of comorbid anxiety and externalizing psychopathology are associated with greater symptom severity and functional and family impairment and underscores the importance of a better understanding of the relationship of OCD characteristics and associated disorders. Results and clinical implications are further discussed.",0,0 +6002,Working with Dreams in a Clinical Setting,"A disturbed sleep pattern, nightmares, and anxiety-filled dreams form a cluster of symptoms belonging to the DSM- IV diagnosis of Post-traumatic Stress Disorder. A psychotherapeutic group approach aimed at reducing these symptoms was undertaken in the form of a workshop. The workshop was not a regular part of the treatment program, but an experimental endeavor, offered to the patients during special occasions in the year (around holidays). The therapist was primarily interested in investigating possibilities for improving the quality of sleep and influencing the patterns of recurring anxiety-filled dreams and nightmares. The method has both structured and psychodynamic elements. The work carried out during the dream group was embedded in the total treatment program. This was crucial to allow personal themes to be continued in the regular treatment program.",0,0 +6003,"Predictors of coping efficacy, negative moods and post-traumatic stress syndrome following major trauma","The purpose of the study was to test relationships among injury appraisals, coping, social support and outcomes of coping efficacy, mood states and post-traumatic stress syndrome. A purposive sample of 152 hospitalized patients a week following major trauma was recruited from two trauma centres. The measures included the modified Ways of Coping Scale; the brief Social Support Questionnaire; the brief Profile of Mood State; the Impact of Event Scale; and selected demographic and injury related variables. Data were analyzed by multivariate statistics. The results indicated that perceived controllability, satisfaction with social support, wishful-thinking coping and problem-focused coping were the significant predictors for coping efficacy; perceived stressfulness, problem-focused coping and wishful thinking explained a significant amount of variance in mood states; avoidance coping and wishful-thinking coping were predictors for post-traumatic stress syndrome. The moderating effects of emotion-focused coping at high and medium levels were identified.",0,0 +6004,"PTSD after deployment to Iraq: conflicting rates, conflicting claims.","Post-traumatic stress disorder (PTSD) has been called one of the signature injuries of the Iraq War. In this review prevalence estimates of PTSD are summarized and discrepancies are discussed in relation to methodological differences between studies.We searched for population-based studies with a minimum sample size of 300. Studies based on help-seeking samples were excluded. We identified 60 possible papers, of which 19 fulfilled the inclusion criteria. Prevalence estimates and study characteristics were examined graphically with forest plots, but because of high levels of heterogeneity between studies, overall estimates of PTSD prevalence were not discussed.The prevalence of PTSD in personnel deployed to Iraq varied between 1.4% and 31%. Stratifying studies by PTSD measure only slightly reduced the variability in prevalence. Anonymous surveys of line infantry units reported higher levels of PTSD compared to studies that are representative of the entire deployed population. UK studies tend to report lower prevalence of PTSD compared with many US studies; however, when comparisons are restricted to studies with random samples, prevalences are similar. US studies that have assessed personnel more than once since return from deployment have shown that PTSD prevalence increases over the 12 months following deployment.Differences in methodologies and samples used should be considered when making comparisons of PTSD prevalence between studies. Further studies based on longitudinal samples are needed to understand how the prevalence of PTSD changes over time.",0,0 +6005,The Effects of Stress Coping Strategies in Post-Traumatic Stress Symptoms Among Earthquake Survivors: An Explanatory Model of Post-Traumatic Stress,"event common to a sample of 304 people (Chile, earthquake February, 27 2010) was determined through the application of the Ways of Coping Questionnaire and the Davidson Scale of Trauma. The results show 4 significant Regression Multiple Linear models explaining the total and the 3 types of PTSD symptoms through WOC such as avoidance and problem solution. However, a first integrated model through structural equations did not attain good fit indexes. The study has been concluded with an alternative integrated model presenting very good adjustment indexes (CMIN/DF=.058, RMSEA=.000, NFI=.999, CFI=.999 and PNFI=.100). Finally, explanations based on neuroimages and covert conditioning are provided along with reflections on the prevention and prevalence of the PTSD.",0,0 +6006,Mitochondria-focused gene expression profile reveals common pathways and CPT1B dysregulation in both rodent stress model and human subjects with PTSD,"Posttraumatic stress disorder (PTSD), a trauma-related mental disorder, is associated with mitochondrial dysfunction in the brain. However, the biologic approach to identifying the mitochondria-focused genes underlying the pathogenesis of PTSD is still in its infancy. Previous research, using a human mitochondria-focused cDNA microarray (hMitChip3) found dysregulated mitochondria-focused genes present in postmortem brains of PTSD patients, indicating that those genes might be PTSD-related biomarkers. To further test this idea, this research examines profiles of mitochondria-focused gene expression in the stressed-rodent model (inescapable tail shock in rats), which shows characteristics of PTSD-like behaviors and also in the blood of subjects with PTSD. This study found that 34 mitochondria-focused genes being upregulated in stressed-rat amygdala. Ten common pathways, including fatty acid metabolism and peroxisome proliferator-activated receptors (PPAR) pathways were dysregulated in the amygdala of the stressed rats. Carnitine palmitoyltransferase 1B (CPT1B), an enzyme in the fatty acid metabolism and PPAR pathways, was significantly over-expressed in the amygdala (P < 0.007) and in the blood (P < 0.01) of stressed rats compared with non-stressed controls. In human subjects with (n = 28) or without PTSD (n = 31), significant over-expression of CPT1B in PTSD was also observed in the two common dysregulated pathways: fatty acid metabolism (P = 0.0027, false discovery rate (FDR) = 0.043) and PPAR (P = 0.006, FDR = 0.08). Quantitative real-time polymerase chain reaction validated the microarray findings and the CPT1B result. These findings indicate that blood can be used as a specimen in the search for PTSD biomarkers in fatty acid metabolism and PPAR pathways, and, in addition, that CPT1B may contribute to the pathology of PTSD.",0,0 +6007,Improving Our Understanding of Posttraumatic Trajectories,,0,0 +6008,Introduction: Psychosocial consequences of the war in the region of former Yugoslavia,"Editorials usually reflect research topics addressed in the articles which follow them as well as highlight central issues, providing an overview of the topic and sometimes outlining its historical development. Most of this is true for this editorial, but there is--unfortunately--an immediate connection to the current political situation as well: I am writing this two weeks after the attacks on the World Trade Center, and many people all over the world are afraid that war may now threaten countries not affected by war for many years. The threat of war makes us think more about the multiple medical and psychosocial consequences which follow it. Yet, there is no such thing as ""war."" Each war has its own profile of events which interact with the particular societies involved and with the people in the war region.",0,0 +6009,Psychological Distress and the Impact of Social Support on Fathers and Mothers of Pediatric Cancer Patients: Long-Term Prospective Results,"To explore the effects of social support on psychological distress of parents of pediatric cancer patients using a prospective design over a 5-year period.Parents of children diagnosed with cancer participated at diagnosis (T1), 6 months (T2), 12 months (T3), and 5 years later (T4). Instruments The General Health Questionnaire and the Social Support List (SSL) measuring amount of support, (dis)satisfaction with support, and negative interactions were administered.Psychological distress and amount of support received decreased significantly from diagnosis to T4. No significant change in (dis)satisfaction with support and negative interactions was found. Social support variables did not show any concurrent or prospective significant effect on mothers' distress at T4. Dissatisfaction with support showed a significant unique concurrent effect on fathers' distress at T4 and negative interactions had a prospective unique effect.Dissatisfaction with support and negative interactions that fathers experienced significantly affected their levels of psychological distress. No such effect was found for mothers.",0,0 +6010,"Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition , and the Impact of Events Scale-Revised","We read with great interest the article by Bienvenu et al1 in a recent issue of CHEST (July 2013) and would like to compliment them on the development and validation of the Impact of Events Scale-Revised (IES-R) for patients with posttraumatic stress disorder (PTSD) after acute lung injury. Psychiatric nosology and diagnostic classification systems are always dynamic and in a state of flux. The authors developed the screening questionnaire and validated it against the Clinician-Administered PTSD Scale (CAPS), which is based on Diagnostic and Statistical Manual of Mental Disorders (DSM), fourth edition, diagnostic criteria.",0,0 +6011,Beyond normality in the study of bereavement: Heterogeneity in depression outcomes following loss in older adults,"Studies of individual differences in bereavement have revealed prototypical patterns of outcome. However, many of these studies were conducted prior to the advent of sophisticated contemporary data analytic techniques. For example, Bonanno et al. (2002) used rudimentary categorization procedures to identify unique trajectories of depression symptomatology from approximately 3 years prior to 4 years following conjugal loss in a representative sample of older American adults. In the current study, we revisited these same data using Latent Class Growth Analysis (LCGA) to derive trajectories and test predictors. LCGA is a technique well-suited for modeling empirically- and conceptually-derived heterogeneous longitudinal patterns while simultaneously modeling predictors of those longitudinal patterns. We uncovered four discrete trajectories similar in shape and proportion to the previous analyses: Resilience (characterized by little or no depression; 66.3%), Chronic Grief (characterized by depression following loss, alleviated by 4 years post-loss; 9.1%), _Pre-existing Chronic Depression (ongoing high pre- through post-loss depression; 14.5%), and Depressed-Improved (characterized by high pre-loss depression that decreases following loss; 10.1%). Using this analytic strategy, we were able to examine multiple hypotheses about bereavement simultaneously. Health, financial stress, and emotional stability emerged as strong predictors of variability in depression only for some trajectories, indicating that depression levels do not have a common etiology across all the bereaved. As such, we find that identifying distinct patterns informs both the course and etiology of depression in response to bereavement.",0,0 +6012,Post traumatic stress disorder in children after tsunami disaster in Thailand: 2 years follow-up.,"On December 26, 2004, the tsunami destroyed many families, communities, and residential areas. Adverse psychological impact on children and adolescents due to a natural disaster of this magnitude has never been reported in Thailand's history particularly as Post-Traumatic Stress Disorder (PTSD).Investigate clinical symptoms and develop a 2-year monitoring and intervention program for PTSD in children affected by the December 26, 2004 tsunami natural disaster The study period started six weeks after the event and was completed after two years.One thousand six hundred and twenty five surviving students from two schools in Takuapa district, Phang-nga Province, were enrolled. Screening tests using Pediatric symptom checklists, Childhood depressive intervention (CDI), and Revised child impact of events scales (CRIES) were done. Psychiatric evaluations were done by child and adolescent psychiatrists. Post Traumatic Stress Disorder (PTSD) was diagnosed using criteria from Diagnostic and Statistical Manual of Mental Disorders, 4th edition.The prevalence of PSTD in the affected students were 57.3, 46.1, 31.6, 10.4, and 7.6% at 6 weeks, 6 months, 1 year, 1 1/2 years, and 2 years, respectively. The female: male ratio was 1.7:1. The peak age was 9-10 years old. Threatened situations were studied. Of the 176 students who risked their lives in the waves, 48 (27.3%) suffered from PTSD. Meanwhile, of the 1314 students who were not hit by the waves but were among affected friends and relatives, 42 students (3.1%) suffered from PTSD. The prevalence of PTSD in those hit by the waves were significantly higher than those who were not [p-value < 0.01, RR = 5.16 (4.04-.6.6)].The prevalence of PSTD in children who suffered from the tsunami disaster was as high as 57.3% at six weeks after the incident. It declined sharply at two years (7.6%) with the help of integrated welfare. The children continue to get financial, rehabilitation, and mental health support to prevent long-term adverse outcomes.",0,0 +6013,Early childhood factors associated with the development of post-traumatic stress disorder: results from a longitudinal birth cohort,"Background. Childhood factors have been associated with increased risk of developing post-traumatic stress disorder (PTSD). Previous studies assessed only a limited number of childhood factors retrospectively. We examined the association between childhood neurodevelopmental, temperamental, behavioral and family environmental characteristics assessed before age 11 years and the development of PTSD up to age 32 years in a birth cohort. Method. Members of a 1972–73 New Zealand birth cohort ( n =1037) who were assessed at ages 26 and 32 years for PTSD as defined by DSM-IV. Results. We identified two sets of childhood risk factors. The first set of risk factors was associated both with increased risk of trauma exposure and with PTSD assessed at age 26. These included childhood externalizing characteristics and family environmental stressors, specifically maternal distress and loss of a parent. The second set of risk factors affected risk for PTSD only and included low IQ and chronic environmental adversity. The effect of cumulative childhood factors on risk of PTSD at age 26 was substantial; over 58% of cohort members in the highest risk quartile for three developmental factors had PTSD as compared to only 25% of those not at high risk on any factors. Low IQ at age 5, antisocial behavior, and poverty before age 11 continued to predict PTSD related to traumatic events that occurred between the ages of 26 and 32. Conclusions. Developmental capacities and conditions of early childhood may increase both risk of trauma exposure and the risk that individuals will respond adversely to traumatic exposures. Rather than being solely a response to trauma, PTSD may have developmental origins.",0,0 +6014,"The effects of trauma types, cumulative trauma, and PTSD on IQ in two highly traumatized adolescent groups.","We investigated the relationship between trauma type, posttraumatic stress disorder (PTSD), and intelligence quotient (IQ) utilizing a development-based taxonomy of trauma in a sample of 390 African-American adolescents and Iraqi refugee adolescents. Utilizing structural equation modeling, we compared different “good-fitting” models that describe the specific relationships between different trauma types, PTSD cluster symptoms (i.e., re-experiencing, arousal, avoidance, and emotional numbness/dissociation), and IQ factors (i.e., perceptual reasoning, verbal comprehension, working memory, and processing speed). Our findings support the hypothesis that different trauma types have different influences, some positive and some negative. Whereas abandonment and personal identity trauma (e.g., sexual abuse) have direct negative effects, secondary trauma (e.g., parents’ involvement in war or combat) has a positive effect on IQ. Collective identity trauma (e.g., oppression) did not have either negative or positive effects on IQ. The PTSD components reexperiencing and arousal generally mediated some of the negative effects of traumas on IQ; avoidance and emotional detachment/dissociation generally mediated positive effects. In conclusion, trauma type differentially impacts IQ. However, cumulative trauma dynamics have total negative significant effects on all of the four IQ components: perceptual reasoning, working memory, processing speed, and verbal comprehension.",0,0 +6015,PTSD symptom cluster profiles of youth who have experienced sexual or physical abuse,"The research examined whether youth (6-17 years old) who were referred for treatment due to sexual, physical, or both types of abuse presented with distinct profiles of PTSD DSM-IV-TR symptom clusters. When examining data for the 749 youth participants, five PTSD symptom cluster profiles were identified with each profile representing approximately 20% of the youth. The five profiles were also differentiated with respect to being referred for physical or sexual abuse, age, parental ratings of internalizing symptoms, and self-reported depression. The youth referred for treatment in the aftermath of child sexual, physical, or both sexual and physical abuse presented with different profiles of PTSD symptom clusters thereby suggesting a need for individualized tailoring of evidenced-based treatments. Two cognitive behavioral approaches, designed for traumatized children and either their nonoffending or offending parents, were described for treating youth with the distinct PTSD profiles.",0,0 +6016,Trajectories of Internalizing Problems in War-Affected Sierra Leonean Youth: Examining Conflict and Postconflict Factors,"Three waves of data from a prospective longitudinal study in Sierra Leone were used to examine internalizing trajectories in 529 war-affected youth (ages 10-17 at baseline; 25% female). Latent class growth analyses identified 4 trajectories: A large majority of youth maintained lower levels of internalizing problems (41.4%) or significantly improved over time (47.6%) despite very limited access to care, but smaller proportions continued to report severe difficulties 6 years postwar (4.5%) or their symptoms worsened (6.4%). Continued internalizing problems were associated with loss of a caregiver, family abuse and neglect, and community stigma. Despite the comparative resilience of most war-affected youth in the face of extreme adversity, there remains a compelling need for interventions that address family- and community-level stressors.",0,0 +6017,The Longitudinal Course of Posttraumatic Stress Disorder Symptoms among Aging Military Veterans,"This study examined the longitudinal course of posttraumatic stress disorder (PTSD) among two samples of Dutch aging military veterans: 576 veterans with a military disability pension and 198 community sample veterans, who fought in World War II, the former Dutch East Indies, and Korea. Both samples were investigated in 1992 and in 1998 with a standardized and validated instrument measuring PTSD symptoms. In 1992, 27% of the veterans with a military disability pension met the criteria for a PTSD diagnosis; in 1998, this was 29%. Of the community sample veterans, 9% reported a PTSD diagnosis in 1992, in 1998 this was 8%. The results provide strong support for the long-term persistence of PTSD symptoms. In addition, PTSD caseness at one time point was associated with significantly elevated PTSD symptom severity at the time of no PTSD diagnosis. No evidence was found for an aggravation of PTSD due to stressors associated with aging.",0,0 +6018,Hypothalamic-Pituitary-Thyroid Axis Function in Women With a Menstrually Related Mood Disorder: Association With Histories of Sexual Abuse,"INTRODUCTION: We previously reported a unique hypothalamic-pituitary- thyroid (HPT) axis profile in women with a menstrually related mood disorder (MRMD) who also had a history of sexual abuse (SA). In the present study, we sought to extend that work by examining the association of an SA history with HPT-axis disturbance in both women with MRMD and women without MRMD. METHODS: Fifty-seven women met the prospective criteria for MRMD (23 with an SA history), and 52 women were non-MRMD (18 with an SA history). Thyroid-stimulating hormone, thyroxin (T4; total and free), and triiodothyronine (T3; total and free) were evaluated in serum, together with thyroid hormone ratios reflecting T4 to T3 conversion. RESULTS: Women with MRMD, compared with women without MRMD, had elevated T3/T4 ratios (p values ≤ .01; reflecting increased conversion of T4 to T3) and lower free and total T4 concentrations (p values = .01). Higher T3/T4 ratios and lower T4 concentrations predicted more severe premenstrual symptoms in all women. An SA history, irrespective of MRMD status, was associated with elevated thyroid-stimulating hormone concentrations (p = .03). However, in women with MRMD, an SA history was associated with elevated T3 concentrations (p = .049), whereas in women without MRMD, an SA history was associated with decreased T3 concentrations (p = .02). CONCLUSIONS: An MRMD and an SA history are associated with independent and interactive effects on the HPT axis. The evidence that an MRMD moderates the influence of SA on T3 concentrations contributes to a growing body of work suggesting that an SA history may identify a distinct subgroup of women with MRMD.",0,0 +6019,Prevalence and Determinants of Chronic Post-Traumatic Stress Disorder After Floods,"To explore the prevalence and determinants of chronic post-traumatic stress disorder (PTSD) among flood victims.A cross-sectional survey was carried out in 2014 among individuals who had experienced the 1998 floods and had been diagnosed with PTSD in 1999 in Hunan, China. Cluster sampling was used to select subjects from the areas that had been surveyed in 1999. PTSD was diagnosed according to DSM-IV criteria, social support was measured according to a Social Support Rating Scale, coping style was measured according to a Simplified Coping Style Questionnaire, and personality was measured by use of the revised Eysenck Personality Questionnaire Short Scale for Chinese. Data were collected through face-to-face interviews by use of a structured questionnaire. Multivariate logistic regression analysis was used to reveal the determinants of chronic PTSD.A total of 123 subjects were interviewed, 17 of whom (14.4%) were diagnosed with chronic PTSD. Chronic PTSD was significantly associated with disaster stressors (odds ratio [OR]: 1.74; 95% confidence interval [CI]: 1.22-2.47), nervousness (OR: 1.09; 95% CI: 1.01-1.17), and social support (OR: 0.85; 95 CI%: 0.74-0.98).Chronic PTSD in flood victims is significantly associated with disaster stressors, nervousness, and social support. These factors may play important roles in identifying persons at high risk of chronic PTSD.",0,0 +6020,"The Minnesota Multiphasic Personality Inventory-2, posttraumatic stress disorder, and women domestic violence survivors.","Empirical evidence and diagnostic decision rules for diagnosing Post-Traumatic Stress Disorder (PTSD) with Minnesota Multiphasic Personality Inventory - 2 were originally developed with a narrow and heterogeneous sample of trauma victims, Vietnam veterans. Relatively little empirical study has been given to the use of the MMPI-2 among domestic violence survivors, especially as it pertains to the issue of Post-Traumatic Stress Disorder. The utility and validity of prior empirical findings, based primarily on Vietnam veterans, cannot be extrapolated to other trauma victims without further empirical evidence supporting such application. In this study the MMPI-2 was administered to 93 women domestic violence survivors from domestic violence (a) shelters, (b) support groups, (c) outreach centers, and (d) other social service agencies. The Post-Traumatic Stress Diagnostic Scale (Foa, 1995) was used to identify which of 93 women survivors met diagnostic criteria for Post-Traumatic Stress Disorder. Multivariate analysis of variance, using nine MMPI-2 scales, found significant differences between women domestic violence survivors with and without PTSD on the F, K, 1(Hs), 2(D), 6(Pa), B(Sc), and PK-PTSD scales. Stepwise discriminant function analysis produced one significant discriminant function, including the K validity and the 1(Hs) scales, a 78% correct classification rate, and a sensitivity and specificity of 88% and 60%, respectively. The PK-PTSD scale correctly classified 68% of all cases, and a sensitivity and specificity of 81% and 45%, respectively, were found. Canonical correlation of MMPI-2 scales with sub-scales from Foa's (1995) Post-Traumatic Stress Diagnostic Scale revealed significant multiple correlations. Major findings suggest the MMPI-2 is sensitive to PTSD symptomatology and capable of discriminating between domestic violence survivors with and without PTSD. The MMPI-2 is as diagnostically efficient for assessing PTSD in domestic violence survivors as it is been found to be for Vietnam veterans. Implications for theory, research, practice, and limitations of this research are discussed.",0,0 +6021,Course-dependent response of brain functional alterations in men with acute and chronic post-traumatic stress disorder: A follow-up functional magnetic imaging study,"Introduction The aim of this study was to investigate the neurofunctional alterations in both acute and chronic post-traumatic stress disorder (PTSD) resulting from the same stress experience. Methods Brain responses to emotional trauma-related and neutral pictures with a symptom provocation task were measured using functional magnetic resonance imaging (fMRI). Twenty-four PTSD patients resulting from a mining accident and 14 controls exposed to the same accident without PTSD two months post-trauma were recruited. In the follow-up study 20 PTSD patients and 14 controls were also recruited after 24 months post-trauma. Correlations were conducted in PTSD between altered fMRI blood oxygenation level-dependent (BOLD) signals of areas extracted as regions of interest and three Clinician-Administered PTSD Scale (CAPS) subscores respectively. Results In response to picture stimulus (traumatic negative pictures versus neutral pictures), the acute PTSD group showed greater activation in the bilateral posterior cingulate gyri, left precuneus, right fusiform and left parahippocampal gyrus than the chronic PTSD group (P   20 voxels). In the acute PTSD group, BOLD signals of either posterior cingulate gyrus correlated positively with CAPS intrusion subscores. There was also no significant correlation between BOLD signals of five regions mentioned above in the chronic PTSD group and three CAPS subscores. Discussion These findings suggested that brain circuits affected in acute PTSD may be more extended than chronic PTSD. The reason may due to the formation of traumatic memory in the acute phase of PTSD.",0,0 +6022,"Deconstructing PTSD: Traumatic Experiences, Posttraumatic Symptom Clusters, and Mental Health Problems among Delinquent Youth","This study investigated interrelations among trauma exposure, posttraumatic stress disorder (PTSD) symptom clusters, and mental health problems among adjudicated adolescents. Girls scored higher than boys on measures of exposure to interpersonal trauma, PTSD symptom clusters, and mental health problems. Results of path analyses were consistent with the hypothesis that PTSD symptom clusters differentially mediate the relations between trauma exposure and mental health problems, with unique patterns of results for boys and girls. For all youth, avoidance mediated the association between trauma and internalizing symptoms whereas reexperiencing and arousal acted as mediators of externalizing. However, for boys only, noninterpersonal traumas also were related to PTSD symptoms, which in turn acted as mediators of internalizing. For girls only, reexperiencing and arousal acted as mediators of internalizing and associated symptoms of PTSD acted as a mediator of externalizing. © 2012",0,0 +6023,Post-traumatic growth in stroke carers: A comparison of theories,"This study examined variables associated with post-traumatic growth (PTG) in stroke carers and compared predictions of two models of PTG within this population: the model of Schaefer and Moos was compared to that of Tedeschi and Calhoun (1992, Personal coping: Theory, research, and application. Westport, CT: Praeger, 149; 1998, Posttraumatic growth: Positive changes in the aftermath of crisis. Mahwah, NJ: Lawrence Erlbaum, 99; 2004, Psychol. Inq., 15, 1, respectively).A cross-sectional survey design was employed.Carers of stroke survivors (N = 71) completed questionnaires measuring PTG, coping style, social support, survivor functioning, age, and carer quality of life. Correlation, multiple regression, and mediation analyses were used to test hypotheses.All carers completing the PTG measure (N = 70) reported growth, but average scores differed from cancer carers (Chambers et al., 2012, Eur. J. Cancer Care, 21, 213; Thombre et al., 2010, J. Psychosocial Oncol., 28, 173). PTG was positively correlated with deliberate and intrusive rumination, avoidance coping, social support, and quality of life. Regression analysis showed that factors identified by Tedeschi and Calhoun (deliberate rumination, intrusive rumination, social support, acceptance coping, survivor functioning) accounted for 49% of variance in PTG, whereas those identified by Schaefer and Moos (active coping, avoidance coping, social support, survivor functioning, and age) accounted for only 21%. Rumination, especially deliberate rumination, explained most variance in PTG and mediated the effect of social support on PTG.The findings add to the limited body of evidence suggesting that stroke carers experience growth. Deliberate rumination and social support are important in explaining growth, and the findings support the model proposed by Tedeschi and Calhoun over that of Schaefer and Moos.What is already known on this subject? Literature on caring for stroke survivors focuses on negative outcomes (Ilse, Feys, de Wit, Putman, & de Weerdt, 2008) to the exclusion of positive outcomes such as post-traumatic growth (PTG; Calhoun & Tedeschi, 1999). Studies of a variety of health conditions have demonstrated that PTG occurs in patients and carers after illness events and is associated with well-being (Gangstad, Norman, & Barton, 2006; Helgeson, Reynolds, & Tomich, 2006; Kim, Schulz, & Carver, 2007). Exploratory studies and studies of benefit finding have shown that PTG occurs in stroke carers (Bacon, Milne, Sheikh, & Freeston, 2009; Buschenfeld, Morris, & Lockwood, 2009; Haley et al., 2009; Thompson, 1991), but there are no studies using standard instruments to assess PTG in this population. Moreover, current theories posit different explanations for PTG (Schaefer & Moos, 1992, 1998; Tedeschi & Calhoun, 2004), and there is a need for empirical tests (Park, 2010). What does this study add? This study extends knowledge by measuring PTG with a standard instrument in a sample of UK stroke carers and investigating associated variables. The study also compared the predictive power of the models of PTG proposed by Tedeschi and Calhoun (2004) and Schaefer and Moos (1992, 1998). PTG was found in UK stroke carers, but levels differed from cancer carers in other countries. Factors associated with PTG were identified; Tedeschi and Calhoun's model best predicted PTG. Deliberate rumination had a direct effect on PTG and also mediated the effect of social support. Deliberate rumination is a possible target for therapeutic interventions to enhance PTG.",0,0 +6024,Assessing DSM-5 latent subtypes of acute stress disorder dissociative or intrusive?,"Acute Stress Disorder (ASD) was first included in the DSM-IV in 1994. It was proposed to account for traumatic responding in the early post trauma phase and to act as an identifier for later Posttraumatic Stress Disorder (PTSD). Unlike PTSD it included a number of dissociative indicators. The revised DSM-5 PTSD criterion included a dissociative-PTSD subtype. The current study assessed if a dissociative-ASD subtype may be present for DSM-5 ASD. Moreover, we assessed if a number of risk factors resulted in an increased probability of membership in symptomatic compared to a baseline ASD profile. We used data from 450 bank robbery victims. Latent profile analysis (LPA) was used to uncover latent profiles of ASD. Multinomial logistic regression was used to determine if female gender, age, social support, peritraumatic panic, somatization, and number of trauma exposures increased or decreased the probability of profile membership. Four latent profiles were uncovered and included an intrusion rather than dissociative subtype. Increased age and social support decreased the probability of individuals being grouped into the intrusion subtype whereas increased peritraumatic panic and somatization increased the probability of individuals being grouped into the intrusion subtype. Findings are discussed in regard to the ICD-11 and the DSM-5.",0,0 +6025,One-year prospective follow-up of motor vehicle accident victims,"One-hundred and thirty-two victims of motor vehicle accidents (MVAs), who sought medical attention as a result of the MVA, were assessed at three points in time: 1-4 months post-MVA, 6 months later, and 12 months later. Of the 48 who met the full criteria for Post-Traumatic Stress Disorder (PTSD) initially, half had remitted at least in part by the 6-month follow-up point and two-thirds had remitted by the 1-yr follow-up. Using logistic regression, 3 variables combined to correctly identify 79% of remitters and non-remitters at the 12-month follow-up point: initial scores on the irritability and foreshortened future symptoms of PTSD and the initial degree of vulnerability the subject felt in a motor vehicle after the MVA. Four variables combined to predict 64% of the variance in the degree of post-traumatic stress symptoms at 12 months: presence of alcohol abuse and/or an Axis-II disorder at the time of the initial assessment as well as the total scores on the hyperarousal and on avoidance symptoms of PTSD present at the initial post-MVA assessment.",0,0 +6026,Five Essential Elements of Immediate and Mid–Term Mass Trauma Intervention: Empirical Evidence,"Given the devastation caused by disasters and mass violence, it is critical that intervention policy be based on the most updated research findings. However, to date, no evidence-based consensus has been reached supporting a clear set of recommendations for intervention during the immediate and the mid-term post mass trauma phases. Because it is unlikely that there will be evidence in the near or mid-term future from clinical trials that cover the diversity of disaster and mass violence circumstances, we assembled a worldwide panel of experts on the study and treatment of those exposed to disaster and mass violence to extrapolate from related fields of research, and to gain consensus on intervention principles. We identified five empirically supported intervention principles that should be used to guide and inform intervention and prevention efforts at the early to mid-term stages. These are promoting: 1) a sense of safety, 2) calming, 3) a sense of self- and community efficacy, 4) connectedness, and 5) hope.",0,0 +6027,"Mental Health, Help Seeking, and Stigma and Barriers to Care Among 3- and 12-Month Postdeployed and Never Deployed U.S. Army Combat Medics","U.S. Army Combat Medic serves as both Soldier and provider of combat casualty care, often in the heat of battle and with limited resources. Yet little is known about their help-seeking behavior and perceived stigma and barriers to care. Participants were three groups of U.S. Army Combat Medics surveyed at 3- and 12-months postdeployment from assignment with line units vs. those Medics who had never deployed to combat. The primary data source was surveys of mental health service utilization, perceived stigma and barriers to care, and depression and post-traumatic stress disorder screens. Medics who received help in the past year from a mental health professional ranged from 18% to 30%, with 18% to 30% seeking mental health assistance from other sources. Previously deployed Medics were more likely to obtain assistance than those who never deployed. Those meeting a mental health screening criteria were more likely to report associated stigma and barriers to care. Findings indicate that Medics in need of assistance report greater perceived barriers to mental health care, as well as stigma from seeking treatment, and that depression may be a salient issue for Medics. The longitudinal nature of the ongoing study will help determine the actual trajectory and onset of depression and post-traumatic stress disorder.",0,0 +6028,Anxiety Disorders and PTSD,"INTRODUCTION This chapter reviews the literature on the prevalence and etiology of anxiety disorders, including posttraumatic stress disorder (PTSD), following disasters. We highlight that there is relatively little information about anxiety disorders other than PTSD; the paucity of data is due to the challenge of the shared phenomenology of these disorders and the difficulty of defining their boundaries. A further challenge is explored, namely, how disasters interact with background morbidity in a community. In considering the etiology of anxiety disorders, the differential role of threat is hypothesized to be differentiated from the more enduring effect of the losses sustained in disasters. Anxiety disorders have an enduring effect in the aftermath of disasters, and many issues remain to be examined in future research, especially in expanding beyond PTSD. To begin, however, it is important to understand the settings in which disasters occur and the anticipations that abound following these events, as these have the potential to bias a rational appraisal of the challenges that will impact the affected community. Managing the psychological impact of disasters is a critical public-health challenge in the aftermath of these events. Informed prevalence and incidence estimates are critical to effective service planning. Unfortunately, there is often dramatization of disaster impact immediately afterward, with fears expressed about the capacity of the population to function and manage effectively (de Ville de Goyet, 2007). © Cambridge University Press 2009.",0,0 +6029,The role of smoking expectancies in the relationship between PTSD symptoms and smoking behavior among women exposed to intimate partner violence,"Intimate partner violence (IPV) is a public health problem associated with negative health consequences, including higher rates of tobacco smoking. Smoking expectancies are related to motivation to quit and relapse. IPV-exposed women endorse higher rates of PTSD symptoms, which are related to smoking and smoking expectancies. The present study sought to examine the relationship among smoking behavior, smoking expectancies, and PTSD symptoms among IPV-exposed women. Participants were 83 women who reported experiencing IPV within the last month, smoked an average of 12 cigarettes per day, and reported moderate levels of nicotine dependence (FTND mean=4.4). Participants completed baseline and follow-up interviews. Multiple regression analyses assessed the relationships among smoking expectancies and PTSD symptoms to cigarettes smoked per day and nicotine dependence. Findings demonstrated that Stimulation/State Enhancement expectancies were positively related to cigarettes per day, whereas PTSD arousal symptoms were negatively related to cigarettes per day, p's<.05. Neither smoking expectancies nor PTSD symptoms were significantly related to nicotine dependence. Supplemental analyses revealed that PTSD re-experiencing symptoms were negatively related and PTSD avoidance/numbing symptoms were positively related to Stimulation/State Enhancement expectancies, p's<.05. This study extends findings regarding the association between PTSD symptoms and smoking among an understudied population - IPV-exposed women. The relationship between PTSD symptoms and smoking differed across PTSD symptom clusters and expectancy scales, which may have implications for treatment development. The fact that expectancies and PTSD symptoms are related to smoking behavior among IPV-exposed women may be important for enhancing prevention and intervention efforts.",0,0 +6030,Acute stress disorder and posttraumatic stress disorder in parents of injured children,"Acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) were examined in 334 parents of children with traffic-related injuries. In the first month after their child's injury, 12% of parents had ASD and another 25% had partial ASD. Among 251 parents assessed again approximately 6 months postinjury, 8% had PTSD and another 7% had partial PTSD. The ASD and PTSD severity were associated (r = .54), but ASD status was not a sensitive predictor of later PTSD. Independent predictors of ASD severity included prior trauma exposure, peritrauma exposure and perceptions of the child's pain and life threat, and child ASD severity. Independent predictors of PTSD severity included prior trauma exposure, parent ASD severity, and parent-rated child physical health at follow-up.",0,0 +6031,50 years of hurdles and hope in anxiolytic drug discovery,"Anxiety disorders are the most prevalent group of psychiatric diseases, and have high personal and societal costs. The search for novel pharmacological treatments for these conditions is driven by the growing medical need to improve on the effectiveness and the side effect profile of existing drugs. A huge volume of data has been generated by anxiolytic drug discovery studies, which has led to the progression of numerous new molecules into clinical trials. However, the clinical outcome of these efforts has been disappointing, as promising results with novel agents in rodent studies have very rarely translated into effectiveness in humans. Here, we analyse the major trends from preclinical studies over the past 50 years conducted in the search for new drugs beyond those that target the prototypical anxiety-associated GABA (γ-aminobutyric acid)-benzodiazepine system, which have focused most intensively on the serotonin, neuropeptide, glutamate and endocannabinoid systems. We highlight various key issues that may have hampered progress in the field, and offer recommendations for how anxiolytic drug discovery can be more effective in the future.",0,0 +6032,Faking it: incentives and malingered PTSD,"Purpose – The purpose of this paper is to address how context for malingering and the provision of incentives influence malingered symptom profiles of post-traumatic stress disorder (PTSD). Design/methodology/approach – A 2 (case context)×3 (incentive) factorial design was utilized. Participants ( n =298) were given an incentive (positive, negative, or no incentive), randomly assigned to a criminal or civil context, and asked to provide a fake claim of child abuse with corresponding malingered symptoms of PTSD. Under these conditions, participants completed several questionnaires pertaining to symptoms of trauma and PTSD. Findings – Results indicated that negative incentives were primarily associated with lower symptom scores. Therefore, “having something to lose” may result in more constrained (and realistic) symptom reports relative to exaggeration evidenced with positive incentives. Originality/value – These results have implications for forensic settings where malingered claims of PTSD are common and incentives for such claims (e.g. having something to gain or lose) frequently exist. Previous studies have failed to address incentives (positive and negative) in relation to a crime (i.e. abuse) that can span both criminal and civil contexts.",0,0 +6033,Mental Health Distress and Related Factors Among Prefectural Public Servants Seven Months After the Great East Japan Earthquake,"To develop an empirically informed support measure for workers, we examined mental health distress and its risk factors among prefectural public servants who were affected by the Great East Japan Earthquake and faced a demanding workload in the midterm of the disaster.We conducted a self-administered health survey of all public servants in the Miyagi prefectural government two and seven months after the Great East Japan Earthquake (3743 workers, 70.6% of all employees). We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for mental distress (defined as K6 score ≥10) in the domain of disaster-work-related stressors, work-related stressors, and disaster-related stressors.Among those with better levels of workplace communication, the only factor that increased the risk of mental distress was not taking a non-work day each week (adjusted OR 2.55, 95% CI 1.27-5.14). Among those with poorer levels of workplace communication, in addition to not taking a non-work day each week (adjusted OR 3.93, 95% CI 3.00-5.15), handling residents' complaints (adjusted OR 1.55, 95% CI 1.00-2.42), having dead or missing family members (adjusted OR 2.87, 95% CI 1.53-5.38), and living in a shelter more than two months after the disaster (adjusted OR 2.80, 95% CI 1.32-5.95) increased the risk of mental distress.All workers should be encouraged to take a non-work day each week. Among workers with poor workplace communication, special attention should be given to those who handle residents' complaints, have lost a family member(s), and are living in a shelter for a prolonged period of time.",0,0 +6034,Susceptibility to PTSD-like behavior is mediated by corticotropin-releasing factor receptor type 2 levels in the bed nucleus of the stria terminalis.,"Posttraumatic stress disorder (PTSD) is a debilitating disease, which affects 8-10% of the population exposed to traumatic events. The factors that make certain individuals susceptible to PTSD and others resilient are currently unknown. Corticotropin-releasing factor receptor type 2 (CRFR2) has been implicated in mediating stress coping mechanisms. Here, we use a physiological PTSD-like animal model and an in-depth battery of tests that reflect the symptomology of PTSD to separate mice into subpopulations of ""PTSD-like"" and ""Resilient"" phenotypes. PTSD-like mice are hypervigilant, hyperalert, insomniac, have impaired attention and risk assessment, as well as accompanying attenuated corticosterone levels. Intriguingly, PTSD-like mice show long-term robust upregulation of BNST-CRFR2 mRNA levels, and BNST-CRFR2-specific lentiviral knockdown reduces susceptibility to PTSD-like behavior. Additionally, using a BNST mRNA expression array, PTSD-like mice exhibit a general transcriptional attenuation profile, which was associated with upregulation of the BNST-deacetylation enzyme, HDAC5. We suggest PTSD to be a disease of maladaptive coping.",0,0 +6035,"Posttraumatic Stress, Heart Rate Variability, and the Mediating Role of Behavioral Health Risks","Posttraumatic stress disorder (PTSD) has been linked to reduced heart rate variability (HRV), which is in turn a risk factor for cardiovascular disease and death. Although hyperarousal and anxiety are thought to underlie this association, behavioral health risks, including smoking, alcohol dependence, obesity, and sleep disturbance, represent potential mechanisms linking PTSD and HRV.To test this hypothesis, short-term laboratory-based and 24-hour ambulatory measures of HRV were collected from 227 young adults (18-39 years), 107 of whom were diagnosed as having PTSD. Latent variable modeling was used to assess the relationship of PTSD symptoms with HRV along with potential behavioral health mediators.PTSD symptoms were associated with reduced HRV (β = -0.21, p = .002). However, this association was reduced in models that adjusted for cigarette consumption and history of alcohol dependence and was rendered nonsignificant in a model adjusting for sleep disturbance. Independent mediation effects were deemed significant via bootstrapping analysis. Together, the three behavioral health factors (cigarette consumption, history of alcohol dependence, and sleep disturbance) accounted for 94% of the shared variance between PTSD symptoms and HRV. Abdominal obesity was not a significant mediator.These results indicate that behavioral factors-specifically smoking, alcohol overuse, and sleep disturbance-mediate the association between PTSD and HRV-based indices of autonomic nervous system dysregulation. Benefits from psychiatric and psychological interventions in PTSD may therefore be enhanced by including modification of health behaviors.",0,0 +6036,Epidemiology of major depression in four cities in Mexico,"Analyses were conducted to estimate lifetime and current prevalence of major depressive disorder (MDD) for four representative cities of Mexico, to identify variables that influence the probability of MDD, and to further describe depression in Mexican culture. A multistage probability sampling design was used to draw a sample of 2,509 adults in four different regions of Mexico. MDD was assessed according to DSM-IV criteria by using the Composite International Diagnostic Interview collected by trained lay interviewers. The prevalence of MDD in these four cities averaged 12.8% for lifetime and 6.1% for the previous 12 months. MDD was highly comorbid with other mental disorders. Women were more likely to have lifetime MDD than were men. Being divorced, separated, or widowed (compared to married or never married) and having experienced childhood trauma were related to higher lifetime prevalence but not to current prevalence. In addition, age and education level were related to current 12-month MDD. Data on the profile of MDD in urban Mexico are provided. This research expands our understanding of MDD across cultures.",0,0 +6037,Prior Assault and Posttraumatic Stress Disorder After Combat Deployment,"Factors that make people vulnerable to or resilient against posttraumatic stress disorder (PTSD) following overwhelming stress are not well understood. The objective of this study was to prospectively examine the relation between prior assault and new-onset PTSD symptoms in a large US military cohort deployed in the wars in Iraq and Afghanistan.Data on exposures and health outcomes were collected in the Millennium Cohort study at enrollment (July 2001 to June 2003) and follow-up (June 2004 to February 2006) from over 55,000 participants. Of these, 5324 were deployed in Iraq and Afghanistan, reported combat exposures, and were free of PTSD at baseline (881 women and 4443 men). We used multivariable logistic regression analysis to model the odds of new-onset PTSD in relation to prior assault.New-onset PTSD symptoms or diagnosis among deployers reporting combat exposures occurred in 22% of women who reported prior assault and 10% not reporting prior assault. Among men reporting prior assault, rates were 12% and 6%, respectively. Adjusting for baseline factors, the odds of new-onset PTSD symptoms was more than 2-fold higher in both women and men who reported assault prior to deployment.Prior assault appears to confer increased vulnerability for, rather than resilience against, PTSD symptoms among military professionals deployed to recent combat operations.",0,0 +6038,Ecological Momentary Assessment of Posttraumatic Stress Disorder Symptoms During a Smoking Quit Attempt,"Smokers with posttraumatic stress disorder (PTSD) tend to lapse more quickly following a quit attempt, which might be explained by changes in PTSD symptoms during a quit attempt. The present study examines changes in PTSD symptoms, negative affect, and craving before and during a quit attempt.Participants in this study were 52 smokers with PTSD who completed random-alarm ecological momentary assessments of PTSD symptoms, negative affect, cigarette craving, and smoking behavior throughout a prequit phase of ad hoc smoking, a phase of abstinence from smoking, and a postlapse phase.Relative to the prequit phase, the abstinent phase was marked by decreases in PTSD reexperiencing, avoidance, and numbing clusters (ps ≤ .01). The odds of PTSD symptom or negative affect variability from one reading in the ecological momentary assessment (EMA)to the next reading was decreased in PTSD reexperiencing, avoidance, and numbing clusters (ps ≤ .02). Smoking cravings were also mildly decreased in the abstinent and postlapse phases (ps < .01), although some cravings in both phases were rated at the maximum intensity. Increased craving was predicted by the previous EMA reading of PTSD symptoms.Results suggested that smoking abstinence is not associated with exacerbation of PTSD symptoms, but PTSD symptoms during abstinence were related to craving levels during the quit attempt.",0,0 +6039,Salivary cortisol and dehydroepiandrosterone sulfate in adolescent rape victims with post traumatic stress disorder,"In chronic sexual abuse victims with post traumatic stress disorder (PTSD), the hypothalamic pituitary adrenal (HPA) axis can be dysregulated. In single rape victims, PTSD symptoms are hypothesized to function as a chronic stressor leading to similar HPA-axis dysregulation. The objective of the current study was to assess HPA-axis functioning in female adolescents with rape-related PTSD, but no prior sexual trauma, in comparison to non-victimized controls.Salivary cortisol and dehydroepiandrosterone sulfate (DHEAS) were measured in 52 female adolescent rape victims with PTSD and 37 healthy adolescents at 0, 15, 30, 45 and 60 min after awakening, both under basal conditions and after 0.5 mg dexamethasone administration.Compared to age-matched controls, adolescent rape victims with PTSD showed significantly reduced cortisol and DHEAS levels. No group differences for the effect of dexamethasone suppression were found. Both the event of rape and PTSD diagnosis, and not factors such as sleep duration, smoking, education or oral contraceptives, accounted for the neuroendocrine differences between rape victims and controls.The results show evidence for a dysregulated HPA-axis in female adolescent victims of single sexual trauma with PTSD. The finding of hypocortisolism is consistent with endocrine dysfunctioning in chronic sexual abuse victims and may have clinical implications with regard to treatment possibilities.",0,0 +6040,Examination of the Relationship Between PTSD and Distress Tolerance in a Sample of Male Veterans With Comorbid Substance Use Disorders,"Distress tolerance (DT), the perceived or actual ability to tolerate negative emotional or physical states, is inversely related to posttraumatic stress disorder (PTSD) symptoms in civilian, community samples. No studies to date have examined the relationship between DT and PTSD in clinical samples of veterans with a comorbid diagnosis of PTSD and a substance use disorder (SUD). Thus, the present study examined the relationship between DT and PTSD in a sample of predominately African American, male veterans (n = 75) diagnosed with comorbid PTSD and SUD (according to a structured clinical interview). Results of hierarchical linear regression models indicated that DT was inversely related to total PTSD symptom severity score, above and beyond depressive symptoms and SUD severity. Of the 4 symptom clusters, DT was inversely associated with intrusions and hyperarousal. These findings are discussed in light of previous work with civilian samples. Determining whether treatment incorporating DT skills would be useful for veterans undergoing PTSD treatment should be evaluated.",0,0 +6041,Replication and extension of a risk profile for Amerasian youth,"The relationship between number of risk factors and symptoms of anxiety and depression was examined in a cohort of Vietnamese Amerasians, replicating a study done with a previous cohort. One hundred forty seven subjects awaiting U.S. placement completed the Hopkins Symptom Checklist, the Vietnamese Depression Scale, and a questionnaire which included items found to be risk factors for psychological distress among Amerasians. Number of risk factors was linearly related to symptoms of both depression and anxiety. Results are consistent with previous findings of the relationship between risk factors and symptoms of psychological distress. The profile may be helpful in anticipating which refugees may be at risk for future psychological distress, and thus be useful in preventively allocating scarce treatment resources.",0,0 +6042,Salivary cortisol and posttraumatic stress disorder in a low-income community sample of women,"Studies of male combat veterans with posttraumatic stress disorder have demonstrated a profile of low cortisol. Studies with women with posttraumatic stress disorder (PTSD) have focused on childhood sexual abuse and holocaust survivors, both of whom experienced trauma during development, which could be different than adult trauma exposure.Using an epidemiologic sample of low-income women from an urban area in Michigan, we conducted structured psychiatric interviews and saliva cortisol collection on a subsample of women with exposure to trauma but never PTSD (n = 72), recent PTSD (n = 29), and past PTSD (n = 70). Saliva cortisol was collected at awakening, 30 minutes later, at bedtime, and during a clinic visit.Recent trauma exposure but not past trauma exposure led to an increase in saliva cortisol. Neither recent PTSD nor past PTSD resulted in any saliva cortisol changes compared with the trauma exposed, never PTSD group. Recent major depression (past 12 months) demonstrated a weak effect (p =.08) on bedtime saliva cortisol.While recent trauma exposure can increase saliva cortisol, neither recent nor past PTSD affected saliva cortisol in our community sample of women. Our data do not support saliva cortisol changes associated with PTSD.",0,0 +6043,Volunteers and professional rescue workers: Traumatization and adaptation after an avalanche disaster,"Objective: To compare the degree of traumatization and adaptation in professional and volunteer rescue workers after two snow avalanches. Method: Questionnaires including demographic questions, the Social Readjustment Rating Scale, the Rescue Workers Questionnaire, the General Health Questionnaire, the Impact of Event Scale, and the Coping Styles Questionnaire were answered by rescue workers (n = 168).Results: In several areas, professional rescuers had stronger fears than volunteers, all the same, volunteers were significantly more anxious and met criteria for PTSD caseness more often than professionals.Conclusion: The findings suggest that voluntary rescue workers suffer from post-traumatic stress disorder symptoms more often than professionals following demanding rescue missions.",0,0 +6044,TRAJECTORIES OF CHANGE IN ANXIETY SEVERITY AND IMPAIRMENT DURING AND AFTER TREATMENT WITH EVIDENCE-BASED TREATMENT FOR MULTIPLE ANXIETY DISORDERS IN PRIMARY CARE,"Coordinated Anxiety Learning and Management (CALM) is a model for delivering evidence-based treatment for anxiety disorders in primary care. Compared to usual care, CALM produced greater improvement in anxiety symptoms. However, mean estimates can obscure heterogeneity in treatment response. This study aimed to identify (1) clusters of participants with similar patterns of change in anxiety severity and impairment (trajectory groups); and (2) characteristics that predict trajectory group membership.The CALM randomized controlled effectiveness trial was conducted in 17 primary care clinics in four US cities in 2006-2009. 1,004 English- or Spanish-speaking patients age 18-75 with panic, generalized anxiety, social anxiety, and/or posttraumatic stress disorder participated. The Overall Anxiety Severity and Impairment Scale was administered repeatedly to 482 participants randomized to CALM treatment. Group-based trajectory modeling was applied to identify trajectory groups and multinomial logit to predict trajectory group membership.Two predicted trajectories, representing about two-thirds of participants, were below the cut-off for clinically significant anxiety a couple of months after treatment initiation. The predicted trajectory for the majority of remaining participants was below the cut-off by 9 months. A small group of participants did not show consistent improvement. Being sicker at baseline, not working, and reporting less social support were associated with less favorable trajectories.There is heterogeneity in patient response to anxiety treatment. Adverse circumstances appear to hamper treatment response. To what extent anxiety symptoms improve insufficiently because adverse patient circumstances contribute to suboptimal treatment delivery, suboptimal treatment adherence, or suboptimal treatment response requires further investigation.",0,0 +6045,Children Exposed to Disaster: II. Risk Factors for the Development of Post-Traumatic Symptomatology,"

ABSTRACT

Objective

To examine the influence of subject and exposure variables on the development of post-traumatic stress disorder (PTSD) symptoms and syndrome in children exposed to disaster.

Method

Three months after Hurricane Hugo, 5,687 school-aged children were surveyed about their experiences and reactions to the hurricane. Self-reports of PTSD symptoms were obtained by use of a PTSD Reaction Index.

Results

The presence of PTSD symptoms was strongly related to children's reported severity of the hurricane, degree of home damage sustained, and continued displacement; however, children's level of trait anxiety and their reported emotional reactivity during the hurricane were more strongly related to the presence of PTSD symptoms than were the exposure factors. Different sets of risk factors appeared to differentially influence the development of the three DSM-III-R PTSD symptom clusters. Little evidence for a differential effect of the risk factors between females and males and younger and older children was found.

Conclusions

Level of trait anxiety appears to be the single strongest risk for the development of severe post-traumatic reactions. The higher rate of post-traumatic symptoms in females and younger children in combination with the absence of differential reaction to the risk factors suggests that females and younger children are more likely to develop posttraumatic reactions following a disaster.",0,0 +6046,Longitudinal analysis of psychological resilience and mental health in Canadian military personnel returning from overseas deployment.,"The relationship between exposure to combat stressors and poorer postdeployment health is well documented. Still, some individuals are more psychologically resilient to such outcomes than others. Researchers have sought to identify the factors that contribute to resilience in order to inform resilience-building interventions. The present study assessed the criterion validity of a model of psychological resilience composed of various intrapersonal and interpersonal variables for predicting mental health among Canadian Forces (CF) members returning from overseas deployment. Participants included 1,584 male CF members who were deployed in support of the mission in Afghanistan between 2008 and 2010. Data on combat experiences and mental health collected through routine postdeployment screening were linked with historical data on the intrapersonal and interpersonal variables from the model. The direct and moderating effects of these variables were assessed using multiple linear regression analyses. Analyses revealed direct effects of only some intrapersonal and interpersonal resilience variables, and provided limited support for moderating effects. Specifically, results emphasized the protective nature of conscientiousness, emotional stability, and positive social interactions. However, other variables demonstrated unexpected negative associations with postdeployment mental health (e.g., positive affect and affectionate social support). Ultimately, results highlight the complexities of resilience, the limitations of previous cross-sectional research on resilience, and potential targets for resilience-building interventions. Additional longitudinal research on the stability of resilience is recommended to build a better understanding of how resilience processes may change over time and contribute to mental health after adverse experiences.",0,0 +6047,Simultaneous Treatment of Neurocognitive and Psychiatric Symptoms in Veterans with Post-Traumatic Stress Disorder and History of Mild Traumatic Brain Injury: A Pilot Study of Mindfulness-Based Stress Reduction,"Treating patient populations with significant psychiatric and neurocognitive symptomatology can present a unique clinical dilemma: progress in psychotherapy can be significantly fettered by cognitive deficits, whereas neurocognitive rehabilitation efforts can be ineffective because of psychiatric overlay. Application of mindfulness-based interventions to address either cognitive or psychiatric symptoms in isolation appears efficacious in many contexts; however, it remains unclear whether this type of intervention might help address simultaneous neurocognitive and psychiatric symptomatology. In a pre-post mixed methods design pilot study, nine Veterans with post-traumatic stress disorder (PTSD) and a history of mild traumatic brain injury with chronic cognitive complaints participated in Mindfulness-Based Stress Reduction (MBSR). Clinical interview, questionnaires, and attention and PTSD measures were administered immediately before, immediately after, and 3 months after MBSR completion. Qualitative and quantitative findings suggest high levels of safety, feasibility, and acceptability. Measurement of attention revealed significant improvement immediately following MBSR (p < 0.05, d = 0.57) and largely sustained improvement 3 months after completion of MBSR (p < 0.10, d = 0.48). Significant reduction in PTSD symptoms was found immediately after MBSR (p < 0.05, d = -1.56), and was sustained 3 months following MBSR completion (p < 0.05, d = -0.93). These results warrant a randomized controlled trial follow-up. Potential mechanisms for the broad effects observed will be explored.",0,0 +6048,Considering resilience in the rehabilitation of people with traumatic disabilities.,"Objectives: To provide discussion on (a) the construct of resilience in relation to people with traumaticinjuries, (b) potential research directions, and (c) reliable and valid measures of resilience. Conclusions:Resilience as a construct is part of the “positive psychology” movement that focuses on identifying thestrengths of an individual when faced with adversity rather than on his or her weaknesses (e.g.,depression, anxiety). Although a universal denition does not exist, resilience is generally considered amultidimensional construct consisting of behaviors, thoughts, and actions, which can be learned over-time. Consequently, there is a growing body of literature examining resilience in different populations(e.g., children, older adults). However, there is a paucity of literature examining the resilience ofindividuals who have experienced a traumatic injury. Potentially, resilience and rehabilitation is a veryfruitful line of research due to the extreme adversity individuals are faced with postinjury when dealingwith the trauma of the injury and resultant impairments.Keywords: resilience, rehabilitation, traumatic, injury",0,0 +6049,Is Partner Violence Worse in the Context of Control?,"M. P. Johnson’s (1995) proposal that there are two qualitatively distinct types of intimate partner violence—intimate terrorism and situational couple violence—has been an influential explanation for disparate findings on sex symmetry in domestic violence. This study examines whether this typology increases our ability to explain variations in the negative outcomes of partner violence as compared with the use of a continuous measure of violence. This study also considers whether the use of control to differentiate between types of violence helps to explain the negative consequences of partner violence. The results, based on analyses of data on 4,575 married women from National Violence Against Women survey, indicate mixed support for Johnson’s argument for a qualitative distinction between IT and SCV.",0,0 +6050,Posttraumatic stress disorder and prolonged grief in refugees exposed to trauma and loss,"BackgroundWhile a large proportion of conflict-affected populations have been dually exposed to trauma and loss, there is inadequate research identifying differential symptom profiles related to bereavement and trauma exposure in these groups. The objective of this study were to (1) determine whether there are distinct classes of posttraumatic stress disorder (PTSD) and prolonged grief disorder (PGD) symptoms in bereaved trauma survivors exposed to conflict and persecution, and (2) examine whether particular types of refugee experiences and stressors differentially predict symptom profiles.MethodsParticipants were 248 Mandaean adult refugees who were assessed at an average of 4.3 years since entering Australia following persecution in Iraq. PTSD, PGD, trauma exposure, adjustment difficulties since relocation, and English proficiency were measured. Latent class analysis was used to elucidate symptom profiles of PTSD and PGD in this sample.ResultsLatent class analysis revealed four classes of participants: a combined PTSD/PGD class (16%), a predominantly PTSD class (25%), a predominantly PGD class (16%), and a resilient class (43%). Whereas membership in the PTSD/PGD class was predicted by exposure to traumatic loss, those in the PGD class were more likely to have experienced adaptation difficulties since relocation, and individuals in the PTSD class were more likely to have experienced difficulties related to loss of culture and support.ConclusionsThis study provides evidence that specific symptom patterns emerge following exposure to mass trauma and loss. These profiles are associated with distinct types of traumatic experiences and post-migration living difficulties. These results have substantial public health implications for assessment and intervention following mass trauma.",0,0 +6051,The prevalence and correlates of adult separation anxiety disorder in an anxiety clinic,"Adult separation anxiety disorder (ASAD) has been identified recently, but there is a paucity of data about its prevalence and associated characteristics amongst anxiety patients. This study assessed the prevalence and risk factor profile associated with ASAD in an anxiety clinic.Clinical psychologists assigned 520 consecutive patients to DSM-IV adult anxiety subcategories using the SCID. We also measured demographic factors and reports of early separation anxiety (the Separation Anxiety Symptom Inventory and a retrospective diagnosis of childhood separation anxiety disorder). Other self-report measures included the Adult Separation Anxiety Symptom Questionnaire (ASA-27), the Depression, Anxiety, Stress Scales (DASS-21), personality traits measured by the NEO PI-R and the Work and Social Adjustment Scale. These measures were included in three models examining for overall differences and then by gender: Model 1 compared the conventional SCID anxiety subtypes (excluding PTSD and OCD because of insufficient numbers); Model 2 divided the sample into those with and without ASAD; Model 3 compared those with ASAD with the individual anxiety subtypes in the residual group.Patients with ASAD had elevated early separation anxiety scores but this association was unique in females only. Except for social phobia in relation to some comparisons, those with ASAD recorded more severe symptoms of depression, anxiety and stress, higher neuroticism scores, and greater levels of disability.Patients with ASAD attending an anxiety clinic are highly symptomatic and disabled. The findings have implications for the classification, clinical identification and treatment of adult anxiety disorders.",0,0 +6052,Posttraumatic Stress Symptoms in Parents of Children with Acute Burns,"To develop a model of risk factors for posttraumatic stress disorder (PTSD) symptoms in parents of children with burns.Immediately following the burn and 3 months later, parents reported on their children's and their own psychological functioning and traumatic stress responses.Approximately 47% of the parents reported experiencing significant posttraumatic stress symptoms 3 months after the burn. Our model indicates three independent pathways to PTSD symptoms (i.e., parent-child conflict, parents' dissociation, and children's PTSD symptoms). Additionally, parents' anxiety predicted increased parent-child conflict, conflict with extended family and size of the burn predicted parents' dissociation, and size of the burn and children's dissociation predicted children's PTSD symptoms.This study suggests that many parents of children with burns suffer from posttraumatic stress symptoms. Interventions that target factors such as family conflict, children's symptoms, and parents' acute anxiety and dissociation may diminish the risk for PTSD.",0,0 +6053,"Comorbidity of PTSD, Major Depression, and Substance Use Disorder Among Adolescent Victims of the Spring 2011 Tornadoes in Alabama and Joplin, Missouri.","The purpose of this study was twofold: (1) to estimate the prevalence of comorbid posttraumatic stress disorder (PTSD), major depressive episode (MDE), and substance use disorder (SUD); and (2) to identify risk factors for patterns of comorbidity among adolescents affected by disasters.A population-based sample of 2,000 adolescents (51% female; 71% Caucasian, 26% African American) aged 12 to 17 years (M = 14.5, SD = 1.7) and their parents was recruited from communities affected by the spring 2011 tornadoes in Alabama and Joplin, Missouri. Participants completed structured telephone interviews assessing demographic characteristics, impact of disaster, prior trauma history, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), symptoms of posttraumatic stress disorder (PTSD) and major depressive episode (MDE), and substance use disorder (SUD) symptoms. Prevalence estimates were calculated for PTSD + MDE, PTSD + SUD, MDE + SUD, and PTSD + MDE + SUD. Hierarchical logistic regression was used to identify risk factors for each comorbidity profile.Overall prevalence since the tornado was 3.7% for PTSD + MDE, 1.1% for PTSD + SUD, 1.0% for MDE + SUD, and 0.7% for PTSD + MDE + SUD. Girls were significantly more likely than boys to meet criteria for PTSD + MDE and MDE + SUD (ps < .05). Female gender, exposure to prior traumatic events, and persistent loss of services were significant risk factors for patterns of comorbidity. Parental injury was associated with elevated risk for PTSD + MDE. Adolescents should be evaluated for comorbid problems, including SUD, following disasters so that appropriate referrals to evidence-based treatments can be made.Results suggest that screening procedures to identify adolescents at risk for comorbid disorders should assess demographic characteristics (gender), impact of the disaster on the family, and adolescents' prior history of stressful events.",0,0 +6054,Paroxetine: safety and tolerability issues,"Paroxetine is a selective serotonin re-uptake inhibitor (SSRI) available in immediate release and controlled release (CR) formulations. Paroxetine is the most potent inhibitor of serotonin re-uptake among the now available SSRIs. Paroxetine has been approved for the treatment of major depressive disorder (MDD), obsessive-compulsive disorder, panic disorder (PD), generalised anxiety disorder, post traumatic stress disorder (PTSD), and social anxiety disorder (SAD) in adults, whereas paroxetine CR is approved for the treatment of MDD, SAD, PD and premenstrual dysphoric disorder in adults. The overall efficacy of paroxetine seems to be comparable to other SSRIs in the treatment of approved indications, although paroxetine treatment induces more sedation, constipation, sexual dysfunction, discontinuation syndrome and weight gain than other SSRIs. Recent data suggest that paroxetine treatment leads to increased rates of congenital malformations, although this evidence is not conclusive. Paroxetine and paroxetine CR are not indicated for use in the paediatric population and are categorised as Pregnancy Class D. In conclusion, whether the tolerability profile of paroxetine differs substantially from other new antidepressants (including other SSRIs) needs to be determined in adequately powered well-designed randomised controlled comparative clinical trials.",0,0 +6055,Trial of Trazodone for Posttraumatic Stress Disorder Using a Multiple Baseline Group Design,"Six patients with combat-related posttraumatic stress disorder (PTSD) entered a multiple-baseline trial of trazodone, beginning with 50 mg/day and increasing to 400 mg/day until response was maximal. Total Clinician-Administered PTSD Scale scores decreased from a mean of 92 at baseline to 79 at end point, and self-reported PTSD symptoms as measured by the Davidson Trauma Scale paralleled these results (mean of 102 at baseline to 88 at end point). Based on clinician global improvement scores, four patients were rated as much improved and two were rated to be minimally improved. Improvement in social and occupational functioning, and depression was minimal. Available follow-up scores for PTSD symptoms indicated that gains were maintained. Sleep was the first symptom to improve at 2 to 3 months. No dropouts during the treatment period occurred, and reported side effects were quite low. These preliminary data suggest that trazodone may be effective in reducing the three primary clusters of symptoms of PTSD. These findings should be confirmed by using a larger sample in a double-blind, placebo-controlled study.",0,0 +6056,New Findings on Alternative Criteria for PTSD in Preschool Children,"An alternative set of criteria for posttraumatic stress disorder (PTSD) for preschool children was analyzed for validity.Sixty-two traumatized children and 63 healthy controls, aged 20 months through 6 years, were assessed. The traumatic experiences included motor vehicle collisions, accidental injuries, abuse, and witnessing violence. The number of symptoms required for clusters C and D and the utility of proposed symptoms were systematically analyzed.No cases met the DSM-IV algorithm for PTSD. Cluster B was endorsed 67.9% of the time. The proportion of cases meeting the cluster C threshold was 2% when three symptoms were required, 11% when two symptoms were required, and 39% when one symptom was required. The rate of cluster D was 45% when two symptoms were required and 73% when one symptom was required. Four novel symptoms did not substantially add to the diagnostic validity of the criteria. The optimal algorithm (one cluster B symptom, one cluster C symptom, and two cluster D symptoms) diagnosed PTSD at a rate of 26%. Measures of comorbid symptoms concurrently provided convergent validation to support this revised algorithm.Revisions to the DSM-IV PTSD criteria continue to be supported so that highly symptomatic young children can be diagnosed.",0,0 +6057,The impact of torture on post-traumatic stress symptoms in war-affected Tamil refugees and immigrants,"The present study examines the effect of torture in generating post-traumatic stress disorder (PTSD) symptoms by comparing its impact with that of other traumas suffered by a war-affected sample of Tamils living in Australia. Traumatic predictors of PTSD were examined among a subsample of 107 Tamils (refugees, asylum seekers, and voluntary immigrants) who had endorsed at least one trauma category on the Harvard Trauma Questionnaire. Principal components analysis (PCA) yielded five trauma factors that were applied to predicting PTSD scores. Tamils exposed to torture returned statistically higher PTSD scores than other war trauma survivors after controlling for overall levels of trauma exposure. The torture factor identified by the PCA was found to be the main predictor of PTSD in a multiple regression analysis. Although limited by sampling constraints and retrospective measurement, the present study provides support for the identification of torture as a particularly traumatic event, even when the impact of other war-related trauma is taken into account.",0,0 +6058,Latent dimensions of posttraumatic stress disorder and their relations with alcohol use disorder,"Purpose: The objective of this study was to evaluate the relationship between factors of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) using confirmatory factor analysis (CFA) in order to further our understanding of the substantial comorbidity between these two disorders.Methods: CFA was used to examine which factors of PTSD's dysphoria model were most related to AUD in a military sample. Ohio National Guard soldiers with a history of overseas deployment participated in the survey (n = 1215). Participants completed the PTSD Checklist and a 12-item survey from the National Survey on Drug Use used to diagnosis AUD.Results: The results of the CFA indicated that a combined model of PTSD's four factors and a single AUD factor fit the data very well. Correlations between PTSD's factors and a latent AUD factor ranged from correlation coefficients of 0.258-0.285, with PTSD's dysphoria factor demonstrating the strongest correlation. However, Wald tests of parameter constraints revealed that AUD was not more correlated with PTSD's dysphoria than other PTSD factors.Conclusions: All four factors of PTSD's dysphoria model demonstrate comparable correlations with AUD. The role of dysphoria to the construct of PTSD is discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0,0 +6059,Characteristics of the first 1000 clients attending an anxiety clinic in South West Sydney,"This paper reports on the clinical and demographic characteristics of the first 1000 consecutive patients attending an anxiety disorders clinic at a district hospital in Sydney, Australia. Data from a large epidemiological study of the Australian population were used as a yardstick for broad comparison. Contrary to past research, a lower prevalence of comorbid anxiety and depression was found in the clinic, possibly because a portion of those patients were filtered out and referred elsewhere for treatment for depression. More female patients attended the clinic than the epidemiological study would predict. Greater numbers of patients with panic disorder, and fewer with posttraumatic stress disorder and social phobia were seen in the clinic than would be predicted by the epidemiological data. Although inferences are tentative because of the differing methods of diagnosis used, the findings indicate the value of comparing epidemiological and clinic profiles to identify those categories of anxiety patients that underutilise services.",0,0 +6060,Endocrine Levels at the Start of Treatment Are Associated With Subsequent Psychological Adjustment in Cancer Patients With Metastatic Disease,"This study examined the association between hormonal profiles at the start of cancer treatment and subsequent psychological symptomatology.Twenty-seven patients with metastatic renal cell carcinoma and 18 patients with metastatic melanoma completed three assessments during the course of treatment: at the start of treatment (baseline), at the end of treatment (3 weeks after baseline), and at a follow-up appointment 1 month later. Cortisol, norepinephrine, and epinephrine levels were measured at baseline using 15-hour urine samples. At each assessment, patients completed the Impact of Event Scale (IES) and the Brief Symptom Inventory (BSI).Patients reported moderate levels of distress throughout treatment as measured by the IES and BSI. Norepinephrine levels at the start of treatment were positively associated with IES total scores at the end of treatment and at follow-up, and cortisol levels were positively associated with IES total scores at follow-up after adjusting for baseline IES and overall distress scores. Norepinephrine levels were also positively associated with depression scores at follow-up, and cortisol levels were positively associated with depression scores at the end of treatment and at follow-up after adjusting for baseline depression and overall distress scores.Hormonal profiles at the start of cancer treatment are associated with subsequent psychological adjustment.",0,0 +6061,"Developing new treatments: on the interplay between theories, experimental science and clinical innovation","It is often argued that behaviour therapy and cognitive-behaviour therapy have a sound theoretical and experimental basis. In the early days of behaviour therapy, the learning theory accounts that were the basis of treatment made clear suggestions about the procedures that were likely to be effective in treatment. In contrast, more recent cognitive-behavioural models tend to specify targets for therapy, but not the procedures that might be optimal for changing the targets. As a consequence, a considerable amount of work has to be done in order to create an effective cognitive-behavioural treatment from a promising cognitive-behavioural model. The process by which cognitive-behavioural treatments are developed is rarely discussed in the literature. For this reason, the way in which one group has used a mixture of phenomenological, experimental and treatment development studies to create effective cognitive therapy programmes for anxiety disorders is described.",0,0 +6062,Effects of acute tryptophan depletion in serotonin reuptake inhibitor-remitted patients with generalized anxiety disorder,"BACKGROUND: Serotonergic antidepressants [selective serotonin reuptake inhibitor (SSRI)] are first-line treatments for generalised anxiety disorder (GAD); however, it is not known if synaptic serotonin (5-HT) availability is important for SSRI efficacy. The present study tested the hypothesis that temporary reduction in central 5-HT transmission, through acute tryptophan depletion (ATD), would reverse the therapeutic effect of the SSRIs in GAD patients. METHODS: Twelve patients (six males) with GAD, who showed sustained clinical improvement with SSRI treatment, underwent ATD in a double-blind, placebo-controlled, within-subjects design over 2 days, 1 week apart. At the peak time of depletion, the participants inhaled 7.5% CO2 and air in random order for at least 12 min each. Psychological responses were measured using the Spielberger State Anxiety Inventory (STAI-S) and GAD-symptom visual analogue scales (VASs; e.g., worry and tense) and Profile of Mood States. RESULTS: Free plasma tryptophan to large neutral amino acid (LNAA) ratio decreased by 92% on the depletion day and decreased by 2% on the control day. Irrespective of depletion condition, 7.5% CO(2) inhalation significantly increased STAI-S and GAD-related VAS scores (all p < 0.05) compared with air inhalation. ATD had no effect on any of these measures despite the substantial reduction in free tryptophan/LNAA ratio. CONCLUSIONS: Although SSRIs treat GAD effectively, the present results suggest that the mechanism of action is different to that seen in panic, social anxiety, and post-traumatic stress disorders. Successful SSRI treatment of GAD may involve long-term receptor changes or alterations in other neurotransmitter systems downstream of serotonin.",0,0 +6063,Agomelatine: mechanism of action and pharmacological profile in relation to antidepressant properties,"Agomelatine behaves both as a potent agonist at melatonin MT1 and MT2 receptors and as a neutral antagonist at 5-HT2C receptors. Accumulating evidence in a broad range of experimental procedures supports the notion that the psychotropic effects of agomelatine are due to the synergy between its melatonergic and 5-hydroxytryptaminergic effects. The recent demonstration of the existence of heteromeric complexes of MT1 and MT2 with 5-HT2C receptors at the cellular level may explain how these two properties of agomelatine translate into a synergistic action that, for example, leads to increases in hippocampal proliferation, maturation and survival through modulation of multiple cellular pathways (increase in trophic factors, synaptic remodelling, glutamate signalling) and key targets (early genes, kinases). The present review focuses on the pharmacological properties of this novel antidepressant. Its mechanism of action, strikingly different from that of conventional classes of antidepressants, opens perspectives towards a better understanding of the physiopathological bases underlying depression.",0,0 +6064,Behavioural sleep problems in children with attention-deficit/hyperactivity disorder (ADHD): protocol for a prospective cohort study,"Children with attention-deficit/hyperactivity disorder (ADHD) commonly experience behavioural sleep problems, yet these difficulties are not routinely assessed and managed in this group. Presenting with similar symptoms to ADHD itself, sleep problems are complex in children with ADHD and their aetiology is likely to be multifactorial. Common internalising and externalising comorbidities have been associated with sleep problems in children with ADHD; however, this relationship is yet to be fully elucidated. Furthermore, limited longitudinal data exist on sleep problems in children with ADHD, thus their persistence and impact remain unknown. In a diverse sample of children with ADHD, this study aims to: (1) quantify the relationship between sleep problems and internalising and externalising comorbidities; (2) examine sleep problem trajectories and risk factors; and (3) examine the longitudinal associations between sleep problems and child and family functioning over a 12-month period.A prospective cohort study of 400 children with ADHD (150 with no/mild sleep problems, 250 with moderate/severe sleep problems) recruited from paediatric practices across Victoria, Australia. The children's parents and teacher provide data at baseline and 6-month and 12-month post enrolment.Parent report of child's sleep problem severity (no, mild, moderate, severe); specific sleep domain scores assessed using the Child Sleep Habits Questionnaire; internalising and externalising comorbidities assessed by the Anxiety Disorders Interview Schedule for Children IV/Parent version.Multiple variable logistic and linear regression models examining the associations between key measures, adjusted for confounders identified a priori.Ethics approval has been granted. Findings will contribute to our understanding of behavioural sleep problems in children with ADHD. Clinically, they could improve the assessment and management of sleep problems in this group. We will seek to publish in leading paediatric journals, present at conferences and inform Australian paediatricians through the Australian Paediatric Research Network.",0,0 +6065,The use of psychosocial stress scales in preterm birth research,"Psychosocial stress has been identified as a potential risk factor for preterm birth. However, an association has not been found consistently, and a consensus on the extent to which stress and preterm birth are linked is still lacking. A literature search was performed with a combination of keywords and MeSH terms to detect studies of psychosocial stress and preterm birth. Studies were included in the review if psychosocial stress was measured with a standardized, validated instrument and if the outcomes included either preterm birth or low birthweight. Within the 138 studies that met inclusion criteria, 85 different instruments were used. Measures that had been designed specifically for pregnancy were used infrequently, although scales were sometimes modified for the pregnant population. The many different measures that have been used may be a factor that accounts for the inconsistent associations that have been observed.",0,0 +6066,Brain-derived neurotrophic factor and inflammatory markers in school-aged children with early trauma,"Objective The impact of childhood trauma (CT) on brain-derived neurotrophic factor (BDNF) and cytokines levels remains unclear. We investigated the association between CT and changes in BDNF and cytokines plasma levels in children. Method We recruited 36 children with trauma (CT+) and 26 children without trauma (CT-). The presence of CT was based on a clinical interview and by Criteria A of DSM-IV criteria for PTSD. Blood samples were drawn from all children to assess BDNF and cytokines. ancova was performed with psychiatric symptoms and BMI as covariates to evaluate group differences in plasma levels. Results CT+ showed increased levels of BDNF and TNF-α after excluding children with history of inflammatory disease (P < 0.05) when compared with those CT-. IL-12p70, IL-6, IL-8, IL-10, and IL-1β levels were not statistically different between groups. Conclusion CT+ showed increased BDNF and proinflammatory cytokines levels. The increase in BDNF levels may be an attempt to neutralize the negative effects of CT, while an increase in TNF-a levels be associated with a proinflammatory state after CT. How these changes associated with trauma relate to other biological changes and illness trajectory later in life remain to be further studied.",0,0 +6067,Factors associated with suicidal ideation in OEF/OIF veterans,"The purpose of this project was to examine factors associated with suicidal ideation in returning Iraq and Afghanistan war veterans.A cross-sectional review of 1740 veterans' initial mental health screening evaluations. One-hundred and thirteen (6.5%) OEF/OIF veterans reported active suicidal ideation at the time of the interview.Prior exposures of physical or sexual abuse and having a history of a prior suicide attempt(s) were associated with the presence of current suicidal ideation, as were having a diagnosis of a psychotic disorder, a depressive disorder, or posttraumatic stress disorder (PTSD). Deployment concerns related to training (protective), the deployment environment, family concerns, deployment concerns, post-deployment support (protective), and post-deployment stressors were also associated with current suicidal ideation. Logistic regression analysis revealed the major risk factors were having a prior suicide attempt, female gender, and a depressive disorder diagnosis; while more perceived current social support was a protective factor. Logistic regression analysis also revealed having comorbid PTSD and depression carried a higher odds ratio for risk than did having either PTSD or depression alone; and that the PTSD avoidance symptom-cluster was associated with more risk than either the re-experiencing or hyper-arousal symptom clusters for current suicidal ideation.As a cross-sectional retrospective medical chart review, limitations include limited generalizability and causal relationships cannot be evaluated.Further investigation of these risk factors is warranted to aid in suicide risk assessment and in the development of targeted interventions to mitigate the identified risk factors and bolster the identified protective factor.",0,0 +6068,Post-Traumatic Stress Disorder and Coronary Heart Disease,"Post-traumatic stress disorder (PTSD) is a mental health condition that occurs relatively commonly in people exposed to situations that cause severe psychological stress, such as natural disasters, combat, or physical attack. In this issue of the Journal , Vaccarino et al. [(1)][1] report that the",0,0 +6069,Mental health and general wellness in the aftermath of Hurricane Ike,"Exposure to natural disasters has been linked to a range of adverse outcomes, including mental health problems (e.g., posttraumatic stress symptoms [PTSS], depression), declines in role functioning (e.g., occupational difficulties), and physical health problems (e.g., somatic complaints). However, prior research and theory suggest that the modal postdisaster response in each of these domains is resilience, defined as low levels of symptoms or problems in a given outcome over time, with minimal elevations that are limited to the time period during the disaster and its immediate aftermath. However, the extent to which disaster survivors exhibit mental health wellness (resilience across multiple mental health conditions) or general wellness (resilience across mental health, physical health, and role functioning domains) remains unexplored. The purpose of this study was to quantify mental health and general wellness, and to examine predictors of each form of wellness, in a three-wave population-based study of Hurricane Ike survivors (N = 658). Latent class growth analysis was used to determine the frequency of resilience on four outcomes (PTSS: 74.9%; depression: 57.9%; functional impairment: 45.1%; days of poor health: 52.6%), and cross-tabulations were used to determine the frequency of mental health wellness (51.2%) and general wellness (26.1%). Significant predictors of both mental health and general wellness included lower peri-event emotional reactions and higher community-level collective efficacy; loss of sentimental possessions or pets and disaster-related financial loss were negative predictors of mental health wellness, and loss of personal property was a negative predictor of general wellness. The results suggest that studies focusing on a single postdisaster outcome may have overestimated the prevalence of mental health and general wellness, and that peri-event responses, personal property loss and collective efficacy have a cross-cutting influence across multiple domains of postdisaster functioning.",1,0 +6070,Treatment Processes of Counseling for Children in South Sudan: A Multiple n = 1 Design,"Studies into treatment processes in low-income settings are grossly lacking, which contributes to the scarcity of evidence-based psychosocial treatment. We conducted multiple n = 1 studies, with quantitative outcome indicators (depression-, PTSD- and anxiety- symptoms, hope) and qualitative process indicators (treatment- perceptions, content and progress) measured before, during and after counseling. We aimed to explore commonalities in treatment processes associated with change profiles within and between cases. The study was conducted in South Sudan with children aged between 10 and 15 years. Change profiles were associated with the quality of the counselor-client relationship (instilling trust and hope through self-disclosure, supportive listening and advice giving), level of client activation, and the ability of the counselor to match treatment strategies to the client's problem presentation (trauma- and emotional processing, problem solving, cognitive strategies). With limited time, due to restricted resources in low-income settings, training courses can now be better focused on key treatment processes. © 2013 Springer Science+Business Media New York.",0,0 +6071,"Anti- Diabetic effects of Crataegus's SPP Branchlet on Blood Lipids, Glucose and Anti-Oxidant Factors in Streptozotocin- Induced Diabetic Rats","Background and purpose: The epidemic of diabetes mellitus is one of the main concerns of the global health arena. This study investigated the effect of oral shoot Crateagus's SPP Branchlet on blood glucose, lipid profile, the level of oxidative stress in diabetic rats. Materials and methods: In this experimental study, we compared four groups of 15 teeth matched male rats: control, control treated with Crataegus's SPP Branchlet powder shoot, diabetic and diabetic treated with powder shoot. High blood glucose of 300 mg/dl and more was considered as an indicator of diabetes. Indicators of oxidative stress, including catalase, malonaldehyde, Superoxide Dismutase, glutathione peroxides and lipid parameters including triglycerides, total cholesterol, LDL, HDL, VLDL and also blood sugar and weight of rats were measured and reported using the mean and SD. Results: The statistical analysis of repeated measures analysis of variance showed that serum glucose, lipid profile (P<0.001) and the indicators of oxidative stress (PGPX, SOD, CAT, MDA< 0.001) were significantly affected with hawthorn. At significant level of 0.05, there is no difference between the treatment groups with control and diabetic groups for catalase. In diabetic rates, significant weight loss was achieved over time and compared with the control group (P<0.001). Conclusion: Based on our study, oral administration of Crataegus's SPP Branchlet in experimental diabetic male rats can improve blood sugar, lipids profile and oxidative stress disorders.",0,0 +6072,Psychological Characteristics of Wounded and Disabled Croatian War Veterans,"Abstract Objective: Evaluation of the psychological state of a group of 119 Croatian disabled war veterans who suffered grave traumatic war experiences during the war in Croatia (1991–1992). Methods: Semistructured Clinical Interview, Profile Index Emotions test, and Zung's Self-Rating Depression Scale were used to assess disabled war veterans accommodated in special institutions for rehabilitation. Results: Changes in psychological functioning were established in 63.8% of disabled war veterans, the most frequent among them being indisposition, irritability, anxiety, and fear. In nearly half of the veterans there were changes in their relationships with close persons, difficulties in accepting the reality of their situations, and increased aggressiveness. Higher average values on the depression index (0.52) were also established. Conclusion: The established change in the psychological profile of disabled Croatian war veterans was lower than expected. However, because of their great vulnerability, it is necessary to increase efforts to secure their complete psychosocial recovery.",0,0 +6073,β2 Nicotinic acetylcholine receptor availability in post-traumatic stress disorder,"Availability of nicotinic acetylcholine receptors containing beta2 subunits (beta2-nAChRs) was studied in unmedicated, symptomatic patients with post-traumatic stress disorder (PTSD) and healthy control subjects, all current non-smokers. A subgroup of participants had a history of smoking. Availability of beta2-nAChRs in the mesiotemporal cortex, prefrontal cortex, thalamus and striatum was determined using the radiotracer [123I]5-IA-85380 ([123I]5-IA) and single-photon emission computed tomography (SPECT). PTSD symptoms were assessed using the Clinician-Administered PTSD Scale (CAPS). Never-smoking PTSD patients compared to never-smoking healthy controls showed significantly higher [123I]5-IA binding in the mesiotemporal cortex (ANOVA: F=6.21, d.f.=1, 11, p=0.030). Among all PTSD patients, there was a significant correlation between the re-experiencing symptom cluster and thalamic [123I]5-IA binding (R2=0.66, p=0.019, Bonferroni corrected). These findings not only suggest an involvement of beta2-nAChRs in the pathophysiology of PTSD but also raise the possibility that this receptor may be a novel molecular target for drug development.",0,0 +6074,CHILDHOOD TRAUMA AND SUBCLINICAL PSYCHOTIC EXPERIENCES IN YOUNG ADULTHOOD: 20-YEAR LONGITUDINAL ANALYSES OF TWO COHORT STUDIES,"Subclinical psychotic experiences (SPE) can progress to serious psychotic disorder (most commonly schizophrenia). There is increasing recognition that people who have experienced childhood trauma have a higher rate of SPE, but these studies are generally retrospective. We report 20-year follow up data on two South Australian cohorts, involving 1339 participants, assessed as children then again as young adults. The first cohort consists of 529 participants exposed to bushfires as children and 464 matched controls. The second cohort consists of 346 participants who grew up in the lead-affected community of Port Pirie. Data collected during childhood for both cohorts included emotional, behavioural and developmental measures. In addition, maternal IQ, children's IQ and lead levels during childhood were assessed in the Port Pirie cohort. The adult evaluations included SPE, total lifetime traumas, and alcohol and cannabis use, collected using questionnaires and structured diagnostic interviews. Analysis of cohort 1 data showed an association between SPE and the total number of traumas experienced by participants. In addition, emotional disturbances and dysfunctional parenting, assessed during childhood, were more common in those with adult SPE. Participants with higher levels of SPE were 4 times more likely to be alcohol dependant and 1.4 times more likely to have symptoms of cannabis dependence. The Port Pirie cohort contained 149 males and 197 females. We looked specifically at gender differences in this cohort and found that trauma exposure during childhood and adolescence was associated with the frequency and distress of both positive and depressive SPE in females only. For male participants, the total number of traumas correlated with only with the level of distress about negative symptoms. Again, alcohol was a stronger predictor of SPE than the use of other drugs including cannabis. In the female Port Pirie participants only, higher cumulative lead levels were associated with greater frequency and distress related to positive SPE. In the male Port Pirie participants, there were relationships between poorer motor and social development at age 3 years and adult SPE. There was a significant negative correlation between maternal IQ and the frequency of SPE reported by the participant 20 years later. In the total Port Pirie sample, greater hyperactivity measured at 7 years was associated with lower frequency and less distress related to negative symptoms in adulthood. There were also associations between aggression and social withdrawal at ages 3-4 years and later SPE. Young people who have experienced a greater number of traumas are more likely to develop SPE. A dysfunctional family environment and childhood behavioural disturbances are also associated with later SPE. We found that alcohol was a stronger predictor of SPE than cannabis. The Port Pirie data shows that there may be gender differences in the pathways to SPE. These findings contribute to our understanding of the contributions of traumatic experiences, lead exposure, family environment and differing developmental trajectories to adult SPE.",0,0 +6075,"Alzheimer's Disease prevalence, costs, and prevention for military personnel and veterans","By 2050, more than 13 million Americans of all ages are estimated to be living with Alzheimer's disease (AD), and the aggregate costs of care will swell to approximately $1.2 trillion. The rapidly climbing number of those affected with AD includes a growing population of aging military veterans affected who may have an added risk for the disease as a consequence of traumatic brain injury, posttraumatic stress disorder, and/or service-related injuries. The increasing number of individuals, the long duration of disability, and the rising cost of care for AD and other dementia to our society are important public health challenges facing many older adults. These challenges are further compounded by a burgeoning military veteran population that is much younger, with an increased risk of AD and other dementia, and who may experience decades-long periods of disability and care. This outlook underscores the critical need for investments in research at the federal and international levels to accelerate the pace of progress in developing breakthrough discoveries that will change the trajectory of AD and related dementia.",0,0 +6076,Influence of Depression on State and Trait Anger in Veterans with Posttraumatic Stress Disorder,"Anger is one of the most important symptoms of posttraumatic stress disorder (PTSD), and is associated with many of the adverse correlates of PTSD. Researchers have proposed theories to explain the relationship between anger and PTSD, but no study to date has examined the mediating role of depression. The purpose of this study was to explore the mediating effects of current major depression disorder (MDD), as well as PTSD numbing and dysphoria symptom clusters (King et al. 1998; Simms et al. 2002) on the relationship between PTSD and anger. There were 98 participants in the study, and all were male veterans with combat-related PTSD taking part in a clinical trial. Results indicated that MDD partially mediated the relationship between PTSD and state anger, while numbing and dysphoria clusters partially mediated the relationships between other PTSD symptom clusters and trait anger. Implications for the treatment of anger in veterans with PTSD are discussed. © 2012 Springer Science+Business Media New York (outside the USA).",0,0 +6077,Responses of International Migrant Women to Abuse Associated With Pregnancy,"The current study aims to identify what newly arrived migrant women do, in the early months post-birth, to respond to abuse associated with pregnancy. Textual data from 59 migrant women were analyzed thematically to identify common responses to abuses. The most common response was to physically leave their countries of origin and move to Canada, or to move out of the shared dwelling. Other responses included taking legal action, remaining silent, reporting the abuse, seeking counseling, isolating themselves, and supporting anger management for the abuser. These results enhance our understanding of the decisions, including inaction, made by migrant women.",0,0 +6078,Plasma brain-derived neurotrophic factor levels in patients suffering from post-traumatic stress disorder,"A number of studies have been done to investigate the role of brain-derived neurotrophic factor (BDNF) in patients with post-traumatic stress disorder (PTSD). In this study we aimed to test the relationship between plasma BDNF levels and PTSD. We solicited 65 subjects having recently experienced road traffic accidents (RTA) conforming to screening criteria. They were given follow-up examinations after one month, three months, and six months. PTSD was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-R-TR, American Psychiatric Association, 2000) using the Mini International Neuropsychiatric Interview (MINI). All participants were divided into two groups: a group with PTSD and a group without PTSD. There were no significant differences in plasma BDNF levels between the two groups at either the 48h or six-month examination. Within the PTSD group, no significant differences were found in plasma BDNF levels between the two examinations. BDNF levels in those without PTSD showed a higher trend over time after trauma. Higher BDNF levels may be an important protective factor for the prevention of traumatized subjects from developing PTSD.",0,0 +6079,"Motor vehicle accidents and adolescents: An empirical study on their emotional and behavioral profiles, defense strategies and parental support","BACKGROUND: Research has limitedly focused on adolescents' emotional-behavioral functioning preceding road collisions and on the role of family support. OBJECTIVE: To verify whether the rates of motorbikes collisions among adolescents are associated with their emotional-behavioral functioning, their use of specific defense strategies and family support. METHOD: N = 150 adolescents who visited an emergency department for road accidents were selected and completed self-report questionnaires assessing emotional-behavioral functioning, difficulty in identifying and describing emotions, use of defense strategies and perceived family support. RESULTS: Higher rates of motorbike collisions are associated with more maladaptive emotional-behavioral functioning. Higher perceived family support is associated with lower rates of collisions. CONCLUSIONS: Recidivism of motor vehicle collision among adolescents can be considered as a form of acting-out caused by their psychological difficulties.",0,0 +6080,Research to practice: a disaster behavioral health framework,"Purpose – Research and experience following a variety of recent disasters has fostered the development of a range of disaster behavioral health interventions that can be used post‐disaster. Consensus documents recommend that five guiding principles be used to inform intervention efforts. These five essential elements, a sense of safety, calming, efficacy, connectedness, and hope, appear critical to the fostering of adaptation and resilience in affected communities. This paper aims to examine the use of these principles in practice.Design/methodology/approach – Translating these five evidence‐informed principles into practice requires dissemination, delivery and prioritizing and validation of the elements. Scholars identify actions for dissemination, delivery, and prioritization and validation, and this paper expands on the literature to identify processes that actualize the research into a framework for practice.Findings – This article describes how disaster behavioral health professionals in Colorado hav...",0,0 +6081,[Prophylaxis and therapy of post-traumatic stress disorder with propranolol: evidence and ethical analysis].,"The beta-antagonistic agent propranolol is increasingly being used in clinical trials for the prophylaxis and treatment of post-traumatic stress disorder (PTSD). This article discusses the evidence for the effectiveness of propranolol in the prophylaxis and treatment of PTSD and the ethical implications of research on these treatment approaches. The efficacy of a prophylactic or therapeutic use could not be shown during the last decade. Both treatment approaches raise ethical questions that should already be addressed during the clinical trials. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0,0 +6082,"Post-traumatic stress influences the brain even in the absence of symptoms: A systematic, quantitative meta-analysis of neuroimaging studies","Stress affects brain function, and may lead to post-traumatic stress disorder (PTSD). Considerable empirical data for the neurobiology of PTSD has been derived from neuroimaging studies, although findings have proven inconsistent. We used an activation likelihood estimation analysis to explore differences in brain activity between adults with and without PTSD in response to affective stimuli. We separated studies by type of control group: trauma-exposed and trauma-naive. This revealed distinct patterns of differences in functional activity. Compared to trauma-exposed controls, regions of the basal ganglia were differentially active in PTSD; whereas the comparison with trauma-naive controls revealed differential involvement in the right anterior insula, precuneus, cingulate and orbitofrontal cortices known to be involved in emotional regulation. Changes in activity in the amygdala and parahippocampal cortex distinguished PTSD from both control groups. Results suggest that trauma has a measurable, enduring effect upon the functional dynamics of the brain, even in individuals who experience trauma but do not develop PTSD. These findings contribute to the understanding of whole-brain network activity following trauma, and its transition to clinical PTSD.",0,0 +6083,"Arousal, numbing, and intrusion: symptom structure of PTSD following assault","This study investigated hypotheses concerning the importance of symptoms of numbing in posttraumatic stress disorder (PTSD).Symptoms of PTSD were assessed in 72 female rape victims and 86 female victims of nonsexual assault approximately 3 months after the crimes occurred. A principal-components factor analysis of subjects' symptoms was then undertaken.The analysis yielded three factors: arousal/avoidance, numbing, and intrusion. These were somewhat different from the symptom clusters in DSM-III-R, since effortful avoidance and numbing symptoms did not load on the same factor. Numbing symptoms appeared to be particularly important in identifying individuals with PTSD.The results imply that there are two patterns of posttrauma symptoms, one characterizing PTSD and the second characterizing a phobic reaction.",0,0 +6084,Manual for ASEBA School-Age Forms & Profiles,,0,0 +6085,Poly-victimization among juvenile justice-involved youths,"This study replicates and extends the research literature on poly-victimization with a vulnerable and under-served population, juvenile justice-involved youths.N=1959, 10-16 year old youths (76% male; 74% youth of color) consecutively newly admitted to juvenile detention facilities completed psychometric measures of trauma history, posttraumatic stress, affect regulation, alcohol/drug use, suicide risk, and somatic complaints.Using latent class analysis derived from 19 types of adversity, three unique classes best fit the data. A poly-victim class (49% female, 51% youth of color) accounted for 5% of the sample and reported a mean of 11.4 (SD=1.1) types. A relatively moderate adversity class (31% female, 70% youth of color) accounted for 36% of the sample and reported a mean of 8.9 (SD=0.3) types of adversity and 2.65 (SD=1.1) types of traumatic adversity. A low adversity class (59% of the sample; 17% female, 78% youth of color) reported a mean of 7.4 (SD=0.4) adversity types but only 0.3 (SD=0.45) types of traumatic adversity. The relatively moderate adversity class was comparable to poly-victims in endorsing extensive non-victimization traumatic adversity (e.g., accidental and loss trauma), but poly-victims were distinct from both moderate and low adversity class members in the likelihood of reporting all but one type of traumatic victimization, multiple types of traumatic victimization, and severe emotional and behavioral problems. Girls were at particularly high risk of poly-victimization, and African American and White youths also were at risk for poly-victimization.Although youth involved in the juvenile justice system typically have experienced substantial victimization, a poly-victimized sub-group, especially (but not exclusively) girls, warrants particular scientific, clinical, and rehabilitative attention in order to address the most severe behavioral and mental health problems and risks faced by this vulnerable population.",0,0 +6086,Chronic social defeat stress disrupts regulation of lipid synthesis,"Several psychiatric disorders increase the risk of cardiovascular disease, including posttraumatic stress disorder and major depression. While the precise mechanism for this association has not yet been established, it has been shown that certain disorders promote an unfavorable lipid profile. To study the interaction of stress and lipid dysregulation, we utilized chronic social defeat stress (CSDS), a mouse model of chronic stress with features of posttraumatic stress disorder and major depression. Following exposure to CSDS, mice were given access to either regular chow or a Western-style diet high in fat and cholesterol (HFD). The combination of social stress and HFD resulted in significant perturbations in lipid regulation, including two key features of the metabolic syndrome: increased plasma levels of non-HDL cholesterol and intrahepatic accumulation of triglycerides. These effects were accompanied by a number of changes in the expression of hepatic genes involved in lipid regulation. Transcriptional activity of LXR, SREBP1c, and ChREBP were significantly affected by exposure to HFD and CSDS. We present CSDS as a model of social stress induced lipid dysregulation and propose that social stress alters lipid metabolism by increasing transcriptional activity of genes involved in lipid synthesis.",0,0 +6087,DSM-5 posttraumatic stress disorder: Factor structure and rates of diagnosis,"Posttraumatic stress disorder (PTSD) is a significant problem among Iraq/Afghanistan-era veterans. To date, however, there has been only limited research on how the recent changes in DSM-5 influence the prevalence and factor structure of PTSD. To address this key issue, the present research used a modified version of a gold-standard clinical interview to assess PTSD among a large sample of Iraq/Afghanistan-era veterans ( N = 414). Thirty-seven percent of the sample met DSM-5 criteria for PTSD compared to a rate of 38% when DSM-IV diagnostic criteria were used. Differences in rates of diagnosis between DSM-IV and DSM-5 were primarily attributable to changes to Criterion A and the separation of the “avoidance” and “numbing” symptoms into separate clusters. Confirmatory factor analysis (CFA) was used to compare the fit of the previous 3-factor DSM-IV model of PTSD to the 4-factor model specified in DSM-5 , a 4-factor “dysphoria” model, and a 5-factor model. CFA demonstrated that the 5-factor model (re-experiencing, active avoidance, emotional numbing, dysphoric arousal, anxious arousal) provided the best overall fit to the data, although substantial support was also found for the 4-factor DSM-5 model. Low factor loadings were noted for two of the symptoms in the DSM-5 model (psychogenic amnesia and reckless/self-destructive behavior), raising questions regarding the adequacy of fit between these symptoms and the other core features of PTSD. Overall, findings suggest the DSM-5 model of PTSD is an improvement over the previous DSM-IV model of PTSD, but still may not represent the true underlying factor structure of PTSD. • We tested the prevalence and factor structure of DSM-5 posttraumatic stress disorder. • 37% of veteran sample met DSM-5 PTSD. • 38% of veteran sample met DSM-IV PTSD. • Confirmatory factor analysis supported DSM-5 symptom structure.",0,0 +6088,"Prolonged Grief Disorder, depression, and posttraumatic stress disorder are distinguishable syndromes","This study examined the distinctiveness of symptoms of Prolonged Grief Disorder (PGD), depression, and posttraumatic stress disorder (PTSD). We compared the fit of a one-factor model with the fit of four hierarchical models in which symptoms formed three distinct correlated higher-order dimensions, and PTSD-items were modeled in different ways.Self-reported data were available from two samples; 572 mourners recruited via the internet and 408 mourners recruited via healthcare workers.In Sample 1, the unitary model did not fit the data. The four hierarchical models all fit better. The model in which PTSD-items constituted four lower-order factors of reexperiencing, avoidance, dysphoria, and hyperarousal fit the data best. The fit was further improved, when one weak PGD-item and one weak PTSD-item were removed, and error-terms of similar items were allowed to correlate. Findings from Sample 1 were replicated in Sample 2.This study relied on self-reported data. Not all PGD-criteria and depression-criteria were assessed.This is the first confirmatory factor analysis study showing that symptoms of PGD, depression, and PTSD represent distinguishable syndromes. PGD-symptoms should be addressed in the assessment and treatment of bereaved people seeking treatment.",0,0 +6089,High-Lethality Status in Patients with Borderline Personality Disorder,"Recurrent suicidal behaviors in patients with Borderline Personality Disorder (BPD) are often considered communicative gestures; however, 10% complete suicide. This study seeks to identify risk factors for suicide within a BPD sample by comparing patients with High- and Low-Lethality attempts. BPD attempters (n = 113) were assessed on demographic, diagnostic, and personality variables: clinical symptoms, suicidal behaviors; childhood, family, and treatment histories; social adjustment; and recent life events. Forty-four High-Lethality attempters, defined by a score of 4 or more on Beck's Medical Lethality Scale, were compared to 69 Low-Lethality attempters. Discriminating variables were entered in a multivariate logistic regression model to define predictors of High-Lethality status. High-Lethality attempters were older, with children, less education, and lower socioeconomic class (SES) than Low-Lethality attempters. They were more likely to have Major Depressive Disorder (MDD), co-morbid Antisocial Personality Disorder (ASPD), and family histories of substance abuse. They reported greater intent to die, more lifetime attempts, hospitalizations, and time in the hospital. High-Lethality status was best predicted by low SES, co-morbid ASPD, extensive treatment histories, and greater intent to die. These characteristics resemble profiles of patients who complete suicide, are not specific for BPD, and do not include impulsivity, aggression, or severity of BPD criteria.",0,0 +6090,Stalking Behavior – An Overview of the Problem and a Case Report of Male-to-Male Stalking during Delusional Disorder,"Stalking is a widespread phenomenon describing a pattern of intrusive and threatening behavior leading to the victim's perception of being harassed and rendered fearful. This paper outlines relevant aspects of the stalking concept and reviews the historical development of this categorization, different typologies of stalking behavior, associated psychiatric diagnoses, frequency and demographic data, psychomedical impact on the victims and therapeutic approaches. Special gender aspects are discussed by presenting a case history of male-to-male stalking.",0,0 +6091,Cognitive change predicts symptom reduction with cognitive therapy for posttraumatic stress disorder.,"There is a growing body of evidence for the effectiveness of trauma-focused cognitive behavior therapy (TF-CBT) for posttraumatic stress disorder (PTSD), but few studies to date have investigated the mechanisms by which TF-CBT leads to therapeutic change. Models of PTSD suggest that a core treatment mechanism is the change in dysfunctional appraisals of the trauma and its aftermath. If this is the case, then changes in appraisals should predict a change in symptoms. The present study investigated whether cognitive change precedes symptom change in Cognitive Therapy for PTSD, a version of TF-CBT.The study analyzed weekly cognitive and symptom measures from 268 PTSD patients who received a course of Cognitive Therapy for PTSD, using bivariate latent growth modeling.Results showed that (a) dysfunctional trauma-related appraisals and PTSD symptoms both decreased significantly over the course of treatment, (b) changes in appraisals and symptoms were correlated, and (c) weekly change in appraisals significantly predicted subsequent reduction in symptom scores (both corrected for the general decrease over the course of therapy). Changes in PTSD symptom severity did not predict subsequent changes in appraisals.The study provided preliminary evidence for the temporal precedence of a reduction in negative trauma-related appraisals in symptom reduction during trauma-focused CBT for PTSD. This supports the role of change in appraisals as an active therapeutic mechanism.",0,0 +6092,"Mothers of adolescent and young adult survivors of childhood cancer: Health beliefs, post-traumatic stress, growth and caregiving practices","Mothers of adolescent and young adult (AYA) childhood cancer survivors often continue to experience psychosocial challenges related to their child's illness and treatment long after the successful treatment of cancer. Such challenges may affect mothers' personal wellbeing and caregiving practices. Three studies were conducted to explore mothers' beliefs regarding their current and future health concerns, how they manage medical issues, relationships, and health-promoting behaviors. A new self-report scale, the Parental Health Competence Beliefs Inventory (pHCBI), was developed (Study 1) to examine the relationship between these beliefs and mothers' psychological well-being (Study 2) and caregiving behavior (Study 3). Eighty-six mothers of AYA childhood cancer survivors were recruited during their child's regularly scheduled clinic visits. Mothers completed the pHCBI and measures of psychosocial wellbeing, including the Perception of Changes in Self questionnaire (PCS) and Posttraumatic Stress Checklist (PCL-C). Exploratory factor analyses (EFA) identified pHCBI scale factors (Study 1) and domains of posttraumatic growth (PTG) (Study 2). Correlational and regression analyses examined the relationships between beliefs, PTG, and posttraumatic stress (PTS). In Study 3, mixed method analyses were used to identify reasons for attending clinic with their child and to explore relationships between these reasons, mothers' beliefs, and demographic and medical variables. The Study 1 EFA revealed a 23-item four-factor solution for the pHCBI: (a) Social Competence, (b) Health Perceptions, (c) Satisfaction with Healthcare, and (d) Health Apprehension. In Study 2, EFA identified three domains of PTG: (a) Interpersonal Relationships, (b) Life Satisfaction, and (c) Life Outlook. Social Competence was correlated with PTG with respect to Interpersonal Relationships and Life Satisfaction. Health Apprehension moderated the linear relationship between PTS and PTG-Life Satisfaction. Qualitative data revealed 10 reasons mothers give for accompanying their child to their follow-up clinic visit (Study 3). Mothers who report lower Satisfaction with Healthcare continued to attend the survivorship clinic out of Concern for Their Child's Health and Wellbeing. The better understanding of mothers' health-related beliefs and caregiving provided by the results of these studies may be useful in promoting mothers' wellbeing and in helping them to adjust to their AYA survivors' growing independence. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0,0 +6093,Adding Missing-Data-Relevant Variables to FIML-Based Structural Equation Models,"Conventional wisdom in missing data research dictates adding variables to the missing data model when those variables are predictive of (a) missingness and (b) the variables containing missingness. However, it has recently been shown that adding variables that are correlated with variables containing missingness, whether or not they are related to missingness, can substantially improve estimation (bias and efficiency). Including large numbers of these auxiliary variables is straightforward for researchers who use multiple imputation. However, what is the researcher to do if 1 of the FIML/SEM procedures is the analysis of choice? This article suggests 2 models for SEM analysis with missing data, and presents simulation results to show that both models provide estimation that is clearly as good as analysis with the EM algorithm, and by extension, multiple imputation. One of these models, the saturated correlates model, also provides good estimates of model fit.",0,0 +6094,Latent classes of childhood trauma exposure predict the development of behavioral health outcomes in adolescence and young adulthood,"Background To develop latent classes of exposure to traumatic experiences before the age of 13 years in an urban community sample and to use these latent classes to predict the development of negative behavioral outcomes in adolescence and young adulthood. Method A total of 1815 participants in an epidemiologically based, randomized field trial as children completed comprehensive psychiatric assessments as young adults. Reported experiences of nine traumatic experiences before age 13 years were used in a latent class analysis to create latent profiles of traumatic experiences. Latent classes were used to predict psychiatric outcomes at age ⩾13 years, criminal convictions, physical health problems and traumatic experiences reported in young adulthood. Results Three latent classes of childhood traumatic experiences were supported by the data. One class (8% of sample), primarily female, was characterized by experiences of sexual assault and reported significantly higher rates of a range of psychiatric outcomes by young adulthood. Another class (8%), primarily male, was characterized by experiences of violence exposure and reported higher levels of antisocial personality disorder and post-traumatic stress. The final class (84%) reported low levels of childhood traumatic experiences. Parental psychopathology was related to membership in the sexual assault group. Conclusions Classes of childhood traumatic experiences predict specific psychiatric and behavioral outcomes in adolescence and young adulthood. The long-term adverse effects of childhood traumas are primarily concentrated in victims of sexual and non-sexual violence. Gender emerged as a key covariate in the classes of trauma exposure and outcomes.",0,0 +6095,Relations Among Peritraumatic Dissociation and Posttraumatic Stress: A Critical Review,"This paper critically reviews the empirical literature addressing the relationship of peritraumatic dissociation to posttraumatic stress. PSYCHLIT and MEDLINE literature searches were conducted to identify relevant studies. The list of articles generated was supplemented by a review of their bibliographies, which resulted in a total of 53 empirical studies. These studies were classified according to the type of potentially traumatizing event investigated and discussed. In the majority of studies, evidence was found for a positive association between peritraumatic dissociation and posttraumatic stress. However, research in this area is limited by several methodological differences and shortcomings with respect to study design, sample characteristics, measurement instruments, and control for moderating or mediating variables. In addition, research is also limited by conceptual problems and the lack of specific time parameters for the occurrence of peritraumatic dissociation. The literature is evaluated according to these methodological differences or shortcomings, and directions for future research are provided.",0,0 +6096,Psychological debriefing for preventing post traumatic stress disorder (PTSD),"Over approximately the last last fifteen years early psychological interventions such as psychological 'debriefing' have been increasingly used to treat psychological trauma. While these intervention have become popular and their use spread to several settings - efficacy had largely not been tested emprically. In 1997 a systmatic review of single session psychological ""debriefing"" was undertaken and this subsequently became a protocol and Cochrane Review published in 1998 (Issue2). This update forms the first substantive update of the original review.To assess the effectiveness of brief psychological debriefing for the management of psychological distress after trauma, and the prevention of post traumatic stress disorder.Electronic searching of MEDLINE, EMBASE, PsychLit, PILOTS, Biosis, Pascal, Occ. Safety and Health,SOCIOFILE, CINAHL, PSYCINFO, PSYNDEX, SIGLE, LILACS, CCTR, CINAHL, NRR, Hand search of Journal of Traumatic Stress. Contact with leading researchers.The inclusion criteria for all randomized studies was that they should focus on persons recently (one month or less) exposed to a traumatic event, should consist of a single session only, and that the intervention involve some form of emotional processing/ventilation by encouraging recollection/reworking of the traumatic event accompanied by normalisation of emotional reaction to the event.11 trials fulfilled the inclusion criteria. Quality was generally poor. Data from two trials could not be synthesised. Two trials involved the use of the intervention in an obstetric setting.Single session individual debriefing did not reduce psychological distress nor prevent the onset of post traumatic stress disorder (PTSD). Those who received the intervention showed no significant short term (3-5 months) in the risk of PTSD (odds ratio 1.22 (95% ci 0.60 to 2.46 )). At one year one trial reported that there was a significantly increased risk of PTSD in those receiving debriefing (odds ratio 2.88 (1.11 to 7.53))odds ratio 95%). There was also no evidence that debriefing reduced general psychological morbidity, depression or anxiety.There is no current evidence that psychological debriefing is a useful treatment for the prevention of post traumatic stress disorder after traumatic incidents. Compulsory debriefing of victims of trauma should cease.",0,0 +6097,"Trajectories of recovery among homeless adults with mental illness who participated in a randomised controlled trial of Housing First: a longitudinal, narrative analysis","This study used longitudinal, narrative data to identify trajectories of recovery among homeless adults with mental illness alongside the factors that contribute to positive, negative, mixed or neutral trajectories over time. We expected that participants who received Housing First (HF) would describe more positive trajectories of recovery than those who were assigned to Treatment as Usual (TAU; no housing or support provided through the study).Narrative interview data were collected from participants at baseline and 18 months after random assignment to HF or TAU.Participants were sampled from the community in Vancouver, British Columbia.Fifty-four participants were randomly and purposively selected from the larger trial; 52 were interviewed at baseline and 43 were reinterviewed 18 months after randomisation.Semistructured interviews were conducted at both time points. For each participant, paired baseline and follow-up narratives were classified as positive, negative, mixed or neutral trajectories of recovery, and thematic analysis was used to identify the factors underlying different trajectories.Participants assigned to HF (n=28) were generally classified as positive or mixed trajectories; those assigned to TAU (n=15) were generally classified as neutral or negative trajectories. Positive trajectories were characterised by a range of benefits associated with good-quality, stable housing (eg, reduced substance use, greater social support), positive expressions of identity and the willingness to self-reflect. Negative, neutral and mixed trajectories were characterised by hopelessness ('things will never get better') related to continued hardship (eg, eviction, substance use problems), perceived failures and loss.HF is associated with positive trajectories of recovery among homeless adults with mental illness. Those who did not receive housing or support continued to struggle across a wide range of life domains. Findings are discussed with implications for addressing services and broader social change in order to benefit this marginalised population.",0,0 +6098,Posttraumatic stress disorder and its comorbidity with depression and somatisation in the elderly – A German community-based study,"Even 60 years after World War II, the German elderly population is significantly more often affected by posttraumatic symptomatology compared to the younger cohorts. This study is addressing prevalence rates of posttraumatic symptomatology and its comorbidity with depression and somatisation.This study examines posttraumatic stress disorder (PTSD) according to DSM-IV, partial PTSD, depression and somatisation in a randomly selected sample of the German general population aged 60-85 years (N = 1.659) using self-rating instruments (Patient Health Questionnaire, PHQ; Post Traumatic Diagnostic Scale, PTDS).One-month prevalence rate was 4.0% for DSM-IV PTSD; another 12.2% fulfilled the criteria of partial PTSD. A significant increase across the age groups was found for partial PTSD. 11.5% of the persons affected by posttraumatic symptomatology fulfil the criteria of a somatoform syndrome, 8.6% fulfil the criteria of major depression and 10.4% fulfil the criteria of other depressive syndromes according to the PHQ. A current posttraumatic symptomatology is associated with increased prevalence rates of somatoform and depressive disorders. Moreover, traumatic experiences without a current PTSD are associated with increased rates of somatoform disorders.Posttraumatic symptomatology is a common phenomenon in the German elderly population. Especially, subsyndromal disorders are very common and increasing across the age groups. Posttraumatic symptomatology is associated with an increased risk of depressive and somatoform disorders. As posttraumatic symptoms are often neglected in geriatric health care, future effort should address the recognition and treatment of posttraumatic symptoms in elderly patients.",0,0 +6099,"An Open Trial of Paroxetine in Patients With Noncombat-Related, Chronic Posttraumatic Stress Disorder","The symptom overlap between posttraumatic stress disorder (PTSD) and other pharmacotherapy-responsive disorders suggests that pharmacotherapy might be effective. Nevertheless, of the eight published placebo-controlled trials investigating the pharmacotherapy of PTSD, only four found statistically significant efficacy for the treatment being studied. This literature possesses a number of methodologic limitations, including the fact that most studies have been conducted with war veterans, who may constitute a more treatment-refractory population. Several open trials and one controlled trial with selective serotonin reuptake inhibitors have reported improvement in some or all core PTSD symptoms (reexperiencing, avoidance, numbing, and hyperarousal). The authors hypothesized that paroxetine might be effective in PTSD, based on findings of its particular efficacy for anxiety and agitation in studies of depressed patients. The study presented here summarizes a 12-week, open-label trial of paroxetine among patients with noncombat-related, chronic PTSD. Outcome was assessed by an independent evaluator, the treating physician, and the patient, with the use of established rating scales for depression, anxiety, general symptoms, and PTSD core symptoms. A repeated-measures analysis of variance revealed highly significant improvement in all three symptom clusters, as well as in associated anxiety, depressive, and dissociative symptoms, with 11 of 17 (65%) patients rated as much or very much improved. The mean reduction in PTSD symptom scores was 48%. Exploratory analyses revealed that cumulative childhood trauma was negatively correlated with pharmacotherapy response (r = -0.52, p = 0.03). There was also significant variation in the time course of response across symptom clusters, which is suggestive of multiple mechanisms of response. Because paroxetine seems a highly promising treatment for all three symptom clusters of PTSD, a placebo-controlled clinical trial is warranted.",0,0 +6100,The management of traumatic stress disorder in infants,"The number of very young children exposed to trauma is under-represented. Trauma interferes with the organisation and development of brain structures and thus may have lasting effects on the individual's life. Traumatic stress disorder (TSD), which is the Axis I diagnosis used in the under-three patient population, encompasses four symptom clusters. Of note is the integral part of the Relationship Disorder Classification (Axis II) during this phase of life. The capacities needed to experience and recall early trauma are largely present from the beginning of life and rapidly develop during the first six months. The treatment of traumatic stress disorder rests on establishing a sense of safety, reducing the overwhelming affects evoked, helping the child to form a coherent narrative and thereby aiding the integration and psychological mastery of the traumatic event. The support of the attachment relationship with an adequate caregiver is pivotal.",0,0 +6101,The Neuropsychological Profile of Comorbid Post-Traumatic Stress Disorder in Adult ADHD,"Objective: ADHD and post-traumatic stress disorder (PTSD) are often comorbid yet despite the increased comorbidity between the two disorders, to our knowledge, no data have been published regarding the neuropsychological profile of adults with comorbid ADHD and PTSD. Likewise, previous empirical studies of the neuropsychology of PTSD did not control for ADHD status. We sought to fill this gap in the literature and to assess the extent to which neuropsychological test performance predicted psychosocial functioning, and perceived quality of life. Method: Participants were 201 adults with ADHD attending an outpatient mental health clinic between 1998 and 2003 and 123 controls without ADHD. Participants completed a large battery of self-report measures and psychological tests. Diagnoses were made using data obtained from structured psychiatric interviews (i.e., Structured Clinical Interview for DSM-IV, Schedule for Affective Disorders and Schizophrenia for School-Age Children Epidemiologic Version). Results: Differences emerged between control participants and participants with ADHD on multiple neuropsychological tests. Across all tests, control participants outperformed participants with ADHD. Differences between the two ADHD groups emerged on seven psychological subtests including multiple Wechsler Adult Intelligence Scale—Third edition and Rey-Osterrieth Complex Figure Test measures. These test differences did not account for self-reported quality of life differences between groups. Conclusion: The comorbidity with PTSD in adults with ADHD is associated with weaker cognitive performance on several tasks that appear related to spatial/perceptual abilities and fluency. Neuropsychological test performances may share variance with the quality of life variables yet are not mediators of the quality of life ratings.",0,0 +6102,Depression and Posttraumatic Stress Disorder at Three Months After Mild to Moderate Traumatic Brain Injury,"To investigate the frequency and risk factors of major depressive disorder (MDD) after mild to moderate traumatic brain injury (TBI), 69 TBI and 52 general trauma (GT) patients were prospectively recruited and studied at 3-months postinjury. There was a nonsignificant difference in the proportion of MDD patients in the TBI and GT groups. Therefore, a composite MDD group (TBI and GT patients) was compared to patients who were nondepressed. Female gender was related to MDD, but no other risk factors were identified. MDD was associated with disability (Glasgow Outcome Scale, Community Integration Questionnaire) and cognitive impairment. MDD was comorbid with posttraumatic stress disorder. Implications for postacute management of mild to moderate TBI are discussed.",0,0 +6103,Executive function in posttraumatic stress disorder (PTSD) and the influence of comorbid depression,"Posttraumatic stress disorder (PTSD) has been associated with neurocognitive deficits, such as impaired verbal memory and executive functioning. Less is known about executive function and the role of comorbid depression in PTSD. Recently, studies have shown that verbal memory impairments may be associated with comorbid depressive symptoms, but their role in executive function impairments is still unclear. To examine several domains of executive functioning in PTSD and the potentially mediating role of comorbid depressive symptoms in the relationship between executive function and PTSD. Executive functioning was assessed in 28 PTSD patients and 28 matched trauma-exposed controls. The Cambridge Neuropsychological Test Automated Battery (CANTAB) with subtests measuring response inhibition (SST), flexibility/set shifting (IED), planning/working memory (OTS) and spatial working memory (SWM) was administered in PTSD patients and trauma-exposed controls. Regression analyses were used to assess the predictive factor of PTSD symptoms (CAPS) and depressive symptoms (HADS-D) in relation to executive function when taking into account the type of trauma. Pearson’s correlations were used to examine the association between PTSD symptom clusters (CAPS) and executive function. The mediating effects of depression and PTSD were assessed using regression coefficients and the Sobel’s test for mediation. Our findings indicate that PTSD patients performed significantly worse on executive function than trauma-exposed controls in all domains assessed. PTSD symptoms contributed to executive functioning impairments (SST median correct, IED total errors, OTS latency to correct, SWM total errors and SWM strategy). Adding depressive symptoms to the model attenuated these effects. PTSD symptom clusters ‘numbing’ and to a lesser extent ‘avoidance’ were more frequently associated with worse executive function (i.e., IED total errors, OTS latency to correct and SWM total errors) than ‘reexperiencing’ and ‘hyperarousal’. Depressive symptoms mediated the relation between PTSD and executive function on some executive function measures (IED total errors and OTS latency to correct), whereas PTSD did not mediate the relation between depression and executive function. PTSD patients perform worse on executive function. The impairments seem to be mostly associated with the less specific PTSD symptom cluster of ‘numbing’. Depressive symptoms seem to mediate the relationship between PTSD and executive function. These findings may have clinical implications with regard to treatment indication and prognosis.",0,0 +6104,Stress-induced neuroplasticity: (Mal)adaptation to adverse life events in patients with PTSD – A critical overview,"Stress is an adaptive response to demands of the environment and thus essential for survival. Exposure to stress triggers hypothalamic-pituitary-adrenocortical (HPA) axis activation and associated neurochemical reactions, following glucocorticoid release from the adrenal glands, accompanied by rapid physiological responses. Stimulation of this pathway results in the activation of specific brain regions, including the hippocampus, amygdala and prefrontal cortex which are enriched with glucocorticoid receptors (GRs). Recent findings indicate that the activation of GRs mediates the regulation of the brain-derived neurotrophic factor (BDNF). BDNF is crucial for neural plasticity, as it promotes cellular growth and synaptic changes. Hence stress-induced activation of these pathways leads to neuroplastic changes, including the formation of long-lasting memories of the experiences. As a consequence, organisms can learn from stressful events and respond in an adaptive manner to similar demands in the future. Whereas an optimal stress level leads to enhancement of memory performance, the exposure to extreme, traumatic or chronic stressors is a risk factor for psychopathologies which are associated with memory impairment and cognitive deficits such as posttraumatic stress disorder (PTSD). In this review article, we will outline the implications of stress exposure on memory formation involving the role of glucocorticoids and BDNF. Within this context, potential adverse effects of neuroplastic alterations will be discussed using the example of PTSD.",0,0 +6105,Effects of psychotherapy on regional cerebral blood flow during trauma imagery in patients with post-traumatic stress disorder: a randomized clinical trial,"Background Functional brain-imaging studies in post-traumatic stress disorder (PTSD) have suggested functional alterations in temporal and prefrontal cortical regions. Effects of psychotherapy on these brain regions have not yet been examined. Method Twenty civilian PTSD out-patients and 15 traumatized control subjects were assessed at baseline using psychometric ratings. Cerebral blood flow was measured using trauma script-driven imagery during 99m technetium hexamethyl-propylene-amine-oxime single-photon emission computed tomography scanning. All 20 out-patients were randomly assigned to treatment or wait-list conditions. Treatment was brief eclectic psychotherapy (BEP) in 16 weekly individual sessions. Results At baseline, greater activation was found in the right insula and right superior/middle frontal gyrus in the PTSD group than in the control group. PTSD patients treated with BEP significantly improved on all PTSD symptom clusters compared to those on the waiting list. After effective psychotherapy, lower activation was measured in the right middle frontal gyrus, compared to the PTSD patients on the waiting list. Treatment effects on PTSD symptoms correlated positively with activation in the left superior temporal gyrus, and superior/middle frontal gyrus. Conclusions BEP induced clinical recovery in PTSD patients, and appeared to modulate the functioning of specific PTSD-related sites in the prefrontal cortical regions.",0,0 +6106,Posttraumatic stress in emergency settings outside North America and Europe: A review of the emic literature,"Mental health professionals from North America and Europe have become common participants in postconflict and disaster relief efforts outside of North America and Europe. Consistent with their training, these practitioners focus primarily on posttraumatic stress disorder (PTSD) as their primary diagnostic concern. Most research that has accompanied humanitarian aid efforts has likewise originated in North America and Europe, has focused on PTSD, and in turn has reinforced practitioners' assumptions about the universality of the diagnosis. In contrast, studies that have attempted to identify how local populations conceptualize posttrauma reactions portray a wide range of psychological states. We review this emic literature in order to examine differences and commonalities across local posttraumatic cultural concepts of distress (CCDs). We focus on symptoms to describe these constructs - i.e., using the dominant neo-Kraepelinian approach used in North American and European psychiatry - as opposed to focusing on explanatory models in order to examine whether positive comparisons of PTSD to CCDs meet criteria for face validity. Hierarchical clustering (Ward's method) of symptoms within CCDs provides a portrait of the emic literature characterized by traumatic multifinality with several common themes. Global variety within the literature suggests that few disaster-affected populations have mental health nosologies that include PTSD-like syndromes. One reason for this seems to be the almost complete absence of avoidance as pathology. Many nosologies contain depression-like disorders. Relief efforts would benefit from mental health practitioners getting specific training in culture-bound posttrauma constructs when entering settings beyond the boundaries of the culture of their training and practice.",0,0 +6107,Profiling Posttraumatic Functional Impairment,"Many individuals who have been exposed to psychological trauma suffer from impaired functioning, regardless of whether they have PTSD. Our purpose was to identify a subset of PTSD symptoms linked to functional impairment to a) improve the likelihood that individuals with posttraumatic impairment receive treatment, and b) offer a method to assess cost-burden of trauma history in epidemiological studies. We examined patterns of trauma-related symptoms in two independent community surveys (N=1002 and 630). Rank ordering of symptoms and their associations with impairment guided construction of an impairment-related profile in the first data set. The profile was then tested in the second data set. The derived symptom profile, consisting of intense recollections and/or emotional symptoms upon exposure to reminders, plus one or more of numbing/detachment, avoidance, sleep problems, concentration problems, or hypervigilance, detected the majority (88% and 74%) of persons with posttraumatic functional impairment. The symptom profile can help identify traumatized individuals who may benefit from treatment but do not necessarily meet criteria for PTSD.",0,0 +6108,"Multidimensional Assessment of Emotion Regulation and Dysregulation: Development, Factor Structure, and Initial Validation of the Difficulties in Emotion Regulation Scale","Given recent attention to emotion regulation as a potentially unifying function of diverse symptom presentations, there is a need for comprehensive measures that adequately assess difficulties in emotion regulation among adults. This paper (a) proposes an integrative conceptualization of emotion regulation as involving not just the modulation of emotional arousal, but also the awareness, understanding, and acceptance of emotions, and the ability to act in desired ways regardless of emotional state; and (b) begins to explore the factor structure and psychometric properties of a new measure, the Difficulties in Emotion Regulation Scale (DERS). Two samples of undergraduate students completed questionnaire packets. Preliminary findings suggest that the DERS has high internal consistency, good test-retest reliability, and adequate construct and predictive validity.",0,0 +6109,The “Thinking a Lot” Idiom of Distress and PTSD: An Examination of Their Relationship among Traumatized Cambodian Refugees Using the “Thinking a Lot” Questionnaire,"“Thinking a lot” (TAL)—also referred to as “thinking too much”—is a key complaint in many cultural contexts, and the current article profiles this idiom of distress among Cambodian refugees. The article also proposes a general model of how TAL generates various types of distress that then cause PTSD-type psychopathology, a model we refer to as the TAL–PTSD model. As tested in this Cambodian refugee sample, the model is supported by the following: (1) the close connection of TAL to PTSD as shown by odds ratio (OR = 19.6), correlation (r = .86), and factor loading; and (2) the mediation of most of the effect of TAL on PTSD by TAL-caused somatic symptoms, catastrophic cognitions, trauma recall, insomnia, and irritability. The questionnaire used in the present study is provided and can be used to examine TAL in other cultural and global contexts to advance the study of this commonly encountered distress form. [idioms of distress, “thinking a lot,” “thinking too much,” Cambodian refugees, PTSD]",0,0 +6110,Impact of Conjoined Exposure to the World Trade Center Attacks and to Other Traumatic Events on the Behavioral Problems of Preschool Children,"To examine the long-term behavioral consequences of exposure to the World Trade Center (WTC) attacks in preschool children and to evaluate whether conjoined exposure to disaster and to other traumatic events has additive effects.Retrospective cohort study.Lower Manhattan, New York.A total of 116 preschool children directly exposed to the WTC attacks. Main Exposures High-intensity WTC attack-related trauma exposure indexed by the child experiencing 1 or more of the following: seeing people jumping out of the towers, seeing dead bodies, seeing injured people, witnessing the towers collapsing, and lifetime history of other trauma exposure. Main Outcome Measure Clinically significant behavioral problems as measured using the Child Behavioral Checklist.Preschool children exposed to high-intensity WTC attack-related events were at increased risk for the sleep problems and anxious/depressed behavioral symptom clusters. Conjoined exposure to high-intensity WTC attack-related events and to other trauma was associated with clinically significant emotionally reactive, anxious/depressed, and sleep-related behavioral problems. Children without a conjoined lifetime history of other trauma did not differ from nonexposed children. Risk of emotionally reactive, anxious/depressed, and attention problems in preschool children exposed to conjoined high-intensity WTC attack-related events and other trauma increased synergistically.Conjoined other trauma exposure seems to amplify the impact of high-intensity WTC attack-related events on behavioral problems. Preschool children exposed to high-intensity events who had no other trauma exposure did not have increased clinically significant behavioral problems. The additive effects of trauma exposure are consistent with an allostatic load hypothesis of stress. More vigorous outreach to trauma-exposed preschool children should become a postdisaster public health priority.",0,0 +6111,Sertraline treatment of comorbid posttraumatic stress disorder and alcohol dependence.,"Posttraumatic stress disorder (PTSD) often co-occurs with alcohol dependence, yet little is known about treatment of this comorbidity. The serotonin selective reuptake inhibitors have been shown preliminarily to be effective in decreasing symptoms of PTSD but have not been studied in individuals with comorbid alcohol dependence. This is of particular interest as the SSRIs also have a modest effect in decreasing alcohol consumption.In this preliminary trial, nine subjects with comorbid PTSD and alcohol dependence were treated in an open-label trial with sertraline for a 12-week period. Symptoms of PTSD and depression were monitored monthly with the Impact of Event Scale and the Hamilton Rating Scale for Depression (HAM-D). Alcohol consumption was monitored by a self-report instrument (Time-Line Follow-Back).There were significant decreases in all three symptom clusters of PTSD measured by overall PTSD symptom scores (p < or = .001) and in HAM-D scores (p < or = .001) during the follow-up period. Days of abstinence increased and average number of drinks decreased during the follow-up period. Four subjects claimed total abstinence during the follow-up period.While limited by small sample size and the open-label, nonblinded study design, this study suggests that sertraline may be useful in the treatment of PTSD complicated by alcoholism. The medication was well tolerated and subjects showed improvement in PTSD symptoms as well as decreased alcohol consumption. A controlled trial of sertraline in this population would be of interest.",0,0 +6112,A group randomized trial of critical incident stress debriefing provided to U.S. peacekeepers,"In a group randomized trial of critical incident stress debriefing (CISD) with platoons of 952 peacekeepers, CISD was compared with a stress management class (SMC) and survey-only (SO) condition. Multilevel growth curve modeling found that CISD did not differentially hasten recovery compared to the other two conditions. For those soldiers reporting the highest degree of exposure to mission stressors, CISD was minimally associated with lower reports of posttraumatic stress and aggression (vs. SMC), higher perceived organizational support (vs. SO), and more alcohol problems than SMC and SO. Soldiers reported that they liked CISD more than the SMC, and CISD did not cause undue distress.",0,0 +6113,Disaster Aid Distribution and Social Conflicts,"Mainstream psychological coping theories that are predominantly individualistic and apolitical tend to neglect diverging interests and social conflicts. Sociological approaches to social conflicts and their resolution and social capital approaches are able to capture these universal features of post-disaster contexts. However, socioculturally distinctive features, specific imbalances of power, and diverging personal and shared ways of dealing with disasters and related aid probably contribute to a locally specific way of coping with disaster aid goods and associated social conflicts. For instance, does the social standard for maintaining harmony (rukun) counter the development of social bitterness? In what way may it hinder resolutions of social conflicts? This chapter explores contributing elements of conflict dynamics and subsequently demonstrates the variety of ways of coping with conflicts. Identified coping styles ranged on a continuum with confrontational, clarifying, and direct (assimilative) strategies on one pole, subversive strategies in the middle, and indirect, accommodative, accepting strategies on the other pole. Several situational elements, such as sense of entitlement, social standing within the community as well as timing issues, that is, the probability of whether justice may still be achieved or not in the short or long term, seemed to moderate which strategy is enacted. © 2014 Springer Science+Business Media, LLC. All rights are reserved.",0,0 +6114,Building child trauma theory from longitudinal studies: A meta-analysis,"Many children are exposed to traumatic events, with potentially serious psychological and developmental consequences. Therefore, understanding development of long-term posttraumatic stress in children is essential. We aimed to contribute to child trauma theory by focusing on theory use and theory validation in longitudinal studies. Forty studies measuring short-term predictors and long-term posttraumatic stress symptoms were identified and coded for theoretical grounding, sample characteristics, and correlational effect sizes. Explicit theoretical frameworks were present in a minority of the studies. Important predictors of long-term posttraumatic stress were symptoms of acute and short-term posttraumatic stress, depression, anxiety, and parental posttraumatic stress. Female gender, injury severity, duration of hospitalization, and elevated heart rate shortly after hospitalization yielded small effect sizes. Age, minority status, and socioeconomic status were not significantly related to long-term posttraumatic stress reactions. Since many other variables were not studied frequently enough to compute effect sizes, existing theoretical frameworks could only be partially confirmed or falsified. Child trauma theory-building can be facilitated by development of encouraging journal policies, the use of comparable methods, and more intense collaboration.",0,0 +6115,Development of the Arabic versions of the Impact of Events Scale‐Revised and the Posttraumatic Growth Inventory to assess trauma and growth in Middle Eastern refugees in Australia,The current study reports on the development of an Arabic version of the Revised version of the Impact of Events Scale (IES‐R). The IES‐R was developed to assist in exploring the relationship betwe...,0,0 +6116,Personal Growth After Severe Fetal Diagnosis,"The traumatic aspects of positive diagnosis of a severe fetal anomaly have garnered the most attention, but the personal growth in the aftermath of this event remains relatively unexplored. We used the five dimensions of growth and change from Posttraumatic Growth Inventory (PTGI) to analyze data generated from ethnographic interviews conducted with 15 women and 10 of their male partners in the aftermath of a severe fetal diagnosis. Eighteen (12 women and 6 men) of these 25 participants experienced positive change across these dimensions. Relating to others was the dimension that showed the most consistent early and prolonged change. Six of the 10 couples had congruent profiles of change. Negative change was evident in 2 women and 2 men. Recognizing the potential for growth allows nurses opportunities to promote it in the aftermath of severe fetal diagnosis.",0,0 +6117,Dysregulation of the Right Brain: A Fundamental Mechanism of Traumatic Attachment and the Psychopathogenesis of Posttraumatic Stress Disorder,"This review integrates recent advances in attachment theory, affective neuroscience, developmental stress research, and infant psychiatry in order to delineate the developmental precursors of posttraumatic stress disorder.Existing attachment, stress physiology, trauma, and neuroscience literatures were collected using Index Medicus/Medline and Psychological Abstracts. This converging interdisciplinary data was used as a theoretical base for modelling the effects of early relational trauma on the developing central and autonomic nervous system activities that drive attachment functions.Current trends that integrate neuropsychiatry, infant psychiatry, and clinical psychiatry are generating more powerful models of the early genesis of a predisposition to psychiatric disorders, including PTSD. Data are presented which suggest that traumatic attachments, expressed in episodes of hyperarousal and dissociation, are imprinted into the developing limbic and autonomic nervous systems of the early maturing right brain. These enduring structural changes lead to the inefficient stress coping mechanisms that lie at the core of infant, child, and adult posttraumatic stress disorders.Disorganised-disoriented insecure attachment, a pattern common in infants abused in the first 2 years of life, is psychologically manifest as an inability to generate a coherent strategy for coping with relational stress. Early abuse negatively impacts the developmental trajectory of the right brain, dominant for attachment, affect regulation, and stress modulation, thereby setting a template for the coping deficits of both mind and body that characterise PTSD symptomatology. These data suggest that early intervention programs can significantly alter the intergenerational transmission of posttraumatic stress disorders.",0,0 +6118,Analysis of neuropsychiatric adverse events during clinical trials of efavirenz in antiretroviral-naive patients: a systematic review.,"People with HIV infection have several risk factors for developing neuropsychiatric adverse events: preexisting conditions, HIV disease stage, and antiretroviral treatment. The most widely used system for assessing neuropsychiatric adverse events in clinical trials is the US Division of AIDS severity grading scale, from Grade 1 (mild) to Grade 4 (life-threatening). First-line treatment with efavirenz has been associated with higher rates of neuropsychiatric adverse events than several other antiretrovirals. A MEDLINE search identified 17 randomized clinical trials of first-line HAART with two nucleoside analogs plus efavirenz, of which 13 reported neuropsychiatric adverse events using the Grade 1-4 system. The percentage of patients with graded neuropsychiatric adverse events, and the system used for analysis, was compared across the trials. Of the 13 trials identified, there were five different methods used to report neuropsychiatric adverse events: Grade 1-4 all, Grade 1-4 drug related, Grade 2-4 all, Grade 2-4 drug related, Grade 3-4 all, Grade 3-4 drug related, and adverse events leading to discontinuation. In addition, three trials used questionnaire-based methods instead of the Division of AIDS grading system. There were a significantly higher percentage of patients with Grade 1-4 neurological or psychiatric adverse events in the efavirenz versus comparator arms in the DMP-006, TMC278-C204, and STARTMRK trials. There were generally too few patients with each individual neuropsychiatric adverse event to allow meaningful comparisons of treatment arms. There were no significant differences in Grade 3 or 4 neuropsychiatric adverse events between the treatment arms in the ACTG 5142 or 2NN trials. In summary, there is a wide range of different systems used to report neuropsychiatric adverse events in HIV clinical trials. Use of a standardized endpoint would improve the interpretability of results across clinical trials.",0,0 +6119,Treatment of Posttraumatic Stress Disorder by Exposure and/or Cognitive Restructuring,"Unanswered questions from controlled studies of posttraumatic stress disorder concern the value of cognitive restructuring alone without prolonged exposure therapy and whether its combination with prolonged exposure is enhancing.In a controlled study, 87 patients with posttraumatic stress disorder of at least 6 months' duration were randomly assigned to have 10 sessions of 1 of 4 treatments: prolonged exposure (imaginal and live) alone; cognitive restructuring alone; combined prolonged exposure and cognitive restructuring; or relaxation without prolonged exposure or cognitive restructuring.Integrity of audiotaped treatment sessions was satisfactory when rated by an assessor unaware of the treatment assignment. Seventy-seven patients completed treatment. The pattern of results was similar regardless of rater, statistical method, measure, occasion, and therapist. Exposure and cognitive restructuring, singly or combined, improved posttraumatic stress disorder markedly on a broad front. Gains continued to 6-month follow-up and were significantly greater than the moderate improvement from relaxation.Both prolonged exposure and cognitive restructuring were each therapeutic on their own, were not mutually enhancing when combined, and were each superior to relaxation.",0,0 +6120,Understanding resilience in armed conflict: Social resources and mental health of children in Burundi,"Little is known about the role of cognitive social capital among war-affected youth in low- and middle-income countries. We examined the longitudinal association between cognitive social capital and mental health (depression and posttraumatic stress disorder (PTSD) symptoms), functioning, and received social support of children in Burundi. Data were obtained from face-to-face interviews with 176 children over three measurement occasions over the span of 4-months. Cognitive social capital measured the degree to which children believed their community was trustworthy and cohesive. Mental health measures included the Depression Self-Rating Scale (DSRS) (Birleson, 1981), the Child Posttraumatic Symptom Scale (Foa et al., 2001), and a locally constructed scale of functional impairment. Children reported received social support by listing whether they received different types of social support from self-selected key individuals. Cross-lagged path analytic modeling evaluated relationships between cognitive social capital, symptoms and received support separately over baseline (T1), 6-week follow-up (T2), and 4-month follow-up (T3). Each concept was treated and analyzed as a continuous score using manifest indicators. Significant associations between study variables were unidirectional. Cognitive social capital was associated with decreased depression between T1 and T2 ( B = −.22, p < .001) and T2 and T3 ( β = −.25, p < .001), and with functional impairment between T1 and T2 ( β = −.15, p = .005) and T2 and T3 ( β = −.14, p = .005); no association was found for PTSD symptoms at either time point. Cognitive social capital was associated with increased social support between T1 and T2 ( β = .16, p = .002) and T2 and T3 ( β = .16, p = .002). In this longitudinal study, cognitive social capital was related to a declining trajectory of children's mental health problems and increases in social support. Interventions that improve community relations in war-affected communities may alter the trajectories of resource loss and gain with conflict-affected children. • Cognitive social capital was associated with less depression. • Cognitive social capital was associated with greater social support. • Change in cognitive social capital was unrelated to social support and depression. • Cognitive social capital is promising for mental health prevention and promotion.",0,0 +6121,What Does National Resilience Mean in a Democracy? Evidence from the United States and Israel,"Given various challenges to national security in democracies, such as terrorism and political violence, a growing need for reconceptualization of the term “resilience” emerges. The interface between national security and resilience is rooted in individuals’ perceptions and attitudes toward institutions and leadership. Therefore, in this article, we suggest that political–psychological features form the basis of citizens’ perceived definitions of national resilience. By comparing national resilience definitions composed by citizens of two democratic countries facing national threats of war and terrorism, the United States and Israel, we found that perceived threats, optimism, and public attitudes such as patriotism and trust in governmental institutions, are the most frequent components of the perceived national resilience. On the basis of these results, a reconceptualization of the term “national resilience” is presented. This can lead to validation of how resilience is measured and provide grounds for further examination of this concept in other democratic countries.",0,0 +6122,Psychological adjustment one year after the diagnosis of breast cancer: A prototype study of delayed post-traumatic stress disorder,"Objective. The utilization of a post-traumatic stress disorder (PTSD) diagnostic framework for categorizing the psychological adjustment of breast cancer (BC) patients has been debated. We wanted to study the prevalence of PTSD and predictors for PTSD. Design. The current study is a one-year follow-up of 64 early BC patients. Methods. PTSD, subclinical PTSD, delayed onset PTSD and several theory-driven predictive variables were examined. Results. Thirteen per cent of the patients showed full symptoms of disease-related PTSD compared with 7% at the initial study (6 weeks after diagnosis). Considerable changes were observed in all PTSD clusters (intrusion, avoidance, and arousal), in most cases representing a decrease in symptom level. Immature defence style, emotional coping, avoidant behaviour, and negative affectivity were all implicated as predicting variables in a hierarchical multiple regression analysis which explained 65% of the variability of PTSD severity one year after diagnosis. Conclusions. This study highlights the PTSD diagnosis as being highly relevant in oncology settings. Early screening for the above-mentioned four variables may help early identification of the patients most at risk of developing PTSD.",0,0 +6123,Avoidant symptoms in PTSD predict fear circuit activation during multimodal fear extinction,"Convergent evidence suggests that individuals with posttraumatic stress disorder (PTSD) exhibit exaggerated avoidance behaviors as well as abnormalities in Pavlonian fear conditioning. However, the link between the two features of this disorder is not well understood. In order to probe the brain basis of aberrant extinction learning in PTSD, we administered a multimodal classical fear conditioning/extinction paradigm that incorporated affectively relevant information from two sensory channels (visual and tactile) while participants underwent fMRI scanning. The sample consisted of fifteen OEF/OIF veterans with PTSD. In response to conditioned cues and contextual information, greater avoidance symptomatology was associated with greater activation in amygdala, hippocampus, vmPFC, dmPFC, and insula, during both fear acquisition and fear extinction. Heightened responses to previously conditioned stimuli in individuals with more severe PTSD could indicate a deficiency in safety learning, consistent with PTSD symptomatology. The close link between avoidance symptoms and fear circuit activation suggests that this symptom cluster may be a key component of fear extinction deficits in PTSD and/or may be particularly amenable to change through extinction-based therapies.",0,0 +6124,Witnessing Parental Violence as a Traumatic Experience Shaping the Abusive Personality,"Summary Previous work by Dutton and his colleagues has established a clinical profile on intimately abusive adult men that is quite similar to profiles of trauma victims in many essential clinical respects. Dutton (in press) showed that arousal modulation problems, affective monitoring, cognitive problem solving deficits, externalizing attributional styles, aggression and dissociative states are common to both groups. Furthermore, intimately abusive men demonstrate similar profiles as men diagnosed independently with PTSD on the MCMI-II. Dutton (1995a, 1995b) attributed the trauma to early assaults on the self through parental shaming, accompanied by insecure attachment and physical abuse victimization. Bowlby (1973) considered insecure attachment itself both a source and consequence of trauma. Since the infant turns to the attachment-object during periods of distress seeking soothing, a failure to obtain soothing maintains high arousal and endocrine secretion. Van der Kolk (1987) considered child abuse a...",0,0 +6125,The impact of motor vehicle injury on distress: Moderators and trajectories over time,"• Post-motor vehicle injury (MVI) distress increased over time, particularly for men. • Pre-MVI distress predicted post-MVI distress. • The link between pre-MVI alcohol and post-MVI distress varied with pre-MVI distress. • Those with partners experienced less distress than the unpartnered. Research reveals that motor vehicle injuries (MVIs) can result in severe and debilitating psychological distress. Yet, not every person who has sustained a MVI suffers psychologically. It appears that risk of distress varies by demographic and psychosocial characteristics. The present study aimed to explore the trajectories of post-MVI distress and the effect of pre-MVI psychological functioning on post-MVI distress. Hierarchical linear modeling was used to explore the longitudinal dataset from the Canadian National Population Health Survey. Participants were assessed up to nine years post-MVI. Post-MVI distress increased over time. Men experienced greater overall distress than women and a greater increase in distress over time. Pre-MVI distress predicted post-MVI distress. This relationship was strongest for those with greater pre-MVI alcohol consumption. At low levels of pre-MVI distress, greater pre-MVI alcohol consumption was related to lower post-MVI distress, but at high levels of pre-MVI distress, greater pre-MVI alcohol consumption predicted increased post-MVI distress. Those with partners experienced less distress than the unpartnered. This study supports the general findings of other post-MVI and post-trauma studies, although the current study’s main and interaction effects reveal more complex and nuanced relationships among variables in their prediction of post-MVI psychological distress.",0,0 +6126,Paradoxical Pain Perception in Posttraumatic Stress Disorder: The Unique Role of Anxiety and Dissociation,"Posttraumatic stress disorder (PTSD) and chronic pain often co-occur and exacerbate each other. Elucidating the mechanism of this co-occurrence therefore has clinical importance. Previously, patients with PTSD with chronic pain were found to demonstrate a unique paradoxical pain profile: hyperresponsiveness together with hyposensitivity to pain. Our aim was to examine whether 2 seemingly paradoxical facets of PTSD (anxiety and dissociation) underlie this paradoxical profile. Patients with PTSD (n = 32) and healthy control individuals (n = 43) underwent psychophysical testing and completed questionnaires. Patients with PTSD had higher pain thresholds and higher pain ratings to suprathreshold stimuli than control individuals. Pain thresholds were positively associated with dissociation levels and negatively associated with anxiety sensitivity levels. Experimental pain ratings were positively associated with anxiety sensitivity and negatively related to dissociation levels. Chronic pain intensity was associated with anxiety, anxiety sensitivity, and pain catastrophizing. It appears that reduced conscious attention toward incoming stimuli, resulting from dissociation, causes delayed response in pain threshold measurement, whereas biases toward threatening stimuli and decreased inhibition, possibly caused by increased anxiety, are responsible for the intensification of experimental and chronic pain. The paradoxical facets of PTSD and their particular influences over pain perception seem to reinforce the coexistence of PTSD and chronic pain, and should be considered when treating traumatized individuals.This article provides new information regarding the underlying mechanism of the coexistence of PTSD and chronic pain. This knowledge could help to provide better management of PTSD and chronic pain among individuals in the aftermath of trauma.",0,0 +6127,Afectaciones psicológicas de niños y adolescentes expuestos al conflicto armado en una zona rural de Colombia.,"Se determinaron las afectaciones psicológicas de 284 niños y adolescentes expuestos al conflicto armado en una zona rural colombiana, seleccionados mediante un muestreo aleatorio por afijación proporcional. Los instrumentos aplicados fueron: la Lista de chequeo de comportamiento infantil, el Auto-reporte de comportamientos de jóvenes, la Lista de síntomas postraumáticos, la Escala de estrategias de afrontamiento para adolescentes y la Escala de resiliencia para escolares. El 72% de la población presentó afectaciones psicológicas: el 64.4%, conductas internalizadas, el 47%, conductas externalizadas en rango clínico. El 32%, problemas somáticos; el 56%, se encontraba en riesgo de estrés postraumático, y el 93% consumía alcohol en grado moderado. La estrategia de afrontamiento más utilizada era dejar que las cosas se arreglaran solas. Se encontró una alta necesidad de atención en salud. Ser hombre constituyó un factor de riesgo de depresión, agresión y problemas sociales en los niños. A su vez, tener hasta doce años y estar cursando un grado escolar bajo, lo fue para los síntomas somáticos en adolescentes. Los resultados evidenciaron la afectación en la salud mental de los participantes.",0,0 +6128,Changes in PTSD and Depression During Prolonged Exposure and Client-Centered Therapy for PTSD in Adolescents,"Depressive symptoms are common among individuals with posttraumatic stress disorder (PTSD). Prolonged exposure therapy (PE) for PTSD has been found to alleviate both PTSD and depressive symptoms, but relatively little is known about the pattern of PTSD and depressive symptom change during treatment. This study aimed to investigate the relationship between changes in PTSD and depression during PE for adolescent (PE-A) and client-centered therapy (CCT). The moderating role of PE-A versus CCT and the possible differences across symptom clusters of PTSD were also examined. Participants were 61 female adolescents with sexual-assault-related PTSD randomized to PE-A (n = 31) or CCT (n = 30). Participants completed the Beck Depression Inventory and the Child PTSD Symptom Scale at pre-, mid-, and posttreatment and before each treatment session. Multilevel mediation analysis indicated a reciprocal but asymmetrical relationship between changes in PTSD and depression during treatment in the overall sample. Moderated mediation analysis showed that the reciprocal relation was observed only during PE-A. Reductions in PTSD led to reductions in depression to a greater extent (48.7%), 95% confidence interval [30.2, 67.2], than vice versa (22.0%), [10.6, 33.4]. For participants receiving CCT, reduction in PTSD led to reductions in depression (31.6%), [11.8, 51.4], but not vice versa (7.4%), [-7.1, 21.9]. The reciprocal relationship between PTSD and depression was also observed across different symptoms clusters of PTSD. Our findings suggest that changes in PTSD led to changes in depressive symptoms to a greater extent than vice versa across PE-A and CCT.",0,0 +6129,"Traumatic impact of a fire disaster on survivors—A 25-year follow-up of the 1978 hotel fire in Borås, Sweden","The objective of this study was to investigate the long-term psychological and mental health outcomes among survivors of a disastrous hotel fire. A 25-year follow-up investigation among adolescent and young adult survivors of a fire disaster was conducted in Borås, Sweden. A self-evaluation questionnaire and four self-rating scales - the IES-22, PTSS-10, GHQ-28 and SoC - were sent by mail to the participants. The results from the self-reported data showed low levels of psychiatric illness. Moreover, the respondents reported a low level of traumatic stress symptoms. More than 50% of the participants stated that the fire had a determining effect on their lives. Sixteen (21.3%) respondents indicated that the fire still had an impact on their daily lives. Differences between men and women were reported in most of the self-rating scales. The results indicate that a traumatizing experience (such as a fire disaster) still had a small effect on psychological health in a long-term perspective.",0,0 +6130,An evidence-based review of the clinical use of sertraline in mood and anxiety disorders,"Sertraline is a selective serotonin reuptake inhibitor that has been used and studied extensively throughout the world and found to be safe and well tolerated in numerous patient populations, including those with either psychiatric and/or medical comorbidities. Randomized clinical trials have shown that it is an effective treatment for depressive and anxiety disorders and its efficacy is unaffected by psychiatric comorbidity. In non-comorbid patients, sertraline is effective for the acute treatment of major depressive disorders and prevention of relapse or recurrence. It is effective for acute treatment and longer-term management of social anxiety disorder, posttraumatic stress disorder,panic disorder, and generalized anxiety disorder. In adults and in pediatric patients, it is an effective short-term and long-term treatment for obsessive compulsive disorder.Sertraline has a good tolerability profile and has low fatal toxicity. In summary, sertraline is as effective as other antidepressants over a wide range of indications but may offer tolerability benefits as well as efficacy in patients with psychiatric and/or medical comorbidities and certain subtypes of depression.",0,0 +6131,The factor structure of posttraumatic stress disorder symptoms among Rwandans exposed to the 1994 genocide: A confirmatory factor analytic study using the PCL-C,"The factor structure of posttraumatic stress disorder (PTSD) symptoms in Euro-American populations has been extensively studied, but confirmatory factor analytic studies from non-Western societies are lacking. Alternative models of DSM-IV symptoms were tested among Rwandan adults (N=465) who experienced trauma during the 1994 genocide. A cluster random survey was conducted with interviews held in Rwandan households. PTSD was assessed with the Posttraumatic Stress Disorder Checklist-Civilian version. Competing models were the DSM-IV, emotional numbing, dysphoria, aroused intrusion, and dysphoric arousal models. Results showed that the emotional numbing, dysphoria, and dysphoric arousal models had almost identical, good fit indices and fit the data significantly better than the other models. The emotional numbing and dysphoric arousal models also exhibited good construct validity. Results suggest that the latent structure of PTSD symptoms in Rwanda are comparable to that found in Euro-American samples, thereby lending further support to the cross-cultural validity of the construct.",0,0 +6132,The Geography of Mental Health and General Wellness in Galveston Bay After Hurricane Ike: A Spatial Epidemiologic Study With Longitudinal Data,"To demonstrate a spatial epidemiologic approach that could be used in the aftermath of disasters to (1) detect spatial clusters and (2) explore geographic heterogeneity in predictors for mental health and general wellness.We used a cohort study of Hurricane Ike survivors (n=508) to assess the spatial distribution of postdisaster mental health wellness (most likely resilience trajectory for posttraumatic stress symptoms [PTSS] and depression) and general wellness (most likely resilience trajectory for PTSS, depression, functional impairment, and days of poor health) in Galveston, Texas. We applied the spatial scan statistic (SaTScan) and geographically weighted regression.We found spatial clusters of high likelihood wellness in areas north of Texas City and spatial concentrations of low likelihood wellness in Galveston Island. Geographic variation was found in predictors of wellness, showing increasing associations with both forms of wellness the closer respondents were located to Galveston City in Galveston Island.Predictors for postdisaster wellness may manifest differently across geographic space with concentrations of lower likelihood wellness and increased associations with predictors in areas of higher exposure. Our approach could be used to inform geographically targeted interventions to promote mental health and general wellness in disaster-affected communities.",0,0 +6133,"Predictors of decline in overall mental health, PTSD and alcohol use in OEF/OIF veterans","This study identified predictors of worsening mental health (including PTSD and alcohol use) over a 6-month period following return from deployment to Iraq (OIF) or Afghanistan (OIF). Using a national sample of 512 OEF/OIF veterans surveyed within 12 months of return from deployment (T1), and 6 months later (T2), we obtained demographic and deployment characteristics, risk and resilience factors, mental health status, PTSD and alcohol abuse. We performed logistic regression analyses to identify predictors of worse mental health, PTSD or alcohol use between T1 and T2, controlling for initial levels. Of the sample, 14-25% showed clinically worse mental health, PTSD or alcohol use. Each outcome was associated with some shared and some unique predictors. For example, younger age and recent medical care were both associated with worse alcohol use. Lack of adequate deployment training was uniquely associated with worse PTSD symptoms.",0,0 +6134,Exposure to workplace bullying and post-traumatic stress disorder symptomology: the role of protective psychological resources,"To examine the relationship between nurses' exposure to workplace bullying and Post-Traumatic Stress Disorder symptomology and the protective role of psychological capital (PsyCap).Workplace bullying has serious organisational and health effects in nursing. Few studies have examined the relation of workplace bullying to serious mental health outcomes, such as Post-Traumatic Stress Disorder. Even fewer have examined the effect of intrapersonal strengths on the health impact of workplace bullying.A survey of 1205 hospital nurses was conducted to test the hypothesized model. Nurses completed standardized measures of bullying, Post-Traumatic Stress Disorder and PsyCap.A moderated regression analysis revealed that more frequent exposure to workplace bullying was significantly related to Post-Traumatic Stress Disorder symptomology regardless of the PsyCap level. That is, PsyCap did not moderate the bullying/PTSD relationship in either group. Bullying exposure and PsyCap were significant independent predictors of Post-Traumatic Stress Disorder symptoms in both groups. Efficacy, a subdimension of PsyCap, moderated the bullying/Post-Traumatic Stress Disorder relationship only among experienced nurses.Workplace bullying appears to be predictive of Post-Traumatic Stress Disorder symptomology, a serious mental health outcome.Workplace bullying is a serious threat to nurses' health and calls for programmes that eliminate bullying and encourage greater levels of positive resources among nurses.",0,0 +6135,"Accuracy of MMPI–2–RF Validity Scales for Identifying Feigned PTSD Symptoms, Random Responding, and Genuine PTSD","The Minnesota Multiphasic Personality Inventory-2-RF (MMPI-2-RF) validity scales were evaluated to determine accuracy when differentiating honest responding, random responding, genuine posttraumatic stress disorder (PTSD), and feigned PTSD. Undergraduate students (n = 109), screened for PTSD, were randomly assigned to 1 of 4 instructional groups: honest, feign PTSD, half random, and full random. Archival data provided clinical MMPI-2-RF profiles consisting of 31 veterans diagnosed with PTSD. Veterans were diagnosed with PTSD using a structured interview and had passed a structured interview for malingering. Validity scales working as a group had correct classification rates of honest (96.6%), full random (88.9%), genuine PTSD (80.7%), fake PTSD (73.1%), and half random (44.4%). Results were fairly supportive of the scales' ability to discriminate feigning and full random responding from honest responding of normal students as well as veterans with PTSD. However, the RF validity scales do not appear to be as effective in detecting partially random responding.",0,0 +6136,Trauma and resilience in young refugees: A 9-year follow-up study,"The aim of the present study was to assess and understand the long-term trajectory of psychological problems among young Middle Eastern refugees in Denmark. Participants were 131 young refugees from the Middle East (76 girls, 55 boys; mean age = 15.3 years) from 67 families. They were assessed first on arrival in Denmark in 1992-1993 and again 8-9 years later. The high prevalence of psychological problems at arrival was considerably reduced by the time of follow-up, but it was still somewhat higher than what has been found in most community studies using the same assessment tools. Groups of children differed in showing low levels of symptoms at arrival that were stable (spared) or increased (reacting) and high levels at arrival that persisted (traumatized) or decreased (adapted). The number of types of traumatic experiences before arrival distinguished the spared and the traumatized young refugees and the number of types of stressful events after arrival the adapted and the traumatized, also after corrections for age, sex, specific traumatic events, parents' education and health, and the social situation of the young refugees. The study emphasizes the importance of environmental factors for healthy long-term adaptation after traumatic experiences related to war and other organized violence.",0,0 +6137,Attendance and substance use outcomes for the Seeking Safety program: Sometimes less is more.,"This study uses data from the largest effectiveness trial to date on treatment of co-occurring posttraumatic stress and substance use disorders, using advances in statistical methodology for modeling treatment attendance and membership turnover in rolling groups.Women receiving outpatient substance abuse treatment (N = 353) were randomized to 12 sessions of Seeking Safety or a health education control condition. Assessments were completed at baseline and at 1 week, 3, 6, and 12 months posttreatment. Outcome measures were alcohol and cocaine use in the prior 30 days captured using the Addiction Severity Index. Latent class pattern mixture modeling (LCPMM) was used to estimate attendance patterns and to test for treatment effects within and across latent attendance patterns and group membership turnover.Across LCPMM analyses for alcohol and cocaine use, similar treatment attendance patterns emerged: Completers never decreased below an 80% probability of attendance, droppers never exceeded a 41% probability of attendance, and titrators demonstrated a 50% to 80% probability of attendance. Among completers, there were significant decreases in alcohol use from baseline to 1-week posttreatment, followed by nonsignificant increases in alcohol during follow-up. No differences between treatment conditions were detected. Titrators in Seeking Safety had lower rates of alcohol use from 1-week through 12-month follow-up compared with control participants. Droppers had nonsignificant increases in alcohol during both study phases. Cocaine use findings were similar but did not reach significance levels.The impact of client self-modulation of treatment dosage and group membership composition may influence behavioral treatment outcomes among this population.",0,0 +6138,Debating war-trauma and post-traumatic stress disorder (PTSD) in an interdisciplinary arena,"Researchers have tried to determine and verify the effects of violent conflicts on the mental health of those affected by focusing on war trauma, posttraumatic stress disorder (PTSD), and other trauma-related disorders. This, in turn, led to the development of different kinds of theories and aid programs that aim at preventing and treating the consequences of violence and mental health. Until now, there is no agreement on the public health value of the concept of PTSD and no agreement on the appropriate type of mental-health care. Instead, psychiatrists have engaged in sometimes fierce discussions over the universality of war trauma, PTSD, and other trauma-related disorders. The two most polar positions are those who try to validate PTSD as a universal and cross-culturally valid psychopathological response to traumatic distress which may be cured or ameliorated with (Western) clinical and psychosocial therapeutic measures, and those who argue that the Western discourse on trauma only makes sense in the context of a particular cultural and moral framework and, therefore, becomes problematic in the context of other cultural and social settings. Although these positions seem mutually exclusive, their debates have led to the development of less radical approaches toward war-trauma and PTSD. The purpose of this literature review is to analyse the discourses on and debates over war-trauma and PTSD in the psychiatric literature in order to establish a better understanding for the diverse conceptualizations, interpretations and proposed healing strategies. Moreover, I discuss the cultural construction and conceptualization of war-trauma and PTSD from an anthropological perspective and show how anthropologists contribute to psychiatric debates so as to ensure more sophisticated diagnoses and healing strategies in culturally diverse contexts.",0,0 +6139,"Adolescent Adjustment, Caregiver-Adolescent Relationships, and Outlook Towards the Future in the Long-Term Aftermath of the Bosnian War","Using a mixed-method design with Bosnian students (n = 63, ages 16–19) and their primary caregivers (n = 50), we explored the impact of post-war adversities on adolescent adjustment, adolescent-caregiver relationships, and future outlook 8 years after the 1992–1995 Bosnian civil war. Adolescents and caregivers identified themes linking the war and its aftermath to ongoing emotional adjustment difficulties, relationships challenges, and negative future outlook. Adolescents’ posttraumatic stress symptoms were positively correlated with self-report measures of interpersonal stressors, existential stressors, parental psychological control, and anxious/withdrawn symptoms. Parental psychological control partially mediated the association between interpersonal post-war adversities and posttraumatic stress symptoms. © 2015, Springer International Publishing.",0,0 +6140,Elaboration on posttraumatic stress disorder diagnostic criteria: a factor analytic study of PTSD exposure to war or terror.,"In societies facing prolonged exposure to war and terror, empirical research provides mixed support for the posttraumatic stress disorder (PTSD) symptom clusters groupings identified by the Diagnostic and Statistical Manual (DSM-IV-TR) as re-experiencing the event, avoidance and emotional numbing, and hyperarousal.This study examines the validity of the PTSD symptom clusters in elements of Israeli society exposed to man-made trauma. Survivors (N=2,198) of seven different war and terror-related traumas were assessed using a DSM-IV-TR based PTSD inventory. Four confirmatory factor analytic models were compared.The most acceptable model was a correlated model consisting of four factors of re-experiencing, avoidance, emotional numbing, and hyperarousal. DSM-IV-TR avoidance empirically split into active avoidance and emotional numbing. These results corroborate knowledge and suggest that in Israel, where stressors are ongoing, the PTSD symptom clusters may be reformulated in DSM-5 to consist of re-experiencing, active avoidance, emotional numbing and hyperarousal.",0,0 +6141,Diagnostic accuracy of three scoring methods for the Davidson Trauma Scale among U.S. military Veterans,"• Three scoring methods for the Davidson Trauma Scale were compared. • Subjects were 804 Afghanistan and Iraq war-era military Service Members and Veterans. • Adding a cut score to the symptom cluster method generally improved specificity. • Cut score in the range of 68–72 provided optimal diagnostic accuracy. Self-report questionnaires are frequently used to identify PTSD among U.S. military personnel and Veterans. Two common scoring methods used to classify PTSD include: (1) a cut score threshold and (2) endorsement of PTSD symptoms meeting DSM-IV-TR symptom cluster criteria (SCM). A third method requiring a cut score in addition to SCM has been proposed, but has received little study. The current study examined the diagnostic accuracy of three scoring methods for the Davidson Trauma Scale (DTS) among 804 Afghanistan and Iraq war-era military Service Members and Veterans. Data were weighted to approximate the prevalence of PTSD and other Axis I disorders in VA primary care. As expected, adding a cut score criterion to SCM improved specificity and positive predictive power. However, a cut score of 68–72 provided optimal diagnostic accuracy. The utility of the DTS, the role of baseline prevalence, and recommendations for future research are discussed.",0,0 +6142,Social support in Vietnam veterans with posttraumatic stress disorder: A comparative analysis.,,0,0 +6143,"Factor structure, internal consistency and reliability of the Posttraumatic Stress Disorder Checklist (PCL): an exploratory study","Posttraumatic stress disorder (PTSD) is an anxiety disorder resulting from exposure to traumatic events. The Posttraumatic Stress Disorder Checklist (PCL) is a self-report measure largely used to evaluate the presence of PTSD.To investigate the internal consistency, temporal reliability and factor validity of the Portuguese language version of the PCL used in Brazil.A total of 186 participants were recruited. The sample was heterogeneous with regard to occupation, sociodemographic data, mental health history, and exposure to traumatic events. Subjects answered the PCL at two occasions within a 15 days' interval (range: 5-15 days).Cronbach's alpha coefficients indicated high internal consistency for the total scale (0.91) and for the theoretical dimensions of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) (0.83, 0.81, and 0.80). Temporal reliability (test-retest) was high and consistent for different cutoffs. Maximum likelihood exploratory factor analysis (EFA) was conducted and oblique rotation (Promax) was applied. The Kaiser-Meyer-Olkin (KMO) index (0.911) and Bartlett's test of sphericity (χ² = 1,381.34, p < 0.001) indicated that correlation matrices were suitable for factor analysis. The analysis yielded three symptom clusters which accounted for 48.9% of the variance, namely, intrusions, avoidance, and numbing-hyperarousal.Our findings provide additional data regarding the psychometric properties of the PCL, including internal consistency, test-retest reliability, and factor validity. Results are discussed in relation to PTSD theoretical models.",0,0 +6144,DEVELOPMENT OF A GUIDED SELF-HELP (GSH) PROGRAM FOR THE TREATMENT OF MILD-TO-MODERATE POSTTRAUMATIC STRESS DISORDER (PTSD),"There is a shortage of suitably qualified therapists able to deliver evidence-based treatment for posttraumatic stress disorder (PTSD), precluding timely access to intervention. This work aimed to develop an optimally effective, feasible, and acceptable guided self-help (GSH) program for treatment of the disorder.The study followed Medical Research Council (MRC) guidance for the development of a complex intervention. A prototype GSH program was developed through an initial modeling phase. Systematic reviews of the literature informed a portfolio of up-to-date information for key stakeholders to consider and discuss in a series of focus groups and semistructured interviews, which included 10 mental health professionals with expertise in the fields of GSH and/or PTSD, and seven former PTSD sufferers. Data were analyzed through a process of Inductive Thematic Analysis and used to inform the content, delivery, and guidance of a GSH program for PTSD. The prototype was piloted with 19 PTSD sufferers in two pilot studies, and refined on the basis of their quantitative results and qualitative feedback.The final version was available online and in hardcopy. It included 11 modules, some being mandatory and others optional, allowing tailoring of the intervention to meet an individual's specific needs. Qualitative and quantitative results of the pilot studies supported its efficacy in terms of reducing traumatic stress symptoms and its acceptability to PTSD sufferers.Delivering psychological treatment in a GSH format shows promise as an effective and acceptable way of treating mild-to-moderate PTSD.",0,0 +6145,"Prewar, war-zone, and postwar predictors of posttraumatic stress in female Vietnam Veteran health care providers.","Using the National Vietnam Veterans Readjustment Study database, we explored predictors of current posttraumatic stress disorder (PTSD) symptom severity in 373 female Vietnam veteran health care pr...",0,0 +6146,Post-traumatic stress disorder screening test performance in civilian primary care,"we determined the test performance characteristics of four brief post-traumatic stress disorder (PTSD) screening tests in a civilian primary care setting.this was a cross-sectional cohort study of adults attending a family medicine residency training clinic in the southeastern USA. Four hundred and eleven participants completed a structured telephone interview that followed an index clinic visit. Screening tests included: PTSD Symptom Checklist-Civilian Version (17 items), SPAN (four items), Breslau's scale (seven items) and Primary Care PTSD screen (PC-PTSD) (four items). A modified Clinician-Administered PTSD Scale was used to determine past month PTSD for comparison. Receiver operating characteristic analysis based on area under the curve (AUC) was used to assess diagnostic efficiency (>0.80 desired). Cut-off scores were selected to yield optimal sensitivity and specificity (>80%).past month PTSD was substantial (women = 35.8% and men = 20.0%; P < 0.01). AUC values were PTSD Symptom Checklist (PCL) (0.897), SPAN (0.806), Breslau's scale (0.886) and PC-PTSD (0.885). Optimal cut-scores yielded the following sensitivities and specificities: PCL (80.0% and 80.7%; cut-off = 43), SPAN (75.9% and 71.6%; cut-off = 3), Breslau's scale (84.5% and 76.4%; cut-off = 4) and PC-PTSD (85.1% and 82.0%; cut-off = 3). Overall and gender-specific screening test performances were explored.results confirm: (i) PTSD was common, especially among women; (ii) all four PTSD screening tests were diagnostically adequate; (iii) Two of four PTSD screening tests showed adequate sensitivity and specificity (>80%) and (iv) The PC-PTSD screening test (four items) appeared to be the best single screening test. There are few studies to establish the utility of PTSD screening tests within civilian primary care.",0,0 +6147,A meta-analytic investigation of the structure of posttraumatic stress disorder symptoms.,"Converging lines of evidence have called into question the validity of conceptualizations of posttraumatic stress disorder (PTSD) based on the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association, 2000) and suggested alternative structural models of PTSD symptomatology. We conducted a meta-analysis of 40 PTSD studies (N = 14,827 participants across studies) that used a DSM-based measure to assess PTSD severity. We aggregated correlation matrices across studies and then applied confirmatory factor analysis to the aggregated matrices to test the fit of competing models of PTSD symptomatology that have gained support in the literature. Results indicated that both prominent 4-factor models of PTSD symptomatology yielded good model fit across subsamples of studies; however, the model comprising Intrusions, Avoidance, Hyperarousal, and Dysphoria factors appeared to fit better across studies. Results also indicated that the best fitting models were not moderated by measure or sample type. Results are discussed in the context of structural models of PTSD and implications for the diagnostic nosology.",0,0 +6148,"Modular Approach to Therapy for Anxiety, Depression, Trauma, or Conduct Problems in outpatient child and adolescent mental health services in New Zealand: study protocol for a randomized controlled trial","Mental health disorders are common and disabling for young people because of the potential to disrupt key developmental tasks. Implementation of evidence-based psychosocial therapies in New Zealand is limited, owing to the inaccessibility, length, and cost of training in these therapies. Furthermore, most therapies address one problem area at a time, although comorbidity and changing clinical needs commonly occur in practice. A more flexible approach is needed. The Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems (MATCH-ADTC) is designed to overcome these challenges; it provides a range of treatment modules addressing different problems, within a single training program. A clinical trial of MATCH-ADTC in the USA showed that MATCH-ADTC outperformed usual care and standard evidence-based treatment on several clinical measures. We aim to replicate these findings and evaluate the impact of providing training and supervision in MATCH-ADTC to: (1) improve clinical outcomes for youth attending mental health services; (2) increase the amount of evidence-based therapy content; (3) increase the efficiency of service delivery.This is an assessor-blinded multi-site effectiveness randomized controlled trial. Randomization occurs at two levels: (1) clinicians (≥60) are randomized to intervention or usual care; (2) youth participants (7-14 years old) accepted for treatment in child and adolescent mental health services (with a primary disorder that includes anxiety, depression, trauma-related symptoms, or disruptive behavior) are randomly allocated to receive MATCH-ADTC or usual care. Youth participants are recruited from 'mainstream', Māori-specific, and Pacific-specific child and adolescent mental health services. We originally planned to recruit 400 youth participants, but this has been revised to 200 participants. Centralized computer randomization ensures allocation concealment. The primary outcome measures are: (i) the difference in trajectory of change of clinical severity between groups (using the parent-rated Brief Problem Monitor); (ii) clinicians' use of evidence-based treatment procedures during therapy sessions; (iii) total time spent by clinicians delivering therapy.If MATCH-ADTC demonstrates effectiveness it could offer a practical efficient method to increase access to evidence-based therapies, and improve outcomes for youth attending secondary care services.Australian and New Zealand Clinical Trials Registry ACTRN12614000297628 .",0,0 +6149,Parent-child discrepancy in reporting children's post-traumatic stress reactions after a traffic accident,"This study examines possible parent-child discrepancies in the reporting of post-traumatic stress reactions in children after a traffic accident. Sixteen children exposed to the same traffic accident were interviewed about post-traumatic stress reactions at 5 weeks and at 6 months after the event, utilizing the Child Posttraumatic Stress Reaction Index (CPTS-RI). Independently, the parents' reported their child's degree of post-traumatic stress reactions on the CPTS-RI: Parent questionnaire, at the same two times. Clinicians also assessed the children's level of general functioning on the Children's Global Assessment Scale. The children reported significantly more post-traumatic stress reactions than observed by their parents 4 weeks after the accident. The parent-child discrepancy was more pronounced among younger children. The level of children's self-reported post-traumatic stress reactions decreased significantly from the first to the second assessment. At the second assessment, 6 months after the accident, there was no significant parent-child discrepancy observed. The children showed a normal level of functioning despite their post-traumatic stress reactions. The reported parent-child discrepancy indicates that information about children's post-traumatic stress reactions after an accident is best obtained directly from the children.",0,0 +6150,Ethnic/Racial Diversity and Posttraumatic Distress in the Acute Care Medical Setting,"Recent commentary has advocated for epidemiological investigation as a foundational science for understanding disparities in the delivery of mental health care and for the development of early trauma–focused interventions. Few acute care investigations have examined the diversity of ethnic/racial heritages or compared variations in early posttraumatic distress in representative samples of injured trauma survivors. Hospitalized injury survivors at two United States level I trauma centers were randomly approached in order to document linguistic and ethnic/racial diversity. Approximately 12% of patients approached were non–English speaking with 16 languages represented. English speaking, inpatients were screened for posttraumatic stress disorder, peritraumatic dissociative, and depressive symptoms. For 269 English speaking study participants, ethnic/racial group status was clearly categorized into one group for 72%, two groups for 25%, and three groups for 3% of participants. Regression analyses that adjusted for relevant clinical and demographic characteristics revealed that relative to whites, patients from American Indian, African American, Hispanic, and Asian heritages demonstrated significant elevations in one or more posttraumatic symptom clusters. A remarkable diversity of heritages was identified, and posttraumatic distress was elevated in ethnic/racial minority patients. Policy–relevant clinical investigations that combine evidence–based treatments, bilingual/bicultural care–management strategies, and support for trauma center organizational capacity building may be required in order to enhance the quality of mental health care for diverse injured trauma survivors.",0,0 +6151,"Metabolic, autonomic and immune markers for cardiovascular disease in posttraumatic stress disorder","Posttraumatic stress disorder (PTSD) has been associated with significantly greater incidence of heart disease. Numerous studies have indicated that health problems for individuals with PTSD occur earlier in life than in the general population. Multiple mechanistic pathways have been suggested to explain cardiovascular disese (CVD) risk in PTSD, including neurochemical, behavioral, and immunological changes. The present paper is a review of recent research that examines cardiovascular and immune risk profiles of individuals with PTSD. First, we address the relatively new evidence that the constellation of risk factors commonly experienced in PTSD fits the profile of metabolic syndrome. Next we examine the findings concerning hypertension/blood pressure in particular. The literature on sympathetic and parasympathetic responsivity in PTSD is reviewed. Last, we discuss recent findings concerning immune functioning in PTSD that may have a bearing on the high rates of CVD and other illnesses. Our primary goal is to synthesize the existing literature by examining factors that overlap mechanistically to increase the risk of developing CVD in PTSD.",0,0 +6152,Profiles of individuals seeking psychiatric help for psychotic symptoms linked to methamphetamine abuse – baseline results from the MAPS (methamphetamine and psychosis study),"Background: Methamphetamine psychosis (MAP) is commonly encountered in psychiatric emergency rooms (ERs) in North America, and little is known regarding the specific needs of this clientele. Aims: This study aimed at describing the psychiatric and socioeconomic profiles of individuals with co-occurring methamphetamine abuse and psychosis profiles. Method: Two hundred and ninety-five (295) individuals needing psychiatric help for MAP were assessed regarding their socioeconomic situation, their substance abuse patterns, family histories, past psychiatric diagnoses, childhood trauma, and co-occurring disorders of depression, PTSD and antisocial personality disorder. Results: Eighty-seven percent had a family history of mental illness or substance abuse and close to 70% had a previous diagnosis of a mental illness, although only 21% of a psychotic disorder. Antisocial personality disorder, depression, and post-traumatic stress disorder were highly prevalent in our sample. Cluster analyses on methamphetamine (...",0,0 +6153,A latent class analysis of adolescent adverse life events based on a Danish national youth probability sample.,"The aim of this study was to determine if there are meaningful clusters of individuals with similar experiences of adverse life events in a nationally representative sample of Danish adolescents. Latent class analysis (LCA) was used to identify such clusters or latent classes. In addition, the relationships between the latent classes and living arrangements and diagnosis of post-traumatic stress disorder (PTSD) were estimated. A four-class solution was found to be the best description of multiple adverse life events, and the classes were labelled ""Low Risk"", ""Intermediate Risk"", ""Pregnancy"" and ""High Risk"". Compared with the Low Risk class, the other classes were found to be significantly more likely to have a diagnosis PTSD and live with only one parent. This paper demonstrated how trauma research can focus on the individual as the unit of analysis rather than traumatic events.",0,0 +6154,Association of Combatant Status and Sexual Violence With Health and Mental Health Outcomes in Postconflict Liberia,"Liberia's wars since 1989 have cost tens of thousands of lives and left many people mentally and physically traumatized.To assess the prevalence and impact of war-related psychosocial trauma, including information on participation in the Liberian civil wars, exposure to sexual violence, social functioning, and mental health.A cross-sectional, population-based, multistage random cluster survey of 1666 adults aged 18 years or older using structured interviews and questionnaires, conducted during a 3-week period in May 2008 in Liberia.Symptoms of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), social functioning, exposure to sexual violence, and health and mental health needs among Liberian adults who witnessed or participated in the conflicts during the last 2 decades.In the Liberian adult household-based population, 40% (95% confidence interval [CI], 36%-45%; n = 672/1659) met symptom criteria for MDD, 44% (95% CI, 38%-49%; n = 718/1661) met symptom criteria for PTSD, and 8% (95% CI, 5%-10%; n = 133/1666) met criteria for social dysfunction. Thirty-three percent of respondents (549/1666) reported having served time with fighting forces, and 33.2% of former combatant respondents (182/549) were female. Former combatants experienced higher rates of exposure to sexual violence than noncombatants: among females, 42.3% (95% CI, 35.4%-49.1%) vs 9.2% (95% CI, 6.7%-11.7%), respectively; among males, 32.6% (95% CI, 27.6%-37.6%) vs 7.4% (95% CI, 4.5%-10.4%). The rates of symptoms of PTSD, MDD, and suicidal ideation were higher among former combatants than noncombatants and among those who experienced sexual violence vs those who did not. The prevalence of PTSD symptoms among female former combatants who experienced sexual violence (74%; 95% CI, 63%-84%) was higher than among those who did not experience sexual violence (44%; 95% CI, 33%-53%). The prevalence of PTSD symptoms among male former combatants who experienced sexual violence was higher (81%; 95% CI, 74%-87%) than among male former combatants who did not experience sexual violence (46%; 95% CI, 39%-52%). Male former combatants who experienced sexual violence also reported higher rates of symptoms of depression and suicidal ideation. Both former combatants and noncombatants experienced inadequate access to health care (33.0% [95% CI, 22.6%-43.4%] and 30.1% [95% CI, 18.7%-41.6%], respectively).Former combatants in Liberia were not exclusively male. Both female and male former combatants who experienced sexual violence had worse mental health outcomes than noncombatants and other former combatants who did not experience exposure to sexual violence.",0,0 +6155,Self-reported adverse health events following smallpox vaccination in a large prospective study of US military service members,"In December 2002, the Department of Defense re-instituted smallpox vaccination for US military forces following growing concerns that smallpox might be employed as a bioterrorist weapon. More than one million service members have been given the smallpox vaccine since 2002, although there have been concerns about the safety of the vaccine. Using a large self-reported prospective database, this analysis investigated a wide variety of self-reported health outcomes and possible association with smallpox vaccination. After confirming self-reported vaccination history with electronic vaccine data, 40,472 individuals were included in the analyses, 8,793 of whom received the smallpox vaccine and 31,679 who did not. No significant adverse associations between smallpox vaccination and self-reported health outcomes, including mental and physical functioning, cardiovascular diseases, and autoimmune disorders, were found. These findings complement studies that utilize other data sources, such as electronic hospitalization records, and may be reassuring to health care providers and those who receive the smallpox vaccination.",0,0 +6156,Predicting Stabilizing Treatment Outcomes for Complex Posttraumatic Stress Disorder and Dissociative Identity Disorder: An Expertise-Based Prognostic Model,"The purpose of this study was to develop an expertise-based prognostic model for the treatment of complex posttraumatic stress disorder (PTSD) and dissociative identity disorder (DID). We developed a survey in 2 rounds: In the first round we surveyed 42 experienced therapists (22 DID and 20 complex PTSD therapists), and in the second round we surveyed a subset of 22 of the 42 therapists (13 DID and 9 complex PTSD therapists). First, we drew on therapists' knowledge of prognostic factors for stabilization-oriented treatment of complex PTSD and DID. Second, therapists prioritized a list of prognostic factors by estimating the size of each variable's prognostic effect; we clustered these factors according to content and named the clusters. Next, concept mapping methodology and statistical analyses (including principal components analyses) were used to transform individual judgments into weighted group judgments for clusters of items. A prognostic model, based on consensually determined estimates of effect sizes, of 8 clusters containing 51 factors for both complex PTSD and DID was formed. It includes the clusters lack of motivation, lack of healthy relationships, lack of healthy therapeutic relationships, lack of other internal and external resources, serious Axis I comorbidity, serious Axis II comorbidity, poor attachment, and self-destruction. In addition, a set of 5 DID-specific items was constructed. The model is supportive of the current phase-oriented treatment model, emphasizing the strengthening of the therapeutic relationship and the patient's resources in the initial stabilization phase. Further research is needed to test the model's statistical and clinical validity.",0,0 +6157,Preventing Post-Traumatic Stress Disorder Resulting from Military Operations,"Military personnel are at high risk for developing post-traumatic stress disorder (PTSD), historically 10 to 50% of all casualties. The best treatment is to provide an opportunity for rest and ventilation of feelings and then to return the person to duty and to his or her peer group. Preventing the cycle of PTSD from starting and thus decreasing psychiatric casualties is feasible. This can be done by promoting unit cohesion and morale, ensuring that individuals know their jobs, inducing stress during training so individuals will be better prepared to cope, providing realistic information about what to expect in combat, and holding group debriefings immediately after any traumatic event. This paper discusses various models for preventing PTSD and examines future directions for the prevention of PTSD.",0,0 +6158,Post-traumatic stress disorder among survivors two years after the 2010 Mount Merapi volcano eruption: A survey study,"The Mount Merapi volcanic eruption in October 2010 was one of Indonesia's largest and most recent natural disasters. A cross-sectional study was undertaken to measure the psychosocial impact of the eruption on survivors in two locations in Yogyakarta, Java, Indonesia. The Impact of Event Scale Revised was used to assess participants' symptoms of post-traumatic stress disorder. Post-Traumatic Stress Disorder responses and demographic characteristics were compared in both locations by conducting bivariate analysis using Mann-Whitney and t tests. The relative contributions of demographic variables and psychosocial impact were examined using multiple linear regression analyses. Two years after the eruption, survivors from the area closest to the eruption had significantly higher Impact of Event Scale Revised scores than those in the comparison area. In particular, females, adults between the ages of 18 and 59, and people who owned their own home experienced the highest levels of psychosocial impact. Nurses and other health professionals need to be aware of the impact of natural disasters on survivors and develop interventions to help people adjust to the psychosocial impact of these events.",0,0 +6159,Suicide‐Bereaved Children and Adolescents: A Controlled Longitudinal Examination,"The current study examined emotional and behavioral sequelae in children who have experienced parental suicide by completing a secondary analysis of data from the Grief Research Study, a longitudinal study of childhood bereavement.Twenty-six suicide-bereaved (SB) children, aged 5 to 17 years, were compared with 332 children bereaved from parental death not caused by suicide (NSB) in interviews 1, 6, 13, and 25 months after the death. Children's emotional reactions to the death, psychiatric symptomatology, and psychosocial functioning after the parent's death were determined.Grief emotions were common in both groups. SB children were more likely to experience anxiety, anger, and shame than NSB children. SB children were more likely to have preexisting behavioral problems and more behavioral and anxiety symptoms throughout the first 2 years compared with NSB children. Indices of depression, suicidality, and psychosocial functioning differed minimally between groups.SB children experience some ""common"" elements of bereavement. In addition, they demonstrate some lifetime risk factors as well as subsequent pathology that suggests a negative behavioral trajectory. As these cohorts have not yet passed through the age of risk, long-term follow-up is critical.",0,0 +6160,Amygdala Transcriptome and Cellular Mechanisms Underlying Stress-Enhanced Fear Learning in a Rat Model of Posttraumatic Stress Disorder,"Severe stress or trauma can cause permanent changes in brain circuitry, leading to dysregulation of fear responses and the development of posttraumatic stress disorder (PTSD). To date, little is known about the molecular mechanisms underlying stress-induced long-term plasticity in fear circuits. We addressed this question by using global gene expression profiling in an animal model of PTSD, stress-enhanced fear learning (SEFL). A total of 15 footshocks were used to induce SEFL and the volatile anesthetic isoflurane was used to suppress the behavioral effects of stress. Gene expression in lateral/basolateral amygdala was measured using microarrays at 3 weeks after the exposure to different combinations of shock and isoflurane. Shock produced robust effects on amygdalar transcriptome and isoflurane blocked or reversed many of the stress-induced changes. We used a modular approach to molecular profiles of shock and isoflurane and built a network of regulated genes, functional categories, and cell types that represent a mechanistic foundation of perturbation-induced plasticity in the amygdala. This analysis partitioned perturbation-induced changes in gene expression into neuron- and astrocyte-specific changes, highlighting a previously underappreciated role of astroglia in amygdalar plasticity. Many neuron-enriched genes were highly correlated with astrocyte-enriched genes, suggesting coordinated transcriptional responses to environmental challenges in these cell types. Several individual genes were validated using RT-PCR and behavioral pharmacology. This study is the first to propose specific cellular and molecular mechanisms underlying SEFL, an animal model of PTSD, and to nominate novel molecular and cellular targets with potential for therapeutic intervention in PTSD, including glycine and neuropeptide systems, chromatin remodeling, and gliotransmission.",0,0 +6161,Assessment of PTSD symptoms in a community exposed to serial murder,"This study examined the presence of PTSD symptoms across time in a community exposed to serial murder. One hundred eighty four subjects (48% response rate) responded to the initial survey while 64 and 30 subjects, respectively, participated in the 9- and 18-month follow-up studies. Results indicated widespread endorsement of PTSD symptoms following the murders. The most severe reactions were found among residents demographically similar to the victims. PTSD symptoms, while not transient, appeared to decrease over time with few subjects still reporting symptoms at 18 months. These data suggest that violent acts such as serial murder can have far reaching psychological consequences for the community and result in vicarious victimization. © 1997 John Wiley & Sons, Inc. J Clin Psychol 53: 809–815, 1997",0,0 +6162,Prazosin for Military Combat-Related PTSD Nightmares: A Critical Review,"Military combat is a common trauma experience associated with posttraumatic stress disorder (PTSD). Trauma-related nightmares are a hallmark symptom of PTSD. They can be resistant to label-pharmacological PTSD treatment, and they are associated with a variety of adverse health outcomes. The purpose of this article is to review and evaluate prazosin therapy for combat-related PTSD nightmares. Consistent with available literature for all-causes PTSD nightmares, prazosin is an effective off-label option for combat-related PTSD nightmares. Future trials may further instruct use in specific combat-exposure profiles.",0,0 +6163,Does abortion increase women's risk for post-traumatic stress? Findings from a prospective longitudinal cohort study,"To prospectively assess women's risk for post-traumatic stress disorder (PTSD) and of experiencing post-traumatic stress symptoms (PTSS) over 4 ears after seeking an abortion, and to assess whether symptoms are attributed to the pregnancy, abortion or birth, or other events in women's lives.Prospective longitudinal cohort study which followed women from approximately 1 week after receiving or being denied an abortion (baseline), then every 6 months for 4 years (9 interview waves).30 abortion facilities located throughout the USA.Among 956 women presenting for abortion care, some of whom received an abortion and some of whom were denied due to advanced gestational age; 863 women are included in the longitudinal analyses.PTSS and PTSD risk were measured using the Primary Care PTSD Screen (PC-PTSD). Index pregnancy-related PTSS was measured by coding the event(s) described by women as the cause of their symptoms.We used unadjusted and adjusted logistic mixed-effects regression analyses to assess whether PTSS, PTSD risk and pregnancy-related PTSS trajectories of women obtaining abortions differed from those who were denied one.At baseline, 39% of participants reported any PTSS and 16% reported three or more symptoms. Among women with symptoms 1-week post-abortion seeking (n=338), 30% said their symptoms were due to experiences of sexual, physical or emotional abuse or violence; 20% attributed their symptoms to non-violent relationship issues; and 19% said they were due to the index pregnancy. Baseline levels of PTSS, PTSD risk and pregnancy-related PTSS outcomes did not differ significantly between women who received and women who were denied an abortion. PTSS, PTSD risk and pregnancy-related PTSS declined over time for all study groups.Women who received an abortion were at no higher risk of PTSD than women denied an abortion.",0,0 +6164,Health and environmental consequences of the world trade center disaster.,"The attack on the World Trade Center (WTC) created an acute environmental disaster of enormous magnitude. This study characterizes the environmental exposures resulting from destruction of the WTC and assesses their effects on health. Methods include ambient air sampling; analyses of outdoor and indoor settled dust; high-altitude imaging and modeling of the atmospheric plume; inhalation studies of WTC dust in mice; and clinical examinations, community surveys, and prospective epidemiologic studies of exposed populations. WTC dust was found to consist predominantly (95%) of coarse particles and contained pulverized cement, glass fibers, asbestos, lead, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and polychlorinated furans and dioxins. Airborne particulate levels were highest immediately after the attack and declined thereafter. Particulate levels decreased sharply with distance from the WTC. Dust pH was highly alkaline (pH 9.0-11.0). Mice exposed to WTC dust showed only moderate pulmonary inflammation but marked bronchial hyperreactivity. Evaluation of 10,116 firefighters showed exposure-related increases in cough and bronchial hyperreactivity. Evaluation of 183 cleanup workers showed new-onset cough (33%), wheeze (18%), and phlegm production (24%). Increased frequency of new-onset cough, wheeze, and shortness of breath were also observed in community residents. Follow-up of 182 pregnant women who were either inside or near the WTC on 11 September showed a 2-fold increase in small-for-gestational-age (SGA) infants. In summary, environmental exposures after the WTC disaster were associated with significant adverse effects on health. The high alkalinity of WTC dust produced bronchial hyperreactivity, persistent cough, and increased risk of asthma. Plausible causes of the observed increase in SGA infants include maternal exposures to PAH and particulates. Future risk of mesothelioma may be increased, particularly among workers and volunteers exposed occupationally to asbestos. Continuing follow-up of all exposed populations is required to document the long-term consequences of the disaster.",0,0 +6165,Psychiatric Comorbidity and Perceived Alcohol Stigma in a Nationally Representative Sample of Individuals with DSM-5 Alcohol Use Disorder,"Background Alcohol use disorder (AUD) is among the most stigmatized health conditions and is frequently comorbid with mood, anxiety, and drug use disorders. Theoretical frameworks have conceptualized stigma-related stress as a predictor of psychiatric disorders. We described profiles of psychiatric comorbidity among people with AUD and compared levels of perceived alcohol stigma across profiles. Methods Cross-sectional data were analyzed from a general population sample of U.S. adults with past-year DSM-5 AUD (n = 3,368) from the National Epidemiologic Survey on Alcohol and Related Conditions, which was collected from 2001 to 2005. Empirically derived psychiatric comorbidity profiles were established with latent class analysis, and mean levels of perceived alcohol stigma were compared across the latent classes while adjusting for sociodemographic characteristics and AUD severity. Results Four classes of psychiatric comorbidity emerged within this AUD sample, including those with: (i) high comorbidity, reflecting internalizing (i.e., mood and anxiety disorders) and externalizing (i.e., antisocial personality and drug use disorders) disorders; (ii) externalizing comorbidity; (iii) internalizing comorbidity; and (iv) no comorbidity. Perceived alcohol stigma was significantly higher in those with internalizing comorbidity (but not those with high comorbidity) as compared to those with no comorbidity or externalizing comorbidity. Conclusions Perceived stigma, as manifested by anticipations of social rejection and discrimination, may increase risk of internalizing psychiatric comorbidity. Alternatively, internalizing psychiatric comorbidity could sensitize affected individuals to perceive more negative attitudes toward them. Future research is needed to understand causal and bidirectional associations between alcohol stigma and psychiatric comorbidity.",0,0 +6166,An investigation of relations between crystal methamphetamine use and posttraumatic stress disorder,"Evidence documents elevated rates of various types of drug use among people with posttraumatic stress disorder (PTSD). However, relatively little research has specifically examined crystal methamphetamine (CM) use among individuals with PTSD. The present study examined the relation between PTSD diagnostic status, PTSD symptom severity within symptom type clusters, and CM use histories among traumatic event-exposed individuals with versus without PTSD. Consistent with expectations, individuals with PTSD were significantly more likely to report CM use than trauma-exposed individuals without PTSD. Additionally, CM users with PTSD reported a longer duration of CM use than trauma-exposed CM users without PTSD. Finally, PTSD avoidance and hyperarousal symptoms, but not re-experiencing, were related to CM use. The potential clinical and research implications of the findings are discussed.",0,0 +6167,Behavioral inhibition and PTSD symptoms in veterans,"Behavioral inhibition (BI), a temperamental bias to respond to novel stimuli with avoidance behaviors, is a risk factor for posttraumatic stress disorder (PTSD). It is unclear whether BI accounts for additional variance in PTSD symptom severity beyond that accounted for by general anxiety. Here, 109 veterans (mean age 50.4 years, 9.2% female) provided self-assessment of PTSD symptoms, state and trait anxiety, combat exposure, and current (adult) and retrospective (childhood) BI. Adult BI was correlated with anxiety and PTSD symptom severity, especially cluster C (avoidance) symptoms, but not with combat exposure. A regression model including adult BI, state and trait anxiety, and combat exposure was able to correctly classify over 80% of participants according to presence or absence of severe PTSD symptoms. Because avoidance behaviors are a core component of PTSD, self-assessments of BI may be an important tool in understanding PTSD and potentially assessing vulnerability to the disorder.",0,0 +6168,Diagnosing attention-deficit hyperactivity disorder (ADHD) in children involved with child protection services: are current diagnostic guidelines acceptable for vulnerable populations?,"Children involved with child protection services (CPS) are diagnosed and treated for attention-deficit hyperactivity disorder (ADHD) at higher rates than the general population. Children with maltreatment histories are much more likely to have other factors contributing to behavioural and attentional regulation difficulties that may overlap with or mimic ADHD-like symptoms, including language and learning problems, post-traumatic stress disorder, attachment difficulties, mood disorders and anxiety disorders. A higher number of children in the child welfare system are diagnosed with ADHD and provided with psychotropic medications under a group care setting compared with family-based, foster care and kinship care settings. However, children's behavioural trajectories change over time while in care. A reassessment in the approach to ADHD-like symptoms in children exposed to confirmed (or suspected) maltreatment (e.g. neglect, abuse) is required. Diagnosis should be conducted within a multidisciplinary team and practice guidelines regarding ADHD diagnostic and management practices for children in CPS care are warranted both in the USA and in Canada. Increased education for caregivers, teachers and child welfare staff on the effects of maltreatment and often perplexing relationship with ADHD-like symptoms and co-morbid disorders is also necessary. Increased partnerships are needed to ensure the mental well-being of children with child protection involvement.",0,0 +6169,Course of recovery for whiplash associated disorders in a compensation setting,"The detailed course of recovery following compensable whiplash associated disorders (WAD) is not well understood. Some people recover within months and others report symptoms for extended periods. Recent research identified distinct recovery pathways. Identifying recovery pathways for people with this condition in compensable settings could assist clinical and claim management.This study aimed to identify recovery trajectories based on disability, pain catastrophising and mental health and, secondly, to examine developmental linkages between the trajectories.A cohort of 246 people with compensable WAD were followed for 24 months after a motor vehicle related injury.Functional Rating Index (FRI), Pain Catastrophising Scale (PCS) and the SF36 Mental Component Score (SF 36 MCS).Group-based trajectory analytical techniques were used to identify distinct post-injury profiles. Multinominal logistic regression modelling identified factors associated with membership of different trajectories.246 people were enrolled a median of 72 days after injury. Three trajectories were identified for the measures used and their prevalences, respectively, were: for disability (FRI) they were mild (47%), moderate (31%), and severe (22%); for pain catastrophising (PCS) they were non-catastrophisers (55%), moderate-low catastrophisers (32%) and clinically significant catastrophisers (13%); and, for mental health (SF36 MCS) they were good mental health (40%), moderately low mental health (42%) and severely low mental health (18%). All groups showed no further recovery beyond 12 months after injury. The significant baseline predictors of the severe disability trajectory were: lower (that means worse) bodily pain scores (SF 36 BPS) (p≤0.01); high pain catastrophising (p≤0.01); and, self-reported fair or poor general health (p=0.03). Conditional probabilities for group membership showed that the three trajectories for both PCS and FRI were linked. Dual membership was high for the mild disability and mild pain catastrophising trajectories and, for the severe disability and clinically significant pain catastrophising trajectories.There is a strong and plausible association between severe disability, clinical levels of pain catastrophising and low mental health. Claimants can be identified at claim notification based on three estimated recovery trajectories. Claim and clinical interventions can be targeted to the profile within each recovery trajectory.",0,0 +6170,Coping with spinal cord injury: Tenacious goal pursuit and flexible goal adjustment,"To investigate the correlation of higher-order coping strategies of tenacious goal pursuit and flexible goal adjustment with adjustment after rehabilitation in spinal cord injury.Cross-sectional correlational study.All 397 eligible patients entered for spinal cord rehabilitation between 1999 and 2009 were contacted and 130 (33%) agreed to complete a self-report questionnaire.Partial correlations were computed between tenacious goal pursuit and flexible goal adjustment and affective and cognitive psychological adjustment. Demographics, spinal cord injury related variables, social support and coping were used as control variables.After controlling for relevant demographic, medical and social support indices, partial correlations between tenacious goal pursuit and indices of adaptation were not significant. Significant partial correlations were observed between flexible goal adjustment and each of the indices of adjustment (r = -0.33, -0.42, 0.51, -0.38, respectively, for depression, anxiety, acceptance, and helplessness) after controlling for all relevant variables in the model. Flexible goal adjustment explained significant additional proportions of variance for each of the adjustment indices (7%, 11%, 18%, and 7%, respectively).Flexible goal adjustment, but not tenacious goal pursuit, is associated with psychological adjustment in spinal cord injury. Further research is needed to understand the mechanisms of flexible goal adjustment. Interventions targeting flexible goal adjustment might be of benefit for the patient.",0,0 +6171,The Course of Serum Inflammatory Biomarkers Following Whiplash Injury and Their Relationship to Sensory and Muscle Measures: a Longitudinal Cohort Study,"Tissue damage or pathological alterations are not detectable in the majority of people with whiplash associated disorders (WAD). Widespread hyperalgisa, morphological muscle changes and psychological distress are common features of WAD. However little is known about the presence of inflammation and its association with symptom persistence or the clinical presentation of WAD. This study aimed to prospectively investigate changes in serum inflammatory biomarker levels from the acute (<3 weeks) to chronic (>3 months) stages of whiplash injury. It also aimed to determine relationships between biomarker levels and hyperalgesia, fatty muscle infiltrates of the cervical extensors identified on MRI and psychological factors. 40 volunteers with acute WAD and 18 healthy controls participated. Participants with WAD were classified at 3 months as recovered/mild disability or having moderate/severe disability using the Neck Disability Index. At baseline both WAD groups showed elevated serum levels of CRP but by 3 months levels remained elevated only in the moderate/severe group. The recovered/mild disability WAD group had higher levels of TNF-α at both time points than both the moderate/severe WAD group and healthy controls. There were no differences found in serum IL-1β. Moderate relationships were found between hyperalgesia and CRP at both time points and between hyperalgesia and IL-1β 3 months post injury. There was a moderate negative correlation between TNF-α and amount of fatty muscle infiltrate and pain intensity at 3 months. Only a weak relationship was found between CRP and pain catastrophising and no relationship between biomarker levels and posttraumatic stress symptoms. The results of the study indicate that inflammatory biomarkers may play a role in outcomes following whiplash injury as well as being associated with hyperalgesia and fatty muscle infiltrate in the cervical extensors.",0,0 +6172,Risk Factors for Psychological Maladjustment of Parents of Children With Cancer,"Objective To examine risk variables for future, more immediate, and persistent psychological distress of parents of pediatric cancer patients. Method Parents (n = 128) completed questionnaires at the time of diagnosis (T1) and 12 months later (T2). Multiple regression analyses were performed using the following as predictors: demographics, illness-related variables, other life events, personality, coping styles, and social support. Results Trait anxiety was the strongest predictor of both fathers' and mothers' future distress. Changes in trait anxiety during the year also accompanied changes in both parents' levels of distress. Additional prospective predictors for fathers were the coping style “social support-seeking” and dissatisfaction with support. Dissatisfaction with support also had short-term effects for fathers. An additional prospective predictor for mothers was the number of pleasant events they had experienced prior to diagnosis, while a short-term effect was found for performance in assertiveness. No predictors for the persistence of distress were found. Conclusions These results underscore the importance of personality anxiety in predicting parents' risk for adjustment difficulties associated with the experience of cancer in one's child. An additional risk factor for fathers was social support. For mothers, previously experienced life events and the frequency of assertive behavior were additional risk factors.",0,0 +6173,"Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001–05: an epidemiological survey","In China and other middle-income countries, neuropsychiatric conditions are the most important cause of ill health in men and women, but efforts to scale up mental health services have been hampered by the absence of high-quality, country-specific data for the prevalence, treatment, and associated disability of different types of mental disorders. We therefore estimated these variables from a series of epidemiological studies that were done in four provinces in China.We used multistage stratified random sampling methods to identify 96 urban and 267 rural primary sampling sites in four provinces of China; the sampling frame of 113 million individuals aged 18 years or older included 12% of the adult population in China. 63 004 individuals, identified with simple random selection methods at the sampling sites, were screened with an expanded version of the General Health Questionnaire and 16,577 were administered a Chinese version of the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV axis I disorders by a psychiatrist.The adjusted 1-month prevalence of any mental disorder was 17.5% (95% CI 16.6-18.5). The prevalence of mood disorders was 6.1% (5.7-6.6), anxiety disorders was 5.6% (5.0-6.3), substance abuse disorders was 5.9% (5.3-6.5), and psychotic disorders was 1.0% (0.8-1.1). Mood disorders and anxiety disorders were more prevalent in women than in men, and in individuals 40 years and older than in those younger than 40 years. Alcohol use disorders were 48 times more prevalent in men than in women. Rural residents were more likely to have depressive disorders and alcohol dependence than were urban residents. Among individuals with a diagnosable mental illness, 24% were moderately or severely disabled by their illness, 8% had ever sought professional help, and 5% had ever seen a mental health professional.Substantial differences between our results and prevalence, disability, and treatment rate estimates used in the analysis of global burden of disease for China draw attention to the need for low-income and middle-income countries to do detailed, country-specific situation analyses before they scale up mental health services.China Medical Board of New York, WHO, and Shandong Provincial Bureau of Health.",0,0 +6174,Retrieval and emotional processing of traumatic memories in posttraumatic stress disorder: Peripheral and central correlates,"Posttraumatic stress disorder (PTSD) is thought to be characterized by dysfunctional memory processes, i.e., the automatic re-experiencing of the traumatic event and the inability to consciously recall facts about the traumatic event, as well as altered emotional processing of trauma-relevant cues. The present study examined the cerebral mechanisms underlying the cued recall of trauma-specific memories and the emotional processing of the presented cues in 16 PTSD patients, 15 trauma-exposed subjects without PTSD and 16 healthy controls. Subjects received questions about their specific trauma as well as other disastrous and neutral events while the electroencephalogram and heart rate were measured. The PTSD patients showed no impairment in trauma-specific declarative memory compared to non-PTSD subjects but had some deficits in general declarative memory as assessed by the Wechsler Memory Scale-Revised. Compared to healthy control subjects, PTSD patients displayed increased P300 and late positive complex amplitudes to trauma-specific questions, indicating enhanced emotional processing of these cues. In line with their behavioral performance, both trauma-exposed groups showed decreased terminal contingent negative variation amplitudes to trauma-specific questions over frontal electrodes reflecting altered memory retrieval. Within-group comparisons revealed that only the PTSD group but not the other groups showed a differentiation between trauma-specific and neutral questions with respect to the LPC, tCNV and P300. Concordantly with previous studies, PTSD patients showed elevated resting heart rate compared to the healthy controls. These findings are discussed in the context of current models of the role of declarative memory in the development and maintenance of PTSD.",0,0 +6175,Characteristics of difficult-to-place youth in state custody: a profile of the Exceptional Care Pilot Project population.,"This study examines the characteristics of Texas youth designated as 'most difficult to place' recipients of service under the Exceptional Care Pilot Project (N = 46). Findings include, among others, high levels of comorbid psychiatric disturbance (> 3 diagnostic groupings), physical (78.3%) and sexual (88%) maltreatment, and placement breakdowns (m = 4.8 therapeutic placements). This initial profile of the population provides a base for helping other states identify and plan for the needs of their most troubled youth.",0,0 +6176,The role of shame and self-critical thinking in the development and maintenance of current threat in post-traumatic stress disorder,"There is increasing recognition of emotions other than fear in post-traumatic stress disorder (PTSD), and recent research has looked at the role of shame. Cognitive theory suggests that PTSD is caused by traumatic experiences being processed in a way that causes ongoing current threat. In this paper we suggest that shame might contribute to the creation/maintenance of ongoing current threat as it attacks an individual's psychological integrity. A correlational design was used to investigate some of the factors that might contribute to a shame response within a PTSD sample. It was hypothesized that individuals with PTSD who report higher levels of shame would be more prone to engage in self-critical thinking and less prone to engage in self-reassuring thinking than individuals with PTSD who report lower levels of shame. Data were gathered using self-report questionnaires, and results supported the hypotheses. It is suggested therapy for shame-based PTSD needs to incorporate strategies to help individuals develop inner caring, compassion and self-reassurance.",0,0 +6177,Toward a Typology of High-Risk Major Stressful Events and Situations in Posttraumatic Stress Disorder and Related Psychopathology,"The diagnosis of posttraumatic stress disorder (PTSD) was introduced in 1980 with the publication of the Diagnostic and Statistical Manual of the American Psychiatric Association, Third Edition (DSM-III). DSM-III put forward a novel syndrome consisting of intrusive, avoidance/numbing, and arousal symptoms as distinctive psychopathology following exposure to traumatic events. The traumatic stressors, although expanded in later editions published in 1987 (DSM-III-R) and 1994 (DSM-IV), focus on life-threatening events and situations. However, at least 12 studies, most of them recent, have found associations between the PTSD symptoms and the PTSD symptom syndrome with stressors, such as unemployment and divorce that would not qualify, even in the broadened DSM-IV diagnosis, as traumatic stressors. These findings challenge the basic assumption on which the PTSD diagnosis is based, the assumption that exposure to life-threatening stressors is the primary cause of a unique set of stress response symptoms. The purpose of this paper is to show how to confront this challenge by developing a typology of stressful situations and events that can be tested systematically for their relation to the PTSD symptom syndrome and other relevant variables. The typology includes but is not limited to the types of situations and events defined as “traumatic” in the DSMs.",0,0 +6178,No morning cortisol response in patients with severe global amnesia,"Activity of the hypothalamus pituitary adrenal (HPA) axis is characterized by a pronounced circadian rhythm. An acute increase in cortisol levels occurs after awakening in the morning with continuously declining levels over the course of the remaining day. The morning cortisol increase probably reflects an activational response of the HPA axis aimed at preparing the body for the day. Some studies found patterns of enhanced or blunted waking cortisol responses observed under chronic stress, burnout, or post traumatic stress disorder. The present study wanted to characterize the morning cortisol response and the circadian cortisol day profile in a sample of six male patients with severe amnesia due to hypoxia, herpes simplex encephalitis or closed head injury. Age and gender matched relatives or friends served as controls. Cortisol was measured from saliva samples collected at home on two consecutive days. The patients were woken up in the morning by their partners or caregivers. The morning cortisol increase typically observed in healthy subjects and also observed in the control group was absent in the amnesic patients. In contrast, a normal circadian day profile was found in the amnesic patients, with a pronounced circadian cortisol decrease. Further studies are needed to understand the neurological or psychological mechanisms leading to a missing morning cortisol response in amnesic patients.",0,0 +6179,Impact of childhood maltreatment on physical health-related quality of life in U.S. active duty military personnel and combat veterans,"Previous studies have found an association between childhood maltreatment (CM) and health-related quality of life (HRQoL), and to a lesser extent have considered whether psychiatric symptoms may explain the relationship. This study aimed to further our understanding of the link between CM and HRQoL by testing whether posttraumatic stress disorder (PTSD) or depressive symptoms mediate the relationship between childhood maltreatment and physical HRQoL. Mediation models were examined in a sample of male Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) active duty and combat veterans (n=249). PTSD and depressive symptoms mediated the relationship between CM and overall physical HRQoL, as well as participation in daily activities due to physical health, bodily pain, and social functioning. Mediation of the relationship between childhood maltreatment and physical and social functioning by depression and PTSD symptoms may lend support to neurobiological hypotheses that childhood maltreatment sensitizes the nervous system and after repeated trauma may lead to the development of psychiatric symptoms, which have a major impact on morbidity and mortality.",0,0 +6180,"PTSD in ICD-10 and proposed ICD-11 in elderly with childhood trauma: prevalence, factor structure, and symptom profiles","Background : The proposal for ICD-11 postulates major changes for posttraumatic stress disorder (PTSD) diagnosis, which needs investigation in different samples. Aims : To investigate differences of PTSD prevalence and diagnostic agreement between ICD-10 and ICD-11, factor structure of proposed ICD-11 PTSD, and diagnostic value of PTSD symptom severity classes. Method : Confirmatory factor analysis and latent profile analysis were used on data of elderly survivors of childhood trauma (>60 years, N =399). Results : PTSD rates differed significantly between ICD-10 (15.0%) and ICD-11 (10.3%, z =2.02, p= 0.04). Unlike previous research, a one-factor solution of ICD-11 PTSD had the best fit in this sample. High symptom profiles were associated with PTSD in ICD-11. Conclusions : ICD-11 concentrates on PTSD’s core symptoms and furthers clinical utility. Questions remain regarding the tendency of ICD-11 to diagnose mainly cases with severe symptoms and the influence of trauma type and participant age on the factor structure. Keywords: Latent class analysis; childhood abuse; World War II; institutional abuse; long term consequences; trauma severity (Published: 21 January 2016) Responsible Editor: Anke Ehlers, University of Oxford, United Kingdom. For the abstract or full text in other languages, please see Supplementary files in the column to the right (under ‘Article Tools’). Citation: European Journal of Psychotraumatology 2016, 7 : 29700 - http://dx.doi.org/10.3402/ejpt.v7.29700",0,0 +6181,Post-traumatic stress disorder in children exposed to violence.,"To investigate to what extent local children exposed to community violence develop post-traumatic stress disorder (PTSD), whether the symptom profile is typical or atypical, and how detection can be improved.A cross-sectional study of two samples of children with a high risk of past exposure to violence.Sixty Xhosa-speaking children aged 10-16 years; 30 from the Children's Home which serves Khayelitsha, and 30 from a school in a violent area of Khayelitsha.A shortened version of the Survey of Exposure to Community Violence (SECV) was administered to determine exposure to violence. Structured questionnaires and a clinical assessment were used to elicit symptoms and make psychiatric diagnoses.All 60 children reported exposure to indirect violence, 57 (95%) had witnessed violence, and 34 (56%) had experienced violence themselves. Twenty-four (40%) met the criteria for on or more DSM-III-R diagnoses and 13 (21.7%) met the criteria for PTSD.Community violence places children at a high risk of developing serious psychiatric disorders and many children develop PTSD. None of the children in the school sample had received intervention prior to the study, pointing towards an urgent need for increased community and professional awareness of children at risk.",0,0 +6182,Early predictors of posttraumatic stress disorder,The benefits of providing early intervention for people recently exposed to trauma have highlighted the need to develop means to identify people who will develop chronic posttraumatic stress disorder (PTSD). This review provides an overview of prospective studies that have indexed the acute reactions to trauma that are predictive of chronic posttraumatic stress disorder. Ten studies of the predictive power of the acute stress disorder diagnosis indicate that this diagnosis does not have adequate predictive power. There is no convergence across studies on any constellation of acute symptoms that predict posttraumatic stress disorder. A review of biological and cognitive mechanisms occurring in the acute posttraumatic phase suggests that these factors may provide more accurate means of predicting chronic posttraumatic stress disorder. Recommendations for future research to facilitate identification of key markers of acutely traumatized people who will develop posttraumatic stress disorder are discussed.,0,0 +6183,Predictors of PTSD in injured trauma survivors: a prospective study,"The aim of this study was to prospectively examine the relationship between immediate and short-term responses to a trauma and the subsequent development of posttraumatic stress disorder (PTSD).All patients consecutively admitted to a general hospital were screened for the presence of physical injury due to a traumatic event. Fifty-one eligible subjects were assessed 1 week and 6 months after the trauma. The initial assessment included measures of event severity, peritraumatic dissociation, and symptoms of intrusion, avoidance, depression, and anxiety. The follow-up assessments added the PTSD module of the Structured Clinical Interview for DSM-III-R--Non-Patient Version and the civilian trauma version of the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder.Thirteen subjects (25.5%) met PTSD diagnostic criteria at follow-up. Subjects who developed PTSD had higher levels of peritraumatic dissociation and more severe depression, anxiety, and intrusive symptoms at the 1-week assessment. Peritraumatic dissociation predicted a diagnosis of PTSD after 6 months over and above the contribution of other variables and explained 29.4% of the variance of PTSD symptom intensity. Initial scores on the Impact of Event Scale predicted PTSD status with 92.3% sensitivity and 34.2% specificity. Symptoms of avoidance that were initially very mild intensified in the subjects who developed PTSD.Peritraumatic dissociation is strongly associated with the later development of PTSD. Early dissociation and PTSD symptoms can help the clinician identify subjects at higher risk for developing PTSD.",0,0 +6184,Outcome of Head and Other Injuries among Israeli Children: Physical Limitations and Stress Symptoms,"BACKGROUND: Head injuries, especially in young children, are frequent and may cause long-lasting impairments. OBJECTIVES: To investigate the outcome of head and other injuries caused by diverse mechanisms and of varied severity. METHODS: The study population consisted of Jews and Arabs (n=792), aged 0-17 years old, hospitalized for injuries in six hospitals in Israel. Caregivers were interviewed during hospitalization regarding circumstances of the injury and sociodemographic variables. Information on injury mechanism, profile and severity, and length of hospitalization was gathered from the medical files. Five months post-injury the caregivers were interviewed by phone regarding physical limitations and stress symptoms. RESULTS: Head injuries occurred in 60% of the children, and of these, 22.2% suffered traumatic brain injury with loss of consciousness (type 1). Among the rest, 22% of Jewish children and 28% of Arab children remained with at least one activity limitation, and no statistically significant differences were found among those with head or other injuries. The odds ratio for at least two stress symptoms was higher for children involved in transport-related injuries (OR 2.70, 95% confidence interval 1.38-5.28) than for other mechanisms, controlling for injury profile. No association was found between stress symptoms and injury severity. CONCLUSIONS: Most children had recovered by 5 months after the injury. Residual activity limitations were no different between those with head or with other injuries. Stress symptoms were related to transport-related injuries, but not to the presence of TBI or injury severity. Language: en",0,0 +6185,Stress-induced alterations in anxiety-like behavior and adaptations in plasticity in the bed nucleus of the stria terminalis,"In vulnerable individuals, exposure to stressors can result in chronic disorders such as generalized anxiety disorder (GAD), major depressive disorder (MDD), and post-traumatic stress disorder (PTSD). The extended amygdala is critically implicated in mediating acute and chronic stress responsivity and anxiety-like behaviors. The bed nucleus of the stria terminalis (BNST), a subregion of the extended amygdala, serves as a relay of corticolimbic information to the paraventricular nucleus of the hypothalamus (PVN) to directly influence the stress response. To investigate the influence of the corticosteroid milieu and housing conditions on BNST function, adult C57Bl/6J were either acutely or chronically administered corticosterone (CORT, 25mg/kg in sesame oil) or vehicle (sesame oil) or were group housed or socially isolated for 1 day (acute) or 6-8 weeks (chronic). To ascertain whether these stressors could influence anxiety-like behavior, studies were performed using the novel open-field (NOF) and the elevated zero maze (EZM) tests. To investigate potential associated changes in plasticity, alterations in BNST function were assessed using ex vivo extracellular field potential recordings in the (dorsal-lateral) dlBNST and a high frequency stimulus protocol to induce long-term potentiation (LTP). Our results suggest that chronic CORT injections and chronic social isolation housing conditions lead to an increase in anxiety-like behavior on the EZM and NOF. Chronically stressed mice also displayed a parallel blunting of LTP in the dlBNST. Conversely, acute social isolation housing had no effect on anxiety-like behavior but still resulted in a blunting of LTP in the dlBNST. Collectively, our results suggest acute and chronic stressors can have a distinct profile on plasticity in the BNST that is not uniformly associated with an increase in anxiety-like behavior.",0,0 +6186,Methodological Basis of a Culture-Specific Coping Approach,"In mainstream psychology, rather specific (and therefore restrictive) research perspectives on coping with disaster dominate. Research uses quantitative methods to build knowledge about the mechanisms and conditions by which disasters affect mental health. The focus of analysis is on measures of individual differences with regard to experiences, coping strategies, and mental health outcomes. Developing generalizable and, potentially, universally applicable models is a major research interest. We argue that methodologies used in mainstream psychologies are not compatible with the purposes of our approach-that is, to describe sociocultural-specific personal and communal long-term coping dynamics after a disaster. We argue that a cultural-psychological approach implies specific propositions about human subjectivity, human agency, and research methods. Previously prominent, restrictive epistemological approaches to coping with disasters need to be broadened by rethinking research units, allowing for complex interrelations instead of assuming a linear causal process, being process-oriented, and including power-critical investigations. This chapter ends with a presentation of the methodological approach used in our case study, which we believe exemplifies alternatives to mainstream psychological research in disaster contexts. © 2014 Springer Science+Business Media, LLC. All rights are reserved.",0,0 +6187,African Americans and anxiety disorders research: Development of a testable theoretical framework.,"The past decade has witnessed a tremendous growth in the population of minorities in this country. As this segment of the population has grown, psychology has slowly begun to realize the need to examine the presentation of psychological symptoms among minorities as well as the response of minorities to traditional psychological treatment. While several investigations have been conducted to date, the results are far from consistent. Some studies have demonstrated marked differences in the symptom profiles and treatment responses of minorities as compared with Whites, while others have found little, if any, differences. A major contributing factor to such inconsistent results may be that research in this area has typically proceeded in the absence of a testable theoretical framework. This review examines research conducted with a specific minority population, African Americans, suffering with a DSM anxiety disorder. We first examine the epidemiological and treatment outcome studies in an effort to ascertain the consistencies and inconsistencies that exist within the literature. More importantly, we then provide a preliminary theoretical framework that not only accounts for the discrepant findings, but also allows investigators to generate testable hypotheses regarding the manifestation and presentation of anxious symptoms, and to evaluate the efficacy of psychological interventions among African Americans. We conclude with suggestions for future investigations in this area.",0,0 +6188,Annual Research Review: The experience of youth with political conflict - challenging notions of resilience and encouraging research refinement,"Drawing on empirical studies and literature reviews, this paper aims to clarify and qualify the relevance of resilience to youth experiencing political conflict. It focuses on the discordance between expectations of widespread dysfunction among conflict-affected youth and a body of empirical evidence that does not confirm these expectations.The expectation for widespread dysfunction appears exaggerated, relying as it does on low correlations and on presumptions of universal response to adversity. Such a position ignores cultural differences in understanding and responding to adversity, and in the specific case of political conflict, it does not account for the critical role of ideologies and meaning systems that underlie the political conflict and shape a young people's interpretation of the conflict, and their exposure, participation, and processing of experiences. With respect to empirical evidence, the findings must be viewed as tentative given the primitive nature of research designs: namely, concentration on violence exposure as the primary risk factor, at the expense of recognizing war's impact on the broader ecology of youth's lives, including disruptions to key economic, social, and political resources; priority given to psychopathology in the assessment of youth functioning, rather than holistic assessments that would include social and institutional functioning and fit with cultural and normative expectations and transitions; and heavy reliance on cross-sectional, rather than longitudinal, studies.Researchers and practitioners interested in employing resilience as a guiding construct will face such questions: Is resilience predicated on evidence of competent functioning across the breadth of risks associated with political conflict, across most or all domains of functioning, and/or across time? In reality, youth resilience amidst political conflict is likely a complex package of better and poorer functioning that varies over time and in direct relationship to social, economic, and political opportunities. Addressing this complexity will complicate the definition of resilience, but it confronts the ambiguities and limitations of work in cross-cultural contexts.",0,0 +6189,The Locus Coeruleus-Noradrenergic System and Stress: Implications for Post-Traumatic Stress Disorder,"Stress is associated with the activation of a number of central physiological systems, which act to enhance arousal and modulate attentional, memory, and other behavioral processes. The net consequence of these actions better permits the organism to contend with a challenging situation and react promptly and effectively when similar conditions are reencountered. It has long been known that stress is associated with a robust activation of the locus coeruleus and other noradrenergic systems. Moreover, evidence indicates a prominent involvement of central noradrenergic systems in a variety of behavioral and cognitive processes associated with stress, including arousal, memory, and attention. Under normal conditions, these actions are likely beneficial to the individual. However, under conditions of extreme stress/trauma, stressor-induced sensitization of noradrenergic systems and long-term actions of norepinephrine may well prove maladaptive. Consistent with this hypothesis, available evidence indicates a prominent involvement of noradrenergic systems in the behavioral pathology associated with various stress-related disorders, particularly post-traumatic stress disorder (PTSD). In particular, there is strong evidence for an involvement of noradrenergic systems in PTSD-related hyperarousal, intrusive memories, and sleep disturbances. Consistent with this, recent studies suggest that pharmacological disruption of noradrenergic neurotransmission may well be efficacious in treating these symptoms of PTSD. Combined, available information indicates that the central noradrenergic systems likely contribute to a broad spectrum of behavioral symptoms of PTSD and that pharmacological treatments targeting noradrenergic neurotransmission will prove clinically beneficial.",0,0 +6190,"Preliminary Evaluation of PTSD Coach, a Smartphone App for Post-Traumatic Stress Symptoms","PTSD Coach is a mobile application (app) designed to help individuals who have post-traumatic stress disorder (PTSD) symptoms better understand and self-manage their symptoms. It has wide-scale use (over 130,000 downloads in 78 countries) and very favorable reviews but has yet to be evaluated. Therefore, this study examines user satisfaction, perceived helpfulness, and usage patterns of PTSD Coach in a sample of 45 veterans receiving PTSD treatment. After using PTSD Coach for several days, participants completed a survey of satisfaction and perceived helpfulness and focus groups exploring app use and benefit from use. Data indicate that participants were very satisfied with PTSD Coach and perceived it as being moderately to very helpful with their PTSD symptoms. Analysis of focus group data resulted in several categories of app use: to manage acute distress and PTSD symptoms, at scheduled times, and to help with sleep. These findings offer preliminary support for the acceptability and perceived helpfulness of PTSD Coach and suggest that it has potential to be an effective self-management tool for PTSD. Although promising, future research is required to validate this, given study limitations.",0,0 +6191,Resilience Moderates the Relationship Between Exposure to Violence and Posttraumatic Reexperiencing in Mi’kmaq Youth,"This study is part of a school-based collaborative research project with a Nova Scotian Mi'kmaq community that hopes to shed light on the relationship between exposure to violence and mental health in First Nations youth. This particular study sought to examine how the multifaceted construct of resilience might act as a protective factor, buffering some students from the negative mental health consequences of exposure to violence. The present paper focuses on whether the construct of resilience, measured by the Child and Youth Resiliency Measure (CYRM; Ungar et al. 2008), has a moderating impact on the relationship between exposure to violence (emotional, physical, and sexual), measured by the Childhood Experience of Violence Questionnaire (CEVQ; Walsh, MacMillan, Trocmé, Jamieson, & Boyle, in press), and posttraumatic stress symptoms, measured by the Child PTSD Symptom Scale (CPSS, Foa et al. 2001). Results showed that the positive relationship between exposure to violence-measured as emotional, physical, and sexual abuse, and witnessing domestic violence-and the reexperiencing symptom cluster of PTSD was moderated by resilience, such that exposure to violence was only predictive of reexperiencing at lower levels of resilience. These findings not only help provide further cross-cultural validation for the CYRM as a measure, but provide support for an ecological conceptualization of resilience. © Springer Science + Business Media, LLC 2009.",0,0 +6192,Effects of early life stress on cognitive and affective function: an integrated review of human literature,"The investigation of putative effects of early life stress (ELS) in humans on later behavior and neurobiology is a fast developing field. While epidemiological and neurobiological studies paint a somber picture of negative outcomes, relatively little attention has been devoted to integrating the breadth of findings concerning possible cognitive and emotional deficits associated with ELS. Emerging findings from longitudinal studies examining developmental trajectories of the brain in healthy samples may provide a new framework to understand mechanisms underlying ELS sequelae.The goal of this review was twofold. The first was to summarize findings from longitudinal data on normative brain development. The second was to utilize this framework of normative brain development to interpret changes in developmental trajectories associated with deficits in cognitive and affective function following ELS.Five principles of normative brain development were identified and used to discuss behavioral and neural sequelae of ELS. Early adversity was found to be associated with deficits in a range of cognitive (cognitive performance, memory, and executive functioning) and affective (reward processing, processing of social and affective stimuli, and emotion regulation) functions.Three general conclusions emerge: (1) higher-order, complex cognitive and affective functions associated with brain regions undergoing protracted postnatal development are particularly vulnerable to the deleterious effects of ELS; (2) the amygdala is particularly sensitive to early ELS; and (3) several deficits, particularly those in the affective domain, appear to persist years after ELS has ceased and may increase risk for later psychopathology.",0,0 +6193,Peeking into the black box: Mechanisms of action for anger management treatment,"We investigated potential mechanisms of action for anger symptom reductions, specifically, the roles of anger regulation skills and therapeutic alliance on changes in anger symptoms, following group anger management treatment (AMT) among combat veterans with posttraumatic stress disorder (PTSD). Data were drawn from a published randomized controlled trial of AMT conducted with a racially diverse group of 109 veterans with PTSD and anger symptoms residing in Hawaii. Results of latent growth curve models indicated that gains in calming skills predicted significantly larger reductions in anger symptoms at post-treatment, while the development of cognitive coping and behavioral control skills did not predict greater symptom reductions. Therapeutic alliance had indirect effects on all outcomes mostly via arousal calming skills. Results suggest that generalized symptom reduction may be mediated by development of skills in calming physiological arousal. In addition, arousal reduction skills appeared to enhance one's ability to employ other anger regulation skills.",0,0 +6194,Finite Mixture Modeling with Mixture Outcomes Using the EM Algorithm,"This paper discusses the analysis of an extended finite mixture model where the latent classes corresponding to the mixture components for one set of observed variables influence a second set of observed variables. The research is motivated by a repeated measurement study using a random coefficient model to assess the influence of latent growth trajectory class membership on the probability of a binary disease outcome. More generally, this model can be seen as a combination of latent class modeling and conventional mixture modeling. The EM algorithm is used for estimation. As an illustration, a random-coefficient growth model for the prediction of alcohol dependence from three latent classes of heavy alcohol use trajectories among young adults is analyzed.",0,0 +6195,Predicting post-traumatic stress disorder in veterans: Interaction of traumatic load with COMT gene variation,"Because post-traumatic stress disorder (PTSD) by definition can occur only after exposure to a traumatic event, military veterans who are at high risk for trauma exposure are a particularly relevant population for studying the interaction of trauma with genetic factors that may predispose for the disorder. A number of studies have implicated specific genes as possible risk factors in developing PTSD, including the catechol-O-methyltransferase gene (COMT).Data from Iraq War veterans (n = 236) were used to examine the interaction between COMT and traumatic experiences in predicting later development of PTSD symptoms. Subjects were assessed for exposure to traumatic events both before and during deployment.The interaction between trauma load and COMT was a significant predictor of PTSD symptoms. Those with the heterozygous genotype (Val/Met) showed fewer symptoms associated with trauma exposure compared to those with either homozygous genotype. This interaction remained significant after controlling for other risk factors for PTSD, including personality dimensions of Internalizing and Externalizing.COMT genotype affects risk for development of PTSD symptoms following exposure to trauma.",0,0 +6196,Using a hybrid model to investigate the comorbidity and symptom overlap between social phobia and the other anxiety disorders and unipolar mood disorders,New hybrid models of psychopathology have been proposed that combine the current categorical approach with symptom dimensions that are common across various disorders. The present study investigated the new hybrid model of social anxiety in a large sample of participants with anxiety disorders and unipolar mood disorders to improve understanding of the comorbidity and symptom overlap between social phobia (SOC) and the other anxiety disorders and unipolar mood disorders. Six hundred and eighty two participants from a specialized outpatient clinic for anxiety treatment completed a semi-structured diagnostic interview and the Multidimensional Assessment of Social Anxiety (MASA). A hybrid model symptom profile was identified for SOC and compared with each of the other principal diagnoses. Significant group differences were identified on each of the MASA scales. Differences also were identified when common sets of comorbidities were compared within participants diagnosed with SOC. The findings demonstrated the influence of both the principal diagnosis of SOC and other anxiety disorders and unipolar mood disorders as well as the influence of comorbid diagnoses with SOC on the six symptom dimensions. These findings highlight the need to shift to transdiagnostic assessment and treatment practices that go beyond the disorder-specific focus of the current categorical diagnostic systems.,0,0 +6197,A prospective examination of post-traumatic stress disorder in rape victims,,0,0 +6198,Translational Fear Inhibition Models as Indices of Trauma-related Psychopathology,"Posttraumatic stress disorder (PTSD) is a debilitating psychiatric condition that arises from exposure to a traumatic event such as combat exposure, a vehicular accident, or an act of violence. The symptom clusters of PTSD include hyperarousal and re-experiencing of the traumatic event when exposed to trauma reminders, as well as avoidance of such reminders. The fear-and anxiety-related symptoms of PTSD can be conceptualized, and subsequently modeled, as the result of fear conditioning such that the traumatic event serves as an unconditioned stimulus and the environmental cues present at the time of the trauma serve as conditioned stimuli that can ultimately elicit conditioned fear responses (i.e., clinical symptoms) long after the trauma has occurred. Many of the most successful treatments for anxiety disorders such as PTSD are based on the principles of fear extinction in which the repeated presentation of a conditioned stimulus, without noxious consequences, reduces the frequency and intensity of a conditioned response. In the current review, we discuss the most widely employed psychophysiological protocols that have been used to study fear processing in human populations, both psychiatrically healthy and with PTSD. Special emphasis is placed on how translational clinical research can inform clinical practices and vice versa. © 2011 Bentham Science Publishers.",0,0 +6199,Climate change and thermal comfort in Hong Kong,"Thermal comfort is a major issue in cities and it is expected to change in the future due to the changing climate. The objective of this paper is to use the universal thermal comfort index (UTCI) to compare the outdoor thermal comfort in Hong Kong in the past (1971-2000) and the future (2046-2065 and 2081-2100). The future climate of Hong Kong was determined by the general circulation model (GCM) simulations of future climate scenarios (A1B and B1) established by the Intergovernmental Panel on Climate Change (IPCC). Three GCMs were chosen, GISS-ER, GFDL-CM2.1 and MRI-CGCM2.3.2, based on their performance in simulating past climate. Through a statistical downscaling procedure, the future climatic variables were transferred to the local scale. The UTCI is calculated by four predicted climate variables: air temperature, wind speed, relative humidity and solar radiation. After a normalisation procedure, future UTCI profiles for the urban area of Hong Kong were created. Comparing the past UTCI (calculated by observation data) and future UTCI, all three GCMs predicted that the future climate scenarios have a higher mode and a higher maximum value. There is a shift from 'No Thermal Stress' toward 'Moderate Heat Stress' and 'Strong Heat Stress' during the period 2046-2065, becoming more severe for the later period (2081-2100). Comparing the two scenarios, B1 exhibited similar projections in the two time periods whereas for A1B there was a significant difference, with both the mode and maximum increasing by 2 °C from 2046-2065 to 2081-2100. © 2012 ISB.",0,0 +6200,PTSD and Chronic Pain: Cognitive-Behavioral Perspectives and Practical Implications,"GH, a 40-year-old software engineer, was referred to the second author by his primary care physician for treatment of Posttraumatic Stress Disorder (PTSD) that developed subsequent to a road traffic collision 9 months earlier. A vehicle struck GH at moderate speed while he was cycling to work during rush-hour traffic and, as a result, he was flipped over the handlebars and thrown against a building wall. He hit his head, cracking the helmet he was wearing, and sustained multiple soft tissue injuries to his neck, upper back, and shoulders that were considered mild in nature. GH was deemed to be not at fault for the accident, and his insurance company replaced his bicycle and helmet and covered his hospital expenses and wage loss. He took 6 weeks off work and resumed fulltime employment after receiving a transfer 6 months after the accident. During his intake interview, GH reported having difficulty performing his job and being easily irritated by colleagues. On examination, he was found to meet diagnostic criteria for PTSD, with scores on various assessment instruments indicating his symptoms to be severe. He was also moderately depressed and was experiencing daily pain in his neck and back, which, although fluctuating in severity from mild to moderate, had persisted over the past 9 months.",0,0 +6201,"Fluoxetine in the acute treatment and relapse prevention of combat-related post-traumatic stress disorder: Analysis of the veteran group of a placebo-controlled, randomized clinical trial","The efficacy and safety of fluoxetine (20-80 mg) was compared with placebo in 144 veterans [36.2 years], diagnosed with combat-related post-traumatic stress disorder (PTSD) selected from a 12-week acute and 24-week relapse prevention PTSD trial. In the acute phase, improvements were greater with fluoxetine than placebo in the disease-specific outcome measures: Treatment Outcome PTSD (TOP-8) total scores (SE):-9.05 (0.90) and -5.20 (1.23), p = 0.001; Clinician Administered PTSD Scale (CAPS) total scores:-31.12 (2.72) and -16.07 (4.24), p < 0.001; all CAPS subscores; Davidson Trauma Scale (DTS) total scores; and other general outcome measures. In the maintenance phase, fluoxetine was superior to placebo in sustaining improvement in TOP-8 [-1.01 (0.91) and 1.56 (0.95)] and CAPS [-4.93 (3.54) and 5.48 (3.66)]. The risk of relapse in the placebo arm was significantly greater than in the fluoxetine arm (log-rank test chi 2 = 4.090, df = 1, p = 0.048). Fluoxetine was well tolerated at a mean daily dose of 65 mg.",0,0 +6202,Anxiety and post-traumatic stress symptoms following wisdom tooth removal,"The purpose of the present study was to determine the psychological impact of wisdom teeth removal and to identify the psychological risk factors for the development of dental anxiety and post-traumatic stress symptoms. Participants were 34 consecutive elective patients referred for surgical removal of a wisdom tooth under local anesthesia. Frequency of previous distressing dental events and general traumatic life events were assessed at baseline (t1), and emotional distress (pain, state anxiety and disturbance) immediately after treatment (t2). Post-traumatic stress responses were determined three days after treatment (t3), and at four weeks follow-up (t4), while severity of dental trait anxiety was assessed at t1 and at t4. Two patients (8%) met screening criteria for Post-Traumatic Stress Disorder (PTSD) at t4. Multivariate analysis revealed that previous exposure to distressing dental events and pre-operative anxiety level predicted anxiety level at t4, accounting for 71% of the variance. Severity of pain during treatment was a significant predictor variable of PTSD symptom severity at t4 (25% explained variance). The findings underline the importance of pain-free treatments and awareness of patients' individual predisposition to anxiety or trauma-related symptoms to reduce the risk of iatrogenic psychological harm.",0,0 +6203,The PRESERVE mortality risk score and analysis of long-term outcomes after extracorporeal membrane oxygenation for severe acute respiratory distress syndrome,"PurposeThis study was designed to identify factors associated with death by 6 months post-intensive care unit (ICU) discharge and to develop a practical mortality risk score for extracorporeal membrane oxygenation (ECMO)-treated acute respiratory distress syndrome (ARDS) patients. We also assessed long-term survivors’ health-related quality of life (HRQL), respiratory symptoms, and anxiety, depression and post-traumatic stress disorder (PTSD) frequencies.MethodsData from 140 ECMO-treated ARDS patients admitted to three French ICUs (2008–2012) were analyzed. ICU survivors contacted >6 months post-ICU discharge were assessed for HRQL, psychological and PTSD status.ResultsMain ARDS etiologies were bacterial (45 %), influenza A[H1N1] (26 %) and post-operative (17 %) pneumonias. Six months post-ICU discharge, 84 (60 %) patients were still alive. Based on multivariable logistic regression analysis, the PRESERVE (PRedicting dEath for SEvere ARDS on VV-ECMO) score (0–14 points) was constructed with eight pre-ECMO parameters, i.e. age, body mass index, immunocompromised status, prone positioning, days of mechanical ventilation, sepsis-related organ failure assessment, plateau pressure andpositive end-expiratory pressure. Six-month post-ECMO initiation cumulative probabilities of survival were 97, 79, 54 and 16 % for PRESERVE classes 0–2, 3–4, 5–6 and ≥7 (p < 0.001), respectively. HRQL evaluation in 80 % of the 6-month survivors revealed satisfactory mental health but persistent physical and emotional-related difficulties, with anxiety, depression or PTSD symptoms reported, by 34, 25 or 16 %, respectively.ConclusionsThe PRESERVE score might help ICU physicians select appropriate candidates for ECMO among severe ARDS patients. Future studies should also focus on physical and psychosocial rehabilitation that could lead to improved HRQL in this population.",0,0 +6204,OPRM1 and Diagnosis-Related Posttraumatic Stress Disorder in Binge-Drinking Patients Living with HIV,"Posttraumatic stress disorder (PTSD) has been linked to numerous negative outcomes in persons living with HIV (PLH) and there is evidence that PTSD symptoms may play a role in maintaining alcohol use problems. The opioid receptor mu-1 (OPRM1) gene may play a role in both PTSD and alcohol use. We examined the association between PTSD and drinking motives as well as variation in the OPRM1 as a predictor of both PTSD and drinking motives in a sample of 201 PLH reporting recent binge drinking. Self-reported PTSD symptom severity was significantly associated with drinking motives for coping, enhancement, and socialization. OPRM1 variation was associated with decreased PTSD symptom severity as well as enhancement motives for drinking.",0,0 +6205,Heart rate after trauma and the specificity of fear circuitry disorders,"Fear circuitry disorders purportedly include post-traumatic stress disorder (PTSD), panic disorder, agoraphobia, social phobia and specific phobia. It is proposed that these disorders represent a cluster of anxiety disorders triggered by stressful events and lead to fear conditioning. Elevated heart rate (HR) at the time of an aversive event may reflect strength of the unconditioned response, which may contribute to fear circuitry disorders.This prospective cohort study assessed HR within 48 h of hospital admission in 602 traumatically injured patients, who were assessed during hospital admission and within 1 month of trauma exposure for lifetime psychiatric diagnosis. At 3 months after the initial assessment, 526 patients (87%) were reassessed for PTSD, major depressive disorder, panic disorder, agoraphobia, social phobia, obsessive compulsive disorder and generalized anxiety disorder.At the 3-month assessment there were 77 (15%) new cases of fear circuitry disorder and 87 new cases of non-fear circuitry disorder (17%). After controlling for gender, age, type of injury and injury severity, patients with elevated HR (defined as ≥96 beats per min) at the time of injury were more likely to develop PTSD [odds ratio (OR) 5.78, 95% confidence interval (CI) 2.32-14.43], panic disorder (OR 3.46, 95% CI 1.16-10.34), agoraphobia (OR 3.90, 95% CI 1.76-8.61) and social phobia (OR 3.98, 95% CI 1.42-11.14). Elevated HR also predicted new fear circuitry disorders that were not co-morbid with a non-fear circuitry disorder (OR 7.28, 95% CI 2.14-24.79).These data provide tentative evidence of a common mechanism underpinning the onset of fear circuitry disorders.",0,0 +6206,Post-Treatment Lyme Syndrome and Central Sensitization,"Central sensitization is a process that links a variety of chronic pain disorders that are characterized by hypersensitivity to noxious stimuli and pain in response to non-noxious stimuli. Among these disorders, treatments that act centrally may have greater efficacy than treatments acting peripherally. Because many individuals with post-treatment Lyme syndrome (PTLS) have a similar symptom cluster, central sensitization may be a process mediating or exacerbating their sensory processing. This article reviews central sensitization, reports new data on sensory hyperarousal in PTLS, explores the potential role of central sensitization in symptom chronicity, and suggests new directions for neurophysiologic and treatment research.",0,0 +6207,The covariation of multiple risk factors in primary care: a latent class analysis,"There is a need to advance the quality of healthcare by increasing knowledge about multiple risk factors and how to intervene to improve health outcomes. In an effort to better describe the presentation of multiple risks, this study involved a database review to describe the prevalence and covariation of multiple risk factors in individuals presenting to primary care. Patients with a primary care encounter from January 1, 2005 to June 30, 2005 (N = 10,043) were identified from the Department of Veteran's Affair's medical database and information about the following risk factors was extracted: alcohol use, psychiatric distress, body mass, smoking status, blood pressure, and posttraumatic stress. Exploratory and confirmatory latent class analyses identified three classes of individuals. Class 1 consisted of individuals with an overall lower level of risk for health problems, but a moderately high likelihood of elevated blood pressure. Individuals in Class 2 appeared to have the greatest need for intervention because they had a moderate to high likelihood of reporting at risk alcohol use, smoking, depression, and posttraumatic stress. Class 3 consisted of individuals reporting the co-occurrence of at risk alcohol use, smoking, and elevated blood pressure. Similar to past research, the findings highlight the need for addressing multiple risk factors in primary care. In addition, this study expands on the literature by identifying specific patterns of covariation among different risk factors that suggest avenues for research and program development. (",0,0 +6208,Influence of RGS2 on Sertraline Treatment for Social Anxiety Disorder,"Only a minority of patients with social anxiety disorder (SAD) has a robust therapeutic response to evidence-based serotonin reuptake inhibitor (SSRI) treatment. To help improve the personalized medicine approach to psychiatric care, we evaluated several candidate genetic predictors of SSRI response in SAD. At the start of a randomized controlled trial (NCT00282828), 346 patients with SAD at three sites received protocol-driven, open-label treatment with sertraline, up to 200. mg/d over 10 weeks. Efficacy was determined using a continuous measure of outcome (Liebowitz Social Anxiety Scale (LSAS)) and dichotomous indicators of response (LSAS ≤ 50) and remission (LSAS ≤ 30). Predictors of efficacy were examined in multivariate regression models that included eight polymorphic variants in four candidate genes (four in RGS2, two in HTR2A, one in SLC6A2, and one in SLC6A4). Adjusting for genetic ancestral cluster and non-genetic predictors of response, all four single-nucleotide polymorphisms (SNPs) in RGS2 predicted change in LSAS over time, at study-wise significance (p=0.00833), with the minor allele associated with less improvement over time. After adjusting for genetic ancestral cluster and non-genetic predictors of remission, two of the four RGS2 SNPs predicted likelihood of remission at or just below study-wise significance (p=0.025): rs4606 (AOR=0.49 (95% CI=0.27-0.90), p=0.022) and rs1819741 (AOR=0.50 (95% CI=0.28-0.92), p=0.027). Variation in RGS2, a gene previously shown to be associated with social anxiety phenotypes and serotonergic neurotransmission, may be a biomarker of the likelihood of substantially benefiting from sertraline among patients with SAD.",0,0 +6209,Trajectory-based methods in clinical psychology: A person centred narrative approach,Abstract Life trajectories in clinical psychology research are often not treated as interactive trajectories but rather as static transversal variables. But developmental pathways are often cumulative and conditional and currently require sophisticated group-based modeling to tease out individual differences in trajectories. Clinical psychologists often require personal information on transitions and turning points in life which require eliciting information through qualitative life history approaches. A method is proposed for identifying life events within the person's narrative and describing trajectories as event spaces likely to reflect end-point psychopathology.,0,0 +6210,Is there a Gulf War Syndrome? Searching for syndromes by factor analysis of symptoms,"Objective. - To search for syndromes in Persian Gulf War veterans. Participants. - Two hundred forty-nine (41%) of the 606 Gulf War veterans of the Twenty-fourth Reserve Naval Mobile Construction Battalion living in 5 southeastern states participated; 145 (58%) had retired from service, and the rest were still serving in the battalion. Design. - Participants completed a standardized survey booklet measuring the anatomical distributions or characteristics of each symptom, a booklet measuring wartime exposures, and a standard psychological personality assessment inventory. Two-stage factor analysis was used to disentangle ambiguous symptoms and identity syndromes. Main Outcome Measures. - Factor analysis-derived syndromes. Results. - Of 249 participants, 175 (70%) reported having had serious health problems that most attributed to the war, and 74 (30%) reported no serious health problems. Principal factor analysis yielded 6 syndrome factors, explaining 71% of the variance. Dichotomized syndrome indicators identified the syndromes in 63 veterans (25%). Syndromes 1 ('impaired cognition,' characterized by problems with attention, memory, and reasoning, as well as insomnia, depression, daytime sleepiness, and headaches), 2 ('confusion-ataxia,' characterized by problems with thinking, disorientation, balance disturbances, vertigo, and impotence), and 3 ('arthro-myo-neuropathy,' characterized by joint and muscle pains, muscle fatigue, difficulty lifting, and extremity paresthesias) represented strongly clustered symptoms; whereas, syndromes 4 ('phobia- apraxia'), 5 ('fever-adenopathy'), and 6 ('weakness-incontinence') involved weaker clustering and mostly overlapped syndromes 2 and 3. Veterans with syndrome 2 were 12.5 times (95% confidence interval, 3.5-44.8) more likely to be unemployed than those with no health problems. A psychological profile, found in 48.4% of those with the syndromes, differed from posttraumatic stress disorder, depression, somatoform disorder, and malingering. Conclusion. - These findings support the hypothesis that clusters of symptoms of many Gulf War veterans represent discrete factor analysis-derived syndromes that appear to reflect a spectrum of neurologic injury involving the central, peripheral, and autonomic nervous systems.",0,0 +6211,Long-Term Pharmacotherapy for Post-Traumatic Stress Disorder,"This article reviews the literature on the long-term pharmacological treatment of post-traumatic stress disorder (PTSD). A PUBMED search was conducted; only studies on the effects of long-term (> 14-weeks) pharmacological treatment for PTSD in adults or children were considered. Our search identified three randomised, double-blind, placebo-controlled studies (one each for sertraline, fluoxetine and risperidone), four open-label studies (one each for sertraline, paroxetine, nefazodone and valproate), one retrospective case series (clozapine) and one pooled analysis (sertraline). All studies involved adult populations, with the exception of the study of clozapine. The studies demonstrate that long-term treatment of PTSD with SSRIs effectively maintains the previous treatment response and improvement in quality of life, converts more patients to responder status and accounts for one-third of overall treatment gains. Greater PTSD severity predicts a longer time to response to these drugs. Discontinuation of SSRI treatment after 12 weeks results in a greater risk of relapse and symptom exacerbation compared with extended treatment. In addition to improved PTSD symptoms, extended treatment with paroxetine improves verbal declarative memory and increases hippocampal volume. Long-term treatment of PTSD with atypical antipsychotics (risperidone and clozapine), non-SSRI antidepressants (nefazodone) and antiepileptic drugs (AEDs; valproate) also appears to result in significant improvements in PTSD symptoms. In conclusion, long-term treatment of PTSD with SSRIs improves the psychiatric and clinical outcome of patients with the disorder and prevents relapse and symptom exacerbation. The effect of other agents (atypical antipsychotics, AEDs and other psychotropic medications) requires further controlled study. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +6212,Family history of a mood disorder indicates a more severe bipolar disorder,"In the clinical setting, patients with bipolar disorder (BD) are often asked about potential family history (FH) of mood disorders. The aim of the present study was to examine differences between BD patients with FH of a mood disorder, and those without, on clinical, personality and social functioning characteristics, as well as on the symptomatic course of the disorder.Data was collected from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). For this report, we included 2600 patients, 1963 of those reported having a first-degree family member with a mood disorder, and 637 reported of no such FH. We investigated the impact of FH on socio-demographic, clinical, personality and quality of life variables, as well as on symptomatology during the first year of treatment.Patients reporting FH of a mood disorder had an earlier age at onset of depression/mania, more phases, rapid cycling and more suicide attempts. Across different assessments, patients with FH showed consistently elevated depressive symptoms, such as lower concentration and energy, higher suicidal ideation, as well as increased racing thoughts and distractibility within the manic spectrum of symptoms. Further, the FH group had lower quality of life, higher neuroticism and higher personality disorder scores compared to patients without FH.Information on FH was obtained through the proband.Overall, BD patients reporting FH of a mood disorder showed a worse clinical profile upon presentation for treatment and a more symptomatic course of the disorder.",0,0 +6213,"Expressive writing and post-traumatic stress disorder: Effects on trauma symptoms, mood states, and cortisol reactivity","This study investigates the boundary conditions (feasibility, safety, and efficacy) of an expressive writing intervention for individuals with post-traumatic stress disorder [PTSD].Randomized trial with baseline and 3-month follow-up measures of PTSD severity and symptoms, mood states, post-traumatic growth, and (post-only) cortisol reactivity to trauma-related stress.Volunteers with a verified diagnosis of PTSD (N=25) were randomly assigned to an experimental group (writing about their traumatic experience) or control group (writing about time management).Expressive writing was acceptable to patients with PTSD and appeared safe to utilize. No changes in PTSD diagnosis or symptoms were observed, but significant improvements in mood and post-traumatic growth were observed in the expressive writing group. Finally, expressive writing greatly attenuated neuroendocrine (cortisol) responses to trauma-related memories.The present study provides insight into several boundary conditions of expressive writing. Writing did not decrease PTSD-related symptom severity. Although patients continue to exhibit the core features of PTSD, their capacity to regulate those responses appears improved following expressive writing. Dysphoric mood decreased after writing and when exposed to traumatic memories, participants' physiological response is reduced and their recovery enhanced.",0,0 +6214,Psychopathology subtypes and symptom correlates among former prisoners of war,"Psychopathology and symptom patterns were studied in 60 former prisoners-of-war (POWs) by administering standardized tests including the Minnesota Multiphasic Personality Inventory (MMPI), an adjustment problem checklist, and a structured clinical interview. Most POWs showed marked psychological impairment, but modal profile analysis identified two prototypic MMPI patterns, which differed in pervasiveness and type of psychopathology. Profile subtypes were defined by unique clusters of clinical symptoms and differed in confinement stress severity. The typology of symptoms argues against a homogeneous conceptualization of stress-induced disorders and suggests the need for definition of the severity and subtype of stress phenomena and individual difference factors in responding to trauma. © 1986 Plenum Publishing Corporation.",0,0 +6215,Antidepressant Drugs in Dermatology,"Recent studies indicate that antidepressant medications may be effective treatments for dermatologic disorders such as chronic urticaria and angioedema, nocturnal pruritus in atopic eczema, and postherpetic neuralgia, even in the absence of coexisting psychopathologic conditions. Their efficacy may be related to their antihistaminic, anticholinergic, and centrally mediated analgesic effects and appears to be independent of their antidepressant effect. It is likely, therefore, that more dermatologists will be prescribing these drugs without a psychiatric consultation.",0,0 +6216,Are gender differences in post-traumatic stress disorder rates attenuated in substance use disorder patients?,"Abstract We review 15 studies that examined rates of post-traumatic stress disorder (PTSD) in substance use disorder (SUD) patients to determine whether the typical female-greaterthan-male gender difference in PTSD rates is attenuated in SUD samples. Since the majority of studies reviewed did not find a gender difference in PTSD rates, we critically examined methodological factors that might account for this attenuation, but none appeared to completely account for the variability in detection of gender differences across studies. Several factors may contribute to making rates of PTSD among SUD males equivalent to the high rates observed in SUD females: 1) the risky lifestyle associated with men's substance abuse may increase their exposure to traumatic events, 2) a history of more severe trauma characteristics may be apparent among men with SUDs, or 3) attenuated gender differences in rates of other comorbidities that increase PTSD risk (e.g., depression) may exist. Clinical implications are discussed. According to epidemiological studies, post-traumatic stress disorder (PTSD) is a highly comorbid condition among those with substance use disorders (SUDs; see review by Stewart, 1996). In the National Comorbidity Survey, a large-scale epidemiologic survey conducted in the U.S., Kessler and colleagues (1997) found that those with alcohol dependence were at 3-4 times increased risk of lifetime PTSD as compared to those without alcohol dependence. Moreover, the presence of comorbid PTSD among individuals being treated for SUDs is related to poorer treatment adherence (Hien, Nunes, Rudnick Levin, & Fraser, 2000) and outcomes, including higher relapse rates (e.g., Ouimette, Brown, & Najavits, 1998; Ouimette, Finney, & Moos, 1999). It has been suggested that if patients with comorbid SUD-PTSD were to receive trauma-specific treatment, they might avoid overutilizing or misusing expensive inpatient SUD treatments, thereby reducing the cost of clinical care (e.g., Brown, Recupero, & Stout, 1995). The delineation of gender variations in the presentation of this comorbidity may identify factors that will improve treatment outcomes (Sonne et al., 2003). A fairly consistent finding across epidemiologic studies on PTSD rates in the general adult population is that women are about twice as likely to have PTSD as men (e.g., Breslau, Chilcoat, Kessler, Peterson, & Lucia, 1999; Breslau, Davis, Andreski, & Peterson, 1991; Breslau, Davis, Andreski, Peterson, & Schultz, 1997; Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995). Moreover, women experience qualitatively different traumatic life experiences than do men. These findings have led to an interest in understanding gender differences in PTSD and their implications for etiology and treatment of the disorder (e.g., Kimerling, Ouimette, & Weitlauf, in press). Early research on comorbid PTSD-SUDs focused almost exclusively on male veterans whose pathology arose in the context of combat trauma; more recently, a focus has emerged on women with comorbid PTSD-SUDs (Najavits, Weiss, & Shaw, 1997). The major purpose of this article is to examine gender as an important individual difference variable with respect to trauma and PTSD among patients with SUDs. This brief review focuses on rates of trauma and PTSD among clinical samples of male and female SUD patients. Summaries of the methods and findings of the studies reviewed in this article are provided in Tables 1 and 2, for trauma exposure rates and PTSD rates, respectively. Gender Differences in Adult Samples Brown et al. (1995) studied the prevalence of trauma histories and comorbid PTSD among 84 adults (48 male; 36 female) seeking treatment at a private hospital inpatient substance-abuse treatment program. Participants completed self-report measures of lifetime trauma exposure and PTSD symptoms. Women were more likely than men to have been physically abused/assaulted (31% vs. …",0,0 +6217,Reactions to Combat Stress in Israeli Veterans Twenty Years After the 1982 Lebanon War,"During the war or shortly thereafter, the most common manifestation of combat induced psychopathology is combat stress reaction (CSR). The long-term consequences of CSR have so far received little scientific attention. The aim of this study was to examine whether CSR is a marker for long-term PTSD and other psychiatric comorbidities. Two groups of veterans from the 1982 Lebanon war were assessed 20 years after the war: one comprised 286 CSR casualties and the other comprised 218 matched non-CSR soldiers. Participants were assessed for PTSD, psychiatric symptomatology, social functioning, physical health, and postwar life events. Twenty years after the war, veterans with antecedent CSR reported more PTSD, psychiatric symptomatology and distress, social dysfunction, and health problems than did non-CSR veterans. We conclude that CSR should be seen as a marker for long-term psychiatric distress and impairment. In addition, the implications of combat-related trauma are broad and varied, and go beyond the narrow scope of PTSD.",0,0 +6218,Predicting Posttraumatic Stress Symptoms From Pretraumatic Risk Factors: A 2-Year Prospective Follow-Up Study in Firefighters,"Most studies focusing on risk factors for posttraumatic stress disorder (PTSD) have used retrospective study designs. Only a small number of studies have prospectively examined risk factors in the immediate aftermath of trauma exposure in predicting PTSD symptoms. The purpose of this study was to identify predictive risk factors for posttraumatic stress symptoms and comorbid psychopathological symptoms present during the time before exposure to traumatic stress in a high-risk population.Forty-three professional firefighters were assessed immediately after basic training (baseline) and at 6, 9, 12, and 24 months after entry into firefighter service. Subjects were screened for psychopathological symptoms, including symptoms of PTSD, depression, and anxiety. Subjects were also characterized with regard to personality traits such as self-efficacy, hostility, and alexithymia. Neuroendocrine activity was assessed by examination of awakening and diurnal salivary cortisol profiles and 24-hour urinary catecholamine excretion. Multiple linear regression analysis was used to analyze posttraumatic stress symptoms at 24-month follow-up as a function of pretraumatic characteristics.A high level of hostility and a low level of self-efficacy at baseline accounted for 42% of the variance in posttraumatic stress symptoms after 2 years. Subjects who had both risk factors at baseline showed a significant increase in measures of PTSD symptoms, depression, anxiety, general psychological morbidity, global symptom severity, and alexithymia during the 2-year period. Biological characteristics were not predictive of the development of psychopathological symptoms.These results suggest that specific personality traits may constitute markers of vulnerability to the development of psychopathological symptoms after trauma exposure. Early identification of preexisting risk factors is needed to provide effective prevention and intervention for individuals who are at risk of developing trauma-related disorders.",0,0 +6219,"Adaptation to Traumatic Stress: Resilient Traits, Resources, and Trajectories of Outcomes","The term resilience is too often poorly operationalized and loosely conceptualized. Historically, it has beendefined as a trait, characteristic, or collection of resources that facilitates healthy adjustment to a potentially traumaticevent (PTE) and has typically been measured at one point in time. More recently, it has been defined as an outcome, or asuccessful course of adaptation following exposure to a severe and overwhelming experience. Inherent in this definition isthe expectation that a cross-sectional evaluation will fall short; if resilience is an adaptation to an experience, it must thenunfold over time. Unfortunately, the absence of a single unifying paradigm of resilience has hindered progress in the field.In this review, we discuss the handful of characteristics that are most consistently linked to low levels of distressfollowing exposure to a PTE and describe several prototypic trait resilience measures for adults. We also describe andcritically evaluate research that has generated distinct typologies or groups with similar trajectories of adjustmentfollowing exposure to PTEs. Finally, we provide examples of several studies of interventions to promote resilience.Ultimately, for the field to advance, clinicians, researchers, and policy-makers need to isolate the factors that reliablypromote a successful adjustment across a broad range of domains, including emotional, physical, and occupationalfunctioning. Once known, prevention and intervention strategies need to be refined and tested so that suffering anddysfunction can be mitigated before chronic and debilitating distress become entrenched in those who do not recover ontheir own.",0,0 +6220,Post-Traumatic Stress Disorder Symptoms among Gulf War Veterans,"This study assessed the prevalence of risk for development of post-traumatic stress disorder (PTSD) symptoms among active duty and reserve veterans from Pennsylvania and Hawaii who either deployed (N = 1,524) or did not deploy (N = 2,727) to the Persian Gulf as a result of Operation Desert Storm. All participants anonymously completed a survey questionnaire that included the Impact of Event Scale and the Brief Symptom Inventory. Results indicate the likelihood of PTSD symptoms in approximately 8.0% of active duty veterans and 9.3% of reserve veterans who deployed to the Persian Gulf. PTSD risk comparisons are made with other active duty Army veterans assessed 1 year earlier. Sources of trauma are presented and implications for future military deployments on potential risks for developing PTSD are discussed.",0,0 +6221,Challenging Anxiety: A Focus on the Specificity of Respiratory Symptoms,"Physiological symptoms are characteristic features of anxiety states. Presumably, specific psychophysiological profiles differentiate between anxiety disorders, which would offer potential for diagnostic purposes. Abundant evidence points to a causal relationship between panic disorder and instability of respiratory regulation. However, the specificity of most measures that indicate aberrant functioning of the respiratory system in PD can be questioned. Possibly, the traditional measures of respiratory functioning are too restricted. The underlying respiratory vulnerability in PD seems to constitute a subtle, unstable trait, which calls for more sensitive and sophisticated measures of respiratory variability and chaos. To increase the probability of finding parameters with diagnostic specificity, the application of disorder specific challenge paradigms is recommended.",0,0 +6222,Viewing Suicide Risk Through a New Lens: The Benefits of Examining Symptom Trajectories,,0,0 +6223,,"The present study provided psychometric data on the KID-SAVE, an empirically based measure of children's exposure to community violence. The KID-SAVE was administered to 470 inner-city children in the third through seventh grades and demonstrated excellent reliability. Factor analysis yielded three subscales: Traumatic Violence, Indirect Violence, and Physical/Verbal Abuse. Initial investigation of construct validity suggested that the KID-SAVE successfully discriminated between groups of children reporting high and low levels of traumatic symptoms. The KID-SAVE appears to be a promising assessment tool and allows for quantification of the severity of violence exposure.",0,0 +6224,DSM-IV post-traumatic stress disorder among World Trade Center responders 11–13 years after the disaster of 11 September 2001 (9/11),"Background Post-traumatic symptomatology is one of the signature effects of the pernicious exposures endured by responders to the World Trade Center (WTC) disaster of 11 September 2001 (9/11), but the long-term extent of diagnosed Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) post-traumatic stress disorder (PTSD) and its impact on quality of life are unknown. This study examines the extent of DSM-IV PTSD 11–13 years after the disaster in WTC responders, its symptom profiles and trajectories, and associations of active, remitted and partial PTSD with exposures, physical health and psychosocial well-being. Method Master's-level psychologists administered sections of the Structured Clinical Interview for DSM-IV and the Range of Impaired Functioning Tool to 3231 responders monitored at the Stony Brook University World Trade Center Health Program. The PTSD Checklist (PCL) and current medical symptoms were obtained at each visit. Results In all, 9.7% had current, 7.9% remitted, and 5.9% partial WTC-PTSD. Among those with active PTSD, avoidance and hyperarousal symptoms were most commonly, and flashbacks least commonly, reported. Trajectories of symptom severity across monitoring visits showed a modestly increasing slope for active and decelerating slope for remitted PTSD. WTC exposures, especially death and human remains, were strongly associated with PTSD. After adjusting for exposure and critical risk factors, including hazardous drinking and co-morbid depression, PTSD was strongly associated with health and well-being, especially dissatisfaction with life. Conclusions This is the first study to demonstrate the extent and correlates of long-term DSM-IV PTSD among responders. Although most proved resilient, there remains a sizable subgroup in need of continued treatment in the second decade after 9/11.",0,0 +6225,Biological Perspectives: Detecting Malingering of Post-Traumatic Stress Disorder (PTSD) in Adults,"The issue of detecting malingering post-traumatic stress disorder (PTSD) is a difficult one. Given the complexity of PTSD and the current state of the art in making accurate diagnosis of various mental health conditions, it should be no surprise that detecting malingering in patients complaining of symptoms of possible PTSD is a difficult process. This article is intended to shed more light than darkness on this process. Clearly, the ideas and approaches that are suggested are meant as an introduction to developing a deeper understanding of the processes associated with detecting malingering of PTSD. In doing this, it is intended to make the process of attempting to detect the possible malingering of PTSD a clearer,more thoughtful, and more clinically useful endeavor. Certainly, such an effort is not free from controversy nor is it perfect. Also, the approaches that are described here are not unique and can be found elsewhere in the literature. Assessing PTSD and detecting possible malingering of PTSD is a difficult task. However, if a clinician takes a multimodal approach to the assessment of PTSD, then the process of detecting possible attempts to malinger this disorder is far less daunting. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +6226,"Pituitary response to metyrapone in Gulf War veterans: Relationship to deployment, PTSD and unexplained health symptoms","Gulf War deployment has been associated with a distinct neuroendocrine profile characterized by low 24h basal ACTH levels and enhanced cortisol and ACTH suppression to low-dose dexamethasone. The metyrapone stimulation test was performed to further characterize hypothalamic-pituitary activity in Gulf War veterans (GWV) and its relationship to unexplained medical symptoms and post-traumatic stress disorder (PTSD).Eleven GWV without PTSD, 18 GWV with PTSD and 15 healthy subjects not exposed to the Gulf War theater (non-exposed) underwent the metyrapone stimulation test, which inhibits cortisol synthesis, impairs cortisol-mediated negative feedback inhibition and in turn increases levels of ACTH and 11-deoxycortisol, a cortisol precursor. These hormones were measured at baseline (7:00 a.m.) and at intervals (from 8:00 a.m. to 4:00 p.m.) following the administration of metyrapone 750mg orally at 7:05 a.m. and at 10:05 a.m.There were group differences in the ACTH response despite similar cortisol and 11-deoxycortisol responses to metyrapone. GWV without PTSD had a significantly attenuated ACTH response compared to non-exposed subjects; GWV with PTSD had a significantly higher ACTH response than GWV without PTSD but did not differ from non-exposed subjects. Among GWV, unexplained medical health symptoms (e.g., neurological, musculoskeletal, cardiac, and pulmonary symptoms) and PTSD symptoms were significantly positively associated with the ACTH response to metyrapone.Gulf War deployment is associated with a substantially lower ACTH response to metyrapone. In contrast, unexplained health symptoms and PTSD in Gulf War veterans are associated with relatively greater hypothalamic-pituitary activity which may reflect increased CRF activity and is evident only in consideration of deployment effects. This pattern of differences suggests either that Gulf War deployment and its associated exposures results in enduring changes in pituitary function or that reduced hypothalamic-pituitary activity protects against the development of PTSD and other deployment-related health problems.",0,0 +6227,Sex differences in orbitofrontal connectivity in male and female veterans with TBI,"More female soldiers are now serving in combat theaters than at any other time. However, little is known about possible sex differences underlying the neuropathology and manifestation of one of modern war's signature injuries, traumatic brain injury (TBI). The paucity of information regarding sex differences in TBI is particularly evident when examining changes in executive function and emotion regulation associated with post concussive events. The current study objective was to observe whether patterns of orbitofrontal (OFC) functional connectivity would differ between female veterans with TBI and their male counterparts. The study further sought to determine whether OFC connectivity might be differentially associated with clinical measures of aggression and hostility. Seventeen female veterans and 24 male veterans, age 18 to 25, who met criteria for TBI completed resting state magnetic resonance imaging (MRI) and clinical assessment measures. Imaging data were analyzed using left and right seed regions of the OFC, and regression analyses were conducted to observe the relationship between resting state connectivity and self-reported aggression. Females and males in this study differed in OFC connectivity, with females demonstrating greater connectivity between left and right OFC and parietal and occipital regions and males demonstrating greater connectivity between left and right OFC and frontal and temporal regions. Significant associations between resting state connectivity and clinical measures were found only in male veterans. These findings suggest that TBI may interact with sex-specific patterns of brain connectivity in male and female veterans and exert divergent effects on clinical profiles of aggression post-injury.",0,0 +6228,Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) is an increasingly recognized and potentially preventable condition. Certain factors, especially the severity of the trauma, perceived lack of social support and peri-traumatic dissociation have been associated with its development. In recent years, a more robust evidence base regarding the management of individuals involved in traumatic events has emerged. Immediately after a traumatic event, simple practical, pragmatic support provided in a sympathetic manner by non-mental health professionals seems most likely to help. For individuals who develop persisting PTSD, trauma-focused cognitive behavioural therapy (TFCBT) may be beneficial within a few months of the trauma. For those who develop chronic PTSD, TFCBT and eye movement desensitization and reprocessing are best supported by the current evidence. Some anti-depressants appear to have a modest beneficial effect and are recommended as a second-line treatment. The current evidence base has allowed the development of guidelines that now require implementation. This has major implications in terms of planning and developing services that allow appropriately qualified and trained individuals to be available to cater adequately for the needs of survivors of traumatic events. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +6229,Posttraumatic stress disorder and family functioning in adolescent cancer,"Twenty three adolescents with a history of cancer, 27 physically abused adolescents, and 23 healthy, nonabused adolescents were administered structured posttraumatic stress disorder (PTSD) interviews and self-report questionnaires regarding family functioning. Thirty five percent of adolescent cancer subjects met criteria for lifetime PTSD as compared to only 7% of the abused adolescents: 17% of the cancer subjects and 11% of the abuse subjects met criteria for current PTSD. Adolescents with cancer viewed their mothers and fathers as significantly more caring and more protective than the comparison and abused adolescents. Cancer subjects who met criteria for lifetime PTSD saw their families as significantly more chaotic than those who did not have PTSD. Eighty three percent of cancer subjects who had lifetime PTSD also had mothers who had PTSD.",0,0 +6230,"Auditory verbal hallucinations in schizophrenia and post-traumatic stress disorder: common phenomenology, common cause, common interventions?","Auditory verbal hallucinations (AVH: 'hearing voices') are found in both schizophrenia and post-traumatic stress disorder (PTSD). In this paper we first demonstrate that AVH in these two diagnoses share a qualitatively similar phenomenology. We then show that the presence of AVH in schizophrenia is often associated with earlier exposure to traumatic/emotionally overwhelming events, as it is by definition in PTSD. We next argue that the content of AVH relates to earlier traumatic events in a similar way in both PTSD and schizophrenia, most commonly having direct or indirect thematic links to emotionally overwhelming events, rather than being direct re-experiencing. We then propose, following cognitive models of PTSD, that the reconstructive nature of memory may be able to account for the nature of these associations between trauma and AVH content, as may threat-hypervigilance and the individual's personal goals. We conclude that a notable subset of people diagnosed with schizophrenia with AVH are having phenomenologically and aetiologically identical experiences to PTSD patients who hear voices. As such we propose that the iron curtain between AVH in PTSD (often termed 'dissociative AVH') and AVH in schizophrenia (so-called 'psychotic AVH') needs to be torn down, as these are often the same experience. One implication of this is that these trauma-related AVH require a common trans-diagnostic treatment strategy. Whilst antipsychotics are already increasingly being used to treat AVH in PTSD, we argue for the centrality of trauma-based interventions for trauma-based AVH in both PTSD and in people diagnosed with schizophrenia.",0,0 +6231,Anhedonia and emotional numbing in combat veterans with PTSD,"We explored relationships between anhedonia and posttraumatic stress disorder (PTSD) symptom clusters, including their role in predicting psychiatric comorbidity. Our measure of anhedonia was derived from an examination of the latent structure of the Beck Depression Inventory. We found evidence for a two-factor solution, leading to anhedonia and undifferentiated, global depressive symptoms scales. In primary analyses, anhedonia had a unique positive relationship with PTSD's emotional numbing symptoms and minimal relationships with other PTSD symptoms. Upon examining the incremental validity of appetitive functioning (i.e., anhedonia, emotional numbing) over and above aversive functioning (i.e., re-experiencing, avoidance, and hyper-arousal PTSD symptoms) variables, greater emotional numbing increased the likelihood of being diagnosed with a major depressive disorder, and greater anhedonia increased the likelihood of being diagnosed with additional anxiety disorders and to a lesser extent, psychotic disorders. Results were consistent with research on the distinction of appetitive and aversive functioning, providing insight into the nature of PTSD.",0,0 +6232,An evaluation of competing models for the structure of PTSD symptoms using external measures of comorbidity,"Research on the structure of posttraumatic stress disorder (PTSD) symptoms has yielded support for two 4-factor models: the King (King, Leskin, King, & Weathers, 1998) and Simms/Watson models (Simms, Watson, & Doebbeling, 2002). This study evaluated them using data drawn from 1,128 Vietnam veterans by comparing associations with a latent internalizing comorbidity variable and five scales from the MMPI-2 Restructured Clinical (RC) Scales (Tellegen et al., 2003). The Simms/Watson dysphoria factor failed to show evidence of superior convergent or discriminant validity in association with external measures relative to the numbing or hyperarousal factors of the King model. Findings raise questions about proposals to abandon the distinction between numbing and hyperarousal symptoms in favor of a dysphoria-based model.",0,0 +6233,Correlation between traumatic events and posttraumatic stress disorder among North Korean defectors in South Korea,"The number of North Korean defectors entering South Korea has been increasing rapidly since 1994. Two hundred North Korean defectors in South Korea were studied to identify their experiences of traumatic events in North Korea and during defection, and the correlation with Posttraumatic Stress Disorder (PTSD). Researchers conducted face-to-face interviews and assisted defectors in performing a self-report assessment of this survey. The study questionnaire consisted of demographic characteristics, the Traumatic Experiences Scale for North Korean Defectors, and the PTSD part of the Structured Clinical Interview for DSM-III-R Korean version. Prevalence rate of PTSD in defectors was 29.5%, with a higher rate for women. In factor analysis, the 25 items of traumatic events experienced in North Korea were divided into three factors: Physical Trauma, Political-Ideological Trauma, and Family-Related Trauma. In addition, the 19 items of traumatic events during defection were grouped into four factors: Physical Trauma, Detection and Capture-Related Trauma, Family-Related Trauma, and Betrayal-Related Trauma. In multifactorial logistic regression analysis, Family-Related Trauma in North Korea had a significant odds ratio.",0,0 +6234,PTSD symptoms in children and adolescents 28 months after a flood: Age and gender differences,"The present study examined the prevalence and predictors of posttraumatic stress disorder symptoms (PTSD) in a sample of 533 students (aged 11 to 21), 28 months after the 1997 Flood in southwestern Poland. The results show that 18% of the participants met all diagnostic criteria for PTSD. Based on hierarchical multiple regression analyses, PTSD criteria symptoms were positively correlated with the degree of exposure to trauma experienced during the disaster. A three-way interaction of trauma, age, and gender showed that more PTSD symptoms were observed among the younger participants and girls than among the older boys. The results confirm the need of research testing culturally sensitive implementation of mental health programs for young victims of disasters, taking into account their age and gender.",0,0 +6235,Heterogeneity in the course of posttraumatic stress disorder: Trajectories of symptomatology,"Unconditional and conditional trajectories of posttraumatic stress disorder (PTSD) symptomatology were examined using a sample of U.S. soldiers deployed on a NATO-led peacekeeping mission to Kosovo. Data were collected at 4 time points, ranging from the weeks leading up to deployment to 9-months postdeployment. Latent class growth analysis revealed 4 unique symptom trajectories: resilience, recovery, delayed, and unrealized anxiety. Variables identified as significant predictors of trajectory class included previous traumatic events, combat exposure, peacekeeping daily hassles, depression, alcohol use, aggressive behavior, stress reactivity, and military rank. Results from this study add to the literature detailing the variability in PTSD course, as well as to the literature pertaining to predictors of PTSD onset and course.",1,0 +6236,Support for the location of negative posttraumatic cognitions in the diagnosis of posttraumatic stress disorder,"Abstract Objective To investigate the extent to which negative posttraumatic cognitions predict, and so can be best located within, the DSM-5 (APA, 2013) individual symptom clusters of posttraumatic stress disorder (PTSD). Method An online survey of traumatic experiences, featuring 528 adults. Results Negative posttraumatic cognitions seem best placed within the Numbing/Detachment symptom cluster. Negative posttraumatic cognitions relating to the self predict higher levels of symptoms across the clusters. While negative cognitions relating to the world contributed to most symptom groups, self-blame cognitions did not. Conclusions Our findings support the placement of posttraumatic cognitions as part of the Numbing/Detachment symptom cluster within the DSM-5rather than the Intrusion, Avoidance and Hyperarousal clusters.",0,0 +6237,The relationship between posttraumatic stress disorder symptoms and paternal parenting of adult children among ex-prisoners of war: A longitudinal study.,"The aversive impact of combat and combat-induced posttraumatic stress disorder (PTSD) on parenting of young children has been examined in a few studies. Nevertheless, the toll of war captivity on parenting and the long-term relations between posttraumatic symptoms and paternal parenting of adult children remains unknown. This longitudinal study examined paternal parenting of adult children among war veterans, some of whom were held in captivity. Furthermore, we examined the mediating role of PTSD symptoms in the association between captivity and parenting. The sample included two groups of male Israeli veterans from the 1973 Yom Kippur War: ex-prisoners of war (ex-POWs) and comparable veterans who had not been held captive. Both groups were assessed via self-report measures of PTSD at three time points: Time 1 (18 after the war), Time 2 (30 after the war), and Time 3 (35 after the war) years after the war. Results shows that ex-POWs reported lower levels of positive parenting compared to comparison group veterans at Time 3. Furthermore, PTSD symptoms at Time 1, Time 2, and Time 3 mediated the association between captivity experience and parenting at Time 3. In addition, it was found that increases in the levels of PTSD symptom clusters over time were associated with lower levels of positive parenting at Time 3.",0,0 +6238,Australian Guidelines for the Treatment of Adults with Acute Stress Disorder and Post-Traumatic Stress Disorder,"Over the past 2–3 years, clinical practice guidelines (CPGs) for post-traumatic stress disorder (PTSD) and acute stress disorder (ASD) have been developed in the USA and UK. There remained a need, however, for the development of Australian CPGs for the treatment of ASD and PTSD tailored to the national health-care context. Therefore, the Australian Centre for Posttraumatic Mental Health in collaboration with national trauma experts, has recently developed Australian CPGs for adults with ASD and PTSD, which have been endorsed by the National Health and Medical Research Council (NHMRC). In consultation with a multidisciplinary reference panel (MDP), research questions were determined and a systematic review of the evidence was then conducted to answer these questions (consistent with NHMRC procedures). On the basis of the evidence reviewed and in consultation with the MDP, a series of practice recommendations were developed. The practice recommendations that have been developed address a broad range of clinical questions. Key recommendations indicate the use of trauma-focused psychological therapy (cognitive behavioural therapy or eye movement desensitization and reprocessing in addition to in vivo exposure) as the most effective treatment for ASD and PTSD. Where medication is required for the treatment of PTSD in adults, selective serotonin re-uptake inhibitor antidepressants should be the first choice. Medication should not be used in preference to trauma-focused psychological therapy. In the immediate aftermath of trauma, practitioners should adopt a position of watchful waiting and provide psychological first aid. Structured interventions such as psychological debriefing, with a focus on recounting the traumatic event and ventilation of feelings, should not be offered on a routine basis.",0,0 +6239,Understanding comorbidity between ptsd and substance use disorders: Two preliminary investigations,"While there is high level of comorbidity of PTSD and substance use disorders (SUDs), little research has focused on the overlapping symptom constellation characteristic of both PTSD and substance use/withdrawal. This report describes two preliminary investigations that address this area. In the first study, the pattern of PTSD symptoms in a sample of women (n = 28) seeking treatment for a SUD and comorbid with PTSD was compared with the symptom pattern of a sample of women (n = 28) with PTSD only. The PTSD + SUD group evidenced significantly more symptoms in the avoidance and arousal symptom clusters than the PTSD-only group. At the individual symptom level, the PTSD + SUD group reported significantly more sleep disturbance than the PTSD-only group. It was also determined that the PTSD + SUD group reported greater traumatic-event exposure than the PTSD-only group. In the second study, PTSD symptoms were compared in a sample of alcohol- dependent and a sample of cocaine-dependent individuals with PTSD. The alcohol- dependent group exhibited significantly more arousal symptoms than the cocaine-dependent group. Implications of the results for the assessment of individuals with comorbid PTSD and SUDs are discussed.",0,0 +6240,Associations Between Post-Traumatic Stress Disorder Symptoms and Alcohol and Other Drug Problems: Implications for Social Work Practice,"This study examines the associations between alcohol and other drug problems (AOD) and post-traumatic stress disorder (PTSD) symptoms in 499 women recruited from outpatient treatment programmes for AOD problems and the general community in western New York. The women were divided into three groups: no-AOD, past-AOD, and current-AOD. The current-AOD group was further subdivided into groups based on alcohol, marijuana, and cocaine misuse. Group comparisons on PTSD symptoms revealed that the current-AOD group experienced more PTSD symptoms than the no-AOD and past-AOD groups. The alcohol and cocaine misuse groups experienced more PTSD symptoms overall and for each symptom cluster than the no-AOD and past-AOD groups, but did not differ from each other or the marijuana group on PTSD symptoms. These findings suggest that individuals who have AOD problems should be assessed for PTSD symptoms and provided with trauma-specific interventions when warranted. Trauma-informed care may benefit those in AOD treatment. Individuals who have PTSD symptoms should be assessed for AOD problems as well.",0,0 +6241,"Cumulative Trauma, Hyperarousal, and Suicidality in the General Population: A Path Analysis","Although trauma exposure and posttraumatic stress disorder (PTSD) both have been linked to suicidal thoughts and behavior, the underlying basis for this relationship is not clear. In a sample of 357 trauma-exposed individuals from the general population, younger participant age, cumulative trauma exposure, and all three Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, PTSD clusters (reexperiencing, avoidance, and hyperarousal) were correlated with clinical levels of suicidality. However, logistic regression analysis indicated that when all PTSD clusters were considered simultaneously, only hyperarousal continued to be predictive. A path analysis confirmed that posttraumatic hyperarousal (but not other components of PTSD) fully mediated the relationship between extent of trauma exposure and degree of suicidal thoughts and behaviors.",0,0 +6242,"Trauma exposure, resilience, social support, and PTSD construct validity among former prisoners of war","Background: The aim of this study was to investigate predictors of persistent symptoms of posttraumatic stress disorder (PTSD) and to examine the construct validity of PTSD in a national sample of 270 World War II and Korean Conflict prisoners of war (POWs). Method: POWs were interviewed at two points in time (1965 and 1990). Predictors included PTSD symptomatology measured in 1965 by items from the Cornell Medical Index (CMI), severity of captivity trauma, resilience factors, and post-trauma social support. The criterion, symptomatology in the early 1990s, was evaluated with the PTSD module of the Structured Clinical Interview for DSM (SCID). Results: The CMI provided only partial coverage of PTSD criteria and appeared to provide only a general index of distress. Clustering of SCID items in two-dimensional space via multidimensional scaling analysis offers some construct validation for the DSM's differentiation of PTSD symptoms into criterion groups, although there was not a perfect match. Trauma severity is best related to PTSD symptomatology experienced in 1990, mitigated in part by greater education level and age at the time of trauma exposure. Surprisingly, 1965 distress added only a modest amount to the prediction of current distress, while post-trauma social support added none. Conclusions: These findings support previous work showing the severe psychological sequelae of POW status 40-50 years after captivity, and indicate that trauma severity during captivity is the best predictor of current PTSD symptomatology. Results also add to our understanding of the conceptual differentiation of PTSD symptoms into separate and distinct symptom clusters.",0,0 +6243,Confirmatory Factor Analysis of the Posttraumatic Stress Disorder Checklist,"Several studies have employed confirmatory factor analysis (CFA) to examine the latent structure of the Posttraumatic Stress Disorder (PTSD) Checklist (PCL; Weathers, Litz, Herman, Huska, & Keane, 1993), a measure that assesses PTSD symptomatology. Findings have failed to support the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision [DSM–IV–TR]; American Psychiatric Association, 2000) PTSD model, consisting of reexperiencing, avoidance/numbing, and arousal factors, and no consensus has emerged regarding the best fitting alternative model. Additionally, most studies have utilized homogeneous trauma samples. This study used CFA to examine the PCL factor structure in a sample with exposure to various traumatic events. Superior fit was demonstrated by a model specifying reexperiencing, avoidance, dysphoria, and arousal factors.",0,0 +6244,Using therapeutic writing to deconstruct recovery from posttraumatic stress disorder (PTSD),"Exposure to physical and psychological trauma has produced a post-millennial epoch of posttraumatic stress disorder (PTSD), a debilitating anxiety disorder that occurs after exposure to an extreme stressor or prolonged victimization. After an extensive review of treatment protocols in 2008, the Institute of Medicine (IOM) exhorted clinicians to focus on defining the concept of recovery, concentrating on symptom reduction, removal of the PTSD diagnosis, and end-state function. Although the IOM report mobilized large-scale efforts to quantify treatments and standardize delivery of treatment protocols, PTSD recovery remains a concept that has been largely unexplored. The primary aim of this study was to answer the following question: What is the basic psychosocial process that men and women undergo in recovering from PTSD? The study also fulfilled some secondary aims: (a) identifying which, if any, elements of traditional therapy contributed to recovery and (b) establishing a realistic timeline for recovery. Charmaz's method of narrative analysis and grounded theory construction was used to generate the PTSD Recovery Model. The model was nonlinear and included six universal stages that occurred during PTSD recovery: Experiencing Trauma, Dominating Diagnosis, Seeking Solace, Surviving Symptoms, Marking Time, and Navigating Recovery. Support for the model came from research participants and experts. Participants (N=41) were predominantly white, female, and had earned college or graduate degrees. Almost half of the participants (47.5%) reported that it required five years or more for them to feel better or attain some degree of recovery after exposure to trauma. Intimate partner violence and child sexual and/or physical abuse were the most commonly reported traumatic events that had caused PTSD. Although participants stated that experienced mental health clinicians were the most helpful persons or treatment in seeking recovery, they also reported that recovery typically involved a combination of traditional and alternative therapies, often used simultaneously. Most participants who reported recovery were actively engaged in seeking beneficial therapies and saw themselves as architects of the healing process. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +6245,Perceived Control is a Transdiagnostic Predictor of Cognitive–Behavior Therapy Outcome for Anxiety Disorders,"Perceived control has been proposed to be a general psychological vulnerability factor that confers an elevated risk for developing anxiety disorders, but there is limited research examining perceived control during cognitive-behavioral therapies (CBT). The present study examined whether treatment resulted in improvements in perceived control, and the indirect effects of CBT on changes in symptoms of obsessive-compulsive disorder, social phobia, generalized anxiety disorder, and panic disorder via changes in perceived control. Participants (n = 606) were a large clinical sample presenting for treatment at an outpatient anxiety disorders clinic. Participants completed a series of self-report questionnaires and a structured clinical interview at an intake evaluation and at two follow-up assessments 12 and 24 months later, with the majority of participants initiating CBT between the first two assessments. Results of latent growth curve models indicated that individuals initiating CBT subsequently reported large increases in perceived control and significant indirect effects of treatment on intraindividual changes in each of the four anxiety disorders examined via intraindividual changes in perceived control. These results suggest that the promotion of more adaptive perceptions of control is associated with recovery from anxiety disorders. Furthermore, the consistent finding of indirect effects across the four anxiety disorders examined underscores the transdiagnostic importance of perceived control in predicting CBT outcomes.",0,0 +6246,Influencing factors of posttraumatic stress disorder in the shipwreck related military rescuers in Yantai.,"Studied the influential factors of posttraumatic stress disorder (PTSD) and the impact on the shipwreck related military rescuers. Ss were 39 military rescuers (aged 17-49 yrs) (38 males and 1 female) who participated in rescue work after a shipwreck in Yantai, China, December 24th, 1999. One mo later, Ss were assessed with the Self-Rating PTSD Scale (X. Liu, et al, 1998), the Chinese revised version of the SCL-90 (W. Wu), the revised Life Event Scale (M. Zhang), the Eysenck Personality Questionnaire (EPQ), and a self-developed questionnaire referring to demographic information, stress of life events, and social supports. The prevalence of PTSD was 17.95% (7 Ss with PTSD). Correlation analysis revealed the significant factors related to PTSD: economic support when disadvantaged, satisfaction with leaders' attitudes and methods in rescue work, satisfaction in dealing with problems and affairs after the accident, stress in the rescue process, the score of the LES, and the N score of the EPQ. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6247,Treatment response heterogeneity in the predominant negative symptoms of schizophrenia: Analysis of amisulpride vs placebo in three clinical trials,"The extent of heterogeneity in response to the psychopharmacological treatment of negative symptoms is unknown.To examine the extent of heterogeneity in response to the treatment of predominantly negative symptoms of schizophrenia.Data were analyzed from three clinical trials that compared placebo or amisulpride for up to 60days. Trial participants had predominantly negative symptoms of schizophrenia (n=485). Heterogeneity of percentage reduction on the Scale for the Assessment of Negative Symptoms (SANS) was examined with trajectory-group based modeling followed by descriptive statistics and the prediction of trajectory group membership with logistic regression modeling. Analyses were repeated separately for the placebo and amisulpride groups.Trajectory group-based modeling identified groups of non- (n=297, 61.2%), gradual-moderate (n=135, 27.8%) and rapid- (n=53, 10.9%) responders. At baseline compared to non-responders, rapid-responders had consistently significantly (p<.05) higher SANS total and subscale scores. Percent SANS improvement at endpoint was greatest for the rapid-responders group, a finding that replicated stratifying by placebo and amisulpride treatment groups. Similarly, in the total sample and stratifying by placebo and amisulpride groups, dropout was not significantly associated with trajectory group membership.Trajectories of treatment response to the psychopharmacological medication of the negative symptoms of schizophrenia demonstrate substantial heterogeneity. Approximately half of the patients included in our analysis showed little improvement, and the most severely ill at baseline responded the most.",0,0 +6248,Failure to detect fabricated posttraumatic stress disorder with the use of the MMPI in a clinical population,"The authors attempted to replicate previous studies that used the Frequency (F) scale and the posttraumatic stress disorder (PTSD) subscale of the MMPI to discriminate Vietnam veterans with PTSD from well-adjusted veterans and mental health professionals who feigned symptoms of PTSD. Profiles of veterans with PTSD were compared to those of veterans with non-PTSD psychiatric disorders and veterans with fabricated PTSD symptoms who sought treatment. Discriminant analysis of F scale and PTSD subscale scores correctly identified only 43.59% of the subjects, thus failing to support use of the MMPI in detecting fabricated symptoms of PTSD in a clinical population.",0,0 +6249,Determinants of psychological resistance and recovery among women exposed to assaultive trauma,"Women exposed to potentially traumatic events (PTEs) are at high risk for developing psychiatric disorders, including posttraumatic stress disorder (PTSD), general anxiety disorder (GAD), major depressive disorder (MDD), and substance-related disorders. However, this risk is not universal. Most women are resistant (i.e., remain asymptomatic), or recover following a brief symptomatic period. This study examined the psychological factors associated with resistant and recovered outcomes in a sample of high-risk women exposed to assault-related PTEs.One hundred and fifty-nine women completed the Life Events Checklist and were administered the Structured Clinical Interview for DSM-IV Axis I Disorders. This resulted in three groups: (1) no diagnosis (no past or current psychiatric disorder diagnosis; n = 56), (2) past diagnosis (a past psychiatric disorder diagnosis, but none currently; n = 31), and (3) current diagnosis (a current diagnosis of one or more psychiatric disorders; n = 72). Groups were compared on sociodemographics, PTE exposure, psychopathology, health-related quality of life (HRQOL), and psychological resilience-related factors.The majority of respondents (79%) did not develop chronic PTSD following assault exposure, and the most common psychiatric outcome was MDD (30%). High endorsement of mastery and social support were associated with the no diagnosis group; and greater reports of mastery and posttraumatic growth were associated with recovery from a past psychiatric disorder. Furthermore, both resilient groups (i.e., no diagnosis and past diagnosis) scored higher on HRQOL measures compared with the current diagnosis group (P < 0.001).Psychological resilience has ramifications to health and well-being, and identifying these factors has potential to inform preventive strategies and treatment interventions for assault exposed women.",0,0 +6250,Combat-related post-traumatic stress disorder etiology: Replicated findings in a national sample of Vietnam-era men,"To examine the generality of recent findings on PTSD etiology in help-seeking Vietnam combat veterans, replication was attempted with data from a national study of Vietnam-era men that included combat veterans. Use of a Guttman scaling technique for assessing combat exposure was found to be robust for use with a national nonclinical sample as well. In addition, multiple regression analysis was used to examine predictive relationships between premilitary adjustment, military adjustment, combat exposure, and post-traumatic stress disorder (PTSD). Results obtained from the national sample showed the same patterning as that reported from the smaller clinical sample. Combat exposure was related significantly to PTSD symptomatology, while premilitary adjustment was not. A previously identified discriminant function, composed of psychological symptoms not found in the DSM III criteria for PTSD, also was cross-validated.",0,0 +6251,The Association Between Parent PTSD/Depression Symptoms and Child PTSD Symptoms: A Meta-Analysis,"The present article presents a meta-analysis of studies examining the association between parent posttraumatic stress disorder (PTSD)/depression symptoms and child PTSD symptoms (PTSS) after a child's exposure to a traumatic event while considering multiple moderating factors to explain heterogeneity of effect sizes.35 studies were included: 32 involving the association between parent and child PTSS and 9 involving the association between parent depression and child PTSS.Across existing studies, both parent and child PTSS (r = 0.31) and parent depression and child PTSS (r = 0.32) yielded significant effect sizes. Parent gender, assessment type (interview vs. questionnaire), differences in assessment type for parents and children, and study design (cross-sectional vs. longitudinal) moderated the relationship between parent and child PTSS.The current findings confirm the associations between parental posttraumatic responses and child PTSS and highlight important moderating factors to include in future studies of child PTSS.",0,0 +6252,Does Knowledge of Predictors of Recovery and Nonrecovery Assist Outcomes After Whiplash Injury?,"Nonsystematic review.Review of prognostic indicators for outcome after whiplash injury and the implications for clinical practice and future research.The capacity to predict outcome after whiplash injury is important to guide the management of the condition. There have now been numerous cohort studies and several systematic reviews of prognosis. It is not clear if the current knowledge of prognostic indicators is useful for clinical practice and to improve outcomes after injury.Nonsystematic review of research investigating the prediction of chronic pain/disability and psychological outcomes after whiplash injury.There remains considerable uncertainty surrounding the identification of clear prognostic indicators after whiplash injury. All systematic reviews note the moderate or lower quality if primary cohort studies and only one systematic review performed meta-analysis. There have been no studies attempting validation of predictive models. At the present time, the knowledge base stands that higher initial pain levels are the most consistent predictor of poor functional recovery. Additional promising factors include physical factors of cold hyperalgesia and loss of neck range of movement, although the latter is inconsistent. Psychological factors of pain catastrophizing, symptoms of post-traumatic stress and recovery perceptions are also prognostic of poor recovery and the presence of depressed mood is inconsistent. Further research is needed to validate predictive models, investigate interactions between factors, and to determine whether modification of predictors is possible and leads to improved outcomes.The understanding of factors predictive of poor recovery after whiplash injury is evolving. Although more research is required to validate predictive models, some factors show consistent predictive capacity and could be used in clinical practice as potential indicators of poor recovery. It is not known if the specific targeting of modifiable prognostic indicators can be achieved or will lead to improved outcomes.",0,0 +6253,The efficacy of a brief internet-based self-help intervention for the bereaved,"Research so far has shown little evidence that written disclosure facilitates recovery from bereavement. There are good reasons to assume that written disclosure may only benefit those bereaved who are at risk for developing problems or who are experiencing significant psychological problems as a result of their loss, and only when appropriate writing instructions are used. Drawing on previous work in the area of post-traumatic stress, a writing intervention was designed to test these assumptions. Bereaved individuals, who were still significantly distressed by their loss, were randomly assigned to the intervention condition (N = 460) or a waiting-list control condition (N = 297). Both groups filled in questionnaires online at baseline, and 3 and 6 months later. The intervention was administered via e-mail immediately after baseline measurement. Results showed that writing decreased feelings of emotional loneliness and increased positive mood, in part through its effect on rumination. However, writing did not affect grief or depressive symptoms. Contrary to expectations, effects did not depend on participants' risk profile or baseline distress level. Implications of these findings are discussed.",0,0 +6254,Incidence and Prediction of Posttraumatic Stress Disorder Symptoms in Severely Injured Accident Victims,"This study was designed to assess the incidence of posttraumatic stress disorder (PTSD) in severely injured accident victims and to predict the presence of PTSD symptoms at a 12-month follow-up.A longitudinal, 1-year follow-up study was carried out with 106 consecutive patients with severe accidental injuries who were admitted to the trauma surgeons' intensive care unit at a university hospital. Patients were interviewed within 1 month and 12 months after the accident. Assessments included an extensive clinical interview, the Impact of Event Scale, the Clinician-Administered PTSD Scale, the Sense of Coherence questionnaire, and the Freiburg Questionnaire of Coping With Illness.A total of 13.4 days (SD=6.6) after the accident, five patients (4.7%) met all criteria for PTSD with the exception of the time criterion. A total of 22 other patients (20.8%) had subsyndromal PTSD. At the 1-year follow-up, two patients (1.9%) had PTSD, and 13 (12.3%) had subsyndromal PTSD. Multiple regression analysis explained 34% of the variance of PTSD symptoms 12 months after the accident. Biographical risk factors, the sense of a death threat, symptoms of intrusion, and problem-oriented coping each contributed significantly to the predictive model.In severely injured accident victims who were healthy before experiencing trauma, the incidence of PTSD was low. One-third of the variance of PTSD symptoms at 1-year follow-up could be predicted by mainly psychosocial variables.",0,0 +6255,Holocaust survivors coping with open heart surgery decades later: posttraumatic symptoms and quality of life,"History of prolonged traumatization has been associated with reduced quality of life (QoL) and difficulties in coping with major life-threatening conditions. We assessed the association between the impact of Holocaust experience (posttraumatic symptoms) and QoL of patients before and after an open heart surgery.Sixty-three Holocaust survivors were interviewed before open heart surgery (at admission), 52 at follow-up at 1 week, and 58 at follow-up at 6 months. The interview included background data, Impact of Event Scale (IES), Mastery scale, and QoL measured by the Nottingham Health Profile. Medical data were retrieved from the patients' charts.The total IES score indicate a high level of posttraumatic symptoms at all the time points (close to a mean of 18), but there was a clear trend of changes in the avoidance subscale: At admission, the patients manifested lower avoidance compared with the levels after the surgery and at the follow-up. No significant differences in IES were found by Holocaust experiences. Significant improvements in most components of QoL were found at the follow-up. In multivariate analyses at each time point, the findings show that those with higher levels of posttraumatic symptoms are more at risk for problems in pain and mobility domains of QoL at admission, for emotional reaction after the surgery, and at the follow-up, these associations are only at trend level, while lower sense of mastery became significant.The improvement in QoL despite persistence of the impact of the Holocaust may indicate that past severe prolonged traumatization does not necessarily reduce the survivors' ability to cope with and regain physical and psychosocial functioning after a severe life-threatening medical condition. This may be further generalized to other significant crisis situations in life, such as prolonged periods of stress, suffered by many populations throughout the world.",0,0 +6256,Profiles of emotion regulation: Understanding regulatory patterns and the implications for posttraumatic stress,"Trauma survivors often experience posttraumatic stress (PTS) and report concurrent difficulties with emotion regulation (ER). Although individuals typically use multiple regulatory strategies to manage emotion, no studies yet examine the influence of a constellation of strategies on PTS in a community sample. We assessed six ER strategies and investigated whether specific profiles of ER (i.e. the typical pattern of regulation, determined by how often each strategy is used) were related to PTS. A hierarchical cluster analysis indicated that four distinct profiles were present: Adaptive Regulation, Active Regulation, Detached Regulation, and Maladaptive Regulation. Further analyses revealed that an individual's profile was not related to frequency of past trauma, but had the power to differentiate symptom severity for overall PTS and each symptom cluster of posttraumatic stress disorder. These findings highlight how profiles characterising multiple regulatory strategies offer a more complete understanding of the ways ER can account for PTS.",0,0 +6257,Challenges in modelling the random structure correctly in growth mixture models and the impact this has on model mixtures,"Lifecourse trajectories of clinical or anthropological attributes are useful for identifying how our early-life experiences influence later-life morbidity and mortality. Researchers often use growth mixture models (GMMs) to estimate such phenomena. It is common to place constrains on the random part of the GMM to improve parsimony or to aid convergence, but this can lead to an autoregressive structure that distorts the nature of the mixtures and subsequent model interpretation. This is especially true if changes in the outcome within individuals are gradual compared with the magnitude of differences between individuals. This is not widely appreciated, nor is its impact well understood. Using repeat measures of body mass index (BMI) for 1528 US adolescents, we estimated GMMs that required variance–covariance constraints to attain convergence. We contrasted constrained models with and without an autocorrelation structure to assess the impact this had on the ideal number of latent classes, their size and composition. We also contrasted model options using simulations. When the GMM variance–covariance structure was constrained, a within-class autocorrelation structure emerged. When not modelled explicitly, this led to poorer model fit and models that differed substantially in the ideal number of latent classes, as well as class size and composition. Failure to carefully consider the random structure of data within a GMM framework may lead to erroneous model inferences, especially for outcomes with greater within-person than between-person homogeneity, such as BMI. It is crucial to reflect on the underlying data generation processes when building such models.",0,0 +6258,Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes.,"To explore the taxonomy of combat-related mild traumatic brain injury (mTBI) based on symptom patterns.Up to 1341 military personnel who experienced a combat-related mTBI within 2 years of evaluation.Neurobehavioral Symptom Inventory and PTSD Checklist-Civilian Version (PCL-C).Cluster analysis revealed the following 4 subtypes: primarily psychiatric (posttraumatic stress disorder) group, a cognitive group, a mixed symptom group, and a good recovery group. The posttraumatic stress disorder cluster (21.9% of the sample) reported symptoms related to hyperarousal and dissociation/depression with few complaints related to cognition or headaches. The cognitive group (21.5% of the sample) had primarily cognitive and headache complaints with few mood symptoms. The mixed profile cluster included 18.6% of the sample and was characterized by a combination of mood complaints (hyperarousal and dissociation/depression), cognitive complaints, and headaches. The largest cluster (37.8% of the sample) had an overall low symptom profile and was labeled the ""good recovery"" group.The results support a unique taxonomy for combat-related mTBI. The clinical differences among these subtypes indicate a need for unique treatment resources and programs.",0,0 +6259,Family history study of the familial coaggregation of borderline personality disorder with axis I and nonborderline dramatic cluster axis II disorders.,"The purpose of this study was to assess the familial coaggregation of borderline personality disorder (BPD) with a full array of axis I disorders and four axis II disorders (antisocial personality disorder, histrionic personality disorder, narcissistic personality disorder, and sadistic personality disorder) in the first-degree relatives of borderline probands and axis II comparison subjects. Four hundred and forty-five inpatients were interviewed about familial psychopathology using the Revised Family History Questionnaire-a semistructured interview of demonstrated reliability. Of these 445 subjects, 341 met both DIB-R and DSM-III-R criteria for BPD and 104 met DSM-III-R criteria for another type of personality disorder (and neither criteria set for BPD). The psychopathology of 1,580 first-degree relatives of borderline probands and 472 relatives of axis II comparison subjects was assessed. Using structural models for familial coaggregation, it was found that BPD coaggregates with major depression, dysthymic disorder, bipolar I disorder, alcohol abuse/dependence, drug abuse/dependence, panic disorder, social phobia, obsessive-compulsive disorder, generalized anxiety disorder, posttraumatic stress disorder, somatoform pain disorder, and all four axis II disorders studied. Taken together, the results of this study suggest that common familial factors, particularly in the areas of affective disturbance and impulsivity, contribute to borderline personality disorder.",0,0 +6260,Neurobiological Risk Factors and Predictors of Vulnerability and Resilience to PTSD,"The risk of developing PTSD following a traumatic experience depends on several vulnerability factors that may be classified into three distinct categories: Pre-traumatic, peri-traumatic, and posttraumatic vulnerability factors. Accordingly, while we attempted to create a profile of the high-risk PTSD patient, the following factors should be included, among others: Small hippocampus, previously altered HPA axis, vulnerable genetic profile, associated body injury, increased post-trauma noradrenergic activity. Some protective factors have been identified and included, but are not limited to coping, resources (e.g., social support, self-esteem, optimism), and finding meaning. Finally, human beings are resilient and in general are able to cope with adverse situations. Therefore, discovering possible resilience factors may assist in identifying the patients at risk and may contribute to developing the strategies to prevent the development of PTSD. © Springer Science+Business Media New York 2015.",0,0 +6261,Diabetes Among Refugee Populations: What Newly Arriving Refugees Can Learn From Resettled Cambodians,"A growing body of literature suggests that cardiometabolic disease generally and type 2 diabetes specifically are problems among refugee groups. This paper reviews rates of cardiometabolic disease and type 2 diabetes among refugees and highlights their unique risk factors including history of malnutrition, psychiatric disorders, psychiatric medications, lifestyle changes toward urbanization and industrialization, social isolation, and a poor profile on the social determinants of health. Promising interventions are presented for preventing and treating diabetes in these groups. Such interventions emphasize well-coordinated medical and mental health care delivered by cross-cultural and multidisciplinary teams including community health workers that are well integrated into the community. Finally, recommendations for service, policy, and research are made. The authors draw on local data and clinical experience of our collective work with Cambodian American refugees whose 30-year trajectory illustrates the consequences of ignoring diabetes and its risk factors in more recent, and soon to be arriving, refugee cohorts.",0,0 +6262,Voxel-based diffusion tensor analysis reveals aberrant anterior cingulum integrity in posttraumatic stress disorder due to terrorism,"Recent functional neuroimaging work has suggested that interregional functional connectivity between the anterior cingulate cortex (ACC), other limbic, and prefrontal regions may be involved in the pathophysiology of posttraumatic stress disorder (PTSD). However, less attention has been paid to the white matter network. Voxel-based analysis enables an exploration of morphological or functional changes throughout the entire brain. Here we undertook the first application of this technology to diffusion tensor data in patients with PTSD. Participants were 9 victims of the Tokyo subway sarin attack with PTSD and 16 matched victims of the same traumatic event without PTSD. The voxel-based analysis showed a significant fractional anisotropy increase in the left anterior cingulum, subjacent to the left ACC gray matter where we previously found a volume decrement, in PTSD subjects. Moreover, the severity was positively, but not significantly associated with the fractional anisotropy of the left anterior cingulum in the victims with PTSD, using the region of interest defined in the native space with the inverse normalization technique. The present study demonstrated further evidence of abnormalities of both the ACC, a structure that is pivotally involved in attention, emotional regulation, and fear conditioning, and of subjacent white matter in the pathology of PTSD.",0,0 +6263,Posttraumatic Stress Disorder in Injured Adults: Etiology by Path Analysis,"Posttraumatic Stress Disorder (PTSD) impairs outcome from injury. We present a path analysis of factors related to the development of PTSD in injured adults.A prospective cohort of 250 patients without severe neurotrauma was evaluated by interview during admission and by mailed self-report 6 months later. Data were gathered from the trauma registry (age, injury mechanism, and Injury Severity Score), social history (gender, income, education, and social support), and survey instruments. Baseline assessment used the Michigan Critical Events Perception Scale (peritraumatic dissociation and subjective threat to life), the Life Experience Survey (stressful exposure history), and the SF36 (general and mental health). PTSD at 6 months was identified with the civilian Mississippi Scale for PTSD. Data are listed as mean +/- SEM or percent (%). Path analysis was conducted by linear regression and significant (p<0.05) variables are shown. Factors are listed with the standardized beta. A negative beta suggests a protective effect.The 176 patients (72%) who completed the 6-month follow-up were 37.7+/-0.88 years old; 75% were men; and blunt (70%), penetrating (13.5%), and burn (16.4%) mechanisms caused the injuries. Assault was involved in 14.5% of the cases. Average income was $44,300+/-2,700/yr, education was 13.0+/-0.15 years, and Injury Severity Score was 13.9+/-0.50. A total of 42.3% of the patients developed PTSD. The 39.7% of the variance in PTSD explained by the model was due to intentional injury (beta = 0.27), male gender (beta = -0.21), age (beta = -0.20), peritraumatic dissociation (beta = 0.174), baseline mental health (beta = -0.21), and prior life-threatening illness (beta = -0.29). Peritraumatic dissociation was due to the patient's sense of threat to life (beta = -0.47), and threat was related to Injury Severity Score (beta = 0.2), assault(beta = 0.14), education (beta = -0.15), and age (beta = -0.19). Baseline SF36 mental health was related to social support (beta = 0.27) and income (beta = 0.21). Income was contingent on education (beta = 0.21).PTSD occurred in 42.3% of injured adults 6 months after trauma and was related to assault, dissociation, female gender, youth, poor mental health, and prior illness. By modeling PTSD, we may learn more of the etiology, risk stratification, and potentials for the treatment of this common and important morbidity of injury.",0,0 +6264,Confirmatory factor analysis of posttraumatic stress symptoms in emergency personnel: An examination of seven alternative models,"Recent studies into the underlying factor structure of posttraumatic stress symptoms often report factor structures that do not replicate the three symptom cluster of re-experiencing, avoidance and arousal symptoms as classified within the Diagnostic and Statistical Manual of Mental disorders (American Psychiatric Association, 1994, 2000). Data from 485 emergency service personnel who had experienced an occupational trauma were submitted to confirmatory factor analysis to test seven alternative factor models of posttraumatic stress symptoms. This study is one of the most comprehensive structural analyses of posttrauma symptoms to date. The model of best fit comprised four first-order factors including intrusion, avoidance, numbing and arousal alongside a general PTSD factor. This study highlighted the difference between the current DSM symptom groupings and those derived empirically.",0,0 +6265,Is Comorbidity of Posttraumatic Stress Disorder and Borderline Personality Disorder Related to Greater Pathology and Impairment?,"The authors examined whether patients with comorbid borderline personality disorder and posttraumatic stress disorder (PTSD) have a more severe clinical profile than patients with either disorder without the other.Outpatients with borderline personality disorder without PTSD (N=101), PTSD without borderline personality disorder (N=121), comorbid borderline personality disorder and PTSD (N=48), and major depression without PTSD or borderline personality disorder (N=469) were assessed with structured interviews for psychiatric disorders and for degree of impairment.Outpatients with diagnoses of comorbid borderline personality disorder and PTSD were not significantly different from outpatients with borderline personality disorder without PTSD, PTSD without borderline personality disorder, or major depression without PTSD or borderline personality disorder in severity of PTSD-related symptoms, borderline-related traits, or impairment.The additional diagnosis of PTSD or borderline personality disorder does little to augment the pathology or dysfunction of patients who have either disorder without the other.",0,0 +6266,Mapping evidence-based treatments for children and adolescents: Application of the distillation and matching model to 615 treatments from 322 randomized trials.,"This study applied the distillation and matching model to 322 randomized clinical trials for child mental health treatments. The model involved initial data reduction of 615 treatment protocol descriptions by means of a set of codes describing discrete clinical strategies, referred to as practice elements. Practice elements were then summarized in profiles, which were empirically matched to client factors (i.e., observed problem, age, gender, and ethnicity). Results of a profile similarity analysis demonstrated a branching of the literature into multiple problem areas, within which some age and ethnicity special cases emerged as higher order splits. This is the 1st study to aggregate evidence-based treatment protocols empirically according to their constituent treatment procedures, and the results point both to the overall organization of therapy procedures according to matching factors and to gaps in the current child and adolescent treatment literature.",0,0 +6267,War stressors and symptom persistence in posttraumatic stress disorder,"Abstract This study focused on delineating aspects of war stressors associated with risk for posttraumatic stress disorder in Vietnam veterans. Findings from 191 Vietnam war veterans are presented, addressing which elements of the war experience predicted PTSD in remission or persistent PTSD. Some experiences, like loss and injury, predicted having had PTSD symptoms in the past, while other experiences, such as exposure to grotesque death, predicted current (persistent) PTSD. Discriminant analysis showed that the more extreme/intense the stressor experiences, the higher the risk for developing PTSD and for persistent symptoms. These findings provide empirical support for the PTSD diagnosis and additional data for refining the PTSD stressor criterion.",0,0 +6268,"Somatoform Disorders and Trauma in Medically-Admitted Children, Adolescents, and Young Adults: Prevalence Rates and Psychosocial Characteristics","The purpose of this study is to describe past traumatic experiences in medically-admitted pediatric and young adult patients diagnosed with somatoform disorders and to explore the demographic, diagnostic, and psychosocial differences between those with and without trauma histories.Retrospective medical record reviews were performed for patients (aged 3-29 years) seen by the Psychiatry Consultation Service (2010-2011) at a pediatric medical hospital and diagnosed with a somatoform disorder. Clinical data collected included demographics, medical history, current physical symptoms, psychiatric diagnoses and history, trauma history, coping styles, family psychiatric and medical history, peer and family factors, psychiatric disposition after discharge, and service utilization.The mean age of the 180 identified patients was 15.1 years. Most patients were girls (75.0%) and White (71.7%). Somatoform diagnoses were primarily pain (51.4%) and conversion disorders (28.9%). Rates of trauma were similar to national norms (29.7%). Trauma history did not correlate with age, sex, race, income, length of hospitalization, or type of somatoform disorders. However, patients with trauma histories had significantly higher rates of psychiatric comorbidities (76.0% vs. 50.8%), past psychiatric treatment (81.1% vs. 59.1%), parent mental illness (69.8% vs. 38.6%), and family conflict (52.8% vs. 37.0%) and were more likely to require inpatient psychiatric hospitalization on discharge (18.9% vs. 6.3%).Prevalence of trauma in a sample of medically-admitted pediatric and young adult patients with somatoform diagnoses was similar to national norms. However, patients with a history of trauma had unique psychiatric and psychosocial profiles compared to those without a history of trauma.",0,0 +6269,Comorbidity of Psychiatric Disorders and Personality Profiles of American World War II Prisoners of War,"To characterize the effects of trauma sustained more than 40 years ago, prevalence of psychiatric disorders and personality dimensions were examined in a sample of 62 former World War II POWs. The negative effects of their experiences are reflected in their multiple lifetime diagnoses and in their current personality profiles. Fifty percent met DSM-III posttraumatic stress disorder (PTSD) criteria within 1 year of release; 18 (29%) continued to meet the criteria 40 years later at examination (chronic PTSD). A lifetime diagnosis of generalized anxiety disorder was found for over half the entire sample; in 42% of those who never had PTSD, 38% of those with recovery from PTSD, and 94% of those with chronic PTSD. Ten percent of those without a PTSD diagnosis had experienced a depressive disorder, as had 23% of those with recovery from PTSD and 61% of the POWs with chronic PTSD. The combination of depressive and anxiety disorders also was frequent in the total sample (61%). Current MMPIs of three groups with psychiatric diagnosis were compared with those of POWs who had no diagnoses and with a group of Minnesota normal men. Profile elevations for the groups, from highest to lowest, were: POWs with chronic PTSD, POWs with recovery from PTSD, POWs with other psychiatric diagnoses, POWs with no disorders, and Minnesota normal men. Symptoms of anxiety, depression, and somatic concerns combined with the personality styles of suppression and denial characterize the current adjustment of negatively affected POWs.",0,0 +6270,Release of gliotransmitters through astroglial connexin 43 hemichannels is necessary for fear memory consolidation in the basolateral amygdala,"Recent in vitro evidence indicates that astrocytes can modulate synaptic plasticity by releasing neuroactive substances (gliotransmitters). However, whether gliotransmitter release from astrocytes is necessary for higher brain function in vivo, particularly for memory, as well as the contribution of connexin (Cx) hemichannels to gliotransmitter release, remain elusive. Here, we microinfused into the rat basolateral amygdala (BLA) TAT-Cx43L2, a peptide that selectively inhibits Cx43-hemichannel opening while maintaining synaptic transmission or interastrocyte gap junctional communication. In vivo blockade of Cx43 hemichannels during memory consolidation induced amnesia for auditory fear conditioning, as assessed 24 h after training, without affecting short-term memory, locomotion, or shock reactivity. The amnesic effect was transitory, specific for memory consolidation, and was confirmed after microinfusion of Gap27, another Cx43-hemichannel blocker. Learning capacity was recovered after coinfusion of TAT-Cx43L2 and a mixture of putative gliotransmitters (glutamate, glutamine, lactate, d-serine, glycine, and ATP). We propose that gliotransmitter release from astrocytes through Cx43 hemichannels is necessary for fear memory consolidation at the BLA. Thus, the present study is the first to demonstrate a physiological role for astroglial Cx43 hemichannels in brain function, making these channels a novel pharmacological target for the treatment of psychiatric disorders, including post-traumatic stress disorder.",0,0 +6271,"Posttraumatic stress disorder, alcohol use, and life stress among African-American women","Robust data document the strong association between posttraumatic stress disorder (PTSD) symptoms and problematic alcohol use in female psychiatric patients. Reasons for this frequent co-morbidity remain unclear, highlighting the value of investigating factors common to both disorders to gain additional clarity. The current study examined whether the psychosocial factor, life stress, mediated the link between PTSD symptomatology and alcohol use in a sample of African-American women from low-income backgrounds with a history of intimate partner violence and suicidality (n = 143). Bootstrapping analysis demonstrated that life stress fully mediated the effect of PTSD symptoms on alcohol use. Consistent with the self-medication hypothesis of addiction, our findings indicate that life stress may be a causal mechanism in the development of subsequent alcohol problems among women with existing PTSD symptomatology. Prevention and treatment implications concerning the target population are discussed.",0,0 +6272,Family and peer social support and their links to psychological distress among hurricane-exposed minority youth.,"Experiencing a disaster such as a hurricane places youth at a heightened risk for psychological distress such as symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression. Social support may contribute to resilience following disasters, but the interrelations of different types of support, level of exposure, and different symptoms among youth is not well understood. This study examined associations among family and peer social support, level of hurricane exposure, and their links to psychological distress using both a large single-time assessment sample (N = 1,098) as well as a longitudinal sample followed over a 6-month period (n = 192). Higher levels of hurricane exposure were related to lower levels of social support from family and peers. Higher levels of family and peer social support demonstrated both concurrent and longitudinal associations with lower levels of psychological distress, with associations varying by social support source and psychological distress outcome. Findings also suggested that the protective effects of high peer social support may be diminished by high hurricane exposure. The results of this study further our understanding of the role of social support in hurricane-exposed youths' emotional functioning and point to the potential importance of efforts to bolster social support following disasters.",0,0 +6273,Surviving the Vajont Disaster,"The aim of the present study was to assess the chronic psychiatric consequences of the Vajont disaster in a group of survivors still living in the valley 36 years after the event. Thirty-nine subjects were assessed by means of a semistructured interview to investigate the extent of the traumatic experience and a structured diagnostic interview for the diagnoses of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). The degree of traumatic exposure significantly predicts the presence of PTSD. The lifetime frequency of full PTSD was 26%, and a further 33% of the sample displayed partial PTSD. Lifetime MDD was present in 28% of the subjects, and its prediction factors were female gender and number of losses of first-degree relatives in the disaster. Trauma-related fears are very common in the sample. A large-scale disaster, such as that of the Vajont valley, affects the psychological health of survivors for decades.",0,0 +6274,Resilience: A psychobiological construct for psychiatric disorders,"Understanding of psychopathology of mental disorder is evolving, particularly with availability of newer insight from the field of genetics, epigenetics, social, and environmental pathology. It is now becoming clear how biological factors are contributing to development of an illness in the face of a number of psychosocial factors. Resilience is a psychobiological factor which determines individual's response to adverse life events. Resilience is a human capacity to adapt swiftly and successfully to stressful/traumatic events and manage to revert to a positive state. It is fundamental for growth of positive psychology which deals with satisfaction, adaptability, contentment, and optimism in people's life. Of late, there has been a paradigm shift in the understanding of resilience in context of stress risk vulnerability dimension. It is a neurobiological construct with significant neurobehavioral and emotional features which plays important role in deconstructing mechanism of biopsychosocial model of mental disorders. Resilience is a protective factor against development of mental disorder and a risk factor for a number of clinical conditions, e.g. suicide. Available information from scientific studies points out that resilience is modifiable factor which opens up avenues for a number of newer psychosocial as well as biological therapies. Early identification of vulnerable candidates and effectiveness of resilience-based intervention may offer more clarity in possibility of prevention. Future research may be crucial for preventive psychiatry. In this study, we aim to examine whether resilience is a psychopathological construct for mental disorder.",0,0 +6275,Exploration of Delayed-Onset Posttraumatic Stress Disorder After Severe Injury,"The first aim of this work was to conduct a rigorous longitudinal study to identify rates of delayed-onset posttraumatic stress disorder (PTSD) in a sample of patients with severe injury. The second aim was to determine what variables differentiated delayed-onset PTSD from chronic PTSD.Randomly selected patients with injury who were admitted to four hospitals around Australia were recruited to the study (N = 834) and assessed in the acute care hospital, at 3 months, and at 12 months. A structured clinical interview was used to assess PTSD at each time point.Seventy-three patients (9%; n = 73) had PTSD at 12 months. Of these, 39 (53%) were classified as having delayed-onset PTSD. Furthermore, 22 (56%) patients with delayed-onset PTSD had minimal PTSD symptoms at 3 months (i.e., they did not have partial/subsyndromal PTSD at 3 months). The variables that differentiated delayed-onset PTSD from chronic PTSD were greater injury severity (odds ratio [OR] = 1.13; 95% confidence interval [CI] = 1.02-1.26), lower anxiety severity at 3 months (OR = 0.73; 95% CI = 0.61-0.87), and greater pain severity at 3 months (OR = 1.39; 95% CI = 1.06-1.84).Delayed-onset PTSD occurred frequently in this sample. Approximately half of the patients with delayed-onset PTSD had minimal PTSD symptoms at 3 months; therefore, their delayed-onset PTSD could not be accounted for by a small number of fluctuating symptoms. As we move toward DSM-V, it is important that research continues to explore the factors that underpin the development of delayed-onset PTSD.",0,0 +6276,Naturalistic Comparison of Models of Programmatic Interventions for Combat-Related Post-Traumatic Stress Disorder,"Objectives: Post-traumatic stress disorder (PTSD) is a difficult-to-treat sequel of combat. Data on effectiveness of alternate treatment structures are important for planning veterans’ psychiatric services. The present study compared clinical presentations and treatment outcomes for Australian veterans with PTSD who participated in a range of models of group-based treatment. Method: Participants consisted of 4339 veterans with combat-related PTSD who participated in one of five types of group-based cognitive behavioural programmes of different intensities and settings. Data were gathered at baseline (intake), as well as at 3 and 9 month follow up, on measures of PTSD, anxiety, depression and alcohol misuse. Analyses of variance and effect size analyses were used to investigate differences at intake and over time by programme type. Results: Small baseline differences by programme intensity were identified. Although significant improvements in symptoms were evident over time for each programme type, no significant differences in outcome were evident between programmes. When PTSD severity was considered, veterans with severe PTSD performed less well in the low-intensity programmes than in the moderate- or high-intensity programmes. Veterans with mild PTSD improved less in high-intensity programmes than in moderate- or low-intensity programmes. Conclusion: Comparable outcomes are evident across programme types. Outcomes may be maximized when veterans participate in programme intensity types that match their level of PTSD severity. When such matching is not feasible, moderate-intensity programmes appear to offer the most consistent outcomes. For regionally based veterans, delivering treatment in their local environment does not detract from, and may even enhance, outcomes. These findings have implications for the planning and purchasing of mental health services for sufferers of PTSD, particularly for veterans of more recent combat or peacekeeping deployments.",0,0 +6277,Increased co-morbidity of depression and post-traumatic stress disorder symptoms and common risk factors in intensive care unit survivors: A two-year follow-up study,"To investigate the long-term psychological impact of intensive care unit (ICU) hospitalization, as well as to establish risk factors which successfully discriminate patients at higher risk.The Medical Outcomes Study Short Form Survey (SF-36), the Center for Epidemiologic Studies for Depression (CES-D), and the Davidson Trauma Scale (DTS) questionnaires were obtained from 48 ICU survivors who were also interviewed and self-reported on several acknowledged risk factors.A high co-morbidity between depression and post-traumatic stress disorder (PTSD) cases was observed. Both CES-D and DTS scores correlated negatively with the SF-36 mental health subscale scores; although a causative relation cannot be attributed to this finding, it indicates a potential negative impact of depression and PTSD symptoms on the patients' quality of life even at 18- to 24-month post-ICU. The most important risk factor associated with a long-term impact on quality of life, depression and PTSD was lifetime history of any psychiatric disorder.During ICU admissions efforts should be made towards identifying and psychologically supporting those patients with a previous history of a psychiatric disease, as they are at considerably higher risk of suffering from the long-term psychological sequelae of ICU admission.",0,0 +6278,Validity and Reliability of the Persian Language Version of the Neuropsychiatry Unit Cognitive Assessment Tool,"<i>Background/Aims:</i> Only a limited number of cognitive screening tools are available for the Persian-speaking population, and we sought to translate and validate the Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG), a multidimensional cognitive screening tool. <i>Methods:</i> We used multiple language specialists to translate and then back-translate the NUCOG, and administered the Persian language NUCOG and Mini-Mental State Examination (MMSE) to 184 individuals: 60 controls and 124 patients, 33 of whom had dementia, 30 non-dementing neurological disorders and 61 a psychiatric illness. <i>Results:</i> The NUCOG outperformed the MMSE in differentiating the patient groups and controls. The ‘profile’ across the 5 NUCOG domains differentiated dementia subgroups such as senile dementia of the Alzheimer type (SDAT), frontotemporal dementia and mild cognitive impairment (MCI). Psychiatric patients with psychosis and posttraumatic stress disorder were more impaired than patients with affective disorders. The NUCOG reliably differentiated controls from patients with MCI (at 86.5/100, sensitivity of 83.3% and specificity of 87.5%) and SDAT (at 75/100, sensitivity and specificity of 100%) patients from controls. <i>Conclusions:</i> The Persian language NUCOG appears to perform strongly in an unselected population, reliably differentiating patients with dementia from controls, and detecting cognitive impairment in a range of clinical disorders.",0,0 +6279,"Post-traumatic stress disorder, social support and cognitive status in community-based older veterans","Objective: The present study investigated the relationships between structural and qualitative aspects of social support, combat-related post-traumatic stress disorder (PTSD) and cognitive status in a New Zealand veterans sample. Methods: A random sample of 232 New Zealand veterans completed a self-report questionnaire and participated in a face-to-face interview. Results: Regression analysis showed that when controlling for age, income, education, depression and general health, PTSD scores had a negative relationship with cognitive status. Those who reported having private, restricted social networks had poorer cognitive functioning. These relationships were independent of each other. Conclusions: The findings suggest that while social support might be a potential target for interventions in at-risk older adults, health professionals need to be aware of the concomitant possible influence of past trauma when dealing with this specific population.",0,0 +6280,Psychobiology of the acute stress response and its relationship to the psychobiology of post-traumatic stress disorder,"The literature to date that examines the biology of the acute stress reactions suggests that relatively lower baseline cortisol is associated with the development of PTSD. This is particularly informative because of the ongoing controversy surrounding baseline cortisol in PTSD. Studies have found low baseline cortisol, normal range, and elevated baseline cortisol in chronic PTSD, and it has been unclear whether this reflects methodologic differences across studies or true heterogeneity within the disorder. Thus, the few studies to date support the finding of low-normal baseline cortisol in chronic PTSD and suggest that it is a pre-existing functional trait. Whether it plays an etiologic role or is an epiphenomenon of some other process is unclear. What does seem clear, however, is that this characteristic is relatively nonspecific to PTSD, given the fact that low cortisol has been observed in multiple subject populations, including normal individuals under chronic stress as well as chronic medical conditions (for review see [23]). For example, it is possible that reduced baseline cortisol reflects the net result of input to the hypothalamus from cortical and subcortical regions of the brain linked to increased vigilance, sensitization to trauma because of prior traumatic experiences, or genetic factors. For example, primate studies have demonstrated persistent alterations in HPA axis functioning in animals reared by mothers living in moderately stressful conditions [24]. The development of PTSD is associated with sensitization of the startle response. Because the neurobiology of startle is well characterized, this finding implicates a role for specific neurocircuitry in PTSD [25]. Non-habituation of the startle response in PTSD appears related to sensitization specifically to contextual cues (i.e., the environment) that signal the presence of potential threat of danger-related fears [26]. This may be the neurobiological correlate to the over-generalization seen in PTSD that distinguishes the disorder from a simple trauma-induced phobia. The bed nucleus of the stria terminalis (BNST) is specifically implicated from preclinical research in the mediation of context-dependent cues [1]. Treatments that result in down-regulation of the BNST are therefore of particular interest in therapeutic models of prevention after trauma. The fact that a number of vulnerability factors associated with increased risk for developing PTSD are also likely to be biologically based (e.g., a genetic component, prior psychiatric history, prior family of history of psychiatric disorder), provides further evidence in support of a role for psychobiological factors in producing PTSD. Nevertheless, the considerable overlap on these measures between those who will develop PTSD, and those who eventually recover spontaneously, belies any attempt to identify any single or pathognomonic biological marker for risk. For now, the standard of care in predicting level of symptomatology and prognosis in the acute setting continues to be based on careful, informed, serial assessments of symptoms and functioning. Because the capacity to learn from and adapt to adverse conditions are essential to the survival of any species, understanding the neurobiological pathways that mediate learning from traumatic experiences in an adaptive way is as important as understanding the etiology of PTSD and other trauma-related maladaptive consequences. Biological models that trace the causal cascade of post-traumatic events in the brain and neuroendocrine systems may offer a multiplicity of possibilities for intervention. It is well established that conditioned responses are robust and persistent. Moreover, the primary mechanism of habituation is overlearning rather than extinction. Interventions that promote overlearning may therefore prove to be the most powerful and efficient preventative treatments. The therapeutics literature supports this hypothesis, in that brief psychosocial interventions based on sophisticated cognitive-behavioral models have proven effective in reducing suffering, symptom severity, and chronicity in individuals presenting with acute PTSD symptoms [27-29]. No acutely administered pharmacologic treatment to date has been shown effective in accelerating the process of recovery or in preventing the development of chronic PTSD. However, pharmacologic interventions that would prevent sensitization of circuits related to context-dependent threat perception, dysregulation of affect, and/or dysregulation of normal circadian rhythms are of theoretical interest and deserve further study.",0,0 +6281,Predictors of long-term prognosis of depression,"Many people with depression experience repeated episodes. Previous research into the predictors of chronic depression has focused primarily on the clinical features of the disease; however, little is known about the broader spectrum of sociodemographic and health factors inherent in its development. Our aim was to identify factors associated with a long-term negative prognosis of depression.We included 585 people aged 16 years and older who participated in the 2000/01 cycle of the National Population Health Survey and who reported experiencing a major depressive episode in 2000/01. The primary outcome was the course of depression until 2006/07. We grouped individuals into trajectories of depression using growth trajectory models. We included demographic, mental and physical health factors as predictors in the multivariable regression model to compare people with different trajectories.Participants fell into two main depression trajectories: those whose depression resolved and did not recur (44.7%) and those who experienced repeated episodes (55.3%). In the multivariable model, daily smoking (OR 2.68, 95% CI 1.54-4.67), low mastery (i.e., feeling that life circumstances are beyond one's control) (OR 1.10, 95% CI 1.03-1.18) and history of depression (OR 3.5, 95% CI 1.95-6.27) were significant predictors (p < 0.05) of repeated episodes of depression.People with major depression who were current smokers or had low levels of mastery were at an increased risk of repeated episodes of depression. Future studies are needed to confirm the predictive value of these variables and to evaluate their accuracy for diagnosis and as a guide to treatment.",0,0 +6282,A Neuropsychological Profile of Childhood Maltreatment Within an Adolescent Inpatient Sample,"Recent research has begun to identify the neurocognitive and psychological effects of childhood maltreatment, although information is limited on the neuropsychological presentation of maltreatment in psychiatrically hospitalized adolescents. This study examined the executive-functioning and language abilities as well as psychopathological presentation of childhood maltreatment victims in an adolescent psychiatric inpatient setting. The sample consisted of adolescent inpatients (ages 13-19 years old) who completed a neuropsychological/psychological assessment during hospitalization (n = 122). The sample was grouped based on childhood maltreatment history, with one group categorized by maltreatment history (n = 49) and the other group characterized by no maltreatment history (n = 73). Analyses revealed statistically significant differences (p < .01) between maltreatment groups on executive functioning, as well as on measures of self-reported depression and anxiety symptoms. No group differences remained after controlling for posttraumatic stress disorder. Further, distinct neuropsychological profiles were identified for specific types of maltreatment experienced. These findings suggest that while childhood maltreatment is associated with a range of neuropsychological impairments, the specific type of maltreatment experienced may have a significant influence on the type and severity of impairments. These findings contribute to the growing body of research on the significant consequences of childhood maltreatment.",0,0 +6283,Conditioned fear extinction and reinstatement in a human fear-potentiated startle paradigm,"The purpose of this study was to analyze fear extinction and reinstatement in humans using fear-potentiated startle. Participants were fear conditioned using a simple discrimination procedure with colored lights as the conditioned stimuli (CSs) and an airblast to the throat as the unconditioned stimulus (US). Participants were extinguished 24 h after fear conditioning. Upon presentation of unsignaled USs after extinction, participants displayed significant fear reinstatement. In summary, these procedures produced robust fear-potentiated startle, significant CS+/CS− discrimination, within-session extinction, and significant reinstatement. This is the first demonstration of fear extinction and reinstatement in humans using startle measures.",0,0 +6284,A confirmatory factor analysis of combined models of the Harvard Trauma Questionnaire and the Inventory of Complicated Grief-Revised: Are we measuring complicated grief or posttraumatic stress?,"The aim of this study was to assess the factorial structure of complicated grief (CG) and investigate the relationship between CG and posttraumatic stress disorder (PTSD) through the assessment of models combining both constructs. The questionnaire was completed by elderly, married respondents with a history of at least one significant, interpersonal loss (145 males and 147 females, 60–81 years). Confirmatory factor analysis (CFA) supported a two-factor model of separation and traumatic distress in CG. To investigate the relationship between CG and PTSD three combined models were specified and estimated using CFA. A model where all five factors, the two factors of CG and the three factors of PTSD, as defined by the DSM-IV, were allowed to correlate provided the best fit. The results indicated a considerable overlap between the dimensions of CG and PTSD, and complicated grief is construct that appears to be largely accounted for by especially the intrusive component of PTSD.",0,0 +6285,The Evolving Construct of Posttraumatic Stress Disorder (PTSD): DSM-5 Criteria Changes and Legal Implications,"In the DSM-5, the diagnosis of posttraumatic stress disorder (PTSD) has undergone multiple, albeit minor, changes. These changes include shifting PTSD placement from within the anxiety disorders into a new category of traumatic and stressor-related disorders, alterations in the definition of a traumatic event, shifting of the symptom cluster structure from three to four clusters, the addition of new symptoms including persistent negative beliefs and expectations about oneself or the world, persistent distorted blame of self or others, persistent negative trauma-related emotions, and risky or reckless behaviors, and the addition of a dissociative specifier. The evidence or lack thereof behind each of these changes is briefly reviewed. These changes, although not likely to change overall prevalence, have the potential to increase the heterogeneity of individuals receiving a PTSD diagnosis both by altering what qualifies as a traumatic event and by adding symptoms commonly occurring in other disorders such as depression, borderline personality disorder, and dissociative disorders. Legal implications of these changes include continued confusion regarding what constitutes a traumatic stressor, difficulties with differential diagnosis, increased ease in malingering, and improper linking of symptoms to causes of behavior. These PTSD changes are discussed within the broader context of DSM reliability and validity concerns.",0,0 +6286,Generalization of contextual fear depends on associative rather than non-associative memory components,"Posttraumatic stress disorder (PTSD) is characterized by the presence of three major symptom clusters: persistent fear memories, hyperarousal, and avoidance. With a passage of time after the trauma, PTSD patients show an increase in unspecific fear and avoidance, a phenomenon termed “fear generalization”. It is not clear whether fear generalization arises from the time-dependent growth of hyperarousal or changes in associative fear. The present study investigated behavioral and neuroanatomical correlates of non-associative and associative fear memory one week vs. one month after a trauma in a mouse model of PTSD with immediate vs. delayed foot shock application. The immediate shock procedure led to a lower contextual fear, but did not influence the hyperarousal (i.e. increased acoustic startle responses) assessed within the first week after the trauma. Only delayed shocked mice demonstrated generalization of contextual fear and an increase in generalized avoidance behavior, with no changes in hyperarousal one month after trauma. We observed the same increase in c-Fos expression following delayed and immediate shock presentation within the lateral, basolateral, central amygdala and CA1, CA3 and dentate gyrus of hippocampus, suggesting that all of these structures contribute to the development of hyperarousal. Only basolateral amygdala and dentate gyrus appeared to be additionally involved in encoding of contextual information. In summary, our results demonstrate the independence of associative and non-associative trauma-related fear. They support the hypothesis that generalized fear emerges in consequence of forgetting specific stimulus attributes associated with the shock context.",0,0 +6287,Developing a Consensus-based Definition of “Kokoro-no Care” or Mental Health Services and Psychosocial Support: Drawing from Experiences of Mental Health Professionals Who Responded to the Great East Japan Earthquake,"In this survey, we aimed to build consensus and gather opinions on 'Kokoro-no care' or mental health services and psychosocial support (MHSPSS) after a disaster, among mental health professionals who engaged in care after the Great East Japan Earthquake.We recruited mental health professionals who engaged in support activities after the Great East Japan Earthquake, which included local health professionals in the affected areas and members of mental health care teams dispatched from outside (n = 131). Adopting the Delphi process, we proposed a definition of 'Kokoro-no care', and asked the participants to rate the appropriateness on a 5-point Likert scale. We also solicited free comments based on the participants' experiences during the disaster. After Round 1, we presented the summary statistics and comments, and asked the participants to re-rate the definition that had been modified based on their comments. This process was repeated twice, until the consensus criterion of ≥ 80% of the participants scoring ≥ 4 on the statement was fulfilled.In Round 1, 68.7% of the respondents rated the proposed definition ≥ 4 for its appropriateness, and 88.4% did so in Round 2. The comments were grouped into categories (and subcategories) based on those related to the definition in general (Appropriate, Continuum of MHSPSS, Cautions in operation, Alternative categorisation of care components, Whether the care component should be categorised according to the professional involved, Ambiguous use of psychology, and Others), to mental health services (Appropriate, More specification within mental health services, More explicit remarks on mental health services, and Others), and to psychosocial support (Whether the care component should be categorised according to the professional involved, Raising concerns about the terms, and Others), and others.We achieved a consensus on the definition of 'Kokoro-no care', and systematically obtained suggestions on the concept, and practical advice on operation, based on the participants' experiences from the Great East Japan Earthquake. This collective knowledge will serve as reference to prepare and respond to future disasters.",0,0 +6288,"CRITICAL INCIDENT, ADULT ATTACHMENT STYLE, AND POSTTRAUMATIC STRESS DISORDER: A COMPARISON OF THREE GROUPS OF SECURITY WORKERS","In this paper the authors render the results of research investigating adult attachment and posttraumatic stress disorder (PTSD) in a sample of Belgian security workers. The sample contained 3 subsamples: 68 individuals who had directly experienced a critical incident, 67 individuals who indirectly went through a critical incident, and 77 individuals who had not experienced a critical incident in the last six months. The analysis of the research results shows that the secure attachment style and the three PTSD trauma symptom clusters in DSM-IV - intrusion, avoidance/numbing, and hyperarousal - discriminate between the three subsamples. In other words, security workers who were directly and actively confronted with a critical incident were significantly more insecurely attached and suffered significantly more from PTSD symptoms than the groups who had no or indirect experience of a critical incident. Furthermore, trauma-focused cognitive-behavioral therapy is widely and quite efficiently used in the treatment of PTSD. Interest has been expressed in medical approaches.",0,0 +6289,Update to an evaluation of ICD-11 PTSD and complex PTSD criteria in a sample of adult survivors of childhood institutional abuse by Knefel & Lueger-Schuster (2013): a latent profile analysis,"The World Health Organization (WHO) International Classification of Diseases, 11th version (ICD-11), has proposed a trauma-related diagnosis of complex posttraumatic stress disorder (CPTSD) separate and distinct from posttraumatic stress disorder (PTSD).To determine whether the symptoms endorsed by individuals who had experienced childhood institutional abuse form classes that are consistent with diagnostic criteria for ICD-11 CPTSD as distinct from PTSD.A latent profile analysis (LPA) was conducted on 229 adult survivors of institutional abuse using the Brief Symptom Inventory and the PTSD Checklist-Civilian Version to assess current psychopathological symptoms.The LPA revealed four classes of individuals: (1) a class with elevated symptoms of CPTSD (PTSD symptoms and disturbances in self-organization); (2) a class with elevated symptoms of PTSD and low disturbances in self-organization; (3) a class with elevated disturbances in self-organization symptoms and some elevated PTSD symptoms; and (4) a class with low symptoms.The results support the existence of a distinct group in our sample, that could be described by the proposed diagnostic category termed CPTSD more precisely than by normal PTSD. In addition, there seems to be a group of persons that do not fulfill the criteria for a trauma-related disorder but yet suffer from psychopathological symptoms.",0,0 +6290,Predictors of outcome of an Internet-based cognitive-behavioural therapy for post-traumatic stress disorder in older adults,"The aim of this study was to evaluate the role of resource-oriented variables such as self-efficacy, locus of control (LOC) and post-traumatic growth (PTG) in predicting treatment response in older adults with post-traumatic stress.Fifty-eight older adults with subsyndromal or greater severity of war-associated post-traumatic stress disorder (PTSD) symptoms completed a randomized controlled Internet-based cognitive-behavioural therapy (CBT) with immediate and delayed treatment groups. Assessments of PTSD severity and resource-oriented variables of self-efficacy, LOC and PTG were conducted at baseline, post-treatment and at a 6-month follow-up.Results revealed that pre-treatment scores on measures of internal LOC and PTG predicted PTSD symptom severity at post-treatment, even after controlling for initial PTSD. At a 6-month follow-up, internal LOC continued to predict PTSD symptom severity. In addition, repeated-measures analyses of variance revealed that, relative to older adults with low internal LOC and PTG, older adults with high internal LOC and PTG, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment.These findings suggest that greater locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Assessment of these constructs may be useful in identifying trauma survivors who are most likely to respond to CBT.Greater internal locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Older adults with initial high internal locus of control and post-traumatic growth, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. It could be assumed that patients with initial functional appraisals could benefit easier and faster from a trauma-focused cognitive-behavioural therapy compared to individuals with lower internal locus of control and post-traumatic growth.",0,0 +6291,"The Utility of the PAI and the MMPI-2 for Discriminating PTSD, Depression, and Social Phobia in Trauma-Exposed College Students","This study investigated the Minnesota Multiphasic Personality Inventory—Revised (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) and the Personality Assessment Inventory (PAI; Morey, 1991) with regard to each instrument's utility for discriminating post-traumatic stress disorder (PTSD) from depression and social phobia in a sample of college students with mixed civilian trauma exposure. Participants were 90 trauma-exposed undergraduates (16 male, 74 female) classified into one of four groups: PTSD, depressive disorders, social phobia, and well-adjusted. For both the PAI and the MMPI-2, profile analysis revealed that the groups differed in the elevation and shape of their profiles. The PAI Traumatic Stress subscale demonstrated good discriminant validity.",0,0 +6292,cis-3-Hexenol and trans-2-hexenal mixture prevents development of PTSD-like phenotype in rats,"Several green leaf volatiles have anxiolytic/antidepressant properties and attenuate adrenocortical stress response in rodents. However, it remains unknown whether a mixture of cis-3-hexenol and trans-2-hexenal so-called 'green odor (GO)' affects fear-associated post-traumatic stress disorder (PTSD)-like behavior. In the present study, fear memory of the initial conditioning stimulus was stably maintained by weekly presentation of conditioned tone. Examination of open field behavior, acoustic startle response, prepulse inhibition, and immobility in the forced swim test for 2 weeks after initial conditioning revealed that conditioned rats sustained anxiety, enhanced startle response, hypervigilance, depression-like behavior, and hypocortisolism, which is consistent with PTSD symptoms. Daily, not acute, GO presentation facilitated fear extinction and reduced PTSD-like behavioral and endocrinal responses. To further investigate the mechanism of effect of GO, we examined the effect of paroxetine (a selective serotonin reuptake inhibitor), p-chlorophenylalanine (PCPA, an irreversible serotonin synthesis inhibitor), alone or in combination of GO on PTSD-like phenotype. The alleviative effects of GO were masked by simultaneous paroxetine administration. PCPA-induced serotonin depletion abolished the effects of GO. Our results suggest that daily GO presentation facilitates fear extinction and prevents development of PTSD-like symptoms.",0,0 +6293,Psychophysiological Assessment of Stress in Chronic Pain: Comparisons of Stressful Stimuli and of Response Systems,"Due to disparate findings across the published studies, the stress-hyperactivity hypothesis has never been fully accepted as a causal mechanism for chronic muscle pain. Two recent comprehensive reviews of the psychophysiological studies of chronic pain came to opposite conclusions about the viability of the hypothesis, which stemmed from differing importance placed on the experimental methodology: the adequacy of stress manipulation. The present study tested the hypotheses that the adequacy of stress manipulation is influenced by stress stimuli type, degree of personal relevance, and selection of criterion for verification of stress experience, and that these factors have a measurable impact on the related physiological responses in a manner that is consistent with a theory of stress applicable to clinical stress disorders. The three factors investigated were: task (imagery, reaction time), relevance (high, low), and manipulation criterion (autonomic, self-report). The tasks were presented to 16 chronic pain patients while muscle, electrodermal, and self-report responses were recorded. Reaction-time tasks and high-relevance conditions led to high muscle and electrodermal responses. Only the high-relevance imagery, however, produced high self-reported distress. Consistent with other research, the present overall data demonstrated differing physiological profiles for different stimuli types. More importantly, these data suggest that the manipulation type and the manipulation criterion influence outcomes of experimental tests of stress on physiological systems, which may directly lead to contrasting conclusions about causal relations between stress and chronic pain conditions.",0,0 +6294,Implications of neuroscientific evidence for the cognitive models of post-traumatic stress disorder,"Brewin's dual representation theory, Ehlers and Clark's cognitive appraisal model, and Dalgleish's schematic, propositional, analogue and associative representational systems model are considered in the light of recent evidence on the neural substrates of post-traumatic stress disorder (PTSD). The models' proposals about the cognitive mechanism of memory dysfunction in PTSD are described and evaluated against current knowledge about the neural pathways and functions disrupted in PTSD. A dual pathway model of memory is consistent with neuroscience of memory. The appraisal model also provides an account of the top-down modulation of memory and arousal problems consistent with current neuroscientific evidence of PTSD. Dalgleish's model is less consistent with the evidence because it relies upon assumptions that cannot yet be tested neuroscientifically. All three models under-specify the causal and maintaining influence of hyperarousal relative to the role it plays in current neuroscientific models of PTSD. Implications of the evidence for improving treatment and prevention are discussed.",0,0 +6295,Psychiatric Comorbidity of Full and Partial Posttraumatic Stress Disorder Among Older Adults in the United States: Results From Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions,"

Objectives

To present findings on the prevalence, correlates, and psychiatric comorbidity of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition posttraumatic stress disorder (PTSD) and partial PTSD in a nationally representative sample of U.S. older adults.

Design, Setting, and Participants

Face-to-face interviews with 9,463 adults age 60 years and older in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions.

Measurements

Sociodemographic correlates; worst stressful experiences; comorbid lifetime mood, anxiety, substance use, and personality disorders; psychosocial functioning; and suicide attempts.

Results

Lifetime prevalences ± standard errors of PTSD and partial PTSD were 4.5% ± 0.25 and 5.5% ± 0.27, respectively. Rates were higher in women (5.7% ± 0.37 and 6.5% ± 0.39) than in men (3.1% ± 0.31 and 4.3% ± 0.37). Older adults with PTSD most frequently identified unexpected death of someone close, serious illness or injury to someone close, and their own serious or life-threatening illness as their worst stressful events. Older adults exposed to trauma but without full or partial PTSD and respondents with partial PTSD most often identified unexpected death of someone close, serious illness or injury to someone close, and indirect experience of 9/11 as their worst events. PTSD was associated with elevated odds of lifetime mood, anxiety, drug use, and borderline and narcissistic personality disorders and decreased psychosocial functioning. Partial PTSD was associated with elevated odds of mood, anxiety, and narcissistic and schizotypal personality disorders and poorer psychosocial functioning relative to older adults exposed to trauma but without full or partial PTSD.

Conclusions

PTSD among older adults in the United States is slightly more prevalent than previously reported and is associated with considerable psychiatric comorbidity and psychosocial dysfunction. Partial PTSD is associated with significant psychiatric comorbidity, particularly with mood and other anxiety disorders.",0,0 +6296,"Low specificity of symptoms on the post-traumatic stress disorder (PTSD) symptom scale: A comparison of individuals with PTSD, individuals with other anxiety disorders and individuals without psychopathology","Objectives Screening for post-traumatic stress disorder (PTSD) takes place in clinical and research settings where diagnostic interviews are not feasible, and typically relies on self-report instruments like the PTSD symptom scale (PSS). Concerns have been raised about the specificity of PTSD symptoms assessed by questionnaires. This study examined whether the PSS distinguishes between patients with PTSD and those with other anxiety disorders or healthy controls. Design A between-participants design was employed. Methods The participants were 65 individuals with PTSD, 40 individuals with other anxiety disorders and 40 healthy controls. They completed the PSS with respect to a range of stressful life-events. Results Using this instrument, 86% of individuals with PTSD and 5% of healthy controls endorsed sufficient symptoms to meet the PTSD diagnosis. This was also the case for 43% of individuals with other anxiety disorders, and self-reported symptoms related to traumatic events and aversive events that are generally not considered traumatic. Conclusions The findings suggest that many people screened positive for PTSD may actually be suffering from another anxiety disorder.",0,0 +6297,Differential neuroendocrine and immune responses to acute psychosocial stress in women with type 1 bipolar disorder,"Bipolar disorder (BD) has been associated with immune imbalance, including lymphocyte activation and increased pro-inflammatory cytokines. Immune activation is part of stress response, and psychosocial stress has been implicated in the pathogenesis of psychiatric disorders. Here, we investigated the neuroendocrine and immune responses to acute psychosocial stress challenge in BD. Thirteen euthymic participants with type 1 BD and 15 healthy controls underwent the Trier Social Stress Test protocol (TSST). Blood samples were collected before and after TSST. Lymphocytes were isolated and stimulated in vitro to assess lymphocyte activation profile, lymphocyte sensitivity to dexamethasone, mitogen-activated protein kinase (MAPK) and nuclear factor kappa B (NF-κB) signaling by flow cytometry. Heart rate and salivary cortisol levels were monitored across the task. BD participants exhibited blunted stress responses as shown by reduced heart rate and salivary cortisol levels in comparison to healthy controls. BD was also associated with reduction in the percentage of regulatory T cells, but with expansion of activated T cells. When compared to controls, patients showed increased lymphocyte MAPK p-ERK and p-NF-κB signaling after the stress challenge, but exhibited a relative lymphocyte resistance to dexamethasone. In conclusion, stress-related neuroendocrine responses are blunted, associated with increased immune activation and lower sensitivity to glucocorticoids in BD. An inability in reducing NF-κB and MAPK signaling following TSST could be underlying the immune imbalance observed in BD.",0,0 +6298,Psychophysiology and posttraumatic stress disorder symptom profile in pregnant African-American women with trauma exposure,"While female sex is a robust risk factor for posttraumatic stress disorder (PTSD), pregnant women are an understudied population in regards to PTSD symptom expression profiles. Because circulating hormones during pregnancy affect emotionality, we assessed whether pregnant women would have increased expression of the intermediate phenotypes of hyperarousal and fear-potentiated startle (FPS) compared to non-pregnant women. We examined PTSD symptom profiles in pregnant (n = 207) and non-pregnant women (n = 370). In a second study, FPS responses were assessed in 15 pregnant and 24 non-pregnant women. All participants were recruited from the obstetrics and gynecology clinic at a public hospital serving a primarily African-American, low socioeconomic status, inner-city population. Our results indicate that overall PTSD symptoms were not different between the groups of women. However, pregnant women reported being more hypervigilant (p = 0.036) than non-pregnant women. In addition, pregnant women showed increased FPS to a safety signal compared to non-pregnant women (p = 0.024). FPS to a safety signal in pregnant women was significantly correlated with PTSD hyperarousal symptoms (r = 0.731, p < 0.001). Furthermore, discrimination between danger and safety signals was present in non-pregnant women (p = 0.008), but not in pregnant women (p = 0.895). Together, these data suggest that pregnant women show clinical and psychophysiological hyperarousal compared to non-pregnant women, and support screening for PTSD and assessment of PTSD risk in pregnant women.",0,0 +6299,"Patterns of victimization, suicide attempt, and posttraumatic stress disorder in Greenlandic adolescents: a latent class analysis","Aim The current study had two main aims. The first was to identify groups of adolescents based on their similarity of responding across a number of victimizing and potentially traumatic events (PTEs). In doing so, we employed the statistical technique of Latent Class Analysis (LCA). The second aim was to assess the relationship between our resultant classes and the covariates of gender, suicide attempt, and PTSD. Methods Two hundred and sixty-nine Greenlandic school students, aged 12-18 (M = 15.4, SD = 1.84) were assessed for their level of exposure to PTEs. In addition, adolescents were assessed for the psychological impact of these events. A LCA was performed on seven binary indicators representing PTEs. Logistic regression was subsequently implemented to ascertain the relationships between latent classes and covariates. Results Three distinct classes were uncovered: a violence, neglect, and bullying class (class 1), a wide-ranging multiple PTE class (class 2), and a normative/baseline class (class 3). Notably, classes 1 and 2 were largely separated by the presence or absence of sexual PTEs. Individuals who reported having previously attempted suicide were almost six times more likely to be members of class 1 (OR = 5.97) and almost four times more likely to be members of class 2 (OR = 3.87) compared to the baseline class (class 3). Individuals who met the diagnostic criteria for PTSD were five times as likely to be members of class 1 and class 2 (OR = 5.09) compared to the baseline class. No significant associations were found between classes and gender. Conclusion The results underline the complexity of the interplay between multiple victimization experiences, traumatization, and suicide attempts. © 2014 Springer-Verlag Berlin Heidelberg.",0,0 +6300,Post-traumatic stress disorder in older adults: a systematic review of the psychotherapy treatment literature,"Older adults represent the fastest growing segment of the US and industrialized populations. However, older adults have generally not been included in randomized clinical trials of psychotherapy for post-traumatic stress disorder (PTSD). This review examined reports of psychological treatment for trauma-related problems, primarily PTSD, in studies with samples of at least 50% adults aged 55 and older using standardized measures.A systematic review of the literature was conducted on psychotherapy for PTSD with older adults using PubMed, Medline, PsychInfo, CINAHL, PILOTS, and Google Scholar.A total of 42 studies were retrieved for full review; 22 were excluded because they did not provide at least one outcome measure or results were not reported by age in the case of mixed-age samples. Of the 20 studies that met review criteria, there were: 13 case studies or series, three uncontrolled pilot studies, two randomized clinical trials, one non-randomized concurrent control study and one post hoc effectiveness study. Significant methodological limitations in the current older adult PTSD treatment outcome literature were found reducing its internal validity and generalizability, including non-randomized research designs, lack of comparison conditions and small sample sizes.Select evidence-based interventions validated in younger and middle-aged populations appear acceptable and efficacious with older adults. There are few treatment studies on subsets of the older adult population including cultural and ethnic minorities, women, the oldest old (over 85), and those who are cognitively impaired. Implications for clinical practice and future research directions are discussed.",0,0 +6301,Posttraumatic stress disorder in organ transplant recipients: a systematic review,"To summarize and critically review the existing literature on the prevalence of posttraumatic stress disorder (PTSD) following organ transplantation, risk factors for posttransplantation PTSD and the relationship of posttransplant PTSD to other clinical outcomes including health-related quality of life (HRQOL) and mortality.We conducted a systematic literature review using PubMed, CINAHL Plus, the Cochrane Library and PsycInfo and a search of the online contents of 18 journals.Twenty-three studies were included. Posttransplant, the point prevalence of clinician-ascertained PTSD ranged from 1% to 16% (n=738), the point prevalence of questionnaire-assessed substantial PTSD symptoms ranged from 0% to 46% (n=1024) and the cumulative incidence of clinician-ascertained transplant-specific PTSD ranged from 10% to 17% (n=482). Consistent predictors of posttransplant PTSD included history of psychiatric illness prior to transplantation and poor social support posttransplantation. Posttransplant PTSD was consistently associated with worse mental HRQOL and potentially associated with worse physical HRQOL.PTSD may impact a substantial proportion of organ transplant recipients. Future studies should focus on transplant-specific PTSD and clarify potential risk factors for, and adverse outcomes related to, posttransplant PTSD.",0,0 +6302,School-based mental health intervention for children in war-affected Burundi: a cluster randomized trial,"BackgroundArmed conflicts are associated with a wide range of impacts on the mental health of children and adolescents. We evaluated the effectiveness of a school-based intervention aimed at reducing symptoms of posttraumatic stress disorder, depression, and anxiety (treatment aim); and improving a sense of hope and functioning (preventive aim).MethodsWe conducted a cluster randomized trial with 329 children in war-affected Burundi (aged 8 to 17 (mean 12.29 years, standard deviation 1.61); 48% girls). One group of children (n = 153) participated in a 15-session school-based intervention implemented by para-professionals, and the remaining 176 children formed a waitlist control condition. Outcomes were measured before, one week after, and three months after the intervention.ResultsNo main effects of the intervention were identified. However, longitudinal growth curve analyses showed six favorable and two unfavorable differences in trajectories between study conditions in interaction with several moderators. Children in the intervention condition living in larger households showed decreases on depressive symptoms and function impairment, and those living with both parents showed decreases on posttraumatic stress disorder and depressive symptoms. The groups of children in the waitlist condition showed increases in depressive symptoms. In addition, younger children and those with low levels of exposure to traumatic events in the intervention condition showed improvements on hope. Children in the waitlist condition who lived on their original or newly bought land showed improvements in hope and function impairment, whereas children in the intervention condition showed deterioration on these outcomes.ConclusionsGiven inconsistent effects across studies, findings do not support this school-based intervention as a treatment for posttraumatic stress disorder and depressive symptoms in conflict-affected children. The intervention appears to have more consistent preventive benefits, but these effects are contingent upon individual (for example, age, gender) and contextual (for example, family functioning, state of conflict, displacement) variables. Results suggest the potential benefit of school-based preventive interventions particularly in post-conflict settings.Trial registrationThe study was registered as ISRCTN42284825",0,0 +6303,Rapid emotional processing in relation to trauma-related symptoms as revealed by magnetic source imaging,"Traumatic stress leads to functional reorganization in the brain and may trigger an alarm response. However, when the traumatic event produces severe helplessness, the predominant peri-traumatic response may instead be marked by a dissociative shutdown reaction. The neural correlates of this dissociative shutdown were investigated by presenting rapidly presented affective pictures to female participants with posttraumatic stress disorder (PTSD), and comparing responses to a Non-PTSD control group.Event-related-magnetic-fields were recorded during rapid visual serial presentation of emotionally arousing stimuli (unpleasant or pleasant), which alternated with pictures with low affective content (neutral). Neural sources, based on the L2-surface-minimum-norm, correlated with the severity of the symptom clusters: PTSD, depression and shutdown dissociation.For the early cortical response (60 to 110 ms), dissociation and PTSD symptom severity show similar spatial distributions of correlates for unpleasant stimuli. Cortical networks that could be involved in the relationships seem to be widespread.We conclude that shutdown dissociation, PTSD and depression all have distinct effects on early processing of emotional stimuli.",0,0 +6304,Psychological Sequelae Resulting From the 2004 Florida Hurricanes: Implications for Postdisaster Intervention,"Objectives. Data are limited regarding mental health effects of disasters such as hurricanes. We sought to determine the prevalence of and major risk factors associated with posttraumatic stress disorder (PTSD), generalized anxiety disorder, and major depressive episode 6 to 9 months after the 2004 Florida hurricanes. Methods. Random-digit dialing was used to recruit a representative population sample of 1452 hurricane-affected adults. Results. Posthurricane prevalence for PTSD was 3.6%, for generalized anxiety disorder was 5.5%, and for major depressive episode was 6.1%. Risk factors varied somewhat across disorders, with the exception of previous exposure to traumatic events, which increased risk of all negative outcomes. Conclusions. Storm exposure variables and displacement were associated primarily with PTSD. Notably, high social support in the 6 months preceding the hurricanes protected against all types of disorders.",0,0 +6305,Dysfunctional or hyperfunctional? The amygdala in posttraumatic stress disorder is the bull in the evolutionary China shop,"Our motivation in writing this Review arose not only from the great value in contributing to this special issue of the Journal of Neuroscience Research but also from the desire to express our opinion that the description of the amygdala as ""dysfunctional"" in posttraumatic stress disorder (PTSD) might not be appropriate. We acknowledge that excessive activation of the amygdala contributes to the cluster of PTSD symptoms, including hypervigilance, intrusive memories, and impaired sleep, that underlies the devastating mental and physical outcomes in trauma victims. The issue that we address is whether the symptoms of PTSD represent an impaired (dysfunctional) or sensitized (hyperfunctional) amygdala status. We propose that the amygdala in PTSD is hyperfunctional rather than dysfunctional in recognition of the fact that the individual has already survived one life-threatening attack and that another may be forthcoming. We therefore consider PTSD to be a state in which the amygdala is functioning optimally if the goal is to ensure a person's survival. The misery caused by a hyperfunctional amygdala in PTSD is the cost of inheriting an evolutionarily primitive mechanism that considers survival more important than the quality of one's life.",0,0 +6306,Interaction between the Cholecystokinin and Endogenous Cannabinoid Systems in Cued Fear Expression and Extinction Retention,"Post-traumatic stress disorder (PTSD) is thought to develop, in part, from improper inhibition of fear. Accordingly, one of the most effective treatment strategies for PTSD is exposure-based psychotherapy. Ideally, neuroscience would inform adjunct therapies that target the neurotransmitter systems involved in extinction processes. Separate studies have implicated the cholecystokinin (CCK) and endocannabinoid systems in fear; however, there is a high degree of anatomical colocalization between the cannabinoid 1 receptor (Cnr1) and CCK in the basolateral amygdala (BLA), a brain region critical for emotion regulation. Although most research has focused on GABA and GABAergic plasticity as the mechanism by which Cnr1 mediates fear inhibition, we hypothesize that a functional interaction between Cnr1 and CCKB receptor (CCKBR) is critical for fear extinction processes. In this study, systemic pharmacological manipulation of the cannabinoid system modulated cued fear expression in C57BL/6J mice after consolidation of auditory fear conditioning. Knockout of the CCKBR, however, had no effect on fear- or anxiety-like behaviors. Nonetheless, administration of a Cnr1 antagonist increased freezing behavior during a cued fear expression test in wild-type subjects, but had no effect on freezing behavior in CCKBR knockout littermates. In addition, we found that Cnr1-positive fibers form perisomatic clusters around CCKBR-positive cell bodies in the BLA. These CCKBR-positive cells comprise a molecularly heterogenous population of excitatory and inhibitory neurons. These findings provide novel evidence that Cnr1 contributes to cued fear expression via an interaction with the CCK system. Dysfunctional Cnr1-CCKBR interactions might contribute to the etiology of, or result from, fear-related psychiatric disease.",0,0 +6307,Six years after the wave. Trajectories of posttraumatic stress following a natural disaster,"The characteristics of long-term trajectories of distress after disasters are unclear, since few studies include a comparison group. This study examines trajectories of recovery among survivors in comparison to individuals with indirect exposure.Postal surveys were sent to Swedish tourists, repatriated from the 2004 Indian Ocean tsunami (n=2268), at 1, 3, and 6 years after the tsunami to assess posttraumatic stress (PTS) and poor mental health. Items were used to ascertain high and moderate disaster exposure groups and an indirect exposure comparison group.Long-term PTS trajectories were best characterized by a resilient (72.3%), a severe chronic (4.6%), a moderate chronic (11.2%) and a recovering (11.9%) trajectory. Trajectories reported higher levels of PTS than the comparison group. Exposure severity and bereavement were highly influential risk factors.These findings have implications regarding anticipation of long-term psychological adjustment after natural disasters and need for interventions after a single traumatic event with few secondary stressors.",1,0 +6308,Characterizing impulsivity profile in patients with obsessive–compulsive disorder,"Impulsivity represents a key dimension in obsessive-compulsive disorder (OCD), in relation to outcome and course. It can be assessed through the Barratt Impulsiveness Scale (BIS), which explores three main areas: attentional, motor, and nonplanning. Present study was aimed to assess level of impulsivity in a sample of OCD patients, in comparison with healthy controls, using the BIS.Seventy-five OCD outpatients, 48 of them having psychiatric comorbidities and 70 healthy controls, were assessed through the BIS, and their scores were analyzed using Student's t-test for independent samples, on the basis of demographic and clinical characteristics.BIS total scores were significantly higher (P: 0.01) in patients compared to controls, with no difference between pure and comorbid patients. Attentional impulsivity scores were significantly higher than controls in patients with pure (P < 0.001) and comorbid OCD (P < 0.001), without differences among them. Patients with multiple OC phenotypes showed higher, though statistically non significant, total and attentional scores, compared to single phenotype patients. In addition, patients with comorbid major depressive disorder had higher, though statistically non significant, total and attentional scores, compared to patients with comorbid bipolar disorder, generalized anxiety disorder, and other disorders.Present findings showed higher impulsivity levels in OCD patients versus controls, particularly in the attentional area, and ultimately suggest a potential cognitive implication.",0,0 +6309,Cortisol response to an experimental stress paradigm prospectively predicts long-term distress and resilience trajectories in response to active police service,"Heterogeneity in glucocorticoid response to experimental stress conditions has shown to differentiate individuals with healthy from maladaptive real-life stress responses in a number of distinct domains. However, it is not known if this heterogeneity influences the risk for developing stress related disorders or if it is a biological consequence of the stress response itself. Determining if glucocorticoid response to stress induction prospectively predicts psychological vulnerability to significant real life stressors can adjudicate this issue. To test this relationship, salivary cortisol as well as catecholamine responses to a laboratory stressor during academy training were examined as predictors of empirically identified distress trajectories through the subsequent 4 years of active duty among urban police officers routinely exposed to potentially traumatic events and routine life stressors (N = 234). During training, officers were exposed to a video vignette of police officers exposed to real-life trauma. Changes in salivary 3-methoxy-4-hydroxyphenylglycol (MHPG) and cortisol in response to this video challenge were examined as predictors of trajectory membership while controlling for age, gender, and baseline neuroendocrine levels. Officers who followed trajectories of resilience and recovery over 4 years mounted significant increases in cortisol in response to the experimental stressor, while those following a trajectory of chronic increasing distress had no significant cortisol change in response to the challenge. MHPG responses were not associated with distress trajectories. Cortisol response prospectively differentiated trajectories of distress response suggesting that a blunted cortisol response to a laboratory stressor is a risk factor for later vulnerability to distress following significant life stressors.",0,0 +6310,Hazardous alcohol use and treatment outcome in male combat veterans with posttraumatic stress disorder,"The relationship between alcohol problems and posttraumatic stress disorder (PTSD) remains unclear. Six hundred and eight combat veterans diagnosed with PTSD were assessed for PTSD symptoms and alcohol problems prior to group cognitive-behavioral treatment. They were reassessed 3 and 9 months after treatment. Participants were classified into low-risk and hazardous drinkers at each time point. Drinking status at intake did not predict PTSD symptoms at intake or follow-up. However, drinking status was associated with PTSD symptoms when both were assessed at follow-up. PTSD arousal symptoms were the only symptom cluster to differentiate drinking groups.",0,0 +6311,Mental health and functional impairment outcomes following a 6-week intensive treatment programme for UK military veterans with post-traumatic stress disorder (PTSD): a naturalistic study to explore dropout and health outcomes at follow-up,"Combat Stress, a UK national charity for veterans with mental health problems, has been funded by the National Health Service (NHS) to provide a national specialist service to deliver treatment for post-traumatic stress disorder (PTSD). This paper reports the efficacy of a PTSD treatment programme for UK veterans at 6 months follow-up.A within subject design.UK veterans with a diagnosis of PTSD who accessed Combat Stress.246 veterans who received treatment between late 2012 and early 2014.An intensive 6-week residential treatment programme, consisting of a mixture of individual and group sessions. Participants were offered a minimum of 15 individual trauma-focused cognitive behavioural therapy sessions. In addition, participants were offered 55 group sessions focusing on psychoeducational material and emotional regulation.Clinicians completed measures of PTSD and functional impairment and participants completed measures of PTSD, depression, anger and functional impairment.We observed significant reductions in PTSD scores following treatment on both clinician completed measures (PSS-I: -13.0, 95% CI -14.5 to -11.5) and self-reported measures (Revised Impact of Events Scale (IES-R): -16.5, 95% CI -19.0 to -14.0). Significant improvements in functional impairment were also observed (eg, Health of the Nation Outcome Scales (HONOS): -6.85, 95% CI -7.98 to -5.72). There were no differences in baseline outcomes between those who completed and those who did not complete the programme, or post-treatment outcomes between those we were able to follow-up at 6 months and those lost to follow-up.In a naturalistic study we observed a significant reduction in PTSD scores and functional impairment following treatment. These improvements were maintained at 6 month follow-up. Our findings suggest it may be helpful to take a closer look at combining individual trauma-focused cognitive behaviour therapy and group sessions when treating veterans with PTSD. This is the first UK study of its kind, but requires further evaluation.",0,0 +6312,Empirical Characterization of Heterogeneous Posttraumatic Stress Responses Is Necessary to Improve the Science of Posttraumatic Stress,"Article AbstractBecause this piece does not have an abstract, we have provided for your benefit the first 3 sentences of the full text.The concept of posttraumatic stress psychopathology is simple and intuitive: following a highly distressing event, some people develop sustained aversive responses that dominate their lives, causing overwhelming distress and havoc in their emotional, cognitive, behavioral, and interpersonal functioning. Despite the conceptual simplicity of posttraumatic stress, a decisive definition of the concept seems out of reach. The posttraumatic stress disorder (PTSD) diagnosis differs both between international standards (ie, International Classification of Diseases) and the US standards (Diagnostic and Statistical Manual of Mental Disorders ) and across iterations of these manuals.",0,0 +6313,Post-Traumatic Stress Disorder Related to the Cancer Experience,"Many healthcare professionals think about Post-Traumatic Stress Disorder (PTSD) in the context of soldiers returning from war zones, victims of abuse, or trauma survivors. Research literature supports a range of psychological stressors that are associated with a cancer diagnosis and subsequent treatment. Psychological responses of distress are most often reported at major transition points, such as diagnosis, treatment, conclusion of treatment, recurrence, and terminal disease, and include but are not limited to shock, denial, fear, anxiety, panic, sadness, depression, and appetite and sleep disturbances. A multimodal approach is needed to diagnose PTSD. This includes data that address social, cognitive, emotional, family, and occupational functioning. The human spirit is resilient. Many research studies have investigated positive life changes that individuals claim are a result of their cancer experiences. sources of posttraumatic growth will help all healthcare professionals foster the strength of the people they care for. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6314,Masculine gender role stress and posttraumatic stress disorder symptom severity among inpatient male crack/cocaine users.,"This study examined the association between masculine gender role stress (MGRS) and posttraumatic stress disorder (PTSD) symptom severity, above and beyond other factors previously found to be associated with PTSD symptoms (e.g., anxiety sensitivity and thought suppression) among 33 crack/cocaine-dependent patients in residential substance abuse treatment. Participants completed a series of questionnaires and were interviewed to determine current PTSD symptom severity. MGRS accounted for a significant amount of additional variance in PTSD symptom severity above and beyond other identified risk factors for PTSD. Results are discussed in terms of their implications for reducing PTSD risk among men following exposure to a potentially traumatic event. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0,0 +6315,"Intersection of Stress, Social Disadvantage, and Life Course Processes: Reframing Trauma and Mental Health","This paper describes the intersection of converging lines of research on the social structural, psychosocial, and physiological factors involved in the production of stress and implications for the field of mental health. Of particular interest are the stress sensitization consequences stemming from exposure to adversity over the life course. Contemporary stress sensitization theory provides important clinical utility in articulating mechanisms through which these multiple levels exert influence on mental health. Stress sensitization models (a) extend understanding of neurobiological and functional contexts within which extreme stressors operate and (b) make clear how these can influence psychologically traumatic outcomes. The value of interventions that are sensitive to current contexts as well as life course profiles of cumulative stress are illustrated through recent treatment innovations.",0,0 +6316,Post-tsunami stress: A study of posttraumatic stress disorder in children living in three severely affected regions in Sri Lanka,"At 3 to 4 weeks after the December 2004 tsunami disaster we assessed symptoms of posttraumatic stress disorder (PTSD) in 264 children who lived in severely affected coastal communities in Manadkadu (northern coast), Kosgoda (western coast), and Galle (southern coast) in Sri Lanka. The prevalence rate of tsunami-related posttraumatic stress disorder (PTSD) (ignoring the time criterion) ranged between 14% and 39% and an additional 5% to 8% had PTSD unrelated to the tsunami. The PTSD symptoms were explained by the severity of the trauma exposure and family loss, as well as previous traumatic events. The results confirm the relevance of the individual history of traumatic events for the genesis of PTSD and indicate a high need of mental health assistance among the tsunami-affected children in Sri Lanka.",0,0 +6317,Test Anxiety Prevention and Intervention Programs in Schools: Program Development and Rationale,"This paper (a) discusses the need for anxiety-focused prevention and intervention efforts, (b) discusses test anxiety interventions as an avenue toward building school partnerships to conduct anxiety-focused prevention and intervention efforts, and (c) provides a brief description of the University of New Orleans test anxiety program model and previously published findings. This paper also presents new data in support of our rationale from one of our screening assessments to highlight the linkages between test anxiety and anxiety problems more broadly and presents a brief summary of initial acceptability data. Data indicate that test anxiety was related to symptoms of anxiety disorders and depression. Moreover, among an initial wave of (n = 59) participants in a new intervention study, acceptability data are promising. For example, 96% indicating they were glad they participated and 70% of students showed substantial knowledge (at least 80% correct) of intervention content. Results are discussed in terms of how the data provide evidence for the importance of targeting test anxiety, future research directions, and applied implications.",0,0 +6318,Social support and stress: The role of social comparison and social exchange processes,"This paper first presents four different conceptualizations of social support: social integration, satisfying relationships, perceived helpfulness and enacted support. Then, classic and contemporary social comparison theory and social exchange theory are analysed as they are two theoretical perspectives that are particularly useful in understanding social support. These perspectives are employed to explain three seemingly paradoxical phenomena in the domain of social support: (1) the fact that support sometimes has negative effects; (2) the fact that the occurrence of stress itself can sometimes decrease the availability of support resources; and (3) the phenomenon that people believe that they give more support than they receive, and that there is more support available for them than for others.",0,0 +6319,Longitudinal Examination of PTSD Symptoms and Problematic Alcohol Use as Risk Factors for Adolescent Victimization,"The current study examined associations between posttraumatic stress disorder (PTSD) symptoms and future interpersonal victimization among adolescents, after accounting for the impact of early victimization exposure, gender, ethnicity, and household income. In addition, problematic alcohol use was tested as a mediator of the relation between PTSD symptoms and subsequent victimization. Participants included a national longitudinal sample of adolescents (N = 3,604) who were ages 12 to 17 at the initial assessment: 50% were male, and 67% were White, 16% African American, and 12% Hispanic. Cohort-sequential latent growth curve modeling was used to examine associations among the study variables. Baseline PTSD symptoms significantly predicted age-related increases in interpersonal victimization, even after accounting for the effects of earlier victimization experiences. In addition, alcohol problems emerged as a partial mediator of this relation, such that one fourth to one third of the effect of PTSD symptoms on future victimization was attributable to the impact of PTSD symptoms on alcohol problems (which, in turn, predicted additional victimization risk). Collectively, the full model accounted for more than half of the variance in age-related increases in interpersonal victimization among youth. Results indicate that PTSD symptoms serve as a risk factor for subsequent victimization among adolescents, over and above the risk conferred by prior victimization. This increased risk occurred both independently and through the impact of PTSD symptoms on problematic alcohol use. Based on these findings, it is hypothesized that the likelihood of repeated victimization among youth might be reduced through early detection and treatment of these clinical problems.",0,0 +6320,Incidence and associations of parental and child posttraumatic stress symptoms in pediatric patients,"Previous studies consistently found remarkable prevalence rates of posttraumatic stress symptoms (PTSS) and posttraumatic stress disorders (PTSD) in pediatric patients and their parents. Findings suggest a significant association between child and parent PTSS. The present study examined, in a sample of pediatric patients with different conditions, incidence rates and determinants of PTSS and PTSD in the patients, and their mothers and fathers. Also, associations of maternal, paternal and child PTSS and PTSD were analyzed.Two hundred and nine children (aged 6.5-14.5 years) were interviewed 5-6 weeks after an accident or a new diagnosis of cancer or diabetes mellitus type 1 by means of the Child PTSD Reaction Index. Their mothers (n = 180) and fathers (n = 175) were assessed with the Posttraumatic Diagnostic Scale.Children reported PTSS levels in the mild range. Sixteen percent of the fathers and 23.9% of the mothers met full DSM-IV diagnostic criteria for current PTSD. Type of trauma impacted differently on parents and children. In children, accident-related injury was associated with higher PTSS scores. Conversely, in parents, diagnosis of cancer in their child was associated with more symptoms. Functional status of the child was also found to be an important predictor of PTSS in children and parents. PTSS scores of mothers and fathers were significantly correlated with each other. However, child PTSS were not significantly related to PTSS of mothers and fathers. This was true for total scores as well as for DSM-IV symptom clusters.There is a need for careful evaluation of PTSS and PTSD in pediatric patients with accidental injuries or sudden onset of severe chronic diseases and in their respective parents. Importantly, children, their mothers, and their fathers should be assessed separately, because a significant association between child and parental PTSS may not exist.",0,0 +6321,Is Post-Traumatic Stress Disorder a helpful concept for adults with intellectual disability?,"Research using the concept of Post-Traumatic Stress Disorder (PTSD) with adults with intellectual disability (ID)assumes they perceive and react to traumatic events in a similar way to non-disabled adults. Reactions to trauma displayed by children may be relevant to adults with ID as well.Two focus groups were held with professionals and practitioners to explore the relevance of criteria from child as well as adult literature to adults with ID who experience trauma. Descriptive thematic analysis was carried out.Abuse, parental bereavement, and having children removed were considered common sources of trauma. Similarities identified between disabled and non-disabled adults were flashbacks and nightmares; distressed by reminders; avoidance; hypervigilance and increased arousal. Differences were the frequent occurrence of multiple rather than single events, which were considered significant in generating chronic problems similar to those described as PTSD; also the occurrence of physical health problems and behavioural re-enactments.Experienced professionals and practitioners considered most of the ideas from PTSD research with non-disabled adults to be relevant to adults with ID who experience trauma, but that some behaviour reported in research with children was also relevant. Topics and questions for use in clinical and research practice with individuals who have experienced trauma were proposed.",0,0 +6322,Assessing the impact of posttraumatic stress disorder (PTSD) among wives of veterans: A phenomenological study of life changing experiences of wives of war veterans diagnosed with PTSD,"Post Traumatic Stress Disorder is a chronic illness that not only destabilizes the victim, but also impacts the lives of family members and those close them by way of compassion fatigue or secondary traumatization. The purpose of this mixed-method, phenomenological study was to explore the lived experiences of a sample of 10 wives of Iraq and Afghanistan war veterans diagnosed with PTSD in order to assess the impact of the veterans' symptoms upon their wives, their marriage, and their family life. The setting was a local community close to Fort Jackson Military Cantonment in Columbia, South Carolina. Ten wives of war veterans diagnosed with PTSD were recruited on a voluntary basis from the local churches where they worshipped. A face-to-face semi-structured interview was conducted in order to explore the wives' lived experiences. Participant's mean score was 82.7 of a possible 85 as measured by the Secondary Traumatic Stress Scale. All participants experienced secondary trauma. African-American participants scored significantly higher than the White participants on the Avoidance and Arousal scales and on Total score. No significant differences were found for ethnicity on the Intrusion scale. Themes found in the interviews related to (1) fears and uncertainties about the future of their marriages; (2) determination to keep their marriage vows; (3) guilt and shame; (4) systemic change in lifestyle; (5) mental and emotional stress; (6) coping strategies, and (7) strength and empowerment. Further studies relating spouses' symptom severity with that of veterans, effectiveness of coping skills, and effects on children are called for. Including veterans' wives in conjoint therapy is recommended, as is the development of principles of marital therapy to help couples move beyond the diagnosis of PTSD and toward recovery. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6323,A French adaptation of the Posttraumatic Diagnostic Scale.,"The factor structure of a French adaptation of the Posttraumatic Diagnostic Scale (PDS-F) based on the original scale by Foa, Cashman, Jaycox, and Perry (1997) was examined in 287 community members. Confirmatory factor analysis evaluated three models: the three symptom clusters of Posttraumatic Stress Disorder (PTSD) defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM–IV; American Psychiatric Association, 1994), the 4-factor King, Leskin, King, and Weathers (1998) model and the 4-factor Simms, Watson, and Doebbelling (2002) model. The data’s fit to the DSM–IV model was unacceptable. Both 4-factor models demonstrated a good fit; however, the Simms et al. (2002) model with intrusions, avoidance, dysphoria, and hyperarousal factors showed the best fit. Scores calculated for the Simms et al. (2002) factors showed good reliability and validity. The study also examined lifetime stressful event reporting and PTSD severity. “Stressful” events not traditionally defined as “traumatic” (e.g., death of a loved one) were frequently endorsed as the respondent’s most stressful event (i.e., index event) and corresponded to a possible PTSD diagnosis. Furthermore, PTSD severity was associated with negative emotional appraisals of the index event (DSM–IV criterion A2 for PTSD) and lifetime cumulative stressful event intensity whereas PTSD severity was not associated with the degree of physical harm of the index event (criterion A1). Lifetime stressful experiences are discussed in light of evidence supporting a dysphoria component in PTSD.",0,0 +6324,Attentional bias for affective visual stimuli in posttraumatic stress disorder and the role of depression,"An attentional bias for trauma-related verbal cues was frequently demonstrated in posttraumatic stress disorder (PTSD) using variants of the emotional Stroop task (EST). However, the mechanisms underlying the Stroop-effect are ill-defined and it is yet unclear how the findings apply to different paradigms and stimulus modalities. To address these open questions, for the first time a spatial-cuing task with pictorial cues of different emotional valence was administered to trauma-exposed individuals with and without PTSD, and non-trauma-exposed controls. Groups did not show different response profiles across affective conditions. However, a group effect was evident when comparing depressed with non-depressed individuals: Those with depression showed delayed attending towards trauma-related cues and faster attending away from negative cues. In correlational analyses, attentional avoidance was associated with both depression and PTSD symptom severity. These findings highlight the need for research on trauma populations and anxiety in general to pay closer attention to depression as an important confound in the study of emotional information processing.",0,0 +6325,Evaluation of a classroom-based psychosocial intervention in conflict-affected Nepal: a cluster randomized controlled trial,"In situations of ongoing violence, childhood psychosocial and mental health problems require care. However, resources and evidence for adequate interventions are scarce for children in low- and middle-income countries. This study evaluated a school-based psychosocial intervention in conflict-affected, rural Nepal.A cluster randomized controlled trial was used to evaluate changes on a range of indicators, including psychiatric symptoms (depression, anxiety, posttraumatic stress disorder), psychological difficulties, resilience indicators (hope, prosocial behavior) and function impairment. Children (n = 325) (mean age = 12.7, SD = 1.04, range 11-14 years) with elevated psychosocial distress were allocated to a treatment or waitlist group.Comparisons of crude change scores showed significant between-group differences on several outcome indicators, with moderate effect sizes (Cohen d = .41 to .58). After correcting for nested variance within schools, no evidence for treatment effects was found on any outcome variable. Additional analyses showed gender effects for treatment on prosocial behavior (mean change difference: 2.70; 95% CI, .97 to 4.44), psychological difficulties (-2.19; 95% CI, -3.82 to -.56), and aggression (-4.42; 95% CI, -6.16 to -2.67). An age effect for treatment was found for hope (.90; 95% CI, -1.54 to -.26).A school-based psychosocial intervention demonstrated moderate short-term beneficial effects for improving social-behavioral and resilience indicators among subgroups of children exposed to armed conflict. The intervention reduced psychological difficulties and aggression among boys, increased prosocial behavior among girls, and increased hope for older children. The intervention did not result in reduction of psychiatric symptoms.",0,0 +6326,A Second-Order Growth Mixture Model for Developmental Research,"Growth mixture modeling, a combination of growth modeling and finite mixture modeling, is a flexible, exploratory method for identifying and describing between-person heterogeneity in change. In this article we introduce a second-order growth mixture model that combines a longitudinal common factor model, measurement invariance constraints, latent growth model, and mixture model. This approach capitalizes on the benefits of multivariate measurement and the flexibility of mixtures for representing heterogeneity. We describe the model and illustrate its use with multi-reporter longitudinal data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development tracking the development of children's externalizing behaviors through elementary school.",0,0 +6327,Confirmatory Factor Analysis of the Posttraumatic Growth Inventory in a Veteran Sample with Posttraumatic Stress Disorder,"The objective of this study was to conduct a confirmatory factor analysis (CFA) of the Posttraumatic Growth Inventory (PTGI) to determine if the factor structure is the same for a veteran sample with posttraumatic stress disorder (PTSD; N = 221) as compared to previous studies that have used more heterogeneous samples of subjects. Analyses were conducted in order to examine the best model fit between three broad dimensional factors, a five-factor structure, or a factor structure consisting of one higher-order “general” factor with five “lower-order” factors. Results of the CFA revealed adequate fits for the five-factor and five-factor higher-order models. The findings of this study support the use of the PTGI total and factor scores when interpreting results in veteran samples with PTSD.",0,0 +6328,Maternal Obesity in Pregnancy: Consequences for Brain Function in the Offspring,"It is perhaps not surprising that an inhospitable intrauterine environment can result in neurodevelopmental disorders, given the enormous changes in brain development that occur during gestation. Here we discuss: (1) Obesity is a state of low-grade inflammation and is thus a candidate for having an unfavorable impact on brain function in the offspring. (2) Maternal obesity has recently been associated with offspring attention deficit hyperactivity disorder and autism spectrum disorder. A recent study found differences in amniotic fluid mRNA for 20 genes in fetuses of obese versus lean women, and several of these genes impact on brain sculpting. (3) The balance between excitable and inhibitory neural function can be disturbed as a consequence of maternal obesity and can lead to hyperexcitability-linked cognitive decline later in life. (4) While most studies of brain development and function have focused on neurons, inflammation and oxidative stress have major effects on microglia and astrocytes, key cells in the sculpting of synapses, neural plasticity, and the formation of neural networks. (5) Animal models are, of necessity, widely used and the temporal trajectory of neurodevelopment to accommodate the requirements of the different species has recently been modeled. While detailed studies are essential for understanding mechanism, it is critical to test the outcomes of manipulating the system on behavior. In this regard considerable care is required to ensure that the most appropriate behavioral test and animal model are used. Thus, there is considerable scope for consolidating our understanding of the effects of maternal obesity on brain function in the offspring. © Springer Science+Business Media New York 2016.",0,0 +6329,Examining the relationship between coping strategies and suicidal desire in a sample of United States military personnel,"Suicidal desire in the military has been previously examined through the lens of the Interpersonal-Psychological Theory of Suicide (IPTS). However, no research has examined the impact of specific coping strategies on perceived burdensomeness, thwarted belongingness, and suicidal ideation in a large population of individuals serving in the US military. Furthermore, the factor structure of previously utilized coping clusters did not apply to our sample of military personnel. Therefore, we found a three-factor solution to be tested in this sample. We hypothesized that specific types of coping behavior clusters (Adaptive and Maladaptive) would predict both IPTS constructs and suicidal ideation. Results indicated that Adaptive and Maladaptive coping clusters predicted the IPTS constructs in the hypothesized directions. However, only the Maladaptive cluster predicted suicidal ideation. These findings implicate the need for further research and suicide prevention efforts focusing on coping strategies, specifically those that are maladaptive in nature, in relation to suicidal ideation in military members.",0,0 +6330,Neuropsychological impairments in panic disorder: A systematic review,"There is a growing body of literature investigating the neuropsychological profile of panic disorder (PD), some of which suggests potential cognitive dysfunction. This paper systematically reviews the existing literature on neuropsychological performance in PD.PsycINFO, EMBASE, MEDLINE and PsycARTICLES databases were searched to identify articles reporting on neuropsychological function in PD published in English during the time period 1980 to March 2012. 14 studies were identified.There was limited support for impairment in short term memory among individuals with PD, although this was not found across all studies. Overall, the reviewed studies did not support the presence of impairment in other areas of cognitive functioning, including executive function, long term memory, visuospatial or perceptual abilities and working memory.Studies with samples of fewer than 15 participants per group were excluded from this review. A limited amount of research has been published on this topic and small sample sizes (under 25 per group) have been used by many studies. Therefore, the current review is based on a small number of studies with limited power.There is limited evidence of specific neuropsychological impairments in participants with PD. Impairments in short term memory warrant further investigation to establish their relevance to clinical practice. Larger sample sizes and appropriate statistical adjustment for multiple comparisons in future studies is highly recommended.",0,0 +6331,Psychiatric comorbidity effects on compensatory cognitive training outcomes for veterans with traumatic brain injuries.,"To investigate the influence of posttraumatic stress disorder (PTSD) diagnosis, and PTSD and depression severity, on the postconcussive symptom trajectory over the course of a 1-year study period.Secondary analysis of a randomized controlled trial comparing veterans who received supported employment combined with compensatory cognitive training to those who received supported employment only. Assessments were conducted at baseline, 3- (postintervention), 6-, and 12-months. Participants were 50 Operation Enduring and Iraqi Freedom (OEF/OIF) veterans with a history of mild to moderate traumatic brain injury (TBI) who were unemployed, seeking work, and who had neuropsychological impairment. Of all participants, 74% met diagnostic criteria for PTSD. All participants received supported employment and half of the sample also received Cognitive Symptom Management and Rehabilitation Therapy (CogSMART), a 12-session, manualized compensatory cognitive training intervention.Veterans with PTSD and greater depression severity endorsed significantly more severe postconcussive symptomatology at all assessment time points. However, the rate of CogSMART-associated improvement in postconcussive symptoms did not differ as a result of psychiatric symptomatology.Study results suggest that for veterans with a history of mild to moderate TBI, presence of comorbid PTSD or depressive symptoms should not preclude participation in cognitive rehabilitation interventions.",0,0 +6332,Conducting applied research on Vietnam combat-related post-traumatic stress disorder,"A paradigmatic shift in post-traumatic stress disorder (PTSD) research is underway. Formistic and mechanistic research designs, characterized by single-category, single-cause, single-effect models, gradually are being replaced by contextual and organistic research designs that feature multi-category, multi-cause, and multi-effect interactional models. Such changes in diagnostic and treatment outcome research require solving many methodological issues in such areas as: measuring types of traumas and stressors; measuring PTSD symptoms and subtypes; measuring subject dispositional characteristics (such as ethnic differences); assessing concurrent and/or pre-existing psychiatric (Axis I) disorders; classifying personality styles and concurrent and/or pre-existing personality (Axis II) disorders; evaluating phase in the development of PTSD as a disorder; measuring current environmental stresses and interpersonal interactions; and assessing secondary gains and readiness for treatment. These and other methodological problems must be addressed as research on PTSD shifts to longitudinal measurement of subjects randomly assigned to treatment conditions.",0,0 +6333,The role of hyperarousal in the manifestation of posttraumatic psychological distress following injury.,"The authors examined the temporal relation among posttraumatic stress disorder symptom clusters, using data derived from a longitudinal study of survivors of orofacial injury (N = 264). They conducted cross-lagged panel analyses, with self-reported symptom data collected at 1, 6, and 12 months postinjury. Results demonstrate that hyperarousal was a potent predictor of subsequent symptoms of reexperiencing and avoidance as well as hyperarousal. By contrast, neither reexperiencing nor avoidance was significantly related to other symptom clusters other than themselves over time. These findings underscore the distinctive nature of hyperarousal in the manifestation of posttraumatic psychological distress over time. Implications for theory, clinical intervention, and future research are discussed.",0,0 +6334,Trajectories of Adjustment in Mothers of Children with Newly Diagnosed Cancer: A Natural History Investigation,"The objectives of this study were (a) to assess negative affectivity and posttraumatic symptomatology in mothers following the diagnosis of cancer in their children; (b) to examine sociodemographic and psychosocial variables associated with change in distress over time; and (c) to identify distinct subgroups of mothers whose patterns and trajectories of adjustment can be distinguished according to available predictor data.Two hundred and twelve mothers at seven sites were assessed just following their child's diagnosis, and again 3 months and 6 months later. Primary outcomes included measures of mood disturbance, depressive symptoms, and symptoms of posttraumatic stress.Overall, mothers demonstrated a pattern of mildly elevated negative affectivity and posttraumatic symptomatology initially, with steady improvements evident at 3- and 6-month follow-up. Distinct adjustment trajectories were evident within the sample as a whole, indicating subgroups of mothers with high-declining, moderate-stable, and low-stable distress levels.These findings highlight considerable resilience among mothers facing the stress of childhood cancer. Intervention efforts aimed at reducing maternal distress might best be targeted towards the subgroup of mothers who may be predicted to exhibit the highest level of distress.",0,0 +6335,Maintaining the Clinical Relevance of Animal Models in Translational Studies of Post-Traumatic Stress Disorder,"The diagnosis of Post-Traumatic Stress Disorder (PTSD) is conditional on directly experiencing or witnessing a significantly threatening event and the presence of a certain minimal number of symptoms from each of four symptom clusters (re-experiencing, avoidance, negative cognition and mood, and hyperarousal) at least one month after the event (DSM 5) (American Psychiatric Association 2013). Only a proportion of the population exposed develops symptoms fulfilling the criteria. The individual heterogeneity in responses of stress-exposed animals suggested that adapting clearly defined and reliably reproducible ""diagnostic"", i.e. behavioral, criteria for animal responses would augment the clinical validity of the analysis of study data. We designed cut-off (inclusion/exclusion) behavioral criteria (CBC) which classify study subjects as being severely, minimally or partially affected by the stress paradigm, to be applied retrospectively in the analysis of behavioral data. Behavioral response classification enables the researcher to correlate (retrospectively) specific anatomic, bio-molecular and physiological parameters with the degree and pattern of the individual behavioral response, and also introduces ""prevalence rates"" as a valid study-parameter. The cumulative results of our studies indicate that, by classifying the data from individual subjects according to their response patterns, the animal study can more readily be translated into clinical ""follow-up"" studies and back again. This article will discuss the concept of the model and its background, and present a selection of studies employing and examining the model, alongside the underlying translational rationale of each.",0,0 +6336,"Mental health profiles among married, never-married, and separated/divorced mothers in a nationally representative sample","Background: Several studies have found that married mothers compared to single mothers had better mental health (Cairney et al. in Soc Psychiatry Psychiatr Epidemiol 38:442-449, 2003; Cairney et al. in Can J Public Health 90:320-324, 1999; Davies et al. in J Marriage Fam 59:294-308, 1997; Lipman et al. in Am J Psychiatry 158:73-77, 2001; Wang in Soc Psychiatry Psychiatr Epidemiol 39:26-32, 2004). Although a relationship between family structure (single vs married mothers) and psychiatric disorders is well established, several questions remain. The present study addressed the question ""Are there differences in the prevalence of psychiatric disorders between married, never-married, and separated/divorced mothers?"" Methods: The present report examined the lifetime prevalence of anxious misery, fear, and externalizing disorders among mothers in relation to family structure (married, never-married, and separated/divorced) in the US National Comorbidity Survey (N=1,534). Results: Results indicated that never-married mothers appeared to be generally similar to married mothers in their mental health profiles. Separated/divorced mothers compared to married mothers had increased odds of having any anxious-misery disorder, depression, dysthymia, generalized anxiety disorder (GAD), posttraumatic stress disorder, any externalizing disorder, and antisocial personality disorder. Differences were found between never-married and separated/divorced mothers, with separated/divorced mothers having increased odds ratios of having any anxious-misery disorder, depression, and GAD. Conclusions: Results are discussed in light of the unique life contexts of married, never-married, and separated/divorced mothers and as further evidence for the case against combining the separated/divorced and never-married marital status into one ""single motherhood"" classification in mental health research. © Springer-Verlag 2006.",0,0 +6337,A study on the long-term effects of child sexual abuse: An empirical investigation of the post-traumatic stress disorder and traumagenic dynamic models.,"Recently, child sexual abuse (CSA) has become an issue of increasing interest and concern in the social and scientific domains. To date, research on CSA has focused on documenting the incidence, prevalence, and impact of sexual abuse, and the literature is in need of theoretically-driven studies. Accordingly, this study assessed the Post-traumatic Stress Disorder (PTSD) and Traumagenic Dynamics (TD) models of CSA. Participants were 603 adult women recruited from two University settings and the Internet, 205 (34%) of whom reported a history of CSA. They completed a series of questionnaires inquiring about their socio-demographic characteristics, childhood experiences and present experiences. The PTSD and TD perspectives were tested using hierarchical multiple regression; the results provide partial support for both formulations of CSA, and suggest that including non-sexual child abuse and parental relationship variables improves prediction in both models. The implications of these findings and future directions for the CSA literature are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6338,Quetiapine as an adjunctive treatment for post-traumatic stress disorder: an 8-week open-label study,"This study evaluated the effectiveness of quetiapine for subjects with post-traumatic stress disorder (PTSD) who were already on a stable dose of a selective serotonin reuptake inhibitor (SSRI) but had significant PTSD symptoms. Fifteen subjects were enrolled in an 8-week open-label trial for PTSD in which quetiapine was added to an SSRI. Subjects were on a stable dose of the SSRI for at least 6 weeks before study entry and had a Clincian-Administered PTSD Scale (CAPS) score of greater than or equal to 50 at study baseline. The mean age of subjects was 49 years (eight men and seven women). The average duration of PTSD was 29 years, one-third of subjects had combat-related PTSD, and two-thirds had noncombat PTSD. The mean dose prescribed in the study was 216 mg per day. The initial median CAPS score was 80, indicating severe PTSD. The addition of a modest dose of quetiapine provided significant relief from PTSD symptoms with a 42% overall improvement in PTSD symptoms based on the CAPS and significant improvement along each dimension of symptoms: re-experiencing (Z=-3.24, P=0.0012), hyperarousal (Z=-3.30, P=0.001) and avoidance (Z=-2.13, P=0.03). Subjects rated themselves as 45% improved on average on the Davidson Trauma Scale and reported a 44% decrease in their level of disability and impairment as reflected by the Sheehan Disability Scale. Subjects with PTSD who had significant PTSD symptoms when on an SSRI benefited from the addition of quetiapine. Patients improved significantly on all three clusters of PTSD symptoms: re-experiencing, hyperarousal and avoidance.",0,0 +6339,Combat Stress Reaction and Changes in Military Medical Profile,"This study examines changes in the military medical profile following participation in war. Two groups of Israeli soldiers who participated in the 1982 Lebanon War were studied: 360 soldiers who were treated for immediate combat stress disorder during the war, and a matched control group of 310 soldiers who participated in the same war and were not identified as combat stress reaction casualties. Significant lowering of the profile after the war was noted for both groups. These changes were much stronger for combat stress reaction casualties. The differences between the groups were especially pronounced with regard to the addition of the psychiatric impairment category to the military medical profile. No background characteristics differentiated between combat stress reaction casualties who lowered their profile and those who did not. The implications of the findings for further research and for military mental health policy are discussed.",0,0 +6340,"Latent profile analyses of posttraumatic stress disorder, depression and generalized anxiety disorder symptoms in trauma-exposed soldiers","Posttraumatic stress disorder (PTSD) is comorbid with major depressive disorder (MDD; Kessler et al., 1995) and generalized anxiety disorder (GAD; Brown et al., 2001). We aimed to (1) assess discrete patterns of post-trauma PTSD-depression-GAD symptoms using latent profile analyses (LPAs), and (2) assess covariates (gender, income, education, age) in defining the best fitting class solution. The PTSD Checklist (assessing PTSD symptoms), GAD-7 scale (assessing GAD symptoms), and Patient Health Questionnaire-9 (assessing depression) were administered to 1266 trauma-exposed Ohio National Guard soldiers. Results indicated three discrete subgroups based on symptom patterns with mild (class 1), moderate (class 2) and severe (class 3) levels of symptomatology. Classes differed in symptom severity rather than symptom type. Income and education significantly predicted class 1 versus class 3 membership, and class 2 versus class 3. In conclusion, there is heterogeneity regarding severity of PTSD-depression-GAD symptomatology among trauma-exposed soldiers, with income and education predictive of class membership.",0,0 +6341,Personality and trauma-related risk factors for traumatic exposure and for posttraumatic stress symptoms (PTSS): A three-year prospective study,"Abstract The aim of this prospective study was twofold: (1) to examine the role of pre-traumatic personality variables in the risk for exposure to trauma, and (2) to explore the role of pre-traumatic personality variables and subjective trauma-related variables – namely proximity to the trauma and its subjective experience – in the risk for developing posttraumatic stress symptoms (PTSS). The study included 1210 Israeli B.A. students assessed twice: at the start of their first academic year (t1), and at the end of their third academic year (t2). Over a period of three academic years, 439 (36%) of the 1210 participants had been exposed to trauma, showing increased PTSS. The findings show that (a) males without a history of psychiatric disorder, who are high in extraversion and openness, are at an elevated risk for traumatic exposure; (b) the subjective trauma-related variables – close proximity to the traumatic event and greater experience of the traumatic event as a threat – are predominant risk factors for PTSS; and (c) females with a history of psychiatric disorder, along with low tendencies of extraversion and openness and high levels of neuroticism, are at a higher risk for PTSS following traumatic exposure.",0,0 +6342,Personality disorders in previously detained adolescent females: A prospective study.,"This longitudinal study investigated the predictive value of trauma and mental health problems for the development of antisocial personality disorder (ASPD) and borderline personality disorder (BPD) in previously detained women. The participants were 229 detained adolescent females who were assessed for traumatic experiences and mental health problems (mean age = 15.5 years). Three to 6 years later (M = 4.5; SD = 0.6), ASPD and BPD were diagnosed with a semistructured interview. Forty percent of the women had a personality disorder (i.e., ASPD 15.8%, BPD 9.2%, or both ASPD and BPD 15.2%). Posttraumatic stress, depressive symptoms, and dissociation during detention increased the risk for BPD in adulthood. Surprisingly, neither conduct problems nor substance dependence predicted ASPD; these findings require further study because they add to the controversy surrounding ASPD in females. The high prevalence rates of personality disorders indicate the need for intervention programs that target these unwanted outcomes.",0,0 +6343,"Psychobiology of PTSD in the acute aftermath of trauma: Integrating research on coping, HPA function and sympathetic nervous system activity","Research on the psychobiological sequelae of trauma has typically focused on long-term alterations in individuals with chronic posttraumatic stress disorder (PTSD). Far less is known about the nature and course of psychobiological risk factors for PTSD during the acute aftermath of trauma. In this review, we summarize data from prospective studies focusing on the relationships among sympathetic nervous system activity, hypothalamic-pituitary-adrenal function, coping strategies and PTSD symptoms during the early recovery (or non-recovery) phase. Findings from pertinent studies are integrated to inform psychobiological profiles of PTSD-risk in children and adults in the context of existing models of PTSD-onset and maintenance. Data regarding bidirectional relations between coping strategies and stress hormones is reviewed. Limitations of existing literature and recommendations for future research are discussed.",0,0 +6344,The Indochinese Psychiatry Clinic: Trauma and Refugee Mental Health Treatment in the 1990s,"The Indochinese Psychiatry Clinic (IPC), located in Boston, was founded in 1981 to meet the special needs of traumatized Cambodian, Vietnamese, and Laotian refugees resettling in the Boston area. Over the past 16 years, IPC has pioneered the field of refugee mental health and the treatment of the psychological and social sequelae of mass violence and torture. IPC developed the bicultural model of psychiatric treatment of refugees suffering from trauma-related mental disorders, which utilizes a multidisciplinary, bicultural team approach that emphasizes understanding the patient's trauma history within the appropriate cultural, social, and political context. This article summarizes IPC's background, patient profile, clinical approach, service elements, and funding structure. Recent immigration and welfare reform legislation will have a harsh impact on the population of refugees who are disabled due to the psychosocial consequences of their traumatic experiences. This legislation and the restrictions on mental health care imposed by public managed care will also affect the providers of their mental health care.",0,0 +6345,Assessing a dysphoric arousal model of acute stress disorder symptoms in a clinical sample of rape and bank robbery victims,"Since the introduction of Acute Stress Disorder (ASD) into the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) research has focused on the ability of ASD to predict PTSD rather than focusing on addressing ASD's underlying latent structure. The few existing confirmatory factor analytic (CFA) studies of ASD have failed to reach a clear consensus regarding ASD's underlying dimensionality. Although, the discrepancy in the results may be due to varying ASD prevalence rates, it remains possible that the model capturing the latent structure of ASD has not yet been put forward. One such model may be a replication of a new five-factor model of PTSD, which separates the arousal symptom cluster into Dysphoric and Anxious Arousal. Given the pending DSM-5, uncovering ASD's latent structure is more pertinent than ever.USING CFA, FOUR DIFFERENT MODELS OF THE LATENT STRUCTURE OF ASD WERE SPECIFIED AND TESTED: the proposed DSM-5 model, the DSM-IV model, a three factor model, and a five factor model separating the arousal symptom cluster.The analyses were based on a combined sample of rape and bank robbery victims, who all met the diagnostic criteria for ASD (N = 404) using the Acute Stress Disorder Scale.The results showed that the five factor model provided the best fit to the data.The results of the present study suggest that the dimensionality of ASD may be best characterized as a five factor structure which separates dysphoric and anxious arousal items into two separate factors, akin to recent research on PTSD's latent structure. Thus, the current study adds to the debate about how ASD should be conceptualized in the pending DSM-5.",0,0 +6346,Tonic immobility mediates the influence of peritraumatic fear and perceived inescapability on posttraumatic stress symptom severity among sexual assault survivors,"This study evaluated whether tonic immobility mediates the relations between perceived inescapability, peritraumatic fear, and posttraumatic stress disorder (PTSD) symptom severity among sexual assault survivors. Female undergraduates (N = 176) completed questionnaires assessing assault history, perceived inescapability, peritraumatic fear, tonic immobility, and PTSD symptoms. Results indicated that tonic immobility fully mediated relations between perceived inescapability and overall PTSD symptom severity, as well as reexperiencing and avoidance/numbing symptom clusters. Tonic immobility also fully mediated the relation between fear and reexperiencing symptoms, and partially mediated relations between fear and overall PTSD symptom severity, and avoidance/numbing symptoms. Results suggest that tonic immobility could be one path through which trauma survivors develop PTSD symptoms. Further study of tonic immobility may inform our ability to treat trauma victims.",0,0 +6347,"Childhood adversity, adult stressful life events, and risk of past-year psychiatric disorder: a test of the stress sensitization hypothesis in a population-based sample of adults","Background Childhood adversity (CA) is associated with adult mental disorders, but the mechanisms underlying this association remain inadequately understood. Stress sensitization, whereby CA increases vulnerability to mental disorders following adult stressful life events, has been proposed as a potential mechanism. We provide a test of the stress sensitization hypothesis in a national sample. Method We investigated whether the association between past-year stressful life events and the 12-month prevalence of major depression, post-traumatic stress disorder (PTSD), other anxiety disorders, and perceived stress varies according to exposure to CA. We used data from the National Epidemiological Survey of Alcohol and Related Conditions (NESARC) ( n =34 653). Results Past-year stressful life events were associated with an increased risk of major depression, PTSD, anxiety disorders, and perceived stress. However, the magnitude of the increased risk varied according to respondents' history of CA. For example, past-year major stressors were associated with a 27.3% increase in the 12-month risk of depression among individuals with ⩾3 CAs and a 14.8% increased risk among individuals without CAs. Stress sensitization effects were present for depression, PTSD, and other anxiety disorders in women and men, although gender differences were found in the threshold of past-year stress needed to trigger such effects. Stress sensitization was most evident among individuals with ⩾3 CAs. Conclusions CA is associated with increased vulnerability to the deleterious mental health effects of adult stressors in both men and women. High levels of CA may represent a general diathesis for multiple types of psychopathology that persists throughout the life course.",0,0 +6348,Altered salivary alpha-amylase awakening response in Bosnian War refugees with posttraumatic stress disorder,"In posttraumatic stress disorder (PTSD), chronic activation of the sympathetic nervous system (SNS) has been suggested. No study so far has investigated diurnal secretion patterns of salivary alpha-amylase (sAA) in PTSD, a promising candidate for non-invasive assessment of SNS activity. We compared sAA diurnal profiles between a group of Bosnian War refugees with PTSD and a healthy control group, and further analyzed for associations with psychiatric symptoms and glucocorticoid (GC) sensitivity of inflammatory regulation. PTSD patients showed a sAA awakening response profile that was opposite to those seen in healthy controls, i.e. an increase instead of a sharp decrease. Patterns of sAA secretion were further positively associated with psychiatric symptoms of PTSD. Finally, higher sAA awakening responses were associated with higher GC sensitivity of inflammatory cytokine production. These findings are in line with altered SNS function in PTSD, and lend further support for employing assessment of diurnal sAA profiles as non-invasive biomarkers in stress-related disease.",0,0 +6349,An investigation of PTSD's core dimensions and relations with anxiety and depression.,"Posttraumatic stress disorder (PTSD) is highly comorbid with anxiety and depressive disorders, which is suggestive of shared variance or common underlying dimensions. The purpose of the present study was to examine the relationship between the latent factors of PTSD with the constructs of anxiety and depression in order to increase understanding of the co-occurrence of these disorders.Data were collected from a nonclinical sample of 186 trauma-exposed participants using the PTSD Checklist and Hospital Anxiety and Depression Scale. Confirmatory factor analyses were conducted to determine model fit comparing 3 PTSD factor structure models, followed by Wald tests comparing the relationships between PTSD factors and the core dimensions of anxiety and depression.In model comparisons, the 5-factor dysphoric arousal model of PTSD provided the best fit for the data, compared to the emotional numbing and dysphoria models of PTSD. Compared to anxious arousal, the dysphoric arousal and numbing factors of PTSD were more related to depression severity. Numbing, anxious arousal, and dysphoric arousal were not differentially related to the latent anxiety factor.The underlying factors of PTSD contain aspects of the core dimensions of both anxiety and depression. The heterogeneity of PTSD's associations with anxiety and depressive constructs requires additional empirical exploration because clarification regarding these relationships will impact diagnostic classification as well as clinical practice.",0,0 +6350,The structure of posttraumatic stress disorder symptoms in combat veterans: A confirmatory factor analysis of the impact of event scale,"There has been controversy over the most appropriate way to define symptom clusters for posttraumatic stress disorder (PTSD). We tested the factor structure of the Impact of Event Scale (IES) in a sample of 195 male combat veterans with chronic PTSD by using confirmatory factor analysis . The two-factor model including Intrusion (i.e., unwanted memories of the event) and Avoidance (i.e., attempts to avoid reminders and numbing of emotional responsiveness) deviated significantly from good fit. However, a four-factor model, including Intrusion and Effortful Avoidance subscales, as well as Sleep Disturbance and Emotional Numbing subscales, fit significantly better. Correlations with other PTSD measures are explored and implications for the conceptualization of PTSD are discussed.",0,0 +6351,Key Elements in Couples Therapy With Veterans With Combat-Related Posttraumatic Stress Disorder.,"If a client dealing with combat-related posttraumatic stress disorder (PTSD) presents for psychotherapy, should you consider including his or her partner in treatment? How could couples therapy be beneficial? What framework do you have to conceptualize the relational issues and potential treatment? Although clinicians have long been encouraged to include families in the treatment of combat-related PTSD, few specific couple-family therapies exist, and outcome research is scarce. Because of the adverse effects of PTSD on relationships, couples therapy can be a powerful adjunct treatment; however, few receive this service. A new framework for conceptualizing couples therapy organizes treatment around the 3 PTSD symptom clusters (reexperiencing, avoidance, and arousal). Relationship consequences of each symptom cluster are summarized, followed by useful treatment interventions and a case study.",0,0 +6352,"Mental Health and Childhood Adversities: A Longitudinal Study in Kabul, Afghanistan","To identify prospective predictors of mental health in Kabul, Afghanistan.Using stratified random-sampling in schools, mental health and life events for 11-to 16-year-old students and their caregivers were assessed. In 2007, 1 year after baseline, the retention rate was 64% (n = 115 boys, 119 girls, 234 adults) with no evidence of selection bias. Self- and caregiver-rated child mental health (Strengths and Difficulties Questionnaire), depressive (Depression Self-Rating Scale), and posttraumatic stress (Child Revised Impact of Events Scale) symptoms and caregiver mental health (Self-Report Questionnaire) were assessed. Lifetime trauma and past-year traumatic, stressful, and protective experiences were assessed.With the exception of posttraumatic stress, one-year trajectories for all mental health outcomes showed significant improvement (p < .001). Family violence had a striking impact on the Strengths and Difficulties Questionnaire data, raising caregiver-rated scores by 3.14 points (confidence interval [CI] 2.21-4.08) or half a standard deviation, and self-rated scores by 1.26 points (CI 0.50-2.03); past-year traumatic beatings independently raised self-rated scores by 1.85 points (CI 0.03-3.66). A major family conflict raised depression scores by 2.75 points (CI 0.89-4.61), two thirds of a standard deviation, whereas improved family life had protective effects. Posttraumatic stress symptom scores, however, were solely contingent on lifetime trauma, with more than three events raising scores by 5.38 points (CI 1.76-9.00).Family violence predicted changes in mental health problems other than posttraumatic stress symptoms in a cohort that showed resilience to substantial socioeconomic and war-related stressors. The importance of prospectively identifying impacts of specific types of childhood adversities on mental health outcomes is highlighted to strengthen evidence on key modifiable factors for intervention in war-affected populations.",0,0 +6353,Parent perspectives on family-based psychosocial interventions in pediatric cancer: a mixed-methods approach,"Family-based interventions in pediatric cancer face challenges associated with integrating psychosocial care into a period of intensive treatment and escalating stress. Little research has sought input from parents on the role of interventions delivered shortly after diagnosis. This mixed-methods study obtained parents' perspectives on the potential role of family-based interventions. Twenty-five parents provided feedback on the structure and timing of psychosocial interventions via focus groups and a questionnaire. Qualitative analyses resulted in three themes that were illustrative of a traumatic stress framework: (1) tension between focusing on child with cancer and addressing other family needs, (2) factors influencing parents' perception of a shared experience with other parents, and (3) the importance of matching interventions to the trajectory of parent adjustment. Quantitative data indicated that parents preferred intervention within 6 months of diagnosis, with almost half favoring within 2 months of diagnosis, and the majority wanted interventions targeted to parents only. Qualitative themes highlight the importance of using a traumatic stress framework to inform the development of family-based interventions for those affected by pediatric cancer.",0,0 +6354,Divalproex in the Treatment of Impulsive Aggression: Efficacy in Cluster B Personality Disorders,"Impulsive aggressive behavior is common in psychiatric disorders and accounts for significant morbidity and mortality. However, little systematic treatment data exist from placebo-controlled trials for this symptom domain. This was a multicenter, randomized, double-blind, placebo-controlled study in which outpatients with a score of > or =15 on the Aggression scale of the Overt Aggression Scale-Modified (OAS-M) and who fulfilled DSM-IV criteria for Cluster B personality disorder (n=96), intermittent explosive disorder (n=116), or post-traumatic stress disorder (n=34) were randomized to divalproex sodium or placebo for 12 weeks duration. Based on average OAS-M Aggression scores over the last 4 weeks of treatment, a treatment effect was not observed in the intent-to-treat data set (combined across the three psychiatric disorders), but was observed in both intent-to-treat and evaluable data sets for patients with Cluster B personality disorders. In the Cluster B evaluable data set, statistically significant treatment differences favoring divalproex were also observed for component items of the OAS-M Aggression score, including verbal assault and assault against objects, as well as OAS-M Irritability score, and Clinical Global Impression (CGI)-Severity at multiple time points throughout the study. No treatment group difference was noted for overall premature discontinuation rate; however, across psychiatric diagnoses, 21 (17%) patients in the divalproex group prematurely discontinued because of an adverse event, as compared to 4 (3%) patients in the placebo group (p <0.001). While a treatment effect was not observed when all diagnostic groups were combined, in a large subgroup of patients with Cluster B disorders, divalproex was superior to placebo in the treatment of impulsive aggression, irritability, and global severity.",0,0 +6355,War-related trauma and symptoms of posttraumatic stress disorder among adult Kosovar refugees,"Since 1999, almost 16,000 Kosovar refugees have entered the United States. Few studies have investigated trauma and symptoms of posttraumatic stress disorder (PTSD) in this population. We conducted a caseworker-assisted survey of 129 Kosovar refugees (aged 18 to 79 years, 55% male). Of these individuals, 78 (60.5%) showed the likely presence of PTSD. The mean number of war-related traumatic events reported was 15 (SD = 4.5). Higher PTSD scores were associated with more traumatic events and female gender.",0,0 +6356,The role of comorbid psychiatric conditions in health status in epilepsy,"Comorbid psychiatric conditions are highly prevalent in patients with epilepsy, yet the long-term implications across multiple mental health conditions are poorly understood. We examined the association between psychiatric diagnoses and self-reported health status in veterans with epilepsy. ANCOVA models were used to derive adjusted SF-36V scores for individuals with epilepsy alone (N=7379) or with additional psychiatric conditions (N=6320): depression, schizophrenia, bipolar disorder, anxiety disorder, substance abuse, and posttraumatic stress disorder (PTSD). Compared with patients with epilepsy alone, scores of veterans with comorbid psychiatric diagnoses averaged 21% lower across all domains. Role Limitation scales exhibited the greatest decrement across domains. A PTSD diagnosis consistently corresponded to lower scores, followed by depression. Schizophrenia contributed the least detriment to perceived health status. Comorbid psychiatric conditions impart significant emotional and physical burdens, requiring timely recognition and treatment of these disorders. Patients with epilepsy are uniquely at risk for high physical-psychiatric comorbidity profiles, with concomitant losses in perceived health status.",0,0 +6357,The Origin and Structure of the Abusive Personality,"Comparisons were made of 120 wife-assaultive men and 40 demographically matched controls. Discriminant functions correctly classified 90% (based on personality scores only) and 95% (personality and anger scores) of men into high and low categories for psychological abuse (as reported by a sample of their female partners). The measure correlated most highly with the discriminant function was borderline personality organization (BPO), but anger and other personality disorders also contributed to discriminatory power. Negativlstic (passive-aggressive + self-defeating) personality disorder was associated with the discriminant function for both emotional abuse and dominance/isolation, but narcissistic and aggressive-sadistic personality disorders were more associated with emotional abuse and avoidant personality disorder was more associated with dominance/isolation. The avoidant-negativistic profile (with associated borderline features) found for these men is also indicative of posttraumatic stress disorder. T...",0,0 +6358,Acute and Chronic Plasma Metabolomic and Liver Transcriptomic Stress Effects in a Mouse Model with Features of Post-Traumatic Stress Disorder,"Acute responses to intense stressors can give rise to post-traumatic stress disorder (PTSD). PTSD diagnostic criteria include trauma exposure history and self-reported symptoms. Individuals who meet PTSD diagnostic criteria often meet criteria for additional psychiatric diagnoses. Biomarkers promise to contribute to reliable phenotypes of PTSD and comorbidities by linking biological system alterations to behavioral symptoms. Here we have analyzed unbiased plasma metabolomics and other stress effects in a mouse model with behavioral features of PTSD. In this model, C57BL/6 mice are repeatedly exposed to a trained aggressor mouse (albino SJL) using a modified, resident-intruder, social defeat paradigm. Our recent studies using this model found that aggressor-exposed mice exhibited acute stress effects including changed behaviors, body weight gain, increased body temperature, as well as inflammatory and fibrotic histopathologies and transcriptomic changes of heart tissue. Some of these acute stress effects persisted, reminiscent of PTSD. Here we report elevated proteins in plasma that function in inflammation and responses to oxidative stress and damaged tissue at 24 hrs post-stressor. Additionally at this acute time point, transcriptomic analysis indicated liver inflammation. The unbiased metabolomics analysis showed altered metabolites in plasma at 24 hrs that only partially normalized toward control levels after stress-withdrawal for 1.5 or 4 wks. In particular, gut-derived metabolites were altered at 24 hrs post-stressor and remained altered up to 4 wks after stress-withdrawal. Also at the 4 wk time point, hyperlipidemia and suppressed metabolites of amino acids and carbohydrates in plasma coincided with transcriptomic indicators of altered liver metabolism (activated xenobiotic and lipid metabolism). Collectively, these system-wide sequelae to repeated intense stress suggest that the simultaneous perturbed functioning of multiple organ systems (e.g., brain, heart, intestine and liver) can interact to produce injuries that lead to chronic metabolic changes and disorders that have been associated with PTSD.",0,0 +6359,Post-traumatic growth among veterans in the USA: results from the National Health and Resilience in Veterans Study,"Background There is increasing recognition that, in addition to negative psychological consequences of trauma such as post-traumatic stress disorder (PTSD), some individuals may develop post-traumatic growth (PTG) following such experiences. To date, however, data regarding the prevalence, correlates and functional significance of PTG in population-based samples are lacking. Method Data were analysed from the National Health and Resilience in Veterans Study, a contemporary, nationally representative survey of 3157 US veterans. Veterans completed a survey containing measures of sociodemographic, military, health and psychosocial characteristics, and the Posttraumatic Growth Inventory-Short Form. Results We found that 50.1% of all veterans and 72.0% of veterans who screened positive for PTSD reported at least ‘moderate’ PTG in relation to their worst traumatic event. An inverted U-shaped relationship was found to best explain the relationship between PTSD symptoms and PTG. Among veterans with PTSD, those with PTSD reported better mental functioning and general health than those without PTG. Experiencing a life-threatening illness or injury and re-experiencing symptoms were most strongly associated with PTG. In multivariable analysis, greater social connectedness, intrinsic religiosity and purpose in life were independently associated with greater PTG. Conclusions PTG is prevalent among US veterans, particularly among those who screen positive for PTSD. These results suggest that there may be a ‘positive legacy’ of trauma that has functional significance for veterans. They further suggest that interventions geared toward helping trauma-exposed US veterans process their re-experiencing symptoms, and to develop greater social connections, sense of purpose and intrinsic religiosity may help promote PTG in this population.",0,0 +6360,Diagnosis and classification of disorders specifically associated with stress: proposals for ICD-11,"The diagnostic concepts of post-traumatic stress disorder (PTSD) and other disorders specifically associated with stress have been intensively discussed among neuro- and social scientists, clinicians, epidemiologists, public health planners and humanitarian aid workers around the world. PTSD and adjustment disorder are among the most widely used diagnoses in mental health care worldwide. This paper describes proposals that aim to maximize clinical utility for the classification and grouping of disorders specifically associated with stress in the forthcoming 11th revision of the International Classification of Diseases (ICD-11). Proposals include a narrower concept for PTSD that does not allow the diagnosis to be made based entirely on non-specific symptoms; a new complex PTSD category that comprises three clusters of intra- and interpersonal symptoms in addition to core PTSD symptoms; a new diagnosis of prolonged grief disorder, used to describe patients that undergo an intensely painful, disabling, and abnormally persistent response to bereavement; a major revision of ""adjustment disorder"" involving increased specification of symptoms; and a conceptualization of ""acute stress reaction"" as a normal phenomenon that still may require clinical intervention. These proposals were developed with specific considerations given to clinical utility and global applicability in both low- and high-income countries.",0,0 +6361,Research Review: Psychosocial adjustment and mental health in former child soldiers - a systematic review of the literature and recommendations for future research,"This article reviews the available quantitative research on psychosocial adjustment and mental health among children (age <18 years) associated with armed forces and armed groups (CAAFAG)--commonly referred to as child soldiers.PRISMA standards for systematic reviews were used to search PubMed, PsycInfo, JSTOR, and Sociological Abstracts in February 2012 for all articles on former child soldiers and CAAFAG. Twenty-one quantitative studies from 10 countries were analyzed for author, year of publication, journal, objectives, design, selection population, setting, instruments, prevalence estimates, and associations with war experiences. Opinion pieces, editorials, and qualitative studies were deemed beyond the scope of this study. Quality of evidence was rated according to the systematic assessment of quality in observational research (SAQOR).According to SAQOR criteria, among the available published studies, eight studies were of high quality, four were of moderate quality, and the remaining nine were of low quality. Common limitations were lack of validated mental health measures, unclear methodology including undefined sampling approaches, and failure to report missing data. Only five studies included a comparison group of youth not involved with armed forces/armed groups, and only five studies assessed mental health at more than one point in time. Across studies, a number of risk and protective factors were associated with postconflict psychosocial adjustment and social reintegration in CAAFAG. Abduction, age of conscription, exposure to violence, gender, and community stigma were associated with increased internalizing and externalizing mental health problems. Family acceptance, social support, and educational/economic opportunities were associated with improved psychosocial adjustment.Research on the social reintegration and psychosocial adjustment of former child soldiers is nascent. A number of gaps in the available literature warrant future study. Recommendations to bolster the evidence base on psychosocial adjustment in former child soldiers and other war-affected youth include more studies comprising longitudinal study designs, and validated cross-cultural instruments for assessing mental health, as well as more integrated community-based approaches to study design and research monitoring.",0,0 +6362,Psychological distress among victimized women on probation and parole: A latent class analysis.,"Latent class analysis was used to identify subgroups of victimized women (N = 406) on probation and parole differentiated by levels of general psychological distress. The 9 primary symptom dimensions from the Brief Symptom Inventory (BSI) were used individually as latent class indicators (Derogatis, 1993). Results identified 3 classes of women characterized by increasing levels of psychological distress; classes were further differentiated by posttraumatic stress disorder symptoms, cumulative victimization, substance use and other domains of psychosocial functioning (i.e., sociodemographic characteristics; informal social support and formal service utilization; perceived life stress; and resource loss). The present research was effective in uncovering important heterogeneity in psychological distress using a highly reliable and easily accessible measure of general psychological distress. Differentiating levels of psychological distress and associated patterns of psychosocial risk can be used to develop intervention strategies targeting the needs of different subgroups of women. Implications for treatment and future research are presented.",0,0 +6363,Sleepless nights in the ICU: the awaken family,"Having a loved-one in the ICU is a traumatic experience for family members that can lead to a cluster of psychological complications, recently defined as post-intensive care family syndrome. In a previous issue of Critical Care, Day and colleagues stressed the severe sleep disturbance and fatigue experienced by a majority of ICU patient family members. However, despite this burden being well characterised, the best preventive coping strategy remains undetermined.",0,0 +6364,Defining victims: a proposed typology for victims of war crimes and their need for reparation,"Born in the ashes of the Second World War, the field of victimology has grown tremendously in recent years, where we have seen much excellent empirical research done on victims. Much of the research deals with specific types of victimization (e.g., domestic violence, rape), empirical aspects of victimization in general (e.g., victimization surveys) and the consequences of victimization (e.g., post-traumatic stress disorder (PTSD)). However, despite the many empirical studies, relatively little attention has been paid to theoretical aspects of victimology. As Landau and Freeman-Longo point out, the dearth of theoretical work in victimology is surprising given that in a relatively new field problems of definition and boundary-setting would be an important starting point for further studies therein. Victimologists have not always shied away from theoretical work. Early victimologists, such as Hans von Hentig, Benjamin Mendelsohn, Marvin Wolfgang and Ezzat Fattah, were very active in developing theoretical victimology. Each developed their own typology of victims in order to better understand, explain and hence prevent victimization. By the early 1980s, under the influence of the victims’ movement, these typologies lost much of their original popularity, as victimology moved away from criminology and stopped trying to explain crime. As Ezzat Fattah observes, there was a shift ‘from victimology of the act to victimology of action’ as victimology became increasingly associated with victim support. © Cambridge University Press 2014.",0,0 +6365,US female veterans in VA primary care: post traumatic stress disorder symptoms and functional status,"We sought to examine the relationship between post traumatic stress disorder (PTSD) symptomatology, demographic variables, and functional status in US female veterans. One hundred ninety-one female veterans were identified from primary care clinics in four VA Medical Centers for participation in this study. The relationship between demographic variables, physical and mental health functional status on the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and PTSD severity on the PTSD Checklist (PCL) was examined using ANOVAs and simple and multiple linear regression modeling. After adjusting for other demographic covariates, PTSD severity was related to age (older patients reported less symptoms), and employment status (veterans who were not working due to disability reported significantly more PTSD symptoms than those who were working). Additionally, after adjusting for relevant demographic covariates, greater PTSD symptomatology was related to worse functioning across both physical and mental health domains on the SF-36. PTSD symptom severity was easily assessed in this primary care sample of female veterans using the PCL. Screening female veterans through primary care clinics is likely to identify women with PTSD who are not functioning as well as their peers and who are in need of specialized services. These findings are similar to those using men identified through VA primary care clinics. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +6366,Attachment Style in the Prediction of Recovery Following Group Treatment of Combat Veterans With Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) can be difficult to treat, with gains often particularly modest in combat veterans. Although group-based treatments are commonly delivered for veterans, little is known about factors influencing their outcomes. Attachment style is known to be associated with psychopathology after trauma and is critical to group-based interventions, but has not yet been investigated in relation to treatment outcome. A better understanding of factors that influence outcome is critical in optimizing the effectiveness of such interventions. This study investigated attachment style as a predictor of outcome for 103 veterans attending group-based treatment for combat-related PTSD. Measures included the Clinician Administered PTSD Scale, PTSD Checklist, and Relationship Styles Questionnaire. Path analyses indicated preoccupied attachment style strongly negatively predicted outcome following treatment. The preoccupied attachment style impedes recovery in group-based treatment for veterans with PTSD. Potential mechanisms underlying this finding are discussed. The results suggest that greater attention should be paid at initial assessment to attachment style of veterans before entering PTSD treatment, particularly group-based interventions.",0,0 +6367,Associations Between Functioning and PTSD Symptom Clusters in a Dismantling Trial of Cognitive Processing Therapy in Female Interpersonal Violence Survivors,"This study conducted secondary analyses of a published trial and sought to determine if different domains of psychosocial functioning (e.g., daily living, work, nonfamily relationships) improved following trauma-focused treatment for posttraumatic stress disorder (PTSD). Cognitive processing therapy (CPT), an empirically supported treatment that involves evaluating trauma-related beliefs and written trauma accounts, was compared to its components: CPT without the written accounts or written accounts only in a sample of 78 women with PTSD secondary to interpersonal violence. Overall and individual domains of functioning significantly improved with treatment and results were similar across treatment groups, Fs (2, 150) ≥ 11.87, ps < .001. Additionally, we investigated whether changes in different PTSD symptom clusters were associated with outcomes in domains of psychosocial functioning, after collapsing across treatment condition. Multiple hierarchical linear regression analyses revealed that overall clinician-assessed PTSD symptom reduction was associated with outcomes in all domains of functioning, βs = .44 to .68, ps < .001. Additionally, improvements in the emotional numbing symptom cluster were associated with outcomes in the nonfamily relationships domain, β = .42, p < .001, and improvements in the hyperarousal symptom cluster were associated with outcomes in the overall, daily living, and household tasks domains, βs = .34 to .39, ps < .01. Results suggest that it may be important to monitor improvements in emotional numbing and hyperarousal symptoms throughout treatment to increase the likelihood of changes in psychosocial functioning. Spanish Abstracts by the Asociación Chilena de Estrés Traumático (ACET) Este estudio condujo un análisis secundario de un ensayo publicado y buscó determinar si diferentes dominios de funcionamiento psicosocial (ej., vida diaria, trabajo, relaciones no familiares) mejoraron después de un tratamiento enfocado en el trauma para trastorno por estrés post-traumático (TEPT). La terapia de procesamiento cognitivo (TPC), un tratamiento respaldado empíricamente que involucra la evaluación de las creencias relacionadas al trauma y los relatos escritos del trauma, fue comparado con sus componentes: TPC sin los relatos escritos o solamente relatos escritos en una muestra de 78 mujeres con TEPT secundario a violencia interpersonal. Los dominios de funcionamiento generales e individuales aumentaron significativamente con el tratamiento y los resultados fueron similares a través de los grupos de tratamiento, Fs (2, 150) ≥ 11.87, ps < .001. Adicionalmente, investigamos si los cambios en los diferentes grupos de síntomas de TEPT se asociaron con resultados en dominios de funcionamiento psicosocial, después de colapsar a través de las condiciones de tratamiento. Un análisis de regresión linear múltiple jerárquica reveló que la reducción general de síntomas de TEPT evaluada por clínicos se asoció con los resultados en todos los dominios de funcionamiento βs = .44 to .68, ps < .001. Adicionalmente, mejorías en el grupo de síntomas de entumecimiento emocional se asociaron con los resultados del dominio de relaciones no familiares, β = .42,p < .001, y mejorías en el grupo de síntomas de hiperexcitabilidad se asociaron con los resultados generales en los dominios, de vida diaria y tareas domésticas βs = .34 to .39, ps < .01.Los resultados sugieren que puede ser importante monitorear las mejorías en los síntomas de entumecimiento emocional e hiperexcitabilidad a lo largo del tratamiento para aumentar la probabilidad de cambios en el funcionamiento psicosocial. Traditional and Simplified Chinese Abstracts by AsianSTSS 標題：人際暴力女倖存者接受認知處理療法的拆解試驗中功能和PTSD症狀羣的關係 撮要：本研究為一已刊登研究的二次分析，驗証治療創傷後壓力症(PTSD)的聚焦創傷法後心理社會功能中不同領域(如日常生活、工作、家庭以外關係)的改進。認知處理療法(CPT)是實証支持的治療，包括評估創傷相連信念和創傷筆記。CPT在研究中對照其中成份：即CPT除去創傷筆記，或只有創傷筆記，而樣本是78名因人際暴力而患上PTSD的婦女。綜合和個別功能領域在治療後明顯改進，而不同治療組別中結果相類，FS (2, 150) 11.87, ps < .001。我們亦檢測不同PTSD症狀羣變化在除去治療狀況因素後會否與心理社會功能領域結果相連。多重階層綫性分析顯示綜合臨床評估PTSD症狀減退與功能的所有領域結果相關，βS= .44至 .68, ps< .001。情感麻木症狀羣的改進和非家庭關係領域結果相連，β= .42, p< .001., 而過激症狀羣改進則與綜合、日常生活和家居事務領域有關係，βS= .34至.39, ps< .01。結論是在治療中監察情感麻木和過激症狀的改進增加心理社會功能改善的機會。 标题：人际暴力女幸存者接受认知处理疗法的拆解试验中功能和PTSD症状羣的关系 撮要：本研究为一已刊登研究的二次分析，验证治疗创伤后压力症(PTSD)的聚焦创伤法后心理社会功能中不同领域(如日常生活、工作、家庭以外关系)的改进。认知处理疗法(CPT)是实证支持的治疗，包括评估创伤相连信念和创伤笔记。CPT在研究中对照其中成份：即CPT除去创伤笔记，或只有创伤笔记，而样本是78名因人际暴力而患上PTSD的妇女。综合和个别功能领域在治疗后明显改进，而不同治疗组别中结果相类，FS (2, 150) 11.87, ps < .001。我们亦检测不同PTSD症状羣变化在除去治疗状况因素后会否与心理社会功能领域结果相连。多重阶层线性分析显示综合临床评估PTSD症状减退与功能的所有领域结果相关，βS= .44至 .68, ps< .001。情感麻木症状羣的改进和非家庭关系领域结果相连，β= .42, p< .001., 而过激症状羣改进则与综合、日常生活和家居事务领域有关系，βS= .34至.39, ps< .01。结论是在治疗中监察情感麻木和过激症状的改进增加心理社会功能改善的机会。",0,0 +6368,Personality Factors in the Anxiety Disorders,"This chapter describes a theoretical framework based on hierarchical models of personality and the anxiety disorders that is able to reflect both the DSM-IV organization of anxiety disorders as a distinct internalizing cluster (separate from mood disorders) as well as the diagnostic specificity within the category of anxiety disorders. The literature examining relationships between higher-order personality dimensions, such as Neuroticism and Extraversion, as well as lower-order facets of personality, such as self-criticism, perfectionism, and anxiety sensitivity, and the anxiety disorders is reviewed. Several mechanisms of interaction between personality factors and anxiety disorders are considered, specifically, vulnerability, scar, and pathoplasty models. Based on this literature, specific personality profiles associated with each anxiety disorder are proposed. © 2009 by Oxford University Press. All rights reserved.",0,0 +6369,Typology of post-traumatic stress disorder in children and adolescents,"Results obtained from clinical and psychopathological studies of 161 patients with post-traumatic stress disorder (PTSD) aged 3-18 years with symptom durations from one month to four years are presented. Four major clinical variants of the type of PTSD were identified in children and adolescents: insomniac (34.8%), phobic (23.6%), psychopathic-like (21.7%), and asthenic-depressive (19.9%). These variants, differing in terms of course and prognosis, occurred at different frequencies in different age and ethnic groups; there were no gender-related differences. © Springer Science+Business Media, Inc. 2007.",0,0 +6370,Posttraumatic Stress Disorder and the MCMI-II,"This study investigated the MCMI-II profile characteristics of 39 veterans diagnosed with Posttraumatic Stress Disorder. Characteristics of the mean group profile were similar to prior findings reported in the literature on the MCMI and Posttraumatic Stress Disorder with highest mean elevations found on the Avoidant, Passive-Aggressive, Schizoid, and Antisocial basic personality scales, the Borderline and Schizotypal pathological personality scales, and with elevations on the Anxiety, Dysthymia, Alcohol Dependence, Drug Dependence, and Major Depression clinical syndrome scales. A multivariate analysis of variance comparing the group with Posttraumatic Stress Disorder with a non-PTSD comparison group of 39 on the basic personality, pathological personality, and the clinical syndrome scales of the MCMI-II was not statistically significant. Nonetheless, univariate analyses of variance comparing the two groups on the individual modifier scales and the individual personality and clinical syndrome scales of the MCMI-II using a Bonferroni adjusted probability indicated significant differences on the Desirability and Histrionic scales. Response-style bias as a possible factor in MCMI-II profiles for the group with Posttraumatic Stress Disorder is also discussed.",0,0 +6371,"The Relations between Violence Exposure, Posttraumatic Stress Symptoms, Secondary Traumatization, Vicarious Post Traumatic Growth and Illness Attribution among Psychiatric Nurses","This study examined posttraumatic stress disorder symptoms (PTSD), secondary traumatization (ST) and vicarious posttraumatic growth (VG) among Israeli psychiatric nurses (PN) who were compared to community nurses (CN). Furthermore, we examined the contribution of PN perceptions of the etiology of their patients' mental illness to their PTSD, ST and VG. Results show that PN reported higher levels of both PTSD and ST symptoms, but lower levels of VG, as compare to CN. While ST symptoms were positively related to VG among CN, PTSD and ST symptoms were negatively associated among PN. Finally, exposure to patients' violence, PTSD or ST symptoms, and illness attribution dimensions of 'powerful others', predicted nurses' VG. PN are an at-risk population for work-related stress residues.",0,0 +6372,Technology-Enhanced Stepped Collaborative Care Targeting Posttraumatic Stress Disorder and Comorbidity After Injury: A Randomized Controlled Trial,"Posttraumatic stress disorder (PTSD) and its comorbidities are endemic among injured trauma survivors. Previous collaborative care trials targeting PTSD after injury have been effective, but they have required intensive clinical resources. The present pragmatic clinical trial randomized acutely injured trauma survivors who screened positive on an automated electronic medical record PTSD assessment to collaborative care intervention (n = 60) and usual care control (n = 61) conditions. The stepped measurement-based intervention included care management, psychopharmacology, and psychotherapy elements. Embedded within the intervention were a series of information technology (IT) components. PTSD symptoms were assessed with the PTSD Checklist at baseline prerandomization and again, 1-, 3-, and 6-months postinjury. IT utilization was also assessed. The technology-assisted intervention required a median of 2.25 hours (interquartile range = 1.57 hours) per patient. The intervention was associated with modest symptom reductions, but beyond the margin of statistical significance in the unadjusted model: F(2, 204) = 2.95, p = .055. The covariate adjusted regression was significant: F(2, 204) = 3.06, p = .049. The PTSD intervention effect was greatest at the 3-month (Cohen's effect size d = 0.35, F(1, 204) = 4.11, p = .044) and 6-month (d = 0.38, F(1, 204) = 4.10, p = .044) time points. IT-enhanced collaborative care was associated with modest PTSD symptom reductions and reduced delivery times; the intervention model could potentially facilitate efficient PTSD treatment after injury.",0,0 +6373,"Mental health survey among landmine survivors in Siem Reap province, Cambodia","Many survivors of the Khmer Rouge period in Cambodia and the subsequent war with Vietnam have now returned to Cambodia. In this two-stage household cluster survey in Siem Reap Province in Cambodia, we explored the mental health consequences on 166 landmine injury survivors selected from 1000 household in 50 clusters and an oversample of all landmine survivors. We found a prevalence of anxiety of 62% for all respondents, 74% for depression, and 34% for post-traumatic stress disorder (PTSD). These prevalences were statistically significantly higher than among the adult population who had not been injured by landmines. These data underscore the importance of providing mental health care services for the people in Siem Reap Province in Cambodia who have been injured by landmines.",0,0 +6374,Exercise augmentation compared to usual care for Post Traumatic Stress Disorder: A Randomised Controlled Trial (The REAP study: Randomised Exercise Augmentation for PTSD),"BackgroundThe physical wellbeing of people with mental health conditions can often be overlooked in order to treat the primary mental health condition as a priority. Exercise however, can potentially improve both the primary psychiatric condition as well as physical measures that indicate risk of other conditions such as diabetes mellitus and cardiovascular disease. Evidence supports the role of exercise as an important component of treatment for depression and anxiety, yet no randomised controlled trials (RCT's) have been conducted to evaluate the use of exercise in the treatment of people with post traumatic stress disorder (PTSD).This RCT will investigate the effects of structured, progressive exercise on PTSD symptoms, functional ability, body composition, physical activity levels, sleep patterns and medication usage.Methods and designEighty participants with a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnosis of PTSD will be recruited. Participants will have no contraindications to exercise and will be cognitively able to provide consent to participate in the study.The primary outcome measures will be PTSD symptoms, measured through the PTSD Checklist Civilian (PCL-C) scale. Secondary outcome measures will assess depression and anxiety, mobility and strength, body composition, physical activity levels, sleep patterns and medication usage. All outcomes will be assessed by a health or exercise professional masked to group allocation at baseline and 12 weeks after randomisation.The intervention will be a 12 week individualised program, primarily involving resistance exercises with the use of exercise bands. A walking component will also be incorporated. Participants will complete one supervised session per week, and will be asked to perform at least two other non-supervised exercise sessions per week. Both intervention and control groups will receive all usual non-exercise interventions including psychotherapy, pharmaceutical interventions and group therapy.DiscussionThis study will determine the effect of an individualised and progressive exercise intervention on PTSD symptoms, depression and anxiety, mobility and strength, body composition, physical activity levels, sleep patterns and medication usage among people with a DSM-IV diagnosis of PTSD.Trial Registration ACTRN12610000579099",0,0 +6375,Rebuild or Relocate? Resilience and Postdisaster Decision-Making After Hurricane Sandy,"Hurricane Sandy struck the east coast of the United States on October 29, 2012, devastating communities in its path. In the aftermath, New York implemented a home buyout program designed to facilitate the permanent relocation of residents out of areas considered to be at risk for future hazards. While home buyout programs are becoming popular as policy tools for disaster mitigation, little is known about what factors influence homeowners to participate in or reject these programs. This study used mixed methods to assess the relationship between community resilience and the relocation decision in two heavily damaged communities in which the majority of residents made different decisions regarding whether or not to pursue a buyout. The sample was composed of residents from Oakwood Beach and Rockaway Park, both working-class communities in New York City, who participated via a community survey (N = 133) and/or in-depth interviews (N = 28). Results suggested that community resilience moderated the relationship between community of residence and the buyout decision, leading to opposite responses on the buyout decision. Contextual community factors, including the history of natural disasters, local cultural norms, and sense of place, were instrumental in explaining these different responses. Implications for disaster policy are discussed.",0,0 +6376,Climate Change,"Health is inextricably linked to climate change. It is important for clinicians to understand this relationship in order to discuss associated health risks with their patients and to inform public policy.To provide new US-based temperature projections from downscaled climate modeling and to review recent studies on health risks related to climate change and the cobenefits of efforts to mitigate greenhouse gas emissions.We searched PubMed and Google Scholar from 2009 to 2014 for articles related to climate change and health, focused on governmental reports, predictive models, and empirical epidemiological studies. Of the more than 250 abstracts reviewed, 56 articles were selected. In addition, we analyzed climate data averaged over 13 climate models and based future projections on downscaled probability distributions of the daily maximum temperature for 2046-2065. We also compared maximum daily 8-hour average ozone with air temperature data taken from the National Oceanic and Atmospheric Administration, National Climate Data Center.By 2050, many US cities may experience more frequent extreme heat days. For example, New York and Milwaukee may have 3 times their current average number of days hotter than 32°C (90°F). High temperatures are also strongly associated with ozone exceedance days, for example, in Chicago, Illinois. The adverse health aspects related to climate change may include heat-related disorders, such as heat stress and economic consequences of reduced work capacity; respiratory disorders, including those exacerbated by air pollution and aeroallergens, such as asthma; infectious diseases, including vectorborne diseases and waterborne diseases, such as childhood gastrointestinal diseases; food insecurity, including reduced crop yields and an increase in plant diseases; and mental health disorders, such as posttraumatic stress disorder and depression, that are associated with natural disasters. Substantial health and economic cobenefits could be associated with reductions in fossil fuel combustion. For example, greenhouse gas emission policies may yield net economic benefit, with health benefits from air quality improvements potentially offsetting the cost of US and international carbon policies.Evidence over the past 20 years indicates that climate change can be associated with adverse health outcomes. Health care professionals have an important role in understanding and communicating the related potential health concerns and the cobenefits from policies to reduce greenhouse gas emissions.",0,0 +6377,Translationally relevant modeling of PTSD in rodents,"Post-traumatic stress disorder (PTSD) is clinically defined in DSM-4 by exposure to a significantly threatening and/or horrifying event and the presence of a certain number of symptoms from each of three symptom clusters at least one month after the event. Since humans clearly do not respond homogeneously to a potentially traumatic experience, the heterogeneity in animal responses might be regarded as confirming the validity of animal studies, rather than as representing a problem. A model of diagnostic criteria for psychiatric disorders could therefore be applied to animal responses to augment the validity of study data, providing that the criteria for classification are clearly defined, reliably reproducible and yield results that conform to findings in human subjects. The method described herein was developed in an attempt to model diagnostic criteria in terms of individual patterns of response by using behavioral measures and determining cut-off scores to distinguish between extremes of response or non-response, leaving a sizeable proportion of subjects in a middle group, outside each set of cut-off criteria. The cumulative results of our studies indicate that the contribution of animal models can be further enhanced by classifying individual animal study subjects according to their response patterns. The animal model also enables the researcher to go one step further and correlate specific anatomic, bio-molecular and physiological parameters with the degree and pattern of the individual behavioral response and introduces prevalence rates as a parameter. The translational value of the classification method and future directions are discussed. © 2013 Springer-Verlag Berlin Heidelberg.",0,0 +6378,Associations between self and other representations and posttraumatic adjustment among political prisoners,"The content and structure of self and other representations and their association with posttraumatic stress symptoms, somatic symptoms, and positive growth were studied among 117 Palestinian male political prisoners. Further, the associations between the representations and the severity of trauma and the post-detention conditions (such as education, place of residency and employment), and the role of representation patterns as a moderator between trauma exposure and symptoms was studied. Cluster analysis identified three representation patterns based on participants' descriptions of their spouse and themselves, and of childhood relationships with their mother and father. Representation patterns differed in negative vs. positive content and in the levels of differentiation and conceptual maturity: The Malevolent Others and Defeated Self representation pattern was characterized by very negative content, and poor differentiation and conceptual maturity in all descriptions; the Moderate Parents and Negative S...",0,0 +6379,Symptoms of post-traumatic stress: Intrusion and avoidance 6 and 12 months after TBI,"Primary objectives: (1) To examine survivors with traumatic brain injury (TBI) for symptoms of avoidance and intrusion, two dimensions of post-traumatic stress (PTS) at 6 and 12 months post-injury. (2) To identify risk factors associated with these symptoms.Research design: Prospective follow-up study.Methods and procedures: Georgia and North Carolina Model Brain Injury Systems participants (n = 198) with mild (19%), moderate (21%) and severe (60%) TBI were interviewed by telephone at 6 and 12 months post-injury. The Impact of Event Scale (IES) was used to identify intrusion and avoidance symptoms.Results: Symptoms consistent with severe PTS increased from 11% at 6 months to 16% 12 months post-injury (p < 0.003). African-Americans (p < 0.01) and women (p < 0.05) reported greater symptomatology at 12 months compared to their counterparts. TBI severity and memory of the event were not associated with PTS-like symptoms. Symptoms increased over time when examined by race, injury intent, gender and age (p < 0.05).Conclusions: Regardless of severity, survivors with TBI are at risk for developing symptoms consistent with PTS. Amnesia for the injury event was not protective against developing these symptoms. African-Americans appear to be at greatest risk.",0,0 +6380,Trajectory of Posttraumatic Stress Disorder Caused by Myocardial Infarction: A Two-Year Follow-up Study,"Objective: A substantial proportion of patients develop posttraumatic stress disorder (PTSD) following myocardial infarction (MI). Previous research on the trajectory over time of PTSD in post-MI patients is scant and refers to self-rated posttraumatic symptoms. The aim of this study was to investigate the longitudinal course of an interviewer-rated diagnosis of PTSD and PTSD symptom severity following MI. Methods: Study participants were 40 patients (78% men, mean age 54 α 8 years) who were diagnosed with PTSD using the Clinician-administered PTSD Scale (CAPS) after an average of 5 α 4 months (range 2–16 months) following an index MI. After a mean follow-up of 26 α 6 months (range 12–36 months), 24 patients underwent a second diagnostic interview. Results: Two-thirds of patients ( n = 16) still qualified for a diagnosis of PTSD at follow-up. In all 24 patients, total PTSD symptoms ( p = 0.001), re-experiencing symptoms ( p < 0.001), avoidance symptoms ( p = 0.015), and, with borderline significance, hyperarousal symptoms ( p < 0.06) had all decreased over time. However, in the subgroup of the 16 patients who had retained PTSD diagnostic status at follow-up, symptoms of avoidance ( p = 0.23) and of hyperarousal ( p = 0.48) showed no longitudinal decline. Longer duration of follow-up was associated with a greater decrease in avoidance symptoms ( p = 0.029) and, with borderline significance, in re-experiencing symptoms ( p < 0.07) across all patients. Conclusion: Although PTSD symptomatology waned over time and in relation to longer follow-up, two-thirds of patients still qualified for a diagnosis of PTSD 2 years after the initial diagnosis. In post-MI patients, clinical PTSD is a considerably persistent condition.",0,0 +6381,Rorschach indicators of chronic childhood sexual abuse in female borderline inpatients.,"Recent research indicates a high incidence of childhood sexual abuse and incest among female patients with a diagnosis of borderline personality disorder (BPD). The author investigated the detection and long-term aftereffects of this abuse using a constellation of Rorschach scores that were predicted to occur more frequently in borderline patients with extended sexual victimization before age 14. Sixty-two subjects were divided into two groups (33 with and 29 without such a history) and compared on the following features: color-dominated percepts, primary-process content, confabulation, activity versus passivity, and two new scores related to dissociative symptoms. Some subjects were also administered the Dissociative Experiences Scale and the DSM-III Structured Clinical Interview for posttraumatic stress disorder. The sexually abused group had significantly higher scores both on the Rorschach features and on the clinical measures. The author contends that the identified Rorschach constellation reflects symptoms associated with these trauma-related syndromes, which are more central to the profile of BPD, both on psychological tests and clinically, than is generally recognized.",0,0 +6382,Childhood Abuse Types and Physical Health at the Age of 24: Testing Health Risk Behaviors and Psychological Distress as Mediators,"This study examines whether adult psychological distress and health risk behaviors mediate the relationship between childhood abuse and physical health in adulthood. A randomly selected population-based sample, with oversampling to include a one-third subgroup of former child protection cases, completed a structured interview. Questions pertained to childhood exposure to abuse, adult psychological distress, physical health, and health risk behaviors. Previous research using this sample had identified three abuse typologies: emotional abuse, sexual abuse, and polyvictimization (physical abuse, emotional abuse, and neglect). All three typologies were significantly associated with poorer self-reported physical health. Psychological distress and health risk behaviors partially mediated the relationship between nonabuse, sexual abuse, polyvictimization, and physical health, and fully mediated the relationship between emotional abuse and physical health. The results of this study indicate that health risk behav...",0,0 +6383,Loss of social resources predicts incident posttraumatic stress disorder during ongoing political violence within the Palestinian Authority,"Exposure to ongoing political violence and stressful conditions increases the risk of posttraumatic stress disorder (PTSD) in low-resource contexts. However, much of our understanding of the determinants of PTSD in these contexts comes from cross-sectional data. Longitudinal studies that examine factors associated with incident PTSD may be useful to the development of effective prevention interventions and the identification of those who may be most at-risk for the disorder.A 3-stage cluster random stratified sampling methodology was used to obtain a representative sample of 1,196 Palestinian adults living in Gaza, the West Bank and East Jerusalem. Face-to-face interviews were conducted at two time points 6-months apart. Logistic regression analyses were conducted on a restricted sample of 643 people who did not have PTSD at baseline and who completed both interviews.The incidence of PTSD was 15.0 % over a 6-month period. Results of adjusted logistic regression models demonstrated that talking to friends and family about political circumstances (aOR = 0.78, p = 0.01) was protective, and female sex (aOR = 1.76, p = 0.025), threat perception of future violence (aOR = 1.50, p = 0.002), poor general health (aOR = 1.39, p = 0.005), exposure to media (aOR = 1.37, p = 0.002), and loss of social resources (aOR = 1.71, p = 0.006) were predictive of incident cases of PTSD.A high incidence of PTSD was documented during a 6-month follow-up period among Palestinian residents of Gaza, the West Bank, and East Jerusalem. Interventions that promote health and increase and forestall loss to social resources could potentially reduce the onset of PTSD in communities affected by violence.",0,0 +6384,Olanzapine treatment for post-traumatic stress disorder: an open-label study,"Post-traumatic stress disorder (PTSD) is a common and increasingly diagnosed mental illness. Recent pharmacotherapeutic research on treatments for this condition has focused on antidepressant drugs with serotonergic actions. However, the presence of intrusive, psychotic-like symptoms in a substantial portion of PTSD patients raises the possibility that antipsychotics with serotonergic properties might also prove useful in treating PTSD. We conducted an open-label 8-week study of olanzapine treatment in veterans with combat-induced PTSD. Primary outcome measures in this study were the Clinician Administered PTSD Scale (CAPS) and the Clinical Global Impressions Improvement scale. Secondary outcome measures included the Hamilton Rating Scales for Depression (HRSD) and Anxiety (HRSA). Forty-eight patients enrolled in the study, and 30 completed the 8-week trial. Results of intent-to-treat and completer analyses demonstrated that all outcome measures improved significantly during treatment. Secondary analyses indicate that improvement in the intrusive symptom cluster of the CAPS was independent of improvement on the HRSD and HRSA. In conclusion, the study indicates that olanzapine treatment is useful in alleviating the symptoms of combat-induced PTSD.",0,0 +6385,Evidence for a Dissociative Subtype of Post-Traumatic Stress Disorder Among Help-Seeking Childhood Sexual Abuse Survivors,"This study examined evidence for a dissociative subtype of post-traumatic stress disorder (PTSD) among women seeking psychotherapy for childhood sexual abuse (CSA). One hundred and twenty-two women seeking treatment for CSA completed a battery of questionnaires assessing PTSD, dissociative symptoms, and child maltreatment. Using signal detection analysis, we identified high and low dissociation PTSD subgroups. A constellation of three PTSD symptoms-hypervigilance, sense of foreshortened future, and sleep difficulties-discriminated between these two subgroups (OR = 8.15). Further evidence was provided by the finding of a nonlinear relationship between severity of childhood maltreatment and dissociation in the women with PTSD. These results provide support for a dissociative subtype of PTSD that may stem from more severe childhood experiences of neglect and abuse.",0,0 +6386,"The Goteborg discotheque fire: posttraumatic stress, and school adjustment as reported by the primary victims 18 months later","On October 29, 1998, around 400 young people were gathered in an old warehouse in Göteborg, Sweden, for a discotheque party. A fire erupted and spread explosively. Adolescents were exposed to dreadful scenes inside and outside the building. In all, 63 young people were killed and 213 physically injured. An 18-month follow-up with 275 adolescents (126 girls) who survived the fire, regarding the effects of the fire on symptoms of posttraumatic stress, school adjustment and performance, is reported.Impact of Events Scale (IES), Clinician Administered Posttraumatic Stress Scale (CAPS) and an interview concerning background factors and issues of public and personal support.The level of posttraumatic stress was generally high, and highest among adolescents with an immigrant background. In all, 25% of the participants met DSM-IV criteria for PTSD. Twenty-three percent of the participants reported having either dropped out of school or repeated a class because of the fire. Students' ratings of how their own school handled the situation, and school absenteeism, were related to ratings of their own performance in school as well as to the level of posttraumatic stress.Traditional talking cures were more sought out by girls than boys. Broad-scale interventions must be complemented with special treatment opportunities for the most severely afflicted. Victims who suffer from high levels of posttraumatic stress need special support for a long period of time to minimise the effects on scholastic achievement and adjustment. Studies of the effects of traumatic events on child and adolescent development should measure school-related effects better than has hitherto been the case.",0,0 +6387,Physical Impairments as Risk Factors for the Development of Posttraumatic Stress Disorder,"The case-control method, a retrospective design useful in studying the etiology of rare diseases, was utilized to examine the relative risk of posttraumatic stress disorder (PTSD) among individuals with six types of traumatic physical impairments. Odds ratios and associated confidence intervals were calculated for each impairment in a group of 45,320 veterans receiving medical services. Four of the six impairments were found to be risk factors for PTSD. Implications for rehabilitation counseling and research are discussed.",0,0 +6388,"Prevalence, comorbidity and course of trauma reactions in young burn-injured children","Infants, toddlers and preschoolers are the highest risk group for burn injury. However, to date this population has been largely neglected. This study examined the prevalence, onset, comorbidity and recovery patterns of posttrauma reactions in young children with burns.Parents of 130 unintentionally burned children (1-6 years) participated in the study. The Diagnostic Infant Preschool Assessment was conducted with parents at 1 and 6 months postinjury.The majority of children were resilient. However, 35% were diagnosed with at least one psychological disorder, there was a high rate of comorbidity with posttraumatic stress disorder, and 8% of children did not experience recovery in distress levels over the course of 6 months.These outcomes are likely to have serious repercussions for a young child's medical and psychosocial recovery as well as their normal developmental trajectories. It is recommended that screening, prevention and early intervention resources are incorporated into paediatric health care settings to optimise children's psychological adjustment following burn injury.",0,0 +6389,The validity of two versions of the GHQ in the WHO study of mental illness in general health care,"Background . In recent years the 12-item General Health Questionnaire (GHQ-12) has been extensively used as a short screening instrument, producing results that are comparable to longer versions of the GHQ. Methods . The validity of the GHQ-12 was compared with the GHQ-28 in a World Health Organization study of psychological disorders in general health care. Results are presented for 5438 patients interviewed in 15 centres using the primary care version of the Composite International Diagnostic Instrument, or CIDI-PC. Results . Results were uniformly good, with the average area under the ROC curve 88, range from 83 to 95. Minor variations in the criteria used for defining a case made little difference to the validity of the GHQ, and complex scoring methods offered no advantages over simpler ones. The GHQ was translated into 10 other languages for the purposes of this study, and validity coefficients were almost as high as in the original language. There was no tendency for the GHQ to work less efficiently in developing countries. Finally gender, age and educational level are shown to have no significant effect on the validity of the GHQ. Conclusions . If investigators wish to use a screening instrument as a case detector, the shorter GHQ is remarkably robust and works as well as the longer instrument. The latter should only be preferred if there is an interest in the scaled scores provided in addition to the total score.",0,0 +6390,"Coping, conversation tactics and marital interaction in persons with acquired profound hearing loss (APHL): Correlates of distress","This study investigated coping strategies, conversation tactics, and marital interaction in acquired profound hearing loss (APHL) and compared emotionally stable (n = 15) and emotionally distressed (n = 7) participants. Nominated family members were assessed on most measures. Comparisons were also made in the subgroup of married participants. A combined distress criterion was derived from scores on standardized measures of anxiety, depression, hearing handicap, and post-traumatic stress. Groups were compared on the Ways-of-Coping Checklist, a newly devised measure of conversation tactics, and on the Couple Behaviour Report. It was found that distressed APHL participants were more likely to cope through avoidance, self-blame, and wishful thinking, and they used more avoidant tactics in conversation. The coping profile of family members did not differentiate distress groups. However, there was some indication of greater employment of coercive tactics by family members of distressed participants. The results...",0,0 +6391,The effect of posttraumatic stress disorder psychoeducation on the nature and severity of traumatic stress symptoms in a Burundian sample,"Post-Traumatic Stress Disorder (PTSD) was recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980 as a syndrome associated with the experience of a traumatic event (ARA, 1980). In recent years, the diagnosis of PTSD has been increasingly applied to diverse cultural settings, even as the validity of the construct sparks controversy and debate. Argument continues over whether the symptoms of PTSD are more driven by universal biological response or cultural factors. A review of the literature that documents recent efforts to identify and treat posttraumatic stress symptoms in diverse populations is provided. Given evidence for the suggestive and iatrogenic effects of some PTSD treatment methods and other interventions, as well as the theoretical support for the presence of social influences germane to cross-cultural research and treatment, it was proposed that PTSD-specific psychoeducation in pre-industrialized settings might diminish otherwise beneficial treatment effects. The present project drew on an indigent, rural Burundian sample and used an experimental design to examine the influence of PTSD psychoeducation on the nature and severity of traumatic stress symptoms reported. Participants were randomized to three conditions: A reconciliation workshop with psychoeducation, a reconciliation workshop without psychoeducation, and a waitlist control. Results showed that participants in the psychoeducation condition experienced a diminished reduction of PTSD symptoms relative to other conditions. There was no differential effect by condition on more general symptoms of anxiety, depression, and somatization symptoms. Secondary hypotheses predicting relationships at baseline between prior exposure to trauma models developed in industrialized societies and the nature and severity of posttraumatic stress symptoms were not supported. The findings are discussed in terms of how they might inform intervention development for traumatic stress in non-industrialized cultural settings. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6392,Psychometric Properties of the Child’s Reaction to Traumatic Events Scale-Revised in English and Lugandan,"Brief and age-appropriate measures of trauma-related symptoms are useful for identifying children in need of clinical services. The current study examines the psychometric properties of the 23-item Child's Reaction to Traumatic Events Scale-Revised (CRTES-R). The CRTES-R includes subscales assessing hyperarousal, avoidance and intrusion. To date, no studies have examined the psychometric properties of this revised measure or cross-cultural differences in its factor structure. Two samples of (a) children (ages 6-21) who had experienced a hurricane in the USA or Grenada (N = 135), and (b) Ugandan children (ages 8-17) who had experienced a variety of traumatic events (N = 339) completed the CRTES-R in English or Lugandan. Confirmatory factor analysis supported an empirically adjusted model with three modified latent factors in both the English (χ2/df = 1.34, CFI = .90, RMSEA = .05) and Lugandan samples (χ2/df = 1.45, CFI = .93, RMSEA = .04). Although the analysis supported separate hyperarousal, avoidance and intrusion subscales, the items that loaded on each factor differed from the original CRTES-R subscales. The English version of the CRTES-R showed good concurrent validity with the Kauai Recovery Index measure of trauma symptoms. Those using the CRTES-R to assess children's experiences of the different symptom types should consider using the empirically-derived subscales described in this paper; however, those who wish to capture a broad spectrum of PTSD symptoms should consider using all the original CRTES-R items and calculating a total score.",0,0 +6393,Dividing Traffic Sub-areas Based on a Parallel K-Means Algorithm,"AbstractIn order to alleviate the traffic congestion and reduce the complexity of traffic control and management, it is necessary to exploit traffic sub-areas division which should be effective in planing traffic. Some researchers applied the K-Means algorithm to divide traffic sub-areas on the taxi trajectories. However, the traditional K-Means algorithms faced difficulties in processing large-scale Global Position System(GPS) trajectories of taxicabs with the restrictions of memory, I/O, computing performance. This paper proposes a Parallel Traffic Sub-Areas Division(PTSD) method which consists of two stages, on the basis of the Parallel K-Means(PKM) algorithm. During the first stage, we develop a process to cluster traffic sub-areas based on the PKM algorithm. Then, the second stage, we identify boundary of traffic sub-areas on the base of cluster result. According to this method, we divide traffic sub-areas of Beijing on the real-word (GPS) trajectories of taxicabs. The experiment and discussion show that the method is effective in dividing traffic sub-areas.KeywordsTraffic Sub-AreasGPS TrajectoriesK-MeansMapReduce",0,0 +6394,Prolonged exposure to post-traumatic stress disorder (PTSD) in an active substance abuser,"Effective treatments for post-traumatic stress disorder (PTSD) have been the focus of research studies for many years, with exposure therapy consistently emerging as the leading treatment for this disorder. However, for a variety of reasons most studies exclude individuals suffering from concurrent substance use disorders. In recent years, this omission has been addressed, and the belief that substance dependent individuals cannot benefit from trauma treatment until they are free from substances is losing favor. Early studies have demonstrated that prolonged exposure therapy can be effective for persons suffering from both disorders. The current case study seeks to provide information on the length of time and type of symptom change in an individual suffering from comorbid PTSD-substance abuse (PTSD-SA). Therefore, prolonged exposure was utilized to treat PTSD in an active abuser of both alcohol and marijuana. Pre- and post-treatment assessments demonstrate dramatic reductions in PTSD symptoms, general an...",0,0 +6395,Testing the number of components in a normal mixture,"We demonstrate that, under a theorem proposed by Vuong, the likelihood ratio statistic based on the Kullback-Leibler information criterion of the null hypothesis that a random sample is drawn from a k 0 -component normal mixture distribution against the alternative hypothesis that the sample is drawn from a k 1 -component normal mixture distribution is asymptotically distributed as a weighted sum of independent chi-squared random variables with one degree of freedom, under general regularity conditions. We report simulation studies of two cases where we are testing a single normal versus a two-component normal mixture and a two-component normal mixture versus a three-component normal mixture. An empirical adjustment to the likelihood ratio statistic is proposed that appears to improve the rate of convergence to the limiting distribution.",0,0 +6396,Trajectories of posttraumatic stress symptomatology in older persons affected by a large-magnitude disaster,"This study examined the nature and determinants of longitudinal trajectories of disaster-related posttraumatic stress disorder (PTSD) symptoms in older persons affected by a large-magnitude disaster. Two hundred six adults age 60 or older (mean = 69, range = 60-92) who resided in the Galveston Bay area when Hurricane Ike struck in September 2008 completed telephone interviews an average of 3-, 6-, and 15-months after this disaster. Latent growth mixture modeling was employed to identify predominant trajectories of disaster-related PTSD symptoms over time; and pre-, peri-, and post-disaster determinants of these trajectories were then examined. A 3-class solution optimally characterized PTSD symptom trajectories, with the majority (78.7%) of the sample having low/no PTSD symptoms over all assessments (i.e., resistant); 16.0% having chronically elevated symptoms (i.e., chronic); and 5.3% having a delayed onset course of symptoms (i.e., delayed-onset). Lower education, greater severity of Hurricane Ike exposure (i.e., Ike-related physical illness or injury and high level of community destruction), and greater number of traumatic and stressful life events after Hurricane Ike, particularly financial problems, were associated with a chronic PTSD trajectory. Greater number of traumatic and stressful life events, particularly financial problems after Hurricane Ike, was also associated with a delayed-onset trajectory. These findings suggest that there are heterogeneous trajectories of disaster-related PTSD symptoms in older adults and that these trajectories have common and unique determinants. They also underscore the importance of prevention efforts designed to mitigate the deleterious effects of post-disaster stressors, most notably financial distress, in older persons affected by disasters.",1,0 +6397,"Heart rate of motor vehicle accident survivors in the emergency department, peritraumatic psychological reactions, ASD, and PTSD severity: A 6-month prospective study","This small-scale study investigates the relationships between the heart rate of motor vehicle accident survivors presenting in the emergency department (ED) and acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) symptom severity. It also examines the relationships between the survivor's heart rate in the ED and peritraumatic dissociation and peritraumatic distress reported 2 weeks posttrauma. Fifty motor vehicle accident (MVA) survivors were assessed 2 weeks, 1 (N = 42), 3 (N = 37), and 6 months (N = 37) post-MVA. The heart rate in the ED predicted self-reported ASD symptom severity and clinician-rated PTSD symptom severity at 6 months but not at 1 or 3 months. Survivors' heart rate in the ED was significantly correlated with peritraumatic dissociation but not peritraumatic distress. These findings support the role of elevated ED heart rate as a predictor of both ASD and chronic PTSD symptom severity and may help to clarify the discrepant findings of previous research.",0,0 +6398,Post-traumatic stress disorder and chronic disease: open questions and future directions,"A large body of research has now firmly established that traumatic events, such as natural disasters, combat, sexual assault, and child abuse, are frequent occurrences throughout the world and that there are substantial consequences of traumatic event experiences. In most countries, the majority of adults report exposure to at least one traumatic event in their lifetime [1]. PTSD, the paradigmatic stress-related mental disorder, emerges in some persons in response to an unpredictable and uncontrollable traumatic event. PTSD is common with lifetime estimates ranging from 1.7 % in South Korea to 8.8 % in Northern Ireland, and past-year prevalences from a high of 3.8 % in Northern Ireland to a low of 0.2 % in China [2]. Separately, evidence shows that persons who experience traumatic events are more likely to report cardiovascular disease, respiratory disease, and other physical illness [3]. Researchers and health professionals commonly treat the brain and the body as if they are distinct entities, and this approach informs most of the scholarship about the consequences of traumatic events. However, recent advances in our understanding of the relation between PTSD and chronic diseases such as cardiovascular disease and type-2 diabetes suggest this approach is misguided. For example, a recent meta-analysis showed that PTSD and PTSD symptoms are associated with worse self-reported health and health-related quality of life [4]. Rigorous prospective studies have provided evidence that PTSD increases risk of first-onset cardiovascular disease and type-2 diabetes [5, 6]. This evidence, and a comparable body of literature, suggests that PTSD may have profound adverse effects on physical health over the life course. This opens up an important new perspective on the study of the consequences of PTSD and an emerging literature is now informing our understanding of how PTSD may be linked to physical illness.",0,0 +6399,Is it time to act? The potential of acceptance and commitment therapy for psychological problems following acquired brain injury,"Behaviour therapies have a well-established, useful tradition in psychological treatments and have undergone several major revisions. Acceptance and Commitment Therapy (ACT) and mindfulness-based approaches are considered a third wave of behavioural therapies. Emerging evidence for ACT has demonstrated that this paradigm has promising effectiveness in improving functionality and well-being in a variety of populations that have psychological disturbances and/or medical problems. In this review we first evaluate traditional cognitive behavioural therapy (CBT) interventions used to manage psychological problems in distressed individuals who have sustained an acquired brain injury (ABI). We provide an overview of the ACT paradigm and the existent evidence base for this intervention. A rationale is outlined for why ACT-based interventions may have potential utility in assisting distressed individuals who have sustained a mild to moderate ABI to move forward with their lives. We also review emerging evidence that lends preliminary support to the implementation of acceptance and mindfulness-based interventions in the rehabilitation of ABI patient groups. On the basis of existent literature, we recommend that it is an opportune time for forthcoming research to rigorously test the efficacy of ACT-based interventions in facilitating ABI patient groups to re-engage in living a valued and meaningful life, in spite of their neurocognitive and physical limitations. The promising utility of testing the efficacy of the ACT paradigm in the context of multimodal rehabilitation programmes for ABI populations is also addressed.",0,0 +6400,Presentation and prevalence of PTSD in a bipolar disorder population: A STEP-BD examination,"Co-occurring psychiatric diagnoses have a negative impact on quality of life and change the presentation and prognosis of bipolar disorder (BD). To date, comorbidity research on patients with BD has primarily focused on co-occurring anxiety disorders and trauma history; only recently has there been a specific focus on co-occurring PTSD and BD. Although rates of trauma and PTSD are higher in those with bipolar disorder than in the general population, little is known about differences across bipolar subtypes.Using the NIMH STEP-BD dataset (N=3158), this study evaluated whether there were baseline differences in the prevalence of PTSD between participants with bipolar disorder I (BDI) and bipolar disorder II (BDII), using the MINI and the Davidson Trauma Scale. Differences in PTSD symptom clusters between patients with BDI and BDII were also evaluated.A significantly greater proportion of participants with BDI had co-occurring PTSD at time of study entry (Χ(2)(1)=12.6; p<.001). BDI and BDII subgroups did not significantly differ in re-experiencing, avoidance, or arousal symptoms.The analysis may suggest a correlational relationship between PTSD and BD, not a causal one. Further, it is possible this population seeks treatment more often than individuals with PTSD alone. Finally, due to the episodic nature of BD and symptom overlap between the two disorders, misdiagnosis is possible.PTSD may be more prevalent in patients with BDI. However, the symptom presentation of PTSD appears similar across BD subtypes. Individuals should be thoroughly assessed for co-occurring diagnoses in an effort to provide appropriate treatment.",0,0 +6401,Examining minor and major depression in adolescents,"Research has shown that a large proportion of adolescents with symptoms of depression and substantial distress or impairment fail to meet the diagnostic criteria for a major depressive disorder (MDD). However, many of these undiagnosed adolescents may meet criteria for a residual category of the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revised (DSM-IV-TR), Depressive Disorder Not Otherwise Specified. Minor Depression (mDEP), an example of one of these categories, allows the inclusion of sub-threshold cases that fall below the diagnostic criteria of the five symptoms required for MDD. Minor depression in adolescence is important because it is significantly related to MDD in adulthood. The present study examines a number of risk factors, functional impairment, comorbidity and service utilization patterns associated with depression in community adolescents who met the DSM-IV criteria for mDEP and compares their profile to adolescents who met the criteria for MDD.Puerto Rican adolescents 11 to 17 years old were selected from an island-wide probability household sample of children ranging in age from 4 to 17. The Diagnostic Interview Schedule in Spanish (DISC IV), together with a structured protocol of risks and protective factors, and service utilization questionnaires were administered to primary caretakers and their children.Our findings indicate that youngsters with mDEP had significant impairment and used more mental health services than those with major depression. In addition, adolescents with mDEP had similar outcomes when compared to those meeting full criteria for MDD in terms of psychosocial correlates and comorbidity.The results, although not definitive, suggest a need for further research in order to determine the validity of the present DSM IV diagnostic criteria for mDEP in adolescents.",0,0 +6402,Distinguishing Trauma-Associated Narcissistic Symptoms from Posttraumatic Stress Disorder: A Diagnostic Challenge,"Individuals with trauma-associated narcissistic symptoms (referred to in this paper by the acronym TANS for simplicity) display a discrete cluster of psychological symptoms that can closely mimic those of PTSD. In TANS, the underlying vulnerability to traumatic stress usually stems from a narcissistic personality disorder or narcissistic personality traits. However, narcissistic symptoms associated with an external traumatic event may be reflexively and erroneously attributed to PTSD, no matter how small or insignificant the traumatic stressor. Mistaking TANS for PTSD usually results in treatment failure. In litigation, distinguishing between TANS and PTSD assists the trier of fact in determining causation and assessing damages.",0,0 +6403,"Posttraumatic stress disorder in a national sample of female and male Vietnam veterans: Risk factors, war-zone stressors, and resilience-recovery variables.","Relationships among pretrauma risk factors (e.g., family instability, childhood antisocial behavior), war-zone stressors (e.g., combat, perceived threat), posttrauma resilience-recovery variables (e.g., hardiness, social support), and posttraumatic stress disorder (PTSD) symptom severity were examined. Data from a national sample of 432 female and 1,200 male veterans were analyzed using structural equation modeling. For both genders, direct links to PTSD from pretrauma, war-zone, and posttrauma variable categories were found; several direct associations between pretrauma and posttrauma variables were documented. Although war-zone stressors appeared preeminent for PTSD in men, posttrauma resilience-recovery variables were more salient for women. Researchers, policymakers, and clinicians are urged to take a broad view on trauma and its sequelae, especially regarding possible multiple exposures over time and the depletion and availability of important resources.",0,0 +6404,Association of life threat and betrayal with posttraumatic stress disorder symptom severity,"The Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association [APA], 2000) emphasizes life threat as the defining feature of psychological trauma. Recent theoretical and empirical work, however, indicates the need to identify and evaluate other key aspects of trauma. Betrayal has been proposed as a pertinent, distinct, and complementary factor that can explain effects of trauma not accounted for by life threat alone. This study examined the relationship between injury, perceived life threat (PLT), and betrayal with posttraumatic stress disorder (PTSD) symptom severity. Trauma-exposed college students (N = 185) completed self-report measures of trauma exposure and PTSD, as well as items regarding life threat, betrayal, and level of medical care received. In hierarchical regressions incorporating injury, PLT, and betrayal, betrayal was associated with all PTSD symptom clusters and PTSD total severity (f2 = .08), whereas PLT was associated with hyperarousal (f2 = .05) and PTSD total (f2 = .03), and injury had no association with PTSD symptoms. In a revised model with trauma type as an additional variable, betrayal was associated with avoidance (f2 = .03), numbing (f2 = .04), and PTSD total (f2 = .03), whereas PLT was associated with reexperiencing (f2 = .04), hyperarousal (f2 = .04), and PTSD total (f2 = .03), and injury was associated with avoidance (f2 = .03). These findings support the idea that betrayal is a core dimension of psychological trauma that may play an important role in the etiology of PTSD.",0,0 +6405,Post-traumatic stress disorder among family physicians in Bosnia and Herzegovina,"The traumatic events experienced by thousands of people in Bosnia and Herzegovina during the 1992-1995 conflict may have a lasting effect on the mental health of the country, characterized by high rates of post-traumatic stress disorder (PTSD). A diagnosis of PTSD among family physicians could affect their ability to diagnose and treat patients for depression, anxiety and PTSD.The aim of the present study was to determine the prevalence of PTSD among family medicine physicians in Bosnia and Herzegovina.A self-administered questionnaire, including the PTSD Checklist-Civilian Version (PCL-C) which is a validated scale for PTSD screening, was distributed to family medicine residents and specialists in Bosnia and Herzegovina. The prevalence of PTSD was determined, and factors related to PTSD were considered.One hundred and thirty-three (90.5%) of the 147 physicians who were available to be surveyed completed the questionnaire. Of the 88% who had a traumatic experience during the war, 18% met the criteria for PTSD. The likelihood of meeting the criteria for PTSD was not affected by age, sex or whether the physician had worked in a field hospital during the war. However, a positive response to the question ""Do you think the traumatic event you experienced during the war still affects you today?"" was highly associated with the diagnosis of PTSD (odds ratio 7.26, 95% confidence interval: 1.57-33.60). Also, this question was shown to have a high degree of sensitivity and negative predictive value, and may be of use as a screening tool for ruling out the presence of PTSD after a traumatic war experience.",0,0 +6406,Cognitive therapy for post-traumatic stress disorder: development and evaluation,"The paper describes the development of a cognitive therapy (CT) program for post-traumatic stress disorder (PTSD) that is based on a recent cognitive model (Behav. Res. Therapy 38 (2000) 319). In a consecutive case series, 20 PTSD patients treated with CT showed highly significant improvement in symptoms of PTSD, depression and anxiety. A subsequent randomized controlled trial compared CT ( N = 14 ) and a 3-month waitlist condition (WL, N = 14 ). CT led to large reductions in PTSD symptoms, disability, depression and anxiety, whereas the waitlist group did not improve. In both studies, treatment gains were well maintained at 6-month follow-up. CT was highly acceptable, with an overall dropout rate of only 3%. The intent-to-treat effect sizes for the degree of change in PTSD symptoms from pre to post-treatment were 2.70–2.82 (self-report), and 2.07 (assessor-rated). The controlled effect sizes for CT versus WL post-treatment scores were 2.25 (self-report) and 2.18 (assessor-rated). As predicted by the cognitive model, good treatment outcome was related to greater changes in dysfunctional post-traumatic cognitions. Patient characteristics such as comorbidity, type of trauma, history of previous trauma, or time since the traumatic event did not predict treatment response, however, low educational attainment and low socioeconomic status were related to better outcome.",0,0 +6407,Assessing reliability and validity of the Arabic language version of the Post-traumatic Diagnostic Scale (PDS) symptom items,"Arab immigrant women are vulnerable to post-traumatic stress disorder (PTSD) because of gender, higher probability of being exposed to war-related violence, traditional cultural values, and immigration stressors. A valid and reliable screen is needed to assess PTSD incidence in this population. This study evaluated the reliability and validity of an Arabic language version of the symptom items in Foa et al.'s [Foa, E.B., Cashman, L., Jaycox, L., and Perry, K. 1997. The validation of a self report measure of posttraumatic stress disorder: the Posttraumatic Diagnostic Scale. Psychological Assessment 9(4), 445–451]. Post-traumatic Diagnostic Scale (PDS) in a sample of Arab immigrant women ( n = 453). Reliability was supported by Cronbach's alpha values for the Arabic language version (0.93) and its subscales (0.77–0.91). Results of group comparisons supported validity: Women who had lived in a refugee camp or emigrated from Iraq — a country where exposure to war and torture is common — were exhibiting depressive symptoms (Center for Epidemiological Studies-Depression Scale (CES-D) score above 18), or reported moderately to severely impaired functioning had significantly higher mean PDS total and symptom subscale scores than women who had not had these experiences or were not exhibiting depressive symptoms. Scores on the PDS and its subscales were also positively correlated with the Profile of Mood States (POMS) depression and anxiety subscales and negatively correlated with the POMS vigor subscale ( r = − .29 to− .39).",0,0 +6408,The association between alexithymia and posttraumatic stress symptoms following multiple exposures to traumatic events in North Korean refugees,"The present study aimed to investigate the effect of the interaction between the number of traumas experienced and alexithymia, on posttraumatic stress disorder (PTSD) symptoms.The sample comprised 199 North Korean refugees. Participants completed the Trauma Exposure Check List for North Korean Refugees, Impact of Event Scale-Revised (IES-R), Toronto Alexithymia Scale-20 (TAS-20), and Center for Epidemiological Studies-Depression Scale (CES-D).TAS-20 scores were positively correlated with IES-R scores (r=0.21, p<0.01), after controlling for gender, age, and CES-D scores. The number of traumas experienced was also positively correlated with IES-R scores (r=0.32, p<0.001), but not with TAS-20 scores, after controlling for gender, age, and CES-D scores. A hierarchical multiple regression analysis revealed a significant interaction between the number of traumas experienced and TAS-20 scores, for IES-R scores (t=2.10, p<0.05). Moderation analysis further revealed that TAS-20 scores moderate the relationship between the number of traumas experienced and IES-R scores (t=2.90, p<0.01). For refugees with higher TAS-20 scores, those who had experienced more traumas had higher IES-R scores. However, within refugees with lower TAS-20 scores, IES-R scores were not significantly different for those who had experienced a higher number of traumas compared with those who had experienced a lower, or average, number of traumas.The results of the current study suggest that, as individuals experience more traumatic events, clearly identifying and expressing emotions become more crucial for reducing PTSD symptoms.",0,0 +6409,"Post-traumatic stress disorder, drug dependence, and suicidality among male Vietnam veterans with a history of heavy drug use","This study examines the roles of post-traumatic stress disorder (PTSD) and drug dependence in non-fatal suicidality, i.e., suicidal ideation and suicide attempt, among Vietnam veterans in their adult years. The sample includes male veterans deployed to Vietnam, including an oversample of those who tested positive for opiates at their return ( n = 642). PTSD, substance abuse, suicidality, and other psychopathology are analyzed using three waves of survey and military data covering the time period from early adolescence to middle adulthood. Measures include the onset and recency of each of the lifetime DSM-IV PTSD symptom criteria, and yearly symptom measures of DSM-IV dependence for alcohol and eight classes of psychoactive substances. Survival and hazard models are applied to assess the effects of drug dependence, PTSD, and other psychopathology on the duration of suicidality. Longitudinal models estimate the casual relationships among PTSD, drug dependence, and suicidality over a 25-year period. Results show evidence of strong continuity of PTSD, drug dependence, and suicidality over time. The causal role of drug dependence on PTSD and suicidality is limited to young adulthood. Evidence is stronger for self-medication in later adulthood. The results indicate that a life course perspective is needed for the combined treatment of PTSD and drug dependence for severely traumatized populations.",0,0 +6410,A case of frontal neuropsychological and neuroimaging signs following multiple primary-blast exposure,"Blast-related traumatic brain injury (TBI) from the Afghanistan and Iraq wars represents a significant medical concern for troops and veterans. To better understand the consequences of primary-blast injury in humans, we present a case of a Marine exposed to multiple primary blasts during his 14-year military career. The neuropsychological profile of this formerly high-functioning veteran suggested primarily executive dysfunction. Diffusion-tensor imaging revealed white-matter pathology in long fiber tracks compared with a composite fractional-anisotropy template derived from a veteran reference control group without TBI. This study supports the existence of primary blast-induced neurotrauma in humans and introduces a neuroimaging technique with potential to discriminate multiple-blast TBI.",0,0 +6411,Motor vehicle accident trauma exposure: Personality profiles associated with posttraumatic diagnoses,"Abstract Personality profiles associated with diagnostically distinct posttraumatic responses were examined. Profiles were compared between three groups defined on the basis of posttraumatic diagnosis following motor vehicle accident (MVA) trauma exposure. The diagnostic groups were: Posttraumatic Stress Disorder (PTSD), Acute Stress Disorder (ASD) without progression to PTSD, and subclinical responses. Participants were male and female community volunteers aged 18 to 77 (N = 83) who had all been exposed to an MVA meeting the DSM-IV diagnostic criteria for a traumatic event. The Personality Assessment Inventory (Morey, 1991) was used to assess psychological variables in the framework of posttraumatic diagnostic groups. The PTSD group scored significantly higher than the ASD and subclinical groups on scales assessing somatic complaints, anxiety, anxiety related disorders, depression, non-psychotic symptoms of schizophrenia, and negative relationships. The profile of the ASD group was characterized by self ...",0,0 +6412,"The relationship between worry, rumination, and comorbidity: Evidence for repetitive negative thinking as a transdiagnostic construct","Repetitive negative thinking (RNT) increases vulnerability to multiple anxiety and depressive disorders and, as a common risk factor, elevated RNT may account for the high levels of comorbidity observed between emotional disorders. The aims of this study were to (a) compare two common forms of RNT (worry and rumination) across individuals with non-comorbid anxiety or depressive disorders, and (b) to examine the relationship between RNT and comorbidity.A structured diagnostic interview and measures of rumination, worry, anxiety, and depression were completed by a large clinical sample with an anxiety disorder or depression (N=513) presenting at a community mental health clinic.Patients without (n=212) and with (n=301) comorbid diagnoses did not generally differ across the principal diagnosis groups (depression, generalised anxiety disorder, social anxiety disorder, panic disorder) on worry or rumination. As predicted, comorbidity was associated with a higher level of RNT.Cross-sectional design precluded causal conclusions and findings may not generalize to excluded anxiety disorders.Consistent with the transdiagnostic hypothesis, RNT was associated with a range of anxiety disorders and depression and with comorbidity for those with a principal depressive disorder, supporting recent evidence that RNT is a transdiagnostic process. The presence of RNT, specifically worry and rumination, should be assessed and treated regardless of diagnostic profile. Future research may show that both pure and comorbid depressed or anxious patients receive incremental benefit from transdiagnostic protocols developed to treat core pathological processes of RNT traditionally associated with separate disorders.",0,0 +6413,Improvement of mood and sleep alterations in posttraumatic stress disorder patients by eye movement desensitization and reprocessing,"Posttraumatic stress disorder (PTSD) patients exhibit depressive and anxiety symptoms, in addition to nightmares, which interfere with sleep continuity. Pharmacologic treatment of these sleep problems improves PTSD symptoms, but very few studies have used psychotherapeutic interventions to treat PTSD and examined their effects on sleep quality. Therefore, in the present study, we sought to investigate the effects of Eye Movement Desensitization Reprocessing therapy on indices of mood, anxiety, subjective, and objective sleep. The sample was composed of 11 healthy controls and 13 PTSD patients that were victims of assault and/or kidnapping. All participants were assessed before, and 1 day after, the end of treatment for depressive and anxiety profile, general well-being and subjective sleep by filling out specific questionnaires. In addition, objective sleep patterns were evaluated by polysomnographic recording. Healthy volunteers were submitted to the therapy for three weekly sessions, whereas PTSD patients underwent five sessions, on average. Before treatment, PTSD patients exhibited high levels of anxiety and depression, poor quality of life and poor sleep, assessed both subjectively and objectively; the latter was reflected by increased time of waking after sleep onset. After completion of treatment, patients exhibited improvement in depression and anxiety symptoms, and in quality of life; with indices that were no longer different from control volunteers. Moreover, these patients showed more consolidated sleep, with reduction of time spent awake after sleep onset. In conclusion, Eye Movement Desensitization and Reprocessing was an effective treatment of PTSD patients and improved the associated sleep and psychological symptoms.",0,0 +6414,Gulf War Illness,"To further elucidate the nature of illness in veterans of the 1990 to 1991 Gulf War (GW) by examining the GW Illness (GWI) definition advanced by the Centers for Disease Control and Prevention, which specified caseness as having at least one symptom from two of the three factors: fatigue, mood-cognition, and musculoskeletal.A total of 311 male and female GW veterans drawn from across the nation were assessed in a survey-based study approximately 10 years after deployment.A total of 33.8% of the probability-weighted sample met GWI criteria. Multiple symptom profiles were found, with more than half of GWI cases endorsing a symptom on all the three factors, and almost all cases endorsing at least one mood-cognition symptom.Although the Centers for Disease Control and Prevention definition has some limitations that should be considered, it remains a useful tool for assessing the presence of illness in GW veterans.",0,0 +6415,Molecular and Therapeutic Potential and Toxicity of Valproic Acid,"Valproic acid (VPA), a branched short-chain fatty acid, is widely used as an antiepileptic drug and a mood stabilizer. Antiepileptic properties have been attributed to inhibition of Gamma Amino Butyrate (GABA) transaminobutyrate and of ion channels. VPA was recently classified among the Histone Deacetylase Inhibitors, acting directly at the level of gene transcription by inhibiting histone deacetylation and making transcription sites more accessible. VPA is a widely used drug, particularly for children suffering from epilepsy. Due to the increasing number of clinical trials involving VPA, and interesting results obtained, this molecule will be implicated in an increasing number of therapies. However side effects of VPA are substantially described in the literature whereas they are poorly discussed in articles focusing on its therapeutic use. This paper aims to give an overview of the different clinical-trials involving VPA and its side effects encountered during treatment as well as its molecular properties.",0,0 +6416,Resilience and post-traumatic stress disorder in the acute aftermath of rape: a comparative analysis of adolescents versus adults,"Rape trauma contributes significantly to the mental burden of disease, affecting resilience and vulnerabilities at every developmental life stage. Appropriate resilience-promoting strategies could potentially buffer or protect trauma-exposed individuals from psychopathology.This study aimed to assess and compare (using validated measuring instruments) resilience, post-traumatic stress disorder (PTSD) and other variables in the acute aftermath of rape, between adolescent and adult females and to assess associations with these variables.We conducted a comparative analysis of resilience, PTSD, prior trauma, demographic variables and psychiatric morbidity in 41 adolescent and 47 adult female rape survivors six weeks post-rape. We assessed the relationship of resilience to PTSD, demographic variables and prior trauma and investigated if resilience levels predicted PTSD after adjusting for prior trauma.We found no significant differences in resilience levels between the groups, but the adolescent PTSD rate (40%) was double that in adults (20%). In adults, a significant negative correlation was evident between resilience and PTSD symptoms scores.More knowledge of resilience versus stress susceptibility for PTSD throughout the lifespan is needed and can inform the development of more effective clinical assessment and resilience-promoting strategies.",0,0 +6417,Glutamatergic Systems and Anxiety,"Anxiety is a normal emotion experienced by humans and other mammalian species. However, anxiety also exists in pathological forms, and anxiety disorders are the most prevalent of psychiatric disorders. Prevalence rates vary with the diagnostic tools used to estimate them, and with study design, but the most extensive studies suggest that within the United States, 15.7 million people are affected yearly and 30 million at some point in their lives (1). In a US study, 6% of men and 13% of women had suffered from an anxiety disorder in the previous 6 mo (2).KeywordsNMDA ReceptorAnxiety DisorderAMPA ReceptorFear ConditioningMetabotropic Glutamate ReceptorThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.",0,0 +6418,"Psychosocial stress and strategies for managing adversity: measuring population resilience in New South Wales, Australia","Populations around the world are facing an increasing number of adversities such as the global financial crisis, terrorism, conflict, and climate change. The aim of this paper was to investigate self-reported strategies and sources of support used to get through ""tough times"" in an Australian context and to identify patterns of response in the general population and differences in potentially vulnerable subgroups.Data were collected through a cross-sectional survey of the New South Wales population in Australia. The final sample consisted of 3,995 New South Wales residents aged 16 years and above who responded to the question: ""What are the things that get you through tough times?""Respondents provided brief comments that were coded into 14 main subject-area categories. The most frequently reported responses were family and self (52%); friends and neighbors (21%); use of positive emotional and philosophical strategies (17%), such as sense of humor, determination, and the belief that things would get better; and religious beliefs (11%). The responses of four population subgroups were compared, based on gender, household income, level of psychological distress, and whether a language other than English was spoken at home. Women reported greater use of friends and neighbors and religious or spiritual beliefs for support, whereas men reported greater use of drinking/smoking and financial supports. Those with lower incomes reported greater reliance on positive emotional and philosophical strategies and on religious or spiritual beliefs. Those with high levels of psychological distress reported greater use of leisure interests and hobbies, drinking/smoking, and less use of positive lifestyle strategies, such as adequate sleep, relaxation, or work/life balance. Those who spoke a language other than English at home were less likely to report relying on self or others (family/friends) or positive emotional and philosophical strategies to get through tough times.Understanding strategies and sources of support used by the population to get through adversity is the first step toward identifying the best approaches to build and support strengths and reduce vulnerabilities. It is also possible to reflect on how large-scale threats such as pandemics, disasters, conflict, bereavement, and loss could impact individual and population resilience.",0,0 +6419,Prospective risk factors for new-onset post-traumatic stress disorder in National Guard soldiers deployed to Iraq,"Background National Guard troops are at increased risk for post-traumatic stress disorder (PTSD); however, little is known about risk and resilience in this population. Method The Readiness and Resilience in National Guard Soldiers Study is a prospective, longitudinal investigation of 522 Army National Guard troops deployed to Iraq from March 2006 to July 2007. Participants completed measures of PTSD symptoms and potential risk/protective factors 1 month before deployment. Of these, 81% ( n =424) completed measures of PTSD, deployment stressor exposure and post-deployment outcomes 2–3 months after returning from Iraq. New onset of probable PTSD ‘diagnosis’ was measured by the PTSD Checklist – Military (PCL-M). Independent predictors of new-onset probable PTSD were identified using hierarchical logistic regression analyses. Results At baseline prior to deployment, 3.7% had probable PTSD. Among soldiers without PTSD symptoms at baseline, 13.8% reported post-deployment new-onset probable PTSD. Hierarchical logistic regression adjusted for gender, age, race/ethnicity and military rank showed that reporting more stressors prior to deployment predicted new-onset probable PTSD [odds ratio (OR) 2.20] as did feeling less prepared for deployment (OR 0.58). After accounting for pre-deployment factors, new-onset probable PTSD was predicted by exposure to combat (OR 2.19) and to combat's aftermath (OR 1.62). Reporting more stressful life events after deployment (OR 1.96) was associated with increased odds of new-onset probable PTSD, while post-deployment social support (OR 0.31) was a significant protective factor in the etiology of PTSD. Conclusions Combat exposure may be unavoidable in military service members, but other vulnerability and protective factors also predict PTSD and could be targets for prevention strategies.",0,0 +6420,Randomised controlled trial of a cognitive narrative intervention for complicated grief in widowhood,"The implementation of bereavement interventions is frequently requested, and its effectiveness has been controversial. The aim of this study is to evaluate the effectiveness of a cognitive narrative intervention for complicated grief (CG) for controlling post-traumatic and depressive issues.The study is a randomised controlled trial and uses the Socio Demographic Questionnaire (SDQ), the Inventory of Complicated Grief (ICG), the Beck Depression Inventory (BDI) and the Impact of Events Scale-Revised (IES-R). There were three phases in the study: (1) The SDQ and CG evaluations were applied to bereaved elders (n = 82). The bereaved elders with the 40 highest ICG values (≥25) were randomly allocated into two groups: the intervention group (n = 20) and control group (n = 20); (2) participants were evaluated using the BDI and IES-R and the IG gave informed consent to participate in an intervention with four weekly 60-min sessions addressing recall, emotional and cognitive subjectivation, metaphorisation and projecting. (3) Two months later, the ICG, BDI and IES-R assessments were repeated.Outcome measures showed a statistically significant reduction of CG, depressive and traumatic symptoms compared to the controls. Very high effect sizes for the ICG, BDI and IES-R reflect the effectiveness of the intervention along the longitudinal profile.These results reinforce the importance of brief interventions that combine a reduced number of sessions with lower costs, which is reflected in an increased adherence to the programme along with high effectiveness.",0,0 +6421,"Heterogeneity of posttraumatic stress symptoms in a highly traumatized low income, urban, African American sample","Trauma is associated with a range of outcomes; identification of homogeneous profiles of posttrauma symptoms may inform theory, diagnostic refinement, and intervention. The present investigation applies a novel analytic technique to the identification of homogeneous subgroups of post-traumatic symptomatology in a large sample of African American adults reporting high levels of trauma. Latent profiles of posttraumatic stress disorder (PTSD) symptom severity were tested using latent profile analysis. Pseudo-class draws were used to characterize class differences across types of trauma, diagnostic comorbidities, and clinically-relevant features. Participants consisted of 2915 highly traumatized African Americans living in low income, urban setting and recruited from medical clinics in Atlanta, GA. Findings supported the presence of six distinct subgroups of posttraumatic stress symptom profiles described as resilient, moderate with amnesia, moderate with diminished interest, moderate without diminished interest and amnesia severe without amnesia, and severe overall. Observed subgroups differed across numerous historical and concurrent factors including childhood trauma, current and lifetime diagnoses of PTSD and major depression, lifetime substance use diagnosis, dissociation, depressive symptoms, emotional dysregulation, negative and positive affect, and history of hospitalization and suicidality. Posttraumatic stress disorder as currently defined is comprised of homogeneous subgroups with important differences in posttraumatic stress symptom endorsement as well as concomitant differentiation of associated diagnoses and clinically-relevant associated features.",0,0 +6422,Centrality of positive and negative deployment memories predicts posttraumatic growth in danish veterans.,"The purpose of the present study was to examine theoretically motivated predictors for the development of positive changes following potentially traumatic experiences (i.e., posttraumatic growth). Specifically, we wanted to examine the prediction that memories of highly negative and positive deployment events predict subsequent posttraumatic growth.A total of 251 Danish soldiers (7% female, mean age 26.4) deployed to forward operating bases in Afghanistan filled out questionnaires before, during, and after deployment. This allowed us to perform prospective as well as cross-sectional analyses of the data.The main findings were that the centrality of highly emotional memories from deployment predicted growth alongside openness to experience, combat exposure, and social support. Importantly, the centrality of both positive and negative memories predicted growth equally well.The perceived importance of both negative and positive events may play an important part in the development of posttraumatic growth.",0,0 +6423,Meta-Analysis of Risk Factors for Secondary Traumatic Stress in Therapeutic Work With Trauma Victims,"Revisions to the posttraumatic stress disorder (PTSD) diagnostic criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) clarify that secondary exposure can lead to the development of impairing symptoms requiring treatment. Historically known as secondary traumatic stress (STS), this reaction occurs through repeatedly hearing the details of traumatic events experienced by others. Professionals who work therapeutically with trauma victims may be at particular risk for this exposure. This meta-analysis of 38 published studies examines 17 risk factors for STS among professionals indirectly exposed to trauma through their therapeutic work with trauma victims. Small significant effect sizes were found for trauma caseload volume (r = .16), caseload frequency (r = .12), caseload ratio (r = .19), and having a personal trauma history (r = .19). Small negative effect sizes were found for work support (r = -.17) and social support (r = -.26). Demographic variables appear to be less implicated although more work is needed that examines the role of gender in the context of particular personal traumas. Caseload frequency and personal trauma effect sizes were moderated by year of publication. Future work should examine the measurement of STS and associated impairment, understudied risk factors, and effective interventions.",0,0 +6424,Single Photon Emission Computed Tomography (SPECT) in Obsessive–Compulsive Disorder Before and After Treatment with Inositol,"Inositol, a glucose isomer and second messenger precursor, regulates numerous cellular functions and has demonstrated efficacy in obsessive-compulsive disorder (OCD) through mechanisms that remain unclear. The effect of inositol treatment on brain function in OCD has not been studied to date. Fourteen OCD subjects underwent single photon emission computed tomography (SPECT) with Tc-99m HMPAO before and after 12 weeks of treatment with inositol. Whole brain voxel-wise SPM was used to assess differences in perfusion between responders and nonresponders before and after treatment as well as the effect of treatment for the group as a whole. There was 1) deactivation in OCD responders relative to nonresponders following treatment with inositol in the left superior temporal gyrus, middle frontal gyrus and precuneus, and the right paramedian post-central gyrus; 2) no significant regions of deactivation for the group as a whole posttreatment; and 3) a single cluster of higher perfusion in the left medial prefrontal region in responders compared to nonresponders at baseline. Significant reductions in the YBOCS and CGI-severity scores followed treatment. These data are only partly consistent with previous functional imaging work on OCD. They may support the idea that inositol effects a clinical response through alternate neuronal circuitry to the SSRIs and may complement animal work proposing an overlapping but distinct mechanism of action.",0,0 +6425,Considering PTSD for DSM-5,"This is a review of the relevant empirical literature concerning the DSM-IV-TR diagnostic criteria for PTSD. Most of this work has focused on Criteria A1 and A2, the two components of the A (Stressor) Criterion. With regard to A1, the review considers: (a) whether A1 is etiologically or temporally related to the PTSD symptoms; (b) whether it is possible to distinguish ""traumatic"" from ""non-traumatic"" stressors; and (c) whether A1 should be eliminated from DSM-5. Empirical literature regarding the utility of the A2 criterion indicates that there is little support for keeping the A2 criterion in DSM-5. The B (reexperiencing), C (avoidance/numbing) and D (hyperarousal) criteria are also reviewed. Confirmatory factor analyses suggest that the latent structure of PTSD appears to consist of four distinct symptom clusters rather than the three-cluster structure found in DSM-IV. It has also been shown that in addition to the fear-based symptoms emphasized in DSM-IV, traumatic exposure is also followed by dysphoric, anhedonic symptoms, aggressive/externalizing symptoms, guilt/shame symptoms, dissociative symptoms, and negative appraisals about oneself and the world. A new set of diagnostic criteria is proposed for DSM-5 that: (a) attempts to sharpen the A1 criterion; (b) eliminates the A2 criterion; (c) proposes four rather than three symptom clusters; and (d) expands the scope of the B-E criteria beyond a fear-based context. The final sections of this review consider: (a) partial/subsyndromal PTSD; (b) disorders of extreme stress not otherwise specified (DESNOS)/complex PTSD; (c) cross- cultural factors; (d) developmental factors; and (e) subtypes of PTSD.",0,0 +6426,Senescence alters blood flow responses to acute heat stress,"Renal and splanchnic sympathetic nerve discharge (SND) responses to heating are significantly reduced in senescent compared with young Fischer-344 (F344) rats (Kenney MJ and Fels RJ. Am J Physiol Regul Integr Comp Physiol 283: R513–R520, 2002). However, the functional significance of this finding is not known. We tested the hypothesis that blood flow distribution profiles to heating are altered in senescent (24 mo old) compared with mature (12 mo old) and young (3 mo old) F344 rats. Visceral organ, skeletal muscle, and tail blood flows were determined with the radionuclide-tagged microsphere technique before (control, 38°C) and during heating that increased body temperature to 41°C in anesthetized F344 rats. Vascular conductance in the kidney, stomach, large intestine, pancreas, spleen, and tail was significantly reduced during control before heating in senescent compared with young F344 rats. Heating significantly decreased kidney, stomach, small and large intestine, and pancreas vascular conductance in young and mature but not senescent F344 rats. Vascular conductance at 41°C in the kidney and small intestine was significantly lower and in the stomach tended to be lower in young compared with senescent rats. Splenic conductance increased during heating in young and senescent rats but was highest in young rats. Tail conductance during heating was significantly increased in young rats but remained unchanged in mature and senescent rats. These results demonstrate a marked attenuation in heating-induced vascular conductance changes in senescent rats, suggesting an important functional consequence for the attenuated SND responses to heating in aged rats.",0,0 +6427,Medical students’ experience and perceptions of their final rotation in psychiatry,"<p><strong>Background.</strong> Evaluation of specific courses, rotations or attachments in medical education is common practice.<strong> </strong></p><p><strong>Objective.</strong> To evaluate medical students’ perceptions of their final psychiatry rotation of 7 weeks. </p><p><strong>Methods.</strong> A questionnaire was developed for medical students to give feedback on their psychiatry rotation at Weskoppies Hospital in Tshwane, South Africa. Four scores were developed: (<em>i</em>) a clinical exposure score for psychiatric conditions encountered during the rotation; (<em>ii</em>) an ethics exposure score comprising confidentiality and informed consent; (<em>iii</em>) an admissions exposure score for different admission options; and (<em>iv</em>) a perception score related to students’ experience of the rotation. The evaluation took place over a period of 4 years, between 2006 and 2009.</p><p><strong>Results.</strong> Over the study period, 87% of 708 students completed the questionnaire. The higher number of female respondents (63%) was in accordance with the general student profile. The four resulting scores were: clinical exposure 67%; ethics exposure 78%; admissions exposure 86%; and perceptions 75%. The main strengths of the rotation were identified as the positive learning environment, exposure to patients, discussions and ward conferences, and approaches followed.</p><p><strong>Conclusions. </strong>The conceptualisation of the tool to elicit specific scores was useful for presenting the findings. The student feedback provided valuable information for the psychiatry curriculum planners and teachers, and led to further adaptations to the structure of the rotations and the learning opportunities provided.</p>",0,0 +6428,Social Anxiety Disorder Is Associated With PTSD Symptom Presentation: An Exploratory Study Within A Nationally Representative Sample,"Posttraumatic stress disorder (PTSD) and social anxiety disorder (SAD) demonstrate a high degree of comorbidity (ranging from 14.8% to 46.0%); however, little is known about the nature of this association. Contemporary research has largely focused on treatment-seeking or veteran samples, and may not generalize to the population as a whole. Large-scale epidemiological studies are needed to fill existing gaps in the literature and to clarify this association for the general population. The current study examined whether the presence of comorbid SAD influenced PTSD symptom presentation. The rate of individual PTSD symptoms was investigated among individuals with PTSD and SAD in comparison to those with PTSD alone. Data were obtained from Wave 2 of the National Epidemiological Survey of Alcohol and Related Conditions, a large, nationally representative survey of American adults (n = 34,653). Analyses revealed elevated rates of PTSD symptoms among those with comorbid PTSD and SAD across all symptom clusters, with significant odds ratios ranging from 1.5 to 4.87. Adjusting for depression and other Axis I disorders did not substantially alter study findings. Results suggest that the presence of SAD is associated with differences in the expression of PTSD symptoms.",0,0 +6429,Patients with chronic whiplash can be subgrouped on the basis of symptoms of sensory hypersensitivity and posttraumatic stress,"The lack of efficacy of rehabilitative approaches to the management of chronic whiplash-associated disorders (WAD) may be in part due to heterogeneity of the clinical presentation of this patient population. The aim of this study was to identify homogeneous subgroups of patients with chronic WAD on the basis of symptoms of PTSD and sensory hypersensitivity and to compare the clinical presentation of these subgroups. Successive k-means cluster analyses using 2, 3 and 4 cluster solutions were performed by using data for 331 (221 female) patients with chronic (>3 months) WAD. The 4 cluster solution was identified as the most clinically relevant, yielding 4 distinct clusters: no to mild posttraumatic stress symptoms and no sensory hypersensitivity (nPnH), no to mild posttraumatic stress symptoms and sensory hypersensitivity (nPH), moderate to severe posttraumatic stress and no sensory hypersensitivity (PnH) and moderate to severe posttraumatic stress and sensory hypersensitivity (PH). The nPnH cluster was the largest cluster, comprising 43.5% of the sample. The PH cluster had significantly worse disability, pain intensity, self-reported mental health status and cervical range of motion in comparison to the nPnH and nPH clusters. These data provide further evidence of the heterogeneity of the chronic WAD population and the association of a more complex clinical presentation with higher disability and pain in this patient group.",0,0 +6430,Weighing the Costs of Disaster,"Disasters typically strike quickly and cause great harm. Unfortunately, because of the spontaneous and chaotic nature of disasters, the psychological consequences have proved exceedingly difficult to assess. Published reports have often overestimated a disaster's psychological cost to survivors, suggesting, for example, that many if not most survivors will develop posttraumatic stress disorder (PTSD); at the same time, these reports have underestimated the scope of the disaster's broader impact in other domains. We argue that such ambiguities can be attributed to methodological limitations. When we focus on only the most scientifically sound research--studies that use prospective designs or include multivariate analyses of predictor and outcome measures--relatively clear conclusions about the psychological parameters of disasters emerge. We summarize the major aspects of these conclusions in five key points and close with a brief review of possible implications these points suggest for disaster intervention. 1. Disasters cause serious psychological harm in a minority of exposed individuals. People exposed to disaster show myriad psychological problems, including PTSD, grief, depression, anxiety, stress-related health costs, substance abuse, and suicidal ideation. However, severe levels of these problems are typically observed only in a relatively small minority of exposed individuals. In adults, the proportion rarely exceeds 30% of most samples, and in the vast majority of methodologically sound studies, the level is usually considerably lower. Among youth, elevated symptoms are common in the first few months following a high-impact disaster, but again, chronic symptom elevations rarely exceed 30% of the youth sampled. 2. Disasters produce multiple patterns of outcome, including psychological resilience. In addition to chronic dysfunction, other patterns of disaster outcome are typically observed. Some survivors recover their psychological equilibrium within a period ranging from several months to 1 or 2 years. A sizeable proportion, often more than half of those exposed, experience only transient distress and maintain a stable trajectory of healthy functioning or resilience. Resilient outcomes have been evidenced across different methodologies, including recent studies that identified patterns of outcome using relatively sophisticated data analytic approaches, such as latent growth mixture modeling. 3. Disaster outcome depends on a combination of risk and resilience factors. As is true for most highly aversive events, individual differences in disaster outcomes are informed by a number of unique risk and resilience factors, including variables related to the context in which the disaster occurs, variables related to proximal exposure during the disaster, and variables related to distal exposure in the disaster's aftermath. Multivariate studies indicate that there is no one single dominant predictor of disaster outcomes. Rather, as with traumatic life events more generally, most predictor variables exert small to moderate effects, and it is the combination or additive total of risk and resilience factors that informs disaster outcomes. 4. Disasters put families, neighborhoods, and communities at risk. Although methodologically complex research on this facet of disasters' impact is limited, the available literature suggests that disasters meaningfully influence relationships within and across broad social units. Survivors often receive immediate support from their families, relatives, and friends, and for this reason many survivors subsequently claim that the experience brought them closer together. On the whole, however, the empirical evidence suggests a mixed pattern of findings. There is evidence that social relationships can improve after disasters, especially within the immediate family. However, the bulk of evidence indicates that the stress of disasters can erode both interpersonal relationships and sense of community. Regardless of how they are affected, postdisaster social relations are important predictors of coping success and resilience. 5. The remote effects of a disaster in unexposed populations are generally limited and transient. Increased incidence of extreme distress and pathology are often reported in remote regions hundreds if not thousands of miles from a disaster's geographic locale. Careful review of these studies indicates, however, that people in regions remote to a disaster may experience transient distress, but increased incidence of psychopathology is likely only among populations with preexisting vulnerabilities (e.g., prior trauma or psychiatric illness) or actual remote exposure (e.g., loss of a loved one in the disaster). Finally, we review the implications for intervention. There is considerable interest in prophylactic psychological interventions, such as critical incident stress debriefing (CISD), that can be applied globally to all exposed survivors in the immediate aftermath of disaster. Multiple studies have shown, however, that CISD is not only ineffective but in some cases can actually be psychologically harmful. Other less invasive and more practical forms of immediate intervention have been developed for use with both children and adults. Although promising, controlled evaluations of these less invasive interventions are not yet available. The available research suggests that psychological interventions are more likely to be effective during the short- and long-term recovery periods (1 month to several years postdisaster), especially when used in combination with some form of screening for at-risk individuals. Such interventions should also target the maintenance and enhancement of tangible, informational, and social-emotional support resources throughout the affected community. Language: en",0,0 +6431,Who Develops Posttraumatic Stress Disorder?,"Nearly half of U.S. adults experience at least one traumatic event in their lifetimes, yet only 10% of women and 5% of men develop posttraumatic stress disorder (PTSD). Why this is so is among the most central questions in current PTSD research. This article reviews the current status of knowledge about who develops PTSD, discussing the strengths and weaknesses of the evidence. We describe the major models used to understand responses to traumatic events, as well as future research directions. We also propose that an exclusive focus on individual differences and individual intervention overlooks opportunities to reduce the prevalence of PTSD by modifying factors at the neighborhood, community, or national level.",0,0 +6432,Psychological assessment of aviators captured in World War II.,"Psychological assessments, including administration of the Minnesota Multiphasic Personality Inventory (MMPI) and structured interviews for Axis I mental disorders and posttraumatic stress disorder (PTSD) specifically, were used to describe 33 World War II (WWII) aviators who were held as prisoners of war (POWs) for an average of 14 months. Results showed more elevated MMPI profile patterns than expected given previous research with pilots (Butcher, 1994) and rates of current and lifetime PTSD at 33%, reasoned to derive from POW trauma. Despite this level of psychopathology, WWII aviator POW survivors were found to be more resilient to captivity effects than age-similar nonaviator WWII POW survivors characterized generally by less advantages in education, military rank, and other personal resources. Compared with aviator former POWs of the Vietnam War studied in their mid-life years (Ursano, Boydstun, & Wheatley, 1981), the present sample appeared to be less psychologically robust. Studies of former prisoners of war (POWs) have revealed that war captivity is associated with increased vulnerability to physical and psychological illnesses. Yet, some POW survivors do not exhibit psychological distress or mental disorders following trauma cessation (Kluznik, Speed, Van Valkenburg, & Magraw, 1986; Sutker, Allain, & Winstead, 1993; Ursano, Boydstun, & Wheatley, 1981). Of interest are studies of American servicemen, primarily aviators, held as prisoners in North Vietnam for periods extending up to 7 or 8 years. The Ursano et al. (1981) follow-up of 253 former POW aviators revealed that, in addition to the potent impact of stressor severity, such characteristics as rank at shoot down, college education, and status as pilots and navigators were associated with lessened risk for psychiatric morbidity, although 25% of these men were labeled with mental disorders. Ursano et al. (1981) described aviators as a well-educated, intelligent military subset, homogeneous in achievement needs and potentially resistant to mental disorders. Butcher (1994) published Minnesota Multiphasic Personality Inventory (MMPI) and MMPI-2 profile patterns of applicants for flight crew positions with a major airline. Results showed that airline pilots, many of whom had served military duty, minimized problems on psychological tests and presented themselves as psychologically robust. These studies shed light on the resilience of pilots generally and survivors of Vietnam POW captivity specifically, but little attention has been directed toward study of",0,0 +6433,"Conduct disorder, war zone stress, and war-related posttraumatic stress disorder symptoms in American Indian Vietnam veterans",This study examined whether conduct disorder (CD) was associated with war zone stress and war-related post-traumatic stress disorder (PTSD) symptoms in American Indian (AI) Vietnam veterans. Cross-sectional lay-interview data was analyzed for 591 male participants from the American Indian Vietnam Veterans Project. Logistic regression evaluated the association of CD with odds of high war zone stress and linear regression evaluated the association of CD and PTSD symptom severity. Childhood CD was not associated with increased odds of high war zone stress. Conduct disorder was associated with elevated war-related PTSD symptoms among male AI Vietnam Veterans independent of war zone stress level and other mediators. Future efforts should examine reasons for this association and if the association exists in other AI populations.,0,0 +6434,Gender Comparison of Exposed Trauma and Posttraumatic Stress Disorder in a Community Sample of Adolescents,"This study surveys the prevalence of exposed traumatic events and posttraumatic stress disorder among the high school students. A total of 735 students were selected by stratified cluster sampling. The self-report trauma checklists and Mississippi Scale were used. The most common traumatic experiences were ""witnessing or being in a bad car accident,"" ""getting some really bad news unexpectedly,"" and witnessing violence. The last 2 experiences were more common among girls. The rate of the subjects who scored more than the cutoff point in the Mississippi Scale was 27.2%. There is an extremely high rate of exposed trauma rate, and approximately one third of them have posttraumatic stress disorder symptoms.",0,0 +6435,Pilot Study of Psilocybin Treatment for Anxiety in Patients With Advanced-Stage Cancer,"Researchers conducted extensive investigations of hallucinogens in the 1950s and 1960s. By the early 1970s, however, political and cultural pressures forced the cessation of all projects. This investigation reexamines a potentially promising clinical application of hallucinogens in the treatment of anxiety reactive to advanced-stage cancer.To explore the safety and efficacy of psilocybin in patients with advanced-stage cancer and reactive anxiety.A double-blind, placebo-controlled study of patients with advanced-stage cancer and anxiety, with subjects acting as their own control, using a moderate dose (0.2 mg/kg) of psilocybin.A clinical research unit within a large public sector academic medical center.Twelve adults with advanced-stage cancer and anxiety.In addition to monitoring safety and subjective experience before and during experimental treatment sessions, follow-up data including results from the Beck Depression Inventory, Profile of Mood States, and State-Trait Anxiety Inventory were collected unblinded for 6 months after treatment.Safe physiological and psychological responses were documented during treatment sessions. There were no clinically significant adverse events with psilocybin. The State-Trait Anxiety Inventory trait anxiety subscale demonstrated a significant reduction in anxiety at 1 and 3 months after treatment. The Beck Depression Inventory revealed an improvement of mood that reached significance at 6 months; the Profile of Mood States identified mood improvement after treatment with psilocybin that approached but did not reach significance.This study established the feasibility and safety of administering moderate doses of psilocybin to patients with advanced-stage cancer and anxiety. Some of the data revealed a positive trend toward improved mood and anxiety. These results support the need for more research in this long-neglected field.clinicaltrials.gov Identifier: NCT00302744.",0,0 +6436,Quality of life two years after severe trauma: A single centre evaluation,"Trauma related injuries are a main cause for long-lasting morbidity and disability especially in younger patients with their productive years ahead. On a routine basis, we assessed health related quality of life two years after trauma of severely injured patients at our level-I trauma centre via posted survey.The posted survey included (1) POLO-Chart questionnaire with European Quality of Life (EuroQoL), Short Form Health Survey-36 (SF 36) and the recently developed and validated Trauma Outcome Profile (TOP) combined with (2) single centre data according to TraumaRegister DGU(®) data sets including trauma mechanism, injuries and initial treatment. Inclusion criteria were severely injured patients ≥ 18 years, treated between 2008 and 2010. Exclusion criteria were death, cognitive impairment, lack of German language and denial of participation.129 datasets were eligible for analysis reflecting a typical trauma collective with mean age 44 years, predominantly male (67%), mean ISS 22 and 98% blunt trauma. Two years after trauma, 62% of the patients reported of relevant remaining pain and 64% of severe functional deficit in at least one body region. Sixty-four percent of the patients suffered from decreased overall quality of life (EuroQoL≤0.8). Additionally, all domains of SF-36 were impaired compared to an age and gender adjusted cohort of healthy individuals, especially domains of pain and activity of daily living. These impairments were associated with decreased 'social functioning' and 'emotional role functioning'. TOP results confirmed these findings: Quality of life was decreased in almost every dimension. TOP additionally identified sequels especially in domains of ""Mental Functioning"" and impairments in psychological recovery including post-traumatic stress disorder, depression and anxiety. Socioeconomic impairments were frequent including further hospitalisations (62%), duration of inability to work ≥ 6 month (54%), financial disadvantages (45%) and work loss (26%).Our results demonstrate that multiple trauma patients two years after injury suffer from impairments including persisting pain, functional deficits, mental and socioeconomic deficits. The 'Trauma Outcome Profile' instrument seems a proper tool to discover impairments in trauma patients early on and guide proper rehabilitation resources to the best of the patient.",0,0 +6437,Mental Health Effects of Intimate Terrorism and Situational Couple Violence Among Black and Hispanic Women,"An important aspect of Johnson’s intimate terrorism (IT) and situational couple violence (SCV) typology is his assertion that victims experience different negative outcomes depending on which category of violence they endure. Anderson calls for reexamining this typology to highlight the importance of coercive control with or without physical violence present. Similar to most studies, Anderson’s research uses a sample that includes mostly White women. The current study employs Anderson’s methods and ordinary least squares (OLS) regression analyses, but uses a sample of predominately Black women and Latinas from the 1998 Chicago Women’s Health Risk Study.",0,0 +6438,Internalizing and Externalizing Subtypes in Female Sexual Assault Survivors: Implications for the Understanding of Complex PTSD,"This study replicated and extended findings of internalizing and externalizing subtypes of posttraumatic psychopathology (Miller, M. W., Greif, J. L., & Smith, A. A. (2003). Multidimensional Personality Questionnaire profiles of veterans with traumatic combat exposure: Internalizing and externalizing subtypes. Psychological Assessment , 15, 205–215; Miller, M. W., Kaloupek, D. G., Dillon, A. L., & Keane, T.M. (2004). Externalizing and internalizing subtypes of combat-related PTSD: A replication and extension using the PSY-5 Scales. Journal of Abnormal Psychology, 113, 636–645) to a female sample of rape survivors with chronic PTSD. Cluster analyses of Schedule for Nonadaptive and Adaptive Personality (Clark, L. A. (1996). SNAP—Schedule for Nonadaptive and Adaptive Personality: Manual for administration, scoring, and interpretation . Minneapolis: University of Minnesota Press.) temperament scale profiles from 143 women with PTSD partitioned the sample into a simple PTSD cluster, defined by normal range personality scores and moderate symptomatology, and 2 more “complex” clusters distinguished by more severe tendencies towards externalizing or internalizing psychopathology. Externalizers were characterized by disinhibition, substance dependence, and Cluster B personality disorder features; internalizers by low positive temperament, high rates of major depressive disorder, and elevations on measures of schizoid and avoidant personality disorder.",0,0 +6439,Post-traumatic stress disorder without the trauma,"Examples are reported of PTSD cases showing full symptomatology (intrusive imagery, avoidance behaviour, disordered arousal) in the absence of a single, acute, dramatic trauma of the kind required by the current DSM-III-R definition. Such trauma is thus not a necessary condition for PTSD, and other evidence shows it to be not a sufficient condition. It is suggested that the DSM-III-R Axis IV distinction between acute and enduring psychosocial stressors be incorporated into the definition to distinguish two pathways to stress disorder, post-traumatic (PTSD) and prolonged duress (PDSD). Differential treatment implications of the two routes are noted.",0,0 +6440,Traumatic Below-elbow Amputations,"Prehension, intelligence, and erect posture distinguish humans from lower animals. Hands are instrumental for our survival and welfare. We use our hands when we work, recreate, and communicate. A handshake, a touch, a sign, or signal has significant social and communicative meanings. Hands play a major role in defining the skill level of our activities and our level of social expression and integration. Indeed, refined psychomotor precision of hand function may distinguish some individuals among us, gifting society with its more skilled craftsmen, surgeons, artisans, musicians, athletes, and the like in a highly digital world. For others, their hands are critical in providing and caring for their families. Injury severity scores may identify the majority of patients that require amputation; however, injury severity scoring system predictions in individual patients may be problematic and should be used with caution. Amputees require comprehensive multidisciplinary treatment and compassion so that they can successfully overcome their losses. Ultimately, the patients must change, adjust, and adapt to successfully reintegrate themselves into their families, peer groups, job settings, and society as a whole. Early amputation may decrease the incidence and severity of phantom pain compared to amputation after the failure of reconstruction. Early prosthetic fitting, training, and physical rehabilitation; early psychological and sociological support; and early return to work facilitate successful functional recovery. Psychological recovery may be a more arduous and extended process than physical recovery. We must teach our amputees from the outset to use their losses as an incentive for success, assist them to regain their quality of life, and encourage them to act as role models for and to educate others.",0,0 +6441,Posttraumatic Stress Disorder Associated With Combat Service in Iraq or Afghanistan,"Studies of posttraumatic stress disorder (PTSD) prevalence associated with deployment to Iraq or Afghanistan report wide variability, making interpretation and projection for research and public health purposes difficult. This article placed this literature within a military context. Studies were categorized according to deployment time-frame, screening case definition, and study group (operational infantry units exposed to direct combat versus population samples with a high proportion of support personnel). Precision weighted averages were calculated using a fixed-effects meta-analysis. Using a specific case definition, the weighted postdeployment PTSD prevalence was 5.5% (95% CI, 5.4-5.6) in population samples and 13.2% (12.8-13.7) in operational infantry units. Both population-level and unit-specific studies provided valuable and unique information for public health purposes; understanding the military context is essential for interpreting prevalence studies.",0,0 +6442,Regular drinking may strengthen the beneficial influence of social support on depression: Findings from a representative Israeli sample during a period of war and terrorism,"Social support is consistently associated with reduced risk of depression. Few studies have investigated how this relationship may be modified by alcohol use, the effects of which may be particularly relevant in traumatized populations in which rates of alcohol use are known to be high.In 2008 a representative sample of 1622 Jewish and Palestinian citizens in Israel were interviewed by phone at two time points during a period of ongoing terrorism and war threat. Two multivariable mixed effects regression models were estimated to measure the longitudinal association of social support from family and friends on depression symptoms. Three-way interaction terms between social support, alcohol use and time were entered into the models to test for effect modification.Findings indicated that increased family social support was associated with less depression symptomatology (p=<.01); this relationship was modified by alcohol use and time (p=<.01). Social support from friends was also associated with fewer depression symptoms (p=<.01) and this relationship was modified by alcohol use and time as well (p=<.01). Stratified analyses in both models revealed that the effect of social support was stronger for those who drank alcohol regularly than those who did not drink or drank rarely.These findings suggest that social support is a more important protective factor for depression among regular drinkers than among those who do not drink or drink rarely in the context of political violence. Additional research is warranted to determine whether these findings are stable in other populations and settings.",0,0 +6443,Reversible and selective inhibitors of monoamine oxidase A in mental and other disorders,"The clinically tested reversiblc inhibitors of monoamine oxidase A (RIMAs) include brofaromine, moclobemide and toloxatone. Moclobemide has shown unequivocal antidepressant activity against serious deprcssivc illness in 4 placebo-controlled double-blind trials. It has been compared with amitriptyline, imipramine, clomipramine, desipramine, maprotiline, fluoxetine, fluvoxamine, tranylcypromine. toloxatone, mianserin and amineptine in the treatment of depressive disorders. Meta-analysis showed convincing evidence of moclobemide efficacy, comparable with the most potent antidepressants available. The efficacy of moclobemide has been demonstrated in psychotic and non-psychotic depression, in depression with and without melancholia, in endogenous depression (both unipolar and bipolar), in retarded depression and in agitated depression. The efficacy of moelobemide, allied to the unusually benign side effect profile, has led to exploration of its use in other disorders. Two small studies have given encouraging results in the treatment of attention-deficit hyperactivity disorder. Large placebo-controlled studies have shown the activity of moclobemide in the depression that accompanies dementia (such as senile dementia of Alzheimer type). The results also suggested that, in this patient population, cognitive ability improved in parallel. Social phobia has also been shown to improve on treatment with either moclobemide or brofaromine. Clinical trials are in progress on the effect of moclobemide in chronic fatigue syndrome. Moreover, there are encouraging results with the use of brofaromine and moclobemide in panic disorder. Other disorders in which treatment with RIMA is of interest include agoraphobia, bulimia, borderline personality disorder, post-traumatic stress disorder, compulsive hair pulling (trichotillomania), dysmorphophobia, kleptomania as well as various anxiety syndromes.",0,0 +6444,The interrelationships between trauma and internalizing symptom trajectories among adolescents in foster care,"Abstract This study examined the interrelationships between changes in trauma and internalizing symptoms among adolescents in foster care. Using three waves of data from the National Survey of Child and Adolescent Well-Being, growth-curve analyses were conducted with a sample of 155 adolescents aged 11–15 in out-of-home care. Findings indicated that the initial level of post-traumatic stress symptoms was significantly associated with the initial level of internalizing symptoms at Wave I and decreases in post-traumatic stress symptoms were significantly associated with decreases in internalizing symptoms from Wave I to Wave IV. Viewing trauma and internalizing symptoms as interrelated affords increased understanding of ways in which adolescents who have experienced high levels of stress express their needs. As such, it may be clinically beneficial to conduct an evaluation of trauma symptoms for adolescents in foster care, regardless of whether there has been a documented history of a traumatic event. Doing so may provide a more comprehensive view into the underlying influences of adolescent behaviors and help capture a broader clinical picture necessary for effective intervention.",0,0 +6445,Psychometric evaluation of Horowitz's impact of event scale: A review,"Despite being developed before the formal introduction of posttraumatic stress disorder (PTSD) within the diagnostic literature, the Impact of Event Scale (Horowitz, Wilner, & Alvarez, 1979) remains one of the most widely used self-report measures of posttraumatic stress. This paper presents an overview of research using the IES in an attempt to assess its psychometric status. It is concluded that the psychometric properties of the IES are satisfactory (although not as a PTSD diagnostic measure) and that continued use of the IES as a measure of intrusive and avoidant processes is warranted.",0,0 +6446,Social reactions as a predictor of PTSD symptom trajectories following sexual assault,"Introduction: Most research on the psychological impact of sexual assault has been cross-sectional. Using a longitudinal design, we examined the course of PTSD in a group of recent rape survivors. We found 4 distinct PTSD symptom trajectories that we labeled resilience, recovery, moderate chronicity, and high chronicity (Steenkamp et al, 2010). Studies have shown that negative social reactions to assault disclosure correlate with greater PTSD symptom severity (Borja, 2006; Ullman & Filipas, 2001) and can deter victims from seeking help (Ahrens, 2006). However, the extent to which social reactions to rape predict different symptom courses is unknown. Method: Sixty-nine sexual assault survivors completed online questionnaires monthly for the first 4 months following the assault. The Social Reactions Questionnaire (SRQ) assesses 7 types of positive and negative reactions to sexual assault disclosure (emotional support, treat differently, distraction, take control, informational support, victim blame, and egocentric; Ullman, 2000). PTSD symptom severity was assessed using the PTSD Checklist (PCL-C, Weathers et al, 1993). Results: An analysis of variance indicated that the moderate chronic group reported significantly more negative reactions than both the recovery (P = .008) and resilience (P = .04) groups. Specifically, negative reactions where the person treated the survivor differently or took control of the situation distinguished between the moderate chronic and the recovery/resilience groups. Blaming the victim or making the situation about the person instead of the survivor distinguished between the moderate chronic and the resilience groups. Discussion: Consistent with previous studies, negative social reactions to assault disclosure were associated with greater PTSD symptom severity. However, this is the first study demonstrating that social reactions after sexual assault predict distinct PTSD trajectories, with negative reactions predicting a chronic PTSD symptom course. This suggests that reactions of mental health providers, friends, and family may affect PTSD symptom trajectories in survivors and has implications for improving social reactions to sexual assault disclosure. Public Health Significance: In addition to interventions directly targeting survivors' distress and PTSD symptoms after sexual assault, it may be helpful to educate others on the impact of negative social reactions after sexual assault disclosure.",0,0 +6447,Post-traumatic stress disorder in different types of stress (clinical features and treatment),"Two types of stress situation were compared: involvement in combat actions and working in the post-Chernobyl atomic energy station clean-up. A total of 30 subjects involved in combat actions (combatants) and 33 clean-up workers were observed for 5-6 years and 15-17 years after involvement in stress situations. Mean ages in the two groups were 27.0 +/- 2.8 and 43.7 +/- 4.5 years respectively. Clinical features were analyzed in terms of the major criteria of post-traumatic stress disorder (PTSD)--""immersion"" in the experience, ""avoidance,"" ""hyperexcitability,"" and ""social functioning."" There were both common features in the two groups of subjects as well as individual characteristics dependent on the nature of the stress. Patients were treated with Coaxil at a dose of 37.5 mg/day for four weeks. In both groups of patients, Coaxil had the most favorable effects on immersion and hyperexcitability, which improved social adaptation. The ""avoidance"" symptom was more resistant. These studies lead to the conclusion that Coaxil is an effective agent for the treatment of different types of PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +6448,Clinical sleep disorder profiles in a large sample of trauma survivors: An interdisciplinary view of posttraumatic sleep disturbance,"Study Objectives: To examine the relationship between psychiatric symptoms and self-reported sleep, sleepiness, and nightmare complaints in a convenience sample of 437 trauma survivors. Method: Based on symptom severity reports, individuals were classified as having psychophysiological insomnia (PPI), chronic nightmare disorder (CND), and sleep-disordered breathing (SDB) profiles. Individuals with each symptom profile were compared to individuals without the respective profile on sleep indices, sleepiness-related impairment, and psychiatric distress (anxiety, depression, posttraumatic stress symptoms). Results: Individuals with PPI (76%), CND (79%), SDB (68%), or all three profiles (46%) had significantly worse sleep onset latency, sleep efficiency, total sleep time, sleep-related functional impairment, and psychiatric distress compared to those without each disorder profile. Conclusions: The majority of trauma survivors in this sample suffered from sleep complaints sufficiently severe to warrant independent clinical attention by sleep medicine specialists. Longitudinal studies are necessary to determine whether these disturbances are caused exclusively by PTSD or another sleep disorder comorbid with PTSD.",0,0 +6449,"Effects of Chronic Posttraumatic Stress Disorder on Metabolic Risk, Quality of Life, and Stress Hormones in Aging Former Refugee Children","It is still unclear whether the association between traumatic stress and physical disease is mediated by posttraumatic stress disorder (PTSD). Therefore, we examined the long-term consequences of PTSD on cardiovascular risk, stress hormones, and quality of life in a sample of former refugee children who were severely traumatized more than six decades ago. In 25 subjects with chronic PTSD and 25 trauma-controlled subjects, we measured the variables of metabolic syndrome supplemented by the ankle-brachial index and highly sensitive C-reactive protein. Quality of life was assessed using the 36-item Short-Form Health Survey. Cortisol, adrenocorticotropin-releasing hormone (ACTH), and dehydroepiandrosterone (DHEA) were measured using the low-dose-dexamethasone suppression test. In addition, salivary cortisol was assessed at 8:00 a.m., 12:00 p.m., 4:00 p.m., and 8:00 p.m. We found a significant group effect between participants with and without PTSD regarding quality of life but not in any metabolic parameter including the ankle-brachial index or cortisol, ACTH, and DHEA in plasma before and after dexamethasone or salivary cortisol. The postulated association between traumatic stress and physical illness does not appear to be mediated by PTSD in this population. Nevertheless, the search for subgroups of PTSD patients with childhood traumatization leading to different metabolic and endocrine long-term consequences in aging PTSD patients is needed.",0,0 +6450,Differential Predictors of Transient Stress Versus Posttraumatic Stress Disorder: Evaluating Risk Following Targeted Mass Violence,"Schools have become a common incident site for targeted mass violence, including mass shootings. Although exposure to mass violence can result in significant distress, most individuals are able to fully recover over time, while a minority develop more pervasive pathology, such as PTSD. The present study investigated how several pre- and posttrauma factors predict posttraumatic stress symptoms (PTSS) in both the acute and distal aftermath of a campus mass shooting using a sample with known levels of pretrauma functioning (N=573). Although the largest proportion of participants evidenced resilience following exposure to the event (46.1%), many reported high rates of PTSS shortly after the shooting (42.1%) and a smaller proportion (11.9%) met criteria for probable PTSD both in the acute and more distal aftermath of the event. While several preshooting factors predicted heightened PTSS after the shooting, prior trauma exposure was the only preshooting variable shown to significantly differentiate between those who experienced transient versus prolonged distress. Among postshooting predictors, individuals reporting greater emotion dysregulation and peritraumatic dissociative experiences were over four times more likely to have elevated PTSS 8months postshooting compared with those reporting less dysregulation and dissociative experiences. Individuals with less exposure to the shooting, fewer prior traumatic experiences, and greater satisfaction with social support were more likely to recover from acute distress. Overall, results suggest that, while pretrauma factors may differentiate between those who are resilient in the aftermath of a mass shooting and those who experience heightened distress, several event-level and posttrauma coping factors help distinguish between those who eventually recover and those whose PTSD symptoms persist over time.",0,0 +6451,Lifetime Prevalence of Psychiatric Disorders among Parents of Children with Bipolar I Disorder: Parental Difference,"Background . Evaluation of family system is an important area in the context of child and adolescent mental health. This study aimed to estimate psychiatric disorders in parents of children and adolescents with bipolar I disorder (BID). Methods and Materials . In this cross-sectional study, during 2012-2013, all of the children and adolescents diagnosed with BID based on Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version were included. All of the parents (both mother and father) were evaluated by Structured Clinical Interview for DSM-IV-TR . Statistical Analysis . Prevalence rates are reported and independent-sample t -test and chi-square test were used when appropriate. Results . A total of 108 families were interviewed. 25% of mothers and 33% of fathers met the criteria for at least one psychiatric disorder, with major depressive disorder, BMD, and cluster B personality disorder being more prevalent. Fathers were more likely to receive a dual psychiatric diagnosis. Cluster B personality disorder and substance dependence were more prevalent among fathers while major depressive disorder was more prevalent among mothers. Conclusion . This study confirmed a higher prevalence of psychiatric disorders in parents of children with BID and emphasizes parental evolution.",0,0 +6452,"Internalizing disorders and leukocyte telomere erosion: a prospective study of depression, generalized anxiety disorder and post-traumatic stress disorder","There is evidence that persistent psychiatric disorders lead to age-related disease and premature mortality. Telomere length has emerged as a promising biomarker in studies that test the hypothesis that internalizing psychiatric disorders are associated with accumulating cellular damage. We tested the association between the persistence of internalizing disorders (depression, generalized anxiety disorder and post-traumatic stress disorder) and leukocyte telomere length (LTL) in the prospective longitudinal Dunedin Study (n=1037). Analyses showed that the persistence of internalizing disorders across repeated assessments from ages 11 to 38 years predicted shorter LTL at age 38 years in a dose-response manner, specifically in men (β=-0.137, 95% confidence interval (CI): -0.232, -0.042, P=0.005). This association was not accounted for by alternative explanatory factors, including childhood maltreatment, tobacco smoking, substance dependence, psychiatric medication use, poor physical health or low socioeconomic status. Additional analyses using DNA from blood collected at two time points (ages 26 and 38 years) showed that LTL erosion was accelerated among men who were diagnosed with internalizing disorder in the interim (β=-0.111, 95% CI: -0.184, -0.037, P=0.003). No significant associations were found among women in any analysis, highlighting potential sex differences in internalizing-related telomere biology. These findings point to a potential mechanism linking internalizing disorders to accelerated biological aging in the first half of the life course, particularly in men. Because internalizing disorders are treatable, the findings suggest the hypothesis that treating psychiatric disorders in the first half of the life course may reduce the population burden of age-related disease and extend health expectancy.",0,0 +6453,Militærmedicinske erfaringer fra krigen mod terror,,0,0 +6454,Psychological Sequelae of the Station Nightclub Fire: Comparing Survivors with and without Physical Injuries Using a Mixed-Methods Analysis,"Surveying survivors from a large fire provides an opportunity to explore the impact of emotional trauma on psychological outcomes.This is a cross-sectional survey of survivors of The Station Fire. Primary outcomes were post-traumatic stress (Impact of Event Scale - Revised) and depressive (Beck Depression Inventory) symptoms. Linear regression was used to examine differences in symptom profiles between those with and without physical injuries. The free-response section of the survey was analyzed qualitatively to compare psychological sequelae of survivors with and without physical injuries.104 participants completed the study survey; 47% experienced a burn injury. There was a 42% to 72% response rate range. The mean age of respondents was 32 years, 62% were male, and 47% experienced a physical injury. No significant relationships were found between physical injury and depressive or post-traumatic stress symptom profiles. In the qualitative analysis, the emotional trauma that survivors experienced was a major, common theme regardless of physical injury. Survivors without physical injuries were more likely to experience survivor guilt, helplessness, self-blame, and bitterness. Despite the post-fire challenges described, most survivors wrote about themes of recovery and renewal.All survivors of this large fire experienced significant psychological sequelae. These findings reinforce the importance of mental health care for all survivors and suggest a need to understand factors influencing positive outcomes.",0,0 +6455,Post-traumatic stress disorder: An overview and its relationship to closed head injuries,"While exposure to traumatic psychological and physical trauma can produce posttraumatic stress disorder (PTSD), multiple factors determine whether a person will develop PTSD following trauma exposure. PTSD has a high rate of comorbidity with psychiatric, substance abuse, and somatization disorders. Persons with PTSD experience profound and persistent alterations in their physiological reactivity to internal and external stimuli which prevents them from utilizing their emotions to process incoming information. These patients have chronically high levels of sympathetic nervous system activity and low levels of glucocorticoids to cope with stress and modulate their catecholamine levels. Neuropsychological assessment of patients with PTSD depends to a large degree on the sensitivity of the measures which are utilized and a pre-existing history of learning disabilities, head trauma, and/or neurological disorders. While closed head injuries (CHI) are unlikely to produce PTSD symptoms, persons with CHI are likely to develop PTSD symptoms if they are exposed to trauma prior to the onset of retrograde amnesia or after the resolution of post-traumatic amnesia. If the traumatic event occurs while the patient with CHI is amnestic or unconscious, they are unlikely to develop PTSD symptoms. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6456,Predicting Treatment Outcome in PTSD: A Longitudinal Functional MRI Study on Trauma-Unrelated Emotional Processing,"In about 30-50% of patients with posttraumatic stress disorder (PTSD), symptoms persist after treatment. Although neurobiological research has advanced our understanding of PTSD, little is known about the neurobiology underlying persistence of PTSD. Two functional MRI scans were collected from 72 war veterans with and without PTSD over a 6- to 8-month interval, during which PTSD patients received trauma-focused therapy. All participants performed a trauma-unrelated emotional processing task in the scanner. Based on post-treatment symptom severity, a distinction was made between remitted and persistent patients. Behavioral and imaging measures of trauma-unrelated emotional processing were compared between the three groups (remitted patients, N=21; persistent patients, N=22; and combat controls, N=25) with repeated-measures (pre- and post-treatment) analyses. Second, logistic regression was used to predict treatment outcome. Before and after treatment, persistent patients showed a higher dorsal anterior cingulate cortex (dACC) and insula response to negative pictures compared with remitted patients and combat controls. Before treatment, persistent patients showed increased amygdala activation in response to negative pictures compared with remitted patients. The remitted patients and combat controls did not differ on the behavioral or imaging measures. Finally, higher dACC, insula, and amygdala activation before treatment were significant predictors of symptom persistence. Our results highlight a pattern of brain activation that may predict poor response to PTSD treatment. These findings can contribute to the development of alternative or additional therapies. Further research is needed to elucidate the heterogeneity within PTSD and describe how differences in neural function are related to treatment outcome. Such approaches are critical for defining parameters to customize PTSD treatment and improve treatment response rates.",0,0 +6457,The Comprehensive Assessment of Defense Style: Measuring Defense Mechanisms in Children and Adolescents,"This study introduces the Comprehensive Assessment of Defense Style (CADS), a new method to assess descriptively the defensive behavior of children and adolescents. Parents of 124 children and adolescents referred to a mental health clinic, of 104 nontreated children, and of 15 children whose fathers were treated for posttraumatic stress disorder completed the CADS. Factor analysis of 28 defenses yielded one mature factor, one immature factor of defenses expressed in relations with the environment (other-oriented), and one of defenses expressed in relations with the self (self-oriented). The CADS significantly discriminated between patients and nonpatients. Psychiatric patients used more immature and fewer mature defenses than control subjects, and adolescents used more mature and fewer other-oriented defenses than children. Girls used more mature and fewer other-oriented defenses than boys. The reliability and validity data of the CADS are encouraging. The three defense factors may be implemented for diagnostic and clinical purposes as well as for screening for psychopathology risk in untreated populations.",0,0 +6458,Cortical hyperexcitability in post-traumatic stress disorder secondary to minor accidental head trauma: a neurophysiologic study.,"We applied paired transcranial magnetic stimulation (pTMS) to patients with post-traumatic stress disorder (PTSD) secondary to minor accidental head trauma. Our purpose was to determine the potential abnormality of motor cortex excitability in this pathologic condition.pTMS stimulation, according to the conditioning-test paradigm employing interstimulus intervals (ISIs) of 1-6 ms, was used to investigate intracortical inhibition in control subjects and patients with PTSD. The study population consisted of 14 patients who had developed PTSD following minor head trauma, 12 healthy volunteers without a clinical history of head trauma and 11 healthy subjects who had reported accidental minor head trauma 1-4 months before the study. This clinical electrophysiologic study was performed at the Department of Neuroscience, University of Rome ""Tor Vergata.""All patients with PTSD exhibited a significantly lower motor evoked potential (MEP) inhibition than controls at 2 ms, 3 ms and 4 ms ISI. The statistical analysis of the pTMS protocol showed a significant effect (F2,36 = 25.63, p < 0.001) of the factor ""group,"" because patients with PTSD showed a mean conditioned MEP amplitude higher than that observed in both control groups for all 6 ISIs analyzed. The ""ISI"" factor was also significant (F5,180 = 89.85, Greenhouse-Geisser epsilon = 0.35; p < 0.001), with the mean conditioned MEP amplitude increasing from 22.5% to 127.8% as the ISI increased from 1 ms to 6 ms. Finally, the interaction of group with ISI was also significant (F10,180 = 8.97, p < 0.001), showing that the condition of PTSD secondary to head trauma was able to affect the MEP amplitude at different ISIs.Our results demonstrate that PTSD can give rise to abnormalities in intracortical inhibition. Our results provide further evidence that alterations in cortical inhibitory circuits may underlie specific forms of neuroticism in humans.",0,0 +6459,Low socioeconomic status and mental health outcomes in colorectal cancer survivors: disadvantage? advantage? … or both?,"The goal of this study is to examine the relationship between socioeconomic status (SES) and both positive and negative mental health (MH) outcomes in a population-based sample of colorectal cancer survivors. On the basis of theoretical conceptualizations of trauma and posttraumatic growth, low SES was hypothesized to be positively associated with both greater negative MH outcomes (e.g., distress) and greater positive MH outcomes (e.g., growth).Colorectal cancer survivors (n = 1300; 57% male; mean age 69.4 and 4.0 years post-diagnosis) were recruited using a regional, population-based cancer registry in the Netherlands and completed a questionnaire assessing current negative and positive MH outcomes. Low, medium, and high SES respondents were identified using an area-level indicator of SES based on aggregated individual fiscal data on monetary home value and household income.Analysis of covariance and logistic regression analyses indicated that low SES was a risk factor for greater negative MH outcomes. Relative to high SES survivors, low SES survivors reported poorer status on nine indices of MH, and high SES survivors were about 50% less likely to report clinically important levels of anxiety and depression. Results provided partial support for the hypothesis low SES was a 'risk' factor for greater positive MH outcomes. Relative to high SES survivors, low SES survivors reported greater positive MH outcomes on 2 of 5 positive MH indices examined (Positive Self-Evaluation, Meaning of Cancer).Study findings are the first to suggest that low SES might increase the likelihood of both greater negative as well as positive MH outcomes in cancer survivors.",0,0 +6460,Improving mental health is key to reduce violence in Israel and Gaza,"The prolonged and complex Israeli–Palestinian conflict profoundly affects the health and wellbeing of both Palestinians and Israelis.1 The present escalation between Hamas and Israel follows a well-worn pattern of confrontation. Superior Israeli military force means that Palestinians have more physical casualties. On both sides, however, many civilians are exposed to conflict-related stressors, and neither Israelis nor Palestinians are immune to their mental or physical health consequences.",0,0 +6461,Psychiatric disorders and functional impairment among disaster victims after exposure to a natural disaster: A population based study,"We aimed to examine psychiatric morbidity and functional impairment after a natural disaster.Norwegian tourists who survived the 2004 tsunami in Khao Lak (n = 63), a severely affected area in Thailand, were interviewed in person 2.5 years after the disaster. The examination included the Mini International Neuropsychiatric Interview, the PTSD module of the Structured Clinical Interview for DSM-IV Axis I disorders, the Work and Social Adjustment Scale (WSAS), the Global Assessment of Functioning function score (GAF-F), and questions covering background characteristics and disaster exposure.The most prevalent disorders were specific phobia (30.2%), agoraphobia (17.5%), social anxiety disorder (11.1%), PTSD (11.1%), major depressive disorder (MDD, 11.1%), and dysthymic disorder (DD, 11.1%). In 24 of the 40 respondents with a current psychiatric disorder, symptoms had originated after the tsunami. The post-tsunami 2.5 year incidence of PTSD and MDD was 36.5% and 28.6%, respectively. Multivariable regression analysis showed that the depressive disorders (MDD and DD) and PTSD were associated with self-reported functional impairment (WSAS), and the depressive disorders were associated with clinician assessed functional impairment (GAF-F).Small sample size and high education may limit the generalizability of the results.Depression and anxiety disorders were common among disaster victims 2.5 years after the 2004 tsunami. Psychiatric disorders other than PTSD, especially depressive disorders, are of clinical importance when considering long-term mental health effect of disasters.",0,0 +6462,Comparing the utility of homogeneous subtypes of cocaine use and related behaviors with DSM-IV cocaine dependence as traits for genetic association analysis,"Because DSM-IV cocaine dependence (CD) is heterogeneous, it is not an optimal phenotype to identify genetic variation contributing to risk for cocaine use and related behaviors (CRBs). We used a cluster analytic method to differentiate homogeneous, highly heritable subtypes of CRBs and to compare their utility with that of the DSM-IV CD as traits for genetic association analysis. Clinical features of CRBs and co-occurring disorders were obtained via a poly-diagnostic interview administered to 9,965 participants in genetic studies of substance dependence. A subsample of subjects (N = 3,443) were genotyped for 1,350 single nucleotide polymorphisms (SNPs) selected from 130 candidate genes related to addiction. Cluster analysis of clinical features of the sample yielded five subgroups, two of which were characterized by heavy cocaine use and high heritability: a heavy cocaine use, infrequent intravenous injection group and an early-onset, heavy cocaine use, high comorbidity group. The utility of these traits was compared with the CD diagnosis through association testing of 2,320 affected subjects and 480 cocaine-exposed controls. Analyses examined both single SNP (main) and SNP–SNP interaction (epistatic) effects, separately for African-Americans and European-Americans. The two derived subtypes showed more significant P values for 6 of 8 main effects and 7 of 8 epistatic effects. Variants in the CLOCK gene were significantly associated with the heavy cocaine use, infrequent intravenous injection group, but not with the DSM-IV diagnosis of CD. These results support the utility of subtypes based on CRBs to detect risk variants for cocaine addiction. © 2013 Wiley Periodicals, Inc.",0,0 +6463,Characterization of Post-traumatic Stress Disorder Using Resting-State fMRI with a Multi-level Parametric Classification Approach,"Functional neuroimaging studies have found intra-regional activity and inter-regional connectivity alterations in patients with post-traumatic stress disorder (PTSD). However, the results of these studies are based on group-level statistics and therefore it is unclear whether PTSD can be discriminated at single-subject level, for instance using the machine learning approach. Here, we proposed a novel framework to identify PTSD using multi-level measures derived from resting-state functional MRI (fMRI). Specifically, three levels of measures were extracted as classification features: (1) regional amplitude of low-frequency fluctuations (univariate feature), which represents local spontaneous synchronous neural activity; (2) temporal functional connectivity (bivariate feature), which represents the extent of similarity of local activity between two regions, and (3) spatial functional connectivity (multivariate feature), which represents the extent of similarity of temporal correlation maps between two regions. Our method was evaluated on 20 PTSD patients and 20 demographically matched healthy controls. The experimental results showed that the features of each level could successfully discriminate PTSD patients from healthy controls. Furthermore, the combination of multi-level features using multi-kernel learning can further improve the classification performance. Specifically, the classification accuracy obtained by the proposed framework was 92.5 %, which was an increase of at least 5 and 17.5 % from the two-level and single-level feature based methods, respectively. Particularly, the limbic structure and prefrontal cortex provided the most discriminant features for classification, consistent with results reported in previous studies. Together, this study demonstrated for the first time that patients with PTSD can be identified at the individual level using resting-state fMRI data. The promising classification results indicated that this method may provide a complementary approach for improving the clinical diagnosis of PTSD. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0,0 +6464,Assessing Positive and Negative Changes in the Aftermath of Adversity: Psychometric Evaluation of the Changes in Outlook Questionnaire.,"The Changes in Outlook Questionnaire (CiOQ; S. Joseph, R. Williams, & W. Yule, 1993) is a 26-item self-report measure that was designed to assess positive and negative changes in the aftermath of adversity. This article had 3 aims: 1st, to investigate the factor structure of the CiOQ; 2nd, to test for internal consistency reliability and convergent and discriminant validity; and, 3rd, to investigate the association between positive and negative changes in outlook, posttraumatic stress, and psychological distress. Three studies are reported. Study 1 provides evidence that positive and negative changes are statistically separable and that the 2-factor model is a better fit than the 1-factor model. Studies 2 and 3 provide evidence for internal consistency reliability, convergent and discriminant validity of the CiOQ, and its associations with posttraumatic stress and psychological distress. In conclusion, the CiOQ has much promise for research on responses to stressful and traumatic events.",0,0 +6465,Nursing Home Disaster Planning and Response: A Policy Perspective,"Nursing home residents are among the most vulnerable members of a community threatened by disaster. In the past, insufficient planning has resulted in preventable morbidity and mortality for nursing home residents during disasters. State and federal policies have evolved over the past decade to improve oversight of nursing home disaster planning. However, continued political advocacy is critically necessary to promote the safety of nursing home residents during potential emergencies and, especially, naturally occurring disasters. Opportunities exist to improve nursing home disaster response, including better preparation and training and dedicated resources for data management and oversight.",0,0 +6466,Testing the latent structure of posttraumatic stress disorder: A taxometric study of combat veterans,"Since the diagnosis of posttraumatic stress disorder (PTSD) first appeared in the psychiatric nomenclature in 1980, considerable debate has revolved around the nature of the condition. Specifically, is PTSD best conceptualized as one end of a continuum of human response to traumatic stress or does it represent a discontinuous latent category? Two taxometric procedures were used to investigate this issue in a random community sample of 692 Australian combat veterans, using structured interview and self-report instruments to assess PTSD symptomatology. Findings favored a dimensional model of PTSD, consistent with previous taxometric work on treatment-seeking samples (A. Ruscio, Ruscio, & Keane, 2002). Implications are drawn for the conceptualization, etiology, and assessment of PTSD.",0,0 +6467,Seeking Safety treatment for male veterans with a substance use disorder and post-traumatic stress disorder symptomatology,"To determine whether substituting Seeking Safety (SS), a manualized therapy for comorbid substance use disorders (SUD) and post-traumatic stress disorder (PTSD) for part of treatment-as-usual (TAU) improves substance use outcomes.Randomized controlled effectiveness trial.Out-patient Veterans Administration Health Care System SUD clinic.Ninety-eight male military Veterans with a SUD and co-occurring PTSD symptomatology.Drug and alcohol use and PTSD severity, measured on the first day of treatment, and 3 (i.e. the planned end of SS sessions) and 6 months following the baseline assessment. Treatment attendance and patient satisfaction were measured following treatment (3-month follow-up). Active coping was measured at treatment intake and following treatment.SS compared to TAU was associated with better drug use outcomes (P < 0.05), but alcohol use and PTSD severity decreased equally under both treatments (P's < 0.01). SS versus TAU was associated with increased treatment attendance, client satisfaction and active coping (all P's < 0.01). However, neither these factors nor decreases in PTSD severity mediated the effect of treatment on drug use.The manualized treatment approach for substance use disorder, Seeking Safety, is well received and associated with better drug use outcomes than 'treatment as usual' in male veterans with post-traumatic stress disorder. However, the mechanism of its effect is unclear.",0,0 +6468,Latent structure of the proposed ICD-11 post-traumatic stress disorder symptoms: Implications for the diagnostic algorithm,"Background The latent structure of the proposed ICD-11 post-traumatic stress disorder (PTSD) symptoms has not been explored. Aims To investigate the latent structure of the proposed ICD-11 PTSD symptoms. Method Confirmatory factor analyses using data from structured clinical interviews administered to injury patients ( n = 613) 6 years post-trauma. Measures of disability and psychological quality of life (QoL) were also administered. Results Although the three-factor model implied by the ICD-11 diagnostic criteria fit the data well, a two-factor model provided equivalent, if not superior, fit. Whereas diagnostic criteria based on this two-factor model resulted in an increase in PTSD point prevalence (5.1% v. 3.4%; z = 2.32, P <0.05), they identified individuals with similar levels of disability ( P = 0.933) and QoL ( P = 0.591) to those identified by the ICD-11 criteria. Conclusions Consistent with theorised reciprocal relationships between re-experiencing and avoidance in PTSD, these findings support an alternative diagnostic algorithm requiring at least two of any of the four re-experiencing/avoidance symptoms and at least one of the two hyperarousal symptoms.",0,0 +6469,The limits of resilience: Distress following chronic political violence among Palestinians,"We examined posttraumatic stress disorder (PTSD) and depression symptom trajectories during ongoing exposure to political violence, seeking to identify psychologically resilient individuals and the factors that predict resilience. Face-to-face interviews were conducted with a random sample of 1196 Palestinian adult residents of the West Bank, Gaza, and East Jerusalem across three occasions, six months apart (September 2007-November 2008). Latent growth mixture modeling identified PTSD, and depression symptom trajectories. Results identified three PTSD trajectories: moderate-improving (73% moderate symptoms at baseline, improving over time), severe-chronic (23.2% severe and elevated symptoms over the entire year); and severe-improving (3.5% severe symptoms at baseline and marked improvement over time). Depression trajectories were moderate-improving (61.5%); severe-chronic (24.4%); severe-improving (14.4%). Predictors of relatively less severe initial symptom severity, and improvement over time for PTSD were less political violence exposure and less resource loss; and for depression were younger age, less political violence exposure, lower resource loss, and greater social support. Loss of psychosocial and material resources was associated with the level of distress experienced by participants at each time period, suggesting that resource-based interventions that target personal, social, and financial resources could benefit people exposed to chronic trauma.",1,0 +6470,Underlying Dimensions of DSM-5 Posttraumatic Stress Disorder and Major Depressive Disorder Symptoms,"This study examined the relationship between the underlying latent factors of major depression symptoms and DSM-5 posttraumatic stress disorder (PTSD) symptoms (American Psychiatric Association, 2013). A nonclinical sample of 266 participants with a trauma history participated in the study. Confirmatory factor analyses were conducted to evaluate the fit of the DSM-5 PTSD model and dysphoria model, as well as a depression model comprised of somatic and nonsomatic factors. The DSM-5 PTSD model demonstrated somewhat better fit over the dysphoria model. Wald tests indicated that PTSD’s negative alterations in cognitions and mood factor was more strongly related to depression’s nonsomatic factor than its somatic factor. This study furthers a nascent line of research examining the relationship between PTSD and depression factors in order to better understand the nature of the high comorbidity rates between the two disorders. Moreover, this study provides an initial analysis of the new DSM-5 diagnostic criteria for PTSD.",0,0 +6471,Toward a visuospatial developmental account of sequence-space synesthesia,"Sequence-space synesthetes experience some sequences (e.g., numbers, calendar units) as arranged in spatial forms, i.e., spatial patterns in their mind's eye or even outside their body. Various explanations have been offered for this phenomenon. Here we argue that these spatial forms are continuous with varieties of non-synesthetic visuospatial imagery and share their central characteristics. This includes their dynamic and elaborative nature, their involuntary feel, and consistency over time. Drawing from literatures on mental imagery and working memory, we suggest how the initial acquisition and subsequent elaboration of spatial forms could be accounted for in terms of the known developmental trajectory of visuospatial representations. This extends from the formation of image-based representations of verbal material in childhood to the later maturation of dynamic control of imagery. Individual differences in the development of visuospatial style also account for variation in the character of spatial forms, e.g., in terms of distinctions such as visual versus spatial imagery, or ego-centric versus object-based transformations.",0,0 +6472,Cognitive processing therapy for veterans with posttraumatic stress disorder: A comparison between outpatient and residential treatment.,"Across the Veterans Affairs (VA) Healthcare System, outpatient and residential posttraumatic stress disorder (PTSD) treatment programs are available to veterans of all ages and both genders; however, no research to date has compared these treatment options. This study compared veterans who received outpatient (n = 514) to those who received residential treatment (n = 478) within a VA specialty clinic on demographic and pretreatment symptom variables. Further, the study examined pre- to posttreatment symptom trajectories across the treatment programs.All 992 veterans met diagnostic criteria for PTSD and attended at least 1 session of cognitive processing therapy (CPT) in either the outpatient or residential program. Bivariate analyses were utilized to investigate differences between samples on demographic variables and severity of pretreatment symptoms. Multilevel modeling (MLM) was used to investigate the change in symptomatology between the 2 samples from pre- to posttreatment.Analyses indicated that the samples differed on all demographic and pretreatment symptom variables, with residential patients reporting higher scores on all assessment measures. MLM results demonstrated that symptom scores improved for all veterans across time, with outpatients consistently reporting fewer symptoms at both time points. The time by program interaction was significant for PTSD-related symptom trajectories, but not for the depression-related symptom trajectory.This is the 1st study to compare pretreatment characteristics and treatment outcome between veterans receiving outpatient and residential PTSD treatment. Findings may help clinicians select appropriate care for their patients by identifying relevant pretreatment characteristics and generally informing expectations of treatment outcome.",0,0 +6473,"Altered gene expression of the innate immune, neuroendocrine, and nuclear factor-kappa B (NF-κB) systems is associated with posttraumatic stress disorder in military personnel","Whole transcriptome analysis provides an unbiased examination of biological activity, and likely, unique insight into the mechanisms underlying posttraumatic stress disorder (PTSD) and comorbid depression and traumatic brain injury. This study compared gene-expression profiles in military personnel with PTSD (n=28) and matched controls without PTSD (n=27) using HG-U133 Plus 2.0 microarrays (Affymetrix), which contain 54,675 probe sets representing more than 38,500 genes. Analysis of expression profiles revealed 203 differentially expressed genes in PTSD, of which 72% were upregulated. Using Partek Genomics Suite 6.6, differentially expressed transcription clusters were filtered based on a selection criterion of ≥1.5 relative fold change at a false discovery rate of ≤5%. Ingenuity Pathway Analysis (Qiagen) of the differentially expressed genes indicated a dysregulation of genes associated with the innate immune, neuroendocrine, and NF-κB systems. These findings provide novel insights that may lead to new pharmaceutical agents for PTSD treatments and help mitigate mental and physical comorbidity risk.",0,0 +6474,Typologies of posttraumatic stress disorder in the U.S. adult population,"Posttraumatic stress disorder (PTSD) is characterized by heterogeneous clusters of re-experiencing, avoidance, numbing, and hyperarousal symptoms. However, data are lacking regarding the predominant, population-based typologies of this disorder, and how they are linked to trauma-related characteristics, psychiatric comorbidities, and health-related quality of life.We used latent class analyses (LCAs) to evaluate predominant typologies of PTSD in a nationally representative sample of 2463 U.S. adults with PTSD. Multinomial logistic regression analyses were then conducted to evaluate trauma-related characteristics, psychiatric comorbidities, and health-related quality of life variables associated with these typologies.LCAs revealed three predominant typologies of PTSD-Anxious-Re-experiencing (weighted prevalence=32.2%), Dysphoric (32.8%), and High Symptom (35.0%). Compared to the Dysphoric class, the Anxious-Re-experiencing and High Symptom classes were more likely to report sexual assault, physical assault, and military combat as their worst traumatic events; had an earlier age of onset and longer duration of PTSD; and were more likely to be diagnosed with nicotine dependence and borderline personality disorder, to have attempted suicide, and had poorer physical health-related quality of life (HRQoL). The High Symptom class had increased odds of all disorders, suicide attempts, and the poorest HRQoL.Diagnoses were based on DSM-IV criteria and cross-sectional analyses preclude examination of how PTSD typologies are temporally related to other variables.PTSD in the general U.S. adult population is characterized by three predominant typologies, which are differentially linked to trauma and clinical characteristics. These findings underscore the importance of personalized approaches to the assessment, monitoring, and treatment of PTSD that take into consideration the heterogeneous manifestations of this disorder.",0,0 +6475,Mental health outcomes at the Jersey Shore after Hurricane Sandy.,"On October 29, 2012, Hurricane Sandy made landfall in the most densely populated region in the US. In New Jersey, thousands of families were made homeless and entire communities were destroyed in the worst disaster in the history of the state. The economic impact of Sandy was huge, comparable to Hurricane Katrina. The areas that sustained the most damage were the small- to medium-sized beach communities along New Jersey's Atlantic coastline. Six months following the hurricane, we conducted a random telephone survey of 200 adults residing in 18 beach communities located in Monmouth County. We found that 14.5% (95% CI = 9.9-20.2) of these residents screened positive for PTSD and 6.0% (95% CI = 3.1-10.2) met criteria for major depression. Altogether 13.5% (95% CI = 9.1-19.0) received mental health counseling and 20.5% (95% CI = 15.1-26.8) sought some type of mental health support in person or online, rates similar to those reported in New York after the World Trade Center disaster In multivariate analyses, the best predictors of mental health status and service use were having high hurricane exposure levels, having physical health limitations, and having environmental health concerns. Research is needed to assess the mental health status and service use of Jersey Shore residents over time, to evaluate environmental health concerns, and to better understand the storm's impact among those with physical health limitations.",0,0 +6476,A family study of PTSD : occurrence and correlates of internalizing disorders in children of OIF/OEF soldiers with combat posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) is one of the most common psychiatric disorders among U.S. combatants who are deployed to Operation Iraqi Freedom and Operation Enduring Freedom conflicts (OIF/OEF). Combat PTSD has been shown to be associated with impaired social, occupational, and physical functioning. An understudied area of research is how PTSD from combat affects interpersonal functioning at the family level. Of particular vulnerability to disruption in relational systems is the parent-child dyad. The present study focused on parental PTSD, child environment, and child psychological symptoms in order to begin delineating pathways connecting parent trauma to child psychopathology. The sample consisted of 21 dyads : Adult participants with and without combat-related PTSD and biological child participants (aged 6 - 17). Parents and children were administered structured diagnostic interviews and dimensional measures of anxiety, depression, and PTSD and home environment. Simple linear regression was used to test a predictive model between fathers' level of PTSD symptoms and child clinical symptoms. Multiple regression was used to test the mediation model of child home environment on the relationship between parent and child symptomatology. Results from descriptive analyses showed that level of fathers' combat exposure was a significant predictor at the alpha = 0.05 level for child anxiety, PTSD symptoms, oppositional, and conduct problems. However, level of fathers' combat exposure did not predict child depression, somatization, or withdrawn symptoms. Results showed no interaction effects. This pilot study demonstrates that the experiences of OIF/OEF combatants such as the nature of their combat exposure during deployment may be important in impacting the psychological outcomes of their offspring. Furthermore, the warzone experiences of OIF/OEF combatants during deployment appear to predict child anxiety, PTSD, and externalizing symptoms, but not child depression, withdrawn symptoms, or somatization. Results of this pilot study should be considered preliminary and the design should be replicated with a larger sample of OIF/OEF combatants. The current findings may be relevant in advancing our knowledge of etiological models of psychiatric illness in youths, identifying at-risk individuals during early life stages, and advancing mental health interventions for military families",0,0 +6477,Evaluating the dimensionality of PTSD in a sample of OIF/OEF veterans.,"Both categorical and dimensional models of mental disorders, including posttraumatic stress disorder (PTSD), are useful for diagnostic and heuristic purposes; however, few empirical studies have compared categorical and dimensional models of PTSD side-by-side or compared these models to a hybrid (dimensional and categorical) model. In the present study, the dimensionality of PTSD was examined by fitting latent profile analytic, confirmatory factor analytic, and factor mixture models in 271 Operation Iraqi Freedom/Operation Enduring Freedom veterans 6 months after return from deployment. Latent profile analysis was used to identify subgroups of individuals with similar PTSD symptom profiles and predictors of subgroup membership, confirmatory factor analysis was used to identify the underlying continuous structure of PTSD in this sample, and factor mixture modeling was used to test whether a hybrid categorical and continuous model of PTSD best fit our sample. A factor mixture model consisting of a 4-factor dysphoria model of PTSD with 2 classes characterized by low and moderate symptom severity was the best-fitting model. Dissociation and deployment concerns emerged as significant predictors of membership in the moderate symptoms class. Implications for PTSD diagnostic conceptualization and treatment planning are discussed.",0,0 +6478,Properties of Swedish posttraumatic stress measures after a disaster,"• The construct of chronic PTSD generally shows temporal invariance. • The dysphoric-arousal model provided better fit than four- and three-factor models. • The Swedish IES-R and the PCL work well as measures of chronic posttraumatic stress. This study evaluated the properties of Swedish versions of self-report measures of posttraumatic stress disorder (PTSD), with emphasis on the Impact of Event Scale-Revised (IES-R). Survey data from adult survivors 1, 3, and 6 years after the 2004 Indian Ocean tsunami ( n = 1506) included the IES-R (from which the IES-6 was derived) and the 12-item General Health Questionnaire (GHQ-12). The PTSD Checklist (PCL) was included in one survey. A structured clinical interview was performed after 6 years ( n = 142). Factor analyses of the IES-R and PCL indicated that a dysphoric-arousal model provided good fit invariant across assessments. Both measures were accurate in excluding PTSD while all measures provided poorer positive predictive values. The IES-R, but not the IES-6 and GHQ-12, evidenced stability across assessments. In conclusion, the Swedish IES-R and PCL are sound measures of chronic PTSD, and the findings illustrate important temporal aspects of PTSD assessment.",0,0 +6479,Giving Voice to the Unsayable: Repairing the Effects of Trauma in Infancy and Early Childhood,"The research on early trauma establishes conclusively that, although there are marked individual differences in how children in the first five years of life respond to and recover from trauma, they consistently show negative biological, emotional, social, and cognitive sequelae after enduring traumatic events. This evidence lends particular urgency to the development, evaluation and implementation of approaches to prevention and treatment that are both empirically supported and can be effectively adapted to mental health community programs and other service systems that serve traumatized children and their families. This article describes the clinical applications and community dissemination of child-parent psychotherapy (CPP), a relationship-based trauma treatment for young children and their families that has substantial empirical evidence of efficacy in decreasing symptoms of traumatic stress and restoring young children's normative developmental trajectories. Clinical illustrations are provided to demonstrate how this intervention is conducted and to consider how it might effect therapeutic change.",0,0 +6480,Mother and Child Reports of Hurricane Related Stressors: Data from a Sample of Families Exposed to Hurricane Katrina,"Families exposed to disasters such as Hurricane Katrina are at risk for numerous adverse outcomes. While previous literature suggests that the degree of disaster exposure corresponds with experiencing negative outcomes, it is unclear if parents and children report similar levels of disaster exposure.The purpose of this paper was to examine levels of disaster stressor agreement among mother-child dyads affected by Hurricane Katrina, and to examine whether discrepancies in disaster stressor reports are associated with higher levels of posttraumatic stress (PTS) symptoms.Participants in this study consisted of 353 dyads of mothers (age M = 38.79 years, SD = 7.52; 68% African American) and children (52% girls; age M = 11.61 years, SD = 1.57) exposed to Hurricane Katrina. Parents and children were assessed at two timepoints, 3 - 7 months and 14 - 17 months postdisaster. Parent and child responses to items regarding hurricane related stressor exposure and PTS symptoms were analyzed.Agreement on hurricane related exposures was predominately slight to moderate, with kappas ranging from κ = .19 to κ = .83. Polynomial regression analyses revealed that when mothers reported low levels of Immediate Loss/Disruption stressors and children reported high levels of these stressors, children reported higher levels of Time 2 PTS symptoms, b = -.72 (.33), p = .03.Overall, levels of mother-child response agreement were low. Discrepancies in mother and child reports predicted higher levels of child PTS symptoms. Clinicians may want to query both parents and children about their disaster experiences when working with families postdisaster.",0,0 +6481,Pharmaceutical Opioid Use and Dependence among People Living with Chronic Pain: Associations Observed within the Pain and Opioids in Treatment (POINT) Cohort,"There is increasing concern about the appropriateness of prescribing pharmaceutical opioids for chronic non-cancer pain (CNCP), given the risks of problematic use and dependence. This article examines pharmaceutical opioid dose and dependence and examines the correlates of each.Baseline data were obtained from a national sample of 1,424 people across Australia (median 58 years, 55% female and experiencing pain for a median of 10 years), who had been prescribed opioids for CNCP. Current opioid consumption was estimated in oral morphine equivalent (OME; mg per day), and ICD-10 pharmaceutical opioid dependence was assessed using the Composite International Diagnostic Interview.Current opioid consumption varied widely: 8.8% were taking <20 mg OME per day, 52.1% were taking 21-90 mg OME, 24.3% were taking 91-199 mg OME, and 14.8% were taking >= 200 mg OME. Greater daily OME consumption was associated with higher odds of multiple physical and mental health issues, aberrant opioid use, problems associated with opioid medication and opioid dependence. A significant minority, 8.5%, met criteria for lifetime ICD-10 pharmaceutical opioid dependence and 4.7% met criteria for past year ICD-10 pharmaceutical opioid dependence. Multivariate analysis found past-year dependence was independently associated with being younger, exhibiting more aberrant behaviors and having a history of benzodiazepine dependence.In this population of people taking opioids for CNCP, consumption of higher doses was associated with increased risk of problematic behaviors, and was more likely among people with a complex profile of physical and mental health problems.",0,0 +6482,"Disasters, Victimization, and Children’s Mental Health","In a representative sample of 2,030 U.S. children aged 2–17, 13.9% report lifetime exposure to disaster, and 4.1% report experiencing a disaster in the past year. Disaster exposure was associated with some forms of victimization and adversity. Victimization was associated with depression among 2- to 9-year-old disaster survivors, and with depression and aggression among 10- to 17-year-old disaster survivors. Children exposed to either victimization only or both disaster and victimization had worse mental health compared to those who experienced neither. More research into the prevalence and effects of disasters and other stressful events among children is needed to better understand the interactive risks for and effects of multiple forms of trauma.",0,0 +6483,Simple versus complex PTSD: A cluster analytic investigation,"A cluster analytic investigation was conducted on measures of PTSD associated features (e.g., personality pathology, dissociative tendencies) to investigate whether empirically-defined clusters correspond to Herman's [1992, Complex PTSD: a syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress, 5, 377-391; 1997, Trauma and recovery (Rev. ed.). New York: Basic Books] distinction between simple and complex PTSD. Results from a sample of 60 PTSD patients were broadly consistent with this distinction, although some inconsistencies were observed. Treatment outcome generally did not differ between the two clusters. Implications for classifying and treating PTSD are discussed.",0,0 +6484,Clustering of symptoms of mental disorder in the medium-term following conflict: An epidemiological study in Timor-Leste,"It is important to define subpopulations with mental health and psychosocial reactions in the medium-term following conflict to ensure that an appropriate array of services are provided to meet the diversity of needs. We conducted a latent class analysis (LCA) on epidemiological data drawn from an urban and rural sample of 1221 adults (581 men and 640 women, response 82%) in post-conflict Timor Leste 4 years after the cessation of violence. The prevalence of PTSD was 4.9%; severe distress 4.8%; anger attacks 38.3%; and paranoid-like symptoms 10.9%. The best fitting LCA yielded three classes comprising those with no or minimal symptoms (86%), a class with anger-paranoia (13%) and a comorbid mental disorder class (1.5%) characterized by PTSD (100%) and severe distress (98%). The comorbid mental disorder class had an over-representation of men, the unemployed, residents in the urban area and persons with the greatest exposure to human rights trauma, murder and health stress. The anger-paranoia class experienced moderate levels of trauma and had an over-representation of urban dwellers, women, and those with higher levels of education. The analysis assists in clarifying the populations with mental disorder and adverse psychosocial reactions in need of intervention in the medium-term following conflict.",0,0 +6485,"Psychiatric disorders in patients with psychogenic non-epileptic seizures, with and without comorbid epilepsy","The aim of this study is to describe similarities and differences in epidemiological, psychiatric and semiologic variables between patients with psychogenic none epileptic seizures (PNES) and comorbid epilepsy (mixed PNES), and patients with PNES without comorbid epilepsy (pure PNES).Forty-three patients with PNES diagnosed by Video-EEG were included. Twenty-four had pure PNES, and ninteen mixed PNES. Female population, age, duration of PNES, psychiatric institutionalization, psychopharmacotherapy, dissociative disorders and posttraumatic stress disorder (PTSD), were significantly higher in the pure PNES patients. Suicide attempts, antiepileptic therapy, conversive, affective and personality disorders were frequent in both groups. In the analysis of seizure semiology, the total lack of responsiveness was significantly higher in the mixed PNES group.Pure PNES patients showed similarities and differences in the psychiatric profile, with a greater prevalence of dissociative disorders and PTSD, factors related to psychiatric severity.",0,0 +6486,Post-Traumatic Stress Disorder (PTSD) Symptoms Predict Delay to Hospital in Patients with Acute Coronary Syndrome,"Increased delay to hospital presentation with acute coronary syndrome (ACS) is associated with poor outcomes. While demographic factors associated with this delay have been well described, scarce data are available on the role of modifiable factors, such as psychosocial disorders, on pre-hospital delay. Patients with symptoms of post-traumatic stress disorder (PTSD) often avoid stressful situations and may delay presenting for care when they experience cardiac symptoms. It is unknown, however, whether PTSD symptoms negatively impact the time to presentation during an ACS.We assessed the relationship between PTSD symptoms and pre-hospital delay in 241 adults with an ACS in the ongoing Prescription Use, Lifestyle, Stress Evaluation (PULSE) study.Overall, 66% of patients were male; 40% were Hispanic or Latino. The mean age was 61.9±11.6 years old. PTSD symptoms were present in 17.8% of patients. Pre-hospital delay was longer for patients with PTSD symptoms compared to those without [geometric mean: 25.8 hours (95% CI 13.8-44.8) vs. 10.7 hours (95% CI 8.3-13.8)]; P = 0.005. After multivariable adjustment for age, sex, ethnicity, depression, left ventricular ejection fraction and history of myocardial infarction, the mean pre-hospital delay was 173% (95% CI: 36%-450%) longer for patients with versus without PTSD symptoms.Among patients presenting with an ACS, PTSD symptoms were independently associated with longer pre-hospital delays. Future studies of pre-hospital delay should examine the mechanisms underlying this association.",0,0 +6487,Facets of pejorative self-processing in complicated grief.,"Complicated grief (CG) has been proposed as a psychiatric response to bereavement distinct from established mood and anxiety disorder diagnoses. Little is known about the nature of cognitive-affective processing in CG, nor any similarities or differences compared with the processing profiles associated with other emotional disorders. Three studies therefore investigated 3 broad facets of negative self-processing associated with either elevated symptoms of, or diagnosis of, CG--namely, self-related attributions or blame, self-devaluation, and cognitions about the future self.These self-processing domains were assessed using a variety of self-report and scenario-based measures either linked specifically to the bereavement or more general in their focus. Study 1 used a correlational design in a community bereaved sample. Study 2 employed an extreme-groups approach looking at individuals high versus low in CG symptoms, and Study 3 compared those with a CG diagnosis to healthy bereaved controls.The data revealed a profile of processing in CG characterized by significant relationships between CG symptoms or diagnosis and both self-devaluation and negative self-related cognitions about the future, but the data provided no support for a similar relationship with negative self-related attributions.These findings extend our understanding of self-related cognitive processing in CG. They also suggest that CG is characterized by a cognitive-affective processing profile that is distinct from that associated with other disorders, notably major depression, in the literature. This has potential implications for the psychological treatment of CG and for its nosological status as a post-loss syndrome distinct from depression.",0,0 +6488,Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after Hurricane Katrina.,"On the basis of theory and previous research, it was hypothesized that predisaster child trait anxiety would predict disaster-related posttraumatic stress symptoms and generalized anxiety disorder symptoms, even after controlling for the number of hurricane exposure events. Results support this hypothesis and further indicate that predisaster negative affect predicted disaster-related posttraumatic stress symptoms and generalized anxiety disorder symptoms. Also, Katrina-related posttraumatic stress disorder symptoms were predicted by the number of hurricane exposure events and sex (being female). Predisaster generalized anxiety disorder symptoms predicted postdisaster generalized anxiety disorder symptoms, and predisaster trait anxiety predicted postdisaster depressive symptoms. Findings are discussed in terms of their relevance for developing interventions to mitigate the impact of disasters in youths.",0,0 +6489,Piecewise Linear–Linear Latent Growth Mixture Models With Unknown Knots,"Latent growth curve models with piecewise functions are flexible and useful analytic models for investigating individual behaviors that exhibit distinct phases of development in observed variables. As an extension of this framework, this study considers a piecewise linear–linear latent growth mixture model (LGMM) for describing segmented change of individual behavior over time where the data come from a mixture of two or more unobserved subpopulations (i.e., latent classes). Thus, the focus of this article is to illustrate the practical utility of piecewise linear–linear LGMM and then to demonstrate how this model could be fit as one of many alternatives—including the more conventional LGMMs with functions such as linear and quadratic. To carry out this study, data ( N = 214) obtained from a procedural learning task research were used to fit the three alternative LGMMs: (a) a two-class LGMM using a linear function, (b) a two-class LGMM using a quadratic function, and (c) a two-class LGMM using a piecewise linear–linear function, where the time of transition from one phase to another (i.e., knot) is not known a priori, and thus is a parameter to be estimated.",0,0 +6490,‘Traumatisers or traumatised’: Trauma experiences and personality characteristics of Australian prisoners,"Post-traumatic stress disorder (PTSD) is over represented in the prisoner population and is predictive of violence and suicide. This raises issues in relation to prisoner management, as well as theoretical issues such as why there is a range of vulnerability for PTSD. The current study examines the relationship between PTSD and personality profiles of prisoners.Data from 1305 participants in the NSW survey of health in prisoners are examined to identify relationships between personality profiles derived from the Temperament and Character Inventory (TCI) and PTSD. Participants are grouped as experiencing no trauma; with a trauma history but no PTSD; and being diagnosed with PTSD. A logistic regression modelled significant predictors of PTSD. These data indicated that women prisoners report PTSD at twice the rate of males. An increased risk for PTSD is associated with high Harm Avoidance, low Self-Directedness, high Persistence and high Self-Transcendence.A combination of both temperament and character traits influences the trajectory towards PTSD development. Targeted treatment of these traits is needed in addressing the problems of prisoners with PTSD and managing the associated risks of violence and suicide.",0,0 +6491,"Mental Health, Social Functioning, and Disability in Postwar Afghanistan","More than 2 decades of conflict have led to widespread human suffering and population displacement in Afghanistan. In 2002, the Centers for Disease Control and Prevention and other collaborating partners performed a national population-based mental health survey in Afghanistan.To provide national estimates of mental health status of the disabled (any restriction or lack of ability to perform an activity in the manner considered normal for a human being) and nondisabled Afghan population aged at least 15 years.A national multistage, cluster, population-based mental health survey of 799 adult household members (699 nondisabled and 100 disabled respondents) aged 15 years or older conducted from July to September 2002. Fifty district-level clusters were selected based on probability proportional to size sampling. One village was randomly selected in each cluster and 15 households were randomly selected in each village, yielding 750 households.Demographics, social functioning as measured by selected questions from the Medical Outcomes Study 36-Item Short-Form Health Survey, depressive symptoms measured by the Hopkins Symptoms Checklist-25, trauma events and symptoms of posttraumatic stress disorder (PTSD) measured by the Harvard Trauma Questionnaire, and culture-specific symptoms of mental illness and coping mechanisms.A total of 407 respondents (62.0%) reported experiencing at least 4 trauma events during the previous 10 years. The most common trauma events experienced by the respondents were lack of food and water (56.1%) for nondisabled persons and lack of shelter (69.7%) for disabled persons. The prevalence of respondents with symptoms of depression was 67.7% (95% confidence interval [CI], 54.6%-80.7%) and 71.7% (95% CI, 65.0%-78.4%), and symptoms of anxiety 72.2% (95% CI, 63.8%-80.7%) and 84.6% (95% CI, 74.1%-95.0%) for nondisabled and disabled respondents, respectively. The prevalence of symptoms of PTSD was similar for both groups (nondisabled, 42.1%; 95% CI, 34.2%-50.1%; and disabled, 42.2%; 95% CI, 29.2%-55.2%). Women had significantly poorer mental health status than men did. Respondents who were disabled had significantly lower social functioning and poorer mental health status than those who were nondisabled. Feelings of hatred were high (84% of nondisabled and 81% of disabled respondents). Coping mechanisms included religious and spiritual practices; focusing on basic needs, such as higher income, better housing, and more food; and seeking medical assistance.In this nationally representative survey of Afghans, prevalence rates of symptoms of depression, anxiety, and PTSD were high. These data underscore the need for donors and health care planners to address the current lack of mental health care resources, facilities, and trained mental health care professionals in Afghanistan.",0,0 +6492,Perceived Safety in Disaster Workers Following 9/11,"The perception of being safe, perceived safety, is an important component of health and the ability to work after exposure to traumatic events of all kinds. The relationship of perceived safety to posttraumatic stress disorder and depression has rarely been examined. This study examined symptoms of posttraumatic stress disorder, depression, and perceived safety in disaster workers 2 weeks after the 9/11 terrorist attacks. Perceived safety was lower in those with greater exposure (e.g., those who felt they were in physical danger, worked with dead bodies, or witnessed someone being killed or seriously injured). Lower perceived safety was associated with greater symptoms of intrusion and hyperarousal but not avoidance. Safety was negatively correlated with depression and peritraumatic dissociation. Lowered perceptions of safety following terrorist events have implications for social and work-related behaviors that can affect long-term health, morale, and productivity in disaster workers and other first responders.",0,0 +6493,Mefloquine and psychotomimetics share neurotransmitter receptor and transporter interactions in vitro,"RationaleMefloquine is used for the prevention and treatment of chloroquine-resistant malaria, but its use is associated with nightmares, hallucinations, and exacerbation of symptoms of post-traumatic stress disorder. We hypothesized that potential mechanisms of action for the adverse psychotropic effects of mefloquine resemble those of other known psychotomimetics.ObjectivesUsing in vitro radioligand binding and functional assays, we examined the interaction of (+)- and (−)-mefloquine enantiomers, the non-psychotomimetic anti-malarial agent, chloroquine, and several hallucinogens and psychostimulants with recombinant human neurotransmitter receptors and transporters.ResultsHallucinogens and mefloquine bound stereoselectively and with relatively high affinity (K i = 0.71–341 nM) to serotonin (5-HT) 2A but not 5-HT1A or 5-HT2C receptors. Mefloquine but not chloroquine was a partial 5-HT2A agonist and a full 5-HT2C agonist, stimulating inositol phosphate accumulation, with similar potency and efficacy as the hallucinogen dimethyltryptamine (DMT). 5-HT receptor antagonists blocked mefloquine’s effects. Mefloquine had low or no affinity for dopamine D1, D2, D3, and D4.4 receptors, or dopamine and norepinephrine transporters. However, mefloquine was a very low potency antagonist at the D3 receptor and mefloquine but not chloroquine or hallucinogens blocked [3H]5-HT uptake by the 5-HT transporter.ConclusionsMefloquine, but not chloroquine, shares an in vitro receptor interaction profile with some hallucinogens and this neurochemistry may be relevant to the adverse neuropsychiatric effects associated with mefloquine use by a small percentage of patients. Additionally, evaluating interactions with this panel of receptors and transporters may be useful for characterizing effects of other psychotropic drugs and for avoiding psychotomimetic effects for new pharmacotherapies, including antimalarial quinolines.",0,0 +6494,Late-life adaptation in the aftermath of extreme stress.,,0,0 +6495,"Children's Coping Assistance: How Parents, Teachers, and Friends Help Children Cope After a Natural Disaster","Investigated the construct of coping assistance, defined as actions taken by significant others to help children cope with stressful events, in the aftermath of Hurricane Andrew. The Children's Coping Assistance Checklist (CCAC) was developed to assess three types of coping assistance (Emotional Processing, Roles and Routines, and Distraction) from three sources (Parents, Teachers, and Friends). The CCAC and measures of children's social support, coping, and posttraumatic stress disorder (PTSD) symptomatology were administered to 506 third through fifth graders 7 months after Hurricane Andrew. Roles and Routines coping assistance was reported most frequently, followed by Distraction and Emotional Processing. Coping assistance from parents and friends was reported more frequently than from teachers. Third graders reported significantly more Emotional Processing from parents and friends than fourth and fifth graders; no sex effects were found. As expected, children with more severe levels of PTSD symptomato...",0,0 +6496,The Post-Accident Syndrome: Variations in the Clinical Picture,"Three hundred and twenty-seven subjects involved in civil accident litigation and referred by solicitors for either plaintiff or defendant were examined. A precise psychiatric diagnosis was applicable in only a minority of subjects, although psychiatric symptoms, including pain, anxiety and depression, were prominent. Overall the clinical picture was an amorphous one. Cluster analysis was performed to examine a variety of clinical, demographic and historical variables. This showed four stable groups, which are here described as: stoic, depressive, phobic motor accident and prior claimants. It is suggested that the phenomenological approach taken here, paying particular attention to clinical sub-groups, may be a more useful route towards the understanding and treatment of post-accident psychiatric disturbance than is the existing but confused approach, in which motivation has been a prime focus of interest. The particular sub-groups demonstrated here, if replicated, could form the basis for such an approach.",0,0 +6497,Decreased regional cerebral blood flow in medial prefrontal cortex during trauma-unrelated stressful imagery in Vietnam veterans with post-traumatic stress disorder.,"Neuroimaging research has demonstrated medial prefrontal cortex (mPFC) hyporesponsivity and amygdala hyperresponsivity to trauma-related or emotional stimuli in post-traumatic stress disorder (PTSD). Relatively few studies have examined brain responses to the recollection of stressful, but trauma-unrelated, personal events in PTSD. In the current study, we sought to determine whether regional cerebral blood flow (rCBF) abnormalities in mPFC and amygdala in PTSD could be observed during the recollection of trauma-unrelated stressful personal events.Participants were 35 right-handed male combat veterans (MCVs) and female nurse veterans (FNVs) who served in Vietnam: 17 (seven male, 10 female) with current military-related PTSD and 18 (nine male, nine female) with no current or lifetime PTSD. We used positron emission tomography (PET) and script-driven imagery to study rCBF during the recollection of trauma-unrelated stressful versus neutral and traumatic events.Voxelwise tests revealed significant between-group differences for the trauma-unrelated stressful versus neutral comparison in mPFC, specifically in the anterior cingulate cortex (ACC). Functional region of interest (ROI) analyses demonstrated that this interaction in mPFC represented greater rCBF decreases in the PTSD group during trauma-unrelated stressful imagery relative to neutral imagery compared to the non-PTSD group. No differential amygdala activation was observed between groups or in either group separately.Veterans with PTSD, compared to those without PTSD, exhibited decreased rCBF in mPFC during mental imagery of trauma-unrelated stressful personal experiences. Functional neuroanatomical models of PTSD must account for diminished mPFC responses that extend to emotional stimuli, including stressful personal experiences that are not directly related to PTSD.",0,0 +6498,"Neighborhood Effects on Heat Deaths: Social and Environmental Predictors of Vulnerability in Maricopa County, Arizona","Background: Most heat-related deaths occur in cities, and future trends in global climate change and urbanization may amplify this trend. Understanding how neighborhoods affect heat mortality fills an important gap between studies of individual susceptibility to heat and broadly comparative studies of temperature–mortality relationships in cities.Objectives: We estimated neighborhood effects of population characteristics and built and natural environments on deaths due to heat exposure in Maricopa County, Arizona (2000–2008).Methods: We used 2000 U.S. Census data and remotely sensed vegetation and land surface temperature to construct indicators of neighborhood vulnerability and a geographic information system to map vulnerability and residential addresses of persons who died from heat exposure in 2,081 census block groups. Binary logistic regression and spatial analysis were used to associate deaths with neighborhoods.Results: Neighborhood scores on three factors—socioeconomic vulnerability, elderly/isolation, and unvegetated area—varied widely throughout the study area. The preferred model (based on fit and parsimony) for predicting the odds of one or more deaths from heat exposure within a census block group included the first two factors and surface temperature in residential neighborhoods, holding population size constant. Spatial analysis identified clusters of neighborhoods with the highest heat vulnerability scores. A large proportion of deaths occurred among people, including homeless persons, who lived in the inner cores of the largest cities and along an industrial corridor.Conclusions: Place-based indicators of vulnerability complement analyses of person-level heat risk factors. Surface temperature might be used in Maricopa County to identify the most heat-vulnerable neighborhoods, but more attention to the socioecological complexities of climate adaptation is needed.",0,0 +6499,Accounting for comorbidity in assessing the burden of epilepsy among US adults: results from the National Comorbidity Survey Replication (NCS-R),"Although epilepsy is associated with substantial role impairment, it is also highly comorbid with other physical and mental disorders, making unclear the extent to which impairments associated with epilepsy are actually due to comorbidities. This issue was explored in the National Comorbidity Survey Replication (NCS-R), a nationally representative household survey of 5692 US adults. Medically recognized epilepsy was ascertained with self-report, comorbid physical disorders with a chronic conditions checklist, and comorbid DSM-IV mental disorders with the Composite International Diagnostic Interview. Lifetime epilepsy prevalence was estimated at 1.8%. Epilepsy was comorbid with numerous neurological and general medical conditions and with a sporadic cluster of mental comorbidities (panic, PTSD, conduct disorder and substance use disorders). Although comorbid disorders explain part of the significant gross associations of epilepsy with impairment, epilepsy remains significantly associated with work disability, cognitive impairment and days of role impairment after controlling comorbidities. The net association of epilepsy with days of role impairment after controlling for comorbidities is equivalent to an annualized 89.4 million excess role impairment days among US adults with epilepsy, arguing that role impairment is a major component of the societal costs of epilepsy per se rather than merely due to disorders comorbid with epilepsy. This estimated burden is likely conservative as some parts of the effects of epilepsy are presumably mediated by secondary comorbid disorders.",0,0 +6500,Persistent mental health disturbances during the 10 years after a disaster: Four-wave longitudinal comparative study,"Although some studies have examined the long-term effects of disasters, very little is known about severe persistent symptoms following disasters. The aim of the present study was to examine persistent mental health problems and to what extent disaster exposure predicts long-term persistent disturbances.Following a major disaster, a four-wave study was conducted (surveys 2-3 weeks, 18 months, 4 years and 10 years after the event) that examined severe post-traumatic stress disorder (PTSD) symptomatology (Impact of Event Scale), anxiety and depression symptoms and sleeping problems (Symptom Check List-90-R), and use of physician-prescribed tranquilizers. Participants were affected adult Dutch native residents (n = 1083). At wave 2 and 3, a control group participated (n = 694). At wave 1, severity of disaster exposure was examined. Multiple imputation was used to target the problem of missing data across surveys due to non-response such as in the fourth wave (61%).In total, 6.7% (95% confidence interval [CI]: 5.1-8.2) developed persistent PTSD symptoms during the 10 years after the event. For anxiety, depression, sleeping problems these prevalences were 3.8% (95%CI: 2.7-5.0), 6.2% (95%CI: 4.7-7.6) and 4.8% (95%CI: 3.5-6.1) respectively. In total 1.3% (95%CI: 0.6-2.0) used tranquilizers at all waves. Approximately one out of 10 with severe symptoms 2-3 weeks after the event, developed persistent symptoms. Even in the long term, affected residents compared to controls had more often chronic anxiety symptoms and sleeping problems. High disaster exposure independently predicted persistent PTSD symptoms (adjusted odds ratio [adj. OR], 4.20; 95%CI: 2.02-8.74, P < 0.001), anxiety (adj. OR, 3.43; 95%CI: 1.28-9.20, P < 0.01), depression symptoms (adj. OR, 2.95; 95%CI: 1.26-6.93, P < 0.01), and sleeping problems (adj. OR, 3.74; 95%CI: 1.56-8.95, P < 0.001).Post-disaster mental health care should (also) target persistent mental health disturbances in the long term, especially PTSD, anxiety, depression symptoms, and sleeping problems. High disaster exposure may be an early marker for risk of persistent symptoms.",0,0 +6501,Borderline personality disorder as seen from an attachment perspective: a review,"There is increasing evidence that both borderline personality disorder and PTSD can be partly understood as damage to the attachment system. Research on primates has shown how severe are the effects of a damaged attachment system. Distress symptoms produced by separation are similar to those seen in narcotic withdrawal and involve aggressive behaviour. Chronic stress in children can cause dysregulation of the normal stress response and maladaptive brain activities. Secure, avoidant, anxious-ambivalent attachment in childhood can now be measured. Insecure children show needless aggression; avoidant children can become either abusers or victims. Disorganized attachment is a mixture of avoidant and anxious-ambivalent behaviour and may lead to adult borderline personality disorder. Patterns of attachment are self-perpetuating and may be transmitted across generations. PTSD is a syndrome resulting from a terrifying state of helplessness. Its manifestations are similar to those seen with disorganized attachment behaviours. Individuals can appear to cut themselves off from memories and feelings that are too painful to acknowledge. As a result trauma can become organized at a sensory and somatic level which is difficult to change. PTSD appears to alter neurophysiology and neuroanatomy. Traumatogenic stimuli may produce abnormal brain activity and, for example, an inability to speak. ‘Flips’ of mental state have been recorded both in patients who have been through childhood abuse and in borderline patients. The goal of treatment for borderline personality disorder should include the integration of dissociated self-states. Copyright © 1999 Whurr Publishers Ltd.",0,0 +6502,Gender differences in bipolar disorder type I and II,"We investigated gender differences in bipolar disorder (BD) type I and II in a representative cohort of secondary care psychiatric in- and out-patients.In the prospective, naturalistic Jorvi Bipolar Study of 191 secondary care psychiatric in- and out-patients, 160 patients (85.1%) could be followed up for 18 months with a life chart.After adjusting for confounders, no marked differences in illness-related characteristics were found. However, female patients with BD had more lifetime comorbid eating disorders (P < 0.001, OR = 5.99, 95% CI 2.12-16.93) but less substance use disorders (P < 0.001, OR = 0.29, 95% CI 0.16-0.56) than males. Median time to recurrence after remission was 3.1 months longer among men than women, female gender carrying a higher hazard of recurrence (P = 0.006, HR = 2.00, 95% CI 1.22-3.27).Men and women with type I and II BD have fairly similar illness-related clinical characteristics, but their profile of comorbid disorders may differ significantly, particularly regarding substance use and eating disorders. In medium-term follow-up, females appear to have a higher hazard of recurrence than males.",0,0 +6503,Temporal analysis of heart rate variability as a predictor of post traumatic stress disorder in road traffic accidents survivors,"Road Traffic Accidents (RTA) are most probably the leading cause of post traumatic stress disorder (PTSD) in developed countries. The autonomic nervous system (ANS) disturbances, due to psychological trauma, are part of the pathophysiology of PTSD. The aim of the present study was to determine whether early heart rate variability (HRV) measurement, a biomarker of the ANS function, could act as a predictor of PTSD development after a RTA.We prospectively investigated 35 survivors of RTA with both physical injury and psychological trauma. HRV data were obtained from 24-h Holter ECG monitoring, which was performed on the second day after the accident. Time domain analysis was applied to the inter-beat (RR) interval time series to calculate the various parameters of HRV. PTSD status was assessed 2 and 6 months after RTA.There was a global diminution of HRV measurements in the PTSD group at both 2 and 6 months. The variability index was the best predictor of PTSD with the area under the receiveroperating curve for discriminating PTSD at 6 months at 0.92 (95% CI: 0.785; 1.046). A cut-off at 2.19% yielded a sensitivity of 85.7% and a specificity of 81.8% for PTSD. Positive and negative predictive values were respectively 75% and 90%. However, initial heart rate (HR) data were relevant at 2 months but not at 6 months.RTA survivors exhibiting lower parasympathetic modulation of HR, indexed by temporal analysis of HRV, are more susceptible to developing PTSD as a short and long-term outcome.",0,0 +6504,The Performance of Post-Traumatic Stress Disorder Subjects in Verbal and Visual False Memory Tasks,"Introduction: The current study investigated verbal and visual false memories among post-traumatic stress disorder sufferers. Methods: This causal-comparative study recruited 20 patients suffering from PTSD according to the DSMIV-TR criteria, and 20 non-PTSD subjects who involved in the same trauma of PTSD as well as 20 normal subjects who were matched for age, sex, and socio-economic status. The instruments included Beck Depression Inventory, Beck Anxiety Inventory, Impact of Event Scale, WIAS (short version), plus the Visual and Verbal False Memory Tasks prepared according to Deese-Roediger-McDermott's (DRM) paradigm. Obtained data were analyzed using the analysis of variance (ANOVA) and Tukey's post-hoc test. Results: Our findings indicated that PTSD patients produced more false memories (both verbal and visual) than non-PTSD and healthy control subjects in both tasks. Conclusion: Such findings are interpretable within the framework of the cognitive theories of PTSD and other memory deficits of PTSD patients. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0,0 +6505,Trauma and bereavement:,"The intersection between trauma and bereavement has only recently been explored. Prior studies of bereavement have often neglected to measure posttraumatic stress disorder (PTSD) symptoms; the few that have offer equivocal findings concerning the role of PTSD symptomatology following loss. Few studies have explored the relationship between PTSD and the other psychological sequelae more commonly associated with loss. The current investigation assessed PTSD symptoms over time following the death of a spouse, using violence and the suddenness of the loss as potential outcome predictors. In addition, the relationship between PTSD and depression symptoms was assessed. Violent death predicted PTSD symptoms and the persistence of depression over time. The suddenness of the loss was not related to PTSD symptoms. This investigation suggests that violent death results in development of PTSD symptoms over and above the normal grief response and thus, may contribute to a more severe grief response.",0,0 +6506,Are Specific Emotion Regulation Strategies Differentially Associated with Posttraumatic Growth Versus Stress?,"Extremely few studies have examined emotion regulation strategies as predictors of posttraumatic growth (PTG). This study aimed to examine several specific emotion regulation strategies, along with meaning making, as predictors of PTG, as opposed to posttraumatic distress. Participants were 107 adult women who had experienced a very stressful or traumatic event within the past 3 years and completed questionnaires measuring emotion regulation, meaning making, distress, and PTG. Emotion suppression positively predicted distress, but not PTG. Meaning making positively predicted PTG and negatively predicted distress. Bootstrapped mediation models showed that emotional processing has a significant indirect effect on PTG and distress through its effect on meaning making. Results indicate that researchers should pay closer attention to emotional processes involved in etiological models of PTG. It might also be helpful to examine specific emotion regulation strategies, as these can point to ways to help people na...",0,0 +6507,Predicting posttraumatic stress symptoms in children following Hurricane Katrina: A prospective analysis of the effect of parental distress and parenting practices,en,0,0 +6508,Post Traumatic Stress Disorder: Psychobiological mechanisms of traumatic remembrance.,"(from the chapter) synthesize the findings from preclinical investigations of learning and memory processes and the neurochemical effects of stress with clinical studies of posttraumatic stress disorder (PTSD) to develop a set of hypotheses related to the role of traumatic remembrance in the pathogenesis and treatment of PTSD / discuss the possible mechanisms underlying memory distortion that occurs in PTSD patients / adopted a cognitive neuroscience perspective that assumed that the features of traumatic memories and dissociative states in PTSD are properties of the underlying neural and psychodynamic networks mediating these functions neural mechanisms of learning and memory: relevance to the reexperiencing symptoms of PTSD [fear conditioning, a possible failure of extinction in PTSD, behavioral sensitization and stress sensitivity in PTSD] / altered memory functions in PTSD [dissociation, declarative memory, encoding of traumatic memories, factors related to traumatic memory recall] / assessment and treatment of PTSD-related memory disturbances (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6509,Abnormalities in whole-brain functional connectivity observed in treatment-naive post-traumatic stress disorder patients following an earthquake,"Background Convergent studies have highlighted the dysfunction of the amygdala, prefrontal cortex and hippocampus in post-traumatic stress disorder (PTSD). However, only a few studies have investigated the functional connectivity between brain regions in PTSD patients during the resting state, which may improve our understanding of the neuropathophysiology of PTSD. The aim of this study was to investigate patterns of whole-brain functional connectivity in treatment-naive PTSD patients without co-morbid conditions who experienced the 8.0-magnitude earthquake in the Sichuan province of China. Method A total of 72 PTSD patients and 86 trauma-exposed non-PTSD controls participated in the resting-state functional magnetic resonance imaging study. All these subjects were recruited from the disaster zone of the 2008 Sichuan earthquake. Functional connectivities between 90 paired brain regions in PTSD patients were compared with those in trauma-exposed non-PTSD controls. Furthermore, Pearson correlation analysis was performed between significantly abnormal connectivities in PTSD patients and their clinician-administered PTSD scale (CAPS) scores. Results Compared with non-PTSD controls, PTSD patients showed weaker positive connectivities between the middle prefrontal cortex (mPFC) and the amygdala, hippocampus, parahippocampal gyrus and rectus, as well as between the inferior orbitofrontal cortex and the hippocampus. In addition, PTSD patients showed stronger negative connectivity between the posterior cingulate cortex (PCC) and the insula. The CAPS scores in PTSD patients correlated negatively with the connectivity between the amygdala and the mPFC. Conclusions PTSD patients showed abnormalities in whole-brain functional connectivity, primarily affecting the connectivities between the mPFC and limbic system, and connectivity between the PCC and insula.",0,0 +6510,Cerebral blood flow changes during retrieval of traumatic memories before and after psychotherapy: a SPECT study,"ABSTRACT Background Traumatic memory is a key symptom in psychological trauma victims and may remain vivid for several years. Psychotherapy has shown that neither the psychopathological signs of trauma nor the expression of traumatic memories are static over time. However, few studies have investigated the neural substrates of psychotherapy-related symptom changes. Method We studied 16 subthreshold post-traumatic stress disorder (PTSD) subjects by using a script-driven symptom provocation paradigm adapted for single photon emission computed tomography (SPECT) that was read aloud during traumatic memory retrieval both before and after exposure-based and cognitive restructuring therapy. Their neural activity levels were compared with a control group comprising 11 waiting-list subthreshold PTSD patients, who were age- and profile-matched with the psychotherapy group. Results Significantly higher activity was observed in the parietal lobes, left hippocampus, thalamus and left prefrontal cortex during memory retrieval after psychotherapy. Positive correlations were found between activity changes in the left prefrontal cortex and left thalamus, and also between the left prefrontal cortex and left parietal lobe. Conclusions Neural mechanisms involved in subthreshold PTSD may share neural similarities with those underlying the fragmented and non-verbal nature of traumatic memories in full PTSD. Moreover, psychotherapy may influence the development of a narrative pattern overlaying the declarative memory neural substrates.",0,0 +6511,A Clinical Approach to the Pharmacotherapy of Aggression in Children and Adolescents,"Overt aggression in its various forms is the most prevalent symptom presenting to pediatric mental health providers, regardless of setting. It is a behavior with a heterogeneous etiology and requires a comprehensive approach to evaluation and treatment. Evaluation of the aggressive child must assess medical, neurologic, psychiatric, psychosocial, familial, and/or educational contributions to behavioral dyscontrol. Multimodal treatment is generally required. At present, there is no single medication to recommend for the treatment of aggressive behavior. Multiple medications have clinically been used in a nonspecific fashion to target excessive childhood aggression. Although successful for some, this approach increases risk for ineffective interventions accompanied by side effects. Until a scientific understanding of the developmental neurobiology of aggression leads to more specific treatment, this review suggests the use of a diagnostic-based approach to the pharmacology of aggression (FIG. 1). Descriptive diagnostic techniques should be used to define the presence of any primary or comorbid psychiatric disorder that presents with aggression as an associated symptom. Treating aggression in the context of these psychiatric syndromes appears to be the most direct approach. Aggression occurring in the context of a medication-responsive psychiatric diagnosis appears most sensitive to pharmacologic intervention. Presently, evidence for efficacy is strongest for aggression in the context of ADHD, psychotic disorder, adolescent-onset bipolar disorder, and ictal aggression It remains less clear that medication can help aggression when it occurs independently of a pharmacologically treatable comorbid psychiatric disorder. Aggression may respond to a target symptom approach where discrete behavioral symptoms that contribute to aggression, such as irritability, explosiveness, fear, or impulsivity, may be modified by medication intervention (FIG. 1). When treatment is approached in this fashion, it is standard practice to use the least toxic and safest intervention first. Behavioral treatment based on contingency management principles could be initially recommended. Medication trials should first use medications that have demonstrated empiric efficacy in reducing aggression (TABLE 1) and that have a favorable safety profile. Neuroleptics to treat aggression in nonpsychotic psychiatrically referred youth should be kept to a minimum, secondary to their significant adverse risk profile. Alternative medications, such as selective serotonin reuptake-inhibiting antidepressants, buspirone, lithium, anticonvulsants, opiate blocking agents, propranolol, nadolol, and clonidine, deserve more clinical research in pediatric aggression. These medications may offer effective and less toxic alternatives in the pharmacologic treatment of inappropriate excessive childhood aggression.",0,0 +6512,Genetics of Posttraumatic Stress Disorder,"ABSTRACT Posttraumatic stress disorder (PTSD) is a prevalent anxiety disorder marked by behavioral, physiologic, and hormonal alterations. PTSD is disabling and commonly follows a chronic course. The etiology of PTSD is unknown, although exposure to a traumatic event constitutes a necessary, but not sufficient, factor. A twin study of Vietnam veterans has shown significant genetic contribution to PTSD. The fact that PTSD's underlying genotypic vulnerability is only expressed following trauma exposure limits the usefulness of family-based linkage approaches. In contrast to the other major psychiatric disorders, large studies for the search of underlying genes have not been described in PTSD to date. Complementary approaches for locating involved genes include association-based studies employing case-control or parental genotypes for transmission dysequilibrium analysis and quantitative trait loci studies in animal models. Identification of susceptibility genes will increase our understanding of traumatic stress disorders and help to elucidate their molecular basis. The current review provides an up-to-date outline of progress in the field of PTSD.",0,0 +6513,The Relationship between Body Mass Index and Mental Health Among Iraq and Afghanistan Veterans,"ABSTRACT BACKGROUND Obesity is a growing public health concern and is becoming an epidemic among veterans in the post-deployment period. OBJECTIVE To explore the relationship between body mass index (BMI) and posttraumatic stress disorder (PTSD) in a large cohort of Iraq and Afghanistan veterans, and to evaluate trajectories of change in BMI over 3 years. DESIGN Retrospective, longitudinal cohort analysis of veterans’ health records PARTICIPANTS A total of 496,722 veterans (59,790 female and 436,932 male veterans) whose height and weight were recorded at the Department of Veterans Affairs (VA) healthcare system at least once after the end of their last deployment and whose first post-deployment outpatient encounter at the VA was at least 1 year prior to the end of the study period (December 31, 2011). MAIN MEASURES BMI, mental health diagnoses. KEY RESULTS Seventy-five percent of Iraq and Afghanistan veterans were either overweight or obese at baseline. Four trajectories were observed: “stable overweight” represented the largest class; followed by “stable obese;” “overweight/obese gaining;” and “obese losing.” During the 3-year ascertainment period, those with PTSD and depression in particular were at the greatest risk of being either obese without weight loss or overweight or obese and continuing to gain weight. Adjustment for demographics and antipsychotic medication attenuated the relationship between BMI and certain mental health diagnoses. Although BMI trajectories were similar in men and women, some gender differences were observed. For example, the risk of being in the persistently obese class in men was highest for those with PTSD, whereas for women, the risk was highest among those with depression. CONCLUSIONS The growing number of overweight or obese returning veterans is a concerning problem for clinicians who work with these patients. Successful intervention to reduce the prevalence of obesity will require integrated efforts from primary care and mental health to treat underlying mental health causes and assist with engagement in weight loss programs.",0,0 +6514,A Prospective Study of Depression Following Combat Deployment in Support of the Wars in Iraq and Afghanistan,"Objective. We investigated relations between deployment and new-onset depression among US service members recently deployed to the wars in Iraq and Afghanistan. Methods. We included 40 219 Millennium Cohort Study participants who completed baseline and follow-up questionnaires and met inclusion criteria. Participants were identified with depression if they met the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire criteria for depression at follow-up, but not at baseline. Results. Deployed men and women with combat exposures had the highest onset of depression, followed by those not deployed and those deployed without combat exposures. Combat-deployed men and women were at increased risk for new-onset depression compared with nondeployed men and women (men: adjusted odds ratio [AOR] = 1.32; 95% confidence interval [CI] = 1.13, 1.54; women: AOR = 2.13; 95% CI = 1.70, 2.65). Conversely, deployment without combat exposures led to decreased risk for new-onset depression compared with those who did not deploy (men: AOR = 0.66; 95% CI = 0.53, 0.83; women: AOR = 0.65; 95% CI = 0.47, 0.89). Conclusions. Deployment with combat exposures is a risk factor for new-onset depression among US service members. Post-deployment screening may be beneficial for US service members exposed to combat.",0,0 +6515,Rates and symptoms of PTSD among cocaine-dependent patients.,"This study evaluated lifetime traumatic events and current posttraumatic stress disorder (PTSD) symptoms in a substance abuse sample.Participants in the study consisted of 558 (75.1% male) cocaine-dependent individuals who completed self-report measures of trauma and PTSD symptoms prior to entry into treatment.Results showed a high number of lifetime traumatic events, even among those without PTSD. General disaster was the most prevalent. Current PTSD was found in 10.9% of the participants, with a significantly higher rate among women (21.6%) than among men (7.2%). For those with PTSD, the most prominent PTSD symptom cluster was arousal, and the most common symptoms were restricted affect, detachment and irritability. Participants with PTSD endorsed a large number of symptoms, almost double that needed to meet diagnostic criteria; however, neither number of traumas nor type of trauma was associated with their level of PTSD symptoms. Even among those not meeting PTSD criteria, subthreshold symptoms were found, with avoidance the most prominent cluster. Sociodemographic and recent cocaine use variables did not differentiate the PTSD from non-PTSD groups.PTSD is present in a sizeable percentage of cocaine-dependent treatment-seeking patients, particularly women. Clinicians might address arousal symptoms in particular, which were the most prominent symptom cluster, and which may be exacerbated by cocaine use. Even among those without PTSD, lifetime trauma is substantial and subthreshold PTSD symptoms are common. Vulnerability to PTSD needs further study, as sociodemographic and cocaine use variables did not distinguish between PTSD and non-PTSD groups.",0,0 +6516,Post-Traumatic Stress Disorder,"

Abstract

Since the start of the wars in Afghanistan and Iraq, the U.S. military has implemented several population-based initiatives to enhance psychological resilience and prevent psychological morbidity in troops. The largest of these initiatives is the Army's Comprehensive Soldier Fitness (CSF) program, which has been disseminated to more than 1 million soldiers. However, to date, CSF has not been independently and objectively reviewed, and the degree to which it successfully promotes adaptive outcomes and prevents the development of deployment-related mental health disorders such as post-traumatic stress disorder (PTSD) is uncertain. This paper critically evaluates the theoretic foundation for and evidence supporting the use of CSF.",0,0 +6517,"Personality, Social Context and Cognitive Predictors of Post-Traumatic Stress Disorder in Myocardial Infarction Patients","The study investigated the relationship between two personality factors (alexithymia and negative affect), social support, the immediate cognitive and emotional response (importance, degree of emotional response, dissociation, fear) to a myocardial infarction and the frequency of post-traumatic stress disorder (PTSD) symptoms three months following a myocardial infarction (MI). Seventy five of eighty nine consecutive hospital admissions completed questionnaires both in hospital and three months subsequently. The study found a PTSD prevalence rate of sixteen percent three months following MI. There was a moderate reduction of intrusive memories of the MI and anxiety symptoms over time and a non-significant reduction in avoidance phenomena. Depressive symptoms did not reduce over time. Significant associations were found between PTSD symptoms at three months and initial intrusion and avoidance symptoms, negative affect, absence of confidant support, dissociation, fright and surprise. The percentage of the v...",0,0 +6518,"Relationships between impact on employment, working conditions, socio-occupational categories and symptoms of post-traumatic stress disorder after the industrial disaster in Toulouse, France","Objectives: The aims of this paper were (1) to analyze the prevalence of symptoms of post-traumatic stress disorder (S-PTSD) in a population of workers 1 year after an industrial disaster; and (2) to assess the role of factors of vulnerability such as the occupational impact of a disaster and economic conditions. Methods: A cross-sectional survey assessing the relationships between socio-occupational category, impact on employment and S-PTSD was conducted by the self-administered impact of event scale-revised. Results: The prevalence of S-PTSD in workers in the peripheral zone (<3 km around the explosion site) was 12% in men and 18% in women. Factors significantly associated with S-PTSD in men were non-managerial socio-occupational category: employees (ORa = 4.3; [2.3; 7.8]), factory workers/laborers (ORa = 3.7; [1.8; 7.6]), intermediate professions (ORa = 3.3; [1.9; 5.9]), and artisans (ORa = 3; [1.3; 7.7]); and layoff (ORa = 2.6; [1.5; 4.5]) or unusable workplace after the explosion (ORa = 1.8; [1.1; 2.8]). In women, factors significantly associated with S-PTSD were the socio-occupational categories of employees and factory workers (ORa = 2.2; [1.4; 3.5]), artisans (ORa = 2.7; [1.3; 5.7]) and intermediate professions, (ORa = 1.5; [1; 2.3]) and reporting of an occupational accident (ORa = 1.5; [1.1; 2.2]). Conclusion: Impact on the workplace and socioeconomic conditions were associated with S-PTSD. The epidemiological approach in disaster situations needs to be improved, particularly in the social and occupational dimension when economically active populations are involved. Vulnerable subgroups, defined by occupational impact and low socioeconomic category, should be taken into account. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +6519,"Hypnotizability, pain threshold, and dissociative experiences","There may be an association between pain threshold, hypnotizability, and dissociative experiences. The purpose of the present study was to examine this association.Forty-one healthy subjects were included in the study. Pain thresholds were determined using a manual algometer. The Dissociative Experiences Scale was administered to all subjects. Hypnotizability of the subjects was assessed by the eye roll sign of the Hypnotic Induction Profile. There were 14, 15, and 12 subjects in the Grade 1, 2, and 3 groups, respectively.Highly hypnotizable subjects had lower pain thresholds and were more likely to report dissociative experiences than the less hypnotizable subjects.There is an association between pain threshold, hypnotizability, and dissociative experiences. It may be suggested that dissociative and somatic symptoms may be integrally linked and related to hypnotic suggestibility.",0,0 +6520,Are We Winning the War Against Posttraumatic Stress Disorder?,"The most methodologically rigorous epidemiological study on American military personnel deployed to Iraq and Afghanistan found that 4.3% of troops developed posttraumatic stress disorder (PTSD). Among deployed combatants, 7.6% developed PTSD, whereas 1.4% of deployed noncombatants did so. The U.S. Department of Veterans Affairs has launched a program ensuring that all veterans with PTSD will receive evidence-based cognitive-behavioral therapy, and the Army has developed Battlemind postdeployment early interventions that reduce risk for the disorder.",0,0 +6521,Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders–Fifth Edition (PCL-5) in veterans.,"This study examined the psychometric properties of the posttraumatic stress disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5; Weathers, Litz, et al., 2013b) in 2 independent samples of veterans receiving care at a Veterans Affairs Medical Center (N = 468). A subsample of these participants (n = 140) was used to define a valid diagnostic cutoff score for the instrument using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5; Weathers, Blake, et al., 2013) as the reference standard. The PCL-5 test scores demonstrated good internal consistency (α = .96), test-retest reliability (r = .84), and convergent and discriminant validity. Consistent with previous studies (Armour et al., 2015; Liu et al., 2014), confirmatory factor analysis revealed that the data were best explained by a 6-factor anhedonia model and a 7-factor hybrid model. Signal detection analyses using the CAPS-5 revealed that PCL-5 scores of 31 to 33 were optimally efficient for diagnosing PTSD (κ(.5) = .58). Overall, the findings suggest that the PCL-5 is a psychometrically sound instrument that can be used effectively with veterans. Further, by determining a valid cutoff score using the CAPS-5, the PCL-5 can now be used to identify veterans with probable PTSD. However, findings also suggest the need for research to evaluate cluster structure of DSM-5. (PsycINFO Database Record",0,0 +6522,"Psychological Symptoms in Older Adults Following Natural Disaster: Nature, Timing, Duration, and Course","Using a prospective design with five follow-up intervals, the study addressed questions regarding the timing of onset, duration, course, and nature of psychological reaction to natural disaster. As participants in a statewide panel study, more than 200 older adults were interviewed both before and after two distinct floods occurred in southeastern Kentucky in 1981 and 1984. Exposure to these incidents, which differed in overall intensity, was assessed at both the individual and community levels. Personal loss was associated with short-term increases in negative affect, limited to one year postflood. Longer-term effects were more dependent on the level of community destruction. Exposure to high levels of community destruction was related to decreased positive affect up to two years postdisaster, whereas exposure to high levels of both community destruction and personal loss was predictive of increased negative affect for two years.",0,0 +6523,Complex partial epileptic signs as a continuum from normals to epileptics: Normative data and clinical populations,"Over a 10-year period, a total of 447 men and 624 women between 18 and 61 years of age were administered an inventory whose items describe experiences that are similar to those evoked by electrical stimulation of the temporal lobes. Empirically determined factors contained experiences of sensory enhancement, affective-dissociation, ego alien intrusions, and literary emphasis. Using this population as a reference, T scores for these clusters were calculated for special normal populations (poets, drama students, false pregnancies) and for clinical groups (post-traumatic stress, anxiety-depersonalization, exotic dissociations, and complex partial epilepsy). Whereas only mild elevations (50 < T < 65) in indicators of temporal lobe signs and symptoms were noted in the special groups, moderate (65 < T < 75) and severe (T > 79) elevations were noted in the clinical populations.",0,0 +6524,Chronic PTSD in Vietnam combat veterans: course of illness and substance abuse,"The purpose of this study was to measure the longitudinal course of specific symptoms of posttraumatic stress disorder (PTSD) and related symptoms of alcohol and substance abuse and the effects of alcohol and substances on the symptoms of PTSD.A structured interview for the assessment of PTSD and alcohol and substance abuse, as well as other factors such as life stressors and treatment, was administered to 61 Vietnam combat veterans with PTSD.Onset of symptoms typically occurred at the time of exposure to combat trauma in Vietnam and increased rapidly during the first few years after the war. Symptoms plateaued within a few years after the war, following which the disorder became chronic and unremitting. Hyperarousal symptoms such as feeling on guard and feeling easily startled developed first, followed by avoidant symptoms and finally by symptoms from the intrusive cluster. The onset of alcohol and substance abuse typically was associated with the onset of symptoms of PTSD, and the increase in use paralleled the increase of symptoms. Patients reported a tendency for alcohol, marijuana, heroin, and benzodiazepines to make PTSD symptoms better, while cocaine made symptoms in the hyperarousal category worse. There was no relationship between treatment interventions and the natural course of PTSD.These findings suggest that symptoms of PTSD begin soon after exposure to trauma, that hyperarousal symptoms are the first symptoms to occur, that the natural course of alcohol and substance abuse parallels that of PTSD, and that specific substances have specific effects on PTSD symptoms.",0,0 +6525,A 6-Year Follow-up Study of Cambodian Refugee Adolescents Traumatized as Children,"Seventy-three percent of a sample of 46 Cambodian youth interviewed in 1984 and 1987 were reinterviewed in 1990 as part of a pretest for a multisite study of Cambodian refugee trauma now under way. An additional sample of convenience of 38 youth were also interviewed to determine reliability and validity of the diagnostic instruments chosen for the larger study. The DSM-III-R diagnosis of post-traumatic stress disorder (PTSD) was found to persist, but the symptoms appeared less intense over time. In contrast, the prevalence of depression dropped markedly since 1987. Subjects remained largely free of comorbid conditions. Diagnostic reliability and validity were satisfactory. The follow-up sample appeared to be functioning well despite their PTSD profiles. The findings are discussed in light of several current controversies surrounding the concept and measurement of PTSD.",0,0 +6526,Sex differences in recovery from PTSD in male and female interpersonal assault survivors,"Men and women differ in exposure to trauma and the development of posttraumatic stress disorder (PTSD); however, research regarding sex differences in recovery from PTSD has been sparse. This study evaluated the treatment response trajectory for 69 male and female interpersonal assault survivors, using a modified Cognitive Processing Therapy (CPT) protocol that allowed survivors to receive up to18 sessions of CPT, with treatment end determined by therapy progress. Few sex differences were observed in trauma history, baseline PTSD and depressive severity, Axis I comorbidity, anger, guilt and dissociation. Women did report more sexual assault in adulthood and elevated baseline guilt cognitions, whereas men reported more baseline anger directed inward. Attrition and total number of sessions did not differ by sex. Over the course of treatment and follow-up, men and women demonstrated similar rates of change in PTSD and depressive symptoms. However, medium effect sizes on both of these primary outcomes at the 3-month follow-up assessment favored women. Several differences in the slope of change emerged on secondary outcomes such that women evidenced more rapid gains on global guilt, guilt cognitions, anger/irritability, and dissociation. Results suggest that male survivors may warrant additional attention to address these important clinical correlates.",0,0 +6527,Trends of Elevated PTSD Risk in Firefighters Exposed to the World Trade Center Disaster: 2001–2005,"Objectives. We identified trends in the prevalence of elevated posttraumatic stress disorder (PTSD) risk as determined by the Fire Department of the City of New York (FDNY)-modified PTSD Checklist in World Trade Center (WTC)-exposed firefighters. We also examined trends in relation to WTC exposure, social support, change in recreational activities, and functional health. Methods. We analyzed 16,826 questionnaires from 10,074 firefighters in yearly intervals, from September 12, 2001, to September 11, 2005. Results. The prevalence of elevated PTSD risk increased over time, from 9.8% in year 1 to 10.6% in year 4 ( p<0.0001). Earliest arrival at the WTC site (odds ratio [OR] = 6.0; 95% confidence interval [CI] 4.4, 8.3), prolonged work at the site (OR=2.0; 95% CI 1.8, 2.3), providing supervision without previous supervisory experience (OR=4.1; 95% CI 2.8, 6.1), and retirement due to a WTC-related disability (OR=1.3; 95% CI 1.1, 1.5) were associated with ever having elevated PTSD risk. Difficulty functioning at home was strongly associated with elevated PTSD risk (ORs ranged from 17.0 [95% CI 14.5, 20.0] in year 1 to 26.7 [95% CI 20.3, 35.2] in year 3), as was difficulty functioning at work (ORs ranged from 12.1 [95% CI 10.2, 14.2] in year 1 to 23.0 [95% CI 14.6, 36.3] in year 2). Conclusions. Elevated PTSD risk was associated with exposure to the WTC site as well as functional impairment, and remained largely unabated during the first four years of the study. Screening for elevated PTSD risk may be useful in identifying those who could benefit from interventions during long-term follow-up, as well as in the immediate aftermath of disasters.",0,0 +6528,"Psychiatric disorders, trauma, and MMPI profile in a Spanish sample of nonepileptic seizure patients","The aim of this study was to examine clinical characteristics in patients with psychogenic nonepileptic seizures and to analyze the Minnesota Multiphasic Personality Inventory (MMPI) profiles and their relation to psychopathology. Thirty patients with nonepileptic seizures confirmed through video-electroencephalography were included. A structured clinical interview (Structured Clinical Interview for DSM-III-R), a measure of personality variables (MMPI), and several structured interviews designed for collecting data on clinical and personal history were administered. Descriptive and comparative statistical methods were used. Of the sample, 67.7% met criteria for two or more simultaneous Axis I diagnoses, and 60% for an Axis II personality disorder. The most frequently elevated scales of the MMPI were Schizophrenia and Depression. There were multiple scale elevations in 12 profiles, the 91.7% of which had elevated ""neurotic"" and ""psychotic"" scales. The subgroup with personality disorders showed higher scores on the MMPI Paranoia and Hypomania scales, and the subgroup with traumatic experiences showed higher scores on the MMPI Hypomania scale. Our sample comprising patients with nonepileptic seizures showed a significant degree of psychopathology and absence of a unique character substrate. According to grades of clinical severity of pseudoseizures, several subgroups and different therapeutic implications may be defined.",0,0 +6529,Serotonin 5-HT1A Agonists,"In 1980, buspirone was found to have anxiolytic potential. This finding initiated the development of the azapirones — highly serotonin 5-HT1A agonists. The balance of evidence suggests that the azapirones act as partial agonists postsynaptically, but as full agonists presynaptically in the dorsal raphé. This review focuses mainly on agents for which there are published clinical trial data. Numerous studies have shown that buspirone, gepirone and ipsapirone are as effective as the benzodiazepines in the treatment of generalised anxiety. However, they have a slower onset of action. The azapirones have a completely different adverse reaction profile (dizziness and gastric complaints) compared with the benzodiazepines (sedation, memory loss and withdrawal dependency). Several controlled studies have shown that the azapirones are effective in depression, particularly of the melancholic type. They have an adverse effects profile similar to, but less severe than, the selective serotonin reuptake inhibitors and different to that of the tricyclic antidepressants. Buspirone has not yet proven to be effective in panic disorder. However, gepirone, ipsapirone and other azapirones may be more effective in this disorder. Early studies indicate promising results for buspirone in the treatment of obsessive-compulsive disorder. Clinical trials in alcoholism are equivocal. Further studies of this class of drugs in the treatment of social phobia, post-traumatic stress disorder, premenstrual syndrome, and compulsive and aggressive disorders are in progress. A principle drawback with this class of drug is their short half-life. However, sustained release preparations are being developed. © 1994, Adis International Limited. All rights reserved.",0,0 +6530,Posttraumatic stress disorder after childbirth: A cross sectional study,"The prevalence of having a posttraumatic stress disorder (PTSD) profile after childbirth and women's cognitive appraisal of the childbirth were studied cross sectionally in an unselected sample of all women who had given birth over a 1-year period in Linköping, Sweden. The PTSD profile was assessed by means of Traumatic Event Scale (TES), which is based on diagnostic criteria from Diagnostic and Statistical Manual of Mental Disorders , fourth edition ( DSM-IV ; American Psychiatric Association, 1994). The women's cognitive appraisal of the childbirth was measured by means of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ). Twenty-eight women (1.7%) of 1640 met criteria for a PTSD profile related to the recent delivery. A PTSD profile was related to a history of having received psychiatric/psychological counseling, a negative cognitive appraisal of the past delivery, mulliparity, and rating the contact with delivery staff in negative terms.",0,0 +6531,Ontogeny of dreaming: A review of empirical studies,"The examination of children's sleep-related mental experiences presents many significant challenges for researchers investigating the developmental trajectories of human dreaming. In contrast to the well-explored developmental patterns of human sleep, data from dream research are strikingly divergent with highly ambiguous results and conclusions, even though there is plenty of indirect evidence suggesting parallel patterns of development between neural maturation and dreaming. Thus results from studies of children's dreaming are of essential importance not only to enlighten us on the nature and role of dreaming but to also add to our knowledge of consciousness and cognitive and emotional development. This review summarizes research results related to the ontogeny of dreaming: we critically reconsider the field, systematically compare the findings based on different methodologies, and highlight the advantages and disadvantages of methods, arguing in favor of methodological pluralism. Since most contradictory results emerge in connection with descriptive as well as content related characteristics of young children's dreams, we emphasize the importance of carefully selected dream collection methods. In contrast nightmare-related studies yield surprisingly convergent results, thus providing strong basis for inferences about the connections between dreaming and cognitive emotional functioning. Potential directions for dream research are discussed, aiming to explore the as yet unraveled correlations between the maturation of neural organization, sleep architecture and dreaming patterns.",0,0 +6532,The Norwegian version of the PTSD Checklist (PCL): Construct validity in a community sample of 2004 tsunami survivors,"The PTSD Checklist (PCL) is a widely used self-administered measure of post-traumatic stress disorder (PTSD) and it has been validated in a variety of languages and cultures.Evaluate the diagnostic validity of the Norwegian version of a specific PCL (PCL-S) for detecting PTSD in epidemiological research.Participants were severely exposed Norwegian survivors from the 2004 South-East Asian tsunami. Of 75 individuals asked to participate, 63 responded (84%). PTSD was assessed by PCL-S and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). These instruments were compared to evaluate the diagnostic validity of the PCL. We used two different scoring methods to diagnose PTSD based on PCL. The first method was based on the dichotomized sum score (cut-off ≥ 50) and the second was based on the flowchart method following DSM-IV symptom criteria. Area under the curve (AUC), Cohen's kappa, sensitivity and specificity were used to evaluate the agreement between the PCL and SCID-I.According to the clinical interview, 11.3% of the participants met the diagnostic criteria for PTSD. The two scoring methods of PCL-S revealed similar results: according to both methods, 14.5% were categorized with PTSD. AUC was 0.98 (95% CI 0.93-1.00). For Cohen's kappa, the agreement was 0.71. Sensitivity was 0.86 and specificity 0.95. Agreement between PCL and SCID-I investigated for each of the three symptom clusters of PTSD and for the 17 individual items showed mostly a moderate to substantial agreement.The Norwegian version of the PCL-S performed well as a diagnostic instrument for detecting PTSD in epidemiological research.",0,0 +6533,Military Social Work: Opportunities and Challenges for Social Work Education,"Military social work is a specialized field of practice spanning the micro-macro continuum and requiring advanced social work knowledge and skills. The complex behavioral health problems and service needs of Iraq and Afghanistan veterans highlight the need for highly trained social work professionals who can provide militarily-relevant and culturally-responsive evidence-informed services. Responding to the military behavioral health workforce and service needs of recently returned veterans presents both opportunities and challenges for military social work education. This article discusses the rationale for a military social work specialization, the need for military social work education, and opportunities and challenges for social work education. An integrated model of intellectual capital is proposed to guide strategic planning for future military social work education.",0,0 +6534,Epigenetic Modification of the Glucocorticoid Receptor Gene Is Linked to Traumatic Memory and Post-Traumatic Stress Disorder Risk in Genocide Survivors,"Recent evidence suggests that altered expression and epigenetic modification of the glucocorticoid receptor gene (NR3C1) are related to the risk of post-traumatic stress disorder (PTSD). The underlying mechanisms, however, remain unknown. Because glucocorticoid receptor signaling is known to regulate emotional memory processes, particularly in men, epigenetic modifications of NR3C1 might affect the strength of traumatic memories. Here, we found that increased DNA methylation at the NGFI-A (nerve growth factor-induced protein A) binding site of the NR3C1 promoter was associated with less intrusive memory of the traumatic event and reduced PTSD risk in male, but not female survivors of the Rwandan genocide. NR3C1 methylation was not significantly related to hyperarousal or avoidance symptoms. We further investigated the relationship between NR3C1 methylation and memory functions in a neuroimaging study in healthy subjects. Increased NR3C1 methylation-which was associated with lower NR3C1 expression-was related to reduced picture recognition in male, but not female subjects. Furthermore, we found methylation-dependent differences in recognition memory-related brain activity in men. Together, these findings indicate that an epigenetic modification of the glucocorticoid receptor gene promoter is linked to interindividual and gender-specific differences in memory functions and PTSD risk.",0,0 +6535,The role of psychosocial factors in the course of pain—a 1-year follow-up study among women living in Sweden,"The understanding of the associations between psychosocial factors and persistent pain and their impact on the course of pain among women is crucial to identify risk populations and prevent long-term pain from developing. The aim of the study was to investigate the course of pain among women and the psychosocial factors associated with it. The study was a 1-year follow-up (FU) among 2,300 women in the general population of Sweden. Sociodemographic and psychosocial factors were analyzed in relation to the course of pain, assessed as the presence of pain during the last 3 months at baseline (BL) and at FU. Thirty-three percent of the women with no pain at BL and 77% of those with pain at BL reported pain at FU. Compared to the pain-free women, those who developed pain at FU reported lower social support and physical quality of life (QoL) and worse mental health. Women with sustained pain were older and reported worse mental health, lack of social support, and lower levels of QoL compared to those who recovered from pain. In the multiple logistic regression analyses, only post-traumatic stress symptoms were associated with the development of pain at FU. Number of pain locations and pain duration at BL and physical QoL were associated with sustained pain. Moreover, social support was identified as a protective factor against sustained pain. Pain is persistent or recurrent in a general female population. The results indicate that psychosocial factors do not work as primary predictors in the course of pain and might be better understood through indirect processes by limiting the individual's resources for handling pain in a functional manner.",0,0 +6536,Stability in Cognitive Function Over 18 Years: Prevalence and Predictors among Older Mexican Americans,"Numerous studies have examined the association of physical, behavioral and social factors with cognitive decline in older adults. Less attention has been placed on factors associated with long-term maintenance of intact cognition even into very old age. A greater understanding of those factors can inform the development of activities for maintaining cognitive strength.Using a sample from the Hispanic Established Populations for Epidemiologic Study of the Elderly, a population-based study of non-institutionalized Mexican Americans aged 65 and older from five Southwestern states (N = 2767), latent class mixture models were developed to identify subgroups of cognitive change over time.Three distinct trajectories of cognitive change were identified and characterized as stable, slow decline and rapid decline. Compared to the rapid decline group, a higher proportion of the stable cognition group were women, had high school education, were married and attended church one or more times per week. Regular church attendance had a significant positive impact in the stable group (β = 0.64, p <0.01), the slow decline group (β = 0.84, p <0.001) and the rapid decline group (β = 2.50, p <0.001). Activity limitations had a consistently negative association with cognition in the stable, slow decline and rapid decline groups (β = -0.37, p <0.001; β = -0.85, p <0.001; and β = -1.58, p <0.001 respectively).Substantial heterogeneity exists in rates of cognitive decline among older Mexican Americans. Interventions targeting cognitive maintenance may benefit from increased focus on factors associated with continued social engagement.",0,0 +6537,Morphine Use after Combat Injury in Iraq and Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) is a common adverse mental health outcome among seriously injured civilians and military personnel who are survivors of trauma. Pharmacotherapy in the aftermath of serious physical injury or exposure to traumatic events may be effective for the secondary prevention of PTSD.We identified 696 injured U.S. military personnel without serious traumatic brain injury from the Navy-Marine Corps Combat Trauma Registry Expeditionary Medical Encounter Database. Complete data on medications administered were available for all personnel selected. The diagnosis of PTSD was obtained from the Career History Archival Medical and Personnel System and verified in a review of medical records.Among the 696 patients studied, 243 received a diagnosis of PTSD and 453 did not. The use of morphine during early resuscitation and trauma care was significantly associated with a lower risk of PTSD after injury. Among the patients in whom PTSD developed, 61% received morphine; among those in whom PTSD did not develop, 76% received morphine (odds ratio, 0.47; P<0.001). This association remained significant after adjustment for injury severity, age, mechanism of injury, status with respect to amputation, and selected injury-related clinical factors.Our findings suggest that the use of morphine during trauma care may reduce the risk of subsequent development of PTSD after serious injury.",0,0 +6538,Blood Lactate and Heat Stress during Training in Rowers,"The purpose of the present study was to test the hypothesis that large increases in blood lactate concentration ([La] (b)) and/or body temperature may occur during an endurance training on a rowing ergometer and disrupt training. The influence of an increase in air convection on the capacity to perform a prolonged exercise was also explored. Ten trained oarsmen were asked to undergo twice, in control (C) and increased air ventilation (AV) conditions, two 30-min trainings on a rowing ergometer at a work rate corresponding to 2.5 mmol . L (-1) of [La] (b) determined during a previous incremental exercise (P (2.5)). Four subjects did not complete the training session in C despite a steady state in [La] (b) in two of them. In these four subjects, the end of the exercise was associated with the highest measured rectal temperatures (T (re), 39.4 +/- 0.1 degrees C) and rate of perceived exertion (RPE, 17.8 +/- 0.3). Regarding the six other subjects, their heart rate, oxygen uptake, RPE, T (re) and water loss values were lower (p < 0.05) in AV than in C. [La] (b) displayed the same profile in C and AV. This study suggests that i) high body temperature may constitute a significant factor of perceived exertion and disrupt indoor training session, and ii) capacity to perform an endurance training on a rowing ergometer was improved by increasing air convection.",0,0 +6539,The effect of persistent posttraumatic stress disorder symptoms on executive functions in preadolescent children witnessing a single incident of death,"We compared executive functions (EFs) of traumatized preadolescent children with and without marked posttraumatic stress disorder (PTSD) symptoms to the performance of a nontraumatized control group, and examined the relationships between EF deficits and functional status in traumatized preadolescent children. Fifty-one preadolescent children who had witnessed a death at school 30 months prior (26 with marked PTSD symptoms and 25 without) and 30 healthy controls who had not been traumatized participated. EFs were examined using the Comprehensive Attention Test (CAT). The functional state of traumatized children was measured by the Parent Report Form-Children's Health and Illness Profile-Children's Edition (PRF-CHIP-CE). The traumatized children, regardless of status of PTSD symptomatology, showed poorer working memory performance than nontraumatized healthy controls. The traumatized children with marked PTSD symptoms performed more poorly on measures of interference control compared to those children without marked PTSD symptoms. Lower levels of EFs were associated with lower risk avoidance and diminished academic achievement in traumatized children. These results indicate that an inhibitory control deficit is specifically associated with the current PTSD symptoms but not with trauma exposure per se.",0,0 +6540,Trauma and posttraumatic stress in users of the Anxiety Disorders Association of America Web site,"The Web site for the Anxiety Disorders Association of America (ADAA) receives more than 5 million visits per month and thus represents a unique medium for the study of anxiety disorders. ADAA Web site users from October 2002 to January 2003 were invited to complete a survey oriented toward trauma history and psychiatric sequelae. A diagnostic approximation of posttraumatic stress disorder (PTSD) was based on responses to the Trauma Questionnaire, the Davidson Trauma Scale, and questions about impairment. The Connor-Davidson Resilience Scale was also used. Variables were tested for their association with PTSD. Among 1558 participants, 87% had a history of trauma, and 38% had current PTSD. The population was comprised predominantly of white middle-class women, half of whom were married. More than 90% were first-time users of the site. Factors associated with PTSD included death of, or harm to, a loved one; personal history of incest, rape, or physical abuse; lower age; lower income; unemployment; missed work; increased medical care; dissatisfaction with psychotropic medication; depressive symptoms; and lower resilience. In this selective convenience sample, there were high rates of traumatization and PTSD. The demographics of this group are similar to those seen in previously studied populations that had contacted the ADAA. Furthermore, the factors associated with PTSD were like those in many community surveys. The ADAA Web site has the opportunity to benefit large numbers of highly distressed individuals.",0,0 +6541,Assessing the longitudinal course of depression and economic integration of south-east Asian refugees: an application of latent growth curve analysis,"This paper has both methodological and substantive application for mental-health researchers. Methodologically, it presents the latent growth curve (LGC) technique within a structural equation modelling (SEM) framework as a powerful tool to analyse change in depressive symptoms and potential correlates of such changes. The rationale for LGC analysis and subsequent elaboration of this statistical approach are presented. The limitations of traditional analytical methods are also addressed. Substantively, the paper considers socio-contextual factors as correlates of change in symptoms, and examines the dynamic systematic relationship with the degree of economic integration of south-east Asian immigrants in Canada over time. Using the LGC technique, this study also investigated how the longitudinal course of subclinical depression places individuals at risk for developing full-blown major depression. The LGC results provided strong evidence for the reciprocal influence between economic integration and subclinical depression of immigrants. The initial level of economic integration negatively influenced the rate of change in subclinical depression whereas the initial level of subclinical depression negatively influenced the rate of change in economic integration. Both initial level and the rate of change in subclinical depression placed individuals at risk for full-blown major depression. However, traditional auto-regressive models were not capable of revealing these dynamic associations. Thus, an investigation of within-individual change in symptoms and potential correlates of such changes is necessary to understand the process that results in full-blown mental disorder.",0,0 +6542,The economic consequences of post-traumatic stress disorder in clients of Veterans Affairs Canada,"Historically, post-traumatic stress disorder (PTSD) was questioned in regard to the ""reality"" of the clinical disorder. Largely during the post-Vietnam era, medical legitimacy pushed an agenda to study the condition, and contemporary interests shifted to cost-effective and effacious treatment identification. Although a priority for mental health, clinical approaches to care are not the only need for individuals who face diagnosis. I explore financial consequences of post-traumatic stress disorder in clients of Veterans Affairs Canada (VAC) to more specifically identify the economic vulnerabilities of veterans in an attempt to inform policy development. As a chronic condition, PTSD requires management over broad periods of time, often outside of the medical complex. Furthermore, a growing number of veterans are young and in search of gainful civilian employment, yet at risk of disrupted work lives as a result of their mental health status. This certainly carries implications for economic well-being. To better understand the relationship between PTSD and economic standing, I build upon current literature to develop two statistical analyses. The first project focuses on describing the relationship between PTSD and income and perceptions of financial security. This sample is marked with health disadvantage at the outset, through connection with VAC services. However, findings illustrate that PTSD holds significant association with economic well-being when other risk factors (including comorbidities) are controlled. This analysis informs caregivers (both medical and non-medical) about the importance of PTSD as a unique health problem with socioeconomic risk among veterans. The second analytic design assesses the specific symptom clusters of post-traumatic stress disorder as they relate to financial outcomes. Specifically, veterans experience symptoms of PTSD without meeting the clinical requirements for diagnosis, thus being left untreated. However, the findings illustrate that symptom clusters of PTSD maintain significant (and distinctive) relationships with various economic outcomes. This supports contemporary psychometric assessments that suggest the diagnostic criteria for PTSD require conceptual revisions. A reconfiguration of diagnostic criteria is supported in confirmatory factor analysis of my sample. I link these findings to targeted policy suggestions for VAC in regard to outreach for veterans with subclinical, yet meaningful, symptoms of post-traumatic stress. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +6543,Main and Interactive Effects of Anxiety Sensitivity and Physical Distress Intolerance with Regard to PTSD Symptoms Among Trauma-Exposed Smokers,"The present study examined the roles of anxiety sensitivity (AS; the tendency to misinterpret physical internal sensations of harmful) and distress tolerance (the capacity to tolerate aversive stimuli) in terms of the expression of posttraumatic stress disorder (PTSD) symptoms among a sample of trauma-exposed, treatment-seeking tobacco smokers (n = 137; Mage = 37.7 years, 48.2% female). It was hypothesized that higher AS and lower physical distress tolerance would interact to predict greater PTSD avoidance and hyperarousal symptoms. Results were partially consistent with this prediction. Specifically, there was a significant interactive effect of AS by physical distress tolerance in terms of PTSD hyperarousal symptom cluster severity. The form of the interaction was in the expected direction, with the highest levels of PTSD hyperarousal symptoms reported among smokers with higher levels of AS and a lower capacity to tolerate physical distress. Findings underscore the importance of considering AS and physical distress tolerance in terms of better understanding mechanisms underlying the expression of PTSD symptoms among trauma-exposed smokers.",0,0 +6544,Severity of injury does not have any impact on posttraumatic stress symptoms in severely injured patients,"Due to improved surgical techniques and more efficient decision making in treating severely injured patients, survival rates have increased over the years. This study was initiated to evaluate the incidence and identify risk factors for developing posttraumatic stress symptoms, using both extensive trauma-related data and data assessing the psychological trauma, in a population of severely injured patients.79 patients admitted to the Department of Multitrauma and Spinal Cord Injury at Sunnaas Rehabilitation Hospital from 2003 to 2005, prospectively completed semistructured psychological interviews and questionnaires, such as Impact of Event Scale-Revised. In addition, extensive injury-related data, such as injury severity score (ISS), new injury severity score (NISS), and probability of survival (PS) were collected.39% had multiple trauma, 34% had multiple injuries including spinal cord injuries, and 27% had isolated spinal cord injuries. Mean NISS was 31.5 (S.D. 13.7). 6% met diagnostic criteria for posttraumatic stress disorder (PTSD) and 9% met the criteria for subsyndromal PTSD. Injury-related data did not influence the prevalence of posttraumatic stress symptoms, however, some psychosocial variables did have a significant impact.We found a low incidence of PTSD and subsyndromal PTSD. No significant differences were found between the patients suffering from posttraumatic stress symptoms and the non-symptoms group in relation to injury-related data such as ISS/NISS, PS, or multiple trauma versus spinal cord injury. The most evident risk factors for developing posttraumatic stress symptoms were symptoms of anxiety, female gender and negative attitudes toward emotional expression.",0,0 +6545,Survivors of the Piper Alpha oil platform disaster: long-term follow-up study,"The long-term psychological effects of surviving a major disaster are poorly understood. We undertook a survey of survivors of the Piper Alpha oil platform disaster (1988).To examine the role of factors relating to the trauma, the survivors and the survivors' circumstances.Ten years after the disaster, 78% (46/59) of the survivors were located, of whom 72% (33/46) agreed to be interviewed. A further three individuals completed postal measures.The most stringent diagnostic criteria for post-traumatic stress disorder (PTSD) were met by 21% (7/33) of the survivors over 10 years after the disaster. Features such as physical injury, personal experience and survivor guilt were associated with significantly higher levels of post-traumatic symptoms.A narrow definition of factors affecting outcome will limit the potential for improving survivor well-being in the long-term after major disasters. Specific symptoms that are not included in the criteria for the diagnosis of PTSD, together with issues such as re-employment, need to be addressed.",0,0 +6546,"The Effects of Age, Gender, Hopelessness, and Exposure to Violence on Sleep Disorder Symptoms and Daytime Sleepiness Among Adolescents in Impoverished Neighborhoods","Although sleep problems are associated with negative outcomes among adolescents, studies have not focused on sleep disorder symptoms among adolescents living in impoverished neighborhoods and how sleep problems may be related to two factors common in those environments: hopelessness and exposure to violence. This study used data from the longitudinal Mobile Youth Survey (MYS; N = 11,838, 49 % female, 93 % African-American) to examine trajectories of sleep problems by age (10-18 years) among impoverished adolescents as a function of gender, feelings of hopelessness, and exposure to violence. The results indicate that sleep problems associated with traumatic stress decline with age, with four notable distinctions. First, the steepest decline occurs during the early adolescent years. Second, the rate of decline is steeper for males than for females. Third, exposure to violence impedes the rate of decline for all adolescents, but more dramatically for females than for males. Fourth, the rate of decline is smallest for adolescents with feelings of hopelessness who also had been exposed to violence. To explore the generalizability of these results to other types of sleep disorders, we analyzed cross-sectional data collected from a subsample of 14- and 15-year-old MYS participants (N = 263, 49 % female, 100 % African-American) who completed a sleep symptoms questionnaire. Four results from the cross-sectional analysis extend the findings of the longitudinal analysis. First, the cross-sectional results showed that symptoms of apnea, insomnia, nightmares, and restless legs syndrome or periodic limb movement disorder (RLS/PLMD), as well as daytime sleepiness, increase as a function of hopelessness. Second, symptoms of insomnia, RLS, and nightmares, as well as daytime sleepiness, increase as function of exposure to violence. Third, symptoms of insomnia and RLS/PLMD are greater under conditions of combined hopelessness and exposure to violence than for either condition alone. Fourth, symptoms of RLS/PLMD are worst for females who have been exposed to violence and experience hopelessness. Overall, the findings suggest that hopelessness and exposure to violence have negative independent and multiplicative effects on adolescent sleep, particularly for females. Understanding the causal factors associated with inadequate sleep in impoverished adolescents is important for three reasons. First, sleep is an important aspect of adolescent development. Second, inadequate sleep has severe consequences for adolescent morbidity, mortality, and overall quality of life. Third, impoverished adolescents are at the most severe risk for poor outcomes, and improvement in their sleep may produce large gains. © 2014 Springer Science+Business Media New York.",0,0 +6547,The long-term costs of traumatic stress: intertwined physical and psychological consequences,"The gradual emergence of symptoms following exposure to traumatic events has presented a major conceptual challenge to psychiatry. The mechanism that causes the progressive escalation of symptoms with the passage of time leading to delayed onset post-traumatic stress disorder (PTSD) involves the process of sensitization and kindling. The development of traumatic memories at the time of stress exposure represents a major vulnerability through repeated environmental triggering of the increasing dysregulation of an individual's neurobiology. An increasing body of evidence demonstrates how the increased allostatic load associated with PTSD is associated with a significant body of physical morbidity in the form of chronic musculoskeletal pain, hypertension, hyperlipidaemia, obesity and cardiovascular disease. This increasing body of literature suggests that the effects of traumatic stress need to be considered as a major environmental challenge that places individual's physical and psychological health equally at risk. This broader perspective has important implications for developing treatments that address the underlying dysregulation of cortical arousal and neurohormonal abnormalities following exposure to traumatic stress.",0,0 +6548,Acute Stress Symptoms in Children: Results From an International Data Archive,"

Objective

To describe the prevalence of acute stress disorder (ASD) symptoms and to examine proposed DSM-5 symptom criteria in relation to concurrent functional impairment in children and adolescents.

Method

From an international archive, datasets were identified that included assessment of acute traumatic stress reactions and concurrent impairment in children and adolescents 5 to 17 years of age. Data came from 15 studies conducted in the United States, United Kingdom, Australia, and Switzerland and included 1,645 children and adolescents. Dichotomized items were created to indicate the presence or absence of each of the 14 proposed ASD symptoms and functional impairment. The performance of a proposed diagnostic criterion (number of ASD symptoms required) was examined as a predictor of concurrent impairment.

Results

Each ASD symptom was endorsed by 14% to 51% of children and adolescents; 41% reported clinically relevant impairment. Children and adolescents reported from 0 to 13 symptoms (mean = 3.6). Individual ASD symptoms were associated with greater likelihood of functional impairment. The DSM-5 proposed eight-symptom requirement was met by 202 individuals (12.3%) and had low sensitivity (0.25) in predicting concurrent clinically relevant impairment. Requiring fewer symptoms (three to four) greatly improved sensitivity while maintaining moderate specificity.

Conclusions

This group of symptoms appears to capture aspects of traumatic stress reactions that can create distress and interfere with children's and adolescents' ability to function in the acute post-trauma phase. Results provide a benchmark for comparison with adult samples; a smaller proportion of children and adolescents met the eight-symptom criterion than reported for adults. Symptom requirements for the ASD diagnosis may need to be lowered to optimally identify children and adolescents whose acute distress warrants clinical attention.",0,0 +6549,Understanding the relationship between co-occurring PTSD and MDD: Symptom severity and affect,"How to best understand theoretically the nature of the relationship between co-occurring PTSD and MDD (PTSD+MDD) is unclear. In a sample of 173 individuals with chronic PTSD, we examined whether the data were more consistent with current co-occurring MDD as a separate construct or as a marker of posttraumatic stress severity, and whether the relationship between PTSD and MDD is a function of shared symptom clusters and affect components. Results showed that the more severe depressive symptoms found in PTSD+MDD as compared to PTSD remained after controlling for PTSD symptom severity. Additionally, depressive symptom severity significantly predicted co-occurring MDD even when controlling for PTSD severity. In comparison to PTSD, PTSD+MDD had elevated dysphoria and re-experiencing - but not avoidance and hyperarousal - PTSD symptom cluster scores, higher levels of negative affect, and lower levels of positive affect. These findings provide support for PTSD and MDD as two distinct constructs with overlapping distress components.",0,0 +6550,Reporting results of latent growth modeling and multilevel modeling analyses: Some recommendations for rehabilitation psychology.,"There has been a general increase in interest and use of modeling techniques that treat data as nested, whether it is people nested within larger units, such as families or treatment centers, or observations nested under people. The popularity can be witnessed by noting the number of new textbooks and articles related to latent growth curve modeling and multilevel modeling. This paper discusses both of these techniques in the context of longitudinal research designs, with the main purposes of highlighting some benefits and issues related to the use of these models and outlining guidelines for reporting results from studies using multilevel modeling or latent growth modeling.These longitudinal analytic techniques can be greatly beneficial to researchers conducting rehabilitation studies, but there are several issues related to their use and reporting that need to be taken into consideration.",0,0 +6551,"Clinical and psychological impact after surgical, medical or expectant management of first-trimester miscarriage - a randomised controlled trial","The management of first-trimester miscarriage has been studied extensively in recent years. However, relatively little attention has been focussed on woman's satisfaction and psychological impact from different treatment modalities.To investigate the clinical and psychological outcomes of surgical, medical and expectant management of first-trimester miscarriage.A prospective randomised controlled trial of 180 women suffering miscarriage managed by either surgical evacuation, medical evacuation or expectant management was conducted in a university-affiliated, tertiary referral hospital. The complete miscarriage rate, clinical symptomatology, complications, women's satisfaction and the psychological impact were evaluated.Women in surgical evacuation (98.1%) had a significantly higher complete miscarriage rate when compared with medical evacuation (70%) and expectant management (79.3%). Women who had surgical evacuation had significantly shorter duration of vaginal bleeding, but higher rate of infection. Women who had medical evacuation had significantly more gastrointestinal symptoms. Despite differences in efficacy and complication profile, there was no significant difference in satisfaction among groups. There were no significant differences in terms of psychological well-being, depression scores, anxiety level, fatigue symptoms as measured in General Health Questionnaire-12, Beck Depression Inventory, Spielberger's State Anxiety Inventory and fatigue scale at treatment and four weeks after treatment. However, women with active intervention had greater post-traumatic stress symptoms as measured in Chinese version of Impact of Event Scale-Revised at the time of treatment when compared with women in expectant management.Without substantial differences in the clinical and psychological impact between different treatment modalities, a more conservative approach with expectant management for miscarriage may be an option for women.",0,0 +6552,Preliminary Reliability and Validity of the Clinician-Administered PTSD Scale for Schizophrenia.,"This study provides preliminary psychometric support for a version of the Clinician-Administered Posttraumatic Stress Disorder (PTSD) Scale (CAPS; D. D. Blake et al., 1990) adapted for use with patients with schizophrenia (CAPS-S; J. S. Gearon. S. Thomas-Lohrman, & A. S. Bellack, 2001). Nineteen women with schizophrenia and co-occurring illicit drug use disorders were administered the CAPS-S, the Structured Clinical Interview for DSM-IV diagnoses (SCID). and scales measuring trauma-related psychopathology. The results indicate that the CAPS-S can distinguish between those with and without PTSD and that the symptom clusters measure unified constructs. Interrater and test-retest reliability were high for PTSD diagnosis and symptom clusters. Solid convergent validity was demonstrated between the CAPS-S and SCID-based PTSD diagnoses and the Impact of Event Scale. There is also preliminary evidence of discriminant validity. These results support the use of the CAPS-S in women with schizophrenia.",0,0 +6553,Violent behaviour and post-traumatic stress disorder,"Future research into violent behaviour and post-traumatic stress disorder will reveal the risk factors for this disorder, and try to explain what it is that, afterexposing an individual to psychological trauma, leads to post-traumatic stress disorder. Possible protective factors and mechanisms to prevent the occurence of post-traumatic stress disorder will be described.",0,0 +6554,Best practices for missing data management in counseling psychology.,"This article urges counseling psychology researchers to recognize and report how missing data are handled, because consumers of research cannot accurately interpret findings without knowing the amount and pattern of missing data or the strategies that were used to handle those data. Patterns of missing data are reviewed, and some of the common strategies for dealing with them are described. The authors provide an illustration in which data were simulated and evaluate 3 methods of handling missing data: mean substitution, multiple imputation, and full information maximum likelihood. Results suggest that mean substitution is a poor method for handling missing data, whereas both multiple imputation and full information maximum likelihood are recommended alternatives to this approach. The authors suggest that researchers fully consider and report the amount and pattern of missing data and the strategy for handling those data in counseling psychology research and that editors advise researchers of this expectation.",0,0 +6555,Assessing Covariates of Adolescent Delinquency Trajectories: A Latent Growth Mixture Modeling Approach,"Using data from a community sample of 1218 boys and girls (mean age at the first wave was 15.5 years), this longitudinal study examined several covariates--adjustment problems, poor academic achievement, negative life events, and unsupportive family environments--of distinctive trajectories of juvenile delinquency. Latent growth mixture modeling analysis revealed 6 trajectory groups: rare offenders, moderate late peakers, high late peakers, decreasers, moderate-level chronics, and high-level chronics. Several factors discriminated between more normative groups and high-level chronic offenders, including poor academic achievement, unsupportive family environments, life events, and substance use, whereas almost no differences were found between groups with more serious offending trajectories. Overall, there was more specificity in correlates of distinctive offending trajectories than expected by general theories of crime (e.g., Gottfredson, M. R., and Hirschi, T., 1990, A General Theory of Crime. Stanford University Press, Stanford, CA). (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +6556,Posttraumatic Stress Disorder Symptoms Might be Destroying your Intimacy: A Test of Mediational Models in a Community Sample of Couples,"The present research focused on the pathways through which the symptoms of posttraumatic stress disorder (PTSD) may negatively impact intimacy. Previous research has confirmed a link between self-reported PTSD symptoms and intimacy; however, a thorough examination of mediating paths, partner effects, and secondary traumatization has not yet been realized. With a sample of 297 heterosexual couples, intraindividual and dyadic models were developed to explain the relationships between PTSD symptoms and intimacy in the context of interdependence theory, attachment theory, and models of self-preservation (e.g., fight-or-flight). The current study replicated the findings of others and has supported a process in which affective (alexithymia, negative affect, positive affect) and communication (demand-withdraw behaviour, self-concealment, and constructive communication) pathways mediate the intraindividual and dyadic relationships between PTSD symptoms and intimacy; Moreover, it also found that the PTSD symptoms of each partner were significantly related; however, this was only the case for those dyads in which the partners had disclosed most everything about their traumatic experiences. As such, secondary traumatization was supported. Finally, although the overall pattern of results suggest a total negative effect of PTSD symptoms on intimacy, a sex difference was evident such that the direct effect of the woman's PTSD symptoms were positively associated with both her and her partner's intimacy. It is possible that the Tend-and-Befriend model of threat response, wherein women are said to foster social bonds in the face of distress, may account for this sex difference. Overall, however, it is clear that PTSD symptoms were negatively associated with relationship quality and attention to this impact in the development of diagnostic criteria and treatment protocols is necessary. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6557,Pathways to change: Trajectories following treatment in women with co-occurring PTSD and substance use disorders,"s / Drug and Alcohol Dependence 146 (2015) e118–e201 e185 Chi-squares & ANOVAs were used to compare dichotomous & continuous variables, respectively. Results: Incentives increased abstinence above control levels antepartum & postpartum: (late-pregnancy: 37% vs 11%; 2wk: 33% vs 15%; 4wk: 31% vs 12%; 8wk: 25% vs 10%; 12wk: 22% vs 7%; 24wk: 15% vs 3%; all p 16) at weeks 4–12 postpartum (all p< .05). Conclusions: In addition to increasing smoking abstinence, voucher-based incentives for smoking cessation decrease postpartum depression. This effect compliments the significant improvements in birth outcomes & breastfeeding duration reported previously with this intervention. Financial support: R01DA14028, R01HD075669, P20GM103644, T32DA07242. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.417 Pathways to change: Trajectories following treatment in women with co-occurring PTSD and substance use disorders Teresa Lopez-Castro1, M. Hu2, D.A. Hien1 1 The City College of New York, New York, NY, United States 2 NY State Psychiatric Institute, New York, NY, United",0,0 +6558,The Early Adolescent or “Juvenile Stress” Translational Animal Model of Posttraumatic Stress Disorder,"The diagnosis of posttraumatic stress disorder (PTSD) requires exposure to a major traumatic event. This criterion has influenced the thinking about causes of the disorder, approaches to treatment, and also how to establish an effective animal model of the disorder. Accordingly, the focus in animal models of PTSD is on what would establish an effective traumatic exposure that would lead to PTSD-related symptoms in the studied animal. However, the prevalence of PTSD among individuals exposed to a traumatic event suggests that the exposure to the trauma is not sufficient to induce PTSD, since most exposed individuals will not develop the disorder. The emphasis in translational animal models of PTSD should thus be on inclusion of relevant risk factors, that together with the exposure to a traumatic event will lead to the development of PTSD. Epidemiological studies indicate that childhood trauma predisposes individuals to develop stress-related disorders later in life. As a result of this finding, we developed an animal model in which exposing rats to early adolescence (postweaning, prepubertal, juvenile) stress was also found to induce a predisposition to develop PTSD following an exposure to an additional stress in adulthood. Within these pre-exposed animals, dissociation could be caused among individuals that exhibited more anxious or more depressive symptoms. This dissociation, which has been recognized also in human patients, required the development of a behavioral profiling approach that enabled grouping animals according to their clusters of symptoms. Interestingly, this approach also enabled the identification of new data on the influence of sex on long-term consequences of “Juvenile Stress.” These data reveal that whilst both male and female rats showed behavioral changes following exposure to a stressor at juvenility, the profile of effects differed between the sexes. Collectively, these findings indicate that the model presented here is an effective translational model for understanding of the etiology of trauma-related disorders and of relevant predisposing factors. © Springer Science+Business Media New York 2015.",0,0 +6559,Clinical meaning of the Keane PTSD scale,"A correlational study that included 82 male inpatient alcoholics was conducted to determine the clinical meaning of the Keane PTSD Scale of the MMPI. The PTSD Scale was correlated with the variables of the Shipley Institute of Living Scale, the Life Purpose Questionnaire, the Existential Depression Test, and the standard MMPI measures, plus the A, R, Es and MacAndrew Scales. The pattern of correlations suggested that the PTSD scale measures general psychological maladjustment and dysphoric feelings rather than any specifiable syndrome. The strong correlation with the Welch A, which measures a general level of maladjustment, suggests that the PTSD and Welch A scales are measuring the same factor. The PTSD scale, therefore, appears to provide very little information about this population beyond that available from the overall clinical profile and the Welch A scale.",0,0 +6560,Posttraumatic stress hyperarousal symptoms mediate the relationship between childhood exposure to violence and subsequent alcohol misuse in Mi'kmaq youth,"This study was part of a school-based collaborative research project with a Canadian Mi'kmaq community that examined the potential role of posttraumatic stress (PTS) symptom clusters in mediating the relationship between childhood exposure to violence (EV) and alcohol misuse in a sample of Mi'kmaq adolescents (N = 166). The study employed a cross-sectional design and used several well-validated self-report questionnaires. Path analytic results showed that when each PTS symptom cluster was independently investigated for mediating effects while controlling for depressive symptoms, age, and gender, only the PTS hyperarousal symptom cluster fully mediated the EV-alcohol misuse relationship. Results are discussed within the context of previous theory and research on the topic of PTS as a mediator between EV and alcohol misuse.",0,0 +6561,Cognitive-behavioral coping strategies associated with combat-related PTSD in treatment-seeking OEF–OIF Veterans,"Posttraumatic stress disorder (PTSD) is associated with intrusive trauma-related thoughts and avoidance behaviors that contribute to its severity and chronicity. This study examined thought control and avoidance coping strategies associated with both a probable diagnosis and symptom severity of combat-related PTSD in a sample of 167 treatment-seeking Operations Enduring Freedom and Iraqi Freedom (OEF-OIF) Veterans. Within one year of returning from deployment, Veterans completed a survey containing measures of combat exposure, coping strategies, psychopathology, and postdeployment social support. Veterans with a positive screen for PTSD scored higher than Veterans without a positive screen for PTSD on measures of worry, self-punishment, social control, behavioral distraction, and avoidance coping strategies. Worry and social avoidance coping were positively related to PTSD symptoms, and greater perceptions of understanding from others were negatively related to these symptoms. A structural equation model revealed that scores on a measure of postdeployment social support were negatively associated with scores on measures of maladaptive cognitive coping (i.e., worry, self-punishment) and avoidance coping (social and non-social avoidance coping) strategies, which were positively associated with combat-related PTSD symptoms. These results suggest that maladaptive thought control and avoidance coping may partially mediate the relation between postdeployment social support and combat-related PTSD symptoms in treatment-seeking OEF-OIF Veterans. Consistent with cognitive therapy models, these findings suggest that interventions that target maladaptive coping strategies such as worry, self-punishment, and social avoidance, and that bolster social support, most notably understanding from others, may help reduce combat-related PTSD symptoms in this population.",0,0 +6562,Utilizing correspondence analysis to characterize the mental health of cardiac patients with diabetes,"The aim of this study was to examine the mental health of cardiac patients with diabetes and whether symptoms varied by gender and/or age. Screening for depression and posttraumatic stress symptoms was conducted on 1003 patients with cardiovascular disease. Correspondence analysis was utilized to identify clinical core profiles. Results suggested that cardiovascular disease patients with diabetes, particularly males, experience high rates of depression, suicide ideation, and posttraumatic stress symptoms. Clinical implications of these findings include targeted mental health screening options as well as offering a closer look at the specific concerns of cardiovascular disease patients with diabetes.",0,0 +6563,Anxiety and prepulse inhibition of acoustic startle in a normative sample: The importance of signal-to-noise ratio,"Abstract Previous studies have used prepulse inhibition of the startle response (PPI) to investigate the anxiety spectrum, primarily in patient samples, with mixed results. The inconsistency in findings may be due, in part, to the use of non-optimal signal-to-noise ratios (SnRs: the difference between background noise intensity and prepulse intensity) in some studies. We proposed that, as SnR approaches +15 dB, anxiety spectrum variables will be negatively correlated with PPI, even in a normative sample. Thus, we used the MCMI-III to measure levels of trait anxiety, posttraumatic stress disorder (PTSD), and the three Cluster C personality disorders in a sample of 53 undergraduate females, and then correlated their scores with their PPI levels at SnRs of +5, +10, and +15 dB. All of the anxiety constructs except obsessive-compulsive personality disorder (OCPD) were correlated with PPI, but only in the +15 dB condition. Although OCPD symptomatology was not correlated with PPI, it was negatively correlated with PTSD and may have been indicative of adaptive functioning in this normative sample. The present study demonstrates that PPI is a sensitive index of anxiety symptomatology even in the normative range, and that a SnR near +15 dB may be necessary to reliably detect associations between PPI and these psychological variables.",0,0 +6564,Lasting Consequences of Traumatic Events on Behavioral and Skeletal Parameters in a Mouse Model for Post-Traumatic Stress Disorder (PTSD),"Post-traumatic stress disorder (PTSD) is an anxiety disorder that not only affects mental health, but may also affect bone health. However, there have been no studies to examine the direct relationship between PTSD and bone.We employed electric shocks in mice to simulate traumatic events that cause PTSD. We also injected the anxiogenic drug FG-7142 prior to electric shocks. Electric shocks created lasting conditioned fear memory in all mice. In young mice, electric shocks elicited not only behavioral response but also skeletal response, and injection of FG-7142 appeared to increase both types of response. For example in behavioral response within the first week, mice shocked alone froze an average of 6.2 sec in 10 sec tests, and mice injected with FG-7142 froze 7.6 sec, both significantly different (P<0.05) from control mice, which only froze 1.3 sec. In skeletal response at week 2, shocks alone reduced 6% bone mineral content (BMC) in total body (P = 0.06), while shocks with FG-7142 injection reduced not only 11% BMC (P<0.05) but also 6% bone mineral density (BMD) (P<0.05). In addition, FG-7142 injection also caused significant reductions of BMC in specific bones such as femur, lumbar vertebra, and tibia at week 3. Strong negative correlations (R(2) = -0.56, P<0.05) and regression (y = 0.2527-0.0037 * x, P<0.01) between freezing behavior and total body BMC in young mice indicated that increased contextual PTSD-like behavior was associated with reduced bone mass acquisition.This is the first study to document evidence that traumatic events induce lasting consequences on both behavior and skeletal growth, and electric shocks coupled with injection of anxiogenic FG-7142 in young mice can be used as a model to study the effect of PTSD-like symptoms on bone development.",0,0 +6565,"Improved Cognitive Function After Transcranial, Light-Emitting Diode Treatments in Chronic, Traumatic Brain Injury: Two Case Reports","Objective: Two chronic, traumatic brain injury (TBI) cases, where cognition improved following treatment with red and near-infrared light-emitting diodes (LEDs), applied transcranially to forehead and scalp areas, are presented. Background: Significant benefits have been reported following application of transcranial, low-level laser therapy (LLLT) to humans with acute stroke and mice with acute TBI. These are the first case reports documenting improved cognitive function in chronic, TBI patients treated with transcranial LED. Methods: Treatments were applied bilaterally and to midline sagittal areas using LED cluster heads [2.1″ diameter, 61 diodes (9 × 633 nm, 52 × 870 nm); 12–15 mW per diode; total power: 500 mW; 22.2 mW/cm2; 13.3 J/cm2 at scalp (estimated 0.4 J/cm2 to cortex)]. Results: Seven years after closed-head TBI from a motor vehicle accident, Patient 1 began transcranial LED treatments. Pre-LED, her ability for sustained attention (computer work) lasted 20 min. After eight weekly LED treatments, her sustained attention time increased to 3 h. The patient performs nightly home treatments (5 years); if she stops treating for more than 2 weeks, she regresses. Patient 2 had a history of closed-head trauma (sports/military, and recent fall), and magnetic resonance imaging showed frontoparietal atrophy. Pre-LED, she was on medical disability for 5 months. After 4 months of nightly LED treatments at home, medical disability discontinued; she returned to working full-time as an executive consultant with an international technology consulting firm. Neuropsychological testing after 9 months of transcranial LED indicated significant improvement (+1, +2SD) in executive function (inhibition, inhibition accuracy) and memory, as well as reduction in post-traumatic stress disorder. If she stops treating for more than 1 week, she regresses. At the time of this report, both patients are continuing treatment. Conclusions: Transcranial LED may improve cognition, reduce costs in TBI treatment, and be applied at home. Controlled studies are warranted.",0,0 +6566,Risk factors and posttraumatic stress disorder: are they especially predictive following exposure to less severe stressors?,"The diagnosis of posttraumatic stress disorder (PTSD) requires exposure to a traumatic stressor, as defined by Criterion A in the DSM criteria for PTSD. Yet, over the course of successive revisions of the diagnostic manual, the range of qualifying stressors has expanded considerably (e.g., watching terrorist attacks on television). Moreover, stressors that fall short of qualifying for even an expanded Criterion A can produce apparent PTSD. Taken together, these findings imply that people who do satisfy symptomatic criteria for PTSD following exposure to less severe stressors carry a heavy burden of risk factors.To test this hypothesis, we examined whether the association between the risk factor of lower intelligence and more severe PTSD and depression symptoms would be greater among women reporting less severe CSA (n = 15) relative to women who reported moderate (n = 54) or high (n = 31) severity CSA.The evidence was consistent with this hypothesis for subjects in the low and moderate severity groups, but less so for those in the high severity group.Lower intelligence was a more potent risk factor for posttraumatic distress among people exposed to less severe relative to moderately severe stressors.",0,0 +6567,Main and interactive effects of a nonclinical panic attack history and distress tolerance in relation to PTSD symptom severity,"The current study investigated the main and interactive effects of a nonclinical panic attack history and distress tolerance in relation to PTSD symptoms. The sample consisted of 91 adults (62.6% women; M(age)=23.45, SD=9.56) who met DSM-IV criteria for trauma exposure, 53.8% of whom met criteria for a recent (past 2 years) history of nonclinical panic attacks. Results indicated that distress tolerance, as measured by the Distress Tolerance Scale (Simons & Gaher, 2005), was significantly related to all PTSD symptom clusters, and a nonclinical panic attack history was significantly related to PTSD re-experiencing and hyperarousal symptoms. The interaction of a nonclinical panic attack history and distress tolerance significantly predicted unique variance in only PTSD hyperarousal symptoms. Implications and future directions are discussed for the role of nonclinical panic attacks and distress tolerance in PTSD symptom expression.",0,0 +6568,Posttraumatic Stress Disorder in Hospitalized Adolescents: Psychiatric Comorbidity and Clinical Correlates,"

ABSTRACT

Objective

To describe the diagnostic comorbidity and clinical correlates of posttraumatic stress disorder (PTSD) in adolescent psychiatric inpatients.

Method

Seventy-four adolescent inpatients were given a structured diagnostic interview, the revised version of the Diagnostic Interview for Children and Adolescents, and a battery of standard self-report measures to assess general trauma exposure, posttraumatic stress symptoms, suicidal behavior, dissociation, and depression.

Results

Ninety-three percent of subjects reported exposure to at least one traumatic event such as being a witness/victim of community violence, witnessing family violence, or being the victim of physical/sexual abuse. Thirty-two percent of subjects met diagnostic criteria for current PTSD, with sexual abuse cited as the most common traumatic stressor in 69% of PTSD cases. Girls were significantly more likely to develop PTSD than boys, although the total number of types of trauma did not differ by gender. Compared with psychiatric controls, male youngsters with PTSD were significantly more likely to have comorbid diagnoses of eating disorders, other anxiety disorders, and somatization disorder. Furthermore, male and female youngsters with PTSD were significantly more likely to have attempted suicide and report greater depressive and dissociative symptoms.

Conclusion

In clinical populations of hospitalized adolescents exposed to multiple forms of trauma, PTSD is a common, but highly comorbid disorder. Specific multimodal assessments and treatments targeted to both PTSD and its comorbidity profile are warranted. J. Am. Acad. Child Adolesc. Psychiatry, 1999, 38(4):385–392.",0,0 +6569,Reintegration Challenges in U.S. Service Members and Veterans Following Combat Deployment,"Although the majority of combat veterans reintegrate into civilian life without long-lasting problems, a sizable minority return from deployment with psychiatric or physical injuries that warrant medical attention. Even in the absence of diagnosable disorders, many experience functional problems that impede full reintegration into civilian life. Considerable resources have been allocated to studying, diagnosing, treating, and compensating combat-related disorders. This important work has resulted in significant improvements in healthcare for those with deployment-related difficulties. Nevertheless, many service members and veterans with reintegration difficulty may not receive needed help. Based on our review, we argue that in addition to treatment and compensation for diagnosable postdeployment problems, a comprehensive approach to reintegration is needed that includes partnership between the government, private sector, and the public.",0,0 +6570,Barriers to Receiving Early Care for PTSD: Results From the Jerusalem Trauma Outreach and Prevention Study,,0,0 +6571,White Matter Microstructure Alterations: A Study of Alcoholics with and without Post-Traumatic Stress Disorder,"Many brain imaging studies have demonstrated reductions in gray and white matter volumes in alcoholism, with fewer investigators using diffusion tensor imaging (DTI) to examine the integrity of white matter pathways. Among various medical conditions, alcoholism and post-traumatic stress disorder (PTSD) are two comorbid diseases that have similar degenerative effects on the white matter integrity. Therefore, understanding and differentiating these effects would be very important in characterizing alcoholism and PTSD. Alcoholics are known to have neurocognitive deficits in decision-making, particularly in decisions related to emotionally-motivated behavior, while individuals with PTSD have deficits in emotional regulation and enhanced fear response. It is widely believed that these types of abnormalities in both alcoholism and PTSD are related to fronto-limbic dysfunction. In addition, previous studies have shown cortico-limbic fiber degradation through fiber tracking in alcoholism. DTI was used to measure white matter fractional anisotropy (FA), which provides information about tissue microstructure, possibly indicating white matter integrity. We quantitatively investigated the microstructure of white matter through whole brain DTI analysis in healthy volunteers (HV) and alcohol dependent subjects without PTSD (ALC) and with PTSD (ALC+PTSD). These data show significant differences in FA between alcoholics and non-alcoholic HVs, with no significant differences in FA between ALC and ALC+PTSD in any white matter structure. We performed a post-hoc region of interest analysis that allowed us to incorporate multiple covariates into the analysis and found similar results. HV had higher FA in several areas implicated in the reward circuit, emotion, and executive functioning, suggesting that there may be microstructural abnormalities in white matter pathways that contribute to neurocognitive and executive functioning deficits observed in alcoholics. Furthermore, our data do not reveal any differences between ALC and ALC+PTSD, suggesting that the effect of alcohol on white matter microstructure may be more significant than any effect caused by PTSD.",0,0 +6572,Examining the role of grief in the etiology of Posttraumatic Stress Disorder (PTSD) symptoms in American Indian adolescents,"The prevalence of Posttraumatic Stress Disorder (PTSD) is reported to be comparatively high in child and adolescent populations (Reinherz, Gaiconia, Leftkowitz, Pakiz, & Frost,1993). However, recent research has suggested that there may be differing etiological factors, specifically, Child Traumatic Grief (CTG), that contributes to the development of PTSD symptoms in American Indian adolescents (Morsette, at al., 2007). First this study demonstrated that CTG symptoms predicted PTSD symptoms above and beyond that which was predicted by violence exposure. Second, it was found that CTG predicted depression above and that which was predicted by PTSD symptoms. Third, it found that grief was significantly correlated with PTSD symptoms. Similarly, grief was also significantly correlated with the depressive symptoms. Finally, using a two-tailed Pearson's Product mom$$ent correlation this study found there was no correlation between PTSD symptoms, grief symptoms, depressive symptoms, and American Indian student's Grade Point Average and absenteeism. However, a post-hoc analysis using a one-tailed Pearson's Product moment correlation indicated a statistical significant correlation between GPA and depression. Additional etiological models are explored. This study is the first to examine etiological factors of PTSD in American Indian adolescents. Additional qualitative research is necessary to better understand the contribution of grief in the development of PTSD symptoms.",0,0 +6573,Posttraumatic Stress Disorder in Children,"Children and psychic trauma: a brief review of contemporary thinking. Children traumatized by witnessing acts of personal violence: homicide, rape, or suicide behavior. Children traumatized in small groups. Children traumatized by catastrophic situations. Children traumatized by Central American warfare. Post-traumatic stress disorder in children with cancer. Children traumatized by physical abuse. Post-traumatic symptoms in incest victims. Interaction of trauma and grief in childhood.",0,0 +6574,Sex differences in objective measures of sleep in post-traumatic stress disorder and healthy control subjects,"A growing literature shows prominent sex effects for risk for post-traumatic stress disorder and associated medical comorbid burden. Previous research indicates that post-traumatic stress disorder is associated with reduced slow wave sleep, which may have implications for overall health, and abnormalities in rapid eye movement sleep, which have been implicated in specific post-traumatic stress disorder symptoms, but most research has been conducted in male subjects. We therefore sought to compare objective measures of sleep in male and female post-traumatic stress disorder subjects with age- and sex-matched control subjects. We used a cross-sectional, 2 × 2 design (post-traumatic stress disorder/control × female/male) involving83 medically healthy, non-medicated adults aged 19-39 years in the inpatient sleep laboratory. Visual electroencephalographic analysis demonstrated that post-traumatic stress disorder was associated with lower slow wave sleep duration (F(3,82) = 7.63, P = 0.007) and slow wave sleep percentage (F(3,82) = 6.11, P = 0.016). There was also a group × sex interaction effect for rapid eye movement sleep duration (F(3,82) = 4.08, P = 0.047) and rapid eye movement sleep percentage (F(3,82) = 4.30, P = 0.041), explained by greater rapid eye movement sleep in post-traumatic stress disorder females compared to control females, a difference not seen in male subjects. Quantitative electroencephalography analysis demonstrated that post-traumatic stress disorder was associated with lower energy in the delta spectrum (F(3,82) = 6.79, P = 0.011) in non-rapid eye movement sleep. Slow wave sleep and delta findings were more pronounced in males. Removal of post-traumatic stress disorder subjects with comorbid major depressive disorder, who had greater post-traumatic stress disorder severity, strengthened delta effects but reduced rapid eye movement effects to non-significance. These findings support previous evidence that post-traumatic stress disorder is associated with impairment in the homeostatic function of sleep, especially in men with the disorder. These findings suggest that group × sex interaction effects on rapid eye movement may occur with more severe post-traumatic stress disorder or with post-traumatic stress disorder comorbid with major depressive disorder.",0,0 +6575,"Differential effectiveness of tianeptine, clonidine and amitriptyline in blocking traumatic memory expression, anxiety and hypertension in an animal model of PTSD","Individuals exposed to life-threatening trauma are at risk for developing post-traumatic stress disorder (PTSD), a debilitating condition that involves persistent anxiety, intrusive memories and several physiological disturbances. Current pharmacotherapies for PTSD manage only a subset of these symptoms and typically have adverse side effects which limit their overall effectiveness. We evaluated the effectiveness of three different pharmacological agents to ameliorate a broad range of PTSD-like symptoms in our established predator-based animal model of PTSD. Adult male Sprague-Dawley rats were given 1-h cat exposures on two occasions that were separated by 10 days, in conjunction with chronic social instability. Beginning 24 h after the first cat exposure, rats received daily injections of amitriptyline, clonidine, tianeptine or vehicle. Three weeks after the second cat exposure, all rats underwent a battery of behavioral and physiological tests. The vehicle-treated, psychosocially stressed rats demonstrated a robust fear memory for the two cat exposures, as well as increased anxiety expressed on the elevated plus maze, an exaggerated startle response, elevated heart rate and blood pressure, reduced growth rate and increased adrenal gland weight, relative to the vehicle-treated, non-stressed (control) rats. Neither amitriptyline nor clonidine was effective at blocking the entire cluster of stress-induced sequelae, and each agent produced adverse side effects in control subjects. Only the antidepressant tianeptine completely blocked the effects of psychosocial stress on all of the physiological and behavioral measures that were examined. These findings illustrate the differential effectiveness of these three treatments to block components of PTSD-like symptoms in rats, and in particular, reveal the profile of tianeptine as the most effective of all three agents.",0,0 +6576,Suicide Attempts in Anorexia Nervosa,"To explore prevalence and patterns of suicidal attempts in persons with anorexia nervosa (AN).Participants were the first 432 persons (22 male, 410 female) enrolled in the NIH funded Genetics of Anorexia Nervosa Collaborative Study. All participants had current or lifetime AN. The participants ranged in age from 16 to 76 (mean = 30.4, SD = 11.3). Suicidal behavior and intent was assessed via the Diagnostic Interview for Genetic Studies. We compared frequency and severity of attempts across diagnostic subtypes and comorbidity, and personality features associated with the presence of suicide attempts in persons with AN.About 16.9% of those with AN attempted suicide. Significantly fewer persons with the restricting subtype (7.4%) reported at least one attempt than those with purging AN (26.1%), AN with binge eating (29.3%), and a mixed picture of AN and bulimia nervosa (21.2%). After controlling for major depression, suicide attempts were associated with substance abuse, impulsive behaviors and traits, Cluster B personality disorders, panic disorder, and post-traumatic stress disorder as well as low self-directedness and eating disorder severity.Suicide attempts in AN are not uncommon, are frequently associated with the intention to die, occur less frequently in persons with the restricting subtype of the illness, and after controlling for depression are associated with a constellation of behaviors and traits associated with behavioral and affective dyscontrol.",0,0 +6577,Can post-traumatic stress disorder be prevented?,"Abstract In the 20-odd years since the cluster of symptoms known as Post Traumatic Stress Disorder (PTSD) has been studied, we have learned a great deal about treating the distress that accompanies trauma in its many forms. We will only know whether or not we have succeeded in preventing the disorder when we have access to long-term studies of people who received intervention immediately following a traumatic event. We do know, however, much more about the impact of trauma on victims and witnesses of traumatic events, sometimes long past the event itself. We know, for example, that ‘triggers'-events reminiscent of the original event-play an extraordinarily important role in the development of symptoms. Removing those triggers is one method for alleviating distress. But a growing interest in the relationship between body, mind, and spirit points toward another possibility: counteracting the stressful triggers with equally powerful images that contain the seeds of recovery. Nurses are continually exposed to pain and suffering, stress and trauma, are themselves vulnerable to PTSD, and perhaps as much as the patients they care for, need hope and healing. We may not be able to prevent stress or distress. But we can alter the intensity and duration of stress related to trauma by naming our demons, daring to struggle with them, and by creating healing communities for ourselves as well as our patients.",0,0 +6578,Comparing the diagnosis of PTSD when assessing worst versus multiple traumatic events in a chronically mentally ill sample,"Despite interest in the nature of the traumatic event required to meet Criterion A for posttraumatic stress disorder (PTSD) as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994), little attention has been paid to the diagnostic ramifications of linking PTSD symptoms to a single traumatic event in the context of multiple trauma exposures. In this study, 67 dually diagnosed clients with at least 2 potential Criterion A traumatic events completed the Posttraumatic Stress Diagnostic Scale twice, in counterbalanced order: once regarding their worst event and once regarding all events. When responding regarding their worst trauma, 53.7% met probable PTSD criteria. This rose to 67.2% when considering all traumas. Although preliminary, these results suggest that linking PTSD symptoms to a single traumatic event excludes a meaningful number of cases who are otherwise indistinguishable based on symptom profile.",0,0 +6579,Perceptions of Trauma and Loss among Children and Adolescents Exposed to Disasters a Mixed-Methods Study,"The purpose of the current study was to extend knowledge of youth exposed to multiple disasters and the experience of cumulative childhood adversity by analyzing perceptions of trauma and loss in children and adolescents. A concurrent mixed-methods design was utilized to explore an ethnically diverse, predominantly low-income sample of youth (N = 4,154) aged 8–18 years from three parishes (counties) in Louisiana impacted by Hurricane Katrina and the Gulf Oil Spill. Youth completed assessments of posttraumatic stress symptoms (PTSS), hurricane exposure and oil spill stress, and responded to an open-ended question regarding lifetime trauma and loss. Independent coders assigned responses to 30 categories using a qualitative codebook based on both predetermined and emerging information. Codes were compared and contrasted for meaning and grouped into broader, organizing themes. Themes of trauma and loss included: death and loss of others, threats to life, family disruption, interpersonal trauma, and life transitions. Trauma and loss predicted PTSS when controlling for hurricane exposure and oil spill stress. Most trauma and loss conferred generalized risk regardless of event typology, although interpersonal trauma had unique effects. Findings improve understanding of the nature and extent of trauma and loss among youth exposed to multiple disasters. The use of a mixed-methods design clarifies prior findings in the broader trauma literature and child disaster studies. Through identification of vulnerable subgroups and patterns in perceptions of trauma and loss, findings have important implications for prevention and intervention strategies that promote long-term recovery. © 2015, Springer Science+Business Media New York.",0,0 +6580,Naive and Memory T Cell Subsets are Differentially Mobilized During Physical Stress,"This study examined the naive and memory phenotypic profiles of CD4+ and CD8hi T cells that were mobilized to the peripheral circulation during a combination of aerobic exercise and heat stress, determining expression of the adhesion molecules CD62L and CD11a on the recruited cells. Twelve recreationally active males (age 27.1 +/- 5.3 yr, height 1.77 +/- 0.08 m, mass 76.9 +/- 12.0 kg, VO2peak 43.9 +/- 6.7 mL x kg(-1) x min(-1)) completed a 40 min bout of cycle ergometry at 65 % of VO2peak while immersed to mid-chest in a water bath at 39 degrees C. Venous blood samples were collected before (T0), during (T40) and 30 min after (T70) exposure to combined exercise and heat stress. Specimens were analyzed by three-colour flow cytometry for CD4+ and CD8hi T cell expression of CD45RO, CD11a and CD62L. Some 80 % of the CD4+ T cells that were mobilized were of the CD45RO memory phenotype, with the numbers of CD11alo and CD62L+ cells increasing more than those of CD11ahi and CD62L- cells. For the CD8hi cells, there was a more equal recruitment of CD45RO- naive (43 %) and CD45RO+ memory (57 %) cells. The majority (84 %) of recruited CD8+ cells were CD11ahi; there was a trend to predominance of CD62L- cells (57 %) for the memory subset, but with almost equal recruitment of CD62L+/- for the naive subset. We conclude that the exercise + heat stress induced trend to an increase in CD4+ T cells is linked in some way to memory phenotype; it cannot be explained simply by a high density expression of CD11a and lack of the lymph node homing receptor (CD62L). Furthermore, although mobilization of CD8hi T cells is not linked to memory phenotype, a high density expression of CD11a and a lack of the lymph node homing receptor are important determinants of CD8hi T cell mobilization.",0,0 +6581,"Psychopathological, biological, and neuroimaging characterization of posttraumatic stress disorder in survivors of a severe coalmining disaster in China","On July 29, 2007, a severe coalmine-flooded disaster occurred in central China and 69 miners were trapped in an about 1400 m underground coal pit. Fortunately, all of them were rescued after 75 h of the ordeal. At 3 and 6 months after the disaster, psychopathological profiles, plasma levels of cortisol and adrenocorticotropic hormone (ACTH) were evaluated in 48 survivors for posttraumatic stress disorder (PTSD) and comorbid symptoms. Magnetic resonance imaging (MRI) study was performed at 6 months. The prevalence of PTSD was 35.4% (17/48) at 3 months and 31.3% (15/48) at 6 months post-disaster, with high rates of comorbid symptoms. Risk factors for PTSD included previous traumatic experience, less than 5 years of being a miner, in an extremely exhausted or sick during the disaster, poor interpersonal relationship and poor sleep quality experienced before the disaster. Mean plasma cortisol levels at 6 months, but not at 3 months, were significantly higher in PTSD-positive subjects than the negative, and positively correlated with the severity of several comorbid symptoms. Either whole or regional brain volumes of PTSD-positive subjects were not significantly different from PTSD-negative subjects, but PTSD subjects had significantly reduced fractional anisotropy values in the right posterior cingulum and bilateral hippocampal body compared to subjects without PTSD. These results suggest that traumatic exposure in severe coalmining disasters results in considerable psychological consequences, with highly prevalent PTSD and comorbid symptoms, which are associated with previous traumatic experience, shorter-length underground services, and poor interpersonal relationships and sleep quality experienced before the disaster. Baseline cortisol level may be a useful biological predictor for different phases of the development of PTSD. The aberrant connectivity of the hippocampus and the cingulum may represent an early pathological response to trauma exposure.",0,0 +6582,Documented combat exposure of US veterans seeking treatment for combat-related post-traumatic stress disorder,"Background There are concerns regarding the validity of combat exposure reports of veterans seeking treatment for combat-related post-traumatic stress disorder (PTSD) within US Veterans Affairs Medical Centers. Aims To verify combat exposure history for a relevant sample through objective historical data. Method Archival records were reviewed from the US National Military Personnel Records Center for 100 consecutive veterans reporting Vietnam combat in a Veterans Affairs PTSD clinic. Cross-sectional clinical assessment and 12-month service use data were also examined. Results Although 93% had documentation of Vietnam war-zone service, only 41% of the total sample had objective evidence of combat exposure documented in their military record. There was virtually no difference between the Vietnam ‘combat’ and ‘no combat’ groups on relevant clinical variables. Conclusions A significant number of treatment-seeking Veterans Affairs patients may misrepresent their combat involvement in Vietnam. There are implications for the integrity of the PTSD database and the Veterans Affairs healthcare system.",0,0 +6583,"Cortical/hippocampal monoamines, HPA-axis changes and aversive behavior following stress and restress in an animal model of post-traumatic stress disorder","Post-traumatic stress disorder (PTSD) is characterized by monoaminergic and hypothalamic–pituitary–adrenal (HPA)-axis abnormalities. Understanding monoamine-HPA-axis responses following stress and restress may provide a greater understanding of the neurobiology of PTSD and of its treatment. Hippocampal and frontal cortex serotonin, noradrenaline and dopamine, plasma corticosterone and aversive behavior were studied in rats on day 1 and day 7 post acute stress (AS = sequential restraint stress, swim stress and halothane exposure), and on day 1 and day 7 post restress (RS = swim stress). After AS, there was an early increase in both avoidant behavior and corticosterone (1 h after stress), with subsequent normalisation (day 7), suggesting an adequate adaptive response to the stressor. However, restress (RS) evoked a significant early HPA-axis hyporesponsiveness (1 h after RS) and a later significant increase in avoidant behavior on day 7 post RS. Hippocampal serotonin, noradrenaline and dopamine concentrations were unchanged 1 h post AS, but were significantly raised on day 7 post AS. Restress, however, reduced serotonin and noradrenaline levels 1 h after and on day 7 post RS, respectively, while dopamine was unchanged. In the frontal cortex only dopamine levels were altered, being significantly elevated 1 h after AS, and reduced on day 7 post RS. AS and RS thus differently effect the HPA-axis, evoking regional-specific brain monoamine changes that underlie maladaptive behavior and other post stress-related sequelae.",0,0 +6584,Chronic Kidney Disease in Central American Agricultural Communities: Challenges for Epidemiology and Public Health,"This paper contextualizes the chronic kidney disease epidemic and related burden of disease affecting Central American farming communities. It summarizes the two main causal hypotheses (heat stress and agrochemicals), draws attention to the consequences of dichotomous reasoning concerning causality, and warns of potential conflicts of interest and their role in manufacturing doubt. It describes some methodological errors that compromise past study findings and cautions against delaying public health actions until a conclusive understanding is reached about the epidemic's causes and underlying mechanisms. It makes the case for a comprehensive approach to the historical, social and epidemiological facts of the epidemic, for critically assessing existing studies and for enhanced rigor in new research.",0,0 +6585,Combat exposure and posttraumatic stress symptomatology among U.S. soldiers deployed to the Gulf War.,"Among the most stressful experiences soldiers encounter during combat is exposure to dead and wounded soldiers and civilians. This article examines the early (9 months postcombat) psychological reactions of U.S. Army soldiers deployed from Germany who served in frontline combat units during the Persian Gulf War. In particular, the article focuses on stress symptoms associated with soldiers' exposure to death and wounding during Operations Desert Shield and Desert Storm. Those soldiers exposed to casualties, especially U.S. casualties, had greater distress scores as measured by the Impact of Event Scale (IES) and a tripartite measure of posttraumatic stress (PTS) symptomatology modeled on the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1987) than did those without such exposure. Rank, type of casualty exposure, and current problems with coworkers and chain of command were additively related to explained variance in IES and PTS symptoma...",0,0 +6586,Bio-socio-demographic factors associated with post-traumatic stress disorder in a sample of postpartum Brazilian women,"Post-traumatic stress disorder (PTSD) is common among women. In the postpartum period, the prevalence is between 1% and 6%. The present study investigated PTSD in a sample of 400 Brazilian women between 2 and 26 weeks postpartum using the Mini-International Neuropsychiatric Interview and found a frequency of 5.3%. The factors associated with the occurrence of PTSD were low purchasing power, a history of psychiatric disorders, clinical disease, and the infant having experienced some complication (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +6587,"Ethnic Identity, Family Cohesion, and Symptoms of Post-traumatic Stress Disorder in Maltreated Youth","Post-traumatic stress disorder (PTSD) is prevalent among maltreated youth, but little empirical work exists regarding the role of ethnic identity and family cohesion as influential factors among different ethnic groups. This study included an ethnically diverse sample of adolescents affiliated with a state-administered residential facility for maltreated youth. Variables included ethnic identity and family cohesion, as well as symptoms of PTSD, depression, dissociation, and post-traumatic cognitions. The most prominent finding was that low family cohesion predicted greater PTSD symptoms, depression, dissociation, and post-traumatic cognitions. This finding was especially pronounced for multiracial youth. Results are discussed within the context of developmental pathways regarding ethnic identity development in multiracial youth.",0,0 +6588,The Effects of Traumatic Stressors and HIV-Related Trauma Symptoms on Health and Health Related Quality of Life,"The study identified relations among traumatic stressors, HIV-related trauma symptoms, comorbid medical conditions, and health related quality of life (HRQL) in individuals with HIV. Participants (N = 118) completed a structured clinical interview on HIV as a traumatic stressor and other severe traumatic stressors and completed the Impact of Event Scale to assess HIV-related trauma symptoms and the Medical Outcomes Study 36-item Short Form (SF-36) to assess HRQL. Medical chart reviews determined comorbid conditions. Path analysis findings indicated participants with prior severe traumatic stressors experienced their HIV diagnosis as traumatic and in turn were more likely to have current HIV-related trauma symptoms which were negatively related to HRQL. HIV as a traumatic stressor was related to coronary artery diseases and HRQL. Traumatic stressors and HIV-related trauma symptoms impact health in individuals with HIV and highlight the need for psychological interventions prior to diagnosis and throughout treatment.",0,0 +6589,PTSD among military personnel,"Although symptoms characteristic of post-traumatic stress disorder (PTSD) have been noted in military personnel for many centuries, it was not until 1980 that the disorder was formally recognized and became the focus of legitimate study. This paper reviews our current state of knowledge regarding the prevalence and course of this complex condition in past and present members of the defence forces. Although rates vary across conflicts and countries, there is no doubt that PTSD affects substantial numbers of personnel and results in considerable impairment in functioning and quality of life. The paper goes on to discuss recent attempts to build resilience and to promote adjustment following deployment, noting that there is little evidence at this stage upon which to draw firm conclusions. Finally, effective treatment for PTSD is reviewed, with particular reference to the challenges posed by this population in a treatment setting.",0,0 +6590,International disaster mental health,"This article distills key issues and controversies in the field of international disaster mental health. It offers perspectives from cross-cultural research and describes current controversies, including the appropriateness of bringing to bear Western structures of mental health and psychiatric diagnosis to non-Western settings. It reports early lessons learned from the field regarding what might best constitute assistance within a foreign culture and where to place emphasis. It recommends becoming involved within the relief establishment.",0,0 +6591,The effect of trauma on expressive language impairment in borderline personality disorder,"Borderline personality disorder (BPD) is a disorder with known expressive language impairments that may be activated in treatment through interpersonal cues to the trauma memory system of these patients. However, there are few BPD studies investigating this phenomenon empirically. Our previous research is the first known investigation revealing expressive language deficits using clinically relevant trauma-salient stimuli; the current study extends this to compare specific expressive language deficits on a neutral and emotive stimulus and relationships with trauma history. BPD and matched control (N = 24) verbalizations were analysed by computerized measures of language impairment and pause profiles. BPD subjects evidenced greater overall language impairment and reduced syntactic complexity, but not semantic complexity compared with controls. No such differences were found between the two groups on the neutral condition. BPD subjects utilized significantly higher proportions of pauses for both the emotive and neutral condition. BPD subjects used significantly greater proportions of pauses when generating adjectives related to early relationship with mother, not father. Presence of physical abuse history and PTSD related to some expressive language deficits. These results support neuroimaging findings demonstrating reduced activation of the pre-frontal cortex or anterior cingulate, alongside increased bilateral activation of the amygdala, during exposure to trauma-salient stimuli. Copyright © 2012 John Wiley & Sons, Ltd.",0,0 +6592,Mental health needs of children exposed to intimate partner violence seeking help from mental health services,"The aim of this study is to examine whether children and adolescents exposed to interparental physical and environmental violence have specific needs when seeking public mental health services compared to non-exposed outpatients. The witnessing of intimate partner violence (IPV), psychopathology, functional impairment, and several individual and family variables were assessed in 520 children aged 8 to 17 years. Results showed that living with violent parents at home increased the child's risk of posttraumatic stress disorder, dysthymia, self-harming behavior, and functional impairment. Exposed children's mothers were more likely to overprotect their sons, punish their daughters and report greater psychopathology, whereas fathers who engaged in marital violence displayed greater emotional distress and were more likely to punish and reject their children. The child's sex moderated the IPV effects on parenting, parental discipline, child's life events and health appraisal. Given the specific clinical profile of exposed children, mental health services should develop schedules to detect, assess, and treat these cases.",0,0 +6593,"Cells, biomarkers, and post-traumatic stress disorder: evidence for peripheral involvement in a central disease","Post-traumatic stress disorder (PTSD) is a complicated CNS syndrome. Looking beyond the CNS, recent studies suggest that peripheral blood mononuclear cells could cause and/or exacerbate PTSD. This review summarizes the literature, describes associations between circulating peripheral blood cells and PTSD, proposes a novel mechanism, and analyzes several biomarkers that appear to associate with PTSD symptoms. Several experimental animal models have shown that peripheral blood mononuclear cell activity can cause hippocampal volume loss and PTSD-like symptoms. Data from these models suggest that a traumatic event and/or traumatic events can trigger peripheral cells to migrate, mediate inflammation, and decrease neurogenesis, potentially leading to CNS volume loss. Biomarkers that associate with PTSD symptoms have the potential to differentiate PTSD from traumatic brain injury, but more work needs to be done. Research examining the mechanism of how traumatic events are linked to peripheral blood mononuclear cell functions and biomarkers may offer improved diagnoses and treatments for PTSD patients.",0,0 +6594,A meta-analysis on the impact of psychiatric disorders and maltreatment on cognition.,"Few studies have attempted to describe the range of cognitive impairments in individuals with psychiatric disorders who experienced maltreatment as children. The aims of this meta-analysis were to establish the impact of maltreatment and psychiatric disorders on cognition, and to examine the change in impact from childhood to adulthood.Twelve publications from 1970 to 2013 were included, with the following inclusion criteria: (a) individuals with a psychiatric disorder who experienced maltreatment, (b) use of at least 1 standardized neuropsychological measure, and (c) use of a control group without any psychiatric disorder or mistreatment. The majority of studies (10/12) were about posttraumatic stress disorder. Several effect sizes were calculated (Hedge's g) according to the cognitive domains.The results of the meta-analysis demonstrate that the combination of psychiatric disorders and childhood maltreatment has a negative impact on global cognitive performance, with a moderate effect size (g = -0.59). The most affected cognitive domains for individuals aged 7- to 18-years-old were visual episodic memory (g = -0.97), executive functioning (g = -0.90), and intelligence (g = -0.68). For individuals over the age of 18-years-old, the most affected cognitive domains were verbal episodic memory (g = -0.77), visuospatial/problem solving (g = -0.73), and attention (g = -0.72). The impact of maltreatment and psychiatric disorders was greater in children than in adults (slope = 0.008, p < .002).The results suggest that exposure to maltreatment and the presence of psychiatric disorders have a broad impact on cognition, with specific neuropsychological profile.",0,0 +6595,Panic Disorder and Agoraphobia in OCD patients: Clinical profile and possible treatment implications,"Panic Disorder (PD) and agoraphobia (AG) are frequently comorbid with obsessive-compulsive disorder (OCD), but the correlates of these comorbidities in OCD are fairly unknown. The study aims were to: 1) estimate the prevalence of PD with or without AG (PD), AG without panic (AG) and PD and/or AG (PD/AG) in a large clinical sample of OCD patients and 2) compare the characteristics of individuals with and without these comorbid conditions.A cross-sectional study with 1001 patients of the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders using several assessment instruments, including the Dimensional Yale-Brown Obsessive-Compulsive Scale and the Structured Clinical Interview for DSM-IV-TR Axis I Disorders. Bivariate analyses were followed by logistic regression models.The lifetime prevalence of PD was 15.3% (N=153), of AG 4.9% (N=49), and of PD/AG 20.2% (N=202). After logistic regression, hypochondriasis and specific phobia were common correlates of the three study groups. PD comorbidity was also associated with higher levels of anxiety, having children, major depression, bipolar I, generalized anxiety and posttraumatic stress disorders. Other independent correlates of AG were: dysthymia, bipolar II disorder, social phobia, impulsive-compulsive internet use, bulimia nervosa and binge eating disorder. Patients with PD/AG were also more likely to be married and to present high anxiety, separation anxiety disorder, major depression, impulsive-compulsive internet use, generalized anxiety, posttraumatic stress and binge eating disorders.Some distinct correlates were obtained for PD and AG in OCD patients, indicating the need for more specific and tailored treatment strategies for individuals with each of these clinical profiles.",0,0 +6596,The Epidemiology of Posttraumatic Stress Disorder,,0,0 +6597,Brain transcriptome profiles in mouse model simulating features of post-traumatic stress disorder,"Social-stress mouse model, based on the resident-intruder paradigm was used to simulate features of human post-traumatic stress disorder (PTSD). The model involved exposure of an intruder (subject) mouse to a resident aggressor mouse followed by exposure to trauma reminders with rest periods. C57BL/6 mice exposed to SJL aggressor mice exhibited behaviors suggested as PTSD-in-mouse phenotypes: intermittent freezing, reduced locomotion, avoidance of the aggressor-associated cue and apparent startled jumping. Brain tissues (amygdala, hippocampus, medial prefrontal cortex, septal region, corpus striatum and ventral striatum) from subject (aggressor exposed: Agg-E) and control C57BL/6 mice were collected at one, 10 and 42 days post aggressor exposure sessions. Transcripts in these brain regions were assayed using Agilent's mouse genome-wide arrays.Pathways and biological processes associated with differentially regulated genes were mainly those thought to be involved in fear-related behavioral responses and neuronal signaling. Expression-based assessments of activation patterns showed increased activations of pathways related to anxiety disorders (hyperactivity and fear responses), impaired cognition, mood disorders, circadian rhythm disruption, and impaired territorial and aggressive behaviors. In amygdala, activations of these pathways were more pronounced at earlier time-points, with some attenuation after longer rest periods. In hippocampus and medial prefrontal cortex, activation patterns were observed at later time points. Signaling pathways associated with PTSD-comorbid conditions, such as diabetes, metabolic disorder, inflammation and cardiac infarction, were also significantly enriched. In contrast, signaling processes related to neurogenesis and synaptic plasticity were inhibited.Our data suggests activations of behavioral responses associated with anxiety disorders as well as inhibition of neuronal signaling pathways important for neurogenesis, cognition and extinction of fear memory. These pathways along with comorbid-related signaling pathways indicate the pervasive and multisystem effects of aggressor exposure in mice, potentially mirroring the pathologic conditions of PTSD patients.",0,0 +6598,What can multiwave studies teach us about disaster research: An analysis of low-income Hurricane Katrina survivors,"Previous research on natural disasters has been limited by a lack of predisaster data and statistical analyses that do not adequately predict change in psychological symptoms. In the current study, we addressed these limitations through analysis of 3 waves of data from a longitudinal investigation of 313 low-income, African American mothers who were exposed to Hurricane Katrina. Although postdisaster cross-sectional estimates of the impact of traumatic stress exposure and postdisaster social support on postdisaster psychological distress were somewhat inflated, the general trends persisted when controlling for predisaster data (B = 0.88 and -0.33, vs. B = 0.81 and -0.27, respectively). Hierarchical linear modeling of the 3 waves of data revealed that lower predisaster social support was associated with higher psychological distress at the time of the disaster (β = -.16), and that higher traumatic stress exposure was associated with greater increases in psychological distress after the storm (β = .86). Based on the results, we suggest that the impact of traumatic stress on psychological trajectories cannot be accounted for solely by preexisting risk, and recommend more complex research designs to further illuminate the complex, dynamic relationships between psychological distress, traumatic stress exposure, and social support.",0,0 +6599,Risk Factors of Posttraumatic Stress Disorder among Survivors after the 512 Wenchuan Earthquake in China,"This study investigated the psychological reactions of survivors of the 512 Wenchuan earthquake in China and the risk factors associated with those reactions. The Impact of Event Scale-Revised (IES-R), Type D Scale-14 (DS14), a self-developed trauma experience questionniare, and a demographic questionnaire were administered to 956 earthquake survivors (389 males and 567 females) in Mianzhu, one of the cities most affected by the earthquake. The results showed that postraumatic stress disorder (PTSD) symptoms affected 84.8% of survivors one to two months after the earthquake. Significant risk factors associated with PTSD symptoms included: (1) being female; (2) older age; (3) higher exposure to traumatic events during the earthquake; and (4) negative affect in Type-D personality.",0,0 +6600,Utilizing pharmacodynamic properties of second-generation antipsychotics to guide treatment,"Second-generation antipsychotics (SGAs) are used for the treatment of multiple psychiatric disorders including schizophrenia, bipolar depression, bipolar mania, autism and major depressive disorder. Additionally, their off-label use has been expanding to include other disorders as well, including post-traumatic stress disorder, obsessive compulsive disorder, generalized anxiety disorder, eating disorders and personality disorders. All SGAs share common properties; however, each individual SGA has a unique pharmacodynamic profile that may be utilized to guide and individualize treatment.",0,0 +6601,"In search of links between social capital, mental health and sociotherapy: A longitudinal study in Rwanda","To date, reviews show inconclusive results on the association between social capital and mental health. Evidence that social capital can intentionally be promoted is also scarce. Promotion of social capital may impact post-conflict recovery through both increased social cohesion and better mental health. However, studies on community interventions and social capital have mostly relied on cross-sectional study designs. We present a longitudinal study in Rwanda on the effect on social capital and mental health of sociotherapy, a community-based psychosocial group intervention consisting of fifteen weekly group sessions. We hypothesized that the intervention would impact social capital and, as a result of that, mental health. We used a quasi-experimental study design with measurement points pre- and post-intervention and at eight months follow-up (2007-2008). Considering sex and living situation, we selected 100 adults for our experimental group. We formed a control group of 100 respondents with similar symptom score distribution, age, and sex from a random community sample in the same region. Mental health was assessed by use of the Self Reporting Questionnaire, and social capital through a locally adapted version of the short Adapted Social Capital Assessment Tool. It measures three elements of social capital: cognitive social capital, support, and civic participation. Latent growth models were used to examine whether effects of sociotherapy on mental health and social capital were related. Civic participation increased with 7% in the intervention group versus 2% in controls; mental health improved with 10% versus 5% (both: p < 0.001). Linear changes over time were not significantly correlated. Support and cognitive social capital did not show consistent changes. These findings hint at the possibility to foster social capital and simultaneously impact mental health. Further identification of pathways of influence may contribute to the designing of psychosocial interventions that effectively promote recovery in war-affected populations.Nederlands Trial Register 1120.",0,0 +6602,Reduced hippocampus volume in the mouse model of Posttraumatic Stress Disorder,"Some, but not all studies in patients with posttraumatic stress disorder (PTSD), report reduced hippocampus (HPC) volume. In particular it is unclear, whether smaller hippocampal volume represents a susceptibility factor for PTSD rather than a consequence of the trauma. To gain insight into the relationship of brain morphology and trauma exposure, we investigated volumetric and molecular changes of the HPC in a mouse model of PTSD by means of in vivo Manganese Enhanced Magnetic Resonance Imaging (MEMRI) and ex vivo ultramicroscopic measurements. Exposure to a brief inescapable foot shock led to a volume reduction in both left HPC and right central amygdala two months later. This volume loss was mirrored by a down-regulation of growth-associated protein-43 (GAP43) in the HPC. Enriched housing decreased the intensity of trauma-associated contextual fear, independently of whether it was provided before or after the shock. Beyond that, enriched housing led to an increase in intracranial volume, including the lateral ventricles and the hippocampus, and to an up-regulation of GAP43 as revealed by MEMRI and Western blot analysis, thus partially compensating for trauma-related HPC volume loss and down-regulation of GAP43 expression. Together these data demonstrate that traumatic experience in mice causes a reduction in HPC and central amygdala volume possibly due to a shrinkage of axonal protrusions. Enriched housing might induce trophic changes, which may contribute to the amelioration of trauma-associated PTSD-like symptoms at behavioural, morphological and molecular levels.",0,0 +6603,The association between adult attachment style and mental health in extreme life-endangering conditions,"Abstract This study examines the association between adult attachment style and psychopathology in extreme life-endangering conditions. A group of 40 Israeli Jewish settlers who lived within the Palestinian Authority territory (high-threat group) were asked to fill out an attachment style scale and psychiatric symptomatology measures. They were compared to a control group of Israeli Jewish persons who lived within the State of Israel. Findings showed higher symptomatology in the high-threat than control group. Secure attachment style was inversely related to symptomatology measures. In contrast, anxious–ambivalent and avoidant attachment styles were positively related to symptomatology measures. However, whereas the anxious–ambivalent attachment style was related to psychopathology in the two threat conditions, the avoidant style was related to psychopathology only in the high-threat group. Results were discussed in terms of attachment theory.",0,0 +6604,Treatment of substance abusing patients with comorbid psychiatric disorders,"To update clinicians on the latest in evidence-based treatments for substance use disorders (SUD) and non-substance use disorders among adults and suggest how these treatments can be combined into an evidence-based process that enhances treatment effectiveness in comorbid patients.Articles were extracted from Pubmed using the search terms ""dual diagnosis,"" ""comorbidity"" and ""co-occurring"" and were reviewed for evidence of effectiveness for pharmacologic and psychotherapeutic treatments of comorbidity.Twenty-four research reviews and 43 research trials were reviewed. The preponderance of the evidence suggests that antidepressants prescribed to improve substance-related symptoms among patients with mood and anxiety disorders are either not highly effective or involve risk due to high side-effect profiles or toxicity. Second generation antipsychotics are more effective for treatment of schizophrenia and comorbid substance abuse and current evidence suggests clozapine, olanzapine and risperidone are among the best. Clozapine appears to be the most effective of the antipsychotics for reducing alcohol, cocaine and cannabis abuse among patients with schizophrenia. Motivational interviewing has robust support as a highly effective psychotherapy for establishing a therapeutic alliance. This finding is critical since retention in treatment is essential for maintaining effectiveness. Highly structured therapy programs that integrate intensive outpatient treatments, case management services and behavioral therapies such as Contingency Management (CM) are most effective for treatment of severe comorbid conditions.Creative combinations of psychotherapies, behavioral and pharmacological interventions offer the most effective treatment for comorbidity. Intensity of treatment must be increased for severe comorbid conditions such as the schizophrenia/cannabis dependence comorbidity due to the limitations of pharmacological treatments.",0,0 +6605,MMPI profiles in PTSD as a function of comorbidity,"A sample of 135 Vietnam veteran inpatients with combat-related PTSD was sorted into three groups, depending upon the presence of concurrent psychiatric disorders: Depression (n = 68), Psychosis (n = 31), and Other (n = 36). Pairwise comparisons were made on the MMPI with respect to the validity indicators, clinical scales, four relevant Harris-Lingoes subscales, the Psychoticism content scale, and the MMPI-PTSD subscale. Results indicate variations in scale elevations as a function of comorbid diagnosis. Various items and scales appear to differentiate the Psychosis group due to greater psychopathology. In general, the results spotlight the heterogeneous aspects that comorbidity brings to PTSD assessment.",0,0 +6606,Readjustment of Urban Veterans: A Mental Health and Substance Use Profile of Iraq and Afghanistan Veterans in Higher Education,"To identify the prevalence of substance use and mental health problems among veterans and student service members/veterans (SSM/V) returning from Iraq and Afghanistan to New York City's low-income neighborhoods.A sample of 122 veterans attending college and 116 veterans not enrolled recruited using respondent-driven sampling.Logistic regression analysis of variation in characteristics of those veterans attending college; linear regression examining effects of college attendance on life satisfaction.Having a traumatic brain injury or disability was positively associated with college attendance. Being married, employed, or in college was predictive of overall life satisfaction. SSM/V were significantly less likely to screen positive for depression or drug use disorder. African American veterans were significantly less likely to attend college than white or Hispanic veterans.Substance use and some mental health disorders do not preclude inner-city veterans from entering higher education. This study contributes to the sparse literature on African American veterans and SSM/V.",0,0 +6607,Profiles of referrals to a psychiatric service: a descriptive study of survivors of the Nairobi US Embassy terrorist bomb blast.,"OBJECTIVE: To document the socio-demographic characteristics and psychiatric profiles of the survivors of the Nairobi United States Embassy terrorist bomb blast referred to a psychiatric and psychotherapy (counselling) service. METHOD: This was a descriptive cross-sectional study. Clinical interviews and structured questionnaires for post-traumatic stress disorder (PTSD) and stress were administered. Survivors of the bomb blast referred to a psychiatric and psychotherapy service one year or more after the bombing were included in the study. These survivors had been treated using psychopharmacotherapy and individualised (not group) therapy/counselling. RESULTS: Eighty-three consecutive referrals to a psychiatric service participated in this study. There were more males and the sample was generally well educated. The referrals made contact with the referring agency for a number of reasons including seeking psychological, financial and medical assistance. All the patients reported varying degrees of psychiatric symptoms and functional impairment on various aspects of social occupational functioning. High scores for PTSD and other related stress were recorded one or more years after the bombing. CONCLUSION: Although the survivors indicated that initial counselling following the blast had helped them, they still scored high on PTSD suggesting that clinically, the initial counselling had little, if any impact on the development of PTSD. There is need for a holistic approach to the management of psychotrauma in individuals. Language: en",0,0 +6608,Exploring the fit of Western PTSD models across three non-Western low- and middle-income countries.,"The purpose of this study was to examine the fit of existing Western posttraumatic stress disorder (PTSD) models across 3 non-Western low and middle income countries (LMIC). Secondary data analysis was conducted from studies among torture survivors in Northern Iraq, sexual violence survivors in the Democratic Republic of Congo (DRC), and Burmese refugees in Thailand. Confirmatory factor analyses were conducted on Harvard Trauma Questionnaire (HTQ) data to compare established Western PTSD models using (a) the 3-factor Diagnostic and Statistical Manual (DSM) 4th edition model, (b) the 4-factor “numbing” model, (c) the 4-factor “dysphoria” model, and (d) the 4- factor DSM-5 model. For both the DRC and Burma all models had adequate fit. Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) determined that the 4-factor “numbing” model was the best fit for the DRC and the 4-factor “dysphoria” model was the best fit for Burma. For Iraq, none of the models had adequate fit. Results support previous research which indicates inconsistency among Western models of PTSD among populations from LMIC. Further research should explore whether this is indicative of the context or potentially other factors.",0,0 +6609,A PSYCHO-PHYSIOLOGICAL COMPARISON OF POST-TRAUMATIC AND PROLONGED DURESS STRESS DISORDERS,"It has been proposed that post-traumatic stress disorder (PTSD) and so-called “prolonged duress stress disorder” (PDSD) have similar symptom profiles and differ only with regard to the presence or absence of a “traumatic event”. This single case experiment investigated whether PTSD can be distinguished from PDSD at the level of patho-physiology. The results indicate that both PTSD and PDSD imagery elicit physiological responses, but these are more readily and more strongly evoked by the former than the latter. These findings suggest that physiological response differences between PTSD and PDSD may be only a matter of degree. Implications are drawn for the psycho-physiological assessment of PDSD and recommendations for further research are made.",0,0 +6610,Olanzapine versus fluphenazine in an open trial in patients with psychotic combat-related post-traumatic stress disorder,"Rationale: Combat-related post-traumatic stress disorder (PTSD) is often complicated with other psychiatric comorbidities, and is refractory to treatment. Objective: The aim of an open, comparative 6-week study was to compare olanzapine and fluphenazine, as a monotherapy, for treating psychotic combat-related PTSD. Method: Fifty-five male war veterans with psychotic PTSD (DSM-IV criteria) were treated for 6 weeks with olanzapine (n=28) or fluphenazine (n=27) in a 5-10 mg/day dose range, once or twice daily. Patients were evaluated at baseline, and after 3 and 6 weeks of treatment, using Watson's PTSD scale, Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression Severity Scale (CGI-S), Clinical Global Impression Improvement Scale (CGI-I), Patient Global Impression Improvement Scale (PGI-I) and Drug Induced Extra-Pyramidal Symptoms Scale (DIEPSS). Results: At baseline, patient's data (age, duration of combat experience and scores in all measurement instruments) did not differ. After 3 and 6 weeks of treatment, olanzapine was significantly more efficacious than fluphenazine in reducing symptoms in PANSS (negative, general psychopathology subscale, supplementary items), Watson's PTSD (avoidance, increased arousal) subscales, CGI-S, CGI-I, and PGI-I scale. Both treatments affected similarly the symptoms listed in PANSS positive and Watson's trauma re-experiencing subscales. Fluphenazine induced more extrapyramidal symptoms. Prolongation of the treatment for 3 additional weeks did not affect the efficacy of either drug. Conclusions: Our data indicate that both fluphenazine and olanzapine were effective for particular symptom profile in psychotic combat-related PTSD. Olanzapine was better than fluphenazine in reducing most of the psychotic and PTSD symptoms, and was better tolerated in psychotic PTSD patients.",0,0 +6611,Long-term perspectives on posttraumatic growth in disaster survivors,"Findings on posttraumatic growth (PTG) and distress have not been consistent. This study examines the relationship in a very long-term perspective. The Posttraumatic Growth Inventory was completed by 46 survivors from a single disaster 27 years posttrauma. Posttraumatic stress was measured by the Impact of Event Scale (IES) immediately after the event, and after 1, 5, and 27 years. In the final follow-up, general mental health was also assessed. Strong positive associations were found between PTG and concurrent posttraumatic stress. Although weaker associations were found for the past, concurrent problems in general mental health clearly coexisted with PTG decades after a disaster, yet mediated by IES.",0,0 +6612,"Anger, hostility, and posttraumatic stress disorder in trauma-exposed adults: A meta-analysis.","This meta-analysis synthesizes the available data on the strength of association between anger and posttraumatic stress disorder (PTSD) and between hostility and PTSD, covering 39 studies with trauma-exposed adults. Effect sizes did not differ for anger and hostility, which could therefore be combined; effect sizes for anger expression variables were analyzed separately. The analyses revealed large effects. The weighted mean effect size (r) was .48 for anger-hostility, .29 for anger out, .53 for anger in, and -.44 for anger control. Moderator analyses were conducted for anger-hostility, showing that effect sizes were substantially larger with increasing time since the event and that effect sizes were larger in samples with military war experience than in samples that had experienced other types of traumatic events.",0,0 +6613,The adverse health effects of synthetic cannabinoids with emphasis on psychosis-like effects,"Cannabis use is associated with an increased risk of psychosis in vulnerable individuals. Cannabis containing high levels of the partial cannabinoid receptor subtype 1 (CB 1 ) agonist tetrahydrocannabinol (THC) is associated with the induction of psychosis in susceptible subjects and with the development of schizophrenia, whereas the use of cannabis variants with relatively high levels of cannabidiol (CBD) is associated with fewer psychotic experiences. Synthetic cannabinoid receptor agonists (SCRAs) are full agonists and often more potent than THC. Moreover, in contrast to natural cannabis, SCRAs preparations contain no CBD so that these drugs may have a higher psychosis-inducing potential than cannabis. This paper reviews the general toxicity profile and the adverse effects of SCRAs with special emphasis on their psychosis-inducing risk. The review shows that, compared with the use of natural cannabis, the use of SCRAs may cause more frequent and more severe unwanted negative effects, especially in younger, inexperienced users. Psychosis and psychosis-like conditions seem to occur relatively often following the use of SCRAs, presumably due to their high potency and the absence of CBD in the preparations. Studies on the relative risk of SCRAs compared with natural cannabis to induce or evoke psychosis are urgently needed.",0,0 +6614,Exploring the Clinical Course of Neck Pain in Physical Therapy: A Longitudinal Study,"To investigate the short-term trajectory of recovery from mechanical neck pain, and predictors of trajectory.Prospective, longitudinal cohort study with 5 repeated measurements over 4 weeks.Community-based physical therapy clinics.Convenience sample of community-dwelling adults (N=50) with uncomplicated mechanical neck disorders of any duration.Usual physical therapy care.Neck Disability Index (NDI), numeric rating scale (NRS) of pain intensity.A total of 50 consecutive subjects provided 5 data points over 4 weeks. Exploratory modeling using latent class growth analysis revealed a linear trend in improvement, at a mean of 1.5 NDI points and 0.5 NRS points per week. Within the NDI trajectory, 3 latent classes were identified, each with a unique trend: worsening (14.5%), rapid improvement (19.6%), and slow improvement (65.8%). Within the NRS trajectory, 2 unique trends were identified: stable (48.0%) and improving (52.0%). Predictors of trajectory class suggest that it may be possible to predict the trajectory. Results are described in view of the sample size.The mean trajectory of improvement in neck pain adequately fits a linear model and suggests slow but stable improvement over the short term. However, up to 3 different trajectories have been identified that suggest neck pain, and recovery thereof, is not homogenous. This may hold value for the design of clinical trials.",0,0 +6615,Bilateral hippocampal volume reduction in adults with post-traumatic stress disorder: A meta-analysis of structural MRI studies,"Over the last decade a significant number of studies have reported smaller hippocampal volume in individuals with symptoms of post-traumatic stress disorder (PTSD) relative to control groups, and in some cases hemispheric asymmetries in this effect have been noted. However these reported asymmetries have not been in a consistent direction, and other well-controlled studies have failed to observe any hippocampal volume difference. This paper reports a systematic review and meta-analysis of studies in which hippocampal volume was estimated from magnetic resonance images in adult patients with PTSD. After applying a variety of selection criteria intended to minimize potential confounds in pooled effect-size estimates, the meta-analysis included 13 studies of adult patients with PTSD that compared the patients to well-matched control groups, for a total of 215 patients and 325 control subjects. The studies varied with respect to participant age, gender distribution, source of trauma, severity of symptoms, duration of disorder, the nature of the control groups, and the methods employed for volumetric quantification. Despite these differences, pooled effect size calculations across the studies indicated significant volume differences in both hemispheres. On average PTSD patients had a 6.9% smaller left hippocampal volume and a 6.6% smaller right hippocampal volume compared with control subjects. These volume differences were smaller when comparing PTSD patients with control subjects exposed to similar levels of trauma, and larger when comparing PTSD patients to control subjects without significant trauma exposure. Such differences are consistent with the notion that exposure to stressful experiences can lead to hippocampal atrophy, although prospective studies would be necessary to unambiguously establish such a relationship. © 2005 Wiley-Liss, Inc.",0,0 +6616,Interventions with women offenders: a systematic review and meta-analysis of mental health gain,"Currently, a conjunction of policy, legislative change in health and social care and the criminal justice system, combined with funding for innovative services make it opportune to assess the evidence base for interventions with women offenders. Women offenders have a distinctive criminological, health and social profile and a gender specific approach to their difficulties is advocated. This systematic review and meta-analysis focus on mental health gain in adult women offenders in forensic health settings, criminal justice institutions and in the community, following therapeutic interventions. Interventions were assessed in terms of specific outcome measures of depression, trauma symptomatology and global mental health status. Comprehensive search strategies yielded 3018 articles, from which we obtained 199 full text articles. Seventeen articles were included in the final review, of which six were excluded from the meta-analysis as there was no comparator group. There is a modest, but increasing, body of...",0,0 +6617,Distinct intrinsic network connectivity patterns of post-traumatic stress disorder symptom clusters,"Objective Post-traumatic stress disorder (PTSD) is considered a multidimensional disorder, with distinct symptom clusters including re-experiencing, avoidance/numbing, hyperarousal, and most recently depersonalization/derealization. However, the extent of differing intrinsic network connectivity underlying these symptoms has not been fully investigated. We therefore investigated the degree of association between resting connectivity of the salience (SN), default mode (DMN), and central executive (CEN) networks and PTSD symptom severity. Method Using resting-state functional MRI data from PTSD participants (n = 21), we conducted multivariate analyses to test whether connectivity of extracted independent components varied as a function of re-experiencing, avoidance/numbing, hyperarousal, and depersonalization/derealization. Results Hyperarousal symptoms were associated with reduced connectivity of posterior insula/superior temporal gyrus within SN [peak Montréal Neurological Institute (MNI): −44, −8, 0, t = −4.2512, k = 40]. Depersonalization/derealization severity was associated with decreased connectivity of perigenual anterior cingulate/ventromedial prefrontal cortex within ventral anterior DMN (peak MNI: 8, 40, −4; t = −3.8501; k = 15) and altered synchrony between two DMN components and between DMN and CEN. Conclusion Our results are consistent with prior research showing intrinsic network disruptions in PTSD and imply heterogeneous connectivity patterns underlying PTSD symptom dimensions. These findings suggest possible biomarkers for PTSD and its dissociative subtype.",0,0 +6618,Synaptic correlates of fear extinction in the amygdala,"Anxiety disorders such as post-traumatic stress are characterized by an impaired ability to learn that cues previously associated with danger no longer represent a threat. However, the mechanisms underlying fear extinction remain unclear. We found that fear extinction in rats was associated with increased levels of synaptic inhibition in fear output neurons of the central amygdala (CEA). This increased inhibition resulted from a potentiation of fear input synapses to GABAergic intercalated amygdala neurons that project to the CEA. Enhancement of inputs to intercalated cells required prefrontal activity during extinction training and involved an increased transmitter release probability coupled to an altered expression profile of ionotropic glutamate receptors. Overall, our results suggest that intercalated cells constitute a promising target for pharmacological treatment of anxiety disorders.",0,0 +6619,Profiles of Resilience and Growth in Youth With Cancer and Healthy Comparisons,"Inconsistent links between posttraumatic stress symptoms (PTS) and posttraumatic growth (PTG) in youth following a stressful life event have been observed in previous literature. Latent profile analysis (LPA) provides a novel approach to examine the heterogeneity of relations between these constructs.Participants were 435 youth (cancer group=253; healthy comparisons = 182) and one parent. Children completed measures of PTS, PTG, and a life-events checklist. Parents reported on their own PTS and PTG. LPA was conducted to identify distinct adjustment classes.LPA revealed three profiles. The majority of youth (83%) fell into two resilient groups differing by levels of PTG. Several factors predicted youth's profile membership.PTS and PTG appear to be relatively independent constructs, and their relation is dependent on contextual factors. The majority of youth appear to be resilient, and even those who experience significant distress were able to find benefit.",0,0 +6620,Body change stress for women with breast cancer: The breast-impact of treatment scale,"Body change stress refers to subjective psychological stress that accompanies women's negative and distressing thoughts, emotions, and behaviors resultant from breast cancer and breast surgeries. Body change stress is manifest with traumatic stress-like symptoms.The development of the Breast-Impact of Treatment Scale (BITS) is described. The construct is assessed with 13 items that comprise a one-factor solution.Tests of convergent validity demonstrate the relationship, but not overlap, of the BITS with measures of stress, emotional distress, and sexuality. The BITS distinguishes between women receiving segmental mastectomy (lumpectomy) versus mastectomy. Incremental validity is shown with comparison to ratings of body satisfaction.An early psychometric foundation enables use of the BITS to assess a common and distressing quality of life outcome for women with breast cancer.",0,0 +6621,Posttraumatic Symptom Structure Across Age Groups,"The applicability of diagnostic criteria of Posttraumatic Stress Disorder to the pediatric population has been a focus of much debate (e.g., Carrion, Weems, Ray, & Reiss, 2002 ), informing changes in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5). The current study examined the factor structure of posttraumatic distress among adult versus pediatric samples using confirmatory factor analysis. The analysis was performed on the DSM-IV-adherent Posttraumatic Diagnostic Scale (Foa, Cashman, Jaycox, & Perry, 1997 ) and Child Posttraumatic Symptom Scale (Foa, Johnson, Feeny, & Treadwell, 2001 ). The sample included 378 adult and 204 child and adolescent victims of diverse single-event traumas. A series of models based on previous findings and DSM-IV specification were evaluated. A 4-factor model (Intrusions, Avoidance, Dysphoria, and Hyperarousal), similar to the DSM-5 model, best fit the data among adults, and a different 4-factor model (Intrusion, Avodiance, Numbing, and Hyperarousal) best fit the data among children and adolescents. Despite some similarity, the posttraumatic symptom profiles of pediatric and adult samples may differ. These differences are not fully incorporated into the DSM-5, and warrant further examination.",0,0 +6622,Crisis Intervention,,0,0 +6623,Peritraumatic dissociation and experiential avoidance as predictors of posttraumatic stress symptomatology,"This study examined whether peritraumatic dissociation serves as a proxy risk factor for experiential avoidance in its relationship with posttraumatic stress disorder (PTSD) symptomatology. One hundred eighty-five trauma survivors completed measures that assessed for peritraumatic dissociation, experiential avoidance, and PTSD symptom severity. The results indicated that peritraumatic dissociation and experiential avoidance were significantly related to PTSD symptomatology at baseline. However, after initial levels of PTSD symptomatology were taken into account, only experiential avoidance was related to PTSD symptoms both 4- and 8-weeks later. These results indicate that peritraumatic dissociation is not a proxy risk factor for experiential avoidance and contributes to the growing body of literature indicating that experiential avoidance is an important factor related to the psychological symptoms experienced by trauma survivors.",0,0 +6624,Paroxetine in the Treatment of Post Traumatic Stress Disorder: Our Experiences,"Posttraumatic stress disorder can develop after individual’s exposure or witnessing of life threatening events. It is characterized by three clusters of symptoms. The course of PTSD is often chronic and impedes individual’s functioning. Studies of PTSD treatment with paroxetine provide evidence for its efficacy in reducing symptoms and its favorable profile of side-effects. The objective of this work was to determine the efficacy of paroxetine in the treatment of PTSD.The sample consisted of 30 subjects with chronic PTSD. All subjects received treatment with paroxetine in therapeutic dose range for six months. Subjects were assessed prior to therapy and following six months of treatment with paroxetine with the use of following instruments: SCL 90-R, Mississippi Questionnaire, and CGI.The results indicate statistically significant reduction on all subscales of SCL 90-R following six months of treatment, P<0,05. The difference between two assessments with Mississippi Questionnaire was statistically significant, P< 0,05. PTSD rate in our sample was reduced from 100% before treatment to 64% after treatment. Paroxetine was administered in daily dose of 20 mg in 88% of the subjects, and 40 mg in the remaining 12%. Unwanted effects were registered in 16,7% of the subjects and they were mild. Objective improvement was registered in 84% of the sample, and subjective improvement was registered in 80%. Reduction of relapse symptoms was registered in 24% of the subjects.Paroxetine proved to be efficient and safe in treatment of symptoms of PTSD in this study.",0,0 +6625,"Living Conditions and Emotional Profiles of Cambodian, Central American, and Québécois Youth","To compare Cambodian and Central American adolescent refugees to Quebec with their Quebec-born peers in regard to emotional and behavioural problems, feelings of competence, and risk-behaviour profiles, and to examine relations between emotional variables and living conditions in the 3 groups.The sample consisted of 76 Cambodian, 82 Central American and 67 Québécois youth living in the Montreal area. The teenagers' internalization and externalization symptoms were assessed using the Child Behaviour Checklist (CBCL) and the Youth Self-Report (YSR); the YSR also provided a measure of their feelings of competence. Risk behaviour was reported by the teenagers. The socioeconomic status of the teenagers' households was taken into account in multiple regression analyses conducted for each group.The level of emotional and behavioural problems reported by teenagers was lowest in Central Americans and highest in Québécois; the latter group also reported more risk behaviours than did either refugee group. The socioeconomic status of the Cambodian and Central American refugee households was lower than that of the Québécois. Living conditions were not a major determinant of emotional distress in young Cambodians, but low annual income was associated with internalizing symptoms among Central American youth. The most powerful predictor of externalizing symptoms among the Québécois youth was having a single-parent household.This study underscores the contrast between the living conditions of young Cambodian and Central American refugees to Quebec and those of Quebec-born youth. These refugees' precarious socioeconomic status is not accompanied by an increase in adolescents' emotional and behavioural problems.",0,0 +6626,Elaboration and Content Analysis of Conceptual Structure in Posttraumatic Stress Disorder,"Three recent studies attempted to substantiate Sewell and Cromwell's (1990) theory of Posttraumatic Stress Disorder (PTSD; American Psychiatric Association, 1994) based on personal construct theory (Kelly, 1955). One crucial aspect of the model that was tested in each of the studies is elaboration, which is the process of bringing more of a person's repertoire of understanding (constructions) to a certain experience to give it meaning. Elaboration is representative of whether or not the individual is using an integrated set of constructs to deal with a traumatic event. A two-part study (1) reanalyzed existing data to assist in understanding discrepancies in past findings, and (2) content analyzed constructs given by subjects in all three studies. Findings concerning elaboration remained somewhat discrepant but suggested possible differences when investigating the emergent versus submerged poles of constructs.",0,0 +6627,Latent structure of posttraumatic stress disorder symptoms in an adolescent sample one month after an earthquake,"Increasing empirical studies suggest that the tripartite posttraumatic stress disorder (PTSD) model described in the DSM-IV does not accurately account for the underlying PTSD factor structure, and several alternative models have been proposed. The present study investigated a newly refined, five-factor model of PTSD symptoms in a sample of Chinese adolescent survivors of an earthquake. A total of 1198 middle school students (653 females, 526 males) with a mean age of 14.4 years (SD = 1.1, range: 11-18) participated in this study one month after an earthquake. The novel five-factor model comprised of intrusion, avoidance, numbing, dysphoric arousal, and anxious arousal demonstrated significantly better fit than two alternative four-factor models. Further analyses revealed differentiable relations between the PTSD factors and external measures of anxiety and depression. These findings provide empirical support for the robustness of five-factor model, and carry implications for further reorganization of PTSD criteria.",0,0 +6628,Utility of the Trauma Symptom Inventory’s Atypical Response Scale in Detecting Malingered Post-Traumatic Stress Disorder,"The authors examined the Trauma Symptom Inventory's (TSI) ability to discriminate 88 student post-traumatic stress disorder (PTSD) simulators screened for genuine PTSD from 48 clinical PTSD-diagnosed outpatients. Results demonstrated between-group differences on several TSI clinical scales and the Atypical Response (ATR) validity scale. Discriminant function analysis using ATR revealed 75% correct patient classification but only 48% correct simulator classification, with an overall correct classification rate of 59% (positive predictive power [PPP] = .71; negative predictive power [NPP] = .51). Individual ATR cutoff scores did not yield impressive classification results, with the optimal cutoff (T score = 61) correctly classifying only 61% of simulators and patients (PPP = .66, NPP = .54). Although ATR was not developed as a malingered PTSD screen, instead serving as a general validity screen, caution is recommended in its current clinical use for detecting malingered PTSD.",0,0 +6629,Emotional and Coping Responses to Serial Killings The Gainesville Murders,"Forensic experts have focused more on the psychological profile of a serial killer rather than on the pronounced effects on the community at large. Coping with a stressful event is thought to influence emotional states. However, little empirical understanding of this process exists. The present study examined changes in psychological factors 9 days after the occurrence of serial killings in a college community. Multivariate analyses of variance conducted on the variables of stress, anxiety, physical symptoms, and depression revealed a significant difference between the group tested after the murders and a cross-sectional cohort group. Univariate analyses revealed that the study class was significantly more depressed compared with the cohort group. The study class was also significantly more depressed compared with their own responses 1 year before the killings. For both classes, depression was significantly correlated with certain coping styles, including escape-avoidance and accept responsibility. Results have implications for certain coping behaviors (i.e., avoidant behaviors), such as that leaving the community may have been maladaptive and perhaps diverted attention from the more necessary active problem-solving behaviors (e.g., increasing security) in addition to increasing depression.",0,0 +6630,Pierre Janet and the breakdown of adaptation in psychological trauma,"In this reappraisal of the work of Pierre Janet at the centenary of the publication of L'automatisme psychologique, the authors review his investigations into the mental processes that transform traumatic experiences into psychopathology. Janet was the first to systematically study dissociation as the crucial psychological process with which the organism reacts to overwhelming experiences and show that traumatic memories may be expressed as sensory perceptions, affect states, and behavioral reenactments. Janet provided a broad framework that unifies into a larger perspective the various approaches to psychological functioning which have developed along independent lines in this century. Today his integrated approach may help clarify the interrelationships among such diverse topics as memory processes, state-dependent learning, dissociative reactions, and posttraumatic psychopathology.",0,0 +6631,Provision of evidence-based therapies to rural survivors of domestic violence and sexual assault via telehealth: Treatment outcomes and clinical training benefits.,"Rural survivors of sexual assault and domestic violence experience considerable difficulties accessing mental health services. Similarly, graduate psychology training programs located in rural locations have historically been limited in their ability to provide trainees with extensive exposure to specific client populations. With the advent of distal technologies–especially secure, encrypted videoconferencing capabilities—it is now possible to connect rural clients with specialized, mental health services provided by university-based training clinics. This article reviews mental health care needs and treatment barriers experienced by rural populations, and describes an innovative solution to begin to address these problems. Specifically, a partnership between a university-based mental health care clinic and 3 rural domestic violence/rape crisis centers is described, and preliminary treatment outcome data are presented. Training benefits reported by graduate student therapists and satisfaction ratings provided by crisis center staff and advocates are also presented and discussed.",0,0 +6632,Treatment of posttraumatic stress disorder in children and adolescents,"We review recent evidence regarding risk factors for childhood posttraumatic stress disorder (PTSD) and treatment outcome studies from 2010 to 2012 including dissemination studies, early intervention studies and studies involving preschool children.Recent large-scale epidemiological surveys confirm that PTSD occurs in a minority of children and young people exposed to trauma. Detailed follow-up studies of trauma-exposed young people have investigated factors that distinguish those who develop a chronic PTSD from those who do not, with recent studies highlighting the importance of cognitive (thoughts, beliefs and memories) and social factors. Such findings are informative in developing treatments for young people with PTSD. Recent randomized controlled trials (RCTs) confirm that trauma-focused cognitive behaviour therapy (TF-CBT) is a highly efficacious treatment for PTSD, although questions remain about effective treatment components. A small number of dissemination studies indicate that TF-CBT can be effective when delivered in school and community settings. One recent RCT shows that TF-CBT is feasible and highly beneficial for very young preschool children. Studies of early intervention show mixed findings.Various forms of theory-based TF-CBT are highly effective in the treatment of children and adolescents with PTSD. Further work is needed to replicate and extend initial promising outcomes of TF-CBT for very young children. Dissemination studies and early intervention studies show mixed findings and further work is needed.",0,0 +6633,Evaluation of a Family-Centered Preventive Intervention for Military Families: Parent and Child Longitudinal Outcomes,"This study evaluates the longitudinal outcomes of Families OverComing Under Stress (FOCUS), a family-centered preventive intervention implemented to enhance resilience and to reduce psychological health risk in military families and children who have high levels of stress related to parental wartime military service.We performed a secondary analysis of evaluation data from a large-scale service implementation of the FOCUS intervention collected between July 2008 and December 2013 at 15 military installations in the United States and Japan. We present data for 2,615 unique families (3,499 parents and 3,810 children) with completed intake and at least 1 postintervention assessment. Longitudinal regression models with family-level random effects were used to assess the patterns of change in child and parent (civilian and military) psychological health outcomes over time.Improvement in psychological health outcomes occurred in both service member and civilian parents. Relative to intake, parental anxiety and depression symptoms were significantly reduced postintervention, and these reductions were maintained at 2 subsequent follow-up assessments. In addition, we identified an improvement over time in emotional and behavioral symptoms and in prosocial behaviors for both boys and girls. We observed reductions in the prevalence of unhealthy family functioning and child anxiety symptoms, as well as parental depression, anxiety, and posttraumatic stress symptoms from intake to follow-up.Longitudinal program evaluation data show sustained trajectories of reduced psychological health risk symptoms and improved indices of resilience in children, civilian, and active duty military parents participating in a strength-based, family-centered preventive intervention.",0,0 +6634,Distinct quantitative sensory testing profiles in nonspecific chronic back pain subjects with and without psychological trauma,"Psychological trauma is associated with an increased risk for chronification of nonspecific chronic back pain (nsCLBP) independent of posttraumatic stress disorder (PTSD). However, the mechanisms underlying the role of psychological trauma in nsCLBP are less clear than in PTSD. Therefore, this study considered whether psychological trauma exposure (TE) is accompanied by specific alterations in pain perception. The study included 56 participants with nsCLBP and TE (nsCLBP-TE), 93 participants with nsCLBP without TE (nsCLBP-W-TE), and 31 pain-free controls. All participants underwent a thorough clinical evaluation. The standardized quantitative sensory testing protocol of the German Research Network on Neuropathic Pain was used to obtain comprehensive profiles on somatosensory functions in painful (back) and non-painful areas (hand). The protocol consisted of thermal and mechanical detection as well as pain thresholds, vibration thresholds, and pain sensitivity to sharp and blunt mechanical stimuli. Psychological trauma was validated by structured clinical interview. Trauma-associated symptom severity, anxiety, and depressive symptomatology were assessed by self-report questionnaires. Differences in somatosensory function were seen only for pressure pain thresholds. Compared with controls, nsCLBP-TE revealed hyperalgesia generalized in space with lower thresholds in painful and non-painful areas, whereas nsCLBP-W-TE demonstrated localized alterations with decreased thresholds only in the pain-affected area of the back (P ≤ 0.006). Our findings suggest an augmented central pain processing in nsCLBP-TE (alterations in painful and non-painful areas), whereas nsCLBP-W-TE show only local changes (alterations only in the painful area) suggesting regional sensitization processes. This finding might explain why TE without PTSD is associated with an increased prevalence of chronic pain.",0,0 +6635,Pre- and post-disaster negative life events in relation to the incidence and severity of post-traumatic stress disorder,"There is evidence suggesting that stressful life events may precede major psychiatric illness, such as major depression, and that the severity of a traumatic event outside the range of usual human experience may provoke post-traumatic stress disorder (PTSD). The present study was carried out to examine the effects of pre- and post-disaster stressful life events on the incidence rate of PTSD following two man-made traumatic events. An epidemiological study examining 127 victims of a flash fire in a ballroom and 55 motor vehicle accident (MVA) victims was undertaken. PTSD symptoms were assessed by means of the Composite International Diagnostic Interview and the pre- and post-disaster stressful life events by means of the Diagnostic Interview Schedule, Disaster Supplement. Binary logistic and multiple linear regression analyses were employed to examine the relationships between PTSD and pre- and post-disaster life events. There were no significant relationships between stressful life events the year prior to the traumatic event and the incidence or severity of PTSD. There were highly significant relationships between the cumulative number and event severity of post-disaster negative life events and the incidence rate and severity of PTSD. The post-disaster life events were significantly more related to the avoidance-depression dimension than to the anxiety-arousal dimension of PTSD. The most significant life events were: loss of job or income, broken relationships, serious illnesses or injuries in the victims and death or illness in close acquaintances. The results of this study show that the number and severity of additional stressful life events signal a higher risk to develop PTSD and a higher severity of the avoidance-depression dimension of PTSD symptomatology.",0,0 +6636,Posttraumatic stress disorder after liver transplantation,"Liver transplantation can lead to the development of posttraumatic stress disorder (PTSD), but the risk factors associated with this progression are not well understood. To study this syndrome in adult liver transplant recipients, a cross-sectional investigation of 296 recipients at our hospital was carried out between January and June 2010.Study participants completed two questionnaires [a PTSD self-rating scale (PTSD-SS) and a validated Chinese version of the Medical Outcomes Study Short Form-36 (SF-36)]. Clinical and demographic data were collected from the records of the Chinese Liver Transplant Registry and via questionnaires.The prevalence of full PTSD and partial PTSD (that met the criteria for 2 of the 3 symptom clusters) was 3.7% and 5.4%, respectively, for all transplant recipients. Significant differences between the recipients with no PTSD, partial PTSD, and full PTSD were found in all SF-36 domains except for physical functioning (P=0.466). In general, domain scores were the highest in the recipients who did not meet the criteria for PTSD and the lowest in the recipients who met the criteria for full PTSD. Greater severity of posttraumatic stress symptoms was correlated with poorer quality of life, especially in the bodily pain (P=0.004), social functioning (P=0.001), role-emotional (P=0.048), and mental health (P<0.001) domains. The model for end-stage liver disease (MELD) scores, complications, and educational status were identified by multiple regression analysis as risk factors for developing PTSD.PTSD occurred after liver transplantation and was significantly associated with decreased quality of life. Higher MELD scores and complications after transplantation were risk factors that contributed to PTSD, and higher education was a protective factor.",0,0 +6637,A Comparison of the Capacity of <em>DSM-IV]</em> and <em>DSM-5]</em> Acute Stress Disorder Definitions to Predict Posttraumatic Stress Disorder and Related Disorders,"This study addresses the extent to which DSM-IV and DSM-5 definitions of acute stress disorder (ASD) predict subsequent posttraumatic stress disorder (PTSD) and related psychiatric disorders following trauma.Patients with randomized admissions to 5 hospitals across Australia (N = 596) were assessed in hospital and reassessed for PTSD at 3 (n = 508), 12 (n = 426), 24 (n = 439), and 72 (n = 314) months using the Clinician-Administered PTSD Scale; DSM-IV definition of PTSD was used at each assessment, and DSM-5 definition was used at 72 months. The Mini-International Neuropsychiatric Interview (MINI) was used at each assessment to assess anxiety, mood, and substance use disorders.Forty-five patients (8%) met DSM-IV criteria, and 80 patients (14%) met DSM-5 criteria for ASD. PTSD was diagnosed in 93 patients (9%) at 3, 82 patients (10%) at 12, 100 patients (12%) at 24, and 26 patients (8%) at 72 months; 19 patients (6%) met DSM-5 criteria for PTSD at 72 months. Comparable proportions of those diagnosed with ASD developed PTSD using DSM-IV (3 months = 46%, 12 months = 39%, 24 months = 32%, and 72 months = 25%) and DSM-5 (43%, 42%, 33%, and 24%) ASD definitions. Sensitivity was improved for DSM-5 relative to DSM-IV for depression (0.18 vs 0.30), panic disorder (0.19 vs 0.41), agoraphobia (0.14 vs 0.40), social phobia (0.12 vs 0.44), specific phobia (0.24 vs 0.58), obsessive-compulsive disorder (0.17 vs 0.47), and generalized anxiety disorder (0.20 vs 0.47). More than half of participants with DSM-5-defined ASD had a subsequent disorder.The DSM-5 criteria for ASD results in better identification of people who will subsequently develop PTSD or another psychiatric disorder relative to the DSM-IV criteria. Although prediction is modest, it suggests that the new ASD diagnosis can serve a useful function in acute trauma settings for triaging those who can benefit from either early intervention or subsequent monitoring.",0,0 +6638,Disasters and youth: A meta-analytic examination of posttraumatic stress.,"Meta-analyze the literature on posttraumatic stress (PTS) symptoms in youths post-disaster.Meta-analytic synthesis of the literature (k = 96 studies; Ntotal = 74,154) summarizing the magnitude of associations between disasters and youth PTS, and key factors associated with variations in the magnitude of these associations. We included peer-reviewed studies published prior to 1/1/2009 that quantitatively examined youth PTS (≤ 18 years at event) after a distinct and identifiable disaster.Despite variability across studies, disasters had a significant effect on youth PTS (small-to-medium magnitude; rpooled = .19, SEr = .03; d = 0.4). Female gender (rpooled = .14), higher death toll (disasters of death toll ≤ 25: rpooled = .09; vs. disasters with ≥ 1,000 deaths: rpooled = .22), child proximity (rpooled = .33), personal loss (rpooled = .16), perceived threat (rpooled = .34), and distress (rpooled = .38) at time of event were each associated with increased PTS. Studies conducted within 1 year post-disaster, studies that used established measures, and studies that relied on child-report data identified a significant effect.Youths are vulnerable to appreciable PTS after disaster, with pre-existing child characteristics, aspects of the disaster experience, and study methodology each associated with variations in the effect magnitude. Findings underscore the importance of measurement considerations in post-disaster research. Areas in need of research include the long-term impact of disasters, disaster-related media exposure, prior trauma and psychopathology, social support, ethnicity/race, prejudice, parental psychopathology, and the effects of disasters in developing regions of the world. Policy and clinical implications are discussed.",0,0 +6639,Link between personality and cancer,"Personality refers to an individual’s enduring and pervasive personal motivation, emotion, interpersonal style, attitudes and behavior that are stable over a long time after young adulthood. In relation to the cancer trajectory, three basic and one other personality traits have been studied with some frequency, namely neuroticism, extraversion, conscientiousness and optimism. The considerable stability of personality over time makes it a potential long-acting etiological factor for the development of cancer. However, the studies performed so far do not give much support to personality as a causative factor for cancer. Some studies of cancer survival have found significant associations between lower optimism and higher neuroticism with shorter survival. More mental distress and fatigue and poorer quality of life is significantly associated with higher neuroticism and lower optimism at cancer screening, diagnosis and primary treatment, short- and long-term follow-up and towards the end of life. Neuroticism is a strong predictor of post-traumatic stress disorder triggered by cancer as a life-threatening experience eventually leading to negative personality changes. To what extent cancer leads to positive personality changes (post-traumatic growth) is currently unsettled. Basic personality traits are strongly associated with lifestyle, which is considered an important etiological factor for the development of cancer. The methodological problems in the study of personality and cancer are considerable, and many research designs used so far may have been too simplistic. Studies of potential biomarkers for personality traits combined with inflammation markers of cellular carcinogenesis in longitudinal designs could be promising for the future. High neuroticism is important for the clinical management of cancer patients and should gain more attention from oncologists in the future.",0,0 +6640,Respiratory and mental health effects of wildfires: an ecological study in Galician municipalities (north-west Spain),"BackgroundDuring the summer of 2006, a wave of wildfires struck Galicia (north-west Spain), giving rise to a disaster situation in which a great deal of the territory was destroyed. Unlike other occasions, the wildfires in this case also threatened farms, houses and even human lives, with the result that the perception of disaster and helplessness was the most acute experienced in recent years. This study sought to analyse the respiratory and mental health effects of the August-2006 fires, using consumption of anxiolytics-hypnotics and drugs for obstructive airway diseases as indicators.MethodsWe conducted an analytical, ecological geographical- and temporal-cluster study, using municipality-month as the study unit. The independent variable was exposure to wildfires in August 2006, with municipalities thus being classified into the following three categories: no exposure; medium exposure; and high exposure. Dependent variables were: (1) anxiolytics-hypnotics; and (2) drugs for obstructive airway diseases consumption. These variables were calculated for the two 12-month periods before and after August 2006. Additive models for time series were used for statistical analysis purposes.ResultsThe results revealed a higher consumption of drugs for obstructive airway diseases among pensioners during the months following the wildfires, in municipalities affected versus those unaffected by fire. In terms of consumption of anxiolytics-hypnotics, the results showed a significant increase among men among men overall -pensioners and non-pensioners- in fire-affected municipalities.ConclusionsOur study indicates that wildfires have a significant effect on population health. The coherence of these results suggests that drug utilisation research is a useful tool for studying morbidity associated with environmental incidents.",0,0 +6641,Pilot study to assess the viability of a rape trauma syndrome questionnaire.,"Studies have revealed that rape victims undergo a number of psychological symptoms following the attack, which constitute a specific syndrome termed the rape trauma syndrome (RTS). Evidence of the RTS has been admitted as scientific testimony in the prosecution of sexual offences and has been integral in their successful conviction. The present study aims to assess the viability of a questionnaire designed to identify the RTS in victims of alleged rape.A 77-item rape trauma syndrome questionnaire (RTSQ) was developed and administered to 30 women who reported rape and 57 nurses who formed the control group. The data were analysed using the Statistical Package for the Social Sciences (Windows Version 6.0).Statistical analysis suggested that the questionnaire was internally consistent and effective in uncovering significant differences between rape victims and controls in their experience of rape trauma symptoms. Rape victims scored significantly higher than controls on the RTS scale. Those who faked rape were also found to endorse a greater number of the rape trauma symptoms than actual rape victims, as well as a greater number of fictitious and unlikely symptoms.This pilot study confirmed the viability of the RTSQ and paves the way for a more rigorous examination of its reliability and validity. In the future, the questionnaire may be of use in ascertaining the veracity of victims' claims of rape in the conviction of sexual offences where circumstances are equivocal.",0,0 +6642,Impaired extinction of learned fear in rats selectively bred for high anxiety - evidence of altered neuronal processing in prefrontal-amygdala pathways,"The impaired extinction of acquired fear is a core symptom of anxiety disorders, such as post-traumatic stress disorder, phobias or panic disorder, and is known to be particularly resistant to existing pharmacotherapy. We provide here evidence that a similar relationship between trait anxiety and resistance to extinction of fear memory can be mimicked in a psychopathologic animal model. Wistar rat lines selectively bred for high (HAB) or low (LAB) anxiety-related behaviour were tested in a classical cued fear conditioning task utilizing freezing responses as a measure of fear. Fear acquisition was similar in both lines. In the extinction trial, however, HAB rats showed a marked deficit in the attenuation of freezing responses to repeated auditory conditioned stimulus presentations as compared with LAB rats, which exhibited rapid extinction. To gain information concerning the putatively altered neuronal processing associated with the differential behavioural response between HAB and LAB rats, c-Fos expression was investigated in the main prefrontal-amygdala pathways important for cued fear extinction. HAB compared to LAB rats showed an attenuated c-Fos response to repeated conditioned stimulus presentations in infralimbic and cingulate cortices, as well as in the lateral amygdala, but facilitated the c-Fos response in the medial part of the central amygdala. In conclusion, the present results support the notion that impaired extinction in high anxiety rats is accompanied by an aberrant activation profile in extinction-relevant prefrontal-amygdala circuits. Thus, HAB rats may represent a clinically relevant model to study the mechanisms and potential targets to accelerate delayed extinction processes in subjects with enhanced trait anxiety.",0,0 +6643,Posttraumatic stress disorder among three-generation families in times of war: A comparison between Israeli Jewish and Arabs after the Second Lebanon War (2006) and Cast Lead Operation (2009).,"There is little mention in the existing literature regarding the differential effects of wars or military operations on 3-generation families. Participants (n = 509; 167 elderly parents, 171 adult offspring, and 171 adult grandchildren) living in the northern and southern regions of Israel were interview after the Second Lebanon War (2006) and the Cast Lead Operation (2009). The participants were sampled by using a cluster sampling. Elderly parents experience higher levels of PTSD symptoms than their adult children or their adult grandchildren do. Women experience higher levels of PTSD symptoms than men and Israeli Arabs and Druze higher levels than Israeli Jews in all 3 generations. A policy should be enacted among the local authorities and the governmental offices that would ensure accessibility to and the ability to provide proper care especially for the elderly population during times of war, military operations, or terror events. In addition, it is important to set up local teams in every local community to deal with the level of mental and emotional preparedness of the homefront and its inhabitants, in case the latter should again become part of the human casualties of the wars and terrorist events that occur in Israel.",0,0 +6644,Comparison of psychiatric disability on the health of nation outcome scales (HoNOS) in resettled traumatized refugee outpatients and Danish inpatients,"Currently, the mental health issues of traumatized refugees are mainly documented in terms of posttraumatic stress disorder, depression, and anxiety. Importantly, there are no reports of the level of psychiatric disability in treatment seeking traumatized refugees resettled in the West. Insufficient acknowledgment of the collective load of bio-psycho-social problems in this patient group hinders effective psychiatric and social service utilization outside the specialized clinics for traumatized refugees.The level of psychiatric disability in traumatized refugees from Danish specialized clinics (N = 448) is documented using routine monitoring data from pre- and post-treatment on the Health of Nation Outcome Scales (HoNOS). Furthermore, the HoNOS ratings are compared with routine monitoring data from Danish inpatients with different diagnoses (N = 10.911).The routinely collected data indicated that despite their outpatient status, traumatized refugees had higher levels of psychiatric disability at pre-treatment compared to most inpatients. Moreover, the traumatized refugees had a HoNOS profile characterized by an overall high problem level in various psychiatric and social domains. The rate of pre- to post-treatment improvement on the HoNOS was smaller for the traumatized refugees than it was for the psychiatric inpatients.The level, and the versatile profile, of psychiatric disability on the HoNOS point to complex bio-psycho-social problems in resettled treatment seeking traumatized refugees. Thus, a broader assessment of symptoms and better cooperation between psychiatric, health care, and social systems is necessary in order to meet the treatment needs of this group.",0,0 +6645,Overview of post-traumatic stress.,"The purpose of this article is to provide an overview of the acute stress response with additional information on post-traumatic stress. There is an emphasis on the theoretical foundations and post-traumatic stress disorder symptoms. Risk factors, symptom clusters, and the diagnostic criteria for post-traumatic stress disorder are described as a foundation for clinical implications and a focused nursing assessment.",0,0 +6646,Posttraumatic stress avoidance symptoms as mediators in the development of alcohol use disorders after exposure to childhood sexual abuse in a Swiss community sample,"This study examined the role of posttraumatic stress disorder (PTSD) symptoms of re-experience, avoidance, and hyperarousal in the relationship between different types of trauma and alcohol use disorders (AUD). We used data from 731 trauma-exposed individuals who participated in the first wave of the PsyCoLaus-study. Trauma characteristics were assessed relatively to the occurrence of lifetime PTSD symptoms and AUD. The results suggest that lifetime and childhood sexual abuse as well as overall childhood trauma were directly linked to AUD and PTSD symptoms, in particular to avoidance symptoms. From single symptom clusters PTSD avoidance was found to specifically mediate the trauma-AUD pathway. Both childhood and sexual trauma strongly contribute to the comorbidity of PTSD and AUD and avoidance-type symptoms appear to play a central role in maintaining this association. Hence, the alleviation of avoidance symptoms might be an important target for therapeutic intervention among victims of sexual abuse before specific addiction treatment is initiated.",0,0 +6647,Comparison of Memory Function and MMPI-2 Profile between Post-traumatic Stress Disorder and Adjustment Disorder after a Traffic Accident,"Differential diagnosis between post-traumatic stress disorder (PTSD) and adjustment disorder (AD) is rather difficult, but very important to the assignment of appropriate treatment and prognosis. This study investigated methods to differentiate PTSD and AD.Twenty-five people with PTSD and 24 people with AD were recruited. Memory tests, the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and Beck's Depression Inventory were administered.There were significant decreases in immediate verbal recall and delayed verbal recognition in the participants with PTSD. The reduced memory functions of participants with PTSD were significantly influenced by depressive symptoms. Hypochondriasis, hysteria, psychopathic deviate, paranoia, schizophrenia, post-traumatic stress disorder scale of MMPI-2 classified significantly PTSD and AD group.Our results suggest that verbal memory assessments and the MMPI-2 could be useful for discriminating between PTSD and AD.",0,0 +6648,Influence of Bodily Injuries on Symptom Reporting Following Uncomplicated Mild Traumatic Brain Injury in US Military Service Members,": To examine the relations among bodily injuries, traumatic stress, and postconcussion symptoms in a sample of combat-injured US service members who sustained a mild traumatic brain injury.: One hundred and thirty-seven service members evaluated and treated at Walter Reed Army Medical Center following medical evacuation from the combat theater of Operation Enduring Freedom and Operation Iraqi Freedom. All had sustained an uncomplicated mild traumatic brain injury and concurrent bodily injuries.: Participants completed 2 symptom checklists within 3 months of injury. Severity of bodily injuries was quantified with a modified version of the Injury Severity Score that excluded intracranial injuries (ISSmod). Participants were classified into 4 ISSmod groups: minor (n = 17), moderate (n = 48), serious (n = 40), severe/critical (n = 32).: Neurobehavioral Symptom Inventory (NBSI) and the Posttraumatic Stress Disorder Checklist-Civilian version (PCLC).: There was a significant negative association between ISSmod scores and the NBSI and PCLC total scores. There were significant main effects across the 4 groups for the NBSI and PCLC total scores. The highest NBSI and PCLC scores were consistently found in the ISSmod minor group, followed by the moderate, serious, and severe/critical groups.: While it might be expected that greater comorbid physical injuries would be associated with greater symptom burden, in this study as the severity of bodily injuries increased, symptom burden decreased. Hypothesized explanations include: underreporting of symptoms; increased peer support; disruption of fear conditioning due to acute morphine use; or delayed expression of symptoms.",0,0 +6649,Latent class analysis of co-morbidity in the Adult Psychiatric Morbidity Survey in England 2007: implications for DSM-5 and ICD-11,"Psychiatric co-morbidity is complex and ubiquitous. Our aim was to describe the extent, nature and patterning of psychiatric co-morbidity within a representative sample of the adult population of England, using latent class analysis.Data were used from the 2007 Adult Psychiatric Morbidity Survey, a two-phase national household survey undertaken in 2007 comprising 7325 participants aged 16 years and older living in private households in England. The presence of 15 common mental health and behavioural problems was ascertained using standardized clinical and validated self-report measures, including three anxiety disorders, depressive episode, mixed anxiety depressive disorder, psychosis, antisocial and borderline personality disorders, eating disorders, post-traumatic stress disorder, attention deficit disorder, alcohol and drug dependencies, problem gambling and attempted suicide.A four-class model provided the most parsimonious and informative explanation of the data. Most participants (81.6%) were assigned to a non-symptomatic or 'Unaffected' class. The remainder were classified into three qualitatively different symptomatic classes: 'Co-thymia' (12.4%), 'Highly Co-morbid' (5.0%) and 'Addictions' (1.0%). Classes differed in mean numbers of conditions and impairments in social functioning, and these dimensions were correlated.Our findings confirm that mental disorders typically co-occur and are concentrated in a relatively small number of individuals. Conditions associated with the highest levels of disability, mortality and cost--psychosis, suicidality and personality disorders--are often co-morbid with more common conditions. This needs to be recognized when planning services and when considering aetiology.",0,0 +6650,PTSD Symptom Clusters Are Differentially Associated with Components of the Acquired Capability for Suicide,"Previous research has established the link between posttraumatic stress disorder (PTSD) and suicidal behavior. In the current study, constructs proposed to explain this relationship were examined, applying the framework of the interpersonal-psychological theory of suicide (IPTS). Relationships between acquired capability for suicide (ACS; i.e., fearlessness about death [FAD] and pain tolerance) and specific PTSD symptom clusters were explored. In a sample of 334 trauma-exposed undergraduates, anxious arousal and FAD were negatively associated, and numbing and pain tolerance were positively associated. Results establish a foundation for investigating the role of ACS in understanding observed relationships between suicidal behavior and PTSD symptoms.",0,0 +6651,Mental Disorders Associated With Subpopulations of Women Affected by Violence and Abuse,"Violence against women is a major public health problem associated with mental disorders. Few studies have examined the heterogeneity of interpersonal violence and abuse (IVA) among women and associated mental health problems. Latent class analysis was used to identify subpopulations of women with similar lifetime histories of IVA victimization and to examine 10 associated past-year mental disorders. Participants were 19,816 adult women who participated in Wave 2 of the National Epidemiologic Study on Alcohol and Related Conditions (NESARC). The 3-class model was best supported by the data. Class 1 (6.7%) had a high probability of witnessing domestic violence as a child. Class 2 (21.8%) had a low probability of all events except lifetime sexual assault. Class 3 (71.5%) had a low probability for all events. Mental disorders were more common among members of Classes 1 and 2 than Class 3. For example, members in Class 1 were approximately 8 and 9 times more likely than members in Class 3 to have had posttraumatic stress disorder or a drug use disorder, respectively, during the past year. Of the 10 mental disorders, 5 were more common among members of Class 1 than of Class 2. Findings suggest the mental health consequences of IVA among women are extensive and interventions should be tailored for distinct subpopulations affected by IVA.",0,0 +6652,Whiplash and post-traumatic stress disorder,This study examined the comorbidity of whiplash and post-traumatic stress disorder (PTSD) following motor vehicle accidents. A treatment strategy in cases with both disorders is proposed.A review of the literature on psychological consequences of motor vehicle accidents and on risk factors associated with developing chronic whiplash complaints is given. A case report is presented to illustrate the treatment strategy.Traffic accidents lead to psychological complaints more often than is realized in clinical practice. It is estimated that PTSD occurs in at least 25% of traffic accident victims who sustain physical injuries. This number is probably higher in patients with chronic whiplash complaints. The case report shows that improvement in relation with the post-traumatic stress symptoms can have a beneficial effect on coping with the chronic whiplash complaints.The psychotherapeutic treatment of patients with chronic whiplash complaints and PTSD should be aimed primarily at coping with the trauma and not at the chronic pain complaints.,0,0 +6653,How does the posttraumatic cognitions inventory fit in a four-factor posttraumatic stress disorder world? An initial analysis.,"The posttraumatic cognitions inventory (PTCI) has emerged as a well-supported measure of trauma-related cognitions and has been associated with overall posttraumatic stress disorder (PTSD) severity. The present study sought to contribute to the literature regarding the utility of this measure and importance of considering the role of trauma-related cognitions in relation to an emerging four-factor model of PTSD symptomatology. To address discrepancies in the previous literature, we first replicated prior research by investigating the relationship between the PTCI cognitions (self, world/other, and self-blame) and overall PTSD symptoms. Next, we used structural equation modeling to examine a model of the relationships between posttraumatic cognitions and a well-supported four-factor model of PTSD (including separate avoidance and numbing clusters). We assessed PTSD symptomatology using both clinician-administered and self-report instruments in a treatment-seeking sample of sexual assault survivors. Results largely supported the theorized model of relationships between posttraumatic cognitions and PTSD symptom clusters. Discrepancies were observed between the two PTSD measures, which may help to clarify previous conflicting reports. Clinical and theoretical implications are considered. © 2012 American Psychological Association.",0,0 +6654,Main and Interactive Effects of Distress Tolerance and Negative Affect Intensity in Relation to PTSD Symptoms among Trauma-Exposed Adults,"The present investigation evaluated the main and interactive effects of distress tolerance and negative affect intensity in relation to posttraumatic stress disorder (PTSD) symptom severity and symptom cluster severity. Participants were 190 trauma-exposed adults (52.6 % women; Mage=25.3 years, SD=11.4) recruited from the community. Distress tolerance (i.e., perceived ability to withstand distressing emotional states) demonstrated significant incremental associations with global PTSD symptom severity as well as Re-Experiencing, Emotional Numbing, and Hyperarousal symptom cluster severity. Negative affect intensity (i.e., perceived intensity of negative emotional responses) demonstrated significant incremental associations with each of the PTSD symptom outcomes. Moreover, the incremental interactive effect of distress tolerance and negative affect intensity was significantly associated with PTSD symptom severity as well as PTSD-Emotional Numbing symptom cluster severity. These incremental effects were evident after accounting for the variance explained by anxiety sensitivity (i.e., fear of anxiety-related sensations). Post hoc probing analyses supported the moderating role of negative affect intensity in the association between distress tolerance and PTSD symptom severity, such that low levels of distress tolerance, in the context of elevated levels of negative affect intensity, were associated with the greatest levels of PTSD symptoms.",0,0 +6655,Cognitive Factors in Persistent versus Recovered Post-Traumatic Stress Disorder after Physical or Sexual Assault: A Pilot Study,"Cognitive models have linked individual differences in the appraisal of traumatic events and their sequelae to the persistence of post-traumatic stress disorder (PTSD). A pilot study investigated this proposal with victims of assault. Eleven assault victims suffering from persistent PTSD and 9 victims who had recovered from PTSD were interviewed retrospectively and compared on potentially relevant cognitive factors. Groups were comparable in terms of characteristics of the assault, gender, age, and initial PTSD severity. Participants with persistent PTSD were less likely than those who had recovered to have engaged in mental planning during the assault and more likely to have experienced mental defeat, and to indicate negative appraisals of their actions during the assault, of others' reactions after the assault, and of their initial PTSD symptoms. They were also more likely to indicate global negative beliefs concerning their perception of themselves, their world or their future. These cognitive factors may maintain PTSD symptoms either directly or by motivating the individual to engage in behaviour that prevents change.",0,0 +6656,Posttraumatic and depressive symptoms in β-endorphin dynamics,"A disturbed beta-endorphin system can be a part of the post-traumatic stress disorder (PTSD) and depression allostasis. Study subjects (N=392) included those with PTSD and/or (stress-induced) depression, and healthy controls with and without traumas. The aim of the study was to examine the network of relations centered around plasma beta-endorphin. The network included anxiety (as a personality trait), traumatic events, pain, aggressiveness, depressive symptoms, and three clusters of PTSD symptoms: intrusions, avoidance, and hyperarousal. Beta-endorphin was represented by individual mean from 13 time points (BEmean), reflecting the total amount of the peripherally secreted hormone, and the coefficient of variation (BEvar), calculated as the ratio of standard deviation to the mean, reflecting the hormone׳s dynamics. BEvar correlated with all other variables, BEmean had no correlations. Structural equation modeling (SEM) was used to examine all interrelations (including their directions) of BEvar and the state/trait variables in the context of their entirety. The model revealed that hyperarousal and anxiety were the only direct agents of peripheral beta-endorphin fluctuations, mediating the effects of other variables. Traumatic events and intrusions act on BEvar via hyperarousal, while depressive symptoms, avoidance, and pain act via anxiety. Hyperarousal should be emphasized as the main agent not only because its effect on BEvar is larger than that of anxiety, but also because it increases anxiety itself (via avoidance and pain). All influences on BEvar are positive and they indicate long-term (sensitizing) effects (as opposed to direct stimulation, for example, by acute pain, anger, etc.). Relations apart from beta-endorphin are also discussed.",0,0 +6657,Group music therapy for patients with persistent post-traumatic stress disorder - an exploratory randomized controlled trial with mixed methods evaluation,"Objectives. Not all patients with post-traumatic stress disorder (PTSD) respond to cognitive behavioural therapy (CBT). Literature suggests group music therapy might be beneficial in treating PTSD. However, feasibility and effectiveness have not been assessed. The study objectives were to assess whether group music therapy was feasible for patients who did not respond to CBT, and whether it has an effect on PTSD symptoms and depression. Design. The study employed mixed methods comprising of an exploratory randomized controlled trial, qualitative content analysis of therapy, and patient interviews. Method. Patients with significant PTSD symptoms (n= 17) following completion of CBT were randomly assigned to treatment (n= 9) or control groups (n= 8). The treatment group received 10 weeks of group music therapy after which exit interviews were conducted. Control group patients were offered the intervention at the end of the study. Symptoms were assessed on the Impact of Events Scale-Revised and Beck Depression Inventory II at the beginning and end of treatment. Results. Treatment-group patients experienced a significant reduction in severity of PTSD symptoms (−20.18; 95% confidence interval [CI]: [−31.23, −9.12]) and a marginally significant reduction in depression (−11.92; 95%CI: [−24.05, 0.21]) at 10 weeks from baseline compared to the control. Patients viewed music therapy as helpful and reported experiences concur with current literature. Conclusions. Group music therapy appears feasible and effective for PTSD patients who have not sufficiently responded to CBT. Limitations include the small sample size and lack of blinding. Further research should address these limitations, test sustainability, and identify specific factors that address symptoms in treatment.",0,0 +6658,Longitudinal analysis of the relationship between symptoms and quality of life in veterans treated for posttraumatic stress disorder.,This study examined how change in posttraumatic stress disorder (PTSD) symptoms relates to change in quality of life. The sample consisted of 325 male Vietnam veterans with chronic PTSD who participated in a randomized trial of group psychotherapy. Latent growth modeling was used to test for synchronous effects of PTSD symptom change on psychosocial and physical health-related quality of life within the same time period and lagged effects of initial PTSD symptom change on later change in quality of life. PTSD symptoms were associated with reduced quality of life before treatment. There were synchronous effects of symptom change on change in quality of life but no significant lagged effects. Results indicate the importance of measuring quality of life in future investigations of PTSD treatment.,0,0 +6659,Cumulative Tertiary Appraisals of Traumatic Events Across Cultures: Two Studies,"Two studies compared the effects of cumulative trauma (CT) with those of cumulative negative (CNTA) and cumulative positive tertiary appraisals (CPTA). The first study was conducted with an adult clinical population in the U.S. (N = 399), while the second study was conducted with adolescent students in Gaza (N = 422). Among the effects found were that path analysis with comulative trauma, positive tertiary appraisal, and cumulative negative tertiary appraisals as independent variables and mental health measures as dependent variables, in both samples, found that CNTA and CPTA had direct positive and direct negative effects, respectively, on PTSD, depression, and anxiety. However, CT, independent from appraisals, had direct effects in producing the more complicated symptom clusters of cumulative trauma disorders.",0,0 +6660,Markers of Inflammation in Midlife Women with Intimate Partner Violence Histories,"Lifetime occurrence of intimate partner violence (IPV) in women has been associated with increased prevalence of aging-related chronic diseases, including those with a pathophysiology involving inflammation. To begin to identify potential biologic mediators of this relationship, this cross-sectional study examined associations between past IPV and circulating levels of C-reactive protein (CRP) and interleukin-6 (IL-6)-measures linked with emergence of aging-related diseases-along with in vitro IL-6 production by peripheral blood mononuclear cells (PBMC) stimulated with either phytohemagglutinin A (PHA) or lipopolysaccharide (LPS).Apparently healthy, midlife women with divorce histories were recruited from the community. Histories of intimate partner psychological aggression, physical assault, sexual coercion, and stalking were assessed, along with current depression, posttraumatic stress symptoms, and health-related characteristics. At two visits, blood was drawn for assessment of biologic measures; measures were averaged across visits.In this sample (n=68), a history of being stalked was significantly positively correlated with CRP levels; in a multiple regression analysis that included body mass index (BMI) and current symptoms, this association was attenuated by adjusting for BMI. Physical assault history was significantly negatively correlated with PHA-stimulated IL-6 production. This was most apparent for severe assault and was not accounted for by BMI or symptoms.IPV histories remitted for an average of 10 years were associated with biologic mediators of inflammation. The profile was not uniformly proinflammatory, suggesting that in situations of traumatic or chronic stress, different aspects of the inflammatory response are differentially regulated and subjected to diverse compensatory mechanisms.",0,0 +6661,Battlefield functioning and chronic PTSD: associations with perceived self efficacy and causal attribution,"This study has two aims: (1) to examine the associations between battlefield functioning and perceived self efficacy (PSE) and attributional style; (2) to examine the unique and cumulative contributions of battlefield functioning, PSE, and attributional style to long term PTSD . The subjects were three groups of Israeli veterans of the 1973 Yom Kippur, who differed in their battlefield functioning: 112 combat stress reaction (CSR) casualties, 98 veterans who received medals for bravery, and 189 controls. The subjects filled out a series of questionnaires that assessed PTSD, PCE, attributional style and PTSD, two decades after the war. CSR casualties exhibited the lowest level of PSE, decorated veterans the highest. The three groups also differed in locus of control , with different attribution for failure. Discriminant analysis of PTSD and non-PTSD veterans showed that sociodemographic background, battlefield performance, PSE and attributional style classified 81% of all veterans correctly. The implications of these findings are discussed.",0,0 +6662,Evidence of a disposition toward fearfulness and vulnerability to posttraumatic stress in dysfunctional pain patients,"Few investigations have addressed whether patient subgroups derived using the Multiaxial Assessment of Pain (MAP) [Turk, D. C., & Rudy, T. E. (1987). Towards a comprehensive assessment of chronic pain patients. Behaviour Research and Therapy, 25, 237-249; Turk, D. C., & Rudy, T. E. (1988). Toward an empirically derived taxonomy of chronic pain patients: integration of psychological assessment data. Journal of Consulting and Clinical Psychology, 56, 233-238.] differ with regard to fear and avoidance. It has, however, been reported that dysfunctional patients exhibit more pain-specific fear and avoidance than patients classified as interpersonally distressed or minimizers/adaptive copers [Asmundson, G. J. G., Norton, G. R., & Allerdings, M. D. (1997). Fear and avoidance in dysfunctional chronic back pain patients. Pain, 69, 231-236.]. We attempted to extend these findings by examining two fear constructs that are receiving increased attention in the chronic pain literature-anxiety sensitivity and PTSD. The sample comprised 115 patients with chronic pain. Of these, 14 (12.2%) were classified as dysfunctional, 21 (18.3%) as interpersonally distressed and 47 (40.8%) as minimizers/adaptive copers. Between-group differences were observed on the fear of cognitive and emotional dyscontrol dimension of anxiety sensitivity, total and symptom cluster scores on the PTSD measure, and depression. No differences were observed for the fear of somatic sensations dimension of anxiety sensitivity or agoraphobia, social phobia, and blood/injury fears. Dysfunctional patients generally exhibited elevated scores relative to one or both of the other MAP subgroups on fear of cognitive and emotional dyscontrol, depressed affect, PTSD symptom total score and PTSD symptom cluster scores. As well, a substantial proportion of dysfunctional and interpersonally distressed patients were classified as having PTSD (71.4 and 42.9%, respectively) when compared to minimizers/adaptive copers (21.3%). These results suggest that MAP subgroups differ with regard to their propensity to be(come) fearful and in their likelihood of having PTSD. Theoretical and clinical implications are discussed.",0,0 +6663,Longitudinal effects of PTSD on memory functioning,"Abstract Numerous studies have demonstrated explicit and working memory deficits related to posttraumatic stress disorder (PTSD), but few have addressed longitudinal changes in memory functioning. There is some evidence to suggest an interactive effect of PTSD and aging on verbal memory decline in Holocaust survivors (Yehuda et al., 2006). However, the longitudinal trajectory of neuropsychological functioning has not been investigated in Vietnam veterans, a younger but substantial population of aging trauma survivors. We administered tests of visual and verbal memory, and working memory to derive different dependent measures in veterans between the ages of 41 and 63, the majority of whom served in the Vietnam War. Twenty-five veterans with PTSD and 22 veterans without PTSD were assessed over two time points (mean age at follow-up = 54.0; mean inter-test interval = 34 months). The PTSD+ group, consisting of veterans with chronic, primarily combat-related PTSD, did not show a significant change in PTSD symptoms over time. Compared to veterans without PTSD, veterans with PTSD showed a greater decline in delayed facial recognition only, and this decline was extremely subtle. ( JINS , 2009, 15 , 853–861.)",0,0 +6664,Transdiagnostic and disorder-specific models of intergenerational transmission of internalizing pathology – ERRATUM,"Reports an error in ""Transdiagnostic and disorder-specific models of intergenerational transmission of internalizing pathology"" by L. R. Starr, C. C. Conway, C. L. Hammen and P. A. Brennan (Psychological Medicine, 2014[Jan], Vol 44[1], 161-172). In the original article, there were errors in Figure 1. The correct Figure 1 is present in the erratum. (The following abstract of the original article appeared in record 2013-44252-015). Background: Numerous studies have supported an association between maternal depression and child psychiatric outcomes, but few have controlled for the confounding effects of both maternal and offspring co-morbidity. Thus, it remains unclear whether the correspondence between maternal and offspring depressive and anxiety disorders is better explained by associations between shared features of maternal and offspring internalizing disorders or by specific effects exerted by unique aspects of individual disorders. Method: Pairs of mothers and offspring overselected for maternal depression (n = 815) were assessed at offspring age 15 years for anxiety and depressive disorders; 705 completed a follow-up at offspring age 20 years. For both mothers and offspring, structural equation modeling was used to distinguish transdiagnostic internalizing pathology - representing the overlap among all depressive and anxiety disorders - from diagnosis-specific forms of pathology. To discriminate between general versus specific pathways of intergenerational transmission of psychopathology, we examined (a) the general association between the maternal and offspring internalizing factors and (b) the correlations between maternal and offspring diagnosis-specific pathology for each disorder. Results: For mothers and offspring, a unidimensional latent variable model provided the best fit to the correlations among depressive and anxiety disorders. The maternal transdiagnostic internalizing factor strongly predicted the corresponding factor among offspring. In addition, the unique component of post-traumatic stress disorder among offspring was significantly related to the analogous unique component among mothers, but specific components of other maternal disorders, including depression, did not predict corresponding offspring pathology. Conclusions: Results suggest that intergenerational transmission of internalizing disorders is largely non-specific. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0,0 +6665,Phenomenology and psychological assessment of complex posttraumatic states,"The authors offer a framework for the assessment of psychological responses associated with exposure to early onset, multiple, or extended traumatic stressors. Six prominent and overlapping symptoms clusters are described: altered self-capacities, cognitive symptoms, mood disturbance, overdeveloped avoidance responses, somatoform distress, and posttraumatic stress. A strategy for the structured, psychometrically valid assessment of these outcomes is introduced, and specific recommendations for use of various generic and trauma-specific child and adult measures are provided. Implications of trauma assessment for treatment planning are discussed.",0,0 +6666,Longitudinal Analysis of Children's Internal States Language and Posttraumatic Stress Symptoms Following a Natural Disaster,"Summary Disclosure of internal states terms (e.g., emotions, cognitions, and perceptions) in traumatic event descriptions is thought to be associated with physical and mental health in adults, but studies with children have been mixed, and the interpretation of many findings is complicated by the lack of longitudinal data. Using data collected from 568 students (ages 7–12 years) attending schools in Miami-Dade County, Florida, this study examined the internal states language in participant's written descriptions of the ‘worst things that happened during the hurricane’ collected 3 and 7 months after Hurricane Andrew. Associations between these internal states and their posttraumatic stress symptoms (PTSS) 3, 7, and 10 months post-hurricane were evaluated using structural equation modeling. Patterns of association suggest that PTSS were not affected by internal states disclosure; rather, internal states language seemed to be a manifestation of PTSS. Implications for risk assessment, theory building, and treatment of PTSS in children are discussed. Copyright © 2014 John Wiley & Sons, Ltd.",0,0 +6667,Persistence of Posttraumatic Stress Symptoms 12 and 36 Months After Acute Coronary Syndrome,"To assess the prevalence and predictors of posttraumatic stress symptoms in patients at 12 and 36 months post hospital admission for an acute coronary syndrome (ACS). There is increasing recognition that posttraumatic stress may develop in the aftermath of an acute cardiac event. However, there has been little research on the longer-term prevalence of posttraumatic stress disorder (PTSD).Posttraumatic stress symptoms were assessed at 12 months in 213 patients with ACS and in 179 patients at 36 months. Predictor variables included clinical, demographic, and emotional factors measured during hospital admission.At 12 months post ACS, 26 (12.2%) patients qualified for a diagnosis of PTSD; 23 (12.8%) patients were identified with PTSD at 36 months. Posttraumatic symptoms at 12 months were associated with younger age, ethnic minority status, social deprivation, cardiac symptom recurrence, history of depression, depressed mood during admission, hostility, and Type D personality. In multiple regression, depressed mood during admission and recurrent cardiac symptoms were independent predictors of posttraumatic symptoms (R(2) = 0.507, p < .001). At 36 months, posttraumatic stress symptoms were independently predicted by posttraumatic symptom levels at 12 months and depressed mood during admission (R(2) = 0.635, p < .001).Posttraumatic stress symptoms persist for at least 3 years after an acute cardiac event. Early emotional responses are important in predicting longer-term posttraumatic stress. It is important to identify patients at risk for posttraumatic stress as they are more likely to experience reduced quality of life.",0,0 +6668,"Resilience, Vulnerability and the Course of Posttraumatic Reactions",,0,0 +6669,Anatomical and functional connectivity in the default mode network of post-traumatic stress disorder patients after civilian and military-related trauma,"Posttraumatic stress disorder (PTSD) is characterized by unwanted intrusive thoughts and hyperarousal at rest. As these core symptoms reflect disturbance in resting-state mechanisms, we investigated the functional and anatomical involvement of the default mode network (DMN) in this disorder. The relation between symptomatology and trauma characteristics was considered. Twenty PTSD patients and 20 matched trauma-exposed controls that were exposed to a similar traumatic event were recruited for this study. In each group, 10 patients were exposed to military trauma, and 10 to civilian trauma. PTSD, anxiety, and depression symptom severity were assessed. DMN maps were identified in resting-state scans using independent component analysis. Regions of interest (medial prefrontal, precuneus, and bilateral inferior parietal) were defined and average z-scores were extracted for use in the statistical analysis. The medial prefrontal and the precuneus regions were used for cingulum tractography whose integrity was measured and compared between groups. Similar functional and anatomical connectivity patterns were identified in the DMN of PTSD patients and trauma-exposed controls. In the PTSD group, functional and anatomical connectivity parameters were strongly correlated with clinical measures, and there was evidence of coupling between the anatomical and functional properties. Type of trauma and time from trauma were found to modulate connectivity patterns. To conclude, anatomical and functional connectivity patterns are related to PTSD symptoms and trauma characteristics influence connectivity beyond clinical symptoms. Hum Brain Mapp 37:589-599, 2016. © 2015 Wiley Periodicals, Inc.",0,0 +6670,Complex posttraumatic stress disorder in traumatised asylum seekers: a pilot study,"Complex posttraumatic stress disorder (cPTSD), a construct associated with early onset and repeated interpersonal trauma, has not previously been assessed in asylum seekers who have experienced major human rights violations. The aim of this pilot study was to describe the cPTSD symptom profile in asylum seekers, and to compare this profile between three groups of people who have experienced: human trafficking, domestic violence and/or torture. Methods: Over a period of eight weeks, clinicians working at the Helen Bamber Foundation charity invited 48 patients currently receiving psychotherapy to take part in the study, of whom 30 (62.5%) agreed. The structured interview for disorders of extreme stress (SIDES) was used to assess cPTSD in 29 asylum seekers, as one patient withdrew during the interview. Results: Participants originated from 18 countries, 72.4% were female, the median age at trauma onset was 17 years and the duration of trauma was ten years. Eight (27.6%) participants were found to have cPTSD, defined as having all six symptom clusters, and 15 (51.7%) had five or more cPTSD symptom clusters. Age at trauma onset, duration of trauma, last trauma experience, gender and trauma type were not found to be associated with cPTSD presence. Conclusions: Extensive cPTSD symptoms were common in all participants, regardless of the nature of the trauma experienced. Future research is needed to enable generalisability of cPTSD symptom profile in asylum seekers.",0,0 +6671,Women in prison: The central issues of gender characteristics and trauma history,"Insufficient attention is being paid to two key issues which are critical to a better understanding of what can be done to improve present services for women in prison. Firstly, the demographics, determinants and profiles of imprisoned women clearly show factors that should be central to any prison policy for women. Secondly, an analysis of the role of trauma history shows its strong influence on offending behaviour. Any modern approach to providing a more acceptable criminal justice policy for women must pay much greater attention to these two important issues.",0,0 +6672,Cognitive and emotional processing through writing among adolescents who experienced the death of a classmate.,"This study investigated how written emotional disclosure reflects the processes by which adolescents cope with a traumatic event they experienced collectively - the sudden death of a classmate. Twenty high school students wrote about their emotional reactions to the death on 3 consecutive days. The writings were coded using the Linguistic Inquiry and Word Count (LIWC) and analyzed using a mixed-methods software (T-LAB). A measure of posttraumatic stress symptoms (Impact of Events Scale-Revised) obtained at baseline (14 days after the death) and 1 week and 4 months' postwriting was used to classify the students into four adjustment trajectories: Delayed Distress, Recovery, Stable-Negative, and Stable-Positive. Textual analysis revealed a progressive elaboration of the traumatic event across the 3 writing days, moving from a factual perspective to the processing of emotions to an integrated emotional and cognitive restructuring of the event. The nature of the writing differed across adjustment trajectories. Specifically, students in the Stable-Positive and Recovery trajectories made greater mention of the deceased classmate and reflected greater cognitive processing of the trauma. Students in the Stable-Negative and Delayed Distress trajectories used more self-references and negative emotion words and showed a greater degree of inhibition. The results provide preliminary clues to adjustment processes in adolescent bereavement. © 2010 American Psychological Association.",0,0 +6673,"Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders","Anxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated.These guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology, diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980-2012). Treatment strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines.These guidelines are presented in 10 sections, including an introduction, principles of diagnosis and management, six sections (Sections 3 through 8) on the specific anxiety-related disorders (panic disorder, agoraphobia, specific phobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder), and two additional sections on special populations (children/adolescents, pregnant/lactating women, and the elderly) and clinical issues in patients with comorbid conditions.Anxiety and related disorders are very common in clinical practice, and frequently comorbid with other psychiatric and medical conditions. Optimal management requires a good understanding of the efficacy and side effect profiles of pharmacological and psychological treatments.",0,0 +6674,"Caregiver distress, shared traumatic exposure, and child adjustment among area youth following the 2013 Boston Marathon bombing","Disasters are associated with myriad negative outcomes in youth, including posttraumatic stress disorder and related psychopathology. Prior work suggests links between caregiver distress and child mental health outcomes following community traumas, but the extent to which caregiver distress is directly linked to post-disaster child functioning, or whether such associations may simply be due to shared traumatic exposure, remains unclear.The current study examined relationships among caregiver distress, caregiver-child shared traumatic exposure, and child outcomes in Boston-area families (N=460) during the six months following the 2013 Boston Marathon bombing. Parents completed surveys about their and their child׳s potentially traumatic experiences during the bombing and subsequent manhunt. Post-attack caregiver distress and child psychological functioning were also assessed.After accounting for caregiver-child shared traumatic exposure, significant associations were retained between caregiver distress and child functioning across several domains. Furthermore, after accounting for caregiver traumatic exposure, caregiver distress moderated relationships between child traumatic exposure and child posttraumatic stress and conduct problems, such that associations between child traumatic exposure and child posttraumatic stress and conduct problems were particularly strong among children of highly distressed caregivers.The cross-sectional design did not permit evaluations across time, and population-based methods were not applied.Findings clarify links between caregiver distress and child psychopathology in the aftermath of disaster and can inform optimal allocation of clinical resources targeting disaster-affected youth and their families.",0,0 +6675,Head and facial injuries due to cluster munitions,"Cluster munitions are weapons that scatter smaller sub-munitions intended to kill or mutilate on impact. They have been used by the Israeli army in the south of Lebanon and are now scattered over wide rural areas affecting its inhabitants. Because of their easily ""pickable"" nature, sub-munitions can inflict injuries to the head and face regions. In this study, we aimed to explore the head and face injuries along with their clinical features in a group of Lebanese patients who suffered from such injuries due to a sub-munition's detonation. The study included all the cases reported between 14 August 2006 and 15 February 2013, with head and face injuries related to cluster bombs. Injuries were classified into brain, eye, otologic and auditory impairments, oral and maxillofacial, and skin and soft-tissue injuries. Psychological effects of these patients were also examined as for post-traumatic stress disorder, major depressive disorder, generalized anxiety disorder and acute stress syndrome. During the study period, there were 417 casualties as a result of cluster munitions' blasts. Out of the total number of victims, 29 (7 %) were injured in the head and the face region. The convention on cluster munitions of 2008 should be adhered to, as these inhumane weapons indiscriminately and disproportionately harm innocent civilians, thereby violating the well-established international principles governing conflict and war today. © 2014 Springer-Verlag.",0,0 +6676,Psychiatric symptoms of noradrenergic dysfunction: A pathophysiological view,"What psychiatric symptoms are caused by central noradrenergic dysfunction? The hypothesis considered in this review is that noradrenergic dysfunction causes the abnormalities in arousal level observed in functional psychoses. In this review, the psychiatric symptoms of noradrenergic dysfunction were inferred pathophysiologically from the neuroscience literature. This inference was examined based on the literature on the biology of psychiatric disorders and psychotropics. Additionally, hypotheses were generated as to the cause of the noradrenergic dysfunction. The central noradrenaline system, like the peripheral system, mediates the alarm reaction during stress. Overactivity of the system increases the arousal level and amplifies the emotional reaction to stress, which could manifest as a cluster of symptoms, such as insomnia, anxiety, irritability, emotional instability and exaggerated fear or aggressiveness (hyperarousal symptoms). Underactivity of the system lowers the arousal level and attenuates the alarm reaction, which could result in hypersomnia and insensitivity to stress (hypoarousal symptoms). Clinical data support the hypothesis that, in functional psychoses, the noradrenergic dysfunction is in fact associated with the arousal symptoms described above. The anti-noradrenergic action of anxiolytics and antipsychotics can explain their sedative effects on the hyperarousal symptoms of these disorders. The results of animal experiments suggest that excessive stress can be a cause of long-term noradrenergic dysfunction.",0,0 +6677,Psychotic features and combat-associated PTSD,"Psychotic symptoms and psychotic disorder diagnoses have occasionally been reported in association with chronic posttraumatic stress disorder (PTSD). Although psychotic features may be related to core PTSD symptoms, i.e., part of the reexperiencing phenomena, it is possible that they are secondary to certain comorbid disorders which are also prevalent in this patient population, e.g. major depression or substance abuse. In a prospective study, combat associated PTSD patients (n = 25) were administered clinical ratings, including the Structured Clinical Interview for DSM-III-R with psychotic screen (SCID-P), Clinician Administered PTSD Scale (CAPS) and the Impact of Events Scale (IES). Thirty-six percent (n = 9) endorsed psychotic symptoms with associated comorbidity including: major depressive episode, bipolar disorder, alcohol or polysubstance abuse panic disorder, and phobias. All but one of the patients with psychotic features also met criteria for major depressive episode. None had a primary psychotic disorder diagnosis. There were no significant differences in total CAPS scores between patients with or without psychotic features (82.6 +/-0 17.6 versus 75.3 +/- 22.4, p ns), nor for the different symptom cluster subscales. There were also no differences in the IES scores between groups (34.8 +/- 10 versus 32.6 +/- 10 p ns). This suggests that these psychotic features may not necessarily reflect severity of PTSD symptoms. PTSD may share a common diathesis with mood disorders including psychotic depression. Further study is needed of these phenomena.",0,0 +6678,Validation of a brief measure of posttraumatic stress disorder: The Distressing Event Questionnaire (DEQ).,"The Distressing Event Questionnaire (DEQ) is a brief instrument for assessing posttraumatic stress disorder (PTSD) according to criteria provided in Diagnostic and Statistical Manual of Mental Disorders (4th ed.). The DEQ possesses high internal consistency and exhibited satisfactory short-term temporal stability in studies with Vietnam War combat veterans and battered women. In a sample of Vietnam War veterans and 4 separate samples of abused women (with histories of incest, rape, intimate partner abuse, or prostitution and abuse), the DEQ exhibited very good discriminative validity when judged against structured interview assessment of PTSD. The DEQ exhibited strong convergent validity with other PTSD measures and other indexes of adjustment and also exhibited strong convergent validity as a measure of PTSD across ethnic groups in both the veteran sample and the combined women's sample.",0,0 +6679,Current status of anxiolytic drugs,"Anxiety disorders commonly seen in primary care are characterized by psychological and physical symptoms of disabling anxiety. However, they are often unrecognized and under-diagnosed. Because of the dearth of trained therapists, pharmacotherapy remains the most widespread form of treatment. Newer anti-anxiety drugs have been developed that are more effective with a better side-effect profile. In this article, the various anxiety disorders are described together with their appropriate pharmacotherapy.",0,0 +6680,Gray Matter Correlates of Posttraumatic Stress Disorder: A Quantitative Meta-Analysis,"

Background

Since the inception of the diagnosis posttraumatic stress disorder (PTSD), attempts have been undertaken to understand why only a subpopulation of individuals exposed to trauma develops PTSD. Cerebral gray matter reductions have been suggested to be a crucial pathobiological marker of PTSD. However, a quantitative meta-analysis of whole-brain voxel-based morphometry studies is lacking.

Methods

Here, we investigated concurrence across voxel-based morphometry studies in PTSD compared with trauma-exposed individuals without PTSD (all together nine studies with 319 subjects) by means of activation likelihood estimation.

Results

We identified brain regions of consistent gray matter reduction in anterior cingulate cortex, ventromedial prefrontal cortex, left temporal pole/middle temporal gyrus, and left hippocampus in PTSD patients compared with individuals exposed to trauma without PTSD.

Conclusions

This is the first quantitative whole-brain meta-analysis showing brain structure deficits in traumatized subjects with PTSD compared with trauma-exposed healthy control subjects. The gray matter deficit profile overlaps with brain networks of emotion processing, fear extinction, and emotion regulation known to be affected in PTSD. Although the data cannot clarify if this is a predisposition or a consequence of the disease, the results may facilitate the need to control for structural characteristics in future functional brain studies.",0,0 +6681,Differential relationships of childhood abuse and neglect subtypes to PTSD symptom clusters among adolescent inpatients,"This article investigates whether childhood abuse and neglect subtypes (i.e., physical, sexual, and emotional abuse, and physical and emotional neglect) differentially predict the severity of individual posttraumatic stress disorder (PTSD) symptom clusters and overall posttraumatic stress. Eighty-nine patients admitted to the short-term adolescent treatment unit of a psychiatric hospital completed a battery of psychological assessments. Findings of multiple regression analyses showed that emotional and sexual abuse rather than physical abuse, emotional neglect, or physical neglect is related to individual symptom cluster severity and overall posttraumatic stress. Results suggested that a greater level of specificity is necessary when assessing child abuse and posttraumatic stress because each level provides more specific information about how to intervene to reduce the risk of negative outcomes.",0,0 +6682,"Enduring Mental Health Morbidity and Social Function Impairment in World Trade Center Rescue, Recovery, and Cleanup Workers: The Psychological Dimension of an Environmental Health Disaster","The World Trade Center (WTC) attacks exposed thousands of workers to hazardous environmental conditions and psychological trauma. In 2002, to assess the health of these workers, Congress directed the National Institute for Occupational Safety and Health to establish the WTC Medical Monitoring and Treatment Program. This program has established a large cohort of WTC rescue, recovery, and cleanup workers. We previously documented extensive pulmonary dysfunction in this cohort related to toxic environmental exposures.Our objective in this study was to describe mental health outcomes, social function impairment, and psychiatric comorbidity in the WTC worker cohort, as well as perceived symptomatology in workers' children.Ten to 61 months after the WTC attack, 10,132 WTC workers completed a self-administered mental health questionnaire.Of the workers who completd the questionnaire, 11.1% met criteria for probable post-traumatic stress disorder (PTSD), 8.8% met criteria for probable depression, 5.0% met criteria for probable panic disorder, and 62% met criteria for substantial stress reaction. PTSD prevalence was comparable to that seen in returning Afghanistan war veterans and was much higher than in the U.S. general population. Point prevalence declined from 13.5% to 9.7% over the 5 years of observation. Comorbidity was extensive and included extremely high risks for impairment of social function. PTSD was significantly associated with loss of family members and friends, disruption of family, work, and social life, and higher rates of behavioral symptoms in children of workers.Working in 9/11 recovery operations is associated with chronic impairment of mental health and social functioning. Psychological distress and psychopathology in WTC workers greatly exceed population norms. Surveillance and treatment programs continue to be needed.",0,0 +6683,A prospective study on paediatric traffic injuries: health-related quality of life and post-traumatic stress,"Objectives: To examine children's reports of their health-related quality of life (HRQoL) following paediatric traffic injury, to explore child and parental post-traumatic stress, and to identify children and parents with adverse outcomes. Design: Prospective cohort study. Assessments: shortly after the injury, three months and six months post injury. Setting: Department of Traumatology, University Hospital. Subjects: Fifty-one young traffic injury victims aged 8-15 years. Main measures: TNO-AZL Children's Quality of Life questionnaire and the Impact of Event Scale. Results: Short-term adverse changes in the child's HRQoL were observed for the child's motor functioning and autonomy. At three months, 12% of the children and 16% of the parents reported serious post-traumatic stress symptoms. Increased stress at three months, or across follow-up, was observed among hospitalized children, children with head injuries, and children injured in a motor vehicle accident. Parental stress was related to low socioeconomic status and the seriousness of the child's injury and accident (hospitalization, head injury, serious injury, motor vehicle involved, others injured). Conclusions: The children reported only temporary effects in their motor functioning and autonomy. Post-traumatic stress symptoms following paediatric traffic injury were not only experienced by the children, but also by their parents.",0,0 +6684,Applying suppression subtractive hybridization technique to investigate gene differential expression profiles in rats liver during the course of heat stress,"Aim: To explore the molecular mechanism of heat stress by isolating diff erentially expressed genes occurred during the course of heat stress and filtrat ing functional gene segments concerned with heat stress with Suppression Subtrac tive Hybridization technique. Methods: There were 2 groups in th e experiment: heat stress group and normal temperature control group. mRNAs were isolated from the liver tissue individually and then transcripted into cDNAs. A fter cut with endonuclease and ligation with adaptors, SSH was carried out with cDNAs of heat stress group as tester while cDNAs of control group as driver. Pro ducts were cloned into T/A vector to form recombined plasmids to transfect compe tence cells for filtration and appraisal. Results: mRNAs were ab undant and of high quality, cDNAs were reverse-transcripted and then cut into s egments about 500 bp successfully. Ligation efficiency was satisfied. The subtr active hybridization library was constructed successfully after effective hybrid ization and 180 segments were primarily isolated from it. Conclusion: Construction of heat stress differentially expressed genes subtractive lib rary has established the foundation of filtrating heat stress concerned genes, i t is of active significance for exploring functional genes that controlled heat stress.",0,0 +6685,A preliminary classification system for homeless veterans with mental illness.,"The purpose of this study was that of defining psychiatric profiles among veterans based on a structured interview of 3,595 individuals administered by outreach mental health clinicians to individuals who were presently or recently homeless. The interview included ratings of presence or absence of current psychiatric disorders; alcoholism, drug abuse, psychosis, mood disorders, personality disorders, PTSD, and adjustment disorders. We identified three subgroups using cluster analysis each showing different diagnostic profiles that were characterized as “addiction” (n 3,061), “psychosis” (n 218), and “personality” disorders (n 54). Cluster membership was related to demographic characteristics, living situation, length of homelessness, and symptoms and complaints including cognitive difficulties, suicidality, violence, and depression. Group comparison statistics were used to compare intercluster differences in demographics, homeless situation, symptoms, and subjective complaints. There were no major intercluster differences in socioethnic, demographic, and homeless situation variables. Differences occurred in complaints of depression, positive symptoms of psychosis, and suicidality. It was concluded that despite the disproportionate sizes of the clusters homeless veterans with mental illness are nevertheless heterogeneous with regard to their psychiatric profiles.",0,0 +6686,Acute stress disorder scale: A self-report measure of acute stress disorder.,,0,0 +6687,DSM-IV Personality Disorders and Their Axis I Correlates in the South African Population,"The prevalence of personality disorders (PD) in the South African population is largely unknown. Thus, we undertook to estimate prevalence, demographic correlates, co-morbidity and treatment rates of DSM-IV PD among South Africans.A three-stage probability sample design was used. Of the 4,433 interviews obtained, based on quality control criteria, 4,315 interviews were retained for analysis. All participants were screened for PD and axis I disorders with the World Health Organisation Composite International Diagnostic Interview. The multiple imputation method was then used to estimate prevalence.The multiple imputation prevalence estimate in the total sample was 6.8%. All three PD clusters were significantly co-morbid with each other and with other axis I disorders. Male gender was the only significant predictor of PD. Of note was the finding that less than one fifth of participants with a possible PD diagnosis had received treatment for a mental health or substance abuse problem in the previous 12 months.The high co-morbidity of PD with axis I disorders in South Africa is consistent with previous reports elsewhere. However, more research is indicated to determine the reasons for the higher prevalence of cluster A disorders than of cluster B and C disorders in this population.",0,0 +6688,The Role of Personality Traits and Profiles in Posttrauma Comorbidity,"Many service members experience symptoms of posttraumatic stress disorder (PTSD) after deployment. PTSD can vary widely in its presentation and associated features, such as comorbid conditions. Research has shown that veterans with PTSD and an internalizing personality profile are more likely to experience internalizing comorbidity (e.g., anxiety, depression), whereas veterans with PTSD and an externalizing personality profile are more likely to experience externalizing comorbidity (e.g., substance abuse, aggression). To date, however, this research has been limited by a focus on diagnosable disorders and personality categories. In a nonclinical sample of 224 National Guard/Reserve service members who had served since 2001, we explored whether personality traits (measured continuously) moderated associations of PTSD symptom severity with the severity of internalizing (depression, anxiety) and externalizing (alcohol abuse, aggression) symptoms. Results showed that the association of PTSD with anxiety was stronger when extraversion was lower (corresponding to an internalizing personality profile). Moreover, the association of PTSD with alcohol abuse was stronger when extraversion was high and conscientiousness was low (corresponding to an externalizing personality profile). Surprisingly, this association was also stronger when extraversion was low and conscientiousness was high. Results offer additional insights into prior research on personality and comorbidity.",0,0 +6689,Chronic Neurobehavioral Effects of Tokyo Subway Sarin Poisoning in Relation to Posttraumatic Stress Disorder,"Chronic neurobehavioral effects of acute sarin poisoning were evaluated in 9 male and 9 female patients who were exposed to sarin poisoning in the Tokyo subway incident in Japan. The investigators used nine neurobehavioral tests, as well as a posttraumatic stress disorder checklist, 6-8 mo after the poisoning occurred. Serum cholinesterase activity in patients on the day of poisoning (i.e., March 20, 1995) ranged from 13 to 131 IU/l (mean=72.1 IU/l). The results of analysis covariance, in which age, education level, alcohol consumption, and smoking status (covariates) were controlled in 18 sarin cases and in 18 controls, showed that the score on the digit symbol (psychomotor performance) test was significantly lower in the sarin cases than in controls. Nonetheless, the scores for the General Health Questionnaires, fatigue of Profile of Mood States, and posttraumatic stress disorder checklist were significantly higher in the sarin cases than controls. The investigators added posttraumatic stress disorder to the covariates, and only the score on the digit symbol test was significantly lower in sarin cases. In addition, the results of stepwise multiple regression analysis in 18 sarin cases revealed that scores for the General Health Questionnaires, fatigue of Profile of Mood States (i.e., fatigue, tension-anxiety, depression, and anger-hostility)-together with the paired-associate learning test-were associated significantly with posttraumatic stress disorder. The association did not remain significant for the digit symbol test score. Perhaps a chronic effect on psychomotor performance was caused directly by acute sarin poisoning; on the other hand, the effects on psychiatric symptoms (General Health Questionnaire) and fatigue (Profile of Mood States) appeared to result from posttraumatic stress disorder induced by exposure to sarin.",0,0 +6690,The effect of post-traumatic stress disorder on HIV disease progression following hurricane Katrina,"Post-traumatic stress disorder (PTSD) is a common psychological outcome of any disaster. The purpose of this study was to examine the effects of PTSD on disease progression among HIV-infected persons in metropolitan New Orleans post-hurricane Katrina. One-year post-storm, a convenience sample of 145 HIV-infected patients who returned to care at the HIV Outpatient Program clinic in New Orleans were interviewed. Clinical factors pre and one and two years post-disaster were abstracted from medical records and compared by PTSD status. Of the 145 participants, 37.2% had PTSD. Those with PTSD were more likely than those without PTSD to have detectable plasma viral loads at both follow-up time points post-disaster and more likely to have CD4 cell counts <200/mm(3) two years post-disaster. They were also more likely to have had medication interruptions immediately post-disaster. Our findings corroborate the findings of others that PTSD accelerates HIV disease progression. Disaster planners should consider the special counseling and medication safeguards needs of HIV-infected persons.",0,0 +6691,Blunted growth hormone response to clonidine in post-traumatic stress disorder,"Hyperactivity of the sympathetic and noradrenergic systems is thought to be a feature of post-traumatic stress disorder (PTSD). Assessment of noradrenergic receptor function can be undertaken by measuring the growth hormone (GH) response to the α 2 -agonist clonidine. The aim of this study was to examine whether subjects with combat-related PTSD (with or without co-morbid depression) have a blunted growth hormone response to clonidine, compared to a combat-exposed control group. Twenty-three Vietnam veterans suffering from PTSD alone, 27 suffering from PTSD and co-morbid depression, and 32 veteran controls with no psychiatric illness were administered 1.5 μg/kg clonidine i.v. Plasma growth hormone was measured every 20 min for 120 min. The growth hormone response to clonidine was significantly blunted in the non-depressed PTSD group compared to both the depressed PTSD group and the control group as measured by peak growth hormone, delta growth hormone and AUC growth hormone. Subjects with PTSD and no co-morbid depressive illness show a blunted growth hormone response to clonidine. This suggests that post-synaptic α 2 -receptors are subsensitive. This finding is consistent with other studies showing increased noradrenergic activity in PTSD.",0,0 +6692,Multi-chaperone-peptide-rich mixture from colo-carcinoma cells elicits potent anticancer immunity,"Chaperones play an important role in inducing anti-cancer immunity. To explore the probability of using chaperone-peptide-rich complexes extracted from colo-carcinoma cells as anti-cancer vaccine, we extracted and prepared chaperone-peptide-rich complexes from CT26 cells, which were subsequently investigated on anti-cancer efficacy.The crude extracts of the CT26 cells treated with heat and Trichosanthin were precipitated with salt and dialyzed to remove proteins below 50kDa and above 300kDa in molecular weight; the proteins with the molecular weights in 70kDa, 90kDa, 95kDa, 110kDa and 170kDa were collected through gel filtration and SDS-PAGE. After confirmation, the purified proteins were used to determine their effects on lymphocyte proliferation, the activities of NK and CTL, tumor suppression and the tumor-bearing mouse survival.The majority of the chaperone-peptides of anti-cancer immunity in CT26 cells, including HSP70-antigen peptide, HSP90-antigen peptide, gp96-antigen peptide, HSP-110 antigen peptide, HSP170-antigen peptide, was satisfactorily extracted that the multi-chaperone-peptide-rich mixtures were obtained. All the mixtures prepared could elicit lymphocyte proliferation, enhance the activities of CTL and NK, reinforce the tumor suppression and prolong the mouse survival.The multi-chaperone-peptide-rich mixtures could be prepared via dialysis and gel filtration combining with SDS-PAGE. Both the heat stress and Trichosanthin could induce and increase the mixtures, of which that treated by 42 degrees C heat and Trichosanthin was found to possess the strongest anti-cancer efficacy.",0,0 +6693,Post-deployment BATTLEMIND training for the UK Armed Forces: a cluster-randomised controlled trial,"Objectives Combat exposure can increase the risk of subsequent psychological ill-health in Armed Forces (AF) personnel. A US post-deployment psycho-educational intervention, Battlemind, has shown a beneficial effect on mental health in US military personnel exposed to high levels of potentially traumatic combat events. Our aim was to evaluate the efficacy of Battlemind in UK AF personnel. Methods Battlemind was compared with the UK standard post-deployment stress and homecoming brief in a cluster randomised controlled trial. 2443 UK AF personnel returning from Afghanistan via Cyprus completed a questionnaire about combat experiences and current mental health status before receiving their randomly allocated intervention, of these, 1616 (66%) completed follow-up approximately 6 months later. Primary outcomes were the General Health Questionnaire (GHQ-12) to measure common mental disorders, and the post traumatic stress disorder checklist (PCL-C) to measure probable PTSD. Secondary outcomes included alcohol misuse, assessed with the AUDIT. The two study arms were compared using mixed-effect models to take account of possible cluster effects. Results We did not find a difference in mental health or overall AUDIT score between Battlemind and the standard brief. Those who received Battlemind were less likely to be classified as binge drinkers than those receiving the standard brief (adjusted OR 0.73 (95% CI 0.58 to 0.92)). Conclusions UK post-deployment Battlemind did not improve mental health compared with the standard post-deployment brief. However, it had a modest impact on reported binge drinking. Alcohol misuse is problematic in the UK AF so an intervention that reduces binge drinking may be helpful.",0,0 +6694,Socially disorganized yet safe: Understanding resilience to crime in neighborhoods in New Zealand,"Abstract Purpose Drawing on theories from environmental criminology, this article identifies neighborhood-level characteristics that promote resiliency in neighborhoods in New Zealand with disadvantageous socioeconomic settings. Methods We used neighborhood-level crime (2008–2010) and socio-economic data to develop a Crime Resilience Index for New Zealand (CRINZ) to quantify neighborhood level resilience to crime across the country. We then examined relationships between the index and a suite of built and social neighborhood-level characteristics. Results Access to built environment factors generally decreased across neighborhoods stratified by resiliency. That is, resilient neighborhoods had decreased access to a range of healthcare, education, and living infrastructures. Very little difference was found in the social environment of high resilient and low resilient neighborhoods in New Zealand. Conclusions Understanding why communities respond differently in similar environments can enable communities to respond better or more effectively to such stressful environments and consequently build resilience. Identifying ‘place-specific’ resilience factors can be effective in reducing crime in neighborhoods.",0,0 +6695,Hurricane Katrina: Maternal Depression Trajectories and Child Outcomes,"The authors examined depression trajectories over two years among mothers exposed to Hurricane Katrina. Risk and protective factors for depression trajectories, as well as associations with child outcomes were analyzed.This study included 283 mothers (age at time 1, M = 39.20 years, SD = 7.21; 62% African American). Mothers were assessed at four time points over two years following Hurricane Katrina. Mothers reported posttraumatic stress symptoms, hurricane exposure, traumatic life events, and social support at time 1. Depressive symptoms were modeled at times 2, 3, and 4. Youth reported their distress symptoms (posttraumatic stress, depression, and anxiety) at time 4.Latent class growth analyses identified three maternal depression trajectories among mothers exposed to Hurricane Katrina: low (61%), resilient (29%), and chronic (10%). Social support was identified as a protective factor among mothers.Three main trajectories of maternal depression following Hurricane Katrina were identified. Social support was protective for mothers. Identified trajectories were not associated with children's distress outcomes. These results have implications for disaster responses, screening efforts, and interventions targeted towards families. Future studies warrant the investigation of additional risk and protective factors that can affect maternal and child outcomes.",0,0 +6696,Profiles of Women Who Have Mental Retardation With and Without a Documented History of Abuse,"Thirty-six women with mental retardation were divided into two groups on the basis of whether they had a documented history of abuse during the preceding 5 years. The women with this history were more likely than the women with no documented history of abuse to be employing passive/avoidant decision-making strategies, reporting higher levels of stress, having dual diagnoses, be receiving counseling, and relying on others to go out into the community. We recommend that special attention be paid to designing interventions that are tailored to the specific needs of these women.",0,0 +6697,"Post-Traumatic Stress Reactions before the Advent of Post-Traumatic Stress Disorder: Potential Effects on the Lives and Legacies of Alexander the Great, Captain James Cook, Emily Dickinson, and Florence Nightingale","Evidence is presented that Alexander the Great, Captain James Cook, Emily Dickinson, and Florence Nightingale each developed symptoms consistent with post-traumatic stress disorder in the aftermath of repeated potentially traumatizing events of differing character. Their case histories also varied with respect to background, premorbid personality style, risk factors, clinical presentation, and course of the illness, illustrating the pleomorphic character of the disorder, as well as the special problems in diagnosing it in historical figures.",0,0 +6698,When the Earth Stops Shaking: Earthquake Sequelae Among Children Diagnosed for Pre-Earthquake Psychopathology,"To examine risk and protective processes for posttraumatic stress reactions and negative sequelae following the Northridge earthquake (EQ) among youths diagnosed for pre-EQ psychopathology.Symptoms of posttraumatic stress disorder (PTSD), depression, general anxiety, and social impairment were evaluated using telephone interviews among 66 children participating in a family-genetic study of childhood-onset depression at the time of the EQ.Significant predictors of PTSD symptoms 1 year after the EQ included perceived stress and resource loss associated with the EQ, a pre-EQ anxiety disorder, and more frequent use of cognitive and avoidance coping strategies. PTSD symptoms were associated with high rates of concurrent general anxiety symptoms, depressive symptoms, and social adjustment problems with friends. The only significant correlation between sibling scores was on measures of sibling reports of objective exposure.Preexisting anxiety disorders represent a risk factor for postdisaster PTSD reactions. Postdisaster services need to attend to the needs of these youths as well as those of youths experiencing high levels of subjective stress, resource loss, and/or high exposure. That children within families show significant variation in postdisaster reactions underscores the need for attention to individual child characteristics and unshared environmental attributes.",0,0 +6699,Different Points of a Continuum? Cross Sectional Comparison of the Current and Pre-contact Psychosocial Problems among the Different Categories of Adolescents in Institutional Care in Nigeria,"The combination of adverse social indicators and a predominantly youthful population puts Nigeria, and indeed many countries of sub-Sahara Africa, at the risk of explosion in the number of youth coming in contact with the juvenile justice system. Despite this risk, custodial childcare systems in the region are still poorly developed with both juvenile offenders and neglected adolescents coming in contact with the systems being kept in the same incarcerating facility. The needs of these different groups of adolescents may be different. Knowing their common and unique needs can inform common prevention strategies and ensure that specific service-needs of different categories of adolescents in institutional custody are met.Data on the family background, pre-contact social circumstance, neurological and anthropometric profiles, and certain aspects of mental health of adolescents drawn from two juvenile justice institutions in Nigeria were obtained. The results for the adolescents on 'criminal code' and those admitted as a case of child neglect were compared using chi-square and odd ratios.Participants were 211 adolescents comprising of 158 on 'criminal code' and 53 declared as 'neglected'. A lot of similarities were found. For instance, the prevalence of parental separation, family transition, experience of street-life and lifetime exposure to traumatic events and posttraumatic stress was equally high among the two groups of adolescents. The adolescents on 'criminal code' however had significantly higher prevalence of conduct and alcohol/substance use disorders while the child neglect group had poorer anthropometric profiles and higher prevalence of neurological disorders.Child neglect and juvenile delinquency in Nigeria may truly be different points of a continuum. There are however fundamental differences that can warrant specific prevention strategies and tailor-made service provision while in custodial care.",0,0 +6700,The effect of compensation claims on outcomes after injury,,0,0 +6701,Notes on the practice of food justice in the U.S.: understanding and confronting trauma and inequity,"The lexicon of the U.S. food movement has expanded to include the term 'food justice.' Emerging after approximately two decades of food advocacy, this term frames structural critiques of agri-food systems and calls for radical change. Over those twenty years, practitioners and scholars have argued that the food movement was in danger of creating an 'alternative' food system for the white middle class. Alternative food networks drew on white imaginaries of an idyllic communal past, promoted consumer-oriented, market-driven change, and left yawning silences in the areas of gendered work, migrant labor, and racial inequality. Justice was often beside the point. Now, among practitioners and scholars we see an enthusiastic surge in the use of the term food justice but a vagueness on the particulars. In scholarship and practice, that vagueness manifests in overly general statements about ending oppression, or morphs into outright conflation of the dominant food movement's work with food justice (see What does it mean to do food justice? Cadieux and Slocum (2015), in this Issue). In this article, we focus on one of the four nodes (trauma/inequity, exchange, land and labor) around which food justice organizing appears to occur: acknowledging and confronting historical, collective trauma and persistent race, gender, and class inequality. We apply what we have learned from our research in U.S. and Canadian agri-food systems to suggest working methods that might guide practitioners as they work toward food justice, and scholars as they seek to study it. In the interests of ensuring accountability to socially just research and action, we suggest that scholars and practitioners need to be more clear on what it means to practice food justice. Towards such clarity and accountability, we urge scholars and practitioners to collaboratively document how groups move toward food justice, what thwarts and what enables them.",0,0 +6702,General growth mixture modeling for randomized preventive interventions,"This paper proposes growth mixture modeling to assess intervention effects in longitudinal randomized trials. Growth mixture modeling represents unobserved heterogeneity among the subjects using a finite-mixture random effects model. The methodology allows one to examine the impact of an intervention on subgroups characterized by different types of growth trajectories. Such modeling is informative when examining effects on populations that contain individuals who have normative growth as well as non-normative growth. The analysis identifies subgroup membership and allows theory-based modeling of intervention effects in the different subgroups. An example is presented concerning a randomized intervention in Baltimore public schools aimed at reducing aggressive classroom behavior, where only students who were initially more aggressive showed benefits from the intervention.",0,0 +6703,Informing the symptom profile of complicated grief,"Background: Complicated Grief (CG) is under consideration as a new diagnosis in DSM5. We sought to add empirical support to the current dialogue by examining the commonly used Inventory of Complicated Grief (ICG) scale completed by 782 bereaved individuals. Methods: We employed IRT analyses, factor analyses, and sensitivity and specificity analyses utilizing our full sample (n = 782), and also compared confirmed CG cases (n = 288) to noncases (n = 377). Confirmed CG cases were defined as individuals bereaved at least 6 months who were seeking care for CG, had an ICG≥30, and received a structured clinical interview for CG by a certified clinician confirming CG as their primary illness. Noncases were bereaved individuals who did not present with CG as a primary complaint (including those with depression, bipolar disorder, anxiety disorders, and controls) and had an ICG<25. Results: IRT analyses provided guidance about the most informative individual items and their association with CG severity. Factor analyses demonstrated a single factor solution when the full sample was considered, but within CG cases, six symptom clusters emerged: (1) yearning and preoccupation with the deceased, (2) anger and bitterness, (3) shock and disbelief, (4) estrangement from others, (5) hallucinations of the deceased, and (6) behavior change, including avoidance and proximity seeking. The presence of at least one symptom from three different symptom clusters optimized sensitivity (94.8%) and specificity (98.1%). Conclusions: These data, derived from a diverse and predominantly clinical help seeking population, add an important perspective to existing suggestions for DSM5 criteria for CG. Depression and Anxiety, 2011. © 2010 Wiley-Liss, Inc.",0,0 +6704,Postdeployment Battlemind training for the U.K. armed forces: A cluster randomized controlled trial.,"Combat exposure can increase the risk of subsequent psychological ill-health in armed forces (AF) personnel. A U.S. postdeployment psycho-educational intervention, Battlemind, showed a beneficial effect on mental health in U.S. military personnel exposed to high combat levels. We evaluated the effectiveness of an anglicized version of postdeployment Battlemind.Battlemind was adapted for the United Kingdom. The main amendments were to sections about carrying weapons, driving, and alcohol misuse. The anglicized Battlemind was compared with the U.K. standard postdeployment brief in a cluster randomized controlled trial. At baseline, 2,443 U.K. AF personnel returning from Afghanistan via Cyprus completed questionnaires about their combat experiences and mental health. Of these, 1,616 (66%) completed 6-month follow-up questionnaires. We used the Posttraumatic Stress Disorder Checklist (PCL-C) to measure probable posttraumatic stress disorder and the General Health Questionnaire (GHQ-12) to measure common mental disorders. Secondary outcomes included alcohol misuse, assessed with the Alcohol Use Disorders Identification Test (AUDIT), and binge drinking. Mixed-effects models were used to account for possible cluster effects.We did not find a difference in mental health or overall AUDIT score. Those who received Battlemind versus the standard brief were less likely to report binge drinking, although the effect size was small (adjusted odds ratio = 0.73, 95% CI [0.58, 0.92]).The anglicized Battlemind did not improve mental health but had a modest impact on the reporting of binge drinking. Alcohol misuse is problematic in military populations; therefore, an intervention that reduces binge drinking may be helpful.",0,0 +6705,White Matter Microstructural Changes as Vulnerability Factors and Acquired Signs of Post-Earthquake Distress,"Many survivors of severe disasters need psychological support, even those not suffering post-traumatic stress disorder (PTSD). The critical issue in understanding the psychological response after experiencing severe disasters is to distinguish neurological microstructural underpinnings as vulnerability factors from signs of emotional distress acquired soon after the stressful life event. We collected diffusion-tensor magnetic resonance imaging (DTI) data from a group of healthy adolescents before the Great East Japan Earthquake and re-examined the DTIs and anxiety levels of 30 non-PTSD subjects from this group 3-4 months after the earthquake using voxel-based analyses in a longitudinal DTI study before and after the earthquake. We found that the state anxiety level after the earthquake was negatively associated with fractional anisotropy (FA) in the right anterior cingulum (Cg) before the earthquake (r = -0.61, voxel level p<0.0025, cluster level p<0.05 corrected), and positively associated with increased FA changes from before to after the earthquake in the left anterior Cg (r = 0.70, voxel level p<0.0025, cluster level p<0.05 corrected) and uncinate fasciculus (Uf) (r = 0.65, voxel level p<0.0025, cluster level p<0.05 corrected). The results demonstrated that lower FA in the right anterior Cg was a vulnerability factor and increased FA in the left anterior Cg and Uf was an acquired sign of state anxiety after the earthquake. We postulate that subjects with dysfunctions in processing fear and anxiety before the disaster were likely to have higher anxiety levels requiring frequent emotional regulation after the disaster. These findings provide new evidence of psychophysiological responses at the neural network level soon after a stressful life event and might contribute to the development of effective methods to prevent PTSD.",0,0 +6706,"Stories of pre‐war, war and exile: Bosnian refugee children in Sweden","While standardized questionnaires produce counts of isolated events, a semi-structured interview derives a story, a complex narrative in time and place. Ninety Bosnian refugee children and adolescents (ages 1-20), resettled in Sweden, were assessed in a semi-structured clinical interview designed to identify and offer support to children at risk. A family-child account of traumatic exposure was analysed quantitatively and qualitatively. Type-stories or clusters of experience were identified for three distinct periods: prior to war, during war, and after war in exile. The extent of trauma-stress exposure during each of these periods proved unrelated. Pre-war experience presented as preponderantly good and safe. Differences in child exposure during war and exile could be understood in relation to identifiable socio-demographic factors; particularly ethnic background, social class, child age and family size. Further, the stories derived cast light on the equity of Swedish refugee reception, exposing both egalitarian and discriminatory tendencies.",0,0 +6707,Post traumatic stress disorder symptoms in a psychiatric population not presenting with trauma: a preliminary study,"Post Traumatic Stress Disorder (PTSD) is a diagnostic category used to describe symptoms arising from emotionally traumatic experience(s). Research suggests that PTSD may be under- diagnosed when trauma is not the presenting problem or when not the focus of clinical intervention. There is a dearth of South African information on the prevalence of PTSD in a psychiatric population. The aim of this study was to determine the prevalence and comorbidity of PTSD in a psychiatric population, not presenting on the basis of trauma.The study was cross sectional and conducted at a psychiatric outpatient clinic in the Durban Metropolitan area. The sample was obtained from patients seen at follow up over a period of twelve weeks. The researcher randomly selected prospective participants and at the end of their consultation the purpose of the study was explained and they were invited to participate. Demographic characteristics and diagnosis were recorded. Thereafter, the Zulu version of the Modified Posttraumatic Diagnostic Scale (MPDS) was administered and data collected.The study demonstrated that 22% of subjects reported symptoms of PTSD where the primary presentation was not trauma related.A significant number of psychiatric patients presenting for non-trauma related psychopathology report symptoms of PTSD when specifically questioned. The findings suggest that such questioning may be overlooked when dealing with psychiatric patients who do not specifically present on the basis of trauma.",0,0 +6708,"Potentially traumatic event exposure, posttraumatic stress disorder, and Axis I and II comorbidity in a population-based study of Norwegian young adults","Epidemiologic research on traumatic stress is limited in Norway. Prevalence and correlates of exposure to potentially traumatic events (PTEs) and posttraumatic stress disorder (PTSD), and patterns of comorbidity with DSM-IV Axis I and II disorders were examined in an epidemiologic sample.Demographics, PTEs and resulting PTSD, and comorbid DSM-IV diagnoses were assessed in 2,794 members of the Norwegian Institute of Public Health Twin Panel. The sample comprised 37% male, with an average age of 28.2 years (SD = 3.9).Approximately, one-quarter of participants had lifetime PTE exposure; most PTEs were more common in men than in women. Lifetime prevalence of PTSD was 2.6%, and was significantly more common in women than men. Being female and type of PTE (both interpersonal and accidental traumatic events) were associated with increased PTSD symptoms, whereas higher education was associated with lower symptoms. PTSD was related to increased odds of most Axis I and II conditions.PTE exposure and PTSD prevalence were lower than in the USA, but comparable to other European countries. Sex differences replicated previous research. The relationship between PTSD and borderline personality disorder was significantly stronger than the relationship between PTSD and any other Axis II conditions.",0,0 +6709,The role of fathers' psychopathology in the intergenerational transmission of captivity trauma: A twenty three-year longitudinal study,"The aversive impact of combat and parents' combat-induced posttraumatic stress disorder (PTSD) on young children has been examined in a few studies. However, the long-term toll of war captivity on the secondary traumatization (ST) of adult offspring remains unknown. This study aimed to assess the longitudinal associations between former prisoners of war (ex-POWs), PTSD, depressive symptoms and their adult offsprings ST.A sample of 134 Israeli father-child dyads (80 ex-POWs dyads and a comparison group of 44 veterans'dyads) completed self-report measures. The fathers participated in three waves of measurements following the Yom Kippur War (T1: 1991, T2: 2003, and T3: 2008), while the offspring took part in T4 (2013).Offspring of ex-POWs with PTSD at T3 reported more ST symptoms than offspring of ex-POWs without PTSD and controls. Ex-POWs' PTSD hyper-arousal symptom cluster at T3 was positively related to offsprings ST avoidance symptom cluster. Offspring of ex-POWs with chronic and delayed PTSD trajectories reported more ST symptoms than offspring of ex-POWS and controls with resilient trajectories. Ex-POWs' PTSD and depression symptoms at T1, T2 and T3 mediated the link between war captivity (groups) and offsprings ST in T4.The use of self-report measures that did not cover the entire span of 40 years since the war, might may bias the results.The intergenerational transmission of captivity related trauma following the Yom Kippur War was exemplified. ST symptoms among ex-POWs' adult offspring are closely related to their father' PTSD and related depressive symptom comorbidity.",0,0 +6710,"The impact of self-efficacy, alexithymia and multiple traumas on posttraumatic stress disorder and psychiatric co-morbidity following epileptic seizures: A moderated mediation analysis","This study investigated the incidence of posttraumatic stress disorder (PTSD) and psychiatric co-morbidity following epileptic seizure, whether alexithymia mediated the relationship between self-efficacy and psychiatric outcomes, and whether the mediational effect was moderated by the severity of PTSD from other traumas. Seventy-one (M=31, F=40) people with a diagnosis of epilepsy recruited from support groups in the United Kingdom completed the Posttraumatic Stress Diagnostic Scale, the Hospital Anxiety and Depression Scale, the Toronto Alexithymia Scale-20 and the Generalized Self-Efficacy Scale. They were compared with 71 people (M=29, F=42) without epilepsy. For people with epilepsy, 51% and 22% met the diagnostic criteria for post-epileptic seizure PTSD and for PTSD following one other traumatic life event respectively. For the control group, 24% met the diagnostic criteria for PTSD following other traumatic life events. The epilepsy group reported significantly more anxiety and depression than the control. Partial least squares (PLS) analysis showed that self-efficacy was significantly correlated with alexithymia, post-epileptic seizure PTSD and psychiatric co-morbidity. Alexithymia was also significantly correlated with post-epileptic seizure PTSD and psychiatric co-morbidity. Mediation analyses confirmed that alexithymia mediated the path between self-efficacy and post-epileptic seizure PTSD and psychiatric co-morbidity. Moderated mediation also confirmed that self-efficacy and PTSD from one other trauma moderated the effect of alexithymia on outcomes. To conclude, people can develop posttraumatic stress disorder symptoms and psychiatric co-morbidity following epileptic seizure. These psychiatric outcomes are closely linked with their belief in personal competence to deal with stressful situations and regulate their own functioning, to process rather than defend against distressing emotions, and with the degree of PTSD from other traumas.",0,0 +6711,A Distinct Pattern of Personality Disturbance following Exposure to Mixtures of Organic Solvents,"To assess systematically the pattern of psychologic distress in chemically exposed workers complaining of personality changes, we administered the Minnesota Multiphasic Personality Inventory to 22 men with a history of exposure to mixtures of organic solvents. Results indicated clinically significant profile elevations in more than 90% of the exposed workers. Moreover, a consistent response profile was noted, indicating a high rate of somatic disturbances, anxiety, depression, social isolation, and fear of losing control. In addition, those workers with the longest exposure duration had the highest elevations on the scale measuring disturbances of thinking, social alienation, poor concentration, and anxiety. Comparisons between these subjects and a group of former prisoners of war with posttraumatic stress disorder revealed strikingly similar clinical profiles. We present a case history that illustrates the nature of this psychologic disturbance.",0,0 +6712,Post-traumatic kyphosis of the thoracic and lumbar spine,"Assessing the initial post-traumatic situation is of imminent importance in choosing the most suitable approach for primary treatment of thoracic and lumbar spine fractures. Misjudging the static situation of the injured spine is a common reason for selecting an inadequate therapeutic procedure. The consequence is a defective spinal position with the corresponding symptoms, which usually requires a complicated surgical procedure. Our experience is based on 34 patients with a post-traumatic defective position of the thoracic and lumbar spine: 12 patients underwent primary surgical and 22 primary conservative treatment. The aim of our study was to demonstrate the initial situation and primary management as well as subsequent problems and the respective surgical procedure applied in our department for correcting and stabilizing the areas involved and to present intermediate results.",0,0 +6713,Smoking intensity and severity of specific symptom clusters in posttraumatic stress disorder,"Smoking prevalence among patients with posttraumatic stress disorder (PTSD) is over 40%. Baseline data from the VA Cooperative Studies Program trial of integrated versus usual care for smoking cessation in veterans with PTSD (N = 863) were used in multivariate analyses of PTSD and depression severity, and 4 measures of smoking intensity: cigarettes per day (CPD), Fagerström Test for Nicotine Dependence (FTND), time to first cigarette, and expired carbon monoxide. Multivariate regression analysis showed the following significant associations: CPD with race (B = -7.16), age (B = 0.11), and emotional numbing (B =0 .16); FTND with race (B = -0.94), education (B = -0.34), emotional numbing (B = 0.04), significant distress (B = -0.12), and PHQ-9 (B = 0.04); time to first cigarette with education (B = 0.41), emotional numbing (B = -0.03), significant distress (B = 0.09), and PHQ-9 (B = -0.03); and expired carbon monoxide with race (B = -9.40). Findings suggest that among veterans with PTSD, White race and emotional numbing were most consistently related to increased smoking intensity and had more explanatory power than total PTSD symptom score. Results suggest specific PTSD symptom clusters are important to understanding smoking behavior in patients with PTSD.",0,0 +6714,Coping responses and posttraumatic stress symptomatology in urban fire service personnel,"Emergency workers, including urban fire fighters and paramedics, must cope with a variety of duty-related stressors including traumatic incident exposures. Little is known about coping responses of emergency workers or whether their coping responses predict future mental health outcomes. The previously formulated Coping Responses of Rescue Workers Inventory (CRRWI) underwent a principal components analysis employing a sample (N = 220) of urban fire fighters and paramedics. Six empirically and theoretically distinct CRRWI components were identified which were relatively stable over a 6-month period. Scores on one of the CRRWI scales, but neither years of service nor their past half year's traumatic incident exposures, predicted future changes in self-reports of posttraumatic stress symptomatology.",0,0 +6715,"Reliability of Standard Health Assessment Instruments in a Large, Population-Based Cohort Study","The Millennium Cohort Study began in 2001 using mail and Internet questionnaires to gather occupational and environmental exposure, behavioral risk factor, and health outcome data from a large, population-based US military cohort. Standardized instruments, including the Patient Health Questionnaire, the Medical Outcomes Study Short Form-36 for Veterans, and the Posttraumatic Stress Disorder (PTSD) Checklist–Civilian Version, have been validated in various populations. The purpose of this study was to investigate internal consistency of standardized instruments and concordance of responses in a test-retest setting. Cronbach alpha coefficients were used to investigate the internal consistency of standardized instruments among 76,742 participants. Kappa statistics were calculated to measure stability of aggregated responses in a subgroup of 470 participants who voluntarily submitted an additional survey within 6 months of their original submission. High internal consistency was found for 14 of 16 health components, with lower internal consistency found among two alcohol components. Substantial test-retest stability was observed for stationary variables, while moderate stability was found for more dynamic variables that measured conditions with low prevalence. These results substantiate internal consistency and stability of several standard health instruments applied to this large cohort. Such reliability analyses are vital to the integrity of long-term outcome studies.",0,0 +6716,Posttraumatic stress disorder in response to HIV infection,"This study investigated the psychological impact of HIV infection through assessment of posttraumatic stress disorder in response to HIV infection. Sixty-one HIV-positive homosexual/bisexual men were assessed for posttraumatic stress disorder in response to HIV infection (PTSD-HIV) using a modified PTSD module of the DIS-III-R. Thirty percent met criteria for a syndrome of posttraumatic stress disorder in response to HIV diagnosis (PTSD-HIV). In over one-third of the PTSD cases, the disorder had an onset greater than 6 months after initial HIV infection diagnosis. PTSD-HIV was associated with other psychiatric diagnoses, particularly the development of first episodes of major depression after HIV infection diagnosis. PTSD-HIV was significantly associated with a pre-HIV history of PTSD from other causes, and other pre-HIV psychiatric disorders and neuroticism scores, indicating a similarity with findings in studies of PTSD from other causes. The findings from this preliminary study suggest that a PTSD response to HIV diagnosis has clinical validity and requires further investigation in this population and other medically ill groups. The results support the inclusion of the diagnosis of life-threatening illness as a traumatic incident that may lead to a posttraumatic stress disorder, which is consistent with the DSM-IV criteria.",0,0 +6717,Incidence of Posttraumatic Stress Disorder and Mild Traumatic Brain Injury in Burned Service Members: Preliminary Report,"Although sustaining physical injury in theater increases service members' risk for posttraumatic stress disorder (PTSD), exposure to explosive munitions may increase the risk of mild traumatic brain injury (mTBI). We hypothesized a higher incidence of PTSD and mTBI in service members who sustained both burn and explosion injuries than in nonexplosion exposed service members.A retrospective review of PTSD and mTBI assessments was completed on burned service members between September 2005 and August 2006. Subjects were divided into cohort groups: (1) PTSD and mTBI, (2) PTSD and no mTBI, (3) mTBI and no PTSD, (4) no mTBI and no PTSD. Specific criteria used for group classification were based on subjects' total score on Posttraumatic Stress Disorder Checklist, Military version (PCL-M), clinical interview, and record review to meet American Congress of Rehabilitation Medicine criteria for mTBI. Descriptive analyses were used.Seventy-six service members met the inclusion criteria. The incidence rate of PTSD was 32% and mTBI was 41%. Eighteen percent screened positive for PTSD and mTBI; 13% screened positive for PTSD, but not mTBI; 23% screened positive for mTBI but not PTSD; 46% did not screen positive for either PTSD or mTBI.Given the high incidence of these disorders in burned service members, further screening of PTSD and TBI appears warranted. Because symptom presentation in PTSD and mTBI is clinically similar in acute and subacute stages, and treatments can vary widely, further research investigating symptom profiles of PTSD and mTBI is warranted.",0,0 +6718,Differentiating PTSD symptomatology with the MMPI-2-RF (Restructured Form) in a forensic disability sample,"The current study was designed to explore models of assessing various forms of Post-Traumatic Stress Disorder (PTSD) symptomatology that incorporate both broad and more narrowly focused affective markers. We used broader markers of demoralization, negative activation, positive activation, and aberrant experiences to predict global PTSD scores, whereas more narrowly focused markers of positive and negative affect were used to differentiate between PTSD symptom clusters. A disability sample consisting of 347 individuals undergoing medico-legal psychological evaluations was used for this study. All participants completed symptom measures of PTSD and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) (from which MMPI-2-RF scores were derived). The results indicated that demoralization was the best individual predictor of PTSD globally, and that more narrowly focused MMPI-2-RF Specific Problems scales provided a differential prediction of PTSD symptom clusters. Theoretical and practical implications of these findings are discussed within contemporary frameworks of internalizing personality and psychopathology.",0,0 +6719,Understanding the relationship of perceived social support to post-trauma cognitions and posttraumatic stress disorder,"Poor social support in the aftermath of a traumatic event is a well-established risk factor for posttraumatic stress disorder (PTSD) among adult trauma survivors. Yet, a great deal about the relationship between social support and PTSD remains poorly understood. In this study, we analyzed data from 102 survivors of a serious motor vehicle accident (MVA) at 4 weeks (Time 1) and 16 weeks (Time 2) post-MVA. We assessed the role of perceived dyadic social support, positive dyadic interaction, and negative dyadic interaction in the development and maintenance of PTSD. In addition, we examined how these social support constructs work together with negative post-trauma cognitions to affect the maintenance of PTSD. Neither perceived social support nor the quality of social interaction (i.e., positive or negative) was associated with PTSD symptom severity at Time 1. However, among those with elevated PTSD symptom severity at Time 1, greater social support and positive social interaction and lower negative social interaction were each associated with reductions in PTSD symptom severity from Time 1 to Time 2. For social support and negative social interaction, this association ceased to be significant when jointly assessed with negative post-trauma cognitions, suggesting that perceived social support and negative dyadic interaction were associated with maintenance of PTSD symptom severity because of their association with negative post-trauma cognitions. These results provide support to models and treatments of PTSD that emphasize the role of negative post-trauma cognitions in maintenance of PTSD.",0,0 +6720,Psychiatric evaluation of physical rehabilitation patients,"We conducted a study to demonstrate the frequency and types of psychiatric/psychological symptoms. A Structured Interview according to the DSM-III-R was conducted which demonstrated that 46 (41.4%) of 111 rehabilitation inpatients met the criteria for some forms of psychiatric disorders: 34 patients for major depression, 10 for adjustment disorder with anxious mood, and 2 for posttraumatic stress disorder. The remaining 65 patients (58.6%) showed normal reactions to their diseases. Average length of hospital stay for patients with major depression was significantly longer than those with no or the other types of psychiatric disease. They were also tested with Zung's Self-Rating Anxiety Scale (SAS), Zung's Self-Rating Depression Scale (SDS), and Profile of Mood States (POMS). Three psychological tests were useful in detecting depression or adjustment disorder among rehabilitation patients; however, these tests are not always specific to the type of psychiatric disorders. Patients with higher scores in those three tests should be referred to a psychiatric consultant for detailed examinations and proper treatments, if necessary.",0,0 +6721,A descriptive analysis of PTSD chronicity in Vietnam veterans,"This study examined the chronicity of PTSD in 530 male and female Vietnam veterans who were drawn from 2 large, ethnically diverse samples. Delayed onset was common, as was a failure to fully remit: 78% of the 239 veterans with full or partial lifetime PTSD were symptomatic in the 3 months prior to assessment. Cluster analysis identified 4 subtypes of posttraumatic response, with women most likely to be in a delayed onset cluster, and minority men most likely to be in a severe chronic cluster. The extent of chronicity observed in this sample underscores the need for treatments that address the persistence of posttraumatic symptoms.",0,0 +6722,The Vasopressin V1b Receptor as a Therapeutic Target in Stress-related Disorders,"The complexity of the stress response would appear to provide multiple opportunities for intervention, but treatment strategies are often centered on the improvement of symptoms rather than attempting to “treat” the stress response. However, recent efforts have begun to focus on the development of pharmacological agents that can attenuate the stress response itself, rather than the symptoms associated with stress. Although CRF, which is the main regulator of the stress system, is the focus of current interest, there is an accumulating body of evidence suggesting that the vasopressinergic system may play an equal role in the regulation of the stress response, and that V1b receptor antagonists may be of potential therapeutic benefit. The availability of SSR149415, the first selective antagonist for the V1b receptor has allowed us to evaluate this hypothesis. SSR149415 is able to attenuate some but not all stress-related behaviors in rodents. While the antidepressant-like activity of the compound was comparable to that of reference antidepressants, the overall profile displayed in anxiety tests was different from that of classical anxiolytics, such as benzodiazepines. The latter were active in a wide range of anxiety models, whereas the V1b receptor antagonist showed clear-cut effects only in particularly stressful situations. It is important to note that SSR149415 is devoid of central depressant effects, even at high doses, and does not affect cognitive processes, suggesting a large therapeutic window. Altogether, these findings suggest that V1b receptor antagonists might be useful as a treatment for major depression and stress disorders that result from traumatic events.",0,0 +6723,Research and treatment of war neuroses at the Clinic for Nervous and Mental Diseases at the Jagiellonian University in Krakow before World War II in the context of psychiatry in Europe,"Celem artykułu jest przegląd badań dotyczących diagnostyki i leczenia nerwic wojennych w Klinice Neurologiczno-Psychiatrycznej Uniwersytetu Jagiellońskiego przed wybuchem II wojny światowej. Zaprezentowano również działalność profesora Jana Piltza ówczesnego kierownika Kliniki i jego najważniejsze dokonania naukowe. Opisywane w artykule publikacje pochodzą głównie z okresu I wojny światowej i obejmują analizy kliniczne następstw stresu doświadczanego na froncie, a także opis sposobów ich leczenia. Przedstawiono również inne najważniejsze doniesienia z obszaru nerwic wojennych, jakie ukazały się w Europie w tym samym czasie. W artykule zwrócono uwagę na bardzo współczesny i wybiegający ponad ówczesną przeciętność sposób myślenia o leczeniu nerwic wojennych prezentowany przez prof. Piltza i jego zespół. Nowatorskie spojrzenie na ich leczenie związane było przede wszystkim z dostrzeganiem przyczyny nerwicy we wcześniejszych zaburzeniach osobowości pacjentów, zaleceniem psychoterapii jako podstawowej metody leczenia, a także podkreślaniem konieczności dalszej rehabilitacji po zakończeniu leczenia szpitalnego. Przywiązywano także dużą wagę do konieczności indywidualnego opracowywania planów terapii dla każdego z pacjentów.",0,0 +6724,Psychopathology in children of Holocaust survivors: a review of the research literature.,"The literature on transgenerational transmission of Holocaust trauma has grown into a rich body of unique psychological knowledge with almost 400 publications. For the time being, however, the transgenerational effect of the Holocaust on the offspring remains a subject of considerable controversy. The main question involves the presence or absence of specific psychopathology in this population. Psychotherapists kept reporting various characteristic signs of distress while research failed to find significant differences between offspring and comparative groups. In an effort to settle this question, the present review of the research literature provides a summary of the findings of 35 comparative studies on the mental state of offspring of Holocaust survivors, published between 1973-1999. This extensive research indicates rather conclusively that the non-clinical population of children of Holocaust survivors does not show signs of more psychopathology than others do. Children of Holocaust survivors tend to function rather well in terms of manifest psychopathology and differences in the mental state of offspring and people in general are small according to most research. The clinical population of offspring, however, tend to present a specific ""psychological profile"" that includes a predisposition to PTSD, various difficulties in separation-individuation and a contradictory mix of resilience and vulnerability when coping with stress.",0,0 +6725,Role of selective serotonin reuptake inhibitors in psychiatric disorders: a comprehensive review,"The selective serotonin reuptake inhibitors (SSRIs) have emerged as a major therapeutic advance in psychopharmacology. As a result, the discovery of these agents marks a milestone in neuropsychopharmacology and rational drug design, and has launched a new era in psychotropic drug development. Prior to the SSRIs, all psychotropic medications were the result of chance observation. In an attempt to develop a SSRI, researchers discovered a number of nontricyclic agents with amine-uptake inhibitory properties, acting on both noradrenergic and serotonergic neurons with considerable differences in potency. A given drug may affect one or more sites over its clinically relevant dosing range and may produce multiple and different clinical effects. The enhanced safety profile includes a reduced likelihood of pharmacodynamically mediated adverse drug-drug interactions by avoiding affects on sites that are not essential to the intended outcome. SSRIs were developed for inhibition of the neuronal uptake pump for serotonin (5-HT), a property shared with the TCAs, but without affecting the other various neuroreceptors or fast sodium channels. The therapeutic mechanism of action of SSRIs involves alteration in the 5-HT system. The plethora of biological substrates, receptors and pathways for 5-HT are candidates to mediate not only the therapeutic actions of SSRIs, but also their side effects. A hypothesis to explain these immediate side effects is that 5-HT is increased at specific 5-HT receptor subtypes in discrete regions of the body where the relevant physiologic processes are regulated. Marked differences exist between the SSRIs with regard to effects on specific cytochrome P450 (CYP) enzymes, and thus the likelihood of clinically important pharmacokinetic drug-drug interactions. Although no clear relationship exists between the clinical efficacy, plasma concentration of SSRIs, nor any threshold that defines toxic concentrations, but therapeutic drug monitoring (TDM) may be useful in special populations, such as in elderly patients, poor metabolizers (PM) of sparteine (CYP2D6) or mephenytoin (CYP2C19), and patients with liver and kidney impairment. Several meta-analyses have reviewed the comparative efficacy of TCAs and SSRIs, and concluded that both TCAs and SSRIs have similar efficacy in the treatment of depression. SSRIs have demonstrated better efficacy and tolerability in the treatment of obsessive compulsive disorder (OCD). They have also been found to be effective in the treatment for social anxiety disorder both in reducing total levels of social anxiety and in improving overall clinical condition. The benefit of SSRIs in anorexia nervosa (AN) is apparently short-term unless medication is given in the context of nutritional or behavioral therapy. No single antidepressant can ever be recommended for every patient, but in a vast majority of patients, SSRIs should be considered as one of the first-line drugs in the treatment of depression.",0,0 +6726,"Postnatal depression and post‐traumatic stress after childbirth: Prevalence, course and co‐occurrence","Research relating to the postnatal mental health of women has tended to focus on postnatal depression. There have been increasing calls to consider the issue of post-partum anxiety disorders, including post-traumatic stress disorder (PTSD). This study sought to provide further evidence regarding the prevalence and longitudinal course of post-traumatic stress symptoms resulting from traumatic birth experiences. The study also investigated the extent to which symptoms of trauma and depression occur together in the postnatal period. Four hundred women were recruited from the maternity ward of a public hospital in South West Sydney. Symptoms of birth trauma and postnatal depression were assessed via questionnaires given at birth, 6 weeks, 6 months and 12 months post-partum. The prevalence of having a PTSD profile at 6 weeks post-partum was 2%. A further 10.5% of women reported experiencing significant distress related to childbirth and several symptoms of post-traumatic stress without meeting full diagnostic criteria. The prevalence of a PTSD profile remained relatively stable across the first 12 months post-partum, with estimates being 2.6% at 6 months and 2.4% at 12 months. The co-morbidity between post-traumatic stress and postnatal depression was high at all three time points. The study highlights the potentially chronic nature of PTSD after childbirth and the importance of viewing post-partum emotional distress in a broader context than simply postnatal depression.",0,0 +6727,"Communal Violence and Child Psychosocial Well-being: Qualitative Findings from Poso, Indonesia","This exploratory study examined the health care system in relation to communal violence-related psychosocial wellbeing in Poso, Indonesia, as preparation for conducting a cluster randomized trial of a psychosocial intervention. We employed focus groups with children ( N = 9), parents ( N = 11), and teachers ( N = 8), as well as semi-structured interviews with families affected by communal violence ( N = 42), and key informants ( N = 33). An interrelated set of problems was found that included poverty, an indigenized trauma construct, morally inappropriate behavior, inter-religious tensions, and somatic problems. Participants emphasized social-ecological interactions between concerns at different systemic levels, although problems were mainly addressed through informal care by families. The programmatic and research implications of these findings are discussed.",0,0 +6728,Functional connectivity reveals inefficient working memory systems in post-traumatic stress disorder,"We applied a covariance-based multivariate analysis to functional magnetic resonance imaging (fMRI) data to investigate abnormalities in working memory (WM) systems in patients with post-traumatic stress disorder (PTSD). Patients (n=13) and matched controls (n=12) were scanned with fMRI while updating or maintaining trauma-neutral verbal stimuli in WM. A multivariate statistical analysis was used to investigate large-scale brain networks associated with these experimental tasks. For the control group, the first network reflected brain activity associated with WM updating and principally involved bilateral prefrontal and bilateral parietal cortex. Controls' second network was associated with WM maintenance and involved regions typically activated during storage and rehearsal of verbal material, including lateral premotor and inferior parietal cortex. In contrast, PTSD patients appeared to activate a single fronto-parietal network for both updating and maintenance tasks. This is indicative of abnormally elevated activity during WM maintenance and suggests inefficient allocation of resources for differential task demands. A second network in PTSD, which was not activated in controls, showed regions differentially activated between WM tasks, including the anterior cingulate, medial prefrontal cortex, fusiform and supplementary motor area. These activations may be linked to hyperarousal and abnormal reactivity, which are characteristic of PTSD.",0,0 +6729,New onset and persistent symptoms of post-traumatic stress disorder self reported after deployment and combat exposures: prospective population based US military cohort study,"To describe new onset and persistence of self reported post-traumatic stress disorder symptoms in a large population based military cohort, many of whom were deployed in support of the wars in Iraq and Afghanistan.Prospective cohort analysis.Survey enrolment data from the millennium cohort (July 2001 to June 2003) obtained before the wars in Iraq and Afghanistan. Follow-up (June 2004 to February 2006) data on health outcomes collected from 50 184 participants.Self reported post-traumatic stress disorder as measured by the posttraumatic stress disorder checklist-civilian version using Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria.More than 40% of the cohort were deployed between 2001 and 2006; between baseline and follow-up, 24% deployed for the first time in support of the wars in Iraq and Afghanistan. New incidence rates of 10-13 cases of post-traumatic stress disorder per 1000 person years occurred in the millennium cohort. New onset self reported post-traumatic stress disorder symptoms or diagnosis were identified in 7.6-8.7% of deployers who reported combat exposures, 1.4-2.1% of deployers who did not report combat exposures, and 2.3-3.0% of non-deployers. Among those with self reported symptoms of post-traumatic stress disorder at baseline, deployment did not affect persistence of symptoms.After adjustment for baseline characteristics, these prospective data indicate a threefold increase in new onset self reported post-traumatic stress disorder symptoms or diagnosis among deployed military personnel who reported combat exposures. The findings define the importance of post-traumatic stress disorder in this population and emphasise that specific combat exposures, rather than deployment itself, significantly affect the onset of symptoms of post-traumatic stress disorder after deployment.",0,0 +6730,Current research on cognitive aspects of anxiety disorders,"Cognitive dysfunction is frequently reported in anxiety disorders. Our aim is to describe recent advances concerning these cognitive aspects.Cognitive dysfunction in anxiety disorders can be classified into four domains. The first concerns executive functions, mainly attentional processes. The second concerns memory, including deficits in working, episodic, and autobiographical memory. The third encompasses maladaptive cognitions, or thoughts and beliefs. Finally, a burgeoning area of research (mainly in obsessive-compulsive disorder and posttraumatic stress disorder) concerns metacognitions, or thoughts and beliefs about one's own thoughts and beliefs. All of these dysfunctions may contribute to maintain or aggravate anxiety disorders. When developing and implementing interventions, researchers and clinicians alike must consider these cognitive aspects, and may need to tailor their approaches accordingly.Advances have clearly been made in the elucidation of the cognitive functioning associated with anxiety disorders. It remains unclear if particular cognitive profiles can help to distinguish anxiety disorders from one another, although emerging evidence suggests this may be the case. Further clarification will add to our understanding of the development and maintenance of these disorders, and may provide targets for future therapy and endophenotypes.",0,0 +6731,Psychological Distress After Orthopedic Trauma: Prevalence in Patients and Implications for Rehabilitation,"Orthopedic trauma is an unforeseen life-changing event. Serious injuries include multiple fractures and amputation. Physical rehabilitation has traditionally focused on addressing functional deficits after traumatic injury, but important psychological factors also can dramatically affect acute and long-term recovery. This review presents the effects of orthopedic trauma on psychological distress, potential interventions for distress reduction after trauma, and implications for participation in rehabilitation. Survivors commonly experience post-traumatic stress syndrome, depression, and anxiety, all of which interfere with functional gains and quality of life. More than 50% of survivors have psychological distress that can last decades after the physical injury has been treated. Early identification of patients with distress can help care teams provide the resources and support to offset the distress. Several options that help trauma patients navigate their short-term recovery include holistic approaches, pastoral care, coping skills, mindfulness, peer visitation, and educational resources. The long-term physical and mental health of the trauma survivor can be enhanced by strategies that connect the survivor to a network of people with similar experiences or injuries, facilitate support groups, and social support networking (The Trauma Survivors Network). Rehabilitation specialists can help optimize patient outcomes and quality of life by participating in and advocating these strategies.",0,0 +6732,"Cardiac stability at differing levels of temporal analysis in panic disorder, post-traumatic stress disorder, and healthy controls","The panic disorder (PD) literature provides evidence for both physiologic rigidity and instability as pathognomonic features of this disorder. This ambiguity may be a result of viewing PD at differential levels of temporal analysis. We assessed cardiac variability across three levels of temporal scale in PD patients, post-traumatic stress disorder (PTSD) patients, and healthy controls. Sixteen healthy controls, 14 PD patients, 23 PTSD patients, and 16 PTSD + PD patients presented for a polysomnogram. Differences were assessed in respiratory sinus arrhythmia (RSA), autoregressive stability of heart rate (HR), and the number of nonspecific accelerations in HR over the night. No differences in RSA were found between groups; however, PD patients exhibited significantly lower autoregressive HR stability, and all patients had significantly more HR accelerations than controls. These data reinforce prior findings demonstrating physiologic instability in PD and indicate that prior equivocalities regarding physiologic variability in PD may be due to limited temporal scaling of measurements.",0,0 +6733,PTSD Symptoms in Intellectually Disabled Victims of Sexual Assault,"The high rates of sexual violence in the country suggest that people with intellectual disabilities (ID) are likely to be sexually victimised. Rape and sexual assault have negative consequences for survivors, with Post Traumatic Stress Disorder (PTSD) being the most common psychiatric diagnosis used to capture the reaction to this trauma. This study sought to investigate the presence of PTSD symptoms in a group of people with ID who had been sexually abused. The Child PTSD Checklist was administered to 54 individuals with ID — 27 with and 27 without a known history of sexual abuse. The Checklist was also administered to the care-givers of those who had been sexually abused. Higher rates of a PTSD diagnosis and a higher intensity of PTSD symptoms were found in the group with than in the group without a history of sexual abuse. There were no significant differences between self and care-giver reports with respect to the prevalence of a PTSD diagnosis, but there were differences on the different symptom clusters. The results indicate that survivors with ID should be asked directly about their internal subjective experiences, with care-giver reports being used as collateral information, and that therapeutic interventions following sexual abuse should be offered.",0,0 +6734,Using the Brief Resilience Scale to Assess Chinese People’s Ability to Bounce Back From Stress,"This study examined the utility of an adapted version of the Brief Resilience Scale (BRS) to measure Chinese undergraduates’ ability to bounce back from stress. The BRS together with measures tapping optimism, self-esteem, pessimism, and physical health were administered to 547 Hong Kong and 268 mainland Chinese undergraduates. The BRS was found to measure one single construct and exhibited convergent validity in both samples. Further analyses using a path analytic model showed that the BRS scores substantially mediated the link between the two positive traits (optimism and self-esteem) and physical health in the two samples. The results suggested that the BRS is a reliable and valid instrument for measuring Chinese undergraduates’ ability to bounce back from stress. The implications for further research related to resilience in Chinese people are discussed.",0,0 +6735,The Psychological Risks of Vietnam for U.S. Veterans: A Revisit with New Data and Methods,"In 1988, the National Vietnam Veterans Readjustment Study (NVVRS) of a representative sample of 1200 veterans estimated that 30.9% had developed posttraumatic stress disorder (PTSD) during their lifetimes and that 15.2% were currently suffering from PTSD. The study also found a strong dose-response relationship: As retrospective reports of combat exposure increased, PTSD occurrence increased. Skeptics have argued that these results are inflated by recall bias and other flaws. We used military records to construct a new exposure measure and to cross-check exposure reports in diagnoses of 260 NVVRS veterans. We found little evidence of falsification, an even stronger dose-response relationship, and psychological costs that were lower than previously estimated but still substantial. According to our fully adjusted PTSD rates, 18.7% of the veterans had developed war-related PTSD during their lifetimes and 9.1% were currently suffering from PTSD 11 to 12 years after the war; current PTSD was typically associated with moderate impairment.",0,0 +6736,Comparison of posttraumatic stress disorder symptom structure models in Hispanic and White college students.,"This study tested measurement invariance between Hispanic (n = 226) and White (n = 278) college students' responses to a well-validated measure of posttraumatic stress disorder (PTSD) symptoms. Participants completed the PTSD Checklist-Civilian Version (PCL-C; Weathers, Litz, Herman, Juska, & Keane, 1993); however, trauma histories were not assessed, nor were responses to the PCL-C indexed to a specific traumatic event. Eight models were tested using within-groups confirmatory factor analysis (CFA); 3 models (D. King, Leskin, King, & Weathers, 1998; Simms, Watson, & Doebbeling, 2002; Smith, Redd, DuHamel, Vickberg, & Ricketts, 1999) showed good fit for both ethnic groups, although differences in the degree of fit were observed between the 2 ethnic groups. Models that demonstrated good fit were then compared for equivalence using multiple group CFA. Factor loadings were equivalent between groups, but intercepts differed between groups in all 3 models. Mean item score differences between Hispanic and White groups were observed on items assessing emotional upset with reminders (Item B4) and emotional distancing (Item C5). D. King and colleagues (1998) model resulted in the best measurement invariance. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +6737,Lost in trans-lation: Interpreting systems of trauma for transgender clients.,"Transgender clients frequently experience multiple types of violence (Mizock & Lewis, 2008), including interpersonal (violence that occurs between, at least, two people), self-directed (violence that is self-inflicted), and collective (violence that is inflicted by larger groups of people/institutions; Krug et al., 2002). Transgender clients who experience any of these types of violence are at a higher risk for developing psychiatric symptoms that may require the attention of a mental health care provider (Mizock & Lewis, 2008). Thus, it is crucial that clinicians understand how transgender clients respond to such violence and how these reactions relate to the clinical needs of transgender clients (Lev, 2004). In this article, we will summarize and cluster the types of violence that have been documented in the transgender literature. We will then highlight PTSD and complex PTSD as conceptual frameworks for working with transgender clients. Furthermore, we will examine how the binary notion of gender ignor...",0,0 +6738,Posttraumatic Stress in U.S. Marines: The Role of Unit Cohesion and Combat Exposure,"Combat exposure is a consistent predictor of posttraumatic stress (PTS). Understanding factors that might buffer the effects of combat exposure is crucial for helping service members weather the stress of war. In a study of U.S. Marines returning from Iraq, hierarchical multiple regression analyses revealed that unit cohesion and combat exposure predicted PTS, depression, and anger. Furthermore, results indicated that unit cohesion may be an important buffer, possibly limiting the development of PTS and depression following combat exposure.",0,0 +6739,Commentaries,,0,0 +6740,"From concepts, theory, and evidence of heterogeneity of treatment effects to methodological approaches: a primer","Implicit in the growing interest in patient-centered outcomes research is a growing need for better evidence regarding how responses to a given intervention or treatment may vary across patients, referred to as heterogeneity of treatment effect (HTE). A variety of methods are available for exploring HTE, each associated with unique strengths and limitations. This paper reviews a selected set of methodological approaches to understanding HTE, focusing largely but not exclusively on their uses with randomized trial data. It is oriented for the ""intermediate"" outcomes researcher, who may already be familiar with some methods, but would value a systematic overview of both more and less familiar methods with attention to when and why they may be used. Drawing from the biomedical, statistical, epidemiological and econometrics literature, we describe the steps involved in choosing an HTE approach, focusing on whether the intent of the analysis is for exploratory, initial testing, or confirmatory testing purposes. We also map HTE methodological approaches to data considerations as well as the strengths and limitations of each approach. Methods reviewed include formal subgroup analysis, meta-analysis and meta-regression, various types of predictive risk modeling including classification and regression tree analysis, series of n-of-1 trials, latent growth and growth mixture models, quantile regression, and selected non-parametric methods. In addition to an overview of each HTE method, examples and references are provided for further reading.By guiding the selection of the methods and analysis, this review is meant to better enable outcomes researchers to understand and explore aspects of HTE in the context of patient-centered outcomes research.",0,0 +6741,Topiramate in the New Generation of Drugs: Efficacy in the Treatment of Alcoholic Patients,"Predicated upon a neuropharmacological conceptual model, there is now solid clinical evidence to support the efficacy of topiramate for the treatment of alcohol dependence. Topiramate treatment can be initiated whilst the alcohol-dependent individual is still drinking - just when crisis intervention is most likely to be needed by a patient with or without his or her family asking the health practitioner for assistance. Because topiramate can be paired with a brief intervention, there is now the exciting possibility of treating most alcohol- dependent individuals in office-based practice or generic treatment settings. Topiramate's additional effects on other impulsedyscontrol disorders make it a particularly interesting compound for the treatment of other comorbid drug or psychiatric disorders. Additionally, future studies should explore whether topiramate can be combined with other putative therapeutic agents to increase its efficacy. One notable clinical challenge in the development of topiramate as a pharmacotherapy to treat alcohol dependence is the determination of the smallest dose that can result in efficacy, thereby achieving the optimum balance between therapeutic benefit and adverse event profile. Animal data do provide support for topiramate's general anti-drinking effects but also indicate that its mechanisms of action might rely on several complex pharmacobehavioral changes. Additional preclinical studies are needed to elucidate more clearly the basic mechanistic processes that underlie topiramate's efficacy as a treatment for alcohol dependence. Preclinical information that topiramate may have differential effects based on genetic vulnerability opens up the possibility of future methods to optimize treatment.",0,0 +6742,Traumatic Brain Injury and Its Neuropsychiatric Sequelae in War Veterans,"The post–September 11, 2001 wars in and around Afghanistan and Iraq have increased awareness of traumatic brain injury (TBI), particularly blast-induced mild TBI. This article provides an overview of TBI and its neuropsychiatric sequelae in U.S. war veterans who participated in the current operations in and around Afghanistan and Iraq, with particular emphasis on blast-related mild TBI. Psychiatric disorders, particularly posttraumatic stress disorder, pain, and sensory impairments are prevalent in war veterans with TBI. Research is needed to more definitively characterize the epidemiology of TBI-related functional difficulties, the effects of blasts compared with other mechanisms of injury, recovery trajectories, and treatment outcomes in this population.",0,0 +6743,Onset of activity and time to response on individual CAPS-SX17 items in patients treated for post-traumatic stress disorder with venlafaxine ER: a pooled analysis,"This pooled analysis of data from two randomized, placebo-controlled trials of venlafaxine extended release (ER) assessed onset of activity and time to response on the 17 symptoms of post-traumatic stress disorder (PTSD) listed in DSM-IV and measured by the 17-item Clinician-Administered PTSD Scale (CAPS-SX17). The intent-to-treat (ITT) population comprised 687 patients (placebo, n=347; venlafaxine ER, n=340). Significant (p<0.05) separation between venlafaxine ER and placebo was observed on most CAPS-SX17 items, with earliest onset of activity and response (week 2) on items 5 (physiological reactivity on exposure to cues) and 14 (irritability or anger outbursts), and (week 4) items 1 (intrusive recollections) and 4 (psychological distress at exposure to cues). Onset of activity and response occurred later (generally, weeks 6-8) on items 9 (diminished interest/participation in activities), 10 (detachment or estrangement), 11 (restricted range of affect), 12 (sense of foreshortened future), all associated with numbing, 15 (difficulty concentrating), 16 (hypervigilance), 17 (exaggerated startle response), associated with hyperarousal, and 6 (avoidance of thoughts/feelings or conversations). Significant differences between venlafaxine ER and placebo were largely absent throughout the treatment period and at the primary week-12 end-point for items 2 (distressing dreams), 7 (avoidance of activities, places or people), 8 (inability to recall important aspect of trauma) and 13 (difficulty falling/staying asleep). These results indicate that symptoms of physiological reactivity and psychological distress in response to cues, and irritability/anger outbursts show early and robust improvement with venlafaxine ER treatment, while symptoms of numbing and hyperarousal take longer. The early and persistent effect of venlafaxine ER over placebo on anger/irritability is noteworthy in view of the clinical significance of these symptoms in PTSD.",0,0 +6744,Co-morbidity: Lessons learned about Post-Traumatic Stress Disorder (PTSD) from developing ptsd scales for the MMPI,"Results from efforts to develop and validate PTSD measures are promising, but a ""gold standard"" has not been achieved. Keane, Malloy, and Fairbank (1984) have developed an MMPI PTSD subscale that has been cross-validated with clinicians' classification of PTSD at acceptable levels of agreement, specificity, and sensitivity. There is, however, room for improvement. Empirical evidence is presented that indicates that the next round of efforts to increase reliability and validity of PTSD measures must account for the presence/absence of co-morbidity (i.e., the simultaneous occurrence of other psychiatric disorders). For example, differences are noted in MMPI group profiles and PTSD scales between psychiatric patients and substance abusers. Second, different MMPI items emerge as indicative of PTSD; these vary as a function of the presence of other Axis I disorders among groups of Vietnam combat veterans who seek treatment for substance abuse. Results substantiate that different MMPI items for classifying PTSD occur with groups that differ in co-morbidity. Improvements in PTSD scale development are more likely when the contributions of pre-existing or subsequently co-occurring psychiatric disorders are taken in account, as well as variations in level of personality maturity. The evidence suggests that a ""family"" of PTSD scales need to be developed that take into account co-morbidity differences.",0,0 +6745,Successful Aging Among Older Veterans in the United States,"

Objective

To develop a unidimensional latent model of successful aging and to evaluate sociodemographic, medical, psychiatric, and psychosocial correlates of this construct in a nationally representative sample of older veterans in the United States.

Methods

Data were analyzed from a cross-sectional web survey of 2,025 U.S. veterans aged 60 to 96 years who participated in the National Health and Resilience in Veterans Study. Self-report measures of sociodemographics; subjective physical, mental, and cognitive functioning; and psychosocial characteristics were used. Confirmatory factor analysis was used to construct a unidimensional latent factor of successful aging. Correlates of scores on this factor were then evaluated.

Results

Most older veterans (82.1%) rated themselves as aging successfully. A unidimensional latent factor composed of seven measures of self-rated successful aging, quality of life, and physical, mental, cognitive, and social functioning provided a good fit to the data. Physical health difficulties (β = −0.39) and current psychological distress (β = −0.33) were most strongly negatively related to scores on this latent factor of successful aging, while protective psychosocial characteristics (β = 0.22), most notably resilience, gratitude, and purpose in life, were most strongly positively related to these scores. Additional positive predictors of successful aging included White, non-Hispanic race, being married or living with partner, perceiving a positive effect of the military on one's life, active lifestyle, positive expectations regarding aging, and conscientiousness; additional negative predictors included substance abuse history.

Conclusion

Results of this study provide a dimensional approach to characterizing components and correlates of successful aging in older veterans. Interventions and policy initiatives designed to mitigate physical health difficulties and psychological distress and to enhance protective psychosocial characteristics such as resilience, gratitude, and purpose in life may help promote successful aging in this population.",0,0 +6746,"Resilience definitions, theory, and challenges: interdisciplinary perspectives","In this paper, inspired by the plenary panel at the 2013 meeting of the International Society for Traumatic Stress Studies, Dr. Steven Southwick (chair) and multidisciplinary panelists Drs. George Bonanno, Ann Masten, Catherine Panter-Brick, and Rachel Yehuda tackle some of the most pressing current questions in the field of resilience research including: (1) how do we define resilience, (2) what are the most important determinants of resilience, (3) how are new technologies informing the science of resilience, and (4) what are the most effective ways to enhance resilience? These multidisciplinary experts provide insight into these difficult questions, and although each of the panelists had a slightly different definition of resilience, most of the proposed definitions included a concept of healthy, adaptive, or integrated positive functioning over the passage of time in the aftermath of adversity. The panelists agreed that resilience is a complex construct and it may be defined differently in the context of individuals, families, organizations, societies, and cultures. With regard to the determinants of resilience, there was a consensus that the empirical study of this construct needs to be approached from a multiple level of analysis perspective that includes genetic, epigenetic, developmental, demographic, cultural, economic, and social variables. The empirical study of determinates of resilience will inform efforts made at fostering resilience, with the recognition that resilience may be enhanced on numerous levels (e.g., individual, family, community, culture).",0,0 +6747,Psychological Trajectories after Intraoperative Awareness with Explicit Recall,,0,0 +6748,Discriminant validity of the TSC-40 in an outpatient setting,"This study examines the discriminant validity of the Trauma Symptom Checklist (TSC-40) in a clinical sample. The TSC-40 was developed as a research instrument for assessing the impact of a history of sexual victimization. Previous validity studies used nonclinical samples of women (Elliott & Briere, 1992; Gold, Milan, Myall, & Johnson, 1994). In the present study, the TSC-40 was administered to 103 men and 79 women requesting services at two outpatient clinics. Information about sexual victimization was collected from the client during intake and from the therapist after the client had received 6 months of therapy. A history of CSA was associated both with high symptom levels across symptom dimensions, and, specifically, with elevation on the trauma subscale of the TSC-40. The findings support the view that, in a clinical setting, CSA is associated both with generalized distress and with PTSD symptoms.",0,0 +6749,Status of Glucocorticoid Alterations in Post-traumatic Stress Disorder,"The current status of glucocorticoid alterations in post-traumatic stress disorder (PTSD) will be described in this chapter. Emphasis will be placed on data that suggest that at least some glucocorticoid-related observations in PTSD reflect pretraumatic glucocorticoid status. Recent observations have provided some evidence that pretraumatic glucocorticoid alterations may arise from genetic, epigenetic, and possibly other environmental influences that serve to increase the likelihood of developing PTSD following trauma exposure, as well as modulate attendant biological alterations associated with its pathophysiology. Current studies in the field of PTSD employ glucocorticoid challenge strategies to delineate effects of exogenously administered glucocorticoids on neuroendocrine, cognitive, and brain function. Results of these studies have provided an important rationale for using glucocorticoid strategies in the treatment of PTSD.",0,0 +6750,Physical and psychological factors predict outcome following whiplash injury,"Predictors of outcome following whiplash injury are limited to socio-demographic and symptomatic factors, which are not readily amenable to secondary and tertiary intervention. This prospective study investigated the predictive capacity of early measures of physical and psychological impairment on pain and disability 6 months following whiplash injury. Motor function (ROM; kinaesthetic sense; activity of the superficial neck flexors (EMG) during cranio-cervical flexion), quantitative sensory testing (pressure, thermal pain thresholds, brachial plexus provocation test), sympathetic vasoconstrictor responses and psychological distress (GHQ-28, TSK, IES) were measured in 76 acute whiplash participants. The outcome measure was Neck Disability Index scores at 6 months. Stepwise regression analysis was used to predict the final NDI score. Logistic regression analyses predicted membership to one of the three groups based on final NDI scores (<8 recovered, 10-28 mild pain and disability, >30 moderate/severe pain and disability). Higher initial NDI score (1.007-1.12), older age (1.03-1.23), cold hyperalgesia (1.05-1.58), and acute post-traumatic stress (1.03-1.2) predicted membership to the moderate/severe group. Additional variables associated with higher NDI scores at 6 months on stepwise regression analysis were: ROM loss and diminished sympathetic reactivity. Higher initial NDI score (1.03-1.28), greater psychological distress (GHQ-28) (1.04-1.28) and decreased ROM (1.03-1.25) predicted subjects with persistent milder symptoms from those who fully recovered. These results demonstrate that both physical and psychological factors play a role in recovery or non-recovery from whiplash injury. This may assist in the development of more relevant treatment methods for acute whiplash.",0,0 +6751,Comparative Profiles Of Women With Ptsd And Comorbid Cocaine Or Alcohol Dependence,"This study examined differences in substance abuse severity, trauma history, posttraumatic stress disorder (PTSD) symptomatology and psychiatric comorbidity among treatment-seeking women (N= 74) with PTSD and either comorbid cocaine or alcohol dependence. Women in the cocaine/PTSD group, compared with the alcohol/PTSD group, demonstrated greater occupational impairment (e.g., greater severity on the employment subscale of the Addiction Severity Index, less monthly income, fewer days worked in past month), more legal problems (e.g., greater number of months incarcerated and arrests for prostitution), and greater social impairment (e.g., fewer number of close friends, less likely to be married). Women in the alcohol/PTSD group evidenced higher rates of exposure to serious accidents, other situations involving serious injury, and other extraordinarily stressful life events. Rates of major depression and social phobia were higher among the alcohol/PTSD group than the cocaine/PTSD group. Women in the alcohol/PTSD group scored higher on the CAPS avoidance, hyperarousal, and total subscale scores. The current findings enhance our understanding of the substance-specific profiles of women with PTSD and comorbid substance use disorders and may have important implications for the design of dual-diagnosis interventions.",0,0 +6752,A review on cognitive impairments in depressive and anxiety disorders with a focus on young adults,"There is growing evidence for cognitive dysfunction in depressive and anxiety disorders. Nevertheless, the neuropsychological profile of young adult patients has not received much systematic investigation. The following paper reviews the existing literature on cognitive impairments in depressive and anxiety disorders particularly among young adults. Additionally, the focus of young adult age group and the effect of confounding variables on study results are discussed.Electronic database searches were conducted to identify research articles focusing on cognitive impairments in depressive or anxiety disorders among young adults published in English during years 1990-2006.Cognitive impairments are common in young adults with major depression and anxiety disorders, although their nature remains partly unclear. Accordingly, executive dysfunction is evident in major depression, but other more specific deficits appear to depend essentially on disorder characteristics. The profile of cognitive dysfunction seems to depend on anxiety disorder subtype, but at least obsessive-compulsive disorder is associated with deficits in executive functioning and visual memory. The conflicting results may be explained by heterogeneity within study participants, such as illness status, comorbid mental disorders, and medication, and other methodological issues, including inadequate matching of study groups and varying testing procedures.The study is a comprehensive review, but not a formal meta-analysis, due to methodological heterogeneity.Cognitive impairments are common in major depression and anxiety disorders. However, more research is needed to confirm and widen these findings, and to expand the knowledge into clinical practice. Controlling of confounding variables in future studies is highly recommended.",0,0 +6753,Comorbid obsessive–compulsive personality disorder in obsessive–compulsive disorder (OCD): A marker of severity,"Comorbid obsessive-compulsive personality disorder (OCPD) is well-described in obsessive-compulsive disorder (OCD). It remains unclear, however, whether OCPD in OCD represents a distinct subtype of OCD or whether it is simply a marker of severity in OCD.The aim of this study was to compare a large sample of OCD subjects (n=403) with and without OCPD on a range of demographic, clinical and genetic characteristics to evaluate whether comorbid OCPD in OCD represents a distinct subtype of OCD, or is a marker of severity.Our findings suggest that OCD with and without OCPD are similar in terms of gender distribution and age at onset of OC symptoms. Compared to OCD-OCPD (n=267, 66%), those with OCD+OCPD (n=136, 34%) are more likely to present with the OC symptom dimensions which reflect the diagnostic criteria for OCPD (e.g., hoarding), and have significantly greater OCD severity, comorbidity, functional impairment, and poorer insight. Furthermore there are no differences in distribution of gene variants, or response to treatment in the two groups.The majority of our findings suggest that in OCD, patients with OCPD do not have a highly distinctive phenomenological or genetic profile, but rather that OCPD represents a marker of severity.",0,0 +6754,A comparison between survival from cancer before and after a physical traumatic injury: physical trauma before cancer is associated with decreased survival,"Prior traumatic experiences have been associated with poorer coping strategies, greater distress, and more posttraumatic stress disorder (PTSD) symptoms following a subsequent cancer diagnosis affecting their survival. However, the impact of prior physical traumatic injury on cancer survival has not been examined.The present study matched patients from the same Level 1 Trauma center who appeared in both the trauma and cancer registries. A total of 498 patients met the criteria between 1998 and 2014 who have experienced both a diagnosis of cancer and a physical traumatic injury. The survival between the patients who had physical trauma before cancer (TBC) versus those that had physical trauma after the cancer diagnosis (TAC) were compared.The TBC group had a higher percentage of males (48 % vs 33 % p = 0.001) and motor vehicle collisions (18 % vs 7 %, p < 0.001), than the TAC group. TBC patients were also significantly younger than TAC patients at the time of the physical traumatic event (68.7 ± 14.6 vs 76.2 ± 12.0 years, p < 0.001), and longer length of time between the cancer diagnosis and physical traumatic injury (2.9 ± 2.9 vs 1.7 ± 2.6 years, p < 0.001). The overall probability of survival for the entire sample was 68 %. Percent survival for the TBC (n = 251) and TAC (n = 247) groups was 56 and 80 % respectively (p < 0.001). Results were consistent regardless of stage of cancer at diagnosis (hazard ratio (HR (Standard Error)). After adjusting for comorbidities Charlson comorbidity index (CCI) (HR = 1.2 (0.06), p = 0.009)), cancer stage (HR = 2.8 (0.12), p < 0.001)), lung cancer (HR = 1.7 (0.25), p < 0.001) and bladder cancer (HR = 3.5 (0.55), p = 0.02), experiencing a prior physical traumatic injury was associated with an increased HR for mortality of 4.6 (0.93), p < 0.001).A physical traumatic episode before cancer diagnosis (TBC) increased the risk of death 4.6 fold compared to the TAC group even after adjusting for CCI, stage of cancer at diagnosis, lung cancer, and bladder cancer. These findings suggest considering a history of physical traumatic injury in cancer patients as a possible risk factor for faster cancer progression and mortality.",0,0 +6755,"Relationships Between Mobbing at Work and MMPI-2 Personality Profile, Posttraumatic Stress Symptoms, and Suicidal Ideation and Behavior","This study investigates the relationships between the experience of mobbing at work and personality traits and symptom patterns as assessed by means of the revised version of the Minnesota Multiphasic Personality Inventory (MMPI-2). Participants were 107 workers who had contacted mental health services because they perceived themselves as victims of mobbing. In line with previous research, the results showed that the MMPI-2 mean profile was characterized by a neurotic component as evidenced by elevations of Scales 1, 2, and 3 and a paranoid component as indicated by elevation of Scale 6. Contrary to previous research, a pattern of positive and significant correlations was found between the frequency of exposure to mobbing behaviors and the MMPI-2 clinical, supplementary, and content scales, including the posttraumatic stress scale. Only about half the participants showed a severity of posttraumatic stress symptoms indicative of a posttraumatic stress disorder. The frequency of exposure to mobbing predicted suicidal ideation and behavior, with depression only partially mediating this relationship. (",0,0 +6756,Neonatizid,"Background: The term neonaticide describes the act of killing a newborn child by a parent (mostly by the mother) within 24 h after birth. The aim of this study was to establish a classification of female perpetrators using psychopathological, mental, social and biographical characteristics and to make a comparison of the frequency between the old and new federal states in Germany. Material and methods: In this study a total of 63 female German perpetrators who killed at least one newborn between 1986 and 2009 are portrayed and classified by epidemiological and psychopathological characteristics and personality profiles. After obtaining consent from the public prosecutors responsible, data were collected from forensic psychiatric expert opinions and legally valid court verdicts. A questionnaire was established to answer the questions on the psychopathological, e.g. do the women suffer from a mental disease when killing their newborn(s), mental, e.g. can personality accentuations be elicited, social, e.g. are the women unemployed and biographical characteristics of the women, e.g. how old are the women? Finally, an investigation was carried out using significance tests to find out if there was a significant statistical difference in the frequency of neonaticide between the eastern and western federal states. Results: A cluster analysis based on the descriptive analysis was developed. The cluster analysis provided a foundation for a dichotomous classification of the perpetrators depending on five criteria. The first category contained 32 perpetrators who were on average 21 years old, who were primiparous and who hid, ignored or did not perceive their pregnancy. Most of them still lived with their parents. The perpetrators either did not have a mental disease or suffered from an acute stress disorder. The second category contained 31 perpetrators who were on average 25 years old, who were pluriparous, who hid their pregnancy and who lived with their partner. These women either did not have a mental disease or suffer from a personality disorder. A statistically significant higher incidence was found in the eastern federal states of Germany. Conclusion: The presented categorization of female perpetrators into two groups, where the features only show a small degree of overlap, should be taken into consideration in the assessment of the reasons for neonaticide. The typology of female perpetrators is more heterogeneous than previously assumed. The presented typologies and knowledge of conditional constellations involved in neonaticide achieve better prerequisites to be able to recognize persons at risk earlier and to instigate preventive measures. © 2015, Springer-Verlag Berlin Heidelberg.",0,0 +6757,Properties of patient-reported outcome measures in individuals following acute whiplash injury,"The aim of this study was to assess the acceptability, reliability, validity and responsiveness of the Short-Form Health Survey (SF-12) and its preference-based derivative (SF-6D), the EQ-5D and the Neck Disability Index (NDI) in patients recovering from acute whiplash injury.Data from the Managing Injuries of the Neck Trial of 3,851 patients with acute whiplash injury formed the basis of this empirical investigation. The EQ-5D and SF-12 were collected at baseline, and all three outcome measures were then collected at 4 months, 8 months and 12 months post-randomisation. The measures were assessed for their acceptability (response rates), internal consistency, validity (known groups validity and discriminant validity) and their internal and external responsiveness.Response rates were broadly similar across the measures, with evidence of a floor effect for the NDI and a ceiling effect for the EQ-5D utility measure. All measures had Cronbach's α statistics of greater than 0.7, indicating acceptable internal consistency. The NDI and EQ-5D utility score correlated more strongly with the physical component scale of the SF-12 than the mental component scale, whilst this was reversed for the SF-6D utility score. The smaller standard deviations in SF-6D utility scores meant there were larger effect sizes for differences in utility score between patients with different injury severity at baseline than for the EQ-5D utility measure. However, the EQ-5D utility measure and NDI were both more responsive to longitudinal changes in health status than the SF-6D.There was no evidence of differences between the EQ-5D utility measure and NDI in terms of their construct validity, discriminant validity or responsiveness in patients with acute whiplash injury. However, both demonstrated superior responsiveness to longitudinal health changes than the SF-6D.",0,0 +6758,Prevalence Estimates of Combat-Related Post-Traumatic Stress Disorder: Critical Review,"The aim of the present study was to provide a critical review of prevalence estimates of combat-related post-traumatic stress disorder (PTSD) among military personnel and veterans, and of the relevant factors that may account for the variability of estimates within and across cohorts, including methodological and conceptual factors accounting for differences in prevalence rates across nations, conflicts/wars, and studies. MEDLINE and PsycINFO databases were examined for literature on combat-related PTSD. The following terms were used independently and in combinations in this search: PTSD, combat, veterans, military, epidemiology, prevalence. The point prevalence of combat-related PTSD in US military veterans since the Vietnam War ranged from approximately 2% to 17%. Studies of recent conflicts suggest that combat-related PTSD afflicts between 4% and 17% of US Iraq War veterans, but only 3-6% of returning UK Iraq War veterans. Thus, the prevalence range is narrower and tends to have a lower ceiling among combat veterans of non-US Western nations. Variability in prevalence is likely due to differences in sampling strategies; measurement strategies; inclusion and measurement of the DSM-IV clinically significant impairment criterion; timing and latency of assessment and potential for recall bias; and combat experiences. Prevalence rates are also likely affected by issues related to PTSD course, chronicity, and comorbidity; symptom overlap with other psychiatric disorders; and sociopolitical and cultural factors that may vary over time and by nation. The disorder represents a significant and costly illness to veterans, their families, and society as a whole. Further carefully conceptualized research, however, is needed to advance our understanding of disorder prevalence, as well as associated information on course, phenomenology, protective factors, treatment, and economic costs.",0,0 +6759,Evidence-based pharmacotherapy of post-traumatic stress disorder (PTSD),"Post-traumatic stress disorder (PTSD) is a prevalent and disabling disorder. Recognition of neurobiological abnormalities associated with this condition suggests the potential efficacy of medication in its treatment. Nevertheless, questions regarding the efficacy of medications remain, despite general endorsement by clinical practice guidelines of selective serotonin reuptake inhibitors (SSRIs) as first-line agents in treating PTSD. This paper reviews evidence from randomized controlled trials (RCTs) for the efficacy of acute and long-term pharmacotherapy for PTSD, including the treatment of refractory PTSD. In addition, we conducted a systematic meta-analysis to compare the efficacy of different medications in treating PTSD. The effects of methodological study features (including year of publication, duration, number of centres) and sample characteristics (proportion of combat veterans, gender composition) were also tested. The largest body of evidence for short- and long-term efficacy of medication currently exists for SSRIs, with promising initial findings for the selective noradrenergic reuptake inhibitor venlafaxine and the atypical antipsychotic risperidone. Treatment effect was predicted by number of centres and recency of the study, with little evidence that sample characteristics predicted response. Evidence for the effectiveness of benzodiazepines is lacking, despite their continued use in clinical practice. Finally, the α1 antagonist prazosin and the atypical antipsychotics show some efficacy in treatment-resistant PTSD. Adequately powered trials that are designed in accordance with best-practice guidelines are required to provide conclusive evidence of clinically relevant differences in efficacy between agents in treating PTSD, and to help estimate clinical and methodological predictors of treatment response.",0,0 +6760,Early cognitive status and productivity outcome after traumatic brain injury: findings from the TBI model systems.,"To evaluate the contribution of early cognitive assessment to the prediction of productivity outcome after traumatic brain injury (TBI) adjusted for severity of injury, demographic factors, and preinjury employment status.Inception cohort.Six inpatient brain injury rehabilitation programs.A total of 388 adults with TBI whose posttraumatic amnesia (PTA) resolved before discharge from inpatient rehabilitation.Administered neuropsychologic tests during inpatient stay on emergence from PTA. Follow-up interview and evaluation. Predictor measures also determined.Productivity status at follow-up 12 months postinjury.Multiple logistic regression analysis revealed that preinjury productivity status, duration of PTA, education level, and early cognitive status each made significant, independent contributions to the prediction of productivity status at follow-up. When adjusted for all other predictors, persons scoring at the 75th percentile on early cognitive status (less impaired) had 1.61 times greater odds (95% confidence interval [CI], 1.07-2.41) of being productive follow-up than those scoring at the 25th percentile (more impaired). Without adjustment, persons scoring at the 75th percentile had 2.46 times greater odds (95% CI, 1.77-3.43) of being productive at follow-up.Findings support the utility of early cognitive assessment by using neuropsychologic tests. In addition to other benefits, early cognitive assessment makes an independent contribution to prediction of late outcome. Findings support the clinical practice of performing initial neuropsychologic evaluations after resolution of PTA.",0,0 +6761,"What are the determinants of post-traumatic stress disorder: age, gender, ethnicity or other? Evidence from 2008 Wenchuan earthquake","To estimate the prevalence of post-traumatic stress disorder (PTSD) and assess determinants related to PTSD symptoms among adult earthquake survivors after the 2008 Wenchuan earthquake in China.Cross-sectional multicluster sample surveys with data collected from four counties.Surveys were conducted separately in four counties in Sichuan Province, with a total of 2004 respondents. Beichuan County and Dujiangyan City were damaged more severely than Yaan County and Langzhong County during the earthquake. In total, 1890 households were represented, with a mean of 2.2 respondents per household. Data were collected using structured interviews, and the Harvard Trauma Questionnaire and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria were used to diagnose PTSD.The prevalence rates of suspected PTSD were 47.3% (n = 436) in heavily damaged areas and 10.4% (n = 93) in moderately damaged areas. The prevalence rates of PTSD symptoms among elderly, middle aged and young adults were 55.8%, 50.2% and 28.6% (P = 0.001), respectively, in heavily damaged areas. Older age, female gender, unmarried/divorced/widowed, ethnic minority, death of family member, no household income and damaged household were independent risk factors for PTSD symptoms in heavily damaged areas.Interventions designed to reduce PTSD among populations affected by the 2008 earthquake should focus on people without household incomes, those with damaged households and those who experienced the death of a family member. Effective, sustainable and culturally sensitive psychosocial interventions and mental health services are required, and attention should be directed to survivors who experienced the death of a family member, women and older adults following the devastating natural disaster. Governments should support income-generating activities and improve living conditions. Trained field personnel can assist with PTSD assessments and referrals, and existing rural healthcare services can be used to provide treatment for common psychiatric disorders.",0,0 +6762,IQ and Posttraumatic Stress Symptoms in Children Exposed to Interpersonal Violence,"Background: The literature is mixed as to the relationship between intelligence quotient (IQ) and Posttraumatic Stress Disorder (PTSD) symptomatology in adult populations. Even less is known about the relationship in children who have been traumatized. Methods: Fifty-nine children and adolescents (mean age = 10.6) with a history of interpersonal violence were evaluated with respect to PTSD symptomatology, number of traumas, and estimated Verbal, Performance and Full scale IQ scores. PTSD symptomatology included symptom levels for cluster B (re-experiencing), cluster C (avoidance and numbing), and cluster D (Hypervigilance) and criterion F, functional impairment. Results: Results indicated that Full scale and Verbal IQ were significantly associated with the number of traumas, re-experiencing symptoms, and impairment. Performance IQ was only associated with impairment. Regression analyses suggested that together PTSD symptomatology predicted Full scale and Verbal IQ but nor Performance IQ and impairment was the single best predictor of IQ generally. Conclusions: Findings provide support for an association between PTSD symptoms and IQ, particularly verbal IQ. Two possible reasons for this relationship are that higher levels of Verbal IQ may serve as a premorbid protective factor against the development of re-experiencing symptoms, or performance on post-trauma Verbal IQ measures may be negatively impacted by expression of PTSD symptoms. Longitudinal studies are needed to clarify which of these two possibilities explains the association. (",0,0 +6763,Short communication: Alterations in expression of gluconeogenic genes during heat stress and exogenous bovine somatotropin administration,"Study objectives were to evaluate hepatic gluconeogenic enzyme gene expression in recombinant bovine somatotropin (rbST)-treated lactating dairy cattle during heat stress (HS) or in thermal-neutral, pair-fed (PF) animals. Twenty-two multiparous (99 d in milk, 656 kg of BW) Holstein cows were subjected to 3 consecutive experimental periods (7 d each): (1) thermal neutral, (2) HS or PF, and (3) HS or PF with rbST (Posilac, administered on d 1 of period 3). Liver biopsies were obtained on the final day of each period. Heat stress conditions progressively decreased dry matter intake for the first 5 to 6 d during period 2 before stabilizing (a decrease of 6.15 kg; 30%) on d 6 and 7, and feed intake remained stable and not different from period 2 during period 3. Cytosolic phosphoenolpyruvate carboxykinase mRNA abundance increased during PF, but was unaffected by HS or bST. Pyruvate carboxylase gene expression increased during HS and PF, and administering bST decreased pyruvate carboxylase mRNA abundance during both HS and PF. Insulin-like growth factor-I gene expression increased following bST administration during HS and PF, confirming hepatic bST responsiveness. Exposure to HS leads to a change in hepatic gluconeogenic enzyme profile that appears to be dependent on plane of nutrition.",0,0 +6764,Ketamine and suicidal ideation in depression: Jumping the gun?,"Depression and suicide are known to be intricately entwined but the neurobiological basis underlying this association is yet to be understood. Ketamine is an N-methyl d-aspartate (NMDA) receptor antagonist used for induction and maintenance of general anaesthesia but paradoxically its euphoric effects lead to its classification under drugs of abuse. The serendipitous finding of rapid-onset antidepressant action of subanaesthetic dosing with ketamine by intravenous infusion has sparked many preclinical and clinical investigations. A remarkable suppression of suicidal ideation was also reported in depressed patients. This review focuses on the clinical trials on ketamine that reported remedial effects in suicidal ideation in depression and addresses also the molecular mechanisms underlying the antidepressant and psychotomimetic actions of ketamine. The neuropsychiatric profile of subanaesthetic doses of ketamine encourages its use in the management of suicidal ideation that could avert emergent self-harm or suicide. Finally, the need for neuroimaging studies in suicidal patients to identify the brain region specific and temporal effects of ketamine, and the possibility of employing ketamine as an experimental tool in rodent-based studies to study the mechanisms underlying suicidal behaviour are highlighted.",0,0 +6765,Cortical Thinning in Patients with Recent Onset Post-Traumatic Stress Disorder after a Single Prolonged Trauma Exposure,"Most of magnetic resonance imaging (MRI) studies about post-traumatic stress disorder (PTSD) focused primarily on measuring of small brain structure volume or regional brain volume changes. There were rare reports investigating cortical thickness alterations in recent onset PTSD. Recent advances in computational analysis made it possible to measure cortical thickness in a fully automatic way, along with voxel-based morphometry (VBM) that enables an exploration of global structural changes throughout the brain by applying statistical parametric mapping (SPM) to high-resolution MRI. In this paper, Laplacian method was utilized to estimate cortical thickness after automatic segmentation of gray matter from MR images under SPM. Then thickness maps were analyzed by SPM8. Comparison between 10 survivors from a mining disaster with recent onset PTSD and 10 survivors without PTSD from the same trauma indicates cortical thinning in the left parietal lobe, right inferior frontal gyrus, and right parahippocampal gyrus. The regional cortical thickness of the right inferior frontal gyrus showed a significant negative correlation with the CAPS score in the patients with PTSD. Our study suggests that shape-related cortical thickness analysis may be more sensitive than volumetric analysis to subtle alteration at early stage of PTSD.",0,0 +6766,PRENATAL REFLECTIVE FUNCTIONING IN PRIMIPAROUS WOMEN WITH A HIGH-RISK PROFILE,ar,0,0 +6767,"Subsyndromal depression in the United States: prevalence, course, and risk for incident psychiatric outcomes","Background Subsyndromal depression (SD) may increase risk for incident major depressive and other disorders, as well as suicidality. However, little is known about the prevalence, course, and correlates of SD in the US general adult population. Method Structured diagnostic interviews were conducted to assess DSM-IV Axis I and II disorders in a nationally representative sample of 34 653 US adults who were interviewed at two time-points 3 years apart. Results A total of 11.6% of US adults met study criteria for lifetime SD at Wave 1. The majority (9.3%) had <5 total symptoms required for a diagnosis of major depression; the remainder (2.3%) reported ⩾5 symptoms required for a diagnosis of major depression, but denied clinically significant distress or functional impairment. SD at Wave 1 was associated with increased likelihood of developing incident major depression [odds ratios (ORs) 1.72–2.05], as well as dysthymia, social phobia, and generalized anxiety disorder (GAD) at Wave 2 (ORs 1.41–2.92). Among respondents with SD at Wave 1, Cluster A and B personality disorders, and worse mental health status were associated with increased likelihood of developing incident major depression at Wave 2. Conclusions SD is prevalent in the US population, and associated with elevated rates of Axis I and II psychopathology, increased psychosocial disability, and risk for incident major depression, dysthymia, social phobia, and GAD. These results underscore the importance of a dimensional conceptualization of depressive symptoms, as SD may serve as an early prognostic indicator of incident major depression and related disorders, and could help identify individuals who may benefit from preventive interventions.",0,0 +6768,Clinician-administered PTSD scale: A review of the first ten years of research,"The Clinician-Administered PTSD Scale (CAPS) is a structured interview for assessing posttraumatic stress disorder (PTSD) diagnostic status and symptom severity. In the 10 years since it was developed, the CAPS has become a standard criterion measure in the field of traumatic stress and has now been used in more than 200 studies. In this paper, we first trace the history of the CAPS and provide an update on recent developments. Then we review the empirical literature, summarizing and evaluating the findings regarding the psychometric properties of the CAPS. The research evidence indicates that the CAPS has excellent reliability, yielding consistent scores across items, raters, and testing occasions. There is also strong evidence of validity: The CAPS has excellent convergent and discriminant validity, diagnostic utility, and sensitivity to clinical change. Finally, we address several concerns about the CAPS and offer recommendations for optimizing the CAPS for various clinical research applications.",0,0 +6769,"Posttraumatic Stress Disorder Following Ethnoreligious Conflict in Jos, Nigeria","In September 2001, ethnoreligious rioting occurred in Jos, Nigeria. Using a multistage cluster sampling technique, 290 respondents were recruited in Jos 7 to 9 months after the riots. Data were collected regarding demographics, exposure to traumatic events, and psychological symptoms. Resting pulse and blood pressure were recorded. A total of 145 (52.5%) witnessed or were victims of personal attacks, 165 (59.6%) lost their possessions, 56 (20.7%) had their homes burned, 44 (16.2%) witnessed relatives' deaths, and 8 (2.9%) were robbed. A total of 252 (89.7%) of the respondents met reexperiencing criteria, 138 (49.1%) met avoidance criteria, and 236 (84.0%) met arousal criteria for posttraumatic stress disorder (PTSD). A total of 116 (41%, 95% confidence interval [CI] = 36% to 47%) met all three categories for PTSD. Only personal attacks (adjusted odds ratio = 2.8, 95% CI = 1.7 to 4.7) and a heart rate of 90 beats/min or more (adjusted odds ratio = 2.8, 95% CI = 1.4 to 5.8) were significantly related to PTSD in a multivariate model.",0,0 +6770,Introduction to the Special Issue: Posttraumatic Stress Related to Pediatric Illness and Injury,"doi:10.1093/jpepsy/jsj052 Advance Access publication August 3, 2005 Journal of Pediatric Psychology vol. 31 no. 4 © The Author 2005. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oupjournals.org Introduction to the Special Issue: Posttraumatic Stress Related to Pediatric Illness and Injury",0,0 +6771,"Personality Characterizations of Outpatients With Schizophrenia, Schizophrenia With Substance Abuse, and Primary Substance Abuse","The study extended previous research on the relationship between personality traits and Axis I disorders. It examined personality differences between individuals diagnosed with schizophrenia and substance abuse and also included individuals dually diagnosed with both schizophrenia and substance abuse. Comparisons were made with respect to characteristics of both normal personality, as measured by the NEO Five-Factor Inventory (NEO-FFI), and disordered personality, as measured by the Millon Multiaxial Personality Inventory. On the NEO-FFI, all groups differed significantly from the NEO-FFI normative sample on at least three personality domains. As predicted, the dual diagnosis group showed the most personality deviance and pathology. The schizophrenia group was primarily distinguished by higher levels of agreeableness, whereas the substance abuse group was more extroverted and showed a prominence of Cluster B personality patterns. An unexpected finding was an interaction between diagnostic group and age, such that older relative to younger individuals in the single diagnosis groups showed greater personality adaptivity and moderation, whereas older individuals in the dual diagnosis group showed less.",0,0 +6772,Treatment and Prevention of Posttraumatic Stress Reactions in Children and Adolescents Exposed to Disasters and Terrorism: What Is the Evidence?,"Youth who are exposed to devastating natural disasters or terrorist attacks report high levels of posttraumatic stress (PTS) and may develop posttraumatic stress disorder (PTSD). This article summarizes evidence on the treatment of PTS reactions in these youth and describes interventions developed for the immediate aftermath of the event, the short-term recovery and rebuilding phase, or the long-term recovery phase. Psychological first aid and evidence-based psychoeducational materials show promise for the early phases of postdisaster recovery. For youth with persistent PTSD, cognitive-behavioral interventions appear promising but require further study. Children and adolescents exposed to disasters and acts of terrorism may need multicomponent interventions because their reactions are often multifaceted and often include other psychological problems.",0,0 +6773,Stress-related genomic responses during the course of heat acclimation and its association with ischemic-reperfusion cross-tolerance,"Acclimation to heat is a biphasic process involving a transient perturbed phase followed by a long lasting period during which acclimatory homeostasis is developed. In this investigation, we used cDNA stress microarray (Clontech Laboratory) to characterize the stress-related genomic response during the course of heat acclimation and to test the hypotheses that 1) heat acclimation influences the threshold of activation of protective molecular signaling, and 2) heat-acclimation-mediated ischemic-reperfusion (I/R) protection is coupled with reprogrammed gene expression leading to altered capacity or responsiveness of protective-signaling pathways shared by heat and I/R cytoprotective systems. Rats were acclimated at 34°C for 0, 2, and 30 days. 32 P-labeled RNA samples prepared from the left ventricles of rats before and after subjection to heat stress (HS; 2 h, 41°C) or after I/R insult (ischemia: 75%, 45 min; reperfusion: 30 min) were hybridized onto the array membranes. Confirmatory RT-PCR of selected genes conducted on samples taken at 0, 30, and 60 min after HS or total ischemia was used to assess the promptness of the transcriptional response. Cluster analysis of the expressed genes indicated that acclimation involves a “two-tier” defense strategy: an immediate transient response peaking at the initial acclimating phase to maintain DNA and cellular integrity, and a sustained response, correlated with slowly developed adaptive, long-lasting cytoprotective signaling networks involving genes encoding proteins that are essential for the heat-shock response, antiapoptosis, and antioxidation. Gene activation was stress specific. Faster activation and suppression of signaling pathways shared by HS and I/R stressors probably contribute to heat-acclimation I/R cross-tolerance.",0,0 +6774,Low platelet-poor plasma concentrations of serotonin in patients with combat-related posttraumatic stress disorder,"

Abstract

Background: Combat-related posttraumatic stress disorder (CR-PTSD) is associated with a dysregulation of various neurotransmitter systems. Methods: We assessed levels of platelet-poor plasma (PPP) norepinephrine (NE), and serotonin (5-HT), and 24-hour urinary excretion of NE, dopamine (DA), and homovanillic acid (HVA) in 17 male outpatients with untreated chronic CR-PTSD (age, 33.1 ± 7.4 years) and 10 normal control subjects (age, 35.8 ± 2.7 years). Results: Compared with the control subjects, the PTSD patients showed significantly lower PPP 5-HT levels, elevated PPP NE levels, and significantly higher mean 24-hour urinary excretion of all three catecholamines (NE, DA, and HVA). The 24-hour urinary HVA values of the CR-PTSD patients correlated significantly and positively with the total Impact of Event Scale scores and the avoidance symptoms cluster scores, and the PPP 5-HT levels correlated negatively with the Hamilton Anxiety Rating Scale scores. The PPP NE/5-HT ratio was significantly higher in the study group than in the control subjects. Conclusions: We believe this combined enhanced noradrenergic activity and diminished 5-HT activity may be relevant to the neurobiology of CR-PTSD.",0,0 +6775,A controlled study of internalizing symptoms in older adolescents with sickle cell disease,"Due to the ongoing medical challenges we hypothesized that older adolescents with sickle cell disease (SCD) would report greater rates of internalizing symptoms and diagnoses. This study is a follow-up to a previous study [1] that found few differences between the emotional well-being of children ages 8-15 with SCD and comparison peers. Our aim is to re-assess internalizing symptoms of youth with SCD and comparison peers at age 18.At follow-up, trained staff members administered semi-structured psychiatric interviews and widely use behavioral health questionnaires to adolescents with SCD (n = 48), their comparison peers (COMP; n = 51) and a caregiver. Mood, internalizing symptoms and diagnoses, were evaluated cross-sectionally at the follow-up (age 18).Psychiatric interview data showed that COMP reported more phobias relative to adolescents with SCD; no significant differences were reported for any other current symptoms (depression, anxiety, or mania). Questionnaire data showed all scores in the normal range with two significant differences: older adolescents with SCD reported more symptoms of tension-anxiety and fatigue-inertia. Both groups reported significant rates of internalizing disorders with 31% of youth with SCD and 35% of COMP having a DSM-IV diagnosis.Psychiatric interview data for both groups of older adolescents suggested considerable psychopathology; questionnaire data for both groups were in the normal range. We report few significant differences-more phobias in comparisons peers; more tension-anxiety and fatigue-inertia reported by youth with SCD. The overall findings suggest considerable resilience for youth with SCD, but both groups of adolescents report significant rates of psychopathology similar to national rates.",0,0 +6776,Beyond resilience and PTSD: Mapping the heterogeneity of responses to potential trauma.,"The formal acceptance of posttraumatic stress disorder (PTSD) as a legitimate diagnostic category in the1980 Diagnostic and Statistical Manual of Mental Disorders stimulated a torrent of research onpsychological trauma. Not surprisingly, PTSD and its treatment had dominated that research. Anothercommon approach has been to measure the average impact of different potentially traumatic events, aswell as the factors that inform that impact. In this article, we consider the limitations of these perspectivesand argue for a broader theoretical approach that takes into account the natural heterogeneity of traumareactions over time. To that end, we review recent attempts to identify prototypical patterns or trajectoriesof trauma reaction that include chronic dysfunction, but also delayed reactions, recovery, and psycho-logical resilience. We consider the advantages but also the limitations and ongoing controversiesassociated with this approach. Finally, we introduce promising new research that uses relative sophis-ticated advances in latent growth mixture modeling as a means of empirically mapping the heterogeneityof trauma responses and consider some of the implications of this approach for existing trauma theories.Keywords: resilience, PTSD, trauma trajections, grief",0,0 +6777,Neurobiology of Memory and Dissociation in Trauma Survivors,Abstract: This symposium examines the neurobiology of memory and dissociation in traumatized individuals. Several paradigms are presented that investigate the specific nature of differences in “remembering” in relation to neuroendocrine profiles among those with and without posttraumatic stress disorder (PTSD). These lines of research may help to clarify the paradox of distortion or absence of some memories and enhancement of others in PTSD.,0,0 +6778,Analysis of heart rate variability in posttraumatic stress disorder patients in response to a trauma-related reminder,"

Abstract

Background: Spectral analysis of heart rate variability has recently been shown to be a reliable noninvasive test for quantitative assessment of cardiovascular autonomic regulatory responses, providing a dynamic map of sympathetic and parasympathetic interaction. In a prior study exploring the state of hyperarousal characterizing the posttraumatic stress disorder (PTSD) syndrome, the authors described standardized heart rate analysis carried out in 9 PTSD patients at rest, which demonstrated clear-cut evidence of a baseline autonomic hyperarousal state. Methods: To examine the dynamics of this hyperarousal state, standardized heart rate analysis was carried out in 9 PTSD patients compared to a matched control group of 9 healthy volunteers. Twenty-minute recordings of electrocardiogram in response to a trauma-related cue as opposed to a resting state were performed and analyzed. The PTSD patients were asked to recount the presumed triggering traumatic event, and the control subjects recounted a significant stressful negative life event. Results: Our results show that, whereas the control subjects demonstrated significant autonomic responses to the stressogenic stimulus supplied by the recounting of a major stressful experience, the PTSD patients demonstrated almost no autonomic response to the recounting of the triggering stressful event. The PTSD patients demonstrated a degree of autonomic dysregulation at rest which was comparable to that seen in the control subjects' reaction to the stress model. Conclusions: The lack of response to the stress model applied in the study appears to imply that PTSD patients experience so great a degree of autonomic hyperactivation at rest, that they are unable to marshal a further stress response to the recounting of the triggering trauma, as compared to control subjects.",0,0 +6779,Adult sexual abuse is associated with elevated neurohormone levels among women with PTSD due to childhood sexual abuse,"Posttraumatic stress disorder (PTSD) has been associated with reduced, similar, or increased urinary cortisol levels. The authors identified a factor that might contribute to such variability when they obtained 24-hour urinary neurohormone profiles on 69 women with PTSD due to childhood sexual abuse. Half (n = 35) had subsequently experienced adult sexual abuse (ASA) while the other half (n = 34) had not. The ASA group had significantly elevated urinary cortisol, norepinephrine and dopamine levels in comparison to the non-ASA group. Neither a history of childhood or adult physical abuse nor other variables contributed to this finding. The results suggest that the psychobiological consequences of exposure to the same traumatic event may differ as a result of an interaction between age and the composite history of trauma exposure.",0,0 +6780,Role of GABA in anxiety and depression,"This review assesses the parallel data on the role of gamma-aminobutyric acid (GABA) in depression and anxiety. We review historical and new data from both animal and human experimentation which have helped define the key role for this transmitter in both these mental pathologies. By exploring the overlap in these conditions in terms of GABAergic neurochemistry, neurogenetics, brain circuitry, and pharmacology, we develop a theory that the two conditions are intrinsically interrelated. The role of GABAergic agents in demonstrating this interrelationship and in pointing the way to future research is discussed.",0,0 +6781,Posttraumatic Stress Symptoms after Exposure to Two Fire Disasters: Comparative Study,"This study investigated traumatic stress symptoms in severely burned survivors of two fire disasters and two comparison groups of patients with ""non-disaster"" burn injuries, as well as risk factors associated with acute and chronic stress symptoms. Patients were admitted to one out of eight burn centers in The Netherlands or Belgium. The Impact of Event Scale (IES) was administered to 61 and 33 survivors respectively of two fire disasters and 54 and 57 patients with ""non-disaster"" burn etiologies at 2 weeks, 3, 6, 12 and 24 months after the event. We used latent growth modeling (LGM) analyses to investigate the stress trajectories and predictors in the two disaster and two comparison groups. The results showed that initial traumatic stress reactions in disaster survivors with severe burns are more intense and prolonged during several months relative to survivors of ""non-disaster"" burn injuries. Excluding the industrial fire group, all participants' symptoms on average decreased over the two year period. Burn severity, peritraumatic anxiety and dissociation predicted the long-term negative outcomes only in the industrial fire group. In conclusion, fire disaster survivors appear to experience higher levels of traumatic stress symptoms on the short term, but the long-term outcome appears dependent on factors different from the first response. Likely, the younger age, and several beneficial post-disaster factors such as psychosocial aftercare and social support, along with swift judicial procedures, contributed to the positive outcome in one disaster cohort.",1,0 +6782,Assessing impact of differential symptom functioning on post-traumatic stress disorder (PTSD) diagnosis,"This article explores the generalizability of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic criteria for post-traumatic stress disorder (PTSD) to various subpopulations. Besides identifying the differential symptom functioning (also referred to as differential item functioning [DIF]) related to various background variables such as gender, marital status and educational level, this study emphasizes the importance of evaluating the impact of DIF on population inferences as made in health surveys and clinical trials, and on the diagnosis of individual patients. Using a sample from the National Comorbidity Study-Replication (NCS-R), four symptoms for gender, one symptom for marital status, and three symptoms for educational level were significantly flagged as DIF, but their impact on diagnosis was fairly small. We conclude that the DSM-IV diagnostic criteria for PTSD do not produce substantially biased results in the investigated subpopulations, and there should be few reservations regarding their use. Further, although the impact of DIF (i.e. the influence of differential symptom functioning on diagnostic results) was found to be quite small in the current study, we recommend that diagnosticians always perform a DIF analysis of various subpopulations using the methodology presented here to ensure the diagnostic criteria is valid in their own studies.",0,0 +6783,Long-Term Trajectories and Service Needs for Military Families,"The deployment of US military personnel to recent conflicts has been a significant stressor for their families; yet, we know relatively little about the long-term family effects of these deployments. Using data from prior military service eras, we review our current understanding of the long-term functioning and needs of military families. These data suggest that overseas deployment, exposure to combat, experiencing or participating in violence during war deployment, service member injury or disability, and combat-related post-traumatic stress disorder (PTSD) all have profound impacts on the functioning of military families. We offer several recommendations to address these impacts such as the provision of family-centered, trauma-informed resources to families of veterans with PTSD and veterans who experienced high levels of combat and war violence. Recent efforts to address the needs of caregivers of veterans should be evaluated and expanded, as necessary. We should also help military families plan for predictable life events likely to challenge their resilience and coping capacities. Future research should focus on the following: factors that mediate the relationship between PTSD, war atrocities, caregiver burden, and family dysfunction; effective family-centered interventions that can be scaled-up to meet the needs of a dispersed population; and system-level innovations necessary to ensure adequate access to these interventions. © 2013 Springer Science+Business Media New York.",0,0 +6784,Posttraumatic stress symptom severity and inflammatory processes in midlife women.,"This cross-sectional study examined associations between current (last 30 days) and past (worst lifetime episode) posttraumatic stress (PTS) symptom severity and two markers of inflammation - circulating C-reactive protein and interleukin-6 (IL-6) - along with in vitro IL-6 production by stimulated peripheral blood mononuclear cells. Healthy, midlife women attended two research visits where a blood draw was followed by either benign questionnaires (visit 1, baseline), or questionnaires and an interview to assess traumatic events and PTS symptoms (visit 2, trauma assessment). All women, but one, were negative for current syndromal posttraumatic stress disorder (PTSD); 13 women (20%) met criteria for past syndromal PTSD. There were no statistically significant associations between current PTS symptoms and biological measures. In contrast, there was a statistically significant past PTS symptom severity × Visit interaction for circulating IL-6 levels. At visit 1 only (baseline), past symptom severity was significantly, negatively associated with IL-6 levels. Further, when past symptom severity reached syndromal levels, IL-6 levels were significantly higher at visit 2 (trauma assessment) than visit 1 (baseline). These results contribute to an emerging literature showing that PTSD and its symptoms are not always associated with a proinflammatory profile. They also raise the possibility that, in the context of severe past PTS symptoms, circulating IL-6 levels may be sensitive to confronting trauma reminders. © 2012 American Psychological Association.",0,0 +6785,Does Acute Stress Disorder Predict Posttraumatic Stress Disorder Following Bank Robbery?,"Unfortunately, the number of bank robberies is increasing and little is known about the subsequent risk of posttraumatic stress disorder (PTSD). Several studies have investigated the prediction of PTSD through the presence of acute stress disorder (ASD). However, there have only been a few studies following nonsexual assault. The present study investigated the predictive power of different aspects of the ASD diagnosis and symptom severity on PTSD prevalence and symptom severity in 132 bank employees. The PTSD diagnosis, based on the three core symptom clusters, was best identified using cutoff scores on the Acute Stress Disorder scale. ASD severity accounted for 40% and the inclusion of other risk factors accounted for 50% of the PTSD severity variance. In conclusion, results indicated that ASD appears to predict PTSD differently following nonsexual assault than other trauma types. ASD severity was a stronger predictor of PTSD than ASD diagnosis.",0,0 +6786,Children in Poverty: Resilience Despite Risk,"Two objectives provided the focus for the Conference on Community Violence and Children's Development that was jointly sponsored by the National Institute of Mental Health and the John D. and Catherine T. MacArthur Foundation. One was to examine the evidence for deficit behaviors that characterized children reared in poverty; the second was to identify the characteristics of children who sustained their competencies despite being reared in comparable environments. These dual objectives took this form: ""What can we conclude from studies of children, their families, and environments about characteristics that predispose children to maladjustment following exposure to violence, and about characteristics that protect children from such adjustment problems following, or in the midst of, violence exposure?""",0,0 +6787,Posttraumatic stress disorder symptoms in cancer: psychometric analysis of the Spanish Posttraumatic Stress Disorder Checklist-Civilian version,"The PTSD Checklist-Civilian version (PCL-C) was used as a screening tool to assess the presence of PTSD symptoms. The aim of this study was to explore the factorial structure of the Spanish version of the PCL-C and calculate the correlation of PTSD symptoms with distress and health-related quality of life.The sample included 494 cancer outpatients. In order to validate the PCL-C, a principal component analysis was applied. The association between variable was measured by Pearson correlation.Findings evidenced three symptoms clusters on the PCL-C version, defined as Hyperarousal/Re-experiencing, Numbing and Avoidance. About 10% of the total sample met clinical PTSD symptoms. In addition, PTSD symptoms were related negatively to health-related quality of life and positively related with distress.The conceptualization of PTSD symptoms for cancer patients is supported by the specific symptom clusters identified on PCL-C.",0,0 +6788,Understanding the pattern of PTSD symptomatology: a comparison of between versus within-group approaches,"This report examines the influence of statistical approach on patterns of Posttraumatic Stress Disorder (PTSD). In this report, 114 women and 51 men were assessed using both the Clinician Administered PTSD Scale (CAPS) and the Posttraumatic Symptom Scale-Self Report measure (PSS-SR). Data were examined using both a between-group and a within-group design. In the between-group approach, three subsamples were formed, representing full syndrome PTSD (fPTSD), partial PTSD (pPTSD), and no PTSD. The fPTSD and pPTSD groups differed on total scores on both PTSD measures, although differences were noted between clinician and self-report measures in specific symptom clusters. In the within-group approach, curve estimation techniques were used to examine linear versus quadratic fit of the data, utilizing the sample as a whole, ranked according to a separate scale of clinical severity. A linear approach was noted for each measure. Results are discussed in light of current design choices in the literature and its impact on the understanding of post-trauma problems.",0,0 +6789,What explains post-traumatic stress disorder (PTSD) in UK service personnel: deployment or something else?,"Background In previous studies an association between deployment to Iraq or Afghanistan and an overall increased risk for post-traumatic stress disorder (PTSD) in UK armed forces has not been found. The lack of a deployment effect might be explained by including, in the comparison group, personnel deployed on other operations or who have experienced traumatic stressors unrelated to deployment. Methods The sample comprised 8261 regular UK armed forces personnel who deployed to Iraq, Afghanistan or other operational areas or were not deployed. Participants completed the PTSD CheckList – Civilian Version (PCL-C) and provided information about deployment history, demographic and service factors, serious accidents and childhood experiences. Results Deployment to Iraq or Afghanistan [odds ratio (OR) 1.2, 95% confidence interval (CI) 0.6–2.2] or elsewhere (OR 1.1, 95% CI 0.6–2.0) was unrelated to PTSD although holding a combat role was associated with PTSD if deployed to Iraq or Afghanistan (OR 2.7, 95% CI 1.9–3.9). Childhood adversity (OR 3.3, 95% CI 2.1–5.0), having left service (OR 2.7, 95% CI 1.9–4.0) and serious accident (OR 2.1, 95% CI 1.4–3.0) were associated with PTSD whereas higher rank was protective (OR 0.3, 95% CI 0.12–0.76). Conclusions For the majority of UK armed forces personnel, deployment whether to Iraq, Afghanistan or elsewhere confers no greater risk for PTSD than service in the armed forces per se but holding a combat role in those deployed to Iraq or Afghanistan is associated with PTSD. Vulnerability factors such as lower rank, childhood adversity and leaving service, and having had a serious accident, may be at least as important as holding a combat role in predicting PTSD in UK armed forces personnel.",0,0 +6790,Cyclic adenosine monophosphate responsive element binding protein in post-traumatic stress disorder,"The cyclic adenosine monophosphate responsive element binding (CREB) protein is a transcription factor involved in different neural processes, such as learning, neuroplasticity and the modulation of stress response. Alterations in the CREB pathway have been observed in the brains and lymphocytes of patients affected by depression and alcohol abuse. Given the lack of information, our study aimed at investigating the levels of total and activated CREB protein in lympho-monocytes of 20 drug-free patients suffering from post-traumatic stress disorders (PTSD), as compared with 20 healthy control subjects.Blood samples were collected from patients and healthy control subjects on the same time and lympho-monocytes were isolated according to standardized methods. CREB protein levels and activation were measured by means of immunoenzymatic techniques.The results showed that PTSD patients had statistically lower levels of total CREB protein in lympho-monocytes than healthy control subjects. On the contrary, no difference in the activated CREB protein was detected.These findings, albeit preliminary, would suggest that the CREB pathway might be involved in the pathophysiology of PTSD. Future studies should clarify if specific PTSD symptom clusters might be related to the CREB pathway.",0,0 +6791,Prospective investigation of the impact of cannabis use disorders on posttraumatic stress disorder symptoms among veterans in residential treatment.,"This investigation sought to provide the first prospective examination of the association between the presence of a current cannabis use disorder (CUD) diagnosis and changes in posttraumatic stress disorder (PTSD) symptoms over time after discontinuation, after accounting for the theoretically relevant effects of age, trauma severity, psychological distress, and co-occurring substance use disorders. The study was longitudinal and assessed clinical patients at two time points: residential PTSD treatment intake and discharge. The sample consisted of 260 male combat-exposed military veteran patients (Mage-52.57 years, SD-5.47) admitted to a Veterans Affairs residential rehabilitation program for PTSD between 2000 and 2008. Diagnoses were obtained using the Structured Clinical Interview for DSM-IV, and PTSD outcomes were determined by the PTSD Checklist-Military Version. Results indicate that the presence of a CUD diagnosis was significantly predictive of lower levels of change (between treatment intake and discharge) in PTSD symptom severity as well as PTSD avoidance-numbing and hyperarousal symptom cluster severity (all ps-.05). This study presents the first evidence of a prospective relation between problematic cannabis use and PTSD symptoms, indicating that individuals with a CUD are likely to experience lower levels of change in PTSD symptoms over time, within the context of discontinuation owing to residential PTSD treatment. © 2011 American Psychological Association.",0,0 +6792,Loving-Kindness in the Treatment of Traumatized Refugees and Minority Groups: A Typology of Mindfulness and the Nodal Network Model of Affect and Affect Regulation,"This article discusses how loving-kindness can be used to treat traumatized refugees and minority groups, focusing on examples from our treatment, culturally adapted cognitive-behavioral therapy (CA-CBT). To show how we integrate loving-kindness with other mindfulness interventions and why loving-kindness should be an effective therapeutic technique, we present a typology of mindfulness states and the Nodal Network Model (NNM) of Affect and Affect Regulation. We argue that mindfulness techniques such as loving-kindness are therapeutic for refugees and minority populations because of their potential for increasing emotional flexibility, decreasing rumination, serving as emotional regulation techniques, and forming part of a new adaptive processing mode centered on psychological flexibility. We present a case to illustrate the clinical use of loving-kindness within the context of CA-CBT.",0,0 +6793,"Anxiety disorders and major depression, together or apart","This paper will discuss the relationship between anxiety and depression. We will begin with a brief historical perspective. We will then move into the twentieth century, with a focus on the 1950s, at which time the introduction of pharmacological treatment options revolutionized the field of psychiatry. The use of psychiatric medications and the observation of treatment response provided an additional means of understanding the relationship between anxiety and depression. From the late 1970s to the 1990s, it became apparent that various medications possessed wider therapeutic profiles than were previously recognized. For example, many medications were found to be efficacious in both anxiety and depressive disorders. These expanded therapeutic profiles provided additional clues to fuel our thinking about the relationship between anxiety and depression. The two major objectives of this paper are, first, to describe and formalize a process of pharmacological dissection and, second, to consider how this process might contribute to our search for a better understanding of the relationship between anxiety and depression.",0,0 +6794,Posttraumatic Stress Symptoms in Children of Mothers Diagnosed with Breast Cancer,"There are inconsistent findings regarding whether a mother's diagnosis of cancer affects her child's psychological health. The aim of this study was to compare maternally perceived symptoms of posttraumatic stress disorder (PTSD) in children of women with and without breast cancer. Forty mothers with breast cancer (assessed within 8 weeks of diagnosis) and 39 mothers without breast cancer were administered the Child Behavior Checklist (CBCL/6-18), UCLA Post Traumatic Stress Disorder (PTSD) Index, and Patient Health Questionnaire (PHQ-9). Descriptive discriminant analysis revealed that mothers with cancer perceived their children to have significantly greater symptoms of PTSD and internalizing distress than the mothers without cancer. No significant difference was found in maternal perception of externalizing symptoms in their children. Results revealed the importance of the assessment of PTSD in children whose mothers have cancer and the discussion includes implications for future research and clinical interventions.",0,0 +6795,Allostasis: The emperor of all (trauma‐related) maladies.,"The construct of allostasis is defined as change in the functioning of biological systems as a result of prolonged exposure to stress. In this article, the construct of bio-behavioral allostasis is proposed to describe peri-traumatic, shorter-term, and chronic changes in neurobiological systems and behaviors that account for the development and long-term maintenance of posttraumatic stress disorder (PTSD) symptoms and associated clinical features. The conceptual framework of bio-behavioral allostasis is applied to generate hypotheses about how premorbid vulnerabilities in different neurobiological systems interact with allostasis to predict heterogeneity in PTSD clinical profiles and patterns of comorbidity likely to develop after trauma exposure. The model offers a means by which to integrate independent theories of PTSD etiology to more fully account for unique features of PTSD, thereby improving its diagnostic discriminant validity. It also enables the identification of symptoms common across disorders that develop during exposure to adverse environments. Conceptualizing PTSD as a process of dynamic allostasis can advance our understanding of trauma-related diagnostic syndromes and inform the development of comprehensive treatments.",0,0 +6796,"Posttraumatic Stress, Problem Drinking, and Functional Outcomes After Injury","Patients undergoing trauma surgery for injury who have subsequent posttraumatic stress disorder (PTSD) or problem drinking will demonstrate significant impairments in functional outcomes compared with patients without these disorders.Prospective cohort study.Level I academic trauma center.One hundred one randomly selected survivors of intentional and unintentional injuries were interviewed while hospitalized and again 1 year later. The investigation achieved a 73% 1-year follow-up rate.Posttraumatic stress disorder was assessed with the Post-traumatic Stress Disorder Checklist and problem drinking was assessed with the Alcohol Use Disorder Identification Test. Functional status was assessed with the Medical Outcomes Study 36-Item Short-Form Health Survey.One year after injury, 30% of patients (n = 22) met symptomatic criteria for PTSD and 25% (n = 18) had Alcohol Use Disorder Identification Test scores indicative of problem drinking. Patients with PTSD demonstrated significant adverse outcomes in 7 of the 8 domains of the Medical Outcomes Study 36-Item Short-Form Health Survey compared with patients without PTSD. In multivariate models that adjusted for injury severity, chronic medical conditions, age, sex, preinjury physical function, and alcohol use, PTSD remained the strongest predictor of an adverse outcome. Patients with problem drinking did not demonstrate clinically or statistically significant functional impairment compared with patients without problem drinking.Posttraumatic stress disorder persisted in 30% of patients 1 year after traumatic injury and was independently associated with a broad profile of functional impairment. The development of treatment intervention protocols for trauma patients with PTSD is warranted.",0,0 +6797,An examination of the synergy of pain and PTSD on quality of life: Additive or multiplicative effects?,"Although models have been proposed to explain common factors that maintain comorbid pain and PTSD [Sharp TJ, Harvey AG. Chronic pain and posttraumatic stress disorder: mutual maintenance? Clin Psychol Rev 2001; 21: 857-77], the exact nature of the relationship between these two conditions and their impact on quality of life (QOL) is unknown. The aim of the present investigation was to examine the unique and interactive effects of PTSD and pain on role functioning and life satisfaction--two important domains of QOL. The study utilized a help-seeking sample of motor vehicle accident (MVA) survivors whose accidents resulted in symptoms of comorbid PTSD and pain (N=192). Hierarchical regression models were used to examine the relationship between four PTSD symptom clusters, pain, and the interaction of each cluster and pain on role functioning and life satisfaction separately. Results of these analyses revealed a significant interaction of pain and emotional numbing on role functioning, suggesting a multiplicative effect on this domain of QOL. Decomposition of this interaction revealed a negative association between numbing and functioning at low levels of pain but no relationship at higher levels. A marginal interaction of pain and hyperarousal also was noted for life satisfaction. Decomposition of the interaction effect revealed a marginal association between hyperarousal and decreased satisfaction only at high levels of pain. A main effect of emotional numbing on decreased life satisfaction also was observed in this model, suggesting a unique influence of numbing. The results of the current research indicate that the synergistic relationship of pain and PTSD may vary across domains of QOL.",0,0 +6798,Initial Patterns of Clinical Care and Recovery From Whiplash Injuries,"Little is known about the most effective pattern of clinical care for acute whiplash. We designed a cohort study to determine whether patterns of early clinical care (involving visits to general practitioners, chiropractors, or specialists) were associated with different rates of recovery.We studied 2486 Saskatchewan adults with whiplash injuries. We defined 8 initial patterns of care that integrated type of provider and number of visits. We used multivariable Cox models to estimate the association between patterns of care and time to recovery while controlling for injury severity and other confounders.There was an independent association between the type and intensity of initial clinical care and time to recovery. We found that patients in the low-utilization general practitioner group had the fastest recovery, even after controlling for injury severity and other confounders. Compared with this group, the high-utilization general practitioner group experienced a 1-year rate of recovery that was 27% slower (adjusted hazard rate ratio [HRR], 0.73; 95% confidence interval [CI], 0.61-0.87); for the high-utilization chiropractic group it was 39% slower (HRR, 0.61; 95% CI, 0.46-0.81); for the high-utilization general practitioner plus chiropractic combined group it was 28% slower (HRR, 0.72; 95% CI, 0.57-0.91); and for those who consulted general practitioners and specialists, it was 31% slower (HRR, 0.69; 95% CI, 0.55-0.87).The type and intensity of clinical care initiated within the first month after the injury is associated with the rate of recovery from whiplash injuries. Our study does not support the hypothesis that early aggressive care promotes faster recovery.",0,0 +6799,EPIDEMIOLOGIC RESEARCH ON INTERPERSONAL VIOLENCE AND COMMON PSYCHIATRIC DISORDERS: WHERE DO WE GO FROM HERE?,"BACKGROUND Interpersonal violence is one of the major causes of death and disability worldwide.[1] For every death, many more people are exposed to nonfatal violence: for example, in national, population-based surveys, estimates of violence exposure before age 18 range from 14.0% for family violence,[2,3] 49.6–53.1% for physical assault, 6.7–8% for sexual victimization, and 24.8–29.7% for community violence.[4] Several major studies and reviews have identified interpersonal violence as a leading contributor to common forms of psychopathology, including depression, anxiety, and substance abuse.[5–7] In the past 20 years, longitudinal studies on violence and psychopathology have proliferated.However, important methodological issues remain that may affect the validity of inferences that may be drawn from the existing data, including confounding by previolence psychiatric disorders, selection bias, limitations to causal inference inherent to observational studies, and a need to consider the evolution of violence exposures and violence across key life stages. As we consolidate current evidence and consider how to move forward in research on the mental health implications of violence, it is worthwhile to examine how these methodological issues affect interpretations of the current literature. In this review, we examine current research on the relationship between interpersonal violence and three of the most common psychiatric disorders: depression, anxiety, and substance abuse. We focus on these disorders due to the important public health burden they place on the population: according",0,0 +6800,Application of the stressor vulnerability model to understanding posttraumatic stress disorder (PTSD) and alcohol-related problems in an undergraduate population.,"Research examining the comorbidity of posttraumatic stress disorder (PTSD) and alcohol-use disorder (AUD) suggests that individuals experiencing PTSD symptoms (PTSS) often drink alcohol as a means to self-medicate their trauma symptoms; however, little attention has been given to moderating variables that may make this association more likely. The stressor vulnerability model proposes that being male, relying on maladaptive forms of coping, and holding positive alcohol-outcome expectancies predispose individuals to engage in alcohol use when experiencing psychological distress. In the current study, sex, avoidance coping (AVC), tension-reduction expectancies (TRE), and emotional-relief drinking-refusal self-efficacy (ERDRSE) were examined as moderators of the relationship between PTSS and alcohol-related problems in a sample of 144 undergraduates. Results indicated that males reporting high levels of TRE exhibited a stronger positive relationship between PTSS and alcohol-related problems than was present for males reporting low levels of TRE and for females reporting either high or low levels of TRE. In addition, a significant positive relationship between PTSS and alcohol-related problems was observed for individuals reporting high levels of TRE and low levels of ERDRSE, but not for individuals reporting high levels of TRE and high levels of ERDRSE, low TRE-low ERDRSE, or low TRE-high ERDRSE. Assessment of these vulnerability factors in traumatized youth and young adults may serve as a useful means of identifying individuals at risk for the development of alcohol-related problems.",0,0 +6801,Racial disparities in traumatic stress in prostate cancer patients: secondary analysis of a National URCC CCOP Study of 317 men,"IntroductionAfrican American men have the highest rates of prostate cancer of any racial group, but very little is known about the psychological functioning of African American men in response to prostate cancer diagnosis and treatment.PurposeIn this secondary analysis of a national trial testing a psychological intervention for prostate cancer patients, we report on the traumatic stress symptoms of African American and non-African American men.MethodsThis analysis includes 317 men (African American: n = 30, 9%; non-African American: n = 287, 91%) who were enrolled in the intervention trial, which included 12 weeks of group psychotherapy and 24 months of follow-up. Using mixed model analysis, total score on the Impact of Events Scale (IES) and its Intrusion and Avoidance subscales were examined to determine mean differences in traumatic stress across all time points (0, 3, 6, 12, 18, and 24 months). In an additional analysis, relevant psychosocial, demographic, and clinical variables were added to the model.ResultsResults showed significantly higher levels of traumatic stress for African American men compared to non-African American men in all models independently of the intervention arm, demographics, and relevant clinical variables. African Americans also had a consistently higher prevalence of clinically significant traumatic stress symptoms (defined as IES total score ≥27). These elevations remained across all time points over 24 months.ConclusionsThis is the first study to show a racial disparity in traumatic stress specifically as an aspect of overall psychological adjustment to prostate cancer. Recommendations are made for appropriate assessment, referral, and treatment of psychological distress in this vulnerable population.",0,0 +6802,Psychosocial and psychological factors associated with post-traumatic stress disorder following traumatic brain injury in adult civilian populations: A systematic review,"Increasing support exists for the development of post-traumatic stress disorder (PTSD) after traumatic brain injury (TBI). Despite the psychological nature of PTSD, previous reviews have mainly focused on the injury-related and neurological characteristics of its presentation in TBI. Consequently, this review systematically examined the psychological and psychosocial variables associated with PTSD symptoms after TBI in civilian adults.Detailed searching retrieved 28 relevant articles which met the inclusion criteria. Each article underwent a thorough quality assessment procedure and data were extracted relevant to the review's aims.Results highlighted several psychological and psychosocial variables associated with PTSD after TBI, including historical factors and those which become relevant after the traumatic event. Furthermore, the results indicated that some factors were not associated with PTSD after TBI, despite a relationship existing with PTSD in the general population. The findings of the quality assessment were utilized throughout the formation of results.The review highlights the importance of addressing psychological and psychosocial factors within the assessment and treatment of PTSD after TBI. The limitations of the research are highlighted and the clinical and research implications discussed.",0,0 +6803,Psychological trauma and evidence for enhanced vulnerability for posttraumatic stress disorder through previous trauma among West Nile refugees,"BackgroundPolitical instability and the civil war in Southern Sudan have resulted in numerous atrocities, mass violence, and forced migration for vast parts of the civilian population in the West Nile region. High exposure to traumatic experiences has been particularly prominent in the Ugandan and Sudanese of the West Nile Region, representing an indication of the psychological strain posed by years of armed conflict.MethodsIn this study the impact of traumatic events on the prevalence and severity of posttraumatic stress disorder (PTSD) in a random sample of 3.339 Ugandan nationals, Sudanese nationals, and Sudanese refugees (1.831 households) of the West Nile region is assessed.ResultsResults show a positive correlation between the number of traumatic events and the number of endorsed PTSD symptoms. Of the 58 respondents who experienced the greatest number of traumatizing experiences, all reported symptoms which met the DSM-IV criteria for PTSD.ConclusionsThere is a clear dose-effect relationship between traumatic exposure and PTSD in the studied populations with high levels of traumatic events. In this context, it is probable that any individual could develop PTSD regardless of other risk-factors once the trauma load reaches a certain threshold.",0,0 +6804,Interactive Effect of Stressful Life Events and the Serotonin Transporter 5-HTTLPR Genotype on Posttraumatic Stress Disorder Diagnosis in 2 Independent Populations,"The 5-HTTLPR polymorphism in the promoter region of the serotonin transporter gene (SLC6A4) has been found to moderate several categories of emotional response after stressful life events. Previous studies generally focused on its effect on depressive symptoms; little is known about its moderation of the development of posttraumatic stress disorder (PTSD).To examine the effects of childhood adversity, adult traumatic events, 5-HTTLPR genotypes, and gene x environment interactions on the etiology of PTSD.A cross-sectional study in which participants in several studies investigating the genetics of substance dependence were also screened for lifetime PTSD. The triallelic system of 5-HTTLPR was genotyped. Logistic regression modeling was used in the analyses.General community.Five hundred eighty-two European American and 670 African American individuals who reported experiences of childhood adversity, adult traumatic events, or both. Main Outcome Measure Diagnosis of PTSD, defined by DSM-IV diagnostic criteria and assessed through the Semi-Structured Assessment for Drug Dependence and Alcoholism interview.Childhood adversity and adult traumatic events both predicted PTSD. Although the 5-HTTLPR genotype alone did not predict the onset of PTSD, it interacted with adult traumatic events and childhood adversity to increase the risk for PTSD, especially for those with high rates of both types of trauma exposure (European American: odds ratio [OR], 2.86; 95% confidence interval [CI], 1.50-5.45; P = .002; African American: OR, 1.88; 95% CI, 1.04-3.40; P = .04; pooled: OR, 2.31; 95% CI, 1.50-3.56; P < .001).Participants who had both childhood adversity and adult traumatic events were more likely to develop lifetime PTSD compared with those who experienced either type of adverse event. The risk was increased in individuals with 1 or 2 copies of the S' (S) allele compared with the L' (L) homozygotes. Our study provides additional direct evidence that PTSD is influenced by the interactive effect of environmental and genetic factors.",0,0 +6805,Managing the psychiatric morbidity of disasters.,"Predicting the morbidity from disasters requires clear conceptual frameworks about the different categories of victims and also the manner in which the consequences emerge over the passage of time. Disasters by their nature are events that create confusion and challenge the ordinary structures within a society to manage the basic needs of that social group. A clear conceptual map is of considerable help in minimising the sense of chaos and restoring the provision of needs. There is now a sufficient body of data about the psychological impacts of disasters to begin to think about these events from a broad conceptual framework. In essence, these are events where an environmental stressor can be conceived of in a similar way to a physical environmental toxin that creates a risk in those with differing degrees of exposure. The management response can be informed by using public health models for minimising the consequences of exposure and ensuring broad based approaches are applied.",0,0 +6806,Posttraumatic Stress Symptom Trajectories Among Children Exposed to Violence,"Little research has examined the developmental course of posttraumatic stress symptoms (PTSS) in children. The current study aimed to identify developmental trajectories of PTSS in childhood and to examine predictors of symptom presentation in 1,178 children from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) studies, a consortium of studies focusing on the causes and effects of child maltreatment. Most children had a history of documented reports with Child Protective Services (CPS) and all were identified as living in high-risk environments. Using group-based trajectory modeling, 3 unique developmental trajectories were identified: Resilient, Clinical-Improving (PTSS in the clinical range at baseline then declining over time), and Borderline-Stable (chronically subclinical PTSS). Children in the Clinical-Improving group were more likely than children in the Resilient group to have reports of physical abuse (RRR = 1.76), emotional abuse (RRR = 2.55), neglect (RRR = 1.57), and exposure to violence at home and in the community (RRR = 1.04). Children in the Borderline-Stable group were more likely than children in the Resilient group to have a CPS history of neglect (RRR = 2.44) and exposure to violence at home and in the community (RRR = 1.04). Many children living in high-risk environments exhibit resilience to PTSS, but exposure to witnessed violence and neglect appear to put children at chronic risk for poor adjustment. These children may require more intensive, integrated clinical services that attend to multiple adverse experiences.",0,0 +6807,Trait Dissociation Predicts Posttraumatic Stress Disorder Symptoms in a Prospective Study of Urban Police Officers,"The current study prospectively examines the predictive relationship of trait dissociation, assessed during academy training, to PTSD symptoms assessed at 12 months of active police duty in relatively young and healthy police academy recruits (N = 180). The roles of pre-academy trauma exposure, exposure to life-threatening critical incidents during police duty, and peritraumatic dissociation at the time of the officer's worst critical incident were also examined. Utilizing path analytic techniques, greater trait dissociation, assessed during academy training, was predictive of both peritraumatic dissociation, and PTSD symptoms assessed at 12 months of police service. Moreover, after accounting for trait dissociation and peritraumatic dissociation, the relationship of previous trauma to later PTSD symptoms was no longer significant, demonstrating that the effect of previous trauma on later vulnerability to PTSD symptoms in this sample may be mediated by both trait and peritraumatic dissociation.",0,0 +6808,Psychological Models of Posttraumatic Stress Disorder and Acute Stress Disorder,"This chapter first reviews early learning theories of posttraumatic stress disorder (PTSD). This section highlights the role of classical and operant conditioning, as these forms of conditioning are the basis for many of the contemporary theories of PTSD and still shape a preponderance of thought on the nature of the disorder. Yet, as is pointed out, these conditioning models fail to account for some of the complexities seen in PTSD. The next section reviews alternative conceptualizations regarding new learning theory models, information-processing models, and emotional processing models, forming the basis for more contemporary thought. The chapter concludes with a brief discussion of challenges in the conceptualization of trauma exposure and PTSD symptoms.",0,0 +6809,PTSD: A Disorder of Recovery?,"INTRODUCTION: A VIEW OF THE ETIOLOGY OF PTSD Posttraumatic stress disorder is the better researched consequence of traumatic events. In its current formulation (APA, 1994) the disorder is essentially linked to the triggering event: It cannot be diagnosed in the absence of a traumatic event, and its core symptoms of reexperiencing and avoidance must refer to the traumatic event. This perspective implies a causal link between the event and subsequent PTSD. Such a link is also intuitively appealing and frequently appears in survivors' narratives. For an external observer as well, the association between a traumatic event and PTSD appears to have some truth to it because many survivors' lives are dramatically changed by an encounter with extreme adversity or evil. Thus, from both the survivor's perspective and that of involved observers, the traumatic event is the cause of PTSD. From a scientific point of view, however, this is only half true because many trauma survivors do not develop PTSD. A traumatic event, accordingly, is a necessary , but certainly not a sufficient cause of PTSD. If so, then what are the alternatives? The oldest alternative to simple causation refers to individual differences in vulnerability. Historically, this mainly concerned predisposing factors, an attribution that often carried value judgments. The latter could extend from assuming a personality defect in those who broke down under stress to more understandingly relegating the causality to the wear and tear of the central nervous system by adverse living circumstances (e.g., McEwen, 2000) or birth circumstances (e.g., Meaney et al., 1991; see also Bagot et al., this volume).",0,0 +6810,Outcome following inpatient trauma treatment: Differential response based on pre-treatment symptom severity.,"The purpose of the current study was to examine the extent to which clients of a Stage 1 inpatient program for adult survivors of childhood trauma experienced improvements in their trauma-related symptoms during and following treatment. In addition, the study aimed to enhance our understanding of who benefited by examining trajectories of symptom change, and the extent to which pretreatment symptom severity differentiated the trajectory groups. We used a waitlist comparison methodology and a 6-month follow-up period to examine treatment outcome. We analyzed the data using linear mixed models and latent class growth modeling. Results indicated that the treatment group experienced significantly greater reduction in their trauma-related symptoms than the waitlist group, and this reduction was largely maintained 6-months following discharge. Examinations of group change trajectories indicated that there were 3 groups with distinct change patterns. Analyses examining pretreatment symptom severity in relation to change trajectories indicated that clients with a range of severities of trauma-related symptoms benefited from the program. Clients for whom the program was less effective in reducing trauma-related symptoms were those with severe anxiety and arousal symptoms at admission. The results support the efficacy of inpatient trauma treatment programs for adult survivors of childhood maltreatment, and suggest that modifications during and following treatment may assist a subset of clients in achieving similar gains. © 2011 American Psychological Association.",0,0 +6811,Similarity of prior trauma exposure as a determinant of chronic stress responding to an airline disaster.,"The cumulative effects of trauma were examined in 108 workers at the site of a major air disaster at 4 time points over a year following the crash. The influence of trauma history on chronic distress and physiological arousal associated with the crash were examined. Stress levels were expected to differ on the basis of the similarity of prior trauma exposure to work at the crash site. Prior traumatic exposure that was ""dissimilar"" to this type of work was associated with greater vulnerability to crash-related stress, that is, more distress and crash-related intrusions during the year following the crash. Accumulation of a variety of different traumatic experiences appeared to sensitize workers to the new stressor and to perpetuate chronic stress. Understanding the role of trauma history is important for improving intervention efforts aimed at alleviating stress following a trauma.",0,0 +6812,Symptoms of posttraumatic stress in children after Hurricane Andrew: A prospective study.,"The authors examined symptoms of posttraumatic stress in 3rd-5th grade children during the school year after Hurricane Andrew. From a conceptual model of the effects of traumatic events, 442 children were evaluated 3, 7, and 10 months postdisaster with respect to (a) their exposure to traumatic events during and after the disaster, (b) their preexisting demographic characteristics, (c) the occurrence of major life stressors, (d) the availability of social support, and (e) the type of coping strategies used to cope with disaster-related distress. Although symptoms of posttraumatic stress disorder (PTSD) declined over time, a substantial level of symptomatology was observed up to 10 months after the disaster. All 5 factors in the conceptual model were predictive of children's PTSD symptoms 7 and 10 months postdisaster. Findings are discussed in terms of the potential utility of the model for organizing thinking about factors that predict the emergence and persistence of PTSD symptoms in children.",0,0 +6813,Concurrent Validity of the Defense and Veterans Pain Rating Scale in VA Outpatients,"The purpose of this report is to investigate the concurrent validity of the Defense and Veterans Pain Rating Scale (DVPRS) with other validated self-report measures in U.S. veterans.This correlational study was conducted using two samples of outpatients at the Washington, DC Veterans Affairs Medical Center who completed self-report measures relevant to pain conditions, including pain disability, quality of life, and mental health. Study 1 and 2 consisted of n = 204 and n = 13 participants, respectively.Bivariate Spearman correlations were calculated to examine the correlation among total scores and subscale scores for each scale of interest. Multiple linear regressions were also computed in Study 1.In Study 1, the DVPRS interference scale (DVPRS-II) was significantly correlated with the Pain Disability Questionnaire (PDQ) (ρ = 0.69, P < 0.001) and the Veterans RAND 36-item Health Survey physical and mental component scales (ρ = -0.37, P < 0.001; ρ = -0.46, P < 0.001, respectively). When controlling for sex, age, and other self-report measures, the relationship between the DVPRS-II and PDQ remained significant. In Study 2, pain interference on the DVPRS and Brief Pain Inventory were highly correlated (ρ = 0.90, P < 0.001); however, the intensity scale of each measure was also highly associated with the interference summary scores.These findings provide preliminary evidence for the concurrent validity of the DVPRS as a brief, multidimensional measure of pain interference that make it a practical tool for use in primary care settings to assess the impact of pain on daily functioning and monitor chronic pain over time.",0,0 +6814,"Personality patterns among Black, White, and Hispanic combat veterans.","Little is known about racial and ethnic differences in personality pathology in combat veterans. Thisinvestigation explored the relationship between race, ethnicity, and personality disorders (PDs) in asample of 96 combat veterans. Ethnoracial group status was based on self-identification, and the groupswere mutually exclusive. PDs were assessed with the MCMI-III , posttraumatic stress disorder (PTSD)was assessed with the Clinician Administered PTSD scale, and combat exposure was assessed with theCombat Exposure Scale. The findings suggest that Hispanic veterans were more likely to have cluster APDs compared to non-Hispanic veterans, even after controlling for demographics, level of combatexposure, and current PTSD. Implications of the results for the research and treatment of culturallydiverse individuals with PDs are discussed.Keywords: personality disorder, combat veteran, race, ethnicity",0,0 +6815,Post-Traumatic Stress Disorder in Children and Adolescents,The past decade has seen a significant increase in our understanding of the unique impact that trauma may have on the developmental trajectory of children and adolescents. We examine the recent clinical and research literature regarding risk factors for post-traumatic stress disorder (PTSD) in childhood and the various manifestations in which PTSD may present in childhood and adolescence. Case vignettes are presented to elucidate issues that often emerge in the diagnosis and treatment of PTSD in childhood and adolescence.,0,0 +6816,Typology of adults diagnosed with mental disorders based on socio-demographics and clinical and service use characteristics,"Mental disorder is a leading cause of morbidity worldwide. Its cost and negative impact on productivity are substantial. Consequently, improving mental health-care system efficiency - especially service utilisation - is a priority. Few studies have explored the use of services by specific subgroups of persons with mental disorder; a better understanding of these individuals is key to improving service planning. This study develops a typology of individuals, diagnosed with mental disorder in a 12-month period, based on their individual characteristics and use of services within a Canadian urban catchment area of 258,000 persons served by a psychiatric hospital.From among the 2,443 people who took part in the survey, 406 (17%) experienced at least one episode of mental disorder (as per the Composite International Diagnostic Interview (CIDI)) in the 12 months pre-interview. These individuals were selected for cluster analysis.Analysis yielded four user clusters: people who experienced mainly anxiety disorder; depressive disorder; alcohol and/or drug disorder; and multiple mental and dependence disorder. Two clusters were more closely associated with females and anxiety or depressive disorders. In the two other clusters, males were over-represented compared with the sample as a whole, namely, substance abuses with or without concomitant mental disorder. Clusters with the greatest number of mental disorders per subject used a greater number of mental health-care services. Conversely, clusters associated exclusively with dependence disorders used few services.The study found considerable heterogeneity among socio-demographic characteristics, number of disorders, and number of health-care services used by individuals with mental or dependence disorders. Cluster analysis revealed important differences in service use with regard to gender and age. It reinforces the relevance of developing targeted programs for subgroups of individuals with mental and/or dependence disorders. Strategies aimed at changing low service users' attitude (youths and males) or instituting specialised programs for that particular clientele should be promoted. Finally, as concomitant disorders are frequent among individuals with mental disorder, psychological services and/or addiction programs must be prioritised as components of integrated services when planning treatment.",0,0 +6817,Lay mental health in the aftermath of disaster: preliminary evaluation of an intervention for Haiti earthquake survivors.,"In the year following the 2010 Haiti earthquake, local earthquake survivors trained as lay mental health workers implemented a culturally-adapted, psychosocial and trauma-focused group intervention for residents of camps for internally displaced peoples (IDPs). Analysis of evaluation data collected at three Port-au-Prince IDP camps revealed decreased self-reported posttraumatic distress (measured using the Harvard Trauma Questionnaire) associated with participation in this intervention. Improvement occurred across all three PTSD symptom clusters (re-experiencing, avoidance, and hyperarousal). Female participants reported higher baseline distress, were more likely to participate in the intervention, and benefitted more than did men. Results provide initial support for the effectiveness of train-the-trainer interventions utilizing local lay disaster survivors.",0,0 +6818,Relationship between post-traumatic stress disorder and diabetes among 105 180 asylum seekers in the Netherlands,"Several reports have demonstrated a relationship between post-traumatic stress disorder (PTSD) and type 2 diabetes (T2DM) mainly in combat veterans. The relationship between PTSD and T2DM has not been evaluated among vulnerable migrant populations. The main objective of this study was therefore to assess the relationship between PTSD and T2DM among asylum seekers in the Netherlands.Analysis of a national electronic database of the Dutch Community Health Services for Asylum seekers aged≥18 years (N=105,180).Asylum seekers with PTSD had a higher prevalence of T2DM compared with those without PTSD. The age-adjusted prevalence ratios (APR) were 1.40 (95% CI, 1.12-1.76) in men and 1.22 (95% CI, 0.95-1.56) in women compared with individuals without PTSD, respectively. There was an interaction between PTSD and comorbid depression (P<0.05) in men and women, indicating that the effect of PTSD and comorbid depression on T2DM differed. When the analyses were stratified by depression status, among non-depressed group, individuals with PTSD had a higher prevalence of T2DM compared with those without PTSD [APR=1.47 (95% CI, 1.15-1.87) in men and APR=1.27 (95% CI, 0.97-1.66) in women]. Among the depressed individuals, however, there was no association between PTSD and T2DM [APR=0.87 (95% CI, 0.43-1.76) in men, and APR=1.00, (95% CI, 0.54-1.83) in women].The findings suggest that history of PTSD is related to high levels of T2DM among asylum seekers independent of comorbid depression. Clinicians and policy makers need to take PTSD into account when assessing and treating diabetes among vulnerable migrant populations.",0,0 +6819,Preliminary Psychometric Properties of the Acceptance and Action Questionnaire–II: A Revised Measure of Psychological Inflexibility and Experiential Avoidance,"The present research describes the development and psychometric evaluation of a second version of the Acceptance and Action Questionnaire (AAQ-II), which assesses the construct referred to as, variously, acceptance, experiential avoidance, and psychological inflexibility. Results from 2,816 participants across six samples indicate the satisfactory structure, reliability, and validity of this measure. For example, the mean alpha coefficient is .84 (.78–.88), and the 3- and 12-month test–retest reliability is .81 and .79, respectively. Results indicate that AAQ-II scores concurrently, longitudinally, and incrementally predict a range of outcomes, from mental health to work absence rates, that are consistent with its underlying theory. The AAQ-II also demonstrates appropriate discriminant validity. The AAQ-II appears to measure the same concept as the AAQ-I ( r = .97) but with better psychometric consistency.",0,0 +6820,Neurobiology of Post-Traumatic Stress Disorder,"Post-Traumatic Stress Disorder (PTSD) is a common and severe psychiatric disorder precipitated by exposure to a psychologically distressing event. PTSD is associated with significant morbidity and mortality and is characterized by the presence of three distinct, but co-occurring, symptom clusters. Research evidence suggests that PTSD has a neurobiological basis. Current research on the neurobiology of PTSD include the utilization of functional brain imaging molecular genetic research; the incorporation of cross-system research including neuroendocrine, neurochemical, and neuroimmunological systems. This book examines the neurobiological basis of PTSD and the future research goals in regards to these findings. © 2010 by Nova Science Publishers, Inc. All rights reserved.",0,0 +6821,SYMPTOMATIC AND FUNCTIONAL ASSESSMENT OF SOCIAL ANXIETY DISORDER IN ADULTS,"There are several old and new tools for assessment of generalized SAD but few for nongeneralized SAD. Scales are available in both self-rated and interviewer-rated formats. Self-rated scales vary in appearance in length and specificity for SAD and psychometric properties. The best-studied self-rated scales are the FQ, FNE, SAAD, SPAI, and SPIN. The FQ is an early scale, with a subscale of social phobia with reasonable psychometric properties and has withstood the test of time. The FNE and SAAD are based on cognitive models of SAD but lack assessment of physiologic arousal symptoms--an important symptom cluster of SAD. The SPIN is a relatively new scale and shows potential especially with its three-item screener for generalized SAD. The two interviewer-rated scales, the LSAS and BSPS, are both widely used and demonstrate sound psychometric properties. Either one can be regarded as a satisfactory scale in the assessment of symptom severity and treatment response. The BSPS also measures several physical symptoms common in SAD. There are fewer validated tools available for nongeneralized SAD. It is a prevalent condition that may account for 25% or more of patients with SAD. More research is required on the epidemiology, recognition, assessment, and treatment of nongeneralized SAD. Education of patients and clinicians, and the use of improved and briefer tools in these settings, may help SAD patients to obtain appropriate help and improve their functioning and productivity. Few tools are available that can reliably assess disability due to SAD, and more research in this area is important and required.",0,0 +6822,Pathways to youth homelessness,"Research documents high levels of psychopathology among homeless youth. Most research, however, has not distinguished between disorders that are present prior to homelessness and those that develop following homelessness. Hence whether psychological disorders are the cause or consequence of homelessness has not been established. The aim of this study is to investigate causal pathways to homelessness amongst currently homeless youth in Australia. The study uses a quasi-qualitative methodology to generate hypotheses for larger-scale research. High rates of psychological disorders were confirmed in the sample 35 homeless youth aged 14-25. The rates of psychological disorders at the point of homelessness were greater than in normative samples, but the rates of clinical disorder increased further once homeless. Further in-depth analyses were conducted to identify the temporal sequence for each individual with a view to establishing a set of causal pathways to homelessness and trajectories following homelessness that characterised the people in the sample. Five pathways to homelessness and five trajectories following homelessness were identified that accounted for the entire sample. Each pathway constituted a series of interactions between different factors similar to that described by Craig and Hodson (1998. Psychological Medicine, 28, 1379-1388) as ""complex subsidiary pathways"". The major findings were that (1) trauma is a common experience amongst homeless youth prior to homelessness and figured in the causal pathways to homelessness for over half of the sample; (2) once homeless, for the majority of youth there is an increase in the number of psychological diagnoses including drug and alcohol diagnoses; and (3) crime did not precede homelessness for all but one youth; however, following homelessness, involvement in criminal activity was common and became a distinguishing factor amongst youth. The implications of these findings for future research and service development are discussed.",0,0 +6823,Stress Detection for PTSD via the StartleMart Game,"Computer games have recently shown promise as a diagnostic and treatment tool for psychiatric rehabilitation. This paper examines the positive impact of affect detection and advanced game technology on the treatment of mental diagnoses such as Post Traumatic Stress Disorder (PTSD). For that purpose, we couple game design and game technology with stress detection for the automatic profiling and the personalized treatment of PTSD via game-based exposure therapy and stress inoculation training. The PTSD treatment game we designed forces the player to go through various stressful experiences while a stress detection mechanism profiles the severity and type of PTSD via skin conductance responses to those in-game stress elicitors. The initial study and analysis of 14 PTSD-diagnosed veteran soldiers presented in this paper reveals clear correspondence between diagnostic standard measures of PTSD severity and skin conductance responses. Significant correlations between physiological responses and subjective evaluations of the stressfulness of experiences, represented as pair wise preferences, are also found. We conclude that this supports the use of the simulation as a relevant treatment tool for stress inoculation training. This points to future avenues of research toward discerning between degrees and types of PTSD using game-based diagnostic and treatment tools.",0,0 +6824,"Complexity of Childhood Sexual Abuse: Predictors of Current Post-Traumatic Stress Disorder, Mood Disorders, Substance Use, and Sexual Risk Behavior Among Adult Men Who Have Sex with Men","Men who have sex with men (MSM) are the group most at risk for HIV and represent the majority of new infections in the United States. Rates of childhood sexual abuse (CSA) among MSM have been estimated as high as 46 %. CSA is associated with increased risk of HIV and greater likelihood of HIV sexual risk behavior. The purpose of this study was to identify the relationships between CSA complexity indicators and mental health, substance use, sexually transmitted infections, and HIV sexual risk among MSM. MSM with CSA histories (n = 162) who were screened for an HIV prevention efficacy trial completed comprehensive psychosocial assessments. Five indicators of complex CSA experiences were created: CSA by family member, CSA with penetration, CSA with physical injury, CSA with intense fear, and first CSA in adolescence. Adjusted regression models were used to identify relationships between CSA complexity and outcomes. Participants reporting CSA by family member were at 2.6 odds of current alcohol use disorder (OR 2.64: CI 1.24-5.63), two times higher odds of substance use disorder (OR 2.1: CI 1.02-2.36), and 2.7 times higher odds of reporting an STI in the past year (OR 2.7: CI 1.04-7.1). CSA with penetration was associated with increased likelihood of current PTSD (OR 3.17: CI 1.56-6.43), recent HIV sexual risk behavior (OR 2.7: CI 1.16-6.36), and a greater number of casual sexual partners (p = 0.02). Both CSA with Physical Injury (OR 4.05: CI 1.9-8.7) and CSA with Intense Fear (OR 5.16: CI 2.5-10.7) were related to increased odds for current PTSD. First CSA in adolescence was related to increased odds of major depressive disorder. These findings suggest that CSA, with one or more complexities, creates patterns of vulnerabilities for MSM, including post-traumatic stress disorder, substance use, and sexual risk taking, and suggests the need for detailed assessment of CSA and the development of integrated HIV prevention programs that address mental health and substance use comorbidities.",0,0 +6825,Project VALOR: design and methods of a longitudinal registry of post-traumatic stress disorder (PTSD) in combat-exposed Veterans in the Afghanistan and Iraqi military theaters of operations,"Few studies have investigated the natural history of post-traumatic stress disorder (PTSD). Project VALOR (Veterans' After-discharge Longitudinal Registry) was designed as a longitudinal patient registry assessing the course of combat-related PTSD among 1600 male and female Veterans who served in Operation Enduring Freedom (OEF) in Afghanistan or Operation Iraqi Freedom (OIF). Aims of the study include investigating patterns and predictors of progression or remission of PTSD and treatment utilization. The study design was based on recommendations from the Agency for Healthcare Quality and Research for longitudinal disease registries and used a pre-specified theoretical model to select the measurement domains for data collection and interpretation of forthcoming results. The registry will include 1200 male and female Veterans with a recent diagnosis of PTSD in the Department of Veteran Affairs (VA) electronic medical record and a comparison group of 400 Veterans without a medical record-based PTSD diagnosis, to also allow for case-control analyses. Data are collected from administrative databases, electronic medical records, a self-administered questionnaire, and a semi-structured diagnostic telephone interview. Project VALOR is a unique and timely registry study that will evaluate the clinical course of PTSD, psychosocial correlates, and health outcomes in a carefully selected cohort of returning OEF/OIF Veterans.",0,0 +6826,Legislative Change Is Associated With Improved Health Status in People With Whiplash,"Interrupted time series.To assess whether a change in legislation improved health status and quality of life for people with whiplash.Whiplash was the most prevalent injury in a compulsory, fault based, third party motor vehicle insurance scheme in New South Wales, Australia. Legislative change removed financial compensation for ""pain and suffering"" for whiplash, introduced clinical practice guidelines for its treatment; and changed regulations to permit earlier acceptance of compensation claims, and earlier access to treatment, for all types of injury.Three independent groups of people with whiplash were identified from insurance data (before legislative change--the 1999 group and, after legislative change--the 2001 and 2003 groups). Health status was assessed 2 years after injury by a telephone interviewer blinded to the study hypotheses. The main outcome measure was disability, as assessed by the Functional Rating Index (FRI). Pain and health-related quality of life was also assessed.The mean FRI at 2 years after injury was 38.0% (SE, 1.9) for the 1999 group, 31.8% (SE, 2.1) for the 2001 group, and 30.1% (SE, 1.8) for the 2003 group (F = 5.0, P = 0.007). Improvement in secondary outcomes, including pain, also occurred.Health status of people with whiplash improved after legislative change. Design of compensation schemes should be undertaken with the understanding that the scheme structure may have substantial effects on the long-term health of injured people.",0,0 +6827,Measurement invariance of posttraumatic stress disorder symptoms among U.S. military personnel,"Studies have not examined the factor structure or measurement invariance of posttraumatic stress disorder (PTSD) symptomatology using population-based data. Confirmatory factor analysis of the PTSD Checklist-Civilian Version (PCL-C) was conducted in a representative sample of U.S. active duty military personnel (N = 15,593). Consistent with prior research, a 4-factor model consisting of reexperiencing, avoidance, emotional numbing, and arousal factors was superior to four alternative models. Measurement invariance was found for factor loadings, but not observed item intercepts when comparing personnel with and without a recent deployment (≤12 months). Findings indicate differences in the level of observed responses across deployment subgroups that exceed what would be expected for individuals with similar PCL latent factors scores. Implications of results are discussed.",0,0 +6828,The Relationship Between Course of PTSD Symptoms in Deployed U.S. Marines and Degree of Combat Exposure,"Large cohort studies suggest that most military personnel experience minimal posttraumatic stress disorder (PTSD) symptoms following warzone deployment, an outcome often labeled resilience. Very low symptom levels, however, may be a marker for low exposure, not resilience, which requires relatively high-magnitude or high-frequency stress exposure as a precondition. We used growth mixture modeling (GMM) to examine the longitudinal course of lifetime PTSD symptoms following combat exposure by disaggregating deployed U.S. Marines into upper, middle, and lower tertiles of combat exposure. All factor models fit the data well; Tucker-Lewis Index (TLI) and comparative fit index (CFI) values ranged from .91 to .97. Three distinct trajectories best explained the data within each tertile. The upper tertile comprised True Resilience (73.2%), New-Onset Symptoms (18.3%), and Pre-existing Symptoms (8.5%) trajectories. The middle tertile also comprised True Resilience (74.5%), New-Onset Symptoms (16.1%), and Pre-existing Symptoms (9.4%) trajectories. The lower tertile comprised Artifactual Resilience (86.3%), Pre-existing Symptoms (7.6%), and New-Onset Symptoms (6.1%) trajectories. True Resilience involved a clinically significant symptom increase followed by a return to baseline, whereas Artifactual Resilience involved consistently low symptoms. Conflating artifactual and true resilience may inaccurately create the expectation of persistently low symptoms regardless of warzone exposure.",1,0 +6829,Application of model-selection criteria to some problems in multivariate analysis,"A review of model-selection criteria is presented, with a view toward showing their similarities. It is suggested that some problems treated by sequences of hypothesis tests may be more expeditiously treated by the application of model-selection criteria. Consideration is given to application of model-selection criteria to some problems of multivariate analysis, especially the clustering of variables, factor analysis and, more generally, describing a complex of variables.",0,0 +6830,An integrated model of risk and protective factors for post-deployment PTSD symptoms in OEF/OIF era combat veterans,"Few attempts have been made to integrate the known risk factors for combat-related posttraumatic stress disorder (PTSD) into a comprehensive model. This study investigated relative contributions of combat experiences, post-battle experiences, and perceptions of threat to post-deployment PTSD symptoms, and also examined whether pre-deployment preparedness moderated associations among these variables.Two hundred seven troops deployed to the Middle East between 2001 and 2008 completed self-report measures. Data were analyzed using path analysis and regressions. A comprehensive model including additive effects, mediation, and moderation was examined.Perceptions of threat mediated the association of combat experiences with PTSD, but not that of post-battle experiences with PTSD. Sense of preparedness for deployment moderated the association of combat experiences with perceived threat, such that troops with low preparedness perceived high levels of threat regardless of combat exposure, whereas troops with high preparedness perceived levels of threat that were correlated with levels of combat.Data were cross-sectional, all assessment was retrospective self-report, and the sample was primarily White, male, and married.Combat and post-battle experiences appear linked to PTSD via separate pathways. Thus, PTSD prevention efforts may need to vary based on types of events experienced. Pre-deployment preparation mitigated perceived threat in the context of low combat exposure, but it did not moderate direct associations of risk factors with PTSD symptoms. Thus, pre-deployment training and preparation do not appear sufficient to protect against PTSD.",0,0 +6831,First steps towards the validation of the relations to others french scale (ERA: Echelle de relations avec les autres),"The aim of the paper is to describe the process of constructing and validating a new scale (called ERA) assessing relations to others. The ERA scale is designed to be all at once time-saving (only 16 items) and widely informative (covering 4 major domains of relations to others: Openness to others - relational distance - personal and relational insight - pleasure through and within the relationship), and can be administered to clinical and non clinical populations. The ERA scale has a good internal coherence, a good external validity, an excellent discriminant validity and a good test-retest reliability. The study of sensitivity to change is still in progress.",0,0 +6832,The Classification of Anxiety Disorders in ICD-10 and DSM-IV: A Concordance Analysis,"On the surface, the classifications of anxiety disorders in DSM-IV and ICD-10 appear quite similar. However, differences exist and are evident in four aspects of the diagnostic criteria: typology, identifying criteria, inclusion and exclusion criteria. The current study uses data from the Australian National Mental Health Survey to model the impact of these differences on the diagnosis of generalized anxiety disorder. The results show that the concordance between the current classifications would be improved with the removal of the criterion for uncontrollability from DSM-IV, a closer focus on the symptoms of hypervigilance and scanning as in DSM-IV and the removal of the clinical significance criterion from DSM-IV. Equivalency of the exclusion criteria between the two classification systems reduces the concordance, demonstrating that each classification systems is a set of <i>inter</i>dependent diagnoses, and to ultimately achieve concordance, all diagnoses must be considered together.",0,0 +6833,Empirical identification of Axis I and Axis II symptom subtypes of sex addiction using Latent Profile Analysis,"Sexual addiction is a disorder characterized by lack of control over sexual urges, pathological relationships and lack of intimacy, mood-altering experiences, and adverse consequences that tend to be disregarded by the person affected. Although not classified as a mental disorder in the Diagnostic Statistical Manual-IV-TR (DSM-IV-TR, APA, 2000) this distressful sexual manifestation is increasingly recognized as a clinical and public health problem. Previous studies suggest commonalities with addictive disorders and maladaptive personality traits. The purpose of the current study was to analyze personality configurations of individuals diagnosed as sex addicts and uncover specific subtypes or profiles associated to sexually addictive behaviors. The study used archival data from 222 individuals, mostly males, treated at a residential program for sex addiction. Latent Profile Analysis (LPA) was utilized to uncover latent classes by using scale scores from the Millon Clinical Multiaxial Inventory-III (MCMI-III) and the Personality Assessment Inventory (PAI). The statistical analyses identified four latent classes for Axis I and five classes for Axis II corresponding to homogeneous subgroups of participants, and determined class membership. Findings were followed up with multivariate and univariate analyses of variances and discriminant analysis to better understand qualitative and quantitative differences among groups. Results revealed significant relationships between class membership and symptoms of Axis I and Axis II disorders measured by other screening tests: the Sexual Addiction Screening Test-Revised (SAST- R), the Eating Disorder Inventory (EDI), Post Traumatic Stress Inventory (PTSI), and the Brief Symptom Inventory (BSI), as well as severity of sexually addictive behaviors, and specific types of behavioral manifestations of sexual addiction as measured by the Sexual Dependency Inventory (SDI-R). No relations were found with legal consequences of addictive behavior. Some implications for treatment of sexual addiction were also addressed. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +6834,"Cerebral dysfunction in type 1 diabetes: effects of insulin, vascular risk factors and blood-glucose levels","Type 1 diabetes can lead to several well-described complications such as retinopathy, nephropathy and peripheral neuropathy. Evidence is accumulating that it is also associated with gradually developing end-organ damage in the central nervous system. This relatively unknown complication can be referred to as ""diabetic encephalopathy"" and is characterised by electrophysiological and neuroradiological changes, such as delayed latencies of evoked potentials, modest cerebral atrophy and (periventricular) white matter lesions. Furthermore, individuals with type 1 diabetes may show performance deficits in a wide range of cognitive domains. The exact mechanisms underlying this diabetic encephalopathy are only partially known. Chronic metabolic and vascular changes appear to play an important role. Interestingly, the differences in the ""cognitive profile"" between type 1 and type 2 diabetes also suggest a critical role for disturbances of insulin action in the central nervous system.",0,0 +6835,PSYCHOLOGICAL RESILIENCE IN OLDER U.S. VETERANS: RESULTS FROM THE NATIONAL HEALTH AND RESILIENCE IN VETERANS STUDY,"Although a large body of empirical research has examined negative psychological outcomes in older veterans, relatively little is known about the prevalence and determinants of psychological resilience in this population.A nationally representative sample of 2,025 U.S. veterans aged 60 and older (mean = 71.0, standard deviation = 7.1, range = 60-96) completed a web-based survey as part of the National Health and Resilience in Veterans Study (NHRVS). Cluster analysis of measures of lifetime potentially traumatic events, and current PTSD, major depression, and generalized anxiety symptoms was used to classify psychological outcomes.A three-group solution best fit the data: Control (low number of lifetime traumas, low current psychological distress; 60.4%); Resilient (high number of lifetime traumas, low current psychological distress; 27.5%); and distressed (high number of lifetime traumas, high current psychological distress; 12.1%). Among older veterans with a high number of traumas, 69.5% were in the Resilient group. Compared to the Distressed group, the Resilient group was more likely to have college or higher level of education, and to be married or living with a partner. They also scored higher on measures of emotional stability, social connectedness (i.e., secure attachment style, social support), protective psychosocial characteristics (e.g., community integration, purpose in life), and positive perceptions of the military's effect on one's life; and lower on measures of physical health difficulties and psychiatric problems, and openness to experiences.Among older U.S. veterans who have endured a high number of traumas in their lifetimes, nearly 70% are psychologically resilient in later life. Prevention efforts targeted toward bolstering social connectedness, community integration, and purpose in life may help promote psychological resilience in older veterans who endured a significant number of traumas in their lives.",0,0 +6836,Influences of Comorbid Disorders on Personality Assessment Inventory Profiles in Women with Posttraumatic Stress Disorder,"The present study describes Personality Assessment Inventory (PAI) profiles for women with posttraumatic stress disorder (PTSD). Four groups of women were sampled: single Axis I diagnosis of PTSD; PTSD and major depressive disorder (MDD); PTSD, MDD, at least one other Axis I disorder; and controls with no Axis I disorder. Higher comorbidity rates were associated with higher mean profile elevations and broader range of endorsed symptoms. The group with the highest rate of comorbidity produced profiles most similar to previously published reports of patients with PTSD. This is in contrast to women with a single diagnosis of PTSD, who produced relative mean elevations only on subscales measuring distress caused by trauma and physiological symptoms of depression. Thus, published profiles may be more reflective of PTSD with comorbidity than a single diagnosis of PTSD.",0,0 +6837,Posttraumatic growth in Veterans of Operations Enduring Freedom and Iraqi Freedom,"A growing body of research has examined the prevalence and correlates of psychopathology, mild traumatic brain injury, and related problems in Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF-OIF). While these studies help characterize the deleterious effects of combat, no known study has examined factors that may enhance posttraumatic growth or positive changes experienced as a result of combat in this population. A total of 272 predominantly older Reservist/National Guard OEF-OIF Veterans completed an anonymous mail survey that assessed combat exposure, psychopathology, psychosocial functioning, social support, and posttraumatic growth. Seventy-two percent of the sample endorsed a significant degree of posttraumatic growth in at least one of the areas assessed, the most common of which were changing priorities about what is important in life (52.2%), being able to better appreciate each day (51.1%), and being better able to handle difficulties (48.5%). Hierarchical regression analysis revealed that younger age, greater posttraumatic stress disorder (PTSD) symptoms, and increased perceptions of unit member support and effort/perseverance were significantly associated with posttraumatic growth. Respondents with PTSD scored higher on an overall measure of posttraumatic growth and on items reflecting appreciation of life and personal strength. This study is limited by a relatively low survey return rate and employment of an abbreviated measure of posttraumatic growth. Results of this study suggest that interventions to bolster unit member support and to enhance perceptions of effort and perseverance may help promote posttraumatic growth in OEF-OIF Veterans.",0,0 +6838,Patterns of healthcare service utilisation following severe traumatic brain injury: An idiographic analysis of injury compensation claims data,"The rate and extent of recovery after severe traumatic brain injury (TBI) is heterogeneous making prediction of likely healthcare service utilisation (HSU) difficult. Patterns of HSU derived from nomothetic samples do not represent the diverse range of outcomes possible within this patient group. Group-based trajectory model is a semi-parametric statistical technique that seeks to identify clusters of individuals whose outcome (however measured) follows a similar pattern of change over time.To identify and characterise patterns of HSU in the 5-year period following severe TBI.Detailed healthcare treatment payments data in 316 adults with severe TBI (Glasgow Coma Scale score 3-8) from the transport accident compensation system in the state of Victoria, Australia was accessed for this analysis. A semi-parametric group-based trajectory analytical technique for longitudinal data was applied to monthly observation counts of HSU data to identify distinct clusters of participants' trajectories. Comparison between trajectory groups on demographic, injury, disability and compensation relevant outcomes was undertaken.Four distinct patterns (trajectories) of HSU were identified in the sample. The first trajectory group comprised 27% of participants and displayed a rapid decrease in HSU in the first year post-injury. The second group comprised 24% of participants and showed a sharp peak in HSU during the first 12 months post-injury followed by a decline over time. The third group comprised 32% of participants and showed a slight peak in HSU in the first few months post-injury and then a slow decline over time. The fourth group comprised 17% of participants and displayed a steady rise in HSU up to 30 months post-injury, followed by a gradual decline to a level consistent with that received in the first months post-injury. Significant differences were observed between groups on factors such as age, injury severity, and use of disability services.There is substantial variation in patterns of HSU following severe TBI. Idiographic analysis can provide rich information for describing and understanding the resources required to help people with TBI.",0,0 +6839,Efficacy of Stellate Ganglion Block in the Treatment of Anxiety Symptoms From Combat-Related Post-Traumatic Stress Disorder: A Case Series,Report the efficacious use of stellate ganglion blocks (SGBs) in treating the anxiety symptoms of four patients diagnosed with combat-related post-traumatic stress disorder (PTSD) and discuss possible mechanisms of action to explain these findings.Successful treatment of PTSD with SGB has been demonstrated and reported previously at Walter Reed Army Medical Center. An identical protocol was used at Tripler Army Medical Center to treat four service members diagnosed with combat-related PTSD.All patients reported received an SGB on the right side at the level of C6. The patient's PTSD symptoms were evaluated using the Post-traumatic Stress Disorder Checklist (PCL). This checklist was distributed one day before treatment and again the day following treatment. The patients were also given the PCL at subsequent follow-up visits to quantify sustained benefit.SGB showed acute benefit for the symptoms of PTSD by markedly reduced PCL scores after the procedure. Benefits were also sustained during close outpatient follow-up.Selective blockade of the right stellate ganglion at C6 is a minimally invasive procedure with an excellent safety profile that may provide sustained relief of PTSD symptoms. The procedure may also provide benefit for those who are resistant to psychotropic intervention.,0,0 +6840,Public Access Defibrillation: Psychological consequences in responders,"Adverse psychological reactions are relatively frequent in professional ambulance crews who attend traumatic events, yet appear unusual in lay persons who attempt resuscitation of victims of out of hospital cardiac arrest.To investigate the psychological profile of first responders to gain insight into possible factors that might protect them against such reactions.Qualitative study of first responders in a community scheme in Barry, South Wales. In depth semi-structured interviews with six subjects were analysed using Interpretive Phenomenological Analysis (IPA).The study identified a resilience phenomenon in first responders accounted for by certain enabling core beliefs about their role, their capacity, and about the meaning of negative and positive outcomes for themselves. A realistic appreciation of their own limitations, confidence in their ability to perform as trained and being able to handle positive and negative outcomes were prominent features. The ability to act with emotional detachment appears a further protective mechanism. This mindset, loosely described as 'a philosophy', protects against the development of adverse reactions to stress or from becoming unduly concerned about negative outcomes. The responders had altruistic motives for undertaking the role yet were capable of operating with a high degree of naturally occurring resilience to stress or undermining anxiety. It is the combination of being motivated by altruism coupled with an inherent resilience that appears to be the crucial protective mechanism.The group demonstrated an apparently innate resilience to the adverse psychological effects of responding with an AED in a PAD scheme. This enables them to operate optimally in stressful situations without experiencing the negative psychological consequences that might otherwise arise. This information may be used to raise awareness about the psychological requirements for the role and to assist screening or selection processes.",0,0 +6841,Event-based prospective memory among veterans: The role of posttraumatic stress disorder symptom severity in executing intentions,"Posttraumatic stress disorder (PTSD) has been linked with neuropsychological deficits in several areas, including attention, learning and memory, and cognitive inhibition. Although memory dysfunction is among the most commonly documented deficits associated with PTSD, our existing knowledge pertains only to retrospective memory. The current study investigated the relationship between PTSD symptom severity and event-based prospective memory (PM).Forty veterans completed a computerized event-based PM task, a self-report measure of PTSD, and measures of retrospective memory.Hierarchical regression analysis results revealed that PTSD symptom severity accounted for 16% of the variance in PM performance, F(3, 36) = 3.47, p < .05, after controlling for age and retrospective memory. Additionally, each of the three PTSD symptom clusters was related, to varying degrees, with PM performance.Results suggest that elevated PTSD symptoms may be associated with more difficulties completing tasks requiring PM. Further examination of PM in PTSD is warranted, especially in regard to its impact on everyday functioning.",0,0 +6842,Child Behavior Checklist Juvenile Bipolar Disorder (CBCL-JBD) and CBCL Posttraumatic Stress Problems (CBCL-PTSP) scales are measures of a single dysregulatory syndrome,"The Child Behavior Checklist Juvenile Bipolar Disorder (CBCL-JBD) profile and Posttraumatic Stress Problems (CBCL-PTSP) scale have been used to assess juvenile bipolar disorder (JBD) and posttraumatic stress disorder (PTSD), respectively. However, their validity is questionable according to previous research. Both measures are associated with severe psychopathology often encompassing multiple DSM-IV diagnoses. Further, children who score highly on one of these scales often have elevated scores on the other, independent of PTSD or JBD diagnoses. We hypothesized that the two scales may be indicators of a single syndrome related to dysregulated mood, attention, and behavior. We aimed to describe and identify the overlap between the CBCL-JBD profile and CBCL-PTSP scales.Two thousand and twenty-nine (2029) children from a nationally representative sample (1073 boys, 956 girls; mean age = 11.98; age range = 6-18) were rated on emotional and behavior problems by their parents using the CBCL. Comparative model testing via structural equation modeling was conducted to determine whether the CBCL-JBD profile and CBCL-PTSP scale are best described as measuring separate versus unitary constructs. Associations with suicidality and competency scores were also examined.The CBCL-JBD and CBCL-PTSP demonstrated a high degree of overlap (r = .89) at the latent variable level. The best fitting, most parsimonious model was one in which the CBCL-JBD and CBCL-PTSP items identified a single latent construct, which was associated with higher parental endorsement of child suicidal behavior, and lower functioning.The CBCL-JBD profile and CBCL-PTSP scale overlap to a remarkable degree, and may be best described as measures of a single syndrome. This syndrome appears to be related to severe psychopathology, but may not conform to traditional DSM-IV classification. These results contribute to the ongoing debate about the utility of the CBCL-JBD and CBCL-PTSP profiles, and offer promising methods of empirically based measurement of disordered self-regulation in youth.",0,0 +6843,DETERMINING THE COGNITIVE PORTS OF ENTRY AMONGST THE POST-TRAUMATIC STATES: TREATMENT IMPLICATIONS,"Post-traumatic stress disorder (PTSD) is one of a range of trauma responses and has claimed the most therapeutic attention, but other post-traumatic states are probably, collectively, as common and produce a comparable level of functional impairment. It is suggested that in accordance with the cognitive theory of emotional disorders (Alford & Beck, 1997) the post-traumatic states are distinguished by differing cognitive content. Further, it is suggested that PTSD clients have particular information processing biases and those with a chronic form of the condition have a cognitive profile similar to those with a personality disorder. The differing cognitive architecture amongst the post-traumatic states suggests different treatment focii (Scott & Stradling, 2001).",0,0 +6844,Intimate Relationship Distress and Combat-related Posttraumatic Stress Disorder,"Combat-related posttraumatic stress disorder (ptsd) has a significant deleterious effect on interpersonal relationships. Intimate partner relationships can play a crucial role in the mediation, amelioration, maintenance, or aggravation of combat-related ptsd. This chapter presents a case of relationship distress in a 28-year-old female spouse of an Operation Iraqi Freedom (OIF) combat veteran with ptsd. The spouse presents with impaired functioning in behavioral, cognitive, and affective domains specifically reactive to the unique symptom clusters of her husband s ptsd. She also reports associated psychosocial problems to include divorce, occupational difficulty, financial problems, caregiver burden, and mental health stigma. Treatment includes a thorough safety assessment, psychiatric evaluation, individual and couple-based cognitive behavioral psychotherapy, and referral to supportive services. Developing a greater understanding of the impact and complex interplay of combat-related ptsd on intimate relationships can be of great benefit to the mental health providers, the veterans, their intimate partners, and the family system. © Springer International Publishing Switzerland 2015.",0,0 +6845,Military-Related Posttraumatic Stress Disorder and Intimate Relationship Behaviors: A Developing Dyadic Relationship Model,"The protracted conflict in Iraq and Afghanistan and an all-volunteer military has resulted in multiple war zone deployments for many service members. While quick redeployment turnaround has left little time for readjustment for either the service member or family, dealing with the long-term sequelae of combat exposure often leaves families and intimate partners ill-prepared for years after deployments. Using a modified grounded theory approach, digitally recorded couple interviews of 23 couples were purposefully selected from a larger sample of 441 couples to better understand the impact of war zone deployment on the couple. The veteran sample was recruited from a randomly selected cohort of men in treatment for posttraumatic stress disorder (PTSD). Overall, it was found when veterans experiencing deployment-related PTSD reenter or start new intimate relationships they may bring with them a unique cluster of interrelated issues which include PTSD symptoms, physical impairment, high rates of alcohol and/or drug abuse, and psychological and physical aggression. These factors contributed to a dynamic of exacerbating conflict. How these couples approached relationship qualities of mutuality, balanced locus of control and weakness tolerance across six axes of caregiving, disability, responsibility, trauma, communication, and community impacted the couple's capacity to communicate and resolve conflict. This dyadic relationship model is used to help inform implications for clinical practice.",0,0 +6846,An epidemiological profile of cashiers holders carpal tunnel syndrome in a grocery store chain,"Occupational diseases are those acquired in the work. Statistics show an increase number of cases, victims like typists, telephone's operators, cashiers and many others with varied levels of involvement. It is composed of disorders affecting the upper limbs being recognized by the Ministry of Social Welfare. Among these diseases stands out for its high occurrence Carpal Tunnel Syndrome (CTS). It has been considered a disease of the century, because its incidence has increased in 40.8% of repetitive stress disorders, with prevalence in females, and predominant age ranging from 25 to 40 years. It is characterized by pain and paresthesia in the first four fingers and wrists, and arm pain, weakness, numbness in the territory of the median nerve, preserving or not the palmar sensation and numbness in the median sensory distribution. This study aims to assess functional capacity and severity of symptoms presented by cashiers diagnosed with CTS. It is a descriptive and quantitative in nature. The population consists of 13 grocery store cashiers of both sexes, with a workload of 42 hours. We will be used as an instrument called the Boston Carpal Tunnel Questionnaire. That purports to be an effective means of measuring the numbness and pain in hands and wrists. Exclusion criteria we consider the subjects who have other diseases associated with CTS. The collection is with the possibility of partial results to be entered in a spreadsheet in Microsoft Excel for data analysis and subsequent discussion and correlation with the current literature.",0,0 +6847,Association Between Exercise and Posttraumatic Stress Symptoms Among Trauma-Exposed Adults,"The present investigation examined associations between intensities of exercise involvement and posttraumatic stress (PTS) symptom cluster severity (reexperiencing, avoidance/numbing, and hyperarousal). The sample was comprised of 108 adults (54.6% women; M age = 23.9, SD = 10.22, range = 18–62), who endorsed exposure to a Diagnostic and Statistical Manual of Mental Disorders (Fourth edition, Text Revision) posttraumatic stress disorder Criterion A traumatic life event but did not meet criteria for any current Axis I psychopathology. After controlling for gender and lifetime number of trauma exposure types experienced, results indicated that vigorous-intensity exercise, but not light- or moderate-intensity exercise, was significantly inversely associated with hyperarousal symptom cluster severity. This study adds to the scarce, yet growing, body of exercise—PTS literature—by illuminating the inverse associations of vigorous-intensity exercise, specifically, and PTS hyperarousal symptom severity among trauma-exposed individuals.",0,0 +6848,Effects of initial resources on the development of strains during a stressful training situation: Some counterintuitive results,"Summary Resource theories of occupational stress argue that employees' personal and environmental resources protect them from too much distress or strain during stressful work experiences. We examined four resources (emotional stability, previous experience, low drain on pre-existing resources, and workgroup quality) available to soldiers at the beginning of a stressful 3-month training experience as predictors of the trajectories of their strains over that period of time. Based on conservation of resources theory and the job demands–resources model, we predicted that the trends of strains would be more favorable (would increase more slowly or decline more quickly) if participants started the training with greater resources. The resources, primarily emotional stability and lack of pre-existing resource drain, tended to be negatively related to strains, consistent with the idea that they can reduce strains. Significant interactions predicting trends were found predicting two of the three strains (post-traumatic stress symptoms and depression, but not reports of physical health). Contrary to expectations, however, the three resources that significantly predicted trends over time (emotional stability, previous experience, and low pre-existing resource drain) were associated with worsening rather than improving strains. Copyright © 2014 John Wiley & Sons, Ltd.",0,0 +6849,Psychosocial Outcomes in Informal Caregivers of the Critically Ill,"The objective of the review was to evaluate and synthesize the prevalence, risk factors, and trajectory of psychosocial morbidity in informal caregivers of critical care survivors.A systematic search of MEDLINE, PsychInfo, PubMed, CINAHL, Cochrane Library, Scopus, PILOTS, EMBASE, and Physiotherapy Evidence Database was undertaken between January and February 2014.Citations were screened independently by two reviewers for studies that investigated psychosocial outcomes (depression, anxiety, stress, posttraumatic stress disorder, burden, activity restriction, and health-related quality of life) for informal caregivers of critical care survivors (mechanically ventilated for 48 hr or more).Data on study outcomes were extracted into a standardized form and quality assessed by two independent reviewers using the Newcastle-Ottawa Scale, the Physiotherapy Evidence Database, and the National Health and Medical Research Council Hierarchy of Evidence guide. Preferred Reporting Items for Systematic Reviews guidelines were followed.Fourteen studies of 1,491 caregivers were included. Depressive symptoms were the most commonly reported outcome with a prevalence of 75.5% during critical care and 22.8-29% at 1-year follow-up. Risk factors for depressive symptoms in caregivers included female gender and younger age. The greatest period of risk for all outcomes was during the patient's critical care admission although psychological symptoms improved over time. The overall quality of the studies was low.Depressive symptoms were the most prevalent in informal caregivers of survivors of intensive care who were ventilated for more than 48 hours and persist at 1 year with a prevalence of 22.8-29.0%, which is comparable with caregivers of patients with dementia. Screening for caregiver risks could be performed during the ICU admission where intervention can be implemented and then evaluated. Further high-quality studies are needed to quantify anxiety, stress, caregiver burden, and posttraumatic stress disorder outcomes in informal caregivers of long-stay patients surviving ICU.",0,0 +6850,"Attachment Disruptions, IQ, and PTSD in African American Adolescents: A Traumatology Perspective","Attachment disruptions, other traumas, posttraumatic stress disorder (PTSD), and intelligence quotient (IQ) were measured in a sample of 181 African American adolescents. Path analysis was utilized to test the effects of different types of attachment disruptions on IQ and PTSD. Findings supported that mother and father abandonments and being in foster care are associated with decreased perceptual reasoning, processing speed, and working memory, and increased discrepancy between perceptual and verbal toward decreased perceptual reasoning. Such suppression and discrepancy contribute to poor academic achievement. Results validated the traumatology perspective on attachment disruptions as traumas that are associated with PTSD, suppression of most IQ potentials, and with potential brain hemispheric desynchronization. The ramifications of these results for helping African American adolescents are discussed.",0,0 +6851,Child development and family mental health in war and military violence: The Palestinian experience,"The article reviews developmental research among Palestinians living in Gaza. The aims are, first, to analyze how exposure to traumatic events associates with children's mental health and their cognitive, emotional and social development. Second, we aimed to model familial and symbolic processes that can either harm or protect the mental health of children. Third, we wanted to learn who the resilient children are in conditions of war and military violence. The reviewed research has been conducted in the context of a Palestinian non-governmental organization, the Gaza Community Mental Health Programme, during the political upheavals involving hopes for peace and intensive war and violence: the First Intifada (1987—1993), the Palestinian Authority rule (1994— ) and the Second Al Aqsa Intifada (2001— ). The results show that life threat, violence and losses form a risk for increased psychological distress. There are, however, a myriad of child, family and society related factors and psycho-socio-physiological processes that protect child development and mental health. They include, e.g. loving and wisely guiding parenting, children's flexible and high cognitive capacity, flexible and multiple coping strategies and narrative and symbolic nocturnal dreaming, as well as social support and good peer relations. Different models explain psychological distress and positive resources, including child resilience. Exposure to trauma is crucial in predicting distress, while familial and developmental issues are important in building resilience. Children's conscious and unconscious cognitive-emotional processes are crucial for underlying mental health and knowledge about them is important in tailoring evidence-based preventive interventions among war victims.",0,0 +6852,Prise en charge médicamenteuse de l’anxiété chez le patient souffrant de schizophrénie,"Anxiety is a major and frequent symptom of schizophrenia, which is associated with an increased risk of relapse, impaired functioning, lower quality of life and increased incidence of suicide attempts. Despite its clinical relevance, anxiety in schizophrenia remains poorly understood. In the prodromic phase, anxiety indicates a progression towards psychotic decompensation. After a first episode, it is an indicator of relapse.Two approaches have been used to investigate anxiety in schizophrenia: (i) categorical approach (comorbidity of schizophrenia and anxiety disorders) and (ii) dimensional approach (anxiety as a major symptom of the ""dysphoric"" dimension). Clinical categorical studies reported an increased frequency of comorbidity between schizophrenia and obsessive-compulsive disorder, panic disorder, social phobia, post-traumatic stress disorder, generalized anxiety disorder, agoraphobia, and specific phobia. The dimensional approach proposes that five different factors contribute to the structure of the Positive and Negative Syndrome Scale (PANSS), with anxiety as a major symptom of the ""dysphoria"" dimension. Concerning diagnosis, it is unclear whether psychotic and neurotic anxiety differs in nature or intensity. Nevertheless, both are frequently opposed.Psychotic anxiety is intense, profound and hermetic. In contrast to neurotic anxiety, it is associated with psychomotor disturbances, such as agitation and sideration. There is no specific tool to evaluate anxiety in schizophrenia. The dimensional approach usually runs an evaluation using items or factors extracted from the most widely-used scales, i.e. PANSS or Brief Psychiatric Rating Scale (BPRS) or from anxiety scales developed in non-schizophrenic populations, such as the Hamilton Anxiety Scale (HAMA). Recently, we developed a specific scale for hetero-evaluation (Échelle Anxiété Schizophrénie [EAS scale]). The EAS scale was recently validated and the study of its sensitivity is ongoing. THERAPEUTICAL ISSUES: Several studies have examined the effects of antipsychotics on the anxious/depressive cluster extracted from the PANSS, and some other studies have specifically evaluated the effect of antipsychotics on depressive symptoms using the Montgomery and Asberg Depression Rating Scale (MADRS) and Calgary Depression Scale for Schizophrenia (CDSS), but to our knowledge, no study has reported the effect of antipsychotics or other treatment on anxiety when using a schizophrenia-specific scale. There are no specific guideline treatments for anxiety in schizophrenia. Among phenothiazines, cyamemazine is frequently prescribed in France, because of its potent anxiolytic activity and good neurological tolerance. Some authors have suggested a specific treatment with benzodiazepines. However, benzodiazepines should be used with caution, due to undesirable actions such as dependence, rebound and potentiation of certain lateral effects.",0,0 +6853,Gulf War illness: a view from Australia,"Australia sent a small, mostly naval, deployment to the 1991 Gulf War. When papers and media concerns arose about unexplained Gulf War illnesses in Gulf War troops from other countries, Australia decided to undertake its own study of Australian veterans. Undertaking a later study, more than 10 years after the Gulf War, allowed us to incorporate some methodological improvements on previous research, such as the inclusion of a face-to-face health assessment where more objective health data could be collected in addition to using a postal questionnaire. Despite the different Gulf War experience for the mostly naval Australian group, there were remarkable consistencies in the patterns of multiple symptom reporting found in overseas studies, including the fact that no unique symptom clusters were identified. In general, this excess symptom reporting was not found to occur with excesses in more objective measures of physical health. These objective physical measures included a wide range of haematological, biochemical and serological markers, a physical examination, spirometry and a step test of fatigability. In contrast, several psychological disorders, including anxiety, post-traumatic stress disorder, depression and substance abuse, were found to occur in excess in the Australian Gulf War group and were associated with Gulf War psychological stressors. These findings have helped raise awareness in Australia of psychological health problems in deployed military personnel.",0,0 +6854,Latent profile analysis and comorbidity in a sample of individuals with compulsive buying disorder,"The aims of this study were to perform a latent profile analysis in a sample of individuals with compulsive buying, to explore the psychiatric comorbidity, and to examine whether or not more severe compulsive buying is associated with greater comorbidity. Compulsive buying measures and SCID data obtained from 171 patients with compulsive buying behavior who had participated in treatment trials at different clinical centers in the U.S. and Germany were analyzed. Latent profile analysis produced two clusters. Overall, cluster 2, included subjects with more severe compulsive buying, and was characterized by higher lifetime as well as current prevalence rates for Axis I and impulse control disorders. Nearly 90% of the total sample reported at least one lifetime Axis I diagnosis, particularly mood (74%) and anxiety (57%) disorders. Twenty-one percent had a comorbid impulse control disorder, most commonly intermittent explosive disorder (11%). Half of the sample presented with at least one current Axis I disorder, most commonly anxiety disorders (44%). Given the substantial psychiatric comorbidity, it is reasonable to question whether or not compulsive buying represents a distinct psychiatric entity vs. an epiphenomenon of other psychiatric disorders.",0,0 +6855,A Systematic Review of PTSD Prevalence and Trajectories in DSM-5 Defined Trauma Exposed Populations: Intentional and Non-Intentional Traumatic Events,"We conducted a systematic review of the literature to explore the longitudinal course of PTSD in DSM-5-defined trauma exposed populations to identify the course of illness and recovery for individuals and populations experiencing PTSD.We reviewed the published literature from January 1, 1998 to December 31, 2010 for longitudinal studies of directly exposed trauma populations in order to: (1) review rates of PTSD in the first year after a traumatic event; (2) examine potential types of proposed DSM-5 direct trauma exposure (intentional and non-intentional); and (3) identify the clinical course of PTSD (early onset, later onset, chronicity, remission, and resilience). Of the 2537 identified articles, 58 articles representing 35 unique subject populations met the proposed DSM-5 criteria for experiencing a traumatic event, and assessed PTSD at two or more time points within 12 months of the traumatic event.The mean prevalence of PTSD across all studies decreases from 28.8% (range =3.1-87.5%) at 1 month to 17.0% (range =0.6-43.8%) at 12 months. However, when traumatic events are classified into intentional and non-intentional, the median prevalences trend down for the non-intentional trauma exposed populations, while the median prevalences in the intentional trauma category steadily increase from 11.8% to 23.3%. Across five studies with sufficient data, 37.1% of those exposed to intentional trauma develop PTSD. Among those with PTSD, about one third (34.8%) remit after 3 months. Nearly 40% of those with PTSD (39.1%) have a chronic course, and only a very small fraction (3.5%) of new PTSD cases appears after three months.Understanding the trajectories of PTSD over time, and how it may vary by type of traumatic event (intentional vs. non-intentional) will assist public health planning and treatment.",0,0 +6856,Posttraumatic stress reactions after single and double trauma,"This study evaluated the severity and symptom profile of posttraumatic stress reactions of 202 adults exposed in 1988 to political violence in Azerbaijan and/or the earthquake in Armenia. High rates of severe posttraumatic stress reactions were found among the most highly exposed individuals, irrespective of the type of trauma. There was no difference in symptom profile for subjects exposed to earthquake versus violence. These similarities in severity and symptom profile may be attributable to common features of the exposures, which included experiencing life-threat and witnessing injury, multilation and death. Recent prior exposure to violence contributed to the severity of reaction to the earthquake. The high rates of chronic and severe posttraumatic stress reactions in Armenia constitute a major public mental health problem.",0,0 +6857,ASD and PTSD in Rape Victims,"In recent years, a number of studies have investigated the prediction of posttraumatic stress disorder (PTSD) through the presence of acute stress disorder (ASD). The predictive power of ASD on PTSD was examined in a population of 148 female rape victims who visited a center for rape victims shortly after the rape or attempted rape. The PTSD diagnosis based solely on the three core symptom clusters was best identified by a subclinical ASD diagnosis based on all ASD criteria except dissociation. However, a full PTSD diagnosis including the A 2 and F criteria was best identified by classifying victims according to a full ASD diagnosis. Regardless of whether cases were classified according to full PTSD status or according to meeting the criteria for the three PTSD core symptom clusters, the classification was correct only in approximately two thirds of the cases. A regression analysis based on ASD severity and sexual problems following the rape accounted for only 28% of the PTSD severity variance. In conclusion, the ASD diagnosis is not an optimal method for identifying those most at risk for PTSD. It remains to be seen whether a better way can be found.",0,0 +6858,A Comparison of the Acute Stress Reactions between the Han and Tibetan Ethnic Groups in Responding to Devastating Earthquakes,"Objective: The purpose of the present study was to investigate whether there were differences in the acute stress reaction (ASR) between the Tibetan and the Han ethnic groups after experiencing devastating earthquakes. Methods: One hundred twelve Han survivors of the Wenchuan earthquake and 112 Tibetan survivors of the Yushu earthquake were rated using the PTSD Checklist-Civilian (PCL-C) according to their trauma experiences, ages, genders, severity levels of injuries, and medical services received. Results: Injured Tibetans had lower scores across symptom clusters of avoidance, numbing, and the total score of PCL-C as compared to Hans. Among Tibetans, severe ASR was associated with a higher education level and earthquake experience, whereas only earthquake experience was associated with severe ASR among injured Hans. Conclusion: Cultural factors may play significant roles in the acute stress reaction of survivors with different cultural backgrounds following an earthquake.",0,0 +6859,Diagnosis and management of generalized anxiety disorder and panic disorder in adults.,"Generalized anxiety disorder (GAD) and panic disorder (PD) are among the most common mental disorders in the United States, and they can negatively impact a patient's quality of life and disrupt important activities of daily living. Evidence suggests that the rates of missed diagnoses and misdiagnosis of GAD and PD are high, with symptoms often ascribed to physical causes. Diagnosing GAD and PD requires a broad differential and caution to identify confounding variables and comorbid conditions. Screening and monitoring tools can be used to help make the diagnosis and monitor response to therapy. The GAD-7 and the Severity Measure for Panic Disorder are free diagnostic tools. Successful outcomes may require a combination of treatment modalities tailored to the individual patient. Treatment often includes medications such as selective serotonin reuptake inhibitors and/or psychotherapy, both of which are highly effective. Among psychotherapeutic treatments, cognitive behavior therapy has been studied widely and has an extensive evidence base. Benzodiazepines are effective in reducing anxiety symptoms, but their use is limited by risk of abuse and adverse effect profiles. Physical activity can reduce symptoms of GAD and PD. A number of complementary and alternative treatments are often used; however, evidence is limited for most. Several common botanicals and supplements can potentiate serotonin syndrome when used in combination with antidepressants. Medication should be continued for 12 months before tapering to prevent relapse.",0,0 +6860,The course of postraumatic stress in children: Examination of symptom trajectories following PICU admission,"Background and aims: Advances in modern medicine have increasingly improved survival rates of critically ill and injured children. Evidence suggests that there is a significant risk for posttraumatic stress symptoms (PTSS) for children following admission to the Paediatric Intensive Care (PICU), however few studies have explored individual recovery patterns, especially in children. Aims: This paper identifies patterns of PTSS in children aged from 1 year following PICU admission using group-based trajectory modelling. Methods: Following IRB approval, maternal reports of child distress from the acute stage and up to 2 years post-PICU admission (n = 272) were examined to: (1) assess the prevalence of distress in the child, (2) identify symptom trajectories, and (3) identify risk factors associated with poor child mental health outcomes following PICU admission. Results: Analysis identified three distinct symptom trajectories in the children. The majority were resilient (82%). A small group had very high symptoms in the acute phase but were below the clinical cut-off after 6 months (recovery 3%). A significant group of children had clinical level symptoms that did not appear to improve over time (chronic 15%). There was no evidence of delayed onset PTSS. Child age and gender do not predict trajectory patterns. Conclusions: There is growing evidence that significant distress in the peritrauma period is linked to continuing clinical level distress symptoms which have the potential to impact on child physical recovery and long term functioning. Research into early interventions for distressed children following critical illness is a matter of urgency.",0,0 +6861,Methodological issues and research recommendations for mild traumatic brain injury: the who collaborating centre task force on mild traumatic brain injury,"The WHO Collaborating Centre for Neurotrauma Task Force on Mild Traumatic Brain Injury performed a comprehensive search and critical review of the literature published between 1980 and 2002 to assemble the best evidence on the epidemiology, diagnosis, prognosis and treatment of mild traumatic brain injury. Of 743 relevant studies, 313 were accepted on scientific merit and comprise our best-evidence synthesis. The current literature on mild traumatic brain injury is of variable quality and we report the most common methodological flaws. We make recommendations for avoiding the shortcomings evident in much of the current literature and identify topic areas in urgent need of further research. This includes the need for large, well-designed studies to support evidence-based guidelines for emergency room triage of children with mild traumatic brain injury and to explore more fully the issue of prognosis after mild traumatic brain injury in the elderly population. We also advocate use of standard criteria for defining mild traumatic brain injury and propose a definition.",0,0 +6862,Longitudinal Determinants of Posttraumatic Stress in a Population-Based Cohort Study,"Posttraumatic stress disorder is a prevalent and disabling psychologic pathology. Longitudinal research on the predictors of posttraumatic stress symptomatology is limited.We recruited 2752 participants to a prospective, population-based cohort study by conducting a telephone survey of adult residents of the New York City metropolitan area in 2002; participants completed 3 follow-up interviews over a 30-month period. Censoring weights were estimated to account for potential bias. We used generalized estimating equation logistic regression models with bootstrapped confidence intervals to assess the predictors of posttraumatic stress over time in multivariable models.Predictors of posttraumatic stress over time included ongoing stressors (odds ratio [OR] = 1.91 per 1 unit increase in number of stressors, [95% confidence interval = 1.55-2.36]) and traumatic events (OR = 1.92 per 1 unit increase in number of traumatic events [CI = 1.71-2.22]), social support (compared with high levels, OR = 1.71 for medium [1.09-2.52]; OR = 1.57 for low [1.08-2.35]), low income (OR = 0.87 per $10,000 increase [0.81-0.92]), female sex (1.60 [1.11-2.23]), and Latino ethnicity (compared with white, OR = 1.74 [1.05-2.97]).These findings suggest that ongoing stressors play a central role in explaining the trajectory of posttraumatic stress over time, and that factors beyond the experience of stressors and traumas may account for sex and ethnic differences in posttraumatic stress risk. Interventions that focus on reducing ongoing adversity may help mitigate the consequences of traumatic events.",0,0 +6863,Trends of Probable Post-Traumatic Stress Disorder in New York City after the September 11 Terrorist Attacks,"The authors investigated trends in probable post-traumatic stress disorder (PTSD) prevalence in the general population of New York City in the first 6 months after the September 11 terrorist attacks. Three random digit dialing telephone surveys of adults in progressively larger portions of the New York City metropolitan area were conducted 1 month, 4 months, and 6 months after September 11, 2001. A total of 1,008, 2,001, and 2,752 demographically representative adults were recruited in the three surveys, respectively. The current prevalence of probable PTSD related to the September 11 attacks in Manhattan declined from 7.5% (95% confidence interval: 5.7, 9.3) 1 month after September 11 to 0.6% (95% confidence interval: 0.3, 0.9) 6 months after September 11. Although the prevalence of PTSD symptoms was consistently higher among persons who were more directly affected by the attacks, a substantial number of persons who were not directly affected by the attacks also met criteria for probable PTSD. These data suggest a rapid resolution of most of the probable PTSD symptoms in the general population of New York City in the first 6 months after the attacks. The psychological consequences of a large-scale disaster in a densely populated urban area may extend beyond persons directly affected by the disaster to persons in the general population.",0,0 +6864,"Post-traumatic stress disorder, depression, and anxiety among Gaza Strip adolescents in the wake of the second Uprising (Intifada)","Children and adolescents of the Gaza Strip have been subjected to continuous violence since the eruption of the second Intifada (Uprising). Little is known, however, about the psychological effects of this violence on children and adolescents of Gaza. Thus, the purpose of the present investigation was to evaluate and describe the psychological effects of exposure of war-like circumstances on this population.Participants for this study were 229 Palestinian adolescents living in the Gaza Strip who were administered measures of post-traumatic stress disorder (PTSD), depression, anxiety, and coping.Of the 229 participants, 68.9% were classified as having developed PTSD, 40.0% reported moderate or severe levels of depression, 94.9% were classified as having severe anxiety levels, and 69.9% demonstrated undesirable coping responses. A canonical discriminant analysis revealed that adolescents diagnosed with PTSD tended to be those who reported the highest levels of depression, anxiety, and positive reappraisal coping, and the lowest levels of seeking guidance and support coping.These results indicate that a significant proportion of Palestinian adolescents living in the Gaza Strip are experiencing serious psychological distress.",0,0 +6865,Emotional Reactivity to a Single Inhalation of 35% Carbon Dioxide and Its Association With Later Symptoms of Posttraumatic Stress Disorder and Anxiety in Soldiers Deployed to Iraq,"The identification of modifiable predeployment vulnerability factors that increase the risk of combat stress reactions among soldiers once deployed to a war zone offers significant potential for the prevention of posttraumatic stress disorder (PTSD) and other combat-related stress disorders. Adults with anxiety disorders display heightened emotional reactivity to a single inhalation of 35% carbon dioxide (CO(2)); however, data investigating prospective linkages between emotional reactivity to CO(2) and susceptibility to war-zone stress reactions are lacking.To investigate the association of soldiers' predeployment emotional reactivity to 35% CO(2) challenge with several indices of subsequent war-zone stress symptoms assessed monthly while deployed in Iraq.Prospective cohort study of 158 soldiers with no history of deployment to a war zone were recruited from the Texas Combat Stress Risk Study between April 2, 2007, and August 28, 2009.Multilevel regression models were used to investigate the association between emotional reactivity to 35% CO(2) challenge (assessed before deployment) and soldiers' reported symptoms of general anxiety/stress, PTSD, and depression while deployed to Iraq.Growth curves of PTSD, depression, and general anxiety/stress symptoms showed a significant curvilinear relationship during the 16-month deployment period. War-zone stressors reported in theater were associated with symptoms of general anxiety/stress, PTSD, and depression. Consistent with the prediction, soldiers' emotional reactivity to a single inhalation of 35% CO(2)-enriched air before deployment significantly potentiated the effects of war-zone stressors on the subsequent development of PTSD symptoms and general anxiety/stress symptoms but not on the development of depression, even after accounting for the effects of trait anxiety and the presence of past or current Axis I mental disorders.Soldiers' emotional reactivity to a 35% CO(2) challenge may serve as a vulnerability factor for increasing soldiers' risk for PTSD and general anxiety/stress symptoms in response to war-zone stressors.",0,0 +6866,A Mixed-Methods Study of Secondary Traumatic Stress in Certified Nurse-Midwives: Shaken Belief in the Birth Process,"Secondary traumatic stress (STS) is an occupational hazard for clinicians who can experience symptoms of posttraumatic stress disorder (PTSD) from exposure to their traumatized patients. The purpose of this mixed-methods study was to determine the prevalence and severity of STS in certified nurse-midwives (CNMs) and to explore their experiences attending traumatic births.A convergent, parallel mixed-methods design was used. The American Midwifery Certification Board sent out e-mails to all their CNM members with a link to the SurveyMonkey study. The STS Scale was used to collect data for the quantitative strand. For the qualitative strand, participants were asked to describe their experiences of attending one or more traumatic births. IBM SPSS 21.0 (Version 21.0, Armonk, NY) was used to analyze the quantitative data, and Krippendorff content analysis was the method used to analyze the qualitative data.The sample consisted of 473 CNMs who completed the quantitative portion and 246 (52%) who completed the qualitative portion. In this sample, 29% of the CNMs reported high to severe STS, and 36% screened positive for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnostic criteria for PTSD due to attending traumatic births. The top 3 types of traumatic births described by the CNMs were fetal demise/neonatal death, shoulder dystocia, and infant resuscitation. Content analysis revealed 6 themes: 1) protecting my patients: agonizing sense of powerlessness and helplessness; 2) wreaking havoc: trio of posttraumatic stress symptoms; 3) circling the wagons: it takes a team to provide support … or not; 4) litigation: nowhere to go to unburden our souls; (5) shaken belief in the birth process: impacting midwifery practice; and 6 moving on: where do I go from here?The midwifery profession should acknowledge STS as a professional risk.",0,0 +6867,Psychiatric morbidity following motor vehicle accidents: A review of methodological issues,"Motor vehicle accidents (MVAs), even those of a nonserious nature, appear to increase the risk of severe psychiatric morbidity in survivors. The present review examines the evidence indicating the levels of psychiatric morbidity in MVA survivors. Although no consistent profile has emerged, the most commonly reported symptoms are depression, anxiety, irritability, driving phobia, anger, sleep disturbances, and headache, with rates of posttraumatic stress disorder (PTSD) across studies of 0% to 100%. Variability in the type and severity of psychiatric outcomes may be due, in part, to methodological inadequacies in many studies, particularly the use of biased population samples, inclusion of subjects exposed to varied types of accidents, an absence of a clear definition of PTSD, a reliance on clinical judgment rather than the use of objective psychometric measures, the failure to include ratings of injury severity, and the absence of assessments for past exposure to traumatic events or preexisting posttraumatic reactions. The most important concern relates to the use of nonrepresentative samples, usually patients referred for medicolegal assessment in whom issues of compensation are of central importance. Gender and age differences distinguish the compensation group from the general population of MVA survivors, who therefore may also differ in the vulnerability to posttraumatic morbidity. It is argued that more systematic research on unselected subject samples is critical to establish epidemiological data on the true nature and extent of psychiatric morbidity following MVAs.",0,0 +6868,A systematic review of post-deployment injury-related mortality among military personnel deployed to conflict zones,"This paper reports on a systematic review of the literature on the post-conflict injury-related mortality of service members who deployed to conflict zones.Literature databases, reference lists of articles, agencies, investigators, and other sources were examined to find studies comparing injury-related mortality of military veterans who had served in conflict zones with that of contemporary veterans who had not served in conflict zones. Injury-related mortality was defined as a cause of death indicated by International Classification of Diseases E-codes E800 to E999 (external causes) or subgroupings within this range of codes.Twenty studies met the review criteria; all involved veterans serving during either the Vietnam or Persian Gulf conflict. Meta-analysis indicated that, compared with non-conflict-zone veterans, injury-related mortality was elevated for veterans serving in Vietnam (summary mortality rate ratio (SMRR) = 1.26, 95% confidence interval (95%CI) = 1.08-1.46) during 9 to 18 years of follow-up. Similarly, injury-related mortality was elevated for veterans serving in the Persian Gulf War (SMRR = 1.26, 95%CI = 1.16-1.37) during 3 to 8 years of follow-up. Much of the excess mortality among conflict-zone veterans was associated with motor vehicle events. The excess mortality decreased over time. Hypotheses to account for the excess mortality in conflict-zone veterans included post-traumatic stress, coping behaviors such as substance abuse, ill-defined diseases and symptoms, lower survivability in injury events due to conflict-zone comorbidities, altered perceptions of risk, and/or selection processes leading to the deployment of individuals who were risk-takers.Further research on the etiology of the excess mortality in conflict-zone veterans is warranted to develop appropriate interventions.",0,0 +6869,A prospective examination of PTSD symptoms as risk factors for subsequent exposure to potentially traumatic events among women.,"Previous research has suggested that both exposure to potentially traumatic events (PTEs) and emotional reactions to such events act as risk factors for subsequent exposure. Although some studies have implicated posttraumatic stress disorder (PTSD) symptoms as risk factors, extant research suffers from a number of methodological limitations, including the use of cross-sectional designs and student populations. The present study sought to address these limitations using a 2-year, 3-wave national probability household sample of 2,863 adult women. After controlling for demographic characteristics, prior exposure to PTEs, and Wave 1 depression and substance abuse, PTSD reexperiencing symptoms at Wave 1 predicted subsequent exposure to interpersonal violence victimization (IPVV) perpetrated by a nonintimate perpetrator; however, PTSD symptoms did not predict intimate partner IPVV. In addition, PTSD hyperarousal symptoms were unique predictors of subsequent exposure to other traumatic stressors. Findings suggest that efforts to prevent PTEs should focus attention on both prior exposure and PTSD symptoms in response to such exposure.",0,0 +6870,Psychological distress and resources among siblings and parents exposed to traumatic events,"We examined symmetries and asymmetries within family members' psychological distress and resources in general and when exposed to traumatic events in particular. PTSD and depressive symptoms indicated distress and resilient attitudes, and satisfaction with quality of life indicated resources. We also analysed potential complementary dynamics between family members and identified family types according to their distress and resources. Concerning trauma impact, we hypothesized that exposure to family military violence (FMV) and recent personal trauma (RPT) predict family members' psychological distress and resources differently, indicating asymmetry in family responses. The participants were 65 Palestinian families each consisting of a mother, a father and their 15-, 17and 19-year-old children. The within-family MANOVA results showed asymmetric in psychological distress and resources in sibling and spousal subsystems, for example older siblings reported a higher level of depressive symptoms than both parents, and mothers reported PTSD more often than fathers. The cluster analysis identified four family types, two with symmetric responses: In the “resilient families” all members showed low distress and high resources, and in the “ordeal families” all showed distress and low resources. In the asymmetric families either the children or the parents showed low distress and high resources, named the “children's strength families” and the “parental strength families”, respectively. Partial correlation analysis revealed complementary dynamics between children and their parents: If mothers reported high levels of psychological distress, the 15and 17-year-olds reported low or vice versa. Spousal complementary dynamics were found in psychosocial resources: If the mother showed highly resilient attitudes, the father showed low or vice versa. As hypothesized, exposure to traumatic events was differently associated with family members’ psychological distress and resources. Family military trauma (FMT) predicted depressive symptoms only among the youngest siblings, and recent personal trauma (RPT) was associated with dissatisfaction with quality of life only among the oldest sibling and fathers.",0,0 +6871,"Overextraction of Latent Trajectory Classes: Much Ado About Nothing? Reply to Rindskopf (2003), Muthén (2003), and Cudeck and Henly (2003).","The comments on D. J. Bauer and P. J. Curran (2003) share 2 common themes. The 1st theme is that model-checking procedures may be capable of distinguishing between mixtures of normal and homogeneous nonnormal distributions. Although useful for assessing model quality, it is argued here that currently available procedures may not always help discern between these 2 possibilities. The 2nd theme is that even if these 2 possibilities cannot be distinguished, a growth mixture model may still provide useful insights into the data. It is argued here that whereas this may be true for the scientific goals of description and prediction, the acceptance of a model that fundamentally misrepresents the underlying data structure may be less useful in pursuit of the goal of explanation.",0,0 +6872,Measurement of individualised quality of life amongst young people with indicated personality disorder during emerging adulthood using the SEIQoL-DW,"Purpose To examine both the feasibility of applying the Schedule for the Evaluation of Individual Quality of Life- Direct Weighting procedure (SEIQoL-DW) as a routine outcome measure within an early intervention service for young people with indicated personality disorder and the overall quality of life (QoL) in this population. Methods SEIQoL-DW was administered alongside the Standardised Assessment of Personality-Abbreviated Scale-Self-Report (SAPAS-SR), Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder Scale (GAD-7) and the Post-Traumatic Stress Disorder-Primary Care (PTSD-PC) as part of routine service evaluation over a 16-month period. Descriptive statistics were calculated for data reflecting use of the SEIQoL-DW alongside demographic and outcome variables. Results The SEIQoL-DW was administered to 52 young adults with indicated personality disorder, with 47 completing the measure, taking an average time of 27 min. Individual QoL was poor with a mean global index score of 55.07 (SD = 22.34). Individual QoL areas formed five main domains-'Aspects of Daily Living', 'Relationships', 'Social Life and Leisure', 'Family' and 'Emotional and Physical Wellbeing'. Conclusion This study further extends the application of the SEIQoL-DW for use as a routine outcome measure within a busy service setting, although ways to accommodate administration time need to be considered. Poor QoL highlights the need for continued development of services to meet the needs of young adults with indicated personality disorder. © Springer Science+Business Media B.V. 2012.",0,0 +6873,Attention to threat images in individuals with clinical and subthreshold symptoms of post-traumatic stress disorder,"Attention to general and trauma-relevant threat was examined in individuals with clinical and subthreshold symptoms of post-traumatic stress disorder (PTSD). Participants' eye gaze was tracked and recorded while they viewed sets of four images over a 6-s presentation (one negative, positive, and neutral image, and either a general threat image or a trauma-relevant threat image). Two trauma-exposed groups (a clinical and a subthreshold PTSD symptom group) were compared to a non-trauma-exposed group. Both the clinical and subthreshold PTSD symptom groups attended to trauma-relevant threat images more than the no-trauma-exposure group, whereas there were no group differences for general threat images. A time course analysis of attention to trauma-relevant threat images revealed different attentional profiles for the trauma-exposed groups. Participants with clinical PTSD symptoms exhibited immediate heightened attention to the images relative to participants with no-trauma-exposure, whereas participants with subthreshold PTSD symptoms did not. In addition, participants with subthreshold PTSD symptoms attended to trauma-relevant threat images throughout the 6-s presentation, whereas participants with clinical symptoms of PTSD exhibited evidence of avoidance. The theoretical and clinical implications of these distinct attentional profiles are discussed.",0,0 +6874,Clinical Utility and Psychometric Properties of the Traumatic Brain Injury Quality of Life Scale (TBI-QOL) in US Military Service Members,"To examine the clinical utility and psychometric properties of the Traumatic Brain Injury Quality of Life (TBI-QOL) scale in a US military population.One hundred fifty-two US military service members (age: M = 34.3, SD = 9.4; 89.5% men) prospectively enrolled from the Walter Reed National Military Medical Center and other nationwide community outreach initiatives. Participants included 99 service members who had sustained a mild traumatic brain injury (TBI) and 53 injured or noninjured controls without TBI (n = 29 and n = 24, respectively).Participants completed the TBI-QOL scale and 5 other behavioral measures, on average, 33.8 months postinjury (SD = 37.9).Fourteen TBI-QOL subscales; Neurobehavioral Symptom Inventory; Posttraumatic Stress Disorder Checklist-Civilian version; Alcohol Use Disorders Identification Test; Combat Exposure Scale.The internal consistency reliability of the TBI-QOL scales ranged from α = .91 to α = .98. The convergent and discriminant validity of the 14 TBI-QOL subscales was high. The mild TBI group had significantly worse scores on 10 of the 14 TBI-QOL subscales than the control group (range, P < .001 to P = .043). Effect sizes ranged from medium to very large (d = 0.35 to d = 1.13). The largest differences were found on the Cognition-General Concerns (d = 1.13), Executive Function (d = 0.94), Grief-Loss (d = 0.88), Pain Interference (d = 0.83), and Headache Pain (d = 0.83) subscales.These results support the use of the TBI-QOL scale as a measure of health-related quality of life in a mild TBI military sample. Additional research is recommended to further evaluate the clinical utility of the TBI-QOL scale in both military and civilian settings.",0,0 +6875,Trajectories of Self-Rated Health Among Veterans: A Latent Growth Curve Analysis of the Impact of Posttraumatic Symptoms,"To examine the effects of combat stress reaction (CSR) and posttraumatic stress symptoms (PTS) on the level and trajectories of self-rated health (SRH) over 20 years after war exposure.A total of 675 veterans comprising two groups, a CSR group (n = 369) and a matched control group without CSR (n = 306), were assessed in a prospective longitudinal design, 1, 2, 3, and 20 years after their participation in the 1982 Lebanon War. SRH and PTS were assessed repeatedly, at each point of measurement.The CSR participants showed more impaired initial SRH than the controls. Although the CSR group showed an improvement in SRH over time, its SRH level remained lower than that of the control group in all 4 points in time. Initial levels of PTS were associated with more impaired SRH and lower improvement over time. In addition, increased levels of PTS in the first follow-up period were related to poorer SRH, in comparison to the predicted trajectory on the basis of CSR and initial PTS.Stress reaction to war trauma affected the trajectory of SRH over a 20-year period. Although the differences between veterans who had shown acute stress reaction and those who had not persisted over the entire period, there was slow improvement in SRH over time among the more impaired CSR group. PTS in the first years after the war slowed this improvement and thus played a key role in the relationship between war trauma and physical health.",0,0 +6876,Abnormal functional architecture of amygdala‐centered networks in adolescent posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) is a prevalent, debilitating, and difficult to treat psychiatric disorder. Very little is known of how PTSD affects neuroplasticity in the developing adolescent brain. Whereas multiple lines of research implicate amygdala-centered network dysfunction in the pathophysiology of adult PTSD, no study has yet examined the functional architecture of amygdala subregional networks in adolescent PTSD. Using intrinsic functional connectivity analysis, we investigated functional connectivity of the basolateral (BLA) and centromedial (CMA) amygdala in 19 sexually abused adolescents with PTSD relative to 23 matched controls. Additionally, we examined whether altered amygdala subregional connectivity coincides with abnormal grey matter volume of the amygdaloid complex. Our analysis revealed abnormal amygdalar connectivity and morphology in adolescent PTSD patients. More specifically, PTSD patients showed diminished right BLA connectivity with a cluster including dorsal and ventral portions of the anterior cingulate and medial prefrontal cortices (p < 0.05, corrected). In contrast, PTSD patients showed increased left CMA connectivity with a cluster including the orbitofrontal and subcallosal cortices (p < 0.05, corrected). Critically, these connectivity changes coincided with diminished grey matter volume within BLA and CMA subnuclei (p < 0.05, corrected), with CMA connectivity shifts additionally relating to more severe symptoms of PTSD. These findings provide unique insights into how perturbations in major amygdalar circuits could hamper fear regulation and drive excessive acquisition and expression of fear in PTSD. As such, they represent an important step toward characterizing the neurocircuitry of adolescent PTSD, thereby informing the development of reliable biomarkers and potential therapeutic targets.",0,0 +6877,Perceived controllability and the development of posttraumatic stress disorder (PTSD) in crime victims,"This study evaluated the association between perception of controllability and the development of posttraumatic stress disorder (PTSD) following criminal assault. Factor analysis of a perceived controllability scale revealed three factors; perceived controllability felt during the assault, expected controllability over future assaults, and perceived controllability over aversive events more generally. Only the latter factor was associated with PTSD symptom severity. The hypothesis that perceived controllability would be negatively associated with assault severity was partially supported. Further analyses showed that the association between controllability and PTSD was not mediated or moderated by assault severity measures. The role of perceived controllability in the development of PTSD is discussed.",0,0 +6878,Autonomic dysregulation in panic disorder and in post-traumatic stress disorder: application of power spectrum analysis of heart rate variability at rest and in response to recollection of trauma or panic attacks,"Power spectral analysis (PSA) of heart rate variability (HRV) offers reliable assessment of cardiovascular autonomic responses, providing a 'window' onto the interaction of peripheral sympathetic and parasympathetic tone. Alterations in HRV are associated with various physiological and pathophysiological processes, and may contribute to morbidity and mortality. Previous studies of posttraumatic stress disorder (PTSD) found lower resting HRV in patients compared to controls, suggesting increased sympathetic and decreased parasympathetic tone. This article describes the analysis of HRV at rest and after psychological stress in panic disorder (PD) patients, in an enlarged sample of PTSD patients, and in healthy control subjects. Standardized heart rate (HR) analysis was carried out in 14 PTSD patients, 11 PD patients and 25 matched controls. ECG recordings were made while subjects were resting ('rest 1'), while recalling the trauma implicated in PTSD, or the circumstances of a severe panic attack, as appropriate ('recall'), and again while resting ('rest 2'). Controls were asked to recall a stressful life event during recall. While both patient groups had elevated HR and low frequency (LF) components of HRV at baseline (suggesting increased sympathetic activity), PTSD patients, unlike PD patients and controls, failed to respond to the recall stress with increases in HR and LF. HRV analysis demonstrates significant differences in autonomic regulation of PTSD and PD patients compared to each other and to control subjects. HRV analysis may augment biochemical studies of peripheral measures in these disorders.",0,0 +6879,Community Disaster Vulnerability,"Disaster vulnerability is rapidly increasing on a global scale, particularly for those populations which are the historical clients of the social work profession. These populations include the very young and very old, the poor, ethnic and racial minorities, and those with physical or mental disabilities. Social workers are increasingly providing services in disasters during response and recovery periods, and are using community interventions to reduce disaster vulnerability. There is a need for a cogent theory of vulnerability and research that addresses improved community disaster practice and community resilience. Community Disaster Vulnerability and Resilience provides a unifying theoretical framework backed by research which can be translated into knowledge for effective practice in disasters. © Springer Science+Business Media New York 2013. All rights are reserved.",0,0 +6880,"Clinicians' Posttraumatic Growth following Hurricane Katrina: The Influence of Life Events, Professional Quality of Life, and Primary and Secondary Traumatic Stress","This study was a secondary data analysis of 244 clinicians living and working in a post-Katrina environment. Using structural equation modeling, clinicians' trauma histories and primary and secondary traumatic stress were assessed in relationship to posttraumatic growth. It was expected that a greater number of traumatic life events would be related to higher levels of traumatic experience and growth. It was also expected that traumatic life experience would be associated with growth. Contrary to expectation, the initial evaluation of the path coefficients showed no significant paths between primary trauma and posttraumatic growth. A closer inspection of measures and model diagnostics revealed three distinct constructs pertaining to primary trauma, none of which were highly correlated. A revised model was then re-fit with the inclusion of two latent variables, primary trauma and posttraumatic growth, which yielded a better fit. The new model was statistically overidentified. The results showed that a greater number of traumatic life events were related to both primary and secondary traumatic stress but not growth. The latent variables revealed a statistically significant relationship between traumatic reexperiencing which related to greater posttraumatic growth in the domain, appreciation for life. Implications for theory development, clinical practice and policy, and future research are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6881,Efficacy of exposure therapy for Japanese patients with posttraumatic stress disorder due to mixed traumatic events: A randomized controlled study,en,0,0 +6882,Risk Factors of Posttraumatic Stress Disorder After an Earthquake Disaster,"This study sought to predict posttraumatic stress disorder (PTSD) from women's reproductive health events after an earthquake experience. Data on antenatal care, pregnancy outcomes, family planning, socioeconomic status, earthquake experiences, and mental health were collected from a random sample of 425 women of reproductive age using the Centers for Disease Control and Prevention Reproductive Health Assessment Toolkit and the Harvard Trauma Questionnaire. Data were analyzed using multivariate regression analysis to predict PTSD symptoms from posttrauma care variables and reproductive health events. Restricted social participation, use of temporary accommodation, pregnancy complications, and use of injectable contraceptives were significant risk factors of PTSD. These factors may be exacerbated by the social context of conservative societies, traditions about health care-seeking behavior, and access to health care. Antecedent reproductive health events influence women's reaction to major trauma including events such as an earthquake.",0,0 +6883,The concept of nomogenic disorders.,"The term 'nomogenic disorders' has been coined for psychopathological conditions created, enhanced, and perpetuated by the law and its application, and for the psychological and social consequences of the law and the way it affects the course of the disease process. Questions are raised regarding the diagnosis, prognosis and therapy of this cluster of disorders. Conditions paradigmatic of nomogenic disorder are presented. Emphasis is placed on the historical development of traumatic neuroses, as they are at present the most frequently encountered nomogenic condition. The clinical and theoretical importance of the concept of nomogenesis is discussed.",0,0 +6884,Pharmacological prevention of post-traumatic stress disorder and acute stress disorder: a systematic review and meta-analysis,"An increasing number of studies have investigated the pharmacological prevention of post-traumatic stress disorder (PTSD) and acute stress disorder (ASD). This is the first systematic review to examine the effects of pharmacotherapies (eg, β blockers, hydrocortisone, and selective serotonin re-uptake inhibitors) given within the first month after a traumatic or aversive event to prevent PTSD or ASD compared with no pharmacotherapy or placebo control.A systematic literature search in PubMed, PsycINFO, Embase, and the Cochrane database of randomised trials was done. Studies included randomised controlled trials, controlled clinical trials, and cohort studies; their overall quality was low to moderate. We computed the pooled incidence risk ratio (IRR): the risk of incidence of PTSD or ASD in the pharmacotherapy groups relative to the incidence of PTSD or ASD in the control groups. Additionally, we computed Hedges'g effect sizes for PTSD or ASD continuous outcomes.15 studies met inclusion criteria (1765 individuals). Pharmacotherapy was more effective in preventing PTSD or ASD than placebo or no intervention (14 studies, 1705 individuals, IRR 0·65, 95% CI 0·55-0·78; number needed to treat 11·36), although no effect was found when only randomised controlled trials were included (ten studies, 300 individuals, IRR 0·69, 95% CI 0·40-1·21). Hydrocortisone showed a large effect in reducing the risk of PTSD (five studies, 164 individuals, IRR 0·38, 95% CI 0·16-0·92).No firm evidence was found for the efficacy of all early pharmacotherapies in the prevention of PTSD or ASD, but hydrocortisone reduced the risk of developing PTSD. The small number of studies and their limited methodological quality cast uncertainty about the effects.None.",0,0 +6885,"Erratum to: Trends in Psychological/Psychiatric Injury and Law: Continuing Education, Practice Comments, Recommendations","This literature review of the major topics in the field of psychological/psychiatric injury and law is aimed at developing practice in the area. The field is a fast-developing one, with over ten major topics that it needs to integrate. In particular, the present review focuses on current work on: law (evidence, tort); forensic psychology; assessment and testing; psychological injuries (posttraumatic stress disorder, chronic pain, traumatic brain injury, other); the APA DSM-5 draft (Diagnostic and statistical manual of mental disorders; American Psychiatric Association 2010); malingering; causality; multicultural considerations; disability; the American Medical Association (AMA) Guides to the evaluation of permanent impairment (Rondinelli et al. 2008); models; and treatment. At the end of each section of the article, practice comments introduce critical issues in applying the research to psychological work in the area. Whether undertaking tort evaluations, disability, and treatment plan assessments or treating individuals with psychological injuries, the professional needs state-of-the-art information in all the areas listed in order to remain scientifically informed, comprehensive, and impartial. The article concludes with recommendations for an integrated field in psychological/psychiatric injury and law, study in the field, research in its major areas, best practice policies, for example in assessment and treatment, and model building.",0,0 +6886,From efficacy to effectiveness: the trajectory of the treatment literature for children with PTSD,"This review summarizes efficacious treatments for preschoolers, children and adolescents with post-traumatic stress disorder, with a focus on the advances made within the last 5 years. There is considerable support for the use of trauma-specific cognitive-behavioral interventions, in both individual and group formats. The research on psychopharmacological treatments lags behind that of psychotherapy and is currently inconclusive. Limitations of the studies are discussed and treatments that warrant further consideration are reviewed. The authors also review current advances in effectiveness and suggest future directions that are important in generalizing the interventions to underserved and hard to reach populations. The article concludes with the authors' projections for the evolution of the field within the upcoming 5 years.",0,0 +6887,The international humanitarian system and the 2004 Indian Ocean earthquake and tsunamis,"The December 2004 Indian Ocean earthquake and tsunamis were an exceptional event. So too was the scale of the response, particularly the level of international funding. Unprecedented donations meant that for once, an international emergency response was largely free of financial constraints. This removal of the funding constraint facilitated observation of the capacity and quality of international disaster aid. The Tsunami Evaluation Coalition conducted five independent thematic assessments in 2005—an impact study was planned, but never implemented. The five evaluations were supported by 44 sub-studies. Based on this work, this paper compares international disaster response objectives, principles and standards with actual performance. It reaches conclusions on four salient aspects: funding; capacity and quality; recovery; and ownership. It ends by proposing a fundamental reorientation of international disaster response approaches that would root them in concepts of sustainable disaster risk reduction and recovery, based on local and national ownership of these processes.",0,0 +6888,Attention-deficit/hyperactivity disorder comorbidity in a sample of veterans with posttraumatic stress disorder,"This study examined attention-deficit/hyperactivity disorder (ADHD) comorbidity in military veterans with a high prevalence of posttraumatic stress disorder (PTSD) and evaluated the relationships between the 2 disorders and exposure to traumatic events. The sample included 222 male and female military veterans who were administered structured clinical interviews based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Results show that 54.5% met the criteria for current PTSD, 11.5% of whom also met the criteria for current adult ADHD. Level of trauma exposure and ADHD severity were significant predictors of current PTSD severity. Evaluation of the underlying structure of symptoms of PTSD and ADHD using confirmatory factor analysis yielded a best-fitting measurement model that comprised 4 PTSD factors and 3 ADHD factors. Standardized estimates of the correlations among PTSD and ADHD factors suggested that the largest proportion of shared variance underlying PTSD-ADHD comorbidity is related to problems with modulating arousal levels that are common to both disorders (ie, hyperarousal and hypoarousal).",0,0 +6889,Twenty-One—Month Follow-up Study of School-Age Children Exposed to Hurricane Andrew,"To explore the 21-month course of posttraumatic stress symptomatology (PTSS) and psychological morbidity in 30 school-age children (7 to 13 years) after exposure to Hurricane Andrew.Pynoos' Posttraumatic Stress Disorder Reaction Index and Achenbach's Teacher's Report Form were administered at 8 and 21 months after Hurricane Andrew.At 21 months 70% of the children endorsed moderate-severe PTSS. The reduction in PTSS was greater for boys than girls. Psychopathology as measured by the Teacher's Report Form increased over the 19-month period. Boys demonstrated significant increases in internalizing symptoms and in Withdrawn, Anxious/Depressed, Social Problems, and Attention Problems scales, and girls showed a significant increase in the Anxious/Depressed scale.Twenty-one months after exposure to Hurricane Andrew, there were continuing high levels of PTSS and evidence of increasing emotional and behavioral problems. While girls sustained higher levels of PTSS, boys demonstrated higher indices of other psychopathology. The enduring effects of disaster associated with secondary stressors and ""traumatic reminders"" continue to be etiologically important for continuing psychological morbidity.",0,0 +6890,A factor analysis of posttraumatic stress disorder symptoms using data pooled from two venlafaxine extended‐release clinical trials,"Confirmatory factor analysis (CFA) of Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) three-factor posttraumatic stress disorder (PTSD) diagnostic criteria was conducted to determine fit for this patient population. An exploratory factor analysis (EFA) of alternate symptom structures was planned to identify symptoms that cluster in this population. The response of symptom factors to treatment with venlafaxine extended release (ER) was explored.Baseline 17-item Clinician-Administered PTSD Scale (CAPS-SX17) data were pooled from patients enrolled in two double-blind, randomized, placebo-controlled trials. The CFA was conducted using maximum likelihood and weighted, least-squares factor extraction methods. The EFA was performed using a polychoric correlation covariance matrix and Pearson correlation matrix.Data from a pooled population of 685 patients (venlafaxine ER: n = 339; placebo: n = 346) were analyzed. CFA rejected the DSM-IV three-factor structure. The EFA identified a different three-factor structure as the best fit: factor 1 included reexperiencing symptoms, factor 2 included symptoms of altered mood and cognition, whereas factor 3 comprised avoidance and arousal symptoms. All DSM-IV symptom factors and all factors in the identified three-factor model responded positively to venlafaxine ER treatment.Data are consistent with literature failing to confirm the three-factor structure of DSM-IV PTSD, and they support the DSM-5 inclusion of a symptom cluster addressing altered mood and cognition in PTSD. The efficacy of venlafaxine ER in reducing a range of symptom clusters in PTSD is consistent with its multiple mechanisms of action.",0,0 +6891,An exploration of the characteristics of post-traumatic stress disorder in reserve forces deployed during desert storm,"Post-traumatic stress disorder (PTSD), previously defined in Vietnam War veterans, was described in 251 Desert Storm reservists. The Mississippi Scale, Revised, was used with a brief demographic profile to survey Army, Marine, and Air Force personnel who had been deployed to Saudi Arabia. Age, sex, marital status, race, rank, duty, length of deployment, and branch of service were not found to be significantly related to PTSD symptoms. However, those surveyed within 3 to 6 months of homecoming reported significantly greater symptoms than those surveyed after 6 months. Five percent of subjects were found to have clinically diagnostic levels of PTSD symptoms 6 months after homecoming. Individuals who expressed difficulty discussing their experiences with more than one person also showed significantly higher PTSD scores. These findings indicate that readjustment reactions were prevalent during the first 6 months and that PTSD could be identified in 5% of the Desert Storm veterans.",0,0 +6892,"Blood Pressure in Firefighters, Police Officers, and Other Emergency Responders","Elevated blood pressure is a major risk factor for cardiovascular morbidity and mortality. Increased risk begins in the prehypertensive range and increases further with higher pressures. The strenuous duties of emergency responders (firefighters, police officers, and emergency medical services (EMS) personnel) can interact with their personal risk profiles, including elevated blood pressure, to precipitate acute cardiovascular events. Approximately three-quarters of emergency responders have prehypertension or hypertension, a proportion which is expected to increase, based on the obesity epidemic. Elevated blood pressure is also inadequately controlled in these professionals and strongly linked to cardiovascular disease morbidity and mortality. Notably, the majority of incident cardiovascular disease events occur in responders who are initially prehypertensive or only mildly hypertensive and whose average premorbid blood pressures are in the range in which many physicians would hesitate to prescribe medications (140-146/88-92). Laws mandating public benefits for emergency responders with cardiovascular disease provide an additional rationale for aggressively controlling their blood pressure. This review provides a background on emergency responders, summarizes occupational risk factors for hypertension and the metabolic syndrome, their prevalence of elevated blood pressure, and evidence linking hypertension with adverse outcomes in these professions. Next, discrepancies between relatively outdated medical standards for emergency responders and current, evidence-based guidelines for blood pressure management in the general public are highlighted. Finally, a workplace-oriented approach for blood pressure control among emergency responders is proposed, based on the seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.",0,0 +6893,Parents of Children With Cancer: At-Risk or Resilient?,"To examine adjustment in parents of children with cancer using a design that minimizes focusing effects and allows for direct comparison with parents of healthy children.Parents of 305 children with cancer and a demographically similar sample of 231 parents of healthy children were evaluated using diagnostic interviews for posttraumatic stress disorder (PTSD), and questionnaire measures of posttraumatic stress symptoms (PTSS) and psychological growth (PG), as well as measures of global psychological functioning.Rates of current and lifetime PTSD in parents of children with cancer were low, and did not differ from comparison parents. Likewise, levels of PTSS were not significantly different from comparison parents, but differed as a function of time since diagnosis, with parents of children who were ≥ 5 years from diagnosis reporting significantly lower PTSS than comparison parents. PG was higher in parents of children with cancer than in comparison parents regardless of time since diagnosis.Parents of children with cancer demonstrate resilience to this challenge.",0,0 +6894,Individual differences in fear: Isolating fear reactivity and fear recovery phenotypes,"Although different people respond differently to threatening events, animal research on the neural basis of fear tends to focus on typical responses. Yet there are substantial individual differences between animals exposed to identical behavioral procedures. In an effort to begin to understand the nature and causes of fear variability and resilience, we separated outbred Sprague-Dawley rats into high and low reactivity, and fast and slow recovery phenotypes, based on freezing levels during fear conditioning and extinction, respectively. Subsequent tests revealed stable differences in both measures, indicating that fear responses reflect trait-like phenotypes in outbred animals. Because clinical disorders may reflect extreme phenotypes, identification of the biological basis for these differences could provide insights into human individual differences in fear.",0,0 +6895,Emotional Responses of Mothers of Late‐Preterm and Term Infants,"ABSTRACT Objective To compare the emotional responses of mothers of late‐preterm infants (34 0/7 to 36 6/7 weeks gestation) with those of mothers of full‐term infants. Design A mixed method comparative study. Setting A southeastern tertiary academic medical center postpartum unit. Participants Sixty mothers: 29 mothers of late‐preterm infants and 31 mothers of full‐term infants. Methods Measures of maternal emotional distress (four standardized measures of anxiety, postpartum depression, posttraumatic stress symptoms, and worry about infant health) and open‐ended semistructured maternal interviews were conducted in the hospital following birth and by phone at one month postpartum. Results Mothers of late‐preterm infants experienced significantly greater emotional distress immediately following delivery, and their distress levels continued to be higher at one month postpartum on each of the standardized measures. Mothers of late‐preterm infants also discussed the altered trajectories in their birth and postpartum experiences and feeling unprepared for these unexpected events as a source of ongoing emotional distress. Conclusion Mothers of late‐preterm infants have greater emotional distress than mothers of term infants for at least one month after delivery. Our findings suggest that it may not be a single event that leads to different distress levels in mothers of late‐preterm and full‐term infants but rather the interaction of multiple alterations in the labor and delivery process and the poorer‐than‐expected infant health outcomes. In the future, researchers need to examine how and when mothers' emotional responses change over time and how their responses relate to parenting and infant health and development.",0,0 +6896,Posttraumatic stress in deployed Marines: Prospective trajectories of early adaptation.,"We examined the course of PTSD symptoms in a cohort of U.S. Marines (N = 867) recruited for the Marine Resiliency Study (MRS) from a single infantry battalion that deployed as a unit for 7 months to Afghanistan during the peak of conflict there. Data were collected via structured interviews and self-report questionnaires 1 month prior to deployment and again at 1, 5, and 8 months postdeployment. Second-order growth mixture modeling was used to disaggregate symptom trajectories; multinomial logistic regression and relative weights analysis were used to assess the role of combat exposure, prior life span trauma, social support, peritraumatic dissociation, and avoidant coping as predictors of trajectory membership. Three trajectories best fit the data: a low-stable symptom course (79%), a new-onset PTSD symptoms course (13%), and a preexisting PTSD symptoms course (8%). Comparison in a separate MRS cohort with lower levels of combat exposure yielded similar results, except for the absence of a new-onset trajectory. In the main cohort, the modal trajectory was a low-stable symptoms course that included a small but clinically meaningful increase in symptoms from predeployment to 1 month postdeployment. We found no trajectory of recovery from more severe symptoms in either cohort, suggesting that the relative change in symptoms from predeployment to 1 month postdeployment might provide the best indicator of first-year course. The best predictors of trajectory membership were peritraumatic dissociation and avoidant coping, suggesting that changes in cognition, perception, and behavior following trauma might be particularly useful indicators of first-year outcomes.",1,0 +6897,Posttraumatic stress disorder and somatic symptoms among child and adolescent survivors following the Lushan earthquake in China: A six-month longitudinal study,"To explore somatic conditions in a sample of 2299 child and adolescent survivors of an earthquake and their relationship to posttraumatic stress disorder (PTSD) symptoms.The Children's Revised Impact of Event Scale, the Patient Health Questionnaire (PHQ)-13 scale, a short version of PHQ-15 scale that omits two items involving sexual pain/problems and menstrual problems, and a project-developed questionnaire were administered to participants three and six months after the earthquake.Among child and adolescent survivors, the prevalence rates of probable PTSD were 37.4 and 24.2% three and six months, respectively, after the earthquake. The most common somatic symptoms were trouble sleeping (58.4 and 48.4%), feeling tired or having low energy (52.0 and 46.1%), and stomach pain (45.8 and 45.4%) after three and six months, respectively. Several specific somatic symptoms evaluated three months after the earthquake including trouble sleeping, headache, and shortness of breath were predictors of the overall PTSD symptoms evaluated six months after the earthquake. Additionally, the symptom of hyperarousal evaluated after three months could predict the overall somatic symptoms evaluated after six months.PTSD and somatic symptoms were common after the earthquake, and a longitudinal association between PTSD and somatic symptoms was detected among child and adolescent survivors. These findings have implications in China and possibly elsewhere.",0,0 +6898,Prevention of Post-Traumatic Stress Disorder After Trauma: Current Evidence and Future Directions,"Post-traumatic stress disorder (PTSD) is a frequent, tenacious, and disabling consequence of traumatic events. The disorder's identifiable onset and early symptoms provide opportunities for early detection and prevention. Empirical findings and theoretical models have outlined specific risk factors and pathogenic processes leading to PTSD. Controlled studies have shown that theory-driven preventive interventions, such as cognitive behavioral therapy (CBT), or stress hormone-targeted pharmacological interventions, are efficacious in selected samples of survivors. However, the effectiveness of early clinical interventions remains unknown, and results obtained in aggregates (large groups) overlook individual heterogeneity in PTSD pathogenesis. We review current evidence of PTSD prevention and outline the need to improve the disorder's early detection and intervention in individual-specific paths to chronic PTSD.",0,0 +6899,Measuring and maximizing coverage in the World Trade Center Health Registry,"The World Trade Center Health Registry (WTCHR) is a database for following people who were exposed to the disaster of 11 September 2001. Hundreds of thousands of people were exposed to the immense cloud of dust and debris, the indoor dust, the fumes from persistent fires, and the mental trauma of the terrorist attacks on the WTC on 9/11. The purpose of the WTCHR is to evaluate the potential short- and long-term physical and mental health effects of the disaster. The definitions of the exposed groups are broad and defined based on an understanding of which groups had the highest exposures to the WTC disaster and its aftermath. The four exposure groups include rescue and recovery workers, residents, students and school staff, and building occupants and passersby in Lower Manhattan. While one goal of the WTCHR was to maximize coverage overall and for each exposure group, another was to ensure equal representation within exposure groups. Because of the multiple sample types pursued, several approaches were required to determine eligibility. Estimates of the number of eligible persons in each of the exposed populations were based on the best available information including Census, entity-specific employment figures, and public and private school enrollment data, among other publicly available sources. To address issues of undercoverage and overcoverage a variety of methods were assessed or applied, including a capture-recapture analyses test of overlapping sample building list sources and automated deduplication of sample records. Estimates of the true eligible population indicate that over 400,000 unique individuals were eligible for the baseline health survey. Interviewer-administered surveys were completed with more than 71,000 persons, resulting in an overall enrollment rate of approximately 17 per cent. Coverage was highest among rescue and recovery workers, followed by residents, students and school staff, and building occupants. Both the accuracy of coverage estimates and the raw number and representativeness of enrollees were maximized by our approach to coverage. In designing a registry which relies on multiple pathways and sources of data to build the sample, it is important to develop a comprehensive approach that considers all sources of error and minimizes bias that may be introduced through the methodology.",0,0 +6900,Pervasive Trauma Exposure Among US Sexual Orientation Minority Adults and Risk of Posttraumatic Stress Disorder,"We assessed sexual orientation disparities in exposure to violence and other potentially traumatic events and onset of posttraumatic stress disorder (PTSD) in a representative US sample.We used data from 34 653 noninstitutionalized adult US residents from the 2004 to 2005 wave of the National Epidemiologic Survey on Alcohol and Related Conditions.Lesbians and gay men, bisexuals, and heterosexuals who reported any same-sex sexual partners over their lifetime had greater risk of childhood maltreatment, interpersonal violence, trauma to a close friend or relative, and unexpected death of someone close than did heterosexuals with no same-sex attractions or partners. Risk of onset of PTSD was higher among lesbians and gays (adjusted odds ratio [AOR] = 2.03; 95% confidence interval [CI] = 1.34, 3.06), bisexuals (AOR = 2.13; 95% CI = 1.38, 3.29), and heterosexuals with any same-sex partners (AOR = 2.06; 95% CI = 1.54, 2.74) than it was among the heterosexual reference group. This higher risk was largely accounted for by sexual orientation minorities' greater exposure to violence, exposure to more potentially traumatic events, and earlier age of trauma exposure.Profound sexual orientation disparities exist in risk of PTSD and in violence exposure, beginning in childhood. Our findings suggest there is an urgent need for public health interventions aimed at preventing violence against individuals with minority sexual orientations and providing follow-up care to cope with the sequelae of violent victimization.",0,0 +6901,"Posttraumatic Stress and Well-Being Following Relationship Dissolution: Coping, Posttraumatic Stress Disorder Symptoms From Past Trauma, and Traumatic Growth","This study investigated posttraumatic stress symptoms (PTSS) and psychological comorbidity following dating relationship dissolution. The roles of coping, posttraumatic growth, and posttraumatic stress disorder (PTSD) severity from past trauma were analyzed. Participants (n = 187) were recruited through an online survey. Emotion-focused coping and PTSD severity from past trauma were positively associated with higher levels of PTSS and psychological comorbidity. Posttraumatic growth was negatively associated with psychological comorbidity; problem-focused coping was negatively associated with PTSS. Emotion-focused coping and PTSD severity from past trauma appeared to be risk factors for psychological outcomes, while posttraumatic growth and problem-focused coping were found to be protective factors.",0,0 +6902,Emotion Modulation in PTSD: Clinical and Neurobiological Evidence for a Dissociative Subtype,"In this article, the authors present evidence regarding a dissociative subtype of PTSD, with clinical and neurobiological features that can be distinguished from nondissociative PTSD. The dissociative subtype is characterized by overmodulation of affect, while the more common undermodulated type involves the predominance of reexperiencing and hyperarousal symptoms. This article focuses on the neural manifestations of the dissociative subtype in PTSD and compares it to those underlying the reexperiencing/hyperaroused subtype. A model that includes these two types of emotion dysregulation in PTSD is described. In this model, reexperiencing/hyperarousal reactivity is viewed as a form of emotion dysregulation that involves emotional undermodulation, mediated by failure of prefrontal inhibition of limbic regions. In contrast, the dissociative subtype of PTSD is described as a form of emotion dysregulation that involves emotional overmodulation mediated by midline prefrontal inhibition of the same limbic regions. Both types of modulation are involved in a dynamic interplay and lead to alternating symptom profiles in PTSD. These findings have important implications for treatment of PTSD, including the need to assess patients with PTSD for dissociative symptoms and to incorporate the treatment of dissociative symptoms into stage-oriented trauma treatment.",0,0 +6903,Understanding the psychological impact of terrorism on youth: Moving beyond posttraumatic stress disorder.,"Comer and Kendall's (2007) comprehensive review of the impact of terrorism on youth organizes this important and burgeoning area of research. The present commentary focuses on youth outcomes associated with proximal contact with terrorist attacks, and highlights several important issues that merit attention. Specifically, the commentary emphasizes the importance of examining youths’ postattack outcomes broadly (in addition to posttraumatic stress disorder and its symptoms), assessing traumatic grief and bereavement when mass casualties occur, and evaluating issues of comorbidity and functional impairment. Future research on the impact of terrorism on youth would benefit from adopting a developmental psychopathology perspective in understanding variables that may influence and be influenced by youths’ reactions to terrorist events. Implications for research and clinical practice are discussed.",0,0 +6904,Validation of lay-administered mental health assessments in a large Army National Guard cohort,"To report the reliability and validity of key mental health assessments in an ongoing study of the Ohio Army National Guard (OHARNG). The 2616 OHARNG soldiers received hour-long structured telephone surveys including the post-traumatic stress disorder (PTSD) checklist (PCV-C) and Patient Health Questionnaire - 9 (PHQ-9). A subset (N = 500) participated in two hour clinical reappraisals, using the Clinician-Administered PTSD Scale (CAPS) and the Structured Clinical Interview for DSM (SCID). The telephone survey assessment for PTSD and for any depressive disorder were both highly specific [92% (standard error, SE 0.01), 83% (SE 0.02)] with moderate sensitivity [54% (SE 0.09), 51% (SE 0.05)]. Other psychopathologies assessed included alcohol abuse [sensitivity 40%, (SE 0.04) and specificity 80% (SE 0.02)] and alcohol dependence [sensitivity, 60% (SE 0.05) and specificity 81% (SE 0.02)].The baseline prevalence estimates from the telephone study suggest alcohol abuse and dependence may be higher in this sample than the general population. Validity and reliability statistics suggest specific, but moderately sensitive instruments.",0,0 +6905,"Relationships between sexual abuse in childhood, post-traumatic stress disorder (PTSD) and cognitive impairments","Current theoretical study shows relationships between sexual abuse during childhood, post-traumatic stress disorder (PTSD) and cognitive impairments. The cognitive perspective of sexual abuse effects and PTSD has been undertaken. Child sexual abuse against children is considered a risk factor in child development due to severe cognitive, emotional and behavioral sequences related to the event. The impact of sexual abuse involves short and long term effects and may be seen during adulthood. Review studies foreground the association between traumatic events (sexual abuse), PTSD, and alterations, structural and functional, in cerebral areas related to biological stress response systems. The necessity of future researches investigating the effects of stress and trauma in the child’s neurodevelopment will be discussed.",0,0 +6906,Challenges Faced by Former Child Soldiers in the Aftermath of War in Uganda,"

Abstract

Purpose

Warfare takes a profound toll of all layers of society, creating multiple and multilevel challenges that impinge on the psychosocial well-being of affected individuals. This study aims to assess the scope and salience of challenges confronting former child soldiers and at identifying additional challenges they face compared to non-recruited young people in war-affected northern Uganda.

Methods

The study was carried out with a stratified random sample of northern Ugandan adolescents (n = 1,008), of whom a third had formerly been recruited (n = 330). The mixed-method comparison design consisted of a constrained free listing task to determine the challenges; a free sorting task to categorize them into clusters; and statistical analysis of their prevalence among formerly recruited youth and of how they compare with those of nonrecruited youth.

Results

Altogether, 237 challenges were identified and clustered into 15 categories, showing that formerly recruited participants mainly identified ""emotional"" and ""training and skills""–related challenges. Compared with nonrecruited counterparts, they reported significantly more ""emotional"" and fewer ""social and relational"" challenges, with the exception of stigmatization. Overall, there was similarity between the challenges reported by both groups.

Conclusions

The challenges confronting formerly recruited youths reach well beyond the effects of direct war exposure and emerge mainly from multiple influence spheres surrounding them. These challenges are largely shared in common with nonrecruited youths. This multidimensional and collective character of challenges calls for comprehensive psychosocial interventions through which healing the psychological wounds of war is complemented by mending the war-affected surroundings at all levels and in all life areas.",0,0 +6907,Post-Traumatic Stress Symptoms and Post-Traumatic Growth: Evidence from a Longitudinal Study following an Earthquake Disaster,"The current longitudinal study aims to examine the bidirectional relationship between post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG).One hundred twenty-two adults in the most severely affected area were investigated by self-report questionnaires at 12 months and 18 months after the Wenchuan Earthquake occurred in China.The autoregressive cross-lagged structure equation analysis revealed that PTG at 12 months post-earthquake could negatively predict PTSS at 18 months post-earthquake above and beyond PTSS stability, whereas PTSS at 12 months post-earthquake could not significantly predict subsequent PTG. Moreover, PTG at 12 months post-earthquake could predict fewer subsequent intrusions, numbing and hyper-arousal symptoms but not avoidance symptoms.Growth can play a role in reducing long-term post-traumatic stress symptoms, and the implication of a positive perspective in post-trauma circumstance is discussed.",0,0 +6908,"Post-Homicide Reactions: Grief, Mourning and Post-Traumatic Stress Disorder following a Drunk Driving Fatality","This article examines the impact of gender, religious beliefs, subjective health status, individuals' past experience with death, social support, and time since the death on the extent of mourning, the extent of grieving, and Post-traumatic Stress Disorder (PTSD) symptomatology. It is proposed that the mode of death complicates the nature and course of bereavement after the death of a primary family member in a drunk driving collision. The unnecessary and violent nature of the death of drunk driving victims adds to the depth and extent of the psychological response to trauma. It is proposed that the models of grief utilized to conceptualize the grieving process are inadequate as a sole measure of the response of this type of death. Therefore, the inclusion of Post-traumatic Stress Disorder was provided for a more comprehensive understanding of this type of grief response. Survey data were collected on 171 primary family members of drunk driving victims (spouses, parents, siblings, or children) randomly selected from support groups and social service agencies throughout Texas. Results provide a greater understanding of the factor influencing the responses of the surviving family members after a drunk driving fatality and demonstrate that the grief and PTSD response share common predictors.",0,0 +6909,Guilt Among Ex-Prisoners of War,"The article explores guilt and its correlates among Israeli ex-prisoners of war (ex-POWs) of the 1973 Yom Kippur War (YKW; N = 119) and a matched group of veterans of the same war who were not held captive (N = 97). Results revealed that compared with controls, ex-POWs reported both more posttraumatic stress symptoms (PTSS) and more guilt, after adjusting for PTSS. Results also revealed a significant PTSS × Group interaction effect on guilt, wherein the association between PTSS and guilt was stronger among ex-POWs than among controls. Among ex-POWs, results showed that feelings of helplessness when falling captive, inwardly directed active coping, and a sense of loss of control during captivity contributed to the prediction of guilt. Support at homecoming made no contributions to variance, and circumstances of falling into captivity did not predict guilt. Results support the notion that guilt is a significant component of the psychological aftermath of war captivity, and highlight its correlates. Clinical...",0,0 +6910,Genetic and Environmental Influences on Posttrauma Adjustment in Children and Adolescents: The Role of Personality Constructs,"The prevalence of exposure to traumatic events in childhood and adolescence is high and is associated with a host of mental health difficulties. However, not all trauma-exposed youth develop mental health difficulties in the wake of trauma, suggesting that other factors, such as personality and genetic influences, may play a role in posttrauma adjustment. In the present article, we provide an overview of how personality factors influence posttrauma trajectories and how both personality and posttrauma adjustment may be influenced by genetic factors. We first review major personality constructs, with a focus on developmental and assessment considerations in trauma-exposed youth. Next, we provide a discussion of genetic influences on personality, exposure to traumatic events, and the development of mental health disorders following traumatic event exposure. Lastly, recommendations for future research are provided. © 2011",0,0 +6911,"Acute Stress Response and Posttraumatic Stress Disorder in Traffic Accident Victims: A One-Year Prospective, Follow-Up Study","OBJECTIVE: This study was designed to assess the natural course of posttraumatic symptoms formation, as well as the degree to which acute stress reactions predict later posttraumatic stress disorder (PTSD) in injured traffic accident victims. METHOD: A prospective, 1-year follow-up study was carried out on 74 injured traffic accident victims and a comparison group of 19 patients who were hospitalized for elective orthopedic surgery. Participants were interviewed within the first week following the accident, and follow-up interviews were performed 1, 3, 6, and 12 months after the accident. At 12 months, a structured clinical interview was administered to determine a formal DSM-III-R diagnosis of PTSD. RESULTS: Twenty-four (32%) of the 74 traffic accident victims, but none of the 19 comparison subjects, met DSM-III-R criteria for PTSD at 1 year. Traffic accident victims who developed PTSD had higher levels of premorbid and comorbid psychopathology. Levels of posttraumatic symptoms were significantly higher from the outset in the subjects who developed PTSD and worsened progressively over the first 3 months, in contrast to subjects without PTSD, who manifested gradual amelioration of symptoms during this time. Existence of posttraumatic symptoms immediately after the accident was a better predictor of later PTSD than was accident or injury severity. CONCLUSIONS: In this study, a significant portion of injured traffic accident victims manifested PTSD 1 year after the event. The development of PTSD at 1 year can be predicted as early as 1 week after the accident on the basis of the existence and severity of early PTSD-related symptoms. However, the first 3 months following the accident appear to be the critical period for the development of PTSD. (Am J Psychiatry 1999; 156:367–373)",0,0 +6912,Comparing posttraumatic stress disorder's symptom structure between deployed and nondeployed veterans.,"We tested two empirically validated 4-factor models of posttraumatic stress disorder (PTSD) symptoms using the PTSD Checklist: King, Leskin, King, and Weathers' (1998) model including reexperiencing, avoidance, emotional numbing, and hyperarousal factors, and Simms, Watson, and Doebbeling's (2002) model including reexperiencing, avoidance, dysphoria, and hyperarousal. Our aim was to determine which fit better in two groups of military veterans: peacekeepers previously deployed to a war zone (deployed group) and those trained for peacekeeping operations who were not deployed (nondeployed group). We compared the groups using multigroup confirmatory factor analysis. Adequate model fit was demonstrated among the nondeployed group, with no significant difference between King et al.'s (1998) model (separating avoidance and numbing) and Simms et al.'s (2002) similar model involving a dysphoria factor. A better fitting factor structure consistent with Simms et al.'s (2002) model was found in the deployed group. Comprehensive measurement invariance testing demonstrated significant differences between the deployed and nondeployed groups on all structural parameters, except observed variable intercepts (thus indicating similarities only in PTSD item severity). These findings add to researchers' understanding of PTSD's factor structure, given the revision of PTSD that will appear in the forthcoming 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2010)--namely, that the factor structure may be quite different between groups with and without exposure to major traumatic events.",0,0 +6913,Internal Verification and Corroboration of Traumatic Memories of Child Sexual Abuse,"ABSTRACT Based on clinical experience and review of the clinical and legal research literature, the author proposes that a cluster of several of six clinical findings is a potential indicator of internal corroboration that trauma occurred, especially that of child sexual abuse. These six clinical findings include: the presence of a high risk disorder or illness; post-traumatic stress disorder; age regression, flashbacks, abreactions or other re-experiencing of the trauma; repetitions, repetition compulsions or re-enactments; characteristics of the memories themselves; and other patterns, dynamics, and connections. The author welcomes the experience and feedback of clinicians who assist survivors of trauma, especially that of child sexual abuse.",0,0 +6914,Recovery from mild traumatic brain injury,"Fatigue is one of the most frequently reported symptoms after Mild Traumatic Brain Injury (MTBI). To date, systematic and comparative studies on fatigue after MTBI are scarce, and knowledge on causal mechanisms is lacking. To determine the severity of fatigue six months after MTBI and its relation to outcome. Furthermore, to test whether injury indices, such as Glasgow Coma Scale scores, are related to higher levels of fatigue. Postal questionnaires were sent to a consecutive group of patients with an MTBI and a minor-injury control group, aged 18–60, six months after injury. Fatigue severity was measured with the Checklist Individual Strength. Postconcussional symptoms and limitations in daily functioning were assessed using the Rivermead Post Concussion Questionnaire and the SF-36. A total of 299 out of 618 eligible (response rate 52%) MTBI patients and 287 out of 482 eligible (response rate 60%) minor-injury patients returned the questionnaire. Ninety-five MTBI patients (32%) and 35 control patients (12%) were severely fatigued. Severe fatigue was highly associated with the experience of other symptoms, limitations in physical and social functioning, and fatigue related problems like reduced activity. Of various trauma severity indices, nausea and headache experienced on the ED were significantly related to higher levels of fatigue at six months. In conclusion, one third of a large sample of MTBI patients experiences severe fatigue six months after injury, and this experience is associated with limitations in daily functioning. Our finding that acute symptoms and mechanism of injury rather than injury severity indices appear to be related to higher levels of fatigue warrants further investigation.",0,0 +6915,Panic disorder among Vietnamese refugees attending a psychiatric clinic: prevalence and subtypes,"This study surveys Vietnamese refugees attending two psychiatric clinics to determine both the prevalence of panic disorder (PD) as well as panic attack subtypes in those suffering PD. A culturally valid adaptation of the SCID-panic module (the Vietnamese Panic Disorder Survey or VPDS) was administered to 100 Vietnamese refugees attending two psychiatric clinics. Utilizing culturally sensitive panic probes, the VPDS provides information regarding both the presence of PD and panic attack subtypes during the month prior to interview. Of 100 patients surveyed, 50 (50%) currently suffered PD. Among the 50 patients suffering PD, the most common panic attack subtypes during the previous month were the following: ""orthostatic dizziness"" (74% of the 50 panic disorder patients [PDPs]), headache (50% of PDPs), wind-induced/temperature-shift-induced (24% of PDPs), effort-induced (18% of PDPs), gastro-intestinal (16% of PDPs), micturition-induced (8% of PDPs), out-of-the-blue palpitations (24% of PDPs), and out-of-the-blue shortness of breath (16% of PDPs). Five mechanisms are adduced to account for this high PD prevalence as well as the specific profile of subtypes: 1) a trauma-caused panic attack diathesis; 2) trauma-event cues; 3) ethnic differences in physiology; 4) catastrophic cognitions generated by cultural syndromes; and 5) a modification of Clark's spiral of panic.",0,0 +6916,Maladaptive cognitive appraisals mediate the evolution of posttraumatic stress reactions: A 6-month follow-up of child and adolescent assault and motor vehicle accident survivors.,"A prospective longitudinal follow-up study (n = 59) of child and adolescent survivors of physical assaults and motor vehicle accidents assessed whether cognitive processes predicted posttraumatic stress symptomatology (PTSS) at 6 months posttrauma in this age group. In particular, the study assessed whether maladaptive posttraumatic appraisals mediated the relationship between initial and later posttraumatic stress. Self-report measures of PTSS, maladaptive appraisals, and other cognitive processes, as well as structured interviews assessing for acute stress disorder and posttraumatic stress disorder (PTSD), were completed at 2-4 weeks and 6 months posttrauma. PTSS and PTSD at 6 months were associated with maladaptive appraisals and other cognitive processes but not demographic or objective trauma severity variables. Only maladaptive appraisals were found to associate with PTSS/PTSD after partialing out initial symptoms/diagnosis and to mediate between initial and later PTSS. It was argued that, on this basis, maladaptive appraisals are involved in the development and maintenance of PTSS over time, whereas other cognitive processes (e.g., subjective threat, memory processes) may have an effect only in the acute phase. The implications of this study for the treatment of PTSS in youths are discussed.",0,0 +6917,Ambulatory cardiovascular functioning in healthy postmenopausal women with victimization histories,"Criminal victimization is a prevalent stressor among women, with potentially long-lasting emotional consequences. The present study examined associations among severity of lifetime victimization, current posttraumatic stress disorder (PTSD) symptoms, and ambulatory blood pressure (ABP) and heart rate (AHR) levels and variability. Thirty-nine healthy post-menopausal women who endorsed a history of criminal victimization completed a measure of PTSD symptom severity and participated in an average of 18 h of ambulatory cardiovascular monitoring. PTSD symptom clusters were associated with AHR. Symptom clusters and lifetime victimization severity jointly predicted ABP, with ABP the highest among severely victimized women with high levels of current intrusions. Given the prevalence of criminal victimization, biopsychosocial research on women's cardiovascular disease risk may benefit from increased attention to this stressor and its psychological sequelae.",0,0 +6918,Couple adjustment and posttraumatic stress disorder symptoms in National Guard veterans of the Iraq war.,"Relationship adjustment and posttraumatic stress disorder (PTSD) symptoms were assessed across two time points in a sample of 313 married or partnered National Guard soldiers recently returned from combat duty in Iraq. Structural equation modeling using a four-factor model for PTSD found the latent variable dysphoria (reflecting generalized distress including aspects of emotional numbing and arousal) had the strongest independent contribution to predicting relationship adjustment at Time 1 and indirectly predicted poorer relationship adjustment at Time 2. Exploratory analysis of gender differences (n = 33 women; n = 280 men) suggested a different pattern of relations between PTSD factors and relationship adjustment among female soldiers at Time 1, with a trend toward trauma specific avoidance being more highly related to relationship adjustment. Clinical and research implications are discussed.",0,0 +6919,Racial differences in the physical and psychosocial health among black and white women with chronic pain.,"Gender-based differences in pain epidemiology, pain threshold, attitudes toward pain management, coping styles and social roles are well described, yet little is known about the chronic pain experience in women or the role race plays. A retrospective analysis of self-reported data using a secondary clinical database was performed to elucidate the relationship between race and pain severity, depression, physical disability, posttraumatic stress disorder (PTSD) as well as affective distress in women with chronic pain. White (n=1,088) and black (n=104) adult women were compared based on their responses to the McGill Pain Questionnaire, Beck Depression Inventory, Pain Disability Index, Posttraumatic Chronic Pain Test and items from the West-Haven Yale Multidisciplinary Pain Inventory. After accounting for sociodemographic, medical, psychological and physical confounders, there was no significant race effect for pain severity or affective distress. However, black women with chronic pain experience more physical impairments than white women with chronic pain (beta = 4.622; p<0.005). Except for the family/home responsibilities, similar differences were found on all PDI subscales. We also found that disability mediates the race-depression relationship such that black women are comparatively more vulnerable to depression as a result of higher disability. Due to the economic, social and emotional impact that disability has on women with chronic pain and their families, these findings have significant implications for chronic pain research as well as its management in black women.",0,0 +6920,Temporal pattern of cochlear nerve degeneration following compression injury: a quantitative experimental observation,"It has been empirically recognized that the cochlear nerve is highly vulnerable to traumatic stress resulting from surgical procedures; therefore, careful manipulation of the cochlear nerve is mandatory in preventing trauma-induced hearing loss during cerebellopontine angle (CPA) surgery. There is, however, no precise knowledge about the temporal pattern of cochlear nerve degeneration following trauma. This study was performed to determine the temporal pattern of injury that occurs after cochlear nerve trauma, knowledge of which is indispensable not only to neurosurgeons but also to all those who manage lesions involving the cochlear nerve.Right suboccipital craniectomies were performed in groups of rats with the aid of a surgical microscope, and the seventh and eighth cranial nerve trunks were identified at the internal auditory meatus. The cochlear nerve was quantifiably compressed while compound action potentials of the cochlear nerve were monitored and recorded. Following injury, one group of rats was killed for histological examination at the end of each week for 4 weeks. Data from this study disclosed that the degeneration of the compressed cochlear nerve progressed in a relatively rapid manner and was complete within 1 week after the insult. The main pathophysiological mechanisms responsible for cochlear neuronal death in this experimental setting appeared to be necrosis, and an apoptotic mechanism seemed to play a subsidiary role.Accurate knowledge about the temporal profile of trauma-induced cochlear nerve degeneration is closely linked with the problem of the therapeutic time window. The results of the present study indicated that any measures to ameliorate cochlear nerve degeneration following trauma should be started as early as possible (within 1 week) after an injury.",0,0 +6921,Cognitive-behavioural Group Intervention for PTSD Symptoms in Children Following the Athens 1999 Earthquake: A Pilot Study,"This study examined the effects of a short-term group cognitive-behavioural intervention in children who were experiencing PTSD symptoms following the Athens 1999 earthquake. Twenty children, aged 8-12 years, referred for treatment to a local child mental health team were assigned, depending on timing of referral to two groups - Group 1 ( N = 10), which started treatment 2 months after the earthquake and Group 2 ( N = 10), which started treatment at 4 months postearthquake. A statistically significant reduction in overall PTSD (Posttraumatic Stress Disorder) symptoms across the three PTSD symptom clusters - intrusion, avoidance, and arousal - as well as in depressive symptoms was reported immediately after the intervention. The treatment also produced a statistically significant improvement in children’s psychosocial functioning. Further significant improvement was reported in children at an 18-month follow-up. Treatment gains were maintained at a 4-year follow-up. Despite several limitations to this study, short-term group CBT (cognitive-behavioural therapy) was found to be a useful treatment approach, which can be offered in clinical settings, particularly if resources are limited.",0,0 +6922,Psychiatric Advanced Practice Nurses Contributions to Supporting Survivors and Caregivers Affected by the Boston Marathon Bombings,"The role of the psychiatric advanced practice nurse in promoting psychological health and resiliency for patients, their families and staff following the Boston Marathon bombings is reviewed.On April 15, 2013, 2 bombs exploded near the finish line at the Boston Marathon. Within minutes, 39 patients suffering from multiple injuries presented at a level I trauma center. The magnitude of this event and its effect on our hospital required a comprehensive response that would promote resiliency and healing.Lessons shared from responders to other tragedies were helpful in guiding our interprofessional efforts. The multiple layers of our response are reviewed to offer learnings that may inform others as they work to promote resiliency and healing following traumatic events.In response to this event, we utilized a trauma-informed care framework emphasizing physical, psychological, and emotional safety to assist staff, survivors, and families on their journey of healing.Emotional reactions were dramatic but were eased by the psychological care and education that our patients, their families, and staff received in the first days to weeks after the bombings.The psychiatric advanced practice nurse can influence positive outcomes by utilizing a trauma-informed care framework.",0,0 +6923,Differential symptom pattern of post-traumatic stress disorder (PTSD) in maltreated children with and without concurrent depression,"The present study attempted to examine specific differences in the Post-Traumatic Stress Disorder (PTSD) symptomatology among abused children with and without concurrent depression.PTSD and depressive symptoms were identified that discriminate between 98 children divided into three groups: (1) abused children with PTSD, (2) nonabused children who meet criteria for Major Depressive Disorder (MDD), and (3) abused children with both PTSD and MDD.Analyses revealed that nine items reflecting depressive symptomatology, primarily vegetative symptoms, differentiated the diagnostic groups (PTSD-only, MDD-only, and the combined group). A discriminant analysis revealed that the sum of responses to the nine significant items adequately predicted diagnostic classification for those with PTSD and depression, but did not correctly diagnose any in the combined group. Analyses also revealed that three post-trauma symptoms, including psychological amnesia, flashbacks/reenactments, and sleep difficulties, discriminated between the groups. The PTSD-only group reported more episodes of psychological amnesia while the PTSD and MDD group experienced more flashbacks.For the sample of abused children examined, these results illuminate differences with respect to PTSD symptom presentation for those children with PTSD who have a concurrent depressive disorder and their nondepressed counterparts. Children with PTSD who have a concurrent depression report greater levels of intrusive PTSD-related symptoms.",0,0 +6924,"Nepali Concepts of Psychological Trauma: The Role of Idioms of Distress, Ethnopsychology and Ethnophysiology in Alleviating Suffering and Preventing Stigma","In the aftermath of a decade-long Maoist civil war in Nepal and the recent relocation of thousands of Bhutanese refugees from Nepal to Western countries, there has been rapid growth of mental health and psychosocial support programs, including posttraumatic stress disorder treatment, for Nepalis and ethnic Nepali Bhutanese. This medical anthropology study describes the process of identifying Nepali idioms of distress and local ethnopsychology and ethnophysiology models that promote effective communication about psychological trauma in a manner that minimizes stigma for service users. Psychological trauma is shown to be a multifaceted concept that has no single linguistic corollary in the Nepali study population. Respondents articulated different categories of psychological trauma idioms in relation to impact on the heart-mind, brain-mind, body, spirit, and social status, with differences in perceived types of traumatic events, symptom sets, emotion clusters and vulnerability. Trauma survivors felt blamed for experiencing negative events, which were seen as karma transmitting past life sins or family member sins into personal loss. Some families were reluctant to seek care for psychological trauma because of the stigma of revealing this bad karma. In addition, idioms related to brain-mind dysfunction contributed to stigma, while heart-mind distress was a socially acceptable reason for seeking treatment. Different categories of trauma idioms support the need for multidisciplinary treatment with multiple points of service entry.",0,0 +6925,Post-traumatic stress disorder and alcohol use disorder,"Our clinical observations along with data in the literature have shown an increased incidence of alcohol use disorder in persons who suffer from post-traumatic stress disorder. In this work we examined alcohol use disorder in war veterans who were suffering from post-traumatic stress disorder (group 1) (n=52) and compared them with veterans who were traumatized but who had not developed a clinical picture of post-traumatic stress disorder (group 2) (n=29) and a sample from the general population (group 3) (n=30). The objective of this work was to establish the cluster symptoms of post-traumatic stress disorder that are related to alcohol use disorder and connected with depression. All of the respondents were males. The methods used were structured clinical interviews for the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders axis I disorders for addiction and post-traumatic stress disorder and Beck's scale for depression. The results obtained showed that there were no statistically significant differences in the incidence of alcohol use disorders between traumatized patients who had and those who had not developed post-traumatic stress disorder, but there was a significant statistical differencefor both groups 1 and 2 in relation to the control group. The variables that correlated positively with alcohol use disorder were the cluster symptoms of re-experiencing and the arousal symptom of the traumatized group and there was also increased depression in both groups examined (groups 1 and 2).",0,0 +6926,Mother–infant bonding impairment across the first 6 months postpartum: the primacy of psychopathology in women with childhood abuse and neglect histories,"Our goal was to examine the trajectory of bonding impairment across the first 6 months postpartum in the context of maternal risk, including maternal history of childhood abuse and neglect and postpartum psychopathology, and to test the association between self-reported bonding impairment and observed positive parenting behaviors. In a sample of women with childhood abuse and neglect histories (CA+, n = 97) and a healthy control comparison group (CA-, n = 53), participants completed questionnaires related to bonding with their infants at 6 weeks, 4 months, and 6 months postpartum and psychopathology at 6 months postpartum. In addition, during a 6-month postpartum home visit, mothers and infants participated in a dyadic play interaction subsequently coded for positive parenting behaviors by blinded coders. We found that all women, independent of risk status, increased in bonding with their infant over the first 6 months postpartum; however, women with postpartum psychopathology (depression and posttraumatic stress disorder [PTSD]) showed consistently greater bonding impairment scores at all timepoints. Moreover, we found that, at the 6-month assessment, bonding impairment and observed parenting behaviors were significantly associated. These results highlight the adverse effects of maternal postpartum depression and PTSD on mother-infant bonding in early postpartum in women with child abuse and neglect histories. These findings also shed light on the critical need for early detection and effective treatment of postpartum mental illness in order to prevent problematic parenting and the development of disturbed mother-infant relationships. Results support the use of the Postpartum Bonding Questionnaire as a tool to assess parenting quality by its demonstrated association with observed parenting behaviors.",0,0 +6927,"Validating female psychopathy subtypes: Differences in personality, antisocial and violent behavior, substance abuse, trauma, and mental health.","Recent empirical investigations utilizing male prisoners have begun to validate clinical conceptualizations of primary and secondary psychopathy subtypes. We extended this literature by identifying similar psychopathic subtypes in female prisoners on the basis of personality structure using model-based cluster analysis. Secondary psychopaths (n = 39) were characterized by personality traits of negative emotionality and low behavioral constraint, an early onset of antisocial and criminal behavior, greater substance use and abuse, more violent behavior and institutional misconduct, and more mental health problems, including symptoms of posttraumatic stress disorder and suicide attempts. Primary psychopaths (n = 31) exhibited few distinguishing personality features but were prolific criminals especially in regards to nonviolent crime, and exhibited relatively few mental health problems despite substantial exposure to traumatic events. The results support alternative etiological pathways to antisocial and criminal behavior that are evident in personality structure as well as gender similarities and differences in the manifestation of psychopathic personalities.",0,0 +6928,A study in contrasts: Inscriptions of posttraumatic stress disorder (PTSD) in two works of fiction,"This study investigates the depiction of Posttraumatic Stress Disorder (PTSD) in two works of fiction, The Bluest Eye, by Toni Morrison, and Ordinary People, by Judith Guest.In each text, the character struggling to mount a defense against the symptoms of PTSD is a child who must confront not only a single, precipitous event but also deleterious, ancillary conditions that threaten to impede the recovery process.This is a study in contrast that utilizes a comparative case analysis of two fictional characters.One child reconstructs an integrated self while the other deteriorates mentally and emotionally.These results suggest factors such as social supports, economic status, race and aesthetic self-image may play critical roles in a child's resiliency to the symptoms of PTSD.",0,0 +6929,Disparate prevalence estimates of PTSD among service members who served in Iraq and Afghanistan: Possible explanations,"The authors reviewed 29 studies that provide prevalence estimates of posttraumatic stress disorder (PTSD) among service members previously deployed to Operations Enduring and Iraqi Freedom and their non-U.S. military counterparts. Studies vary widely, particularly in their representativeness and the way PTSD is defined. Among previously deployed personnel not seeking treatment, most prevalence estimates range from 5 to 20%. Prevalence estimates are generally higher among those seeking treatment: As many as 50% of veterans seeking treatment screen positive for PTSD, though much fewer receive a PTSD diagnosis. Combat exposure is the only correlate consistently associated with PTSD. When evaluating PTSD prevalence estimates among this population, researchers and policymakers should carefully consider the method used to define PTSD and the population the study sample represents.",0,0 +6930,Do post-traumatic stress symptoms predict reactions of adaptation to disability after a sudden-onset spinal cord injury?,"Based on the perspective that post-traumatic stress disorder (PTSD) reflects a reaction of adaptation to trauma, the goal of this research was to examine the ability of PTSD symptom clusters (re-experiencing, avoidance, and hyperarousal) to predict eight reactions of adaptation to disability (shock, anxiety, denial, depression, internalized anger, externalized hostility, acknowledgment, and adjustment) among individuals with non-congenital spinal cord injuries. Individuals (all of whom attended either a specialized civilian or a veteran spinal cord injury clinic in Texas) completed two self-report questionnaires--the Reactions to Impairment and Disability Inventory (RIDI) and the Purdue Posttraumatic Stress Disorder Scale Revised (PPTSD-R). According to the statistical fit indices, five of the fit indices suggested that the revised model was a good fit to the data, whereas one fit index and the chi/df ratio indicated that the revised model fit the data poorly. The model provided information on the ability of PTSD clusters to predict reactions of adaptation, which suggested a specific pattern of vacillation of post-traumatic responses during the process of adaptation. These findings need replication before proposing interventions for post-traumatic stress responses after the onset of a spinal cord injury.",0,0 +6931,Elevated brain cannabinoid CB1 receptor availability in post-traumatic stress disorder: a positron emission tomography study,"Endocannabinoids and their attending cannabinoid type 1 (CB1) receptor have been implicated in animal models of post-traumatic stress disorder (PTSD). However, their specific role has not been studied in people with PTSD. Herein, we present an in vivo imaging study using positron emission tomography (PET) and the CB1-selective radioligand [(11)C]OMAR in individuals with PTSD, and healthy controls with lifetime histories of trauma (trauma-exposed controls (TC)) and those without such histories (healthy controls (HC)). Untreated individuals with PTSD (N=25) with non-combat trauma histories, and TC (N=12) and HC (N=23) participated in a magnetic resonance imaging scan and a resting PET scan with the CB1 receptor antagonist radiotracer [(11)C]OMAR, which measures the volume of distribution (VT) linearly related to CB1 receptor availability. Peripheral levels of anandamide, 2-arachidonoylglycerol, oleoylethanolamide, palmitoylethanolamide and cortisol were also assessed. In the PTSD group, relative to the HC and TC groups, we found elevated brain-wide [(11)C]OMAR VT values (F(2,53)=7.96, P=0.001; 19.5% and 14.5% higher, respectively), which were most pronounced in women (F(1,53)=5.52, P=0.023). Anandamide concentrations were reduced in the PTSD relative to the TC (53.1% lower) and HC (58.2% lower) groups. Cortisol levels were lower in the PTSD and TC groups relative to the HC group. Three biomarkers examined collectively--OMAR VT, anandamide and cortisol--correctly classified nearly 85% of PTSD cases. These results suggest that abnormal CB1 receptor-mediated anandamide signaling is implicated in the etiology of PTSD, and provide a promising neurobiological model to develop novel, evidence-based pharmacotherapies for this disorder.",0,0 +6932,Duration of Exposure and the Dose-Response Model of PTSD,A dose-response model underlies posttraumatic stress disorder (PTSD) and posits a relationship between event magnitude and clinical outcome. The present study examines whether one index of event magnitude—duration of exposure—contributes to risk of PTSD among female victims of sexual assault. Findings support a small but significant contribution of event duration to clinical status in the immediate aftermath of trauma but not at 3-month follow-up. The opposite pattern is obtained for subjective appraisals of threat. These findings add to a growing literature that suggests that a simple application of the dose-response model to objective event characteristics may be insufficient to explain the risk of PTSD.,0,0 +6933,Cortisol Level and Perinatal Outcome in Pregnant Women With Posttraumatic Stress Disorder: A Pilot Study,"Posttraumatic stress disorder (PTSD) affects 12% of women in the United States and could affect childbearing via behavioral and neuroendocrine mechanisms. This pilot study collected preliminary data about the extent to which the low cortisol profile found in patients with PTSD also occurs in the hormonal context of pregnancy, as well as the association between PTSD and less optimal processes and outcomes of pregnancy. Standardized psychiatric diagnostic telephone interviews, salivary cortisol assays, and medical records review were evaluated in a community sample of 25 women pregnant with their first child. Higher PTSD symptom counts correlated with worse overall perinatal outcomes summarized by an Optimality Index Score (n = 22; r = -.725; P < .001). The women whose symptoms met diagnostic criteria for PTSD or partial PTSD had lower peak basal salivary cortisol concentrations (n = 14; mean = .4584 versus .8123; P = .010). Further research on the effects of PTSD on pregnancy processes and outcomes is warranted. Differences in cortisol levels were consistent with the pattern seen in nonpregnant women with PTSD. This finding suggests that salivary cortisol would be a useful biological measure to include in perinatal research on PTSD and childbearing.",0,0 +6934,Problems in Statistical Analysis of Attrition in Randomized Controlled Clinical Trials of Antidepressant for Geriatric Depression,"Attrition from clinical trials is unavoidable in geriatric psychiatry and beyond. It results in incomplete data and consequently imposes three fundamental challenges: greater bias, reduced power, and less generalizability. In an effort to assess the extent of attrition and the relevance of statistical methods applied to analyze incomplete data in geriatric psychiatry, we reviewed 69 published antidepressant randomized clinical trials conducted since 1975. The median attrition rate estimated from these trials was 26.6%; nevertheless, we found that many trials lack data analytic strategies to address the problem of attrition. Most of the applied statistical analyses involved chi-square tests, t-tests, and analysis of variance (ANOVA), each of which assume that data are missing completely at random. Even when imputation for missing data due to attrition was attempted, only the last observation carried forward (LOCF) method was implemented. The LOCF imputation can actually increase bias of the results in the analysis of repeatedly measured outcomes. In addition, despite the longitudinal nature of repeatedly measured outcomes, the statistical methods used are for analysis of cross-sectional data. Thus, the data analytic strategies did not adequately meet the challenges arising from attrition. We encourage the use of mixed-effects models to reduce the impact of attrition on bias, power and generalizability in antidepressant RCTs for geriatric depression. For imputation, we recommend use of multiple imputation methods instead of LOCF.",0,0 +6935,Impact of comorbid depression on quality of life in male combat Veterans with posttraumatic stress disorder,"For Veterans with posttraumatic stress disorder (PTSD), depression is a highly comorbid condition. Both conditions have been associated with decreased quality of life, and research suggests that comorbid PTSD and depression may result in worse quality of life than PTSD alone. However, research is needed to elucidate the effect of comorbidity on a broader variety of quality of life domains. In this study, we used baseline data of 158 male combat Veterans taking part in a PTSD treatment trial and examined the unique relationships between quality of life domains and PTSD symptom clusters, major depressive disorder (MDD) diagnosis, and self-reported depressive symptoms. Veterans with comorbid PTSD-MDD reported significantly worse satisfaction-related quality of life than those with PTSD alone, although this finding was largely attributable to PTSD numbing symptoms. Subsequent analyses comparing the effect of numbing symptoms to depressive symptoms revealed that depression exerted a stronger influence, although numbing symptoms were still uniquely associated with quality of life. We discuss implications for treatment and research, as well as the need to address negative affect in Veterans with PTSD.",0,0 +6936,Integrating genomics and neuromarkers for the era of brain-related personalized medicine,"The harsh reality is that many medical treatments do not work as expected in a significant percentage of patients, and occasionally there are serious side effects. A new paradigm of personalized medicine is emerging, which proactively tailors treatment to each individual’s biological and psychological profile. The first proof-of-concept phase of personalized medicine has now been achieved. However, it has thus far focused on the use of genomic markers and on disorders of the body. The complexity of the brain is likely to require a shift from a single genetic marker focus to a more integrated approach in which additional brain-related information (neuromarkers) is taken into account. Codevelopment of genomic neuromarkers with new compounds in a personalized medicine approach will lead to increased drug R&D and treatment benefits. The emerging genomic neuromarker potential has begun to be incorporated into the template for the next version of the Diagnostic and Statistical Manual (DSM-V). The statistical power of large subject numbers in databases in general (and standardized databases in particular) provides an ideal source for elucidating the best genomic–neuromarker profiles (explaining most of the main-effects variance), which will empower a brain-related personalized medicine into mainstream clinical practice.",0,0 +6937,Post-traumatic stress disorder: a biopsychological perspective.,"This paper provides a critical review of the current explanatory models of the post-traumatic stress disorder (PTSD). Most of these models are incomplete and lack empirical confirmation. It is argued that unidimensional treatment modalities, derived from such models, fail to address the complex nature of the disorder and are likely to generate partial results. A broad hypothesis-testing approach, combining biological, psychological and psychosocial interventions, should be preferred in clinical practice. Rehabilitation should replace curative techniques and unrealistic goals in many cases.",0,0 +6938,[Analysis on factors affecting the severity of post-traumatic stress disorder in transferred casualty after Earthquake].,"OBJECTIVE: To investigated the related factors which affecting the severity degrees of post-traumatic stress disorder (PTSD) in transferred casualty after Wenchuan Earthquake. METHODS: Taking PTSD symptoms self-assessment scale (PCL-C) to involve 386 wounded who suffered 40 days after the earthquake disaster, from 11 hospitals and were transferred to Chongqing city. Multi-stage cluster sampling method was used. 354 valid questionnaires were recovered to explore the relevant factors affecting the severity on the symptoms of PTSD. RESULTS: This survey contains 354 subjects, with male 154 (43.6%), female 200 (56.4%), age 43.76 +/- 21.22, nation alities: Han people 236 (66.7%), Qiang people 114 (32.2%), others 4 (1.1%), and marriage status as unmarried 92 (26.1%), married 253 (71.7%), others 9 (2.2%). The wounded women PTSD have more serious symptoms than men, and there were differences between them in repeated and disturbing dreams of this stressful experience (t = 2.46, P = 0.014), a strong sense of psychological suffering annoyance (t = 2.02, P = 0.044), having difficulty concentrating (t = 2.04, P = 0.042), being super-alert (t = 2.465, P = 0.014) etc, also in the total scores (t = 2.489, P = 0.013) (P Language: zh",0,0 +6939,Etiologic factors in the development of posttraumatic stress disorder in children and adolescents,"Abstract This article presents an overview of the literature on potential etiological factors in the development of PTSD in children. An etiological model for PTSD is offered which generates hypotheses for identifying links between exposure to traumatic events and consequent symptoms, as well as testing relationships between exposure variables and other possible mediating factors. Three possible kinds of interaction between etiologic and mediating variables, leading to different levels of symptoms, are presented. Findings from 25 recent studies examining etiologic factors are considered to form an empirical basis for current knowledge about PTSD in children. Severity of trauma exposure and parental trauma-related distress have consistently produced positive correlations with PTSD symptoms. Length of time since trauma exposure is consistently negatively correlated with PTSD severity. Findings regarding relationships between PTSD risk, age and gender are inconsistent at this time. Other gaps in our current knowledge and understanding are identified, and implications for future clinical and research efforts are discussed.",0,0 +6940,The relationship between post traumatic stress disorder and post traumatic growth: gender differences in PTG and PTSD subgroups,"Purpose: This study investigated the post traumatic stress disorder (PTSD) and post traumatic growth (PTG) in 2,300 earthquake survivors 1 year after the 2008 Wenchuan earthquake. This study aimed to investigate the relationship between PTSD and PTG and also tested for the gender differences in PTSD and PTG subgroups. Methods: A stratification random sampling strategy and questionnaires were used to collect the data. The PTSD was assessed using the PTSD Check list-Civilian and the PTG was assessed using the Post traumatic growth inventory. 2,300 individuals were involved in the initial survey with 2,080 completing the final questionnaire, a response rate of 90.4 %. One-way ANOVA analyses were performed to investigate the gender differences in the PTSD and PTG subgroups. Results: One year following the earthquake, 40.1 and 51.1 % of survivors reported PTSD and PTG, respectively. A bivariate correlation analysis indicated that there was a positive association between PTG and PTSD. The PTG and PTSD variance analysis conducted on female and male subgroups suggested that women were more affected than men. Conclusions: Given the relatively high PTG prevalence, it was concluded that researchers need to pay more attention to the positive outcomes of an earthquake rather than just focusing on the negative effects. The surveys and analyses indicated that psychological intervention and care for the earthquake disaster survivors should focus more on females and older people, who tend to be more adversely affected. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0,0 +6941,Multiple Traumatic Experiences and the Development of Posttraumatic Stress Disorder,"This study assesses the differential and combined impacts of multiple lifetime stressors in the development and severity of posttraumatic stress disorder (PTSD) symptoms. One hundred and four clinical and 64 nonclinical participants were assessed for their exposure to four types of interpersonal trauma: physical and sexual abuse in childhood, lifetime community violence, and domestic violence in adulthood. PTSD symptomatology was assessed using the Los Angeles Symptom Checklist (LASC). Results indicated that exposure to lifetime multiple traumatic experiences was positively correlated with severity of PTSD symptoms. Clinical participants had experienced significantly more multiple traumas and had a higher rate of PTSD than the nonclinical participants. Results also suggested that adults who had experienced childhood sexual abuse were at higher risk for the development of PTSD related to interpersonal violence than adults who were not sexually abused as children.",0,0 +6942,Health in police officers: Role of risk factor clusters and police divisions,"Law enforcement is a stressful occupation associated with significant health problems. To date, most studies have focused on one specific factor or one domain of risk factors (e.g., organizational, personal). However, it is more likely that specific combinations of risk factors are differentially health relevant and further, depend on the area of police work.A self-selected group of officers from the criminal, community, and emergency division (N = 84) of a Swiss state police department answered questionnaires assessing personal and organizational risk factors as well as mental and physical health indicators.In general, few differences were observed across divisions in terms of risk factors or health indicators. Cluster analysis of all risk factors established a high-risk and a low-risk cluster with significant links to all mental health outcomes. Risk cluster-by-division interactions revealed that, in the high-risk cluster, Emergency officers reported fewer physical symptoms, while community officers reported more posttraumatic stress symptoms. Criminal officers in the high-risk cluster tended to perceived more stress. Finally, perceived stress did not mediate the relationship between risk clusters and posttraumatic stress symptoms.In summary, our results support the notion that police officers are a heterogeneous population in terms of processes linking risk factors and health indicators. This heterogeneity thereby appeared to be more dependent on personal factors and individuals' perception of their own work conditions than division-specific work environments. Our findings further suggest that stress-reduction interventions that do not target job-relevant sources of stress may only show limited effectiveness in reducing health risks associated with police work.",0,0 +6943,"Do cognitive models help in predicting the severity of posttraumatic stress disorder, phobia, and depression after motor vehicle accidents? A prospective longitudinal study.","The study investigated the power of theoretically derived cognitive variables to predict posttraumatic stress disorder (PTSD), travel phobia, and depression following injury in a motor vehicle accident (MVA). MVA survivors (N = 147) were assessed at the emergency department on the day of their accident and 2 weeks, 1 month, 3 months, and 6 months later. Diagnoses were established with the Structured Clinical Interview for DSM-IV. Predictors included initial symptom severities; variables established as predictors of PTSD in E. J. Ozer, S. R. Best, T. L. Lipsey, and D. S. Weiss's (2003) meta-analysis; and variables derived from cognitive models of PTSD, phobia, and depression. Results of nonparametric multiple regression analyses showed that the cognitive variables predicted subsequent PTSD and depression severities over and above what could be predicted from initial symptom levels. They also showed greater predictive power than the established predictors, although the latter showed similar effect sizes as in the meta-analysis. In addition, the predictors derived from cognitive models of PTSD and depression were disorder-specific. The results support the role of cognitive factors in the maintenance of emotional disorders following trauma.",0,0 +6944,Visual false memories in post-traumatic stress disorder (PTSD),"There is an ongoing debate whether or not patients with post-traumatic stress disorder (PTSD) are more prone to produce false memories. The present study investigated this question using a visual variant of the Deese-Roediger-McDermott (DRM) paradigm, additionally addressing underlying mechanisms of false memory production (e.g., depression, dissociation, emotional valence, arousal). The visual paradigm was administered to 48 traumatized individuals with (n=20) and without PTSD (n=28) and 28 non-traumatized controls. Groups did not differ with regard to memory performance and memory confidence. False memories were correlated with depression. We recommend that future studies employ trauma-related material to further explore memory aberrations in PTSD.",0,0 +6945,Relations among peritraumatic dissociation and posttraumatic stress: A meta-analysis,"A meta-analysis was performed on the empirical literature which addressed the relationship of peritraumatic dissociation to posttraumatic stress (PTS). Extensive literature searches were conducted to identify as many relevant studies as possible, and revealed 59 independent eligible studies. All studies were coded using a detailed code sheet that included effect measures, variables that indicated the methodological quality of the studies, and substantial variables that might theoretically affect the relationship between peritraumatic dissociation and PTS. A significant positive relation between peritraumatic dissociation and PTS was found. Differences in the methodological rigor between studies - time elapsed since peritraumatic dissociation, design, sample type, and study type - significantly and sufficiently explained the variability in effect sizes between studies. Theoretical variables did not explain such variability. Although results underline earlier findings, due to designs of the reviewed studies no conclusions could be drawn as to causal relations between peritraumatic dissociation and PTS.",0,0 +6946,Predicting post-traumatic symptoms in cardiac patients,"The purpose of this study was to identify correlates and predictors of the symptoms of post-traumatic stress disorder (PTSD) in a cohort of patients with myocardial infarction, while the patients were in hospital and 3 months after infarction.Longitudinal, consecutive referrals were used.From a possible 68 consecutive patients with a first myocardial infarction who completed questionnaires in hospital and survived to 3-month follow-up, 39 completed follow-up questionnaires.PTSD measures were taken in hospital and 3 months after discharge. Predictor variables were measures of mood taken in hospital and measures of the immediate cognitive and emotional reactions at the time of the infarct.Associations between the independent variables and PTSD symptoms were stronger at 3-month follow-up than while in hospital. At this time, the frequency of intrusive thoughts was predicted by the degree of fright at the time of the event (adjusted R(2) = 0.262; beta =.57; t = 3.30; P <.01) and positive affect scores (additional adjusted R(2) = 0.112; beta = -.37 t = -2.18; P <.05). The degree of physiologic arousal at the time of such flashbacks was predicted by levels of negative affect in hospital (adjusted R(2) = 0.174; beta =.46; t = 2.46; P <.05), which also predicted avoidance scores (adjusted R(2) = 0.203; beta =.48; t = 2.62; P <.05).Because many of the symptoms of PTSD are self-remitting, and intervening too early in the course of the disorder may exacerbate the disorder, it is important not to intervene too early or over-treat this disorder. Formal treatment may be useful if provided some months after discharge from hospital. If either secondary or primary care services are to treat myocardial infarction-related PTSD effectively, it is important to identify patients who are at risk for it. These data contribute to the development of a profile of patients at risk.",0,0 +6947,The somatic symptom paradox in DSM-IV anxiety disorders: suggestions for a clinical focus in psychophysiology,"Although DSM-IV criteria for anxiety disorders include physiological symptoms, these symptoms are evaluated exclusively by verbal report. The current review explores the background for this paradox and tries to demonstrate on theoretical and empirical grounds how it could be resolved, providing new insights about the role of psychophysiological measures in the clinic. The three-systems approach to evaluating anxiety argues that somatic measures as well as verbal and behavioral ones are indispensable. However, the low concordance between these domains of measurement impugns their reliability and validity. We argue that concordance can be improved by examining the relationship of variables less global than anxiety and by restriction to specific anxiety disorders. For example, recent evidence from our and other laboratories indicate a prominent role of self-reported and physiologically measured breathing irregularities in panic disorder. Nonetheless, even within a diagnosis, anxiety patients vary radically in which somatic variables are deviant. Thus, in clinical practice, individual profiles of psychological and physiological anxiety responses may be essential to indicate distinct therapeutic approaches and ways of tracking improvement. Laboratory provocations specific to certain anxiety disorders and advances in ambulatory monitoring vastly expand the scope of self-report and physiological measurement and will likely contribute to a refined assessment of anxiety disorders.",0,0 +6948,Family and Past History of Mental Illness as Predisposing Factors in Post-Traumatic Stress Disorder,"Family studies of post-traumatic stress disorder (PTSD) have given inconsistent results to date. Identifying predisposing factors in PTSD compared to anxiety disorders may help to clarify the classification of PTSD as a diagnostic entity.Retrospective case note study of 87 PTSD patients who participated in an RCT, and 51 PTSD patients and 87 agoraphobics treated routinely in outpatients.Compared to agoraphobics, PTSD patients had significantly less family history of anxiety disorder but not mental illness in general. They also had significantly less personal history of mental illness prior to the index episode.Trauma precipitated PTSD in subjects who had significantly fewer premorbid predisposing factors than did agoraphobics. Such factors may predispose agoraphobics to become psychiatrically ill after more minor trauma. Research is needed to systematically compare the events which precipitate PTSD as opposed to agoraphobia and other anxiety disorders.",0,0 +6949,Posttraumatic stress disorder in eating disorder patients: The roles of psychological distress and timing of trauma,"Exposure to traumatic events may be a risk factor for subsequent development of an eating disorder (ED). In a previous study, we showed that trauma exposure impacted symptom load in ED patients. We also saw an effect of trauma on general psychological distress. The aim of the present study was to investigate the association between Posttraumatic stress disorder (PTSD) and ED severity, to focus on the mediating role of psychological distress for the association, and to assess the role of timing of trauma in relation to emergence of ED. Participants were Swedish adult ED patients with a history of traumatic exposure (N=843, Mean age 27.2, 97.3% female). One fourth (24.1%) of the participants had a lifetime diagnosis of PTSD. PTSD had an impact on ED severity, but the impact was mediated by psychological distress. When stratifying the sample based on timing of trauma a significant effect was present only in those with trauma within a year of emergence of ED. The results suggest emotion regulation as a possible underlying factor of interest in future research.",0,0 +6950,Patterns and Predictors of Trajectories of Depression after an Urban Disaster,"To identify and understand the patterns and predictors of depressive symptom trajectories over time after mass traumatic events.Data were used from a prospective, representative sample of adult residents of the New York City metropolitan area (N=2,282) followed up across four survey waves between 2001 (after the September 11 attacks) and 2004. Semi-parametric group-based modeling was used to identify trajectories, as well as the time-fixed and time-varying predictors of distinct depressive trajectories.Five distinct trajectories of depression were characterized: minimal symptomatology at all time points (group 1, 39% of sample), mild delayed depression (group 2, 34% of sample), recovery (group 3, 6% of sample), severe delayed depression (group 4, 13% of sample), and chronic severe depression (group 5, 8% of sample). Among members of distinct trajectories, lower household income, exposure to ongoing stressors, and exposure to traumatic events were commonly associated with an increased number of depressive symptoms.Ongoing socioeconomic adversity appears to be centrally associated with a worse course of depression after exposure to traumatic events. Identifying distinct trajectories of depression and the preventable factors that are associated with them may facilitate the development of interventions that aim to promote better mental health.",0,0 +6951,"Neuropsychophysical optimization by REAC technology in the treatment of: sense of stress and confusion. Psychometric evaluation in a randomized, single blind, sham-controlled naturalistic study","Neuropsychophysical optimization by REAC technology in the treatment of: sense of stress and confusion. Psychometric evaluation in a randomized, single blind, sham-controlled naturalistic study Vania Fontani1, Lucia Aravagli1, Matteo Lotti Margotti2, Alessandro Castagna1, Piero Mannu1, Salvatore Rinaldi11Department of Neuro Psycho Physio Pathology, 2Department of Information Technology and Statistical Analysis, Rinaldi Fontani Institute, Florence, ItalyPurpose: The aim of this study is to investigate the effects of neuropsychophysical optimization (NPPO) protocol treatment by radioelectric asymmetric conveyer (REAC) technology in the management of sense of stress and confusion (SSC); an analysis of a single cluster of the psychological stress measure (PSM) test.Patients and methods: The PSM, a self-administered questionnaire, was used to measure psychological stress and SSC for a group of 888 subjects. Data were collected immediately prior to and following the 4-week REAC-NPPO treatment cycle.Results: This study demonstrates a significant reduction in scores measuring subjective perceptions of stress for subjects treated with one cycle of REAC-NPPO. At the end-point of the study, the number of treated subjects reporting symptoms of stress-related SSC on the PSM test was significantly reduced, whereas there was no difference in sham-treated subjects.Conclusion: One cycle of REAC-NPPO appears to reduce subjective perceptions of SSC measured by the PSM.Trial registration: This trial has been registered in the Australian New Zealand Clinical Trials Registry as ACTRN12607000497404.Keywords: stress disorders, adaptation disorders, REAC, NPPO",0,0 +6952,Increase of serum triiodothyronine concentration in soldiers with combat-related chronic post-traumatic stress disorder with or without alcohol dependence,"Background: Post-traumatic stress disorder (PTSD) is a relatively new psychiatric disorder with three clusters of symptoms: trauma re-experiencing, avoidance, and increased arousal. The condition develops after a person sees, is involved in, or hears of an extreme traumatic stressor such as war, torture, natural catastrophe, assault, rape, or serious accident. PTSD is also often comorbid with other psychiatric disorders, especially with alcohol dependence. Several hormonal alterations have been reported in veterans with combat-related PTSD, including elevations in certain thyroid hormones, e.g., total T3; however, previous studies have not controlled for alcohol dependence, a common comorbid psychiatric disorder in this population. Objective: The first aim of our study was to assess possible differences in basal serum levels of free triiodothyronine (FT3), total triiodothyronine (TT3), free thyroxine (FT4), total thyroxine (TT4), and thyroid stimulating hormone (TSH) in Croatian soldiers with combat-related chronic PTSD alone or comorbid with alcohol dependence and in healthy controls. The second purpose of the study was to determine any correlation between duration of combat activities, number of combat traumas, intensity and duration of PTSD symptoms, and serum levels of TT3, FT3, TT4, FT4, and TSH in this sample. Method: We analyzed basal serum FT3, TT3, FT4, TT4, and TSH concentrations in soldiers with combat-related chronic PTSD (N = 43), combat-related chronic PTSD comorbid with alcohol dependence (N = 41), and in healthy controls (N = 39) using a luminoimmunochemical assay. Results: Soldiers with chronic combat-related PTSD with or without comorbid alcohol addiction had significantly higher values of TT3 than the control group (F = 19.556, p < 0.01). There was a significant correlation between TT3 levels and number of traumatic events in both the PTSD group (r = 0.663, p < 0.01) and those with PTSD comorbid with alcohol dependence (r = 0.836, p < 0.01). There was also a significant correlation between TT3 levels and symptoms of increased arousal in both PTSD (r = 0.419, p < 0.01) and PTSD comorbid with alcohol dependence (r = 0.516, p < 0.01). Conclusion: Elevated concentrations of serum TT3 are associated with combat-related PTSD, regardless of its comorbidity with alcohol dependence, and also with the number of traumatic events and symptoms of increased arousal. Given that current pharmacotherapy for PTSD is inadequate, reduction of TT3 may be a new strategy for pharmacologic intervention that could contribute to more effective treatment of this disorder.",0,0 +6953,Complicated grief: implications for the treatment of post-traumatic stress disorder in couples,"Complicated grief has many interfaces with post-traumatic stress disorder (PTSD) including avoidance, flashbacks and shattered assumptions. Increasing use of cognitive behavioural therapy (CBT) models in grief work are drawing on lessons learned in PTSD treatment. However, models used in grief work, such as attachment, the Dual Process Model (Stroebe & Schut, 1999) and Psychosocial Transition Theory (Parkes, 1993), are less commonly applied to understanding and treating PTSD. This paper gives an overview of how these theories explain complicated grief and PTSD and considers implications they have on treatment of couples, based on literature review and clinical experience. Treatment implications include treating PTSD before traumatic grief, working with intra-couple coping style differences, promoting acceptance and forgiveness and taking a full attachment history.",0,0 +6954,A latent growth mixture modeling approach to PTSD symptoms in rape victims.,"The research literature has suggested that longitudinal changes in posttraumatic stress disorder (PTSD) could be adequately described in terms of one universal trajectory, with individual differences in baseline levels (intercept) and rate of change (slope) being negligible. However, not everyone who has experienced a trauma is diagnosed with PTSD, and symptom severity levels differ between individuals exposed to similar traumas. The current study employed the latent growth mixture modeling technique to test for multiple trajectories using data from a sample of Danish rape victims (N = 255). In addition, the analysis aimed to determine whether a number of explanatory variables could differentiate between the trajectories (age, acute stress disorder [ASD], and perceived social support). Results concluded the existence of two PTSD trajectories. ASD was found to be the only significant predictor of one trajectory characterized by high initial levels of PTSD symptomatology. The present findings confirmed the existence of multiple trajectories with regard to PTSD symptomatology in a way that may be useful to clinicians working with this population.",1,0 +6955,Vulnerability to PTSD: Psychosocial and Demographic Risk and Resilience Factors,"The risk of developing PTSD after a traumatic experience depends on several vulnerability factors that may be classified into three distinct categories—pre-traumatic, peri-traumatic, and posttraumatic. Accordingly, while attempting to draw the profile of the high-risk patient for PTSD, the following factors should be included, among others: The history of previous trauma, the history of previous psychiatric disorder, female gender, ethnic minority, high severity of initial posttraumatic symptoms (ASR), associated body injury, “high-risk” traumatic event (man-made trauma), and peri-traumatic dissociation. In contrast, various resilience factors may be protective and act to prevent the development of PTSD. Although resilience factors were generally not discussed in this chapter, future research should be designed to uncover resilience factors, in order to differentiate between high-risk and low-risk patients in order to identifying the patients at risk and to attempt to develop the strategies to prevent the development of PTSD. © Springer Science+Business Media New York 2015.",0,0 +6956,Murine model of repeated exposures to conspecific trained aggressors simulates features of post-traumatic stress disorder,"We evaluated repeated exposures of mice to a trained aggressor mouse as a model (adapted from ""social stress"" models of traumatic stress) for aspects of post-traumatic stress disorder (PTSD). Using a ""cage-within-cage resident-intruder"" protocol, subject C57BL/6J mice were exposed to aggressors for 6 h daily for 5 or 10 days. At one to three random times during each 6-h session, subjects were exposed directly to aggressor for 1 min or 10 bites, whichever came first. Behavioral, physiological, and histological changes associated with aggressor-exposure were assessed for up to 6 weeks. During aggressor exposure, subjects displayed less territorial behavior, gained weight, and increased body temperature. One day after the last aggressor exposure, inflammatory cardiac histopathologies were prevalent; after 10 days, only mild myocardial degeneration with fibrosis or fibroplasias was evident, while controls showed almost no cardiac abnormalities at any time. After 4 weeks, the medial prefrontal cortex of control mice showed increased dendritic spine density, but aggressor-exposed mice showed no increase. Behaviors affected by aggressor exposure were evaluated in a partition test wherein the subject mouse is separated from the aggressor by a fenestrated partition that permits sensory cues to pass but prevents direct physical interaction. For up to 4-6 weeks after the last aggressor exposure, subjects showed prolonged grooming, freezing, retarded locomotion and no tail rattling. PTSD and its co-morbidities are often consequent to repeated aggravated ""social"" assaults (e.g., combat) and manifest socially over time, suggesting the relevance of this repeated aggressor-exposure model to clinical aspects of PTSD.",0,0 +6957,Factors Affecting Exits From Homelessness Among Persons With Serious Mental Illness and Substance Use Disorders,"We sought to understand the housing trajectories of homeless consumers with serious mental illness (SMI) and co-occurring substance use disorders (SUD) and to identify factors that best predicted achievement of independent housing.Using administrative data, we identified homeless persons with SMI and SUD admitted to a residential rehabilitation program from December 2008 to November 2011. Our primary outcome measure was independent housing status. On a random sample (N = 36), we assessed a range of potential predictors of housing outcomes, including symptoms, cognition, and social/community supports. We used the Residential Time-Line Follow-Back (TLFB) Inventory to gather housing histories since exiting rehabilitation and to identify housing outcomes. We used Recursive Partitioning (RP) to identify variables that best differentiated participants by these outcomes.We identified 3 housing trajectories: stable housing (n = 14), unstable housing (n = 15), and continuously engaged in housing services (n = 7). In RP analysis, 2 variables (Symbol Digit Modalities Test [SDMT], a neurocognitive speed of processing measure, and Behavior and Symptom Identification Scale [BASIS-24] Relationships subscale, which quantifies symptoms affecting relationships) were sufficient to capture information provided by 26 predictors to classify participants by housing outcome. Participants predicted to continuously engage in services had impaired processing speeds (SDMT score < 32.5). Among consumers with SDMT score ≥ 32.5, those predicted to achieve stable housing had fewer interpersonal symptoms (BASIS-24 Relationships subscale score < 0.81) than those predicted to have unstable housing. This model explains 57% of this sample's variability and 14% of this population's variability in housing outcomes.Because cognition and symptoms influencing relationships predicted housing outcomes for homeless adults with SMI and SUD, cognitive and social skills training may be useful for this population.",0,0 +6958,Exposure to War Crimes and Implications for Peace Building in Northern Uganda,"Since the late 1980s, the Lord's Resistance Army has waged war against the Ugandan People's Democratic Army and the people of northern Uganda. Ending the conflict and achieving peace have proven to be challenges. In this context, it is important to examine population-based data on exposure to war crimes to understand how survivors perceive mechanisms aimed at achieving a lasting peace.To assess the level of exposure to war-related violence and the prevalence of posttraumatic stress disorder (PTSD) and depression symptoms in northern Uganda and to determine how these variables are associated with respondents' views about peace.Multistage, stratified, random cluster survey of 2585 adults aged 18 years or older conducted in villages and camps for internally displaced persons in 4 districts of northern Uganda in April and May 2005.Rates and patterns of exposure to trauma; symptom criteria for PTSD, assessed via the PTSD Checklist-Civilian Version with a total severity score of 44; symptoms of depression, assessed via the Johns Hopkins Depression Symptom Checklist with a cutoff of 42; and opinions and attitudes about peace.Among the respondents, 1774 of 2389 (74.3%) met PTSD symptom criteria and 1151 of 2585 (44.5%) met depression symptom criteria. Four patterns of exposure to trauma were distinguished: those with low exposure (group 1; 21.4%), witnesses to war-related violence (group 2; 17.8%), those threatened with death and/or physically injured (group 3; 16.4%), and those abducted (group 4; 44.3%). Respondents in groups 3 and 4, who experienced the most traumatic exposures, were more likely to have PTSD symptoms compared with group 1 (group 3 vs group 1: odds ratio [OR], 7.04 [95% confidence interval {CI}, 5.02-9.87]; group 4 vs group 1: OR, 6.07 [95% CI, 4.77-7.71]). Groups 3 and 4 were also more likely to meet depression symptom criteria (group 3 vs group 1: OR, 5.76 [95% CI, 4.34-7.65]; group 4 vs group 1: OR, 4.00 [95% CI, 3.16-5.06]). Respondents who met the PTSD symptom criteria were more likely to identify violence as a means to achieve peace (OR, 1.31; 95% CI, 1.05-1.65). Respondents who met the depression symptom criteria were less likely to identify nonviolence as a means to achieve peace (OR, 0.77; 95% CI, 0.65-0.93).Our study found high prevalence rates for symptoms of PTSD and depression in a conflict zone. Respondents reporting symptoms of PTSD and depression were more likely to favor violent over nonviolent means to end the conflict.",0,0 +6959,Dimensional structure and prospective evolution of posttraumatic stress symptomatology in World Trade Center responders,"Background: Posttraumatic stress disorder (PTSD) is an anxiety disorder characterized by heterogeneous clusters of re-experiencing, avoidance, numbing, and hyperarousal symptoms. A large body of confirmatory factor analytic (CFA) studies has demonstrated that four-factor dysphoria and emotional numbing models provide a better representation of PTSD symptom dimensionality compared to the three-factor DSM-IV model. Recently, CFA studies of various trauma-exposed samples have found that a novel five-factor model, which separates the DSM-IV hyperarousal symptom cluster into distinct dysphoric and anxious arousal clusters, provides a superior representation of PTSD symptom dimensionality. To date, however, no study of which we are aware has evaluated the best dimensional representation of PTSD symptoms in World Trade Center (WTC) responders, or how symptom clusters from this model are prospectively related. Methods: Confirmatory factor analyses (CFAs) were used to examine the factor structure of the PTSD Checklist in a cohort of 10,835 WTC responders, including 4,035 police responders and 6,800 non-traditional responders, who were evaluated an average of 3, 6, and 8 years after the WTC attacks. An autoregressive cross-lagged panel regression analysis was then conducted to evaluate interrelationships among PTSD symptom clusters over time. Results: CFAs revealed that a five-factor model comprised of intercorrelated clusters of re-experiencing, avoidance, emotional numbing, dysphoric arousal, and anxious arousal symptoms provided the best representation of PTSD symptoms in police and non-traditional WTC responders. In police responders, anxious arousal symptoms were most strongly prospectively linked to reexperiencing symptoms, and dysphoric arousal to numbing symptoms in the intermediate-term, while re-experiencing symptoms predominantly drove numbing symptoms in the long-term. In non-traditional responders, anxious arousal symptoms were most strongly prospectively linked to re-experiencing symptoms, while dysphoric arousal symptoms predominantly drove numbing symptoms over time. In both groups of responders, avoidance symptoms drove re-experiencing symptoms over time. Conclusions: A novel 5-factor model comprised of re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal symptoms best represented PTSD symptomatology in both traditional and non-traditional disaster responders. Prospective interrelationships among these symptom clusters suggest that targeting hyperarousal and avoidance symptoms early after disaster exposure may help reduce later symptoms of re-experiencing and numbing in disaster responders.",0,0 +6960,"It's all my fault: A mediational model of shame, guilt, posttraumatic stress disorder and depression in a sample of battered women","Feelings of shame and guilt have received increased attention in mental health research. Women who are victims of Intimate Partner Violence (IPV) experience a wide array of emotions and stigma associated with their status, which may impact their physical and mental health. A fairly common response to traumatic events such as IPV is for the victim to blame herself and experience feelings of responsibility, shame, and guilt. The current study examined the relationships between trauma-related factors, the social/emotional factors of shame and guilt, and symptoms of Posttraumatic Stress Disorder (PTSD), depression, and the comorbid condition in a sample of 137 battered women residing in domestic violence shelters. It was suggested that shame would be a predictor and mediator for depression, as both constructs are related to self-evaluation. Guilt was suggested as a predictor and mediator for PTSD, as both of these constructs are related to events or behaviors. Shame was found to be a significant mediator in the relationship between trauma-related factors and symptoms of depression. A combined shame and guilt score was found to significantly mediate comorbid symptoms. Guilt alone failed to demonstrate significant mediation of PTSD symptoms. Predictive models using trauma-related factors along with shame and guilt were found to account for a significant amount of variance in mental health symptoms. This research supports the importance shame and guilt, particularly in combination, and their contribution to mental health in female IPV victims. Future research on the interrelationships and distinction between shame and guilt as they impact psychopathology are needed, as well as refinements to these and other predictive models for use in early detection, treatment, and potentially prevention of mental health problems following IPV victimization. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6961,An Investigation of Malingering Posttraumatic Stress Disorder on the Personality Assessment Inventory,"Utilizing the Personality Assessment Inventory (PAI; Morey, 1991), this study aimed to isolate a pattern of responding that is indicative of an attempt to malinger posttraumatic stress disorder (PTSD). The PAI profiles of 116 male participants were examined. Profiles of a group of 29 alcohol-abusing veterans with a primary Axis I (American Psychiatric Association, 1994) diagnosis of PTSD and a group of 30 alcohol-abusing veterans with no other diagnoses were compared to those of 27 undergraduate men instructed to feign PTSD. Control data were obtained from another group of 30 undergraduates. The student malingerers produced PAI profiles that were significantly different from the veterans with PTSD. Seven scales distinguished the malingerers from the veterans with an actual diagnosis of PTSD. Malingerers tended to overexaggerate pathology, inflating their scores on many clinical scales greater than the mean of the PTSD sample. Malingerers also scored higher on Morey's (1993) 8-item Malingering Index than either group of veterans and the controls. Only 2 scales reliably differentiated alcohol-abusing veterans with PTSD from those without the disorder. The implications of these findings in the diagnosis of PTSD are discussed.",0,0 +6962,Menstrual cycle and sex affect hemodynamic responses to combined orthostatic and heat stress,"Women have decreased orthostatic tolerance compared with men, and anecdotal evidence suggests women are more susceptible to orthostatic intolerance in warm environments. Because estrogen and progesterone affect numerous physiological variables that may alter orthostatic tolerance, the purpose of our study was to compare orthostatic tolerance across the menstrual cycle phases in women during combined orthostatic and heat stress and to compare these data with those of men. Eight normally menstruating women and eight males (22 +/- 4.0 and 23 +/- 3.5 yr, respectively) completed the protocol. Women were studied during their early follicular (EF), ovulatory (OV), and midluteal (ML) phases. Men were studied twice within 2-4 wk. Heart rate, cardiac output, blood pressure, core temperature (T(c)), and cutaneous vascular conductance (CVC) were measured during three head-up tilt tests, consisting of two tilts in the thermoneutral condition and one tilt after a 0.5 degrees C rise in T(c). There was no difference in orthostatic tolerance across the menstrual cycle phases, despite higher CVC in the ML phase after heating (EF, 42.3 +/- 4.8; OV, 40.1 +/- 3.7; ML, 57.5 +/- 4.5; P < 0.05). Orthostatic tolerance in the heat was greater in men than women (P < 0.05). These data suggest that although many physiological variables associated with blood pressure regulation fluctuate during the menstrual cycle, orthostatic tolerance in the heat remains unchanged. Additionally, our data support a clear sex difference in orthostatic tolerance and extend upon previous data to show that the sex difference in the heat is not attributable to fluctuating hormone profiles during the menstrual cycle.",0,0 +6963,Post-traumatic stress disorder among patients with orofacial pain.,"To examine the presence and impact of post-traumatic stress disorder (PTSD) in a sample of patients seeking treatment for orofacial pain.One hundred forty-one consecutive patients with an array of orofacial pain conditions were screened using a structured clinical interview for PTSD and the PTSD Symptom Checklist--Civilian Version (PCL), a brief PTSD self-report inventory. Additionally, participants received a clinical examination and self-report questionnaires to assess pain, coping styles, and presence of post-traumatic symptoms.Thirty-three (23%) patients received a full lifetime or current PTSD diagnosis, with an additional 11 patients receiving a partial PTSD diagnosis. Only 5 of these 44 patients had ever been previously diagnosed with PTSD. PTSD symptoms were associated with higher pain scores (P < .05) and affective distress (P < .01). Furthermore, discriminant function analyses suggested that the PCL accurately classified 89% of these cases (sensitivity = .85, specificity = .90, positive predictive power = 74%, negative predictive power = 95%).These results suggest that PTSD is prevalent in the orofacial pain setting and that PTSD symptomatology is associated with increased pain and affective distress that may complicate clinical presentation. Furthermore, PTSD can be accurately and efficiently assessed using a brief, self-report inventory.",0,0 +6964,The Experience of Disaster:,,0,0 +6965,Posttraumatic Stress in the Aftermath of Mass Shootings,"Recent mass shooting incidents in the USA include the 2007 shooting at Virginia Tech and the 2012 shootings at the Aurora, Colorado movie theatre and Sandy Hook elementary school in Newtown, Connecticut. Although these events generated much national attention, surprisingly, little research has evaluated mental health impacts of mass shootings, and no efforts to our knowledge have been made to synthesize the empirical findings. In this chapter, we review the extant literature on posttraumatic stress in the aftermath mass shootings. We identified 35 peer-reviewed articles, comprised of 19 independent samples in the aftermath of 14 mass shooting incidents. The prevalence of posttraumatic stress disorder in these studies ranged from 3 to 91 %. Several factors could underlie this wide variation, including differences in the assessment measures, criteria used to define cases, timing of assessment, and sample characteristics. Risk factors for more severe posttraumatic stress symptoms have been identified, including demographic and pre-incident characteristics (e.g., female gender, pre-incident psychological symptoms), event exposure (e.g., greater proximity to the attack, acquaintance with the deceased), and fewer psychosocial resources (e.g., emotion regulation difficulties, lower social support). Further research that draws on pre-incident and longitudinal data will yield important insights into the processes that exacerbate or sustain posttraumatic stress over time and provide important information for crisis preparedness and post-incident mental health interventions.",0,0 +6966,Hypohydration and acute thermal stress affect mood state but not cognition or dynamic postural balance,"Equivocal findings have been reported in the few studies that examined the impact of ambient temperature (T a) and hypohydration on cognition and dynamic balance. The purpose of this study was to determine the impact of acute exposure to a range of ambient temperatures (T a 10-40 C) in euhydration (EUH) and hypohydration (HYP) states on cognition, mood and dynamic balance. Thirty-two men (age 22 ± 4 years, height 1.80 ± 0.05 m, body mass 85.4 ± 10.8 kg) were grouped into four matched cohorts (n = 8), and tested in one of the four T a (10, 20, 30, 40 C) when EUH and HYP (-4 % body mass via exercise-heat exposure). Cognition was assessed using psychomotor vigilance, 4-choice reaction time, matching to sample, and grammatical reasoning. Mood was evaluated by profile of mood states and dynamic postural balance was tested using a Biodex Balance System. Thermal sensation (TS), core (T core) and skin temperature (T sk) were obtained throughout testing. Volunteers lost -4.1 ± 0.4 % body mass during HYP. T sk and TS increased with increasing T a, with no effect of hydration. Cognitive performance was not altered by HYP or thermal stress. Total mood disturbance (TMD), fatigue, confusion, anger, and depression increased during HYP at all T a. Dynamic balance was unaffected by HYP, but 10 C exposure impaired balance compared to all other T a. Despite an increase in TMD during HYP, cognitive function was maintained in all testing environments, demonstrating cognitive resiliency in response to body fluid deficits. Dynamic postural stability at 10 C appeared to be hampered by low-grade shivering, but was otherwise maintained during HYP and thermal stress. © 2012 Springer-Verlag Berlin Heidelberg (outside the USA).",0,0 +6967,Toll-like receptor expression and function in type I bipolar disorder,"Bipolar disorder (BD) has been associated with immune imbalance and low-grade inflammation. The underlying mechanisms remain largely obscure but may involve changes in cell signaling. Toll-like receptors (TLRs) are widely expressed by immune cells. Specific binding of TLRs to pathogen- or danger-associated signals leads to inflammatory responses. Here, we analyzed the frequencies of TLR-1, TLR-2, TLR-4, TLR-5 and TLR-6 in monocytes, regulatory T cells (Tregs) and activated T cells from type I BD euthymic patients and healthy controls (HCs). Monocytes were stimulated in vitro with specific TLR agonists (flagellin, LPS, LTA, BLP and PGN) and immunophenotyped. Cytokines (IL-8, IL-1beta, IL-6, IL-10, TNF-alpha and IL-12p70) were assessed with cytometric bead arrays. At baseline, increased percentages of TLR-1+ and TLR-2+ monocytes and reduced expression of TLR-5 were observed in BD. Following stimulation, the percentage of TLR-1+, TLR-2+, and TLR-6+ monocytes was higher in BD subjects than in HCs. Increased levels of IL-8, IL-12p70 and TNF were observed following stimulation with TLR-1, TLR-2 and TLR-6 agonists, suggesting increased signaling via these receptors in BD. In contrast to HCs, BD patients exhibited no changes in TLR-5 expression following stimulation. The percentage of TLR-2+ Treg cells as well as activated T cells expressing both TLR-2 and TLR-5 increased in BD patients. Given the importance of TLRs in triggering immune responses, our data indicate a role for these receptors in the low-grade inflammatory profile documented in BD.",0,0 +6968,A developmental psychopathology model of childhood traumatic stress and intersection with anxiety disorders,"

Abstract

Empirical findings regarding childhood traumatic stress are placed within a developmental life-trajectory model that incorporates a tripartite etiology of posttrauma distress. This approach recognizes an intricate matrix of child-intrinsic factors, developmental maturation and experience, life events, and evolving family and social ecologies. Of central developmental importance in the field of traumatic stress is the ontogenesis of appraisal, emotional response, emotional and physiological regulation, and consideration of protective action with regard to danger. The complexity of traumatic situations and their aftermath suggests the relevance of multiple stress diatheses in understanding individual variability in proximal and distal effects. Neurobiological systems that subserve danger mature over childhood and adolescence. Neurophysiological and neurohormonal studies among traumatized children and adolescents suggest potential neurodevelopmental stage-related vulnerabilities within these systems. Advances in child development and traumatic stress provide tools for investigating proximal and distal interplay of psychopathology, disturbances in the acquisition and maintenance of developmental competencies, and life-trajectory outcomes. A developmental psychopathology model suggests different avenues by which dangerous circumstances, childhood traumatic experiences, and posttraumatic stress disorder (PTSD) can intersect with other anxiety disorders over the life span.",0,0 +6969,"Prevalence and predictors of mental disorders among women in Sanliurfa, Southeastern Turkey","Mental health is one of the most important public health issues because of major contributor to the global burden of disease. In this study, we examined the prevalence and predictors of mental disorders among married women from 15 to 49 years of age and the need for mental health services in the primary health care settings.In this cross-sectional study, 270 women were selected using probability cluster sampling method at 95% confidence interval (91.5% response rate). The Structured Clinical Interview for DSM-IV (SCID-I) and women socio-demographic information form were used to collect data.Although the prevalence of mental disorder was 25.9% (8.5% with one diagnosis; 17.4% were two or more diagnoses), 4.7% of these women had contacted a carer in the last year for psychological reasons. According to the SCID-I assessment, the most prevalent diagnoses were major depressive disorder (7.3%), phobic disorder (4.8%) and posttraumatic stress disorder (3.6%). In this study, comorbid diagnoses were present in 67.2% of patients. Logistic regression analyses revealed that domestic violence, history of previous trauma, anemia and cutaneous leishmaniasis were significant predictors of any mental disorders (P < 0.05).These findings highlight the need for systematic development of community-based mental health services in conjunction with primary health care services for the screening, early identification and treatment of women suffering from mental disorders, and the improvement of anemia and cutaneous leishmaniasis control programme.",0,0 +6970,Post-traumatic stress disorder and depression prevalence and associated risk factors among local disaster relief and reconstruction workers fourteen months after the Great East Japan Earthquake: a cross-sectional study,"Many local workers have been involved in rescue and reconstruction duties since the Great East Japan Earthquake (GEJE) on March 11, 2011. These workers continuously confront diverse stressors as both survivors and relief and reconstruction workers. However, little is known about the psychological sequelae among these workers. Thus, we assessed the prevalence of and personal/workplace risk factors for probable post-traumatic stress disorder (PTSD), probable depression, and high general psychological distress in this population.Participants (N = 1294; overall response rate, 82.9%) were workers (firefighters, n = 327; local municipality workers, n = 610; hospital medical workers, n = 357) in coastal areas of Miyagi prefecture. The study was cross-sectional and conducted 14 months after the GEJE using a self-administered questionnaire which included the PTSD Checklist-Specific Version, the Patient Health Questionnaire-9, and the K6 scale. Significant risk factors from bivariate analysis, such as displacement, dead or missing family member(s), near-death experience, disaster related work, lack of communication, and lack of rest were considered potential factors in probable PTSD, probable depression, and high general psychological distress, and were entered into the multivariable logistic regression model.The prevalence of probable PTSD, probable depression, and high general psychological distress was higher among municipality (6.6%, 15.9%, and 14.9%, respectively) and medical (6.6%, 14.3%, and 14.5%, respectively) workers than among firefighters (1.6%, 3.8%, and 2.6%, respectively). Lack of rest was associated with increased risk of PTSD and depression in municipality and medical workers; lack of communication was linked to increased PTSD risk in medical workers and depression in municipality and medical workers; and involvement in disaster-related work was associated with increased PTSD and depression risk in municipality workers.The present results indicate that at 14 months after the GEJE, mental health consequences differed between occupations. High preparedness, early mental health interventions, and the return of ordinary working conditions might have contributed to the relative mental health resilience of the firefighters. Unlike the direct effects of disasters, workplace risk factors can be modified after disasters; thus, we should develop countermeasures to improve the working conditions of local disaster relief and reconstruction workers.",0,0 +6971,Emotional disorders: Cluster 4 of the proposed meta-structure for DSM-V and ICD-11,"Background The extant major psychiatric classifications DSM-IV, and ICD-10, are atheoretical and largely descriptive. Although this achieves good reliability, the validity of a medical diagnosis would be greatly enhanced by an understanding of risk factors and clinical manifestations. In an effort to group mental disorders on the basis of aetiology, five clusters have been proposed. This paper considers the validity of the fourth cluster, emotional disorders, within that proposal. Method We reviewed the literature in relation to 11 validating criteria proposed by a Study Group of the DSM-V Task Force, as applied to the cluster of emotional disorders. Results An emotional cluster of disorders identified using the 11 validators is feasible. Negative affectivity is the defining feature of the emotional cluster. Although there are differences between disorders in the remaining validating criteria, there are similarities that support the feasibility of an emotional cluster. Strong intra-cluster co-morbidity may reflect the action of common risk factors and also shared higher-order symptom dimensions in these emotional disorders. Conclusion Emotional disorders meet many of the salient criteria proposed by the Study Group of the DSM-V Task Force to suggest a classification cluster.",0,0 +6972,A 50-year prospective study of the psychological sequelae of World War II combat,"The authors took advantage of a 50-year prospective study of World War II veterans to examine the predictors and correlates of combat exposure, symptoms of posttraumatic stress disorder (PTSD), and trait neuroticism.The subjects were 107 veterans who had been extensively studied before and immediately after serving overseas in World War II. All served as members of the study until the present time, and 91 completed questionnaires of both PTSD symptoms and neuroticism.In this study group, variables associated with positive psychosocial health in adolescence and at age 65 predicted combat exposure. Combat exposure and number of physiological symptoms during combat stress--but not during civilian stress--predicted symptoms of PTSD in 1946 and 1988. Combat exposure also predicted early death and study attrition. Psychosocial vulnerability in adolescence and at age 65 and physiological symptoms during civilian stress--but not during combat stress--predicted trait neuroticism at age 65.Combat exposure predicted symptoms of PTSD but not nonspecific measures of psychopathology. Premorbid vulnerability predicted subsequent psychopathology but not symptoms of PTSD.",0,0 +6973,Estimating post-traumatic stress disorder in the community: lifetime perspective and the impact of typical traumatic events – Corrigendum,"Reports an error in ""Estimating post-traumatic stress disorder in the community: Lifetime perspective and the impact of typical traumatic events"" by N. Breslau, E.L. Peterson, L.M. Poisson, L.R. Schultz and V.C. Lucia (Psychological Medicine, 2004[Jul], Vol 34[5], 889-898). There was an error in the first sentence of the 'Data analysis' section on page 891. The correct version of the sentence is present in the erratum. (The following abstract of the original article appeared in record 2004-17343-013). Community surveys have assessed post-traumatic stress disorder (PTSD) in relation to traumatic events designated by respondents as the worst they have ever experienced. An assessment of PTSD in relation to all reported traumas would impose too great a burden on respondents, a considerable proportion of whom report multiple traumas. The 'worst event' method is efficient for identifying persons with PTSD, but may overestimate the conditional probability of PTSD associated with the entire range of PTSD-level traumas. In this report, we evaluate this potential bias. The Detroit Area Survey of Trauma (n = 2181) estimated the PTSD risk from two samples of traumas: (1) a representative sample of traumas formed by selecting a random trauma from each respondent's list of traumas; and (2) traumas designated by respondents as the worst (the standard method). Results showed that both estimation methods converged on key findings, including identifying trauma types with the highest probability of PTSD and sex differences in the risk of PTSD. Compared to the random events, the 'worst event' method yielded a moderately higher conditional probability for PTSD (0.136 v. 0.092). The bias was due almost entirely to the deviation of the distribution of the worst events from expected values, if all event types had equal prior selection probabilities. Direct adjustment, setting the distribution equal to expected values and applying the observed probabilities of PTSD associated with individual event types brought the estimate close to the unbiased estimate, based on the randomly selected traumas. Only the 'worst event' method can be used as a short-cut to assessing all traumas. The bias in the estimated risk of PTSD is modest and is attenuated by direct adjustment. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0,0 +6974,A Comparison of Multidimensional Health Profiles across Three Trauma-Exposed Diagnostic Groups,"Posttraumatic stress disorder has been associated with adverse health outcomes. The extent to which the health effects of PTSD differ from other diagnoses has not been explored empirically. The current study investigated the Multidimensional Health Profile (including both Psychosocial and Health factors), across three diagnostic groups and one group of well-adjusted participants (N=92) in a contrastedgroups design. Participants were all trauma-exposed and were assessed using structured clinical interviews. The PTSD and depression groups tended to differ from the social phobia and well-adjusted groups. Both the PTSD and depression groups demonstrated elevated profiles on variables assessing psychological distress, negative social exchange, and hypochondriasis. Results are consistent with prior research suggesting PTSD is associated with worse psychological and health functioning relative to trauma-exposed individuals without PTSD, although these health outcomes seem to differ little between those with PTSD and those with depression. © Springer Science+Business Media, LLC 2011.",0,0 +6975,Pathways to change: Use trajectories following trauma-informed treatment of women with co-occurring post-traumatic stress disorder and substance use disorders,"Introduction and Aims Despite advances towards integration of care for women with co-occurring substance use disorder (SUD) and post-traumatic stress disorder (PTSD), low abstinence rates following SUD/PTSD treatment remain the norm. The utility of investigating distinct substance use trajectories is a critical innovation in the detection and refining of effective interventions for this clinical population. Design and Methods The present study reanalysed data from the largest randomised clinical trial to date for co-occurring SUD and PTSD in women (National Drug Abuse Treatment Clinical Trials Network; Women and Trauma Study). Randomised participants (n = 353) received one of two interventions in addition to treatment as usual for SUD: (i) trauma-informed integrative treatment for PTSD/SUD; or (ii) an active control psychoeducation course on women's health. The present study utilised latent growth mixture models (LGMM) with multiple groups to estimate women's substance use patterns during the 12-month follow-up period. Results Findings provided support for three different trajectories of substance use in the post-treatment year: (i) consistently low likelihood and use frequency; (ii) consistently high likelihood and use frequency; and (iii) high likelihood and moderate use frequency. Covariate analyses revealed improvement in PTSD severity was associated with membership in a specific substance use trajectory, although receiving trauma-informed treatment was not. Additionally, SUD severity, age and after-care efforts were shown to be related to trajectory membership. Discussion and Conclusions Findings highlight the necessity of accounting for heterogeneity in post-treatment substance use, relevance of trauma-informed care in SUD recovery and benefits of incorporating methodologies like LGMM when evaluating SUD treatment outcomes. [López-Castro T, Hu M-C, Papini S, Ruglass LM, Hien DA. Pathways to change: Use trajectories following trauma-informed treatment of women with co-occurring post-traumatic stress disorder and substance use disorders. Drug Alcohol Rev 2015]",0,0 +6976,Toward Optimal Early Management After Whiplash Injury to Lessen the Rate of Transition to Chronicity,"Expert debate and synthesis of research to inform future management approaches for acute whiplash disorders.To identify a research agenda toward improving outcomes for acute whiplash-injured individuals to lessen the incidence of transition to chronicity.International figures are concordant, estimating that 50% of individuals recover from pain and disability within 3 to 6 months of a whiplash injury. The remainder report continuing symptoms up to 1 to 2 years or longer postinjury. As no management approach to date has improved recovery rates, new clinical/research directions are required for early management of whiplash-injured patients.A group of multidisciplinary researchers critically debated evidence and current research concerning whiplash from biological, psychological, and social perspectives toward informing future research directions for management of acute whiplash.It was recognized that effective treatments for acute whiplash are constrained by a limited understanding of causes of whiplash-associated disorders. Acute whiplash presentations are heterogeneous leading to the proposal that a research priority was development of a triage system based on modifiable prognostic indicators and clinical features to better inform individualized early management decisions. Other priorities identified included researching effective early pain management for individuals presenting with moderate to high levels of pain; development of best education/information for acute whiplash; testing the efficacy of stratified and individualized rehabilitation, researching modes of delivery considering psychosocial modulators of pain and disability; and the timing, nature, and mode of delivery of cognitive-behavioral therapies. Directions were highlighted for future biomechanical research into injury prevention.The burden of whiplash injuries, the high rate of transition to chronicity, and evidence of limited effects of current management on transition rates demand new directions in evaluation and management. Several directions have been proposed for future research, which reflect the potential multifaceted dimensions of an acute whiplash disorder.",0,0 +6977,PMTS and stress response sequences in parents of children with spina bifida,"To test the presence and progress of Pediatric Medical Traumatic Stress (PMTS) symptoms in parents of children with spina bifida (SB).Parents of 23 newborns with SB were interviewed prospectively and parents of 58 school-aged children with SB were interviewed retrospectively. PMTS symptoms were assessed with 17 DSM-IV criteria for the clusters Intrusion, Avoidance, and Increased Arousal.Within 3 months after the SB diagnosis, 75% of the parents met diagnostic criteria for symptoms of Intrusion and Increased Arousal, but not of Avoidance. In parents of school-aged children with SB, PMTS symptoms had declined in the first 4 years of the child's life and stabilized during the school years. Approximately 30% of the mothers and 20% of the fathers still met diagnostic criteria for Intrusion, Avoidance and Increased Arousal. In mothers of children with open SB, symptoms of Intrusion and Increased Arousal had decreased more slowly than in mothers of children with closed SB.An SB diagnosis initially provokes traumatic stress symptoms in three-quarters of the parents; however, in most of them, these symptoms diminish during the first 4 years of the child's life. In a minority of the parents, severe stress symptoms persist beyond middle childhood. Professional psychological help may need to be offered to this selective group of parents whose levels of stress do not decline after the child's preschool years. Longitudinal research is needed to further investigate and confirm the trends that were found in parents' psychological adjustment to SB.",0,0 +6978,The effects of childbirth-related post-traumatic stress disorder on women and their relationships: A qualitative study,"There is converging evidence that 1%-2% of women develop post-traumatic stress disorder (PTSD) as a result of childbirth. The current study aimed to explore the long-term effects of childbirth-related PTSD on women, their relationship with their partner and their relationship with their child. Semi-structured interviews were carried out with six women who reported clinically significant PTSD after birth, ranging from 7 months to 18 years beforehand. Interviews were transcribed and analysed using thematic analysis. Childbirth-related PTSD was found to have wide-ranging effects on women and their relationships. Women reported changes in physical well-being, mood and behaviour, social interaction, and fear of childbirth. Women reported negative effects on their relationship with their partner, including sexual dysfunction, disagreements and blame for events of birth. The mother-baby bond was also seriously affected. Nearly all women reported initial feelings of rejection towards the baby but this changed over time. Long-term, women seemed to have either avoidant or anxious attachments with their child. It is concluded that childbirth-related PTSD can have severe and lasting effects on women and their relationships with their partner and children. Further research is needed to compare this to normal difficulties experienced by women after having children.",0,0 +6979,The function of image control in the psychophysiology of posttraumatic stress disorder,"The physiological response to trauma-related stimuli of up to one third of participants with posttraumatic stress disorder (PTSD) cannot be discriminated from that of controls. Psychophysiological measures (heart rate and blood pressure) of 22 PTSD and 23 control civilian participants, all exposed to missile attacks during the Gulf War, were recorded while listening to five scripts. The physiological response of PTSD subjects with high image control (IC) was lower than that of PTSD participants with low IC and similar to that of non-PTSD subjects. The physiological response poorly discriminated high IC PTSD participants from controls, but was successful in discriminating low IC PTSD subjects from controls with 91% specificity and 92% sensitivity. Image control is proposed as a function influencing physiological response in PTSD.",0,0 +6980,Functional Neuroimaging Research in Posttraumatic Stress Disorder,"Neuroimaging research in posttraumatic stress disorder (PTSD) is only two decadesold, but is rapidly expanding and evolving in methodological sophistication (Pitmanet al. 2001; Hull 2002; Liberzon and Phan 2003). Earlier structural and symptom-provocation studies are giving way to hypothesis-driven cognitive activationstudies, longitudinal and treatment studies, and translationally driven integrativestudies. The focused review of functional neuroimaging research in PTSD that followsdiscusses findings to better understand the functional neuroanatomy underlyingPTSD symptoms and pathophysiology. We begin with a selective review of theresearch on functional neuroanatomy of emotions that is specifically relevant toPTSD. The ensuing discussion links the two bodies of literature in order to providea better understanding of the processing of threat-related emotions and how this informsour understanding of the brain mechanisms that subserve PTSD.PTSD is characterized by exposure to life-threatening event/s associated withintense emotional reactions. Symptom clusters consist of reexperiencing the trauma(such as nightmares and intrusive memories), avoidance and numbing (avoidingtrauma-related cues, feeling emotionally distant from loved ones), and hyperarousal(hypervigilance, sleep disturbances) (American Psychiatric Association 2000). Becausethese criteria are descriptive, atheoretical, and not confined to a specific diagnosis,it is possible that patients with different neurobiological subtypes will sharethe same diagnosis or that patients with similar neurobiological abnormalities maycross descriptive categorical boundaries. Neurobiological evidence does offer thepotential to identify findings specific to trauma exposure and/or to PTSD's symptomsand pathophysiology, thereby helping to differentiate, define, and treat thesedisorders in a more meaningful way.One powerful, noninvasive means of investigating brain function in PTSD is theuse of relatively new neuroimaging methods such as magnetic resonance imaging(MRI) and positron emission tomography (PET). MRI methodology relies on spinproperties of protons in human brain tissue to outline brain structures and estimate their volume. Functional MRI (fMRI) uses the paramagnetic properties of oxy- anddeoxyhemoglobin in conjunction with rapid acquisition sequences to create maps ofblood-oxygen level dependent (BOLD) signal activity, i.e., blood flow reflective ofneuronal firing, thereby allowing the study of neural processing of specific tasks.Single photon emission computed tomography (SPECT) and PET use radio-emittingisotopes of biologically relevant molecules to estimate blood flow, metabolicrate, receptor binding, and quantification and the assessment of pharmacologicalactivity in vivo.",0,0 +6981,Measuring Intrafamily Conflict and Violence: The Conflict Tactics (CT) Scales,"Development of research on intrafamily and violence requires both conceptual clarity and measures of the concepts. The introduction to this paper therefore seeks to clarifj and distinguish the concepts of conflict, conflict of interest, hostility, and violence. The main part qf the paper describes the Conflict Tactics (CT) Scales. The CT Scales are designed to measure the use qf Reasoning, VerbalAggression, and Violence within the family. Information is presented on the following aspects of this instrument: theoretical rational, acceptability to respondents, scoring, factor structure, reliability, validity, and norms for a nationally representative sample of 2,143 couples.",0,0 +6982,Incidence of Hospital-Treated Traumatic Brain Injury in the Oslo Population,"<i>Background:</i> The aim of this prospective, population-based study is to present the incidence of hospital-treated traumatic brain injury (TBI) in Oslo, Norway, and to describe the severity of brain injuries and outcome of the patients’ acute medical care. <i>Methods:</i> Data were obtained from hospital admission registers and medical records from May 2005 to May 2006. The initial severity of TBI was measured by the Glasgow Coma Scale. The region is urban with a population of 534,129. <i>Results:</i> The 445 patients identified represent an annual incidence of 83.3/100,000. The median age was 29 years. The male:female ratio was 1.8:1.0. The highest incidence of TBI hospitalizations was found in the elderly males and the youngest children. The most common causes of TBI were falls (51%) and transport accidents (29.7%). Intracranial lesions were found more often in the elderly. The case fatality rate was 2.0/100 hospitalized patients and was highest in the elderly. <i>Conclusions:</i> The incidence of hospital-treated TBI in this study is considerably lower than that found in previous studies from Norway and Scandinavia. Despite the apparent decline in TBI hospitalization rates, our findings should also draw attention to the need for more effective preventive programmes related to falls. Studies that assess long-term consequences of TBI in elderly patients are also needed.",0,0 +6983,Cognitive factors involved in the onset and maintenance of posttraumatic stress disorder (PTSD) after physical or sexual assault,"Cognitive factors hypothesised to influence the development and maintenance of PTSD were investigated. 92 assault victims completed questionnaires assessing a range of cognitive variables. Factors relating to onset of PTSD were investigated by comparing victims who did and who did not suffer PTSD. Factors relating to maintenance of PTSD were investigated by comparing victims who had recovered from PTSD with victims who had persistent PTSD. Cognitive factors associated with both onset and maintenance of PTSD were: appraisal of aspects of the assault itself (mental defeat, mental confusion, appraisal of emotions); appraisal of the sequelae of the assault (appraisal of symptoms, perceived negative responses of others, permanent change); dysfunctional strategies (avoidance/safety seeking) and global beliefs impacted by assault. Cognitive factors that were associated only with the onset of PTSD were: detachment during assault; failure to perceive positive responses from others and mental undoing. Relationships between the cognitive variables and PTSD remained significant when variations in perceived and objective assault severity were statistically controlled. The cognitive factors identified in the study may contribute to PTSD directly, by generating a sense of ongoing threat, or indirectly, by motivating cognitive and behavioural strategies that prevent recovery, or by affecting the nature of the traumatic memory.",0,0 +6984,Relationship between Persistent Post-traumatic Stress Disorder and Human Remains Exposure for Staten Island Barge and Landfill Recovery and Clean-up Workers After 9/11,"After the September 11, 2001 World Trade Center (WTC) disaster, recovery and clean-up efforts were concentrated at the WTC site and the Staten Island (SI) Fresh Kills landfill and barges. Research is limited regarding the long-term health effects of human remains exposure during clean-up and recovery work at the SI landfill and barges. We studied 1,592 WTC Health Registry enrollees who worked at the SI landfill, loading piers and barges after the 9/11/01 attacks to assess the relationship between remains exposure and persistent posttraumatic stress disorder (PTSD) 10-11 years later. A dose-response relationship was found between frequency of human remains exposure and persistent PTSD (adjusted odds ratio (AOR): every day (AOR) = 4.77; 95% confidence interval (CI): 2.00-11.52, almost every day (AOR) = 4.35; 95% CI: 1.75-10.80), and some days (AOR) = 2.98; 95% CI: 1.43-6.22). When exposed to human remains, sanitation workers had higher odds of persistent PTSD, compared to firefighters and police. In addition, respondents who scored lower on a social support scale had higher odds of persistent PTSD. The findings highlight the need for strategies to reduce the risk of PTSD associated with exposure to human remains in future disasters.",0,0 +6985,Chernobyl Clean-up Workers' Perception of Radiation Threat,"The goals of this study were: (1) to compare the psychometric profiles of male Chernobyl liquidators who met DSM-III-R criteria for current PTSD with those who did not, and (2) to explore liquidators' perception and assessment of the 'invisible' stressor of the radioactive hazard. Results of t-test comparisons between the PTSD and non-PTSD groups for the various psychometric measures are shown. Both diagnostic groups were similar in regard to their mean ages and education levels. The PTSD group scored significantly higher than the non-PTSD group on all the measures of PTSD and general psychiatric symptomatology, state and trait anxiety, depression. On the whole, results of this study demonstrate the determining role of individual perception and assessment of radioactive hazard in the development of post-traumatic stress and place this problem among the most important in studying the psychological consequences of experiencing radioactive threat. The real working conditions and the level of information also affected workers' estimate of the severity of the radiation hazard in Chernobyl.",0,0 +6986,Differences in patterns of depression after treatment for breast cancer,"Depression is a significant problem for some breast cancer survivors after the end of treatment. This study assessed depression using the CES-D for 84 breast cancer patients at the conclusion of radiation treatment, and at 3 and 6 months post-treatment. Based on the pattern of CES-D scores, patients were divided into five groups: (1) Stay Depressed (scores above clinical cutoff for depression at all timepoints); (2) Recover (above threshold at baseline, but below at follow-up); (3) Become Depressed (below threshold at baseline, but above at follow-up); (4) Never Depressed (below threshold at all times); and (5) Vacillate (none of the above patterns). This study examined the relationships between depression groups and a variety of medical, demographic, and psychological measures, including anxiety and quality of life (QOL). Number of children at home significantly distinguished the groups, with the Become Depressed group having more children and the Vacillate group having fewer children. Anxiety levels were different among the groups, with Recover and Never Depressed groups having consistently lower anxiety scores. QOL scores also distinguished the groups in that Never Depressed patients demonstrated better QOL than all other groups. The findings have implications for understanding resilience in cancer patients.",0,0 +6987,A cluster randomized controlled trial to determine the efficacy of Trauma Risk Management (TRiM) in a military population,"Trauma Risk Management is a peer-support program that aims to promote help-seeking in the aftermath of traumatic events. Prior to its implementation, the British military conducted a randomized controlled trial of Trauma Risk Management against standard care in 12 warships; 6 were randomized to use Trauma Risk Management after collecting baseline measurements. Follow up after 12–18 months found no significant change in psychological health or stigma scores in either group; however, the studied vessels only encountered low numbers of critical incidents. Additionally, measurements of organizational functioning were modestly better in the Trauma Risk Management ships. The authors conclude that within organizations using Trauma Risk Management may be beneficial and may, in time, lead to a valuable cultural shift.",0,0 +6988,Course of Alcohol Dependence Among Vietnam Combat Veterans and Nonveteran Controls*,"Identifying developmental trajectories of alcohol use is fundamental in building theories of alcoholism etiology and course. The purpose of this study was to replicate and generalize our previous finding that had been based on a twin sample drawn from the Vietnam Era Twin Registry. In this study, we made use of a nontwin sample of Vietnam veterans drawn from the Vietnam Era Study--a 25-year follow-up of the Vietnam Drug User Returns project that assessed the long-term medical and psychiatric consequences of substance abuse or dependence in Vietnam.Alcohol-related behaviors and psychiatric status were assessed in a sample of 839 individuals that comprised 323 veterans who tested positive for drugs (i.e., opiates, barbiturates, or amphetamines) on discharge from Vietnam, 319 veterans who tested negative for drugs at that time, and a nonveteran control sample (n = 197). Individuals with a lifetime diagnosis of alcohol dependence (n = 293) were selected for further analysis. Using detailed life history charts, in-person structured interviews were conducted, which entailed retrospective reports covering the 25 years since the 1972 survey. Measures of alcohol and drug use as well as psychiatric symptoms were obtained by assessing each year of the follow-up interval, beginning with 1972.Using latent growth mixture modeling, a four-class model was identified with trajectories that were parallel to those identified in our previous studies based on the Vietnam Era Twin Registry: severe chronic alcoholics, severe nonchronic alcoholics, late-onset alcoholics, and young-adult alcoholics.Present findings provide additional support for the replicability and generalizability of meaningful differences in the course of alcoholism from early adulthood to midlife.",0,0 +6989,Identifying experiences of physical and psychological violence in childhood that jeopardize mental health in adulthood,"This study examined associations between profiles of physical and psychological violence in childhood from parents and two dimensions of mental health in adulthood (negative affect and psychological well-being). Profiles were distinguished by the types of violence retrospectively self-reported (only physical, only psychological, or both psychological and physical violence), as well as by the frequency at which each type of violence reportedly occurred (never, rarely, or frequently).Multivariate regression models were estimated using data from the National Survey of Midlife in the U.S. (MIDUS). An adapted version of the Conflict Tactics Scales (CTS) was used to collect respondents' reports of physical and psychological violence in childhood from each parent. Respondents also reported on current experiences of negative affect and psychological well-being.Regarding violence from mothers, reports of frequent psychological violence-even when coupled with never or rarely having experienced physical violence-were associated with more negative affect and less psychological well-being in adulthood. Nearly all profiles of violence in childhood from fathers-with the exception of reports of rare physical violence only-were associated with poorer adult mental health.Results provide evidence that frequent experiences of psychological violence from parents-even in the absence of physical violence and regardless of whether such violence is from mothers or fathers-can place individuals' long-term mental health at risk. Moreover, frequent physical violence from fathers-even in the absence of psychological violence-also serves as a risk factor for poorer adult mental health.Findings provide additional empirical support for the importance of prevention and intervention efforts directed toward children who experience physical and psychological violence from parents, as well as among adults who reportedly experienced in childhood only one type of violence and especially psychological violence at high levels of frequency.",0,0 +6990,A Longitudinal Investigation of the Relationship between Posttraumatic Stress Symptoms and Posttraumatic Growth in a Cohort of Israeli Jews and Palestinians during Ongoing Violence,"OBJECTIVES: Meta-analytic evidence based on cross-sectional investigations between posttraumatic growth (PTG) and posttraumatic stress disorder (PTSD) demonstrates that the two concepts are positively related and that ethnic minorities report greater PTG. Few longitudinal studies have quantified this relationship so the evidence is limited regarding the potential benefit PTG may have on post-traumatic adjustment and whether differences between ethnic groups exist. METHODS: The current study attempts to fill a substantial gap in the literature by exploring the relationship between PTG and PTSD symptom clusters longitudinally using a nationally representative cohort of 1613 Israelis and Palestinian Citizens of Israel (PCI) interviewed via telephone on three measurement occasions during one year. Latent cross-lagged structural models estimated the relationship between PTG and each PTSD symptom cluster, derived from confirmatory factor analysis, representing latent and statistically invariant PTSD symptom factors, best representing PTSD for both ethnic groups. RESULTS: PTG was not associated with less PTSD symptom severity in any of the four PTSD clusters, for Jews and PCI. In contrast, PTSD symptom severity assessed earlier was related to later reported PTG in both groups. CONCLUSIONS: This study demonstrates that PTSD symptoms contribute to greater reported PTG, but that PTG does not provide a salutatory benefit by reducing symptoms of PTSD. Language: en",0,0 +6991,Millennium Cohort: enrollment begins a 21-year contribution to understanding the impact of military service,"

Abstract

Objective

In response to health concerns of military members about deployment and other service-related exposures, the Department of Defense (DoD) initiated the largest prospective study ever undertaken in the U.S. military.

Study Design and Setting

The Millennium Cohort uses a phased enrollment strategy to eventually include more than 100,000 U.S. service members who will be followed up through the year 2022, even after leaving military service. Subjects will be linked to DoD and Veterans Affairs databases and surveyed every 3 years to obtain objective and self-reported data on exposures and health outcomes.

Results

The first enrollment phase was completed in July 2003 and resulted in 77,047 consenting participants, well representative of both active-duty and Reserve/Guard forces. This report documents the baseline characteristics of these Cohort members, describes traditional, postal, and Web-based enrollment methods; and describes the unique challenges of enrolling, retaining, and following such a large Cohort.

Conclusion

The Millennium Cohort was successfully launched and is becoming especially relevant, given current deployment and exposure concerns. The Cohort is representative of the U.S. military and promises to provide new insight into the long-term effects of military occupations on health for years to come.",0,0 +6992,Clarifying the Relationship Between AS Dimensions and PTSD Symptom Clusters: Are Negative and Positive Affectivity Theoretically Relevant Constructs?,"The association between anxiety sensitivity (AS) and posttraumatic stress disorder (PTSD) has been established in contemporary literature; however, research is divided over the nature of specific relationships between AS dimensions and PTSD symptoms clusters. Further, a paucity of research has examined the AS and PTSD relationship while accounting for theoretically relevant variables, such as negative (NA) and positive affect (PA). The purpose of the current study was twofold: first, to clarify divergent findings regarding the contribution of AS dimensions to PTSD symptom clusters, and, second, to further assess the relevance of NA and PA within the AS/PTSD relationship. Hierarchal regression analyses showed that, beyond shared variance attributable to NA and PA, AS somatic concerns were significantly associated with three of four PTSD symptom (i.e., reexperiencing, numbing, hyperarousal), AS cognitive concerns were only associated with hyperarousal, and AS socially observable symptoms were not significantly associated with any PTSD symptom clusters. These findings suggest that AS somatic concerns are the most robust predictor of variance within the AS/PTSD relationship and further clarify the theoretical importance of NA and PA within this relationship. Comprehensive results, implication, and directions for future research are discussed.",0,0 +6993,"Epigenetics, brain, behavior, and the environment","Early experiences can modify regulatory factors affecting gene expression in such a way that, although the DNA sequence itself is not changed, the individual's physiology and behavior is substantially influenced. In some instances these epigenetic effects are exerted upon exposure, while in other instances they are transmitted across generations via incorporation into the germline. Examples of both types of epigenetic effects are presented. First, experience with siblings (littermates) organizes behaviors and their underlying neural substrates in such a way that, as adults, rats and knockout mice behave differently. Second, exposure to the fungicide vinclozolin early in pregnancy imprints the male lineage in such a manner that rats exhibit distinct behavioral profiles as well as unique patterns of gene expression in relevant brain regions. Taken together, this work demonstrates that present and past environments alike modify both social and affiliative related behaviors and their related metabolic activity in specific brain nuclei as well as influencing the abundance of specific genes altering the epigenome in the target brain areas.",0,0 +6994,Sedation of Critically Ill Patients Undergoing Mechanical Ventilation,"Achieving and maintaining an optimal level of comfort and safety in the ICU plays an integral part in caring for critically ill patients. In general, the choice of sedative agent used in ICU patients should be driven by the specific indications and goals of sedation for each patient and the clinical pharmacology of the sedative agent in a particular patient, including its onset and offset of effect and its side-effect profile. Utilizing standard rating scales and unit-based guidelines facilitates the proper use of sedation and analgesia. The triad of factors that lead to agitation include pain, delirium, and anxiety. These factors should be addressed in a stepwise manner and treatment should be focused to a specific indication. Use of sedative hypnotics should be limited to those patients requiring a deeper level of sedation to provide maximal comfort and safety for the patient, or in those in whom agitation is not controlled even after addressing the factors of the triad. © 2013, Lippincott Williams & Wilkins.",0,0 +6995,Behaviorally inhibited temperament is associated with severity of post-traumatic stress disorder symptoms and faster eyeblink conditioning in veterans,"Prior studies have sometimes demonstrated facilitated acquisition of classically conditioned responses and/or resistance to extinction in post-traumatic stress disorder (PTSD). However, it is unclear whether these behaviors are acquired as a result of PTSD or exposure to trauma, or reflect preexisting risk factors that confer vulnerability for PTSD. Here, we examined classical eyeblink conditioning and extinction in veterans self-assessed for current PTSD symptoms, exposure to combat, and the personality trait of behavioral inhibition (BI), a risk factor for PTSD. A total of 128 veterans were recruited (mean age 51.2 years; 13.3% female); 126 completed self-assessment, with 25.4% reporting a history of exposure to combat and 30.9% reporting current, severe PTSD symptoms (PTSS). The severity of PTSS was correlated with current BI (R(2) = 0.497) and PTSS status could be predicted based on current BI and combat history (80.2% correct classification). A subset of the veterans (n = 87) also completed the eyeblink conditioning study. Among veterans without PTSS, childhood BI was associated with faster acquisition; veterans with PTSS showed delayed extinction, under some conditions. These data demonstrate a relationship between current BI and PTSS, and indicate that the facilitated conditioning sometimes observed in patients with PTSD may partially reflect personality traits such as childhood BI that pre-date and contribute to vulnerability for PTSD.",0,0 +6996,"Traumatic Life Events and Psychopathology in a High Risk, Ethnically Diverse Sample of Young Children: A Person-Centered Approach","Studies of the association between traumatic experiences and psychopathology in early childhood have primarily focused on specific types of events (e.g., sexual abuse) or aggregated different types of events without differentiating among them. We extend this body of work by investigating patterns of traumatic event exposure in a high-risk, ethnically diverse sample of children ages 3-6 (N = 211; 51 % female) and relating these different patterns to parents' reports of child externalizing, internalizing, and post-traumatic stress symptomatology. Using latent class analysis, which divides a heterogeneous population into homogenous subpopulations, we identified three patterns of traumatic events based on parents' responses to an interview-based assessment of trauma exposure in young children: (1) severe exposure, characterized by a combination of family violence and victimization; (2) witnessing family violence without victimization; and (3) moderate exposure, characterized by an absence of family violence but a moderate probability of other events. The severe exposure class exhibited elevated internalizing and post-traumatic stress symptoms relative to the witness to violence and moderate exposure classes, controlling for average number of traumatic events. Results highlight the need for differentiation between profiles of traumatic life event exposure and the potential for person-centered methods to complement the cumulative risk perspective.",0,0 +6997,The influence of pre-deployment neurocognitive functioning on post-deployment PTSD symptom outcomes among Iraq-deployed Army soldiers,"Abstract This study evaluated associations between pre-deployment neurocognitive performance and post-deployment posttraumatic stress disorder (PTSD) symptoms in a sample of deployed active duty Army soldiers. As part of a larger longitudinal study, each participant completed baseline measures of memory, executive attention, and response inhibition, and baseline and post-deployment self-report measures of PTSD symptom severity. Data were subjected to multiple regression analyses that examined associations between baseline neurocognitive performances and longitudinal PTSD symptom outcome. Results revealed that pre-trauma immediate recall of visual information was associated with post-deployment PTSD symptom severity, even after controlling for pre-deployment PTSD symptom levels, combat intensity, age, gender, and test-retest interval. There was also an interaction between pre-deployment PTSD symptom severity and pre-deployment immediate visual recall and verbal learning, indicating that neurocognitive performances were more strongly (and negatively) associated with residualized post-deployment PTSD symptoms at higher levels of pre-deployment PTSD symptoms. These findings highlight the potential role of pre-trauma neurocognitive functioning in moderating the effects of trauma exposure on PTSD symptoms.( JINS , 2009, 15 , 840–852.)",0,0 +6998,The association between positive screen for future persistent posttraumatic stress symptoms and injury incident variables in the pediatric trauma care setting,"Posttraumatic stress (PTS) disorder after injury is a significant yet underaddressed issue in the trauma care setting. Parental anxiety may impact a child's risk of future, persistent PTS symptoms after injury. This study aimed to: (1) identify injury incident and demographic variables related to a positive screen for future, persistent PTS symptoms in children; and (2) examine the relationship between parental anxiety and a positive screen for future, persistent PTS symptoms in children.From November 2009 to August 2010, 124 patients were enrolled at a pediatric trauma center. Inclusion criteria were as follows: (1) age 7 years to 17 years; (2) hospitalized for at least 24 hours after physical trauma; and (3) English or Spanish speaking. State and trait anxiety were measured for both pediatric patients and their parents/guardians via the state trait anxiety inventory for children and state trait anxiety inventory, respectively. Risk for future, persistent PTS, among pediatric patients was assessed via the screening tool for early predictor of posttraumatic stress disorder (STEPP).Of 116 participants assessed via the STEPP, 32 (28%) screened positive for risk of future, persistent PTS symptoms. Motor vehicle collision and parental presence at injury were associated with a positive STEPP screen. The effect of parental presence on positive STEPP screen was modified by parental trait anxiety. Children of anxious parents present at injury were over 14 times as likely to screen positive for risk of future, persistent PTS, as those without a parent present.The risk of future, persistent PTS, after injury among the pediatric population is substantial. Parents with existing trait anxiety are shown to influence their child's risk for future, persistent PTS, particularly if present at the injury event. Further study of PTS prevention and control strategies are needed among this population within the trauma care setting.Epidemiological study, level II.",0,0 +6999,Confirmatory factor analysis of posttraumatic stress symptoms in cambodian refugees,"This study used confirmatory factor analysis to examine the factor structure of the Cambodian version of the Harvard Trauma Questionnaire in 488 Cambodian refugees residing in the United States. Five alternative conceptual models were compared. A model with four correlated factors reflecting symptoms of re-experiencing, avoidance, emotional numbing, and hyperarousal provided the best fit to these data. The avoidance and emotional numbing clusters demonstrated distinct associations with depression symptoms, providing some evidence of the construct validity of the four-factor solution.",0,0 +7000,The Dynamics of Posttraumatic Stress Disorder in South African Political Ex-Detainees,This paper explores the dynamic factors involved in the generation of the classical posttraumatic stress disorder (PTSD) in a population of Black South African political ex-detainees. A model is proposed of the evolution of inner psychic events in response to the detention-related trauma which result in the typical symptom cluster.,0,0 +7001,[PTSD as result of the 1997 flood--occurrence and display of distemper].,"The occurrence and course of PTSD in the countryside environment as the result of flood in 1997 has been described. The research was experimented around four villages by Nysa Kłodzka river-basin; the area was affected by disaster unexpectedly and extremely hard.97 people have been tested as the straightforward witnesses of flood. They had never been treated by a psychiatrist before 1997 and they haven't experienced any other stressful event that might have been an independent reason of the occurrence PTSD. The extent of trauma, risk of shock and the length of time that those examined were in danger was identical. None of the studied had received psychological or psychiatric support after the disaster. The research was carried out by one investigator (psychiatrist) 60-63 months after the flood at the victims' houses (the psychiatrist's visit was preceded by the phone appointment). The research instrument--Composite International Diagnostic Interview CIDI: section A (referred to demographic dates) and section N (referred to PTSD).PTSD diagnosis was made in 30.9% of the examined group. The distempered people are mostly educated at the lowest level (49.9% with the ground education) or unemployed (39.2%). Older people were more susceptible to PTSD. PTSD diagnosis was made more often for men (39.5%) than for women (25.4), what is directly related to the lower education and a worse material status of the examined men. Full symptomatic PTSD, remaining up to 60-63 months after the flood, was confirmed in 15.5% of the studied group.The frequency and profile of PTSD occurrence (lower educated, older and the poor people) in the examined group is consistent with the other studies done. The fact that PTSD diagnosis was more frequent amongst men (39.5% vs. 25.4% in women) has been mentioned and explained above. No person in the group has confirmed the short (lasting only up to one month) term of persistence of the symptoms what is tantamount to no acute stress disorder right after the flood. It might be probably caused by the permanence of flood destruction and the prolonged exposure to the stress factor.",0,0 +7002,Fertility of Lactating Dairy Cows Administered Recombinant Bovine Somatotropin During Heat Stress,"Administration of recombinant bovine somatotropin (bST) to lactating dairy cows during heat stress increases milk yield, but it also can increase body temperature and may therefore compromise fertility. However, it is possible that bST treatment could increase fertility during heat stress because it has been reported to increase fertility in lactating cows. In addition, bST increases secretion of insulin-like growth factor-I (IGF-I) that promotes embryo survival. The purpose of this study was to determine effects of bST on reproductive function in lactating dairy cows during heat stress. The experiment was conducted in southern Georgia from July to November 2005 using lactating Holstein cows (n = 276 for reproductive traits). For first service timed artificial insemination (TAI), cows were presynchronized with 2 injections of PGF(2alpha) given 14 d apart followed by a modified Ovsynch protocol (GnRH and insemination at 72 h following PGF(2alpha) ). Pregnancy was diagnosed by using ultrasonography on d 29 and reconfirmed by palpation between d 45 and 80 post-TAI. Nonpregnant cows were resynchronized with the modified Ovsynch protocol and received a second TAI. Treatment with bST started 1 wk before the start of Ovsynch and continued at 2-wk intervals. Blood samples were collected from a subset of cows to determine IGF-I profiles immediately before the first bST injection, 1 wk later, and at d 35 of bST treatment. Rectal temperatures were assessed on d 29 of bST treatment. Pregnancy rates (d 45 to 80 post-TAI) did not differ between bST and control cows for first- (16.7 vs. 15.2%) or second-service TAI (14.8 vs. 17.2%). Plasma concentrations of IGF-I and milk yield were greater for bST-treated cows following the initiation of bST treatment and bST increased rectal and vaginal temperatures. Body condition score was less for bST-treated cows. In conclusion, treatment with bST during heat stress increased IGF-I concentrations, milk yield over time, and rectal and vaginal temperatures without affecting first- or second-service pregnancy rates. Thus, at least under certain housing conditions, bST can be used to improve milk yield during heat stress without compromising fertility.",0,0 +7003,Multiple Traumatic Experiences and the Expression of Traumatic Stress Symptoms for Children and Adolescents,"In order to understand the differential presentation of trauma stress symptoms over the course of development from children to adolescents, a sample of more than 11,000 children and adolescents were studied who were identified as to whether they had experienced multiple trauma experiences prior to placement in child welfare custody. Six age groups were compared on their presentation of symptoms associated with traumatic experiences. Trauma stress symptoms were dramatically different for children and adolescents despite the similarity of trauma experiences. Implications for understanding and addressing multiple trauma experiences across a developmental trajectory are discussed.",0,0 +7004,Acute stress trajectories 1 year after a breast cancer diagnosis,"Purpose: The purpose of this study was to evaluate the longitudinal trajectories of acute stress reactions over the course of diagnosis, treatment, and follow-up assessments in a group of non-metastatic breast cancer patients during five different moments of the illness process, and to identify psychological predictors of the trajectories. Methods: The sample was formed by 102 non-metastatic breast cancer patients treated with adjuvant chemotherapy. Latent growth mixture models (LGMM) were used to identify latent classes, and we used multinomial logistic regression in a conditional model to examine predictors to differentiate between trajectories. Results: We identified four different groups according to their trajectories: (1) a resilient group, (44.5 %); (2) a mild acute stress group, (40.6 %); (3) a delayed–recovery group (11.9 %); and (4) a chronic acute stress group (2.9 %). Moreover, anxious preoccupation showed the strongest significant effects in predicting each class, whereas cognitive avoidance and type C personality had moderate effects for participants in the mild acute stress group. Conclusions: This study demonstrates that the majority of breast cancer patients in our study were resilient, with only a small percentage showing chronic acute stress. Because coping strategies, specifically anxious preoccupation, and not more stable variables played a main role in the prediction of acute stress trajectories, future preventive interventions should center in promoting more adaptive coping strategies in breast cancer patients. © 2015, Springer-Verlag Berlin Heidelberg.",1,0 +7005,The effects of insecure attachment orientations and perceived social support on posttraumatic stress and depressive symptoms among civilians exposed to the 2009 Israel–Gaza war: A follow-up Cross-Lagged panel design study,"A follow-up Cross-Lagged-design was used to test the effects of attachment orientations and perceived social support on posttraumatic stress disorder (PTSD) and major depressive disorder symptoms (MDD) in a sample of 135 Israeli students who were evacuated from a university campus located near the Israel–Gaza border in response to increased missile-fire in the area. An internet-based data collection procedure enabled the simultaneous survey of evacuees located up to 40 km from the border at war, both during the fighting and 4 months after the ceasefire. Proximity to the border did not affect levels of PTSD or MDD symptoms, attachment orientation, or levels of perceived social support. Analyses involving Cross-Lagged Panel Correlation (CLPC) path models revealed that Attachment–Anxiety had significant positive effects on PTSD, MDD, and perceived social support. Neither PTSD nor MDD nor perceived social support had any reciprocal follow-up effect on Attachment–Anxiety. These findings underscore the central role of individual trait personality differences in predicting changes in both mental health problems and interpersonal relations over time, following exposure to trauma.",0,0 +7006,Personality traits of the Five-Factor Model are associated with work-related stress in special force police officers,"Purpose: The police work is particularly stressful. The aim of this work was to clarify whether the personality factors are associated with perceived stress levels or reactivity to environmental stressors in a special body of police. Methods: The police officers in charge of guaranteeing public order at the L'Aquila G8 meeting were subjected to a control of their levels of work-related stress in anticipation of the event. Personality was assessed by the Italian version of the Five-Factor Model questionnaire, while stress was measured three times (during routine work in January 2009, preparation and imminence of the event, in April and July 2009, respectively) with the demand/control/support model of Karasek and the effort/reward imbalance model of Siegrist. A total of 289 of 294 officers took part in the survey. Results: Some personality traits of the Five-Factor Model were associated with stress levels and stress reactivity. Neuroticism (low emotional stability) showed the strongest associations with job strain (demand/control ratio) (β = 0.115, p < 0.05) and effort/reward imbalance (β = 0.270, p < 0.001) and was associated with most of the stress variables. High agreeableness was associated with low effort/reward imbalance (β = -0.157, p < 0.01). Conclusions: Personality factors may mitigate or increase the strain induced by environmental stressors. © 2013 Springer-Verlag Berlin Heidelberg.",0,0 +7007,"Temperature, stress, disorder, and crystallization effects in laser diodes: measurements and impacts","This paper reviews extensive Raman scattering, reflectance modulation and luminescence microprobe measurements made on GaInP/AlGaInP, GaAs/AlGaAs and InGaAs/AlGaAs ridge quantum well lasers to investigate (i) laser operating temperatures, (ii) built-in mechanical stress, (iii) atomic disorder in mirror facets, (iv) Si recrystallization effects in mirror coatings, and (v) correlations of these parameters with laser performance and reliability data. Mirror temperatures have been found to depend sensitively on mirror treatment, mirror structure design, the geometry of a deposited heat spreader, the type of coupling of the laser to a heat sink, the number of active quantum wells, the type of cladding layer, and the strength of lattice disorder at the mirror surfaces. Axial temperatures drop from the hot mirror side along the cavity to low constant values within typically 10 μm. Degradation processes have been observed in real time by continuously monitoring the mirror temperature. Dark line defects formed during laser operation exhibit a temperature gradually increasing with time. The mirrors suffer catastrophic optical damage within seconds after having reached a critical temperature. Temperature maps show a striking localized hot spot within the optical near-field pattern. Strong structural and compositional lattice disorder have been identified as potential root causes of strong mirror heating. Disorder strongly suppresses the catastrophic optical mirror damage power limit. Ridge waveguide lasers show a characteristic camel hump-like stress profile, i.e. high compressive strain levels of up to 5 kbar near the ridge slopes and reduced compressive stress or even low tensile stress fields towards the ridge center. The measured stress fields affect the formation of defects and the optical near-field pattern. Ion-beam deposited amorphous Si layers in mirror coating stacks rapidly recrystallize under high power exposure. This reduces the reflectivity of the coating and increases the transmitted power. Model experiments demonstrate that the recrystallization can modify the effective kink-free optical output power.",0,0 +7008,Resource Loss and Naturalistic Reduction of PTSD Among Inner-City Women,"Halting the process of psychosocial and material resource loss has been theorized as being associated with the reduction of posttraumatic stress disorder (PTSD). This study examines how the limiting of resource loss is related to alleviation of PTSD symptoms among 102 inner-city women, who originally met diagnostic criteria for PTSD after experiencing interpersonal traumatic events such as child abuse, rape, and sexual assault. Participants whose PTSD symptoms improve and become nondiagnostic for PTSD are compared with those who remain diagnostic. The two groups are not significantly different at pretest. However, at the 6-month time point, those who become nondiagnostic for PTSD report less resources loss in three of four domains. This pattern suggests that as PTSD symptoms decrease, women's material and psychosocial resource loss diminishes, which in turn, may aid their recovery process.",0,0 +7009,Remission from post-traumatic stress disorder in adults: A systematic review and meta-analysis of long term outcome studies,"Posttraumatic stress disorder (PTSD) is a frequent mental disorder associated with significant distress and high costs. We conducted the first systematic review and meta-analysis on spontaneous long-term remission rates, i. e., without specific treatment. Data sources were searches of databases, hand searches, and contact with authors. Remission estimates were obtained from observational prospective studies of PTSD without specific treatment. Remission was defined as the actual percentage of PTSD cases at baseline who are non-cases after a minimum of ten months. Forty-two studies with a total of 81,642 participants were included. The mean observation period was 40 months. Across all studies, an average of 44.0% of individuals with PTSD at baseline were non-cases at follow-up. Remission varied between 8 and 89%. In studies with the baseline within the first five months following trauma the remission rate was 51.7% as compared to 36.9% in studies with the baseline later than five months following trauma. Publications on PTSD related to natural disaster reported the highest mean of remission rate (60.0%), whereas those on PTSD related to physical disease reported the lowest mean of remission rate from PTSD (31.4%). When publications on natural disaster were used as a reference group, the only type of traumatic events to differ from natural disaster was physical disease. No other measured predictors were associated with remission from PTSD. Long-term remission from PTSD without specific treatment varies widely and is higher in studies with the baseline within five months following trauma.",0,0 +7010,"Trauma, Genes, and the Neurobiology of Personality Disorders","A model for personality dysfunction posits an interaction between inherited susceptibility and environmental factors such as childhood trauma. Core biological vulnerabilities in personality include dimensions of affective instability, impulsive aggression, and cognition/perceptual domains. For the dimension of impulsive aggression, often seen in borderline personality disorder (BPD), the underlying neurobiology involves deficits in central serotonin function and alterations in specific brain regions in the cingulate and the medial and orbital prefrontal cortex. The role of trauma in the development of personality disorder and especially for BPD remains unclear. Although recent studies suggest that BPD is not a trauma-spectrum disorder and that it is biologically distinct from posttraumatic stress disorder, high rates of childhood abuse and neglect do exist for individuals with personality dysfunction. Personality symptom clusters seem to be unrelated to specific abuses, but they may relate to more enduring aspects of interpersonal and family environments in childhood. Whereas twin and family studies indicate a partially heritable basis for impulsive aggression, studies of serotonin-related genes to date suggest only modest contributions to behavior. Gene-environment interactions involving childhood maltreatment are demonstrated in recent studies on antisocial behaviors and aggressive rhesus monkeys and highlight the need for further research in this important area.",0,0 +7011,Buprenorphine in the treatment of non-suicidal self-injury: a case series and discussion of the literature,"Abstract A global public health problem, non-suicidal self-injury (NSSI) is highly prevalent in both males and females, and tends to first occur in adolescence. NSSI is correlated with a history of childhood trauma, and with a variety of developmental and psychiatric disorders. NSSI is associated with increased risk of morbidity and premature death from suicide, accidents, and natural causes. Current treatment approaches are inadequate for a substantial number of people. Converging evidence for opioid system dysregulation in individuals with NSSI make this a promising area of investigation for more effective treatments. The pharmacological profile of buprenorphine, a potent μ-opioid partial agonist and κ-opioid antagonist, suggests that it may be beneficial. In this paper, we describe the successful treatment of severe NSSI with buprenorphine in six individuals, followed by discussion and further recommendations.",0,0 +7012,Mental illness and housing outcomes among a sample of homeless men in an Australian urban centre,"Objective: The over-representation of mental illness among homeless people across the globe is well documented. However, there is a dearth of Australian literature on the mental health needs of homeless individuals. Furthermore, longitudinal research examining the factors that contribute to better housing outcomes among this population is sparse. The aim of this research is to describe the mental illness profile of a sample of homeless men in an Australian urban centre (in Sydney) and examine the factors associated with better housing outcomes at 12-month follow-up. Methods: A longitudinal survey was administered to 253 homeless men who were involved in the Michael Project: a 3-year initiative which combined existing accommodation support services with assertive case management and access to coordinated additional specialist allied health and support services. A total of 107 participants were followed up 12 months later. The survey examined the demographics of the sample and lifetime mental disorder diagnoses, and also included psychological screeners for current substance use and dependence, psychological distress, psychosis, and post-traumatic stress. Results: Consistent with existing literature, the prevalence of mental illness was significantly greater amongst this sample than the general Australian population. However, mental illness presentation was not associated with housing situation at 12-month follow-up. Instead, type of support service at baseline was the best predictor of housing outcome, wherein participants who received short to medium-term accommodation and support were significantly more likely to be housed in stable, long-term housing at the 12-month follow-up than participants who received outreach or emergency accommodation support. Conclusions: This study provides evidence to support an innovative support model for homeless people in Australia and contributes to the limited Australian research on mental illness in this population.",0,0 +7013,Re-establishment of Anxiety in Stress-Sensitized Mice Is Caused by Monocyte Trafficking from the Spleen to the Brain,"Persistent anxiety-like symptoms may have an inflammatory-related pathophysiology. Our previous work using repeated social defeat (RSD) in mice showed that recruitment of peripheral myeloid cells to the brain is required for the development of anxiety. Here, we aimed to determine if 1) RSD promotes prolonged anxiety through redistribution of myeloid cells and 2) prior exposure to RSD sensitizes the neuroimmune axis to secondary subthreshold stress.Mice were subjected to RSD and several immune and behavioral parameters were determined .5, 8, or 24 days later. In follow-up studies, control and RSD mice were subjected to subthreshold stress at 24 days.Repeated social defeat-induced macrophage recruitment to the brain corresponded with development and maintenance of anxiety-like behavior 8 days after RSD, but neither remained at 24 days. Nonetheless, social avoidance and an elevated neuroinflammatory profile were maintained at 24 days. Subthreshold social defeat in RSD-sensitized mice increased peripheral macrophage trafficking to the brain that promoted re-establishment of anxiety. Moreover, subthreshold social defeat increased social avoidance in RSD-sensitized mice compared with naïve mice. Stress-induced monocyte trafficking was linked to redistribution of myeloid progenitor cells in the spleen. Splenectomy before subthreshold stress attenuated macrophage recruitment to the brain and prevented anxiety-like behavior in RSD-sensitized mice.These data indicate that monocyte trafficking from the spleen to the brain contributes re-establishment of anxiety in stress-sensitized mice. These findings show that neuroinflammatory mechanisms promote mood disturbances following stress-sensitization and outline novel neuroimmune interactions that underlie recurring anxiety disorders such as posttraumatic stress disorder.",0,0 +7014,Is Posttraumatic Stress in Youth a Culture-Bound Phenomenon? A Comparison of Symptom Trends in Selected U.S. and Russian Communities,"The cross-cultural applicability of the concept of posttraumatic stress was investigated by assessing symptom frequency and levels of comorbid psychopathology in adolescents from the United States and Russia.A self-report survey was conducted in representative samples of 2,157 adolescents 14 to 17 years old from urban communities of the United States (N=1,212) and Russia (N=945).In both countries, the levels of all three major clusters of posttraumatic symptoms (reexperiencing, avoidance, and arousal), as well as of internalizing psychopathology, increased along with the level of posttraumatic stress. Expectations about the future had a tendency to decrease with increasing posttraumatic stress. No differences between countries in significant interaction effects for symptom levels were found.The current findings suggest that posttraumatic symptoms and their associations with other adolescent mental health problems are not culture bound and that the psychological consequences of trauma follow similar dynamics cross-culturally.",0,0 +7015,Patients with Generalized Anxiety Disorder and a History of Trauma: Somatic Symptom Endorsement,"The authors investigated the types and rates of trauma exposure and differences in symptom endorsement in a clinical sample of patients diagnosed with generalized anxiety disorder (GAD). Fifty-eight patients with GAD were assessed using the Structured Clinical Interview (SCID) and Trauma Assessment for Adults. In order to explore the relationship between specific traumatic event(s) and clinical presentation, the presence of somatic symptoms associated with GAD, including muscle tension, autonomic hyperactivity, and vigilance/scanning clusters (using DSM-III-R criteria), were examined. Patients with a history of sexual assault before 18 years (25.9%) endorsed fewer somatic symptoms, specifically fewer motor tension and autonomic GAD symptoms, than patients with other types of trauma. These findings indicate that early exposure to serious trauma, specifically childhood sexual assault, may lead to a different clinical presentation in GAD patients.",0,0 +7016,"Compassion satisfaction, compassion fatigue, anxiety, depression and stress in registered nurses in Australia: study 1 results","Aim To explore compassion fatigue and compassion satisfaction with the potential contributing factors of anxiety, depression and stress. Background To date, no studies have connected the quality of work-life with other contributing and co-existing factors such as depression, anxiety and stress. Method A self-report exploratory cross sectional survey of 132 nurses working in a tertiary hospital. Result The reflective assessment risk profile model provides an excellent framework for examining the relationships between the professional quality of work factors and contributing factors within the established risk profiles. The results show a definite pattern of risk progression for the six factors examined for each risk profile. Additionally, burnout and secondary traumatic stress were significantly related to higher anxiety and depression levels. Higher anxiety levels were correlated with nurses who were younger, worked full-time and without a postgraduate qualification. Twenty percent had elevated levels of compassion fatigue: 7.6% having a very distressed profile. At-risk nurses' stress and depression scores were significantly higher than nurses with higher compassion satisfaction scores. Implications for nursing managers The employed nurse workforce would benefit from a psychosocial capacity building intervention that reduces a nurse's risk profile, thus enhancing retention.",0,0 +7017,"Prevalence, risk factors and aging vulnerability for psychopathology following a natural disaster in a developing country","Objectives This study explored the psychopathological reactions to a natural disaster and their respective risk factors among the elderly in Honduras and their vulnerability as compared to other adults. Study subjects and sample Eight hundred respondents of both genders aged 15 years and above, of which 103 were 60 and over, were selected from high, middle and low residential status areas in Tegucigalpa that had suffered high and low exposure to the devastating effects of Hurricane Mitch. Research instruments CIDI was used to diagnose PTSD and the Impact of Events Scale was administered as a measure of severity of post-traumatic reaction. Depression and alcohol misuse were examined using screening instruments. The SRQ was used as both a measure of emotional distress and dichotomized to screen for probable psychiatric disorder. Results PTSD, depression and SRQ-case were found, respectively in 13.6%, 18.8%, and 21.4% of the elderly. Their reactions did not differ in frequency than of those of younger adults. Among the elderly, pre-hurricane psychological problems and the intensity of exposure were associated with increased risk for all outcomes measured except for alcohol misuse. Conclusion No evidence was found for a differential vulnerability on the part of the elderly as compared with younger adults. Among the elderly increasing age was not a factor. Copyright © 2005 John Wiley & Sons, Ltd.",0,0 +7018,Lifetime Sexual and Physical Victimization among Male Veterans with Combat-Related Post-traumatic Stress Disorder,"Because of the high prevalence of post-traumatic stress disorder (PTSD) among veteran men and the limited research on victimization in this group, we recruited 133 male veterans with combat-related PTSD from a psychiatric inpatient unit and assessed them for lifetime physical and sexual trauma. Results indicated that 96% of the sample had experienced some form of victimization over their lifetimes; 60% reported childhood physical abuse, 41% childhood sexual abuse, 93% adulthood physical assault, and 20% adulthood sexual assault. In the preceding year alone, 46% experienced either physical or sexual assault. These findings support the need for routine inquiry into the histories of noncombat victimization in this cohort. Determining the lifetime history of trauma exposure may have implications for vulnerability to subsequent development of PTSD and the risk of future violence.",0,0 +7019,Personality Subgroups in an Inpatient Vietnam Veteran Treatment Program,"Millon Clinical Multiaxial Inventory personality profiles of 250 male inpatient Vietnam veterans were examined to locate subgroups within that population. Using a hierarchical cluster analysis to form relatively homogeneous groups, four clusters were identified which accounted for 98% of the population. Three clusters had Millon profiles suggestive of a stress reaction and one cluster had a profile indicative of an antisocial adjustment. As measured by a PTSD subscale of the Minnesota Multiphasic Personality Inventory two clusters are high stress groups and two clusters are lower stress groups. The two Millon personality profiles in the high stress category were an 8-2-1/6 group and a 2-8-1-3 group. The lower stress groups had profiles of /8-2 and 6/8-5. The high stress groups are considered Posttraumatic Stress Disorder groups and the lower stress groups are considered nonPosttraumatic Stress Disorder groups.",0,0 +7020,Externalizing and Internalizing Subtypes of Combat-Related PTSD: A Replication and Extension Using the PSY-5 Scales.,"This study replicated and extended prior findings of internalizing and externalizing subtypes of posttraumatic response (M. W. Miller, J. L. Greif, & A. A. Smith, 2003). Cluster analyses of the Minnesota Multiphasic Personality Inventory--2 Personality Psychopathology--Five (MMPI-2 PSY-5; A. R. Harkness, J. L. McNulty, Y. S. Ben-Porath, 1995) profiles obtained from 736 veterans with posttraumatic stress disorder (PTSD) partitioned the sample into a low pathology cluster defined by personality scores in the normal range, an externalizing cluster characterized by low constraint and high negative emotionality, and an internalizing cluster with high negative emotionality and low positive emotionality. Externalizers showed the highest rates of alcohol-related and antisocial personality disorders; internalizers, the highest rates of panic and major depressive disorder. These findings support the development of a personality-based typology of posttraumatic response designed to account for heterogeneity in the expression of PTSD and associated psychopathology.",0,0 +7021,PTSD in the armed forces: What have we learned from the recent cohort studies of Iraq/Afghanistan?,"Post-traumatic stress disorder (PTSD) was formally recognised as a psychiatric disorder in 1980, largely in response to America's attempts to make sense of the costs of the Vietnam war [Wessely, S., & Jones, E. (2004). Psychiatry and the 'lessons of Vietnam': What were they, and are they still relevant? War & Society, 22(1), 89-103.]. Interestingly, all of this occurred without much contribution from epidemiology, which came later (Wessely & Jones, 2004). This cannot be said of the current conflicts, where from the outset there has been a focus of attention on the epidemiology of PTSD in those who served in either Iraq or Afghanistan, even whilst the conflicts were ongoing. In this editorial, we focus on this recent epidemiological contribution to the understanding of PTSD in military personnel.",0,0 +7022,Erratum for “Posttraumatic stress after a motor vehicle accident: A six-month follow-up study utilizing latent growth modeling”,"Reports an error in ""Posttraumatic stress after a motor vehicle accident: A six-month follow-up study utilizing latent growth modeling"" by Kitty K. Wu and Mike W. L. Cheung (Journal of Traumatic Stress, 2006[Dec], Vol 19[6], 923-936). Mike W. L. Chueng's affiliation was incorrectly listed in the print version. The correct affiliation is: Department of Psychology, National University of Singapore, Singapore. (The following abstract of the original article appeared in record 2007-00025-016.) Features of posttraumatic stress disorder (PTSD) for 596 survivors of motor vehicle accidents were examined by self-report measures at 1 week, 1 month, 3 months, and 6 months after the motor vehicle accident (MVA). Latent growth modeling was utilized to study the trend and predictors of the level of distress. Results indicated that 5-20% of the participants reported to have a significant level of posttraumatic stress in one, two, or three of the PTSD symptom clusters within the period studied. Survivors with significant acute stress 1 week after the MVA had a higher risk for developing chronic posttraumatic stress. Although the severity of intrusive and hyperarousal symptoms decreased over time, the severity of avoidance symptoms remained unchanged. Factors predicting the course of PTSD after an MVA are identified. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +7023,"Organophosphate-induced brain damage: Mechanisms, neuropsychiatric and neurological consequences, and potential therapeutic strategies","Organophosphate (OP)-induced brain damage is defined as progressive damage to the brain, resulting from the cholinergic neuronal excitotoxicity and dysfunction induced by OP-induced irreversible AChE inhibition. This delayed secondary neuronal damage that occurs mainly in the cholinergic regions of the brain that contain dense accumulations of cholinergic neurons and the majority of cholinergic projection, might be largely responsible for persistent profound neuropsychiatric and neurological impairments (memory, cognitive, mental, emotional, motor and sensory deficits) in the victims of OP poisoning. Neuroprotective strategies for attenuating OP-induced brain damage should target different development stages of OP-induced brain damage, and may include but not limited to: (1) Antidote therapies with atropine and related efficient anticholinergic drugs; (2) Anti-excitotoxic therapies targeting attenuation of cerebral edema and inflammatory reaction, blockage of calcium influx, inhibition of apoptosis program, and the control of seizures; (3) Neuroprotective strategies using cytokines, antioxidants and NMDAR antagonists (a single drug or a combination of drugs) to slow down the process of secondary neuronal damage; and (4) Therapies targeting individual symptoms or clusters of chronic neuropsychiatric and neurological symptoms. These neuroprotective strategies may help limit or prevent secondary neuronal damage at the early stage of OP poisoning and attenuate the subsequent neuropsychiatric and neurological impairments, thus reducing the long-term disability caused by exposure to OPs.",0,0 +7024,Validity of the Type D personality construct in Danish post-MI patients and healthy controls,"Type D personality has been associated with increased risk of depression, vital exhaustion, social alienation, a higher number of reinfarctions, and higher mortality rates in patients with established coronary artery disease (CAD) independent of traditional biomedical risk factors. The construct was developed in Belgian cardiac patients, but little is known about its applicability in other nationalities. The objectives of the present article were to cross-validate the Type D Personality Scale-16 (DS16) in a Danish sample of patients with a first myocardial infarction and a random sample of healthy controls, and to investigate whether Type D is associated with posttraumatic stress disorder (PTSD). A questionnaire was given to 112 consecutive patients with a first myocardial infarction 4 to 6 weeks post infarction, and to 115 healthy controls selected randomly from the general population. The two-factor structure of the DS16 and the internal consistency of the Negative Affectivity ( α =.83) and Social Inhibition ( α =.76) subscales were confirmed. The construct validity of the DS16 was confirmed against scales that measure similar constructs, and the discriminant validity of the DS16 against measures of psychopathology . In a pooled sample of patients and healthy controls, comparison of both groups confirmed that Type D may be conceptualised as a marker of general emotional distress , with Type D persons scoring higher on depression, anxiety, and the PTSD symptom clusters arousal and avoidance compared with non-Type D persons. A regression analysis run in two steps showed that the inclusion of Type D in the model lead to an improvement in the level of prediction of PTSD above and beyond a model that included gender, age, MI, neuroticism , and extroversion. Type D (OR=4.46; 95% CI: 1.36 to 14.64), diagnosis of MI (OR=4.03; 95% CI: 1.43 to 11.35), and neuroticism (OR=1.32; 95% CI: 1.13 to 1.53) were independently associated with PTSD, adjusting for all other variables. These findings indicate that the Type D construct is equally applicable in Danish patients with CAD, and that Type D is associated with PTSD.",0,0 +7025,A TWIN REGISTRY STUDY OF FAMILIAL AND INDIVIDUAL RISK FACTORS FOR TRAUMA EXPOSURE AND POSTTRAUMATIC STRESS DISORDER,"This study examines the association of individual and familial risk factors with exposure to trauma and posttraumatic stress disorder (PTSD) in male twins (N = 6744) from the Vietnam Era Twin Registry. Independent reports of familial psychopathology from co-twins were used to avoid the potential biases of the family history method. Risk for exposure to traumatic events was increased by service in Southeast Asia, preexisting conduct disorder, preexisting substance dependence, and a family history of mood disorders whose effects appear to be partly genetic. Preexisting mood disorders in the individual were associated with decreased odds of traumatic exposure. Risk of developing PTSD following exposure was increased by an earlier age at first trauma, exposure to multiple traumas, paternal depression, less than high school education at entry into the military, service in Southeast Asia, and preexisting conduct disorder, panic disorder or generalized anxiety disorder, and major depression. Results suggest the association of familial psychopathology and PTSD may be mediated by increased risk of traumatic exposure and by preexisting psychopathology.",0,0 +7026,Psychosocial Concerns and Interventions for Cancer Survivors,"In light of the increasing population living with a history of cancer in the United States, it is important to attend to quality of life and health in this group, and to develop effective interventions to address psychosocial and physical concerns across the course of the cancer trajectory. The goals of this article are to document the need for attention to psychosocial domains; offer a brief overview of the current status of the empirical literature on effects of psychosocial interventions with cancer survivors, relying on systematic reviews and meta-analyses conducted in the last decade; highlight recent examples of randomized, controlled psychosocial intervention trials directed toward cancer survivors after the completion of primary medical treatments (ie, the re-entry phase and beyond); and identify directions for application and research.",0,0 +7027,"A Computerized, Self-Administered Questionnaire to Evaluate Posttraumatic Stress Among Firefighters After the World Trade Center Collapse","We sought to determine the frequency of psychological symptoms and elevated posttraumatic stress disorder (PTSD) risk among New York City firefighters after the World Trade Center (WTC) attack and whether these measures were associated with Counseling Services Unit (CSU) use or mental health-related medical leave over the first 2.5 years after the attack.Shortly after the WTC attack, a computerized, binary-response screening questionnaire was administered. Exposure assessment included WTC arrival time and ""loss of a co-worker while working at the collapse."" We determined elevated PTSD risk using thresholds derived from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, and a sensitivity-specificity analysis.Of 8487 participants, 76% reported at least 1 symptom, 1016 (12%) met criteria for elevated PTSD risk, and 2389 (28%) self-referred to the CSU, a 5-fold increase from before the attack. Higher scores were associated with CSU use, functional job impairment, and mental health-related medical leave. Exposure-response gradients were significant for all outcomes.This screening tool effectively identified elevated PTSD risk, higher CSU use, and functional impairment among firefighters and therefore may be useful in allocating scarce postdisaster mental health resources.",0,0 +7028,Risk indicators for post-traumatic stress disorder in adolescents exposed to the 5.12 Wenchuan earthquake in China,"In Chinese adolescents exposed to the Wenchuan earthquake, we used the Children's Revised Impact of Event Scale (CRIES) as the screening tool, and Post-traumatic Cognitions Inventory (PTCI) and the Social Support Rating Scale (SSRS) were used to assess the cognitive status and their social supports, to evaluate the prevalence and the predictors variables of post-traumatic stress disorder (PTSD) after the Wenchuan earthquake in China, which occurred on 12 May 2008. Subjects with a CRIES score greater than 30 were interviewed and assessed using the DSM-IV criteria for PTSD diagnosis by a trained psychiatrist with the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Lifetime version (Kiddie-SADS-L). We found the overall prevalence of PTSD was 2.5% in 3208 adolescents from the surrounding areas of the epicentre 6months after the earthquake. Risk factors for post-traumatic stress symptoms are as follows: being female, being buried/injured during the earthquake, having parents who were severely injured, having classmate(s) who died, having a house destroyed, and witnessing someone buried/wounded/dying during the earthquake. Individuals with better social support had significantly lower scores on the CRIES. There were significant differences in cognitive style between individuals at low risk for PTSD (CRIES<30) and those at high risk for PTSD (CRIES≥30). Post-traumatic cognition emerged as an important factor that was associated with PTSD reactions in children. Social support can lessen the impact of a natural disaster by affecting post-traumatic cognition.",0,0 +7029,Risk factors for PTSD-related traumatic events: a prospective analysis,"The authors previously identified suspected risk factors for traumatic events related to posttraumatic stress disorder (PTSD) on the basis of data gathered retrospectively. In this study, they tested that model prospectively.A random sample of 1,200 persons was drawn from all 21- to 30-year-old members of a large health maintenance organization. In 1989, 1,007 of these persons were interviewed, and suspected risk factors were measured. In 1992, 979 were reinterviewed, and the 3-year incidence of exposure to traumatic events was ascertained.Nineteen percent of the sample reported traumatic events during the 3-year follow-up. A history of past exposure to traumatic events signaled an increase in the liability to exposure during follow-up, independent of suspected risk factors. Two predictors of exposure, neuroticism and extroversion, identified retrospectively, also predicted exposure prospectively. The odds for exposure among males and persons with less than a college education were marginally significant. Early misconduct and a family history of psychiatric disorder-predictors of exposure in the retrospective data-were not significant predictors at 3-year follow-up. Blacks had a higher incidence of exposure during follow-up than whites. An exploratory reanalysis suggested that the discrepancy between the retrospective and prospective results may be explained by the inclusion of childhood exposure in the lifetime retrospective inquiry.The assumption that PTSD-related traumatic events are random phenomena was unsupported. Among young adults, those with less education, blacks, and those with high neuroticism and extroversion scores are more likely than others to be exposed to traumatic events and are thus at greater risk for PTSD.",0,0 +7030,Broadening the focus in supporting reintegrating Iraq and Afghanistan veterans: Six key domains of functioning.,"As the major ground troop presence in the Middle East is reduced, it is time to reflect, maximize lessons learned, and look forward to what lies ahead for the nearly 2.6 million service members of the United States military who have deployed in support of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn. A systematic review of the literature on postdeployment functioning of Iraq and Afghanistan troops was conducted. Findings are described and contextualized in terms of service members' ongoing strengths, needs, and challenges. The corpus of research on deployed personnel indicates that service members demonstrate resilience in the face of war-related stressors. However, postdeployment impairment in 6 functional domains emerged in the literature review, including mental health, social and role functioning, relationship functioning and family life, spirituality, physical health, and financial well-being. Although risk factors and future trajectories vary across these domains, psychiatric difficulties are a consistent predictor of a worsened course. Implications for clinical practice are described based on the review findings. To promote wellbeing in the years ahead, it is important that service members are supported in their various roles (such as in the classroom, the workforce, and the family). In addition, routine assessment of functioning across domains is highly recommended for postdeployment service members. (PsycINFO Database Record © 2015 APA, all rights reserved).",0,0 +7031,Molecular Events Triggered by Heat Shock in Y1 Adrenocortical Cells,"Several stimuli, including stress conditions, promote the activation of MAP kinases family members (ERK1/2, JNK, p38). In turn, these enzymes regulate several cellular functions. Given that MAPK activation requires the phosphorylation of these proteins, their inactivation depends on the activity of specific phosphatases. MAPK phosphatase-1 (MKP-1), a phosphatase specifically involved in the inactivation of MAPK family members, is induced by mitogenic stimuli and stress conditions. Here we describe the effect of heat shock (HS), 10 min, 45 degrees C, on MAPKs activities and MKP-1 mRNA and protein levels in Y1 adrenocortical cells. Western blot analysis performed with antibodies against the phosphorylated forms of ERK1/2 and JNK revealed that HS produced the rapid activation of these kinases. Their inactivation was also a rapid event and occurred together with the increase of MKP-1 protein levels detected by Western blot analysis. In addition, the effect of HS on MKP-1 protein levels seems to be exerted at the transcriptional level, since the amount of its mRNA in heat shocked cells was higher than in nonheated cells. Comparison of the temporal profiles of MKP-1 protein induction and MAPKs phospho-dephosphorylation suggests that MKP-1 induction could contribute to ERK1/2 and JNK inactivation after HS.",0,0 +7032,Measuring Secondary Traumatic Stress Symptoms in Military Spouses With the Posttraumatic Stress Disorder Checklist Military Version,"Little research to date has examined secondary traumatic stress symptoms in spouses of military veterans. This study investigated the presence and severity of posttraumatic stress symptoms in a sample of 227 Army National Guard veterans and secondary traumatic stress symptoms among their spouses. The veterans completed the posttraumatic stress disorder (PTSD) Checklist Military Version (PCL-M) (Weathers et al., 1993) to determine the probable prevalence rate of posttraumatic stress symptoms. A modified version of the PCL-M was used to assess secondary traumatic stress symptoms in the spouses. A confirmatory factor analysis showed that the modified version of the PCL-M used to assess secondary traumatic stress symptoms in spouses fits using the same four-factor PTSD structure as the PCL-M for veterans. This study provides initial evidence on the underlying symptom structure of secondary traumatic stress symptoms among spouses of traumatic event victims.",0,0 +7033,Trajectories of Posttraumatic Stress Among Urban Residents,"Urban residents experience a wide range of traumatic events and are at increased risk of assaultive violence. Although previous research has examined trajectories of posttraumatic stress (PTS) through latent class growth analysis (LCGA) among persons exposed to the same index events (e.g., a natural disaster), PTS trajectories have not been documented among urban residents. The aims of this study were to conduct LGCA with a sample of trauma survivors from Detroit, Michigan (N = 981), and to explore predictors of trajectory membership. Participants completed three annual telephone surveys, each of which included the posttraumatic stress disorder (PTSD) Checklist-Civilian Version. Four PTS trajectories were detected. Although the majority evidenced a trajectory of consistently few symptoms (Low: 72.5%), 4.6% were in a trajectory of chronic severe PTSD (High), and the remainder were in trajectories of consistently elevated, but generally subclinical, levels of PTS (Decreasing: 12.3%; Increasing: 10.6%). Socioeconomic disadvantage (e.g., lower income), more extensive trauma history (e.g., childhood abuse), and fewer social resources (e.g., lower social support) were associated with membership in higher PTS trajectories, relative to the Low trajectory. The results suggest that efforts to reduce PTS in urban areas need to attend to socioeconomic vulnerabilities in addition to trauma history and risk for ongoing trauma exposure.",0,0 +7034,Neurobiological indicators of disinhibition in posttraumatic stress disorder,"Deficits in impulse control are increasingly recognized in association with posttraumatic stress disorder (PTSD). To our further understanding of the neurobiology of PTSD-related disinhibition, we examined alterations in brain morphology and network connectivity associated with response inhibition failures and PTSD severity. The sample consisted of 189 trauma-exposed Operation Enduring Freedom/Operation Iraqi Freedom veterans (89% male, ages 19-62) presenting with a range of current PTSD severity. Disinhibition was measured using commission errors on a Go/No-Go (GNG) task with emotional stimuli, and PTSD was assessed using a measure of current symptom severity. Whole-brain vertex-wise analyses of cortical thickness revealed two clusters associated with PTSD-related disinhibition (Monte Carlo cluster corrected P < 0.05). The first cluster included portions of right inferior and middle frontal gyri and frontal pole. The second cluster spanned portions of left medial orbital frontal, rostral anterior cingulate, and superior frontal gyrus. In both clusters, commission errors were associated with reduced cortical thickness at higher (but not lower) levels of PTSD symptoms. Resting-state functional magnetic resonance imaging analyses revealed alterations in the functional connectivity of the right frontal cluster. Together, study findings suggest that reductions in cortical thickness in regions involved in flexible decision-making, emotion regulation, and response inhibition contribute to impulse control deficits in PTSD. Furthermore, aberrant coupling between frontal regions and networks involved in selective attention, memory/learning, and response preparation suggest disruptions in functional connectivity may also play a role.",0,0 +7035,Meta-analytic review of event-related potential studies in post-traumatic stress disorder,"In recent years there has been an accumulation of studies that have utilized the measurement of event-related potentials (ERP) to examine the neuroelectric correlates of hypothesized alterations in information processing in persons with post-traumatic stress disorder (PTSD). The objective of this meta-analysis was to summarize the findings of ERP PTSD research, including studies that have examined P50 auditory sensory gating, augmenting-reducing P200, and P300 in target detection oddball tasks. The results suggest that persons with PTSD exhibit alterations in the amplitude and latency of ERP within these paradigms that support the hypothesis that changes in information processing can accompany PTSD. The results were also consistent with recent cognitive neuropsychological findings in PTSD research.",0,0 +7036,Family satisfaction predicts life satisfaction trajectories over the first 5 years after traumatic brain injury.,"Examined the influence of functional impairment, stable marital status, and family satisfaction on life satisfaction trajectories for 609 individuals (435 men, 174 women) over the first 5 years after traumatic brain injury (TBI).Participants completed the Family Satisfaction Scale (FSS), Functional Independence Measure (FIM), and the Life Satisfaction Index (LSI) at years 1, 2, 4, and 5 after sustaining a TBI.Trajectory modeling revealed that higher family satisfaction was associated with increases in life satisfaction for individuals with less functional impairment. Stable marital status was not significantly associated with life satisfaction trajectories.Family satisfaction appears to have pronounced beneficial effects on life satisfaction for persons with less functional impairment after TBI regardless of marital status. In contrast, a stable marriage appears to have no apparent benefits to self-reported life satisfaction over the first 5 years post-TBI. Theoretical and clinical implications of these results are discussed.",0,0 +7037,PTSD and Depression Among Displaced Chinese Workers After the World Trade Center Attack: A Follow-up Study,"We conducted a follow-up assessment to assess the development of Posttraumatic Stress Disorder (PTSD) and depression among Chinese immigrants after the World Trade Center attack. Sixty-five Chinese displaced workers who were originally interviewed in May 2002 were re-interviewed in March 2003. Whereas depression scores decreased over time, average PTSD scores remained unchanged. The trajectory of posttraumatic stress symptoms was more complex, with an increasing number of individuals who show no or little emotional health problems and another increasing group of individuals with exacerbated posttraumatic stress symptoms. Although the mean values of the re-experiencing and hypervigilance cluster did not change over time, the mean value of the avoidance/numbing cluster increased significantly from time 1 (M= 4.60, SD = 4.98) to time 2 (M= 6.34, SD = 4.24), (F1.61=5.69,P= .02). A higher proportion of subjects met diagnostic criteria of PTSD at time 2 (27%) than at time 1 (21%). The study highlights the importance of ongoing mental health surveillance of diverse cultural and linguistic groups after a major traumatic event.",0,0 +7038,Responses to violence and trauma: the case of post-traumatic stress disorder,"Chapter 9 describes and evaluates the relatively recent mental health models of the impact of trauma, and discusses the ways that traumatic events affect people, the political and cultural effects of understanding these consequences as ‘disorder’, particularly as Post-traumatic Stress Disorder (PTSD), and concludes by looking at the relevance of the concept of PTSD to forensic populations.",0,0 +7039,Clustering of Trauma and Associations with Single and Co-Occurring Depression and Panic Attack over Twenty Years,"Individuals who experience one type of trauma often experience other types, yet few studies have examined the clustering of trauma. This study examines the clustering of traumatic events and associations of trauma with risk for single and co-occurring major depressive disorder (MDD) and panic attack for 20 years after first trauma. Lifetime histories of MDD, panic attack, and traumatic events were obtained from participants in an Australian twin sample. Latent class analysis was used to derive trauma classes based on each respondent's trauma history. Associations of the resulting classes and of parental alcohol problems and familial effects with risk for a first onset of single and co-occurring MDD and panic attack were examined from the year of first trauma to 20 years later. Traumatic events clustered into three distinct classes characterized by endorsement of little or no trauma, primarily nonassaultive, and primarily assaultive events. Individuals in the assaultive class were characterized by a younger age at first trauma, a greater number of traumatic events, and high rates of parental alcohol problems. Members of the assaultive trauma class had the strongest and most enduring risk for single and co-occurring lifetime MDD and panic attack. Assaultive trauma outweighed associations of familial effects and nonassaultive trauma with risk for 10 years following first trauma.",0,0 +7040,Patterns of violence against women: A latent class analysis.,"This study examined patterns of nine types of violence against women (VAW) and associated mental health problems. The following self-reported, lifetime violence victimization was examined among 1424 employed women: (1) childhood physical abuse, (2) childhood sexual abuse, (3) physical abuse between parents/guardians during childhood, (4) psychological intimate partner violence (IPV), (5) physical IPV, (6) sexual IPV, (7) adult physical or sexual assault by a non-intimate partner, (8) physical workplace violence, and (9) psychological workplace violence. Latent class analysis was used to identify homogenous patterns, called ""classes,"" of women's ""yes/no"" responses to experiencing these types of violence. The best model consisted of 4-classes characterized by the following probabilities: low violence (class 1: 63.1%), high psychological and physical IPV (class 2: 15.6%), high physical and psychological workplace violence (class 3: 12.4%), and moderate to high childhood abuse (class 4: 9.0%). When compared to class 1 (low violence), membership in classes 2 (IPV) and 4 (childhood abuse) was associated with screening positive for depression in the past week at baseline after controlling for the influence of demographic characteristics on class membership. Also, when compared to class 1 (low all), membership in class 2 (IPV) was associated with greater odds of screening positive for posttraumatic stress disorder in the past month at the six month follow-up assessment. Findings document distinct patterns of VAW and associated proximal and distal mental health outcomes. Implications for interventions aimed to improve employed women's health are discussed.",0,0 +7041,Psychogenic status epilepticus in children,"Epilepsy features, psychiatric profile, psychosocial factors, and outcome are described for six children (three males) aged 5-15 years (mean 12.1) with psychogenic status epilepticus (PSE), i.e., prolonged or repetitive psychogenic seizures (PSs), >30 minutes, simulating status epilepticus. They had epilepsy, they were on chronic anticonvulsants (ACVs), and some had other neurological deficits. All received intravenous and/or rectal ACVs prior to suspicion of PSE. PSE was confirmed via video/EEG, demonstrating no epileptogenic activity during alleged seizures. Provocation and placebo therapy techniques were used in two. Psychiatric assessment identified comorbid disorders such as depression, anxiety disorder, obsessive-compulsive disorder, obsessive-compulsive symptoms, and posttraumatic stress disorder. Psychosocial stressors were almost ubiquitous. Psychiatric intervention included psychotherapy, family therapy, and medical treatment in one patient. Outcome was monitored for an average of 3.6 years (3-5 years). PSE did not recur. PSs recurred in three. Psychiatric comorbidity improved in four, who accepted psychiatric intervention and whose epilepsy also improved. In conclusion, the occurrence of PSE in children and adolescents with epilepsy is stressed. Prompt diagnosis was often missed in the acute care setting, and this carries important implications for iatrogenic complications. PSE diagnosis resulted in identification and management of comorbid psychiatric disorders. This was probably important in reducing the predominating anxiety and affective disorders in most patients as well as PSE recurrence. Epilepsy severity and associated deficits were most likely important factors in determining outcome.",0,0 +7042,Posttraumatic Stress Disorder and Depression Following Trauma: Understanding Comorbidity,"Posttraumatic stress disorder (PTSD) and major depression occur frequently following traumatic exposure, both as separate disorders and concurrently. This raises the question of whether PTSD and depression are separate disorders in the aftermath of trauma or part of a single general traumatic stress construct. This study aimed to explore the relationships among PTSD, depression, and comorbid PTSD/depression following traumatic injury.A group of 363 injury survivors was assessed just prior to discharge from hospital and 3 and 12 months postinjury. Canonical correlations were used to examine the relationship between PTSD and depression symptom severity and a set of predictor variables. Multinomial logistic regression was used to identify whether the diagnostic categories of PTSD, depression, and comorbid PTSD/depression were associated with different groups of predictors.The majority of psychopathology in the aftermath of trauma was best conceptualized as a general traumatic stress factor, suggesting that when PTSD and depression occur together, they reflect a shared vulnerability with similar predictive variables. However, there was also evidence that in a minority of cases at 3 months, depression occurs independently from PTSD and was predicted by a different combination of variables.While PTSD and comorbid PTSD/depression are indistinguishable, the findings support the existence of depression as a separate construct in the acute, but not the chronic, aftermath of trauma.",0,0 +7043,Posttraumatic Stress Following Pediatric Injury,"After pediatric injury, transient traumatic stress reactions are common, and about 1 in 6 children and their parents develop persistent posttraumatic stress (PTS) symptoms that are linked to poorer physical and functional recovery. Meta-analytic studies identify risk factors for persistent PTS, including preinjury psychological problems, peritrauma fear and perceived life threat, and posttrauma factors such as low social support, maladaptive coping strategies, and parent PTS symptoms. There is growing prospective data indicating that children's subjective appraisals of the injury and its aftermath influence PTS development. Secondary prevention of injury-related PTS often involves parents and focuses on promoting adaptive child appraisals and coping strategies. Web-based psychoeducation and targeted brief early intervention for injured children and their parents have shown a modest effect, but additional research is needed to refine preventive approaches. There is a strong evidence base for effective psychological treatment of severe and persistent PTS via trauma-focused cognitive behavioral therapy; evidence is lacking for psychopharmacological treatment. Pediatric clinicians play a key role in preventing injury-related PTS by providing ""trauma-informed"" pediatric care (ie, recognizing preexisting trauma, addressing acute traumatic stress reactions associated with the injury event, minimizing potentially traumatic aspects of treatment, and identifying children who need additional monitoring or referral).",0,0 +7044,Posttraumatic Stress Disorder After Severe Traumatic Brain Injury,"This study indexed the profile of posttraumatic stress disorder (PTSD) after severe traumatic injury to the brain.Patients who sustained a severe traumatic brain injury (N=96) were assessed for PTSD 6 months after the injury with the PTSD Interview, a structured clinical interview based on DSM-III-R criteria.PTSD was diagnosed in 26 (27.1%) of the patients. While only 19.2% (N=5) of the patients with PTSD reported intrusive memories of the trauma, 96.2% (N=25) reported emotional reactivity. Intrusive memories, nightmares, and emotional reactivity had very strong positive predictive values for the presence of PTSD.These findings indicate that PTSD can develop after severe traumatic brain injury. The predominance of emotional reactivity and the relative absence of traumatic memories in patients with PTSD who suffered impaired consciousness during trauma suggest that traumatic experiences can mediate PTSD at an implicit level.",0,0 +7045,Cognitive and behavioural post-traumatic impairments: What is the specificity of a brain injury ? A study within the ESPARR cohort,"The variety and extent of impairments occurring after traumatic brain injury vary according to the nature and severity of the lesions. In order to better understand their interactions and long-term outcome, we have studied and compared the cognitive and neurobehavioral profile one year post onset of patients with and without traumatic brain injury in a cohort of motor vehicle accident victims.The study population is composed of 207 seriously injured persons from the ESPARR cohort. This cohort, which has been followed up in time, consists in 1168 motor vehicle accident victims (aged 16 years or more) with injuries with all degrees of severity. Inclusion criteria were: living in Rhone county, victim of a traffic accident having involved at least one wheel-conducted vehicle and having occurred in Rhone county, alive at the time of arrival in hospital and having presented in one of the different ER facilities of the county. The cohort's representativeness regarding social and geographic criteria and the specificities of the accidents were ensured by the specific targeting of recruitment. Deficits and impairments were assessed one year after the accident using the Neurobehavioral Rating Scale - Revised and the Trail-Making Test. Within our seriously injured group, based on the Glasgow Score, the presence of neurological deficits, aggravation of neurological condition in the first 72hours and/or abnormal cerebral imaging, we identified three categories: (i) moderate/severe traumatic brain injury (n=48), (ii) mild traumatic brain injury (n=89), and (iii) severely injured but without traumatic brain injury (n=70).The most frequently observed symptoms were anxiety, irritability, memory and attention impairments, depressive mood and emotional lability. While depressive mood and irritability were observed with similar frequency in all three groups, memory and attention impairments, anxiety and reduced initiative were more specific to traumatic brain injury whereas executive disorders were associated with moderate/severe traumatic brain injury.The presence and the initial severity of a traumatic brain injury condition the nature and frequency of residual effects after one year. Some impairments such as irritability, which is generally associated with traumatic brain injury, do not appear to be specific to this population, nor does depressive mood. Substantial interactions between cognitive, affective and neurobehavioral disorders have been highlighted.",0,0 +7046,"The Temporal Elements of Psychological Resilience: An Integrative Framework for the Study of Individuals, Families, and Communities","Psychological resilience has become a popular concept. Owing to that popularity, the word resilience has taken on myriad and often overlapping meanings. To be a useful framework for psychological research and theory, the authors argue, the study of resilience must explicitly reference each of four constituent temporal elements: (a) baseline or preadversity functioning, (b) the actual aversive circumstances, (c) postadversity resilient outcomes, and (d) predictors of resilient outcomes. Using this framework to review the existing literature, the most complete body of evidence is available on individual psychological resilience in children and adults. By contrast, the research on psychological resilience in families and communities is far more limited and lags well behind the rich theoretical perspective available from those literatures. The vast majority of research on resilience in families and communities has focused primarily on only one temporal element, possible predictors of resilient outcomes. Surpr...",0,0 +7047,A longitudinal follow-up of posttraumatic stress: from 9 months to 20 years after a major road traffic accident,"Although road traffic accidents (RTA) are a major cause of injury and a cause of posttraumatic stress (PTS) in the aftermath, little is known about the long-term psychological effects of RTA.This prospective longitudinal study assessed long-term PTS, grief, and general mental health after a bus carrying 23 sixth-grade schoolchildren crashed on a school outing and 12 children died. Directly affected (i.e., children in the crash) and indirectly affected children (i.e., all pupils in the sixth grade who were not in the crash) were surveyed at 9 months (N = 102), 4 years (N = 51), and 20 years (N = 40) after the event. Psychological distress was assessed by single items, including sadness, avoidance, intrusions, and guilt. After 20 years, PTS was assessed by the Impact of Event Scale-Revised.Stress reactions were prevalent 9 months after the event, with sadness (69%) and avoidance (59%) being highly represented in both directly and indirectly affected groups, whereas, nightmares (60%) and feelings of guilt (50%) were only frequent in those directly affected. The frequency of sadness and avoidance decreased after 4 years in the indirectly exposed (ps < .05). After 20 years, the directly affected had a higher prevalence of PTS (p = .003), but not decreased general mental health (p = .14), than those indirectly affected.The limitations preclude assertive conclusions. Nonetheless, the findings corroborate previous studies reporting traumatic events are associated with long-term PTS, but not with decreased general mental health.",0,0 +7048,"Single prolonged stress decreases glutamate, glutamine, and creatine concentrations in the rat medial prefrontal cortex","Application of single prolonged stress (SPS) in rats induces changes in neuroendocrine function and arousal that are characteristic of post traumatic stress disorder (PTSD). PTSD, in humans, is associated with decreased neural activity in the prefrontal cortex, increased neural activity in the amygdala complex, and reduced neuronal integrity in the hippocampus. However, the extent to which SPS models these aspects of PTSD has not been established. In order to address this, we used high-resolution magic angle spinning proton magnetic resonance spectroscopy (HR-MAS (1)H MRS) ex vivo to assay levels of neurochemicals critical for energy metabolism (creatine and lactate), excitatory (glutamate and glutamine) and inhibitory (gamma amino butyric acid (GABA)) neurotransmission, and neuronal integrity (N-acetylaspartate (NAA)) in the medial prefrontal cortex (mPFC), amygdala complex, and hippocampus of SPS and control rats. Glutamate, glutamine, and creatine levels were decreased in the mPFC of SPS rats when compared to controls, which suggests decreased excitatory tone in this region. SPS did not alter the neurochemical profiles of either the hippocampus or amygdala. These data suggest that SPS selectively attenuates excitatory tone, without a disruption of neuronal integrity, in the mPFC.",0,0 +7049,PATH: a program to build resilience and thriving in undergraduates,"We developed and tested a brief three-session program to build resilience (protection from depressive symptoms) and thriving (positive growth) in undergraduates by teaching adaptive explanatory styles. In Study 1, a pretest–posttest waiting list control experiment with 28 undergraduates found that our Program for Accelerated Thriving and Health (PATH) significantly increased optimistic and personal control explanatory styles (Attributional Style Questionnaire), resilience (Beck Depression Inventory-II), and thriving (Connor–Davidson Resilience Scale 10). In Study 2, a placebo control experiment with 63 undergraduates found a modified version of the program to significantly increase resilience. All effects were at least moderate in size. As predicted, a personal control explanatory style significantly predicted thriving in both studies. Predictors of resilience and thriving were discussed in terms of differentiating the constructs.",0,0 +7050,Paroxetine in the treatment of post-traumatic stress disorder: pooled analysis of placebo-controlled studies,"Post-traumatic stress disorder (PTSD) is increasingly understood to be a medical disorder characterised by particular psychobiological dysfunctions that respond to specific treatments. Paroxetine is a selective serotonin re-uptake inhibitor that has been found effective in the treatment of major depression as well as a range of anxiety disorders. This paper reviews data on the use of paroxetine for the treatment of adult PTSD. There have been three 12-week, placebo-controlled studies of paroxetine in PTSD. As these followed a partly similar design, a pooled analysis of the studies is possible and is reported here. Paroxetine is effective in the short-term treatment of PTSD, resulting in significantly better response and remission rates than placebo, improving sleep disturbance and reducing each of the symptom clusters of PTSD, as well as the disability associated with this condition. The medication is effective in both male and female PTSD patients and whether or not there are comorbid disorders such as depression.",0,0 +7051,The Missing Link in Resilience Research,"Bonanno, Romero and Klein (this issue) review many aspects of individual, family and community resilience studies, highlighting the fact that resilience is a multi-dimensional, complex construct wh...",0,0 +7052,Risk factors of severity of post-traumatic stress disorder among survivors with physical disabilities one year after the Wenchuan earthquake,"On May 12, 2008, a devastating earthquake measuring 8.0 on the Richter scale struck Wenchuan County and surrounding areas in China. This study aimed to assess post-traumatic stress disorder (PTSD) in the aftermath of the earthquake, and to evaluate factors of severity of PTSD symptoms among survivors with physical disabilities. We conducted a population-based cross-sectional survey and recruited 817 survivors with physical disabilities in three stricken areas. Assessment measures included the PTSD Checklist-Civilian Version (PCL-C) and the 12-item General Health Questionnaire (GHQ-12). Our study showed that 27.42% of the survivors with physical disabilities had PTSD symptoms one year after the Wenchuan earthquake. In the regression model, geographic location, female, suffering from paralysis following the earthquake, and going into a coma in the earthquake were associated with severe PTSD symptoms. Our findings suggest that a substantial proportion of physically disabled survivors of a big earthquake may have severe PTSD symptoms. The associated factors of PTSD identified in our study could inform the implementation of preventive programs for this population and give hint on the way to cope with this kind of disaster in the future.",0,0 +7053,"Clinical epidemiology in patients admitted at Mathari Psychiatric Hospital, Nairobi, Kenya","Background: Knowledge of types and co-morbidities of disorders seen in any facility is useful for clinical practice and planning for services. Aim: To study the pattern of co-morbidities of and correlations betweenpsychiatric disorders in in-patients of Mathari Hospital, the premier psychiatric hospital in Kenya. Study Design: Cross-sectional. Methods: All the patients who were admitted at Mathari Hospital in June 2004 and were well enough to participate in the study were approached for informed consent. Trained psychiatric charge nurses interviewed them using the Structured Clinical Interview for DSM-IV Axis I disorders Clinical Version (SCID-I). Information on their socio-demographic profiles and hospital diagnoses was extracted from their clinical notes using a structured format. Results: Six hundred and ninety-one patients participated in the study. Sixty-three percent were male. More than three quarters (78%) of the patients were aged between 21 and 45 years. More than half (59.5%) of the males and slightly less than half (49.4%) of the females were single. All the patients were predominantly of the Christian faith. Over 85% were dependants of another family member and the remainder were heads of households who supported their own families. Schizophrenia, bipolar I disorder, psychosis, substance use disorder and schizo-affective disorder were the most common hospital and differential diagnoses. Of the anxiety disorders, only three patients were under treatment for post-traumatic stress disorder (PTSD). Nearly a quarter (24.6%) of the patients were currently admitted for a similar previous diagnosis. Schizophrenia was the most frequent DSM-IV (Diagnostic and Statistical Manual of Mental Disorders' fourth edition) diagnosis (51%), followed by bipolar I disorder (42.3%), substance use disorder (34.4%) and major depressive illness (24.6%). Suicidal features were common in the depressive group, with 14.7% of this group reporting a suicidal attempt. All DSM-IV anxiety disorders, including obsessive-compulsive disorders, were highly prevalent although, with the exception of three cases of PTSD, none of these anxiety disorders were diagnosed clinically. Traumatic events were reported in 33.3% of the patients. These were multiple and mainly violent events. Despite the multiplicity of these events, only 7.4% of the patients had a PTSD diagnosis in a previous admission while 4% were currently diagnosed with PTSD. The number of DSM-IV diagnoses was more than the total number of patients, suggesting co-morbidity, which was confirmed by significant 2-tailed correlation tests. Conclusion: DSM-IV substance use disorders, major psychiatric disorders and anxiety disorders were prevalent and co-morbid. However, anxiety disorders were hardly diagnosed and therefore not managed. Suicidal symptoms were common. These results call for more inclusive clinical diagnostic practice. Standardized clinical practice using a diagnostic tool on routine basis will go a long way in ensuring that no DSM-IV diagnosis is missed. This will improve clinical management of patients and documentation. © Springer-Verlag 2008.",0,0 +7054,Linguistic Predictors of Post-Traumatic Stress Disorder Symptoms Following 11 September 2001,"Summary Prior research has linked content analysis drawn from text narratives to psychopathology in trauma survivors. This study used a longitudinal design to determine whether linguistic elements of narrative memories of first hearing about the events of 11 September 2001 predict later post-traumatic stress disorder (PTSD). Narratives and self-report PTSD symptoms were collected within 1 week and again 5 months after 9/11 in 40 undergraduates. People who used more “we” words at Time 1 had fewer acute PTSD symptoms. Use of more cognitive mechanism words, more religion words, more first-person singular pronouns, and fewer anxiety words at Time 1 were related to more chronic PTSD symptoms. Linguistic characteristics accounted for variance in chronic PTSD symptoms above and beyond acute PTSD symptoms. This study provides evidence that lasting PTSD symptoms can be predicted through language in the immediate aftermath of the trauma. Copyright © 2011 John Wiley & Sons, Ltd.",0,0 +7055,"Political violence, social integration, and youth functioning: Palestinian youth from the Intifada","Informed by social ecological, social capital, and social disorganization theories, this study tested an ecological model of youth experience in the Palestinian Intifada. The sample included 6,000 Palestinian 14 year olds, assessed in 1994 and 1995 after the end of the conflict. Data from retrospective self-reports of youth exposure to and involvement in political violence, and self-reports of current individual functioning (depression and antisocial behavior) and integration in several social contexts (family, peer relations, religion, education, and community), revealed: direct associations between Intifada experience and antisocial behavior and depression (females only); Intifada experience was positively associated with religiosity and unrelated to social integration in family, school, and peer relations; in some cases, social integration in family, education, religion, and peer relations significantly moderated the associations between Intifada experience and youth problems; integration in the several social contexts was directly related in predictable ways to youth problem behaviors, with neighborhood disorganization the most consistent and powerful predictor. The discussion centers around youth resilience to the effects of political violence, the role of psychological meaning children and adolescents can attach to political violence, and the overall salience of social integration in youth development. © 2001 John Wiley & Sons, Inc.",0,0 +7056,The temporal relationship between posttraumatic stress disorder and problem alcohol use following traumatic injury.,"Chronic alcohol abuse is a major public health concern following trauma exposure; however, little is known about the temporal association between posttraumatic stress disorder (PTSD) symptoms and problem alcohol use. The current study examined the temporal relationship between PTSD symptom clusters (re-experiencing, effortful avoidance, emotional numbing, and hyperarousal) and problem alcohol use following trauma exposure. This study was a longitudinal survey of randomly selected traumatic injury patients interviewed at baseline, 3 months, 12 months, and 24 months following injury. Participants were 1,139 injury patients recruited upon admission from 4 Level 1 trauma centers across Australia. Participants were assessed using the Clinician Administered PTSD Scale and Alcohol Use Disorders Identification Test. Results indicated that high levels of re-experiencing, effortful avoidance, and hyperarousal symptoms at 12 months were associated with greater increases (or smaller decreases) in problem alcohol use between 12 and 24 months. Findings also suggested that high levels of problem alcohol use at 12 months were associated with greater increases (or smaller decreases) in emotional numbing symptoms between 12 and 24 months. These findings highlight the critical importance of the chronic period following trauma exposure in the relationship between PTSD symptoms and problem alcohol use.",0,0 +7057,Mental health of workers and volunteers responding to events of 9/11: Review of the literature,"Background: Disaster workers responding to the events of September 11th were exposed to traumatic events. No study has systematically investigated the diverse mental health status and needs of the heterogeneous population of disaster workers responding to the events of September 11th. Methods: Using PubMed and Medline and the search terms of “September 11, 2001” or “September 11” or “9/11”or “WTC” or “World Trade Center”, the authors reviewed all articles that examined the mental health outcomes of workers at one of the three September 11th crash sites or the Fresh Kills landfill in New York City. Results: In total, 25 articles met study inclusion criteria, often using different methodologies. The articles described varying degrees of mental health symptomatology, risk factors for adverse mental health outcomes, and utilization of mental health services. Conclusions: The mental health needs of workers exposed to the events of September 11th ranged from little to no care to pharmacotherapy. A range of risk factors, including exposures at the WTC site and occupational activities, impacted on these needs but the role of specific mental health interventions was less clear. These findings suggest the need for a future program for disaster workers consisting of an accessible mental health treatment service supported by comprehensive postdisaster surveillance and emphasis on pre-disaster mental wellness. A number of areas for further consideration and study were identified, including the need for a more diverse exploration of involved responder populations as well as investigation of potential mental health outcomes beyond post-traumatic stress disorder (PTSD). Mt Sinai J Med 75:115–127, 2008 © 2008 Mount Sinai School of Medicine",0,0 +7058,An epidemiologic approach to the development of early trauma focused intervention,"Early, trauma-focused intervention development has emphasized unidirectional trajectories that begin with basic research and efficacy trials followed later by effectiveness and dissemination studies. In this article, the authors present methods derived from social and clinical epidemiology that constitute foundational research in the development of early trauma-focused intervention. They also describe how population-based practice research may serve to feed back and inform what has been conceptualized as earlier stages of intervention development such as efficacy trials. Examples of relevant epidemiologic research methods are presented to illustrate these points. The authors posit that the continued application of population-based methods may produce treatments that can be feasibly applied to the unique patient, provider, organizational, and community contexts relevant to early interventions for survivors of trauma.",0,0 +7059,Altered lipid peroxidation markers are related to post-traumatic stress disorder (PTSD) and not trauma itself in earthquake survivors,"The traumatic life events, including earthquakes, war, and interpersonal conflicts, cause a cascade of psychological and biological changes known as post-traumatic stress disorder (PTSD). Malondialdehyde (MDA) is a reliable marker of lipid peroxidation, and paraoxonase is a known antioxidant enzyme. The aims of this study were to investigate the relationship between earthquake trauma, PTSD effects on oxidative stress and the levels of serum paraoxonase 1 (PON1) enzyme activity, and levels of serum MDA. The study was carried out on three groups called: the PTSD group, the traumatized with earthquake exercise group, and healthy control group, which contained 32, 31, and 38 individuals, respectively. Serum MDA levels and PON1 enzyme activities from all participants were measured, and the results were compared across all groups. There were no significant differences between the PTSD patients and non-PTSD earthquake survivors in terms of the study variables. The mean PON1 enzyme activity from PTSD patients was significantly lower, while the mean MDA level was significantly higher than that of the healthy control group (p < 0.01 for both measurements). Similarly, earthquake survivors who did not develop PTSD showed higher MDA levels and lower PON1 activity when compared to healthy controls. However, the differences between these groups did not reach a statistically significant level. Increased MDA level and decreased PON1 activity measured in PTSD patients after earthquake and may suggest increased oxidative stress in these patients. The nonsignificant trends that are observed in lipid peroxidation markers of earthquake survivors may indicate higher impact of PTSD development on these markers than trauma itself. For example, PTSD diagnosis seems to add to the effect of trauma on serum MDA levels and PON1 enzyme activity. Thus, serum MDA levels and PON1 enzyme activity may serve as biochemical markers of PTSD diagnosis. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0,0 +7060,Post-traumatic stress disorder: Issues of co-morbidity,"There is considerable controversy over whether or not post-traumatic stress disorder (PTSD) should be considered as a separate diagnostic entity. The present study utilized the Symptom Checklist-90 (SCL-90) in order to examine the degree of overlap between PTSD and the related diagnoses of anxiety, depression and obsession-compulsion in a group of Israeli Lebanon War PTSD casualties. We found that the SCL-90 was able both to identify and discriminate between the clinical groups. Multiple discriminant analysis showed that although there is overlap between PTSD and obsessive-compulsive disorder, PTSD is, in fact, discriminated from all the other patient groups.",0,0 +7061,"Psychophysiologic reactivity, subjective distress, and their associations with PTSD diagnosis.","Intense subjective distress and physiologic reactivity upon exposure to reminders of the traumatic event are each diagnostic features of posttraumatic stress disorder (PTSD). However, subjective reports and psychophysiological data often suggest different conclusions. For the present study, we combined data from five previous studies to assess the contributions of these two types of measures in predicting PTSD diagnosis. One hundred fifty trauma-exposed participants who were classified into PTSD or non-PTSD groups based on structured diagnostic interviews completed the same script-driven imagery procedure, which quantified measures of psychophysiologic reactivity and self-reported emotional responses. We derived four discriminant functions (DiscFxs) that each maximally separated the PTSD from the non-PTSD group using (1) psychophysiologic measures recorded during personal mental imagery of the traumatic event; (2) self-report ratings in response to the trauma imagery; (3) psychophysiologic measures recorded during personal mental imagery of another highly stressful experience unrelated to the index traumatic event; and (4) self-report ratings in response to this other stressor. When PTSD status was simultaneously regressed on all four DiscFxs, trauma-related psychophysiological reactivity was a significant predictor, but physiological reactivity resulting from the highly stressful, but not traumatic script, was not. Self-reported distress to the traumatic experience and the other stressful event were both predictive of PTSD diagnosis. Trauma-related psychophysiologic reactivity was the best predictor of PTSD diagnosis, but self-reported distress contributed additional variance. These results are discussed in relation to the Research Domain Criteria framework.",0,0 +7062,Alcohol Use Biomarkers Predicting Cognitive Performance: A Secondary Analysis in Veterans With Alcohol Dependence and Posttraumatic Stress Disorder,"We conducted a secondary analysis of baseline data from a recently completed pharmacological pilot clinical trial among 30 veterans with alcohol dependence and posttraumatic stress disorder (PTSD). This trial included baseline measures of alcohol use biomarkers, both indirect (carbohydrate-deficient transferrin, GGT [γ-glutamyltransferase], mean corpuscular volume, AST [aspartate aminotransferase], alanine aminotransferase) and direct (ethyl glucuronide, ethyl sulfate), as well as neurocognitive measures (Trail Making Test parts A and B, Hopkins Verbal Learning Test-Revised, Balloon Analogue Risk Task, Delay Discounting Task).Two regression models were estimated and tested for each neurocognitive measure (dependent measure). The first model included the alcohol use biomarker alone as the predictor. The second model included the alcohol use biomarker along with the following 3 additional predictors: Beck Depression Inventory, Clinician-Administered PTSD Scale, and receiving medications.In both models, the indirect biomarkers, such as GGT and AST, significantly predicted performance on the Hopkins Verbal Learning Test-Revised %Retention. GGT alone significantly predicted performance on the Trail Making Test part A.Indirect alcohol use biomarkers may have a specific role in identifying those veterans with alcohol dependence and PTSD who have impaired cognitive performance. However, direct alcohol use biomarkers may not share such a role.",0,0 +7063,Dimensions of Trauma and Specific Symptoms of Complex Posttraumatic Stress Disorder in Inner-City Youth: A Preliminary Study,"We examined relations of posttraumatic stress disorder (PTSD) symptoms with dimensions of trauma, including environment (Domestic vs. Community) and proximity (Indirect vs. Direct trauma) among inner-city youth. Participants (n = 65) reported traumatic events they had experienced on a version of the UCLA PTSD Reaction Index Trauma Exposure Screen, and reported PTSD symptoms with the PTSD Checklist--Civilian version (PCL-C). High rates of trauma and PTSD were found, consistent with other reports of inner-city youth. The 49% of youth surveyed met criteria for PTSD on the PCL-C symptom scale with a score cutoff of 35. Females reported elevated PTSD symptom scores and a higher incidence of Domestic trauma than did males but similar incidence of other trauma types. When males and females were combined, Domestic trauma significantly correlated with each of the PTSD symptom clusters of intrusions, numbing/avoidance, and hyperarousal. When participants with Community trauma were excluded from analyses to reduce confounding environmental influence, Domestic trauma marginally correlated with numbing/avoidance symptoms. Our findings suggest that Domestic trauma may result in more emotional numbing/avoidance symptoms than other types of trauma. Further analyses suggested that Community trauma may result in more intrusions and hyperarousal symptoms rather than emotional numbing. Environmental aspects of trauma, rather than the proximity of trauma, may have greater impact on presentation of PTSD. Future studies with larger samples are needed to confirm these findings.",0,0 +7064,Social relationships and PTSD symptomatology in combat veterans.,"The primary purpose of this study is to determine if recent combat veterans discriminate between different sources of social support, and then preliminarily investigate the relationship of social support source on posttraumatic stress disorder (PTSD) symptomatology. Participants included 83 married male combat veterans. Principal-axis factor analysis with equamax rotation observed four distinct latent factors for each source of support examined. ANOVAs were performed to determine the relationship of each source of support from the distinct latent factors on the level of PTSD. Results indicate that the level of PTSD is related to support received from a significant other, F(1, 81) 30.36, p .001, family, F(1, 81) 8.10, p .006, and military peers, F(1, 81) 6.70, p .011, but not friends, F(1, 81) 1.79, p .18. In general, higher levels of support from each category were associated with lower levels of PTSD in combat veterans. The results suggest that combat veterans distinguish between specific sources of social support, which may have a protective effect on the level of PTSD.",0,0 +7065,Regional differences in acute corticosterone-induced dendritic remodeling in the rat brain and their behavioral consequences,"Glucocorticoid released by stressful stimuli elicits various stress responses. Acute treatment with a single dose of corticosterone (CORT; predominant glucocorticoid of rats) alone has previously been shown to trigger anxiety behavior and robust dendritic hypertrophy of neurons in the basolateral amygdala (BLA). Neurons in the medial prefrontal cortex (mPFC) are also known to be highly sensitive to stress and regulate anxiety-like behaviors. Nevertheless, we know less about acute CORT-induced structural changes of other brain regions and their behavioral outcomes. In addition, the temporal profile of acute CORT effects remains to be examined. The current study investigates time course changes of dendritic architectures in the stress vulnerable brain areas, the BLA and mPFC, and their behavioral consequences after acute treatment with a single dose of CORT.Acute CORT treatment produced delayed onset of dendritic remodeling in the opposite direction in the BLA and mPFC with different time courses. Acute CORT induced dendritic hypertrophy of BLA spiny neurons, which was paralleled by heightened anxiety, both peaked 12 days after the treatment. Meanwhile, CORT-induced dendritic atrophy of mPFC pyramidal neurons peaked on day 6, concomitantly with impaired working memory. Both changed dendritic morphologies and altered behavioral outcomes were fully recovered.Our results suggest that stress-induced heightened anxiety appears to be a functional consequence of dendritic remodeling of BLA neurons but not that of mPFC. Instead, stress-induced dendritic atrophy of mPFC neurons is relevant to working memory deficit. Therefore, structural changes in the BLA and the mPFC might be specifically associated with distinct behavioral symptoms observed in stress-related mental disorders. Remarkably, stress-induced dendritic remodeling in the BLA as well as mPFC is readily reversible. The related behavioral outcomes also follow the similar time course in a reversible manner. Therefore, further studies on the cellular mechanism for the plasticity of dendrites architecture might provide new insight into the etiological factors for stress-related mental illness such as posttraumatic stress disorder (PTSD).",0,0 +7066,The Synthetic Evaluation Model for Analysis of Flooding Hazards,"Although many previous epidemiological studies have reported the incidence of diseases, mortality rate and economic losses after natural disasters, none of these studies has been comprehensive enough. Our aim was to establish a synthetic evaluation model (SEM) that can be used to analyze flood hazards.Initial evaluation indicators were selected using systematic and literature data analysis. These indicators were tested with single or multiple variable analyses. Final evaluation indicators and their weights were determined using the Delphi procedure. We established a SEM of flood hazards using the hierarchy method and tested the model using jack-knife analysis.The SEM on flood hazards consists of 6 first-rank indicators and 24 second-rank indicators. First-rank indicators were: direct casualties (w = 0.2123), the increased incidence and prevalence rate of the disease (w = 0.1715), excess mortality rate (w = 0.1745), mental injury (w = 0.1038), epidemic focus expansion (w = 0.1572) and economic loss (w = 0.1807). The agreement of the model reached 98.2% tested with the jack-knife analysis.A SEM of flood hazards was established with an agreement of 98.2%, which can be used to evaluate the hazards, and assist public health-care workers provide appropriate flood disaster management.",0,0 +7067,Post-deployment Multi-symptom Disorder rehabilitation: An integrated approach to rehabilitation,"Veterans and active duty service members returning from Operation New Dawn and those having returned from Operations Iraqi and Enduring Freedom frequently report the presence of overlapping, co-morbid symptom clusters consisting of chronic pain, mild cognitive complaints, and posttraumatic stress symptoms/disorder or mood disturbance. This presentation has been called Post-deployment Multi-symptom Disorder (PMD) and its implications not only impact various functional domains, but have also influenced a system/continuum of care to rise to meet the challenges of treating PMD. This continuum is based on innovation informed by evidence-based therapies, systemic limitations, and a focus on functional improvement rather than diagnostic classification.The purpose of this paper is to describe the symptomatic, functional and systemic challenges inherent to PMD conceptualization and treatment.The constituent clusters of PMD are defined and exemplified, its functional impact is illustrated, and a continuum of care at a large southeastern Veterans Affairs (VA) hospital offering an interdisciplinary approach to integrated rehabilitation is described. Three case examples are provided that that underscore the importance of vocation for improved behavioral health and quality of life.The case examples demonstrate how vocational rehabilitation services are an integral component of PMD treatment.}",0,0 +7068,Functional Impairment as a Variable in Adjustment Post-Combat,"This study examined how functional impairment relates to postcombat adjustment over time, controlling for the influence of combat exposure. Analyses used sequential random coefficient models to examine 2 hypotheses: a) combat exposure and functional impairment predict the change in posttraumatic stress, depression, and anger/aggression symptoms during the first year postcombat; and b) combat exposure and functional impairment at reintegration predict symptom scores at 1 year postdeployment. A Brigade Combat Team completed surveys at reintegration, 4 months, and 12 months after a 1-year deployment to Iraq. Soldiers reporting high functional impairment at reintegration had higher symptoms at both follow-up periods, and functional impairment was a significant predictor of symptoms at the last time point, even after accounting for the influence of combat exposure. There was also an interaction effect, such that functional impairment exacerbated the impact of combat exposure on posttraumatic stress and anger/a...",0,0 +7069,A Longitudinal and Retrospective Study of PTSD Among Older Prisoners of War,"The authors examined the longitudinal changes in posttraumatic stress disorder (PTSD) symptom levels and prevalence rates over a 4-year time period among American former prisoners of war (POWs) from World War II and the Korean War. Retrospective symptom reports by World War II POWs dating back to shortly after repatriation were examined for 1) additional evidence of changing PTSD symptom levels and 2) evidence of PTSD cases with a long-delayed onset.PTSD prevalence rates and symptom levels were measured by the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder. For the longitudinal portion of the study, participants were 177 community-dwelling World War II and Korean POWs. For the retrospective portion, participants were 244 community-dwelling World War II POWs.PTSD prevalence rates and symptom levels increased significantly over the 4-year measurement interval. Retrospective symptom reports indicated that symptoms were highest shortly after the war, declined for several decades, and increased within the past two decades. Long-delayed onset of PTSD symptoms was rare. Demographic and psychosocial variables were used to characterize participants whose symptoms increased over 4 years and differentiate participants who reported a long-delayed symptom onset.Both longitudinal and retrospective data support a PTSD symptom pattern of immediate onset and gradual decline, followed by increasing PTSD symptom levels among older survivors of remote trauma.",0,0 +7070,The “Cut-Off Behavioral Criteria” Method: Modeling Clinical Diagnostic Criteria in Animal Studies of PTSD,"Posttraumatic stress disorder (PTSD) is clinically defined by exposure to a significantly threatening and/or horrifying event and the presence of a certain number of symptoms from each of three symptom clusters at least one month after the event. The procedures involved in defining clinical diagnostic criteria for mental disorders are lengthy and quit stringent. The APA and WHO (responsible for the DSM and ICD, respectively) periodically review the diagnostic criteria, a process which engenders heated discussion in the literature, with the aim of refining and improving their clinical, epidemiological, and research validity.Animal behavioral studies, however, have generally tended to overlook this aspect and have commonly regarded the entire group of animals subjected to certain study conditions as homogeneous. The method to be described below was developed in an attempt to model diagnostic criteria in terms of individual patterns of response using behavioral measures and determining cut-off scores to distinguish between extremes of response or nonresponse, leaving a sizeable proportion of subjects in a middle group, outside each set of cut-off criteria. This chapter will discuss the concept of the model and its background, provide detailed protocols for each of its components, and present a selection of studies employing and examining the model, alongside the underlying translational rationale of each. © 2011 Springer Science+Business Media, LLC.",0,0 +7071,Substance abuse and post-traumatic stress disorder comorbidity,"This article reviews the extant literature on substance abusers with and without a comorbid diagnosis of post-traumatic stress disorder (PTSD) and reveals the discontinuity between clinical lore and empirical research. Included is an overview of PTSD-substance abuse theoretical models and comorbidity prevalence rates, as well as an evaluation of the comparative data on treatment outcome and psychosocial factors, such as coping skills, for PTSD versus non-PTSD substance abusers. In addition, we discuss the controversy surrounding sequential versus simultaneous treatment approaches for such 'dually-diagnosed' patients. We conclude by identifying gaps in current knowledge about the nature and impact of PTSD on substance abuse treatment outcome and outlining needs for future research.",0,0 +7072,The Link Between Post-traumatic Stress Disorder and Physical Comorbidities: A Systematic Review,"Context: Returning veterans from Afghanistan and Iraq will increase frequency of post-traumatic stress disorder (PTSD). Little is known about its impact on physical health. Objective: Systematic literature review focusing on the association between PTSD and specific physical disorders. Data Sources: An electronic search using PUBMED and hand search of four journals with an anxiety focus for studies published between January 1981 and July 2008, plus a manual search of article bibliographies. Study Selection: Original research reports focusing on PTSD and its association with physical health. Studies investigating only PTSD symptoms, trauma and physical disorders classified at the organ-system level were excluded. Eighty studies were reviewed and seven selected for final analysis. Data Extraction Specific physical-health diagnoses were organized by system and tabulated. They were considered positive only if results were statistically significant. Total number of positive and negative studies for each diagnosis was then calculated for review. Results: Seven studies examined the relationship between PTSD and specific physical disorders. Arthritis was associated with PTSD in most studies. Data conflicted regarding diabetes, coronary heart disease, and stroke. Conclusions: Few studies have examined the relationship between PTSD and physical health. Large, prospective epidemiological trials are needed. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +7073,A Prospective Study on the Association Between Caregiver Psychological Symptomatology and Symptom Clusters of Pediatric Posttraumatic Stress Disorder,"This study investigated the influence of caregiver psychological symptoms on posttraumatic stress disorder (PTSD) symptoms in traumatized children. One-hundred eleven children and caretakers were assessed in this study. Children (N = 59) with a history of exposure to interpersonal violence were evaluated for reexperiencing, avoidance/numbing, and hyperarousal symptom clusters using the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA). The 52 primary caregivers were evaluated using the Symptom Checklist-90-Revised (SCL-90-R) on 9 domains of psychological symptomatology: anxiety, depression, hostility, interpersonal sensitivity, obsessive-compulsive disorder, paranoid ideation, phobic anxiety, psychoticism, and somatization. At 14-month follow-up, 45 of the children were re-evaluated with the CAPS-CA. Caregiver psychological symptoms in the domains of anxiety, depression, interpersonal sensitivity, obsessive-compulsive disorder, and paranoid ideation were associated with less improvement in total pediatric PTSD symptoms. Analysis of PTSD symptoms by cluster showed that greater caregiver symptomatology in the domains of anxiety, depression, interpersonal sensitivity, and obsessive-compulsive disorder were associated with less improvement in the hyperarousal symptom cluster. These results suggest caregiver symptomatology may be specifically associated with hyperarousal symptoms in pediatric trauma.",0,0 +7074,Women Reentering the Community: Understanding Addiction and Trauma-Related Characteristics of Recidivism,"Women represent 26% of those arrested for serious crimes; many have posttraumatic stress and co-occurring substance use disorders, which may influence recidivism. This study examined 57 women residing in a community re-entry program after exiting prison. Participants completed the Trauma Symptom Inventory and Substance Abuse Subtle Screening Inventory. A discriminant function analysis accounted for 34% of between-group variability and provided a profile of women who recidivated. Women who recidivated had greater alcohol dependence and lower rates of sexual dysfunction and sexual concerns. Practitioners should consider potential links between substance abuse, trauma, and sexual behavior in treatment settings.",0,0 +7075,Serum triiodothyronine elevation in Israeli combat veterans with posttraumatic stress disorder: A cross-cultural study,"This study examines the thyroid hormonal profile in Israeli combat veterans with posttraumatic stress disorder (PTSD) and compares it with the previously reported profile in American Vietnam combat veterans with PTSD. Eleven male combat veterans with PTSD were compared with 11 normal subjects. Thyroid junction was evaluated by the measurement of serum total triiodothyronine (TT3), free triiodothyronine (FT3), total thyroxine (TT4), free thyroxine (FT4), thyroxine-binding globulin (TBG), and thyroid-stimulating hormone (TSH). The mean total T3 level in the Israeli PTSD patients (160.5 ng/dL) was significantly elevated (t = 2.53, p < .02) above that of the comparison group (135.5 ng/dL). Total T3 mean levels were not significantly different between the Israeli PTSD group and two American PTSD groups, but all three PTSD groups had significantly higher total T3 levels than both Israeli and American comparison groups. This preliminary study indicates that T3 elevation in combat-related PTSD may extend across cultures and suggests that further comparison of Israeli and American PTSD and normal groups may be useful in evaluating the significance and implications of the unusual alterations in the thyroid system in PTSD.",0,0 +7076,A cognitive model of posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) is a common reaction to traumatic events. Many people recover in the ensuing months, but in a significant subgroup the symptoms persist, often for years. A cognitive model of persistence of PTSD is proposed. It is suggested that PTSD becomes persistent when individuals process the trauma in a way that leads to a sense of serious, current threat. The sense of threat arises as a consequence of: (1) excessively negative appraisals of the trauma and/or its sequelae and (2) a disturbance of autobiographical memory characterised by poor elaboration and contextualization, strong associative memory and strong perceptual priming. Change in the negative appraisals and the trauma memory are prevented by a series of problematic behavioural and cognitive strategies. The model is consistent with the main clinical features of PTSD, helps explain several apparently puzzling phenomena and provides a framework for treatment by identifying three key targets for change. Recent studies have provided preliminary support for several aspects of the model.",0,0 +7077,Post-traumatic stress disorder symptoms form a traumatic and non-traumatic stress response dimension,"Objective: This study aims to determine whether symptoms of post-traumatic stress disorder (PTSD) form a latent dimension reflecting responsivity to life events and whether PTSD symptoms are specific to traumatic life events. Method: A 30-year longitudinal study of a general population sample of 987 individuals were assessed for PTSD symptoms, exposure to adverse life events, and a variety of psychosocial measures. PTSD symptoms were tested using a confirmatory factor model and a range of fitted models were used to identify significant predictors of latent PTSD symptoms. Results: The rate of DSM IV PTSD was 1.9%. However, subjects reported high rates of at least one significant traumatic or negative life event and PTSD symptoms. The PTSD symptoms conformed well to a single latent factor. There were strong linear associations between severity of PTSD symptoms and exposure to traumatic and non-traumatic life events. Factors contributing to latent PTSD symptoms were gender, childhood anxiety, neuroticism, self-esteem, and quality of parental care. Conclusion: Criteria for PTSD form an underlying dimension reflecting the individual’s level of responsivity to traumatic and non-traumatic stressful life events. PTSD symptoms form a continuum of severity with minor stress symptoms at one end and severe PTSD at the other.",0,0 +7078,Time does not heal all wounds: Quality of life and psychological distress of people who survived the Holocaust as children 55 years later,"The present study assessed posttraumatic stress disorder (PTSD) symptoms, psychological distress, and subjective quality of life (QoL) in a group of 43 child Holocaust survivors and a community sample of 44 persons who had not personally experienced the Holocaust. The participants were administered the PTSD-Scale, the SCL-90, and the WHOQOL-Bref. Results showed that the child survivors had higher PTSD symptom scores, higher depression, anxiety, somatization, and anger-hostility scores; and lower physical, psychological, and social QoL than did the comparison group. The findings suggest that the psychological consequences of being a child during the Holocaust can be long lasting.",0,0 +7079,In Search of an Effective Treatment for Combat-Related Post-Traumatic Stress Disorder (PTSD): Can the Stellate Ganglion Block Be the Answer?,"Notes that post-traumatic stress disorder (PTSD) is a common and intractable condition associated with severe stress and trauma. PTSD has been difficult to treat with conventional methods. A glimmer of hope for this condition may be found in the use of stellate ganglion block (SGB), a technique traditionally used for the treatment of chronic pain-anesthetic blockade of a sympathetic ganglion administered at C7. In this edition of Pain Practice, S. W. Mulvaney et al. (see record 2010-14345-013) describe a significant resolution of PTSD symptoms using SGB in a pilot study of Operation Iraqi Freedom veterans, leading to a subsequent complete weaning of the patients off their psychiatric drugs. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +7080,Frequency of trauma exposure and Post-Traumatic Stress Disorder in Italy: analysis from the World Mental Health Survey Initiative,"Epidemiological studies have examined the relative importance of Traumatic Events (TEs) in accounting for the societal burden of post-traumatic stress disorder (PTSD). However, most studies used the worst trauma experienced, which can lead to an overestimation of the conditional risk of PTSD. Although a number of epidemiological surveys on PTSD have been carried out in the United States, only a few studies in limited sample have been conducted in Italy. This study, carried out in the framework of the World Mental Health Survey Initiative, is a cross-sectional household survey of a representative sample of the Italian adult population. Lifetime prevalence of TEs and 12-month prevalence of PTSD were evaluated using the Composite International Diagnostic Interview (CIDI). Reports of PTSD associated with randomly selected TEs were weighted by the individual-level probabilities of TE selection to generate estimates of population-level PTSD risk associated with each TE. Network events was the most commonly reported class of TEs (29.4%). War events had the highest conditional risk of PTSD (12.2%). The TEs that contributed most to societal PTSD burden were unexpected death of a loved one (24.1%) and having seen atrocities (18.2%). Being female was related to high risk of PTSD after experiencing a TE. Exposure to network events is commonly reported among Italian adults, but two TEs are responsible for the highest burden associated with PTSD: the unexpected death of someone close and sexual assault. These results can help designing public health interventions to reduce the societal PTSD burden. • Prevalence of exposure to at least one lifetime traumatic event was 56.1%. • The TE contributing most to PTSD burden was unexpected death of a loved one. • Being female was related to high risk of PTSD after experiencing a TE.",0,0 +7081,"The Roles of Love, Attachment, and Altruism in the Adjustment to Military Trauma","Abstract This chapter summarizes research on the associations among love in the form of a secure adult attachment, posttraumatic stress disorder (PTSD), and altruism. The chapter is organized into five sections. The first section briefly reviews PTSD and its symptom clusters. The second section provides an overview of attachment theory and explores evidence that early childhood attachment patterns endure as adult attachment styles. The third section efforts to link attachment theory to the concept of adult love. The fourth section explores the relationship between attachment styles and the development of PTSD in those exposed to trauma, suggesting that love and secure attachment may protect against PTSD or ameliorate its course. The final section introduces altruistic intent into the adult attachment equation and examines the relationships among altruism, loving attachments, and PTSD.",0,0 +7082,Psychiatric disorders in patients with psychogenic nonepileptic seizures and drug-resistant epilepsy: A study of an Argentine population,"Epidemiological data show that up to 20-30% of patients with psychogenic nonepileptic seizures (PNESs), resembling drug-resistant epilepsy (DRE), are referred to tertiary epilepsy centers. Furthermore, both disorders present high psychiatric comorbidity, and video-EEG is the gold standard to make differential diagnoses. In this study, we described and compared the clinical presentation and the frequency of psychiatric disorders codified in DSM IV in two groups of patients, one with PNESs and the other with DRE, admitted in a tertiary care epilepsy center of Buenos Aires, Argentina. We included 35 patients with PNESs and 49 with DRE; all were admitted in the video-EEG unit in order to confirm an epilepsy diagnosis and determine surgical treatment possibilities. All patients underwent a neurological and psychiatric assessment, according to standardized protocol (SCID I and II; DSM IV criteria). Student's t test was performed to compare continuous variables and Chi square test to compare qualitative variables. In this study, 33 (67%) patients with DRE and 35 (100%) patients with PNESs met criteria for at least one disorder codified in Axis I of DSM IV (p=0.003). Differences in the frequency of psychiatric disorder presentation were found between groups. Anxiety disorders (16.32% vs 40%; p=0.015), trauma history (24.5% vs 48.57%; p=0.02), posttraumatic stress disorder (4.08% vs 22.85%; p=0.009), and personality cluster B disorders (18.37% vs 42.86%; p=0.02) were more frequent in the group with PNESs. Psychotic disorders were more frequent in the group with DRE (20.4% vs 2.85%; p=0.019). Depression was equally prevalent in both groups. Standardized psychiatric assessment provides information that could be used by the mental health professional who receives the referral in order to improve quality of care and smooth transitions to proper PNES treatment, which should include a multidisciplinary approach including neurology and psychiatry.",0,0 +7083,Dissociation and posttraumatic stress disorder in Vietnam combat veterans,"This study compared current dissociative symptoms and dissociation at the time of specific traumatic events in Vietnam combat veterans with posttraumatic stress disorder (PTSD) and Vietnam combat veterans without PTSD.Vietnam combat veterans who sought treatment for PTSD (N = 53) were compared to Vietnam combat veterans without PTSD (N = 32) who sought treatment for medical problems. Dissociative symptoms were evaluated with the Dissociative Experiences Scale. Dissociation at the time of a combat-related traumatic event was evaluated retrospectively with the modified Dissociative Experiences Questionnaire. The Combat Exposure Scale was used to measure level of combat exposure.There was a significantly higher level of dissociative symptoms, as measured by the Dissociative Experiences Scale, in patients with PTSD (mean = 27.0, SD = 18.0) than in patients without PTSD (mean = 13.7, SD = 16.0). This difference persisted when the difference in level of combat exposure was controlled with analysis of covariance. PTSD patients also reported more dissociative symptoms at the time of combat trauma, as measured retrospectively by the Dissociative Experiences Questionnaire (mean = 11.5, SD = 1.6) than non-PTSD patients (mean = 1.8, SD = 2.1).Dissociative symptoms are an important element of the long-term psychopathological response to trauma.",0,0 +7084,PTSD and Associated Mental Health Consequences of Motor Vehicle Collisions,"The frequency with which motor vehicle collisions (MVCs) occur makes them one of the greatest causes of posttraumatic psychopathology. While the physical injury associated with severe MVC is the focus of highly sophisticated hospital care services, the psychological injury that often accompanies surviving severe MVC is mostly overlooked. This chapter establishes the prevalence of posttraumatic stress disorder (PTSD) and other forms of psychopathology that occur following MVCs, outlining the course of MVC-related traumatic stress symptoms, and describing the impact of traumatic stress symptoms on the quality of life and functional status of traumatized individuals. For an MVC to be considered potentially traumatic, it must involve actual or threatened injury. This point is important in interpreting the literature because the majority of studies that have examined the prevalence of psychopathology following MVC have used injury survivors. The pretrauma, peritrauma, and posttrauma factors that are considered most predictive of posttrauma psychopathology are also reviewed.",0,0 +7085,The Minnesota Multiphasic Personality Inventory–2 Restructured Form in National Guard soldiers screening positive for posttraumatic stress disorder and mild traumatic brain injury.,"The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2 RF) was administered to 251 National Guard soldiers who had recently returned from deployment to Iraq. Soldiers were also administered questionnaires to identify posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). On the basis of responses to the screening instruments, the National Guard soldiers who produced a valid MMPI-2 RF were classified into four groups: 21 soldiers who screened positive for PTSD only, 33 soldiers who screened positive for mTBI only, 9 soldiers who screened positive for both conditions, and 166 soldiers who did not screen positive for either condition. Results showed that the MMPI-2 RF was able to differentiate across the groups with the MMPI-2 RF specific problem scale Anxiety adding incrementally to MMPI-2 Restructured Clinical scales in predicting PTSD. Both MMPI-2 RC1 (Somatic Complaints) and MMPI-2 RF head pain complaints predicted mTBI screen but did not add incrementally to each other. Of note, all of the MMPI-2 RF validity scales associated with overreporting, including Symptom Validity-Revised (FBS-r), were not significantly elevated in the mTBI group. These findings support the use of the MMPI-2 RF in assessing PTSD in non-treatment-seeking veterans. This further suggests that a positive screen for mTBI alone is not associated with significant emotional disturbance.",0,0 +7086,Emotion regulation profiles in psychogenic non-epileptic seizures,"

Abstract

Background

Psychogenic non-epileptic seizures (PNES) are frequently encountered in epilepsy referral centers, yet there is limited understanding of the emotion processing style in this psychiatrically heterogeneous population. Understanding profiles of emotion regulation in PNES will provide further evidence of the psychogenic nature of the disorder and will potentially inform psychotherapeutic interventions.

Methods

Fifty-five patients with PNES underwent a neuropsychiatric evaluation and completed self-report questionnaires that measured difficulties in emotion regulation, psychopathology severity and quality of life.

Results

Through the use of cluster analysis, two groups were identified; Cluster 1 represented a highly emotion dysregulated group while Cluster 2 represented a low emotion dysregulated group. Additional analyses revealed that each group significantly differed from normative data. Finally, Cluster 1 was significantly associated with several measures of psychiatric symptoms, higher rates of comorbid psychiatric diagnoses and impairment in quality of life.

Conclusions

These findings suggest that patients with PNES may be subject to high levels of emotion dysregulation, severe psychiatric symptomatology and impaired quality of life, or to low emotion dysregulation characterized by emotional unawareness or avoidance. These profiles clearly differ from normative data regarding emotion regulation and their identification may help tailor psychotherapeutic interventions.",0,0 +7087,Posttraumatic stress disorder after childbirth: Analysis of symptom presentation and sampling,"There is converging evidence that approximately 2% of women fulfill PTSD criteria following childbirth. This study examined the presentation and symptom structure of PTSD after birth and key risk factors in women from internet and community samples. PTSD was measured in 1423 women after birth recruited via the community ( n = 502) or internet ( n = 921). Demographic, obstetric, and trauma history variables were also measured. Full PTSD diagnostic criteria were endorsed by 2.5% of women from the community and 21% of women on the internet. Many more endorsed individual PTSD symptom criteria, suggesting this might be inflated by postnatal factors. Samples differed on demographic and obstetric characteristics. Factor analysis found two PTSD symptom clusters of re-experiencing and avoidance (RA) and numbing and arousal (NA). PTSD cases were predicted by parity, delivery type, NA and RA symptoms, and the interaction between sexual trauma and delivery type. This correctly identified 60% of PTSD cases. Questionnaire measurement of PTSD means prevalence rates may be over-estimated. Differences between samples suggest that internet samples over represent symptomatic women. Results emphasise the importance of measuring full diagnostic criteria in postnatal samples, as reports of symptoms may be inflated. In addition a few risk factors are identified that could be used to screen for women at risk.",0,0 +7088,Children’s Postdisaster Trajectories of PTS Symptoms: Predicting Chronic Distress,"There are no studies of the distinct trajectories of children's psychological distress over the first year after a destructive natural disaster and the determinants of these trajectories.We examined these issues using an existing dataset of children exposed to Hurricane Andrew, one of the most devastating natural disasters in US history.At 3-months postdisaster, 568 children (55 % girls; grades 3-5) residing in areas most directly affected by the hurricane completed measures of hurricane exposure and stressors, social support, coping, and general anxiety. Children also reported major life events occurring since the hurricane (at 7-months) and posttraumatic stress (PTS) symptoms at 3-, 7-, and 10-months postdisaster.Latent growth mixture modeling identified three trajectories of PTS reactions: resilient (37 %), recovering (43 %), and chronic distress (20 %). Predictors of the trajectories were examined. Odds ratios indicated that, compared to the resilient trajectory, girls were more likely to be in the recovering and chronically distressed trajectories, as were children reporting higher anxiety and greater use of coping strategies that reflected poor emotion regulation. Compared to the recovering trajectory, children in the chronically distressed trajectory had greater odds of reporting high anxiety, less social support, more intervening life events, and greater use of poor emotion regulation strategies.Hurricane exposure may be less effective in identifying children who develop chronic postdisaster distress than other child (anxiety, coping) and contextual variables (social support, life events). Effective screening after disasters is critical for identifying youth most in need of limited clinical resources.",1,0 +7089,Treatment of anxiety disorders with venlafaxine XR,"When venlafaxine was introduced in 1994, it was the first of the newer generation antidepressants to be classified as a serotonin norepinephrine reuptake inhibitor (SNRI). An extended release (XR) formulation of venlafaxine, introduced in 1997, subsequently received regulatory approval for treatment of three anxiety disorders: generalized anxiety disorder, social anxiety disorder and panic disorder. Although less extensively studied, venlafaxine XR also appears to have efficacy for two other anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder. In contrast to the treatment of depression, for which meta-analyses suggest an efficacy advantage relative to selective serotonin reuptake inhibitors (SSRIs), evidence of differential efficacy has not yet been established for any of the anxiety disorders. The overall tolerability profile of venlafaxine XR is generally comparable to that of the SSRIs, although there is greater incidence of noradrenergically mediated side effects (i.e., dry mouth and constipation), as well as a dose-dependent risk of treatment-emergent high blood pressure. Concerns about safety in overdose have also recently emerged. Despite these caveats, venlafaxine XR is an effective and generally well-tolerated option for treatment of anxiety disorders.",0,0 +7090,Disorder specificity despite comorbidity: Resting EEG alpha asymmetry in major depressive disorder and post-traumatic stress disorder,"The approach-withdrawal and valence-arousal models highlight that specific brain laterality profiles may distinguish depression and anxiety. However, studies remain to be conducted in multiple clinical populations that directly test the diagnostic specificity of these hypotheses. The current study compared electroencephalographic data under resting state, eyes closed conditions in patients with major depressive disorder (MDD) (N=15) and post-traumatic stress disorder (PTSD) (N=14) relative to healthy controls (N=15) to examine the specificity of brain laterality in these disorders. Key findings included (1) reduced left-frontal activity in MDD, (2) a positive correlation between PTSD severity and right-frontal lateralisation, (3) greater activity in PTSD patients relative to MDD within the right-parietotemporal region, and (4) globally increased alpha power in MDD. Findings partially support the diagnostic applicability of the theoretical frameworks. Future studies may benefit from examining task-driven differences between groups.",0,0 +7091,DIAGNOSIS OF POSTTRAUMATIC STRESS DISORDER AFTER SURGERY FOR PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT,"To investigate the prevalence of posttraumatic stress disorder (PTSD) in patients who underwent surgery for primary rhegmatogenous retinal detachment and to explore variables associated with the disorder.Subjects eligible for the study were patients aged 18 years or older, who underwent surgery for primary rhegmatogenous retinal detachment at the Goldschleger Eye Institute, from January 1, 2004, to December 31, 2009, and were followed for at least 1 month. Study patients were screened for the existence of PTSD symptoms via a telephone survey, and positively identified patients were asked to undergo a structured psychiatric interview. Posttraumatic stress disorder was assessed by the Clinician Administered PTSD Scale, and the 25-item National Eye Institute visual function questionnaire (NEI-VFQ-25) was used as a measure of vision-related quality of life. Objective clinical measures were obtained from the patient's medical records. Clinical variables were compared between PTSD-diagnosed patients, patients who were screened for PTSD but were found to be PTSD negative in the interview (false-positive group), and patients who were found negative for PTSD in the screening survey.Of the 547 eligible patients, 366 were enrolled in the study. Nine patients (2.5%) met the criteria for PTSD diagnosis. Posttraumatic stress disorder patients reported significantly more traumatic events in their past (P = 0.015), and for these patients, NEI-VFQ-25 composite score was significantly lower (P < 0.001). Clinical measures were not found as independent risk factors for PTSD prediction.Posttraumatic stress disorder may develop in the aftermath of primary rhegmatogenous retinal detachment. Previous traumatic events and NEI-VFQ-25 scores were found as independent risk factors for PTSD prediction.",0,0 +7092,"Performance, egg quality, and immune response of laying hens fed diets supplemented with mannan-oligosaccharide or an essential oil mixture under moderate and hot environmental conditions","In total, 432 thirty-six-week-old laying hens were fed a basal diet supplemented with mannan-oligosaccharide (MOS) or an essential oil mixture (EOM) from 36 to 51 wk of age. Hens were divided into 3 equal groups replicated 6 times with 24 hens per replicate. No significant difference was observed among the dietary treatments in terms of performance indices. Different from the dietary manipulation, high environmental temperatures negatively influenced all of the laying performance traits except the feed conversion ratio in association with the diminished feed consumption. The MOS, and particularly the EOM, tended to alleviate the deleterious effect of heat stress on BW gain. Mortality was higher in MOS-fed hens than with other treatments. A supplementation diet with MOS or EOM provided increments in eggshell weight (P < 0.01). Relative albumen weight was significantly decreased (P < 0.05) in response to EOM or MOS supplementation; however, this was not the case in the yolk weight rate. The MOS decreased albumen height and Haugh unit (P < 0.05). High environmental temperatures hampered entire egg quality characteristics except for the eggshell breaking strength and egg yolk weight. These results indicated that heat stress adversely affected both productive performance and egg quality. As for the results of this study, neither MOS nor EOM was efficacious in improving efficiency of egg production and stimulating humoral immune response in laying hens reared under moderate and hot climatic conditions. However, the ameliorative effect exerted by MOS and EOM on eggshell characteristics is conclusive.",0,0 +7093,Posttraumatic Stress Disorder in the National Comorbidity Survey,"Data were obtained on the general population epidemiology of DSM-III-R posttraumatic stress disorder (PTSD), including information on estimated life-time prevalence, the kinds of traumas most often associated with PTSD, sociodemographic correlates, the comorbidity of PTSD with other lifetime psychiatric disorders, and the duration of an index episode.Modified versions of the DSM-III-R PTSD module from the Diagnostic Interview Schedule and of the Composite International Diagnostic Interview were administered to a representative national sample of 5877 persons aged 15 to 54 years in the part II subsample of the National Comorbidity Survey.The estimated lifetime prevalence of PTSD is 7.8%. Prevalence is elevated among women and the previously married. The traumas most commonly associated with PTSD are combat exposure and witnessing among men and rape and sexual molestation among women. Posttraumatic stress disorder is strongly comorbid with other lifetime DSM-III-R disorders. Survival analysis shows that more than one third of people with an index episode of PTSD fail to recover even after many years.Posttraumatic stress disorder is more prevalent than previously believed, and is often persistent. Progress in estimating age-at-onset distributions, cohort effects, and the conditional probabilities of PTSD from different types of trauma will require future epidemiologic studies to assess PTSD for all lifetime traumas rather than for only a small number of retrospectively reported ""most serious"" traumas.",0,0 +7094,Alexithymia and PTSD symptoms in urban police officers: Cross-sectional and prospective findings,"The relationship of alexithymia to posttraumatic stress disorder (PTSD) symptomatology was examined cross-sectionally in 166 urban police officers surveyed between 1998 and 1999 and prospectively in 54 of these officers who participated in a follow-up survey after the September 11, 2001 (9/11) terrorist attacks. In cross-sectional analyses, alexithymia scores were positively associated with PTSD symptom levels and self-reported childhood emotional abuse--neglect, but not with cumulative level of critical incident exposure. Alexithymia scores accounted for 11.2% of the variance in PTSD symptoms prior to accounting for additional predictors, but did not retain significance in the final model. In prospective analyses, alexithymia scores significantly predicted 9/11-related PTSD symptom severity over and above pre-9/11 PTSD symptoms.",0,0 +7095,Brain cortical thickness in male adolescents with serious substance use and conduct problems,"Adolescents with substance use disorder (SUD) and conduct problems exhibit high levels of impulsivity and poor self-control. Limited work to date tests for brain cortical thickness differences in these youths.To investigate differences in cortical thickness between adolescents with substance use and conduct problems and controls.We recruited 25 male adolescents with SUD, and 19 male adolescent controls, and completed structural 3T magnetic resonance brain imaging. Using the surface-based morphometry software FreeSurfer, we completed region-of-interest (ROI) analyses for group cortical thickness differences in left, and separately right, inferior frontal gyrus (IFG), orbitofrontal cortex (OFC) and insula. Using FreeSurfer, we completed whole-cerebrum analyses of group differences in cortical thickness.Versus controls, the SUD group showed no cortical thickness differences in ROI analyses. Controlling for age and IQ, no regions with cortical thickness differences were found using whole-cerebrum analyses (though secondary analyses co-varying IQ and whole-cerebrum cortical thickness yielded a between-group cortical thickness difference in the left posterior cingulate/precuneus). Secondary findings showed that the SUD group, relative to controls, demonstrated significantly less right > left asymmetry in IFG, had weaker insular-to-whole-cerebrum cortical thickness correlations, and showed a positive association between conduct disorder symptom count and cortical thickness in a superior temporal gyrus cluster.Functional group differences may reflect a more nuanced cortical morphometric difference than ROI cortical thickness. Further investigation of morphometric differences is needed. If replicable findings can be established, they may aid in developing improved diagnostic or more targeted treatment approaches.",0,0 +7096,Symptom patterns associated with posttraumatic stress disorder among Vietnam veterans exposed to war trauma,"The authors tested whether the relationship between traumatic stress and posttraumatic stress disorder is captured more accurately by aggregating symptoms, as in DSM-III, or differentiating them into the subtypes of denial and reexperiencing. Their findings indicate that distinguishing between the responses of denial and reexperiencing is an alternative and potentially more useful approach for understanding posttraumatic stress disorder and its origins in war trauma than the comprehensive model proposed in DSM-III. The analysis suggests that biases in the current model of posttraumatic stress disorder may lead to underestimation of its prevalence. The authors conclude that reconsideration of what constitutes the disorder is warranted.",0,0 +7097,Drug use disorders and post-traumatic stress disorder over 25 adult years: Role of psychopathology in relational networks,"In traumatized populations, drug use disorders and post-traumatic stress disorder (PTSD) persist for many years. Relational factors that mediate this persistence have rarely been systematically examined. Our aim is to examine the relative effects of psychopathology in familial and non-familial networks on the persistence of both disorders over adulthood.We utilized longitudinal data from an epidemiologically ascertained sample of male Vietnam veterans (n=642). Measures included DSM-IV drug use disorders, other psychiatric disorders, network problem history and time-varying marital and employment characteristics. Longitudinal measures of veterans' psychopathology and social functioning were retrospectively obtained for each year over a 25 year period. We used generalized estimating equations (GEE) to estimate the relative effects of network problems on veteran's drug use disorders and PTSD after adjusting for covariates.Veterans' mean age was 47 years in 1996. Prevalence of illicit drug disorders declined from 29.8% in 1972 to 8.3% in 1996, but PTSD remained at 11.7% from 13.2% in 1972. While 17.0% of veterans reported a familial drug use problem, 24.9% reported a non-familial drug use problem. In full GEE models, a non-familial drug problem was a significant predictor of illicit drug use disorders over 25 years (OR=2.21, CI=1.59-3.09), while both familial depression (OR=1.69, CI=1.07-2.68) and non-familial drinking problem (OR=1.66, CI=1.08-2.54) were significant predictors of PTSD over 25 years.Familial and non-familial problems in networks differentially affect the persistence of drug use disorders and PTSD in traumatized male adults.",0,0 +7098,Posttraumatic Stress Disorders and Addiction,"Disorders related to stress or trauma are common among patients with substance use disorders (SUD). In clinical samples of patients with SUD, the prevalence of lifetime Posttraumatic Stress Disorder (PTSD) ranges from 26 % to 52 %, and from 15 % to 41 % for current PTSD. A substantial number of these patients suffer from the consequences of severe and prolonged interpersonal trauma usually referred to as “Complex PTSD”. Another common consequence of repeated interpersonal trauma in childhood are dissociative symptoms that may or may not co-occur with PTSD in SUD patients. While several hypotheses can explain the relationships between SUD and PTSD, the self-medication hypothesis has the strongest empirical support. Patients with both disorder have a more severe clinical profile than SUD patients without PTSD, poorer adherence to treatment, a shorter duration of abstinence, and worse outcomes across a variety of measures. Their clinical needs often make a treatment approach necessary that integrates SUD specific and trauma specific interventions. Several trauma treatments focusing on the present (i.e. providing skills training and psycho-education) and, more recently, also past-focused (i.e. exposure-based) treatments have been evaluated in SUD patients with co-occurring PTSD. Some of them outperformed SUD treatment-as-usual on PTSD and/or substance use outcomes. Findings on the effects of medication in patients with SUD and co-occurring PTSD are scarce and remain inconclusive. © Springer-Verlag Berlin Heidelberg 2015.",0,0 +7099,Estimating statistical power for open-enrollment group treatment trials,"

Abstract

Modeling turnover in group membership has been identified as a key barrier contributing to a disconnect between the manner in which behavioral treatment is conducted (open-enrollment groups) and the designs of substance abuse treatment trials (closed-enrollment groups, individual therapy). Latent class pattern mixture models (LCPMMs) are emerging tools for modeling data from open-enrollment groups with membership turnover in recently proposed treatment trials. The current article illustrates an approach to conducting power analyses for open-enrollment designs based on the Monte Carlo simulation of LCPMM models using parameters derived from published data from a randomized controlled trial comparing Seeking Safety to a Community Care condition for women presenting with comorbid posttraumatic stress disorder and substance use disorders. The example addresses discrepancies between the analysis framework assumed in power analyses of many recently proposed open-enrollment trials and the proposed use of LCPMM for data analysis.",0,0 +7100,An open trial of exposure therapy based on deconditioning for post-traumatic stress disorder,"Twenty-three patients who had experienced a major stressful event were given a debriefing session followed by eight weekly sessions of imaginal exposure and in vivo exposure. Patients recounted their traumatic experiences aloud, using the first person and the present tense, and included as much detail as possible. This account was audiotaped and patients were asked to listen to the tape between treatment sessions. There were reductions of 42 percent in the Impact of Events Scale (IES), of 61 percent in the General Health Questionnaire (GHQ), of 38 percent in the Symptom Checklist-90 (SCL-90) questionnaire, and of 35 percent in the Clinician Administered Post-Traumatic Stress scale (CAPS), all of which were statistically significant. The number of patients who satisfied the diagnostic criteria for post-traumatic stress disorder was halved.",0,0 +7101,"Brief Report: Pediatric Cancer, Parental Coping Style, and Risk for Depressive, Posttraumatic Stress, and Anxiety Symptoms","According to the stress and coping goodness of fit model, parents' risk for psychological symptoms was hypothesized to decrease as a function of using emotional regulation and problem appraisal strategies more frequently, and to increase as a function of using problem-solving and avoidant behaviors more frequently to cope with an uncontrollable stressor--pediatric cancer diagnosis.Parents (N = 150) completed measures of depression, PTSD, anxiety, and coping style.Regression analyses revealed that symptoms decreased as a function of using problem appraisal and an emotional regulation strategy (social support) more frequently; and increased as a function of using problem-solving strategies, avoidant coping (substance use), and another emotional regulation strategy (negative self-blame) more frequently.The findings provide some support for the model but suggest that the method of coping (e.g., social support) might be considered in addition to the focus of the coping strategy (e.g., emotional regulation).",0,0 +7102,The MMPI and the post-traumatic stress syndrome in vietnam era veterans,"MMPI profiles of Post-traumatic Stress outpatient and newly admitted Random Psychiatric inpatient veterans are practically identical, which indicates the severity of delayed response to stress in Vietnam veterans, especially those from urban, disadvantaged environments.",0,0 +7103,A Reevaluation of the Use of the MMPI in the Assessment of Combat-Related Posttraumatic Stress Disorder,"This study attempts to validate previously developed, empirically based Minnesota Multiphasic Personality Inventory (MMPI) decision rules (Keane, Malloy, & Fairbank, 1984) to aid in the diagnosis of combat-related posttraumatic stress disorder (PTSD). Four groups of 21 subjects each were identified: PTSD, psychotic, depressed, and chronic pain. A decision rule based on the standard clinical scales resulted in a correct classification rate (PTSD vs. non-PTSD) of 81% across the four-group sample. An empirically derived MMPI PTSD scale resulted in a correct classification rate of 77%. However, 43% of the PTSD subjects were incorrectly classified as non-PTSD by these rules. Independent, blind sorting of the 84 MMPI profiles by two doctoral-level clinical psychologists resulted in ""hit rates"" similar to the MMPI decision rules. The present results suggest that the previously derived, empirically based MMPI decision rules for PTSD do scarcely better than chance on correct classification of individuals with PTSD. We suggest that the differential diagnosis of PTSD is difficult because of the wide variety of symptoms in common with other diagnostic groups, and hence the variability of PTSD subjects on psychometric measures. We also suggest that the MMPI decision rules of Keane et al. (1984) may have utility in identifying subgroup(s) of combat-related PTSDs.",0,0 +7104,Cognitive behavioral therapy for the treatment of post-traumatic stress disorder: a review,"Post-traumatic stress disorder (PTSD) is a psychiatric sequel to a stressful event or situation of an exceptionally threatening or catastrophic nature. Cognitive behavioral therapy (CBT) has been used in the management of PTSD for many years. This paper reviews the effectiveness of CBT for the treatment of PTSD following various types of trauma, its potential to prevent PTSD, methods used in CBT, and reflects on the mechanisms of action of CBT in PTSD.Electronic databases, including PubMed, were searched for articles on CBT and PTSD. Manual searches were conducted for cross-references in the relevant journal sites.The current literature reveals robust evidence that CBT is a safe and effective intervention for both acute and chronic PTSD following a range of traumatic experiences in adults, children, and adolescents. However, nonresponse to CBT by PTSD can be as high as 50%, contributed to by various factors, including comorbidity and the nature of the study population. CBT has been validated and used across many cultures, and has been used successfully by community therapists following brief training in individual and group settings. There has been effective use of Internet-based CBT in PTSD. CBT has been found to have a preventive role in some studies, but evidence for definitive recommendations is inadequate. The effect of CBT has been mediated mostly by the change in maladaptive cognitive distortions associated with PTSD. Many studies also report physiological, functional neuroimaging, and electroencephalographic changes correlating with response to CBT.There is scope for further research on implementation of CBT following major disasters, its preventive potential following various traumas, and the neuropsychological mechanisms of action.",0,0 +7105,Correlates of Battered Women's Psychological Distress: Severity of Abuse and Duration of the Postabuse Period,"Although psychological disturbances among abused women are well documented, it is unclear whether such disturbances are a reaction to the abusive experience. The present study hypothesized that, if the disturbances are a reactive state, the severity of disturbance would be related to the time since the relationship ended as well as the severity of the psychological and physical abuse experienced. Participants were 50 abused women who completed valid MMPI-2s and revised Conflict Tactic Scales. The results indicated that MMPI-2 scores were significantly correlated with both types of abuse but not with duration of time since the abusive relationship was terminated. The MMPI-2 profiles of abused women and suggestions for research are discussed.",0,0 +7106,Transition and change: Prospective effects of posttraumatic stress on smoking trajectories in the first year of college.,"College matriculation begins a period of transition that is marked by new freedoms and responsibilities and by increases in a variety of risky behaviors, including smoking. Trauma and posttraumatic stress disorder (PTSD) are well-established risk factors for smoking outcomes, and thus may be a point of intervention for college smoking. Yet, no studies have examined associations among trauma, PTSD, and smoking in college students. The present study provides such an examination.Matriculating student smokers (N = 346) completed surveys in September (T1) and at 5 subsequent time points (T2-T6) over their first year of college. With latent growth analysis, we modeled smoking trajectories conditioned on PTSD symptom status (i.e., No PTSD Symptoms vs. Partial PTSD vs. Full PTSD).Results showed that although smoking tended to decline during the first semester for all groups, significant risk for escalation in smoking during the second semester was conferred specifically by the presence of PTSD at matriculation.Interventions that offer support and resources to students entering college with PTSD may help to prevent smoking behaviors from escalating and may ultimately prevent the adoption of daily smoking in later adulthood.",0,0 +7107,The effect of trauma onset and frequency on PTSD-associated symptoms,"Different trauma characteristics have been suggested to lead to distinct symptom profiles. This study investigates the effect of two trauma characteristics, age of onset and frequency, on PTSD symptom profiles.Trauma characteristics (childhood versus adulthood trauma and single versus multiple trauma), psychiatric diagnosis, PTSD severity, depressive symptoms, dissociation, guilt, shame, anger, and interpersonal sensitivity were assessed in 110 PTSD outpatients.Single versus multiple trauma and childhood versus adulthood trauma groups did not differ in depressive symptom and co-morbidity. Multiple trauma patients reported more dissociation, guilt, shame, and interpersonal sensitivity than those that experienced single trauma. Anger of multiple trauma patients was more often directed towards themselves, whereas anger in single trauma patients was more often directed towards others. Childhood trauma patients reported more dissociation and state anger than adulthood trauma patients. However, with the exception of multiple trauma patients having more dissociation and shame than those with single trauma, all differences disappeared after controlling for PTSD severity.This study is a first step in unraveling the impact of different trauma characteristics. Causal inferences are limited, though, because of the cross-sectional design.The results suggest that experiencing trauma at young age or multiple times may lead to different symptom profiles but these are, with the exception of dissociation and shame, dependent on PTSD severity. These results support the proposed DSM-V criteria in which these symptoms appear as part of the disorder, and stress the importance of early treatment.",0,0 +7108,Resilience following spinal cord injury: A prospective controlled study investigating the influence of the provision of group cognitive behavior therapy during inpatient rehabilitation.,"To examine change in resilience in people with spinal cord injury (SCI) when group cognitive behavior therapy (GCBT) was added to routine psychosocial rehabilitation (RPR).A prospective repeated-measures cohort design was used to determine the efficacy of the addition of GCBT (n = 50). The control group consisted of individuals receiving RPR, which included access to individual CBT (ICBT) when required (n = 38). Groups were assessed on 3 occasions: soon after admission, within 2 weeks of discharge, and 6-months postdischarge. Measures included sociodemographic, injury, and psychosocial factors. The outcome variable was resilience, considered an important outcome measure for recovery. To adjust for baseline differences in self-efficacy, depressive mood and anxiety between the 2 groups, these factors were entered into a repeated measures multivariate analysis of covariance (MANCOVA) as covariates. Latent class analysis was used to determine the best-fitting model of resilience trajectories for both groups.The MANCOVA indicated that the addition of GCBT to psychosocial rehabilitation did not result in improved resilience compared with the ICBT group. Trajectory data indicated over 60% were demonstrating acceptable resilience irrespective of group.Changes in resilience mean scores suggest the addition of GCBT adds little to resilience outcomes. Latent class modeling indicated both groups experienced similar trajectories of improvement and deterioration. Results highlight the importance of conducting multivariate modeling analysis that isolates subgroups of related cases over time to understand complex trajectories. Further research is needed to clarify individual differences in CBT intervention preference as well as other factors which impact on resilience.",0,0 +7109,Measuring psychological resilience to disasters: are evidence-based indicators an achievable goal?,"Despite rising interest on the concept of societal resilience and its measurement, little has been done to provide operational indicators. Importantly, an evidence-based approach to assess the suitability of indicators remains unexplored. Furthermore few approaches that exist do not investigate indicators of psychological resilience, which is emerging as an important component of societal resilience to disasters. Disasters are events which overwhelm local capacities, often producing human losses, injury and damage to the affected communities. As climate hazards and disasters are likely to increase in the coming decades, strengthening the capacity of societies to withstand these shocks and recover quickly is vital. In this review, we search the Web of Knowledge to summarize the evidence on indicators of psychological resilience to disasters and provided a qualitative assessment of six selected studies. We find that an evidence-based approach using features from systematic reviews is useful to compile, select and assess the evidence and elucidate robust indicators. We conclude that strong social support received after a disaster is associated with an increased psychological resilience whereas a female gender is connected with a decrease in the likelihood of a resilient outcome. These results are consistent across disaster settings and cultures and are representative of approximately 13 million disaster-exposed civilians of adult age. An approach such as this that collects and evaluates evidence will allow indicators of resilience to be much more revealing and useful in the future. They will provide a robust basis to prioritize indicators to act upon through intersectoral policies and post-disaster public health interventions.",0,0 +7110,"Health Care Utilization by United Nations Peacekeeping Veterans with Co-occurring, Self-Reported, Post-Traumatic Stress Disorder and Depression Symptoms versus Those Without","It remains to be determined whether patients with comorbid post-traumatic stress disorder (PTSD) and depression use more health care resources than do those without. United Nations peacekeeping veterans from Canada were divided into four groups, i.e., PTSD alone (n = 23), depression alone (n = 167), comorbid PTSD and depression (n = 119), and neither (n = 164), and compared with respect to total number of visits to any health care professional in the past year. Analysis of variance revealed that the groups significantly differed in total visits. Post hoc analyses indicated that veterans with co-occurring PTSD and depression symptoms had more visits than did those in the other groups and that veterans with PTSD symptoms alone and depression symptoms alone had more visits than did those with neither PTSD nor depression. Additional analyses revealed that veterans with co-occurring PTSD and depression symptoms made more visits to general practitioners, specialists, pharmacists, and mental health professionals than did the others. Future research directions and implications for treatment planning are discussed.",0,0 +7111,Risk factors for DSM–5 posttraumatic stress symptoms (PTSS) among Israeli civilians during the 2014 Israel-Hamas war.,"In light of current modifications in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria for posttraumatic stress disorder (PTSD), this study aimed to revalidate well-known PTSD risk factors related to terrorism and war in Israel, namely, proximity to the Gaza Strip, dissociative symptoms, acute stress disorder (ASD) symptoms, and social support. One hundred and sixty Israeli civilians were assessed during the 2014 Israel-Hamas war at 2 time points: 1 week after the beginning of the operation (t1) and 1 month after initial evaluation (t2), using the DSM-5 PTSD Symptom Levels Scale (PSLS; Gil, Weinberg, Or-Chen, & Harel, 2015). A paired t test analysis showed significant reduction in the respondents' posttraumatic stress symptoms (PTSS) 1 month after the initial assessment point. A structural equation model (SEM) showed that higher ASD symptoms at t1 and higher dissociative symptoms at t2 increased the risk for PTSS at t2. Conversely, higher peritraumatic dissociation at t1 decreased the risk for PTSS at t2. Proximity to the Gaza Strip, and social support, failed to demonstrate significant association with PTSS at t2. DSM-5 PTSS 1 month after prolonged traumatic exposure are strongly associated with high ASD symptoms at 1 week as a risk factor; high levels of peritraumatic dissociation at 1 week as a protective factor; and high levels of dissociative symptoms at 1 month as a risk factor. Theoretically and clinically the findings of the study further suggest that ongoing massive terrorism and war cannot be viewed or treated as identical to other traumas.",0,0 +7112,Risk Factors for Posttraumatic Stress Disorder in Female Help-Seeking Victims of Sexual Assault,"Posttraumatic stress disorder (PTSD) is common in the aftermath of rape and other sexual assault, but the risk factors leading to PTSD following rape have been shown to differ from those related to PTSD following nonsexual assault. This prospective study examined risk factors for PTSD severity in 148 female help-seeking victims of sexual assault. Approximately 70% of the victims experienced significant levels of traumatization, with 45% reporting symptoms consistent with a probable PTSD diagnosis. Regression analyses showed that relationship with the assailant, number of assailants, the nature of the assault, perceived positive social support, support satisfaction, feeling let down by others, and prior exposure to sexual trauma did not significantly predict PTSD severity at the final level of analysis. In accordance with suggestions by Dancu, Riggs, Hearst-Ikeda, and Shoyer (1996), it is suggested that this is partly caused by a very high degree of traumatization in the sample. Instead, previous nonsexual traumatic experiences and negative affectivity accounted for 30% of the variance in PTSD severity. Although more research is needed on risk factors of assault-related PTSD, these findings suggest that although sexual assault is associated with a high degree of PTSD severity, prior nonsexual victimization and high levels of negative affectivity appear to further increase the vulnerability toward developing symptoms of assault-related PTSD. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0,0 +7113,Contrasting models of posttraumatic stress disorder: Reply to Monroe and Mineka (2008).,"We address the four main points in Monroe and Mineka (2008)'s Comment. First, we first show that the DSM PTSD diagnosis includes an etiology and that it is based on a theoretical model with a distinguished history in psychology and psychiatry. Two tenets of this theoretical model are that voluntary (strategic) recollections of the trauma are fragmented and incomplete while involuntary (spontaneous) recollections are vivid and persistent and yield privileged access to traumatic material. Second, we describe differences between our model and other cognitive models of PTSD. We argue that these other models share the same two tenets as the diagnosis and we show that these two tenets are largely unsupported by empirical evidence. Third, we counter arguments about the strength of the evidence favoring the mnemonic model, and fourth, we show that concerns about the causal role of memory in PTSD are based on views of causality that are generally inappropriate for the explanation of PTSD in the social and biological sciences.",0,0 +7114,Chronic probable ptsd in police responders in the world trade center health registry ten to eleven years after 9/11,"Background Police enrolled in the World Trade Center Health Registry (WTCHR) demonstrated increased probable posttraumatic stress disorder (PTSD) after the terrorist attack of 9/11/2001. Methods Police enrollees without pre-9/11 PTSD were studied. Probable PTSD was assessed by Posttraumatic Stress Check List (PCL). Risk factors for chronic, new onset or resolved PTSD were assessed using multinomial logistic regression. Results Half of police with probable PTSD in 2003-2007 continued to have probable PTSD in 2011–2012. Women had higher prevalence of PTSD than men (15.5% vs. 10.3%, P = 0.008). Risk factors for chronic PTSD included decreased social support, unemployment, 2+ life stressors in last 12 months, 2+ life-threatening events since 9/11, 2+ injuries during the 9/11 attacks, and unmet mental health needs. Conclusion Police responders to the WTC attacks continue to bear a high mental health burden. Improved early access to mental health treatment for police exposed to disasters may be needed. Am. J. Ind. Med. 58:483–493, 2015. © 2015 Wiley Periodicals, Inc.",0,0 +7115,Genomic predictors of combat stress vulnerability and resilience in U.S. Marines: A genome-wide association study across multiple ancestries implicates PRTFDC1 as a potential PTSD gene,"Research on the etiology of post-traumatic stress disorder (PTSD) has rapidly matured, moving from candidate gene studies to interrogation of the entire human genome in genome-wide association studies (GWAS). Here we present the results of a GWAS performed on samples from combat-exposed U.S. Marines and Sailors from the Marine Resiliency Study (MRS) scheduled for deployment to Iraq and/or Afghanistan. The MRS is a large, prospective study with longitudinal follow-up designed to identify risk and resiliency factors for combat-induced stress-related symptoms. Previously implicated PTSD risk loci from the literature and polygenic risk scores across psychiatric disorders were also evaluated in the MRS cohort.Participants (N=3494) were assessed using the Clinician-Administered PTSD Scale and diagnosed using the DSM-IV diagnostic criterion. Subjects with partial and/or full PTSD diagnosis were called cases, all other subjects were designated controls, and study-wide maximum CAPS scores were used for longitudinal assessments. Genomic DNA was genotyped on the Illumina HumanOmniExpressExome array. Individual genetic ancestry was determined by supervised cluster analysis for subjects of European, African, Hispanic/Native American, and other descent. To test for association of SNPs with PTSD, logistic regressions were performed within each ancestry group and results were combined in meta-analyses. Measures of childhood and adult trauma were included to test for gene-by-environment (GxE) interactions. Polygenic risk scores from the Psychiatric Genomic Consortium were used for major depressive disorder (MDD), bipolar disorder (BPD), and schizophrenia (SCZ).The array produced >800K directly genotyped and >21M imputed markers in 3494 unrelated, trauma-exposed males, of which 940 were diagnosed with partial or full PTSD. The GWAS meta-analysis identified the phosphoribosyl transferase domain containing 1 gene (PRTFDC1) as a genome-wide significant PTSD locus (rs6482463; OR=1.47, SE=0.06, p=2.04×10(-9)), with a similar effect across ancestry groups. Association of PRTFDC1 with PTSD in an independent military cohort showed some evidence for replication. Loci with suggestive evidence of association (n=25 genes, p<5×10(-6)) further implicated genes related to immune response and the ubiquitin system, but these findings remain to be replicated in larger GWASs. A replication analysis of 25 putative PTSD genes from the literature found nominally significant SNPs for the majority of these genes, but associations did not remain significant after correction for multiple comparison. A cross-disorder analysis of polygenic risk scores from GWASs of BPD, MDD, and SCZ found that PTSD diagnosis was associated with risk sores of BPD, but not with MDD or SCZ.This first multi-ethnic/racial GWAS of PTSD highlights the potential to increase power through meta-analyses across ancestry groups. We found evidence for PRTFDC1 as a potential novel PTSD gene, a finding that awaits further replication. Our findings indicate that the genetic architecture of PTSD may be determined by many SNPs with small effects, and overlap with other neuropsychiatric disorders, consistent with current findings from large GWAS of other psychiatric disorders.",0,0 +7116,Similar factors predict disability and posttraumatic stress disorder trajectories after whiplash injury,"Distinct developmental trajectories for neck disability and posttraumatic stress disorder (PTSD) symptoms after whiplash injury have recently been identified. This study aimed to identify baseline predictors of membership to these trajectories and to explore their dual development. In a prospective study, 155 individuals with whiplash were assessed at or = 13° C (OR = 26.320, 95% CI = 4.981-139.09), initial pain level (VAS) (OR = 4.3, 95% CI = 4.98-139.1), and age (OR = 1.109, 95% CI = 1.043-1.180) predicted a chronic/severe disability trajectory. The same baseline factors also predicted chronic moderate/severe PTSD (CPT > or = 13° C, OR = 9.7, 95% CI = 2.22-42.44; initial pain level [VAS]: OR = 2.13, 95% CI = 1.43-3.17; age: OR = 1.07, 95% CI = 1.01-1.14). There was good correspondence of trajectory group for both disability and PTSD. These findings support the proposal of links between the development of chronic neck related disability and PTSD after whiplash injury. Developmental trajectories of disability and posttraumatic stress disorder (PTSD) after whiplash injury are mostly in synchrony, and similar factors predict their membership. This suggests links between the development of chronic neck pain-related disability and PTSD.",0,0 +7117,Cultural protection against traumatic stress: traditional support of children exposed to the ritual of female genital cutting,"This study explores the factors addressed in folk psychology in The Gambia for protecting the girl-child from the potential traumatic stress of female genital cutting (FGC). The type and quality of the psychological care was analyzed and compared with research on traumatic stress and principles for crisis and trauma intervention. Thirty-three qualitative indepth interviews were conducted with mothers who had supervised their daughters' FGC, women who had been circumcised, and professional circumcisers. The findings indicate that the girls have largely managed to handle the potentially traumatic event of FGC. The event is placed in a meaningful system of understanding, and the stress is dealt with in a traditional way that to a great extent follows empirically-based and evidence-based principles of crisis intervention. However, the approach tends to be culturally encoded, based on the local cultural belief system. This puts circumcised individuals in a potentially vulnerable position if they are living outside the homeland's supportive cultural context, with consequences for psychological and culturally competent FGC health care in exile.",0,0 +7118,Clinical challenges in the treatment of patients with posttraumatic stress disorder and substance abuse,"The aim of this article is to review the current literature on co-occuring posttraumatic stress disorder and substance-use disorder, with an emphasis on clinical aspects and emerging treatments.In clinical populations (focusing on either disorder), about 25-50% have a lifetime dual diagnosis of posttraumatic stress disorder and substance-use disorder. Patients with both disorders have a more severe clinical profile than those with either disorder alone, lower functioning, poorer well being, and worse outcomes across a variety of measures. In recent years, several promising treatment programs have been developed specifically for co-occuring posttraumatic stress disorder and substance-use disorder, with one model having been established as effective thus far.Comorbid posttraumatic stress disorder/substance-use disorder is a frequent diagnosis in clinical populations that severely affects course and outcome. Treatment approaches appropriate for this vulnerable population need to be evaluated further and implemented in routine practice.",0,0 +7119,Prevention of Posttraumatic Stress Disorder by Early Treatment,"Preventing posttraumatic stress disorder (PTSD) is a pressing public health need.To compare early and delayed exposure-based, cognitive, and pharmacological interventions for preventing PTSD.Equipoise-stratified randomized controlled study.Hadassah Hospital unselectively receives trauma survivors from Jerusalem and vicinity.Consecutively admitted survivors of traumatic events were assessed by use of structured telephone interviews a mean (SD) 9.61 (3.91) days after the traumatic event. Survivors with symptoms of acute stress disorder were referred for clinical assessment. Survivors who met PTSD symptom criteria during the clinical assessment were invited to receive treatment.Twelve weekly sessions of prolonged exposure (PE; n = 63), or cognitive therapy (CT; n = 40), or double blind treatment with 2 daily tablets of either escitalopram (10 mg) or placebo (selective serotonin reuptake inhibitor/placebo; n = 46), or 12 weeks in a waiting list group (n = 93). Treatment started a mean (SD) 29.8 (5.7) days after the traumatic event. Waiting list participants with PTSD after 12 weeks received PE a mean (SD) 151.8 (42.4) days after the traumatic event (delayed PE).Proportion of participants with PTSD after treatment, as determined by the use of the Clinician-Administered PTSD Scale (CAPS) 5 and 9 months after the traumatic event. Treatment assignment and attendance were concealed from the clinicians who used the CAPS.At 5 months, 21.6% of participants who received PE and 57.1% of comparable participants on the waiting list had PTSD (odds ratio [OR], 0.21 [95% CI, 0.09-0.46]). At 5 months, 20.0% of participants who received CT and 58.7% of comparable participants on the waiting list had PTSD (OR, 0.18 [CI, 0.06-0.48]). The PE group did not differ from the CT group with regard to PTSD outcome (OR, 0.87 [95% CI, 0.29-2.62]). The PTSD prevalence rates did not differ between the escitalopram and placebo subgroups (61.9% vs 55.6%; OR, 0.77 [95% CI, 0.21-2.77]). At 9 months, 20.8% of participants who received PE and 21.4% of participants on the waiting list had PTSD (OR, 1.04 [95% CI, 0.40-2.67]). Participants with partial PTSD before treatment onset did similarly well with and without treatment.Prolonged exposure, CT, and delayed PE effectively prevent chronic PTSD in recent survivors. The lack of improvement from treatment with escitalopram requires further evaluation. Trauma-focused clinical interventions have no added benefit to survivors with subthreshold PTSD symptoms. Trial Registration clinicaltrials.gov Identifier: NCT00146900.",0,0 +7120,Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study,"In the empirical and clinical literature, complex posttraumatic stress disorder (PTSD) and personality disorders (PDs) are suggested to be predictive of drop-out or reduced treatment effectiveness in trauma-focused PTSD treatment.In this study, we aimed to investigate if personality characteristics would predict treatment compliance and effectiveness in stabilizing complex PTSD treatment.In a randomized controlled trial on a 20-week stabilizing group cognitive behavioral treatment (CBT) for child-abuse-related complex PTSD, we included 71 patients of whom 38 were randomized to a psycho-educational and cognitive behavioral stabilizing group treatment. We compared the patients with few PD symptoms (adaptive) (N=14) with the non-adaptive patients (N=24) as revealed by a cluster analysis.We found that non-adaptive patients compared to the adaptive patients showed very low drop-out rates. Both non-adaptive patients, classified with highly different personality profiles ""withdrawn"" and ""aggressive,"" were equally compliant. With regard to symptom reduction, we found no significant differences between subtypes. Post-hoc, patients with a PD showed lower drop-out rates and higher effect sizes in terms of complex PTSD severity, especially on domains that affect regulation and interpersonal problems.Contrary to our expectations, these preliminary findings indicate that this treatment is well tolerated by patients with a variety of personality pathology. Larger sample sizes are needed to study effectiveness for subgroups of complex PTSD patients.",0,0 +7121,High dose hydrocortisone immediately after trauma may alter the trajectory of PTSD: Interplay between clinical and animal studies,"High-dose corticosteroids have been reported to reduce symptoms of acute stress and post-traumatic stress in polytrauma patients and in animal studies. The underlying mechanism of action remains largely unclear. These issues were addressed in parallel in the clinical and preclinical studies below. In this preliminary study, 25 patients with acute stress symptoms were administered a single intravenous bolus of high-dose hydrocortisone (100-140 mg) or placebo within 6 h of a traumatic event in a prospective, randomized, double-blind, placebo-controlled pilot study. Early single high-dose hydrocortisone intervention attenuated the core symptoms of both the acute stress and of subsequent PTSD in patients. High-dose hydrocortisone treatment given in the first few hours after a traumatic experience was associated with significant favorable changes in the trajectory of exposure to trauma, as expressed by the reduced risk of the development of PTSD post-trauma. In parallel, a comparative study of morphological arborization in dentate gyrus and its modulating molecules was performed in stress-exposed animals treated with high-dose hydrocortisone. Steroid-treated stressed animals displayed significantly increased dendritic growth and spine density, with increased levels of brain-derived neurotrophic factor (BDNF) and obtunded postsynaptic density-95 (PSD-95) levels. The animal study provided insights into the potential mechanism of this intervention, as it identified relevant morphological and biochemical associations to the clinical observations. Thus, evidence from clinical and animal studies suggests that there is a ""window of opportunity"" in the early aftermath of trauma to help those who are vulnerable to the development of chronic PTSD.",0,0 +7122,A factor analytic comparison of five models of PTSD symptoms,"This study examined the factor structure of PTSD symptoms in a sample of college students (n=344) reporting exposure to a range of traumatic events. The sample was randomly split and an exploratory factor analysis was conducted with half of the sample. The factor structure obtained in the exploratory analysis was evaluated against three other models using confirmatory factor analysis utilizing the second half of the sample. This series of factor analyses identified and confirmed a three-factor symptom structure consisting of intrusion/avoidance, dysphoria, and hyperarousal clusters. These results add to the body of literature which has found that PTSD includes a cluster of symptoms shared with other diagnoses (dysphoria) and a more specific factor related directly to the effects of encountering traumatic experiences.",0,0 +7123,Relationship between posttraumatic stress disorder symptoms and the course of whiplash complaints,"This study investigates the relationship between posttraumatic stress disorder (PTSD) symptoms (avoidance, reexperiencing, and hyperarousal) and the presence, severity, and duration of neck complaints after motor vehicle accidents. Individuals who had been involved in traffic accidents and had initiated compensation claim procedures with a Dutch insurance company were sent questionnaires (Q1) containing complaint-related questions and the Self-Rating Scale for PTSD. Of the 997 questionnaires that were dispatched, 617 (62%) were returned. Only car accident victims were included in this study ( n =240). Complaints were monitored using additional questionnaires that were administered 6 months (Q2) and 12 months (Q3) after the accident. PTSD was related to the presence and severity of concurrent post-whiplash syndrome. More specifically, the intensity of hyperarousal symptoms that were related to PTSD at Q1 was found to have predictive validity for the persistence and severity of post-whiplash syndrome at 6 and 12 months follow-up. Results are consistent with the idea that PTSD hyperarousal symptoms have a detrimental influence on the recovery and severity of whiplash complaints following car accidents.",0,0 +7124,Advances in genomics and epigenetic biomarkers for vulnerability and treatment response in mood and anxiety disorders,"Objective: Our current efforts in identifying reliable markers to stratify patients with mood and anxiety disorders into biologically relevant categories have so far not been highly successful. Here we will highlight approaches that combine genetic and environmental risk factors and epigenetic measures to identify subsets of patients that are likely biologically more homogeneous and may profit from similar treatment strategies. Methods: DNA methylation, gene expression and genotyping, combined with endocrine and neuroimaging measures as well as information on antidepressant treatment response from different studies will be presented. Results: Interaction of a specific functional polymorphism in the FKBP5 gene together with exposure to early trauma leads to epigenetic changes that further derepress the transcription of that gene. This interaction of two risk factors is on the one hand associated with a number of distinct psychiatric diagnoses, including depression, PTSD and psychosis. On the other hand, patients with this specific epigenetic profile represent a subgroup of patients with unique endocrine, gene expression and neuroimaging biomarkers. Preliminary evidence suggest that depressed patients with the FKBP5 risk allele and exposure to early trauma may preferentially respond to cognitive behavioral therapy (CBT). We will also present data from genome-wide genetic and epigenetic studies investigating pattern associated with differential antidepressive response to CBT vs. medication. Conclusion: This series of studies highlights that identifying subgroups of patients using epigenetic measures and integrating genetic and environmental factors could be useful for more targeted treatment approaches that make use of pathophysiologic findings that can transcend current diagnostic categories.",0,0 +7125,The endocannabinoid system as a possible target to treat both the cognitive and emotional features of post-traumatic stress disorder (PTSD),"Post-traumatic stress disorder (PTSD) is a psychiatric disorder of significant prevalence and morbidity, whose pathogenesis relies on paradoxical changes of emotional memory processing. An ideal treatment would be a drug able to block the pathological over-consolidation and continuous retrieval of the traumatic event, while enhancing its extinction and reducing the anxiety symptoms. While the latter benefit from antidepressant medications, no drug is available to control the cognitive symptomatology. Endocannabinoids regulate affective states and participate in memory consolidation, retrieval, and extinction. Clinical findings showing a relationship between Cannabis use and PTSD, as well as changes in endocannabinoid activity in PTSD patients, further suggest the existence of a link between endocannabinoids and maladaptive brain changes after trauma exposure. Along these lines, we suggest that endocannabinoid degradation inhibitors may be an ideal therapeutic approach to simultaneously treat the emotional and cognitive features of PTSD, avoiding the unwanted psychotropic effects of compounds directly binding cannabinoid receptors.",0,0 +7126,The modeling of internalizing disorders on the basis of patterns of lifetime comorbidity: Associations with psychosocial functioning and psychiatric disorders among first-degree relatives.,"Two broadband latent factors--internalizing and externalizing--have frequently been identified in studies of the hierarchical structure of psychopathology. In the present research, 3 competing measurement models of putative internalizing disorders (i.e., a parsimonious single-factor model, a model based on the Diagnostic and Statistical Manual of Mental Disorders [4th ed., American Psychiatric Association, 1994], and an alternative model proposed by Krueger, 1999, and Watson, 2005) were evaluated in terms of their ability to account for lifetime patterns of diagnostic comorbidity. Four diagnostic assessments were performed on an age-based cohort of 816 persons over a 15-year interval. Each of the 3 measurement models demonstrated adequate or good fit to the data and similar approximating abilities. Additional analyses, however, suggested that nonspecific aspects of lifetime mood/anxiety or distress/fear disorders (i.e., general negative affect) largely accounted for indicators of psychosocial functioning at age 30 as well as densities of specific psychiatric disorders among the 1st-degree relatives of probands. The relevance of these findings for theoretical and descriptive models of internalizing disorders is discussed.",0,0 +7127,Emerging roles for atypical antipsychotics in chronic post-traumatic stress disorder,"Post-traumatic stress disorder is an anxiety disorder that may occur after the individual is exposed to severe psychologic trauma such as combat, sexual assault, or childhood physical or sexual abuse. Chronic post-traumatic stress disorder may result in considerable psychologic pain and suffering for the individual in addition to significant functional impairment. In addition to the heterogeneity of symptoms that occur in post-traumatic stress disorder, there may also be extensive comorbidity with other anxiety disorders, mood disorders, psychotic disorders, and other psychiatric disorders. This complicates the treatment picture. Currently, accepted treatments for post-traumatic stress disorder include psychotherapy, in particular cognitive behavioral-based approaches and antidepressant medication. However, many patients are refractory to these initial treatments or have only a partial response. In light of this, may clinicians combine additional classes of psychotropic agents and different psychotherapeutic approaches to enhance treatment response. This article reviews the literature on the use of atypical antipsychotics in the treatment of post-traumatic stress disorder. Most of the research to date has involved combat veterans partially responsive or refractory to treatment, namely with antidepressants. Studies have shown improvement across post-traumatic stress disorder symptom clusters, as well as improvement in comorbid psychotic symptoms or disorders. More research is needed to confirm these recent findings and further delineate the role of atypical antipsychotics in the treatment of post-traumatic stress disorder. Currently, possible indications for their use include treatment-resistant post-traumatic stress disorder and post-traumatic stress disorder with comorbid psychotic features.",0,0 +7128,Distinguishing distress and psychopathology among survivors of the Oakland/Berkeley firestorm.,"Disaster mental health research has historically focused on assessment of psychopathology, using measures of psychiatric symptoms and disorders. The Oakland/Berkeley firestorm provided an opportunity to explore resilience among highly exposed survivors through consideration of psychiatric variables in the context of personality. The Diagnostic Interview Schedule/Disaster Supplement was administered to 62 firestorm survivors at approximately 4, 16, and 39 months and the Temperament and Character Inventory administered at 16 months postdisaster. Few individuals had postdisaster psychopathology (16% with any diagnosis, 5%with PTSD). There was considerable evidence of distress, however, indicated by an abundance of reported posttraumatic symptoms, functional impairments, and endorsement of emotional upset, all of which decreased substantially over time. Group C (avoidance/numbing) posttraumatic symptoms were relatively uncommon and were specifically associated with elevated Self-Transcendence. Groups B (intrusion) and D (hyperarousal) symptoms were prevalent and were associated with high Harm Avoidance and low Self-Directedness. The generally healthy personality profiles of these firestorm survivors reflected their psychological resilience. Examination of symptoms and distress in the context of psychiatric disorders after this disaster demonstrated that symptomatic distress is not inconsistent with psychological resilience. The choice of research focus and methods can provide very different portraits of outcomes post-disaster.",0,0 +7129,Treatment-Resistant Posttraumatic Stress Disorder: Strategies for Intervention,"Abstract The mainstay of treatment for chronic posttraumatic stress disorder (PTSD) is a combination of psychotherapy and medication treatments. The first-line medications for PTSD are antidepressants, with two selective serotonin reuptake inhibitors (sertraline and paroxetine) currently Food and Drug Administration-indicated for PTSD. However, many patients do not have an adequate response to antidepressants, therefore, combinations with other antidepressants or with other classes of psychotropic medication are often utilized to enhance the therapeutic response. Other agents that have been used include mood stabilizers, antiadrenergics, anxiolytics, and atypical antipsychotics. The heterogeneity of symptom clusters in PTSD as well as the complex psychiatric comorbidities (eg, with depression or substance abuse) further support the notion that combinations of medications may be needed. To date, there is a paucity of data to support specific strategies for augmenting antidepressants in PTSD. This review will address representative existing studies and discuss several potential pharmacologic strategies for patients suffering from treatment refractory PTSD.",0,0 +7130,"Comparative Study of Heart Rate Variability in Patients with Schizophrenia, Bipolar Disorder, Post-traumatic Stress Disorder, or Major Depressive Disorder","Heart rate variability (HRV) changes as a function of psychiatric illness. This study aimed to evaluate HRV among patients with various psychiatric disorders.The present study recruited patients with schizophrenia (n=35), bipolar disorder (n=41), post-traumatic stress disorder (PTSD; n=34), or major depressive disorder (n=34) as well as healthy controls (n=27). The time-domain analysis (the standard deviation of all RR intervals [SDNN] and the square root of the mean squared differences of successive normal sinus intervals [RMSSD]), the frequency-domain analysis (very low frequency, low frequency [LF], high frequency [HF], and total power [TP]), and a non-linear complexity measure the approximate entropy were computed.SDNN and HF were significantly reduced in patients with schizophrenia compared with healthy controls. SDNN, RMSSD, TP, LF, and HF were significantly reduced in bipolar patients compared with healthy controls. HF was significantly reduced in PTSD patients compared with healthy controls.Our findings indicate that HRV is not sufficiently powerful to discriminate among various psychiatric illnesses. However, our results suggest that HRV, particularly HF, could be used as a tool for discriminating between psychiatric patients and healthy controls.",0,0 +7131,All PTSD symptoms are highly associated with general distress: Ramifications for the dysphoria symptom cluster.,"This study used longitudinal data collected from two trauma-exposed samples, survivors of community violence (N = 294) and wildfire evacuees (N = 234), to examine a key claim underlying a proposed reformulation of the symptom structure of posttraumatic stress disorder (PTSD). This theory, which we term the PTSD-dysphoria model, posits that 8 of 17 symptoms of PTSD reflect dysphoria or general psychological distress and might be deemphasized to improve the utility of the PTSD construct (Simms, Watson, & Doebbeling, 2002). For each sample, we analyzed PTSD symptoms and measures of general distress administered at 2 time points. A consistent pattern of findings was observed across assessments for each sample: All 17 PTSD symptoms were highly associated with measures of general distress. Moreover, we found no evidence that dysphoria symptoms were more highly correlated than PTSD-specific symptoms with general distress. Results call into question both the conceptual basis and the clinical utility of differentiating between symptoms that appear to be relatively specific to PTSD and those that seem more broadly characteristic of general psychological distress.",0,0 +7132,Changes in Pain Catastrophizing Following Physical Therapy for Musculoskeletal Injury: The Influence of Depressive and Post-traumatic Stress Symptoms,"Purpose: The aim of the present study was to investigate the factors that influence the change in pain catastrophizing during the course of a physical therapy intervention for musculoskeletal injury. Methods: 187 clients enrolled in a 7-week physical therapy intervention were divided into four mutually exclusive groups on the basis of a pre-treatment assessment: (1) clients whose pre-treatment catastrophizing scores and measures of mental health problems were below clinical threshold, (2) clients whose pre-treatment catastrophizing scores were above clinical threshold but who scores on measures of mental health problems were below clinical threshold, (3) clients whose pre-treatment catastrophizing scores were above clinical threshold and whose scores on measures of mental health problems were also above clinical threshold, and (4) clients whose pre-treatment catastrophizing scores were below clinical threshold but whose scores on measures of mental health problems were above clinical threshold. Results: The most prevalent risk profile consisted of clients with high levels of pain catastrophizing and high mental health problems (37 %), followed by the low catastrophizing and low mental health problems profile (35 %), the high catastrophizing and low mental health problems profile (16 %), and low catastrophizing and high mental health problems profile (10 %). Clients were considered non-responders if their post-treatment catastrophizing score remained above clinical threshold following treatment. Chi square analyses revealed a significantly higher proportion of non-responders in the high catastrophizing and mental health problem group than in any other group. Conclusions: The presence of mental health symptoms markedly reduces the effectiveness of physical therapy for reducing catastrophizing scores. The 'risk value' of high catastrophizing scores thus appears to vary as a function of the presence or absence of mental health symptoms. The findings argue for the inclusion of measures of mental health problems in the routine screening of individuals treated in physical therapy. © 2013 Springer Science+Business Media New York.",0,0 +7133,Neurodevelopment and Behavior after Transcatheter versus Surgical Closure of Secundum Type Atrial Septal Defect,"To assess the neuropsychological and behavioral profiles of school-aged children treated for atrial septal defect, secundum type (ASD-II) with open-heart surgery or catheterization.Patients (n = 48; mean age, 9 years, 3 months) and a matched healthy group (mean age, 9 years, 2 months) were evaluated with a shortened intelligence scale (Wechsler Intelligence Scale for Children, third edition, Dutch version) and a developmental neuropsychological test battery (Developmental Neuropsychological Assessment, second edition, Dutch version). Parents completed behavioral checklists (Achenbach Child Behavior Checklist for Children aged 6-18). Hospitalization variables were retrieved from medical files for studying associations with long-term neurodevelopment.Compared with the healthy matched controls, patients treated for ASD-II had significantly lower scores on subtasks underlying such Developmental Neuropsychological Assessment, second edition, Dutch version domains as Attention and Executive Functioning, Language, Working Memory, Sensorimotor Functioning, Social Cognition, and Visuospatial Information Processing. Only subtle differences, mainly in Visuospatial Information Processing, were found between the surgical repair and transcatheter repair groups. Socioeconomic status, longer hospital stay, and larger defect size were associated with neurocognitive outcome measures. Parents of patients reported more thought problems, posttraumatic stress problems, and lower school performance compared with parents of healthy peers.After treatment for ASD-II, children display a range of neuropsychologic difficulties that may increase their risk for learning problems and academic underachievement. Differences related to treatment were not found. Our results suggest that neurodevelopmental and behavioral follow-up at school age is warranted in this group.",0,0 +7134,A Phase I Study of Low-Pressure Hyperbaric Oxygen Therapy for Blast-Induced Post-Concussion Syndrome and Post-Traumatic Stress Disorder,"This is a preliminary report on the safety and efficacy of 1.5 ATA hyperbaric oxygen therapy (HBOT) in military subjects with chronic blast-induced mild to moderate traumatic brain injury (TBI)/post-concussion syndrome (PCS) and post-traumatic stress disorder (PTSD). Sixteen military subjects received 40 1.5 ATA/60 min HBOT sessions in 30 days. Symptoms, physical and neurological exams, SPECT brain imaging, and neuropsychological and psychological testing were completed before and within 1 week after treatment. Subjects experienced reversible middle ear barotrauma (5), transient deterioration in symptoms (4), and reversible bronchospasm (1); one subject withdrew. Post-treatment testing demonstrated significant improvement in: symptoms, neurological exam, full-scale IQ (+14.8 points; p<0.001), WMS IV Delayed Memory (p=0.026), WMS-IV Working Memory (p=0.003), Stroop Test (p<0.001), TOVA Impulsivity (p=0.041), TOVA Variability (p=0.045), Grooved Pegboard (p=0.028), PCS symptoms (Rivermead PCSQ: p=0.0002), PTSD symptoms (PCL-M: p<0.001), depression (PHQ-9: p<0.001), anxiety (GAD-7: p=0.007), quality of life (MPQoL: p=0.003), and self-report of percent of normal (p<0.001), SPECT coefficient of variation in all white matter and some gray matter ROIs after the first HBOT, and in half of white matter ROIs after 40 HBOT sessions, and SPECT statistical parametric mapping analysis (diffuse improvements in regional cerebral blood flow after 1 and 40 HBOT sessions). Forty 1.5 ATA HBOT sessions in 1 month was safe in a military cohort with chronic blast-induced PCS and PTSD. Significant improvements occurred in symptoms, abnormal physical exam findings, cognitive testing, and quality-of-life measurements, with concomitant significant improvements in SPECT.",0,0 +7135,A longitudinal analysis of posttraumatic stress disorder symptoms and their relationship with Fear and Anxious-Misery disorders: Implications for DSM-V,"This paper examined the hypothesis that PTSD-unique symptom clusters of re-experiencing, active avoidance and hyperarousal were more related to the fear/phobic disorders, while shared PTSD symptoms of dysphoria were more closely related to Anxious-Misery disorders (MDD/GAD). Confirmatory factor and correlation analyses examining PTSD, anxiety and mood disorder data from 714 injury survivors interviewed 3, 12 and 24-months following their injury supported this hypothesis with these relationships remaining robust from 3-24 months posttrauma. Of the nine unique fear-oriented PTSD symptoms, only one is currently required for a DSM-IV diagnosis. Increasing emphasis on PTSD fear symptoms in DSM-V, such as proposed DSM-V changes to mandate active avoidance, is critical to improve specificity, ensure inclusion of dimensionally distinct features and facilitate tailoring of treatment.",0,0 +7136,An Introduction to Latent Class Growth Analysis and Growth Mixture Modeling,"In recent years, there has been a growing interest among researchers in the use of latent class and growth mixture modeling techniques for applications in the social and psychological sciences, in part due to advances in and availability of computer software designed for this purpose (e.g., Mplus and SAS Proc Traj). Latent growth modeling approaches, such as latent class growth analysis (LCGA) and growth mixture modeling (GMM), have been increasingly recognized for their usefulness for identifying homogeneous subpopulations within the larger heterogeneous population and for the identification of meaningful groups or classes of individuals. The purpose of this paper is to provide an overview of LCGA and GMM, compare the different techniques of latent growth modeling, discuss current debates and issues, and provide readers with a practical guide for conducting LCGA and GMM using the Mplus software.",0,0 +7137,Childhood physical abuse and combat-related posttraumatic stress disorder in Vietnam veterans,"Early trauma in the form of childhood physical or sexual abuse has been associated with adult psychopathology. The purpose of this study was to compare rates of childhood abuse in Vietnam veterans with and without combat-related posttraumatic stress disorder (PTSD).Premilitary stressful and traumatic events including childhood abuse and other potential predisposing factors were assessed in Vietnam combat veterans who sought treatment for PTSD (N = 38) and Vietnam combat veterans without PTSD who sought treatment for medical disorders (N = 28). Stressful and traumatic events including childhood physical abuse were assessed with the Checklist of Stressful and Traumatic Events and a clinician-administered interview for the assessment of childhood abuse. Level of combat exposure was measured with the Combat Exposure Scale.Vietnam veterans with PTSD had higher rates of childhood physical abuse than Vietnam veterans without PTSD (26% versus 7%). The association between childhood abuse and PTSD persisted after controlling for the difference in level of combat exposure between the two groups. Patients with PTSD also had a significantly higher rate of total traumatic events before joining the military than patients without PTSD (mean = 4.6, SD = 4.5, versus mean = 2.8, SD = 2.9).These findings suggest that patients seeking treatment for combat-related PTSD have higher rates of childhood physical abuse than combat veterans without PTSD. Childhood physical abuse may be an antecedent to the development of combat-related PTSD in Vietnam combat veterans.",0,0 +7138,Children with Multi-Trauma Histories: Special Considerations for Care and Implications for Treatment Selection,"The complex symptom profiles of young children with histories of trauma exposure underscore the importance of matching individual child characteristics and symptom needs with existing evidence-based treatment protocols. Children (N = 134) between the ages of 2–12 and their caregivers were administered the Child Behavioral Checklist, Trauma Symptom Checklist for Young Children, and the Trauma Symptom Checklist for Children-Alternate Version at baseline and end of treatment. ANCOVA analyses examined the relationships between the number of different types of trauma exposures, child gender, placement status, child age, type of treatment received, and end of treatment symptom scores. Child age at the start of treatment was found to influence externalizing and total problem scores at the end of treatment when baseline scale scores were held constant. Older children were found to have significantly higher levels of externalizing and total problem scores at the end of treatment compared to younger children in the sample. Significant improvements were found between baseline and termination outcome scores regardless of treatment type, however, results suggest that differences in severity of symptoms may vary by treatment type. Study findings suggest that latency age children and their caregivers may have differing trauma-related treatment needs compared to younger children and may benefit from an adjusted focus in treatment. The matching of individual child characteristics and need can help maximize emotional and behavioral outcomes and the addition of a cognitive-based treatment modality may be indicated for some children.",0,0 +7139,Possible cultural effects on the increments of somatic symptoms in subjectively resilient depressed patients,"Introduction While previous literatures have provided substantial evidence on the burden of somatic symptoms and the prognostic value of resilience in the treatment course of depression, little is speculated on the relationship between resilience and somatic symptoms in depressed patients. We aimed to clarify the relationship between resilience and somatic symptoms in depressed patients retrospectively. Methods Two hundred and fifty-four outpatients with depressive disorders participated in the study and completed self-administered questionnaires regarding demographic, clinical and psychological factors. We divided the patients into four groups based on their scores of Connor-Davidson Resilience Scale and Beck Depression Inventory. The partial correlation analysis was implemented to show the relationship between somatic symptoms and resilience after controlling for depression, and one-way analysis of variance was conducted to demonstrate the differences in somatization scores of Symptoms Checklist-90-Revised in the aforementioned four groups. Results After the correlation analysis, somatization was significantly correlated with resilience even after controlling for depressive symptoms. The one-way analysis of vairance and post-hoc analysis revealed statistically significant differences in somatization scores between the four groups, with the high Beck Depression Inventory, high Connor-Davidson Resilience Scale group having the highest somatization scores. Discussion Striving to be resilient during the peak of depression, cultural factors and positive illusions of depressed patients can result in high resilience scores and high somatization scores in depressed patients, and such clinical implications would help clinicians evaluate resilience and somatization in depressed patients with multidimensional aspects.",0,0 +7140,PTSD's underlying symptom dimensions and relations with behavioral inhibition and activation,"• We examined the relation between PTSD factors and BIS/BAS dimensions in a primary care sample. • PTSD's avoidance and dysphoria factor had a significantly greater association with BIS compared to BAS. • PTSD's re-experiencing factor related more to BIS than BAS. • PTSD's avoidance significantly mediated the relation between BIS/BAS and PTSD's dysphoria. Reinforcement sensitivity theory (RST) stipulates that individuals have a behavioral activation system (BAS) guiding approach (rewarding) behaviors ( Gray, 1971 , Gray, 1981 ), and behavioral inhibition system (BIS) guiding conflict resolution between approach and avoidance (punishment) behaviors ( Gray & McNaughton, 2000 ). Posttraumatic stress disorder (PTSD) severity overall relates to both BIS (e.g., Myers et al., 2012 , Pickett et al., 2011 ) and BAS ( Pickett et al., 2011 ). Using a more refined approach, we assessed specific relations between PTSD's latent factors ( Simms, Watson, & Doebbeling, 2002 ) and observed variables measuring BIS and BAS using 308 adult, trauma-exposed primary care patients. Confirmatory factor analysis and Wald chi-square tests demonstrated a significantly greater association with BIS severity compared to BAS severity for PTSD's dysphoria, avoidance, and re-experiencing factors. Further, PTSD's avoidance factor significantly mediated relations between BIS/BAS severity and PTSD's dysphoria factor.",0,0 +7141,Cognitive-behavioural interventions for mood and anxiety disorders in HIV: A systematic review,"Mood and anxiety disorders are highly prevalent and comorbid with HIV/AIDS. However, there is a paucity of research on the effectiveness of cognitive-behavioural interventions (CBI) for common mental disorders in HIV-infected adults. The present study sought to review the existing literature on the use of CBI for depression and anxiety in HIV-positive adults and to assess the effect size of these interventions.We did duplicate searches of databases (from inception to 17-22 May 2012). The following online databases were searched: PubMed, The Cochrane Central Register of Controlled Trials and PsychArticles.We identified 20 studies suitable for inclusion. A total of 2886 participants were enroled in these studies, of which 2173 participants completed treatment. The present review of the literature suggests that CBI may be effective in the treatment of depression and anxiety in individuals living with HIV/AIDS. Significant reductions in depression and anxiety were reported in intervention studies that directly and indirectly targeted depression and/or anxiety. Effect sizes ranged from 0.02 to 1.02 for depression and 0.04 to 0.70 for anxiety.Some trials included an immediate postintervention assessment but no follow-up assessments of outcome. This omission makes it difficult to determine whether the intervention effects are sustainable over time.The present review of the literature suggests that CBI may have a positive impact on the treatment of depression and anxiety in adults living with HIV/AIDS.",0,0 +7142,Substance use disorders among personality disordered patients admitted for day hospital treatment. Implications for service developments,"Personality disorders (PD) and substance use disorders (SUD) are highly comorbid conditions. However, their treatment services are often separated. The aims of this study was to investigate how extensive this separation was prior to a Norwegian health reform (2004) that promoted integration, and to discuss clinical challenges for an integrated treatment of PD and SUD. All patients with a diagnosis of PD (n=1783) admitted to 10 day hospital treatment programs (1993-2003) were examined. Diagnoses were assessed by Mini International Neuropsychiatric Interview and Structured Clinical Interview for DSM-IV interviews. Socio-demographic data, psychosocial functioning (Global Assessment of Functioning Scale), symptom distress (Symptom Check List-90-Revised), interpersonal problems (Circumplex of Interpersonal Problems) and treatment course were recorded. The majority of patients were females (72%) and the prevalence of SUD was low (14%). SUD occurred among all PD categories. Patients with borderline PD were over-represented and patients with cluster C disorders were under-represented in the SUD sample. The SUD sample contained more men and it was associated with more previous violence against self and others. The reported violence was partly explained by gender (males) and diagnoses (borderline and SUD). PD patients with SUD also displayed more aggression during treatment and dropped out more frequently. The findings demonstrate that the female dominated specialized psychiatric treatment services for PD to a large extent had excluded PD patients who also had SUD. The reasons are probably related to the surplus problems that characterized the SUD sample and gender issues. Implications for the development of the PD and SUD services with respect to an integrated treatment for these comorbid conditions are discussed.",0,0 +7143,Hemispheric asymmetry in non-linear interdependence of EEG in post-traumatic stress disorder,"While volumetric and metabolic imaging on post-traumatic stress disorder (PTSD) patients has been intensively performed, few studies using electroencephalograms (EEG) have been done as yet. The aim of the present study was to investigate abnormalities in functional connectivity of cortical networks in PTSD.Non-linear interdependence (NI), a measure of bidirectional, non-linear information transmission between two time series, was used. Resting EEG were recorded for 18 PTSD patients and 18 sex-matched healthy subjects on 16 channels with their eyes closed.The NI patterns in PTSD patients were hemisphere asymmetric: an increase in NI in the fronto-parieto-temporal regions of the left hemisphere (F7, F3, T3, C3, T5 and P3) and a decrease in the fronto-parieto-occipital regions of the right hemisphere (F4, C4, P4 and O2). The non-linearity of NI in EEG, estimated from the surrogate data method, exhibited an increase in the PTSD patients as compared with that of healthy subjects, particularly in the left hemispheric cortex.Abnormal functional connectivity in PTSD can be assessed using NI, a measure of multi-channel EEG.",0,0 +7144,Aripiprazole in the treatment of posttraumatic stress disorder: an open-label trial,"Post traumatic stress disorder is frequent in the general population (7.8%-lifetime-USA). The selective serotonin reuptake inhibitors are the first choice of treatment but result in low remission rates. This study aims to evaluate the effect of aripiprazole monotherapy for the treatment of post traumatic stress disorder.Thirty-two patients diagnosed with post traumatic stress disorder were included in a 16-week open label trial of aripiprazole. They were evaluated at baseline, week 8, and 16 with the Clinician-Administered PTSD Scale, Beck Depression Inventory, Beck Anxiety Inventory, Medical Outcome Study Short Form 36, and Social Adjustment Scale. Statistical analysis were performed with an intention-to-treat approach and last observation carried forward. A general linear model for repeated measures comparing the factor with 3 continuous measures from baseline, 8 and 16 weeks was used. A between-subject factor was includedNine patients discontinued the treatment. The mean aripiprazole dose was 9.6 (+/- 4.3) mg/day. The mean scores at baseline and endpoint for all measures were: Clinician-Administered PTSD Scale - 82.7 (+/- 23.1) and 51.4 (+/- 31.4) (F = 11.247, p = 0.001); Beck Anxiety Inventory - 31.7 (+/- 13.4) and 25.4 (+/- 18.2) (F = 8.931, p = 0.011); Social Adjustment Scale - 2.4 (+/- 0.45) and 2.27 (+/- 0.57) (F = 8.633, p = 0.012); Medical Outcome Study Short Form 36 - 76.6 (+/- 14.11) and 94.01 (+/- 25.06) (F = 10.127 p = 0.007); and Beck Depression Inventory - 26.06 (+/- 11.6) and 21.35 (+/- 12.6) (F = 1.580, p = 0.042). In all measurements, the differences were statistically significant.Patients achieved a good response to treatment with aripiprazole, but placebo-controlled studies are needed for more accurate results.",0,0 +7145,Posttraumatic stress disorder in older adults: an overview of characteristics and treatment approaches,"Posttraumatic stress disorder (PTSD) is a common and disabling condition following a traumatic event. Despite its high prevalence rates, relatively little is known about the manifestation and course of the disorder in older adults. Moreover, there has been little evaluation of the efficacy of psychotherapeutic treatment approaches for older patients.This overview aims to summarize available data on the prevalence and symptoms of late-life PTSD and to review the current treatment approaches for older adults.The course and severity of PTSD symptoms in older adults depend on the time the trauma occurred (early versus late life). In the case of acute traumatization, lower prevalence rates and symptom severities are generally observed in older than in younger populations. In the case of early-life traumatization, a decline in PTSD symptom severity can be observed over the life course. Research on treatment approaches has produced promising results, indicating that disorder-specific interventions (i.e., trauma confrontation and cognitive restructuring) can be effectively combined with an age-specific narrative life-review approach.Given the limited empirical evidence, caution is warranted in generalizing the reported findings. Nevertheless, it is possible to draw a number of conclusions concerning the characteristics and treatment of PTSD in older adults. Further research is needed to better understand the various presentations of PTSD in late life and to validate and improve the effectiveness of available treatment approaches.",0,0 +7146,N-glycosylation profiling of plasma provides evidence for accelerated physiological aging in post-traumatic stress disorder,"The prevalence of age-related diseases is increased in individuals with post-traumatic stress disorder (PTSD). However, the underlying biological mechanisms are still unclear. N-glycosylation is an age-dependent process, identified as a biomarker for physiological aging (GlycoAge Test). To investigate whether traumatic stress accelerates the aging process, we analyzed the N-glycosylation profile in n=13 individuals with PTSD, n=9 trauma-exposed individuals and in n=10 low-stress control subjects. Individuals with PTSD and trauma-exposed individuals presented an upward shift in the GlycoAge Test, equivalent to an advancement of the aging process by 15 additional years. Trauma-exposed individuals presented an intermediate N-glycosylation profile positioned between severely traumatized individuals with PTSD and low-stress control subjects. In conclusion, our data suggest that cumulative exposure to traumatic stressors accelerates the process of physiological aging.",0,0 +7147,Hippocampal volume in borderline personality disorder with and without comorbid posttraumatic stress disorder: A meta-analysis,"Abstract Background Several studies have found a reduction in hippocampal volume in borderline personality disorder (BPD) patients. Methods In order to investigate the degree to which comorbid posttraumatic stress disorder (PTSD) could account for reduction in hippocampal volume in these patients, we conducted a systematic review and meta-analysis of studies that compared hippocampal volume in BPD patients with and without PTSD relative to healthy controls. Results Seven articles, involving 124 patients and 147 controls, were included. We found a statistically significant reduction for the left and right hippocampus. Data from the four studies that discriminated BPD patients with and without PTSD indicate that hippocampal volumes were reduced bilaterally in BPD patients with PTSD, relative to healthy controls, but that results were mixed for BPD patients without PTSD, relative to healthy controls. Conclusions Results from this meta-analysis suggest that hippocampal volumes are reduced in patients with BPD, relative to healthy controls, but particularly in cases in which patients are diagnosed with comorbid PTSD.",0,0 +7148,Two Sides of the Same Coin: Cannabis Dependence and Mental Health Problems in Help-Seeking Adolescent and Young Adult Outpatients,"The aim of the current study was to delineate the psychiatric profile of cannabis dependent young people (14-29 years old) with mental health problems (N = 36) seeking treatment via a research study. To do so, the Structured Clinical Interview for DSM-IV-TR Axis I Disorders and the Structured Clinical Interview for DSM-IV Childhood Diagnoses were used to obtain DSM-IV diagnoses, while a modified Timeline Followback interview and self-reports were used to measure cannabis use, cannabis-related problems, and impairment. Most individuals had at least two Axis I disorders in addition to cannabis dependence. Anxiety disorders were common, with posttraumatic stress disorder, social phobia, and generalised anxiety disorder accounting for the majority of these diagnoses. On average, young people reported a moderate degree of dependence and functional impairment, and a substantial number of cannabis-related problems. Although both males and females reported using similar quantities of cannabis per month, females reported using cannabis more frequently than males. The current data suggest that young people who present for cannabis use treatment in the context of a mental health issue may have a variety of psychiatric problems that need addressed and that males and females may have slightly different profiles. If cannabis use treatments are to advance for this population, more attention needs to be paid to the complex issues that young people present to treatment with.",0,0 +7149,"Affective forecasts and the Valentine's Day shootings at NIU: People are resilient, but unaware of it","People overestimate the extent to which emotion-producing life events affect subsequent affect. However, research has yet to conclusively demonstrate that this phenomenon occurs following significant trauma affecting entire communities, or whether it applies to predictions of discrete emotions. Exploring such issues, student reports of emotion states were collected both before and after the oncampus Valentine's Day, 2008 shootings at Northern Illinois University (NIU). A separate group of students not on campus when the shootings occurred provided emotion state reports and predictions of the emotions they would expect to experience 2 weeks after a shooting occurred. Examination of these data suggests that: (1) emotion states of NIU students reflected resilience, and (2) students made affective forecasting errors indicating that this resilience was unexpected. These data confirm results of prior affective forecasting studies, extending them to cases of traumatic experiences, and suggest that such studies c...",0,0 +7150,Impact of Chronic Critical Illness on the Psychological Outcomes of Family Members,"The uncertain trajectory of chronic critical illness exposes the patient's family to heightened levels of psychological distress. Symptoms of psychological distress affect more than half of family members exposed to the patient's chronic critical illness. Although symptoms often dissipate over time, a significant proportion of family members will remain at moderate to high risk for psychological distress well after the patient's death or discharge from the intensive care unit. Family members of chronically critically ill patients are often involved in the decision making for the patients. Irrational or uninformed decision making can occur when family members experience high levels of psychological distress. Attention to the psychological needs and provision of support to family members enhance the formulation of treatment decisions consistent with the patient's preferences and mitigate unnecessary resource use. In this article, the impact of chronic critical illness on family members' risk for depression, anxiety, and posttraumatic stress disorder is described and a review of evidence-based strategies to support the psychological needs of family members coping with a patient's chronic critical illness is provided.",0,0 +7151,Characterizing the resilient officer: Individual attributes at point of entry to policing.,"Research investigating the process of adaptation in newly recruited police officers is scarce and has yielded mixed results. Some research highlights the incidence of difficulty in adjusting to the role of police officer such as predictors of elevated stress and symptoms of posttraumatic stress disorder (PTSD). Others have investigated why the majority of officers are resilient to the work and organizational challenges presented. This article examines personality, prior experience, and coping strategies of 94 newly recruited Australian police officers. The data provide a picture of police personnel who are not selected with personality profiling. Results demonstrated that the officers' personality profiles, as measured by the NEO Five-Factor Inventory, were consistent with U.S. adult norms, except for elevated levels of extraversion. Common coping strategies include positive reinterpretation, acceptance, and planning. Measures of PTSD and positive posttrauma changes were higher in recruits who had endured...",0,0 +7152,Prevention of Trauma and Stressor-Related Disorders: A Review,"Posttraumatic stress disorder (PTSD) is a common, frequently chronic, and disabling condition which, along with acute stress disorder (ASD), is categorized as a trauma- and stressor-related disorder by the DSM-5. These disorders are unique in requiring exposure to a severe stressor, which implies that potential sufferers could be identified and helped before developing a disorder. Research on prevention strategies for stress-related disorders has taken a number of avenues, including intervention before and after trauma and the use of both psychosocial and somatic approaches. Despite advances in neurobiological understanding of response to trauma, clinical evidence for preventive interventions remains sparse. This review provides an overview of prevention approaches and summarizes the existing literature on prevention of ASD and PTSD, including clinical and preclinical studies. Given the potential benefits to trauma survivors and society, the development of effective preventive interventions should be given greater priority. Resources should be directed to adequately test promising interventions in clinical trials, and research should be conducted according to translational research principles in which preclinical research informs the design of clinical studies.",0,0 +7153,Mixture or Homogeneous? Comment on Bauer and Curran (2003).,"D. J. Bauer and P. J. Curran (2003) raised some interesting issues with respect to mixture models of growth curves. Many useful lessons can be learned from their work, and more can be learned by extending the inquiry in related directions. These lessons involve the following issues: (a) what a mixture distribution looks like, (b) the meaning of the term homogeneous distribution, (c) the importance of model checking, (d) advantages and disadvantages of using mixtures and similar procedures to approximate complicated distributions, and (e) intrinsic versus nonintrinsic transformability.",0,0 +7154,Psychosocial Implications During Adolescence for Infant Heart Transplant Recipients,"As more heart transplant recipients survive into late adolescence, research addressing long-term psychosocial and neurodevelopmental outcomes is imperative. The limited literature available suggests risk for psychosocial difficulties and lower cognitive, academic, and neuropsychological functioning. This paper reviews topic-related literature and provides preliminary data examining psychosocial and neuropsychological functioning of adolescents who received their heart transplant during infancy.This paper offers a literature review AND presents preliminary data from studies conducted through Loma Linda University Children's Hospital (LLUCH). Study one examined psychosocial functioning and quality of life of adolescent infant heart transplant recipients. In study two, cognitive, academic, and neuropsychological data were analyzed.Study 1: Overall psychosocial functioning fell in the Average range, however, a significant percentage of participants presented with difficulties on one or more of the psychosocial domains. Quality of life was also within normal limits, though concerns with general health and bodily discomfort were noted. Study 2: Cognitive functioning was assessed to be Below Average, with 43-62% of the participants demonstrating significant impairments. Neuropsychological functioning yielded significant weakness on language functioning, and mild weakness on visual-motor integration and executive functioning.While the majority of the participants demonstrate psychosocial resiliency, a subgroup present with difficulties suggesting the need for intervention. Cognitive/neuropsychological functioning suggests poorer functioning with patterns similar to other high-risk pediatric populations. These results are preliminary and further research on long-term psychosocial and neuropsychological development of pediatric heart transplant recipients is needed to better understand and ameliorate developmental trajectories.",0,0 +7155,Posttraumatic stress disorder symptom severity and HIV-risk behaviors among substance-dependent inpatients,"Despite findings that the co-occurrence of posttraumatic stress disorder (PTSD) and substance use disorders (SUD) is associated with heightened risk for a variety of risky behaviors, few studies have examined behaviors linked to heightened risk for HIV infection and transmission in particular, or explored the unique associations between specific PTSD symptom clusters and these HIV-risk behaviors. Therefore, the goal of this study was to examine the associations between PTSD symptom severity and HIV-risk behaviors (i.e., risky sexual behavior [RSB] and injection drug use [INJ]) within an ethnically diverse sample of 85 SUD patients in residential SUD treatment. Participants completed a battery of questionnaires assessing PTSD symptom severity and HIV-risk behaviors, including RSB and INJ. Results demonstrated significant positive associations between PTSD symptom severity and RSB; however, no significant relationship between PTSD symptom severity and INJ was found. Furthermore, the severity of hyperarousal symptoms in particular was found to significantly predict RSB above and beyond age and all other PTSD symptom clusters. Results of this study suggest that PTSD symptoms (and, more specifically, the hyperarousal symptoms of PTSD) may heighten the risk for some forms of HIV-risk behaviors (RSB) but not others (INJ). Results highlight the importance of identifying and targeting hyperarousal symptoms in the treatment of SUD patients experiencing symptoms of PTSD in order to reduce HIV infection or transmission risk.",0,0 +7156,"Trauma Type and Gender Effects on PTSD, General Distress, and Peritraumatic Dissociation","This study examined the independent and interaction effects of trauma type and gender on posttraumatic stress disorder (PTSD), general psychopathology, and peritraumatic dissociation. We assessed 1,503 college students (58.3% female) who experienced a natural disaster, loss of a loved one, or interpersonal violence. Interpersonal violence survivors, those with multiple trauma histories, and women reported more PTSD symptoms, general psychopathology, and peritraumatic dissociation than other trauma group survivors, single trauma group survivors, and men. A trauma type by gender interaction was identified for peritraumatic dissociation. The results are discussed within the context of clinical practice and assessment.",0,0 +7157,Impaired Response Inhibition in Veterans with Post-Traumatic Stress Disorder and Mild Traumatic Brain Injury,"Abstract Combat veterans with post-traumatic stress disorder (PTSD) can show impairments in executive control and increases in impulsivity. The current study examined the effects of PTSD on motor response inhibition, a key cognitive control function. A Go/NoGo task was administered to veterans with a diagnosis of PTSD based on semi-structured clinical interview using DSM-IV criteria ( n = 40) and age-matched control veterans ( n = 33). Participants also completed questionnaires to assess self-reported levels of PTSD and depressive symptoms. Performance measures from the patients (error rates and reaction times) were compared to those from controls. PTSD patients showed a significant deficit in response inhibition, committing more errors on NoGo trials than controls. Higher levels of PTSD and depressive symptoms were associated with higher error rates. Of the three symptom clusters, re-experiencing was the strongest predictor of performance. Because the co-morbidity of mild traumatic brain injury (mTBI) and PTSD was high in this population, secondary analyses compared veterans with PTSD+mTBI ( n = 30) to veterans with PTSD only ( n = 10). Although preliminary, results indicated the two patient groups did not differ on any measure ( p > .88). Since cognitive impairments could hinder the effectiveness of standard PTSD therapies, incorporating treatments that strengthen executive functions might be considered in the future. ( JINS , 2012, 18 , 1–10)",0,0 +7158,Predicting post‐traumatic growth and post‐traumatic stress in firefighters,"Emergency service workers (e.g., firefighters, police, and paramedics) are exposed to elevated levels of potentially traumatising events through the course of their work. Such exposure can have lasting negative consequences (e.g., post‐traumatic stress disorder (PTSD)) and/or positive outcomes (e.g., post‐traumatic growth (PTG)). Research had implicated trauma, occupational and personal variables that account for variance in post‐trauma outcomes yet at this stage no research has investigated these factors and their relative influence on both PTSD and PTG in a single study. Based in Calhoun and Tedeschi's model of PTG and previous research, in this study regression models of PTG and PTSD symptoms among 218 firefighters were tested. Results indicated organisational factors predicted symptoms of PTSD, while there was partial support for the hypothesis that coping and social support would be predictors of PTG. Experiencing multiple sources of trauma, higher levels of organisational and operational stress, and utilising cognitive reappraisal coping were all significant predictors of PTSD symptoms. Increases in PTG were predicted by experiencing trauma from multiple sources and the use of self‐care coping. Results highlight the importance of organisational factors in the development of PTSD symptoms, and of individual factors for promoting PTG.",0,0 +7159,Mechanisms of change in cognitive behavioral therapy for panic disorder: The unique effects of self-efficacy and anxiety sensitivity,"The present study examined temporal dependencies of change of panic symptoms and two promising mechanisms of change (self-efficacy and anxiety sensitivity) during an 11-session course of cognitive-behavior therapy (CBT) for Panic Disorder (PD). 361 individuals with a principal diagnosis of PD completed measures of self-efficacy, anxiety sensitivity, and PD symptoms at each session during treatment. Effect size analyses indicated that the greatest changes in anxiety sensitivity occurred early in treatment, whereas the greatest changes in self-efficacy occurred later in treatment. Results of parallel process latent growth curve models indicated that changes in self-efficacy and anxiety sensitivity across treatment uniquely predicted changes in PD symptoms. Bivariate and multivariate latent difference score models indicated, as expected, that changes in anxiety sensitivity and self-efficacy temporally preceded changes in panic symptoms, and that intraindividual changes in anxiety sensitivity and self-efficacy independently predicted subsequent intraindividual changes in panic symptoms. These results provide strong evidence that changes in self-efficacy and anxiety sensitivity during CBT influence subsequent changes in panic symptoms, and that self-efficacy and anxiety sensitivity may therefore be two distinct mechanisms of change of CBT for PD that have their greatest impact at different stages of treatment.",0,0 +7160,Examining a Comprehensive Model of Disaster-Related Posttraumatic Stress Disorder in Systematically Studied Survivors of 10 Disasters,"Objectives. Using a comprehensive disaster model, we examined predictors of posttraumatic stress disorder (PTSD) in combined data from 10 different disasters. Methods. The combined sample included data from 811 directly exposed survivors of 10 disasters between 1987 and 1995. We used consistent methods across all 10 disaster samples, including full diagnostic assessment. Results. In multivariate analyses, predictors of PTSD were female gender, younger age, Hispanic ethnicity, less education, ever-married status, predisaster psychopathology, disaster injury, and witnessing injury or death; exposure through death or injury to friends or family members and witnessing the disaster aftermath did not confer additional PTSD risk. Intentionally caused disasters associated with PTSD in bivariate analysis did not independently predict PTSD in multivariate analysis. Avoidance and numbing symptoms represented a PTSD marker. Conclusions. Despite confirming some previous research findings, we found no associations between PTSD and disaster typology. Prospective research is needed to determine whether early avoidance and numbing symptoms identify individuals likely to develop PTSD later. Our findings may help identify at-risk populations for treatment research.",0,0 +7161,What we don't expect when expecting: Evidence for heterogeneity in subjective well-being in response to parenthood.,"A recent article in New York Magazine echoed what psychological studies of parenthood have consistently demonstrated since the 1970s: ""Most people assume that having children will make them happier. Yet a wide variety of academic research shows that parents are not happier than their childless peers, and in many cases are less so"" (Senior, 2010). There is consistent evidence that, as opposed to other life events that cause transient disruptions in life satisfaction, becoming a parent appears to cause harm to individual subjective well-being (Twenge, Campbell, & Foster, 2003), and that this harm is sustained over time (Clark, Diener, Georgellis, & Lucas, 2008). The current investigation was predicated on the concern that these findings may be the result of the methodology used to examine them. As the experience of parenthood does not represent a unified phenomenon, we employed a methodological approach that allows for the exploration of heterogeneity as well as its predictors. By modeling heterogeneous trajectories within a prospective design from 4 years prior to 4 years after the birth of a parent's first child, we find that the majority of individuals (84.2%) demonstrate no long-term effects on life satisfaction in response to childbirth. Only a small percentage demonstrate the sustained declines (7.2%), and a significant cohort, previously unobserved in the literature, demonstrate dramatic and sustained improvements in response to parenthood (4.3%), providing compelling evidence for heterogeneity in life satisfaction among parents. Key demographic covariates that distinguish between trajectories of response are also explored.",0,0 +7162,An Office Mental Status Examination for Complex Chronic Dissociative Symptoms and Multiple Personality Disorder,"Chronic complex dissociative symptoms can be readily inquired about in the diagnostic interview leading to a clinical diagnosis of MPD in many cases. It is most useful to begin with inquiry about amnesia, autohypnotic, posttraumatic, pseudopsychotic, and passive-influence symptoms, and childhood abuse or traumatization. As this proceeds, overt dissociation is commonly noted including spontaneous trances, age-regression, blending or overlap of states, or frank switching. When this occurs, the interviewer can pursue more detailed information about the patient's experiences. Tracking these processes may readily lead to the clear appearance of an alter personality or will help make the patient sufficiently comfortable that he or she will allow the full emergence of an alter if this is directly requested. In other cases, however, methods such as use of ideomotor signals, formal induction of trance, and even barbiturate-facilitated interviews may be necessary to permit the full emergence of an alter. The symptom-cluster method is a useful clinical diagnostic tool to elicit dissociative symptoms for the diagnosis of MPD. Combined with diagnostic tools such as the DES, the DDIS, and the SCID-D, this method can help the clinician make the diagnosis of MPD in a far more expeditious and rigorous fashion. In addition, all psychiatric patients should be screened for a history of blackouts, time loss, trance experiences, childhood trauma, and PTSD symptoms. This will improve case finding to help clinicians begin to treat the single largest preventable cause of mental illness: the sequelae of childhood abuse, trauma, and family violence.",0,0 +7163,Prediction of PTSD in Police Officers after Six Months – a Prospective Study,"The aim of this prospective study was to explore the predictors for the development of PTSD in police officers six months after encountering situations of a potentially traumatic nature. Fifty-nine police officers were studied immediately after the event (T1) and six months later (T2). At T2 PTSD was assessed using the Structured Clinical Interview for DSM-IV (SCID-I). PTSD was predicted by intrusions (Impact of Event Scale–Revised; IES-R), the impairment scale (is), global assessment of functioning scale (GAF), gender, age and sense of coherence scale (SOC). The diagnosis of an acute stress disorder (ASD) at T1 had a high specificity for identifying PTSD at T2. The strongest predictor for the development of PTSD was found to be the factor intrusions. Contrary to our expectations, age was not a significant predictive factor for PTSD. Thus, acute stress disorder (ASD) and a high degree of intrusions experienced immediately after a traumatic incident helped to identify early police officers at risk of developing chronic PTSD.",0,0 +7164,Long-Term Trajectories of PTSD in Vietnam-Era Veterans: The Course and Consequences of PTSD in Twins,"We estimated the temporal course of posttraumatic stress disorder (PTSD) in Vietnam-era veterans using a national sample of male twins with a 20-year follow-up. The complete sample included those twins with a PTSD diagnostic assessment in 1992 and who completed a DSM-IV PTSD diagnostic assessment and a self-report PTSD checklist in 2012 (n = 4,138). Using PTSD diagnostic data, we classified veterans into 5 mutually exclusive groups, including those who never had PTSD, and 4 PTSD trajectory groups: (a) early recovery, (b) late recovery, (c) late onset, and (d) chronic. The majority of veterans remained unaffected by PTSD throughout their lives (79.05% of those with theater service, 90.85% of those with nontheater service); however, an important minority (10.50% of theater veterans, 4.45% of nontheater veterans) in 2012 had current PTSD that was either late onset (6.55% theater, 3.29% nontheater) or chronic (3.95% theater, 1.16% nontheater). The distribution of trajectories was significantly different by theater service (p < .001). PTSD remains a prominent issue for many Vietnam-era veterans, especially for those who served in Vietnam.",0,0 +7165,Brief report: The relationship between post‐traumatic stress disorder symptoms and overgeneral autobiographical memory in older adults,The aim of this study was to investigate the relationship between post‐traumatic stress disorder (PTSD) symptoms and autobiographical memory specificity in older adults.Older adult trauma survivors...,0,0 +7166,Effects of Heat Stress and Sex on Pacing in Marathon Runners,"Recent research suggests that women tend to exhibit less of a precipitous decline in run velocity during the latter stages of a marathon than men when the covariates of age and run time are controlled for. The purpose of this study was to examine this sex effect with the added covariate of heat stress on pacing, defined as the mean velocity of the last 12.2 km divided by the mean velocity of the first 30 km. A secondary purpose of this investigation was to compare the pacing profiles of the elite men and women runners and the pacing profiles of the elite and nonelite runners. Subjects included 22,990 men and 13,233 women runners from the 2007 and 2009 Chicago marathons for which the mean ambient temperatures were 26.67° C and 2.77° C, respectively. Each 5-km split time was measured via an electronic chip worn on the participants' shoe. Multiple regression analysis indicated that age, sex, heat stress, and overall finish time (p < 0.01 for each) were simultaneous independent elements of pacing. Nonelite women were consistently better pacers than nonelite men in both marathons, and this sex difference was magnified from cold to warm race temperatures. No difference (p < 0.05) in pacing was found between elite men and women runners. Elite men and women had enhanced pacing over their nonelite counterparts. In hotter temperatures, coaches of novice runners should advise their athletes to implement a slower initial velocity to maintain or increase running velocity later in the race.",0,0 +7167,The relationship of peritraumatic dissociation and posttraumatic stress: Findings in female Vietnam theater veterans.,,0,0 +7168,"The Prevalence of Trauma and Childhood Adversity in an Urban, Hospital-Based Violence Intervention Program","Hospitals represent a promising locus for preventing recurrent interpersonal violence and its psychological sequella. We conducted a cross-sectional analysis to assess the prevalence of post-traumatic stress disorder (PTSD) and adverse childhood experiences (ACEs) among victims of interpersonal violence participating in a hospital-based violence intervention program. Participants completed PTSD and ACE screenings four to six weeks after violent injury, and data were exported from a case management database for analysis. Of the 35 program participants who completed the ACE and/or PTSD screenings, 75.0% met full diagnostic criteria for PTSD, with a larger proportion meeting diagnostic criteria for symptom-specific clusters. For the ACE screening, 56.3% reported three or more ACEs, 34.5% reported five or more ACEs, and 18.8% reported seven or more ACEs. The median ACE score was 3.5. These findings underscore the importance of trauma-informed approaches to violence prevention in urban hospitals and have implications for emergency medicine research and policy.",0,0 +7169,Dysfunctional meaning of posttraumatic intrusions in chronic PTSD,"The paper suggests that the negative idiosyncratic meaning of posttraumatic intrusions (e.g., 'I am going crazy') and cognitive strategies intended to control the intrusions play a major role in maintaining posttraumatic stress disorder. Two studies of 159 and 138 motor vehicle accidents survivors showed that the dysfunctional meaning of intrusions explained a proportion of the variance of the intrusion-related distress, strategies used to end the intrusions, and PTSD severity that was not explained by intrusion frequency, accident severity, or by general catastrophic thoughts when anxious. Rumination, thought suppression, and distraction when having intrusions showed substantial correlations with PTSD severity, as did avoidance of reminders of the accident. The results have implications for the treatment of chronic PTSD.",0,0 +7170,Mechanisms of Change in Written Exposure Treatment of Posttraumatic Stress Disorder,"Although the effectiveness of exposure therapy for PTSD is recognized, treatment mechanisms are not well understood. Emotional processing theory (EPT) posits that fear reduction within and between sessions creates new learning, but evidence is limited by self-report assessments and inclusion of treatment components other than exposure. We examined trajectories of physiological arousal and their relation to PTSD treatment outcome in a randomized controlled trial of written exposure treatment, a protocol focused on exposure to trauma memories. Hierarchical linear modeling was used to model reduction in Clinician Administered PTSD Scale score as a predictor of initial activation and within- and between-session change in physiological arousal. Treatment gains were significantly associated with initial physiological activation, but not with within- or between-session changes in physiological arousal. Treatment gains were associated with larger between-session reductions in self-reported arousal. These findings highlight the importance of multimethod arousal assessment and add to a growing literature suggesting refinements of EPT.",0,0 diff --git a/examples/prior_example/generated_data/dataset_without_priors.csv b/examples/prior_example/generated_data/dataset_without_priors.csv new file mode 100644 index 0000000..0993061 --- /dev/null +++ b/examples/prior_example/generated_data/dataset_without_priors.csv @@ -0,0 +1,4545 @@ +record_id,title,abstract,label,makita_priors +2627,Annual Research Review: Resilience and mental health in children and adolescents living in areas of armed conflict - a systematic review of findings in low- and middle-income countries,"Researchers focused on mental health of conflict-affected children are increasingly interested in the concept of resilience. Knowledge on resilience may assist in developing interventions aimed at improving positive outcomes or reducing negative outcomes, termed promotive or protective interventions.We performed a systematic review of peer-reviewed qualitative and quantitative studies focused on resilience and mental health in children and adolescents affected by armed conflict in low- and middle-income countries.Altogether 53 studies were identified: 15 qualitative and mixed methods studies and 38 quantitative, mostly cross-sectional studies focused on school-aged children and adolescents. Qualitative studies identified variation across socio-cultural settings of relevant resilience outcomes, and report contextually unique processes contributing to such outcomes. Quantitative studies focused on promotive and protective factors at different socio-ecological levels (individual, family-, peer-, school-, and community-levels). Generally, promotive and protective factors showed gender-, symptom-, and phase of conflict-specific effects on mental health outcomes.Although limited by its predominantly cross-sectional nature and focus on protective outcomes, this body of knowledge supports a perspective of resilience as a complex dynamic process driven by time- and context-dependent variables, rather than the balance between risk- and protective factors with known impacts on mental health. Given the complexity of findings in this population, we conclude that resilience-focused interventions will need to be highly tailored to specific contexts, rather than the application of a universal model that may be expected to have similar effects on mental health across contexts.",0,0 +2628,Profiling the Trauma Related Symptoms of Bosnian Refugees Who Have not Sought Mental Health Services,"The objective of this study was to profile trauma related psychiatric symptoms in a group of refugees not seeking mental health services and to consider the services implications. The study involved research assessments of two groups of Bosnian refugees: those who have not presented for mental health services and those who have. A total of 28 of 41 nonpresenters (70%) met symptom criteria for posttraumatic stress disorder (PTSD) diagnosis. All service presenters (N = 29) met symptom criteria for PTSD diagnosis. The group that did not present for services reported substantial but lower trauma exposure, PTSD symptom severity, and depression symptom severity. They had significant differences on all subscales of the MOS SF-36, indicating better health status. We concluded that those who do not seek services have substantial symptom levels, but their self-concept appears to be less oriented toward illness and help seeking. Innovative access, engagement, and preventive interventions are needed to address those who have symptoms but do not readily seek help for trauma mental health services.",0,0 +2629,"Acute panicogenic, anxiogenic and dissociative effects of carbon dioxide inhalation in patients with post-traumatic stress disorder (PTSD)","Increased anxiety and panic to inhalation of carbon dioxide (CO(2)) has been described in patients with anxiety disorders, especially panic disorder, compared to healthy subjects. Post-traumatic stress disorder (PTSD) has been hypothesised to resemble panic disorder and is currently classified as an anxiety disorder in DSM-IV. However, there are only very few data available about the sensitivity of patients with PTSD to CO(2).In 10 patients with PTSD, 10 sex- and age-matched healthy subjects and 8 patients with panic disorder we assessed anxiety, panic, dissociative and PTSD symptoms before and after a single vital capacity inhalation of 35% CO(2).Patients with PTSD showed an increased anxiety, panic and dissociative reaction to the inhalation of 35% CO(2) compared to healthy participants. PTSD subjects' responses were indistinguishable from those of panic patients. Additionally, PTSD-typical symptoms like post-traumatic flashbacks were provoked in patients with PTSD after the inhalation of CO(2).In our sample, PTSD was associated with an increased CO(2) reactivity, pointing to an increased susceptibility of PTSD patients to CO(2) challenge.",0,0 +2630,A Pooled Analysis of Gender and Trauma-Type Effects on Responsiveness to Treatment of PTSD With Venlafaxine Extended Release or Placebo,"To examine effects of gender and trauma type on response to treatment with venlafaxine extended release (ER) or placebo in patients with posttraumatic stress disorder (PTSD).Data were pooled from 2 flexible-dose, parallel-group, randomized, double-blind, placebo-controlled trials: a 12-week trial conducted in the United States (March 2001 to December 2002) and a 24-week trial conducted in 12 countries outside the United States (October 2001 to December 2003). Six hundred eighty-seven outpatients with DSM-IV-diagnosed PTSD and a 17-item Clinician-Administered PTSD Scale abbreviated 1-week Symptom Status version (CAPS-SX-17) score > or = 60 were randomly assigned to treatment with venlafaxine ER (37.5 mg/day-300 mg/day, N = 340) or placebo (N = 347). The primary efficacy end point was the CAPS-SX-17 total score at week 12. Secondary end points included CAPS-SX-17 cluster scores for reexperiencing, avoidance/numbing, and hyperarousal and scores on the Connor-Davidson Resilience Scale (CD-RISC), Clinical Global Impressions-Severity of Illness scale, Sheehan Disability Scale (SDS), and 17-item Hamilton Rating Scale for Depression (HAM-D-17). Analysis-of-covariance models were used to test for differences by gender and trauma type (accidental injury, combat, nonsexual abuse, adult sexual abuse, childhood sexual abuse, unexpected death, and other), treatment (venlafaxine ER vs. placebo), and the treatment-by-trauma-type interaction.Using last-observation-carried-forward analysis, significant effects of treatment with venlafaxine ER were found on the CAPS-SX-17 total score and on all CAPS-SX-17 cluster scores and most other secondary measures. No significant treatment-by-gender interactions were observed. Trauma type significantly affected treatment responsiveness on symptom-related disability (SDS, p = .0057) and resilience (CD-RISC, p = .0012), with a nearly significant effect on depression (HAM-D-17, p = .0625).Overall, there does not appear to be a significant effect of gender on the efficacy of venlafaxine ER in the treatment of PTSD. Trauma type may affect treatment outcome but seems to affect domains such as disability and resilience more than core PTSD symptoms.",0,0 +2631,Twelve-Month Use of Mental Health Services in the United States,"Dramatic changes have occurred in mental health treatments during the past decade. Data on recent treatment patterns are needed to estimate the unmet need for services.To provide data on patterns and predictors of 12-month mental health treatment in the United States from the recently completed National Comorbidity Survey Replication.Nationally representative face-to-face household survey using a fully structured diagnostic interview, the World Health Organization's World Mental Health Survey Initiative version of the Composite International Diagnostic Interview, carried out between February 5, 2001, and April 7, 2003.A total of 9282 English-speaking respondents 18 years and older.Proportions of respondents with 12-month DSM-IV anxiety, mood, impulse control, and substance disorders who received treatment in the 12 months before the interview in any of 4 service sectors (specialty mental health, general medical, human services, and complementary and alternative medicine). Number of visits and proportion of patients who received minimally adequate treatment were also assessed.Of 12-month cases, 41.1% received some treatment in the past 12 months, including 12.3% treated by a psychiatrist, 16.0% treated by a non-psychiatrist mental health specialist, 22.8% treated by a general medical provider, 8.1% treated by a human services provider, and 6.8% treated by a complementary and alternative medical provider (treatment could be received by >1 source). Overall, cases treated in the mental health specialty sector received more visits (median, 7.4) than those treated in the general medical sector (median, 1.7). More patients in specialty than general medical treatment also received treatment that exceeded a minimal threshold of adequacy (48.3% vs 12.7%). Unmet need for treatment is greatest in traditionally underserved groups, including elderly persons, racial-ethnic minorities, those with low incomes, those without insurance, and residents of rural areas.Most people with mental disorders in the United States remain either untreated or poorly treated. Interventions are needed to enhance treatment initiation and quality.",0,0 +2632,Rats exposed to traumatic stress bury unfamiliar objects — A novel measure of hyper-vigilance in PTSD models?,"Electric shocks lead to lasting behavioral deficits in rodents, and as such are often used to model post-traumatic stress disorder (PTSD) in the laboratory. Here we show that a single exposure of rats to 3 mA-strong shocks results in a marked social avoidance that lasts at least 28 days; moreover, the response intensifies over time. In an attempt to study the impact of cue reminders on the behavior of shocked rats, we administered shocks in the presence of a highly conspicuous, 10 cm-large object. This object was introduced into the home cage of rats 28 days after shock exposure. Shocked rats manipulated the object considerably less than controls. More importantly, however, the object was buried by shocked rats. This behavior was virtually absent in controls. The response strongly depended on the intensity of shocks, and was robust. Rats shocked with 3 mA currents spent 40% of time burying the object, which was often hardly visible at the end of the 5 min test. Subsequent experiments demonstrated that the response was not cue-specific as unfamiliar objects were also buried. Rats are well known to bury dangerous objects; the shock-prod burying test of anxiety is based on this response. Behavioral similarities with this test and the differences from the marble-burying behavior of mice suggest that traumatized rats bury unfamiliar objects in defense, and the response can be interpreted as a sign of hyper-vigilance. We further suggest that object burying can be used as a sign of hyper-vigilance in models of PTSD.",0,0 +2633,Trigeminal Nerve Stimulation for Comorbid Posttraumatic Stress Disorder and Major Depressive Disorder,"External stimulation of the trigeminal nerve (eTNS) is an emerging neuromodulation therapy for epilepsy and depression. Preliminary studies suggest it has an excellent safety profile and is associated with significant improvements in seizures and mood. Neuroanatomical projections of the trigeminal system suggest eTNS may alter activity in structures regulating mood, anxiety, and sleep. In this proof-of-concept trial, the effects of eTNS were evaluated in adults with posttraumatic stress disorder (PTSD) and comorbid unipolar major depressive disorder (MDD) as an adjunct to pharmacotherapy for these commonly co-occurring conditions.Twelve adults with PTSD and MDD were studied in an eight-week open outpatient trial (age 52.8 [13.7 sd], 8F:4M). Stimulation was applied to the supraorbital and supratrochlear nerves for eight hours each night as an adjunct to pharmacotherapy. Changes in symptoms were monitored using the PTSD Patient Checklist (PCL), Hamilton Depression Rating Scale (HDRS-17), Quick Inventory of Depressive Symptomatology (QIDS-C), and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q).Over the eight weeks, eTNS treatment was associated with significant decreases in PCL (p = 0.003; median decrease of 15 points; effect size d 1.5), HDRS-17 (p < 0.001; 42% response rate, 25% remission; d 2.1), and QIDS-C scores (p < 0.001; d 1.8), as well as an improvement in quality of life (Q-LES-Q, p < 0.01). eTNS was well tolerated with few treatment emergent adverse events.Significant improvements in PTSD and depression severity were achieved in the eight weeks of acute eTNS treatment. This novel approach to wearable brain stimulation may have use as an adjunct to pharmacotherapy in these disorders if efficacy and tolerability are confirmed with additional studies.",0,0 +2634,Military Resilience: A Concept Analysis,"Since the events surrounding September 11, 2011, and natural disasters, research on resilience has shifted from children to adult resilience. The military began to embrace the concept in 2008 in an effort to decrease the number of military service member (SM) suicides.The purpose of this article is to explain resilience as it relates to military SMs using the process for concept analysis outlined by Walker and Avant (2005).Adaptive coping, personal control, hardiness, and social support are the attributes that characterize psychological resilience in SMs. Antecedents for resilience are life events such as serious accidents, prior deployments where death is witnessed, and combat involvement. Consequences of high resilience include decreased mental health symptoms and career and personal success, while consequences of low resilience include increased mental health symptoms and participating in high-risk behaviors.Understanding resilience as it relates to SMs is critical. Nurses must be able to assess SMs and be equipped to refer them or their family members to the most appropriate care. As more is learned about resilience in the military community, there may be broader implications to the civilian community. Improved understanding of psychological resilience may lead to improved interventions appropriate for both civilians and military SMs.",0,0 +2635,Looking like the enemy: An interpretative phenomenological analysis of how race-related stressors in the military contribute to post traumatic stress disorder in Asian American and Pacific Islander Vietnam veterans,"Although significant evidence exists in the current literature about both the impact of race-related stressors on racial minority groups as well as the psychological impact of military-related stressors, there is very little research demonstrating the complexities of what a soldier may experience when a war is fought in a country where she/he resembles the enemy. This study explores how race-related stressors experienced in the military by Vietnam War veterans of Asian American and Pacific Islander (AAPI) ancestry contributed to the severity of post-traumatic stress disorder (PTSD) and other trauma-related psychiatric disorders. This topic has been explored by researchers out of the VA Pacific Islands Health Care System, National Center for PTSD in 1994 and their findings suggest that race-related stressors is a significant predictor of PTSD symptoms for Vietnam veterans of AAPI ancestry. Almost two decades since that study was conducted, this dissertation will examine, through the use of focus groups, if certain phenomenological themes have remained constant over time and also if new ones emerge. The generated hypothesis is that there will be phenomenological themes that abide over time related to the extended biopsychosocial effects of race-related stressors, particularly in the context of war. The second hypothesis posits that new themes will also surface as a result of the different political, social, and cultural climate these veterans currently reside in nearly two decades later. Clinical implications and suggestions for future research are also explored. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0,0 +2636,The North Sea Oil Rig Disaster,"Located halfway between the United Kingdom and Norway, the Ekofisk is the most highly developed of the oil fields of the North Sea. Approximately two dozen permanent and a few floating rigs are in operation there; some of them are interconnected by bridges. From the Ekofisk pipelines, crude oil is channeled to Teesside in England and gas to Emden in western Germany. The basic function of the Ekofisk fields is the supply of energy, made possible by the gigantic achievements of modern technology. Considerable attention has been given to safety issues, yet accidents and disasters have occurred.",0,0 +2637,The Use of Latent Trajectory Models in Psychopathology Research.,"Despite the recent surge in the development of powerful modeling strategies to test questions about individual differences in stability and change over time, these methods are not currently widely used in psychopathology research. In an attempt to further the dissemination of these new methods, the authors present a pedagogical introduction to the structural equation modeling based latent trajectory model, or LTM. They review several different types of LTMs, discuss matching an optimal LTM to a given question of interest, and highlight several issues that might be particularly salient for research in psychopathology. The authors augment each section with a review of published applications of these methods in psychopathology-related research to demonstrate the implementation and interpretation of LTMs in practice.",0,0 +2638,Anxiety sensitivity and post-traumatic stress reactions: Evidence for intrusions and physiological arousal as mediating and moderating mechanisms,"A growing body of research has implicated anxiety sensitivity (AS) and its dimensions in the development of post-traumatic stress disorder (PTSD). However, the mechanism(s) that may account for the association between AS and PTSD remains unclear. Using the ""trauma film paradigm,"" which provides a prospective experimental tool for investigating analog intrusion development, the present study examines the extent to which intrusions mediate the association between AS and the development of posttraumatic stress reactions. After completing a measure of AS and state mood, unselected participants (n = 45) viewed a 10 min film of graphic scenes of fatal traffic accidents and then completed a second assessment of state mood. Participants then kept a daily diary to record intrusions about the film for a one-week period. Post-traumatic stress reactions about the film were then assessed after the one-week period. The results showed that general AS and physical and cognitive concerns AS predicted greater post-traumatic stress reactions about the film a week later. Furthermore, the number of intrusions the day after viewing the traumatic film, but not fear and disgust in response to the trauma film, mediated the association between general AS (and AS specifically for physical and cognitive concerns) and post-traumatic stress reactions a week later. Subsequent analysis also showed that physiological arousal during initial exposure to the traumatic film moderated the association between general AS and the number of intrusions reported the day after viewing the film. The implications of these analog findings for conceptualizing the mechanism(s) that may interact to explain the role of AS in the development of PTSD and its effective treatment are discussed.",0,0 +2639,Trajectories of Exposure to Community Violence and Mental Health Symptoms Among Serious Adolescent Offenders,"The present study uses longitudinal data to investigate whether differences in exposure to community violence discriminate among serious juvenile offenders in terms of mental health symptomatology for depression, anxiety, posttraumatic stress, and hostility. Group-based modeling and moderation analyses are used to assess the influence of exposure to violence on mental health outcomes. The results demonstrate a moderating effect of psychosocial maturity and social support between exposure to community violence and adverse mental health consequences for youth on the stable low exposure trajectory. In addition, youth who experience stable high exposure to violence consistently suffer worse outcomes. The study contributes to the development of empirically derived profiles of serious youth offenders. While all of the youth in this study may face the stigma of being labeled as dangerous, some (particularly those on the chronic exposure trajectory) might find themselves in a situation where their psychological status exacerbates an already tenuous situation: reentry. Therefore, reentry services should better target the specific needs of this returning subgroup of serious youth offenders.",0,0 +2640,A spatial analysis of functional outcomes and quality of life outcomes after pediatric injury,"BackgroundChanges in health-related quality of life (HRQoL) are more regularly being monitored during the first year after injury. Monitoring changes in HRQoL using spatial cluster analysis can potentially identify concentrations of geographic areas with injury survivors with similar outcomes, thereby improving how interventions are delivered or in how outcomes are evaluated.MethodsWe used a spatial scan statistic designed for oridinal data to test two different spatial cluster analysis of very low, low, high, and very high HRQoL scores. Our study was based on HRQoL scores returned by children treated for injury at British Columbia Children’s Hospital and discharged to the Vancouver Metropolitan Area. Spatial clusters were assessed at 4 time periods – baseline (based on pre-injury health as reported prior to discharge from hospital), and one, four, and twelve months after discharge. Outcome data were measured used the PedsQL™ outcome scale. Outcome values of very low, low, high, and very high HRQoL scores were defined by classifying PedsQL™ scores into quartiles. In the first test, all scores were assessed for clustering without specifying whether the response score was from a baseline or follow-up response. In the second analysis, we built a space-time model to identify whether HRQoL responses could be identified at specific time points.ResultsAmong all participants, geographic clustering of response scores were observed globally and at specific time periods. In the purely spatial analysis, five significant clusters of ‘very low’ PedsQL physical and psychosocial health outcomes were identified within geographic zones ranging in size from 1 to 21 km. A space-time analysis of outcomes identified significant clusters of both ‘very low’ and ‘low’ outcomes between survey months within zones ranging in size from 3 to 5 km.ConclusionMonitoring patient health outcomes following injury is important for planning and targeting interventions. A common theme in the literature is that future prevention efforts may benefit from identifying those most a risk of developing ongoing problems after injury in effort to target resources to those most in need. Spatial scan statistics are tools that could be applied for identifying concentrations of poor recovery outcomes. By classifying outcomes as a categorical variable, clusters of ‘potentially low’ outcomes can also be mapped, thereby identifying populations whose recovery status may decrease.",0,0 +2641,Post-Traumatic Stress Diagnostic Scale (PDS),,0,0 +2642,ASSESSMENT OF COMA AND IMPAIRED CONSCIOUSNESS,"

Abstract

A clinical scale has been evolved for assessing the depth and duration of impaired consciousness and coma. Three aspects of behaviour are independently measured—motor responsiveness, verbal performance, and eye opening. These can be evaluated consistently by doctors and nurses and recorded on a simple chart which has proved practical both in a neurosurgical unit and in a general hospital. The scale facilitates consultations between general and special units in cases of recent brain damage, and is useful also in defining the duration of prolonged coma.",0,0 +2643,Frequency and predictors of post-traumatic stress disorder after stroke: A pilot study,"

Abstract

Objective

Few data exist about post-stroke symptoms of post-traumatic stress disorder (sPTSD) and none on DSM-IV formally diagnosed PTSD (fdPTSD). We investigated the frequency and predictors of sPTSD and fdPTSD 1–6months after a nondisabling ischemic stroke (IS) or transient ischemic attack (TIA).

Methods

Consecutive patients were assessed for sPTSD (Impact of Events Scale-Revised, IES-R, significant if >30) and fdPTSD (PTSD-Interview). We recorded sociodemographic factors, stroke features (including severity of the initial deficit, persistent disability, localization), associated mood changes, peritraumatic reactions during the stroke (Peritraumatic Distress Inventory (PDI) for fear and distress, Peritraumatic Dissociative Experience Questionnaire for cognitive appraisal), and psychiatric history. Patients with sPTSD and fdPTSD were compared to patients with IES-R<30.

Results

Among the 40 patients (65% male, mean age 52years) studied post-IS (n=30; mean initial NIHSS 4) or TIA, 25% had sPTSD, including 10% with fdPTSD. sPTSD was more frequent in women (p=0.02), patients with intense peritraumatic reactions especially on PDI (p=0.001) or identified prior depression and anxiety (p=0.007). No other demographic factors or stroke characteristics were associated with sPTSD. Forty percent of sPTSD patients were depressed versus none of the controls (p<0.002). All fdPTSD patients had ≥3 prior psychiatric co-morbidities.

Conclusions

After nondisabling IS or TIA, sPTSD is frequent, with fdPTSD for 10%. Patients with intense peritraumatic reactions, women, and those with prior psychiatric morbidity, require particular attention to detect sPTSD.",0,0 +2644,Child abuse and mental disorders in Canada,"Nationally representative Canadian data on the prevalence of child abuse and its relation with mental disorders are lacking. We used contemporary, nationally representative data to examine the prevalence of 3 types of child abuse (physical abuse, sexual abuse and exposure to intimate partner violence) and their association with 14 mental conditions, including suicidal ideation and suicide attempts.We obtained data from the 2012 Canadian Community Health Survey: Mental Health, collected from the 10 provinces. Respondents aged 18 years and older were asked about child abuse and were selected for the study sample (n = 23,395). The survey had a multistage stratified cluster design (household response rate 79.8%).The prevalence of any child abuse was 32% (individual types ranged from 8% to 26%). All types of child abuse were associated with all mental conditions, including suicidal ideation and suicide attempts, after adjustment for sociodemographic variables (adjusted odds ratios ranged from 1.4 to 7.9). We found a dose-response relation, with increasing number of abuse types experienced corresponding with greater odds of mental conditions. Associations between child abuse and attention deficit disorder, suicidal ideation and suicide attempts showed stronger effects for women than men.We found robust associations between child abuse and mental conditions. Health care providers, especially those assessing patients with mental health problems, need to be aware of the relation between specific types of child abuse and certain mental conditions. Success in preventing child abuse could lead to reductions in the prevalence of mental disorders, suicidal ideation and suicide attempts.",0,0 +2645,"Traumatic Brain Injury, Shell Shock, and Posttraumatic Stress Disorder in the Military—Past, Present, and Future","With preferential use of high explosives in modern warfare, traumatic brain injury (TBI) has become a common injury for troops. Most TBIs are classified as ""mild,"" although military personnel with these injuries can have persistent symptoms such as headache, memory impairment, and behavioral changes. During World War I, soldiers in the trenches, undergoing unrelenting artillery bombardment, suffered from similar symptoms, designated at the time as ""shell shock."" Dr Frederick Mott proposed studying the brains of deceased soldiers to elucidate the neuropathology of this clinical entity. Subsequent to a British government enquiry after World War I, the term ""shell shock"" was banned and further investigation into a possible organic cause for these symptoms was discontinued. Nevertheless, similar clinical entities, such as combat or battle fatigue and posttraumatic stress disorder, continue to be encountered by combatants in subsequent military conflicts. To this day, there exists a paucity of neuropathology studies investigating the effects of high explosives on the human brain. By analogy, studies have recently revealed that athletes with repeated head trauma can develop a neurodegenerative disease, chronic traumatic encephalopathy, who present with similar clinical features. Given current circumstance, we propose completing the work envisioned by Dr Mott almost 100 years ago.",0,0 +2646,Consumer involvement in consent document development: a multicenter cluster randomized trial to assess study participants' understanding,"Despite widespread agreement on the importance of informed consent in clinical research, uncertainty remains about the adequacy of current consent procedures and documentation.The objective of the study was to compare an informed consent document developed by a consumer group of potential study participants to one developed by the study investigators. The study was a cluster randomized, controlled study embedded in a 'parent' randomized controlled trial of 1092 participants with Gulf War veterans' illnesses recruited in 1999-2000 at 20 US medical centers. Centers were randomized to the investigator-developed or participant-developed consent document. The primary outcome measure was an Informed Consent Questionnaire-4 (ICQ-4), a validated four-item scale measuring self-reported participant understanding scored from 0 to 1. Secondary outcomes included the Client Satisfaction Questionnaire-8 and measures of study refusal and adherence to the parent trial protocol.There were no significant differences between consent documents on the ICQ-4 score overall or at any of the time points. Mean (95% CI) treatment differences ranged from +0.020 (-0.015, 0.055) (better understanding) at entry to -0.021 (-0.054, 0.012) (worse understanding) at three-months for the participant versus the investigator document group. There were also no significant differences in satisfaction, adherence to the protocol, or in the proportion of patients who refused to participate in the trial.The consumer group may not have been representative of the study participants and they did not suggest dramatic changes to the consent document. The outcome assessment questionnaire was not validated prior to the trial's initiation.Consumer modification of the consent document did not lead to either benefit or harm in understanding, satisfaction, or study refusal and adherence rates. This study did demonstrate, however, that embedding consent studies in a clinical trial is feasible and can address important questions about informed consent without disrupting the primary study.",0,0 +2647,"Epidemiology of multiple childhood traumatic events: child abuse, parental psychopathology, and other family-level stressors","Background: Multiple family-level childhood stressors are common and are correlated. It is unknown if clusters of commonly co-occurring stressors are identifiable. The study was designed to explore family-level stressor clustering in the general population, to estimate the prevalence of exposure classes, and to examine the correlation of sociodemographic characteristics with class prevalence. Method: Data were collected from an epidemiological sample and analyzed using latent class regression. Results: A six-class solution was identified. Classes were characterized by low risk (prevalence = 23%), universal high risk (7 %), family conflict (11 %), household substance problems (22 %), non-nuclear family structure (24 %), parent's mental illness (13 %). Conclusions: Class prevalence varied with race and welfare status, not gender. Interventions for childhood stressors are person-focused; the analytic approach may uniquely inform resource allocation. © Steinkopff Verlag 2004.",0,0 +2648,Optimization and characterization of an antagonist for vasopressin 1a (V1a) receptor,"Evidence from preclinical and human studies demonstrate that arginine vasopressin and vasopressin receptor 1a (V1a-R) play a crucial role in the pathophysiology of psychiatric disorders such as anxiety, depression and post-traumatic stress disorder (PTSD). The lack of selective, brain-penetrant and orally active V1a receptor antagonists has hampered the progress in our understanding of the precise/complete pharmacological role of V1a-R in central nervous system disorders and the development of novel treatments for these disorders. The optimization of promising V1a-R antagonist lead compounds and testing in known and relevant in vivo animal models will be a significant step forward in our understanding of the role of V1a-R in CNS disorders and in the development of novel treatments of anxiety, depression and PTSD. The lack of published data regarding brain-penetration and off-target selectivity, along with intellectual property barriers of the known V1a-R antagonists precludes their potential usefulness as CNS agents. As a result, there is a substantial need to discover centrally active V1a-R antagonists that are useful as in vivo tools to better understand the pharmacological role of V1a-R in CNS disorders with the potential as clinically therapeutic agents. The Scripps Research Institute Molecular Screening Center (SRIMSC), part of the Molecular Libraries Probe Production Centers Network (MLPCN), reports ML389 as a highly potent V1a-R antagonist with an IC50 of 40 nM, and high selectivity (selectivities vs. vasopressin 1b receptor, vasopressin 2 receptor, and the oxytocin receptor of >1250 fold). ML389 was identified by medicinal chemistry optimization of lead compounds. A set of pharmacokinetic analyses show that ML389 has good brain penetration, no significant activity at four human cytochrome P450 subtypes, high binding for human and rodent plasma protein, and an encouraging in vivo pharmacokinetic profile in mice. Broad selectivity screening data against a panel of receptors, transporters, and ion channels suggest that ML389 is generally inactive against a broad array of off targets and does not likely exert unwanted effects. ML389 serves as a novel V1a-R antagonist that can be developed as a therapeutic for the treatment of psychiatric disorders such as anxiety, depression and PTSD.",0,0 +2649,Evaluating Risk Factors and Possible Mediation Effects in Posttraumatic Depression and Posttraumatic Stress Disorder Comorbidity,"Objectives. On September 11, 2001 (9/11), attacks on the World Trade Center (WTC) killed 341 Fire Department of the City of New York (FDNY) firefighters and injured hundreds more. Previous WTC-related studies reported high rates of comorbid depression and posttraumatic stress disorder (PTSD), identifying disability retirement, alcohol use, and early arrival at the WTC site as correlates. However, those studies did not evaluate risk factors that could have mediated the observed comorbidity. We identified unique risk factors for each condition in an effort to better understand comorbidity. Methods. We screened retired WTC-exposed firefighters using self-administered questionnaires including the Center for Epidemiologic Studies Depression Scale, the Post Traumatic Stress Disorder Checklist, and the Alcohol Use Disorders Identification Test. We performed regression analyses to compare independent predictors of elevated depression and PTSD risk, and also tested a mediation hypothesis. Results. From December 2005 to July 2007, 23% and 22% of 1,915 retirees screened positive for elevated depression and PTSD risk, respectively, with comorbidity >70%. Controlling for comorbidity, we identified unique risk factors for (7) depression: problem alcohol use and (2) PTSD: early arrival at the WTC site. Conclusions. Our data support the premise that PTSD and depression are different responses to trauma with unique risk factors. The data also suggest a hypothesis that PTSD mediates the relationship between early WTC arrival and depression, while depression mediates the relationship between alcohol use and PTSD, a more complex relationship than shown in previous studies. Clinicians should consider these factors when evaluating patients for depression and PTSD.",0,0 +2650,Treating Multiple Incident Post-Traumatic Stress Disorder (PTSD) in an Inner City London Prison: The Need for an Evidence Base,"Background: Mental health problems have been found to be more prevalent in prison populations, and higher rates of post-traumatic stress disorder (PTSD) have been found in sentenced populations compared to the general population. Evidence-based treatment in the general population however has not been transferred and empirically supported into the prison system. Aims: The aim of this manuscript is to illustrate how trauma focused work can be applied in a prison setting. Method: This report describes a two-phased approach to treating PTSD, starting with stabilization, followed by an integration of culturally appropriate ideas from narrative exposure therapy (NET), given that the traumas were during war and conflict, and trauma-focused cognitive behavioural therapy (TF-CBT). Results : PTSD and scores on paranoia scales improved between start and end of treatment; these improvements were maintained at a 6-month follow-up. Conclusion : This case report 1 illustrates successful treatment of multiple incident PTSD in a prison setting using adaptations to TF-CBT during a window of opportunity when individuals are more likely to be free from substances and live in relative stability. Current service provision and evidence-based practice for PTSD is urgently required in UK prisons to allow individuals to engage in opportunities to reduce re-offending, free from mental health symptoms.",0,0 +2651,Stress-induced enhancement of fear conditioning activates the amygdalar cholecystokinin system in a rat model of post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD), a debilitating psychiatric disease characterized by invasive and persistent fear memories-induced stressful experience, is associated with numerous changes in neuroendocrine function. Here, we investigated whether PTSD-like symptoms are associated with changes in the cholecystokinin (CCK) system in the basolateral amygdala. We developed an animal model of PTSD using multiple foot shocks at 1.1 mA. The resulting conditioned fear response was severe (>80% freezing) and maintained for at least 28 days. The stress-associated neurotransmitters norepinephrine, dopamine, and corticotrophin-releasing hormone were elevated at 1 day after foot shock. CCK immunoreactivity and extracellular concentration as well as the expression of CCK receptors (CCK1R, CCK2R) increased progressively for 28 days following foot shock. Taken together, these results suggest that stress-induced activation of the CCK system in the BLA, which may contribute toward the development of PTSD-like symptoms.",0,0 +2652,"Female Domestic Violence Offenders: Their Attachment Security, Trauma Symptoms, and Personality Organization","Unlike male domestic violence offenders, female domestic violence offenders have traditionally been overlooked in research and theory, despite the fact that females also have high rates of domestic violence perpetration. Towards the aim of extending extant research on male and female pepetrators of domestic violence, we examined attachment style, trauma symptoms, and personality organization in 33 female offenders receiving mandated treatment for domestic violence. These offenders were compared to 32 nonoffending women receiving psychological treatment. The Experiences in Close Relationships Revised (ECR-Revised) was used to examine adult attachment, the Trauma Symptom Inventory (TSI) was used to examine trauma symptomology, and finally, the Millon Clinical Multiaxial Inventory III (MCMI-III) was used to examine cluster B personality traits. Analyses indicated that female domestic violence offenders reported less attachment security, more trauma-related symptoms, and more personality psychopathology (Antisocial, Borderline, and Dependent Subscales) than did nonoffender clinical comparison women. © 2007 Springer Publishing Company.",0,0 +2653,Identification of post traumatic stress disorder and risk factors in military first responders 6months after Wen Chuan earthquake in China,"Military personnel commonly serve as first responders to natural disasters. Our aim is to identify Post-Traumatic Stress Disorder (PTSD) and determine risk in military responders to the Wen Chuan earthquake.Analyses were carried out on 1056 of the 1125 soldiers enrolled. In addition to social demographic characteristics, the Davidson Trauma Scale (DTS) and an Earthquake exposure screening scale were administered.PTSD prevalence was 6.53% (69 cases). Logistic regression indicated that intensity of traumatic exposure (odds ratio 6.46, 95% CI 4.47-9.32, p<0.001), not having received psychological counseling (odds ratio 3.28, 95% CI 1.31-8.20, p<0.02) and regular drinking (odds ratio 2.42, 95% CI 1.04-5.62, p<0.05) were significant predictors of PTSD. Being a single-child, not being raised by both parents and regular smoking also independently predicted PTSD if intensity of earthquake traumatic exposure was not included in the model.The self-rated DTS was used to classify PTSD in this study and psychiatric co-morbidity outside of PTSD was not assessed in this sample.PTSD is a concern for Military disaster responders; to identify those with high risk of developing PTSD would be important and beneficial.",0,0 +2654,Therapeutic Effects of Melatonin Receptor Agonists on Sleep and Comorbid Disorders,"Several melatonin receptors agonists (ramelteon, prolonged-release melatonin, agomelatine and tasimelteon) have recently become available for the treatment of insomnia, depression and circadian rhythms sleep-wake disorders. The efficacy and safety profiles of these compounds in the treatment of the indicated disorders are reviewed. Accumulating evidence indicates that sleep-wake disorders and co-existing medical conditions are mutually exacerbating. This understanding has now been incorporated into the new Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Therefore, when evaluating the risk/benefit ratio of sleep drugs, it is pertinent to also evaluate their effects on wake and comorbid condition. Beneficial effects of melatonin receptor agonists on comorbid neurological, psychiatric, cardiovascular and metabolic symptomatology beyond sleep regulation are also described. The review underlines the beneficial value of enhancing physiological sleep in comorbid conditions.",0,0 +2655,Short-term psychiatric adjustment of children and their parents following meningococcal disease,"To assess short-term changes in child and parent psychiatric status following meningococcal disease.Prospective cohort study; 3-month follow-up using parent, teacher, and child questionnaires.Hospital admissions to three pediatric intensive care units and 19 general pediatric wards.Sixty children aged 3-6 yrs, 60 mothers, and 45 fathers.We administered measures of illness severity (Glasgow Meningococcal Septicaemia Prognostic Score, days in hospital) and psychiatric morbidity (Strengths and Difficulties Questionnaires, parent and teacher versions; Impact of Event scales; General Health Questionnaire-28).In children admitted to pediatric intensive care units, parental reports at 3-month follow-up showed a significant increase in emotional and hyperactivity symptoms and in related impairment; symptoms of posttraumatic stress disorder were present in four of 26 (15%) children >8 yrs old. Regarding the parents, 26 of 60 (43%) mothers in the total sample had questionnaire scores indicative of high risk for psychiatric disorder and 22 of 58 (48%) for posttraumatic stress disorder. In fathers there was high risk for psychiatric disorder in 11 of 45 (24%) and for posttraumatic stress disorder in 8 of 43 (19%). Severity of the child's physical condition on admission was significantly associated with hyperactivity and conduct symptoms at follow-up. Length of hospital admission was associated with psychiatric symptoms in the child and posttraumatic stress disorder symptoms in parents. There were also significant associations between psychiatric symptoms in children and parents.Admission of children to pediatric intensive care units for meningococcal disease is associated with an increase in and high levels of psychiatric and posttraumatic stress disorder symptoms in children and parents. Length of admission is associated with psychiatric symptoms in children and posttraumatic stress disorder symptoms in parents. Pediatric follow-up should explore psychiatric as well as physical sequelae in children and parents.",0,0 +2656,Biological and clinical framework for posttraumatic stress disorder,"Three decades of posttraumatic stress disorder (PTSD) research have placed it well on the map. PTSD is a young disorder that started being properly understood only from 1980 with incorporation in DSM-III, in which it was acknowledged that exposure to traumatic events can lead to long-term psychopathology. This chapter reviews the history and nosology of the disorder, epidemiology, and etiology, as well as the clinical features. It lists the diagnostic assessments and provides an overview of the biological framework of the disorder by addressing brain, neurohormonal, and transmitter alterations. Exposure to traumatic events is commonplace. The majority of exposed subjects are resilient, as this is still the rule rather than the exception. The reported prevalence of PTSD is twice as common in females compared to males. The A criterion in PTSD expressed the traumatic event, after which the symptom clusters are based on intrusions, avoidance, and irritability. Gene–environmental studies are needed, with a focus on specific, distinct endophenotypes and influences from environmental factors (e.g., traumatic early-life experiences, with abuse or neglect, as well as exposure to disasters or combat). PTSD is often accompanied by comorbid disorders, such as depression and other anxiety disorders, as well as drug and alcohol abuse and dependence. The disorder is heterogeneous, sometimes with complex features that focus on emotional dysregulation, attachment, and dissociation. Several validated trauma assessments are available that allow quantification of trauma symptomatology. The biological framework is based on the concepts of stress sensitization and fear conditioning as well as failure of inhibition. After the decade of the hippocampus we have seen a shift to the decade of the amygdala in the new millennium. Given the specific role of the prefrontal cortex in (neuro)psychological functions in patients with PTSD (i.e., attention and cognitive interference), interest in the role of the prefrontal cortex will increase significantly. Increased multidisciplinary involvement, with inclusion of genetics, endocrinology, immunology, (neuro)psychology, and psychopathology, is essential to find consistency between biological, emotional, and cognitive dysfunction in PTSD. A variety of effective psychological and pharmacological interventions can be used to treat PTSD. The mechanisms of exposure therapy and cognitive therapy in influencing neurobiological markers need to be further investigated. The same goes for emerging therapies such as eye movement desensitization and reprocessing, virtual reality exposure, internet therapy, and neurofeedback. There are no specific drugs for PTSD, except for the treatment of irritability and depressive features with selective serotonin reuptake inhibitors. Other options, such as specific serotonergic agents, e.g., 5-HT1A antagonists, norepinephrine blockers, corticotropin-releasing factor antagonists, glucocorticoid receptor antagonists, prazosin and α1-adrenergic blocker with nightmares, and use of beta-blockers early after trauma exposure, are investigated. New treatment options such as d-cycloserine and cortisol seem to offer opportunities to influence memory consolidation of traumatic experiences in timed relation to exposure. For health economy it is important to be aware that there is an economic burden associated with PTSD, and treatments require the use of scarce resources. They will ultimately provide tools to ascertain the relative efficiency of different treatment options and plan the availability of these for the affected population. This can be seen as the biggest challenge for the future evolution of the disorder.",0,0 +2657,"Child and Family Resilience: A Call for Integrated Science, Practice, and Professional Training","Science and practice focused on child resilience and family resilience have deep and intertwined roots, yet there have been surprisingly few efforts to systematically integrate the theory, findings, and implications of these two traditions of work. In this article, the authors discuss parallels in concepts and processes that link the sciences of child and family resilience and the potential of relational developmental systems theory to provide an integrative framework for understanding and promoting resilience in children and families. The authors describe components of an integrated approach to child and family resilience, highlighting examples from recent research, and discuss implications for research, practice, and professional training.",0,0 +2658,Resolution of Stressful Experiences as an Indicator of Coping Effectiveness in Young Adults: An Event History Analysis,"Coping research has been limited by an almost exclusivefocus on emotional distress as an indicator of coping effectiveness. The present study considers the role of stressful event duration as an indicator of coping effectiveness. The effects of specific coping strategies on the duration and resolution of different types of stressful experiences was examined in a cross-sectional, retrospective study of a large young adult sample (N = 829; age range = 21 to 26; 60% female; 94% Caucasian). Results revealed that use of coping strategies varied among different types of stressors, which included interpersonal problems, role strains, illnesses, and transitional experiences. Event history analyses indicated that avoidance and active cognitive coping were linked with longer duration, while active behavioral coping was linked with shorter duration. These coping differences did not account for the differences in duration across stressor domain. Finally, the impact of coping on duration varied as events progressed.",0,0 +2659,Prospective Study of Posttraumatic Stress Disorder and Depression Following Trauma,"OBJECTIVE: The purpose of this study was to prospectively evaluate the onset, overlap, and course of posttraumatic stress disorder (PTSD) and major depression following traumatic events. METHOD: The occurrence of PTSD and major depression and the intensity of related symptoms were assessed in 211 trauma survivors recruited from a general hospital's emergency room. Psychometrics and structured clinical interview (the Structured Clinical Interview for DSM-III-R and the Clinician-Administered PTSD Scale) were administered 1 week, 1 month, and 4 months after the traumatic event. Heart rate was assessed upon arrival at the emergency room for subjects with minor physical injury. Twenty-three subjects with PTSD and 35 matched comparison subjects were followed for 1 year. RESULTS: Major depression and PTSD occurred early on after trauma; patients with these diagnoses had similar recovery rates: 63 survivors (29.9%) met criteria for PTSD at 1 month, and 37 (17.5%) had PTSD at 4 months. Forty subjects (19.0%) met criteria for major depression at 1 month, and 30 (14.2%) had major depression at 4 months. Comorbid depression occurred in 44.5% of PTSD patients at 1 month and in 43.2% at 4 months. Comorbidity was associated with greater symptom severity and lower levels of functioning. Survivors with PTSD had higher heart rate levels at the emergency room and reported more intrusive symptoms, exaggerated startle, and peritraumatic dissociation than those with major depression. Prior depression was associated with a higher prevalence of major depression and with more reported symptoms. CONCLUSIONS: Major depression and PTSD are independent sequelae of traumatic events, have similar prognoses, and interact to increase distress and dysfunction. Both should be targeted by early treatment interventions and by neurobiological research.",0,0 +2660,Latent Variable Mixture Modeling,"This chapter discusses models with latent variables that are continuous and/ or categorical. It also gives an overview of modeling issues related to crosssectional analysis using latent class models, modeling of longitudinal data using latent class models, and modeling of longitudinal data using a combination of continuous and categorical latent variables (growth mixture models). A series of examples are presented. The analyses are carried out within a general latent variable modeling f\work shown in the appendix using the Mplus program (Muthen & Muthen, 1998). Mplus input specifications for these analyses can be obtained from www.statmodel.com. To introduce the analyses, a brief overview of modeling ideas is presented in Figs. 1.1 to 1.3.",0,0 +2661,"Olfactory identification dysfunction, aggression and impulsivity in war veterans with post-traumatic stress disorder","Background Due to neuropsychological conceptualizations of orbitoprefrontal cortex (OFC) dysfunction underpinning impulsive aggression and the incidence of such behaviour in post-traumatic stress disorder (PTSD), this study aimed to explore olfactory identification (OI) ability in war veterans with PTSD as a probe of putative OFC dysfunction; and to explore the utility of OI ability in predicting aggressive and impulsive behavior in this clinical population. Method Participants comprised 31 out-patient male war veterans with PTSD (mean=58.23 years, s.d .=2.56) recruited from a Melbourne Veterans Psychiatry Unit, and 31 healthy age- and gender-matched controls (mean=56.84 years, s.d .=7.24). All participants were assessed on clinical measures of PTSD, depression, anxiety, and alcohol misuse; olfactory identification; neurocognitive measures of dorsolateral prefrontal, lateral prefrontal and mesial temporal functioning; and self-report measures of aggression and impulsivity. Results War veterans with PTSD exhibited significant OI deficits (OIDs) compared to controls, despite uncompromised performance on cognitive measures. OIDs remained after covaring for IQ, anxiety, depression and alcohol misuse, and were significant predictors of aggression and impulsivity. Conclusions This research contributes to emerging evidence of orbitoprefrontal dysfunction in the pathophysiology underlying PTSD. This is the first study to report OIDs as a predictor of aggression and impulsivity in this clinical population. It prompts further exploration of the potential diagnostic utility of OIDs in the assessment of PTSD. Such measures may help delineate the clinical complexity of PTSD, and support more targeted interventions for individuals with a greater susceptibility to aggressive and impulsive behaviors.",0,0 +2662,The longitudinal course of posttraumatic stress disorder symptom clusters among war veterans.,"The aim of this study was to examine the long-term trajectories and interrelationships of posttraumatic stress disorder (PTSD) symptom clusters (intrusion, avoidance, and hyperarousal) in clinical and nonclinical groups of war veterans.Six hundred seventy-five Israeli veterans from the 1982 Lebanon War were assessed. The clinical group consisted of 369 who had combat stress reaction (CSR) during the war, and the nonclinical group consisted of 306 veterans with no antecedent CSR. The 2 groups were matched in age, education, military rank, and assignment. They were prospectively evaluated 1, 2, and 20 years after the war.The clinical group endorsed a higher number of symptoms than the nonclinical group, both cross-sectionally and across time. In both the clinical and nonclinical groups, the clusters of intrusion, avoidance, and hyperarousal were interrelated at any given point in time and across 20 years. In both groups, avoidance was found to be a particularly stable symptom cluster over time. Finally, hyperarousal levels 1 year after the war were found to play an important role in both groups, as they predicted future avoidance and intrusion symptoms.The findings of this study suggest that PTSD is not a monolithic disorder, as symptom clusters differ in several important aspects. Also, the course and severity of symptoms differ between clinical and nonclinical groups. Finally, practitioners are encouraged to focus on the identification and treatment of early hyperarousal due to its prominent role in the development of other PTSD symptoms.",0,0 +2663,The expansion of the field of research on ayahuasca: Some reflections about the ayahuasca track at the 2010 MAPS “Psychedelic Science in the 21st Century” conference,"A recent conference sponsored by the Multidisciplinary Assoiation for Psychedelic Studies (MAPS) in collaboration with the effter Research Institute, the Beckley Foundation and the Council n Spiritual Practices held fromApril 15th to 18th 2010, in San Jose, SA (MAPS, 2010) united 90 presenters and 1100 participantswith he goal of giving visibility to studies on the therapeutic potentials f psychedelics (psilocybin,MDMA, ibogaine, ayahuasca, etc.) in the reatment of often intractable ailments such as anxiety in terminal ancer patients, cluster headaches, obsessive–compulsive disorers, drug addiction, and post-traumatic stress disorders, as well s the role of these substances in human enhancement and welleing in general. MAPS was chartered in 1986, with the mission to evelop cannabis and psychedelics into prescription medicines to reat illnesses, tobuildanetworkof clinicswhere theseprescription edicines can be administered, and to provide public education n the harm and benefits of using psychedelics and cannabis. The nstitution has managed to get the permission of the DEA and FDA o conduct a number of clinical trials with psychedelics over the ears. Straddling the fence between establishment and counterculure, MAPS has generally been criticized by mainstream medicine or promoting the use of “dangerous drugs,” while other members f the psychedelic community have complained thatMAPS is either oo medically focused or too incendiary in its tactics with the US overnment. Ultimately,MAPS continues to enjoy the popular suport of many and occupy a leading position on the field, such as the evelopment, with the support of other important institutions, of he Psychedelic Science in the 21st Century conference The gathering was held in Silicon Valley, where psychedelics ave often, though quietly, been credited with helping to inspire",0,0 +2664,Refugee children in Sweden: Post-Traumatic Stress Disorder in Iranian preschool children exposed to organized violence,"Fifty preschool children from 47 Iranian families living as refugees in Sweden were assessed individually, simultaneously with parental interviews focusing on exposure to organized violence and post-traumatic stress symptomatology in the children. Information given by the children increased the prevalence of a Post-Traumatic Stress Disorder (PTSD) diagnosis (DSM-III-R) from 2% to 21% in the 42 children with traumatic exposure through war and political persecution. The amount of traumatic exposure was strongly related to the prevalence of PTSD. The stability of prevalence was high in a follow-up 2 and 1/2 years later; 23% of the children with traumatic exposure still met the full criteria of PTSD according to DSM-III-R.",0,0 +2665,Epigenetic mechanisms mediating vulnerability and resilience to psychiatric disorders,"The impact that stressful encounters have upon long-lasting behavioural phenotypes is varied. Whereas a significant proportion of the population will develop ""stress-related"" conditions such as post-traumatic stress disorder or depression in later life, the majority are considered ""resilient"" and are able to cope with stress and avoid such psychopathologies. The reason for this heterogeneity is undoubtedly multi-factorial, involving a complex interplay between genetic and environmental factors. Both genes and environment are of critical importance when it comes to developmental processes, and it appears that subtle differences in either of these may be responsible for altering developmental trajectories that confer vulnerability or resilience. At the molecular level, developmental processes are regulated by epigenetic mechanisms, with recent clinical and pre-clinical data obtained by ourselves and others suggesting that epigenetic differences in various regions of the brain are associated with a range of psychiatric disorders, including many that are stress-related. Here we provide an overview of how these epigenetic differences, and hence susceptibility to psychiatric disorders, might arise through exposure to stress-related factors during critical periods of development.",0,0 +2666,"Military blast exposure, ageing and white matter integrity","Mild traumatic brain injury, or concussion, is associated with a range of neural changes including altered white matter structure. There is emerging evidence that blast exposure-one of the most pervasive causes of casualties in the recent overseas conflicts in Iraq and Afghanistan-is accompanied by a range of neurobiological events that may result in pathological changes to brain structure and function that occur independently of overt concussion symptoms. The potential effects of brain injury due to blast exposure are of great concern as a history of mild traumatic brain injury has been identified as a risk factor for age-associated neurodegenerative disease. The present study used diffusion tensor imaging to investigate whether military-associated blast exposure influences the association between age and white matter tissue structure integrity in a large sample of veterans of the recent conflicts (n = 190 blast-exposed; 59 without exposure) between the ages of 19 and 62 years. Tract-based spatial statistics revealed a significant blast exposure × age interaction on diffusion parameters with blast-exposed individuals exhibiting a more rapid cross-sectional age trajectory towards reduced tissue integrity. Both distinct and overlapping voxel clusters demonstrating the interaction were observed among the examined diffusion contrast measures (e.g. fractional anisotropy and radial diffusivity). The regions showing the effect on fractional anisotropy included voxels both within and beyond the boundaries of the regions exhibiting a significant negative association between fractional anisotropy and age in the entire cohort. The regional effect was sensitive to the degree of blast exposure, suggesting a 'dose-response' relationship between the number of blast exposures and white matter integrity. Additionally, there was an age-independent negative association between fractional anisotropy and years since most severe blast exposure in a subset of the blast-exposed group, suggesting a specific influence of time since exposure on tissue structure, and this effect was also independent of post-traumatic stress symptoms. Overall, these data suggest that blast exposure may negatively affect brain-ageing trajectories at the microstructural tissue level. Additional work examining longitudinal changes in brain tissue integrity in individuals exposed to military blast forces will be an important future direction to the initial findings presented here.",0,0 +2667,Predator Stress-Induced CRF Release Causes Enduring Sensitization of Basolateral Amygdala Norepinephrine Systems that Promote PTSD-Like Startle Abnormalities,"The neurobiology of post-traumatic stress disorder (PTSD) remains unclear. Intense stress promotes PTSD, which has been associated with exaggerated startle and deficient sensorimotor gating. Here, we examined the long-term sequelae of a rodent model of traumatic stress (repeated predator exposure) on amygdala systems that modulate startle and prepulse inhibition (PPI), an operational measure of sensorimotor gating. We show in rodents that repeated psychogenic stress (predator) induces long-lasting sensitization of basolateral amygdala (BLA) noradrenergic (NE) receptors (α1) via a corticotropin-releasing factor receptor 1 (CRF-R1)-dependent mechanism, and that these CRF1 and NE α1 receptors are highly colocalized on presumptive excitatory output projection neurons of the BLA. A profile identical to that seen with predator exposure was produced in nonstressed rats by intra-BLA infusions of CRF (200 ng/0.5 μl), but not by repeated NE infusions (20 μg/0.5 μl). Infusions into the adjacent central nucleus of amygdala had no effect. Importantly, the predator stress- or CRF-induced sensitization of BLA manifested as heightened startle and PPI deficits in response to subsequent subthreshold NE system challenges (with intra-BLA infusions of 0.3 μg/0.5 μl NE), up to 1 month after stress. This profile of effects closely resembles aspects of PTSD. Hence, we reveal a discrete neural pathway mediating the enhancement of NE system function seen in PTSD, and we offer a model for characterizing potential new treatments that may work by modulating this BLA circuitry.The present findings reveal a novel and discrete neural substrate that could underlie certain core deficits (startle and prepulse inhibition) that are observed in post-traumatic stress disorder (PTSD). It is shown here that repeated exposure to a rodent model of traumatic stress (predator exposure) produces a long-lasting sensitization of basolateral amygdala noradrenergic substrates [via a corticotropin-releasing factor (CRF)-dependent mechanism] that regulate startle, which is exaggerated in PTSD. Moreover, it is demonstrated that the sensitized noradrenergic receptors colocalize with CRF1 receptors on output projection neurons of the basolateral amygdala. Hence, this stress-induced sensitization of noradrenergic receptors on basolateral nucleus efferents has wide-ranging implications for the numerous deleterious sequelae of trauma exposure that are seen in multiple psychiatric illnesses, including PTSD.",0,0 +2668,Resilience in the face of potential trauma: Clinical practices and illustrations,"Many persons exposed to loss or potentially traumatic events manage the stresses of these experiences with minimal to no impact on their daily functioning. The prevalence of this resilient capacity has surprised researchers and clinicians alike and refocused clinical practice. We review three key points about resilience: resilience is different from the process of recovery; resilience in the face of loss or potential trauma is common; and there are multiple and sometimes unexpected pathways to resilience. We then present six clinical practices informed by the study of resilience, illustrating key points with clinical vignettes. © 2006 Wiley Periodicals, Inc. J Clin Psychol: In Session 62: 971–985, 2006.",0,0 +2669,Novelty-evoked activity in open field predicts susceptibility to helpless behavior,"Learned helplessness in animals has been used to model disorders such as depression and post-traumatic stress disorder (PTSD), but there is a lack of knowledge concerning which individual behavioral characteristics at baseline can predict helpless behavior after exposure to inescapable stress. The first aim of this study was to determine behavioral predictors of helplessness using the novel and familiar open-field tests, sucrose consumption, and passive harm-avoidance tasks before learned helplessness training and testing. Individual differences in physiologic responses to restraint stress were also assessed. A cluster analysis of escape latencies from helplessness testing supported the division of the sample population of Holtzman rats into approximately 50% helpless and 50% non-helpless. Linear regression analyses further revealed that increased reactivity to the novel environment, but not general activity or habituation, predicted susceptibility to learned helplessness. During restraint stress there were no mean differences in heart rate, heart rate variability, and plasma corticosterone between helpless and non-helpless rats; however, a lower heart rate during stress was associated with higher activity levels during exploration. Our most important finding was that by using an innocuous screening tool such as the novel and familiar open-field tests, it was possible to identify subjects that were susceptible to learned helplessness.",0,0 +2670,"Use of a Frequency-Modulated System for Veterans with Blast Exposure, Perceived Hearing Problems, and Normal Hearing Sensitivity","Traumatic brain injury can impact the central auditory system leading to poor auditory recall and increased difficulties hearing in poor acoustic environments. In recent years, audiologists have increasingly encountered blast-exposed veterans who report speech understanding problems that are disproportionate to their essentially normal hearing sensitivity, and thus are thought to have an auditory processing disorder. In light of studies showing frequency-modulated (FM) systems to be effective rehabilitation for auditory processing difficulties, we examined the use of an FM system intervention for blast-exposed veterans with functional hearing problems in the presence of normal hearing sensitivity. The outcomes for three veterans who were provided with an FM system as part of a multisite randomized clinical trial are described. Data indicate that FM systems are beneficial for some patients reporting hearing problems in the presence of normal hearing sensitivity but factors other than audiometric profile and reported complaints influence outcome. These include understanding of speech in noise, patient communication demands, auditory lifestyle, and the presence of posttraumatic stress disorder or other mental health factors. Furthermore, education (and reeducation if necessary) of the patient and their spouse or family is critical to successful outcome.",0,0 +2671,Post-traumatic stress disorder in a Danish population of elderly bereaved,"The objectives of this study were to examine psychological sequalae of loss of a spouse in late life especially the occurrence of post-traumatic stress disorder (PTSD) and possible predictors of PTSD and symptom development. Fifty-four bereaved Danes (mean age 75 years) from five geographically different areas were studied by the Harvard Trauma Questionnaire (HTQ), the Trauma Symptom Checklist (TSC), and the Crisis Support Scale (CSS). One month after the loss, 27% of the subjects had PTSD. Six months after the loss, this number decreased to 17%; if the A2 criterion was dismissed, the number increased to 24%. Lack of expressive ability, numbing, fear of death or illness, and helplessness in relation to the loss predicted 73% of the variance of the HTQ-total scores. The study concluded that for a considerable number of elderly, losing a spouse in late life appeared to be a traumatic experience. Pre- and peritraumatic factors together with numbing were important predictors of traumatization. Research implications are discussed.",0,0 +2672,"The Effects of Disaster Exposure and Post-Disaster Critical Incidents on Intrusions, Avoidance Reactions and Health Problems Among Firefighters: A Comparative Study","Firefighters are at risk to be confronted with critical incidents and disasters. This study focused on the predictive value of these variables and their interaction effect for intrusions, avoidance reactions, and health problems among firefighters 18 months post-disaster (N = 639). Furthermore, the course of intrusions, avoidance reactions, and health problems in the period 2–3 weeks to 18 months post-disaster was assessed. Health problems were compared with those of non-affected firefighters (N = 132). Results showed that only disaster exposure and critical incidents accounted for a significant but small proportion of the variance (R 2 < .07) of intrusions, avoidance reactions and health problems among the affected firefighters. Health problems among affected firefighters did not decline in the period 2–3 weeks–18 months post-disaster, in contrast to intrusions and avoidance reactions. Health problems of both groups were comparable at T2. Results suggest that resilience in firefighters is rather high.",0,0 +2673,Quantitative somatosensory testing of subjects with chronic post-traumatic headache: Implications on its mechanisms,"Chronic headache is one of the most prominent symptoms among subjects with traumatic head injury (THI). Despite the relatively high prevalence of chronic post-traumatic headache (CPTHA) and its enormous effect on the already poor quality of life of subjects with THI, its mechanisms has not been studied in depth.To conducted quantitative somatosensory testing in THI subjects with and without chronic post-traumatic headache (CPTHA) in order to shed light on the yet, unknown pathophysiology of CPTHA.THI subjects with and without CPTHA and healthy controls underwent thermal and mechanical threshold measurements in painful and pain-free regions in the head and in their hands (a remote pain-free region) and filled out and the post-traumatic stress disorder (PTSD) inventory. In addition, the THI and CPTHA filled out the Mc'Gill pain questionnaire (MPQ).THI subjects with CPTHA had significantly higher thermal thresholds in both the head and hand indicating central damage to the pain and temperature system and in addition, a significantly lower pressure-pain threshold in the head as well as more severe PTSD symptomatology than the pain-free THI subjects and healthy controls.The sensory profile of subjects with CPTHA suggests that CPTHA may be a form of central pain. The cranial mechanical hyperalgesia may originate from peripheral tissue damage accompanying the THI. Psychological factors may contribute to the development, and maintenance of CPTHA in susceptible individuals.",0,0 +2674,No association between ADCYAP1R1 and post-traumatic stress disorder in two independent samples,"Presents a study which aims to replicate genetic association between single nucleotide polymorphisms rs2267735 and post-traumatic stress disorder (PTSD) in two independent samples. The first sample consisted of women from the Nurses' Health Study II (NHSII) and second sample contained 6074 individuals recruited for genetic studies of substance dependence at five US sites. The authors were unable to replicate the association between rs2267735 and PTSD in these two large independent samples. The findings do not, however, exclude the possibility that the pituitary adenylate cyclase-activating peptide-ligand type 1 receptor (PACAP-PACl1) receptor pathway has a role in the production of PTSD. Further research is needed to understand how selection factors, demographic characteristics and social context influence the role of the PACAP-PACl receptor pathway in PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +2675,Review of VA/DOD Clinical Practice Guideline on management of acute stress and interventions to prevent posttraumatic stress disorder,"This article summarizes the recommendations of the Department of Veterans Affairs (VA)/Department of Defense (DOD) VA/DOD Clinical Practice Guideline for Management of Post-Traumatic Stress that pertain to acute stress and the prevention of posttraumatic stress disorder, including screening and early interventions for acute stress states in various settings. Recommended interventions during the first 4 days after a potentially traumatic event include attending to safety and basic needs and providing access to physical, emotional, and social resources. Psychological first aid is recommended for management of acute stress, while psychological debriefing is discouraged. Further medical and psychiatric assessment and provision of brief, trauma-focused cognitive-behavioral therapy are warranted if clinically significant distress or functional impairment persists or worsens after 2 days or if the criteria for a diagnosis of acute stress disorder are met. Follow-up monitoring and rescreening are endorsed for at least 6 months for everyone who experiences significant acute posttraumatic stress. Four interventions that illustrate early intervention principles contained in the VA/DOD Clinical Practice Guideline are described.",0,0 +2676,Recruitment and Attrition Issues in Military Clinical Trials and Health Research Studies,"conducting long-term multidisciplinary research projects across a range of military health issues. The plethora of individually funded studies, program grants, and multisite military health research consortia speak to the considerable national investment in the well-being of the U.S. service member. In the context of the current economic situation, maximizing efficiency through optimal human subject participation is of paramount importance to research. A range of factors, however, can contribute to less-than-ideal levels of study participation. 5 Poor recruitment and high dropout rates are not only frustrating and costly, but they also pose a threat to the interpretation, integrity, and validity of research findings. A number of articles have reported obstacles to civilian study participation and have outlined strategies for overcoming those obstacles. 5‐11 However, to the best of our knowledge, none have been devoted to the unique challenges inherent to research with military service members. In this commentary, we review the civilian literature for recruitment and retention factors that potentially may also have relevance to military populations. We then examine research study recruitment and attrition in the U.S. military, highlighting militaryspecific issues that may impact study participation. Finally, we suggest strategies for improving research participation by service members.",0,0 +2677,"Depressive symptoms and psychological distress during the first five years after traumatic brain injury: Relationship with psychosocial stressors, fatigue and pain","To determine the prevalence of depressive symptoms among individuals with traumatic brain injury (TBI) and to identify predictors of depressive symptoms and psychological distress.A longitudinal study with assessments at 3 months, 1 year and 5 years after injury.A total of 118 individuals (29% females; mean age 32.5; range 16-55 years) with mild-to-severe TBI who were hospitalized in the Trauma Referral Centre from 2005 to 2007.Self-report assessments using the Hospital Anxiety- and Depression Scale, the Symptom Checklist 90-Revised and the Fatigue Severity Scale. Injury severity, trauma scores, pain, fatigue, substance abuse and demographic characteristics were also recorded.The prevalence of depressive symptoms was 18% at 3 months, 13% at 1 year and 18% at 5 years after injury. Only 4% had persistent depressive symptoms at all time-points. At 1 year post-injury, anxiety, age, ongoing stressors and employment status predicted depressive symptoms (R2 = 0.43, p < 0.001), and ongoing stressors, employment status, fatigue and pain predicted psychological distress (R2 = 0.45, p < 0.001).Psychosocial stressors and employment status contributed to depressive symptoms and psychological distress, whereas injury severity did not have any predictive value. The prevalence of depressive symptoms remained stable over time, emphasizing the importance of recognizing and treating depression early after the injury.",0,0 +2678,Mental Health Over Time in a Military Sample: The Impact of Alcohol Use Disorder on Trajectories of Psychopathology After Deployment,"To identify trajectories of depression and posttraumatic stress (PTS) symptom groups after deployment and determine the effect of alcohol use disorder on these trajectories, depression symptoms were modeled using the 9-item Patient Health Questionnaire in 727 Ohio National Guard members, and PTS symptoms were modeled using the PTSD Checklist in 472 Ohio National Guard members. There were 55.8% who were resistant to depression symptoms across the 4 years of study, and 41.5% who were resistant to PTS symptoms. There were 18.7% and 42.2% of participants who showed resilience (experiencing slightly elevated symptoms followed by a decline, according to Bonanno et al., 2002) to depression and PTS symptoms, respectively. Mild and chronic dysfunction constituted the smallest trajectory groups across disorders. Marital status, deployment to an area of conflict, and number of lifetime stressors were associated with membership into different latent groups for depression (unstandardized β estimates range = 0.69 to 1.37). Deployment to an area of conflict, number of lifetime traumatic events and education predicted membership into different latent groups for PTS (significant unstandardized β estimate range = 0.83 to 3.17). AUD was associated with an increase in both symptom outcomes (significant unstandardized β estimate range = 0.20 to 9.45). These results suggested that alcohol use disorder may have contributed substantially to trajectories of psychopathology in this population.",1,0 +2679,Health-related quality of life after burns,"Health-related quality of life (HRQOL) is an important parameter after medical treatments. Knowledge of (predictors of) diminished quality of life can help improve medical outcome. The aim of this study was to quantify health loss in patients with burns and to assess the contribution of injury extent, age, gender, and psychologic factors to HRQOL and speed of recovery. A multicenter prospective cohort design was used to address these aims.Data were obtained from 260 adults with burns. Patients completed the EQ-5D at 3 weeks, 3, 6, 9, and 18 months after burn and psychologic questionnaires during hospitalization. Patients' scores were compared with an age- and gender-weighted normpopulation.Patients suffered from substantial health losses at short term, but after 18 months the majority reached a HRQOL comparable with the norm population with the exception of patients requiring two or more surgeries. The best predictor of long-term HRQOL and the speed of recovery was the number of surgeries, followed by psychologic problems. Both predicted baseline and trajectories of improvement. Symptoms of traumatic stress were most debilitating over time.Both injury severity and psychologic problems play a pivotal role in reduced HRQOL and the speed of recovery. The number of surgeries seems to give a practically useful indication of the expected recovery speed that could aid in decision making and provides adequate information for patients in the aftermath of their initial surgical treatment. Screening for traumatic stress is recommended.",0,0 +2680,"A comparative study of fluoxetine, moclobemide, and tianeptine in the treatment of posttraumatic stress disorder following an earthquake","Abstract. Purpose Although antidepressant drugs have been proven as an effective treatment for posttraumatic stress disorder (PTSD), there are few comparative studies of antidepressants that are acting on different neurotransmitters. The main aim of this study is to compare the efficacy of different class of antidepressant drugs on the PTSD. Subjects/materials and methods. – In this open label study, the patients who met DSM-IV criteria for PTSD were randomly assigned to flexible doses of fluoxetine, moclobemide, or tianeptine. After the first assessment, consecutive assessments were performed at the end of weeks 2, 4, 8, and 12 using clinician administered PTSD scale (CAPS) and Clinical Global Impression of Severity (CGI-S). Changes in the total score of CAPS and sub-scale scores of symptom clusters (re-experience, avoidance, and hyperarousal) were the main output of efficacy. All statistics were based on intention-to-treat and last-observation-carried-forward (LOCF) principles. Results. Thirty-eight patients were assigned to fluoxetine, 35 patients were assigned to moclobemide, and 30 patients were assigned to tianeptine group. Gender distributions and mean ages of the treatment groups were not significantly different. Drop-out rates due to an adverse events or unknown reasons were not significantly different among fluoxetine (18.4%), moclobemide (14.3%), and tianeptine (20.0%) groups. All three treatments has led to a significant improvement in PTSD severity assessed with CAPS total score (ANOVA P < 0.001). Similarly, total scores of re-experiencing, avoidance, and hyperarousal clusters that are subscales of CAPS were significantly reduced by all three treatments (with ANOVA all P values < 0.001). There was not significant difference in terms of treatment effect between three groups. Discussion. – Treatment groups showed very similar improvement on all ratings scales. The findings support that fluoxetine, moclobemide, and tianeptine are all effective in the treatment of PTSD. Different mechanisms of action for these antidepressant drugs might result in the same common neurochemical end point. However, further studies using different classes of antidepressant drugs are needed.",0,0 +2681,Suicide Ideation and Deliberate Self-Harm among Ex-Prisoners of War,"The current study aims to assess the relations among war captivity, PTSD, suicidal ideation (SI), and deliberate self-harm (DSH) among former prisoners of war (ex-POWs). Israeli ex-POWs (N = 176) and a matched control group of combat veterans (controls; N = 118) were assessed using self-report measures. Ex-POWs with PTSD reported higher levels of both SI and DSH compared to ex-POWs and comparable veterans without PTSD. Furthermore, captivity-related variables as well as PTSD symptom clusters were positively related to both SI and DSH. However, only loss of emotional control in captivity and posttraumatic intrusion and emotional numbing symptoms, predicted SI. Ex-POWs with PTSD endorse high levels of SI and DSH. Among ex-POWs, both SI and DSH share similar captivity-related and posttraumatic symptoms correlates but only posttraumatic intrusion and emotional numbing symptoms predict SI.",0,0 +2682,"Examining cumulative victimization, community violence exposure, and stigma as contributors to PTSD symptoms among high-risk young women.","This study examines patterns of lifetime victimization within the family, community violence exposure, and stigma as contributors to posttraumatic stress disorder (PTSD) symptoms within a sample of 198 high-risk young women who are pregnant or parenting. We used cluster analysis to identify 5 profiles of cumulative victimization, based on participants' levels of witnessing intimate partner violence (IPV), physical abuse by an adult caregiver, and sexual victimization, all beginning by age 12. Hierarchical regression was used to examine these 5 clusters (ranging from a High All Victimization cluster characterized by high levels of all 3 forms of violence, to a Low All Victimization cluster characterized by low levels of all 3 forms), along with community violence exposure and stigma, as predictors of PTSD symptoms. We found that 3 of the cumulative victimization clusters, in comparison with Low All Victimization, were significant predictors of PTSD symptoms, as was stigma, while community violence exposure was not a significant predictor.",0,0 +2683,Post traumatic stress disorder: Insights from cat hair and catfish,"Post traumatic stress disorder (PTSD) is an anxiety disorder that develops in some, but not all, individuals following a traumatic experience. Established PTSD is difficult to treat, therefore prevention and early intervention is important to reduce prevalence. Identifying individuals susceptible to developing PTSD before trauma exposure and investigating neurophysiological processes that contribute to the disease will help develop better treatment and preventive methods. Limitations to such investigations in humans make animal models a necessary tool. Like humans, only some rats develop PTSD-like behavior after trauma but pre-trauma identification of these rats was not possible until now. We were able to reliably predict before trauma exposure which rats are susceptible (Susceptible) or resistant (Resistant) to developing two PTSD-like symptoms: impaired fear extinction and lasting elevation in acoustic startle responses. We hypothesized that Susceptible rats will have pre-existing alterations in plasticity-related responses in the hippocampus, a brain region whose altered size and function is associated with PTSD diagnosis. We also hypothesized that Susceptible rats will differ from Resistant rats in the acquisition of a traumatic event and tested this using Arc/H1a catFISH, a cellular imaging technique that detects neurons expressing plasticity-related immediate early genes (IEGs) during behavior. We found that, in Resistant rats a large proportion of the same dorsal CA1 (dCA1) neurons expressed IEGs during two identical explorations of the experimental box. This suggests that dCA1 responds to identical events with high fidelity. In Susceptible rats, however, different neuronal ensembles expressed IEGs during identical explorations suggesting a lack of fidelity in hippocampal response to identical events. In addition fewer ventral CA3 neurons expressed IEGs during the second exploration in Susceptible as compared to Resistant rats. We also examined the basolateral nucleus of the amygdala, but found no difference in IEG expression. Contrary to hypothesis, differences between Susceptible and Resistant rats during a foot shock paired exploration (traumatic event) were not pronounced. These findings show that rats susceptible to developing PTSD-like symptoms can be behaviorally identified and have altered hippocampal plasticity-related responses prior to the trauma. This study provides a frame-work for the investigation and remediation of susceptibilities. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +2684,"Sertraline Treatment of Children and Adolescents With Posttraumatic Stress Disorder: A Double-Blind, Placebo-Controlled Trial","The aim of this study was to evaluate the safety and efficacy of sertraline in children and adolescents who met Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for posttraumatic stress disorder (PTSD).Children and adolescents (6-17 years old) meeting DSM-IV criteria for PTSD were randomized to 10 weeks of double-blind treatment with sertraline (50-200 mg/day) or placebo. The primary efficacy measure was the University of California, Los Angeles Post-Traumatic Stress Disorder Index for DSM-IV (UCLA PTSD-I).A total of 131 patients met entry criteria and were randomized to sertraline (n = 67; female, 59.7%; mean age, 10.8; mean UCLA PTSD-I score, 43.8 ± 8.5) or placebo (n = 62; female, 61.3%; mean age, 11.2; mean UCLA PTSD-I score, 42.1 ± 8.8). There was no difference between sertraline and placebo in least squares (LS) mean change in the UCLA PTSD-I score, either on a completer analysis (-20.4 ± 2.1 vs. -22.8 ± 2.1; p = 0.373) or on an last observation carried forward (LOCF) end point analysis (-17.7 ± 1.9 vs. -20.8 ± 2.1; p = 0.201). Attrition was higher on sertraline (29.9%) compared to placebo (17.7%). Discontinuation due to adverse events occurred in a 7.5% treated with sertraline and 3.2% treated with placebo.Sertraline was a generally safe treatment in children and adolescents with PTSD, but did not demonstrate efficacy when compared to placebo during 10 weeks of treatment. ClinicalTrials.gov Identifier: NCT00150306.",0,0 +2685,Distinctiveness of prolonged grief disorder symptoms among survivors of the Great East Japan Earthquake and Tsunami,"Prolonged Grief Disorder (PGD) has been proposed for diagnostic classification as an independent psychiatric disorder. Previous research has investigated it in relation to other axis I disorders in order to determine whether it could be considered an independent nosological entity. The distinctiveness of this condition was apparent in cases of ordinary bereavement and in those following human-made disasters. However, this disorder may be expanded to include bereavement resulting from natural disasters. The present study aims to explore the differences between this disorder and posttraumatic stress disorder or major depressive disorder as experienced after the Great East Japan Earthquake and Tsunami. The subjects were 82 hospital workers. Each type of disorder was assessed by means of the Inventory of Complicated Grief, the Impact of Event Scale-Revised, and the Center for Epidemiological Studies Depression Scale. Exploratory factor analysis showed 3 dimensions, with PGD items independently clustering in the same dimension. Our findings support the uniqueness of PGD even in a post-natural disaster situation in a non-Western culture and warrant grief intervention for high-risk bereaved survivors.",0,0 +2686,Employment Status and Posttraumatic Stress Disorder Following Compensation Seeking in Victims of Violence,"The current study was developed to explore the associations between posttraumatic stress disorder (PTSD), level of compensation for pain and suffering, and employment status in a sample of victims of violence ( n = 226) who had held a full-time job at time of victimization and had filed a claim with the Dutch Victim Compensation Fund (DVCF) thereafter. Based on previous research, it was expected that PTSD would be associated with current unemployment. If a relationship between the two were to be found, the study would explore whether this should be ascribed to the presence of a sense of foreshortened future. Results confirmed this hypothesis and indicated that participants with PTSD were more prone to be currently unemployed than non-PTSDs. Additional analyses revealed that PTSD symptom severity and symptom cluster scores were also positively associated to higher unemployment rates. The observed relationships were not merely due to a high level of compensation for pain and suffering and failed to remain significant after adjusting for sense of foreshortened future. Implications for policy practice as well as strengths and limitations of the study were discussed.",0,0 +2687,"Trauma Exposure and Posttraumatic Stress Disorder Among Employees of New York City Companies Affected by the September 11, 2001 Attacks on the World Trade Center","Several studies have provided prevalence estimates of posttraumatic stress disorder (PTSD) related to the September 11, 2001 (9/11) attacks in broadly affected populations, although without sufficiently addressing qualifying exposures required for assessing PTSD and estimating its prevalence. A premise that people throughout the New York City area were exposed to the attacks on the World Trade Center (WTC) towers and are thus at risk for developing PTSD has important implications for both prevalence estimates and service provision. This premise has not, however, been tested with respect to DSM-IV-TR criteria for PTSD. This study examined associations between geographic distance from the 9/11 attacks on the WTC and reported 9/11 trauma exposures, and the role of specific trauma exposures in the development of PTSD.Approximately 3 years after the attacks, 379 surviving employees (102 with direct exposures, including 65 in the towers, and 277 with varied exposures) recruited from 8 affected organizations were interviewed using the Diagnostic Interview Schedule/Disaster Supplement and reassessed at 6 years. The estimated closest geographic distance from the WTC towers during the attacks and specific disaster exposures were compared with the development of 9/11-related PTSD as defined by the Diagnostic and Statistical Manual, Fourth Edition, Text Revision.The direct exposure zone was largely concentrated within a radius of 0.1 mi and completely contained within 0.75 mi of the towers. PTSD symptom criteria at any time after the disaster were met by 35% of people directly exposed to danger, 20% of those exposed only through witnessed experiences, and 35% of those exposed only through a close associate's direct exposure. Outside these exposure groups, few possible sources of exposure were evident among the few who were symptomatic, most of whom had preexisting psychiatric illness.Exposures deserve careful consideration among widely affected populations after large terrorist attacks when conducting clinical assessments, estimating the magnitude of population PTSD burdens, and projecting needs for specific mental health interventions.",0,0 +2688,The effect of strategies of personal resilience on depression recovery in an Australian cohort: A mixed methods study,"Strategies of personal resilience enable successful adaptation in adversity. Among patients experiencing depression symptoms, we explored which personal resilience strategies they find most helpful and tested the hypothesis that use of these strategies improves depression recovery. We used interview and survey data from the Diagnosis, Management and Outcomes of Depression in Primary Care 2005 cohort of patients experiencing depression symptoms in Victoria, Australia. A total of 564 participants answered a computer-assisted telephone interview question at 12 months follow-up, about what they found most helpful for their depression, stress or worries. Depressive disorder and severity were measured at annual follow-up using the Composite International Diagnostic Interview and the Patient Health Questionnaire self-rating questionnaire. Using interview responses, we categorised participants as users or not of strategies of personal resilience, specifically, drawing primarily on expanding their own inner resources or pre-existing relationships: 316 (56%) were categorised as primarily users of personal resilience strategies. Of these, 193 (61%) reported expanding inner resources, 79 (25%) drawing on relationships and 44 (14%) reported both. There was no association between drawing on relationships and depression outcome. There was evidence supporting an association between expanding inner resources and depression outcome: 25 per cent of users having major depressive disorder 1 year later compared to 38 per cent of non-users (adjusted odds ratio: 0.59, confidence interval: 0.36–0.97). This is the first study to show improved outcome for depression for those who identify as most helpful the use of personal resilience strategies. The difference in outcome is important as expanding inner resources includes a range of low intensity, yet commonly available strategies.",0,0 +2689,Vulnerability Factors for Disaster-Induced Child Post-Traumatic Stress Disorder: The Case for Low Family Resilience and Previous Mental Illness,"Objective: The aim of the present study was to investigate whether parent report of family resilience predicted children's disaster-induced post-traumatic stress disorder (PTSD) and general emotional symptoms, independent of a broad range of variables including event-related factors, previous child mental illness and social connectedness. Methods: A total of 568 children (mean age = 10.2 years, SD = 1.3) who attended public primary schools, were screened 3 months after Cyclone Larry devastated the Innisfail region of North Queensland. Measures included parent report on the Family Resilience Measure and Strengths and Difficulties Questionnaire (SDQ)–emotional subscale and child report on the PTSD Reaction Index, measures of event exposure and social connectedness. Results: Sixty-four students (11.3%) were in the severe–very severe PTSD category and 53 families (28.6%) scored in the poor family resilience range. A lower family resilience score was associated with child emotional problems on the SDQ and longer duration of previous child mental health difficulties, but not disaster-induced child PTSD or child threat perception on either bivariate analysis, or as a main or moderator variable on multivariate analysis (main effect: adjusted odds ratio (OR adj ) = 0.57, 95% confidence interval (CI) = 0.13–2.44). Similarly, previous mental illness was not a significant predictor of child PTSD in the multivariate model (OR adj = 0.75, 95%CI = 0.16–3.61). Conclusion: In this post-disaster sample children with existing mental health problems and those of low-resilience families were not at elevated risk of PTSD. The possibility that the aetiological model of disaster-induced child PTSD may differ from usual child and adolescent conceptualizations is discussed.",0,0 +2690,PTSD personality subtypes in women exposed to intimate-partner violence.,"There is considerable research implicating posttraumatic stress disorder (PTSD) as a common reaction to intimate-partner violence (IPV; Golding, 1999). PTSD is categorized as a single disorder; however, there is significant heterogeneity in its symptom-presentation patterns (Dickstein, Suvak, Litz, & Adler, 2010). Researchers have posited underlying personality characteristics as potentiating different expressions of PTSD (Miller, Greif, & Smith, 2003). Specifically, a model with 3 personality subtypes (i.e., externalizing, internalizing, and simple) has been proposed to explain PTSD symptom-pattern heterogeneity (Miller, 2003; Miller & Resick, 2007). The current study tested the PTSD personality-subtype model in a sample of 129 women exposed to a range of IPV experiences. Temperament patterns of women reporting clinically significant PTSD symptoms replicated the 3 personality-subtype patterns found in previous investigations (i.e., an externalizing subtype group characterized by high negative emotionality and low disinhibition, an internalizing subtype group characterized by high negative emotionality and low positive emotionality, and a simple subtype group characterized by midrange scores across the temperament variables; Miller et al., 2003; Miller, Kaloupek, Dillon, & Keane, 2004; Miller & Resick, 2007). Differences between personality-subtype groups and women without clinically significant PTSD symptoms were found (p < .05), with women reporting personality patterns consistent with the internalizing and externalizing subtype groups exhibiting higher comorbid personality pathology and psychological difficulties. Implications are discussed for personality as a risk or resiliency factor in PTSD and as contributing to explaining PTSD symptom heterogeneity.",0,0 +2691,"Substance abuse, memory, and post-traumatic stress disorder","• We discuss effects of nicotine, cocaine, and alcohol on memory. • We describe comorbidities for abuse of nicotine, cocaine, and alcohol with PTSD. • CPP We discuss how nicotine, cocaine, and alcohol may alter the course and treatment of PTSD. A large body of literature demonstrates the effects of abused substances on memory. These effects differ depending on the drug, the pattern of delivery (acute or chronic), and the drug state at the time of learning or assessment. Substance use disorders involving these drugs are often comorbid with anxiety disorders, such as post-traumatic stress disorder (PTSD). When the cognitive effects of these drugs are considered in the context of the treatment of these disorders, it becomes clear that these drugs may play a deleterious role in the development, maintenance, and treatment of PTSD. In this review, we examine the literature evaluating the cognitive effects of three commonly abused drugs: nicotine, cocaine, and alcohol. These three drugs operate through both common and distinct neurobiological mechanisms and alter learning and memory in multiple ways. We consider how the cognitive and affective effects of these drugs interact with the acquisition, consolidation, and extinction of learned fear, and we discuss the potential impediments that substance abuse creates for the treatment of PTSD.",0,0 +2692,"Emergency Workers’ Quality of Life: The Protective Role of Sense of Community, Efficacy Beliefs and Coping Strategies","This study, involving a sample of 764 emergency workers, investigates dimensions of quality of life at work (Compassion fatigue, Burnout and Compassion satisfaction), and their relationships with Coping strategies and some psychosocial variables (Sense of Community, Collective Efficacy and Self-efficacy). Results indicate the usefulness of distinguishing between positive and negative indicators of emergency workers’ quality of life. Compassion satisfaction is positively correlated with efficacy beliefs, Sense of Community and the use of Active coping strategies. Burnout and Compassion fatigue are especially correlated with the use of dysfunctional coping strategies like distraction and self-criticism. Volunteer emergency workers enjoy a higher well being than full-time professional workers. Results and their implications for interventions aimed at increasing rescue workers’ quality of life by enhancing psychosocial competences are discussed.",0,0 +2693,Forebrain-Specific CRF Overproduction During Development is Sufficient to Induce Enduring Anxiety and Startle Abnormalities in Adult Mice,"Corticotropin releasing factor (CRF) regulates physiological and behavioral responses to stress. Trauma in early life or adulthood is associated with increased CRF in the cerebrospinal fluid and heightened anxiety. Genetic variance in CRF receptors is linked to altered risk for stress disorders. Thus, both heritable differences and environmentally induced changes in CRF neurotransmission across the lifespan may modulate anxiety traits. To test the hypothesis that CRF hypersignaling is sufficient to modify anxiety-related phenotypes (avoidance, startle, and conditioned fear), we induced transient forebrain-specific overexpression of CRF (CRFOE) in mice (1) during development to model early-life stress, (2) in adulthood to model adult-onset stress, or (3) across the entire postnatal lifespan to model heritable increases in CRF signaling. The consequences of these manipulations on CRF peptide levels and behavioral responses were examined in adulthood. We found that transient CRFOE during development decreased startle habituation and prepulse inhibition, and increased avoidance (particularly in females) recapitulating the behavioral effects of lifetime CRFOE despite lower CRF peptide levels at testing. In contrast, CRFOE limited to adulthood reduced contextual fear learning in females and increased startle reactivity in males but did not change avoidance or startle plasticity. These findings suggest that forebrain CRFOE limited to development is sufficient to induce enduring alterations in startle plasticity and anxiety, while forebrain CRFOE during adulthood results in a different phenotype profile. These findings suggest that startle circuits are particularly sensitive to forebrain CRFOE, and that the impact of CRFOE may be dependent on the time of exposure.",0,0 +2694,"Depression, Anxiety, and Perinatal-Specific Posttraumatic Distress in Mothers of Very Low Birth Weight Infants in the Neonatal Intensive Care Unit","To compare the trajectories and determine the predictors of maternal distress defined as a continuous spectrum of symptomatology and elevated symptomatology, of depression, anxiety, and perinatal-specific posttraumatic stress (PPTS), in mothers of very low birth weight (VLBW) infants throughout the neonatal intensive care unit (NICU) hospitalization.Sixty-nine mothers completed psychological questionnaires within the first month of their infant's NICU hospitalization and again 2 weeks before NICU discharge. Multiple regression models determined maternal psychological, reproductive, sociodemographic, and infant medical predictors of maternal distress.Perinatal-specific posttraumatic stress remained stable throughout the NICU hospitalization, whereas other aspects of distress declined. Previous psychological history and infant medical variables predicted higher PPTS but no other aspects of distress. Reproductive variables predicted anxiety and PPTS; history of fetal loss initially predicted lower PPTS but throughout hospitalization primipara status emerged as a predictor of higher anxiety and PPTS. Sociodemographic variables predicated initial, but not later, depressive distress.Psychological screening is important in the NICU. The PPTS profile suggests it may require distinct treatment. Primiparas should be targeted for intervention.",0,0 +2695,Co-occurring posttraumatic stress and depression symptoms after sexual assault: A latent profile analysis,"Symptoms of posttraumatic stress disorder (PTSD) and depression frequently co-occur, but their distinctiveness following trauma remains unclear. We examined patterns of PTSD and depression symptoms after sexual assault to evaluate the extent to which assault survivors primarily reported symptoms of both disorders or whether there were meaningfully distinct subgroups with discordant PTSD and depression symptoms.Latent profile analysis was used to examine self-reported PTSD and depression symptoms among 119 female sexual assault survivors at 1-, 2-, 3-, and 4-months post-assault.At all time points, a 4-class solution fit the data best, revealing four subgroups with low, low-moderate, high-moderate, and severe levels of both PTSD and depression symptoms. Within each subgroup, PTSD symptom severity co-occurred with comparable depression symptom severity. At no time point were there reliable subgroups with discordant PTSD and depression symptom severities. Emotional numbing, hyperarousal, and overall PTSD symptom severity reliably distinguished each class from the others. Class membership at 1-month post-assault predicted subsequent class membership and functional impairment.Additional research is needed to evaluate predictors of class membership, temporal stability of classes, and generalizability to other trauma populations.Co-occurring and comparably severe PTSD and depression symptoms are pervasive among female sexual assault survivors. The absence of a distinct subset of individuals with only PTSD or depression symptoms suggests that PTSD and depression may be manifestations of a general posttraumatic stress response rather than distinct disorders after trauma. Integrated treatments targeting both PTSD and depression symptoms may therefore prove more efficient and effective.",0,0 +2696,"Prior trauma and PTSD among homeless mothers: Effects on subsequent stress appraisals, coping, posttraumatic growth, and health outcomes","There is much evidence that the experience of trauma is related to poorer subsequent outcomes, including mental health symptoms, poor physical health, and substance abuse. A high number of previous lifetime traumas and/or the experience of PTSD symptoms may contribute to difficulties adjusting to future life stress. However, some factors may protect individuals from the effects of posttraumatic stress and mediate the relationship between trauma exposure and adjustment outcomes. For instance, stress appraisals and coping behaviors may affect how an individual responds to stressful experiences. Furthermore, there is a growing interest in the potential for positive change following stressful life events (i.e., ""posttraumatic growth"" (PTG)). This longitudinal study investigated the effect of prior trauma history and PTSD symptoms on subsequent mental health, physical health, substance use, and posttraumatic growth in a sample of 70 homeless mothers. Participants' appraisals and coping behaviors with regard to a future life stressor and the contribution of these factors on adjustment outcomes were examined. The potential moderating effect of social support on appraisals, coping, and subsequent outcomes was also tested. A series of hierarchical regression analyses were conducted to test the effect of the proposed predictors on each adjustment outcome separately. Results indicated that the sample reported moderate to high levels of posttraumatic growth as a result of a recent life stressor. This is the first study to demonstrate that this phenomenon is observed in homeless mothers. Higher levels of PTSD symptomatology (but not number of prior traumas) and use of avoidant coping predicted greater subsequent mental health symptoms. Appraisals of a stressor as threatening and use of active coping contributed to posttraumatic growth. The examined variables did not significantly predict physical health or substance use outcomes in this sample. No significant moderating effect of social support on any of the outcomes was found. Implications for future research and for the development of interventions aimed at reducing the negative effects of trauma and facilitating posttraumatic growth in homeless women are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +2697,WHITE MATTER INTEGRITY AND ITS RELATIONSHIP TO PTSD AND CHILDHOOD TRAUMA-A SYSTEMATIC REVIEW AND META-ANALYSIS,"Recent reviews and meta-analyses reported structural gray matter changes in patients suffering from adult-onset posttraumatic stress disorder (PTSD) and in subjects with and without PTSD who experienced childhood trauma. However, it remains unclear if such structural changes are also affecting the white matter. The aim of this systematic review is to provide a comprehensive overview of all empirical investigations measuring white matter integrity in populations affected by PTSD and/or childhood trauma. To this end, results from different methodological approaches were included. Twenty-five articles are reviewed of which 10 pertained to pediatric PTSD and the effects of childhood trauma measured during childhood, seven to the effects of childhood trauma measured during adulthood, and eight to adult-onset PTSD. Overall, reductions in white matter volume were reported more often than increases in these populations. However, the heterogeneity of the exact locations indicates only a weak overlap across published studies. In addition, a meta-analysis was carried out on seven whole-brain diffusion tensor imaging (DTI) studies in adults. Significant clusters of both increases and decreases were identified in various structures, most notably the cingulum and the superior longitudinal fasciculus. Future research directions are discussed.",0,0 +2698,Neuropeptide receptor ligands as drugs for psychiatric diseases: the end of the beginning?,"The search for novel drugs for treating psychiatric disorders is driven by the growing medical need to improve on the effectiveness and side-effect profile of currently available therapies. Given the wealth of preclinical data supporting the role of neuropeptides in modulating behaviour, pharmaceutical companies have been attempting to target neuropeptide receptors for over two decades. However, clinical studies with synthetic neuropeptide ligands have been unable to confirm the promise predicted by studies in animal models. Here, we analyse preclinical and clinical results for neuropeptide receptor ligands that have been studied in clinical trials for psychiatric diseases, including agents that target the receptors for tachykinins, corticotropin-releasing factor, vasopressin and neurotensin, and suggest new ways to exploit the full potential of these candidate drugs.",0,0 +2699,Contemporary Longitudinal Methods for the Study of Trauma and Posttraumatic Stress Disorder,"Traditional methods for analyzing trends in longitudinal data have typically emphasized average group change over time. In this article, we propose multilevel, regression-based methods for examining inter-individual differences in intra-individual change and apply these methods to research in trauma and posttraumatic stress disorder (PTSD). The outcome or dependent variable of interest is reconceptualized as an index of dynamic change reflecting the trend or trajectory of an individual's PTSD symptom severity scores across time. A basic statistical model is presented, and analyses and findings are demonstrated with an existing database used in previously published studies. The methods offer promise for future study of the natural course of PTSD chronicity or recovery, risk and resilience factors that influence individual growth or decline, and critical timepoints for intervention.",0,0 +2700,"Traumatic brain injury, dissociation, and posttraumatic stress disorder in road traffic accident survivors","This study investigated the symptom profiles of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) in participants who did and did not sustain traumatic brain injury (TBI), following a road traffic accident. The participants were assessed at three time points: as soon as possible posttrauma as well as at 6 weeks and 3 months posttrauma. At the first assessment, fewer participants from the TBI group recalled feeling fear and helplessness at the time of the trauma, fewer TBI participants reported recurrent intrusive thoughts and images, and more TBI participants reported dissociation since the trauma, relative to the non-TBI group. At the second assessment, fewer participants from the TBI group recalled feeling intense helplessness at the time of the trauma. Fewer TBI participants also reported reliving and physiological reactions on trauma reminders relative to the non-TBI group. At 3 months posttrauma, there was no difference in PTSD symptom profile between non-TBI and TBI groups. Our findings indicate that the presence of TBI is likely to influence the distribution of certain symptoms, but need not be a significant barrier to diagnosing ASD and PTSD.",0,0 +2701,Relations among emotion regulation and DSM-5 symptom clusters of PTSD,"Abstract Emotion regulation has been implicated as a risk and maintaining factor for posttraumatic stress disorder (PTSD). Three aspects of emotion regulation have demonstrated the strongest relations with PTSD symptoms: experiential avoidance, rumination, and thought suppression. Given that emotion regulation has demonstrated differential relations with DSM-IV PTSD symptom clusters, the current study sought to examine these relations with the DSM-5 symptom clusters of PTSD. Participants were recruited via Amazon's Mechanical Turk (N = 403). All participants endorsed trauma exposure. Measures included the PTSD Checklist for DSM-5 (PCL-5), the Acceptance and Action Questionnaire-II (AAQ-II), the negative affect scale of the Positive and Negative Affect Schedule (PANAS-NA; included as a control variable), the Ruminative Responses Scale (RRS), and the White Bear Suppression Inventory (WBSI). A path analysis model in Mplus indicated that the AAQ-II demonstrated large effects with all four PTSD symptom clusters. Of those relations, the largest was observed for the AAQ-II and the Negative Alterations in Cognition and Mood cluster of PTSD. Results suggest that individual variation in PTSD symptoms may have implications for the salience of particular emotion regulation strategies.",0,0 +2702,Risk factors of posttraumatic stress disorder within emergency medical service personnel,"The current study examined the relationship between risk factors for posttraumatic stress disorder (PTSD) in Emergency Medical Service (EMS) personnel. It was hypothesized that EMS workers who were female; older; single; had less social support; reported more life stressors, depression, peritraumatic dissociation, history of trauma, negative cognitions; and experienced more life-threatening critical incidents would report a greater number of PTSD symptoms. The participants completed the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), the Center for Epidemiologic Studies Depression Scale (CES-D), the Posttraumatic Cognitions Inventory (PTCI), the Peritraumatic Dissociative Experiences Questionnaire (PDEQ), the Traumatic Events Questionnaire (TEQ), the Multidimensional Scale of Perceived Social Support (MSPSS), the Life Experiences Survey (LES), and a researcher-created EMS Demographic Questionnaire. To access predictor variables related to PTSD, all eight predictor variables were entered into a multiple regression in their continuous form. The criterion variable was the participants' score on the PCL-C. Preliminary Pearson product-moment correlations revealed that six of the eight predictor variables yielded statistically significant correlations with the PCL-C total score. Overall, these eight predictor variables were able to account for 64% of the variability in PTSD (adjusted R2 = .64, p < .001). Upon further examination, depression, traumatic events, negative cognitions, and sex all significantly contributed to the regression equation. The results of this study indicate that this combination of predictor variables is related to PTSD. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +2703,Influence of PTSD symptom clusters on smoking status among help-seeking Iraq and Afghanistan veterans,"Despite the strong association between smoking and posttraumatic stress disorder (PTSD), mechanisms influencing smoking in this population remain unclear. Previous smoking research has largely examined PTSD as a homogenous syndrome despite the fact that PTSD is composed of four distinct symptom clusters (i.e., reexperiencing, effortful avoidance, emotional numbing, and hyperarousal). Examination of the relationship between smoking and PTSD symptom clusters may increase understanding of mechanisms influencing comorbidity between smoking and PTSD. The goals of the present study were to (a) examine the influence of overall PTSD symptom severity on likelihood of smoking and smoking heaviness and (b) examine the influence of each PTSD symptom cluster on smoking.Participants (N = 439) were Operation Iraqi Freedom/Operation Enduring Freedom combat veterans referred to VA mental health services.Multinomial logistic regression was chosen to accommodate a three-level outcome, in which the likelihood of being a nonsmoker was compared with (a) light smoking (1-9 cigarettes/day), (b) moderate smoking (10-19 cigarettes/day), and (c) heavy smoking (> or =20 cigarettes/day). Results showed that veterans with higher levels of overall PTSD symptomatology were more likely to endorse heavy smoking (Wald = 4.56, p = .03, odds ratio [OR] = 1.65). Veterans endorsing high levels of emotional numbing were also more likely to endorse heavy smoking (Wald = 6.49, p = .01, OR = 1.81); all other PTSD symptom clusters were unrelated to smoking.The association between emotional numbing and heavy daily smoking suggests that veterans with PTSD may smoke to overcome emotional blunting following trauma exposure.",0,0 +2704,Gender differences in risk factors for trauma exposure and post-traumatic stress disorder among inner-city drug abusers in and out of treatment,"Over the past two decades there has been a growing awareness of the comorbidity between post-traumatic stress disorder (PTSD) and substance use disorders in the general population. The purpose of these analyses was to examine, in a population of drug users, the role of gender in (1) predicting the nature of the traumatic event and PTSD symptoms, (2) patterns of substance use disorders in relation to trauma exposure and PTSD symptoms, (3) comorbidity of other psychiatric disorders with trauma exposure and PTSD, and (4) the temporal association of substance use disorder, exposure to trauma, and PTSD. Drug abusers (n = 464) were interviewed using the Diagnostic Interview Schedule for DSM-III-R (DIS) and the Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM). Although more women than men met criteria for DSM-III-R PTSD, there were no gender differences on endorsement for a traumatic event. Adult antisocial behavior, affective disorder, schizophrenia, other anxiety disorder and polysubstance use predicted exposure to an event, whereas, only schizophrenia and other anxiety disorder predicted PTSD. In men, drug use preceded the exposure to an event, while in women, the onset age for both drug use and exposure to an event were nearly identical. This work suggests implications for gender-based education and prevention interventions.",0,0 +2705,Emotion dysregulation facets as mediators of the relationship between PTSD and alcohol misuse,"Posttraumatic stress disorder (PTSD) and alcohol misuse, which frequently co-occur among combat veterans, have been linked to emotion dysregulation. Emotion dysregulation may explain the link between PTSD and alcohol misuse, and this investigation tested emotion dysregulation as a mediator of that relationship.Correlations between PTSD symptoms and cluster symptoms, emotion dysregulation full and subscales, and alcohol misuse were examined in a sample of 139 combat Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans (45% African American; 89% men). Emotion dysregulation full scale and subscales were examined as mediators of the relationship between PTSD symptoms and alcohol misuse for the full sample and men only.PTSD symptoms and symptom clusters, emotion dysregulation, and alcohol misuse showed positive correlations for the full sample and men only. Neither the full scale of emotion dysregulation nor the facets of emotion dysregulation mediated the relationship between PTSD symptoms and alcohol misuse for the full sample; among men, the Impulse Control Difficulties when Upset and Lack of Emotional Clarity subscales were mediators of that relationship.Impulse control difficulties and lack of emotional clarity may play an important role in the link between PTSD and alcohol misuse for male veterans and should be an important target in treatment for individuals with both disorders. Addressing impulse control difficulties and lack of emotional clarity in those with PTSD and alcohol misuse may improve outcomes by helping individuals identify and describe upsetting emotions and develop healthy coping alternatives to alcohol misuse.",0,0 +2706,Comparison of two widely used PTSD-screening instruments: Implications for public mental health planning,"Epidemiological research serves a critical role in public mental health planning in the aftermath of disasters, particularly via estimation of the mental health burden and potential needs of affected communities. However, different measures are used across studies to assess mental health response, making cross-study comparison difficult. The National Women's Study Posttraumatic Stress Disorder module (NWS-PTSD) and PTSD Checklist (PCL) have been among the most widely used measures of PTSD in postdisaster research. Here, the authors used a sample of 233 New York City-area residents who were administered both the NWS-PTSD and PCL 4 months after the September 11, 2001 terrorist attacks. The PCL yielded higher prevalence estimates at the symptom, cluster, and diagnostic levels. Implications for the interpretation of epidemiological data are discussed.",0,0 +2707,Symptom-specific effects of fluoxetine in post-traumatic stress disorder,"The selective serotonin reuptake inhibitors have become a first line treatment for post-traumatic stress disorder (PTSD). In a recent double-blind study in civilians, fluoxetine produced clinically and statistically significant effects on all general measures of PTSD. We examined the specific effects of fluoxetine versus placebo in the above mentioned study of PTSD clusters and individual symptoms. Individuals were included if they met criteria for PTSD according to the Structured Clinical Interview for DSM-III-R (SCID). Symptoms were assessed at sequential time points by the Structured Interview for PTSD (SIP), a clinician interview based assessment, and a self-report scale, the Davidson Trauma Scale (DTS). A total of 53 patients were included in the analysis. On the SIP and DTS, fluoxetine was found to produce statistically significant changes on all clusters. Significant effects for fluoxetine were noted on 10 items of the DTS, and 8 items of the SIP. The SIP and DTS had 6 items in common that were significant. Fluoxetine exerts a broad spectrum effect in reducing all the symptom clusters of PTSD in this sample. The symptoms of being physically upset at reminders of the trauma, avoiding thoughts of the trauma, having difficulty enjoying things, feeling distant/estranged, having a sense of foreshortened future, and impaired concentration, were the symptoms most responsive to the effects of treatment with fluoxetine on both scales.",0,0 +2708,Latent classes of PTSD symptoms in Iraq and Afghanistan female veterans,"Recent studies have used latent class analysis (LCA) to identify subgroups of individuals who share similar patterns of PTSD symptom endorsement; however, further study is needed among female veterans, whose PTSD symptom expression may vary from that of their male counterparts. The current study examined latent PTSD symptom classes in female veterans who returned from recent military service in Iraq and Afghanistan, and explored military and demographic variables associated with distinct PTSD symptom presentations. A retrospective analysis was conducted using existing medical records from female Iraq and Afghanistan veterans who were new users of VA mental health outpatient (MHO) care, had received a PTSD diagnosis anytime during the post-deployment period, and completed the PTSD checklist within 30 days of their first MHO visit ( N =2425). The LCA results identified four latent classes of PTSD symptom profiles in the sample: High Symptom, Intermediate Symptom, Intermediate Symptom with High Emotional Numbing (EN), and Low Symptom. Race/ethnicity, age, time since last deployment, and distance from a VA facility emerged as predictors of PTSD symptom presentation. The current study was cross-sectional and utilized administrative data. The results may not be generalizable to female veterans from other service eras. Longer times between end of last deployment and initiation of MHO services were associated with more symptomatic classes. Exploration of PTSD symptom presentation may enhance our understanding of the service needs of female veterans with PTSD, and suggests potential benefits to engaging veterans in MHO soon after last deployment.",0,0 +2709,Symptom Patterns among Youth Exposed to Intimate Partner Violence,"Children and adolescents exposed to intimate partner violence display a broad range of symptoms. We sought to differentiate symptom patterns and predictors of these patterns using a person-oriented approach. Previous cluster analysis research of exposed youth was extended to include youth PTSD symptoms and trauma history. Participants were 74 mothers who had received a police call for domestic violence, and who had a child between 2 and 17 years old. Cluster analysis was used to identify four symptom patterns among exposed youth: Typical, Asymptomatic, General Distress, and Acute PTSD. These patterns were replicated in separate cluster analyses with younger and older participants. Symptom patterns were differentiated by maternal distress, maternal aggression, and youth trauma history, but not by male partner aggression. Implications for assessment and treatment of youth exposed to intimate partner violence, and suggestions for further research, are discussed. © 2008 Springer Science+Business Media, LLC.",0,0 +2710,The Psychological and Medical Sequelae of War in Central American Refugee Mothers and Children,"To investigate the physical and mainly psychological sequelae of exposure to war in Central American children and their mothers who immigrated to the United States on average 4 years before the study began.Interview study.Twenty-two immigrant Central American women caretakers and 1 of their children aged 5 to 13 years.Standardized and new measures were administered to assess children's physical and mental health symptoms and exposure to political violence.Eighteen of the 22 children had chronic health problems. Fifteen children and all of the adults had observed traumatic events, including bombings and homicides. Thirteen of the children showed mental health symptom profiles above established norms, although only 2 met the criteria for posttraumatic stress disorder according to their own reports. Many of the caretakers were unaware of their child's psychological distress. Four of the mothers exhibited posttraumatic stress disorder, and their symptoms predicted their child's mental health.Pediatricians are sometimes the first and only contacts these families have with health care providers. Caretakers' reports of children's mental health are often incomplete. It is therefore important for physicians to probe for ""hidden"" symptoms in refugee children. These family members may need referrals to social and psychological services, and pediatricians can open the gates to existing community networks of support. Because we found that maternal mental health influences the child's, the child's interests are well served when pediatricians also encourage the mother to contact services for herself if she confides that she is experiencing some of the severe psychological sequelae reported by the women in this study.",0,0 +2711,Hormone profiles in humans experiencing military survival training,"Clinical models of the human response to intense, acute stress have been limited to laboratory settings or cross sectional characterizations. As a result, data about the sensitivity of the human neuroendocrine activation to realistic stressors of varying magnitudes are limited. The U.S. Army survival course offers a unique opportunity to examine, in a controlled manner, the human response to acute, realistic, military stress.Salivary data were collected in 109 subjects at baseline during four stress exposure time points and at recovery. Serum data was collected at baseline and recovery in 72 subjects and at baseline and during stress exposure in a subgroup of subjects (n = 21).Cortisol significantly increased during the captivity experience and was greatest after subjects' exposure to interrogations. Cortisol remained significantly elevated at recovery. Testosterone was significantly reduced within 12 hours of captivity. Reductions of both total and free T4 and of total and free T3 were observed, as were increases in thyrotropin.The stress of military survival training produced dramatic alterations in cortisol, percent free cortisol, testosterone, and thyroid indices. Different types of stressors had varying effects on the neuroendocrine indices. The degree of neuroendocrine changes observed may have significant implications for subsequent responses to stress.",0,0 +2712,Interpersonal Subtypes and Therapy Response in Patients Treated for Posttraumatic Stress Disorder,"Interpersonal traits may influence psychotherapy success. One way of conceptualizing such traits is the interpersonal circumplex model. In this study, we analyse interpersonal circumplex data, assessed with the Inventory of Interpersonal Problems (Horowitz, Strauß, & Kordy, 1994) from a randomized study with 138 patients suffering from posttraumatic stress disorder after trauma in adulthood. The study compared cognitive processing therapy and dialogical exposure therapy, a Gestalt-based intervention. We divided the interpersonally heterogeneous sample according to the quadrants of the interpersonal circumplex. The division into quadrants yielded subgroups that did not differ in their general psychological distress, but the cold-submissive quadrant tended to exhibit higher posttraumatic stress disorder symptom severity and interpersonal distress than the other three. There was also a trend for patients in different quadrants to be affected differently by the treatments. Correlation analyses supported these results: in cognitive processing therapy, more dominant patients had more successful therapies, while in dialogical exposure therapy, success was not correlated with interpersonal style. Results indicate that especially patients with cold interpersonal styles profited differentially from the two treatments offered. Dividing samples according to the interpersonal circumplex quadrants seems promising. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message: Interpersonal traits may contribute to psychotherapy outcome. Dividing the sample according to the quadrants of the interpersonal circumplex, as opposed to cluster analysis, yielded promising results. Patients higher in dominance fared better with cognitive processing therapy, while interpersonal style had no correlations with therapy success in dialogical exposure therapy.",0,0 +2713,"Mental Health, Demographic, and Risk Behavior Profiles of Pregnant Survivors of Childhood and Adult Abuse","Our objective was to address the gap in knowledge about the extent to which perinatal mental health and risk behaviors are associated with childhood and adult experiences of abuse that arises because of barriers to screening and disclosure about past and current abuse. Survey data from an ongoing study of the effects of posttraumatic stress on childbearing were used to describe four groups of nulliparous women: those with no abuse history, adult abuse only, childhood abuse only, and abuse that occurred during both periods. The rates of abuse history disclosure were higher in the research context than in the clinical settings. Mental health morbidity and risk behaviors occurred in a dose-response pattern with cumulative abuse exposure. Rates of current posttraumatic stress disorder ranged from 4.1% among those never abused to 11.4% (adult only), 16.0% (childhood only), and 39.2% (both periods). Women abused during both periods also were more likely to be using tobacco (21.5%) and drugs (16.5%) during pregnancy. We conclude that mental health and behavioral risk sequelae affect a significant portion of both childhood and adult abuse survivors in prenatal care. The integration into the maternity setting of existing evidence-based interventions for the mental health and behavioral sequelae of abuse is needed.",0,0 +2714,"Combat, dissociation, and posttraumatic stress disorder in Australian Vietnam veterans","The specificity of various wartime stressors for different posttraumatic stress disorder (PTSD) symptoms is inconsistently reported in the literature. Combat, wounding, and peritraumatic dissociation have not been assessed together in their effects on each of the various PTSD symptom clusters. This cohort study of a random sample of male Australian Army Vietnam veterans yielded psychiatric assessments of 641 subjects. PTSD measures comprised symptom criteria for reexperiencing, numbing and avoidance, hyperarousal, and PTSD diagnosis both lifetime and current within the past month. Logistic regression is used to examine the effects of combat, wounding, and peritraumatic dissociation together on PTSD. Combat experiences comprised four components derived from a principal components analysis of combat experiences: direct combat exposure, exposure to death and injury, exposure to civilian death and injury, and exposure to mutilation. Each was differentially related to reexperiencing, avoidance, hyperarousal, and PTSD diagnosis. Being wounded was not related to lifetime or current PTSD and peritraumatic dissociation was related to all diagnostic components of PTSD in the presence of other variables.",0,0 +2715,Attachment insecurities and the processing of threat-related information: Studying the schemas involved in insecure people's coping strategies.,"In 6 studies we examined procedural, scriptlike knowledge associated with 2 different kinds of attachment insecurity: anxiety and avoidance. The studies examined associations between attachment insecurities, the cognitive accessibility of sentinel and rapid fight-flight schemas, and the extent to which these schemas guide the processing of threat-related information and actual behavior during an experimentally induced threatening event. Anxious attachment was associated with (a) greater accessibility of the sentinel schema in narratives of threatening events; (b) faster, deeper, and more schema-biased processing of information about components of the sentinel schema; and (c) quicker detection of a threat. Avoidant attachment was associated with greater accessibility of the rapid fight-flight schema in narratives of threatening events and faster, deeper, and more schema-biased processing of information about components of the schema. We discuss implications of the findings for understanding the cognitive aspects of insecure people's coping strategies in threatening situations, as well as the potential benefits of these strategies to the people who enact them and to the groups to which they belong.",0,0 +2716,A Typology of Psychiatric Reactions to Motor Vehicle Accidents,"Perhaps owing to their commonness, nonserious motor vehicle accidents, i.e. those not resulting in death or major bodily injury, have received scant systematic study in the psychiatric literature. However, patients presenting with lingering psychiatric distress following such accidents are seen commonly in practice. The authors reviewed the patterns of presentation and background circumstances in a series of 55 such cases, presenting at varying periods of time after the incident. They found such patients to cluster into four distinct groups. The most common presentation was that of a depressive syndrome, outnumbering those with features of posttraumatic stress disorder by 3:1.",0,0 +2717,Natural Course of Posttraumatic Stress Disorder: A 20-Month Prospective Study of Turkish Earthquake Survivors,"Objective: A 20-month prospective follow-up of survivors of the severe earthquake in Turkey in 1999 examined the natural course of posttraumatic stress disorder (PTSD) and the contribution of different symptom clusters to the emergence of PTSD. Method: Subjects were randomly sampled in a suburb of Istanbul that was severely affected by the earthquake. A total of 464 adults were assessed with a self-report instrument for PTSD symptoms on 3 consecutive surveys that were administered 1 to 3, 6 to 10, and 18 to 20 months following the earthquake. Results: The prevalence of PTSD was 30.2% on the first survey and decreased to 26.9% and 10.6% on the second and third surveys, respectively. Female subjects showed initially higher (34.8%) PTSD rates compared with male subjects (19.1%). However, gender differences disappeared by the time of the third survey due to high spontaneous remission rates in female subjects. Low levels of chronic and delayed-onset PTSD were observed. A major contribution of the avoidance symptoms to PTSD diagnosis was identified by statistical analysis. Conclusions: Initial PTSD following an earthquake may be as prevalent as in other natural disasters, but high rates of spontaneous remission lead to low prevalence 1.5 years following the earthquake. Initial avoidance characteristics play a major role in the emergence of PTSD.",0,0 +2718,"The relationship between sense of hope, family support and post-traumatic stress disorder among children: The case of young victims of rocket attacks in Israel","Post-traumatic stress disorder (PTSD) is diagnosed commonly in Israeli children following violent episodes of the ongoing Arab–Israeli conflict. Research has suggested that as many as 70% of war-affected children present symptoms of PTSD. This study examined two factors that may contribute to resiliency: perceived social support and sense of hope. The research participants (n = 311) were children who experienced the rocket attacks during Israel's Second Lebanon War and a control group of Israeli children from a town that was not affected directly by the 2006 war. It was hypothesized that a complex relationship would be demonstrated between presentation of symptoms of PTSD and perceived social support. It was hypothesized further that an inverse relationship would be measured between sense of hope and presentation of symptoms of PTSD in the children who experienced the rocket attacks and that those in the control group would show less symptoms of PTSD than those in the experimental group. Finally, females ...",0,0 +2719,Do compensation processes impair mental health? A meta-analysis,"Victims who are involved in a compensation processes generally have more health complaints compared to victims who are not involved in a compensation process. Previous research regarding the effect of compensation processes has concentrated on the effect on physical health. This meta-analysis focuses on the effect of compensation processes on mental health.Prospective cohort studies addressing compensation and mental health after traffic accidents, occupational accidents or medical errors were identified using PubMed, EMBASE, PsycInfo, CINAHL, and the Cochrane Library. Relevant studies published between January 1966 and 10 June 2011 were selected for inclusion.Ten studies were included. The first finding was that the compensation group already had higher mental health complaints at baseline compared to the non-compensation group (standardised mean difference (SMD)=-0.38; 95% confidence interval (CI) -0.66 to -0.10; p=.01). The second finding was that mental health between baseline and post measurement improved less in the compensation group compared to the non-compensation group (SMD=-0.35; 95% CI -0.70 to -0.01; p=.05). However, the quality of evidence was limited, mainly because of low quality study design and heterogeneity.Being involved in a compensation process is associated with higher mental health complaints but three-quarters of the difference appeared to be already present at baseline. The findings of this study should be interpreted with caution because of the limited quality of evidence. The difference at baseline may be explained by a selection bias or more anger and blame about the accident in the compensation group. The difference between baseline and follow-up may be explained by secondary gain and secondary victimisation. Future research should involve assessment of exposure to compensation processes, should analyse and correct for baseline differences, and could examine the effect of time, compensation scheme design, and claim settlement on (mental) health.",0,0 +2720,A Meta-Analysis of Risk Factors for Combat-Related PTSD among Military Personnel and Veterans,"Post-traumatic stress disorder (PTSD), a complex and chronic disorder caused by exposure to a traumatic event, is a common psychological result of current military operations. It causes substantial distress and interferes with personal and social functioning. Consequently, identifying the risk factors that make military personnel and veterans more likely to experience PTSD is of academic, clinical, and social importance. Four electronic databases (PubMed, Embase, Web of Science, and PsycINFO) were used to search for observational studies (cross-sectional, retrospective, and cohort studies) about PTSD after deployment to combat areas. The literature search, study selection, and data extraction were conducted by two of the authors independently. Thirty-two articles were included in this study. Summary estimates were obtained using random-effects models. Subgroup analyses, sensitivity analyses, and publication bias tests were performed. The prevalence of combat-related PTSD ranged from 1.09% to 34.84%. A total of 18 significant predictors of PTSD among military personnel and veterans were found. Risk factors stemming from before the trauma include female gender, ethnic minority status, low education, non-officer ranks, army service, combat specialization, high numbers of deployments, longer cumulative length of deployments, more adverse life events, prior trauma exposure, and prior psychological problems. Various aspects of the trauma period also constituted risk factors. These include increased combat exposure, discharging a weapon, witnessing someone being wounded or killed, severe trauma, and deployment-related stressors. Lastly, lack of post-deployment support during the post-trauma period also increased the risk of PTSD. The current analysis provides evidence of risk factors for combat-related PTSD in military personnel and veterans. More research is needed to determine how these variables interact and how to best protect against susceptibility to PTSD.",0,0 +2721,"Associations of adult separation anxiety disorder with conflict-related trauma, ongoing adversity, and the psychosocial disruptions of mass conflict among West Papuan refugees.","Refugees commonly experience traumatic events that threaten the self and close others, suggesting the possibility that they may experience overlapping symptoms of posttraumatic stress disorder (PTSD) and separation anxiety disorder (SAD). We examine this possibility among West Papua refugees (n = 230) displaced to Port Moresby, Papua New Guinea. We also examine associations between the combined PTSD-SAD construct and indices of past trauma exposure, ongoing adversity, and the psychosocial disruptions caused by mass conflict and displacement. We applied culturally adapted interview modules to assess symptoms of PTSD, SAD, traumatic events (TEs), ongoing adversity, and 5 psychosocial dimensions. Latent class analysis identified a PTSD class (23%), a posttraumatic (PT) SAD class (22%), and a low-symptom class (55%). Compared with the low-symptom class, both the PTSD and PT-SAD classes endorsed higher levels of exposure to all domains of TEs (conflict-related trauma, witnessing murder, childhood related adversities, traumatic losses, and health stress) and ongoing adversity (access to health care, displacement/separation, safety in the community, and access to basic needs), but the 2 comorbid groups did not differ on these indices. The PT-SAD class alone scored higher than the low-symptom reference class in relation to disruptions to the psychosocial domains (safety/security, bonds/network, access to justice, roles/identities, existential meaning) and higher than the PTSD class on safety/security, justice and roles/identities. Our findings suggest that the PT-SAD pattern may represent a response to the most severe forms of psychosocial disruptions of mass conflict among refugees. A focus on separation anxiety may enhance psychotherapies designed to treat PTSD in refugees. (PsycINFO Database Record",0,0 +2722,Childhood maltreatment is associated with distinct genomic and epigenetic profiles in posttraumatic stress disorder,"Childhood maltreatment is likely to influence fundamental biological processes and engrave long-lasting epigenetic marks, leading to adverse health outcomes in adulthood. We aimed to elucidate the impact of different early environment on disease-related genome-wide gene expression and DNA methylation in peripheral blood cells in patients with posttraumatic stress disorder (PTSD). Compared with the same trauma-exposed controls ( n = 108), gene-expression profiles of PTSD patients with similar clinical symptoms and matched adult trauma exposure but different childhood adverse events ( n = 32 and 29) were almost completely nonoverlapping (98%). These differences on the level of individual transcripts were paralleled by the enrichment of several distinct biological networks between the groups. Moreover, these gene-expression changes were accompanied and likely mediated by changes in DNA methylation in the same loci to a much larger proportion in the childhood abuse (69%) vs. the non-child abuse-only group (34%). This study is unique in providing genome-wide evidence of distinct biological modifications in PTSD in the presence or absence of exposure to childhood abuse. The findings that nonoverlapping biological pathways seem to be affected in the two PTSD groups and that changes in DNA methylation appear to have a much greater impact in the childhood-abuse group might reflect differences in the pathophysiology of PTSD, in dependence of exposure to childhood maltreatment. These results contribute to a better understanding of the extent of influence of differences in trauma exposure on pathophysiological processes in stress-related psychiatric disorders and may have implications for personalized medicine.",0,0 +2723,The Epidemiology of Post-Traumatic Stress Disorder after Disasters,"Traumatic experiences are relatively common. More than two thirds of persons in the general population may experience a significant traumatic event at some point in their lives, and up to one fifth of people in the United States may experience such an event in any given year (1–5). Although comparable international data are limited, large proportions of populations in many countries have been exposed to terrorism, forced relocation, and violence, which suggests that the overall prevalence of exposure to traumatic events worldwide may be even higher than that in the United States (6, 7). Disasters (e.g., floods, transportation accidents) are traumatic events that are experienced by many people and may result in a wide range of mental and physical health consequences (8). In one survey of US residents, 13 percent of the sample reported a lifetime exposure to natural or human-generated disaster (9). In the National Comorbidity Survey, 18.9 percent of men and 15.2 percent of women reported a lifetime experience of a natural disaster (4). Post-traumatic stress disorder (PTSD) is the most commonly studied and probably the most frequent and debilitating psychological disorder that occurs after traumatic events and disasters (8, 10). The growing threat of terrorism worldwide has heightened our awareness of disasters as a potentially important determinant of population health and suggests a pressing need both to identify key areas of consensus in postdisaster research and to highlight areas that require additional study (11). It is our purpose in this review to contribute to this overall goal by comprehensively and systematically assessing the epidemiologic evidence about PTSD after disasters.",0,0 +2724,The Role of Anxiety Control and Treatment Implications of Informant Agreement on Child PTSD Symptoms,"The goal of this study is to examine parent and child agreement of child posttraumatic stress disorder (PTSD) symptoms pre- and posttreatment, as well as potential moderators of agreement including treatment responder status, child anxiety control, and parent self-reported PTSD symptoms. We examined child self-reported and parent-reported child PTSD symptoms from the Diagnostic Interview Schedule for Children. Of the 141 parent-child pairs, the mean age of children was 12.72 (SD = 3.40), 53% were female, and 54% were Black. A subsample of participants (n = 47) was assessed after completion of a cognitive behavioral therapy treatment for PTSD. Moderate levels of agreement were found at baseline, though Criterion D (increased arousal) symptoms had lower levels of agreement than the other symptom clusters. Symptom agreement was lower at posttreatment. Treatment responders had higher levels of baseline informant agreement than treatment nonresponders. Child perceived anxiety control significantly moderated informant agreement, such that pairs with children who had high levels of perceived control of their anxiety had lower PTSD symptom agreement where children reported lower symptoms relative to their parents. Contrary to expectations, parent self-reported PTSD did not moderate parent-child symptom agreement. Factors associated with higher parent-child agreement of child PTSD symptoms were being a PTSD treatment responder and children with lower perceived anxiety control. These findings have potential implications for determining those who may benefit from greater symptom monitoring over the course of intervention and potential alternative intervention approaches.",0,0 +2725,Physiological Reactivity to Cognitive Stressors: Variations by Age and Socioeconomic Status,"The present study focused on age and SES differences in stress reactivity in response to cognitively challenging tasks. Specifically, we assessed within-person trajectories of cortisol, a steroid hormone released by the adrenal gland in response to stressors, before, during, and after exposure to cognitively challenging tasks. We extend the current literature by simultaneously examining age and SES differences in physiological reactivity. Findings suggest that age and SES both play an important role in reactivity, such that it was the older adults with higher SES who were the most physiologically reactive to cognitive stressors. Implications of these findings for cognitive aging research are discussed.",0,0 +2726,Multimodal PTSD characterization via the StartleMart game,"Computer games have recently shown promise as a diagnostic and treatment tool for psychiatric rehabilitation. This paper examines the potential of combining multiple modalities for detecting affective responses of patients interacting with a simulation built on game technology, aimed at the treatment of mental diagnoses such as post traumatic stress disorder (PTSD). For that purpose, we couple game design and game technology to create a game-based tool for exposure therapy and stress inoculation training that utilizes stress detection for the automatic profiling and potential personalization of PTSD treatments. The PTSD treatment game we designed forces the player to go through various stressful experiences while a stress detection mechanism profiles the severity and type of PTSD by analyzing the physiological responses to those in-game stress elicitors in two separate modalities: skin conductance (SC) and blood volume pulse (BVP). SC is often used to monitor stress as it is connected to the activation of the sympathetic nervous system (SNS). By including BVP into the model we introduce information about para-sympathetic activation, which offers a more complete view of the psycho-physiological experience of the player; in addition, as BVP is also modulated by SNS, a multimodal model should be more robust to changes in each modality due to particular drugs or day-to-day bodily changes. Overall, the study and analysis of 14 PTSD-diagnosed veteran soldiers presented in this paper reveals correspondence between diagnostic standard measures of PTSD severity and SC and BVP responsiveness and feature combinations thereof. The study also reveals that these features are significantly correlated with subjective evaluations of the stressfulness of experiences, represented as pairwise preferences. More importantly, the results presented here demonstrate that using the modalities of SC and BVP captures a more nuanced representation of player stress responses than using SC alone. We conclude that the results support the use of the simulation as a relevant treatment tool for stress inoculation training, and suggest the feasibility of using such a tool to profile PTSD patients. The use of multiple modalities appears to be key for an accurate profiling, although further research and analysis are required to identify the most relevant physiological features for capturing user stress.",0,0 +2727,Errors in self-report of post-traumatic stress disorder after severe traumatic brain injury,"Assessing PTSD by questionnaire can lead to false positive diagnosis after severe traumatic brain injury. Sumpter and McMillan, reported quantitative data on 34 people with severe TBI; 59% were PTSD 'cases' by questionnaire assessment, but only 3% using a structured interview. The present paper describes ways in which these individuals made errors on questionnaires. Some did not follow questionnaire instructions because of inattention and concrete thinking or instead reported effects of brain injury. Symptom overlap between TBI and PTSD, including insomnia, irritability and impaired concentration can cause errors. Brain injury can also provoke curiosity about loss of memory (during coma, retrograde and post-traumatic amnesia), decreased participation, social withdrawal and difficulty adjusting to injury that may be mistaken for fear-associated PTSD symptoms. Assessment of PTSD by questionnaire can lead to erroneous conclusions and factors related to brain injury must be carefully considered when investigating PTSD.",0,0 +2728,Dysregulation in microRNA Expression Is Associated with Alterations in Immune Functions in Combat Veterans with Post-Traumatic Stress Disorder,"While the immunological dysfunction in combat Veterans with post-traumatic stress disorder (PTSD) has been well documented, the precise mechanisms remain unclear. The current study evaluated the role of microRNA (miR) in immunological dysfunction associated with PTSD. The presence of peripheral blood mononuclear cells (PBMC) and various lymphocyte subsets in blood collected from PTSD patients were analyzed. Our studies demonstrated that the numbers of both PBMC and various lymphocyte subsets increased significantly in PTSD patients. When T cells were further analyzed, the percentage of Th1 cells and Th17 cells increased, regulatory T cells(Tregs) decreased, while Th2 cells remained unaltered in PTSD patients. These data correlated with increased plasma levels of IFN-γ and IL-17 while IL-4 showed no significant change. The increase in PBMC counts, Th1 and Th17 cells seen in PTSD patients correlated with the clinical scores. High-throughput analysis of PBMCs for 1163 miRs showed that the expression of a significant number of miRs was altered in PTSD patients. Pathway analysis of dysregulated miRs seen in PTSD patients revealed relationship between selected miRNAs and genes that showed direct/indirect role in immunological signaling pathways consistent with the immunological changes seen in these patients. Of interest was the down-regulation of miR-125a in PTSD, which specifically targeted IFN-γ production. Together, the current study demonstrates for the first time that PTSD was associated with significant alterations in miRNAs, which may promote pro-inflammatory cytokine profile. Such epigenetic events may provide useful tools to identify potential biomarkers for diagnosis, and facilitate therapy of PTSD.",0,0 +2729,Dopamine D2 receptor (DRD2) gene and susceptibility to posttraumatic stress disorder: A study and replication,"Subjects on an addiction treatment unit who had been exposed to severe combat conditions in Vietnam were screened for posttraumatic stress disorder (PTSD). Of 24 with PTSD, 58.3% carried the D2A1 allele. Of the remaining eight who did not meet PTSD criteria, 12.5% carried the D2A1 allele (p = 0.04). In a replication study of 13 with PTSD, 61.5% carried the D2A1 allele. Of the remaining 11 who did not meet criteria for PTSD, 0% carried the D2A1 allele (p = 0.002). For the combined group 59.5% of those with PTSD carried the D2A1 allele versus 5.3% of those who did not have PTSD (p = 0.0001). These results suggest that a DRD2 variant in linkage disequilibrium with the D2A1 allele confers an increased risk to PTSD, and the absence of the variant confers a relative resistance to PTSD.",0,0 +2730,"Incidence, clinical correlates and treatment effect of rage in anxious children","Episodic rage represents an important and underappreciated clinical feature in pediatric anxiety. This study examined the incidence and clinical correlates of rage in children with anxiety disorders. Change in rage during treatment for anxiety was also examined. Participants consisted of 107 children diagnosed with an anxiety disorder and their parents. Participants completed structured clinical interviews and questionnaire measures to assess rage, anxiety, functional impairment, family accommodation and caregiver strain, as well as the quality of the child's relationship with family and peers. Rage was a common feature amongst children with anxiety disorders. Rage was associated with a more severe clinical profile, including increased anxiety severity, functional impairment, family accommodation and caregiver strain, as well as poorer relationships with parents, siblings, extended family and peers. Rage was more common in children with separation anxiety, comorbid anxiety, attention deficit/hyperactivity disorder and behavioral disorders, but not depressive symptoms. Rage predicted higher levels of functional impairment, beyond the effect of anxiety severity. Rage severity reduced over treatment in line with changes in anxiety symptoms. Findings suggest that rage is a marker of greater psychopathology in anxious youth. Standard cognitive behavioral treatment for anxiety appears to reduce rage without adjunctive treatment.",0,0 +2731,Shortening the CES–D to improve its ability to detect cases of depression.,"Psychometric analyses evaluated how primary care patients with and without major depressive disorder endorsed individual response options on the Center for Epidemiologic Studies-Depression Scale (CES-D; L. S. Radloff, 1977). The analyses were then used to identify a subset of items that when appropriately weighted improved the efficiency with which depressed individuals were identified. Efficiency of the revised measure was evaluated relative to standard cutpoints used with the full scale. Results showed that some improvement in most indices of efficiency could be achieved with half as many items and a simplified scoring scheme, but great improvement in one measure was usually achieved only at the expense of other measures of efficiency. The efficiency of the CES-D can be improved with appropriate analytic techniques, but its limitations as a self-report screening measure persist.",0,0 +2732,Trauma amid ‘culture of avoidance’: Symptom profile of PTSD in Bedouin members of the Israel Defense Forces,"The appropriateness and cultural relevance of the construct of posttraumatic stress disorder (PTSD) has been questioned by previous studies of non-Western populations. The current study examined the symptom profile of PTSD in an ethnic minority group of Bedouin members of the Israel Defense Forces (N=317). Comparing individuals with PTSD to traumatized individuals without PTSD, we identified a pattern of symptoms that differed between the groups: while symptoms from the re-experiencing cluster were those most frequently reported by the PTSD group, avoidance symptoms were the most frequently reported by the traumatized group without PTSD. Our findings highlight the role of sociocultural considerations in the development of trauma-related problems and the special meaning of avoidant strategies for traumatized individuals from non-Western backgrounds.",0,0 +2733,Anxiety sensitivity taxon and trauma: discriminant associations for posttraumatic stress and panic symptomatology among young adults,"The present investigation examined whether the anxiety sensitivity (AS) taxon interacts with theoretically relevant traumatic types of aversive life events to show discriminant (concurrent) associations with posttraumatic stress symptoms, but not panic attacks or bodily vigilance among young adults. The interaction between the AS Taxon Scale and trauma exposure accounted for significant variance above and beyond negative affectivity and each of the main effects in terms of a posttraumatic stress disorder (PTSD) symptom-severity criterion variable, but not for posttraumatic-related thoughts and beliefs or either panic-relevant criterion variable. Thus, results suggest that although the AS taxon may function as a common cognitive diathesis for PTSD and panic outcomes, the AS taxon coupled with traumatic life events may confer emotional vulnerability that is specific to PTSD symptoms. These findings are discussed in terms of theoretical and clinical implications for PTSD and panic vulnerability.",0,0 +2734,A Brief Retrospective Method for Identifying Longitudinal Trajectories of Adjustment Following Acute Stress,"Research increasingly indicates that prototypical trajectories of resilience, recovery, delayed, and chronic distress characterize reactions to acute adversity. However, trajectory research has been limited by the practical and methodological difficulties of obtaining pre-event and longitudinal data. In two studies, we employed a novel method in which trained interviewers provided a graphical depiction of prototypical stress trajectories to participants and asked them to select the one that best described their experience. In Study 1, self-identified trajectories from 21 high-exposure survivors of the September 11th World Trade Center attacks distinguished variation in posttraumatic stress disorder and depression symptoms at 7 and 18 months, and were consistent with trajectories based on longitudinal outcomes and friend/relative ratings. In Study 2, we examined self-identified trajectories from 115 bereaved spouses at 1.5 to 3 years. Persons who identified a resilient trajectory, compared with recovery and chronic distress trajectories, had fewer interviewer-rated symptoms of grief, depression, and posttraumatic stress disorder were rated as functioning more effectively by friends, reported higher life satisfaction, and had fewer somatic complaints. The present results provide initial evidence for the construct validity of a cross-sectional and less demanding method for identifying acute stress trajectories.",0,0 +2735,Nonpathological response to ongoing traumatic stress.,"For individuals faced with ongoing traumatic stress, a range of adverse reactions are possible. Carrying over models from acute trauma, developed for soldiers suffering months and years after returning from combat, and for victims of rape and other community violence, most psychological literature emphasizes psychopathological syndromes, especially posttraumatic stress disorder (PTSD). The implicit assumption is that reactions that entail significant suffering must be explained by a diagnosable disorder. Ironically, this locates the mechanisms that explain ongoing suffering within the mind of the victim rather than in the stressful context in which s/he is forced to live. We present a description and venture theoretical consideration of an alternative phenomenon, which we refer to as ongoing traumatic stress response (OTSR). OTSR is not a diagnosis nor label, but an alternative framework through which to make sense of intense psychological suffering in the increasingly common situation of ongoing traumatic stress. In this article, we consider conceptual boundaries that distinguish pathologic reactions such as PTSD from nonpathologic reactions better captured by OTSR. We draw a distinction between PTSD, which is conceptualized as a disorder because it is driven primarily by internal psychological effects of a past trauma, and OTSR, which is determined by real and external environmental factors in the present. To illustrate these boundaries, we provide examples of how experiences and behaviors that may appear to reflect symptoms of PTSD or other disorders are actually adaptive and normative under extreme conditions, despite their causing clinical levels of distress. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +2736,Neurobiology of suicidal behavior in post-traumatic stress disorder,"Posttraumatic stress disorder (PTSD) is a frequent and severe disorder that can develop after exposure to a traumatic event. People with PTSD suffer from a range of symptoms that interfere with their capacities to enjoy normal life. Post-traumatic stress disorder is frequently comorbid with other psychiatric disorders. Multiple lines of evidence suggest an important relationship between PTSD and suicidal behavior. This association has been observed both in clinical and in general population samples, and is irrespective of the type of trauma that led to PTSD. High rates of suicidal behavior have been found among PTSD patients exposed to combat trauma, physical or sexual abuse, intimate partner violence and natural disasters. Neurobiological changes observed in PTSD include alterations in the hypothalamic–pituitary–adrenal axis, increased noradrenergic activity, and changes in the serotonergic and other neurotransmitter systems. Further studies of the role of the endocannabinoid system in the pathophysiology of PTSD may help to develop new modalities to treat PTSD and suicidal behavior in persons with PTSD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)",0,0 +2737,Race Differences in Depressive Symptoms: A Dynamic Perspective on Stress Exposure and Vulnerability,"The existence, nature, and strength of race differences in mental health remain unclear after several decades of research. In this research, we examine black-white differences in the relationship between acute stressors and depressive symptoms. We reframe the stress exposure and differential vulnerability hypotheses in the context of long-term trajectories of stress and depression, and we hypothesize that trajectories of stress growth will be associated with trajectories of depressive symptom growth. Using latent growth curve analysis of a sample of 1,972 older persons interviewed three times at three-year intervals, we test the hypotheses that (1) growth in exposure to loss-related events will predict growth in depressive symptoms, and (2) African Americans will experience greater stress growth than whites. Results support the hypotheses. Stress growth exhibited a linear increase for blacks but not for whites, and predicted depression growth for both races, but explained more variance for blacks than for whites.",0,0 +2738,Use of khat and posttraumatic stress disorder as risk factors for psychotic symptoms: A study of Somali combatants,"The chewing of the khat leaves, which contain the amphetamine-like cathinone, is a traditional habit in Somalia. Our objective was to explore the effects of khat use and Posttraumatic Stress Disorder (PTSD) on paranoid symptoms and to test a potential causal chain. We report on a cross-sectional study in Somalia that was conducted in 2003. Trained local staff interviewed 8723 personnel of armed groups in seven regional convenience samples. Of them, 8124 were included in the analysis. We assessed current khat use, PTSD symptoms, functional drug use and paranoid ideation using items from the Composite International Diagnostic Interview (CIDI) and the Somali version of the Posttraumatic Stress Diagnostic Scale (PDS). Applying the causal steps approach, in a series of logistic regression models, we used PTSD as independent and paranoia as outcome variable; the quantity of khat use was defined as mediator variable and functional drug use as moderator. The results showed that respondents with PTSD used khat more frequently. Khat chewers with PTSD reported a higher intake compared to khat chewers without PTSD. Among excessive khat chewers with PTSD, paranoia was most frequent. The greatest amount of khat use was among respondents with PTSD who indicated that they found drugs help them to forget war experiences. The proposed mediated moderation model was supported by the data, i.e. besides the direct effects of PTSD and functional drug use on paranoia, the amount of khat use appeared to be a mechanism, by which paranoia is caused. We conclude that in our data we have uncovered a relationship between khat, PTSD and paranoia. Khat is functionally used by respondents with PTSD. Findings support a dose effect: the more khat consumption and when a respondent has PTSD, the higher the odds for paranoid ideation. However, the proposed causal chain needs to be confirmed in longitudinal studies. Demobilization and reintegration programs in Somalia need to be prepared to deal with complex psychological problems.",0,0 +2739,Mitochondrial Gene Expression Profiles and Metabolic Pathways in the Amygdala Associated with Exaggerated Fear in an Animal Model of PTSD,"The metabolic mechanisms underlying the development of exaggerated fear in post-traumatic stress disorder (PTSD) are not well defined. In the present study, alteration in the expression of genes associated with mitochondrial function in the amygdala of an animal model of PTSD was determined. Amygdala tissue samples were excised from 10 non-stressed control rats and 10 stressed rats, 14 days post-stress treatment. Total RNA was isolated, cDNA was synthesized, and gene expression levels were determined using a cDNA microarray. During the development of the exaggerated fear associated with PTSD, 48 genes were found to be significantly upregulated and 37 were significantly downregulated in the amygdala complex based on stringent criteria (p < 0.01). Ingenuity pathway analysis revealed up- or downregulation in the amygdala complex of four signaling networks - one associated with inflammatory and apoptotic pathways, one with immune mediators and metabolism, one with transcriptional factors, and one with chromatin remodeling. Thus, informatics of a neuronal gene array allowed us to determine the expression profile of mitochondrial genes in the amygdala complex of an animal model of PTSD. The result is a further understanding of the metabolic and neuronal signaling mechanisms associated with delayed and exaggerated fear.",0,0 +2740,Posttraumatic stress disorder in veterans with spinal cord injury: Trauma-related risk factors,"Trauma-related risk factors for posttraumatic stress disorder (PTSD) were examined in a sample of 125 veterans with spinal cord injury. Category of injury was found to be the most consistent predictor of PTSD diagnosis and symptom severity with paraplegia predicting more PTSD symptoms than quadriplegia. The occurrence of a head injury at the time of the trauma was found to predict PTSD symptom severity measures, but not PTSD diagnosis. Trauma recency consistently predicted Impact of Event score (IES) and was found to be related to current PTSD severity and lifetime PTSD diagnosis in multiple but not simple regression models. Trauma severity was found to be significantly related to self-reported PTSD symptoms and lifetime PTSD diagnosis in simple but not in multiple regression analyses. Type of trauma, alcohol or other drug (AOD) use during the trauma and loss of consciousness (LOC) during the trauma were not consistently associated with PTSD symptom severity or diagnosis.",0,0 +2741,Epidemiological risk factors for trauma and PTSD.,,0,0 +2742,Elucidating the transdiagnostic dimensional structure of trauma-related psychopathology: Findings from VA cooperative study 504 – risperidone treatment for military service related chronic post traumatic stress disorder,"Three of the most common trauma-related mental disorders—posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD)—are highly comorbid and share common transdiagnostic symptom dimensions of threat (i.e., fear) and loss (i.e., dysphoria) symptomatology. However, empirical evaluation of the dimensional structure of component aspects of these disorders is lacking. Using structured clinical interview data from U.S. military veterans with chronic military-related PTSD, we evaluated the transdiagnostic dimensional structure of PTSD, MDD, and GAD symptoms. We then examined the relationship between the best-fitting transdiagnostic model of these symptoms, and measures of physical and mental functioning, and life satisfaction and well-being. Exploratory factor analysis revealed that a 3-factor transdiagnostic model comprised of loss (i.e., dysphoria), threat (i.e., anxious arousal, re-experiencing, and avoidance symptoms), and somatic anxiety (i.e., physiological manifestations of anxiety) symptoms provided the best representation of trauma-related PTSD, MDD, and GAD symptoms. Somatic anxiety symptoms were independently associated with physical functioning, while loss symptoms were independently associated with mental functioning and life satisfaction and well-being. Evaluation of study aims in a relatively homogeneous sample of veterans with chronic, military-related PTSD. Results of this study suggest that a 3-factor transdiagnostic model best characterizes the dimensional structure of PTSD, MDD, and GAD symptoms in military veterans with chronic military-related PTSD. This model evidenced external validity in demonstrating differential associations with measures of physical and mental functioning, and life satisfaction and well-being. Results provide support for emerging contemporary models of psychopathology, which emphasize transdiagnostic and dimensional conceptualizations of mental disorders. Such models may have utility in understanding the functional status of trauma survivors.",0,0 +2743,Psychopathology and resilience following traumatic injury: A latent growth mixture model analysis.,"To investigate trajectories of PTSD and depression following traumatic injury using latent class growth curve modeling.A longitudinal study of 330 injured trauma survivors was conducted and participants were assessed during hospitalization, and at 1, 3, and 6 months follow-up. Acute Stress Disorder (ASD) was assessed during hospitalization using the Acute Stress Disorder Interview (ASD-I), PTSD was measured at all follow-up with the Post-Traumatic Stress Diagnostic Scale (PDS) and depression was measured at hospitalization with the (BSI) and at follow-up with the Center for Epidemiologic Studies Depression Scale (CESDS). Covariates were explored, including coping self-efficacy, anger, education level, and mechanism of injury.Four latent classes were identified for PTSD and Depression symptoms: chronic distress, delayed distress, recovered, and resilience. When compared to the resilient group, individuals with chronic distress were more likely to have been assaulted, had higher levels of anger, and had less coping self-efficacy. The delayed distress group had lower education levels, higher levels of coping self-efficacy, and higher levels of anger. Individuals in the recovered group had fewer years of education, and higher levels of anger.The majority of the injured trauma sample demonstrated resiliency, with those exhibiting distress doing so as a delayed, chronic, or recovered trajectory. Coping self efficacy, education, assaultive trauma type, and anger were important covariates of depression and PTSD trajectories. These results are similar to studies of individuals who experienced a major health threat and with survivors from the World Trade Center attacks in the U.S.",1,0 +2744,"Severity, timing, and duration of reactions to trauma in the population: an example from Mexico","Normative data describing acute reactions to trauma are few. Of 2509 Mexican adults interviewed with the Composite International Diagnostic Interview, 1241 met trauma exposure criteria for index events occurring more than 1 year previously. The modal response, describing 45%, was a reaction to trauma that was mild (present but below levels of posttraumatic stress disorder symptom criteria), immediate (within the first month), and transient (over within a year). Nonetheless, 29% experienced immediate and serious reactions. Of these, 44% had chronic posttraumatic stress disorder symptoms. Those whose reactions were serious and chronic differed in many ways from those whose reactions were serious but transient. They had more traumatic events during their lives, and their index events were more likely to have occurred in childhood and to have involved violence. They had more symptoms and functional impairment after the trauma and higher levels of depressive and somatic symptoms when data were collected. Psychiatrically significant reactions to trauma persist often enough to justify their detection and treatment. Persons in need of acute intervention can be identified on the basis of the nature and severity of the initial response as well as characteristics of the stressor.",0,0 +2745,Positive symptoms of psychosis in posttraumatic stress disorder,"The possible presence of hallucinations and delusional thoughts in posttraumatic stress disorder (PTSD) was investigated. Other symptom clusters were also assessed in order to further clarify the nature of PTSD. Twenty combat veterans with PTSD were compared to 18 combat veterans without PTSD on symptom rating scales. The subjects with PTSD exhibited a greater degree of depression, anxiety, agitation, anhedonia, and positive symptoms of psychosis than the comparison group. Specifically, the PTSD group manifested increased hallucinations, delusions, and bizarre behavior. Some of these positive symptoms did not appear to be due to reexperiencing of the trauma. The groups were not significantly different on indices of mania, thought disorder, or inertia. The clinical and diagnostic implications of the results are discussed. A diagnosis of PTSD should be considered with patients who have positive symptoms in the absence of thought disorder.",0,0 +2746,The dynamics of cumulative trauma and trauma types in adults patients with psychiatric disorders: Two cross-cultural studies.,There is an intricate divide between three major valid paradigms in studying traumatic processes: The psychiatric paradigm that focused mostly on the survival types of traumas and on posttraumatic ...,0,0 +2747,Individual differences in posttraumatic stress disorder symptom profiles in Holocaust survivors in concentration camps or in hiding,"Symptom patterns were compared between Holocaust survivors in concentration camp (n = 70) and those who were in 'hiding' (n = 30) during the war. The impact of age at the time of the trauma, gender, and cumulative lifetime stress, and the effect of each of these variables controlling for the others, on posttraumatic stress disorder (PTSD) symptoms were also evaluated. A significant negative relationship between age at the time of the trauma and symptoms of psychogenic amnesia, hypervigilence and emotional detachment, and a positive correlation between age and intrusive thoughts, were observed. Cumulative lifetime stress was positively associated with symptoms of avoidance. The study provides the first empirical data regarding the factors that potentially explain individual differences in PTSD symptom patterns in Holocaust survivors.",0,0 +2748,Pharmacotherapy for post-traumatic stress disorder: Systematic review and meta-analysis,"Pharmacological treatment is widely used for post-traumatic stress disorder (PTSD) despite questions over its efficacy.To determine the efficacy of all types of pharmacotherapy, as monotherapy, in reducing symptoms of PTSD, and to assess acceptability.A systematic review and meta-analysis of randomised controlled trials was undertaken; 51 studies were included.Selective serotonin reuptake inhibitors were found to be statistically superior to placebo in reduction of PTSD symptoms but the effect size was small (standardised mean difference -0.23, 95% CI -0.33 to -0.12). For individual pharmacological agents compared with placebo in two or more trials, we found small statistically significant evidence of efficacy for fluoxetine, paroxetine and venlafaxine.Some drugs have a small positive impact on PTSD symptoms and are acceptable. Fluoxetine, paroxetine and venlafaxine may be considered as potential treatments for the disorder. For most drugs there is inadequate evidence regarding efficacy for PTSD, pointing to the need for more research in this area.",0,0 +2749,Resilience in highly stressed urban children: concepts and findings.,"The Rochester Child Resilience Project is a coordinated set of studies of the correlates and antecedents of outcomes relating to resilience among profoundly stressed urban children. The studies have been conducted over the course of the past decade. Based on child test data, parent, teacher, and self ratings of child adjustment, and in-depth individual interviews with parents and children, a cohesive picture has developed of child and family milieu variables that consistently differentiate children with resilient versus stress-affected outcomes within this highly stressed sample. Resilient children are characterized by an easy temperament and higher IQ; sound parent/child relationships; a parent's sense of efficacy; the parent's own wellness, especially mental health; and the child's perceived competence, realistic control, empathy, and social problem-solving.",0,0 +2750,A novel use for testosterone to treat central sensitization of chronic pain in fibromyalgia patients,"Fibromyalgia is a diffuse chronic pain condition that occurs predominantly in women and may be under-reported in men. Symptoms include a loss of feeling of well-being and generalized widespread flu-like muscle aches and pain that fail to resolve due to central sensitization of nociceptive neurons. It has commonalities with a myriad of other chronic pain conditions which include PTSD, ""Gulf War Syndrome"", and various stress-induced conditions caused, for example, by viral infection, emotional or physical stress, trauma, combat, accident or surgery. It is not understood why some individuals are susceptible to this condition and others are not. White et al., elsewhere in this issue, present a clinical feasibility study designed to test the hypothesis that 1) low or deficient testosterone serum levels are linked to a high risk for an inflamed nociceptive nervous system and resultant chronic pain states, and 2) a testosterone transdermal gel applied once a day by fibromyalgia patients can be an effective therapeutic against chronic pain. Here, a short profile of fibromyalgia is provided along with a brief summary of best practices currently recommended by clinical specialists. The link between testosterone and pain is then discussed, with an overview of scientific studies that lay the foundation for testosterone as a possible important additional therapeutic that has the potential to be safely administered and effective but also avoid the adverse effects of other therapeutics. Finally, novel mechanisms by which testosterone therapy is likely to down-modulate pain signaling are proposed.",0,0 +2751,A focus group study of the impact of trauma exposure in the 9/11 terrorist attacks,"Much of the mental health research that has emerged from the September 11 (9/11) attacks has been focused on posttraumatic stress disorder and its symptoms. To better understand the broader experience of individuals following a disaster, focus groups were conducted with individuals from affected companies both at Ground Zero and elsewhere in New York City.Twenty-one focus groups with a total of 140 participants were conducted in the second post-9/11 year. Areas of identified concern were coded into the following themes: Disaster Experience, Emotional Responses, Workplace Issues, Coping, and Issues of Public Concern.Discussions of focus groups included material represented in all five themes in companies both at Ground Zero and elsewhere. The emphasis and the content within these themes varied between the Ground Zero and other companies. Content suggesting symptoms of PTSD represented only a minority of the material, especially in the company groups not at Ground Zero.This study's findings revealed an array of psychosocial concerns following the 9/11 attacks among employees of companies in New York City that extended far beyond PTSD. This study's results provide further evidence that trauma exposure is central to individuals' post-disaster experience and focus, and to individuals' adjustment and experience after disaster.",0,0 +2752,Unsupervised Fuzzy Clustering Analysis Supports Behavioral Cutoff Criteria in an Animal Model of Posttraumatic Stress Disorder,"Unsupervised fuzzy clustering (UFC) analysis is a mathematical technique that groups together objects in the multidimensional feature space according to a specified similarity measurement, thereby yielding clusters of similar data points that can be represented by a set of prototypes or centroids.Since clinical studies of mental disorders distinguish between affected and unaffected individuals, we designed an inclusion/exclusion criteria (cutoff behavioral criteria [CBC]) approach for animal behavioral studies. The effect of classifying the study population into clearly affected versus clearly unaffected individuals according to behaviors on two behavioral paradigms was statistically significant.Here the raw data from previous studies were subjected to UFC algorithms as a means of objectively testing the validity of the concept of the CBC for our experimental model. The first UFC algorithm yielded two clearly discrete clusters, found to consist almost exclusively of the exposed animals in the one and unexposed animals in the other. The second algorithm yielded three clusters corresponding to animals designated as clearly affected, partially affected, and clearly unaffected. The algorithm for physiological data in addition to behavioral data failed to elicit discrete clusters.The UFC analysis yielded data that support the conceptual contention of the CBC and lends additional validity to our previous behavioral studies.",0,0 +2753,The 5-HTTLPR Polymorphism and Posttraumatic Stress Disorder: A Meta-Analysis,en,0,0 +2754,Prospective predictors of posttraumatic stress disorder symptoms: Direct and mediated relations.,"This study assessed the relations between pretrauma risk (neuroticism, negative affect, prior distress) and protective (self-esteem, optimism) factors and posttraumatic stress disorder (PTSD) symptoms and potential mediators (subjective event-related distress, unsupportive social interactions, perceived control) of those relations. Students (N = 1,528) at four U.S. universities completed online surveys assessing pretrauma risk and protective factors at Time 1 (T1); 84% (N = 1,281) completed a survey 2 months later (T2). PTSD symptoms and the three potential mediators were assessed among those who experienced potentially traumatic events between T1 and T2 (n = 264). PTSD symptoms related to prior traumas were controlled in all analyses. In structural equation modeling (SEM) analyses, the relation between risk factors and PTSD symptoms was mediated by unsupportive social interactions. Protective factors did not independently predict PTSD symptoms when risk factors also were included in the SEM models. Implications for research and practice are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +2755,Implicit and explicit memory in survivors of chronic interpersonal violence.,"We investigated the relationship of implicit and explicit memory to a range of symptoms in a sample of 27 women with exposure to chronic interpersonal violence (IPV). Participants viewed the first 3 letters (""stems"") of trauma-related, general threat, and neutral words; valenced words were matched with neutral words with the same stem. Free recall and a word-stem completion task were used to test explicit and implicit memory, respectively. Participants exhibited increased implicit memory for trauma-related words as compared with both general threat words and neutral ""match"" words. They also showed increased explicit memory for both general threat and trauma-related words. Finally, although neither implicit nor explicit memory was correlated with PTSD symptoms, implicit memory for trauma-related words was significantly correlated with symptoms associated with ongoing IPV. Interpersonal sensitivity, hostility, and alexithymia were significantly correlated with implicit, but not explicit, memory for trauma words. Somatization, dissociation, and alexithymia were negatively correlated with explicit, but not implicit, memory for general-threat words. These findings suggest that memory processes in survivors of IPV are closely related to the symptom profile associated with complex trauma. Exploring memory processes in survivors of IPV may lend unique insight into the development and maintenance of the symptom profile associated with IPV.",0,0 +2756,Gender Differences in Mental Health Diagnoses Among Iraq and Afghanistan Veterans Enrolled in Veterans Affairs Health Care,"Objectives. We examined gender differences in sociodemographic, military service, and mental health characteristics among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans. We evaluated associations between these sociodemographic and service characteristics and depression and posttraumatic stress disorder (PTSD) diagnoses. Methods. In a retrospective, cross-sectional study, we used univariate descriptive statistics and log binominal regression analyses of Department of Veterans Affairs (VA) administrative data on 329 049 OEF and OIF veterans seeking VA health care from April 1, 2002, through March 31, 2008. Results. Female veterans were younger and more likely to be Black and to receive depression diagnoses than were male veterans, who were more frequently diagnosed with PTSD and alcohol use disorders. Older age was associated with a higher prevalence of PTSD and depression diagnoses among women but not among men. Conclusions. Consideration of gender differences among OEF and OIF veterans seeking health care at the VA will facilitate more targeted prevention and treatment services for these newly returning veterans.",0,0 +2757,Household Survey of Psychiatric Morbidity in Cambodia,"Aims: To estimate the prevalence of psychiatric symptoms in the Kampong Cham province and to determine the association between these symptoms and an impaired social functioning. Methods: Cross-sectional cluster sample survey conducted among adults randomly selected within 50 clusters distributed over the province. Results: Of the respondents, 42.4% reported symptoms that met the Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria for depression, 53% displayed high anxiety symptoms and 7.3% met posttraumatic stress disorder (PTSD) criteria. Posttraumatic symptoms of intrusion and avoidance were present in 47.8% and 45.4% respectively. When reviewing comorbidities, 29.2% had depression and anxiety symptoms, 16.5% anxiety symptoms, 6.1% depression and 7.1% had triple comorbidity (PTSD, depression and anxiety). Regarding social functioning, 25.3% reported being socially impaired. Respondents with comorbid symptoms for depression, anxiety and PTSD were associated with an increased risk for social impairment compared with others. Being over 65 years and having experienced violent events were other factors associated with social impairment. Conclusion: Five years after the return of a more stable context in Cambodia, the prevalence of psychiatric symptoms in the community remains high. In addition, these symptoms are strongly associated with social impairment. This suggests that beyond psychosocial programs, the implementation of adapted clinical psychiatric care should be considered as a priority.",0,0 +2758,Psychosocial screening and outcome measurement in paediatric burns services in the UK,Rationale: The British Burn Association Psychosocial Special Interest Group convened a small working party to review available psychosocial screening tools and outcome measures that could be piloted in paediatric burn services across the UK. Psychosocial screening tools can be administered around the time of a child's admission to identify any pre-morbid psychosocial factors known to impact on treatment and/or recovery after a burn. Psychosocial outcome measures can be used to measure the key psychosocial domains shown to be important after a burn injury. Methods: The Working Party therefore made the following recommendations (subsequently endorsed by the wider BBA Psychosocial Special Interest Group membership): 1. Psychosocial screening tool: A wider pilot of a tool developed and piloted in Manchester be carried out. It is designed to be administered by nursing staff as part of the burns integrated care pathway and then reviewed by the psychology service on a weekly basis (or more often if required). It has proven useful in highlighting psychosocial need that support/intervention can then be directed towards. 2. Psychosocial outcome measures: A nullpacknull ofmeasures to be completed at particular time-points during inpatient and outpatient phases was identified. These cover the domains of: child well-being (PTSD; emotional and behavioural well-being and quality of life; pain; appearance concerns) and parental/family well-being. A number of burns services treating children across the UK agreed to pilot these tools and report back. Results: This paper presents the output of the Working Party and preliminary findings from this pilot. It explores: (i) progress around the practicalities of implementing these recommendations; (ii) the information gathered on the profile of the families of children that are being admitted to UK burn services; (iii) whether the screening tool is facilitating greater psychosocial care for families; and (iv) preliminary outcome data for this patient cohort. Conclusion: The paper concludes with lessons learned and recommendations for future directions.,0,0 +2759,"Recent Trends in the Sociodemographic, Clinical Profile and Psychiatric Comorbidity Associated with Posttraumatic Stress Disorder: A Study from Kashmir, India","To estimate the Prevalence of post-traumatic stress disorders (PTSD) among adults in field practise areas of Government Medical College, Srinagar, India.The present study was cross-sectional in nature and was conducted in field practice areas of Government Medical College Srinagar. Three blocks of field practise areas of Government Medical College, Srinagar comprising of various villages were selected. Further 10 per cent of these villages were selected by the method of randomization sampling and then 10 per cent of household were taken again by systemic random sampling. In the selected household all adult population (18 years and above) were selected and screened by using General health questionnaires(GHQ). The patients who screened positive for PTSD (post-traumatic stress Disorders) were assessed and diagnosed. From the line listing the positive cases, the prevalence rates were calculated.Of the total 3400 subjects (age≥18 years), the prevalence of posttraumatic stress disorders among general population was found to be 3.76%. Prevalence was found to be more in females (Chi-square test=2.086, p>0.05 (Insignificant). Most of cases were found to be in the age group 0-40 years. Most of the cases were unmarried, illiterate and belong to lower socioeconomic class. Death of near one comprised the major traumatic event. Acute onset Posttraumatic stress disorder was the commonest type, previous history of psychiatric illness was found in 12 % of patients and drug abuse was present in 22.6%.Our findings clearly indicates that posttraumatic stress disorders (PTSD) is a prevalent disorder in the developing world, especially in disaster prone regions and in areas of political unrest. Resilience to various traumatic events in Kashmir has developed over the years and this might explains the lower prevalence of Post-traumatic disorder (PTSD) in our study.",0,0 +2760,Family and individual factors associated with substance involvement and PTS symptoms among adolescents in greater New Orleans after Hurricane Katrina.,"This study examined the influence of hurricane impact as well as family and individual risk factors on posttraumatic stress (PTS) symptoms and substance involvement among clinically referred adolescents affected by Hurricane Katrina.A total of 80 adolescents (87% male; 13-17 years old; mean age = 15.6 years; 38% minorities) and their parents were interviewed at the adolescent's intake into substance abuse treatment, 16 to 46 months postdisaster. Independent measures included hurricane impact variables (initial loss/disruption and perceived life threat); demographic and predisaster variables (family income, gender, predisaster adolescent substance use, predisaster trauma exposure, and parental substance abuse); postdisaster family factors (parental psychopathology, family cohesion, and parental monitoring); and postdisaster adolescent delinquency.Hierarchical multivariate regression analyses showed that adolescent substance involvement was associated with higher family income, lower parental monitoring (adolescent report), and more adolescent delinquency. Adolescent-reported PTS symptoms were associated with greater hurricane-related initial loss/disruption, lower family cohesion (adolescent report), and more adolescent delinquency, whereas parent-reported adolescent PTS symptoms were associated with greater parental psychopathology, lower parental monitoring (adolescent report), and lower family cohesion (parent report).The results suggest that hurricane impact was related only to adolescent-reported PTS. However, certain postdisaster family and individual risk factors (low family cohesion and parental monitoring, more adolescent delinquency) were associated both with adolescent substance involvement and with PTS symptoms. Identification of these factors suggests directions for future research as well as potential target areas for screening and intervention with substance-abusing adolescents after disasters.",0,0 +2761,"Psychometric Properties of Darryl, a Cartoon Based Measure to Assess Community Violence-Related PTSD in Children","OBJECTIVE: To examine the reliability and validity of Darryl, a cartoon-based measure of PTSD symptoms and a screening tool for identifying children and adolescents with a PTSD diagnosis. METHOD: Exposure to community violence, PTSD symptoms and diagnostic status were assessed in a sample of 49 children and adolescents at an urban outpatient psychiatry clinic. RESULTS: Darryl has good internal consistency for the full scale and adequate reliability for each DSM-IV PTSD symptom cluster. Darryl correlates significantly (r = 0.64, P < 0.001) with the most frequently used measure for assessing PTSD in children (CPTSD-RI). As a screening tool, Darryl has excellent sensitivity and specificity in relationship to the KID-SCID. CONCLUSIONS: In comparison to other child PTSD measures, Darryl has comparable or better psychometric properties and assesses PTSD symptoms in a more developmentally appropriate manner, especially in the domain of community violence. The value of Darryl as a screening tool remains preliminary given the limited number of diagnosed cases of PTSD in the study sample. Full scale efforts at replication are warranted.",0,0 +2762,Phenomenology of Posttraumatic Stress Disorder and Acute Stress Disorder,"This chapter reviews how fear-conditioning models of posttraumatic stress disorder (PTSD) have been bolstered by our growing understanding of neurocircuitry involving the amygdala, hippocampus, and prefrontal cortex. It describes the reexperiencing, avoidant/numbing, and hyperarousal symptom clusters as well as other PTSD diagnostic criteria with specific reference to DSM-IV's changes in the A (A1 and A2) stressor criterion. Associated symptoms (e.g., danger to self or others, intolerance of ongoing stressors, capacity to acquire social support, and risk of reactivation and relapse) are briefly discussed. Longitudinal course, comorbidity, epidemiology, risk factors, and cross-cultural issues are also addressed. Other posttraumatic syndromes described include acute stress disorder, partial/subsyndromal PTSD, and complex PTSD. Finally, clinical issues in assessment are considered. © 2009 by Oxford University Press. All rights reserved.",0,0 +2763,Traumatic memories and pseudomemories in posttraumatic stress disorder,"Intrusive imagery was investigated in survivors of motor vehicle accidents with (a) posttraumatic stress disorder (PTSD) and accurate recall of the trauma, (b) PTSD and amnesia of the trauma, (c) no PTSD, or (d) control participants who simulated PTSD. Imagery was precipitated by presentation of an audiotape of a motor vehicle accident. Whereas the traumatic imagery of participants who had accurate recall of their trauma was consistent with third party accounts of the trauma, the imagery of amnesic participants was inconsistent with these accounts. Participants were then interviewed about cognitive and emotional aspects of their responses. All participants with PTSD and simulators reported similar levels of imagery detail, involuntariness, re-experiencing, and emotional response, and reported higher levels than participants with no PTSD. Findings are discussed in terms of cognitive and contextual factors that can mediate accurate and inaccurate traumatic imagery. © 1998 John Wiley & Sons, Ltd.",0,0 +2764,Effect of Eliminating Compensation for Pain and Suffering on the Outcome of Insurance Claims for Whiplash Injury,"The incidence and prognosis of whiplash injury from motor vehicle collisions may be related to eligibility for compensation for pain and suffering. On January 1, 1995, the tort-compensation system for traffic injuries, which included payments for pain and suffering, in Saskatchewan, Canada, was changed to a no-fault system, which did not include such payments. To determine whether this change was associated with a decrease in claims and improved recovery after whiplash injury, we studied a population-based cohort of persons who filed insurance claims for traffic injuries between July 1, 1994, and December 31, 1995.Of 9006 potentially eligible claimants, 7462 (83 percent) met our criteria for whiplash injury. The six-month cumulative incidence of claims was 417 per 100,000 persons in the last six months of the tort system, as compared with 302 and 296 per 100,000, respectively, in the first and second six-month periods of the no-fault system. The incidence of claims was higher for women than for men in each period; the incidence decreased by 43 percent for men and by 15 percent for women between the tort period and the two no-fault periods combined. The median time from the date of injury to the closure of a claim decreased from 433 days (95 percent confidence interval, 409 to 457) to 194 days (95 percent confidence interval, 182 to 206) and 203 days (95 percent confidence interval, 193 to 213), respectively. The intensity of neck pain, the level of physical functioning, and the presence or absence of depressive symptoms were strongly associated with the time to claim closure in both systems.The elimination of compensation for pain and suffering is associated with a decreased incidence and improved prognosis of whiplash injury.",0,0 +2765,Physiological Employment Standards III: physiological challenges and consequences encountered during international military deployments,"Modern international military deployments in austere environments (i.e., Iraq and Afghanistan) place considerable physiological demands on soldiers. Significant physiological challenges exist: maintenance of physical fitness and body composition, rigors of external load carriage, environmental extremes (heat, cold, and altitude), medical illnesses, musculoskeletal injuries, traumatic brain injuries, post-traumatic stress disorder, and environmental exposure hazards (i.e., burn pits, vehicle exhaust, etc.). To date there is very little published research and no comprehensive reviews on the physiological effects of deployments. The purpose of this paper is to overview what is currently known from the literature related mainly to current military conflicts with regard to the challenges and consequences from deployments. Summary findings include: (1) aerobic capacity declines while muscle strength, power and muscular endurance appear to be maintained, (2) load carriage continues to tax the physical capacities of the Soldier, (3) musculoskeletal injuries comprise the highest proportion of all injury categories, (4) environmental insults occur from both terrestrial extremes and pollutant exposure, and (5) post-deployment concerns linger for traumatic brain injury and post-traumatic stress disorder. A full understanding of these responses will assist in identifying the most effective risk mitigation strategies to ensure deployment readiness and to assist in establishment of military employment standards. © 2013 Springer-Verlag Berlin Heidelberg (outside the USA).",0,0 +2766,Escitalopram reversed the traumatic stress-induced depressed and anxiety-like symptoms but not the deficits of fear memory,"Rationale: Posttraumatic stress disorder (PTSD) is a trauma-induced mental disorder characterised by fear extinction dysfunction in which fear circuit monoamines are possibly associated. PTSD often coexists with depressive/anxiety symptoms, and selective serotonin reuptake inhibitors (SSRIs) are recommended to treat PTSD. However, therapeutic mechanisms of SSRIs underlying the PTSD fear symptoms remain unclear. Objectives: Using a rodent PTSD model, we examined the effects of early SSRI intervention in mood and fear dysfunctions with associated changes of monoamines within the fear circuit areas. Methods: A 14-day escitalopram (ESC) regimen (5 mg/kg/day) was undertaken in two separate experiments in rats which previously received a protocol of single prolonged stress (SPS). In experiment 1, sucrose preference and elevated T-maze were used to index anhedonia depression and avoidance/escape anxiety profiles. In experiment 2, the percentage of freezing time was measured in a 3-day fear conditioning paradigm. At the end of our study, tissue levels of serotonin (5-HT) in the medial prefrontal cortex, amygdala, hippocampus, and striatum were measured in experiment 1, and the efflux levels of infralimbic (IL) monoamines were measured in experiment 2. Results: In experiment 1, ESC corrected both behavioural (depression/anxiety) and neurochemical (reduced 5-HT tissue levels in amygdala/hippocampus) abnormalities. In experiment 2, ESC was unable to correct the SPS-impaired retrieval of fear extinction. In IL, ESC increased the efflux level of 5-HT but failed to reverse SPS-reduced dopamine (DA) and noradrenaline (NA). Conclusions: PTSD-induced mood dysfunction is psychopathologically different from PTSD-induced fear disruption in terms of disequilibrium of monoamines within the fear circuit areas. © 2016 Springer-Verlag Berlin Heidelberg",0,0 +2767,Does Opiate Use in Traumatically Injured Individuals Worsen Pain and Psychological Outcomes?,"Opiate use for chronic pain is becoming increasingly controversial. There has been a shift away from supporting the use of opiates for treatment of chronic pain. In addition to lack of effectiveness, concerns for adverse clinical outcomes, addiction, and death have provided the impetus for this change. The purpose of this study was to investigate the percent of trauma patients still using opiates, their pain levels, and psychological outcomes 4 months posttrauma. This was a study to evaluate chronic pain at 4 months posttrauma in 101 participants from a single level 1 trauma center. Eighty of the 101 participants developed chronic pain 4 months after their initial traumatic injury (79%). Of those who developed chronic pain, 27 (26%) were still using opiates. Those using narcotics at 4 months posttrauma had significantly more pain, life interference, depression, and anxiety. Posttraumatic stress disorder (PTSD) was not significantly influenced by narcotic use in this analysis. However, the mean associated with those using narcotics was higher and diagnostic for PTSD. Those taking opiates did not have significantly better relief from their pain using treatments or medications than those not using opiates (F = 8, P = .08). These findings bring into question the appropriate use of opiates for chronic pain and the possible exacerbating effects on pain and psychopathology in traumatically injured patients.This article identifies data that provide evidence that narcotic pain medication needs to be used carefully in traumatically injured patients with chronic pain, especially in those individuals with comorbid psychological pathology.",0,0 +2768,Male war-zone veterans' perceived relationships with their children: The importance of emotional numbing,"Despite growing recognition of substantial interpersonal impairment among many war-zone veterans with posttraumatic stress disorder (PTSD), little is known about the association between PTSD symptomatology and veterans' relationships with their children. This study examined the differential pattern of associations between the symptom clusters of PTSD and the perceived father-child relationships of 66 male Vietnam veterans. Analyses revealed that only the emotional numbing cluster was significantly related to perceived quality of all relationship domains. The association between emotional numbing and perceived relationship quality remained significant in regression analyses even after controlling for fathers' family-of-origin stressors, combat exposure, depression, and substance abuse. Findings suggest that emotional numbing may be the component of PTSD most closely linked to interpersonal impairment in war-zone veterans.",0,0 +2769,Noradrenergic Mechanisms in the Pathophysiology of Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) is a serious psychiatric illness that may develop in individuals after exposure to a traumatic event. Recent data suggest that trauma and/or long-term stressors can cause alterations in the functioning of neuroanatomical structures and neural networks throughout the central nervous system. Specifically, dysregulation in central and perhaps, peripheral noradrenergic neural networks has been implicated as the cause of specific symptom clusters in the pathophysiology of PTSD. In this review, both clinical and preclinical data are presented to highlight types of noradrenergic dysfunction observed in individuals with PTSD. Additionally, the role of noradrenaline dysregulation in the acquisition/initiation, and maintenance of hyperarousal and reexperiencing symptom clusters in PTSD will be addressed.",0,0 +2770,STATISTICAL SUPPORT FOR SUBTYPES IN POSTTRAUMATIC STRESS DISORDER: THE HOW AND WHY OF SUBTYPE ANALYSIS,"A number of researchers have argued for the existence of different subtypes of posttraumatic stress disorder (PTSD). In the current paper we present criteria by which to assess these putative subtypes, clarify potential pitfalls of the statistical methods employed to determine them, and propose alternative methods for such determinations. Specifically, three PTSD subtypes are examined: (1) complex PTSD, (2) externalizing/internalizing PTSD, and (3) dissociative/nondissociative PTSD. In addition, three criteria are proposed for subtype evaluation, these are the need for (1) reliability and clarity of definition, (2) distinctions between subtypes either structurally or by mechanism, and (3) clinical meaningfulness. Common statistical evidence for subtyping, such as statistical mean difference and cluster analysis, are presented and evaluated. Finally, more robust statistical methods are suggested for future research on PTSD subtyping.",0,0 +2771,The Rorschach and Traumatic Loss: Can the Presence of Traumatic Loss Be Detected From the Rorschach?,"Loss, an expected part of everyone's life, can be a catalyst promoting significant growth. But all losses are not the same or affect everyone in like manner. Some losses are of such magnitude and intensity that individuals cannot cope, and, therefore, they keep reliving them (posttraumatic stress syndrome) as if through repeated attempts (Freud, 1923-1922/1961) they might master what had been initially so overwhelming. This study, using an inpatient hospital sample, examines the Rorschach protocols of individuals who had experienced traumatic loss in childhood or early adolescence and compares them with a control group of individuals who appear to have no such history. Our hypotheses that victims of early trauma have a distinguishing Rorschach profile was validated in the exploratory study. Further study is needed to clarify whether factors other than traumatic loss may be contributing to this profile.",0,0 +2772,Should psychiatrists use atypical antipsychotics to treat nonpsychotic anxiety?,"There is neurobiologically based, theoretical support for the use of antipsychotic medications in the treatment of anxiety, and two first-generation neuroleptics are approved by the United States Food and Drug Administration for the treatment of nonpsychotic anxiety. However, neuroleptics are associated with a large side effect burden, which has limited their utility in the treatment of nonpsychotic disorders. Because of their somewhat improved safety profile, atypical antipsychotics are increasingly used for the treatment of nonpsychotic anxiety. The published literature describing the efficacy of atypical antipsychotics in randomized, controlled trials involving patients with anxiety disorders is briefly reviewed, and the safety of atypical antipsychotics in nonpsychotic disorders is discussed. There is moderately strong controlled evidence supporting the use of some atypical antipsychotics, either as adjunctive treatment or monotherapy, in the treatment of nonpsychotic anxiety; however, the side effect burden of some atypical antipsychotics probably outweighs their benefits for most patients with anxiety disorders. The evidence to date does not warrant the use of atypical antipsychotics as first-line monotherapy or as first- or second-line adjunctive therapy in the treatment of anxiety disorders. Rigorous, independently funded, long-term studies are needed to support the off-label use of atypical antipsychotics in the treatment of anxiety disorders. Nevertheless, some patients with highly refractory anxiety disorders may benefit from the judicious and carefully monitored use of adjunctive atypical antipsychotics. A careful risk-benefit assessment must be undertaken by the physician, on a case-by-case basis, with appropriate informed consent.",0,0 +2773,"Alcohol use motives among traumatic event-exposed, treatment-seeking adolescents: Associations with posttraumatic stress","The current study evaluated the linkage between posttraumatic stress symptoms and alcohol use motives among 49 traumatic event-exposed adolescents (M(age)=16.39 years). It was hypothesized that posttraumatic stress symptom levels would be positively associated with coping-related drinking motives specifically (cf., social, enhancement, or conformity motives) and that coping-related drinking motives would evidence associations with the hyperarousal and reexperiencing posttraumatic stress symptom types. Findings were consistent with hypotheses, suggesting traumatic event-exposed adolescents may be using alcohol to manage posttraumatic stress symptoms.",0,0 +2774,Life-Altering Outcomes after Lower Extremity Injury Sustained in Motor Vehicle Crashes,"Lower extremity injuries (LEIs) sustained in vehicular crashes result in physical problems and unexpected psychosocial consequences. Their significance is diminished by low Abbreviated Injury Scale scores.Drivers who sustained LEIs were identified as part of the Crash Injury Research and Engineering Network (CIREN) and interviewed during hospitalization, at 6 months, and at 1 year. All were occupants of newer vehicles with seatbelts and airbags.Sixty-five patients were followed for 1 year. Injuries included mild brain injury (43%), ankle/foot fractures (55%), and bilateral injuries (37%). One year post-injury, 46% reported limitations in walking and 22% with ankle/foot fractures were unable to return to work. Depression (39%), cognitive problems (32%), and post-traumatic stress disorder (18%) were significant in the mild brain injury group.Long-lasting physical and psychological burdens may impede recovery and alter the lifestyle of patients with LEI. These issues need to be addressed by trauma center personnel.",0,0 +2775,The Amygdala in Post-Traumatic Stress Disorder,"Over the past decade, neuroimaging studies have yielded important insights into the function of the amygdala in post-traumatic stress disorder (PTSD). The results of these studies are presented here. Because neurocircuitry models of PTSD also emphasize the role of the medial prefrontal cortex, findings regarding that brain region are discussed as well. The reviewed studies suggest that (1) the amygdala is hyperresponsive to both trauma-related and unrelated stimuli in PTSD, (2) amygdala activation is positively correlated with PTSD symptom severity and, in some studies, inversely correlated with medial prefrontal cortex function, (3) symptom reduction after treatment is associated with decreased amygdala activation and increased medial prefrontal cortex activation, and (4) medial prefrontal cortex is hyporesponsive in PTSD, perhaps reflecting diminished inhibitory control over the amygdala. All of this information suggests that the amygdala and medial prefrontal cortex play important roles in the pathogenesis or maintenance of this disorder. Limitations and future directions of this research are discussed.",0,0 +2776,Reassessing War Stress: Exposure and the Persian Gulf War,"Research has shown a clear association between war-zone exposure and psychological readjustment in soldiers. Newer findings suggest that certain event and person characteristics are especially influential in this process. The present article has the following goals: (a) to review existing parameters in the traditional measurement of war-zone exposure, (b) to consider conceptual and methodological limitations in these approaches, (c) to present empirical data from a cohort of Persian Gulf War veterans that support the utility of a broader conceptualization of war trauma, and (d) to examine how gender may be differentially associated with some dimensions of war-zone stress and psychological outcome following deployment. Data suggest that identifying diverse dimensions of war-zone stress may enhance efforts to understand veterans' initial and long-range wartime recovery.",0,0 +2777,Bushfire impact on youth,"The authors examined the association between disaster-related traumatic experiences and posttraumatic stress disorder (PTSD) symptoms in 155 youth, aged 8–18 years, from the Lower Eyre Peninsula of South Australia who were affected by January 2005 bushfires. Youth completed measures of PTSD symptoms and disaster experiences 11–5 months postdisaster. Many youth (27%) reported moderate to severe levels of PTSD symptoms; younger children reported greater PTSD symptom severity than older youth. Perceived personal life threat and ongoing loss/disruption were related to greater PTSD symptomatology. Following disasters, it may be helpful to identify young children and youth who perceived that their life was threatened and experienced more ongoing life disruption, as these youth may be at higher risk for persistent PTSD symptoms.",0,0 +2778,Identifying and Determining the Symptom Severity Associated With Polyvictimization Among Psychiatrically Impaired Children in the Outpatient Setting,"Polyvictimization involves experiencing multiple forms of maltreatment or other interpersonal victimization, and places children at risk for severe psychosocial impairment. Children with psychiatric problems are at risk for polyvictimization, and polyvictimized child psychiatric inpatients have been found to have particularly severe psychiatric symptoms. Cluster analysis was used to identify a polyvictimized subgroup (N = 22, 8%) among 295 outpatient admissions in 2007-2009 to a child psychiatry outpatient clinic, based on chart review of documented maltreatment, parental impairment (history of arrest, psychiatric illness, and substance use), and multiple out-of-home placements. Polyvictimization was associated with severe parent-reported externalizing problems and clinician-rated psychosocial impairment, independent of demographics and psychiatric diagnoses. Posttraumatic stress disorder (PTSD) was the only psychiatric diagnosis associated with polyvictimization. Polyvictimization merits further clinical and research assessment with child psychiatry outpatients. Evidence-based PTSD assessment and treatment for polyvictimized children with adaptations to address their severe impairment and externalizing problems also warrants empirical evaluation.",0,0 +2779,Family relationshipsembedded in United Statesmilitary culture,"United States military personnel and their families have made substantial sacrifices to protect and defend their country in the service of the post-9/11 global war on terrorism (MacDermid Wadsworth, 2010; Willerton, MacDermid Wadsworth, and Riggs, 2011). Service members, their romantic partners, and their children have handled the increased operational tempo of deployments resulting from both Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) with impressive resilience (Bonanno et al., 2012; Cozza, Chun, and Polo, 2005; Lester et al., 2010), although the challenges of war can take a substantial toll on people’s physical health (Badr, Barker, and Milbury, 2011; Gorman, Eide, and Hilse-Gorman, 2010), mental health (Mansfield et al., 2010; Milliken, Auchterlonie, and Hoge, 2007; Pfefferbaum et al., 2011), and relationship health (Adams, Durand, and Castro, 2006; Allen et al., 2010; Nelson Goff et al., 2007). One foundation of this resilience is undoubtedly the strong military identity that many families embrace. US military culture espouses the ideals of courage, fortitude, strength, fairness, discipline, loyalty, respect for authority, determination, and valor (Coll, Weiss, and Yarvis, 2011; Greene et al., 2010b; Ulmer, Collins, and Jacobs, 2000), and these qualities are the signature values of many active duty and reserve component military families (Hall, 2008). To be a US military family is to be proud, to be strong, and to be brave (Hall 2011a; 2011b; Park, 2011). Although military culture provides a pervasive backdrop for how service members and their families navigate domestic life (Hall 2008; 2011a; Sherman and Bowling, 2011), scholarship on the interpersonal functioning of military couples and families has not always been sensitive to the unique parameters at play. With some notable exceptions (Palmer, 2008; Pincus et al., 2001; Riggs and Riggs, 2011), scholars have tended to apply established theories of relationship functioning to the military context without fully taking into account the social circumstances that envelop military personnel, their romantic partners, and their children. The result is a body of work (including some of our own research) that underemphasizes the distinctive trademarks of military life. As Wiens and Boss (2006) noted, ""To understand how best to support today’s military families, it is essential to understand their contexts. What are the contextual sources of their stress and resiliency?"" (p. 25). This chapter takes up that question. © Cambridge University Press 2014.",0,0 +2780,Complicating Factors Associated with Mild Traumatic Brain Injury: Impact on Pain and Posttraumatic Stress Disorder Treatment,"The nature of combat in Iraq and Afghanistan has resulted in high rates of comorbidity among chronic pain, posttraumatic stress disorder (PTSD), and mild traumatic brain injury (mTBI) in Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF). Although separate evidence-based psychological treatments have been developed for chronic pain and PTSD, far less is known about how to approach treatment when these conditions co-occur, and especially when they co-occur with mTBI. To provide the best care possible for OEF/OIF Veterans, clinicians need to have a clearer understanding of how to identify these conditions, ways in which these conditions may interact with one another, and ways in which existing evidence-based treatments can be modified to meet the needs of individuals with mTBI. The purpose of the present paper is to review the comorbidity of pain, PTSD, and mTBI in OEF/OIF Veterans, and provide recommendations to clinicians who provide care to Veterans with these conditions. First, we will begin with an overview of the presentation, symptomatology, and treatment of chronic pain and PTSD. The challenges associated with mTBI in OEF/OIF Veterans will be reported and data will be presented on the comorbidity among all three of these conditions in OEF/OIF Veterans. Second, we will present recommendations for providing psychological treatment for chronic pain and PTSD when comorbid with mTBI. Finally, the paper concludes with a discussion of the need for a multidisciplinary treatment approach, as well as a call for continued research to further refine existing treatments for these conditions. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +2781,Psychological resilience in sport performers: a review of stressors and protective factors,"Psychological resilience is important in sport because athletes must utilise and optimise a range of mental qualities to withstand the pressures that they experience. In this article, we discuss psychological resilience in sport performers via a review of the stressors athletes encounter and the protective factors that help them withstand these demands. It is hoped that synthesising what is known in these areas will help researchers gain a deeper profundity of resilience in sport, and also provide a rigorous and robust foundation for the development of a sport-specific measure of resilience. With these points in mind, we divided the narrative into two main sections. In the first section, we review the different types of stressors encountered by sport performers under three main categories: competitive, organisational and personal. Based on our recent research examining psychological resilience in Olympics champions, in the second section we discuss the five main families of psychological factors (viz. positive personality, motivation, confidence, focus, perceived social support) that protect the best athletes from the potential negative effect of stressors. It is anticipated that this review will help sport psychology researchers examine the interplay between stressors and protective factors, which will, in turn, focus the analytical lens on the processes underlying psychological resilience in athletes.",0,0 +2782,"Psychosocial buffers of traumatic stress, depressive symptoms, and psychosocial difficulties in veterans of Operations Enduring Freedom and Iraqi Freedom: The role of resilience, unit support, and postdeployment social support","Little research has examined the role of protective factors such as psychological resilience, unit support, and postdeployment social support in buffering against PTSD and depressive symptoms, and psychosocial difficulties in veterans of Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF).A total of 272 OEF/OIF veterans completed a survey containing PTSD and depression screening measures, and questionnaires assessing resilience, social support, and psychosocial functioning.Lower unit support and postdeployment social support were associated with increased PTSD and depressive symptoms, and decreased resilience and psychosocial functioning. Path analyses suggested that resilience fully mediated the association between unit support and PTSD and depressive symptoms, and that postdeployment social support partially mediated the association between PTSD and depressive symptoms and psychosocial functioning.Generalizability of results is limited by the relatively low response rate and predominantly older and reserve/National Guard sample.These results suggest that interventions designed to bolster unit support, resilience, and postdeployment support may help protect against traumatic stress and depressive symptoms, and improve psychosocial functioning in veterans.",0,0 +2783,The Relationship Between PTSD Arousal Symptoms and Depression Among Mothers Exposed to the World Trade Center Attacks,"Posttraumatic stress disorder (PTSD) is associated with greater risk of developing comorbid depression. However, little is known about the relationship between specific PTSD symptom clusters and comorbid depression. Approximately 4 years after the World Trade Center (WTC) attacks, we examined the association between PTSD symptom clusters and depression severity among 64 mothers directly exposed to the WTC attacks. Severity scores were computed for each PTSD symptom cluster by summing symptom frequency. Partial correlations with depression severity were calculated separately for PTSD symptom clusters, controlling for demographic variables, time elapsed since the attacks, WTC attack exposure, meeting PTSD criterion A, and the other cluster scores. Higher arousal symptom cluster scores were significantly correlated with persistent depression, but the re-experiencing and avoidance symptom clusters were not. Subsequent analyses isolating shared symptoms of PTSD and depression from those unique to PTSD suggest a complex interrelationship among symptoms of arousal, numbing, and depression.",0,0 +2784,"Trauma, time and mental health: a study of temporal reintegration and Depressive Disorder among Southeast Asian refugees","Background. Prior research suggested that time splitting – suppressing the past and dissociating it from present and future – protected refugee mental health in the aftermath of catastrophe. The current study investigates temporal reintegration, defined as cognitive recapture of the past and reconnecting it with present and future, the mental health effects of temporal reintegration, and factors moderating the associated risk for Depressive Disorder. Method. A community sample of 608 Southeast Asian refugees, resettled in Vancouver British Columbia between 1979 and 1981, were interviewed on three separate occasions over a 10-year period. Participants performed a temporal orientation task and responded to questions about employment, social relations and mental health. Depressive Disorder, measured by a typology derived from Grade of Membership analysis of symptoms, constituted the dependent variable. Latent Growth Curve Analysis was used to examine both levels and rates of change in the probability of Depressive Disorder as predicted by changes in temporal reintegration, as well as the contribution of putative social and psychological moderators to explaining variations in growth parameters. Results. Time relatedness increased over the duration of the study. Temporal reintegration jeopardized mental health. Employment and relational stability each moderated the mental health effects of temporal reintegration. Conclusions. Although time splitting may be effective in coping with adversity over the short-term, eventual temporal reintegration is probably ineluctable. Stability in love and work are protective factors, mitigating the mental health vicissitudes of temporal reintegration. Implications for optimal timing of clinical interventions are discussed.",0,0 +2785,Early responding to traumatic events,"Summary How to respond optimally following traumatic events remains a Holy Grail. A number of early interventions lack evidence of effect. Practical, pragmatic support provided in an empathic manner is likely to be an appropriate initial response and complement the high levels of resilience shown by individuals exposed to traumatic events.",0,0 +2786,Sexual and Nonsexual Dating Violence Perpetration: Testing an Integrated Perpetrator Typology,"The present study tested the validity of an integrated sexual and nonsexual violence perpetrator typology outlined by Monson and Langhinrichsen-Rohling (1998) in a sample of 670 dating individuals. Two-hundred-and-sixty-five of the participants (87 men, 178 women) reported some act of sexual and/or physical dating violence perpetration in their lifetime. The data supported at least three perpetrator types, namely, the Relationship-only, Generally Violent/Antisocial, and Histrionic/Preoccupied types. Overall, these findings indicate that different factors may cause or maintain the intimate violence perpetrated within this heterogeneous population. There were important gender differences in perpetrator type membership, highlighting the differences in men's and women's use of violence. The implications of these findings are discussed with regard to the development of typologies, their application to men and women perpetrators, as well as their utility for the assessment and treatment of perpetrators.",0,0 +2787,Adverse Health Effects in African American Residents Living Adjacent to Chemical Industries,"The objective of the present study was to compare the physical and psychological health of three groups of African Americans (N = 310): acute sulfuric acid exposed, nonacute exposed, and unexposed controls. Instruments included a health questionnaire, a Toxic Symptom Checklist, the Profile of Mood States (POMS), the Post-Traumatic Stress and the Neurotoxic Anxiety scales of the MMPI-2, the Impact of Event Scale, the Symptom Check List 90-Revised (SCL 90-R), and several brief mood and personality scales. Blood pressure and pulse rates were also taken. Matching produced 51 three-way pairs. MANOVA results indicate significant effects for exposure. Significant univariate Fs (p < .05) were foundfor all the scales across the exposed groups exceptfor the Toxic Symptom category of memory/concentration, POMS depression, and 5 of the 9 SCL 90-R subscales. The t-test results using adjusted a = .0167 indicate both exposed groups had more mood and health symptoms than the controls. The acute were the most symptomatic, and both exposed groups had more respiratory problems, skin rashes, and allergies; results that are consistent with chemical exposure. Results also indicate all three groups had higher than average blood pressure, and the SCL 90-R scores for all three groups were higher than reported in the manual.",0,0 +2788,Association between flashbacks and structural brain abnormalities in posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) is reliably associated with reduced brain volume relative to healthy controls, in areas similar to those found in depression. We investigated whether in a PTSD sample brain volumes in these areas were related to reporting specific symptoms of PTSD or to overall symptom severity.Structural MRI scans were obtained from 28 participants diagnosed with PTSD according to DSM-IV-TR. Participants reported the extent of individual PTSD symptoms using the Posttraumatic Diagnostic Scale. Voxel-based morphometry applying the Dartel algorithm implemented within SPM5 was used to identify volumetric changes, related to PTSD total, symptom cluster, and individual symptom scores.Brain volume was unrelated to overall PTSD severity, but greater reexperiencing scores predicted reduced volumes in the middle temporal and inferior occipital cortices. Increased reports of flashbacks predicted reduced volume in the insula/parietal operculum and in the inferior temporal gyrus.The data illustrate the value of analyses at the symptom level within a patient population to supplement group comparisons of patients and healthy controls. Areas identified were consistent with a neurobiological account of flashbacks implicating specific abnormalities in the ventral visual stream.",0,0 +2789,Distinguishing Between Latent Classes and Continuous Factors with Categorical Outcomes: Class Invariance of Parameters of Factor Mixture Models,"Factor mixture models (FMM's) are latent variable models with categorical and continuous latent variables which can be used as a model-based approach to clustering. A previous paper covered the results of a simulation study showing that in the absence of model violations, it is usually possible to choose the correct model when fitting a series of models with different numbers of classes and factors within class. The response format in the first study was limited to normally distributed outcomes. The current paper has two main goals, firstly, to replicate parts of the first study with 5-point Likert scale and binary outcomes, and secondly, to address the issue of testing class invariance of thresholds and loadings. Testing for class invariance of parameters is important in the context of measurement invariance and when using mixture models to approximate non-normal distributions. Results show that it is possible to discriminate between latent class models and factor models even if responses are categorical. Comparing models with and without class-specific parameters can lead to incorrectly accepting parameter invariance if the compared models differ substantially with respect to the number of estimated parameters. The simulation study is complemented with an illustration of a factor mixture analysis of ten binary depression items obtained from a female subsample of the Virginia Twin Registry.",0,0 +2790,Posttraumatic stress symptom trajectories in children living in families reported for family violence,"The present study examined latent class trajectories of posttraumatic stress disorder (PTSD) and associations between demographics, prior trauma, and reason for referral on class membership. Children ages 7-18 (n=201) were recruited for participation in the Navy Family Study following reports to the U.S. Navy's Family Advocacy Program (FAP). Initial interviews were conducted 2-6 weeks following FAP referral, with follow-ups conducted at 9-12, 18-24, and 36-40 months. Growth mixture modeling revealed two latent class trajectories: a resilient class and a persistent symptom class. Relative to youth in the resilient class, participants in the persistent symptom class were more likely to be older and to report exposure to a greater number of trauma experiences at Time 1.",0,0 +2791,"PTSD symptom clusters, feelings of revenge, and perceptions of perpetrator punishment severity in victims of interpersonal violence","Feelings of revenge have often been found to correlate with symptoms of posttraumatic stress disorder (PTSD). Which PTSD symptom cluster prevails in this association is, however, unknown. Furthermore, previous studies suggest that revenge may be satisfied by perceptions of perpetrator punishment severity, but did not control for concurrent symptoms of PTSD. Therefore, this study explored associations between PTSD symptom clusters, feelings of revenge, and perceived perpetrator punishment severity in a sample of victims of interpersonal violence. Results indicated that the re-experiencing/intrusion symptom cluster was the only index of PTSD which was related to victims' feelings of revenge (n=207). Revenge correlated negatively with perceptions of punishment severity in victim who knew that the perpetrator had been sentenced, but not after adjustment for PTSD symptoms (n=96).",0,0 +2792,Understanding the pharmacokinetics of anxiolytic drugs,"Anxiety disorders are considered the most common mental disorders and they can increase the risk for comorbid mood and substance use disorders, significantly contributing to the global burden of disease. For this reason, anxiolytics are the most prescribed psychoactive drugs, particularly in the Western world.This review aims to analyze pharmacokinetic profile, plasma level variations so as the metabolism, interactions and possible relation to clinical effect of several drugs which are used primarily as anxiolytics. The drugs analyzed include benzodiazepines, anticonvulsants (pregabalin, gabapentin), buspirone, β-blockers and antihistamines (hydroxyzine). Regarding the most frequently used anxiolytic benzodiazepines, data on alprazolam, bromazepam, chlordesmethyldiazepam, chlordiazepoxide, clotiazepam, diazepam, etizolam, lorazepam, oxazepam, prazepam and clonazepam have been detailed.There is a need for a more balanced assessment of the benefits and risks associated with benzodiazepine use, particularly considering pharmacokinetic profile of the drugs to ensure that patients, who would truly benefit from these agents, are not denied appropriate treatment. An optimal pharmacological approach involving an integrative pharmacokinetic and pharmacodynamic optimization strategy would ensure better treatment and personalization of anxiety disorders. So it would be desirable for the development of new anxiolytic drug(s) that are more selective, fast acting and free from the unwanted effects associated with the traditional benzodiazepines as tolerance or dependence.",0,0 +2793,Quantifying Resilience to Enhance Individualized Training,"Resilience is the human ability to adapt in the face of tragedy, trauma, adversity, hardship, and ongoing life stressors. To date, experimental reports on this subject have focused on long-term trajectories (weeks to months) of resilience, with little or no focus on whether significant changes to resilience could be achieved by short-term interventions. Currently, an individual’s resilience is defined either by self-report or by behavioral changes such as the development of depression, post-traumatic stress disorder, or suicide. We propose that the quantification of an individual’s physiological and behavioral response to stress under controlled conditions is an indication of the individual’s level of resilience. To address such real-time resilience, we propose the first in a series of studies to evaluate real-time human resilience by exposing participants to controlled stressors while assessing the stress response. Activation of the hypothalamus-pituitary-adrenal cortex axis and sympathetic branch of the autonomic nervous system via monitoring of the pupil constriction, heart and respiration rate, muscle tonicity, salivary cortisol, and electrodermal activity will be assessed. Stress exposure will consist of virtual stressors presented using Virtual Battlespace 2 software-based scenarios, such as noise exposure, time pressure, and emotion-induction tasks, as well as external stressors such as socio-evaluative stress via the Trier social stress task, while evaluating decision-making and performance. The relationship between performance and the physiological stress response will be quantified, including the creation of a series of stress-performance trajectories based upon individual differences. Such an analysis is similar to probing for resilience in material testing, in which a load is applied to a candidate material, and the resulting forces and observable changes in dimension are quantified and reported via stress-strain curves. Ongoing studies will examine how this resilience measure may be integrated into a closed-loop training system to provide appropriate coping strategies to optimize resilience training. Such training programs, which take into account individual perceptions of stressors and physiological responses, are expected to be effective in helping trainees develop resiliency during high-stress operations.",0,0 +2794,Premorbid combat related ptsd in Huntington's disease - Case report.,"Huntington's disease (HD) is a neurodegenerative, autosomal dominant disease that manifests with a triad of symptom clusters including movement disorder, cognitive impairment and psychiatric symptoms. We present a patient with HD who, prior to developing neurological signs and symptoms, had been exposed to war trauma and had developed posttraumatic stress disorder. Fifteen years later he manifested with dysarthria, difficulties with swallowing and involuntary movement. What brought him to psychiatrist was a heteroanamnestically noticed change in personality with irritable mood, impulsivity, aggressive outbursts in behavior and delusional ideation. Therapy was stared with haloperidol, but patient developed severe extrapiramidal side effects. Subsequent treatment with olanzapine, diazepam and omega 3 fatty acids lead to mood stabilization and better impulse control with even some improvement in motoric symptoms. To our knowledge, this is the first case report on combat related PTSD as psychiatric disorder manifested prior to HD. We discuss a possible influence of psychological stress disorder on severity of psychiatric symptoms in the HD. The importance of personalized approach in both psychopharmacological and psychotherapeutical treatment of patients with HD is emphasized. If the influence of environmental stress on the psychiatric phenotype of the disease should be confirmed by clinical trials and further studies, both screening methods and interventions aimed to reduce psychological stress in carriers of Huntington gene could be considered.",0,0 +2795,[Sleep electroencephalography in depression and mental disorders with depressive comorbidity].,"Traditional scoring of sleep EEG in depressed patients shows abnormalities in sleep maintenance, sleep architecture, REM sleep, the distribution of slow wave and REM sleep during the night. Computerized analysis that comprises the period-amplitude analysis procedure and spectral analysis discloses changes in delta activity and distribution of delta activity. However, these methods of analysing EEG sleep are not able to distinguish the various concepts of depression: endogenous and non-endogenous depression, unipolar and bipolar depression, psychotic and non-psychotic depression. Polysomnographical data in patients with recurrent depression show alteration during remission suggesting trait-like abnormalities of sleep in depression illness. Shortened REM latency is not specific in depression. This sleep parameter is defined in many different ways explaining the heterogeneousness of study results and the failure of constituting a biological marker. Many sleep parameters are affected by several factors such as age, gender and severity. Several physiopathological hypotheses have been proposed to explain EEG sleep alterations. They refer either to circadian rhythms such as the two process model of Borbély, the phase advance hypothesis and the circadian amplitude hypothesis, or to neurotransmitter abnormalities such as the cholinergic hypothesis. None of them takes sufficient account of all the sleep abnormalities. Sleep abnormalities have also been described in other psychiatric disorders such as mania, panic and obsessional-compulsive disorders, generalized anxiety, phobias, post-traumatic stress disorder, eating disorders, borderline personality, schizophrenia and dementia. None of them have a particular sleep EEG profile which allows to differentiate between them. A concomitant episode of major depression cannot be uncovered by sleep recordings.",0,0 +2796,Traumatic Stress Disorders in Children and Adolescents,"Abstract Many children and adolescents who experience potentially traumatic events, such as natural disasters, acts of violence, physical injuries, child abuse, and life-threatening medical illnesses, display significant stress symptoms. In fact, these potentially traumatic events can lead to the development of acute stress disorder (ASD) and/or posttraumatic stress disorder (PTSD) and cause significant psychological impairment. In this chapter, we discuss the types of potentially traumatic events that lead to ASD or PTSD in youth, as well as various aspects of trauma exposure. We next review available evidence on the definition, prevalence, and course of ASD and PTSD in youth, and the risk factors associated with their development. To date, relatively few studies have examined ASD and existing evidence calls into question the validity of dissociative symptoms as part of the existing ASD diagnostic criteria for youth. In contrast, many studies have evaluated PTSD and its symptoms in youth exposed to trauma, although PTSD prevalence rates vary substantially depending on a host of factors, including the type of traumatic event experienced, the degree of exposure to the event, and the informant for PTSD symptoms, among other factors. We also discuss developmental considerations for the ASD and PTSD diagnoses and directions for future research. The chapter closes with a brief summary of proposed changes to the diagnostic criteria for ASD and PTSD in youth that are being considered for the DSM-5.",0,0 +2797,Improved Sleep in Military Personnel is Associated with Changes in the Expression of Inflammatory Genes and Improvement in Depression Symptoms,"Sleep disturbances are common in military personnel and are associated with increased risk for psychiatric morbidity, including posttraumatic stress disorder (PTSD) and depression, as well as inflammation. Improved sleep quality is linked to reductions in inflammatory bio-markers; however, the underlying mechanisms remain elusive.In this study, we examine whole genome expression changes related to improved sleep in 68 military personnel diagnosed with insomnia. Subjects were classified into the following groups and then compared: improved sleep (n = 46), or non-improved sleep (n = 22) following three months of standard of care treatment for insomnia. Within subject differential expression was determined from microarray data using the Partek Genomics Suite analysis program and the ingenuity pathway analysis (IPA) was used to determine key regulators of observed expression changes. Changes in symptoms of depression and PTSD were also compared.At baseline, both groups were similar in demographics, clinical characteristics, and gene-expression profiles. The microarray data revealed that 217 coding genes were differentially expressed at the follow-up-period compared to baseline in the participants with improved sleep. Expression of inflammatory cytokines were reduced including IL-1β, IL-6, IL-8, and IL-13, with fold changes ranging from -3.19 to -2.1, and there were increases in the expression of inflammatory regulatory genes including toll-like receptors 1, 4, 7, and 8 in the improved sleep group. IPA revealed six gene networks, including ubiquitin, which was a major regulator in these gene-expression changes. The improved sleep group also had a significant reduction in the severity of depressive symptoms.Interventions that restore sleep likely reduce the expression of inflammatory genes, which relate to ubiquitin genes and relate to reductions in depressive symptoms.",0,0 +2798,Surviving the ICU Does Not Mean That the War Is Over,,0,0 +2799,Television Exposure in Children after a Terrorist Incident,"This study examined the influence of bomb-related television viewing in the context of physical and emotional exposure on posttraumatic stress symptoms--intrusion, avoidance, and arousal--in middle school students following the 1995 Oklahoma City bombing. Over 2,000 middle school students in Oklahoma City were surveyed 7 weeks after the incident. The primary outcome measures were the total posttraumatic stress symptom score and symptom cluster scores at the time of assessment. Bomb-related television viewing in the aftermath of the disaster was extensive. Both emotional and television exposure were associated with posttraumatic stress at 7 weeks. Among children with no physical or emotional exposure, the degree of television exposure was directly related to posttraumatic stress symptomatology. These findings suggest that television viewing in the aftermath of a disaster may make a small contribution to subsequent posttraumatic stress symptomatology in children or that increased television viewing may be a sign of current distress and that it should be monitored. Future research should examine further whether early symptoms predict increased television viewing and/or whether television viewing predicts subsequent symptoms.",0,0 +2800,ESTIMATING UNKNOWN KNOTS IN PIECEWISE LINEAR-LINEAR LATENT GROWTH MIXTURE MODELS,"A piecewise linear-linear latent growth mixture model (LGMM) combines features of a piecewise linear-linear latent growth curve (LGC) model with the ideas of latent class methods all within a structural equation modeling (SEM) context. A piecewise linear-linear LGMM is an appropriate framework for analyzing longitudinal data that come from a mixture of two or more subpopulations (i.e., latent classes) where each latent class incorporates a separate growth trajectory corresponding to multiple growth phases from which repeated measurements arise. The benefit of the model is that it allows the specification of each growth phase to conform to a particular form of overall change process within each latent class thereby making these models flexible and useful for substantive researchers. There are two main objectives of this current study. The first objective is to demonstrate how the parameters of a piecewise linear-linear LGMM, including the unknown knot, can be estimated using standard SEM software. A series of Monte Carlo simulations empirically investigated the ability of piecewise linear-linear LGMMs to recover true (known) growth parameters of distinct populations. Specifically, the current research compared the performance of the piecewise linear-linear LGMM under different manipulated conditions of (1) sample size, (2) class mixing proportions, (3) class separation of location of knot, (4) the mean of the slope growth factor of the second phase, (5) the variance of the slope growth factor of the second phase, and (6) residual variance of the observed variables. The second objective is to address the issue of model mis-specification. It is important to analyze this issue because applied researchers have to make model selection decisions. Therefore, the current research examined the possibility of extracting spurious latent classes. To achieve this objective 1-, 2-, and 3-class piecewise linear-linear LGMMs were fit to data sets generated under different manipulated conditions using a 2-class piecewise linear-linear LGMM as a population model. The number of times the correct model (i.e., 2-class piecewise linear-linear LGMM) was preferred over incorrect models (i.e., 1- and 3-class piecewise linear-linear LGMMs) using the Bayesian Information Criterion (BIC) was examined. Results suggested that the recovery of model parameters, specifically, the variances of growth factors were generally poor. In addition, none of the manipulated conditions were systematically related to the outcome measures, parameter bias and variability index of parameter bias. Furthermore, among all the manipulated conditions, the residual variance of observed variable had the strongest statistically significant effect on both the model convergence rate and the model selection rate. Other manipulated conditions that had an impact on the model convergence rate and/or the model selection rate were the growth factor mean of slope of the second phase, the growth factor variance of slope of the second phase, and the class mixing proportion. The manipulated conditions whose levels had no influence on either the model convergence rate or the model selection rate were sample size and the class separation of location of knot. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +2801,d-Cycloserine administered directly to infralimbic medial prefrontal cortex enhances extinction memory in sucrose-seeking animals,"d-Cycloserine (DCS), a co-agonist at the N-methyl-D-aspartate (NMDA) receptor, has proven to be an effective adjunct to cognitive behavioral therapies that utilize extinction. This pharmacological-based enhancement of extinction memory has been primarily demonstrated in neuropsychiatric disorders characterized by pathological fear (e.g. posttraumatic stress disorder and various phobias). More recently, there has been an interest in applying such a strategy in the disorders of appetitive learning (e.g. substance abuse and other addictions), but these studies have generated mixed results. Here we first examined whether extinction memory encoding in a sucrose self-administration model is dependent on NMDA receptors. The NMDA antagonist (±)-3-(2-carboxypiperazin-4-yl)propyl-1-phosphonic acid (5mg/kg, i.p.) administered 2h prior to the first extinction training session effectively inhibited extinction memory recall 24h later, without affecting the expression of the conditioned sucrose-seeking response while the drug was on board. This profile of effects suggests a specific effect on extinction memory consolidation. Next, we sought to enhance extinction memory using the co-agonist DCS (10 μg/side) by infusion directly into infralimbic medial prefrontal cortex, a brain site implicated in extinction memory recall in conditioned fear models. Indeed, infusion of DCS immediately after the first extinction training session effectively enhanced extinction memory recall 24h later. Collectively, these data suggest that the neurobiological mechanisms and the neurocircuitry mediating extinction memory are similar regardless of the valence (aversive or appetitive) of the conditioned behavior, and that similar pharmacological strategies for treatment may be applied to neuropsychiatric disorders characterized by a failure to inhibit pathological emotional memories.",0,0 +2802,Incubation of conditioning-specific reflex modification: Implications for post traumatic stress disorder,"Incubation of fear has been used to account for the delayed manifestation of symptoms of fear and anxiety including the delayed onset of Post Traumatic Stress Disorder (PTSD). We have shown the utility of classical conditioning-specific modification of the rabbit nictitating membrane response (NMR) as a model of PTSD. This modification includes an exaggeration in the size and a change in the timing of the unconditioned NMR after several days of classical conditioning. To assess the effects of incubation on conditioning-specific modification, we measured changes in responding as a function of the time between classical conditioning and NMR testing. After just one day of classical conditioning resulting in modest levels of learning, increases in response size were an inverted-U shaped function of days of incubation with little if any change occurring one and ten days after training but significant change occurring after six days. The incubation effect persisted for a week. An unpaired control group showed no change in the size of the response confirming the incubation effect was associative. The results bear a striking resemblance to symptoms of PTSD that do not always occur immediately after trauma and become exacerbated over time and then persist. They point to a window when incubation can exacerbate symptoms and speak to the vulnerability of re-experiencing trauma too soon. This could be a serious problem for military or emergency personnel recalled to combat or a disaster site without sufficient time to deal with the effects of their initial experiences.",0,0 +2803,Increased response variability as a marker of executive dysfunction in veterans with post-traumatic stress disorder,"The stability of cognitive control processes over time can be indexed by trial-to-trial variability in reaction time (RT). Greater RT variability has been interpreted as an indicator of executive dysfunction, inhibitory inefficiency, and excessive mental noise. Previous studies have demonstrated that combat veterans with post-traumatic stress disorder (PTSD) show substantial impairments in inhibitory control, but no studies have examined response variability in this population. In the current experiment, RT variability in the Go/NoGo response inhibition task was assessed for 45 veterans with PTSD and 34 control veterans using the intra-individual coefficient of variation (ICV) and ex-Gaussian analysis of RT distributions. Despite having mean RTs that were indistinguishable from controls, the PTSD patients had significantly greater RT variability as measured by ICV. More variable RTs were in turn associated with a greater number of false alarm errors in the patients, suggesting that less consistent performers were less successful at inhibiting inappropriate responses. RT variability was also highly correlated with self-reported symptoms of PTSD, depression, and attentional impulsiveness. Furthermore, response variability predicted diagnosis even when controlling for PTSD symptom severity. In turn, PTSD severity was correlated with self-rated attentional impulsiveness. Deficits in the top-down cognitive control processes that cause greater response variability might contribute to the maintenance of PTSD symptomology. Thus, the distractibility issues that cause more variable reaction times might also result in greater distress related to the trauma.",0,0 +2804,Theoretical perspectives of traumatic stress and debriefings,"The purpose of this article was to attempt to identify and examine the core set of elements or factors which are germane to understanding the process and effects of traumatic stress and psychological debriefings. Before these factors are addressed, relevant questions regarding the nature, level of care, and implementation of debriefings are raised. A person-environment interactional model is used to explain the typologies of traumatic events and stressor dimensions. Factors considered fundamental to crisis response, goals common to debriefings, and the need to recognize the diversity of traumatic events are then reviewed.",0,0 +2805,A nationwide US study of post-traumatic stress after hospitalization for physical injury,"ABSTRACT Background Injured survivors of individual and mass trauma are at risk for developing post-traumatic stress disorder (PTSD). Few investigations have assessed PTSD after injury in large samples across diverse acute care hospital settings. Method A total of 2931 injured trauma survivors aged 18–84 who were representative of 9983 in-patients were recruited from 69 hospitals across the USA. In-patient medical records were abstracted, and hospitalized patients were interviewed at 3 and 12 months after injury. Symptoms consistent with a DSM-IV diagnosis of PTSD were assessed with the PTSD Checklist (PCL) 12 months after injury. Results Approximately 23% of injury survivors had symptoms consistent with a diagnosis of PTSD 12 months after their hospitalization. Greater levels of early post-injury emotional distress and physical pain were associated with an increased risk of symptoms consistent with a PTSD diagnosis. Pre-injury, intensive care unit (ICU) admission [relative risk (RR) 1·17, 95% confidence interval (CI) 1·02–1·34], pre-injury depression (RR 1·33, 95% CI 1·15–1·54), benzodiazepine prescription (RR 1·46, 95% CI 1·17–1·84) and intentional injury (RR 1·32, 95% CI 1·04–1·67) were independently associated with an increased risk of symptoms consistent with a PTSD diagnosis. White injury survivors without insurance demonstrated approximately twice the rate of symptoms consistent with a diagnosis of PTSD when compared to white individuals with private insurance. By contrast, for Hispanic injury survivors PTSD rates were approximately equal between uninsured and privately insured individuals. Conclusions Nationwide in the USA, more than 20% of injured trauma survivors have symptoms consistent with a diagnosis of PTSD 12 months after acute care in-patient hospitalization. Coordinated investigative and policy efforts could target mandates for high-quality PTSD screening and intervention in acute care medical settings.",0,0 +2806,The Interactive Effect of Worry and Intolerance of Uncertainty on Posttraumatic Stress Symptoms,"In this study, relations among worry, intolerance of uncertainty (IU), and posttraumatic stress symptoms (PTSS) were examined in N = 89 participants with a trauma history. Both worry and IU shared significant zero-order correlations with each of the three DSM-IV posttraumatic stress symptom clusters. Partial correlations, controlling for the overlap among the symptom clusters, suggested that both worry and IU shared unique associations only with hyperarousal. Finally, and consistent with predictions, IU moderated the relation between worry and PTSS. When examining each PTSS cluster separately, evidence of the moderating role of IU was found only in relation to hyperarousal. More specifically, simple effects revealed that worry had a significant positive association with PTSS and hyperarousal only at high levels of IU. These findings suggest a specific risk profile of high worry in conjunction with high IU for the development and maintenance of PTSS, with particular relevance to hyperarousal symptoms. Conceptual and practical implications of these findings regarding common PTSD treatment approaches are discussed. © 2012 Springer Science+Business Media New York.",0,0 +2807,Intolerance of Uncertainty and PTSD Symptoms: Exploring the Construct Relationship in a Community Sample with a Heterogeneous Trauma History,"Intolerance of uncertainty has received substantial empirical attention in recent years. The contribution of intolerance of uncertainty to the development and maintenance of anxiety disorders has become increasingly recognized by researchers; however, relationships between intolerance of uncertainty and symptoms of posttraumatic stress disorder remain largely unexplored. As part of a larger study, North American community members (n = 122, 81 % women) with a heterogeneous trauma history completed self-report measures assessing intolerance of uncertainty and its dimensions (inhibitory and prospective intolerance of uncertainty) and posttraumatic stress disorder symptoms (re-experiencing, avoidance, numbing, hyperarousal). Intolerance of uncertainty total scores accounted for statistically significant variance in each posttraumatic stress disorder symptom score except re-experiencing. Inhibitory intolerance of uncertainty scores accounted for statistically significant variance in each posttraumatic stress disorder symptom score except re-experiencing. Prospective intolerance of uncertainty scores did not account for statistically significant variance in any of the posttraumatic stress disorder symptom scores. Results suggest that intolerance of uncertainty relates differentially to posttraumatic stress disorder symptom clusters and inhibitory intolerance of uncertainty appears to be the main component of the relationship. © 2013 Springer Science+Business Media New York.",0,0 +2808,"Diagnostic, demographic, memory quality, and cognitive variables associated with acute stress disorder in children and adolescents.","To date, no studies have investigated factors associated with acute stress disorder (ASD) in children and adolescents. Relationships between ASD and a number of demographic, trauma, cognitive, and trauma memory variables were therefore investigated in a sample (N=93) of children and adolescents involved in assaults and motor vehicle accidents. Several cognitive variables and the quality of trauma memories, but not demographic or trauma variables, were correlated with ASD and also mediated the relationship between peritraumatic threat and ASD. Finally, nosological analyses comparing ASD with indexes of posttraumatic stress disorder in the month posttrauma revealed little support for the dissociation mandate that uniquely characterizes ASD. The results are discussed with respect to assessment and treatment for the acute traumatic stress responses of children and young people.",0,0 +2809,The Structure of Maladaptive Schemas: A Confirmatory Factor Analysis and a Psychometric Evaluation of Factor-Derived Scales,"One thousand and thirty-seven psychiatric patients and non-patients from six different sites completed the 205-item Young Schema Questionnaire or its shortended form, the 75-item Young Schema Questionnaire-S. Among 888 of the subjects, who all were patients, a confirmatory factor analysis (CFA) of the 75 items included in both forms of the questionnaire clearly yielded the 15 Early Maladaptive Schema (EMS) factors rationally developed by J. E. Young (1990). Confirmatory factor analyses, testing three models of the higher-order structure of the 15 EMSs, indicated that a four-factor model was the best alternative. The results slightly favored a correlated four second-order factor model over one also including a third-order global factor. The four factors or schema domains were Disconnection, Impaired Autonomy, Exaggerated Standards, and Impaired Limits. Scales derived from the four higher-order factors had good internal and test-retest reliabilities and were related to DSM-IV Cluster C personality traits, agoraphobic avoidance behavior, and depressive symptoms. (",0,0 +2810,[Less severe sexual child abuse and its sequelae: are there different psychic and psychosomatic symptoms in relation to various forms of sexual interaction?].,"A typology of less severe sexual encounters was used to analyze short and long term sequelae of sexual abuse via intimate skin contact. Well known theoretical approaches on the harmful effects of sexual abuse were tested. Do we find different peri- and posttraumatic reactions dependent upon varied forms of sexual interactions with children? A cluster analysis was calculated with symptom variables that were described in 141 child statements taken out of written expert opinions. Afterwards variance analyses of these symptom clusters were conducted in reference to six different abuse constellations. Different symptom profiles were found for these six abuse constellations. Panic symptoms, shame related feelings, avoidant behavior and physical reactions showed significant results. The sequelae to different forms of less severe sexual child abuse differ and depend more upon the situational dynamic than upon the kind of relationship between adult and child.",0,0 +2811,Pre-attack symptomatology and temperament as predictors of children's responses to the September 11 terrorist attacks,"The aims of this study were to assess the psychological response of children following the September 11, 2001 terrorist attacks in New York and Washington, DC and to examine prospective predictors of children's post-attack responses.Children's responses were assessed in a community sample of children in Seattle, Washington, participating in an ongoing study. Symptomatology and temperament assessed prior to the attacks were examined as prospective predictors of post-attack post-traumatic stress (PTS), anxiety, depression and externalizing problems.Children demonstrated PTS symptoms and worries at levels comparable to those in children directly experiencing disasters, with 77% of children reporting being worried, 68% being upset by reminders, and 39% having upsetting thoughts. The most common PTS symptom cluster was re-experiencing, and 8% of children met criteria consistent with PTSD. African-American children reported more avoidant PTS symptoms and being more upset by the attacks than European-American children. Girls reported being more upset than boys. Prior internalizing, externalizing, social competence and self-esteem were related to post-attack PTS; and child inhibitory control, assessed prior to the 9/11 attacks, demonstrated a trend towards an association with post-attack PTS symptoms controlling for prior levels of symptomatology. PTS predicted child-report anxiety and conduct problem symptoms at follow-up, approximately 6 months after 9/11.Children experiencing a major disaster at a distance or indirectly through media exposure demonstrated worries and PTS symptoms suggesting that communities need to attend to children's mental health needs in response to national or regional disasters. Pre-disaster symptomatology or low self-regulation may render children more vulnerable in response to a disaster, and immediate post-disaster responses predict subsequent symptomatology. These variables might be used in the identification of children in need of intervention.",0,0 +2812,Pavlovian eyeblink conditioning in combat veterans with and without post-traumatic stress disorder,"Several recent studies have investigated relationships between post-traumatic stress disorder (PTSD) and learning and memory problems. These reports have found in general that not only does PTSD affect trauma-related memories, but when patients with PTSD are compared with similar trauma patients without PTSD, general memory impairments have been found. The present paper reports a study in which associative learning, using Pavlovian eyeblink conditioning, was investigated in combat veterans with and without chronic PTSD, using interstimulus intervals of 500 and 1000 msec in two separate experiments. Although several recent reports suggest that larger-magnitude autonomic conditioned responses occur in patients with PTSD during Pavlovian conditioning, the present study found evidence of impaired Pavlovian eyeblink conditioning in combat veterans with and without PTSD, compared to non-combat veterans. Although these data suggest that combat leads to an impaired associative learning process regardless of whether PTSD is apparent, a group of community-dwelling combat veterans not under medical treatment showed normal conditioning, suggesting that variables other than prior combat must also be involved.",0,0 +2813,The role of alcohol misuse in PTSD outcomes for women in community treatment: a secondary analysis of NIDA's Women and Trauma Study.,"Individuals with comorbid substance use and posttraumatic stress disorder may differentially benefit from integrated trauma-focused interventions based on specific presenting characteristics such as substance use type and PTSD severity. The current study is a secondary analysis of a NIDA Clinical Trials Network study exploring the effectiveness of two interventions for women with comorbid PTSD and substance use disorders.Generalized estimating equations were used to examine the association of baseline alcohol misuse with PTSD outcome measures over time for all randomized participants.Women entering treatment with baseline alcohol misuse had higher Post Traumatic Stress Disorder Symptom Scale (PSS-SR) total scores (t=2.43, p<.05), cluster C (avoidance/numbing) scores (t=2.63, p<.01), and cluster D (hyper-arousal) scores (t=2.31, p<.05). For women with alcohol misuse, after treatment week 1, PSS-SR scores were significantly lower in the Seeking Safety intervention during treatment (chi(2)(1)=4.00, p<.05) and follow-up (chi(2)(1)=4.87, p<.05) compared to those in the health education intervention. Alcohol misusers in the Seeking Safety group who had higher baseline hyper-arousal severity improved more quickly than those with lower baseline hyper-arousal severity during treatment (chi(2)(1)=4.06, p<.05).These findings suggest that the type of substance abuse at treatment entry may inform treatment selection, predict treatment response among those with co-occurring PTSD and substance use disorders, and indicate a more severe clinical picture.",0,0 +2814,"The dimensional structure of posttraumatic stress symptomatology in 323,903 U.S. veterans","There is ongoing debate regarding the optimal dimensional structure of posttraumatic stress disorder symptomatology. A better understanding of this structure has significant implications, as it can provide more refined phenotypic measures for use in studies of the etiology and neurobiology of PTSD, as well as for use as endpoints in treatment studies of this disorder. In this study we analyzed the dimensional structure of PTSD symptomatology, as assessed using the PTSD Symptom Checklist-Military Version in 323,903 Veterans. Confirmatory factor analyses were used to compare two 4-factor models and a newly proposed 5-factor model to the 3-factor DSM-IV model of PTSD symptom dimensionality. To evaluate the external validity of the best-fitting model, we then conducted a structural equation model examining how the symptom dimensions of this model related to diagnoses of depression, anxiety, and substance use disorder. Results indicated that a newly proposed 5-factor ‘dysphoric arousal’ model comprised of separate re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal symptom clusters provided a significantly better fit to the data compared to the DSM-IV and the two alternative four-factor models. External validity analyses revealed that numbing symptoms were most strongly related to diagnoses of depression and substance use disorder, and that dysphoric arousal symptoms were most strongly related to a diagnosis of anxiety disorder. Thus the dimensional structure of PTSD may be best represented by five symptom dimensions. The clinical implications of these results and implications for further refinement of extant PTSD assessment instruments are discussed.",0,0 +2815,Increased Prefrontal Cortical Thickness Is Associated with Enhanced Abilities to Regulate Emotions in PTSD-Free Women with Borderline Personality Disorder,"Previous studies suggest that amygdala, insula and prefrontal cortex (PFC) disintegrity play a crucial role in the failure to adequately regulate emotions in Borderline Personality Disorder (BPD). However, prior results are confounded by the high rate of comorbidity with Posttraumatic Stress Disorder (PTSD), which itself has been associated with changes in frontolimbic circuitry. We thus scrutinized the link between PFC, amygdala, insula, and the ability to regulate emotions, contrasting 17 women with BPD without comorbid PTSD to 27 non-clinical control women and in addition to those with BPD and PTSD (n = 14). BPD women without PTSD, but not those with comorbid PTSD, had increased cortical thickness in the dorsolateral PFC (DLPFC) in comparison to control women. Furthermore, cortical thickness in the DLPFC of BPD women without PTSD positively correlated with emotion regulation scores and furthermore was positively associated with amygdala volume, as well as cortical thickness of the insula. Our findings highlight the importance of disentangling the impact of BPD and PTSD on the brain and suggest possible compensatory mechanisms for the impaired emotion regulation in BPD women without PTSD.",0,0 +2816,Aftermaths of combat stress reactions: A three-year study,"The current study provides an overview of a study assessing the psychological and somatic health adjustment of Lebanon War veterans one, two and three years after the war, comparing combat stress reactions (CSR) casualties with controls. Findings indicated that combat-related psychopathology was overwhelmingly more prevalent among CSR casualties than among their matched controls one, two and three years after war. In addition, the passage of time had no effect on the relative psychiatric symptomatology, social functioning, self-efficacy, and somatic complaints in either of the two study groups. This stable mental health status of the CSR casualty over the three years of the study contrasts with the observed decline in trauma-related distress in the third year. Results are discussed in terms of the emotional sequelae of war trauma.",0,0 +2817,"Posttraumatic stress disorder symptoms among low-income, African American women with a history of intimate partner violence and suicidal behaviors: Self-esteem, social support, and religious coping","There is a dearth of research on risk/protective factors for posttraumatic stress disorder (PTSD) among low-income African American women with a history of intimate partner violence (IPV), presenting for suicidal behavior or routine medical care in a large, urban hospital. We examined self-esteem, social support, and religious coping as mediators between experiences of child maltreatment (CM) and IPV and symptoms of PTSD in a sample (N = 134) of low-income African American women. Instruments used included the Index of Spouse Abuse, the Childhood Trauma Questionnaire, the Taylor Self-Esteem Inventory, the Multidimensional Profile of Social Support, the Brief Religious Coping Activities Scale, and the Davidson Trauma Scale. Both CM and IPV related positively to PTSD symptoms. Risk and resilience individual difference factors accounted for 18% of the variance in PTSD symptoms over and above IPV and CM, with self-esteem and negative religious coping making unique contributions. Both variables mediated the abuse-PTSD symptom link. In addition, we tested an alternate model in which PTSD symptoms mediated the relationship between abuse and both self-esteem and negative religious coping.",0,0 +2818,Police officers: a high-risk group for the development of mental health disturbances? A cohort study,"Policing is generally considered a high-risk profession for the development of mental health problems, but this assumption lacks empirical evidence. Research question of the present study is to what extent mental health disturbances, such as (very) severe symptoms of anxiety, depression and hostility are more prevalent among police officers than among other occupational groups.Multicomparative cross-sectional study using the data of several cross-sectional and longitudinal studies in the Netherlands.Two samples of police officers (N=144 and 503), employees of banks (N=1113) and employees of banks who were robbed (N=144); employees of supermarkets (N=335), and a psychiatric hospital (N=219), employees of a governmental social welfare organisation (N=76), employees who followed a training based on rational-motive therapy to strengthen their assertiveness (N=710), soldiers before deployment (N=278) and before redeployment (N=236) and firefighters (N=123). The numbers refer to respondents with complete data.Prevalence of severe (subclinical level) and very severe symptoms (clinical level) were computed using the Dutch norm tables (80th percentile and 95th percentile, respectively) of the Symptom Check List Revised (SCL-90-R). All comparisons were controlled for age, gender and education.Multivariate logistic regression and analyses showed that the prevalence of clinical and subclinical levels of symptoms of anxiety, depression and hostility among police officers were not significantly higher than among comparison groups. The same pattern was found for the other SCL-90-R subscales.We found no indications that self-reported mental health disturbances were more prevalent among police officers than among groups of employees that are not considered high-risk groups, such as employees of banks, supermarkets, psychiatric hospital and soldiers before deployment.",0,0 +2819,A Study of Symptoms of the Post-traumatic Stress Disorder and Its Related Factors in Adolescents after the Wenchuan Earthquake,"Objective:To investigate the related factors of post-traumatic stress disorder(PTSD) among adolescents in different areas after the Wenchuan Earthquake.Methods:With Revised Impact of Events Scale for Children(CRIES-13) and self made survey,1267 students in the extremely severe disaster areas in Mianzhu,Sichuan province and the severe disaster areas in Baoji,Shaanxi were tested.Results:The extent of disaster exposure in Mianzhu was significantly higher than that in Baoji.However,there was no difference in the extent of PTSD symptoms between the two areas(t=0.181,df=1265,P=0.857),but only significant difference in the incidence rate(χ2=8.766,df=1,P=0.003),and the incidence rate of PTSD in Mianzhu areas was significantly higher than that of Baoji areas.Conclusion:5·12 Wenchuan earthquake has caused severe post-traumatic response in adolescents both in the extremely severe disaster areas and the severe disaster areas,but the former is higher in the incidence rate of PTSD,and age,sex,getting trapped in the earthquake,having relatives and friends injured in the earthquake,witnessing death in the earthquake were all significant predictors for PTSD severity.",0,0 +2820,Differential roles of childhood adversities and stressful war experiences in the development of mental health symptoms in post-war adolescents in northern Uganda,"BackgroundPrevious studies have shown a relationship between stressful war experiences and mental health symptoms in children and adolescents. To date, no comprehensive studies on the role of childhood adversities have been conducted with war-exposed adolescents living in post-war, low-resource settings in Sub-Saharan Africa.MethodsA cross-sectional study of 551 school-going adolescents aged 13-21 years old was undertaken four years post-war in northern Uganda. Participants completed self-administered questionnaires assessing demographics, stressful war experiences, childhood adversities, posttraumatic stress disorder (PTSD), depression, and anxiety symptoms.ResultsOur analyses revealed a main effect of gender on all mental health outcomes except avoidance symptoms, with girls reporting higher scores than boys. Stressful war experiences were associated with all mental health symptoms, after adjusting for potential confounders. Childhood adversity was independently associated with depression symptoms but not PTSD, anxiety, and PTSD cluster symptoms. However, in situations of high childhood adversity, our analyses showed that stressful war experiences were less associated with vulnerability to avoidance symptoms than in situations of low childhood adversity.ConclusionsBoth stressful war experiences and childhood adversities are risk factors for mental health symptoms among war-affected adolescents. Adolescents with histories of high childhood adversities may be less likely to develop avoidance symptoms in situations of high stressful war experiences. Further exploration of the differential roles of childhood adversities and stressful war experiences is needed.",0,0 +2821,Physical Health and Posttraumatic Stress Disorder Symptoms in Women Experiencing Intimate Partner Violence,"This correlational-predictive study addresses the associations between intimate partner violence (IPV) and physical health and posttraumatic stress disorder (PTSD) symptoms, including: 1) detailed physical health symptoms reported and health care sought by women in intimate abusive relationships, 2) relationships between physical health symptoms, IPV, and PTSD, and 3) unique predictors of physical health symptoms. An ethnically diverse sample of 157 abused women was recruited from crisis shelters and the community. The women averaged almost 34 years of age and had been in the abusive relationship for slightly more than 5 years. The women experienced physical health symptoms falling into 4 groups: neuromuscular, stress, sleep, and gynecologic symptoms. Women experiencing more severe IPV reported more physical health and PTSD symptomatology. PTSD avoidance and threats of violence or risk of homicide uniquely predicted physical health. More than 75% of the women had sought treatment from a health care professional in the previous 9 months. Implications for practice are discussed.",0,0 +2822,An Expressive Arts Therapy Model with Groups for Post-Traumatic Stress Disorder.,"(from the chapter) This chapter sets forth a model of group treatment for children who have been impacted by abuse and neglect. This model of group therapy was developed for a population of children aged between 9 and 12. An overview of group therapy theory precedes a brief review of my integration of recent trauma research with direct clinical practice in the field. This research has served as a foundation for the treatment model as well as a rationale for the use of expressive arts and play therapy with children who have developed post-traumatic stress disorder symptoms (PTSD). A case example will be presented to demonstrate how theory and practice can be integrated. The remainder of the chapter focuses on the specifics of this particular treatment model. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +2823,"Psychological consequences of trauma in MVA perpetrators – Relationship between post-traumatic growth, PTSD symptoms and individual characteristics","The study explores two problems rarely discussed in literature. Firstly, it presents the psychological consequences of traumatic stress in perpetrators of motor vehicle accidents (MVAs). The attention of both clinicians and researchers is very seldom focused on this group of MVA participants, as in the natural way, people have a tendency to empathise with victims and distancing from those who make harm to others. MVA perpetrators usually feel no right to complain about experienced symptoms of poor well-being, and guilt prevent them against searching for any help. Such a situation may lead to further problems related to traffic safety, as persistent and untreated symptoms of PTSD or other anxiety disorders may negatively affect driving behaviour. Secondly, apart from post-traumatic psychopathology, the symptoms of post-traumatic growth (PTG) in MVA perpetrators together with factors related to them are analysed in the study. The examination results from the comprehensive sample of MVA perpetrators (n = 236) referred to Occupational Medicine Centres in the catchment area of Mazowieckie Voivodship, Poland, indicate that both PTSD and PTG symptoms are experienced by MVA perpetrators. The key predictors of PTG are neuroticism, conscientiousness, agreeableness and intensity of PTSD symptoms. Moreover, sex and perpetrators’ injuries during the accident seem to play a vital role in the process of post-traumatic growth. Those of subjects who were women or were injured generally declared more positive changes in their life as a consequences of the accident they caused.",0,0 +2824,Validity of the osu post-traumatic stress disorder scale and the behavior assessment system for children self-report of personality with child tornado survivors,"Tornadoes and other natural disasters can lead to anxiety and posttraumatic stress disorder (PTSD) in children. This study provides further validity for the Oklahoma State University Post-Traumatic Stress Disorder Scale–Child Form (OSU PTSDS-CF) by comparing it to the Behavior Assessment System for Children Self-Report of Personality (BASC-SRP). Correlations were significant at 0.01 between BASC-SRP scales of Anxiety, Atypicality, and Clinical Maladjustment, and at least 0.05 between OSU PTSDS-CF scales for Social Stress, Depression, Inadequacy, and Emotional Symptoms Index (ESI). Analyses of variance (ANOVAs) yielded significant differences at 0.01 between children with and without PTSD, based on OSU PTSDS-CF cut-off scores, for BASC-SRP Anxiety, Atypicality, and Clinical Maladjustment. ANOVAs were significant at 0.05 for Social Stress, Locus of Control, Relationship with Parents, and ESI. Results yielded moderate effect sizes, and BASC-SRP means were within normal limits for all groups. Practitioners are encouraged to supplement the BASC-SRP with PTSD measures in children who have experienced trauma. © 2008 Wiley Periodicals, Inc.",0,0 +2825,Systems Biology,"Genome sequences are now available that enable us to determine the biological components that make up a cell or an organism. The discipline of systems biology examines how these components interact and form networks, and how the networks generate whole cell functions corresponding to observable phenotypes. This 2006 textbook devoted to systems biology describes how to model networks, how to determine their properties, and how to relate these to phenotypic functions. The prerequisites are some knowledge of linear algebra and biochemistry. Though the links between the mathematical ideas and biological processes are made clear, the book reflects the irreversible trend of increasing mathematical content in biology education. Therefore to assist both teacher and student, in an associated web site Palsson provides problem sets, projects and Powerpoint slides, and keeps the presentation in the book concrete with illustrative material and experimental results.",0,0 +2826,Randomized Controlled Trial of Online Expressive Writing to Address Readjustment Difficulties Among U.S. Afghanistan and Iraq War Veterans,"We examined the efficacy of a brief, accessible, nonstigmatizing online intervention-writing expressively about transitioning to civilian life. U.S. Afghanistan and Iraq war veterans with self-reported reintegration difficulty (N = 1,292, 39.3% female, M = 36.87, SD = 9.78 years) were randomly assigned to expressive writing (n = 508), factual control writing (n = 507), or no writing (n = 277). Using intention to treat, generalized linear mixed models demonstrated that 6-months postintervention, veterans who wrote expressively experienced greater reductions in physical complaints, anger, and distress compared with veterans who wrote factually (ds = 0.13 to 0.20; ps < .05) and greater reductions in PTSD symptoms, distress, anger, physical complaints, and reintegration difficulty compared with veterans who did not write at all (ds = 0.22 to 0.35; ps ≤ .001). Veterans who wrote expressively also experienced greater improvement in social support compared to those who did not write (d = 0.17). Relative to both control conditions, expressive writing did not lead to improved life satisfaction. Secondary analyses also found beneficial effects of expressive writing on clinically significant distress, PTSD screening, and employment status. Online expressive writing holds promise for improving health and functioning among veterans experiencing reintegration difficulty, albeit with small effect sizes.",0,0 +2827,Prazosin for treatment of nightmares related to posttraumatic stress disorder,"The efficacy of prazosin for the treatment of posttraumatic stress disorder (PTSD)-related nightmares is reviewed.PTSD is an anxiety disorder that can occur after experiencing or witnessing a life-threatening event, such as military combat, natural disasters, terrorist attacks, serious accidents, or violent personal assaults. The event that induced PTSD is often relived through nightmares or flashbacks. Sleep disturbances affect approximately 70% of patients with PTSD. Several medications have been evaluated for reducing PTSD-related nightmares, with limited success. Prazosin is a centrally and peripherally acting alpha(1)-adrenergic antagonist whose mechanism of action, favorable adverse-effect profile, and low cost make it a promising agent for the treatment of PTSD. To date, two case reports, two chart reviews, three open-label trials, and two placebo-controlled trials have been published documenting the efficacy and safety of prazosin in the treatment of PTSD-related nightmares. Therapy with prazosin resulted in a reduction in nightmares in patients with both combat- and noncombat-related trauma. A therapeutic benefit occurred with prazosin dosages as low as 1 mg daily, and suppression of nightmare symptoms occurred within one week of prazosin initiation. The most frequently reported adverse event was orthostatic hypotension. The variability in the populations studied (e.g., combat, noncombat, recent traumatic experiences) leaves additional unanswered questions that must be addressed in large, randomized, controlled trials.Prazosin appears to be a promising and well-tolerated agent for the management of PTSD-related nightmares. Further well-designed trials are warranted to establish its place in the treatment of PTSD.",0,0 +2828,Neuroendocrine activity and memory-related impairments in posttraumatic stress disorder,"This article reviews memory-related impairments in trauma survivors with posttraumatic stress disorder and their possible association to neuroendocrine alterations seen in this disorder. The neuroendocrine profile in PTSD first described in chronically ill combat veterans is characterized by lower basal cortisol levels, higher glucocorticoid receptor number, enhanced sensitivity to exogenous steroids, and increased variation in basal cortisol levels over the diurnal cycle. The generalizability and time course of these neuroendocrine alterations are explored in longitudinal studies and studies in other traumatized populations. These studies suggest that at least some aspects of this neuroendocrine profile can also be seen in other populations, including women, children, and victims of childhood trauma. Additionally, the alterations may be present early in the course of illness, perhaps even in the immediate aftermath of trauma, and may continue to be manifest in elderly trauma survivors. The mechanisms by which these neuroendocrine alterations may influence the formation and processing of traumatic memories are discussed.",0,0 +2829,Identifying crime victims who are at high risk for post traumatic stress disorder: developing a practical referral instrument,"Objective To construct a practical instrument for the identification and referral of crime victims who are at high risk for post traumatic stress disorder (PTSD). Method: Crime victims filing a complaint at a police station were asked to fill out a questionnaire probing risk factors for PTSD (n=126). One and 3 months later, these victims filled out a self-report version of the PTSD Symptom Scale (PSS-SR). Results: The combination of four items predicted persistent PTSD with a sensitivity of 1.00 and a specificity of 0.62. The items were: being victims of a violent crime, knowing the perpetrator, experiencing the results of the crime as worse than was expected, and blaming oneself for the event. Only 25% of PTSD cases received emotional support from a victim assistance organization. Conclusion: This study demonstrates that early detection of high-risk victims and their referral to treatment is both necessary and possible.",0,0 +2830,"Violent communities, family choices, and children's chances: An algorithm for improving the odds","Abstract Data are presented concerning the early predictors of adaptational success and failure among 72 children attending their 1st years of elementary school in a violent Washington, D.C., neighborhood. Adaptational failures were defined as those children who were doing poorly or failing in school and rated by their parents as suffering clinically significant levels of behavior problems. Adaptational successes were defined as children whose performance as students was rated in the average to excellent range and whose parent-rated levels of behavior problems were within the normal range. Despite the fact that these children were being raised in violent neighborhoods, had been exposed to relatively high levels of violence in the community, and were experiencing associated distress symptoms, community violence exposure levels were not predictive of adaptational failure or success. Instead, adaptational status was systematically related to characteristics of the children's homes. More specifically, the children's chances of adaptational failure rose dramatically as a function of living in unstable and/or unsafe homes. Moreover, it was not the mere accumulation of environmental adversities that gave rise to adaptational failure in these children. Rather, it was only when such adversities contaminated or eroded the stability and/or safety levels of the children's homes that the odds of their adaptational failure increased. We argue that this erosion of the quality of the child's microsystem (i.e., family) by adversities and pressures in the exosystem (i.e., community) is not an inevitable process. Although not yet well understood, it is a process over which families have and must exercise control. The implications of these data for improving children's chances of physical, psychological, and academic survival in violent neighborhoods are considered.",0,0 +2831,"Predictors of Prolonged Grief, Resilience, and Recovery Among Bereaved Spouses","Most reactions to loss can be characterized by three prototypical trajectories of resilience, gradual recovery, and chronic distress (Bonanno, ). However, research on the factors that uniquely predict these trajectories of response has been limited. We examined theoretically relevant predictors of each of the trajectory patterns.We assessed 115 bereaved spouses at 1.5 to 3 years postloss and 74 married controls. To identify grief trajectory, we provided bereaved participants with a graphical depiction of the trajectories and asked them to select the one that best described their experience.Group comparisons revealed substantial differences between resilient and prolonged grievers, and almost no differences between resilient and married controls. Multivariate analyses indicated that prolonged grief, when compared to resilience, was uniquely associated with maladaptive dependency traits, difficulty accessing positive memories of the deceased, and higher recalled marital adjustment.The present results extend our understanding of factors associated with distinct trajectories of adjustment after loss.",0,0 +2832,Creatine kinase isoenzyme profiles in the plasma of the domestic fowl (Gallus domesticus): effects of acute heat stress,"Creatine kinase isoenzyme activities in extracts of plasma, skeletal muscle, heart and brain tissue of domestic fowls were separated by anion exchange chromatography and tissue specific distributions of the isoenzyme designated MM-CK, BB-CK1 and BB-CK2 were demonstrated. The muscle isoenzyme (MM-CK) was the predominant form in plasma (99 per cent) and its activity increased in response to an episode of acute heat stress.",0,0 +2833,Psychometric properties of the Posttraumatic Cognition Inventory within a Northern Ireland adolescent sample,"This study sought to investigate the psychometric properties of the Posttraumatic Cognitions Inventory (PTCI; Foa et al., 1999, Psychol. Assess., 11, 303) among a cohort of older adolescents and to determine the relationship between post-traumatic cognitions and a variety of psychological outcomes including depression, anxiety, stress, and loneliness.The PTCI was investigated among a large sample (N = 785) of Northern Irish adolescents. Confirmatory factor analysis and composite reliability analysis were conducted to assess the psychometric properties of the scale.The familiar three-factor solution of negative cognitions of self, negative cognitions of the world and others, and self-blame was supported; however, it was necessary to remove eight items from the original 33-item scale. The three-factor structure was subsequently demonstrated to be factorially invariant across gender and to possess satisfactory internal reliability. The three PTCI factors were found to correlate with depression, anxiety, stress, and three dimensions of loneliness.These results provide the first piece of evidence that older adolescents cognitively respond to trauma in a similar manner to adults, that the PTCI is factorially invariant between genders, and that trauma cognitions are correlated with feelings of loneliness. The contextual dependent nature of the structure of the PTCI factors is discussed in relation to future research efforts.The PTCI is a valid and reliable measure of trauma-related cognitions among adolescents and works equally well for male adolescents and female adolescents. Trauma cognitions are associated with a range of mental health problems beyond post-traumatic stress disorder including depression, anxiety, stress, and various aspects of loneliness. Reductions in trauma cognitions in survivors of trauma will have wide-scale clinical benefits to patient well-being. The exact structure and make-up of items in the PTCI may well be dependent on culture, context, and the nature of the trauma. The study is limited due to the fact that the authors could not assess the severity of the trauma experienced by the adolescent sample.",0,0 +2834,Dimensional complexity of the EEG in patients with posttraumatic stress disorder,"Recent electrophysiological studies have reported evidence of information processing abnormalities in patients with posttraumatic stress disorder (PTSD). The aim of this study is to examine dynamical complexity of the EEG in PTSD patients, which is thought to reflect information processing of the brain. Resting EEG recordings (32,800 data points acquired continuously from 82 s of an EEG record) were obtained in 16 channels of 27 patients with PTSD from a mixed civilian trauma population and 14 healthy subjects. The correlation dimension (D2) of the EEG was used to quantify the complexity of the cortical dynamics underlying the EEG signal. The PTSD patients were found to have lower D2 values than those of the healthy subjects in most channels (Fp1, F8, C4, P4, T3, T4, T5, T6, and O1), indicating that PTSD patients have globally reduced complexity in their EEG waveforms. This study supports the hypotheses that PTSD patients exhibit disturbed cortical information processing, and that non-linear dynamical analysis of the EEG can be a tool for detecting changes in neurodynamics of the brain in PTSD.",0,0 +2835,[Features of a short stay service facility for the severely motor and intellectually disabled persons in relation to the Niigata Chuetsu Prefecture earthquake in 2004].,"Twenty-four handicapped victims of the Niigata-Chuetsu earthquake have used our ""short-stay-service"" . We have summarized the characteristics of this utilization. Two prominent patterns were noted:1) The mean duration of the stays was clearly longer when compared to ordinary service, and correlated with the proximity of the victims to the focus of the earthquake, and 2) victims living near the epicenter took longer to start utilizing the short-stay service. The Niigata-Chuetsu earthquake has destroyed roads and highways at over 200 locations, preventing transportation, isolating the seismic center, and resulting in delayed rescue of the handicapped victims and their admittance to the institution. More of the 24 victims were from the severest region (on 7 of the Japanese seismic intensity scale) than from the violent region (scale 6). Unfortunately, the social and administrative network for supporting and protecting severely motor and intellectually disabled persons is still at an embryonic stages. Based of this experience, we propose the building and organization of a functional network for the disabled.",0,0 +2836,Observations on the Use of Growth Mixture Models in Psychological Research,"Psychologists are applying growth mixture models at an increasing rate. This article argues that most of these applications are unlikely to reproduce the underlying taxonic structure of the population. At a more fundamental level, in many cases there is probably no taxonic structure to be found. Latent growth classes then categorically approximate the true continuum of individual differences in change. This approximation, although in some cases potentially useful, can also be problematic. The utility of growth mixture models for psychological science thus remains in doubt. Some ways in which these models might be more profitably used are suggested.",0,0 +2837,Frequency and Content of Dreams Associated with Trauma,"Sleep disturbances and dream-related disorders play a prominent role in trauma victims' clinical profile. Although some progress has been made in understanding the impact of sleep mechanisms and nightmares in the development, maintenance, and treatment of posttraumatic stress disorder (PTSD), little is known about the actual content of trauma-related dreams beyond the more strictly defined PTSD nightmares. This article presents key methodological issues, reviews findings on dream recall frequency following trauma exposure, examines the incidence of dream-related disorders as a function of trauma characteristics and personality variables, and reviews findings on the relationship between dream content and specific types of traumas. It is concluded that greater clinical and research efforts should be directed at understanding the natural course and impact of dream-related disorders as well as normal dream processes in trauma victims.",0,0 +2838,Comorbid depressive symptoms in treatment-seeking PTSD outpatients affect multiple domains of quality of life,"No study has examined the impact of the comorbid Axis I conditions on the quality of life (QoL) of patients with a primary diagnosis of PTSD. Our goal was to investigate the influence of comorbid disorders on the QoL of treatment-seeking outpatients with PTSD.The diagnoses of PTSD and of the comorbid disorders were established using the SCID-I. The 54 volunteers also completed the Posttraumatic Stress Disorder Checklist - Civilian Version, the BDI, the BAI, the Trauma History Questionnaire, and a socio-demographic questionnaire. Quality of life was assessed by means of the WHOQOL-BREF, a 26-item self-administered scale that measures four domains of QoL: psychological, physical, social, and environmental. Multiple linear regression models were fitted to investigate the relationship between the severity of post-traumatic, mood, and anxiety symptoms; the presence of specific current comorbid disorders and of psychotic symptoms, the number of current comorbid conditions, and a history of child abuse for each of the four domains of QoL, after adjusting for the effect of socio-demographic characteristics.The severity of PTSD symptoms impacted negatively on the psychological and physical domains. The severity of depressive symptoms correlated negatively with QoL in all domains, independently of sex, age, occupation, and marital status. The psychotic symptoms impacted negatively on the environmental domain. A history of child abuse was negatively associated with the psychological and the social domains.The severity of comorbid depressive symptoms is one of the most important factors in the determination of the QoL in patients with PTSD.",0,0 +2839,Stressful life events and predictors of post-traumatic growth among high-risk early emerging adults,"Stressful life events (SLEs) may elicit positive psychosocial change among youth, referred to as Post-traumatic Growth (PTG). We assessed types of SLEs experienced, degree to which participants reported PTG, and variables predicting PTG across 24 months among a sample of high risk, ethnically diverse early emerging adults. Participants were recruited from alternative high schools (n = 564; mean age=16.8; 65% Hispanic). Multi-level regression models were constructed to examine the impact of environmental (SLE quantity, severity) and personal factors (hedonic ability, perceived stress, developmental stage, future time orientation) on a composite score of PTG. The majority of participants reported positive changes resulted from their most life-altering SLE of the past two years. Predictors of PTG included fewer SLEs, less general stress, having a future time perspective, and greater identification with the developmental stage of Emerging Adulthood. Findings suggest intervention targets to foster positive adaptation among early emerging adults who experience frequent SLEs.",0,0 +2840,Group-Based Trajectory Modeling in Clinical Research,"Group-based trajectory models are increasingly being applied in clinical research to map the developmental course of symptoms and assess heterogeneity in response to clinical interventions. In this review, we provide a nontechnical overview of group-based trajectory and growth mixture modeling alongside a sampling of how these models have been applied in clinical research. We discuss the challenges associated with the application of both types of group-based models and propose a set of preliminary guidelines for applied researchers to follow when reporting model results. Future directions in group-based modeling applications are discussed, including the use of trajectory models to facilitate causal inference when random assignment to treatment condition is not possible.",0,0 +2841,Posttraumatic stress disorder in children: The influence of developmental factors,"Despite the prevalence of childhood trauma, there are currently no developmentally oriented cognitive theories of posttraumatic stress disorder (PTSD). This paper outlines the definitional issues of PTSD in children, reviews the incidence of PTSD in children, and compares PTSD profiles in children and adults. We propose that a cognitive theory of childhood PTSD needs to accommodate developmental factors, including knowledge, language development, memory, emotion regulation, and social cognition, in addition to contextual factors such as family interactions. Implications of these developmental factors for assessment and treatment of traumatized children are discussed.",0,0 +2842,"Relations among posttraumatic stress disorder, comorbid major depression, and HPA function: A systematic review and meta-analysis","Exposure to traumatic stress is associated with increased risk for posttraumatic stress disorder (PTSD) and alterations of hypothalamic-pituitary-adrenocortical (HPA) function. Research linking traumatic stress with HPA function in PTSD has been inconsistent, however, in part due to (a) the inclusion of trauma-exposed individuals without PTSD (TE) in control groups and (b) a failure to consider comorbid major depressive disorder (MDD) and moderating variables. This meta-analysis of 47 studies (123 effect sizes, N=6008 individuals) revealed that daily cortisol output was lower for PTSD (d=-.36, SE=.15, p=.008) and PTSD+MDD (d=-.65, SE=.25, p=.008) groups relative to no trauma controls (NTC); TE and NTC groups did not differ significantly from each other. Afternoon/evening cortisol was lower in TE (d=-.25, SE=.09, p=.007) and PTSD (d=-.27, SE=.12, p=.021) groups and higher in PTSD+MDD groups (d=.49, SE=.24, p=.041) relative to NTC. Post-DST cortisol levels were lower in PTSD (d=-.40, SE=.12, p<.001), PTSD+MDD (d=-.65, SE=.14, p<.001), and TE groups (d=-.53, SE=.14, p<.001) relative to NTC. HPA effect sizes were moderated by age, sex, time since index event, and developmental timing of trauma exposure. These findings suggest that enhanced HPA feedback function may be a marker of trauma-exposure rather than a specific mechanism of vulnerability for PTSD, whereas lower daily cortisol output may be associated with PTSD in particular.",0,0 +2843,Impact of Exposure to Trauma on Posttraumatic Stress Disorder Symptomatology in Swedish Tourist Tsunami Survivors,"The aim was to examine long-term mental health and posttraumatic stress symptomatology in a Swedish tourist population after exposure to the 2004 Southeast Asian tsunami. Data from 4822 returned questionnaires 14 months after the disaster were analyzed. Respondents were categorized into 3 subgroups: (1) danger-to-life exposure group (having been caught or chased by the waves), (2) nondanger-to-life exposure group (exposed to other disaster-related stressors), and (3) low exposure group. Main outcome measures were General Health Questionnaire-12 and Impact of Event Scale-22-Revised. Danger-to-life exposure was an important factor in causing more severe posttraumatic stress symptoms and in affecting mental health. Female gender, single status, and former trauma experiences were associated with greater distress. Other factors related to more severe symptoms were loss of relatives, physical injuries, viewing many dead bodies, experiencing life threat, and showing signs of cognitive confusion. Disaster exposure has a substantial impact on survivors, which stresses the need for long-lasting support.",0,0 +2844,Post-traumatic stress symptoms in relatives in the first weeks after severe traumatic brain injury,"Severe traumatic brain injury (STBI) can cause psychological stress in proxies in the long-term. This study assessed post-traumatic stress (PTS) symptoms in proxies of survivors of STBI in the short-term and investigated stress-associated factors.Prospective cross-sectional study, conducted at three Swiss trauma centres over 1 year. Patient and proxy demographics, trauma data including Glasgow Coma Scale (GCS) and management data were collected. The proxies' PTS symptoms were assessed by applying the Impact of Event Scale-Revised (IES-R), once in the first month after the accident (median: 11 days).Sixty-nine proxies were included; 52 proxies were female (77.8%). Mean IES-R sum score for intrusions was 13.38 (SD=7.26), for avoidance 8.91 (SD=5.94), and for hyperarousal 9.07 (SD=6.75). Clinically significant PTS symptoms were observed in 36 proxies (52.2%); mean IES-R sum scores were significantly higher in women. IES-R sub-scale values were inversely related with GCS at the scene of the accident and on hospital admission.More than half of proxies had clinically significant PTS symptoms shortly after their relative's accident. More severe PTS symptoms were found in women and in proxies of patients with poorer initial GCS scores. Further research into risk groups in the short- and long-term and the long-term impact on patients of PTS syndrome in proxies is warranted.",0,0 +2845,"Trauma, Survival and Resilience in War Zones","This book, based upon a series of psychological research studies, examines Sierra Leone as a case study of a constructivist and narrative perspective on psychological responses to warfare, telling the stories of a range of survivors of the civil war. The authors explore previous research on psychological responses to warfare while providing background information on the Sierra Leone civil war and its context. Chapters consider particular groups of survivors, including former child soldiers, as well as amputee footballers, mental health service users and providers, and refugees. Implications of the themes emerging from this research are considered with respect to how new understandings can inform current models of trauma and work with its survivors. Amongst the issues concerned will be post-traumatic stress and post-traumatic growth; resilience; mental health service provision; perpetration of atrocities; and forgiveness. The book also provides a critical consideration of the appropriateness of the use of Western concepts and methods in an African context. Drawing upon psychological theory and rich narrative research, Trauma, Survival and Resilience in War Zones will appeal to researchers and academics in the field of clinical psychology, as well as those studying post-war conflict zones. © 2016 David A. Winter, Rachel Brown, Stephanie Goins and Clare Mason.",0,0 +2846,A Pilot Study of Interpersonal Psychotherapy for Posttraumatic Stress Disorder,"This article describes pilot testing of interpersonal psychotherapy adapted for posttraumatic stress disorder (PTSD). Unlike most psychotherapies for PTSD, interpersonal psychotherapy is not exposure-based, focusing instead on interpersonal sequelae of trauma.Fourteen consecutively enrolled subjects with chronic PTSD (DSM-IV) from various traumas received an open, 14-week interpersonal psychotherapy trial.Treatment was well tolerated: 13 subjects (93%) completed therapy. After 14 weeks, 12 of 14 subjects no longer met diagnostic criteria for PTSD, 69% responded (50% Clinician Administered PTSD Scale score decrement), and 36% remitted (score < or =20). Thirteen subjects reported declines in PTSD symptoms across all three symptom clusters. Depressive symptoms, anger reactions, and interpersonal functioning also improved.Treating interpersonal sequelae of PTSD appears to improve other symptom clusters. Interpersonal psychotherapy may be an efficacious alternative for patients who refuse repeated exposure to past trauma. This represents an exciting extension of interpersonal psychotherapy to an anxiety disorder.",0,0 +2847,Violent behaviour and post-traumatic stress disorder in US Iraq and Afghanistan veterans,"Background Violence towards others in the community has been identified as a significant problem for a subset of Iraq and Afghanistan veterans. Aims To investigate the extent to which post-traumatic stress disorder (PTSD) and other risk factors predict future violent behaviour in military veterans. Method A national, multiwave survey enrolling a random sample of all US veterans who served in the military after 11 September 2001 was conducted. A total of 1090 veterans from 50 US states and all military branches completed two survey waves mailed 1 year apart (retention rate = 79%). Results Overall, 9% endorsed engaging in severe violence and 26% in other physical aggression in the previous year, as measured at Wave 2. Younger age, financial instability, history of violence before military service, higher combat exposure, PTSD, and alcohol misuse at Wave 1 were significantly associated with higher severe violence and other physical aggression in the past year at Wave 2. When combinations of these risk factors were present, predicted probability of violence in veterans rose sharply. Veterans with both PTSD and alcohol misuse had a substantially higher rate of subsequent severe violence (35.9%) compared with veterans with alcohol misuse without PTSD (10.6%), PTSD without alcohol misuse (10.0%) or neither PTSD nor alcohol misuse (5.3%). Using multiple regression, we found that veterans with PTSD and without alcohol misuse were not at significantly higher risk of severe violence than veterans with neither PTSD nor alcohol misuse. There was a trend for other physical aggression to be higher in veterans with PTSD without alcohol misuse. Conclusions Co-occurring PTSD and alcohol misuse was associated with a marked increase in violence and aggression in veterans. Compared with veterans with neither PTSD nor alcohol misuse, veterans with PTSD and no alcohol misuse were not significantly more likely to be severely violent and were only marginally more likely to engage in other physical aggression. Attention to cumulative effects of multiple risk factors beyond diagnosis – including demographics, violence history, combat exposure, and veterans' having money to cover basic needs like food, shelter, transportation, and medical care – is crucial for optimising violence risk management.",0,0 +2848,Stockholm Syndrome and Child Sexual Abuse,"This article, based on an analysis of unstructured interviews, identifies that the emotional bond between survivors of child sexual abuse and the people who perpetrated the abuse against them is similar to that of the powerful bi-directional relationship central to Stockholm Syndrome as described by Graham (1994). Aspects of Stockholm Syndrome could be identified in the responses of adult survivors of child sexual abuse, which appeared to impact on their ability to criminally report offenders. An emotional bond, which has enabled the sexual abuse of children, has served to protect the offender long after the abuse has ceased. The implications of Stockholm Syndrome could offer valuable insights to those working in the field of child sexual abuse.",0,0 +2849,Posttraumatic Stress Disorder and Identification in Disaster Workers,"OBJECTIVE: Disaster workers who work with deceased victims are at increased risk of posttraumatic stress disorder (PTSD). Identification with the deceased has been proposed as one of the mechanisms in this stress-illness relationship. To examine this hypothesis, this study investigated three types of identification with the dead in a group of disaster workers: identification with the deceased as oneself, identification with the deceased as a friend, and identification with the deceased as a family member. METHOD: Fifty-four volunteer disaster workers who worked with the dead following an explosion on the USS Iowa naval ship were assessed 1, 4, and 13 months after the disaster. PTSD symptoms (measured with the DSMPTSD-IV scale), intrusive and avoidant disaster-related symptoms (measured with the Impact of Event Scale), somatization and general distress (measured with the SCL-90-R), and health care utilization were assessed. RESULTS: Disaster workers who reported identification with the deceased as a friend were more likely than those who did not to have PTSD, more intrusive and avoidant symptoms, and greater levels of other posttraumatic symptoms including somatization. Disaster workers who reported identification with the deceased as a family member had greater intrusive symptoms 1 month after the disaster than those who did not. There were no differences between those who did and did not identify with the deceased as self. Health care utilization was not associated with identification. CONCLUSIONS: Identification with the deceased is a risk factor for PTSD and posttraumatic symptoms in disaster workers exposed to the dead. Identification with the dead as a friend is specifically associated with higher risk for these workers.",0,0 +2850,"Posttraumatic stress disorder, poor physical health and substance use behaviors in a national trauma-exposed sample","Both experiencing a traumatic event and PTSD are related to physical health problems (e.g., Schnurr and Jankowski, 1999) and health-risk behavior (e.g., Stewart, 1996). Using structural equation modeling analyses, we examined the interrelationships among number of distinct traumatic event exposures, PTSD diagnosis, physical health, and substance use behavior using epidemiological data from the National Comorbidity Survey Replication (NCS-R; Kessler et al., 2004). Results provide some evidence that PTSD mediates the relationship between: (a) number of distinct traumatic event exposures and poor physical health defined by clusters of difficulties with gastrointestinal, musculoskeletal, and/or cardiovascular health, and (b) number of distinct traumatic event exposures and substance use behaviors. However, substance use behaviors did not significantly mediate the relationship between PTSD and poor physical health.",0,0 +2851,PTSD prevalence and symptom structure of DSM-5 criteria in adolescents and young adults surviving the 2011 shooting in Norway,"Diagnostic criteria for Posttraumatic Stress Disorder (PTSD) have been revised for DSM-5. Two key changes include alteration of the clustering of PTSD symptoms and new PTSD symptom criteria related to negative alterations in cognition and mood. In this study, we empirically investigated these changes.We interviewed 325 adolescents and young adults who survived the 2011 youth camp shooting at Utøya Island, Norway. The UCLA PTSD Reaction Index for DSM-IV was used to assess symptoms of PTSD. In addition, 11 questions were added to assess the four new symptom criteria within the new DSM-5 symptom categories.PTSD prevalence did not differ significantly whether DSM-IV (11.1%) or DSM-5 (11.7%) criteria were used and the Cohen׳s Kappa for consistency between the diagnoses was 0.061. Confirmatory factor analyses showed that the four-factor structure of the DSM-5 fit the data adequately according to the conceptual model outlined.The homogeneity of this sample of highly exposed subjects may preclude generalization to less severely exposed groups. Also, we did not assess criterion G in regard to symptoms causing clinically significant distress and functional impairment.The prevalence of PTSD was quite similar regardless of diagnostic system. The relatively low concordance between the diagnoses has implications for eligibility for a diagnosis of PTSD.",0,0 +2852,"Trauma Exposure, Posttraumatic Stress, and Psychiatric Comorbidity in Female Juvenile Offenders","To document the rate of posttraumatic stress disorder (PTSD) in female juvenile offenders and its relationship to trauma history, comorbid diagnoses, attributional style, and family functioning.The psychological profiles and trauma histories of 100 incarcerated female juvenile offenders (ages 13.5-19 years) were assessed using a semistructured interview. Two self-report measures were used to assess family functioning and attributional style.High rates of PTSD were reported by offenders (37%), with sexual abuse the precipitant in 70% of cases. Offenders with PTSD had significantly more comorbid diagnoses than those without (PTSD = 5.4, no PTSD = 3.1, p < .001). The majority (73%) of comorbid diagnoses appeared concurrently with or after PTSD onset. The presence of four or more psychiatric diagnoses (OR = 14.48, p < .001) and a history of sexual abuse (OR = 7.91, p < .001) were independently associated with a diagnosis of PTSD among female juvenile offenders.These results suggest a link among trauma, PTSD, and the development of further psychopathology in female juvenile offenders. This link highlights the importance of comprehensive diagnosis and treatment of this and other comorbid disorders to ensure the effectiveness of interventions designed to treat antisocial behavior.",0,0 +2853,Amygdala modulation of memory-related processes in the hippocampus: potential relevance to PTSD,"A key assumption in the study of stress-induced cognitive and neurobiological modifications is that alterations in hippocampal functioning after stress are due to an excessive activity exerted by the amygdala on the hippocampus. Research so far focused on stress-induced impairment of hippocampal plasticity and memory but an exposure to stress may simultaneously also result in strong emotional memories. In fact, under normal conditions emotionally charged events are better remembered compared with neutral ones. Results indicate that under these conditions there is an increase in activity within the amygdala that may lead to memory of a different quality. Studying the way emotionality activates the amygdala and the functional impact of this activation we found that the amygdala modulates memory-related processes in other brain areas, such as the hippocampus. However, this modulation is complex, involving both enhancing and suppressing effects, depending on the way the amygdala is activated and the hippocampal subregion examined. The current review summarizes our findings and attempts to put them in context with the impact of an exposure to a traumatic experience, in which there is a mixture of a strong memory of some aspects of the experience but impaired memory of other aspects of that experience. Toward that end, we have recently developed an animal model for the induction of predisposition to stress-related disorders, focusing on the consequences of exposure to stressors during juvenility on the ability to cope with stress in adulthood. Exposing juvenile-stressed rats to an additional stressful challenge in adulthood revealed their impairment to cope with stress and resulted in significant elevation of the amygdala. Interestingly, and similar to our electrophysiological findings, differential effects were observed between the impact of the emotional challenge on CA1 and dentate gyrus subregions of the hippocampus. Taken together, the results indicate that long-term alterations within the amygdala contribute to stress-related mnemonic symptoms and suggest that elucidating further these intra-amygdala alterations and their effects on modulating other brain regions is likely to be beneficial for the development of novel approaches to treat stress-related disorders.",0,0 +2854,Single-Prolonged Stress Induces Apoptosis by Activating Cytochrome C/Caspase-9 Pathway in a Rat Model of Post-traumatic Stress Disorder,"The purpose of this study was to provide a novel insight into the mechanism of how amygdala might participate in PTSD by investigating the changes of cytochrome c oxidase (COX), caspase-9, and caspase-3 in the amygdala of single-prolonged stress (SPS) rats. A total of 80 healthy, male Wistar rats were selected for this study. The models of post-traumatic stress disorder (PTSD) were created by SPS, which is an established animal model for PTSD. The change of COX was detected by light microscope and transmission electron microscopy (TEM). The expression of caspase-9 and caspase-3 in the basolateral amygdala was examined by immunofluorescence and reverse transcription-polymerase chain reaction (RT-PCR). SPS exposure resulted in a significant change of COX in the SPS model groups compared with the normal control group. Evaluation by enzymohistochemistry indicated translocation of COX from mitochondria to cytoplasm. The expression of both caspase-9 and caspase-3 significantly increased 1 day after SPS stimulation, then gradually increased and peaked at SPS 7d. This findings suggest changes of COX, caspase-9, and caspase-3 in the amygdala of SPS rats, which may play important roles in the pathogenesis of PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +2855,"Post Traumatic Stress, Context, and the Lingering Effects of the Hurricane Katrina Disaster among Ethnic Minority Youth","This study examined the stability of post traumatic stress disorder (PTSD) symptoms in a predominantly ethnic minority sample of youth exposed to Hurricane Katrina. Youth (n∈=∈191 grades 4th thru 8th) were screened for exposure to traumatic experiences and PTSD symptoms at 24 months (Time 1) and then again at 30 months (Time 2) post-disaster. PTSD symptoms did not significantly decline over time and were higher than rates reported at earlier time points for more ethnically diverse samples. Younger age, female sex, and continued disrepair to the child's home predicted stable elevated PTSD symptoms. Findings are consistent with predictions from contextual theories of disaster exposure and with epidemiological data from adult samples suggesting that the incidence of PTSD post Katrina is showing an atypical pattern of remittance. Theoretical, applied, and policy implications are discussed. © 2009 Springer Science+Business Media, LLC.",0,0 +2856,Psychosocial adjustment of directly exposed survivors 7 years after the Oklahoma City bombing,"Abstract Objective The aim of this study was to prospectively examine the long-term course of psychiatric disorders, symptoms, and functioning among 113 directly exposed survivors of the Oklahoma City bombing systematically assessed at 6 months and again nearly 7 years postbombing. Methods The Diagnostic Interview Schedule/Disaster Supplement was used to assess predisaster and postdisaster psychiatric disorders and symptoms and other variables of relevance to disaster exposure and outcomes. Results Total prevalence of posttraumatic stress disorder (PTSD) was 41%. Seven years postbombing, 26% of the sample still had active PTSD. Delayed-onset PTSD and new postdisaster alcohol use disorders were not observed. PTSD nonremission was predicted by the occurrence of negative life events after the bombing. Posttraumatic symptoms among survivors without PTSD decayed more rapidly than for those with PTSD, and symptoms remained at 7 years even for many who did not develop PTSD. Those with PTSD reported more functioning problems at index than those without PTSD, but functioning improved dramatically over 7 years, regardless of PTSD or remission from PTSD. No survivors had long-term employment disability based on psychiatric problems alone. Conclusions These findings have potentially important implications for anticipation of long-term emotional and functional recovery from disaster trauma.",0,0 +2857,Growth mixture modelling in developmental psychology: overview and demonstration of heterogeneity in developmental trajectories of adolescent antisocial behaviour,"Recent advances in statistical techniques for longitudinal data analysis have provided increased capabilities for elucidating individual differences in trajectories of change in child behaviours and abilities. However, most techniques still assume that there is a single underlying distribution with respect to changes over time, about which children are normally distributed. If there are multiple subgroups of youth following distinct developmental trajectories with unique predictors, however, the results of these statistical techniques may provide an incomplete analysis of the data. A newer class of statistical techniques, latent growth mixture modelling, provides a robust framework for examining heterogeneity in patterns of development. This paper illustrates the use of latent growth mixture modelling for examining heterogeneity in developmental trajectories of adolescent antisocial behaviour. Copyright © 2006 John Wiley & Sons, Ltd.",0,0 +2858,Dysfunction and Post-Traumatic Stress Disorder in Fracture Victims 50 Months after the Sichuan Earthquake,"This study aimed to evaluate the effectiveness of a rehabilitation intervention on physical dysfunction (PDF) and post-traumatic stress disorder (PTSD) in fracture victims 50 months after the Sichuan earthquake of 2008 and to identify risk factors for PTSD.This is a retrospective cohort study. Four hundred and fifty-nine earthquake-related fracture victims from Mianzhu city, Sichuan Province who did not qualify for disability pension participated. Two hundred and forty-five subjects received regular rehabilitation and 214 did not. Muscle strength, joint range of motion (ROM),sensory function, and sit-to-stand balance capacity were evaluated to assess PDF. The PTSD Checklist-Civilian Version (PCL-C) was administered to screen for PTSD. An ordinary least square regression was used to predict PTSD, and a logistic regression was used to predict PDF. In addition a Least Angle Regression (LARS) was carried out for PTSD to study the effects of rehabilitation and PDF at the same time.Unadjusted and adjusted group differences in physical dysfunction (p<0.01) and PTSD prevalence (p<0.05) were significant in favor of the rehabilitation group. In addition, being female, average or above family income, having witnessed death and fearfulness were found risk factors for PTSD symptoms 50 months after the earthquake. Both PDF and rehabilitation were selected predictors by LARS demonstrating opposite effects.PDF and PTSD were significantly reduced by the rehabilitation intervention. Future medical intervention strategies should consider rehabilitation in order to assist survivors in dealing with both physical and psychological effects of natural disaster.",0,0 +2859,Differentiating Overreporting and Extreme Distress: MMPI-2 Use With Compensation-Seeking Veterans With PTSD,"This purpose of this study was to examine overreporting on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) in compensation-seeking veterans with posttraumatic stress disorder (PTSD). A sample of veterans tested during a V.A. hospital compensation and pension exam were given the MMPI-2 and measures of PTSD, depression, and combat exposure. Veteran's MMPI-2s were only included in the analyses if their profile was extremely exaggerated, as measured by an F scale T score above 80, did not elevate the MMPI-2 VRIN and TRIN scales, and had a primary diagnosis of PTSD (n = 127). Using the Infrequency-Psychopathology, F(p), scale to distinguish overreporting from distress, it was found that 98 veterans elevated profiles due to distress, whereas 29 elevated due to overreporting, F(p) below and above 7, respectively. Differences between groups on MMPI-2 clinical scales and the other measures were assessed. Implications of these findings for assessing veteran response style and using the MMPI-2 with a PTSD population are discussed.",0,0 +2860,Feigning post-traumatic stress disorder on the PAI,"Multiscale personality inventories have been used to detect dissimulation of PTSD. The Personality Assessment Inventory (PAI) is a self-report inventory which has validity indicators that may be used to detect dishonest or biased self-report. The accuracy of these validity indicators was tested by comparing non-traumatized individuals instructed to fake PTSD with patients diagnosed as having PTSD and normal controls. Twenty-five individuals completed the PAI with the instruction to feign PTSD. The PAI results of these participants were compared to a cohort of 19 patients diagnosed as suffering from PTSD and 21 controls. Eleven of the 25 individuals instructed to fake PTSD on the PAI produced a profile consistent with this diagnosis. However, more than half of the faked profiles were correctly identified as feigned by the validity indicators. Specificity of the validity indicators was very high. The results of this study indicate that the PAI can be one useful source of information for the clinician when assessing for the possible distortion of PTSD symptoms. Copyright © 2000 John Wiley & Sons, Ltd.",0,0 +2861,Patterns of Maternal Distress Among Children With Cancer and Their Association With Child Emotional and Somatic Distress,"To identify patterns of distress among mothers of children with cancer over the initial 6 months of treatment and to examine these patterns as predictors of child somatic and emotional distress.Data were gathered regarding maternal perceived stress and affective distress from mothers of children (N = 65, mean age = 8.3 years) with cancer at 2 to 5 weeks postdiagnosis, then at 12 to 14 weeks and 22 to 24 weeks. Mothers and nurses provided indexes of child somatic and emotional distress at these assessments.Hierarchical and k-means cluster analyses revealed four distinct patterns of maternal distress: high, moderate, declining, and low. The high maternal distress group reported higher child emotional distress at all three points but higher child somatic distress only at the final assessment. Maternal distress group was unrelated to nurse-reported child distress.The identification of four empirically derived patterns of maternal distress may explain some of the variance in the literature regarding parental distress vis-à-vis pediatric cancer treatment and may have relevance to intervention efforts. Differences in the relations between maternal distress groups and mother- and nurse-reported child distress underscore the importance of collecting child distress data from multiple sources.",0,0 +2862,Early-life trauma is associated with rapid eye movement sleep fragmentation among military veterans,"The role of sleep in the relations between early-life trauma and the development of adverse psychological trajectories is relatively unknown and was the primary aim of the present study. Military veterans were evaluated for posttraumatic stress disorder, combat exposure, trauma history, sleep quality, disruptive nocturnal behaviors, and a subsample completed overnight polysomnography that yielded objectively measured sleep parameters. When relevant variables were controlled, increased earlier-life traumatic event exposure was associated with increased rapid-eye-movement sleep (REMs) fragmentation, and increased REMs fragmentation was associated with increased later-life disruptive nocturnal behaviors. REMs fragmentation carried an indirect relation between earlier-life trauma and later-life disruptive nocturnal behaviors. Objectively measured sleep parameters were used to describe REMs fragmentation physiology. The current findings elucidate the important role that earlier-life trauma exposure may have in the development of REM sleep physiology, and how this altered sleep physiology may have dynamic influences on subsequent posttraumatic stress symptoms in adulthood.",0,0 +2863,Comparing exposure metrics for classifying ‘dangerous heat’ in heat wave and health warning systems,"Heat waves have been linked to excess mortality and morbidity, and are projected to increase in frequency and intensity with a warming climate. This study compares exposure metrics to trigger heat wave and health warning systems (HHWS), and introduces a novel multi-level hybrid clustering method to identify potential dangerously hot days. Two-level and three-level hybrid clustering analysis as well as common indices used to trigger HHWS, including spatial synoptic classification (SSC), and the 90th, 95th, and 99th percentiles of minimum and relative minimum temperature (using a 10 day reference period), were calculated using a summertime weather dataset in Detroit from 1976 to 2006. The days classified as 'hot' with hybrid clustering analysis, SSC, minimum and relative minimum temperature methods differed by method type. SSC tended to include the days with, on average, 2.5 °C lower daily minimum temperature and 5.3 °C lower dew point than days identified by other methods. These metrics were evaluated by comparing their performance in predicting excess daily mortality. The 99th percentile of minimum temperature was generally the most predictive, followed by the three-level hybrid clustering method, the 95th percentile of minimum temperature, SSC and others. Our proposed clustering framework has more flexibility and requires less substantial meteorological prior information than the synoptic classification methods. Comparison of these metrics in predicting excess daily mortality suggests that metrics thought to better characterize physiological heat stress by considering several weather conditions simultaneously may not be the same metrics that are better at predicting heat-related mortality, which has significant implications in HHWSs.",0,0 +2864,A Multisite Study of Initial Respiration Rate and Heart Rate as Predictors of Posttraumatic Stress Disorder,"Fear-conditioning models posit that increased arousal at the time of trauma predicts subsequent posttraumatic stress disorder (PTSD). This multisite study evaluated the extent to which acute heart rate and respiration rate predict subsequent chronic PTSD.Traumatically injured patients admitted to 4 hospitals across Australia between April 2004 and February 2006 were initially assessed during hospital admission (N = 1105) and were reassessed 3 months later for PTSD by using the Clinician-Administered PTSD Scale-IV and for major depressive disorder (MDD) by using the Mini-International Neuropsychiatric Interview (English version 5.0.0) (N = 955). Heart rate, respiration rate, and blood pressure were assessed on the initial day of traumatic injury.Ninety patients (10%) met criteria for PTSD and 159 patients (17%) met criteria for MDD at the 3-month assessment. Patients with PTSD compared to those without PTSD had higher heart rate (90.16 +/- 18.66 vs. 84.84 +/-17.41, t = 2.74, p < .01) and respiration rate (20.24 +/- 5.16 vs. 18.58 +/- 4.29, t = 3.43, p < .001) immediately after injury. There were no heart rate or respiration rate differences between patients who did and did not develop MDD. Patients were more likely to develop PTSD at 3 months if they had a heart rate of at least 96 beats per minute (15% vs. 8%, OR = 2.12, 95% CI = 1.34 to 3.33) or respiration rate of at least 22 breaths per minute (18% vs. 8%, OR = 2.42, 95% CI = 1.48 to 3.94).Elevated heart rate and respiration rate are predictors of subsequent PTSD. These data underscore the need for future research into secondary prevention strategies that reduce acute arousal immediately after trauma and may limit PTSD development in some individuals.",0,0 +2865,"Attachment to therapist, the working alliance and emotional processing of traumatic material in session among veterans diagnosed with posttraumatic stress disorder","Title from PDF of title page (University of Missouri--Columbia, viewed on August 25, 2010).",0,0 +2866,Association of Posttraumatic Stress Disorder With Reduced In Vivo Norepinephrine Transporter Availability in the Locus Coeruleus,"Animal data suggest that chronic stress is associated with a reduction in norepinephrine transporter (NET) availability in the locus coeruleus. However, it is unclear whether such models are relevant to posttraumatic stress disorder (PTSD), which has been linked to noradrenergic dysfunction in humans.To use positron emission tomography and the radioligand [11C]methylreboxetine to examine in vivo NET availability in the locus coeruleus in the following 3 groups of individuals: healthy adults (HC group), adults exposed to trauma who did not develop PTSD (TC group), and adults exposed to trauma who developed PTSD (PTSD group) and to evaluate the relationship between NET availability in the locus coeruleus and a contemporary phenotypic model of PTSD symptoms.Cross-sectional positron emission tomography study under resting conditions at academic and Veterans Affairs medical centers among 56 individuals in the following 3 study groups: HC (n = 18), TC (n = 16), and PTSD (n = 22).The [11C]methylreboxetine-binding potential of NET availability in the locus coeruleus and the severity of PTSD symptoms assessed using the Clinician-Administered PTSD Scale.The PTSD group had significantly lower NET availability than the HC group (41% lower, Cohen d = 1.07). NET availability did not differ significantly between the TC and HC groups (31% difference, Cohen d = 0.79) or between the TC and PTSD groups (15% difference, Cohen d = 0.28). In the PTSD group, NET availability in the locus coeruleus was independently positively associated with the severity of anxious arousal (ie, hypervigilance) symptoms (r = 0.52) but not with any of the other PTSD symptom clusters.These results suggest that PTSD is associated with significantly reduced NET availability in the locus coeruleus and that greater NET availability in this brain region is associated with increased severity of anxious arousal symptoms in individuals with PTSD.",0,0 +2867,Trauma-informed sexuality education: recognising the rights and resilience of youth,"Experiences of maltreatment during childhood and the emergence of sexuality during adolescence are both critical developmental issues that intersect in meaningful ways, yet the two are often isolated from each other in practice. Despite the prevalence of childhood maltreatment, sexuality education does not accommodate young people with trauma histories. This results in curricula and content that ignore the particular needs and experiences of a proportion of students in sexuality education classrooms. Trauma interventions commit a similar oversight by neglecting the prospects for positive, growth-promoting sexual experiences and relationships among young people who have been abused. The failure to account for young people's resilience in the sexual domain results in treatment approaches that emphasise sexual risks (e.g. revictimisation) and problem behaviours to the exclusion of guidance in cultivating positive sexualities. Consequently, many forms of sexuality education and maltreatment interventions may ...",0,0 +2868,Factors discriminating among profiles of resilience and psychopathology in children exposed to intimate partner violence (IPV),"To evaluate the social and emotional adjustment of 219 children in families with varying levels of intimate partner violence (IPV) using a model of risk and protection. To explore factors that differentiate children with poor adjustment from those with resilience.Mothers who experienced IPV in the past year and their children ages 6-12 were interviewed. Standardized measures assessed family violence, parenting, family functioning, maternal mental health, and children's adjustment and beliefs.Using cluster analysis, all cases with valid data on the Child Behavior Checklist, Child Depression Inventory, General Self-Worth and Social Self-Competence measures were described by four profiles of children's adjustment: Severe Adjustment Problems (24%); children who were Struggling (45%); those with Depression Only (11%); and Resilient (20%) with high competence and low adjustment problems. Multinomial logistic regression analyses showed children in the Severe Problems cluster witnessed more family violence and had mothers higher in depression and trauma symptoms than other children. Resilient and Struggling children had mothers with better parenting, more family strengths and no past violent partner. Parents of children with Severe Problems were lacking these attributes. The Depressed profile children witnessed less violence but had greater fears and worries about mother's safety.Factors related to the child, to the mother and to the family distinguish different profiles of adjustment for children exposed to IPV who are living in the community. Resilient children have less violence exposure, fewer fears and worries, and mothers with better mental health and parenting skills, suggesting avenues for intervention with this population.Findings suggest that child adjustment is largely influenced by parent functioning. Thus, services should be targeted at both the child and the parent. Clinical interventions shaped to the unique needs of the child might also be tested with this population.",0,0 +2869,"The Bosnian version of the international self-report measure of posttraumatic stress disorder, the Posttraumatic Stress Diagnostic Scale, is reliable and valid in a variety of different adult samples affected by war","The aim of the present study was to assess the internal consistency and discriminant and convergent validity of the Bosnian version of a self-report measure of posttraumatic stress disorder (PTSD), the Posttraumatic Stress Diagnostic Scale (PTDS). The PTDS yields both a PTSD diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) and a measure of symptom severity.812 people living in Sarajevo or in Banja Luka in Bosnia-Herzegovina, of whom the majority had experienced a high number of traumatic war events, were administered the PTDS and other measures of trauma-related psychopathology. The psychometric properties of the instrument were assessed using Cronbach's alpha and principal components analysis, and its construct validity was assessed via Spearman correlation coefficients with the other instruments.The PTDS and its subscales demonstrated high internal consistency. The principal components revealed by an exploratory analysis are broadly consistent with the DSM-IV subscales except that they reproduce some previously reported difficulties with the ""numbing"" items from the avoidance subscale. The construct validity of the PTDS was supported by appropriate correlations with other relevant measures of trauma related psychopathology.The Bosnian version of the PTDS thus appears to be a time-economic and psychometrically sound measure for screening and assessing current PTSD. This self-report measure awaits further validation by interview methods.",0,0 +2870,"Resilience, internalized stigma, self-esteem, and hopelessness among people with schizophrenia: Cultural comparison in Austria and Japan","Resilience is becoming an important topic in people with schizophrenia since there is evidence that it increases the probability for long-term recovery. The current study investigated transcultural differences in resilience across schizophrenia patients from two different geographical regions, Austria and Japan. Another objective was to examine transcultural differences in internalized stigma, self-esteem, and hopelessness, which can be expected to be relevant in this context, as well as the interrelations between these subjective elements of recovery and symptom severity. To this end, patients from outpatient mental health services in Innsbruck, Austria (N=52) and Tokyo, Japan (N=60) as well as 137 healthy comparison subjects from both countries were included into this cross-sectional study. Notably, we detected a significant country effect with markedly lower resilience (F=74.4, p<0.001) and self-esteem scores (F=226.0, p<0.001) as well as higher hopelessness scores (F=37.4, p<0.001) among Japanese subjects in general. In addition, both Austrian and Japanese patients indicated significantly lower degrees of resilience (F=57.5, p<0.001), self-esteem (F=51.8, p<0.001), and hope (F=29.5, p<0.001) compared to healthy control subjects. The inter-correlations between subjective elements of recovery were comparable in size in the two patient samples, but the inter-correlations between these issues and residual symptoms of schizophrenia as objective domains of recovery were markedly higher in Austrian subjects. This suggests that schizophrenia patients from Western European and Japanese cultures may have different needs to achieve recovery. In conclusion, it will be critical to develop culture-specific psychosocial programs and to examine their feasibility and effectiveness among these patients.",0,0 +2871,Pilot study on prolonged exposure of Japanese patients with posttraumatic stress disorder due to mixed traumatic events,"This pilot study investigated the feasibility of Prolonged Exposure (PE) treatment for Japanese patients with posttraumatic stress disorder (PTSD) due to mixed traumatic events. Among 12 participants in this study, 9 women and 1 man completed between 9 and 15 weekly individual PE sessions; 2 female participants dropped out in early sessions. Among completers, the authors identified a significant reduction of symptom severity scores from pretreatment to posttreatment in terms of PTSD and depression on therapist-rated and self-rated measurements. Symptom levels remained low in 3- and 6-month follow-up assessments. Our findings suggest that PE is feasible and can be accepted for PTSD patients not only in Western countries, but also for those in Japan.",0,0 +2872,Hierarchical organization of axis I psychiatric disorder comorbidity through age 30,"Hierarchical models of psychopathology based on substantial numbers of lifetime diagnostic categories have not been sufficiently evaluated, even though such models have relevance for theories of disorder etiology, course, or prognosis. In this research, a hierarchical component model of 16 Axis I disorders is derived, and model elements are evaluated in terms of their ability to demonstrate distinct associations with several clinically-relevant variables. Participants were 816 randomly selected adolescents from the community who were repeatedly assessed for psychiatric disorders and associated risk and protective factors over a 14-year period. First-degree relatives were also interviewed to establish their lifetime psychiatric history. Patterns of lifetime comorbidity among 16 psychiatric disorders were described at five levels of organization. In addition to the broadest level that accounted for the most variance in disorder covariation, evidence was obtained at successive levels in the hierarchy for internalizing and externalizing broad-band domains that could be subdivided into more refined clusters. The validity and potential utility of the resultant hierarchical model were further supported by distinct associations that components at each level had with exposure to childhood adversities, psychiatric disorders among first-degree relatives, and psychosocial functioning at ~age 30. A large number of DSM Axis I disorders can be described within broad-band internalizing and externalizing domains, and further differentiation within these domains is possible and likely useful for some purposes. Implications of this research for conceptualizing relations among psychiatric disorders are discussed.",0,0 +2873,A Guide to Psychological Debriefing: Managing Emotional Decompression and Post-Traumatic Stress Disorder,"(from the cover) Traumatic events strike unexpectedly and can turn everyday life upside down. Frequently, people suffering trauma cannot get past the experience and develop Post-Traumatic Stress Disorder (PTSD). Psychological debriefing (PD) is a process commonly used to prevent an individual from developing PTSD, allowing them to re-examine the event in a safe and controlled environment. This book offers a practical introduction to PTSD and psychological debriefing, and outlines an enhanced model of PD: 'Emotional Decompression'. Structured like a deep-sea dive, it incorporates carefully planned safety stops for discussion and explanation on the way back to the 'surface' to avoid getting 'the bends'. The book presents a range of recovery models, from the 'simple' models developed by Williams and Horowitz to the more complex 'Snakes and Ladders' model developed by the author. This book is essential for health practitioners, counselors, psychologists and professionals working with clients suffering from PTSD, as well as students. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +2874,The role of ex-POWs’ PTSD symptoms and trajectories in wives’ secondary traumatization.,"Secondary traumatization describes the phenomenon whereby those in proximity to trauma survivors develop psychological symptoms similar to those experienced by the direct survivor. The current study examined secondary trauma (ST) and generalized distress symptoms (general psychiatric symptomatology, functional disability, and self-rated health) in wives of former prisoners of war (ex-POWs). The study compared wives of Israeli ex-POWs from the 1973 Yom Kippur War with wives of a matched control group of non-POW Yom Kippur War combat veterans (CVs). The wives also were divided into groups based on their husbands' current posttraumatic stress disorder (PTSD) status and PTSD trajectory (i.e., chronic, delayed), and their outcomes were compared with resilient CVs. We found that wives of ex-POWs with PTSD reported higher ST and generalized distress than wives of ex-POWs and non-POW CVs without PTSD. Wives of ex-POWs with chronic PTSD reported the highest levels of functional disability. We also found that the relationships between husbands' prior captivity, and wives' ST and general psychiatric symptomatology were fully mediated by the husbands' PTSD symptoms. These findings indicate that it is exposure to a partner with PTSD that leads to overall ST and other distress symptoms, and not simply to a trauma survivor. Furthermore, the more severe their husbands' PTSD, the more wives are at risk for ST and general psychiatric symptomatology. Wives of partners with PTSD should therefore be considered high-risk groups for ST and distress that may require targeted interventions.",0,0 +2875,"Community-building before, during, and after times of trauma: The application of the LINC model of community resilience in Kosovo.","A family's heritage and values have profound bearing on the stressors they encounter and how they cope. Socioeconomic change, natural and man-made disasters, and international migration are major influences on the integrity of society. In these times of global financial crisis, communities around the world are in danger of losing their intrinsic structure and protective factors. Connectedness or attachment to family and culture of origin correlate with reduced risk-taking behaviors and a reduction in family and societal violence, posttraumatic stress, addiction, depression, suicidality, sexual risk taking, and other chronic and/or life-threatening health problems and illnesses. Facilitating these families' cultural and community ties and enhancing their access to extended-family and community resources can thus be protective against trauma. These relationships foster resilience and reduce the short- and long-term effects of stress on families and communities. Targets of interventions may be individuals, families, or communities. Assessment of vulnerabilities, protective factors, goals, and resources encourages and facilitates collaboration across natural and artificial support systems. Such collaboration is important in building resilience rather than perpetuating vulnerability and long-term problems for individuals, their families, and the communities in which they live. The recent Kosovar experience in implementing the LINC Model of Community Resilience illustrates these principles, as applied in the context of substance abuse services and community rebuilding in the period soon after armed conflict.",0,0 +2876,Pharmacotherapy for post traumatic stress disorder (PTSD),"Post traumatic stress disorder (PTSD) is a prevalent and disabling disorder. Evidence that PTSD is characterised by specific psychobiological dysfunctions has contributed to a growing interest in the use of medication in its treatment.To assess the effects of medication for post traumatic stress disorder.We searched the Cochrane Depression, Anxiety and Neurosis Group specialised register (CCDANCTR-Studies) on 18 August 2005, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library issue 4, 2004), MEDLINE (January 1966 to December 2004), PsycINFO (1966 to 2004), and the National PTSD Center Pilots database. Reference lists of retrieved articles were searched for additional studies.All randomised controlled trials (RCTs) of pharmacotherapy for PTSD.Two raters independently assessed RCTs for inclusion in the review, collated trial data, and assessed trial quality. Investigators were contacted to obtain missing data. Summary statistics were stratified by medication class, and by medication agent for the selective serotonin reuptake inhibitors (SSRIs). Dichotomous and continuous measures were calculated using a random effects model, heterogeneity was assessed, and subgroup/sensitivity analyses were undertaken.35 short-term (14 weeks or less) RCTs were included in the analysis (4597 participants). Symptom severity for 17 trials was significantly reduced in the medication groups, relative to placebo (weighted mean difference -5.76, 95% confidence intervals (CI) -8.16 to -3.36, number of participants (N) = 2507). Similarly, summary statistics for responder status from 13 trials demonstrated overall superiority of a variety of medication agents to placebo (relative risk 1.49, 95% CI 1.28 to 1.73, number needed to treat = 4.85, 95% CI 3.85 to 6.25, N = 1272). Medication and placebo response occurred in 59.1% (N = 644) and 38.5% (628) of patients, respectively. Of the medication classes, evidence of treatment efficacy was most convincing for the SSRIs. Medication was superior to placebo in reducing the severity of PTSD symptom clusters, comorbid depression and disability. Medication was also less well tolerated than placebo. A narrative review of 3 maintenance trials suggested that long term medication may be required in treating PTSD.Medication treatments can be effective in treating PTSD, acting to reduce its core symptoms, as well as associated depression and disability. The findings of this review support the status of SSRIs as first line agents in the pharmacotherapy of PTSD, as well as their value in long-term treatment. However, there remain important gaps in the evidence base, and a continued need for more effective agents in the management of PTSD.",0,0 +2877,Psychological resilience and dysfunction among hospitalized survivors of the SARS epidemic in Hong Kong: A latent class approach.,"To examine trajectories of psychological functioning using latent class analysis on a sample of hospitalized survivors of the 2003 severe acute respiratory syndrome (SARS) epidemic in Hong Kong.A longitudinal study of 997 survivors, recruited from among 1,331 individuals hospitalized for SARS, were interviewed at 6, 12, and 18 months after hospitalization.Psychological and physical functioning at each time point was measured using the 12-item Medical Outcome Study Short-Form Health Survey (SF-12).Four latent classes were identified--chronic dysfunction, delayed dysfunction, recovery, and resilience. All groups had better physical health than the chronic group. Resilient and recovered individuals had greater social support and less SARS-related worry, and resilient individuals were more likely to be male. The resilient group also had greater social support than the delayed group and better physical functioning than the recovered group.This study demonstrated that longitudinal outcome trajectories following a major health-threat event in an Asian sample bear close resemblance to prototypical trajectories observed in trauma studies using Western samples. Unique predictors of the trajectories included factors observed in previous studies, such as social support, as well as factors of particular relevance to a major disease outbreak, such as SARS-related worry.",0,0 +2878,"Traumatic stress, oxidative stress and post-traumatic stress disorder: neurodegeneration and the accelerated-aging hypothesis","Post-traumatic stress disorder (PTSD) is associated with elevated risk for a variety of age-related diseases and neurodegeneration. In this paper, we review evidence relevant to the hypothesis that chronic PTSD constitutes a form of persistent life stress that potentiates oxidative stress (OXS) and accelerates cellular aging. We provide an overview of empirical studies that have examined the effects of psychological stress on OXS, discuss the stress-perpetuating characteristics of PTSD, and then identify mechanisms by which PTSD might promote OXS and accelerated aging. We review studies on OXS-related genes and the role that they may have in moderating the effects of PTSD on neural integrity and conclude with a discussion of directions for future research on antioxidant treatments and biomarkers of accelerated aging in PTSD.",0,0 +2879,Post-traumatic stress avoidance is attenuated by corticosterone and associated with brain levels of steroid receptor co-activator-1 in rats,"Individuals with post-traumatic stress disorder (PTSD) avoid trauma-related stimuli and exhibit blunted hypothalamic-pituitary-adrenal (HPA) axis activation at the time of stress. Our rodent model of stress mimics the avoidance symptom cluster of PTSD. Rats are classified as ""Avoiders"" or ""Non-Avoiders"" post-stress based on the avoidance of a predator-odor paired context. Previously, we found Avoiders exhibit an attenuated HPA stress response to predator odor. We hypothesized that corticosterone administration before stress would reduce the magnitude and incidence of stress-paired context avoidance. Furthermore, we also predicted that Avoiders would exhibit altered expression of glucocorticoid receptor (GR) signaling machinery elements, including steroid receptor co-activator (SRC)-1. Male Wistar rats (n = 16) were pretreated with corticosterone (25 mg/kg) or saline and exposed to predator-odor stress paired with a context and tested for avoidance 24 h later. A second group of corticosterone-naïve rats (n = 24) were stressed (or not), indexed for avoidance 24 h later, and killed 48 h post-odor exposure to measure phosphorylated GR, FKBP51 and SRC-1 levels in the paraventricular nucleus (PVN), central amygdala (CeA) and ventral hippocampus (VH), all brain sites that highly express GRs and regulate HPA function. Corticosterone pretreatment reduced the magnitude and incidence of avoidance. In Avoiders, predator-odor exposure led to lower SRC-1 expression in the PVN and CeA, and higher SRC-1 expression in the VH. SRC-1 expression in PVN, CeA and VH was predicted by prior avoidance behavior. Hence, a blunted HPA stress response may contribute to stress-induced neuroadaptations in central SRC-1 levels and behavioral dysfunction in Avoider rats.",0,0 +2880,Psychological Assessment of Patients with Dissociative Identity Disorder,"This article discusses how psychologic assessment can assist in the diagnosis of dissociative identity disorder (DID) and in planning treatment for patients who are dissociative. A battery of tests that can assess the extent of dissociation is outlined, the research on dissociation on various psychologic tests is reviewed, and new Rorschach data on severely dissociative patients that can be useful in planning treatment is presented. Diagnosing DID is a complex process and requires assessors to have knowledge of the assessment and treatment literature on posttraumatic stress disorder (PTSD), dissociative disorders, and personality disorders. The literature provides excellent reviews of assessment of posttraumatic states [1–4]. In addition to the complexity of assessing PTSD itself, assessment of DID requires the patient to reveal what is often a private, hidden world to a powerful stranger [5]. These challenges may be further compounded because many of the measures, particularly the projective tests, can open up emotional wounds and stir potentially painful memories, triggering dissociation and switching among dissociated states during the testing itself [5,6]. Clinicians must develop a collaborative relationship with patients who have DID before beginning the assessment to make the experience therapeutic rather than retraumatizing. A collaborative relationship will also help yield meaningful, rather than defended, test results.",0,0 +2881,Are lifestyle behavioral factors associated with health-related quality of life in long-term survivors of non-Hodgkin lymphoma?,"The objective of the current study was to determine whether survivors of non-Hodgkin lymphoma are meeting select American Cancer Society (ACS) health-related guidelines for cancer survivors, as well as to examine relationships between these lifestyle factors and health-related quality of life (HRQoL) and posttraumatic stress (PTS).A cross-sectional sample of 566 survivors of NHL was identified from the tumor registries of 2 large academic medical centers. Respondents were surveyed regarding physical activity, fruit and vegetable intake, body weight, tobacco use, HRQoL using the Medical Outcomes Study Short Form-36, and PTS using the Posttraumatic Stress Disorder CheckList-Civilian form. Lifestyle cluster scores were generated based on whether individuals met health guidelines and multiple linear regression analysis was used to evaluate relationships between lifestyle behaviors and HRQoL scores and PTS scores.Approximately 11% of participants met all 4 ACS health recommendations. Meeting all 4 healthy recommendations was related to better physical and mental QoL (standardized regression coefficient [β], .57 [P<.0001] and β, .47 [P = .002]) and to lower PTS scores (β, -0.41; P = .01).Survivors of NHL who met more ACS health-related guidelines appeared to have better HRQoL and less PTS. Unfortunately, many survivors are not meeting these guidelines, which could impact their overall well-being and longevity.",0,0 +2882,Heat stress deteriorates mitochondrial β-oxidation of long-chain fatty acids in cultured fibroblasts with fatty acid β-oxidation disorders,"Mitochondrial fatty acids beta-oxidation disorder (FAOD) has become popular with development of tandem mass spectrometry (MS/MS) and enzymatic evaluation techniques. FAOD occasionally causes acute encephalopathy or even sudden death in children. On the other hand, hyperpyrexia may also trigger severe seizures or encephalopathy, which might be caused by the defects of fatty acid beta-oxidation (FAO). We investigated the effect of heat stress on FAO to determine the relationship between serious febrile episodes and defect in beta-oxidation of fatty acid in children. Fibroblasts from healthy control and children with various FAODs, were cultured in the medium loaded with unlabelled palmitic acid for 96 h at 37 degrees C or 41 degrees C. Acylcarnitine (AC) profiles in the medium were determined by MS/MS, and specific ratios of ACs were calculated. Under heat stress (at 41 degrees C), long-chain ACs (C12, C14, or C16) were increased, while medium-chain ACs (C6, C8, or C10) were decreased in cells with carnitine palmitoyl transferase II deficiency, very-long-chain acyl-CoA dehydrogenase deficiency and mitochondrial trifunctional protein deficiency, whereas AC species from short-chain (C4) to long-chain (C16) were barely affected in medium-chain acyl-CoA dehydrogenase and control. While long-chain ACs (C12-C16) were significantly elevated, short to medium-chain ACs (C4-C10) were reduced in multiple acyl-CoA dehydrogenase deficiency. These data suggest that patients with long-chain FAODs may be more susceptible to heat stress compared to medium-chain FAOD or healthy control and that serious febrile episodes may deteriorate long-chain FAO in patients with long-chain FAODs.",0,0 +2883,Determinants of resource needs and utilization among refugees over time,"This study examined refugees' resource needs and utilization over time, investigated the relationships between pre-displacement/socio-demographic variables and resource needs and utilization, and explored the role of resource needs and utilization on psychiatric symptom trajectories.Iraqi refugees to the United States (N = 298) were assessed upon arrival and at 1-year intervals for 2 years for socio-demographic variables and pre-displacement trauma experiences, their need for and utilization of 14 different resources, and PTSD and depressive symptoms.Although refugees reported reduction of some needs over time (e.g., need for cash assistance declined from 99 to 71 %), other needs remained high (e.g., 99 % of refugees reported a need for health care at the 2-year interview). Generally, the lowest needs were reported after 2 years, and the highest utilization occurred during the first year post-arrival. Pre-displacement trauma exposure predicted high health care needs but not high health care utilization. Both high need for and use of health care predicted increasing PTSD and depressive symptoms. Specifically, increased use of psychological care across the three measurement waves predicted more PTSD and depression symptoms at the 2-year interview.Differences emerged between need for and actual use of resources, especially for highly trauma-exposed refugees. Resettlement agencies and assistance programs should consider the complex relationships between resource needs, resource utilization, and mental health during the early resettlement period.",0,0 +2884,Profiles of Adaptation Among Child Victims of Suspected Maltreatment,"This research seeks to identify profiles of adaptation among child victims of suspected maltreatment using a social-ecological framework. Data were drawn from the LONGSCAN multisite longitudinal study. Participants were 597 12-year-old children of diverse backgrounds (57% girls) with at least one Child Protective Services report of suspected maltreatment (M = 3.4 reports). Self-, caregiver-, and teacher-reports were collected to assess child competence, psychological and behavioral problems, and family and neighborhood characteristics. Latent Profile Analysis was used to classify individuals into empirically derived groups. The best-fitting model yielded five distinct profiles: consistent resilience; consistent maladaptation; posttraumatic stress problems; school maladaptation, family protection; and low socialization skills. Findings underscore the heterogeneity of child adaptation and reveal unique profiles of adaptation and contextual protection. Within-person variation in functioning suggests the need for comprehensive assessment across domains and contexts to address the clinical needs of maltreated youth.",0,0 +2885,Postdeployment Suicidal Ideations and Trajectories of Posttraumatic Stress Disorder in Danish Soldiers,"Article AbstractObjective: Suicidal ideation in veterans is of great concern. The objective of this study is to examine how heterogeneous posttraumatic stress disorder (PTSD) trajectories are associated with postdeployment suicidal ideation in veterans 2.5 years postdeployment to a combat zone in Afghanistan. If PTSD trajectories are associated with postdeployment suicidal ideations, then the accumulative knowledge on what characterizes veterans falling into different PTSD trajectories may provide better opportunities for early identification of suicidal high-risk veterans.Method: In this prospective study of 743 Danish soldiers deployed to Afghanistan from February to August in 2009, we collected data at 6 time points from 6 weeks before deployment to 2.5 years after homecoming (total for this study: 456). At all assessments, the soldiers responded to a comprehensive questionnaire including measures of PTSD (measured by the PTSD Checklist, Civilian Version) and other mental and physical health variables, demographics, and social and combat-related factors. Suicidal ideation was measured by an item from the European Parasuicide Study Interview Schedule II. In a previous study based on soldiers from this cohort, we identified 6 PTSD trajectories using latent growth mixture modeling, which we have extracted and applied as independent variables in this study. Adjusted multivariable logistic regression analyses were applied to examine whether deployed soldiers with certain PTSD symptom trajectories were more likely to report suicidal ideation 2.5 years after homecoming.Results: Two PTSD trajectories with high PTSD symptom level 2.5 years after return were significantly associated with suicidal ideation 2.5 years after homecoming. Thus, a relieved-worsening class, described by initial decreasing PTSD symptom levels followed by a steep increase in symptoms had higher risk of suicidal ideation (OR = 7.84; 95% CI, 1.68-36.6), which was also the case for a late-onset class (OR 5.2; 95% CI, 2.21-12.24) when compared to a low-stable class.Conclusions: Heterogeneous PTSD trajectories are associated with suicidal ideation in veterans 2.5 years after homecoming.",0,0 +2886,The descriptive epidemiology of internalizing and externalizing psychiatric dimensions,"Background: There is a growing recognition that comorbidity among individual mental disorders is best explained by the broad, psychiatric dimensions of internalization (sub-divided into distress and fear) and externalization. The aims of the current study were to examine the descriptive epidemiology of these psychiatric dimensions. Methods: Continuous measures of distress, fear and externalization dimensions were obtained from principal components analysis of 11 common ICD-10 mental disorders in a large (N = 10,641) community sample. The relationships between these three dimensions and sociodemographic, physical illness and personality disorder characteristics were determined using multivariate linear regression analyses. Results: The results suggest that the distress dimension is more strongly related to disadvantageous sociodemographic characteristics and physical health conditions than either the fear or externalizing dimensions. The results also demonstrate some specificity in profiles particularly with regard to the personality disorders. Conclusions: Greater emphasis should be placed on continuous psychiatric dimensions that are thought to underlie the expression of putatively independent mental disorders. \ \text",0,0 +2887,Post-traumatic stress disorder following disasters: a systematic review,"Background Disasters are traumatic events that may result in a wide range of mental and physical health consequences. Post-traumatic stress disorder (PTSD) is probably the most commonly studied post-disaster psychiatric disorder. This review aimed to systematically assess the evidence about PTSD following exposure to disasters. Method A systematic search was performed. Eligible studies for this review included reports based on the DSM criteria of PTSD symptoms. The time-frame for inclusion of reports in this review is from 1980 (when PTSD was first introduced in DSM-III) and February 2007 when the literature search for this examination was terminated. Results We identified 284 reports of PTSD following disasters published in peer-reviewed journals since 1980. We categorized them according to the following classification: (1) human-made disasters ( n =90), (2) technological disasters ( n =65), and (3) natural disasters ( n =116). Since some studies reported on findings from mixed samples (e.g. survivors of flooding and chemical contamination) we grouped these studies together ( n =13). Conclusions The body of research conducted after disasters in the past three decades suggests that the burden of PTSD among persons exposed to disasters is substantial. Post-disaster PTSD is associated with a range of correlates including sociodemographic and background factors, event exposure characteristics, social support factors and personality traits. Relatively few studies have employed longitudinal assessments enabling documentation of the course of PTSD. Methodological limitations and future directions for research in this field are discussed.",0,0 +2888,Posttraumatic Stress Symptomatology as a Mediator of the Association Between Military Sexual Trauma and Post-Deployment Physical Health in Women,"This study examined posttraumatic stress symptomatology (PSS) as a mediator of the association between military sexual trauma and post-deployment physical health. Relationships were examined in a sample of 83 female veterans of the first Gulf War (1990-1991) approximately 10 years post-deployment. Participants reported on the frequency of sexual harassment and sexual assault experienced during deployment. Physical health was measured using participants' self-reports of pre-deployment and post-deployment symptoms within 7 body systems. Sexual harassment exposure was not found to be associated with PSS-mediated associations with physical health symptoms. However, sexual assault during deployment was found to be associated with PSS and 4 of the 7 health symptom clusters assessed: gastrointestinal, genitourinary, musculoskeletal, and neurological symptoms. Furthermore, PSS was found to be a significant mediator of the sexual assault-physical health relationship in each of these domains, with the indirect path accounting for 74% to 100% of the relationship. The findings from the current study indicate that sexual assault has detrimental associations with physical health and that PSS plays a primary role in that relationship.",0,0 +2889,Exposure to Prolonged Socio-Political Conflict and the Risk of PTSD and Depression among Palestinians,"Little is known about the impact of traumatic experiences and stressful life conditions on people in low-income countries who live in conditions of ongoing political violence. In order to determine the prevalence and predictors of post-traumatic stress disorder (PTSD) and major depression (MD) among Palestinians subjected to chronic political violence and upheaval, we used a stratified multi-stage cluster random sampling strategy to interview a representative sample of 1,200 Palestinian adults living in Gaza, the West Bank, and East Jerusalem. Prevalence of PTSD/MD for men living in the West Bank, Gaza, and East Jerusalem was 25.4%/29.9%, 22.6%/27.6%, and 16.1%/16.1%, respectively. For women, the prevalence of PTSD/MD was 23.8%/29.0%, 23.9%/28.9%, and 19.7%/27.6%. Among men, PTSD was significantly positively associated with age group, two or more incidences of political violence (compared to none), greater intrapersonal resource loss, and loss of faith in government. MD was positively associated with experiencing exposure to one, or two or more, incidences of political violence (compared to none), and greater interpersonal and intrapersonal resource loss. Among women, PTSD was positively associated with greater interpersonal and intrapersonal resource loss, and MD was positively associated with death of a loved one, two or more socio-political stressors (compared to none) previous to the past year, one or more socio-political stressors (compared to none) in the past year, and greater interpersonal and intrapersonal resource loss. Interpersonal and intrapersonal resource losses were consistently associated with PTSD and MD, suggesting potential targets for intervention and prevention efforts and thus provide important keys to treatment in areas of ongoing conflict.",0,0 +2890,Psychosocial Factors Limit Outcomes after Trauma,"Psychological morbidity compromises return to work after trauma. We demonstrate this relationship and present methods to identify risks for significant psychological morbidity.Thirty-five adults were evaluated prospectively for return to functional employment after injury using demographic data, validated psychological and health measures, and the Michigan Critical Events Perception Scale. Evaluation was conducted at admission and at 1 and 5 months after injury.Poor return to work at 5 months was attributable to physical disability (p < 0.05) and psychological disturbance (p < 0.05) in a regression model that controlled for preinjury employment and psychopathologic factors as well as injury severity. A high score on the Impact of Events Scale administered during acute admission predicted development of acute stress disorder at 1 month (p < 0.01, odds ratio (OR) = 9.4) and posttraumatic stress disorder at 5 months (p < 0.05, OR = 6.7). Peritraumatic dissociation on the Michigan Critical Events Perception Scale was predictive for development of acute stress disorder (p < 0.05, OR = 5.8) at 1 month and posttraumatic stress disorder (p < 0.05, OR = 7.5) at 5 months.Psychological morbidity after injury compromises return to work independent of preinjury employment and psychopathologic condition, Injury Severity Score, or ambulation. A high Impact of Events Scale score or peritraumatic dissociation at admission predicts this morbidity.",0,0 +2891,The Equivalence of Traditional and Diagnostic Classification Model Approaches in Analyzing Empirical and Simulated Posttraumatic Stress Disorder Data,"The purpose of this study was to evaluate the performance of a log-linear cognitive diagnosis model (LCDM) as compared to three traditional scoring methods for the diagnosis of posttraumatic stress disorder (PTSD) as measured by the Posttraumatic Stress Disorder Checklist (PCL) civilian and military versions. Both civilian (empirical) and military (simulated) data were used in this study. Changes in the measurement and structure of PTSD have occurred over the years, especially as it related to military Veterans. Just recently in 2013, the diagnostic criteria for PTSD was changed to a four-dimensional diagnosis, although this study used the pre-2013 three-dimensional diagnosis due to the time period and instruments used to collect the empirical sample and the original samples used as parameters for the simulated data. Model parameters, respondent estimates, respondent classifications, and rates of agreement between the diagnostic methods were explored for both empirical and simulated data and further for sample size differences with the simulated data. The LCDM structural model was found to be comparable to the CFA model and the average item intercept -.539, showing that roughly 37% of respondents who were not positive for any PTSD clusters endorsed the item as being a problem they experienced. The average main effect parameter was 2.318, the size of which is relative to the size of the intercept where the lower intercepts and higher main effects showed more discrimination between those respondents who were ill or not ill with PTSD. Since posttraumatic stress disorder is both a compensatory and non-compensatory diagnosis the LCDM was evaluated on how well it was able to reflect these dimensions in the respondent estimates and classifications. Overall, the LCDM performed poorly compared to the traditional scoring, with the LCDM performing better at the symptom cluster level than at the diagnostic level. The potential utility of this feedback to a practicing clinician was found to be not yet suitable to clinical practice, but this study shows an opportunity to refine the PCL instrument to perform better in the LCDM framework, or to develop an instrument that is more discriminating and may be useful in differential diagnosis. (PsycINFO Database Record (c) 2015 APA, all rights reserved)",0,0 +2892,“Clinical brain profiling”: A neuroscientific diagnostic approach for mental disorders,"Clinical brain profiling is an attempt to map a descriptive nosology in psychiatry to underlying constructs in neurobiology and brain dynamics. This paper briefly reviews the motivation behind clinical brain profiling (CBP) and presents some provisional validation using clinical assessments and meta-analyses of neuroscientific publications. The paper has four sections. In the first, we review the nature and motivation for clinical brain profiling. This involves a description of the key aspects of functional anatomy that can lead to psychopathology. These features constitute the dimensions or categories for a profile of brain disorders based upon pathophysiology. The second section describes a mapping or translation matrix that maps from symptoms and signs, of a descriptive sort, to the CBP dimensions that provide a more mechanistic explanation. We will describe how this mapping engenders archetypal diagnoses, referring readers to tables and figures. The third section addresses the construct validity of clinical brain profiling by establishing correlations between profiles based on clinical ratings of symptoms and signs under classical diagnostic categories with the corresponding profiles generated automatically using archetypal diagnoses. We then provide further validation by performing a cluster analysis on the symptoms and signs and showing how they correspond to the equivalent brain profiles based upon clinical and automatic diagnosis. In the fourth section, we address the construct validity of clinical brain profiling by looking for associations between pathophysiological mechanisms (such as connectivity and plasticity) and nosological diagnoses (such as schizophrenia and depression). Based upon the mechanistic perspective offered in the first section, we test some particular hypotheses about double dissociations using a meta-analysis of PubMed searches. The final section concludes with perspectives for the future and outstanding validation issues for clinical brain profiling.",0,0 +2893,PREVENTING PTSD: THE VALUE OF INNER RESOURCEFULNESS AND A SENSE OF PERSONAL CONTROL OF A SITUATION. IS IT A MATTER OF PROBLEM-SOLVING OR ANXIETY MANAGEMENT?,"The accounts of five subjects who survived life threatening experiences without the development of PTSD were examined, focusing on the coping strategies and cognitions described in these situations. The study aimed to determine whether there was a common pattern of response amongst subjects in these situations similar to the cognitive patterns described by the senior author of the previous case study (Ness & Macaskill, 2000) who survived a near drowning experience without the development of PTSD. In the search for common coping strategies all five respondents in the study completed the Locus of Control Scale (Rotter, 1966) and the Self-Control Schedule (Fisher & Reason, 1988). All five respondents demonstrated the use of problem solving as their main cognitive strategy, utilizing specific information from their previous experience relevant to their life-threatening situation. Respondents did not appear to rely on coping strategies aimed at the management of acute anxiety symptomatology. There was no common pattern among respondents in profiles on the Self-Control Schedule or the Locus of Control Scale. The possible implications of this case series study are discussed in relation to opportunities for the prevention of PTSD, the use of debriefing and the treatment of post-traumatic stress.",0,0 +2894,The Multidimensional Inventory of Dissociation (MID): A Comprehensive Measure of Pathological Dissociation,"This article describes the development and validation of the Multidimensional Inventory of Dissociation (MID). The MID is a 218-item, self-administered, multiscale instrument that comprehensively assesses the phenomenological domain of pathological dissociation and diagnoses the dissociative disorders. The MID measures 14 major facets of pathological dissociation; it has 23 dissociation diagnostic scales that simultaneously operationalize (1) the subjective/ phenomenological domain of pathological dissociation and (2) the hypothesized dissociative symptoms of dissociative identity disorder (Dell, 2001a). The MID was designed for clinical research and for diagnostic assessment of patients who present with a mixture of dissociative, posttraumatic, and borderline symptoms. The MID demonstrated internal reliability, temporal stability, convergent validity, discriminant validity, and construct validity. The MID also exhibited incremental validity over the Dissociative Experiences Scale (DES) by predicting an additional 18% of the variance in weighted abuse scores on the Traumatic Experiences Questionnaire (TEQ). Confirmatory factor analysis (CFA) did not support a one-factor model of the MID's clinical scales (i.e., the 14 facets and the 23 diagnostic symptoms). In contrast, however, CFA of the MID's factor scales (Dell & Lawson, 2005) has strongly supported a one-factor model. It was concluded that both the MID's 168 dissociation items and the construct of pathological dissociation have a second-order, unifactorial structure.",0,0 +2895,Cognitive Model of the Maintenance and Treatment of Post-traumatic Stress Disorder Applied to Children and Adolescents,"The diagnosis of post-traumatic stress disorder (PTSD) has recently been established as a useful construct in children and adolescents, and is also now held to be a helpful framework when describing symptoms in refugees or survivors of war. This article reviews existing models of PTSD and existing evidence for treatment efficacy in both adults and children, and leads on to discuss the application of the Ehlers and Clark (2000) cognitive model to work with children and adolescents. The difference between techniques such as exposure and cognitive restructuring is examined. Two vignettes illustrate the practical details of working with young refugees with PTSD, including both exposure and cognitive restructuring in different phases of therapy, the importance of a collaborative formulation, and the importance of parental support during treatment as well as cultural and language factors specific to refugees.",0,0 +2896,Obsessive-Compulsive and Post Traumatic Avoidance Symptoms Influence the Response to Antihypertensive Therapy: Relevance in Uncontrolled Hypertension,"Aim: To investigate the association of uncontrolled hypertension with psychological factors associated with high cardiovascular morbidity and mortality (type D personality, depression, posttraumatic stress-related symptoms). Methods: 205 consecutive outpatient hypertensives completed three questionnaires evaluating Type D personality (DS 16), post traumatic symptoms (revised Impact of Events Scale), symptoms of anxiety, hostility, depression and obsessive-compulsive traits (subscales of the Symptom Checklist). Uncontrolled hypertension was diagnosed when clinic sitting blood pressure was above 140/90 mmHg (130/80 in the presence of diabetes or nephropathy), despite reported adherence to treatment with at least three antihypertensive medications, including a diuretic. Results: Uncontrolled hypertension (39%), was predicted by lower scores at Symptom Checklist obsessive-compulsive subscale and higher number of post traumatic avoidance symptoms, older age, diabetes, higher systolic pressure at first visit and longstanding hypertension. Type D personality correlated with depression, hostility, anxiety, compulsiveness, history of malignancy, and older age, but not with uncontrolled hypertension. Conclusions: Uncontrolled hypertension is associated with low obsessionality and avoidance symptoms, which reduce compliance to treatment. On the contrary, type D personality is not correlated with uncontrolled hypertension, as it includes compulsiveness, which improves compliance. A multidisciplinary approach to the hypertensive patient is mandatory to establish if the psychological profile affects compliance.",0,0 +2897,Do adverse childhood experiences increase the risk of postdeployment posttraumatic stress disorder in US Marines?,"BackgroundPosttraumatic stress disorder (PTSD) has been associated with combat intensity, lack of social support, and adverse childhood factors among military personnel in previous studies. It has not been well established if adverse childhood experiences reported predeployment are independently associated with postdeployment PTSD.MethodsData were evaluated from 8,391 male responders of the Recruit Assessment Program survey at Marine Corps Recruit Depot in San Diego who were deployed in support of military conflicts between September 2001 and June 2004. Using patient medical records to determine PTSD diagnoses, Cox proportional hazard modeling was performed to examine if adverse childhood experiences were independently associated with postdeployment PTSD.ResultsAfter adjustment, those who reported adverse childhood experiences in more than one category were significantly more likely to be diagnosed with postdeployment PTSD. Specifically, childhood physical neglect was mostly strongly associated with postdeployment PTSD.ConclusionsFindings suggest that Marines who experience multiple types of adverse childhood experiences may be at increased risk for postdeployment PTSD. It is possible, however, that these results indicate that men willing to report childhood adverse experiences are also more willing to seek care for PTSD.",0,0 +2898,Heterogeneity in signaled active avoidance learning: substantive and methodological relevance of diversity in instrumental defensive responses to threat cues,"Individuals exposed to traumatic stressors follow divergent patterns including resilience and chronic stress. However, researchers utilizing animal models that examine learned or instrumental threat responses thought to have translational relevance for Posttraumatic Stress Disorder (PTSD) and resilience typically use central tendency statistics that assume population homogeneity. This approach potentially overlooks fundamental differences that can explain human diversity in response to traumatic stressors. The current study tests this assumption by identifying and replicating common heterogeneous patterns of response to signaled active avoidance (AA) training. In this paradigm, rats are trained to prevent an aversive outcome (shock) by performing a learned instrumental behavior (shuttling between chambers) during the presentation of a conditioned threat cue (tone). We test the hypothesis that heterogeneous trajectories of threat avoidance provide more accurate model fit compared to a single mean trajectory in two separate studies. Study 1 conducted 3 days of signaled AA training (n = 81 animals) and study 2 conducted 5 days of training (n = 186 animals). We found that four trajectories in both samples provided the strongest model fit. Identified populations included animals that acquired and retained avoidance behavior on the first day (Rapid Avoiders: 22 and 25%); those who never successfully acquired avoidance (Non-Avoiders; 20 and 16%); a modal class who acquired avoidance over 3 days (Modal Avoiders; 37 and 50%); and a population who demonstrated a slow pattern of avoidance, failed to fully acquire avoidance in study 1 and did acquire avoidance on days 4 and 5 in study 2 (Slow Avoiders; 22.0 and 9%). With the exception of the Slow Avoiders in Study 1, populations that acquired demonstrated rapid step-like increases leading to asymptotic levels of avoidance. These findings indicate that avoidance responses are heterogeneous in a way that may be informative for understanding both resilience and PTSD as well as the nature of instrumental behavior acquisition. Characterizing heterogeneous populations based on their response to threat cues would increase the accuracy and translatability of such models and potentially lead to new discoveries that explain diversity in instrumental defensive responses.",0,0 +2899,Lessons from the 2004 Asian tsunami: Epidemiological and nosological debates in the diagnosis of post-traumatic stress disorder in non-Western post-disaster communities,"Background: The nosological validity of post-traumatic stress disorder (PTSD) remains controversial in non-Western communities. After natural disasters, epidemiological studies often overlook these conceptual debates and assess post-traumatic stress symptoms (PTSS) by short screening instruments. Such PTSS estimates are reported as inflated prevalence rates of PTSD in post-disaster settings. Aims: To discuss the prevalence and determinants of PTSS within the context of pertinent epidemiological and nosological debates. Methods: We assessed PTSS and grief symptoms of 643 survivors from five Indian villages struck by the Asian tsunami using the Impact of Events Scale – Revised and Complicated Grief Assessment Scale. We adopted a case control design and employed complex sample multiple logistic regression statistics to study the determinants of PTSS. Results: The prevalence of PTSS was 15.1% (95% CI 12.3%–17.9%). PTSS was significantly associated with traumatic grief, female gender, physical injury, death of children and financial losses, but not with functional disability ( p = .91). Conclusions: Although PTSS were common in this population, elevating them to a psychiatric construct of PTSD is questionable, when functional impairment and avoidance behaviours were absent. Grief reactions, socio-economic burden, and poor support systems contribute towards PTSS. We highlight the important issues regarding the nosological validity and epidemiology of PTSD in non-Western communities.",0,0 +2900,Treatment of concurrent PTSD and OCD: A commentary on the case of Howard,"The complexity inherent in treating patients diagnosed with multiple disorders often leaves clinicians feeling unsure of how best to encourage change, or even where to begin. The present commentary discusses the interplay between the symptoms of posttraumatic stress disorder and obsessive-compulsive disorder ( Kimble, 2000 ). Focusing on the need to assess the interplay of the two symptom clusters, the paper presents a model for understanding the etiological and functional relations that could link the symptoms of posttraumatic stress disorder and obsessive-compulsive disorder. Further, the paper discusses ways in which a clinician might approach such complex cases in order to address all of the client's needs in an effective and efficient manner.",0,0 +2901,Exploratory factor analysis of two measures of posttraumatic stress disorder (PTSD) symptoms in a non-clinical sample of college students,"This study investigated the psychometric structure of two widely utilized measures of posttraumatic symptoms in a primarily Caucasian non-clinical sample. Given the prevalence of trauma exposure in non-referred samples, measurement of resulting symptoms is a critical issue. Exploratory factor analysis was utilized to assess and compare the factor structure of the Impact of Event Scale [IES; Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: a measure of subjective stress. Psychosomatic Medicine, 41, 209-218] and the Mississippi Scale for Posttraumatic Stress Disorder, Civilian version [MIS-Civ; Vreven, D. L., Gudanowski, D. M., King, L. A., & King, D. W. (1995). The Civilian Version of the Mississippi PTSD Scale-a psychometric evaluation. Journal of Traumatic Stress, 8, 91-109] in a sample of college students reporting exposure to potentially traumatic events. The psychometric structure of the IES was largely consistent with the two-factor structure widely reported in the literature, while the structure of the MIS-Civ varied considerably in this sample. Notably, non-clinical samples tended to report fewer social and occupational dysfunction than clinical samples predominantly utilized in PTSD research. Implications for use of these instruments in screening samples are discussed.",0,0 +2902,Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study,"South Africa's unique history, characterised by apartheid, a form of constitutional racial segregation and exploitation, and a long period of political violence and state-sponsored oppression ending only in 1994, suggests a high level of trauma exposure in the general population. The aim of this study was to document the epidemiology of trauma and posttraumatic stress disorder (PTSD) in the South African general population.The South African Stress and Health Study is a nationally representative survey of South African adults using the WHO's Composite International Diagnostic Interview (CIDI) to assess exposure to trauma and presence of DSM-IV mental disorders.The most common traumatic events were the unexpected death of a loved one and witnessing trauma occurring to others. Lifetime and 12-month prevalence rates of PTSD were 2.3% and 0.7% respectively, while the conditional prevalence of PTSD after trauma exposure was 3.5%. PTSD conditional risk after trauma exposure and probability of chronicity after PTSD onset were both highest for witnessing trauma. Socio-demographic factors such as sex, age and education were largely unrelated to PTSD risk.The occurrence of trauma and PTSD in South Africa is not distributed according to the socio-demographic factors or trauma types observed in other countries. The dominant role of witnessing in contributing to PTSD may reflect the public settings of trauma exposure in South Africa and highlight the importance of political and social context in shaping the epidemiology of PTSD.",0,0 +2903,Resposta ao estresse: II. Resiliência e vulnerabilidade,"A crescente exposicao a estressores na vida cotidiana aumentou significativamente a investigacao da resposta ao estresse nas duas ultimas decadas. Embora associada a consequencias negativas, pois muitas patologias fisicas e mentais sao desencadeadas por exposicao cronica a estressores, esta resposta e indispensavel para sobrevivencia do individuo e e extremamente adaptativa quando ativada de forma aguda. Na parte I desta revisao foram abordados os conceitos de homestase e alostase e os sistemas fisiologicos ativados durante a resposta ao estresse. Na parte II serao discutidos fatores que modulam a resposta ao estresse tais como sexo, temperamento, periodos criticos do desenvolvimento e a presenca ou ausencia de suporte social. A interacao entre os fatores geneticos e ambientais gera os perfis da resposta psicofisiologica que caracterizam os fenotipos de susceptibilidade e resiliencia frente aos estressores e sua relacao com uma patologia mental cada vez mais presente na sociedade moderna, o transtorno de estresse pos-traumatico.",0,0 +2904,Psychogene Störungen bei deutschen Soldaten des Ersten und Zweiten Weltkrieges,"In the First and Second World War German soldiers frequently suffered from psychogenic disorders. By comparison a change in the prevalences can be noted: in the First World War dissociative disorders dominated the clinical impression (""shell shock""), in the Second World War they could rarely be seen but were replaced by somatoform and psychosomatic diseases. The discussion about numerous reasons for this development has not been completed yet and is still not free from political attitudes. To achieve a more scientific point of view, the perspective of psychotraumatology might be helpful. According to psychotraumatic research, dissociative and somatoform disorders can emerge in a close relation to a Posttraumatic Stress Disorder. The choice of symptoms depends on personality traits of the victim, but also on specific factors that characterise the situation in which the trauma appears. The mixture of pathogenetic and protective influences includes e. g. the possibility of flight- or fight reactions, feelings of trauma-associated guilt and group cohesion in the military unit. These factors can be useful to help explain the change of symptoms between both wars. In addition the analysis of situational conditions in former wars can give hints to actual planning and prophylaxis strategies in modern military psychiatry, that has to adjust to very different military operation fields.",0,0 +2905,Gastroesophageal Reflux Symptoms and Comorbid Asthma and Posttraumatic Stress Disorder Following the 9/11 Terrorist Attacks on World Trade Center in New York City,"Excess gastroesophageal reflux disease (GERD) was reported in several populations exposed to the September 11 2001 (9/11) terrorist attacks on the World Trade Center (WTC). We examined new onset gastroesophageal reflux symptoms (GERS) since 9/11 and persisting up to 5-6 years in relation to 9/11-related exposures among the WTC Health Registry enrollees, and potential associations with comorbid asthma and posttraumatic stress disorder (PTSD).This is a retrospective analysis of 37,118 adult enrollees (i.e., rescue/recovery workers, local residents, area workers, and passersby in lower Manhattan on 9/11) who reported no pre-9/11 GERS and who participated in two Registry surveys 2-3 and 5-6 years after 9/11. Post-9/11 GERS (new onset since 9/11) reported at first survey, and persistent GERS (post-9/11 GERS reported at both surveys) were analyzed using log-binomial regression.Cumulative incidence was 20% for post-9/11 GERS and 13% for persistent GERS. Persistent GERS occurred more often among those with comorbid PTSD (24%), asthma (13%), or both (36%) compared with neither of the comorbid conditions (8%). Among enrollees with neither asthma nor PTSD, the adjusted risk ratio (aRR) for persistent GERS was elevated among: workers arriving at the WTC pile on 9/11 (aRR=1.6; 95% confidence interval (CI) 1.3-2.1) or working at the WTC site > 90 days (aRR=1.6; 1.4-2.0); residents exposed to the intense dust cloud on 9/11 (aRR=1.5; 1.0-2.3), or who did not evacuate their homes (aRR=1.7; 1.2-2.3); and area workers exposed to the intense dust cloud (aRR=1.5; 1.2-1.8).Disaster-related environmental exposures may contribute to the development of GERS. GERS may be accentuated in the presence of asthma or PTSD.",0,0 +2906,Pathways for psychological adjustment in breast cancer: A longitudinal study on coping strategies and posttraumatic growth,"This longitudinal study examined the role of coping strategies and posttraumatic growth (PTG) on the psychological adjustment to breast cancer trajectory. The participants were 50 women assessed at the time of surgery (T1), during adjuvant treatment (T2) and six months after the end of treatment (T3). Women completed questionnaires assessing coping strategies, PTG and psychological adjustment (psychological quality of life, anxiety and depression). Results showed that the greatest impact of breast cancer on women's adjustment occurred at T1, when patients were significantly more anxious than in the other phases of the disease. The type of surgery and adjuvant treatment did not account for the course of PTG and adjustment. Coping through seeking social support and using cognitive strategies at T1 were linked to psychological quality of life and depression at T3 via PTG dimension of personal resources and skills at T2. Findings emphasise the value of promoting adaptive coping strategies and PTG in order to improve psychological adjustment in breast cancer patients.",0,0 +2907,A preliminary study of the association between traditional masculine behavioral norms and PTSD symptoms in Iraq and Afghanistan veterans.,"Studies identifying a high prevalence of posttraumatic stress disorder (PTSD) and low treatment utilization among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) Veterans reinforce the need for a greater understanding of the disorder in this population. Although traditional masculine norms have been found to relate to both help seeking and PTSD among civilians, little is known about their impact on war Veterans. The current study examined relationships between masculine behaviors, using the Masculine Behavior Scale (MBS), and PTSD symptoms in OEF/OIF Veterans, drawing on archival clinical data from 69 patients at an outpatient PTSD clinic. Despite a positive trend, total MBS scores were not correlated with overall PTSD severity. However, the MBS subscale Exaggerated Self-Reliance and Control positively predicted hyperarousal symptoms in a hierarchical regression model. Unexpectedly, the MBS subscale Success Dedication negatively predicted avoidance, suggesting that this masculine norm may serve a protective function against avoidance symptoms. Results suggest that elements of masculinity are related to specific PTSD symptom clusters in ways that may be both adaptive and maladaptive. Implications for PTSD treatment are discussed. © 2011 American Psychological Association.",0,0 +2908,Examination of the latent factor structure of the Alcohol Use Disorders Identification Test in two independent trauma patient groups using confirmatory factor analysis,"Recent research on the factor structure of the Alcohol Use Disorders Identification Test (AUDIT) provides support for two underlying factors: consumption and consequences. The current study sought to extend these findings to two independent and diverse trauma populations: traumatic injury patients and military veterans treated for posttraumatic stress disorder. The 2- and 3-factor solutions provided the best fit to the data, but there was a very high correlation between the second and third factors of the 3-factor solution. Parsimony suggests that the 2-factor solution is the preferred model. The 2-factor model has implications for alcohol screening using the AUDIT and supports the goal of screening to identify those with hazardous drinking and alcohol use disorders. An algorithm is proposed to inform alcohol screening protocols in a range of health settings for trauma-exposed patient groups.",0,0 +2909,Examination of the Content Specificity of Posttraumatic Cognitions in Combat Veterans With Posttraumatic Stress Disorder,"Cognitive theories have proposed the idea of content specificity, which holds that emotional disorders are associated with unique sets of negative cognitions. The existent research exploring the content specificity related to posttraumatic stress disorder (PTSD) and depression is sparse, and research is especially needed in veteran samples. The purpose of this study was to examine the associations of PTSD symptom clusters and comorbid depressive symptoms with posttraumatic cognitions.This study was cross-sectional in design, and the sample consisted of data from 150 male combat veterans with PTSD drawn from the baseline assessments of a large clinical trial. Analyses involved a series of separate and simultaneous linear regressions to examine the unique associations of comorbid depressive symptoms and PTSD symptom clusters with posttraumatic cognitions, as well as post hoc analyses to examine the mediational role of comorbid depressive symptoms.Findings demonstrated that posttraumatic negative cognitions about the self and self-blame were most strongly associated with comorbid depressive symptoms and the depression-related PTSD numbing cluster. Comorbid depressive symptoms also partially mediated nearly all the relationships between posttraumatic cognitions and PTSD symptom clusters.The findings of this study suggest that posttraumatic cognitions about the self and self-blame are not specific to PTSD but rather are more strongly related to symptoms of depression and negative affect. The results also suggest a potential pathway from posttraumatic cognitions to PTSD through the partially mediating influence of comorbid depression, and highlight the need to assess and treat comorbid depression in veterans with PTSD.",0,0 +2910,F Scale Elevation and PTSD MMPI Profiles,MMPI profiles for 87 PTSD veteran inpatients were classified and studied according to MMPI F Scale elevation. Mean MMPI profiles and frequency of high two-point code types were studied for different levels of F Scale elevation. Similar mean profile configurations were found for subgroups with F ≥ 70 with Scales 2 and 8 appearing as the two highest clinical scales. For F < 70 the configuration was different in that Scale 8 was not one of the two highest scales. The 2-8/8-2 high two-point code was the modal high two-point code for the total sample but the relative frequency of high two-point codes did vary somewhat within and across levels of F Scale elevation.,0,0 +2911,Relationship of Quality of Life and Perceived Control With Posttraumatic Stress Disorder Symptoms 3 to 6 Months After Myocardial Infarction,"This study examined whether psychological variables were associated with posttraumatic stress disorder (PTSD) symptoms 3 to 6 months after myocardial infarction.The sample included 52 patients with myocardial infarction. A structured interview was used to obtain information about PTSD symptoms, quality of life, and ratings of perceived control, danger, and predictability, as well as information about stressful events that occurred during hospitalization.Four patients (7.7%) met criteria for the diagnosis of PTSD. Elevated PTSD scores were associated with poorer quality of life (r = -0.32 to -0.79). Lower perceived control was associated with higher PTSD symptom scores (r = -0.30 to -0.52). Finally, PTSD scores were significantly correlated with the number of times patients were readmitted to the hospital (r = 0.35-0.57).Approximately 8% of patients experienced PTSD 3 to 6 months following MI. Increasing levels of PTSD symptoms were correlated with poorer quality of life. Perceived lack of control during the MI and multiple hospitalizations may be related to the severity of PTSD symptoms.",0,0 +2912,"Journalists, War, and Post Traumatic Stress Disorder *","(from the chapter) In this study of how war journalists deal with the stresses and physical dangers of their work, approximately one in five journalists was found to have ""probable"" Post Traumatic Stress Disorder (PTSD) while one in three showed evidence of psychological distress. Some of the large news organizations have belatedly discovered that war journalists are at risk for disorders such as PTSD. While confidential psychiatric help is now offered to war journalists within these organizations, the same does not apply to freelance journalists. The latter also lack the logistical back-up provided by the large organizations to their journalists in the field. Thus, the freelancer is potentially at greater risk for developing more frequent and enduring psychological difficulties. PTSD is potentially a chronic disorder. It also impacts on the quality of life and is known to affect the lives of family members too. For all these reasons, it behoves the news organizations to provide speedy access to therapy for their staff and any freelance journalists whom they may employ on a contract basis. It is equally important that no stigma be attached to those journalists requiring therapy. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +2913,Resilience to Loss and Potential Trauma,"Initial research on loss and potentially traumatic events (PTEs) has been dominated by either a psychopathological approach emphasizing individual dysfunction or an event approach emphasizing average differences between exposed and nonexposed groups. We consider the limitations of these approaches and review more recent research that has focused on the heterogeneity of outcomes following aversive events. Using both traditional analytic tools and sophisticated latent trajectory modeling, this research has identified a set of prototypical outcome patterns. Typically, the most common outcome following PTEs is a stable trajectory of healthy functioning or resilience. We review research showing that resilience is not the result of a few dominant factors, but rather that there are multiple independent predictors of resilient outcomes. Finally, we critically evaluate the question of whether resilience-building interventions can actually make people more resilient, and we close with suggestions for future research on resilience.",0,0 +2914,Mental health of children and adolescents with epilepsy: analysis of clinical and neuropsichological aspects,"Epilepsy compromises the development of cognitive and social skills and represents a risk of psychiatric comorbidity. Objective: To compare psychopathological symptoms in children with epilepsy and in a healthy group, and to correlate the results with neuropsychological and clinical variables. Method: Forty five children with idiopathic epilepsy and sixty five healthy controls underwent neuropsychological evaluation and their caregivers replied to a psychopathology questionnaire (Child Behavior Checklist – CBCL). Results: There were significant differences in CBCL, with poorer results showed mainly by patients with epilepsy. There was no significant association between any psychopathological symptom and disease duration or amount of antiepileptic drugs used. There was positive correlation between intelligence quocient and CBCL on items such as sluggish cognitive tempo, aggressive behavior, attention problems and activities and a negative relation between academic achievement, conduct and rule-breaking behavior. Conclusion: Children with epilepsy had the worse results in the psychopathology evaluation. Certain psychopathological variables are related to the cognitive profile, with no relation to clinical variables.",0,0 +2915,Childbirth-related post-traumatic stress disorder in couples: A qualitative study,"Previous research has established that women can develop childbirth-related post-traumatic stress disorder (PTSD), but the effect of this on a couple's relationship has not been examined. This study aimed to look at the experience and impact of childbirth-related PTSD in women and their partners.This was a qualitative interview study of six couples, where at least one partner had clinically significant symptoms of childbirth-related PTSD.Semi-structured interviews were conducted separately with each partner and interview transcripts subjected to thematic analysis.Analysis identified four themes with 18 subthemes as follows: (1) birth factors (pain, negative emotions in labour, perceived lack of control, lack of choice or lack of involvement in decision-making, restricted movement or physical restraint, and expectations not being met); (2) quality of care (information provision, staff factors, continuity of care and environment); (3) effects on relationship with partner (impact on physical relationship, communication within the relationship, negative emotions within the relationship, receiving or giving support from partner, coping together as a couple and overall effect on the relationship); and (4) effects on relationship with child (perceptions of the child and parent-baby bond).This study suggests that PTSD may have a negative impact on the couple's relationship and the parent-baby bond.",0,0 +2916,Epidemiology and Impact of Scarring After Burn Injury,"The purpose of this study was to perform a systematic review of the existing literature on the incidence of hypertrophic scarring and the psychosocial impact of burn scars. In a comprehensive literature review, the authors identified 48 articles published since 1965 and written in English which reported the incidence and risk factors for hypertrophic scarring or assessed outcomes related to scarring. Most studies had important methodological limitations limiting the generalizability of the findings. In particular, the absence of standardized valid measures of scarring and other outcome variables was a major barrier to drawing strong conclusions. Among studies on hypertrophic scarring, the prevalence rate varied between 32 and 72%. Identified risk factors included dark skin, female gender, young age, burn site on neck and upper limb, multiple surgical procedures, meshed skin graph, time to healing, and burn severity. With regard to psychosocial outcomes, two studies compared pediatric burn survivors with a nonburn comparison group on a body image measure; neither study found differences between groups. Across studies, burn severity and location had a modest relationship with psychosocial outcome variables. Psychosocial variables such as social comfort and perceived stigmatization were more highly associated with body image than burn characteristics. To advance our knowledge of the epidemiology of scars and the burden of scars, future studies need to implement more rigorous methodologies. In particular, standardized valid measures of scarring and other outcomes should be developed. This process could be facilitated by an international collaboration among burn centers.",0,0 +2917,The Phenomenology of Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) has been recognized for centuries, but has been named and formally characterized only recently. Criteria of PTSD in DSM-IV are a mixture of the new and old; some of the changes have far-reaching consequences. Acute stress disorder represents a new category that is long overdue. Even when well characterized, PTSD is an unusually broad condition with an uncertain epidemiology, a variable course, and a confused mixture of risk factors and vulnerabilities.",0,0 +2918,A Typological Analysis of Behavioral Profiles of Sexually Abused Children,"A cluster analysis is used to explore differential outcomes in 123 French Canadian children reporting sexual abuse contrasted with 123 control children. Mothers' reports of behavioral problems on the Child Behavior Checklist, abuse-related variables, personal factors, and family characteristics are used as potential variables discriminating clusters. Results reveal four clusters: (a) anxiety constellation group refers to children displaying behavior problems on a subset of scales, (b) the severe distress group refers to children showing a broader array of behavior problems, (c) victims of less severe sexual abuse (SA) group consists of children disclosing mostly extrafamilial SA, and (d) resilient children refers to children who, while disclosing severe abuse, rely less on avoidance coping. Findings underscore the need to go beyond abuse-related variables to orient treatment for children disclosing sexual abuse and for tailoring interventions to distinct subgroups.",0,0 +2919,Psychometric Properties of the German Version of the Child Post-Traumatic Cognitions Inventory (CPTCI-GER),"Dysfunctional trauma-related cognitions are associated with posttraumatic stress disorder (PTSD). The psychometric properties of the German version of the Child Post-Traumatic Cognitions Inventory (CPTCI-GER) were assessed in a sample of 223 children and adolescents (7-16 years) with a history of different traumatic events. Confirmatory factor analyses supported the original two-factor structure--permanent and disturbing change (CPTCI-PC) and fragile person in a scary world (CPTCI-SW). The total scale and both subscales showed good internal consistency. Participants with PTSD had significantly more dysfunctional trauma-related cognitions than those without PTSD. Dysfunctional posttraumatic cognitions correlated significantly with posttraumatic stress symptoms (PTSS; r = .62), depression (r = .71), and anxiety (r = .67). The CPTCI-GER has good psychometric properties and may facilitate evaluation of treatments and further research on the function of trauma-related cognitions in children and adolescents. (Partial) correlations provide empirical support for the combined DSM-5 symptom cluster negative alterations in cognitions and mood.",0,0 +2920,The role of offender profiling in classifying rapists: Implications for counselling,"Abstract The offender profiling process is an investigative technique used to identify the major personality and behavioural characteristics of the offender based upon an analysis of the crime(s) he or she has committed (Douglas & Burgess, 1986). Attempts have been made in both England and America to classify rapists into various subgroups. Instead of definitive groups of offenders a suggestion is made as to the formation of a dimensional typology of rapists. This would allow for the difficulties in defining boundaries for subgroups and accounting for individual differences and heterogeneity of both the rapist and the assault. The various criteria that attempt to distinguish the different types of offender are discussed including behavioural and motivational characteristics of the offender, lay theories of rape and the victim-offender relationship. The implications of the dimensional typology are outlined. There are indications that some factors may contribute to a longer and more complicated recovery pro...",0,0 +2921,Post-Weaning to Pre-Pubertal (‘Juvenile’) Stress: A Model of Induced Predisposition to Stress-Related Disorders,"Human studies suggest that childhood trauma predisposes individuals to develop stress-related disorders such as depression and post-traumatic stress disorder (PTSD). Recent years have witnessed growing interest in effectively modeling in animals the long-term effects of childhood emotional trauma on stress responses in adulthood. Most studies concerned with the impact of early-life stress on subsequent stress responses in adulthood in rodents have focused on the post-natal pre-weaning period. However, psychiatric studies often refer to human childhood rather than infancy when investigating the patients’ traumatic history of stress-related psychopathologies. In accordance with that, we have examined the consequences of stress exposure at a later early-life period, the post-weaning, pre-puberty (juvenile) period, which holds greater resemblance to human childhood. This review summarizes a series of studies examining the impact of exposure of rats to stressors during ‘juvenility’ (‘juvenile stress’) on the ability of these animals to cope with stress later in life. Exposure to relatively brief but significant stress experience during juvenility was found to impair the ability of animals to cope with stressful challenges in adulthood. These behavioral manifestations were associated with lasting alterations in limbic system brain regions of neuromodulatory pathways, such as alterations in the expression of cell adhesion molecules, GABAergic system functioning and alterations in levels of circulating corticosterone. Importantly, these studies have also demonstrated considerable individual and sex differences, which call for the development of adequate analysis approaches. The juvenile stress model combined with characterization of individual profiles is presented as a useful model to study in rodents different facets of stress-related disorders and neural mechanisms of vulnerability and resilience to stress.",0,0 +2922,Towards a post-traumatic subtype of obsessive–compulsive disorder,"We evaluated whether traumatic events are associated with a distinctive pattern of socio-demographic and clinical features of obsessive-compulsive disorder (OCD). We compared socio-demographic and clinical features of 106 patients developing OCD after post-traumatic stress disorder (PTSD; termed post-traumatic OCD), 41 patients developing OCD before PTSD (pre-traumatic OCD), and 810 OCD patients without any history of PTSD (non-traumatic OCD) using multinomial logistic regression analysis. A later age at onset of OCD, self-mutilation disorder, history of suicide plans, panic disorder with agoraphobia, and compulsive buying disorder were independently related to post-traumatic OCD. In contrast, earlier age at OCD onset, alcohol-related disorders, contamination-washing symptoms, and self-mutilation disorder were all independently associated with pre-traumatic OCD. In addition, patients with post-traumatic OCD without a previous history of obsessive-compulsive symptoms (OCS) showed lower educational levels, greater rates of contamination-washing symptoms, and more severe miscellaneous symptoms as compared to post-traumatic OCD patients with a history of OCS.",0,0 +2923,Prototypes of Student Veterans with Post Traumatic Stress Disorder and Traumatic Brain Injury among Faculty in Illinois Public Four-Year Universities.,"One of the primary reasons many college students with disabilities, and more specifically college student veterans with disabilities, do not seek support services is due to the stigma associated with disability, especially cognitive and mental health disabilities. The purpose of the present study was to explore how public university faculty in the state of Illinois perceive a college student veteran with the concurrent disabilities of post traumatic stress disorder (PTSD) and traumatic brain injury (TBI). This information was gleaned by means of a mixed-method, online survey. Through iterative, comparative, qualitative analysis, characteristics used to describe college student veterans with the PTSD and TBI were classified into six emergent prototypes. These prototypes included (1) the mature independent student; (2) the American hero; (3) the special needs student; (4) the isolated student; (5) the volatile student; and (6) the wounded warrior. Secondary analyses quantitatively examined the relationship between contact with a student veteran and the proportion of positive responses given for each participant as well as the relationship between contact with a student veteran and the proportion of negative responses given for each participant. Pearson correlation analysis indicated no significant relationship between prior contact factor scores and the proportion of positive responses given by faculty r(269) = .032, p = .597 nor was there a significant relationship detected between prior contact factor scores and the proportion of negative responses given by faculty r(269) = -.020, p= .745. Tertiary analysis examined the proportion of positive to negative perceptions by faculty. Overall, faculty responses were more negative than positive. Implications for best practices at the administration level as well as for faculty and students were discussed. Limitations to the study were also discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0,0 +2924,Investigating the MMPI–2 Trauma Profile in Treatment-Seeking Peacekeepers,"Most available research on MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) scores in combat veterans suffering from posttraumatic stress disorder (PTSD) has focused on Vietnam veterans. No data are available from peacekeepers suffering from PTSD. The aim of this study was to investigate the relationship between PTSD and the MMPI-2 in a sample of 120 treatment seeking peacekeeping veterans. Results show that relative to a non-PTSD reference group, veterans who screened positive for PTSD scored higher on Scales F, 2 (D), 4 (Pd), 6 (Pa), 7 (Pt), 8 (Sc), and 0 (Si) of the MMPI-2. Scales 2 (D), 7 (Pt), and 8 (Sc) were highest in the mean PTSD profile but no 2- or 3-point code type could be defined. Moderate correlations were found between a self-report measure for PTSD symptoms and scores on MMPI-2 clinical scales 1 (Hs), 2 (D), 6 (Pa), 7 (Pt), and 8 (Sc). The MMPI-2 proved to be useful in assessing the broad range of symptoms typically present in trauma populations as well as the severity of posttraumatic morbidity.",0,0 +2925,Trauma and post‐traumatic stress disorder (PTSD) in a high secure forensic learning disability population: future directions for practice,"Literature on trauma and post‐traumatic stress disorder (PTSD) has neglected the needs of people with intellectual disability, particularly those in forensic settings. The National Centre for High Secure Learning Disability Services at Rampton Hospital conducted a service evaluation on aspects of trauma experience and post‐trauma symptoms in the current population. File information and self‐reports indicated that most individuals had experienced a great deal of lifetime trauma, typically multiple types of abuse. A high rate of potentially trauma‐related symptoms was noted in files. However, file records of potentially traumatic events, including abuse, were often lacking in detail. There was limited information about the events themselves, and there was no information to suggest that any trauma‐specific assessments had been used to measure trauma exposure or symptoms. PTSD as a diagnosis was rarely considered, and there was little consideration of trauma‐specific interventions. While some individuals said that their experiences had resulted in a lot of distress, others could not talk about the past at all. This paper discusses the problem of assessing past trauma and response in a forensic intellectual disability population, and future directions for practice in forensic services. The service under study plans to address the needs of patients who have experienced trauma and abuse by conducting routine structured assessments, offering adapted evidence‐based psychological interventions where appropriate, and providing trauma‐specific education for staff to promote a compassionate approach.",0,0 +2926,Evaluation of Two Web-Based Alcohol Interventions in the U.S. Military,"The U.S. military has traditionally had high rates of alcohol misuse and alcohol-related problems, necessitating effective treatment programs that minimize participant burden. Web-based interventions have shown promise as efficient treatment options for college students and adults but have not been widely evaluated in the military. This study evaluated the efficacy of two web-based alcohol interventions originally created for civilians and then adapted for U.S. military personnel.Two web-based alcohol interventions, Alcohol Savvy and Drinker's Check-Up, were adapted for use among military populations. The interventions were evaluated using a convenience sample of 3,070 active-duty military personnel at eight installations. Following a baseline survey, participants were assigned to one of three treatment conditions: (a) Alcohol Savvy, (b) Drinker's Check-Up, or (c) control (no program participation). Follow-up surveys were completed by 1,072 participants 1 month following baseline and by 532 participants 6 months following baseline.At 1-month follow-up, participants who completed the Drinker's Check-Up intervention had significant reductions in multiple measures of alcohol use relative to controls. Positive outcomes were found for average number of drinks consumed per occasion, frequent heavy episodic drinker status, and estimated peak blood alcohol concentration. These reductions in alcohol use at the 1-month follow-up were maintained at the 6-month follow-up. There were no statistically significant changes in alcohol use for participants who completed Alcohol Savvy.This study expands the literature on the effectiveness of web-based treatment for alcohol misuse. Findings indicate that web-based programs (Drinker's Check-Up in particular) can significantly decrease several indicators of alcohol use in U.S. military personnel.",0,0 +2927,The impact of social support on psychological distress for U.S. Afghanistan/Iraq era veterans with PTSD and other psychiatric diagnoses,"This study aimed to examine the degree to which posttraumatic stress disorder (PTSD) affects the relationship between social support and psychological distress for U.S. Afghanistan/Iraq era veterans with and without co-occurring psychiatric disorders. Veterans (N=1825) were administered self-report questionnaires and a structured diagnostic interview as part of a multi-site study of post-deployment mental health through the Department of Veterans Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC). Main and interaction effects models assessed the association between psychological distress and social support for three comparisons conditions (Controls vs. PTSD-only, non-PTSD, and PTSD plus co-morbid diagnoses). Having PTSD was a critical factor in attenuating the strength of this association, more so than other diagnoses. Furthermore, those with PTSD plus co-morbid diagnoses did not demonstrate significantly larger attenuation in that association compared to the PTSD-only group, indicating that psychiatric comorbidity may be less important in considering the role of social support in PTSD. By understanding this relationship, new avenues for engaging and enhancing treatment outcomes related to social support for veterans of this cohort may be identified. Additional longitudinal research could help evaluate the effect of PTSD symptom clusters, social support type, and trauma exposure type on these relationships.",0,0 +2928,Corticotrophin-releasing hormone type 1 receptor gene (CRHR1) variants predict posttraumatic stress disorder onset and course in pediatric injury patients.,"Posttraumatic stress disorder (PTSD) is a common and disabling anxiety disorder that may occur in the aftermath of exposure to potentially traumatic life events. PTSD is moderately heritable, but few specific molecular variants accounting for this heritability have been identified. Genes regulating the hypothalamic-pituitary-adrenal (HPA) axis, such as corticotrophin-releasing hormone type 1 receptor gene (CRHR1), have been implicated in traumatic-stress related phenotypes but have yet to be studied in relation to PTSD. The present study sought to examine the relation between 9 single nucleotide polymorphisms (SNPs) in the CRHR1 gene and posttraumatic stress symptoms in a prospective study of pediatric injury patients (n=103) who were first assessed in the acute aftermath of their injury at the hospital. Results indicated that multiple SNPs were associated with acute symptoms at a univariate level, and after correction for multiple testing, rs12944712 was significantly related to acute PTSD symptoms. Longitudinal latent growth curve analyses suggest that rs12944712 is also related to both acute symptom level and trajectory of symptoms over time. The present study adds support for the role of CRHR1 in the stress response following potentially traumatic event exposure in youth. It should be noted that the sample size in this study was small, and therefore statistical power was low; following, results from this study should be considered preliminary. Although results are not definitive, the findings from this study warrant future replication studies on how variation in this gene relates to response to traumatic event exposure in youth.",0,0 +2929,An examination of the relation between combat experiences and combat-related posttraumatic stress disorder in a sample of Connecticut OEF–OIF Veterans,"Combat exposure is an important risk factor for posttraumatic stress disorder (PTSD). However, little research has examined specific combat experiences associated with PTSD and confirmatory factor analytically (CFA)-derived re-experiencing, avoidance, dysphoria, and hyperarousal symptom clusters.A total of 285 predominantly older National Guard/Reservist OEF-OIF Veterans completed an anonymous mail survey that assessed demographics and deployment history, a broad range of combat experiences, PTSD, and unit and postdeployment social support.Personally witnessing someone from one's unit or an ally unit being seriously wounded or killed (β = 0.22), and being exposed to ""friendly"" fire (β = 0.14) and land mines/traps (β = 0.13) were the only three combat experiences associated with severity of combat-related PTSD symptoms, after adjustment for age, relationship status, unit support, postdeployment social support, and other combat experiences. Differential patterns of associations were observed for specific combat experiences in relation to CFA-derived symptom clusters (e.g., experiencing ""friendly"" fire was associated with re-experiencing and dysphoria symptoms, but not avoidance and hyperarousal symptoms). Personally witnessing someone from one's unit or an ally unit being seriously wounded or killed (odds ratio [OR] = 4.34; 95% confidence interval [CI] = 1.62-11.61) and being exposed to ""friendly"" fire (OR = 2.94; 95%CI = 1.16-7.47) emerged as independent predictors of a positive screen for probable PTSD.Results of this study suggest that witnessing someone in one's unit or ally unit being seriously wounded or killed while in a combat zone and being exposed to ""friendly"" fire are most strongly associated with combat-related PTSD in this sample of OEF/OIF Veterans. Examination of the relation between specific combat experiences and combat-related PTSD in OEF/OIF Veterans may help inform etiologic models of PTSD, and guide prevention and treatment approaches in this population.",0,0 +2930,"Trajectories of psychological distress among low‐income, female survivors of Hurricane Katrina.","The purpose of this study was to investigate trajectories of psychological distress among low-income, primarily unmarried and African American women who survived Hurricane Katrina (N = 386). Data were collected in the year prior to the hurricane as well as approximately 1 and 3 years thereafter. Using Latent Class Growth Analysis (LCGA), we detected 6 distinct trajectory groups. Over half of the participants fit into a trajectory consistent with resilience; that is, they maintained low levels of psychological distress over the course of the study, but experienced an elevation in symptoms at the first predisaster time point followed by a return to predisaster levels. The other trajectories reflected a range of psychological responses to disasters and indicated that predisaster functioning had a major influence on postdisaster psychological outcomes. Degree of exposure to hurricane-related stressors, experiences of human and pet bereavement, perceived social support, and socioeconomic status were significant predictors of trajectory group membership. Implications for research and policy are discussed.",0,0 +2931,Borderline Personality Disorder and Posttraumatic Stress Disorder at Psychiatric Discharge Predict General Hospital Admission for Self-Harm,"We investigated whether posttraumatic stress disorder (PTSD) was predictor of suicidal behavior even when adjusting for comorbid borderline personality disorder (BPD) and other salient risk factors. To study this, we randomly selected 308 patients admitted to a psychiatric hospital because of suicide risk. Baseline interviews were performed within the first days of the stay. Information concerning the number of self-harm admissions to general hospitals over the subsequent 6 months was retrieved through linkage with the regional hospital registers. A censored regression analysis of hospital admissions for self-harm indicated significant associations with both PTSD (β = .21, p < .001) and BPD (β = .27, p < .001). A structural model comprising two latent BPD factors, dysregulation and relationship problems, as well as PTSD and several other variables, demonstrated that PTSD was an important predictor of the number of self-harm admissions to general hospitals(B = 1.52, p < .01). Dysregulation predicted self-harm directly (B = 0.28, p < .05), and also through PTSD [corrected]. These results suggested that PTSD and related dysregulation problems could be important treatment targets for a reduction in the risk of severe self-harm in high-risk psychiatric patients.",0,0 +2932,Posttraumatic Stress Disorder: A Primer for Trauma Surgeons,"In 1980, posttraumatic stress disorder (PTSD) officially became classified as an anxiety disorder in the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition. Since then, there has been increasing recognition that PTSD is a prevalent disorder that may have significant impact on the quality of life for survivors of traumatic events. More recently, methodologically sound research has begun to provide important insight into this disorder. The following review serves to provide the trauma surgeons information on PTSD in terms of its diagnosis, prevalence, risk factors, treatment strategies, and outcomes, with the goal of minimizing the sequelae of PTSD and maximizing postinjury quality of life.",0,0 +2933,Psycho-educational interventions designed to prevent deployment-related psychological ill-health in Armed Forces personnel: a review,"Background Employers such as the Armed Forces (AF) and emergency services, who predictably expose their staff to potentially traumatic events (PTEs), often provide psycho-educational briefings in an attempt to mitigate possible adverse psychological sequelae. Within the military, psycho-educational briefings are widely used, particularly following exposure to PTEs on operations. The aim of this review was to evaluate the efficacy of these interventions and make appropriate recommendations. Method A search of Medline, PsycINFO and EMBASE was conducted, bibliographies of retrieved articles were searched and experts in the field were consulted. Results Two surveys and seven intervention studies were identified for inclusion in the review. Only three studies were randomized controlled trials (RCTs). Overall, the review found some evidence of benefit of psycho-educational interventions but it was not consistent across studies or outcomes and effects were small. However, there was also little evidence to suggest that they caused harm. There was some evidence that the beneficial effects may be greater for those who have been exposed to a higher number of PTEs. Conclusions Given the high operational tempo currently faced by coalition forces personnel, there remains a pressing need to identify the most effective way of minimizing the impact of exposure to potentially traumatic deployment incidents. To date, few psycho-educational interventions designed to prevent deployment-related psychological ill-health have been evaluated systematically in methodologically robust studies. The review recommends that future interventions are theoretically based and evaluated in cluster RCTs that examine both process and outcome variables.",0,0 +2934,Environmental Hyperthermic Infant and Early Childhood Death,"Infant and early childhood death caused by environmental hyperthermia (fatal heat stroke) is a rare event, typically occurring in vehicles or beds. The aims of this study were to describe the demographics, circumstances, pathology, and manner of death in infants and young children who died of environmental hyperthermia and to compare these cases with those reported in the literature. Scene investigation, autopsy reports, and the microscopic slides of cases from three jurisdictions were reviewed. The subjects in 10 identified cases ranged in age from 53 days to 9 years. Eight were discovered in vehicles and 2 in beds. When the authors' cases were grouped with reported cases, the profile of those in vehicles differed from those in beds. The former were older, were exposed to rapidly reached higher temperatures, and often had more severe skin damage. The latter were mostly infants and were exposed to lower environmental temperatures. Hepatocellular necrosis and disseminated intravascular coagulation were reported in victims who survived at least 6 hours after the hyperthermic exposure. The consistent postmortem finding among nearly all victims was intrathoracic petechiae, suggesting terminal gasping in an attempt at autoresuscitation before death. The manner of death was either accident or homicide. Recommendations for the scene investigation are made.",0,0 +2935,Optimizing the Protection Against the Physiological Burden of CBRN Clothing,"Soldiers can wear chemical, biological, radiological and nuclear (CBRN) protective clothing to be protected against warfare agents. The disadvantage of that clothing is that higher protection introduces higher physiological burden. Therefore an optimum between comfort and protection must be found. Models of all relevant processes were created to find this optimum. The airflow profile around a cylinder with clothing-representing a dressed human body part-was modelled. This flow profile was used for calculating the agent vapour breakthrough through the clothing and for calculating the deposition of agents onto the skin (as indicators for protection). The flow profile was also used for calculating the temperature profile around the body part and the relative humidity underneath and in the clothing (as representative for physiological burden). As a result a tool was created, which can be used to identify the optimum properties of CBRN protective clothing, depending on the intended mission of the soldiers.",0,0 +2936,"[Post-traumatic stress, post-traumatic depression and major depressive episode: literature].","Although they are likely to add their effects, physical and psychic traumata (or traumas) can provoke in different ways the appearance of depressive symptoms sometimes common. Post-traumatic depression, reactional depression, major depressive disorder and post-traumatic stress disorder represent different clinical and nosographic disorders in despite of their occasionally common symptomatic core. Historically, it is interesting to note during the XXth century the true semantic change of the terms of trauma from the somatic field to the psychic sphere. Physical traumatism is often represented by a material shock for the subject and by its organic consequences. It is defined as an event that leaves its mark which itself inflicts and handicaps the vital trajectory of the subject. It primarily comprises brain and rachis injuries, whose evolution is frequently characterized by the occurrence/appearance of a depressive disorder, whose genesis rests on psychological but also neurobiologic and physical arguments. Thus major depressive disorders are often present in the course of various physical traumatisms mainly related to nervous system. In accordance with several studies, the prevalence of major depressive disorders ranges from 25% to 50%. These mood disorders occur in the year which follows the accidental event. Their average time of revelation is estimated at four months and their average duration lies between three and six months. Lastly, although these depressive illnesses present clinical symptoms comparable with those observed in other contexts, some nuances can be raised. Nonetheless, they confine sometimes with true clinical forms depending on the intensity, the form, the circumstances or the consequences of the trauma. Psychic traumatism doesn't have the same profile and rests for much dedicated with the reexperiencing. Thus for some authors, depression illness represents a disorder that occurs after a traumatic event whereas others see a differential diagnosis which exludes or which represents a comorbidity with post-traumatic stress disorder. The review of the literature allows us to emphasize the complexity of the links as well as the clinical and epidemiologic differences between stress disorder and major depressive disorder. From the clinical point of view, the major features of PTSD are articulated around a triad of symptoms. They include the reexperiencing symptoms of the traumatic event such as intrusive memories and recurrent nightmares, the protective reactions such as avoidance of the stimuli associated with the trauma and emotional numbing, and the arousal symptoms such as the startled response and hypervigilance. The complexity of this syndrom is due to the frequent combination of these symptoms with other nonspecific ones. As far as the mood is concerned (the mood symptoms are concerned), the regrouping of some of these symptoms allows the clinician to sometimes releave a depressive symptomatology without being able to assess the DSM diagnosis of major depressive disorder. Epidemiologic studies dealing with the risk of installation of a PTSD after a traumatic event reveal differences in the prevalence depending on the nature of the traumatic events: ranging from 1% in general population to 80% following some situations of extreme and durable psychic suffering. Between both poles, one finds a prevalence ranging between 20 and 50% following other events such as serious accidents, natural disasters or criminal assaults. The clinical features of depressive episodes comorbid or associated with PTSD have some characteristics making it possible to individualize various clinical forms as a function of traumatic event type: asthenic, characterial or with somatic symptoms. According to the majority of authors, the co-occurrence of post-traumatic stress disorder and major depressive disorder is high although differential diagnosis is sometimes difficult. However, conceptual differences remain and two conceptions are distinguished. For some authors, like Bleich and Shalev, there would not be true chronological evolution from PTSD to MDD. Moreover the presence of symptoms considered as pertaining to the mood register within the criteria of PTSD would be clearly predictive of the occurrence and the severity of the diagnosis but not of the chronicity. For others, there would be a continuity between post-traumatic stress disorder and major depressive disorder. It is the case in many studies of veterans but also for civilian traumatic events. It is also the case for the American national study of comorbidity in which Kessler concludes that for 78% of the subjects who present a comorbidity PTSD/MDD (comorbidity raised for 48% of the 5,877 subjects included), the mood disorder is secondary to PTSD. (ABSTRACT TRUNCATED)",0,0 +2937,Randomized Controlled Trial of Accelerated Resolution Therapy (ART) for Symptoms of Combat-Related Post-Traumatic Stress Disorder (PTSD),"Therapies for post-traumatic stress disorder (PTSD) endorsed by the Department of Defense and Veterans Administration are relatively lengthy, costly, and yield variable success. We evaluated Accelerated Resolution Therapy (ART) for the treatment of combat-related psychological trauma.A randomized controlled trial of ART versus an Attention Control (AC) regimen was conducted among 57 U.S. service members/veterans. After random assignment, those assigned to AC were offered crossover to ART, with 3-month follow-up on all participants. Self-report symptoms of PTSD and comorbidities were analyzed among study completers and by the intention-to-treat principle.Mean age was 41 ± 13 years with 19% female, 54% Army, and 68% with prior PTSD treatment. The ART was delivered in 3.7 ± 1.1 sessions with a 94% completion rate. Mean reductions in symptoms of PTSD, depression, anxiety, and trauma-related guilt were significantly greater (p < 0.001) with ART compared to AC. Favorable results for those treated with ART persisted at 3 months, including reduction in aggression (p < 0.0001). Adverse treatment-related events were rare and not serious.ART appears to be a safe and effective treatment for symptoms of combat-related PTSD, including refractory PTSD, and is delivered in significantly less time than therapies endorsed by the Department of Defense and Veterans Administration.",0,0 +2938,THE PERSONAL POLITICS OF DISASTER: NARRATIVES OF SURVIVORS OF A SOUTH AFRICAN SHANTY TOWN FIRE,"Despite the fact that natural disasters occur more commonly in low and middle income countries than in wealthier countries, we know relatively little about how these disasters are experienced in such contexts. South Africa presents an especially telling example in which it is clear that natural events are affected profoundly by sociopolitical factors, including the spatial design of the apartheid city. We report here on interviews with twenty survivors of the biggest shanty town fire in the history of Cape Town, South Africa. The narratives of participants demonstrate that in order to understand the human cost of such disasters it is as important to understand the politics of the precursors of the disaster as well as what occurred subsequent to the disaster. The South African case, like that of Hurricane Katrina, underscores the fact that disaster, far from being an acute event which happens to individuals, is better understood as part of a far longer sociopolitical process affecting individuals, groups, and, indeed, societies.",0,0 +2939,"Longitudinal study of PTSD, depression, and quality of life among adolescents after the Parnitha earthquake","To investigate the course of PTSD, depression, and current quality of life among adolescents 32-months after the 1999 Parnitha earthquake in Greece.The follow-up was conducted among 511 adolescents originally evaluated at 3-months post-earthquake using the UCLA PTSD Reaction Index (PTSD-RI), Depression Self-Rating Scale (DSRS), and Quality of Life Questionnaire (QOLQ).Mean PTSD scores for the whole sample had subsided to mild levels; however, 8.8% were still experiencing moderate to severe levels of symptoms, and 13.6% met criteria for clinical depression. Frequency of experiencing reminders of the earthquake in the past month best explained the variance (15%) in PTSD severity, followed by depression at 3-months (8%). The QOLQ domain scores were negatively correlated with PTSD and depression. Depression at 3-months was the best predictor of QOLQ at 32-months, explaining 16% of the variance.Self-report instruments were used; hence the responses may have been over- or under-estimated; also, the findings may not be generalizable to other ethnic groups.Ongoing screening is recommended after disaster to identify adolescents who continue to experience moderate to severe levels of PTSD and depressive symptoms. Specific interventions to reduce reactivity to earthquake-related reminders should be a component of post-disaster recovery programs. A quality of life measure can provide important information in addition to traditional scales for monitoring the course of recovery among adolescents after disasters.",0,0 +2940,"[Repeated amenorrhea in an adolescent girl in the course of flood disaster in Kłodzko Region, July 1997].","A natural disaster has been defined as a disruption of human ecology that exceeds the capacity of the community to function normally.After the flood disaster in Kłodzko Region, July 1997, the major problem in female adolescents was observed: secondary amenorrhea.17 female adolescents, aged 13-18, which injured from the flood disaster with secondary amenorrhea were investigated. A control random group consists of 17 girls diagnosed before oral contraception. Diagnostic work-up includes history, physical and psychological examinations, hormonal profiles, transvaginal ultrasonography, color Doppler analysis of utero-ovarian arterial blood flow.FSH, LH, E2 plasma levels and LH/FSH ratio were significantly lower in the amenorrheic group compared to normal girls. Prolactin serum levels after metoclopramid administration were significantly higher in the amenorrheic group. Lower impedance to blood flow in the intraovarian arteries have been shown. Psychosomatic disorders related to hypothalamic amenorrhoea were diagnosed.Psychosocial stress observed during the flood disaster caused hypogonadotropic hypogonadism amenorrhoea in the female adolescents.",0,0 +2941,Structural equation model trees.,"In the behavioral and social sciences, structural equation models (SEMs) have become widely accepted as a modeling tool for the relation between latent and observed variables. SEMs can be seen as a unification of several multivariate analysis techniques. SEM Trees combine the strengths of SEMs and the decision tree paradigm by building tree structures that separate a data set recursively into subsets with significantly different parameter estimates in a SEM. SEM Trees provide means for finding covariates and covariate interactions that predict differences in structural parameters in observed as well as in latent space and facilitate theory-guided exploration of empirical data. We describe the methodology, discuss theoretical and practical implications, and demonstrate applications to a factor model and a linear growth curve model.",0,0 +2942,Posttraumatic growth in the aftermath of a disaster: looking for the role of gender,"In the past 10 years, the literature on disasters and mental health has shifted from a focus on psychopathology, to an interest in documenting manifestations of resilience in the face of mass trauma. The Jin et al. study, published in this issue of the Journal, examines gender differences in the relationship between posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) in the aftermath of the Wenchuan Earthquake in China. The study suggests that the coping response to PTSD may differ between males and females, and raises interesting questions about the types of factors that contribute to the manifestation of high versus low PTG given high levels of PTSD. At the same time, this type of study highlights the need to investigate the long-term impact and meaning of PTG, and to examine whether it reflects an adaptive process with long-term benefits in the face of traumatic exposures, or an illusory type of posttraumatic response.",0,0 +2943,Posttraumatic Stress Disorder Following an Air Disaster: A Prospective Study,"OBJECTIVE: The purpose of this study was to determine predictors of posttraumatic stress disorder (PTSD) in health care workers exposed to a disaster, in order to facilitate early case identification and prevention of subsequent morbidity. METHOD: Following an air disaster, 355 military medical health care workers were studied over an 18-month follow-up period. Measures included assessment of peritraumatic reactions associated with the disaster, the frequency of other stressful events after the disaster, and standard PTSD rating scales at 6, 12, and 18 months. RESULTS: Multivariate logistic regression of data on health care workers who cared for victims of the air disaster showed that PTSD was more likely to develop in those who had not completed college, those who had worked with burn victims, those who had experienced more stressful life events in a period of approximately 6 months following the disaster, and those who experienced emotional numbness immediately after the disaster. CONCLUSIONS: Results suggest that lower levels of education, exposure to grotesque burn injuries, stressful life events following exposure, and feelings of numbness following exposure are useful predictors of subsequent development of PTSD. (Am J Psychiatry 1998; 155:934–938)",0,0 +2944,The Relationship between Cortisol Activity during Cognitive Task and Posttraumatic Stress Symptom Clusters,"The latest development in the dimensional structure of posttraumatic stress disorder (PTSD) is a novel 6-factor model, which builds on the newly released DSM-5. One notable gap in the literature is that little is known about how distinct symptom clusters of PTSD are related to hypothalamic-pituitary-adrenal (HPA) axis activity when people perform a relatively less stressful cognitive task. The purpose of this study was to investigate the relationship between cortisol activity when individuals perform cognitive tasks in the laboratory and a contemporary phenotypic model of posttraumatic stress symptomatology in earthquake survivors.Salivary cortisol while performing cognitive tasks was collected and analyzed in 89 adult earthquake survivors. The PTSD Checklist for the DSM-5 (PCL-5) was used to assess the severity of total PTSD as well as six distinct symptom clusters. Regression analyses were conducted to examine the associations between the six distinct PTSD symptom clusters and cortisol profiles.The results showed that the score of the negative affect symptom cluster, but not anhedonia or other clusters, was positively associated with cortisol levels before and during the cognitive tasks.The results showed that higher cortisol levels before and during cognitive tasks might be specifically linked to a distinct symptom cluster of PTSD-negative affect symptomatology. This suggests that a distinction should be made between negative affect and anhedonia symptom clusters, as the 6-factor model proposed.",0,0 +2945,The Trauma of Truth Telling: Effects of Witnessing in the Rwandan Gacaca Courts on Psychological Health,"Truth telling has come to play a pivotal role in postconflict reconciliation processes around the world. A common claim is that truth telling is healing and will lead to reconciliation. The present study applies recent psychological research to this issue by examining whether witnessing in the gacaca, the Rwandan village tribunals for truth and reconciliation after the 1994 genocide, was beneficial for psychological health. The results from the multistage, stratified cluster random survey of 1,200 Rwandans demonstrate that gacaca witnesses suffer from higher levels of depression and PTSD than do nonwitnesses, also when controlling for important predictors of psychological ill health. Furthermore, longer exposure to truth telling has not lowered the levels of psychological ill health, nor has the prevalence of depression and PTSD decreased over time. This study strongly challenges the claim that truth telling is healing and presents a novel understanding of the complexity of truth-telling processes in postconflict peace building.",0,0 +2946,Expressive and Defensive Behavior during Discourse on Unresolved Topics: A Single Case Study of Pathological Grief,"Both psychodynamic and social-cognitive theoretical domains have control process models of behavior but with different ideas about the purpose and loci of control. This study examines expressive and defensive behaviors associated with different topics of discourse in the time-limited psychotherapy of a woman treated for pathological grief. Conceptually the study is based on a model of defensive control processes that integrates states of mind and person schemas. Theoretically derived measures of discourse topics, verbal and nonverbal defensive behaviors, emotional disclosure, and states of mind were applied to transcripts and videotapes of the entire therapy. Evidence from combined cluster and factor analyses supported the existence of recurring emotionally significant states. Two of these are particularly interesting from a clinical perspective: One, a ""shimmering"" state of intense emotional expression with concurrent signs of avoidance, was associated with topics identified clinically as stressful, unresolved, and conflictual. The other, a state of more uniformly stifled emotionality, was characteristic of discourse thought of clinically as resistance.",0,0 +2947,Psychological Impact of Fire Disaster on Children and Their Parents,"Six weeks following a major wildfire, children's psychosocial functioning was examined. Employing a multimethod assessment approach, the short-term mental health consequences of the fire were evaluated. Individual adjustment was compared between families who reported high levels of loss as a result of the fire (high-loss group) and families who reported relatively low levels of loss resulting from the fire (low-loss group). Standardized assessment procedures were employed for children and adolescents as well as their parents. In general, high-loss participants reported slightly higher levels of post-traumatic stress disorder (PTSD) symptoms and significantly higher scores on the Impact of Events Scale. PTSD symptoms reported by parents were generally significantly correlated with (but not concordant with) PTSD symptoms reported by their children. The high-loss group scored significantly higher on the Resource Loss Index than did the low-loss group. Preexisting and comorbid disorders and previous stressors are described. A methodological framework for future studies in this area is discussed.",0,0 +2948,"Socio-demographic and Clinical Profile of Substance Abusers Attending a Regional Drug De-addiction Centre in Chronic Conflict Area: Kashmir, India.","The menace of substance abuse is not only a socially unacceptable reality, but in its entirety is a disease and emerging as a major public health challenge.To study the socio-demographic and clinical profile of patients attending the drug de-addiction centre.A descriptive study was undertaken in a drug de-addiction centre at the Police Hospital in Srinagar, and all patients (198) who were admitted during this period were interviewed.The mean (SD) age of patients was 26.8 years (SD 7.37), and over half (56%) belonged to the lower-middle social class. Poly-substance abuse was seen in 91.9%; medicinal opioids and cannabis were the most common substances abused. Most common age of initiation was 11-20 years (76.8%), with peer pressure and relief from a negative mood state being the most common reasons given for starting the drug(s). Prevalence of a co-morbid psychiatric disorder was high, on the order of 49.5%. A high rate of volatile substance use was observed among adolescents (54.5%).A pattern of poly-substance abuse was found to be quite common in patients, and use of volatile substances at a very young age emerged as a new trend. The dreadful repercussions of substance abuse justify the urgency to evolve a comprehensive strategy.",0,0 +2949,Faking PTSD From a Motor Vehicle Accident on the MMPI-2,"The MMPI-2 is often used to assess posttraumatic stress disorder (PTSD) in individuals who claim psychological injury as a result of a motor vehicle accident. There is concern that attorneys can coach plaintiffs to fake PTSD. The purpose of this study was to determine whether prior symptom knowledge increased one's ability to fake PTSD on the MMPI-2. Eighty-four female undergraduate students completed the MMPI-2 under either of two conditions, informed (given DSM-IV diagnostic criteria for PTSD prior to testing) or uninformed (no diagnostic criteria provided). It was hypothesized that the informed subjects would more accurately fake PTSD than the uninformed subjects. Results indicated that knowledge about the specific symptoms of PTSD did not create a more accurate profile, but rather was likely to produce more invalid (F>T89) profiles, detecting them as malingerers.",0,0 +2950,,"Dissociative responses to trauma have been hypothesized to be associated with long-term increases in psychopathology. The purpose of this study was to examine dissociative responses to premilitary, combat-related and postmilitary traumatic events and long-term psychopathology in Vietnam combat veterans with (n = 34) and without (n = 28) posttraumatic stress disorder (PTSD). PTSD patients reported higher levels of dissociative states at the time of combat-related traumatic events than non-PTSD patients. Higher levels of dissociative states persisted in PTSD patients in the form of higher levels of dissociative states in-response to postmilitary traumatic events. In addition, dissociative responses to combat trauma were associated with higher long-term general dissociative symptomatology as measured by scores on the Dissociative Experience Scale, as well as increases in the number of flashbacks since the time of the war. These findings are consistent with previous formulations that dissociation in the face of trauma is a marker of long-term psychopathology.",0,0 +2951,"PTSD as a mediator of sexual revictimization: The role of reexperiencing, avoidance, and arousal symptoms","Theory and research suggest that posttraumatic stress disorder (PTSD) may mediate the relationship between child sexual abuse and adult sexual assault. However, little empirical research has examined the mediational role of PTSD. In the present study, the authors use structural equation modeling to examine the degree to which the three symptom clusters that define PTSD (reexperiencing, avoidance, and hyperarousal) contribute to sexual revictimization. To assess PTSD symptomatology, undergraduate women completed questionnaires (N = 1,449), which detailed the history and severity of childhood and adult sexual assault experiences. Results indicated that PTSD mediated sexual revictimization. When PTSD symptom clusters were examined individually, only the hyperarousal cluster was a significant mediator. Results are discussed in terms of information-processing mechanisms that may underlie sexual revictimization.",0,0 +2952,Post-traumatic stress disorder in a person with a diagnosis of schizophrenia: Examining the efficacy of psychological intervention using single N methodology,"Psychological intervention for post-traumatic stress disorder (PTSD) in a person with a diagnosis of schizophrenia is presented using single N methodology. Psychological formulation and intervention were informed by psychological models of PTSD symptom persistence that focus on dual maintaining factors of (a) disturbance in the form of trauma autobiographical memory and (b) problematic trauma-related appraisals. Baseline assessment of difficulties related to intrusive memories, problematic trauma-related appraisals (e.g., responsibility appraisals) and associated negative emotions (e.g., anger) was followed by two phases of intervention: (1) written elaboration of the trauma memory and (2) cognitive restructuring of problematic trauma-related appraisals. Treatment produced reduction in ratings of distress in all domains and there were clinically significant reductions in PTSD symptomatology and co-morbid depression on standardized self-report measures. There were, however, differential effects of treatment components as evidenced during the sequential introduction of treatment components. These are discussed and directions for future research in the treatment of PTSD in persons with severe mental health problems are highlighted. Copyright © 2007 John Wiley & Sons, Ltd.",0,0 +2953,The Effects of Family and Community Violence on Children,"This review examines theoretical and empirical literature on children's reactions to three types of violence--child maltreatment, community violence, and interparental violence. In addition to describing internalizing and externalizing problems associated with exposure to violence, this review identifies ways that violence can disrupt typical developmental trajectories through psychobiological effects, post-traumatic stress disorder (PTSD), cognitive consequences, and peer problems. Methodological challenges in this literature include high rates of co-occurrence among types of violence exposure, co-occurrence of violence with other serious life adversities, heterogeneity in the frequency, severity, age of onset, and chronicity of exposure, and difficulties in making causal inferences. A developmental psychopathology perspective focuses attention on how violence may have different effects at different ages and may compromise children's abilities to face normal developmental challenges. Emphasis is placed on the variability of children's reactions to violence, on outcomes that go beyond diagnosable disorders, and on variables that mediate and moderate children's reactions to violence.",0,0 +2954,Psychopharmacology in Psycho-oncology,"Psychopharmacological intervention is a major clinical and research area in oncology and palliative care. Over the last 35 years, psychotropic drugs have been shown to have a number of important indications for the treatment of the most common psychiatric disorders, such as depression, anxiety, stress-related syndromes, severe adjustment disorders, sleep disorders and delirium, which combined affect at least 30-40% of patients with cancer and even a higher percentage of patients in an advanced phase of illness. The availability of new drugs, with less side-effects and safer pharmacological profiles, has been a major advance in clinical psycho-oncology. Interestingly, several drugs have also been found to be helpful for the adjuvant treatment of cancer-related symptoms, such as pain, hot flashes, pruritus, nausea and vomiting, fatigue, and cognitive impairment, making psychopharmacology an important tool for the improvement of cancer patients' quality of life. The aim of this paper is to summarize recent relevant data concerning the use of psychotropic drugs, namely antidepressants, anxiolytics, antipsychotics, anticonvulsants and psychostimulants in patients with cancer. © 2013 Springer Science+Business Media New York.",0,0 +2955,Mapping family stress: The application of family adaptation theory to post-traumatic stress disorder,Abstract This articel examines the role of interpersonal factors in the maintenance of Post-Traumatic Stress Disorder (PTSD) and suggests a need for clinicans to conceptualize PTSD within a family systems context. A case study illustrates the use of Family Adaptation Theory as a model for assessment and intervention.,0,0 +2956,"Non-Peptidic CRF1 Receptor Antagonists for the Treatment of Anxiety, Depression and Stress Disorders","Anxiety and depression are psychiatric disorders that constitute a major health concern worldwide, and new pharmacological approaches with the potential for improved efficacy and decreased side effect profiles relative to currently marketed drugs are desired. Since the identification of corticotropin releasing factor (CRF) by Vale and colleagues in 1981, an extensive research effort has solidified the importance of this 41 amino acid peptide in mediating the body's behavioral, endocrine, and autonomic responses to stress. The further identification of CRF receptor subtypes has provided compelling targets for novel pharmaceutical agents. The present review focuses on the potential of non-peptidic antagonists of the CRF(1) receptor subtype as a novel therapeutic approach for the treatment of anxiety and depression. The first section reviews preclinical and clinical evidence implicating CRF, in general, and CRF(1) receptors, in particular, in anxiety and depression. Clinical studies have demonstrated a dysfunctional hypothalamic-pituitary-adrenal (HPA) axis and/or elevated CRF levels in depression and in some anxiety disorders. Preclinical data utlilizing correlational methods, genetic models, and exogenous CRF administration techniques in rodents and non-human primates supports a link between hyperactive CRF pathways and anxiogenic and depressive-like symptoms. Studies employing the use of receptor knockouts and selective, non-peptidic antagonists of the CRF(1) receptor have demonstrated anxiolytic and antidepressant effects under certain types of laboratory conditions. A Phase II, open-label, clinical trial in major depressive disorder has reported that a CRF(1) receptor antagonist was safe and effective in reducing symptoms of anxiety and depression. In the second section, a topological approach is used to describe the design strategies employed to produce potent, non-peptidic CRF(1) receptor antagonists. Two main topologies, featuring a center core, a top side-chain, and a pending aromatic ring, can be used to characterize the vast majority of currently known CRF(1) receptor antagonists. By exploiting some of these structural elements, pharmacological, physicochemical, and pharmacokinetic properties can be modulated and optimized. However, as a result of a relatively conservative iteration process during the structural optimization, the chemical space presently defined by the existing CRF(1) receptor antagonists still remains fairly narrow. Expanding these structural and topological boundaries, while optimizing the ""drug-like"" properties of the CRF(1) receptor antagonists, seems to be a common objective across pharmaceutical companies to maximize the chances for a clinical success in the near future.",0,0 +2957,Age-Associated Epigenetic Upregulation of the FKBP5 Gene Selectively Impairs Stress Resiliency,"Single nucleotide polymorphisms (SNPs) in the FK506 binding protein 5 (FKBP5) gene combine with traumatic events to increase risk for post-traumatic stress and major depressive disorders (PTSD and MDD). These SNPs increase FKBP51 protein expression through a mechanism involving demethylation of the gene and altered glucocorticoid signaling. Aged animals also display elevated FKBP51 levels, which contribute to impaired resiliency to depressive-like behaviors through impaired glucocorticoid signaling, a phenotype that is abrogated in FKBP5-/- mice. But the age of onset and progressive stability of these phenotypes remain unknown. Moreover, it is unclear how FKBP5 deletion affects other glucocorticoid-dependent processes or if age-associated increases in FKBP51 expression are mediated through a similar epigenetic process caused by SNPs in the FKBP5 gene. Here, we show that FKBP51-mediated impairment in stress resiliency and glucocorticoid signaling occurs by 10 months of age and this increased over their lifespan. Surprisingly, despite these progressive changes in glucocorticoid responsiveness, FKBP5-/- mice displayed normal longevity, glucose tolerance, blood composition and cytokine profiles across lifespan, phenotypes normally associated with glucocorticoid signaling. We also found that methylation of Fkbp5 decreased with age in mice, a process that likely explains the age-associated increases in FKBP51 levels. Thus, epigenetic upregulation of FKBP51 with age can selectively impair psychological stress-resiliency, but does not affect other glucocorticoid-mediated physiological processes. This makes FKBP51 a unique and attractive therapeutic target to treat PTSD and MDD. In addition, aged wild-type mice may be a useful model for investigating the mechanisms of FKBP5 SNPs associated with these disorders.",0,0 +2958,Frail Elderly as Disaster Victims: Emergency Management Strategies,"To identify the vulnerabilities of elderly to disasters, and to develop strategies to address these vulnerabilities.A relevant literature search of journal articles, government training materials, news reports, and materials from senior organizations was conducted.The vulnerability of the elderly to disasters is related to their impaired physical mobility, diminished sensory awareness, chronic health conditions, and social and economic limitations that prevent adequate preparation for disasters, and hinder their adaptability during disasters. Frail elderly, those with serious physical, cognitive, economic, and psycho-social problems, are at especially high risk.This segment of the population is growing rapidly. Therefore, it is important that emergency management recognize the frail elderly as a special needs population, and develop targeted strategies that meet their needs. Several management strategies are presented and recommendations for further action are proposed.",0,0 +2959,Trazodone: properties and utility in multiple disorders,"Trazodone is an established antidepressant that is prescribed frequently as an off-label hypnotic with wide acceptance among psychiatrists. Owing to its atypical mixed serotonergic and adrenolytic pharmacology, trazodone has been investigated in a number of disorders besides depression and insomnia, including anxiety disorders, chronic pain, frontal cognitive dysfunctions, erectile dysfunction and others. Clinical studies using subjective and objective measures generally tend to support its efficacy as a hypnotic in depressed subjects. Various other attributes of trazodone, including interaction with adrenergic receptors, formation of an active metabolite with potent serotonergic activity, low abuse potential and putative utility in various disorders, warrant further exploration. The adverse effects of trazodone generally mirror its serotonergic activity and include sedation, headache, sweating, weight changes and gastrointestinal effects such as nausea and vomiting. Clinicians and patients should be cognizant of the risk for potential, but rare, cardiovascular adverse effects of trazodone. The safety and toxicology of trazodone should be examined under current standards of drug development before exposure to new patient populations. This article provides an overview of trazodone with a focus on its clinical pharmacology and opportunities, gaps and scientific strategies in developing it for new indications such as insomnia, anxiety disorders, chronic pain and frontal cognitive dysfunction. Modified release formulations, alternate forms of drug delivery and combination products are discussed as strategies to optimize the efficacy of trazodone and improve its safety profile.",0,0 +2960,PATTERNS OF LIFETIME PTSD COMORBIDITY: A LATENT CLASS ANALYSIS,"Posttraumatic stress disorder (PTSD) is associated with high rates of psychiatric comorbidity, most notably substance use disorders, major depression, and other anxiety disorders. However, little is known about how these disorders cluster together among people with PTSD, if disorder clusters have distinct etiologies in terms of trauma type, and if they confer greater burden over and above PTSD alone.Utilizing Latent Class Analysis, we tested for discrete patterns of lifetime comorbidity with PTSD following trauma exposure (n = 409). Diagnoses were based on the Structured Clinical Interview for DSM-IV (SCID). Next, we examined if gender, trauma type, symptom frequency, severity, and interference with everyday life were associated with the latent classes.Three patterns of lifetime comorbidity with PTSD emerged: a class characterized by predominantly comorbid mood and anxiety disorders; a class characterized by predominantly comorbid mood, anxiety, and substance dependence; and a relatively pure low-comorbidity PTSD class. Individuals in both high comorbid classes had nearly two and a half times the rates of suicidal ideation, endorsed more PTSD symptom severity, and demonstrated a greater likelihood of intimate partner abuse compared to the low comorbidity class. Men were most likely to fall into the substance dependent class.PTSD comorbidity clusters into a small number of common patterns. These patterns may represent an important area of study, as they confer distinct differences in risk and possibly etiology. Implications for research and treatment are discussed.",0,0 +2961,Genetic approaches to understanding post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) is increasingly recognized as both a disorder of enormous mental health and societal burden, but also as an anxiety disorder that may be particularly understandable from a scientific perspective. Specifically, PTSD can be conceptualized as a disorder of fear and stress dysregulation, and the neural circuitry underlying these pathways in both animals and humans are becoming increasingly well understood. Furthermore, PTSD is the only disorder in psychiatry in which the initiating factor, the trauma exposure, can be identified. Thus, the pathophysiology of the fear and stress response underlying PTSD can be examined and potentially interrupted. Twin studies have shown that the development of PTSD following a trauma is heritable, and that genetic risk factors may account for up to 30-40% of this heritability. A current goal is to understand the gene pathways that are associated with PTSD, and how those genes act on the fear/stress circuitry to mediate risk vs. resilience for PTSD. This review will examine gene pathways that have recently been analysed, primarily through candidate gene studies (including neuroimaging studies of candidate genes), in addition to genome-wide associations and the epigenetic regulation of PTSD. Future and on-going studies are utilizing larger and collaborative cohorts to identify novel gene candidates through genome-wide association and other powerful genomic approaches. Identification of PTSD biological pathways strengthens the hope of progress in the mechanistic understanding of a model psychiatric disorder and allows for the development of targeted treatments and interventions.",0,0 +2962,Exposure to dysfunctional parenting and trauma events and posttraumatic stress profiles among a treatment sample with coexisting depression and alcohol use problems,"Trauma exposure (including experiencing dysfunctional parenting when a child) and posttraumatic stress disorder (PTSD) frequently coexist with major depressive disorder (MDD) and alcohol use disorders (AUD), with the impact of this comorbidity usually studied as a dual disorder (i.e. PTSD-MDD or PTSD-AUD). This study explores trauma exposure (including to dysfunctional parenting), PTSD symptom severity and PTSD in people seeking treatment for coexisting depressive symptoms and alcohol use problems.Participants (n = 221) with current depression and alcohol use problems were recruited. Trauma exposure, PTSD symptoms and PTSD were assessed using the Posttraumatic Stress Diagnostic Scale. The Measure of Parenting Style assessed dysfunctional parenting (neglect/over-control/abuse) experienced as a child.Most participants experienced trauma (71.6%, n = 159), with more than one-third reaching DSM-IV criteria for current PTSD (38.0%, n = 84). Unique to this study was that there were no gender differences in rates of trauma exposure, number of traumatic events and PTSD. More severe PTSD symptoms and PTSD were associated with: childhood neglect; earlier depression onset; more severe depression and alcohol problems; and lower general functioning. More severe problems with alcohol were related to Intrusion and Avoidance symptoms, while severe alcohol dependence symptoms were related to hyperarousal.PTSD symptoms and PTSD are highly prevalent in those with coexisting depression and alcohol use problems and are associated with a history of childhood neglect and higher levels of comorbidity. Trauma, PTSD symptoms and PTSD should be assessed and addressed among people seeking treatment for coexisting depression and alcohol problems.",0,0 +2963,Does acute stress disorder predict post-traumatic stress disorder in traffic accident victims? Analysis of a self-report inventory,"The objective of this study was to account for acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) morbidity in a self-report survey of traffic accident victims and to evaluate the relationship between ASD and PTSD in this sample, and furthermore, to find both a model of independent variables accounting for variance in ASD and PTSD symptom level. Ninety patients, treated at an emergency ward after traffic accidents, participated in this longitudinal self-report survey. ASD was assessed using the Acute Stress Disorder Scale (ASDS) and PTSD was assessed at 6-8 months follow-up using the Posttraumatic Diagnostic Scale (PDS). Twenty-five patients (28%) met the cutoff scores for ASDS. Fifteen patients (17%) fulfilled criteria for PTSD according to the PDS. ASD was only able to predict 50% of patients who later developed high levels of PTSD symptomatology. A model of three variables explained 35% of the variance in ASD symptom level. Two variables explained 40% of the variance in PTSD symptom level. In both regression models, dissatisfaction with social support was associated with a higher symptom level. The results from this study reflect already voiced problems with the ASD diagnosis. The lack of precision in predicting who will develop PTSD is pronounced in this study. The acute traumatic symptom level explains a large part of the variance in PTSD symptom level. However, other variables also seem to play an important role. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +2964,Sequential Temporal Dependencies in Associations Between Symptoms of Depression and Posttraumatic Stress Disorder: An Application of Bivariate Latent Difference Score Structural Equation Modeling,"Depression and posttraumatic stress disorder (PTSD) are highly comorbid conditions that may arise following exposure to psychological trauma. This study examined their temporal sequencing and mutual influence using bivariate latent difference score structural equation modeling. Longitudinal data from 182 emergency room patients revealed level of depression symptom severity to be positively associated with changes in PTSD intrusion, avoidance, and hyperarousal over 3 time intervals, beginning shortly after the traumatic event. Higher scores on depression anticipated increases (or worsening) in PTSD symptom severity. The pattern of influence from PTSD symptom severity to change in depression symptom severity simply followed the general trend toward health and well-being. Results are discussed in terms of the dynamic interplay and associated mechanisms of posttrauma depression and PTSD symptom severity.",0,0 +2965,Social determinants of mid- to long-term disaster impacts on health: A systematic review,"Disasters cause a wide range of health impacts. Although there remains a need to understand and improve acute disaster management, a stronger understanding of how health is affected in the medium and longer term is also required to inform the design and delivery of measures to manage post-disaster health risks, and to guide actions taken before and during events which will also lead to reduction in health impact. Social determinants exert a powerful influence on different elements of risk, principally vulnerability, exposure and capacity, and thus, on people's health. As disaster health data and research has tended to focus on the short-term health impacts, no systematic assessment of the social determinants of the mid- to long-term health impacts of disasters has been identified. We assessed the chronic health impacts of disasters and explored the potential socioeconomic determinants of health impact through a systematic review. Our findings, based on 28 studies, highlighted that regardless of health outcomes and event types, the influence of disasters on chronic heath persists beyond the initial disaster period, affecting people's health for months to years. Using the World Health Organization's conceptual framework for the social determinants of health, we identified a total of 35 themes across the three conceptual domains (determinants related to the socioeconomic and political context, structural determinants, and intermediate determinants) as potentially influencing disaster impact. Investment to tackle modifiable underlying determinants could aid disaster risk management, improve medium and long-term health outcomes from disasters, and build community resilience.",0,0 +2966,Post-traumatic stress disorder predicts future weight change in the Millennium Cohort Study,"Objective To prospectively examine the association between post-traumatic stress disorder (PTSD) and weight change. Methods Longitudinal analysis techniques were used to examine data (2001–2008) from Millennium Cohort Study participants, consisting of U.S. service members and veterans. Using the PTSD Checklist–Civilian Version, PTSD was assessed as none, resolved, new onset, or persistent. Subsequent weight change was assessed as stable (≤3% loss or gain), >3% weight loss, >3% but <10% weight gain, and ≥10% weight gain. Results Of the 38,352 participants, 2391 (6.2%) had PTSD (838 resolved, 1024 new onset, and 529 persistent), and 11% of participants subsequently had ≥10% weight gain. In multivariable models, PTSD was associated with higher odds of ≥10% weight gain (new onset OR: 1.44 [95% CI: 1.20–1.73]; persistent OR: 1.51 [CI: 1.17–1.96]; resolved OR: 1.30 [CI: 1.05–1.60]) compared with those without PTSD. New-onset and persistent PTSD were also associated with higher odds of >3% weight loss (OR: 1.41 [CI: 1.17–1.71]; OR: 1.42 [CI: 1.09–1.86], respectively). Conclusions PTSD is independently associated with a higher risk of weight gain and loss, the former of which leads to a higher prevalence of overweight and obesity and a higher risk of comorbidities associated with excessive body adiposity.",0,0 +2967,Cognitive Behavioral Therapy for Posttraumatic Stress Disorder in Women,"

Context

The prevalence of posttraumatic stress disorder (PTSD) is elevated among women who have served in the military, but no prior study has evaluated treatment for PTSD in this population. Prior research suggests that cognitive behavioral therapy is a particularly effective treatment for PTSD.

Objective

To compare prolonged exposure, a type of cognitive behavioral therapy, with present-centered therapy, a supportive intervention, for the treatment of PTSD.

Design, Setting, and Participants

A randomized controlled trial of female veterans (n=277) and active-duty personnel (n=7) with PTSD recruited from 9 VA medical centers, 2 VA readjustment counseling centers, and 1 military hospital from August 2002 through October 2005.

Intervention

Participants were randomly assigned to receive prolonged exposure (n = 141) or present-centered therapy (n = 143), delivered according to standard protocols in 10 weekly 90-minute sessions.

Main Outcome Measures

Posttraumatic stress disorder symptom severity was the primary outcome. Comorbid symptoms, functioning, and quality of life were secondary outcomes. Blinded assessors collected data before and after treatment and at 3- and 6-month follow-up.

Results

Women who received prolonged exposure experienced greater reduction of PTSD symptoms relative to women who received present-centered therapy (effect size, 0.27;P = .03). The prolonged exposure group was more likely than the present-centered therapy group to no longer meet PTSD diagnostic criteria (41.0% vs 27.8%; odds ratio, 1.80; 95% confidence interval, 1.10-2.96;P = .01) and achieve total remission (15.2% vs 6.9%; odds ratio, 2.43; 95% confidence interval, 1.10-5.37;P = .01). Effects were consistent over time in longitudinal analyses, although in cross-sectional analyses most differences occurred immediately after treatment.

Conclusions

Prolonged exposure is an effective treatment for PTSD in female veterans and active-duty military personnel. It is feasible to implement prolonged exposure across a range of clinical settings.

Trial Registration

clinicaltrials.gov Identifier:NCT00032617",0,0 +2968,Studies on Genetics of Heat Tolerance in Dairy Cattle with Reduced Weather Information via Cluster Analysis,"The objective of this study was to explore the possibility of reducing the number of weather stations for studies on genetics of heat tolerance in dairy cattle. The similarity of information from 21 Georgia weather stations was analyzed by cluster analysis. Two major clusters have been found, separating Georgia along the NE and SW line. One weather station was selected for each of the clusters based on the minimal distance to all the remaining weather stations and on completeness of the weather information. The production dataset consisted of 114,751 first-parity test-day records for milk on 14,297 Holsteins from 120 herds in Georgia. Analyses using a model for daily milk yield with temperature-humidity index classes and several other fixed effects showed no increase in error sum of squares when using only two weather stations. The threshold of heat stress was different for each of the two regions but the rate of decline after the threshold was similar. After accounting for different thresholds, the genetic component of heat tolerance for milk was higher with the two-station model. Genetic studies on or evaluation for heat tolerance based on information from a few carefully selected weather stations can be as accurate as those based on information from numerous such stations.",0,0 +2969,An Introduction to Latent Variable Mixture Modeling (Part 2): Longitudinal Latent Class Growth Analysis and Growth Mixture Models,"Pediatric psychologists are often interested in finding patterns in heterogeneous longitudinal data. Latent variable mixture modeling is an emerging statistical approach that models such heterogeneity by classifying individuals into unobserved groupings (latent classes) with similar (more homogenous) patterns. The purpose of the second of a 2-article set is to offer a nontechnical introduction to longitudinal latent variable mixture modeling.3 latent variable approaches to modeling longitudinal data are reviewed and distinguished.Step-by-step pediatric psychology examples of latent growth curve modeling, latent class growth analysis, and growth mixture modeling are provided using the Early Childhood Longitudinal Study-Kindergarten Class of 1998-1999 data file.Latent variable mixture modeling is a technique that is useful to pediatric psychologists who wish to find groupings of individuals who share similar longitudinal data patterns to determine the extent to which these patterns may relate to variables of interest.",0,0 +2970,Loneliness Trajectories: The Role of Posttraumatic Symptoms and Social Support,"This study prospectively examines the longitudinal course of loneliness, social support, and posttraumatic symptoms (PTS) among Israeli war veterans. Two groups of veterans with and without antecedent combat stress reaction (CSR) were assessed at three points of time during a 20-year period. Veterans with CSR reported higher levels of loneliness compared with veterans without CSR. Loneliness remained stable among veterans with CSR but decreased among veterans without CSR. Baseline level of social support predicted the trajectory of change in loneliness. Finally, higher levels of PTS and lower levels of social support were associated with more loneliness among veterans with CSR.",0,0 +2971,Delayed-Onset Posttraumatic Stress Disorder: A Systematic Review of the Evidence,"Objective: Since the diagnosis of delayed-onset posttraumatic stress disorder (PTSD) was introduced in DSM-III, there has been controversy over its prevalence and even its existence. The authors sought to resolve discrepant findings concerning the prevalence of delayed-onset PTSD by conducting a systematic review of the evidence. Method: A literature search was conducted for case reports and group studies with adequate measurement of delayed-onset PTSD according to DSM criteria. Studies that met inclusion criteria were examined for the defined length of delay for delayed-onset PTSD, presence of symptoms before full diagnostic criteria were met, length of follow-up, prevalence estimates, and other variables. Studies were also examined for differences between immediate-onset PTSD, delayed-onset PTSD, and no-PTSD cases. Results: Ten case studies and 19 group studies met criteria for inclusion in the review. Studies consistently showed that delayed-onset PTSD in the absence of any prior symptoms was rare, whereas delayed onsets that represented exacerbations or reactivations of prior symptoms accounted on average for 38.2% and 15.3%, respectively, of military and civilian cases of PTSD. Conclusions: The discrepant findings in the literature concerning prevalence can be largely, but not completely, explained as being due to definitional issues. Little is known about what distinguishes the delayed-onset and immediate-onset forms of the disorder. Continuing scientific study of delayed-onset PTSD would benefit if future editions of DSM were to adopt a definition that explicitly accepts the likelihood of at least some prior symptoms.",0,0 +2972,Vinorelbine and gemcitabine vs vinorelbine and carboplatin as first-line treatment of advanced NSCLC. A phase III randomised controlled trial by the Norwegian Lung Cancer Study Group,"Platinum-based doublet chemotherapy is the standard first-line treatment for advanced non-small cell lung cancer (NSCLC), but earlier studies have suggested that non-platinum combinations are equally effective and better tolerated. We conducted a national, randomised study to compare a non-platinum with a platinum combination.Eligible patients had stage IIIB/IV NSCLC and performance status (PS) 0-2. Patients received up to three cycles of vinorelbine 60 mg m(-2) p.o.+gemcitabine 1000 mg m(-2) i.v. day 1 and 8 (VG) or vinorelbine 60 mg m(-2) p.o. day 1 and 8+carboplatin area under the curve=5 (Calvert's formula) i.v. day 1 (VC). Patients ≥75 years received 75% of the dose. Endpoints were overall survival, health-related quality of life (HRQoL), toxicity, and the use of radiotherapy.We randomised 444 patients from September 2007 to April 2009. The median age was 65 years, 58% were men and 25% had PS 2. Median survival was VG: 6.3 months; VC: 7.0 months, P=0.802. Vinorelbine plus carboplatin patients had more grade III/IV nausea/vomiting (VG: 4%, VC: 12%, P=0.008) and grade IV neutropenia (VG: 7%, VC: 19%, P<0.001). Infections, HRQoL and the use of radiotherapy did not differ significantly between the treatment groups.The two regimens yielded similar overall survival. The VG combination had only a slightly better toxicity profile.",0,0 +2973,Sustained Elevation of Serum Interleukin-6 and Relative Insensitivity to Hydrocortisone Differentiates Posttraumatic Stress Disorder with and Without Depression,"

Background

Elevated levels of proinflammatory cytokines, especially interleukin-6 (IL-6), can mediate the greater risk for cardiovascular disease in individuals with posttraumatic stress disorder (PTSD), particularly in those with comorbid major depressive disorder (MDD). However, IL-6 levels are not consistently elevated in either PTSD or MDD. Although PTSD is associated with supersensitivity to glucocorticoids; prior studies have not evaluated the effect of comorbid MDD.

Methods

Serum IL-6 levels were measured hourly between 7:00 pm and 7:00 am in individuals with PTSD with comorbid MDD (PTSD + MDD) (n = 9) and compared with those with PTSD without MDD (PTSD − MDD) (n = 9) and nontraumatized healthy control subjects (n = 14). Group differences in serum IL-6, plasma adrenocorticotropic hormone (ACTH), and plasma cortisol response to 30 mg of intravenous hydrocortisone were evaluated using linear mixed models.

Results

Only subjects with PTSD + MDD exhibited higher, overnight serum IL-6 levels compared with individuals with PTSD − MDD (p < .01) and healthy control subjects (p < .001). Peak overnight IL-6 levels positively correlated with severity of PTSD (r = .56, p < .01) and depressive symptoms (r = .54, p < .01). Hydrocortisone administration significantly reduced IL-6 levels in both PTSD groups; however, IL-6 levels in PTSD + MDD were higher than both PTSD − MDD (p < .05) and healthy control subjects (p < .01). Following hydrocortisone administration, there was a greater reduction in levels of ACTH in PTSD − MDD compared with control subjects (p < .01).

Conclusions

Sustained elevations of overnight IL-6 levels and relatively decreased sensitivity to hydrocortisone distinguish PTSD + MDD from PTSD − MDD. Novel strategies that decrease IL-6 levels offer a new direction in the prevention and treatment of PTSD and associated comorbid medical illnesses.",0,0 +2974,A three-year follow-up study of the psychosocial predictors of delayed and unresolved post-traumatic stress disorder in Taiwan Chi-Chi earthquake survivors,"To predict the longitudinal course of post-traumatic stress disorder (PTSD) in survivors three years following a catastrophic earthquake using multivariate data presented six months after the earthquake.Trained assistants and psychiatrists used the Disaster-related Psychological Screening Test (DRPST) to interview earthquake survivors 16 years and older and to assess current and incidental psychopathology. A total of 1756 respondents were surveyed over the three-year follow-up period.A total of 38 (9.1%) of the original 418 PTSD subjects and 40 of the original 1338 (3.0%) non-PTSD subjects were identified as having PTSD at the 3-year post-earthquake follow up. Younger age, significant financial loss, and memory/attention impairment were predictive factors of unresolved PTSD and delayed PTSD.The longitudinal course of PTSD three years after the earthquake could be predicted as early as six months after the earthquake on the basis of demographic data, PTSD-related factors, and putative factors for PTSD.",0,0 +2975,Distinctive Trajectory Groups of Mental Health Functioning among Assertive Community Treatment Clients: An Application of Growth Mixture Modelling Analysis,"Objective: Assertive community treatment (ACT) studies that have used conventional, statistical growth modelling methods have not examined different trajectories of outcomes or covariates that could influence different trajectories, even though heterogeneity in outcomes has been established in other research on severe mental illness. The purpose of our study was to examine the general trend in mental health functioning of ACT clients over a 2-year follow-up time period, to discover groups of ACT clients with distinctive longitudinal trajectories of mental health functioning, and to examine if some of the key sociodemographic and illness-related factors influence group membership. Method: A 2-year, prospective, within-subjects study of 216 ACT clients within southern Ontario, collected functional outcome data at baseline and 12 and 24 months using the Colorado Client Assessment Record. Baseline covariates included sex, primary diagnosis, number of comorbidities, hospitalization history, and duration of illness. Growth mixture modelling (GMM) was used to examine trajectories. Results: Clinical staff assessments of ACT clients showed a statistically significant improvement in functioning and 84% achieved successful community tenure. GMM analysis identified 2 classes of ACT clients: class 1 (79.63% of clients) experienced lower and stable overall functioning, and class 2 (20.37%) showed a better baseline functioning score and improvement in the overall functioning over time. Class membership was predicted by the number of comorbidities and diagnosis. Conclusions: Our study suggests general stability in overall functioning for the sampled ACT clients over 2 years, but significant heterogeneity in trajectories of functioning.",0,0 +2976,Heterogeneity of posttraumatic stress disorder symptoms in Croatian war veterans: retrospective study.,"To determine the relationship between the intensity of combat-related posttraumatic stress disorder (PTSD) and the intensity of predominating symptoms.The study included 151 veterans from 1992-1995 war in Croatia (aged 38.3+/-7.3 years) with PTSD. The veterans were psychologically tested with the Mississippi Scale for Combat-related PTSD (M-PTSD), Questionnaire on Traumatic Combat and War Experiences (USTBI-M), and Minnesota Multiphasic Personality Inventory-version 201 (MMPI-201).The discriminative analysis of the data revealed that the group with lower PTSD intensity had the highest scores on MMPI scales D (depression, T-score 98.3+/-5.6), Hs (hypochondriasis, 90.1+/-5.1), and Hy (hysteria, 89.5+/-4.9), whereas the group with higher PTSD intensity, besides these three scales (D=95.7+/-5.3; Hs=87.6+/-4.3; Hy=85.6+/-4.7), also had clinically significantly elevated Pt (psychastenia, 80.6+/-5.6), Sc (schizophrenia, 79.6+/-4.8), and Pa (paranoia, 85.6+/-5.4) scales, with the highest Pa scale.It was possible to differentiate study participants with different PTSD intensity on the basis of their MMPI profile. More intense PTSD was associated with externalized symptoms, such as aggression, acting-out, hostility, and mistrust, whereas less intensive PTSD was associated with mostly depressive symptoms. Our study showed that different intensity of PTSD has different symptom patterns.",0,0 +2977,Battle for the mind: World War 1 and the birth of military psychiatry,"

Summary

The 100th anniversary of the outbreak of World War 1 could be viewed as a tempting opportunity to acknowledge the origins of military psychiatry and the start of a journey from psychological ignorance to enlightenment. However, the psychiatric legacy of the war is ambiguous. During World War 1, a new disorder (shellshock) and a new treatment (forward psychiatry) were introduced, but the former should not be thought of as the first recognition of what is now called post-traumatic stress disorder and the latter did not offer the solution to the management of psychiatric casualties, as was subsequently claimed. For this Series paper, we researched contemporary publications, classified military reports, and casualty returns to reassess the conventional narrative about the effect of shellshock on psychiatric practice. We conclude that the expression of distress by soldiers was culturally mediated and that patients with postcombat syndromes presented with symptom clusters and causal interpretations that engaged the attention of doctors but also resonated with popular health concerns. Likewise, claims for the efficacy of forward psychiatry were inflated. The vigorous debates that arose in response to controversy about the nature of psychiatric disorders and the discussions about how these disorders should be managed remain relevant to the trauma experienced by military personnel who have served in Iraq and Afghanistan. The psychiatric history of World War 1 should be thought of as an opportunity for commemoration and in terms of its contemporary relevance—not as an opportunity for self-congratulation.",0,0 +2978,The clinical course over the first year of Whiplash Associated Disorders (WAD): pain-related disability predicts outcome in a mildly affected sample,"Different recovery patterns are reported for those befallen a whip-lash injury, but little is known about the variability within subgroups. The aims were (1) to compare a self-selected mildly affected sample (MILD) with a self-selected moderately to severely affected sample (MOD/SEV) with regard to background characteristics and pain-related disability, pain intensity, functional self-efficacy, fear of movement/(re)injury, pain catastrophising, post-traumatic stress symptoms in the acute stage (at baseline), (2) to study the development over the first year after the accident for the above listed clinical variables in the MILD sample, and (3) to study the validity of a prediction model including baseline levels of clinical variables on pain-related disability one year after baseline assessments.The study had a prospective and correlative design. Ninety-eight participants were consecutively selected. Inclusion criteria; age 18 to 65 years, WAD grade I-II, Swedish language skills, and subjective report of not being in need of treatment due to mild symptoms. A multivariate linear regression model was applied for the prediction analysis.The MILD sample was less affected in all study variables compared to the MOD/SEV sample. Pain-related disability, pain catastrophising, and post-traumatic stress symptoms decreased over the first year after the accident, whereas functional self-efficacy and fear of movement/(re)injury increased. Pain intensity was stable. Pain-related disability at baseline emerged as the only statistically significant predictor of pain-related disability one year after the accident (Adj r² = 0.67).A good prognosis over the first year is expected for the majority of individuals with WAD grade I or II who decline treatment due to mild symptoms. The prediction model was not valid in the MILD sample except for the contribution of pain-related disability. An implication is that early observations of individuals with elevated levels of pain-related disability are warranted, although they may decline treatment.",0,0 +2979,Schneiderian symptoms and childhood trauma in the general population,"The Dissociative Disorders Interview Schedule (DDIS) was administered to a sample of 502 adults in the city of Winnipeg, Manitoba, Canada. Findings indicate that Schneiderian symptoms are highly related to childhood trauma and other dissociative symptoms clusters in the general population, as they are in clinical populations. Implications of the findings are discussed.",0,0 +2980,Longitudinal study of probable post-traumatic stress disorder in firefighters exposed to the World Trade Center disaster,"Symptoms of post-traumatic stress disorder (PTSD) have been reported even years after the terrorist attacks of September 11, 2001 (9/11).We used screening tools to assess the prevalence of probable PTSD in 9/11-exposed firefighters at two time points, within 6 months of 9/11 (baseline) and 3-4 years post-disaster (follow-up).Five thousand six hundred fifty-six individuals completed assessments at both times. 15.5% reported probable PTSD post-9/11, 8.6% at baseline and 11.1% at follow-up, on average 2.9 (SD 0.5) years later. Analyses revealed that nearly half of all probable PTSD occurred as delayed onset (absent baseline, present follow-up). Compared with the resilient group (no probable PTSD at either time), probable PTSD at baseline, and delayed onset at follow-up were each associated with concomitant functional impairment (OR 19.5 and 18.9), respectively.Similar percentages of firefighters met criteria for baseline and delayed onset probable PTSD at follow-up, years later. Both were associated with substantial functional impairment. Early risk identification could provide opportunities for mental health interventions before symptoms compromise work and social relationships.",0,0 +2981,Research on injury compensation and health outcomes: ignoring the problem of reverse causality led to a biased conclusion,"This study highlights the serious consequences of ignoring reverse causality bias in studies on compensation-related factors and health outcomes and demonstrates a technique for resolving this problem of observational data.Data from an English longitudinal study on factors, including claims for compensation, associated with recovery from neck pain (whiplash) after rear-end collisions are used to demonstrate the potential for reverse causality bias. Although it is commonly believed that claiming compensation leads to worse recovery, it is also possible that poor recovery may lead to compensation claims--a point that is seldom considered and never addressed empirically. This pedagogical study compares the association between compensation claiming and recovery when reverse causality bias is ignored and when it is addressed, controlling for the same observable factors.When reverse causality is ignored, claimants appear to have a worse recovery than nonclaimants; however, when reverse causality bias is addressed, claiming compensation appears to have a beneficial effect on recovery, ceteris paribus.To avert biased policy and judicial decisions that might inadvertently disadvantage people with compensable injuries, there is an urgent need for researchers to address reverse causality bias in studies on compensation-related factors and health.",0,0 +2982,"Victimization Profiles, Non-Suicidal Self-Injury, Suicide Attempt, and Post-Traumatic Stress Disorder Symptomology","Few studies have incorporated multiple dimensions of victimization or examined whether victimization profiles differ by gender. Consequently, the present study sought to extend prior research by using latent class analysis (LCA) to identify naturally occurring subgroups of individuals who have experienced victimization, and to test for sex differences. Data from 4,016 females and 3,032 males in the Adult Psychiatric Morbidity Survey (APMS) were analyzed. Evidence of the existence of similar victimization subtypes for both males and females emerged, with a three-class solution providing the best fit to the data for both sexes. Furthermore, the classes were labeled “low victimization” (the baseline class; Class 3), the “high victimization class” (Class 1), and “the bullying and domestic violence class” (Class 2) for both males and females. Multinomial logistic regression was used to interpret the nature of the latent classes, or groups, by estimating the associations with post-traumatic stress disorder (PTSD) dimensions, suicide attempt, and non-suicidal self-injury. Although different constellations of victimization experiences did not emerge through the gender-specific analyses, the nature of the associations between class membership and external variables differed between males and females. Findings highlight the heterogeneity of victimization experiences and their relations to functioning, and have implications for policy and practice implications.",0,0 +2983,Efficacy of a Satyananda Yoga Intervention for Reintegrating Adults Diagnosed with Posttraumatic Stress Disorder,"The prevalence of posttraumatic stress disorder (PTSD) in ex-combatants from illegal armed groups in Colombia has been estimated at 37.4%. This high prevalence indicates a need to explore alternative and adjunctive therapies in the treatment of PTSD. A randomized controlled trial was undertaken to evaluate the efficacy and safety of a protocol based on Satyananda Yoga® in PTSD-diagnosed reintegrating adults in Colombia. One hundred reintegrating adults (n = 50 for each of the yoga and control arms) from Bogota and Medellin participated in this study. Yoga participants engaged in a Satyananda Yoga intervention for 16 weeks while the control group continued the regular demobilization program. The Posttraumatic Stress Disorder Checklist - Civilian Version (PCL-C) was used to evaluate the effects of the applied therapy. Outcomes were assessed before entry and after the treatment. T-tests revealed a treatment effect of d = 1.15 for the yoga group and a between-groups effect size of d = .73. The difference in improvement in PCL-C scores between both groups was 18.91% (p < 0.05). The highest percentage of improvement was observed in the re-experiencing symptom cluster (23.71%; p < 0.05), with a treatment effect of d = 1.40 for the yoga group and a between-groups effect size of d = 1.15. The data suggest that Satyananda Yoga methodology is an effective therapy for reintegrating adults diagnosed with PTSD. Further research is needed in order to evaluate prolonged effects of this alternative therapy.",0,0 +2984,Structural Validity of the Posttraumatic Stress Disorder Checklist Among College Students With a Trauma History,"The authors conducted confirmatory factor analyses to test three-factor and four-factor models of posttraumatic stress disorder (PTSD) using the PTSD Checklist with college students reporting a traumatic event history. The authors found support for the three-factor DSM-IV-based PTSD diagnostic model including reexperiencing, avoidance/numbing, and hyperarousal symptom factors, with slightly better support for a four-factor model separating the avoidance and numbing factors. Results further attest to the PTSD Checklist's construct validity, and to research finding that PTSD avoidance and numbing constructs are distinct.",0,0 +2985,Mental disorders and smoking trajectories: A 10-year prospective study among adolescents and young adults in the community,"Numerous studies have documented an association between mental disorders and onset of cigarette smoking. Yet, there is little understanding of the potential impact of mental disorders on trajectories of smoking over time. The objective of this study was to investigate this relationship among adolescents over a 10-year span. Data were drawn from the Early Developmental Stages of Psychopathology Study, a 10-year prospective investigation of youth in Germany. Growth mixture modeling was used to identify smoking trajectories and logistic regression analyses were used to examine relationships between mental disorders and subsequent trajectories. Four trajectories were identified: non-users; increasing use; decreasing use; persistent use. Alcohol/drug use disorders, stress disorders, anxiety disorders, somatoform disorder and nicotine dependence were associated with nicotine use (as compared to the non-smoker class). However, comparisons between trajectories of nicotine use showed that any stress disorder predicted only decreasing use compared to the other two trajectories; nicotine dependence, alcohol/illicit drug use disorders as well as panic disorder and somatoform disorders were inversely associated with increasing use; nicotine dependence and alcohol/drug use disorders were associated with persistent use. Several mental disorders appear to be non-specific markers of the range of smoking trajectories while others predict specific trajectories. Numerous disorders (e.g., alcohol/drug use disorders) do not appear to occur only prior to and predict increased smoking trajectory as had been previously suggested, but rather they also occur concurrently, with high levels of smoking and in some cases smoking persists at a steady level over time.",0,0 +2986,Posttraumatic stress disorders in children and adolescents,"Millions of children are exposed to traumatic experiences each year. Over 30% of these children develop a clinical syndrome with emotional, behavioral, cognitive, social, and physical symptoms called posttraumatic stress disorder. The symptoms of posttraumatic stress disorder fall into three clusters: reenactment of the traumatic event: avoidance of cues associated with the event or general withdrawal; and physiological hyperreactivity. Significant physical and medical problems in childhood, adolescence, and adulthood appear to be related to childhood trauma. Current treatment approaches include postacute psychoeducation, individual psychotherapy, pharmacotherapy, and cognitive-behavioral therapy. Despite increasing attention over the past 10 years, childhood posttraumatic stress disorder remains an understudied public health problem.",0,0 +2987,The World Trade Center Disaster and the Health of Workers: Five-Year Assessment of a Unique Medical Screening Program,"Approximately 40,000 rescue and recovery workers were exposed to caustic dust and toxic pollutants following the 11 September 2001 attacks on the World Trade Center (WTC). These workers included traditional first responders, such as firefighters and police, and a diverse population of construction, utility, and public sector workers.To characterize WTCrelated health effects, the WTC Worker and Volunteer Medical Screening Program was established. This multicenter clinical program provides free standardized examinations to responders. Examinations include medical, mental health, and exposure assessment questionnaires; physical examinations; spirometry; and chest X rays.Of 9,442 responders examined between July 2002 and April 2004, 69% reported new or worsened respiratory symptoms while performing WTC work. Symptoms persisted to the time of examination in 59% of these workers. Among those who had been asymptomatic before September 11, 61% developed respiratory symptoms while performing WTC work. Twenty-eight percent had abnormal spirometry; forced vital capacity (FVC) was low in 21%; and obstruction was present in 5%. Among nonsmokers, 27% had abnormal spirometry compared with 13% in the general U.S. population. Prevalence of low FVC among nonsmokers was 5-fold greater than in the U.S. population (20% vs. 4%). Respiratory symptoms and spirometry abnormalities were significantly associated with early arrival at the site.WTC responders had exposure-related increases in respiratory symptoms and pulmonary function test abnormalities that persisted up to 2.5 years after the attacks. Longterm medical monitoring is required to track persistence of these abnormalities and identify late effects, including possible malignancies. Lessons learned should guide future responses to civil disasters.",0,0 +2988,Ethical challenges with the left ventricular assist device as a destination therapy,"The left ventricular assist device was originally designed to be surgically implanted as a bridge to transplantation for patients with chronic end-stage heart failure. On the basis of the REMATCH trial, the US Food and Drug Administration and the US Centers for Medicare & Medicaid Services approved permanent implantation of the left ventricular assist device as a destination therapy in Medicare beneficiaries who are not candidates for heart transplantation. The use of the left ventricular assist device as a destination therapy raises certain ethical challenges. Left ventricular assist devices can prolong the survival of average recipients compared with optimal medical management of chronic end-stage heart failure. However, the overall quality of life can be adversely affected in some recipients because of serious infections, neurologic complications, and device malfunction. Left ventricular assist devices alter end-of-life trajectories. The caregivers of recipients may experience significant burden (e.g., poor physical health, depression, anxiety, and posttraumatic stress disorder) from destination therapy with left ventricular assist devices. There are also social and financial ramifications for recipients and their families. We advocate early utilization of a palliative care approach and outline prerequisite conditions so that consenting for the use of a left ventricular assist device as a destination therapy is a well informed process. These conditions include: (1) direct participation of a multidisciplinary care team, including palliative care specialists, (2) a concise plan of care for anticipated device-related complications, (3) careful surveillance and counseling for caregiver burden, (4) advance-care planning for anticipated end-of-life trajectories and timing of device deactivation, and (5) a plan to address the long-term financial burden on patients, families, and caregivers.Short-term mechanical circulatory devices (e.g. percutaneous cardiopulmonary bypass, percutaneous ventricular assist devices, etc.) can be initiated in emergency situations as a bridge to permanent implantation of ventricular assist devices in chronic end-stage heart failure. In the absence of first-person (patient) consent, presumed consent or surrogate consent should be used cautiously for the initiation of short-term mechanical circulatory devices in emergency situations as a bridge to permanent implantation of left ventricular assist devices. Future clinical studies of destination therapy with left ventricular assist devices should include measures of recipients' quality of end-of-life care and caregivers' burden.",0,0 +2989,Findings of Mild Traumatic Brain Injury in Combat Veterans With PTSD and a History of Blast Concussion,"Veterans with chronic posttraumatic stress disorder were evaluated for a history of blast concussion, controlling for confounding conditions. Electroencephalograms were analyzed by discriminant function for traumatic brain injury. A difference was found in discriminant scores between veterans with and without blast concussion. More members of the blast group had attentional symptoms and attentional dysfunction. Combat veterans with a remote history of blast injury have persistent electroencephalographic features of traumatic brain injury as well as attentional problems. The authors hypothesize that these constitute a type of chronic postconcussive syndrome that has cognitive and mood symptoms overlapping those of posttraumatic stress disorder.",0,0 +2990,Aged neuropeptide Y transgenic rats are resistant to acute stress but maintain spatial and non-spatial learning,"The behavioral phenotype of five-month-old rats overexpressing neuropeptide Y (NPY) has previously been described [Proc Natl Acad Sci USA 97 (2000) 12852]. In this transgenic rat model, there is central overexpression of prepro-NPY mRNA and NPY peptide in the hippocampus and hypothalamus and decreased Y1 binding sites within the hippocampus. These molecular and neurochemical events led to altered anxiety profile and learning abilities in NPY-overexpressing rats. In the present study, anxiety and learning/memory related behaviors were examined in one-year-old NPY-transgenic rats in order to assess any behavioral changes that may have occurred during the aging process. As observed in 5-month-old overexpressing rats, aged NPY-transgenic animals are resistant to acute physical restraint stress measured by the elevated-plus maze and demonstrate anxiolytic-like activity in the open field. However, in contrast to data in young rats, there was no significant difference between aged wildtype and NPY-transgenic animals in relation to spatial and non-spatial memory as indicated by the (allo- and ego-centric) Morris water maze and object recognition test. It would thus appear that the anxiolytic-like profile observed in young NPY-overexpressing rats is maintained in older animals providing further evidence for a role for NPY in anxious behaviors. However, the cognitive deficits observed in young rats do not appear to occur in older animals suggesting the existence of compensatory mechanisms leading to a reversal of the learning deficits noted in younger animals. These results also provide additional evidence for the mechanistic dissociation between anxiety and cognition-related behaviors modulated by NPY.",0,0 +2991,A Randomised Controlled Trial of a Cognitive-Behavioural Therapy Program for Managing Social Anxiety After Acquired Brain Injury,"Abstract Despite the prevalence of psychiatric illness in people with acquired brain injury (ABI), there are very few empirically validated studies examining the efficacy of treatments targeting commonly occurring disorders such as depression and anxiety. Using a randomised controlled trial, this study evaluated the efficacy of a cognitive behavioural intervention specifically designed for managing social anxiety following ABI. Twelve brain-injured participants were screened, randomly allocated to either treatment group (TG) or a wait list group (WLG), and proceeded through to the final stages of therapy. The TG received between 9 and 14 hourly, individual sessions of cognitive behavioural therapy. Repeated measures analyses revealed significant improvements in general anxiety, depression and a transient mood measure, tension-anxiety, for the TG when compared to the WLG at posttreatment. These treatment gains were maintained at one-month follow-up. Although in the predicted direction, postintervention improvements in social anxiety and self-esteem for the TG were not significant in comparison with the WLG. This study lends support to the small body of literature highlighting the potential of cognitive behavioural interventions for managing the psychological problems that serve as a barrier to rehabilitation following ABI.",0,0 +2992,The Impact of Event Scale-Revised: Psychometric properties in a sample of motor vehicle accident survivors,"This study examined the factor structure, internal consistency, concurrent validity, and discriminative validity of the Impact of Event Scale-Revised (IES-R, [Weiss, D. S. & Marmar, C. R. (1997). The Impact of Event Scale-Revised. In: J. P. Wilson & T. M. Keane (Eds.). Assessing psychological trauma and PTSD (pp. 399-411). New York: Guilford Press]) in a sample of 182 individuals who had experienced a serious motor vehicle accident. Results supported the three-factor structure of the IES-R, Intrusion, Avoidance, and Hyperarousal, with adequate internal consistency noted for each subscale. Support was obtained for the concurrent and discriminative validity, as well as the absence of social desirability effects. Although some differences were noted between the IES-R Avoidance subscale and diagnostically based measures of this cluster of symptoms, these differences do not necessarily signify measurement problems with the IES-R. The IES-R seems to be a solid measure of post-trauma phenomena that can augment related assessment approaches in clinical and research settings.",0,0 +2993,Identification of sexually abused female adolescents at risk for suicidal ideations: a classification and regression tree analysis.,"This study explored the clinical profiles of 77 female teenager survivors of sexual abuse and examined the association of abuse-related and personal variables with suicidal ideations. Analyses revealed that 64% of participants experienced suicidal ideations. Findings from classification and regression tree analysis indicated that depression, posttraumatic stress symptoms, and hopelessness discriminated profiles of suicidal and nonsuicidal survivors. The elevated prevalence of suicidal ideations among adolescent survivors of sexual abuse underscores the importance of investigating the presence of suicidal ideations in sexual abuse survivors. However, suicidal ideation is not the sole variable that needs to be investigated; depression, hopelessness and posttraumatic stress symptoms are also related to suicidal ideations in survivors and could therefore guide interventions.",0,0 +2994,Posttraumatic Stress Disorder (PTSD) and Posttraumatic Stress Symptoms (PTSS) in Families of Adolescent Childhood Cancer Survivors,"To describe rates and concordance of posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSS) in adolescent childhood cancer survivors and their mothers and fathers.Participants were 150 adolescent survivors of childhood cancer, 146 mothers, and 103 fathers who completed the Impact of Events Scale-Revised, the Posttraumatic Stress Disorder Reaction Index, and the PTSD module of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition.PTSS are common in families of childhood cancer survivors. Parents reported more symptomatology than former patients. Mothers and fathers had relatively equal rates of current PTSD and levels of PTSS. Nearly 30% of mothers met diagnostic criteria since their child's diagnosis, with 13.7% currently experiencing PTSD. Nearly 20% of families had at least one parent with current PTSD. Ninety-nine percent of the sample had at least one family member reexperiencing symptoms.Both PTSD and PTSS help in understanding the experience of adolescent cancer survivors and their families. Within families of childhood cancer survivors, it is likely that some member may be experiencing treatable bothersome memories, arousal, or avoidance specific to the cancer experience.",0,0 +2995,Trajectories of caregiver depressive symptoms while providing end-of-life care,"The course of caregivers' depressive symptoms may not be homogenous. This study identified trajectories of depressive symptoms among caregivers providing end-of-life care to cancer patients and profiled the unique characteristics of caregivers within each trajectory.Trajectories of depressive symptoms were explored in 447 caregivers who completed the Center for Epidemiological Studies Depression Scale over four periods close to the patient's death (1-30, 31-90, 91-180, and >180 days). Distinct trajectories were identified by latent class analysis.Four trajectories were identified as endurance, resilience, moderately symptomatic, and chronically distressed and contained 32.0%, 11.4%, 36.9%, and 19.7% of the sample, respectively. Caregivers in the endurance trajectory were relatively well-adjusted individuals with less education, adequate financial support, and ample psychological resources but provided care to older patients with greater symptom distress. They perceived less subjective caregiving burden than caregivers with moderate or chronic depressive symptoms. Caregivers in the resilience trajectory were in a more vulnerable position than those in other trajectories when they first transitioned into the caregiving role because they were more likely to be the patient's spouse, have greater educational attainment and insufficient finances, provide higher intensity assistance to a younger relative, and have weaker psychological resources. However, they were older, reported greater confidence in caregiving, and perceived less caregiving burden than caregivers in other trajectories. The moderately symptomatic and chronically distressed trajectories were differentiated only by the strength of psychological resources.Caregivers of terminally ill cancer patients follow distinct depressive-symptom trajectories while providing end-of-life care.",0,0 +2996,"Superior efficacy of St John's wort extract WS®5570 compared to placebo in patients with major depression: a randomized, double-blind, placebo-controlled, multi-center trial [ISRCTN77277298]","The aim of the current study was to assess the antidepressant efficacy and safety of Hypericum perforatum (St. John's wort) extract WS 5570 at doses of 600 mg/day in a single dose and 1200 mg/day in two doses.The participants in this double-blind, randomized, placebo-controlled, multi-center clinical trial were male and female adult out-patients with an episode of mild or moderate major depressive episode (single or recurrent episode, DSM-IV criteria). As specified by the relevant guideline, the study was preceded by a medication-free run-in phase. For the 6-week treatment, 332 patients were randomized: 123 to WS 5570 600 mg/day, 127 to WS 5570 1200 mg/day, and 82 to placebo. The primary outcome measure was the change in total score on the Hamilton Rating Scale for Depression (HAM-D, 17-item version) between baseline and endpoint. Additional measures included the number of responders, the number of patients in remission, and several other standard rating scales. Efficacy and safety were assessed after 2 and 6 weeks. The design included an interim analysis performed after randomization with the option of early termination.After 6 weeks of treatment, mean +/- standard deviation decreases in HAM-D total scores of 11.6 +/- 6.4, 10.8 +/- 7.3, and 6.0 +/- 8.1 points were observed for the WS 5570 600 mg/day, 1200 mg/day and placebo groups, respectively (endpoint analysis). Secondary measures of treatment efficacy also showed that both WS 5570 groups were statistically superior to placebo. Significantly more patients in the WS 5570 treatment groups than in the placebo group showed treatment response and remission. WS 5570 was consistently more effective than placebo in patients with either less severe or more severe baseline impairment. The number of patients who experienced remission was higher in the WS 5570 1200 mg/day group than the WS 5570 600 mg/day group. The incidence of adverse events was low in all groups. The adverse event profile was consistent with the known profile for Hypericum extract preparations.Hypericum perforatum extract WS 5570 at doses of 600 mg/day (once daily) and 1200 mg/day (600 mg twice daily) were found to be safe and more effective than placebo, with comparable efficacy of the WS 5570 groups for the treatment of mild to moderate major depression.",0,0 +2997,Lifetime Events and Posttraumatic Stress Disorder in 4 Postconflict Settings,"Little is known about the impact of trauma in postconflict, low-income countries where people have survived multiple traumatic experiences.To establish the prevalence rates of and risk factors for posttraumatic stress disorder (PTSD) in 4 postconflict, low-income countries.Epidemiological survey conducted between 1997 and 1999 among survivors of war or mass violence (aged >/=16 years) who were randomly selected from community populations in Algeria (n = 653), Cambodia (n = 610), Ethiopia (n = 1200), and Gaza (n = 585).Prevalence rates of PTSD, assessed using the PTSD module of the Composite International Diagnostic Interview version 2.1 and evaluated in relation to traumatic events, assessed using an adapted version of the Life Events and Social History Questionnaire.The prevalence rate of assessed PTSD was 37.4% in Algeria, 28.4% in Cambodia, 15.8% in Ethiopia, and 17.8% in Gaza. Conflict-related trauma after age 12 years was the only risk factor for PTSD that was present in all 4 samples. Torture was a risk factor in all samples except Cambodia. Psychiatric history and current illness were risk factors in Cambodia (adjusted odds ratio [OR], 3.6; 95% confidence interval [CI], 2.3-5.4 and adjusted OR,1.6; 95% CI, 1.0-2.7, respectively) and Ethiopia (adjusted OR, 3.9; 95% CI, 2.0-7.4 and adjusted OR, 1.8; 95% CI, 1.1-2.7, respectively). Poor quality of camp was associated with PTSD in Algeria (adjusted OR, 1.8; 95% CI, 1.3-2.5) and in Gaza (adjusted OR, 1.7; 95% CI, 1.1-2.8). Daily hassles were associated with PTSD in Algeria (adjusted OR, 1.6; 95% CI, 1.1-2.4). Youth domestic stress, death or separation in the family, and alcohol abuse in parents were associated with PTSD in Cambodia (adjusted OR, 1.7; 95% CI, 1.1-2.6; adjusted OR, 1.7; 95% CI, 1.0-2.8; and adjusted OR, 2.2; 95% CI, 1.1-4.4, respectively).Using the same assessment methods, a wide range of rates of symptoms of PTSD were found among 4 low-income populations who have experienced war, conflict, or mass violence. We identified specific patterns of risk factors per country. Our findings indicate the importance of contextual differences in the study of traumatic stress and human rights violations.",0,0 +2998,The Impact of Caregiver Distress on the Longitudinal Development of Child Acute Post-traumatic Stress Disorder Symptoms in Pediatric Injury Victims,The present study prospectively examined the development of child PTSD symptoms (PTSS) and the impact of caregiver PTSS on child PTSS following injury.One hundred and eighteen ED patients and their caregivers were interviewed in-hospital and 2- and 6-weeks posttrauma. Structural equation modeling and hierarchical linear regressions examined the development of PTSS.A model combining child and caregiver 2-week PTSS into one latent family PTSS variable provided the best fit to the data. Child in-hospital avoidance symptoms predicted higher levels of 2-week family PTSS. Two-week family PTSS predicted child 6-week PTSS. Post hoc analyses revealed an interaction between in-hospital caregiver avoidance symptoms and child reexperiencing symptoms in predicting 6-week child PTSS.Results highlight the dynamic development of child PTSS. Different symptom clusters may be related to higher PTSS at differing times posttrauma and may inform the development of time-sensitive methods of assessment and intervention for injury victims.,0,0 +2999,Course of posttraumatic stress symptoms over the 5 years following an industrial disaster: A structural equation modeling study,"The present study examined individual latent changes in posttraumatic stress disorder (PTSD) symptoms over a 60-month period after an industrial disaster. Participants were recruited from survivors of a factory explosion. Participants were assessed retrospectively for peritraumatic reactions and acute stress symptoms. Posttraumatic stress disorder symptoms were then assessed at 6, 15, and 60 months. Using structural equation modeling, the authors tested 3 hypotheses of individual latent change: stability of PTSD symptoms between 6, 15, and 60 months; change between 6 and 15 months; and change between 15 and 60 months. Only one model provided a good fit suggesting that PTSD symptoms evolved between 6 and 15 months after trauma exposure and remained stable at the individual level thereafter.",0,0 +3000,Examining the relationship between blast-induced mild traumatic brain injury and posttraumatic stress-related traits,"Emerging evidence suggests that mild traumatic brain injury (mTBI) resulting from blast exposure may contribute to the occurrence of posttraumatic stress disorder (PTSD) and related affective sequelae, such as anxiety and depression. Many studies have used survey techniques to describe blast exposure leading to comorbid mTBI and related persistent postconcussive symptoms (PPCS) with PTSD in military populations. Despite this, there is a lack of literature that examines possible biological mechanisms by which blast exposure contributes to the development of PTSD sequelae. This Mini-Review addresses the current literature on potential neurophysiological changes that may contribute to PTSD-like traits as a result of a single or multiple exposures to blast events. Evidence from clinical blast-induced mTBI populations and animal models of blast-induced mTBI was evaluated with an emphasis on behavioral and physiological symptoms similar to those seen in PTSD populations and models. From the analysis, we propose potential mechanisms that merit further investigation for better understanding of how blast exposures may produce a higher rate of comorbid PPCS, PTSD, and affective phenomena. An improved understanding of PTSD-like outcomes resulting from blast exposure will ultimately help facilitate the development of future treatments and contribute to a better understanding of PTSD sequelae that develop from physical trauma.",0,0 +3001,"Use of Prescription Pain Medications Among Medical Cannabis Patients: Comparisons of Pain Levels, Functioning, and Patterns of Alcohol and Other Drug Use","Management of chronic pain is one of the most common reasons given by individuals seeking medical cannabis. However, very little information exists about the concurrent use of cannabis and prescription pain medication (PPM). This study fills this gap in knowledge by systematically comparing medical cannabis users who use or do not use PPM, with an emphasis on understanding whether concurrent use of cannabis and PPM is associated with more serious forms of alcohol and other drug involvement.Data from this study were collected from a medical cannabis clinic in southwestern Michigan (N = 273). Systematic comparisons were made on measures of sociodemographics, reasons for substance use, pain, functioning, and perceptions of PPM and medical cannabis efficacy.PPM users tended to be older and reported higher levels of pain and lower levels of functioning. The overall sample exhibited higher lifetime and past-3-month rates of alcohol and other noncannabis drug use than did the general population. Approximately 40% of subjects reported combining cannabis with alcohol, but no significant difference was observed between PPM users and nonusers. PPM users and nonusers did not exhibit any difference in either lifetime or past-3-month use of other drugs, including cocaine, sedatives, street opioids, and amphetamines. PPM users rated the efficacy of cannabis higher than PPM for pain management and indicated a strong desire to reduce PPM usage.Use of PPM among medical cannabis users was not identified as a correlate for more serious forms of alcohol and other drug involvement. However, longitudinal study designs are needed to better understand the trajectories of alcohol and other drug involvement over time among medical cannabis users.",0,0 +3002,An Integrative Two-Factor Model of Post-Traumatic Stress,"(from the book) provides [a] macroanalytic integrative construction of post-traumatic stress wherein posttraumatic stress disorder (PTSD) is viewed as an epiphenomenon / [builds] an integrative 2-factor model wherein biological factors are inextricably intertwined with psychological factors to explain the posttraumatic stress phenomenon, (from the chapter) [suggests] that PTSD is an epiphenomenon undergirded by a core 2-factor phenomenology consisting of (1) subcortical neurological hypersensitivity and (2) psychological hypersensitivity / the neurobiology of PTSD was posited to be a combination of amygdalar-hippocampus neural networks with numerous and varied efferent projections (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +3003,Low emotional response to traumatic footage is associated with an absence of analogue flashbacks: An individual participant data meta-analysis of 16 trauma film paradigm experiments,"Most people will experience or witness a traumatic event. A common occurrence after trauma is the experience of involuntary emotional memories of the traumatic event, herewith ""flashbacks"". Some individuals, however, report no flashbacks. Prospective work investigating psychological factors associated with an absence of flashbacks is lacking. We performed an individual participant data meta-analysis on 16 experiments (n = 458) using the trauma film paradigm to investigate the association of emotional response to traumatic film footage and commonly collected baseline characteristics (trait anxiety, current depression, trauma history) with an absence of analogue flashbacks. An absence of analogue flashbacks was associated with low emotional response to the traumatic film footage and, to a lesser extent, low trait anxiety and low current depression levels. Trauma history and recognition memory for the film were not significantly associated with an absence of analogue flashbacks. Understanding why some individuals report an absence of flashbacks may aid preventative treatments against flashback development.",0,0 +3004,Fear and avoidance of internal experiences among patients with substance use disorders and PTSD: The centrality of anxiety sensitivity*,"This study evaluated anxiety sensitivity, cognitive avoidance, and alexithymia and their relationship to posttraumatic stress disorder (PTSD) and alcohol use indices concurrently and prospectively in an outpatient substance abuse treatment sample that screened positive for PTSD (N=58). Anxiety sensitivity accounted for substantial variance in the PTSD clusters, reexperiencing, avoidance, and hyperarousal, both concurrently and prospectively. Cognitive avoidance accounted for additional variance with concurrent PTSD avoidance symptoms. Anxiety sensitivity and cognitive avoidance were largely not associated with alcohol use indices. Alexithymia was largely redundant with cognitive avoidance and was, therefore, not included in the regression analyses. Theoretical and treatment implications of these findings are discussed in the context of individuals with dually diagnosed PTSD and substance abuse disorders.",0,0 +3005,Directions in Disaster Resilience Policy,"Currently, a range of common terms are being used differently within government and the emergency management community. This paper provides a foundation for an understanding of the term 'resilience' so that constructive discussion can emerge amongst those involved in disaster management policy and practice. In doing so, we provide a short review of how the term can be used differently within policy, as well as how it has come to be influential in emergency management policy.",0,0 +3006,Correlation between Genotypes and Behavioral Phenotypes in a Mouse Model simulating aspects of Human Post‐traumatic Stress Disorder (PTSD),"Biologically meaningful correlations between behavioral phenotypes and genotypes are evaluated in a modified ‘residentintruder’- type stress on mice. This model was established by housing male C57BL/6 naïve subject mice with an SJL aggressor (Agg) mouse without direct contact for 6 h/d for 10 d or 5 d, and then briefly pairing the C57BL/6 mice with the Agg mice for 3x/d. Controls (C), also housed without food/liquid during the 6hr session, did not experience direct physical contact with Agg. At time points of 24 hours or 6 wks after the last exposure, behaviors of C and aggressor-exposed (Agg-E) mice were studied using the partition test, which allows mutual exposure of only sensory cues without physical contact. Behavioral patterns (partition avoidance, freezing) of Agg-E mice suggested fear and social withdrawal, the reported traits of PTSD. Global gene expression profiling of three major stress-relevant brain regions, namely Hippocampus (HC), Amygdala (AY), and Medial Pre-Frontal Cortex (mPFC) shows a clear genotype distribution between the C and Agg-E in AY and not in HC which is a positive correlation with PTSD symptom severity. The cluster pattern of MPFC reflects similarity between the genotype profile and behavioral phenotype. Further comprehensive analysis can potentially lead to identifying diagnostic and therapeutic biomarkers that serve as internal indicators of the complex psycho-pathogenesis.",0,0 +3007,Posttraumatic stress and posttraumatic growth among low-income mothers who survived Hurricane Katrina.,"The purpose of the study was to explore the relationship between posttraumatic stress (PTS) and posttraumatic growth (PTG) after Hurricane Katrina, and the role of demographics, predisaster psychological distress, hurricane-related stressors, and psychological resources (optimism and purpose) in predicting each.Participants were 334 low-income mothers (82.0% non-Hispanic Black) living in the New Orleans area prior to Hurricane Katrina, who completed surveys in the year prior to the hurricane (T1 [Time 1]) and 1 and 3 years thereafter (T2 and T3).Higher T2 and T3 PTS full-scale and symptom cluster subscales (Intrusion, Avoidance, and Hyperarousal) were significantly associated with higher T3 PTG, and participants who surpassed the clinical cutoff for probable posttraumatic stress disorder at both T2 and T3 had significantly higher PTG than those who never surpassed the clinical cutoff. Older and non-Hispanic Black participants, as well as those who experienced a greater number of hurricane-related stressors and bereavement, reported significantly greater T3 PTS and PTG. Participants with lower T2 optimism reported significantly greater T3 intrusive symptoms, whereas those with higher T1 and T2 purpose reported significantly greater T3 PTG.Based on the results, we suggest practices and policies with which to identify disaster survivors at greater risk for PTS, as well as longitudinal investigations of reciprocal and mediational relationships between psychological resources, PTS, and PTG.",0,0 +3008,Clinical Presentation of PTSD in World War II Combat Veterans,"Clinicians have increasingly recognized posttraumatic stress disorder (PTSD) among Vietnam veterans, but the disorder may be easily overlooked among World War II combat veterans. The authors review recent studies of PTSD in older veterans and describe five cases that illustrate the diverse clinical presentations of PTSD in this population. Symptoms included anxiety, cognitive and somatic complaints, depression, alcohol dependence, and amnestic periods. Despite the varied presentations, a fairly consistent patient profile emerged. Patients avoided reminders of war, showed an exaggerated startle response, and experienced restless sleep and chronic anxiety. Factors associated with exacerbations of symptoms were retirement and reminders of war experiences. Although past studies have emphasized resuppression of the trauma, the authors encourage a flexible approach to treatment, including exploratory techniques.",0,0 +3009,Common genetic and environmental contributions to post-traumatic stress disorder and alcohol dependence in young women,"The few genetically informative studies to examine post-traumatic stress disorder (PTSD) and alcohol dependence (AD), all of which are based on a male veteran sample, suggest that the co-morbidity between PTSD and AD may be attributable in part to overlapping genetic influences, but this issue has yet to be addressed in females.MethodData were derived from an all-female twin sample (n=3768) ranging in age from 18 to 29 years. A trivariate genetic model that included trauma exposure as a separate phenotype was fitted to estimate genetic and environmental contributions to PTSD and the degree to which they overlap with those that contribute to AD, after accounting for potential confounding effects of heritable influences on trauma exposure.Additive genetic influences (A) accounted for 72% of the variance in PTSD; individual-specific environmental (E) factors accounted for the remainder. An AE model also provided the best fit for AD, for which heritability was estimated to be 71%. The genetic correlation between PTSD and AD was 0.54.The heritability estimate for PTSD in our sample is higher than estimates reported in earlier studies based almost exclusively on an all-male sample in which combat exposure was the precipitating traumatic event. However, our findings are consistent with the absence of evidence for shared environmental influences on PTSD and, most importantly, the substantial overlap in genetic influences on PTSD and AD reported in these investigations. Additional research addressing potential distinctions by gender in the relative contributions of genetic and environmental influences on PTSD is merited.",0,0 +3010,Deployment-related stress and trauma in Dutch soldiers returning from Iraq,"Some questionnaire studies have shown increased mental health problems, including probable post-traumatic stress disorder (PTSD), in soldiers deployed to Iraq.To test prospectively whether such problems change over time and whether questionnaires provide accurate estimates of deployment-related PTSD compared with a clinical interview.Dutch infantry troops from three cohorts completed questionnaires before deployment to Iraq (n=479), and about 5 months (n=382, 80%) and 15 months (n=331, 69%) thereafter. Post-traumatic stress disorder was evaluated by questionnaire and clinical interview.There were no group changes for general distress symptoms. The rates of PTSD for each cohort were 21, 4 and 6% based on questionnaires at 5 months. The deployment-related rates of PTSD based on the clinical interview were 4, 3 and 3%.There was a specific effect of deployment on mental health for a small minority. Questionnaires eliciting stress symptoms gave substantial overestimations of the rate of PTSD.",0,0 +3011,Heat Acclimation and Heat Stress Have Different Effects on Cholinergic Muscarinic Receptors,"In this brief report we have proved that membranal changes take place upon short-term heat acclimation. These changes may switch on a cascade of transient acclimatory compensatory responses as well as long-term processes. The changes observed in the MR profile are heat acclimation specific, and differ from those observed upon heat stress. These bring about functional changes in the signal transduction pathway for water secretion in the submaxillary salivary gland. A recovery period from heat stress, similar to STHA, leads to MR upregulation and decreased binding affinity. This response, however, is more pronounced than that observed upon STHA. The functional importance of the phenomenon is unclear. However, it could designate a novel component of the heat shock response.",0,0 +3012,Posttraumatic Stress Disorder and Posttraumatic Growth in Breast Cancer Patients: A Systematic Review,"Breast cancer, potentially a traumatic stressor, may be accompanied by negative outcomes, such as posttraumatic stress disorder or positive changes, such as posttraumatic growth. The authors reviewed 24 studies published from 1990 to 2010 that measured posttraumatic stress disorder and posttraumatic growth in women with breast cancer, in terms of frequency rates, factors associated with posttraumatic stress disorder and posttraumatic growth, and their interrelationships. A relatively small percentage of women experienced posttraumatic stress disorder, while the majority of them reported posttraumatic growth. Age, education, economic status, subjective appraisal of the threat of the disease, treatment, support from significant others, and positive coping strategies were among the most frequently reported factors associated with these phenomena. Moreover, posttraumatic stress disorder and posttraumatic growth were not related. Future research should shed more light on posttraumatic growth and posttraumatic stress disorder among women with breast cancer, the parameters that influence them, and their possible relationship.",0,0 +3013,Development of a depersonalization severity scale,"Our aim was to develop a clinician-rated scale assessing depersonalization severity for use in clinical trials of Depersonalization Disorder and trauma-related disorders in general. The 6-item Depersonalization Severity Scale (DSS) was administered to 63 participants with DSM-IV Depersonalization Disorder as diagnosed by the SCID-D, and its psychometric properties were examined. The sensitivity of the DSS and of the Dissociative Experiences Scale (DES) to treatment change was assessed in blinded, controlled settings. Individual items were widely distributed across the severity range. Interrater reliability was excellent and internal consistency was moderate. The DSS had high convergent and discriminant validity and was sensitive to treatment change. The DES was also sensitive to treatment change. We recommend piloting the DSS in future treatment trials of trauma-spectrum disorders.",0,0 +3014,Post-traumatic stress disorder in victims of traumatic events.,"The present study obtained data on frequency of Post-traumatic Stress Disorder (PTSD) symptoms, victims' gender and age, type of trauma and diagnostic comorbidity in a sample of 274 subjects (77 male and 197 female), victims of a severe traumatic event. The Checklist of Stressful and Traumatic Events, Trauma Assessment for Adults (TAA) Revised, Structured Interview for PTSD (SIP), Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) were used. Results indicated that 28% of the subjects met the criteria for Posttraumatic Stress Disorder, and that females were more likely than males to receive the PTSD classification. Significant differences were found in the PTSD diagnoses related to type of traumatic event and depression and anxiety symptoms.",0,0 +3015,Posttraumatic stress disorder and symptoms among American Indians and Alaska Natives: a review of the literature,"American Indians and Alaska Natives (AI/ANs) experience high rates of trauma and posttraumatic stress disorder (PTSD). We reviewed existing literature to address three interrelated questions: (1) What is the prevalence of PTSD and PTSD symptoms among AI/ANs? (2) What are the inciting events, risk factors, and co-morbidities in AI/ANs, and do they differ from those in the general U.S. population? (3) Are studies available to inform clinicians about the course and treatment of PTSD in this population?We searched the PubMed and Web of Science databases and a database on AI/AN health, capturing an initial sample of 77 original English-language articles published 1992–2010. After applying exclusion criteria, we retained 37 articles on prevalence of PTSD and related symptoms among AI/AN adults. We abstracted key information and organized it in tabular format.AI/ANs experience a substantially greater burden of PTSD and related symptoms than U.S. Whites. Combat experience and interpersonal violence were consistently cited as leading causes of PTSD and related symptoms. PTSD was associated with bodily pain, lung disorders, general health problems, substance abuse, and pathological gambling. In general, inciting events, risk factors, and co-morbidities appear similar to those in the general U.S. population.Substantial research indicates a strikingly high incidence of PTSD in AI/AN populations. However, inciting events, risk factors, and co-morbidities in AI/ANs, and how they may differ from those in the general population, are poorly understood. Very few studies are available on the clinical course and treatment of PTSD in this vulnerable population.",0,0 +3016,"Expression of intracellular cytokines, HSP72, and apoptosis in monocyte subsets during exertional heat stress in trained and untrained individuals","This study examined intracellular cytokine, heat shock protein (HSP) 72, and cellular apoptosis in classic and inflammatory CD14 + monocyte subsets during exertional heat stress (EHS). Subjects were divided into endurance-trained [TR; n = 12, peak aerobic power (V̇o 2peak ) = 70 ± 2 ml·kg lean body mass (LBM) −1 ·min −1 ] and sedentary-untrained (UT; n = 11, V̇o 2peak = 50 ± 1 ml·kg LBM −1 ·min −1 ) groups before walking at 4.5 km/h with 2% elevation in a climatic chamber (40°C, 30% relative humidity) wearing protective clothing until exhaustion (Exh). Venous blood samples at baseline and 0.5°C rectal temperature increments (38.0, 38.5, 39.0, 39.5, and 40.0°C/Exh) were analyzed for cytokines (TNF-α, IL-1β, IL-6, IL-1ra, and IL-10) in CD14 ++ CD16 − /CD14 + CD16 + and HSP72/apoptosis in CD14 Bri /CD14 Dim subsets. In addition, serum levels of extracellular (e)HSP72 were also examined. Baseline and Exh samples were separately stimulated with LPS (1 μg/ml) or heat shocked (42°C) and cultured in vitro for 2 h. A greater temperature-dependent increase in CD14 + CD16 + cells was observed in TR compared with UT subjects as well as a greater LPS tolerance following in vitro LPS stimulation. TNF-α and IL-1β cytokine expression was elevated in CD14 + CD16 + but not in CD14 ++ CD16 − cells. A greater induction of intracellular HSP72 and eHSP72 was observed in TR compared with UT subjects, which coincided with reduced apoptosis at Exh and following in vitro heat shock. Induced HSP in vitro was not uniform across CD14 + subsets. Findings suggest that circulating CD14 + CD16 + , but not CD14 ++ CD16 − monocytes, contribute to the proinflammatory cytokine profiles observed during EHS. In addition, the enhanced HSP72 response in endurance-trained individuals may confer improved heat tolerance through both anti-inflammatory and anti-apoptotic mechanisms.",0,0 +3017,Relationship of Trauma Symptoms to Amygdala-Based Functional Brain Changes in Adolescents,en,0,0 +3018,The Detection of Feigned Psychiatric Disorders Using the MMPI-2-RF Overreporting Validity Scales: An Analog Investigation,"Individuals who are motivated to feign psychological problems to achieve a desired outcome (e.g., insanity defense) may overreport symptoms of psychopathology, with type of pathology being dependent on the setting. In the current investigation, we examined the utility of the overreporting validity scales (infrequent responses [F-r], infrequent psychopathology responses [F P-r], infrequent somatic responses [Fs], and symptom validity [FBS-r]) on the Minnesota Multiphasic Personality Inventory-2-Restructured Form (Ben-Porath and Tellegen 2008) to detect research participants instructed to simulate one of three mental disorders: major depressive disorder (MDD), schizophrenia (SCH), or post-traumatic stress disorder (PTSD). The restructured clinical (RC) and overreporting validity scale scores of bona fide psychiatric patients with a primary diagnosis of either MDD, SCH, or PTSD were compared to two groups of simulators-naïve (i.e., undergraduate students with no training in mental disorders) and sophisticated (i.e., individuals with advanced training in psychopathology or personal experience with the disorder asked to overreport symptoms). Examination of the RC Scale profiles revealed that the sophisticated simulators produced symptom profiles more similar to the profiles of the psychiatric patients than did the naïve simulators. For the overreporting validity scales, the sophisticated simulators were less likely to be detected as feigning compared to the naïve simulators; overall, the validity scales were able to distinguish patients from simulators and accurately classify most of the simulators regardless of their level of ""symptom"" sophistication. Examination and comparison of the validity scales revealed that across disorders and level of research participant symptom sophistication, the F P-r scale best differentiated simulators from patients. © 2011 Springer Science+Business Media, LLC.",0,0 +3019,The buffering effect of resilience on depression among individuals with spinal cord injury: A structural equation model.,"To translate the theoretical constructs from a model of resilience into a structural equation model and evaluate relationships among the model's theoretical constructs associated with resilience and the occurrence of depressive symptoms.Quantitative descriptive research design using structural equation modeling (SEM).Two-hundred and fifty-five individuals with SCI recruited from the Canadian Paraplegic Association (CPA).Outcome was measured by the Center for Epidemiologic Studies-Depression Scale.The resilience model fit the data relatively well: χ² (200, N = 255) = 451.57, p < .001; χ²/df = 2.26; CFI = .92, RMSEA = 0.070 (90% CI: 0.062-0.079), explaining 77% of the variance in depressive symptomatology. Severity of SCI-related stressors significantly influenced perceived stress (β = .60) and perceived stress, in turn, affected depressive symptoms (β = .66), characteristics of resilience (β = -.43), and social support (β = -.26). The resilience characteristics had an inverse relationship with depressive symptoms (β = -.29). No direct relationship was found between severity of SCI-related stressors and depressive symptoms.Findings provide support for the resilience model and suggests characteristics of resilience ""buffer"" the perceptions of stress on depressive symptoms. The resilience model may be useful to guide clinical interventions designed to improve the mental health of individuals with SCI.",0,0 +3020,Post-traumatic stress disorder among adolescents with bipolar disorder and its relationship to suicidality,"The aims of this cross-sectional pilot study were to ascertain the rates of post-traumatic stress disorder (PTSD) among adolescents with bipolar disorder (BPD) and major depressive disorder (MDD) relative to a comparison group comprised of non-affectively ill patients, and to determine whether PTSD is related to suicidal ideation and attempts. The impetus for the study was born of clinical impressions derived in the course of routine clinical practice.Patients were screened by a single interviewer for BPD, MDD and PTSD, panic disorder, obsessive-compulsive disorder (OCD) and social phobia using the apposite modules from the Structured Clinical Interview for DSM-IV (SCID) and histories of suicidal ideation and attempts. The data were subjected to analysis using a logistic regression model.The database included 34 patients with BPD, 79 with MDD and 26 with a non-affective disorder. The risk for PTSD for a patient with BPD significantly exceeded that for a patient with MDD [odds ratio (OR) = 4.9, 95% confidence interval (CI) = 1.9-12.2, p = 0.001]. Patients with PTSD had an insignificantly increased risk for suicidal ideation (OR = 2.8, 95% CI = 0.9-8.9, p = 0.069), and a 4.5-fold significantly increased risk of having had a suicide attempt (OR = 4.5, 95% CI = 1.7-11.7, p = 0.002). The relationship between PTSD and suicide attempts remained significant even after controlling for the confounding effects of concurrent panic disorder, OCD and social phobia (OR = 3.4, 95% CI = 1.1-10.0, p = 0.023).Patients with BPD have a greater risk for PTSD than those with MDD. Post-traumatic stress disorder is significantly related to history of suicide attempts.",0,0 +3021,Factor Structure and Psychometric Properties of the Posttraumatic Stress Disorder (PTSD) Checklist and DSM-5 PTSD Symptom Set in a Long-Term Postearthquake Cohort in Armenia,"Psychometric properties of the Armenian-language posttraumatic stress disorder (PTSD) Checklist–Civilian version (PCL-C) and the DSM-5 PTSD symptom set were examined in a long-term cohort of earthquake survivors. In 2012, 725 survivors completed the instruments. Item-/scale-level analysis and confirmatory factor analysis (CFA) were performed for both scales. In addition, exploratory factor analysis (EFA) was conducted for DSM-5 symptoms. Also, the differential internal versus external specificity of PTSD symptom clusters taken from the most supported PTSD structural models was examined. Both scales had Cronbach’s alpha greater than .9. CFA of PCL-C structure demonstrated an excellent fit by a four-factor (reexperiencing, avoidance, numbing, and hyperarousal) model known as numbing model; however, a superior fit was achieved by a five-factor model (Elhai et al.). EFA yielded a five-factor structure for DSM-5 symptoms with the aforementioned four domains plus a negative state domain. This model achieved an acceptable fit during CFA, whereas the DSM-5 criteria-based model did not. The Armenian-language PCL-C was recommended as a valid PTSD screening tool. The study findings provided support to the proposed new classification of common mental disorders, where PTSD, depression, and generalized anxiety are grouped together as a subclass of distress disorders. Recommendations were made to further improve the PTSD diagnostic criteria.",0,0 +3022,Correlates of persisting posttraumatic symptoms in children and adolescents 18 months after a cyclone disaster,"Objective: To describe PTSD symptom persistence and resolution, including the potential phenomenon of late-onset PTSD, in children and adolescents 18 months after a cyclone disaster; and to investigate factors that predict longer-term symptom outcome. Method: 71 children and 191 adolescents who were screened three months after a Category 5 Cyclone were re-screened 18 months post-disaster. Child-report measures included the PTSD Reaction Index, measures of event exposure and social connectedness. Results: Approximately 1-in-5 children and 1-in-12 adolescents endorsed cyclone-related PTSD symptoms at the moderate to severe level 18 months post-disaster. Of these approximately one-half (44.8%) of children were in the ‘high-persister’ group at 18-month follow-up. Persistence of low symptoms was very common (97.6%) and late-onset PTSD was a rare phenomenon. This pattern was similar in adolescents: 25.0% were in the ‘high-persister’ group and few students experienced late-onset PTSD. In multivariate analysis, only initial severe to very severe PTSD category made a significant independent contribution to explaining persisting moderate to severe PTSD symptoms in primary school students (ORadj=8.33, 95% CI=1.45-47.84). There was a trend for a similar result in secondary students. Conclusion: A child or adolescent with few PTSD symptoms three months post-disaster is likely to remain so unless a further traumatic event occurs. However, if symptomatic at three months, there is approximately a 30-45% chance that the child or adolescent will still be symptomatic 18 months after the disaster. Given the high rate of students in the ‘resolver’ group, initial posttraumatic symptoms are a necessary but not sufficient condition for predicting chronic symptomatology. Other targets for predictive modelling include initial threat perception and high and low social connectedness.",0,0 +3023,Outcomes after ARDS: a distinct group in the spectrum of disability after complex and protracted critical illness.,"ARDS represents an important public health problem for patients, family caregivers and society. The last decade has seen a burgeoning literature focussed on the outcomes of this patient group and has informed important new knowledge about the devastating and often irreversible morbidity related to nerve, muscle and brain injury More recent studies have reinforced these robust themes of physical and neuropsychological morbidity in other patient groups and have shown that outcomes after ARDS are one segment of a spectrum of disability and may not be widely generalizable across older patients with multiple comorbidities and protracted length of stay in the critical care unit. Our literature has reached theme saturation in terms of morbidity and needs to identify and begin to address the research agenda for the next decade. Several of these themes will be addressed here and include the following: 1) to generate large diverse datasets to understand different outcome trajectories over time to facilitate risk stratification and inform development of rehabilitation programs; 2) to embrace mixed methodology as a new longitudinal study standard to facilitate detailed qualitative observations to augment insights from quantitative data; 3) to educate patients, families, colleagues and decision-makers about outcomes after critical illness to inform policy and decision-making; 4) to embrace family caregivers and provide intervention when needed and ongoing support across transitions of care; 5) prioritize functional outcome measures over those targeted at health-related quality of life for construction of more focussed rehabilitation interventions; 6) embrace translational research programs to elucidate the relationship between functional outcome and molecular mechanism to gain further insight into the pathophysiology of critical illness, muscle and brain injury and potential insights into novel therapeutic strategies.",0,0 +3024,Diagnostic efficacy of posttraumatic symptoms in children exposed to disaster,"Examined 5 conditional probability indices to determine the diagnostic efficacy of 48 symptoms associated with posttraumatic stress disorder (PTSD) in 5,687 children exposed to Hurricane Hugo, of whom 5.5% had a diagnosis of posttraumatic stress syndrome (PTSS). Moderate levels of sensitivity and high levels of specificity were obtained for most symptoms. Odds ratios more precisely demonstrated that some Diagnostic and Statistical Manual of Mental Disorders (DSM) symptoms of PTSD, especially when combined, were useful for identifying children with PTSS but that anxiety symptoms and some DSM symptoms of PTSD had poor diagnostic utility. Satisfying criteria for the DSM-III-R numbing/avoidance cluster and symptoms from the numbing/avoidance cluster had the highest diagnostic efficacy, suggesting that avoidance may be the hallmark of severe posttraumatic reactions. These results suggest which symptoms should be conceptualized as central versus peripheral to the disorder and which symptoms and symptom combinations clinicians should attend to most when diagnosing or screening PTSD in children.",0,0 +3025,Resilience and development: Contributions from the study of children who overcome adversity,"Abstract This article reviews the research on resilience in order to delineate its significance and potential for understanding normal development. Resilience refers to the process of, capacity for, or outcome of successful adaptation despite challenging or threatening circumstances. Three resilience phenomena are reviewed: (a) good outcomes in high-risk children, (b) sustained competence in children under stress, and (c) recovery from trauma. It is concluded that human psychological development is highly buffered and that long-lasting consequences of adversity usually are associated with either organic damage or severe interference in the normative protective processes embedded in the caregiving system. Children who experience chronic adversity fare better or recover more successfully when they have a positive relationship with a competent adult, they are good learners and problem-solvers, they are engaging to other people, and they have areas of competence and perceived efficacy valued by self or society. Future studies of resilience will need to focus on processes that facilitate adaptation. Such studies have the potential to illuminate the range and self-righting properties of, constraints on, and linkages among different aspects of cognitive, emotional, and social development.",0,0 +3026,Posttraumatic stress and symptom improvement in Norwegian tourists exposed to the 2004 tsunami – a longitudinal study,"Mental health consequences of disasters are frequently studied. However, few studies have investigated symptom improvement in victims after natural disasters. This study aimed to identify predictors of 6 months post-disaster stress symptoms and to study 6 months and 24 months course of symptoms among Norwegian tourists who experienced the 2004 tsunami.Norwegian tourists (≥ 18 years) who experienced the 2004 tsunami (n = 2468) were invited to return a postal questionnaire at two points of time. The first data set was collected at 6 months (T1, n = 899) and the second data set at 24 months post-disaster (T2, n = 1180). The population studied consisted of those who responded at both assessments (n = 674). Impact of Event Scale Revised (IES-R) was used to measure posttraumatic stress symptoms. IES-R score ≥ 33 (caseness) was used to identify various symptom trajectories from T1 to T2. Multiple linear regression was used to determine predictors of posttraumatic stress at T1 and to identify variables associated with symptom improvement from T1 to T2.The majority was identified as non-case at both assessments (57.7%), while 20.8% of the respondents were identified as case at both assessments. Symptoms at T1 were positively related to female gender, older age, unemployment, being chased or caught by the waves, witnessing death or suffering, loss of loved ones, experiencing intense fear during the disaster, low conscientiousness, neuroticism and low levels of social support. The IES-R sum score declined from 24.6 (SD = 18.5) at T1 to 22.9 (SD = 18.3) at T2, p < 0.001. Emotional stability and high IES-R scores at T1 were positively related to symptom improvement, while received social support was not. Being referred to a mental health specialist was negatively related to symptom improvement.A significant minority (20-30%) among Norwegian tourists developed enduring posttraumatic stress symptoms in the aftermath of the 2004 tsunami. Tsunami exposure, peritraumatic fear, neuroticism and low levels of social support were the strongest predictors of posttraumatic stress at 6 months post-disaster. Decrease in posttraumatic stress was related to emotional stability and higher symptom levels at T1. Being referred to a mental health specialist did not facilitate symptom improvement.",0,0 +3027,The structure and short-term stability of the emotional disorders: a dimensional approach,"Background Factor-analytic studies have found that depressive, bipolar, post-traumatic, obsessive–compulsive, and anxiety disorders – jointly referred to as the emotional disorders – form an internalizing spectrum that includes distress and fear subfactors. However, placement of some disorders is uncertain. Also, prior research analysed dichotomous interview-based diagnoses or dimensional self-report measures. We investigated this structure using a third-generation measure – the Interview for Mood and Anxiety Symptoms (IMAS) – that combines strengths of a clinical interview with dimensional assessment. Method The interview was administered to 385 students and 288 psychiatric out-patients. Participants were reinterviewed 2 months later. Results Exploratory and confirmatory factor analyses identified three factors: distress (depression, generalized anxiety, post-traumatic stress, irritability, and panic syndrome); fear (social anxiety, agoraphobia, specific phobia, and obsessive–compulsive); and bipolar (mania and obsessive–compulsive). The structure was consistent over time and across samples, except that panic and agoraphobia had higher factor loadings in patients. Longitudinal analyses revealed high temporal stability of the factors (test–retest r = 0.72 to 0.87), but also substantial disorder-specific stability. Conclusions This investigation – which bridges diagnostic and self-report studies – found three subfactors of internalizing psychopathology. It provided support for a new subfactor, clarified the placement of obsessive–compulsive and bipolar disorders, and demonstrated that this model generalizes across populations. The accumulating research suggests the need to recognize formally the close links among the emotional disorders, as well as empirical clusters within this spectrum. The IMAS demonstrated strong psychometric properties and can be useful for various research and clinical applications by providing dimensional, interview-based assessment of the emotional disorders.",0,0 +3028,"Longitudinal Relationships of Social Reactions, PTSD, and Revictimization in Sexual Assault Survivors","Sexual assault survivors receive various positive and negative social reactions to assault disclosures, yet little is known about the directionality of associations of social reactions to posttraumatic stress disorder (PTSD) symptoms over time. Data from a large, diverse sample of women who had experienced adult sexual assault was analyzed with hierarchical linear modeling (HLM) to examine how negative and positive reactions relate to PTSD symptoms over 3 years and to test the hypothesis that the relationship between negative social reactions and PTSD symptoms is reciprocal. We found that, as predicted, social reactions predicted subsequent PTSD symptoms, and in turn PTSD symptoms predicted subsequent social reactions. We also investigated the role of sexual revictimization by comparing women who suffered (vs. not) additional sexual victimization during the course of our study. Revictimized women had greater PTSD symptoms and more negative social reactions, but associations of social reactions with PTSD symptoms did not vary according to revictimization status. Implications for practice and suggestions for future research are discussed.",0,0 +3029,The Psychological Impact of Exposure to the 2008 Snowstorms on Migrant Workers in China,"This study aimed to estimate the prevalence of posttraumatic stress disorder (PTSD) and to identify associated risk factors among migrant workers 4 years after the 2008 snowstorm in China. A cross-sectional survey of 528 respondents was conducted to collect data in Changsha, the capital of Hunan Province. A multistage cluster sampling method was applied in selecting subjects from migrant workers’ gathering areas. Association between the independent variables and PTSD was analyzed using logistic regression analysis. The prevalence of PTSD was 17.42% among migrant workers in Changsha. Being male, being older than 35 years, being an electrician, having dependent children, suffering property damage, being without medical insurance, and having low social support were risk factors significantly related to the development of PTSD. Effective and sustainable mental health services should be directed particularly to the migrant workers, who are among the groups most vulnerable to the direct impact of snowstorms.",0,0 +3030,A Comparative Study of Trauma and Posttraumatic Stress Disorder Prevalence in Epilepsy Patients and Psychogenic Nonepileptic Seizure Patients,"This study tests the hypothesis that trauma histories, including histories of physical and sexual abuse, and posttraumatic stress disorder (PTSD) are more prevalent in psychogenic non-epileptic seizure (NES) patients than in epilepsy patients.Thirty-five inpatients with intractable seizures were evaluated for trauma history and PTSD. After these assessments, patients were diagnosed as having either epileptic or nonepileptic seizures through EEG monitoring.NES diagnosis correlated with PTSD and total number of lifetime traumas, adult traumas, and abuse traumas. Contrary to previous hypotheses, reported childhood sexual abuse (CSA) did not correlate significantly with NES diagnosis. However, CSA predicted PTSD in a discriminant analysis.We found evidence for the hypothesized relations between trauma, abuse, PTSD, and NES diagnosis. However, elevated levels in both seizure-disorder groups suggest that routine assessment for abuse, trauma, and PTSD might facilitate medical care and treatment for all intractable seizure patients.",0,0 +3031,Longitudinal modeling of population heterogeneity: Methodological challenges to the analysis of empirically derived criminal trajectory profiles,,0,0 +3032,A second look at comorbidity in victims of trauma: the posttraumatic stress disorder–major depression connection,"We examine whether traumatic events increase the risk for major depression independent of their effects on posttraumatic stress disorder (PTSD).Data come from the Epidemiologic Study of Young Adults in southeast Michigan (N = 1007). Retrospective and prospective data were used to estimate the risk of major depression in persons with PTSD and persons exposed to trauma with no PTSD, compared with persons who did not experience a trauma. National Comorbidity Survey data were used to evaluate the influence of trauma type.In the retrospective lifetime data, hazard ratios were, for first-onset major depression in exposed persons with PTSD, 2.8 and, in exposed persons with no PTSD, 1.3 (not significant), as compared with persons who were not exposed. Corresponding estimates from the prospective data were 11.7 and 1.4 (not significant). The difference in the risk for depression associated with PTSD versus exposure without PTSD is unlikely to be due to differences in trauma type.The findings of a markedly increased risk for major depression in persons with PTSD, but not in exposed persons without PTSD, do not support the hypothesis that PTSD and major depression in trauma victims are influenced by separate vulnerabilities.",0,0 +3033,Dimensionality of posttraumatic stress symptoms: a confirmatory factor analysis of DSM-IV symptom clusters and other symptom models,"Recent exploratory [Taylor, S., Kuch, K., Koch, W. J., Crockett, D. J., & Passey, G. (1998). The structure of posttraumatic stress symptoms. Journal of Abnormal Psychology, 107, 154-160.] and confirmatory [Buckley, T. C., Blanchard, E. B., & Hickling, E. J. (1998). A confirmatory factor analysis of posttraumatic stress symptoms. Behaviour Research and Therapy, 36, 1091-1099; King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998). Confirmatory factor analysis of the clinician-administered PTSD scale: evidence for the dimensionality of posttraumatic stress disorder. Psychological Assessment, 10, 90-96.] factor analytic investigations suggest that the three symptom clusters of posttraumatic stress disorder (PTSD) as defined in the Diagnostic and Statistical Manual [4th ed.; DSM-IV; American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.] may not provide the best conceptualization of symptom dimensionality. However, the alternative models have not been in agreement, nor have they been compared against each other or models based on the DSM-IV. The purpose of the present investigation was to test a series of dimensional models suggested by these recent factor analytic investigations and the DSM-IV. Using data collected with the PTSD Checklist--Civilian Version [Weathers, F. W., Litz, B. T., Huska, J. A., & Keane, T. M. (1994). PCL-C for DSM-IV. Boston: National Center for PTSD--Behavioral Science Division.] from 349 referrals to a primary care medical clinic, we used confirmatory factor analysis to evaluate a: (1) hierarchical four-factor model, (2) four-factor intercorrelated model, (3) hierarchical three-factor model, (4) three-factor intercorrelated model, and (5) hierarchical two-factor model. The hierarchical four-factor model (comprising four first-order factors corresponding to reexperiencing, avoidance, numbing, and hyperarousal all subsumed by a higher-order general factor) provided the best overall fit to the data; although, all models met some standards specified for good model fit. More research is needed to establish the dimensional nature of PTSD symptoms and to assess whether identified dimensions differ as a function of the trauma experience. Implications for assessment, diagnosis, and treatment are also discussed.",0,0 +3034,Sleep Disturbances in Posttraumatic Stress Disorder,"Sleep disturbances are common complaints among patients with posttraumatic stress disorder (PTSD), as well as intrusive recollection, avoidance of disturbing stimuli, difficulty in concentration, and depressive symptoms. Patients with PTSD frequently report difficulty falling or staying asleep and recurrent nightmares related to the traumatic events. These sleep disturbances are part of the diagnostic criteria for PTSD and are included in both the re-experiencing (Criterion B) and increased arousal (Criterion D) symptom cluster in the DSM-IV-TR. Despite these sleep complaints, polysomnographic studies have not provided consistent evidence of sleep disturbances, especially regarding non-rapid eye movement (REM) sleep. However, the characteristic sleep disturbances, in particular the repetitive, stereotypical nightmares may be relatively specific to PTSD. The presence of nightmares in PTSD has been hypothesized as a dysfunction of REM sleep mechanisms and investigators have reported various types of REM sleep abnormalities. Treatment studies also have shown that antidepressants, such as nefazodone, trazodone, fluvoxamine, and image rehearsal therapy are beneficial in the treatment of PTSD-related sleep disturbances as well as core symptoms of this anxiety disorder; however, these sleep disturbances may persist and impair the quality of life in PTSD patients for several decades. It is important, therefore, to understand the characteristics of sleep disturbances in PTSD and these treatments. In this review, we discuss the clinical features and objective findings of sleep disturbances in PTSD and these treatments based on the published literature, including our findings. © 2010 Nova Science Publishers, Inc. All rights reserved.",0,0 +3035,A meta-analysis of risk factors for post-traumatic stress disorder in children and adolescents,"Post-traumatic stress disorder (PTSD) is a complex and chronic disorder that causes substantial distress and interferes with social and educational functioning. Consequently, identifying the risk factors that make a child more likely to experience traumatic distress is of academic, clinical and social importance. This meta-analysis estimated the population effect sizes of 25 potential risk factors for PTSD in children and adolescents aged 6-18 years across 64 studies (N=32,238). Medium to large effect sizes were shown for many factors relating to subjective experience of the event and post-trauma variables (low social support, peri-trauma fear, perceived life threat, social withdrawal, comorbid psychological problem, poor family functioning, distraction, PTSD at time 1, and thought suppression); whereas pre-trauma variables and more objective measures of the assumed severity of the event generated small to medium effect sizes. This indicates that subjective peri-trauma factors and post-event factors are likely to have a major role in determining whether a child develops PTSD following exposure to a traumatic event. Such factors could potentially be assessed following a potentially traumatic event in order to screen for those most vulnerable to developing PTSD and target treatment efforts accordingly. The findings support the cognitive model of PTSD as a way of understanding its development and guiding interventions to reduce symptoms.",0,0 +3036,Dissociation and hypnotizability in posttraumatic stress disorder,"The authors compared the hypnotizability of 65 Vietnam veteran patients with posttraumatic stress disorder (PTSD) to that of a normal control group and four patient samples using the Hypnotic Induction Profile. The patients with PTSD had significantly higher hypnotizability scores than patients with diagnoses of schizophrenia (N = 23); major depression, bipolar disorder--depressed, and dysthymic disorder (N = 56); and generalized anxiety disorder (N = 18) and the control sample (N = 83). This finding supports the hypothesis that dissociative phenomena are mobilized as defenses both during and after traumatic experiences. The literature suggests that spontaneous dissociation, imagery, and hypnotizability are important components of PTSD symptoms.",0,0 +3037,Differences in the determinants of posttraumatic stress disorder and depression after a mass traumatic event,"Background: Hurricane Ike struck the Galveston Bay area of Texas on September 13, 2008, leaving substantial destruction and a number of deaths in its wake. We assessed differences in the determinants of posttraumatic stress disorder (PTSD) and depression after this event, including the particular hurricane experiences, including postevent nontraumatic stressors, that were associated with these pathologies. Methods: 658 adults who had been living in Galveston and Chambers counties, TX in the month before Hurricane Ike were interviewed 2–5 months after the hurricane. We collected information on experiences during and after Hurricane Ike, PTSD and depressive symptoms in the month before the interview, and socio-demographic characteristics. Results: The prevalence of past month hurricane-related PTSD and depression was 6.1 and 4.9%, respectively. Hurricane experiences, but not socio-demographic characteristics, were associated with Ike-related PTSD. By contrast, lower education and household income, and more lifetime stressors were associated with depression, as were hurricane exposures and hurricane-related stressors. When looking at specific hurricane-related stressors, loss or damage of sentimental possessions was associated with both PTSD and depression; however, health problems related to Ike were associated only with PTSD, whereas financial loss as a result of the hurricane was associated only with depression. Conclusions: PTSD is indeed a disorder of event exposure, whereas risk of depression is more clearly driven by personal vulnerability and exposure to stressors. The role of nontraumatic stressors in shaping risk of both pathologies suggests that alleviating stressors after disasters has clear potential to mitigate the psychological sequelae of these events. Depression and Anxiety, 2011. © 2011 Wiley-Liss, Inc.",0,0 +3038,PTSD Symptoms in Bosnian Refugees 1 Year After Resettlement in the United States,"The authors' goal was to describe the characteristics of posttraumatic stress disorder (PTSD) symptoms on resettlement in the United States and at 1-year follow-up among Bosnian refugees as well as possible factors affecting the PTSD symptom profile among these refugees.They used standardized instruments to assess 34 Bosnian refugees for PTSD at resettlement in the United States and 1 year later.Fifteen of the refugees were diagnosed with PTSD at 1-year follow-up, compared with 25 at initial assessment. The average PTSD severity score at follow-up was 12.5, compared with 20.6 at initial assessment. At 1-year follow-up, 25 of the refugees experienced a decrease in severity of PTSD symptoms, one remained the same, and eight experienced an increase in severity. Older refugees were significantly more likely to have PTSD than younger refugees, and older refugees had more severe symptoms.The level of PTSD diagnosis and symptoms in Bosnian refugees remained substantial 1 year after their resettlement in the United States, although there were notable overall decreases. Older refugees appeared to be at greater risk.",0,0 +3039,Anger regulation deficits in combat-related posttraumatic stress disorder,"We describe a typology of regulatory deficits associated with anger in combat-related posttraumatic stress disorder (PTSD). Cognitive, arousal, and behavioral domain deficits in anger regulation were observed clinically in PTSD patients with high levels of anger who were participating in a multi-year trial of a structured anger treatment. We also describe a category of patients whose anger type we have termed 'ball of rage'. These patients exhibit regulatory deficits in all three domains of anger regulation. We offer a conceptual framework to advance the understanding of anger associated with PTSD and to guide its effective treatment.",0,0 +3040,Role of postsynaptic density protein-95 in the maintenance of peripheral nerve injury-induced neuropathic pain in rats,"Our previous work has demonstrated that postsynaptic density protein-95, a molecular scaffolding protein that binds and clusters N-methyl-D-aspartate receptors at neuronal synapses, plays an important role in the development of peripheral nerve injury-induced neuropathic pain. The current study further investigated the possible involvement of postsynaptic density protein-95 in the maintenance of neuropathic pain. Mechanical and thermal hyperalgesia were induced within 3 days and maintained for 15 days or longer after unilateral injury to the fifth lumbar spinal nerve. The rats injected intrathecally with postsynaptic density protein-95 antisense oligodeoxynucleotide every 24 h for 4 days from day 7 to day 10 post-surgery exhibited not only a marked decrease in spinal cord postsynaptic density protein-95 protein expression but also a significant reduction in mechanical and thermal hyperalgesia on day 11 post-surgery. The rats injected with sense oligodeoxynucleotide did not display these changes. However, in the rats without nerve injury, postsynaptic density protein-95 antisense oligodeoxynucleotide given intrathecally every 24 h for 4 days did not affect responses to mechanical and thermal stimulation. In addition, postsynaptic density protein-95 antisense oligodeoxynucleotide did not change locomotor activity of experimental animals. Our results indicate that the deficiency of postsynaptic density protein-95 protein in the spinal cord significantly attenuates nerve injury-induced mechanical and thermal hyperalgesia during both the development and maintenance of chronic neuropathic pain. These results suggest that postsynaptic density protein-95 might be involved in the central mechanisms of chronic neuropathic pain and provide a novel target for development of new pain therapies.",0,0 +3041,Comparison of the PTSD symptom scale-interview version and the clinician-administered PTSD scale,"The Clinician-Administered PTSD Scale (CAPS) is one of the most frequently used measures of posttraumatic stress disorder (PTSD). It has been shown to be a reliable and valid measure, although its psychometric properties in nonveteran populations are not well known. One problem with the CAPS is its long assessment time. The PTSD Symptom Scale--Interview Version (PSS-I) is an alternative measure of PTSD severity, requiring less assessment time than the CAPS. Preliminary studies indicate that the PSS-I is reliable and valid in civilian trauma survivors. In the present study we compared the psychometric properties of the CAPS and the PSS-I in a sample of 64 civilian trauma survivors with and without PTSD. Participants were administered the CAPS, the PSS-I, and the Structured Clinical Interview for DSM-IV (SCID) by separate interviewers, and their responses were videotaped and rated by independent clinicians. Results indicated that the CAPS and the PSS-I showed high internal consistency, with no differences between the two measures. Interrater reliability was also high for both measures, with the PSS-I yielding a slightly higher coefficient. The CAPS and the PSS-I correlated strongly with each other and with the SCID. Although the CAPS had slightly higher specificity and the PSS-I had slightly higher sensitivity to PTSD, overall the CAPS and the PSS-I performed about equally well. These results suggest that the PSS-I can be used instead of the CAPS in the assessment of PTSD, thus decreasing assessment time without sacrificing reliability or validity.",0,0 +3042,The Effect of a Yoga Intervention on Alcohol and Drug Abuse Risk in Veteran and Civilian Women with Posttraumatic Stress Disorder,"Individuals with posttraumatic stress disorder (PTSD) often exhibit high-risk substance use behaviors. Complementary and alternative therapies are increasingly used for mental health disorders, although evidence is sparse.Investigate the effect of a yoga intervention on alcohol and drug abuse behaviors in women with PTSD. Secondary outcomes include changes in PTSD symptom perception and management and initiation of evidence-based therapies.The current investigation analyzed data from a pilot randomized controlled trial comparing a 12-session yoga intervention with an assessment control for women age 18 to 65 years with PTSD. The Alcohol Use Disorder Identification Test (AUDIT) and Drug Use Disorder Identification Test (DUDIT) were administered at baseline, after the intervention, and a 1-month follow-up. Linear mixed models were used to test the significance of the change in AUDIT and DUDIT scores over time. Treatment-seeking questions were compared by using Fisher exact tests.The mean AUDIT and DUDIT scores decreased in the yoga group; in the control group, mean AUDIT score increased while mean DUDIT score remained stable. In the linear mixed models, the change in AUDIT and DUDIT scores over time did not differ significantly by group. Most yoga group participants reported a reduction in symptoms and improved symptom management. All participants expressed interest in psychotherapy for PTSD, although only two participants, both in the yoga group, initiated therapy.Results from this pilot study suggest that a specialized yoga therapy may play a role in attenuating the symptoms of PTSD, reducing risk of alcohol and drug use, and promoting interest in evidence-based psychotherapy. Further research is needed to confirm and evaluate the strength of these effects.",0,0 +3043,PTSD symptom clusters are differentially related to substance use among community women exposed to intimate partner violence,"Women who experience intimate partner violence (IPV) have higher rates of posttraumatic stress disorder (PTSD) and substance abuse compared to women who do not experience IPV. However, the extent to which IPV-related PTSD symptoms are related to women's substance use involvement largely has been unexplored. The current study investigated PTSD symptomatology and substance use in a community sample of 212 IPV-exposed women. Drug-using women reported higher PTSD severity scores compared to women who reported no substance use or alcohol use only. Moreover, the reexperiencing, avoidance and numbing, and arousal clusters demonstrated unique associations with substance use involvement. Findings not only elucidate the associations among IPV-related PTSD symptoms and substance use, but they also can inform community-based preventive interventions.",0,0 +3044,Impact of physical injury on mental health after the 2004 Southeast Asia tsunami,"The risk of developing enduring post-traumatic stress reactions and mental health problems in the aftermath of disasters is substantial. However, there are inconsistencies regarding the contribution of physical injury as an independent risk factor for developing psychiatric morbidity after disasters.The aim was to assess whether physical injury was associated with post-traumatic stress reactions and general mental health after adjusting for perceived life-threat in the aftermath of the 2004 tsunami.A sample of 1501 highly exposed survivors from the 2004 Southeast Asia tsunami was selected from a cohort of Swedish survivors surveyed 14 and 36 months after the event. The impact of physical injury on post-traumatic stress and general mental health was assessed by regression models accounting for subjective life-threat.Physical injury was associated with higher levels of post-traumatic stress reactions and poorer general mental health. These associations were observed at both 14 and 36 months after the disaster.Physical injury has a specific contribution to the association between traumatic experience and both post-traumatic stress reactions and general mental health in victims of the 2004 tsunami. The effect is stable over several years.",0,0 +3045,Pain and neurological sequelae of cluster munitions on children and adolescents in South Lebanon,"This paper aims at evaluating the neurological repercussions arising from injuries sustained due to cluster munitions in children up to 18 years in South Lebanon following the 2006 conflict. Data on neurological and pain symptoms suffered during and after treatment because of sub-munitions in South Lebanon from August 2006 till late 2011 were prospectively recorded. Patients were divided into subcategories; children aged 12 and under and adolescents aged between 13 and 18. During the study period, there were 407 casualties, 122 (30 %) of which were aged 18 years or younger. There were 116 (95 %) males and six (5 %) females. Average age was 14 years. 10 (8.2 %), all males, died as a result of their injuries. 42 (34.4 %) were children and 80 (65.6 %) were adolescents. 112 had surgical treatments for their injuries. 83 out of 112 patients (74 %) with non-lethal injuries had amputations, 67 % children and 78 % adolescents. Among those who had amputations, 31 (37.4 %) suffered from phantom limb pain and 71 % suffered from stump/residual limb pain. 88 % of patients were diagnosed with post-traumatic stress disorder (44 % children and 77 % adolescents) and 41 % were diagnosed with post-concussion syndrome. Four patients (3.6 %) suffered from traumatic brain injuries, both penetrating and closed. Pain syndromes were found in all patients who had amputation. The injury related comorbidities together with many post-concussion syndrome cases, and fewer traumatic brain injuries lead into a high level of physical, psychosocial and economic burdens on the community. © 2013 Springer-Verlag Italia.",0,0 +3046,Group Exposure Therapy Treatment for Post-Traumatic Stress Disorder in Female Veterans,"The purpose of this study was to examine the application of a group exposure therapy model, the content of which consisted solely of repeated imaginal exposure during sessions, in a clinical sample of female veterans with post-traumatic stress disorder (PTSD). Establishing group delivery of exposure therapy will expand options, increase efficiency, and introduce group curative factors.Eighty-eight female veterans with PTSD completed a six-session exposure group, three participants per group, as a component of a larger treatment program. The PTSD symptom checklist (PCL) was used as the outcome measure and administered in each session.Pre/post-paired t-tests showed significant improvement in PTSD on the PCL, with 40% of completers showing at least a 10-point drop in the PCL scores. In addition, a repeated measures analysis of variance showed a significant main effect and a significant quadratic equation, with expected initial increases in the PCL followed by a decrease below baseline at session 6.The group exposure treatment protocol showed positive outcomes on PTSD symptoms in a real-world clinical sample of female veterans. The implications include an expansion of exposure treatment choices for veterans with PTSD and increased options for therapists.",0,0 +3047,Predictors of post-traumatic stress disorder following severe injury,"The chronicity and morbidity of established post-traumatic stress disorder (PTSD) has stimulated interest in recognizing and understanding the early development of the disorder. Acute stress disorder, a new diagnosis intended to facilitate early case detection, rests on the occurrence of dissociative reactions. It remains uncertain whether dissociation is a universal or unique early predictor of subsequent PTSD. Traumatic injury is an important and relatively understudied antecedent of PTSD. The objective of this study was to preliminarily identify which previously implicated early reactions and risk factors would apply to the prediction of PTSD following severe traumatic injury. Patients admitted to a regional Level I trauma center following life threatening events who had recall of the incident and did not have signs of traumatic brain injury or recent psychopathology were enrolled. Comprehensive assessments were conducted during hospitalization and after discharge approximately 2 months after the traumatic event. At follow-up, 24% of the available 50 subjects met full criteria for PTSD and an additional 22% met criteria for two of three symptom clusters. Early symptoms of heightened arousal and coping with disengagement were independent predictors of PTSD severity at follow-up. Relationships to initial dissociative reactions and a diagnosis of ASD were not significant. These early predictors found in a setting of severe injury only partially overlap findings from previous PTSD studies.",0,0 +3048,Predictors of PTSD and Delayed PTSD After Disaster,"In the present study we sought to identify factors associated with posttraumatic stress disorder (PTSD) following the World Trade Center Disaster (WTCD) and examine changes in PTSD status over time. Our data come from a two-wave, prospective cohort study of New York City adults who were living in the city on September 11, 2001. We conducted a baseline survey 1 year after the attacks (year 1), followed by a survey 1 year later (year 2). Overall, 2368 individuals completed the year 1 survey, and 1681 were interviewed at year 2. Analyses for year 1 indicated that being younger, being female, experiencing more WTCD events, reporting more traumatic events other than the WTCD, experiencing more negative life events, having low social support, and having low self-esteem increased the likelihood of PTSD. For year 2, being middle-aged, being Latino, experiencing more negative life events and traumas since the WTCD, and having low self-esteem increased the likelihood of PTSD. Exposure to WTCD events was not related to year 2 PTSD once other factors were controlled. Following previous research, we divided study respondents into four categories: resilient cases (no PTSD years 1 or 2), remitted cases (PTSD year 1 but not year 2), delayed cases (no PTSD year 1 but PTSD year 2), and acute cases (PTSD both years 1 and 2). Factors predicting changes in PTSD between year 1 and year 2 suggested that delayed PTSD cases were more likely to have been Latino, to have experienced more negative life events, and to have had a decline in self-esteem. In contrast, remitted cases experienced fewer negative life events and had an increase in self-esteem. We discuss these findings in light of the psychosocial context associated with community disasters and traumatic stress exposures.",0,0 +3049,Treatment of post-traumatic stress disorder in patients with severe mental illness: A review,"Although the prevalence of post-traumatic stress disorder (PTSD) is high among those with severe mental illness, little is known about the use of interventions to lessen the burden of PTSD in this population. Currently, there are limited data about safe and effective interventions to treat these individuals. This systematic published work review presents the scientific published work reporting studies of psychological treatment approaches for individuals with comorbid PTSD and severe mental illness. A secondary aim of this study was to identify the specific models implemented and tested, and their impact upon patient outcomes. A review of the published work from January 2001 through January 2012 of English-language publications retrieved from the Cumulative Index of Nursing and Allied Health Literature (CINAHL), MEDLINE, and the American Psychological Association generated abstracts (PsycINFO) databases was conducted. Six studies met the inclusion criteria for the review. The treatment programs described were cognitive-behavioural therapy, psychoeducation, exposure-based cognitive-behavioural therapy, and eye movement desensitization and reprocessing. Evidence of the effectiveness of these programs is examined. Data to support the use of these interventions are limited, indicating the need for further research and efficacy trials. Future areas of research and implications for nursing are discussed.",0,0 +3050,Attachment and Mental Health Symptoms Among U.S. Afghanistan and Iraq Veterans Seeking Health Care Services,"Attachment theory has become a primary framework for understanding adjustment to traumas. In a convenience sample of 157 U.S. service members from the Afghanistan and Iraq wars seeking health care services at a Veterans Administration (VA) hospital, this study examined (a) the impact of attachment characteristics on several key mental health symptoms in this new generation of veterans, (b) the relative frequencies of prominent attachment styles in the sample, and (c) how these higher order orientations related to study outcomes. First, with demographic and military background factors in the model, attachment-related anxiety and avoidance were each uniquely associated with posttraumatic stress symptoms (PTSS), psychiatric distress, and alcohol misuse, βs = .25 to .60. Second, latent class analysis highlighted the underrepresentation of avoidant veterans of a dismissive type in the sample. Third, of the different possible types of attachment insecurities, veterans with a fearful disorganized orientation were also shown to be particularly vulnerable to PTSS and other problems, even when compared to preoccupied-dependent persons. These findings yield further support for the protective benefit of attachment security, while also suggesting the importance of both attachment anxiety and avoidance in the context of postdeployment adjustment.",0,0 +3051,The Role of Hypnosis in the Detection of Psychogenic Seizures,"In this preliminary clinical investigation, hypnosis was used in the differential diagnosis of epileptic versus psychogenic seizures (PS). Eight patients with a clinical profile suggesting the presence of PS were given a hypnotic suggestion in which they had to go back in time to the exact moment of their last seizure. They were then asked to concentrate their attention on any unusual feeling or bodily sensation. All 8 patients presented a PS during the age regression protocol. In 6 cases, independent testimony from family members corroborated the morphological similarity of the induced attack and the ones presented in their natural environment. Also, the seizures ended abruptly after a command was given to stop them. A control group of 5 epileptic subjects did not present any signs of discomfort or seizure behavior during the hypnotic protocol. It is argued that a simple procedure as the one described in this investigation can be useful as a diagnostic tool in the differentiation of epileptic from PS attacks.",0,0 +3052,"The Impact of Previous Suicide Ideations, Traumatic Stress, and Gender on Future Suicide Ideation Trajectories Among Black American Adolescents: A Longitudinal Investigation","It has long been asserted that previous suicide behaviors (gestures and attempts) are a significant predictor of future suicide behaviors. Less is known about the extent to which this axiom applies to suicide ideations. The current investigation explored suicide ideations in a longitudinal sample of Black American adolescents (N = 977) aged 11 to 18. Logistic growth models were conducted with future suicide ideations as the dependent variable and the number of previous suicide ideations, traumatic stress, and gender as independent variables. Results show, first, that previous suicide ideations and traumatic stress are potent predictors of future suicide ideations. Second, the probability of future suicide ideations is higher when both the number of previous suicide ideations and traumatic stress levels increase, and this probability remains higher as the adolescent ages. These results demonstrate that the long-held proposition that previous suicide behaviors are predictive of future suicide behavior traje...",0,0 +3053,Glycine reuptake inhibitor RG1678: A pharmacologic characterization of an investigational agent for the treatment of schizophrenia,"Dysfunctional N-methyl-d-aspartate (NMDA) receptor neurotransmission has been implicated in the pathophysiology of schizophrenia. It is thought that this abnormal functioning can be corrected by increasing availability of the NMDA co-agonist glycine through inhibition of glycine transporter type 1 (GlyT1). Herein is described the pharmacologic profile of RG1678, a potent and noncompetitive glycine reuptake inhibitor. In vitro, RG1678 noncompetitively inhibited glycine uptake at human GlyT1 with a concentration exhibiting half-maximal inhibition (IC(50)) of 25 nM and competitively blocked [(3)H]ORG24598 binding sites at human GlyT1b in membranes from Chinese hamster ovary cells. In hippocampal CA1 pyramidal cells, RG1678 enhanced NMDA-dependent long-term potentiation at 100 nM but not at 300 nM. In vivo, RG1678 dose-dependently increased cerebrospinal fluid and striatal levels of glycine measured by microdialysis in rats. Additionally RG1678 attenuated hyperlocomotion induced by the psychostimulant d-amphetamine or the NMDA receptor glycine site antagonist L-687,414 in mice. RG1678 also prevented the hyper-response to d-amphetamine challenge in rats treated chronically with phencyclidine, an NMDA receptor open-channel blocker. In the latter experiment, a decrease in ex vivo striatal [(3)H]raclopride binding was also measured. These data demonstrate that RG1678 is a potent, noncompetitive glycine reuptake inhibitor that can modulate both glutamatergic and dopaminergic neurotransmission in animal experiments that model aspects of schizophrenia. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0,0 +3054,"Determinants of the development of post-traumatic stress disorder, in the general population","To assess (1) the lifetime prevalence of exposure both to trauma and post-traumatic stress disorder (PTSD); (2) the risk of PTSD by type of trauma; and (3) the determinants of the development of PTSD in the community.The Diagnostic Interview for Genetic Studies was administered to a random sample of an urban area (N = 3,691).(1) The lifetime prevalence estimates of exposure to trauma and PTSD were 21.0 and 5.0%; respectively, with a twice as high prevalence of PTSD in women compared to men despite a similar likelihood of exposure in the two sexes; (2) Sexual abuse was the trauma involving the highest risk of PTSD; (3) The risk of PTSD was most strongly associated with sexual abuse followed by preexisting bipolar disorder, alcohol dependence, antisocial personality, childhood separation anxiety disorder, being victim of crime, witnessing violence, Neuroticism and Problem-focused coping strategies. After adjustment for these characteristics, female sex was no longer found to be significantly associated with the risk of PTSD.The risk for the development of PTSD after exposure to traumatic events is associated with several factors including the type of exposure, preexisting psychopathology, personality features and coping strategies which independently contribute to the vulnerability to PTSD.",0,0 +3055,"Brain‐derived neurotropic factor polymorphisms, traumatic stress, mild traumatic brain injury, and combat exposure contribute to postdeployment traumatic stress","BACKGROUND: In addition to experiencing traumatic events while deployed in a combat environment, there are other factors that contribute to the development of posttraumatic stress disorder (PTSD) in military service members. This study explored the contribution of genetics, childhood environment, prior trauma, psychological, cognitive, and deployment factors to the development of traumatic stress following deployment. METHODS: Both pre- and postdeployment data on 231 of 458 soldiers were analyzed. Postdeployment assessments occurred within 30 days from returning stateside and included a battery of psychological health, medical history, and demographic questionnaires; neurocognitive tests; and blood serum for the D2 dopamine receptor (DRD2), apolipoprotein E (APOE), and brain-derived neurotropic factor (BDNF) genes. RESULTS: Soldiers who screened positive for traumatic stress at postdeployment had significantly higher scores in depression (d = 1.91), anxiety (d = 1.61), poor sleep quality (d = 0.92), postconcussion symptoms (d = 2.21), alcohol use (d = 0.63), traumatic life events (d = 0.42), and combat exposure (d = 0.91). BDNF Val66 Met genotype was significantly associated with risk for sustaining a mild traumatic brain injury (mTBI) and screening positive for traumatic stress. Predeployment traumatic stress, greater combat exposure and sustaining an mTBI while deployed, and the BDNF Met/Met genotype accounted for 22% of the variance of postdeployment PTSD scores (R (2) = 0.22, P CONCLUSION: These findings suggest predeployment traumatic stress, genetic, and environmental factors have unique contributions to the development of combat-related traumatic stress in military service members. Language: en",0,0 +3056,Double disadvantage: the influence of childhood maltreatment and community violence exposure on adolescent mental health,"Childhood maltreatment is a key risk factor for maladjustment and psychopathology. Although maltreated youth are more likely to experience community violence, both forms of adversity are generally examined separately. Consequently, little is known about the unique and interactive effects that characterize maltreatment and community violence exposure (CVE) on mental health.Latent Profile Analysis (LPA) was applied to data from a community sample of high-risk adolescents and young adults (n = 204, M = 18.85) to categorize groups of participants with similar patterns of childhood (i.e. past) maltreatment exposure. Associations between childhood maltreatment, CVE and mental health outcomes were then explored using multivariate regression and moderation analyses.Latent Profile Analysis identified three groups of individuals with low, moderate and severe levels of childhood maltreatment. Maltreatment was associated with more internalizing, externalizing, and trauma-related symptoms. By contrast, CVE showed independent associations with only externalizing and trauma-related symptoms. Typically, childhood maltreatment and CVE exerted additive effects; however, these forms of adversity interacted to predict levels of anger.Exposure to maltreatment and community violence is associated with increased levels of clinical symptoms. However, while maltreatment is associated with increased symptoms across a broad range of mental health domains, the impact of community violence is more constrained, suggesting that these environmental risk factors differentially impact mental health functioning.",0,0 +3057,"PTSD symptoms, life events, and unit cohesion in U.S. soldiers: Baseline findings from the neurocognition deployment health study","Relationships among a modifiable situational factor (unit cohesion), prior stressful life events, and posttraumatic stress disorder (PTSD) symptoms were assessed in 1,579 U.S. Army soldiers with no history of contemporary war zone deployment. It was predicted that unit cohesion would attenuate the dose-response relationship between past stressor exposures and PTSD symptoms at relatively moderate levels of exposure. Consistent with this hypothesis, regression analysis revealed that life experiences and unit cohesion strongly and independently predicted PTSD symptoms, and that unit cohesion attenuated the impact of life experiences on PTSD. Some military personnel reported significant predeployment, stress-related symptoms. These symptoms may serve as vulnerabilities that could potentially be activated by subsequent war-zone deployment. Higher predeployment unit cohesion levels appear to ameliorate such symptoms, potentially lessening future vulnerability.",0,0 +3058,Serotonin and Sensitivity to Trauma-Related Exposure in Selective Serotonin Reuptake Inhibitors-Recovered Posttraumatic Stress Disorder,"

Background

Selective serotonin reuptake inhibitors (SSRIs) are first-line treatments for posttraumatic stress disorder (PTSD). Serotonergic (5HT) attenuation of stress sensitivity is postulated from SSRIs' effects in other anxiety disorders, and we studied this in PTSD.

Methods

Ten patients with PTSD fully recovered on SSRIs (Clinical Global Impression Scale—I 1 and 2) were enrolled in the study. Patients were tested on two occasions 1 week apart; in each session, they received a drink containing large neutral amino acids (LNAAs) either with (sham tryptophan depletion [STD], control) or without (acute tryptophan depletion [ATD]) tryptophan. At 5.5 hours after the drink, subjects were exposed to a trauma-related exposure challenge. Self-reports of PTSD (visual analogue scales [VAS] and the Davidson Trauma Scale [DTS]), anxiety (Spielberger State Inventory [STAI] Form Y-1), and mood (Profile of Mood States [POMS]) were obtained. Heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure were also measured.

Results

The trauma-related exposure challenge induced anxiety on both days, with more marked responses on the ATD day according to VAS, DTS, POMS, and DBP (p < .05). A trend of significance (.1 > p > .05) was observed for STAI Form Y-1, HR, and SBP.

Conclusions

These data demonstrate that ATD accentuates responses to trauma-related stimuli in SSRI-recovered PTSD. They also suggest that SSRI-induced increases in serotonin function restrain PTSD symptoms, especially under provocation, supporting a role for serotonin in mediating stress resilience.",0,0 +3059,Evaluation of a corticotropin releasing hormone type 1 receptor antagonist in women with posttraumatic stress disorder: study protocol for a randomized controlled trial,"Pharmacologic treatment options for posttraumatic stress disorder (PTSD) are limited in number and effectiveness. Medications currently in use to treat PTSD were originally approved based on their efficacy in other disorders, such as major depression. Substantial research in PTSD suggests that increased activity of corticotropin releasing hormone (CRH)-containing circuits are involved in the pathophysiology of the disease. This Phase II trial aims to evaluate the efficacy of a CRH type 1 receptor (CRHR1) antagonist in the treatment of PTSD.Currently untreated adult women, ages 18 to 65 years, with a primary psychiatric diagnosis of PTSD of at least 3 months' duration, are being enrolled in a parallel-group, double-blind, placebo-controlled, randomized clinical trial evaluating the efficacy and safety of GSK561679, a novel CRHR1 receptor antagonist. GSK561679 (or matching placebo) is prescribed at a fixed dose of 350 mg nightly for six weeks. The primary trial hypothesis is that GSK561679 will reduce symptoms of PTSD, as measured by the Clinician-Administered PTSD Scale (CAPS), significantly more than placebo after six weeks of treatment. Putative biological markers of PTSD which may influence treatment response are measured prior to randomization and after five weeks' exposure to the study medication, including: fear conditioning and extinction using psychophysiological measures; variants of stress-related genes and gene expression profiles; and indices of HPA axis reactivity. In addition, the impact of PTSD and treatment on neuropsychological performance and functional capacity are assessed at baseline and after the fifth week of study medication. After completion of the six-week double blind treatment period, subjects enter a one-month follow-up period to monitor for sustained response and resolution of any adverse effects.Considerable preclinical and human research supports the hypothesis that alterations in central nervous system CRH neuronal activity are a potential mediator of PTSD symptoms. This study is the first to assess the efficacy of a specific antagonist of a CRH receptor in the treatment of PTSD. Furthermore, the biological and neuropsychological measures included in this trial will substantially inform our understanding of the mechanisms of PTSD.Clinicaltrials.gov Identifier: NCT01018992.Registered 6 November 2009. First patient randomized 14 January 2010.",0,0 +3060,"636,120 Ways to Have Posttraumatic Stress Disorder","In an attempt to capture the variety of symptoms that emerge following traumatic stress, the revision of posttraumatic stress disorder (PTSD) criteria in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has expanded to include additional symptom presentations. One consequence of this expansion is that it increases the amorphous nature of the classification. Using a binomial equation to elucidate possible symptom combinations, we demonstrate that the DSM-IV criteria listed for PTSD have a high level of symptom profile heterogeneity (79,794 combinations); the changes result in an eightfold expansion in the DSM-5, to 636,120 combinations. In this article, we use the example of PTSD to discuss the limitations of DSM-based diagnostic entities for classification in research by elucidating inherent flaws that are either specific artifacts from the history of the DSM or intrinsic to the underlying logic of the DSM's method of classification. We discuss new directions in research that can provide better information regarding both clinical and nonclinical behavioral heterogeneity in response to potentially traumatic and common stressful life events. These empirical alternatives to an a priori classification system hold promise for answering questions about why diversity occurs in response to stressors.",0,0 +3061,"Posttraumatic stress disorder, depression, and perceived needs for psychological care in older persons affected by Hurricane Ike","To examine the prevalence and correlates of disaster-related posttraumatic stress disorder (PTSD), depression, and needs for psychological care in older persons affected by Hurricane Ike.A total of 193 adults aged 60 or older who resided in the Galveston Bay area were interviewed 2-5 months following Hurricane Ike. Pre-, peri-, and post-disaster variables hypothesized to be related to PTSD and depressive symptoms, and perceived needs for psychological care were assessed.Weighted prevalences of past-month Ike-related PTSD and depression were 7.6% and 8.6%, respectively. Risk factors for Ike-related PTSD symptoms were predominantly peri-disaster in nature, with greater hurricane exposure, and peri-event dissociative and autonomic activation symptoms associated positively with these symptoms. Risk factors for depressive symptoms were predominantly pre-disaster in nature, with being married/living with partner associated negatively, and prior disaster exposure and pre-disaster PTSD or depression associated positively with these symptoms. 27.2% of the sample endorsed at least one of the perceived needs for psychological care assessed. A history of PTSD or depression, greater peri-event autonomic activation, and Ike-related PTSD and depressive symptoms were associated with greater need for psychological care.This study is limited by its cross-sectional design and employment of psychiatric screening instruments.A substantial proportion of older adults may have PTSD and depression, as well as perceived needs for psychological care, after a disaster. Assessment of disaster exposures, and peri-event dissociative and autonomic symptoms may help identify older adults at risk for disaster-related psychopathology. Older adults with a history of PTSD or depression, and greater peri-event autonomic activation and PTSD symptoms may be more likely to have needs for psychological care.",0,0 +3062,Emotional Processing Therapy for post traumatic stress disorder,"While prolonged exposure is considered one of the “gold standard” and recommended treatments for post traumatic stress disorder (PTSD), it has been poorly utilised in clinical practice. Individuals with PTSD often find it too distressing to confront memories, and therapists may be uncomfortable using the therapy. A new Emotional Processing Therapy is described in which an emotional approach to prolonged exposure provides individuals with a new insight into how trauma is processed. A conceptual analysis of exposure suggests that it is exposure to distressing emotional experiences which is a key element. Viewing it as an emotion-based therapy, allows the creative addition of new emotional elements. Through exploring the individual’s emotional processing style, previously learned and unhelpful patterns can be addressed, and the addition of an “emotional preparation” phase helps them understand why it is important to face emotionally distressing memories before exposure sessions begin. Emotional Processing Th...",0,0 +3063,The relation between multiple pains and mental disorders: Results from the World Mental Health Surveys,"It is unclear whether differences exist in the prevalence of mood, anxiety and alcohol use disorders among persons with multiple pain conditions compared with those with single pain problems. We conducted population surveys in 17 countries in Europe, the Americas, the Middle East, Africa, Asia, and the South Pacific. Participants were community-dwelling adults (N=85,088). Mental disorders were assessed with the Composite International Diagnostic Interview. Pain was assessed by self-report. Both multiple and single site pain problems were associated with mood and anxiety disorders, but not with alcohol abuse or dependence. In general, the prevalence of specific mood and anxiety disorders followed a linear pattern with the lowest rates found among persons with no pain, intermediate rates among those with one pain, and highest rates among those with multi-site pain problems. Relative to persons not reporting pain, the pooled estimates of the age-sex adjusted odds ratios were 1.8 (1.7-2.0) for mood disorders and 1.9 (1.8-2.1) for anxiety disorders for persons with single site pain; 3.7 (3.3-4.1) for mood disorders and 3.6 (3.3-4.0) for anxiety disorders among those with multi-site pain. Our results indicate that the presence of multiple pain conditions was strongly and comparably associated with mood and anxiety disorders in diverse cultures. This consistent pattern of associations suggests that diffuse pain and psychiatric disorders are generally associated, rather than diffuse pain representing an idiom for expressing distress that is specific to particular cultural settings or diffuse pain solely representing a form of masked depression.",0,0 +3064,"Hierarchical convergence of PTSD symptom clusters: A comparison of the numbing, dysphoria, and dysphoric arousal models of PTSD.","Previous research has found support for 3 intercorrelated models of posttraumatic stress disorder (PTSD): the Numbing model (King, Leskin, King, & Weathers, 1998), the Dysphoria model (Simms, Watson, & Doebbelling, 2002), and the Dysphoric Arousal model (Elhai et al., 2011). Researchers have not yet examined whether the symptom clusters represented by these 3 models would converge together in the same manner at the second-order level. The aim of the present study was to compare the efficiency of 1- and 2-factor hierarchical structures for each of the 3 PTSD models. Two large samples (total N = 3,178) of college students who reported a traumatic event completed a measure of PTSD. Confirmatory factor analysis showed that Elhai et al.'s (2011) Dysphoric Arousal model fit the data best at the first-order, intercorrelated level. Examination of the fit of the hierarchical structures showed important differences among the models: the Numbing model fit a 2-factor second-order structure more efficiently than it fit a single-factor hierarchical structure, whereas the Dysphoria model was better explained at the second-order level by a single-factor, General PTSD structure. The Dysphoric Arousal model showed poor fit statistics with both the 1- and 2-factor hierarchical structures, suggesting that Elhai et al.'s (2011) model does not fit either the General PTSD representation or a 2-factor hierarchical conception of PTSD. The differences in fit of the 3 models at the hierarchical level have implications for the measurement, theoretical understanding, and treatment of PTSD. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0,0 +3065,Interpersonal Processes in the Anxiety Disorders,"We examine the role of interpersonal processes in the anxiety disorders, a group of conditions characterized by excessive and incapacitating anxiety. The chapter begins with an empirical review that summarizes what is known about the interpersonal factors associated with social anxiety disorder, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. We then examine similarities and differences among the disorders as a first step toward establishing their unique interpersonal profiles. Despite limitations in extant studies, the literature as a whole supports the notion that interpersonal processes play a key role in these conditions. We end with suggestions for the way in which interpersonal theory might provide leads for future research. © 2011 John Wiley & Sons, Inc. All rights reserved.",0,0 +3066,Memory impairments in posttraumatic stress disorder are related to depression,"The present study focuses on verbal learning and memory alterations in refugees with posttraumatic stress disorder, and whether the alterations are related to attention, acquisition, storage, or retrieval. Twenty-one refugees exposed to war and political violence with chronic PTSD, were compared to an exposed control sample of 21 refugees without PTSD. No differences were found in attention span, but tests of verbal memory showed less efficient learning in the PTSD sample. Group differences in delayed recall could be explained by learning efficiency. No differences were seen in recognition memory. These results indicate that memory alterations in PTSD are related to impaired acquisition and less effective encoding of the memory material and not to impaired attention span and/or impaired retrieval. Controlling for specific PTSD symptom clusters and self-reported depression showed that the intrusion subscale and depressive reactions are the most important symptoms in understanding the memory alterations in PTSD.",0,0 +3067,Validation of a Tibetan Translation of the Hopkins Symptom Checklist–25 and the Harvard Trauma Questionnaire,"This study sought to translate and validate the Hopkins Symptom Checklist–25 (HSCL) and the Harvard Trauma Questionnaire (HTQ) in a Tibetan population. Translated questionnaires were administered to 57 Tibetan survivors of torture/human rights abuses living in the United States and receiving services in a torture treatment program. Participants were evaluated to determine if they met criteria for major depressive episode, generalized anxiety disorder, or posttraumatic stress disorder (PTSD). Coefficient alpha for the HSCL Anxiety subscale (.89), Depression subscale (.92), and the HTQ (.89) were high. Diagnostic accuracy using receiver operating characteristic curve analysis generated good classification accuracy for anxiety (.89), depression (.92), and PTSD (.83). However, although sensitivity and specificity for HSCL subscales were quite high, the HTQ generated low sensitivity (.33), partly because of a low rate of PTSD. Results support the reliability and validity of the HSCL but suggest further study of the HTQ with this population is required.",0,0 +3068,Post-traumatic stress disorder symptoms in emotionally distressed individuals referred for a depression prevention intervention: relationship to problem-solving skills,"Objectives This study examined the rates of syndromal and subthreshold post-traumatic stress disorder (PTSD) and PTSD symptom scores in participants with symptoms of emotional distress, subsyndromal depression, and a history of traumatic exposure. Participants had been referred to a study of an indicated depression prevention intervention using problem-solving therapy in primary care. We hypothesized that higher severity of PTSD symptom scores would predict poorer problem-solving skills. In addition, some reports have suggested that there are higher rates of PTSD in minority populations relative to Caucasians; thus we hypothesized that race would also predict problem-solving skills in these individuals. Methods We examined the rates of traumatic exposure, syndromal, and subthreshold PTSD. In those exposed to trauma, we performed a multiple linear regression to examine the effects of PTSD symptoms, depression symptoms, race, age, and gender on social problem-solving skills. Results Of the 244 participants, 64 (26.2%) reported a traumatic event; 6/234 (2.6%) had syndromal PTSD, and 14/234 (6.0%) had subthreshold PTSD. By way of regression analysis, higher PTSD symptom scores predicted poorer problem-solving skills. In addition, racial status (Caucasian vs. African American) predicted problem-solving skills; Caucasians exhibited lower levels of problem-solving skills. Conclusions Individuals presenting with subsyndromal depressive symptoms may also have a history of traumatic exposure, subthreshold and syndromal PTSD. Thus, screening these individuals for PTSD symptoms is important and may inform clinical management decisions because problem-solving skills are lower in those with more severe PTSD symptoms (even after adjusting for race, age, gender, and depressive symptoms). Copyright © 2011 John Wiley & Sons, Ltd.",0,0 +3069,"Prevalence of mental disorders among children exposed to war: a systematic review of 7,920 children","Worldwide, millions of children are affected by armed conflict. However, data on the prevalence of mental disorders among these children is sparse. We aimed to determine the prevalence of mental disorders among children affected by war using a systematic review and meta-regression analysis. We systematically reviewed existing literature to identify studies on prevalence of post-traumatic stress disorder (PTSD), anxiety, depression and psychosis among children exposed to armed conflict. We searched electronic databases and references listed in studies to obtain eligible studies. We pooled studies using the random-effects method and explored heterogeneity using meta-regression analysis. Seventeen studies met our inclusion criteria. Studies included 7,920 children. Sample sizes ranged from 22 to 2,976. Four studies were conducted during a conflict and others during post-conflict. All the studies reported PTSD as the primary outcome ranging from 4.5 to 89.3%, with an overall pooled estimate of 47% (9% CI: 35-60%, I2 = 98%). Meta-analysis heterogeneity was attributable to study location (OR 1.33, 95% CI: 1.27-1.41), method of measurement (OR 1.36, 95% CI: 1.29-1.44) and duration since exposure to war (coefficient 0.17, 95% CI: 0.94-0.25). In addition, four studies reported elevated depression that allowed pooling (43%, 95% CI: 31-55%) and three studies reported elevated anxiety disorders allowing pooling (27%, 95% CI: 21-33%). Our systematic review suggests a higher prevalence rate of mental disorders among children exposed to conflict than among the general population. Given the number of current conflicts, there is a paucity of information regarding mental disorders among children affected by war.",0,0 +3070,"Mental imagery, emotion and psychopathology across child and adolescent development","Mental imagery-based interventions are receiving increasing interest for the treatment of psychological disorders in adults. This is based on evidence that mental imagery potently influences the experience of emotion in non-clinical samples, and that a number of psychological disorders are marked by syndrome-specific, distressing abnormalities in mental imagery. During childhood and adolescence, neurocognitive development impacting mental imagery processes may moderate its relationship with clinically-relevant emotional symptoms at a number of potential loci. Crucially, these changes could impact vulnerability to distressing mental imagery and the efficacy of mental imagery-based clinical interventions. This review synthesises evidence pertaining to developmental changes in the role and content of mental imagery, and in the cognitive sub-processes required to generate and sustain mental images. Subsequently, we discuss implications for understanding the developmental relationship between mental imagery, emotion and psychopathology. Translational cognitive neuroscience research investigating the content, emotional impact and neurocognitive substrates of mental imagery across development may reveal insights into trajectories of vulnerability to symptoms of a number of psychological disorders. If proper consideration is given to developmental factors, techniques based on mental imagery may be valuable as part of a treatment armoury for child and adolescent clinical populations and those at risk of emotional disorders.",0,0 +3071,Functional outcome and quality of life in victims of terrorist explosions as compared to conventional trauma,"Background: Following trauma, the number of preventable deaths is low. Outcome should also be measured in terms of quality of life (QoL). Studies analyzing QoL in trauma patients have been published, but little is known about the long term QoL of victims of terrorist attacks. Methods: This is a case-control study of casualties of the March 11, 2004 attacks in Madrid. Patients treated for other trauma with similar age and Injury Severity Score (ISS), served as controls. Patients were assessed using the POLO-Chart (VAS, SF-36 and TOP). Results: Fifty-eight patients were included, 32 casualties admitted following the March 11, 2004 attacks and 26 controls. Both groups were comparable in age (average = 37), ISS (average = 23) and time from trauma (average = 1,770 days). Subjects demonstrated lower scores for the VAS, and the SF-36 clusters social functioning, role emotional and mental health. There was a tendency towards higher prevalence of symptoms associated to posttraumatic stress disorder (PTSD) in subjects (p = 0.056). Subjects suffered from higher residual pain in the head region (p = 0.032). Strong association was found between the presence of symptoms associated to depression, anxiety and PTSD and worse QoL (p < 0.001). Conclusion: Subjects present more emotional distortions, residual pain in the head region and a tendency towards a worsened perception of their own health and wellness. They also present symptoms associated to PTSD more frequently. The presence of symptoms associated to PTSD, depression or anxiety was an independent variable related to lower QoL in both groups. © 2010 Urban & Vogel.",0,0 +3072,Interaction between genetic variants and exposure to Hurricane Katrina on post-traumatic stress and post-traumatic growth: A prospective analysis of low income adults,"There is considerable variation in psychological reactions to natural disasters, with responses ranging from relatively mild and transitory symptoms to severe and persistent posttraumatic stress (PTS). Some survivors also report post-traumatic growth (PTG), or positive psychological changes due to the experience and processing of the disaster and its aftermath. Gene-environment interaction (GxE) studies could offer new insight into the factors underlying variability in post-disaster psychological responses. However, few studies have explored GxE in a disaster context.We examined whether ten common variants in seven genes (BDNF, CACNA1C, CRHR1, FKBP5, OXTR, RGS2, SLC6A4) modified associations between Hurricane Katrina exposure and PTS and PTG. Data were from a prospective study of 205 low-income non-Hispanic Black parents residing in New Orleans prior to and following Hurricane Katrina.We found a significant association (after correction) between RGS2 (rs4606; p=0.0044) and PTG, which was mainly driven by a cross-over GxE (p=0.006), rather than a main genetic effect (p=0.071). The G (minor allele) was associated with lower PTG scores for low levels of Hurricane exposure and higher PTG scores for moderate and high levels of exposure. We also found a nominally significant association between variation in FKBP5 (rs1306780, p=0.0113) and PTG, though this result did not survive correction for multiple testing.Although the inclusion of low-income non-Hispanic Black parents allowed us to examine GxE among a highly vulnerable group, our findings may not generalize to other populations or groups experiencing other natural disasters. Moreover, not all participants invited to participate in the genetic study provided saliva.To our knowledge, this is the first study to identify GxE in the context of post-traumatic growth. Future studies are needed to clarify the role of GxE in PTS and PTG and post-disaster psychological responses, especially among vulnerable populations.",0,0 +3073,The Dynamics of Posttraumatic Growth Across Different Trauma Types in a Palestinian Sample,"A Palestinian sample was used to explore the dynamics of posttraumatic growth (PTG) across different trauma types. Cumulative trauma, posttraumatic stress disorder, depression, anxiety, PTG, and stress-related growth (SRG) measures were administered. As predicted, only type I traumas were associated with PTG. Type II traumas were not associated with PTG, while type III collective identity traumas were negatively associated with PTG. Results indicated that PTG was not a significant predictor of any mental health symptoms and that PTG is different from SRG, which seems to describe growth in non-traumatic situations. The results suggest that it is important to analyze trauma profiles rather than single trauma.",0,0 +3074,Near-infrared spectroscopy analysis of frontal lobe dysfunction in schizophrenia,"Previous studies have shown that near-infrared spectroscopy (NIRS) has high temporal resolution, requires little restraint, and is suitable for examining the effect of psychological tasks on brain circulation. In the present study, frontal function in schizophrenic patients was analyzed by NIRS during random number generation (RNG), ruler-catching (RC), and sequential finger-to-thumb (SFT) tasks.Two sets of NIRS probes were attached to the foreheads of 13 schizophrenic patients and 10 control subjects approximately at Fp1-F7 and Fp2-F8. Near-infrared spectroscopy was conducted at a sampling rate of 1 Hz, with the pathlength being determined by time-resolved spectroscopy with differential pathlength factor measurements. The absolute changes in oxygenated (oxy-Hb) and deoxygenated (deoxy-Hb) hemoglobin concentrations in response to each task were measured, and total hemoglobin (total-Hb) concentration was calculated as the sum of the two.During RNG task, total- and oxy-Hb concentrations increased, and deoxy-Hb decreased, but the responses were significantly smaller in schizophrenic patients. During RC task, oxy-Hb in schizophrenic patients tended to decrease, in contrast to the mostly increasing response in control subjects. No group difference was observed during SFT task.Task-dependent profile of functional abnormalities was observed in schizophrenic frontal brain metabolism. These results support the usefulness of NIRS data in investigating frontal lobe dysfunction and evaluating psychopathologic condition in schizophrenic patients.",0,0 +3075,Reported rapes at a hospital rape centre: Demographic and clinical profiles,"2South Africa has one of the highest incidences of rape in the world and the most violent types of rape in the world, with gang rape and severe physical injury to rape victims commonly occurring. 3,4 Moreover, the consequences of rape potentially include many medical and psychological difficulties, such as unwanted pregnancy, risk of sexually transmitted infections (STIs), genital and physical injury, and psychological disturbance e.g. post-traumatic stress disorder, major depression, increased risk of suicidal ideation, and alcohol and drug abuse problems. 5,6 Rape survivors have specific health needs, ideally met by providing integrated and holistic post-rape services, including the provision of pregnancy testing and prevention, termination of pregnancy, testing and treatment of STIs and injuries, and psychosocial counselling. 7 Rape survivors strongly value the availability of HIV prophylaxis, an understanding health care provider, access to and receiving counselling, and thorough physical examination, emphasising the need for a holistic approach to post-rape care. 8,9 The Act aims to provide certain services to survivors of sexual assault to minimise or prevent further traumatisation, yet the only medical service conditionally provided to rape survivors is the provision of post-exposure prophylaxis (PEP). 2",0,0 +3076,A Socio-interpersonal Perspective on PTSD: The Case for Environments and Interpersonal Processes,"Post-traumatic stress disorder (PTSD) is a common reaction to traumatic experiences. We propose a socio-interpersonal model of PTSD that complements existing models of post-traumatic memory processes or neurobiological changes. The model adds an interpersonal perspective to explain responses to traumatic stress. The framework draws from lifespan psychology, cultural psychology and research into close relationships and groups. Additionally, clinical knowledge about PTSD is incorporated. This involves knowledge about shame, guilt, estrangement feelings and protective factors, such as social support and forgiveness. Three levels are proposed at which relevant interpersonal processes can be situated and should be adequately researched. First, the individual level comprises social affective states, such as shame, guilt, anger and feelings of revenge. Second, at the close relationship level, social support, negative exchange (ostracism and blaming the victim), disclosure and empathy are proposed as dyadic processes relevant to PTSD research and treatment. Third, the distant social level represents culture and society, in which the collectivistic nature of trauma, perceived injustice, and social acknowledgement are concepts that predict the response trajectories to traumatic stress. Research by the current authors and others is cited in an effort to promote future investigation based on the current model. Methodological implications, such as multi-level data analyses, and clinical implications, such as the need for couple, community or larger-level societal interventions, are both outlined.The socio-interpersonal model proposes an interpersonal view of the processes that occur in the aftermath of a traumatic experience. At the individual level, the model integrates the social affective phenomena that clinical research identifies in PTSD patients, including shame, guilt, anger, revenge and the urges or reluctance to disclose. At the level of close relationships, there is an emphasis on the role of the individuals' partner, family or social support in the development or maintenance of PTSD and its recovery. At the distant social level, societal and cultural factors, e.g., individualistic versus collectivistic or other human value orientations, are acknowledged as contributing to the severity and course of PTSD. Increasing attention should be given to new approaches of PTSD treatment that refer to an interpersonal view of PTSD, e.g., communication training, PTSD-specific couples' therapy or community programs.",0,0 +3077,Parent and child distress after war exposure,"The purpose of this study was to examine multiple distress symptoms (i.e., post-traumatic stress [PTS], anxiety, depression) among parents and children exposed to the Gulf Crisis in 1990-1991. Profiles of parent distress were identified, and the relationship between parent distress and specific child distress symptoms was examined.Parents and children were assessed at one time point.Participants included 151 children (Mage = 10.62 years; 51% female) and 140 parents (Mage = 40 years; 81% female).Utilizing latent profile analysis, three parallel profiles of parent distress were identified: low distress, moderate distress, and high distress. Parent distress was a risk factor for child depression, but it was not a risk factor for child PTS or anxiety.Findings support the importance of broadening the scope of research conducted after exposure to traumatic events to include the assessment of anxiety and depression, as well as PTS, among both parents and children. Additional implications for research and clinical work are discussed.Findings support the importance of screening for multiple distress symptoms among both children and parents after war exposure. Based on our findings, clinicians may want to consider including parents in therapy for children reporting psychological distress, especially depression symptoms, after exposure to traumatic events. This study was cross-sectional. Thus, we are not able to infer direction or causality. The generalizability of our study should be interpreted with caution, as findings will need to be replicated across other populations and other cultures.",0,0 +3078,Fluvoxamine,"Synopsis Fluvoxamine is a selective serotonin reuptake inhibitor which was initially developed as an antidepressant. Additional clinical research has identified several other disorders of the central nervous system in whichfluvoxamine has potential benefits, and which are the focus of this review. At present, the largest volume of data concerns the use of fluvoxamine in obsessive-compulsive disorder. Oral fluvoxamine at dosages of up to 300 mg/day is effective in alleviating, although not preventing, the symptoms of obsessivecompulsive disorder in 40 to 50% of patients, and limited data indicate that it is as effective as clomipramine. Encouraging initial data are also available regarding the efficacy of fluvoxamine in panic disorder. Further data are required to fully establish the efficacy of fluvoxamine in preventing panic attacks, and to investigate possible beneficial effects in the treatment of anxiety symptoms, bulimia nervosa, alcohol (ethanol )-induced amnesia, schizophrenia and several other psychiatric disorders, and pain states. Comparative and long term data in all disorders in which fluvoxamine shows potential are also required. Fluvoxamine is well tolerated by the majority of patients. Nausea is the most frequent adverse effect and can lead to withdrawal from treatment. However, nausea and most other adverse effects are generally mild to moderate in nature. Fluvoxamine induces less anticholinergic and sedative effects than tricyclic antidepressants, and does not appear to have cardiotoxic effects. In addition, as with many other antidepressants there is no evidence thatfluvoxamine induces suicidal behaviour. Compared with tricyclic antidepressants,fluvoxamine is relatively safe in overdose. Thus, studies available to date have demonstrated the efficacy offluvoxamine in obsessive-compulsive disorder. Efficacy in other central nervous system disorders has been indicated but further confirmatory data are required, as are comparative data in all disorders. The improved tolerability profile of fluvoxamine compared with many other agents used in these conditions will help to establish the agent as a useful alternative in obsessive-compulsive disorder, and in other conditions if preliminary efficacy findings are confirmed. Pharmacological Properties Fluvoxamine is a potent and selective inhibitor of serotonin reuptake. In addition to its lack of effects on other monoamine reuptake mechanisms, fluvoxamine has little or no effect on the neuronal function of other monoamines and has a low affinity for the receptors of a variety of neurotransmitters. While acute inhibition of serotonin reuptake by fluvoxamine is well documented, clinical response is slower and therefore is not readily explained by this acute effect. Studies in animals and humans have shown that fluvoxamine, unlike the tricyclic antidepressants, has relatively few cardiovascular or anticholinergic effects. In addition, fluvoxamine does not appear to have pro-convulsive or sedative effects, and does not impair cognition. Fluvoxamine has anxiolytic and anti-nociceptive activity in some animal models, and reduces alcohol (ethanol) intake in alcohol-preferring rats. Pain thresholds in healthy volunteers are increased by fluvoxamine. The pharmacokinetic properties of fluvoxamine are well established. The drug is almost completely absorbed following oral administration and the extent of absorption is not affected by the presence of food in the gastrointestinal tract. Maximum plasma concentrations are reached within 2 to 8 hours of administration and steady-state concentrations are achieved after 10 days. There is no drug accumulation after repeated administration. Fluvoxamine is extensively metabolised in the liver, with 11 pharmacologically inactive metabolites identified. Most of a dose offluvoxamineis excreted in the urine, with only about 3% as unchanged parent compound. Mean elimination half-life is 14 to 22 hours. Limited data suggest that the pharmacokinetic parameters of fluvoxamine are not affected by increased age, renal impairment or geneti polymorphism. However, elimination half-life is increased in patients with hepatic disease. Therapeutic Potential Fluvoxamine at oral dosages of 50 to 300 mg/day has been investigated in a number of non-depressive disorders. Positive results in 6 placebo-controlled trials support the efficacy of fluvoxamine in obsessive-compulsive disorder. At present, comparative data are limited but promising, with 2 trials showing that fluvoxamine is as effective as clomipramine. As with clomipramine, fluvoxamine reduces but does not eliminate obsessions and compulsions, is effective in only 40 to 50% of patients and has a delay in onset of action of approximately 4 weeks. Limited data indicate that fluvoxamine may also be effective in preventing panic attacks, although further placebo-controlled comparisons with standard agents are required. Encouraging preliminary results suggest that fluvoxamine may have potential in the treatment of anxiety symptoms, bulimia nervosa, alcohol- induced amnesia, schizophrenia and several other psychiatric disorders, and pain syndromes. Fluvoxamine does not appear to be effective in patients with dementia, post-traumatic stress disorder or menstrually related disorders, or in reducing body weight in obese patients. Tolerability Fluvoxamine is well tolerated in patients with depression or other central nervous system disorders at oral dosages of up to 300 mg/day for up to 12 weeks. Long term tolerability has not been fully established. A least 43% of patients experience at least 1 adverse effect, with the highest incidence of adverse effects being associated with the gastrointestinal tract (nausea, vomiting, abdominal pain) and central nervous system (somnolence, headache, insomnia). Asthenia is also a common adverse effect. The most common adverse effect is nausea, which can result in discontinuation of therapy. Most adverse effects are transient and of mild to moderate severity. No fluvoxamine-associated clinically significant changes in vital signs or laboratory parameters have been reported. Fluvoxamine produces fewer anticholinergic effects than tricyclic antidepressants, and is thought to have less epileptogenic potential than these agents. In addition, fluvoxamine does not appear to have any cardiotoxic effects. The adverse effects profile of fluvoxamine appears to be similar to that of other selective serotonin reuptake inhibitors. Fluvoxamine treatment has not been associated with an increase in suicidal behaviour, and the agent is considered less harmful than tricyclic antidepressants in overdose. Dosage and Administration For the treatment of non-depressive disorders, fluvoxamine has been administered at oral dosages of 50 to 300 mg/day. Dosages over 100 mg/day were most commonly used. Titration of the dosage in 50mg increments is recommended for the treatment of depression and a similar procedure should probably be used for other disorders. A starting dosage of 50 mg/day may reduce nausea. Dosage should not exceed 100 mg/day in patients with hepatic or renal impairment. While it does not seem necessary to reduce the dosage in elderly patients, slow titration of the dosage should be employed in these patients. Caution is recommended when administering fluvoxamine with agents with which it is known to interact, such as lithium, theophylline, tricyclic antidepressants or warfarin. In addition, cautious use is recommended when fluvoxamine is administered to patients with epilepsy or a medical condition that may be exacerbated by vomiting. Fluvoxamine should not be administered with or within 2 weeks of withdrawing a monoamine oxidase inhibitor, and a monoamine oxidase inhibitor should not be started within 1 week of stopping fluvoxamine. © 1994, Adis International Limited. All rights reserved.",0,0 +3079,Posttraumatic stress reactions among Rwandan youth in the second year after the genocide: Rising trajectory among girls.,"This study examines levels of traumatic stress reactions among youth attending school in the second year after the 1994 Rwandan genocide. From August to December 1995, the survey team visited 22 schools throughout Rwanda. The survey (n 942; youth aged 8 to 19 years) assessed exposure to wartime violence and symptoms of posttraumatic stress disorder (PTSD), as outlined in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM–IV; American Psychiatric Association, 2000). Mean symptom levels and the proportion of respondents meeting DSM–IV PTSD symptom criteria (“probable PTSD”) were examined for evidence of systematic decline over time. Multivariate analyses controlled for major confounders and the complex survey design. Overall, traumatic stress reactions increased among youth interviewed at successively later time points. For example, in the first third of the survey period, the “probable PTSD” rate was 48%; in the second, 54%; and in the third, 58%. The rise was confined to females. Among females, the adjusted odds of having “probable PTSD” in the last third of the study period was 2.71 (95% CI [1.66, 4.43]) fold higher than in the first. These results suggest that in planning health services in postconflict settings, humanitarian agencies should be alert to the possibility that traumatic stress reactions among youth may not decline with passage of time. Despite limitations in design, to date, this report represents the only formal structured evaluation of the mental health of youth living in the community, in the very early aftermath of catastrophic violence.",0,0 +3080,Neuroticism and post-traumatic stress disorder: a prospective investigation,"Background Neuroticism has been consistently correlated with the post-traumatic stress disorder (PTSD) response to traumatic events. Interpretation of these findings is limited by the retrospective nature of these findings: neuroticism was measured after the trauma had occurred. The prospective association of neuroticism with PTSD has not been examined (the relationship of neuroticism with PTSD symptoms was examined in a few prospective studies). We evaluate prospectively the relationship of neuroticism, measured at baseline, with the cumulative occurrence of PTSD during the subsequent 10 years, using data from a longitudinal epidemiological study of young adults. Method A sample of 1007 young adults randomly selected from the membership of a large health maintenance organization in southeast Michigan was assessed at baseline and followed up at 3, 5 and 10 years later. We conducted a series of multinomial logistic regressions to estimate the relative risk (RR) of exposure to trauma and PTSD by neuroticism at baseline, adjusting for history of major depression ( n = 990). Results During the 10-year follow-up, 50.2% of the sample experienced traumatic events and 5.2% developed PTSD. Neuroticism score at baseline increased significantly the RR of PTSD response to trauma. Additional analysis revealed that, among persons with history of major depression at baseline, RR for PTSD associated with neuroticism was equal to the null value of 1, but was increased significantly among those with no history of major depression. Conclusions The results confirm the role of neuroticism as diathesis in the PTSD response to traumatic experiences.",0,0 +3081,Derivation of a clinical prediction rule to identify both chronic moderate/severe disability and full recovery following whiplash injury,"Recovery following a whiplash injury is varied: approximately 50% of individuals fully recover, 25% develop persistent moderate/severe pain and disability, and 25% experience milder levels of disability. Identification of individuals likely to develop moderate/severe disability or to fully recover may help direct therapeutic resources and optimise treatment. A clinical prediction rule (CPR) is a research-generated tool used to predict outcomes such as likelihood of developing moderate/severe disability or experiencing full recovery from whiplash injury. The purpose of this study was to assess the plausibility of developing a CPR. Participants from 2 prospective, longitudinal studies that examined prognostic factors for poor functional recovery following whiplash injury were used to derive this tool. Eight factors, previously identified as predictor variables of poor recovery, were included in the analyses: initial neck disability index (NDI), initial neck pain (visual analogue scale), cold pain threshold, range of neck movement, age, gender, presence of headache, and posttraumatic stress symptoms (Posttraumatic Diagnostic Scale [PDS]). An increased probability of developing chronic moderate/severe disability was predicted in the presence of older age and initially higher levels of NDI and hyperarousal symptoms (PDS) (positive predictive value [PPV]=71%). The probability of full recovery was increased in younger individuals with initially lower levels of neck disability (PPV=71%). This study provides initial evidence for a CPR to predict both chronic moderate/severe disability and full recovery following a whiplash injury. Further research is needed to validate the tool, determine the acceptability of the proposed CPR by practitioners, and assess the impact of inclusion in practice.",0,0 +3082,Exploring posttraumatic stress disorder symptom profile among pregnant women,"Posttraumatic stress disorder (PTSD) is more prevalent in perinatal than general samples of women (6-8% vs. 4-5%). To explore potential causes, we examined the symptom profiles of women belonging to two separate samples: a perinatal clinic sample (n = 1581) and a subsample of women in a similar age range from the U. S. National Women's Study (NWS) (n = 2000). Within the perinatal sample, risk ratios were higher for all 17 PTSD symptoms among women with current PTSD compared with unaffected women, suggesting that higher rates are not likely due to measurement error. The younger age and greater social disadvantage in the perinatal clinic sample contributed only a small proportion of variance in symptom levels compared with extent of trauma exposure and pre-existing PTSD. Compared with the national study sample's symptom profile, the perinatal sample had higher rates of occurrence of five symptoms: detachment, loss of interest, anger and irritability, trouble sleeping, and nightmares. This analysis confirms that PTSD rates are higher in perinatal samples, which is likely due to exacerbation of pre-existing PTSD among women of a younger age and greater social disadvantage. Further elucidation is warranted, including identifying triggers and determining if there are needs for pregnancy-specific interventions.",0,0 +3083,Post-traumatic stress disorder is associated with poor health behaviors: Findings from the Heart and Soul Study.,"Posttraumatic stress disorder (PTSD) results in substantial disability, including increased risk of cardiovascular disease (CVD). Poor health behaviors are major risk factors for initial and recurrent CVD events. Therefore, this study investigated whether PTSD is associated with poor health behaviors in patients with CVD.Cross-sectional study of 1,022 men and women with CVD. PTSD was assessed with the Computerized Diagnostic Interview Schedule for DSM-IV. Physical activity, medication adherence and smoking history were determined by self-report questionnaires. Multivariate logistic and linear regression models were used to evaluate the association of PTSD with health behaviors.Of the 1,022 participants, 95 (9%) had PTSD. PTSD was associated with significantly higher rates of physical inactivity in terms of overall exercise (OR 1.6, 95% CI [1.0-2.6]; p = .049), light exercise (OR 1.7, 95% CI [1.0-2.9]; p = .045), and self-rated level of exercise compared to others of their age and sex (OR 1.8, 95% CI [1.0-3.0]; p = .047). Participants with PTSD were more likely to report medication nonadherence, including forgetting medications (OR 1.8, 95% CI [1.0-3.3]; p = .04) or skipping medications (OR 1.7, 95% CI [1.1-2.9]; p = .03). Participants with PTSD also reported a greater smoking history (β 6.4 pack years, 95% CI [1.8-10.9]; p = .006), which remained significant after adjustment for depression and income.Among patients with heart disease, those with PTSD were more likely to report physical inactivity, medication nonadherence and smoking. The majority of these associations were explained by adjustment for comorbid depression and lower income.",0,0 +3084,Incidence and Prediction of Post-Traumatic Stress Disorder at 6 Months After Motor Vehicle Accidents in Japan,"Incidence proportion of post-traumatic stress disorder (PTSD) after motor vehicle accidents (MVA) vary considerably across countries, and whether heart rate (HR) and respiratory rate (RR) immediately after MVA predict subsequent PTSD remains controversial. This study examined the incidence proportion of PTSD at 6 months after MVA in Japan, and the predictors of PTSD in MVA survivors.Patients with MVA-related injuries consecutively admitted to the intensive care unit of a teaching hospital in Tokyo were recruited. Six months after MVA, PTSD was diagnosed using the Clinician Administered Post-traumatic Stress Disorder Scale (CAPS).Of the 300 participants, 106 completed the assessments at 6 months after MVA and PTSD was diagnosed in 7.5% of the patients. Eight of the 300 participants (2.7%) were regarded as having PTSD after imputing their CAPS score at follow-up assessment for participants who dropped out. In multivariate regression analysis, no variables were shown to be independent predictors for PTSD. HR and RR did not predict PTSD in the analysis.The results suggested that the incidence proportion of PTSD following MVA in Japan was lower than that in most developed countries, and HR and RR might not be accurate screening tools despite their importance in a fear-conditioning model of the genesis of PTSD.",0,0 +3085,Trajectories of life satisfaction in the first 5 years following traumatic brain injury.,"The trajectories of life satisfaction for 609 individuals who sustained a traumatic brain injury (TBI) were studied. Hierarchical linear modeling analysis examined individual level growth trends over the first 5 years following TBI using gender, functional independence, age, and time to estimate life satisfaction trajectories.Participants completed the Functional Independence Measure and the Life Satisfaction Inventory at years 1, 2, 4, and 5 after sustaining TBI.Participants who reported higher functional independence at year 1 also had higher life satisfaction at year 1. Participants with lower functional independence across the 5-year period had life satisfaction trajectories that decreased at significantly greater rates than the individuals with more functional independence. The life satisfaction trajectory declined for the sample, but participants reporting lower cognitive and motor functional independence had significantly greater declines in life satisfaction trajectories. Age and gender were not significant factors in predicting life satisfaction trajectories following TBI.Individuals with greater cognitive and motor impairments following TBI are likely to experience significant declines in life satisfaction within 5 years of living with TBI.",0,0 +3086,War Exposure and Maternal Reactions in the Psychological Adjustment of Children from Bosnia-Hercegovina,,0,0 +3087,Neurobehavioral Mechanisms of Traumatic Stress in Post-traumatic Stress Disorder.,"Post-traumatic stress disorder (PTSD) is a debilitating psychiatric disorder that develops following trauma exposure. It is characterized by four symptom clusters: intrusion, avoidance, negative alteration in cognitions and mood, and alterations in arousal and reactivity. Several risk factors have been associated with PTSD, including trauma type and severity, gender and sexual orientation, race and ethnicity, cognitive reserve, pretrauma psychopathology, familial psychiatric history, and genetics. Great strides have been made in understanding the neurobiology of PTSD through animal models and human imaging studies. Most of the animal models have face validity, but they have limitations in the generalization to the human model of PTSD. Newer animal models, such as the ""CBC"" model, have better validity for PTSD, which takes into account the different components of its diagnostic criteria. To date, fear conditioning and fear extinction animal models have provided support for the hypothesis that PTSD is a dysregulation of the processes related to fear regulation and, especially, fear extinction. More research is needed to further understand these processes as they relate not only to PTSD but also to resilience. Further, this research could be instrumental in the development of novel effective treatments for PTSD.",0,0 +3088,Cross-Validation of the MMPI-2 in Detecting Malingered Posttraumatic Stress Disorder,"We attempted to cross-validate findings from a previous study (Elhai, Gold, Sellers, & Dorfman, in press) using a clinical sample of combat-related war veterans to distinguish genuine from malingered posttraumatic stress disorder (PTSD) on the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). The MMPI-2 scores of 124 male combat war veterans at the PTSD outpatient treatment program of a Veterans Affairs Medical Center were compared with those of 84 adult college students instructed and trained to malinger PTSD. MMPI-2 overreporting variables examined were F, F-Fb, F-K, F(p), Ds2, O-S, OT, and FBS. A stepwise discriminant analysis identified F. F-Fb, F-K, Ds2, O-S, and OT as the best malingering predictors. A predictive discriminant analysis yielded good hit rates for the model with impressive cross-validation results. We assessed cutting scores for the predictors of the model. We discuss clinical implications for using the MMPI-2 to distinguish malingered PTSD from combat-related PTSD.",0,0 +3089,Identifying longitudinal trajectories of emotional distress symptoms 5 years after traumatic brain injury,"To evaluate longitudinal trajectories of emotional distress symptoms after traumatic brain injury (TBI).Longitudinal study.Patients with mild-to-severe TBI, 118 patients participated at 3 months, 109 attended at 1-year and 89 attended the 5-year follow-up. Emotional distress was measured with the Impact of Event Scale-Revised. Patients were also assessed for coping style, anxiety, depression, substance abuse and trauma severity.Based on growth mixture modelling, four trajectories of emotional distress symptoms were identified: 73.5% of patients were characterized by a pattern of resilience, 6.8% by a pattern of delayed distress, 14.6% by recovery and 5.1% by chronic distress. Relative to the resilience trajectory, avoidant-coping style and psychiatric problems were related to recovery and chronic trajectories. The delayed trajectory was similar to the resilience trajectory, except for elevated depressive and anxiety symptoms at 1- and 5-years. Demographics and injury-related variables were not significantly associated with emotional distress trajectories.Resilience was the most common trajectory following TBI. Patients characterized by recovery and chronic trajectories required attention and long-term clinical monitoring of their symptoms. Future research would benefit from longitudinal studies to analyse emotional distress symptoms and the strength of resilience over time.",1,0 +3090,A critical evaluation of the complex PTSD literature: Implications for DSM-5,"Complex posttraumatic stress disorder (CPTSD) has been proposed as a diagnosis for capturing the diverse clusters of symptoms observed in survivors of prolonged trauma that are outside the current definition of PTSD. Introducing a new diagnosis requires a high standard of evidence, including a clear definition of the disorder, reliable and valid assessment measures, support for convergent and discriminant validity, and incremental validity with respect to implications for treatment planning and outcome. In this article, the extant literature on CPTSD is reviewed within the framework of construct validity to evaluate the proposed diagnosis on these criteria. Although the efforts in support of CPTSD have brought much needed attention to limitations in the trauma literature, we conclude that available evidence does not support a new diagnostic category at this time. Some directions for future research are suggested.",0,0 +3091,Use of the Personality Assessment Inventory in Assessment of Posttraumatic Stress Disorder in Women,"This study investigated the utility of the Personality Assessment Inventory (PAI) for the assessment of posttraumatic stress disorder (PTSD). Participants were 55 community-residing adult women who were administered a comprehensive battery that included the PAI and the Clinician-Administered PTSD Scale (CAPS). Participants were classified as either PTSD or non-PTSD based on the CAPS, and PAI profiles were compared between the two groups. Significant group differences were found for seven PAI clinical scales (Anxiety, Depression, Anxiety-Related Disorders, Somatic Complaints, Paranoia, Borderline Features, and Schizophrenia), one validity scale (Negative Impression), and two treatment scales (Nonsupport and Treatment Rejection). When all PAI scales and component subscales are considered, the largest group differences were found for the physiological subscale of the Depression scale (DEP-P) and the Traumatic Stress subscale of the Anxiety-Related Disorders scale (ARD-T). ARD-T and DEP-P also demonstrated excellent diagnostic utility. Finally, correlations between PAI scales and four CAPS symptom clusters provided additional validity evidence, in particular supporting a distinction between effortful avoidance and numbing. Taken together, these results support the use of the PAI in the assessment of PTSD. © 2005 Springer Science+Business Media, Inc.",0,0 +3092,"A comprehensive review of auditory verbal hallucinations: lifetime prevalence, correlates and mechanisms in healthy and clinical individuals","Over the years, the prevalence of auditory verbal hallucinations (AVHs) have been documented across the lifespan in varied contexts, and with a range of potential long-term outcomes. Initially the emphasis focused on whether AVHs conferred risk for psychosis. However, recent research has identified significant differences in the presentation and outcomes of AVH in patients compared to those in non-clinical populations. For this reason, it has been suggested that auditory hallucinations are an entity by themselves and not necessarily indicative of transition along the psychosis continuum. This review will examine the presentation of auditory hallucinations across the life span, as well as in various clinical groups. The stages described include childhood, adolescence, adult non-clinical populations, hypnagogic/hypnopompic experiences, high schizotypal traits, schizophrenia, substance induced AVH, AVH in epilepsy, and AVH in the elderly. In children, need for care depends upon whether the child associates the voice with negative beliefs, appraisals and other symptoms of psychosis. This theme appears to carry right through to healthy voice hearers in adulthood, in which a negative impact of the voice usually only exists if the individual has negative experiences as a result of their voice(s). This includes features of the voices such as the negative content, frequency, and emotional valence as well as anxiety and depression, independently or caused by voices presence. It seems possible that the mechanisms which maintain AVH in non-clinical populations are different from those which are behind AVH presentations in psychotic illness. For example, the existence of maladaptive coping strategies in patient populations is one significant difference between clinical and non-clinical groups which is associated with a need for care. Whether or not these mechanisms start out the same and have differential trajectories is not yet evidenced. Future research needs to focus on the comparison of underlying factors and mechanisms that lead to the onset of AVH in both patient and non-clinical populations.",0,0 +3093,Longitudinal Relationships between Posttraumatic Stress Symptoms and Sleep Problems in Adolescent Survivors following the Wenchuan Earthquake in China,"To examine the longitudinal relationships between Posttraumatic Stress Disorder (PTSD) and sleep problems among adolescent survivors in the Wenchuan earthquake, China.350 adolescent survivors were randomly selected from several primary and secondary schools in the counties of Wenchuan and Maoxian, the two areas most severely affected by the Wenchuan earthquake. Participants completed Revised Child PTSD Symptom Scale and Sleep Problems Subscale of Self-generated Child Behavior Problems Questionnaire at one year (T1), one-and-a-half years (T2), two years (T3) after the earthquake, respectively.There was a bidirectional relationship between intrusive symptom clusters of PTSD and sleep problems from T1 to T2, and this relationship became non-significant from T2 to T3. There was a one-way predictive relationship of avoidance symptom clusters of PTSD onto sleep problems from T1 to T3. The hyperarousal symptom clusters of PTSD had effects on sleep problems from T1 to T2 but not from T2 to T3, while sleep problems have no significant effect on hyperarousal symptom clusters of PTSD from T1 to T3. In addition, the relationships between three symptom clusters of PTSD and sleep problems weakened with time change.From 1 year to 1.5 years after the earthquake, all the three symptom clusters of PTSD could be important predictive factors for the development and maintenance of sleep problems, while sleep problems could only be risk factors for the intrusive symptom clusters of PTSD. From 1.5 years to 2 years, only the avoidance symptom clusters of PTSD were risk factors for sleep problems, and sleep problems had no significant effects on any symptom clusters of PTSD. Overall, the relationship between PTSD and sleep problems weakened with time change.",0,0 +3094,Training Resilience for High-risk Environments: Towards a Strength-based Approach within the Military,"In this chapter, we introduced the concept of resilience as especially relevant for soldiers as they nowadays operate in cumulative stressful environments. Resilience is different from traditional approaches to building, maintaining and restoring soldiers’ adaptation capabilities, because it focuses on positive adjustment besides the absence of pathology after a potentially traumatic event. We introduced the definition of military resilience the ability to maintain optimal performance during acute situations, positively recover afterwards, and sustain combat motivation under chronic stressful circumstances. Whether a soldier is resilient depends on the available internal and external resources. Several internal and external resources have been identified. However, not many studies have investigated the interplay between internal and external resources. More knowledge on the combined effects of these resources could provide valuable insights in how to best enhance military resilience. We discussed existing resilience interventions for personnel in high-risk occupations. Most interventions focused on individual resources and were based on cognitive principles that aim to enhance awareness and knowledge that will enable a soldier to better cope with stressful situations. Although these interventions addressed the positive adaptation perspective of resilience, the full range of resources has yet to be capitalized upon. In addition, only a few interventions explicitly aim to enhance resilience through external resources. Future interventions should include the positive adaptation perspective and address external resources to enhance effectiveness of resilience interventions.",0,0 +3095,Epigenetic and immune function profiles associated with posttraumatic stress disorder,"The biologic underpinnings of posttraumatic stress disorder (PTSD) have not been fully elucidated. Previous work suggests that alterations in the immune system are characteristic of the disorder. Identifying the biologic mechanisms by which such alterations occur could provide fundamental insights into the etiology and treatment of PTSD. Here we identify specific epigenetic profiles underlying immune system changes associated with PTSD. Using blood samples (n = 100) obtained from an ongoing, prospective epidemiologic study in Detroit, the Detroit Neighborhood Health Study, we applied methylation microarrays to assay CpG sites from more than 14,000 genes among 23 PTSD-affected and 77 PTSD-unaffected individuals. We show that immune system functions are significantly overrepresented among the annotations associated with genes uniquely unmethylated among those with PTSD. We further demonstrate that genes whose methylation levels are significantly and negatively correlated with traumatic burden show a similar strong signal of immune function among the PTSD affected. The observed epigenetic variability in immune function by PTSD is corroborated using an independent biologic marker of immune response to infection, CMV-a typically latent herpesvirus whose activity was significantly higher among those with PTSD. This report of peripheral epigenomic and CMV profiles associated with mental illness suggests a biologic model of PTSD etiology in which an externally experienced traumatic event induces downstream alterations in immune function by reducing methylation levels of immune-related genes.",0,0 +3096,Relief of serotonin selective reuptake inhibitor induced sexual dysfunction with low-dose mianserin in patients with traumatic brain injury,"Rationale: Serotonin selective reuptake inhibitors (SSRI) are commonly used in the treatment of many psychiatric disorders. Although possessing a relatively mild side effect profile, these drugs can cause a number of difficulties, including sexual dysfunction. A variety of strategies have been reported in the management of SSRI-induced sexual dysfunction, including dose reduction, drug holidays, substitution of another antidepressant drug, and various augmentation strategies, including use of sildenafil citrate (Viagra), buspirone, and others. Objectives: We aimed to examine the effect of adding another medication, mianserin, a mainly postsynaptic serotonin 2A agonist, to ongoing SSRI treatment in order to alleviate sexual side effects caused by SSRIs. Methods: The patients included in this study suffered from traumatic brain injury and from psychiatric complications that necessitated the use of SSRIs. Seventeen patients were included in this study, all were being treated with SSRIs, and all complained of sexual dysfunction. Mianserin was added to on-going treatment at low doses, 7.5-15 mg/day. Patients were followed for at least 3 months. Results: Fifteen of the 17 patients (88%) included in this study reported improvement in sexual dysfunction following this intervention. Ten (59%) reported that sexual function achieved pretreatment level. Five (29%) reported ""significant improvement,"" and two (12%) did not respond to this intervention and were given sildenafil citrate, with good results. Side effects were minimal and included dry mouth, drowsiness, headaches, and agitation. Conclusions: The use of low-dose mianserin as an add-on treatment to SSRIs appears to be an effective and well tolerated intervention for sexual dysfunction caused by SSRIs.",0,0 +3097,Assessing Long-Term Effects of Trauma: Diagnosing Symptoms of Avoidance and Numbing,"OBJECTIVE: This study compared the discovery of posttraumatic stress disorder (PTSD) symptoms by means of the Structured Clinical Interview for DSM-III-R (SCID) with a semistructured, psychodynamic clinical interview in a long-term follow-up of the survivors of the Buffalo Creek (W.Va.) flood. METHOD: Videotaped semistructured, psychodynamic clinical interviews of a small group of survivors (N=6) were compared with the results obtained in a prior group-level SCID investigation. RESULTS: Seventy-two percent of the total PTSD symptoms for the subjects studied were elicited exclusively by the psychodynamic clinical interview. PTSD cluster C symptoms of avoidance and numbing of general responsiveness were especially sensitive to discovery by this method. CONCLUSIONS: The psychodynamic clinical interview should be included in the design of studies that seek to investigate long-term effects of trauma, which are especially likely to be manifest in negative symptoms and subtle character change. (Am J Psychiatry 1999; 156:483–485)",0,0 +3098,La honte d’être soi. De l’intérêt de la psychothérapie à médiation artistique pour la réhabilitation des personnes en situation d’exclusion sociale,"Resume Dans le cadre d’un projet de recherche multi-annuel portant sur les relations entre les evenements biographiques traumatogenes, vecus depuis l’enfance, et le fonctionnement structurel de la personnalite a l’âge adulte, nous presentons les resultats d’une etude longitudinale. L’etude concerne l’evaluation d’ateliers d’art-therapie proposes a des personnes en situation de marginalisation et d’exclusion (n = 34). L’exploration du processus therapeutique est basee sur l’application de grilles d’analyse de contenu originales permettant d’utiliser la production artistique a titre de recherche. Des vignettes cliniques illustrent l’etre-au-monde singulier et l’angoisse existentielle des sujets qui se sentent discrimines et deracines et dont l’estime de soi est fortement ebranlee. La discussion porte sur la pertinence des resultats de l’etude, dans le cadre de la litterature actuelle concernant le psycho-traumatisme, la discrimination et la grande precarite, ainsi que sur la possibilite de degager de l’analyse de la production artistique quelques indices montrant une reprise du processus de subjectivation.",0,0 +3099,Associations between the SS variant of 5-HTTLPR and PTSD among adults with histories of childhood emotional abuse: Results from two African American independent samples,"Prior studies have found that the 5-HTTLPR polymorphism in the promoter region of the serotonin transporter gene (SLC6A4) interacts with stressful life events to increase general risk for PTSD, but this association has not extended to African American samples. Further, little is known about the effects of this interaction on specific PTSD symptom clusters, despite indications that clusters may have different biological substrates. The current study examined the interaction between exposure to childhood emotional abuse and 5-HTTLPR genotype on risk for PTSD symptom severity and severity of specific PTSD symptom clusters in two African American samples.Participants were 136 African American household residents from Detroit, MI and 546 African American patients recruited from waiting rooms in primary care clinics in Atlanta, GA. Participants reported emotional abuse exposure and PTSD symptom severity, and provided DNA for triallelic 5-HTTLPR genotyping. Analysis of covariance (ANCOVA) was used to examine main effects and interactions.In both African American samples, 5-HTTLPR genotype modified the effect of emotional abuse on PTSD symptom severity. Participants with the low-expression SS genotype who were exposed to emotional abuse had significantly lower reexperiencing and arousal symptom severity scores.The DNHS genetic sample size was small, and abuse data were assessed retrospectively.The SS variant of 5-HTTLPR appears to buffer against developing the reexperiencing and arousal symptoms of PTSD in two independent African American samples exposed to childhood emotional abuse. Findings also highlight the importance of considering emotional abuse experiences in patients with suspected PTSD.",0,0 +3100,Perceived Threat to Life Predicts Posttraumatic Stress Disorder after Major Trauma: Risk Factors and Functional Outcome,"The importance of psychological morbidity after major trauma, such as posttraumatic stress disorder (PTSD), is continuing to gain attention in trauma outcomes research. The Trauma Recovery Project is a large prospective epidemiologic study designed to examine multiple outcomes after major trauma, including quality of life (QoL) and PTSD. The specific objectives of the present report are to examine risk factors for PTSD and to assess the impact on QoL at the 6-, 12-, and 18-month follow-up time points in the Trauma Recovery Project population.Between December 1, 1993, and September 1, 1996, 1,048 eligible trauma patients triaged to four participating trauma center hospitals in the San Diego Regionalized Trauma System were enrolled in the study. The enrollment criteria for the study included age 18 years and older, admission Glasgow Coma Scale score of 12 or greater, and length of stay > 24 hours. QoL was measured after injury using the Quality of Well-being scale, a sensitive index to the well end of the functioning continuum (range, 0 = death to 1.000 = optimum functioning). Early symptoms of acute stress reaction (SASR) at discharge were assessed using the Impact of Events Scale (score > 30 = SASR). PTSD at 6-month follow-up was diagnosed using standardized Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, criteria. Patient outcomes were assessed at discharge and at 6, 12, and 18 months after discharge.PTSD was diagnosed in 32% (261 of 824) patients at 6-month follow-up. Perceived threat to life predicted PTSD onset (odds ratio [OR], 1.6; p < 0.01) and early SASR (OR, 2.2; p < 0.001). PTSD was more frequent in women (39%) than in men (29%) and in younger low-income patients. Other major risk factors were penetrating trauma (OR, 2.3; p < 0.001) and assaults (OR, 1.5; p < 0.05). PTSD had a major impact on QoL at 6-, 12-, and 18-month follow-up (Quality of Well-being scale score: 6 months, 0.576 vs. 0.658; 12 months, 0.620 vs. 0.691; 18 months, 0.620 vs. 0.700; p < 0.0001).These results provide new and provocative evidence that perceived threat to life and mechanism predict PTSD after major traumatic injury. PTSD had a prolonged and profound impact on short- and long-term outcome and QoL.",0,0 +3101,Characterizing Aggression and Its Association to Anger and Hostility Among Male Veterans With Post-Traumatic Stress Disorder,"The basis for the associations among anger, hostility, aggressive behavior, and post-traumatic stress disorder (PTSD) remains unclear. We suggest classifying aggressive behavior may elucidate the associations among these factors. On the basis of diagnostic and neurobiological similarities between impulsive aggression (IA) and PTSD, we proposed that IA was the predominant form of aggression in PTSD and that anger and hostility would not significantly predict PTSD when IA was also included as a predictor.We used cross-sectional self-report data obtained from two samples of male veterans (N = 136).Over 70% of veterans with PTSD reported IA compared to 29% of those without PTSD. IA, not anger, hostility, or premeditated aggression significantly predicted a diagnosis of PTSD.Associations between anger and PTSD may be unique to individuals with IA, and considering impulsive and premeditated aggressors separately may account for the heterogeneity found within samples of aggressive veterans with PTSD.",0,0 +3102,Whiplash following rear end collisions: a prospective cohort study,"The purpose of this study was to investigate the factors which predict neck pain initially and at 1 year following a rear end collision.All people who reported a rear end collision to the Devon and Cornwall Constabulary were identified and formed the basis of the cohort. People were excluded if they were under 18 years of age or had suffered a head injury. The main outcome measures were neck pain lasting for more than a week after the accident and neck pain at least 1 day a week at 1 year. Logistic regression was used to investigate associations between demographic and accident related variables and outcomes.A total of 1147 people reported rear end collisions to the police during the study period and 503 (44%) agreed to take part in the study. Of the respondents, 78% had neck pain lasting for more than a week and 52% still had pain at 1 year. Age (odds ratio, 95% confidence interval: 0.957, 0.942-0.972) and prior history of neck pain (8.32, 2.89-23.89) were the most important predictors of early neck pain. The most important predictors of pain at 1 year were the initial neck visual analogue scale (VAS) score (1.03, 1.01-1.05) and the presence of a compensation claim (4.09, 1.62-10.32). There was only weak evidence that measures of the severity of the impact were associated with outcomes.Demographic variables and the presence of a compensation suit show the strongest correlation with acute and chronic neck pain following rear end collisions.",0,0 +3103,Development and Initial Validation of Military Deployment-Related TBI Quality-of-Life Item Banks,"To investigate unique factors that affect health-related quality of life (QOL) in individuals with military deployment-related traumatic brain injury (MDR-TBI) and to develop appropriate assessment tools, consistent with the TBI-QOL/PROMIS/Neuro-QOL systems.Three focus groups from each of the 4 Veterans Administration (VA) Polytrauma Rehabilitation Centers, consisting of 20 veterans with mild to severe MDR-TBI, and 36 VA providers were involved in early stage of new item banks development. The item banks were field tested in a sample (N = 485) of veterans enrolled in VA and diagnosed with an MDR-TBI.Focus groups and survey.Developed item banks and short forms for Guilt, Posttraumatic Stress Disorder/Trauma, and Military-Related Loss.Three new item banks representing unique domains of MDR-TBI health outcomes were created: 15 new Posttraumatic Stress Disorder items plus 16 SCI-QOL legacy Trauma items, 37 new Military-Related Loss items plus 18 TBI-QOL legacy Grief/Loss items, and 33 new Guilt items. Exploratory and confirmatory factor analyses plus bifactor analysis of the items supported sufficient unidimensionality of the new item pools. Convergent and discriminant analyses results, as well as known group comparisons, provided initial support for the validity and clinical utility of the new item response theory-calibrated item banks and their short forms.This work provides a unique opportunity to identify issues specific to individuals with MDR-TBI and ensure that they are captured in QOL assessment, thus extending the existing TBI-QOL measurement system.",0,0 +3104,Pharmacotherapy for disordered sleep in post-traumatic stress disorder: a systematic review,"Sleep disorders, such as insomnia and nightmares, are common problems in post-traumatic stress disorder (PTSD), exert a strong negative influence on the quality of life and are a great challenge for clinical psychiatry. Several studies have reported on the efficacy of drugs for the treatment of PTSD-related sleep disorders. These studies have not been systematically reviewed. This is the first review on the effectiveness of sleep medication in PTSD. We performed a Medline, EMBASE and Cochrane Library Indexed search, using the keywords: PTSD, pharmacotherapy, therapy, sleep, nightmares, insomnia and review. From this database, English-language, human subject, data driven papers published after 1980 were selected. Forty eight articles are discussed. Open-label and case studies suggest efficacy for some antidepressants, anticonvulsants and atypical antipsychotics. Only a few placebo-controlled studies have been published. They show promising results for the atypical antipsychotic olanzapine, and the alpha1-adrenoceptor antagonist prazosin. In comparison to the incidence and impact of sleep complaints in PTSD, the pharmacotherapeutic armamentarium for PTSD-related sleep complaints remains poorly investigated. Some recent studies show promising results, especially for alpha1-adrenoceptor and 5-HT2 receptor antagonists. However, randomized controlled trials with larger populations need to be conducted.",0,0 +3105,Post-Traumatic Stress Disorder and Health Problems Among Medically Ill Canadian Peacekeeping Veterans,"Objective: The aim of the present study was to examine the relationship between post-traumatic stress disorder (PTSD) symptom severity and four significant health conditions (gastrointestinal disorders, musculoskeletal problems, headaches, and cardiovascular problems). Method: Participants included 707 Canadian peacekeeping veterans with service-related disabilities, from a random, national Canadian survey, who had been deployed overseas. Results: PTSD severity was significantly related to gastrointestinal disorders, musculoskeletal problems, and headaches, but not to cardiovascular problems. Controlling for demographic factors did not affect PTSD's relationships with the three significant health conditions. Conclusions: The present study supports previous work in finding consistent relations between PTSD severity and specific types of medical problems.",0,0 +3106,An Evaluation of the Relation Between Distress Tolerance and Posttraumatic Stress within a Trauma-Exposed Sample,"The present investigation examined the incremental associations between distress tolerance, or the perceived capacity to tolerate emotional distress, and global posttraumatic stress symptom severity as well as symptom cluster severity, beyond the variance accounted for by number of trauma exposure types and negative affectivity. The sample consisted of 140 adults (72 women; M(age)=25.9, SD=11.1) who endorsed exposure to traumatic life events, as defined by posttraumatic stress disorder diagnostic criterion A (American Psychiatric Association 2000). Participants did not meet diagnostic criteria for current axis I psychopathology. Distress tolerance demonstrated significant incremental associations with global posttraumatic stress symptom severity (p<.01) as well as re-experiencing (p<.05), avoidance (p=.05), and hyperarousal (p<.001) symptom cluster severity. Given the cross-sectional study design, causation cannot be inferred. Theoretical implications and future directions for better understanding associations between distress tolerance and posttraumatic stress are discussed.",0,0 +3107,Neural Correlates of Traumatic Recall in Posttraumatic Stress Disorder,"Functional activation studies of posttraumatic stress disorder (PTSD) using symptom provocation paradigms have implicated dysfunction in limbic and paralimbic brain regions. Increased or altered cerebral blood flow has been observed in amygdala and insula. Decreased or absent activity has been seen in medial prefrontal and anterior cingulate cortex (ACC). These brain regions comprise a neural circuit that has been demonstrated as important for emotional processing and emotional regulation. We studied combat veterans with PTSD (n=16), combat veterans without PTSD (combat controls, n=15), and age-matched healthy control subjects (n=15) with [O-15] H2O PET under a script-driven imagery paradigm of personalized traumatic/stressful and emotionally neutral events. Preliminary findings show that PTSD patients and combat controls had differential blood flow patterns during emotional recall in amygdala, insula and medial prefrontal cortex. Consistent with and extending prior findings, these preliminary results replicate differential patterns of activation in limbic and paralimbic regions of PTSD patients and trauma exposed controls suggesting that these neural substrates may be involved in the deficits in emotional processing in PTSD on one hand, and in resilience to trauma on the other.",0,0 +3108,A Web-Based Early Intervention Can Prevent Long-Term PTS Reactions in Children With High Initial Distress Following Accidental Injury,"The present study explored the targeting of a preventative information provision intervention delivered to children following accidental injury by assessing the impact of initial traumatic distress on response to treatment. Analyses were based on baseline and 6-month outcome of child traumatic stress in a control (n = 28) and an intervention group (n = 31). Moderation of treatment outcome by initial levels of child traumatic stress was assessed through multiple hierarchical regression analyses. Results indicated the interaction between treatment provision and initial level of posttraumatic stress significantly predicted 6-month outcome (β = -.42, p = .019). When initial distress was high, children in the control group demonstrated an increase in trauma symptoms, and had significantly higher trauma symptoms at follow-up than those in the treatment group (d = 0.94, p = .008). When initial distress was not elevated, no significant differences were noted between the groups. These results indicate that a preventative early intervention may be best targeted at children presenting with the specific risk factor of high initial distress.",0,0 +3109,Susceptibility of the Trauma Symptom Inventory to Malingering,"This study examined the sensitivity and specificity of the Trauma Symptom Inventory (TSI; Briere, 1995), a self-report measure of psychological sequelae of potentially traumatic events, to malingering. An optimal cutting score for a validity scale--Atypical Responding (ATR)--designed to identify exaggeration or other unusual response sets was developed in an analogue sample of 155 college students and subsequently applied to TSI profiles from several samples of patients with various psychiatric disorders. Use of a cross-validated T-score cutoff of 61 and below on the ATR scale produced good sensitivity (81%) and specificity (92%) rates in the analogue sample. Participants in the analogue sample who reported a history of traumatic experiences were no more able to successfully malinger trauma symptoms than were participants without such histories. Furthermore, false-positive rates in the clinical samples were generally low, suggesting that relatively few genuinely symptomatic individuals would be misclassified as malingering.",0,0 +3110,Heterogeneity in the response to rheumatoid arthritis (RA): The challenge of accounting for individual variability in the face of chronic disease,,0,0 +3111,Cluster analysis of obsessive-compulsive symptomatology: identifying obsessive-compulsive disorder subtypes.,"There is increasing evidence that obsessive-compulsive disorder (OCD) is a heterogeneous disorder. Different clinical subtypes may be characterized by differing pathophysiological mechanisms and treatment outcomes.A cluster analysis was performed on 45 items of the Yale-Brown Obsessive-Compulsive Symptoms Checklist (YBOCS-CL) for 261 patients with OCD. Cluster solutions emerging at different linkage distance levels, and the associations of identified clusters with demographic, clinical and relevant genetic variables, were investigated.A 6-cluster solution emerged at a linkage distance level of 1.5, and a 3-cluster solution emerged at a linkage distance level of 2.1. The 3 clusters in the latter solution were labeled I) Contamination / washing, II) Hoarding / symmetry / ordering, and III) Obsessional / checking. Increased Cluster III scores were associated with earlier age of OCD onset and the Met/Met (L/L) genotype of the COMT Val158Met polymorphism.The data here are consistent with previous work delineating the different symptom subtypes of OCD, also with previous work suggesting that the Met/Met (L/L) genotype of the COMT Val158Met polymorphism may be associated with anxiety symptoms, as well as with previous work suggesting that dopaminergic genes may be particularly important in early-onset OCD.",0,0 +3112,"Exploratory Factor Analysis of Diagnostic and Statistical Manual, 5th Edition, Criteria for Posttraumatic Stress Disorder","One change to the posttraumatic stress disorder (PTSD) nomenclature highlighted in the Diagnostic and Statistical Manual, 5th Edition (DSM-5; American Psychiatric Association, 2013) is the conceptualization of PTSD as a diagnostic category with four distinct symptom clusters. This article presents exploratory factor analysis to test the structural validity of the DSM-5 conceptualization of PTSD via an online survey that included the PTSD Checklist-5. The study utilized a sample of 113 college students from a large Midwestern university and 177 Amazon Mechanical Turk users. Participants were primarily female, Caucasian, single, and heterosexual with an average age of 32 years. Approximately 30% to 35% of participants met diagnostic criteria for PTSD based on two different scoring criteria. Results of the exploratory factor analysis revealed five distinct symptom clusters. The implications for the classification of PTSD are discussed.",0,0 +3113,Psychological Models in Rehabilitation Psychology,"Abstract Rehabilitation psychology depends upon a broad theoretical base incorporating frameworks, theories, models, and methodologies from many different areas of psychology, as well as from other professions invested in the health and rehabilitation of persons living with disabilities and chronic health conditions. This chapter considers some illustrative models that have been influential in rehabilitation psychology—both historically and in the present—including the biopsychosocial model, and psychological models derived from learning theory and behavior modification, psychoanalytic theory, social psychology, neuropsychology, and cognitive-behavioral theory. The current status of these models, their impact on current clinical practice, and future directions—including the role of dynamic models sensitive to differential trajectories of growth, adjustment, and development over time—will be discussed.",0,0 +3114,Post-traumatic growth in women after childbirth,"Childbirth is a complex event that leads to a variety of psychological outcomes. This cross-sectional study examined post-traumatic growth in women following childbirth (N = 219) using an online questionnaire, and explored associations between growth, support and control during birth, coping after birth and symptoms of post-traumatic stress disorder (PTSD). At least moderate degrees of growth were reported by 50.2% of women and average levels of growth were similar to those reported following accidents and assaults. Growth was positively related to approach coping and the avoidant strategy of seeking alternative rewards, but was unrelated to support and control during birth, other avoidant coping strategies after birth, and PTSD symptoms. It is concluded that growth does occur following childbirth. Further research is needed to clarify factors associated with growth in women following childbirth and to determine if growth is associated with psychological benefits in this population.",0,0 +3115,Posttraumatic Stress Disorder: Protective and Risk Factors in 18 Survivors of a Plane Crash,"The aim of this study is to identify protective and risk factors related to the development of posttraumatic stress disorder (PTSD) on a sample of survivors from a single plane crash. Eighteen survivors were examined 6 months following the event. The subjects all underwent psychiatric interviews, Clinician-Administered PTSD Scale structured interviews, personality and cognitive tests. Only 38.9% of them presented with all of the symptoms of PTSD; 22.2% showed no symptoms for PTSD; remaining survivors exhibited emotional/affective symptoms related to the event. In addition to the severity of the traumatic event itself, other risk factors identified were the loss of a relative, the manifestation of depressive symptoms, and the severity of physical injuries sustained. Low levels of hostility and high levels of self-efficacy represented protective factors against developing PTSD.",0,0 +3116,Glutamate and anxiety disorders,"Anxiety disorders are among the most prevalent psychiatric disorders, but they represent a particular challenge for treatment. The standard first-line treatments, including antidepressants, benzodiazepines, and buspirone, result in significant response rates for a majority of patients; however, unfavorable side effect profiles or risk for dependency for particular agents might limit their use by anxious patients, who often have low thresholds for medication discontinuation. Novel pharmacologic agents that modulate particular receptors, ion channels, or transporters relevant to glutamatergic neurotransmission may represent a new approach to the treatment of anxiety disorders, with generally more favorable side effect profiles. Although the role of glutamate in the pathophysiology of anxiety disorders is listill being elucidated, the use of these agents in treatment of anxiety disorders and commonly comorbid conditions such as substance abuse and mood disorders will continue to increase.",0,0 +3117,"Post-disaster stressful life events and WTC-related posttraumatic stress, depressive symptoms, and overall functioning among responders to the World Trade Center disaster","The current study examined contributions of post-disaster stressful life events in relation to the maintenance of WTC-related posttraumatic stress, depressive symptoms, and overall functioning among rescue, recovery, and clean-up workers who responded to the September 11, 2001 World Trade Center (WTC) terrorist attacks.Participants were 18,896 WTC responders, including 8466 police officers and 10,430 non-traditional responders (85.8% male; 86.4% Caucasian; M(age) = 39.5, SD = 8.8) participating in the WTC Health Program who completed an initial examination between July, 2002 and April, 2010 and who were reassessed, on average, 2.5 years later.Path analyses were conducted to evaluate contributions of life events to the maintenance of WTC-related posttraumatic stress, depressive symptoms, and overall functioning. These analyses were stratified by police and non-traditional responder groups and adjusted for age, sex, time from 9/11 to initial visit, WTC exposures (three WTC contextual exposures: co-worker, friend, or a relative died in the disaster; co-worker, friend, or a relative injured in the disaster; and responder was exposed to the dust cloud on 9/11), and interval from initial to first follow-up visit. In both groups, WTC-related posttraumatic stress, depressive symptoms, and overall functioning were stable over the follow-up period. WTC exposures were related to these three outcomes at the initial assessment. WTC-related posttraumatic stress, depressive symptoms, and overall functioning, at the initial assessment each predicted the occurrence of post-disaster stressful life events, as measured by Disaster Supplement of the Diagnostic Interview Schedule. Post-disaster stressful life events, in turn, were associated with subsequent mental health, indicating partial mediation of the stability of observed mental health.The present findings suggest a dynamic interplay between exposure, post-disaster stressful life events, and WTC-related posttraumatic stress, depressive symptoms, and overall functioning among WTC disaster responders.",0,0 +3118,Posttraumatic stress following childbirth: A review,"To assess the empirical basis of prevalence and risk factors of childbirth-related posttraumatic stress symptoms and PTSD in mothers, the relevant literature was critically reviewed. A MEDLINE and PSYCHLIT search using the key words ""posttraumatic stress"", ""PTSD"", ""childbirth"" and ""traumatic delivery"" was performed. The generated list of articles was supplemented by a review of their bibliographies. A total of 31 articles was selected. The primary inclusion criterion was report of posttraumatic stress symptoms or PTSD specifically related to childbirth. Case studies and quantitative studies on regular childbirth and childbirth by emergency cesarean section were identified. Consistency among studies was found with regard to development of posttraumatic stress symptoms as a consequence of traumatic delivery. Methodological issues concerning prevalence and risk factors were discussed. Case studies and quantitative studies confirm that childbirth may be experienced as so emotionally intense that it can lead to the development of posttraumatic stress symptoms or even a PTSD-profile. Among the identified risk factors were a history of psychological problems, trait anxiety, obstetric procedures, negative aspects in staff-mother contact, feelings of loss of control over the situation, and lack of partner support. The conclusion of the current review is twofold. First, traumatic reactions to childbirth are an important public health issue. Secondly, studying childbirth offers opportunity to prospectively study the development of posttraumatic stress reactions.",0,0 +3119,Oral administration of Bacillus subtilis strain BSB3 can prevent heat stress-related adverse effects in rats,"To determine the efficacy of Bacillus subtilis strain in prevention of heat stress-related complications in rats.Male Sprague-Dawley rats weighing 250-300 g were treated by oral gavage with B. subtilis BSB3 strain or PBS twice a day for 2 days. Half of the rats of each group were exposed to heat stress (45°C, relative humidity 55% for 25 min), while the remaining rats were placed at identical conditions but at 25°C. Bacterial translocation, histological changes in the intestine, cytokines profile, serum lipopolysaccharide level (LPS), as well as vesiculation of erythrocytes were analysed and compared between groups. Adverse effects of heat stress (morphological changes in intestine, bacterial translocation, elevated levels of LPS and IL-10, increased vesiculation of erythrocytes) were observed only in rats not protected with B. subtilis strain and exposed to heat. All registered parameters in rats pretreated with bacilli and exposed to heat were similar to control groups.Bacillus subtilis BS3B strain was effective in the prevention of complications related to heat stress in rats.This work will contribute towards better understanding of probiotics' mechanisms of action and will bring new approaches to characterize and use of beneficial bacteria.",0,0 +3120,"Physical Health Status of World Trade Center Rescue and Recovery Workers and Volunteers—New York City, July 2002–August 2004",,0,0 +3121,Stress and Cortisol in Disaster Evacuees: An Exploratory Study on Associations with Social Protective Factors,"Though cumulative emotional and physical effects of disasters may diminish evacuees’ short and long-term mental and physical health, social factors may buffer such consequences. We approached survivors of the October 2007 San Diego, California firestorms. We gathered data during the evacuation and 3 months afterward. Questionnaires measured social support as well as PTSD, depression, and anxiety symptoms. Saliva samples were used to assess the stress hormone, cortisol. Analyses, adjusting for age, gender, and socioeconomic status, showed PTSD symptoms were associated with flattening of the diurnal cortisol rhythm during evacuation. Secondary analyses showed those reporting a family emphasis on moral and religious values had lower psychological distress. Though anxiety symptoms had significantly decreased in the overall sample at follow-up, blunted cortisol rhythms persisted among those individuals with continued high anxiety. Results highlight a possible psychological, and perhaps a physiological, benefit of social and existential factors in disaster situations. Future work should explore the role of psychosocial factors and stress physiology in the development of long-term health concerns among individuals exposed to disaster. © 2015, Springer Science+Business Media New York.",0,0 +3122,Role of distinct PTSD symptoms in intimate partner reabuse: A prospective study,"This prospective study examines the impact of four posttraumatic stress disorder (PTSD) symptom clusters (hyperarousal, reexperiencing, numbing, and avoidance) on reabuse over 1 year among women exposed to intimate partner violence (IPV). The covariates include severity of IPV, a history of childhood violence, and characteristics of the abusive relationship. Although both hyperarousal and numbing symptoms were higher at baseline among women subsequently reabused, only numbing symptoms increased the odds of reabuse after controlling for the covariates. Greater IPV severity and shorter relationship duration also increased the risk of reabuse. Results indicate that specific symptoms of PTSD, especially numbing, need to be addressed to increase the safety of women seeking services for IPV.",0,0 +3123,"MMPI, MMPI-2 and PTSD: Overview of scores, scales, and profiles","A number of issues should be considered when applying profile interpretations and subscales derived from the original MMPI. These issues and the overall utility of the MMPI-2 for posttraumatic stress disorder (PTSD) evaluations are summarized. The Keane PTSD scale is found to be an effective tool for differential diagnosis when a cut-off score of 28 is used. The Schlenger PTSD scale warrants additional study. Various MMPI-2 validity scales are useful in detecting malingering, but concurrence regarding cut-off scores is lacking. The 2-8/8-2 MMPI PTSD profile does not emerge as consistently on the MMPI-2 as it did on the MMPI, due to the frequent elevation of scale 7 on the MMPI-2.",0,0 +3124,Coping strategies in civilians during air attacks,"Coping strategies may influence the psychological outcome after a stressful event, both as coping at the time of the event and as strategies of dealing with its consequences after the event. The aim of the study was to investigate coping strategies used by civilians during the air attacks in Yugoslavia in 1999, and their association with the level of exposure, gender and psychological symptoms 1 year later.The sample is a non-selective group of 139 medical students from the University of Belgrade, Yugoslavia. Open questions and content analysis were used to assess coping strategies. Symptoms of intrusion and avoidance were assessed, as well as general psychological symptoms.Content analysis of answers to open questions revealed nine categories of coping strategies (sport and walks, leisure activities, talking and gathering, humor, avoidance, philosophical approach, getting information, work, and substance abuse). A cluster analysis identified three groups of students with different styles of coping. Students that used dominantly 'talking and gathering' had the highest, and the ones that mostly used 'leisure activities' the lowest scores on intrusion. There were significant gender differences in how coping strategies were associated with intrusive symptoms.The type of coping strategies used during the air attacks may contribute to the level of intrusive symptoms 1 year after the event. Different coping strategies might be effective in men and women to reduce intrusive symptoms. Longitudinal and prospective studies are needed to draw definite conclusions on causal relationships between coping strategies and levels of posttraumatic stress.",0,0 +3125,The Parent Report Form of the CHIP–Child Edition,"Valid, comprehensive instruments to describe, monitor, and evaluate health from childhood through adolescence are almost nonexistent, but are critical for health resource planning, evaluation of policy, preventive, and clinical interventions, and understanding trajectories of health during this important period of life.The objectives of this study were to describe the development, testing, and final versions of the Parent Report Form of the Child Health and Illness Profile-Child Edition (CHIP-CE/PRF), designed to measure the health of children 6 to 11 years old from the caregiver perspective.Parents (N=1049) completed a version of the CHIP-CE/PRF in 4 locations in the United States, either in clinic waiting rooms or their homes. They differed in race/ethnicity, socioeconomic level, and native language.The Parent CHIP-CE is feasible; parents with a 5th-grade reading level complete the 76-item PRF in 20 minutes. Its domains (Satisfaction, Comfort, Risk Avoidance, Resilience, and Achievement) measure structurally distinct, interrelated aspects of health. Domain reliability is high: internal consistency=0.79-0.88; retest reliability (ICC)=0.71-0.85. Validity is supported. The scale scores are sensitive to predicted age, gender, and socioeconomic status differences in health.The CHIP-Child Edition/Parent Report Form is a psychometrically sound, conceptually based measure of child health that works well in diverse populations. It produces scores that parallel those of children on the CHIP-CE/CRF and adolescents on the CHIP-AE and allows health to be consistently assessed from childhood through adolescence. It should meet many needs for describing, monitoring, and understanding child health and evaluating outcomes of interventions.",0,0 +3126,Du pré-partum au post-partum : étude des profils et des symptomatologies maternelles,"Resume Objectifs Si les recherches sur les troubles psychiatriques en pre-partum sont nombreuses, il n’existe, a notre connaissance, aucune etude se focalisant sur les profils psychopathologiques des femmes en pre-partum. Le but de cette etude longitudinale est d’examiner les typologies de femmes en pre-partum et d’examiner si ces typologies se differencient au niveau des symptomes de troubles en post-partum immediat et a long terme. Participants, materiel et methode Quarante-six femmes ont rempli, entre le 8e et le 9e mois de grossesse (T1), des questionnaires mesurant la peur de l’accouchement et les symptomes de stress pretraumatique. Trois jours post-accouchement (T2), elles ont complete des mesures concernant l’experience et la douleur de l’accouchement et la detresse perinatale. A 6 semaines du post-partum (T3), des echelles mesurant les symptomes de depression postnatale et de stress post-traumatique ont egalement ete remplies. La symptomatologie anxio-depressive a egalement ete mesuree aux 3 temps de l’etude. Resultats Quatre typologies ont ete identifiees en pre-partum : le « groupe resilient » presentant une faible symptomatologie ; le « groupe peur » avec des symptomes averes de peur de l’accouchement ; le « groupe anxieux » rapportant une anxiete suspectee ; le « groupe stress pretraumatique-peur-anxiete-depression » avec des symptomes multiples. Nos resultats montrent egalement un impact des troubles en pre-partum sur les symptomatologies presentes en post-partum. Conclusion Les recherches sur les troubles en pre-partum et leurs etiologies sont a encourager afin de prevenir la formation de troubles secondaires.",0,0 +3127,Posttraumatic stress among children in Kurdistan,"To identify a posttraumatic stress disorder profile for the Child Behaviour Checklist.Checklist item scores for 806 school-aged children in Iraqi Kurdistan (201 randomly selected from the general population, 241 orphans, 199 primary medical care visitors and 165 hospital in-patients) were analysed against the Posttraumatic Stress Symptom Scale for Children (PTSS-C) scores, estimating not only stress diagnoses, but also nonstress-related, child-specific posttraumatic symptoms.Twenty checklist items, which revealed significant correlations with the stress diagnoses, formed the checklist-stress profile with acceptable reliability and validity, and significant correlation to the PTSS-C estimates.A child-specific stress profile for the checklist is recommended for use as a screening instrument.",0,0 +3128,"Negative Affect Predicts Adults’ Ratings of the Current, but Not Childhood, Impact of Adverse Childhood Events","Adverse childhood events (ACE's) have been empirically related to a wide range of negative health and mental health outcomes. However, not all individuals who experience ACE's follow a trajectory of poor outcomes, and not all individuals perceive the impact of ACE's as necessarily negative. The purpose of this study was to investigate positive and negative affect as predictors of adults' ratings of both the childhood and adult impact of their childhood adversity. Self-report data on ACE experiences, including number, severity, and 'impact' were collected from 158 community members recruited on the basis of having adverse childhood experiences. Results indicated that, regardless of event severity and number of different types of adverse events experienced, high levels of negative affect were the strongest predictor of whether the adult impact of the adverse childhood events was rated as negative. All individuals rated the childhood impact of events the same. Implications are discussed. © 2012 Springer Science+Business Media, LLC.",0,0 +3129,Effects of psychological and biomechanical trauma on brain and behavior,"The current conflicts in Iraq and Afghanistan have resulted in a large cohort of military personnel exposed to combat-related psychological trauma as well as biomechanical trauma, including proximity to blast events. Historically, the long-term effects of both types of trauma have been viewed as having different neural substrates, with some controversy over the proper attribution of such symptoms evident after each of the major conflicts of the last century. Recently, great effort has been directed toward distinguishing which neuropsychiatric sequelae are due to which type of trauma. Of interest, however, is that the chronic effects of exposure to either process are associated with a significant overlap in clinical symptoms. Furthermore, similar brain regions are vulnerable to the effects of either psychological or biomechanical trauma, raising the possibility that shared mechanisms may underlie the clinically observed overlap in symptom profile. This paper reviews the literature on the neural substrate of biomechanical and psychological injury and discusses the implications for evaluation and treatment of the neuropsychiatric sequelae of these processes.",0,0 +3130,Bullying boys: the traumatic effects of bullying in male adolescent learners,"This study investigated the nature and extent of the relationship between bullying and trauma among male adolescent learners. Trauma was operationalised through the multiple constructs of post-traumatic stress, anxiety, depression, dissociation and anger.In this quantitative study, two objective measures were administered (viz. the Olweus Bullying/ Victimisation Scale and the Trauma Symptom Checklist for children) to a sample of male adolescent learners between the ages of 12 and 17, from a South African male-only high school (n = 486).Statistical analysis (correlational analysis and MANOVA) produced evidence to suggest that there was a statistically significant relationship between bullying and trauma, and this was strongest for the victim role. The relationship between bullying and trauma was dependent on the frequency of bullying; as the frequency of being bullied increased so too did the mean scores of all the five trauma subscales. In general, the findings indicated that learners presented with elevated levels of internalising trauma outcomes. Depression demonstrated the highest correlation with the victim role, followed by Posttraumatic stress. In addition, 22.4% of learners could be clinically and sub-clinically diagnosed with post-traumatic stress and 21.0% with dissociation. Overall, the findings corroborate the argument that repetitive stressful events (such as bullying) are related to symptom-clusters of ongoing trauma.",0,0 +3131,"Circulating lymphocyte subsets, natural killer cell cytotoxicity, and components of hypothalamic-pituitary-adrenal axis in Croatian war veterans with posttraumatic stress disorder: cross-sectional study.","To determine peripheral blood lymphocyte subsets--T cells, helper T cells, cytotoxic T cells, B cells, and natural killer cells, natural killer cell cytotoxicity, serum cortisol concentration, and lymphocyte glucocorticoid receptor expression in Croatian combat veterans diagnosed with chronic posttraumatic stress disorder (PTSD); and to examine the relationship between the assessed parameters and the time passed since the traumatic experience.Well-characterized group of 38 PTSD patients was compared to a group of 24 healthy civilians. Simultaneous determination of lymphocyte subsets and the expression of intracellular glucocorticoid receptor was performed using three-color flow cytometry. Natural killer cell cytotoxicity was measured by (51)Cr-release assay and the serum cortisol concentration was determined by radioimmunoassay.We found higher lymphocyte counts in PTSD patients than in healthy controls (2294.7+/-678.0/microL vs 1817.2+/-637.0/microL, P=0.007) and a positive correlation between lymphocyte glucocorticoid receptor expression and the number of years that passed from the traumatic experience (r(s)=0.43, P=0.008). Lymphocyte glucocorticoid receptor expression positively correlated with serum cortisol concentration both in PTSD patients (r=0.46, P=0.006) and healthy controls (r=0.46, P=0.035).This study confirmed that the immune system was affected in the course of chronic PTSD. Our findings also indicated that the hypothalamic-pituitary-adrenal axis profile in PTSD was associated with the duration of the disorder. Due to the lack of power, greater sample sizes are needed to confirm the results of this study.",0,0 +3132,Levels of Trauma Among Women Inmates with HIV Risk and Alcohol Use Disorders: Behavioral and Emotional Impacts,"An increasing number of women are involved in the criminal justice system. Women in corrections are often of low socioeconomic status, medically underserved and exposed to a variety of traumatic events. Programs and services provided in correctional settings should be informed by the unique profiles and needs of these women. This study sought to identify distinct sub-groups (classes) of incarcerated women based on differences in their qualitative (types of trauma) and quantitative (number of) trauma experiences. Demographics, psychosocial and behavioral characteristics were measured in 149 women entering jail, who reported recent hazardous drinking and HIV sexual risk behavior. Two classes based on trauma exposure of women were identified through latent class analysis. The classes did not differ with respect to qualitative differences in trauma exposure (both classes reported all forms of trauma), but did differ with respect to quantitative differences (Class 2 reported more exposure to trauma in all categories than Class 1). The classes also differed significantly on current psychological functioning, alcohol treatment, problems, and consequences, drug histories, sexual risk, medical conditions, and social group characteristics. In all areas, members of Class 2 were significantly more likely to report higher levels of measured variables. Nearly all women in our sample reported levels of trauma exposure, suggesting a need for intervention and attention. Through identifying these separate classes, limited resources for trauma survivors in the correctional setting could be most appropriately allocated.",0,0 +3133,Borderline personality disorder and Axis I psychiatric and substance use disorders among women experiencing homelessness in three US cities,"In this study, we report prevalence rates of borderline personality disorder (BPD) and Axis I psychiatric and substance use disorders among randomly selected women who were experiencing episodes of homelessness in three US cities.The sample consists of 156 women, 79 from Omaha, NE, 39 from Pittsburgh, PA, and 38 from Portland, OR. It included 140 women from shelters and 16 women from meal locations. Latent class analysis was used to evaluate BPD symptoms.A large majority of the women (84.6 %) met criteria for at least one lifetime psychiatric disorder, about three-fourths (73.1 %) met criteria for a psychiatric disorder in the past year, and 39.7 % met past month criteria for a psychiatric disorder. Approximately three-fourths of the sample (73.7 %) met lifetime criteria for at least two disorders, about half (53.9 %) met criteria for at least three lifetime disorders, and approximately one-third (39.1 %) met criteria for four or more disorders. Latent class analyses indicated that 16.7 % of the women could be categorized as low self-harm BPD and 19.9 % high self-harm BPD.In shelters and in treatment settings, these women will present with complex histories of multiple serious psychiatric disorders. They are highly likely to manifest symptoms of BPD, post-traumatic stress disorder, and substance abuse disorders in addition to other psychiatric symptoms which will add to clinical complications.",0,0 +3134,Support for the mutual maintenance of pain and post-traumatic stress disorder symptoms,"Background Pain and post-traumatic stress disorder (PTSD) are frequently co-morbid in the aftermath of a traumatic event. Although several models attempt to explain the relationship between these two disorders, the mechanisms underlying the relationship remain unclear. The aim of this study was to investigate the relationship between each PTSD symptom cluster and pain over the course of post-traumatic adjustment. Method In a longitudinal study, injury patients ( n =824) were assessed within 1 week post-injury, and then at 3 and 12 months. Pain was measured using a 100-mm Visual Analogue Scale (VAS). PTSD symptoms were assessed using the Clinician-Administered PTSD Scale (CAPS). Structural equation modelling (SEM) was used to identify causal relationships between pain and PTSD. Results In a saturated model we found that the relationship between acute pain and 12-month pain was mediated by arousal symptoms at 3 months. We also found that the relationship between baseline arousal and re-experiencing symptoms, and later 12-month arousal and re-experiencing symptoms, was mediated by 3-month pain levels. The final model showed a good fit [χ 2 =16.97, df=12, p >0.05, Comparative Fit Index (CFI)=0.999, root mean square error of approximation (RMSEA)=0.022]. Conclusions These findings provide evidence of mutual maintenance between pain and PTSD.",0,0 +3135,"Anxiety, post-traumatic stress disorder and depression in Korean War veterans 50 years after the war","Background There has been no comprehensive investigation of psychological health in Australia's Korean War veteran population, and few researchers are investigating the health of coalition Korean War veterans into old age. Aims To investigate the association between war service, anxiety, post-traumatic stress disorder (PTSD) and depression in Australia's 7525 surviving male Korean War veterans and a community comparison group. Method A survey was conducted using a self-report postal questionnaire which included the PTSD Checklist, the Hospital Anxiety and Depression scale and the Combat Exposure Scale. Results Post-traumatic stress disorder (OR 6.63, P <0.001), anxiety (OR 5.74, P <0.001) and depression (OR 5.45, P <0.001) were more prevalent in veterans than in the comparison group. These disorders were strongly associated with heavy combat and low rank. Conclusions Effective intervention is necessary to reduce the considerable psychological morbidity experienced by Korean War veterans. Attention to risk factors and early intervention will be necessary to prevent similar long-term psychological morbidity in veterans of more recent conflicts.",0,0 +3136,Lamotrigine has an anxiolytic-like profile in the rat conditioned emotional response test of anxiety: a potential role for sodium channels?,"Rationale: Many anticonvulsants are used in disorders other than epilepsy. For example, lamotrigine is reported to be effective in post-traumatic stress disorder and mania. Objective: We assessed the effects of the anticonvulsants lamotrigine, valproate and carbamazepine in an animal model of anxiety. We assessed a wide range of pharmacological tools to delineate the mechanism of lamotrigine's anxiolytic effect. Methods: We assessed these compounds in the rat conditioned emotional response (CER) test of anxiety. Results: Lamotrigine (30-80 mg/kg) dose-dependently and reproducibly engendered an anxiolytic response in this test, with similar efficacy to benzodiazepines. Carbamazepine (20-40 mg/kg) and riluzole (10 mg/kg), which block Na+ channels by a similar mechanism as lamotrigine, were also anxiolytic. By contrast, valproate (100-600 mg/kg) was inactive and appears to differ in its interaction with Na+ channels. The SSRI paroxetine, the GABAA receptor positive modulator propofol, the NMDA antagonists memantine and (+)MK-801, and the Ca2+ channel antagonist nifedipine were all inactive in the CER test, suggesting these mechanisms may not mediate the anxiolytic effect of lamotrigine. More directly, we showed that the anxiolytic effect of lamotrigine could be blocked by co-administering rats with the Na+ channel activator veratrine (0.1 mg/kg). By contrast, neither the Ca2+ channel agonist BAYK8644 (0.5 mg/kg) nor the 5-HT1A or 5-HT 1/2 antagonists WAY100635 (0.3 mg/kg) and metergoline (3 mg/kg), respectively, were able to block the effect. Conclusion: Lamotrigine's anxiolytic effect in the CER test may be mediated via block of Na+ channels, and this may represent a target for the development of novel anxiolytics. (",0,0 +3137,Posttraumatic symptoms and suicide risk,"Abstract The relationship between traumatic events and suicide risk is well known. Most researches agree that Posttraumatic Stress Disorder (PTSD) plays a major role in this link. However, less is known about the specific posttraumatic symptom constellation that predicts suicide risk. In the current study we examined the posttraumatic symptom's profile which is associated with suicide risk, in a community sample of men with no known psychopathology. The research population included 103 men aged 25–45. They were administered the ‘Traumatic Event Questionnaire’, ‘PTSD Scale’, ‘Suicide Risk Scale’ (SRS) and the SCL-90. Results indicated that suicide risk was predicted by high levels of depression and hostility. High levels of arousal symptom and low levels of avoidance added a significant contribution to that prediction, suggesting that avoidance may serve as a buffer against suicide risk, while high levels of arousal may increase suicide risk. These findings may serve mental health professionals to identify high-risk persons also in a non-clinical population.",0,0 +3138,“War neurosis” and associated physical conditions: an exploratory statistical analysis,Abstract Records of the war service disability claims for Australian Vietnam veterans in Tasmania (n = 751) were analysed to establish patterns of interrelationships between categories of disability. The predicted relationship between psychiatric disability and stress related skin disabilities was strongly supported and relationships between psychiatric and other medical disabilities were found. An exploratory principal components analysis produced three independent components which accounted for 21.2 percent of total variance. Component 1 was interpreted as a general military service component and components 2 and 3 were labelled as stress components. The most likely interpretation of the two stress components was that they reflect differences in profiles of records for disability claims depending on the time when the disability presented. The relevance of the findings is discussed.,0,0 +3139,Efficacy of Psychoeducational Group Therapy in Reducing Symptoms of Posttraumatic Stress Disorder Among Multiply Traumatized Women,"Objective: The role of group therapy in treatment of posttraumatic stress disorder (PTSD) has been traditionally restricted to issues of self-esteem and interpersonal relationships, rather than primary symptoms of the disorder. In this study, the authors examined the effectiveness of a 16-week trauma-focused, cognitive-behavioral group therapy, named Interactive Psychoeducational Group Therapy, in reducing primary symptoms of PTSD in five groups (N=29) of multiply traumatized women diagnosed with chronic PTSD. Method: The authors made assessments at baseline, at 1-month intervals during treatment, at termination, and at 6-month follow-up by using self-report and structured interview measures of PTSD and psychiatric symptoms. The absence of a control group limits the conclusions drawn from the study.Results: At termination, subjects showed significant reductions in all three clusters of PTSD symptoms (i.e., reexperiencing, avoidance, and hyperarousal) and in depressive symptoms; they showed near-significant reductions in general psychiatric and dissociative symptoms, at termination. These improvements were sustained at 6-month follow-up.Conclusions: The role of group therapy in PTSD treatment should not be prematurely restricted to addressing self-esteem and interpersonal dimensions only. The use of structured, cognitive-behavioral elements within the group format may allow for more targeted treatment of core symptoms of the disorder. Am J Psychiatry 1998; 155: 1172-1177",0,0 +3140,Validation of the UCLA Child Post traumatic stress disorder-reaction index in Zambia,"Sexual violence against children is a major global health and human rights problem. In order to address this issue there needs to be a better understanding of the issue and the consequences. One major challenge in accomplishing this goal has been a lack of validated child mental health assessments in low-resource countries where the prevalence of sexual violence is high. This paper presents results from a validation study of a trauma-focused mental health assessment tool - the UCLA Post-traumatic Stress Disorder - Reaction Index (PTSD-RI) in Zambia.The PTSD-RI was adapted through the addition of locally relevant items and validated using local responses to three cross-cultural criterion validity questions. Reliability of the symptoms scale was assessed using Cronbach alpha analyses. Discriminant validity was assessed comparing mean scale scores of cases and non-cases. Concurrent validity was assessed comparing mean scale scores to a traumatic experience index. Sensitivity and specificity analyses were run using receiver operating curves.Analysis of data from 352 youth attending a clinic specializing in sexual abuse showed that this adapted PTSD-RI demonstrated good reliability, with Cronbach alpha scores greater than .90 on all the evaluated scales. The symptom scales were able to statistically significantly discriminate between locally identified cases and non-cases, and higher symptom scale scores were associated with increased numbers of trauma exposures which is an indication of concurrent validity. Sensitivity and specificity analyses resulted in an adequate area under the curve, indicating that this tool was appropriate for case definition.This study has shown that validating mental health assessment tools in a low-resource country is feasible, and that by taking the time to adapt a measure to the local context, a useful and valid Zambian version of the PTSD-RI was developed to detect traumatic stress among youth. This valid tool can now be used to appropriately measure treatment effectiveness, and more effectively and efficiently triage youth to appropriate services.",0,0 +3141,"Prevalence, Risk, and Correlates of Posttraumatic Stress Disorder Across Ethnic and Racial Minority Groups in the United States","We assess whether posttraumatic stress disorder (PTSD) varies in prevalence, diagnostic criteria endorsement, and type and frequency of potentially traumatic events (PTEs) among a nationally representative US sample of 5071 non-Latino whites, 3264 Latinos, 2178 Asians, 4249 African Americans, and 1476 Afro-Caribbeans.PTSD and other psychiatric disorders were evaluated using the World Mental Health-Composite International Diagnostic Interview (WMH-CIDI) in a national household sample that oversampled ethnic/racial minorities (n=16,238) but was weighted to produce results representative of the general population.Asians have lower prevalence rates of probable lifetime PTSD, whereas African Americans have higher rates as compared with non-Latino whites, even after adjusting for type and number of exposures to traumatic events, and for sociodemographic, clinical, and social support factors. Afro-Caribbeans and Latinos seem to demonstrate similar risk to non-Latino whites, adjusting for these same covariates. Higher rates of probable PTSD exhibited by African Americans and lower rates for Asians, as compared with non-Latino whites, do not appear related to differential symptom endorsement, differences in risk or protective factors, or differences in types and frequencies of PTEs across groups.There appears to be marked differences in conditional risk of probable PTSD across ethnic/racial groups. Questions remain about what explains risk of probable PTSD. Several factors that might account for these differences are discussed, as well as the clinical implications of our findings. Uncertainty of the PTSD diagnostic assessment for Latinos and Asians requires further evaluation.",0,0 +3142,Stress modulation of drug self-administration: Implications for addiction comorbidity with post-traumatic stress disorder,"Drug abuse and dependence present significant health burdens for our society, affecting roughly 10% of the population. Stress likely contributes to the development and persistence of drug use; for example, rates of substance dependence are elevated among individuals diagnosed with post-traumatic stress disorder (PTSD). Thus, understanding the interaction between stress and drug use, and associated neuroadaptations, is key for developing therapies to combat substance use disorders. For this purpose, many rodent models of the effects of stress exposure on substance use have been developed; the models can be classified according to three categories of stress exposure: developmental, adult nonsocial, and adult social. The present review addresses preclinical findings on the effect of each type of trauma on responses to and self-administration of drugs of abuse by focusing on a key exemplar for each category. In addition, the potential efficacy of targeting neuropeptide systems that have been implicated in stress responses and stress system neuroadaptation in order to treat comorbid PTSD and substance abuse will be discussed. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0,0 +3143,GAD65 haplodeficiency conveys resilience in animal models of stress-induced psychopathology,"GABAergic mechanisms are critically involved in the control of fear and anxiety, but their role in the development of stress-induced psychopathologies, including post-traumatic stress disorder (PTSD) and mood disorders is not sufficiently understood. We studied these functions in two established mouse models of risk factors for stress-induced psychopathologies employing variable juvenile stress and/or social isolation. A battery of emotional tests in adulthood revealed the induction of contextually generalized fear, anxiety, hyperarousal and depression-like symptoms in these paradigms. These reflect the multitude and complexity of stress effects in human PTSD patients. With factor analysis we were able to identify parameters that reflect these different behavioral domains in stressed animals and thus provide a basis for an integrated scoring of affectedness more closely resembling the clinical situation than isolated parameters. To test the applicability of these models to genetic approaches we further tested the role of GABA using heterozygous mice with targeted mutation of the GABA synthesizing enzyme GAD65 [GAD65(+/-) mice], which show a delayed postnatal increase in tissue GABA content in limbic and cortical brain areas. Unexpectedly, GAD65(+/-) mice did not show changes in exploratory activity regardless of the stressor type and were after the variable juvenile stress procedure protected from the development of contextual generalization in an auditory fear conditioning experiment. Our data demonstrate the complex nature of behavioral alterations in rodent models of stress-related psychopathologies and suggest that GAD65 haplodeficiency, likely through its effect on the postnatal maturation of GABAergic transmission, conveys resilience to some of these stress-induced effects.",0,0 +3144,Prevention of chronic PTSD with early cognitive behavioral therapy. A meta-analysis using mixed-effects modeling,"Post-traumatic stress disorder (PTSD) is of great interest to public health, due to the high burden it places on both the individual and society. We meta-analyzed randomized-controlled trials to examine the effectiveness of early trauma-focused cognitive-behavioral treatment (TFCBT) for preventing chronic PTSD. Systematic bibliographic research was undertaken to find relevant literature from on-line databases (Pubmed, PsycINFO, Psyndex, Medline). Using a mixed-effect approach, we calculated effect sizes (ES) for the PTSD diagnoses (main outcome) as well as PTSD and depressive symptoms (secondary outcomes), respectively. Calculations of ES from pre-intervention to first follow-up assessment were based on 10 studies. A moderate effect (ES = 0.54) was found for the main outcome, whereas ES for secondary outcomes were predominantly small (ES = 0.27-0.45). The ES for the main outcome decreased to small (ES = 0.34) from first follow-up to long-term follow-up assessment. The mean dropout rate was 16.7% pre- to post-treatment. There was evidence for the impact of moderators on different outcomes (e.g., the number of sessions on PTSD symptoms). Future studies should include survivors of other trauma types (e.g., burn injuries) rather than predominantly survivors of accidents and physical assault, and should compare early TFCBT with other interventions that previously demonstrated effectiveness.",0,0 +3145,Statistical and Substantive Checking in Growth Mixture Modeling: Comment on Bauer and Curran (2003).,This commentary discusses the D. J. Bauer and P. J. Curran (2003) investigation of growth mixture modeling. Single-class modeling of nonnormal outcomes is compared with modeling with multiple latent trajectory classes. New statistical tests of multiple-class models are discussed. Principles for substantive investigation of growth mixture model results are presented and illustrated by an example of high school dropout predicted by low mathematics achievement development in Grades 7-10.,0,0 +3146,Neurostructural imaging findings in children with post-traumatic stress disorder: Brief review,"Child maltreatment has been associated with different psychiatric disorders. Studies on both animals and humans have suggested that some brain areas would be directly affected by severe psychological trauma. The pathophsysiology of post-traumatic stress disorder (PTSD) appears to be related to a complex interaction involving genetic and environmental factors. Advanced neuroimaging techniques have been used to investigate neurofunctional and neurostructural abnormalities in children, adolescents, and adults with PTSD. This review examined structural brain imaging studies that were performed in abused and traumatized children, and discusses the possible biological mechanisms involved in the pathophysiology of PTSD, the implications and future directions for magnetic resonance imaging (MRI) studies. Published reports in refereed journals were reviewed by searching Medline and examining references of the articles related to structural neuroimaging of PTSD. Structural MRI studies have been performed in adults and children to evaluate the volumetric brain alterations in the PTSD population. In contrast with studies involving adults, in which hippocampus volumetric reduction was the most consistent finding, studies involving children and adolescents with PTSD have demonstrated smaller medial and posterior portions of the corpus callosum.",0,0 +3147,THE DISSOCIATIVE SUBTYPE OF PTSD: A REPLICATION AND EXTENSION,The nature of the relationship between dissociation and posttraumatic stress disorder (PTSD) has clinical and nosological importance. The aim of this study was to evaluate the evidence for a dissociative subtype of PTSD in two independent samples and to examine the pattern of personality disorder (PD) comorbidity associated with the dissociative subtype of PTSD.Latent profile analyses were conducted on PTSD and dissociation items reflecting derealization and depersonalization in two samples of archived data: Study 1 included 360 male Vietnam War Veterans with combat-related PTSD; Study 2 included 284 female Veterans and active duty service personnel with PTSD and a high base rate of exposure to sexual trauma.The latent profile analysis yielded evidence for a three-class solution in both samples: the model was defined by moderate and high PTSD classes and a class marked by high PTSD severity coupled with high levels of dissociation. Approximately 15% of the male sample and 30% of the female sample were classified into the dissociative class. Women (but not men) in the dissociative group exhibited higher levels of comorbid avoidant and borderline PD diagnoses.Results provide support for a dissociative subtype of PTSD and also suggest that dissociation may play a role in the frequent co-occurrence of PTSD and borderline PD among women. These results are pertinent to the on-going revisions to the DSM and suggest that consideration should be given to incorporating a dissociative subtype into the revised PTSD criteria.,0,0 +3148,A qualitative review of migrant women's perceptions of their needs and experiences related to pregnancy and childbirth,"A synthesis of the evidence of migrant women's perceptions of their needs and experiences in relation to pregnancy and childbirth.Despite the fact that all European Union member states have ratified human rights-based resolutions aimed at non-discrimination, there is a relationship between social inequality and access to pre-, intra-, and postpartum care.A qualitative systematic review of studies from European countries.A search was made for relevant articles published between January 1996-June 2010.Data were analysed by means of thematic synthesis.Sixteen articles were selected, analysed, and synthesized. One overall theme; 'Preserving one's integrity in the new country' revealed two key aspects; 'Struggling to find meaning' and 'Caring relationships'. 'Struggling to find meaning' comprised four sub-themes; 'Communication and connection', 'Striving to cope and manage', 'Struggling to achieve a safe pregnancy and childbirth', and 'Maintaining bodily integrity'. 'Caring relationships' was based on the following three sub-themes: 'Sources of strength', 'Organizational barriers to maternity care', and 'The nature and quality of caring relationships'.The results of this review demonstrate that migrant women are in a vulnerable situation when pregnant and giving birth and that their access to health services must be improved to better meet their needs. Research is required to develop continuity of care and improve integrated maternal care.",0,0 +3149,The development of a Clinician-Administered PTSD Scale,"Several interviews are available for assessing PTSD. These interviews vary in merit when compared on stringent psychometric and utility standards. Of all the interviews, the Clinician-Administered PTSD Scale (CAPS-1) appears to satisfy these standards most uniformly. The CAPS-1 is a structured interview for assessing core and associated symptoms of PTSD. It assesses the frequency and intensity of each symptom using standard prompt questions and explicit, behaviorally-anchored rating scales. The CAPS-1 yields both continuous and dichotomous scores for current and lifetime PTSD symptoms. Intended for use by experienced clinicians, it also can be administered by appropriately trained paraprofessionals. Data from a large scale psychometric study of the CAPS-1 have provided impressive evidence of its reliability and validity as a PTSD interview.",0,0 +3150,Five years later: Recovery from post traumatic stress and psychological distress among low-income mothers affected by Hurricane Katrina,"Hurricane Katrina, which struck the Gulf Coast of the United States in August 2005, exposed area residents to trauma and extensive property loss. However, little is known about the long-run effects of the hurricane on the mental health of those who were exposed. This study documents long-run changes in mental health among a particularly vulnerable group-low income mothers-from before to after the hurricane, and identifies factors that are associated with different recovery trajectories. Longitudinal surveys of 532 low-income mothers from New Orleans were conducted approximately one year before, 7-19 months after, and 43-54 months after Hurricane Katrina. The surveys collected information on mental health, social support, earnings and hurricane experiences. We document changes in post-traumatic stress symptoms (PTSS), as measured by the Impact of Event Scale-Revised, and symptoms of psychological distress (PD), as measured by the K6 scale. We find that although PTSS has declined over time after the hurricane, it remained high 43-54 months later. PD also declined, but did not return to pre-hurricane levels. At both time periods, psychological distress before the hurricane, hurricane-related home damage, and exposure to traumatic events were associated with PTSS that co-occurred with PD. Hurricane-related home damage and traumatic events were associated with PTSS without PD. Home damage was an especially important predictor of chronic PTSS, with and without PD. Most hurricane stressors did not have strong associations with PD alone over the short or long run. Over the long run, higher earnings were protective against PD, and greater social support was protective against PTSS. These results indicate that mental health problems, particularly PTSS alone or in co-occurrence with PD, among Hurricane Katrina survivors remain a concern, especially for those who experienced hurricane-related trauma and had poor mental health or low socioeconomic status before the hurricane.",0,0 +3151,The experience of traumatic events disrupts the measurement invariance of a posttraumatic stress scale,"Studies that include multiple assessments of a particular instrument within the same population are based on the presumption that this instrument measures the same construct over time. But what if the meaning of the construct changes over time due to one's experiences? For example, the experience of a traumatic event can influence one's view of the world, others, and self, and may disrupt the stability of a questionnaire measuring posttraumatic stress symptoms (i.e., it may affect the interpretation of items). Nevertheless, assessments before and after such a traumatic event are crucial to study longitudinal development of posttraumatic stress symptoms. In this study, we examined measurement invariance of posttraumatic stress symptoms in a sample of Dutch soldiers before and after they went on deployment to Afghanistan (N = 249). Results showed that the underlying measurement model before deployment was different from the measurement model after deployment due to invariant item thresholds. These results were replicated in a sample of soldiers deployed to Iraq (N = 305). Since the lack of measurement invariance was due to instability of the majority of the items, it seems reasonable to conclude that the underlying construct of PSS is unstable over time if war-zone related traumatic events occur in between measurements. From a statistical point of view, the scores over time cannot be compared when there is a lack of measurement invariance. The main message of this paper is that researchers working with posttraumatic stress questionnaires in longitudinal studies should not take measurement invariance for granted, but should use pre- and post-symptom scores as different constructs for each time point in the analysis.",0,0 +3152,A comparison of the SPRINT and CAPS assessment scales for posttraumatic stress disorder,"The Clinician-Administered PTSD Scale for DSM-IV (CAPS) is a widely used assessment tool for (posttraumatic stress disorder) (PTSD). However, a shorter assessment tool may be beneficial for clinical work. Here, we compare such a tool, the Short PTSD Rating Interview (SPRINT) to the CAPS. We found that the SPRINT rating scale performs similarly to the CAPS rating scale in the assessment of PTSD symptom clusters and total scores, and that the SPRINT takes significantly less time to administer than the CAPS.",0,0 +3153,Increased generalization of learned associations is related to re-experiencing symptoms in veterans with symptoms of post-traumatic stress,"One interpretation of re-experiencing symptoms in post-traumatic stress disorder (PTSD) is that memories related to emotional information are stored strongly, but with insufficient specificity, so that stimuli which are minimally related to the traumatic event are sufficient to trigger recall. If so, re-experiencing symptoms may reflect a general bias against encoding background information during a learning experience, and this tendency might not be limited to learning about traumatic or even autobiographical events. To test this possibility, we administered a discrimination-and-transfer task to 60 Veterans (11.2% female, mean age 54.0 years) self-assessed for PTSD symptoms in order to examine whether re-experiencing symptoms were associated with increased generalization following associative learning. The discrimination task involved learning to choose the rewarded object from each of six object pairs; each pair differed in color or shape but not both. In the transfer phase, the irrelevant feature in each pair was altered. Regression analysis revealed no relationships between re-experiencing symptoms and initial discrimination learning. However, re-experiencing symptom scores contributed to the prediction of transfer performance. Other PTSD symptom clusters (avoidance/numbing, hyperarousal) did not account for significant additional variance. The results are consistent with an emerging interpretation of re-experiencing symptoms as reflecting a learning bias that favors generalization at the expense of specificity. Future studies will be needed to determine whether this learning bias may pre-date and confer risk for, re-experiencing symptoms in individuals subsequently exposed to trauma, or emerges only in the wake of trauma exposure and PTSD symptom development.",0,0 +3154,Is mixed-handedness a marker of treatment response in posttraumatic stress disorder?: A pilot study,"Recent studies suggest that mixed-handedness is a risk factor for posttraumatic stress disorder (PTSD). This study examined whether mixed-handed veterans with combat-related PTSD respond more poorly to psychosocial treatment. Consistency of hand preference was assessed in 150 Vietnam combat veterans with PTSD using the Edinburgh Handedness Inventory (R. C. Oldfield, 1971). Growth modeling analyses using Mplus (L. K. Muthén & B. Muthén, 2002) identified that PTSD veterans with mixed-handedness reported significantly less treatment improvement on the PTSD Checklist (F. W. Weathers, B. T. Litz, D. S. Herman, J. A. Huska, & T. M. Keane, 1993) than did veterans with consistent handedness. These data suggest that mixed-handedness is associated with poorer PTSD treatment response. Several possible explanations for this finding are discussed.",0,0 +3155,Cell type-specific modifications of corticotropin-releasing factor (CRF) and its type 1 receptor (CRF1) on startle behavior and sensorimotor gating,"The corticotropin-releasing factor (CRF) family of peptides and receptors coordinates the mammalian endocrine, autonomic, and behavioral responses to stress. Excessive CRF production has been implicated in the etiology of stress-sensitive psychiatric disorders such as posttraumatic stress disorder (PTSD), which is associated with alterations in startle plasticity. The CRF family of peptides and receptors mediate acute startle response changes during stress, and chronic CRF activation can induce startle abnormalities. To determine what neural circuits modulate startle in response to chronic CRF activation, transgenic mice overexpressing CRF throughout the central nervous system (CNS; CRF-COE(CNS)) or restricted to inhibitory GABAergic neurons (CRF-COE(GABA)) were compared across multiple domains of startle plasticity. CRF overexpression throughout the CNS increased startle magnitude and reduced ability to inhibit startle (decreased habituation and decreased prepulse inhibition (PPI)), similar to previous reports of exogenous effects of CRF. Conversely, CRF overexpression confined to inhibitory neurons decreased startle magnitude but had no effect on inhibitory measures. Acute CRF receptor 1 (CRF1) antagonist treatment attenuated only the effects on startle induced by CNS-specific CRF overexpression. Specific deletion of CRF1 receptors from forebrain principal neurons failed to alter the effects of exogenous CRF or stress on startle, suggesting that these CRF1 expressing neurons are not required for CRF-induced changes in startle behaviors. These data indicate that the effects of CRF activation on startle behavior utilize an extensive neural circuit that includes both forebrain and non-forebrain regions. Furthermore, these findings suggest that the neural source of increased CRF release determines the startle phenotype elicited. It is conceivable that this may explain why disorders characterized by increased CRF in cerebrospinal fluid (e.g. PTSD and major depressive disorder) have distinct symptom profiles in terms of startle reactivity.",0,0 +3156,Abnormal serum lipid profile in Brazilian police officers with post-traumatic stress disorder,"To measure the serum lipid composition of a sample of Brazilian police officers with and without PTSD regularly exposed to potentially traumatic situations.A cross-sectional survey was conducted with 118 active duty male police officers. Serum concentrations for total cholesterol, LDL-C, HDL-C, and triglycerides were enzymatically determined. Body mass index (BMI) was obtained for each participant.Officers with PTSD exhibited significantly higher serum total cholesterol, LDL-C and triglycerides levels than those without PTSD. Total cholesterol and triglycerides, but not LDL-C, remained associated with PTSD diagnosis after controlling for confounding influences (i.e. socio-demographics, BMI, and tobacco, alcohol and medication use).The sample size was small. A nutritional interview was employed instead of established scales to assess alimentary habits, tobacco or alcohol consumption. A self-report screening tool was used to assess the prevalence of PTSD.The association between PTSD and abnormal serum lipid profile and a tendency to exhibit higher BMI suggests that individuals with PTSD may be at increased risk for developing metabolic syndrome, a condition that by itself could account for many of the most serious PTSD-related physical health problems.",0,0 +3157,Etiological factors in the development of posttraumatic stress disorder.,"(from the chapter) focuses on epidemiologic and descriptive studies in an effort to delineate specific factors that contribute to the development of posttraumatic stress disorder (PTSD) [primarily in veteran populations] / [review] noncombat-related trauma . . . as it relates to the generalizability of findings related to trauma / findings from studies at the West Haven Veterans Administration Medical Center (VAMC) on the role of dissociation in the etiology of PTSD are presented and discussed (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +3158,Anxiety sensitivity and aspects of alexithymia are independently and uniquely associated with posttraumatic distress,"Using a sample of adult survivors of physical trauma requiring hospitalization (N = 677), we examined the relationship of aspects of alexithymia and anxiety sensitivity to symptoms of posttraumatic distress (PTD). At the bivariate level, both aspects of alexithymia and anxiety sensitivity were positively associated with acute PTD symptomatology, but anxiety sensitivity was more strongly related to PTD symptoms. At the multivariate level, both anxiety sensitivity and aspects of alexithymia made unique and independent contributions to both total PTD symptoms and the majority of PTD symptom clusters. At the facet level, anxiety sensitivity-physical concerns and anxiety sensitivity-psychological concerns, and the alexithymic dimension of difficulty identifying feelings, were uniquely associated with acute PTD symptoms. Findings are discussed in terms of potential clinical implications.",0,0 +3159,Psychiatric morbidity following a natural disaster: An Australian bushfire,"This study investigated the prevalence of mental health problems after a major bushfire in Australia and examined the validity of the General Health Questionnaire (GHQ) (Goldberg 1978) against the Anxiety, Affective and Post-Traumatic Stress Disorder modules of the Diagnostic Interview Schedule (DIS; Robins et al. 1981). Study 1 was carried out 12 months after the Ash Wednesday bushfires and sought to include all the victims of the fires. Study 2 was conducted 20 months after the fires and included a sample of victims who had experienced major losses in the fires. Twelve months after the fires, 42% (n = 1,526) of the victims were defined as a potential psychiatric case using the GHQ. This rate indicated a significantly greater level of morbidity than found in communities that have not experienced a natural disaster. Twenty months after the fires, 23% (n = 43) were defined as ""cases"". The 28-item GHQ was found to be a valid instrument for defining the presence of psychiatric disorder in a disaster-effected community. The findings demonstrated that lasting psychiatric morbidity is associated with natural disasters.",0,0 +3160,Leg Extension Power Is a Pre-Disaster Modifiable Risk Factor for Post-Traumatic Stress Disorder among Survivors of the Great East Japan Earthquake: A Retrospective Cohort Study,"Post-traumatic stress disorder (PTSD) is a common psychological problem following natural disasters. Although pre-disaster risk factors are important for early detection and proactive support, the examination of such has been limited to sociodemographic factors, which were largely unaffected by the disasters. We examined the association between pre-disaster physical functioning and lifestyle and PTSD symptoms five months after the earthquake in the Great East Japan Earthquake survivors who were participating in a pre-existing cohort study.We designed a retrospective cohort study of a cooperative association in Sendai from August 2010 to August 2011. In 2010, lifestyle, physical condition, and sociodemographic factors were examined by self-reported questionnaires completed by 522 employees of this organization. We also measured the leg extension power of all the participants. PTSD symptoms were evaluated by the Japanese version of the Impact of Event Scale-Revised (IES-R-J) following the earthquake of 2011.In multivariate linear regression analysis, leg extension power (β = -0.128, P = 0.025), daily drinking (β = 0.203, P = 0.006), and depressive symptoms (β = 0.139, P = 0.008) were associated with total score of the IES-R-J among men. Moreover, for the IES-R-J subscale, leg extension power was also negatively associated with Intrusion (β = -0.114, P = 0.045) and Hyperarousal (β = -0.163, P = 0.004) after adjusting for all other significant variables. For women, hypertension (β = 0.226, P = 0.032) and depressive symptoms (β = 0.205, P = 0.046) were associated with the total score of the IES-R-J.Leg extension power is a potentially modifiable pre-disaster risk factor among men for attenuating the severity of PTSD symptoms associated with great disasters such as the Great East Japan Earthquake among men.",0,0 +3161,Post-traumatic stress disorder symptoms in first-time myocardial infarction patients: roles of attachment and alexithymia,"To explore the roles of attachment and alexithymia in the severity of post-traumatic stress disorder symptoms and to specify the relationship between sub-dimensions of attachment, alexithymia and posttraumatic stress disorder symptoms in patients with first-time myocardial infarction in mainland China.Patients experiencing myocardial infarction have a risk of developing post-traumatic stress disorder symptoms. However, there have been few studies on the roles of attachment and alexithymia.A cross-sectional survey design.Ninety-seven patients participated in the assessment of post-traumatic stress disorder symptoms, attachment and alexithymia from June-December in 2012. To assess post-traumatic stress disorder symptoms and their correlates, we administered the Post-traumatic Stress Disorder Checklist-Civilian Version, the 20-item Toronto Alexithymia Scale and the Experiences in Close Relationships Scale 5-17 days after the remission of first myocardial infarction attack.Twenty-five (25·77%) patients met the criteria of posttraumatic stress disorder symptoms. Greater attachment anxiety and avoidance were associated with more severe posttraumatic stress disorder symptoms. Except for externally oriented thinking, all dimensions of alexithymia were significantly correlated with post-traumatic stress symptoms. In the regression model, attachment anxiety and difficulties identifying feelings were found to be predictive and the total regression equation explained 24·2% variance of posttraumatic stress disorder symptoms among myocardial infarction patients.First-time myocardial infarction patients were at risk of developing posttraumatic stress disorder symptoms. Attachment anxiety and difficulties identifying feelings were positively associated with posttraumatic stress disorder symptoms in the early stage of myocardial infarction rehabilitation. It is essential to evaluate the causal relationship between attachment, alexithymia and posttraumatic stress disorder symptoms in longitudinal studies.",0,0 +3162,Post-traumatic stress disorder among people exposed to the Ventotene street disaster in Rome,"To test five hypotheses on Post-traumatic stress disorder (PTSD): 1) Is PTSD the most prevalent disorder after trauma? 2) Is the proximity to the disaster related to the risk of PTSD? 3) Is PTSD associated with child mourning or separation, previous stress, or familiarity for psychiatric disorders? 4) Does the exposition to trauma increase substance abuse or somatization? 5) Can episodic trauma cause long-lasting psychiatric morbidity?Clinical assessment of subjects exposed to an explosion in a building caused by a gas-leak. Best estimate clinical diagnoses were made according to DSM-IV-TR criteria. The Zung Depression Rating Scale, the Zung Anxiety Rating Scale, and the Clinician Administered Post Traumatic Stress Disorder Scale were used in the clinical assessment. Statistical analysis was performed by means of t-test with Bonferroni's correction on continuous variables and chi2 or Fisher test on categorical variables.PTSD was the most prevalent disorder after trauma, diagnosed in 32 (36.8%) subjects. The subjects who had not seen dead or injured people were more likely to receive no psychiatric diagnosis. Civil status, parenthood, death of relatives in the disaster, personal injuries, history of child mourning or separation, of previous stress, as well as familiarity for any psychiatric disorder or substance use disorder were not related with the rate of ascertained psychiatric diagnoses. Nearly two years after trauma, most of patients who had suffered PTSD still met PTSD criteria.The 1st and the 5th hypotheses were corroborated, the 3rd and the 4th hypotheses were not confirmed. The 2nd hypothesis was partially confirmed.",0,0 +3163,Mental health and resiliency following 44 months of terrorism: a survey of an Israeli national representative sample,"Israeli citizens have been exposed to intense and ongoing terrorism since September 2000. We previously studied the mental health impact of terrorism on the Israeli population (Bleich et al., 2002), however the long-term impact of ongoing terrorism has not yet been examined. The present study evaluated the psychological sequelae of 44 months of terrorism in Israel, and sought to identify factors that may contribute to vulnerability and resilience.This was a telephone survey using strata sampling of 828 households, which reached a representative sample of 702 adult Israeli residents (84.8% contact rate). In total, 501 people (60.5%) agreed to participate. The methodology was similar to that of our previous study. Exposure to terrorism and other traumatic events, number of traumatic stress-related symptoms (TSRS), percentage of respondents with symptom criteria for post-traumatic stress disorder (PTSD), traumatic stress (TS) resiliency and feelings of depression, anxiety, optimism, sense of safety, and help-seeking were the main outcome measures.In total, 56 participants (11.2%) were directly exposed to a terrorist incident, and 101 (20.2%) had family members or friends exposed. Respondents reported a mean +/- SD of 5.0 +/- 4.5 TSRS; 45 (9%) met symptom criteria for PTSD; and 72 (14.4%) were TS-resilient. There were 147 participants (29.5%) who felt depressed, 50 (10.4%) felt anxious, and almost half (235; 47%) felt life-threatening danger; 48 (9.7%) felt the need for professional help. Women and people of Arab ethnicity had more TSRS, more PTSD, and less TS resiliency. Injury following a life-threatening experience, a major stressful life event, and a major loss of income were associated with PTSD. Immigrant status, lower education, low sense of safety, low sense of social support, high societal distress, and injury following life-threatening experiences were associated with TSRS. TSRS did not increase with exposure severity. This study revealed less depression and functional impairment, similar rates of PTSD, increased help-seeking and poorer TSRS and TS resiliency than our initial study, 2 years previously.The response of people in Israel to 4 years of terrorism is heterogeneous. Vulnerability factors change over time; Arab ethnicity, immigrant status and less education, not found to be risk factors in our previous study, were found in the present study to contribute to trauma-related distress. Prior experience of highly stressful events increases vulnerability to adverse psychological effects of terror.",0,0 +3164,Toward an Empirical Definition of Pediatric PTSD: The Phenomenology of PTSD Symptoms in Youth,"To examine the frequency and intensity of posttraumatic stress disorder (PTSD) symptoms and their relation to clinical impairment, to examine the requirement of meeting all DSM-IV symptom cluster criteria (i.e., criteria B, C, D), and to examine the aggregation of PTSD symptom clusters across developmental stages.Fifty-nine children between the ages of 7 and 14 years with a history of trauma and PTSD symptoms were assessed with the Clinician-Administered PTSD Scale for Children and Adolescents.Data support the utility of distinguishing between the frequency and the intensity of symptoms in the investigation of the phenomenology of pediatric PTSD. Children fulfilling requirements for two symptom clusters did not differ significantly from children meeting all three cluster criteria with regard to impairment and distress. Reexperience (cluster B) showed increased aggregation with avoidance and numbing (cluster C) and hyperarousal (cluster D) in the later stages of puberty.Frequency and intensity of symptoms may both contribute to the phenomenology of pediatric PTSD. Children with subthreshold criteria for PTSD demonstrate substantial functional impairment and distress.",0,0 +3165,"Associations between Post-Traumatic Stress Symptoms, Stimulant Use, and Treatment Outcomes: A Secondary Analysis of NIDA's Women and Trauma Study","Background and Objectives To examine the associations between post-traumatic stress disorder (PTSD) symptoms, stimulant use, and treatment outcomes among dually diagnosed women. Methods Participants were 141 women who participated in a multisite clinical trial of group treatments for PTSD and addictions. Results Generalized linear models indicated Seeking Safety (SS; a cognitive-behavioral intervention) was significantly more effective than Women's Health Education (WHE; a control group intervention) in reducing stimulant use at follow-up among women who were heavy stimulant users at pre-treatment and who showed improvements in PTSD symptoms. There were no significant differences between the interventions among women who were light stimulant users at treatment entry. Conclusions and Scientific Significance These findings suggest that integrated treatment of co-occurring PTSD and addictions may be more effective than general health education approaches for heavy stimulant users. Assessment of frequency of stimulant use among individuals with PTSD symptoms may inform treatment selection for this population. (Am J Addict 2014;23:90–95)",0,0 +3166,The co-occurrence of PTSD and dissociation: differentiating severe PTSD from dissociative-PTSD,"A dissociative-posttraumatic stress disorder (PTSD) subtype has been included in the DSM-5. However, it is not yet clear whether certain socio-demographic characteristics or psychological/clinical constructs such as comorbid psychopathology differentiate between severe PTSD and dissociative-PTSD. The current study investigated the existence of a dissociative-PTSD subtype and explored whether a number of trauma and clinical covariates could differentiate between severe PTSD alone and dissociative-PTSD.The current study utilized a sample of 432 treatment seeking Canadian military veterans. Participants were assessed with the Clinician Administered PTSD Scale (CAPS) and self-report measures of traumatic life events, depression, and anxiety. CAPS severity scores were created reflecting the sum of the frequency and intensity items from each of the 17 PTSD and 3 dissociation items. The CAPS severity scores were used as indicators in a latent profile analysis (LPA) to investigate the existence of a dissociative-PTSD subtype. Subsequently, several covariates were added to the model to explore differences between severe PTSD alone and dissociative-PTSD.The LPA identified five classes: one of which constituted a severe PTSD group (30.5 %), and one of which constituted a dissociative-PTSD group (13.7 %). None of the included, demographic, trauma, or clinical covariates were significantly predictive of membership in the dissociative-PTSD group compared to the severe PTSD group.In conclusion, a significant proportion of individuals report high levels of dissociation alongside their PTSD, which constitutes a dissociative-PTSD subtype. Further investigation is needed to identify which factors may increase or decrease the likelihood of membership in a dissociative-PTSD subtype group compared to a severe PTSD only group.",0,0 +3167,Paranoia and post-traumatic stress disorder in the months after a physical assault: a longitudinal study examining shared and differential predictors,"Background Being physically assaulted is known to increase the risk of the occurrence of post-traumatic stress disorder (PTSD) symptoms but it may also skew judgements about the intentions of other people. The objectives of the study were to assess paranoia and PTSD after an assault and to test whether theory-derived cognitive factors predicted the persistence of these problems. Method At 4 weeks after hospital attendance due to an assault, 106 people were assessed on multiple symptom measures (including virtual reality) and cognitive factors from models of paranoia and PTSD. The symptom measures were repeated 3 and 6 months later. Results Factor analysis indicated that paranoia and PTSD were distinct experiences, though positively correlated. At 4 weeks, 33% of participants met diagnostic criteria for PTSD, falling to 16% at follow-up. Of the group at the first assessment, 80% reported that since the assault they were excessively fearful of other people, which over time fell to 66%. Almost all the cognitive factors (including information-processing style during the trauma, mental defeat, qualities of unwanted memories, self-blame, negative thoughts about self, worry, safety behaviours, anomalous internal experiences and cognitive inflexibility) predicted later paranoia and PTSD, but there was little evidence of differential prediction. Conclusions Paranoia after an assault may be common and distinguishable from PTSD but predicted by a strikingly similar range of factors.",0,0 +3168,Resilience in the Face of Potential Trauma,"Until recently, resilience among adults exposed to potentially traumatic events was thought to occur rarely and in either pathological or exceptionally healthy individuals. Recent research indicates, however, that the most common reaction among adults exposed to such events is a relatively stable pattern of healthy functioning coupled with the enduring capacity for positive emotion and generative experiences. A surprising finding is that there is no single resilient type. Rather, there appear to be multiple and sometimes unexpected ways to be resilient, and sometimes resilience is achieved by means that are not fully adaptive under normal circumstances. For example, people who characteristically use self-enhancing biases often incur social liabilities but show resilient outcomes when confronted with extreme adversity. Directions for further research are considered.",0,0 +3169,Comparison of long-term outcomes following traumatic injury: What is the unique experience for those with brain injury compared with orthopaedic injury?,"

Abstract

Objective

Whilst it has been well-demonstrated that traumatic brain injury (TBI) results in long-term cognitive, behavioural and emotional difficulties, less is understood about how these outcomes differ from those following traumatic orthopaedic injury (TOI). The aim of this study was to compare self-reported outcomes at 5–10 years post-injury for those with TBI, TOI, and uninjured controls. It was hypothesised that participants with TBI would have greater cognitive difficulties; participants with TOI and TBI would have similar functional and physical outcomes, both being poorer than controls; and participants with TBI would have poorer psychosocial outcomes than those with TOI.

Participants and methods

Eighty-eight individuals with complicated mild to severe TBI and 96 with TOI recruited during inpatient rehabilitation were followed up 5–10 years post-injury, together with 48 controls followed over a similar period. Self-report measures of global functioning (GOS-E), quality of life (SF-36), psychological wellbeing (SCL-90-R, HADS, PCL-S), psychosocial difficulties (SIP), cognitive difficulties (SF-36 COG), pain (BPI), and fatigue (FSS) were administered.

Results

Outcomes for individuals with TBI and TOI differed significantly from controls, with poorer global functioning, and greater psychological distress and interference from pain. Only participants with TBI reported greater cognitive difficulties and anxiety than controls, and were less likely to be employed or in a relationship. Participants with TBI reported greater anxiety, PTSD, psychological distress and psychosocial difficulties than those with TOI.

Conclusions

Both TOI and TBI cause long-term disability, interference from pain, and psychological distress. However, cognitive impairments, unemployment, lack of long-term relationships, anxiety and PTSD are more substantial long-term problems following TBI. Findings from this study have implications for managing risks associated with these injury groups and tailoring rehabilitation to improve long-term outcomes.",0,0 +3170,Subthreshold post traumatic stress disorder in the survivors of Marmara earthquake,"This study was conducted in order to determine the symptom profile and risk factors associated with subthreshold post traumatic stress disorder (PTSD). It was conducted in 1316 subjects who had experienced the Marmara Earthquake. The data collected included socio-demographic features, experiences during the earthquake and risk factors associated with trauma. The subjects who have at least one symptom in each of the B, C or D clusters in DSM-IV PTSD diagnostic criteria were accepted as ""subthreshold PTSD"". It was found that the prevalence of full PTSD and subthreshold PTSD was 13.8% and 28.0%, respectively. Female gender, excessive horror during the earthquake, damage to the home, being trapped under the rubble, loss of loved ones, and preexisting alcohol abuse were found to be the risk factors both for full PTSD and subthreshold PTSD. People with subthreshold PTSD seem to have similarities with full PTSD patients, as regards socio-demographic features, risk factors and functional impairment. It is concluded that the need for treatment of subthreshold PTSD patients should be considered. (",0,0 +3171,The younger sibling of PTSD: similarities and differences between complicated grief and posttraumatic stress disorder,"Just as traumatic experiences may lead to posttraumatic stress disorder (PTSD) in some individuals, grief may also be a serious health concern for individuals who have experienced bereavement. At present, neither the DSM-IV nor the ICD-10 recognizes any form of grief as a mental disorder. The aim of this review is to summarize recent advances in definition, assessment, prevention, and treatment of complicated grief disorder (CGD) and to compare CGD with PTSD. Four areas are identified to be of importance to clinicians and researchers: (a) the recently proposed consensus criteria of CGD for DSM-V and ICD-11, (b) available assessment instruments, (c) recent prevention and treatment techniques and related effectiveness studies, and (d) emerging disorder models and research on risks and protective factors. This review focuses on the similarities and differences between CGD and PTSD and highlights how a PTSD-related understanding aids the investigation and clinical management of CGD.",0,0 +3172,Increased Polysedative Use in Veterans with Posttraumatic Stress Disorder,"Posttraumatic stress disorder (PTSD) treatment is often complicated in veterans by co-occurring conditions including pain, insomnia, brain injury, and other mental disorders. Pharmacologic approaches to these conditions can produce an accumulation of sedating medications with potential for safety concerns.The objective of this study was to characterize polysedative prescribing among veterans with PTSD over an 8-year period.National Department of Veterans Affairs (VA) data were used to identify veterans with PTSD using International Classification of Diseases, Ninth Revision codes among regular medication users. Prescribing of benzodiazepines, hypnotics, atypical antipsychotics, opioids, and muscle relaxants was determined annually. Prevalence and incidence rates were determined for each medication class from 2004 through 2011. Polysedative use was determined from longitudinal refill patterns that indicated concurrent use across sedative classes.In 2004, 9.8% of veterans with PTSD concurrently received medications from three or more sedative classes. By 2011, the prevalence of concurrent use involving three or more classes increased to 12.1%. Polysedative use varied across demographic subgroups, with higher rates observed among women, rural residents, younger adults, Native Americans and Whites. The most common combination was an opioid plus a benzodiazepine, taken concurrently by 15.9% of veterans with PTSD.Important trends in polysedative use among veterans with PTSD illustrate the complexity of treating an intersecting cluster of symptoms managed by sedative medications. As the VA seeks to improve care by focusing on non-pharmacologic options, our findings emphasize the need for a comprehensive approach that encompasses overlapping conditions of relevance to veterans with PTSD.",0,0 +3173,Antipsychotic Medication Utilization Trends Among Texas Veterans: 1997–2002,"Background An antipsychotic utilization pattern has evolved substantially over the past 20 years or so due to the introduction of the second-generation antipsychotics (SGAs) and the increasing understanding of their adverse effect profile. Objective To understand antipsychotic utilization trends (including monotherapy, antipsychotic switching, and combination therapy) and to investigate factors associated with antipsychotic index medication selection (SGAs vs first-generation antipsychotics [FGAs]) among Texas veterans. Methods Data were taken from the Veterans Administration North Texas Health Care System (VANTHCS) and South Texas Veterans Health Care System (STVHCS) from January 1996 to December 2003. Adults with continuous enrollment (1 y before and after the Index date) who had newly initiated antipsychotic therapy were included. Prescriptions were followed for up to 12 months. Descriptive analyses examined utilization trends; logistic regression evaluated factors associated with antipsychotic index medication selection. Results: A total of 8096 patients were included in the study (VANTHCS n = 4477; STVHCS n = 3619), with the majority being male (93.6%) and white (62.6%) and nearly naif aged 55 years or older (44.1%). Between 1997 and 2002, antipsychotic prescriptions changed from primarily FGAs (1997:71.7%; 1999; 25.2%; 2002: 5.7%) to SGAs. Over the 6-year time frame, risperidone (31.0%) and olanzapine (30.7%) were most commonly prescribed. The overall combination therapy slightly increased over time (4.3%), switching to another antipsychotic remained stable (14.2%), and antipsychotic monotherapy remained dominant (81.5%). Hispanic and black patients were less likely than white patients to be initiated on SGAs. Patients who were older, had hypertension, and were in STVHCS were less likely to start on SGAs. Patients with dyslipidemia, bipolar disorder, and treatment in recent years were more likely to start on SGAs Conclusions: SGAs have replaced FGAs as first-line medications for patients with mental disorders. Race, age, physical comorbidities (ie, dyslipidemia, hypertension), and treatment initiation year were important factors in index medication selection.",0,0 +3174,Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis,"The WHO International Classification of Diseases, 11th version (ICD-11), has proposed two related diagnoses, posttraumatic stress disorder (PTSD) and complex PTSD within the spectrum of trauma and stress-related disorders.To use latent profile analysis (LPA) to determine whether there are classes of individuals that are distinguishable according to the PTSD and complex PTSD symptom profiles and to identify potential differences in the type of stressor and severity of impairment associated with each profile.An LPA and related analyses were conducted on 302 individuals who had sought treatment for interpersonal traumas ranging from chronic trauma (e.g., childhood abuse) to single-incident events (e.g., exposure to 9/11 attacks).THE LPA REVEALED THREE CLASSES OF INDIVIDUALS: (1) a complex PTSD class defined by elevated PTSD symptoms as well as disturbances in three domains of self-organization: affective dysregulation, negative self-concept, and interpersonal problems; (2) a PTSD class defined by elevated PTSD symptoms but low scores on the three self-organization symptom domains; and (3) a low symptom class defined by low scores on all symptoms and problems. Chronic trauma was more strongly predictive of complex PTSD than PTSD and, conversely, single-event trauma was more strongly predictive of PTSD. In addition, complex PTSD was associated with greater impairment than PTSD. The LPA analysis was completed both with and without individuals with borderline personality disorder (BPD) yielding identical results, suggesting the stability of these classes regardless of BPD comorbidity.Preliminary data support the proposed ICD-11 distinction between PTSD and complex PTSD and support the value of testing the clinical utility of this distinction in field trials. Replication of results is necessary.",0,0 +3175,Diagnostic utility and factor structure of the PTSD Checklist in older adults,"ABSTRACT Background: Little research has examined the diagnostic utility and factor structure of commonly used posttraumatic stress disorder (PTSD) assessment instruments in older persons. Methods: A total of 206 adults aged 60 or older (mean age = 69 years; range = 60–92), who resided in the Galveston Bay area when Hurricane Ike struck in September 2008, completed a computer-assisted telephone interview two–five months after this disaster. Using the PTSD Checklist (PCL), PTSD symptoms were assessed related both to this disaster and to participants’ worst lifetime traumatic event. Total PCL scores were compared to PCL-based, Diagnostic and Statistical Manual of Mental Disorders , 4th edition (DSM-IV)-derived probable diagnoses of PTSD to determine optimal cut scores. Confirmatory factor analyses (CFAs) were conducted to evaluate PTSD symptom structure. Results: Receiver operating characteristic analyses indicated that a PCL score of 39 achieved optimal sensitivity and specificity in assessing a PCL-based, algorithm-derived DSM-IV diagnosis of worst event-related PTSD; and that a score of 37 optimally assessed probable Ike-related PTSD. CFAs revealed that a recently proposed five-factor model – comprised of re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal factors – provided a better fitting representation of both worst event- and disaster-related PTSD symptoms than alternative models. Current Ike-related anxious arousal symptoms demonstrated a significantly stronger association with current generalized anxiety than depressive symptoms, thereby supporting the construct validity of this five-factor model of PTSD symptomatology. Conclusions: A PCL score of 37 to 39 may help identify probable PTSD in older persons. The expression of PTSD symptoms in older adults may be best characterized by a recently proposed five-factor model with distinct dysphoric arousal and anxious arousal clusters.",0,0 +3176,The looming maladaptive style predicts shared variance in anxiety disorder symptoms: further support for a cognitive model of vulnerability to anxiety,"Looming vulnerability pertains to a distinct cognitive phenomenology characterized by mental representations of dynamically intensifying danger and rapidly rising risk as one projects the self into an anticipated future [J. Pers. Soc. Psychol. 79 (2000) 837]. While looming appraisals can be experienced as state elicitation, some individuals are hypothesized to develop an enduring cognitive pattern of cross-situational looming appraisals, the looming maladaptive style (LMS), which functions as a cognitive vulnerability to anxiety. In the present study, we examined the extent to which the LMS predicts common variance in numerous anxiety disorder symptoms, independent of the potentially confounding effects of current depressive symptoms. Specifically, we hypothesized that controlling for depressive symptoms, LMS would predict shared variance in a latent factor comprised of indicators of five anxiety disorder symptoms: obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, social phobia, and specific phobic fears. Measures of these anxiety disorder symptoms, depressive symptoms, and looming vulnerability were administered to unselected college student population. Structural equations modeling analyses provided support for our hypothesis that LMS predicts shared variance in anxiety disorder symptoms and suggest that this cognitive style may be an overarching dimension of vulnerability to anxiety.",0,0 +3177,Post concussion syndrome ebb and flow: Longitudinal effects and management,"This research identified persistent post concussion symptoms (PCS) in a group of 20 adult subjects. PCS generally lasted for two years with a mean of 3.35 years. Typical symptoms included physical and cognitive fatigue, depressive behaviors, sensitivity to noise, social withdrawal, irritability, concentration and problem solving difficulties, loss of libido and much difficulty making decisions at even the simplest strategic level. They represented a hard core group for whom the original symptoms persisted well beyond the 6~month period. Participants identified their PCS according to sensory, somatic affective and cognitive items immediately following their trauma (01) and two years later (02). Counseling and psychotherapy intervention took place between 01 and 02. Items on the PCS schedules and the Beck Depression Inventory (II) demonstrated significant decline in the presence of overall symptoms most noticeably in reduction of agitation, irritability and suicidal wishes. However, subjects throughout generally experienced the feeling that they were being punished which equated with behaviors comparable with learned helplessness. The PCS group considered themselves to be different people after trauma. They had different goals, changing lifestyle, relationships and employment and were more often in a dependent state. Comparability with other conditions such as PTSD and chronic fatigue syndrome (CFS) was demonstrated by individuals who experienced persistent and invasive post concussion symptoms.",0,0 +3178,Trauma and victims: epidemiology of post-traumatic stress disorder,"Riassunto Scopo - Presentare una esaustiva review degli studi riguardanti l'epidemiologia del DPTS condotti nella popolazione generale, tra i soggetti a rischio, e, infine, tra gruppi clinicamente selezionati. Disegno - Attraverso Excepta Medica Psychiatry CD-ROM 1980-1993 (ottobre), utilizzando come parola chiave «Post-Traumatic Stress Disorder», sono stati identificati 1.057 articoli pubblicati nel periodo considerate Sono stati anche consultati altri data base della letteratura medica (MEDLINE CD-ROM 1988-1993); è stata quindi operata una ricerca manuale su tutti i numeri del Journal of Traumatic Stress. Risultati - In totale, 135 lavori che hanno soddisfatto i criteri di inclusione prescelti sono stati inclusi nella review. I due terzi (n = 86, 64%) di queste ricerche sono state condotte negli USA. Solo 8 (6%) sono le indagini effettivamente realizzate nei paesi del Terzo Mondo. L'ampiezza del campione varia da un minimo di 11 soggetti, numero riscontrato in due studi, sino ad un massimo di 22.436, per un campione medio di 500 e mediano di 108. Per quanto attiene ai metodi di valutazione, in un terzo degli studi (n = 45, 33%), i ricercatori hanno impiegato un questionario (auto- o etero- somministrato). In un altro terzo delle ricerche elencate (n = 44, 33%) e stata somministrata un'intervista strutturata (la DIS, la SCID, o la SADS), mentre nei rimanenti studi la valutazione diagnostica si è basata o su una procedura clinica non strutturata, o sulla somministrazione di altri strumenti specifici dai quali è possibile inferire una diagnosi di DPTS (M-PTSD, IES, SCL-90-R,o pochi altri). In 77 studi (57%) i ricercatori hanno basato la loro valutazione sui criteri diagnostici propri del DSM-III, mentre in altri 55 (41%) su quelli del DSM-III-R. La prevalenza del DPTS e analizzata quindi separatamente per le diverse popolazioni studiate. Conclusioni - Nell'arco di soli 13 anni, a partire cioe dalla definizione di criteri diagnostici operazionali ben definiti per il DPTS, sono stati condotti numerosi studi volti ad indagare la prevalenza, i fattori di rischio, la storia naturale, il decorso e l' esito di questo disturbo tra campioni diversi di popolazioni a rischio; inoltre, anche il livello qualitativo di queste ricerche, per quanto attiene alia sofisticazione metodologica, si è accresciuto sensibilmente in un tempo tutto sommato breve. Molte aree, pero', restano tuttora inesplorate, ed inoltre appare imperativo avviare ricerche estensive tra le popolazioni dei paesi in via di sviluppo, maggiormente esposte a disastri naturali o provocati dall'uomo.",0,0 +3179,Treatment of post traumatic stress disorder symptoms in emotionally distressed individuals,"Older individuals with emotional distress and a history of psychologic trauma are at risk for post traumatic stress disorder (PTSD) and major depression. This study was an exploratory, secondary analysis of data from the study ""Prevention of Depression in Older African Americans"". It examined whether Problem Solving Therapy-Primary Care (PST-PC) would lead to improvement in PTSD symptoms in patients with subsyndromal depression and a history of psychologic trauma. The control condition was dietary education (DIET). Participants (n=60) were age 50 or older with scores on the Center for Epidemiologic Studies-Depression scale of 11 or greater and history of psychologic trauma. Exclusions stipulated no major depression and substance dependence within a year. Participants were randomized to 6-8 sessions of either PST-PC or DIET and followed 2 years with booster sessions every 6 months; 29 participants were in the PST-PC group and 31 were in the DIET group. Mixed effects models showed that improvement of PTSD Check List scores was significantly greater in the DIET group over two years than in the PST-PC group (based on a group time interaction). We observed no intervention⁎time interactions in Beck Depression Inventory or Brief Symptom Inventory-Anxiety subscale scores.",0,0 +3180,Subtypes of Clinical Presentations in Malingerers of Posttraumatic Stress Disorder: An MMPI-2 Cluster Analysis,"This paper investigated subtypes of individuals trained and instructed to malinger Posttraumatic Stress Disorder (PTSD) through a cluster analysis of their Minnesota Multiphasic Personality Inventory-2 (MMPI-2) clinical and validity scales. Participants were 84 men and women college students at a community college in the southeastern United States. Two well fitting MMPI-2 cluster solutions were evaluated with discriminant analyses and multivariate analyses of variance (MANOVAs); a 2-cluster solution was deemed optimal. Significant between-cluster differences emerged in follow-up analyses on most of the content scales of the MMPI-2. Most demographic variables did not account for differences in cluster membership. Clusters differed in their reported clarity of the materials used to educate them about PTSD. Discriminant analyses yielded better correct classification rates than those from previous studies, when the more severely symptomatic cluster was compared with a sample of clinical combat-related PTSD veterans. Implications are considered in conducting future malingered PTSD investigations.",0,0 +3181,Risk Factors for Posttraumatic Stress Symptomatology in Police Officers: A Prospective Analysis,"This study examines internal and external risk factors for posttraumatic stress symptoms in 262 traumatized police officers. Results show that 7% of the entire sample had PTSD, as established by means of a structured interview; 34% had posttraumatic stress symptoms or subthreshold PTSD. Trauma severity was the only predictor of posttraumatic stress symptoms identified at both 3 and 12 months posttrauma. At 3 months posttrauma, symptomatology was further predicted by introversion, difficulty in expressing feelings, emotional exhaustion at time of trauma, insufficient time allowed by employer for coming to terms with the trauma, dissatisfaction with organizational support, and insecure job future. At 12 months posttrauma, posttraumatic stress symptoms were further predicted by lack of hobbies, acute hyperarousal, subsequent traumatic events, job dissatisfaction, brooding over work, and lack of social interaction support in the private sphere. Implications of the findings regarding organizational risk factors are discussed in the light of possible occupational health interventions.",0,0 +3182,Post-Traumatic Stress Disorder: Some Diagnostic and Clinical Issues,"The development of post-traumatic stress disorder (PTSD) in a group of 42 individuals exposed to a multiple homicide was examined. A comparison of DSM-III and DSM-III-R indicated that 74% qualified for a diagnosis of PTSD using DSM-III, but only 33% met the criteria outlined in DSM-III-R. The most commonly reported symptoms were found to be intrusive recollections of the event and exaggerated startle response. In general, those symptoms that are new additions in the revised version were the least frequently reported, whilst guilt, which has been excluded from DSM-III-R, was experienced by 38% of the sample. It is suggested that the new criteria may not cluster with the core syndrome of PTSD.",0,0 +3183,Risk and Protective Factors for Psychopathology Among Older versus Younger Adults After the 2004 Florida Hurricanes,"Previous research demonstrates increased resiliency to psychopathology after disasters among older adults. However, little is known about differences in age-based risk and protective factors for postdisaster mental illness.The authors used random-digit dialing methodology to survey 1,130 older adults (60+ years) and 413 younger adults residing in Florida counties directly affected by the 2004 hurricanes. Assessed risk and protective factors included demographics, social support, displacement, incurred dollar losses, perceived positive outcomes, and self-rated health status. Outcome variables included symptom counts of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-defined posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD).Older adults reported fewer symptoms of PTSD, MDD, and GAD. Explanatory risk variables accounted for large proportions of variance, but differed in meaningful ways across age groups.Although older adults are less symptomatic, their psychologic reactions appear more closely connected to economic consequences of disasters.",0,0 +3184,The Consequences of Violence on the Mental Health of the Elderly,"This chapter reviews the prevalence and risk factors associated with violence during the life course of the elderly, including its short and long-term consequences. As violence is highly prevalent in many societies individuals who have been exposed to violence have also grown old. There is limited knowledge about the long-term implications of early exposure into late life. Elder abuse has become a major issue in public health; however, the elderly are also victims to crime, war, atrocities in society, and trauma from disasters. The mental health implications of exposure to violence are reviewed, in particular post-traumatic stress disorder. Controlled studies on treatment of older individuals exposed to violence are rare. The findings suggest that exposure to violence in childhood, as a young adult or as an elder all have adverse effects on mental health in old age. The trajectory of these mental health outcomes suggests that the elderly may have a path of resilience. © Springer Science+Business Media Dordrecht 2015",0,0 +3185,"Post-traumatic stress disorder symptoms, underlying affective vulnerabilities, and smoking for affect regulation","Post-traumatic stress disorder (PTSD) is overrepresented among cigarette smokers. It has been hypothesized that those with PTSD smoke to alleviate negative affect and counteract deficient positive affect commonly associated with the disorder; however, limited research has examined associations between PTSD symptoms, smoking motives, and affective vulnerability factors. In the current study, we examined (1) whether PTSD symptoms were associated with positive reinforcement and negative reinforcement smoking motives; and (2) whether two affective vulnerability factors implicated in PTSD-anxiety sensitivity and anhedonia-mediated relationships between PTSD symptoms and smoking motives.Data were drawn from a community sample of non-treatment-seeking smokers recruited without regard for trauma history (N = 342; 10+ cig/day). We used the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) to assess overall PTSD symptom severity as well as individual PTSD subfactors.Overall, PTSD symptom severity was significantly associated with negative reinforcement, but not positive reinforcement, smoking motives. Variation in anxiety sensitivity significantly mediated the relation between PTSD symptom severity and negative reinforcement smoking motives, whereas anhedonia did not. Regarding PTSD subfactors, emotional numbing was the only PTSD subfactor associated with smoking rate, while re-experiencing symptoms were uniquely associated with both positive reinforcement and negative reinforcement smoking motives.Findings suggest that anxiety sensitivity may be an important feature associated with PTSD that enhances motivation to smoke for negative reinforcement purposes. Smoking cessation interventions that alleviate anxiety sensitivity and enhance coping with negative affect may be useful for smokers with elevated PTSD symptoms.",0,0 +3186,Review of sertraline and its clinical applications in psychiatric disorders,"Sertraline (Zoloft, Pfizer) has been shown in numerous controlled studies to have similar efficacy to other selective serotonin (5-HT) re-uptake inhibitors (SSRIs) in the treatment of depression and anxiety disorders. Further research is indicating that the efficacy of sertraline extends even beyond the treatment of depression and anxiety to include utility in eating disorders, premenstrual dysphoric disorder (PMDD) and possibly substance abuse treatment. Along with other SSRIs, sertraline offers several advantages over older antidepressants, including improved patient tolerability, low risk of lethality in overdose and no dependence potential. In head-to-head comparisons, sertraline appears to be at least as well-tolerated as other SSRIs and may even have a more favourable side effect profile. Low potential for pharmacokinetic drug interactions is another advantage of sertraline. Unlike fluoxetine, fluvoxamine and paroxetine, sertraline is not a potent inhibitor of any of the cytochrome P450 isoenzyme systems. As a result of its proven efficacy, good tolerability and lack of pharmacokinetic interactions, sertraline should be considered first-line in the treatment of anxiety and depressive disorders.",0,0 +3187,Pain Descriptors Used by Military Personnel Deployed to Iraq and Afghanistan Following Combat-Related Blast Experience,"Pain complaints are highly prevalent among military personnel of the combat operations in Iraq and Afghanistan, due, in part, to blast-related injuries. Further, pain often co-occurs with condition...",0,0 +3188,"Contribution of cognitive factors to the prediction of post-traumatic stress disorder, phobia and depression after motor vehicle accidents","Past research into the psychological consequences of traumatic events has largely focused on post-traumatic stress disorder (PTSD), although other anxiety disorders and depression are also common in the aftermath of trauma. Little is known about differential predictors of these conditions. The present study investigated the extent to which theoretically derived cognitive variables predict PTSD, phobias and depression after motor vehicle accidents. The cognitive predictors were compared to a set of established, mainly non-cognitive predictors. In addition, we tested how disorder-specific the cognitive predictors are. Participants (n=101) were interviewed within a year after having been injured in a motor vehicle accident. Diagnoses of PTSD, travel phobias and depression, symptom severities and predictor variables were assessed with self-report questionnaires and structured interviews. In multiple regression analyses, the sets of cognitive variables derived from disorder-specific models explained significantly greater proportions of the variance of the symptom severities than the established predictors (PTSD 76% vs. 45%, depression 72% vs. 46% and phobia 66% vs. 40%), and than cognitive variables derived from the models of the other disorders. In addition, the majority of individual cognitive variables showed the expected pattern of differences between diagnostic groups. The results support the hypothesis that disorder-specific sets of cognitive factors contribute to the development and maintenance of PTSD, phobias and depression following traumatic events.",0,0 +3189,Posttraumatic Stress Disorder in Patients With Burns,"Among 39 patients with burns evaluated a mean of 12 months after hospital discharge, 38% met DSM-III-R criteria for post-traumatic stress disorder (PTSD) for at least 1 month. With proposed DSM-IV criteria, 43% met criteria for past or current PTSD. Analysis of specific symptom clusters of PTSD revealed that 74% of patients had been affected by a reexperience symptom for at least 1 month, but only 30% were currently experiencing flashbacks. No correlation was found between several clinical correlates (TBSA, length of hospitalization, and age) and development of PTSD. There was no correlation between presence of a DSM-III-R psychiatric diagnosis at the time of hospitalization and later development of PTSD and no correlation between whether or not a psychiatric diagnosis emerged during hospitalization and later development of PTSD. Finally, patients who had injuries that they could not prevent were no more likely to experience PTSD.",0,0 +3190,Trauma Related Guilt Inventory – psychometric properties of the Polish adaptation (TRGI-PL),"AIM : Although various aspects of guilt are frequent problems of patients suffering from PTSD, they have been included into the diagnostic criteria for PTSD just in the present version DSM-5. Kubany proposed a cognitive conceptualization of guilt in PTSD followed by development of the Trauma Related Guilt Inventory (TRGI). The aim of the paper is to present psychometric properties of the Polish version of the inventory - the TRGI-PL.A Polish adaptation of the Trauma-Related Guilt Inventory was applied to a sample of 280 motor vehicle (MVA) participants (147 females, 133 males of age from 18 to 80 (M=34,93, SD=13,71) within 1-24 months after a MVA (M=10,18, SD=6,23). Validation of the Polish version was done by analyzing the internal structure of the instrument and comparing the emotional and cognitive aspects of guilt assessed by the TRGI with PTSD symptoms, post-traumatic cognitions and responsibility for MVA and subjective agreement with the judgment.The model with four latent factors: Distress, Hindsight-Bias/Responsibility, Wrongdoing and Insufficient Justification scales showed acceptable fit (Satorra-Bentler chi2=518,62, df=203, p<0,01, RMSEA=0,079, CFI=0,96, GFI=0,97), what confirms the four-factor structure of guilt, obtained in the studies on original TRGI version. Reliability coefficients are similar to original version. Correlations with other PTSD measures showed satisfactory convergent and discriminative validity.The Polish adaptation of the Trauma-Related Guilt Inventory is a reliable and valid tool for assessing guilt as a multidimensional phenomenon, comprising emotional and several cognitive characteristics, in trauma survivors.",0,0 +3191,Post-Traumatic Stress Disorder: A Comment on the Value of ‘Mixed Trauma’ Treatment Groups,"(1996). Post-Traumatic Stress Disorder: A Comment on the Value of ‘Mixed Trauma’ Treatment Groups. Australasian Psychiatry: Vol. 4, No. 5, pp. 258-259.",0,0 +3192,The effects of preterm birth on mother-infant interaction and attachment during the infant's first two years,"Abstract Objective. Early mother–infant relationships in preterm populations were evaluated in the context of a systematic review of the literature. Design and setting. A systematic search of three electronic databases (PsychINFO, PubMed and Cochrane Library) was undertaken. Three studies of maternal attachment, 18 studies of mother–preterm infant interaction and eight studies of infant attachment were included. Studies of preterm infant attachment were also evaluated using a meta-analysis. Results. Studies of mother–preterm infant interactions showed that the differences in maternal interaction behavior between mothers of preterm infants and mothers of full-term infants seem to be most evident during the first six months of life. Differences in the preterm infant's interaction behavior seem also to continue for six months after birth. However, five of 18 studies showed an equal or even higher quality of mother–infant interaction in groups of preterm compared to groups of full-term infants. Studies of maternal and infant attachment indicated that preterm infants and their mothers are not at higher risk of insecure attachment than full-term infants and their mothers. Conclusions. The mother–preterm infant relationship is complex, and some relational patterns forecast greater psychological risk than others. It is important to decrease maternal stress and early separation in every possible way during hospitalization as well as after discharge.",0,0 +3193,Personality Assessment Inventory profiles of veterans: Differential effects of mild traumatic brain injury and psychopathology,"Objective: Neuropsychiatric complaints often accompany mild traumatic brain injury (mTBI), a common condition in post-deployed Veterans. Self-report, multi-scale personality inventories may elucidate the pattern of psychiatric distress in this cohort. This study investigated valid Personality Assessment Inventory (PAI) profiles in post-deployed Veterans. Method: Measures of psychopathology and mTBI were examined in a sample of 144 post-deployed Veterans divided into groups: healthy controls (n = 40), mTBI only (n = 31), any mental health diagnosis only (MH; n = 25), comorbid mTBI and Posttraumatic Stress Disorder (mTBI/PTSD; n = 23), and comorbid mTBI, PTSD, and other psychological diagnoses (mTBI/PTSD/MDD+; n = 25). Results: There were no significant differences between the mTBI and the control group on mean PAI subscale elevation, or number of subscale elevations above 60T or 70T. The other three groups had significantly higher overall mean scores, and more elevations above 60 and 70T compared to both controls and mTBI only. The mTBI/PTSD/MDD+ group showed the highest and most elevations. After entering demographics, PTSD, and number of other psychological diagnoses into hierarchical regressions using the entire sample, mTBI history did not predict mean PAI subscale score or number of elevations above 60T or 70T. PTSD was the only significant predictor. There were no interaction effects between mTBI and presence of PTSD, or between mTBI and total number of diagnoses. Conclusions: This study suggests that mTBI alone is not uniquely related to psychiatric distress in Veterans, but that PTSD accounts for self-reported symptom distress. © 2015, Springer Science+Business Media New York (outside the USA).",0,0 +3194,Relationship between PTSD symptomatology and nicotine dependence severity in crime victims,"Smoking rates are higher and cessation rates are lower among individuals with posttraumatic stress disorder (PTSD) compared to the general population, thus understanding the relationship between PTSD and nicotine dependence is important. In a sample of 213 participants with a crime-related trauma (109 with PTSD), the relationship between PTSD status, smoking status (smoker vs. non-smoker), substance abuse diagnosis (SUD), PTSD symptoms, and sex was assessed. SUD diagnosis was significantly related to smoking status, but PTSD symptomatology and sex were not. Among smokers (n=117), increased nicotine dependence severity was associated with being male and with increased level of PTSD avoidance symptoms. Correlations indicated that PTSD avoidance and hyperarousal symptom clusters and total PTSD symptom scores were significantly related to nicotine dependence severity in males, while PTSD symptomatology in general did not correlate with dependence severity for females. The results suggest that level of PTSD symptomatology, particularly avoidance symptoms, may be important targets for smoking cessation treatment among male smokers who have experienced a traumatic event.",0,0 +3195,PTSD symptoms as risk factors for intimate partner violence revictimization and the mediating role of victims' violent behavior,"Apart from being a consequence of intimate partner violence (IPV), posttraumatic stress disorder (PTSD) can also be a risk factor for IPV revictimization. The current study examined how each of 4 PTSD symptom clusters (reexperiencing, arousal, avoidance, and numbing) related to revictimization in a sample of 156 female help-seeking victims of IPV, recruited from various victim support services in the Netherlands. In addition, we hypothesized that victim-perpetrated IPV would mediate the relation between PTSD symptomatology and IPV revictimization. Our results show that victims' PTSD reexperiencing symptoms predict revictimization of partner violence (d = .45 for physical IPV revictimization; d = .35 for psychological IPV revictimization); the other 3 PTSD symptom clusters were not related to IPV revictimization. Furthermore, victim-perpetrated psychological IPV was found to partially mediate the relation between victims' PTSD reexperiencing symptoms and IPV revictimization (Z = 2.339, SE = 0.044, p = .019 for physical IPV revictimization, and Z = 2.197, SE = 0.038, p = .028 for psychological IPV revictimization). Findings indicate that IPV victims with higher levels of PTSD reexperiencing symptoms may be more likely to perpetrate psychological IPV themselves, which may put them at greater risk for receiving IPV in return. Based on these results, a focus on individual PTSD symptom clusters and victim behaviors seems relevant for practice and may contribute to a decrease in victims' risk for future IPV.",0,0 +3196,Expanding the Science of Resilience: Conserving Resources in the Aid of Adaptation,In considering resilience to stress there are several key organizing principles that will aid both research and understanding. Understanding resilience is critical to illumination of the stress pro...,0,0 +3197,"What predicts psychological resilience after disaster? The role of demographics, resources, and life stress.","A growing body of evidence suggests that most adults exposed to potentially traumatic events are resilient. However, research on the factors that may promote or deter adult resilience has been limited. This study examined patterns of association between resilience and various sociocontextual factors. The authors used data from a random-digit-dial phone survey (N = 2,752) conducted in the New York City area after the September 11, 2001, terrorist attack. Resilience was defined as having 1 or 0 posttraumatic stress disorder symptoms and as being associated with low levels of depression and substance use. Multivariate analyses indicated that the prevalence of resilience was uniquely predicted by participant gender, age, race/ethnicity, education, level of trauma exposure, income change, social support, frequency of chronic disease, and recent and past life stressors. Implications for future research and intervention are discussed.",0,0 +3198,"Post-traumatic stress disorder, social anxiety disorder, and depression in survivors of the Kosovo War: Experiential avoidance as a contributor to distress and quality of life","Few studies have been conducted on psychological disorders other than post-traumatic stress disorder (PTSD) in war survivors. The aim of this study was to examine PTSD, social anxiety disorder (SAD), and major depressive disorder (MDD) and their associations with distress and quality of life in 174 Albanian civilian survivors of the Kosovo War. This included testing of conceptual models suggesting that experiential avoidance might influence associations between anxiety and mood disorders with psychological functioning. Each of the three psychiatric disorders was associated with greater experiential avoidance and psychological distress, and lower quality of life. Being a refugee was associated with a higher likelihood of having SAD and MDD. We found evidence for experiential avoidance as a partial mediator of the respective effects of SAD and PTSD on quality of life; experiential avoidance did not mediate the effects of disorders on global distress. We also found support for a moderation model showing that only war survivors without SAD and low experiential avoidance reported elevated quality of life; people with either SAD or excessive reliance on experiential avoidance reported compromised, low quality of life. This is the third independent study, each using a different methodology, to find empirical support for this moderation model [Kashdan, T. B., & Breen, W. E. (2008). Social anxiety and positive emotions: a prospective examination of a self-regulatory model with tendencies to suppress or express emotions as a moderating variable. Behavior Therapy, 39, 1-12; Kashdan, T. B., & Steger, M. F. (2006). Expanding the topography of social anxiety: an experience sampling assessment of positive emotions and events, and emotion suppression. Psychological Science, 17, 120-128]. Overall, we provided initial evidence for the importance of addressing PTSD, SAD, MDD, and experiential avoidance in primarily civilian war survivors.",0,0 +3199,Differential Effects of Subtypes of Trauma Symptoms on Couples' Hypothalamus-Pituitary-Adrenal (HPA) Axis Reactivity and Recovery in Response to Interpersonal Stress,"Abstract: This article examined the relation of five subtypes of trauma symptoms to hypothalamus-pituitary-adrenal (HPA) functioning as assessed with salivary cortisol before, during, and after an experimentally induced interpersonal conflict task in 194 heterosexual young adult couples. Trauma history and symptoms were assessed through structured clinical interviews and standardized self-report measures. Hierarchical linear modeling was used to analyze the effects of trauma symptoms on trajectories of cortisol reactivity to and recovery from the interpersonal stress. Trauma-related anxiety, depression, sleep disturbances, and dissociation significantly predicted cortisol reactivity and recovery. Trauma-related anxiety, sleep disturbances, and sexual problems significantly predicted partners' cortisol reactivity to interpersonal stress.",0,0 +3200,"Trauma and Posttraumatic Stress Disorder in an Urban Xhosa Primary Care Population: Prevalence, Comorbidity, and Service Use Patterns","Despite increased awareness of the prevalence and morbidity of psychiatric illnesses, relatively few studies have been undertaken in primary care settings in the African context. The authors determined the prevalence of trauma exposure and posttraumatic stress disorder (PTSD) in a South African township primary health care clinic and assessed associated demographic factors, comorbidity, service use, service satisfaction, and quality of life. Subjects were directly interviewed using translated, standardized instruments to assess variables described. Retrospective chart analysis assessed clinician case identification and psychotropic drug-prescribing habits. Of the 201 participants, 94% reported exposure to traumatic events (mean, 3.8). Trauma was associated with single status (p =.01), and PTSD was associated with poverty and single status (p =.04). Both sexes were equally likely to develop PTSD. PTSD (current; 19.9%), depression (37%), and somatization disorder (18.4%) were the most common diagnoses. Comorbidity with PTSD was high and included depression (75%, p <.01), somatization (35%, p <.01), and panic disorder (25%, p <.01). Levels of functional impairment were higher for subjects with PTSD, depression, and somatization than for those without (p <.05). PTSD comorbid with depression compounded impairment (p =.04). Levels of trauma, PTSD, and depression did not increase service use or dissatisfaction with services. Clinicians did not identify trauma (0%) or psychopathology (0%), and psychotropic medication was prescribed for only 1% of participants. In this population, trauma and PTSD were highly prevalent and associated with significant unidentified morbidity and comorbidity. Patients remain untreated for years in the current system of primary care consultations.",0,0 +3201,The impact of ecological momentary assessment on posttraumatic stress symptom trajectory,"Ecological momentary assessment includes continuous, real-time gathering of self-report data in a participant's natural environment. The current study evaluated the possible impact of this assessment strategy on severity of posttraumatic stress (PTS) in a sample of participants who reported experiencing a past traumatic event. Participants with clinically elevated PTS symptoms reported symptom severity at three time-points: during an initial screening, following an unmonitored period, and following two weeks of monitoring. During the monitoring period, participants carried an Android device which prompted them to report PTS symptoms and negative emotions six times daily. PTS severity scores were then compared across these three time-points. Results indicated that participating in the ecological momentary assessment protocol was associated with a significant reduction in PTS severity, whereas significant changes were not noted over the unmonitored control condition. The authors conclude that ecological momentary assessment may have therapeutic value even when not combined with formal intervention, and it may be a useful tool for improving the efficiency of a stepped-care approach to treating PTS symptoms.",0,0 +3202,Long-Term Positive and Negative Psychological Late Effects for Parents of Childhood Cancer Survivors: A Systematic Review,"Increasing survival rates in childhood cancer have yielded a growing population of parents of childhood cancer survivors (CCSs). This systematic review compiles the literature on positive and negative long-term psychological late effects for parents of CCSs, reported at least five years after the child's diagnosis and/or two years after the end of the child's treatment. Systematic searches were made in the databases CINAHL, EMBASE, PsycINFO, and PubMed. Fifteen studies, published between 1988 and 2010, from 12 projects were included. Thirteen studies used quantitative methodology, one quantitative and qualitative methodology, and one qualitative methodology. A total of 1045 parents participated in the reviewed studies. Mean scores were within normal ranges for general psychological distress, coping, and family functioning. However, a substantial subgroup reported a clinical level of general psychological distress, and 21-44% reported a severe level of posttraumatic stress symptoms. Worry, disease-related thoughts and feelings, marital strains, as well as posttraumatic growth was reported. Several factors were associated with the long-term late effects, such as parents' maladaptive coping during earlier stages of the childs disease trajectory and children's current poor adjustment. Quality assessments of reviewed studies and clinical implications of findings are discussed and recommendations for future research are presented.",0,0 +3203,Measuring the Severity of Negative and Traumatic Events,"We devised three measures of the general severity of events, which raters applied to participants' narrative descriptions: 1) placing events on a standard normed scale of stressful events, 2) placing events into five bins based on their severity relative to all other events in the sample, and 3) an average of ratings of the events' effects on six distinct areas of the participants' lives. Protocols of negative events were obtained from two non-diagnosed undergraduate samples (n = 688 and 328), a clinically diagnosed undergraduate sample all of whom had traumas and half of whom met PTSD criteria (n = 30), and a clinically diagnosed community sample who met PTSD criteria (n = 75). The three measures of severity correlated highly in all four samples but failed to correlate with PTSD symptom severity in any sample. Theoretical implications for the role of trauma severity in PTSD are discussed.",0,0 +3204,Treatment Outcome in Depressed Latinos Predicted by Concomitant Psychosislike Symptoms,"We compared treatment response (≥50 decrease in Nine-Item Patient Health Questionnaire total score) among 24 Latinos with major depressive disorder, presenting with and without specific psychosislike symptoms: A, hearing noises or house sounds, B, hearing voices calling one's name, C, seeing fleeting visions such as shadows, and D, symptoms more likely to be truly psychotic (e.g., poorly defined and short-lasting voices [other than B], fleeting paranoid ideation, or fleeting ideas of reference). 18 subjects (75%) endorsed symptoms of cluster A, 12 (50%) of cluster B, 10 (31%) of cluster C, and 12 (50%) of cluster D. Only subjects who reported symptoms from the D cluster exhibited significantly unfavorable depressive outcomes (compared to those with absence of D symptoms). The authors propose a phenomenological differentiation between benign psychosislike symptoms (clusters A-C) and the expression of the psychotic continuum (cluster D) in depressed Latinos.",0,0 +3205,Translational evidence for a role of endocannabinoids in the etiology and treatment of posttraumatic stress disorder,"• Endocannabinoids are involved in the etiology of PTSD . • They are linked to anxious arousal symptoms. • Enhancing endocannabinois function may specifically treat this symptom complex of PTSD. Posttraumatic stress disorder (PTSD) is a prevalent, chronic, and disabling anxiety disorder that may develop following exposure to a traumatic event. Despite the public health significance of PTSD, relatively little is known about the etiology or pathophysiology of this disorder, and pharmacotherapy development to date has been largely opportunistic instead of mechanism-based. Recently, an accumulating body of evidence has implicated the endocannabinoid system in the etiology of PTSD, and targets within this system are believed to be suitable for treatment development. Herein, we describe evidence from translational studies arguing for the relevance of the endocannabinoid system in the etiology of PTSD. We also show mechanisms relevant for treatment development. There is convincing evidence from multiple studies for reduced endocannabinoid availability in PTSD. Brain imaging studies show molecular adaptations with elevated cannabinoid type 1 (CB 1 ) receptor availability in PTSD which is linked to abnormal threat processing and anxious arousal symptoms. Of particular relevance is evidence showing reduced levels of the endocannabinoid anandamide and compensatory increase of CB 1 receptor availability in PTSD, and an association between increased CB 1 receptor availability in the amygdala and abnormal threat processing, as well as increased severity of hyperarousal, but not dysphoric symptomatology, in trauma survivors. Given that hyperarousal symptoms are the key drivers of more disabling aspects of PTSD such as emotional numbing or suicidality, novel, mechanism-based pharmacotherapies that target this particular symptom cluster in patients with PTSD may have utility in mitigating the chronicity and morbidity of the disorder.",0,0 +3206,Obesogenic Family Types Identified through Latent Profile Analysis,"Obesity may cluster in families due to shared physical and social environments.This study aims to identify family typologies of obesity risk based on family environments.Using 2007-2008 data from 706 parent/youth dyads in Minnesota, we applied latent profile analysis and general linear models to evaluate associations between family typologies and body mass index (BMI) of youth and parents.Three typologies described most families with 18.8% ""Unenriched/Obesogenic,"" 16.9% ""Risky Consumer,"" and 64.3% ""Healthy Consumer/Salutogenic."" After adjustment for demographic and socioeconomic factors, parent BMI and youth BMI Z-scores were higher in unenriched/obesogenic families (BMI difference = 2.7, p < 0.01 and BMI Z-score difference = 0.51, p < 0.01, respectively) relative to the healthy consumer/salutogenic typology. In contrast, parent BMI and youth BMI Z-scores were similar in the risky consumer families relative to those in healthy consumer/salutogenic type.We can identify family types differing in obesity risks with implications for public health interventions.",0,0 +3207,Risk and preventive factors of post-traumatic stress disorder (PTSD): alcohol consumption and intoxication prior to a traumatic event diminishes the relative risk to develop PTSD in response to that trauma,"Previous reports examined the effects of selected pre- (e.g. female gender, previous trauma), peri- (e.g. the horror of the trauma, threatened death) or post-exposure (e.g. the physical injury caused by the trauma) risk factors on the development of post-traumatic stress disorder (PTSD), an anxiety disorder associated with a traumatic event outside the range of usual human experience. We hypothesized that alcohol consumption prior to traumatic events may reduce the incidence rate of PTSD. The aim of this study was to examine the effects of the above risk factors and preventive factors, such as alcohol consumption, on the development of PTSD.An epidemiological cohort study was carried out on 127 victims trapped in a ballroom fire. Data were collected, 7-9 months after the traumatic event, by means of the Composite International Diagnostic Interview (CIDI) and structured interviews, aimed to assess the above pre-, peri- and post-exposure factors. Logistic regression analysis was used to examine the association of PTSD with the etiologic factors and to delineate those risk factors which contribute most to the development of PTSD.Female gender, the number of previous trauma, a past history of simple phobia, threatened death, trauma exposure, hospitalization for trauma-induced injuries and the presence of burns increased the odds of PTSD, whereas a sense of control during the trauma, and alcohol consumption and intoxication decreased the odds of PTSD. Six factors made independent contributions to the prediction of PTSD, i.e. the number of previous trauma, a past history of simple phobia, loss of control (increase the odds), a sense of control, alcohol consumption and alcohol intoxication (decrease the odds).The results of this study show that the development of PTSD is determined by the effects of pre-, peri- and post-exposure risk factors and may be prevented by the effects of peri-traumatic factors, such as sense of control, alcohol consumption and intoxication.",0,0 +3208,"The relationship between glucocorticoid receptor polymorphisms, stressful life events, social support, and post-traumatic stress disorder","It is debatable whether or not glucocorticoid receptor (GR) polymorphisms moderate susceptibility to PTSD. Our objective was to examine the effects of stressful life events, social support, GR genotypes, and gene-environment interactions on the etiology of PTSD.Three tag single nucleotide polymorphisms, trauma events, stressful life events, and social support were assessed in 460 patients with PTSD and 1158 control subjects from a Chinese Han population. Gene-environment interactions were analyzed by generalized multifactor dimensionality reduction (GMDR).Variation in GR at rs41423247 and rs258747, stressful life events, social support, and the number of traumatic events were each separately associated with the risk for PTSD. A gene-environment interaction among the polymorphisms, rs41423247 and rs258747, the number of traumatic events, stressful life events, and social support resulted in an increased risk for PTSD. High-risk individuals (a large number of traumatic events, G allele of rs258747 and rs41423247, high level stressful life events, and low social support) had a 3.26-fold increased risk of developing PTSD compared to low-risk individuals. The association was statistically significant in the sub-groups with and without childhood trauma.Our data support the notion that stressful life events, the number of trauma events, and social support may play a contributing role in the risk for PTSD by interacting with GR gene polymorphisms.",0,0 +3209,Children's reactions to a natural disaster: symptom severity and degree of exposure,"Abstract Self-report data for 5,687 children ranging in age from 9 to 19 years were collected approximately three months after Hurricane Hugo devastated the rural community where the children lived. Information about the children's perceptions of hurricane severity, degree of home damage suffered as a result of the hurricane, and hurricane-related parental job loss was used to categorize children into four levels of hurricane exposure. Reports of anxiety were obtained via the Revised Children's Manifest Anxiety Scale (RCMAS) and reports of posttraumatic stress disorder (PTSD) symptoms were obtained via the Reaction Index (RI). Significantly higher anxiety scores and significantly more PTSD symptomatology was found for children experiencing more or more severe exposure to the hurricane. Girls reported more anxiety and PTSD symptoms than boys, and black children were more likely than the white children to report PTSD symptomatology. Additionally, girls were more severely affected by increasing levels of hurricane exposure as indicated by their RI scores. These results indicate that, similar to adult and child victims of crime and adult victims of disaster, the development of PTSD symptoms in children exposed to a natural disaster is a function of the degree of exposure to the traumatic event. The results also suggest that children's trait negative affectivity may moderate the effects of exposure on the development of PTSD symptoms.",0,0 +3210,The structure of post-traumatic stress symptoms in young survivors of war,"Research on the dimensionality of post-traumatic stress disorder (PTSD) has generally failed to provide support for the three clusters of PTSD suggested in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). However, much research has been restricted to samples in North America and Western European countries. The aim of the current study was to test four alternative factor models among a relatively understudied population-young civilian survivors of war who had experienced war-related events as adolescents-in order to establish whether the factor structure of PTSD is consistent among various traumatized populations and age groups. Using the Posttraumatic Stress Diagnostic Scale, the results indicated that the four-factor model including intrusion, avoidance, hyperarousal, and numbing factors provided a better fit than the three-factor model suggested by the DSM-IV. The current study offers additional support from another population for a four-factor model of PTSD that implies a separation of avoidance and numbing items. Case conceptualization and treatment implications are discussed.",0,0 +3211,Post-traumatic stress disorder in partners of people with epilepsy,"The objectives of the present study were to examine whether living with an individual who suffered from epilepsy was a potentially traumatizing event and to identify predictive risk factors in developing post-traumatic stress disorder (PTSD).Six hundred fourteen respondents completed the Harvard Trauma Questionnaire, the Crisis Support Scale, the Hopkins Symptom Checklist-25, and the Dyadic Adjustment Scale. In addition, demographic variables were included in order to identify factors that might predict PTSD.The percentage of the participants that fulfilled the symptom criteria of PTSD was 7.7%, and an additional 43.9% reported a subclinical level of PTSD. Clinical and subclinical anxiety was unveiled in 9.3% of the respondents.Partners were at risk of PTSD when living with a patient with epilepsy. Identified variables that explained PTSD were frequency and types of seizures medication, side effects, and objective and subjective epilepsy severity, anxiety, and depression. High level of social support decreased the level of traumatic stress.",0,0 +3212,Post-traumatic stress and coping factors among search and recovery divers,"Irish search and recovery divers dive on a voluntary basis to recover missing persons. During these procedures, they encounter situations not typically part of ordinary human experience and might be expected to experience psychological effects as a result.To investigate the association of post-traumatic stress disorder (PTSD) symptoms with previous experience of missing person recovery among divers, and to investigate the coping mechanisms used.Self-administered questionnaires were distributed to all 206 active search divers in Ireland. A validated questionnaire, the Impact of Event Scale revised (IES-R), was used together with a coping questionnaire to compare the level of symptoms in divers with and without recovery experience, and to describe the main coping factors.One hundred and fifty-five questionnaires were returned, a response rate of 75%. Divers with prior missing person recovery experience scored lower on all three PTSD dimensions (avoidance, intrusion and hyper-arousal) with a significant difference for intrusion (P < 0.001). Coping mechanisms listed by the divers were search and recovery training, support from peers and search unit and sense of duty.The results do not support the hypothesis of an accumulation of traumatic experience in experienced divers but may indicate a survivor bias of the most resilient individuals, or a wearing off of vulnerability to traumatic events with experience.",0,0 +3213,Bullying: a source of chronic post traumatic stress?,"This study surveyed 165 care professionals on their experience of workplace bullying. The results showed that in a 2-year period 40% had been bullied and 68% had observed bullying taking place. Of the 67 care professionals that had been bullied 44% were experiencing high levels of PTSD symptoms based on the general factor of the IES-E. However, when these results were examined further it was found that the symptoms clustered rather differently to those of victims of other forms of trauma. In victims of bullying, the symptoms of arousal and re-experience formed a single cluster of symptoms with avoidance remaining as a separate cluster. These results are challenging in both the classification of Post Traumatic Stress Disorder and for the treatment of victims of bullying.",0,0 +3214,Parenting an infant with a congenital anomaly,"The present study examined psychological adjustment in parents of infants with congenital anomalies (CAs), focusing on the interval from the disclosure of the diagnosis to six months after the infant’s birth and considering the effects of the parent’s gender and the timing of diagnosis (pre- vs postnatal). Within-group diversity was also examined by identifying distinct patterns of individual adjustment over time. Parents of 43 infants (43 mothers and 36 fathers) with a pre- or postnatal diagnosis of a CA answered questionnaires assessing psychological distress and quality of life one month after the disclosure of the diagnosis and six months after the infant’s birth. Results showed a significant reduction in psychological distress and a significant increase in physical quality of life over time, for both parents, regardless of the timing of diagnosis. In all, 57% of parents presented a pattern of recovery from diagnosis to six months post birth and 26.6% presented a pattern of resilience. However, 15.2% of parents showed chronic adjustment difficulties. Findings suggest that most parents tend to adjust to their infant’s CA, although some experienced difficulties and should be targeted for specialised counselling. Both members of the couple should be acknowledged, as both experience similar patterns of adjustment.",0,0 +3215,The role of shame in distinguishing perpetrators of intimate partner violence in U.S. veterans,"Increasing attention is being paid to the fact that exposure to traumatic stressors in military combat may lead to perpetration of intimate partner violence (IPV). Because shame has been identified as a factor in posttraumatic stress disorder (PTSD), the current cross-sectional study examined the relationship in U.S. veterans between IPV and PTSD, depression, guilt, and shame. We hypothesized that shame would be the strongest correlate of perpetration of IPV and that shame would mediate the relationship between PTSD and IPV. Participants were 264 primarily male and Caucasian mixed-era veterans presenting for psychological treatment at a Veterans Affairs hospital. They completed standard measures of depression, PTSD symptoms, shame, and guilt and a local checklist was used to dichotomize the sample regarding IPV. Discriminant analysis indicated that shame contributed most (standardized canonical discriminant function coefficient = .44) to distinguishing perpetrators of IPV. In addition, the results were consistent with shame as a mediator of the relationship between PTSD and IPV. These results are in line with studies indicating that shame is linked to IPV perpetration in nonveteran samples (Harmon, 2002; Rand, 2004; Schibik, 2002) and suggests that shame may be an important aspect of the relationship between PTSD and IPV.",0,0 +3216,Postmigration Living Problems and Common Psychiatric Disorders in Iraqi Asylum Seekers in the Netherlands,"In a previous community-based, national study among Iraqi asylum seekers, a long asylum procedure was found to have a higher risk for common psychiatric disorders than adverse life events in Iraq. In the present article, the postmigration period is considered in more detail and evaluated in relationship with psychiatric disorders. Respondents were interviewed with fully structured, culturally validated, translated questionnaires. With the use of a Post- migration Living Problems questionnaire, worries about all kinds of problems were gathered. Psychiatric (DSM-IV) disorders were measured with the Composite International Diagnostic Interview 2.1. Factor analysis was done on the postmigration living problems, and in univariate and multivariate analyses, associations with psychopathology were calculated. Results show that clusters of postmigration living problems could be identified: family issues, discrimination, asylum procedure, socioeconomic living conditions, socioreligious aspects, and work-related issues. There was a significant relationship between all clustered postmigration living problems and psychopathology, except for socioreligious aspects. Multivariate logistic regression showed that lack of work, family issues, and asylum procedure stress had the highest odds ratios for psychopathology. The findings appeal to governments to shorten the asylum procedures, allow asylum seekers to work, and give preference to family reunion. Mental health workers should recognize the impact of postmigration living problems and consider focusing their treatment on coping with these problems instead of traumas from the past.",0,0 +3217,Psychometric properties of the Korean version of the Short Post-Traumatic Stress Disorder Rating Interview (K-SPRINT),"Aims: The Short Post-traumatic Stress Disorder (PTSD) Rating Interview (SPRINT) is a validated, eight-item, brief global assessment scale for PTSD. This report investigated the psychometric properties of the Korean version of the SPRINT (K-SPRINT). Methods: Eighty-seven PTSD patients, 47 other psychiatric patients, and 63 healthy control subjects were enrolled in the study. All subjects completed a psychometric assessment package that included the K-SPRINT and the Korean versions of the Clinician-Administered PTSD Scale (CAPS), the Beck Depression Inventory (BDI), and the State Trait Anxiety Inventory (STAI). Results: The K-SPRINT showed good internal consistency (Cronbach's α = 0.86) and test–retest reliability (r = 0.82). K-SPRINT showed moderatecorrelations with CAPS (r = 0.71). An exploratory factor analysis produced one K-SPRINT factor. The optimal diagnostic efficiency (91.9%) of the K-SPRINT was found at a total score of 15, at which point the sensitivity and specificity were 90.8% and 92.7%, respectively. Conclusions: The present findings demonstrate that the K-SPRINT had good psychometric properties and can be used as a reliable and valid instrument for the assessment of PTSD.",0,0 +3218,"Active Multimodal Psychotherapy in Children and Adolescents with Suicidality: Description, Evaluation and Clinical Profile","The aim of this study was to describe and evaluate the clinical pattern of 14 youths with presenting suicidality, to describe an integrative treatment approach, and to estimate therapy effectiveness. Fourteen patients aged 10 to 18 years from a child and adolescent outpatient clinic in Stockholm were followed in a case series. The patients were treated with active multimodal psychotherapy. This consisted of mood charting by mood-maps, psycho-education, wellbeing practice and trauma resolution. Active techniques were psychodrama and body—mind focused techniques including eye movement desensitization and reprocessing. The patients were assessed before treatment, immediately after treatment and at 22 months post treatment with the Global Assessment of Functioning Scale. The clinical pattern of the group was observed. After treatment there was a significant change towards normality in the Global Assessment of Functioning scale both immediately post-treatment and at 22 months. A clinical pattern, post trauma suicidal reaction, was observed with a combination of suicidality, insomnia, bodily symptoms and disturbed mood regulation. We conclude that in the post trauma reaction suicidality might be a presenting symptom in young people. Despite the shortcomings of a case series the results of this study suggest that a mood-map-based multimodal treatment approach with active techniques might be of value in the treatment of children and youth with suicidality.",0,0 +3219,Validation of the PTSD checklist-civilian version in survivors of bone marrow transplantation,"Life-threatening illness now qualifies as a precipitating stessor for posttraumatic stress disorder (PTSD). We examined the validity of the PTSD Checklist-Civilian Version (PCL-C; Weathers, Litz, Herman, Juska, & Keane, 1993), a brief 17-item inventory of PTSD-like symptoms, in a sample of 111 adults who had undergone bone marrow transplantation an average of 4.04 years previously. Exploratory factor analysis of the PCL-C identified four distinct patterns of symptom responses: Numbing-Hyperarousal, Dreams-Memories of the Cancer Treatment, General Hyperarousal, Responses to Cancer-Related Reminders and Avoidance-Numbing. Respondents meeting PTSD symptom criteria on the PCL-C had significantly lower physical, role, and social functioning, greater distress and anxiety, and significantly more intrusive and avoidant responses than individuals who did not meet PTSD symptom criteria.",0,0 +3220,South African adolescents with cystic fibrosis: a qualitative exploration of their bio-psychosocial fields,"This qualitative case study explored risk factors and protective factors in the bio-psychosocial fields of adolescents living with cystic fibrosis (CF).Semi-structured interviews were conducted with adolescents in the middle and late adolescent years (15-22 years) who had the defining characteristics of CF and were living in Gauteng province.Themes emerged from individual interviews. The fundamental human need to be understood and to understand was negatively affected as the illness affected socialisation and learning. Participants experienced an array of emotions including loss and bereavement linked to their illness and when friends with CF died. Constructive internal dialogue and positive thinking emerged as protective variables. Participants generally showed awareness of how they regulated their contact with the illness and how they self-regulate. Despite the severity of their symptoms and the taxing demands of managing CF, participants expressed hope for the future and could find some meaning in the illness.Adolescents with CF who participated in this study indicated that they felt different from their peers. Apart from the general developmental tasks typical to adolescence they faced the challenge of managing a severe chronic and potentially terminal illness.",0,0 +3221,Structural Model Analysis of HIV Risk Behaviors among Sexually Active Minority Adolescents,"Contents of this article are solely the responsibility of the authors and do not necessarily reflect the opinions, official policy or position of the U.S. Department of Health and Human Services, the Substance Abuse and Mental Health Services Administration or Centers for Mental Health Services and Substance Abuse Prevention.To evaluate an HIV risk profile in sexually active black and Hispanic adolescents using a structural equation model (SEM).Grantees from 15 states and Washington, DC, were selected to participate in the study. Black and Hispanic adolescents (N = 2,371) who completed the baseline instrument were required to have experienced vaginal, oral or anal sex in order to be included in this study. Total minority youths who self-reported as black but not Hispanic were n = 1,455 and for Hispanic n = 916.The hypothesized model fit moderately well (CFI = 0.940, TLI = 0.928, RMSEA = 0.039). The key significant direct effect was found (P < 0.05) for higher alcohol, tobacco and other drug use related to nonuse of condoms, more sex partners and use of substances before sex.Current findings underscore the need to incorporate culturally sensitive strategies in developing programs for minority youth. However, given that minority group members often report greater experiences of discrimination than whites, future research in this area should also include an examination of the role of other stressors such as racial disparities and their potential cumulative impact on minority youth and their risks for alcohol, tobacco and other drug use and HIV.",0,0 +3222,Recent Developments in Potential Anxiolytic Agents Targeting GABAA/BzR Complex or the Translocator Protein (18kDa) (TSPO),"Anxiety disorders are frequent and disabling disorders. For short-term treatment, benzodiazepines are useful due to their rapid onset of anxiolytic action. However, these compounds have sedative properties and may induce tolerance, abuse liability and withdrawal symptoms. First-line choices for the long-term treatment are selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors. The major disadvantage of these compounds is their delayed onset of action. It is obvious that there is a need for novel pharmacological approaches that combine a rapid anxiolytic efficacy with the lack of tolerance induction, abuse liability and withdrawal symptoms. A very important target for the development of such compounds is the -amino-butyric-acid (GABA)A receptor. Subtype specific benzodiazepines are being developed, but also phytotherapeutic agents experience a renaissance as GABAA receptor modulators. On the other hand, GABA related compounds, e.g. tiagabine, did not show pronounced anxiolytic efficacy. Neuroactive steroids such as allopregnanolone and tetrahydrodeoxycorticosterone (THDOC) are potent modulators of GABAA receptors. To date synthetic neuroactive steroids could not be established in the treatment of anxiety disorders. Regarding endogenous neurosteroidogenesis, recently the translocator protein (18kDa) (TSPO) has been identified as a potential novel target. TSPO is supposed to play an important role for the synthesis of neuroactive steroids. TSPO ligands may promote the synthesis of neuroactive steroids via induction of cholesterol translocation to the inner mitochondrial membrane. First clinical studies revealed promising results. In this review, we discuss putative compounds affecting the GABAergic system which may provide the basis for fast acting anxiolytics with a favorable side effect profile.",0,0 +3223,Longitudinal changes of telomere length and epigenetic age related to traumatic stress and post-traumatic stress disorder,"Several studies have reported an association between traumatic stress and telomere length suggesting that traumatic stress has an impact on ageing at the cellular level. A newly derived tool provides an additional means to investigate cellular ageing by estimating epigenetic age based on DNA methylation profiles. We therefore hypothesise that in a longitudinal study of traumatic stress both indicators of cellular ageing will show increased ageing. We expect that particularly in individuals that developed symptoms of post-traumatic stress disorder (PTSD) increases in these ageing parameters would stand out. From an existing longitudinal cohort study, ninety-six male soldiers were selected based on trauma exposure and the presence of symptoms of PTSD. All military personnel were deployed in a combat zone in Afghanistan and assessed before and 6 months after deployment. The Self-Rating Inventory for PTSD was used to measure the presence of PTSD symptoms, while exposure to combat trauma during deployment was measured with a 19-item deployment experiences checklist. These groups did not differ for age, gender, alcohol consumption, cigarette smoking, military rank, length, weight, or medication use. In DNA from whole blood telomere length was measured and DNA methylation levels were assessed using the Illumina 450K DNA methylation arrays. Epigenetic ageing was estimated using the DNAm age estimator procedure. The association of trauma with telomere length was in the expected direction but not significant (B=-10.2, p=0.52). However, contrary to our expectations, development of PTSD symptoms was associated with the reverse process, telomere lengthening (B=1.91, p=0.018). In concordance, trauma significantly accelerated epigenetic ageing (B=1.97, p=0.032) and similar to the findings in telomeres, development of PTSD symptoms was inversely associated with epigenetic ageing (B=-0.10, p=0.044). Blood cell count, medication and premorbid early life trauma exposure did not confound the results. Overall, in this longitudinal study of military personnel deployed to Afghanistan we show an acceleration of ageing by trauma. However, development of PTSD symptoms was associated with telomere lengthening and reversed epigenetic ageing. These findings warrant further study of a perhaps dysfunctional compensatory cellular ageing reversal in PTSD.",0,0 +3224,Outcomes of posttraumatic stress disorder.,"The typical reaction to a life-threatening experience is one of distress, anxiety, and fear. This is characteristic of the basic survival instinct; these emotions enhance the individual's memory of the traumatic experience and thus serve to help in the recognition and avoidance of similarly dangerous situations in the future. In a significant minority of individuals, however, the natural reaction to trauma becomes uncontrollably and disastrously intensified, resulting in the symptoms of posttraumatic stress disorder (PTSD). PTSD varies in severity and duration between individuals, often relating to personal characteristics and the nature of the trauma to which a person is subjected. However, several factors, namely, chronicity, impairment, comorbidity, and somatization, are significantly related to and can influence the course of PTSD and subsequent outcome. This article briefly reviews each of these factors.",0,0 +3225,Trauma and Posttraumatic Stress Disorder in the Community,"The study estimates the relative importance of specific types of traumas experienced in the community in terms of their prevalence and risk of leading to posttraumatic stress disorder (PTSD).A representative sample of 2181 persons in the Detroit area aged 18 to 45 years were interviewed by telephone to assess the lifetime history of traumatic events and PTSD, according to DSM-IV. Posttraumatic stress disorder was assessed with respect to a randomly selected trauma from the list of traumas reported by each respondent, using a modified version of the Diagnostic Interview Schedule, Version IV, and the World Health Organization Composite International Diagnostic Interview.The conditional risk of PTSD following exposure to trauma was 9.2%. The highest risk of PTSD was associated with assaultive violence (20.9%). The trauma most often reported as the precipitating event among persons with PTSD (31% of all PTSD cases) was sudden unexpected death of a loved one, an event experienced by 60% of the sample, and with a moderate risk of PTSD (14.3%). Women were at higher risk of PTSD than men, controlling for type of trauma.The risk of PTSD associated with a representative sample of traumas is less than previously estimated. Previous studies have overestimated the conditional risk of PTSD by focusing on the worst events the respondents had ever experienced. Although recent research has focused on combat, rape, and other assaultive violence as causes of PTSD, sudden unexpected death of a loved one is a far more important cause of PTSD in the community, accounting for nearly one third of PTSD cases.",0,0 +3226,Attributional style and anxiety sensitivity as maintenance factors of posttraumatic stress symptoms: A prospective examination of a diathesis–stress model,"Diathesis-stress models of posttraumatic stress disorder (PTSD) assert that traumatic events function as stressors that interact with vulnerabilities to influence the development of PTSD. The present study prospectively examined negative attributional style (NAS) and anxiety sensitivity (AS) as maintenance factors for PTSD in female adult sexual assault victims. A diathesis-stress model was tested by examining interactions between the vulnerabilities and negative life events. The present study included both the traditional three-factor model of PTSD (re-experiencing, avoidance and emotional numbing, and arousal) and the dysphoria four-factor model of PTSD (re-experiencing, avoidance, arousal, and dysphoria). Robust regression analyses revealed that negative life events at Time 2 significantly predicted increases in all clusters of the three-factor model (i.e., re-experiencing, avoidance and numbing, and arousal) and the re-experiencing, arousal, and dysphoria clusters of the four-factor model (but not avoidance). Neither NAS nor AS significantly independently predicted any of the symptom clusters for either model. Both NAS and AS interacted with negative life events to predict increases in the avoidance and numbing symptoms. However, examination of the dysphoria four-factor model of PTSD revealed that the NAS and AS interactions with negative life events only predicted dysphoria symptoms.",0,0 +3227,A controlled comparison of eye movement desensitization and reprocessing versus exposure plus cognitive restructuring versus waiting list in the treatment of post-traumatic stress disorder,"A total of 105 patients with post-traumatic stress disorder (PTSD) were randomly allocated to eye-movement desensitization and reprocessing (EMDR) (n = 39) versus exposure plus cognitive restructuring (E + CR) (n = 37) versus waiting list (WL) (n = 29) in a primary care setting. EMDR and E + CR patients received a maximum of 10 treatment sessions over a 10-week period. All patients were assessed by blind raters prior to randomization and at end of the 10-week treatment or waiting list period. EMDR and E + CR patients were also assessed by therapists at the mid-point of the 10-week treatment period and on average at 15 months follow-up. Patients were assessed on a variety of assessor-rated and self-report measures of PTSD symptomatology including the Clinician Administered PTSD Scale (CAPS), the Impact of Events Scale (IOE) and a self-report version of the SI-PTSD Checklist. Measures of anxiety and depression included the Montgomery Asberg Depression Rating Scale (MADRS), the Hamilton Anxiety Scale (HAM-A) and the Hospital Anxiety and Depression Scale (HADS). A measure of social function, the Sheehan Disability Scale was also used. Drop-out rates between the three groups were 12 EMDR, 16 E + CR and five WL. Treatment end-point analyses were conducted on the remaining 72 patients. Repeated measures analysis of variance of treatment outcome at 10 weeks revealed significant time, interaction and group effects for all the above measures. In general there were significant and substantial pre–post reductions for EMDR and E + CR groups but no change for the WL patients. Both treatments were effective over WL. The only indication of superiority of either active treatment, in relation to measures of clinically significant change, was a greater reduction in patient self-reported depression ratings and improved social functioning for EMDR in comparison to E + CR at the end of the treatment period and for fewer number of treatment sessions for EMDR (mean 4.2) than E + CR (mean 6.4) patients. At 15 months follow-up treatment gains were generally well-maintained with the only difference, in favour of EMDR over E + CR, occurring in relation to assessor-rated levels of clinically significant change in depression. However, exclusion of patients who had subsequent treatment during the follow-up period diminished the proportion of patients achieving long-term clinically significant change. In summary, at end of treatment and at follow-up, both EMDR and E + CR are effective in the treatment of PTSD with only a slight advantage in favour of EMDR. Copyright © 2002 John Wiley & Sons, Ltd.",0,0 +3228,Plasma neurotransmitters and cortisol in chronic illness: role of stress.,"We routinely measured plasma neurotransmitters and hormone levels in order to investigate the role of stress on many types of diseases. In this study, we present results obtained from patients with severe chronic diseases. The study sample consisted of 88 patients (asthmatics, ulcerative colitis, Crohn's disease, chronic active hepatitis, chronic relapsing hepatitis, multiple sclerosis, trigeminal neuralgia, systemic lupus erithematous, and rheumatoid arthritis), and their respective controls. Noradrenaline (NA), adrenaline (Ad), dopamine (DA), platelet-serotonin (pS), free-serotonin (fS), growth hormone (GH) and cortisol (CRT) were determined during both exacerbation and improvement periods. A profile compatible with uncoping stress disorder (raised NA-Ad-DA + fS + CRT as well as low pS and NA/Ad ratio) was found during exacerbation periods when compared with improvement, as seen in controls. However, during improvement periods the neurochemical profile remained significantly different from that of normal controls. The neurochemical plus hormonal plasma profiles registered in chronic illness, both during exacerbation and improvement periods, strongly suggest that an uncoping stress mechanism underlies diseases of these patients.",0,0 +3229,Children Exposed to Disaster: I. Epidemiology of Post-Traumatic Symptoms and Symptom Profiles,"To determine the range and severity of post-traumatic stress disorder (PTSD) symptoms exhibited by children after exposure to a natural disaster.Three months after Hurricane Hugo struck Berkeley County, South Carolina, 5,687 school-aged children were surveyed about their experiences and reactions related to the storm. Self-reports of PTSD symptoms were obtained by use of a PTSD Reaction Index.Significant variation in the prevalence of PTSD symptoms was found across race, gender, and age groups. Self-reported symptoms were used to derive a post-traumatic stress syndrome classification according to DSM-III-R guidelines for the diagnosis of PTSD. More than 5% of the sample reported sufficient symptoms to be classified as exhibiting this post-traumatic stress syndrome. Females and younger children were more likely to receive this classification. At the symptom level, females reported more symptoms associated with emotional processing and emotional reaction to the trauma. Males were more likely to report symptoms related to cognitive and behavioral factors. Younger children were more likely to report symptoms overall.Children exposed to a high magnitude natural disaster report sufficient symptoms to establish a DSM-III-R derived classification of a PTSD syndrome. Differences between gender, age, and race groups appear to be related to differential risk of exposure, reporting biases, as well as a differential risk for developing post-traumatic symptoms.",0,0 +3230,The Psychiatric Genomics Consortium Posttraumatic Stress Disorder Workgroup: Posttraumatic Stress Disorder Enters the Age of Large-Scale Genomic Collaboration,"The development of posttraumatic stress disorder (PTSD) is influenced by genetic factors. Although there have been some replicated candidates, the identification of risk variants for PTSD has lagged behind genetic research of other psychiatric disorders such as schizophrenia, autism, and bipolar disorder. Psychiatric genetics has moved beyond examination of specific candidate genes in favor of the genome-wide association study (GWAS) strategy of very large numbers of samples, which allows for the discovery of previously unsuspected genes and molecular pathways. The successes of genetic studies of schizophrenia and bipolar disorder have been aided by the formation of a large-scale GWAS consortium: the Psychiatric Genomics Consortium (PGC). In contrast, only a handful of GWAS of PTSD have appeared in the literature to date. Here we describe the formation of a group dedicated to large-scale study of PTSD genetics: the PGC-PTSD. The PGC-PTSD faces challenges related to the contingency on trauma exposure and the large degree of ancestral genetic diversity within and across participating studies. Using the PGC analysis pipeline supplemented by analyses tailored to address these challenges, we anticipate that our first large-scale GWAS of PTSD will comprise over 10 000 cases and 30 000 trauma-exposed controls. Following in the footsteps of our PGC forerunners, this collaboration-of a scope that is unprecedented in the field of traumatic stress-will lead the search for replicable genetic associations and new insights into the biological underpinnings of PTSD.",0,0 +3231,Risk factors for posttraumatic stress disorder,Introduction. Strategies to study risk for the development of PTSD. Epidemiological risk factors for trauma and PTSD. Genetic risk factors for PTSD: a twin study. Family studies of PTSD: a review. Parental PTSD as a risk factor for PTSD. Neurocognitive risk factors for PTSD. Psychophysiological expression of risk factors for PTSD. Risk factors for the acute biological and psychological response to trauma. Personality as a risk factor for PTSD. Risk factors for PTSD reflections and recommendations. Index.,0,0 +3232,Idioms of Distress Among Trauma Survivors: Subtypes and Clinical Utility,"In this introduction to the Special Issue on Trauma and Idioms of Distress, we provide an overview of the concept and typology of ""idioms of distress,"" focusing particularly on their clinical utility. This includes the role of idioms as indicators of trauma exposure, of various types of psychopathology and of levels of distress, risk and functioning. It likewise includes the fact that idioms of distress may profoundly influence the personal meaning of having a trauma-related disorder, may shape the interpersonal course of the disorder and may pattern help-seeking and self-treatment. Finally, it illustrates the fact that idioms may also help clinicians understand sufferers' views of the causes of their distress, constitute key therapeutic targets and help increase therapeutic empathy and treatment adherence. This special issue focuses on the role played by idioms of distress in the local trauma ontology, the associations between the idioms and psychiatric disorders occurring in the context of trauma and the mechanisms by which the idioms profoundly influence the personal and interpersonal course of trauma-related disorders.",0,0 +3233,Clinical efficacy of a Phaseolus vulgaris and Cynara scolymus mixture on satiety,"Rondanelli M, Giacosa A, Orsini F, Opizzi A, Villani S. Appetite control and glycaemia reduction in overweight subjects treated with a combination of two highly standardized extracts from Phaseolus vulgaris and Cynara scolymus. Phytother Res 2011; 25: 1275–82.",0,0 +3234,Posttraumatic stress disorder in school-age children exposed to domestic violence: An examination of emotion regulation and cognitive inhibition as predictors of PTSD symptomatology,"Exposure to the physical abuse of a parent can be a traumatic event for a child, leaving the child fearful, helpless, and horrified. Research results have documented that children exposed to domestic violence are at increased risk for developing trauma symptoms characteristic of Posttraumatic Stress Disorder (PTSD). This study examined how childhood developmental factors, specifically emotion regulation and inhibition, predict PTSD symptomatology in school-age children exposed to domestic violence. Based on Horowitz's (1986) Stress Response Theory of PTSD, this study was formulated on the premise that effective coping of trauma material requires a balance of mental processes. Child participants between the ages of 8 and 12 and their mothers were asked to complete a battery of assessment measures that included the following areas: posttraumatic stress symptoms, avoidance, emotion regulation, and inhibition. The current study extends the research literature regarding PTSD symptoms in children and the influence of developmental factors. Based on results from the current study, emotion regulation seems to function as a protective factor in children, and was predictive of lower levels of avoidance symptoms Children reported to have high emotion regulation skills varied on PTSD avoidance symptoms as a function of inhibitory control. Specifically, inhibitory control was a significant predictor of symptoms for children with high emotion regulation skills Inhibition was predictive of higher rates of PTSD symptoms (child reported) when using a child-report measure of thought suppression (WBSI). Maternal report of inhibitory control and maternal report of PTSD Total symptoms were negatively correlated, thus, as inhibitory control increases, PTSD avoidance symptoms decrease Finally, avoidance symptoms were found to be an important mediator of inhibition and the development of PTSD arousal and reexperiencing symptoms in children. Post Hoc analyses also revealed emotion regulation as a mediator of maternal report of inhibitory control skills on PTSD Total symptoms. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +3235,Factors associated with comorbidity patterns in full and partial PTSD: Findings from the PsyCoLaus study,"Subtypes of comorbid conditions and their associated trauma and clinical characteristics in full and partial PTSD were examined. Data from 289 subjects from the general population that met criteria for full or partial PTSD were analyzed. Latent class analyses (LCA) were performed to derive homogeneous patterns of DSM-IV Axis-I disorders and anti-social personality comorbid to PTSD. Logistic regression models were conducted to characterize these classes by trauma-related and clinical features. The LCA revealed three classes: (1) low comorbidity; (2) high comorbidity with primarily substance-related disorders and a higher proportion of males; and (3) more severe PTSD-symptomatology and higher comorbid anxiety disorders and depression, almost entirely represented by females. Exposure to sexual abuse was more likely in the substance-dependent class and contributed strongly to the distinction between classes. Affective disorders tended to precede the onset of PTSD in the substance-dependent class, whereas phobias were more likely to follow PTSD in the depressed-anxious class. Posttrauma onset of alcohol use disorders in the substance dependent class confirmed the self-medication hypothesis. The three classes of comorbidity and their sequence of onset with PTSD suggest different mechanisms involved in their development. Our findings suggest that PTSD-related comorbidity subtypes also apply to individuals with partial PTSD.",0,0 +3236,"PTSD symptoms, potentially traumatic event exposure, and binge drinking: A prospective study with a national sample of adolescents","Research demonstrates substantial comorbidity between PTSD and alcohol use disorders. Evidence for functional relationships between PTSD and problematic alcohol use has not always been consistent, and there have been few investigations with adolescent samples. Further, research has not consistently controlled for cumulative potentially traumatic event (PTE) exposure when examining prospective relationships between PTSD and problematic alcohol use (i.e., binge drinking). This study examines the prospective relationships between PTSD symptoms, problematic alcohol use, and cumulative PTE exposure measured at three time points over approximately three years among a nationally representative sample of adolescents exposed to at least one PTE (n=2399 and age range=12-17 at Wave 1). Results from parallel process latent growth curve models demonstrated that increases in cumulative PTE exposure over time positively predicted increases in both PTSD symptoms and binge drinking, whereas increases in PTSD symptoms and increases in binge drinking were not related when controlling for the effect of cumulative PTE exposure. Further analyses suggested that these relationships are specific to assaultive PTEs and are not found with non-assaultive PTEs. Theoretical implications are discussed.",0,0 +3237,The Posttraumatic Stress Disorder Diagnosis in Preschool- and Elementary School-Age Children Exposed to Motor Vehicle Accidents,"Increasingly, children are being diagnosed with psychiatric disorders, including preschool-age children. These diagnoses in young children raise questions pertaining to 1) how diagnostic algorithms for individual disorders should be modified for young age groups, 2) how psychopathology is best detected at an early stage, and 3) how to make use of multiple informants. The authors examined these issues in a prospective longitudinal assessment of preschool- and elementary school-age children who were exposed to a traumatic event.Participants were 114 children (age range: 2-10 years) who had experienced a motor vehicle accident. Parents and older children (age range: 7-10 years) completed structured interviews 2-4 weeks (initial assessment) and 6 months (6-month follow-up) after the traumatic event. A recently proposed alternative symptom algorithm for diagnosing posttraumatic stress disorder (PTSD) was utilized and compared with the standard DSM-IV algorithms for diagnosing PTSD and acute stress disorder.At the 2- to 4-week assessment, 11.5% of the children met conditions for a diagnosis of PTSD based on the alternative algorithm criteria per parent report, and 13.9% met criteria for this diagnosis at the 6-month follow-up. These percentages were much higher than those for DSM-IV diagnoses of acute stress disorder and PTSD. Among 7- to 10-year-old subjects, the use of combined parent- and child-reported symptoms to derive a diagnosis resulted in an increased number of children in this age group who were identified with psychiatric illness relative to the use of parent report alone. Agreement between parent and child on symptoms for 1) a diagnosis of PTSD based on the alternative algorithm criteria and 2) diagnoses of DSM-IV acute stress disorder and PTSD in this age group was poor. Among 2- to 6-year-old subjects, the alternative algorithm PTSD diagnosis per parent report was a more sensitive predictor of later onset psychopathology relative to a diagnosis of DSM-IV acute stress disorder or PTSD per parent report. However, among 7- to 10-year-old subjects, a combined symptom report (from both parent and child) was optimal in predicting posttraumatic psychopathology.These findings support the use of the proposed alternative algorithm for assessing PTSD in young children and suggest that the diagnosis of PTSD based on the alternative algorithm criteria is stable from the acute phase onward. When both parent- and child-reported symptoms are utilized for the assessment of PTSD among 7- to 10-year-old children, the alternative algorithm and DSM-IV criteria have broad comparable validity. However, in the absence of child-reported symptoms, the alternative algorithm criteria per parent report appears to be an optimal diagnostic measure of PTSD among children in this age group, relative to the standard DSM-IV algorithm for diagnosing the disorder.",0,0 +3238,Trajectory and predictors of depression in a 12-month prospective study after the Madrid March 11 terrorist attacks,"Few longitudinal studies have examined the trajectory of and the risk factors for depression in a representative sample of the population exposed to terrorism. A 12 month prospective study was conducted among a sample of Madrid city residents after the March 11, 2004 terrorist attacks. We aimed to document the trajectories of depressive symptoms and determine the risk factors associated with these trajectories.We conducted telephone surveys among a representative sample of Madrid citizens (N = 1589) to recruit baseline respondents approximately 1 month after the March 11 terrorist attacks. Participants were re-contacted at 6 and 12 months after baseline for further telephone interviews.Findings reveal heterogeneity in the longitudinal trajectories of depression ranging from the absence of depressive symptoms over time, to transient or chronic depression. Life and recent stressors, experiencing direct exposure to the attacks, personality traits, poor physical health and other psychological disorders were principally associated with a worse trajectory of depression after this event.Consistent with a stress diathesis model, ongoing stressors and intense event exposure are key drivers of a chronic depression trajectory after a mass traumatic event.",0,0 +3239,Treatment of post-traumatic stress disorder with eye movement desensitization and reprocessing: Outcome is stable in 35-month follow-up,"Post-traumatic stress disorder (PTSD) is an anxiety disorder that may follow major psychological trauma. The disorder is longstanding, even chronic, and there is a need for effective treatment. The most effective short-term treatments are cognitive behavioural therapy and eye movement desensitization and reprocessing (EMDR). Twenty subjects with chronic PTSD following occupational health hazards from “person under train” accidents or assault at work were treated with five sessions of EMDR. They were assessed with psychometric scales and diagnostic interviews before treatment, directly after treatment, at 8 months, and at 35 months after the end of Therapy. The primary outcome variable was full diagnosis of PTSD according to the DSM-IV diagnostic criteria. Results from interview-based and self-evaluation psychometric scales were used as secondary outcome variables. Immediately following treatment, the patients were divided up into two groups, initial remitters (12 of 20) and non-remitters (8 of 20). There were no drop-outs during therapy, but three patients withdrew during follow-up. The initial result was maintained at the 35-month follow-up. The secondary outcome variables also showed a significant immediate change towards normality that was stable during the long-term follow-up. After 3 years of follow-up, 83% of the initial remitters had full working capacity.",0,0 +3240,Therapy implications of child abuse in multi-risk families,"Objectives: Our aim is to critique Australian child maltreatment policy, outline abuse trends and provide data on family risk factors. Method: We identified policy gaps and reviewed family profiles within selective child maltreatment databases. Data sources included international and Australian literature, Queensland Department of Child Safety reports and a research clinical database. Results: Data reviewed suggest that a pattern of co-occurring complex multiple system family problems characterize substantiated abuse cases. Conclusions: The presence of multiple family problems suggests the need for a new treatment paradigm. Multisystemic Therapy for child physical abuse and neglect is an evidence-based intervention that matches the therapeutic needs of such families.",0,0 +3241,Risk factors for the development versus maintenance of posttraumatic stress disorder,"This study examined risk factors for posttraumatic stress disorder (PTSD) in Vietnam veterans: 68 women and 414 men of whom 88 were White, 63 Black, 80 Hispanic, 90 Native Hawaiian, and 93 Japanese American. Continuation ratio logistic regression was used to compare the predictive power of risk factors for the development versus maintenance of full or partial PTSD. The development of PTSD was related to premilitary, military, and postmilitary factors. The maintenance of PTSD was related primarily to military and postmilitary factors. Multivariate analyses identified different models for development and maintenance. We conclude that development of PTSD is related to factors that occur before, during, and after a traumatic event, whereas failure to recover is related primarily to factors that occur during and after the event.",0,0 +3242,A PILOT STUDY OF GROUP MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) FOR COMBAT VETERANS WITH POSTTRAUMATIC STRESS DISORDER (PTSD),"""Mindfulness-based"" interventions show promise for stress reduction in general medical conditions, and initial evidence suggests that they are accepted in trauma-exposed individuals. Mindfulness-based cognitive therapy (MBCT) shows substantial efficacy for prevention of depression relapse, but it has been less studied in anxiety disorders. This study investigated the feasibility, acceptability, and clinical outcomes of an MBCT group intervention adapted for combat posttraumatic stress disorder (PTSD).Consecutive patients seeking treatment for chronic PTSD at a VA outpatient clinic were enrolled in 8-week MBCT groups, modified for PTSD (four groups, n = 20) or brief treatment-as-usual (TAU) comparison group interventions (three groups, n = 17). Pre and posttherapy psychological assessments with clinician administered PTSD scale (CAPS) were performed with all patients, and self-report measures (PTSD diagnostic scale, PDS, and posttraumatic cognitions inventory, PTCI) were administered in the MBCT group.Intent to treat analyses showed significant improvement in PTSD (CAPS (t(19) = 4.8, P < .001)) in the MBCT condition but not the TAU conditions, and a significant Condition × Time interaction (F[1,35] = 16.4, P < .005). MBCT completers (n = 15, 75%) showed good compliance with assigned homework exercises, and significant and clinically meaningful improvement in PTSD symptom severity on posttreatment assessment in CAPS and PDS (particularly in avoidance/numbing symptoms), and reduced PTSD-relevant cognitions in PTCI (self blame).These data suggest group MBCT as an acceptable brief intervention/adjunctive therapy for combat PTSD, with potential for reducing avoidance symptom cluster and PTSD cognitions. Further studies are needed to examine efficacy in a randomized controlled design and to identify factors influencing acceptability and efficacy.",0,0 +3243,Nefazodone in post-traumatic stress disorder: results from six open-label trials,"Nefazodone, an antidepressant which blocks serotonin (5-HT)2 receptors and 5-HT reuptake, was evaluated in the treatment of post-traumatic stress disorder (PTSD) in six open-label studies involving both civilians and combat veterans. Our objective was to report this available pooled data to characterize the response of this drug in PTSD. Specifically, we looked at response rates using three different criteria, the effect of nefazodone on each PTSD cluster and individual symptoms and, lastly, variables that might predict response. One hundred and five outpatients with chronic PTSD were treated with nefazodone titrated up to 600 mg/day, 92 of whom were entered in an intent to treat analysis. We used the percentage drop in score between baseline and endpoint on main scale as a common measure to evaluate outcome. The response criterion of a drop in score of at least 30%, 40% and 50% revealed response rates of 46, 36 and 26%, respectively. Nefazodone showed a broad spectrum of action on PTSD symptoms. This profile might make nefazodone a useful drug to treat PTSD. Predictors of response include age, sex and trauma type. Double-blind, placebo-controlled clinical trials in PTSD are in progress to assess the utility of nefazodone as a treatment in this disorder.",0,0 +3244,Interpreting the WHOQOL-Brèf: Preliminary Population Norms and Effect Sizes,"Since publication use of the WHOQOL-Bref has rapidly risen. However, as yet no population norms have been published as a reference point against which researchers can interpret their findings. This study provides preliminary population norms for this purpose. Randomly sampled community residents from two studies were pooled and used to examine the properties of the WHOQOL-Bref by age group, gender and health status. The results showed that general norms for the WHOQOL-Bref domains were 73.5 (SD=18.1) for the Physical health domain, 70.6 (14.0) for Psychological wellbeing, 71.5 (18.2) for Social relationships and 75.1 (13.0) for the Environment domain. In general scores declined slightly by age group. For females scores were stable across the lifespan with an accelerated decline after the age of 60 years. Males exhibited a more consistent and even decline across the lifespan. There were significant differences in WHOQOL-Bref scores when reported by health status, with those in poor health obtaining scores that were up to 50% lower than those in excellent health. Effect sizes between different health status levels are reported. These preliminary norms and effect sizes may be used as reference points for interpreting WHOQOL-Bref scores. They provide additional information to the numerous national studies already reporting on the validity of the WHOQOL-Bref.",0,0 +3245,"""Sexual assault-characteristis effects of PTSD and psychosocial mediators: A cluster-analysis approach to sexual assault types"": Correction to Peter-Hagene and Ullman (2014).","Reports an error in ""Sexual Assault-Characteristics Effects on PTSD and Psychosocial Mediators: A Cluster-Analysis Approach to Sexual Assault Types"" by Liana C. Peter-Hagene and Sarah E. Ullman (Psychological Trauma: Theory, Research, Practice, and Policy, Advanced Online Publication, Aug 18, 2014, np). In the article, there was an error in the abstract. The second to last sentence should have read, ""The effect of assault-characteristics clusters on Time 2 PTSD was mediated by Time 1 self-blame and turning against social reactions."" (The following abstract of the original article appeared in record 2014-33772-001.) Using cluster analysis, we investigated the effects of assault characteristics (i.e., level of violence, subjective distress, alcohol consumption, perpetrator identity) on PTSD symptoms, and whether these effects are mediated by postassault social and psychological reactions. A large community sample of women sexual assault survivors completed 2 mail surveys at a 1-year interval. In line with prior research, cluster analyses revealed the existence of 3 general categories of sexual assault, which we described as ""high violence,"" ""alcohol-related,"" and ""moderate sexual severity."" Alcohol-related assaults resulted in fewer PTSD symptoms than high-violence assaults at Time 1, but not at Time 2. Alcohol-related and violent assaults resulted in more PTSD symptoms than moderate-severity assaults at both times. The effect of assault-characteristics clusters on Time 2 PTSD was mediated by Time 1 self-blame and turning against social reactions. The importance of considering effects of violence and alcohol consumption during the assault to better understand postassault PTSD, including implications for theory and practice, are discussed. (PsycINFO Database Record",0,0 +3246,Magnitude of Life Events and Seriousness of Illness,"A study investigating the relationship between the quantity of life change that patients have undergone during the 2 years before the onset of their illness, and the seriousness of that illness, is described in this report. The sample represented 42 disease items and 232 patients. Thirty-six percent",0,0 +3247,Posttraumatic disorders following injury: an empirical and methodological review,"Although there has been a marked increase in research on psychological disorders following physical injury in recent years, there are many discrepancies between the reported findings. This paper reviews the prevalence outcomes of recent studies of the mental health sequelae of physical injury with a focus on posttraumatic stress disorder (PTSD), acute stress disorder (ASD), and depression. The review critically outlines some of the methodological factors that may have contributed to these discrepancies. The phenomenological overlap between organic and psychogenic symptoms, the use of narcotic analgesia, the role of brain injury, the timing and content of assessments, and litigation are discussed in terms of their potential to confound findings with this population. Recommendations are proposed to clarify methodological approaches in this area. It is suggested that a clearer understanding of the psychological effects of physical injury will require the widespread adoption of more rigorous, standardized and transparent methodological procedures.",0,0 +3248,POST-TRAUMATIC STRESS DISORDER IS ASSOCIATED WITH INCREASED INCIDENCE OF INSULIN RESISTANCE AND METABOLIC SYNDROME,"Insulin resistance (IR) increases atherogenesis and atherosclerotic plaque instability and further increases risk of myocardial infarction, but its potential association with Post-traumatic stress disorder(PTSD) has not been evaluated. This study assessed the association of PTSD with incidence of IR",0,0 +3249,Women at War: Implications for Mental Health,"Few studies have investigated the impact of deployment stressors on the mental health outcomes of women deployed to Iraq in support of Operation Iraqi Freedom. This pilot study examined exposure to combat experiences and military sexual harassment in a sample of 54 active duty women and assessed the impact of these stressors on post-deployment posttraumatic stress disorder (PTSD) symptoms and depressive symptoms. Within 3 months of returning from deployment to Iraq, participants completed (a) the Combat Experiences Scale and the Sexual Harassment Scale of the Deployment Risk and Resilience Inventory, (b) the Primary Care PTSD Screen, and (c) an abbreviated version of the Center for Epidemiological Studies-Depression scale. Approximately three quarters of the sample endorsed exposure to combat experiences, and more than half of the sample reported experiencing deployment-related sexual harassment, with nearly half of the sample endorsing both stressors. Approximately one third of the sample endorsed clinical or subclinical levels of PTSD symptoms, with 11% screening positive for PTSD and 9% to 14% of the sample endorsing depressive symptoms. Regression analyses revealed that combat experiences and sexual harassment jointly accounted for significant variance in post-deployment PTSD symptoms, whereas military sexual harassment was identified as the only unique significant predictor of these symptoms. Findings from the present study lend support to research demonstrating that military sexual trauma may be more highly associated with post-deployment PTSD symptoms than combat exposure among female service members and veterans.",0,0 +3250,Analysis of Kinase Gene Expression in the Frontal Cortex of Suicide Victims: Implications of Fear and Stress†,"Suicide is a serious public health issue that results from an interaction between multiple risk factors including individual vulnerabilities to complex feelings of hopelessness, fear, and stress. Although kinase genes have been implicated in fear and stress, including the consolidation and extinction of fearful memories, expression profiles of those genes in the brain of suicide victims are less clear. Using gene expression microarray data from the Online Stanley Genomics Database and a quantitative PCR, we investigated the expression profiles of multiple kinase genes including the calcium calmodulin-dependent kinase (CAMK), the cyclin-dependent kinase, the mitogen-activated protein kinase (MAPK), and the protein kinase C (PKC) in the prefrontal cortex (PFC) of mood disorder patients died with suicide (N = 45) and without suicide (N = 38). We also investigated the expression pattern of the same genes in the PFC of developing humans ranging in age from birth to 49 year (N = 46). The expression levels of CAMK2B, CDK5, MAPK9, and PRKCI were increased in the PFC of suicide victims as compared to non-suicide controls (false discovery rate, FDR-adjusted p < 0.05, fold change >1.1). Those genes also showed changes in expression pattern during the postnatal development (FDR-adjusted p < 0.05). These results suggest that multiple kinase genes undergo age-dependent changes in normal brains as well as pathological changes in suicide brains. These findings may provide an important link to protein kinases known to be important for the development of fear memory, stress associated neural plasticity, and up-regulation in the PFC of suicide victims. More research is needed to better understand the functional role of these kinase genes that may be associated with the pathophysiology of suicide.",0,0 +3251,"Basic emotion profiles in healthy, chronic pain, depressed and PTSD individuals","To compare self-reports of five basic emotions across four samples: healthy, chronic pain, depressed and post-traumatic stress disorder (PTSD), and to investigate the extent to which basic emotion reports discriminate between individuals in healthy or clinical groups.In total, 439 participants took part in this study: healthy (n = 131), chronic pain (n = 220), depressed (n = 24) and PTSD (n = 64). The participants completed the trait version of the Basic Emotion Scale. Basic emotion profiles were compared both within each group and between the healthy group and each of the three other groups. Discriminant analysis was used to assess the extent to which basic emotions can be used to classify the participants as belonging to the healthy group or one of the clinical groups.In the healthy group, happiness was experienced more than any other basic emotion. This was not found in the clinical groups. In comparison to the healthy participants, the chronic pain group experienced more fear, anger and sadness, the depressed group reported more sadness and the PTSD group experienced all of the negative emotions more frequently. Discriminant analysis revealed that happiness was the most important variable in determining whether an individual belonged to the healthy group or one of the clinical groups. Anger was found to further discriminate between depressed and chronic pain individuals.The findings demonstrate that basic emotion profile analysis can provide a useful foundation for the exploration of emotional experience both within and between healthy and clinical groups.",0,0 +3252,The major symptoms of hysteria.,,0,0 +3253,Beacon: a web portal to high‐quality mental health websites for use by health professionals and the public,"Objective To describe the Beacon web portal, which lists and rates quality health websites, collects user characteristics and publishes user feedback; and to report summary data on Beacon's highest-rated (best evidence-based) sites for mental health. Data sources A systematic search was undertaken in February 2009 for potentially relevant websites through a review of research papers and a recently published book, an internet search of Open Directory Project medical categories, a review of material on a high-profile mental health portal, and a survey of international researchers. Selection criteria All sites were ranked on a 7-point scale from -1 to 5, with negative scores indicating evidence of no effect and scores of 2 or more indicating evidence of efficacy based on reports in the scientific literature. Results By March 2010, 183 sites had been identified, of which 122 focused on physical health or wellbeing, 40 targeted anxiety, and 23 targeted depression. Of the eight generalised anxiety disorder sites identified, four achieved ratings of 2 or above. Two social anxiety disorder sites achieved scores higher than 2. Ten panic disorder sites were identified, with three achieving ratings of 2 or above; and five post-traumatic stress disorder sites were identified, with two achieving ratings of 2 or above. Of the 23 identified depression sites, four achieved a rating of 2 or above. Conclusions There are a number of high-quality mental health websites on the internet, and Beacon provides a portal to enable the wide dissemination of these resources.",0,0 +3254,"Social Support, Stressors, and Frailty Among Older Mexican American Adults","There is little research on the effects of stressors and social support on frailty. Older Mexican Americans, in particular, are at higher risk of medical conditions, such as diabetes, that could contribute to frailty. Given that the Mexican American population is rapidly growing in the United States, it is important to determine whether there are modifiable social factors related to frailty in this older group.To address the influence of social support and stressors on frailty among older Mexican Americans, we utilized five waves of the Hispanic Established Populations for the Epidemiologic Study of the Elderly (Hispanic EPESE) to examine the impact of stressors and social support on frailty over a 12-year period. Using a modified version of the Fried and Walston Frailty Index, we estimated the effects of social support and stressors on frailty over time using trajectory modeling (SAS 9.2, PROC TRAJ).We first grouped respondents according to one of three trajectories: low, progressive moderate, and progressive high frailty. Second, we found that the effects of stressors and social support on frailty varied by trajectory and by type of stressor. Health-related stressors and financial strain were related to increases in frailty over time, whereas social support was related to less-steep increases in frailty.Frailty has been hypothesized to reflect age-related physiological vulnerability to stressors, and the analyses presented indicate partial support for this hypothesis in an older sample of Mexican Americans. Future research needs to incorporate measures of stressors and social support in examining those who become frail, especially in minority populations.",0,0 +3255,Latent classes of posttraumatic stress and growth,"Potentially traumatic events may lead to different patterns of posttraumatic stress symptoms and posttraumatic growth. The objective of the present study was to identify subgroups with different patterns of posttraumatic reactions, and to determine whether these subgroups differed in terms of personal and social resources and indicators of adjustment.This study used survey data collected 10 months after the 2011 Oslo bombing attack to investigate patterns of reactions among ministerial employees (N=1970).We applied latent class analyses with covariates to extract subgroups of individuals.Three classes of individual reactions were extracted, and these were similar among those who were and those who were not physically proximate to the bombing attack: ""High stress/high growth"" (27% and 11%, respectively), ""Low stress/high growth"" (74% and 42%, respectively), and ""Low stress/low growth"" (only among the not physically proximate: 47%). The classes differed in terms of gender, neuroticism, and social support as well as life satisfaction and daily functioning.Heterogeneous patterns of posttraumatic reactions were found. Physical proximity is not necessary to experience posttraumatic stress or growth after political violence. Among individuals with low stress, posttraumatic growth may not encompass higher life satisfaction or functioning.",0,0 +3256,"Functional associations among trauma, ptsd, and substance-related disorders","This review article presents several potential functional pathways which may explain the frequent co-occurrence of PTSD and substance abuse disorders in traumatized individuals. Emerging empirical studies which have examined these potential pathways are reviewed, including studies on relative order of onset, PTSD patients' perceptions of various drug effects, comparisons of PTSD patients with and without comorbid substance use disorders, and correlational studies examining the relations between severity of specific PTSD symptom clusters and substance disorder symptoms. Research on the acute and chronic effects of alcohol and other drugs on cognitive and physiological variables relevant to PTSD intrusion and arousal symptoms is reviewed to highlight ways in which these two sets of PTSD symptoms might be functionally interrelated with substance abuse. Finally, based on these findings, recommendations are made for the treatment of individuals with comorbid PTSD-substance use disorders.",0,0 +3257,Longitudinal Pathways Between Political Violence and Child Adjustment: The Role of Emotional Security about the Community in Northern Ireland,"Links between political violence and children’s adjustment problems are well-documented. However, the mechanisms by which political tension and sectarian violence relate to children’s well-being and development are little understood. This study longitudinally examined children’s emotional security about community violence as a possible regulatory process in relations between community discord and children’s adjustment problems. Families were selected from 18 working class neighborhoods in Belfast, Northern Ireland. Participants (695 mothers and children, M = 12.17, SD = 1.82) were interviewed in their homes over three consecutive years. Findings supported the notion that politically-motivated community violence has distinctive effects on children’s externalizing and internalizing problems through the mechanism of increasing children’s emotional insecurity about community. Implications are considered for understanding relations between political violence and child adjustment from a social ecological perspective.",0,0 +3258,A Review of Health-Related Quality of Life in Adult Traumatic Brain Injury Survivors in the Context of Combat Veterans,"Health-related quality of life (HRQOL) research in traumatic brain injury (TBI) populations is beginning to emerge in the literature. Because rehabilitation and reintegration issues are complex with TBI, especially with new combat veterans, it is critical that future HRQOL research be designed to consider these issues. Utilizing explicit definitions and a conceptual model of HRQOL can provide researchers with a holistic base on which to build interventions for successful patient outcomes. The conceptual model of HRQOL of C.E. Ferrans, J.J. Zerwic, J.E. Wilbur, and J.L. Larson (2005) is an exemplar model that presents clear definitions and encompasses domains of HRQOL relevant to TBI survivors and their families. This review was organized utilizing the model of HRQOL of Ferrans et al. The objective of this review was to identify gaps in current knowledge of HRQOL and TBI. These findings were then used to develop recommendations for future research with combat veterans who have sustained a TBI.",0,0 +3259,Rethinking First Response: Effects of the Clean Up and Recovery Effort on Workers at the World Trade Center Disaster Site,"We sought to describe the physical and mental health effects of the cleanup and recovery effort on workers at the World Trade Center disaster site.A mailed survey was sent to truck drivers, heavy equipment operators, laborers, and carpenters. It assessed work-related exposures and somatic and mental health symptoms. In one open-ended question, respondents shared any aspect of their experiences they wished; these 332 narrative responses were analyzed using qualitative techniques.Respondents reported suffering debilitating consequences of their work, including depression, drug use, and posttraumatic stress disorder. They felt poorly prepared to work in a disaster, lacked protective equipment and training, and felt overwhelmed by the devastation they faced.These workers' experiences were qualitatively similar to the experiences of the first responders. To protect workers in the future, the focus on preparing ""first"" responders should be reconsidered more broadly.",0,0 +3260,The symptom structure of posttraumatic stress disorder in the National Comorbidity Replication Survey,"Previous research has provided mixed findings for the validity of various three- and four-factor models of posttraumatic stress disorder (PTSD) symptomatology. However, much of this research has been restricted to clinical samples rather than nationally representative community-based samples. The current study employed confirmatory factor analysis to evaluate the validity of three competing models of PTSD symptom structure using the DSM-IV-based National Comorbidity Replication Survey (part II of the NCS-R: N=5692). Individuals with a lifetime diagnosis of PTSD (N=588) were selected and symptom assessment was based on the World Health Organization Composite International Diagnostic Interview. Strong support was found for both the DSM-IV three-factor model and a four-factor model of PTSD symptoms by King et al. [King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998). Confirmatory factor analysis of the clinician-administered PTSD scale: evidence for the dimensionality of posttraumatic stress disorder. Psychological Assessment,10, 90-96], a variation of the DSM-IV model in which avoidance and numbing are viewed as separate factors. There was some evidence, however, that the King et al. [King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998). Confirmatory factor analysis of the clinician-administered PTSD scale: evidence for the dimensionality of posttraumatic stress disorder. Psychological Assessment,10, 90-96] model demonstrated a significantly superior fit over the DSM-IV three-factor model. Because this study provided support for both the DSM-IV three-factor model and the King et al., four-factor model of PTSD symptoms, further research is still necessary to provide more definitive conclusions in this area.",0,0 +3261,Enhancing Resilience: Families and Communities as Agents for Change,"In this article, the Linking Human Systems (LINC) Community Resilience model, a theoretical framework for initiating and sustaining change in communities that have undergone rapid and untimely transition or loss, is presented. The model assumes that individuals, families, and communities are inherently competent and resilient, and that with appropriate support and encouragement, they can access individual and collective strengths that will allow them to transcend their loss. This competence can be nurtured by helping people regain a sense of connectedness with one another; with those who came before them; with their daily patterns, rituals, and stories that impart spiritual meaning; and with tangible resources within their community. Rather than imposing artificial support infrastructures, LINC interventions engage respected community members to act as natural agents for change. These ""community links"" provide a bridge between outside professionals, families, and communities, particularly in circumstances in which outside intervention may not be welcomed. The article illustrates how LINC interventions successfully have been used in communities around the world.",0,0 +3262,Laypersons' expectations of recovery and beliefs about whiplash injury: A cross-cultural comparison between Australians and Singaporeans,"Background Beliefs and expectations are thought to influence outcome following whiplash injury. Studies have proposed a link between rates of chronic whiplash and laypersons' expectations about outcome following a motor vehicle accident. The prevalence of chronic whiplash is relatively high in Australia and apparently low in Singapore. This study's objectives were to compare laypersons' beliefs and expectations of recovery of whiplash injury in Brisbane and Singapore and to assess the effect of demographic factors on whiplash beliefs. Methods A cross-sectional study using online surveys was conducted on adult Internet users in Brisbane (Australia) and Singapore. The 14-item whiplash beliefs questionnaire (WBQ) was used to evaluate whiplash beliefs. Two additional items assessed expectations of recovery. Individual items of WBQ, WBQ score and expectations of recovery were analysed. Stratified analysis was performed to adjust for sampling bias due to quota sampling. Results A total of 402 participants from Singapore and 411 participants from Brisbane, Australia, completed the survey. While participants from Singapore demonstrated slightly more negative whiplash beliefs than participants from Brisbane [t(811) = −5.72; p < 0.0001], participants from both samples were similar in their expectations of quick recovery and return to normal activities following whiplash injury. Only gender had a significant effect on whiplash beliefs [estimated marginal means of WBQ score for men = 21.5; standard error (SE) = 0.20; women = 22.5; SE = 0.20; F(1,810) = 11.2; p = 0.001]. Conclusions Laypersons' expectations of recovery and beliefs about whiplash injury in Brisbane and Singapore were generally similar and mostly positive. Our results demonstrate that cultural differences reflected by laypersons' beliefs may not reflect the differences in prevalence of chronic whiplash between countries.",0,0 +3263,The relationship between acute stress disorder and posttraumatic stress disorder in severely injured trauma survivors,"This prospective longitudinal study was designed to investigate the relationship between acute stress disorder (ASD) and the subsequent development of posttraumatic stress disorder (PTSD) in a population of severely injured hospitalised trauma survivors. Symptoms of ASD were assessed just prior to discharge in 307 consecutive admissions to a Level 1 Trauma Centre, with PTSD assessments completed at 3 and 12 months post-injury. A well-established structured clinical interview was adopted for both assessments. Only 1% of the sample met criteria for an ASD diagnosis (at a mean of 8 days post-injury), while the incidence of PTSD was 9% at 3 months and 10% at 12 months. Although all ASD symptom clusters contributed to the prediction of subsequent PTSD severity, logistic regression indicated that only re-experiencing and arousal predicted a categorical PTSD diagnosis. The dissociative symptoms that form the core of ASD were rarely endorsed and showed high specificity but low sensitivity, resulting in a high proportion of false negative diagnoses. Reducing the number of dissociative symptoms required for a diagnosis ameliorated, but did not resolve, the problem. In this particular population, the low sensitivity of the ASD diagnosis renders it a poor screening test for use in identifying high risk individuals for early intervention and prevention strategies.",0,0 +3264,"Epigenetics of Posttraumatic Stress Disorder: Current Evidence, Challenges, and Future Directions","Posttraumatic stress disorder (PTSD) is a stress-related psychiatric disorder that is thought to emerge from complex interactions among traumatic events and multiple genetic factors. Epigenetic regulation lies at the heart of these interactions and mediates the lasting effects of the environment on gene regulation. An increasing body of evidence in human subjects with PTSD supports a role for epigenetic regulation of distinct genes and pathways in the pathogenesis of PTSD. The role of epigenetic regulation is further supported by studies examining fear conditioning in rodent models. Although this line of research offers an exciting outlook for future epigenetic research in PTSD, important limitations include the tissue specificity of epigenetic modifications, the phenomenologic definition of the disorder, and the challenge of translating molecular evidence across species. These limitations call for studies that combine data from postmortem human brain tissue and animal models, assess longitudinal epigenetic changes in living subjects, and examine dimensional phenotypes in addition to diagnoses. Moreover, examining the environmental, genetic, and epigenetic factors that promote resilience to trauma may lead to important advances in the field.",0,0 +3265,Variations in emotional abuse experiences among multiply maltreated young adolescents and relations with developmental outcomes,"Based on the data obtained through Child Protective Services (CPS) case records abstraction, this study aimed to explore patterns of overlapping types of child maltreatment in a sample of urban, ethnically diverse male and female youth (n= 303) identified as maltreated by a large public child welfare agency.A cluster analysis was conducted on data for 303 maltreated youth. The overall categorization of four types of abuse (i.e., physical, sexual, emotional abuse and neglect) was used to provide a starting point for clustering of the 303 cases and then the subtypes of emotional abuse were broken down in the clusters. The different clusters of child maltreatment were compared on the multiple outcomes such as mental health, behavior problems, self-perception, and cognitive development.In this study, we identified four clusters of child maltreatment experiences. Three patterns involved emotional abuse. One cluster of children experienced all four types. Different clusters were differentially associated with multiple outcome measures. In general, multiply-maltreated youth fared worst, especially when the cluster involved sexual abuse. Also, sex differences were found in these associations. Boys who experienced multiple types of maltreatment showed more difficulties than girls.These results reiterate the importance of creating more complex models of child maltreatment. Children who have experienced various types of maltreatment are especially in need of more attention from professionals and resources should be allocated accordingly.",0,0 +3266,"The relationship among cognitive schemas, job-related traumatic exposure, and posttraumatic stress disorder in journalists","American newspaper journalists (N = 906) participated in a study examining a cognitive mediational model for explaining the relationship between exposure to work-related traumatic events and work-related posttraumatic stress disorder (PTSD). Results indicated (a) greater exposure to work-related traumatic events was associated with work-related PTSD symptoms, as well as negative cognitive schemas; (b) cognitive beliefs partially accounted for PTSD symptoms, but the full cognitive mediational model was not supported. Implications include targeting interventions for journalists who experience traumatic stress and modifying theories about PTSD symptoms in journalists.",0,0 +3267,Systematic Review and Meta-Analysis of Multiple-Session Early Interventions Following Traumatic Events,"The authors sought to determine the efficacy of multiple-session psychological interventions to prevent and treat traumatic stress symptoms beginning within 3 months of a traumatic event.Nine computerized databases were searched, and manual searches were conducted of reference lists of selected articles as well as two journals. In addition, key researchers in the field were contacted to determine whether they were aware of other relevant studies. The reviewers identified randomized controlled trials of multiple-session psychological treatments aimed at preventing or reducing traumatic stress symptoms in individuals within 3 months of exposure to a traumatic event. Details of the studies were independently extracted by two reviewers, and outcome data were entered into the Review Manager software package. Quality assessment was also conducted by two researchers independently.Twenty-five studies examining a range of interventions were identified. For treatment of individuals exposed to a trauma irrespective of their symptoms, there was no significant difference between any intervention and usual care. For treatment of traumatic stress symptoms irrespective of diagnosis, trauma-focused cognitive-behavioral therapy (CBT) was more effective than waiting list or supportive counseling conditions. The difference was greatest for treatment of acute stress disorder and acute posttraumatic stress disorder.Trauma-focused CBT within 3 months of a traumatic event appears to be effective for individuals with traumatic stress symptoms, especially those who meet the threshold for a clinical diagnosis.",0,0 +3268,"Displacement, Gender, and the Challenges of Parenting after Hurricane Katrina","In emergency situations and in the aftermath of disaster, parents are essential in caring for children. Yet very little has been written explicitly about the experiences of mothers and fathers - either as individuals or partners - in postdisaster contexts. With the understanding that parenting is a gendered endeavor that occurs in a society stratified by race and class, this article focuses on the responses of mothers and fathers to Hurricane Katrina. This article draws on data gathered in Louisiana through observations, focus groups, and in-depth interviews with parents and other adults responsible for the care of children. Through a qualitative analysis, this research examines the strategies that mothers and fathers used to deal with the challenges of parenting in the aftermath of Katrina, the role of advocates who worked on behalf of families, the importance of kin networks, and the uniqueness of New Orleans and what the city means for families struggling to recover after the storm.",0,0 +3269,"The Millennium Cohort Study: A 21-Year Prospective Cohort Study of 140,000 Military Personnel","Does military service, in particular operational deployment, result in a higher risk of chronic illness among military personnel and veterans? The Millennium Cohort Study, the largest Department of Defense prospective cohort study ever conducted, will attempt to answer this question. The probability-based sample of 140,000 military personnel will be surveyed every 3 years during a 21-year period. The first questionnaire, scheduled for release in summer 2001, will be sent to 30,000 veterans who have been deployed to southwest Asia, Bosnia, or Kosovo since August 1997 and 70,000 veterans who have not been deployed to these conflict areas. Twenty thousand new participants will be added to the group in each of the years 2004 and 2007 to complete the study population of 140,000. The participants will have the option of completing the study questionnaire either on the paper copy received in the mail or through the World Wide Web-based version, which is available at www.MillenniumCohort.org. This will be one of the first prospective studies ever to offer such an option. The initial survey instrument will collect data regarding demographic characteristics, self-reported medical conditions and symptoms, and health-related behaviors. Validated instruments will be incorporated to capture self-assessed physical and mental functional status (Short Form for Veterans), psychosocial assessment (Patient Health Questionnaire), and post-traumatic stress disorder (Patient Checklist-17). Information obtained from the survey responses will be linked with other military databases, including data on deployment, occupation, vaccinations, health care utilization, and disability. In addition to revealing changes in veterans' health status over time, the Millennium Cohort Study will serve as a data repository, providing a solid foundation upon which additional epidemiological studies may be constructed.",0,0 +3270,Stress and Health during Medical Humanitarian Assistance Missions,"The present research examined stress and health among service members deployed on a medical humanitarian assistance mission to Kazakstan. Team members were surveyed before and during their deployment. Team members underestimated how much stress they would experience in terms of isolation and inability to help the local population. Team members also used less adaptive coping mechanisms than anticipated and showed elevations in alcohol and cigarette consumption. Despite these negative experiences, reports of depression and physical symptoms did not increase during the deployment. This may have been a function of team members being personally involved in important and relevant work during the humanitarian operation.",0,0 +3271,Internal validity of an anxiety disorder screening instrument across five ethnic groups,"We tested the factor structure of the National Anxiety Disorder Screening Day instrument (n=14860) within five ethnic groups (White, Black, Hispanic, Asian, Native American). Conducted yearly across the US, the screening is meant to detect five common anxiety syndromes. Factor analyses often fail to confirm the validity of assessment tools' structures, and this is especially likely for minority ethnic groups. If symptoms cluster differently across ethnic groups, criteria for conventional DSM-IV disorders are less likely to be met, leaving significant distress unlabeled and under-detected in minority groups. Exploratory and confirmatory factor analyses established that the items clustered into the six expected factors (one for each disorder plus agoraphobia). This six-factor model fit the data very well for Whites and not significantly worse for each other group. However, small areas of the model did not appear to fit as well for some groups. After taking these areas into account, the data still clearly suggest more prevalent PTSD symptoms in the Black, Hispanic and Native American groups in our sample. Additional studies are warranted to examine the model's external validity, generalizability to more culturally distinct groups, and overlap with other culture-specific syndromes.",0,0 +3272,Life after Trauma: Personality and Daily Life Experiences of Traumatized People,"In this study, we explored differences in personality and daily life experiences of traumatized (n = 26) versus nontraumatized (n = 30) college students. Study participants completed a variety of personality measures as well as a 28-day experience sampling study assessing daily activities, emotions, and physical health. Although not differing on general demographics, traumatized individuals reported more trait anxiety and lower self-esteem than nontraumatized individuals. They scored higher on Neuroticism, were more introverted, and were less emotionally stable than nontraumatized participants. Traumatized individuals also reported more cognitive disturbances, emotional blunting, and interpersonal withdrawal. They did not report being more depressed, but did endorse cognitive styles associated with heightened risk for depression. Earlier age of trauma was associated with more pathological outcomes: lower self-esteem and psychological well-being, more anxiety, more pessimism, and emotional constriction of positive mood. We compare this symptom profile to that of posttraumatic stress disorder.",0,0 +3273,Exploring the Lived-Experience of Limerence: A Journey toward Authenticity,"Limerence is an acute onset, unexpected, obsessive attachment to one person, the Limerent Object, which is rarely reported in scientific literature. Presented here is an interpretative phenomenological analysis to explore the livedexperience of six international Limerent respondents. The condition's unique and common journey is conceptualised in a Limerence Trajectory, which is characterized by generally sequential yet overlapping super-ordinate themes. The themes primarily regard experiences of ruminative thinking, free floating anxiety and depression temporarily fixated and the disintegration of the self. These themes are further linked to an inclination to reintegrate unresolved past life(s) experiences and to progress to a state of greater authenticity (i.e., being truer to one's inner self). A paradigm shift is identified in the realization that both a real and idealized Limerent Object are involved which may relate to attachment anxieties. Symptomology relating to Obsessive Compulsive Disorder, addiction, separation anxiety and depression, Post Traumatic Stress Disorder, disassociated states and maladaptive fantasy are discussed. The study authors and respondents collective aim is to promote awareness, research and resources for Limerent Experiencers and those who seek to support them.",0,0 +3274,Religious meaning-making at the community level: The forced relocation from the Gaza Strip.,"The purpose of the current study was to describe the process of religious coping in a religious community that underwent a forced relocation. Whereas previous work on meaning-making processes has looked at individuals, we sought to understand what happens to the process of religious coping when an entire community experiences a shared stressful event. Using Park’s (2005) model of religion as a meaningmaking framework, we analyzed open-ended narratives of 230 former residents of Gush Katif who wrote about the ways in which they coped with their relocation, 8 to 10 months after it took place. The primary finding was that participants referred to the impact of the relocation on their religious beliefs and referred to it not only as individuals but also, and perhaps mostly, as members of a community. Analyzing the content of these answers revealed four pathways of religious coping: resilient (no change in religious belief), strengthening of belief, weakening of belief, and open crisis. The findings suggest that in collective events, and especially in communities, meaning-making processes take place at both individual and collective levels. We discuss the findings in light of existing theories of religious coping.",0,0 +3275,Treatment type and demographic characteristics as predictors for cancer adjustment: Prospective trajectories of depressive symptoms in a population sample.,"Prospectively identifying individuals at heightened risk for depression can alleviate the disease burden of distal physical and mental health consequences after cancer onset. Our objective was to identify heterogeneous trajectories of adjustment in cancer patients, using treatment-type as a predictor.Participants were followed for 6 years within the Health and Retirement Study (HRS), a prospective population-based cohort study. The sample consisted of 1,294 middle-aged participants who were assessed once before and 3 time points after their report of an initial cancer diagnosis. In addition to self-reported depressive symptoms, subjects indicated receipt of surgical, radiological, or chemical interventions as part of their usual oncological care.Four symptom trajectories were identified with Latent Growth Mixture Modeling: an increasing depression (10.5%), chronic depression (8.0%), depressed-improved (7.8%), and stable-low depression (73.7%). A conditional model using participants with available predictor data (n = 545) showed individuals in the emerging depression class were significantly more likely to have received chemo/medication therapy when compared with the remitting depression, stable-low, and chronic depression classes. Participants in the chronic and depressed-improved classes generally had worse baseline health, and the depressed-improved were also younger in age.Patients who exhibited increasing depressive symptoms had a greater probability of receiving chemo/medication therapy than any other adjustment trajectory group, although the majority of chemotherapy patients did not exhibit depressive symptom changes. These data underscore the diversity of ways that patients adjust to cancer, and suggest cancer treatment, baseline health, and age may influence long-term patterns of psychological adjustment.",0,0 +3276,"Children and war: Risk, resilience, and recovery","This article reviews and reflects on studies that have explored the effects of war on children around the world. Most are cross-sectional and based on self-reports. They describe a range of mental health problems, related to dose effects and to the negative impact of being a victim or witness of violent acts, threats to and loss of loved ones, prolonged parental absence, and forced displacement. The more recent the exposure to war, and the older the child, the higher was the likelihood of reported posttraumatic stress disorder symptoms. Especially vulnerable to long-term emotional distress were child soldiers, children who were raped, and children who had been forcibly displaced. In adulthood, war-traumatized children displayed significantly increased risks for a wide range of medical conditions, especially cardiovascular diseases. Among protective factors that moderated the impact of war-related adversities in children were a strong bond between the primary caregiver and the child, the social support of teachers and peers, and a shared sense of values. Among the few documented intervention studies for children of war, school-based interventions, implemented by teachers or locally trained paraprofessionals, proved to be a feasible and low-cost alternative to individual or group therapy. More longitudinal research with multiple informants is needed to document the trajectories of risk and resilience in war-affected children, to assess their long-term development and mental health, and to identify effective treatment approaches.",0,0 +3277,Additive Gene-Environment Effects on Hippocampal Structure in Healthy Humans,"Hippocampal volume loss has been related to chronic stress as well as genetic factors. Although genetic and environmental variables affecting hippocampal volume have extensively been studied and related to mental illness, limited evidence is available with respect to G × E interactions on hippocampal volume. The present MRI study investigated interaction effects on hippocampal volume between three well-studied functional genetic variants (COMT Val158Met, BDNF Val66Met, 5-HTTLPR) associated with hippocampal volume and a measure of environmental adversity (life events questionnaire) in a large sample of healthy humans (n = 153). All three variants showed significant interactions with environmental adversity with respect to hippocampal volume. Observed effects were additive by nature and driven by both recent as well as early life events. A consecutive analysis of hippocampal subfields revealed a spatially distinct profile for each genetic variant suggesting a specific role of 5-HTTLPR for the subiculum, BDNF Val66Met for CA4/dentate gyrus, and COMT Val158Met for CA2/3 volume changes. The present study underscores the importance of G × E interactions as determinants of hippocampal volume, which is crucial for the neurobiological understanding of stress-related conditions, such as mood disorders or post-traumatic stress disorder (PTSD).",0,0 +3278,Prevalence of post-traumatic stress disorder among adolescents after the Wenchuan earthquake in China,"Background The Wenchuan earthquake was a catastrophic earthquake in China. The aim of this study is to explore longitudinally the rates of post-traumatic stress disorder (PTSD) and depression in adolescents after the Wenchuan earthquake, and to identify independent predictors of PTSD. Method PTSD and depression symptoms among adolescents at 6, 12 and 18 months after the Wenchuan earthquake were investigated using the PTSD Checklist Civilian Version and the Beck Depression Inventory (BDI). Subjects in this study included 548 high school student survivors in a local boarding high school. Results The rates of PTSD symptoms were 9.7%, 1.3% and 1.6% at the 6-, 12- and 18-month follow-ups, respectively. BDI scores were found to be the best predictor of severity of PTSD at 6, 12 and 18 months. Gender was another variable contributing significantly to PTSD at 6 and 12 months after the earthquake. In the 12-month follow-up, home damage was found to be a predictor of severity of PTSD symptoms. Being a child with siblings was found to be a predictor of severity of PTSD symptoms at 12 and 18 months after the earthquake. Conclusions PTSD symptoms changed gradually at various stages after the earthquake. Depression symptoms were predictive of PTSD symptoms in the 18-month follow-up study. Other predictors of PTSD symptoms included female gender and being a child with siblings. The results of this study may be helpful for further mental health interventions for adolescents after earthquakes.",0,0 +3279,"Finding One's Way to ""a Place Where I Am Respected"": the Experiences of First-Generation Vietnamese Americans with Depression and/or Post-traumatic Stress Disorder","Despite the high prevalence of depression and post-traumatic stress disorder among first-generation Vietnamese Americans, their underutilization of mental health services continues to persist. The question of how culturally sensitive mental health services can be delivered to engage this population effectively in treatment has been a key issue for disparities research for the past several decades. Ample literature has identified individual, sociocultural and structural factors that influence mental health service use among this population, but very few studies have explored the perceptions of the clients themselves about mental illness or their pathways to care. Twenty-one individual, inductive, and qualitative one-on-one interviews were conducted to address three aims: 1) to explore the conceptualizations of health among first-generation Vietnamese Americans living with depression and/or PTSD, 2) to illustrate the pathways through which this population obtained outpatient mental health services, and 3) to describe their expectations and perceptions of outpatient mental health treatment. Constructivist grounded theory (GT) guided all aspects of this study. The participants were mostly female and ranged in age from 42 to 74 years. Two major themes, bounded within these four walls and finding one's way to a place where I am respected, emerged as overarching processes through which the participants described their experiences. Their rich stories portrayed journeys through losing, finding and reclaiming their self worth -- journeys marked with losses, sacrifices, disruptions, stigma, resilience, coming to terms with their conditions, and managing their illnesses. These men and women remained optimistic on the road to reclaiming their sense of self worth, despite being crippled by their legacies of war, trauma, and migration to the United States. Their stories offer a culturally nuanced understanding of how participants explained their emotional discomforts, how they found their various ways to agencies that could help ease these discomforts, and the unexpected resources and relationships they gained from outpatient mental health care. This study's findings provide strong implications for social work research, practice, and policy that can help empower these individuals to find purpose and hope in their lives.",0,0 +3280,Psychophysiology in the Study of Psychological Trauma: Where Are We Now and Where Do We Need to Be?,"Posttraumatic stress disorder (PTSD) is a major public health concern, which has been seeing increased recent attention partly due to the wars in Iraq and Afghanistan. Historically, research attempting to understand the etiology and treatment of PTSD has made frequent use of psychophysiological measures of arousal as they provide a number of advantages in providing objective, non-self-report outcomes that are closely related to proposed neurobiological mechanisms and provide opportunity for cross-species translation. Further, the ongoing shift in classification of psychiatric illness based on symptom clusters to specific biological, physiological, and behavioral constructs, as outlined in the US National Institute of Mental Health (NIMH) Research Domain Criteria project (RDoC), promises that psychophysiological research will continue to play a prominent role in research on trauma-related illnesses. This review focuses on the current state of the knowledge regarding psychophysiological measures and PTSD with a focus on physiological markers associated with current PTSD symptoms, as well as markers of constructs thought to be relevant to PTSD symptomatology (safety signal learning, fear extinction), and psychophysiological markers of risk for developing PTSD following trauma. Future directions and issues for the psychophysiological study of trauma including traumatic brain injury (TBI), treatment outcome studies, and new wearable physiological monitoring technologies are also discussed.",0,0 +3281,Psychometric properties of the Posttraumatic Stress Disorder Symptom Scale Interview for DSM–5 (PSSI–5).,"Changes to the diagnostic criteria for posttraumatic stress disorder (PTSD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) create a need for valid and reliable updated assessment tools. This study examined key psychometric properties (e.g., internal consistency, test-retest reliability, interrater reliability, and convergent and discriminant validity) of the PTSD Symptom Scale Interview for DSM-5 (PSSI-5), a modified version of the PSS-I (PTSD Symptom Scale)-Interview Version for the DSM-IV. Participants were 242 urban community residents, veterans, and college undergraduates, recruited from 3 study sites, who had experienced a DSM-5 Criterion A traumatic event. The PSSI-5 demonstrated good internal consistency (α = .89) and test-retest reliability (r = .87), as well as excellent interrater reliability for the total severity score (intraclass correlation = .98) and interrater agreement for PTSD diagnosis (κ = .84). The PSSI-5 also demonstrated convergent validity with 3 measures of PTSD (i.e., Clinician-Administered PTSD Scale for DSM-5, Posttraumatic Diagnostic Scale for DSM-5, and PTSD Checklist-Specific Version; all rs > .72) and discriminant validity with the Beck Depression Inventory-II and the State-Trait Anxiety Inventory-Trait scale. Receiver operating characteristic analysis yielded a cutoff score of 23 for identifying a probable PTSD diagnosis. Together, these findings indicate that the PSSI-5 is a valid and reliable instrument for assessing PTSD diagnosis and severity. (PsycINFO Database Record",0,0 +3282,Social Work Practice for Promoting Health and Wellbeing,,0,0 +3283,The Course of Posttraumatic Stress in Children: Examination of Recovery Trajectories Following Traumatic Injury,"Group-based trajectory modeling was used to identify patterns of posttraumatic stress symptom (PTSS) in children 6-16 years following accidental injury. The aims were to: (a) identify probable groups of children following distinct trajectories, and (b) identify risk factors affecting the probability of group membership.Children's Impact of Events Scale (n = 190) was used to assess PTSS up to 2 years post injury. Age, gender, type of injury, and preinjury behavior were assessed as risk factors.Three distinct trajectory groups were identified: resilient (57%), elevated stress symptoms which recovered quickly (33%), and chronic (10%). Younger children were more likely to be in the recovery group. Those with serious injuries were more likely to be in the chronic group. Preinjury child behavior problems were predictive of recovery and high chronic symptoms.Identification of distinct PTSS trajectory groups has implications for understanding the course and treatment of PTSS in children.",0,0 +3284,Models for pedestrian gap acceptance behaviour analysis at unprotected mid-block crosswalks under mixed traffic conditions,"Pedestrian safety is an important aspect while crossing the road and it can be explained by pedestrian gap acceptance behaviour. The statistical models such as multiple linear regression (MLR) is often used to model linear relationships between dependent variable (viz., pedestrian gap acceptance behaviour) and independent variables, due to their ability to quantitatively predict the effect of various factors on the dependent variable. However such linear models cannot consider the effect of several variables on the output variable, due to primary assumptions of normality, linear, homoscedasticity and multicollinearity. In this regard, the non-linear models based on the artificial neural network (ANN), which are free from assumptions of linear models, can be easily employed for obtaining the effect of several input variables on the pedestrian accepted gap size. However, researchers have rarely applied ANN modelling technique for predicting the pedestrian gap acceptance behaviour, as the pedestrian gap acceptance behaviour depends on several pedestrian, traffic and vehicular characteristics. The ANN based models would be quite useful in establishing relationship between these factors on the pedestrian gap acceptance behaviour at midblock crosswalks under mixed traffic conditions. In this direction, the present study adopts both MLR as well as ANN with different pedestrian, traffic and vehicular characteristics to assess the significant contributing factors for pedestrians’ gap acceptance behaviour at unprotected mid-block crosswalks under mixed traffic conditions. For this purpose, a video graphic survey was conducted at a six lane divided road at unprotected mid-block crossing in Mumbai, India. The data such as pedestrian (gender and age), vehicular, traffic and pedestrian behavioural characteristics were extracted to model pedestrian accepted gaps. The model results show that pedestrian rolling behaviour has a significant effect on pedestrian accepted gap size. The model results concluded that ANN has a better prediction with possibility to consider the effect of more number of variables on the pedestrian gap acceptance behaviour as compared to the MLR model under mixed traffic conditions. However, the quantification of significant contributing variables on pedestrian accepted gap size is easy by MLR model as compared to the ANN technique. So, both models have their own significant role in pedestrian gap acceptance analysis. The developed models may be useful to enhance the existing mid-block crosswalk facilities or planning new facilities by more accurate prediction of the pedestrian gap acceptance behaviour considering the influence of various factors under mixed traffic conditions.",0,0 +3285,Cognitive Debt and Alzheimer's Disease,"We propose the concept of Cognitive Debt to characterize thoughts and behaviors that increase vulnerability to symptomatic Alzheimer's disease (AD). Evidence indicates that depression, anxiety, sleep disorder, neuroticism, life stress, and post-traumatic stress disorder increase risk for AD, and we suggest they do so by increasing Cognitive Debt. Repetitive negative thinking (RNT), a behaviorally measurable process common to these factors, may drive Cognitive Debt acquisition. RNT transcends disorder-specific definition, encompasses rumination and worry, and is defined by perseverative, negative thought tendencies. Evidence of dysregulated stress responses supports the concept of Cognitive Debt, of RNT as its causal mechanism, and of an interaction with the APOE-ε4 genotype to increase vulnerability to clinical AD, independent from traditional AD pathology. Defining a more specific behavioral profile of risk would enable interventions to be targeted earlier and more precisely at individuals most vulnerable to developing AD. Additionally, modulating RNT could potentially reduce risk of clinical AD. Interventions to reduce RNT are discussed, as are suggestions for future research. For these reasons we submit that the Cognitive Debt model may aid understanding of the psychological mechanisms that potentially increase predisposition to AD.",0,0 +3286,The importance of secondary trauma exposure for post-disaster mental disorder,"Background. Interventions to treat mental disorders after natural disasters are important both for humanitarian reasons and also for successful post-disaster physical reconstruction that depends on the psychological functioning of the affected population. A major difficulty in developing such interventions, however, is that large between-disaster variation exists in the prevalence of post-disaster mental disorders, making it difficult to estimate need for services in designing interventions without carrying out a post-disaster mental health needs assessment survey. One of the daunting methodological challenges in implementing such surveys is that secondary stressors unique to the disaster often need to be discovered to understand the magnitude, type, and population segments most affected by post-disaster mental disorders. Methods. This problem is examined in the current commentary by analyzing data from the WHO World Mental Health (WMH) Surveys. We analyze the extent to which people exposed to natural disasters throughout the world also experienced secondary stressors and the extent to which the mental disorders associated with disasters were more proximally due to these secondary stressors than to the disasters themselves. Results. Lifetime exposure to natural disasters was found to be high across countries (4.4–7.5%). 10.7–11.4% of those exposed to natural disasters reported the occurrence of other related stressors (e.g. death of a loved one and destruction of property). A monotonic relationship was found between the number of additional stressors and the subsequent onset of mental disorders Conclusions. These results document the importance of secondary stressors in accounting for the effects of natural disasters on mental disorders. Implications for intervention planning are discussed.",0,0 +3287,Introduction to a Special Issue on Research with Youth Exposed to Disasters and Violence,,0,0 +3288,Missing data: Our view of the state of the art.,"Statistical procedures for missing data have vastly improved, yet misconception and unsound practice still abound. The authors frame the missing-data problem, review methods offer advice, and raise issues that remain unresolved. They clear up common misunderstandings regarding the missing at random (MAR) concept. They summarize the evidence against older procedures and, with few exceptions, discourage their use. They present, in both technical and practical language, 2 general approaches that come highly recommended: maximum likelihood (ML) and Bayesian multiple imputation (MI). Newer developments are discussed, including some for dealing with missing data that are not MAR. Although not yet in the mainstream, these procedures may eventually extend the ML and MI methods that currently represent the state of the art.",0,0 +3289,Posttraumatic Stress Disorder across Two Generations of Cambodian Refugees,"To examine the expression of war-related trauma as manifested by DSM-III-R rates of posttraumatic stress disorder (PTSD) and major depressive disorder in two generations of Cambodian refugees living in the western United States.A probability sample of 209 Khmer adolescents and one of their parents were interviewed using portions of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version and the PTSD section of the Diagnostic Interview for Children and Adolescents. Interviews were conducted in English by a master's-level clinician with a Khmer interpreter.PTSD was found to be significantly related across parent-child generations. A nonsignificant generational trend was also found for depressive disorders. A number of environmental variables measured in the study (amount of reported war trauma, loss, living arrangements, treatment received, socioeconomic status) were not related to these findings. Parents were more likely to report an earlier onset of PTSD symptoms.This study suggests that PTSD in refugees may cluster in families. Whether this phenomenon is caused by a genetic susceptibility to trauma awaits further research. PTSD and depressive disorders in refugee populations, while often comorbid, appear to follow different courses over time.",0,0 +3290,Acute psychophysiological arousal and posttraumatic stress disorder: A two-year prospective study,"This study investigated the role of acute arousal in the development of posttraumatic stress disorder (PTSD). Hospitalized motor vehicle accident survivors (n = 146) were assessed for acute stress disorder (ASD) within 1 month of the trauma, 6 months later, and reassessed for PTSD 2 years posttrauma (n = 87). Heart rates (HR) were assessed on the day of hospital discharge. Participants who had PTSD 2 years posttrauma had higher HR at hospital discharge than those without PTSD. A diagnosis of ASD or a resting HR of 95 beats per minute had moderate sensitivity (74%) and specificity (91%) in predicting PTSD. These findings suggest that caution is required in using acute HR as a predictor of longer-term PTSD following trauma.",0,0 +3291,The association of posttraumatic stress disorder and quality of life during the first year after acute coronary syndrome,"Acute coronary syndrome [ACS, including unstable angina (UA) or myocardial infarction (MI)] events can be psychologically traumatic experiences for patients given their unpredictable, sudden onset and life-threatening nature [1]. Although posttraumatic stress disorder (PTSD) is commonly associated with index events of war or assault, PTSD is also associated with life-threatening illness and in particular ACS with approximately 12% of patients developing PTSD [1,2].",0,0 +3292,Low early morning plasma cortisol in posttraumatic stress disorder is associated with co-morbid depression but not with enhanced glucocorticoid feedback inhibition,"Co-morbid major depressive disorder (MDD) in individuals with posttraumatic stress disorder (PTSD) confers a more severe clinical course and is associated with distinct biologic abnormalities. Although dysregulation in the hypothalamic pituitary adrenal (HPA) axis has been well established in PTSD, the impact of commonly co-occuring MDD has received scant attention.Overnight (7p.m. to 7a.m.) plasma cortisol, adrenocorticotropic hormone (ACTH), dehydroepiandrosterone sulphate (DHEA-S) were measured at 30 min intervals in 9 participants with PTSD with MDD (PTSD+MDD), 9 with PTSD without MDD (PTSD-MDD) and 16 non-traumatized healthy controls. A low-dose dexamethasone suppression test was administered to evaluate feedback sensitivity to glucocorticoids. Linear mixed models with body mass index (BMI) and age as covariates and Bonferroni corrected post hoc tests assessed group differences.Compared to healthy controls, subjects with PTSD+MDD, but not those subjects with PTSD-MDD, exhibited lower basal plasma cortisol levels between 1:30 a.m. and 3:30 a.m. and at 4:30 a.m. and 6:30 a.m. (effect size d=0.75). Despite similar plasma ACTH levels between the three groups, the ACTH/cortisol ratio was higher in PTSD+MDD patients compared to controls. We obtained similar results when the patient and control groups were re-studied 1 week later, and when men and current smokers were excluded. Basal plasma DHEA-S levels, and cortisol and ACTH response to a low-dose dexamethasone suppression test were similar in all three groups.Lower early morning plasma cortisol levels and a high ACTH/cortisol ratio in subjects with PTSD and co-morbid MDD may not be due to enhanced peripheral sensitivity to glucocorticoids. A central abnormality in glucocorticoid regulation could explain HPA axis dysfunction in this subgroup.",0,0 +3293,Posttraumatic Stress Disorder Among Israeli Ex-Prisoners of War 18 and 30 Years After Release,"Article AbstractBackground: The psychological responses to captivity were measured in a sample of former prisoners of war (POWs) 18 and 30 years after release from captivity. Method: 209 Israeli veterans of the 1973 Yom Kippur War (103 ex-POWs and 106 controls) who had taken part in a previous study conducted in 1991 participated in the current study conducted in 2003. The study assessed current rates of posttraumatic stress disorder (PTSD), changes in PTSD over time, and the contribution of captivity severity (objective and subjective), sociodemographic variables, and psychological appraisal and coping with captivity to predicting PTSD using standardized self-report questionnaires. Results: Twenty-three percent of the ex-POWs met PTSD criteria and were 10 times more likely than controls to experience deterioration in their psychological condition in the 12-year interval between the 2 assessments. Almost 20% of ex-POWs who did not meet PTSD criteria in 1991 met criteria in the current assessment, in comparison to almost 1% of the controls. Current PTSD was predicted by younger age at the time of captivity, by loss of emotional control and higher subjective appraisal of suffering in captivity, and by a greater number of PTSD symptoms in the 1991 assessment. Conclusion: It is important to follow up and offer treatment to former POWs. Special attention should be paid to those who lost emotional control in captivity and to those who felt that the conditions of their captivity were severe.",0,0 +3294,Shared and unique predictors of post-traumatic growth and distress,"This prospective longitudinal study compared pretraumatic, peritraumatic, and post-traumatic predictors of post-traumatic growth (PTG) and post-traumatic stress disorder (PTSD). A total of 103 Israeli former prisoners of the Yom Kippur War were followed over 30 years. Sociodemographic variables, trauma exposure, reactions in captivity, world assumptions, social support, and personality factors were assessed in 1991, and PTG and PTSD symptoms in 2003. Hierarchical regression modeling showed that although some predictors, namely, loss of control and active coping during captivity, predicted both PTG and PTSD, others predicted one outcome and not the other. Self-controllability predicted PTG while sociodemographic factors predicted PTSD when controlling for PTSD and PTG, respectively. The findings indicate that salutary and pathogenic trauma outcomes share some but not all precursors, underscoring their multifaceted relationship.",0,0 +3295,Associations between posttraumatic stress disorder symptom clusters and cigarette smoking.,"Understanding the relationship between Posttraumatic stress disorder (PTSD) and cigarette smoking has been difficult because of PTSD's symptomatic heterogeneity. This study examined common and unique lifetime cross-sectional relationships between PTSD symptom clusters [Re-experiencing (intrusive thoughts and nightmares about the trauma), Avoidance (avoidance of trauma-associated memories or stimuli), Emotional Numbing (loss of interest, interpersonal detachment, restricted positive affect), and Hyperarousal (irritability, difficulty concentrating, hypervigilance, insomnia)] and three indicators of smoking behavior: (1) smoking status; (2) cigarettes per day; and (3) nicotine dependence. Participants were adult respondents in the National Epidemiologic Survey of Alcohol and Related Conditions with a trauma history (n = 23,635). All four symptom clusters associated with each smoking outcome in single-predictor models (ps <. 0001). In multivariate models including all of the symptom clusters as simultaneous predictors, Emotional Numbing was the only cluster to retain a significant association with lifetime smoking over and above the other clusters, demographics, and Axis-I comorbidity (OR = 1.30, p < .01). While Avoidance uniquely associated with smoking status and nicotine dependence in multivariate models, these relations fell below significance after adjusting for demographics and comorbidity. No clusters uniquely associated with cigarettes per day. Hyperarousal uniquely related with nicotine dependence over and above the other clusters, demographics, and Axis-I comorbidity (OR = 1.51, p < .001). These results suggest the following: (a) common variance across PTSD symptom clusters contribute to PTSD's linkage with smoking in the American population; and (b) certain PTSD symptom clusters may uniquely associate with particular indicators of smoking behavior. These findings may clarify the underpinnings of PTSD-smoking comorbidity and inform smoking interventions for trauma-exposed individuals.",0,0 +3296,Trajectories of maternal depression over 7 years: Relations with child psychophysiology and behavior and role of contextual risks,"Abstract This study examines the relation between the longitudinal course of maternal depression during the child's early life and children's psychophysiology and behavior at age 6.5 years. One hundred fifty-nine children of depressed and nondepressed mothers were followed from infancy through age 6.5 years. Growth mixture modeling was used to identify classes of depressed mothers based on the longitudinal course of the mother's depression. School-aged children of chronically depressed mothers were found to have elevated externalizing behavior problems, decreased social competence, reduced frontal brain activation (EEG power), and higher respiratory sinus arrhythmia reactivity. Children of mothers with decreasing and stable mild depression were found to have increased hyperactivity and attention problems compared to children of nondepressed mothers. Contextual risk factors were found to mediate the relation between maternal depression and child behavioral outcomes.",0,0 +3297,Risk Factors for Depression After a Disaster,"Environmental stressors such as mass disasters may contribute to an increased prevalence of depression within the population affected. We examined the prevalence of probable major depression and risk factors for depression in the 6-month period after the September 11, 2001, attacks on the World Trade Center among New York City (NYC) metropolitan residents. A total of 2700 persons who were representative of the NYC metropolitan area were included in this cross-sectional telephone survey. The prevalence of probable major depression in the 6 months after the attacks was 9.4%. Multivariate logistic regression covariates associated with the likelihood of probable major depression included being directly affected by the attacks, having a perievent panic attack, experiencing multiple life stressors, and having been exposed to previous traumatic events. Mass traumatic event exposure appears to be an independent environmental risk factor for depression in the postdisaster context; specific reactions such as perievent panic attacks may have prognostic value.",0,0 +3298,Posttraumatic Stress Disorder Increases Risk of Criminal Recidivism Among Justice-Involved Persons With Mental Disorders,"Posttraumatic stress disorder (PTSD) is a potentially important, yet understudied, mental disorder to consider in models of criminal recidivism. The present study sought to address this gap in the literature with a large-scale secondary analysis of observational data from a sample of justice-involved persons with mental disorders. Administrative data were reviewed for 771 adult jail detainees with mental disorders. Hierarchical logistic regression models showed that PTSD was associated with a greater likelihood of general (arrest for any new charge) and serious (arrest for a new felony charge) recidivism during the year following the index arrest, after controlling for risk conferred by a recent history of arrest, demographic characteristics, and other mental disorders. Furthermore, risk of rearrest for new charges was comparable for PTSD and substance use disorders. Findings show that PTSD increases risk of both general and serious recidivism and suggest it should be considered in interventions to reduce justice-system involvement.",0,0 +3299,Association between traumatic events and post-traumatic stress disorder: results from the ESEMeD-Spain study,"The relative importance of traumatic events (TEs) in accounting for the social burden of post-traumatic stress disorder (PTSD) could vary according to cross-cultural factors. In that sense, no such studies have yet been conducted in the Spanish general population. The present study aims to determine the epidemiology of trauma and PTSD in a Spanish community sample using the randomly selected TEs method.The European Study of the Epidemiology of Mental Disorders (ESEMeD)-Spain is a cross-sectional household survey of a representative sample of adult population. Lifetime prevalence of self-reported TEs and lifetime and 12-month prevalence of PTSD were evaluated using the World Health Organization (WHO) Composite International Diagnostic Interview. Reports of PTSD associated with randomly selected TEs were weighted by the individual-level probabilities of TE selection to generate estimates of population-level PTSD risk associated with each TE.Road accident was the most commonly self-reported TE (14.1%). Sexual assault had the highest conditional risk of PTSD (16.5%). The TEs that contributed most to societal PTSD burden were unexpected death of a loved one (36.4% of all cases) and sexual assault (17.2%). Being female and having a low educational level were associated with low risk of overall TE exposure and being previously married was related to higher risk. Being female was related to high risk of PTSD after experiencing a TE.Having an accident is commonly reported among Spanish adults, but two TE are responsible for the highest burden associated with PTSD: the unexpected death of someone close and sexual assault. These results can help designing public health interventions to reduce the societal PTSD burden.",0,0 +3300,Abnormal recruitment of working memory updating networks during maintenance of trauma-neutral information in post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) is characterised by disturbances in concentration and memory, symptoms which are a source of further distress for patients. Related to this, abnormalities in underlying working memory (WM) systems have been identified [Clark, C.R., McFarlane, A.C., Morris, P., Weber, D.L., Sonkkilla, C., Shaw, M.E., Marcina, J., Tochon-Danguy, H.J., Egan, G.F., 2003. Cerebral function in posttraumatic stress disorder during verbal working memory updating: a positron emission tomography study. Biological Psychiatry 53, 474-481.], indicating dysfunction in left hemisphere brain regions. In this study, we performed functional magnetic resonance imaging (fMRI) in 13 patients with severe PTSD and matched non-traumatized Controls, during performance of visuo-verbal tasks that involved either maintenance or continual updating of word stimuli in WM. The PTSD group failed to show differential activation during WM updating, and instead appeared to show abnormal recruitment of WM updating network regions during WM maintenance. These regions included the bilateral dorsolateral prefrontal cortex (DLPFC) and the inferior parietal lobe (IPL). Several other regions were significantly more activated in Controls than in PTSD during WM updating, including the hippocampus, the anterior cingulate (AC), and the brainstem pons, key regions that are consistently implicated in the neurobiology of PTSD. These findings suggest compensatory recruitment of networks in PTSD normally only deployed during updating of WM and may reflect PTSD patients' difficulty engaging with their day-to-day environment.",0,0 +3301,Hostility is related to clusters of T-cell cytokines and chemokines in healthy men,"Hostility is a risk factor for adverse health outcomes as diverse as cardiovascular disease and post-traumatic stress disorder (PTSD). Cytokines have been suggested to mediate this relationship. We investigated whether in healthy men a relation existed between hostility and T-cell mitogen-induced cytokines and chemokines. Male Dutch military personnel (n=304) were included before deployment. Eleven cytokines and chemokines were measured in supernatants of T-cell mitogen-stimulated whole blood cultures by multiplex immunoassay. Factor analysis was used to identify clusters of cytokines and chemokines. In a regression analysis hostility was related to the cytokine/chemokine clusters, and the potential risk factors age, BMI, smoking, drinking, previous deployment, early life trauma and depression. Explorative factor analysis showed four functional clusters; a pro-inflammatory factor (IL-2, TNFalpha, IFNgamma), an anti-inflammatory factor (IL-4, IL-5, IL-10), IL-6/chemokine factor (IL-6, MCP-1, RANTES, IP-10), and MIF. Hostility was significantly related to decreased IL-6/chemokine secretion and increased pro- and anti-inflammatory cytokines. There was an inverse relation between age and hostility scores. Early life trauma and depression were positively and independently related to hostility as well. This study represents a novel way of investigating the relation between cytokines and psychological characteristics. Cytokines/chemokines clustered into functional factors, which were related to hostility in healthy males. Moreover this relation appeared to be independent of reported depression and early trauma.",0,0 +3302,Construct Validity of the Posttraumatic Stress Disorder Checklist in Cancer Survivors: Analyses Based on Two Samples.,"The measurement of posttraumatic stress disorder (PTSD) is critically important for the identification and treatment of this disorder. The PTSD Checklist (PCL; F. W. Weathers and J. Ford, 1996) is a self-report measure that is increasingly used. In this study, the authors investigated the factorial validity of the PCL with data from 236 cancer survivors who received a bone marrow or stem cell transplantation. The authors examined the fit of these data with the clinical model of 3 symptom clusters for PTSD, as proposed in the Diagnostic and Statistical Manual of Mental Disorders, and alternative models tested in prior research. By using confirmatory factor analysis the authors found that a 4-first-order-factor model of PTSD provided the best fit. The relations of PTSD symptoms with sociodemographic and medical variables were also explored.",0,0 +3303,Use of prescription drugs and future delinquency among adolescent offenders,"

Abstract

Non-medical use of prescription drugs (NMUPD) by adolescents is a significant public health concern. The present study investigated the profile of NMUPD in 1349 adolescent offenders from the Pathways to Desistance project, and whether NMUPD predicted future delinquency using longitudinal data. Results indicated that increased frequency and recency of NMUPD in adolescent offenders are related to some demographic factors, as well as increased risk for violence exposure, mental health diagnoses, other drug use, and previous delinquency, suggesting that severity of NMUPD is important to consider. However, ANCOVA analyses found that NMUPD was not a significant predictor of drug-related, non-aggressive, or aggressive delinquency 12months later beyond other known correlates of delinquency. Age, sex, exposure to violence, lower socioeconomic status, more alcohol use, and having delinquency histories were more important than NMUPD in predicting future delinquency. These findings suggest that although NMUPD is an important risk factor relating to many correlates of delinquency, it does not predict future delinquency beyond other known risk factors.",0,0 +3304,Financial and social circumstances and the incidence and course of PTSD in Mississippi during the first two years after Hurricane Katrina,"Hurricane Katrina was the most devastating natural disaster to hit the United States in the past 75 years. The authors conducted interviews of 810 persons who were representative of adult residents living in the 23 southernmost counties of Mississippi before Hurricane Katrina. The prevalence of posttraumatic stress disorder (PTSD) since Hurricane Katrina was 22.5%. The determinants of PTSD were female gender, experience of hurricane-related financial loss, postdisaster stressors, low social support, and postdisaster traumatic events. Kaplan-Meier survival curves suggest that exposure to both hurricane-related traumatic events and to financial and social stressors influenced the duration of PTSD symptoms. Postdisaster interventions that aim to improve manipulable stressors after these events may influence the onset and course of PTSD.",0,0 +3305,Post-traumatic amnesia and the nature of post-traumatic stress disorder after mild traumatic brain injury,"Abstract The prevalence and nature of post-traumatic stress disorder (PTSD) following mild traumatic brain injury (MTBI) is controversial because of the apparent paradox of suffering PTSD with impaired memory for the traumatic event. In this study, 1167 survivors of traumatic injury (MTBI: 459, No TBI: 708) were assessed for PTSD symptoms and post-traumatic amnesia during hospitalization, and were subsequently assessed for PTSD 3 months later ( N = 920). At the follow-up assessment, 90 (9.4%) patients met criteria for PTSD (MTBI: 50, 11.8%; No-TBI: 40, 7.5%); MTBI patients were more likely to develop PTSD than no-TBI patients, after controlling for injury severity (adjusted odds ratio: 1.86; 95% confidence interval, 1.78–2.94). Longer post-traumatic amnesia was associated with less severe intrusive memories at the acute assessment. These findings indicate that PTSD may be more likely following MTBI, however, longer post-traumatic amnesia appears to be protective against selected re-experiencing symptoms. ( JINS , 2009, 15 , 862–867.)",0,0 +3306,The PHQ-9,"While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity.The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as ""0"" (not at all) to ""3"" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients.As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples.In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.",0,0 +3307,Screening for substance abuse in individuals with traumatic brain injury,"To determine the utility of the CAGE, the Brief Michigan Alcohol Screening Test (BMAST) and the Substance Abuse Subtle Screening Inventory (SASSI-3) with individuals with traumatic brain injury (TBI), two studies were conducted examining the accuracy, sensitivity and specificity of these instruments.Data from self-report instruments were compared to a clinical interview, Structured Clinical Interview for DSM-IV (SCID), to determine the accuracy, sensitivity and specificity.Two studies were conducted. In study I, 100 individuals with TBI were screened for alcohol abuse using the CAGE and the resulting classifications were compared with those derived from the SCID. In study II, 223 individuals were screened for alcohol abuse and drug abuse using the BMAST and SASSI-3 and the results of these screenings were compared with diagnoses obtained by the SCID.The specificity of the self-report instruments was moderately high, ranging between 81-83%. The specificity of the CAGE for alcohol abuse both pre- and post-TBI was high, 96% and 86%, respectively. The sensitivity of the self-report instruments was most variable, ranging from 32-95%, with the SASSI face valid drug scale and the CAGE alcohol post-TBI indicating the most sensitivity, 95 and 91%, respectively.The findings suggest that the CAGE may be useful in screening for alcohol abuse and the face valid drug sub-scale of the SASSI-3 may be useful in screening for drug abuse in individuals with TBI.",0,0 +3308,Student-teacher relationship trajectories and mental health problems in young children,"This longitudinal study classified groups of children experiencing different trajectories of student-teacher relationship quality over the transition from preschool into school, and determined the strength of the association between different student-teacher relationship trajectories and childhood mental health problems in the second year of primary school.A community sample of 460 Australian children were assessed in preschool (age 4), the first school year (age 5), and second school year (age 6). Teachers at all three assessments reported on student-teacher relationship quality with the Student Teacher Relationship Scale. When the children were at preschool and in their second school year, parents and teachers rated children's mental health problems using the Strengths and Difficulties Questionnaire.Latent-class growth modelling identified two trajectories of student-teacher relationship quality: (1) a stable-high student-teacher relationship quality and (2) a moderate/declining student-teacher relationship quality trajectory. Generalised linear models found that after adjusting for family demographic characteristics, having a stable high quality student-teacher relationship trajectory was associated with fewer parent-rated and teacher-rated total mental health problems, and fewer conduct, hyperactivity, and peer problems, and greater prosocial behaviour at age 6. A stable high quality trajectory was also associated with fewer teacher-rated, but not parent-rated emotional symptoms. These effects remained after adjustment for levels of mental health problems at age 4.Findings suggest that early intervention and prevention strategies that focus on building stable high quality student-teacher relationships during preschool and children's transition into formal schooling, may help reduce rates of childhood mental health problems during the early school years.",0,0 +3309,Duties of a psychiatric-neurological consultation/ liaison service in a prison setting,"Demonstrated are standards for diagnostic and therapeutic competence deriving from the duties of a psychiatric-neurological consultation/liaison service maintained in a German prison over a 4-year period. Homogeneous age distribution (32.5 +/- 4.4 years) and the lower social status of the patients characterized the mental disorders observed in the male multinational group of patients investigated (n = 170). These included schizophrenic, affective, neurotic and psychosocial stress disorders, alcohol and drug dependence and specific personality disorders. Besides tendencies towards dissimulation, culture-bound differences in symptomatology, the phenomenon of malingering and the reluctance of prisoners, by reason of their status as such, to divulge personal information on relevant aspects of personal identity were factors complicating the diagnostic process. Epileptic syndromes and lesions of the peripheral nervous system dominated the profile of neurological diseases, mandating experience in all established technical examination procedures of neurology. Therapeutic competence in psychiatry and neurology has to satisfy not only the diversity of the manifest diseases and disorders, calling for cooperation with various medical specialists and hospitals, it must also recognize particularly the limitations of therapy in a prison setting (e.g. observation of suicidal patients). Confidentiality and transparency of medical behavior are absolute variables in the treatment of prisoners that can be rather easily realized in a consultation/liaison service.",0,0 +3310,Posttraumatic Growth in Populations with Posttraumatic Stress Disorder-A Systematic Review on Growth-Related Psychological Constructs and Biological Variables,"Posttraumatic growth (PTG) and Posttraumatic Stress Disorder (PTSD) are possible consequences of trauma. PTG is supposed to emerge from cognitive processes and can have functional and dysfunctional aspects. This systematic review aims to identify and evaluate publications assessing PTG in adults diagnosed with PTSD in order to analyse the relationship between both constructs, how PTG is related to specific psychological variables and if there are biological variables linked to PTG. This extended review evaluates the quality of measures applied and is the first to study PTG only in populations meeting full PTSD criteria. In addition, the relationship between PTG and other relevant constructs, such as openness, optimism and social support, is explored. Our systematic literature search identified 140 studies of which 19 fulfilled our inclusion criteria; most of them used the Post-Traumatic Growth Inventory. Results indicate that trauma survivors with PTSD exhibit more PTG than those without PTSD and that PTG can be intensified during the therapeutic process whereat it is unclear whether PTG is a desirable outcome of PTSD therapy. Positive correlations between PTG and PTSD are reported. For diagnosed populations, we could not find strong evidence of a quadratic relationship between PTG and PTSD, although some studies support this hypothesis. Findings regarding the association of PTG with psychological variables are heterogeneous. Only one study focused on PTG as well as on biological variables (salivary cortisol) but did not discuss possible links between these two so far unconnected research fields in PTSD. Copyright © 2015 John Wiley & Sons, Ltd.Trauma survivors with PTSD develop more PTG than those without PTSD, it remains unclear whether PTSD and PTG are curvilinearly related. PTG can be enhanced through PTSD therapy, nevertheless one must not assume that PTG is a favorable treatment outcome since we do not know if the development of PTG during therapy promotes the reduction of PTSD symptoms. It is unclear whether PTG in PTSD sufferers is a constructive outcome of cognitive processes or a positive illusion in favor of avoidance and denial. Results regarding the association of personality factors, social support and PTG are inconsistent, studies on biological aspects of PTG are lacking.",0,0 +3311,Broadening the etiological discourse on Alzheimer's disease to include trauma and posttraumatic stress disorder as psychosocial risk factors,"Biomedical perspectives have long dominated research on the etiology and progression of Alzheimer's disease (AD); yet these approaches do not solely explain observed variations in individual AD trajectories. More robust biopsychosocial models regard the course of AD as a dialectical interplay of neuropathological and psychosocial influences. Drawing on this broader conceptualization, we conducted an extensive review of empirical and theoretical literature on the associations of trauma, posttraumatic stress disorder (PTSD) and AD to develop a working model that conceptualizes the role of psychosocial stressors and physiological mechanisms in the onset and course of AD. The proposed model suggests two pathways. In the first, previous life trauma acts as a risk factor for later-life onset of AD, either directly or mediated by PTSD or PTSD correlates. In the second, de novo AD experiential trauma is associated with accelerated cognitive decline, either directly or mediated through PTSD or PTSD correlates. Evidence synthesized in this paper indicates that previous life trauma and PTSD are strong candidates as psychosocial risk factors for AD and warrant further empirical scrutiny. Psychosocial and neurological-based intervention implications are discussed. A biopsychosocial approach has the capacity to enhance understanding of individual AD trajectories, moving the field toward ‘person-centered’ models of care. • Alzheimer's disease is influenced by both neurological and psychosocial factors. • Trauma and PTSD are strong psychosocial risk factor candidates. • Earlier life trauma is associated with later-life Alzheimer's disease onset. • Alzheimer's disease experiential trauma associated with illness progression.",0,0 +3312,Reduced GABAA benzodiazepine receptor binding in veterans with post-traumatic stress disorder,"-aminobutyric acid (GABAA) receptors are thought to play an important role in modulating the central nervous system in response to stress. Animal data have shown alterations in the GABAA receptor complex by uncontrollable stressors. SPECT imaging with benzodiazepine ligands showed lower distribution volumes of the benzodiazepine-GABAA receptor in the prefrontal cortex of patients with post-traumatic stress disorder (PTSD) in one, but not in another study. The objective of the present study was to assess differences in the benzodiazepine-GABAA receptor complex in veterans with and without PTSD using [C]flumazenil and positron emission tomography (PET). Nine drug naive male Dutch veterans with deployment related PTSD and seven male Dutch veterans without PTSD were recruited, and matched for age, region and year of deployment. Each subject received a [C]flumazenil PET scan and a structural magnetic resonance imaging scan. Dynamic 3D PET scans with a total duration of 60 min were acquired, and binding in template based and manually defined regions of interest (ROI) was quantified using validated plasma input and reference tissue models. In addition, parametric binding potential images were compared on a voxel-by-voxel basis using statistical parametric mapping (SPM2). ROI analyses using both template based and manual ROIs showed significantly reduced [C]flumazenil binding in PTSD subjects throughout the cortex, hippocampus and thalamus. SPM analysis confirmed these results. The observed global reduction of [C]flumazenil binding in patients with PTSD provides circumstantial evidence for the role of the benzodiazepine-GABAA receptor in the pathophysiology of PTSD and is consistent with previous animal research and clinical psychopharmacological studies. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +3313,Neuropsychiatric diagnosis and management of chronic sequelae of war-related mild to moderate traumatic brain injury,"Soldiers with a traumatic brain injury (TBI) present with an array of neuropsychiatric symptoms that can be grouped into nosological clusters: (1) cognitive dysfunctions: difficulties in memory, attention, language, visuospatial cognition, sensory-motor integration, affect recognition, and/or executive function typically associated with neocortical damage; (2) neurobehavioral disorders: mood, affect, anxiety, posttraumatic stress, and psychosis, as well as agitation, sleep problems, and libido loss, that may have been caused by damage to the cortex, limbic system, and/or brain stem monoaminergic projection systems; (3) somatosensory disruptions: impaired smell, vision, hearing, equilibrium, taste, and somatosensory perception frequently caused by trauma to the sensory organs or their projections through the brain stem to central processing systems; (4) somatic symptoms: headache and chronic pain; and (5) substance dependence. TBI-related cognitive impairment is common in veterans who have served in recent conflicts in the Middle East and is often related to blasts from improvised explosive devices. Although neurobehavioral disorders such as depression and posttraumatic stress disorder commonly occur after combat, the presentation of such disorders in those with head injury may pass undetected with use of current diagnostic criteria and neuropsychological instruments. With a multidimensional approach (such as the biopsychosocial model) applied to each symptom cluster, psychological, occupational, and social dysfunction can be delineated and managed.",0,0 +3314,The Predictive Power of Peritraumatic Dissociation and Acute Stress Symptoms for Posttraumatic Stress Symptoms: A Three-Month Prospective Study,"The authors prospectively examined the power of peritraumatic dissociation and acute stress symptoms in predicting posttraumatic stress disorder (PTSD) symptoms.Thirty-five assault victims were assessed with the Peritraumatic Dissociative Experiences Questionnaire within 24 hours of the assault. Participants were reassessed 2 weeks after the trauma with the Stanford Acute Stress Reaction Questionnaire and 3 months after the trauma with the Clinician-Administered PTSD Scale and the Impact of Event Scale. Correlational analyses and a hierarchical multiple regression were conducted.Peritraumatic dissociation and acute stress symptoms were correlated with later PTSD symptoms and diagnosis. Together, peritraumatic dissociation and acute stress symptoms accounted for 33% of the variance in PTSD symptoms.These results support earlier findings that peritraumatic dissociative experiences and acute stress are robust predictors of PTSD. Such symptoms may be of use for identifying at an early stage individuals at highest risk of remaining symptomatic. Future studies should investigate the predictive power of specific peritraumatic and acute stress disorder symptom clusters.",0,0 +3315,Peritraumatic tonic immobility in a large representative sample of the general population: association with posttraumatic stress disorder and female gender,"Tonic immobility is an involuntary response to inescapable life-threatening events. Peritraumatic tonic immobility has been reported in convenience samples of female victims of sexual assault and in mixed-gender victims of different types of trauma. This study evaluated peritraumatic tonic immobility in a representative general population sample and its association with posttraumatic stress disorder (PTSD) and gender.3231 victims of traumatic events aged 15-75 years responded to the Tonic Immobility Scale. PTSD and traumatic events were assessed using the Composite International Diagnostic Interview (CIDI 2.1). We calculated the means and the standard deviations of Tonic Immobility Scale scores stratified by PTSD and gender. The association between tonic immobility scores and gender was explored controlling for potential confounders through a multiple linear regression model.Tonic immobility scores were more than double in those who met criteria for PTSD and were almost four points higher in women. Gender differences remained statistically significant even after adjustment for confounding variables.The cross-sectional and retrospective design may have given rise to recall bias. Results presented here may not apply to small and medium rural areas and the CIDI 2.1 can lead to a certain degree of misclassification.We have expanded the scope of previous investigations on peritraumatic tonic immobility which were based on convenience samples only, showing its occurrence in victims of traumatic events using a large representative sample of the general population. Furthermore, we confirmed in an unbiased sample the association between peritraumatic tonic immobility and PTSD and female gender.",0,0 +3316,"Symptoms of prolonged grief, depression, and adult separation anxiety: Distinctiveness and correlates","Research has shown that prolonged grief disorder (PGD) is a disorder distinct from other disorders including major depression and posttraumatic stress disorder (PTSD). This study aimed to extend this research by examining the distinctiveness of symptoms of PGD relative to symptoms of adult separation anxiety disorder, also taking into account depression. Data were available from 205 bereaved individuals who completed measures tapping these symptoms together with a complementary measure of mental and physical health. Findings showed that symptoms of PGD, depression, and adult separation anxiety disorder were better conceptualized as distinct dimensions instead of a unitary dimension of distress. Correlations between the three symptom clusters were moderate to large. Cause of loss was the single variable that was associated with all three symptom clusters with loss due to violent cause giving rise to more severe symptoms. All three symptom clusters were associated with lower concurrent mental and physical health.",0,0 +3317,"A Cross-Sectional, Randomized Cluster Sample Survey of Household Vulnerability to Extreme Heat among Slum Dwellers in Ahmedabad, India","Extreme heat is a significant public health concern in India; extreme heat hazards are projected to increase in frequency and severity with climate change. Few of the factors driving population heat vulnerability are documented, though poverty is a presumed risk factor. To facilitate public health preparedness, an assessment of factors affecting vulnerability among slum dwellers was conducted in summer 2011 in Ahmedabad, Gujarat, India. Indicators of heat exposure, susceptibility to heat illness, and adaptive capacity, all of which feed into heat vulnerability, was assessed through a cross-sectional household survey using randomized multistage cluster sampling. Associations between heat-related morbidity and vulnerability factors were identified using multivariate logistic regression with generalized estimating equations to account for clustering effects. Age, preexisting medical conditions, work location, and access to health information and resources were associated with self-reported heat illness. Several of these variables were unique to this study. As sociodemographics, occupational heat exposure, and access to resources were shown to increase vulnerability, future interventions (e.g., health education) might target specific populations among Ahmedabad urban slum dwellers to reduce vulnerability to extreme heat. Surveillance and evaluations of future interventions may also be worthwhile.",0,0 +3318,Does Comorbid Posttraumatic Stress Disorder Affect the Severity and Course of Psychotic Major Depressive Disorder?,"Major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) are commonly comorbid conditions that result in greater severity, chronicity, and impairment compared with either disorder alone. However, previous research has not systematically explored the potential effects of the psychotic subtyping of MDD and comorbid PTSD.The sample in this retrospective case-control study conducted from December 1995 to August 2006 consisted of psychiatric outpatients with DSM-IV-diagnosed psychotic MDD with PTSD, psychotic MDD without PTSD, or nonpsychotic MDD with PTSD presenting for clinic intake. Clinical indices of severity, impairment, and history of illness were assessed by trained diagnosticians using the Structured Clinical Interview for DSM-IV Axis I Disorders supplemented by items from the Schedule for Affective Disorders and Schizophrenia.In terms of current severity and impairment, the psychotic MDD with PTSD (n = 34) and psychotic MDD only (n = 26) groups were similar to each other, and both tended to be more severe than the nonpsychotic MDD with PTSD group (n = 263). In terms of history of illness, the psychotic MDD with PTSD group tended to show greater severity and impairment relative to either the psychotic MDD only or nonpsychotic MDD with PTSD groups. Furthermore, the psychotic MDD with PTSD patients had an earlier time to depression onset than patients with either psychotic MDD alone or nonpsychotic MDD with PTSD, which appeared to contribute to the poorer history of illness demonstrated in the former group.Future research should explore the possibility of a subtype of psychotic depression that is associated with PTSD, resulting in a poorer course of illness. The current findings highlight the need for pharmacologic and psychotherapeutic approaches that can be better tailored to psychotic MDD patients with PTSD comorbidity.",0,0 +3319,Posttraumatic Disorders Following Injury: Assessment and Other Methodological Considerations,"Physical injury in civilian populations is a frequent event. In 2000, 11% of the U.S. population (approximately 30 million people) were treated in emergency departments following nonfatal injuries (National Centre for Injury Prevention and Control-Electronic Database, 2000). Not only does injury occur frequently, but it often occurs at a severity to be classified as a traumatic event. Breslau et al. (1991) found that a lifetime prevalence of serious injury or serious motor vehicle crash was 41.9%, rating second in frequency of traumatic events. The conditional risk for developing Posttraumatic Stress Disorder (PTSD) following serious accidents and injury is relatively low (Kessler et al., 1995); that is, the risk of developing PTSD in all those who are exposed to traumatic injury is low relative to other traumatic events such as interpersonal violence (Breslau et al., 1998). Nevertheless, serious injury is a leading cause of PTSD because of the frequency with which injury occurs. For example, Breslau et al. (1998) found that serious injury accounted for nearly one-quarter of the PTSD cases in their community sample. This was also the case in both the National Comorbidity Survey (Kessler et al., 1995) and the equivalent Australian study (Creamer et al., 2001). Taken together, although the conditional risk of developing PTSD following serious injury is low, the substantial frequency with which injury occurs makes injury one of the most frequent causes of PTSD. This chapter aims to orient both practitioner and researcher to the current status of research regarding PTSD following injury. However, when evaluating this literature and when conducting assessments with injury survivors, researchers and practitioners alike must be cognizant of a number of key issues that may impact on the diagnosis of PTSD. These factors include the following: differentiating among the physical, psychological, and environmental origin of symptoms; head injury and how it complicates assessment; the impact of secondary stressors; the influence of medications on symptom presentation; and the role of litigation. Appropriate attention to these factors will help to optimize the reliability and consistency of mental health assessments following injury.",0,0 +3320,Signs of Mood and Anxiety Disorders in Chimpanzees,"In humans, traumatic experiences are sometimes followed by psychiatric disorders. In chimpanzees, studies have demonstrated an association between traumatic events and the emergence of behavioral disturbances resembling posttraumatic stress disorder (PTSD) and depression. We addressed the following central question: Do chimpanzees develop posttraumatic symptoms, in the form of abnormal behaviors, which cluster into syndromes similar to those described in human mood and anxiety disorders?In phase 1 of this study, we accessed case reports of chimpanzees who had been reportedly subjected to traumatic events, such as maternal separation, social isolation, experimentation, or similar experiences. We applied and tested DSM-IV criteria for PTSD and major depression to published case reports of 20 chimpanzees identified through PrimateLit. Additionally, using the DSM-IV criteria and ethograms as guides, we developed behaviorally anchored alternative criteria that were applied to the case reports. A small number of chimpanzees in the case studies met DSM-IV criteria for PTSD and depression. Measures of inter-rater reliability, including Fleiss' kappa and percentage agreement, were higher with use of the alternative criteria for PTSD and depression. In phase 2, the alternative criteria were applied to chimpanzees living in wild sites in Africa (n = 196) and chimpanzees living in sanctuaries with prior histories of experimentation, orphanage, illegal seizure, or violent human conflict (n = 168). In phase 2, 58% of chimpanzees living in sanctuaries met the set of alternative criteria for depression, compared with 3% of chimpanzees in the wild (p = 0.04), and 44% of chimpanzees in sanctuaries met the set of alternative criteria for PTSD, compared with 0.5% of chimpanzees in the wild (p = 0.04).Chimpanzees display behavioral clusters similar to PTSD and depression in their key diagnostic criteria, underscoring the importance of ethical considerations regarding the use of chimpanzees in experimentation and other captive settings.",0,0 +3321,"Posttraumatic Stress Symptoms, Intrusive Thoughts, Loss, and Immune Function after Hurricane Andrew","To examine the impact of and relationship between exposure to Hurricane Andrew, a severe stressor, posttraumatic stress symptoms and immune measures.Blood draws and questionnaires were taken from community volunteer subjects living in the damaged neighborhoods between 1 and 4 months after the Hurricane.The sample exhibited high levels of posttraumatic stress symptoms by questionnaire (33% overall; 76% with at least one symptom cluster), and 44% scored in the high impact range on the Impact of Events (IES) scale. A substantial proportion of variance in posttraumatic stress symptoms could be accounted for by four hurricane experience variables (damage, loss, life threat, and injury), with perceived loss being the highest correlate. Of the five immune measures studied Natural Killer Cell Cytotoxicity (NKCC) was the only measure that was meaningfully related (negatively) to both damage and psychological variables (loss, intrusive thoughts, and posttraumatic stress disorder (PTSD). White blood cell counts (WBCs) were significantly positively related with the degree of loss and PTSD experienced. Both NKCC (lower) and WBC were significantly related to retrospective self-reported increase of somatic symptoms after the hurricane. Overall, the community sample was significantly lower in NKCC, CD4 and CD8 number, and higher in NK cell number compared to laboratory controls. Finally, evidence was found for new onset of sleep problems as a mediator of the posttraumatic symptom-NKCC relationship.Several immune measures differed from controls after Hurricane Andrew. Negative (intrusive) thoughts and PTSD were related to lower NKCC. Loss was a key correlate of both posttraumatic symptoms and immune (NKCC, WBC) measures.",0,0 +3322,Full and Partial Post-Traumatic Stress Disorder among World War II Prisoners of War,"<i>Background:</i> The aim of the study is to evaluate the frequency and characteristics of full and partial post-traumatic stress disorder (PTSD) among 66 World War II Nazi prisoners of war, some of whom had been deported to death camps. <i>Methods:</i> The Structured Clinical Interview for DSM-IV was used to assess the presence of PTSD and major depression. The Dissociative Experiences Scale and the 58-item version of the Hopkins Symptom Checklist were also administered. Partial PTSD was defined as the presence of at least one symptom in each of the clusters defined by DSM-IV. <i>Results:</i> Forty-eight percent of the subjects have a partial PTSD, while 20% reported the full syndrome. When compared to subjects with full PTSD, those with partial PTSD showed a significantly lower frequency of comorbid depression and lower levels of psychological distress, as measured by the Symptom Checklist. No differences were found with regards to dissociative symptoms and help-seeking. <i>Conclusions:</i> The problem of definition of PTSD partial syndromes deserves more attention in the literature.",0,0 +3323,"Post-Traumatic Stress Disorder: Definition, Prevalence, and Risk Factors","In this chapter, we provide the definition and diagnostic criteria for post-traumatic stress disorder (PTSD). Next, the prevalence data for this disorder are reviewed, with a particular focus on how prevalence rates vary with demographic characteristics (e.g., gender) and trauma type. The literature on risk and resilience factors for the development and maintenance of PTSD is then discussed. The chapter concludes with a discussion of contemporary statistical methods that may be used to advance our knowledge and understanding of PTSD.",0,0 +3324,Early childhood behavior trajectories and the likelihood of experiencing a traumatic event and PTSD by young adulthood,"This study modeled children's trajectories of teacher rated aggressive-disruptive behavior problems assessed at six time points between the ages of 6 and 11 and explored the likelihood of being exposed to DSM-IV qualifying traumatic events and posttraumatic stress disorder (PTSD) in 837 urban first graders (71% African American) followed-up for 15 years. Childhood trajectories of chronic high or increasing aggressive-disruptive behavior distinguished males more likely to be exposed to an assaultive violence event as compared to males with a constant course of low behavior problems (OR(chronic high) = 2.8, 95% CI = 1.3, 6.1 and OR(increasing) = 4.5, 95% CI = 2.3, 9.1, respectively). Among females, exposure to traumatic events and vulnerability to PTSD did not vary by behavioral trajectory. The findings illustrate that repeated assessments of disruptive classroom behavior during early school years identifies more fully males at increased risk for PTSD-level traumatic events, than a single measure at school entry does.",0,0 +3325,Attachment Patterns and Working Alliance in Trauma Therapy for Victims of Political Violence,"We examined the development of alliance in therapy in different attachment groups in a naturalistic setting. The participants were 36 self-referred Palestinian political ex-prisoners, who were victims of torture and ill treatment and had sought psychotherapy. Their therapy lasted for 10-12 months. The analyses showed that the development of alliance during therapy followed different patterns across the attachment groups. Yet early alliance did not differ between the groups. For the autonomous individuals, alliance dropped in the middle of therapy, and increased back to its initial level by the end. Similarly, for the preoccupied individuals alliance decreased steeply in the middle of the therapy, and then increased even more steeply by the end. In contrast, for the dismissing individuals, alliance was approximately the same at the beginning and in the middle of the therapy, and then it decreased at the end.",0,0 +3326,Chronic Stress Increases the Plasmalemmal Distribution of the Norepinephrine Transporter and the Coexpression of Tyrosine Hydroxylase in Norepinephrine Axons in the Prefrontal Cortex,"Norepinephrine (NE) potently modulates the cognitive and affective functions of the prefrontal cortex (PFC). Deficits in NE transmission are implicated in psychiatric disorders, and antidepressant drugs that block the NE transporter (NET) effectively treat these conditions. Our initial ultrastructural studies of the rat PFC revealed that most NE axons (85–90%) express NET primarily within the cytoplasm and lack detectable levels of the synthetic enzyme tyrosine hydroxylase (TH). In contrast, the remaining 10–15% of PFC NE axons exhibit predominantly plasmalemmal NET and evident TH immunoreactivity. These unusual characteristics suggest that most PFC NE axons have an unrecognized, latent capacity to enhance the synthesis and recovery of transmitter. In the present study, we used dual-labeling immunocytochemistry and electron microscopy to examine whether chronic cold stress, a paradigm that persistently increases NE activity, would trigger cellular changes consistent with this hypothesis. After chronic stress, neither the number of profiles exhibiting NET labeling nor their size was changed. However, the proportion of plasmalemmal NET nearly doubled from 29% in control animals to 51% in stressed rats. Moreover, the expression of detectable TH in NET-labeled axons increased from only 13% of profiles in control rats to 32% of profiles in stressed animals. Despite the consistency of these findings, the magnitude of the changes varied across individual rats. These data represent the first demonstration of activity-dependent trafficking of NET and expression of TH under physiological conditions and have important implications for understanding the pathophysiology and treatment of stress-related affective disorders.",0,0 +3327,Coping with displacement from Hurricane Katrina: predictors of one-year post-traumatic stress and depression symptom trajectories,"Abstract This study examined predictors of symptom trajectories of 93 adult survivors of Hurricane Katrina who were displaced and relocated to Colorado. Survivors were interviewed within six months of the hurricane and then again six months later. Four symptom trajectories were identified for clinical levels of depression and post-traumatic stress: resilient, recovered, delayed onset, and chronic. High levels of adaptive coping and coping efficacy characterized the resilient groups and low levels of both characterized the chronic groups. The recovered groups were characterized by low levels of adaptive coping coupled with high coping efficacy, and the delayed groups were characterized by high secondary control coping in the presence of low primary control coping, though some symptom-specific differences were found for these two groups. African American (67%) participants did not differ from European American (28%) participants in terms of membership in trajectory groups, though analyses revealed that displacement stress and positive religious coping were especially relevant predictors for African American participants. The results are interpreted in light of the Conservation of Resources Theory (Hobfoll, 2001) and implications for treatment and preventive intervention are discussed.",0,0 +3328,Risk and Resilience Factors among Italian Municipal Police Officers Exposed to Critical Incidents,Police officers are exposed to critical events as part of their duty which can affect their well-being. The present study examines the relationships between risk and protective factors and health outcome following critical incident exposure among police officers. Person-oriented analyses were applied to questionnaire data from a sample of 509 Italian municipal police officers. Two groups with different patterns of risk and protective factors were found by cluster analysis. One group (resilient officers) had higher levels of protective factors such as self-esteem and social support and lower levels of risk factors such as peritraumatic distress and perceived threat in comparison to the other group (non resilient police officers). The resilient group reported fewer traumatic stress reactions than the non resilient group in spite of a similar degree of exposure to critical incidents and better health than expected in spite of severe abuse. The two groups differed according to sleeping pills use but not for alcohol and smoking habits. Risk and protective factors could offer an explanation of resilience as an outcome. (,0,0 +3329,The prevalence of long-term post-traumatic stress symptoms among adolescents after the tsunami in Aceh,"The aim of this study was to identify long-term post-traumatic stress disorder (PTSD) symptoms in Aceh 4.5 years after the tsunami and to examine whether certain factors affected the severity of PTSD symptoms among adolescents. The PTSD symptoms of 482 adolescents aged 11 to 19 years were assessed according to the Child Post-Traumatic Stress Reaction Index (CPTSD-RI). The severity of the disaster was identified by the Traumatic Exposure Severity Scale (TESS). Of the adolescents who completed the questionnaire, 54 (11.2%), 124 (25.7%), 196 (40.7%), 103 (21.4%) and 5 (1%), respectively, reported none, mild, moderate, severe and very severe symptoms on CPTSD-RI. Gender, loss of parents, somatic response and support level were significantly associated with the total score on CPTSD-RI (P < 0.05). The TESS-Occurrence Scale and CPTSD-RI were significantly correlated (r= 0.33, P < 0.05). The TESS-Distress Scale was significantly correlated with CPTSD-RI (r= 0.48, P < 0.05). The study indicated that the symptoms of PTSD, ranging from very severe to moderate, could persist for a long time after the tsunami and be affected by gender, loss of parents, somatic response, support level and severity of the disaster.",0,0 +3330,Long-term mental health outcome in post-conflict settings: Similarities and differences between Kosovo and Rwanda,"Background: Few studies investigated the long-term mental health outcome in culturally different post-conflict settings. This study considers two surveys conducted in Kosovo 8 years after the Balkans war and in Rwanda 14 years after the genocide. Methods: All participants ( n = 864 in Kosovo; n = 962 in Rwanda) were interviewed using the posttraumatic stress disorder (PTSD) and major depressive episode (MDE) sections of the Mini International Neuropsychiatric Interview (MINI) and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Results: Proportions of participants who met diagnostic criteria for either PTSD or MDE were 33.0% in Kosovo and 31.0% in Rwanda, with co-occurrence of both disorders in 17.8% of the Rwandan sample and 9.5% of the Kosovan sample. Among patients with PTSD, patterns of symptoms significantly differed in the two settings, with avoidance and inability to recall less frequent and sense of a foreshortened future and increased startle response more common in Rwanda. Significant differences were also observed in patients with MDE, with loss of energy and difficulties concentrating less frequent and suicidal ideation more common in Rwanda. Comorbid PTSD and MDE were associated with decreased SF-36 subjective mental and physical health scores in both settings, but significantly larger effects in Kosovo than in Rwanda. Conclusion: Culturally different civilian populations exposed to mass trauma may differ with respect to their long-term mental health outcome, including comorbidity, symptom profile and health perception.",0,0 +3331,Longitudinal mental health screening results among postdeployed U.S. soldiers preparing to deploy again,"Mental health concerns have been documented in soldiers postdeployed from Iraq or Afghanistan, but information is limited regarding individuals directed to deploy again. Routine screening assessed symptoms of posttraumatic stress disorder, depression, anxiety, panic, and hazardous alcohol consumption among 443 soldiers after returning from deployment and again before the next deployment. Initial rates for meeting screening criteria were under 9% with most around 5%. The average number of symptoms reported for depression, anxiety, and alcohol consumption decreased from first to second screening, as did the percentage of participants who met screening criteria for hazardous alcohol consumption. No change was observed on other screening measures. The findings suggest that mental health symptoms remain stable or decline for soldiers repeating deployment.",0,0 +3332,"Serum chemical profile of feeder pigs, as influenced by market stress and feeding regimen.","Two hundred eighty-eight crossbred feeder pigs were used in 2 trials to determine the effects of feed and/or water deprivation at an auction market, and the effects of restricting the intake of the receiving diet on their serum chemical profile. The study also was designed to assess the value of the serum chemical profile as a diagnostic data base for stress disorders in feeder pigs. Performance data indicated that feeder pigs provided water only at the auction facilities lost significantly more weight than did those provided feed and water. Feeder pigs deprived of both feed and water were not significantly different in body weight from either group. Several serum chemical values (creatinine, triglycerides, cholesterol, blood urea nitrogen, and lactate dehydrogenase) were significantly influenced by feed deprivation, but not by feed and water deprivation. However, only the serum creatinine values were significantly different after the 24-hour posttransport period. There were no significant differences in pig weight or serum chemical values 84 days after pigs had arrived at the finishing unit. The serum chemical profile, widely used in human medicine, appears not to provide a reliable marker for identification of short-term nutritional deprivation, nor for transport stress in feeder pigs.",0,0 +3333,Delayed recall of childhood sexual abuse memories and the awakening rise and diurnal pattern of cortisol,"Traumatic stress associated with childhood sexual abuse (CSA) may result in chronic alterations of stress-sensitive neurochemical systems (e.g., the hypothalamic-pituitary-adrenal axis and sympathetic-adrenal medullary activity). Some authors have suggested that these alterations might help explain why some individuals, after a period of inability to remember, demonstrate delayed recall of CSA memories (i.e., ""recovered"" memories). The present study is the first study that explored morning cortisol responses and circadian cortisol profiles among women with recovered (n=7), repressed (n=8), or continuous (n=6) memories of CSA and women without a history of CSA (n=9). Although there were group differences in current depression and post-traumatic stress symptoms, we found no differences in cortisol awakening response or daytime profile between women reporting recovered, repressed, or continuous memories of CSA as compared to women without a history of CSA. Implications for neurobiological models intended to explain the delayed recall of CSA are discussed.",0,0 +3334,Posttraumatic Stress Disorder Among Firearm Assault Survivors: Risk and Resiliency Factors in Recovery from Violent Victimization,"Firearm violence in the United States has reached epidemic proportions, and yet little is known about the psychosocial impact of firearm assault on its survivors. This study set out to: (1) determine the rate of chronic Posttraumatic Stress Disorder (PTSD), and (2) to identify pre-assault factors, assault characteristics, and factors in the post-assault recovery environment that serve as risk or protective factors for the development of PTSD in a sample of firearm assault survivors. In addition, a qualitative analysis drew upon in-depth interviews with six firearm assault survivors about their recovery experience. Fifty-five firearm assault survivors recruited from an urban trauma center completed a number of measures assessing pre-assault factors, assault characteristics, factors in the post-assault recovery environment, and PTSD symptomatology. Fifty-eight percent of the sample met full diagnostic criteria for PTSD 3 to 36 months post-assault. Hierarchical multiple regression analysis supported a model in which negative change of outlook, assault severity, and adopting safeguarding behaviors served as risk factors for the presence of PTSD after firearm assault; while social support operated as a resiliency factor protecting individuals from development of PTSD after severe violent victimization. Qualitative analysis revealed a number of commonalities in the recovery experience for both impaired and resilient survivors. The findings suggest that firearm assault survivors are at high risk for the development of chronic PTSD. Further, the use of a high-risk screening tool that assesses risk and protective factors for the development of chronic PTSD may have important clinical applications in identifying victims most in need of clinical intervention. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +3335,Impact of Traumatic Events on Posttraumatic Stress Disorder among Danish Survivors of Sexual Abuse in Childhood,"Childhood sexual abuse can be extremely traumatic and lead to lifelong symptomatology. The present study examined the impact of several demographic, abuse, and psychosocial variables on posttraumatic stress disorder severity among a consecutive sample of treatment-seeking, adult child sexual abuse survivors (N = 480). The child sexual abuse sample was characterized by severe trauma exposure, insecure attachment, and significant traumatization, with an estimated 77% suffering from posttraumatic stress disorder, more than twice the level of the comparison group. Regression analyses revealed risk factors associated with the development of posttraumatic stress disorder in which the strongest predictors being additional traumas, negative affectivity, and somatization. The findings add to existing research confirming the stressful nature of child sexual abuse and the variables that contribute to the development and severity of posttraumatic stress disorder.",0,0 +3336,Hypnotizability and trauma symptoms after burn injury,"This study investigated the association of trauma symptoms and hypnotizability in 43 hospitalized survivors of burn injury. Three to 17 days after the injury, participants rated the frequency of intrusive and avoidance symptoms and were interviewed with the posttraumatic stress disorder module of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-III-R. The Hypnotic Induction Profile was also administered at the postburn, hospital stage of recovery. Results indicated that when participants were divided into low, mid-range, and high hypnotizability categories, high hypnotizability was associated with more intrusive, avoidance, and arousal symptoms. Although causal relations cannot be assessed in this cross-sectional study, these results suggest that, as compared to the low and mid-range categories, high hypnotizables may experience a greater frequency of trauma symptoms after burn injury.",0,0 +3337,"The interrelationships between moral attitudes, posttraumatic stress disorder symptoms and mixed lateral preference in Israeli reserve combat troops","Background: Combat soldiers often encounter moral dilemmas during operational deployment, especially when an armed engagement is situated within a civilian setting. The study of moral dilemmas and posttraumatic stress disorder (PTSD) has mostly focused on the impact of war atrocities and moral injury. However, the relationship between moral attitudes and different combat-related pathologies has not been thoroughly addressed by quantitative studies. Aims: We aimed to assess the relationship between combatant’s moral attitudes, severity of PTSD symptoms and mixed lateral preference. Methods: Data on moral objection, PTSD severity and lateral preference were collected in a right-handed non-pathologic sample ( n = 147) of reserve combat troops in the Israel Defense Forces (IDF). Results: Nearly one-fifth (19.7%) of the reserve personnel who served in the occupied territories have reported high moral objection to the commands they were expected to act upon. This group of participants exhibited more PTSD symptoms and higher levels of mixed lateral preference. Multiple linear regression analyses revealed a mediating role of moral objection in the relationship between PTSD symptoms severity and lateral preference. Conclusions: Our findings suggest that moral objection has significant implications on combatant’s psychological and organic well-being. The findings highlight the need to include moral attitudes in research and clinical practice among combat personnel and veterans.",0,0 +3338,Psychological intimate partner violence: the major predictor of posttraumatic stress disorder in abused women,"Intimate partner violence (IPV) significantly impacts women mental and physical wellbeing and therefore represents a worldwide public health problem. A clear association between IPV and increased risk to develop posttraumatic stress disorder (PTSD) has been documented. However, few studies examined how different features of IPV (physical, psychological, sexual) interact with other traumatic stress experiences (physical, psychological and sexual childhood abuse and adulthood victimization by other/s than the partner) in determining PTSD. Women abused by the partner ( n =75) were compared with non-abused control women ( n =52). Information about sociodemographic profile and relevant personal characteristics was obtained through structured interviews. A comprehensive questionnaire was designed for a face-to-face interview in order to obtain detailed information about duration and frequency of the different types of violent acts above mentioned. The incidence and severity of symptoms of current PTSD were assessed with Echeburua's Severity of Symptom Scale of Posttraumatic Stress Disorder, a structured interview based on DSM-IV criteria. Women suffering from IPV had a significantly higher rate of PTSD symptomatology as compared to control women, whereas childhood abuse variables did not explain PTSD score variance. In addition, the severity of IPV was significantly and positively correlated with the intensity of PTSD symptoms. Women involved in an abusive relationship were more frequently exposed to other experiences of adulthood victimization, suggesting that their higher PTSD vulnerability could be a result of cumulative traumatic experiences. A relevant result of the correlation analysis was the strong, positive association between PTSD and each different type of IPV. In particular, the psychological component of intimate partner violence was the strongest predictor of posttraumatic stress disorder. This study underlines the importance of separating the effects of the different types of intimate partner abuse when taking into account its effects on women mental health.",0,0 +3339,"Men's Pathways to Risky Sexual Behavior: Role of Co-Occurring Childhood Sexual Abuse, Posttraumatic Stress Disorder, and Depression Histories","Recent reports of sexually transmitted infection-rate increases among men indicate the need for renewed study of male sexual risk behavior to aid development of updated and novel risk reduction interventions. Men who have childhood sexual abuse (CSA) histories consistently report frequent sexual risk behavior. The objective of this sturdy is to explore whether posttraumatic stress disorder (PTSD) and depression are moderators and/or mediators of the association between CSA and sexual risk in adult men. A cross-sectional survey study employing random digit dial recruitment was administered to men aged 18-49 years from Philadelphia County. Two hundred ninety eight men were recruited and screened for CSA history, administered items from the Posttraumatic Stress Diagnostic Scale (PDS) and Center for Epidemiologic Studies- Depression (CES-D), and asked to estimate their number of lifetime sexual partners (LSPs). Effects of sociodemographic characteristics, CSA, PTSD, and depression on the number of LSPs were modeled using Poisson regression. Results show that 197 (66%) men participated; 43 (22%) had CSA histories. CSA was significantly associated with PTSD/depression (P=.03). Four sociodemographic variables (age, race, sexual identity, and education), CSA (incidence rate ratio, IRR=1.47, P<.001), PTSD (IRR=1.19, P=.04), depression (IRR=1.29, P=.001), all 2-way interactions, and the 3-way CSA/PTSD/depression interaction (IRR=11.00, P<.001) were associated with the number of LSPs (R2=0.27). In conclusion, sexual partnership patterns unique to men with CSA histories and comorbid PTSD/depression appear to lead to substantially higher numbers of LSPs. Estimates of this relationship may have been biased toward the null by underreporting that can occur with phone surveys. Cross-sectional studies do not support causal inferences; however, the identification of a moderating and mediating influence of PTSD/depression on the relationship between CSA and sexual risk behavior is important and suggests the need for future studies with larger samples that examine trajectories for CSA, psychiatric illness, and sexual partnerships.",0,0 +3340,Cohort Profile: The Study of Health in Pomerania,"Henry Volzke, y Dietrich Alte,1y Carsten Oliver Schmidt, Dorte Radke, Roberto Lorbeer, Nele Friedrich, Nicole Aumann, Katharina Lau, Michael Piontek, Gabriele Born, Christoph Havemann, Till Ittermann, Sabine Schipf, Robin Haring, Sebastian E Baumeister, Henri Wallaschofski, Matthias Nauck, Stephanie Frick, Andreas Arnold, Michael Junger, Julia Mayerle, Matthias Kraft, Markus M Lerch, Marcus Dorr, Thorsten Reffelmann, Klaus Empen, Stephan B Felix, Anne Obst, Beate Koch, Sven Glaser, Ralf Ewert, Ingo Fietze, Thomas Penzel, Martina Doren, Wolfgang Rathmann, Johannes Haerting, Mario Hannemann, Jurgen Ropcke, Ulf Schminke, Clemens Jurgens, Frank Tost, Rainer Rettig, Jan A Kors, Saskia Ungerer, Katrin Hegenscheid, Jens-Peter Kuhn, Julia Kuhn, Norbert Hosten, Ralf Puls, Jorg Henke, Oliver Gloger, Alexander Teumer, Georg Homuth, Uwe Volker, Christian Schwahn, Birte Holtfreter, Ines Polzer, Thomas Kohlmann, Hans J Grabe, Dieter Rosskopf, Heyo K Kroemer, Thomas Kocher, Reiner Biffar,17,y Ulrich John20y and Wolfgang Hoffmann1y",0,0 +3341,An updated animal model capturing both the cognitive and emotional features of post-traumatic stress disorder (PTSD),"The new-released Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines post-traumatic stress disorder (PTSD) as a ""trauma and stressor-related disorder"". PTSD pathogenesis relies on paradoxical changes of emotional memory processing induced by the trauma exposure and associated with emotional dysfunction. Several animal models of PTSD have been validated and are currently used. Each one mimics a particular subset of the disorder with particular emphasis, mainly driven by the past classification of PTSD in the DSM-4, on the emotional features. In view of the recent update in the DSM-5, our aim was to develop, by using well-validated paradigms, a modified model of PTSD able to mimic at the same time both the cognitive and emotional features of the disease. We exposed male rats to either a piece of worn cat collar or to a series of inescapable footshocks paired with a PTSD risk factor, i.e., social isolation. Animals were subsequently re-exposed to the conditioned contexts at different time intervals in order to test memory retention for the stressors. In addition, footshock-exposed rats were tested in the elevated-plus-maze and social interaction tests. We found that rats exposed to a cat collar exhibited an acute fear response that did not lead to enduring memory retention. Conversely, footshock-exposed rats expressed a successful retention of the stressful experience at 1, 7, 14, 21 and 56 post-exposure days. Footshock-exposed rats displayed an anxious behavioral profile in the social interaction test and a significantly reduced locomotor activity in the elevated-plus-maze test. These dysfunctions were not observed when animals were socially housed, thus highlighting a social buffering effect in the development of the pathology. Our results underline the good validity of a footshock-based paradigm paired with social isolation as a PTSD animal model, able to mimic at the same time both some of the enduring cognitive and emotional facets of the pathology.",0,0 +3342,Power analyses for correlations from clustered study designs,"Power analysis constitutes an important component of modern clinical trials and research studies. Although a variety of methods and software packages are available, almost all of them are focused on regression models, with little attention paid to correlation analysis. However, the latter is arguably a simpler and more appropriate approach for modelling concurrent events, especially in psychosocial research. In this paper, we discuss power and sample size estimation for correlation analysis arising from clustered study designs. Our approach is based on the asymptotic distribution of correlated Pearson-type estimates. Although this asymptotic distribution is easy to use in data analysis, the presence of a large number of parameters creates a major problem for power analysis due to the lack of real data to estimate them. By introducing a surrogacy-type assumption, we show that all nuisance parameters can be eliminated, making it possible to perform power analysis based only on the parameters of interest. Simulation results suggest that power and sample size estimates obtained under the proposed approach are robust to this assumption.",0,0 +3343,Risk and resilience in canine search and rescue handlers after 9/11,"Research has suggested that rescue workers are at increased risk for psychological distress. To determine whether 9/11 deployment was a significant risk factor for canine search and rescue handlers, 82 deployed handlers were compared to 32 nondeployed handlers on measures of posttraumatic stress disorder (PTSD), depression, anxiety, acute stress, and clinical diagnoses. Deployed handlers reported more PTSD and general psychological distress 6 months after 9/11. Among deployed handlers, prior diagnoses and peritraumatic reactions were associated with psychological distress whereas social support and training were protective. Results suggest that more extensive screening and prophylactic interventions for individuals with a history of mental illness could be beneficial. Future research should examine identified risk/resilience factors prospectively, and training and intervention should be designed accordingly.",0,0 +3344,Coming to Our Senses: Appreciating the Sensorial in Medical Anthropology,"This article supports the call for the sensorially engaged anthropological study of healing modalities, popular health culture, dietary practices, drug foods and pharmaceuticals, and idioms of distress. Six concepts are of central importance to sensorial anthropology: embodiment, the mindful body, mimesis, local biology, somatic idioms of distress, and 'the work of culture'. Fieldwork in South and Southeast Asia and North America illustrates how cultural interpretations associate bodily sensations with passions (strong emotions) and anxiety states, and bodily communication about social relations. Lay interpretations of bodily sensations inform and are informed by local understanding of ethnophysiology, health, illness, and the way medicines act in the body. Bodily states are manipulated by the ingestion of substances ranging from drug foods (e.g., sources of caffeine, nicotine, dietary supplements) to pharmaceuticals that stimulate or suppress sensations concordant with cultural values, work demands, and health concerns. Social relations are articulated at the site of the body through somatic modes of attention that index bodily ways of knowing learned through socialization, bodily memories, and the ability to relate to how another is likely to be feeling in a particular context. Sensorial anthropology can contribute to the study of transformative healing and trajectories of healthcare seeking and patterns of referral in pluralistic healthcare arenas.",0,0 +3345,Psychopharmacological treatment with lithium and antiepileptic drugs: suggested guidelines from the Danish Psychiatric Association and the Child and Adolescent Psychiatric Association in Denmark,"A subcommittee under the Danish Psychiatric Association and the Child and Adolescent Psychiatric Association in Denmark have recently developed national guidelines for the psychopharmacological treatment with lithium and antiepileptic drugs, and the present translation aims at contributing to the international discussion on the development of proper guidelines for the treatment of bipolar disorder. Among the antiepileptic drugs, the report deals with valproate, carbamazepine and lamotrigine and to a lesser extent with oxcarbazepine, gabapentin and topiramate. The various drugs will be reviewed, outlining the scientific evidence for mood-stabilizing properties and discussing major side effects, the most important interactions with other drugs and practical use. Special considerations during pregnancy and lactation, during treatment of children and adolescents and during treatment of the elderly will also be presented. Antidepressants and antipsychotics are beyond the scope of the report, but due to the mood-stabilizing properties of at least some of the atypical antipsychotics, these agents will be brought into some focus in connection with the overall treatment guidelines for the different phases of bipolar disorder given at the end of this report.",0,0 +3346,Cost-utility analysis of different treatments for post-traumatic stress disorder in sexually abused children,"Post-traumatic stress disorder (PTSD) is diagnosed in 20% to 53% of sexually abused children and adolescents. Living with PTSD is associated with a loss of health-related quality of life. Based on the best available evidence, the NICE Guideline for PTSD in children and adolescents recommends cognitive behavioural therapy (TF-CBT) over non-directive counselling as a more efficacious treatment.A modelled economic evaluation conducted from the Australian mental health care system perspective estimates incremental costs and Quality Adjusted Life Years (QALYs) of TF-CBT, TF-CBT combined with selective serotonin reuptake inhibitor (SSRI), and non-directive counselling. The ""no treatment"" alternative is included as a comparator. The first part of the model consists of a decision tree corresponding to 12 month follow-up outcomes observed in clinical trials. The second part consists of a 30 year Markov model representing the slow process of recovery in non-respondents and the untreated population yielding estimates of long-term quality-adjusted survival and costs. Data from the 2007 Australian Mental Health Survey was used to populate the decision analytic model.In the base-case and sensitivity analyses, incremental cost-effectiveness ratios (ICERs) for all three active treatment alternatives remained less than A$7,000 per QALY gained. The base-case results indicated that non-directive counselling is dominated by TF-CBT and TF-CBT + SSRI, and that efficiency gain can be achieved by allocating more resources toward these therapies. However, this result was sensitive to variation in the clinical effectiveness parameters with non-directive counselling dominating TF-CBT and TF-CBT + SSRI under certain assumptions. The base-case results also suggest that TF-CBT + SSRI is more cost-effective than TF-CBT.Even after accounting for uncertainty in parameter estimates, the results of the modelled economic evaluation demonstrated that all psychotherapy treatments for PTSD in sexually abused children have a favourable ICER relative to no treatment. The results also highlighted the loss of quality of life in children who do not receive any psychotherapy. Results of the base-case analysis suggest that TF-CBT + SSRI is more cost-effective than TF-CBT alone, however, considering the uncertainty associated with prescribing SSRIs to children and adolescents, clinicians and parents may exercise some caution in choosing this treatment alternative.",0,0 +3347,"Future of brain stimulation: New targets, new indications, new technology","In the last quarter of a century, DBS has become an established neurosurgical treatment for Parkinson's disease (PD), dystonia, and tremors. Improved understanding of brain circuitries and their involvement in various neurological and psychiatric illnesses, coupled with the safety of DBS and its exquisite role as a tool for ethical study of the human brain, have unlocked new opportunities for this technology, both for future therapies and in research. Serendipitous discoveries and advances in structural and functional imaging are providing abundant ""new"" brain targets for an ever-increasing number of pathologies, leading to investigations of DBS in diverse neurological, psychiatric, behavioral, and cognitive conditions. Trials and ""proof of concept"" studies of DBS are underway in pain, epilepsy, tinnitus, OCD, depression, and Gilles de la Tourette syndrome, as well as in eating disorders, addiction, cognitive decline, consciousness, and autonomic states. In parallel, ongoing technological development will provide pulse generators with longer battery longevity, segmental electrode designs allowing a current steering, and the possibility to deliver ""on-demand"" stimulation based on closed-loop concepts. The future of brain stimulation is certainly promising, especially for movement disorders-that will remain the main indication for DBS for the foreseeable future-and probably for some psychiatric disorders. However, brain stimulation as a technique may be at risk of gliding down a slippery slope: Some reports indicate a disturbing trend with suggestions that future DBS may be proposed for enhancement of memory in healthy people, or as a tool for ""treatment"" of ""antisocial behavior"" and for improving ""morality.""",0,0 +3348,Psychological Distress of Rescue Workers Eight and One-Half Years After Professional Involvement in the Amsterdam Air Disaster,"This study examined specific and general psychological distress 8.5 years following the 1992 cargo aircraft crash in Amsterdam. Participants included 334 occupationally exposed fire fighters and 834 occupationally exposed police officers compared with reference groups of 194 fire fighters and 634 police officers who were exposed to duty-related stressors other than the disaster. On the standardized instruments of psychological distress, exposed fire fighters reported more somatic complaints and fatigue, while exposed police officers reported higher psychological distress on all aspects. The degree and type of exposure at the disaster site and other background factors were associated with several outcomes of psychological distress levels of exposed rescue workers. The disasters' aftermath of rumors about potential health consequences due to toxic exposure likely contributed to the long-lasting psychological distress of some of the rescue workers as well.",0,0 +3349,PTSD Symptoms Mediate the Effect of Attachment on Pain and Somatisation after Whiplash Injury,"Introduction: The development of persistent pain post-whiplash injury is still an unresolved mystery despite the fact that approximately 50% of individuals reporting whiplash develop persistent pain. There is agreement that high initial pain and PTSD symptoms are indicators of a poor prognosis after whiplash injury. Recently attachment insecurity has been proposed as a vulnerability factor for both pain and PTSD. In order to guide treatment it is important to examine possible mechanisms which may cause persistent pain and medically unexplained symptoms after a whiplash injury. Aim: The present study examines attachment insecurity and PTSD symptoms as possible vulnerability factors in relation to high levels of pain and somatisation after sub-acute whiplash injury. Methods: Data were collected from 327 patients (women = 204) referred consecutively to the emergency unit after acute whiplash injury. Within 1-month post injury, patients answered a questionnaire regarding attachment insecurity, pain, somatisation, and PTSD symptoms. Multiple mediation analyses were performed to assess whether the PTSD symptom clusters mediated the association between attachment insecurity, pain, and somatisation. Results: A total of 15% fulfilled the DSM-IV symptom cluster criteria for a possible PTSD diagnosis and 11.6% fulfilled the criteria for somatisation. PTSD increased the likelihood of belonging to the moderate-severe pain group three-fold. In relation to somatisation the likelihood of belonging to the group was almost increased four-fold. The PTSD symptom clusters of avoidance and hyperarousal mediated the association between the attachment dimensions, pain, and somatisation. Conclusion: Acknowledging that PTSD is part of the aetiology involved in explaining persistent symptoms after whiplash, may help sufferers to gain early and more suited treatment, which in turn may prevent the condition from becoming chronic.",0,0 +3350,"Trajectories of life satisfaction after traumatic brain injury: Influence of life roles, age, cognitive disability, and depressive symptoms.","(a) Identify life satisfaction trajectories after moderate to severe traumatic brain injury (TBI); (b) establish a predictive model for these trajectories across the first 5 years postinjury; and (c) describe differences in these life satisfaction trajectory groups, focusing on age, depressive symptoms, disability, and participation in specific life roles.Analysis of the longitudinal TBI Model Systems National Database was performed on data collected prospectively at 1-, 2-, and 5-years post-TBI. Participants (n = 3,012) had a moderate to severe TBI and were 16 years old and older.Four life satisfaction trajectories were identified across the first 5 years postinjury, including: stable satisfaction, initial satisfaction declining, initial dissatisfaction improving, and stable dissatisfaction. Age, depressive symptoms, cognitive disability, and life role participation as a worker, leisure participant, and/ or religious participant at 1-year postinjury significantly predicted trajectory group membership. Life role participation and depressive symptoms were strong predictors of life satisfaction trajectories across the first 5 years post-TBI.The previously documented loss of life roles and prevalence of depression after a moderate to severe TBI make this a vulnerable population for whom low or declining life satisfaction is a particularly high risk. Examining individual life role participation may help to identify relevant foci for community-based rehabilitation interventions or supports.",0,0 +3351,Individual and Community-Level Determinants of Mental and Physical Health After the Deepwater Horizon Oil Spill: Findings from the Gulf States Population Survey,"The 2010 Deepwater Horizon oil spill had enormous consequences on the environment. Prevalence of mental and physical health conditions among Gulf residents after the disaster, however, are still being assessed. The Gulf State Population Survey (GSPS) was a representative survey of 38,361 residents in four Gulf States and was conducted from December 2010 to December 2011. Analysis of the GSPS data showed that differences in individual characteristics and direct or indirect exposure to the disaster drove the individual-level variation in health outcomes (mental distress, physical distress, and depression). Direct exposure to the disaster itself was the most important determinant of health after this event. Selected county-level characteristics were not found to be significantly associated with any of our health indicators of interest. This study suggests that in the context of an overwhelming event, persons who are most directly affected through direct exposure should be the primary focus of any public health intervention effort. © 2014, National Council for Behavioral Health (outside the USA).",0,0 +3352,Age differences in the psychological consequences of Hurricane Hugo.,"At 12, 18, and 24 months after Hurricane Hugo, 831 adults were interviewed regarding their disaster-related stressors and present psychological state. The study's purposes were to assess whether age influenced one's vulnerability to postdisaster stress and to evaluate four different perspectives on disaster recovery that have been previously used to explain age differences. Regression analyses demonstrated that disaster exposure had substantial and pervasive psychological effects. The analyses also revealed a curvilinear interaction between disaster exposure and age. Younger people exhibited the most distress in the absence of disaster, but middle-aged people did so in its presence. Differential exposure, resources, and inoculation all failed to explain these differences, however, the burden perspective had considerable explanatory power.",0,0 +3353,"PTSD, Endophenotypes, the RDoC, and the DSM-5","The search for endophenotypes that stand between genetics and disease has been applied to the diagnostic entity of Posttraumatic Stress Disorder (PTSD). Advances are being made in understanding the pathway to disorder in PTSD in terms of brain regions, neuronal networks, stress-related systems (e.g., the hypothalamic-pituitary-adrenal (HPA) axis), and their underlying genetic and neurogenetic bases. The latter are affected by gene-environmental interactions and epigenetic effects, and the environment and context reciprocally interrelate with them, as well. Therefore, a primary focus on (neuro)pathophysiological intermediates in the disease pathway, as appears emphasized in the research domain criteria (RDoC) approach to etiology of psychiatric disorder, and to which the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) subscribes, might detract from a more inclusive biopsychosocial approach that would be more applicable in the case of PTSD. The paper undertakes a comprehensive review of the recent literature in the areas of endophenotypes, neurogenetics, epigenetics, neural networks, HPA axis, neuronal networks, pathways, the PTSD five-factor model, allostasis, and the RDoC criteria for psychiatric diagnosis, and then returns to the topic of endophenotypes. Neuronal networks constitute one integrating area that could help in arriving at an appropriate model of PTSD endophenotype. Pathway analysis provides a rich field for discerning individual differences in PTSD development, more so than the static approach of using DSM-5 symptom criteria. A model of endophenotypes is presented, which considers these factors in relation to PTSD. The paper concludes with implications for the DSM-5, for practice and for court, especially that it would be premature to seek individual biomarkers of PTSD given the current state of knowledge, even if it is burgeoning. © 2014 Springer Science+Business Media New York.",0,0 +3354,Social Information Processing in Anger Expression and Partner Violence in Returning U.S. Veterans,"We examined social information processing factors that could represent pathways through which posttraumatic stress disorder (PTSD) symptoms relate to anger expression and intimate partner violence (IPV) perpetration in returning U.S. veterans. The sample included 92 male Operation Enduring Freedom/Operation Iraqi Freedom veterans, primarily Caucasian (77.4%), with smaller numbers of African American, Asian, Hispanic or Latino, American Indian or Alaskan Native, and other minority participants (9.7%, 2.2%, 2.2%, 3.2%, and 5.3% respectively). The average age was 40.37 (SD = 9.63) years. Data were collected through self-report questionnaires (PTSD Checklist, State-Trait Anger Expression Scale, Revised Conflict Tactics Scales) and the Articulated Thoughts in Simulated Situations experimental protocol. Laboratory-based assessment of cognitive biases and hostile attributions were tested as mediators of associations between PTSD symptoms and anger expression and IPV. Among the PTSD symptom clusters, hyperarousal symptoms were most strongly associated with anger expression (r = .50) and IPV perpetration (r = .27). Cognitive biases mediated associations between PTSD total scores and 3 of 4 PTSD cluster scores as well as anger expression. Hostile attribution biases were also associated with IPV perpetration (r = .23). We discuss the implications of these findings for understanding social information processing mechanisms for the relationship between PTSD symptoms and aggression.",0,0 +3355,Cumulative trauma and symptom complexity in children: A path analysis,"Multiple trauma exposures during childhood are associated with a range of psychological symptoms later in life. In this study, we examined whether the total number of different types of trauma experienced by children (cumulative trauma) is associated with the complexity of their subsequent symptomatology, where complexity is defined as the number of different symptom clusters simultaneously elevated into the clinical range. Children's symptoms in six different trauma-related areas (e.g., depression, anger, posttraumatic stress) were reported both by child clients and their caretakers in a clinical sample of 318 children. Path analysis revealed that accumulated exposure to multiple different trauma types predicts symptom complexity as reported by both children and their caretakers.",0,0 +3356,Girls’ childhood trajectories of disruptive behavior predict adjustment problems in early adolescence,"It is widely recognized that early onset of disruptive behavior is linked to a variety of detrimental outcomes in males, later in life. In contrast, little is known about the association between girls' childhood trajectories of disruptive behavior and adjustment problems in early adolescence.This study used nine waves of data from the ongoing Pittsburgh Girls Study. A semiparametric group-based model was used to identify trajectories of disruptive behavior in 1,513 girls from age 6 to 12 years. Adjustment problems were characterized by depression, self-harm, Post Traumatic Stress Disorder (PTSD), substance use, interpersonal aggression, sexual behavior, affiliation with delinquent peers, and academic achievement at ages 13 and 14.Three trajectories of childhood disruptive behavior were identified: low, medium, and high. Girls in the high group were at increased risk for depression, self-harm, PTSD, illegal substance use, interpersonal aggression, early and risky sexual behavior, and lower academic achievement. The likelihood of multiple adjustment problems increased with trajectories reflecting higher levels of disruptive behavior.Girls following the high childhood trajectory of disruptive behavior require early intervention programs to prevent multiple, adverse outcomes in adolescence and further escalation in adulthood.",0,0 +3357,The course of PTSD symptoms among Gulf War veterans: A growth mixture modeling approach,"Relatively little is known about the course of PTSD symptoms over time following trauma exposure. Accordingly, this study utilized a specialized structural equation modeling approach, growth mixture modeling, to examine the trajectory of PTSD symptoms across three time points in a sample of Gulf War veterans (n at Time 1 = 2,949, n at Time 2 = 2,313, and n at Time 3 = 1,327). Results were most consistent with a two-group model suggesting that the course of PTSD symptoms following the Gulf War was best characterized by two distinct growth curves: (1) low levels of PTSD symptoms with little increase over time and (2) higher levels of initial symptoms with a significant increase over time. Thus, it appears that response to Gulf War experiences is not homogeneous, and that a subset of individuals may experience relatively more PTSD symptoms over time. In addition, men, Whites, those reporting more education, and those reporting less combat exposure had a significantly higher probability of being classified into the less symptomatic group.",1,0 +3358,Full and partial posttraumatic stress disorder: findings from a community survey,"Full and partial posttraumatic stress disorder (PTSD) following trauma exposure were examined in a community sample in order to determine their prevalence and their relative importance and functional significance.A standardized telephone interview with a series of trauma probes and a DSM-IV PTSD checklist was administered to a random sample of 1,002 persons in a midsized Midwestern Canadian city. The authors determined current (i.e., 1-months) prevalence rates of full PTSD, i.e., all DSM-IV criteria, and partial PTSD, i.e., fewer than the required number of DSM-IV criterion C symptoms (avoidance/numbing) or criterion D symptoms (increased arousal). Additional questions about interference with functioning were also posed.The estimated prevalence of full PTSD was 2.7% for women and 1.2% for men. The prevalence of partial PTSD was 3.4% for women and 0.3% for men. Interference with work or school was significantly more pronounced in persons with full PTSD than in those with only partial symptoms, although the latter were significantly more occupationally impaired than traumatized persons without PTSD.These findings in an epidemiologic sample underscore observations from patient and military groups that many traumatized persons suffer from a subsyndromal form of PTSD. These persons with partial PTSD, although somewhat less impaired than persons with the full syndrome, nonetheless exhibit clinically meaningful levels of functional impairment in association with their symptoms. This subthreshold form of PTSD may be especially prevalent in women. Additional study of partial PTSD is warranted.",0,0 +3359,Longitudinal linkages between perceived social support and posttraumatic stress symptoms: Sequential roles of social causation and social selection,"The authors examined social causation and social selection explanations for the association between perceptions of social support and psychological distress. Data came from a sample of 557 victims of natural disaster in Mexico. Structural equation modeling analyses indicated that social causation (more social support leading to less posttraumatic stress disorder [PTSD]) explained the support-to-distress relationship in the earlier postdisaster phase, 6 to 12 months after the impact. Both causal mechanisms emerged as significant paths in the midpoint of the study (12 and 18 months). Only social selection (more PTSD leading to less social support) accounted for the support-to-distress relationship at 18 to 24 months after the event. Interpersonal and social dynamics of disasters may explain why these two contrasting causal mechanisms emerged over time.",0,0 +3360,Health-Related Quality of Life After Aneurysmal Subarachnoid Hemorrhage: Profile and Clinical Factors,"Health-related quality of life has recently been suggested as a supplement to the traditional neurological outcome measures from the patient's perspective according to the World Health Organization model and may capture the effects of other factors such as posttraumatic stress disorder and neuroendocrine dysfunction.To explore the profile and clinical factors of quality of life after aneurysmal subarachnoid hemorrhage using the data we obtained from the recently completed Intravenous Magnesium Sulphate After Aneurysmal Subarachnoid Hemorrhage (IMASH) trial.This study was registered at www.strokecenter.org/trials and www.ClinicalTrials.gov (NCT00124150). Data from a patient cohort obtained with the Short Form-36 questionnaire completed at 6 months were used for analysis.Patients with aneurysmal subarachnoid hemorrhage demonstrated a decrease in quality of life according to the Short Form-36 at 6 months. The physical and mental health scores correlated with the Extended Glasgow Outcome Scale and had the potential to avoid the ceiling effect. Multiple regression analyses showed that the physical component scores were related to age, World Federation of Neurological Surgeons grade, and chronic hydrocephalus and that the mental component scores were not related to the traditional prognostic factors.Subarachnoid hemorrhage caused a decrease in quality of life. Chronic hydrocephalus is related to a decrease in physical health quality of life.",0,0 +3361,"Prevalence, comorbidity and predictors of anxiety disorders in children and adolescents in rural north-eastern Uganda","Child and adolescent anxiety disorders are the most prevalent form of childhood psychopathology. Research on child and adolescent anxiety disorders has predominantly been done in westernized societies. There is a paucity of data on the prevalence, comorbidity, and predictors of anxiety disorders in children and adolescents in non-western societies including those in sub-Saharan Africa. This paper investigates the prevalence, comorbidity, and predictors of anxiety disorders in children and adolescents in north-eastern Uganda.To determine the prevalence of DSM-IV anxiety disorders, as well as comorbidity patterns and predictors in children and adolescents aged 3 to 19 years in north-eastern Uganda.Four districts (Lira, Tororo, Kaberamaido and Gulu) in rural north-eastern Uganda participated in this study. Using a multi-stage sampling procedure, a sample of 420 households with children aged 3-19 years from each district was enrolled into the study. The MINI International Neuropsychiatric Interview for children and adolescents (MINI KID) was used to assess for psychiatric disorders in 1587 of 1680 respondents.The prevalence of anxiety disorders was 26.6%, with rates higher in females (29.7%) than in males (23.1%). The most common disorders in both males and females were specific phobia (15.8%), posttraumatic stress disorder (PTSD) (6.6%) and separation anxiety disorder (5.8%). Children below 5 years of age were significantly more likely to have separation anxiety disorder and specific phobias, while those aged between 14-19 were significantly more likely to have PTSD. Anxiety disorders were more prevalent among respondents with other psychiatric disorders; in respondents with two or more co-morbid psychiatric disorders the prevalence of anxiety disorders was 62.1%. Predictors of anxiety disorders were experience of war trauma (OR = 1.93, p < 0.001) and a higher score on the emotional symptom scale of the SDQ (OR = 2.58, p < 0.001). Significant socio-demograghic associations of anxiety disorders were found for female gender, guardian unemployment, living in permanent housing, living without parents, and having parents without education.The prevalence of anxiety disorders in children and adolescents in rural north-eastern Uganda is high, but consistent in terms of gender ratio and progression over time with a range of prior work in other contexts. Patterns of comorbidity and predictors of anxiety disorders in this setting are also broadly consistent with previous findings from western community studies. Both psychosocial stressors and exposure to war trauma are significant predictors of anxiety disorders.Prevention and treatment strategies need to be put in place to address the high prevalence rates of anxiety disorders in children and adolescents in Uganda.",0,0 +3362,Violence exposure in home and community: Influence on posttraumatic stress symptoms in Army recruits,"This study assessed the levels and types of violence exposure, levels of posttraumatic stress symptoms, and the relationship among exposure to violence, posttraumatic stress symptoms, and early discharge in U.S. Army recruits at Basic Combat Training (BCT). The study applied a modified ABCX model of family stress adaptation developed by McCubbin, Thompson, and McCubbin (1996). A sample of 779 BCT recruits were surveyed before training began. At the end of training, data was collected on those recruits who had been discharged before completion of training. Statistical measures of association were used to assess the relationship between the variables. Results supported all three of the hypotheses tested. Significant positive relationships were found between violence exposure and trauma symptoms, as well as levels of trauma symptoms and odds of early discharge. Patterns of association were found between types of exposure to community versus home violence and specific symptom clusters of traumatic stress.",0,0 +3363,Trauma Exposure and Health: The Role of Depressive and Hyperarousal Symptoms,"Posttraumatic stress disorder (PTSD) and depressive symptoms have been theorized to mediate the relationship between trauma exposure and physical health symptoms. Although empirical evidence supports this premise, studies conducted to date have employed statistical mediation analyses that are now broadly criticized. Furthermore, the mediating roles of both PTSD and depressive symptoms have seldom been examined concurrently, and it remains unclear which PTSD symptom clusters uniquely mediate this relationship. The aim of the present study was to examine the mediating role of reexperiencing, avoidance/numbing, hyperarousal, and depressive symptoms in the relationship between trauma exposure and physical health symptoms. Participants were 516 Spanish female undergraduate students. Physical health symptoms were compared between those who reported trauma exposure (n = 266) and those who did not (n = 250). Data from trauma-exposed participants were analyzed using regression models with bootstrapping to test mediation. Results of the analyses showed that the trauma-exposed group reported significantly more physical health symptoms (r2 = .035). Hyperarousal and depressive symptoms uniquely mediated the relationship between trauma exposure and physical health symptoms. Our findings clarify some of the mechanisms by which negative health consequences occur subsequent to trauma exposure.",0,0 +3364,Requiring both avoidance and emotional numbing in DSM-V PTSD: Will it help?,"The proposed DSM-V criteria for posttraumatic stress disorder (PTSD) specifically require both active avoidance and emotional numbing symptoms for a diagnosis. In DSM-IV, since both are included in the same cluster, active avoidance is not essential. Numbing symptoms overlap with depression, which may result in spurious comorbidity or overdiagnosis of PTSD. This paper investigated the impact of requiring both active avoidance and emotional numbing on the rates of PTSD diagnosis and comorbidity with depression.We investigated PTSD and depression in 835 traumatic injury survivors at 3 and 12 months post-injury. We used the DSM-IV criteria but explored the potential impact of DSM-IV and DSM-V approaches to avoidance and numbing using comparison of proportion analyses.The DSM-V requirement of both active avoidance and emotional numbing resulted in significant reductions in PTSD caseness compared with DSM-IV of 22% and 26% respectively at 3 and 12 months posttrauma. By 12 months, the rates of comorbid PTSD in those with depression were significantly lower (44% vs. 34%) using the new criteria, primarily due to the lack of avoidance symptoms.These preliminary data suggest that requiring both active avoidance and numbing as separate clusters offers a useful refinement of the PTSD diagnosis. Requiring active avoidance may help to define the unique aspects of PTSD and reduce spurious diagnoses of PTSD in those with depression.",0,0 +3365,HERITABILITY OF SOCIAL ANXIETY-RELATED CONCERNS AND PERSONALITY CHARACTERISTICS: A TWIN STUDY,"Negative evaluation fears figure prominently in the cognitive psychology of patients with social phobia. In this study, we examine the heritability of negative evaluation fears by using a twin sample. The authors also examine the relationships between negative evaluation fears and personality dimensions relevant to social phobia. Scores on the brief version of the Fear of Negative Evaluation Scale (BFNE) were examined in a sample of 437 (245 monozygotic and 192 dizygotic) twin pairs. Biometrical model fitting was conducted by using standard statistical methods. Genetic and environmental correlations with personality dimensions (from the Dimensional Assessment of Personality Pathology-Basic Questionnaire) were also calculated. Broad heritability estimate of the BFNE was 48%. Additive genetic effects and unique environmental effects emerged as the primary influences on negative evaluation fears. Genetic correlations between BFNE scores and the submissiveness, anxiousness, and social avoidance facets of the Dimensional Assessment of Personality Pathology-Basic Questionnaire were high (r(g) =.78 to.80). A cognitive dimension central to the phenomenology (and, perhaps, cause) of social phobia, the fear of being negatively evaluated, is moderately heritable. Moreover, the same genes that influence negative evaluation fears appear to influence a cluster of anxiety-related personality characteristics. Implications and limitations of these findings are discussed.",0,0 +3366,Gastrointestinal Symptoms and Altered Intestinal Permeability Induced by Combat Training Are Associated with Distinct Metabotypic Changes,"Physical and psychological stress have been shown to modulate multiple aspects of gastrointestinal (GI) physiology, but its molecular basis remains elusive. We therefore characterized the stress-induced metabolic phenotype (metabotype) in soldiers during high-intensity combat training and correlated the metabotype with changes in GI symptoms and permeability. In a prospective, longitudinal study, urinary metabotyping was conducted on 38 male healthy soldiers during combat training and a rest period using gas chromatography-mass spectrometry. The urinary metabotype during combat training was clearly distinct from the rest period (partial least-squares discriminant analysis (PLSDA) Q(2) = 0.581), confirming the presence of a unique stress-induced metabotype. Differential metabolites related to combat stress were further uncovered, including elevated pyroglutamate and fructose, and reduced gut microbial metabolites, namely, hippurate and m-hydroxyphenylacetate (p < 0.05). The extent of pyroglutamate upregulation exhibited a positive correlation with an increase in IBS-SSS in soldiers during combat training (r = 0.5, p < 0.05). Additionally, the rise in fructose levels was positively correlated with an increase in intestinal permeability (r = 0.6, p < 0.005). In summary, protracted and mixed psychological and physical combat-training stress yielded unique metabolic changes that corresponded with the incidence and severity of GI symptoms and alteration in intestinal permeability. Our study provided novel molecular insights into stress-induced GI perturbations, which could be exploited for future biomarker research or development of therapeutic strategies.",0,0 +3367,The association between post-traumatic stress disorder symptoms and the quality of life among Wenchuan earthquake survivors: the role of social support as a moderator,"Objective: To examine the role of the three types of social support as possible moderating factors between post-traumatic stress disorder (PTSD) and its relationship to two domains of the quality of life (QOL). Methods: A cross-sectional survey was done in a local area near the epicenter of the severe earthquake in Wenchuan. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), the standard Chinese 12-item Short Form (SF-12v2), and the Social Support Rating Scale (SSRS) were used to interview a total of 2,080 earthquake survivors in the one-year follow-up period. Multiple regressions were performed to evaluate the moderating role of social support on the relationship between PTSD and QOL. Results: Among survivors one-year after the Wenchuan earthquake, being a woman (p < 0.01), having a lower level of education (p < 0.01), having a lower level of income (p < 0.01), having a worse housing status (p < 0.05) and having a higher level of exposure (p < 0.05) were risk factors for a poorer QOL (DELTAR2 = 0.063). PTSD symptoms negatively influenced the QOL (DELTAR2 = 0.145), while social support positively influenced the QOL (DELTAR2 = 0.016). However, the interaction between social support and PTSD weakened the negative effect of PTSD on the QOL (DELTAR2 = 0.012). Subjective support and support availability moderated the association between PTSD and the QOL (DELTAR2 = 0.010). Conclusion: Subjective support and support availability are more useful strategies to improve the QOL of the earthquake survivors with PTSD symptoms. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +3368,"The Effects of Mild Traumatic Brain Injury, Post-Traumatic Stress Disorder, and Combined Mild Traumatic Brain Injury/Post-Traumatic Stress Disorder on Returning Veterans","United States veterans of the Iraqi (Operation Iraqi Freedom [OIF]) and Afghanistan (Operation Enduring Freedom [OEF]) conflicts have frequently returned from deployment after sustaining mild traumatic brain injury (mTBI) and enduring stressful events resulting in post-traumatic stress disorder (PTSD). A large number of returning service members have been diagnosed with both a history of mTBI and current PTSD. Substantial literature exists on the neuropsychological factors associated with mTBI and PTSD occurring separately; far less research has explored the combined effects of PTSD and mTBI. The current study employed neuropsychological and psychological measures in a sample of 251 OIF/OEF veterans to determine whether participants with a history of mTBI and current PTSD (mTBI+PTSD) have poorer cognitive and psychological outcomes than participants with mTBI only (mTBI-o), PTSD only (PTSD-o), or veteran controls (VC), when groups are comparable on intelligence quotient, education, and age. The mTBI+PTSD group performed more poorly than VC, mTBI-o, and PTSD-o groups on several neuropsychological measures. Effect size comparisons suggest small deleterious effects for mTBI-o on measures of processing speed and visual attention and small effects for PTSD-o on measures of verbal memory, with moderate effects for mTBI+PTSD on the same variables. Additionally, the mTBI+PTSD group was significantly more psychologically distressed than the PTSD-o group, and PTSD-o group was more distressed than VC and mTBI-o groups. These findings suggest that veterans with mTBI+PTSD perform significantly lower on neuropsychological and psychiatric measures than veterans with mTBI-o or PTSD-o. The results also raise the possibility of mild but persisting cognitive changes following mTBI sustained during deployment.",0,0 +3369,Post‐traumatic stress disorder related to birth: a prospective longitudinal study in a French population,"The objective of the current study is to determine the prevalence of post‐traumatic stress disorder (PTSD) following birth in a French sample, as well as to examine predictive variables. This study collected data from women at four different times: 48 h, 1 month, 4 months and 9 months post‐partum. PTSD symptoms were measured using the Impact of Events Scale‐Revised (IES‐R). Predictive variables were examined with four questionnaires: the Labor Agentry Scale (LAS), the Multidimensional Scale of Perceived Social Support (MSPSS), the Edinburgh Postnatal Depression Scale (EPDS) and a researcher‐designed personal information form. PTSD rates varied from 5% (1 month post‐partum) to 2.9% (9 months post‐partum). Primiparity, birth preparation classes, transfer to a tertiary care centre, perception of external control, feeling of pain during birth and depressive symptoms were significant predictors of the global IES‐R score. Results provide a basis for considering changes in healthcare delivery and prevention prog...",0,0 +3370,"Posttraumatic intrusion, avoidance, and social functioning: A 20-year longitudinal study.","The study assesses posttraumatic intrusion, avoidance, and social functioning among 214 Israeli combat veterans from the first Lebanon War with and without combat stress reaction (CSR) 1, 2, 3, and 20 years after the war. CSR veterans reported higher intrusion and avoidance than did non-CSR veterans. With time, there was a decline in these symptoms. In addition, intrusion and avoidance were associated with problems in social functioning on a given year, and they longitudinally predicted social dysfunction 2, 3, and 20 years after the war. CSR veterans presented stronger temporal covariations between intrusion-avoidance and social functioning. The findings suggest that CSR is a marker for future psychopathology and point to the role of avoidance in social dysfunction.",0,0 +3371,The Mental Health Impact of 9/11 on Inner-City High School Students 20 Miles North of Ground Zero,"To determine the rate of post-traumatic stress disorder (PTSD) after 9/11 in a sample of New York City high school students and associations among personal exposure, loss of psychosocial resources, prior mental health treatment, and PTSD.A total of 1214 students (grades 9 through 12) attending a large community high school in Bronx County, 20 miles north of ""Ground Zero,"" completed a 45-item questionnaire during gym class on one day eight months after 9/11. Students were primarily Hispanic (62%) and African American (29%) and lived in the surrounding neighborhood. The questionnaire included the PCL-T, a 17-item PTSD checklist supplied by the Office of Behavioral and Social Science Research of the National Institutes of Health (NIH). The PCL-T was scored following the DSM-IV criteria for PTSD requiring endorsement of at least one repeating symptom, two hyperarousal symptoms, and three avoidance symptoms. Bivariate analysis comparing PTSD with personal exposure, loss of psychosocial resources, and mental health variables was done and multiple logistic regression was used to identify significant associations.There were 7.4 % of students with the PTSD symptom cluster. Bivariate analysis showed a trend for females to have higher rates of PTSD (males [6%] vs. females [9%], p = .06] with no overall ethnic differences. Five of the six personal exposure variables, and both of the loss of psychosocial resources and mental health variables were significantly associated with PTSD symptom cluster. Multiple logistic regression analysis found one personal exposure variable (having financial difficulties after 9/11, odds ratio [OR] = 5.27; 95% confidence interval [CI] 2.9-9.7); both the loss of psychosocial resources variables (currently feeling less safe, OR = 3.58; 95% CI 1.9-6.8) and currently feeling less protected by the government, (OR = 4.04; 95% CI 2.1-7.7); and one mental health variable (use of psychotropic medication before 9/11, OR = 3.95; 95% CI 1.2-13.0) were significantly associated with PTSD symptom cluster.We found a rate of PTSD in Bronx students after 9/11 that was much higher than other large studies of PTSD in adolescents done before 9/11. Adolescents living in inner cities with high poverty and violence rates may be at high risk for PTSD after a terrorist attack. Students who still felt vulnerable and less safe eight months later and those with prior mental health treatment were four times more likely to have PTSD than those without such characteristics, highlighting the influence of personality and mental health on development of PTSD after a traumatic event.",0,0 +3372,Shifting the Odds of Lifelong Mental Illness Through an Understanding of the Profiles of Adolescents and Young Adults with Serious Mental Health Conditions,Every day families and mental health providers are called upon to make tough decisions in determining the best quality of care for adolescents and young adults with serious mental health conditions. This study profiles the behavioral and emotional needs and risk behaviors of adolescents and young adults seeking mental health services based on assessment of strengths and needs at program entry. © 2013 Springer Science+Business Media New York.,0,0 +3373,History of trauma and dissociative symptoms among patients with obsessive-compulsive disorder and social anxiety disorder,"We aimed to compare the history of trauma and the profile and severity of dissociative symptoms of patients with obsessive-compulsive disorder (OCD) to those of patients with social anxiety disorder (SAD). Patients with OCD (n = 34) and patients with SAD (n = 30) were examined with the following instruments: Trauma History Questionnaire (THQ), Dissociative Experience Scale (DES), Obsessive-Compulsive Inventory (OCI), Liebowitz Social Anxiety Scale (LSAS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Patients with OCD reported significantly lower rates of exposure to traumatic events. Nevertheless, the severity of dissociative symptoms was not significantly different between the groups. Regression analyses showed that, while the OCI scores better predicted the variance on DES scores in the OCD sample, the LSAS and the BAI better predicted the variance on the DES among patients with SAD. Patients with OCD are probably less vulnerable to some types of traumatic experiences. Dissociative symptoms may cut across different anxiety disorders. (",0,0 +3374,A Prospective Study of Heart Rate Response Following Trauma and the Subsequent Development of Posttraumatic Stress Disorder,"Physiological arousal during traumatic events may trigger the neurobiological processes that lead to posttraumatic stress disorder (PTSD). This study prospectively examined the relationship between heart rate and blood pressure recorded immediately following a traumatic event and the subsequent development of PTSD.Eighty-six trauma survivors who presented at the emergency department of a general hospital were followed up for 4 months. Heart rate and blood pressure were recorded on arrival at the emergency department. Heart rate, anxiety, depression, and PTSD symptoms were assessed 1 week, 1 month, and 4 months later. The clinician-administered PTSD scale defined PTSD status at 4 months.twenty subjects (23%) met PTSD diagnostic criteria at the 4-month assessment (PTSD group), and 66 (77%) did not (non-PTSD group). Subjects who developed PTSD had higher heart rates at the emergency department (95.5+/-13.9 vs 83.3+/-10.9 beats per minute, t=4.4, P<.001) and 1 week later (77.8+/-11.9 vs 72.0+/-9.5 beats per minute, t=2.25, P<.03), but not after 1 and 4 months. The groups did not differ in initial blood pressure measurement. Repeated-measures analysis of variance (ANOVA) for heart rate showed a significant group effect (P<.02), time effect (P<.001), and group x time interaction (P<.001). The time effect and group x time interaction remained significant when adjusted for sex, age, trauma severity, immediate response, and dissociation during the traumatic event.Elevated heart rate shortly after trauma is associated with the later development of PTSD.",0,0 +3375,Cultural bias in suicidal behaviour among refugees with post-traumatic stress disorder,"The study was primarily designed to assess the prevalence of suicidal behaviour among asylum applicants diagnosed as having post-traumatic stress disorder (PTSD) and the impact of cultural bias factors (such as religion and nationality) in suicidal dynamics. The traumatic stressors reported in the study included being subjected to or forced to witness war atrocities, imprisonment, torture, sexual violence, other's suicide, and summary or mock executions. The study included 64 PTSD patients who were examined as part of a diagnostic and suicidal risk assessment after referral. Suicide risk assessments were assisted with scores of the SAD PERSONS Scale. Most PTSD patients reported suicidal behaviour. Nearly half of the refugees with PSTD diagnoses had a history of suicide attempts. Religious proscription or nationality was not found to be a significant deterrent of suicidal behaviour, and no differences between the various religious groups were established on this point. Another noteworthy finding in the pre...",0,0 +3376,The role of work in the recovery of persons with psychiatric disabilities.,"This study explored the role of work in the recovery of employed and unemployed persons with psychiatric disabilities. Fourteen persons with psychiatric disabilities participated in semi-structured interviews. Content analysis revealed that the experience of recovery was based on six major dimensions: self-definition, empowerment, connections to others, meaning of work, vocational future, and meaning of recovery. Differences in these six dimensions led to the identification of three profiles of recovery: recovery as uncertain, recovery as a self-empowering experience, and recovery as a challenging experience. Each profile described a specific context in which participation in work or avoidance of work can be understood and vocational interventions can be designed.",0,0 +3377,Early identification of posttraumatic stress following military deployment: Application of machine learning methods to a prospective study of Danish soldiers,"Pre-deployment identification of soldiers at risk for long-term posttraumatic stress psychopathology after home coming is important to guide decisions about deployment. Early post-deployment identification can direct early interventions to those in need and thereby prevents the development of chronic psychopathology. Both hold significant public health benefits given large numbers of deployed soldiers, but has so far not been achieved. Here, we aim to assess the potential for pre- and early post-deployment prediction of resilience or posttraumatic stress development in soldiers by application of machine learning (ML) methods.ML feature selection and prediction algorithms were applied to a prospective cohort of 561 Danish soldiers deployed to Afghanistan in 2009 to identify unique risk indicators and forecast long-term posttraumatic stress responses.Robust pre- and early postdeployment risk indicators were identified, and included individual PTSD symptoms as well as total level of PTSD symptoms, previous trauma and treatment, negative emotions, and thought suppression. The predictive performance of these risk indicators combined was assessed by cross-validation. Together, these indicators forecasted long term posttraumatic stress responses with high accuracy (pre-deployment: AUC = 0.84 (95% CI = 0.81-0.87), post-deployment: AUC = 0.88 (95% CI = 0.85-0.91)).This study utilized a previously collected data set and was therefore not designed to exhaust the potential of ML methods. Further, the study relied solely on self-reported measures.Pre-deployment and early post-deployment identification of risk for long-term posttraumatic psychopathology are feasible and could greatly reduce the public health costs of war.",0,0 +3378,iMStrong: Deployment of a Biosensor System to Detect Cocaine Use,"Biosensor systems are increasingly promoted for use in behavioral interventions. Portable biosensors might offer advancement over self-report use and can provide improved opportunity for detection and intervention in patients undergoing drug treatment programs. Fifteen participants wore a biosensor wristband capable of detecting multiple physiologic markers of sympathetic nervous system (SNS) arousal for 30 days. Urine drug screening and drug use self-report were obtained twice per week. A parameter trajectory description method was applied to capture abrupt changes in magnitude of three measures of SNS activity: Electrodermal activity (EDA), skin temperature and motion. Drug use events detected by the biosensor were verified using a triad of parameters: the biosensor data, urine drug screens, and patient self-report of substance use. Twelve positive cocaine urine screens were identified. Thirteen self-reported episodes of cocaine use were recorded. Distinct episodes with biometric parameters consistent with cocaine use were identified on biosensor data. Eleven potential cocaine use episodes were identified by biosensors that were missed by both self-report and drug screening. Study participants found mobile biosensors to be acceptable, and compliance with the protocol was high. Episodes of cocaine use, as measured by supraphysiologic changes in biophysiometric parameters, were detected by analysis of biosensor data in instances when self-report or drug screening or both failed. Biosensors have substantial potential in detecting substance abuse, in understanding the context of use in real time, and in evaluating the efficacy of behavioral interventions for drug abuse.",0,0 +3379,"The cumulative effect of different childhood trauma types on self-reported symptoms of adult male depression and PTSD, substance abuse and health-related quality of life in a large active-duty military cohort","History of childhood trauma (CT) is highly prevalent and may lead to long-term consequences on physical and mental health. This study investigated the independent association of CT with symptoms of adult depression and posttraumatic stress disorder (PTSD), mental and physical health-related quality of life (HRQoL), as well as current tobacco consumption and alcohol abuse in a large homogenous cohort of 1254 never-deployed, young male Marines enrolled in the Marine Resiliency Study. Independent effects of CT history, number and type of CT on outcomes were analyzed using hierarchical multivariate logistic regression models. Our results suggested dose-dependent negative effect of an increasing number of trauma types of CT on depression, PTSD and HRQoL. Experience of single CT type demonstrated overall weak effects, while history of multiple CT types distinctively increased the likelihood of adult PTSD symptomology (OR: 3.1, 95% CI: 1.5-6.2), poor mental (OR: 2.3, 95% CI: 1.7-3.1) and physical HRQoL (OR: 1.4, 95% CI: 1.1-1.9). Risk for depression symptoms was similar for both single and multiple CT (OR: 2.2, 95% CI: 1.3-3.8 and OR: 2.1, 95% CI: 1.2-3.5 respectively). CT history had no effects on current tobacco use and alcohol abuse. Our study thus provides evidence for substantial additive effect of different CT types on adult mental and physical health with increasing levels of exposure.",0,0 +3380,Structure of Posttraumatic Stress Disorder Symptoms in Pain and Pain-Free Patients Scheduled for Major Surgery,"Factor-analytic studies of the structure of posttraumatic stress disorder (PTSD) symptoms have yielded inconsistent results. One of the reasons for the inconsistency may be that PTSD is highly comorbid with other disorders; the observed factor structure might depend on the particular comorbid disorder. One such disorder is chronic pain. The goal of the present study was to investigate whether PTSD symptom structure differs between pain and pain-free patients scheduled to undergo major surgery. Four hundred and forty-seven patients who were approached 7 to 10 days prior to scheduled surgery completed the PTSD Checklist-Civilian (PCL-C) Version and the Current Pain and Pain History Questionnaire; the latter was used to divide patients into pain (N = 175) and pain-free (N = 272) groups. Results showed that in pain-free patients, PTSD symptoms were best expressed as 2 symptom clusters (re-experiencing/avoidance; emotional numbing/hyperarousal) accounting for 52.4% of the variance. In pain patients, PTSD symptoms were best expressed as a single symptom cluster accounting for 51.1% of the variance. These results suggest different interrelationships among PTSD symptoms in these 2 populations. Results reflect the need for (1) controlling for pain in studies looking at PTSD-symptom expression and (2) further research on PTSD-symptom expression in pain populations.These results may have important implications for research on the comorbidity between PTSD and chronic pain, as well as for treatment of PTSD symptoms in patients presenting with pain problems.",0,0 +3381,"Distribution of Traumatic and Other Stressful Life Events by Race/Ethnicity, Gender, SES and Age: A Review of the Research","Much research has shown that reports of stressful life events are related to a wide variety of psychiatric and physical health outcomes. Relatively little research exists, however, on the distribution of the events according to gender, age, racial/ethnic background, and socioeconomic status (SES). Such information would help identify groups at greatest risk for further investigation. This paper presents a review of the relevant studies. We find that traumatic (e.g., life threatening) events appear to be more frequent for men, while men and women differ more consistently on types rather than on overall numbers of stressful events other than traumatic. Traumatic and other stressful events tend to be more frequent in low SES and racial/ethnic minorities groups, and finally, both traumatic and other stressful events are reported more by younger age groups in samples 18 years of age and older. The limitations and implications of these findings for further research and preventive interventions are discussed, especially the need for more detailed information about individual events.",0,0 +3382,Control theory and psychopathology: An integrative approach,"Perceptual control theory (PCT; Powers, 1973) is presented and adapted as a framework to understand the causes, maintenance, and treatment of psychological disorders. PCT provides dynamic, working models based on the principle that goal-directed activity arises from a hierarchy of negative feedback loops that control perception through control of the environment. The theory proposes that psychological distress arises from the unresolved conflict between goals. The present paper integrates PCT, control theory, and self-regulatory approaches to psychopathology and psychotherapy and recent empirical findings, particularly in the field of cognitive therapy. The approach aims to offer fresh insights into the role of goal conflict, automatic processes, imagery, perceptual distortion, and loss of control in psychological disorders. Implications for psychological therapy are discussed, including an integration of the existing work on the assessment of control profiles and the use of assertive versus yielding modes of control.",0,0 +3383,Kompleksowa opieka nad dzieckiem z zespołem stresu pourazowego,"The essential feature of posttraumatic stress disorder (PTSD) is the development of characteristic symptoms following exposure to a traumatic event that arouses - intense fear, helplessness, or horror, or in children - disorganized or agitated behaviour. Symptoms are categorized into three clusters: persistent re-experiencing of the stressor, persistent avoidance of reminders and emotional numbing, and persistent symptoms of increased arousal. Childhood PTSD confers increased risk for a number of problems in later childhood, adolescence and adulthood. Among psychotherapies there is convincing evidence that trauma-focused therapies, that is that specifically address the child's traumatic experiences, are superior to nonspecific or nondirective therapies in resolving PTSD symptoms. Among the trauma-focused psychotherapies, TF-CBT has received the most empirical support for the treatment of childhood PTSD. The first step in the psychotherapy for posttraumatic stress disorder in children is helping the child gain a sense of mastery over the trauma and helping the child to feel safe again. In older children, gaining a sense of mastery includes the ability to recall, relate, narrate, and reconsider the trauma without feeling overwhelmed and without dissociating. Relaxation training and medication may be helpful in enabling the child to do this. In younger children, play provides an opportunity to work through the trauma. The victims of domestic violence especially required long-term psychological and psychiatric treatment. © PSYCHIATR. PSYCHOL.",0,0 +3384,The Psychopathology of Posttraumatic Embitterment Disorders,"<i>Background:</i> The posttraumatic embitterment disorder (PTED) was introduced as a new subgroup of adjustment disorders. The trigger event in PTED is an exceptional, though normal negative life event that is experienced as a violation of basic beliefs and values. The predominant emotion in PTED is embitterment. This study presents first data on the psychopathological profile of PTED. <i>Method:</i> 48 inpatients were diagnosed by clinical judgment as suffering from PTED. Patients were then interviewed with the standardized Mini International Neuropsychiatric Interview (MINI) and an additional interview section on the diagnostic criteria for PTED. Patients also filled in the Symptom Checklist-90-Revision (SCL-90-R), and the Impact of Event Scale (IES-R). <i>Results:</i> According to the MINI68.8% of the patients fulfilled the criteria for adjustment disorders, 52.1% for major depression, 41.7% for dysthymia, and 35.4% for generalized anxiety disorders. 100% of patients reported that they were suffering from intrusive thoughts about the event. 97.9% of the patients complained about persistent negative mood, 91.7% about restlessness, 83.3% inhibition of drive and loss of interest, 77.1% phobic avoidance of places related to the event, and 75% resignation, but 91.7% reported normal mood when distracted. The SCL-90-R indicated a high load of general psychopathological complaints with an average positive symptom total score of 52.26. Characteristic were feelings of injustice (100%), embitterment (97.7%), and rage (91.7%). The IES-R scale indicated a high prevalence of posttraumatic stress, with an average total score of 3.23. The average duration of illness was 31.7 months. <i>Conclusions:</i> The PTED patients are suffering from severe, multiform, and disabling symptoms. Their clinical features pose difficult diagnostic problems. The predominant complaints about feelings of injustice, embitterment, and rage and the results of the IES speak for the importance of the critical event for the development and understanding of such disorders.",0,0 +3385,Postintensive care unit psychological burden in patients with chronic obstructive pulmonary disease and informal caregivers: A multicenter study,"To determine the prevalence and risk factors of symptoms of anxiety, depression, and posttraumatic stress disorder-related symptoms in patients with chronic obstructive pulmonary disease and their relatives after an intensive care unit stay.Prospective multicenter study.Nineteen French intensive care units.One hundred twenty-six patients with chronic obstructive pulmonary disease who survived an intensive care unit stay and 102 relatives.None.Patients and relatives were interviewed at intensive care unit discharge and 90 days later to assess symptoms of anxiety and depression using Hospital Anxiety and Depression Scale (HADS) and posttraumatic stress disorder-related symptoms using the Impact of Event Scale (IES). At intensive care unit discharge, 90% of patients recollected traumatic psychological events in the intensive care unit. At day 90, we were able to conduct telephone interviews with 53 patients and 47 relatives. Hospital Anxiety and Depression Scale scores indicated symptoms of anxiety and depression in 52% and 45.5% of patients at intensive care unit discharge and in 28.3% and 18.9% on day 90, respectively. Corresponding prevalence in relatives were 72.2% and 25.7% at intensive care unit discharge and 40.4% and 14.9% on day 90, respectively. The Impact of Event Scale indicated posttraumatic stress disorder-related symptoms in 20.7% of patients and 29.8% of relatives on day 90. Peritraumatic dissociation assessed using the Peritraumatic Dissociative Experiences Questionnaire was independently associated with posttraumatic stress disorder-related symptoms in the patients and relatives. Previous intensive care unit experience and recollection of bothersome noise in the intensive care unit predicted posttraumatic stress disorder-related symptoms in the patients.Psychiatric symptoms were found to be common in a group of 126 patients with chronic obstructive pulmonary disease who survived an intensive care unit stay and their relatives at intensive care unit discharge and 90 days later. Peritraumatic dissociation at intensive care unit discharge was found to independently predict posttraumatic stress disorder-related symptoms in this sample of patients and relatives.",0,0 +3386,Rationale for iloperidone in the treatment of posttraumatic stress disorder.,"Multiple controlled efficacy studies are available to support the use of psychotropic medications in the treatment of posttraumatic stress disorder symptoms. Iloperidone, a recently approved atypical antipsychotic, has yet to be evaluated in such a manner. This unique agent has the highest affinity of all antipsychotics toward alpha-1 receptors. Antagonism of central nervous system alpha-1 receptors has been implicated in certain aspects of posttraumatic stress disorder, as evidenced by the beneficial role of prazosin in treating nightmares. Additional reduction in hypervigilance may occur through blockade of dopamine receptor D2 and serotonin receptors in the 5-HT2 family. Further investigation of iloperidone is warranted in the treatment of patients with posttraumatic stress disorder due to its unique receptor binding profile.",0,0 +3387,Compassion Fatigue and Burnout Amongst Clinicians: A Medical Exploratory Study,"Compassion fatigue is a broad term comprising of two components - burnout and secondary traumatic stress. The current study is aimed at identifying 'burnout' and 'compassion fatigue' among clinicians involved in care of individuals suffering from medical illness.A total of 60 clinicians were included in the study. A semi-structured questionnaire was administered to gather information related to personal, professional, anthropometric, and metabolic profile of the study participants. Professional Quality of Life Scale (ProQoL Version V) was used to assess burnout, compassion satisfaction and secondary traumatic stress. Analysis was carried out using the SPSS version 19.0.The mean age of clinicians was 46.68±11.06 (range 26-67 years). Burnout score was significantly higher in those involved in diabetology practice. Similarly, compassion satisfaction score was greater among those with greater years of practice as well as among those in private practice. Clinicians who reported a poor working condition, as opposed to good, had more burnout and less compassion satisfaction.The current study suggests that it is important to find out ways of decreasing burnout and compassion fatigue among clinicians.",0,0 +3388,"Principles and neurobiological correlates of concentrative, diffuse, and insight meditation.","T he term meditation encompasses a broad variety of mental-training practices that vary between cultures and traditions, ranging from techniques designed to promote physical health, relaxation, and improved concentration, to exercises performed with farther-reaching goals, such as developing a heightened sense of well-being, cultivating altruistic behaviors, and, for some, attaining enlightenment. Meditation can be conceptualized as complex emotional and attentional regulatory practices in which mental and somatic events are affected by specific mental-training practices. Meditation is typically associated with a concurrent state of heightened vigilant awareness and reduced metabolic activity—which lead to improved physical health, psychological balance, and emotional stability. Not all meditation practices focus on the training of specific cognitive skills, and in those that do, the methodologies and outcomes often vary. It is therefore essential to be explicit about the type of meditation practice under investigation. Different types of meditation can be classified based on how the practitioner’s attentional processes are regulated and directed. In this article we focus on the two most common styles of meditation derived from Buddhist traditions: (1) concentrative, or focused-attention, meditation, and (2) diffuse, or open-monitoring, meditation. Concentrative meditation involves maintaining and continually refocusing attention on a chosen object, such as a body sensation, single point in space, color, object, sound, or affective state such as compassion. Open-monitoring meditation involves developing a present-centered and unattached/neutral mode of observation toward all sensational phenomena, including thoughts.",0,0 +3389,Clinical applications of electroconvulsive therapy and transcranial magnetic stimulation for the treatment of major depressive disorder: a critical review,"Depression is a common and debilitating psychiatric disorder that is often unable to be effectively treated with pharmacotherapeutic agents alone. Electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) are among several somatic therapies available for the treatment of major depression. The purpose of this article is to synthesize current information on ECT and repetitive TMS as treatments for pharmacotherapy-resistant major depression regarding its use in neuropsychiatric clinical practice. The current psychiatric literature indicates that both ECT and TMS are effective antidepressant treatments. ECT is a safe and highly effective treatment for depression. The literature also illustrates that TMS has a favorable side-effect profile, excellent tolerability and modest efficacy. To date, additional research is being conducted to further enhance ECT and TMS treatment, and to further define their role in treatment algorithms.",0,0 +3390,Emotional numbing and pain intensity predict the development of pain disability up to one year after lateral thoracotomy,"Little is known about the factors that predict the transition of acute, time limited pain to chronic pathological pain following postero-lateral thoracotomy. The aim of the present prospective, longitudinal study was to determine the extent to which (1) pre-operative pain intensity, pain disability, and post-traumatic stress symptoms (PTSS) predict post-thoracotomy pain disability 6 and 12 months later; and (2) if these variables, assessed at 6 months, predict 12 month pain disability. Fifty-four patients scheduled to undergo postero-lateral thoracotomy for intrathoracic malignancies were recruited before surgery and followed prospectively for one year. The incidence of chronic post-thoracotomy pain was 68.1% and 61.1% at the 6 and 12 month follow-ups, respectively. Multiple regression analyses showed that neither pre-operative factors nor acute movement-evoked post-operative pain predicted 6 or 12 month pain disability. However, concurrent pain intensity and emotional numbing, but not avoidance symptoms, made unique, significant contributions to the explanation of pain disability at each follow-up (total R(2)=76.3.0% and 63.9% at 6 and 12 months, respectively, both p<0.0009). The relative contribution of pain intensity decreased, while that of emotional numbing increased with time, indicating a progressive de-coupling of pain intensity and disability and a concomitant strengthening of the link between emotional numbing and disability. This suggests that pain may serve as a traumatic stressor which causes increased emotional numbing. The results also support recent suggestions that avoidance and emotional numbing constitute separate PTSS clusters. Further research is required to determine the source(s) of emotional numbing after postero-lateral thoracotomy and effective interventions.",0,0 +3391,Associations with duration of compensation following whiplash sustained in a motor vehicle crash,"Continued exposure to compensation systems has been reported as deleterious to the health of participants. Understanding the associations with time to claim closure could allow for targeted interventions aimed at minimising the time participants are exposed to the compensation system.To identify the associations of extended time receiving compensation benefits with the aim of developing a prognostic model that predicts time to claim closure.Prospective cohort study in people with whiplash associated disorder.Time to claim closure, in a privately underwritten fault based third party traffic crash insurance scheme in New South Wales, Australia.Cox proportional hazard regression modelling.Of the 246 participants, 25% remained in the compensation system longer than 24 months with 15% remaining longer than three years. Higher initial disability (Functional Rating Index≥25 at baseline) (HRR: 95% CI, 1.916: 1.324-2.774, p<0.001); and lower initial mental health as measured by SF-36 Mental Component Score (HRR: 95% CI, 0.973: 0.960-0.987, p<0.001) were significantly and independently associated with an increased time-to-claim closure. Shorter time to claim closure was associated with having no legal involvement (HRR: 95% CI, 1.911: 1.169-3.123, p=0.009); and, not having a prior claim for compensation (HRR: 95% CI, 1.523: 1.062-2.198, p=0.022).Health and insurance related factors are independently associated with time to claim closure. Both factors need to be considered by insurers in their assessment of complexity of claims. Interventions aimed at minimising the impact of these factors could reduce claimants' exposure to the compensation system. In turn insurers can potentially reduce claims duration and cost, while improving the health outcomes of claimants.",0,0 +3392,The impact of PTSD symptoms on physical and mental health functioning in returning veterans,"This study aimed to determine the unique impact of PTSD symptoms, beyond other frequently examined factors on physical and mental health functioning in a sample of returning veterans. Assessments of 168 returning OEF/OIF veterans conducted an average of six months following return from deployment included measures of emotional disorders and the Short Form (36) Health Survey. Hierarchical multiple regressions revealed significant, unique contribution of Clinician-Administered PTSD Scale (CAPS) score above all other predictors in the model (demographics, severity of trauma exposure, physical injury, substance abuse and depressive symptoms), for both the physical (8%) and mental (6%) health aggregate scores, along with significant prediction of physical health (4-10%) and mental health (3-7%) subscale scores. The only other significant predictors were age for physical health scores, and depressive symptoms for mental health scores. PTSD criterion B (re-experiencing) symptoms uniquely predicted reduced physical health functioning and higher experience of bodily pain, while criterion D (hyperarousal) symptoms uniquely predicted lower feelings of energy/vitality and poorer perceptions of emotional health.",0,0 +3393,The Effectiveness of the Personality Assessment Inventory With Feigned PTSD,"Malingered posttraumatic stress disorder (PTSD) poses a formidable clinical challenge because of the apparent ease in feigning PTSD. As an additional confound, some patients with genuine PTSD produce elevated profiles on feigning indicators that are difficult to distinguish from feigned PTSD. The current study utilized 109 inpatients from a trauma unit to examine whether the Personality Assessment Inventory and the Detailed Assessment of Posttraumatic Stress can effectively differentiate between genuine and feigned PTSD. As a primary focus, Resnick’s model of malingered PTSD was evaluated with its three subtypes: pure malingering, partial malingering, and false imputation. They were tested on their ability to (a) effectively simulate PTSD and (b) avoid being classified as feigning. The partial malingering group proved to be the best feigning group in achieving these two goals. Overall, the Personality Assessment Inventory Malingering Index and Negative Distortion Scale were the most effective at identifying feigning.",0,0 +3394,"Trajectories of posttraumatic stress symptoms (PTSS) after major war among Palestinian children: Trauma, family- and child-related predictors","Research shows great individual variation in changes in posttraumatic stress symptoms (PTSSs) after major traumas of terrorist attacks, military combat, and natural disasters. Earlier studies have identified specific mental health trajectories both in children and adults. This study aimed, first, to identify potential PTSS-related trajectories by using latent class growth analyses among children in a three-wave assessment after the 2008/2009 War on Gaza, Palestine. Second, it analyzed how family- and child related factors (e.g., attachment relations, posttraumatic cognitions (PTCs), guilt, and emotion regulation) associate with the trajectory class membership.The sample consisted of 240 Palestinian children (49.4% girls and 50.6% boys) of 10-13 years of age (M=11.29, SD=0.68), who completed PTSS (CRIES) assessments at 3 (T1), 5 (T2), and 11 (T3) months after the war. Children reported their personal exposure to war trauma, attachment style, cognitive trauma processing, and emotion regulation, and their parents reported family war trauma exposure and attachment style.Results revealed a three-trajectory solution, a majority of children belonging to the Recovery trajectory (n=183), and a minority belonged either to Resistant trajectory (n=29) or to Increasing symptoms trajectory (n=28). Low levels of negative posttraumatic cognitive appraisals, feelings of guilt and emotion regulation were characteristic of children in the Resistant trajectory as compared to Increasing symptoms trajectory. Father׳s attachment security was further associated with the Resistant trajectory membership. Children׳s attachment avoidance and high parental trauma were typical to children in Recovery trajectory (as compared to the Increasing symptoms trajectory).",1,0 +3395,Frequencies and predictors of barriers to mental health service use: a longitudinal study of Hurricane Ike survivors,"BackgroundThe majority of disaster survivors suffering from psychological symptoms do not receive mental health services. Research on barriers to service use among disaster survivors is limited by a lack of longitudinal studies of representative samples and investigations of predictors of barriers. The purpose of this study was to address these limitations through analysis of a three-wave population-based study of Hurricane Ike survivors (N = 658).MethodsFrequencies of preference, outcome expectancy, resource, and stigma barriers among participants with unmet mental health needs were documented and logistic regression using a generalized estimating equations approach explored predisposing (e.g., age), illness-related (e.g., posttraumatic stress) and enabling (e.g., insurance coverage) factors as predictors of each type of barrier.ResultsPreference barriers were most frequently cited at each wave, whereas stigma barriers were least frequently cited. Older age and higher emotional support predicted preference barriers; being a parent of a child under 18-years old at the time of the hurricane, higher generalized anxiety, and lack of insurance predicted resource barriers; and higher posttraumatic stress predicted stigma barriers.ConclusionsThese findings suggest that postdisaster practices targeting subpopulations most likely to have barriers to service use may be indicated.",0,0 +3396,"Outcome Evaluation of the Veterans Affairs Salt Lake City Integrative Health Clinic for Chronic Pain and Stress-Related Depression, Anxiety, and Post-Traumatic Stress Disorder","Objectives: The purpose of this longitudinal outcome research study was to determine the effectiveness of the Integrative Health Clinic and Program (IHCP) and to perform a subgroup analysis investigating patient benefit. The IHCP is an innovative clinical service within the Veterans Affairs Health Care System designed for nonpharmacologic biopsychosocial management of chronic nonmalignant pain and stress-related depression, anxiety, and symptoms of post-traumatic stress disorder (PTSD) utilizing complementary and alternative medicine and mind–body skills. Methods: A post-hoc quasi-experimental design was used and combined with subgroup analysis to determine who benefited the most from the program. Data were collected at intake and up to four follow-up visits over a 2-year time period. Hierarchical linear modeling was used for the statistical analysis. The outcome measures included: Health-Related Quality of Life (SF-36), the Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Subgroup comparisons included low anxiety (BAI < 19, n = 82), low depression (BDI < 19, n = 93), and absence of PTSD (n = 102) compared to veterans with high anxiety (BAI ≥ 19, n = 77), high depression (BDI > 19, n = 67), and presence of PTSD (n = 63). Results: All of the comparison groups demonstrated an improvement in depression and anxiety scores, as well as in some SF-36 categories. The subgroups with the greatest improvement, seen at 6 months, were found in the high anxiety group (Cohen's d = 0.52), the high-depression group (Cohen's d = 0.46), and the PTSD group (Cohen's d = 0.41). Conclusions: The results suggest IHCP is an effective program, improving chronic pain and stress-related depression, anxiety, and health-related quality of life. Of particular interest was a significant improvement in anxiety in the PTSD group. The IHCP model offers innovative treatment options that are low risk, low cost, and acceptable to patients and providers.",0,0 +3397,SKA2 methylation is associated with decreased prefrontal cortical thickness and greater PTSD severity among trauma-exposed veterans,"Methylation of the SKA2 (spindle and kinetochore-associated complex subunit 2) gene has recently been identified as a promising biomarker of suicide risk. Based on this finding, we examined associations between SKA2 methylation, cortical thickness and psychiatric phenotypes linked to suicide in trauma-exposed veterans. About 200 trauma-exposed white non-Hispanic veterans of the recent conflicts in Iraq and Afghanistan (91% male) underwent clinical assessment and had blood drawn for genotyping and methylation analysis. Of all, 145 participants also had neuroimaging data available. Based on previous research, we examined DNA methylation at the cytosine-guanine locus cg13989295 as well as DNA methylation adjusted for genotype at the methylation-associated single nucleotide polymorphism (rs7208505) in relationship to whole-brain cortical thickness, posttraumatic stress disorder symptoms (PTSD) and depression symptoms. Whole-brain vertex-wise analyses identified three clusters in prefrontal cortex that were associated with genotype-adjusted SKA2 DNA methylation (methylation(adj)). Specifically, DNA methylation(adj) was associated with bilateral reductions of cortical thickness in frontal pole and superior frontal gyrus, and similar effects were found in the right orbitofrontal cortex and right inferior frontal gyrus. PTSD symptom severity was positively correlated with SKA2 DNA methylation(adj) and negatively correlated with cortical thickness in these regions. Mediation analyses showed a significant indirect effect of PTSD on cortical thickness via SKA2 methylation status. Results suggest that DNA methylation(adj) of SKA2 in blood indexes stress-related psychiatric phenotypes and neurobiology, pointing to its potential value as a biomarker of stress exposure and susceptibility.",0,0 +3398,"Predicting symptom clusters of posttraumatic stress disorder (PTSD) in Croatian war veterans: the role of socio-demographics, war experiences and subjective quality of life.","Previous research has documented multiple chains of risk in the development of PTSD among war veterans. However, existing studies were mostly carried out in the West, while they also did not analyze specific symptom clusters of PTSD. The aim of this study was to examine the role of socio-demographic characteristics, war experiences and subjective quality of life in the prediction of three clusters of PTSD symptoms (i.e., avoidance, intrusion, hyperarousal).This study comprised 184 male participants who have survived war imprisonment during the Croatian Homeland War in the period from 1991 to 1995. The data was collected through several self-report measuring instruments: questionnaire on socio-demographic data, war experiences (Questionnaire on Traumatic Combat and War Experiences), subjective quality of life (WHO-Five Well-being Index), and PTSD symptoms (Impact of Events Scale - Revised).The level of three symptom clusters of PTSD was found to be moderate to high, as indicated by the scores on the IES-R. Results of the three hierarchical regression analyses showed the following: traumatic war experiences were significant predictors of avoidance symptoms; traumatic war experiences and subjective quality of life were significant predictors of hyperarousal symptoms; and traumatic war experiences, material status and subjective quality of life were significant predictors of intrusion symptoms.These findings support the widespread belief that the development of war-related PTSD is accounted for by multiple chains of risk, while traumatic war experiences seem to be the only predictor of all three symptom clusters. Future research should put more emphasis on specific PTSD symptom clusters when investigating the etiopathogenesis of this disorder among war-affected populations.",0,0 +3399,The Severity of Childhood Abuse and Neglect in Relationship to Post-Traumatic Stress Disorder Among Female Sex Workers in the Netherlands,"In this article, the relationship between childhood abuse and neglect and post-traumatic stress disorder (PTSD) in adulthood is examined in a sample of 123 female indoor sex workers in the Netherlands. It was hypothesized that the severity of childhood abuse and neglect is associated with the severity of PTSD. In this study, a substantial number of sex workers had experienced abuse, neglect, or both during childhood. Furthermore, a substantial number suffered from PTSD. Results show significant differences between sex workers suffering from PTSD and sex workers not suffering from PTSD, in the extent to which they have experienced abuse or neglect. Logistic regression analysis shows emotional abuse contributes significantly to the prediction of PTSD. Our findings suggest that the high rate of PTSD among sex workers might be partially related to childhood experiences, indicating that a number of sex workers might be traumatized before entering sex work.",0,0 +3400,A Pilot Study of Acute Stress Symptoms in Parents and Youth Following Diagnosis of Type I Diabetes,"The primary aims of this exploratory study were to determine the rate of occurrence of acute stress disorder (ASD) in children newly diagnosed with Type 1 diabetes and their parents, to examine relationships with demographic and psychosocial factors, and to examine the relationships between ASD symptom clusters and early adherence behavior (clinic attendance). The sample consisted of 102 parents of children ages 0-17 years and 40 youth ages 11-17 who were evaluated within three days of diabetes diagnosis. Eighteen percent of parents and 17% of youth reported subthreshold symptoms of ASD. Acute stress symptoms and demographic variables predicted clinic attendance, with a differential pattern evident in the responses of youth and their parents. These findings reinforce the importance of screening symptoms of ASD in youth with newly diagnosed diabetes and their parents to assist in identifying families who may be in need of additional support. © Springer Science+Business Media, LLC 2011.",0,0 +3401,"PTSD Is a Chronic, Fluctuating Disorder Affecting the Mental Quality of Life in Older Adults","Examine the longitudinal course of posttraumatic stress disorder (PTSD) in older adults and its influence on mental health quality of life (MHQoL).Evaluation performed at baseline, and 3 and 6 months postrandomization as part of a longitudinal trial.A total of 1,185 participants, with a mean (±SD) age of 73.53 (±5.98) years, at seven primary care sites (including five Veterans Affairs clinics), were divided into four groups, namely, no trauma (n = 661), trauma only (n = 319), partial PTSD (n = 114), and PTSD (n = 81), based on reports of trauma and associated PTSD symptoms.The prevalence of comorbid depression, anxiety, and alcohol use disorders, assessed using the Diagnostic and Statistical Manual, Fourth Edition, criteria and changes in MHQoL, as assessed by the Short Form-36 mental component score.At baseline, the PTSD group had higher frequencies of comorbid depression and anxiety disorders and worse MHQoL than the other groups. Both chronic (participants diagnosed with PTSD at all three assessments) and fluctuating (participants moving to or from one of the other groups) trajectories of course were observed during the follow-up period, which appeared to be separate from that of the comorbid disorders. Even after accounting for those comorbid disorders, PTSD had an independent association with poorer MHQoL at multiple time points, especially in men, whereas trauma without PTSD symptoms (trauma only) had better MHQoL.PTSD had chronic and fluctuating courses, with negative effects on MHQoL, while partial PTSD might represent a transitional state, underscoring the need to better identify and treat PTSD at any phase in later life.",0,0 +3402,Response of Post-Mortem Human Head Under Primary Blast Loading Conditions: Effect of Blast Overpressures,"Blast induced neurotrauma (BINT), and posttraumatic stress disorder (PTSD) are identified as the “signature injuries” of recent conflicts in Iraq and Afghanistan. The occurrence of mild to moderate traumatic brain injury (TBI) in blasts is controversial in the medical and scientific communities because the manifesting symptoms occur without visible injuries. Whether the primary blast waves alone can cause TBI is still an open question, and this work is aimed to address this issue. We hypothesize that if a significant level of intracranial pressure (ICP) pulse occurs within the brain parenchyma when the head is subjected to pure primary blast, then blast induced TBI is likely to occur. In order to test this hypothesis, three post mortem human heads are subjected to simulated primary blast loading conditions of varying intensities (70 kPa, 140 kPa and 200 kPa) at the Trauma Mechanics Research Facility (TMRF), University of Nebraska-Lincoln. The specimens are placed inside the 711 mm × 711 mm square shock tube at a section where known profiles of incident primary blast (Friedlander waveform in this case) are obtained. These profiles correspond to specific field conditions (explosive strength and stand-off distance). The specimen is filled with a brain simulant prior to experiments. ICPs, surface pressures, and surface strains are measured at 11 different locations on each post mortem human head. A total of 27 experiments are included in the analysis. Experimental results show that significant levels of ICP occur throughout the brain simulant. The maximum peak ICP is measured at the coup site (nearest to the blast) and gradually decreases towards the countercoup site. When the incident blast intensity is increased, there is a statistically significant increase in the peak ICP and total impulse (p<0.05). Even after five decades of research, the brain injury threshold values for blunt impact cases are based on limited experiments and extensive numerical simulations; these are still evolving for sports-related concussion injuries. Ward in 1980 suggested that no brain injury will occur when the ICP<173 kPa, moderate to severe injury will occur when 173 kPa<ICP<235 kPa and severe injury will occur when ICP>235 kPa for blunt impacts. Based on these criteria, no injury will occur at incident blast overpressure level of 70 kPa, moderate to severe injuries will occur at 140 kPa and severe head injury will occur at the incident blast overpressure intensity of 200 kPa. However, more work is needed to confirm this finding since peak ICP alone may not be sufficient to predict the injury outcome.",0,0 +3403,Reduction of Nightmares and Other PTSD Symptoms in Combat Veterans by Prazosin: A Placebo-Controlled Study,"Prazosin is a centrally active alpha(1) adrenergic antagonist. The authors' goal was to evaluate prazosin efficacy for nightmares, sleep disturbance, and overall posttraumatic stress disorder (PTSD) in combat veterans.Ten Vietnam combat veterans with chronic PTSD and severe trauma-related nightmares each received prazosin and placebo in a 20-week double-blind crossover protocol.Prazosin (mean dose=9.5 mg/day at bedtime, SD=0.5) was superior to placebo for the three primary outcome measures: scores on the 1) recurrent distressing dreams item and the 2) difficulty falling/staying asleep item of the Clinician-Administered PTSD Scale and 3) change in overall PTSD severity and functional status according to the Clinical Global Impression of change. Total score and symptom cluster scores for reexperiencing, avoidance/numbing, and hyperarousal on the Clinician-Administered PTSD Scale also were significantly more improved in the prazosin condition, and prazosin was well tolerated.These data support the efficacy of prazosin for nightmares, sleep disturbance, and other PTSD symptoms.",0,0 +3404,Substance Use And Misuse After Disasters:,"Introduction Exposure to various traumatic events, as well as resulting disturbances such as posttraumatic stress disorder (PTSD), is associated with increased substance use (Breslau, Davis, & Schultz, 2003; Feldner, Babson, & Zvolensky, 2007; McFarlane, 1998; Morissette, Tull, Gulliver, Kamholz, & Zimering, 2007; Stewart, 1996). In particular, studies have shown that alcohol and tobacco consumption increase through both initiation of and increasing use of these substances. It is, however, unclear whether this is also true in the aftermath of large-scale catastrophes or disasters. The distinction between individual traumatic experiences and collective experiences (e.g., disasters) may be sometimes unclear (Galea, Nandi, & Vlahov, 2005). Moreover, comorbidity profiles of PTSD and substance use and misuse, as well as the population under study, may differ between types of trauma (Deering, Glover, Ready, Eddleman, & Alarcon, 1996). Insight into substance use and misuse after disaster is important for several reasons. First, similar to PTSD and other mental health disturbances, understanding the prevalence of substance use and misuse after disasters is necessary in estimating the need for mental health services (see Cao, McFarlane, & Klimidis, 2003) and in organizing programs to prevent prolonged and increased use to minimize adverse affects on health and functioning. Second, information on comorbidity (e.g., PTSD, depression), correlates, and predictors of substance use may help to identify victims who are at risk for substance disorders and increased substance use in the short, medium and/or long term. © Cambridge University Press 2009.",0,0 +3405,Comorbid Chronic Pain and Posttraumatic Stress Disorder Across the Lifespan: A Review of Theoretical Models,"(from the chapter) The primary aim of this chapter is to provide a critical review and synthesis of the existing literature investigating the relationship between chronic pain and posttraumatic stress disorder (PTSD). The chapter begins with a presentation of the diagnostic criteria, prevalence, and theoretical models of chronic pain and PTSD. Research is then presented describing the co-occurrence of the two disorders, and several theoretical models are highlighted that may serve to explain the similar mechanisms by which these two disorders may be maintained. This chapter then addresses how comorbid chronic pain and PTSD may present differently in youth, with consideration of how theoretical models of the comorbidity of pain and PTSD may be modified to incorporate developmental factors. Furthermore, the chapter helps to explicate how the experience of comorbid chronic pain and PTSD can vary from childhood to adulthood. Finally, the chapter closes with a section on implications for treatment as well as a call for continued research to further refine the models reviewed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +3406,Interpersonal Conflict and Referrals to Counseling Among Married Soldiers Following Return From Deployment,"Deployment represents a significant potential strain on military families. The impact of postdeployment stresses may be increased if family coping resources are diminished by returning service members' physical injuries, mental health issues, or substance abuse. This article examines the health and mental health correlates of self-reported concerns regarding interpersonal conflict among married soldiers following return from deployment and the likelihood that soldiers acknowledging such concerns are referred to counseling services. Among 20,166 married Army soldiers completing Post-Deployment Health Reassessments, 18% reported having experienced serious interpersonal conflict with their spouse, family members, close friends, or coworkers. Results indicate that interpersonal conflict was more common among those who reported health problems, depression, post-traumatic stress disorder, and alcohol abuse. Among soldiers reporting interpersonal conflict and not already receiving services, 11% were referred to service. Findings support the need to communicate with soldiers and their spouses about the availability of services following return from deployment and to continue efforts to reduce stigma associated with seeking treatment.",0,0 +3407,A Second Look at Prior Trauma and the Posttraumatic Stress Disorder Effects of Subsequent Trauma,"Previous studies showed increased probability of a posttraumatic stress disorder (PTSD) effect of trauma in persons who had experienced prior trauma. The evidence comes chiefly from retrospective data on earlier events, obtained from trauma-exposed persons with and without PTSD. A generally overlooked major limitation is the failure to assess the PTSD response to the prior trauma.To estimate the risk of PTSD after traumas experienced during follow-up periods in relation to respondents' prior traumatic events and PTSD.A cohort study of young adults interviewed initially in 1989, with repeated assessments during a 10-year follow-up.The sample was randomly selected from a large health maintenance organization in Southeast Michigan, representing the geographic area.The relative risk of PTSD precipitated by traumatic events occurring during follow-up periods in relation to prior exposure and PTSD that had occurred during preceding periods, estimated by general estimating equations (n = 990).The conditional risk of PTSD during the follow-up periods was significantly higher among trauma-exposed persons who had experienced prior PTSD, relative to those with no prior trauma (odds ratio, 3.01; 95% confidence interval, 1.52-5.97). After adjustment for sex, race, education, and preexisting major depression and anxiety disorders, the estimates were only marginally revised. In contrast, the conditional risk of PTSD during follow-up among trauma-exposed persons who had experienced prior traumatic events but not PTSD was not significantly elevated, relative to trauma-exposed persons with no prior trauma. The difference between the 2 estimates was significant (P = .005).Prior trauma increases the risk of PTSD after a subsequent trauma only among persons who developed PTSD in response to the prior trauma. The findings suggest that preexisting susceptibility to a pathological response to stressors may account for the PTSD response to the prior trauma and the subsequent trauma.",0,0 +3408,The role of guilt in the development of post-traumatic stress disorder: A systematic review,"Post-traumatic stress disorder (PTSD) can be a debilitating condition associated with a myriad of emotions. Guilt is an important associated feature of PTSD that has received far less recognition than other symptoms often associated with fear and intense threat. The nature of the relationship between guilt and PTSD remains elusive and requires further clarification. The aim of the current paper was to review the extant literature regarding the link between guilt and PTSD.A systematic database search of PsycINFO, Medline, Embase and Web of Science identified articles that enabled examination of the guilt-PTSD relationship. A total of 27 articles met inclusion criteria for this review.There were cross-sectional relationships between guilt and PTSD symptomology with evidence of associations between PTSD symptoms and cognitions related to perceived wrong doing and self-blame. However, the direction of association between guilt and PTSD is unclear and possibly confounded by overlapping constructs such as shame.The review is constrained by the absence of longitudinal and experimental research and studies, which control for potential confounding variables. The reliability and validity of measures of guilt and PTSD is also not consistently reported.This review outlines four competing models of the guilt-PTSD relationship and examines existing evidence linking the two constructs. The current literature is too preliminary to offer any strong support for one model over the other. However, in critically appraising existing studies, this review helps to inform the design of future studies investigating the association between guilt and PTSD.",0,0 +3409,Suicide in the US Army,"Suicide in the US Army is a high-profile public health problem that is complex and poorly understood. Adding to the confusion surrounding Army suicide is the challenge of defining and understanding individuals/populations dying by suicide. Data from recent studies have led to a better understanding of risk factors for suicide that may be specifically associated with military service, including the impact of combat and deployment on increased rates of psychiatric illness in military personnel. The next steps involve applying these results to the development of empirically supported suicide prevention approaches specific to the military population. This special article provides an overview of suicide in the Army by synthesizing new information and providing clinical pearls based on research evidence.",0,0 +3410,Work-related quality of life and posttraumatic stress disorder symptoms among female veterans.,"Posttraumatic stress disorder (PTSD) can have pervasive, negative effects on multiple aspects of quality of life. We investigated the relationship between PTSD symptom clusters and work-related quality of life among female veterans. Although prior studies have shown that PTSD symptom clusters are differentially related to work-related quality of life, no study has assessed these relationships in women specifically.Participants were 253 female veterans with current PTSD. We assessed three components of work-related quality of life (employment status, clinician-rated occupational impairment, and self-rated occupational satisfaction) and performed analyses with and without adjusting for self-reported depression symptoms.None of the PTSD symptom clusters were associated with employment status. All PTSD symptom clusters had significant independent associations with occupational impairment. All PTSD symptom clusters except avoidance were significantly associated with lower occupational satisfaction, but none had independent associations with occupational satisfaction. No single PTSD symptom cluster emerged as most strongly associated with occupational outcomes. Symptoms of depression had substantial associations across all occupational outcomes, independent of PTSD symptoms.Knowledge about how PTSD relates to occupational outcomes in women veterans is important for addressing the needs of this growing segment of the VA patient population, in which PTSD is a prevalent condition. Because PTSD had differential relationships with the three components of work-related quality of life, measuring only one component, or using an aggregate measure, may obscure important distinctions. Resolving depression symptoms also may be integral to achieving meaningful recovery.",0,0 +3411,Treatment-related reductions in PTSD and changes in physical health symptoms in women,"This study examined the relationship between change in posttraumatic stress disorder (PTSD) symptoms over the course of PTSD treatment and the association with changes in general physical health symptoms. Both positive health habits (e.g., exercise) and negative (e.g., smoking), were examined to determine if they accounted for the association between changes in PTSD severity over time and changes in physical health. Participants were 150 women seeking treatment for PTSD. Latent growth curve modeling indicated a substantial relationship (R 2 = 34 %) between changes in PTSD and changes in physical health that occurred during and shortly following treatment for PTSD. However, there was no evidence to suggest that changes in health behaviors accounted for this relationship. Thus, PTSD treatment can have beneficial effects on self-reported physical health symptoms, even without direct treatment focus on health per se, and is not accounted for by shifts in health behavior. © 2013 Springer Science+Business Media New York (outside the USA).",0,0 +3412,A prospective investigation of the role of cognitive factors in persistent Posttraumatic Stress Disorder (PTSD) after physical or sexual assault,"The effectiveness of psychological treatments for PTSD is likely to be enhanced by improved understanding of the factors involved in maintaining the disorder. Ehlers and Clark [A cognitive model of persistent posttraumatic stem disorder Behav. Res. Ther. 38 (2000) 319-345] recently proposed a cognitive model of maintenance. The current study aimed to investigate several cognitive factors highlighted in Ehlers and Clark's model using a prospective design. Fifty-seven victims of physical or sexual assault participated in the study. Cognitive factors were assessed within 4 months of assault and victims were followed-up 6 and 9 months after the assault. Cognitive variables which significantly predicted PTSD severity at both follow-ups were: cognitive processing style during assault (mental defeat, mental confusion, detachment); appraisal of assault sequelae (appraisal of symptoms, perceived negative responses of others, permanent change); negative beliefs about self and world; and maladaptive control strategies (avoidance/safety seeking). Relationships between early appraisals, control strategies, and processing styles and subsequent PTSD severity remained significant after statistically controlling for gender and perceived assault severity. These findings support the cognitive model of PTSD proposed by Ehlers and Clark and suggest that effective treatment will need to address these cognitive factors.",0,0 +3413,Pharmacotherapy of post-traumatic stress disorder,"In the Diagnostic and Statistical Manual of Mental Disorders (DSM)-III, DSM-III-R and DSM-IV, the diagnosis of post-traumatic stress disorder (PTSD) requires the presence of three symptom clusters: re-experiencing, avoidance and hyperarousal. The selective serotonin reuptake inhibitors (SSRIs), in particular sertraline and paroxetine, have emerged as the treatment of choice for trauma victims experiencing these three symptom clusters. While not approved by the U.S. Food and Drug Administration, other pharmacological agents are often used, some for symptoms found in victims of early, chronic or extreme stress. Referred to as having type II trauma, complex PTSD, disorders of extreme stress and enduring personality change after catastrophic experience, these patients, with symptoms such as dissociation, somatization and self-injurious behavior, need to be recognized as suffering from a trauma-related disorder qualitatively different from that presently captured in the DSM-IV. In this paper we will refer to DSM-IV's construct as simple PTSD (sPTSD); to complex PTSD/disorders of extreme stress as cPTSD/DES; and to both as PTSD. We will review existing evidence for the efficacy of SSRIs in treating sPTSD as well as different pharmacological interventions that are necessary for the treatment of cPTSD/DES. In addition, since both sPTSD and cPTSD/DES frequently coexist with other mental disorders, treatment of comorbid PTSD will be addressed. Finally, given that existing rating scales are not designed to measure symptoms of cPTSD/DES, we will describe the Symptoms of Trauma Scale (SOTS), designed to measure symptoms of both sPTSD and cPTSD.",0,0 +3414,Beware of multiple traumas in PTSD assessment: the role of reactivation mechanism in intrusive and hyper-arousal symptoms,"Post-traumatic stress disorder (PTSD) is a major public health problem defined by three symptom clusters: intrusion thoughts, avoidance mechanisms and hyper-arousal. Several authors have emphasized, that some or all of these symptoms related to a past traumatic experience could be reactivated, even after long asymptomatic periods. This study investigates the role of an additional trauma in the reactivation of a childhood trauma among a group of former hidden children (n = 65), the Jewish youths who spent World War II in various hideaway shelters in Nazi-occupied Europe. They were compared with a control group.The presence or absence of an additional trauma in adulthood was assessed and PTSD symptoms were measured by using the Impact of Event Scale-Revised.An additional trauma reactivates PTSD symptoms of intrusion thoughts and, marginally, symptoms of hyper-arousal. At the opposite, symptoms of avoidance were not reactivated.Our results confirm the role of an additional trauma in the reactivation of traumatic memories, related to an earlier trauma, in later life. Clinical and theoretical implications are discussed and perspectives are proposed.",0,0 +3415,ACUTE POST-TRAUMATIC STRESS DISORDER IN PRISONERS OF WAR RELEASED FROM DETENTION CAMPS,"The aim of the present study was to assess acute psychiatric disturbances in Croatian prisoners of war (POWs) released after 6-9 months of detention. Immediately (1-3 days) after exchange with the other side, 47 prisoners of war were examined at the Zagreb University Clinic for Infectious Diseases by a team of medical professionals to assess their physical and psychological health, and therapeutic needs. The team consisted of a general practitioner, surgeon, infectious diseases specialist, psychiatrist and clinical psychologist. All prisoners were active soldiers from Vukovar, and were of similar age, social background, combat activity and duration of detention. All were severely physically and psychically maltreated in the detention camp. Sixteen (34%) had symptoms of current post-traumatic stress syndrome as assessed by the Watsons PTSD questionnaire. In a structured clinical interview, all POWs reported at least 2 (average 8-9) symptoms of psychological disturbance. All POWs ranked the withdrawal of information on their families and the situation in Croatia as the most painful experience during detention. Minnesota Multiphasic Personality Inventory (MMPI-201 version) profiles of the prisoners of war showed a significant difference between the POWs with and without diagnosed PTSD on the paranoia scale. In conclusion, although only one third of the POWs released after 6-9 months of detention and torture had manifest PTSD, most had several symptoms of psychological disturbances with dominating anxiotic-depressive and psychosomatic reactions. Careful follow-up is needed to asses the extent and late consequences of polytrauma experienced by this high-risk group.",0,0 +3416,Hurricane Andrew's Landfall in South Florida. Part II: Surface Wind Fields and Potential Real-Time Applications,"All available wind data associated with Hurricane Andrew’s passage were analyzed for periods corresponding to landfall south of Miami and emergence from southwest Florida. At landfall in southeast Florida, maximum sustained 1-min surface wind speeds VM1 reached just over 60 m s 01 in the northern eyewall over land; by the time Andrew exited the Florida peninsula, the peak value of VM1 over land decreased to 40 ‐ 45 m s 01 . Radar reflectivity observations from Tampa and Melbourne could not support an obvious correlation of convective cell development with coastal convergence during landfall on the southeast coast. On the southwest coast, however, convective cell development in the southern eyewall was supported by a coastal convergence maximum. Comparison of the wind swath with two independent Fujita-scale damage maps indicated that peak swath speeds compared well with damage-derived speed equivalents in the worst damaged areas but were higher than equivalents in moderately damaged areas. Comparison of the analysis maximum wind swath with an engineering survey of damaged homes suggests that homes exposed to a wide range of wind directions while subjected to high wind speeds suffered the most damage. Potential real-time applications of wind field products include warning dissemination, emergency management, storm surge and wave forecasting, and wind engineering. Development of damage assessment models for disaster mitigation is addressed from the viewpoint of an electrical utility.",0,0 +3417,Neuropathic Ocular Pain due to Dry Eye Is Associated With Multiple Comorbid Chronic Pain Syndromes,"Recent data show that dry eye (DE) susceptibility and other chronic pain syndromes (CPS) such as chronic widespread pain, irritable bowel syndrome, and pelvic pain, might share common heritable factors. Previously, we showed that DE patients described more severe symptoms and tended to report features of neuropathic ocular pain (NOP). We hypothesized that patients with a greater number of CPS would have a different DE phenotype compared with those with fewer CPS. We recruited a cohort of 154 DE patients from the Miami Veterans Affairs Hospital and defined high and low CPS groups using cluster analysis. In addition to worse nonocular pain complaints and higher post-traumatic stress disorder and depression scores (P < .01), we found that the high CPS group reported more severe neuropathic type DE symptoms compared with the low CPS group, including worse ocular pain assessed via 3 different pain scales (P < .05), with similar objective corneal DE signs. To our knowledge, this was the first study to show that DE patients who manifest a greater number of comorbid CPS reported more severe DE symptoms and features of NOP. These findings provided further evidence that NOP might represent a central pain disorder, and that shared mechanistic factors might underlie vulnerability to some forms of DE and other comorbid CPS.DE patients reported more frequent CPS (high CPS group) and reported worse DE symptoms and ocular and nonocular pain scores. The high CPS group reported symptoms of NOP that share causal genetic factors with comorbid CPS. These results imply that an NOP evaluation and treatment should be considered for DE patients.",0,0 +3418,Commentary: Women in combat and the risk of post-traumatic stress disorder and depression,"Studies among civilian populations have consistently shown that when compared with men, women have significantly higher prevalence rates of depression and anxiety disorders, including post-traumatic stress disorder (PTSD). Studies of general military populations in garrison have paralleled findings from civilian studies. Research on the gender differences associated with military deployment, such as Vietnam, Persian Gulf War, or peacekeeping operations, has found inconsistent results. These studies are not representative of current extended combat deployments in Iraq or Afghanistan, war zones that lack traditional front lines and in which women are serving in roles that put them at greater risk than in the past. Although women are excluded from serving in direct combat specialties, such as infantry or armour, and are therefore not at the same risk as male soldiers, they do serve in a variety of support positions where they travel outside military bases, work alongside combat soldiers, come under direct fire and may become casualties. These positions include military police, transportation, intelligence, pilots, medics, mechanics, civil affairs and other roles. Among the 3004 US fatalities from Iraq reported through 31 December 2006, 66 (2.2%) were women; among 127 UK fatalities, 3 (2.4%) were women. About two-thirds of these deaths involved hostile fire. In contrast, only one woman was reported to have died by hostile fire in Vietnam and five in the Persian Gulf War. An important unanswered question is whether there are gender differences in the risk of PTSD and other mental health problems among men and women exposed to similar levels of combat. The article by Dr Rona and colleagues is notable for being one of the first studies of gender differences in mental health concerns associated with deployment to the Iraq combat theatre. This study paves the way for future efforts to understand gender differences in the mental health impact of operations in Iraq and Afghanistan. The article reports a number of different findings among veterans of two wars and era controls that includes a trend analysis of changes in the health of UK military veterans between 1997 and 2005 in addition to the gender comparisons. The trend analysis is difficult to interpret due to the crosssectional design, lack of uniformity in the survey instruments (especially for the alcohol measure), demographic differences between the samples, differences in the prevalence of combat experiences and markedly different time frames for surveying following the return from deployment. Within the context of this larger effort, however, there are important comparisons of the prevalence of mental health concerns by gender for each cross-sectional deployed sample. Among the deployed Iraq War study group in the Rona et al. study, 26.7% of women compared with 19.8% of men reported high levels of psychological distress on the General Health Questionnaire (GHQ), a measure made up of questions pertaining mostly to depression. However, this difference in prevalence between men and women is considerably smaller than the differences found in most studies of civilian and non-deployed military populations. In terms of post-traumatic stress symptoms among Iraq War veterans, most notable was the lack of gender differences, which contrasts with the marked gender differences reported in many studies on PTSD in both civilian and military populations. In the study by Rona et al., 8.4% of women and 7.1% of men met the criteria for post-traumatic stress reaction and a smaller percentage met full criteria for PTSD. This finding suggests that combat deployment to Iraq is not associated with a higher risk of mental health problems among female compared with male service members, at least during the time frame that was measured, relatively proximal to homecoming. Some additional evidence from the United States supports the findings by Rona and colleagues regarding the minimal gender differences in mental health outcomes. All US troops receive a brief mental health assessment for depressive symptoms, posttraumatic stress symptoms, and concerns about family and relationship functioning when they return from deployment. Among the first 222 620 Army and Marine service members (10.6% of whom were women) who completed this assessment after returning from Iraq, 24% of the women reported some sort of mental health concern compared with 19% of the men, prevalences remarkably similar to the GHQ measures seen among UK–Iraq War service members. A more detailed survey was conducted among a sample of 2064 US soldiers (including 288 females) from infantry and combat support units during the middle of a year-long deployment to Iraq or Kuwait (August–October 2004). Among this sample, 13% of the male soldiers and 12% of the female y To accompany the article by Rona RJ, Fear NT, Hull L, Wessely S. ‘‘Women in novel occupational roles: mental health trends in the UK armed forces.’’",0,0 +3419,Symptoms of PTSD Associated With Painful and Nonpainful Vicarious Reactivity Following Amputation,"Although the experience of vicarious sensations when observing another in pain have been described postamputation, the underlying mechanisms are unknown. We investigated whether vicarious sensations are related to posttraumatic stress disorder (PTSD) symptoms and chronic pain. In Study 1, 236 amputees completed questionnaires about phantom limb phenomena and vicarious sensations to both innocuous and painful sensory experiences of others. There was a 10.2% incidence of vicarious sensations, which was significantly more prevalent in amputees reporting PTSD-like experiences, particularly increased arousal and reexperiencing the event that led to amputation (φ = .16). In Study 2, 63 amputees completed the Empathy for Pain Scale and PTSD Checklist-Civilian Version. Cluster analyses revealed 3 groups: 1 group did not experience vicarious pain or PTSD symptoms, and 2 groups were vicarious pain responders, but only 1 had increased PTSD symptoms. Only the latter group showed increased chronic pain severity compared with the nonresponder group (p = .025) with a moderate effect size (r = .35). The findings from both studies implicated an overlap, but also divergence, between PTSD symptoms and vicarious pain reactivity postamputation. Maladaptive mechanisms implicated in severe chronic pain and physical reactivity posttrauma may increase the incidence of vicarious reactivity to the pain of others.",0,0 +3420,Genome-wide Epigenetic Regulation by Early-Life Trauma,"Our genome adapts to environmental influences, in part through epigenetic mechanisms, including DNA methylation. Variations in the quality of the early environment are associated with alterations in DNA methylation in rodents, and recent data suggest similar processes in humans in response to early-life adversity.To determine genome-wide DNA methylation alterations induced by early-life trauma.Genome-wide study of promoter methylation in individuals with severe abuse during childhood. PATIENTS, SETTING, AND MAIN OUTCOME MEASURES: Promoter DNA methylation levels were profiled using methylated DNA immunoprecipitation followed by microarray hybridization in hippocampal tissue from 41 French-Canadian men (25 with a history of severe childhood abuse and 16 control subjects). Methylation profiles were compared with corresponding genome-wide gene expression profiles obtained by messenger RNA microarrays. Methylation differences between groups were validated on neuronal and nonneuronal DNA fractions isolated by fluorescence-assisted cell sorting. Functional consequences of site-specific promoter methylation were assessed by luciferase assays.We identified 362 differentially methylated promoters in individuals with a history of abuse compared with controls. Among these promoters, 248 showed hypermethylation and 114 demonstrated hypomethylation. Validation and site-specific quantification of DNA methylation in the 5 most hypermethylated gene promoters indicated that methylation differences occurred mainly in the neuronal cellular fraction. Genes involved in cellular/neuronal plasticity were among the most significantly differentially methylated, and, among these, Alsin (ALS2) was the most significant finding. Methylated ALS2 constructs mimicking the methylation state in samples from abused suicide completers showed decreased promoter transcriptional activity associated with decreased hippocampal expression of ALS2 variants.Childhood adversity is associated with epigenetic alterations in the promoters of several genes in hippocampal neurons.",0,0 +3421,Posttraumatic stress disorder: An exploratory study examining rates of trauma and PTSD and its effect on client outcomes in community mental health,"BackgroundRates of trauma and Posttraumatic Stress Disorder (PTSD) were examined in order to compare the profile in clients of an Australian Public Mental Health Service with that reported in the international literature for clients with major mental illness and to explore the effect of this on client health outcomes. Potential factors contributing to increased levels of trauma/PTSD in this group of clients and the issue of causality between PTSD and subsequent mental illness was also explored.MethodsA convenience sample of 29 clients was screened for trauma and PTSD using the Posttraumatic Stress Diagnostic Scale™ (PDS) and selected outcome measures. Paired and independent samples t-test and ANOVA were applied to the data.ResultsHigh levels of undocumented trauma and PTSD were found. Twenty clients, (74%) reported exposure to multiple traumatic events; 33.3% (9) met DSM IV diagnostic criteria for PTSD. Significant difference was found for PTSD symptomatology, severity and impairment and for client and clinician-rated scores of Quality of Life (QOL) outcomes in the PTSD group. No effect for PTSD symptomatology on the Working Alliance (WA) was found. Factors that may influence higher rates of PTSD in this group were identified and included issues associated with the population studied, the predominance of assaultive violence found, and vulnerability and risks factors associated with re-traumatisation within the social and treating environments.ConclusionA similar trauma and PTSD profile to that reported in the international literature, including greater levels of trauma and PTSD and a poorer QOL, was found in this small sample of clients. It is postulated that the increased levels of trauma/PTSD as reported for persons with major mental illness, including those found in the current study, are primarily related to the characteristics of the population that access public mainstream psychiatric services and that these factors have specific implications for service delivery, and raise issues of efficiency and effectiveness of resource use in achieving successful outcomes in public mental health services for clients with co-morbid PTSD. Further research with a more rigorous design is needed to test these preliminary findings within Australian Community Mental Health Services.",0,0 +3422,Stress-Induced Lipocalin-2 Controls Dendritic Spine Formation and Neuronal Activity in the Amygdala,"Behavioural adaptation to psychological stress is dependent on neuronal plasticity and dysfunction at this cellular level may underlie the pathogenesis of affective disorders such as depression and post-traumatic stress disorder. Taking advantage of genome-wide microarray assay, we performed detailed studies of stress-affected transcripts in the amygdala - an area which forms part of the innate fear circuit in mammals. Having previously demonstrated the role of lipocalin-2 (Lcn-2) in promoting stress-induced changes in dendritic spine morphology/function and neuronal excitability in the mouse hippocampus, we show here that the Lcn-2 gene is one of the most highly upregulated transcripts detected by microarray analysis in the amygdala after acute restraint-induced psychological stress. This is associated with increased Lcn-2 protein synthesis, which is found on immunohistochemistry to be predominantly localised to neurons. Stress-naïve Lcn-2(-/-) mice show a higher spine density in the basolateral amygdala and a 2-fold higher rate of neuronal firing rate compared to wild-type mice. Unlike their wild-type counterparts, Lcn-2(-/-) mice did not show an increase in dendritic spine density in response to stress but did show a distinct pattern of spine morphology. Thus, amygdala-specific neuronal responses to Lcn-2 may represent a mechanism for behavioural adaptation to psychological stress.",0,0 +3423,Posttraumatic Stress Symptom Profiles of Battered Women: A Comparison of Survivors in Two Settings,"This study sought to develop a profile of posttraumatic stress symptoms experienced by battered women and to explore differences among subsamples. Two groups of survivors from five states were compared: 159 who had obtained help at domestic violence programs (DVP) and 33 who had obtained help at other types of programs (NDVP). They completed three self-report measures of posttraumatic stress and a fear questionnaire. Sixty percent of the women in the DVP group and 62% in the NDVP group met criteria for a diagnosis of posttraumatic stress disorder (PTSD). The most common symptoms were: nightmares intrusive memories of the abuse, avoiding reminders of it, and hyperarousal, and nightmares. DVP women experienced a variety of symptoms more frequently. Group differences in PTSD symptomatology were not present after statistically controlling for severity and frequency of the violence and length of time since the abusive relationship.",0,0 +3424,"Measuring resilience after spinal cord injury: Development, validation and psychometric characteristics of the SCI-QOL Resilience item bank and short form","To describe the development and psychometric properties of the Spinal Cord Injury--Quality of Life (SCI-QOL) Resilience item bank and short form.Using a mixed-methods design, we developed and tested a resilience item bank through the use of focus groups with individuals with SCI and clinicians with expertise in SCI, cognitive interviews, and item-response theory based analytic approaches, including tests of model fit and differential item functioning (DIF).We tested a 32-item pool at several medical institutions across the United States, including the University of Michigan, Kessler Foundation, the Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital and the James J. Peters/Bronx Department of Veterans Affairs medical center.A total of 717 individuals with SCI completed the Resilience items.A unidimensional model was observed (CFI=0.968; RMSEA=0.074) and measurement precision was good (theta range between -3.1 and 0.9). Ten items were flagged for DIF, however, after examination of effect sizes we found this to be negligible with little practical impact on score estimates. The final calibrated item bank resulted in 21 retained items.This study indicates that the SCI-QOL Resilience item bank represents a psychometrically robust measurement tool. Short form items are also suggested and computer adaptive tests are available.",0,0 +3425,Social vs. environmental stress models of depression from a behavioural and neurochemical approach,"Major depression is a mental disorder often preceded by exposure to chronic stress or stressful life events. Recently, animal models based on social conflict such as chronic social defeat stress (CSDS) are proposed to be more relevant to stress-induced human psychopathology compared to environmental models like the chronic mild stress (CMS). However, while CMS reproduces specifically core depressive symptoms such as anhedonia and helplessness, CSDS studies rely on the analysis of stress-induced social avoidance, addressing different neuropsychiatric disorders. Here, we study comparatively the two models from a behavioural and neurochemical approach and their possible relevance to human depression. Mice (C57BL/6) were exposed to CMS or CSDS for six weeks and ten days. Anhedonia was periodically evaluated. A battery of test applied during the fourth week after the stress procedure included motor activity, memory, anxiety, social interaction and helplessness. Subsequently, we examined glutamate, GABA, 5-HT and dopamine levels in the prefrontal cortex, hippocampus and brainstem. CMS induced a clear depressive-like profile including anhedonia, helplessness and memory impairment. CSDS induced anhedonia, hyperactivity, anxiety and social avoidance, signs also common to anxiety and posttraumatic stress disorders. While both models disrupted the excitatory inhibitory balance in the prefrontal cortex, CMS altered importantly this balance in the brainstem. Moreover, CSDS decreased dopamine in the prefrontal cortex and brainstem. We suggests that while depressive-like behaviours might be associated to altered aminoacid neurotransmission in cortical and brain stem areas, CSDS induced anxiety behaviours might be linked to specific alteration of dopaminergic pathways involved in rewarding processes.",0,0 +3426,Cognitive Behavioral Therapy for PTSD: The Role of Complex PTSD on Treatment Outcome,"Posttraumatic stress disorder (PTSD) represents an often chronic and debilitating mental illness resulting from exposure to trauma. Although the most compelling evidence for the treatment of PTSD is cognitive behavioral therapy (CBT), many patients experience residual functional impairment, or relapse, suggesting that this approach does not work for all cases of PTSD. Repeated severe trauma, particularly during development, might increase the risk for a more intricate clinical profile, called complex PTSD (CPTSD), which might contribute to poorer treatment response. The following provides a comprehensive summary of the evidence examining whether CPTSD symptomatology is related to poorer treatment outcome of CBT, reviews the literature on the treatment of CPTSD, and offers insights into current issues and future directions of the construct.",0,0 +3427,SWiFT: A Rapid Triage Tool for Vulnerable Older Adults in Disaster Situations,"ABSTRACT Background: In 2005, Hurricane Katrina caused extensive damage to parts of Mississippi, Louisiana, and Alabama, causing many people, including vulnerable older adults, to evacuate to safe surroundings. Approximately 23,000 evacuees—many of them 65 years old or older, frail, and lacking family to advocate for their care—arrived at the Reliant Astrodome Complex in Houston, Texas. There was no method for assessing the immediate and long-term needs of this vulnerable population. Methods: A 13-item rapid needs assessment tool was piloted on 228 evacuees 65 years old and older by the Seniors Without Families Team (SWiFT), to test the feasibility of triaging vulnerable older adults with medical and mental health needs, financial needs, and/or social needs. Results: The average age of the individuals triaged was 66.1 ± 12.72 (mean ± standard deviation [SD]) years. Of these, 68% were triaged for medical and or mental health needs, 18% were triaged for financial assistance, and 4% were triaged for social assistance. More than half of the SWiFT-triaged older adults reported having hypertension. Conclusions: The SWiFT tool is a feasible approach for triaging vulnerable older adults and provides a rapid determination of the level of need or assistance necessary for vulnerable older people during disasters. The tool was only piloted, thus further testing to determine reliability and validity is necessary. Potentially important implications for using such a tool and suggestions for preparing for and responding to disaster situations in which vulnerable older adults are involved are provided. ( Disaster Med Public Health Preparedness . 2008;2(Suppl 1):S45–S50)",0,0 +3428,Personality-guided therapy for posttraumatic stress disorder.,"This practical resource sheds light on the role personality factors play in the genesis and treatment of Posttraumatic Stress Disorder (PTSD). Using Theodore Millon's personality-guided psychology as a framework, the authors provide insight into this challenging disorder. They discuss factors that can help protect against stress or increase vulnerability to stress. They also explore the biological foundations of PTSD and offer practical guidance on how to assess PTSD and how to incorporate an understanding of personality in the formation of the therapeutic alliance.",0,0 +3429,Gender differences in probable posttraumatic stress disorder among police responders to the 2001 World Trade Center terrorist attack,"Police responders to the 2001 World Trade Center (WTC) disaster were previously reported to have an increased prevalence of probable posttraumatic stress disorder (PTSD).Four thousand seventeen police responders (3,435 men and 582 women) were interviewed 2-3 years after 9/11/01 as part of the World Trade Center Health Registry. Demographic, occupational, and event-specific risk factors were evaluated for probable PTSD, determined by DSM-IV criteria using the Posttraumatic Stress Checklist (PCL).Overall prevalence of probable PTSD was 8.3% (women: 13.9%; men: 7.4%, P < 0.001). Risk factors for both genders included 9/11-related injury and older age. For men, specific risk factors were: presence in WTC Towers on 9/11 and Hispanic ethnicity; and for women, witnessing horror and education less than a college degree.Significantly higher prevalence of probable PTSD was found for female police responders. Although consistent with civilian populations, this finding contrasts with other studies of PTSD and WTC rescue and recovery workers, and police prior to 9/11.",0,0 +3430,"Self-reported cannabis use characteristics, patterns and helpfulness among medical cannabis users","Little research has investigated the demographic and symptom profile of medical cannabis users in states in the USA that have legalized cannabis use.In the present cross-sectional study, we investigated the demographic profile of 217 adults currently receiving medical cannabis, as well as differences in problematic use and perceived helpfulness in terms of (i) symptoms of psychological disorders and pain, and (ii) motives for use.Findings indicated that medical cannabis users (i) use and perceive cannabis to be beneficial for multiple conditions, some for which cannabis is not specifically prescribed or allowed at the state level; and (ii) report similar rates of disordered use as compared with population estimates among regular users. Furthermore, problematic cannabis use was predicted by several symptoms of psychological disorders (e.g. depression) and a variety of use motives (e.g. coping), while cannabis was reported as particularly helpful among those with several psychological symptoms (e.g. traumatic intrusions), as well as those reporting use for social anxiety reasons.Results are discussed in terms of future directions for research given the current debates regarding legalization of cannabis for medical purposes and, more generally, the lack of empirical data to inform such debates.",0,0 +3431,Discriminant analysis of posttraumatic stress disorder among a group of Viet Nam veterans,"The authors designed a study to identify those independent variables which would statistically discriminate between a group of Viet Nam veterans who were experiencing posttraumatic stress disorder and those who were not. DSM-III criteria for diagnosis were used to measure and operationally define posttraumatic stress disorder. Five variables distinguished between groups: veterans with the disorder reported a negative perception of their family's helpfulness on return home, a higher level of combat, a more immediate discharge after the war, an external locus of control, and a more supportive attitude toward the war before they entered the service. The authors discuss the implications and limitations of these findings.",0,0 +3432,Evidence-Based Treatment of Anxiety in Patients With Cancer,"Anxiety is a dynamic response to perceived threat that is common among patients with cancer and fluctuates at critical points in the disease trajectory. A substantial minority of patients may experience clinically significant anxiety resulting from a range of potential etiologic factors. This review summarizes evidence-based recommendations for treatment of anxiety in oncology settings. Recommendations are based on the nature and time course of anxiety and the results of meta-analyses, systematic reviews, and individual trials in cancer populations. The evidence-based literature supports the use of psychosocial and psychopharmacologic treatments to prevent or alleviate anxiety symptoms. Conclusions are tempered by study heterogeneity and methodologic limitations and a lack of trials that included patients with clinically significant anxiety. In oncology settings, accessibility and acceptability of evidence-based treatments vary, and patients may seek a variety of resources to manage cancer concerns. Treatment planning should incorporate contributing factors to anxiety and patient preferences for psychiatric care.",0,0 +3433,Perceived injustice in fibromyalgia: Psychometric characteristics of the Injustice Experience Questionnaire and relationship with pain catastrophising and pain acceptance,"To validate a Spanish version of the Injustice Experience Questionnaire (IEQ), a measure of perceived injustice, in a fibromyalgia sample and to examine its relationship with pain catastrophising and pain acceptance.The IEQ was administered along with the Pain Visual Analogue Scale, the Fibromyalgia Impact Questionnaire, the Hospital Anxiety and Depression Scale, the Pain Catastrophizing Scale (PCS) and the Chronic Pain Acceptance Questionnaire (CPAQ) to 250 primary care patients with fibromyalgia.The IEQ had good test-retest reliability (intraclass correlation coefficient=0.98) and internal consistency (Cronbach's α=0.92). The factor structure obtained was similar to the original validation study. The multiple regression analyses showed that perceived injustice (PI) accounted for significant pain-related outcomes after controlling pain intensity, PCS and CPAQ. Principal component analysis of both the IEQ and the CPAQ taken together showed that the two constructs do not represent opposite extremes of the same dimension.The IEQ is a reliable assessment tool for measuring PI among patients with fibromyalgia. PI seems to be distinct from catastrophising, although the two constructs are very similar. The factor analysis showed that PI and acceptance represent related constructs, and this entails relevant implications for therapy, as acceptance-based interventions would be appropriate.",0,0 +3434,Mild Transient Hypercapnia as a Novel Fear Conditioning Stimulus Allowing Re-Exposure during Sleep,"Studies suggest that sleep plays a role in traumatic memories and that treatment of sleep disorders may help alleviate symptoms of posttraumatic stress disorder. Fear-conditioning paradigms in rodents are used to investigate causal mechanisms of fear acquisition and the relationship between sleep and posttraumatic behaviors. We developed a novel conditioning stimulus (CS) that evoked fear and was subsequently used to study re-exposure to the CS during sleep.Experiment 1 assessed physiological responses to a conditioned stimulus (mild transient hypercapnia, mtHC; 3.0% CO2; n = 17)+footshock for the purpose of establishing a novel CS in male FVB/J mice. Responses to the novel CS were compared to tone+footshock (n = 18) and control groups of tone alone (n = 17) and mild transient hypercapnia alone (n = 10). A second proof of principle experiment re-exposed animals during sleep to mild transient hypercapnia or air (control) to study sleep processes related to the CS.Footshock elicited a response of acute tachycardia (30-40 bpm) and increased plasma epinephrine. When tone predicted footshock it elicited mild hypertension (1-2 mmHg) and a three-fold increase in plasma epinephrine. When mtHC predicted footshock it also induced mild hypertension, but additionally elicited a conditioned bradycardia and a smaller increase in plasma epinephrine. The overall mean 24 hour sleep-wake profile was unaffected immediately after fear conditioning.Our study demonstrates the efficacy of mtHC as a conditioning stimulus that is perceptible but innocuous (relative to tone) and applicable during sleep. This novel model will allow future studies to explore sleep-dependent mechanisms underlying maladaptive fear responses, as well as elucidate the moderators of the relationship between fear responses and sleep.",0,0 +3435,World Trade Center disaster and sensitization to subsequent life stress: A longitudinal study of disaster responders,"The current study examined the role of World Trade Center (WTC) disaster exposure (hours spent working on the site, dust cloud exposure, and losing friend/loved one) in exacerbating the effects of post-disaster life stress on posttraumatic stress disorder (PTSD) symptoms and overall functioning among WTC responders.Participants were 18,896 responders (8466 police officers and 10,430 non-traditional responders) participating in the WTC Health Program who completed an initial examination between July, 2002 and April, 2010 and were reassessed an average of two years later.Among police responders, there was a significant interaction, such that the effect of post-disaster life stress on later PTSD symptoms and overall functioning was stronger among police responders who had greater WTC disaster exposure (β's=.029 and .054, respectively, for PTSD symptoms and overall functioning). This moderating effect was absent in non-traditional responders. Across both groups, post-disaster life stress also consistently was related to the dependent variables in a more robust manner than WTC exposure.The present findings suggest that WTC exposure may compound post-disaster life stress, thereby resulting in a more chronic course of PTSD symptoms and reduced functioning among police responders.",0,0 +3436,Development of a Brief Coping Checklist for Use with Pediatric Populations,"Although the process of coping and utilization of coping strategies has received widespread attention in the adult literature, there is a relative dearth of information on these processes in children and adolescents. As the importance of assessing and teaching coping strategies becomes apparent in behavioral medicine with adults, such investigations need to be extended to pediatric populations. The present study describes the development of a brief coping checklist. Preliminary psychometric investigations conducted with healthy adolescents demonstrated adequate reliability at 3-day, 7-day, 14-day, and 10-week intervals and concurrent validity with previously established measures of coping. The utility of the checklist with pediatric patients and in particular chronically ill children is also examined.",0,0 +3437,Psychopathology Among New York City Public School Children 6 Months After September 11,"Children exposed to a traumatic event may be at higher risk for developing mental disorders. The prevalence of child psychopathology, however, has not been assessed in a population-based sample exposed to different levels of mass trauma or across a range of disorders.To determine prevalence and correlates of probable mental disorders among New York City, NY, public school students 6 months following the September 11, 2001, World Trade Center attack.Survey.New York City public schools.A citywide, random, representative sample of 8236 students in grades 4 through 12, including oversampling in closest proximity to the World Trade Center site (ground zero) and other high-risk areas.Children were screened for probable mental disorders with the Diagnostic Interview Schedule for Children Predictive Scales.One or more of 6 probable anxiety/depressive disorders were identified in 28.6% of all children. The most prevalent were probable agoraphobia (14.8%), probable separation anxiety (12.3%), and probable posttraumatic stress disorder (10.6%). Higher levels of exposure correspond to higher prevalence for all probable anxiety/depressive disorders. Girls and children in grades 4 and 5 were the most affected. In logistic regression analyses, child's exposure (adjusted odds ratio, 1.62), exposure of a child's family member (adjusted odds ratio, 1.80), and the child's prior trauma (adjusted odds ratio, 2.01) were related to increased likelihood of probable anxiety/depressive disorders. Results were adjusted for different types of exposure, sociodemographic characteristics, and child mental health service use.A high proportion of New York City public school children had a probable mental disorder 6 months after September 11, 2001. The data suggest that there is a relationship between level of exposure to trauma and likelihood of child anxiety/depressive disorders in the community. The results support the need to apply wide-area epidemiological approaches to mental health assessment after any large-scale disaster.",0,0 +3438,The Human Capacity to Thrive in the Face of Potential Trauma,"For decades, researchers have documented remarkable levels of resilience in children who were exposed to corrosive early environments, such as those in which poverty or chronic maltreatment were present; however, relatively little research has examined resilience in children or adults who were exposed to isolated and potentially traumatic events. The historical emphasis on psychological and physiologic dysfunction after potentially traumatic events has suggested that such events almost always produce lasting emotional damage. Recent research, however, has consistently shown that across different types of potentially traumatic events, including bereavement, serious illness, and terrorist attack, upward of 50% of people have been found to display resilience. Research has further identified substantial individual variation in response to potentially traumatic events, including 4 prototypical and empirically derived outcome trajectories: chronic dysfunction, recovery, resilience, and delayed reactions. Factors that promote resilience are heterogeneous and include a variety of person-centered variables (eg, temperament of the child, personality, coping strategies), demographic variables (eg, male gender, older age, greater education), and sociocontextual factors (eg, supportive relations, community resources). It is surprising that some factors that promote resilience to potentially traumatic events may be maladaptive in other contexts, whereas other factors are more broadly adaptive. Given the growing evidence that resilience is common, psychotherapeutic treatment should be reserved for those in genuine need.",0,0 +3439,Does Time Heal all Wounds? : A Longitudinal Study of Development of Posttraumatic Stress Symptoms in Parents of Children With Cancer,Does Time Heal all Wounds? : A Longitudinal Study of Development of Posttraumatic Stress Symptoms in Parents of Children With Cancer,0,0 +3440,Post-traumatic stress symptoms among mothers of children with leukemia undergoing treatment: a longitudinal study,"To assess post-traumatic stress symptoms (PTSS) in mothers of children over 2 years of leukemia treatment, to identify possible early family and child predictors of this symptomatology and to indicate the temporal trajectory of PTSS.Participants were 76 Italian mothers (mean age = 37.30 years; SD = 6.07) of children receiving treatment for acute lymphoblastic (n = 69) or myeloid (n = 7) leukemia. Mothers had 12.05 years of education (SD = 3.87), and their incomes were average (52.1%), high (26%) and low (21.9%) for Italian norms, never in poverty. The pediatric patients with leukemia were equally distributed by gender with their mean age of 7.10 years (SD = 4.18). Post-traumatic stress symptoms were measured by a 17-item checklist. Scales assessing anxiety, depression, physical (Brief Symptom Inventory 18) and cognitive functioning (Problem Scale), and life evaluation were also used. There were five assessment points: 1 week (T1), 1 month (T2), 6 months (T3), 12 months (T4) and 24 months post-diagnosis (T5).The main results indicated moderate presence of clinical PTSS (≥9 symptoms: 24% at T2, 18% at T3, 16% at T4 and 19% at T5) that remained stable across time points, whereas Brief Symptom Inventory 18 Global score decreased and life evaluation improved. A series of hierarchical regression models identified cognitive functioning early after the diagnosis as the best predictive factor of PTSS across time points.Specific psychological interventions could be devised for mothers at risk for short and long-term PTSS just after the diagnosis.",0,0 +3441,Trajectories of Posttraumatic Stress Symptoms in Significant Others of Patients With Severe Traumatic Brain Injury,"Long-term psychological distress has been reported among significant others of patients who sustained a traumatic brain injury (TBI). This study examined the course and potential predictors of posttraumatic stress symptoms in a relative sample (N = 135) drawn from a national cohort study on severe TBI in Switzerland. Latent growth mixture model analyses revealed two main groups: Across 3, 6, and 12 months after the accident, 63% of the sample indicated fairly low symptom severity (“resilient” course), whereas 37% showed persistence of “higher distress” as indicated by elevated scores on the Impact of Event Scale–Revised. Group membership was significantly associated with self-reported dysfunctional disclosure style. Implications for research and practice are discussed.",0,0 +3442,"Child Sexual Abuse, Post-Traumatic Stress Disorder, and Substance Use: Predictors of Revictimization in Adult Sexual Assault Survivors","This study examined the unique effects of child sexual abuse simultaneously with post-traumatic stress disorder symptom clusters, problem drinking, and illicit drug use in relation to sexual revictimization in a community sample of female adult sexual assault victims. Participants (N=555) completed two surveys a year apart. Child sexual abuse predicted more post-traumatic stress disorder symptoms in adult sexual assault victims. Posttraumatic stress disorder numbing symptoms directly predicted revictimization, whereas other post-traumatic stress disorder symptoms (reexperiencing, avoidance, and arousal) were related to problem drinking, which in turn predicted revictimization. Thus, numbing symptoms and problem drinking may be independent risk factors for sexual revictimization in adult sexual assault victims, particularly for women with a history of childhood sexual abuse.",0,0 +3443,"Characteristics of Successful Fakers versus Unsuccessful Fakers: Is Empathy, Intelligence, Or Personality Associated with Faking PTSD on the MMPI-2?","Moyer, Burkhardt, and Gordon found in 2002 that some individuals could fake PTSD on the MMPI-2. In light of these results, a follow-up study was conducted to assess whether attributes such as empathy, intelligence, subjectivity, or insightfulness influenced ability to fake a PTSD profile on the MMPI-2. 35 subjects from the previous study were divided into two groups, successful fakers and unsuccessful fakers. Analysis indicated no significant differences between groups on the measures of empathy or intelligence. However, a significant difference was found between groups on the Schizophrenia and Cynicism scales and falling just short of significance on the Hypochondriasis scale. These results suggested that individuals able to fake PTSD are more insightful and less subjective, which makes them better at role-playing.",0,0 +3444,"Cellular, molecular, and epigenetic mechanisms in non-associative conditioning: Implications for pain and memory","• Review behavioral sensitization in response to noxious stimulation or injury. • Review functional, synaptic, and cellular mechanisms of sensitization. • Review epigenetic mechanisms in learning- and pain-related sensitization. Sensitization is a form of non-associative conditioning in which amplification of behavioral responses can occur following presentation of an aversive or noxious stimulus. Understanding the cellular and molecular underpinnings of sensitization has been an overarching theme spanning the field of learning and memory as well as that of pain research. In this review we examine how sensitization, both in the context of learning as well as pain processing, shares evolutionarily conserved behavioral, cellular/synaptic, and epigenetic mechanisms across phyla. First, we characterize the behavioral phenomenon of sensitization both in invertebrates and vertebrates. Particular emphasis is placed on long-term sensitization (LTS) of withdrawal reflexes in Aplysia following aversive stimulation or injury, although additional invertebrate models are also covered. In the context of vertebrates, sensitization of mammalian hyperarousal in a model of post-traumatic stress disorder (PTSD), as well as mammalian models of inflammatory and neuropathic pain is characterized. Second, we investigate the cellular and synaptic mechanisms underlying these behaviors. We focus our discussion on serotonin-mediated long-term facilitation (LTF) and axotomy-mediated long-term hyperexcitability (LTH) in reduced Aplysia systems, as well as mammalian spinal plasticity mechanisms of central sensitization. Third, we explore recent evidence implicating epigenetic mechanisms in learning- and pain-related sensitization. This review illustrates the fundamental and functional overlay of the learning and memory field with the pain field which argues for homologous persistent plasticity mechanisms in response to sensitizing stimuli or injury across phyla.",0,0 +3445,"Baksbat (Broken Courage): The Development and Validation of the Inventory to Measure Baksbat, a Cambodian Trauma-based Cultural Syndrome of Distress","This article outlines the development and validation of an inventory measuring a Cambodian cultural syndrome of distress called 'baksbat' (broken courage). The inventory development phase involved ethnographic interviews with a preliminary group of 53 experts having knowledge or experience of baksbat. The initial ethnographically derived inventory with 32 items was developed and administered to a second group of 390 consecutive patients to assess factor loadings. The validation phase used confirmatory factor analysis (CFA) to test goodness-of-fit of four hypothesized factor models of the newly developed inventory in a third group of 159 participants. CFA confirms three-factor models that have the best goodness-of-fit, thus a 24-item baksbat inventory clustering of three-symptom categories was developed. Multiple regression, which assesses the relationship between the dependent variable (PTSD) and a subcluster of baksbat inventory (predictors), shows baksbat inventory accounts for 47 % of the total variance of symptoms in PTSD (R2 =.47). Of the three-symptom clusters, 'psychological distress' shows significant contribution to the total variance of symptoms in PTSD (β = .63, p < .001). Of significance, some symptoms of baksbat were independent from symptoms of PTSD with isolated symptoms that are culturally specific. These preliminary findings suggest that baksbat could be a potential Cambodian trauma-based syndrome with its own culturally validated inventory. © 2012 Springer Science+Business Media New York.",0,0 +3446,Alert but less alarmed: a pooled analysis of terrorism threat perception in Australia,"Previous Australian research has highlighted disparities in community perceptions of the threat posed by terrorism. A study with a large sample size is needed to examine reported concerns and anticipated responses of community sub-groups and to determine their consistency with existing Australian and international findings.Representative samples of New South Wales (NSW) adults completed terrorism perception questions as part of computer assisted telephone interviews (CATI) in 2007 (N = 2081) and 2010 (N = 2038). Responses were weighted against the NSW population. Data sets from the two surveys were pooled and multivariate multilevel analyses conducted to identify health and socio-demographic factors associated with higher perceived risk of terrorism and evacuation response intentions, and to examine changes over time.In comparison with 2007, Australians in 2010 were significantly more likely to believe that a terrorist attack would occur in Australia (Adjusted Odd Ratios (AOR) = 1.24, 95%CI:1.06-1.45) but felt less concerned that they would be directly affected by such an incident (AOR = 0.65, 95%CI:0.55-0.75). Higher perceived risk of terrorism and related changes in living were associated with middle age, female gender, lower education and higher reported psychological distress. Australians of migrant background reported significantly lower likelihood of terrorism (AOR = 0.52, 95%CI:0.39-0.70) but significantly higher concern that they would be personally affected by such an incident (AOR = 1.57, 95%CI:1.21-2.04) and having made changes in the way they live due to this threat (AOR = 2.47, 95%CI:1.88-3.25). Willingness to evacuate homes and public places in response to potential incidents increased significantly between 2007 and 2010 (AOR = 1.53, 95%CI:1.33-1.76).While an increased proportion of Australians believe that the national threat of terrorism remains high, concern about being personally affected has moderated and may reflect habituation to this threat. Key sub-groups remain disproportionately concerned, notably those with lower education and migrant groups. The dissonance observed in findings relating to Australians of migrant background appears to reflect wider socio-cultural concerns associated with this issue. Disparities in community concerns regarding terrorism-related threat require active policy consideration and specific initiatives to reduce the vulnerabilities of known risk groups, particularly in the aftermath of future incidents.",0,0 +3447,Examining the relation between posttraumatic stress disorder and suicidal ideation in an OEF/OIF veteran sample,"This study examined the relation between posttraumatic stress disorder (PTSD) and suicidal ideation among U.S. military veterans deployed during Operation Enduring Freedom and/or Operation Iraqi Freedom. Specific aims included investigation of (1) whether PTSD was associated with suicidal ideation after controlling for combat exposure and history of suicide attempt(s), (2) whether PTSD was associated with suicidal ideation absent a co-occurring depressive disorder (MDD) or alcohol use disorder (AUD), (3) whether co-occurring MDD or AUD increased risk of suicidal ideation among those with PTSD and (4) whether PTSD/MDD symptom clusters were differentially associated with suicidal ideation. Results pointed to unique effects associated with prior suicide attempt(s), PTSD and MDD. PTSD-diagnosed participants with co-occurring MDD or AUD were not significantly more likely to endorse suicidal ideation than PTSD-diagnosed participants without such comorbidity. The 'emotional numbing' cluster of PTSD symptoms and the 'cognitive-affective' cluster of MDD symptoms were uniquely associated with suicidal ideation.",0,0 +3448,"Second Generation Antipsychotics (SGAs) in children and adolescents: prescription, efficacy, safety and open questions","Objectives: In children and adolescents, antipsychotics are being used in large and increasing quantities for a wide range of disorders and psychopathology, including psychotic, mood, and disruptive behaviour disorders, as well as to treat irritability associated with autism, tic disorders, obsessive-compulsive disorder, posttraumatic stress disorder and aggression. Both in Europe and in the US, however, the majority of these clinical uses are off-label and they exceed the available database regarding efficacy and safety. Aim of this article is to succinctly review available data on antipsychotic efficacy and adverse effects in children and adolescents and provide a general guide for the evaluation and management of antipsychotic-related efficacy and adverse effects. Methods: Medline and PubMed (1970-2008) databases were searched for articles using keywords like child, adolescent, antipsychotics, clozapine, risperidone, paliperidone, olanzapine, quetiapine, ziprasidone, aripiprazole and the like; English language, humans and clinical trials were used as limits. Papers addressing double-blind studies were firstly considered as main source of information, open label studies and reviews only when appropriate. Results: Currently available evidence indicates an increase in the use of SGAs in paediatric population, with different antipsychotics showing similar efficacies (except clozapine for treatment-resistant early onset schizophrenia) with different tolerability/safetyprofiles (i.e., weight gain and metabolic syndrome with olanzapine, hyperprolactinaemia with risperidone). Although more data are needed, children and adolescents seem generally more susceptible than adults to develop sedation, acute EPSs, withdrawal dyskinesia, hyperprolactinaemia, and age-inappropriate weight gain with related metabolic abnormalities. Given the paucity of data (especially in the long term) it is difficult to conduct a careful risk-benefit assessment when choosing an antipsychotic treatment. Families and patients should be involved in the process of selecting appropriate treatments for each patient. Conclusions: Clinicians and researchers should use age appropriate side effect measures that also take severity and time course of adverse effects into account to help assessing and managing more comprehensively antipsychotic risks and benefits in a given individual. Safety and efficacy data should inform a careful antipsychotic selection that takes general probabilities and patient/family preferences into account. Adverse effects are generally more easily predicted than therapeutic efficacy and differences in efficacy between antipsychotics are generally smaller than those for adverse effects: initial treatment selection should be guided largely by varying adverse effect profiles across medications.",0,0 +3449,Initial reliability and validity of a new retrospective measure of child abuse and neglect,"This report presents initial findings on the reliability and validity of a new retrospective measure of child abuse and neglect, the Childhood Trauma Questionnaire.Two hundred eighty-six drug- or alcohol-dependent patients were given the Childhood Trauma Questionnaire as part of a larger test battery, and 40 of these patients were given the questionnaire again after an interval of 2 to 6 months. Sixty-eight of the patients were also given a structured interview for child abuse and neglect, the Childhood Trauma Interview, that was developed by the authors.Principal-components analysis of responses on the Childhood Trauma Questionnaire yielded four rotated orthogonal factors: physical and emotional abuse, emotional neglect, sexual abuse, and physical neglect. Cronbach's alpha for the factors ranged from 0.79 to 0.94, indicating high internal consistency. The Childhood Trauma Questionnaire also demonstrated good test-retest reliability over a 2- to 6-month interval (intraclass correlation = 0.88), as well as convergence with the Childhood Trauma Interview, indicating that patients' reports of child abuse and neglect based on the Childhood Trauma Questionnaire were highly stable, both over time and across type of instruments.These findings provide strong initial support for the reliability and validity of the Childhood Trauma Questionnaire.",0,0 +3450,Long-Term Outcome of Motor Vehicle Accident Injury,"To define the psychological outcome at 5 years of a sample of non-head-injured motor vehicle accident victims and identify baseline predictors.Self-report questionnaires were completed by 111 consecutive subjects who had been injured in a motor vehicle accident 5 years earlier and who had been assessed previously in a prospective 1-year study.Although most subjects reported a good outcome, a substantial minority described continuing social, physical, and psychological difficulties and a quarter of those studied suffered phobic anxiety about travel as a driver or passenger. There was little change in quality of life outcome and effects on travel between assessments at 3 months, 1 year, and 5 years. The prevalence of posttraumatic stress disorder remained approximately 10% throughout the follow-up; most early cases had remitted by 5 years, and a similar number of delayed new onsets had occurred between 1 year and 5 years. PTSD at 5 years was predicted by physical outcome and by postaccident intrusive memories and emotional distress. Compensation proceedings were initiated by 66 subjects and were often prolonged and a cause of distress. There were no significant associations with outcome. Trends for a poor outcome in claimants, especially those not settled at 5 years, may be due to their having more serious physical problems.Psychological complications are important and persistent after injury in a motor vehicle accident, are associated with adverse effects on everyday activities, and pose a challenge for consultation-liaison psychiatry.",0,0 +3451,Diagnosing posttraumatic stress disorder with the MMPI clinical scales: A review of the literature,"A review of the literature resulted in 21 published studies that reported mean MMPI profile patterns for PTSD patients. Of these, six (29%) reported that the mean 8-2 profile pattern significantly differentiated PTSD patients from non-PTSD patients. The majority of studies found additional PTSD profile patterns reflecting nearly all of the MMPI clinical scales. The data indicate some common group profile patterns for inpatient veterans, prisoner's of war, and inpatient veteran substance abusers. The results also support the hypothesis that there is a continuum from inpatient to outpatient and veteran to civilian populations that corresponds with both symptom and stressor severity. It is concluded that although there is some typicality in similar populations, clinicians should expect heterogeneous MMPI profiles from PTSD patients representing a diversity of clinical symptoms and styles.",0,0 +3452,Using Bayesian statistics for modeling PTSD through Latent Growth Mixture Modeling: implementation and discussion,"After traumatic events, such as disaster, war trauma, and injuries including burns (which is the focus here), the risk to develop posttraumatic stress disorder (PTSD) is approximately 10% (Breslau & Davis, 1992). Latent Growth Mixture Modeling can be used to classify individuals into distinct groups exhibiting different patterns of PTSD (Galatzer-Levy, 2015). Currently, empirical evidence points to four distinct trajectories of PTSD patterns in those who have experienced burn trauma. These trajectories are labeled as: resilient, recovery, chronic, and delayed onset trajectories (e.g., Bonanno, 2004; Bonanno, Brewin, Kaniasty, & Greca, 2010; Maercker, Gäbler, O'Neil, Schützwohl, & Müller, 2013; Pietrzak et al., 2013). The delayed onset trajectory affects only a small group of individuals, that is, about 4-5% (O'Donnell, Elliott, Lau, & Creamer, 2007). In addition to its low frequency, the later onset of this trajectory may contribute to the fact that these individuals can be easily overlooked by professionals. In this special symposium on Estimating PTSD trajectories (Van de Schoot, 2015a), we illustrate how to properly identify this small group of individuals through the Bayesian estimation framework using previous knowledge through priors (see, e.g., Depaoli & Boyajian, 2014; Van de Schoot, Broere, Perryck, Zondervan-Zwijnenburg, & Van Loey, 2015).We used latent growth mixture modeling (LGMM) (Van de Schoot, 2015b) to estimate PTSD trajectories across 4 years that followed a traumatic burn. We demonstrate and compare results from traditional (maximum likelihood) and Bayesian estimation using priors (see, Depaoli, 2012, 2013). Further, we discuss where priors come from and how to define them in the estimation process.We demonstrate that only the Bayesian approach results in the desired theory-driven solution of PTSD trajectories. Since the priors are chosen subjectively, we also present a sensitivity analysis of the Bayesian results to illustrate how to check the impact of the prior knowledge integrated into the model.We conclude with recommendations and guidelines for researchers looking to implement theory-driven LGMM, and we tailor this discussion to the context of PTSD research.",0,0 +3453,"Latent change in discrete data: Unidimensional, multidimensional, and mixture distribution Rasch models for the analysis of repeated observations.","A survey of unidimensional, multidimensional, and mixture distribution Rasch models is presented with a particular focus on model applications for the analysis of change in repeated measures designs. A mover-stayer mixed Rasch model is specified for modeling global change in one of two latent subpopulations and for modeling stability in the other latent subpopulation. The application of unidimensional, multidimensional, and mixture distribution Rasch models for the analysis of change is illustrated using data on the development of understanding and solving arithmetic word problems in 1,030 2nd-3rd grade school children. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +3454,Posttraumatic stress and physical health among adults: The role of coping mechanisms,"ABSTRACTThe purpose of the present study was to examine whether coping mechanisms predict physical health, after controlling for posttraumatic stress disorder (PTSD) symptom clusters in a non-clinical sample of adults. Data were collected from 483 adults through an online survey. Most of the participants (66.7%) reported lifetime exposure to at least one traumatic event. The final sample of this study included 319 trauma-exposed individuals. Results indicated that PTSD symptoms on the avoidance and hyperarousal clusters had significant positive relationships with self-reported physical health symptoms. After controlling for gender and PTSD, denial, behavioral disengagement, and self-blame significantly and positively predicted physical health symptoms.",0,0 +3455,Posttraumatic stress symptoms predict impaired neutrophil recovery in stem cell transplant recipients,"Objective Despite the potentially life-saving effects of stem cell transplant (SCT), many transplant patients experience traumatic stress reactions due to mortality threat, interpersonal isolation, financial and occupational loss, and invasive medical procedures. Emerging evidence suggests that trauma-related stress symptoms (TSS) predict significant health complications following SCT. The aim of the current prospective study was to examine TSS in the acute aftermath of SCT as a predictor of neutrophil recovery following SCT, a crucial component of immune defense against infection. Methods Fifty-one autologous SCT recipients were assessed for TSS 7 days after SCT. Patients' absolute neutrophil counts were collected from medical charts for the first 30 days following SCT. Hierarchical linear growth modeling was used to test the hypothesis that TSS at day 7 would be associated with delayed recovery of neutrophil counts from days 9 to 30 post SCT, that is, when neutrophil counts began to recover. Results As hypothesized, TSS measured 7 days after SCT was significantly associated with slower neutrophil recovery even after pre-existing TSS, depression, distress related to physical symptoms, and potential medical confounds were statistically controlled. Exploratory analyses showed that of the TSS symptom clusters, re-experiencing symptoms and hyperarousal symptoms predicted neutrophil recovery, whereas avoidance symptoms did not. Conclusion Though traumatic stress symptoms may be a normative response to SCT, our findings suggest that TSS following SCT may interfere with neutrophil recovery and overall health. These results provide further insight as to potential mechanisms by which traumatic stress translates to poor medical outcomes for SCT patients. Copyright © 2015 John Wiley & Sons, Ltd.",0,0 +3456,Reduced Anterior Cingulate and Orbitofrontal Volumes in Child Abuse–Related Complex PTSD,"Article AbstractObjective: Classic posttraumatic stress disorder (PTSD) is associated with smaller hippocampus, amygdala, and anterior cingulate cortex (ACC) volumes. We investigated whether child abuse-related complex PTSD—a severe form of PTSD with affect dysregulation and high comorbidity—showed similar brain volume reductions. Method: We used voxel-based morphometry to measure gray matter concentrations in referred outpatients with child abuse-related complex PTSD (n = 31) compared to matched healthy nontraumatized controls (n = 28). Complex PTSD was diagnosed using the Structured Clinical Interview for DSM-IV-TR and the Structured Clinical Interview for Disorders of Extreme Stress. All respondents were scanned on a 1.5-T magnetic resonance system at the VU Medical Center, Amsterdam, The Netherlands, between September 2005 and February 2006. Results: As was hypothesized, patients with child abuse-related complex PTSD showed reductions in gray matter concentration in right hippocampus (PSVC corrected = .04) and right dorsal ACC (PSVC corrected = .02) compared to controls. In addition, a reduction in gray matter concentration in the right orbitofrontal cortex (OFC) was found. Severity of child abuse and PTSD-hyperarousal correlated negatively with ACC volume. Impulsivity correlated negatively with hippocampus volume, and anger, with hippocampus and OFC volume. Comorbidity of borderline personality disorder—compared to comorbid cluster C personality disorder—accounted for more extensive reductions in the ACC and OFC volume. Conclusions: In complex PTSD, not only the hippocampus and the ACC but also the OFC seem to be affected, even in the absence of comorbid borderline personality disorder. These results suggest that neural correlates of complex PTSD are more severe than those of classic PTSD.J Clin PsychiatrySubmitted: September 26, 2008; accepted July 7, 2009. Online ahead of print: July 13, 2010 (doi:10.4088/JCP.08m04754blu). Corresponding author: Kathleen Thomaes, MD, GGZ Ingeest, Department of Psychiatry, VU University Medical Center, A J Ernststraat 887, 1081 HL Amsterdam, The Netherlands (k.thomaes@vumc.nl).",0,0 +3457,ACCIDENT LITIGANTS WITH NEUROTIC SYMPTOMS,"Experience gained from an examination of 750 consecutive litigants leads to the conclusion that the aetiology of neurotic symptoms after accidents is so complex that diagnostic labels implying single causation give a false and oversimplified picture. Terms such as compensation neurosis, traumatic neurosis, Mediterranean back, postconcussion syndrome and many others illustrate preconceived ideas of causation which are in most cases not warranted, and it is recommended that this group of patients be considered under the general label of sufferers from accident neurosis. The many symptoms which occur are discussed, and it is found that they present in such endless variety, and in varying severity from mild to completely disabling; they do not cluster in any consistent way to justify the delineating of discrete syndromes which are artificial and misleading; their existence confuses rather than clarifies our understanding of these unfortunate people. Language: en",0,0 +3458,Different clinical courses of children exposed to a single incident of psychological trauma: a 30-month prospective follow-up study,"We investigated the distinct longitudinal trajectories of posttraumatic stress symptoms in a sample of 167 children, who witnessed death of two mothers of their schoolmates.The cohort was followed-up at 2 days (T1), 2 months (T2), 6 months (T3), and 30 months (T4) after the traumatic event. The children's posttraumatic stress symptoms (T1-T4), depression (T1, T3 and T4), state anxiety (T1, T3 and T4), and quality of life (T4) were assessed, along with parental stress related to child rearing (T4). Different trajectory patterns of the children's posttraumatic stress symptoms were identified using growth mixture modeling (GMM).Four different patterns of symptom change were identified, which were consistent with the prototypical model, and were named Recovery (19.9%), Resilience (72.7%), Chronic Dysfunction (1.8%), and Delayed Reactions (5.6%). Significant differences were found in depression and anxiety scores, children's quality of life, and parental rearing stress according to the distinct longitudinal trajectories of posttraumatic stress symptoms.The present study suggests that individual differences should be taken into account in the clinical course and outcome of children exposed to psychological trauma. The two most common trajectories were the Resilience and the Recovery types, together suggesting that over 90% of children were evidenced with a favorable 30-month outcome. The latent classes were associated with significant mean differences in depression and anxiety scores, supporting the clinical validity of the distinct trajectories.",1,0 +3459,[Trauma and stressor-related disorders: diagnostic conceptualization in DSM-5].,"The Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) includes a distinct diagnostic group of trauma and stressor-related disorders that has been set apart from anxiety disorders. From a perspective of adult psychiatry this new disorder category includes posttraumatic stress disorder (PTSD), acute stress disorder (ASD), and adjustment disorders. The PTSD is based on narrower trauma criteria that focus on acute life-threatening situations, serious injury, or sexual violence by way of direct confrontation, witnessing or indirect confrontation. Indirect confrontation, however, is reserved only for violent or accidental events that occurred to close family members or friends. The former A2 criterion of an intense emotional reaction to trauma has been removed. A deliberately broad approach to clinical PTSD phenomenology has created an empirically driven new cluster of persistent negative alterations in cognition and mood due to experiencing traumatic events. The ASD has been reconceptualized as an intense stress syndrome with a clear need of acute treatment during the early course after traumatic exposure. Adjustment disorders continue to emphasize maladaptive emotional and behavioral responses to unspecific, non-traumatic stressors in an intensity that is beyond social or cultural norms. Neither complex PTSD nor prolonged grief disorders have received an independent diagnostic status within DSM-5. With respect to stress-related disorders major divergences between DSM-5 and the future International Classification of Diseases 11 (ICD-11) are to be expected. © 2014 Springer-Verlag.",0,0 +3460,Trajectories of psychological distress among Chinese women diagnosed with breast cancer,"Background: The distinct trajectories of psychological distress over the first year of the diagnosis with breast cancer (BC) and its determinants have not been explored. Methods: 285 of 405 Chinese women receiving surgery for BC were assessed at 5-day, 1-month, 4-month, and 8-month post-surgery on measures of psychological distress, optimism, treatment decision-making (TDM) difficulties, satisfaction with treatment outcome, satisfaction with medical consultation, and physical symptom distress. Latent growth mixture modelling identified trajectories of psychological response to BC. Multinominal logistic regression compared TDM difficulties, satisfaction with treatment outcome, satisfaction with medical consultation, optimism, and physical symptom distress, by distress pattern adjusted for age, education, employment status, and stage of disease. Results: Four distinct trajectories of distress were identified, namely, resilience (66%), chronic distress (15%), recovered (12%), and delayed-recovery (7%). TDM difficulties, optimism, satisfaction with consultation, and physical symptom distress predicted distress trajectories. Psychologically resilient women had less physical symptom distress at early post-surgery compared with women with other distress patterns. Compared with the resilient group, women in the recovered or chronic distress groups experienced greater TDM difficulties, whereas women in the delayed-recovery group reported greater dissatisfaction with the initial medical consultation. Women in the chronic distress group reported greater pessimistic outlook. Conclusion: Optimism and better early post-operative treatment outcomes predicted resilience to distress. Pre-operative interventions helping women to establish a realistic expectation of treatment outcome may minimize disappointment with treatment outcome and resultant distress, whereas post-operative rehabilitation should focus on symptom management. Copyright © 2009 John Wiley & Sons, Ltd.",0,0 +3461,Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study,"

Summary

Background

Plausible projections of future mortality and disability are a useful aid in decisions on priorities for health research, capital investment, and training. Rates and patterns of ill health are determined by factors such as socioeconomic development, educational attainment, technological developments, and their dispersion among populations, as well as exposure to hazards such as tobacco. As part of the Global Burden of Disease Study (GBD), we developed three scenarios of future mortality and disability for different age-sex groups, causes, and regions.

Methods

We used the most important disease and injury trends since 1950 in nine cause-of-death clusters. Regression equations for mortality rates for each cluster by region were developed from gross domestic product per person (in international dollars), average number of years of education, time (in years, as a surrogate for technological change), and smoking intensity, which shows the cumulative effects based on data for 47 countries in 1950–90. Optimistic, pessimistic, and baseline projections of the independent variables were made. We related mortality from detailed causes to mortality from a cause cluster to project more detailed causes. Based on projected numbers of deaths by cause, years of life lived with disability (YLDs) were projected from different relation models of YLDs to years of life lost (YLLs). Population projections were prepared from World Bank projections of fertility and the projected mortality rates.

Findings

Life expectancy at birth for women was projected to increase in all three scenarios; in established market economies to about 90 years by 2020. Far smaller gains in male life expectancy were projected than in females; in formerly socialist economies of Europe, male life expectancy may not increase at all. Worldwide mortality from communicable maternal, perinatal, and nutritional disorders was expected to decline in the baseline scenario from 17·2 million deaths in 1990 to 10·3 million in 2020. We projected that non-communicable disease mortality will increase from 28·1 million deaths in 1990 to 49·7 million in 2020. Deaths from injury may increase from 5·1 million to 8·4 million. Leading causes of disability-adjusted life years (DALYs) predicted by the baseline model were (in descending order): ischaemic heart disease, unipolar major depression, road-traffic accidents, cerebrovascular disease, chronic obstructive pulmonary disease, lower respiratory infections, tuberculosis, war injuries, diarrhoeal diseases, and HIV. Tobacco-attributable mortality is projected to increase from 3·0 million deaths in 1990 to 8·4 million deaths in 2020.

Interpretation

Health trends in the next 25 years will be determined mainly by the ageing of the world's population, the decline in age-specific mortality rates from communicable, maternal, perinatal, and nutritional disorders, the spread of HIV, and the increase in tobacco-related mortality and disability. Projections, by their nature, are highly uncertain, but we found some robust results with implications for health policy.",0,0 +3462,Altered brain structural connectivity in post-traumatic stress disorder: A diffusion tensor imaging tractography study,"Post-traumatic stress disorder (PTSD) is characterized by dysfunction of several discrete brain regions such as medial prefrontal gyrus with hypoactivation and amygdala with hyperactivation. However, alterations of large-scale whole brain topological organization of structural networks remain unclear.Seventeen patients with PTSD in motor vehicle accident survivors and 15 normal controls were enrolled in our study. Large-scale structural connectivity network (SCN) was constructed using diffusion tensor tractography, followed by thresholding the mean factional anisotropy matrix of 90 brain regions. Graph theory analysis was then employed to investigate their aberrant topological properties.Both patient and control group showed small-world topology in their SCNs. However, patients with PTSD exhibited abnormal global properties characterized by significantly decreased characteristic shortest path length and normalized characteristic shortest path length. Furthermore, the patient group showed enhanced nodal centralities predominately in salience network including bilateral anterior cingulate and pallidum, and hippocampus/parahippocamus gyrus, and decreased nodal centralities mainly in medial orbital part of superior frontal gyrus.The main limitation of this study is the small sample of PTSD patients, which may lead to decrease the statistic power. Consequently, this study should be considered an exploratory analysis.These results are consistent with the notion that PTSD can be understood by investigating the dysfunction of large-scale, spatially distributed neural networks, and also provide structural evidences for further exploration of neurocircuitry models in PTSD.",0,0 +3463,Specific Symptoms Predict Suicidal Ideation in Vietnam Combat Veterans with Chronic Post-Traumatic Stress Disorder,"Previous research documented the elevated risk of suicide and suicidal ideation among Vietnam veterans with post-traumatic stress disorder (PTSD). The aim of the current study was to examine which Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, PTSD symptom clusters are most associated with suicidal ideation in this population. Fifty Vietnam combat veterans enrolled in treatment for PTSD responded to the Beck Scale for Suicide Ideation and were interviewed with the Clinician-Administered PTSD Scale. In linear regression analysis, it was found that the reexperiencing symptom cluster was significantly associated with suicidal ideation but the other two symptom clusters (avoidance/numbing and increased arousal) were not. Furthermore, scores on a measure of severity of combat exposure were not found to be significantly related to PTSD symptoms or suicidal ideation. The results of this study suggest the importance of reexperiencing symptoms for predicting which individuals with combat-related PTSD are most at risk for suicidal ideation and behavior.",0,0 +3464,Severe paroxysmal hypertension (Pseudopheochromocytoma),"Paroxysmal hypertension always engenders a search for a catecholamine-secreting pheochromocytoma. Yet 98% of people with paroxysmal hypertension do not have this tumor. The cause and management of paroxysmal hypertension remain a mystery, and the subject of remarkably few papers. This review presents an approach to understanding and successfully treating this disorder. Patients experience symptomatic blood pressure surges likely linked to sympathetic nervous system stimulation. A specific personality profile associated with this disorder suggests a psychological basis, attributable to repressed emotion related to prior emotional trauma or a repressive (nonemotional) coping style. Based on this understanding, three forms of intervention, alone or in combination, appear successful: antihypertensive therapy with agents directed at the sympathetically mediated blood pressure elevation (eg, combined (alpha)- and (beta)-blockade or central (alpha)-agonists such as clonidine); psychopharmacologic interventions including anxiolytic and/or antidepressant agents; and psychological intervention, particularly reassurance and increased psychological awareness. An appropriately selected intervention can reduce or eliminate attacks in most patients.",0,0 +3465,Testimony Psychotherapy in Bosnian Refugees: A Pilot Study,"Objective:The authors sought to describe the use of the testimony method of psychotherapy in a group of traumatized adult refugees from genocide in Bosnia-Herzegovina. Method:The subjects were 20 Bosnian refugees in Chicago who gave written informed consent to participate in a case series study of testimony psychotherapy. All subjects received testimony psychotherapy, averaging six sessions, approximately 90 minutes, weekly or biweekly. Subjects received standardized instruments for posttraumatic stress disorder (PTSD), depression, traumatic events, global functioning, and prior psychiatric history. The instruments were administered before treatment, at the conclusion of the treatment, and at the 2- and 6-month follow-ups.Results:The posttreatment assessments demonstrated significant decreases in the rate of PTSD diagnosis, PTSD symptom severity, and the severity of reexperiencing, avoidance, and hyperarousal symptom clusters. Depressive symptoms demonstrated a significant decrease, and there was a significant increase in scores on the Global Assessment of Functioning Scale. Two-month and 6-month follow-up assessments demonstrated further significant decreases in all symptoms and an increase in scores on the Global Assessment of Functioning Scale. Conclusions:This pilot study provides preliminary evidence that testimony psychotherapy may lead to improvements in PTSD and depressive symptoms, as well as to improvement of functioning, in survivors of state-sponsored violence. Am J Psychiatry 1998; 155: 1720-1726",0,0 +3466,A Prospective Examination of Symptoms of Posttraumatic Stress Disorder in Victims of Nonsexual Assault,"Symptoms of posttraumatic stress disorder (PTSD) were examined prospectively in 84 non-sexual assault victims (53 women, 31 men) beginning shortly after the assault (mean = 18.68 days) and continuing weekly for 3 months. At the initial assessment, 71% of the women and 50% of the men met symptom criteria for PTSD. The incidence of PTSD decreased to 42% of the women and 32% of the men by the fourth assessment, and at the final assessment, 21% of the women but none of the men remained with PTSD. An examination of specific PTSD symptoms indicated that many subjects who were not diagnosed with PTSD at the final assessment retained significant symptoms of PTSD, particularly reexperiencing and arousal symptoms. The severity of PTSD did decrease significantly over the course of the study, but only in those groups who were not diagnosed with the disorder at the final assessment. Women who were diagnosed with PTSD at the final assessment did not show a significant decrease in symptom severity over the course of the study. The results are discussed with regard to implications for understanding the development and persistence of posttrauma pathology, and directions for future research are outlined.",0,0 +3467,Responses to civilian war experiences: Predictors of psychological functioning and coping,"This study investigated civilian war trauma in Central American refugees, focusing on the diagnosis of posttraumatic stress disorder (PTSD) as related to war experience and demographic characteristics. Sixty eight percent of the refugees met the diagnostic criteria for PTSD. Diagnosis was best predicted by number of war experiences, severity of war trauma and level of anxiety/depression. Higher numbers of war experiences predicted PTSD severity, as did involvement in the legalization process, parenthood, and being a citizen of El Salvador. In examining the PTSD symptom cluster scores, it was found that number of war experiences was a significant predictor in all clusters. These results are helpful in increasing our knowledge about the role of war experiences in civilian PTSD and the unique situation of the Central American refugees.",0,0 +3468,Posttraumatic stress symptoms and smoking among World Trade Center disaster responders: A longitudinal investigation,"The current longitudinal study examined posttraumatic stress disorder (PTSD) symptom severity in relation to smoking abstinence and reduction over time among responders to the World Trade Center (WTC) disaster.Participants were 763 police and 1881 non-traditional (e.g., construction workers) WTC responders who reported being smokers at an initial examination obtained between July 2002 and July 2011 at the WTC Health Program (WTC-HP). WTC responders were reassessed, on average, 2.5 years later.For police WTC responders, higher levels of WTC-related PTSD symptoms at the initial visit were associated with a decreased likelihood of smoking abstinence (OR=0.98, p=.002) and with decreased smoking reduction (β=-.06, p=.012) at the follow-up visit. WTC-related PTSD symptom severity was not related to likelihood of smoking abstinence or change in number of cigarettes smoked among non-traditional responders. Post hoc analyses suggested that for police, hyperarousal PTSD symptoms were predictive of decreased abstinence likelihood at the follow-up visit (OR=0.56, p=.006).The present findings suggest that PTSD symptoms may be differentially related to smoking behavior among police and non-traditional WTC responders in a naturalistic, longitudinal investigation. Future work may benefit from exploring further which aspects of PTSD (as compared to each other and to common variance) explain smoking maintenance.",0,0 +3469,The latent factor structure of acute stress disorder following bank robbery: Testing alternative models in light of the pending DSM-5,"Acute stress disorder (ASD) was introduced into the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) to identify posttraumatic stress reactions occurring within the first month after a trauma and thus help to identify victims at risk of developing posttraumatic stress disorder (PTSD). Since its introduction, research into ASD has focused on the prediction of PTSD, whereas only a few studies have investigated the latent structure of ASD. Results of the latter have been mixed. In light of the current proposal for the ASD diagnosis in the pending DSM-5, there is a profound need for empirical studies that investigate the latent structure of ASD prior to the DSM-5 being finalized.Based on previous factor analytic research, the DSM-IV, and the proposed DSM-5 formulation of ASD, four different models of the latent structure of ASD were specified and estimated.The analyses were based on a national study of bank robbery victims (N = 450) using the acute stress disorder scale.The results of the confirmatory factor analyses showed that the DSM-IV model provided the best fit to the data. Thus, the present study suggests that the latent structure of ASD may best be characterized according to the four-factor DSM-IV model of ASD (i.e., dissociation, re-experiencing, avoidance, and arousal) following exposure to bank robbery.The results are pertinent in light of the pending DSM-5 and add to the debate about the conceptualization of ASD. .",0,0 +3470,Caregiver—child mental health: a prospective study in conflict and refugee settings,"Background In humanitarian settings, family-level drivers of mental health are insufficiently documented; we examined the strength of caregiver—child associations with two-wave, family-level Afghan data. Methods We recruited a gender-balanced sample of 681 caregiver—child dyads (n = 1,362 respondents) using stratified random-sampling in government schools in Kabul (364 dyads) and refugee schools in Peshawar (317 dyads). One year after baseline, we re-interviewed 64% of Kabul and 31% of Peshawar cohorts (n = 331 dyads, 662 respondents), retaining fewer Peshawar families due to refugee repatriation. In multivariable analyses adjusted for baseline, we assessed the extent to which caregiver mental health (Self-Report Questionnaire, SRQ-20) was associated with child symptom scores of post-traumatic stress (Child Revised Impact of Events Scale, CRIES), depression (Depression Self-Rating Scale, DSRS), psychiatric difficulties, impact, and prosocial strength (Strength and Difficulties Questionnaire, SDQ). Results Caregiver mental health was prospectively associated with all eight measures of child mental health at follow-up, adjusted for baseline. For post-traumatic stress, caregiver mental health had a predictive impact comparable to the child experiencing one or two lifetime trauma events. For depression, caregiver mental health approached the predictive impact of female gender. Thus a one SD change in caregiver SRQ-20 was associated with a 1.04 point change on CRIES and a 0.65 point change in DSRS. For multi-informant SDQ data, caregiver—child associations were strongest for caregiver ratings. For child-rated outcomes, associations were moderated by maternal literacy, a marker of family-level dynamics. Both adults and children identified domestic violence and quality of home life as independent risk and protective factors. Conclusions In the context of violence and displacement, efforts to improve child mental health require a thoughtful consideration of the mental health cascade across generations and the cluster of adversities that impact family wellbeing. We identify culturally meaningful leverage points for building family-level resilience, relevant to the prevention and intervention agenda in global mental health.",0,0 +3471,The invention of post-traumatic stress disorder and the social usefulness of a psychiatric category,"A central assumption behind psychiatric diagnoses is that a disease has an objective existence in the world, whether discovered or not, and exists independently of the gaze of psychiatrists or anyone else. In other words, neolithic people had post-traumatic stress disorder as have people in all epochs since. However, the story of post-traumatic stress disorder is a telling example of the role of society and politics in the process of invention rather than discovery. The diagnosis is a legacy of the American war in Vietnam and is a product of the post-war fortunes of the conscripted men who served there. They came home to find that they were being blamed for the war. Epithets like “babykiller” and “psychopath” were thrown at them by some who had watched on television the US military's atrocities against defenceless peasants. This reception was a primary factor in the well publicised difficulties—such as antisocial behaviour—that some military personnel had in readjusting to their peacetime roles. Those who were seen by psychiatrists were diagnosed as having an anxiety state, depression, substance misuse, personality disorder, or schizophrenia; these diagnoses were later supplanted by post-traumatic stress disorder. Early proponents of the diagnosis of post-traumatic stress disorder were part of the antiwar movement in the United States; they were angry that military psychiatry was being used to serve the interests of the military rather than those of the soldier-patients. The proponents lobbied hard for veterans to receive specialised medical care under the new diagnosis, which became the successor to the older diagnoses of battle fatigue and war neurosis. The new diagnosis was meant to shift the focus of attention from the details of a soldier's background and psyche to the fundamentally traumatogenic nature of war. This was a powerful and essentially political transformation: Vietnam veterans were to be seen …",0,0 +3472,Posttraumatic stress disorder among Turkish veterans of the Southeast,"Objective: Traumatic events induced deliberately by humans such as terrorism causes posttraumatic stress disorder (PTSD) and other psychiatric disorders. Data analysis of the present study consists of two phases. At first phase, the prevalence of PTSD and depression comorbid to PTSD of veterans who were physically injured while doing their military service at South East Region was investigated. At the second phase, the role of risk factors of negative changes at the relationship with their environment and the need of psychological help on developing PTSD and depression comorbid to PTSD was examined. Methods: The study conducted with 247 southeast veterans. Age range of veterans is 24-49 (36.55±5.29). The years after the injury ranged from 2 to 28 years (15.35±5.3). All participants were evaluated with Demographic Information Questionnaire and Traumatic Stress Symptom Checklist (TSSC). Findings: The prevalence of PTSD was 29.6% (n=73), depression comorbid to PTSD 16.6% (n=41). There was a significant difference on PTSD and depression comorbid to PTSD among veterans who reported negative changes in the relationship with their environment and veterans who don’t reported negative changes in the relationship with their environment. Similarly, there was a significant difference on PTSD and depression comorbid to PTSD between veterans who need of psychological help and veterans who don’t need psychological help. However, there was no significant interaction effect among veterans who reported negative changes in the relationship with their environment and need of psychological help. Discussion: Southeast veterans are under the risk of direct death treat such as taking a part in battle or facing with mine explosion. Therefore, psychological and psychiatric services should be constituted to those who are physically injured and veterans who done military service at that region but not injured. Although it has been a long time, PTSD and depression comorbid to PTSD was found among southeast veterans who were exposed to frequent life-threatening traumatic experiences such as being in the middle of battle or stepping on mine. Since it is observed that both having a negative relationships with their surroundings and the need of psychological help increase the probability of PTSD and depression comorbid to PTSD, institutions which will provide psychological and psychiatric services to veterans deployed in the area should established. Key words:",0,0 +3473,"Hypnotizability, Posttraumatic Stress, and Depressive Symptoms in Metastatic Breast Cancer","This study assessed whether high hypnotizability is associated with posttraumatic stress and depressive symptoms in a sample of 124 metastatic breast cancer patients. Hypnotic Induction Profile Scores were dichotomized into low and high categories; posttraumatic intrusion and avoidance symptoms were measured with the Impact of Events Scale (IES); hyperarousal symptoms with items from the Profile of Mood States; and depressive symptoms with the Center for Epidemiologic Studies-Depression Scale. High hypnotizability was significantly related to greater IES total, IES intrusion symptoms, and depressive symptoms. A logistic regression model showed that IES total predicts high hypnotizability after adjusting for depressive symptoms and hyperarousal. The authors relate these results to findings in other clinical populations and discuss implications for the psychosocial treatment of metastatic breast cancer.",0,0 +3474,Psychological predictors of chronic posttraumatic stress disorder after motor vehicle accidents.,"A prospective longitudinal study assessed 967 consecutive patients who attended an emergency clinic shortly after a motor vehicle accident, again at 3 months, and at 1 year. The prevalence of posttraumatic stress disorder (PTSD) was 23.1% at 3 months and 16.5% at 1 year. Chronic PTSD was related to some objective measures of trauma severity, perceived threat, and dissociation during the accident, to female gender, to previous emotional problems, and to litigation. Maintaining psychological factors, that is, negative interpretation of intrusions, rumination, thought suppression, and anger cognitions, enhanced the accuracy of the prediction. Negative interpretation of intrusions, persistent medical problems, and rumination at 3 months were the most important predictors of PTSD symptoms at 1 year. Rumination, anger cognitions, injury severity, and prior emotional problems identified cases of delayed onset.",0,0 +3475,Disaster Resiliency,"Natural disasters in recent years have brought the study of disaster resiliency to the forefront. The importance of community preparedness and sustainability has been underscored by such calamities as Hurricane Katrina in 2005 and the Japanese tsunami in 2011. Natural disasters will inevitably continue to occur, but by understanding the concept of resiliency as well as the factors that lead to it, communities can minimize their vulnerabilities and increase their resilience. In this volume, editors Naim Kapucu, Christopher V. Hawkins, and Fernando I. Rivera gather an impressive array of scholars to provide a much needed re-think to the topic disaster resiliency. Previous research on the subject has mainly focused on case studies, but this book offers a more systematic and empirical assessment of resiliency, while at the same time delving into new areas of exploration, including vulnerabilities of mobile home parks, the importance of asset mapping, and the differences between rural and urban locations. Employing a variety of statistical techniques and applying these to disasters in the United States and worldwide, this book examines resiliency through comparative methods which examine public management and policy, community planning and development, and, on the individual level, the ways in which culture, socio-economic status, and social networks contribute to resiliency. The analyses drawn will lead to the development of strategies for community preparation, response, and recovery to natural disasters. Combining the concept of resiliency, the factors that most account for the resiliency of communities, and the various policies and government operations that can be developed to increase the sustainability of communities in face of disasters, the editors and contributors have assembled an essential resource to scholars in emergency planning, management, and policy, as well as upper-level students studying disaster management and policy. © 2013 Taylor & Francis.",0,0 +3476,Patterns of Distress in African-American Mothers of Preterm Infants,"To examine inter-relationships among stress due to infant appearance and behavior in the neonatal intensive care unit (NICU), parental role alteration stress in the NICU, depressive symptoms, state anxiety, posttraumatic stress symptoms, and daily hassles exhibited by African-American mothers of preterm infants and to determine whether there were subgroups of mothers based on patterns of psychological distress.One hundred seventy-seven African-American mothers completed questionnaires on their psychological distress at enrollment during infant hospitalization and 2, 6, 12, 18, and 24 months after term.Psychological distress measures were intercorrelated. There were four latent classes of mothers: the low distress class with low scores on all measures; the high NICU-related stress class with high infant appearance and parental role stress and moderate scores on other measures; the high depressive symptoms class with high depressive symptoms and state anxiety and moderately elevated scores on NICU-related stress and posttraumatic stress symptoms; the extreme distress class with the highest means on all measures. Infants in the high stress class were sicker than infants in the other classes. The extreme distress class mothers averaged the lowest educational level. The classes differed on distress measures, worry about the child, and parenting stress through 24 months with the extreme distress class having the highest values.Although different types of maternal psychological distress were substantially related, there were distinct subgroups of mothers that were identifiable in the NICU. Moreover, these subgroups continued to differ on trajectories of distress and on their perceptions of the infants and parenting through 24 months after term.",0,0 +3477,Characteristics of posttraumatic stress disorder in ex prisoners of war.,"Post Traumatic Stress Disorder is a frequent consequence of surviving the stress of the war. The majority of research studies confirm that the severity, duration and the proximity to the traumatic events have significant influence on the outcome of surviving psychological trauma. There is also evidence that the prisoners of war who have survived severe, repetitive traumatization will develop PTSD more frequently, and that the characteristics and the severity of symptoms is more serious compared with the veterans of war who did not survive imprisonment. This paper analyzes the presence of the symptoms of PTSD according to frequency in a group of former prisoners of war and a group of war veterans who did not experience imprisonment. The research sample is comprised of subjects who were selected by the method of randomized stratified sample and divided an experimental and control group. Experimental subgroup E1 consist of 50 former prisoners of war who have sought psychiatric help after being released from the prisons, and subgroup E2 consist of 50 former prisoners of war who never sought psychiatric assistance. Control group is divided in subgroup K1 that consist of 30 veterans of war who did not survive imprisonment, and who have occasionally sought psychiatric assistance after the war, and subgroup K2 that consist of 30 veterans of war who did not survive imprisonment and who never sought psychiatric assistance. All subjects were male, none of them had any prior psychiatric history. The instruments used in the study were the following: general and sociobiographic questionnaire designed by the authors, traumatic events questionnaire which is a modified version of the Harvard Trauma Questionnaire, PTSD questionnaire designed according to DSM IV diagnostic criteria. Results in relation to degree of traumatic experience demonstrate that there is a significant statistical difference (P<0.005) between the experimental and control group. PTSP is statistically significantly more represented among the former prisoners of war than among the war veterans who were not detained in camps (P<0.05). Average scores for all symptom clusters (fear and helplessness, re-experiencing symptoms, avoidance symptoms, and hyper-arousal symptoms) were higher in the experimental group than in a control group.",0,0 +3478,Differential changes in muscle composition exist in traumatic and nontraumatic neck pain.,"A population based cross-sectional study.To clarify relative constituents of viable muscle in 2-dimensional cross-sectional area (CSA) measures of ventral and dorsal cervical muscles in patients with chronic whiplash-associated disorders (WAD), idiopathic neck pain, and healthy controls.Previous data using T1-weighted magnetic resonance image demonstrated large amounts of neck muscle fat infiltration and increased neck muscle CSA in patients with chronic WAD but not in idiopathic neck pain or healthy controls.Magnetic resonance images were obtained for 14 cervical muscle regions in 136 females, including 79 with chronic whiplash, 23 with chronic idiopathic neck pain, and 34 healthy controls.Without fat removed, relative CSA of 7 of 14 muscle regions in the participants with chronic WAD was larger, 3 of 14 smaller and 4 of 14 similar to healthy individuals. When T1-weighted signal representing the lipid content of these muscles was removed, 8 of 14 relative muscle CSA in patients with whiplash were similar, 5 of 14 were smaller and only 1 of 14 was larger than those observed in healthy controls. Removal of fat from the relative CSA measurement did not alter findings between participants with idiopathic neck pain and healthy controls.These findings clarify that previous reports of increased relative CSA in patients with chronic whiplash represent cervical muscle pseudohypertrophy. Relative muscle CSA measures reveal atrophy in several muscles in both patients with WAD and idiopathic neck pain, which supports inclusion of muscle conditioning in the total management of these patients.3.",0,0 +3479,On the Horizon,"This review demonstrates that many advances have been made in burn care that have made dramatic differences in mortality, clinical outcomes, and quality of life in burn survivors; however, much work remains. In reality, the current standard of care is insufficient and we cannot be satisfied with the status quo. We must strive for the following goals: no deaths due to burn, no scarring, and no pain. These particular goals have only begun to be confronted.",0,0 +3480,Personality and Trauma: Adult Attachment and Posttraumatic Distress Among Former Political Prisoners.,"Attachment patterns are especially salient in facing danger and threats to one's life. Earlier research has suggested that secure persons are protected and insecure persons vulnerable in conditions of traumatic stress. We argued that the general view may not apply to the complex person-trauma interaction that is characteristic to torture and ill-treatment. Rather, as Crittenden maintains, each attachment pattern involves a unique strategy that is the most adaptive solution, depending on the nature of the trauma. We hypothesized that the general view of the secure attachment pattern being protective, and the insecure patterns being unprotective, would apply when political prisoners are exposed to physical torture and ill-treatment. Whereas, when exposed to psychological torture involving interpersonal cruelty, securely attached persons would be more vulnerable than insecure. The hypotheses were examined among 176 Palestinian male former political prisoners living in the Gaza Strip. Their mental health was ...",0,0 +3481,Plasma cortisol and neuropeptide Y in female victims of intimate partner violence,"The experience of intimate partner violence (physical and sexual violence) has been linked to psychiatric disorders such as posttraumatic stress disorder, yet data on the neuroendocrine profile in this population is sparse. This study sought to examine baseline plasma cortisol and neuropeptide Y (NPY) levels in female victims of intimate partner violence (IPV).Morning plasma samples were collected for cortisol and NPY determination in 22 women with histories of IPV (10 with current PTSD, 12 without current or lifetime PTSD) and 16 non-abused controls.Mean cortisol levels were significantly lower in IPV subjects compared with controls, but did not distinguish IPV subjects with and without PTSD. There were no significant differences in mean NPY levels between the groups. Neither cortisol nor NPY levels were significantly correlated with PTSD symptoms.These preliminary findings suggest that victims of IPV, like women traumatized by childhood abuse, may be characterized by alterations in hypothalamic-pituitary-adrenal axis functioning, however, further study is needed to identify specific stress system disturbances in this group.",0,0 +3482,A Diagnosis of Insomnia Is Associated With Differential Expression of Sleep-Regulating Genes in Military Personnel,"Sleep disturbance is a common and disturbing symptom in military personnel, with many individuals progressing to the development of insomnia, which is characterized by increased arousals, wakefulness after sleep onset, and distorted sleep architecture. The molecular mechanisms underlying insomnia remain elusive, limiting future therapeutic development to address this critical issue. We examined whole gene expression profiles associated with insomnia. We compared subjects with insomnia ( n = 25) to controls ( n = 13) without insomnia using microarray gene expression profiles obtained from peripheral samples of whole blood obtained from military personnel. Compared to controls, participants with insomnia had differential expression of 44 transcripts from 43 identified genes. Among the identified genes, urotensin 2 was downregulated by more than 6 times in insomnia participants, and the fold-change remained significant after controlling for depression, posttraumatic stress disorder, and medication use. Urotensin 2 is involved in regulation of orexin A and B activity and rapid eye movement during sleep. These findings suggest that differential expression of these sleep-regulating genes contributes to symptoms of insomnia and, specifically, that switching between rapid eye movement and nonrapid eye movement sleep stages underlies insomnia symptoms. Future work to identify therapeutic agents that are able to regulate these pathways may provide novel treatments for insomnia.",0,0 +3483,A Trial of Prazosin for Combat Trauma PTSD With Nightmares in Active-Duty Soldiers Returned From Iraq and Afghanistan,"The authors conducted a 15-week randomized controlled trial of the alpha-1 adrenoreceptor antagonist prazosin for combat trauma nightmares, sleep quality, global function, and overall symptoms in active-duty soldiers with posttraumatic stress disorder (PTSD) returned from combat deployments to Iraq and Afghanistan.Sixty-seven soldiers were randomly assigned to treatment with prazosin or placebo for 15 weeks. Drug was titrated based on nightmare response over 6 weeks to a possible maximum dose of 5 mg midmorning and 20 mg at bedtime for men and 2 mg midmorning and 10 mg at bedtime for women. Mean achieved bedtime doses were 15.6 mg of prazosin (SD=6.0) and 18.8 mg of placebo (SD=3.3) for men and 7.0 mg of prazosin (SD=3.5) and 10.0 mg of placebo (SD=0.0) for women. Mean achieved midmorning doses were 4.0 mg of prazosin (SD=1.4) and 4.8 mg of placebo (SD=0.8) for men and 1.7 mg of prazosin (SD=0.5) and 2.0 mg of placebo (SD=0.0) mg for women. Primary outcome measures were the nightmare item of the Clinician-Administered PTSD Scale (CAPS), the Pittsburgh Sleep Quality Index, and the change item of the Clinical Global Impressions Scale anchored to functioning. Secondary outcome measures were the 17-item CAPS, the Hamilton Depression Rating Scale, the Patient Health Questionnaire-9, and the Quality of Life Index. Maintenance psychotropic medications and supportive psychotherapy were held constant.Prazosin was effective for trauma nightmares, sleep quality, global function, CAPS score, and the CAPS hyperarousal symptom cluster. Prazosin was well tolerated, and blood pressure changes did not differ between groups.Prazosin is effective for combat-related PTSD with trauma nightmares in active-duty soldiers, and benefits are clinically meaningful. Substantial residual symptoms suggest that studies combining prazosin with effective psychotherapies might demonstrate further benefit.",0,0 +3484,Delivering a Victim Impact Statement: Emotionally effective or counter-productive?,"Although the delivery of a Victim Impact Statement (VIS) in court is assumed to contribute to the healing and recovery process of victims of violent crimes, its effectiveness to facilitate emotional recovery is widely debated. The current longitudinal study is the first to empirically examine the psychological effects of delivering a VIS in terms of the two most important emotional reactions after crime: anger and anxiety. It extends previous findings by showing that the debate concerning the effectiveness of delivering a VIS is not a ‘black and white’ matter. In this article, we argue that the question should not be whether delivering a VIS ‘works’ or ‘doesn’t work’ for the victim, but for whom, and under which conditions. We show that delivering a VIS does not give rise to direct ‘therapeutic’ effects. However, we found that feelings of anger and anxiety decrease for victims who experience more control over their recovery process and higher levels of procedural justice.",0,0 +3485,Persistent Pain in Adolescents Following Traumatic Brain Injury,"Traumatic brain injury (TBI) is a leading cause of pediatric disability. Although persistent pain has been recognized as a significant postinjury complication, there is a paucity of data concerning the postinjury pain experience of youth. This study aimed to examine the prevalence of persistent pain in adolescents after TBI, identify risk factors for pain, and evaluate the impact of pain on adolescent health-related quality of life. Participants included 144 adolescents with mild to severe TBI who were followed over 36 months after injury. At 3-, 12-, 24-, and 36-month assessments, measures of pain intensity, depression, posttraumatic stress disorder, and health-related quality of life were completed by adolescents. Findings demonstrated that 24.3% of adolescents reported persistent pain (defined as usual pain intensity ≥3/10) at all assessment points after TBI. Female sex (odds ratio = 2.73, 95% confidence interval = 1.12-6.63) and higher levels of depressive symptoms at 3 months after injury (odds ratio = 1.26, 95% confidence interval = 1.12-1.43) were predictors of persistent pain at 36 months. Furthermore, mixed linear models indicated that early pain experience at 3 months following TBI was associated with a significantly poorer long-term health-related quality of life.This is the first study to examine the prevalence of persistent pain over long-term follow-up in adolescents after TBI and its impact on health-related quality of life. These findings indicate that adolescents with TBI may benefit from timely evaluation and intervention to minimize the development and impact of pain.",0,0 +3486,C-39 * Resilience and Symptom Reporting following Mild Traumatic Brain Injury,"OBJECTIVE: The purpose of this study was to examine the relationship between resilience and symptom reporting following mild traumatic brain injury (mTBI). METHOD: Participants included 196 U.S. military service members (mean age = 29.2 years, SD = 8.4) who sustained a mTBI (78.8% 12 months post-injury). Three groups were derived based on self-reported resilience on the Response to Stressful Experiences Scale: low (n = 51), moderate (n = 71), and high (n = 74). Outcome measures included the Neurobehavioral Symptom Inventory (NSI) and PTSD Checklist-Civilian (PCL-C). RESULTS: There were significant main effects for all NSI and PCL-C total scores and symptom clusters (all p < .05). Pairwise comparisons revealed that the low resilience group reported greater symptomatology compared to the moderate and high resilience groups on the NSI and PCL-C total scores, NSI affective cluster, and PCL-C avoidance and hyperarousal clusters (all p < .005; d = .44-.83). Additionally, the low resilience group reported greater symptomatology compared to the high resilience group on the NSI somatic/sensory and cognitive clusters, and the PCL-C re-experiencing symptom cluster (all p < .05; d = .53-.75). Using logistic regression analyses, both the NSI and PCL-C total scores were significant predictors of high versus low resilience groups (both p < .01). However, the NSI and PCL-C total scores more reliably predicted the high resilience group (85.1% and 83.8% correctly classified, respectively) compared to the low resilience group (41.2% and 43.1% correctly classified). CONCLUSION(S): These results suggest that service members who have low resilience endorse greater symptomatology following mTBI compared to those who have high resilience.",0,0 +3487,"The co-occurrence of childhood sexual abuse, adult sexual assault, intimate partner violence, and sexual harassment: A mediational model of posttraumatic stress disorder and physical health outcomes.","This study examined the co-occurrence of childhood sexual abuse, adult sexual assault, intimate partner violence, and sexual harassment in a predominantly African American sample of 268 female veterans, randomly sampled from an urban Veterans Affairs hospital women's clinic. A combination of hierarchical and iterative cluster analysis was used to identify 4 patterns of women's lifetime experiences of violence co-occurrence. The 1st cluster experienced relatively low levels of all 4 forms of violence; the 2nd group, high levels of all 4 forms; the 3rd, sexual revictimization across the lifespan with adult sexual harassment; and the 4th, high intimate partner violence with sexual harassment. This cluster solution was validated in a theoretically driven model that examined the role of posttraumatic stress disorder (PTSD) as a mediator of physical health symptomatology. Structural equation modeling analyses revealed that PTSD fully mediated the relationship between violence and physical health symptomatology. Consistent with a bio-psycho-immunologic theoretical model, PTSD levels more strongly predicted pain-related physical health symptoms compared to nonpain health problems. Implications for clinical interventions to prevent PTSD and to screen women for histories of violence in health care settings are discussed.",0,0 +3488,Using mixture models with known class membership to address incomplete covariance structures in multiple-group growth models,"Multi-group latent growth modelling in the structural equation modelling framework has been widely utilized for examining differences in growth trajectories across multiple manifest groups. Despite its usefulness, the traditional maximum likelihood estimation for multi-group latent growth modelling is not feasible when one of the groups has no response at any given data collection point, or when all participants within a group have the same response at one of the time points. In other words, multi-group latent growth modelling requires a complete covariance structure for each observed group. The primary purpose of the present study is to show how to circumvent these data problems by developing a simple but creative approach using an existing estimation procedure for growth mixture modelling. A Monte Carlo simulation study was carried out to see whether the modified estimation approach provided tangible results and to see how these results were comparable to the standard multi-group results. The proposed approach produced results that were valid and reliable under the mentioned problematic data conditions. We also present a real data example and demonstrate that the proposed estimation approach can be used for the chi-square difference test to check various types of measurement invariance as conducted in a standard multi-group analysis.",0,0 +3489,History and Use of Relative Importance Indices in Organizational Research,"The search for a meaningful index of the relative importance of predictors in multiple regression has been going on for years. This type of index is often desired when the explanatory aspects of regression analysis are of interest. The authors define relative importance as the proportionate contribution each predictor makes to R 2 , considering both the unique contribution of each predictor by itself and its incremental contribution when combined with the other predictors. The purposes of this article are to introduce the concept of relative importance to an audience of researchers in organizational behavior and industrial/organizational psychology and to update previous reviews of relative importance indices. To this end, the authors briefly review the history of research on predictor importance in multiple regression and evaluate alternative measures of relative importance. Dominance analysis and relative weights appear to be the most successful measures of relative importance currently available. The authors conclude by discussing how importance indices can be used in organizational research.",0,0 +3490,Mild traumatic brain injury,"Mild traumatic brain injury (TBI) is common but accurate diagnosis and defining criteria for mild TBI and its clinical consequences have been problematic. Mild TBI causes transient neurophysiologic brain dysfunction, sometimes with structural axonal and neuronal damage. Biomarkers, such as newer imaging technologies and protein markers, are promising indicators of brain injury but are not ready for clinical use. Diagnosis relies on clinical criteria regarding depth and duration of impaired consciousness and amnesia. These criteria are particularly difficult to confirm at the least severe end of the mild TBI continuum, especially when relying on subjective, retrospective accounts. The postconcussive syndrome is a controversial concept because of varying criteria, inconsistent symptom clusters and the evidence that similar symptom profiles occur with other disorders, and even in a proportion of healthy individuals. The clinical consequences of mild TBI can be conceptualized as two multidimensional disorders: (1) a constellation of acute symptoms that might be termed early phase post-traumatic disorder (e.g., headache, dizziness, imbalance, fatigue, sleep disruption, impaired cognition), that typically resolve in days to weeks and are largely related to brain trauma and concomitant injuries; (2) a later set of symptoms, a late phase post-traumatic disorder, evolving out of the early phase in a minority of patients, with a more prolonged (months to years), sometimes worsening set of somatic, emotional, and cognitive symptoms. The later phase disorder is highly influenced by a variety of psychosocial factors and has little specificity for brain injury, although a history of multiple concussions seems to increase the risk of more severe and longer duration symptoms. Effective early phase management may prevent or limit the later phase disorder and should include education about symptoms and expectations for recovery, as well as recommendations for activity modifications. Later phase treatment should be informed by thoughtful differential diagnosis and the multiplicity of premorbid and comorbid conditions that may influence symptoms. Treatment should incorporate a hierarchical, sequential approach to symptom management, prioritizing problems with significant functional impact and effective, available interventions (e.g., headache, depression, anxiety, insomnia, vertigo).",0,0 +3491,VICTIMIZATION OF WOMEN AND ITS IMPACT ON ASSESSMENT AND TREATMENT IN THE PSYCHIATRIC EMERGENCY SETTING,"An understanding of victimization is critical to the practice of emergency psychiatry. Victimization histories are disturbingly common among women presenting to the PES, particularly among frequent service users. The sequelae of victimization are both psychological and physical and often impair health and functioning across numerous domains. PTSD, BPD, and substance-use disorders are often seen among women with victimization histories, which can be particularly challenging for PES providers. Screening for trauma on PES presentation or history should not be overlooked in any person, including severely mentally ill, homeless, disabled, or elderly women. PES clinicians should remember to ask about victimization and pose questions privately in a direct and an open-ended format while conveying empathic validation. Clinical assessment of women with victimization histories in the PES should be guided by the principles of standard emergency psychiatry and be informed by an understanding of trauma. This includes a working knowledge of trauma dynamics, adherence to sound professional boundaries, and care not to retraumatize patients or re-enact perpetrator-victim dynamics. Voyeurism and regression should be avoided, particularly when eliciting trauma history. The PES should be a place for screening and acute intervention, not for conducting intensive trauma therapy. In the PES, the focus should remain on triage and treatment priorities, those of safety and stabilization, and carefully evaluating for substance use and psychosis. The PES ideally provides a ""holding environment"" that affords a balance of nurturing, limits, consistency, and communication. A basic knowledge of cognitive-behavioral interventions affording ""crisis survival strategies,"" such as DBT, can be particularly useful to PES clinicians. Clinicians also need to monitor issues of countertransference and the potential to be dismissive to these women with complex, comorbid, and chronic problems and diseases. The role for the use of psychotropic medication in PES cohorts with victimization histories should target acute symptoms. Involving regular providers of these decisions is advised to coordinate care and minimize splitting and risks of polypharmacy. Although the SSRIs are effective in symptom management of disorders related to victimization, patients must be reminded of the side-effect profile, particularly sexual dysfunction and withdrawal and discontinuation syndromes.",0,0 +3492,Dissociative processes and symptoms of posttraumatic stress in Vietnam veterans,"The diagnostic taxonomy of posttraumatic stress disorder (PTSD) is a contentious issue. Commentators are divided as to whether PTSD should remain grouped with the anxiety disorders or conceptualized as a dissociative disorder. This study sought to clarify the issue by investigating the extent to which anxiety and dissociative processes differentially predict the severity of each of the three symptoms clusters in PTSD. Seventy-four Australian veterans of the Vietnam War were assessed on measures of dissociation, trait anxiety, and posttraumatic stress symptomatology. Multiple regression analyses showed that all three symptoms clusters were predicted by anxiety, but the clusters differed in the pattern of their relationship with dissociation variables. The failure of pathological dissociation to predict PTSD symptoms prompts a reconsideration of the point at which dissociative mechanisms may impact on this disorder. The findings are consistent with current classification of combat-related PTSD as an anxiety disorder.",0,0 +3493,The first president's pathway into ESTSS: memories and ideas for future issue. Patients as partners,"This article addresses Wolter De Loos' pathway into ESTSS that ended on 6th January 2004. His footsteps are still printed in the field of psychotraumatology as he showed the field how a physician was trying to integrate his working field with that of psychiatry, with a great passion for his patients. Erica M. Van der Schrieck-De Loos outlines the perspectives of her father as funding president of the ESTSS by using his Opening Address of the Fourth ESTSS Conference in 1995. This address emphasized that the mixture of righteousness and offence in warfare is ubiquitious and everlasting. The perspective of the first president's pathway has been integrated with the current vision of the author to show that the patient can be a partner of the healthcare team. A suggestion for ESTSS main objective number (8), contained within the ESTSS mission statement, is to involve patients as partners of the traumatic stress care team into accelerating traumatic stress care across Europe and beyond.",0,0 +3494,Impact of Event Scale-Revised,,0,0 +3495,The Posttraumatic Stress Disorder Checklist as a Screening Measure for Posttraumatic Stress Disorder in Rehabilitation After Burn Injuries,"To determine the profile of posttraumatic stress disorder (PTSD) among outpatients with burn injuries referred to psychology in a rehabilitation hospital, and the utility of the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) as a screening measure for PTSD.Retrospective psychological chart review.Outpatient burn clinic of a rehabilitation hospital.Outpatients (N=132) with burns referred to psychology between December 1999 and January 2010.Psychological evaluation and self-report questionnaires measuring PTSD and depression.The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition to assess clinical diagnosis of disorders, PCL-C to measure PTSD, and the Beck Depression Inventory-II to measure depression.Of 132 outpatients, 127 (96%) had work-related injuries, 116 (88%) were men, and 16 (12%) were women. Mean age ± SD at injury was 39.0±11.1 years. Mean time from injury to assessment was 15.7±42.7 months. Burn etiology included: electrical (46.2%), scald (28.0%), flame (16.7%), chemical (5.3%), and contact (3.8%). Most patients (75%) were diagnosed with PTSD, either clinical (39.4%) or subclinical (35.6%). PTSD (clinical or subclinical) was frequently diagnosed in the following etiology groups: scald (85.7%), flame (77.3%), and electrical (74.6%). There were significant relationships between PTSD and depression (P<.001), and between subclinical PTSD and adjustment disorder (P<.03). PCL-C mean scores ± SD in the clinical and subclinical PTSD groups were 59.7±8.9 and 43.5±15.6, respectively. A PCL-C total score of 50 or higher had a sensitivity of 90% and specificity of 79% for PTSD diagnosis.There was a high prevalence of PTSD (clinical or subclinical) among outpatients with burns referred to psychology. Prospective screening of psychological symptoms, clinical assessment, and intervention is warranted, especially for patients with work-related burn injuries. Our results suggest that PCL-C is a useful screening measure for PTSD in patients with burns.",0,0 +3496,Stress Induced Hypothalamus-Pituitary-Adrenal Axis Responses and Disturbances in Psychological Profiles in Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome,"Chronic pelvic pain in men has a strong relationship with biopsychosocial stress and central nervous system sensitization may incite or perpetuate the pain syndrome. We evaluated patients and asymptomatic controls for psychological factors and neuroendocrine reactivity under provoked acute stress conditions.Men with pain (60) and asymptomatic controls (30) completed psychological questionnaires including the Perceived Stress, Beck Anxiety, Type A behavior and Brief Symptom Inventory for distress from symptoms. Hypothalamic-pituitary-adrenal axis function was measured during the Trier Social Stress Test with serum adrenocorticotropin hormone and cortisol reactivity at precise times, before and during acute stress, which consisted of a speech and mental arithmetic task in front of an audience. The Positive and Negative Affective Scale measured the state of emotions.Patients with chronic pelvic pain had significantly more anxiety, perceived stress and a higher profile of global distress in all Brief Symptom Inventory domains (p <0.001), scoring in the 94th vs the 49th percentile for controls (normal population). Patients showed a significantly blunted plasma adrenocorticotropin hormone response curve with a mean total response approximately 30% less vs controls (p = 0.038) but no differences in any cortisol responses. Patients with pelvic pain had less emotional negativity after the test than controls, suggesting differences in cognitive appraisal.Men with pelvic pain have significant disturbances in psychological profiles compared to healthy controls and evidence of altered hypothalamic-pituitary adrenal axis function in response to acute stress. These central nervous system observations may be a consequence of neuropsychological adjustments to chronic pain and modulated by personality.",0,0 +3497,PROSPECTIVE INVESTIGATION OF MENTAL HEALTH FOLLOWING SEXUAL ASSAULT,"Comorbidity in psychological disorders is common following exposure to a traumatic event. Relatively little is known about the manner in which changes in the symptoms of a given type of psychological disorder in the acute period following a trauma impact changes in symptoms of another disorder. This study investigated the relationship between changes in posttraumatic stress disorder (PTSD), depression, and anxiety symptoms in the first 12 weeks following sexual assault.Participants were 126 women who had been sexually assaulted in the previous 4 weeks.Lower level mediation analyses revealed that changes in PTSD symptoms had a greater impact on changes in depression and anxiety than vice versa.The finding highlights the role of PTSD symptoms in influencing subsequent change in other psychological symptoms. These findings are discussed in the context of models detailing the trajectory of psychological disorders following trauma, and clinical implications are considered.",0,0 +3498,Prostatic epithelial polyp diagnosed in a bladder wash,"Prostatic epithelial polyps, also known as adenomatous polyps or papillary adenomas with prostatic type epithelium, are uncommon lesions. These lesions typically involve the adult male urethra, trigone, or bladder dome. Diagnosis is usually made by biopsy. Presence of clusters of benign columnar cells in urine cytologic material can suggest the presence of such polyps and must be included in the differential diagnosis.",0,0 +3499,Prospective Evaluation of Parent Distress Following Pediatric Burns and Identification of Risk Factors for Young Child and Parent Posttraumatic Stress Disorder,"Early childhood is a high-risk time for exposure to potentially traumatic medical events. We have previously reported that 10% of young children continue to have posttraumatic stress disorder (PTSD) 6 months after burn injury. This study aimed to 1) document the prevalence and prospective change in parental psychological distress over 6 months following their child's burn injury and 2) identify risk factors for posttraumatic stress symptoms (PTSS) in young children and their parents.Participants were 120 parents of 1-6-year-old children with unintentional burn injuries. Data were collected within 2 weeks, 1 month, and 6 months of burn injury using developmentally sensitive diagnostic interviews and questionnaires.Within the first month, ∼ 25% of parents had a probable PTSD diagnosis, and moderate to extremely severe levels of depression, anxiety, and stress. Distress levels decreased significantly over time; however, 5% of parents still had probable PTSD at 6 months. Hierarchical multiple regression and path analyses indicated that parent posttraumatic stress reactions contributed significantly to the development and maintenance of child PTSS. Other risk factors for child PTSS included premorbid emotional and behavioral difficulties and larger burn size. Risk factors identified for parent PTSS included prior trauma history, acute distress, greater number of child invasive procedures, guilt, and child PTSS.The findings from this study suggest that parents' responses to a traumatic event may play a particularly important role in a young child's psychological recovery. However, further research is needed to confirm the direction of the relationship between child and parent distress. This study identified variables that could be incorporated into screening tools or targeted by early intervention protocols to prevent the development of persistent child and parent PTSS following medical trauma.",0,0 +3500,Impact of short-term heat stress on physiological responses and expression profile of HSPs in Barbari goats,"Six, nonpregnant, Barbari goats aged 4–5 years were selected for the study. For the first 6 days, the animals were kept in psychrometric chamber at thermoneutral temperature for 6 h each day to make them acclimated to climatic chamber. On the 7th day, the animals were exposed to 41 °C temperature for 3 h and then to 45 °C for the next 3 h. Cardinal physiological responses were measured, and blood samples (3 ml) were collected at 1-h interval during the heat exposure period and then once after 6 h of the heat exposure. The rectal temperature (RT) and respiratory rate (RR) increased significantly (P < 0.05) during the heat exposure compared to pre- and postexposure. The relative messenger RNA (mRNA) expression of heat shock protein (HSP)60, HSP70, and HSP90 increased significantly (P < 0.05) within 1 h after exposure to heat stress at 41 and 45 °C and decreased significantly (P < 0.05) in next 2 h but remain significantly (P < 0.05) elevated from preexposure. HSP105/110 relative mRNA expression level remained unchanged during the first 4 h, and thereafter, it increased significantly (P < 0.05) and reached the peak at 6 h. Relative protein expression pattern of HSPs during exposure to heat stress showed similar trend as observed for the relative mRNA expression. Given the response sensitivity and intensity of HSP genes to environmental stresses, HSP70 was found to be the most sensitive to temperature fluctuation, and it could be used as an important molecular biomarker to heat stress in animals. © 2014, ISB.",0,0 +3501,Surveying Treatment Preferences in U.S. Iraq-Afghanistan Veterans With PTSD Symptoms: A Step Toward Veteran-Centered Care,en,0,0 +3502,Posttraumatic Stress Disorder Symptom Clusters and Perpetration of Intimate Partner Violence: Findings From a U.S. Nationally Representative Sample,"Associations between posttraumatic stress disorder (PTSD) and perpetration of intimate partner violence (IPV) have not been extensively studied in nonveteran samples. Secondary analysis was conducted using a nationally representative U.S. sample and limited to those who reported being in a relationship in the past year (N = 25,652). This sample was mostly White (72.0%), the majority had completed high school/ general educational development (GED; 87.8%), about half were female (49.2%), and the mean age was 46.44 years (SD = 15.92). We hypothesized that a diagnosis of PTSD in the past year would be associated with greater perpetration of IPV and that the arousal/reactivity and intrusion symptom clusters would evidence the strongest associations with IPV. Consistent with expectations, a PTSD diagnosis in the past year was associated with greater perpetration of IPV, OR = 2.07, 95% CI [1.89, 2.26]. Among those with a PTSD diagnosis in the past year (n = 1,742), arousal/reactivity symptom cluster scores were associated with greater perpetration of IPV for both men and women, AOR = 1.27, 95% CI [1.11, 1.44]; intrusion symptom cluster scores were associated with perpetration of IPV for men only, AOR = 1.56, 95% CI [1.20, 2.04]; whereas negative cognitions/mood symptom cluster scores were only significant among women, AOR = 1.12, 95% CI [1.01, 1.24]. Results suggested that theoretical and empirical work linking PTSD and perpetration of IPV in military samples extends to the general population.",0,0 +3503,Are avoidance and numbing distinct PTSD symptom clusters?,"We present the conceptual basis and empirical evidence for considering avoidance and numbing as distinct posttraumatic stress disorder (PTSD) symptom clusters. The majority of data from factor analytic studies supports the position that avoidance and numbing are distinct symptom clusters. As well, the available data suggest that (a) different treatment modalities have differential effects on reducing avoidance but not numbing, (b) patients with more severe pretreatment numbing have poorer treatment outcomes, (c) avoidance and numbing have different patterns of correlation with depression, and (d) they have different correlations with physiological indices of attention. We conclude that avoidance and numbing are distinct PTSD symptom clusters. This distinction has implications for revising current diagnostic criteria. The recognition of this distinction may lead to advances in understanding and treating PTSD.",0,0 +3504,Posttraumatic Stress and Posttraumatic Stress Disorder after Termination of Pregnancy and Reproductive Loss: A Systematic Review,"Objective . The aims of this systematic review were to integrate the research on posttraumatic stress (PTS) and posttraumatic stress disorder (PTSD) after termination of pregnancy (TOP), miscarriage, perinatal death, stillbirth, neonatal death, and failed in vitro fertilisation (IVF). Methods . Electronic databases (AMED, British Nursing Index, CINAHL, MEDLINE, SPORTDiscus, PsycINFO, PubMEd, ScienceDirect) were searched for articles using PRISMA guidelines. Results . Data from 48 studies were included. Quality of the research was generally good. PTS/PTSD has been investigated in TOP and miscarriage more than perinatal loss, stillbirth, and neonatal death. In all reproductive losses and TOPs, the prevalence of PTS was greater than PTSD, both decreased over time, and longer gestational age is associated with higher levels of PTS/PTSD. Women have generally reported more PTS or PTSD than men. Sociodemographic characteristics (e.g., younger age, lower education, and history of previous traumas or mental health problems) and psychsocial factors influence PTS and PTSD after TOP and reproductive loss. Conclusions . This systematic review is the first to investigate PTS/PTSD after reproductive loss. Patients with advanced pregnancies, a history of previous traumas, mental health problems, and adverse psychosocial profiles should be considered as high risk for developing PTS or PTSD following reproductive loss.",0,0 +3505,A Cross-Sectional Analysis of Clinical Outcomes Following Chiropractic Care in Veterans With and Without Post-Traumatic Stress Disorder,"This study was a cross-sectional analysis of clinical outcomes for 130 veteran patients with neck or low back complaints completing a course of care within the chiropractic clinic at the VA of Western New York in 2006. Multivariate analysis of variance (MANOVA) was utilized, comparing baseline and discharge scores for both the neck and low back regions and for those patients with and without post-traumatic stress disorder (PTSD). Patients with PTSD (n = 21) experienced significantly lower levels of score improvement than those without PTSD (n = 119) on self-reported outcome measures of neck and low back disability. These findings, coupled with the theorized relationships between PTSD and chronic pain, suggest that the success of conservative forms of management for veteran patients with musculoskeletal disorders may be limited by the presence of PTSD. Further research is warranted to examine the potential contributions of PTSD on chiropractic clinical outcomes with this unique patient population.",0,0 +3506,Post-traumatic stress symptoms 5 years after military deployment to Afghanistan,,0,0 +3507,Post-traumatic Growth Inventory: Psychometric properties of the Arabic version in Palestinian adults.,"In the current study, we investigated the psychometric properties of an Arabic version of the posttraumatic growth inventory in an adult group of Palestinians in Gaza. The internal consistency of the total scale, as well as its sub-scales, was satisfactory. Furthermore, the scale significantly correlated with stress related growth. The experience of posttraumatic growth was not related to Post Traumatic Stress Disorder, but was significantly related to cumulative trauma. Cumulative Trauma predicted post traumatic growth. Using confirmatory factor analysis, a five, three, two and one factor, as well as a hierarchical structure models were compared. While the five, the three, the one and the hierarchical models were relatively satisfactory, the two factor model had the best fit to the data. The Arabic version of the instrument appeared to be a sound measure for the experience of posttraumatic growth in Palestinian adults. Further, a modest to moderate degree of posttraumatic growth was found in the current multiply traumatized sample. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +3508,The correspondence of daily and retrospective PTSD reports among female victims of sexual assault.,"Research addressing the association between daily and retrospective symptom reports suggests that retrospective reports are typically inflated. The present study examined the association between daily posttraumatic stress disorder (PTSD) symptom reports over 1 month and a corresponding retrospective report (PTSD Checklist [PCL]; Weathers et al., 1993) for both total scores and symptom clusters. The authors hypothesized that greater PTSD symptom instability and greater depression would be associated with poorer agreement between daily and retrospective reports. Data were collected from 132 female college students who were sexually assaulted. Multilevel modeling indicated very strong agreement between mean daily and retrospective reports for total scores and symptom clusters, with pseudo-R2 ranging from .55 to .77. Depression symptoms did not moderate this association, but daily-retrospective agreement was lowest for the avoidance cluster, which was also the most unstable. Finally, retrospective recall for each symptom cluster showed acceptable specificity to the corresponding daily symptom clusters. Overall, these findings suggest that retrospective memories for global PTSD symptoms and symptom clusters, as assessed by the PCL, are consistent with daily reports over a 1-month period. Implications for clinical assessment methodology are discussed.",0,0 +3509,Are Selective Serotonin Reuptake Inhibitors Safe for Drivers? What is the Evidence?,"

Abstract

Background

Selective serotonin reuptake inhibitors (SSRIs) are widely used medications to treat several psychiatric diseases and, above all, depression. They seem to be as effective as older antidepressants but have a different adverse effect profile. Despite their favorable safety profile, little is known about their influence on traffic safety.

Objective

To conduct a literature review to summarize the current evidence on the role of SSRIs in traffic safety, particularly concerning undesirable effects that could potentially impair fitness to drive, experimental and pharmacoepidemiologic studies on driving impairment, 2 existing categorization systems for driving-impairing medications, and the European legislative procedures for assessing fitness to drive before issuing a driver's license and driving under the influence of medicines.

Methods

The article search was performed in the following electronic databases: MEDLINE, PsycINFO, ScienceDirect, and SafetyLit. The English-language scientific literature was searched using key words such as SSRIs and psychomotor performance, car crash or traffic accident, and adverse effects. For inclusion in this review, papers had to be full-text articles, refer to possible driving-related adverse effects, and be experimental or pharmacoepidemiologic studies on SSRIs and traffic accident risks. No restrictions concerning publication year were applied.

Results

Ten articles were selected as background information on driving-related adverse effects, and 15 articles were selected regarding experimental and pharmacoepidemiologic work. Regarding SSRI adverse effects, the most reported undesirable effects referring to driving impairment were anxiety, agitation, sleep disturbances, headache, increased risk of suicidal behavior, and deliberate self-harm. Regarding the remaining issues addressed in this article, inconsistencies were found between the outcomes of the selected experimental and epidemiologic studies and between the 2 existing categorization systems under evaluation. Some pitfalls of the current legislative scenario were identified as well.

Conclusions

Based on the current evidence, it was concluded that more experimental and epidemiologic research is needed to elucidate the relationship between SSRI use and traffic safety. Furthermore, a revision of the existing categorization systems and harmonized European legislation in the field of medication use and driving were highly recommended.",0,0 +3510,Traumatic Brain Injury in a Child Psychiatry Outpatient Clinic: A Controlled Study,"To demonstrate the similarity of children with a history of traumatic brain injury (TBI), particularly mild TBI, to matched children without such a history, within a child psychiatry outpatient clinic.This is a chart review of patients presenting to a child psychiatry outpatient clinic over a 3-year period. Children with TBI were matched by age, sex, race, and social class to children with no history of TBI. Axis I and II diagnoses, use of special education services, and IQ scores were compared.Seventy-four (5.6%) of 1,333 consecutive clinic cases had a definite TBI. Of these, 64 were mild. Only 3 of 59 comparisons that were made between TBI and control subjects were significant. A developmental communication disorder cluster was significantly more frequent in the TBI group. Autism and a pervasive developmental disorder cluster were significantly more frequent in the control group.In a child psychiatry clinic, patients with a history of TBI are virtually indistinguishable from matched children without TBI. Caution should be exercised before attributing the child's problems, especially long-term problems, to the TBI unless the injury was severe or the child is exhibiting related phobic or posttraumatic stress symptomatology.",0,0 +3511,Auricular Acupuncture: A Brief Introduction for Military Providers,"Injured veterans returning from Operation Iraqi Freedom and Operation Enduring Freedom often require long-term medical management for a variety of complex physical and mental health conditions. These conditions can be challenging to treat with conventional Western medicine practices alone. Recently, complementary and alternative medicine practices have been used within military settings, and have been well received by veterans. Auricular acupuncture is a practice that has provided veterans with a new approach to manage symptoms associated with a wide range of health conditions. This treatment has become an attractive treatment option because of its low cost, portability, minimal side effect profile, and ease of use in clinical and operational settings. Although formally trained Oriental medicine practitioners have historically performed these treatments, military health care providers are now receiving education and training to administer these treatments. This education and training allows military health care providers to expand their knowledge of acupuncture and provide this treatment to veterans across the continuum of care. The purpose of this article is to provide a fundamental description of auricular acupuncture and increase awareness of this treatment and its relevance to military settings.",0,0 +3512,Moderating Effects of a Postdisaster Intervention on Risk and Resilience Factors Associated With Posttraumatic Stress Disorder in Chinese Children,en,0,0 +3513,Healing with Plant Intelligence: A Report from Ayahuasca,"Numerous and diverse reports indicate the efficacy of shamanic plant adjuncts (e.g., iboga, ayahuasca, psilocybin) for the care and treatment of addiction, post-traumatic stress disorder, cancer, cluster headaches, and depression. This article reports on a first-person healing of lifelong asthma and atopic dermatitis in the shamanic context of the contemporary Peruvian Amazon and the sometimes digital ontology of online communities. The article suggests that emerging language, concepts, and data drawn from the sciences of plant signaling and behavior regarding “plant intelligence” provide a useful heuristic framework for comprehending and actualizing the healing potentials of visionary plant “entheogens” (Wasson 1971) as represented both through first-person experience and online reports. Together with the paradigms and practices of plant signaling, biosemiotics provides a robust and coherent map for contextualizing the often reported experience of plant communication with ayahuasca and other entheogenic plants. The archetype of the “plant teachers” (called Doctores in the upper Amazon) is explored as a means for organizing and interacting with this data within an epistemology of the “hallucination/perception continuum (Fischer 1975). “Ecodelic” is offered as a new linguistic interface alongside “entheogen” (Wasson 1971).",0,0 +3514,Trauma-Related Correlates of Alcohol Use in Recently Deployed OEF/OIF Veterans,"The co-occurrence of posttraumatic stress disorder (PTSD) and alcohol use disorders (AUDs) is well documented. Little is known about the factors that contribute to alcohol use and the development of AUDs among military personnel following deployment. The primary aim of this study was to examine trauma-related correlates of alcohol use in recently deployed Operation Enduring Freedom/Operation Iraqi Freedom veterans. Members of the Rhode Island National Guard and Army Reserves (N = 238) completed an in-person, initial assessment an average of 6 months postdeployment. Multiple regression analyses examined predictors of drinking outcomes (combat exposure, total PTSD symptoms, and PTSD symptom clusters) after accounting for gender, age, and history of AUD. Results indicated that total PTSD symptoms, but not combat exposure, significantly predicted alcohol use at the initial assessment. When PTSD symptom clusters were considered separately, reexperiencing symptoms (Cluster B) were the strongest predictor of total alcohol use (B = 3.58, p = .002) and heavy drinking episodes (B = 0.31, p = .005). Implications for these findings include early identification of risk factors that could lead to the development of AUDs, and the importance of integrated treatment approaches for co-occurring PTSD and AUD among veterans postdeployment.",0,0 +3515,The Effectiveness of Art Therapy Interventions in Reducing Post Traumatic Stress Disorder (PTSD) Symptoms in Pediatric Trauma Patients,"Although post traumatic stress disorder (PTSD) in children has been extensively studied during the past 15 years, little research exists regarding the efficacy of treatment interventions. This report describes an outcome-based art therapy research project currently conducted at a large urban hospital trauma center. Included are the theoretical rationale and overview of an art therapy treatment intervention called the Chapman Art Therapy Treatment Intervention (CATTI) designed to reduce PTSD symptoms in pediatric trauma patients. Used in this study, the CATTI was evaluated for efficacy in measuring the reduction of PTSD symptoms at intervals of 1 week, 1 month, and 6 months after discharge from the hospital. An early analysis of the data does not indicate statistically significant differences in the reduction of PTSD symptoms between the experimental and control groups. However, there is evidence that the children receiving the art therapy intervention did show a reduction in acute stress symptoms.",0,0 +3516,"Psychological symptoms of Turkish children and adolescents after the 1999 earthquake: Exposure, gender, location, and time duration",The authors describe their study of posttraumatic stress symptoms of children and adolescents after the 1999 earthquakes in Turkey. The rate of possible PTSD cases is also presented. The findings are reported as the results of two different studies. Location had a main effect on almost all of the dependent variables for both samples. The posttraumatic stress symptom scores for both groups significantly decreased 3 months after the initial assessment. The best predictors of the perceived posttraumatic stress symptoms for both children and adolescents were found to be perceived negative school performance and exposure.,0,0 +3517,Longitudinal trajectories of cigarette smoking following rape,"Although prior research has identified increases in cigarette smoking following trauma exposure, no studies have examined longitudinal trajectories of smoking following rape. The present investigation identified and characterized longitudinal (< 3 months, 3-6 months, and > 6 months post-assault) trajectories of smoking (N = 152) following a rape in a sample of 268 sexual assault victims participating in a forensic medical exam. Further, the authors examined acute predictors of subsequent smoking trajectories. Of participants endorsing smoking post-rape, a two-class solution was identified, with the majority of participants (74.6%) evidencing moderate smoking with a slight decrease over time and remaining participants showing heavy smoking with a slight increase over time. Having sustained an injury, minority status, and post-examination distress all predicted subsequent smoking trajectory.",0,0 +3518,The evaluation of Franco-Quebec victims of child sexual abuse and their mothers: The implementation of a standard assessment protocol,"There were two aims: first, to evaluate the feasibility of applying a standard assessment protocol to Franco-Quebec victims of child sexual abuse and nonoffending mothers; and second, to compare results from an initial sample with available data from English-speaking samples.A standard individual case study design was used for victims and mothers; and the satisfaction of the nine participating youth workers was assessed. Four self-report instruments for victims and five for mothers were chosen on the bases of workers' priorities, sensitivity to the impact of CSA, and the availability of published norms on English-speaking samples. Results are reported on 48 confirmed victims and 40 nonoffending mothers.The protocol was favorably received by the CPS workers, supervisors and all mothers and victims. Percentages of clinically distressed victims varied from highs of 68% on the externalization difficulties of the Child Behavior Checklist and 67% for 2- to 6-year-olds on the Child Sexual Behavior Inventory, to lows of 10% on hostility symptoms and 13% on the Dissociation Scale of the Trauma Symptom Check for Children. The rate of symptom-free children was lower (19%) and that of revictimization higher (30%) than most published estimates (Kendall-Tackett, Williams, & Finkelhor, 1993). Most mothers reported elevated emotional distress (depression, 59%) and symptoms of post-traumatic stress (intrusiveness, 67%). Although 87% of mothers believed the allegations, only 45% offered adequate emotional support.The implementation phase of this research was successful, given the positive reactions of workers and clients. Results on standard instruments from this French-speaking sample were similar to profiles of English-speaking victims and their mothers but firm conclusions on appropriate norms will require larger samples, cross cultural contrasts, and the evaluation of additional variables.",0,0 +3519,The Impact of Rape on Women's Sexual Health Risk Behaviors.,"This study used cluster analysis to identify three patterns of sexual health risk behaviors in a sample of adult rape survivors (N=102). Women in the 1st cluster (high risk) reported substantial increases from pre- to postrape in their frequency of sexual activity, number of sexual partners, infrequency of condom use, and frequency of using alcohol and/or drugs during sex. The 2nd cluster (moderate risk) reported increases in frequency of sexual activity and number of partners but mitigated that risk with increased condom use. Survivors in the 3rd cluster (low risk) indicated that their sexual health behaviors had become much less risky postrape. An ecological model predicting cluster membership revealed that individual-level and contextual factors predict patterns of risk behaviors.",0,0 +3520,Symptoms of Posttraumatic Stress Disorder and Borderline Personality Disorder in Veterans of Operation Desert Storm,"OBJECTIVE: The present report is part of a follow-along investigation focusing on the evolution of trauma-related symptoms in veterans of Operation Desert Storm. The goal of the current report was to examine three hypotheses on the relationship between severity of war-related trauma, symptoms of posttraumatic stress disorder (PTSD), and symptoms of borderline personality disorder with a mixed retrospective/prospective design. METHOD: Ninety-four National Guard reservists completed self-administered measures of combat-related trauma, PTSD symptoms, and borderline personality disorder features after their Gulf War duty. RESULTS: Consistent with study hypotheses, prewar features of borderline personality disorder predicted variability in postwar PTSD symptoms beyond that predicted by combat exposure, combat exposure predicted variability in postwar features of borderline personality disorder, and PTSD severity assessed shortly after combat exposure accounted for additional variability in subsequent features of borderline personality disorder. CONCLUSIONS: Taken together, the present findings suggest that trauma, symptoms of PTSD, and features of borderline personality disorder are related to one another in a complex fashion that may exceed simple linear models. Clinical and research implications for the relationships among trauma, PTSD, and borderline personality disorder are discussed.",0,0 +3521,Predicting fears of intimacy among individuals with post-traumatic stress symptoms by their sensory profile,"Introduction The purpose of the research was: (1) to compare fears of intimacy between people with post-traumatic stress symptoms and healthy controls; (2) to examine the relationships between sensory processing patterns and fears of intimacy among people with post-traumatic stress symptoms; (3) to examine the ability of post-traumatic stress symptoms and sensory processing patterns to predict fears of intimacy. Method The study consisted of 60 people between 24 and 62 years old. Thirty of the participants had post-traumatic stress symptoms and the other 30 were healthy controls. All participants were involved in an intimate relationship. Participants completed the Post-traumatic Stress Disorder Symptom Scale, the Adolescent/Adult Sensory Profile, and the Fear of Close Personal Relationship Questionnaire. Findings Higher prevalence of extreme sensory sensitivity, avoidance, and low registration was found among the study group. These patterns significantly correlated with impaired emotional responses associated with intimacy. Low registration and group membership predicted fears of intimacy. Conclusion Sensory processing difficulties may contribute to the impaired intimate relationships of people with post-traumatic stress symptoms. Occupational therapists may help people with post-traumatic stress symptoms to be aware of their sensory processing difficulties and their impact on social/intimate relationships. This awareness may contribute to the person's ability to cope with post-traumatic stress symptoms, enable better emotional performance, and elevate quality of life.",0,0 +3522,Exploring differences between the ICD-11 and DSM-5 models of PTSD: Does it matter which model is used?,"Alternative symptom profiles for posttraumatic stress disorder (PTSD) are presented in the DSM-5 and ICD-11. This study compared DSM-5 PTSD symptom profiles with ICD-11 PTSD symptom profiles among a large group of trauma-exposed individuals from Denmark. Covariates, and rates of co-occurrence with other psychiatric disorders were also investigated. A sample of treatment-seeking adult survivors of childhood sexual abuse (n=434) were assessed using self-report measures of PTSD and other psychiatric disorders. A significantly larger proportion of individuals met caseness for DSM-5 PTSD (60.0%) compared to ICD-11 PTSD (49.1%). This difference was largely attributable to low endorsement of the ICD-11 re-experiencing criteria. Replacement of the 'recurrent nightmares' symptom with the 'recurrent thoughts/memories' symptom seemed to balance the proportion of individuals meeting caseness for both taxonomies. Levels of co-occurrence with anxiety and thought disorder were higher for the DSM-5 model of PTSD compared to the ICD-11 model. Current results merit careful consideration in the selection of symptom indicators for the new ICD model of PTSD, particularly with respect to the re-experiencing symptom category.",0,0 +3523,"Rationale, Design, and Baseline Findings from a Randomized Trial of Collaborative Care for Chronic Musculoskeletal Pain in Primary Care","This article describes the rationale, design, and baseline findings from an ongoing study of collaborative care for chronic musculoskeletal pain and comorbid depression.Cluster randomized clinical trial.Forty-two clinicians and 401 patients from five Veterans Affairs primary care clinics.The intervention was based on the chronic care model, and included patient and provider activation and education, patient assessment, outcomes monitoring, and feedback to providers over 12 months. The intervention team consisted of a full-time psychologist care manager and a part-time physician internist. Approaches included goal setting emphasizing function, patient activation and educating about fear avoidance, and care management.Main outcomes are Roland-Morris Disability Questionnaire (RMDQ) score, depression severity (Patient Health Questionnaire-9), and pain severity (Chronic Pain Grade Severity subscale) at 6 and 12 months.Fifteen percent of primary care patients mailed a study advertisement letter requested screening for the study. The mean age of enrolled patients was 62. Back and neck or joint pain diagnoses were present in 67% and 65% of patients, respectively. Mean pain duration was 15 years, and mean RMDQ score (range 0-24) was 14.7 (standard deviation = 4.4). Sixty-five percent of patients were receiving disability. Eighteen percent of patients met criteria for major depression, 17% for posttraumatic stress disorder, and 9% for alcohol misuse. Thirty-nine percent of patients felt strongly that experiencing pain was a sign of damage, and 60% reported strong avoidance of painful activities.These baseline data support the rationale to develop a multifaceted approach to treat chronic pain in primary care that includes detection and treatment of psychiatric comorbidity.",0,0 +3524,Effectiveness of a Counseling Intervention after a Traumatic Childbirth: A Randomized Controlled Trial,"Adverse childbirth experiences can evoke fear and overwhelming anxiety for some women and precipitate posttraumatic stress disorder. The objective of this study was to assess a midwife-led brief counseling intervention for postpartum women at risk of developing psychological trauma symptoms.Of 348 women screened for trauma symptoms, 103 met inclusion criteria and were randomized into an intervention (n = 50) or a control (n = 53) group. The intervention group received face-to-face counseling within 72 hours of birth and again via telephone at 4 to 6 weeks postpartum. Main outcome measures were posttraumatic stress symptoms, depression, self-blame, and confidence about a future pregnancy.At 3-month follow-up, intervention group women reported decreased trauma symptoms, low relative risk of depression, low relative risk of stress, and low feelings of self-blame. Confidence about a future pregnancy was higher for these women than for control group women. Three intervention group women compared with 9 control group women met the diagnostic criteria for posttraumatic stress disorder at 3 months postpartum, but this result was not statistically significant.A high prevalence of postpartum depression and trauma symptoms occurred after childbirth. Although most women improved over time, the intervention markedly affected participants' trajectory toward recovery compared with women who did not receive counseling.A brief, midwife-led counseling intervention for women who report a distressing birth experience was effective in reducing symptoms of trauma, depression, stress, and feelings of self-blame. The intervention is within the scope of midwifery practice, caused no harm to participants, was perceived as helpful, and enhanced women's confidence about a future pregnancy.",0,0 +3525,Broad Clinical Phenotype and Facets of Emotion Regulation in Interpersonal Trauma Survivors,"This study examines broad-based psychopathology in a community sample of female survivors of interpersonal trauma. The extent to which facets of emotion regulation predict symptom presentation among this population is examined.Hierarchical cluster analysis examining symptoms of posttraumatic stress disorder, depression, somatization, and alcohol abuse was used to identify symptom clusters in an ethnically diverse sample (N = 205).Approximately 17% of the sample fell into a severe symptom group characterized by clinical levels of distress across all four disorders. The largest group (46%) was marked by subclinical distress across all four disorders, while the final group (37%) reported subclinical distress, but with a relative absence of alcohol abuse. Of the 6 emotion regulation subscales from the Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004), 2 consistently predicted group membership: nonacceptance and impulsivity.Cluster analyses revealed symptom clusters that may vary in their appropriateness for current posttrauma interventions. Implications for research and clinical practice are discussed.",0,0 +3526,Factors associated with chronicity in posttraumatic stress disorder: A prospective analysis of a national sample of women.,"The current study sought to identify factors associated with posttraumatic stress disorder (PTSD) chronicity over a 2-year time period in a national sample of adult women selected via random-digit dialing. Participants meeting diagnostic criteria for PTSD (n = 190) at the initial assessment were interviewed and certain baseline predictors of chronicity 2 years later were examined. Number of PTSD reexperiencing symptoms, rape history, and childhood history of physical assault were all predictive of chronicity at the follow-up assessment. No relationship emerged between remission status and treatment seeking, though approximately half who remitted did so without professional treatment. These risk factors for chronicity may help identify those individuals with PTSD who are most in need of intervention. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +3527,A Comparison Between Dually Diagnosed Inpatients with and without Axis II Comorbidity and the Relationship to Treatment Outcome,"The presence of a personality disorder (PD) has been associated with certain types of poor treatment outcomes in patients with substance use disorders (SUDs). The purpose of this study was to determine the prevalence of comorbid PDs in psychiatrically hospitalized adults with both non-SUD Axis I disorders and SUDs, and to assess the relationship between Axis II psychopathology and degree of pretreatment addiction severity and treatment outcome.One hundred consecutive inpatients admitted to a mixed dual diagnosis inpatient unit were assessed using semistructured interviews for SUDs, non-SUD Axis I disorders, and PDs. Pretreatment severity was assessed using a modified version of the Addiction Severity Index (ASI). Outcome measures were assessed both during hospitalization and at an initial follow-up appointment after discharge. Statistical analyses were performed comparing dually diagnosed patients with and without Axis II psychopathology.A significant number (53%) of the patients met criteria for at least one personality disorder. Of the PDs, Cluster B PDs were the most prevalent, particularly borderline personality disorder (74%) and antisocial personality disorder (66%). Dually diagnosed patients without an Axis II diagnosis had less severe pretreatment severity measures. During hospitalization, patients with Axis II disorders had higher levels of psychopathology on the Brief Symptom Inventory (BSI) subscales of sensitivity and hostility. However, there was no difference in overall degree of global improvement during hospitalization. During follow-up, patients with Axis II disorders were significantly less likely to be compliant in attending their initial follow-up appointment.Dual diagnosis inpatients with PDs appear to improve as much as patients without PDs during their inpatient hospitalizations; however, they appear to be less likely to be compliant with attending their initial follow-up appointment.",0,0 +3528,Neuroticism and self-criticism associated with posttraumatic stress disorder in a nationally representative sample,"Broad and specific psychological traits may uniquely differentiate trauma victims with PTSD from trauma victims without PTSD, but there is a need for representative, population-based research. We investigated elevated neuroticism and self-criticism in association with the presence versus absence of PTSD in a nationally representative sample of adults who experienced a traumatic stressor. Respondents were from the National Comorbidity Survey Part II (N=5877) (). Individuals who experienced one or more traumatic events were selected (N=3238). In separate regression analyses, elevated levels of neuroticism and self-criticism were each significantly associated with PTSD among men and women who had experienced one or more traumatic events. After controlling for types of traumas experienced and other previously identified factors (Bromet, Sonnega, & Kessler, 1998. American Journal of Epidemiology, 147, 353-361), neuroticism remained significantly associated with PTSD in women and both neuroticism and self-criticism remained significant in men. Evidence from this nationally representative sample of adults who experienced traumatic events suggests that self-criticism and especially the broad personality domain of neuroticism may represent robust psychological dimensions associated with the presence of PTSD.",0,0 +3529,Maternal posttraumatic stress disorder symptom trajectories following Hurricane Katrina: An initial examination of the impact of maternal trajectories on the well-being of disaster-exposed youth,"ObjectivesThis study examined trajectories of posttraumatic stress disorder symptoms in impoverished mothers impacted by Hurricane Katrina, as well as how predictive the maternal trajectories were for youth posttraumatic stress symptoms 2 years post-Katrina.Methods360 mother participants displaced by Hurricane Katrina completed self-report measures across four time points related to Hurricane exposure, trauma history, and posttraumatic stress symptoms. Additionally, the youth offspring completed a self-report measure of posttraumatic stress symptoms.ResultsLatent Class Growth Analysis demonstrated three primary trajectories emerged among females impacted by Katrina, namely, (1) chronic (4 %), (2) recovering (30 %), and (3) resilient (66 %), respectively. These trajectories were significantly impacted by prior trauma history, but not hurricane exposure. Additionally, data indicated that children whose parents fell into the chronic PTS trajectory also reported high levels of PTS symptoms.ConclusionsThis study identified three main trajectories typical of female PTS symptoms following disaster and was the first known study to document associations between PTS outcomes among adults and their offspring impacted by a large natural disaster. Future research is warranted and should explore additional risk and protective factors that impact both the parental and child outcomes.",1,0 +3530,Comparison of nefazodone and sertraline for the treatment of posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) is a prevalent condition that has been shown to be responsive to pharmacotherapy. Few head-to-head comparisons of medications used in the treatment of PTSD have been published. This 12-week, randomized, double-blind study compares the effectiveness, safety, and tolerability of nefazodone and sertraline for the treatment of PTSD. Thirty-seven male and female outpatients meeting DSM-IV criteria for PTSD were randomly assigned to receive nefazodone (maximum dose 600 mg/day; average dose 463 mg/day) or sertraline (maximum dose 200/day; average dose 153 mg/day). The primary outcome measures were the 17-item total severity score of the Clinician Administered PTSD Scale, Part 2 (CAPS-2) and the Clinical Global Impression Improvement Scale (CGI-I). Other assessments included the Davidson Trauma Scale (DTS), the Top-8 PTSD Rating Scale, Sheehan Disability Scale (SDS), Montgomery-Asberg Depression Rating Scale (MADRS), Hamilton Anxiety Scale (HAM-A), and Pittsburgh Sleep Quality Index (PSQI). Twenty-six subjects had at least one post-randomization CAPS-2 assessment and were therefore included in the data analysis. There were no statistically significant differences between treatment groups on any of the outcome measures. There was a significant effect for time in both groups, indicating an improvement in PTSD symptoms, depression, sleep, and quality of life over time. CAPS-2 scores for all of the PTSD symptom clusters decreased significantly over time. This study did not find significant differences in the effectiveness of nefazodone and sertraline for the treatment of PTSD. Larger trials are warranted.",0,0 +3531,Psychopharmacology of Pediatric Posttraumatic Stress Disorder,"To review the current knowledge of pharmacotherapy in the treatment of Post-traumatic Stress Disorder (PTSD) as it applies to children and adolescents and to provide a rational approach to medication use in Pediatric PTSD.The literature on the psychopharmacology of Pediatric PTSD is reviewed. Additionally, literature is reviewed on the neurobiological systems presumptively involved in trauma as well as studies in the pharmacology of adult PTSD, as they pertain to the treatment of Pediatric PTSD.There are too few studies in the current Pediatric PTSD literature to confirm treatment recommendations. Downward extrapolation from the adult literature combined with an understanding of the neurobiology of PTSD and its comorbid conditions may serve as the basis for a rational pharmacotherapy of PTSD in childhood. The effectiveness of targeting pharmacological agents at PTSD symptom clusters and associated comorbid conditions remains to be verified in controlled clinical trials.The state of psychopharmacology for Pediatric PTSD is in its earliest stages. While there are insufficient numbers of controlled pharmacological trials to make firm recommendations, the field requires a starting point for a rational psychopharmacological approach. Pharmacotherapy may provide symptom relief of both the debilitating primary symptoms and the comorbid conditions in children suffering from PTSD.",0,0 +3532,Physical Symptom Trajectories Following Trauma Exposure: Longitudinal Findings from the Normative Aging Study,"This study modeled physical symptom trajectories from ages 30 to 75 in 1079 older male military veterans who were assessed every 3 to 5 years since the 1960s. Combat exposure and noncombat trauma were used to define four groups: no trauma (N = 249), noncombat trauma only (N = 333), combat only (N = 152), and both combat and noncombat trauma (N = 345). Number of symptoms on the Cornell Medical Index physical symptom scale increased 29% per decade. Men who had experienced either combat or noncombat trauma did not differ from nonexposed men, but those who had experienced both combat and noncombat trauma had 16% more symptoms across all ages. There were no differences in age-related trajectories as a function of trauma history. In cross-sectional analysis, men with combat and noncombat trauma had more posttraumatic stress disorder symptoms, but not more depression symptoms, than men with either no trauma or noncombat trauma only. Discussion focuses on the importance of considering physical as well as psychological outcomes of exposure to traumatic events.",0,0 +3533,Use of Generic Versus Region-Specific Functional Status Measures on Patients With Cervical Spine Disorders,"Few data exist to support the use of functional status measures on patients with disorders of the cervical spine. This study was designed to compare the construct validity and sensitivity to change of the Neck Disability Index (NDI) and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36).Patients (N = 146) with a variety of disorders of the cervical spine completed the NDI and the SF-36 prior to treatment. Following discharge from treatment, 69 of these patients completed a second NDI and SF-36.There was evidence for the construct validity and sensitivity to change of the NDI and the physical and mental component scores of the SF-36. The ability of the NDI and SF-36 to detect change varied, depending on the construct tested. The SF-36 was superior in some instances, and the NDI was superior in other instances. The NDI appears to measure both mental and physical health-related factors.There appears to be substantial overlap between the 2 measures. The use of both measures, therefore, is probably not necessary. [Riddle DL, Stratford PW. Use of generic versus region-specific functional measures on patients with cervical spine disorders.",0,0 +3534,"Community Resilience as a Metaphor, Theory, Set of Capacities, and Strategy for Disaster Readiness","Communities have the potential to function effectively and adapt successfully in the aftermath of disasters. Drawing upon literatures in several disciplines, we present a theory of resilience that encompasses contemporary understandings of stress, adaptation, wellness, and resource dynamics. Community resilience is a process linking a network of adaptive capacities (resources with dynamic attributes) to adaptation after a disturbance or adversity. Community adaptation is manifest in population wellness, defined as high and non-disparate levels of mental and behavioral health, functioning, and quality of life. Community resilience emerges from four primary sets of adaptive capacities--Economic Development, Social Capital, Information and Communication, and Community Competence--that together provide a strategy for disaster readiness. To build collective resilience, communities must reduce risk and resource inequities, engage local people in mitigation, create organizational linkages, boost and protect social supports, and plan for not having a plan, which requires flexibility, decision-making skills, and trusted sources of information that function in the face of unknowns.",0,0 +3535,Mental Health Treatments In The Wake Of Disaster,"INTRODUCTION There is overwhelming evidence that disasters can lead to a range of posttraumatic mental health problems. The aim of this chapter is to review the evidence for psychological and pharmacological approaches to treating people with adverse psychological reactions after disaster; specifically, we focus on interventions that can be provided in the short and intermediate phases after disaster. First we review common postdisaster psychiatric disorders. We then turn to describing and outlining the evidence for psychological approaches to treatment. Next we review pharmacological treatments for posttraumatic conditions. Finally, we comment on factors that influence the management of psychological approaches in the acute postdisaster environment. PSYCHOLOGICAL EFFECTS OF DISASTERS There is convergent evidence that an array of psychiatric disorders arise after disasters. Posttraumatic stress disorder (PTSD) is the most commonly identified, and the disorder is characterized by three clusters of symptoms, including reexperiencing of the traumatic event, avoidance and numbing, and hyperarousal. Symptoms need to be present for at least 1 month and cause clinically significant distress or impairment in functioning to fulfill criteria for PTSD. Rates of PTSD were reported in 34% of survivors of the Oklahoma City bombing (North et al., 1999) and 53% after Australian bushfires (McFarlane, 1986). Across studies, the prevalence of PTSD is higher among direct victims (30%–40%) than rescue personnel (10%–20%; Neria, Nandi, & Galea, 2007). © Cambridge University Press 2009.",0,0 +3536,An event-related brain potential investigation of PTSD and PTSD symptoms in abused children,"We tested 186 children ranging in age from 6 years, 10 months to 13 years, 7 months; 174 suffered either physical and/or sexual abuse, and 12 were nonabused children. Abused subjects were grouped in four different ways. The primary grouping was based on whether subjects satisfied the DSM III-R criteria for posttraumatic stress disorder (PTSD). Secondary groupings were based upon the three symptom clusters used to make the PTSD diagnosis (arousal, avaidance, and reexperiencing). In each of these groupings three separate subgroups were formed with approximately 25 percent in the high and low symptom count subgroups and the remaining 50 percent in the middle symptom count subgroup.Subjects listened to four different intensity levels (65, 80, 95, and 102 dB) of a 1 KHz tone, pseudo-randomly ordered, while event-related brain potentials (ERPs) were recorded. Two separate blocks were used, one with short intervals (4±1 sec) between tones and the other with longer intervals (17±2 sec). PTSD subjects presented a greater P2-N2 ERP intensity gradient (i.e., a larger increase in the P2-N2 ERP component as tone intensity increased) than did abused subjects without PTSD. Abused subjects with the highest number of reexperiencing symptoms showed a similar P2-N2 augmenting effect when compared to those with the lowest number of reexperiencing symptoms. Subjects with the highest number of arousal symptoms showed a shallower intensity gradient for the N1-P2 ERP component than did those with fewer arousal symptoms. The results are discussed in relation to previous results reported on adults with PTSD and in terms of CNS processing of stimulus intensity information.",0,0 +3537,"The psychotherapeutic potential of MDMA (3,4-methylenedioxymethamphetamine): an evidence-based review","Aims and rationale: The purpose of this study was to review whether methylenedioxymethamphetamine (MDMA) has the appropriate pharmacodynamic profile to be a therapeutic agent. Materials and methods: Empirical descriptions of MDMA's subjective effects in humans will be reviewed to evaluate the proposal that MDMA has psychotherapeutic properties. The focus will be published evidence on its functional effects in therapeutic, medical, and other situations. Results: MDMA is a powerful central nervous system (CNS) stimulant which affects several neurotransmitter systems and intensifies a range of psychobiological functions. Its acute mood effects can be very positive and life enhancing, and the affirmative cognitions engendered during MDMA therapy may well endure afterwards. However, MDMA also has a number of potential anti-therapeutic characteristics. Acutely, it can also intensify negative cognitions, and these may similarly endure over time. Psychotherapists have found that setting, intention, and expectancy are crucial for a positive outcome, but these factors cannot be guaranteed. Post-MDMA, there is a period of neurotransmitter recovery when low moods predominate, and these may exacerbate psychiatric distress. The explanations proposed for MDMA-assisted therapy are all psychodynamic, and a neurochemical model needs to be outlined. It has been suggested that enduring therapeutic gains can follow a single session, but again, this lacks a clear psychopharmacological rationale. Finally, diathesis-stress models suggest that psychiatric individuals are more prone to acute and chronic abreactions to CNS stimulants such as MDMA. Conclusions: There are a number of issues which need to be addressed before it can be argued that MDMA might be clinically useful for psychotherapy. (",0,0 +3538,The effect of paternal heat stress on protein profiles of pre-implantation embryos in the mouse,"The study was undertaken to compare the protein profiles of [35S]-methionine-labelled control-sired embryos with heat-sired embryos at 7, 14 or 21 days after mature fertile B6CBF F1 male mice were kept at 36 +/- 0.3 degrees C and 62 +/- 2.7% relative humidity for 24 h. One-dimensional gel electrophoresis and autoradiographs were used to examine the protein profiles between the two-cell embryos and the blastocysts. The results obtained demonstrate that paternal heat stress 7 or 14 days earlier did not apparently affect protein patterns of two-cell embryos, four-cell to eight-cell embryos, morulae or blastocysts. However, 21 days earlier, there were changes in protein patterns of two-cell embryos and abnormal embryos, but not the morulae. To further support and extend these results, two-dimensional gel electrophoresis and phosphorimaging were employed and the results obtained show that paternal heat stress 21 days before mating affected protein profiles of two-cell embryos and morulae in the mouse. Together, these findings have indicated that paternal heat stress affects most but not all protein patterns of pre-implantation embryos, which strongly supports our previous results demonstrating that paternal heat stress significantly reduced the developmental proportion of pre-implantation embryos in the mouse.",0,0 +3539,Posttraumatic stress and sleep: Differential relations across types of symptoms and sleep problems,"Posttraumatic stress symptoms and self-reported sleep problems reliably covary. The current study investigated how posttraumatic stress symptom clusters (i.e., hyperarousal, avoidance, and reexperiencing) relate to trouble initiating and maintaining sleep and nightmares. Participants included traumatic event-exposed respondents from the NCS-R. Results suggested that posttraumatic stress symptom severity is related to trouble initiating and maintaining sleep and nightmares. Investigation of symptom clusters indicated that reexperiencing symptoms were related to trouble initiating and maintaining sleep and nightmares, while hyperarousal symptoms were related to trouble maintaining sleep and nightmares. Findings partially support both reexperiencing and hyperarousal-based models of the relation between sleep and posttraumatic stress.",0,0 +3540,Perceptual processing advantages for trauma-related visual cues in post-traumatic stress disorder,"Intrusive re-experiencing in post-traumatic stress disorder (PTSD) comprises distressing sensory impressions from the trauma that seem to occur 'out of the blue'. A key question is how intrusions are triggered. One possibility is that PTSD is characterized by a processing advantage for stimuli that resemble those that accompanied the trauma, which would lead to increased detection of such cues in the environment.We used a blurred picture identification task in a cross-sectional (n=99) and a prospective study (n=221) of trauma survivors.Participants with acute stress disorder (ASD) or PTSD, but not trauma survivors without these disorders, identified trauma-related pictures, but not general threat pictures, better than neutral pictures. There were no group differences in the rate of trauma-related answers to other picture categories. The relative processing advantage for trauma-related pictures correlated with re-experiencing and dissociation, and predicted PTSD at follow-up.A perceptual processing bias for trauma-related stimuli may contribute to the involuntary triggering of intrusive trauma memories in PTSD.",0,0 +3541,Investigating Differences in Truthful and Fabricated Symptoms of Traumatic Stress over Time,"False allegations of victimization typically are accompanied by malingered emotional symptomology to corroborate claims. This analog study was designed to compare truthful and fabricated symptom profiles on measures of post-traumatic stress (i. e., Revised Impact of Event Scale, Post-Traumatic Stress Disorder (PTSD) Checklist, Trauma Symptom Inventory) and levels of symptom consistency over time. Participants (undergraduate students) described their mental health symptoms for both traumas at time 1 (N=291), time 2 (N=252, 3 month), and time 3 (N=181, 6 months). Results indicated that fabricated traumas were associated with inflated symptom profiles. Validity scales were not effective at discerning symptom veracity, although reports could be discriminated somewhat by atypical responding and clinical scales. PTSD symptoms in malingerers also were reported more consistently over time. This research offers applicable information for identifying feigned traumatic stress. © 2010 Springer Science + Business Media, LLC.",0,0 +3542,Divalproex in the Treatment of Posttraumatic Stress Disorder,"To evaluate the efficacy of divalproex for the treatment of posttraumatic stress disorder (PTSD) hyperarousal symptom cluster.Under double-blind conditions, 85 US military veterans with PTSD were randomized to treatment with divalproex or placebo for 8 weeks. All patients who received at least 1 dose of medication and 1 postbaseline assessment (n = 82) were included in the efficacy population. The primary outcome measure was the hyperarousal subscale of the Clinician-Administered PTSD Scale.There were no significant intergroup differences in primary or secondary end points. The final mean (SD) divalproex dose and serum valproic acid level were 2309 +/- 507 mg/d and 82 +/- 30 mg/L, respectively.Divalproex monotherapy was not effective in the treatment of chronic PTSD in predominantly older male combat veterans. Further study is needed to determine the efficacy of divalproex in the management of PTSD in women or civilians or in combination with antidepressants.",0,0 +3543,Resilience and Distress: Israelis Respond to the Disengagement from Gaza and the Second Lebanese War,"Resilience and distress in Israeli society were assessed at three points in time: before and after the Israeli disengagement from Gaza, and after the second Lebanese war. A random sample of 366 Israelis was assessed for nation-related anxiety and hostility, personal resources and post-traumatic symptoms. The lowest levels of anxiety were observed at the second time point, after the disengagement. Respondents with high-resilience profiles showed lower levels of post-traumatic symptoms and higher levels of personal resources. The findings underscore Israelis' resilience and the importance of personal resources in ongoing nationally stressful situations. © 2011 Springer Science+Business Media, LLC.",0,0 +3544,The psychological treatment of Post Traumatic Stress Disorder (PTSD) in adult refugees: A review of the current state of psychological therapies,"Background: Large numbers of refugees flee their countries of origin each year. A proportion of these people will have witnessed or experienced traumatic events and may be suffering from psychological distress requiring intervention.Aims: The article aims to review the literature relating to the psychological treatment of Post Traumatic Stress Disorder (PTSD) in adult refugees. The clinical implications of existing research and specific challenges faced by health services in meeting the mental health needs of non-western individuals are discussed.Method: A literature search of English language journals was conducted using the Web of Science, Medline and PsycInfo databases.Findings: There is a dearth of research in this area and the majority of studies conducted have significant methodological limitations. Despite this, the psychotherapeutic studies to date indicate some potentially effective treatments with traumatized refugees and have attempted to employ innovative treatment elements taking into account issues of diversity.Conclusions: Research and practice in this area is in its infancy and further research is necessary. Culturally sensitive adaptations of CBT seem promising and further research is needed to clarify the value of such specific elements in therapy. The need for greater therapist awareness of issues of diversity raises issues for training and continual professional development.",0,0 +3545,Cultural differences in personal identity in post-traumatic stress disorder,"This study investigated cultural differences in goals, self-defining memories, and self-cognitions in those with and without post-traumatic stress disorder (PTSD).Trauma survivors with and without PTSD, from independent and interdependent cultures (N=106) provided major personal goals, self-defining memories, and self-cognitions.Trauma survivors with PTSD from independent cultures reported more goals, self-defining memories, and self-cognitions that were trauma-related than non-PTSD trauma survivors from independent cultures. In contrast, for those from interdependent cultures, there was no difference between trauma survivors with and without PTSD in terms of trauma-centred goals, self-defining memories, and self-cognitions.The results suggest cultural variability in the impact of trauma on memory and identity, and highlight the need for contemporary models of PTSD to more explicitly consider culture in their accounts of PTSD. Clinical implications of these findings, such as cultural considerations in assessment and treating trauma relevant self-schema in cognitive therapy for PTSD, are discussed.",0,0 +3546,A critique of the female sexual perpetrator research,"This paper critically reviewed the research literature on female sex-offenders based on all the identified studies with a sample exceeding 10 from 1989 to 2004. Thirteen studies were identified. Five exploratory studies were individually summarized and critiqued as a group. The eight comparative studies were individually discussed and critiqued. Strengths and weaknesses of the current research were discussed. Conclusions about the research and suggestions for future research were provided. Notable conclusions were: that female sex-offenders are more likely to have been sexually victimized than other populations, offended by themselves, and commit serious forms of sexual abuse. There are also some promising typologies for this heterogeneous population, but they need further replication.",0,0 +3547,Retrospective surveillance of metabolic parameters affecting reproductive performance of Japanese Black breeding cows,"This retrospective study was conducted to confirm the relationship between pre- and postpartum metabolic parameters and postpartum reproductive performance and to clarify seasonal characteristics of the metabolic parameters by using our metabolic profile test (MPT) database of Japanese Black breeding herds. In evaluation 1, MPT databases of blood samples from multiparous cows collected prepartum and postpartum were divided into two groups according to calving interval, and each MPT parameter was compared. In evaluation 2, the same MPT databases used in evaluation 1 were divided into two groups according to the sampling period. Significant differences were found in the prepartal total protein and postpartal γ-glutamyltransferase in evaluation 1. In evaluation 2, significant differences were found in the prepartal and postpartal total protein, albumin/globulin ratio, and glucose. Clear seasonal differences in MPT results emphasized the usefulness of the MPT in breeding cattle herds fed home-pasture roughage and suggest that unsatisfactory reproductive performance during hot periods reflects inadequate nutritional content of the diet and possible reduced feed intake due to heat stress.",0,0 +3548,The relationships between posttraumatic stress symptom clusters and marital intimacy among war veterans.,"This study examined (a) the relationships between posttraumatic stress disorder (PTSD) symptom clusters and marital intimacy among Israeli war veterans and (b) the role of self-disclosure and verbal violence in mediating the effects of PTSD avoidance and hyperarousal symptoms on marital intimacy. The sample consisted of 219 participants divided into 2 groups: ex-prisoners of war (ex-POWs; N = 125) and a comparison group of veterans who fought in the same war but were not held in captivity (N = 94). Ex-POWs displayed higher levels of PTSD symptoms and verbal violence and lower levels of self-disclosure than did controls. Although ex-POWs and controls did not differ in level of marital intimacy, they did, however, present a different pattern of relationships between PTSD clusters and intimacy. In ex-POWs, self-disclosure mediated the relations between PTSD avoidance and marital intimacy. Verbal aggression was also found via indirect effect of hyperarousal on marital intimacy. The results point to the importance of self-disclosure and verbal violence as interpersonal mechanisms for the relations between posttraumatic symptoms on marital intimacy of ex-POWs.",0,0 +3549,Predictors of the Development of Posttraumatic Stress Disorder Among Police Officers,"This retrospective study examined risk and protective factors for the development of posttraumatic stress disorder (PTSD) in a sample of 132 Canadian police officers. Structured interviews were conducted in order to assess the most distressing work-related traumatic events and determine diagnoses of full or partial PTSD. Participants completed self-administered questionnaires assessing several potential predictors. The results suggested that 7.6% of the participants developed full PTSD, whereas 6.8% had partial PTSD following an incident at work. A multiple logistic regression analysis indicated that the most potent risk factor for the development of full or partial PTSD was peritraumatic dissociation. Social support from colleagues during the event emerged as a significant protective factor. Clinical implications of the findings are discussed.",0,0 +3550,Children's Coping in the Context of Disasters and Terrorism,"Disasters and terrorism present significant and often overwhelming challenges for children and families worldwide. Individual, family, and social factors influence disaster reactions and the diverse ways in which children cope. This article links conceptualizations of stress and coping to empirical knowledge of children's disaster reactions, identifies limitations in our current understanding, and suggests areas for future study of disaster coping. Coping strategies, developmental trajectories influencing coping, and the interplay between parent and child coping represent critical areas for advancing the field and for informing programs and services that benefit children's preparedness and foster resilience in the face of mass trauma.",0,0 +3551,INTEGRATIVE ASSESSMENT OF BRAIN FUNCTION IN PTSD: BRAIN STABILITY AND WORKING MEMORY,"Posttraumatic Stress Disorder (PTSD) is characterized by symptoms of hyperarousal, avoidance and intrusive trauma-related memories and deficits in everyday memory and attention. Separate studies in PTSD have found abnormalities in electroencephalogram EEG, in event-related potential (ERP) and behavioral measures of working memory and attention. The present study seeks to determine whether these abnormalities are related and the extent to which they share this relationship with clinical symptoms. EEG data were collected during an eyes-open paradigm and a one-back working memory task. Behavioral and clinical data (CAPS) were also collected. The PTSD group showed signs of altered cortical arousal as indexed by reduced alpha power and an increased theta/alpha ratio, and clinical and physiological measures of arousal were found to be related. The normal relationship between theta power and ERP indices of working memory was not affected in PTSD, with both sets of measures reduced in the disordered group. Medication appeared to underpin a number of abnormal parameters, including P3 amplitude to targets and the accuracy, though not speed, of target detection. The present study helps to overcome a limitation of earlier studies that assess such parameters independently in different groups of patients that vary in factors such as comorbidity, medication status, gender and symptom profile. The present study begins to shed light on the relationship between these measures and suggests that abnormalities in brain working memory may be linked to underlying abnormalities in brain stability.",0,0 +3552,Factor analysis of the impact of event scale with children in war,"To evaluate the psychometric properties of the Impact of Event Scale (IES scale) in children a study was conducted on 1787 children exposed to the warfare in Croatia, Bosnia and Herzegovina. The study group comprised 877 girls and 910 boys ranging in age from 6 to 15 years attending 28 arbitrary selected schools in Zagreb. High levels of posttraumatic reactions were found in the group of children. The pattern of endorsement and the factor structure of the IES scale were similar to that found in other samples. This supports the use of the IES in the assessment of posttraumatic stress reactions in children. Two factors emerged from a Principal Component Analysis, labeled intrusion (9 items), and avoidance (4 items). As in other studies, this study documented problems with several items (items 2, 12 and 15), items that should be considered omitted from the IES. Girls reported significantly more distress on 13 out of the 15 items. Both the overall IES score as well as the intrusion and avoidance score were significantly higher in girls than boys. The factor structure for boys and girls were very similar, and the reliability of the scale was adequate across different age groups and for subgroups of displaced and refugee children.",0,0 +3553,Combat Experience and Postservice Psychosocial Status as Predictors of Suicide in Vietnam Veterans,"The authors examined potential risk factors for suicide among 38 Vietnam veterans using 46 Vietnam veterans who died from motor vehicle accidents as a comparison group. The veterans were selected from Los Angeles County Medical Examiner's file (1977-1982). Data for these veterans were obtained from military service records, the coroner's reports, and the psychological autopsy conducted with the decedents' family members. No military service factor was associated with suicide. The characteristics of Vietnam veteran suicide cases were not substantially different from non-Vietnam veteran suicide cases with respect to known demographic risk factors. The psychological profile of Vietnam veteran suicide cases are also similar to non-Vietnam veteran suicide cases in most instances. Symptoms related to posttraumatic stress disorder were observed more frequently among suicide cases than accident cases. However, suicides were not associated with specific combat experiences or military occupation. The extent of combat experience in Vietnam per se as measured in this study is not a good predictor of suicide death.",0,0 +3554,Trajectories of life satisfaction five years after medical discharge for traumatically acquired disability.,"We studied the predictive impact of family satisfaction, marital status, and functional impairment on the trajectories of life satisfaction over the first 5 years following medical treatment for traumatic spinal cord injury, burns, or interarticular fractures (total N = 662). It was anticipated that fewer functional impairments, being married, and greater family satisfaction would predict higher life satisfaction trajectories.The Functional Independence Measure, the Family Satisfaction Scale, and the Life Satisfaction Index were administered 12, 24, 48, and 60 months postdischarge.Trajectory modeling revealed that greater functional impairment significantly predicted lower life satisfaction, regardless of injury type. However, this association diminished when marital status and family satisfaction were entered into the models. Greater family satisfaction and being married predicted greater life satisfaction across time. Moreover, there was no evidence for increases in life satisfaction trajectories over time: Trajectories were stable across time for all injury groups.Results suggest that being married and greater family satisfaction promote life satisfaction among those who traumatically acquire disability, and these beneficial effects may be more salient than the degree of functional impairment imposed by the condition.",0,0 +3555,Behavioral and Emotional Profiles of Neglected Children,"This study explored the emotional and behavioral profiles of 41 neglected children, ages 6 to 12 years, who were compared with a control group of 41 children. The Achenbach System was used in order to describe emotional and behavioral profiles based on the Diagnostic Criteria of the DSM-IV [Diagnostic and Statistical Manual of Mental Disorders, 4th ed.]). Neglected children had more symptoms on DSM-IV Scales related to conduct or attention/hyperactivity problems. Based on the perceptions of teachers, children exposed to neglect showed more externalized and internalized problems as well as symptoms on DSM-IV Scales. Results supported the relevance of using the Diagnostic Criteria of the DSM-IV and the importance of getting the different perceptions of respondents to better understand the emotional and behavioral portrait of neglected children. © 2013",0,0 +3556,"Post-conflict mental health needs: a cross-sectional survey of trauma, depression and associated factors in Juba, Southern Sudan","The signing of the Comprehensive Peace Agreement in January 2005 marked the end of the civil conflict in Sudan lasting over 20 years. The conflict was characterised by widespread violence and large-scale forced migration. Mental health is recognised as a key public health issue for conflict-affected populations. Studies revealed high levels of post-traumatic stress disorder (PTSD) amongst populations from Southern Sudan during the conflict. However, no studies have been conducted on mental health in post-war Southern Sudan. The objective of this study was to measure PTSD and depression in the population in the town of Juba in Southern Sudan; and to investigate the association ofdemographic, displacement, and past and recent trauma exposure variables, on the outcomes of PTSD and depression.A cross-sectional, random cluster survey with a sample of 1242 adults (aged over 18 years) was conducted in November 2007 in the town of Juba, the capital of Southern Sudan. Levels of exposure to traumatic events and PTSD were measured using the Harvard Trauma Questionnaire (original version), and levels of depression measured using the Hopkins Symptom Checklist-25. Multivariate logistic regression was used to analyse the association ofdemographic, displacement and trauma exposure variables on the outcomes of PTSD and depression. Multivariate logistic regression was also conducted to investigate which demographic and displacement variables were associated with exposure to traumatic events.Over one third (36%) of respondents met symptom criteria for PTSD and half (50%) of respondents met symptom criteria for depression. The multivariate logistic regression analysis showed strong associations of gender, marital status, forced displacement, and trauma exposure with outcomes of PTSD and depression. Men, IDPs, and refugees and persons displaced more than once were all significantly more likely to have experienced eight or more traumatic events.This study provides evidence of high levels of mental distress in the population of Juba Town, and associated risk-factors. Comprehensive social and psychological assistance is urgently required in Juba.",0,0 +3557,Setting Apart the Affected: The Use of Behavioral Criteria in Animal Models of Post Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) affects about 20-30% of exposed individuals. Clinical studies of PTSD generally employ stringent criteria for inclusion in study populations, and yet in animal studies the data collection and analysis are generally expressed as a function of exposed vs nonexposed populations, regardless of individual variation in response. Prior data support an approach to animal models analogous to inclusion criteria in clinical studies. This series of studies sought to assess prevalence rates of maladaptive vs adaptive responses determined according to a more stringent approach to the concept of inclusion/exclusion criteria (cutoff behavioral criteria-CBC), consisting of two successive behavioral tests (elevated plus maze and acoustic startle response tests). The rats were exposed to stressors in two different paradigms; exposure to a predator and underwater trauma. The prevalence rates of maladaptive responses to stress in these two distinct models dropped over time from 90% in the acute phase to 25% enduring/maladaptive response at 7 days, to remain constant over 30 days. As setting the affected individuals apart from the unaffected approximates clinical studies, it might also help to clarify some of the pending issues in PTSD research.",0,0 +3558,Psychological factors after traumatic amputation in landmine survivors: The bridge between physical healing and full recovery,"Limb loss due to a landmine injury is sudden and devastating. The resulting disability makes life challenging in a world where physical ability is the 'norm'. In order to better understand the psychological adjustments individuals make in their recovery from a landmine injury, the Landmine Survivors Network conducted an exploratory qualitative study to determine factors that contribute to an individual's recovery. The study examined psychosocial aspects, coping strategies, and resilience characteristics of limb loss survivors across differing cultural, societal and economic backgrounds.Eighty-five participants (68 persons of limb loss, 10 family members, seven service providers) were interviewed using a semi-structured protocol in the USA and an open-ended format in six landmine affected countries. Data analysis was completed using grounded theory analytic strategies.Data indicated that the survivors' acceptance of limb loss and their state of psychological recovery were greatly influenced by the individual's resilience characteristics, social support, medical care, economic situation and societal attitudes toward people with disabilities.Recovery from traumatic amputation in landmine survivors needs to be comprehensive and coordinated, and requires addressing the individual's physical, psychological, economic and social needs within the context of family, community, and the socio-cultural environment in which they live.",0,0 +3559,Culture and Posttraumatic Stress Disorder (PTSD): A Proposed Conceptual Framework,"It is widely accepted that the understanding of any psychological disorder needs to be contextualised within cultural parameters. The notion that current diagnostic taxonomies are not always universally applicable does not mean that all symptoms are not applicable. We present a framework that is aimed at being a starting point from which to delineate universal and culture specific elements of PTSD. The framework follows the possible influence of cultural factors on (a) the formation of an intrusive memory, (b) an understanding of how such a memory becomes pathological, and (c) how symptoms are expressed from the intrusive memory core of PTSD. While the framework presents certain elements (e.g. intrusive memory and core schemas) as centrally important, the focus is on a heuristic framework that allows for the study of the dynamic interaction between potentially universal and cultural factors and how this interaction may produce the symptom profile generally seen with PTSD. Tentative recommendations are made for a research agenda and are presented after a brief exploration of the strengths and weaknesses of such a framework.",0,0 +3560,Providing Psychosocial Support to Children and Families in the Aftermath of Disasters and Crises,"Disasters have the potential to cause short- and long-term effects on the psychological functioning, emotional adjustment, health, and developmental trajectory of children. This clinical report provides practical suggestions on how to identify common adjustment difficulties in children in the aftermath of a disaster and to promote effective coping strategies to mitigate the impact of the disaster as well as any associated bereavement and secondary stressors. This information can serve as a guide to pediatricians as they offer anticipatory guidance to families or consultation to schools, child care centers, and other child congregate care sites. Knowledge of risk factors for adjustment difficulties can serve as the basis for mental health triage. The importance of basic supportive services, psychological first aid, and professional self-care are discussed. Stress is intrinsic to many major life events that children and families face, including the experience of significant illness and its treatment. The information provided in this clinical report may, therefore, be relevant for a broad range of patient encounters, even outside the context of a disaster. Most pediatricians enter the profession because of a heartfelt desire to help children and families most in need. If adequately prepared and supported, pediatricians who are able to draw on their skills to assist children, families, and communities to recover after a disaster will find the work to be particularly rewarding.",0,0 +3561,Crisis support and psychiatric symptomatology in adult survivors of the Jupiter cruise ship disaster,"The aim of the present study was to explore the relationship between crisis support and psychiatric symptomatology among adult survivors in the year following the Jupiter cruise ship disaster. Evidence is presented that support decreases over the following year, and that higher levels of crisis support are strongly related to better psychological outcome. Crisis support is shown to retain its association with symptomatology even when satisfaction with support is partialled out. These data are discussed with reference to the debate over the relative importance of received vs. perceived support.",0,0 +3562,Risk factors for psychological and physical health problems after a man-made disaster,"There are few prospective studies on risk factors for health problems after disasters in which actual pre-disaster health data are available.To examine whether survivors' personal characteristics, and pre-disaster psychological problems, and disaster-related variables, are related to their post-disaster health.Two studies were combined: a longitudinal survey using the electronic medical records of survivors' general practitioners (GPs), from 1 year before to 1 year after the disaster, and a survey in which questionnaires were filled in by survivors, 3 weeks and 18 months after the disaster. Data from both surveys and the electronic medical records were available for 994 survivors.After adjustment for demographic and disaster-related variables, pre-existing psychological problems were significantly associated with post-disaster self-reported health problems and post-disaster problems presented presented to the to the GP. This association was found for both psychological and physical post-disaster problems.In trying to prevent long-term health consequences after disaster, early attention to survivors with pre-existing psychological problems, and to those survivors who are forced to relocate or are exposed to many stressors during the disaster, appears appropriate.",0,0 +3563,Treatment of posttraumatic stress disorder with nefazodone,"Selective serotonin reuptake inhibitors are useful in the treatment of posttraumatic stress disorder (PTSD), but have a number of side-effects which limit their acceptability. A newer serotonergic compound, nefazodone, has a different side-effect profile, thus making it a potentially promising compound to study. Seventeen private practice patients with PTSD were treated with nefazodone up to 600 mg/day for a maximum total treatment period of 12 weeks. All subjects were civilians, and were monitored for efficacy and side-effects at weeks 1, 2, 4, 6, 8 and 12. Nefazodone was associated with statistically significant improvement in mean scores on all six rating scales used to assess change from baseline in PTSD symptoms. Additionally, statistically significant improvement from baseline were seen for the intrusive, avoidant/numbing, and hyperarousal clusters on a global PTSD scale. Early improvements in nightmares and general sleep disturbance were observed. Overall, there was a 43% response rate at endpoint, or 60% in treatment completers, by observer rating. Side-effects (assessed on the Medication Effects Scale) were generally benign. Nefazodone was associated with clinical improvement in this population, and now needs to be studied in double-blind, placebo controlled, protocols.",0,0 +3564,Variation in Mouse Basolateral Amygdala Volume is Associated With Differences in Stress Reactivity and Fear Learning,"A wealth of research identifies the amygdala as a key brain region mediating negative affect, and implicates amygdala dysfunction in the pathophysiology of anxiety disorders. Although there is a strong genetic component to anxiety disorders such as posttraumatic stress disorder (PTSD) there remains debate about whether abnormalities in amygdala function predispose to these disorders. In the present study, groups of C57BL/6 x DBA/2 (B x D) recombinant inbred strains of mice were selected for differences in volume of the basolateral amygdala complex (BLA). Strains with relatively small, medium, or large BLA volumes were compared for Pavlovian fear learning and memory, anxiety-related behaviors, depression-related behavior, and glucocorticoid responses to stress. Strains with relatively small BLA exhibited stronger conditioned fear responses to both auditory tone and contextual stimuli, as compared to groups with larger BLA. The small BLA group also showed significantly greater corticosterone responses to stress than the larger BLA groups. BLA volume did not predict clear differences in measures of anxiety-like behavior or depression-related behavior, other than greater locomotor inhibition to novelty in strains with smaller BLA. Neither striatal, hippocampal nor cerebellar volumes correlated significantly with any behavioral measure. The present data demonstrate a phenotype of enhanced fear conditioning and exaggerated glucocorticoid responses to stress associated with small BLA volume. This profile is reminiscent of the increased fear processing and stress reactivity that is associated with amygdala excitability and reduced amygdala volume in humans carrying loss of function polymorphisms in the serotonin transporter and monoamine oxidase A genes. Our study provides a unique example of how natural variation in amygdala volume associates with specific fear- and stress-related phenotypes in rodents, and further supports the role of amygdala dysfunction in anxiety disorders such as PTSD.",0,0 +3565,Trusted Information Sources Used During and After Superstorm Sandy: TV and Radio were Used More Often than Social Media,"Health and safety professionals and the public are interested in the best methods of providing timely information about disasters. The objective of this study was to examine information sources used for Superstorm Sandy with respect to the storm, evacuation routes, shelters, safety, and health issues. Respondents in central New Jersey and Jersey shore communities were differentially impacted by the storm. Jersey shore respondents had higher evacuation rates (47% vs. 13%), higher flood waters in homes, longer power outages (average 23 vs. 6 d), and longer periods without Internet (29 vs. 6 d). Electricity outages disrupted both sources and receivers of communication. Both groups obtained most of their information regarding safety from television, radio, friends, and Web/e-mail. Information sources on health varied by location, with central Jersey respondents using mainly TV and the Web, and Jersey shore respondents obtaining health information from the radio and TV (before the storm). For information on evacuation routes, Jersey shore respondents obtained information from many sources, while central Jersey respondents obtained it from TV. Information on mold was largely obtained from friends and the Web, since mold issues were dealt with several weeks after Sandy. The reliance on traditional sources of information (TV, radio, friends) found in this study suggests that the extreme power outages rendered Web, cell phones, and social media on cell phones less usable, and suggests the need for an integrated communication strategy with redundancies that takes into account prolonged power outages over large geographical areas.",0,0 +3566,Measures of endothelial dysfunction in plasma of patients with posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) confers an increased cardiovascular risk. In 14 otherwise healthy patients with PTSD and in 14 age- and gender-matched non-PTSD controls, we investigated whether the categorical diagnosis of PTSD and severity of PTSD symptom clusters (i.e. re-experiencing, avoidance, arousal, and overall score) would be associated with plasma concentrations of three markers of endothelial dysfunction [soluble tissue factor (sTF), von Willebrand factor (VWF), and soluble intercellular adhesion molecule (sICAM)-1]. Compared with controls, patients had significantly higher sTF; this difference became nonsignificant when controlling for psychological distress. VWF and sICAM-1 levels were not significantly different between patients and controls. In the entire sample virtually all PTSD symptom clusters correlated significantly and positively with sTF and VWF but not with sICAM-1. The correlation between symptoms of re-experiencing and sTF was significantly different between patients and controls. Controlling for symptoms of anxiety and depression (i.e. psychological distress) rendered most associations between PTSD symptom clusters and sTF nonsignificant, whereas controlling for age retained significance of associations with VWF. Posttraumatic stress showed a continuous relationship with sTF and VWF, with the former relationship being partly affected by psychological distress. This suggests one mechanism by which posttraumatic stress could contribute to atherosclerosis.",0,0 +3567,"The Impact of Clergy-Perpetrated Sexual Abuse: The Role of Gender, Development, and Posttraumatic Stress","The literature on clergy-perpetrated sexual abuse suggests that there are two modal populations of survivors: boys and adult women. We review what is known about trauma and post-traumatic stress disorder following sexual abuse and explore the different treatment needs for these two survivor groups. For children, clergy-perpetrated sexual abuse can catastrophically alter the trajectory of psychosocial, sexual, and spiritual development. Depending on the age at which abuse occurred, adult clients may present with clinical issues that are more appropriate for a younger developmental stage. Additionally, the symptoms of traumatic stress may be misunderstood when clients conceptualize their abuse as an ""affair"" or ""consensual"" relationship. We discuss empirically supported treatments for post-traumatic stress disorder and potential adaptations for the needs of clergy-perpetrated sexual abuse survivors.",0,0 +3568,"Community resilience: concepts, assessment, and implications for intervention","Although stress research has emphasized individual well-being, many types of stress are experienced collectively: the events bring harm, pain, and loss to large numbers of people simultaneously. Natural disasters, terrorist attacks, war, political oppression, epidemics, and economic recessions happen to whole communities and, sometimes, whole societies. This is not to say that all exposed individuals experience the event identically; in a disaster, one person may lose a loved one, while another loses a home, and another only a few possessions. Nor is this to say that all exposed individuals respond identically; a person’s psychological, social, and material resources powerfully shape his or her capacity to cope and function effectively. When stress pervades the community, however, these factors tell only part of the story. To have an ecologically valid understanding of mass trauma, we must recognize that survivors are connected and dependent upon one another’s coping strategies. Their attributions and actions reflect a host of social influences, social comparisons, and emergent norms. They help each other but also compete for scarce resources. Household preparedness is vital, but one household can no more prepare for disaster than it could, on its own, protect itself from crime or disease, educate its children, or keep the roads safe. Consequently, an individual’s resilience is inextricably linked to the community’s ability to prepare for, respond to, and adapt to adverse conditions. Simply put, when problems are shared, so must be solutions. In recognition of such interdependencies, “community resilience” has emerged as a key concept for disaster readiness, although by no means limited to this one goal (Norris et al., 2008). This chapter will explore the concept of community resilience in some depth. Broadly, the chapter is organized into four sections. The first section provides our perspective on the meaning of resilience, including definitions that work across levels of analysis (individual, family, organization, community, society). The second section describes the adaptive capacities theorized to yield community resilience. This is followed by an outline of measurement strategies and challenges in assessing capacities, including some of our own pilot work. The concluding section makes recommendations for intervention and raises issues that need to be addressed in future research. © Cambridge University Press 2011.",0,0 +3569,Social issues and post-disaster recovery: A qualitative study in an Iranian context,"The physical impacts of a disaster are usually the most obvious impacts, and they are easily measured. However, there is not sufficient in-depth understanding of social issues arising after disasters. This qualitative study explored three main concepts regarding social issues after an earthquake in an Iranian context: social vulnerability, social uncertainty and confusion, and ignorance of local social capital. Negligence of social issues after disasters leads to delays in returning back to normal life. Policymakers are encouraged to take a comprehensive plan into account which considers these issues and facilitates the process of returning to normal life after earthquakes.",0,0 +3570,Victimization and Posttraumatic Stress Disorder Among Homeless Adolescents,"To examine street victimization and posttraumatic stress symptoms among urban homeless adolescents and to test whether emotional numbing and avoidance represent distinct posttraumatic stress disorder (PTSD) symptom clusters.Structured, private interviews were conducted with homeless adolescents (N = 374) in the Seattle metropolitan area (95% response rate) from 1995 to 1998.Eighty-three percent of street youths were physically and/or sexually victimized after leaving home. Approximately 18% of these youths met research criteria for PTSD. Results from a confirmatory factor analysis suggest that disaggregating symptoms of avoidance from symptoms of emotional numbing provides a better fit of the data than the current DSM-IV model in which these symptoms are combined in one factor.Sexual and physical victimization are serious threats for homeless adolescents, and those who are victimized are at risk for PTSD. Results challenge the belief that symptoms of avoidance and numbing represent one unified cluster in this population.",0,0 +3571,Post-traumatic stress disorder: symptom profiles in men and women,"To investigate the symptom frequencies of a relatively large sample of post-traumatic stress disorder (PTSD) sufferers and compare male and female symptom profiles.A total of 103 consecutive attendees at a clinic for PTSD were examined using a checklist of DSM-IV PTSD characteristics. The presence and absence of all symptoms was evaluated in a research interview. Some additional symptoms were also routinely asked about, such as mood lability, substance use, sex drive or libido. Symptom profiles of male and female sufferers of PTSD were compared using the chi-squared statistical test.Structured interview using checklist of DSM-IV PTSD characteristics.Certain symptoms were present in more than 30% of sufferers. Symptom frequencies for anxiety, insomnia, distressing and recurrent dreams, flashback imagery and intrusive thoughts, irritability, poor concentration, avoidance behaviour and detachment all reached frequencies above 70%. Some symptoms (such as inability to recall parts of the trauma and restricted affect) occurred in no more than 35% of sufferers.Men are significantly more likely than women to suffer with irritability (p < 0.05) and to use alcohol to excess (p < 0.05). Symptoms tend to follow an acute stress reaction, occur early and persist for many months. A case is made for restricting the diagnosis to the most prevalent symptoms and for including some often overlooked symptoms in the diagnostic guidelines, namely low mood, mood lability, and impaired libido.",0,0 +3572,Exposure to Hurricane-Related Stressors and Mental Illness After Hurricane Katrina,"Uncertainty exists about the prevalence, severity, and correlates of mental disorders among people exposed to Hurricane Katrina.To estimate the prevalence and associations between DSM-IV anxiety-mood disorders and hurricane-related stressors separately among prehurricane residents of the New Orleans metropolitan area and the remainder of the areas in Alabama, Louisiana, and Mississippi affected by Katrina.Community survey.A probability sample of 1043 English-speaking prehurricane residents of the areas affected by Hurricane Katrina was administered via telephone survey between January 19 and March 31, 2006. The survey assessed hurricane-related stressors and screened for 30-day DSM-IV anxiety-mood disorders.The K6 screening scale of anxiety-mood disorders and the Trauma Screening Questionnaire scale for posttraumatic stress disorder (PTSD), both calibrated against blinded structured clinical reappraisal interviews to approximate the 30-day prevalence of DSM-IV disorders.Prehurricane residents of the New Orleans metropolitan area were estimated to have a 49.1% 30-day prevalence of any DSM-IV anxiety-mood disorder (30.3% estimated prevalence of PTSD) compared with 26.4% (12.5% PTSD) in the remainder of the sample. The vast majority of respondents reported exposure to hurricane-related stressors. Extent of stressor exposure was more strongly related to the outcomes in the New Orleans metropolitan area subsample than the remainder of the sample. The stressors most strongly related to these outcomes were physical illness/injury and physical adversity in the New Orleans metropolitan area subsample and property loss in the remainder of the sample. Sociodemographic correlates were not explained either by differential exposure or reactivity to hurricane-related stressors.The high prevalence of DSM-IV anxiety-mood disorders, the strong associations of hurricane-related stressors with these outcomes, and the independence of sociodemographics from stressors argue that the practical problems associated with ongoing stressors are widespread and must be addressed to reduce the prevalence of mental disorders in this population.",0,0 +3573,Bayesian Inference for Growth Mixture Models with Latent Class Dependent Missing Data,"Growth mixture models (GMMs) with nonignorable missing data have drawn increasing attention in research communities but have not been fully studied. The goal of this article is to propose and to evaluate a Bayesian method to estimate the GMMs with latent class dependent missing data. An extended GMM is first presented in which class probabilities depend on some observed explanatory variables and data missingness depends on both the explanatory variables and a latent class variable. A full Bayesian method is then proposed to estimate the model. Through the data augmentation method, conditional posterior distributions for all model parameters and missing data are obtained. A Gibbs sampling procedure is then used to generate Markov chains of model parameters for statistical inference. The application of the model and the method is first demonstrated through the analysis of mathematical ability growth data from the National Longitudinal Survey of Youth 1997 (Bureau of Labor Statistics, U.S. Department of Labor, 1997). A simulation study considering 3 main factors (the sample size, the class probability, and the missing data mechanism) is then conducted and the results show that the proposed Bayesian estimation approach performs very well under the studied conditions. Finally, some implications of this study, including the misspecified missingness mechanism, the sample size, the sensitivity of the model, the number of latent classes, the model comparison, and the future directions of the approach, are discussed.",0,0 +3574,Metabolic Syndrome: Relative Risk Associated with Post-Traumatic Stress Disorder (PTSD) Severity and Antipsychotic Medication Use,"In recent years, numerous lines of converging evidence have revealed an association between post-traumatic stress disorder (PTSD) and impaired physical health outcomes, including cardiovascular disease and metabolic syndrome. Although these findings have been interpreted as indicating a direct association of PTSD with metabolic syndrome and obesity, previous studies have not addressed the important confound of antipsychotic drug usage in this population. Second generation antipsychotic medications themselves are associated with metabolic syndrome and obesity, and it is unclear whether the common utilization of these drugs in PTSD may account for some if not all of the observed metabolic problems.The present study examined the relative contributions of PTSD severity and use of antipsychotic medications to risk of metabolic syndrome among veterans.Cross-sectional clinical data, including five factors representing metabolic syndrome, psychiatric diagnoses, and medications were gathered from 253 veterans enrolling in mental health services. We used a logistic regression model to measure the relative association of antipsychotic medication use and PTSD severity on risk of metabolic syndrome.We found that antipsychotic medication usage was not uniquely associated with elevated risk of metabolic syndrome (Wald = 0.30, ns) when PTSD severity and other sociodemographic, psychiatric, and behavioral variables were accounted for. Furthermore, PTSD severity continued to be a significant and unique predictor of risk for metabolic syndrome (Wald = 4.04, p < 0.05).These findings suggest that chronic and moderately severe PTSD, independent of antipsychotic medications, is associated with increased risk of metabolic syndrome.",0,0 +3575,A cognitive behaviour therapy (CBT) programme for anxiety following moderate–severe traumatic brain injury (TBI): Two case studies,"CBT is a potentially effective treatment for anxiety disorders following TBI; however, empirical evidence has mainly come from clients with mild TBI. This paper describes a CBT-based anxiety treatment programme adapted for clients with more severe injuries. Two case studies are provided to illustrate the implementation of the programme, as a step toward larger scale testing of the programme's feasibility.A manualised adapted CBT treatment manual was used to deliver CBT in a standardised manner to two clients, one with severe and one with moderate TBI. Outcome was evaluated using a single-subject design with repeated measures of anxiety, mood and coping style at pre- and post-CBT.The two clients demonstrated positive treatment response on either a measure of anxiety or a continuous measure of distress. Although neither demonstrated a clinically significant change according to the primary outcome measure (Hospital Anxiety and Depression Scale), they showed significant change in at least one corroborated measure of anxiety.This study suggests the potential utility of the adapted CBT programme for clients with moderate-severe TBI. Limitations of the single case studies were discussed, while noting how they would be addressed in a follow-up randomised controlled trial.",0,0 +3576,Recognizing and Responding to Post-Traumatic Stress Disorder in People With Cancer,"To describe post-traumatic stress disorder (PTSD) in patients with cancer and identify nursing assessment and intervention strategies.Discussion of recent research literature in relation to oncology nursing practice.4%-19% of patients with cancer experience symptoms of PTSD. When PTSD routinely is considered as a risk for patients with cancer, nurses can reframe intense psychological and physiologic reactions or patient distress as possible trauma reactions and implement appropriate interventions and referral.Patients with cancer may experience PTSD as a consequence of their cancer diagnosis, treatment, or a past traumatic episode. PTSD may interfere with patients' ability to tolerate treatment and return for crucial follow-up care. To date, no studies have explored interventions for PTSD in adult patients with cancer.Oncology nurses can help patients with PTSD by interpreting psychological symptoms with the possibility of PTSD in mind, screening for PTSD across the illness trajectory, providing emotional support, teaching coping strategies, and advocating for further assessment, medical treatment, and appropriate referral within the multidisciplinary care team.",0,0 +3577,Report from the CDC: Mental Health of Women in Postwar Afghanistan,"More than two decades of war and a culture that has denied women freedom of movement, access to healthcare, and education have affected the mental health status of Afghan women more than that of men. In 2002, the Centers for Disease Control and Prevention (CDC) conducted a national population-based mental health survey in Afghanistan. The prevalence of symptoms of depression was 73% (standard error [SE] 8.15) and 59% (SE 5.59), of symptoms of anxiety was 84% (SE 2.98) and 59% (SE 8.65), and of posttraumatic stress disorder (PTSD) was 48% (SE 6.19) and 32% (SE 4.22) for female and male respondents, respectively. Mean scores for social functioning were lower for women (52.00 [SE 2.77]) than for men (66.63 [SE 3.92]). Women had significantly lower mental health status and poorer social functioning than did men. Results of our survey underscore the need for financial donors and healthcare planners to address the current lack of mental healthcare resources, facilities, and trained mental healthcare professionals in Afghanistan and to establish mental health services directed at the specific needs of women. This study highlights the negative impact that war, restrictions in freedoms, and socioeconomic hardship have had on the mental health and social functioning of women in Afghanistan.",0,0 +3578,Exposure to Trauma and Posttraumatic Stress Disorder Symptoms in Older Veterans Attending Primary Care: Comorbid Conditions and Self-Rated Health Status,"OBJECTIVES: Assess the prevalence of posttraumatic stress disorder (PTSD) symptomatology and its association with health characteristics in a geriatric primary care population. DESIGN: Cross-sectional screening assessments during a multisite trial for the treatment of depression, anxiety, and at-risk drinking. SETTING: Department of Veterans Affairs (VA)-based primary care clinics across the United States. PARTICIPANTS: Seventeen thousand two hundred five veterans aged 65 and older. MEASUREMENTS: Sociodemographic information, the General Health Questionnaire (GHQ-12), questions about death wishes and suicidal ideation, quantity and frequency of alcohol use, smoking, exposure to traumatic events, and PTSD symptom clusters. RESULTS: Twelve percent (2,041/17,205) of participants screened endorsed PTSD symptoms. Veterans with PTSD symptoms from some (partial PTSD) or each (PTSD all clusters) of the symptom clusters were significantly more likely to report poor general health, currently smoke, be divorced, report little or no social support, and have a higher prevalence of mental distress, death wishes, and suicidal ideation than those with no trauma history or those with trauma but no symptoms. Group differences were most pronounced for mental distress and least for at-risk drinking. Presence of PTSD all clusters was associated with poorer outcomes on all of the above-mentioned health characteristics than partial PTSD. CONCLUSION: PTSD symptoms are common in a substantial minority of older veterans in primary care, and careful inquiry about these symptoms is important for comprehensive assessment in geriatric populations.",0,0 +3579,Trajectories of Attachment Insecurities Over a 17-Year Period: A Latent Growth Curve Analysis of the Impact of War Captivity and Posttraumatic Stress Disorder,"In this study, we assessed the 17-year trajectories of attachment insecurities (anxiety and avoidance) and examined their relations to having been a prisoner of war and suffering from Posttraumatic Stress Disorder (PTSD). The sample included two groups of Israeli veterans from the 1973 Yom Kippur war: ex-prisoners of war and comparable control individuals who had not been held captive. They completed self-report measures of anxious and avoidant attachment and PTSD at three time points: 18, 30, and 35 years after the war. Ex-POWs were less secure with respect to attachment than the controls at the initial assessment, and although the controls experienced a decline in attachment insecurity over the 17-year period, the anxiety and avoidance scores of the ex-POWs increased over time. We also found that PTSD was associated with higher attachment insecurity scores at each time point, beyond the effect of war captivity. Implications of the findings for both attachment theory and the psychological effects of trau...",0,0 +3580,"Resource loss, resource gain, and psychological resilience and dysfunction following cancer diagnosis: A growth mixture modeling approach.","This study investigated trajectories of psychological distress and their relationships with change in psychosocial resources in the year following cancer diagnosis.Chinese colorectal cancer (CRC) patients (n = 234) were assessed within 12 weeks of diagnosis (T1) and again at 3-month (T2) and 12-month (T3) follow-ups. Growth mixture modeling was used to analyze the longitudinal data.Psychological distress was measured at the three time-points using Hospital Anxiety and Depression Scale (HADS).Growth mixture models identified four classes: chronic distress (7-9%), delayed distress (10-13%), recovery (13-16%), and resilient (65-67%). People in chronic distress were more likely to demonstrate loss in physical functioning and social relational quality than those in delayed distress, and loss in physical functioning, optimism, and hope than those in recovery, but more likely to demonstrate stability/gain in optimistic personalities than those in delayed distress and resilient. People in resilient were more likely to report stability/gain in optimistic personalities than those in delayed distress but not those in recovery.Understanding differential outcome trajectories and associated change in coping resources has implications for developing ongoing psychological services for cancer patients during the diagnosis and treatment process.",1,0 +3581,Novel Approach to the Role of NMDA Receptors in Traumatic Brain Injury,"For more than two decades the intensive research effort on the role of NMDA receptors (NMDAR) in traumatic brain injury (TBI) and cerebral ischemia (stroke) was led by the observations that extracellular concentrations of glutamate and aspartate are elevated after the insult and play a major role in brain pathologies. Indeed, NMDAR antagonists were shown to improve post-injury recovery in animal models and subsequently, large scale placebocontrolled clinical trials in TBI and stroke were performed with NMDAR antagonists. However, all these trials have demonstrated either no benefit or even deleterious effects. The discrepancy between the animal and human studies prompted us to investigate the temporal changes of the NMDAR after brain insult in TBI and stroke mouse models. We found that the early hyperactivation of the NMDAR is followed by loss of functional NMDAR which persists for weeks. Such dynamic changes could well explain the discrepancies between the preclinical and clinical experience as well as suggest alternative modes of treatment, namely, activation, rather than blockade of the NMDAR in the sub-acute period after TBI and stroke. Stimulation of the glycine modulatory site of the glycine/NMDAR by the partial agonist Dcycloserine (DCS) when given at least 24 hrs after TBI or stroke was shown to improve recovery of neurobehavioral and cognitive functions. It was also shown to restore impaired hippocampal Long-Term potentiation (LTP) and induce expression of Brain Derived-Neurotrophic Factor (BDNF) in a TBI model and to improve somatosensory and cognitive function in a stroke model. Experiments to optimize the DCS treatment paradigm showed that similar benefits were demonstrated in TBI mice whether the drug was given as a single injection at 24 or 72 hrs post injury, or as double (24 and 48 hrs) or triple (24, 48 and 72 hrs) doses. Interestingly, beneficial effects of DCS were reported in a range of animal models of human diseases as well as in several clinical indications thought to involve disruptions in NMDAR function, such as drug addiction, post-traumatic stress disorder, Parkinson's disease, aging and psychiatric disorders. As DCS has a good safety profile, and is already in use in humans in several different indications, and based on studies with DCS in the mouse TBI model, a multi-center prospective randomized controlled clinical trial, aiming to assess the effect of a single dose of DCS on cognitive outcome in patients with moderate TBI has recently begun.",0,0 +3582,Degree of exposure and peritraumatic dissociation as determinants of PTSD symptoms in the aftermath of the Ghislenghien gas explosion,"This paper investigates risk factors for the development of posttraumatic stress symptoms in the different survivor groups involved in a technological disaster in Ghislenghien (Belgium). A gas explosion instantly killed five firefighters, one police officer and 18 other people. Moreover, 132 people were wounded among which many suffered severe burn injuries.In the framework of a large health survey of people potentially involved in the disaster, data were collected from 3,448 households, of which 7,148 persons aged 15 years and older, at 5 months (T1) and at 14 months (T2) after the explosion. Hierarchical regression was used to determine the significant predictors and to assess their proportion in variance accounted for.The degree of exposure to the disaster was a predictor of the severity of posttraumatic stress symptoms. Peritraumatic dissociation appeared to be the most important predictor of the development of posttraumatic stress symptoms at T1. But at T2, posttraumatic stress symptoms at T1 had become the most important predictor. Dissatisfaction with social support was positively linked to development of posttraumatic stress symptoms at T1 and to the maintenance of these symptoms at T2. Survivors who received psychological help reported significant benefits.In harmony with the findings from studies on technological disasters, at T1 6,0% of the respondents showed sufficient symptoms to meet all criteria for a full PTSD. At T2, 6,6% still suffered from posttraumatic stress symptoms. The symptoms of the different victim categories clearly indicated the influence of the degree of exposure on the development of posttraumatic stress symptoms. Problems inherent to retrospective scientific research after a disaster are discussed.",0,0 +3583,The Role of Emotion in PTSD: Two Preliminary Studies,"Background: Two studies are presented that highlight the role of emotion in PTSD in which we examine what emotions in addition to anxiety may be present. Aims: The first aim was to assess the overall emotion profile across the five basic emotions of anxiety, sadness, anger, disgust, and happiness in clients attending a stress clinic. A small pilot study was also carried out to see how the emotion profiles impacted on outcome for CBT. Method: In Study 1, 75 consecutive attenders at a trauma service who were diagnosed with PTSD were assessed with a number of measures that included the Basic Emotions Scale. Results: The results showed that less than 50% of PTSD cases presented with anxiety as the primary emotion, with the remainder showing primary emotions of sadness, anger, or disgust rather than anxiety. A second pilot study involved the follow-up across exposure-based CBT of 20 of the participants from Study 1. Conclusions: The results suggest that anxiety-based PTSD is more likely to benefit from exposure than is non-anxiety based PTSD. Implications both for the classification and the treatment of PTSD are considered.",0,0 +3584,"The association between post-traumatic stress-related symptoms, resilience, current stress and past exposure to violence: a cross sectional study of the survival of Quechua women in the aftermath of the Peruvian armed conflict","BackgroundThe long lasting resilience of individuals and communities affected by mass violence has not been given equal prominence as their suffering. This has often led to psychosocial interventions in post-conflict zones being unresponsive to local realities and ill-equipped to foster local strengths. Responding to the renewed interest in resilience in the field of violence and health, this study examines the resilience and post-traumatic responses of Indigenous Quechua women in the aftermath of the political violence in Peru (1980–2000).MethodsA cross-sectional study examined the relationship between resilience, post-traumatic responses, exposure to violence during the conflict and current life stress on 151 Quechua women participants. Purposive and convenience sampling strategies were used for recruitment in Ayacucho, the area most exposed to violence. The study instruments were translated to Quechua and Spanish and cross-culturally validated. Data was analyzed using hierarchical regression analysis. A locally informed trauma questionnaire of local idioms of distress was also included in the analysis.FindingsSixty percent of women (n = 91) were recruited from Ayacucho city and the rest from three rural villages; the mean age was 45 years old. Despite high levels of exposure to violence, only 9.3% of the sample presented a level of symptoms that indicated possible PTSD. Resilience did not contribute to the overall variance of post-traumatic stress related symptoms, which was predicted by past exposure to violence, current life stress, age, and schooling (R2 = .421). Resilience contributed instead to the variance of avoidance symptoms (Stand β = −.198, t = −2.595, p = 0.010) while not for re-experiencing or arousal symptoms.ConclusionsThese findings identified some of the pathways in which resilience and post-traumatic responses interrelate in the aftermath of violence; yet, they also point to the complexity of their relationship, which is not fully explained by linear associations, requiring further examination. Age and gender-sensitive health care is considered critical almost fifteen years after the end of the conflict. The notable resilience of Quechua women—despite exposure to a continuum of violence and social inequalities—also calls for enhanced recognition of women not only as victims of violence but also as complex social actors in the reconstruction of post-conflict societies.",0,0 +3585,The Relationship Between Dating Violence and Psychosocial Problems in a Sample of Adolescent Pregnancy Termination Patients,"The relationship between dating violence and 13 psychosocial problems, conceptually organized into three symptom clusters--depressive, family problem, and posttraumatic stress--was investigated in a sample of adolescent pregnancy termination patients, ages 14 to 21. Results of a multivariate multiple-regression analysis indicated that, after controlling for age, ethnicity, general aggression problems, and problems with peers, dating violence was significantly related with the symptoms clusters. At the univariate level, the results suggested that dating violence was significantly related with self-esteem problems, guilt, and suicidal thinking from the depressive symptoms cluster and with guilt and stress from the posttraumatic stress cluster. The implications of these findings are discussed.",0,0 +3586,Imagery rehearsal therapy: An emerging treatment for posttraumatic nightmares in veterans.,"Nightmares are a common complaint among service members exposed to traumatic events, but prevailing paradigms are disposed to a view that nightmares are a secondary phenomenon untreatable with direct therapeutic intervention. Imagery rehearsal therapy is a cognitive-imagery approach with proven efficacy in the treatment of nightmares in civilian trauma victims. Imagery rehearsal therapy not only has potential to reduce nightmare intensity and frequency, but controlled studies show clinically meaningful decreases in all clusters of posttraumatic stress disorder symptoms as well as insomnia. Limited data support its use with combat veterans. Directions for future research with combat veterans are recommended. © 2010 American Psychological Association.",0,0 +3587,A systematic review of the comorbidity between PTSD and alcohol misuse,"Purpose This systematic review aimed to assess (1) the level of comorbidity of post-traumatic stress disorder (PTSD) and alcohol misuse reported in research studies since 2007 and (2) any associations found between specific PTSD symptom clusters and alcohol misuse. Methods A literature search was carried out to capture any papers published from 2007 to the end of July 2012. Six hundred and twenty abstracts were identified and reviewed, and 42 papers were included in the final review after applying inclusion and exclusion criteria. Results The prevalence of comorbid alcohol misuse in those with PTSD ranged from 9.8 to 61.3 %. The prevalence of comorbid PTSD in those with alcohol misuse ranged from 2.0 to 63.0 %, and the majority of prevalence rates were over 10.0 %. Almost all of the odds ratios representing the strength of association between the conditions across a variety of populations were significant, and those ranged from 1.1 to 4.87. Of the different PTSD symptom clusters, this review found most evidence for associations between alcohol misuse and both avoidance/numbing symptoms and hyperarousal symptoms. Conclusions Given that comorbidity appears to be common, the evidence from this systematic review supports the use of routine screening for comorbidity in populations who are known to have PTSD or alcohol misuse. © 2014 Springer-Verlag Berlin Heidelberg.",0,0 +3588,Acute Stress Disorder Symptoms Predict All-Cause Mortality Among Myocardial Infarction Patients: a 15-Year Longitudinal Study,"Studies have recognized myocardial infarction (MI) as a risk for acute stress disorder (ASD), manifested in dissociative, intrusive, avoidant, and hyperarousal symptoms during hospitalization.This study examined the prognostic role of ASD symptoms in predicting all-cause mortality in MI patients over a period of 15 years.One hundred and ninety-three MI patients filled out questionnaires assessing ASD symptoms during hospitalization. Risk factors and cardiac prognostic measures were collected from patients' hospital records. All-cause mortality was longitudinally assessed, with an endpoint of 15 years after the MI.Of the participants, 21.8 % died during the follow-up period. The decedents had reported higher levels of ASD symptoms during hospitalization than had the survivors, but this effect became nonsignificant when adjusting for age, sex, education, left ventricular ejection fraction, and depression. A series of analyses conducted on each of the ASD symptom clusters separately indicated that-after adjusting for age, sex, education, left ventricular ejection fraction, and depression-dissociative symptoms significantly predicted all-cause mortality, indicating that the higher the level of in-hospital dissociative symptoms, the shorter the MI patients' survival time.These findings suggest that in-hospital dissociative symptoms should be considered in the risk stratification of MI patients.",0,0 +3589,A Systematic Review of Resilience in the Physically Ill,"Resilience is the capacity of individuals to maintain, or regain, their mental health in the face of significant adversity, including physical illness.We conducted a systematic review of resilience and related concepts in the physically ill to determine factors associated with predicting or promoting resilience.An electronic search of PsychInfo, Medline, and CINAHL databases between 1950 and May 2009 was performed using the terms resilience, and various types of physical illnesses. Inclusion criteria were broad and exclusion criteria were not published in English or not focused on resilience in physical illness.A total of 475 articles were retrieved and 52 articles met inclusion/exclusion criteria. Psychological factors associated with resilience were self-efficacy, self-esteem, internal locus of control, optimism, mastery, hardiness, hope, self-empowerment, acceptance of illness, and determination. Social support was highly predictive of, and associated with, resilience. Coping strategies such as positive cognitive appraisal, spirituality, active coping, and mastery were also associated with resilience. Resilience factors directly salient to physical illness such as self-care, adherence to treatment, health related quality of life, illness perception, pain perception, exercise adherence, and physical outcomes were also found.These findings need to be considered and when appropriate incorporated into the psychological and psychiatric care of physically ill individuals.",0,0 +3590,Antidepressant treatment of posttraumatic stress disorder.,"Recent large double-blind, placebo-controlled trials have indicated that sertraline is an effective and well-tolerated treatment for posttraumatic stress disorder (PTSD). The avoidance/numbing symptom cluster improved the most significantly with sertraline, but significant improvements were also noted for the intrusive/reexperiencing and arousal symptom clusters. Smaller double-blind, placebo-controlled trials have also indicated that fluoxetine is an effective treatment for PTSD. Multiple small, open studies with other selective serotonin reuptake inhibitors and newer antidepressants indicate that these medications show some promise. Older studies indicate some efficacy for tricyclic antidepressants, and monoamine oxidase inhibitors are a reasonable choice, particularly for intrusive/reexperiencing symptoms.",0,0 +3591,Posttraumatic stress disorder and posttraumatic growth among Israeli ex-pows,"In this article, the authors present a prospective study that dealt with pathological (posttraumatic stress disorder; PTSD) and salutary (posttraumatic growth; PTG) outcomes of captivity and the correlates of those outcomes among a sample of ex-prisoners of war (POWs) and a control group of combat veterans. Posttraumatic stress disorder and its correlates were assessed in 1991 and 2003, and PTG was assessed in 2003. The results indicate that ex-POWs exhibited higher levels of PTSD and PTG than did the controls. In addition, both linear and quadratic associations between PTSD and PTG were found. The authors discuss some unresolved issues related to assessment of PTG and salutary outcomes, and outline directions for future research.",0,0 +3592,"Inflammatory markers in post-traumatic stress disorder: a systematic review, meta-analysis, and meta-regression","Studies investigating inflammatory markers in post-traumatic stress disorder (PTSD) have yielded mixed results. The aim of our study was to compare concentrations of inflammatory markers in patients with PTSD compared with healthy controls.We did a meta-analysis and meta-regression of studies comparing inflammatory markers between patients with PTSD and healthy controls by searching PubMed, Embase, Scopus, Web of Science, and PsycINFO for articles published between Jan 1, 1960, and April 7, 2015. From eligible studies (ie, cross-sectional studies or baseline data from longitudinal studies of peripheral blood cytokine concentrations that compared adults with PTSD with healthy controls), we extracted outcomes of interest, such as mean and SD of peripheral blood cytokines, the time of day blood was collected, whether the study allowed patients with comorbid major depressive disorder in the PTSD group, whether patients were medication free, and severity of PTSD symptoms. We undertook meta-analyses whenever values of inflammatory markers were available in two or more studies. A random-effects model with restricted maximum-likelihood estimator was used to synthesise the effect size (assessed by standardised mean difference [SMD]) across studies.8057 abstracts were identified and 20 studies were included. Interleukin 6 (SMD 0.88; p=0.0003), interleukin 1β (SMD 1.42; p=0.045), and interferon γ (SMD 0.49; p=0.002) levels were higher in the PTSD group than in healthy controls. Subgroup meta-analysis of patients who were not given medication showed higher tumour necrosis factor α (TNFα; SMD 0.69, 95% CI 0.35-1.02; p<0.0001) in the PTSD group than the control group in addition to the aforementioned cytokines. TNFα (SMD 1.32, 0.13-2.50; p=0.003), interleukin 1β (SMD 2.35, 0.01-4.68; p=0.048), and interleukin 6 (SMD 1.75, 0.97-2.53; p<0.0001) levels remained increased in the PTSD group in a subgroup meta-analysis of studies that excluded comorbid major depressive disorder. Illness duration was positively associated with interleukin 1β levels (b=0.33, p<0.0001) and severity with interleukin 6 (b=0.02, p=0.042). A model composed of several variables-presence of comorbid major depressive disorder, use of psychotropic medications, assay used, and time of day blood was collected-explained the large amount of heterogeneity between interleukin 1β, interleukin 6, and C-reactive protein studies. Egger's linear regression test revealed a potential publication bias for interleukin 1β. Additionally, for most inflammatory markers, study heterogeneity was reported to be high (I(2)>75%).PTSD is associated with increased interleukin 6, interleukin 1β, TNFα, and interferon γ levels. This information might be useful for consideration of chronic low-grade inflammation as a potential target or biomarker in PTSD treatment. Use of psychotropic medication and presence of comorbid major depressive disorder were important moderators that might explain the inconsistency between results of previous studies. Our search strategy used a range of databases and we made exhaustive effort to acquire data by contacting the authors. Notably, high levels of between-study heterogeneity were recorded for most cytokine variables measured in our analysis. However, meta-regression analysis could explain a large amount of this heterogeneity.None.",0,0 +3593,Pressure Pain Threshold Testing Demonstrates Predictive Ability in People With Acute Whiplash,"Longitudinal cohort study.To determine whether pressure pain threshold (PPT), tested at 2 standardized sites, could provide additional prognostic ability to predict short-term outcomes in people with acute whiplash, after controlling for age, sex, and baseline pain intensity.PPT may be a valuable assessment and prognostic indicator for people with whiplash-associated disorder. The extent to which PPT can predict short-term disability scores has yet to be explored in people with acute (of less than 30 days in duration) whiplash-associated disorder in a clinical setting.Eligible patients were recruited from community-based physiotherapy clinics in Canada. Baseline measurements included PPT, as well as pain intensity, age, and sex. Neck-related disability was collected with the Neck Disability Index 1 to 3 months after PPT testing. Multiple linear regression models were constructed to evaluate the unique contribution of PPT in the prediction of follow-up disability scores.A total of 45 subjects provided complete data. A regression model that included sex, baseline pain intensity, and PPT at the distal tibialis anterior site was the most parsimonious model for predicting short-term Neck Disability Index scores 1 to 3 months after PPT testing, explaining 38.6% of the variance in outcome. None of the other variables significantly improved the predictive power of the model.Sex, pain intensity, and PPT measured at a site distal to the injury were the most parsimonious set of predictors of short-term neck-related disability score, and represented promising additions to assessment of traumatic neck pain. Neither age nor PPT at the local site was able to explain significant variance beyond those 3 predictors. Limitations to interpretation are addressed.",0,0 +3594,Catecholamine responses to virtual combat: implications for post-traumatic stress and dimensions of functioning,"Posttraumatic stress disorder (PTSD) symptoms can result in functional impairment among service members (SMs), even in those without a clinical diagnosis. The variability in outcomes may be related to underlying catecholamine mechanisms. Individuals with PTSD tend to have elevated basal catecholamine levels, though less is known regarding catecholamine responses to trauma-related stimuli. We assessed whether catecholamine responses to a virtual combat environment impact the relationship between PTSD symptom clusters and elements of functioning. Eighty-seven clinically healthy SMs, within 2 months after deployment to Iraq or Afghanistan, completed self-report measures, viewed virtual-reality (VR) combat sequences, and had sequential blood draws. Norepinephrine responses to VR combat exposure moderated the relationship between avoidance symptoms and scales of functioning including physical functioning, physical-role functioning, and vitality. Among those with high levels of avoidance, norepinephrine change was inversely associated with functional status, whereas a positive correlation was observed for those with low levels of avoidance. Our findings represent a novel use of a virtual environment to display combat-related stimuli to returning SMs to elucidate mind-body connections inherent in their responses. The insight gained improves our understanding of post-deployment symptoms and quality of life in SMs and may facilitate enhancements in treatment. Further research is needed to validate these findings in other populations and to define the implications for treatment effectiveness.",0,0 +3595,Professional Quality of Life and Clinical Competencies among Korean Nurses,"Clinical competence among nurses is an essential requirement for the provision of safe and effective patient care. This study aims to classify types of professional quality of life experienced by Korean nurses, and examine the relationship between demographic and professional characteristics and clinical competence among nurses experiencing each type.A total of 335 nurses completed questionnaires assessing professional quality of life, clinical competence, and demographic and professional characteristics. Following identification of the underlying factors of professional quality of life, we classified participants into three clusters.There were significant differences in age, marital status, religion, educational status, and position between clusters. Results also revealed that nurses with high compassion satisfaction and low compassion fatigue (burnout, secondary traumatic stress) tended to have higher clinical competence.This study demonstrated that it is possible to directly examine the relationship between professional quality of life level and clinical competence among nurses. Thus, interventions to increase nurses' compassion satisfaction and relieve compassion fatigue are needed, as professional quality of life may affect clinical competence.",0,0 +3596,Pharmacotherapy for post-traumatic stress disorder - a systematic review and meta-analysis.,"Post-traumatic stress disorder (PTSD) is a prevalent and disabling condition. Evidence that PTSD is characterized by specific psychobiological dysfunctions has contributed to a growing interest in use of medication in its treatment.To assess the effects of medication in the treatment of PTSD.Systematic review of randomised controlled trials (RCTs) following the Cochrane Collaboration guidelines. A more detailed version of the review is published in the Cochrane Database of Systematic Reviews.We searched the Cochrane Depression, Anxiety and Neurosis Group specialised register, the Cochrane Central Register of Controlled Trials (Cochrane Library issue 4, 2004), MEDLINE (January 1966 - December 2004), PsycINFO (1966 - 2004), the National PTSD Center Pilots database, and the meta register module of the Controlled Trials database. Reference lists of retrieved articles were searched for additional studies. Two raters independently assessed RCTs for inclusion in the review, collated trial data, and assessed trial quality. Investigators were contacted to obtain missing data. Summary statistics were stratified by medication class, and by medication agent for the selective serotonin re-uptake inhibitors (SSRIs). Dichotomous and continuous measures were calculated using a random effects model, heterogeneity was assessed, and subgroup/sensitivity analyses were done.Thirty-five short-term (14 weeks or less) RCTs were included in the analysis (4 597 participants). Symptom severity for 17 trials was significantly reduced in the medication groups, relative to placebo (weighted mean difference (WMD) = -5.76, 95% confidence interval (CI)-8.16 - -3.36, N = 2 507). Similarly, summary statistics for responder status from 13 trials demonstrated overall superiority of a variety of medication agents compared with placebo (relative risk (RR) = 1.49, 95% CI: 1.28, 1.73, number needed to treat (NNT) = 4.85, N = 1 272). Medication and placebo response occurred in 59.1% (N = 644) and 38.5% (N = 628) of patients, respectively. Of the medication classes, evidence of treatment efficacy was most convincing for the SSRIs. Medication was also effective in reducing the severity of the PTSD re-experiencing/intrusion, avoidance/numbing, and hyperarousal symptom clusters in 9 trials (N = 1 304). In addition, medication was superior to placebo in reducing comorbid depression and disability. Medication was also less well tolerated than placebo. A narrative review of the 3 maintenance trials suggested that long-term medication may be required in treating PTSD.Medication treatments can be effective in treating PTSD, acting to reduce its core symptoms, as well as associated depression and disability, and should be considered as part of the treatment of this disorder. The findings of this review support the status of SSRIs as first-line agents in the pharmacotherapy of PTSD, as well as their value in longterm treatment. However, there remain important gaps in the evidence base, and there is a continued need for more effective agents in the management of PTSD.",0,0 +3597,Resilience in developmental psychopathology: Contributions of the Project Competence Longitudinal Study,"Abstract Contributions of the Project Competence Longitudinal Study (PCLS) to resilience science and developmental psychopathology are highlighted in this article. Initiated by Norman Garmezy, the PCLS contributed models, measures, and methods, as well as working definitions of concepts like competence, developmental tasks, protective factors, and resilience. Findings from the study corroborated the feasibility of studying adaptation in a normative group of school children, identifying patterns of resilience, competence without major adversity, and maladaptive paths through life. Competence was multidimensional, showing continuity and change over time. Cascading effects across domains indicated that competence and problems spread over time. Thus, adult achievements in developmental tasks were rooted in childhood and adolescence. Young people who showed resilience had much in common with similarly successful peers who experienced less adversity over time, including high-quality relationships with parents and other adults, and good cognitive, as well as social–emotional, skills. Maladaptive youth in the study often faced high adversity with little adaptive capacity (internal or external) and tended to generate stressful experiences. Resilience often emerged in childhood and endured, but there also were late bloomers whose lives turned around in the transition to adulthood. The role of collaboration and mentorship in the PCLS is also discussed.",0,0 +3598,Profile of psychiatric patients presenting to a tertiary care emergency department of Karachi.,"This study reviewed the presentations of psychiatric patients admitted through the Emergency Department (ED), The Aga Khan University Hospital, Karachi. Psychiatric patients admitted through the ED to the psychiatry ward were compared to those admitted through the same units other than the psychiatry ward, from 2006 to 2010 using medical records. Psychiatric patients were defined as those in whom psychiatry consult was generated and 1127 cases were included in study. There were 550 (48.8%) female patients. Most common presentations in the ED were sleep-related problems (n=205, 15.9%) followed by aggressive behavior (n=191, 14.8%). Depression was the most common diagnosis made in the ED (n=331, 29.3%) and at the time of discharge from the hospital (n=354, 29.5%). Psychiatric patients presenting to the ED had signs and symptoms which one generally disregards. However, these minor indicators can lead to major events in a patient's life.",0,0 +3599,Post-traumatic stress disorder in Asian refugees,"This study profiles 127 cases of Vietnamese, Cambodian, Laotian and Chinese refugee outpatients diagnosed with post-traumatic stress disorder (PTSD). Traumatic etiologies included victims of wars such as political refugees, concentration camp prisoners and victims of rape, severe personal losses (property or human lives). These traumata were experienced by our subjects during the period between the end of the Vietnam war in April 1975 and recent times, when they finally arrived in the USA. Clinical symptoms of these subjects reflected many influences of their oriental culture background and are characterized by internalization that needs to be overcome for assessment as well as for therapy. Symptomatic treatment with psychopharmacology and supportive therapy are helpful while cultural approaches have been adopted by many patients to reach the inner self pathology that could be of both mental and organic in nature. These facts need to be taken into consideration in the future description of the PTSD clinical picture. Recommendations are made for future PTSD studies in Vietnam, Cambodia and Laos, and to promote a global movement for prevention of any socio-political situation that may generate PTSD.",0,0 +3600,Thiol supplementation in aged animals alters antioxidant enzyme activity after heat stress,"Declines in oxidative and thermal stress tolerance are well documented in aging systems. It is thought that these alterations are due in part to reductions in antioxidant defenses. Although intracellular thiols are major redox buffers, their role in maintaining redox homeostasis is not completely understood, particularly during aging, where the reliance on antioxidant enzymes and proteins may be altered. To determine whether thiol supplementation improved the antioxidant enzyme profile of aged animals after heat stress, young and old Fischer 344 rats were treated with N-acetylcysteine (NAC; 4 mmol/kg ip) 2 h before heat stress. Liver tissue was collected before and 0, 30, and 60 min after heat stress. Aging was associated with a significant decline in tissue cysteine and glutathione (GSH) levels. There was also an age-related decrease in copper-zinc superoxide dismutase activity. Heat stress did not alter liver GSH, glutathione disulfide, or antioxidant enzyme activity. With NAC treatment, old animals took up more cysteine than young animals as reflected in an increase in liver GSH and a corresponding decrease in glutamate cysteine ligase activity. Catalase activity increased after NAC treatment in both age groups. Copper-zinc superoxide dismutase activity did not change with heat stress or drug treatment, whereas manganese superoxide dismutase activity was increased in old animals only. These data indicate that GSH synthesis is substrate limited in old animals. Furthermore, aged animals were characterized by large fluctuations in antioxidant enzyme balance after NAC treatment, suggesting a lack of fine control over these enzymes that may leave aged animals susceptible to subsequent stress.",0,0 +3601,Pain and quality of life 1 year after admission to the emergency department: factors associated with pain,"Objectives: This study describes the prevalence of pain in trauma patients 1 year after hospital admission and investigates separately health-related quality of life (QoL) for patients suffering severe pain and for those without pain. Moreover, psychosocial factors are examined for their impact on pain. Methods: Patients were contacted 12 months after admission in order to complete the following questionnaires: Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), Trauma Outcome Profile (TOP), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Impact of Event Scale-Revised (IES-R) and additional questions concerning satisfaction, work and financial status. Relevant pain at follow-up was defined as <80 points on the pain subscale of the TOP. Results: Two hundred and twenty patients were included. The Injury Severity Score (ISS) ranged from 1 to 41. Fifty-three percent (53 %) of patients suffered a severe trauma (ISS > 15). One year after injury, 55 % of patients had relevant pain according to the TOP. Patients with pain were older (41.4 vs. 34.4 years, p = 0.003) and had slightly more severe injuries (ISS 17.1 vs. 14.9, p = 0.115). There were significant differences between pain and no-pain patients on all domains of QoL (p < 0.001) and on the BDI, STAI and IES-R (p < 0.001). Pain patients more often experienced a stressful event and job-related and financial difficulties. Multivariate logistic regression analysis revealed post-traumatic stress disorder (PTSD) as the strongest predictor for pain [odds ratio (OR): 4.38, p = 0.015], followed by a stressful life event (OR: 4.08, p = 0.001). Discussion: Pain is strongly associated with psychosocial complaints 1 year after trauma. For the treatment of pain following a traumatic event, social reintegration and emotional regulation by means of occupational rehabilitation and psychotherapy should receive more attention. © 2013 Springer-Verlag Berlin Heidelberg.",0,0 +3602,Analysis of prevalence of PTSD and its influencing factors among college students after the Wenchuan earthquake,"Abstract Background This study explored the prevalence and severity of post-traumatic stress disorder (PTSD) in college students who lived in earthquake center one year after the Wenchuan earthquake on May 12, 2008, the factors affecting the prevalence of PTSD was also investigated. Methods 2987 students studying at the senior normal school in Tibetan autonomous region which was one of the most devastated regions were selected for this study. The PTSD Checklist-Civilian Version (PCL-C) was used as a screening instrument. Results A total of 420 cases (14.1%) were diagnosed with PTSD, among which mild, moderate, severe and extreme symptoms were reported in 122, 185, 106 and 7 cases, respectively. The PTSD prevalence in college students lived in the severely affected area was significantly higher than that in the less severe area (P < 0.001). According to the multivariate logistic regression analysis, the students who were injured in the earthquake, those lost their first degree relative, and those confronted with dead bodies were more likely to express PTSD. Male students were more prone than female students to develop PTSD. However, the students who received psychological tutorship were less prone to express PTSD. Conclusions At one year after the earthquake, the PTSD rate in college students in the severely affected area was high. The social support, psychological help and rehabilitation project should be strengthened to improve their ability to cope with the trauma.",0,0 +3603,Posttraumatic stress after a motor vehicle accident: A six-month follow-up study utilizing latent growth modeling,"Features of posttraumatic stress disorder (PTSD) for 596 survivors of motor vehicle accidents were examined by self-report measures at 1 week, 1 month, 3 months, and 6 months after the motor vehicle accident (MVA). Latent growth modeling was utilized to study the trend and predictors of the level of distress. Results indicated that 5-20% of the participants reported to have a significant level of posttraumatic stress in one, two, or three of the PTSD symptom clusters within the period studied. Survivors with significant acute stress 1 week after the MVA had a higher risk for developing chronic posttraumatic stress. Although the severity of intrusive and hyperarousal symptoms decreased over time, the severity of avoidance symptoms remained unchanged. Factors predicting the course of PTSD after an MVA are identified.",0,0 +3604,Varenicline for tobacco dependence: panacea or plight?,"This review examines the postmarketing experience with varenicline, including case reports, newer clinical trials and secondary analyses of large clinical datasets.Varenicline has been shown to be an effective treatment in a broad range of tobacco users with medical, behavioral and diverse demographic characteristics. Recent studies finding excellent safety and efficacy in groups of smokers with diseases including chronic obstructive pulmonary disease are particularly encouraging and call for increased use of this medication for smoking cessation. Despite case reports of serious neuropsychiatric symptoms in patients taking varenicline, including changes in behavior and mood, causality has not been established. Recent analyses of large datasets from clinical trials have not demonstrated that varenicline is associated with more depression or suicidality than other treatments for smoking cessation.Now that additional clinical trials in specific populations and observational studies on treatment-seeking smokers outside of clinical trials have been published, we can be confident that varenicline remains the most efficacious monotherapy for smoking cessation and that its side-effect profile remains good. The risk-to-benefit ratio of receiving varenicline to quit smoking must include the increased chances of quitting smoking and avoiding the sizeable risks of smoked-caused disease and death that remain if tobacco addiction is not properly treated.",0,0 +3605,APA's resilience initiative.,"Resilience is the human ability to adapt in the face of tragedy, trauma, adversity, hardship, and ongoing significant life stressors. Focus groups conducted by the APA Practice Directorate after the terrorist attacks of September 11, 2001, found people to be experiencing a chronic sense of stress and uncertainty for which they wanted to be more resilient. In response, APA launched its public education campaign, “The Road to Resilience,” in August 2002. A key component of the campaign is community outreach by psychologists, in which psychologists around the country bring information about resilience directly into their communities. This has allowed psychologists to help their communities and to help communities better understand the value of psychology.",0,0 +3606,The role of high-density lipoprotein cholesterol in risk for posttraumatic stress disorder: Taking a nutritional approach toward universal prevention,"Abstract Several cross-sectional studies, but no prospective studies, have reported an association between an abnormal lipid profile and posttraumatic stress disorder (PTSD). We hypothesized that an abnormal lipid profile might predict risk for developing PTSD. In this prospective study, we analyzed data from 237 antidepressant-naïve severely injured patients who participated in the Tachikawa Cohort of Motor Vehicle Accident Study. High-density lipoprotein cholesterol (HDL-C) levels at baseline were significantly lower in patients with PTSD than those without PTSD at 6 months after motor vehicle accident (MVA) and were inversely associated with risk for PTSD. In contrast, triglycerides (TG) at baseline were significantly higher in patients with PTSD than in those without PTSD at 6 months post-MVA and were positively associated with risk for PTSD. There was no clear association between low-density lipoprotein cholesterol or total cholesterol and risk for PTSD. In conclusion, low HDL-C and high TG may be risk factors for PTSD. Determining lipid profiles might help identify those at risk for PTSD after experiencing trauma.",0,0 +3607,The Moderating Role of Distress Tolerance in the Relationship Between Posttraumatic Stress Disorder Symptom Clusters and Suicidal Behavior Among Trauma Exposed Substance Users in Residential Treatment,"The co-occurrence of posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) is associated with greater risk for suicidal behavior than either disorder alone. Research highlights the relevance of PTSD symptoms in particular to suicide risk within this population. Research has also provided support for an association between distress tolerance (DT) and both PTSD symptoms and suicidal behavior. This study examined the role of DT in the relationship between PTSD symptom severity and suicidal behavior in a sample of 164 SUD inpatients with a history of Criterion A traumatic exposure. Results indicated that DT moderated the relationship between PTSD symptoms (overall, re-experiencing, and hyperarousal) and medically attended suicide attempts, with the magnitude of the relationship increasing at higher levels of DT.",0,0 +3608,Reductions in traumatic stress following a coping intervention were mediated by decreases in avoidant coping for people living with HIV/AIDS and childhood sexual abuse.,"To examine whether (a) Living in the Face of Trauma (LIFT), a group intervention to address coping with HIV and childhood sexual abuse (CSA), significantly reduced traumatic stress over a 1-year follow-up period more than an attention-matched support group comparison intervention; and (b) reductions in avoidant coping over time mediated reductions in traumatic stress.In a randomized controlled trial, 247 participants completed measures of traumatic stress and avoidant coping at pre- and post intervention, and at 4-, 8-, and 12-month follow-ups. Latent growth curve modeling examined changes over the 5 time points; standardized path coefficients provide estimates of effects.As compared with the support intervention, the coping intervention led to a reduction in traumatic stress over time (b = -.20, p < .02). Participants in the coping intervention also reduced their use of avoidant coping strategies more than did participants in the support intervention (b = -.22, p < .05). Mediation analyses showed reductions in avoidant coping related to reductions in traumatic stress (b = 1.45, p < .001), and the direct effect of the intervention on traumatic stress was no longer significant (b = .04, ns), suggesting that changes in avoidant coping completely mediated intervention effects on traumatic stress.The LIFT intervention significantly reduced traumatic stress over time, and changes in avoidant coping strategies mediated this effect, suggesting a focus on current stressors and coping skills improvement are important components in addressing traumatic stress for adults living with HIV and CSA.",0,0 +3609,"Associations Between Prolonged Grief Disorder, Depression, Posttraumatic Stress Disorder, and Anxiety in Rwandan Genocide Survivors","A number of studies have demonstrated that symptoms of prolonged grief disorder (PGD) represent a symptom cluster distinct from bereavement-related depression, anxiety, and posttraumatic stress disorder (PTSD). The aim of the present study was to confirm and extend these findings using the most recent criteria defining PGD. The authors interviewed a total of 400 orphaned or widowed survivors of the Rwandan genocide. The syndromes were strongly linked to each other with a high comorbidity. Principal axis factoring resulted in the emergence of 4 different factors. The symptoms of depression, along with the cognitive, emotional, and behavioral symptoms of PGD, loaded on the first factor, symptoms of anxiety on the second factor, symptoms of PTSD on the third factor, and the separation distress symptoms of PGD on the fourth factor. This indicates that the concept of PGD includes symptoms that are conceptually related to depression. However, the symptom cluster of separation distress presents a grief-specific dimension that may surface unrelated to depressive symptoms.",0,0 +3610,The use of antidepressant drugs in dermatology.,"This paper provides an updated review of the use of antidepressant drugs in dermatology. Some of the psychiatric disorders that are usually comorbid with dermatological disorders and respond to antidepressants include major depressive disorder, obsessive compulsive disorder, body dysmorphic disorder, social phobia and post-traumatic stress disorder usually secondary to trauma and abuse during early life. Cutaneous symptoms may be the feature of a primary psychiatric disorder, e.g. cutaneous body image problems, dermatitis artefacta, neurotic excoriations and trichotillomania, or psychiatric syndromes may be comorbid with a primary dermatological disorder such as the association of major depressive disorder or social phobia with psoriasis and obsessive compulsive disorder with acne excoriee. Some of the salient pharmacological properties of the tricyclic antidepressants (TCAs) and the selective serotonin reuptake inhibitor (SSRI) antidepressants are reviewed. The review indicates that the SSRI antidepressants are potentially beneficial in the management of all the major psychiatric syndromes that are encountered in dermatological disorders. The generally more favourable side-effect profile of the SSRIs, such as lower cardiotoxicity in contrast to the TCAs, has made them the first-line agents for the treatment of depression. Furthermore, some of the pharmacological properties of the antidepressant agents that are not related to their antidepressant activity, such as the histamine H1 blocking effect of TCAs, such as doxepin, amitriptyline and trimipramine, are of benefit in dermatological conditions such as urticaria and pruritus. This paper reviews the general guidelines for use of antidepressants and salient drug-drug interactions resulting mainly from the inhibition of the cytochrome P450 (CYP) 2D6 and 3A3/4 isoenzymes by some of the SSRI antidepressants. Before prescribing an antidepressant agent, the specific guidelines, side-effect profile, drug-drug interactions and most current indications should always be obtained.",0,0 +3611,"Multisite Investigation of Traumatic Brain Injuries, Posttraumatic Stress Disorder, and Self-reported Health and Cognitive Impairments","Few large-scale, multisite investigations have assessed the development of posttraumatic stress disorder (PTSD) symptoms and health outcomes across the spectrum of patients with mild, moderate, and severe traumatic brain injury (TBI).To understand the risk of developing PTSD symptoms and to assess the impact of PTSD on the development of health and cognitive impairments across the full spectrum of TBI severity.Multisite US prospective cohort study.Eighteen level I trauma centers and 51 non-trauma center hospitals.A total of 3047 (weighted n = 10 372) survivors of multiple traumatic injuries between the ages of 18 and 84 years.Severity of TBI was categorized from chart-abstracted International Classification of Diseases, Ninth Revision, Clinical Modification codes. Symptoms consistent with a DSM-IV diagnosis of PTSD were assessed with the PTSD Checklist 12 months after injury. Self-reported outcome assessment included the 8 Medical Outcomes Study 36-Item Short Form Health Survey health status domains and a 4-item assessment of cognitive function at telephone interviews 3 and 12 months after injury.At the time of injury hospitalization, 20.5% of patients had severe TBI, 11.7% moderate TBI, 12.9% mild TBI, and 54.9% no TBI. Patients with severe (relative risk, 0.72; 95% confidence interval, 0.58-0.90) and moderate (0.63; 0.44-0.89) TBI, but not mild TBI (0.83; 0.61-1.13), demonstrated a significantly diminished risk of PTSD symptoms relative to patients without TBI. Across TBI categories, in adjusted analyses patients with PTSD demonstrated an increased risk of health status and cognitive impairments when compared with patients without PTSD.More severe TBI was associated with a diminished risk of PTSD. Regardless of TBI severity, injured patients with PTSD demonstrated the greatest impairments in self-reported health and cognitive function. Treatment programs for patients with the full spectrum of TBI severity should integrate intervention approaches targeting PTSD.",0,0 +3612,"Prevalence and trends of benzodiazepine use among Veterans Affairs patients with posttraumatic stress disorder, 2003–2010","Although the Veterans Affairs and Department of Defense (VA/DoD) clinical guidelines for management of posttraumatic stress disorder (PTSD) recommend against routine benzodiazepine use, little is known about the trends and clinical and prescription profiles of benzodiazepine use since these guidelines were released in 2004. This retrospective study included 64,872 patients with a PTSD diagnosis received from care at facilities in VA Northwest Veterans Integrated Service Network (VISN 20) during 2003–2010. Annual prevalence of any use was defined as any prescription for benzodiazepines, and long-term use was defined as >90 days’ supply, in a year. Gender-specific logistic regressions were fit to estimate any and long-term benzodiazepine use, test for linear trends over 8-years and explore factors associated with trends. The trend of age-adjusted benzodiazepine use over 8-years rose significantly from 25.0 to 26.8% among men and 31.2 to 38.8% among women. Long-term use in men and women increased from 15.4 to 16.4% and 18.0 to 22.7%, respectively. Comorbid psychiatric and alcohol use disorders (AUD) were associated with a greater increase in long-term use of benzodiazepines. In 2010, 61% of benzodiazepine users received >90 days’ supply. Among those prescribed benzodiazepines long-term, 11% had AUD and 47% were also prescribed opioids long-term. Despite VA/DoD clinical guidelines recommending against routine use of benzodiazepines for PTSD, the adjusted prevalence of long-term use increased among men and women with PTSD in VISN 20. Widespread concomitant use of benzodiazepines and opioids suggests risk management systems and research on the efficacy and safety of these medications are needed.",0,0 +3613,"The impact of the refugee decision on the trajectory of PTSD, anxiety, and depressive symptoms among asylum seekers: A longitudinal study","To examine prospectively the trajectory of trauma-related psychiatric symptoms and disability amongst asylum seekers over the course of the refugee determination process. To identify the direct impact of the refugee decision on psychiatric symptoms by adjusting for other variables, namely sociodemographic characteristics, past trauma, and ongoing postmigration stresses.A prospective cohort study of asylum seekers recruited from a random sample of immigration agents in Sydney, Australia.Consecutive asylum seekers were referred for interview by immigration agents. Interviews were undertaken after the initial application and on average, 3.8 months after the refugee decision.Measures assessed premigration trauma and postmigration stressors. Mental health status was assessed using the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist-25. Functional impairment was assessed with the Medical Outcomes Study-Short Form 12.Sixty-two of 73 asylum seekers were retained at follow-up. The accepted (16) and rejected (46) groups did not differ on premigration trauma or baseline psychiatric symptoms. Postdecision, the accepted group showed substantial improvements in posttraumatic stress disorder, anxiety, depression, and in mental health functioning, whereas the rejected group maintained high levels of symptoms on all psychiatric indices.Establishing secure residency status for asylum seekers may be important to their recovery from trauma-related psychiatric symptoms. The practical and theoretical implications are discussed.",0,0 +3614,"Gold mining on Mayan-Mam territory: Social unravelling, discord and distress in the Western highlands of Guatemala","This article examines the influence of a large-scale mining operation on the health of the community of San Miguel Ixtahuacán, Guatemala. An anti-colonial narrative approach informed by participatory action research principles was employed. Data collection included focus groups and one-on-one interviews from August to November of 2011. Over this period, we interviewed 15 Mam Mayan men and 41 women (n = 56) between the ages of 18 and 64 including health care workers, educators, spiritual leaders, agricultural workers and previous mine employees from 13 villages within the municipality. Participants' accounts pointed to community health experiences of social unravelling characterized by overlapping narratives of a climate of fear and discord and embodied expressions of distress. These findings reveal the interconnected mechanisms by which local mining operations influenced the health of the community, specifically, by introducing new threats to the safety and mental wellbeing of local residents.",0,0 +3615,"Factor Structure, Reliability, and Known Groups Validity of the German Version of the Childhood Trauma Questionnaire (Short-Form) in Swiss Patients and Nonpatients","The Childhood Trauma Questionnaire-Short Form is the most widely used instrument to assess childhood trauma and has been translated into 10 languages. However, research into validity and reliability of these translated versions is scarce. The present study aimed to investigate the factor structure, internal consistency, reliability, and known-groups validity of the German Childhood Trauma Questionnaire-Short Form (Bernstein & Fink, 1998). Six-hundred and sixty-one clinical and nonclinical participants completed the German Childhood Trauma Questionnaire-Short Form. A confirmatory factor analysis was conducted to assess the 5-factor structure of the original Childhood Trauma Questionnaire-Short Form. To investigate known-groups validity, the confirmatory factor analysis latent factor levels between clinical and nonclinical participants were compared. The original 5-factor structure was confirmed, with only the Physical Neglect scale showing rather poor fit. As a conclusion, the results support the validity and reliability of the German Childhood Trauma Questionnaire-Short Form. It is recommended to use the German Childhood Trauma Questionnaire-Short Form to assess experiences of childhood trauma.",0,0 +3616,A comparison of PTSD symptom patterns in three types of civilian trauma,"Posttraumatic stress disorder (PTSD) is assumed to be an equivalent syndrome regardless of the type of traumatic event that precipitated it. However, the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) and previous research suggest that the clinical presentation of PTSD varies by trauma type. This study compared PTSD symptom profiles in three types of civilian trauma: sexual assault (n = 86), motor vehicle accident (n = 162), and sudden loss of a loved one (n = 185). Groups differed in overall PTSD severity and displayed distinct PTSD symptom patterns. Results suggest that different trauma types lead to unique variants of the PTSD syndrome, which may result from different etiological factors and may require different treatment approaches.",0,0 +3617,Item order effects in the evaluation of posttraumatic stress disorder symptom structure.,"Factor analytic research has demonstrated consistently that the 3-factor DSM-IV model of posttraumatic stress disorder (PTSD) symptom structure provides a poorer fit than alternative 4- and 5-factor models. In the current study we examined whether order of item presentation accounts for these findings. In a large sample (N = 1,311) of trauma-exposed undergraduates we conducted a series of confirmatory factor analyses using the PTSD Checklist and Posttraumatic Stress Diagnostic Scale, which present symptom items in the same order as DSM-IV, and the Detailed Assessment of Posttraumatic Stress, which presents items in a different order. Across all 3 measures the 3-factor DSM-IV model provided a relatively worse fit and the 5-factor dysphoric arousal model provided a relatively better fit compared with other tested models. We also examined the distinctiveness of 2 pairs of symptom clusters that appear in the dysphoric arousal model--avoidance versus numbing and dysphoric arousal versus anxious arousal--by comparing their patterns of associations with external correlates. Avoidance and numbing demonstrated differential associations with external correlates, as did dysphoric arousal and anxious arousal. Taken together, results indicate that order effects are unlikely to account for differences in relative fit between leading models of PTSD symptom structure. We discuss the need for future research in this area, especially studies designed to evaluate order effects more directly.",0,0 +3618,On the viability of PTSD Checklist (PCL) short form use: Analyses from Mississippi Gulf Coast Hurricane Katrina survivors.,"One measure commonly used to assess posttraumatic stress disorder is the PTSD Checklist (PCL). Lang and Stein (2005) extracted 4 subsets of PCL items, validating 2 of them for possible use in screening in primary care settings. The viability of the 4 item subsets was evaluated psychometrically in the present study with a sample of Hurricane Katrina survivors (N = 337). Corrected item-total and corrected item-cluster correlations were calculated and compared with those obtained by Lang and Stein. In addition, the sensitivity, specificity, and overall correct classification of the 4 item subsets were evaluated. With methodology approximating Lang and Stein's work, the current data would lead to the development of different screening versions of the PCL. Although some psychometric support was achieved (e.g., high sensitivity), use of the Lang and Stein PCL item subsets for screening natural disaster survivors appears unjustified on the basis of the present data.",0,0 +3619,0429 Chronic Probable Posttraumatic Stress Disorder among Police Registrants in the World Trade Centre Health Registry Ten Years after 9/11/01,"

Objectives

The World Trade Centre Health Registry (WTCHR) prospectively follows a cohort of over 71 000 individuals who reported being directly exposed to the 9/11/01 terrorist attack. Among police registrants at Survey Wave 2, 5–6 years after 9/11/01, four unique trajectories of probable PTSD symptoms were identified: resilient (83%), recovered (2.5%), delayed onset (11.2%) and chronic (5.3%). The current study documents the longitudinal trajectories of PTSD in police officers exposed to the WTC attacks at Wave 3 (2011–2012), over 10 years since the WTC attack.

Method

We examined the prevalence of probable PTSD at the Wave 3 survey using a cut-off score of 44 or greater on the event-specific Posttraumatic Stress Disorder Checklist (PCL) and at least one re-experiencing symptom (DSM-IV criterion B), three avoidance or numbing symptoms (DSM-IV criterion C), and two hyperarousal symptoms (DSM-IV criterion D).

Results

Probable PTSD was 14.4% (95% CI 13.0–15.9%) at Wave 2 and 12.9% (95% CI, 11.6–14.3%) at Wave 3. Significant predictors of chronic probable PTSD 10 years post-disaster (n = 59/2241, 2.6%) include age 45–69 (aOR 3.16, 95% CI, 1.7–6.0), number of stressful events witnessed on 9/11/01 (aOR 3.00, 1.6–5.8), five or more stressful life events since 9/11/01 (aOR 5.42, 1.9–15.2), and unmet mental health care needs (aOR 6.86, 3.3–14.1). Protective factors include social support (aOR 0.34, 0.1–0.97) and number of close friends or relatives (aOR 0.92, 0.87–0.98).

Conclusions

Chronic probable PTSD among police responders continues to be a significant problem, associated both with intervening stressful life events and unmet mental health care needs.",0,0 +3620,Pharmacological inhibition of endocannabinoid degradation modulates the expression of inflammatory mediators in the hypothalamus following an immunological stressor,"The endocannabinoid system is an important regulator of the nervous, neuroendocrine, and immune systems, thus representing a novel therapeutic target for stress-related neuroinflammatory and psychiatric disorders. However, there is a paucity of data relating to the effects of endocannabinoids on neuroinflammatory mediators following an immune stress/challenge in vivo. This study investigated the effects of URB597, a selective inhibitor of fatty acid amide hydrolyase (FAAH), the enzyme that preferentially metabolizes anandamide, on lipopolysaccharide (LPS)-induced increases in the expression of immune mediators in the hypothalamus. Systemic administration of URB597 increased the levels of anandamide and the related N-acylethanolamines, N-palmitoylethanolamide, and N-oleoylethanolamide, but not 2-arachidonoyl glycerol, in the hypothalamus and spleen. URB597 attenuated the LPS-induced increase in interleukin (IL)-1β expression while concurrently augmenting the LPS-induced increase in suppressor of cytokine signalling (SOCS)-3 expression. In addition, URB597 tended to enhance and reduce the LPS-induced increase in IL-6 and IL-10 mRNA expression, respectively. LPS-induced increases in peripheral cytokine levels or plasma corticosterone were not altered by URB597. The present study provides evidence for a role for FAAH in the regulation of LPS-induced expression of inflammatory mediators in the hypothalamus. Improved understanding of endocannabinoid-mediated regulation of neuroimmune function has fundamental physiological and potential therapeutic significance in the context of stress-related disorders.",0,0 +3621,Neural Correlates of Psychotherapy in Anxiety and Depression: A Meta-Analysis,"Several studies have used neuroimaging methods to identify neural change in brain networks associated to emotion regulation after psychotherapy of depression and anxiety. In the present work we adopted a meta-analytic technique specific to neuroimaging data to evaluate the consistence of empirical findings and assess models of therapy that have been proposed in the literature. Meta-analyses were conducted with the Activation Likelihood Estimation technique, which evaluates the overlap between foci of activation across studies. The analysis included 16 studies found in Pubmed (200 foci of activation and 193 patients). Separate meta-analyses were conducted on studies of 1) depression, post-traumatic stress disorder and panic disorder investigated with rest state metabolism (6 studies, 70 patients); 2) depression, post-traumatic stress disorder and panic disorder investigated with task-related activation studies (5 studies, 65 patients); 3) the previous studies considered jointly; and 4) phobias investigated with studies on exposure-related activation (5 studies, 57 patients). Studies on anxiety and depression gave partially consistent results for changes in the dorsomedial prefrontal cortex and in the posterior cingulated gyrus/precuneus. Several areas of change in the temporal lobes were also observed. Studies on the therapy of phobia were consistent with a reduction of activity in medial temporal areas. The cluster of change in the prefrontal cortex may refer to increased recruitment of control processes, as hypothesized by influential models of emotion regulation changes due to psychotherapy. However, not all areas associated with controlled emotion regulation were detected in the meta-analysis, while involvement of midline structures suggested changes in self-related information processing. Changes in phobia were consistent with reduced reactivity to phobic stimuli.",0,0 +3622,"Comorbidity in pediatric bipolar disorder: Prevalence, clinical impact, etiology and treatment","Research on pediatric bipolar disorder (PBD) is providing a plethora of empirical findings regarding its comorbidity. We addressed this question through a systematic review concerning the prevalence, clinical impact, etiology and treatment of main comorbid disorders involved.A comprehensive database search was performed from 1990 to August 2014. Overall, 167 studies fulfilled the inclusion criteria.Bipolar youth tend to suffer from comorbid disorders, with highest weighted mean prevalence rate arising from anxiety disorders (54%), followed by attention deficit hyperactivity disorder (ADHD) (48%), disruptive behavior disorders (31%), and substance use disorders (SUD) (31%). Furthermore, evidence indicates that ADHD and anxiety disorders negatively affect the symptomatology, neurocognitive profile, clinical course and the global functioning of PBD. Likewise, several theories have been posited to explain comorbidity rates in PBD, specifically common risk factors, one disorder being a risk factor for the other and nosological artefacts. Lastly, randomized controlled trials highlight a stronger therapeutic response to stimulants and atomoxetine (vs. placebo) as adjunctive interventions for comorbid ADHD symptoms. In addition, research focused on the treatment of other comorbid disorders postulates some benefits from mood stabilizers and/or SGA.Epidemiologic follow-up studies are needed to avoid the risk of nosological artefacts. Likewise, more research is needed on pervasive developmental disorders and anxiety disorders, especially regarding their etiology and treatment.Psychiatric comorbidity is highly prevalent and is associated with a deleterious clinical effect on pediatric bipolarity. Different etiological pathways may explain the presence of these comorbid disorders among bipolar youth. Standardized treatments are providing ongoing data regarding their effectiveness for these comorbidities among bipolar youth.",0,0 +3623,"The assessment of psychological symptoms of patients referred to community mental health teams: distress, chronicity and life interference","Mental health trusts are concerned to allocate scarce resources to those patients requiring secondary care services, rather than to those who can be managed in the community. It is important therefore to gain insight into the types of patient being referred into community mental health teams. This study was undertaken to explore this question. 421 patients completed the General Health Questionnaire and a newly devised symptom checklist, which allows assessment of distress/severity, chronicity and interference with life of individual symptoms. 81% of patients met criteria for caseness on the GHQ and those who did not still had a number of chronic symptoms. In regard to specific symptom profiles referred patients endorsed a wide variety of symptoms, related to anxiety, depression and impulse control. The most common anxiety symptom related to adjustment reactions and possibly post-traumatic stress. The most common mood symptom was mood instability, followed by fatigue and sleep problems. The majority of patients believed that they had had their symptoms and problems for longer than a year, indicating that many of the referrals to community teams are not short-term crises. Data suggests that the vast majority of referrals are appropriate but also point to a need for specific forms of intervention for the most common symptoms. Copyright © 2004 John Wiley & Sons, Ltd.",0,0 +3624,Gender Differences in Posttraumatic Stress Symptoms Among OEF/OIF Veterans: An Item Response Theory Analysis,"Establishing whether men and women tend to express different symptoms of posttraumatic stress in reaction to trauma is important for both etiological research and the design of assessment instruments. Use of item response theory (IRT) can reveal how symptom reporting varies by gender and help determine if estimates of symptom severity for men and women are equally reliable. We analyzed responses to the PTSD Checklist (PCL) from 2,341 U.S. military veterans (51% female) who completed deployments in support of operations in Afghanistan and Iraq (Operation Enduring Freedom/Operation Iraqi Freedom [OEF/OIF]), and tested for differential item functioning by gender with an IRT-based approach. Among men and women with the same overall posttraumatic stress severity, women tended to report more frequent concentration difficulties and distress from reminders whereas men tended to report more frequent nightmares, emotional numbing, and hypervigilance. These item-level gender differences were small (on average d = 0.05), however, and had little impact on PCL measurement precision or expected total scores. For practical purposes, men's and women's severity estimates had similar reliability. This provides evidence that men and women veterans demonstrate largely similar profiles of posttraumatic stress symptoms following exposure to military-related stressors, and some theoretical perspectives suggest this may hold in other traumatized populations.",0,0 +3625,The role of executive function in posttraumatic stress disorder: A systematic review,"Although posttraumatic stress disorder (PTSD) has been associated with disturbances in verbal memory, studies examining executive functioning in PTSD show mixed results.A systematic review and meta-analysis were performed to compare executive functioning in patients with current PTSD and controls without any psychiatric disorder. Standard mean differences (SMD) in executive functioning scores were calculated using random-effects models. Covariates were added to examine whether differences exist between subgroups.Across 18 studies, 1080 subjects were included. In comparison with 431 exposed controls and 227 healthy controls, 422 people with PTSD showed significantly impaired executive functioning. Subgroup analyses revealed more pronounced differences between PTSD patients and exposed controls than healthy controls. Male gender, higher age, war trauma, and higher severity of co-morbid depressive symptoms were related to poorer executive functioning in PTSD patients compared to exposed controls.Due to insufficient data and heterogeneity, not all subgroup differences or characteristics could be taken into account.Overall, PTSD patients were found to show impaired executive functioning. Future research should further elucidate the subgroup effects and focus on clinical implications with regard to daily functioning and treatment outcome.",0,0 +3626,USING LATENT PROFILE MODELS AND UNSTRUCTURED GROWTH MIXTURE MODELS TO ASSESS THE NUMBER OF LATENT CLASSES IN GROWTH MIXTURE MODELING,"Growth mixture modeling has gained much attention in applied and methodological social science research recently, but the selection of the number of latent classes for such models remains a challenging issue. This problem becomes more serious when one of the key assumptions of this model, proper model-specification is violated. The current simulation study compared the performance of a linear growth mixture model in determining the correct number of latent classes against two less parametrically restricted options, a latent profile model and an unstructured growth mixture model. A variety of conditions were examined, both for properly and improperly specified models. Results indicate that prior to the application of linear growth mixture model, the unstructured growth mixture model is a promising way to identify the correct number of unobserved groups underlying the data by using most model fit indices across all the conditions investigated in this study. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +3627,Posttraumatic Stress Disorder Symptom Structure in Injured Children: Functional Impairment and Depression Symptoms in a Confirmatory Factor Analysis,"To examine the factor structure of posttraumatic stress disorder (PTSD) symptoms in children and adolescents who have experienced an acute single-incident trauma, associations between PTSD symptom clusters and functional impairment, and the specificity of PTSD symptoms in relation to depression and general distress.Examined PTSD symptom structure in two samples of children (8 to 17 years of age) assessed an average of 6 months after unintentional injury: (1) a combined dataset of 479 children assessed with a PTSD symptom checklist, and (2) a sample of 204 children assessed via a standardized clinical interview. We evaluated the fit of six alternative models for the factor structure of PTSD symptoms, and the association of PTS symptom clusters with indicators of functional impairment. We then evaluated three models for the structure of PTSD and depression symptoms jointly, to examine specificity of PTSD versus general distress or mood symptoms.In both samples, the DSM-IV 3-factor model fit the data reasonably well. Two alternative four-factor models fit the data very well: one that separates effortful avoidance from emotional numbing, and one that separates PTSD-specific symptoms from general emotional distress. Effortful avoidance and dysphoria symptoms were most consistently associated with impairment. The best-fitting model for PTSD and depression symptom clusters had three factors: PTSD-specific, depression-specific, and general dysphoria symptoms.The DSM-IV model for PTSD symptom categories was a reasonable fit for these child data, but several alternative models fit equally well or better, and suggest potential improvements to the current diagnostic criteria for PTSD in children.",0,0 +3628,"THE DISSOCIATIVE SUBTYPE OF POSTTRAUMATIC STRESS DISORDER: RATIONALE, CLINICAL AND NEUROBIOLOGICAL EVIDENCE, AND IMPLICATIONS","Background Clinical and neurobiological evidence for a dissociative subtype of posttraumatic stress disorder (PTSD) has recently been documented. A dissociative subtype of PTSD is being considered for inclusion in the forthcoming Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) to address the symptoms of depersonalization and derealization found among a subset of patients with PTSD. This article reviews research related to the dissociative subtype including antecedent, concurrent, and predictive validators as well as the rationale for recommending the dissociative subtype. Methods The relevant literature pertaining to the dissociative subtype of PTSD was reviewed. Results Latent class analyses point toward a specific subtype of PTSD consisting of symptoms of depersonalization and derealization in both veteran and civilian samples of PTSD. Compared to individuals with PTSD, those with the dissociative subtype of PTSD also exhibit a different pattern of neurobiological response to symptom provocation as well as a differential response to current cognitive behavioral treatment designed for PTSD. Conclusions We recommend that consideration be given to adding a dissociative subtype of PTSD in the revision of the DSM. This facilitates more accurate analysis of different phenotypes of PTSD, assist in treatment planning that is informed by considering the degree of patients’ dissociativity, will improve treatment outcome, and will lead to much-needed research about the prevalence, symptomatology, neurobiology, and treatment of individuals with the dissociative subtype of PTSD.",0,0 +3629,,"Empirical evidence was provided on the utility of the Screen for Adolescent Violence Exposure (SAVE) in assessing adolescent exposure to school, home, and community violence. The SAVE was empirically developed on 1,250 inner-city adolescents, and obtained excellent reliability and validity. Both exploratory and confirmatory factor analyses identified three factors: Traumatic Violence, Indirect Violence, and Physical/Verbal Abuse. The SAVE demonstrated utility in classifying high- and low-violence participants, and correlated significantly with both objective crime data and theoretically relevant constructs (anger, posttraumatic stress symptoms, and internalizing/externalizing problems). Thus, the SAVE provides measurement of the stressor criterion associated with posttraumatic stress disorder, and allows quantification of severity of violence exposure by setting.",0,0 +3630,The Role of Peritraumatic Dissociation and Gender in the Association Between Trauma and Mental Health in a Palestinian Community Sample,"This research focused on gender-specific trauma exposure and mental health symptoms among Palestinians living in conditions of military violence. It also examined the gender-specific role of peritraumatic dissociation in moderating the association between lifetime trauma and mental health.A random sample of 311 Palestinian women and 274 men ages 16-60 years from the Gaza Strip participated. The subjects were asked about lifetime trauma and peritraumatic dissociation during their most severe traumatic experience. Mental health was indicated by total scores and diagnostic variables of posttraumatic stress disorder (PTSD), anxiety, mood (depression), and somatization disorders. Symptoms of hostility were assessed as a total score.The women reported a lower level of lifetime trauma than the men, but exposure to trauma was associated with PTSD among both genders. Exposure to lifetime trauma was further associated with anxiety, mood, and somatoform disorders only among women but not among men. No gender differences were found in the level of peritraumatic dissociation. Analyses on moderating effects showed that peritraumatic dissociation made both men and women more vulnerable to symptoms of hostility and men to depressive symptoms when they were exposed to lifetime trauma.The results are consistent with previous studies in more peaceful conditions: men experience more traumatic events, whereas exposure is associated with more severe psychiatric disorders among women. Peritraumatic dissociation as an acute response to trauma constituted a risk for mental health symptoms in both genders.",0,0 +3631,Posttraumatic reactions to an earthquake: Multidimensional scaling profile analysis of adolescent survivors,"The current study examined the prototypical profiles of posttraumatic stress reactions among a sample of 282 adolescent survivors of the 2008 Wenchuan earthquake in China. Based on a dimensional perspective, the results of profile analysis via multidimensional scaling (PAMS) model revealed a two-dimensional solution corresponding to four profiles: intrusion, avoidance/arousal, partial avoidance, and hyperarousal. These profiles of posttraumatic stress symptoms equally manifested across gender. In addition, the Intrusion Profile was found to be associated with more elevated psychological distress symptoms. Results are discussed with respect to the typical posttraumatic stress symptoms following the earthquake.",0,0 +3632,Effects of childhood development on late-life mental disorders,"To explore recent findings bridging childhood development and common late-life mental disorders in the elderly.We addressed aging as a part of the developmental process in central nervous system, typical and atypical neurodevelopment focusing on genetic and environmental risk factors and their interplay and links between psychopathology from childhood to the elderly, unifying theoretical perspectives and preventive intervention strategies.Current findings suggest that childhood development is strictly connected to psychiatric phenotypes across the lifespan. Although we are far from a comprehensive understanding of mental health trajectories, some initial findings document both heterotypic and homotypic continuities from childhood to adulthood and from adulthood to the elderly. Our review also highlights the urgent need for investigations on preventive interventions in individuals at risk for mental disorders.",0,0 +3633,"Profiles of adult survivors of severe sexual, physical and emotional institutional abuse in Ireland","Adult survivors of institutional abuse were interviewed with a comprehensive assessment protocol which included the Childhood Trauma Questionnaire, the Institutional Child Abuse Processes and Coping Inventory, the Structured Clinical Interviews for DSM IV axis I disorders and personality disorders, the Trauma Symptoms Inventory, a Life Problems Checklist, the Experiences in Close Relationships Inventory and the Kansas Marital Satisfaction Scale. Profiles were identified for subgroups who described severe sexual (N=60), physical (N=102), or emotional (N=85) abuse as their worst forms of maltreatment. Survivors of severe sexual abuse had the most abnormal profile, which was characterized by higher rates of all forms of child maltreatment and higher rates of posttraumatic stress disorder, alcohol and substance abuse, antisocial personality disorder, trauma symptoms, and life problems",0,0 +3634,Predictive factors of chronic post-traumatic stress disorder 6 months after a road traffic accident,"This study sets out to identify risk factors for post-traumatic stress disorder (PTSD) after a road traffic accident with a view to improving prevention.The study used a prospective cohort of road traffic accident casualties. All subjects over 15 years of age were recruited in the course of an interview conducted while they were receiving care in a hospital of the Rhône area administrative département. Six months after their accident, they answered a self-administered postal questionnaire that included the Post-traumatic Check-List Scale (PCLS) in order to evaluate PTSD. Multivariate logistic regression analysis was conducted to compare those subjects with a PCLS score of 44 or over with those with a lower score, in order to identify factors that might be associated with PTSD.592 subjects (out of 1168) returned the 6-month questionnaire and 541 completed the PCLS test. One hundred subjects had a PCLS score ≥ 44, suggesting PTSD, and 441 subjects did not. The factors associated with PTSD were initial injury severity, post-traumatic amnesia, the feeling of not being responsible for their accident and persistent pain 6 months after it. A lower odds-ratio was associated with users of two-wheel than four-wheel motor vehicles (OR=0.4; 0.2-0.9).Besides predictive factors for PTSD (injury severity, post-traumatic amnesia and the feeling of not being responsible for their accident), our study suggested a reduced risk of PTSD among two-wheel motor vehicle users.",0,0 +3635,Trauma-related symptoms in veterans of Operation Desert Storm: a 2-year follow-up,"This study was a 2-year follow-up in an ongoing prospective examination of development of trauma-related symptoms over time in a community group of veterans of Operation Desert Storm.Sixty-two National Guard reservists, from one medical and one military police unit, completed the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder and a DSM-III-R-based posttraumatic stress disorder (PTSD) symptom scale 1 month, 6 months, and 2 years after returning from the Middle East. Differences in symptom severity over time were analyzed by using repeated measure analyses of variance.Scores on the Mississippi scale, but not the DSM-III-R PTSD scale, increased significantly over time. Symptoms of hyperarousal were more severe at all time points than were symptoms of reexperiencing or avoidance. Level of combat exposure, as reflected by the Desert Storm trauma questionnaire, was significantly associated with the score on the Mississippi scale at 2 years but not at 1 month or 6 months. All subjects who met the Mississippi scale's diagnostic criteria for PTSD at 1 or 6 months still met the criteria at 2 years.Although symptoms were relatively mild, there was an overall increase in PTSD symptoms over 2 years. The statistical relationship between level of combat exposure and PTSD symptoms at 2 years, and not before, suggests that it may take time for the consequences of traumatic exposure to become apparent. Moreover, degree of exposure may be important in predicting the eventual development of symptoms. Continued follow-up will address the evolution of PTSD symptoms in Gulf War veterans.",0,0 +3636,Intelligence and Other Predisposing Factors in Exposure to Trauma and Posttraumatic Stress Disorder,"Prospective data on standardized measures of early predispositions would allow a strong test of hypotheses about suspected risk factors of posttraumatic stress disorder (PTSD) and exposure to traumatic events.To prospectively examine the extent to which intelligence, anxiety disorders, and conduct problems in childhood influence the risk for PTSD and for exposure to traumatic events.A longitudinal study of a randomly selected sample assessed at age 6 years and followed up to age 17 years.Samples were randomly selected from the 1983-1985 newborn discharge lists of 2 major hospitals in southeast Michigan (N=823).Cohort members with follow-up data at age 17 years (n=713; 86.6% of the initial sample).Cumulative exposure up to age 17 years of qualifying traumatic events; DSM-IV PTSD among participants who have experienced 1 or more traumatic events.Youth with teacher ratings of externalizing problems above the normal range at age 6 years were at increased risk for exposure to assaultive violence (adjusted odds ratio, 2.6; 95% confidence interval, 1.4-4.9). Youth aged 6 years with an IQ greater than 115 had decreased risk for exposure to traumatic events (adjusted odds ratio for assaultive violence, 0.3; 95% confidence interval, 0.2-0.7); a decreased risk for nonassaultive trauma (adjusted odds ratio, 0.6; 95% confidence interval, 0.3-0.9); and a decreased conditional risk for PTSD (adjusted odds ratio, 0.2; 95% confidence interval, 0.1-0.9). The conditional risk for PTSD was increased for youth with anxiety disorders and teacher ratings of externalizing problems above the normal range at 6 years of age.The results of this prospective community study highlight the role of intelligence in avoidance of exposure to traumatic experiences and their PTSD effects. They underscore the need for investigating cognitive processes in persons' responses to traumatic experiences and the involvement of general intelligence in these processes.",0,0 +3637,A historical review of trauma-related diagnoses to reconsider the heterogeneity of PTSD,"Based on the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, there are 636,120 ways for an individual to qualify for a diagnosis of posttraumatic stress disorder (PTSD) (Galatzer-Levy & Bryant, 2013). To unravel this heterogeneity, we examine the historical trajectory of trauma-related diagnoses. Our review addresses four traumas (i.e., combat, natural disaster, life-threatening accident and sexual assault) that have contributed the most to conceptual models of PTSD. Although these trauma types are all subsumed under the same diagnostic label, our literature review indicates that the psychological consequences of different traumatic experiences are traditionally studied in isolation. Indeed, most research addresses hypotheses regarding specific trauma types using samples of individuals selected for their experience with that specific event. We consider the possibility that PTSD is not a single, unified construct and what this means for future research and clinical applications.",0,0 +3638,Trauma Typology as a Risk Factor for Aggression and Self-Harm in a Complex PTSD Population: The Mediating Role of Alterations in Self-Perception,"This study examined the role of prolonged, repeated traumatic experiences such as childhood and sectarian trauma in the development of posttraumatic aggression and self-harm. Forty-four adult participants attending therapy for complex trauma in Northern Ireland were obtained via convenience sampling. When social desirability was controlled, childhood emotional and physical neglect were significant correlates of posttraumatic hostility and history of self-harm. These relationships were mediated by alterations in self-perception (e.g., shame, guilt). Severity of sectarian-related experiences was not related to self-destructive behaviors. Moreover, none of the trauma factors were related to overt aggressive behavior. The findings have implications for understanding risk factors for posttraumatic aggression and self-harm, as well as their treatment.",0,0 +3639,"Profiles of childhood trauma: Betrayal, frequency, and psychological distress in late adolescence.","With an emphasis on betrayal trauma, this study used latent profile analysis to examine how childhood traumas co-occur and whether trauma patterns differentially predicted psychological distress.A community sample of 806 adolescents and young adults participated. Youths reported their trauma histories, and lifetime DSM-IV disorders were assessed using a structured diagnostic interview.Latent profile analysis yielded 5 profiles: high betrayal trauma physical violence and emotional abuse (HBTPE), high betrayal trauma sexual and emotional abuse (HBTSE), low betrayal trauma (LBT), parent death (PD), and a no/low trauma profile. Logistic regression analyses compared youths in the no/low trauma profile to those in the trauma profiles. Youths in the HBTPE profile were more likely to have moderate/severe major depressive disorder (odds ratio [OR] = 2.92, 95% CI [1.16, 7.32]), posttraumatic stress disorder (OR = 4.33, 95% CI [1.34, 14.03]), and hallucinations (OR = 5.03, 95% CI [2.00, 12.67]); youths in the HBTSE and LBT profiles were more likely to experience hallucinations (OR = 3.19, 95% CI [1.21, 8.39] and OR = 3.20, 95% CI [1.01, 10.19], respectively); and youths in the PD profile were more likely to have moderate/severe depression (OR = 2.42, 95% CI [1.07, 5.43]).Specific trauma types co-occurred when considering type, level of betrayal, and frequency. The emergence of the 2 high betrayal trauma profiles, with differing symptom presentations, suggests that experiences of high betrayal traumas are not homogenous and specific trauma-focused interventions may be more appropriate for differing trauma profiles.",0,0 +3640,Brittle diabetes: psychopathological aspects.,"The term ""brittle"" is used to described an uncommon subgroup of type I diabetics whose lives are disrupted by severe glycaemic instability with repeated and prolonged hospitalization. Psychosocial problems are the major perceived underlying causes of brittle behaviour. Aim of this study is a systematic psychopathological assessment of brittleness using specific parameters of general psychopathology and personality traits following the multiaxial format (axis I and II) of the current DSM-IV-TR diagnostic criteria for mental disorders.Patients comprised 21 brittle type I diabetics and a case-control group of 21 stable diabetics, matched for age, gender, years of education, and diabetes duration. General psychopathology and the DSM-IV-TR personality traits/disorders were assessed using the Syptom Checklist-90-R (SCL-90-R) and the Millon Clinical Multiaxial Inventory-III (MCMI-III).The comparison for SCL-90-R parameters exclusively revealed higher scores in ""Phobic Anxiety"" subscale in brittle diabetics. No differences in all the other SCL-90-R primary symptom dimensions and in the three SCL-90-R global distress indices were observed between the two diabetic groups, as well as in the all MCMI-III clinical syndrome categories corresponding to DSM-IV-TR specific psychiatric disorders. However, brittle patients presented lower scores in MCMI-III compulsive personality traits and higher scores in paranoid, schizoid, schizotypal, antisocial, borderline, narcissistic, avoidant, dependent, depressive, and passive-aggressive personality traits.In this study, brittle diabetics show no differencies in terms of global severity of psychopathological distress and axis I specific DSM-IV-TR diagnoses in comparison with non-brittle subjects (except for phobic anxiety). Differently, brittle diabetics are characterized from less functional and maladaptive personality features and suffer more frequently and intensively from specific pathological personality traits of all DSM-IV-TR clusters.",0,0 +3641,Relationships between hormonal profile and novelty seeking in combat-related posttraumatic stress disorder,"This study examines relationships between hormonal levels and novelty seeking in a group of 27 Vietnam veterans with combat-related posttraumatic stress disorder (PTSD). Novelty seeking in the veteran sample, measured by the Cloninger Tridimensional Personality Questionnaire (TPQ), was almost twice as high as previously published norms. A distinctive pattern of significant positive correlations was found between novelty seeking scores and serum total triiodothyronine (T3), free T3, the T3/free thyroxine (FT4) ratio, urinary norepinephrine and the norepinephrine/cortisol ratio, while a negative correlation was found between novelty seeking scores and urinary cortisol levels. The findings were confirmed by t test analyses of high vs low novelty seeking subgroups and do not appear to be related simply to the severity of PTSD. These preliminary findings indicate the need to include measures of characterological traits in psychoendocrine studies of PTSD and to investigate their possible usefulness in subtyping this disorder.",0,0 +3642,Ethnic differences in symptoms among female veterans diagnosed with PTSD,"Among U.S. male Vietnam veterans, Hispanics have been shown to have higher rates of posttraumatic stress disorder (PTSD) than African Americans and non-Hispanic Whites (Kulka et al., 1990). In terms of gender, Tolin and Foa's (2006) meta-analysis suggested women experience higher rates of PTSD than men. This study examined ethnic differences in PTSD and other symptomatology among 398 female veterans (63% non-Hispanic White, 28% Hispanic, 9% African American) seeking treatment for PTSD from 1995 to 2009 at a Veterans Administration (VA) behavioral health clinic. The following symptom clusters were examined: anxiety/PTSD, depression, anger/hostility, and psychotic/dissociative symptoms. Few differences were found among the groups, suggesting the 3 ethnic groups studied were more similar than different. African American female veterans, however, scored higher on measuring ideas of persecution/paranoia, although this may reflect an adaptive response to racism. These findings warrant further investigation to elucidate this relationship.",0,0 +3643,Less is more? Assessing the validity of the ICD-11 model of PTSD across multiple trauma samples,"In the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the symptom profile of posttraumatic stress disorder (PTSD) was expanded to include 20 symptoms. An alternative model of PTSD is outlined in the proposed 11th edition of the International Classification of Diseases (ICD-11) that includes just six symptoms.The objectives of the current study are: 1) to independently investigate the fit of the ICD-11 model of PTSD, and three DSM-5-based models of PTSD, across seven different trauma samples (N=3,746) using confirmatory factor analysis; 2) to assess the concurrent validity of the ICD-11 model of PTSD; and 3) to determine if there are significant differences in diagnostic rates between the ICD-11 guidelines and the DSM-5 criteria.The ICD-11 model of PTSD was found to provide excellent model fit in six of the seven trauma samples, and tests of factorial invariance showed that the model performs equally well for males and females. DSM-5 models provided poor fit of the data. Concurrent validity was established as the ICD-11 PTSD factors were all moderately to strongly correlated with scores of depression, anxiety, dissociation, and aggression. Levels of association were similar for ICD-11 and DSM-5 suggesting that explanatory power is not affected due to the limited number of items included in the ICD-11 model. Diagnostic rates were significantly lower according to ICD-11 guidelines compared to the DSM-5 criteria.The proposed factor structure of the ICD-11 model of PTSD appears valid across multiple trauma types, possesses good concurrent validity, and is more stringent in terms of diagnosis compared to the DSM-5 criteria.",0,0 +3644,Posttraumatic stress symptoms and structure among orphan and vulnerable children and adolescents in Zambia,"Background Scant information exists on posttraumatic stress disorder (PTSD) symptoms and structure in youth from developing countries. Methods We describe the symptom profile and exposure to trauma experiences among 343 orphan and vulnerable children and adolescents from Zambia. We distinguished profiles of posttraumatic stress symptoms using latent class analysis. Results Average number of trauma-related symptoms (21.6; range 0–38) was similar across sex and age. Latent class model suggested three classes varying by level of severity: low (31% of the sample), medium (45% of the sample), and high (24% of the sample) symptomatology. Conclusions Results suggest that PTSD is a continuously distributed latent trait.",0,0 +3645,Identifying Classes of Veterans With Multiple Risk Factors,"As researchers examine the efficacy of interventions that simultaneously target more than 1 symptom, it is important to identify ways to help guide research and program development. This study used electronic medical record data to examine the covariation of multiple risk factors regularly assessed among primary care patients. It also examined the health care utilization of those patients identifying where the health care system came in contact with them to help identify the ideal locations these interventions may be most often used. We obtained data for six risk factors, as well as the number of primary care, mental health, and emergency department visits, from Veteran patients with a primary care visit. There were three main groups of primary care patients, identified using latent class analysis and regression. Although the smallest group, the ""High Treatment Need"" group, had an increased probability of screening positive for all four risk factors, the post-traumatic stress disorder screen was a significant discriminator of this group from the others. Results show that this group had the greatest number of encounters in all health care locations suggesting significant opportunities for intervention. However, future research is needed to examine the current interventions offered and potential avenues where risk factors may be addressed simultaneously.",0,0 +3646,"Attachment styles, traumatic events, and PTSD: a cross-sectional investigation of adult attachment and trauma","The aim of the present study was to examine the association between post-traumatic stress disorder (PTSD) and adult attachment in a young adult population. A sample of 328 Danish students (mean age 29.2 years) from four different schools of intermediate education level were studied by the Harvard Trauma Questionnaire (HTQ), the Revised Adult Attachment Scale (RAAS), the Trauma Symptom Checklist (TSC), the Crisis Support Scale (CSS), the Coping Style Questionnaire (CSQ), and the World Assumption Scale (WAS). Attachment styles were associated with number of PTSD symptoms, negative affectivity, somatization, emotional coping, attributions, and social support. The distribution of attachment styles in relation to PTSD symptoms could be conceived as uni-dimensional.",0,0 +3647,The Posttraumatic Stress Disorder (PTSD) Family Workshop: A Pilot Study of Preliminary Outcomes and Effect Sizes of an Attachment-Based Intervention for Family Members of Veterans with Combat-Related PTSD,"Objective. Social support and secure attachment confer protection against the development of post traumatic stress disorder (PTSD) after trauma exposure. Yet there are few empirically-supported interventions for PTSD that address the impact on the family and significant relationships. This research is an intervention development study for ""The PTSD Family Workshop,"" an attachment-based group intervention for family members of veterans with combat-related PTSD. The study examines preliminary outcomes and treatment effect sizes and tests research hypotheses. Methods. Research hypotheses were tested through an adaptation of a partial crossover design. All research was conducted at the Stratton VA Medical Center and all participants were family members of veterans receiving treatment for combat-related PTSD. Intervention content includes PTSD psycho-education, a description of the impact of PTSD on their veterans and their important others and the factors that influence resilience and readjustment. Participants were recruited for participation in 4 group; each group being composed of an Immediate (n=17) and a Delay (n=11) condition. Participants completed standardized pre-test, post-delay and post-intervention assessments. Study domains included knowledge of PTSD, caregiver empathic concern, caregiver adaptive coping behavior and caregiver burden. Results. Data analyses revealed that participants who completed the PTSD Family Workshop reported a significant increase in their knowledge of PTSD, their empathic concern and their adaptive coping behaviors as compared to wait-list participants. Analyses of caregiver burden were not significant. Treatment effect sizes were calculated at d=1.66, d=.50 and d=.60 for knowledge of PTSD, caregiver empathic concern and caregiver adaptive coping behaviors respectively. Conclusion. Research findings support the development and study of innovative treatments for veterans with combat-related PTSD. Results are encouraging and suggest that brief intervention can be of benefit for family members of veterans with PTSD. Overall, this work increased access for psycho-education and support for family members of veterans in the VA system and provided preliminary data for a larger scale controlled study to test intervention efficacy and examine its relationship to outcomes for veterans. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +3648,Is implementation of the 2013 Australian treatment guidelines for posttraumatic stress disorder cost-effective compared to current practice? A cost-utility analysis using QALYs and DALYs,"Objective: To assess, from a health sector perspective, the incremental cost-effectiveness of three treatment recommendations in the most recent Australian Clinical Practice Guidelines for posttraumatic stress disorder (PTSD). The interventions assessed are trauma-focused cognitive behavioural therapy (TF-CBT) and selective serotonin reuptake inhibitors (SSRIs) for the treatment of PTSD in adults and TF-CBT in children, compared to current practice in Australia. Method: Economic modelling, using existing databases and published information, was used to assess cost-effectiveness. A cost-utility framework using both quality-adjusted life-years (QALYs) gained and disability-adjusted life-years (DALYs) averted was used. Costs were tracked for the duration of the respective interventions and applied to the estimated 12 months prevalent cases of PTSD in the Australian population of 2012. Simulation modelling was used to provide 95% uncertainty around the incremental cost-effectiveness ratios. Consideration was also given to factors not considered in the quantitative analysis but could determine the likely uptake of the proposed intervention guidelines. Results: TF-CBT is highly cost-effective compared to current practice at $19,000/QALY, $16,000/DALY in adults and $8900/QALY, $8000/DALY in children. In adults, 100% of uncertainty iterations fell beneath the $50,000/QALY or DALY value-for-money threshold. Using SSRIs in people already on medications is cost-effective at $200/QALY, but has considerable uncertainty around the costs and benefits. While there is a 13% chance of health loss there is a 27% chance of the intervention dominating current practice by both saving dollars and improving health in adults. Conclusion: The three Guideline recommended interventions evaluated in this study are likely to have a positive impact on the economic efficiency of the treatment of PTSD if adopted in full. While there are gaps in the evidence base, policy-makers can have considerable confidence that the recommendations assessed in the current study are likely to improve the efficiency of the mental health care sector.",0,0 +3649,Deciding on the Number of Classes in Latent Class Analysis and Growth Mixture Modeling: A Monte Carlo Simulation Study,"Mixture modeling is a widely applied data analysis technique used to identify unobserved heterogeneity in a population. Despite mixture models' usefulness in practice, one unresolved issue in the application of mixture models is that there is not one commonly accepted statistical indicator for deciding on the number of classes in a study population. This article presents the results of a simulation study that examines the performance of likelihood-based tests and the traditionally used Information Criterion (ICs) used for determining the number of classes in mixture modeling. We look at the performance of these tests and indexes for 3 types of mixture models: latent class analysis (LCA), a factor mixture model (FMA), and a growth mixture models (GMM). We evaluate the ability of the tests and indexes to correctly identify the number of classes at three different sample sizes (n = 200, 500, 1,000). Whereas the Bayesian Information Criterion performed the best of the ICs, the bootstrap likelihood ratio test ...",0,0 +3650,Too tired to care? The psychological effects of working with trauma,"This quantitative and qualitative longitudinal study was designed to examine the effects on caregivers working therapeutically with seriously traumatized people. The participants were 13 healthcare workers seconded into a trauma and recovery team (TRT) set up to help those traumatized by the Omagh bombing on 15 August 1998. Quantitative data were collected using the Compassion Satisfaction/Fatigue Test and the Life Status Review Questionnaire. Qualitative data regarding positive and negative aspects of working with traumatized individuals, as well as caregiver's experience leaving the TRT, were gathered using open-ended questions contained in the final data set. These questionnaires were completed at four points in time: August 1998, December 1998, August 1999 and February 2001. Ethical approval for the study was gained from the Sperrin Lakeland Trust research committee. Analysis of the quantitative data indicated that levels of compassion fatigue and burnout increased, respectively, from 18.85 to 34.46 and 22.38 to 29.69 over the first year. Levels of compassion satisfaction decreased from 87.62 to 80.15, while levels of satisfaction with life (53.85 to 40.38) and life status (11.23 to 5.62) also decreased. Findings also demonstrated that compassion satisfaction is possibly a protective factor against compassion fatigue and burnout, in that caregivers with high compassion satisfaction scores were less likely to have corresponding high compassion fatigue and burnout scores. Findings from the qualitative data generated, revealed that team spirit and camaraderie, along with the satisfaction of seeing clients recover, were the most positive aspects of working in the team. Media interest, coping with and containing anger shown by bereaved relatives and dealing with the content of client's stories were the most negative. Themes to emerge from leaving the team included lack of understanding and support from non-trauma managers and an underestimation of the impact on caregivers of finishing in the team. Strategies that were found to be beneficial in helping to alleviate the negative effects of working with trauma were also elicited. This research has implications for practice, management and education.",0,0 +3651,Characterizing the effects of sertraline in post-traumatic stress disorder,"Background. Sertraline has a proved efficacy in post-traumatic stress disorder (PTSD), but it is unknown which symptoms respond or in what sequence this occurs. Such information might be useful clinically and heuristically. Method. The study examined the effects of sertraline on the individual symptoms of PTSD. It also examined whether early changes in anger explained drug-induced change in other symptoms over time. Mixed models analysis was applied to datasets from two 12-week placebo-controlled trials of sertraline. A validated self-rating scale (DTS) was used to assess treatment efficacy. Results. Sertraline was superior to placebo on 15 of 17 symptoms, especially in the numbing and hyperarousal clusters. A strong effect was found on anger from week 1, which partly explained the subsequent effects of sertraline on other symptoms, some of which began to show significantly greater response to drug than to placebo at week 6 (emotional upset at reminders, anhedonia, detachment, numbness, hypervigilance) and week 10 (avoidance of activities, foreshortened future). Conclusions. Sertraline exercises a broad spectrum effect in PTSD. Effects are more apparent on the psychological rather than somatic symptoms of PTSD, with an early modulation of anger and, perhaps, other affects, preceding improvement in other symptoms.",0,0 +3652,The work compatibility improvement framework: preliminary findings of a case study for defining and measuring the human-at-work system,"Although researchers traditionally examined the 'risk' characteristics of work settings in health studies, few work models, such as the 'demand-control' and 'motivation-hygiene theory', advocated the study of the positive and the negative aspects of work for the ultimate improvement of work performance. The objectives of the current study were: (a) to examine the positive and negative characteristics of work in the machining department in a small manufacturing plant in the Midwest USA, and, (b) to report the prevalence of musculoskeletal and stress outcomes. A focus group consisting of worker experts from the different job categories in the machining department confirmed the management's concerns. Accordingly, 56 male and female workers, employed in three shifts, were surveyed on the demand/energizer profiles of work characteristics and self-reported musculoskeletal/stress symptoms. On average, one-fourth to one-third of the workers reported 'high' demand, and over 50% of the workers documented 'low' energizers for certain work domains/sub-domains, such as 'physical task content'/'organizational' work domains and 'upper body postural loading'/'time organization' work sub-domains. The prevalence of workers who reported 'high' musculoskeletal/stress disorder cases, was in the range of 25-35% and was consistent with the results of 'high' demands and 'low' energizers. The results of this case study confirm the importance of adopting a comprehensive view for work improvement and sustainable growth opportunities. It is paramount to consider the negative and positive aspects of work characteristics to ensure optimum organizational performance. The Work Compatibility Improvement Framework, proposed in the reported research, is an important endeavor toward the ultimate improvement and sustainable growth of human and organizational performance.",0,0 +3653,Post-traumatic Stress Disorder Symptoms in Children After the 1999 Marmara Earthquake in Turkey,"Objective: The aim of this study is to evaluate the symptoms of post-traumatic stress disorder in different age groups of children after the 1999 Marmara earthquake in Turkey. Method: The study included thirty-five patients, two to sixteen years old, who presented to the child and adolescent psychiatry department with symptoms of PTSD after the earthquake. An Earthquake Information Form and a Post-traumatic Stress Disorder Symptoms Checklist were filled out with clinical interviews of cases",0,0 +3654,Resilience in the initial year of caregiving for a family member with a traumatic spinal cord injury.,"Individuals who assume caregiving duties for a family member disabled in a traumatic injury often exhibit considerable distress, yet few studies have examined characteristics of those who may be resilient in the initial year of caregiving. Reasoning from the influential Pearlin model of caregiving (Pearlin & Aneshensel, 1994) and the resilience process model (Bonanno, 2005), we expected a significant minority of caregivers would be chronically distressed and another group would be resilient throughout the inaugural year of caregiving for a person with a traumatic spinal cord injury (SCI), and these groups would differ significantly in primary and secondary stress and in personal resources and mediators.Twenty men and 108 women who identified as caregivers for a family member who incurred a traumatic SCI consented to complete measures during the inpatient rehabilitation and at 1 month, 6 months, and 12 months postdischarge.Latent growth mixture modeling of depression symptoms over time revealed 3 groups of caregivers: chronic (24%), recovery (24%) and resilient (48%). The chronic group reported more anxiety, negative affect, and ill health than the other 2 groups throughout the year. The resilient group was best characterized by their enduring levels of positive affect and supportive social networks.A large percentage of individuals are resilient in the initial year of caregiving, and those who have problems adapting exhibit significant distress soon following the traumatic event. Early detection of and psychological interventions for individuals who have difficulty adjusting are indicated, as their distress is unlikely to abate untreated over the year.",0,0 +3655,Characteristics of the traumatic stressors experienced by rural first responders,"First responders routinely experience work-related events that meet the definition of a traumatic stressor. Despite the high exposure to traumatic events, prevalence rates of posttraumatic stress disorder (PTSD) are relatively low. This discrepancy points to the potential value of identifying factors that distinguish those traumatic stressors that produce ongoing traumatic stress symptoms from those that do not. The present study surveyed 181 first responders from rural settings. A repeated-measures design was used to compare characteristics of traumatic stressors that were or were not associated with ongoing PTSD symptoms. A factor analysis revealed that distressing events were characterized by chaos and resource limitations. Consistent with contemporary models, two mediational analyses revealed that each event characteristic predicted peritraumatic dissociation and posttraumatic cognitions, which in turn predicted PTSD symptoms. Moreover, the effect of each event characteristic on PTSD symptoms was partially mediated by these cognitive processes.",0,0 +3656,A longitudinal investigation of posttraumatic stress disorder in patients with ovarian cancer,"Exposure to the aggressive and life-threatening nature of ovarian cancer and its treatment is potentially traumatic. However, little is known about the occurrence of posttraumatic stress disorder (PTSD) in these patients.A total of 121 women newly diagnosed with ovarian cancer were recruited into a prospective longitudinal study of the course of PTSD and the factors that predict its development and persistence. Between 82 and 111 were assessed at each of the four time points subsequent to their diagnosis, and 63 women provided complete data from the beginning of chemotherapy treatment, midtreatment, end of treatment and 3-months follow-up on PTSD.Between 36% and 45% of the total sample experienced PTSD at some point, with a nonsignificant but progressive increase in prevalence over time. Of those women with complete data, only 30% never experienced PTSD at any time. Most of the women were intermittent cases of PTSD (57%, n=36), while 13% (n=8) were persistent cases. Younger women were at higher risk of experiencing PTSD.The prevalence of women newly diagnosed with ovarian cancer with persistent PTSD is relatively low (13%); however, our findings highlight that the trajectory of the illness and its associated stressors may constitute an enormous challenge and may be perceived as traumatic and stressful for most of the women in our sample at least once. Repetitive screening for PTSD and the provision of psychological treatments could ameliorate PTSD symptoms.",0,0 +3657,Effects of trauma on children: occupational therapy to support recovery,"Each year millions of the world's children witness, are victimized by or participate in traumatic events, placing them at risk for developing post-traumatic stress disorder. If this disorder is left untreated, a child's developmental trajectory can be compromised. Occupational therapists are in key positions to recognize the signs and symptoms of post-traumatic stress in children that interfere with functioning. Expressive therapies, long used in occupational therapy practice, are well suited to help children achieve an adaptive response to trauma. Two brief case studies are presented, describing the application of occupational therapy using expressive media with children who experienced post-traumatic stress disorders. The results of this preliminary investigation suggest that occupational therapists working in early intervention programmes can be helpful in identifying children in need and in providing treatment based on expressive therapies, stress management and cognitive-behavioural modalities. Further research is recommended to examine the efficacy of different occupational therapy frames of reference in treating children with post-traumatic stress disorder. Copyright © 1999 Whurr Publishers Ltd.",0,0 +3658,What is Posttraumatic Stress Disorder?,"Our understanding of posttraumatic stress disorder (PTSD) has increased significantly over the last 2 decades. Although the cause of the condition is usually easy to determine in individual patients, the symptoms of PTSD are diverse and a mixture of psychological processes are involved. This article presents a broad overview of PTSD, including its definition according to DSM-IV and ICD-10 diagnostic criteria, and its clinical course with reference to its association with depression and other mental disorders. The article also briefly reviews the assessment of patients and considers physiologic features such as responses to startle stimuli that appear to be useful in diagnosing PTSD and in differentiating it from other anxiety disorders and depression. Finally, a brief overview of the treatment of PTSD is given, including psychological and biological treatment options.",0,0 +3659,Post-traumatic Stress Disorder in an Emergency Department Population One Year after Hurricane Katrina,"Hurricane Katrina resulted in a significant amount of injury, death, and destruction.To determine the prevalence of, and risk factors for, symptoms of post-traumatic stress disorder (PTSD) in an emergency department (ED) population, 1 year after hurricane Katrina.Survey data including the Primary Care PTSD (PC-PTSD) screening instrument, demographic data, and questions regarding health care needs and personal loss were collected and analyzed.Seven hundred forty-seven subjects completed the survey. The PC-PTSD screen was positive in 38%. In the single variate analysis, there was a correlation with a positive PC-PTSD screen and the following: staying in New Orleans during the storm (odds ratio [OR] 1.73, 95% confidence interval [CI] 1.28-2.34), having material losses (OR 1.64, 95% CI 1.03-2.60), experiencing the death of a loved one (OR 1.96, 95% CI 1.35-1.87), needing health care during the storm (OR 2.01, 95% CI 1.48-2.73), and not having health care needs met during the storm (OR 2.00, 95% CI 1.26-3.18) or after returning to New Orleans (OR 2.29, 95% CI 1.40-3.73). In the multivariate analysis, the death of a loved one (OR 1.87, 95% CI 1.26-2.78), being in New Orleans during the storm (OR 1.69, 95% CI 1.22-2.33), and seeking health care during the storm (OR 1.69, 95% CI 1.22-2.35) were associated with positive PC-PTSD screens.There was a high prevalence of PTSD in this ED population surveyed 1 year after hurricane Katrina. By targeting high-risk patients, disaster relief teams may be able to reduce the impact of PTSD in similar populations.",0,0 +3660,Peace and War,"In the study reported here, we examined posttraumatic stress disorder (PTSD) symptoms in 746 Danish soldiers measured on five occasions before, during, and after deployment to Afghanistan. Using latent class growth analysis, we identified six trajectories of change in PTSD symptoms. Two resilient trajectories had low levels across all five times, and a new-onset trajectory started low and showed a marked increase of PTSD symptoms. Three temporary-benefit trajectories, not previously described in the literature, showed decreases in PTSD symptoms during (or immediately after) deployment, followed by increases after return from deployment. Predeployment emotional problems and predeployment traumas, especially childhood adversities, were predictors for inclusion in the nonresilient trajectories, whereas deployment-related stress was not. These findings challenge standard views of PTSD in two ways. First, they show that factors other than immediately preceding stressors are critical for PTSD development, with childhood adversities being central. Second, they demonstrate that the development of PTSD symptoms shows heterogeneity, which indicates the need for multiple measurements to understand PTSD and identify people in need of treatment.",1,0 +3661,Population Mental Health,,0,0 +3662,Pharmacotherapy of PTSD,,0,0 +3663,Standardized Self-Report Measures of Civilian Trauma and PTSD.,,0,0 +3664,Enhancing the Health Care Experiences of Adult Female Survivors of Childhood Sexual Abuse,"This article addresses the medical issues presented by women who were sexually abused in childhood and provides a detailed and direct link between the existing literature and its implications for the medical system. A profile of the sexual abuse survivor is given, including child sexual abuse (CSA) characteristics and sequelae that influence the adult female survivor's health. Post-traumatic Stress Disorder is outlined as part of a complex interplay of physiological and psychological symptomatology that can compromise the CSA survivor's ability to access health care treatment and forge a positive provider/patient relationship. This article emphasizes that effective treatment with sexual abuse survivors must include interdisciplinary collaboration among health care professionals. Management of the CSA patient, a case vignette illustrating salient themes, and finally, guidelines for the health care practitioner are presented.",0,0 +3665,Neuropsychological Dysfunction in Severe Accidental Electrical Shock: Two Case Reports,"There has been a relative absence of studies that have longitudinally examined the neuropsychological profiles of women who have sustained severe accidental electrical shocks. A case is reported of a college-educated woman who received an estimated 120-V electrical shock. Neuropsychological assessments conducted at 2 months, and at 1 and 2 years postinjury, revealed a diversity of deficits indicative of diffuse, mild to moderate neurocognitive dysfunction, as well as symptomatology consistent with depression and posttraumatic stress disorder. For comparison, a second case of a man who received a 69,000-Velectrical injury is also presented. Although only minimal neurocognitive deficits were observed in this individual, he exhibited a similar psychological profile. The results of this study are discussed in light of the contrasting neurocognitive findings but consistent psychological presentations across the two cases.",0,0 +3666,"Analysis of trauma exposure, symptomatology and functioning in Jewish Israeli and Palestinian adolescents","Background There has been no reported research comparing Jewish Israeli and Palestinian adolescents regarding the effect of ongoing political violence on adolescent psychosocial, family, post-traumatic stress disorder (PTSD) and aggression problems. Aims To compare Israeli and Palestinian responses regarding the relationship between exposure to traumatic events and psychosocial, behavioural, emotional and family problems. Method A cluster sample of youths aged 14–18 years, including 442 Jewish Israeli adolescents in Ariel, Haifa and Tel-Aviv, and 450 Palestinian adolescents in Gaza cities, villages and refugee camps were surveyed in 2006 using our Traumatic Events Questionnaire (TEV), the Brief Symptoms Inventory (BSI), the PTSD Symptom Scale – Interview (PSS–I), the Index of Peer Relations scale (IPR), Buss–Perry Aggression Questionnaire (BPAQ) and the MacMaster Family Assessment Device (FAD). Results Palestinian respondents had higher scores in the TEV, BSI, PSS–I and BPAQ questionnaires, and greater problems in functioning as revealed in the IPR and FAD. The social functioning of the adolescents with their peers predicted mental health symptoms and PTSD symptoms. Lower socioeconomic status predicted mental health symptoms, PTSD, pathology of participants' family functioning and the social functioning of the adolescents with their peers. Parents' education positively effected the FAD score and the avoidance item on the PSS–I, and religiosity improved the score on the FAD. Females reported more symptoms on the BSI and PSS–I than males, and males more symptoms on the FAD and IPR than females. Conclusions Both respondent groups had significant emotional and behavioural problems. Individual and community treatment, and community and social development, are likely to be useful for both populations, particularly Palestinians.",0,0 +3667,Personality heterogeneity in PTSD: Distinct temperament and interpersonal typologies.,"Researchers examining personality typologies of posttraumatic stress disorder (PTSD) have consistently identified 3 groups: low pathology, internalizing, and externalizing. These groups have been found to predict functional severity and psychiatric comorbidity. In this study, we employed Latent Profile Analysis to compare this previously established typology, grounded in temperament traits (negative emotionality; positive emotionality; constraint), to a novel typology rooted in interpersonal traits (dominance; warmth) in a sample of individuals with PTSD (n = 155). Using Schedule for Nonadaptive and Adaptive Personality (SNAP) traits to create latent profiles, the 3-group temperament model was replicated. Using Interpersonal Circumplex (IPC) traits to create latent profiles, we identified a 4-group solution with groups varying in interpersonal style. These models were nonredundant, indicating that the depiction of personality variability in PTSD depends on how personality is assessed. Whereas the temperament model was more effective for distinguishing individuals based on distress and comorbid disorders, the interpersonal model was more effective for predicting the chronicity of PTSD over the 10 year course of the study. We discuss the potential for integrating these complementary temperament and interpersonal typologies in the clinical assessment of PTSD.",0,0 +3668,"Coping with Chronic Social Stress in Mice: Hypothalamic-Pituitary-Adrenal/ Sympathetic-Adrenal-Medullary Axis Activity, Behavioral Changes and Effects of Antalarmin Treatment: Implications for the Study of Stress-Related Psychopathologies","The aim of this study was to analyze the individual differences that lead to the development of psychopathological changes in response to chronic social stress. We also assessed the ability of an antagonist of the corticotrophin-releasing hormone (CRH) receptors to reverse the effects of stress. Male adult mice were exposed to repeated defeat experiences for 21 days using a sensorial contact model. After 18 days of defeat, two groups of subjects were established (active and passive), according to their behaviors during social confrontation. Antalarmin treatment was given for 4 and 6 days. The results corroborated previous data indicating that subjects who adopted a passive coping strategy had higher corticosterone levels after 21 days of defeat and decreased resting levels 3 days later. Moreover, they showed higher resting expression levels of hypothalamic CRH than their active counterparts. On day 24, the experimental animals were subjected to another social defeat to determine whether the stress response remained. The increase in corticosterone and hypothalamic CRH levels was similar for all of the stressed subjects, but the passive subjects also had a greater CRH response in the amygdala. Passive subjects had decreased levels of adrenal dopamine β-hydroxylase, tyrosine hydroxylase and plasma adrenaline compared to the active subjects, and lower plasma noradrenaline levels than manipulated controls. The passive profile of physiological changes in both the hypothalamic-pituitary-adrenal and sympathetic-adrenal-medullary (SAM) axes has been associated with changes related to mood disorders, such as posttraumatic stress disorder and depression. The active coping profile is characterized by similar corticosterone resting levels to controls and increased SAM activity. Both profiles showed alterations in the novel palatable and forced swimming tests, with the passive profile being the most vulnerable to the effects of stress in this last test. Pharmacological treatment with antalarmin failed to reverse the effects of stress.",0,0 +3669,The Role of Craniocerebral Trauma in the Dynamics of Combat-Related Post-Traumatic Stress Disorder,"Study aim: To address the question of the dynamics of the clinical signs of post-traumatic stress disorder (PTSD) and the strength of their relationship with organic changes in the brain. Materials and methods: A longitudinal observations study of 87 combat veterans during the Karabakh war of 1992-1994 was performed in 2009-2011. Two groups of patients were identified. Group 1 consisted of 45 veterans who had sustained mild combat-related craniocerebral trauma followed by the development of PTSD; group 2 consisted of 42 veterans with organic brain damage of traumatic origin. Full general somatic and neurological investigations of patients were undertaken, along with assessment of the patients' status using a set of psychometric and other scales (including scales for assessment of post-traumatic reactions-the Clinician-Administered PTSD Scale (CAPS) and the Mississippi Scale for Combat-Related PTSD). Results and conclusions: Analysis of patients' status during the study and comparison with data relating to the time at which trauma was sustained showed that the groups of patients with PTSD were characterized, despite some reduction in post-traumatic symptomatology, by a higher level of severity of all PTSD symptoms during the whole of the 15-18 years of disease development, with simultaneous increases in organic mental changes. In patients with organic brain lesions, the corresponding symptomatology was more severe immediately after the traumatic event than at the time of the study. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0,0 +3670,"DEVELOPING AN INTEGRATED BRAIN, BEHAVIOR AND BIOLOGICAL RESPONSE PROFILE IN POSTTRAUMATIC STRESS DISORDER (PTSD)","The present study sought to determine a profile of integrated behavioral, brain and autonomic alterations in PTSD. Previous findings suggest that PTSD is associated with changes across electrophysiological (EEG and ERP), autonomic and cognitive/behavioral measures. In particular, PTSD has been associated with reduced cognitive performance, altered cortical arousal (measured by EEG), diminished late ERP component to oddball task targets (reduced P3 amplitude) and increased autonomic arousal relative to healthy controls. The present study examined measures of cognitive function, auditory oddball ERP components, autonomic function (heart rate and skin conductance) and EEG during resting conditions in 44 individuals with PTSD and 44 non-trauma-exposed controls, and predicted that an integrated profile of changes across a number of these measures would show a high level of sensitivity and specificity in discriminating PTSD from controls. Nine variables showing strongly significant (p < 0.002) between-group differences were entered into a discriminant function analysis. Four of these measures successfully discriminated the PTSD and non-PTSD groups: change in tonic arousal, duration of attention switching, working memory reaction time and errors of commission during visuospatial maze learning. Tonic arousal change contributed the most variance in predicting group membership. These results extend previous findings and provide an integrated biomarker profile that characterizes both PTSD and non-PTSD groups with a high degree of sensitivity and specificity. This outcome provides a platform for future studies to test how this profile of disturbances in autonomic and information processing may be unique to PTSD or may occur generically across clinical and/or other anxiety disorders.",0,0 +3671,Post-ICU consequences of patient wakefulness and sedative exposure during mechanical ventilation,"Objective: To determine the relationship between measures of critical illness (sedative/analgesic administration, wakefulness and organ dysfunction), intensive care unit (ICU) recall and symptoms of posttraumatic stress disorder. Design: Prospective, observational study with post-ICU follow-up. Setting: Medical and surgical ICUs at a teaching hospital. Patients: Two hundred seventy-seven subjects requiring > 36 h of mechanical ventilation were enrolled; 149 completed follow-up interviews 2 months later and 80 at 6 months. Interventions: None. Results: ICU recall was greater for events occurring at the end of critical illness; however, 18% of subjects had amnesia for the entire ICU course. Factual ICU recall was weakly associated with increased wakefulness during mechanical ventilation (r2 = 0.03-0.11, p< 0.05). Posttraumatic stress disorder prevalence was 17% at 2 months and 15% at 6 months. The avoidance-numbing cluster had the highest specificity (91%) for a formal diagnosis and the re-experiencing cluster had the lowest (69%). Recall of a delirious memory during critical illness was associated with more severe posttraumatic stress symptoms, but there was no association between posttraumatic stress symptoms and factual recall of ICU events. Neither ICU recall nor posttraumatic stress symptoms were associated with the intensity of sedative administration during mechanical ventilation. Posttraumatic stress symptoms were lowest in patients either the most awake during mechanical ventilation or the least awake. Conclusion: Wakefulness during mechanical ventilation has a greater influence on post-ICU recall and posttraumatic stress symptoms than sedative drug exposure or severity of illness. It is difficult to predict the future psychological consequences of an individual patient's critical illness. (",0,0 +3672,Estimating the Dimension of a Model,"The problem of selecting one of a number of models of different dimensions is treated by finding its Bayes solution, and evaluating the leading terms of its asymptotic expansion. These terms are a valid large-sample criterion beyond the Bayesian context, since they do not depend on the a priori distribution.",0,0 +3673,Does Mental Health Stigma Change Across the Deployment Cycle?,"Prior research on mental health stigma in military personnel has been cross-sectional. We prospectively examined the course of perceived mental health stigma in a cohort of deployed U.S. combat Marines.Participants (N = 768) were assessed 1 month before a 7-month deployment to Afghanistan, and again at 1, 5, and 8 months postdeployment. We also examined three predictors of the course of stigma: post-traumatic stress disorder symptom severity, vertical and horizontal unit cohesion, and mental health treatment utilization while deployed.Perceptions of stigma remained largely stable across the deployment cycle, with latent growth curve analyses revealing a statistically significant but small decrease in stigma over time. Lower post-traumatic stress disorder symptoms and greater perceived vertical and horizontal support predicted decreases in stigma over time, whereas mental health treatment utilization in theater did not predict the course of stigma.Perceived stigma was low and largely stable over time.",0,0 +3674,Omega-3 polyunsaturated fatty acids and anxiety disorders,"

Abstract

Anxiety disorders are a common group of psychiatric illnesses which have significant personal, family and societal costs. Current treatments have limited efficacy in many patients highlighting a need for new therapeutic approaches to be explored. Anxiety disorders exhibit marked comorbity with mood disorders suggesting the existence of mechanistic similarities. Such a notion is supported by observations that some conventional pharmacotherapies are both effective antidepressants and anxiolytics. As such, given that omega-3 PUFA supplementation may be effective in the treatment of major depressive disorder it is reasonable to propose that they may also possess anxiolytic properties. Experimental data in support of such a hypothesis is currently lacking although reduced abundance of omega-3 PUFA have been reported in patients with anxiety, while supplementation with omega-3 PUFA appears to inhibit activation of the HPA axis and can ameliorate some of the symptoms of anxiety. Clinical investigations carried out to date have, however, involved small numbers of participants. Larger trials using a variety of omega-3 PUFA species in clinically well-defined patients with anxiety will be required to demonstrate a therapeutic role for omega-3 PUFA in these disorders. Given the excellent side effect profile of omega-3 PUFA as well as their strong theoretical rationale, such future trials appear justified.",0,0 +3675,Measurement Properties of the Neck Disability Index: A Systematic Review,"Study Design Systematic review of clinical measurement. Objective To find and synthesize evidence on the psychometric properties and usefulness of the neck disability index (NDI). Background The NDI is the most commonly used outcome measure for neck pain, and a synthesis of knowledge should provide a deeper understanding of its use and limitations. Methods And Measures Using a standard search strategy (1966 to September 2008) and 4 databases (Medline, CINAHL, Embase, and PsychInfo), a structured search was conducted and supplemented by web and hand searching. In total, 37 published primary studies, 3 reviews, and 1 in-press paper were analyzed. Pairs of raters conducted data extraction and critical appraisal using structured tools. Ranking of quality and descriptive synthesis were performed. Results Horizon estimation suggested the potential for 1 missed paper. The agreement between raters on quality assessments was high (kappa = 0.82). Half of the studies reached a quality level greater than 70%. Failures to report clear psychometric objectives/hypotheses or to rationalize the sample size were the most common design flaws. Studies often focused on less clinically applicable properties, like construct validity or group reliability, than transferable data, like known group differences or absolute reliability (standard error of measurement [SEM] or minimum detectable change [MDC]). Most studies suggest that the NDI has acceptable reliability, although intraclass correlation coefficients (ICCs) range from 0.50 to 0.98. Longer test intervals and the definition of stable can influence reliability estimates. A number of high-quality published (Korean, Dutch, Spanish, French, Brazilian Portuguese) and commercially supported translations are available. The NDI is considered a 1-dimensional measure that can be interpreted as an interval scale. Some studies question these assumptions. The MDC is around 5/50 for uncomplicated neck pain and up to 10/50 for cervical radiculopathy. The reported clinically important difference (CID) is inconsistent across different studies ranging from 5/50 to 19/50. The NDI is strongly correlated (>0.70) to a number of similar indices and moderately related to both physical and mental aspects of general health. Conclusion The NDI has sufficient support and usefulness to retain its current status as the most commonly used self-report measure for neck pain. More studies of CID in different clinical populations and the relationship to subjective/work/function categories are required. J Orthop Sports Phys Ther 2009;39(5):400–417. doi:10.2519/jospt.2009.2930",0,0 +3676,Involvement of Anomalous Apoptosis in Impairments to Synaptic Plasticity in Post-Traumatic Stress Disorder,"Enzyme-linked immunosorbent assay was used to measure levels of apoptosis and synaptic plasticity marker proteins, i.e., annexin A5 and complexin 2 respectively, as well as the proinflammatory cytokine tumor necrosis factor alpha (TNF-alpha ), in serum from patients with post-traumatic stress disorder (PTSD) in comparison with healthy subjects. Correlations between these parameters were studied. The results obtained here showed that annexin A5 and complexin 2 concentrations in PTSD patients were significantly lower than normal, while TNF-alpha levels were higher. PTSD patients showed a positive correlation between annexin A5 and complexin 2 levels on the one hand, and a negative correlation between annexin A5 and TNF-alpha levels on the other. These data lead to the conclusion that the pathogenesis of PTSD is characterized by reduced apoptosis associated with defects in synaptic plasticity. It is suggested that anomalous apoptosis may also be among the factors supporting the development of the chronic inflammation typical of the pathogenesis of PTSD. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0,0 +3677,Self-Enhancement Among High-Exposure Survivors of the September 11th Terrorist Attack: Resilience or Social Maladjustment?,"The authors examined self-enhancing bias as a predictor of adjustment among individuals in or near the World Trade Center during the September 11, 2001, terrorist attacks. Resilience was defined from categorical and continuous analyses of both participant self-report and friend and relative ratings of adjustment. Self-enhancement was associated with a resilient outcome, ratings of better adjustment prior to September 11th, greater positive affect, and reduced perceptions of social constraints. Additional analyses indicated that self-enhancers' reduced symptom levels were fully mediated by their low perceived social constraints. However, consistent with previous evidence suggesting a social cost to self-enhancement, at 18 months post-September 11th, self-enhancers' friends and relatives also rated them as decreasing in social adjustment and as being less honest.",0,0 +3678,Does prior psychological health influence recall of military experiences? a prospective study,"In a prospective study, we evaluated pre- and postdeployment psychological health on recall of risk factors to assess recall bias. Measures of the General Health Questionnaire (GHQ), PTSD Checklist (PCL), and symptom clusters from the PCL were obtained from 681 UK military personnel along with information on traumatic and protective risk factors. Postdeployment psychological health was more important in explaining recall of traumatic experiences than predeployment psychological health. Predeployment intrusive cluster scores were highly associated with traumatic exposures. Postdeployment, but not predeployment GHQ showed small effects for most risk factors. With the exception of intrusive thoughts, there is insufficient evidence to suggest predeployment psychological status would be useful in correcting for recall bias in subsequent cross-sectional studies.",0,0 +3679,When the killer suffers: Post-traumatic stress reactions following homicide,"Objectives. The present study aimed to consider the extent to which post-traumatic stress disorder (PTSD) occurs after homicide and to examine characteristics of the offence and the offender which contribute to the development of these symptoms. It was proposed that type of violence (reactive versus instrumental) would be related to PTSD symptoms. Using Blackburn's typology of violent offenders, it was also hypothesized that primary and secondary psychopath, controlled and inhibited types would demonstrate differing forms of violence, prevalences and patterns of post-traumatic stress symptoms following the homicide. Method. Eighty homicide perpetrators were allocated equally to the four offender types based on their profiles on the Special Hospitals Assessment of Personality and Socialisation (SHAPS). Each offender completed the Post-Traumatic Stress Disorder Interview and the violence displayed during the index offence was classified as either reactive or instrumental. Results. Of the total sample, 52% met criteria for current PTSD. Reactive violence and reporting that the offence was traumatic were related to a current diagnosis of PTSD. Differing prevalences and patterns of PTSD symptoms were noted for Blackburn's offender types. Primary psychopaths showed instrumental violence and were the least traumatized. Secondary psychopaths were the most symptomatic, but not necessarily due to involvement in the homicide. Controlled and inhibited types both typically displayed reactive violence and had higher levels of current PTSD symptoms related to involvement in the offence itself. Conclusions. The extent to which PTSD follows homicide is a function of both personality type and form of violence. The results can be understood in terms of the cognitive model of Meichenbaum (1996) and also the defining dimensions of Blackburn's typology.",0,0 +3680,Behavioral markers of coping and psychiatric symptoms among sexually abused children,"The current study examined coping and psychiatric symptoms in a longitudinal sample of sexually abused children. Coping was behaviorally coded from children's forensic interviews in the aftermath of sexual abuse. Using principal components analysis, coping behaviors were found to cluster into 3 categories: avoidant, expressive, and positive affective coping. Avoidant coping had predictive utility for a range of psychiatric symptoms, including depressive, posttraumatic stress, anxiety, and dissociative symptoms as well as aggression and attention problems measured 8–36 months following the forensic interview. Specific behaviors, namely fidgetiness and distractibility, were also found to be associated with future symptoms. These findings suggest the predictive utility of avoidant behaviors in general, and fidgetiness and distractibility in particular, among sexually abused children.",0,0 +3681,Posttraumatic Stress Disorder Symptom Structure in Chinese Adolescents Exposed to a Deadly Earthquake,"This present study examined the structure of posttraumatic stress disorder (PTSD) symptoms in a large sample of Chinese adolescents exposed to a deadly earthquake. A total of 2,800 middle school students aged 12 to 18 years participated in the study 6 months after the ""Wenchuan Earthquake"". Results of confirmatory factor analysis indicated that a five-factor intercorrelated model composed of intrusion, avoidance, numbing, dysphoric arousal, and anxious arousal, fit data significantly better than both the four-factor numbing model King et al. (Psychological Assessment 10:90-96, 1998) and the four-factor dysphoria model Simms et al. (Journal of Abnormal Psychology 111:637-647, 2002). Further examination of the external convergent and discriminant validity revealed that except for the dysphoric arousal factor, the remaining four PTSD factors yielded significantly different correlations with external measures of anxiety vs. depression. The findings add to the limited literature on the factor structure of PTSD in youths and on the five-factor PTSD model. In addition, they provide more detail into the latent psychopathological processes of PTSD, and inform the forthcoming DSM-5. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +3682,A Population-Based Study of Familial and Individual-Specific Environmental Contributions to Traumatic Event Exposure and Posttraumatic Stress Disorder Symptoms in a Norwegian Twin Sample,"Objective: Posttraumatic stress disorder (PTSD) is one of the only disorders in the Diagnostic and Statistical Manual of Mental Disorders that requires an environmental exposure. The relationship between liability factors for trauma exposure and those for PTSD symptoms following exposure are unclear. Methods: Exposure to a trauma and resulting PTSD symptoms were assessed in a sample of 2,794 members of the Norwegian Institute of Public Health Twin Panel. Results: In the full sample, 737 twins experienced a trauma. A modified causal, contingent, common pathway model was used to examine trauma exposure and liability for PTSD. Genetic and common environmental factors could not be distinguished, so a model that included only familial and individual specific components was fit. The best-fitting model suggested that familial factors played an important role in liability for trauma exposure and for resulting PTSD symptoms, and that there was a modest transmission between trauma exposure and subsequent PTSD symptoms. Conclusions: One third of the variance in liability of PTSD symptoms is due to familial factors, and of this, approximately one fifth overlaps with the familial liability for trauma exposure while the other four fifths of the variance is specific to the risk of PTSD symptoms following exposure. The hypothesis that PTSD is etiologically similar to exposures to a traumatic event is not supported, suggesting that the factors that confer risk for trauma do not overlap completely with those that confer risk for PTSD.",0,0 +3683,"Pain and PTSD symptoms in female veterans⋆,⋆⋆","There has been growing empirical examination of the co-occurrence of pain and post-traumatic stress disorder (PTSD) symptoms, and existing evidence suggests that the symptoms associated with each have a close association. To date, however, the association has only been examined within samples of mostly male participants.In the present study, pain and PTSD symptoms were examined in a sample of 221 female veterans who utilised the VA Healthcare System between 1998 and 1999.Women who visited the clinic between 1998 and 1999 were mailed a self-report questionnaire package designed to elicit information regarding general health (including pain experiences), military and trauma history, childhood abuse and neglect, and PTSD symptoms. Analyses were conducted to identify differences in pain experience between those women classified as having PTSD, subsyndromal PTSD, and no PTSD. Analyses were also conducted to determine the degree to which pain-related (e.g., current pain, interference with activity) variables predicted PTSD symptom cluster scores.The three groups differed significantly on a number of pain-related variables. Analyses suggested that pain-related variables were significant predictors of PTSD symptom cluster scores.These results indicate that the association between pain and PTSD symptoms, previously observed in primarily male samples, is generalisable to females. Clinical implications and possible mechanisms of association are discussed.",0,0 +3684,Posttraumatic Stress Disorder Among Cuban Children and Adolescents After Release From a Refugee Camp,"The authors compared self-reported symptoms of posttraumatic stress disorder (PTSD) in a cohort of Cuban children and adolescents with assessments of internalizing and externalizing behaviors by the children's teachers.Eighty-seven children and adolescents who had left Cuba by sea in the summer of 1994 and who had been confined to refugee camps for up to eight months before arriving in the United States were evaluated four to six months later. Self-reported symptoms of PTSD were assessed with the Post-Traumatic Stress Disorder Reactive Index, and internalizing and externalizing behaviors were assessed with the Child Behavioral Check List-Teacher Report Form.A majority of the children reported moderate to severe PTSD symptoms. The most common symptom clusters were avoidance (67 percent), regressive behaviors (64 percent), reexperiencing the traumatic events (60 percent), somatic symptoms (52 percent), and hyperarousal (51 percent). Eighty-six percent of the children reported that the refugee experience had severely affected most of their peers. A statistically significant dose-effect relationship was found between the number of stressors and the severity of self-reported PTSD symptoms. There was a modest relationship between withdrawn behavior and children's feelings that they would die at sea and witnessing violence at the camps. Age and witnessing violence in the camps were moderately associated with PTSD. Teachers' overall ratings of externalizing and internalizing behaviors did not produce any clinically significant findings.PTSD symptoms among refugee children and adolescents who have been exposed to multiple and prolonged stressors may continue unabated after the stressors are removed. The symptoms are experienced subjectively and may go unnoticed by adults.",0,0 +3685,Systems of Care for Traumatized Children: The Example of a School-Based Intervention Model,"In this chapter we will describe the development of a system of care for children through educational systems. Providing a continuum of trauma services for Israeli school children during long periods of exposure to trauma focuses on an array of services ranging from prevention to intervention. The school-based intervention model incorporates principles of both community and clinical psychology. Traditionally, services have focused on those who have been identified as suffering from posttraumatic stress disorders or other clinical diagnoses. The continuum of trauma services model recognizes the importance of treating those who are suffering, while not overlooking the large, silent majority of the population who cope reasonably well through other trajectories. The provision of a range of services, from community interventions to clinical interventions within one system of care, forms one of the touchstones of this model. © Springer Science+Business Media New York 2015.",0,0 +3686,"Steroids, psychosis and poly-substance abuse","Objective To review consequences of the changing demographic profile of anabolic-androgenic steroid (AAS) use. Method Case report and review of key papers. Results We report here a case of a 19-year-old Irish male presenting with both medical and psychiatric side effects of methandrostenolone use. The man had a long-standing history of harmful cannabis use, but had not experienced previous psychotic symptoms. Following use of methandrostenolone, he developed rhabdomyolysis and a psychotic episode with homicidal ideation. Discussion Non-medical AAS use is a growing problem associated with medical, psychiatric and forensic risks. The population using these drugs has changed with the result of more frequent poly-substance misuse, potentially exacerbating these risks. Conclusion A higher index of suspicion is needed for AAS use. Medical personnel need to be aware of the potential side effects of their use, including the risk of violence. Research is needed to establish the magnitude of the problem in Ireland.",0,0 +3687,Post traumatic stress disorder: undiagnosed cases in a tertiary inpatient setting,"Objective: Post traumatic stress disorder (PTSD) is a common, debilitating anxiety disorder characterized by emotional and physical symptoms that may occur after exposure to a severely traumatic event. Since it occurs commonly as a comorbid diagnosis with other mood- and anxiety disorders, we postulated that this disorder may be under- diagnosed in therapeutic wards where anxiety and mood disorders are treated. The study thus sought to determine the prevalence of undiagnosed PTSD in an inpatient population, and to compare the demographic details and comorbid diagnoses of subjects with and without PTSD. Method: The Clinician-administered PTSD Scale for DSM-IV (CAPS) was administered to 40 subjects who were inpatients in a therapeutic ward of a large psychiatric hospital and who had never had a diagnosis of PTSD before. Results:16 (40%) subjects met the DSM-IV criteria for PTSD. We did not find significant clinical differentiating factors between subjects with and without PTSD; however subjects with PTSD were more likely to use cannabis. Conclusions: PTSD remains undiagnosed in many patients admitted to therapeutic units. Keywords: Stress Disorders, Post-Traumatic; Diagnosis; Inpatients;African Journal of Psychiatry Vol. 11 (2) 2008 pp. 119-122",0,0 +3688,Whiplash-associated disorder: musculoskeletal pain and related clinical findings,"The aim of this paper was to review the physical and psychological processes associated with whiplash-associated disorders. There is now much scientific data available to indicate the presence of disturbed nociceptive processing, stress system responses, muscle and motor changes as well as psychological factors in both acute and chronic whiplash-associated disorders. Some of these factors seem to be associated with the transition from acute to chronic pain and have demonstrated prognostic capacity. Further investigation is required to determine if these processes can be modified and if modification will lead to improved outcomes for this condition. The burden of whiplash injuries, the high rate of transition to chronicity, and evidence of limited effects of current management on transition rates demand new directions in evaluation and management. The understanding of processes underlying this condition is improving and this lays the foundation for the development of more effective management approaches.",0,0 +3689,Event-list construction and treatment of exposure data in research on political violence,"Event lists are commonly applied for measuring exposure to various kinds of potentially stressful and traumatizing life events. Before making general conclusions about the psychological effects of exposure to such events, problematic issues related to the use of event-list data need to be discussed and resolved. This article focuses on issues related to the construction and application of event lists for measuring exposure to political violence such as issues related to reliability, the applicability of the additive assumption, whether to weight event-list items, and the possible consequences of incomplete event lists. Alternative future approaches to these measurement issues are also discussed.",0,0 +3690,Neuroanatomy and Neuroimaging of Anxiety Disorders,"Neuroimaging methods can be used to examine functional brain differences between healthy individuals and those with anxiety disorders. After the brain regions implicated in the pathophysiology of anxiety disorders (e.g., amygdalo-cortical circuitry) are reviewed, neuroimaging studies of posttraumatic stress disorder (PTSD), social anxiety disorder (SAD), specific phobia (SP), and panic disorder (PD) that report activations in these regions are discussed. Studies of obsessive-compulsive disorder (OCD) implicate a distinct neurocircuitry profile (i.e., cortico-striatal-thalamic circuit) compared to the other anxiety disorders. Few neuroimaging studies of generalized anxiety disorder (GAD) have been conducted. In addition, results from functional connectivity analyses and the effects of treatment on neuroimaging findings are summarized.",0,0 +3691,Longitudinal Assessment of Dissociation in Holocaust Survivors With and Without PTSD and Nonexposed Aged Jewish Adults,"The trajectory of posttraumatic stress disorder (PTSD) and PTSD-related symptoms in relation to aging is not well understood. We previously observed higher levels of dissociation as measured by the Dissociative Experiences Scale (DES) among older Holocaust survivors with, compared to those without, PTSD, though scores on the DES in Holocaust survivors were markedly lower than those that had been reported for younger cohorts. We undertook a longitudinal evaluation of dissociation in Holocaust survivors. Twenty-six Holocaust survivors with current PTSD, 30 Holocaust survivors without current PTSD, and 19 nonexposed were evaluated at the initial evaluation and subsequently 8.11 years later. Repeated measures analysis of variance (ANOVA) on the DES scores from these times demonstrated a significant main effect for time and a significant group by time interaction, reflecting a marked decline in Holocaust survivors, particularly those with PTSD. Controlling for age obliterated the effect of time, but not the group by time interaction. A similar pattern was shown with The Clinician Administered PTSD Scale (CAPS) scores. Different symptoms related to PTSD show different trajectories of change with age, with dissociation appearing to be less prominent with age.",0,0 +3692,Posttraumatic Shame and Guilt,"Posttraumatic shame and guilt are important dimensions of posttraumatic syndromes, including simple and complex post-traumatic stress disorder (PTSD). The concepts of posttraumatic shame and guilt have received little theoretical or empirical investigation in the field of traumatology. It is proposed that there are acute and prolonged states of posttraumatic shame and guilt that can be compared in their consequences across eight psychosocial dimensions: (a) self-attribution processes, (b) emotional states and capacity for affect regulation, (c) appraisal and interpretation of actions, (d) the impact of states of shame and guilt on personal identity, (e) suicidality, (f) defensive patterns, (g) proneness to psychopathology and PTSD, and (h) the dimensions of the self-structure adversely affected by states of posttraumatic shame and guilt. The experience of posttraumatic states of shame and guilt are associated with compounded affective processesin PTSD, depression, and substance use disorders.",0,0 +3693,Offenders as victims: post-traumatic stress disorder and substance use disorder among male prisoners,"Background: Comorbid substance use disorder(s) and post-traumatic stress disorder (SUD-PTSD) is common among prisoners and linked to an increased risk of criminal recidivism; however, little is known about the characteristics of prisoners with this comorbidity. Aim: This study provides a preliminary examination of the clinical and criminal profile of male inmates with symptoms of SUD-PTSD, and examines whether this profile differs according to whether a person has experienced a trauma while in prison. Methods: Thirty male inmates from two correctional centres in Sydney, Australia, were recruited and assessed using a structured interview. Results: The sample reported extensive criminal, substance use and trauma histories. A history of substance dependence was almost universal (90%) and 56.7% met diagnostic criteria for PTSD with the remainder experiencing sub-threshold symptoms. Forty-three per cent reported a traumatic event while in prison. Those who had experienced trauma in prison, compared to those wh...",0,0 +3694,"Predictors of Intimate Partner Violence Revictimization: The Relative Impact of Distinct PTSD Symptoms, Dissociation, and Coping Strategies","Psychological distress and coping strategies following intimate partner violence (IPV) victimization may impact survivors' risk for future IPV. The current study prospectively examined the impact of distinct posttraumatic stress disorder (PTSD) symptom clusters (reexperiencing, avoidance, numbing, and hyperarousal), dissociation, and coping strategies (engagement and disengagement coping) on IPV revictimization among recently abused women. Women (N = 69) who were seeking services for IPV and experienced their most recent episode of physical IPV between 2 weeks and 6 months prior to study enrollment completed measures of physical IPV, psychological distress, and coping strategies at baseline and at 6-month follow-up. The women averaged 36 years of age and 67% of the sample was African American. Separate Poisson regression analyses revealed that PTSD hyperarousal symptoms, dissociation, engagement coping, and disengagement coping each significantly predicted physical IPV revictimization at the 6-month follow-up (with effect sizes ranging from a 1.20-1.34 increase in the likelihood of Time 2 physical IPV with a 1 SD increase in the predictor). When these significant predictors were examined together in a single Poisson regression model, only engagement and disengagement coping were found to predict physical IPV revictimization such that disengagement coping was associated with higher revictimization risk (1.29 increase in the likelihood of Time 2 physical IPV with one SD increase in disengagement coping) and engagement coping was associated with lower revictimization risk (1.30 decrease in the likelihood of Time 2 physical IPV with one SD increase in engagement coping). The current findings suggest that coping strategies are important and potentially malleable predictors of physical IPV revictimization.",0,0 +3695,[Insufficient cooperativeness in forensic neuropsychiatric assessment: prevalence estimates of negative response bias].,"In the context of independent medical examinations, negative response bias in patients is a problem of primary importance, especially in cases where self-reported symptoms cannot be directly verified by the examiner. Estimates of the prevalence of uncooperativeness in neuropsychological evaluations demonstrated that invalid test profiles are to be expected in a sizable minority of examinees. However, no estimates have ever been published in German-speaking countries. Symptom validity was checked in 235 patients who reported cognitive symptoms after suffering an accident and who underwent forensic neuropsychiatric assessment. Patient classification was based on the results obtained with the Word Memory Test (WMT) or the Medical Symptom Validity Test (MSVT). When applying the recommended cutoffs for these tests, 44.3 percent of the sample was found to be classified as suspect for insufficient effort. In a subsample of 47 patients with claims of posttraumatic stress disorder 51.1 percent were found to score below the cutoffs. These findings underline the importance of modern methods for assessment of symptom validity in forensic contexts. Cooperativeness of compensation claimants cannot be assumed solely on the basis of clinical impression.",0,0 +3696,All Symptoms Are Not Created Equal: The Prominent Role of Hyperarousal in the Natural Course of Posttraumatic Psychological Distress.,"This 3-wave longitudinal study examined the natural course of posttraumatic stress disorder symptoms using data collected from young adult survivors of community violence. Three key findings emerged. 1. Mean levels of distress for each symptom cluster decreased over time, with reexperiencing decreasing most rapidly. 2. Cross-lagged panel analysis revealed that hyperarousal strongly influences, but is not generally influenced by, other symptoms clusters. 3. Trajectory analysis demonstrated that respondents for whom hyperarousal was the most pronounced baseline symptom showed lower overall symptom improvement relative to trauma exposed counterparts for whom hyperarousal was a less prominent early symptom. Implications for theory, research, and clinical practice are discussed.",0,0 +3697,Traumatic Stress Symptomatology After Child Maltreatment and Single Traumatic Events: Different Profiles,"The sequelae of child maltreatment tend to extend current posttraumatic stress disorder (PTSD) symptoms. This study examined this assumption, hypothesizing that (a) PTSD and trauma-related symptoms are more severe after single trauma than after child maltreatment; (b) symptoms unrelated to trauma are more severe after child maltreatment than after single trauma; and (c) a comorbid association of clinical PTSD with trauma-related symptoms is more prevalent after single trauma, whereas a comorbid association of clinical PTSD with trauma unrelated symptoms is more prevalent after child maltreatment. The Trauma Symptom Checklist for Children (TSCC) assessed PTSD and trauma-related symptoms in 256 children (83 children exposed to single trauma, 173 to child maltreatment). The Strengths and Difficulties Questionnaire (SDQ) assessed trauma-unrelated symptoms. Single-trauma children reported significantly more severe PTSD and trauma-related symptoms. Significantly more severe trauma unrelated symptoms were reported after child maltreatment. A significant relation was found between clinical PTSD and more severe trauma-related symptoms in both samples. Likelihood of children meeting PTSD symptoms after trauma seems to decrease when traumatization becomes more complex. Findings support our assumption that symptomatology of maltreated children extends current PTSD symptoms.",0,0 +3698,Clinical Phenomenology of Childhood Abuse–Related Complex PTSD in a Population of Female Patients: Patterns of Personality Disturbance,"Complex posttraumatic stress disorder (PTSD) involves a variety of personality disturbances presumed to result from repeated interpersonal trauma such as child abuse. As Complex PTSD patients are a heterogeneous population, we searched for clinically relevant personality-based subtypes.This study used a cluster analysis of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), Axis II features within a sample of 71 female outpatients with systematically assessed child abuse-related Complex PTSD.Two main subtypes were found: adaptive and nonadaptive. The latter was further differentiated into withdrawn, alienated, suffering, and aggressive subtypes, characterized by different levels of introversion and disinhibition. Among the nonadaptive subtypes, the severity of Complex PTSD symptoms was lowest in the withdrawn (introverted only) subtype. The subtypes differed in their level of dissociation and depression but did not differ regarding PTSD symptoms, trauma history, or parental bonding characteristics.Confirming earlier findings, our study found personality-based Complex PTSD subtypes, which could implicate differential treatment needs and results.",0,0 +3699,Hippocampal volume in aging combat veterans with and without post-traumatic stress disorder: Relation to risk and resilience factors,"To examine whether there are post-traumatic stress disorder (PTSD) related differences in hippocampal volume in middle-aged and elderly veterans and to examine the relationship of neuroendocrine activity, memory performance, and measures of risk and resilience for PTSD to hippocampal volume in this cohort.Seventeen veterans with chronic PTSD and 16 veterans without chronic PTSD received an MRI scan followed by neuroendocrine assessment (24-h urinary cortisol excretion and the lysozyme IC(50-DEX), a measure of glucocorticoid receptor (GR) responsiveness), and cognitive testing.Veterans with PTSD did not differ from those without PTSD in hippocampal volume, but they did show significantly lower urinary cortisol levels, and poorer memory performance on the Wechsler Logical Memory test and Digit Span test. Smaller left hippocampal volumes were observed in veterans who developed PTSD in response to their first reported traumatic exposure, compared to veterans who had first experienced a traumatic event to which they did not develop PTSD, prior to experiencing a subsequent event that led to PTSD. In contrast, the two neuroendocrine measures were associated with risk factors related to early trauma exposure.Although hippocampal volume was not found to differ between subjects with and without PTSD, smaller hippocampal volumes in PTSD may be associated with specific risk and resilience factors. These may be distinct from vulnerability markers associated with increased responsiveness to glucocorticoids and/or other neuroendocrine measures that have been observed in combat-related PTSD.",0,0 +3700,"Memory deficits, postconcussive complaints, and posttraumatic stress disorder in a volunteer sample of veterans.","To better understand how memory impairment is related to postconcussive complaints and to posttraumatic stress disorder (PTSD) and whether these relationships remain after controlling for premorbid cognitive ability.We examined memory impairment, premorbid cognitive ability, postconcussive complaints, and symptoms of PTSD in 205 veterans, 135 of who gave a self-reported history of concussion and exposure to a traumatic life event. We limited our sample to those who gave good effort on cognitive testing according to a symptom validity measure.Although memory impairment was not associated with a history of concussion, it was associated with severity of postconcussive complaints. That association was no longer significant after controlling for premorbid IQ. A similar analysis yielded slightly different findings for PTSD. Memory impairment was associated with PTSD diagnosis, although it was not associated with severity of PTSD symptoms after controlling for premorbid ability.These data are consistent with multifactorial models of the etiology of postconcussion disorder and PTSD such as the ""burden of adversity hypothesis"" described by Brenner, Vanderploeg, and Terrio (2009). In such models, symptom severity and course of recovery are determined not only by trauma severity but (also) premorbid risk factors and postonset complications. (PsycINFO Database Record (c) 2013 APA, all rights reserved).",0,0 +3701,Association between posttraumatic stress disorder and inflammation: A twin study,"The association of posttraumatic stress disorder (PTSD) with cardiovascular disease risk may be mediated by inflammation. Our objective was to examine the association between PTSD and measures of inflammation and to determine whether these associations are due to shared familial or genetic factors. We measured lifetime history of PTSD using the Structured Clinical Interview for DSM-IV in 238 male middle-aged military veteran twin pairs (476 individuals), selected from the Vietnam Era Twins Registry, who were free of cardiovascular disease at baseline. We assessed inflammation using levels of high-sensitivity C-reactive protein (hsCRP), interleukin 6 (IL-6), fibrinogen, white blood cells, vascular cell adhesion molecule-1, and intercellular adhesion molecule-1 (ICAM-1). Geometric mean levels and percent differences by PTSD were obtained from mixed-model linear regression analyses with adjustment for potential confounders. Within-pair analysis was conducted to adjust for shared family environment and genetics (monozygotic pairs). Overall, 12.4% of participants had a lifetime history of PTSD. Adjusted mean levels of hsCRP and ICAM-1 were significantly higher among those with vs. without PTSD [hsCRP: 1.75 vs. 1.31mg/l (33% difference); ICAM-1: 319 vs. 293ng/ml (9% difference)]. Adjustment for depression rendered the association of PTSD with hsCRP non-statistically significant. For IL-6, no consistent association was seen. Within-pair analysis produced associations that were similar in direction for all three markers but lesser in magnitude for hsCRP and IL-6. There was no evidence of interaction by zygosity. Elevated hsCRP and ICAM-1 are associated with PTSD, and these associations may be confounded by shared non-genetic, antecedent familial and environmental factors.",0,0 +3702,Ecstasy and other club drugs: a review of recent epidemiologic studies,"This review highlights the epidemiologic research on club drug use in the past year, with a focus on clinical epidemiology, social epidemiology, new methodological approaches, and alternative explanations for drug use behaviors.Although 3,4-methylenedioxy-N-methylamphetamine (MDMA) or ecstasy is currently classified as a type of hallucinogen and its withdrawal is not recognized in the Diagnostic and Statistical Manual of Mental Disorders, there is evidence for the association of withdrawal symptoms with MDMA abstinence. Findings from latent class analysis indicate that MDMA users have a significantly higher risk of dependence than lysergic acid diethylamide users. Research on sociodemographic factors associated with club drug use continues to be a main focus worldwide. New epidemiologic research methods have been developed to enable researchers to monitor real-time drug use behaviors and to conduct surveys on sensitive issues in public places. In addition to traditional behavioral models, researchers began to examine the club drug phenomenon in the context of economic environment.Recent findings on MDMA use further question the current drug classification in the diagnostic systems. Despite the continuous growth in the club drug research literature, there is no study on the influence of genetic factors on club drug use. More research in this area is needed.",0,0 +3703,"Cognition and depression: the effects of fluvoxamine, a sigma-1 receptor agonist, reconsidered","Cognitive impairment is a primary feature of patients with major depressive disorder (MDD) and is characterised by stress-induced neural atrophy. Via alpha-adrenergic, anti-cholinergic and anti-histaminic activities, several antidepressants can cause significant counter-therapeutic cognitive impairment. Evidence is emerging of the involvement of sigma-1 receptor agonism in the mechanism of action of some antidepressants, notably fluvoxamine. Sigma-1 receptors are abundant in areas affected by depression/stress-induced cerebral atrophy and their ligands have a unique pharmacological profile; they may promote neurogenesis and initiate adaptive neural plasticity as a protection/reaction to stress. Fluvoxamine, as a potent sigma-1 receptor agonist, has shown ameliorating effects in animal models of psychosis, depression, stress, anxiety, obsessive-compulsive disorder (OCD) and aggression and has been shown to improve cognitive impairments. In humans, fluvoxamine may repair central nervous system (CNS) atrophy and restore cognitive function. The current review explores the mechanisms through which sigma-1 receptors can modulate cognitive function and examines how antidepressant therapy with fluvoxamine may help improve cognitive outcomes in patients with depression. Copyright © 2010 John Wiley & Sons, Ltd.",0,0 +3704,Intensive cognitive therapy for post-traumatic stress disorder: Case studies,"There is good evidence from randomized controlled trials that cognitive therapy (CT) for post-traumatic stress disorder (PTSD) (Ehlers et al., 2009) is an effective treatment (Duffy, Gillespie, & Clark, 2007; Ehlers, Clark, Hackmann, McManus, & Fennell, 2005; Ehlers et al., 2003). Furthermore, CT has been successfully disseminated to routine clinical settings in which, in contrast to randomized trials, no exclusion criteria are applied (Duffy et al., 2007; Gillespie, Duffy, Hackmann, & Clark, 2002). Finally, CT has been shown to work for acute and chronic PTSD following from one or two events (Ehlers et al., 2003, 2005), and for very chronic PTSD following multiple traumas (Duffy et al., 2007). The efficacy and effectiveness of CT for PTSD is in line with the finding from recent meta-analyses that trauma-focused cognitive behaviour therapy (CBT) is effective in the treatment of PTSD (e.g., Bisson et al., 2007). Other effective forms of trauma-focused CBT are Foa’s Prolonged Exposure (Foa & Rothbaum, 1998; Foa et al., 2005) and Resick’s Cognitive Processing Therapy (Resick & Schnicke, 1993).",0,0 +3705,PTSD in physically and sexually abused psychiatrically hospitalized children,"The history of sexual and physical abuse and the diagnosis of PTSD were examined in 98 psychiatrically hospitalized children. Relative to past studies, there was an increased incidence of abuse and of prevalence of PTSD. Specific instruments for assessing abuse and PTSD are suggested.",0,0 +3706,Childhood Sexual Abuse and Psychosomatic Symptoms in Irritable Bowel Syndrome,"Irritable bowel syndrome is characterized by chronic gastrointestinal symptoms without a demonstrable physical cause. In a subgroup of patients, irritable bowel syndrome may be part of a cluster of psychosomatic symptoms related to childhood sexual abuse. To investigate this possibility, the Dissociative Disorders Interview Schedule (DDIS), the Dissociative Experiences Scale (DES) and the Symptom Checklist-90 (SCL-90) were administered to 105 subjects with either irritable bowel syndrome, inflammatory bowel disease (Crohn's disease or ulcerative colitis), or other gastrointestinal disorders. The subjects in the three groups did not differ on the DES, the SCL-90 or most sections of the DDIS. However, subjects with irritable bowel syndrome reported much higher rates of childhood sexual abuse and psychosomatic symptoms.",0,0 +3707,The geography of post-disaster mental health: spatial patterning of psychological vulnerability and resilience factors in New York City after Hurricane Sandy,"Only very few studies have investigated the geographic distribution of psychological resilience and associated mental health outcomes after natural or man made disasters. Such information is crucial for location-based interventions that aim to promote recovery in the aftermath of disasters. The purpose of this study therefore was to investigate geographic variability of (1) posttraumatic stress (PTS) and depression in a Hurricane Sandy affected population in NYC and (2) psychological vulnerability and resilience factors among affected areas in NYC boroughs.Cross-sectional telephone survey data were collected 13 to 16 months post-disaster from household residents (N = 418 adults) in NYC communities that were most heavily affected by the hurricane. The Posttraumatic Stress Checklist for DSM-5 (PCL-5) was applied for measuring posttraumatic stress and the nine-item Patient Health Questionnaire (PHQ-9) was used for measuring depression. We applied spatial autocorrelation and spatial regimes regression analyses, to test for spatial clusters of mental health outcomes and to explore whether associations between vulnerability and resilience factors and mental health differed among New York City's five boroughs.Mental health problems clustered predominantly in neighborhoods that are geographically more exposed towards the ocean indicating a spatial variation of risk within and across the boroughs. We further found significant variation in associations between vulnerability and resilience factors and mental health. Race/ethnicity (being Asian or non-Hispanic black) and disaster-related stressors were vulnerability factors for mental health symptoms in Queens, and being employed and married were resilience factors for these symptoms in Manhattan and Staten Island. In addition, parental status was a vulnerability factor in Brooklyn and a resilience factor in the Bronx.We conclude that explanatory characteristics may manifest as psychological vulnerability and resilience factors differently across different regional contexts. Our spatial epidemiological approach is transferable to other regions around the globe and, in the light of a changing climate, could be used to strengthen the psychosocial resources of demographic groups at greatest risk of adverse outcomes pre-disaster. In the aftermath of a disaster, the approach can be used to identify survivors at greatest risk and to plan for targeted interventions to reach them.",0,0 +3708,Diagnostic alterations for post-traumatic stress disorder: examining data from the National Comorbidity Survey Replication and National Survey of Adolescents,"Background Two alternative models of post-traumatic stress disorder (PTSD) appear to represent the disorder's latent structure better than the traditional Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) three-factor PTSD model. The present study examines the impact of using these structural models for the diagnosis of lifetime PTSD while retaining the DSM-IV PTSD's six-symptom diagnostic requirement. Method Data were gathered from large-scale, epidemiological datasets collected with adults (National Comorbidity Survey Replication) and adolescents (National Survey of Adolescents). Two alternative, empirically supported four-factor models of PTSD were compared with the DSM-IV three-factor PTSD diagnostic model. Results Results indicated that the diagnostic alterations resulted in substantially improved structural validity, downward adjustments of PTSD's lifetime prevalence (roughly 1 percentage point decreases in adults, 1–2.5 percentage point decreases in adolescents), and equivalent psychiatric co-morbidity and sociodemographic associations. Conclusions Implications for modifying PTSD diagnostic criteria in future editions of DSM are discussed.",0,0 +3709,Remote stress detection using a visible spectrum camera,"Heart rate variability (HRV) can be an important indicator of several conditions that affect the autonomic nervous system, including traumatic brain injury, post-traumatic stress disorder and peripheral neuropathy. Recent work has shown that some of the HRV features can potentially be used for distinguishing a subject’s normal mental state from a stressed one. In all of these past works, HRV analysis is performed on the cardiac activity data acquired by conventional electrocardiography electrodes, which may introduce additional stress and complexity to the acquired data. In this paper we use remotely acquired time-series data extracted from the human facial skin reflectivity signal during rest and mental stress conditions to compute HRV driven features. We further apply a set of classification algorithms to distinguishing between these two states. To determine heart beat signal from the facial skin reflectivity, we apply Principal Component Analysis (PCA) for denoising and Independent Component Analysis (ICA) for source selection. To determine the signal peaks to extract the RR-interval time-series, we apply a threshold-based detection technique and additional peak conditioning algorithms. To classify RR-intervals, we explored classification algorithms that are commonly used for medical applications such as logistic regression and linear discriminant analysis (LDA). Goodness of each classifier is measured in terms of sensitivity/specificity. Results from each classifier are then compared to find the optimal classifier for stress detection. This work, performed under an IRB approved protocol, provides initial proof that remotely-acquired heart rate signal can be used for stress detection. This result shows promise for further development of a remote-sensing stress detection technique both for medical and deception-detection applications.",0,0 +3710,Long-Term Course of Post-Traumatic Stress Disorder (PTSD) in German Soldiers: Effects of Inpatient Eye Movement Desensitization and Reprocessing Therapy and Specific Trauma Characteristics in Patients with Non-Combat-Related PTSD,"In this study, we retrospectively evaluated a patient population of 89 German soldiers who received inpatient treatment for post-traumatic stress disorder at the German Armed Forces Hospital in Hamburg from 1998 to 2003.Patients were nonrandomly assigned to a treatment group who received eye movement desensitization and reprocessing and a comparison group with general hospital treatment and relaxation training. Follow-up information was obtained 29 months post-treatment. Trauma-related symptoms were assessed using the Impact of Event Scale and the Post-Traumatic Stress Scale (PTSS-10) as parameters of improvement.The Impact of Event Scale showed that inpatient trauma therapy with eye movement desensitization and reprocessing significantly improved the course of post-traumatic stress disorder. In addition, the Impact of Event Scale indicated a significantly poorer long-term outcome for patients who had been confronted with death during their traumatic experience. Other factors tested were of no significant influence.These results may influence further treatment strategies for traumatized German soldiers.",0,0 +3711,Involving Parents in Indicated Early Intervention for Childhood PTSD Following Accidental Injury,"Accidental injuries represent the most common type of traumatic event to which a youth is likely to be exposed. While the majority of youth who experience an accidental injury will recover spontaneously, a significant proportion will go on to develop Post-Traumatic Stress Disorder (PTSD). And yet, there is little published treatment outcome research in this area. This review focuses on two key issues within the child PTSD literature-namely the role of parents in treatment and the timing of intervention. The issue of parental involvement in the treatment of child PTSD is a question that is increasingly being recognized as important. In addition, the need to find a balance between providing early intervention to at risk youth while avoiding providing treatment to those youth who will recover spontaneously has yet to be addressed. This paper outlines the rationale for and the development of a trauma-focused CBT protocol with separate parent and child programs, for use with children and adolescents experiencing PTSD following an accidental injury. The protocol is embedded within an indicated intervention framework, allowing for the early identification of youth at risk within a medical setting. Two case studies are presented in order to illustrate key issues raised in the review, implementation of the interventions, and the challenges involved. © 2012 Springer Science+Business Media, LLC.",0,0 +3712,Positive and negative emotion prospectively predict trajectories of resilience and distress among high-exposure police officers.,"Responses to both potentially traumatic events and other significant life stressors have been shown to conform to discrete patterns of response such as resilience, anticipatory stress, initial distress with gradual recovery, and chronic distress. The etiology of these trajectories is still unclear. Individual differences in levels of negative and positive emotion are believed to play a role in determining risk and resilience following traumatic exposure. In the current investigation, we followed police officers prospectively from academy training through 48 months of active duty, assessing levels of distress every 12 months. Using latent class growth analysis, we identified 4 trajectories closely conforming to prototypical patterns. Furthermore, we found that lower levels of self-reported negative emotion during academy training prospectively predicted membership in the resilient trajectory compared with the more symptomatic trajectories following the initiation of active duty, whereas higher levels of positive emotion during academy training differentiated resilience from a trajectory that was equivalently low on distress during academy training but consistently grew in distress through 4 years of active duty. These findings emerging from a prospective longitudinal design provide evidence that resilience is predicted by both lower levels of negative emotion and higher levels of positive emotion prior to active duty stressor exposure.",0,0 +3713,Posttraumatic symptomatology in children exposed to war,"This study examines affective and behavioral symptomatology in two groups of school-age children who were traumatized to different degrees during the war in Croatia (N = 1034). Six self-reported questionnaires were used to assess the following: number and type of war experiences, PTSD symptoms, anxiety, depression, psychosomatic symptoms, and psychosocial adaptation. Canonical discriminant analysis yielded a significant discriminant function that indicates moderate differentiation between the two groups of children according to the assessed symptoms. The results of a 2 x 2 x 2 ANOVAs (gender x age x level of traumatization) indicate that the children's reactions to war traumata varied in respect to all factors, as well as their interaction. The results indicate that gender differences are more prominent in older children. Older girls report more posttraumatic stress reactions, anxiety and depression, but at the same time seem better adapted than boys. Younger children, particularly those who survived more war even report more PTSD symptoms than older children.",0,0 +3714,Is dissociation a multidimensional construct? Data from the Multiscale Dissociation Inventory,"The dimensionality of dissociation was examined in a combined sample of 1,326 general population, clinical, and university participants who completed the Multiscale Dissociation Inventory (MDI). Principal components analysis identified five moderately intercorrelated factors (mean r = .39): Disengagement, Identity Dissociation, Emotional Constriction, Memory Disturbance, and Depersonalization/Derealization. Differential relationships were found between individual MDI factors and demographics, trauma history, clinical status, posttraumatic stress, and scores on other dissociation measures. Surprisingly, after controlling for sex and age, trauma exposure accounted for only 3 to 7% of the variance in MDI factors. The notion of dissociation as a general trait was not supported. Instead, dissociation may represent a variety of phenomenologically distinct and only moderately related symptom clusters whose ultimate commonality is more theoretical than empirical.",0,0 +3715,Health-Related Quality of Life 2 Years to 7 Years After Burn Injury,"Knowledge concerning the trajectory and predictors of health-related quality of life (HRQoL) years after burn injury is fragmentary and these factors were therefore assessed using the EQ-5D questionnaire.Consecutive adult burn patients were included during hospitalization and assessed at 3 months, 6 months, and 12 months. In addition, an interview was performed at 2 years to 7 years postburn. Data concerning injury characteristics, sociodemographic variables, psychiatric disorders, and HRQoL were obtained.The EQ-5D dimension Mobility improved between hospitalization and 3 months, while Anxiety/Depression improved between 12 months and 2 years to 7 years. Other dimensions improved gradually. At 2 years to 7 years, only the dimensions Pain/Discomfort and Usual activities were lower than in the general population. In addition, overall HRQoL was lower than in the general population when measured by EQ VAS but not by EQ-5D index. EQ-5D index at 2 years to 7 years was predicted by EQ-5D index at 12 months and concurrent work status and pain. EQ VAS at 2 years to 7 years was predicted by previous assessments of work status, posttraumatic stress disorder and EQ VAS, and concurrent work status and substance abuse. Total amount of explained variance ranged between 17% and 57%.HRQoL after burn is conveniently screened by EQ VAS. Impairment after 2 years to 7 years is mainly reflected in the EQ dimensions Pain/Discomfort and Usual activities and can be predicted in part by information available before or at 12 months.",0,0 +3716,Drug-resistant chronic migraine: the Italian GON project,"Chronic daily headache is a major problem due to severe disability and high socio-economic costs. In the last years, some trials have shown potential benefit from new therapeutic approach by occipital neurostimulation techniques, already applied with some success for the treatment of chronic cluster headache. Due to the extremely heterogeneous population suffering from refractory chronic daily headaches, we propose a national multicenter experimental study involving Italian ANIRCEF Headache Centres with the aim to evaluate the efficacy of occipital neurostimulation in a selected group representative for the drug-resistant chronic migraine. Patients with chronic migraine according to Manzoni's modified IHS criteria-2011, with or without medication overuse headache, will be selected. Duration of illness should be at least 2 years and pharmacological refractoriness defined strictly for experimental-surgical purposes as those patients who have properly tried without success almost all available classes of prophylactic medications. Those presenting with medication overuse should have tried at least two previous detoxification treatments. A full psychopathological assessment will be performed by a psychiatrist, to exclude mainly psychotic disorder, ongoing severe status of an affective disorder, severe post traumatic stress disorder. Headache characteristics and abortive treatments used will be reported daily on a predisposed diary during 3-month baseline and continuously through the post implant follow up, while disability and QoL scale (MIDAS, SF-12) will be completed baseline, 6 and 12 months after implant. © Springer-Verlag 2012.",0,0 +3717,"Effects of traumatic brain injury and posttraumatic stress disorder on Alzheimer's disease in veterans, using the Alzheimer's Disease Neuroimaging Initiative","Both traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) are common problems resulting from military service, and both have been associated with increased risk of cognitive decline and dementia resulting from Alzheimer's disease (AD) or other causes. This study aims to use imaging techniques and biomarker analysis to determine whether traumatic brain injury (TBI) and/or PTSD resulting from combat or other traumas increase the risk for AD and decrease cognitive reserve in Veteran subjects, after accounting for age. Using military and Department of Veterans Affairs records, 65 Vietnam War veterans with a history of moderate or severe TBI with or without PTSD, 65 with ongoing PTSD without TBI, and 65 control subjects are being enrolled in this study at 19 sites. The study aims to select subject groups that are comparable in age, gender, ethnicity, and education. Subjects with mild cognitive impairment (MCI) or dementia are being excluded. However, a new study just beginning, and similar in size, will study subjects with TBI, subjects with PTSD, and control subjects with MCI. Baseline measurements of cognition, function, blood, and cerebrospinal fluid biomarkers; magnetic resonance images (structural, diffusion tensor, and resting state blood-level oxygen dependent (BOLD) functional magnetic resonance imaging); and amyloid positron emission tomographic (PET) images with florbetapir are being obtained. One-year follow-up measurements will be collected for most of the baseline procedures, with the exception of the lumbar puncture, the PET imaging, and apolipoprotein E genotyping. To date, 19 subjects with TBI only, 46 with PTSD only, and 15 with TBI and PTSD have been recruited and referred to 13 clinics to undergo the study protocol. It is expected that cohorts will be fully recruited by October 2014. This study is a first step toward the design and statistical powering of an AD prevention trial using at-risk veterans as subjects, and provides the basis for a larger, more comprehensive study of dementia risk factors in veterans.",0,0 +3718,The relation between parenting stress and adolescents' somatisation trajectories: A growth mixture analysis,"The impact of somatisation in adolescence is substantial. Knowledge on (predictors of) individual-level development of somatisation is necessary to develop tailored treatment. The current study assessed individual-level development of somatisation by means of latent mixed modelling. Parenting stress was included as a predictor of somatisation trajectory membership and within-trajectory variation.A total of 1499 adolescents and one of their parents (mostly the mother) agreed to participate. Questionnaires were administered when the adolescents were respectively 12-13 (T1), 13-14 (T2), and 14-15 (T3) years old. Adolescents reported on their somatisation, parents on their parenting stress.Four individual somatisation trajectories were found: increased, long-term low, long-term high, and decreased. Higher early parenting stress (T1) significantly predicted less favourable trajectory membership (increased and long-term high). The relation between later parenting stress (T2 and T3) and somatisation depended on trajectory membership. For adolescents in the long-term high and decreased somatisation trajectories, lower T2 and T3 parenting stress was related to higher somatisation, while for adolescents in the long-term low and increased trajectories, higher T2 and T3 parenting stress was related to higher somatisation.The results support a general recommendation to prevent the onset of high levels of parenting stress. In addition, for families in which high levels of parenting stress already exist, clinicians should be aware of natural fluctuations in parenting stress, its associated features (e.g., aspects of overall care, like looking for professional help) and of the consequences this might have for the adolescent.",0,0 +3719,Do gender and age moderate the symptom structure of PTSD? Findings from a national clinical sample of children and adolescents,"A substantial body of evidence documents that the frequency and intensity of posttraumatic stress disorder (PTSD) symptoms are linked to such demographic variables as female sex (e.g., Kaplow et al., 2005) and age (e.g., Meiser-Stedman et al., 2008). Considerably less is known about relations between biological sex and age with PTSD's latent factor structure. This study systematically examined the roles that sex and age may play as candidate moderators of the full range of factor structure parameters of an empirically supported five-factor PTSD model (Elhai et al., 2011). The sample included 6591 trauma-exposed children and adolescents selected from the National Child Traumatic Stress Network's Core Data Set. Confirmatory factor analysis using invariance testing (Gregorich, 2006) and comparative fit index difference values (Cheung and Rensvold, 2002) reflected a mixed pattern of test item intercepts across age groups. The adolescent subsample produced lower residual error variances, reflecting less measurement error than the child subsample. Sex did not show a robust moderating effect. We conclude by discussing implications for clinical assessment, theory building, and future research.",0,0 +3720,Factor analysis and AIC,,0,0 +3721,"Ecosystem services and urban heat riskscape moderation: water, green spaces, and social inequality in Phoenix, USA","Urban ecosystems are subjected to high temperatures--extreme heat events, chronically hot weather, or both-through interactions between local and global climate processes. Urban vegetation may provide a cooling ecosystem service, although many knowledge gaps exist in the biophysical and social dynamics of using this service to reduce climate extremes. To better understand patterns of urban vegetated cooling, the potential water requirements to supply these services, and differential access to these services between residential neighborhoods, we evaluated three decades (1970-2000) of land surface characteristics and residential segregation by income in the Phoenix, Arizona, USA metropolitan region. We developed an ecosystem service trade-offs approach to assess the urban heat riskscape, defined as the spatial variation in risk exposure and potential human vulnerability to extreme heat. In this region, vegetation provided nearly a 25 degrees C surface cooling compared to bare soil on low-humidity summer days; the magnitude of this service was strongly coupled to air temperature and vapor pressure deficits. To estimate the water loss associated with land-surface cooling, we applied a surface energy balance model. Our initial estimates suggest 2.7 mm/d of water may be used in supplying cooling ecosystem services in the Phoenix region on a summer day. The availability and corresponding resource use requirements of these ecosystem services had a strongly positive relationship with neighborhood income in the year 2000. However, economic stratification in access to services is a recent development: no vegetation-income relationship was observed in 1970, and a clear trend of increasing correlation was evident through 2000. To alleviate neighborhood inequality in risks from extreme heat through increased vegetation and evaporative cooling, large increases in regional water use would be required. Together, these results suggest the need for a systems evaluation of the benefits, costs, spatial structure, and temporal trajectory for the use of ecosystem services to moderate climate extremes. Increasing vegetation is one strategy for moderating regional climate changes in urban areas and simultaneously providing multiple ecosystem services. However, vegetation has economic, water, and social equity implications that vary dramatically across neighborhoods and need to be managed through informed environmental policies.",0,0 +3722,Compensation-Seeking and Extreme Exaggeration of Psychopathology Among Combat Veterans Evaluated for Posttraumatic Stress Disorder,"We extended the work of Smith and Frueh (1996) by evaluating whether combat veterans classified as ""extreme exaggerators"" were more likely to be compensation-seeking, and to report greater levels of psychopathology across self-report instruments than ""nonexaggerators."" Of 119 veterans who completed the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) at an outpatient posttraumatic stress disorder (PTSD) clinic, 26 (22%) and 17 (14%) were identified as extreme exaggerators using two MMPI-2 validity indicators with stringent cutoffs (F-K > or = 22; F(p) > or = 8). These veterans were much more likely to be compensation seeking and scored much higher on self-report measures of various psychological symptoms than nonexaggerators, despite having lower rates of PTSD diagnoses and similar rates of other comorbid diagnoses. Findings suggest that the validity indices of the MMPI-2 can play a critical role, as a screening instrument, in identifying veterans who may be exaggerating their psychopathology to gain disability compensation.",0,0 +3723,PTSD symptom severity and psychiatric comorbidity in recent motor vehicle accident victims: A latent class analysis,"We conducted a latent class analysis (LCA) on 249 recent motor vehicle accident (MVA) victims to examine subgroups that differed in posttraumatic stress disorder (PTSD) symptom severity, current major depressive disorder and alcohol/other drug use disorders (MDD/AoDs), gender, and interpersonal trauma history 6-weeks post-MVA. A 4-class model best fit the data with a resilient class displaying asymptomatic PTSD symptom levels/low levels of comorbid disorders; a mild psychopathology class displaying mild PTSD symptom severity and current MDD; a moderate psychopathology class displaying severe PTSD symptom severity and current MDD/AoDs; and a severe psychopathology class displaying extreme PTSD symptom severity and current MDD. Classes also differed with respect to gender composition and history of interpersonal trauma experience. These findings may aid in the development of targeted interventions for recent MVA victims through the identification of subgroups distinguished by different patterns of psychiatric problems experienced 6-weeks post-MVA.",0,0 +3724,Primary focal dystonia: evidence for distinct neuropsychiatric and personality profiles,"Primary focal dystonia (PFD) is characterised by motor symptoms. Frequent co-occurrence of abnormal mental conditions has been mentioned for decades but is less well defined. In this study, prevalence rates of psychiatric disorders, personality disorders and traits in a large cohort of patients with PFD were evaluated.Prevalence rates of clinical psychiatric diagnoses in 86 PFD patients were compared with a population based sample (n = 3943) using a multiple regression approach. Furthermore, participants were evaluated for personality traits with the 5 Factor Personality Inventory.Lifetime prevalence for any psychiatric or personality disorder was 70.9%. More specifically, axis I disorders occurred at a 4.5-fold increased chance. Highest odds ratios were found for social phobia (OR 21.6), agoraphobia (OR 16.7) and panic disorder (OR 11.5). Furthermore, an increased prevalence rate of 32.6% for anxious personality disorders comprising obsessive-compulsive (22.1%) and avoidant personality disorders (16.3%) were found. Except for social phobia, psychiatric disorders manifested prior to the occurrence of dystonia symptoms. In the self-rating of personality traits, PFD patients demonstrated pronounced agreeableness, conscientiousness and reduced openness.Patients with PFD show distinct neuropsychiatric and personality profiles of the anxiety spectrum. PFD should therefore be viewed as a neuropsychiatric disorder rather than a pure movement disorder.",0,0 +3725,A biopsychosocial deconstruction of “personality change” following acquired brain injury,"The judgement of personality change following acquired brain injury (ABI) is a powerful subjective and social action, and has been shown to be associated with a range of serious psychosocial consequences. Traditional conceptualisations of personality change (e.g., Lishman, 1998) have largely derived from individualist concepts of personality (e.g., Eysenck, 1967). These assume a direct link between neurological damage and altered personhood, accounting predominantly for their judgements of change. This assumption is found as commonly in family accounts of change as in professional discourse. Recent studies and perspectives from the overlapping fields of social neuroscience, cognitive approaches to self and identity and psychosocial processes following ABI mount a serious challenge to this assumption. These collectively identify a range of direct and indirect factors that may influence the judgement or felt sense of change in personhood by survivors of ABI and their significant others. These perspectives are reviewed within a biopsychosocial framework: neurological and neuropsychological deficits, psychological mechanisms and psychosocial processes. Importantly, these perspectives are applied to generate a range of clinical interventions that were not identifiable within traditional conceptualisations of personality changes following ABI.",0,0 +3726,Psychopathology in female juvenile offenders,"Background: The aim was to document the spectrum of present and lifetime psychological disorders in female juvenile offenders, and to examine the relations between mental health status and socio-demographic, family and trauma variables. Method: One hundred juvenile offenders were matched with a comparison group of 100 females on age and socioeconomic status (SES). Psychological profiles and trauma histories of both groups were assessed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime Version (K-SADS-PL) and family functioning was assessed with the Family Adaptability and Cohesion Scale II (FACES II) self-report measure. Results: Rates of psychopathology were higher for offenders than non-offenders (p < .001), with particularly high levels of conduct disorder (91% v.1%, p < .001), substance abuse disorders (85% v. 5%, p < .001), depression (55% v. 25%, p < .001) and posttraumatic stress disorder (37% v. 4%, p < .001). In the offenders, 78% met the criteria for three or more diagnoses. The number of psychiatric diagnoses was the most significant factor associated with offender status (OR = 21.26, p < .001). Conclusions: There is a high prevalence of psychological disorder in females in juvenile justice custody and this has a very strong association with offender status. Because these co-morbid disorders are treatable, there is a clear opportunity to intervene to decrease psychological distress.",0,0 +3727,The University of California at Los Angeles post-traumatic stress disorder reaction index,"Over the past decade, the University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index has been one of the most widely used instruments for the assessment of traumatized children and adolescents. This paper reviews its development and modifications that have been made as the diagnostic criteria for post-traumatic stress disorder have evolved. The paper also provides a description of standard methods of administration, procedures for scoring, and psychometric properties. The Reaction Index has been extensively used across a variety of trauma types, age ranges, settings, and cultures. It has been broadly used across the US and around the world after major disasters and catastrophic violence as an integral component of public mental health response and recovery programs. The Reaction Index forms part of a battery that can be efficiently used to conduct needs assessment, surveillance, screening, clinical evaluation, and treatment outcome evaluation after mass casualty events.",0,0 +3728,Theoretical Accounts of Gulf War Syndrome: From Environmental Toxins to Psychoneuroimmunology and Neurodegeneration,"Non-specific illness includes a wide variety of symptoms: behavioural (e.g., reduced food and water intake), cognitive (e.g., memory and concentration problems) and physiological (e.g., fever). This paper reviews evidence suggesting that such symptoms can be explained more parsimoniously as a single symptom cluster than as a set of separate illnesses such as Gulf War Syndrome (GWS) and chronic fatigue syndrome (CFS). This superordinate syndrome could have its biological basis in the activity of pro-inflammatory cytokines (in particular interleukin-1: IL-1), that give rise to what has become known as the 'sickness response'. It is further argued that the persistence of non-specific illness in chronic conditions like GWS may be (in part) attributable to a bio-associative mechanism (Ferguson and Cassaday, 1999). In the case of GWS, physiological challenges could have produced a non-specific sickness response that became associated with smells (e.g., petrol), coincidentally experienced in the Persian Gulf. On returning to the home environment, these same smells would act as associative triggers for the maintenance of (conditioned) sickness responses. Such associative mechanisms could be mediated through the hypothalamus and limbic system via vagal nerve innervation and would provide an explanation for the persistence of a set of symptoms (e.g., fever) that should normally be short lived and self-limiting. We also present evidence that the pattern of symptoms produced by the pro-inflammatory cytokines reflects a shift in immune system functioning towards a (T-helper-1) Th1 profile. This position contrasts with other immunological accounts of GWS that suggest that the immune system demonstrates a shift to a Th2 (allergy) profile. Evidence pertaining to these two contrasting positions is reviewed.",0,0 +3729,"Assessment and diagnosis of mild traumatic brain injury, posttraumatic stress disorder, and other polytrauma conditions: Burden of adversity hypothesis.","Military personnel returning from Iraq and Afghanistan have been exposed to physical and emotional trauma. Challenges related to assessment and intervention for those with posttraumatic stress disorder (PTSD) and/or history of mild traumatic brain injury (TBI) with sequelae are discussed, with an emphasis on complicating factors if conditions are co-occurring. Existing literature regarding cumulative disadvantage is offered as a means of increasing understanding regarding the complex symptom patterns reported by those with a history of mild TBI with enduring symptoms and PTSD.The importance of early screening for both conditions is highlighted. In addition, the authors suggest that current best practices include treating symptoms regardless of etiology to decrease military personnel and veteran burden of adversity.",0,0 +3730,Epigenetics in Posttraumatic Stress Disorder,"Reported exposure to traumatic event is relatively common within the general population (40–90%), but only a fraction of individuals will develop posttraumatic stress disorder (PTSD). Indeed, the lifetime prevalence of PTSD is estimated to range between 7% and 12%. The factors influencing risk or resilience to PTSD after exposure to traumatic events are likely both environmental, such as type, timing, and extent of trauma, and genetic. Recently, epigenetic mechanisms have been implicated in mediating altered risk for PTSD as they can reflect both genetic and environmental influences. In this chapter, we describe the accumulating evidences for epigenetic factors in PTSD highlighting the importance of sensitive periods as well as methodological aspects such as tissue availabilities for such studies. We describe studies using a candidate gene approach focusing mainly on key players in the stress hormone regulation that show epigenetic alterations both in humans and in animal models for PTSD. We also summarize the results of epigenome-wide studies reporting associations with PTSD. For the above, we focus on one epigenetic mechanism, DNA methylation, as it is so far the best studied for this disorder. Finally, we describe how epigenetic mechanisms could be responsible for the long-lasting effects of gene–environment interactions observed in PTSD.",0,0 +3731,"Peritraumatic distress, posttraumatic stress disorder symptoms, and posttraumatic growth in victims of violence","This study explored whether peritraumatic distress and posttraumatic stress disorder (PTSD) symptoms are curvilinearly related to posttraumatic growth in victims of violence several years after victimization (Time 1; n = 678) and 6 months later (Time 2, n = 205). At both time points, curve estimation revealed linear and quadratic associations between peritraumatic distress and posttraumatic growth and quadratic associations between PTSD symptoms and posttraumatic growth. In multivariate regressions controlling for background variables, the linear peritraumatic distress and quadratic PTSD symptom terms remained significant predictors of posttraumatic growth Time 1 scores. For Time 2, the linear peritraumatic distress term remained significant, though only prior to controlling for posttraumatic growth Time 1 scores. The results suggest that peritraumatic distress enables growth after substantial time has elapsed since victimization.",0,0 +3732,Classification of chronic pain patients with the Brief Symptom Inventory: Patient characteristics of cluster profiles.,"In this study, the psychological symptom patterns of individuals with chronic pain on the Brief Symptom Inventory (BSI) were cluster analyzed. Cluster analysis was initially performed on a large sample of people with chronic pain (n = 1,489) and then cross-validated on a smaller sample (n = 244). A 2-cluster solution was deemed most appropriate. The clusters reflected low- and high-profile elevations on all BSI subscales. Among persons in the smaller sample, high-profile participants were more likely to be involved in litigation, report a higher frequency of posttraumatic stress symptoms, and display poorer psychosocial functioning. The results suggest that the BSI subgroups are associated with psychosocial characteristics that may be important in terms of treatment planning and outcome.",0,0 +3733,Bias in longitudinal data analysis with missing data using typical linear mixed-effects modelling and pattern-mixture approach: An analytical illustration,"We analytically derive the fixed-effects estimates in unconditional linear growth curve models by typical linear mixed-effects modelling (TLME) and by a pattern-mixture (PM) approach with random-slope-dependent two-missing-pattern missing not at random (MNAR) longitudinal data. Results showed that when the missingness mechanism is random-slope-dependent MNAR, TLME estimates of both the mean intercept and mean slope are biased because of incorrect weights used in the estimation. More specifically, the estimate of the mean slope is biased towards the mean slope for completers, whereas the estimate of the mean intercept is biased towards the opposite direction as compared to the estimate of the mean slope. We also discuss why the PM approach can provide unbiased fixed-effects estimates for random-coefficients-dependent MNAR data but does not work well for missing at random or outcome-dependent MNAR data. A small simulation study was conducted to illustrate the results and to compare results from TLME and PM. Results from an empirical data analysis showed that the conceptual finding can be generalized to other real conditions even when some assumptions for the analytical derivation cannot be met. Implications from the analytical and empirical results were discussed and sensitivity analysis was suggested for longitudinal data analysis with missing data.",0,0 +3734,Long-term outcome of eight clinical trials of CBT for anxiety disorders: Symptom profile of sustained recovery and treatment-resistant groups,"Few clinical trials of cognitive behaviour therapy (CBT) for anxiety disorders have conducted follow-up beyond one year post-treatment. This paper summarises the long-term outcome of eight clinical trials of CBT for anxiety disorders in terms of diagnostic status, healthcare usage and symptom severity and compares the symptom profile of participants with the best and worst outcomes relative to chronic depression and the normal population.Follow-up at 2-14years with 396 patients (51% of those available to contact) employed structured diagnostic interview, assessment of healthcare usage and self-report measures of symptom severity. This paper concerns 336 participants who had either no disorder or at least one anxiety disorder and information on healthcare usage over the follow-up period.Only 38% recovered with little or no treatment over the follow-up period while 30% had a very poor outcome despite extensive treatment for anxiety over many years. The symptom profile of this 'treatment-resistant' group was comparable to 76 patients with chronic depression and significantly worse than normative data for psychiatric outpatients. Chronic anxiety disorder with co-morbid depression has a more severe symptom profile than chronic anxiety disorder alone.The follow-up sample, although broadly representative, may have a bias towards a more favourable picture of overall outcome.The long-term outcome of anxiety disorders, irrespective of diagnosis or active treatment, is diverse but with a tendency towards chronicity. Distinctions between acute and chronic presentations of common mental disorders are more important than distinctions between chronic anxiety and chronic depression.",0,0 +3735,The relationship between compensable status and long‐term patient outcomes following orthopaedic trauma,"OBJECTIVE: To determine the relationship between compensable status in a compensation scheme and long-term outcomes after orthopaedic trauma. DESIGN AND SETTING: Prospective cohort study within two adult Level 1 trauma centres in Victoria, Australia. PARTICIPANTS: Blunt trauma patients aged 18-64 years, admitted between September 2003 and August 2004 with orthopaedic injuries and funded by the no-fault compensation scheme for transport-related injury, or deemed non-compensable. MAIN OUTCOME MEASURES: 12-item Short Form Health Survey (SF-12) and return to work or study at 12 months after injury. RESULTS: Of 1033 eligible patients, 707 (68.8%) provided follow-up data; 450 compensable and 247 non-compensable patients completed the study. After adjusting for differences across the groups (age, injury severity, head injury status, injury group, and discharge destination) using multivariate analyses, compensable patients were more likely than non-compensable patients to report moderate to severe disability at follow-up for the physical (adjusted odds ratio [AOR], 2.0; 95% CI, 1.3-2.9), and mental (AOR, 1.6; 95% CI, 1.1-2.5) summary scores of the SF-12. Compensable patients were less likely than non-compensable patients to have returned to work or study, even after adjusting for injury severity, age, head injury status and discharge destination (AOR, 0.6; 95% CI, 0.3-0.9). CONCLUSIONS: Patients covered by the no-fault compensation system for transport-related injuries in Victoria had worse outcomes than non-compensable patients. Language: en",0,0 +3736,Cognitive predictors of posttraumatic stress disorder in children: results of a prospective longitudinal study,"The present study explored whether cognitive factors specified in the Ehlers and Clark model (Behav. Res. Ther. 38 (2000) 319) of posttraumatic stress disorder (PTSD) predict chronic PTSD in children who had experienced a road traffic accident. Children were assessed at 2 weeks, 3 months, and 6 months after the accident. Data-driven processing during the accident, negative interpretation of intrusive memories, alienation from other people, anger, rumination, thought suppression and persistent dissociation at initial assessment predicted PTSD symptom severity at 3 and 6 months. On the basis of sex and stressor severity variables, 14% of the variance of PTSD symptoms at 6 months could be explained. The accuracy of the prediction increased to 49% or 53% when the cognitive variables measured at initial assessment or 3 months, respectively, were taken into account.",0,0 +3737,Optimism and Consumption: Psychological Costs of Malaysia-Sulu Dispute,"This research aims to examine the moderating effect of optimism on the relationship between psychological cost and consumption level during disputes. Psychometric-based questionnaire was developed and distributed in March 2013 to find Sabahan had severe symptoms of stress. This stress level induced the consumption level and also leisure cost in attempts to overcome the dispute. Interestingly, those Sabahans who were more inclined to optimism-might rethink their consumption/spending decision making. In other words, there is a moderating effect of optimism on the relationship between stress level and consumption during disputes.",0,0 +3738,Posttraumatic stress disorder in parents of children with chronic illnesses: A meta-analysis.,"To estimate PTSD prevalence in parents of children with chronic illnesses or undergoing invasive procedures, and its association with higher risk of PTSD among parents.Sixteen studies reporting prevalence of PTSD in parents of children with chronic illnesses were identified through a systematic review in Pubmed, Web of Science, Pilots and PsycINFO databases.Pooled current PTSD prevalence was calculated for parents from these studies. Pooled PTSD prevalence ratios were obtained by comparing parents of children with chronic diseases with parents of healthy children. Meta-regression was used to identify variables that could account for the lack of homogeneity.Pooled PTSD prevalence was 19.6% in mothers, 11.6% in fathers, and 22.8% in parents in general (p < .001). Pooled prevalence ratio for the four studies reporting on mothers and comparison healthy groups was 4.2 (p < .001).The high prevalence of PTSD found in this population highlights the importance of promptly assessing and treating post-traumatic symptoms in parents of children with chronic diseases as a key step to prevent the negative consequences of PTSD and preserve their competency as caregivers.",0,0 +3739,On structural equation modeling with data that are not missing completely at random,"A general latent variable model is given which includes the specification of a missing data mechanism. This framework allows for an elucidating discussion of existing general multivariate theory bearing on maximum likelihood estimation with missing data. Here, missing completely at random is not a prerequisite for unbiased estimation in large samples, as when using the traditional listwise or pairwise present data approaches. The theory is connected with old and new results in the area of selection and factorial invariance. It is pointed out that in many applications, maximum likelihood estimation with missing data may be carried out by existing structural equation modeling software, such as LISREL and LISCOMP. Several sets of artifical data are generated within the general model framework. The proposed estimator is compared to the two traditional ones and found superior.",0,0 +3740,Vulnerability to post-traumatic stress disorder and psychological morbidity in aged holocaust survivors,"Objective Although high rates of post-traumatic stress disorder (PTSD) and psychological morbidity have been consistently reported in Holocaust survivors (HS), reports are inconsistent about which factors are associated with psychological morbidity. In a study of the oldest HS cohort yet reported, we aim to clarify why this variability exists by examining factors associated with PTSD and psychological morbidity, including for the first time measures of personality and defense mechanisms. Methods One hundred HS randomly selected from a convenience sample of 309 respondents to a survey of Jewish persons aged 60 years and older living in the community in Sydney were assessed using the following instruments: demographics, severity of trauma experienced, General Health Questionnaire (GHQ-28), PTSD diagnosis (DSM-IV), Brief Psychiatric Rating Scale, Impact of Events Scale, Defense Style Questionnaire, modified Eysenck Personality Inventory. Results Older age, experience of more severe trauma, use of immature defense mechanisms and higher neuroticism were associated with significant PTSD and psychological morbidity; severity of trauma was associated with PTSD and with more severe psychological morbidity. Conclusions A profile of survivors at-risk can be identified that may have application to survivors of more recent holocausts. Late life may be a period of vulnerability in the aftermath of severe trauma. Copyright © 2004 John Wiley & Sons, Ltd.",0,0 +3741,Psychoneuroendocrine assessment of posttraumatic stress disorder: Current progress and new directions,1. Studies in our laboratory have used the psychoendocrine strategy to explore differences in basal hormone levels between patients with posttraumatic stress disorder (PTSD) and other groups. This approach has allowed us to explore the relationship between hormone levels and specific psychological and biological processes which appear to develop following exposure to extreme trauma. 2. The concurrent assessment of several hormonal systems provides an opportunity to explore differences in hormonal patterns in various psychiatric disorders. PTSD appears to be characterized by a specific profile of hormonal changes that is distinct from that of other diagnostic groups and normal controls. These findings raise the possibility that the psychoendocrine approach may be useful in further exploring the pathophysiology and diagnosis of PTSD. 3. This paper reviews psychoendocrine changes in PTSD and describes updated multivariate methods that further elucidate psychological and neurochemical correlates of hormonal alterations in this disorder.,0,0 +3742,"Preventive Health Behaviors, Health-Risk Behaviors, Physical Morbidity, and Health-Related Role Functioning Impairment in Veterans with Post-Traumatic Stress Disorder","An examination of the relationships between health behaviors (preventive and risk-related), physician-diagnosed medical problems, role-functioning impairment because of physical morbidity, and post-traumatic stress disorder was conducted on a large cohort of consecutive treatment-seeking cases (N = 826) presenting to an outpatient Veterans Affairs post-traumatic stress disorder clinic. Results revealed that the sample rates of several medical conditions were markedly elevated when compared with general population rates for men of comparable age. The rates of smoking and other behavioral risk variables were greater than rates among men in the general population. Moreover, the majority of the sample did not engage in preventive health behaviors such as exercise and medical screening at levels consistent with health care guidelines. Physical role functioning indices of the SF-36 reveal greater role-functioning impairment because of physical morbidity in this psychiatric sample relative to the age adjusted general population norms. The health care implications of these data are discussed, as are areas for future research.",0,0 +3743,Behavioural psychopathology of child sexual abuse in schoolgirls referred to a tertiary centre: A North London study,"The sexually abused girls in this study were a sub-sample of a group of girls referred to a Regional Centre for Psychotherapy for the whole of London, North Thames. An inclusion criterion was that they were psychologically symptomatic and so it is likely that they were more problematic cases causing concern in their locality. The control clinical group consisted of referrals to local Child and Family consultation services, were an opt-in matched sample and not a total clinic referral sample. In addition, the reasons for referral covered both child disorder and family problems. It is, therefore, important to bear in mind the differences between these two groups. Certain clear cut findings have emerged from this study. No disorders specific to child sexual abuse in girls were identified but the extent and severity of the disturbance in the sexually abused sample was most striking. In these girls an event (CSA), together with referral because of emotional symptoms, was associated with enhanced severity of disorder and comorbidity particularly with reference to a cluster of disorders comprising post-traumatic stress disorder, depressive disorder, anxiety disorders (general and separation), social phobias and reactive attachment disorder. In the community clinic sample the identified disorders were mainly those of separation anxiety disorders and adjustment. Wide comorbidity was common in the sexual abuse sample and also severity of impairment was notable when compared to the clinic sample. However, because of the selected nature of the abuse group the findings are not generalisable beyond the population from which they emerged. The view is advanced that there are strong grounds for exploring the utility of psychodynamic psychotherapy in similar samples of sexually abused girls. These findings are discussed in the light of the current literature.",0,0 +3744,The Hospital Anxiety and Depression Scale,A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.,0,0 +3745,The Preeminence of Early Life Trauma as a Risk Factor for Worsened Long-Term Health Outcomes in Women,"Early life trauma (ELT) comprises an array of disturbingly common distressing experiences between conception and the beginning of adulthood with numerous and significant potential long-term, even transgenerational, health consequences of great public health concern, including depression, cardiovascular disease, and other psychiatric and medical disorders, and neurobiological, psychological, and behavioral effects which are sufficiently robust to confound many types of biomedical research. The impact of ELT on a woman’s health trajectory appears to vary with the specific characteristics of the ELT (e.g., type, number of different types, severity, and timing), the individual (e.g., age, genetics, epigenetics, personality, and cognitive factors), and the individual’s environment (e.g., level of social support and ongoing stressors) and to be mediated to a significant extent by persistent changes in a number of biological systems, dysregulation of those governing the stress response chief among them. Growing knowledge of the risk factors and pathophysiological mechanisms by which ELT confers diathesis to various poor health outcomes and the unique treatment–response profiles of women with ELT will lead to much needed improvements in prevention, diagnostic, and therapeutic efforts, including more effective psychotherapy and pharmacotherapy approaches, hopefully making strides toward improvements in the lives of women everywhere and ending countless cycles of intergenerational trauma-associated pathology. This article attempts to broadly summarize the current state of knowledge about the long-term sequelae of ELT for women’s health. © 2015, Springer Science+Business Media New York.",0,0 +3746,The neurobiology of abandonment homicide,"A review is made of the typical modus operandi and psychological profile of uxoricide (wife murder) perpetrators. Typically, most had traumatic childhood and have current personality disorders (PD; typically Dependent, Passive–Aggressive, or Borderline PD). The uxoricide occurred during attempted abandonment of the relationship by the female and was characterized by extreme violence and elements of disorganized behavior by the perpetrator. A review is also made of the neuroanatomy and neurobiology of aggression. It is found that the orbitofrontal cortex (OFC) is implicated in control of aggressive impulses. This cortical area matures during the critical “rapprochement subphase” of early development (1.5–2 years). Attachment dysfunction during this period may interfere with critical development. It is found that low levels of serotonin (5-HT) and high levels of norepinephrine (NE) are implicated in aggression. It is also found that low levels of 5-HT and high levels of NE are long-term neurobiological sequelae of trauma. Attachment trauma can occur during the rapprochement subphase. It is suggested that a biological basis may serve to connect early trauma experience with a specific rage response to abandonment and spousal homicide. Neural networks containing malignant memories may be the neural mechanism by which perceived abandonment generates such symbolic terror and rage.",0,0 +3747,Prediction of Outcome for Veterans with Post-Traumatic Stress Disorder Using Constructs from the Transtheoretical Model of Behaviour Change,"Post-traumatic stress disorder (PTSD) is a disabling condition, sometimes unresponsive to treatment. The aim of the present study was to examine the predictive utility of constructs from the transtheoretical model of behaviour change (TTM) known to predict outcome for other disorders.A sample of 50 veterans presenting for a PTSD treatment programme provided data for this longitudinal study. Variables were assessed at four time-points during the treatment programme. Multiple regression and mixed-effects regression were utilized to determine the predictive utility of variables from the TTM.Allocated stage of change at the time of a 2 day introduction programme predicted follow-up symptom severity, but changes therein during treatment did not predict changes in symptom severity. However, changes in the continuous readiness-to-change variable and behavioural processes of change were predictive of such changes.Despite some difficulties in the application of the TTM to PTSD, the model does appear to predict treatment outcome. Veterans who have increased readiness to change and who make more use of behavioural processes of change are likely to have improved outcomes.",0,0 +3748,Pathological Modes of Remembering,"The experience of a severe stressor can lead to involuntary and persistent recollections of the event in some affected individuals. These unwanted spontaneous memories are usually accompanied by intense emotions and psychological distress, leaving the individual unable to cope. The present chapter aims to give a comprehensible introduction to the pathological consequences that may arise from the exposure to traumatic stress. It is an attempt to provide some insight into what can be considered a traumatic event, which natural stress reactions can be expected, what we know about risk factors for the development of posttraumatic stress disorder, and which dysfunctional strategies may contribute to the maintenance of the disorder.",0,0 +3749,"Efficacy of Sertraline in Preventing Relapse of Posttraumatic Stress Disorder: Results of a 28-Week Double-Blind, Placebo-Controlled Study","The study examined the efficacy of sertraline, compared with placebo, in sustaining improvement and preventing relapse over 28 weeks in patients with posttraumatic stress disorder (PTSD) who had completed a 12-week double-blind, placebo-controlled acute treatment study and a subsequent 24-week open-label study of continuation treatment with sertraline.Ninety-six patients were randomly assigned, in a double-blind design, to 28 weeks of maintenance treatment with sertraline (50-200 mg, N=46; 78% were women) or placebo (N=50; 62% were women). Measures used in biweekly assessments included the Clinician-Administered PTSD Scale, the Impact of Event Scale, and the Clinical Global Impression severity and improvement ratings. Kaplan-Meier analyses were used to estimate time to discontinuation from the study due to relapse, relapse or study discontinuation due to clinical deterioration, and acute exacerbation.Continued treatment with sertraline yielded lower PTSD relapse rates than placebo (5% versus 26%). Patients who received placebo were 6.4 times as likely to experience relapse as were patients who received sertraline. Kaplan-Meier analyses confirmed the protective effect of sertraline in significantly extending time in remission. The ability of sertraline to sustain improvement was comparable across the three core PTSD symptom clusters (reexperiencing/intrusion, avoidance/numbing, and hyperarousal). A regression analysis found early response during acute treatment to be associated with a more than 16-fold reduced risk of relapse after placebo substitution. Sertraline, at a mean endpoint dose of 137 mg, was well tolerated, with no sertraline-related adverse events observed at a rate of 10% or higher.The results provide evidence for the ability of sertraline both to sustain improvement in PTSD symptoms and to provide prophylactic protection against relapse.",0,0 +3750,Post-traumatic stress disorder as a consequence of bullying at work and at school. A literature review and meta-analysis,"Bullying has been established as a prevalent traumatic stressor both in school and at workplaces. It has been claimed that the mental and physical health problems found among bullied persons resembles the symptomatology of Post Traumatic Stress Disorder (PTSD). Yet, it is still unclear whether bullying can be considered as a precursor to PTSD. Through a review and meta-analysis of the research literature on workplace- and school bullying, the aims of this study were to determine: 1) the magnitude of the association between bullying and symptoms of PTSD, and 2) whether the clinical diagnosis of PTSD applies to the consequences of bullying. Altogether 29 relevant studies were identified. All had cross-sectional research designs. At an average, 57% of victims reported symptoms of PTSD above thresholds for caseness. A correlation of .42 (95% CI: .36–.48; p < .001) was found between bullying and an overall symptom-score of PTSD. Correlations between bullying and specific PTSD-symptoms were in the same range. Equally strong associations were found among children and adults. Two out of the three identified clinical diagnosis studies suggested that bullying is associated with the PTSD-diagnosis. Due to a lack of longitudinal research and structural clinical interview studies, existing literature provides no absolute evidence for or against bullying as a causal precursor of PTSD. • Summarizes research literature on the associations between bullying and PTSD • The majority of victims reports symptoms of PTSD. • Exposure to bullying is cross-sectionally associated with symptoms of PTSD. • No longitudinal studies and few studies with clinical diagnosis • It is not possible to determine causal associations between bullying and PTSD based on existing literature.",0,0 +3751,Promoting Independent Task Performance by Persons with Severe Developmental Disabilities through a New Computer-Aided System,"This study involved two experiments. In Experiment 1, a computer-aided system for promoting task performance by 6 persons with severe developmental disabilities was compared with a card system. The computer-aided system was portable and presented pictorial task instructions (one instruction per step) and prompts. In Experiment 2, the same systemwas used, but the number of instruction occasions was reduced. In one condition, the system presented all the instructions used in Experiment 1 but mostly in clusters rather than individually. In another, the system presented part of the Experiment 1 instructions. Three Experiment 1 participants also served in Experiment 2. Experiment 1 results indicated all 6 participants had higher percentages of correct steps with the computer system and preferred it to the card system. Experiment 2 results indicated that the condition in which the instructions were clusteredwas more effective for maintaining correct task performance. Implications of the findings were discussed.",0,0 +3752,Family Violence: Clinical Indicators among Military and Post-Military Personnel,"Child and spouse abuse continues to be a critically important problem for the medical and mental health professions. Examined are recent clinical data and research addressing this most serious concern among military and post-military personnel. Criteria useful in the identification of risk persons and diagnosis and treatment of family violence are discussed. Specific attention is given to the diagnostic indicators, the abusing family profile, the traumatic process of abuse, and strategies relevant to psychiatric intervention. Guidelines for military mental health and medical professionals are explored.",0,0 +3753,Psychopathological comorbidities in medication-overuse headache: a multicentre clinical study,"In medication-overuse headache (MOH) patients, the presence of psychopathological disturbances may be a predictor of relapse and poor response to treatment. This multicentre study aimed to assess the occurrence of psychopathological disorders in MOH patients by comparing the incidence of psychopathological disturbances with episodic migraine (EM) patients and healthy controls (HC).The psychopathological assessment of patients and HC involved the administrations of the Beck Depression Inventory, the Beck Anxiety Inventory, the Modified Mini International Neuropsychiatric Interview (M-MINI), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Leeds Dependence Questionnaire.The MOH, EM and HC groups (88, 129 and 102 subjects, respectively) differed significantly from each other for the presence of moderate/severe anxiety, whereas mood disorder and depression were revealed in similar proportions for both MOH and EM patients. By stratifying the M-MINI questionnaire results according to the number of psychiatric disorders, it was found that MOH patients had a more complex profile of psychiatric comorbidity. Furthermore, clinically relevant obsessive-compulsive disturbances for abused drugs assessed by Y-BOCS appeared to be more represented in the MOH group, whilst the prevalence of this trait in the EM group was comparable to that of HC (12.5%, 0.8% and 0%, respectively).Our study indicates the multiple presence of psychopathological comorbidities in patients with MOH. In light of this, it is recommended that the assessment of the psychopathological profile be included in an evaluation of MOH patients, allowing the clinician to more rapidly start an appropriate behavioural treatment, which would greatly improve MOH management.",0,0 +3754,Treatment of Acute Stress Disorder,"Recent trauma survivors with acute stress disorder (ASD) are likely to subsequently develop chronic posttraumatic stress disorder (PTSD). Cognitive behavioral therapy for ASD may prevent PTSD, but trauma survivors may not tolerate exposure-based therapy in the acute phase. There is a need to compare nonexposure therapy techniques with prolonged exposure for ASD.To determine the efficacy of exposure therapy or trauma-focused cognitive restructuring in preventing chronic PTSD relative to a wait-list control group.A randomized controlled trial of civilians who experienced trauma and who met the diagnostic criteria for ASD (N = 90) seen at an outpatient clinic between March 1, 2002, and June 30, 2006.Patients were randomly assigned to receive 5 weekly 90-minute sessions of either imaginal and in vivo exposure (n = 30) or cognitive restructuring (n = 30), or assessment at baseline and after 6 weeks (wait-list group; n = 30).Measures of PTSD at the 6-month follow-up visit by clinical interview and self-report assessments of PTSD, depression, anxiety, and trauma-related cognition.Intent-to-treat analyses indicated that at posttreatment, fewer patients in the exposure group had PTSD than those in the cognitive restructuring or wait-list groups (33% vs 63% vs 77%; P = .002). At follow-up, patients who underwent exposure therapy were more likely to not meet diagnostic criteria for PTSD than those who underwent cognitive restructuring (37% vs 63%; odds ratio, 2.10; 95% confidence interval, 1.12-3.94; P = .05) and to achieve full remission (47% vs 13%; odds ratio, 2.78; 95% confidence interval, 1.14-6.83; P = .005). On assessments of PTSD, depression, and anxiety, exposure resulted in markedly larger effect sizes at posttreatment and follow-up than cognitive restructuring.Exposure-based therapy leads to greater reduction in subsequent PTSD symptoms in patients with ASD when compared with cognitive restructuring. Exposure should be used in early intervention for people who are at high risk for developing PTSD.",0,0 +3755,Prevalence of Depression–PTSD Comorbidity: Implications for Clinical Practice Guidelines and Primary Care-based Interventions,"Compared to those with depression alone, depressed patients with posttraumatic stress disorder (PTSD) experience more severe psychiatric symptomatology and factors that complicate treatment.To estimate PTSD prevalence among depressed military veteran primary care patients and compare demographic/illness characteristics of PTSD screen-positive depressed patients (MDD-PTSD+) to those with depression alone (MDD).Cross-sectional comparison of MDD patients versus MDD-PTSD+ patients.Six hundred seventy-seven randomly sampled depressed patients with at least 1 primary care visit in the previous 12 months. Participants composed the baseline sample of a group randomized trial of collaborative care for depression in 10 VA primary care practices in 5 states.The Patient Health Questionnaire-9 assessed MDD. Probable PTSD was defined as a Primary Care PTSD Screen > or = 3. Regression-based techniques compared MDD and MDD-PTSD+ patients on demographic/illness characteristics.Thirty-six percent of depressed patients screened positive for PTSD. Adjusting for sociodemographic differences and physical illness comorbidity, MDD-PTSD+ patients reported more severe depression (P < .001), lower social support (P < .001), more frequent outpatient health care visits (P < .001), and were more likely to report suicidal ideation (P < .001) than MDD patients. No differences were observed in alcohol consumption, self-reported general health, and physical illness comorbidity.PTSD is more common among depressed primary care patients than previously thought. Comorbid PTSD among depressed patients is associated with increased illness burden, poorer prognosis, and delayed response to depression treatment. Providers should consider recommending psychotherapeutic interventions for depressed patients with PTSD.",0,0 +3756,The Prevalence of Posttraumatic Stress Disorder Among Children and Adolescents Affected by Tsunami Disaster in Tamil Nadu,"The Asian earthquake and subsequent tsunami of December 2004, one of the largest natural disasters in recent history, resulted in the deaths of over 250,000 people and massive destruction in 8 countries. As with any disaster, children are at risk for developing short- and long-term psychological consequences, including posttraumatic stress disorder (PTSD). One area particularly affected by this disaster was southern India. Five hundred twenty-three juvenile survivors of the tsunami were studied to determine the prevalence of PTSD. The survey was conducted in 2 waves. Interviews were conducted by postgraduate psychiatric social work students, proficient in the local language of Tamil and trained in PTSD-related data collection. The Impact of Event Scale-8 items Tamil Version and Child Behaviour Checklist Post-traumatic Stress Disorder-Tamil Revised Version, with age-specific measures and validated for the local culture and language, were used for the study. Our study revealed a prevalence of 70.7% for acute PTSD and 10.9% for delayed onset PTSD. PTSD was more prevalent among girls and more severe among adolescents exposed to loss of life or property. These results indicate that PTSD is widely prevalent among the survivors of the tsunami, reinforcing the need to develop an effective, culturally sensitive outreach therapy strategy for them.",0,0 +3757,"The association of exposure, risk, and resiliency factors with PTSD among Jews and Arabs exposed to repeated acts of terrorism in Israel","Israel has faced ongoing terrorism since the beginning of the Al Aqsa Intifada in September 2000. The authors examined risk and resiliency factors associated with posttraumatic stress disorder (PTSD) among 1,117 Jews and 394 Arab adult citizens of Israel during August and September 2004 through telephone interviews. Probable PTSD was found among 6.6% of Jews and 18.0% of Arabs. Predictors of probable PTSD in a multivariate model for Jews were refusal to report income, being traditionally religious, economic and psychosocial resource loss, greater traumatic growth, and lower social support. For Arabs, predictors were low education and economic resource loss among those exposed to terrorism. Findings for only those directly exposed to terrorism were similar to those for the overall national sample.",0,0 +3758,Symptoms of post‐traumatic stress disorder in couples after birth: association with the couple's relationship and parent–baby bond,"Recent research suggests a proportion of women develop post-traumatic stress disorder (PTSD) after childbirth. To date, the effects of postnatal PTSD on the couple's relationship and the parent-baby bond have not been examined. In the present study, 64 couples completed questionnaires about the birth, symptoms of PTSD, the couple's relationship and parent-baby bond 9 weeks after childbirth. Results showed 5% of men and women had severe symptoms of PTSD. Symptoms were strongly associated within couples and were related to similar birth factors for men and women. PTSD symptoms were associated with neither the parent-baby bond nor couple's relationship. The mother-baby bond was not associated with any variables measured in this study. However, the father-baby bond was associated with the couple's relationship. It is concluded that men and women have comparable levels of PTSD symptoms 9 weeks after birth. Furthermore, these results suggest postnatal symptoms of PTSD have little association with the couple's relationship or the parent-baby bond in the short term. However, further research is needed to address methodological considerations.",0,0 +3759,Cross-Sectional Analysis of Dutch Repatriated Service Members From Southern Afghanistan (2003–2014),"A systematic analysis of the complete medical support organization of the Dutch Armed Forces regarding repatriated service members from Afghanistan has not been performed so far.All information were collated in a specifically designed electronic database and gathered from the archive of the Central Military Hospital for all Dutch service members receiving treatment for wounds or diseases sustained in the Afghan theater from July 2003 till January 2014.Traumatic injuries were the main cause (63%, 141/223) of repatriation, and improvised explosive devices the major (67%, 60/89) mechanism of injury in the battle casualty group. The mean time between injury and medical evacuation from Afghanistan was 8 days, and this was reduced to 3.6 days in case of polytrauma casualties (ISS > 15).Sixty percent of all Dutch medical evacuations from Afghanistan were not directly related to combat operations. A standard medical examination/endurance test in the predeployment phase could be useful as screening tool in reduction of the disease nonbattle injury casualty rate. Shorter transport intervals might improve morbidity and mortality of casualties, a timeframe of 48 to 72 hours for receiving definitive treatment seems feasible. Further research is necessary to identify delay factors and possible improvements in the medical support organization.",0,0 +3760,MMPI scales for diagnosing acute and chronic PTSD in civilians,"To develop new Minnesota Multiphasic Personality Inventory (MMPI) scales for diagnosing acute and chronic posttraumatic stress disorder (PTSD), 237 civilians with PTSD or panic disorder (controls) completed the MMPI-R. All 399 items were submitted to chi-square analysis to select those differentiating acute or chronic PTSD from controls. The analyses yielded an MMPI Acute PTSD scale (32 items) and a MMPI Chronic PTSD scale (41 items). Discriminating between acute PTSD and controls, the MMPI Acute PTSD scale had a hit rate of 83% and the MMPI Chronic PTSD scale produced a hit rate of 75% to 80%. Cross-validation produced similar hit rates. These scales scores were not substantially influenced by gender or types of traumatic events, and only the MMPI Acute PTSD scale seemed to not be sensitive to co-morbidity.",0,0 +3761,Taking care of staff: A comprehensive model of support for paramedics and emergency medical dispatchers.,"Following a brief overview of alternative Employee Assistance Programs (EAPs), this article proposes a comprehensive model of care for emergency service personnel. The pivotal element of the multilayered model is the Peer Support Officer (PSO) component providing early support to ambulance personnel following exposure to potentially traumatic events. After initial recruit training, peer supporters engage in professional supervision and annual psychological first aid education and counseling skill development workshops. The model is embedded within the workforce and is available to personnel for both work-related and personal matters. The success of the EAP relies on collaboration between the employer, professional counselors, and the trained peer support officers as well as extensive education and resilience building for employees. This article proposes that the model outlined offers high-profile, well-trained, and well-supervised peer support officers as an effective alternative to the more common approa...",0,0 +3762,"PTSD symptom increases in Iraq-deployed soldiers: Comparison with nondeployed soldiers and associations with baseline symptoms, deployment experiences, and postdeployment stress","This prospective study examined: (a) the effects of Iraq War deployment versus non-deployment on pre- to postdeployment change in PTSD symptoms and (b) among deployed soldiers, associations of deployment/postdeployment stress exposures and baseline PTSD symptoms with PTSD symptom change. Seven hundred seventy-four U.S. Army soldiers completed self-report measures of stress exposure and PTSD symptom severity before and after Iraq deployment and were compared with 309 soldiers who did not deploy. Deployed soldiers, compared with non-deployed soldiers, reported increased PTSD symptom severity from Time 1 to Time 2. After controlling for baseline symptoms, deployment-related stressors contributed to longitudinal increases in PTSD symptoms. Combat severity was more strongly associated with symptom increases among active duty soldiers with higher baseline PTSD symptoms.",0,0 +3763,Eye movement desensitization and reprocessing in posttraumatic stress disorder: A pilot study using assessment measures,"Spectacular claims have been made regarding the efficacy of eye movement desensitization and reprocessing (EMDR) in the treatment of posttraumatic stress disorder (PTSD), but almost entirely on the basis of patients' reports and without objective criteria. This study reports on the treatment of eight patients with a diagnosis of PTSD who received EMDR treatment over four sessions. Assessment measures included two structured interviews, three self-report inventories, and the electromyogram (EMG). Assessments were conducted pre and posttreatment, and at 3-month follow-up. Despite some residual pathology at posttreatment and follow-up, significant improvements were obtained on all measures and across all PTSD symptom clusters. Compared with other treatments of PTSD, change was achieved in far fewer sessions.",0,0 +3764,"P50 suppression, prepulse inhibition, and startle reactivity in the same patient cohort suffering from posttraumatic stress disorder","Psychophysiological alterations like impaired gating and increased startle have been reported in patients with posttraumatic stress disorder (PTSD). However, findings are inconsistent, and potential relationships to symptomatology remain unclear.The present study investigates two distinct operational measures of gating and startle reactivity within the same patients suffering from PTSD and their relationship to PTSD symptomatology.Prepulse inhibition of the acoustic evoked startle reflex, P50 suppression of auditory event related potentials, and startle reactivity were assessed in three distinct experiments in 27 PTSD patients and compared to 25 healthy control subjects.PTSD patients exhibited impaired P50 suppression and exaggerated startle. Lower P50 suppression was associated with higher levels of general psychopathology. Patients and control subjects did not differ in PPI.Some of the limitations include, that the control group compromised of non-trauma exposure subjects and menstrual cycle in female participants potentially affecting PPI was not controlled.Deficient P50 gating, not related to specific trauma or distinct symptom clusters reflects a robust finding in PTSD patients. In contrast, further research is needed to clarify whether PPI is affected in PTSD.",0,0 +3765,The HPA axis and perinatal depression: a hypothesis,"Episodes of depression and anxiety are as common during pregnancy as postpartum. Some start in pregnancy and resolve postpartum, others are triggered by parturition and some are maintained throughout. In order to determine any biological basis it is important to delineate these different subtypes. During pregnancy, as well as the rise in plasma oestrogen and progesterone there is a very large increase in plasma corticotropin releasing hormone (CRH), and an increase in cortisol. The latter reaches levels found in Cushing's syndrome and major melancholic depression. Levels of all these hormones drop rapidly on parturition. We here suggest that the symptoms of antenatal and postnatal depression may be different, and linked in part with differences in the function of the hypothalamic pituitary adrenal (HPA) axis. There are two subtypes of major depression, melancholic and atypical, with some differences in symptom profile, and these subtypes are associated with opposite changes in the HPA axis. Antenatal depression may be more melancholic and associated with the raised cortisol of pregnancy, whereas postnatal depression may be more atypical, triggered by cortisol withdrawal and associated with reduced cortisol levels. There is evidence that after delivery some women experience mild bipolar II depression, and others experience post traumatic stress disorder. Both of these are associated with atypical depression. It may also be that some women are genetically predisposed to depression of the melancholic type and some to depression of the atypical type. These women may be more or less vulnerable to depression at the different stages of the perinatal period. (",0,0 +3766,Political violence and mental health in Nepal: prospective study,"Background Post-conflict mental health studies in low-income countries have lacked pre-conflict data to evaluate changes in psychiatric morbidity resulting from political violence. Aims This prospective study compares mental health before and after exposure to direct political violence during the People's War in Nepal. Method An adult cohort completed the Beck Depression Inventory and Beck Anxiety Inventory in 2000 prior to conflict violence in their community and in 2007 after the war. Results Of the original 316 participants, 298 (94%) participated in the post-conflict assessment. Depression increased from 30.9 to 40.6%. Anxiety increased from 26.2 to 47.7%. Post-conflict post-traumatic stress disorder (PTSD) was 14.1%. Controlling for ageing, the depression increase was not significant. The anxiety increase showed a dose–response association with conflict exposure when controlling for ageing and daily stressors. No demographic group displayed unique vulnerability or resilience to the effects of conflict exposure. Conclusions Conflict exposure should be considered in the context of other types of psychiatric risk factors. Conflict exposure predicted increases in anxiety whereas socioeconomic factors and non-conflict stressful life events were the major predictors of depression. Research and interventions in postconflict settings therefore should consider differential trajectories for depression v. anxiety and the importance of addressing chronic social problems ranging from poverty to gender and ethnic/caste discrimination.",0,0 +3767,Youth offspring of mothers with posttraumatic stress disorder have altered stress reactivity in response to a laboratory stressor,"Parental Posttraumatic Stress Disorder (PTSD), particularly maternal PTSD, confers risk for stress-related psychopathology among offspring. Altered hypothalamic-pituitary-adrenal (HPA) axis functioning is one mechanism proposed to explain transmission of this intergenerational risk. Investigation of this mechanism has been largely limited to general stress response (e.g., diurnal cortisol), rather than reactivity in response to an acute stressor. We examined cortisol reactivity in response to a laboratory stressor among offspring of mothers with a lifetime diagnosis of PTSD (n=36) and age- and gender- matched control offspring of mothers without PTSD (n=36). Youth (67% girls; mean age=11.4, SD=2.6) participated in a developmentally sensitive laboratory stressor and had salivary cortisol assessed five times (one pre-stress, one immediate post-stress, and three recovery measures, spaced 15min apart). Results were consistent with the hypothesis that offspring of mothers with PTSD would exhibit a dysregulated, blunted cortisol reactivity profile, and control offspring would display the expected adaptive peak in cortisol response to challenge profile. Findings were maintained after controlling for youth traumatic event history, physical anxiety symptoms, and depression, as well as maternal depression. This finding contributes to the existing literature indicating that attenuated HPA axis functioning, inclusive of hyposecretion of cortisol in response to acute stress, is robust among youth of mothers with PTSD. Future research is warranted in elucidating cortisol reactivity as a link between maternal PTSD and stress-related psychopathology vulnerability among offspring.",0,0 +3768,The role of locus of control and coping style in predicting longitudinal PTSD-trajectories after combat exposure,"While longitudinal posttraumatic stress responses are known to be heterogeneous, little is known about predictors of those responses. We investigated if locus of control (LOC) and coping style are associated with long-term PTSD-trajectories after exposure to combat. Six hundred and seventy five Israeli soldiers with or without combat stress reaction (CSR) from the Lebanon war were assessed 1, 2, and 20 years after the war. Combat exposure, LOC, and coping style were then investigated as covariates of the trajectories of resilience, recovery, delayed onset, and chronicity. Symptomatic trajectories in the CSR and the non-CSR group were significantly associated to varying degrees with perceived life threat during combat (ORs: 1.76-2.53), internal LOC (0.77-0.87), emotional coping style (0.28-0.34), and low use of problem-focused coping (2.12-3.11). In conclusion, assessment of LOC and coping can aid prediction of chronic PTSD outcomes of combat exposure.",0,0 +3769,"Relationships between posttraumatic stress disorder (PTSD), dissociation, quality of life, hopelessness, and suicidal ideation among earthquake survivors","Researches have demonstrated that Posttraumatic stress disorder (PTSD) is one of the most common stress reactions in the face of disasters and significantly associated with a broad range of trauma-induced sequelaes including anxiety, depression, suicidality as well as functional impairments. To date, though many aspects of risk factors with respect to the development and maintenance of PTSD have been addressed, mediating role of dissociation has received relatively less attention. In the present study, we examined relations of PTSD with quality of life, hopelessness, suicidal ideation, and mediational effect of pathological dissociation in these connections. 583 subjects most of whom experienced a severe earthquake participated in the study after two years of the disaster. We found that being female, being single, earthquake exposure, and having greater suicidal ideation were significant predictors of PTSD symptom severity. Role-Physical, Bodily-Pain, General Health and Role-Emotional subscales of the SF-36 were inversely associated with PTSD symptom severity. Pathological dissociation significantly mediated the substantial associations between predictors and PTSD symptom clusters. Chronic dissociation appears to put trauma exposed individuals in jeopardy of prolonged posttraumatic reactions by mediating the negative influences of risk factors in the face of experienced earthquake.",0,0 +3770,Longitudinal Trajectories of Posttraumatic Stress Disorder Symptoms and Binge Drinking Among Adolescent Girls: The Role of Sexual Victimization,"Many studies have documented associations among sexual victimization (SV), posttraumatic stress disorder (PTSD) symptoms, and alcohol use; however, few have examined these associations longitudinally among adolescents. The present study evaluated the effect of SV on the longitudinal trajectory of PTSD symptoms and binge drinking (BD) among adolescent girls, a population known to have high rates of SV and alcohol use.Participants (N = 1,808 at wave 1) completed interviews regarding PTSD symptoms, BD, and SV experiences over approximately 3 years.Multilevel modeling revealed decreases in PTSD symptoms over the course of the study; however, compared with nonvictims, adolescents who were sexually victimized reported greater PTSD symptoms at wave 1 and maintained higher levels of PTSD symptoms over the course of the study after controlling for age. SV reported during the study also predicted an acute increase in PTSD symptoms at that occasion. BD increased significantly over the course of the study; however, SV did not predict initial BD or increases over time. SV reported during the study was associated with acute increases in BD at that occasion, although this effect diminished when participants reporting substance-involved rape were excluded.SV was associated with immediate and long-lasting elevations in PTSD symptoms, but not with initial or lasting elevations in BD over time, suggesting that adolescent victims have yet to develop problematic patterns of alcohol use to cope with SV. However, SV was associated with acute increases in PTSD symptoms and BD, suggesting a need for BD interventions to reduce alcohol-related SV.",0,0 +3771,Predictors of Suicidal Ideation in a Gender-Stratified Sample of OEF/OIF Veterans,"There is a growing concern about suicide among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans. We examined the role of postdeployment mental health in associations between deployment stressors and postdeployment suicidal ideation (SI) in a national sample of 2,321 female and male OEF/OIF veterans. Data were obtained via survey, and path analysis was used. For women and men, mental health symptoms largely accounted for associations between deployment stressors and SI; however, they only partly accounted for the sexual harassment and SI association among women. These findings enhance the understanding of the mental health profile of OEF/OIF veterans.",0,0 +3772,Prevalence and correlates of respiratory and non-respiratory panic attacks in the general population,"Panic attacks are heterogeneous with regards to symptom profile. Subtypes of panic attacks have been proposed, of which the most investigated is respiratory panic attacks (RPA). Limited information exists about RPA in the general population.The prevalence and correlates of RPA and non-respiratory panic attacks (NRPA) were examined in a subsample (n=8.796) of individuals participating in a cross-sectional survey of the adult general population of six European countries. Panic attacks, mental disorders, and chronic physical conditions were assessed with the Composite International Diagnostic Interview (CIDI) 3.0. Data on use of health services and disability were obtained.The lifetime prevalence of RPA was 6.77 and the 12-month prevalence was 2.26. No robust associations of RPA with sociodemographic characteristics, mental disorders or physical conditions were found as compared to NRPA. RPA were associated with increased use of health services but similar disability in comparison to NRPA.Few direct data are available on the validity of the CIDI to assess RPA. Other definitions of RPA exist in the literature.Our findings suggest that there are very few differences between RPA and NRPA and do not support the need of subtyping panic attacks in current classification systems.",0,0 +3773,Expression profiling associates blood and brain glucocorticoid receptor signaling with trauma-related individual differences in both sexes,"Significance Because posttraumatic stress disorder (PTSD) occurs in a subset of trauma-exposed persons, expression profiling in the context of an animal model that focuses on individual differences in stress response permits identification of the relevant signaling pathways that lead to sustained impairment or resilience. The inclusion of blood and brain samples from both sexes is important because it allows the detection of convergent susceptibility pathways and concomitant identification of blood-based biomarkers. The across tissue and sex involvement of glucocorticoid receptor signaling with exposure-related individual differences suggests that targeting this signaling pathway may lead to a promising therapeutic strategy in PTSD.",0,0 +3774,Heart rate measured in the acute aftermath of trauma can predict post-traumatic stress disorder: A prospective study in motor vehicle accident survivors,"To determine whether increased physiological arousal immediately after trauma or at emergency admission can predict post-traumatic stress disorder (PTSD) in motor vehicle accident (MVA) survivors with physical injuries.We included 119 MVA survivors with physical injuries. In this prospective cohort study, heart rate (HR) and blood pressure (BP) were assessed during ambulance transport (T1) and at hospital admission (T2). One and four months after the accident, we assessed patients for PTSD (Davidson trauma scale, confirmed with the structured clinical interview for DSM-IV axis I disorders). Multivariate logistic regression models assessed the relationship between HR or BP and PTSD.PTSD was diagnosed in 54 (45.4%) patients at 1 month and in 39 (32.8%) at 4 months. In the multivariate analysis, HR at T1 or at T2 predicted PTSD at 1 month (OR=1.156, 95% CI [1.094;1.221] p<0.0001). Only HR at T1 (not at T2) predicted PTSD at 4 months (OR=1.059, 95% CI [1.013; 1.108] p=0.012). Injury severity predicted PTSD at 4 months (OR=1.207, 95% CI [1.085; 1.342] p=0.001). A cut-off of 84 beats per minute yielded a sensitivity of 62.5% and a specificity of 75.0% for PTSD.HR measured at the scene of MVA and severity of injury predicted PTSD 4 months later.",0,0 +3775,Psychometric properties of the Impact of Event Scale—Revised,"This study investigated the psychometric properties of the Impact of Event Scale -- Revised (IES-R) in two samples of male Vietnam veterans: a treatment-seeking sample with a confirmed posttraumatic stress disorder (PTSD) diagnosis (N = 120) and a community sample with varying levels of traumatic stress symptomatolgy (N = 154). The scale showed high internal consistency (alpha = 0.96). Confirmatory factor analysis did not provide support for a three-factor solution corresponding to the three subscales of intrusion, avoidance, and hyperarousal. Exploratory factor analysis suggested that either a single, or a two-factor solution (intrusion/hyperarousal and avoidance), provide the best account of date. However, correlations among the subscales were higher in the community sample than in the treatment sample, suggesting that the IES-R may be sensitive to a more general construct of traumatic stress in those with lower symptom levels. The correlation between the IES-R and the PTSD Checklist was high (0.84) and a cutoff of 1.5 (equivalent to a total score of 33) was found to provide the best diagnostic accuracy.",0,0 +3776,Resource Loss as a Predictor of Posttrauma Symptoms Among College Women Following the Mass Shooting at Virginia Tech,"We examined risk factors for posttrauma symptomatology, 2 and 6 months following the April 2007 mass shooting at Virginia Tech. Using a conservation of resources framework and a Web-based survey methodology, we prospectively evaluated the relations among preshooting distress, social support, resource loss, and posttrauma symptomatology in a sample of 293 female students enrolled at the university at the time of the shootings. Structural equation modeling supported that preshooting social support and distress predicted resource loss postshooting. Resource loss predicted symptomatology 2 months and 6 months after the shooting. Implications of the results for research and intervention following mass trauma are discussed. © 2009 Springer Publishing Company.",0,0 +3777,Prevalence of post-traumatic stress disorder among patients with substance use disorder: it is higher than clinicians think it is,"This study had three objectives. Firstly, the prevalence of post-traumatic stress disorder (PTSD) and trauma exposure was compared between individuals with and without substance use disorder (SUD). Secondly, we compared self-rating of PTSD and clinical judgement. Thirdly, an analysis of the characteristics of SUD/PTSD patients was performed.The sample consisted of 423 patients with SUD and 206 healthy controls. All individuals were screened on PTSD using the self-rating inventory for PTSD.Significantly higher numbers of PTSD and trauma exposure were found in the SUD group (resp. 36.6 and 97.4%). PTSD went frequently unnoticed when relying on clinical judgement alone. Patients with SUD/PTSD were significantly more often unemployed and had a lower educational level. Axis I comorbidity and especially depressive disorders were more common in the SUD/PTSD group.It is concluded that patients with SUD/PTSD are a substantial and vulnerable subgroup in addiction treatment facilities and that a systematic screening for PTSD is required.",0,0 +3778,Anxiety sensitivity in traumatized Cambodian refugees: A discriminant function and factor analytic investigation,"We examined the psychometric properties and factor structure of a Cambodian translation of the Anxiety Sensitivity Index (ASI) and an Augmented ASI (the ASI supplemented with a 9-item addendum that assesses additional Cambodian concerns about anxiety-related sensations). Both the ASI and the Augmented ASI distinguished among three diagnostic groups: highest score, PTSD with panic disorder (PP group); next, panic disorder without PTSD (P group); and then, other disorders than PTSD or panic disorder (O group). In the discriminant function analysis using the Augmented ASI, the best classificatory predictor (PP vs. P vs. O) was an Addendum item (""It scares me when I stand up and feel dizzy""). The principal component analysis (oblimin rotation) of the ASI yielded a 3-factor solution (I, Weak Heart Concerns; II, Control Concerns; III, Social Concerns) and of the Augmented ASI, a 4-factor solution (I, Weak Heart Concerns; II, Control Concerns; III, Wind Attack Concerns; IV, Social Concerns). The item clustering within the factor solution of both the ASI and Augmented ASI illustrates the role of cultural syndromes in generating fear of mental and bodily events.",0,0 +3779,Longitudinal Assessment of Mental Health Problems Among Active and Reserve Component Soldiers Returning From the Iraq War,"To promote early identification of mental health problems among combat veterans, the Department of Defense initiated population-wide screening at 2 time points, immediately on return from deployment and 3 to 6 months later. A previous article focusing only on the initial screening is likely to have underestimated the mental health burden.To measure the mental health needs among soldiers returning from Iraq and the association of screening with mental health care utilization.Population-based, longitudinal descriptive study of the initial large cohort of 88 235 US soldiers returning from Iraq who completed both a Post-Deployment Health Assessment (PDHA) and a Post-Deployment Health Re-Assessment (PDHRA) with a median of 6 months between the 2 assessments.Screening positive for posttraumatic stress disorder (PTSD), major depression, alcohol misuse, or other mental health problems; referral and use of mental health services.Soldiers reported more mental health concerns and were referred at significantly higher rates from the PDHRA than from the PDHA. Based on the combined screening, clinicians identified 20.3% of active and 42.4% of reserve component soldiers as requiring mental health treatment. Concerns about interpersonal conflict increased 4-fold. Soldiers frequently reported alcohol concerns, yet very few were referred to alcohol treatment. Most soldiers who used mental health services had not been referred, even though the majority accessed care within 30 days following the screening. Although soldiers were much more likely to report PTSD symptoms on the PDHRA than on the PDHA, 49% to 59% of those who had PTSD symptoms identified on the PDHA improved by the time they took the PDHRA. There was no direct relationship of referral or treatment with symptom improvement.Rescreening soldiers several months after their return from Iraq identified a large cohort missed on initial screening. The large clinical burden recently reported among veterans presenting to Veterans Affairs facilities seems to exist within months of returning home, highlighting the need to enhance military mental health care during this period. Increased relationship problems underscore shortcomings in services for family members. Reserve component soldiers who had returned to civilian status were referred at higher rates on the PDHRA, which could reflect their concerns about their ongoing health coverage. Lack of confidentiality may deter soldiers with alcohol problems from accessing treatment. In the context of an overburdened system of care, the effectiveness of population mental health screening was difficult to ascertain.",0,0 +3780,"NEUROPHYSIOLOGICALLY-BASED MEAN-FIELD MODELLING OF TONIC CORTICAL ACTIVITY IN POST-TRAUMATIC STRESS DISORDER (PTSD), SCHIZOPHRENIA, FIRST EPISODE SCHIZOPHRENIA AND ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)","A recently developed quantitative model of cortical activity is used that permits data comparison with experiment using a quantitative and standardized means. The model incorporates properties of neurophysiology including axonal transmission delays, synaptodendritic rates, range-dependent connectivities, excitatory and inhibitory neural populations, and intrathalamic, intracortical, corticocortical and corticothalamic pathways. This study tests the ability of the model to determine unique physiological properties in a number of different data sets varying in mean age and pathology. The model is used to fit individual electroencephalographic (EEG) spectra from post-traumatic stress disorder (PTSD), schizophrenia, first episode schizophrenia (FESz), attention deficit hyperactivity disorder (ADHD), and their age/sex matched controls. The results demonstrate that the model is able to distinguish each group in terms of a unique cluster of abnormal parameter deviations. The abnormal physiology inferred from these parameters is also consistent with known theoretical and experimental findings from each disorder. The model is also found to be sensitive to the effects of medication in the schizophrenia and FESz group, further supporting the validity of the model.",0,0 +3781,Posttraumatic Stress Disorder: Memory and Learning Performance in Children and Adolescents,"Despite the wealth of information in adult posttraumatic stress disorder (PTSD) literature, few studies have explored the memory and learning performance of trauma-exposed youth. This study examined if memory deficits are associated with PTSD or with trauma exposure in the absence of PTSD.Youth exposed to traumatic incidents underwent clinical interviews to diagnose PTSD and exclude major comorbid disorders. Youth with conditions that could impede performance on a memory scale (e.g., limited intellectual functioning, current substance abuse, psychopharmacological treatment) were excluded. Three groups of participants were identified (PTSD positives [n = 29], traumatized PTSD negatives [n = 62], and nontraumatized control subjects [n = 40]). Participants completed the Wide Range Assessment of Memory and Learning (WRAML).Youth with PTSD evidenced significantly lower scores on the WRAML General Memory, Verbal Memory, and Learning indices compared with nontraumatized control subjects. With the exception of Verbal Memory, youth with and without PTSD performed comparably on all other indices. Nonsignificant differences were noted on the Visual Memory Index.General memory and verbal memory impairments as evidenced in adult populations were observed among this sample of youth. Given the developmental trajectory of memory capabilities, the implications of such early trauma exposure and memory deficits are considered.",0,0 +3782,Resource conservation as a strategy for community psychology,"Conservation of resources (COR) theory (Hobfoll, 1988, 1989) was applied to social intervention and research. COR theory depicts resource loss as disproportionately weighted in comparison to resource gain. COR theory further posits that to prevent resource loss or establish resources, other resources must be invested. Resources contribute to further resource gain, whereas lack of resources contributes to ongoing resource loss. Consequently, people, groups, or organizations that are endowed with strong personal or social resource reserves should better resist the deleterious effects of stress and withstand everyday challenges. One of the basic principles of the theory—that loss is disproportionately weighted compared to gain—was tested in two samples and strongly supported. Implications of the model for intervention were discussed.",0,0 +3783,"Traumatic bereavement, acute dissociation, and posttraumatic stress: 14 years after the MSEstoniadisaster",en,0,0 +3784,Overview and Clinical Presentation of Generalized Anxiety Disorder,"1. To distinguish GAD from panic disorder is not difficult if a patient has frequent, spontaneous panic attacks and agoraphobic symptoms, but many patients with GAD have occasional anxiety attacks or panic attacks. Such patients should be considered as having GAD. An even closer overlap probably exists between GAD and social phobia. Patients with clear-cut phobic avoidant behavior may be distinguished easily from patients with GAD, but patients with social anxiety without clear-cut phobic avoidant behavior may overlap with patients with GAD and possibly should be diagnosed as having GAD and not social phobia. The cardinal symptoms of GAD commonly overlap with those of social phobia, particularly if the social phobia is more general and not focused on a phobic situation. For example, free-floating anxiety may cause the hands to perspire and may cause a person to be shy in dealing with people in public, and thus many patients with subthreshold social phobic symptoms have, in the authors' opinion, GAD and not generalized social phobia. The distinction between GAD and obsessive-compulsive disorder, acute stress disorder, and posttraumatic stress disorder should not be difficult by definition. At times, however, it may be difficult to distinguish between adjustment disorder with anxious mood from GAD or anxiety not otherwise specified, particularly if the adjustment disorder occurs in a patient with a high level of neuroticism or trait anxiety or type C personality disorder. Table 2 presents features distinguishing GAD from other psychiatric disorders. 2. Lifetime comorbid diagnoses of other anxiety or depression disorders, not active for 1 year or more and not necessitating treatment during that time period, should not effect a diagnosis of current GAD. On the other hand, if concomitant depressive symptoms are present and if these are subthreshold, a diagnosis of GAD should be made, and if these are full threshold, a diagnosis of MDD should be made. 3. If GAD is primary and if no such current comorbid diagnosis, such as other anxiety disorders or MDD, is present, except for minor depression and dysthymia, or if only subthreshold symptoms of other anxiety disorders are present, GAD should be considered primary and treated as GAD; however, patients with concurrent threshold anxiety or mood disorders should be diagnosed according to the definitions of these disorders in the DSM-IV and ICD-10 and treated as such. 4. Somatization disorders are now classified separately from anxiety disorders. Some of these, particularly undifferentiated somatization disorder, may overlap with GAD and be diagnostically difficult to distinguish. The authors believe that, as long as psychic symptoms of anxiety are present and predominant, patients should be given a primary diagnosis of GAD. 5. Two major shifts in the DSM diagnostic criteria for GAD have markedly redefined the definition of this disorder. One shift involves the duration criterion from 1 to 6 months, and the other, the increased emphasis on worry and secondary psychic [table: see text] symptoms accompanied by the elimination of most somatic symptoms. This decision has had the consequence of orphaning a large population of patients suffering from GAD that is more transient and somatic in its focus and who typically present not to psychiatrists but to primary care physicians. Therefore, clinicians should consider using the ICD-10 qualification of illness duration of ""several months"" to replace the more rigid DSM-IV criterion of 6 months and to move away from the DSM-IV focus on excessive worry as the cardinal symptom of anxiety and demote it to only another important anxiety symptom, similar to free-floating anxiety. One also might consider supplementing this ICD-10 criterion with an increased symptom severity criterion as, for example, a Hamilton Anxiety Scale of 18. Finally, the adjective excessive, not used in the definition of other primary diagnostic criteria, such as depressed mood for MDD, should be omitted (Table 3). 6. One may want to consider the distinction of trait (chronic) from state (acute) anxiety, but whether the presence of some personality characteristics, particularly anxious personality or Cluster C personality and increased neuroticism, as an indicator of trait [table: see text] anxiety is a prerequisite for anxiety disorders; occurs independently of anxiety disorders; or is a vulnerability factor that, in some patients, leads to anxiety symptoms and, in others, does not, is unknown. 7. Symptoms that some clinicians consider cardinal for a diagnosis of GAD, such as extreme worry, obsessive rumination, and somatization, also are present in other disorders, such as MDD. (ABSTRACT TRUNCATED)",0,0 +3785,When the Foundations of Life have been Upset…. An Integrated Clinical and Experimental Study with Refugees and Asylum Seekers,"Aim of the study Recent research results in clinical psychology, health psychology and neurobiology underline the relationship between dissociative states, complex posttraumatic syndromes and borderline functioning . Our study is meant to investigate the traumatic hypothesis of borderline functioning and to develop appropriate psychotherapeutic measures based on artistic mediations. Subject or material and methods We undertook an integrated clinical and experimental study with a sample of 73 refugees and asylum seekers. In a second stage, those who suffered from PTSD or complex post-traumatic states were offered to attend arts psychotherapeutic sessions.. We combined a semi-structured biographical interview, a projective test, i.e. the Sentences Completion Test , for which we developed a new manner of interpretation , and psychometric scales, i.e. the HADS and the Index of Wellbeing . Furthermore, we analysed the artistic production with the help of original rating scales . Results With the help of non parametric multidimensional statistics, we extracted two profiles of personality functioning, linked either to repeated breaks, negligence and maltreatment from the beginning of life, or either to a recent external catastrophe, interrupting a continuous life course. Through the evaluation of the arts therapeutic sessions, we could note the first signs of resumption of the blocked process of subjectivation. Discussion The results of the study support the traumatogenic hypothesis of borderline functioning, as well as current clinical considerations concerning the defensive role of dissociation in complex posttraumatic states. Conclusions The study opens tracks for future research concerning an in depth investigation of the arts therapeutic process with traumatized people.",0,0 +3786,Psychometric Evaluation of the Moral Injury Events Scale,"Literature describing the phenomenology of the stress of combat suggests that war-zone experiences may lead to adverse psychological outcomes such as post-traumatic stress disorder not only because they expose persons to life threat and loss but also because they may contradict deeply held moral and ethical beliefs and expectations. We sought to develop and validate a measure of potentially morally injurious events as a necessary step toward studying moral injury as a possible adverse consequence of combat. We administered an 11-item, self-report Moral Injury Events Scale to active duty Marines 1 week and 3 months following war-zone deployment. Two items were eliminated because of low item-total correlations. The remaining 9 items were subjected to an exploratory factor analysis, which revealed two latent factors that we labeled perceived transgressions and perceived betrayals; these were confirmed via confirmatory factor analysis on an independent sample. The overall Moral Injury Events Scale and its two subscales had favorable internal validity, and comparisons between the 1-week and 3-month data suggested good temporal stability. Initial discriminant and concurrent validity were also established. Future research directions were discussed.",0,0 +3787,Voluntary exercise does not ameliorate context memory and hyperarousal in a mouse model for post-traumatic stress disorder (PTSD),"We investigated the effects of voluntary wheel running as model for intervention on the development of contextual fear and hyperarousal in a mouse model of post-traumatic stress disorder (PTSD). Physical exercise in general has been associated with improved hippocampus-dependent memory performance both in animals and humans. However, studies that have tried to link physical exercise and contextual conditioning in an animal model of PTSD, revealed mixed findings.Here we tested contextual fear conditioning, generalized fear response, acoustic startle response and emotionality in C57BL/6NCrl mice which had free access to a running wheel for 28 days, compared with control animals which did not run and mice which did not receive a shock during the conditioning phase.We found no significant effects of voluntary running on the above-mentioned variables, except for enhanced anxiety levels in the Dark-Light-Box and O-Maze tests of running mice.Our results suggest that running as a model for intervention does not ameliorate contextual aversive learning but has the potency to change emotional behaviours.",0,0 +3788,A Study of Posttraumatic Stress and Growth in Tsunami Relief Volunteers,"Twenty female relief volunteers who had participated in the post-tsunami relief operations in the coastal areas of Tamil Nadu, India, under the aegis of nongovernmental organizations and charitable trusts were assessed for posttraumatic stress, posttraumatic growth, and dissociative experiences. They also responded to a set of questions in order to determine the direction (upward-downward) of their counterfactual thoughts. The observed data were subjected to a multivariate analysis of variance and multiple discriminant analysis to identify the key underlying dimensions. The main effects of amnesia, depersonalization, percentage of dissociation, and family type were highly significant. Discriminant coefficients suggested the importance of relating to others and proactive coping. They also suggested the importance of intrusion, avoidance, and appreciation of life.",0,0 +3789,The prevalence of lifetime and partial post-traumatic stress disorder in Vietnam theater veterans,,0,0 +3790,‘Comparisons of traumatic and positive memories in people with and without PTSD profile’,"According to most post-traumatic stress disorder (PTSD) theories, memory mechanisms are involved in its development and maintenance. However, the specific memory characteristics responsible for this disorder are still not well known. In the present study, 210 participants having reported at least one traumatic experience were assigned to a PTSD or to a non-PTSD symptom profile group. Both groups rated their memories for their most traumatic and intense positive life events. We observed that the traumatic memories of PTSD profile participants were more clear, detailed and judged as significant compared with those of the non-PTSD profile group. However, participants in the first group acknowledged having more difficulties putting their traumatic memories into words and controlling these remembrances. These differences were absent in their positive memories. Additionally, clear relationships emerged between memory ratings and PTSD symptoms measures. Results are discussed according to fragmentation and superiority views of traumatic memories in PTSD. Copyright © 2006 John Wiley & Sons, Ltd. Language: en",0,0 +3791,Trajectory of Traumatic Stress Symptoms in the Aftermath of Extreme Natural Disaster,"This study investigated the trajectory of traumatic stress symptoms in the aftermath of the 2004 Southeast Asian earthquake-tsunami. A total of 265 adult Thai survivors were assessed at 2 weeks and 6 months following the earthquake-tsunami. The percentages of survivors reporting traumatic stress symptoms were 22% at 2 weeks and 30% at 6 months postdisaster. Four trajectories of traumatic stress symptoms were identified: 12% of survivors presented with chronic stress symptoms, 18% had a delayed onset, 10% showed improvement, and the remaining 60% maintained a stable emotional equilibrium. Among survivors, the chronic group was the oldest, the delayed group reported the lowest level of perceived government support, and the resilient group experienced the fewest postdisaster psychiatric symptoms. Results pointed to the need to broaden the conceptualization of postdisaster stress responding as well as to establish disaster psychiatry and related mental health activities in the region.",0,0 +3792,"A Diathesis-Stress Model of Posttraumatic Stress Disorder: Ecological, Biological, and Residual Stress Pathways","The symptoms captured within the contemporary diagnostic definition of posttraumatic stress disorder (PTSD) have been studied for more than 100 years. Yet, even with increasingly advanced discoveries regarding the etiology of PTSD, a comprehensive and up-to-date etiological model that incorporates both medical and psychological research has not been described and systematically studied. The diathesis-stress model proposed here consolidates existing medical and psychological research data on etiological factors associated with PTSD into 3 causal pathways: residual stress, ecological, and biological. In combination, these pathways illuminate how PTSD might develop and who might be at higher risk for developing the disorder. Research and treatment implications related to the diathesis-stress model are discussed.",0,0 +3793,Critically Evaluating Typologies of Internet Sex Offenders: A Psychological Perspective,"Understanding why indecent images of children are produced and collected involves issues beyond the legal definition of child pornography. An over-emphasis on a legal approach will not necessarily assist in the development of preventative and control strategies. This article provides a brief overview of the way in which the Internet can be misused for sexual gratification and has identified some of the issues that seem to be significant in understanding the nature and dimensions of Internet sexual offending. The main descriptive typologies that underpin research relating to Internet child sex offenders have been reviewed and critically evaluated. As discussed throughout this article, one of the most challenging issues continues to be the difficulty in placing Internet sex offenders into categories. The foregoing discussion indicates that Internet sex offenders comprise a heterogeneous population and that there appears to be a lack of a coherent and agreed framework for defining their activity.",0,0 +3794,Randomized Controlled Trial of Group Cognitive Behavioural Therapy for Post-Traumatic Stress Disorder in Children and Adolescents Exposed to Tsunami in Thailand,"Background: Post-traumatic stress disorder (PTSD) is a common and debilitating consequence of natural disaster in children and adolescents. Accumulating data show that cognitive behavioural therapy (CBT) is an effective treatment for PTSD. However, application of CBT in a large-scale disaster in a setting with limited resources, such as when the tsunami hit several Asian countries in 2004, poses a major problem. Aims: This randomized controlled trial aimed to test for the efficacy of the modified version of CBT for children and adolescents with PSTD. Method: Thirty-six children (aged 10–15 years) who had been diagnosed with PSTD 4 years after the tsunami were randomly allocated to either CBT or wait list. CBT was delivered in 3-day, 2-hour-daily, group format followed by 1-month posttreatment self-monitoring and daily homework. Results: Compared to the wait list, participants who received CBT demonstrated significantly greater improvement in symptoms of PTSD at 1-month follow-up, although no significant improvement was observed when the measures were done immediately posttreatment. Conclusions: Brief, group CBT is an effective treatment for PTSD in children and adolescents when delivered in conjunction with posttreatment self-monitoring and daily homework.",0,0 +3795,"Prevalence of War-Related Mental Health Conditions and Association With Displacement Status in Postwar Jaffna District, Sri Lanka","Nearly 2.7 million individuals worldwide are internally displaced (seeking refuge in secure areas of their own country) annually by armed conflict. Although the psychological impact of war has been well documented, less is known about the mental health symptoms of forced displacement among internally displaced persons.To estimate the prevalence of the most common war-related mental health conditions, symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression, and to assess the association between displacement status and these conditions in postwar Jaffna District, Sri Lanka.Between July and September 2009, a cross-sectional multistage cluster sample survey was conducted among 1517 Jaffna District households including 2 internally displaced persons camps. The response rate was 92% (1448 respondents, 1409 eligible respondents). Two percent of participants (n = 80) were currently displaced, 29.5% (n = 539) were recently resettled, and 68.5% (n = 790) were long-term residents. Bivariable analyses followed by multivariable logistic regression models were performed to determine the association between displacement status and mental health.Symptom criteria of PTSD, anxiety, and depression as measured by the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist-25.The overall prevalences of symptoms of PTSD, anxiety, and depression were 7.0% (95% confidence interval [CI], 5.1%-9.7%), 32.6% (95% CI, 28.5%-36.9%), and 22.2% (95% CI, 18.2%-26.5%), respectively. Currently displaced participants were more likely to report symptoms of PTSD (odds ratio [OR], 2.71; 95% CI, 1.28-5.73), anxiety (OR, 2.91; 95% CI, 1.89-4.48), and depression (OR, 4.55; 95% CI, 2.47-8.39) compared with long-term residents. Recently resettled residents were more likely to report symptoms of PTSD (OR, 1.96; 95% CI, 1.11-3.47) compared with long-term residents. However, displacement was no longer associated with mental health symptoms after controlling for trauma exposure.Among residents of Jaffna District in Sri Lanka, prevalence of symptoms of war-related mental health conditions was substantial and significantly associated with displacement status and underlying trauma exposure.",0,0 +3796,Posttraumatic growth and posttraumatic distress: A longitudinal study.,"This longitudinal study examined the course and bidirectional relation between posttraumatic distress and posttraumatic growth (PTG). A sample of Israeli ex-prisoners of war and matched controls were followed over 17 years. Participants’ posttraumatic stress disorder (PTSD), depression, and anxiety symptoms were measured at three time-points. PTG was assessed twice. Applying an autoregressive cross-lagged modeling strategy, initial PTSD predicted subsequent PTG above and beyond PTG stability, but not vice versa. Cross-lagged relations of PTG to depression and anxiety were not significant. Moreover, analysis of PTG trajectory revealed that individuals with PTSD reported higher PTG levels across times than those without PTSD. Thus, growth is facilitated and maintained by endorsement rather than absence of PTSD. The findings are discussed in the context of the illusionary versus adaptive notion of PTG.",0,0 +3797,Post-traumatic stress disorder and illness perceptions over time following myocardial infarction and subarachnoid haemorrhage,"This study investigated post-traumatic stress disorder (PTSD) symptoms and illness perceptions in people who suffered the acute medical trauma of a myocardial infarction (MI) or a subarachnoid haemorrhage (SAH). The study tested hypotheses regarding changes in PTSD symptoms and illness perceptions over time, associations between PTSD and illness perceptions and cognitive predictors of PTSD.The study employed a longitudinal design and measured the illness perceptions and PTSD symptoms of an MI group (N=17) and a SAH group (N=27). Data were collected within 2 weeks of admission (T1), 6 weeks after admission (T2) and 3 months after admission (T3). Statistical analysis was undertaken to examine associations between illness perceptions and PTSD and to examine cognitive predictors of PTSD.The prevalence of PTSD within the total acute medical trauma sample was 16% at 2 weeks, 35% at 6 weeks and 16% at 3 months. Illness perception factors of identity, timeline (acute/chronic), consequences and emotional representation were strongly correlated with PTSD at all three time points. PTSD symptoms and illness perceptions were shown to have changed over time. The results also showed that several illness perception factors are significant predictors of PTSD.Both PTSD symptoms and illness perceptions changed significantly over time following an MI or SAH. Illness perception factors are significant predictors of PTSD.",0,0 +3798,Mental Health Services Required after Disasters: Learning from the Lasting Effects of Disasters,"Disasters test civil administrations' and health services' capacity to act in a flexible but well-coordinated manner because each disaster is unique and poses unusual challenges. The health services required differ markedly according to the nature of the disaster and the geographical spread of those affected. Epidemiology has shown that services need to be equipped to deal with major depressive disorder and grief, not just posttraumatic stress disorder, and not only for victims of the disaster itself but also the emergency service workers. The challenge is for specialist advisers to respect and understand the existing health care and support networks of those affected while also recognizing their limitations. In the initial aftermath of these events, a great deal of effort goes into the development of early support systems but the longer term needs of these populations are often underestimated. These services need to be structured, taking into account the pre-existing psychiatric morbidity within the community. Disasters are an opportunity for improving services for patients with posttraumatic psychopathology in general but can later be utilized for improving services for victims of more common traumas in modern society, such as accidents and interpersonal violence.",0,0 +3799,State of psychiatry in Denmark,"Danish psychiatry has gone through profound changes over the past two to three decades, reducing inpatient-based treatment and increasing outpatient treatment markedly. The number of patients treated has almost doubled, and the diagnostic profile has broadened, now including a substantial number of common mental disorders, in particular depression and anxiety. Furthermore, 'new' diagnostic groups are represented in the treatment statistics with steeply increasing incidences, e.g. attention deficit hyperactivity disorder (ADHD) and eating disorders, especially in the outpatient part of the statistics. Over the same 30 years, the number of available beds has been reduced by 60-70%; however, as the length of stay of inpatients has been reduced markedly, the departments are still able to treat a high number of patients. The financial budgeting of psychiatry is not increasing equivalently to the somatic specialities, handicapping development in psychiatry. Action has been taken to increase research activity in psychiatry. This is facilitated by an increasing interest among medical students and young graduate physicians attracted by the neuropsychiatric paradigm, rapidly implemented in Danish psychiatry.",0,0 +3800,Has psychiatry tamed the “ketamine tiger?” Considerations on its use for depression and anxiety,"Ketamine has been available for approximately 50 years as an anesthetic agent. It is known to have potent effects on the central nervous system glutamatergic system, in particular blockade of N-methyl-D-aspartate (NMDA) receptors. Based upon pre-clinical evidence of involvement of the glutamatergic system in mood disorders, studies have been undertaken to test the antidepressant properties of ketamine. Several well-controlled studies, along with open-label case series, have established that ketamine can have rapid antidepressant effects. Additionally, data exist showing benefits of ketamine in post-traumatic stress disorder as well as obsessive compulsive disorder. However, improvements in these conditions tend to be short-lived with single infusions of ketamine. Of concern, ketamine has been associated with neurotoxicity in pre-clinical rodent models and is well-known to cause psychotomimetic effects and addiction in humans. While ketamine has been proven safe for use in sub-anesthetic doses administered once or a few times, the safety profile of prolonged use has not been established. Aspects of safety, possible mechanisms of action, and future directions of ketamine research are discussed in addition to the clinical literature on its use in psychiatric conditions.",0,0 +3801,Posttraumatic stress disorder in OEF/OIF veterans with and without traumatic brain injury,"Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) are presenting with high rates of co-occurring posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI). The purpose of this study was to compare the clinical presentations of combat-veterans with PTSD and TBI (N = 40) to those with PTSD only (N = 56). Results suggest that the groups present two distinct clinical profiles, with the PTSD + TBI group endorsing significantly higher PTSD scores, higher overall anxiety, and more functional limitations. The higher PTSD scores found for the PTSD + TBI group appeared to be due to higher symptom intensity, but not higher frequency, across PTSD clusters and symptoms. Groups did not differ on additional psychopathology or self-report of PTSD symptoms or executive functioning. Further analysis indicated PTSD severity, and not TBI, was responsible for group differences, suggesting that treatments implicated for PTSD would likely be effective for this population.",0,0 +3802,Summary of a National Institute of Mental Health workshop: developing animal models of anxiety disorders,"There exists a wide range of animal models and measures designed to assess anxiety or fearfulness. However, the relationship between these models and clinical anxiety symptoms and syndromes is unclear. The National Institute of Mental Health convened a workshop to discuss the relationship between existing behavioral models of anxiety and the clinical profile of anxiety disorders. A second goal of this workshop was to outline various approaches towards modeling components of anxiety disorders.To briefly describe epidemiological and behavioral manifestations of clinical anxiety syndromes and how they relate to commonly employed animal models of anxiety. To describe approaches and considerations for developing, improving, and adapting anxiety models to better understand the neurobiology of anxiety.Clinicians, psychiatrists and clinical and basic neuroscientists presented data exemplifying different approaches towards understanding anxiety and the role of animal models. Panel members outlined what they considered to be critical issues in developing and employing animal models of anxiety.This review summarizes the discussions and conclusions of the workshop including recommendations for improving upon existing models and strategies for developing novel models.The probability of developing comprehensive animal models that accurately reflect the relative influences of factors contributing to anxiety disorder syndromes is quite low. However, ample opportunity remains to better define and extend existing models and behavioral measures related to specific processes that may be disrupted in anxiety disorders and to develop new models that consider the impact of combined factors in determining anxious behaviors.",0,0 +3803,Obsessive-Compulsive Disorder and Posttraumatic Stress Disorder,"<i>Background: </i>Previous studies suggested an association between exposure to trauma or stressful life events and obsessive-compulsive disorder (OCD). This study investigates the hypothesis that traumatic events and posttraumatic stress disorders (PTSD) precede the onset of OCD. <i>Sampling and Methods:</i> 210 cases with OCD from university treatment facilities were compared with 133 sex- and age-matched controls from the adult general population. The data were derived from a German family study on OCD (GENOS). Direct interviews were carried out with the German version of the Schedule for Affective Disorders and Schizophrenia – Lifetime Version for Anxiety Disorders (DSM-IV). <i>Results:</i> Severe traumatization occurred in 6.2% of the OCD cases and in 8.3% of the controls. The lifetime prevalence rates of traumatization, PTSD and acute stress disorder were not different between the subjects with OCD and controls (p > 0.05). In 6 cases, acute stress disorder, subclinical or full PTSD preceded the onset of OCD, in 3 cases the trauma-related disorders and OCD occurred within the same year, in 5 other cases, the trauma-related disorders started after the onset of OCD. <i>Conclusion:</i> There is no significant association of traumatization or PTSD with OCD compared with controls. Given the low rate of trauma-related disorders occurring before (2.9%) or within (1.5%) the same year as the onset of OCD other factors than severe traumatic events determine the onset of OCD in most of the cases.",0,0 +3804,Self-Report of Psychological Function Among OEF/OIF Personnel Who Also Report Combat-Related Concussion,"MMPI-2 RF profiles of 128 U.S. soldiers and veterans with history of concussion were examined. Participants evaluated in forensic (n = 42) and clinical (n = 43) settings showed significantly higher validity and clinical elevations relative to a research group (n = 43). In the full sample, a multivariate GLM identified main effects for disability claim status and Axis I diagnosis across numerous MMPI-2 RF scales. Participants with co-morbid PTSD and concussion showed significant Restructured Clinical and Specific Problem scale elevations relative to those without Axis I diagnosis. Participants with PTSD and active disability claims were especially prone to elevate on FBS/FBS-r and RBS. Implications for neuropsychologists who routinely administer the MMPI-2/RF in the context of combat-related concussion are discussed.",0,0 +3805,Metabolite profiling in posttraumatic stress disorder,"Traumatic stress does not only increase the risk for posttraumatic stress disorder (PTSD), but is also associated with adverse secondary physical health outcomes. Despite increasing efforts, we only begin to understand the underlying biomolecular processes. The hypothesis-free assessment of a wide range of metabolites (termed metabolite profiling) might contribute to the discovery of biological pathways underlying PTSD.Here, we present the results of the first metabolite profiling study in PTSD, which investigated peripheral blood serum samples of 20 PTSD patients and 18 controls. We performed liquid chromatography (LC) coupled to Quadrupole/Time-Of-Flight (QTOF) mass spectrometry. Two complementary statistical approaches were used to identify metabolites associated with PTSD status including univariate analyses and Partial Least Squares Discriminant Analysis (PLS-DA).Thirteen metabolites displayed significant changes in PTSD, including four glycerophospholipids, and one metabolite involved in endocannabinoid signaling. A biomarker panel of 19 metabolites classifies PTSD with 85% accuracy, while classification accuracy from the glycerophospholipid with the highest differentiating ability already reached 82%.This study illustrates the feasibility and utility of metabolite profiling for PTSD and suggests lipid-derived and endocannabinoid signaling as potential biological pathways involved in trauma-associated pathophysiology.",0,0 +3806,Public Health Consequences of Terrorism on Maternal–Child Health in New York City and Madrid,"Past research provides evidence for trajectories of health and wellness among individuals following disasters that follow specific pathways of resilience, resistance, recovery, or continued dysfunction. These individual responses are influenced by event type and pre-event capacities. This study was designed to utilize the trajectories of health model to determine if it translates to population health. We identified terrorist attacks that could potentially impact population health rather than only selected individuals within the areas of the attacks. We chose to examine a time series of population birth outcomes before and after the terrorist events of the New York City (NYC) World Trade Center (WTC) attacks of 2001 and the Madrid, Spain train bombings of 2004 to determine if the events affected maternal-child health of those cities and, if so, for how long. For percentages of low birth weight (LBW) and preterm births, we found no significant effects from the WTC attacks in NYC and transient but significant effects on rates of LBW and preterm births following the bombings in Madrid. We did find a significant positive and sustained effect on infant mortality rate in NYC following the WTC attacks but no similar effect in Madrid. There were no effects on any of the indicator variables in the comparison regions of New York state and the remainder of Spain. Thus, population maternal-health in New York and Madrid showed unique adverse effects after the terrorist attacks in those cities. Short-term effects on LBW and preterm birth rates in Madrid and long-term effects on infant mortality rates in NYC were found when quarterly data were analyzed from 1990 through 2008/2009. These findings raise questions about chronic changes in the population's quality of life following catastrophic terrorist attacks. Public health should be monitored and interventions designed to address chronic stress, environmental, and socioeconomic threats beyond the acute aftermath of events.",0,0 +3807,Latent Trajectories of Trauma Symptoms and Resilience,"To identify trajectories of posttraumatic stress disorder (PTSD) symptoms from before to 2.5 years after deployment and to assess risk factors for symptom fluctuations and late-onset PTSD.743 soldiers deployed to Afghanistan in 2009 were assessed for PTSD symptoms using the PTSD Checklist (PCL) at 6 occasions from predeployment to 2.5 years postdeployment (study sample = 561). Predeployment vulnerabilities and deployment and postdeployment stressors were also assessed.Six trajectories were identified: a resilient trajectory with low symptom levels across all assessments (78.1%) and 5 trajectories showing symptom fluctuations. These included a trajectory of late onset (5.7%), independently predicted by earlier emotional problems (OR = 5.59; 95% CI, 1.57-19.89) and predeployment and postdeployment traumas (OR = 1.10; 95% CI, 1.04-1.17 and OR = 1.13; 95% CI, 1.00-1.26). Two trajectories of symptom fluctuations in the low-to-moderate range (7.5% and 4.1%); a trajectory of symptom relief during deployment, but with a drastic increase at the final assessments (2.0%); and a trajectory with mild symptom increase during deployment followed by relief at return (2.7%) were also found. Symptom fluctuation was predicted independently by predeployment risk factors (depression [OR = 1.27; 95% CI, 1.16-1.39], neuroticism [OR = 1.10; 95% CI, 1.00-1.21], and earlier traumas [OR = 1.09; 95% CI, 1.03-1.16]) and deployment-related stressors (danger/injury exposure [OR = 1.20; 95% CI, 1.04-1.40]), but not by postdeployment stressors.The results confirm earlier findings of stress response heterogeneity following military deployment and highlight the impact of predeployment, perideployment, and postdeployment risk factors in predicting PTSD symptomatology and late-onset PTSD symptoms.",1,0 +3808,"60,000 Disaster Victims Speak: Part II. Summary and Implications of the Disaster Mental Health Research","On the basis of the literature reviewed in Part I of this two-part series (Norris, Friedman, Watson, Byrne, Diaz, and Kaniasty, this volume), the authors recommend early intervention following disasters, especially when the disaster is associated with extreme and widespread damage to property, ongoing financial problems for the stricken community, violence that resulted from human intent, and a high prevalence of trauma in the form of injuries, threat to life, and loss of life. Meeting the mental health needs of children, women, and survivors in developing countries is particularly critical. The family context is central to understanding and meeting those needs. Because of the complexity of disasters and responses to them, inter-agency cooperation and coordination are extremely important elements of the mental health response. Altogether, the research demands that we think ecologically and design and test societal- and community-level interventions for the population at large and conserve scarce clinical resources for those most in need.",0,0 +3809,An examination of PTSD symptoms and relationship functioning in U.S. soldiers of the Iraq War over time,"We examined associations between overall posttraumatic stress disorder (PTSD) symptoms, symptom clusters of PTSD (reexperiencing, avoidance, dysphoria, and arousal), and relationship adjustment cross sectionally and longitudinally using self-report measures from a dyadic sample of U.S. National Guard soldiers from the Iraq war and their intimate partners (N = 49 couples). Results of multilevel modeling revealed that Time 1 PTSD symptom severity significantly predicted lower relationship adjustment as rated by partners at Time 2 after controlling for baseline relationship adjustment (β = −.20, p = .025). Total PTSD symptoms did not significantly predict soldiers' ratings of relationship adjustment at Time 2. For soldiers, the PTSD symptom cluster of dysphoria was uniquely and significantly related to relationship adjustment ratings both at Time 1 and at Time 2, controlling for Time 1 adjustment. For partners, none of the soldiers' PTSD symptoms clusters was uniquely associated with Time 1 relationship adjustment or with change in adjustment over time. In contrast, findings regarding the effect of relationship adjustment on changes in PTSD over time found that Time 1 relationship adjustment was not associated with changes in PTSD symptoms at Time 2.",0,0 +3810,"Exposure to war traumatic experiences, post-traumatic stress disorder and post-traumatic growth among nurses in Gaza","ACCESSIBLE SUMMARY: What is known on the subject? This study builds on existing research on war-related factors that may affect health-care staff by particularly focusing on trauma exposure in both professional and everyday life, as well as on correlates of later positive psychological changes. What this paper adds to existing knowledge? It shows that one in five nursing staff working in Gaza experienced post-traumatic stress symptoms within the clinical range, 2 years after an incursion on Gaza and after being exposed to substantial trauma during this period. Participants appeared to develop a variety of post-traumatic growth responses following trauma exposure. Although nurses experienced traumatic events both as civilians and in their health-care capacity, personal exposure was strongly associated with PTSD symptoms. What are the implications for practice? Support to nursing and other health-care professionals in war situations should entail different levels, remain available well after an acute conflict, and take into consideration both personal and practice-related traumatic events. Mental health nursing practitioners can play a pivotal role in this. ABSTRACT: Aim To establish the association between war traumatic experiences, post-traumatic stress disorder (PTSD) symptoms and post-traumatic growth among nurses in the Gaza Strip, 2 years after an incursion on Gaza, and during a period of ongoing trauma exposure. This study builds on existing evidence by considering exposure to personal and work-related traumatic events, and on factors associated with later positive psychological adaptation. METHODS The sample consisted of 274 randomly selected nurses in Gaza who completed the Gaza Traumatic Events Checklist, PTSD Checklist, and Posttraumatic Growth Inventory. RESULTS Of the nurses, 19.7% reported full PTSD. There was a significant relationship between traumatic events and PTSD scores; as well as between community-related traumatic events and post-traumatic growth. Participants reported a range of traumatic events, but PTSD and post-traumatic growth scores were more strongly associated with community rather than work-related traumas. DISCUSSION Nursing professionals experienced high levels of distress 2 years following an acute period of conflict, both as civilians and in their health-care capacity. Implications for Practice There is need for different levels of support for health-care staff in war-affected areas. Mental health nursing professionals have a central role in training, counselling and support to other health-care colleagues. Language: en",0,0 +3811,Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers,"PurposeWe sought to estimate the pooled current prevalence of posttraumatic stress disorder (PTSD) among rescue workers and to determine the variables implicated in the heterogeneity observed among the prevalences of individual studies.MethodsA systematic review covering studies reporting on the PTSD prevalence in rescue teams was conducted following four sequential steps: (1) research in specialized online databases, (2) review of abstracts and selection of studies, (3) review of reference list, and (4) contact with authors and experts. Prevalence data from all studies were pooled using random effects model. Multivariate meta-regression models were fitted to identify variables related to the prevalences heterogeneity.ResultsA total of 28 studies, reporting on 40 samples with 20,424 rescuers, were selected. The worldwide pooled current prevalence was 10%. Meta-regression modeling in studies carried out in the Asian continent had, on average, higher estimated prevalences than those from Europe, but not higher than the North American estimates. Studies of ambulance personnel also showed higher estimated PTSD prevalence than studies with firefighters and police officers.ConclusionsRescue workers in general have a pooled current prevalence of PTSD that is much higher than that of the general population. Ambulance personnel and rescuers from Asia may be more susceptible to PTSD. These results indicate the need for improving pre-employment strategies to select the most resilient individuals for rescue work, to implement continuous preventive measures for personnel, and to promote educational campaigns about PTSD and its therapeutic possibilities.",0,0 +3812,Gender and Comorbid Psychopathology in Adolescents With Alcohol Dependence,"Although several mental disorders have been shown to be common in adolescents with substance use disorders, prior studies have not specifically focused on alcohol dependence and have not had sufficient sample sizes to examine gender effects. This study contrasts mental disorder diagnoses and symptoms between a sample of adolescents with alcohol dependence and a community control sample of adolescents and incorporates gender analyses.Adolescents (aged 14 years 0 months to 18 years 0 months) with alcohol dependence (females: n = 55; males: n = 78) and community-dwelling control adolescents without substance use disorders (females: n = 44; males: n = 42) were assessed by means of a semistructured interview for DSM-III-R.While cannabis and hallucinogen use disorders were common in the alcohol dependence group, females and males had similar rates. Conduct disorder (CD), oppositional defiant disorder, attention-deficit hyperactivity disorder, major depression (MD), and posttraumatic stress disorder (PTSD) had significantly higher rates in the alcohol dependence than in the community control group. Depression and PTSD symptoms were more strongly associated with alcohol dependence in females than in males. A configural frequency analysis showed that CD and MD tended to occur together in both female and male adolescents with alcohol dependence.While alcohol-dependent females and males similarly exhibited more comorbid disorders than control adolescents, gender affects the relationship of alcohol dependence to MD and PTSD. Rather than reflecting distinct types, the comorbid disorders of CD and MD jointly characterize many adolescents with alcohol dependence.",0,0 +3813,MCMI and 16-PF With Vietnam Veterans: Profiles and Concurrent Validation of MCMI,"The issue of concurrent validation for the Millon Clinical Multiaxial Inventory (MCMI) is addressed. A carefully defined group of Vietnam veterans with posttraumatic stress disorder (PTSD) were identified (n = 60). They were given the MCMI and 16-PF Results showed that the passive—aggressive and avoidant personality styles (8-2) with schizoid and borderline features and symptoms of dysthymia and anxiety were characteristic of Vietnam veterans with PTSD on the MCMI. The 16-PF pattern of this group was one with low stens on Warmth, Emotional Stability, Happy-Go-Lucky, Boldness, Self-Discipline, and Extraversion; and high stens on Suspiciousness, Insecurity, Self-Sufficiency, and Anxiety. When each MCMI scale was inspected separately for correlates of the 16-PF, considerable concurrent validation resulted. Clinicians are encouraged to use these scales for the identification and personologic description of the PTSD disorder with veterans.",0,0 +3814,Neurocircuitry models of posttraumatic stress disorder and beyond: A meta-analysis of functional neuroimaging studies,"Over the past two decades a relatively large number of studies have investigated the functional neuroanatomy of posttraumatic stress disorder (PTSD). However, findings are often inconsistent, thus challenging traditional neurocircuitry models of PTSD. As evidence mounts that cognition and behavior is an emergent property of interacting brain networks, the question arises whether PTSD can be understood by examining dysfunction in large-scale, spatially distributed neural networks. We used the activation likelihood estimation quantitative meta-analytic technique to synthesize findings across functional neuroimaging studies of PTSD that either used a non-trauma (N=20) or trauma-exposed (N=19) comparison control group. In line with neurocircuitry models, our findings support hyperactive amygdala and hypoactive medial prefrontal regions, but suggest hyperactive hippocampi. Characterization of additional regions under a triple network model showed functional alterations that largely overlapped with the salience network, central executive network, and default network. However, heterogeneity was observed within and across the neurocircuitry and triple network models, and between results based on comparisons to non-trauma and trauma-exposed control groups. Nonetheless, these results warrant further exploration of the neurocircuitry and large-scale network models in PTSD using connectivity analyses.",0,0 +3815,Commentary: Developmental Trauma Disorder: A Missed Opportunity in DSM V.,"This is a commentary on the proposal of van der Kolk, et al. (2009) to include the diagnosis of developmental trauma disorder in the DSM V. As is now known, it was not accepted. Importantly, a commentary relating to this must include comments on both diagnosis and trauma in children. We will first comment on general issues of diagnostic systems in child psychiatry and then, if we are to use DSM V, why there should be a separate category for developmental trauma.",0,0 +3816,A psychological profile of Elian Gonzalez.,,0,0 +3817,Trends in mental illness and suicidality after Hurricane Katrina,"A representative sample of 815 pre-hurricane residents of the areas affected by Hurricane Katrina was interviewed 5–8 months after the hurricane and again 1 year later as the Hurricane Katrina Community Advisory Group (CAG). The follow-up survey was carried out to study patterns-correlates of recovery from hurricane-related post-traumatic stress disorder (PTSD), broader anxiety-mood disorders and suicidality. The Trauma Screening Questionnaire screening scale of PTSD and the K6 screening scale of anxiety-mood disorders were used to generate DSM-IV prevalence estimates. Contrary to results in other disaster studies, where post-disaster mental disorder typically decreases with time, prevalence increased significantly in the CAG for PTSD (20.9 vs 14.9% at baseline), serious mental illness (SMI; 14.0 vs 10.9%), suicidal ideation (6.4 vs 2.8%) and suicide plans (2.5 vs 1.0%). The increases in PTSD-SMI were confined to respondents not from the New Orleans Metropolitan Area, while the increases in suicidal ideation-plans occurred both in the New Orleans sub-sample and in the remainder of the sample. Unresolved hurricane-related stresses accounted for large proportions of the inter-temporal increases in SMI (89.2%), PTSD (31.9%) and suicidality (61.6%). Differential hurricane-related stress did not explain the significantly higher increases among respondents from areas other than New Orleans, though, as this stress was both higher initially and decreased less among respondents from the New Orleans Metropolitan Area than from other areas affected by the hurricane. Outcomes were only weakly related to socio-demographic variables, meaning that high prevalence of hurricane-related mental illness remains widely distributed in the population nearly 2 years after the hurricane.",0,0 +3818,Relationship of alexithymia and temperament and character dimensions with lifetime post-traumatic stress disorder in male alcohol-dependent inpatients,"Aims: The purpose of the present study was to evaluate the prevalence of lifetime post-traumatic stress disorder (PTSD) in male alcohol-dependent inpatients and to investigate the relationship of PTSD with alexithymia and temperament and character dimensions. Methods: Participants were 156 consecutively admitted male alcohol-dependent subjects. Patients were investigated using the Clinician-Administered PTSD Scale (CAPS), the Toronto Alexithymia Scale (TAS-20) and the Temperament and Character Inventory (TCI). Results: Among alcohol-dependent inpatients 32.1% were considered as having lifetime PTSD. Mean scores of alexithymia, novelty seeking (NS), harm avoidance (HA) and self-transcendence (ST) were higher in the PTSD group, whereas age and self-directedness (S) were lower. Among age and other factors of TAS-20, ‘difficulty in identifying feelings (DIF)’ predicted PTSD in a logistic regression model. When age and personality dimensions of TCI were taken as independent variables, S predicted PTSD in the logistic regression model. Finally, among subscales of TCI, ‘impulsiveness versus reflection’ (NS2) and ‘congruent second nature versus bad habits’ (S5) predicted PTSD. Conclusions: Alexithymia and personality traits, particularly high DIF and S scores are related with lifetime PTSD diagnosis, even when controlling for age among alcohol-dependent inpatients. Causal relationships between alexithymia, personality dimensions and PTSD, and their implications on treatment are not clear and should be evaluated in longitudinal studies.",0,0 +3819,Association of Posttraumatic Stress Disorder With Increased Prevalence of Metabolic Syndrome,"Few studies have compared prevalence rates of metabolic abnormalities in antipsychotic-treated patients with different psychiatric disorders, including posttraumatic stress disorder (PTSD). In this study, we examined components of metabolic syndrome among middle-aged and older patients with psychiatric disorders.In the study, 203 outpatients older than 40 years and with psychotic symptoms that needed antipsychotic treatment were enrolled. Among them, 65 had a diagnosis of schizophrenia, 56 had dementia, 49 had mood disorder, and 33 had PTSD. Clinical evaluations included medical history, use of psychotropic and other medications, adverse effects, physical examination, and clinical laboratory tests for metabolic profiles.Overall, the prevalence rates of metabolic syndrome were 72% in patients with PTSD, 60% in those with schizophrenia, 58% in those with mood disorder, and 56% in those with dementia. There were significant differences in body mass index, diastolic blood pressure, waist circumference, and high-density lipoprotein cholesterol among the 4 diagnostic groups. Posttraumatic stress disorder, schizophrenia, and mood disorder groups had significantly higher body mass indexes compared with the dementia group. The PTSD group also had significantly higher diastolic blood pressure compared with the dementia and mood disorder groups.Posttraumatic stress disorder may be associated with worsened metabolic profile. The overall frequency of metabolic syndrome and its components in patients with PTSD taking antipsychotics seemed to be at least equivalent, if not slightly worse, compared with that in patients with schizophrenia, dementia, or a mood disorder.",0,0 +3820,Posttraumatic stress predicting depression and social support among college students: Moderating effects of race and gender.,"More than half of the students entering college report a history of potentially traumatic events; however, little is known about the relationship of trauma exposure and posttraumatic stress disorder (PTSD) symptomatology to college students' mental health and access to social support or whether these relationships may show variations as a function of race and gender. The purpose of this study was to explore whether the relationships between PTSD symptoms and both depression and social support were moderated by gender and race. Data were collected from 631 African American (AA) and 299 European American (EA) freshmen students attending 2 universities in the Southeast. The majority of the students (74.3% of the AA and 68.2% of the EA sample) reported lifetime exposure to at least 1 traumatic event. PTSD symptomatology was significantly and positively associated with depression symptoms for all groups (i.e., AA and EA males and females); however, the relationship between these 2 variables was strongest for EA men. Similarly, the relationship between PTSD symptoms on the avoidance cluster and social support was stronger for EA males than other groups; avoidance symptoms did not significantly predict social support for AA men.",0,0 +3821,Burden of Medical Illness in Women With Depression and Posttraumatic Stress Disorder,"Depression and posttraumatic stress disorder (PTSD) are important women's health issues. Depression is known to be associated with poor physical health; however, associations between physical health and PTSD, a common comorbidity of depression, have received less attention.To examine number of medical symptoms and physical health status in women with PTSD across age strata and benchmark them against those of women with depression alone or with neither depression nor PTSD.A random sample of Veterans Health Administration enrollees received a mailed survey in 1999-2000 (response rate, 63%). The 30 865 women respondents were categorized according to whether a health care provider had ever told them that they had PTSD, depression (without PTSD), or neither. Outcomes were self-reported medical conditions and physical health status measured with the Veterans SF-36 instrument, a version of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) modified for use in veteran populations.Across age strata, women with PTSD (n = 4348) had more medical conditions and worse physical health status (physical functioning, role limitations due to physical problems, bodily pain, and energy/vitality scales from the Veterans SF-36) than women with depression alone (n = 7580) or neither (n = 18 937). In age-adjusted analyses, the Physical Component Summary score was on average 3.4 points lower in women with depression alone and 6.3 points lower in women with PTSD than in women with neither (P<.001).Posttraumatic stress disorder is associated with a greater burden of medical illness than is seen with depression alone. The presence of PTSD may account for an important component of the excess medical morbidity and functional status limitations seen in women with depression.",0,0 +3822,Sincerity of effort versus feigned movement control of the cervical spine in patients with whiplash-associated disorders and asymptomatic persons: a case-control study.,"Cross-sectional design.To investigate whether the Fly Test can be used to differentiate patients with whiplash-associated disorders (WAD) from asymptomatic persons who deliberately feign symptoms and from WAD patients exaggerating symptoms.The lack of valid clinical tests makes it difficult to detect a justifiable cause for compensation claims in traumatic neck-pain disorders.The Fly Test recorded the accuracy of neck movements in patients with WAD (n = 34) and asymptomatic persons (n = 31). The participants followed a moving ""Fly"" on a computer screen with a cursor from sensors mounted on the head. Two conditions were tested, sincere versus feigned efforts. In the former, the participants moved their neck as accurately as possible. In the latter, a short text was presented describing a fictitious accident (asymptomatic group) or imagining more intense pain/suffering (WAD group), and the test was performed as affected by these more serious conditions. Amplitude accuracy (AA), time on target (ToT) and jerk index (JI) were compared across patterns, conditions and groups.The sincere effort in the WAD group was significant compared to the feigned effort of the asymptomatic group (p < 0.001). For AA, correct categorization of 81.5% of the performances was made, where a mean score above 5.5 mm differentiated feigned versus sincere efforts in asymptomatic and WAD groups (sensitivity 79.4%, specificity 67.7%). For ToT, score above 11% indicated correctly categorized WAD patients (sensitivity 82.4%, specificity 64.5%).The Fly Test can provide clinicians a clue when patients with mild to moderate pain/disability are feigning or exaggerating symptoms.",0,0 +3823,Demoralization and the longitudinal course of PTSD following Hurricane Mitch,"Background and Objectives: Numerous studies of disasters have used measures of non-specific distress as outcome measures. The utility of these measures as predictive of the long-term outcome of disasters has remained unclear, in particular the relationship with PTSD. This study examines whether demoralization is predictive and a useful concept to examine the long-term outcome of disaster related PTSD. Methods: The 1998 Hurricane Mitch that impacted Honduras was examined two-months (n = 800) and two-years following the disaster in a longitudinal community-based sample of 604 adults. Respondents were selected from a stratified sample in Tegucigalpa based on exposure and social economic status. PTSD diagnosed using the CIDI module at both periods of time. Demoralization was measured using the PERI-D at 2-months post-disaster. Results: The PERI-D, increased demoralization, was significantly associated with PTSD at two-month and two-years. In addition, increased demoralization was associated with increased risk of PTSD chronicity. Decreased demoralization was associated with PTSD remission. New onset PTSD was associated increased demoralization; however, the finding was not appreciated after controlling for potential confounders. Conclusions: Demoralization can be measured using a simple screening questionnaire that may be a useful in identifying individuals who may be at increased risk for PTSD in the short-term, as well as in the long-term following a disaster.",0,0 +3824,The shaping of vulnerability factors including core cognitive beliefs and their subsequent role in posttraumatic stress disorder and general clinical psychopathology,"ABSTRACT The present study examines the role of core beliefs in posttraumatic outcome including the development and maintenance of PTSD and general clinical psychopathology in a non-treatment seeking college-age population. Although trauma and clinical PTSD literatures are replete with references concerning the potential impact that traumatic and/or uncontrollable stressor(s) may have on cognitive schemata and their role in negative posttraumatic adjustment, little empirical research exists that delineates potentially important differences in the nature and quality of core belief systems for which both trauma and PTSD history are controlled. Unique aspects of the present study include: 1) the inclusion of two domains of core belief measures (i.e., early maladaptive schemas via the Schema Questionnaire as proposed by Young (1994) and the three basic personal belief systems as measured by the World Assumptions Scale (WAS) that have been posited by Janoff-Bulman (1985) as centrally related to traumatization experiences; 2) the examination of these broad ranging core belief systems in relation to other factors that have been found or proposed to be significantly related to PTSD development and/or maintenance, including aspects of the traumatic event(s), dissociation, and related areas of clinical symptomatology; and 3) the use of four specific study groups that controlled for both level of traumatization and PTSD symptomatology (no trauma; trauma without past or current PTSD; PTSD in remission; and PTSD current) to enhance conclusions regarding the most potent predictors of PTSD symptomatology by analyzing these factors simultaneously across progressive (i.e., continuous) levels of PTSD symptomatology, as well as between the discrete diagnostic groups. Three main overarching hypotheses were generated in this study, and related to: 1) the detection of general between-group differences between the four study groups on important indices of PTSD se verity, core beliefs, and measures of clinical symptomatology; 2) specific core beliefs that would predict PTSD symptomatology to a equal or greater extent than other important factors that have been related to posttraumatic adjustment, irrespective of depression status; and 3) cognitive specificity of core belief systems between major domains of clinical symptomatology (i.e., anxiety and depression) as well as within specific clinical domains (i.e., within types of anxiety). The results largely supported these hypotheses, where specific subtypes of core beliefs were strongly associated with posttraumatic outcome. In particular, the core belief of vulnerability demonstrated a highly consistent relationship with PTSD severity, as well as all domains of anxiety assessed within the study (i.e., state anxiety, anxiety sensitivity, and worry). This finding is consistent with Beck’s (1967) hypothesis that vulnerability schemata underlie the anxiety disorders. Furthermore, evidence was found both for the specificity of core cognitive beliefs between major domains of…",0,0 +3825,Corrigendum to “The relative efficacy of bona fide psychotherapies for treating post-traumatic stress disorder: A meta-analysis of direct comparisons” [Clinical Psychology Review 28 (2008) 766–75],"Reports an error in ""The relative efficacy of bona fide psychotherapies for treating post-traumatic stress disorder: A meta-analysis of direct comparisons"" by Steven G. Benish, Zac E. Imel and Bruce E. Wampold (Clinical Psychology Review, 2008[Jun], Vol 28[5], 746-758). There are three errors in the original analysis that appear in Table 1: The effect size for all measures should be d=.40 for Foa et al. (1999), while all measures and PTSD measures for Devilly & Spence (1999) should be d=.43 and d=.57, respectively. In the original analysis, data from Resick et al. (1988) was erroneously included in lieu of Resick (2002) including the quotation. The correct effect size for Resick et al. (2002) all measures and PTSD measures should be d=.31 and d=.27, respectively. (The following abstract of the original article appeared in record 2008-05435-003.) Psychotherapy has been found to be an effective treatment of post-traumatic stress disorder (PTSD), but meta-analyses have yielded inconsistent results on relative efficacy of psychotherapies in the treatment of PTSD. The present meta-analysis controlled for potential confounds in previous PTSD meta-analyses by including only bona fide psychotherapies, avoiding categorization of psychotherapy treatments, and using direct comparison studies only. The primary analysis revealed that effect sizes were homogenously distributed around zero for measures of PTSD symptomology, and for all measures of psychological functioning, indicating that there were no differences between psychotherapies. Additionally, the upper bound of the true effect size between PTSD psychotherapies was quite small. The results suggest that despite strong evidence of psychotherapy efficaciousness vis-a-vis no treatment or common factor controls, bona fide psychotherapies produce equivalent benefits for patients with PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +3826,Social Bonds and Posttraumatic Stress Disorder,"Retrospective and prospective studies consistently show that individuals exposed to human-generated traumatic events carry a higher risk of developing Posttraumatic Stress Disorder (PTSD) than those exposed to other kinds of events. These studies also consistently identify perceptions of social support both before and after a traumatic event as an important factor in the determining vulnerability to the development of PTSD. We review the literature on interpersonal traumas, social support and risk for PTSD and integrate findings with recent advances in developmental psychopathology, attachment theory and social neuroscience. We propose and gather evidence for what we term the social ecology of PTSD, a conceptual framework for understanding how both PTSD risk and recovery are highly dependent on social phenomena. We explore clinical implications of this conceptual framework.",0,0 +3827,PTSD Symptoms in Urban Adolescent Girls: Compounded Community Trauma,"To describe the assessments for exposure to violent events and posttraumatic stress disorder (PTSD) symptoms in a population of urban adolescent girls.Seventy-nine urban adolescent girls attending an adolescent medicine clinic were assessed via clinician-assisted self-report measures called the Adolescent Self-Report Trauma Questionnaire. The questionnaire gathered information on demographics, exposure to community and domestic violent events, and PTSD symptoms.The adolescents experienced between 8 and 55 different types of community and domestic violent events, with the mean number of violent events being 28. Hyperarousal cluster symptoms were present in 90%, reexperiencing clusters symptoms in 89%, and avoidance cluster symptoms in 80%, while 67% met symptom criteria for PTSD. Increased number of types of violent events was positively correlated with meeting PTSD criteria (p = .01) and with increased PTSD severity scores (p = .001).These urban adolescent girls have experienced prolonged and repeated exposure to multiple types of community as well as domestic violent events, via multiple modalities of contact, over time. They reported a high percentage of PTSD symptoms across all three symptom clusters. The authors propose the concept of ""compounded community trauma"" and discuss its marked impact on female adolescent development.",0,0 +3828,"Ten-year follow-up study of PTSD diagnosis, symptom severity and psychosocial indices in aging holocaust survivors","We performed a longitudinal study of holocaust survivors with and without post-traumatic stress disorder (PTSD) by assessing symptoms and other measures at two intervals, approximately 10 years apart.The original cohort consisted of 63 community-dwelling subjects, of whom 40 were available for follow-up.There was a general diminution in PTSD symptom severity over time. However, in 10% of the subjects (n=4), new instances of delayed onset PTSD developed between time 1 and time 2. Self-report ratings at both assessments revealed a worsening of trauma-related symptoms over time in persons without PTSD at time 1, but an improvement in those with PTSD at time 1.The findings suggest that a nuanced characterization of PTSD trajectory over time is more reflective of PTSD symptomatology than simple diagnostic status at one time. The possibility of delayed onset trajectory complicates any simplistic overall trajectory summarizing the longitudinal course of PTSD.",0,0 +3829,Quantitative electroencephalogram (qEEG) in combat veterans with post-traumatic stress disorder (PTSD),"Only a small number of studies have used quantitative electroencephalography (qEEG) in research of the post-traumatic stress disorder (PTSD). The results are not consistent. The aim of the present investigation was to compare qEEG in combat veterans with and without PTSD. The hypothesis is that differences among qEEG characteristics will be found regarding the presence/absence of PTSD. Seventy-nine combat veterans with PTSD comprised the experimental group and 37 veterans without PTSD were included as controls. After the informed consent, they were investigated by the resting EEG recordings. The results demonstrate that PTSD veterans had decreased alpha power and increased beta power. These results suggest an altered neurobiology in PTSD. Various explanations have been offered for alpha activity decrease observed in PTSD veterans. Increased beta rhythm may play a role as a potential marker in differentiating subtypes of PTSD.",0,0 +3830,Research on psychedelics moves into the mainstream,"The backlash against the recreational use of psychedelic drugs in the 1960s had a negative effect on research into their potential therapeutic benefit. But now attitudes are changing and work in this area is being revitalised, with several early-stage trials underway. Kelly Morris reports.",0,0 +3831,Open Trial of Interpersonal Psychotherapy for Chronic Post Traumatic Stress Disorder,"Objective: The aim of this study was to investigate the feasibility of adapting group-based interpersonal psychotherapy (IPT-G) for patients with chronic post traumatic stress disorder (PTSD). Methods: Thirteen subjects with DSM-IV-defined PTSD, with symptom duration greater than 12 months, entered the study, an 8-week treatment programme conducted in a clinical setting using IPT-G modified for the treatment of PTSD. Data obtained were analysed qualitatively and quantitatively. Results: All 13 subjects completed the treatment programme and showed significant improvement in social functioning, general wellbeing and depressive symptoms. Treatment completers demonstrated a moderate reduction in the avoidant symptom cluster of PTSD. These improvements appeared stable at 3-month follow-up. Benefits appeared to be associated with perceived intra-therapy progress in resolving identified IPT problem areas. Qualitative analysis found that themes of ‘reconnection’ and ‘interpersonal efficacy’ were core parts of the experience of the treatment. Conclusion: IPT-G modified for PTSD appears to be of modest symptomatic benefit, but may lead to improvement in social functioning, general psychological wellbeing and enhanced interpersonal functioning. Further studies are indicated.",0,0 +3832,Influence of childhood adversity on health among male UK military personnel,"Background Exposure to childhood adversity may explain why only a minority of combatants exposed to trauma develop psychological problems. Aims To examine the association between self-reported childhood vulnerability and later health outcomes in a large randomly selected male military cohort. Method Data are derived from the first stage of a cohort study comparing Iraq veterans and non-deployed UK military personnel. We describe data collected by questionnaire from males in the regular UK armed forces ( n =7937). Results Pre-enlistment vulnerability is associated with being single, of lower rank, having low educational attainment and serving in the Army. Pre-enlistment vulnerability is associated with a variety of negative health outcomes. Two main factors emerge as important predictors of ill health: a ‘family relationships’ factor reflecting the home environment and an ‘externalising behaviour’ factor reflecting behavioural disturbance. Conclusions Pre-enlistment vulnerability is an important individual risk factor for ill health in military men. Awareness of such factors is important in understanding post-combat psychiatric disorder.",0,0 +3833,Polyvictimization: Latent profiles and mental health outcomes in a clinical sample of adolescents.,"Exposure to multiple traumatic events (polyvictimization) is a reliable predictor of deleterious health outcomes and risk behaviors in adolescence. The current study extends the literature on the prevalence and consequences of adolescent trauma exposure by (a) empirically identifying and characterizing trauma exposure profiles in a large, ethnically diverse, multi-site, clinical sample of adolescents, and (b) evaluating relations among identified profiles with demographic characteristics and clinical correlates.Data from the National Child Traumatic Stress Network Core Data Set were used to identify and characterize victimization profiles using latent class analysis in a sample of 3,485 adolescents (ages 13-18, 63% female, 35.7% White, 23.2% Black/African American, 35.0% Hispanic/Latino). Multiple measures of psychological distress and risk behaviors were evaluated as covariates of trauma exposure classes.Five trauma exposure classes, or profiles, were identified. Four classes-representing approximately half the sample-were characterized by polyvictimization. Polyvictimization classes were differentiated on number of trauma types, whether emotional abuse occurred, and whether emotional abuse occurred over single or multiple developmental epochs. Unique relations with demographic characteristics and mental health outcomes were observed.Results suggest polyvictimization is not a unidimensional phenomenon but a diverse set of trauma exposure experiences with unique correlates among youth. Further research on prevention of polyvictimization and mechanisms linking chronic trauma exposure, gender, and ethnicity to negative outcomes is warranted.",0,0 +3834,"Repeated administration of AC-5216, a ligand for the 18kDa translocator protein, improves behavioral deficits in a mouse model of post-traumatic stress disorder","Post-traumatic stress disorder (PTSD) is a severely disabling anxiety disorder that may occur following exposure to a serious traumatic event. It is a psychiatric condition that can afflict anyone who has experienced a life-threatening or violent event. Previous studies have shown that changes in 18 kDa translocator protein (TSPO) expression (or function), a promising target for treating neurological disorders without benzodiazepine-like side effects, may correlate with PTSD. However, few studies have investigated the anti-PTSD effects of TSPO ligands. AC-5216, a ligand for TSPO, induces anxiolytic- and anti-depressant-like effects in animal models. The present study aimed to determine whether AC-5216 ameliorates PTSD behavior in mice. Following the training session consisting of exposure to inescapable electric foot shocks, animals were administered AC-5216 daily during the behavioral assessments, i.e., situational reminders (SRs), the open field (OF) test, the elevated plus-maze (EPM) test, and the staircase test (ST). The results indicated that exposure to foot shocks induced long-term behavioral deficiencies in the mice, including freezing and anxiety-like behavior, which were significantly ameliorated by repeated treatment with AC-5216 but without any effect on spontaneous locomotor activity or body weight. In summary, this study demonstrated the anti-PTSD effects of AC-5216 treatment, suggesting that TSPO may represent a therapeutic target for anti-PTSD drug discovery and that TSPO ligands may be a promising new class of drugs for the future treatment of PTSD.",0,0 +3835,Long-term dynamic-oriented group psychotherapy of posttraumatic stress disorder in war veterans: prospective study of five-year treatment.,"To assess the effectiveness of the long-term group psychotherapy in the treatment of posttraumatic stress disorder (PTSD) in war veterans on the basis of clinical picture of PTSD, associated neurotic symptoms, and adopted models of psychological defense mechanisms.Prospective cohort study involved 59 war veterans who participated in dynamic-oriented supportive group psychotherapy for five years. The groups met once a week for 90 minutes. Forty-two veterans finished the program. The Clinician-Administered PTSD Scale structured interview was used to assess the intensity of PTSD. Crown-Crisp Index was used to evaluate other neurotic symptoms, and Life Style Questionnaire was used to assess the defense mechanisms. The assessments were done at the beginning of psychotherapy, after the second, and after the fifth year of treatment. Comorbid diagnoses, hospitalizations, and outpatient clinic treatments were also recorded.Long-term group psychotherapy reduced the intensity of PTSD symptoms in our patients (the difference between Clinician-Administered PTSD Scale score at the beginning and the end of treatment, F=9.103, P=0.001). Other neurotic symptoms and the characteristic profile of defense mechanisms did not change significantly during the course of treatment. Predominant defense mechanisms were projection (M=82.0-/+14.4) and displacement (M=69.0-/+16.8). None of the symptoms or defense mechanisms present at the beginning of the treatment changed significantly after two or five years of treatment. The number of diagnosed major depressive episodes, which increased after the second year of psychotherapy, decreased by the end of treatment.Psychotherapy can reduce the intensity of PTSD symptoms, but the changes in the personality of veterans with PTSD are deeply rooted. Traumatic experiences lead to the formation of rigid defense mechanisms, which cannot be significantly changed by long-term group psychotherapy.",0,0 +3836,Mental Health Symptoms Following War and Repression in Eastern Afghanistan,"Decades of armed conflict, suppression, and displacement resulted in a high prevalence of mental health symptoms throughout Afghanistan. Its Eastern province of Nangarhar is part of the region that originated the Taliban movement. This may have had a distinct impact on the living circumstances and mental health condition of the province's population.To determine the rate of exposure to traumatic events; estimate prevalence rates of symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety; identify resources used for emotional support and risk factors for mental health symptoms; and assess the present coverage of basic needs in Nangarhar province, Afghanistan.A cross-sectional multicluster sample survey of 1011 respondents aged 15 years or older, conducted in Nangarhar province during January and March 2003; 362 households were represented with a mean of 2.8 respondents per household (72% participation rate).Posttraumatic stress disorder symptoms and traumatic events using the Harvard Trauma Questionnaire; depression and general anxiety symptoms using the Hopkins Symptom Checklist; and resources for emotional support through a locally informed questionnaire.During the past 10 years, 432 respondents (43.7%) experienced between 8 and 10 traumatic events; 141 respondents (14.1%) experienced 11 or more. High rates of symptoms of depression were reported by 391 respondents (38.5%); anxiety, 524 (51.8%); and PTSD, 207 (20.4%). Symptoms were more prevalent in women than in men (depression: odds ratio [OR], 7.3 [95% confidence interval [CI], 5.4-9.8]; anxiety: OR, 12.8 [95% CI, 9.0-18.1]; PTSD: OR, 5.8 [95% CI, 3.8-8.9]). Higher rates of symptoms were associated with higher numbers of traumas experienced. The main resources for emotional support were religion and family. Medical care was reported to be insufficient by 228 respondents (22.6%).In this survey of inhabitants of Nangarhar province, Afghanistan, prevalence rates of having experienced multiple traumatic events and having symptoms of anxiety, depression, and PTSD were high. These findings suggest that mental health symptoms in this region should be addressed at the population and primary health care level.",0,0 +3837,Decreased Cerebrospinal Fluid Allopregnanolone Levels in Women with Posttraumatic Stress Disorder,"Alterations in the gamma-amino-butyric acid (GABA) neurotransmitter system have been identified in some populations with posttraumatic stress disorder (PTSD).To further investigate factors of relevance to GABAergic neurotransmission in PTSD, we measured cerebrospinal fluid (CSF) levels of allopregnanolone and pregnanolone combined (ALLO: congeners that potently and positively modulate effects of GABA at the GABA(A) receptor), 5alpha-dihydroprogesterone (5alpha-DHP: the immediate precursor for allopregnanolone), dehydroepiandrosterone (DHEA: a negative modulator of GABA(A) receptor function), and progesterone with gas chromatography, mass spectrometry in premenopausal women with (n = 9) and without (n = 10) PTSD. Subjects were free of psychotropic medications, alcohol, and illicit drugs; all were in the follicular phase of the menstrual cycle except three healthy and four PTSD subjects receiving oral contraceptives.There were no group differences in progesterone, 5alpha-DHP, or DHEA levels. The PTSD group ALLO levels were < 39% of healthy group levels. The ALLO/DHEA ratio correlated negatively with PTSD re-experiencing symptoms (n = -.82, p < 008; trend) and with Profile of Mood State depression/dejection scores (n = -0.70, p < 0008).Low CSF ALLO levels in premenopausal women with PTSD might contribute to an imbalance in inhibitory versus excitatory neurotransmission, resulting in increased PTSD re-experiencing and depressive symptoms.",0,0 +3838,A longitudinal study of the role of cortisol in posttraumatic stress disorder symptom clusters,"Research examining the role of cortisol in posttraumatic stress disorder (PTSD) has largely been cross-sectional studies and few studies have examined cortisol in relation to specific symptom clusters. Examining cortisol in relation to specific PTSD symptom clusters could aid in identifying candidates for symptom-specific treatments. Hence, cortisol was examined in relation to specific PTSD symptom clusters including reexperiencing, avoidance, numbing, and hyperarousal symptoms.A repeated-measures longitudinal design was utilized to predict PTSD symptom clusters.Mothers of children (N = 27) diagnosed with cancer completed a measure of PTSD, and they provided salivary cortisol samples at the time of their child's diagnosis as well as monthly for the following 12 months.Multi-level modeling analyses revealed that higher cortisol levels were significantly related to higher levels of numbing symptoms. Although numbing symptoms declined as cortisol levels declined across 12 months postcancer diagnosis, mothers with higher cortisol levels still reported more numbing symptoms. Reexperiencing, avoidance, and hyperarousal symptoms were not found to be related to cortisol level across time.The findings offer support for the role of cortisol in the manifestation of numbing symptoms. Further research is recommended with other trauma groups to maximize generalizations.",0,0 +3839,Counselling for post-traumatic stress disorder,"Post-traumatic stress disorder - definition, presentation and assessment a cognitive-behavioural conceptualization of post-traumatic stress disorder an overview of cognitive-behavioural counselling for PTSD/ counselling for acute PTSD - illustrative cases counselling for chronic PTSD - illustrative cases counselling for PTSD from prolonged duress (PDSD) - illustrative cases counselling for concurrent anxiety and depression counselling for concurrent irritability counselling for PTSD - service delivery.",0,0 +3840,Re-examination of the Controversial Coexistence of Traumatic Brain Injury and Posttraumatic Stress Disorder: Misdiagnosis and Self-Report Measures,"The coexistence of traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) remains a controversial issue in the literature. To address this controversy, we focused primarily on the civilian-related literature of TBI and PTSD. Some investigators have argued that individuals who had been rendered unconscious or suffered amnesia due to a TBI are unable to develop PTSD because they would be unable to consciously experience the symptoms of fear, helplessness, and horror associated with the development of PTSD. Other investigators have reported that individuals who sustain TBI, regardless of its severity, can develop PTSD even in the context of prolonged unconsciousness. A careful review of the methodologies employed in these studies reveals that investigators who relied on clinical interviews of TBI patients to diagnose PTSD found little or no evidence of PTSD. In contrast, investigators who relied on PTSD questionnaires to diagnose PTSD found considerable evidence of PTSD. Further analysis revealed that many of the TBI patients who were initially diagnosed with PTSD according to self-report questionnaires did not meet the diagnostic criteria for PTSD upon completion of a clinical interview. In particular, patients with severe TBI were often misdiagnosed with PTSD. A number of investigators found that many of the severe TBI patients failed to follow the questionnaire instructions and erroneously endorsed PTSD symptoms because of their cognitive difficulties. Because PTSD questionnaires are not designed to discriminate between PTSD and TBI symptoms or determine whether a patient's responses are accurate or exaggerated, studies that rely on self-report questionnaires to evaluate PTSD in TBI patients are at risk of misdiagnosing PTSD. Further research should evaluate the degree to which misdiagnosis of PTSD occurs in individuals who have sustained mild TBI.",0,0 +3841,Resilience after 9/11: Multimodal neuroimaging evidence for stress-related change in the healthy adult brain,"Exposure to psychological trauma is common and predicts long-term physical and mental health problems, even in those who initially appear resilient. Here, we used multimodal neuroimaging in healthy adults who were at different distances from the World Trade Center on 9/11/01 to examine the neural mechanisms that may underlie this association. More than 3 years after 9/11/01, adults with closer proximity to the disaster had lower gray matter volume in amygdala, hippocampus, insula, anterior cingulate, and medial prefrontal cortex, with control for age, gender, and total gray matter volume. Further analysis showed a nonlinear (first-order quadratic) association between total number of traumas in lifetime and amygdala gray matter volume and function in the whole group. Post hoc analysis of subgroups with higher versus lower levels of lifetime trauma exposure revealed systematic associations between amygdala gray matter volume, amygdala functional reactivity, and anxiety that suggest a nonlinear trajectory in the neural response to accumulated trauma in healthy adults.",0,0 +3842,Acute and Chronic Posttraumatic Stress Disorder in Motor Vehicle Accident Victims,"This study reports the rates of acute and chronic posttraumatic stress disorder (PTSD) in a suburban community study group of 122 victims of serious motor vehicle accidents and a comparison group of 42 (who had been involved in minor, non-motor-vehicle accidents) followed over 12 months.Motor vehicle accident victims were systematically recruited and examined with comparison subjects at 1, 3, 6, 9, and 12 months after the accident. The authors used the Structured Clinical Interview for DSM-III-R to assess DSM-III-R axis I disorders including PTSD.One month after the accident, 34.4% of the motor vehicle accident victims met criteria for PTSD (versus 2.4% of the comparison subjects). Similarly, at 3 and 6 months, rates of PTSD were higher (25.2% and 18.2%) in the motor vehicle accident victims than in the comparison group. Female victims were 4.64 times more likely than male victims to have PTSD at 1 month. Victims with a history of PTSD were 8.02 times more likely at 1 month and 6.81 times more likely at 3 months to have PTSD than those without a history of PTSD. Having an axis II disorder increased the risk for PTSD at 6 months. After adjustment for a history of PTSD and potentially confounding variables, women were 4.39 times more likely than men to develop PTSD at 1 month but did not have a higher risk for chronic PTSD; at 6 months, those with an axis II disorder were at greater risk of PTSD.Rates of PTSD are high in victims of serious motor vehicle accidents and remain high 9 months later. Female victims have an increased risk of acute but not chronic PTSD. Individuals with a history of PTSD are at risk of acute and chronic PTSD. An axis II disorder increases the risk for chronic but not acute PTSD.",0,0 +3843,Early Trajectory of Psychiatric Symptoms after Traumatic Brain Injury: Relationship to Patient and Injury Characteristics,"Psychiatric disturbance is common and disabling after traumatic brain injury (TBI). Few studies have investigated the trajectory of psychiatric symptoms in the first 6 months postinjury, when monitoring and early treatment might prevent persistent difficulties. The aim of this study was to examine the trajectory of psychiatric symptoms 1-6 months post-TBI, the patient/injury characteristics associated with changes, and characteristics predictive of persisting symptoms. A secondary analysis was performed on data from a clinical trial with three data collection points. Across eight centers, 872 participants with complicated mild to severe TBI were administered the Brief Symptom Inventory (BSI) at 30, 90, and 180 days postinjury. Mixed-effects models were used to assess longitudinal changes in the BSI Global Severity Index (GSI). Multi-variate logistic regression was used to assess predictors of clinically significant GSI elevations persisting to 6 months post-TBI. In general, GSI scores improved over time. Women improved faster than men; race/ethnicity was also significantly associated with rate of change, with Hispanics showing the most and African Americans the least improvement. Clinically significant psychiatric symptoms (caseness) occurred in 42% of the sample at 6 months, and more than one type of symptom was common. Significant predictors of caseness included African American race, age from 30 to 60 years, longer post-traumatic amnesia (PTA) duration, pre-TBI unemployment, and pre-TBI risky alcohol use. Findings indicate that psychiatric symptoms are common in the first 6 months post-TBI and frequently extend beyond the depression and anxiety symptoms that may be most commonly screened. Patients with longer PTA and preinjury alcohol misuse may need more intensive monitoring for symptom persistence.",0,0 +3844,Symptom structure of PTSD following breast cancer,"Identification of posttraumatic stress disorder (PTSD) symptoms and diagnoses in survivors of cancer is a growing area of research, but no published data exist regarding the symptom structure of PTSD in survivors of malignant disease. Findings from investigations of the PTSD symptom structure in other trauma populations have been inconsistent and have not been concordant with the re-experiencing, avoidance/numbing, and arousal symptom clusters specified in DSM-IV. The present study employed confirmatory factor analysis to evaluate the extent to which the implied second-order factor structure of PTSD was replicated in a sample of 142 breast cancer survivors. PTSD symptoms were measured using the PTSD Checklist--Civilian Version (PCL-C). Fit indices reflected a moderate fit of the symptom structure implied by the DSM-IV. These findings provide some tentative support for the DSM-IV clustering of PTSD symptoms and for the validity of cancer-related PTSD.",0,0 +3845,Reformulating PTSD forDSM-V: Life after Criterion A,"The diagnosis of posttraumatic stress disorder has been criticized on numerous grounds, but principally for three reasons (a) the alleged pathologizing of normal events, (b) the inadequacy of Criterion A, and (c) symptom overlap with other disorders. The authors review these problems along with arguments why the diagnosis is nevertheless worth retaining in an amended form. A proposal for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) is put forward that involves abolishing Criterion A, narrowing the B criteria to focus on the core phenomena of flashbacks and nightmares, and narrowing the C and D criteria to reduce overlap with other disorders. The potential advantages and disadvantages of this formulation are discussed.",0,0 +3846,Diagnostic and clinical profiles of treatment-seeking men with and without substance use disorders.,"This study compared treatment-seeking men with and without a history of substance use disorders (SUD), both lifetime and current, on diagnostic and clinical variables in order to elucidate their clinical profile. Analyses revealed that men with a history of SUD were more likely meet criteria for a cluster B personality disorder, particularly borderline and antisocial personality disorder, and for anxiety disorders, particularly posttraumatic stress disorder (PTSD). Men with lifetime and current SUD reported a significantly higher frequency of hospitalizations and had lower scores on global functioning. Despite the high prevalence of SUD in this sample, depressive and anxiety disorders were the leading reasons for treatment seeking in this large outpatient psychiatric clinic. Implications of the observed diagnostic and clinical correlates of lifetime SUD among treatment-seeking men are discussed. © 2010 American Psychological Association.",0,0 +3847,The structure of Pavlovian fear conditioning in the amygdala,"Do different brains forming a specific memory allocate the same groups of neurons to encode it? One way to test this question is to map neurons encoding the same memory and quantitatively compare their locations across individual brains. In a previous study, we used this strategy to uncover a common topography of neurons in the dorsolateral amygdala (LAd) that expressed a learning-induced and plasticity-related kinase (p42/44 mitogen-activated protein kinase; pMAPK), following auditory Pavlovian fear conditioning. In this series of experiments, we extend our initial findings to ask to what extent this functional topography depends upon intrinsic neuronal structure. We first showed that the majority (87 %) of pMAPK expression in the lateral amygdala was restricted to principal-type neurons. Next, we verified a neuroanatomical reference point for amygdala alignment using in vivo magnetic resonance imaging and in vitro morphometrics. We then determined that the topography of neurons encoding auditory fear conditioning was not exclusively governed by principal neuron cytoarchitecture. These data suggest that functional patterning of neurons undergoing plasticity in the amygdala following Pavlovian fear conditioning is specific to memory formation itself. Further, the spatial allocation of activated neurons in the LAd was specific to cued (auditory), but not contextual, fear conditioning. Spatial analyses conducted at another coronal plane revealed another spatial map unique to fear conditioning, providing additional evidence that the functional topography of fear memory storing cells in the LAd is non-random and stable. Overall, these data provide evidence for a spatial organizing principle governing the functional allocation of fear memory in the amygdala. (",0,0 +3848,Relationships between psychopathological and demographic variables and posttraumatic growth among Holocaust survivors.,"The relationship between posttraumatic growth and posttraumatic stress disorder (PTSD) symptoms, depression, anxiety, and vulnerability, as well as demographic differences in growth was examined in a group of 23 Holocaust survivors. The posttraumatic growth aspect of spiritual change was found to correlate positively and significantly with the PTSD symptom clusters of intrusion, avoidance, and hyperarousal. Numerous demographic variables were also found to relate to posttraumatic growth including survivors' age during the Holocaust; the nature of their Holocaust experiences; and whether they were ever alone, without family, during their Holocaust experiences as well as survivor support group membership.",0,0 +3849,Meta-analysis of dropout in treatments for posttraumatic stress disorder.,"Many patients drop out of treatments for posttraumatic stress disorder (PTSD); some clinicians believe that trauma-focused treatments increase dropout.We conducted a meta-analysis of dropout among active treatments in clinical trials for PTSD (42 studies; 17 direct comparisons).The average dropout rate was 18%, but it varied significantly across studies. Group modality and greater number of sessions, but not trauma focus, predicted increased dropout. When the meta-analysis was restricted to direct comparisons of active treatments, there were no differences in dropout. Differences in trauma focus between treatments in the same study did not predict dropout. However, trauma-focused treatments resulted in higher dropout compared with present-centered therapy (PCT), a treatment originally designed as a control but now listed as a research-supported intervention for PTSD.Dropout varies between active interventions for PTSD across studies, but variability is primarily driven by differences between studies. There do not appear to be systematic differences across active interventions when they are directly compared in the same study. The degree of clinical attention placed on the traumatic event does not appear to be a primary cause of dropout from active treatments. However, comparisons of PCT may be an exception to this general pattern, perhaps because of a restriction of variability in trauma focus among comparisons of active treatments. More research is needed comparing trauma-focused interventions to trauma-avoidant treatments such as PCT.",0,0 +3850,Mismatch of posttraumatic stress disorder (PTSD) symptoms andDSM-IV symptom clusters in a cancer sample: Exploratory factor analysis of the PTSD Checklist-Civilian Version,"The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994a) conceptualization of posttraumatic stress disorder (PTSD) includes three symptom clusters: reexperiencing, avoidance/numbing, and arousal. The PTSD Checklist-Civilian Version (PCL-C) corresponds to the DSM-IV PTSD symptoms. In the current study, we conducted exploratory factor analysis (EFA) of the PCL-C with two aims: (a) to examine whether the PCL-C evidenced the three-factor solution implied by the DSM-IV symptom clusters, and (b) to identify a factor solution for the PCL-C in a cancer sample. Women (N = 148) with Stage II or III breast cancer completed the PCL-C after completion of cancer treatment. We extracted two-, three-, four-, and five-factor solutions using EFA. Our data did not support the DSM-IV PTSD symptom clusters. Instead, EFA identified a four-factor solution including reexperiencing, avoidance, numbing, and arousal factors. Four symptom items, which may be confounded with illness and cancer treatment-related symptoms, exhibited poor factor loadings. Using these symptom items in cancer samples may lead to overdiagnosis of PTSD and inflated rates of PTSD symptoms.",0,0 +3851,"Symptoms of Posttraumatic Stress Disorder in Parents of Transplant Recipients: Incidence, Severity, and Related Factors","Objective. To examine the incidence, severity, and factors related to posttraumatic stress disorder (PTSD) symptoms in parents of pediatric solid organ transplant recipients. Method. A total of 170 caregivers of pediatric transplant recipients completed self-report measures of psychological functioning between 10 and 38 months after their child’s most recent transplant. Demographic data, child health variables, and ratings of medical attitudes and social functioning were also collected to help explain individual differences in psychological functioning. Results. Although caregivers of pediatric transplant recipients did not report elevated levels of depression or anxiety, they did report elevated levels of PTSD symptoms. Multiple regression analyses revealed that PTSD symptoms were most strongly associated with parent reports of child health, family impact of the transplant, and attitudes toward medical caregivers. Conclusions. PTSD seems to be relatively common in parents of pediatric transplant recipients and may be largely the result of how parents perceive and interpret the transplant experience.",0,0 +3852,The Evolution of Post-Traumatic Stress Disorder following Moderate-to-Severe Traumatic Brain Injury,"Increasing evidence indicates that post-traumatic stress disorder (PTSD) may develop following traumatic brain injury (TBI), despite most patients having no conscious memory of their accident. This prospective study examined the frequency, timing of onset, symptom profile, and trajectory of PTSD and its psychiatric comorbidities during the first 4 years following moderate-to-severe TBI. Participants were 85 individuals (78.8% male) with moderate or severe TBI recruited following admission to acute rehabilitation between 2005 and 2010. Using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Disorders (SCID-I), participants were evaluated for pre- and post-injury PTSD soon after injury and reassessed at 6 months, 12 months, 2 years, 3 years, and 4 years post-injury. Over the first 4 years post-injury, 17.6% developed injury-related PTSD, none of whom had PTSD prior to injury. PTSD onset peaked between 6 and 12 months post-injury. The majority of PTSD cases (66.7%) had a delayed-onset, which for a third was preceded by subsyndromal symptoms in the first 6 months post-injury. PTSD frequency increased over the first year post-injury, remained stable during the second year, and gradually declined thereafter. The majority of subjects with PTSD experienced a chronic symptom course and all developed one or more than one comorbid psychiatric disorder, with mood, other anxiety, and substance-use disorders being the most common. Despite event-related amnesia, post-traumatic stress symptoms, including vivid re-experiencing phenomena, may develop following moderate-to-severe TBI. Onset is typically delayed and symptoms may persist for several years post-injury.",0,0 +3853,"Child-adolescent posttraumatic stress disorder: Prevalence, risk factors, and comorbidity.","(create) This chapter explores prevalence, risk factors, and comorbidity issues in child-adolescent posttraumatic stress disorder (PTSD)., (from the chapter) Topics include: child-adolescent posttraumatic stress disorder (PTSD): prevalence and risk factors; epidemiology of child-adolescent exposure to traumatic events; PTSD prevalence rates among clinical samples of stress-exposed children and adolescents (crime-related PTSD, war-related PTSD, disaster-related PTSD); comorbidity; risk factors; and implications for future research. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +3854,Buffalo Creek survivors in the second decade: Stability of stress symptoms.,"A follow-up study of 120 adult survivors of the Buffalo Creek dam collapse of 1972 showed group changes 14 years after the event. Decreased symptoms were noted in all areas, although significant psychopathology remained in about one-quarter of the survivors. A small group with delayed onset of symptoms was identified.",0,0 +3855,Factor structure of posttraumatic stress disorder symptoms in OEF/OIF veterans presenting to a polytrauma clinic.,"A significant number of Operation Iraqi Freedom/Operation Enduring Freedom (OEF/OIF) veterans are returning from deployment and presenting to Veterans Health Administration (VHA) polytrauma clinics with elevated rates of posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). Inherent to the accurate assessment and treatment of this diagnostically complex group of veterans is the assumption that the construct of PTSD is the same in this population as in other trauma groups. To our knowledge, no previous study has examined the structure of PTSD in this relevant and fast-growing population of treatment-seeking OEF/OIF veterans. Evidence suggests that the latent structure of PTSD symptoms is best represented by a four-factor model, rather than the three-factor model found in the current DSM-IV-TR. Thus, we examined the three and four-factor models using the PTSD Check List-Civilian (PCL-C) in a sample of treatment-seeking OEF/OIF veterans seen through a VHA polytrauma clinic.A chart review was conducted for OEF/OIF veterans (N = 361) seen through a VHA outpatient polytrauma clinic from September 2007 through August 2008. Participants completed the PCL-C as part of a comprehensive polytrauma evaluation.Confirmatory factor analyses showed that the DSM-IV-TR three-factor model did not fit the data well. A direct comparison showed that the four-factor model provided a superior fit relative to the three-factor model.Results extend the generalizability of the four-factor model to OEF/OIF veterans presenting to Veterans Health Administration (VHA) polytrauma clinics.",0,0 +3856,Resting-state fMRI studies in epilepsy,"Epilepsy is a disease characterized by abnormal spontaneous activity in the brain. Resting-state functional magnetic resonance imaging (RS-fMRI) is a powerful technique for exploring this activity. With good spatial and temporal resolution, RS-fMRI is a promising approach for accurate localization of the focus of seizure activity. Although simultaneous electroencephalogram-fMRI has been performed with patients in the resting state, most studies focused on activation. This mini-review focuses on RS-fMRI alone, including its computational methods and its application to epilepsy.",0,0 +3857,Why verbal psychotherapy is not enough to treat Post Traumatic Stress Disorder: a Biosystemic approach to stress debriefing,"Clinical and common experience shows that the consequences of traumatic events (physical and sexual violence, natural or civil disasters, witnessing violent events, serious diseases or bereavements, etc.) on people's lives is one of the main causes of mental suffering. The prevalence of Post Traumatic Stress Disorder (PTSD) is estimated to be as low as 0.5–1% (Frans, Rimmo, Aberg, & Fredrikson, 2005) and as high as 9.5% (Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995). It is clear the important role psychotherapy plays in facing similar conditions and restoring a state of wellness; hence the need for specific methodologies of intervention based on scientific evidence. The purpose of this article is to illustrate how mind-body techniques may usefully be integrated into psychotherapy protocols and can be used in the prevention and treatment of symptoms related to PTSD. These techniques may empower the ‘body's innate intelligence’ and improve self-regulation when addressing factors such as trauma, mind/bod...",0,0 +3858,World Trade Center Disaster Exposure-Related Probable Posttraumatic Stress Disorder among Responders and Civilians: A Meta-Analysis,"The World Trade Center (WTC) disaster on September 11, 2001 was an unprecedented traumatic event with long-lasting health consequences among the affected populations in the New York metropolitan area. This meta-analysis aimed to estimate the risk of probable posttraumatic stress disorder (PTSD) associated with specific types of WTC exposures. Meta-analytical findings from 10 studies of 3,271 to 20,294 participants yielded 37 relevant associations. The pooled summary odds ratio (OR) was 2.05 (95% confidence interval (CI): 1.82, 2.32), with substantial heterogeneity linked to exposure classification, cohort type, data source, PTSD assessment instrument/criteria, and lapse time since 9/11. In general, responders (e.g. police, firefighters, rescue/recovery workers and volunteers) had a lower probable PTSD risk (OR = 1.61; 95% CI: 1.39, 1.87) compared to civilians (e.g. residents, office workers, and passersby; OR = 2.71, 95% CI: 2.35, 3.12). The differences in ORs between responders and civilians were larger for physical compared to psychosocial exposure types. We also found that injury, lost someone, and witnessed horror were the three (out of six) most pernicious exposures. These findings suggest that these three exposures should be a particular focus in psychological evaluation and treatment programs in WTC intervention and future emergency preparedness efforts.",0,0 +3859,Gender Differences in Posttraumatic Stress Disorder and Help Seeking in the U.S. Army,"Inconsistent findings between studies of gender differences in mental health outcomes in military samples have left open questions of differential prevalence in posttraumatic stress disorder (PTSD) among all United States Army soldiers and in differential psychosocial and comorbid risk and protective factor profiles and their association with receipt of treatment.This study assesses the prevalence and risk factors of screening positive for PTSD for men and women based on two large, population-based Army samples obtained as part of the 2005 and 2008 U.S. Department of Defense Surveys of Health Related Behaviors among Active Duty Military Personnel.The study showed that overall rates of PTSD, as measured by several cutoffs of the PTSD Checklist, are similar between active duty men and women, with rates increasing in both men and women between the two study time points. Depression and problem alcohol use were strongly associated with a positive PTSD screen in both genders, and combat exposure was significantly associated with a positive PTSD screen in men. Overall, active duty men and women who met criteria for PTSD were equally likely to receive mental health counseling or treatment, though gender differences in treatment receipt varied by age, race, social support (presence of spouse at duty station), history of sexual abuse, illness, depression, alcohol use, and combat exposure.The study demonstrates that the prevalence of PTSD as well as the overall utilization of mental health services is similar for active duty men compared with women. However, there are significant gender differences in predictors of positive PTSD screens and receipt of PTSD treatment.",0,0 +3860,Coping Strategies as Mediators of the Relations Among Perceived Control and Distress in Sexual Assault Survivors.,"Two studies assessed whether coping strategies mediate the relations among 2 forms of perceived control (past and present control) and postassault distress among female sexual assault survivors. In Study 1, longitudinal data were gathered from 2 weeks to 1 year postassault (N = 171). Past control (behavioral self-blame) was associated with more distress partly because it was associated with greater social withdrawal. Present control (control over the recovery process) was associated with less distress partly because it was associated with less social withdrawal and more cognitive restructuring. In Study 2, cross-sectional data were gathered from a community sample of nonrecent survivors of sexual assault (N = 131). Coping strategies again mediated the relations among the measures of past and present control and distress.",0,0 +3861,Posttraumatic Stress Disorder in Mothers of Pediatric Cancer Survivors,"Prevalence of posttraumatic stress disorder (PTSD) in 24 mothers of pediatric cancer survivors was compared with its prevalence among 23 mothers of healthy children. Significantly more mothers of pediatric cancer survivors were diagnosed with lifetime PTSD. Significant differences were also found in lifetime arousal, as well as current and lifetime reexperience and avoidance symptom clusters. Significant difference existed in the distribution of the number of prediagnosis high-magnitude events experienced by the mothers diagnosed with current PTSD as compared with the prediagnosis experience of the mothers who were not diagnosed with current PTSD. Illness severity, level of perceived family and extrafamilial social support, and Symptom Checklist-90-Revised global severity index scores did not significantly differ in the PTSD-positive and PTSD-negative groups.",0,0 +3862,"Prior health care utilization as a potential determinant of enrollment in a 21-year prospective study, the Millennium Cohort Study","Results obtained from self-reported health data may be biased if those being surveyed respond differently based on health status. This study was conducted to investigate if health, as measured by health care use preceding invitation, influenced response to invitation to a 21-year prospective study, the Millennium Cohort Study. Inpatient and outpatient diagnoses were identified among more than 68,000 people during a one-year period prior to invitation to enroll. Multivariable logistic regression defined how diagnoses were associated with response. Days spent hospitalized or in outpatient care were also compared between responders and nonresponders. Adjusted odds of response to the questionnaire were similar over a diverse range of inpatient and outpatient diagnostic categories during the year prior to enrollment. The number of days hospitalized or accessing outpatient care was very similar between responders and nonresponders. Study findings demonstrate that, although there are some small differences between responders and nonresponders, prior health care use did not affect response to the Millennium Cohort Study, and it is unlikely that future study findings will be biased by differential response due to health status prior to enrollment invitation.",0,0 +3863,"Attachment from Infancy to Early Adulthood in a High‐Risk Sample: Continuity, Discontinuity, and Their Correlates","This study explores the stability of attachment security and representations from infancy to early adulthood in a sample chosen originally for poverty and high risk for poor developmental outcomes. Participants for this study were 57 young adults who are part of an ongoing prospective study of development and adaptation in a high-risk sample. Attachment was assessed during infancy by using the Ainsworth Strange Situation (Ainsworth & Wittig) and at age 19 by using the Berkeley Adult Attachment Interview (George, Kaplan, & Main). Possible correlates of continuity and discontinuity in attachment were drawn from assessments of the participants and their mothers over the course of the study. Results provided no evidence for significant continuity between infant and adult attachment in this sample, with many participants transitioning to insecurity. The evidence, however, indicated that there might be lawful discontinuity. Analyses of correlates of continuity and discontinuity in attachment classification from infancy to adulthood indicated that the continuous and discontinuous groups were differentiated on the basis of child maltreatment, maternal depression, and family functioning in early adolescence. These results provide evidence that although attachment has been found to be stable over time in other samples, attachment representations are vulnerable to difficult and chaotic life experiences.",0,0 +3864,Trajectories of Response to Treatment for Posttraumatic Stress Disorder,"Research on the predictors of response to cognitive-behavioral treatments for PTSD has often produced inconsistent or ambiguous results. We argue this is in part due to the use of statistical techniques that explore relationships among the entire sample of participants rather than homogeneous subgroups. Using 2 large randomized controlled trials of Cognitive Processing Therapy (CPT), CPT components, and Prolonged Exposure, we employed growth mixture modeling to identify distinct trajectories of treatment response and to determine the predictors of those trajectories. We determined that the participants' trajectories could be best represented by 2 latent classes, which we subsequently labeled responders (87% of the sample) and nonresponders (13% of the sample). Notably, there was not a separate class for partial responders. Assignment to the nonresponder class was associated with receiving the written accounts (WA) component of CPT, a pretreatment diagnosis of major depression (MDD), and more pretreatment hyperarousal symptoms. Thus, it appears that some individuals do not benefit from merely writing about their trauma and processing it with the therapist; they may also need to engage in cognitive restructuring to successfully ameliorate their symptoms. Additionally, those who meet criteria for MDD or have high levels of hyperarousal at the onset of treatment might require additional treatment or support.",0,0 +3865,Chronic Multisymptom Illness Complex in Gulf War I Veterans 10 Years Later,"Prior research has demonstrated that shortly after the 1991 Gulf War (Gulf War I), chronic multisymptom illness (CMI) was more common among deployed veterans than among nondeployed veterans. The aims of the current study were to determine the prevalence of CMI among deployed and nondeployed veterans 10 years after Gulf War I, compare the distribution of comorbid conditions, and identify prewar factors associated with CMI. Cross-sectional data collected from 1,061 deployed veterans and 1,128 nondeployed veterans examined between 1999 and 2001 were analyzed. CMI prevalence was 28.9% among deployed veterans and 15.8% among nondeployed veterans (odds ratio = 2.16, 95% confidence interval: 1.61, 2.90). Deployed and nondeployed veterans with CMI had similarly poorer quality-of-life measures and higher prevalences of symptom-based medical conditions, metabolic syndrome, and psychiatric disorders. Diagnoses of prewar anxiety disorders (not related to post-traumatic stress disorder) and depression were associated with CMI among both deployed and nondeployed veterans. Nicotine dependence and veteran-reported physician-diagnosed infectious mononucleosis were associated with CMI among deployed veterans, and migraine headaches and gastritis were associated with CMI among nondeployed veterans. CMI continues to be substantially more prevalent among deployed veterans than among nondeployed veterans 10 years after Gulf War I, but it manifests similarly in both groups. It is likely to be a common, persistent problem among veterans returning from the current Gulf War.",0,0 +3866,Differential effects of prolonged exposure on posttraumatic stress disorder symptoms in female veterans.,"We compared the effect of Prolonged Exposure (PE) on posttraumatic stress disorder (PTSD) symptom clusters and individual symptoms relative to a nonspecific comparison therapy (present-centered therapy; PCT) to identify the unique benefits of PE. We used data from a 12-site randomized clinical trial that found PE to be more effective than PCT for reducing PTSD symptom severity.Participants were 284 female veterans and active duty soldiers with PTSD (M age = 44.8 years, range = 22-78; 45.4% non-White). Participants were randomized to 10 weekly sessions of PE or PCT and assessed before and after treatment and at 3- and 6-month follow-ups. The primary measure of PTSD symptoms and symptom clusters (reexperiencing, avoidance, numbing, and hyperarousal) was the Clinician-Administered PTSD Scale (CAPS; Weathers et al., 2001) but we also assessed self-reported PTSD using the PTSD Checklist-Specific Version (PCL; Weathers, Litz, Herman, Huska, & Keane, 1993).Almost all clinician-rated and self-reported symptoms improved from pre- to posttreatment in both conditions. In the analyses of clinician-rated PTSD, PE had greater benefit than PCT on avoidance and numbing clusters. PE also had greater benefit on most individual symptoms in these clusters as well as on distress related to reminders. In the analyses of self-reported PTSD, PE had greater benefit than PCT on all clusters and on most individual symptoms.PE may be especially helpful for individuals with significant avoidance and numbing. Giving patients information about how a treatment can help with the symptoms that create the greatest burden can facilitate choosing the treatment that is best for them.",0,0 +3867,General Growth Mixture Analysis with Antecedents and Consequences of Change,"Many studies of youth, adolescents, and adults related to delinquent, antisocial, and criminal offending, have utilized a language of trajectory typologies to describe individual differences in the behavioral course manifest in their longitudinal data. The two most common statistical methods currently in use are the semiparametric group-based modeling, also known as latent class growth analysis and general growth mixture analysis, with the latter method being the focus of this chapter. In concert with the growing popularity of these data-driven, group-based methods for studying developmental and life-course behavior trajectories have come active and spirited ontological discussions about the nature of the emergent trajectory groups resulting from the analyses. In this chapter, we presuppose that there are analytic, empirical, and substantive advantages inherent in using discrete components to (partially) describe population heterogeneity in longitudinal processes. Conceptually as well as empirically, we will discuss the use of auxiliary information in terms of antecedents and consequences of trajectory group membership. The inclusion of auxiliary information in growth mixture analysis is a necessary step in understanding as well as evaluating the fidelity and utility of the resultant trajectory profiles from a given study, regardless of one’s beliefs about the veracity of the method itself.",0,0 +3868,Validating the Primary Care Posttraumatic Stress Disorder Screen and the Posttraumatic Stress Disorder Checklist with soldiers returning from combat.,"The purpose of the research was to assess the diagnostic efficiency of the Primary Care Posttraumatic Stress Disorder Screen (PC-PTSD) and the Posttraumatic Stress Disorder Checklist (PCL) as clinical screening tools for active duty soldiers recently returned from a combat deployment. A secondary goal was to examine the item-level characteristics of both the PC-PTSD and the PCL. A validation study conducted with a sample of 352 service members showed that both the PC-PTSD and PCL had good diagnostic efficiency. The overall diagnostic efficiency assessed by the area under the curve (AUC) was virtually the same for both the PC-PTSD and PCL. The most efficient cutoff values for the PC-PTSD were either 2 or 3 ""yes"" responses with the latter favoring specificity. For the PCL, the most efficient cutoff values were between 30 and 34, mirroring recommended PCL cutoff values from some studies in primary care settings. The examination of item characteristics suggested a 4-item PCL with an AUC virtually identical to that of the full PCL. Item analyses also identified that the most discriminate item in both scales pertained to symptoms of avoidance. Implications and limitations are discussed.",0,0 +3869,Plasma brain-derived neurotrophic factor level may contribute to the therapeutic response to eye movement desensitisation and reprocessing in complex post-traumatic stress disorder: a pilot study,Plasma brain-derived neurotrophic factor level may contribute to the therapeutic response to eye movement desensitisation and reprocessing in complex post-traumatic stress disorder: a pilot study - Volume 24 Issue 6,0,0 +3870,Prognosis After Whiplash Injury,"Nonsystematic review and discussion of prognosis after whiplash injury.To summarize the research and identify a research agenda for improving prognostic models after whiplash injury.With up to 50% of individuals failing to fully recover after whiplash injury, the capacity to determine a precise estimate of prognosis will be important. Systematic reviews note inconsistencies and shortcomings of research in this area.A nonsystematic review and discussion.Most prognostic whiplash studies are phase 1 (exploratory) studies with few confirmatory or validation studies yet available. It is recognized that whiplash is a heterogeneous condition and clinicians require prognostic indicators for clinical use. Although the evidence is not sufficiently strong to make firm recommendations, there are some prognostic factors that have shown consistency across studies and could be considered as preliminary flags or guides to gauge patients potentially at risk of poor recovery. These include pain and/or disability levels, neck range of movement, cold and mechanical hyperalgesia and psychological factors of recovery beliefs/expectations, post-traumatic stress symptoms, depression, and pain catastrophizing. It is not known whether these factors can be modified or whether modification will improve outcomes, thus they should not be considered directives for management. Research priorities identified to develop improved predictive models include confirmation and validation of factors identified in phase 1 studies; investigation of the interaction between variables; investigation of the predictive value of changes in variables over time; the inclusion of validated outcomes including measures of pain and disability as well as perceived recovery and psychological outcomes.The current evidence is not sufficiently robust to be able to confidently predict outcome after whiplash injury. A preliminary set of consistent factors has been proposed to assist clinicians in identifying individuals at risk of poor recovery. Directions for the development of improved prognostic models are discussed.",0,0 +3871,Burn Rehabilitation,"ABSTRACTEsselman PC, Thombs BD, Magyar-Russell G, Fauerbach JA: Burn rehabilitation: State of the science. Am J Phys Med Rehabil 2006;85:383–413.",0,0 +3872,Cutaneous Vascular Responses to Hypercapnia During Whole-Body Heating,"Hypercapnia may be encountered in lung disease as well as during situations involving rebreathing of previously expired air (e.g., occupational diving). Inhibitory effects of elevated arterial carbon dioxide partial pressure on the central nervous system may result in impaired thermoregulation. This study tested the hypothesis that in heat-stressed subjects, cutaneous vascular responsiveness [expressed as cutaneous vascular conductance (CVC)] would be reduced during hypercapnic exposure.Four men and three women (mean - SD; age: 35 +/- 7 yr) rested supine while wearing a tube-lined suit perfused with 34 degrees C water (normothermia). Following normothermic data collection, 50 degrees C water was perfused through the suit to increase internal temperature approximately 1 degrees C (whole-body heating). In both thermal conditions, a normoxic-hypercapnic (5% CO2, 21% O2, balance N2) gas mixture was inspired while forearm skin blood flux (laser-Doppler flowmetry) was measured continuously and was used for calculation of CVC (skin blood flux/mean arterial pressure).End-tidal CO2 increased similarly throughout hypercapnic exposure during both normothermic and whole-body heating conditions (7.9 +/- 2.4 and 8.3 +/- 1.9 mmHg, respectively). However, CVC was not different between normocapnia and hypercapnia under either thermal condition (normothermia: 0.42 +/- 0.24 vs. 0.39 +/- 0.21 flux units/mmHg for normocapnia and hypercapnia, respectively; heat stress: 1.89 +/- 0.67 vs. 1.92 +/- 0.63 flux units/ mmHg for normocapnia and hypercapnia, respectively).Based on these findings, mild hypercapnia is unlikely to impair heat dissipation by reducing cutaneous vasodilation.",0,0 +3873,Post-traumatic stress disorder and color preference in released prisoners of war,"The Luscher Color Test was administered to a sample of 188 male ex-prisoners of war (aged 18-66 years), who underwent psychiatric and psychological examination. The aim of this study was to evaluate possible connections between PTSD symptom clusters and color preferences, and possible impact of post-war and post-imprisonment period on color choice. The obtained results showed a prevalence of 6.9% for full PTSD diagnosis and 38.8% for Partial PTSD diagnosis. Furthermore, we found increased preference for violet (dominantly in those with one symptom cluster) and green (dominantly in those with full PTSD or two symptom clusters) and decreased preference for red (all subgroups). The persistence of the post-trauma period influenced even more pronounced preference for green, and even lesser preference for red.",0,0 +3874,Post-traumatic stress behavioural responses in inbred mouse strains: can genetic predisposition explain phenotypic vulnerability?,"Clinical studies of twin pairs and families of post-traumatic stress disorder (PTSD) patients raise questions as to possible genetic predisposition to PTSD. Studies using isogenic animal populations exposed to a stress paradigm could elucidate the relative contributions of genotype and environment to endophenotypic expression. The prevalence of individuals displaying severely compromised behavioural responses to predator scent stress (PSS) was assessed in six inbred strains of mice in an animal model of PTSD that classifies individuals into groups according to the degree of their behavioural response. The choice of strains was based on the frequent use of these mice in transgenic research. The prevalence of extreme behavioural response in the elevated plus maze and the acoustic startle response paradigms, performed in sequence, was assessed at baseline and 7 d after PSS exposure between and within strains, and compared to differences in circulating corticosterone levels. Narrow-sense trait heritability was determined by comparing the between-strain variance to the total variance. Although strain-specific differences in anxiety-like behaviours were demonstrated, the results revealed a significant degree of individual variability in response patterns within each of the inbred strains, yielding a baseline heritability factor for anxiety-like behaviours of 30%, but only 10% for response to stress exposure. Baseline anxiety-like behaviours were found not to be predictive of post-exposure behavioural responses. The response of the individual to stress is multifactorial and environmental factors play a predominant role in characterizing the individual response to stress exposure, although there are significant genetic underpinnings.",0,0 +3875,Trajectories of PTSD risk and resilience in World Trade Center responders: an 8-year prospective cohort study,"Background Longitudinal symptoms of post-traumatic stress disorder (PTSD) are often characterized by heterogeneous trajectories, which may have unique pre-, peri- and post-trauma risk and protective factors. To date, however, no study has evaluated the nature and determinants of predominant trajectories of PTSD symptoms in World Trade Center (WTC) responders. Method A total of 10835 WTC responders, including 4035 professional police responders and 6800 non-traditional responders (e.g. construction workers) who participated in the WTC Health Program (WTC-HP), were evaluated an average of 3, 6 and 8 years after the WTC attacks. Results Among police responders, longitudinal PTSD symptoms were best characterized by four classes, with the majority (77.8%) in a resistant/resilient trajectory and the remainder exhibiting chronic (5.3%), recovering (8.4%) or delayed-onset (8.5%) symptom trajectories. Among non-traditional responders, a six-class solution was optimal, with fewer responders in a resistant/resilient trajectory (58.0%) and the remainder exhibiting recovering (12.3%), severe chronic (9.5%), subsyndromal increasing (7.3%), delayed-onset (6.7%) and moderate chronic (6.2%) trajectories. Prior psychiatric history, Hispanic ethnicity, severity of WTC exposure and WTC-related medical conditions were most strongly associated with symptomatic trajectories of PTSD symptoms in both groups of responders, whereas greater education and family and work support while working at the WTC site were protective against several of these trajectories. Conclusions Trajectories of PTSD symptoms in WTC responders are heterogeneous and associated uniquely with pre-, peri- and post-trauma risk and protective factors. Police responders were more likely than non-traditional responders to exhibit a resistant/resilient trajectory. These results underscore the importance of prevention, screening and treatment efforts that target high-risk disaster responders, particularly those with prior psychiatric history, high levels of trauma exposure and work-related medical morbidities.",1,0 +3876,Posttraumatic stress in children following acute physical injury,"To prospectively assess the presence of posttraumatic stress disorder (PTSD) in children hospitalized following acute physical injury. The focus was identification of the incidence of PTSD, PTSD symptoms, and exploration of factors associated with development of PTSD symptoms and disorder.Forty children ages 8-17 were interviewed approximately 1 month following a serious injury and assessed for PTSD, pretrauma behavior problems, levels of peritraumatic fear, and posttraumatic thought suppression.Twenty-two and a half percent of participants met DSM-IV diagnostic criteria for PTSD; 47.5% met criteria for at least two of the three PTSD symptom clusters. Greater thought suppression was associated with increased symptoms of PTSD, as were the child's peritraumatic fear response and pretrauma internalizing behaviors.Results suggest that many children who have been hospitalized for physical trauma may be experiencing clinically significant PTSD symptomatology and may benefit from psychological as well as medical intervention.",0,0 +3877,Deployment Risk and Resilience Inventory: A Collection of Measures for Studying Deployment-Related Experiences of Military Personnel and Veterans,This article describes the development of an inventory to assess key psychosocial risk and resilience factors for military personnel and veterans deployed to war zones or other hazardous environmen...,0,0 +3878,Stress disorders following traumatic injury: Assessment and treatment considerations,"Traumatic injury is a relatively common occurrence, with approximately 40 million injury-related visits to emergency departments in the United States per year. Psychiatric complications of physical injury are a public health concern. Approximately 12% to 16% of survivors of traumatic injury are diagnosed with acute stress disorder (ASD), and 30% to 36% warrant a diagnosis of posttraumatic stress disorder (PTSD) 12 months after the traumatic event. Phenomena related to injury, such as blood loss, pain, administration of narcotic analgesics, and traumatic brain injury, as well as high rates of premorbid psychiatric and substance abuse and/or dependence disorders, often overlap with stress-related symptoms of psychological origin. This complicates the assessment of dissociative processes required for the diagnosis of ASD, as well as the three core PTSD symptom clusters (re-experiencing of the trauma, avoidance and numbing, and hyperarousal). This article reviews specific aspects of stress disorders in the context of traumatic injury, with a focus on aspects of assessment. Psychopharmacologic and behavioral treatment recommendations are also reviewed.",0,0 +3879,"Neighborhood disadvantage, stress, and drug use among adults.","This paper explores the relationships among neighborhood disadvantage, stress, and the likelihood of drug use in a sample of adults (N = 1,101). Using the 1995 Detroit Area Study in conjunction with tract-level data from the 1990 census, we find a positive relationship between neighborhood disadvantage and drug use, and this relationship remains statistically significant net of controls for individual-level socioeconomic status. Neighborhood disadvantage is moderately associated with drug related behaviors, indirectly through increased social stressors and higher levels of psychological distress among residents of disadvantaged neighborhoods. A residual effect of neighborhood disadvantage remains, net of a large number of socially relevant controls. Finally, results from interactive models suggest that the relationship between neighborhood disadvantage and drug use is most pronounced among individuals with lower incomes.",0,0 +3880,Practical assessment and evaluation of mental health problems following a mass disaster.,"Almost all individuals who experience a severe trauma will develop symptoms of posttraumatic stress disorder (PTSD) shortly after the traumatic event. Although the natural history of PTSD varies according to the type of trauma, most people do not develop enduring PTSD, and, in many of those who do, it resolves within 1 year without treatment. To the extent that is possible, maintenance of normal daily activities is believed to help patients cope more successfully in the aftermath of major trauma. In the case of a disaster such as the Asian tsunami, the whole community is involved, and it is impossible to continue with normal daily activities. To improve overall outcome after trauma, it would be optimal to identify individuals at increased risk for developing PTSD. This article describes screening and assessment tools for posttrauma mental health problems, particularly PTSD, and examines in more detail instruments that can be used in rapid field assessment of individuals who may be affected or who have already been identified and require monitoring. Self-rated instruments are most appropriate, but the choice of instrument will depend on the local situation and availability of appropriately validated questionnaires. The article also addresses important aspects of training nonmedical personnel in screening and assessment.",0,0 +3881,Symptom profiles of patients with DSM-III anxiety disorders,"The authors used symptom profiles, demographic data, and other variables to compare 316 patients representing all specific DSM-III anxiety disorders except posttraumatic stress disorder to each other and to published norms for both an unselected psychiatric outpatient population and normal subjects. The results support the grouping of these disorders, with the possible exception of obsessive-compulsive disorder, into one general diagnostic category of ""anxiety disorders."" The distinction between the specific diagnoses of simple phobia and social phobia was also supported; however, the differentiation between panic disorder, agoraphobia, and generalized anxiety was only weakly supported.",0,0 +3882,"Economics of Disaster Risk, Social Vulnerability, and Mental Health Resilience","We investigate the relationship between exposure to Hurricanes Katrina and/or Rita and mental health resilience by vulnerability status, with particular focus on the mental health outcomes of single mothers versus the general public. We advance a measurable notion of mental health resilience to disaster events. We also calculate the economic costs of poor mental health days added by natural disaster exposure. Negative binomial analyses show that hurricane exposure increases the expected count of poor mental health days for all persons by 18.7% (95% confidence interval [CI], 7.44-31.14%), and by 71.88% (95% CI, 39.48-211.82%) for single females with children. Monthly time-series show that single mothers have lower event resilience, experiencing higher added mental stress. Results also show that the count of poor mental health days is sensitive to hurricane intensity, increasing by a factor of 1.06 (95% CI, 1.02-1.10) for every billion (U.S.$) dollars of damage added for all exposed persons, and by a factor of 1.08 (95% CI, 1.03-1.14) for single mothers. We estimate that single mothers, as a group, suffered over $130 million in productivity loss from added postdisaster stress and disability. Results illustrate the measurability of mental health resilience as a two-dimensional concept of resistance capacity and recovery time. Overall, we show that natural disasters regressively tax disadvantaged population strata.",0,0 +3883,Relationship BetweenToxoplasma gondiiand Mood Disturbance in Women Veterans,"Toxoplasma gondii is an intracellular protozoan parasite with zoonotic potential that causes acute and chronic diseases, which has been associated with schizophrenia, depression, bipolar disorder, and suicidal behavior. Military personnel may be at increased risk for exposure to the parasite when deployed to countries with high prevalence rates.Women Veterans were recruited to participate in the study at an event to recognize women Veterans and later through e-mails. Blood samples were collected from 70 women Veterans (mean age: 47 years) and analyzed for T. gondii IgG titer. Participants completed a demographic instrument, Center for Epidemiologic Studies Depression scale, Profile of Mood States (POMS), and Post-Traumatic Stress Disorder Checklist-Military.The infectivity rate was lower than the rate in the United States (11.4% [8 out of 70 were seropositive], but 6 of the 8 [75%] had been deployed outside the United States. Pearson correlations and t tests showed significant relationships between T. gondii seropositivity and Center for Epidemiologic Studies Depression score), POMS-depression, POMS-confusion, and POMS-anger subscale scores, and total mood disturbance score.This study is the first to describe biobehavioral relationships between chronic T. gondii infection, depression, and dysphoric moods in a military veteran population.",0,0 +3884,Preliminary Evidence for a Classroom Based Psychosocial Intervention for Disaster Exposed Children with Posttraumatic Stress Symptomatology,"Background: In 2004, a firework factory in a residential area of a large Danish city exploded. The children at the local school were screened for symptoms of posttraumatic stress disorder (PTSD) 16 months and 31/2 years after the incident. A large proportion of the children still suffered from a substantial number of symptoms 31/2 years after the incident. Thus, a treatment program designed to target PTSD symptoms in trauma-exposed children was established. Objectives: The first aim of this study was to provide preliminary evidence that a classroom-based psychosocial intervention program for children with posttraumatic stress would be associated with reductions in symptoms. The second aim was to evaluate the usefulness of the Darryl, a cartoon-based PTSD screening instrument. Methods: One hundred and eight children participated in the treatment program, all of whom fulfilled at least two out of the three DSM-IV PTSD symptom clusters. The children were screened for PTSD symptoms at baseline and 1 month after treatment using Darryl. Results: There was a statistically significant reduction in PTSD symptoms from pre-treatment to post-treatment. Furthermore, a logistic regression analysis revealed that being female, being young, and having a high PTSD score at baseline predicted a probable PTSD diagnosis post-treatment. Conclusion: The present study provides preliminary evidence of feasibility and that the treatment program described may help to alleviate PTSD symptoms children with chronic PTSD symptoms. Furthermore, the results indicated that the Darryl instrument is a useful screening tool for assessing PTSD symptoms in this sample of children. © 2013 Springer Science+Business Media New York.",0,0 +3885,Latent profiles of PTSD symptoms in women exposed to intimate partner violence,"Studies have utilized latent class analysis (LCA) and latent profile analysis (LPA) to examine posttraumatic stress disorder (PTSD) symptom profiles in a range of populations. Further study is needed to explore symptom profiles among women exposed to intimate partner violence (IPV). The current study examined latent symptom profiles in a sample of IPV-exposed women, and explored trauma-related cognitive appraisals associated with these PTSD symptom presentations.An LPA was conducted using cross-sectional data from a non-treatment seeking community sample of women recruited following a police-reported incident of IPV by a male perpetrator (N=229). Multinomial regression analyses determined associations between latent profile membership and trauma-related appraisals.The LPA identified five PTSD symptom profiles: Low Symptom (46% of the sample); Low Symptom with High Hypervigilance (17%); Intermediate Symptom (16%); Intermediate Symptom with High Hypervigilance (11%); and High Symptom (10%). Trauma-related appraisals, including fear, alienation, and self-blame, were the strongest independent predictors of PTSD symptom profile membership.The study focused on female victims of IPV by a male partner, and findings may not generalize to other gender configurations (e.g. same-sex couples, male victims, etc.). The LPA is cross-sectional, and the stability of these profiles over time warrants further study.These findings suggest the need for careful consideration of differences among IPV-exposed women within the larger context of PTSD research and clinical intervention. Identifying latent subgroups may provide an empirical basis for practitioners to design and implement PTSD intervention efforts that are tailored to specific symptom profiles.",0,0 +3886,Psychiatric outcomes after childbirth: can posttraumatic growth protect me from disordered eating symptoms?,"Purpose: While many studies on mood disorder and posttraumatic stress disorder (PTSD) following childbirth have been conducted, little is known regarding posttraumatic growth (PTG) and disordered eating in the postpartum period. This study aims to (a) identify the typology of women following childbirth based on anxiety, depressive, PTSD symptoms and level of PTG and (b) evaluate whether these profiles differ on disordered eating symptoms. Methods: Up to 2 years after childbirth, 306 French-speaking mothers [mean age (SD) = 29.4 (4.6) years] completed questionnaires assessing PTSD, depressive, anxiety and disordered-eating symptoms and level of posttraumatic growth. Results: Four profiles were highlighted: a first one labeled growing cluster (22.2  \% of the sample, n = 68), a second one labeled low level of symptoms cluster (37.6  \% of the sample, n = 115), a third one labeled vulnerable cluster (21.6  \% of the sample, n = 66) and a last one labeled anxious–depressed–traumatized cluster (18.6  \% of the sample, n = 57). Our findings also highlight an impact of these profiles on disordered eating symptoms, suggesting that disordered eating in postpartum would not be the result of pregnancy. Conclusion: Consistent with our expectation, our findings suggest a potential protective role of posttraumatic growth on the development of disordered eating symptoms. Further researches focusing on traumatic experience, disordered eating and posttraumatic growth in postpartum are warranted.",0,0 +3887,Heterogeneity in the latent structure of PTSD symptoms among Canadian veterans.,"The current study used factor mixture modeling to identify heterogeneity (i.e., latent classes) in 2 well-supported models of posttraumatic stress disorder's (PTSD) factor structure. Data were analyzed from a clinical sample of 405 Canadian veterans evaluated for PTSD. Results were consistent with our hypotheses. Each PTSD factor model was best represented by 2 latent classes of participants, differing with respect to PTSD symptom severity. Furthermore, classes were most strongly distinguished by factor scores related to emotional numbing or dysphoria. For both factor models, class membership was significantly predicted by age and depression diagnosis. Implications of these findings are discussed.",0,0 +3888,"Posttraumatic Stress, Anxiety, and Depression Symptoms Among Children After Hurricane Katrina: A Latent Profile Analysis","This study utilized Latent Profile Analysis to identify typologies of distress (i.e., patterns of posttraumatic stress, anxiety, and depression symptoms) among children exposed to Hurricane Katrina. Outcomes and risk factors for these pattern groups were examined. Participants were children (n = 353; ages 8-15 years) affected by Hurricane Katrina. Children were assessed at 3 - 7 months (Time 1) and 14 - 17 months (Time 2) post-Katrina. Results identified three pattern groups (No Disturbance, PTS Only, and Mixed Internalizing) at Time 1. Children in the No Disturbance group reported the lowest levels of internal distress, while the Mixed Internalizing group reported the highest levels of internal distress at Time 2. The Mixed Internalizing and the PTS Only groups reported greater school problems than the No Disturbance group at Time 2. Perceived life threat and community violence exposure were risk factors associated with higher likelihood of falling in the PTS Only and Mixed Internalizing groups, compared to the No Disturbance group. Immediate loss and disruption was also a risk factor associated with a higher likelihood of falling in the PTS Only group, compared to the No Disturbance group. Finally, social support from parents or a classmate/friend was a significant protective factor associated with a lower likelihood of falling into a symptomatic pattern group.",0,0 +3889,Symptom Overreporting in Combat Veterans Evaluated for PTSD: Differentiation on the Basis of Compensation Seeking Status,"We examined the role of compensation-seeking status on response patterns to self-report inventories of acute psychopathology and psychological distress in a group of 165 combat veterans evaluated for posttraumatic stress disorder (PTSD) at a Department of Veteran Affairs (VA) Medical Center. Veterans completed the Minnesota Multiphasic Personality Inventory-Revised, Beck Depression Inventory, Mississippi Scale for Combat-Related PTSD, a fixed-response format version of the Dissociative Experiences Scale, and Impact of Events Scale as part of a standard assessment battery. Results showed that compensation-seeking veterans endorsed dramatically higher levels of psychopathology across measures and produced sharply elevated ""fake-bad"" validity indices as compared to non-compensation-seeking veterans. Differences between the two groups on most scales and indices exceeded effect sizes of 1.0, even when effects of income, global assessment of functioning, and clinician-rated severity of PTSD were controlled for. It is suggested that the availability of VA disability compensation for combat-related PTSD impedes accurate initial assessment of veterans presenting for treatment and may impair estimation of long-term therapeutic outcome in this population.",0,0 +3890,Assessing the ‘true’ effect of active antidepressant therapy v. placebo in major depressive disorder: use of a mixture model,"Background There is controversy about the implications of relatively small average drug–placebo differences observed in randomised controlled trials of antidepressant medications. Aims To investigate whether efficacy is better understood as a large effect in a subgroup of patients. Method The mixture model was used to identify patient subgroups (patients benefiting or not benefiting from treatment) to directly model the skewness of Montgomery–åsberg Depression Rating Scale (MADRS) scores at week 8. Results The MADRS scores improved by 15.9 points (95% CI 15.2–16.6) among patients who benefited from treatment. The proportion of patients who benefited from escitalopram and not from placebo treatment was 19.5%, corresponding to a number needed to treat of 5. Conclusions This model gave a considerably better fit to the data than the analysis of covariance model in which all patients were assumed to benefit from treatment. The small average antidepressant–placebo difference obscures a much larger effect in a clinically meaningful subgroup of patients.",0,0 +3891,DSM–5’s Posttraumatic Stress Disorder with Dissociative Symptoms: Challenges and Future Directions,"The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, formally recognizes a dissociative subtype of posttraumatic stress disorder (PTSD; PTSD with dissociative symptoms). This nomenclative move will boost empirical and theoretical efforts to further understand the links between dissociation, trauma, and PTSD. This article examines the empirical literature showing that patients with PTSD can be divided into 2 different groups based on their neurobiology, psychological symptom profile, history of exposure to early relational trauma, and depersonalization/derealization symptoms. It then explores the conceptual and empirical challenges of conceiving 1 of these types as reflecting a ""dissociative"" type of PTSD. First, this classification is based on the presence of a limited subset of dissociative symptoms (i.e., depersonalization, derealization). This sets aside an array of positive and negative psychoform and somatoform dissociative symptoms that may be related to PTSD. Second, empirical evidence suggests heightened dissociation in PTSD compared to many other disorders, indicating that dissociation is relevant to PTSD more broadly rather than simply to the so-called dissociative subtype. This article sets out important issues to be examined in the future study of dissociation in PTSD, which needs to be informed by solid conceptual understandings of dissociation.",0,0 +3892,A new instrument to assess social functioning in mental health settings,"This article present a new social functioning self-report instrument in French language the Questionnaire de Fonctionnement Social (QFS), initially developed in order to assess social functioning in patients involved ingroup psychotherapy programs conducted in a specialist mental health setting. The psychometric analysis globally support the validity of the QFS and suggest that it performs similarly to other standardized measure of social functioning. Brief, easy to complete and score, the QFS seems to be an appropriate instrument for use not only in research protocols but also in clinical psychiatric settings. Within the often costly exercise of routine measurement, this short questionnaire should help identifying social dysfunctions otherwise not always recognized, making informed clinical decision and monitoring therapeutic responses. The QFS, while promising, needs further validation by study of its use namely in other settings (e.g. community mental health setting,...), with other patient groups (for instance, suffering from other mental disorders or chronic medical illnesses) and, more generally, with other non-clinical populations (e.g. pensioners, prisoners, refugees,...).",0,0 +3893,Trauma and stress-related disorders in German emergency physicians: the predictive role of personality factors.,"Emergency medical personnel (EMP) are repeatedly exposed to traumatic and stressful events with possible consequences on their mental wellbeing. Out of the group of EMP, we chose German Emergency Physicians (EP), because they represent a distinct group within the German pre-hospital emergency services. In this group, we studied the prevalence rates of posttraumatic stress disorder (PTSD), burnout and depression. We specifically focussed on the role of personality and other factors of vulnerability. Four hundred eighty-seven German EPs answered questionnaires with scales assessing probable PTSD, burnout, depression, and personality factors. Additionally, we asked for biographic, occupational and mental health information. More than 90% of the participants reported at least one traumatic event. We found low to moderate levels of stress-related disorders with 16.8% of participants meeting the criteria for probable PTSD, 4.1% for burnout, and 3.1% for clinical depression. We identified four clusters of personalities that were related to the prevalence of PTSD and depression. The type of personality seems to be more predictive of the development of trauma and stress-related disorders than the EPs' traumatic experiences.",0,0 +3894,Coping and Emotional Adjustment Following Traumatic Brain Injury,"To examine the association between coping style and emotional adjustment following traumatic brain injury.Thirty three individuals who had sustained a traumatic brain injury (mean duration of posttraumatic amnesia = 32 days) between 1(1/2) months and almost 7 years previously.Coping Scale for Adults, Hospital Anxiety and Depression Scale, Rosenberg Self-Esteem Scale, State-Trait Anger Expression Inventory, and the Sickness Impact Profile.Approximately 50% of the sample reported clinically significant levels of anxiety and depression. Coping characterized by avoidance, worry, wishful thinking, self-blame, and using drugs and alcohol was associated with higher levels of anxiety, depression, and psychosocial dysfunction and lower levels of self-esteem. Coping characterized by actively working on the problem and using humor and enjoyable activities to manage stress was associated with higher self-esteem. Lower premorbid intelligence (measured via the National Adult Reading Test) and greater self-awareness (measured via the Self-Awareness of Deficits Interview) were associated with an increased rate of maladaptive coping.The strong association between the style of coping used to manage stress and emotional adjustment suggests the possibility that emotional adjustment might be improved by the facilitation of more adaptive coping styles. It is also possible that improving emotional adjustment may increase adaptive coping. The development and evaluation of interventions aimed at facilitating adaptive coping and decreasing emotional distress represent important and potentially fruitful contributions to enhancing long-term outcome following brain injury.",0,0 +3895,Epidemiology ofDSM-5Drug Use Disorder,"Current information on the prevalence and sociodemographic and clinical profiles of individuals in the general population with DSM-5 drug use disorder (DUD) is limited. Given the present societal and economic context in the United States and the new diagnostic system, up-to-date national information is needed from a single uniform data source.To present nationally representative findings on the prevalence, correlates, psychiatric comorbidity, disability, and treatment of DSM-5 DUD diagnoses overall and by severity level.In-person interviews were conducted with 36,309 adults in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III, a cross-sectional representative survey of the United States. The household response rate was 72%; person-level response rate, 84%; and overall response rate, 60.1%. Data were collected April 2012 through June 2013 and analyzed from February through March 2015.Twelve-month and lifetime DUD, based on amphetamine, cannabis, club drug, cocaine, hallucinogen, heroin, nonheroin opioid, sedative/tranquilizer, and/or solvent/inhalant use disorders.Prevalences of 12-month and lifetime DUD were 3.9% and 9.9%, respectively. Drug use disorder was generally greater among men, white and Native American individuals, younger and previously or never married adults, those with lower education and income, and those residing in the West. Significant associations were found between 12-month and lifetime DUD and other substance use disorders. Significant associations were also found between any 12-month DUD and major depressive disorder (odds ratio [OR], 1.3; 95% CI, 1.09-1.64), dysthymia (OR, 1.5; 95% CI, 1.09-2.02), bipolar I (OR, 1.5; 95% CI, 1.06-2.05), posttraumatic stress disorder (OR, 1.6; 95% CI, 1.27-2.10), and antisocial (OR, 1.4; 95% CI, 1.11-1.75), borderline (OR, 1.8; 95% CI, 1.41-2.24), and schizotypal (OR, 1.5; 95% CI, 1.18-1.87) personality disorders. Similar associations were found for any lifetime DUD with the exception that lifetime DUD was also associated with generalized anxiety disorder (OR, 1.3; 95% CI, 1.06-1.49), panic disorder (OR, 1.3; 95% CI, 1.06-1.59), and social phobia (OR, 1.3; 95% CI, 1.09-1.64). Twelve-month DUD was associated with significant disability, increasing with DUD severity. Among respondents with 12-month and lifetime DUD, only 13.5% and 24.6% received treatment, respectively.DSM-5 DUD is a common, highly comorbid, and disabling disorder that largely goes untreated in the United States. These findings indicate the need for additional studies to understand the broad relationships in more detail; estimate present-day economic costs of DUDs; investigate hypotheses regarding etiology, chronicity, and treatment use; and provide information to policy makers about allocation of resources for service delivery and research. Findings also indicate an urgent need to destigmatize DUD and educate the public, clinicians, and policy makers about its treatment to encourage affected individuals to obtain help.",0,0 +3896,The relations between posttraumatic stress disorder symptoms and disorder of extreme stress (not otherwise specified) symptoms following war captivity.,"War captivity is a recognized pathogenic agent for both posttraumatic stress disorder (PTSD) symptoms and disorder of extreme stress not otherwise specified (DESNOS) symptoms, also known as Complex PTSD. However, the relationship between the two disorders remains unclear. While some scholars assume that the two diagnoses are overlapping and share the same predictors, others believe that the two diagnoses are relatively independent and differ in phenomenology and functional impairment. This study aims to assess both PTSD and DESNOS symptoms and their inter-relations among ex-prisoners of war (ex-POWs) and matched controls, 35 years after the end of the war.The sample included two groups of male Israeli veterans from the 1973 Yom Kippur War: ex-POWs (n = 176) and comparable veterans who had not been held captive (n = 118). PTSD and DESNOS symptoms, battlefield and captivity stressors, and ways of coping in captivity were assessed using self-report questionnaires in 2008.Ex-POWs reported a higher number of PTSD symptoms and higher rates of PTSD symptoms that fill criteria for the diagnosis of PTSD than controls. Furthermore, ex-POWs reported a higher number of DESNOS symptom clusters and higher rates of DESNOS symptoms that fill criteria for the diagnosis of DESNOS. Moreover, we found positive relationships between PTSD symptom clusters and DESNOS symptom clusters. Finally, weight loss and mental suffering in captivity, loss of emotional control and total number of DESNOS symptoms predicted total number of PTSD symptoms. However, only the total number of PTSD symptoms predicted the total number of DESNOS symptoms.This study demonstrated the heavy and extensive toll of war captivity, three decades after the ex-POWs' release from captivity. Importantly, approaching the publication of DSM-5, this study depicts both the high number of DESNOS symptom clusters alongside PTSD symptoms and highlights the complex relationship between the two diagnostic entities. Thus, DESNOS characteristics might be viewed as associated features of PTSD but also that the symptoms of PTSD are the core foundations of DESNOS.",0,0 +3897,A Brief Measure for Assessing Generalized Anxiety Disorder,"Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity.A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use.A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale.The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.",0,0 +3898,Rates of Major Depressive Disorder and Clinical Outcomes Following Traumatic Brain Injury,"Uncertainties exist about the rates, predictors, and outcomes of major depressive disorder (MDD) among individuals with traumatic brain injury (TBI).To describe MDD-related rates, predictors, outcomes, and treatment during the first year after TBI.Cohort from June 2001 through March 2005 followed up by structured telephone interviews at months 1 through 6, 8, 10, and 12 (data collection ending February 2006).Harborview Medical Center, a level I trauma center in Seattle, Washington.Five hundred fifty-nine consecutively hospitalized adults with complicated mild to severe TBI.The Patient Health Questionnaire (PHQ) depression and anxiety modules were administered at each assessment and the European Quality of Life measure was given at 12 months.Two hundred ninety-seven of 559 patients (53.1%) met criteria for MDD at least once in the follow-up period. Point prevalences ranged between 31% at 1 month and 21% at 6 months. In a multivariate model, risk of MDD after TBI was associated with MDD at the time of injury (risk ratio [RR], 1.62; 95% confidence interval [CI], 1.37-1.91), history of MDD prior to injury (but not at the time of injury) (RR, 1.54; 95% CI, 1.31-1.82), age (RR, 0.61; 95% CI, 0.44-0.83 for > or = 60 years vs 18-29 years), and lifetime alcohol dependence (RR, 1.34; 95% CI, 1.14-1.57). Those with MDD were more likely to report comorbid anxiety disorders after TBI than those without MDD (60% vs 7%; RR, 8.77; 95% CI, 5.56-13.83). Only 44% of those with MDD received antidepressants or counseling. After adjusting for predictors of MDD, persons with MDD reported lower quality of life at 1 year compared with the nondepressed group.Among a cohort of patients hospitalized for TBI, 53.1% met criteria for MDD during the first year after TBI. Major depressive disorder was associated with history of MDD and was an independent predictor of poorer health-related quality of life.",0,0 +3899,"Crisis support, attributional style, coping style, and post-traumatic symptoms","Abstract Although disaster is believed to be aetiological in the development of post-traumatic stress disorder, there exist large unexplained individual differences in the severity and chronicity of symptoms. For this reason, attention has begun to focus on those variables that might mediate between disaster and subsequent outcome. One such variable is crisis support. However, it has been suggested that associations between self-report measures of support and symptoms may be a function of attributional style and coping style. It is shown in the present study that crisis support is able to predict symptoms over and above attributional style and coping style.",0,0 +3900,Psychosocial Interventions and Therapeutic Support as a Standard of Care in Pediatric Oncology,"Research indicates that a subset of youths with childhood cancer and their parents will experience significant psychological distress throughout the course of their illness. Importantly, the existing literature indicates that psychosocial support is beneficial in decreasing symptoms of distress in these families. The aim of the current review is to determine the extent of the evidence to support a standard of psychosocial care for children and their families throughout the cancer trajectory; thus, we examined the research related to psychosocial outcomes in youth with cancer and their parents.",0,0 +3901,Posttraumatic stress disorder: the etiologic specificity of wartime stressors,"The authors examined the effects of wartime stressors in a sample of 69 Vietnam veterans who were psychiatric inpatients in a Veterans Administration hospital. Participation in atrocities and the cumulative exposure to combat stressors, each independently of the other, conferred a significant risk for posttraumatic stress disorder. In contrast, the effect of these war experiences on the onset of panic, major depression, and mania was not significant. The results indicate that extreme stressors are uniquely linked with posttraumatic stress disorder's characteristic cluster of symptoms but challenge DSM-III's implicit assumption that the reexperienced trauma is the stressor responsible for posttraumatic stress disorder.",0,0 +3902,The latent structure of acute stress disorder: A posttraumatic stress disorder approach.,"Acute stress disorder (ASD) was first included in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) to account for the psychological symptoms present during the one-month period between trauma exposure and a posttraumatic stress disorder (PTSD) diagnosis. The diagnostic criteria sets of both ASD and PTSD are similar; however, ASD includes additional dissociative items. Factor analytic research into ASD is rare, whereas there is a plethora of research on the factor structure of PTSD symptoms. This study tested whether the latent structure of ASD is similar to the latent structure of PTSD. Five models were tested by using data from Danish rape victims (N = 380); a unidimensional model, the DSM-IV 4-factor ASD model, a King, Leskin, King, and Weathers (1998) replication model, a Simms, Watson, and Doebbeling (2002) replication model, and a 3-factor model. Model fit was assessed by using a number of fit indices, including the root-mean-square error of approximation, comparative fit index, Tucker-Lewis index, and standardized root-mean-square residual. However, based on the fit indices, 3 models were deemed indistinguishable. Chi-square difference tests concluded that a 3-factor model and two 4-factor models did not differ in fit. Overall, the current 4-factor ASD latent structure proposed by the DSM-IV was not supported. A 3-factor structure was deemed preferential on the basis of parsimony. Furthermore, of all models, the unidimensional model provided the poorest fit to the data. These findings are pertinent given that the DSM-5 ASD task force is considering implementing either a 4-factor conceptualization or a unidimensional approach to the ASD diagnosis. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +3903,The role of DNA methylation in stress-related psychiatric disorders,"Epigenetic modifications in response to traumatic experience and stress are emerging as important factors in the long-term biological trajectories leading to stress-related psychiatric disorders, reflecting both environmental influences as well as individual genetic predisposition. In particular, recent evidence on DNA methylation changes within distinct genes and pathways but also on a genome-wide level provides new insights into the pathophysiology of stress related psychiatric disorders. This review summarizes current findings and concepts on DNA methylation changes in stress-related disorders with a focus on major depressive disorder and posttraumatic stress disorder (PTSD). We highlight studies of DNA methylation in animals and humans pertinent to these disorders, both focusing on candidate loci as well as genome-wide studies. We describe molecular mechanisms of how exposure to stress can induce long lasting changes in DNA methylation and how these may relate to the pathophysiology of depression and PTSD. We discuss data suggesting that DNA methylation, even in peripheral tissues, appears to be an informative reflection of environmental exposures on the genome and may have potential as a biomarker for the early prevention of stress-related disorders.",0,0 +3904,A history in-care predicts unique characteristics in a homeless population with mental illness,"Multiple studies of homeless persons report an increased prevalence of a history in-care, but there is a dearth of information on associated outcomes or relevant demographic profiles. This information is critical to understanding if certain individuals are at elevated risk or might benefit from specific intervention. Here, we investigate how a history in-care relates to demographics and multiple outcome measures in a homeless population with mental illness. Using the Mini International Neuropsychiatric Interview (MINI), the Short-Form 12, and a trauma questionnaire, we investigated baseline differences in demographics and length of homelessness in the At Home/Chez Soi Trial (N=504) Winnipeg homeless population with and without a history in-care. Approximately 50% of the homeless sample reported a history in-care. This group was significantly more likely to be young, female, married or cohabitating, of Aboriginal heritage, have less education, and have longer lifetime homelessness. Individuals of Aboriginal heritage with a history in-care were significantly more likely to report a familial history of residential school. Individuals with a history in-care experienced different prevalence rates of Axis 1 mental disorders. Those with a history in-care also reported significantly more traumatic events (particularly interpersonal). A distinctive high-risk profile emerged for individuals with a history in-care. Sociocultural factors of colonization and intergenerational transmission of trauma appear to be particularly relevant in the trajectories for individuals of Aboriginal heritage. Given the high prevalence of a history in-care, interventions and policy should reflect the specific vulnerability of this population, particularly in regards to trauma-informed services.",0,0 +3905,Differences in PTSD Prevalence and Associated Risk Factors Among World Trade Center Disaster Rescue and Recovery Workers,"This study compared the prevalence and risk factors of current probable posttraumatic stress disorder (PTSD) across different occupations involved in rescue/recovery work at the World Trade Center site.Rescue and recovery workers enrolled in the World Trade Center Health Registry who reported working at the World Trade Center site (N=28,962) were included in the analysis. Interviews conducted 2-3 years after the disaster included assessments of demographic characteristics, within-disaster and work experiences related to the World Trade Center, and current probable PTSD.The overall prevalence of PTSD among rescue/recovery workers was 12.4%, ranging from 6.2% for police to 21.2% for unaffiliated volunteers. After adjustments, the greatest risk of developing PTSD was seen among construction/engineering workers, sanitation workers, and unaffiliated volunteers. Earlier start date and longer duration of time worked at the World Trade Center site were significant risk factors for current probable PTSD for all occupations except police, and the association between duration of time worked and current probable PTSD was strongest for those who started earlier. The prevalence of PTSD was significantly higher among those who performed tasks not common for their occupation.Workers and volunteers in occupations least likely to have had prior disaster training or experience were at greatest risk of PTSD. Disaster preparedness training and shift rotations to enable shorter duration of service at the site may reduce PTSD among workers and volunteers in future disasters.",0,0 +3906,"Relationships Among Predeployment Risk Factors, Warzone-Threat Appraisal, and Postdeployment PTSD Symptoms","Previous research indicates a relationship between perceived fear for one's safety (i.e., threat appraisal) and posttraumatic stress disorder (PTSD). This prospective study examined relationships among deployment- and predeployment-related variables, threat appraisal, and postdeployment PTSD symptom severity. Prior to Iraq deployment, 774 U.S. Army soldiers completed self-report measures assessing previous life stressors, deployment history, current (predeployment) PTSD symptoms, deployment preparedness, and unit cohesion. Following deployment, participants completed self-report measures assessing combat intensity, deployment threat appraisal, and current (postdeployment) PTSD symptoms. Structural equation modeling revealed that predeployment PTSD symptom severity, prior warzone deployment, unit cohesion, and preparedness were each independently associated with deployment threat appraisal, even after taking into account combat intensity. Deployment threat appraisal was associated with postdeployment PTSD severity. Results indicated that predeployment PTSD symptom severity, history of warzone deployment, and preparedness-risk factors previously thought to influence PTSD outcomes directly-were either partially or fully mediated by threat appraisal. The model explained 15% of the variance in deployment threat appraisal and 50% of the variance in postdeployment PTSD severity. Helping service members cope with exposure to extreme stress during deployment by modifying certain prewar risk factors may facilitate reduction of PTSD symptoms following deployment.",0,0 +3907,Determining the Relative Importance of Predictors in Logistic Regression: An Extension of Relative Weight Analysis,"Techniques such as dominance analysis and relative weight analysis have been proposed recently to evaluate more accurately predictor importance in ordinary least squares (OLS) regression. Similar questions of predictor importance also arise in instances where logistic regression is the primary mode of analysis. This article presents an extension of relative weight analysis that can be applied in logistic regression and thus aids in the determination of predictor importance. We briefly review relative importance techniques and then discuss a new procedure for calculating relative importance estimates in logistic regression. Finally, we present a substantive example applying this new approach to an example data set.",0,0 +3908,Impact of combat and non-military trauma exposure on symptom reduction following treatment for veterans with posttraumatic stress disorder,"Military veterans with posttraumatic stress disorder (PTSD) frequently report exposure to multiple other traumas in addition to their military experiences. This study aimed to examine the impact of exposure-related factors for military veterans with PTSD on recovery after participation in a group-based treatment program. Subjects included 1548 military veterans with PTSD participating in specialist veterans' PTSD programs across Australia. The study included measures of PTSD, depression, anxiety and alcohol use. Analyses of variance found higher combat exposure was associated with more severe PTSD at intake. No differences in PTSD intake severity were evident in those with additional non-military trauma. Severity of combat exposure did not affect treatment outcomes, although those with low combat exposure and additional non-military trauma (which included high rates of molestation) did report reduced symptom improvement. These findings have implications for considerations of optimal interventions for those with lower levels of combat exposure and additional non-military trauma.",0,0 +3909,Mortality rates between treated post-traumatic stress disorder Israeli male veterans compared to non-diagnosed veterans,"The literature suggests that post-traumatic stress disorder (PTSD) is associated with increased mortality. However, to date, mortality rates amongst veterans diagnosed with post-traumatic stress disorder have not been reported for Israeli veterans, who bear a different profile than veterans from other countries. This study aims to evaluate age-adjusted mortality rates amongst Israeli Defense Forces veterans with and without PTSD diagnosis. The study was carried out in a paired sample design with 2457 male veterans with treated PTSD and 2457 matched male veterans without a PTSD diagnosis. Data on PTSD and non-PTSD veterans was collected from the Rehabilitation Division of the Israeli Ministry of Defense (MOD) and the Israeli Defense Forces' (IDF) special unit for treatment of combat stress reaction. Mortality data were collected from the Ministry of the Interior (MOI) computerized database. Comparison of mortality rates between PTSD and non-PTSD veterans was done using paired observations survival analysis by applying a proportional hazards regression model. Overall no statistically significant difference in mortality rates was found between veterans with treated PTSD and veterans without PTSD. These findings hold even when excluding veterans who died in battle and including non-PTSD veterans who died before their matched PTSD veteran was diagnosed. However, among pairs with similar military jobs PTSD group had significantly less mortality. The results of this large national cohort suggest that treated PTSD is not associated with increased mortality. We submit that the lack of this association represents the ""net"" pathophysiology of PTSD due to the unique characteristics of the sample.",0,0 +3910,Group-Based Trajectory Modeling (Nearly) Two Decades Later,"The Author(s) 2010. This article is published with open access at Springerlink.com Nearly two decades have passed since the publication of ‘‘Age, Criminal Careers, and Population Heterogeneity: Specification and Estimation of a Nonparametric Mixed Poisson Model’’ by Nagin and Land (1993). In that article Nagin and Land laid out a statistical method that has come to be called group-based trajectory modeling. The principle objective of the paper was to address issues related to the ‘‘hot topic’’ of the time—the criminal career debate—not to lay out a new statistical methodology. As described in the paper’s abstract, these issues were: ‘‘First, is the life course of individual offending patterns marked by distinctive periods of quiescence? Second, at the level of the individual, do offending rates vary systematically with age? In particular, is the age-crime curve single peaked or flat? Third, are chronic offenders different from less active offenders? Do offenders themselves differ in systematic ways?’’ Figure 1 reports Nagin’s (2005) updated version of the trajectories reported in Nagin and Land (1993). The analysis is based on the classic dataset assembled by Farrington and West (1990), which includes data on convictions from age 10 to 32 in a sample of over 400 males from a poor neighborhood in London, England. A four group model, analyzed using the zero-inflated Poisson modeling option, was found to best fit the data. The largest trajectory group accounted for 69.5% of the population, and was composed of individuals who generally had no convictions. The three offending trajectories included an adolescentlimited group (12.4% of the population), which peaked sharply in late adolescence, and then declined to a near zero rate of offending by age 20, a high chronic trajectory (5.9% of the population) with a high-humped shaped trajectory and a low rate chronic trajectory that accounted for the remaining 12.2% of the population. Also, shown in the figure are 95% confidence intervals around each trajectory. The dominant legacy of Nagin and Land (1993), however, was not its answers to the specific questions listed in the abstract but the methodology itself. A review of applications",0,0 +3911,Coping with Gulf War combat stress: Mediating and moderating effects.,,0,0 +3912,Thirty years of using a series of personality questionnaires constructed by computer.,"The series of personality questionnaires constructed using a computer was created on the basis of cybernetic theories of personality, which presupposes the existence of six conative control systems: a system for the regulation of defense responses, a system for the regulation of attack responses, a system for controlling physiological functions, a system for coordination of regulatory functions, system for integration of regulatory functions and system for regulation of activity. Six personality questionnaires measure the intensity of the following pathological personality tendencies: 1. neurasthenia and anxiety, 2. aggressiveness and impulsiveness, 3. conversive neurotic disorders, 4. psychotic dissociation, 5. psychotic regression and 6. extroversion-introversion.The sample consisted of 4368 persons: 3496 subjects without a diagnosis, and 872 patients with a psychiatric diagnosis. Participants had to fill in the six personality questionnaire. Data were collected anonymously, during psychological treatment at the Neuropsychiatric Hospital ""Dr. Ivan Barbot"" in Popovača, at the Department of Occupational Medicine and Transport and the Department of Mental Health and Addiction Prevention at Dr. Andrija Štampar Institute of Public Health and for the purpose of selection of candidates for employment in the period from 1984 until today. Basic metric characteristics were determined for all scales. Factor structure of the scales was determined using principal component analysis; as canonical discriminant analysis, polar taxons analysis and canonical correlation analysis are special cases of factor analysis, results of factor analysis were used for further processing.Results from earlier studies are replicated on much larger sample: metric characteristics of scales are very good, as in previous studies, similar structure of polar taxons was found and discrimination between healthy subjects ad those with psychiatric diagnoses was successful. Canonical correlation analysis showed interconnection of reactions on certain scales and extremely complex relationship between them which indirectly confirms the theoretical model on the basis of which the scales are formed.The usefulness of this scales is confirmed in clinical setting and in selection of candidates for employment.",0,0 +3913,Symptoms of post-traumatic stress disorder after non-traumatic events: evidence from an open population study,"Post-traumatic stress disorder (PTSD) is the only psychiatric condition that requires a specific event to have occurred for its diagnosis.To gather evidence from the adult general population on whether life events (e.g. divorce, unemployment) generate as many symptoms of post-traumatic stress as traumatic events (e.g. accidents, abuse).Data on demographic characteristics and history of stressful events were collected through a written questionnaire sent to a random sample of 2997 adults. Respondents also filled out a PTSD symptom checklist, keeping in mind their worst event. Mean PTSD scores were compared, controlling for differences between the two groups. Differences in item scores and in the distribution of the total PTSD scores were analysed.Of the 1498 respondents, 832 were eligible for inclusion in our analysis. For events from the past 30 years the PTSD scores were higher after life events than after traumatic events; for earlier events the scores were the same for both types of events. These findings could not be explained by differences in demographics, history of stressful events, individual item scores, or the distribution of the total PTSD scores.Life events can generate at least as many PTSD symptoms as traumatic events. Our findings call for further studies on the specificity of traumatic events as a cause of PTSD.",0,0 +3914,Family cohesion and posttraumatic intrusion and avoidance among war veterans: a 20-year longitudinal study,"Background: The bi-directional relationships between combat-induced posttraumatic symptoms and family relations are yet to be understood. The present study assesses the longitudinal interrelationship of posttraumatic intrusion and avoidance and family cohesion among 208 Israeli combat veterans from the 1982 Lebanon War. Methods: Two groups of veterans were assessed with self-report questionnaires 1, 3 and 20 years after the war: a combat stress reaction (CSR) group and a matched non-CSR control group. Results: Latent Trajectories Modeling showed that veterans of the CSR group reported higher intrusion and avoidance than non-CSR veterans at all three points of time. With time, there was a decline in these symptoms in both groups, but the decline was more salient among the CSR group. The latter also reported lower levels of family cohesion. Furthermore, an incline in family cohesion levels was found in both groups over the years. Most importantly, Autoregressive Cross-Lagged Modeling among CSR and non-CSR veterans revealed that CSR veterans' posttraumatic symptoms in 1983 predicted lower family cohesion in 1985, and lower family cohesion, in turn, predicted posttraumatic symptoms in 2002. Conclusions: The findings suggest that psychological breakdown on the battlefield is a marker for future family cohesion difficulties. Our results lend further support for the bi-directional mutual effects of posttraumatic symptoms and family cohesion over time. © 2012 Springer-Verlag.",0,0 +3915,Autonomic dysfunction in women with chronic pelvic pain,"We compared the Autonomic Symptom Profile results in 16 women with chronic pelvic pain (CPP) and 15 age-matched healthy subjects. Moderately severe generalized autonomic symptomology occurs in women with CPP, but not in controls. Further study including autonomic testing is needed to confirm results and explore the mechanism of dysfunction.",0,0 +3916,You want to measure coping but your protocol’ too long: Consider the brief cope,"Studies of coping in applied settings often confront the need to minimize time demands on participants. The problem of participant response burden is exacerbated further by the fact that these studies typically are designed to test multiple hypotheses with the same sample, a strategy that entails the use of many time-consuming measures. Such research would benefit from a brief measure of coping assessing several responses known to be relevant to effective and ineffective coping. This article presents such a brief form of a previously published measure called the COPE inventory (Carver, Scheier, & Wcintraub, 1989), which has proven to be useful in health-related research. The Brief COPE omits two scales of the full COPE, reduces others to two items per scale, and adds one scale. Psychometric properties of the Brief COPE arc reported, derived from a sample of adults participating in a study of the process of recovery after Hurricane Andrew.",0,0 +3917,Posttraumatic Concerns: A Patient-Centered Approach to Outcome Assessment After Traumatic Physical Injury,"Approximately 2.5 million Americans are admitted to the hospital after traumatic physical injury each year. Few investigations have elicited patients' perspectives regarding posttraumatic outcomes.To identify and categorize physically injured trauma survivors' posttraumatic concerns.Prospective longitudinal investigation; trauma survivors were interviewed during the post-injury hospitalization and again 1, 4, and 12 months after the trauma.Ninety-seven, randomly selected, English speaking, hospitalized survivors of motor vehicle-crashes or assaults.At the end of each interview patients were asked, ""Of all the things that have happened to you since you were injured, what concerns you the most?"" Using an iterative process and working by consensus, investigators categorized patient concerns in content domains. Concern domains were then compared with established measures of posttraumatic stress disorder (PTSD) symptoms and limitations in physical functioning.Seven categories of posttraumatic concerns were identified. During the course of the year, 73% of patients expressed physical health concerns, 58% psychological concerns, 53% work and finance concerns, 40% social concerns, 10% legal concerns, 10% medical concerns, and 20% uncodable concerns. Rater agreement on concern categorization was substantial (kappa = 0.72). The mean number of concerns expressed per patient gradually decreased over time (1 month mean = 1.51; 12 month mean = 1.26) and resembled the trajectories of PTSD symptoms and functional limitations.The concerns of physically injured trauma survivors are readily elicited and followed up during the course of the year after injury. Open-ended inquiry regarding posttraumatic concerns may complement standardized outcome assessments by identifying and contextualizing the outcomes of greatest importance to patients.",0,0 +3918,Child Mental Health in the Aftermath of Disaster: A Review of PTSD Studies,"INTRODUCTION Epidemiological investigations provide strong evidence that experiencing disaster-related traumatic events in childhood can have significant adverse psychopathological consequences (Hoven et al., 2005; La Greca, Silverman, Vernberg, & Prinstein, 1996; Lonigan, Shannon, Finch, Jr., Daugherty, & Taylor, 1991). Clearly, understanding how such exposure to disaster affects children's mental health and psychosocial development is important, both for elucidating vulnerabilities specific to children, and for informing and guiding appropriate responses, including treatment, which fosters resilience and speeds recovery. The greatest promise for advancing knowledge on this topic depends upon systematic assessment, using diagnostic-based measures in well-designed, longitudinal investigations of representative samples of children (in sufficient numbers) to allow for meaningful analyses. Unfortunately, to date, no study with children that includes all of these elements could be identified. As a nascent field of inquiry, disaster mental health research in children is now ideally poised to review its own recent research, including emphasis and approach, so as to determine a future trajectory. In an effort to stimulate and facilitate this process and to identify critical knowledge gaps, this chapter systematically examines the extant literature, focusing on methodological issues. In an effort to identify lacunae in our collective research agenda, we offer a conceptual typology, or classification schema, for reviewing the kinds of disasters that have been studied and the research methods employed. © Cambridge University Press 2009.",0,0 +3919,Community Resilience and the Principles of Mass Trauma Intervention,"Drawing upon literatures in several disciplines, Norris and colleagues (in press) concluded that the resilience of communities, and consequently the wellness of communities, rests upon a network of adaptive capacities, particularly Economic Development, Social Capital, Information and Communication, and Community Competence. There are numerous ways in which efforts to build community resilience might also achieve the five essential elements of mass trauma intervention explicated by Hobfoll and colleagues. Thus, it is argued here that efforts to reduce risk and resource inequities, engage local people in mitigation, create organizational linkages, boost and protect social supports, cultivate trusted and responsible information resources, and enhance decision–making skills will augment more specific intervention efforts to promote safety, calming, efficacy, hope, and connectedness in the aftermath of mass trauma. Many of these outcomes require systems and social changes that can be the target of intervention efforts before as well as after disasters.",0,0 +3920,NEO-PI profiles in PTSD as a function of trauma level,"One hundred Vietnam veterans with combat-related PTSD were administered the NEO Personality Inventory (NEO-PI) and the Combat Exposure Scale and were sorted into three groups based on trauma exposure level. Results indicate no significant differences among the personality profiles of the three trauma-exposed groups. A normative NEO-PI profile for persons diagnosed with combat-related PTSD is presented, characterized by an extremely high Neuroticism score (T > 75) and an extremely low Agreeableness score (T < 25).",0,0 +3921,Auditory Startle Response in Trauma Survivors With Posttraumatic Stress Disorder: A Prospective Study,"Previous studies have shown elevated autonomic responses to startling tones in trauma survivors with chronic posttraumatic stress disorder (PTSD). The origin of these abnormal responses is obscure. The present study attempted to clarify this issue by prospectively evaluating responses to sudden, loud tones in individuals who arrived at a hospital emergency room after psychologically traumatic events.By using a previously established protocol, autonomic and muscular responses to the tones were evaluated at 1 week, 1 month, and 4 months after the traumatic event. Structured diagnostic interviews performed at 4 months classified subjects into groups with (N=36) and without (N=182) PTSD, which were further subdivided according to the presence or absence of major depressive disorder as follows: neither PTSD nor depression (N=166), depression alone (N=16), PTSD alone (N=21), and both PTSD and depression (N=15).The groups showed comparable physiological responses to the tones at 1 week posttrauma. However, at 1 and 4 months posttrauma, the subjects with PTSD showed a greater heart rate response and required more stimulus trials to reach the criteria of skin conductance and orbicularis oculi electromyogram nonresponse. These findings were not significantly influenced by comorbid depression and were not explained by the severity of the traumatic event or by the intensity of the initial symptoms.Differences in physiological response to startling tones develop along with PTSD in the months that follow a traumatic event. This pattern supports the theories that associate PTSD with progressive neuronal sensitization.",0,0 +3922,"Post-traumatic stress symptom, metacognition, emotional schema and emotion regulation: A structural equation model","Abstract Objective The present study aimed to assess the direct and indirect impacts of the metacognition, emotional schema and emotion regulation in prediction of post-traumatic stress (PTS) symptom. Method Participants consisted of 678 high school students from earthquake-stricken areas of eastern Azerbaijan selected from Varzaghan, Ahar and Heris by multistage cluster sampling. PTSD Symptom Scale—Self Report (PSS-SR), Metacognition Questionnaire—Adolescent Version (MCQ-A), Leahy Emotional Schema Scale (LESS) and Difficulties in Emotion Regulation Scale (DERS) were utilized for data collection. SPSS software and LISREL software were used for data analysis. Results The results of SEM and path analysis indicated the direct and indirect (through emotion regulation) impacts of metacognition and also indirect (through emotion regulation) impact of emotional schema on PTS symptom. Model examination presented the good fitness of the proposed theoretical model. Conclusions Consistent with metacognitive model and also emotional schema model, results of this study indicated the impact of metacognition and emotional schema on post-traumatic stress symptom through emotion regulation. This finding emphasizes that both metacognitive and emotional factors are important in explanation of PTS symptom.",0,0 +3923,Five psychosocial variables related to the existence of Post-Traumatic Stress Disorder symptoms,"Sixty Vietnam veterans from a midwestern VA Medical Center were surveyed to determine the relationship between symptoms of Post-Traumatic Stress Disorder (PTSD) and five psychosocial variables: Intensity of combat experienced in Vietnam, current subjective impact of the previously experienced stress of Vietnam experiences, current level of life stress, extent and nature of social support available to the veteran during the first year of return from Vietnam, and pre-service psychosocial functioning. A stepwise discriminant function analysis revealed that combat intensity, current impact of the previously experienced events in Vietnam, and current level of life stress correctly classified 75% of the total cases. These findings were supported by other lines of analyses, including tests of correlation and stepwise regression analysis. Current levels of life stress, especially disruption in interpersonal relationships, also were associated significantly with PTSD symptoms. These findings are consistent with previous reports on the etiology and correlates of PTSD symptoms and suggest the existence of a quantifiable constellation of symptoms associated with psychological sequelae of severely stressful trauma.",0,0 +3924,Post traumatic stress disorder in armed robbery victims and ex-prisoners of war,"The aim of this study was to examine the prevalence of Post Traumatic Stress Disorder (PTSD) symptom clusters in 72 armed robbery victims (AR) at their work place. 19 were assaulted twice or three times, while 15 suffered mild or minor physical injury. Subjects were 47 female and 25 male employees who were having 1 to 11 months of sick leave period at the time of examination. According to psychiatric examination 38.9% fulfilled criteria for PTSD, while others had different combination of symptoms. Statistical analysis showed that the whole group dominantly expressed persistent re-experience of the event, followed by arousal symptoms. Those with full PTSD diagnosis did not differ from others in age, level of education, number of assaults, length of sick leave period or the fact that they had or had not been physically injured. No difference was found between those who suffered only one attack and those who were assaulted two or three times in a short period of time. The repetition of identical or very similar trauma situation did not contribute to the increased number of psychological problems measured by PTSD scales. Additionally we compared the structure of PTSD in AR victims and in a group of 100 male ex-prisoners of war (ex-POW). The results indicate greater occurrence of full PTSD in AR group, as well as re-experience and arousal symptoms combination in those with partial PTSD, while ex-POW group dominantly showed arousal symptoms as isolated cluster, followed by combination of re-experience and arousal symptoms.",0,0 +3925,Screening in special populations: A “case study” of recent vietnamese immigrants,"

Purpose

To determine how the medical and social profile of a particular special population, Vietnamese immigrants, should be used to tailor screening protocols that differ from those designed for the general population.

Patients and methods

A consecutive series of Vietnamese immigrants living in the United States for less than 6 months were evaluated by interviewer-administered standardized questionnaire and medical record review. A total of 99 new Vietnamese immigrants (47 women and 52 men) aged 19 to 71 years presenting for primary care to two neighborhood health centers between October 1994 and June 1995 were identified. Data collected included smoking status, alcohol use (CAGE questionnaire), depression (Vietnamese Depression Scale [VDS]), PPD status, stool ova and parasites, hepatitis B and syphilis serologies.

Results

Overall, 32% were smokers and significantly more men than women smoked (54% vs. 9%) (P <.00001). Although 24% of patients used alcohol, none responded positively to any of the CAGE questions. Using the VDS, 17% (17 of 99) were depressed; age 40 and older was the only sociodemographic factor associated with depression (P <.00001). Ova or parasites were found in 51% (41 of 80), and 63% of those infected (26 of 41) required treatment for pathogenic infections. Seventy percent (66 of 94) tested positive on the tuberculin skin test (PPD), and antituberculous medication was recommended in 39% (37 of 94). Eighty-three percent (80 of 96) had been exposed to hepatitis B, and 14% (13 of 96) were chronic hepatitis B carriers.

Conclusions

Caring for special populations provides an opportunity to institute appropriate unique screening tests not recommended for the general population. In the case of new Vietnamese immigrants, routine screening protocols should include the following: testing for tuberculosis by PPD, stool ova and parasite examinations, hepatitis B serologies, and assessment for depression and smoking status. The CAGE questionnaire may not be an effective instrument for detecting alcohol abuse in this particular population.",0,0 +3926,Procedural justice and quality of life in compensation processes,"There is considerable evidence that being involved in compensation processes has a negative impact on claimants' health. Previous studies suggested that this negative effect is caused by a stressful compensation process: claimants suffered from a lack of communication, a lack of information, and feelings of distrust. However, these rather qualitative findings have not been quantitatively investigated yet. This observational study aimed to fill this gap of knowledge, investigating the claimants' perceived fairness of the compensation process, the provided information, and the interaction with lawyers and insurance companies, in relation to the claimants' quality of life.Participants were individuals injured in traffic accidents, older than 18 years, who were involved in a compensation process in the Netherlands. They were recruited by three claims settlement offices. Outcome measures were procedural, interactional, and informational justice, and quality of life.Participants (n=176) perceived the interaction with lawyers to be fairer than the interaction with insurance companies (p<.001). The length of hospital stay was positively associated with procedural justice (β=.31, p<.001). Having trunk/back injury was negatively related to procedural justice (β=-.25, p=.001). Whiplash injury and length of time involved in the claim process were not associated with any of the justice scales. Finally, procedural justice was found to be positively correlated with quality of life (rs=.22, p=.004).The finding that the interaction with insurance companies was considered less fair than the interaction with lawyers may imply that insurers could improve their interaction with claimants, e.g. by communicating more directly. The result that claimants with mild injuries and with trunk/back injuries considered the compensation process to be less fair than those with respectively severe injuries and injuries to other body parts suggests that especially the former two require an attentive treatment. Finally, the fact that procedural justice was positively correlated with quality of life could implicate that it is possible to improve claimants' health in compensation processes by enhancing procedural justice, e.g. by increasing the ability for claimants to express their views and feelings and by involving claimants in the decision-making process.",0,0 +3927,Flooding and Mental Health: A Systematic Mapping Review,"Floods are the most common type of global natural disaster. Floods have a negative impact on mental health. Comprehensive evaluation and review of the literature are lacking.To systematically map and review available scientific evidence on mental health impacts of floods caused by extended periods of heavy rain in river catchments.We performed a systematic mapping review of published scientific literature in five languages for mixed studies on floods and mental health. PUBMED and Web of Science were searched to identify all relevant articles from 1994 to May 2014 (no restrictions).The electronic search strategy identified 1331 potentially relevant papers. Finally, 83 papers met the inclusion criteria. Four broad areas are identified: i) the main mental health disorders-post-traumatic stress disorder, depression and anxiety; ii] the factors associated with mental health among those affected by floods; iii) the narratives associated with flooding, which focuses on the long-term impacts of flooding on mental health as a consequence of the secondary stressors; and iv) the management actions identified. The quantitative and qualitative studies have consistent findings. However, very few studies have used mixed methods to quantify the size of the mental health burden as well as exploration of in-depth narratives. Methodological limitations include control of potential confounders and short-term follow up.Floods following extreme events were excluded from our review.Although the level of exposure to floods has been systematically associated with mental health problems, the paucity of longitudinal studies and lack of confounding controls precludes strong conclusions.We recommend that future research in this area include mixed-method studies that are purposefully designed, using more rigorous methods. Studies should also focus on vulnerable groups and include analyses of policy and practical responses.",0,0 +3928,Patterns of recovery from trauma: The use of intraindividual analysis.,"Patterns of recovery from sexual and nonsexual assault were examined. Two studies containing data from female victims of these assaults were analyzed. In Study 1, victims (N = 101) underwent 12 weekly assessments with measures of posttraumatic stress disorder (PTSD), depression, and state anxiety. In Study 2, victims (N = 108) underwent monthly assessments on the same measures. The authors examined the effects of type of trauma and time of peak reaction on long-term recovery using intraindividual analysis of change. In both studies, initial and peak reactions of rape victims were more severe than were those of nonsexual assault victims on all measures of psychopathology. Victims with delayed peak reaction exhibited more severe pathology at the final assessment than did victims with early peak reaction. Results of Study 2 indicated a slower recovery rate from sexual than nonsexual assault; in Study 1 a similar pattern of recovery emerged. The advantages of an individual-focused, longitudinal approach to recovery from a trauma are discussed.",0,0 +3929,Psychosocial care for seriously injured children and their families: A qualitative study among Emergency Department nurses and physicians,"Approximately one in five children who sustain a serious injury develops persistent stress symptoms. Emergency Department nurses and physicians have a pivotal role in psychosocial care for seriously injured children. However, little is known about staff's views on this role.Our aim was to investigate Emergency Department staff's views on psychosocial care for seriously injured children.We conducted semi-structured interviews with 20 nurses and physicians working in an Australian Paediatric Emergency Department. We used purposive sampling to obtain a variety of views. The interviews were transcribed verbatim and major themes were derived in line with the summative analysis method. We also mapped participants' strategies for child and family support on the eight principles of Psychological First Aid (PFA).Five overarching themes emerged: (1) staff find psychosocial issues important but focus on physical care; (2) staff are aware of individual differences but have contrasting views on vulnerability; (3) parents have a central role; (4) staff use a variety of psychosocial strategies to support children, based on instinct and experience but not training; and (5) staff have individually different wishes regarding staff- and self-care. Staff elaborated most on strategies related to the PFA elements 'contact and engagement', 'stabilization', 'connection with social supports' and least on 'informing about coping'.The strong notion of individual differences in views suggests a need for training in psychosocial care for injured children and their families. In addition, further research on paediatric traumatic stress and psychosocial care in the ED will help to overcome the current paucity of the literature. Finally, a system of peer support may accommodate wishes regarding staff care.",0,0 +3930,"Toward an integrative model of the spectrum of mood, behavioral and personality disorders based on fear and anger traits: I. Clinical implications","Current formal psychiatric approaches to nosology are plagued by an unwieldy degree of heterogeneity with insufficient appreciation of the commonalities of emotional, personality, behavioral, and addictive disorders. We address this challenge by building a spectrum model that integrates the advantages of Cloninger's and Akiskalian approaches to personality and temperament while avoiding some of their limitations. We specifically propose that ""fear"" and ""anger"" traits--used in a broader connotation than in the conventional literature--provide an optimum basis for understanding how the spectra of anxiety, depressive, bipolar, ADHD, alcohol, substance use and other impulse-control, as well as cluster B and C personality disorders arise and relate to one another. By erecting a bidimensional approach, we attempt to resolve the paradox that apparently polar conditions (e.g. depression and mania, compulsivity and impulsivity, internalizing and externalizing disorders) can coexist without cancelling one another. The combination of excessive or deficient fear and anger traits produces 4 main quadrants corresponding to the main temperament types of hyperthymic, depressive, cyclothymic and labile individuals, which roughly correspond to bipolar I, unipolar depression, bipolar II and ADHD, respectively. Other affective temperaments resulting from excess or deficiency of only fear or anger include irritable, anxious, apathetic and hyperactive. Our model does not consider schizophrenia. We propose that ""healthy"" or euthymic individuals would have average or moderate fear and anger traits. We further propose that family history, course and comorbidity patterns can also be understood based on fear and anger traits. We finally discuss the implications of the new derived model for clinical diagnosis of the common psychiatric disorders, and for subtyping depression and anxiety as well as cognitive and behavioral styles. We submit this proposed schema represented herein as a heuristic attempt to build bridges between basic and clinical science.",0,0 +3931,The two-factorial symptom structure of post-traumatic stress disorder: depression–avoidance and arousal–anxiety,"The first part of this study showed that the DSM-III-R symptom structure of post-traumatic stress disorder (PTSD), i.e. criteria B (reexperience), C (avoidance-numbing), and D (arousal), and, consequently the diagnosis of PTSD, could not be validated in fire and car-accident victims. The aims of this study were to: (i) determine the factors as well as their structure in the symptoms of PTSD; and (ii) develop a new classification or typology of PTSD. Exploratory and confirmatory factor analyses and cluster analyses were employed to: (i) examine the factors in PTSD symptomatology; and (ii) find and validate adequate diagnostic criteria for PTSD. The Composite International Diagnostic Interview (CIDI), PTSD Module, was used between 7 and 9 months after the traumatic event in a study group of 185 victims of two different traumatic events, i.e. 130 fire and 55 car-accident victims. Our findings support the existence of two factors, i.e. a first labeled 'depression-avoidance (DAV) dimension', as it contains items reminiscent of depression and avoidance, and a second labeled 'the anxiety-arousal (AA) dimension', as it contains symptoms reminiscent of anxiety and increased arousal. Cluster analysis yielded two clusters, i.e. a cluster of subjects with PTSD cases and another with non-cases. Our PTSD algorithm was significantly less restrictive than the DSM-III-R diagnosis of PTSD. There are only quantitative, but no qualitative, differences between the cluster analytically derived classes.PTSD is not a well-delineated clinical entity, as there is a clinical continuum from PTSD non-cases to cases with less and more severe DAV and AA symptoms. It is more appropriate to express PTSD in terms of general severity of PTSD and severity of the DAV and AA dimensions.",0,0 +3932,"Longitudinal linkages between posttraumatic stress disorder and posttraumatic growth in adolescent survivors following the Wenchuan earthquake in China: A three-wave, cross-lagged study","The aim of this study is to examine the longitudinal relationships between posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) among adolescent survivors of the 2008 Wenchuan earthquake in China. The participants in our study included 245 adolescent survivors who were randomly selected from several primary and secondary schools in the counties of Wenchuan, which are the areas most severely affected by the Wenchuan earthquake. Participants completed the Revised Child PTSD Symptom Scale and the Posttraumatic Growth Inventory (PTGI) at 3.5 years after the earthquake (T1), 4.5 years after the earthquake (T2), and 5.5 years after the earthquake (T3). The results found that PTSD reported in T1 and T2 predicted subsequent PTG reported at T2 and T3 and that PTG did not predict PTSD from T1 to T3. In addition, the cross-sectional correlation between PTSD and PTG weakened from T1 to T3. These results indicate that PTSD and PTG can coexist in individuals after a traumatic experience, and they further suggest that the reduction in PTSD does not indicate the appearance of PTG.",0,0 +3933,The Role of Emotional Numbing in Sexual Functioning Among Veterans of the Iraq and Afghanistan Wars,"Post-traumatic stress disorder (PTSD) negatively impacts sexuality, yet few studies have evaluated which component of PTSD contributes to this known association. The present study examined which of four PTSD clusters (numbing, avoidance, intrusiveness, and hyperarousal) was most closely linked to sexual problems in a sample of 197 veterans from the Iraq or Afghanistan wars. Newly registered veterans completed a packet of questionnaires including standardized measures of PTSD and questions regarding sexual functioning. A stepwise logistic regression was performed to examine the relationship between symptom cluster and sexual functioning. As predicted, only the numbing cluster was retained in the regression model. The numbing cluster appears to be intimately tied to sexual functioning, assessment of which should be part of a comprehensive evaluation during the postdeployment readjustment phase. Those exhibiting numbing symptoms should be thoroughly assessed for sexual functioning problems and referred for treatment as necessary.",0,0 +3934,Predictors of healthy behaviour in long-term survivors of childhood cancer,"Aim. The objective of this study was to examine the factors contributing to healthy behaviour in young adult long-term survivors of childhood cancer. Background. Young adult childhood cancer survivors can adopt more healthy behaviour than the general population as a way to minimize the adverse consequences, that is, late effects of cancer and its treatment. Knowledge about the predictors of healthy behaviour in childhood cancer survivors can help providers assist young adult survivors with minimizing late effects. Design and methods. A cross-sectional correlational design and convenience sampling were used. Data were collected by mailed survey. Study measures included an investigator-developed demographic and disease form, the Mishel Uncertainty in Illness Scale-Community, the Post-traumatic Stress Disorder Index and the Health Promoting Lifestyle Profile II. Fifty-one per cent (N = 46) of eligible survivors responded to the survey. Data from 45 participants were used in the analyses. Results. 43·3% of variance in healthy behaviour was explained by a model that included uncertainty (β = −0·37, p = 0·007), post-traumatic stress symptoms (β = −0·10, p = −0·44), interactions with primary care providers (β = 0·33, p = 0·01) and a history of special educational assistance (β = −0·23, p = 0·06). Conclusion. Young adult childhood cancer survivors who have higher levels of uncertainty, higher levels of symptoms of post-traumatic stress, lower frequency of primary healthcare interaction and poorer cognitive resources were more likely to report lower levels of healthy behaviour. Relevance to clinical practice. The findings can guide the clinical assessment of young adult survivors with regard to their health behaviours and needs they may have for education and supportive care. Findings also help inform the design of health promotion interventions for this specific group of cancer survivors.",0,0 +3935,"Differential diagnosis of PTSD, schizophrenia, and depression with the MMPI-2","This study used 102 male, veteran, psychiatric inpatients to describe patterns of MMPI-2 clinical and content scales that most accurately discriminate among patients diagnosed with PTSD, schizophrenia, and depression. Single scale accuracy classification using scales PK and PS was unacceptably low. Optimally weighted scales, including PK, Sc, BIZ, and ANX, correctly classified 70% of the patients. Suggestions for facilitating the use of formal decision rules are offered. © 1999 John Wiley & Sons, Inc. J Clin Psychol 55: 217–223, 1999.",0,0 +3936,[Psychopathological profile of battered women according to age].,"In this paper, differential psychopathological consequences in battered women according to age were analysed in a sample of 148 victims seeking psychological treatment in a Family Violence Centre. The younger victims exposed to intimate partner violence suffered more often from physical violence and were at higher risk for their lives than the older ones. The prevalence rate of posttraumatic stress disorder (PTSD) was higher (42%) in the younger victims than in the older ones (27%). Likewise, younger victims were affected by more depressive symptoms and lower self-esteem than the older ones. The severity of PTSD in the younger victims was related to the presence of forced sexual relationship but in the older ones, it was related to the perceived threat to their lives. Implications of this study for clinical practice and future research in this field are commented upon.",0,0 +3937,Anxiety disorders as early stages of malignant psychopathological long-term outcomes: results of the 10-years prospective EDSP Study,"Introduction: Epidemiological studies consistently evidence that anxiety, depressive and substance use disorders are the most frequent mental disorders in adults with high rates of comorbidity. Little long-term outcome research has examined the psychopathological developmental trajectories which would allow for conclusions regarding improved early identification and targeted intervention. Methods: A representative community sample (N = 3,021; age 14-24) was prospectively followed-up over 10 years. Mental disorders were assessed using a standardized diagnostic interview (DSM-IV/M-CIDI). Results: While anxiety disorders reveal the earliest onset in childhood and adolescents, the incidence for depressive and substance use disorders increases in adolescence and young adulthood. Two thirds of those with an anxiety, depressive, or substance use disorder reveal comorbidity with an average of 3.3 diagnoses (SD = 1.7). Among those with any comorbidity, 79.1% meet criteria for a substance use disorder, 52.8% for a depressive disorder, and 59.6% for an anxiety disorder. While anxiety disorders emerge temporally primary in the majority of comorbid cases (74.2%), substance use (67.5%) and depressive disorders (71.8%) are mostly secondary onset conditions. Circumscribed phobias (specific phobia, social phobia, phobia NOS) and panic attacks increase the risk for onset of comorbid - more complex - anxiety disorders (GAD, panic disorder, agoraphobia, OCD, PTSD) (Hazard Ratio (HR) = 2.5, p < .001). Survival analyses with Cox regressions revealed that the higher the overall number of anxiety diagnoses, the greater the risk for subsequent substance use disorders (HR1 vs 0 Anx = 1.5, HR2 vs 0 Anx = 2.3, HR3+ vs 0 Anx = 2.6; p < .001), depression (HR1 vs 0 Anx = 2.0,HR2 vs 0 Anx = 2.6,HR3+ vs 0 Anx = 3.6; p < .001), and suicidality (HR1 vs 0 Anx = 3.8,HR2 vs 0 Anx = 4.8,HR3+ vs 0 Anx = 21.8; p < .001). Conclusions: Childhood and adolescent anxiety syndromes and disorders are an important gateway for unfavourable long-term psychopathological outcomes. Findings support 'sequential comorbidity' or 'staging models of psychopathology' which suggest that an early cascade of anxiety conditions contributes to a substantial proportion of adult substance use and depressive disorders, possibly due to self-medication and demoralization. Such models are of potential usefulness for diagnostic and treatment planning purposes, emphasizing the need for early identification and targeted interventions to prevent the onset of anxiety disorders and a cascade of secondary psychopathology.",0,0 +3938,Coping effectiveness and coping diversity under traumatic stress.,"The effectiveness of different strategies of coping and the impact of coping diversity were tested under traumatic stress conditions. Participants were 632 U.S. soldiers stationed in Iraq (mean age = 27.7, 98% male). Results indicate that four of nine functional coping strategies (including some emotion-focused coping) as defined by the COPE scale were inversely related to psychological symptom, whereas five of six dysfunctional strategies were positively related. Overall, in comparison to the norm group, soldiers showed a depressed level of functional coping strategies. Hierarchical regression, used to control for demographics and coping strategy intercorrelations, indicated that positive reinterpretation, emotional social support, and humor were most strongly related to lower psychological symptoms, whereas venting emotions, denial, mental disengagement, behavioral disengagement, and alcohol and drug use were related to higher levels of psychological symptoms. Two indices of coping diversity were tested. The index more strongly related to higher psychological adjustment was the sum of deviations from the mean of specific coping strategies combined with the alignment of functional and dysfunctional strategy clusters. Implications for research and application were discussed.",0,0 +3939,Anxiety Sensitivity as a Moderator of the Relation Between Trauma Exposure Frequency and Posttraumatic Stress Symptomatology,"The present study tested if the global anxiety sensitivity construct and its constituent factors (i.e., physical, mental incapacitation, and social concerns) moderate the relation between traumatic event exposure frequency and posttraumatic stress symptomatology. Participants were 61 rural young adults who reported experiencing at least 1 lifetime traumatic event. Consistent with prediction, anxiety sensitivity total and subfactor levels moderated the relation between trauma exposure frequency and posttraumatic stress symptomatology. These moderating effects were above and beyond variance accounted for by the respective anxiety sensitivity and stress main effects as well as other theoretically relevant factors (e.g., negative affectivity). Findings are discussed in relation to better understanding cognitive-based individual difference factors associated with posttraumatic stress symptomatology.",0,0 +3940,On growth curves and mixture models,"The multilevel model of change and the latent growth model are flexible means to describe all sorts of population heterogeneity with respect to growth and development, including the presence of sub-populations. The growth mixture model is a natural extension of these models. It comes at hand when information about sub-populations is missing and researchers nevertheless want to retrieve developmental trajectories from sub-populations. We argue that researchers have to make rather strong assumptions about the sub-populations or latent trajectory classes in order to retrieve existing population differences. A simulated example is discussed, showing that a sample of repeated measures drawn from two sub-populations easily leads to the mistaken inference of three sub-populations, when assumptions are not met. The merits of methodological advises on this issue are discussed. It is concluded that growth mixture models should be used with understanding, and offer no free way to growth patterns in unknown sub-populations. Copyright © 2006 John Wiley & Sons, Ltd.",0,0 +3941,Predictors of chronic posttraumatic stress symptoms following burn injury: Results of a longitudinal study,"The authors' goal was to examine the course and predictors of posttraumatic stress symptoms among persons hospitalized for burns. A total of 301 participants completed self-report measures assessing peritraumatic mental state, anxiety related to pain, and posttraumatic stress symptoms. Twenty-six percent of the participants were suffering from posttraumatic stress symptoms at 2-3 weeks postburn and 15% of them at 12 months postburns. In general, a decrease in symptoms was observed over time, although a substantial part of the participants with acute stress symptoms suffers from chronic posttraumatic stress symptoms 1-year postburn. Symptoms were predicted by anxiety measures and objective factors, such as female gender, locus, and severity of injury.",0,0 +3942,"ADX71743, a Potent and Selective Negative Allosteric Modulator of Metabotropic Glutamate Receptor 7: In Vitro and In Vivo Characterization","Metabotropic glutamate receptor 7 (mGlu(7)) has been suggested to be a promising novel target for treatment of a range of disorders, including anxiety, post-traumatic stress disorder, depression, drug abuse, and schizophrenia. Here we characterized a potent and selective mGlu(7) negative allosteric modulator (NAM) (+)-6-(2,4-dimethylphenyl)-2-ethyl-6,7-dihydrobenzo[d]oxazol-4(5H)-one (ADX71743). In vitro, Schild plot analysis and reversibility tests at the target confirmed the NAM properties of the compound and attenuation of L-(+)-2-amino-4-phosphonobutyric acid-induced synaptic depression confirmed activity at the native receptor. The pharmacokinetic analysis of ADX71743 in mice and rats revealed that it is bioavailable after s.c. administration and is brain penetrant (cerebrospinal fluid concentration/total plasma concentration ratio at C(max) = 5.3%). In vivo, ADX71743 (50, 100, 150 mg/kg, s.c.) caused no impairment of locomotor activity in rats and mice or activity on rotarod in mice. ADX71743 had an anxiolytic-like profile in the marble burying and elevated plus maze tests, dose-dependently reducing the number of buried marbles and increasing open arm exploration, respectively. Whereas ADX71743 caused a small reduction in amphetamine-induced hyperactivity in mice, it was inactive in the mouse 2,5-dimethoxy-4-iodoamphetamine-induced head twitch and the rat conditioned avoidance response tests. In addition, the compound was inactive in the mouse forced swim test. These data suggest that ADX71743 is a suitable compound to help unravel the physiologic role of mGlu(7) and to better understand its implication in central nervous system diseases. Our in vivo tests using ADX71743, reported here, suggest that pharmacological inhibition of mGlu(7) is a valid approach for developing novel pharmacotherapies to treat anxiety disorders, but may not be suitable for treatment of depression or psychosis.",0,0 +3943,"The association between childhood trauma and lipid levels in an adult low-income, minority population","BACKGROUND: The objective of this study is to investigate the association between childhood trauma and lipid profiles in adults from a highly traumatized population at-risk for cardiovascular disease. METHOD: We recruited 452 participants, primarily African-American and of low socioeconomic status, from general medical clinics in a large urban hospital. We performed direct comparisons, univariate analysis of variance and regression analyses together and separated by sex, examining the associations of child abuse, body mass index, lipid lowering drug use, blood pressure, age, and substance use to HDL levels and HDL/LDL ratios. RESULTS: A history of moderate to severe levels of childhood trauma and abuse was associated with a significant decrease in HDL levels (P≤.01) and HDL/LDL ratios (P≤.001) relative to males with low levels of abuse. This relationship held when the status of lipid-lowering drugs was considered. When controlling for age, substance abuse, tobacco use, and adult trauma, the effects of childhood trauma remained significant. We found a significant child abuse by sex interaction on HDL/LDL ratios [F(1,369)=13.0, P≤.0005] consistent with a differential effect of trauma on dyslipidemia in male but not female subjects. CONCLUSIONS: Our data suggest that childhood trauma exposure, obtained with self-report measures, may contribute to increased risk of cardiovascular disease by way of stress-mediated alterations of lipid concentration and composition in male, but not female, subjects. Language: en",0,0 +3944,Profile of two cohorts: UK and US prospective studies of military health,"Abstract : In the United Kingdom and United States, these two independent cohort studies have been instituted to prospectively study the health of service personnel and veterans. From comparisons with baseline information, these studies are designed to better inform the military and the public on how best to protect the health of their armed forces and better understand the long-term risks of some occupational exposures that extend beyond military communities. In order to do this, these studies consider: 1) The underlying physical and mental health of the military populations before, during, and after military service; and 2) The specific effects of deployment, deployment-related exposures, and other occupational exposures upon personnel compared with unexposed subgroups. Whilst previous studies have attempted to address these topics, they have often been limited in their generalisability to all service branches and components of the military, or previous population-based methodologies have been largely limited to cross-sectional or retrospective methods. Although follow-up to the National Vietnam Veterans Readjustment Survey, called the National Vietnam Veterans Longitudinal Study, is still ongoing, this study is focused on a single deployment. Similarly, the Air Force Health study, a 20-year longitudinal study of approximately 20,000 Vietnam veterans, assessed potential health effects associated with exposure to aerial spraying of dioxins. Here, we present two prospective, longitudinal, multi-service studies of active duty and Reserve/National Guard personnel that will continue to follow participants even after they have left military service. We describe these two studies in detail, comparing study populations, methodology, and the published literature so far. Potential areas for future collaboration are also explored. By understanding the inherent similarities and differences between these two cohorts and leveraging each study?s unique strengths and strategies to minimize",0,0 +3945,"Associations between body mass index, post-traumatic stress disorder, and child maltreatment in young women","The objective of this study was to examine interrelationships between child maltreatment, post-traumatic stress disorder (PTSD) and body mass index (BMI) in young women. We used multinomial logistic regression models to explore the possibility that PTSD statistically mediates or moderates the association between BMI category and self-reported childhood sexual abuse (CSA), physical abuse (CPA), or neglect among 3,699 young women participating in a population-based twin study. Obese women had the highest prevalence of CSA, CPA, neglect, and PTSD (p<.001 for all). Although all three forms of child maltreatment were significantly, positively associated with overweight and obesity in unadjusted models, only CSA was significantly associated with obesity after adjusting for other forms of maltreatment and covariates (OR=2.21, 95% CI: 1.63, 3.00). CSA and neglect, but not CPA, were associated with underweight in unadjusted models; however, after adjusting for other forms of maltreatment and covariates, the associations were no longer statistically significant (OR=1.43, 95% CI: 0.90-2.28 and OR=2.16, 95% CI: 0.90-5.16 for CSA and neglect, respectively). Further adjustment for PTSD generally resulted in modest attenuation of effects across associations of child maltreatment forms with BMI categories, suggesting that PTSD may, at most, be only a weak partial mediator of these associations. Future longitudinal studies are needed to elucidate the mechanisms linking CSA and obesity and to further evaluate the role of PTSD in associations between child maltreatment and obesity.",0,0 +3946,"Relationships between explanatory style, posttraumatic growth and posttraumatic stress disorder symptoms among Chinese breast cancer patients","Many existing models posit that cognitive processing style is an important factor affecting self-perceived positive changes. In this study, the effects of explanatory style (the manner in which people cognitively process and explain why they experience good and bad events) on both posttraumatic growth (PTG) and posttraumatic stress disorder (PTSD) symptoms were examined among 90 Chinese women with breast cancer. It was found that explanatory style for good events, but not for bad events, was significantly associated with self-reported PTG. Women who attributed the causes of positive events to internal, global and stable factors tended to report more posttraumatic growth. In contrast, explanatory style for bad events, as opposed to good events, was significantly and positively correlated with PTSD symptoms. Among the three dimensions of explanatory style (internal, stable and global), the tendency to globalise the causes of good and bad events were the most important predictors of self-reported PTG and PTSD symptoms, respectively. While enhancing an optimistic explanatory style for bad events might reduce posttraumatic stress symptoms, cultivating an optimistic explanatory style for good events is likely to increase self-perceived positive changes after breast cancer diagnosis and treatment.",0,0 +3947,Post-traumatic stress symptoms in Guillain-Barré syndrome patients after prolonged mechanical ventilation in ICU: a preliminary report,"Thirty percent of Guillain-Barré syndrome (GBS) patients require mechanical ventilation (MV) in intensive care unit (ICU). Post-traumatic stress disorder (PTSD) is found in ICU survivors, and the traumatic aspects of intubation and MV have been previously reported as risk factors for PTSD after ICU. Our objective was to determine long-term PTSD or post-traumatic stress symptoms (PTSS) in GBS patients after prolonged MV in ICU. We assessed GBS patients who had MV for more than 2 months. PTSD was assessed using Horowitz Impact of Event Scale (IES), IES-Revisited (IES-R), and the Post-traumatic CheckList Scale; functional outcome using Rankin and Barthel scales; quality of life (QoL) using Nottingham Health Profile (NHP) and 36-Item Short Form Health Survey (SF-36) and depression using Hospital Anxiety and Depression Scale (HAD) and Beck questionnaire. Thirteen patients could be identified and analyzed. They had only mild disability. They were neither anxious nor depressed with an anxiety HAD at 5 (4-11.5), a depression HAD at 1 (0-3.5) and a Beck at 1 (0-5). QoL was mildly decreased in our population with a NHP at 78.5 (12.8-178.8) and mild decreased SF-36. Compared with the French population, the SF-36 sub-categories were, however, not statistically different. Twenty-two percentage of our 13 patients had PTSD and PTSS with a Horowitz IES at 12 (2-29), and an IES-R at 16 (2-34.5). Although severe GBS patients requiring prolonged MV had good functional recovery and no difference in QoL, they had a high incidence of PTSS.",0,0 +3948,Modelling Psychological Responses to the Great East Japan Earthquake and Nuclear Incident,"The Great East Japan (Tōhoku/Kanto) earthquake of March 2011 was followed by a major tsunami and nuclear incident. Several previous studies have suggested a number of psychological responses to such disasters. However, few previous studies have modelled individual differences in the risk perceptions of major events, or the implications of these perceptions for relevant behaviours. We conducted a survey specifically examining responses to the Great Japan earthquake and nuclear incident, with data collected 11-13 weeks following these events. 844 young respondents completed a questionnaire in three regions of Japan; Miyagi (close to the earthquake and leaking nuclear plants), Tokyo/Chiba (approximately 220 km from the nuclear plants), and Western Japan (Yamaguchi and Nagasaki, some 1000 km from the plants). Results indicated significant regional differences in risk perception, with greater concern over earthquake risks in Tokyo than in Miyagi or Western Japan. Structural equation analyses showed that shared normative concerns about earthquake and nuclear risks, conservation values, lack of trust in governmental advice about the nuclear hazard, and poor personal control over the nuclear incident were positively correlated with perceived earthquake and nuclear risks. These risk perceptions further predicted specific outcomes (e.g. modifying homes, avoiding going outside, contemplating leaving Japan). The strength and significance of these pathways varied by region. Mental health and practical implications of these findings are discussed in the light of the continuing uncertainties in Japan following the March 2011 events.",0,0 +3949,Prevalence of post-traumatic stress disorder in first-episode psychosis,"Psychosis can be considered one of the most severe stressors that an individual may face. Previous studies have suggested that the traumatic experience of psychotic symptoms and hospitalization may provoke a post-traumatic type reaction.The aim of this study was to establish the point prevalence of post-traumatic stress disorder (PTSD) among patients recovering from a first-episode of psychosis in Singapore, and to elucidate the factors associated with it.Patients from the Early Psychosis Intervention Programme in Singapore, who were recovering from their first psychotic episode, participated in this study. Diagnoses were made using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) - Text Revised Axis I Disorders. The Clinician-Administered PTSD Scale, an interviewer-rated semi-structured interview, was used to diagnose PTSD.Sixty-one patients (30 males, 31 females) were recruited. Twelve (19.7%) patients were diagnosed with PTSD. Hospitalization for treatment, whether compulsory or otherwise, did not increase the rate of PTSD. The Chinese ethnic group had lower risk of developing PTSD (adjusted odds ratio 0.14, P = 0.018).There was a high prevalence of PTSD in patients recovering from their first psychotic episode. This study raises awareness among clinicians and hopes to promote early recognition and treatment of PTSD so as to potentially improve outcome.",0,0 +3950,Childhood trauma increases the risk of post-traumatic stress disorder in response to first-episode psychosis,"Objective: To investigate the relationship between childhood trauma, post-traumatic stress symptoms due to the experience of childhood trauma, and post-traumatic stress symptoms due to the experience of psychosis. Method: The current study assessed childhood trauma and post-traumatic stress disorder (PTSD) symptoms as a result of both childhood trauma and psychosis using the Impact of Events Scale - Revised, in a group of 36 people with first-episode psychosis. Results: Reported rates of clinical level post-psychotic PTSD symptoms, childhood trauma and childhood trauma-related clinical level PTSD symptoms were 47% (95% CI 31–64%), 64% (95% CI 48–80%) and 39% (95% CI 23–55%), respectively. Reporting childhood trauma increased the risk of developing post-psychosis PTSD 27-fold (95% CI 2.96–253.80, p = 0.01). Having childhood trauma-related PTSD increased the risk of developing post-psychosis PTSD 20-fold (95% CI 3.38–123.25, p = 0.01). These risks were not explained by illness factors such as duration of untreated psychosis, age of onset or severity of psychotic symptoms. Those without post-psychotic PTSD symptoms at clinical levels were unlikely to report childhood trauma (6%; 95% CI 3–8%). Conclusions: These results suggest the cognitive, social and biological consequences of childhood trauma can prevent effective recovery from the trauma of acute first-episode psychosis resulting in post-psychotic PTSD. Treatment strategies for post-psychotic PTSD must address childhood trauma and related PTSD.",0,0 +3951,Associations between Pittsburgh Sleep Quality Index factors and health outcomes in women with posttraumatic stress disorder,"The Pittsburgh Sleep Quality Index (PSQI) is a widely used measure of subjective sleep disturbance in clinical populations, including individuals with posttraumatic stress disorder (PTSD). Although the severity of sleep disturbance is generally represented by a global symptom score, recent factor analytic studies suggest that the PSQI is better characterized by a two- or three-factor model than a one-factor model. This study examined the replicability of two- and three-factor models of the PSQI, as well as the relationship between PSQI factors and health outcomes, in a female sample with PTSD.The PSQI was administered to 319 women with PTSD related to sexual or physical assault. Confirmatory factor analyses tested the relative fit of one-, two-, and three-factor solutions. Bivariate correlations were performed to examine the shared variance between PSQI sleep factors and measures of PTSD, depression, anger, and physical symptoms.Confirmatory factor analyses supported a three-factor model with Sleep Efficiency, Perceived Sleep Quality, and Daily Disturbances as separate indices of sleep quality. The severity of symptoms represented by the PSQI factors was positively associated with the severity of PTSD, depression, and physical symptoms. However, these health outcomes correlated as much or more with the global PSQI score as with PSQI factor scores.These results support the multidimensional structure of the PSQI. Despite this, the global PSQI score has as much or more explanatory power as individual PSQI factors in predicting health outcomes.",0,0 +3952,Trajectories of PTSD and substance use disorders in a longitudinal study of personality disorders.,"This study investigated the co-occurrence of posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) in a sample (N = 668) recruited for personality disorders and followed longitudinally as part of the Collaborative Longitudinal Personality Disorders Study. The study both examined rates of co-occurring disorders at baseline and temporal relationships between PTSD and substance use disorders over 4 years. Subjects with a lifetime history of PTSD at baseline had significantly higher rates of SUDs (both alcohol and drug) than subjects without PTSD. Latent class growth analysis, a relatively novel approach used to analyze trajectories and identify homogeneous subgroups of participant on the basis of probabilities of PTSD and SUD over time, identified 6 classes, which were compared with respect to a set of functioning and personality variables. The most consistent differences were observed between the group that displayed low probabilities of both SUD and PTSD and the group that displayed high probabilities of both.",0,0 +3953,Dissociative Symptomatology in Posttraumatic Stress Disorder and Disorders of Extreme Stress,"ABSTRACT The present study was designed to assess differences in dissociative symptoms in adults with Posttraumatic Stress Disorder (PTSD) vs. PTSD plus Disorders of Extreme Stress Not Otherwise Specified (DESNOS). This study was done for two reasons: (1) to better understand the clinical profile of DESNOS clients in order to inform more effective treatment, and (2) to further empirical research on the validity of the DESNOS construct. To assess severity of dissociative symptoms, the authors administered the Dissociative Experiences Scale (DES) to 155 participants with PTSD. Using the Structured Interview for Disorders of Extreme Stress (SIDES), participants were divided into two groups: those who also met criteria for DESNOS and those who did not. DES means are provided for the two groups. Participants with PTSD plus DESNOS scored higher than participants with only PTSD on the measure of dissociative symptomatology, particularly on the DES scales that tap absorption/fantasy and depersonalization/derealization. The two groups did not differ on the amnesia subscale of the DES. Findings support the construct validity of the DESNOS concept and further delineate the clinical profiles of community-based PTSD with and without DESNOS, thus contributing to the knowledge base on the assessment of complex adaptations to trauma.",0,0 +3954,Psychological trauma exposure and trauma symptoms among individuals with high and low levels of dental anxiety,"This questionnaire-based study investigated the traumatic background and trauma-related symptomatology among 141 treatment-seeking individuals with high levels of dental anxiety and among a low-anxious reference group consisting of 99 regular dental patients. The highly anxious individuals reported a significantly higher number of traumatic events, both within and outside the dental or medical setting, than those in the reference group (73% vs. 21%). Horrific experiences in the dental setting were the most common traumatic events reported. Of the highly anxious individuals, 46.1% indicated suffering from one or more of the post-traumatic stress disorder (PTSD) symptom clusters (re-experiencing, avoidance, loss of interest, and insomnia), while in the reference group this percentage was 6%. Severity of dental anxiety was significantly associated with number of screening criteria for specific phobia and the extent to which the anxious subjects displayed symptoms of post-traumatic stress. Two variables were uniquely predictive for positive diagnostic screens for dental phobia and PTSD: having experienced a horrific dental treatment and having been a victim of a violent crime. In conclusion, post-traumatic symptoms are common accompaniments of severe forms of dental anxiety and are experienced even when dental treatment is not imminent.",0,0 +3955,"Development, Reliability, and Validity of a Dissociation Scale","Dissociation is a lack of the normal integration of thoughts, feelings, and experiences into the stream of consciousness and memory. Dissociation occurs to some degree in normal individuals and is thought to be more prevalent in persons with major mental illnesses. The Dissociative Experiences Scale (DES) has been developed to offer a means of reliably measuring dissociation in normal and clinical populations. Scale items were developed using clinical data and interviews, scales involving memory loss, and consultations with experts in dissociation. Pilot testing was performed to refine the wording and format of the scale. The scale is a 28-item self-report questionnaire. Subjects were asked to make slashes on 100-mm lines to indicate where they fall on a continuum for each question. In addition, demographic information (age, sex, occupation, and level of education) was collected so that the connection between these variables and scale scores could be examined. The mean of all item scores ranges from 0 to 100 and is called the DES score. The scale was administered to between 10 and 39 subjects in each of the following populations: normal adults, late adolescent college students, and persons suffering from alcoholism, agoraphobia, phobic-anxious disorders, posttraumatic stress disorder, schizophrenia, and multiple personality disorder. Reliability testing of the scale showed that the scale had good test-retest and good split-half reliability. Item-scale score correlations were all significant, indicating good internal consistency and construct validity. A Kruskal-Wallis test and post hoc comparisons of the scores of the eight populations provided evidence of the scale's criterion-referenced validity.(ABSTRACT TRUNCATED AT 250 WORDS)",0,0 +3956,Exposure of French EMS providers to violence,"Objectives: Evaluate the problem of violence in French EMS system and characterize assaults. Study design: Multicentric, descriptive, open study. Patients and methods: A questionnaire was given to a sample of prehospital care providers in Paris area. People were asked about assaults during their careers, typology of the assaults and consequences. Results are presented in percentage and means. Results: Two hundred seventy-six questionnaires were returned. One or more assaults were recounted by 23% (61/271) of the sample (median of 8 ± 7 years experience on the job). The injuries were bruises in 40% (17/43), wounds in 9% (4/43) and fractures in 2% (1/43). Only 4% of assaults were followed by sick leave, 15% by a complaint. After the assaults, 4% (2/45) reported having got therapy against post-traumatic stress disorder. Eighty-eight per cent reported verbal threat and 41% physical threat. Thirteen per cent (25/200) were threatened with a knife and 12% (23/200) with a gun. Only 9% (24/270) had a formal training for management of violence. Conclusion: Formal training in the management of violent encounters and prevention of post-traumatic stress should be developed.",0,0 +3957,Impact of pre-enlistment antisocial behaviour on behavioural outcomes among UK military personnel,"Purpose: Concern has been raised over alleged increases in antisocial behaviour by military personnel returning from the deployment in Iraq and Afghanistan. US-based research has shown that post-deployment violence is related not only to combat experience, but also to pre-enlistment antisocial behaviour (ASB). This study aimed to examine the association between pre-enlistment ASB and later behavioural outcomes, including aggression, in a large randomly selected UK military cohort. Methods: Baseline data from a cohort study of 10,272 UK military personnel in service at the time of the Iraq war in 2003 were analysed. The associations between pre-enlistment ASB and a range of socio-demographic and military variables were examined as potential confounders. Logistic regression analyses were performed to examine the relationship between pre-enlistment ASB and military behavioural outcomes such as severe alcohol use, violence/aggression and risk-taking behaviour, controlling for confounders. Results: 18.1% were defined as having displayed preenlistment ASB. Pre-enlistment ASB was significantly associated with factors such as younger age, low educational achievement, male gender, non-officer rank, Army personnel, being a regular, increasing time spent on the deployment and having a combat role. Pre-enlistment ASB was associated with increased risk of negative behavioural outcomes (severe alcohol misuse, outbursts of anger or irritability, fighting or assaultative behaviour and risk-taking behaviour), after controlling for confounders, suggesting that such background information may identify individuals who are more vulnerable to subsequent behavioural disturbance. Conclusion: The results of this study suggest that those already demonstrating ASB prior to joining the military are more likely to continue on this trajectory, thus emphasising the importance of considering pre-enlistment behaviour when exploring the aetiology of aggression in military personnel. © Springer-Verlag 2011.",0,0 +3958,A distinct neurochemical profile in WKY rats at baseline and in response to acute stress: implications for animal models of anxiety and depression,"Wistar-Kyoto (WKY) rats exhibit hyperresponsive neuroendocrine and behavioral responses to stress that exceed normal controls and are especially prone to develop stress-induced depressive disorder. Pharmacological studies indicate altered serotonin (5-HT), norepinephrine (NE) and dopamine (DA) systems functioning in WKY rats, yet no attempt has been made to provide a comprehensive assessment of the neurochemical profile for WKY rats as compared to the outbred progenitor controls, Wistar rats. To this end, male, WKY and Wistar rats (N=6/group) were exposed to an acute forced-swim stress or were left untreated as controls. The prefrontal cortex (PFCtx), striatum, nucleus accumbens (NAS), and amygdala were assayed for levels of NE, DA and 5-HT, as well as major metabolites, by high-pressure liquid chromatography (HPLC) with electrochemical detection. In a separate experiment, designed to assess baseline and stress-induced neuroendocrine activation, male, Wistar and WKY rats (N=6/group) were exposed to an acute forced-swim stress of 15 min or were left untreated as controls. Animals were killed immediately after the test (T=0), 30 min after the test (T=30) or 60 min after the test (T=60), and control animals were killed immediately after weighing. After decapitation, trunk blood was collected and plasma was isolated by centrifugation and analyzed for corticosterone by immunoassay. The neurochemical results demonstrate distinct patterns of baseline and stress-induced monoamine turnover in WKY rats, including alterations to DA and 5-HT turnovers in prefrontal cortex and nucleus accumbens, two critical brain areas implicated in anxiety, depression and drug reward. The neuroendocrine results indicate that WKY rats exhibited a sustained corticosterone response to acute stress, as compared to Wistar controls. Overall, these data are predicted to be useful for understanding the anxiety- and depressive-like behavioral phenotype exhibited by these animals and for increased understanding of the role genetic background in altering neurochemical function.",0,0 +3959,Mental Health Outcomes and Predictors of Chronic Disorders After the North Sea Oil Rig Disaster,"The present study examined long-term mental health outcomes following a major disaster, including the relative risks (RR) of developing psychiatric disorders. Trauma exposure and predisaster vulnerability factors were examined as predictors of chronic psychopathology. Standardized questionnaires measuring psychological distress were completed 5½ months, 14 months, 5 years, and 27 years after the disaster. Twenty seven years after the disaster, 48 (79%) survivors and a matched comparison group of 62 (78%) nondisaster-exposed controls were assessed using the Structured Clinical Interview for DSM-IV, axis I Disorders. The prevalence of posttraumatic stress disorder among the survivors was 6.1%, and the risk of having a psychiatric disorder was more than 3 times higher than in the comparison group (RR = 3.44, 95% confidence interval = 1.6-7.6). Disaster exposure and general neurotic personality predicted chronic psychopathology, which was reported by 20.9% of the participants. Findings from this study suggest that increased risk of psychopathology persists 27 years after disaster. Both disaster exposure and vulnerable personality are important predictors of chronic psychopathology.",0,0 +3960,Chemistry and Pharmacology of GABAB Receptor Ligands,"This chapter presents new clinical applications of the prototypic GABA(B) receptor agonist baclofen for the treatment of addiction by drugs of abuse, such as alcohol, cocaine, nicotine, morphine, and heroin, a novel baclofen prodrug Arbaclofen placarbil, the GABA(B) receptor agonist AZD3355 (Lesogabaran) currently in Phase 2 clinical trials for the treatment of gastroesophageal reflux disease, and four positive allosteric modulators of GABA(B) receptors (CGP7930, GS39783, NVP-BHF177, and BHFF), which have less propensity for the development of tolerance due to receptor desensitization than classical GABA(B) receptor agonists. All four compounds showed anxiolytic affects. In the presence of positive allosteric modulators the ""classical"" GABA(B) receptor antagonists CGP35348 and 2-hydroxy-saclofen showed properties of partial GABA(B) receptor agonists. Seven micromolar affinity GABA(B) receptor antagonists, phaclofen; 2-hydroxy-saclofen; CGP's 35348, 36742, 46381, 51176; and SCH50911, are discussed. CGP36742 (SGS742) showed statistically significant improvements of working memory and attention in a Phase 2 clinical trial in mild, but not in moderate Alzheimer patients. Eight nanomolar affinity GABA(B) receptor antagonists are presented (CGP's 52432, 54626, 55845, 56433, 56999, 61334, 62349, and 63360) that were used by pharmacologists for numerous in vitro and in vivo investigations. CGP's 36742, 51176, 55845, and 56433 showed antidepressant effects. Several compounds are also available as radioligands, such as [(3)H]CGP27492, [(3)H]CGP54626, [(3)H]CGP5699, and [(3)H]CGP62349. Three novel fluorescent and three GABA(B) receptor antagonists with very high specific radioactivity (>2,000 Ci/mmol) are presented. [(125)I]CGP64213 and the photoaffinity ligand [(125)I]CGP71872 allowed the identification of GABA(B1a) and GABA(B1b) receptors in the expression cloning work.",0,0 +3961,Children and war†,"Children bear disproportionate consequences of armed conflict. The 21st century continues to see patterns of children enmeshed in international violence between opposing combatant forces, as victims of terrorist warfare, and, perhaps most tragically of all, as victims of civil wars. Innocent children so often are the victims of high-energy wounding from military ordinance. They sustain high-energy tissue damage and massive burns - injuries that are not commonly seen in civilian populations. Children have also been deliberately targeted victims in genocidal civil wars in Africa in the past decade, and hundreds of thousands have been killed and maimed in the context of close-quarter, hand-to-hand assaults of great ferocity. Paediatricians serve as uniformed military surgeons and as civilian doctors in both international and civil wars, and have a significant strategic role to play as advocates for the rights and welfare of children in the context of the evolving 'Laws of War'. One chronic legacy of contemporary warfare is blast injury to children from landmines. Such blasts leave children without feet or lower limbs, with genital injuries, blindness and deafness. This pattern of injury has become one of the post-civil war syndromes encountered by all intensivists and surgeons serving in four of the world's continents. The continued advocacy for the international ban on the manufacture, commerce and military use of antipersonnel landmines is a part of all paediatricians' obligation to promote the ethos of the Laws of War. Post-traumatic stress disorder remains an undertreated legacy of children who have been trapped in the shot and shell of battle as well as those displaced as refugees. An urgent, unfocused and unmet challenge has been the increase in, and plight of, child soldiers themselves. A new class of combatant comprises these children, who also become enmeshed in the triad of anarchic civil war, light-weight weaponry and drug or alcohol addiction. The International Criminal Court has outlawed as a War Crime, the conscription of children under 15 years of age. Nevertheless, there remain more than 300000 child soldiers active and enmeshed in psychopathic violence as part of both civil and international warfare. The typical profile of a child soldier is of a boy between the ages of 8 and 18 years, bonded into a group of armed peers, almost always an orphan, drug or alcohol addicted, amoral, merciless, illiterate and dangerous. Paediatricians have much to do to protect such war-enmeshed children, irrespective of the accident of their place of birth. Only by such vigorous and maintained advocacy can the world's children be better protected from the scourge of future wars.",0,0 +3962,"Resilience and other stability concepts in ecology: notes on their origin, validity and usefulness","Resilience and other stability concepts in ecology: notes on their origin, validity and usefulness",0,0 +3963,Post-traumatic stress disorder among asylum seekers and refugees in Istanbul may be predicted by torture and loss due to violence,"Background: Turkey is both a source and target for asylum seekers seeking refugee status in countries of European Union. There is a scarcity of research on the mental health issues of asylum seekers and refugees residing in Turkey. Aims: This study aimed: 1) to provide clinical and demographic information on asylum seekers and refugees receiving mental health services from a non-governmental refugee support program in Istanbul between 2005 and 2007, and 2) to evaluate the differences between patients diagnosed with post-traumatic stress disorder (PTSD) with those who did not meet criteria. Methods: The study was conducted at the Mental Health Division of the Refugee Advocacy Support Group. Between July 2005 and February 2007, 1209 asylum seekers applied to the support group; 75 of these individuals (6.2%) were referred for psychiatric evaluation while 57 were diagnosed as having a psychopathology. The number of analyzed subjects was 57. Results: PTSD and major depressive disorder were the most common diagnoses (55.2% for both). The most common criteria of PTSD reported were problems in concentration and social isolation (97.3% for both). Suffering torture and losing a significant other due to violence were found to be associated with a diagnosis of PTSD. Conclusions: This study is the first of its kind to be conducted on a mixed refugee population residing in Turkey and focusing on their mental health problems. Our results should be tested within larger samples of refugees residing in different cities of Turkey.",0,0 +3964,Psychological resilience in OEF–OIF Veterans: Application of a novel classification approach and examination of demographic and psychosocial correlates,"A growing number of studies have examined the prevalence and correlates of psychopathology in Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF-OIF), but few have examined determinants of resilience in this population. This study employed a novel approach to classify psychological resilience in a cross-sectional sample of OEF-OIF Veterans. A total of 272 predominantly older reserve/National Guard OEF/OIF Veterans completed a mail survey that assessed combat exposure, psychopathology, psychosocial functioning, and aspects of social support. Cluster analysis of scores on measures of combat exposure and PTSD symptoms revealed that a three-group solution best fit the data: Controls (low combat exposure, low PTSD symptoms); PTSD (high combat exposure, high PTSD symptoms); and Resilient (high combat exposure, low PTSD symptoms). Compared to the PTSD group, the Resilient group was more likely to be in a relationship and active duty; they also scored lower on a measure of psychosocial dysfunction, and higher on measures of psychological resilience and postdeployment social support. Logistic regression analysis revealed that being in a relationship, having fewer psychosocial difficulties, and reporting greater perceptions of purpose/control and family support and understanding were significantly associated with resilient group membership. Results of this study demonstrate a novel approach to classifying psychological resilience and suggest that interventions to mitigate psychosocial difficulties, enhance perceptions of purpose and control, and bolster family support and understanding may help promote resilience to combat-related PTSD in OEF-OIF Veterans.",0,0 +3965,Head Injury as a PTSD Predictor Among Oklahoma City Bombing Survivors,"The aim of the Oklahoma City (OKC) bombing retrospective review was to investigate the relationship between physical injury, environmental contributors, and psychiatric disorders such as posttraumatic stress disorder (PTSD) in an event-based, matched design study focused on injury.The 182 selected participants were a random subset of the 1,092 direct survivors from the OKC bombing. Only 124 of these 182 cases had a full complement of medical/clinical data in the OKC database. These 124 cases were assessed to explore relationships among PTSD diagnoses, levels of blast exposure, and physical injuries. Associations among variables were statistically tested using contingency analysis and logistic regression.Comparison of the PTSD cases to symptoms/diagnoses reported in the medical records reveals a statistically significant association between PTSD and head/brain injuries associated with head acceleration. PTSD was not highly correlated with other injuries. Although blast pressure and impulse were highly correlated with head injuries, the correlation with PTSD was not statistically significant. Thus, a correlation between blast pressure and PTSD may exist, but higher fidelity pressure calculations are required to elucidate this potential relationship.This study provides clear evidence that head injury is associated with subsequent PTSD, giving caregivers' information on what physical injuries may suggest the development of psychologic disorders to aid them in developing a profile for the identification of future survivors of terrorist attacks and Warfighters with brain injuries and potential PTSD.",0,0 +3966,Resilience and symptom reporting following mild traumatic brain injury in military service members,"The purpose of this study was to examine the relationship between resilience and symptom reporting following mild traumatic brain injury (mTBI). It was hypothesized that, as resilience increases, self-reported symptoms would decrease.Cross-sectional design.Participants were 142 US military service members who sustained a mTBI, divided into three resilience groups based on participants' responses on the Response to Stressful Experiences Scale: Moderate (n = 42); High (n = 51); and Very High (n = 49). Participants completed the Neurobehavioral Symptom Inventory (NSI) and PTSD Checklist-Civilian Version (PCL-C) within 12 months following injury.There were significant main effects for the NSI total score, cognitive cluster and affective cluster, as well as for the PCL-C total score, avoidance cluster and hyperarousal cluster. Pairwise comparisons revealed that there was a negative relationship between resilience and self-reported symptoms overall. Specifically, participants with higher resilience reported fewer post-concussion and PTSD-related symptoms than participants with lower levels of resilience.These findings underscore the important role that resilience plays in symptom expression in military service members with mTBI and suggest that research on targeted interventions to increase resilience in the acute phase following injury is indicated.",0,0 +3967,Longitudinal Cluster Analysis with Applications to Growth Trajectories,"Longitudinal studies play a prominent role in health, social, and behavioral sciences as well as in the biological sciences, economics, and marketing. By following subjects over time, temporal changes in an outcome of interest can be directly observed and studied. An important question concerns the existence of distinct trajectory patterns. One way to discover potential patterns in the data is through cluster analysis, which seeks to separate objects (individuals, subjects, patients, observational units) into homogeneous groups. There are many ways to cluster multivariate data. Most methods can be categorized into one of two approaches: nonparametric and model-based methods. The first approach makes no assumptions about how the data were generated and produces a sequence of clustering results indexed by the number of clusters k=2,3,... and the choice of dissimilarity measure. The later approach assumes data vectors are generated from a finite mixture of distributions. The bulk of the available clustering algorithms are intended for use on data vectors with exchangeable, independent elements and are not appropriate to be directly applied to repeated measures with inherent dependence.Multivariate Gaussian mixtures are a class of models that provide a flexible parametric approach for the representation of heterogeneous multivariate outcomes. When the outcome is a vector of repeated measurements taken on the same subject, there is often inherent dependence between observations. However, a common covariance assumption is conditional independence---that is, given the mixture component label, the outcomes for subjects are independent. In Chapter 2, I study, through asymptotic bias calculations and simulation, the impact of covariance misspecification in multivariate Gaussian mixtures. Although maximum likelihood estimators of regression and prior probability parameters are not consistent under misspecification, they have little asymptotic bias when mixture components are well separated or if the assumed correlation is close to the truth even when the covariance is misspecified. I also present a robust standard error estimator and show that it outperforms conventional estimators in simulations and can provide evidence that the model is misspecified. The main goal of a longitudinal study is to observed individual change over time; therefore, observed trajectories have two prominent features: level and shape of change over time. These features are typically associated with baseline characteristics of the individual. Grouping by shape and level separately provides an opportunity to detect and estimate these relationships. Although many nonparametric and model-based methods have been adapted for longitudinal data, most fail to explicitly group individuals according to the shape of their repeated measure trajectory. Some methods are thought to group by shape, but the dissimilarity between trajectories is not defined in terms of any one specific feature of the data. Rather, the methods are based on the entire vector and cluster trajectories by the level because it tends to dominate the variability between data vectors. These methods discover shape groups only if level and shape are correlated. To fulfill the need for clustering based explicitly on shape, I propose three methods Chapter 4 that are adaptations of available algorithms. One approach is to use a dissimilarity measure based on estimated derivatives of functions underlying the trajectories. One challenge for this approach is estimating the derivatives with minimal bias and variance. The second approach explicitly models the variability in the level within a group of similarly shaped trajectories using a mixture model resulting in a multilayer mixture model. One difficulty with this method comes in choosing the number of shape clusters. Lastly, vertically shifting the data by subtracting the subject-specific mean directly removes the level prior to modeling. This non-invertible transformation can result in singular covariance matrixes, which makes parameter estimation difficult. In theory, all of these methods should cluster based on shape, but each method has shortfalls. I compare these methods with existing clustering methods in a simulation study in Chapter 5 and find that the vertical shifted mixture model outperforms the existing and other proposed methods. A subset of the clustering methods are then compared on a real data set of childhood growth trajectories from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) study in Chapter 6. Vertically shifting the data prior to fitting a mixture model results in groups based on the shape of their growth over time in contrast to the standard mixture model assuming either conditional independence or a more general correlation. The group means do not drastically change between methods for this data set, but group membership differs enough to impact inference about the relationship between baseline covariates and distinct groups.",0,0 +3968,"Childhood trauma and dissociation in patients with alcohol dependence, drug dependence, or both—A multi-center study","The aims of this study were to examine the level of dissociative symptoms in patients with different substance related disorders (alcohol dependence, drug dependence, and combined alcohol and drug dependence), and to investigate the influence of potentially traumatic events in childhood, age, gender, and posttraumatic stress disorder on the relationship between dissociative symptoms and type of substance abuse.Of the 459 participants (59.7% male) 182 (39.7%) were alcohol-dependent (A), 154 (33.6%) were drug-dependent (D), and 123 (26.8%) were dependent on both, alcohol and drugs (AD) based on the DSM-IV criteria for a current diagnosis. Participants completed the Childhood Trauma Questionnaire (CTQ) and the Dissociative Experiences Scale (DES). The International Diagnostics Checklist (IDCL) was administered to diagnose PTSD.Higher levels of dissociation were observed in patients with drug dependence as compared to patients with mere alcohol dependence (mean DES group A: 9.9+/-8.8; group D: 12.9+/-11.7; group AD: 15.1+/-11.3). However, when severity of potentially traumatic events in childhood, PTSD, age and gender were included in the analysis, the influence of the type of substance abuse did not prove to be statistically significant. The variable most strongly related to dissociative symptoms was severity of potentially traumatic events in childhood, in particular emotional abuse, even after controlling for PTSD and other potential confounders.It seems appropriate to screen SUD patients for dissociative symptoms, especially those with a more complex risk profile including (additional) drug abuse, female gender, younger age and most importantly a history of childhood trauma.",0,0 +3969,Discriminant validity and gender differences in DSM-5 posttraumatic stress disorder symptoms,"The posttraumatic stress disorder (PTSD) literature is replete with investigations of factor structure, however, few empirical studies have examined discriminant validity and the moderating role of gender on factor structure and symptom expression. This study aimed to address these gaps.An online, population-based study of 3175 Australian adults was conducted. This study analyzed data from 642 participants who reported a traumatic event. Overall, 10.2% (13.4% females, 7.6% males) met diagnostic criteria for current PTSD.Confirmatory factor analyses indicated that eight factor models provided excellent fit to the data. The DSM-5 model, anhedonia and hybrid models provided strong fit to the data, based on statistical fit indices and parsimony. The models' factors were significantly associated with a number of external correlates. Factor structure was gender invariant for the three models, albeit significant latent mean-level differences were apparent in relation to the intrusion/re-experiencing and alterations in arousal and reactivity factors. Bonferroni-adjusted Wald chi-square tests indicated significant gender differences in four DSM-5 PTSD symptoms: females reported significantly higher rates of negative beliefs, diminished interest, restricted affect and sleep disturbance symptoms compared to men.Response rate to the survey was low. However, the number of respondents who completed the survey was high and population weights were employed to account for self-selection biases and aid generalizability.The findings provide support for the DSM-5, anhedonia and hybrid models compared to alternative models based on DSM-5 symptoms. Discriminant validity analyses indicated similar patterns of significant associations with the transdiagnostic factors, potentially suggesting that all the PTSD factors are related to non-specific distress. Further research investigating how gender influences PTSD symptom expression is warranted, including possible gender differences in symptom item interpretation.",0,0 +3970,Test of the trauma outcome process assessment model: One model of individual and environmental factors to explain adjustment.,"The Trauma Outcome Process Assessment (TOPA) is a theoretical model, based on a large body of empirical research establishing key variables that consistently are associated with a range of outcomes...",0,0 +3971,Predicting post-traumatic stress disorder following first onset acute coronary syndrome: Testing a theoretical model,"This research identified which theoretically predicted factors (Joseph, Williams, & Yule, 1997) were associated with the severity of post-traumatic stress disorder (PTSD) symptoms 1 and 6 months following onset of acute coronary syndrome (ACS). Predictor variables included event factors, peri-traumatic distress; and maintaining factors including coping strategies, social support, re-appraisal of event threat, and beliefs about the nature of ACS. Associations with alexithymia were also explored.One hundred and fifty participants completed questionnaires in hospital and at 1- and 6-month follow-up.Hierarchical multiple regression including both baseline and contemporaneous variables explained 52 and 42% of the variance in PTSD symptoms at each follow-up. At 1-month follow-up, predictors of PTSD symptoms were as follows: peri-traumatic distress, concern over symptoms, illness comprehension, and lack of social support. At 6-month follow-up, predictors were: peri-traumatic distress, lack of social support, use of problem-focused coping, and continued symptoms.The Joseph et al. model was generally supported. The data allow some degree of prediction of high risk individuals and suggest some possible interventions.",0,0 +3972,Internalizing and externalizing personality styles and psychopathology in OEF-OIF veterans,"Previous research with other trauma populations demonstrated that internalizing and externalizing personality styles are associated with different PTSD comorbidities. The present study tested this association in two distinct Operation Enduring Freedom–Operation Iraqi Freedom (OEF/OIF) combat samples. Cluster analysis was used to categorize subtypes, which were compared on measures of PTSD, depression, anxiety, and substance use. Internalizers showed the highest rates of PTSD and depression. Externalizers had higher rates of alcohol problems in one sample only, whereas the other sample showed more substance misuse. In general, these findings suggest that this method of classifying trauma survivors is useful in OEF/OIF populations. Results suggest some differences across this population in terms of how substance use issues are expressed in externalizers.",0,0 +3973,In their own words: Trauma and substance abuse in the lives of formerly homeless women with serious mental illness.,"In-depth interviews were conducted with 13 formerly homeless mentally ill women to capture their individual life trajectories of mental illness, substance abuse, and trauma in their own words. Cross-case analyses produced 5 themes: (a) betrayals of trust, (b) graphic or gratuitous nature of traumatic events, (c) anxiety about leaving their immediate surroundings (including attending group treatment programs), (d) desire for one's own space, and (e) gender-related status loss and stigmatization. Findings suggest formerly homeless mentally ill women need (and want) autonomy, protection from further victimization, and assistance in restoring status and devalued identity. Avenues for intervention include enhanced provider training, addressing experiences of betrayal and trauma, and more focused attention to current symptoms rather than previous diagnoses.",0,0 +3974,A multidimensional spectrum approach to post-traumatic stress disorder: comparison between the Structured Clinical Interview for Trauma and Loss Spectrum (SCI-TALS) and the Self-Report instrument (TALS-SR),"Dimensional approaches to psychiatric disorders have shown an increased relevance in the ongoing debate for the forthcoming Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. In line with previously validated instruments for the assessment of different mood, anxiety, eating and psychotic spectra, we tested the validity and reliability of a newly developed Structured Clinical Interview for Trauma and Loss Spectrum (SCI-TALS). The instrument is based on a multidimensional approach to post-traumatic stress spectrum that includes a range of threatening or frightening experiences, as well as a variety of potentially significant losses, to which an individual can be exposed. Furthermore, it explores the spectrum of the peritraumatic reactions and post-traumatic symptoms that may ensue from either type of life events, targeting soft signs and subthreshold conditions, as well as temperamental and personality traits that may constitute risk factors for the development of the disorder. The aim of the present study is to describe the reliability of the self-report version of the SCI-TALS: the TALS-SR. Thirty patients with PTSD and thirty healthy control subjects were assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Half of the patients and controls received the TALS-SR first and the SCI-TALS after 15 days; for the other half of the sample, the order of administration was reversed. Agreement between the self-report and the interview formats was substantial. Intraclass correlation coefficients ranged from 0.934 to 0.994, always exceeding the threshold of 0.90. Our findings provide substantial support for the reliability of the TALS-SR questionnaire.",0,0 +3975,Multiple risk-behavior profiles of smokers with serious mental illness and motivation for change.,"Individuals with serious mental illness (SMI) are dying on average 25 years prematurely. The leading causes are chronic preventable diseases. In the context of a tobacco-treatment trial, this exploratory study examined the behavioral risk profiles of adults with SMI to identify broader interventional needs.Recruited from five acute inpatient psychiatry units, participants were 693 adult smokers (recruitment rate = 76%, 50% male, 45% Caucasian, age M = 39, 49% had income < $10,000) diagnosed with mood disorders (71%), substance-use disorders (63%), posttraumatic stress disorder (39%), psychotic disorders (25%), and attention deficit-hyperactivity disorder (25%). The Staging Health Risk Assessment, the primary measure used in this study, screened for risk status and readiness to change 11 health behaviors, referencing the period prior to acute hospitalization.Participants averaged 5.2 (SD = 2.1) risk behaviors, including smoking (100%), high-fat diet (68%), inadequate fruits/vegetables (67%), poor sleep (53%), physical inactivity (52%), and marijuana use (46%). The percent prepared to change ranged from 23% for tobacco and marijuana to 76% for depression management. Latent class analysis differentiated three risk groups: the global higher risk group included patients elevated on all risk behaviors; the global lower risk group was low on all risks; and a mood and metabolic risk group, characterized by inactivity, unhealthy diet, sleep problems, and poor stress and depression management. The global higher risk group (11% of sample) was younger, largely male, and had the greatest number of risk behaviors and mental health diagnoses; had the most severe psychopathologies, addiction-treatment histories, and nicotine dependence; and the lowest confidence for quitting smoking and commitment to abstinence.Most smokers with SMI engaged in multiple risks. Expanding targets to treat co-occurring risks and personalizing treatment to individuals' multibehavioral profiles may increase intervention relevance, interest, and impact on health.",0,0 +3976,"Efficacy and Safety of Topiramate Monotherapy in Civilian Posttraumatic Stress Disorder: A Randomized, Double-Blind, Placebo-Controlled Study","Objective: This double-blind, placebo-controlled trial assessed efficacy and safety of topiramate monotherapy in civilian posttraumatic stress disorder (PTSD). Method: Outpatients (18-64 years) with DSM-IV non-combat-related PTSD and Clinician-Administered PTSD Scale (CAPS) scores (greater-than or equal to) 50 were eligible. Topiramate was started at 25 mg/day and titrated by 25-50 mg/week to 400 mg/day or maximum tolerated dose. Data were collected between April 26, 2002, and February 4, 2004. Primary efficacy, change in total CAPS score, and secondary efficacy measures were assessed by analysis of covariance in the intent-to-treat (ITT) population with last observation carried forward. Results: The ITT population comprised 38 patients with mean (plus or minus) SD baseline total CAPS scores of 88.3 (plus or minus) 13.8 (topiramate, N = 19) and 91.1 (plus or minus) 13.7 (placebo, N = 19). Although a decrease in total CAPS score was noted (topiramate, -52.7; placebo, -42.0), this difference was not statistically significant (p = .232). Topiramate-treated patients exhibited significant reductions in reexperiencing symptoms (CAPS cluster B: topiramate, 74.9%; placebo, 50.2%; p = .038) and Treatment Outcome PTSD scale (topiramate, 68.0%; placebo, 41.6%; p = .025). Reductions approaching statistical significance, based on a nominal p value, were noted in mean total Clinical Global Impressions-Improvement Scale scores (topiramate, 1.9 (plus or minus) 1.2; placebo, 2.6 (plus or minus) 1.1; p = .055). Conclusion: These preliminary results suggest that further, adequately powered studies of topiramate for the treatment of civilian PTSD are warranted.",0,0 +3977,An evaluation of the DSM-5 factor structure for posttraumatic stress disorder in survivors of traumatic injury,"Confirmatory factor analytic studies of the latent structure of DSM-5 PTSD symptoms using self-report data (Elhai et al., 2012; Miller et al., 2013) have found that the four-factor model implied by the DSM-5 diagnostic criteria provided adequate fit to their data. However, the fit of this model is yet to be assessed using data derived from gold standard structured interview measures. This study evaluated the fit of the DSM-5 four-factor model and an alternative four-factor model in 570 injury survivors six years post-injury using the Clinician Administered PTSD Scale (Blake et al., 1990), updated to include items measuring new DSM-5 symptoms. While both four-factor models fitted the data well, very high correlations between the 'Intrusions' and 'Avoidance' factors in both models and between the 'Negative Alterations in Cognitions and Mood' and 'Arousal and Reactivity' factors in the DSM-5 model and the 'Dysphoria' and 'Hyperarousal' factors in the alternative model were evident, suggesting that a more parsimonious two-factor model combining these pairs of factors may adequately represent the latent structure. Such a two-factor model fitted the data less well according to χ(2) difference testing, but demonstrated broadly equivalent fit using other fit indices. Relationships between the factors of each of the four-factor models and the latent factors of Fear and Anxious-Misery/Distress underlying Internalizing disorders (Krueger, 1999) were also explored, with findings providing further support for the close relationship between the Intrusion and Avoidance factors. However, these findings also suggested that there may be some utility to distinguishing Negative Alterations in Cognition and Mood symptoms from Arousal and Reactivity symptoms, and/or Dysphoria symptoms from Hyperarousal symptoms. Further studies are required to assess the potential discriminant validity of the two four-factor models.",0,0 +3978,Developmental Patterns of Adverse Childhood Experiences and Current Symptoms and Impairment in Youth Referred For Trauma-Specific Services,"By the time children reach adolescence, most have experienced at least one type of severe adversity and many have been exposed to multiple types. However, whether patterns of adverse childhood experiences are consistent or change across developmental epochs in childhood is not known. Retrospective reports of adverse potentially traumatic childhood experiences in 3 distinct developmental epochs (early childhood, 0- to 5-years-old; middle childhood, 6- to 12-years-old; and adolescence, 13- to 18-years-old) were obtained from adolescents (N = 3485) referred to providers in the National Child Traumatic Stress Network (NCTSN) for trauma-focused assessment and treatment. Results from latent class analysis (LCA) revealed increasingly complex patterns of adverse/traumatic experiences in middle childhood and adolescence compared to early childhood. Depending upon the specific developmental epoch assessed, different patterns of adverse/traumatic experiences were associated with gender and with adolescent psychopathology (e.g., internalizing/externalizing behavior problems), and juvenile justice involvement. A multiply exposed subgroup that had severe problems in adolescence was evident in each of the 3 epochs, but their specific types of adverse/traumatic experiences differed depending upon the developmental epoch. Implications for research and clinical practice are identified.",0,0 +3979,Validation and Utility of a Self-report Version of PRIME-MD<SUBTITLE>The PHQ Primary Care Study</SUBTITLE>,"The Primary Care Evaluation of Mental Disorders (PRIME-MD) was developed as a screening instrument but its administration time has limited its clinical usefulness.To determine if the self-administered PRIME-MD Patient Health Questionnaire (PHQ) has validity and utility for diagnosing mental disorders in primary care comparable to the original clinician-administered PRIME-MD.Criterion standard study undertaken between May 1997 and November 1998.Eight primary care clinics in the United States.Of a total of 3000 adult patients (selected by site-specific methods to avoid sampling bias) assessed by 62 primary care physicians (21 general internal medicine, 41 family practice), 585 patients had an interview with a mental health professional within 48 hours of completing the PHQ.Patient Health Questionnaire diagnoses compared with independent diagnoses made by mental health professionals; functional status measures; disability days; health care use; and treatment/referral decisions.A total of 825 (28%) of the 3000 individuals and 170 (29%) of the 585 had a PHQ diagnosis. There was good agreement between PHQ diagnoses and those of independent mental health professionals (for the diagnosis of any 1 or more PHQ disorder, kappa = 0.65; overall accuracy, 85%; sensitivity, 75%; specificity, 90%), similar to the original PRIME-MD. Patients with PHQ diagnoses had more functional impairment, disability days, and health care use than did patients without PHQ diagnoses (for all group main effects, P<.001). The average time required of the physician to review the PHQ was far less than to administer the original PRIME-MD (<3 minutes for 85% vs 16% of the cases). Although 80% of the physicians reported that routine use of the PHQ would be useful, new management actions were initiated or planned for only 117 (32%) of the 363 patients with 1 or more PHQ diagnoses not previously recognized.Our study suggests that the PHQ has diagnostic validity comparable to the original clinician-administered PRIME-MD, and is more efficient to use.",0,0 +3980,Headache Diagnoses Among Iraq and Afghanistan War Veterans Enrolled in VA: A Gender Comparison,"To examine the prevalence and correlates of headache diagnoses, by gender, among Iraq and Afghanistan War Veterans who use Department of Veterans Affairs (VA) health care.Understanding the health care needs of recent Veterans, and how these needs differ between women and men, is a priority for the VA. The potential for a large burden of headache disorders among Veterans seeking VA services exists but has not been examined in a representative sample.We conducted a historical cohort study using national VA inpatient and outpatient data from fiscal year 2011. Participants were all (n = 470,215) Iraq and Afghanistan War Veteran VA users in 2011; nearly 13% were women. We identified headache diagnoses using International Classification of Diseases (ICD-9) diagnosis codes assigned during one or more VA inpatient or outpatient encounters. Descriptive analyses included frequencies of patient characteristics, prevalence and types of headache diagnoses, and prevalence of comorbid diagnoses. Prevalence ratios (PR) with 95% confidence intervals (CI) were used to estimate associations between gender and headache diagnoses. Multivariate models adjusted for age and race. Additional models also adjusted for comorbid diagnoses.In 2011, 56,300 (11.9%) Veterans received a headache-related diagnosis. While controlling for age and race, headache diagnoses were 1.61 times more prevalent (95% CI = 1.58-1.64) among women (18%) than men (11%). Most of this difference was associated with migraine diagnoses, which were 2.66 times more prevalent (95% CI = 2.59-2.73) among women. Cluster and post-traumatic headache diagnoses were less prevalent in women than in men. These patterns remained the same when also controlling for comorbid diagnoses, which were common among both women and men with headache diagnoses. The most prevalent comorbid diagnoses examined were depression (46% of women with headache diagnoses vs 40% of men), post-traumatic stress disorder (38% vs 58%), and back pain (38% vs 46%).Results of this study have implications for the delivery of post-deployment health services to Iraq and Afghanistan War Veterans. Migraine and other headache diagnoses are common among Veterans, particularly women, and tend to occur in combination with other post-deployment health conditions for which patients are being treated.",0,0 +3981,Short and longer-term psychological consequences of Operation Cast Lead: documentation from a mental health program in the Gaza Strip,"There is growing recognition of the psychological impact of adversity associated with armed conflict on exposed civilian populations. Yet there is a paucity of evidence on the value of mental health programs in these contexts, and of the chronology of psychological sequelae, especially in prolonged conflicts with repeated cycles of extreme violence. Here, we describe changes in the psychological profile of new patients in a mental health program after the military offensive Cast Lead, in the context of the prolonged armed conflict involving the Gaza Strip.This study analyses routinely collected program data from a Médecins Sans Frontières mental health program in the Gaza Strip spanning 2007-2011. Data consist of socio-demographic as well as clinical baseline and follow-up data on new patients entering the program. Comparisons were made through Chi square and Fisher's exact tests, univariate and multivariate logistic and linear regression.PTSD, depression and other anxiety disorders were the most frequent psychopathologies, with 21% having multiple diagnoses. With a median of nine sessions, clinical improvement was recorded for 83% (1122/1357), and more common for those with separation anxiety, acute and posttraumatic disorders as principal diagnosis (855/1005), compared to depression (141/183, p<0.01). Noted changes proximal to Operation Cast Lead were: a doubling in patient case load with a broader socio-economic background, shorter interval from an identified traumatic event to seeking care, and a rise in diagnoses of acute and posttraumatic stress disorders. Sustained changes included: high case load, more distal triggering events, and increase in diagnoses of other anxiety disorders (especially for children 15 years and younger) and depression (especially for patients 16 years and older).Evolving changes in patient volume, diagnoses and recall period to triggering events suggest a lengthy and durable effect of an intensified exposure to violence in a context of prolonged conflict. Our findings suggest that mental health related humanitarian relief in protracted conflicts might need to prepare for an increase in patients with changing profiles over an extended period following an acute flare-up in violence.",0,0 +3982,"The impact of being afforded a college education on posttraumatic growth, trauma resilience, and academic resilience in individuals exposed to trauma","Trauma resilience has many definitions and trajectories; however, theorists remain consistent on the idea that some individuals who endure trauma do not succumb to its impact, but instead flourish in its aftermath. Research that focuses on individuals who do exhibit symptoms, yet go on to achieve notable feats is important to understanding how various paths of resilience and growth interact and can be encouraged. The purpose of this study was to examine the factors associated with being provided a college education on trauma resilience, academic resilience, and posttraumatic growth in ""at risk"" students who have experienced a traumatic event. Participants included approximately 146 individuals (77 Males, 69 Females) named as Horatio Alger Association of Distinguished Americans' National Scholars who exemplify academic resiliency and were selected based on their ability to demonstrate integrity and perseverance in overcoming adversity. Participants were asked to complete an electronic survey designed to assess whether or not the participant meets criteria for Posttraumatic Stress Disorder (PTSD), shows posttraumatic growth as a result of facing adversity, and/or shows academic resilience. Qualitative questions were utilized to uncover themes or factors related to the student's ability to be resilient. Results indicated that as the number of events that the participants were exposed to increased, participants were less likely to meet criteria for a PTSD diagnosis. Second, there was not a significant relationship found between posttraumatic growth and academic resilience, but a significant relationship was found between posttraumatic growth and trauma resilience. Lastly, the most commonly supported theme reported by participants as being influential in their growth, ability to make meaning of their past adversities, and academic success was learning that there were other individuals who had been through similar adversities and had persevered. Recognizing the aspects of the program that were the most beneficial to the students can not only provide insight into why this group of at-risk students were resilient, but can also illuminate the needs of other at-risk students in their journeys towards resiliency. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +3983,Looking for resilience: Understanding the longitudinal trajectories of responses to stress,"Taking advantage of two large, population-based, and longitudinal datasets collected after the 1999 floods in Mexico (n=561) and the September 11, 2001 terrorist attacks in New York (n=1267), we examined the notion that resilience may be best understood and measured as one member of a set of trajectories that may follow exposure to trauma or severe stress. We hypothesized that resistance, resilience, recovery, relapsing/remitting, delayed dysfunction, and chronic dysfunction trajectories were all possible in the aftermath of major disasters. Semi-parametric group-based modeling yielded the strongest evidence for resistance (no or mild and stable symptoms), resilience (initially moderate or severe symptoms followed by a sharp decrease), recovery (initially moderate or severe symptoms followed by a gradual decrease), and chronic dysfunction (moderate or severe and stable symptoms), as these trajectories were prevalent in both samples. Neither Mexico nor New York showed a relapsing/remitting trajectory, and only New York showed a delayed dysfunction trajectory. Understanding patterns of psychological distress over time may present opportunities for interventions that aim to increase resilience, and decrease more adverse trajectories, after mass traumatic events.",1,0 +3984,Psychosocial Risk Factors in Women: Special Reference to Depression and Posttraumatic Stress Disorder,"Women have a higher susceptibility than men to a set of psychosocial factors that have been linked to increased risk of ischemic heart disease (IHD), such as depression, early life adversities, and posttraumatic stress disorder (PTSD). In this chapter we discuss the notion that these psychosocial risk factors, particularly if they are present at young age, may set a trajectory of increased IHD risk in women, even though clinical events may occur years later. Emerging data suggest that young women are uniquely susceptible to the adverse cardiovascular effects psychosocial stress, which can result in earlier onset of IHD or more adverse prognosis if the disease is already manifest. Women’s vulnerability to psychosocial stress could also play a role in sex differences in the pathophysiology of IHD; for example it could help explain their higher propensity to abnormal coronary vasomotion and micro-vascular disease, which has been described in women compared with men. Young women are severely under-represented in studies of cardiovascular disease. In future research, it will be crucial to study women earlier in their life to better understand the risk pathways linking psychosocial stress to IHD risk, in order to devise successful preventive and treatment strategies to ameliorate such risk. © Springer International Publishing Switzerland 2015.",0,0 +3985,Child and Adolescent Mental Health Research in the Context of Hurricane Katrina: An Ecological Needs-Based Perspective and Introduction to the Special Section,This article introduces the special section on child and adolescent mental health research in the context of Hurricane Katrina. We outline the purpose and intent of the special section and present an integrative perspective based on broad contextual theories of human development with which to think about the impact of disasters like Katrina. The perspective emphasizes multiple levels of influence on mental health and normal development through the impairment of multiple human needs. The perspective helps show the interconnections among the diverse theoretical and methodological paradigms that are utilized to understand the impact of disasters on youth and may help to guide future research.,0,0 +3986,Psychosocial Predictors of Distress in Parents of Children Undergoing Stem Cell or Bone Marrow Transplantation,"To examine psychosocial predictors of distress (mood disturbance, perceived stress, caregiver burden) in parents of children undergoing stem cell or bone marrow transplantation (BMT).Measures of prior illness experiences, premorbid child behavior problems, family environment, social support, and parental coping behavior were obtained from the resident parents of 151 children prior to the children's admission for BMT. Parents subsequently completed assessments of their mood disturbance, perceived stress, and caregiving burden on a weekly basis through week +6 post-BMT, and then monthly through month +6 post-BMT.Significant changes were observed in parental distress across the course of BMT. After correcting for demographic and medical factors, several significant predictors of parental distress trajectories were identified, including prior parent and patient illness-related distress, premorbid child internalizing behavior problems, the family relationship dimensions of the family environment, and parental avoidant coping behaviors. Multivariable models were developed using a hierarchical modeling approach. The best-fit model accounted for approximately 50% of the variance in parental global distress.Subgroups of parents at higher risk for increased distress during the acute phase of transplant have been identified. These findings can help target parents who may be in greater need of intervention aimed at reducing transplant-related distress.",0,0 +3987,A Twin Study of Genetic and Environmental Contributions to Liability for Posttraumatic Stress Symptoms,"We studied 4042 Vietnam era veteran monozygotic and dizygotic male twin pairs to determine the effects of heredity, shared environment, and unique environment on the liability for 15 self-reported posttraumatic stress disorder symptoms included in the symptom categories of reexperiencing the trauma, avoidance of stimuli related to the trauma, and increased arousal. Quantitative genetic analysis reveals that inheritance has a substantial influence on liability for all symptoms. Symptoms in the reexperiencing cluster and one symptom in the avoidance and numbing cluster are strongly associated with combat exposure, and monozygotic pairs are more highly concordant for combat exposure than dizygotic pairs. By fitting a bivariate genetic model, we show that there are significant genetic influences on symptom liability, even after adjusting for differences in combat exposure; genetic factors account for 13% to 30% of the variance in liability for symptoms in the reexperiencing cluster, 30% to 34% for symptoms in the avoidance cluster, and 28% to 32% for symptoms in the arousal cluster. There is no evidence that shared environment contributes to the development of posttraumatic stress disorder symptoms.",0,0 +3988,Children in Adoptive Families: Overview and Update,"To summarize the past 10 years of published research concerning the 2% of American children younger than 18 years old who are adoptees.Review recent literature on developmental influences, placement outcome, psychopathology, and treatment.Adoption carries developmental opportunities and risks. Many adoptees have remarkably good outcomes, but some subgroups have difficulties. Traditional infant, international, and transracial adoptions may complicate adoptees' identity formation. Those placed after infancy may have developmental delays, attachment disturbances, and posttraumatic stress disorder. Useful interventions include preventive counseling to foster attachment, postadoption supports, focused groups for parents and adoptees, and psychotherapy.Variables specific to adoption affect an adopted child's developmental trajectory. Externalizing, internalizing, attachment, and posttraumatic stress disorder symptoms may arise. Child and adolescent psychiatrists can assist both adoptive parents and children.",0,0 +3989,Developmental Trajectories and Predictors of Prosocial Behavior Among Adolescents Exposed to the 2008 Wenchuan Earthquake,"This longitudinal study examined the developmental trajectories of prosocial behavior and related predictors among adolescents exposed to the 2008 Wenchuan earthquake. At 6-, 18-, and 30-months postearthquake, we followed a sample of 1,573 adolescents. Self-report measures were used to assess earthquake exposure, postearthquake negative life events, prosocial behavior, symptoms of posttraumatic stress disorder, depression, anxiety, social support, and coping style. Data were analyzed using growth mixture modeling and multinomial logistic regressions. Four trajectories of postearthquake prosocial behavior were identified in the sample: (a) high/enhancing (35.0%), (b) high/stable (29.4%), (c) low/declining (33.6%), and (d) low/steeply declining (2.0%). Female gender, more social support, and greater positive coping were significant factors related to a higher probability of developing the high/enhancing trajectory. These findings may be helpful for us to identify adolescents with poor prosocial behavior after exposure to earthquakes so as to provide them with appropriate intervention.",0,0 +3990,Preclinical Perspectives on Posttraumatic Stress Disorder Criteria in DSM-5,"Posttraumatic stress disorder (PTSD) now sits within the newly created ""Trauma- and Stressor-Related Disorders"" section of the Diagnostic and Statistical Manual of Mental Disorders (fifth edition; DSM-5). Through the refinement and expansion of diagnostic criteria, the DSM-5 version better clarifies the broad and pervasive effects of trauma on functioning, as well as the impact of development on trauma reactions. Aggressive and dissociative symptoms are more thoroughly characterized, reflecting increasing evidence that reactions to trauma often reach beyond the domains of fear and anxiety (these latter domains were emphasized in DSM-IV). These revised criteria are supported by decades of preclinical and clinical research quantifying traumatic stress-induced changes in neurobiological and behavioral function. Several features of the DSM-5 PTSD criteria are similarly and consistently represented in preclinical animal models and humans following exposure to extreme stress. In rodent models, for example, increases in anxiety-like, helplessness, or aggressive behavior, along with disruptions in circadian/neurovegetative function, are typically induced by severe, inescapable, and uncontrollable stress. These abnormalities are prominent features of PTSD and can help us in understanding the pathophysiology of this and other stress-associated psychiatric disorders. In this article we examine some of the changes to the diagnostic criteria of PTSD in the context of trauma-related neurobiological dysfunction, and discuss implications for how preclinical data can be useful in current and future clinical conceptualizations of trauma and trauma-related psychiatric disorders.",0,0 +3991,Posttraumatic stress disorder symptoms in adolescents: risk factors versus resilience moderation,"Exposure to community violence and trauma, stress, and childhood abuse and neglect have been identified as risk factors for the development of posttraumatic stress disorder (PTSD) symptoms among adolescents. Although evidence suggests that resilience may moderate the relationship between some of these risk factors and PTSD symptoms, no studies to date have examined these risk factors collectively.Our first aim was to examine the relationship between exposure to community violence, childhood abuse and neglect, perceived stress, and PTSD symptoms. Our second aim was to examine the extent to which resilience moderated the relationship between risk factors and PTSD symptoms.A convenience sample of 787 participants was drawn from 5 public secondary schools in the Cape Town metropole of South Africa. The participants were invited to complete a battery of questionnaires on a single occasion.Of the participants, 48.3% were Black, 58.6% were female, and 31.6% were in grade 8. After controlling for covariates, we found that exposure to community violence, perceived stress, and childhood abuse and neglect together accounted for 33.4% of the variance in PTSD symptoms (F(8,778) = 71.06, P < .001). Nevertheless, resilience moderated the relationship between childhood abuse and symptoms of PTSD (beta = .09, t(786) = 2.88, P < .001), where the independent effect of childhood abuse and neglect on PTSD symptoms was significantly reduced with increasing resilience. Resilience did not, however, interact with exposure to community violence or perceived levels of stress to influence PTSD symptoms.High levels of exposure to community violence, perceived stress, and childhood abuse and neglect may contribute to the development of PTSD symptoms in South African adolescents. However, high levels of resilience may buffer the negative effects of childhood abuse and neglect.",0,0 +3992,Stepping Off the Hedonic Treadmill,"Theorists have long maintained that people react to major life events but then eventually return to a setpoint of subjective well-being. Yet prior research is inconclusive regarding the extent of interindividual variability. Recent theoretical models suggest that there should be heterogeneity in long-term stress responding ( Bonanno, 2004 ; Muthén & Muthén, 2000 ). To test this idea, we used latent growth mixture modeling to identify specific patterns of individual variation in response to three major life events (bereavement, divorce, and marriage). A four-class trajectory solution provided the best fit for bereavement and marriage, while a three-class solution provided the best fit for divorce. Relevant covariates predicted trajectory class membership. The modal response across events was a relatively flat trajectory (i.e., no change). Nevertheless, some trajectories diverged sharply from the modal response. Despite the tendency to maintain preevent levels of SWB, there are multiple and often divergent trajectories in response to bereavement, divorce, and marriage, underscoring the essential role of individual differences.",0,0 +3993,Negative affectivity as a transdiagnostic factor in patients with common mental disorders,"Screening and monitoring systems are increasingly used in psychotherapy, but it has been questioned whether outcome measurement using multiple questionnaires is warranted. Arguably, type and number of assessment instruments should be determined by empirical research. This study investigated the latent factor structure of a multi-dimensional outcome measurement strategy used in English services aligned to the Improving Access to Psychological Therapies (IAPT) programme.Factor analyses and structural equation models were performed on 11,939 intake assessments of outpatients accessing an IAPT service between 2008 and 2010. We examined whether three routinely employed instruments (PHQ-9 for depression, GAD-7 for anxiety, WSAS for functional impairment) assess empirically different dimensions.The instruments were found to assess mainly one general dimension and only some items of the GAD-7 and WSAS assess unique variance beyond this general dimension. In a structural equation model the disorder-specific factor scores were predicted by patients׳ diagnostic categories.Since a large naturalistic data base was used, missing data for diagnoses and scale items were encountered. Diagnoses were obtained with brief case-finding measures rather than structured diagnostic interviews.Although the items seem to address mostly one dimension, some variance is due to differences between individuals in anxiety and impairment. While this generally supports multi-dimensional assessment in a primary care population, the clinical upshot of the study is to concentrate attention on transdiagnostic factors as a target for treatment.",0,0 +3994,Serving within the British army: research into mental health benefits,"The mental health (MH) of soldiers remains extremely newsworthy and is regularly featured in high profile media forums that focus on post-traumatic stress disorder. However, the authors feel that there are distinct benefits to serving within the Army, and that it provides effective occupational medical, MH and welfare support. This research study explores potential benefits and stressors of being in the Army and provides an overview of Army mental health services (AMHS) through the perspectives of AMHS personnel, 84% of which were nurses. The study indicated that the Army can provide a protective community, sharing a bond based on common values and experiences. The Army can provide soldiers with career opportunities that are not available in civilian life, and there are opportunities to develop an employment profile, enhanced by internal and external educational training, and encapsulated within a progressive career pathway. The Army can also be seen to offer an escape route, preventing soldiers entering a life of crime, and supplying the stable family these soldiers had never experienced. The provision of leadership, within an environment where soldiers are valued and stigma is not tolerated can potentially shield against MH problems.",0,0 +3995,Sympathetic system modulation to treat post-traumatic stress disorder (PTSD): A review of clinical evidence and neurobiology,A review of clinical evidence and neurobiology on the effects of modulation of sympathetic system modulation to treat post-traumatic stress disorder (PTSD) is being presented . The review provides an overview of currently available treatments followed by efficacy of orally effective sympathetic blocking agents. The main focus of the review is the application of stellate ganglion blocks (SGBs) or a local anesthetic blockade of the sympathetic ganglion in the neck.,0,0 +3996,Dissociative experiences in obsessive-compulsive disorder and trichotillomania: Clinical and genetic findings,"A link between dissociation proneness in adulthood and self-reports of childhood traumatic events (including familial loss in childhood, sexual/physical abuse and neglect) has been documented. Several studies have also provided evidence for an association between dissociative experiences and trauma in patients with various psychiatric disorders, including post-traumatic stress disorder, borderline personality, dissociative identity and eating disorders. Based on the relative paucity of data on dissociation and trauma in obsessive-compulsive disorder (OCD) and trichotillomania (TTM), the primary objective of this study was to examine the relationship between trauma and dissociative experiences (DE) in these two diagnostic groups. Furthermore, the availability of clinical and genetic data on this sample allowed us to explore clinical and genetic factors relevant to this association. A total of 110 OCD and 32 TTM patients were compared with respect to the degree of dissociation (using the Dissociative Experiences Scale [DES]) and childhood trauma (using the Childhood Trauma Questionnaire [CTQ]). Patients were classified on the DES as either ""high"" (mean DES score >/= 30) or ""low"" (mean DES score < 30) dissociators. Additional clinical and genetic factors were also explored with chi-square and t tests as appropriate. A total of 15.8% of OCD patients and 18.8% of TTM patients were high dissociators. OCD and TTM groups were comparable on DES and CTQ total scores, and in both OCD and TTM groups, significant positive correlations were found between mean DES scores and mean CTQ subscores of emotional abuse, physical abuse, sexual abuse, and physical neglect. In the OCD group, high dissociators were significantly younger than low dissociators, and significantly more high dissociators than low dissociators reported a lifetime (current and past) history of tics (P <.001), Tourette's syndrome (P =.019), bulimia nervosa (P =.003), and borderline personality disorder (P =.027). In the TTM group, significantly more high dissociators than low dissociators reported (lifetime) kleptomania (P =.005) and depersonalisation disorder (P =.005). In the Caucasian OCD patients (n = 114), investigation of genetic polymorphisms involved in monoamine function revealed no significant differences between high and low dissociator groups. This study demonstrates a link between childhood trauma and DE in patients with OCD and TTM. High dissociative symptomatology may be present in a substantial proportion of patients diagnosed with these disorders. High dissociators may also be differentiated from low dissociators on some demographic features (e.g., lower age) and comorbidity profile (e.g., increased incidence of impulse dyscontrol disorders). Additional work is necessary before conclusions about the role of monoaminergic systems in mediating such dissociation can be drawn.",0,0 +3997,Short screening scales to monitor population prevalences and trends in non-specific psychological distress,"Background. A 10-question screening scale of psychological distress and a six-question short-form scale embedded within the 10-question scale were developed for the redesigned US National Health Interview Survey (NHIS). Methods. Initial pilot questions were administered in a US national mail survey ( N = 1401). A reduced set of questions was subsequently administered in a US national telephone survey ( N = 1574). The 10-question and six-question scales, which we refer to as the K10 and K6, were constructed from the reduced set of questions based on Item Response Theory models. The scales were subsequently validated in a two-stage clinical reappraisal survey ( N = 1000 telephone screening interviews in the first stage followed by N = 153 face-to-face clinical interviews in the second stage that oversampled first-stage respondents who screened positive for emotional problems) in a local convenience sample. The second-stage sample was administered the screening scales along with the Structured Clinical Interview for DSM-IV (SCID). The K6 was subsequently included in the 1997 ( N = 36116) and 1998 ( N = 32440) US National Health Interview Survey, while the K10 was included in the 1997 ( N = 10641) Australian National Survey of Mental Health and Well-Being. Results. Both the K10 and K6 have good precision in the 90th–99th percentile range of the population distribution (standard errors of standardized scores in the range 0·20–0·25) as well as consistent psychometric properties across major sociodemographic subsamples. The scales strongly discriminate between community cases and non-cases of DSM-IV/SCID disorders, with areas under the Receiver Operating Characteristic (ROC) curve of 0·87–0·88 for disorders having Global Assessment of Functioning (GAF) scores of 0–70 and 0·95–0·96 for disorders having GAF scores of 0–50. Conclusions. The brevity, strong psychometric properties, and ability to discriminate DSM-IV cases from non-cases make the K10 and K6 attractive for use in general-purpose health surveys. The scales are already being used in annual government health surveys in the US and Canada as well as in the WHO World Mental Health Surveys. Routine inclusion of either the K10 or K6 in clinical studies would create an important, and heretofore missing, crosswalk between community and clinical epidemiology.",0,0 +3998,Role of risk factors proximate to time of trauma in the course of PTSD and MDD symptoms following traumatic injury,"Questions exist regarding whether posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are unique sequelae of trauma or a manifestation of a single form of psychopathology. Using latent growth modeling, we examined the role of risk factors occurring within 48 hours of the time of trauma on the course of PTSD and MDD symptoms over an 8-month period in 163 participants recruited from a level 1 surgical trauma center. Both PTSD and MDD symptoms showed peak prevalence by 1 month and significantly decreased over 7 months. Greater postinjury pain and PTSD symptoms (measured within 48 hours of trauma) predicted higher rates of both PTSD and MDD symptoms at 1 month. Other predictors were unique to each disorder. Results suggest that PTSD and MDD are related consequences of trauma.",0,0 +3999,Post-traumatic stress disorder symptom clusters in Turkish child and adolescent trauma survivors,"This study identified post-traumatic stress disorder (PTSD) symptom clusters in Turkish children and adolescents who experienced the 1999 Marmara Earthquake, which was classified as one of the world's six deadliest earthquakes in the 20th century. Two hundred ninety three children and adolescents (152 females and 141 males between the ages of 8 and 15) living in Izmit, the epicenter of the earthquake, participated in this study. The Post-Traumatic Stress Disorder Reaction Index for Children (CPTSD-RI) was administered to assess PTSD symptoms. A confirmatory factor analysis (CFA), using data from the CPTSD-RI, was conducted to determine whether the DSM-IV-TR symptom structure of PTSD was valid in Turkish children and adolescents. The CFA model supported the three-symptom cluster model. Limitations and implications for future research studies are included in the discussion. (",0,0 +4000,Post traumatic stress psychopathology 8 years after a flooding in Italy,"Objective: Post Traumatic Stress Psychopathology (PTSP) was assessed among village's inhabitants 8 years after the 1996 Versilia flooding in Italy. Methods: The sample was formed by 61 subjects. The Davidson Trauma Scale (DTS) was used to evaluate PTSP. Gender and two class of age (young and old subjects) were considered as demographic characteristics. Results: No significant differences resulted on DTS total and factor scores between female and male subjects. On the contrary, significant differences emerged on Hyperarousal Total and Hyperarousal Frequency between young and old subjects. People considered having enough symptoms for full Post Traumatic Stress Disorder (PTSD) were 45.9% (N=28), while 35.8% (N=20) had subthreshold PTSD, and 21.3% (N=13) had no PTSD. In the full PTSD subgroup old subject had a mean Hyperarousal Frequency significantly higher than young subjects, while in the subthreshold PTSD subgroup old subjects have a mean score on Intrusion Frequency, Intrusion Severity, Total Intrusion, Total Frequency and Total score significantly higher than young subjects. Conclusion: This study confirms that the traumatic impact of a flooding on a population hit some years before is not time-limited, showing the persistence of a high level of PTSP 8 years later. Old subjects showed on Hyperarousal Total and Hyperarousal Frequency within the whole sample, on Hyperarousal Frequency within the full PTSD subgroup, and on all Intrusion clusters, Total Frequency and Total score in the subthreshold PTSD subgroup, significantly higher scores than young subjects. Further specific research is needed in the elderly, in order to facilitate a better understanding of PTSP that is present in this unique population.",0,0 +4001,Posttraumatic Stress Disorder and Work-Related Injury,"The literature indicates a substantial overlap between chronic pain and posttraumatic stress disorder (PTSD) symptoms in individuals who sustain accidental injury. To date, however, there have been no studies of PTSD symptoms in individuals who experience work-related injury. Consequently, we assessed 139 consecutive injured workers using the Modified PTSD Symptom Scale (Falsetti, Resnick, & Kirkpatrick, 1993), as well as a number of general measures of psychopathology. Most participants reported chronic pain and all were receiving workers compensation. Results indicated that 34.7% and 18.2% of the sample reported symptoms consistent with PTSD and partial PTSD, respectively. When PTSD symptom frequency and severity were considered criterion variables in multiple regression analyses, depression was found to be significantly associated with the former and anxiety sensitivity, social fears, and somatic focus with the later. Finally, these measures of general psychopathology correctly classified 78.6% of individuals with PTSD and 81.3% of those with no PTSD. These results suggest that a considerable proportion of injured workers display symptoms consistent with PTSD and that these symptoms are related to general negative affect. Implications, including the suggestion of clinical intake screening of PTSD in this population, are discussed.",0,0 +4002,Epigenetic findings for PTSD and lower respiratory symptoms in male WTC responders,"After the World Trade Center (WTC) attack on 9/11/2001, the CDC established a consortium of clinics (WTC-Health Programs) in the NY-metropolitan area to detect, monitor and treat WTC-related health problems occurring among responders to the disaster. More than 25% of these responders (∼30,000) have WTC-related post-traumatic stress disorder (PTSD) and lower respiratory symptoms. These two conditions are often co-morbid (OR = 2.5). Longitudinal findings indicate that WTC-PTSD is associated with an increased risk of new-onset respiratory disease (but not vice versa). One explanation for this finding is that PTSD can result in a chronic stress response, including immunologic dysregulation. Epigenetics is a promising approach to elucidating biological processes underlying the PTSD-lower respiratory symptoms link. To further our understanding of the association among responders, the current study investigated DNA methylation patterns in peripheral blood of WTC responders and examined associations between methylation, PTSD symptom severity (PTSD Checklist [PCL]), and lower respiratory symptoms. Participants were 224 male (mean/ SD age = 49.6/8.1), primarily Caucasian (78%) responders enrolled in the WTC Health Program. Methylation was assessed with HumanMethylation450 BeadChip. As expected, no CpG site reached genome-wide significance (lowest p-value: 10-6). However, a network-based approach revealed that PTSD symptoms are correlated with reduced methylation in CpG sites that belong to a cluster of highly interacting genes involved in regulation of NF-κB transcription factor activity (fdr < 2 × 10-2). NF-κB is a protein complex that plays a significant role in regulating the immune response. The observed effect was driven primarily by sites within immunoregulatory genes TLR9, DAB2IP, TAOK3, and TRAF3, with the strongest effect on cg16302310 in the promoter region of TLR9. This site correlated significantly both with PTSD symptoms (r = -0.29, p = 3.91 × 10-5) and lower respiratory symptoms (r = -0.18, p = 0.01), indicating that demethylation of TLR9 is associated with greater symptom severity. The association between PTSD symptoms and lower respiratory symptoms was reduced when controlling for cg16302310 (p =0.04), which suggests that methylation mediates the PTSD-lower respiratory symptoms link. These results are a promising step in understanding the biologicalmechanisms underlying PTSD, lower respiratory symptoms, and their comorbidity. Specifically, our data build upon previous work that has implicated NF-κB and TLR9 in PTSD and highlights a potential pathway from PTSD to lower respiratory symptoms. Future work is needed to assess the observed relations longitudinally to evaluate directionality and to investigate the downstream effects of these epigenetic differences.",0,0 +4003,Violence Exposure and PTSD Among Delinquent Girls,"This study focuses on the unique trauma histories of incarcerated girls. In particular, this study draws upon data obtained from 100 incarcerated adolescent girls, highlighting areas of similarity to and difference from incarcerated boys, including: overall levels of traumatic violence exposure, exposure to unique forms of traumatic violence, psychological symptomatology, and hypothesized trajectories of involvement in serious delinquent activity. In addition, a case example is presented to illustrate our hypotheses about the trajectories of adolescent girls' involvement in serious delinquent behavior, as well as the prominent role of early trauma histories and repeat victimization in these trajectories.",0,0 +4004,"Parent and Child Agreement for Acute Stress Disorder, Post-Traumatic Stress Disorder and other Psychopathology in a Prospective Study of Children and Adolescents Exposed to Single-Event Trauma","Examining parent-child agreement for Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorder (PTSD) in children and adolescents is essential for informing the assessment of trauma-exposed children, yet no studies have examined this relationship using appropriate statistical techniques. Parent-child agreement for these disorders was examined by structured interview in a prospective study of assault and motor vehicle accident (MVA) child survivors, assessed at 2-4 weeks and 6 months post-trauma. Children were significantly more likely to meet criteria for ASD, as well as other ASD and PTSD symptom clusters, based on their own report than on their parent's report. Parent-child agreement for ASD was poor (Cohen's kappa = -.04), but fair for PTSD (Cohen's kappa = .21). Agreement ranged widely for other emotional disorders (Cohen's kappa = -.07-.64), with generalised anxiety disorder found to have superior parent-child agreement (when assessed by phi coefficients) relative to ASD and PTSD. The findings support the need to directly interview children and adolescents, particularly for the early screening of posttraumatic stress, and suggest that other anxiety disorders may have a clearer presentation post-trauma.",0,0 +4005,Reliability and validity of the Korean version of the Impact of Event Scale-Revised,"The aim of this study was to explore the reliability and validity of the Impact of Event Scale-Revised Korean version (IES-R-K), a self-report scale for assessment of posttraumatic stress disorder (PTSD).The original Impact of Event Scale-Revised was translated into Korean, and the comparability of content was verified through back-translation procedures. This multicenter study included 93 patients with PTSD, 73 nonpsychotic psychiatric patients, and 88 healthy controls drawn from 18 hospitals across the country. The subjects were assessed using IES-R-K, Clinician-Administered PTSD Scale (CAPS), Beck Depression Inventory, and State Trait Anxiety Inventory (STAI; state anxiety subscale [STAI-S], trait anxiety subscale [STAI-T]) scales.In the reliability test, Cronbach alpha coefficient and test-retest reliability were .93 and 0.91, respectively, indicating that the IES-R-K has good internal consistency. One-way analysis of variance revealed significant differences in IES-R-K scores among the patients with PTSD, nonpsychotic psychiatric patients, and healthy controls (F = 139.1, P < .001). Duncan post hoc test showed the significant differences among the 3 groups. To assess the validity of the IES-R-K, correlation coefficient between the IES-R-K and CAPS, STAI-S, and STAI-T was calculated. We found that there was a relatively high degree of correlation between the IES-R-K and CAPS (r = 0.92, P < .001). However, there was a relatively less degree of correlation between STAI-S and STAI-T and IES-R-K (r = 0.30, P < .001). Taken these together, IES-R-K showed good discriminant validity.The IES-R-K showed good reliability and validity for the assessment of PTSD symptom severity. The IES-R-K is a useful instrument for assessing PTSD symptoms in Korea.",0,0 +4006,Posttraumatic stress symptoms in children after Hurricane Katrina: Predicting the need for mental health services.,"The purpose of this study was to examine factors related to the development of posttraumatic stress symptoms in children and adolescents after Hurricane Katrina. It was hypothesized that a positive correlation would exist between trauma exposure variables and symptoms indicating need for mental health services experienced 2 years after Hurricane Katrina. Specifically, the authors hypothesized that experiences associated with natural disaster including personal loss, separation from family and/or community, and lack of community support as well as previous loss or trauma would be related to increased symptomatology in both children and adolescents. This study included 7,258 children and adolescents from heavily affected Louisiana parishes. Measures included the Hurricane Assessment and Referral Tool for Children and Adolescents developed by the National Child Traumatic Stress Network (NCTSN, 2005). Results were generally supportive of our hypotheses, and specific exposure and demographic variables were found to be strongly related to posttraumatic stress symptoms in children and adolescents.",0,0 +4007,"Predictors of symptoms of post-traumatic stress disorder after the AZF chemical factory explosion on 21 September 2001, in Toulouse, France","To analyse in the general population the prevalence and predictors of symptomatology consistent with post-traumatic stress disorder (S-PTSD) 18 months after an industrial explosion.Cross-sectional survey.A random sample of 1191 city inhabitants, including an oversample of the immediate area (<3 km). S-PTSD was measured by the self-administered Impact of Event Scale-Revised. The relation between S-PTSD and individual vulnerability factors, immediate exposure and post-trauma factors was analysed by gender.S-PTSD was more prevalent in the immediate area than in the peripheral area (women 19% vs 8%; men 8% vs 2%, p<0.01). In the immediate area, S-PTSD was independently associated with birth outside France (men: OR(a) = 13.9, 95% CI 3.7 to 52.8; women: OR(a) = 2.1, 95% CI 1.0 to 4.2), age more than 40 years (men: OR(a) = 4.3, 95% CI 1.01 to 18.2; women: OR(a) = 2.3, 95% CI 1.1 to 4.5), previous psychotropic treatment (men: OR(a) = 11.5, 95% CI 2.4 to 53.6), proximity to the explosion (less educated men only) (OR(a) = 9.3, 95% CI 1.9 to 44.7), rescue efforts (men: OR(a) = 5.2, 95% CI 1.5 to 18.2), temporarily uninhabitable home (men: OR(a) = 5.8, 95% CI 1.9 to 18.1), personal injury (women: OR(a) = 3.7, 95% CI 1.7 to 8.4), financial difficulties (men: OR(a) = 17.4, 95% CI 4.2 to 72.1; women: OR(a) = 3.4, 95% CI 1.7 to 7.1) and inconvenience due to closure of public services (women: OR(a) = 4.1, 95% CI 1.6 to 9.9).Individual vulnerability, exposure and post-trauma factors were associated with S-PTSD. Vulnerable subgroups, defined by low socioeconomic characteristics may warrant focused screening after such disasters.",0,0 +4008,The predictive value of post-traumatic stress disorder symptoms for quality of life: a longitudinal study of physically injured victims of non-domestic violence,"Little is known about longitudinal associations between post-traumatic stress disorder (PTSD) and quality of life (QoL) after exposure to violence. The aims of the current study were to examine quality of life (QoL) and the predictive value of post-traumatic stress disorder (PTSD) for QoL in victims of non-domestic violence over a period of 12 months.A single-group (n = 70) longitudinal design with three repeated measures over a period of 12 months were used. Posttraumatic psychological symptoms were assessed by using the Impact of Event Scale, a 15-item self-rating questionnaire comprising two subscales (intrusion and avoidance) as a screening instrument for PTSD. The questionnaire WHOQOL-Bref was used to assess QoL. The WHOQOL-BREF instrument comprises 26 items, which measure the following broad domains: physical health, psychological health, social relationships, and environment. Results of the analysis were summarized by fitting Structural Equation Modelling (SEM).For each category of PTSD (probable cases, risk level cases and no cases), the mean levels of the WHOQOL-Bref subscales (the four domains and the two single items) were stable across time of assessment. Individuals who scored as probable PTSD or as risk level cases had significantly lower scores on the QoL domains such as physical health, psychological health, social relationships and environmental than those without PTSD symptoms. In addition, the two items examining perception of overall quality of life and perception of overall health in WHOQOL showed the same results according to PTSD symptoms such as QoL domains. PTSD symptoms predicted lower QoL at all three assessments. Similarly PTSD symptoms at T1 predicted lower QoL at T2 and PTSD symptoms at T2 predicted lower QoL at T3.The presence of PTSD symptoms predicted lower QoL, both from an acute and prolonged perspective, in victims of non-domestic violence. Focusing on the individual's perception of his/her QoL in addition to the illness may increase the treatment priorities and efforts.",0,0 +4009,Depression and Posttraumatic Stress Disorder Among Women with Vulvodynia: Evidence from the Population-Based Woman to Woman Health Study,"Psychological disorders may affect the pain experience of women with vulvodynia, but evidence remains limited. The present study aimed to describe the magnitude of the association of depression and posttraumautic stress disorder (PTSD) with the presence of vulvodynia in a nonclinical population from southeastern Michigan.Baseline data from 1,795 women participating in the Woman to Woman Health Study, a multiethnic population-based study, was used for this analysis. Validated screening questionnaires were conducted to assess vulvodynia, depression, and PTSD. Modified Poisson regression models with a robust variance estimation were used to estimate prevalence ratios (PR) and their 95% confidence intervals (CI) for the association between vulvodynia status and two mental health conditions, depression and PTSD.In the adjusted models, women who screened positive for depression had a 53% higher prevalence of having vulvodynia (PR=1.53; 95% CI: 1.12, 2.10) compared with women who screened negative for depression. Women who screened positive for PTSD had more than a two-fold increase in the prevalence of having vulvodynia (PR=2.37; 95% CI: 1.07, 5.25) compared with women who screened negative for PTSD.The increased prevalence of vulvodynia among those screening positive for depression or PTSD suggests that these disorders may contribute to the likelihood of reporting vulvodynia. Alternatively, vulvodynia, depression, and PTSD may have a common pathophysiological and risk profile. Prospective studies are needed to improve our understanding of the temporal relation between mental health conditions and vulvar pain.",0,0 +4010,Social acknowledgment as a victim or survivor: A scale to measure a recovery factor of PTSD,"The development and validation of a new measure of social acknowledgment as a victim or survivor is presented, whose items were derived from previous research on social recovery factors of post-traumatic stress disorder. The Social Acknowledgment Questionnaire (SAQ) was administered to nontreatment seeking traumatized persons—178 former political prisoners in East Germany and 151 recently traumatized interpersonal crime victims. Principal components analysis yielded three factors—Recognition as victim, General disapproval, and Family disapproval. The factors showed high internal consistency and good test-retest reliability; correlated moderately to strong with measures of PTSD severity, social support, and reluctance to talk about the trauma. In comparison to a conventional measure of social support, the SAQ predicted comparably better between persons with high- and low-PTSD severity.",0,0 +4011,Open Trial of Nefazodone for Combat-Related Posttraumatic Stress Disorder,"Because of its ability to block 5-HT2 receptors postsynaptically and inhibit 5-HT reuptake presynaptically and/or its enhancement of sleep quality, nefazodone may be useful for symptom management in posttraumatic stress disorder (PTSD) patients.Ten patients with combat-related DSM-IV posttraumatic stress disorder (PTSD) entered an open-label 12-week trial of nefazodone with a 4-week follow-up, beginning with 100 mg/day and increasing as necessary to achieve a maximal response or until reaching a maximum dosage of 600 mg/day.Nefazodone was well tolerated, and no significant changes in sexual function were reported. Based on Clinical Global Impressions-Improvement scores, all 10 patients were rated as much improved. All PTSD symptoms (except self-reported PTSD reexperiencing symptoms), sleep, and clinician-rated depression significantly improved at week 12. At follow-up, significant changes were maintained, and self-reported PTSD reexperiencing symptoms had also significantly improved. Effect sizes for all changed symptoms were moderate to large at week 12 and at follow-up. Self-reported and clinician-rated anger significantly improved. Self-reported depression failed to improve. Improvement in social and occupational functioning was minimal.These preliminary data suggest that nefazodone may be effective in reducing the 3 primary PTSD symptom clusters and may be particularly helpful in improving sleep and decreasing anger.",0,0 +4012,Neuropsychiatric profile of a case of post traumatic stress disorder following an electric shock.,"Exposure to extraordinary stressors or life-threatening events has been shown to result in negative cognitive, behavioural and emotional outcomes including the cluster of symptoms constituting Post Traumatic Stress Disorder (PTSD). This disorder has most often been studied in military veterans and victims of abuse who also show high rates of comorbid conditions. We report a case of PTSD following an electrical injury in a patient with no past psychiatric history. Implications for a full range of examinations including comprehensive neuropsychiatric testing are discussed. Results suggest that such approach addresses the complexity of a differential diagnosis between organic and psychiatric dysfunctions.",0,0 +4013,"Social interaction in the aftermath of conflict-related trauma experiences among women in Walungu Territory, Democratic Republic of Congo","The aim of this study was to understand the relative contribution of posttraumatic stress disorder (PTSD)- and non-PTSD-associated reductions in social interaction among a group of adult Congolese women (N = 701) who have experienced multiple and different traumatic events and are participating in a village livestock microfinance programme. The two main outcomes were frequency of (1) family/community members visiting women's homes and (2) women visiting family/community members in their home. Bivariate and multivariable linear regression was used to understand relationships between multiple and grouped trauma experiences, PTSD, depression and social interaction. The majority of women (51.6%) reported rarely or never visiting family/community members or having family/community members visit the woman's home (54.9%). In the multivariable model, material deprivation was significantly associated with fewer visits in the woman's home. Exposure to certain conflict-related traumas, but not material deprivation, was significantly associated with fewer visits to the homes of family/community members. Increased symptoms of PTSD were significantly associated with fewer visitors in woman's home and fewer visits to the homes of family/community members. A better understanding of the social effects of conflict on individuals and local communities is necessary to support rebuilding of local communities.",0,0 +4014,Awake/sleep cortisol levels and the development of posttraumatic stress disorder in injury patients with peritraumatic dissociation.,"Differences in the time of day that cortisol is sampled and failure to consider the impact of peritraumatic dissociation have been hypothesized as factors possibly contributing to the inconsistent findings in research examining associations between cortisol levels soon after trauma exposure and the subsequent development of posttraumatic stress disorder (PTSD). The present study examined associations between urinary cortisol levels during wake and sleep times soon after a serious injury and the subsequent development of PTSD in adult patients reporting low or high peritraumatic dissociative (PD) symptoms. Thirty-nine injury patients (20 with high and 19 with low PD symptoms) provided a 15-hour (6 PM to 9 AM) urine sample at 3-weeks post-injury and completed the Clinician Administered PTSD Scale at a 7-week follow-up. Participants collected their urine during wake and sleep times separately. Results showed that in the total sample and in the high PD group, wake, but not sleep, cortisol levels were lower in patients who developed PTSD compared to those who did not. A multiple linear regression analysis revealed a significant main effect of PD and a non-significant interaction between wake cortisol and PD in predicting PTSD symptom severity. In addition, results showed that PD was a better predictor of PTSD symptom severity than wake cortisol levels. These results were consistent with prior research indicating lower afternoon/evening cortisol levels in PTSD and strong associations between PD and PTSD, but did not support the existence of subgroups of PTSD patients (dissociators versus non-dissociators) who may differ in basal cortisol levels.",0,0 +4015,Differing psychotropic profiles of the anticonvulsants in bipolar and other psychiatric disorders,"Abstract Several compounds from the anticonvulsant category have played a major role in therapeutic approaches to bipolar illness, particularly carbamazepine, valproate, and lamotrigine. At the same time there is little evidence that covert seizures underlie the affective disorders, or that all anticonvulsants are effective acute antimanic or mood stabilizing agents. For example, recent FDA-approved anticonvulsants (gabapentin, the gamma-aminobutyric acid (GABA) re-uptake inhibitor tiagabine, and topiramate) that exert major effects on GABAergic systems and increase brain GABA in patients as measured by magnetic resonance spectroscopy, do not appear to be effective acute antimanic agents based on controlled clinical trials or detailed open observations. This raises the question as to what mechanistic properties within the anticonvulsant class are associated with positive effects in bipolar illness; candidates include blockade of sodium channels and decreased release of glutamate, decreased calcium influx through the NMDA receptor, increases in potassium efflux, as well as a variety of aminergic effects and effects on gene expression. With the exception of lamotrigine, mood stabilizers (including lithium, valproate, and carbamazepine) appear to be better acute and prophylactic antimanics than antidepressants, and preliminary data suggest this for zonisamide as well. Some of the anticonvulsants appear useful in targeting a variety of other syndromes and ones that are often comorbid with bipolar illness, including anxiety disorders, substance abuse disorders, migraine, eating disorders, and obesity. Gabapentin is effective in panic anxiety and social phobia as well as chronic pain syndromes, whereas a large range of anticonvulsants may be useful in the treatment of sleep disorders and paroxysmal components of posttraumatic stress disorder. Recent data indicate that topiramate has the ability to reduce alcohol intake and craving in patients with primary alcoholism compared with placebo, and both topiramate and zonisamide share the positive side effect of inducing weight loss of a magnitude similar to that achieved with the FDA-approved weight-loss drug sibutramine. Thus, while there is an apparent absence of seizures in bipolar illness, and anticonvulsant efficacy is not sufficient for classifying the psychotropic properties of these agents, some of the mechanisms that are pertinent to inhibiting paroxysmal discharges in the epilepsies may also be pertinent to the wide range of primary or adjunctive uses of the anticonvulsants in a range of neuropsychiatric disorders.",0,0 +4016,Does the evocation of traumatic memories confound subsequent working memory performance in posttraumatic stress disorder (PTSD)?,"The role of heightened arousal has been previously discussed as a contributor to neurocognitive impairment in posttraumatic stress disorder (PTSD). To investigate whether psychological effects (distraction, re-location of resources) elicited by the evocation of traumatic memories impact on subsequent cognitive performance in PTSD, two parallel versions of a working memory task were administered to 33 trauma-exposed participants (15 with and 18 without PTSD). Between first and second working memory assessment a trauma-related interview was conducted including the narration of the trauma. Levels of working memory impairment in PTSD patients remained unchanged. This study provides preliminary evidence that neurocognitive impairment is not secondary to psychological effects induced by the evocation of traumatic memories. Nevertheless, it is recommended that future PTSD research should devote more care to the order in which trauma-related and other dependent variables such as cognitive tests are presented to participants. Depression and Anxiety 25:175–179, 2008. © 2008 Wiley-Liss, Inc.",0,0 +4017,Use of the Hand Test in the Assessment of Combat-Related Stress,"This study investigated the effectiveness of the Hand Test in discriminating the differential symptomatology of posttraumatic stress (PTS) in Vietnam combat veterans (VCVs). Participants were 108 VCV outpatients, 85 of whom met the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) criteria for posttraumatic stress disorder (PTSD), and 23 patients that were found to meet some, but not the minimum criteria, required for a diagnosis of PTSD by the DSM-IV. The latter group of patients was classified into a subclinical PTSD, posttraumatic stress symptoms (PTSS) group. Results showed higher levels of overall psychopathology, a vulnerable capacity for coping, and a tendency for feelings of inadequacy and inferiority in the PTSD group. The PTSD group also exhibited more limited interaction with the world around them than the PTSS group, which may be indicative of withdrawal, apathy, or a lack of concern with environmental activities and goals. These findings are discussed in relation to the assessment, understanding, and treatment of PTS symptomatology and PTSD.",0,0 +4018,Recovery from PTSD following Hurricane Katrina,"We examined patterns and correlates of speed of recovery of estimated posttraumatic stress disorder (PTSD) among people who developed PTSD in the wake of Hurricane Katrina.A probability sample of prehurricane residents of areas affected by Hurricane Katrina was administered a telephone survey 7-19 months following the hurricane and again 24-27 months posthurricane. The baseline survey assessed PTSD using a validated screening scale and assessed a number of hypothesized predictors of PTSD recovery that included sociodemographics, prehurricane history of psychopathology, hurricane-related stressors, social support, and social competence. Exposure to posthurricane stressors and course of estimated PTSD were assessed in a follow-up interview.An estimated 17.1% of respondents had a history of estimated hurricane-related PTSD at baseline and 29.2% by the follow-up survey. Of the respondents who developed estimated hurricane-related PTSD, 39.0% recovered by the time of the follow-up survey with a mean duration of 16.5 months. Predictors of slow recovery included exposure to a life-threatening situation, hurricane-related housing adversity, and high income. Other sociodemographics, history of psychopathology, social support, social competence, and posthurricane stressors were unrelated to recovery from estimated PTSD.The majority of adults who developed estimated PTSD after Hurricane Katrina did not recover within 18-27 months. Delayed onset was common. Findings document the importance of initial trauma exposure severity in predicting course of illness and suggest that pre- and posttrauma factors typically associated with course of estimated PTSD did not influence recovery following Hurricane Katrina.",0,0 +4019,Posttraumatic Stress Disorder in Infants and Young Children Exposed to War-Related Trauma,"Although millions of the world's children are growing up amidst armed conflict, little research has described the specific symptom manifestations and relational behavior in young children exposed to wartime trauma or assessed factors that chart pathways of risk and resilience.Participants included 232 Israeli children 1.5 to 5 years of age, 148 living near the Gaza Strip and exposed to daily war-related trauma and 84 controls. Children's symptoms were diagnosed, maternal and child attachment-related behaviors observed during the evocation of traumatic memories, and maternal psychological symptoms and social support were self-reported.PTSD was diagnosed in 37.8% of war-exposed children (n = 56). Children with PTSD exhibited multiple posttraumatic symptoms and substantial developmental regression. Symptoms observed in more than 60% of diagnosed children included nonverbal representation of trauma in play; frequent crying, night waking, and mood shifts; and social withdrawal and object focus. Mothers of children with PTSD reported the highest depression, anxiety, and posttraumatic symptoms and the lowest social support, and displayed the least sensitivity during trauma evocation. Attachment behavior of children in the Exposed-No-PTSD group was characterized by use of secure-base behavior, whereas children with PTSD showed increased behavioral avoidance. Mother's, but not child's, degree of trauma exposure and maternal PTSD correlated with child avoidance.Large proportions of young children exposed to repeated wartime trauma exhibit a severe posttraumatic profile that places their future adaptation at significant risk. Although more resilient children actively seek maternal support, avoidance signals high risk. Maternal well-being, sensitive behavior, and support networks serve as resilience factors and should be the focus of interventions for families of war-exposed infants and children.",0,0 +4020,"Posttraumatic Stress Disorder: Etiology, Epidemiology, and Treatment Outcome","Posttraumatic stress disorder (PTSD) results from exposure to a traumatic event that poses actual or threatened death or injury and produces intense fear, helplessness, or horror. U.S. population surveys reveal lifetime PTSD prevalence rates of 7% to 8%. Potential reasons for varying prevalence rates across gender, cultures, and samples exposed to different traumas are discussed. Drawing upon a conditioning model of PTSD, we review risk factors for PTSD, including pre-existing individual-based factors, features of the traumatic event, and posttrauma social support. Characteristics of the trauma, particularly peritraumatic response and related cognitions, and posttrauma social support appear to confer the greatest risk for PTSD. Further work is needed to disentangle the interrelationships among these factors and elucidate the underlying mechanisms. Based upon existing treatment outcome studies, we recommend use of exposure therapies and anxiety management training as first-line treatment for PTSD. Among psychopharmacological treatments, selective serotonin reuptake inhibitors evidence the strongest treatment effects, yet these effects are modest compared with psychological treatments.",0,0 +4021,Content not quantity is a better measure of muscle degeneration in whiplash,"Whiplash associated disorder (WAD) represents an enormous economic, social and personal burden. Five out of 10 people with WAD never fully recover and up to 25% continue to have moderate to severe pain-related disability. Unfortunately, clear and definitive reasons as to why half of individuals with WAD recover uneventfully and the other half do not, remain elusive. Identifying the factors that can reliably predict outcome holds considerable importance for not only WAD, but arguably for other acute musculoskeletal traumas. The precise pathology present in WAD has been controversial and often biased by outdated models. Fortunately, a combination of new measurement technology that illuminates pain processing, physical and social functioning and post-traumatic stress responses (and possibly markers of altered muscle size/shape/physiology) is providing a clearer picture of the multisystem pathophysiology in individuals with persistent WAD. The aim of this professional issues paper is to illuminate the clinical and research communities with regards to the growing body of knowledge for determining the trajectory of a patient with whiplash.",0,0 +4022,Nitric oxide as inflammatory mediator in post-traumatic stress disorder (PTSD): evidence from an animal model,"Post-traumatic stress disorder (PTSD) is a severe anxiety disorder that may develop after experiencing or witnessing a traumatic event. Recent clinical evidence has suggested the involvement of neurodegenerative pathology in the illness, particularly with brain imaging studies revealing a marked reduction in hippocampal volume. Of greater significance is that these anatomical changes appear to be positively correlated with the degree of cognitive deficit noted in these patients. Stress-induced increases in plasma cortisol have been implicated in this apparent atrophy. Although not definitive, clinical studies have observed a marked suppression of plasma cortisol in PTSD. The basis for hippocampal neurodegeneration and cognitive decline therefore remains unclear. Stress and glucocorticoids increase glutamate release, which is recognized as an important mediator of glucocorticoid-induced neurotoxicity. Recent preclinical studies have also noted that glutamate and nitric oxide (NO) play a causal role in anxiety-related behaviors. Because of the prominent role of NO in neuronal toxicity, cellular memory processes, and as a neuromodulator, nitrergic pathways may have an important role in stress-related hippocampal degenerative pathology and cognitive deficits seen in patients with PTSD. This paper reviews the preclinical evidence for involvement of the NO-pathway in PTSD, and emphasizes studies that have addressed these issues using time-dependent sensitization - a putative animal model of PTSD.",0,0 +4023,A group therapy approach to treating combat posttraumatic stress disorder: Interpersonal reconnection through letter writing.,"Many who have served in a war zone carry deep emotional wounds that go beyond the typical symptom clusters of reexperiencing, avoidance/numbing, and hyperarousal that comprise a diagnosis of posttraumatic stress disorder (PTSD). Specifically, many combatants experience unresolved grief, guilt, and shame caused by losses and traumatic experiences suffered in war, called ""moral injury"" by some clinicians and researchers (e.g., Litz et al., 2009; Shay, 1994). We describe the aspects of human attachment that set the stage for grief, guilt, and shame, and outline the 3-phase group therapy model we have implemented in a clinical setting to foster the reconnection of severed human bonds. Special attention is paid to killing and related phenomena that are unique to combat PTSD. The program phases include psychoeducation, trauma-focused therapy, and aftercare, which focuses on assisting the veterans in reconnecting with their families and communities. The use of letter writing as an intervention is illustrated through case examples, and clinical outcomes are anecdotally described.",0,0 +4024,Post-acute polytrauma rehabilitation and integrated care of returning veterans: Toward a holistic approach.,"Throughout the history of war, exposure to combat has been associated with clusters of physical and psychological symptoms labeled in various ways, from ""hysteria"" to ""shell shock"" in World War I to ""polytrauma"" in Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF).To describe the historical conceptualizations of combat injury and the ways they are relevant to developing current rehabilitation strategies, discuss the symptom complex presented by OEF/OIF veterans, and describe key elements and principles of holistic, integrated care for post-acute OEF/OIF veterans.A conceptualization of rehabilitation recognizing a final common pathway of functional disability and suffering is proposed, and both systematic and treatment-specific aspects at the core of a veteran-centered holistic approach are discussed.",0,0 +4025,Cancer-Related Intrusive Thoughts as an Indicator of Poor Psychological Adjustment at 3 or More Years After Breast Surgery: A Preliminary Study,"Intrusive thoughts are one of the re-experiencing symptoms in posttraumatic stress disorder, and have been suggested as a predictor for the continuous presence of psychological distress in cancer survivors. The aim of this preliminary study was to examine the possibility of using cancer-related intrusive thoughts (CITs) as an indicator of psychological distress and adjustment after breast surgery. A consecutive series of ambulatory breast cancer survivors at 3 or more years after surgery were given the Structured Clinical Interview for DSM-IV (SCID) and self-report questionnaires, including Profile Of Mood States (POMS), Impact of Event Scale (IES) and Mental Adjustment to Cancer (MAC) scale, to measure psychological distress and/or adjustment. The SCID identified a history of CITs in 34 (46 \% ) of the 74 participants. No significant differences were found in the POMS and IES psychological distress scores between subjects with and without a history of CITs. Subjects with a history of CITs showed significantly higher levels of anxious preoccupation, one of the MAC subscale scores. The association continued to be significant after controlling for potential confounders such as social support, depression, avoidance, arousal, and neuroticism. The results indicated that CITs might be useful for indicating poor psychological adjustment, but not distress, in patients at 3 or more years after breast surgery.",0,0 +4026,Emotion regulation in relation to social functioning: An investigation of child self-reports,"Relations between child self-reports of specific aspects of emotion regulation and specific aspects of social functioning in school were studied in two samples (N = 129/135) of 8- to 9-year-old children. The newly developed child self-report measure had significant relations to parent (Sample 1) and teacher (Sample 2) ratings of emotion regulation. In line with expectations (Rydell, Berlin, & Bohlin, 2003), poor regulation of anger and exuberance was associated with externalizing problems in both samples, poor regulation of fear had associations with social anxiety or internalizing problems in the two samples and poor regulation of sadness had marginal relations to internalizing problems in one sample. In both samples, good regulation of all emotions except fear was associated with prosocial behaviour. In Sample 1, several independent effects of child self-reports of emotion regulation on outcomes were demonstrated after controlling for parent reports of emotion regulation.",0,0 +4027,Resilience to potential trauma: Toward a lifespan approach.,,0,0 +4028,Prevalence and predictors of stress disorders following two earthquakes,"Background: Studies about stress disorders following a disaster have mainly been based on single-event trauma with little emphasis on multiple traumas. Aims: This study investigated the prevalence and predictors of stress disorders following two earthquakes in China. Methods: Subjects were randomly sampled from 11 villages in rural China. A total of 624 subjects were administered with the 12-item General Health Questionnaire (GHQ-12), Symptom Checklist -90-R (SCL-90-R), Coping Style Scale and Social Support Rating Scale. This was followed by a structural clinical interview using the Chinese translation of the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV-TR axis 1 disorders (SCID-I-P) for acute stress disorder (ASD) and post-traumatic stress disorder (PTSD). Results: The prevalence of ASD and PTSD was 15% and 29%, respectively. Regression analysis indicated that high intensity of trauma exposure, lower educational level, subjective feeling of economic status and psychological stress after the first earthquake significantly predicted the outcome of PTSD. Conclusions: The study suggested that the prevalence of stress disorders in two earthquakes were higher than that experienced in a single disaster. The intensity of trauma exposure, low educational level, bad subjective feeling of economic status, and psychological stress after the first earthquake could be used to identify survivors at risk of developing PTSD in two earthquakes.",0,0 +4029,Social support barriers and mental health in terrorist attack survivors,"To expand our understanding of social support and mental health, we introduce a measure of social support barriers and investigate the relationship between these barriers, social support, mental health and gender in survivors of the terrorist attack on Utøya Island, Norway.Survivors (N=285) were interviewed face to face. We used confirmatory factor analysis (CFA) to assess the latent factor structure of the Social Support Barriers Scale and perceived social support (FSSQ), and linear regression analyses to investigate the associations between social support variables and mental health (PTSD-RI and HSCL-8).The CFA indicated that social support barriers and perceived social support were two separable latent constructs. Social support barriers were highly associated with posttraumatic stress reactions (adjusted regression coefficient=0.38, 95% CI=0.29-0.47. p<0.001) as well as with psychological distress (adjusted regression coefficient=0.35, 95% CI=0.26-0.43, p<0.001). In contrast, neither perceived social support nor gender was associated with mental health after adjustment for barriers.Most analyses were based on cross-sectional data. This is the first study to use a quantitative measure of social support barriers.Social support barriers may be a new opening to understand the relationship between social support and mental health and may have a role in explaining why women are at increased risk for mental health problems. Clinicians should explore not only perceived social support but also barriers to making use of these resources when consulting young people facing major life adversities.",0,0 +4030,Parental intimate partner homicide and its consequences for children: protocol for a population-based study,"The loss of a parent due to intimate partner homicide has a major impact on children. Professionals involved have to make far-reaching decisions regarding placement, guardianship, mental health care and contact with the perpetrating parent, without an evidence base to guide these decisions. We introduce a study protocol to a) systematically describe the demographics, circumstances, mental health and wellbeing of children bereaved by intimate partner homicide and b) build a predictive model of factors associated with children's mental health and wellbeing after intimate partner homicide.This study focuses on children bereaved by parental intimate partner homicide in the Netherlands over a period of 20 years (1993 - 2012). It involves an incidence study to identify all Dutch intimate partner homicide cases between 1993 and 2012 by which children have been bereaved; systematic case reviews to describe the demographics, circumstances and care trajectories of these children; and a mixed-methods study to assess mental health, wellbeing, and experiences regarding decisions made and care provided.Clinical experience and initial research suggest that the children involved often need long-term intensive mental health and case management. The costs of these services are extensive and the stakes are high. This study lays the foundation for an international dataset and evidence-informed decision making.",0,0 +4031,Examining the relationship between race-related stressors and post-traumatic stress disorder among African American male Vietnam veterans,"It is estimated that 1,700,000 Vietnam War veterans have experienced ""clinically serious stress reaction symptoms"" (National Center for Post Traumatic Stress Disorder, 2005). Of this figure, all ethnic minorities (except for Japanese) reported the greatest life time prevalence of posttraumatic stress disorder (PTSD) compared to Whites (Kulka, Schlenger, Fairbank, Hough, Jordan, Marmar, & Weiss, 1990). The National Vietnam Veterans Readjustment Study (NVVRS) found that African American Vietnam War veterans had greater exposure to war stressors and had more predisposing factors than Whites (Kulka et al., 1990). The Race-Related Stressor Scale (RRSS) is the only instrument that exists to measure race-related stressors that contribute uniquely and substantially to PTSD symptoms and generalized psychiatric distress in an ethnic minority Vietnam Veteran sample. A previous study found that race-related stressors account for a significant proportion of the variance in PTSD symptoms of Asian American Vietnam Veterans (Loo, Fairbank, Scurfield, Ruch, King, Adams, & Chemtob, 2001). Although African American Vietnam War veterans are one of the most frequently studied samples, no instrument exists to measure race-related exposure accounting for their PTSD symptoms. There are two purposes of this study: Primary is to adapt and validate the RRSS using an African American Vietnam Veteran sample, and secondary is to examine the amount of variability the adapted RRSS accounts for in PTSD and generalized psychiatric distress symptoms. This new measure will be called the Vietnam Racial Stressor Scale for African American Vietnam Veterans (VRSS). The construct validity of the adapted RRSS will be examined by investigating the relationship between the VRSS, PTSD, and general psychiatric distress symptoms, controlling for military rank and exposure to combat. The temporal stability of the VRSS will be assessed using Cronbach's Alpha method. Results of the temporal stability of the VRSS will be compared to Loo et al., (2001) RRSS temporal stability for Asian American Vietnam War veterans. A general discussion of the temporal stability comparisons between the RRSS and its adaptations will suggest the generalizability of the RRSS with other Vietnam War veteran ethnic groups. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4032,Children's Environmental Health in the Twenty-First Century,"In the twenty-first century, the global burden of disease trends are the result of complex interaction among rapid industrialization and urbanization, unsustainable use of natural resources, and population growth. In addition, global environmental changes due to climate change, ozone depletion, desertification/deforestation, loss of biodiversity, and increased used of some biotechnologies are having an important impact on human health. Many other factors also play an important role in the population's health response to global environmental threats, including poverty, malnutrition, poor sanitation, and infectious diseases. Worldwide, the burden of environmental disease is much higher for children than adults, especially in young children under 5 years of age. Quantification of the burden of diseases attributable to environment shows that environmental risk factors can contribute to more than one-third of the disease burden in children, a fraction of disease that could be prevented. Children are often exposed to multiple environmental threats combined with other behavioral, social, and economic risk factors. Many of the environmental health risk factors are shared among children's home, school, and community. Therefore, an integrated approach should be considered in order to create healthy environments for children. The promotion of safe environments for children has to involve decision makers, nongovernmental organizations (NGOs), families, and various sectors including health, education, housing, environment, agriculture, industry, transport, and energy. Multiple initiatives have been proposed from collection, evaluation, and dissemination of information on children's health and the potential environmental threats to research, monitoring, risk assessment, and policies to improve the environmental conditions and ultimately children's growth and development.",0,0 +4033,The relationship between cognitive control and posttraumatic stress symptoms,"Recently researchers have theorized that individual differences in cognitive control (i.e., the ability to complete goal-directed behavior by actively maintaining information while inhibiting irrelevant information) may elucidate processes involved in disorders characterized by intrusive thoughts and memories. By this account, the relationship between cognitive control and emotional disorders would be specific to symptoms associated with intrusive cognitions, such as re-experiencing symptoms of posttraumatic stress disorder (PTSD).In the present study, 77 undergraduate participants with a self-reported history of trauma exposure were administered assessments of cognitive control (working memory capacity; WMC), PTSD symptoms, trait anxiety, and depression. PTSD symptoms from each of the three symptom clusters (re-experiencing, avoidance, and hyperarousal) were predicted from trait anxiety, depression, and WMC performance scores using separate regression models.After controlling for trait anxiety and depression, there was a negative, statistically significant relationship between cognitive control and re-experiencing symptoms but not avoidance or hyperarousal symptoms.The study was completed cross-sectionally and did not include a diagnostic assessment of PTSD.Findings add to extant literature suggesting a relationship between cognitive control and intrusive cognitions. Moreover, the present study expands the current literature by demonstrating the specificity of this relationship within individuals with varying degrees of PTSD symptom severity.",0,0 +4034,Computerised Test Generation for Cross-National Military Recruitment: A Handbook,"“‘Computerised Test Generation for Cross-National Military Recruitment’ by Prof. Sidney H. Irvine is a handbook for use in occupational psychology, test construction and psychometrics. The book describes the development of the British Army Recruitment Battery (BARB) by Prof. Irvine and his colleagues at the University of Plymouth. BARB is a computer-administered selection battery that is still in use to this day and is capable of developing new parallel tests for every candidate in the recruitment process. In telling the story, Sidney Irvine describes not only the development of the battery itself, funded by the UK Ministry of Defence, but all the work that went on before and afterwards, in the United Kingdom, with European allies and in the United States. Prof. Irvine argues that judicious application of the current state-of-the art in psychometric selection tests can be used to maximise retention and minimise attrition. As such, this long-awaited book will be of great interest to psychologists, psychometricians, test developers, those involved in personnel selection and all with an interest in military history, in particular the history of military science. With a foreword and chapter introductions from a worldwide array of subject matter experts, the book also has a full subject index and an extensive bibliography. I commend it heartily.” — Professor Jamie Hacker Hughes CPsychol CSci FBPsS, Former Defence Consultant Advisor in Clinical Psychology, Ministry of Defence, United Kingdom. © 2014 The author and IOS Press. All rights reserved.",0,0 +4035,The association between latent depression subtypes and remission after treatment with citalopram: A latent class analysis with distal outcome,"The objectives were to characterize latent depression subtypes by symptoms, evaluate sex differences in and examine correlates of these subtypes, and examine the association between subtype and symptom remission after citalopram treatment.Latent class analysis was applied to baseline data from 2772 participants in the Sequenced Treatment Alternatives to Relieve Depression trial. Indicators were from the Quick Inventory of Depressive Symptomatology. Separate multinomial logistic models identified correlates of subtypes and the association between subtype and the distal outcome of remission.Four latent subtypes were identified: Mild (men: 37%, women: 27%), Moderate (men: 24%, women: 21%), Severe with Increased Appetite (men: 13%, women: 22%), and Severe with Insomnia (men: 26%, women: 31%). Generalized anxiety disorder, bulimia, and social phobia were correlated with Severe with Increased Appetite and generalized anxiety disorder, post-traumatic stress disorder, and social phobia with Severe with Insomnia. Relative to those with the Mild subtype, those with Severe with Increased Appetite (odds ratiomen (OR): 0.48; 95% confidence interval (CI): 0.25-0.92; OR women: 0.59; 95% CI: 0.41-0.86) and those with Severe Depression with Insomnia (ORmen: 0.65; 95% CI: 0.41-1.02; ORwomen: 0.45; 95% CI: 0.32-0.64) were less likely to achieve remission.The sample size limited exploration of higher order interactions.Insomnia and increased appetite distinguished latent subtypes. Sex and psychiatric comorbidities differed between the subtypes. Remission was less likely for those with the severe depression subtypes. Sleep disturbances, appetite changes, and other mental disorders may play a role in the etiology and treatment of depression.",0,0 +4036,A Test of Missing Completely at Random for Multivariate Data with Missing Values,"Abstract A common concern when faced with multivariate data with missing values is whether the missing data are missing completely at random (MCAR); that is, whether missingness depends on the variables in the data set. One way of assessing this is to compare the means of recorded values of each variable between groups defined by whether other variables in the data set are missing or not. Although informative, this procedure yields potentially many correlated statistics for testing MCAR, resulting in multiple-comparison problems. This article proposes a single global test statistic for MCAR that uses all of the available data. The asymptotic null distribution is given, and the small-sample null distribution is derived for multivariate normal data with a monotone pattern of missing data. The test reduces to a standard t test when the data are bivariate with missing data confined to a single variable. A limited simulation study of empirical sizes for the test applied to normal and nonnormal data suggests th...",0,0 +4037,The Brain and Propranolol Pharmacokinetics in the Elderly.,"Propranolol, a non-selective β-blocker, has been found to have a tremendous array of indications. Recent evidence has suggested that propranolol may be effective in patients suffering from post-traumatic stress disorder by suppressing activity in the amygdala and thereby inhibiting emotional memory formation. Dosage requirements have been well established in the pediatric and adult population, however, there has been no definitive geriatric dose recommended in the package inserts made available to the public. The aim of this paper is to use pharmacokinetic simulations in order to establish a pharmacokinetic profile dosage equivalent for the elderly as has been found in young patients. After completing the Monte-Carlo simulations for the elderly and young patients, a single 10mg dose in the elderly has shown comparable pharmacokinetic profiles as found in young patients administered a 40mg single dose.",0,0 +4038,Memory performance and dysfunctional cognitions in recent trauma victims and patients with post-traumatic stress disorder,"In order to investigate whether cognitive dysregulation contributed to memory impairment in trauma patients, recent trauma victims, post-traumatic stress disorder (PTSD) patients and healthy controls were compared with regard to verbal memory and dysfunctional cognitions. There were no significant group differences with regard to verbal memory. Concerning dysfunctional cognitions, recent trauma victims hardly differed from controls, unlike PTSD patients, who showed more negative appraisal, more dysfunctional thought control strategies and externality than controls. None of them were related to memory performance in the recent trauma group, and there was a negative correlation with distraction strategy in PTSD patients. In recent trauma victims, negative appraisal increased with time since the trauma. Copyright © 2007 John Wiley & Sons, Ltd.",0,0 +4039,The mutual prospective influence of child and parental post-traumatic stress symptoms in pediatric patients,"Previous studies found notable rates of post-traumatic stress symptoms (PTSS) and post-traumatic stress disorder (PTSD) in pediatric patients and their parents and suggest a significant association between child and parent PTSS. However, little is known about mutual influences between child and parental PTSS over time. This study prospectively examined the presence of PTSS and PTSD and the mutual influence of child and parental PTSS in a large sample of pediatric patients with different medical conditions. A total of 287 children (aged 6.5-16 years) and their mothers (n = 239) and fathers (n = 221) were assessed at 5-6 weeks and 1 year after an accident or a new diagnosis of cancer or diabetes mellitus type 1 in the child. At the first assessment 11.1% and at the second assessment 10.2% of the children had moderate to severe PTSS. At 5-6 weeks 29.3% of mothers and 18.6% of fathers met criteria for PTSD. At 1 year the rates were 14.6% for mothers and 7.9% for fathers. There were considerable differences of PTSS among different medical diagnostic groups in children and parents. Mothers were more vulnerable than fathers. Structural equation analysis revealed that initially high PTSS in mothers and fathers were longitudinally related to poorer recovery from PTSS in the child. Cross-lagged effects from the child to the parents and from one parent to the other were not significant. This study highlights the long-term influence of parental PTSS on the child's recovery after trauma and calls for a family systems approach and for early interventions in the treatment of traumatized pediatric patients.",0,0 +4040,Post-Traumatic Stress Disorder in Episodic and Chronic Migraine,"To assess and contrast the relative frequency of self-reported post-traumatic stress disorder (PTSD) in patients with episodic migraine and chronic/ transformed migraine.Several risk factors have been identified as risk factors for chronification of headache disorders. Childhood abuse has been suggested as a risk factor for chronic pain in adulthood. In addition depression, as well as several other psychiatric disorders, are co-morbid with migraine. Recent data suggest that PTSD may be more common in headache sufferers than in the general population.This was a prospective, pilot study conducted at a headache center. Adult subjects with episodic, chronic, or transformed migraine were included. Demographic information, depression history, body mass index (BMI), and headache characteristics were obtained. PTSD was assessed using the life events checklist (LEC) and the PTSD checklist, civilian version (PCL-C). We contrasted the data from episodicmigraineurs and chronic/transformed migraine participants (CM) and conducted multivariate analyses, adjusting for covariates.Of the 60 participants included, 91.7% were female with a mean age of 41.4+/-12.5 years old. EM was diagnosed in 53.3% and CM in 46.7%. The mean BMI was not significantly different between groups. In contrast, the relative frequency of depression was significantly greater in subjects with CM (55.2%) than EM (21.9%, P=.016). There was no significant difference in the percentage of participants reporting at least 1 significant traumatic life event (LE) or in the mean number of traumatic LEs between EM and CM participants. However, the relative frequency of PTSD reported on the PCL in CM (42.9%) was significantly greater as compared to EM (9.4%, P=.0059. After adjusting for depression and other potential confounders, the difference remained significant P=.023).PTSD is more common in CM than in episodic migraineurs. This suggests that PTSD may be a risk factor for headache chronification, pending longitudinal studies to test this hypothesis.",0,0 +4041,Posttraumatic Stress Disorder Symptom Severity and Socioeconomic Factors Associated with Veterans Health Administration Use among Women Veterans,"The Veterans Health Administration (VA) has historically focused on treating men. Although women veterans' VA use is increasing, they remain more likely than male veterans to receive their care in non-VA settings. To date, there is limited research on factors associated with VA use among women. We examined the relationship between demographic, civilian, military, and health-related variables with past-year VA use among women veterans.Women veterans were recruited over the internet to participate in an anonymous national survey (n = 617) in 2013. An empirically derived decision tree was computed using signal detection software for iterative receiver operator characteristics (ROC) to identify variables with the best sensitivity/specificity balance associated with past-year VA use.ROC analysis indicated that 85% of participants with high posttraumatic stress disorder (PTSD) and depressive symptoms and who were younger than 54 years of age used VA in the past year. Of those who were 54 years of age or older and had very high PTSD symptoms, 94% used the VA in the last year. By contrast, only 40% of participants with relatively lower PTSD symptoms had VA past-year use, although among these individuals, VA past-year use increased to 65% for those with a relatively lower income.Findings suggest that greater PTSD symptoms, depressive symptoms, and low income correlate with VA use, with very high PTSD symptoms in older groups, high PTSD symptoms coupled with high depressive symptoms in younger groups, and low income in those with lower PTSD symptoms each associated with greater past-year VA use. Ensuring PTSD assessment and treatment, and addressing socioeconomic factors, may be key strategies for health care delivered directly or through contract with VA facilities.",0,0 +4042,Identifying latent trajectories of personality disorder symptom change: Growth mixture modeling in the longitudinal study of personality disorders.,"Although previous reports have documented mean-level declines in personality disorder (PD) symptoms over time, little is known about whether personality pathology sometimes emerges among nonsymptomatic adults, or whether rates of change differ qualitatively among symptomatic persons. Our study sought to characterize heterogeneity in the longitudinal course of PD symptoms with the goal of testing for and describing latent trajectories. Participants were 250 young adults selected into two groups using a PD screening measure: those who met diagnostic criteria for a DSM-III-R PD (PPD, n = 129), and those with few PD symptoms (NoPD, n = 121). PD symptoms were assessed three times over a 4-year study using semistructured interviews. Total PD symptom counts and symptoms of each DSM-III-R PD were analyzed using growth mixture modeling. In the NoPD group, latent trajectories were characterized by stable, minor symptoms; the rapid or gradual remission of subclinical symptoms; or the emergence of symptoms of avoidant, obsessive-compulsive, or paranoid PD. In the PPD group, three latent trajectories were evident: rapid symptom remission, slow symptom decline, or a relative absence of symptoms. Rapid remission of PD symptoms was associated with fewer comorbid disorders, lower Negative Emotionality, and greater Positive Emotionality and Constraint, whereas emergent personality dysfunction was associated with comorbid PD symptoms and lower Positive Emotionality. In most cases, symptom change for one PD was associated with concomitant changes in other PDs, depressive symptoms, and anxiety. These results indicate that the longitudinal course of PD symptoms is heterogeneous, with distinct trajectories evident for both symptomatic and nonsymptomatic individuals. The prognosis of PD symptoms may be informed by an assessment of personality and comorbid psychopathology.",0,0 +4043,Diagnosis of Posttraumatic Stress Disorder (PTSD) by the Structured Clinical Interview SCID-I,"Cel Trafna i rzetelna diagnoza pourazowego zaburzenia stresowego jest ważna w praktyce klinicznej, orzecznictwie i badaniach naukowych. Celem badania było określenie właściwości psychometrycznych polskiej wersji ustrukturalizowanego wywiadu klinicznego SCID-I-PTSD, przeznaczonego do diagnozy pourazowego zaburzenia stresowego w oparciu o kryteria DSM-IV-TR. Metoda W badaniu uwzględniono dane od pięciuset dwudziestu sześciu uczestników wypadków drogowych. Podstawę diagnozy klinicznej stanowił wywiad SCID-I-PTSD. Osoby badane wypełniały także zestaw narzędzi samoopisowych służących do oceny objawów PTSD (PDS), depresji (BDI-II), lęku (STAI) i potraumatycznych przekonań (PTCI). Wyniki Pomiar za pomocą wywiadu cechuje wysoka rzetelność oraz trafność zbieżna i różnicowa. W porównaniu do narzędzia samoopisowego wywiad SCID-I-PTSD charakteryzuje się wyższą specyficznością. Pozycje wywiadu wykazują dobre własności psychometryczne (za wyjątkiem pozycji C3) oraz brak stronniczości w odniesieniu do płci. Analizy nie pozwoliły na jednoznaczne określenie struktury czynnikowej objawów PTSD. Wnioski Otrzymane wyniki pozwalają twierdzić, że ustrukturalizowany wywiad kliniczny SCID-I, część poświęcona badaniu PTSD, wchodząca w skład Modułu F (zaburzenia lękowe) stanowi trafne i rzetelne narzędzie diagnozy pourazowego zaburzenia stresowego.",0,0 +4044,"Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care","The current combat operations in Iraq and Afghanistan have involved U.S. military personnel in major ground combat and hazardous security duty. Studies are needed to systematically assess the mental health of members of the armed services who have participated in these operations and to inform policy with regard to the optimal delivery of mental health care to returning veterans.We studied members of four U.S. combat infantry units (three Army units and one Marine Corps unit) using an anonymous survey that was administered to the subjects either before their deployment to Iraq (n=2530) or three to four months after their return from combat duty in Iraq or Afghanistan (n=3671). The outcomes included major depression, generalized anxiety, and post-traumatic stress disorder (PTSD), which were evaluated on the basis of standardized, self-administered screening instruments.Exposure to combat was significantly greater among those who were deployed to Iraq than among those deployed to Afghanistan. The percentage of study subjects whose responses met the screening criteria for major depression, generalized anxiety, or PTSD was significantly higher after duty in Iraq (15.6 to 17.1 percent) than after duty in Afghanistan (11.2 percent) or before deployment to Iraq (9.3 percent); the largest difference was in the rate of PTSD. Of those whose responses were positive for a mental disorder, only 23 to 40 percent sought mental health care. Those whose responses were positive for a mental disorder were twice as likely as those whose responses were negative to report concern about possible stigmatization and other barriers to seeking mental health care.This study provides an initial look at the mental health of members of the Army and the Marine Corps who were involved in combat operations in Iraq and Afghanistan. Our findings indicate that among the study groups there was a significant risk of mental health problems and that the subjects reported important barriers to receiving mental health services, particularly the perception of stigma among those most in need of such care.",0,0 +4045,PTSD (Post-Traumatic Stress Disorder) in Later Life,"(from the chapter) Posttraumatic stress disorder (PTSD) is a stress reaction characterized by symptoms of reexperiencing, avoidance/numbing, and hyperarousal following 1 month or more an exposure to extreme trauma. Trauma at late life is plentiful and treatable. Data of the past two decades do not suggest that older adults are at greater risk than younger adults for poor psychosocial outcomes following exposure to trauma. There is simply insufficient evidence to conclude that trauma causes more negative psychosocial consequences in older adults. Empirically supported therapies that apply to younger groups have applicability to older groups as well. The six-step model proposed here, which incorporates key elements of traditional cognitive and behavioral therapies but also expands them to include a trauma focus, is a comprehensive treatment for acute or chronic PTSD. The model treats the whole person with PTSD problems. Memories are modified or transformed directly only as a last resort. Throughout, factors related specifically to aging, mourning for losses, giving meaning to experiences, reestablishing self-coherence and self-continuity, achieving ego integration, and culture and social support are integrated. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4046,"Bipolar Disorder Comorbidity in Anxiety Disorders: Relationship to demographic profile, symptom severity, and functional impairment","Background and Objectives: High rates of comorbidity between anxiety dis- orders and bipolar disorder (BD) have been reported. Studies on the impact of BD comor- bidity in individuals with a principal anxiety disorder have been limited. Methods: Individuals (N = 186) seeking anxiety disorder treatment completed ques- tionnaires and a diagnostic interview. Anxious individuals with comorbid BD were com- pared to anxious individuals with comorbid depression, and individuals with an anxiety disorder only. Results: Anxious individuals with BD were more likely to report being single, separated or divorced, and to present with greater substance abuse and comorbidity than individuals with an anxiety disorder only. Anxious individuals with BD also presented with lower household income than anxious individuals with depression, and individuals with anxiety only. Anxious individuals with either comorbid BD or comorbid depression reported greater functional impairment and more severe symptoms than individuals with anxiety only. Conclusions: Overall, the presence of comorbid BD was associated with demographic and clinical factors that have been previously shown to adversely affect treatment out- come in people with anxiety disorders.",0,0 +4047,Schizophrenia patients with and without Post-traumatic Stress Disorder (PTSD) have different mood symptom levels but same cognitive functioning,"Objective To investigate differences in cognitive function and level of psychopathology in patients with schizophrenia (SZ) with or without psychological traumatization/post-traumatic stress disorder (PTSD). We hypothesized that traumatized patients with or without PTSD would have more severe cognitive impairments because of the neuropathological changes associated with PTSD, and more severe psychopathology compared with non-traumatized SZ patients. Method Seventy-five SZ patients with traumatization and 217 SZ patients without traumatization were evaluated regarding the symptoms and cognitive functioning, using standard symptom scales (PANSS; CDSS) and a neuropsychological test battery (IQ, verbal memory, attention, working memory, psychomotor speed, and executive functioning). Results No significant differences were observed between the groups in cognitive test performance. The patients in the traumatized group with PTSD showed significantly more current depression than the non-traumatized group (P = 0.012). Conclusion The findings did not support the hypothesis that the presence of comorbid PTSD/traumatization in SZ is associated with increased cognitive impairment. The increase in current depression in SZ with comorbid traumatization suggests that more severe psychopathology is associated with traumatization.",0,0 +4048,Factors associated with risk of depression and relevant predictors of screening for depression in clinical practice: a cross-sectional study among HIV-infected individuals in Denmark,"Depression and psychiatric disorders are frequent among HIV-infected individuals. The aim of this study was to determine the prevalence of depression and describe the psychiatric history of HIV-infected individuals in an out-patient clinic in Denmark and to identify factors of clinical importance that may be used to identify patients at risk of depression.In 2013, 212 HIV-infected patients were included in a questionnaire study. We used the Beck Depression Inventory II (BDI-II) to assess the prevalence and severity of depressive symptoms. Patients with a BDI-II score ≥ 20 were offered a clinical evaluation by a consultant psychiatrist. Logistic regression was used to determine predictors associated with risk of depression.Symptoms of depression (BDI-II score ≥ 14) were observed in 75 patients (35%), and symptoms of moderate to major depression (BDI-II score ≥ 20) in 55 patients (26%). There was also a high prevalence of co-occurring mental illness. In a multivariate model, self-reported stress, self-reported perception that HIV infection affects all aspects of life, self-reported poor health, not being satisfied with one's current life situation, previous alcohol abuse, nonadherence to antiretroviral therapy and previously having sought help because of psychological problems were independently associated with risk of depression.Symptoms of depression and co-occurring mental illness are under-diagnosed and under-treated among HIV-infected individuals. We recommend that screening of depression should be conducted regularly to provide a full psychiatric profile to decrease the risk of depression and improve adherence and quality of life in this population.",0,0 +4049,Disaster preparedness and the chronic disease needs of vulnerable older adults.,"About 80% of older adults have at least one chronic condition that makes them more vulnerable than healthy people during a disaster. These chronic conditions - combined with the physiological, sensory, and cognitive changes experienced as part of aging - result in frail older adults having special needs during emergencies. Planning and coordination among public health and emergency preparedness professionals and professionals who provide services for the aging are essential to meet these special needs. Several tools and strategies already exist to help prepare these professionals to protect and assist older adults during a disaster. These include having professionals from diverse fields work and train in coalitions, ensuring that advocates for older adults participate in community-wide emergency preparedness, and using community mapping data to identify areas where many older adults live.",0,0 +4050,The PTSD Symptom Scale's latent structure: An examination of trauma-exposed medical patients,"Several studies have employed confirmatory factor analysis (CFA) to evaluate the latent structure of posttraumatic stress disorder (PTSD) assessment measures among various trauma-exposed populations. Findings have generally failed to support the current three-factor DSM-IV PTSD conceptualization, demonstrating the need to consider alternative models. The present study used CFA to evaluate seven models, including intercorrelated and hierarchical versions of two models with the most empirical support. Data were utilized from a heterogeneous trauma-exposed sample of general medical patients (n=252). Based on several indices, the three-factor DSM-IV PTSD model was shown to be inferior to alternative models. The strongest support was found for an intercorrelated four-factor model, separating avoidance and numbing symptoms into distinct factors. Validity for this model was partially supported by divergent relations between factors and external variables. Implications of the results are discussed, and a framework is proposed for resolving discrepant findings in the PTSD CFA literature.",0,0 +4051,Young Offenders' Experiences of Traumatic Life Events: A Qualitative Investigation,"This investigation aimed to look at how a group of young offenders attending an inner-city youth offending team experienced adverse and traumatic life events. A qualitative approach was used and semi-structured interviews were conducted with eight young offenders about their perceptions of difficult experiences and the effects of such events. The interviews were analysed using Interpretative Phenomenological Analysis (Smith, Jarman, & Osborn, 1999). Analysis of the accounts yielded a number of themes. Young offenders experienced violence at home, in the community and in custody. Instability and transitions emerged as important themes in relation to school and home. Deprivation was experienced both in terms of poverty and the literal and emotional absence of parents. A variety of cognitive, emotional and behavioural responses to adverse/traumatic experiences were identified, including a blocking out of painful experience and aggression to self and others. There were barriers to seeking or making use of professional support. Custody appeared to offer an opportunity to reflect on and re-evaluate life trajectory. The study concluded that greater consideration of trauma when carrying out assessments would enable ;at risk' young offenders to be identified using clinical interviewing along side standardized measures to aid assessment of the complexity and uniqueness of the response to trauma.",0,0 +4052,Prevalence and risk factors for posttraumatic stress disorder: a cross-sectional study among survivors of the Wenchuan 2008 earthquake in China,"Background: The impact of the May 2008 Wenchuan earthquake, measuring a massive 8.0 on the surface wave magnitude scale, on public health in China has been significant and multifaceted. In light of extant data on prevalence and risk factors for posttraumatic stress disorder (PTSD) after other natural diasters, we collected data from the Wenchuan earthquake survivors to estimate the prevalence of PTSD and to characterize a range of PTSD risk factors. Methods: A cross-sectional multicluster sample survey of 446 respondents (201 from the Qiang ethnic-minority group, 245 the majority Han Chinese group) was conducted in August 2008 in Beichuan county, Sichuan province, a region that was severely affected by the earthquake. In total, 240 households were represented, with a mean of 2.2 respondents per household. Data were collected from structured interviews and the Harvard Trauma Questionnaire (HTQ) and DSM-IV criteria were used to diagnose PTSD. Results: The prevalence of PTSD was 45.5% (203/446). Low household income, being from an ethnic minority, living in a shelter or temporary house, death in family, and household damage were factors significantly related to increased odds of PTSD. Conclusions: PTSD is common after a major disaster. Postdisaster mental health recovery programs that include early identification, ongoing monitoring, preventive and intervention programs, and sustained psychosocial support are needed for the highest-risk population, namely, the bereaved, people without incomes and those with serious household damage. These populations may also benefit from governmental and nongovernmental programs that provide social and economic support, as suggested by earlier studies. Depression and Anxiety, 2009. © 2009 Wiley-Liss, Inc.",0,0 +4053,Pre-trauma verbal ability at five years of age and the risk of post-traumatic stress disorder in adult males and females,"Previous studies have shown that high cognitive ability, measured in childhood and prior to the experience of traumatic events, is protective of PTSD development. Our aim was to test if the association between pre-trauma verbal ability ascertained at 5 years with DSM-IV lifetime post-traumatic stress disorder (PTSD) at 21 years was subject to effect modification by gender, trauma type or prior behaviour problems. Using a prospective birth cohort of young Australians, we found that both trauma type and behaviour problems did not change the association between cognitive ability and PTSD. During multivariate analysis, testing for the interactive effect of gender revealed that verbal ability was linearly and inversely associated with PTSD in females only, with those in the lowest verbal ability quintile having strongly increased odds of PTSD (OR=3.89: 95% CI; 1.50, 10.10) compared with those in the highest quintile. A graph of the interaction revealed lower verbal ability placed females, but not males, at an increased risk of PTSD. Our results indicate that lower verbal ability in early childhood is a vulnerability factor for PTSD in females but not in males, and may constitute a gender-specific risk factor responsible for part of the increased risk of PTSD found in females compared with males.",0,0 +4054,Adverse Childhood Events and the Risk for New-Onset Depression and Post-Traumatic Stress Disorder Among U.S. National Guard Soldiers,"This article examines the relationship between childhood adversity and postdeployment new-onset psychopathology among a sample of U.S. National Guard personnel deployed during Operation Iraqi Freedom and Operation Enduring Freedom with no history of post-traumatic stress disorder (PTSD) or depression. We recruited a sample of 991 Ohio Army National Guard soldiers and conducted structured interviews to assess traumatic event exposure, a history of childhood adversity, and postdeployment depression, and PTSD, consistent with the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition. We assessed childhood adversity by using questions from the Childhood Adverse Events Survey. In multivariable logistic models, a history of any childhood adversity was significantly associated with new-onset depression, but not PTSD, postdeployment. This finding suggests that a history of childhood adversity is predisposing for new-onset depression, among U.S. National Guard soldiers who were deployed with no prior history of PTSD or depression. This highlights the centrality of childhood experience for the production of mental health among soldiers.",0,0 +4055,[Heat health warning systems: possibilities of improvement].,"In the summer of 2003 the temperatures reached were responsible for a large number of deaths in Europe. A year after this fact, many countries had implemented some sort of plan of prevention against excessive temperatures. Plans that had already shown its ability to prevent a large proportion of avoidable mortality in other latitudes. Since then, a lot of papers have been published providing new data on health effects of a heat wave, which can help increase the efficiency of these prevention plans. Knowing the weather conditions at risk, defining ""heat wave"" or to take into account the time that the plan should be active from the study of the relationship between temperature and their effects on health, to identify weather patterns that modulate the relationship between temperature and mortality, locate the profile of people at risk or to develop protocols for action as accurately as possible and based on scientific knowledge are elements drawn from studies carried on in recent years that should be taken into account.",0,0 +4056,"PTSD Symptom Trajectories in Disaster Volunteers: The Role of Self-Efficacy, Social Acknowledgement, and Tasks Carried Out","Millions of volunteers respond after disasters, with a 24% to 46% risk of developing posttraumatic stress disorder (PTSD). It is unclear which symptom trajectories develop and how they differ between core (volunteering before the disaster) and noncore volunteers (joining after the disaster) and which factors predict trajectories. Symptoms of PTSD were assessed at 6-, 12-, and 18-months postearthquake in 449 volunteers in Indonesia. Demographics, previous mental health service use, self-efficacy, social acknowledgment, and type of tasks were assessed at 6 months. In both core and noncore volunteers, 2 PTSD symptom trajectories emerged: a resilient trajectory (moderate levels of symptoms with a slow decrease over time; 90.9%) and a chronic trajectory (higher levels of symptoms with an increase over time; 9.1%). In both trajectories, core volunteers had fewer symptoms than noncore volunteers. Core volunteers in the chronic trajectory were characterized by having sought prior mental help, reported lower levels of self-efficacy and social acknowledgment, and were more likely to have provided psychosocial support to beneficiaries (Cramér's V = .17 to .27, partial η(2) = .02 to .06). Aid organizations should identify and follow up chronic PTSD trajectories in volunteers, including the noncore, who may be out of sight to the organization after the acute response phase.",1,0 +4057,Hallmarks of Posttraumatic Stress: Symptom Z-Scores in a Tsunami-Affected Tourist Population,"<i>Background:</i> To date, little research has been published on the prominence of the various psychiatric symptoms that result from exposure to a natural disaster. In our study of stress-related symptoms among Norwegian tourists who were repatriated after the 2004 southeast Asian tsunami, we evaluated to what extent symptom scores differed between individuals who were exposed to the disaster and those who were not. <i>Methods:</i> Participants (n = 899) completed a questionnaire via post 6 months after the disaster. The participants were categorized according to their level of exposure to the disaster: danger exposed (caught or chased by the waves), nondanger exposed (other disaster-related stressors) and not exposed. Symptoms were assessed by the General Health Questionnaire (GHQ-28), the Post Traumatic Symptom Scale (PTSS-10), and the Impact of Event Scale – Revised (IES-R). We used z-transformation of symptom scores (Z-scores) to evaluate the extent to which symptom scores among disaster-exposed individuals differed from those in the nonexposed reference group. <i>Results:</i> The IES-R revealed the greatest differences between nonexposed and disaster-exposed individuals. Hyperarousal was the most prominent symptom cluster that related to disaster exposure, followed by intrusion and then avoidance. Symptoms of anxiety, social dysfunction, withdrawal, somatization and feelings of guilt were more closely linked to exposure than were symptoms of depression. <i>Conclusions:</i> Our results indicate that symptoms of hyperarousal may be more closely linked to acute exposure to a natural disaster such as a tsunami than other symptoms of psychological distress.",0,0 +4058,"Anxiety, cognition, and habit: A multiple memory systems perspective","Consistent with a multiple systems approach to memory organization in the mammalian brain, numerous studies have differentiated the roles of the hippocampus and dorsal striatum in ""cognitive"" and ""habit"" learning and memory, respectively. Additional research indicates that activation of efferent projections of the basolateral amygdala (BLA), a brain region implicated in mammalian emotion, modulates memory processes occurring in other brain structures. The present brief review describes research designed to link these general concepts by examining the manner in which emotional state may influence the relative use of multiple memory systems. In a dual-solution plus-maze task that can be acquired using either hippocampus-dependent or dorsal striatal-dependent learning, acute pre-training or pre-retrieval emotional arousal (restraint stress/inescapable foot shock, exposure to the predator odor TMT, or peripheral injection of anixogenic drugs) biases rats towards the use of habit memory. Moreover, intra-BLA injection of anxiogenic drugs is sufficient to bias rats towards the use of dorsal striatal-dependent habit memory. In single-solution plus-maze tasks that require the use of either cognitive or habit learning, intra-BLA infusions of anxiogenic drugs result in a behavioral profile indicating an impairing effect on hippocampus-dependent memory that effectively produces enhanced habit learning by eliminating competitive interference between cognitive and habit memory systems. It is speculated that the predominant use of habit memory that can be produced by anxious and/or stressful emotional states may have implications for understanding the role of learning and memory processes in various human psychopathologies, including for example post-traumatic stress disorder and drug addiction.",0,0 +4059,Testing the dimensionality of posttraumatic stress responses in young Chinese adult earthquake survivors: further evidence for “dysphoric arousal” as a unique PTSD construct,"This study investigated an alternative five-factor diagnostic model for posttraumatic stress disorder (PTSD) symptoms, and tested external convergent and discriminant validity of the model in a young Chinese sample of earthquake survivors.A total of 938 participants (456 women, 482 men) aged 15-20 years were recruited from a vocational school originally located in Beichuan County Town which was almost completely destroyed by the ""Wenchuan Earthquake."" The participants were administrated with the PTSD Checklist and the Hopkins Symptoms Checklist-25 12 months after the earthquake.The results of confirmatory factor analysis showed that the five-factor intercorrelated model (intrusion, avoidance, numbing, dysphoric arousal, and anxious arousal) fit the data significantly better than the four-factor numbing model proposed by King et al. (1998: Psychol Assess 10:90-96) and the four-factor dysphoria model proposed by Simms et al. (2002: J Abnorm Psychol 111:637-647). Further analyses indicated that four out of five PTSD factors yielded significantly different correlations with external measures of anxiety versus depression.The findings provide further empirical evidence in favor of the five-factor diagnostic model of PTSD, and carry implications for the upcoming DSM-5.",0,0 +4060,"Clinical and neuropsychological correlates of major depression following post-traumatic brain injury, a prospective study","Major depression disorder (MDD) is the most frequent psychiatric complication after traumatic brain injury (TBI), with a prevalence of 14-77%. The aim of this study was to analyse the psychiatric sequelae of TBI, and to identify the neuropsychological and psychopathological correlates of post-TBI MDD in order to highlight their differences from those of primary MDD.This was a longitudinal, prospective, case-control study. Sixteen patients with closed brain injury, and a lesion revealed by computed tomography (CT), were recruited and were evaluated one (T1), three (T3) and six (T6) months after discharge from Neurosurgery Department; the controls were six patients with MDD. The psychiatric symptoms were evaluated using brief psychiatric rating scale (BPRS), Hamilton depression rating scale (HRSD), Beck depression inventory scale (BDI), Hamilton anxiety rating scale (HRSA), global assessment of functioning (GAF) and instrumental activity of daily living (IADL). Neuropsychological profiles were assessed by using neuropsychological tests, focused on memory and frontal-executive functioning.At T1, MDD was observed in 10 cases (62.5%), a manic episode in 12.5%, and post-traumatic stress disorder in 6.5%. At T3 and T6, MDD was diagnosed in, respectively, eight (50%) and six cases (37.5%). Post TBI MDD had less severe depressive symptoms, showed greater social isolation and hostility and more cognitive deficits in comparison with the control group.MDD is a frequent TBI complication. Patients with post-TBI MDD have a specific psychopathological profile characterised by a less severe depressive symptomatology and a neuropsychological pattern that is significantly associated with greater deficits in cognitive functions than those with primary MDD.",0,0 +4061,Behavioral Problems and Service Utilization in Children with Chronic Illnesses Referred for Trauma-Related Mental Health Services,"Given its prevalence and impact on health and well-being, children's exposure to traumatic experiences is of growing importance to pediatricians and other medical providers. Little is known, however, about the traumatic experiences profiles, trauma-related sequelae, and service use patterns of youth with chronic or recurrent medical problems/disabilities. This study aimed to fill this research gap.Participants were children less than 18 years of age who were referred for assessment and/or treatment services at one of the 56 National Child Traumatic Stress Network centers from 2004 to 2010 across the United States and had experienced at least one of 13 types of traumatic experience(s) (n = 9885; mean = 11 years, SD = 4.3; 52.3% girls). Generalized linear mixed models were used to examine associations among types of trauma, emotional and behavioral problems, and rates of service utilization adjusting for treatment center-level random effects, demographic characteristics, and the total number of types of trauma exposures.Among children seeking treatment for traumatic stress, those with comorbid medical problems/disabilities had different demographic characteristics, different types of trauma exposure, and more service utilization in multiple sectors before trauma treatment entry than those without comorbid medical problems/disabilities. Those without comorbid medical problems/disabilities had higher levels of some types of traumatic exposures, associated symptoms, and higher levels of behavioral problems at home, school, or day care. Those with medical disorders/disabilities were at 30% to 40% higher odds of meeting clinical criteria for hyperarousal and re-experiencing posttraumatic stress disorder symptoms, used more medical and mental health services for trauma, and had more emotional and behavioral concerns.Given that pediatricians are more likely to see children with medical disabilities and concerns than those without, there is an opportunity to ask directly about traumatic exposures and associated symptoms and provide support and interventions to promote resilience. Integrating trauma screening and mental health services into medical care could be especially beneficial for children with chronic medical conditions.",0,0 +4062,Mindfulness-Based Stress Reduction for Veterans Exposed to Military Sexual Trauma: Rationale and Implementation Considerations,"Military sexual trauma (MST) represents a significant public health concern among military personnel and Veterans and is associated with considerable morbidity and suicide risk. It is estimated that 22% of Veteran women and 1% of Veteran men experienced sexual assault or repeated, threatening sexual harassment during their military service. Exposure to traumatic stress has detrimental effects on emotion regulation, which refers to a set of strategies used to modulate different components of emotion at different points on the trajectory of an emotional response. Mindfulness-based interventions offer approaches to health that focus on mind and body practices that can help regulate the experience and expression of difficult emotions. Mindfulness-based stress reduction (MBSR) is an evidence-based therapy shown to be effective for depression, anxiety, and post-traumatic stress disorder. This article discusses the rationale for providing MBSR to Veterans who have been exposed to MST. The article also discusses ways to facilitate implementation of this practice in the U.S. Department of Veterans Affairs health care system. We address potential barriers to care and ways to facilitate implementation at the patient, provider, organization/local, and policy levels. MBSR is likely to be an important component of a comprehensive approach to care for Veterans exposed to MST.",0,0 +4063,A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder.,"Posttraumatic stress disorder (PTSD) is associated with regional alterations in brain structure and function that are hypothesized to contribute to symptoms and cognitive deficits associated with the disorder. We present here the first systematic meta-analysis of neurocognitive outcomes associated with PTSD to examine a broad range of cognitive domains and describe the profile of cognitive deficits, as well as modifying clinical factors and study characteristics. This report is based on data from 60 studies totaling 4,108 participants, including 1,779 with PTSD, 1,446 trauma-exposed comparison participants, and 895 healthy comparison participants without trauma exposure. Effect-size estimates were calculated using a mixed-effects meta-analysis for 9 cognitive domains: attention/working memory, executive functions, verbal learning, verbal memory, visual learning, visual memory, language, speed of information processing, and visuospatial abilities. Analyses revealed significant neurocognitive effects associated with PTSD, although these ranged widely in magnitude, with the largest effect sizes in verbal learning (d = -.62), speed of information processing (d = -.59), attention/working memory (d = -.50), and verbal memory (d =-.46). Effect-size estimates were significantly larger in treatment-seeking than community samples and in studies that did not exclude participants with attention-deficit/hyperactivity disorder, and effect sizes were affected by between-group IQ discrepancies and the gender composition of the PTSD groups. Our findings indicate that consideration of neuropsychological functioning in attention, verbal memory, and speed of information processing may have important implications for the effective clinical management of persons with PTSD. Results are further discussed in the context of cognitive models of PTSD and the limitations of this literature.",0,0 +4064,Psychological interventions for post-traumatic stress disorder and comorbid substance use disorder: A systematic review and meta-analysis.,"Co-morbid post-traumatic stress disorder (PTSD) and substance use disorder (SUD) are common, difficult to treat, and associated with poor prognosis. This review aimed to determine the efficacy of individual and group psychological interventions aimed at treating comorbid PTSD and SUD, based on evidence from randomised controlled trials. Our pre-specified primary outcomes were PTSD severity, drug/alcohol use, and treatment completion. We undertook a comprehensive search strategy. Included studies were rated for methodological quality. Available evidence was judged through GRADE. Fourteen studies were included. We found that individual trauma-focused cognitive-behavioural intervention, delivered alongside SUD intervention, was more effective than treatment as usual (TAU)/minimal intervention for PTSD severity post-treatment, and at subsequent follow-up. There was no evidence of an effect for level of drug/alcohol use post-treatment but there was an effect at 5-7 months. Fewer participants completed trauma-focused intervention than TAU. We found little evidence to support the use of individual or group-based non-trauma-focused interventions. All findings were judged as being of low/very low quality. We concluded that there is evidence that individual trauma-focused psychological intervention delivered alongside SUD intervention can reduce PTSD severity, and drug/alcohol use. There is very little evidence to support use of non-trauma-focused individual or group-based interventions.",0,0 +4065,Flashbacks and post-traumatic stress disorder: the genesis of a 20th-century diagnosis,"It has been argued that post-traumatic stress disorder (PTSD) is a timeless condition, which existed before it was codified in modern diagnostic classifications but was described by different names such as 'railway spine' and 'shellshock'. Others have suggested that PTSD is a novel presentation that has resulted from a modern interaction between trauma and culture.To test whether one core symptom of PTSD, the flashback, has altered in prevalence over time in soldiers subjected to the intense stress of combat.Random selections were made of UK servicemen who had fought in wars from 1854 onwards and who had been awarded war pensions for post-combat disorders. These were studied to evaluate the incidence of flashbacks in defined, at-risk populations.The incidence of flashbacks was significantly greater in the most recent cohort, veterans of the 1991 Persian Gulf War; flashbacks were conspicuous by their absence in ex-servicemen from the Boer War and the First and Second World Wars.Although this study raises questions about changing interpretations of post-traumatic illness, it supports the hypothesis that some of the characteristics of PTSD are culture-bound. Earlier conflicts showed a greater emphasis on somatic symptoms.",0,0 +4066,"Effects of telephone health mentoring in community-recruited chronic obstructive pulmonary disease on self-management capacity, quality of life and psychological morbidity: a randomised controlled trial","To assess benefits of telephone-delivered health mentoring in community-based chronic obstructive pulmonary disease (COPD).Cluster randomised controlled trial.Tasmanian general practices: capital city (11), large rural (3), medium rural (1) and small rural (16).Patients were invited (1207) from general practitioner (GP) databases with COPD diagnosis and/or tiotropium prescription, response rate 49% (586), refused (176) and excluded (criteria: smoking history or previous study, 68). Spirometry testing (342) confirmed moderate or severe COPD in 182 (53%) patients.By random numbers code, block stratified on location, allocation by sequentially numbered, opaque and sealed envelopes.Health mentor (HM) group received regular calls to manage illness issues and health behaviours from trained community health nurses using negotiated goal setting: problem solving, decision-making and action planning.usual care (UC) group received GP care plus non-interventional brief phone calls.Measured at 0, 6 and 12 months, the Short Form 36 (SF-36) and St George's Respiratory Questionnaire (SGRQ, primary); Partners In Health (PIH) Scale for self-management capacity, Hospital Anxiety and Depression Scale (HADS), Center for Epidemiologic Studies-Depression (CES-D) questionnaire, Post-Traumatic Stress Disorder Checklist, Satisfaction with life and hospital admissions (secondary).182 participants with COPD (age 68±8 years, 62% moderate COPD and 53% men) were randomised (HM=90 and UC=92). Mixed model regression analysis accounting for clustering, adjusting for age, gender, smoking status and airflow limitation assessed efficacy (regression coefficient, β, reported per 6-month visit). There was no difference in quality of life between groups, but self-management capacity increased in the HM group (PIH overall 0.15, 95% CI 0.03 to 0.29; knowledge domain 0.25, 95% CI 0.00 to 0.50). Anxiety decreased in both groups (HADS A 0.35; 95% CI -0.65 to -0.04) and coping capacity improved (PIH coping 0.15; 95% CI 0.04 to 0.26).Health mentoring improved self-management capacity but not quality of life compared to regular phone contact, which itself had positive effects where decline is generally expected.",0,0 +4067,From prematurity to parenting stress: The mediating role of perinatal post-traumatic stress disorder,"Preterm delivery may lead to the emergence of symptoms of Post-Traumatic Stress disorder (PTSD), which may, in turn, affect the quality of the mother-child relationship. The aim of this study is to shed light on the development of parenting stress in mothers of preterm and full-term children. It is hypothesized that PTSD symptoms mediate the relationship between preterm/full-term birth and the levels of parenting stress. Perinatal PTSD, parenting stress and social support were assessed in 156 mothers of full-term children and 87 mothers of preterm children. Mothers of preterm children experienced more post-traumatic stress and parenting stress than mothers of full-term children. However, the relationship between preterm delivery and subsequent levels of parenting stress was mediated by PTSD symptoms. These findings suggest that the maternal perception of childbirth as a traumatic experience and the subsequent development of PTSD symptoms are pivotal in the emergence of parenting stress.",0,0 +4068,In the shadow of terror: Posttraumatic stress and psychiatric co-morbidity following bombing in Iraq: The role of shattered world assumptions and altered self-capacities,"Whilst research has looked at posttraumatic stress disorder (PTSD) and psychiatric co-morbidity among civilians exposed to bombing, there is a lack of longitudinal data on the development of these outcomes and the psychological factors associated with them, particularly among Iraqi civilians. This study aimed to: investigate 1) the trajectory of PTSD and psychiatric co-morbidity following bombing among civilians in Iraq and 2) the link between shattered world assumptions, altered self-capacities and identified health outcomes. One hundred and eighty (F = 90, M = 90) Iraqi civilians exposed to first time bombing were recruited approximately one month (time 1) after the bombing and five months (time 2) after the baseline assessment. A control group data (178, F = 91, M = 87) from people who were not exposed to bombing was also collected. They completed the Posttraumatic Stress Diagnostic Scale, the General Health Questionnaire-28, the World Assumptions Questionnaire and the Inventory of Altered Self-Capacities. The results showed that there was a significant decline in the proportion of people meeting the screening criteria for PTSD and psychiatric co-morbidity symptoms over time. For the cross-sectional analysis, controlling for demographic variables, regression analysis showed that severity of the bombing (β = .16), controllability of events (β = -.21), safety and vulnerability (β=.31) and affect dysregulation (β = .37) significantly predicted PTSD time 1. Controllability of events (β = -.20) and affect dysregulation (β = .37) also predicted psychiatric co-morbidity at time 1. For the prospective analysis, controlling for PTSD and psychiatric co-morbidity at time 1, none of these dimensions predicted PTSD and psychiatric co-morbidity at time 2. Findings are discussed in terms of individual resilience. It can be concluded that following bombing, civilians developed PTSD and psychiatric co-morbidity which declined over time. Civilians' perceptions of their ability to control events in the world and regulate their affect had a short term impact on the severity of these symptoms.",0,0 +4069,"Safety and efficacy of sildenafil citrate in treating erectile dysfunction in patients with combat-related post-traumatic stress disorder: a double-blind, randomized and placebo-controlled study","To evaluate the safety and efficacy of sildenafil citrate for treating erectile dysfunction (ED) in patients with combat-related post-traumatic stress disorder (PTSD).In all, 266 combat-exposed war veterans with ED (aged 37-59 years) were recruited. They met the Diagnostic and Statistical Manual of Mental Disorders-IV criteria for PTSD according to the Structured Clinical Interview for Patients, Investigator Version. The patients were also evaluated with the Clinician-Administered PTSD Scale, both to establish the diagnosis of PTSD and to measure symptom severity. Only patients with psychogenic ED were included in the study. Patients with comorbid conditions (diabetes mellitus, hypercholesterolaemia, hypertension, Peyronie's disease) and smokers of more than five cigarettes daily were excluded. The patients were randomly divided into a group of 133 who received 100 mg of on-demand sildenafil 0.75-2 h before sexual stimulation, and 133 who received placebo. Patients were asked to use > or =16 doses or attempts at home. The efficacy of the treatments was assessed every four attempts during treatment, and at the end of the study, using responses to the 15-question International Index of Erectile Function (IIEF), Sexual Encounter Profile diary questions 2 and 3, Erectile Dysfunction Inventory of Treatment Satisfaction questionnaire, patients' event logs of sexual activity, and a Global Assessment Question about erections.Sildenafil did not produce significantly and substantially greater improvement than placebo in each of the primary and secondary outcome measures (P = 0.08). A normal EF domain score (> or =26) at endpoint was reported by 13 (9.8%), and 11 (8.3%) of patients on the sildenafil and placebo regimens, respectively (P = 0.09). Patients treated with sildenafil had no statistically significantly greater improvement in the five sexual function domains of the IIEF questionnaire than those treated with placebo (P = 0.08). The incidences of treatment-emergent adverse events were significantly greater in the sildenafil arm than in the placebo group (P = 0.01).Sildenafil is no better than placebo in treating PTSD-emergent ED. Further randomized clinical trials are warranted in combat veterans and other populations with PTSD to better elucidate the role of phosphodiesterase type 5 inhibitors in treating PTSD-emergent ED.",0,0 +4070,Combat exposure severity as a moderator of genetic and environmental liability to post-traumatic stress disorder,"Background Twin studies of veterans and adults suggest that approximately 30–46% of the variance in post-traumatic stress disorder (PTSD) is attributable to genetic factors. The remaining variance is attributable to the non-shared environment, which, by definition, includes combat exposure. This study used a gene by measured environment twin design to determine whether the effects of genetic and environmental factors that contribute to the etiology of PTSD are dependent on the level of combat exposure. Method The sample was drawn from the Vietnam Era Twin Registry (VETR) and included 620 male–male twin pairs who served in the US Military in South East Asia during the Vietnam War era. Analyses were based on data from a clinical diagnostic interview of lifetime PTSD symptoms and a self-report measure of combat exposure. Results Biometric modeling revealed that the effects of genetic and non-shared environment factors on PTSD varied as a function of level of combat exposure such that the association between these factors and PTSD was stronger at higher levels of combat exposure. Conclusions Combat exposure may act as a catalyst that augments the impact of hereditary and environmental contributions to PTSD. Individuals with the greatest exposure to combat trauma were at increased risk for PTSD as a function of both genetic and environmental factors. Additional work is needed to determine the biological and environmental mechanisms driving these associations.",0,0 +4071,Prevention and Treatment of Post-Traumatic Stress Disorder in Adolescents,"(create) Post-Traumatic Stress Disorder (PTSD) has a significant negative impact on the biological, psychological, and social development of those youth who develop the disorder following exposure to a traumatic event (Pynoos, 1994). Given the frequency with which young people today experience traumatic events, the authors feel that it is important that we develop a model for primary prevention and health promotion in those youth who have experienced trauma. In this chapter the authors look at individual, family and social risk factors and protective factors related to PTSD; evidence-based treatment interventions; psychopharmacology for PTSD; and prevention of PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4072,Sex-related and non-sex-related comorbidity subtypes of tic disorders: a latent class approach,"Recent evidence suggests that there may be more than one Gilles de la Tourette syndrome (GTS)/tic disorder phenotype. However, little is known about the common patterns of these GTS/tic disorder-related comorbidities. In addition, sex-specific phenomenological data of GTS/tic disorder-affected adults are rare. Therefore, this community-based study used latent class analyses (LCA) to investigate sex-related and non-sex-related subtypes of GTS/tic disorders and their most common comorbidities.The data were drawn from the PsyCoLaus study (n = 3691), a population-based survey conducted in Lausanne, Switzerland. LCA were performed on the data of 80 subjects manifesting motor/vocal tics during their childhood/adolescence. Comorbid attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder, depressive, phobia and panic symptoms/syndromes comprised the selected indicators. The resultant classes were characterized by psychosocial correlates.In LCA, four latent classes provided the best fit to the data. We identified two male-related classes. The first class exhibited both ADHD and depression. The second class comprised males with only depression. Class three was a female-related class depicting obsessive thoughts/compulsive acts, phobias and panic attacks. This class manifested high psychosocial impairment. Class four had a balanced sex proportion and comorbid symptoms/syndromes such as phobias and panic attacks. The complementary occurrence of comorbid obsessive thoughts/compulsive acts and ADHD impulsivity was remarkable.To the best of our knowledge, this is the first study applying LCA to community data of GTS symptoms/tic disorder-affected persons. Our findings support the utility of differentiating GTS/tic disorder subphenotypes on the basis of comorbid syndromes.",0,0 +4073,Post traumatic stress disorder and adaptive capacity in victims of intimate partner violence,"The goal of this article was to identify the existing relationship between Post Traumatic Stress Disorder (PTSD) and the adaptive capacity in a group of victims of intimate partner violence residing in Medellin (Colombia). The sample consisted of 26 people, both male and female selected from different health and social centers. The instruments used were the PTSD Symptom Severity Scale and the Maladjustment Scale. Descriptive statistics and Pearson's Correlation Coefficient were used for data analysis. The results reinforce the initiative of considering PTSD as a diagnostic category unmistakably associated to intimate partner violence; 84.2% of the sample reported Post Traumatic Stress Disorder symptomatology, mainly avoidance and hyperarousal, as well as somatic manifestations. Maladjustment levels were highly elevated, 93.2% average, the areas with the lowest level of adaptive capacity were marital life and family life, while maladjustment levels exhibited significant associations with overall PTSD and hyperarousal (p <0.01). In general, the participants exhibited emotional affliction in their responses, characterized by the presence of somatic anxiety, an intense fear of re-experiencing the abuse situations and a marked response of increased arousal.",0,0 +4074,An Integration of American Nontraditional and Mesoamerican Traditional Approaches as a Treatment Model for Traumatic Stress and Post-Traumatic Stress Disorder (PTSD),"Traumatic stress and Post-Traumatic Stress Disorder (PTSD) are rampant in American culture, even within nuclear families. This may cause disorganization of attachment bonds and increase the likelihood of PTSD when exposed to future traumatic events. The objective of this study is to assess the similarities and differences among psychotherapeutic treatment modalities employed in the United States, Cognitive Behavioral Therapy (CBT); Eye Movement Desensitization and Reprocessing (EMDR); Structured Intervention for Trauma for Children, Adolescents and Parents (SITCAP); Hypnosis; and finally Curanderismo, a Mesoamerican traditional treatment modality with similar practices to those found in Transpersonal Psychology for the treatment of PTSD. This heuristic study consists of interviews with co-researchers gathered in urban settings in the United States; urban, rural, and jungle settings in Mexico; and the personal and professional experiences of the researcher with both modalities. This study includes description of the therapeutic use of the temazcal (a Mesoamerican sweat lodge); limpias (a ritualized clearing of the subtle energy field); the medicinal and spiritual applications of herbalism; shamanic ritual; and the platica (a specific and highly interpersonal counseling style employed by curanderos), and the significance of holism and equilibrium in the Mesoamerican healing paradigm. In addition to these, this discussion also presents the role of prayer and interpersonal touch related to healing traumatic stress, and PTSD. An analysis of the results produced the development of an integrated healing model to reflect the positive aspects of all researched modalities toward efficacious treatments for traumatic stress and PTSD. Finally, this research examines and discusses the implications, limitations, and future research of this model for trauma treatment and research. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4075,Cognitive–Behavioral Theory and Preparation for Professionals at Risk for Trauma Exposure,"Military personnel, emergency first responders, and others whose work environments include exposure to traumatic events are at risk for developing posttraumatic stress disorder (PTSD). To help prevent negative sequelae, there is a strong need to identify well-operationalized, empirically supported, theoretically framed models of healthy adaptation to potentially traumatic events. Cognitive–behavioral theories (CBTs) describe etiological factors in trauma, guide research that has identified risk for PTSD, and help develop interventions that can effectively reduce posttrauma symptomatology. In this article, the authors draw on CBT and empirical research on post-traumatic stress to propose possible cognitive–behavioral mechanisms in trauma adaptation. They then suggest directions for future research, including areas for prevention interventions for at-risk professionals.",0,0 +4076,Psychometric Properties and Confirmatory Factor Analysis of the Posttraumatic Stress Disorder Checklist for Chinese Survivors of Road Traffic Accidents,"Abstract Objectives: To examine the psychometric properties and factor structure of the Chinese version of the Posttraumatic Stress Disorder Checklist. Participants and Methods: A total of 481 survivors of road traffic accidents completed the Posttraumatic Stress Disorder Checklist, Impact of Event Scale-Revised, and General Health Questionnaire 1 week after a road traffic accident. Their responses were studied to investigate the factor structure and validity of the Posttraumatic Stress Disorder Checklist. To examine the diagnostic utility of the Checklist, an independent sample of 45 road traffic accident survivors completed the Posttraumatic Stress Disorder Checklist and the Clinician-administered Post-traumatic Disorder Scale 1 month after their road traffic accidents. Results: A hierarchical 4-factor model was identified as providing the best account of the data for the Posttraumatic Stress Disorder Checklist. The diagnostic efficiency of the mixed scoring criteria, using a minimum symptom score of 4 with either a total score of 44 or 50, was confirmed as a means of screening for post-traumatic stress disorder. Conclusions: The Chinese version of the Posttraumatic Stress Disorder Checklist was found to have satisfactory reliability and validity. Key words: Accidents, traffic; Life change events; Questionnaires; Stress disorders, post-traumatic ... (ProQuest: ... denotes formula omitted.) Introduction According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV),1 the prevalence of acute stress disorder in individuals exposed to trauma ranges from 14 to 33%. In the adult population the lifetime prevalence of post-traumatic stress disorder (PTSD) found in community-based studies is approximately 8%. However, there are few psychometrically sound Chinese language PTSD-related assessment instruments for clinical and research use. Although the Chinese version of the Impact of Event Scale-Revised (IES-R) has been proven a useful means of examining traumatic stress, the items included do not bear a direct reference to the diagnostic criteria in the DSM-IV.2-6 The PTSD Checklist (PCL)7 is a 17-item, selfreported rating scale instrument that parallels DSM-IV's diagnostic criteria B, C, and D for PTSD. Thus, the PCL may yield information that has greater predictive validity on a diagnostic level than the IES-R. The PCL's structure may also enable researchers to draw more precise comparisons with data derived from PTSD-relevant interviews such as the Clinician-administered PTSD Scale (CAPS).8 The PCL's diagnostic sensitivities and specificities in different languages have been demonstrated. This includes the English version,7,9,10 French version,11 and Spanish version.12 As it takes only a short period, roughly 5 minutes, to administer the PCL, it compares favourably with the 40 to 60 minutes needed for diagnostic interviews (e.g. CAPS), making the PCL a good candidate as a screening tool for PTSD. There is a need for PTSD-related assessment instruments in Chinese, so this study was conducted to investigate the psychometric properties of the Chinese version of the PCL and to provide preliminary results for guiding future use of the PCL as a valid and reliable PTSD assessment instrument in Chinese. This study aimed to examine the psychometric properties of the Chinese version of the PCL when applied to survivors of road traffic accidents (RTAs) attending accident and emergency (A&E) services. Data collected from 481 respondents 1 week after experiencing a RTA were used to study the internal consistency, reliability, and factor structure of the PCL. Given the personal impact, nature and recency of the event, data from RTA survivors at this point should enable us to understand the psychometric properties of the PCL. The concurrent validity of the PCL was examined by studying its relationship with self-reported measures of general psychological distress and posttraumatic stress, respectively. …",0,0 +4077,Understanding acute psychological distress following natural disaster,"A household probability sample of 229 adults was interviewed four to seven months after the Sierra Madre earthquake (June 28, 1991; Los Angeles County). The study predicted psychological distress from these variables: demographics, traumatic event history, low magnitude event history, earthquake related threat perceptions, and earthquake related resource loss. Based on the Conservation of Resources (COR) stress model, it was predicted that resource loss would be central in predicting psychological distress. Three major hypotheses were supported: (1) resource loss was positively associated with psychological distress; (2) resource loss predicted psychological distress when other predictors were statistically controlled; and (3) resource loss was associated with mild to moderate elevations in of psychological distress. The findings support COR stress theory. Theoretical and practical implications are discussed.",0,0 +4078,Risperidone ameliorates post-traumatic stress disorder-like symptoms in modified stress re-stress model,"The management for post-traumatic stress disorder (PTSD) involves chronic administration of drugs. We have modified the stress re-stress (SRS) model to study the effect of chronic administration of risperidone (RIS) after induction of PTSD in rats. On day-1 (D-1) rats underwent training session for elevated-plus maze (EPM) test. On D-2, rats were subjected to stress protocol of 2 h restraint and 20 min forced-swim test (FST) followed by halothane anesthesia. The rats were exposed to re-stress (FST) on D-8 and at six day intervals on D-14, D-20, D-26 and D-32. The rats were treated with RIS (0.01, 0.1 and 1.0 mg/kg; p.o. ) and standard drug, paroxetine (PAX; 10.0 mg/kg; p.o. ) from D-8 to D-32. RIS (0.1 mg/kg) and PAX ameliorated SRS-induced immobility. RIS in median dose reversed SRS-induced hypocorticosteronemia both in urine and plasma. RIS in median dose improved SRS-induced behavioral perturbations such as memory impairment and anxiety-like behavior in EPM and Y-maze tests. RIS (0.1 mg/kg) reversed SRS-induced increase in amygdalar serotonin level. RIS (0.1 mg/kg) increased the expression of hippocampal MR thereby reversing the SRS-induced decrease in MR/GR ratio. Pearson's analysis of data on D-32 showed that there was significant correlation of plasma corticosterone, amygdalar serotonin and hippocampal ratio of mineralocorticoid (MR)/glucocorticoid receptor (GR) with SRS-induced behavioral abnormalities. Hence, median dose of RIS shows anti-PTSD-like effect in the modified SRS model. PAX had earlier onset of action in ameliorating behavioral effects of PTSD compared to RIS. However, RIS showed anti-PTSD like effect in sub-therapeutic dose. The mode of anti-PTSD action of RIS seems to involve the HPA-axis and serotonergic system, whereas PAX did not show any significant action on these pathways. The effect of repeated treatment of drugs for PTSD can be evaluated using the modified SRS model. • Modified SRS showed PTSD related behavioral abnormalities. • RIS in median dose reversed SRS-induced hypocorticosteronemia in urine and plasma. • RIS improved SRS-induced behavioral abnormalities. • RIS reversed SRS-induced decrease in MR:GR in hippocampus. • Modified SRS can be used to evaluate repeated drug treatment schedules for PTSD.",0,0 +4079,Examining posttraumatic stress symptoms in a national sample of homicide survivors: Prevalence and comparison to other violence victims,en,0,0 +4080,Therapeutic Prospects of PPARs in Psychiatric Disorders: A Comprehensive Review,"Peroxisome Proliferator-Activated Receptors (PPARs) are a family of nuclear receptors whose activation modulates the gene expression that underlies both the glucid-lipid and the inflammation pathways. While many PPARs agonists have been used for years as medication for metabolic disorders, an increasing attention is being currently dedicated to these drugs for inflammation-related pathologies. Within the psychiatric field, it has recently appeared that inflammatory processes are highly suspected in the pathophysiology of several important disorders, such as schizophrenia and mood disorders. By their anti-inflammatory properties, PPARs might have a disease-modifying action that could help in improving the outcome of patients. Furthermore, recent data suggest that PPARs could also modulate the expression of some neurotransmission factors. Therefore, PPARs may directly modify the information processing, and have a potential symptomatic action on several psychiatric disorders. At last, PPARs action of metabolic regulation could have a role on corrective or even preventive strategies against the metabolic adverse events that are commonly observed with some current psychiatric medications, notably antipsychotics. This triple potential action profile of PPARs modulators is investigated in this article, successively for schizophrenia spectrum disorders and mood disorders. Theoretical involvements of PPARs are also discussed for the treatment of Post- Traumatic Stress Disorder and Personality Disorders. At the time of the emerging concept of psychoneuroimmunology, PPARs open original therapeutic prospects for the psychiatric research.",0,0 +4081,Children’s Disaster Reactions: the Influence of Family and Social Factors,"This review examines family (demographics, parent reactions and interactions, and parenting style) and social (remote effects, disaster media coverage, exposure to secondary adversities, and social support) factors that influence children’s disaster reactions. Lower family socioeconomic status, high parental stress, poor parental coping, contact with media coverage, and exposure to secondary adversities have been associated with adverse outcomes. Social support may provide protection to children in the post-disaster environment though more research is needed to clarify the effects of certain forms of social support. The interaction of the factors described in this review with culture needs further exploration. © 2015, Springer Science+Business Media New York.",0,0 +4082,Post-Traumatic Stress Disorder in the Military Veteran,"Post-traumatic stress disorder (PTSD) has followed in the wake of wars throughout history, even wars that have been brief and successful. Soldiers are at marked risk for chronic functional impairment as well as specific psychiatric conditions such as dysthymia, panic disorders, obsessive disorder, and others. Premilitary functioning and genetics play definite roles in the likelihood of developing PTSD, whereas long-term outcome depends upon a number of additional factors such as severity of combat exposure and chronic physical disabilities. Primary prevention, understandably, is both desirable and difficult, and secondary prevention is both attainable and effective. Likewise, treatment is significantly effective in some, but not all, veterans.",0,0 +4083,Changing for Better or Worse? Posttraumatic Growth Reported by Soldiers Deployed to Iraq,"There has been increased interest in self-perceived posttraumatic growth, but few longitudinal studies have focused on its relationship with posttraumatic stress. Self-perceived growth is generally thought to facilitate adjustment, but some researchers have proposed that it reflects a dysfunctional coping strategy that impedes adjustment and leads to posttraumatic stress. In this prospective longitudinal study, we examined the relationship between self-perceived posttraumatic growth and stress. Participants were soldiers deployed to Iraq. They were tested before their deployment ( N = 479) and again 5 months ( n = 382; 80%) and 15 months ( n = 331; 69%) after returning home. Cross-lagged panel analysis indicated that more perceived growth 5 months postdeployment was associated with more posttraumatic stress 15 months postdeployment, even after we controlled for stressor severity, posttraumatic stress at 5 months, and potential predeployment confounders (extraversion, neuroticism, and cognitive ability). Findings suggest that it may be counterproductive to promote perceived growth to enhance adjustment after traumatic events.",0,0 +4084,Prevalence of psychiatric disorders three years after the 1999 earthquake in Turkey: Marmara Earthquake Survey (MES),"Background: The objective of the study is to describe the community prevalence of psychiatric disorder, mainly posttraumatic stress disorder (PTSD) and Major Depressive Disorder (MDD) 3 years after a devastating earthquake. Methods: Three years after the Marmara Earthquake, 683 individuals from the epicentre were randomly selected to form a representative sample and were assessed with Composite International Diagnostic Interview (CIDI), General Health Questionnaire (GHQ), Traumatic Stress Symptom Checklist (TSSC) and Beck Depression Inventory (BDI). Results: The 36 months prevalence of PTSD and MDD after the Marmara Earthquake were 19.2% and 18.7% respectively. The current prevalence of PTSD and MDD in the affected community was found to be 11.7% and 10.5%, respectively. PTSD and MDD were the most prevalent disorders after the disaster and showed a decrease over time. However, only 38.9% of the PTSD cases identified at any time over the 3 years were in remission at the 3rd-year. The co-occurrence of MDD with PTSD resulted in a decrease in the rate of recovery from PTSD. MDD was also the most prevalent disorder accompanying PTSD. Of all the subjects 37.5% with PTSD still met the MDD criteria at the 3rd year postearthquake. Conclusions: In comparison with the data from pre-earthquake national mental health profile, the present study showed that the prevalence of MDD, panic disorder, OCD, GAD, social phobia and special phobias were still higher in the affected region 3 years after the earthquake. (",0,0 +4085,Effects of a formula of components from Shengmai Powder on glucocorticoid receptor in rats after thermal injury,"To investigate the effects of a formula of components from Shengmai Powder, a compound traditional Chinese herbal medicine, on glucocorticoid receptor (GR) in rats after thermal injury.A total of 32 male SD rats were randomly assigned into normal control group, untreated group, ginsenosides group and components group, with 8 rats in each group. Rats in the normal control group were intragastrically administered with normal saline (NS) at room temperature once daily. Rats in the untreated group were treated with NS before thermal injury, and rats in the components group and ginsenosides group were once daily treated with a mixture of aqueous extracts of Ophiopogonis Japoni, Fructus schizandrae Chinensis and ginsenosides and ginsenosides respectively. Rats were administered for one week. After the last administration, rats in the untreated group and treated groups underwent thermal injury for one hour, and then were sacrificed immediately by decapitation. Blood serum was collected, and the serum corticosterone (CS) and adrenocorticotropic hormone (ACTH) levels were determined with enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (RIA) respectively. The liver, lung and kidney homogenates were used to determine the GR binding capacity by radioligand receptor binding assay. The results were analyzed by one point analysis.GR binding capacities in liver, lung and kidney cytosols in the untreated group were obviously lower than those in the normal control group (P<0.01). The GR binding capacities in the liver and lung cytosols in the components group and the ginsenosides group were significantly higher than those in the untreated group (P<0.01), but no significant difference was found in kidney cytosol. Compared with the ginsenosides group, GR binding capacity in liver cytosol in the components group was increased (P<0.01), but there were no noticeable differences when compared with the GR binding capacities in lung and kidney cytosols. Serum CS and ACTH levels of the normal rats were (66+/-16)microg/L and (59+/-18) ng/L respectively. There were significant differences in CS and ACTH levels between the normal control group and the other groups (P<0.01), in which the serum CS and ACTH levels were (113+/-33)microg/L and (125+/-20) ng/L, (123+/-26) microg/L and (110+/-30) ng/L and (118+/-17) microg/L and (115+/-35) ng/L respectively. But there was no significant difference between the untreated group and the other treated groups.The formula of components from Shengmai Powder can enhance the effect of ginsenosides in up-regulating GR in rats after thermal injury.",0,0 +4086,Cognitive therapy for people with post-traumatic stress disorder to multiple events: Working out where to start,"(create) Many people presenting for help with post-traumatic stress disorder (PTSD) have re-experiencing symptoms relating to more than one traumatic event and this can be daunting to clinicians. Although there is now a substantial literature on working with single-incident PTSD, less is available to help clinicians working with those with PTSD to multiple events. Despite over 25 years of epidemiological research on the prevalence of traumatic events and PTSD, the proportion of this population with PTSD to more than one event remains unclear. Many clinicians have argued that the psychological effects of isolated traumatic events and repeated trauma are different and require different treatment. Herman (1992) proposed a phased model of treatment for people who have experienced multiple traumatic events. The first priority is ensuring safety. This includes reducing the risk of further trauma (e.g., organizing alternative accommodation for victims of domestic violence), reducing self-harm, improving affect-regulation, and controlling dissociation. The second phase, 'remembrance', involves providing a detailed account of the trauma so that it can be incorporated within an autobiographical narrative. In the third, 'reconnection' phase, a sense of self is (re-)established encompassing more than their identity as a trauma survivor. Most guidance for clinicians working with people with PTSD to multiple events refers to themes likely to be important, such as trust and intimacy, or describes particular treatment approaches, such as testimony or narrative exposure therapy. Advice regarding the order in which to work on memories relates to constructing a hierarchy of trauma memories and collaborative decision-making with clients (Hembree, Rauch, & Foa, 2003). Control over treatment and sensitive pacing of the work are, clearly, essential for clients whose control was taken away during the trauma. However, greater attention to the cognitive factors within the formulation and the relationship between the traumatic events assists with this process. It can help identify which re-experiencing symptoms can be treated most quickly, giving the client an early experience of success, which can hearten them to tackle even more distressing memories. People with PTSD to multiple traumatic events fall into different groups, which tend to have distinct presentations: (1) people with PTSD to multiple events in childhood, often physical or sexual abuse; (2) people with PTSD to multiple events in adulthood, including victims of domestic violence, people in high-risk occupational groups such as emergency personnel, and asylum-seekers and refugees; and (3) people with PTSD to traumatic events in both childhood and adulthood. The two cases presented in this chapter represent differing presentations of this third group. All aspects of treatment needed for PTSD to single events are also required for the treatment of PTSD to multiple events. The emphasis here is on additional elements useful with PTSD to multiple events. There are some issues particular to specific groups-those with histories of childhood abuse are likely to present with more dissociative symptoms, for example-but the same general principles apply across groups. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4087,The latent structure of posttraumatic stress disorder among adolescents,"Debate has arisen over whether posttraumatic stress disorder (PTSD) is most accurately conceptualized as representing a discrete clinical syndrome or an extreme reaction to traumatic life events. Recent taxometric research using predominantly adult samples appears to support a dimensional model of PTSD, raising questions about the utility of current psychiatric nosology which depicts PTSD as a distinct entity. The present study sought to use taxometric procedures to examine the latent structure of posttraumatic stress reactions among a national epidemiologic sample of 2,885 adolescents. Results were consistent with previous taxometric studies in supporting a dimensional model of posttraumatic stress reactions. The implications of these findings for public policy, as well as the etiology and assessment of posttraumatic stress reactions, are discussed.",0,0 +4088,Demoralisation syndrome does not explain the psychological profile of community-based asylum-seekers,"Demoralisation syndrome (DS) has been advanced as a construct that features hopelessness, meaninglessness, and existential distress. Demoralisation and DS have predominantly been considered secondary only to illness; hence there is scant research on demoralisation or DS in populations affected by extreme environmental stress.The current study aimed to determine the prevalence of demoralisation, its predictors, and the relevance of DS in a community-based forced-migrant population.A convenience sample of 131 adult asylum-seekers (n=98) and refugees (n=33) without recognised mental disorders in Melbourne, Australia, were assessed cross-sectionally on posttraumatic stress, anxiety, depression, post-migration stress, and demoralisation. Socio-demographic data were analysed with relevant clinical data. Predictive aims were investigated using bivariate statistical tests and exploratory aims were investigated using correlational and linear regression analyses.Seventy nine percent of the sample met criteria for demoralisation (asylum-seekers=83%; refugees=66%), with asylum-seekers being 2.55 (95% C.I.=1.03-6.32, Z=2.03, p=.04) times more likely to be demoralised than refugees. No relationship between demoralisation and time in the refugee determination process emerged. The regression model explained 47.5% of variance in demoralisation scores for the total sample F(9,111)=13.07, p<.0001, with MDD and anxiety score making unique significant contributions.Demoralisation was widespread through the asylum-seeker and refugee population and its prevalence was attributable to a range of social and psychiatric factors. However, DS had little explanatory power for psychiatric morbidity, which was more suggestive of a pan-distress symptom complex.",0,0 +4089,"Suicidality, Psychopathology, and Gender in Incarcerated Adolescents in Austria","Article AbstractObjective: Delinquent juveniles are at extreme risk for suicide with death rates 4 times higher than in the general population. Whereas psychopathologic risk factors for suicidal behavior in nonforensic adolescent populations are well defined, psychopathologies associated with suicidality in delinquent juveniles are not yet clear. The objective of this study was to determine gender-specific psychopathologic profiles associated with suicidality in detained juveniles. Method: The Massachusetts Youth Screening Instrument-Second Version, the Youth Self-Report, and the Mini-International Neuropsychiatric Interview for children and adolescents were used to investigate juveniles in an Austrian pretrial detention facility. The study sample consisted of all juveniles entering the system between March 2003 and January 2005. Of the 370 eligible participants, 319 completed the study (53 girls and 266 boys; age range, 14 to 21 years; mean = 16.67, SD = 1.45 years). Results: We found significantly higher prevalence rates of both current (p < .01) and lifetime (p < .001) suicidality in girls than in boys. Suicidal boys exhibited more psychopathology and a wider range of psychopathology compared to nonsuicidal boys. For suicidal girls, psychopathologies appeared more circumscribed (all relevant p values < .04). Using signal detection methods, major depressive disorder, attention-deficit/hyperactivity disorder, and social phobia identified boys athighest risk of suicidality, while a diagnosis of posttraumatic stress disorder identified girls at highest risk. Conclusions: Suicidality levels are high in delinquent adolescents, especially in girls. Psychopathologic risk factors seem to be gender specific in this population. Not only depression, but also psychopathologies that usually do not arouse strong suspicion for an association with suicidal behavior, i.e., social phobia and ADHD in boys and PTSD in girls, might increase suicide risk. Further research in other countries is needed to replicate our results with respect to sociocultural influences.",0,0 +4090,Minnesota Multiphasic Personality Inventory (MMPI)-derived psychopathology subtypes among former prisoners of war (POWs): Replication and extension,"Psychopathology and symptom patterns identified among former prisoners of war (POWs) by Sutker, Winstead, Goist, Malow, and Allain (1986) were replicated in an independent sample of 51 former POWs with similar personal backgrounds and military experiences. Data collection instruments included the Minnesota Multiphasic Personality Inventory (MMPI), self-report measures of anxiety and depression, and a structured clinical interview including a POW Trauma Index. Two prototypic MMPI profile patterns were identified using modal profile analysis (Skinner & Lei, 1980). Both were highly similar in shape and elevation to those reported in the previous investigation. Multiprofile-multisample analysis produced prototypic profile patterns which were accurate representations of profiles identified in separate analyses of the derivation and replication samples (r's ≥.96). Representing unique constellations of clinical features, profile subtypes were associated differentially with confinement stress severity, postservice adjustment, and nature and extent of stress-induced symptomatology. © 1988 Plenum Publishing Corporation.",0,0 +4091,Pharmacological Management of Mood and Anxiety Disorders in Headache Patients,"There is emerging evidence that treatment of comorbid mood and anxiety disorders can improve headache treatment outcome when implemented within a comprehensive program. Effective treatment for comorbid mood and anxiety disorders requires screening headache patients and accurately diagnosing specific psychiatric disorders when present. Specific dual-action antidepressant, anticonvulsant, and atypical antipsychotic medications can serve as dual agents that simultaneously treat both headaches and a mood or anxiety disorder. Serotonin reuptake inhibitors and most other antidepressant, anxiolytic, and mood-stabilizing medications are generally ineffective for headache prophylaxis. However, they can be safely added to a headache regimen for treatment of a comorbid psychiatric disorder. Treatment of comorbid psychiatric disorders in headache patients requires patient education about the psychiatric disorder, its treatment, possible side-effects, and expected benefits. Clinicians need to be sensitive to possible stigma that some patients fear from a psychiatric diagnosis or its treatment.",0,0 +4092,"Exposure, probable PTSD and lower respiratory illness among World Trade Center rescue, recovery and clean-up workers","Background Thousands of rescue and recovery workers descended on the World Trade Center (WTC) in the wake of the terrorist attack of September 11, 2001 (9/11). Recent studies show that respiratory illness and post-traumatic stress disorder (PTSD) are the hallmark health problems, but relationships between them are poorly understood. The current study examined this link and evaluated contributions of WTC exposures. Method Participants were 8508 police and 12 333 non-traditional responders examined at the WTC Medical Monitoring and Treatment Program (WTC-MMTP), a clinic network in the New York area established by the National Institute for Occupational Safety and Health (NIOSH). We used structural equation modeling (SEM) to explore patterns of association among exposures, other risk factors, probable WTC-related PTSD [based on the PTSD Checklist (PCL)], physician-assessed respiratory symptoms arising after 9/11 and present at examination, and abnormal pulmonary functioning defined by low forced vital capacity (FVC). Results Fewer police than non-traditional responders had probable PTSD (5.9% v . 23.0%) and respiratory symptoms (22.5% v . 28.4%), whereas pulmonary function was similar. PTSD and respiratory symptoms were moderately correlated ( r =0.28 for police and 0.27 for non-traditional responders). Exposure was more strongly associated with respiratory symptoms than with PTSD or lung function. The SEM model that best fit the data in both groups suggested that PTSD statistically mediated the association of exposure with respiratory symptoms. Conclusions Although longitudinal data are needed to confirm the mediation hypothesis, the link between PTSD and respiratory symptoms is noteworthy and calls for further investigation. The findings also support the value of integrated medical and psychiatric treatment for disaster responders.",0,0 +4093,The prevalence of PTSD following the violent death of a child and predictors of change 5 years later,"In this study, we examined the violent death bereavement trajectories of 173 parents by following them prospectively for 5 years after their children's deaths by accident, suicide, homicide, or undetermined causes. Using latent growth curve methodology, we examined how the initial level of PTSD and the rate of change over time were influenced by 9 predictors: the deceased children's causes of death, parents' gender, self-esteem, 3 coping strategies, perceived social support, concurrent levels of mental distress, and an intervention offered in early bereavement. Six of the nine factors predicted initial levels of PTSD; however, only parents' gender and perceived social support predicted change in PTSD over the 5-year time frame. Five years postdeath, 3 times as many study mothers (27.7%) met diagnostic criteria for PTSD and twice as many study fathers (12.5%) met diagnostic criteria for PTSD compared with the normative samples.",0,0 +4094,Traumatic brain injury and posttraumatic stress disorder: a preliminary investigation of neuropsychological test results in PTSD secondary to motor vehicle accidents,This study investigated the effect of traumatic brain injury on the development of posttraumatic stress disorder (PTSD). Subjects were 107 motor vehicle accident survivors including 38 individuals who were diagnosed with posttraumatic stress disorder (PTSD). Neuropsychological testing was administered to all subjects during an initial diagnostic evaluation. Results showed that subjects who had lost consciousness during their MVA had greater impairment on speed dependent tests and delayed recall of verbal material. Subjects who suffered traumatic brain injury (TBI) were also found to have developed PTSD as often as those who had not reported TBI. Implications for future research and clinical utility are discussed.,0,0 +4095,Validity of the Dissociative Experiences Scale in screening for multiple personality disorder: a multicenter study,"The Dissociative Experiences Scale has proved a reliable and valid instrument to measure dissociation in many groups, but its capacity to distinguish patients with multiple personality disorder from patients with other psychiatric disorders has not yet been conclusively tested.A discriminant analysis was performed to classify 1,051 subjects as having or not having multiple personality disorder. Another discriminant analysis was performed on a subgroup of 883 subjects more closely representing patients in a typical psychiatric facility in terms of base rates of dissociative disorders. A cutoff score of 30 was also used to classify subjects, and Bayes's theorem, which allows for the calculation of the positive predictive value and the negative predictive value of a screening test, was applied.According to discriminant analysis of the total study group, the scale's sensitivity was 76% and its specificity was also 76%; according to discriminant analysis of the more representative subgroup, the scale's sensitivity was 76% and its specificity was 85%. Use of the cutoff score of 30 produced similar results. Results of the application of Bayes's theorem showed that 17% of the subjects scoring 30 or higher would actually have multiple personality disorder and 99% of those scoring less than 30 would not have multiple personality disorder.These results indicate that the Dissociative Experiences Scale performs quite well as a screening instrument to identify subjects with multiple personality disorder. In addition, the consistency of responses to scale items across centers indicates that the symptoms reported by patients with multiple personality disorder are highly similar across diverse geographic centers. This consistency supports the reliability and validity of the diagnosis of multiple personality disorder across centers.",0,0 +4096,"Personality, posttraumatic stress and trauma type: factors contributing to posttraumatic growth and its domains in a Turkish community sample","Posttraumatic growth (PTG) is conceptualized as a positive transformation resulting from coping with and processing traumatic life events. This study examined the contributory roles of personality traits, posttraumatic stress (PTS) severity and their interactions on PTG and its domains, as assessed with the Posttraumatic Growth Inventory Turkish form (PTGI-T). The study also examined the differences in PTG domains between survivors of accidents, natural disasters and unexpected loss of a loved one.The Basic Personality Traits Inventory, Posttraumatic Diagnostic Scale, and PTGI-T were administered to a large stratified cluster community sample of 969 Turkish adults in their home settings.The results showed that conscientiousness, agreeableness, and openness to experience significantly related to the total PTG and most of the domains. The effects of extraversion, neuroticism and openness to experience were moderated by the PTS severity for some domains. PTG in relating to others and appreciation of life domains was lower for the bereaved group.Further research should examine the mediating role of coping between personality and PTG using a longitudinal design.",0,0 +4097,"Trauma memories, mental health, and resilience: a prospective study of Afghan youth","Background Studies of war-affected youth have not yet examined how trauma memories relate to prospective changes in mental health and to subjective or social experiences. Methods We interviewed a gender-balanced, randomly selected sample of Afghan child-caregiver dyads (n = 331, two waves, 1 year apart). We assessed lifetime trauma with a Traumatic Event Checklist, past-year events with a checklist of risk and protective events, and several child mental health outcomes including posttraumatic distress (Child Revised Impact of Events Scale, CRIES) and depression. We examined the consistency of trauma recall over time, identified mental health trajectories with latent transition modeling, and assessed the predictors of posttraumatic distress and depression trajectories with multinomial logistic regressions. Results From baseline to follow-up, reports of lifetime trauma significantly changed (p ≤ 0.01). A third of the cohort reported no trauma exposure; only 10% identified the same event as their most distressing experience. We identified four CRIES trajectories: low or no distress (52%), rising distress (15%), declining distress (21%), and sustained high distress (12%). Youth with chronic posttraumatic distress were more likely to be girls (OR = 5.78, p ≤ 0.01), report more trauma exposure at baseline (OR = 1.55, p ≤ 0.05) and follow-up (OR = 5.96, p ≤ 0.01), and experience ongoing domestic violence (OR = 4.84, p ≤ 0.01). The risks of rising distress and sustained distress showed a steady increase for youth recalling up to four traumatic experiences. Depression and CRIES trajectories showed weak comorbidity. Conclusions Memories of violent events are malleable, embedded in social experiences, and present heterogeneous associations with posttraumatic distress. Our study provides insights on resilience and vulnerability to multiple adverse childhood experiences, highlighting research and clinical implications for understanding trauma in conflict-affected youth.",0,0 +4098,"Mindfulness Skills, Anxiety Sensitivity, and Cognitive Reactivity in Patients with Posttraumatic Stress Disorder","In trauma-exposed individuals, those with relatively high levels of mindfulness skills tend to have lower levels of symptoms. Mindfulness has also been associated with decreased anxiety sensitivity and cognitive reactivity, and vulnerability factors related to posttraumatic and depressive symptom severity. In this cross-sectional study, our aim was to further investigate the associations among mindfulness skills, anxiety sensitivity, cognitive reactivity, and symptom severity in patients with posttraumatic stress disorder (PTSD). Outpatients with PTSD (N = 101) filled out questionnaires. All facets of mindfulness correlated negatively with reactivity measures and with symptom severity, except for the facet observe. In hierarchical multiple regression analysis, describe, non-judgment, and non-reactivity predicted PTSD symptom severity above and beyond anxiety sensitivity and trauma exposure severity. Describe, act with awareness, and non-judgment also predicted depressive symptom severity above and beyond cognitive reactivity and number of experienced traumatic events. In conclusion, mindfulness skills were indeed uniquely related to symptom severity and cognitive reactivity measures. Our results furthermore support a five-facet model of mindfulness. In addition, the outcomes are a cross-cultural contribution to research on the relevance of mindfulness skills in the treatment of PTSD. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0,0 +4099,Intranetwork and internetwork functional connectivity alterations in post-traumatic stress disorder,"A large number of previous neuroimaging studies have explored the functional alterations of post-traumatic stress disorder (PTSD). However, abnormalities in the functional architecture of resting-state networks in PTSD were rarely elucidated.This study used independent component analysis to explore the resting-state intranetwork and internetwork functional connectivity differences between 20 PTSD patients and 20 matched healthy controls (HCs).Selective alterations of intranetwork and internetwork intrinsic functional connectivities were found in the PTSD patients. Compared with HCs, the PTSD patients exhibited significantly decreased network connectivity within the anterior default mode network, posterior default mode network (pDMN), salience network (SN), sensory-motor network, and auditory network. Furthermore, the PTSD patients exhibited increased internetwork connectivity between SN and pDMN.This study lacked recruitment of trauma-exposed HCs, which limits our ability to determine whether the alterations are caused by PTSD or trauma exposure.The findings suggested that the PTSD patients exhibited abnormal functional connectivity at the brain network level. Notably, the enhanced internetwork connectivity between SN and pDMN in the PTSD patients may be associated with hyperarousal and heightened anxiety in PTSD.",0,0 +4100,Individual and Collective Traumatic Memories: A Qualitative Study of Post-Traumatic Stress Disorder Symptoms in Two Latin American Localities,"A qualitative analysis of material from a number of field trips to Peru and Colombia shows the diagnosis of post-traumatic stress disorder (PTSD) to be culture related. When a local community consists of collective, functional units, as in some Peruvian villages, people have a tendency to not react solely with conventional PTSD symptoms, or to have the attitude that traumatic memory should be treated with crisis intervention. This is in contrast to some villages in Colombia where people are more individualistically oriented and reactions to trauma are more concerned with guilt and shame. In Peru, psychosocial work is carried out mostly by strengthening the construction of the local community, whereas in Colombia, individual psychological interventions are more widely used and accepted. The study demonstrates that the concept of traumatic memory should be considered in both collective and individual aspects, depending on the nature of the underlying organisation of society and culture.",0,0 +4101,Frequent binge drinking five to six years after exposure to 9/11: Findings from the World Trade Center Health Registry,"Exposure to 9/11 may have considerable long-term impact on health behaviors, including increased alcohol consumption. We examined the association between frequent binge drinking, posttraumatic stress disorder (PTSD), and number of 9/11-specific experiences among World Trade Center Health Registry (Registry) enrollees five-to-six years after 9/11.Participants included 41,284 lower Manhattan residents, workers, passers-by, and rescue/recovery workers aged 18 or older without a pre-9/11 PTSD diagnosis who completed Wave 1 (2003-2004) and Wave 2 (2006-2007) interviews. Frequent binge drinking was defined as consuming five or more drinks on five or more occasions in the prior 30 days at Wave 2. Probable PTSD was defined as scoring 44 or greater on the PTSD Checklist. 9/11 exposure was measured as the sum of 12 experiences and grouped as none/low (0-1), medium (2-3), high (4-5) and very high (6+).Frequent binge drinking was significantly associated with increasing 9/11 exposure and PTSD. Those with very high and high exposures had a higher prevalence of frequent binge drinking (13.7% and 9.8%, respectively) than those with medium and low exposures (7.5% and 4.4%, respectively). Upon stratification, very high and high exposures were associated with frequent binge drinking in both the PTSD and no PTSD subgroups.Our findings suggest that 9/11 exposure had an impact on frequent binge drinking five-to-six years later among Registry enrollees. Understanding the effects of traumatic exposure on alcohol use is important to identify risk factors for post-disaster alcohol misuse, inform policy, and improve post-disaster psychological and alcohol screening and counseling.",0,0 +4102,AAGP Position Statement: Disaster Preparedness for Older Americans: Critical Issues for the Preservation of Mental Health,"The Disaster Preparedness Task Force of the American Association for Geriatric Psychiatry was formed after Hurricane Katrina devastated New Orleans to identify and address needs of the elderly after the disaster that led to excess health disability and markedly increased rates of hopelessness, suicidality, serious mental illness (reported to exceed 60% from baseline levels), and cognitive impairment. Substance Abuse and Mental Health Services Administration (SAMHSA) outlines risk groups which fail to address later effects from chronic stress and loss and disruption of social support networks. Range of interventions recommended for Preparation, Early Response, and Late Response reviewed in the report were not applied to elderly for a variety of reasons. It was evident that addressing the needs of elderly will not be made without a stronger mandate to do so from major governmental agencies (Federal Emergency Management Agency [FEMA] and SAMHSA). The recommendation to designate frail elderly and dementia patients as a particularly high-risk group and a list of specific recommendations for research and service and clinical reference list are provided.",0,0 +4103,Regularized Finite Mixture Models for Probability Trajectories,"Finite mixture models are widely used in the analysis of growth trajectory data to discover subgroups of individuals exhibiting similar patterns of behavior over time. In practice, trajectories are usually modeled as polynomials, which may fail to capture important features of the longitudinal pattern. Focusing on dichotomous response measures, we propose a likelihood penalization approach for parameter estimation that is able to capture a variety of nonlinear class mean trajectory shapes with higher precision than maximum likelihood estimates. We show how parameter estimation and inference for whether trajectories are time-invariant, linear time-varying, or nonlinear time-varying can be carried out for such models. To illustrate the method, we use simulation studies and data from a long-term longitudinal study of children at high risk for substance abuse.",0,0 +4104,Dimensional Structure of <em>DSM-5</em> Posttraumatic Stress Disorder Symptoms,"To evaluate the prevalence of DSM-5 posttraumatic stress disorder (PTSD) and factor structure of PTSD symptomatology in a nationally representative sample of US veterans and examine how PTSD symptom clusters are related to depression, anxiety, suicidal ideation, hostility, physical and mental health-related functioning, and quality of life.Data were analyzed from the National Health and Resilience in Veterans Study, a nationally representative survey of 1,484 US veterans conducted from September through October 2013. Confirmatory factor analyses were conducted to evaluate the factor structure of PTSD symptoms, and structural equation models were constructed to examine the association between PTSD symptom clusters and external correlates.12.0% of veterans screened positive for lifetime PTSD and 5.2% for past-month PTSD. A 5-factor dysphoric arousal model and a newly proposed 6-factor model both fit the data significantly better than the 4-factor model of DSM-5. The 6-factor model fit the data best in the full sample, as well as in subsamples of female veterans and veterans with lifetime PTSD. The emotional numbing symptom cluster was more strongly related to depression (P < .001) and worse mental health-related functioning (P < .001) than other symptom clusters, while the externalizing behavior symptom cluster was more strongly related to hostility (P < .001).A total of 5.2% of US veterans screened positive for past-month DSM-5 PTSD. A 6-factor model of DSM-5 PTSD symptoms, which builds on extant models and includes a sixth externalizing behavior factor, provides the best dimensional representation of DSM-5 PTSD symptom clusters and demonstrates validity in assessing health outcomes of interest in this population.",0,0 +4105,Understandings of Coping: A Critical Review of Coping Theories for Disaster Contexts,"This chapter addresses the behavior, thoughts, experiences, and feelings of individuals who have been exposed to strain and stress. First, we introduce the many different approaches associated with both psychological and broader social science-based understandings of coping. We then analyze the extent to which these approaches can be applied in a disaster-related context. In the first part of this chapter, we examine the person-centered coping models that dominate stress research in mainstream psychological approaches. These models are similar to the goal-based models of human nature in which the basic motivation of human beings is to move toward goals while avoiding threats. Depending on the model in question, the main focus lies either in the cognitive processes of appraisal and emotion regulation, attribution of meaning, and religious forms of coping or on the conceptualization as a mental health problem. In contrast, resource-oriented coping theories emphasize the social and material contexts of stress processes. Social contexts and interactions are also more central to the field of community psychology and in the research on social support. Sociology and related social sciences have even broader models in which community coping and resilience of communities are studied as a social or collective process. When considering community resilience, or the application of social capital or local knowledge, the coping resources of larger social units are of primary importance, as collective meanings, emotions, and agency come to the fore. © 2014 Springer Science+Business Media, LLC. All rights are reserved.",0,0 +4106,Developmental trajectories of adolescent popularity: A growth curve modelling analysis,"Growth curve modelling was used to examine developmental trajectories of sociometric and perceived popularity across eight years in adolescence, and the effects of gender, overt aggression, and relational aggression on these trajectories. Participants were 303 initially popular students (167 girls, 136 boys) for whom sociometric data were available in Grades 5-12. The popularity and aggression constructs were stable but non-overlapping developmental dimensions. Growth curve models were run with SAS MIXED in the framework of the multilevel model for change [Singer, J. D., & Willett, J. B. (2003). Applied longitudinal data analysis. Oxford, UK: Oxford University Press]. Sociometric popularity showed a linear change trajectory; perceived popularity showed nonlinear change. Overt aggression predicted low sociometric popularity but an increase in perceived popularity in the second half of the study. Relational aggression predicted a decrease in sociometric popularity, especially for girls, and continued high-perceived popularity for both genders. The effect of relational aggression on perceived popularity was the strongest around the transition from middle to high school. The importance of growth curve models for understanding adolescent social development was discussed, as well as specific issues and challenges of growth curve analyses with sociometric data.",0,0 +4107,Mental Health Consequences of Disasters,"We present in this review the current state of disaster mental health research. In particular, we provide an overview of research on the presentation, burden, correlates, and treatment of mental disorders following disasters. We also describe challenges to studying the mental health consequences of disasters and discuss the limitations in current methodologies. Finally, we offer directions for future disaster mental health research.",0,0 +4108,Validity of the Hospital Anxiety and Depression Scale to assess depression and anxiety following traumatic brain injury as compared with the Structured Clinical Interview for DSM-IV,"Rating scales are often used in the assessment of depression and anxiety in traumatic brain injury (TBI), but few have been validated for use with this population. Overlap of symptoms between such disorders and TBI may lead to under- or over-diagnosis of depression or anxiety.100 participants with mild to severe TBI, and 87 informants, were interviewed using the SCID-IV (Axis I). The HADS was administered at the same time.According to the SCID-IV, 34 participants were diagnosed with major depression and 36 with an anxiety disorder. Higher HADS scores were associated with a greater likelihood of depression and anxiety. However, the ""clinical"" categories of the HADS did not strongly correspond with the clinical diagnoses of depression and anxiety. Compared with SCID diagnoses, the depression subscale of the HADS had a sensitivity of 62% and a specificity of 92%. The anxiety subscale had a sensitivity of 75% and a specificity of 69%. Positive predictive and negative predictive values were calculated.This study included mostly moderate to severe TBI individuals, recruited from a rehabilitation hospital. Therefore, they may not necessarily be representative of the entire TBI population.The HADS was a reliable measure of emotional distress in this TBI sample; however the cut-off scores and categories were not useful in predicting caseness of depression and anxiety. Clinicians should be mindful of the sequelae of TBI that may confound the scores yielded in rating scales and should follow up with a psychiatric interview when diagnosis is unclear.",0,0 +4109,Neural Systems for Cognitive and Emotional Processing in Posttraumatic Stress Disorder,"Individuals with posttraumatic stress disorder (PTSD) show altered cognition when trauma-related material is present. PTSD may lead to enhanced processing of trauma-related material, or it may cause impaired processing of trauma-unrelated information. However, other forms of emotional information may also alter cognition in PTSD. In this review, we discuss the behavioral and neural effects of emotion processing on cognition in PTSD, with a focus on neuroimaging results. We propose a model of emotion-cognition interaction based on evidence of two network models of altered brain activation in PTSD. The first is a trauma-disrupted network made up of ventrolateral PFC, dorsal anterior cingulate cortex (ACC), hippocampus, insula, and dorsomedial PFC that are differentially modulated by trauma content relative to emotional trauma-unrelated information. The trauma-disrupted network forms a subnetwork of regions within a larger, widely recognized network organized into ventral and dorsal streams for processing emotional and cognitive information that converge in the medial PFC and cingulate cortex. Models of fear learning, while not a cognitive process in the conventional sense, provide important insights into the maintenance of the core symptom clusters of PTSD such as re-experiencing and hypervigilance. Fear processing takes place within the limbic corticostriatal loop composed of threat-alerting and threat-assessing components. Understanding the disruptions in these two networks, and their effect on individuals with PTSD, will lead to an improved knowledge of the etiopathogenesis of PTSD and potential targets for both psychotherapeutic and pharmacotherapeutic interventions.",0,0 +4110,Life Course Epidemiology of Trauma and Related Psychopathology in Civilian Populations,"Traumatic events are ubiquitous exposures that interact with life course events to increase risk of acute psychopathology and alter mental health trajectories. While the majority of persons exposed to trauma experience mild to moderate psychological distress followed by a return to pre-trauma health, many persons exposed to trauma experience substantial distress that lasts for several years. Therefore, in an effort to understand why exposure to trauma can provoke such a range of reactions, we apply a life course approach that considers the complex accumulation and interaction of life experiences that range from social to biological factors, which occur over the life span-from gestation to death and across generations. We present this evidence in three categories: genetics and biology, individual exposures, and community experiences, followed by discussing challenges in existing research and directions for future study.",0,0 +4111,Adolescent Survivors of “Ethnic Cleansing”: Observations on the First Year in America,"To describe the psychiatric assessments and trauma testimonies of 12 Bosnian adolescents newly resettled in America.Twelve Bosnian adolescents who experienced the massive psychic trauma of ""ethnic cleansing"" were assessed during the first year after their resettlement in the United States. Assessments consisted of systematic, trauma-focused, clinical interviews that included standard assessment scales of posttraumatic stress disorder (PTSD) and depression, as well as the opportunity to give testimony about their experiences.PTSD was diagnosed in 25% of subjects and depressive disorders in 17%. Reexperiencing cluster symptoms were present in 50%, avoidance cluster symptoms in 31%, and hyperarousal cluster symptoms in 29%.The relatively low rate of PTSD in this sample (in comparison with adult survivors of ""ethnic cleansing"" and with Cambodian adolescent survivors) may be attributable to normal prior development, time-limited adversity, lack of physical or sexual traumas, rejoining nuclear families, or insufficient time for the development of delayed-onset PTSD. It may also be a reflection of the resiliency of adolescence.",0,0 +4112,Fluvoxamine treatment in veterans with combat-related post-traumatic stress disorder,"This study was designed to investigate the efficacy of the antidepressant fluvoxamine in the treatment of combat-related post-traumatic stress disorder (PTSD). Fifteen veterans with combat-related PTSD and no other psychiatric diagnosis except depression were recruited to participate in a 14-week open-label study of fluvoxamine. Patients underwent a 30-day washout period and were rated with the Clinician Administered PTSD Scale (CAPS), Mississippi Scale, Beck Depression Inventory (BDI), Hamilton Rating Scale for Depression (HAM-D) and Hamilton Rating Scale for Anxiety (HAM-A) at baseline, and every 2 weeks until week 14. Three patients stopped fluvoxamine prematurely due to side effects and 7 withdrew consent before completing the 14-week trial. Eight patients completed at least 8 weeks of treatment. The total daily dose of fluvoxamine ranged from 100 to 300 mg with a mean daily dose of 150 mg at week 14. Intent-to-treat analysis revealed a significant improvement in total CAPS scores, and in the intrusion and the avoidance/numbing subscales. The CAPS hyperarousal scores did not change significantly. HAM-A score also improved significantly. No significant changes were seen on the Mississippi scale, HAM-D, or Beck Depression Inventory in the intent-to-treat analysis. In summary, our study shows that fluvoxamine appears to improve combat-related PTSD symptoms but not depressive symptoms. The high attrition rate and lack of a placebo group limits the conclusions of our study. Controlled studies of fluvoxamine in the treatment of PTSD are warranted. Depression and Anxiety 15:29–33, 2002. © 2002 Wiley-Liss, Inc.",0,0 +4113,Peritraumatic and Persistent Dissociation in the Presumed Etiology of PTSD,"Dissociative responses that occur at the time of a trauma (peritraumatic dissociation) have been described as a major risk factor for subsequent posttraumatic stress disorder (PTSD). The current study evaluated peritraumatic dissociation and PTSD from a multivariate perspective, along with a less-investigated phenomenon: trauma-specific dissociation that begins during or after an event and continues until the time of assessment (persistent dissociation).In two studies, 52 local community participants and 386 participants from the general population with histories of exposure to at least one traumatic event were assessed for the presence of PTSD and were administered measures of dissociation and peritraumatic distress.In both studies, peritraumatic dissociation, persistent dissociation, peritraumatic distress, and generalized dissociative symptoms were associated with PTSD by univariate analyses. However, multivariate analyses in both studies indicated that PTSD status was no longer related to peritraumatic dissociation once other variables (especially persistent and generalized dissociation) were taken into account. In contrast, persistent dissociation was a strong predictor at univariate and multivariate levels.Trauma-related persistent dissociation is a substantial predictor of PTSD, whereas peritraumatic dissociation ceases to predict PTSD at the multivariate level. These findings suggest that it is less what happens at the time of a trauma (e.g., disrupted encoding) that predicts PTSD than what occurs thereafter (i.e., persistent avoidance).",0,0 +4114,The role of childhood maltreatment in the altered trait and global expression of personality in cocaine addiction,"Drug addictions are debilitating disorders that are highly associated with personality abnormalities. Early life stress (ELS) is a common risk factor for addiction and personality disturbances, but the relationships between ELS, addiction, and personality are poorly understood.Ninety-five research participants were assessed for and grouped by ELS history and cocaine dependence. NEO-FFI personality measures were compared between the groups to define ELS- and addiction-related differences in personality traits. ELS and cocaine dependence were then examined as predictors of personality trait scores. Finally, k-means clustering was used to uncover clusters of personality trait configurations within the sample. Odds of cluster membership across subject groups was then determined.Trait expression differed significantly across subject groups. Cocaine-dependent subjects with a history of ELS (cocaine+/ELS+) displayed the greatest deviations in normative personality. Cocaine dependence significantly predicted four traits, while ELS predicted neuroticism and agreeableness; there was no interaction effect between ELS and cocaine dependence. The cluster analysis identified four distinct personality profiles: Open, Gregarious, Dysphoric, and Closed. Distribution of these profiles across subject groups differed significantly. Inclusion in cocaine+/ELS+, cocaine-/ELS+, and cocaine-/ELS- groups significantly increased the odds of expressing the Dysphoric, Open and Gregarious profiles, respectively.Cocaine dependence and early life stress were significantly and differentially associated with altered expression of individual personality traits and their aggregation as personality profiles, suggesting that individuals who are at-risk for developing addictions due to ELS exposure may benefit from personality centered approaches as an early intervention and prevention.",0,0 +4115,PTSD symptom clusters associated with physical health and health care utilization in rural primary care patients exposed to natural disaster,"This study investigated the influence of exposure to a tornado disaster and disaster-related posttraumatic stress disorder (PTSD) symptomatology on physical health complaints and primary health care utilization among rural medical patients. One-hundred five patients completed self-report measures assessing disaster exposure, PTSD symptoms, and self-reported physical health complaints. Objective rates of health care utilization were gathered by a review of medical records. Tornado disaster exposure and generalized psychological distress were associated with physical health complaints one year following the disaster. After controlling for age, gender, and levels of predisaster health care utilization, PTSD Cluster C (avoidance) symptoms were associated with increased rates of postdisaster health care utilization. Implications of these findings for interventions within the medical system are discussed.",0,0 +4116,Prevalence and duration of PTSD in survivors 6 years after a natural disaster,"The present study aimed to examine the prevalence of posttraumatic stress disorder (PTSD) in survivors with low levels of risk factors for PTSD. The sample included 142 adults (58% women, 54% university education, 93% employed/students/retired) on vacation in Southeast Asia during the 2004 Indian Ocean disaster. Semi-structured clinical interviews (SCID-I) were performed after 6 years including PTSD, depression, specific phobia, and alcohol abuse. The 6-year prevalence of PTSD was 11.3% and the current prevalence was 4.2%, with onset mainly within 1 month and remission within 3 years post-disaster. Suicidal ideation and comorbidity were common in PTSD cases. Lifetime prevalence of depression was 19%, specific phobia 7%, and alcohol abuse 4%. The findings suggest elevated levels of PTSD but not other disorders as compared with general population samples, but still lower levels than other disaster samples. Despite benign circumstances, however, the course and burden of PTSD were comparable to similar studies.",0,0 +4117,"Dimensions of trauma associated with posttraumatic stress disorder (PTSD) caseness, severity and functional impairment: a study of Bosnian refugees resettled in Australia","Refugee survivors of inter-ethnic warfare vary greatly in the extent and range of their trauma experiences. Discerning which experiences are most salient to generating and perpetuating disorders such as posttraumatic stress disorder (PTSD) is critical to the mounting rational strategies for targeted psychosocial interventions. In a sample of Bosnian Muslim refugees (n=126) drawn from a community centre and supplemented by a snowball sampling method, PTSD status and associated disability were measured using the clinician-administered PTSD Scale (CAPS) for DSM-IV. A principal components analysis (PCA) based on a pool of trauma items yielded four coherent trauma dimensions: Human Rights Violations, Threat to Life, Traumatic Loss and Dispossession and Eviction. A cluster analysis identified three subgroupings according to extent of trauma exposure. There were no differences in PTSD risk for the group most exposed to human rights violations (internment in concentration camps, torture) compared to the general war-exposed group. Logistic regression analysis using the dimensions derived from the PCA indicated that Threat to Life alone of the four trauma factors predicted PTSD status, a finding that supports the DSM-IV definition of a trauma. Both Threat to Life and Traumatic Loss contributed to symptom severity and disability associated with PTSD. It may be that human rights violations pose a more general threat to the survivor's future psychosocial adaptation in areas of functioning that extend beyond the confines of PTSD.",0,0 +4118,"INTERACTIONS OF IMMUNOLOGICAL, PSYCHOLOGICAL, HORMONAL, AND NUTRITIONAL ALTERATIONS IN WAR-RELATED CHRONIC STRESS","Background and purpose: Stress-induced effects on neuroendocrine and immune functions are well established. The nature of relations in these multidirectionally interacting allostatic systems is difficult to evaluate in humans. To assess the complex responses to war-related chronic stress we used multivariate statistical model analysis. Materials and methods: Twenty-nine detainees released from the concentration camp and 15 controls were included in the study. Psychological status was assessed by COR-NEX2 and Hamilton tests, nutritional status by serum albumin and total protein levels, and endocrine status by serum cortisol, (beta)-endorphin, prolactin, T3 and T4 levels. Immune status was estimated by flow cytometric enumeration of the lymphocyte subpopulations, NK and phagocytic activities and serum cytokines (IL-2, TNF, IFN) levels. To assess the relations between psychological, nutritional, endocrine and immune statuses representet by sets of several variables each, multivariate canonical correlation and cluster analysis were aplyed. Results: Although no causal relationship can be inferred from this study, multiple interactions were established between the statuses examined. Psychological and nutritional variables correlated with T lymphocyte activation and non-specific immune functions while hormonal and psychological statuses, being in correlation, contributed to the relation with immunofunctional variables. By cluster analysis, all variables employed were structured into four clusters, reflecting more or less the same relation among the psychological, endocrine, immune and nutritional statuses. Conclusion: The multivariate model analyses employed confirmed the prevailing influence of chronic stress on hormonal and immunological responses, although in order to arrive at a more reliable interpretation of such complex interactions, some other important variables and larger sample size should be employed.",0,0 +4119,Combat Stress Injury,,0,0 +4120,THE ANXIETY SPECTRUM AND THE REFLEX PHYSIOLOGY OF DEFENSE: FROM CIRCUMSCRIBED FEAR TO BROAD DISTRESS,"Guided by the diagnostic nosology, anxiety patients are expected to show defensive hyperarousal during affective challenge, irrespective of the principal phenotype. In the current study, patients representing the whole spectrum of anxiety disorders (i.e., specific phobia, social phobia, panic disorder with or without agoraphobia, obsessive-compulsive disorder, generalized anxiety disorder (GAD), posttraumatic stress disorder(PTSD)), and healthy community control participants, completed an imagery-based fear elicitation paradigm paralleling conventional intervention techniques. Participants imagined threatening and neutral narratives as physiological responses were recorded. Clear evidence emerged for exaggerated reactivity to clinically relevant imagery--most pronounced in startle reflex responding. However, defensive propensity varied across principal anxiety disorders. Disorders characterized by focal fear and impairment (e.g., specific phobia) showed robust fear potentiation. Conversely, for disorders of long-enduring, pervasive apprehension and avoidance with broad anxiety and depression comorbidity (e.g., PTSD secondary to cumulative trauma, GAD), startle responses were paradoxically diminished to all aversive contents. Patients whose expressed symptom profiles were intermediate between focal fearfulness and broad anxious-misery in both severity and chronicity exhibited a still heightened but more generalized physiological propensity to respond defensively. Importantly, this defensive physiological gradient--the inverse of self-reported distress--was evident not only between but also within disorders. These results highlight that fear circuitry could be dysregulated in chronic, pervasive anxiety, and preliminary functional neuroimaging findings suggest that deficient amygdala recruitment could underlie attenuated reflex responding. In summary, adaptive defensive engagement during imagery may be compromised by long-term dysphoria and stress-a phenomenon with implications for prognosis and treatment planning.",0,0 +4121,The factor structure of Posttraumatic Stress Disorder symptoms among bereaved individuals: A confirmatory factor analysis study,"Posttraumatic Stress Disorder (PTSD) is defined in DSM-IV as an anxiety disorder that encompasses symptom-clusters of reexperiencing, avoidance, and hyperarousal. Several studies have examined the factor structure of PTSD symptoms. To our knowledge, no studies have yet examined the factor structure of loss-related PTSD symptoms in samples exclusively comprised of bereaved individuals. Such an examination is important because it can advance our understanding of the stability of the structure of PTSD symptoms across groups confronted with different aversive life-events and of processes underlying the occurrence of PTSD symptoms after loss. In this study, five alternative models of the factor structure of PTSD symptoms were examined in a sample of 347 mourners. Results showed that, in this group, PTSD symptoms are best conceptualized as forming four factors: reexperiencing, avoidance, dysphoria, and hyperarousal. Patterns of correlations with depression and complicated grief supported the validity of the model.",0,0 +4122,Emotional processing of fear: Exposure to corrective information.,"In this article we propose mechanisms that govern the processing of emotional information, particularly those involved in fear reduction. Emotions are viewed as represented by information structures in memory, and anxiety is thought to occur when an information structure that serves as program to escape or avoid danger is activated. Emotional processing is denned as the modification of memory structures that underlie emotions. It is argued that some form of exposure to feared situations is common to many psychotherapies for anxiety, and that confrontation with feared objects or situations is an effective treatment. Physiological activation and habituation within and across exposure sessions are cited as indicators of emotional processing, and variables that influence activation and habituation of fear responses are examined. These variables and the indicators are analyzed to yield an account of what information must be integrated for emotional processing of a fear structure. The elements of such a structure are viewed as cognitive representations of the stimulus characteristic of the fear situation, the individual's responses in it, and aspects of its meaning for the individual. Treatment failures are interpreted with respect to the interference of cognitive defenses, autonomic arousal, mood state, and erroneous ideation with reformation of targeted fear structures. Applications of the concepts advanced here to therapeutic practice and to the broader study of psychopathology are discussed.",0,0 +4123,Complexities in Complex Posttraumatic Stress Disorder in Inpatient Women: Evidence From Cluster Analysis of MCMI-III Personality Disorder Scales,"Herman's (1992a) clinical formulation of complex posttraumatic stress disorder (PTSD) captures the extensive diagnostic comorbidity seen in patients with a history of repeated interpersonal trauma and severe psychiatric disorders. Yet the sheer breadth of symptoms and personality disturbance encompassed by complex PTSD limits its descriptive usefulness. This study employed cluster analysis of the MCMI-III (Millon, 1994) personality disorder scales to determine whether there is meaningful heterogeneity within a group of 227 severely traumatized women who were treated in a specialized inpatient program. The analysis distinguishes 5 clinically meaningful clusters, which we label alienated, withdrawn, aggressive, suffering, and adaptive. The study examined differences among these 5 personality disorder clusters on the MCMI-III clinical syndrome scales, as well as on the Brief Symptom Inventory (Derogatis, 1993), Dissociative Experiences Scale (E. M. Bernstein & Putnam, 1986), Adult Attachment Scale (Collins & Read, 1990), and Childhood Trauma Questionnaire (D.P. Bernstein, 1995). We present a classification-tree method for determining the cluster membership of new cases and discuss the implications of the findings for diagnostic assessment, treatment, and research.",0,0 +4124,Toward a lifespan approach to resilience and potential trauma,"As much as we might wish it otherwise, bad things happen: war, natural disaster, the death of close friends and relatives, serious accidents, senseless abuse or violence at the hand of others, and so on. Any of these things can and all too often do happen, and at every stage of life. Epidemiological data indicate that most adults experience at least one and usually several potentially traumatic events (PTE) during the course of their lives (Norris, 1992; Kessler et al., 1995; Breslau et al., 2000), and that most children are also exposed to such experiences (Copeland et al., 2007). It is important to note, however, that life event research typically relies on retrospective accounts, which more than likely underestimate the frequency of PTEs. Indeed, a recent study that measured life events among college students over a four-year period using a weekly internet survey reported an average of six PTEs per student (Lalande & Bonanno, 2011). Perhaps because acutely aversive events are so dreaded, both clinicians and the lay public tend to assume that they will almost always result in lasting emotional damage. The available evidence, however, suggests a more complex and far more encouraging picture. To emphasize the pronounced individual differences in the way people react to adversity, we emphasize that such events are only “potentially traumatic” (Norris, 1992; Bonanno, 2004), for the simple reason that not everyone experiences them as traumatic. Most people in fact cope with PTEs remarkably well (Bonanno, 2004, 2005; Bonanno & Mancini, 2008). Although some do, in fact, endure lasting emotional difficulties, the vast majority of people exposed to extreme adversity recover a semblance of their normal level of functioning within several months to several years after the event, and many if not most show little evidence of more than transient disruptions in functioning. © Cambridge University Press 2011.",0,0 +4125,Attachment-Related Consequences of War Captivity and Trajectories of Posttraumatic Stress Disorder: A 17-Year Longitudinal Study,"Attachment security contributes to resilience in times of stress, but it can be disrupted by traumatic events that shatter positive views of self and others. We followed Israeli ex-POWs of the Yom Kippur War over 17 years and examined associations between trajectories of posttraumatic stress disorder (PTSD) and disruptions in the regulatory functions of the attachment system. Fifty-nine ex-POWs and 39 control veterans from the same war who had reported on PTSD 18, 30, and 35 years after the war performed laboratory cognitive tasks assessing activation of mental representations of security in response to threat and the ability of these representations to color neutral stimuli with positive affect and reduce access to trauma-related thoughts. As compared to controls, ex-POWs with persistent PTSD over the 17-year period exhibited dramatic disruptions in the soothing and healing functions of attachment security representations. These disruptions were not evident among ex-POWs with a worsening PTSD trajectory or a stable resilience trajectory. The implications of attachment-system functioning for understanding posttraumatic processes are discussed.",0,0 +4126,Multisample cross-validation of a model of childhood posttraumatic stress disorder symptomatology,"This study is the latest advancement of our research aimed at best characterizing children's posttraumatic stress reactions. In a previous study, we compared existing nosologic and empirical models of PTSD dimensionality and determined the superior model was a hierarchical one with three symptom clusters (Intrusion/Active Avoidance, Numbing/Passive Avoidance, and Arousal; Anthony, Lonigan, & Hecht, 1999). In this study, we cross-validate this model in two populations. Participants were 396 fifth graders who were exposed to either Hurricane Andrew or Hurricane Hugo. Multisample confirmatory factor analysis demonstrated the model's factorial invariance across populations who experienced traumatic events that differed in severity. These results show the model's robustness to characterize children's posttraumatic stress reactions. Implications for diagnosis, classification criteria, and an empirically supported theory of PTSD are discussed.",0,0 +4127,"Race, age, and gender influences among clusters of african american and white patients with chronic pain","

Abstract

Racial and ethnic minorities, older people, and women are differentially affected by chronic pain. This study aimed to identify the experiences of adult African Americans and whites with chronic pain while identifying patient clusters on the basis of clinical characteristics as well as race, age, and gender influences within and between clusters. Three clusters of patients with chronic pain were identified within race, age, and gender categories: chronic pain syndrome, good pain control, and disability with mild syndrome. African American and younger patients experiencing chronic pain were more likely to present with chronic pain syndrome. African American patients presenting with chronic pain syndrome or disability with mild pain syndrome reported a higher disability than their counterparts. Older patients and women within the good pain control cluster reported a lower level of (1) pain and depression and (2) depression, respectively. Older patients presenting with a disability with mild syndrome also reported lower pain and depression. Despite similar physical, emotional, and pain characteristics, this study confirmed that the chronic pain experience differs across racial and age groups. Further study is necessary to evaluate how these factors influence pain services among an ethnically diverse population across the age continuum.

Perspective

This study found important racial and age-related variability in the symptom severity of patients with chronic pain presenting with similar physical, emotional, and pain characteristics to a tertiary care pain center. These findings have important clinical implications on chronic pain assessment and management.",0,0 +4128,Postdisaster PTSD over four waves of a panel study of Mexico's 1999 flood,"Samples of adults representative of Tezuitlán, Puebla and Villahermosa, Tobasco (combined N = 561), were interviewed 6, 12, 18, and 24 months after the devastating 1999 floods and mudslides in Mexico. Current DSM-IV PTSD and major depressive disorder (MDD) were assessed with the Composite International Diagnostic Interview. At Wave 1, PTSD was highly prevalent (24% combined), especially in Tezuitlán (46%), which had experienced mass casualties and displacement. Both linear and quadratic effects of time emerged, as PTSD symptoms initially declined but subsequently stabilized. Differences between cities lessened as time passed. Comorbidity between PTSD and MDD was substantial. The findings demonstrate that the international health community needs to be prepared for epidemics of PTSD when disasters strike developing areas of the world.",0,0 +4129,An Association Between Stress-Induced Disruption of the Hypothalamic-Pituitary-Adrenal Axis and Disordered Glucose Metabolism in an Animal Model of Post-Traumatic Stress Disorder,"Retrospective clinical reports suggesting that traumatic stress populations display an increased propensity for glucose metabolism disorders were examined in a controlled prospective animal model. Stress-induced behavioural and hypothalamic-pituitary-adrenal (HPA) axis response patterns were correlated to central and peripheral parameters of glucose metabolism and signalling, and to body measurements in Sprague–Dawley rats exposed to predator scent stress. Forty days post-exposure, fasting blood glucose and insulin levels, oral glucose tolerance test, body weight and white adipose tissue mass, systemic corticosterone levels and brain expression of insulin receptor (IR) and insulin-sensitive glucose transporter 4 (GLUT4) protein levels were evaluated. In a second experiment inbred strains with hyper- (Fischer) and hypo- (Lewis) reactive HPA axes were employed to assess the association of metabolic data with behavioural phenomenology versus HPA axis response profile. For data analysis, animals were classified according to their individual behavioural response patterns (assessed at day 7) into extreme, partial and minimal response groups. The exposed Sprague–Dawley rats fulfilling criteria for extreme behavioural response (EBR) (20.55%) also exhibited significant increases in body weight, abdominal circumference and abdominal white adipose tissue mass; a hyperglycaemic oral glucose tolerance test; and fasting hyperglycaemia, hyperinsulinaemia and hypercorticosteronemia, whereas minimal responders (MBR) and control animals displayed no such disturbances. Hippocampal and hypothalamic expression of IR and GLUT4 protein were significantly lower in EBR than in MBR and control rats. The inbred strains showed no metabolic differences at baseline. Exposed Fischer rats displayed hyperglycaemia and hyperinsulinaemia, whereas Lewis rats did not. A significant protracted disorder of glucose metabolism was induced by exposure to a stress paradigm. This metabolic response was associated with the characteristic pattern of HPA axis (corticosterone) response, which underlies the behavioural response to stress.",0,0 +4130,Cluster Analysis as a Method of Recovering Types of Intraindividual Growth Trajectories: A Monte Carlo Study,"There has been increased interest in and application of cluster analysis in longitudinal applications to identify distinctive developmental patterns of intraindividual change. This article used Monte Carlo experiments to evaluate the adequacy of cluster analysis to recover group membership based on simulated latent growth curve (LGC) models. The simulated LGC models were manipulated by varying growth parameters (e.g., elevation, dispersion, and shape) for subpopulation growth curves (e.g., linear and quadratic growth models). The evaluation of cluster analysis to recover individual membership in these growth curve subpopulations was completed via the Kappa statistics. Cluster analysis failed to recover adequately growth subtypes when the difference between growth curves was shape only. It was much more successful when the distance between initial mean levels was large (e.g., difference of two standard deviations), independent of difference in the shape of the growth curves. Tentative guidelines were proposed to facilitate the evaluation of the adequacy of a cluster analytic solution to recover subtype heterogeneity in longitudinal (intraindividual) growth curves.",0,0 +4131,A 6-Month Follow-Up Study of Posttraumatic Stress and Anxiety/Depressive Symptoms in Korean Children After Direct or Indirect Exposure to a Single Incident of Trauma,"Article AbstractObjectives: The aims of this study were to examine the symptoms of posttraumatic stress and anxiety/depression in Korean children after direct or indirect exposure to a single incident of trauma during a fire-escape drill and to assess the incidence of psychiatric disorders in this population.Method: A total of 1,394 students who attended the elementary school at which the traumatic event took place were evaluated using self-administered questionnaires (the Child Posttraumatic Stress Disorder-Reaction Index , State Anxiety Scale of the State-Trait Anxiety Inventory for Children , and Children's Depression Inventory ), as well as structured diagnostic interviews (Diagnostic Interview Schedule for Children, Version-IV ) at 2 days (time point 1), 2 months (time point 2), and 6 months (time point 3) after the incident. The 335 students who witnessed the accident were defined as the direct-exposure group, and the remaining students (n = 1,059) were defined as the indirect- exposure group. The study was conducted from May to November 2007.Results: At time point 1, the prevalence of severe posttraumatic stress disorder (PTSD), anxiety, and depressive symptoms was 18.2%, 5.5%, and 3.4%, respectively. The prevalence of severe PTSD symptoms, as measured by the CPTSD-RI, was significantly higher in the direct-exposure group than in the indirect-exposure group (36.6% vs 12.7%, respectively; P < .001). At time point 2, the prevalence of severe PTSD symptoms was 7.4% (14.0% in the direct- exposure group and 4.9% in the indirect-exposure group, P < .001). The mean total CPTSD-RI score was significantly higher (P < .001) in the direct-exposure group than in the indirect-exposure group. At time point 3, thirty-eight of the 58 subjects (65.5%) evaluated with the DISC-IV in the direct-exposure group had 1 or more of the 7 anxiety/depressive disorders assessed, including subthreshold diagnoses. Among the diagnoses meeting full DSM-IV criteria for each disorder, agoraphobia was the most prevalent (22.4%), followed by generalized anxiety disorder (13.8%), separation anxiety disorder (6.9%), PTSD (5.2%), and social phobia (5.2%). When the subthreshold diagnoses were considered along with the full syndrome diagnoses, separation anxiety disorder was the most common diagnosis (41.4%), followed by agoraphobia (34.5%), obsessive-compulsive disorder (22.4%), PTSD (20.7%), and social phobia (20.7%).Conclusions: The results of this study provide important evidence that various anxiety/depressive disorders, in addition to PTSD, might follow after direct or indirect exposure to trauma. Our findings highlight the importance of comprehensive screening for psychiatric problems in children exposed to trauma of any scale.Submitted: November 25, 2008; accepted February 11, 2009. Online ahead of print: June 16, 2009.Corresponding author: Dr Jae-Won Kim, Department of Child and Adolescent Psychiatry, College of Medicine, Seoul National University Hospital, 28 Yongon-Dong, Chongno-Gu, Seoul, Korea (adore412@paran.com).",0,0 +4132,Posttraumatic Stress Disorder and Impaired Autonomic Modulation in Male Twins,"Posttraumatic stress disorder (PTSD) has been linked to increased morbidity. An inflexibility of the autonomic nervous system might be the underlying mechanism. We aimed to assess whether PTSD and combat trauma exposure are associated with lower heart rate variability (HRV), a measure of autonomic function and a predictor of death.We measured HRV by power spectral analysis on 24-hour ambulatory electrocardiogram in 459 middle-aged veteran male twins. Combat trauma was assessed with the combat exposure scale, and current and remitted PTSD was assessed with the Structured Clinical Interview for Psychiatry Disorders. Mixed-effects regression models were used to test associations of PTSD and HRV between and within twin pairs.Of all twins, 211 had combat exposure, 31 had current PTSD, and 43 had remitted PTSD. Current PTSD was inversely associated with very-low-frequency and low-frequency HRV both in individual twins and within 20 pairs discordant for current PTSD. Twins with current PTSD had a 49% lower low-frequency HRV than their brothers without PTSD (p<.001). Remitted PTSD was not associated with HRV. Results were robust to adjustment for depression and other risk factors. Combat exposure was inversely associated with most HRV frequencies, but this association mostly diminished after adjustment for current PTSD.In middle-aged veteran men, combat exposure and current PTSD are associated with measures of autonomic inflexibility previously shown to have prognostic significance. The negative health impact of combat exposure on autonomic function is mediated largely through PTSD and might reverse with remission of PTSD.",0,0 +4133,Stress sensitization following a disaster: a prospective study,"Background According to the stress sensitization hypothesis, prior exposure to extreme stressors may lead to increased responsiveness to subsequent stressors. It is unclear whether disaster exposure is associated with stress sensitization and, if so, whether this effect is lasting or temporary. This study aimed to investigate the occurrence and duration of stress sensitization prospectively following a major disaster. Method Residents affected by a fireworks disaster ( n =1083) participated in surveys 2–3 weeks (T1), 18–20 months (T2) and almost 4 years (T3) after the disaster. Participants reported disaster exposure, including direct exposure, injury and damage to their home at T1, and also stressful life events (SLEs) at T2 and T3. Feelings of anxiety and depression, concentration difficulty, hostility, sleep disturbance, and intrusion and avoidance of disaster-related memories were used as indicators of distress. Results Residents whose home was completely destroyed responded with greater distress to SLEs reported 18–20 months following the disaster than residents whose home was less damaged. There were no differences in stress responsiveness almost 4 years after the disaster. Conclusions During the first years after a disaster, stress sensitization may occur in disaster survivors who experienced extreme disaster exposure. Stress sensitization may explain the persistence or progression of distress over time following extreme stressor exposure.",0,0 +4134,Treating Traumatized Children,"Ford, Pat-Horenczyk, Brom, Introduction. Layne, Beck, Rimmasch, Southwick, Moreno, Hobfoll, Promoting Resilient Posttraumatic Adjustment in Childhood and Beyond: Unpacking Life Events, Adjustment Trajectories, Resources, and Interventions. PART I: Risk and Protective Factors. Pat-Horenczyk, Rabinowitz, Rice, Tucker-Levin, The Search for Risk and Protective Factors in Childhood PTSD: From Variables to Processes. Cohen, Parenting in the Throes of Traumatic Events: Risks and Protection. Keren, Tyano, A Developmental Approach: Looking at the Specificity of Reactions to Trauma in Infants. Knight, Geltman, Ellis, Physical and Mental Health Functioning in Sudanese Unaccompanied Minors. Bifulco, Risk and Resilience in Young Londoners. PART II: Resilience. Brom, Kleber, Resilience as the Capacity for Processing Traumatic Experiences. Hobfoll, Horsey, Lamoureux, Resiliency and Resource Loss in Times of Terrorism and Disaster: Lessons Learned for Children and Families and Those Left Untaught. Tol, Jordans, Reis, Jong, Ecological Resilience: Working with child-related psychosocial resources in war-affected communities. Meichenbaum, Bolstering Resilience: Benefiting from Lessons Learned. PART III. Recovery: Empirically-based Systemic Interventions for Traumatized Children. Ford, Albert, Hawke, Prevention and Treatment Interventions for Traumatized Children: Restoring Children's Capacities for Self-Regulation. Van Horn, Lieberman, Using Dyadic Therapies to Treat Traumatized Young Children. DeRosa, Pelcovitz, Group Treatment for Chronically Traumatized Adolescents: Igniting SPARCS of Change. Saltzman, Babayon, Lester, Beardslee, Pynoos, Family-Based Treatment for Child Traumatic Stress: A Review and Report on Current Innovations. Kagan, Transforming Troubled Children into Tomorrow's Heroes. Pat-Horenzcyk, Ford, Brom, Toward A Developing Science and Practice of Childhood Traumatic Stress: Concluding Comments",0,0 +4135,Cognitive Changes During Prolonged Exposure Versus Prolonged Exposure Plus Cognitive Restructuring in Female Assault Survivors With Posttraumatic Stress Disorder.,"The authors report on changes in cognitions related to posttraumatic stress disorder (PTSD) among 54 female survivors of sexual and nonsexual assault with chronic PTSD who completed either prolonged exposure alone or in combination with cognitive restructuring. Treatment included 9-12 weekly sessions, and assessment was conducted at pretreatment, posttreatment, and a modal 12-month follow-up. As hypothesized, treatment that included prolonged exposure resulted in clinically significant, reliable, and lasting reductions in negative cognitions about self, world, and self-blame as measured by the Posttraumatic Cognitions Inventory. The hypothesis that the addition of cognitive restructuring would augment cognitive changes was not supported. Reductions in these negative cognitions were significantly related to reductions in PTSD symptoms. The addition of cognitive restructuring did not significantly augment the cognitive changes. Theoretical implications of the results are discussed.",0,0 +4136,The Use of Debriefing With Children,"The debate over the use of psychological debriefing in the early aftermath of a traumatic event has raged for decades, yet little attention has been paid to its use with perhaps the most vulnerable of victims, children and adolescents. While recommendations against the use of group debriefing with adults seem to have been made based on research of individual debriefing, recommendations regarding its use with children have been made based on the adult literature. In this review, we outline the possible mechanisms of harm and benefit of debriefing with a discussion of developmental concerns. The available empirical and nonempirical literature on the use of debriefing with youth is summarized. While research does not currently evidence harm in the use of debriefing with children, there is no strong support for its use either. We present both clinical considerations and research implications as they relate to debriefing as well as what this debate has taught us about the challenges to disseminating and evaluating early crisis interventions in general. © 2015, Springer Science+Business Media New York.",0,0 +4137,Development of the World Health Organization WHOQOL-BREF Quality of Life Assessment,"Background. The paper reports on the development of the WHOQOL-BREF, an abbreviated version of the WHOQOL-100 quality of life assessment. Method. The WHOQOL-BREF was derived from data collected using the WHOQOL-100. It produces scores for four domains related to quality of life: physical health, psychological, social relationships and environment. It also includes one facet on overall quality of life and general health. Results. Domain scores produced by the WHOQOL-BREF correlate highly (0·89 or above) with WHOQOL-100 domain scores (calculated on a four domain structure). WHOQOL-BREF domain scores demonstrated good discriminant validity, content validity, internal consistency and test–retest reliability. Conclusion. These data suggest that the WHOQOL-BREF provides a valid and reliable alternative to the assessment of domain profiles using the WHOQOL-100. It is envisaged that the WHOQOL-BREF will be most useful in studies that require a brief assessment of quality of life, for example, in large epidemiological studies and clinical trials where quality of life is of interest. In addition, the WHOQOL-BREF may be of use to health professionals in the assessment and evaluation of treatment efficacy.",0,0 +4138,"Post-traumatic stress disorder, depression, anxiety and quality of life in patients with traffic-related injuries","This paper reports a study to investigate and follow-up relationships between post-traumatic stress disorder, anxiety, depression and quality of life in patients after traffic-related injuries.Worldwide, traffic accidents kill 1.2 million people and injure 50 million people per year. Accidental injuries are fourth in the top five causes of death in Taiwan. For survivors, traffic accidents not only cause physical impairments, but also psychological trauma, such as post-traumatic stress disorder, depression and anxiety, all of which affect the quality of life.An exploratory, correlational design was used, and participants were recruited consecutively. Data were collected at 1 and 6 weeks post-injury for 64 patients from two major medical centres in Taiwan. Instruments were the New Injury Severity Scale, Post-traumatic Stress Disorder Reaction Index, Beck Depression Inventory, State Anxiety Inventory and Medical Outcomes Study Questionnaire. The data were collected in 2002.Statistically significant improvements occurred in depression, anxiety and the quality of life between week 1 and week 6 (P<0.05); high levels of post-traumatic stress disorder symptoms at week 1 (87.5%) and at week 6 (82.8%) showed no statistically significant improvement. There was a positive correlation between post-traumatic stress disorder and depression (r=0.70, P<0.001) and between post-traumatic stress disorder and anxiety (r=0.57, P<0.001), and a negative correlation between post-traumatic stress disorder and quality of life (r=-0.47, P<0.001). Depression was the most important variable to predict post-traumatic stress disorder at week 6, with depression levels at week 6 being a more powerful predictor than those at week 1. Regression analysis revealed that depression (19%) at week 1, depression at week 6 (45%), anxiety (3.8%) at week 6 and post-traumatic stress disorder (5.8%) explained a statistically significant amount of the variance at week 6.The findings suggest that traffic accidents have an impact on people's psychosocial wellbeing. Healthcare professionals need to implement interventions to decrease post-traumatic stress disorder, depression and anxiety to increase the quality of life for patients following traffic injuries.",0,0 +4139,Explosive anger as a response to human rights violations in post-conflict Timor-Leste,"Over several decades, clinicians have documented a pattern of explosive anger amongst survivors of gross human rights violations. Yet there is a dearth of epidemiological research investigating explosive anger in post-conflict countries. In the present study undertaken in Timor-Leste between March and November 2004, we identified an indigenous descriptor for explosive anger, including this index in the East Timor Mental Health Epidemiological Needs Study, a small area total population survey of 1544 adults living in an urban and a rural area. Other measures included indices of past trauma events, post-traumatic stress and general psychological distress, and socio-demographic variables. We found that 38% of the population reached the defined threshold of one attack of explosive anger a month (average=1 episode every 2-3 days). Only a minority of persons with explosive anger reached threshold scores for post-traumatic stress and general psychological distress. High levels of trauma exposure represented the strongest predictor of explosive anger. Latent class analysis identified three sub-groups with explosive anger: young trauma-affected adults living in the capital city who were unemployed; an older group, predominantly men, who had experienced extensive violence, including combat, assault and torture; and a less well characterized group of women. The findings offer support for a sequential model of explosive anger in which experiences of past persecution are compounded by frustrations in the post-conflict environment. The data provide a foundation for exploring further the role of trauma-induced anger in the cycles of violence that are prevalent in post-conflict countries.",0,0 +4140,ICD–11 Complex PTSD in U.S. National and Veteran Samples,"The 11th edition of the International Classification of Diseases ( ICD–11) is under development, and current proposals include major changes to trauma-related psychiatric diagnoses, including a heavily restricted definition of posttraumatic stress disorder (PTSD) and the addition of complex PTSD (CPTSD). We aimed to test the postulates of CPTSD in samples of 2,695 community participants and 323 trauma-exposed military veterans. CPTSD prevalence estimates were 0.6% and 13% in the community and veteran samples, respectively; one quarter to one half of those with PTSD met criteria for CPTSD. There were no differences in trauma exposure across diagnoses. A factor mixture model with two latent dimensional variables and four latent classes provided the best fit in both samples: Classes differed by their level of symptom severity but did not differ as a function of the proposed PTSD versus CPTSD diagnoses. These findings should raise concerns about the distinctions between CPTSD and PTSD proposed for ICD–11.",0,0 +4141,"Early PTSD Symptom Trajectories: Persistence, Recovery, and Response to Treatment: Results from the Jerusalem Trauma Outreach and Prevention Study (J-TOPS)","Uncovering heterogeneities in the progression of early PTSD symptoms can improve our understanding of the disorder's pathogenesis and prophylaxis.To describe discrete symptom trajectories and examine their relevance for preventive interventions.Latent Growth Mixture Modeling (LGMM) of data from a randomized controlled study of early treatment. LGMM identifies latent longitudinal trajectories by exploring discrete mixture distributions underlying observable data.Hadassah Hospital unselectively receives trauma survivors from Jerusalem and vicinity.Adult survivors of potentially traumatic events consecutively admitted to the hospital's emergency department (ED) were assessed ten days and one-, five-, nine- and fifteen months after ED admission. Participants with data at ten days and at least two additional assessments (n = 957) were included; 125 received cognitive behavioral therapy (CBT) between one and nine months.We used LGMM to identify latent parameters of symptom progression and tested the effect of CBT on these parameters. CBT consisted of 12 weekly sessions of either cognitive therapy (n = 41) or prolonged exposure (PE, n = 49), starting 29.8±5.7 days after ED admission, or delayed PE (n = 35) starting at 151.8±42.4 days. CBT effectively reduced PTSD symptoms in the entire sample.Latent trajectories of PTSD symptoms; effects of CBT on these trajectories.THREE TRAJECTORIES WERE IDENTIFIED: Rapid Remitting (rapid decrease in symptoms from 1- to 5-months; 56% of the sample), Slow Remitting (progressive decrease in symptoms over 15 months; 27%) and Non-Remitting (persistently elevated symptoms; 17%). CBT accelerated the recovery of the Slow Remitting class but did not affect the other classes.The early course of PTSD symptoms is characterized by distinct and diverging response patterns that are centrally relevant to understanding the disorder and preventing its occurrence. Studies of the pathogenesis of PTSD may benefit from using clustered symptom trajectories as their dependent variables.",1,0 +4142,Heightened pain perception in illicit substance–using patients in the ED: implications for management,"Substance users are commonly perceived to overstate their pain. Few data exist comparing pain intensity, perception, and related psychiatric comorbidities in the emergency department (ED) population. To compare pain severity, duration, interference with function, and psychiatric and mood disturbance in substance-using (SU) and non–substance-using (NSU) patients in the ED. This is a cross-sectional study. The setting is in an urban ED. Participants are SU and NSU patients in moderate to severe pain (numerical rating scale, 5-10). Outcome measures are as follows: pain intensity and duration, other painful conditions, pain-related functional interference (0-10), psychiatric disorders, and mood distress (profile of mood scale, 0-44). Of the 148 patients who enrolled, 28 (19%) reported recent illicit substance use (SU) and 120 (81%) did not (NSU). The SU patients' mean pain intensity was 8.96 (confidence interval [CI], 7.47-8.14) vs 7.81 (CI, 8.48-9.45) for NSU ( P = .003). The SU patients reported higher levels of pain interference. Fifty-four percent of SU patients vs 31% of NSU patients reported a psychiatric illness ( P = .02). Mean Profile of Mood State score was higher in SU (32.3; CI, 27.4-37.1) than in NSU (22.5; CI, 20.2-24.8; P < .001). Chronic pain was reported by 29% of SU patients vs 16% of NSU patients, and 75% of SU patients vs 58% of NSU patients reported another concurrent painful condition ( P = .10). The SU patients report more severe pain and functional interference, more psychiatric illness and mood distress, and more chronically painful conditions. Given the complex interplay between pain, substance use, and mood disorders, increased attention should be paid to identifying patients with these associated conditions and to facilitating appropriate referrals. Effective treatment of this challenging patient population requires treating the entirety of their medical, psychiatric, and addictive diseases.",0,0 +4143,The effectiveness of mirtazapine in the treatment of post-traumatic stress disorder: A 24-week continuation therapy,"Few studies for the long-term effects of antidepressants on post-traumatic stress disorder (PTSD) have been conducted. The aim of the present study was to investigate the effectiveness of mirtazapine during the 24-week continuation treatment in patients with PTSD. Out of 15 patients who participated in the previous 8-week short-term study, 12 patients completed 24-week continuation treatment with mirtazapine. The effectiveness was evaluated at week 12 and week 24 using Impact of Event Scale-Revised (IES-R), Short PTSD Rating Interview (SPRINT), Interviewer-Administered Structured Interview for PTSD (SIP) and Montgomery-Asberg Depression Rating Scale (MADRS). The tolerability of continuation treatment was also reported. The scores on the IES-R, SPRINT, SIP and MADRS were significantly reduced over time from baseline to week 24, the end-point (F=36.1, d.f.=4, P<0.001; F=106.3, d.f.=4, P<0.001; F=121.1, d.f.=4, P<0.001; F=198.9, d.f.=4, P<0.001). On post-hoc analysis, the scores of all four measures were significantly reduced at the end point since week 8. However, after Bonferroni's correction, that was statistically significant in SPRINT only. The number of patients whose scores were reduced over 50% in all four scales had a tendency of incremental increase from three at week 8 to eight at the end point (P=0.063). No serious drug-related side-effects occurred. These results suggest that the mirtazapine may be effective in the continuation treatment of PTSD as well as short-term treatment. Further and better-designed studies are necessary.",0,0 +4144,Impact of age on long-term cognitive function after traumatic brain injury.,"To examine the association of age and time postinjury with cognitive outcome 5-22 years following traumatic brain injury (TBI), in relation to matched uninjured controls.One hundred twelve participants with mild to very severe TBI, aged 16-81 years at the time of injury, were cognitively assessed on measures of processing speed and attention, verbal and visual memory, executive function, and working memory. Results were compared with those of 112 healthy controls individually matched for current age, gender, education, and estimated IQ.Older injured individuals performed worse than did younger injured individuals across all cognitive domains, after controlling for the performance of controls. In relation to matched controls, long-time survivors performed disproportionately worse than did more recently injured individuals, irrespective of age.After maximum spontaneous recovery from TBI, poorer cognitive functioning appears to be associated with both older age at the time of injury and increased time postinjury. These findings have implications for prognosis, early treatment recommendations, and long-term issues of differential diagnosis and management planning.",0,0 +4145,Dose-effect relationships of trauma to symptoms of depression and post-traumatic stress disorder among Cambodian survivors of mass violence,"The dose-effect relationships of cumulative trauma to the psychiatric symptoms of major depression and post-traumatic stress disorder (PTSD) in a community study of Cambodian survivors of mass violence were evaluated.In 1990, a survey of 1000 households was conducted in a Thai refugee camp (Site 2) using a multi-stage random sampling design. Trauma history and psychiatric symptoms were assessed for two time periods. Analysis used linear dose-response regression modelling.993 Cambodian adults reported a mean of 14 Pol Pot era trauma events and 1.3 trauma events during the past year. Symptom categories of depression, PTSD, dissociative and culturally dependent symptoms exhibited strong dose-effect responses with the exception of avoidance. All symptom categories, except avoidant symptoms, were highly correlated.Cumulative trauma continued to affect psychiatric symptom levels a decade after the original trauma events. The diagnostic validity of PTSD criteria, with the notable exception of avoidance, was supported. Inclusion of dissociative and culturally dependent symptoms increased the cultural sensitivity of PTSD.",0,0 +4146,Personalidad y resiliencia en un cuerpo especial de la Policía Nacional de España,"Resumen Se valora la relacion entre datos sociodemograficos, personalidad y resiliencia en una muestra de 348 policias masculinos de las unidades de intervencion policial (UIP) de Espana (N = 348) entre los 23 y los 38 anos (M = 26.88, DT = 3.12). Los resultados mostraron que la edad y el nivel educativo junto con la dominancia, la escrupulosidad, perseverancia, control de los impulsos y emociones estaban muy relacionados con la resiliencia. Ademas, el 66% de la varianza en resiliencia vendria dado por cuatro variables: la edad y el nivel academico y el teson y el control de las emociones. Se discute la importancia de algunas variables socio-demograficas y diferencias individuales como predictoras del nivel de resiliencia en profesionales especializados de la policia y se abren algunas vias de trabajo para el estudio de la resiliencia en otros colectivos profesionales expuestos de forma constante a situaciones de extrema adversidad.",0,0 +4147,Longitudinal trajectories and predictors of adolescent suicidal ideation and attempts following inpatient hospitalization.,"Remarkably little is known regarding the temporal course of adolescent suicidal ideation and behavior, the prediction of suicidal attempts from changes in suicidal ideation, or the prediction of suicidal attempts after accounting for suicidal ideation as a predictor. A sample of 143 adolescents 12-15 years old was assessed during psychiatric inpatient hospitalization and again at 3, 6, 9, 15, and 18 months postdischarge through a series of structured interviews and parent- and adolescent-reported instruments. Symptoms of depression, posttraumatic stress disorder, externalizing psychopathology, hopelessness, and engagement in several forms of self-injurious/suicidal behaviors (i.e., suicide threats/gestures, plans, nonsuicidal self-injury [NSSI]) were assessed. Latent growth curve analyses revealed a period of suicidal ideation remission between baseline and 6 months following discharge, as well as a subtle period of suicidal ideation reemergence between 9 and 18 months postdischarge. Changes in suicidal ideation predicted suicide attempts. After accounting for the effects of suicidal ideation, baseline suicide threats/gestures also predicted future suicide attempts. Higher adolescent-reported depressive symptoms, lower parent-reported externalizing symptoms, and higher frequencies of NSSI predicted weaker suicidal ideation remission slopes. Findings underscore the need for more longitudinal research on the course of adolescent suicidality.",0,0 +4148,Adapted Character Styles of Vietnam Veterans with Posttraumatic Stress Disorder,"A total of 189 male Vietnam veterans who were admitted to a specialized inpatient treatment program were evaluated using the Millon Clinical Multiphasic Personality Inventory to assess character styles. The veterans were assessed for Posttraumatic Stress Disorder by using a subscale of the Minnesota Multiphasic Personality Inventory (MMPI) and 72% of the patients were classified as having Posttraumatic Stress Disorder. The character styles of passive-aggressive, schizoid, avoidant, and borderline were significantly associated with these patients. The most common 2-point profile was passive-aggressive and avoidant (8-2 or 2–8) and was significantly related to the diagnosis. While drug and alcohol abuse were common problem areas for the entire sample, the profile of patients with Posttraumatic Stress was different from those of substance abusers. These results indicate that treating Vietnam veterans with this disorder requires adopting strategies which include a character style focus as well as a symptom focus.",0,0 +4149,"A pilot study on peritraumatic dissociation and coping styles as risk factors for posttraumatic stress, anxiety and depression in parents after their child's unexpected admission to a Pediatric Intensive Care Unit","To study the prevalence of posttraumatic stress disorder (PTSD), anxiety and depression in parents three months after pediatric intensive care treatment of their child and examine if peritraumatic dissocation and coping styles are related to these mental health problems.This is a prospective cohort study and included parents of children unexpectedly admitted to the Pediatric Intensive Care Unit (PICU) from January 2006 to March 2007. At three months follow-up parents completed PTSD (n = 115), anxiety and depression (n = 128) questionnaires. Immediately after discharge, parents completed peritraumatic dissocation and coping questionnaires. Linear regression models with generalized estimating equations examined risk factors for mental health problems.Over 10% of the parents were likely to meet criteria for PTSD and almost one quarter for subclinical PTSD. Respectively 15% to 23% of the parents reported clinically significant levels of depression and anxiety. Peritraumatic dissocation was most strongly associated with PTSD, anxiety as well as depression. Avoidance coping was primarily associated with PTSD.A significant number of parents have mental health problems three months after unexpected PICU treatment of their child. Improving detection and raise awareness of mental health problems is important to minimize the negative effect of these problems on parents' well-being.",0,0 +4150,Mental health diagnoses and counseling among pilots of remotely piloted aircraft in the United States Air Force.,"Remotely piloted aircraft (RPA), also known as drones, have been used extensively in the recent conflicts in Iraq and Afghanistan. Although RPA pilots in the U.S. Air Force (USAF) have reported high levels of stress and fatigue, rates of mental health (MH) diagnoses and counseling in this population are unknown. We calculated incidence rates of 12 specific MH outcomes among all active component USAF RPA pilots between 1 October 2003 and 31 December 2011, and by various demographic and military variables. We compared these rates to those among all active component USAF manned aircraft (MA) pilots deployed to Iraq/Afghanistan during the same period. The unadjusted incidence rates of all MH outcomes among RPA pilots (n=709) and MA pilots (n=5,256) were 25.0 per 1,000 person-years and 15.9 per 1,000 person-years, respectively (adjusted incidence rate ratio=1.1, 95% confidence interval=0.9-1.5; adjusted for age, number of deployments, time in service, and history of any MH outcome). Th ere was no significant difference in the rates of MH diagnoses, including post-traumatic stress disorder, depressive disorders, and anxiety disorders between RPA and MA pilots. Military policymakers and clinicians should recognize that RPA and MA pilots have similar MH risk profiles.",0,0 +4151,Psychopathology in Substance Abusing Women Reporting Childhood Sexual Abuse,"This study compared MMPI-2 profiles and evaluated the ability of the MMPI-2 and its two new post-traumatic stress scales (PK and PS) to discriminate women in outpatient substance abuse treatment reporting positive (n = 24) and negative (n = 69) child sexual abuse histories. T-tests revealed significantly higher mean scores for the sexual abuse group for the following scales: F, 1, 2, 3, 4, 6, 7, and 8. A discriminant analysis yielded a linear function of L, F, 3, 5, 8, and PK that correctly categorized 75% with positive histories and 77% with negative histories. The optimal cutoff PK score was 17, which correctly classified 75% and 46% of those reporting positive and negative abuse histories, respectively. These findings support early identification of abuse survivors among substance abusing women and suggests that the MMPI-2 may be useful in patient-treatment matching.",0,0 +4152,Historical trauma: Politics of a conceptual framework,"The concept of historical trauma (HT) is compelling: Colonialism has set forth cumulative cycles of adversity that promote morbidity and mortality at personal and collective levels, with especially strong mental health impacts. Yet as ongoing community-based as well as scholarly discussions attest, lingering questions continue to surround HT as a framework for understanding the relationships between colonialism and indigenous mental health. Through an overview of 30 recent peer-reviewed publications that aim to clarify, define, measure, and interpret how HT impacts American Indian and Alaska Native (AIAN) mental health, this paper examines how the conceptual framework of HT has circulated in ways shaped by interactions among three prominent research approaches: evidence-based, culturally relevant, and decolonizing. All define current approaches to AIAN mental health research, but each sets forth different conceptualizations of the connections between colonialism and psychological distress. The unfolding trajectory of research about HT reflects persistent tensions in how these frameworks interact, but also possibilities for better integrating them. These considerations aim to advance conversations about the politics of producing knowledge about AIAN mental health, and support ongoing calls for greater political pluralism in mental health research.",0,0 +4153,Adverse Psychological Impact of Operative Obstetric Interventions: A Prospective Longitudinal Study,"Objective: This paper reports the findings of a prospective longitudinal study of 272 nulliparous pregnant women, which investigated as one of its objectives the psychological sequelae of obstetric procedures. Method: Participants completed structured interviews and standardised, published psychometric questionnaires, including the Rosenberg Self-Esteem Scale and the Profile of Mood States late in pregnancy and again early in the postpartum period. Results: Little evidence was found to support the notion that the total number of obstetric interventions was linked to a deterioration in postpartum mood. Significant adverse psychological effects were associated with the mode of delivery. Those women who had spontaneous vaginal deliveries were most likely to experience a marked improvement in mood and an elevation in self-esteem across the late pregnancy to early postpartum interval. In contrast, women who had Caesarean deliveries were significantly more likely to experience a deterioration in mood and a diminution in self-esteem. The group who experienced instrumental intervention in vaginal deliveries fell midway between the other two groups, reporting neither an improvement nor a deterioration in mood and self-esteem. Conclusions: The findings of this study suggest that operative intervention in first childbirth carries significant psychological risks rendering those who experience these procedures vulnerable to a grief reaction or to posttraumatic distress and depression.",0,0 +4154,Investigating the dissociative subtype of posttraumatic stress disorder in a sample of traumatized detained youth.,"In this study, we tested the validity of a dissociative subtype in a sample of 225 detained adolescents (142 boys, 83 girls) likely meeting full or partial criteria for posttraumatic stress disorder (PTSD). Competing theories of dissociation pose controversy regarding dissociation as a taxon versus a continuum, and results of the current study contribute to this debate by providing evidence of distinct group differences between those high and low in dissociation. Mixture modeling revealed 2 groups of youth with differing levels of depersonalization/derealization dissociative symptoms. Differences between the 2 groups of youth were investigated regarding trauma exposure and several posttraumatic reactions: posttraumatic stress symptoms (PTSS), emotion dysregulation, and emotional numbing. Compared with youth classified in the low-dissociation group, youth who exhibited high levels of dissociation demonstrated higher levels of total PTSS, posttraumatic symptom clusters of emotional numbing, intrusion, and associated features, as well as reporting more difficulties with emotion dysregulation. To test theory regarding the factors that increase the likelihood of persistent dissociation, bootstrapped regression analyses were performed to examine the possibility of an indirect effect of peritraumatic dissociation. Results consistent with statistical mediation suggested that the presence of peritraumatic dissociation at the time of trauma may contribute to the continuation of dissociative symptoms as a more generalized pattern. The results of the current study have implications for clinical treatment with traumatized youth.",0,0 +4155,Over-time changes in PTSD and depression among children surviving the 1999 Istanbul earthquake,"Objective: To follow-up on child and adolescent victims with full criteria of PTSD and depression, and to examine the impact of treatment. Method: One to two months following a 7.4-magnitude quake in Turkey, 160 students were examined by self-report questionnaire, psychiatric interview, clinician-administered post-traumatic stress disorder scale (CAPS), and depression and anxiety inventories. At baseline, 96 students were diagnosed with PTSD, and 49 had comorbid depression with anxiety symptoms. After 18-20 months, 74 of 96 students were found and reassessed by psychiatric interview and CAPS; 25 had been treated with cognitive-behavioral therapy (CBT) and pharmocotherapy, and 49 did not have any treatment. Binary logistic regression was used to identify significant predictors of persistent PTSD. Variables entered included pre-quake, quake and post-quake factors, having co-morbid depression upon initial interview, receipt of drug therapy, and number of months of CBT. Results: At follow-up, many had symptoms of PTSD with anxiety, but only 14 subjects met the full criteria of PTSD, and four students had major depression with anxiety symptoms. Only one variable-having been in serious personal danger during the quake (e.g., trapped in the house or under rubble)-was significantly associated with being symptomatic at follow-up. Conclusion: Regardless of receipt of treatment, diagnoses of PTSD and depression were much reduced. More research is needed about resiliency factors. © 2009 Steinkopff Verlag Darmstadt.",0,0 +4156,Resilience and Trajectories of Posttraumatic Stress Among Youth Exposed to Disaster,"Multiple trajectories of posttraumatic stress (PTS) symptoms are hypothesized following disaster in a number of theoretical perspectives. Increasingly, those with rapidly declining, transient, or stable low symptoms are defined as resilient. This article examines trajectories to understand acute reactions to disaster, and explores the need to define resilience as more than just symptom trajectories.An urban school-based sample of youth exposed to both hurricanes Katrina and Gustav (n=141; grades 4 through 8) were assessed for PTS symptoms at 12 months and 6 months pre-Gustav (Times 1 and 2); and then again at 1 month post-Gustav (Time 3).Data indicated that there were significant decreases in mean PTS symptoms post-Gustav, but individual trajectories were identified consistent with theory. Whereas an ostensibly resilient group was identified (stable low symptoms), results suggest that the group was heterogeneous in terms of disaster experiences, and that those with low symptoms but relatively high Katrina disaster exposure had a unique coping style.Results provide prospective data to support theories of multiple trauma exposure trajectories, and highlight the importance of empirically identifying resilient youth in terms of both functioning and level of risk exposure in disaster samples.",0,0 +4157,MDMA assisted psychotherapy found to have a large effect for chronic post-traumatic stress disorder,"Comments on an article by Peter Oehen et al. (see record 2012-34703-005). Oehen et al. (2013) reported a well-designed, randomized, double-blind, active placebo controlled trial of MDMA assisted psychotherapy in a small sample (N=12) of participants with resistant, chronic post-traumatic stress disorder (PTSD). Given that the sample is small, the statistical power of the study using analysis of variance is low. A potential solution is to express the findings in terms of effect sizes using Cohen's d, which is a way of estimating the magnitude of the difference between two means that is independent of the sample size. In that case, a d value of 0.20 is considered to be a small effect, 0.50 a medium effect and 0.80 a large effect. Thus, given than the full dose group had higher baseline levels of both clinician-observed and self-reported PTSD symptoms than the active placebo group, authors can say that these subjects with resistant, chronic PTSD showed, on average, a substantial improvement in PTSD symptoms over the course of MDMA assisted psychotherapy. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +4158,,"Findings from a longitudinal study are presented on the relationships between the problems and stresses resulting from Hurricane Andrew and posthurricane minor deviant behavior. The sample (N = 4,978) included Hispanic, African-American, and White non-Hispanic middle school students enrolled in Dade County, Florida public schools. Two waves of data were collected prior to the hurricane; a third was obtained approximately 6 months following the storm. Results indicated that females were likely to report higher levels of hurricane-related stress symptoms than males. After controlling for prehurricane levels of minor deviance, family support, and race/ethnicity, hurricane stress symptom level remained a significant predictor of posthurricane minor deviant behavior. The findings lend support to stress theories of social deviance.",0,0 +4159,Risk Factors for Posttraumatic Stress Disorder in Haitian Students,"The aim of this study was to assess the prevalence of posttraumatic stress disorder (PTSD) in undergraduate students after the Haiti earthquake on January 12, 2010, as well as to identify the risk factors involved in the development of PTSD symptoms in this sample. Evaluations concerning depression, anxiety, risk and protective factors, and PTSD symptoms were conducted in 246 Haitian undergraduate students enrolled in a Dominican private university. Results indicate a prevalence of 36% for PTSD 2 years after the earthquake, with a high prevalence also of depression (31.7%) and anxiety (21.1%). Some of the risk factors identified are being female, a history of psychiatric treatment, and the amount of personal and material losses. The instauration of crisis management and follow-up protocols after traumatic events was deemed to be needed. Further research is necessary to study the long-term effects of this tragedy, not only in undergraduate students, but also in the working class Haitian immigrants living in the Dominican Republic.",0,0 +4160,Quantitative testing of pain perception in subjects with PTSD – Implications for the mechanism of the coexistence between PTSD and chronic pain,"Post-traumatic stress disorder (PTSD) often co-occurs with chronic pain. Neither the underlying mechanism of this comorbidity nor the nature of pain perception among subjects with PTSD is well defined. This study is the first systematic and quantitative evaluation of pain perception and chronic pain in subjects with PTSD. The study group consisted of 32 outpatients with combat- and terror-related PTSD, 29 outpatients with anxiety disorder and 20 healthy controls. Quantitative somatosensory testing included the measurement of warm, cold, light touch and heat-pain thresholds and responses to acute suprathreshold heat and mechanical stimuli. Chronic pain was characterized, and levels of PTSD and anxiety symptomatology were assessed by self-report questionnaires. Subjects with PTSD exhibited higher rates of chronic pain, more intense chronic pain and more painful body regions compared with the other two groups. PTSD severity correlated with chronic pain severity. Thresholds of subjects with PTSD were significantly higher than those of subjects with anxiety and healthy controls, but they perceived suprathreshold stimuli as being much more intense than the other two groups. These results suggest that subjects with PTSD exhibit an intense and widespread chronic pain and a unique sensory profile of hyposensitivity to pain accompanied by hyper-reactivity to suprathreshold noxious stimuli. These features may be attributed to the manner with which PTSD subjects emotionally interpret and respond to painful stimuli. Alternatively, but not mutually exclusive, the findings may reflect altered sensory processing among these subjects.",0,0 +4161,"Anger, PTSD, and the nuclear family: A study of Cambodian refugees","This study profiles the family-directed anger of traumatized Cambodian refugees, all survivors of the Pol Pot genocide (1975–1979), who were patients at a psychiatric clinic in Lowell, MA, USA. We focus on the nuclear family (NF) unit, the NF unit defined as the patient's “significant other” (i.e. spouse or boyfriend/girlfriend) and children. Survey data were collected from a convenience sample of 143 Cambodian refugee patients from October 2006 to August 2007. The study revealed that 48% (68/143) of the patients had anger directed toward a NF member in the last month, with anger directed toward children being particularly common (64 of the 143 patients, or 49% [64/131] of the patients with children). NF-type anger was severe, for example, almost always resulting in somatic arousal (e.g., causing palpitations in 91% [62/68] of the anger episodes) and often in trauma recall and fears of bodily dysfunction. Responses to open-ended questions revealed the causes of anger toward a significant other and children, the content of anger-associated trauma recall, and what patients did to gain relief from anger. A type of cultural gap, namely, a linguistic gap (i.e., the parent's lack of English language skills and the child's lack of Khmer language skills), seemingly played a role in generating conflict and anger. NF-type anger was associated with PTSD presence. The effect of anger on PTSD severity resulted in part from anger-associated trauma recall and fears of bodily dysfunction, with 54% of the variance in PTSD severity explained by that regression model. The study: 1) suggests that among traumatized refugees, family-related anger is a major clinical concern; 2) illustrates how family-related anger may be profiled and investigated in trauma-exposed populations; and 3) gives insights into how family-related anger is generated in such populations.",0,0 +4162,Sleep and anxiety disorders,"Sleep disturbances-particularly insomnia - are highly prevalent in anxiety disorders and complaints such as insomnia or nightmares have even been incorporated in some anxiety disorder definitions, such as generalized anxiety disorder and posttraumatic stress disorder. In the first part of this review, the relationship between sleep and anxiety is discussed in terms of adaptive response to stress. Recent studies suggested that the corticotropin-releasing hormone system and the locus ceruleus-autonomic nervous system may play major roles in the arousal response to stress. It has been suggested that these systems may be particularly vulnerable to prolonged or repeated stress, further leading to a dysfunctional arousal state and pathological anxiety states, Polysomnographic studies documented limited alteration of sleep in anxiety disorders. There is some indication for alteration in sleep maintenance in generalized anxiety disorder and for both sleep initiation and maintenance in panic disorder; no clear picture emerges for obsessive-compulsive disorder or posttraumatic stress disorder. Finally, an unequivocal sleep architecture profile that could specifically relate to a particular anxiety disorder could not be evidenced; in contrast, conflicting results are often found for the same disorder. Discrepancies between studies could have been related to illness severity, diagnostic comorbidity, and duration of illness. A brief treatment approach for each anxiety disorder is also suggested with a special focus on sleep.",0,0 +4163,Foundations of posttraumatic stress disorder: Does early life trauma lead to adult posttraumatic stress disorder?,"Abstract The effects of childhood abuse are diverse, and although pathology is not the only outcome, psychiatric illness, including posttraumatic stress disorder (PTSD), can develop. However, adult PTSD is less common among those who experienced single-event traumas as children than it is among those who experienced childhood abuse. In addition, PTSD is more common among adults than children who experienced childhood abuse. Such evidence raises doubt about the direct, causal link between childhood trauma and adult PTSD. The experience of childhood trauma, and in particular abuse, has been identified as a risk factor for subsequent development of PTSD following exposure to adult trauma, and a substantial literature identifies revictimization as a factor that plays a pivotal role in this trajectory. The literature on the developmental effects of childhood abuse and pathways to revictimization, when considered in tandem with the biological effects of early stress in animal models, may provide some explanations for this. Specifically, it seems possible that permanent sensitization of the hypothalamic–pituitary–adrenal axis and behavioral outcomes are a consequence of childhood abuse, and these combine with the impact of retraumatization to sustain, perpetuate, and amplify symptomatology of those exposed to maltreatment in childhood.",0,0 +4164,Outcomes and moderators of a preventive schoolbased mental health intervention for children affected by war in Sri Lanka: a cluster randomized trial,"We aimed to examine outcomes, moderators and mediators of a preventive school-based mental health intervention implemented by paraprofessionals in a war-affected setting in northern Sri Lanka. A cluster randomized trial was employed. Subsequent to screening 1,370 children in randomly selected schools, 399 children were assigned to an intervention (n=199) or waitlist control condition (n=200). The intervention consisted of 15 manualized sessions over 5 weeks of cognitive behavioral techniques and creative expressive elements. Assessments took place before, 1 week after, and 3 months after the intervention. Primary outcomes included post-traumatic stress disorder (PTSD), depressive, and anxiety symptoms. No main effects on primary outcomes were identified. A main effect in favor of intervention for conduct problems was observed. This effect was stronger for younger children. Furthermore, we found intervention benefits for specific subgroups. Stronger effects were found for boys with regard to PTSD and anxiety symptoms, and for younger children on pro-social behavior. Moreover, we found stronger intervention effects on PTSD, anxiety, and function impairment for children experiencing lower levels of current war-related stressors. Girls in the intervention condition showed smaller reductions on PTSD symptoms than waitlisted girls. We conclude that preventive school-based psychosocial interventions in volatile areas characterized by ongoing war-related stressors may effectively improve indicators of psychological wellbeing and posttraumatic stress-related symptoms in some children. However, they may undermine natural recovery for others. Further research is necessary to examine how gender, age and current war-related experiences contribute to differential intervention effects.",0,0 +4165,Genetic Association Analysis of 300 Genes Identifies a Risk Haplotype in SLC18A2 for Post-traumatic Stress Disorder in Two Independent Samples,"The genetic architecture of post-traumatic stress disorder (PTSD) remains poorly understood with the vast majority of genetic association studies reporting on single candidate genes. We conducted a large genetic study in trauma-exposed European-American women (N=2538; 845 PTSD cases, 1693 controls) by testing 3742 SNPs across more than 300 genes and conducting polygenic analyses using results from the Psychiatric Genome-Wide Association Studies Consortium (PGC). We tested the association between each SNP and two measures of PTSD, a severity score and diagnosis. We found a significant association between PTSD (diagnosis) and SNPs (top SNP: rs363276, odds ratio (OR)=1.4, p=2.1E-05) in SLC18A2 (vesicular monoamine transporter 2). A haplotype analysis of 9 SNPs in SLC18A2, including rs363276, identified a risk haplotype (CGGCGGAAG, p=0.0046), and the same risk haplotype was associated with PTSD in an independent cohort of trauma-exposed African-Americans (p=0.049; N=748, men and women). SLC18A2 is involved in transporting monoamines to synaptic vesicles and has been implicated in a number of neuropsychiatric disorders including major depression. Eight genes previously associated with PTSD had SNPs with nominally significant associations (p<0.05). The polygenic analyses suggested that there are SNPs in common between PTSD severity and bipolar disorder. Our data are consistent with a genetic architecture for PTSD that is highly polygenic, influenced by numerous SNPs with weak effects, and may overlap with mood disorders. Genome-wide studies with very large samples sizes are needed to detect these types of effects.",0,0 +4166,Examination of fatigue development in elite soccer in a hot environment: a multi-experimental approach,"The study examines fatigue in elite soccer played in hot conditions. High-profile soccer players (n=20) were studied during match play at ∼31 °C. Repeated sprint and jump performances were assessed in rested state and after a game and activity profile was examined. Additionally, heart rate (HR), blood lactate, muscle temperature and body mass changes were determined. Repeated sprint and jump performances were reduced (P<0.05) by 2.6% and 8.2%, respectively, after the game. The fatigue index in the repeated sprint test was 6.0±0.7% after the game compared with 1.7±1.0% at rest (P<0.05). High-intensity running was 57±4% lower (P<0.05) during the last 15-min interval of the game compared with the first 15-min period. No differences were observed in mean HR or blood lactates between halves. Muscle temperature was 40.5±0.4 °C after the first half, which was 0.8±0.2 °C higher (P<0.05) than after the second half. Net fluid loss during the game was >2% of the body mass. Correlations were observed between net-fluid loss and repeated sprint test fatigue index after the game (r=0.73, P<0.05) and Yo-Yo intermittent recovery, level 1 test performance and high-intensity running during the final 15 min of the game (r=0.51, P<0.05). The study provides direct evidence of compromised repeated sprint and jump performances induced by soccer match play and pronounced reduction in high-intensity running toward the end of an elite game played in a hot environment. This fatigue could be associated training status and hyperthermia/dehydration.",0,0 +4167,Traumatic Events and Mental Health in the Community: a New Zealand Study,"Background: Adverse mental health effects in response to a variety of distressing events in specific populations are well documented. However, comparatively little research has been conducted within large community samples outside North America. Aims: To assess the prevalence and psychological impact of specific traumatic events in a New Zealand community sample. Methods: Prevalence and psychological impact of 12 traumatic events was examined in a community sample of 1,500 New Zealand adults using a three-stage cluster sampling method. Traumatic events, psychological distress, psychological well-being, and post-traumatic stress disorder symptoms were assessed using modifi ed versions of the Traumatic Stress Schedule, Mental Health Inventory, and Civilian Mississippi Scale. The effects of age, gender and ethnicity were controlled for while assessing impact of traumatic events. Results: Sixty-one per cent of the sample experienced trauma events in their lifetime, with 9% experiencing events in the past year. Accident-related events were most common in the present sample. Violent crime produced the greatest impact. Tests of interactions involving age, gender, and ethnicity were not significant. Conclusions: New Zealand community-residing individuals experience post-traumatic stress symptoms, reduced psychological well-being, and increased psychological distress following the experience of violent crime and accidents specifically. Study limitations and suggestions for future research are discussed.",0,0 +4168,"Epidemiology of trauma, post-traumatic stress disorder (PTSD) and co-morbid disorders in Chile","Background. In this study we examined the prevalence rates of post-traumatic stress disorder (PTSD), types of trauma most often associated with PTSD, the co-morbidity of PTSD with other lifetime psychiatric disorders, which disorders preceded PTSD, and gender differences in PTSD and trauma exposure in a representative sample of Chileans. Method. The DSM-III-R PTSD and antisocial personality disorder modules from the Diagnostic Interview Schedule (DIS) and modules for a range of DSM-III-R diagnoses from the Composite International Diagnostic Interview (CIDI) were administered to a representative sample of 2390 persons aged 15 to over 64 years in three cities in Chile. Results. The lifetime prevalence of PTSD was 4·4% (2·5% for men and 6·2% for women). Among persons exposed to trauma, rape was most strongly associated with PTSD. Onset of PTSD significantly increased the risk of developing each of the 10 other tested disorders. Among those exposed to trauma, women were significantly more likely to develop PTSD, after controlling for assaultive violence. Conclusions. This study highlights the importance of investigating the prevalence of PTSD, patterns of co-morbidity of PTSD, and gender differences in PTSD in non-English-speaking countries.",0,0 +4169,Late and Long‐Term Effects of Breast Cancer Treatment and Surveillance Management for the General Practitioner,"To examine the most common long-term and late effects of breast cancer treatment, the American Society of Clinical Oncology guidelines for surveillance, and recommendations for the primary care provider's role in delivering breast cancer survivorship care.A comprehensive literature review was conducted using CINAHL, PubMed, Google Scholar, and hand searches using the search terms breast cancer, survivor, and long-term or late effects.Articles published in English from 2002 to 2012 that addressed the long-term or late effects of adults with breast cancer were included.Findings are discussed categorically, including the most common late and long-term psychosocial effects from relevant studies.Topics relevant to survivors included challenges to psychosocial, emotional, and cognitive well-being; satisfaction with life; sexuality; body image; anxiety; fear of recurrence and post-traumatic stress disorder; depression; cognitive dysfunction challenges to physical well-being; adverse cardiovascular events; fatigue; lymphedema; musculoskeletal symptoms; accelerated bone loss and fractures; pain; skin changes due to radiation; disease recurrence; and new breast cancers.With earlier detection methods and improvements in treatment options making breast cancer a highly survivable disease, there are more survivors of breast cancer than ever. The clinicians' role in survivorship care is more important than ever to manage the potential long-term and late effects of treatment, physical and emotional well-being, and recurrent disease surveillance. However, the clinician's role in cancer follow-up care is often poorly defined leading to a lack of awareness about the needs of survivors of breast cancer, suboptimal communication between providers and survivors, and an overall deficiency in quality care.",0,0 +4170,Self-injurious behaviors in posttraumatic stress disorder: An examination of potential moderators,"Despite increasing evidence for a relation between posttraumatic stress disorder (PTSD) and self-injurious behaviors (SIB), limited research has examined the factors that may moderate the associations between PTSD and both nonsuicidal SIB (deliberate self-harm; DSH) and suicidal SIB (suicide attempts). Nonetheless, research suggests that characteristics of the traumatic event, co-occurring borderline personality disorder (BPD), and emotion dysregulation may influence the relations between PTSD and SIB. Thus, the aim of this study was to examine the moderating role of these factors in the association between PTSD and SIB (including history and frequency of DSH and suicide attempts, and DSH versatility) among a sample of substance use disorder inpatients with ( n =116) and without ( n =130) a history of PTSD. Results from stepwise regression analyses indicate that sexual assault-related PTSD predicted suicide attempt frequency and DSH versatility among those with PTSD. Furthermore, results from hierarchical linear and logistic regression analyses suggest that co-occurring BPD moderates the relationship between PTSD and both DSH history and versatility and emotion dysregulation moderates the relationship between PTSD and DSH frequency. Specifically, the relations between PTSD and DSH outcomes were stronger among participants with co-occurring BPD and higher levels of emotion dysregulation. This study is limited by its reliance on cross-sectional, self-report data. Despite limitations, findings suggest distinct risk factors for suicide attempts and DSH, and highlight the importance of examining characteristics of the trauma and associated BPD and emotion dysregulation in assessing risk for SIB in PTSD.",0,0 +4171,Valoración psicológica en delitos de violencia de género mediante el Inventario Clínico y Multiaxial de Millon III (MCMI-III),"In this study, psychological assessment of 127 women presenting charges of gender-based violence (GVB) and 55 male suspects, were analyzed by the MCMI-III, as well as the influence of sociodemographic data and GVB features on these MCMI-III scores. Average age of women was 36.25 (SD = 10.48) and average age of men was 42.54 years old (SD = 12.93). Both groups were referred to the Legal Medicine Institute by the Woman Violence Court and all of them were administered the Millon Clinical Multiaxial Inventory III (MCMI-III). Differential profiles according to age, maltreatment duration and years of cohabitation were obtained. Women presented high scores in Social desirability, Compulsive personality, Anxiety, Dysthymia, Somatization and Depression. Men presented Narcissistic features, Depression and Substance abuse. As maltreatment extended in time, Schizoid, Depressive and Self-destructive features increased in women, as well as Dysthymia and PTSD, obtaining lower scores on Social desirability and Histrionic personality.",0,0 +4172,"Dynamics of in Vivo Release of Molt-Inhibiting Hormone and Crustacean Hyperglycemic Hormone in the Shore Crab, Carcinus maenas","Very little is known regarding the release patterns or circulating titers of neuropeptides in crustaceans, in particular those concerned with regulation of molting hormone (ecdysteroid) synthesis, molt-inhibiting hormone (MIH), and crustacean hyperglycemic hormone (CHH), which is also an adaptive hormone, centrally important in carbohydrate metabolism. Furthermore, the currently accepted model of molt control is founded on an untested hypothesis suggesting that molting can proceed only after decline in MIH titer. Accordingly, we measured simultaneous circulating neuropeptide profiles for both MIH and CHH by RIA of purified hemolymph during the molt cycle at fine temporal scale during day/night cycles and seasonally. For CHH we additionally determined release patterns after physiologically relevant stress. Results show that both hormones are released exclusively and episodically, rather than continuously, with notably short half-lives in circulation, suggesting dynamic and short-lived variations in levels of both hormones. During the molt cycle, there are no overt changes in MIH titer, except a massive and unprecedented increase in MIH during late premolt, just before ecdysis. The function of this hormone surge is unknown. Treatment with various stressors (hypoxia, temperature shock) showed that CHH release occurs extremely rapidly, within minutes of stress. Release of CHH after stressful episodes during premolt (when gut endocrine cells synthesize large quantities of CHH) is exclusively from the sinus gland: CHH from the gut is never involved in the stress response. The results show a hitherto unsuspected dynamism in release of MIH and CHH and suggest that currently accepted models of molt control must be reconsidered.",0,0 +4173,A causal model of post-traumatic stress disorder: disentangling predisposed from acquired neural abnormalities,"Discriminating neural abnormalities into the causes versus consequences of psychopathology would enhance the translation of neuroimaging findings into clinical practice. By regarding the traumatic encounter as a reference point for disease onset, neuroimaging studies of post-traumatic stress disorder (PTSD) can potentially allocate PTSD neural abnormalities to either predisposing (pre-exposure) or acquired (post-exposure) factors. Based on novel research strategies in PTSD neuroimaging, including genetic, environmental, twin, and prospective studies, we provide a causal model that accounts for neural abnormalities in PTSD, and outline its clinical implications. Current data suggest that abnormalities within the amygdala and dorsal anterior cingulate cortex represent predisposing risk factors for developing PTSD, whereas dysfunctional hippocampal-ventromedial prefrontal cortex (vmPFC) interactions may become evident only after having developed the disorder.",0,0 +4174,Analysis of a case series of workers with mobbing syndrome,"Mobbing represents nowadays a major challenge for Occupational Medicine. We examined, during the last seven years, 253 patients who asked medical assistance for psychopathological problems by them ascribed to mobbing in the working environment. All patients underwent occupational health visit, psychological counselling (including personality tests administration), and psychiatric evaluation. A clinical picture probably due to mobbing was diagnosed in 37 workers: 2 cases of Post-Traumatic Stress Disorder (PTSD), 33 of Adjustment Disorder (AD), and 2 of anxiety disorder. Regarding mobbing typology, we found 19 cases of vertical mobbing (by an employer/manager to employees), 14 cases of strategic mobbing, 3 cases of horizontal mobbing (among colleagues), and one non intentional mobbing. In conclusion, a pure mobbing syndrome was diagnosed in a lower proportion than that reported by other investigators. The described interdisciplinary approach appears useful for the diagnostic assessment of suspect mobbing cases, that in turn is crucial for prognosis and treatment, as well as in relation to medico-legal issues and work-related compensation claims.",0,0 +4175,Disasters and Depressive Symptoms in Children: A Review,"Background Disasters are destructive, potentially traumatic events that affect millions of youth each year.ObjectiveThe purpose of this paper was to review the literature on depressive symptoms among youth after disasters. Specifically, we examined the prevalence of depression, risk factors associated with depressive symptoms, and theories utilized in this research area.MethodsWe searched MEDLINE, PsycInfo, and PubMed electronic databases for English language articles published up to May 1, 2013. Reference lists from included studies were reviewed to capture additional studies. Only quantitative, peer reviewed studies, conducted with youth under the age of 18 years, that examined postdisaster depressive symptoms were included. Seventy-two studies met inclusion criteria. Prevalence of depressive symptoms, disaster type, correlates of depressive symptoms, and theories of depressive symptoms were reviewed.ResultsOnly 27 studies (38 %) reported on prevalence rates among youth in their sample. Prevalence rates of depression among youth postdisaster ranged from 2 to 69 %. Potential risk factors were identified (e.g., female gender, exposure stressors, posttraumatic stress symptoms). Theories were examined in less than one-third of studies (k = 21).ConclusionsGiven the variability in prevalence rates, difficulty identifying a single profile of youth at risk for developing depressive symptoms, and lack of a unifying theory emerging from the studies, recommendations for future research are discussed. Use of established batteries of assessments could enable comparisons across studies. Merging existing theories from children’s postdisaster and depression literatures could aid in the identification of risk factors and causal pathways.",0,0 +4176,Key determinants of the MMPI-PTSD subscale: Treatment considerations,"Seventy-five “in country” Vietnam combat psychiatric inpatients were given a battery of measures upon admission to the medical center. These included the MMPI, VETS Adjustment Scale, State-Trait Anxiety Scale, Rotter Locus of Control, Profile of Mood Scale, and a variation of the Figley Stress Scale that measures current stress. Post-traumatic stress disorder (PTSD) was determined by the MMPI-PTSD subscale. Ten of the battery variables were used as predictors for a multiple regression analysis on the MMPI-PTSD subscale. Results yielded a multiple R of .89 for two predictors, Figley Stress Scale and Rotter Locus of Control (external). Patients with PTSD, therefore, suffer most from perceived and experienced current stressors and a low sense of control. Arguments are made for more present-centered and interpersonal strategies in the treatment of PTSD combat veterans.",0,0 +4177,Understanding posttraumatic stress disorder: insights from the methylome,"Genome-wide association studies (GWAS) have identified numerous disease-associated variants; however, these variants have a minor effect on disease and explain only a small amount of the heritability of complex disorders. The search for the missing heritability has shifted attention to rare variants, copy number variants, copy neutral variants and epigenetic modifications. The central role of epigenetics, and specifically DNA methylation, in disease susceptibility and progression has become more apparent in recent years. Epigenetic mechanisms facilitate the response to environmental changes and challenges by regulating gene expression. This makes the study of DNA methylation in psychiatric disorders such as posttraumatic stress disorder (PTSD) highly salient, as the environment plays such a vital role in disease aetiology. The epigenome is dynamic and can be modulated by numerous factors, including learning and memory, which are important in the context of PTSD. Numerous studies have shown the effects of early life events, such as maternal separation and traumas during adulthood, on DNA methylation patterns and subsequent gene expression profiles. Aberrations in adaptive DNA methylation contribute to disease susceptibility when an organism is unable to effectively respond to environmental demands. Epigenetic mechanisms are also involved in higher order brain functions. Dysregulation of methylation is associated with neurodevelopmental and neurodegenerative cognitive disorders, affective disorders, addictive behaviours and altered stress responses. A thorough understanding of how the environment, methylome and transcriptome interact and influence each other in the context of fear and anxiety is integral to our understanding and treatment of stress-related disorders such as PTSD.",0,0 +4178,Functional significance of a novel 7-factor model of DSM-5 PTSD symptoms: Results from the National Health and Resilience in Veterans Study,"While posttraumatic stress disorder (PTSD) symptoms in the recently published Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are clustered into four factors, emerging confirmatory factor analytic studies suggest that this disorder is best characterized by seven symptom clusters, including re-experiencing, avoidance, negative affect, anhedonia, externalizing behaviors, and anxious and dysphoric arousal symptoms. To date, however, data are lacking regarding the relation between this novel model of DSM-5 PTSD symptoms and measures of clinical significance in this population (e.g., functioning).Using data from the National Health and Resilience in Veterans Study (NHRVS), a contemporary, nationally representative sample of 1484 U.S. veterans, we evaluated clinical and functional correlates of a novel 7-factor model of DSM-5 PTSD symptoms.Differential patterns of associations were observed between DSM-5 PTSD symptom clusters, and psychiatric comorbidities, suicidal ideation, hostility, and functioning and quality of life. Anhedonia symptoms, in particular, were strongly related to current depression, as well as reduced mental functioning and quality of life. Externalizing behaviors were most strongly related to hostility, supporting the convergent validity of this construct.Cross-sectional design and employment of self-report measures.These results suggest that a more refined 7-factor model of DSM-5 PTSD symptoms may provide greater specificity in understanding associations with comorbid psychopathology, suicidal ideation, and functioning and quality of life in U.S. veterans. They further suggest that prevention and treatment efforts that target distinct aspects of the PTSD phenotype may be more effective in mitigating key clinical and functional outcomes in this population.",0,0 +4179,Randomized controlled evaluation of an early intervention to prevent post-rape psychopathology,"A randomized between-group design was used to evaluate the efficacy of a video intervention to reduce post-traumatic stress disorder (PTSD) and other mental health problems, implemented prior to the forensic medical examination conducted within 72 h post-sexual assault. Participants were 140 female victims of sexual assault (68 video/72 nonvideo) aged 15 years or older. Assessments were targeted for 6 weeks (Time 1) and 6 months (Time 2) post-assault. At Time 1, the intervention was associated with lower scores on measures of PTSD and depression among women with a prior rape history relative to scores among women with a prior rape history in the standard care condition. At Time 2, depression scores were also lower among those with a prior rape history who were in the video relative to the standard care condition. Small effects indicating higher PTSD and Beck Anxiety Inventory (BAI) scores among women without a prior rape history in the video condition were observed at Time 1. Accelerated longitudinal growth curve analysis indicated a videoxprior rape history interaction for PTSD, yielding four patterns of symptom trajectory over time. Women with a prior rape history in the video condition generally maintained the lowest level of symptoms.",0,0 +4180,Facial asymmetry detection in patients with body dysmorphic disorder,"Cognitive-behavioral models of body dysmorphic disorder (BDD) propose that individuals with BDD may possess a better or more developed sense of aestheticality than do individuals without BDD. Evidence for this proposition, however, is limited. One perceptual process that could contribute to heightened aestheticality is the ability to detect differences in symmetry. In this experiment we tested whether individuals with BDD (n=20), relative to individuals with obsessive compulsive disorder (OCD; n=20) and healthy controls (n=20), show an enhanced ability to detect differences in the symmetry of others' faces, symmetry of dot arrays, and/or show a greater preference for symmetrical faces. Individuals with BDD were not significantly more accurate in detecting differences in facial symmetry or dot arrays relative to individuals with OCD and healthy controls. Individuals with OCD took longer to make facial symmetry judgments than did individuals in the other two groups. All participants, regardless of diagnostic group, preferred more symmetrical faces than nonsymmetrical ones. Taken together, our results do not support a heightened perceptual ability or evaluative preference for symmetry among individuals with BDD.",0,0 +4181,Peritraumatic and trait dissociation differentiate police officers with resilient versus symptomatic trajectories of posttraumatic stress symptoms,"Research has consistently demonstrated that stress reactions to potentially traumatic events do not represent a unified phenomenon. Instead, individuals tend to cluster into prototypical response patterns over time including chronic symptoms, recovery, and resilience. We examined heterogeneity in a posttraumatic stress disorder (PTSD) symptom course in a sample of 178 active-duty police officers following exposure to a life-threatening event using latent growth mixture modeling (LGMM). This analysis revealed 3 discrete PTSD symptom trajectories: resilient (88%), distressed-improving (10%), and distressed-worsening (2%). We further examined whether trait and peritraumatic dissociation distinguished these symptom trajectories. Findings indicate that trait and peritraumatic dissociation differentiated the resilient from the distressed-improving trajectory (trait, p < .05; peritraumatic, p < .001), but only peritraumatic dissociation differentiated the resilient from the distressed-worsening trajectory (p < .001). It is essential to explore heterogeneity in symptom course and its predictors among active-duty police officers, a repeatedly exposed group. These findings suggest that police officers may be a highly resilient group overall. Furthermore, though there is abundant evidence that dissociation has a positive linear relationship with PTSD symptoms, this study demonstrates that degree of dissociation can distinguish between resilient and symptomatic groups of individuals.",1,0 +4182,Selective blockade of 2-arachidonoylglycerol hydrolysis affects learning and memory performance while slowing down epileptogenesis in rodents,"Background: Endocannabinoids (eCBs) play a key neuromodulatory role in the central nervous system, regulating appetite, cognition, emotion, mood and pain by activation of cannabinoid (CB1) receptors. Alterations in the eCB system has been associated with disease in several major therapeutic areas. In particular, changes in tissue concentrations of their natural lipid ligands, N-arachidonoylethanolamine (anandamide) and 2-arachidonoyglycerol (2-AG) have been observed in neurological and psychiatric disorders, observations which have fueled considerable pharmaceutical interest in developing eCB-manipulating drugs to treat these conditions. These include compounds that act at CB1 receptors or inhibit anandamide degradation by fatty acid amide hydrolase (FAAH). Much less attention focused on the identification of drugs that modify 2-AG levels via manipulation of the serine hydrolase monoacylglycerol lipase (MAGL), its principal degradative enzyme. Here we report the pharmacological profile of a potent and selective MAGL inhibitor, Compound A. Methods: MAGL selectivity and activity of Compound A were determined in in vitro and ex vivo biochemical assays, followed by a pharmacokinetic study to measure its brain exposure in mice. The effects of Compound A were then evaluated using rodent models with a focus on cognition and epilepsy tests since there is recent evidence that the modulation of 2-AG levels affects cognitive processes and seizure activity. Results: Compound A behaves as a highly selective and competitive reversible inhibitor of mouse and human MAGL (IC50=29 and 3.8 nM, respectively). It does not affect the activities of other human serine hydrolases or interact with a panel of selected kinases, neurotransmitter transporters, ion channels and receptors, including the binding of a highaffinity ligand to CB1 and CB2 receptors. Ex vivo assays confirmed the degree of selectivity across eCBs as Compound A decreased MAGL activity (ID50=2.7mg/kg po), while increasing levels of 2-AG (MED=3mg/kg po) in the absence of effect on other serine hydrolase substrates. Compound A demonstrated excellent brain permeability in the mouse (brain/plasma 4.3 at 10 mg/kg po). In a preliminary experiment, Compound A was found to decrease in vitro long term potentiation in rat hippocampus. This finding is in line with those of behavioral experiments showing that Compound A affected learning performance in the novel object recognition task (NOR), the Y-maze (YM) and the Morris water maze test, suggesting alterations in episodic, working and spatial memory. The effects of Compound A in the NOR and YM were antagonized by rimonabant suggesting that they were mediated by CB1 receptors. It is noteworthy that no tolerance to the effects of the drug was observed in the latter test upon repeated administration for 5 days. Interestingly, the effects of Compound A in the NOR were similar to those observed following genetic deletion of MAGL, supporting further the role of 2-AG in the intrinsic modulation of cognitive processes. In acute seizure tests in mice, Compound A was inactive over a wide dose-range in the 6-Hz model and after the administation of the convulsants pentylenetetrazole and kainate. However, in the mouse corneal kindling model of partial epilepsy, repeated administration of Compound A for 2 weeks delayed the acquisition and decreased the expression of kindled seizures, suggesting antiepileptogenic and anticonvulsant activities. Conclusions: These findings demonstrate that selective pharmacological or genetic blockade of 2-AG hydrolysis affects memory performance, suggesting that MAGL inhibitors may be of limited utility as therapeutic agents for CNS disorders. However, it cannot be totally excluded that they may serve to treat psychopathologies hallmarked by an inability to extinguish maladaptive behaviors, such as posttraumatic stress syndrome and obsessive-compulsive disorder. Finally, our study reveals a previously unsuspected role of 2-AG in epileptogenesis process, a finding which deserves further investigation to determine t e therapeutic potential of MAGL inhibitors as antiepileptic drugs.",0,0 +4183,Does Language of Retrieval Affect the Remembering of Trauma?,"Semantic and episodic bilingual memory has been extensively researched. Research has also been conducted in the area of autobiographical memory. This study investigated traumatic bilingual memories. This study was a preliminary exploration of possible differences in the reporting of the intensity of 3 clusters of posttraumatic stress disorder symptoms and 5 specific characteristics of traumatic memory in the first versus second languages of bilingual (Spanish-English) individuals who sustained traumatic experiences in childhood. Participants were 19 Spanish-English coordinate bilingual individuals. A repeated measures design examined the prediction that, regardless of the order in which language was presented (whether Spanish-English or English-Spanish), bilingual participants would rate the intensity of specific symptoms and characteristics of traumatic memory higher in their first language. It is hypothesized that the first language is most closely connected to early experience between the self and the first other. Additionally, the relation between affect and first language is different from the relation between affect and second language. P. Janet (1919/1925) and current trauma research suggest that traumatic memories may be encoded differently from ordinary memories. Matching language at the time that traumatic memories were experienced with the later language of retrieval may significantly facilitate the healing process by allowing unique access to traumatic memories through the first language.",0,0 +4184,"Pretrauma problems, prior stressor exposure, and gender as predictors of change in posttraumatic stress symptoms among physically injured children and adolescents.","This study addressed predictors of change in posttraumatic stress symptoms (PTSS) among youths who had experienced physical injuries. The influences of pretrauma internalizing and externalizing problems, prior stressor exposure, and gender were investigated. Additionally, gender was examined as a moderator of the associations between internalizing problems and PTSS, externalizing problems and PTSS, and prior stressor exposure and PTSS.Participants were 157 children and adolescents (75% male; age M = 13.30 years, SD = 3.60; 44% Caucasian, 39% African American, 13% Hispanic, and 4% other) admitted to 2 hospitals for physical injuries. Youths and their parents completed measures of PTSS (Child Posttraumatic Stress Reaction Index), internalizing and externalizing problems (Child Behavior Checklist), and prior stressor exposure (Coddington Life Events Scale, Child) during the hospital stay; youths completed up to 3 additional PTSS assessments targeted at 3, 6, and 12 months postinjury.Multilevel regression analyses revealed a significant average decline in PTSS over time (p < .05) that followed a curvilinear trajectory. Externalizing problems, prior stressor exposure, and female gender predicted higher initial PTSS levels (p < .05). Gender moderated the influence of internalizing problems, externalizing problems, and prior stressor exposure on decline in PTSS over time (p < .05). Patterns of recovery for those with high and low levels of each characteristic differed for girls and boys.Findings suggest targets for clinical consideration, both with respect to identifying subgroups of children and adolescents that may warrant early assessment and monitoring and timing of more directed PTSS treatment intervention.",0,0 +4185,Patterns of psychological distress in mothers of preterm infants.,"Mothers of preterm infants experience significant psychological distress, with elevated levels of inter-correlated depressive, stress, anxiety and post-traumatic stress symptoms. In a sample of racially and ethnically diverse mothers of preterm infants, we identified differing patterns of psychological distress during infant hospitalization and examined the effect of these psychological distress patterns on longitudinal trajectories of each psychological distress measure and on maternal perceptions of the child over the first year of the infant's life. Mothers of preterm infants (N=232) completed five questionnaires assessing depressive symptoms, anxiety, post-traumatic stress symptoms, stress due to infant appearance, and stress due to parental role alteration during enrollment during the neonatal hospitalization, discharge, and at 2, 6, and 12 months of age adjusted for prematurity. Latent class analysis on the enrollment psychological distress variables allowed us to identify five sub-groups of mothers exhibiting similar patterns of psychological distress, differing primarily in degree and type: low distress, moderate distress, high NICU-related distress, high depressive and anxiety symptoms, and extreme distress. These classes continued to show different longitudinal trajectories for the psychological distress measures through 12 months corrected age. Mothers in the extreme distress class and, to a lesser degree, mothers in the high depressive and anxiety symptom class remained at risk of significant psychological distress one year after discharge and had less positive perceptions of their child (greater worry and higher perceptions of child vulnerability). In conclusion, distinctive sub-groups of mothers during hospitalization had different patterns of psychological distress throughout the 12-month period and may require different interventions in the NICU.",0,0 +4186,Posttraumatic stress disorder symptoms and functional impairment among OEF and OIF National Guard and Reserve veterans,"The aims of the present investigation were (a) to examine associations between posttraumatic stress disorder (PTSD; diagnosis and symptoms) and different aspects of functioning, severity, and subjective distress among Operation Iraqi Freedom and Operation Enduring Freedom National Guard and Reserve veterans, and (b) to examine the unique contribution of PTSD symptom clusters to different aspects of functioning and distress. Participants were 124 veterans who had returned from war-zone deployment. A PTSD diagnosis and PTSD symptoms were significantly associated with nearly all of the psychosocial functioning and distress measures, controlling for Axis I disorders and other covariates. Of the PTSD symptom clusters, numbing/avoidance symptoms were the strongest predictors of interpersonal and social functioning, and hyperarousal symptoms were the strongest predictors of overall severity and distress.",0,0 +4187,Specific Trauma Subtypes Improve the Predictive Validity of the Harvard Trauma Questionnaire in Iraqi Refugees,"Trauma exposure contributes to poor mental health among refugees, and exposure often is measured using a cumulative index of items from the Harvard Trauma Questionnaire (HTQ). Few studies, however, have asked whether trauma subtypes derived from the HTQ could be superior to this cumulative index in predicting mental health outcomes. A community sample of recently arrived Iraqi refugees (N = 298) completed the HTQ and measures of posttraumatic stress disorder (PTSD) and depression symptoms. Principal components analysis of HTQ items revealed a 5-component subtype model of trauma that accounted for more item variance than a 1-component solution. These trauma subtypes also accounted for more variance in PTSD and depression symptoms (12 and 10%, respectively) than did the cumulative trauma index (7 and 3%, respectively). Trauma subtypes provided more information than cumulative trauma in the prediction of negative mental health outcomes. Therefore, use of these subtypes may enhance the utility of the HTQ when assessing at-risk populations.",0,0 +4188,Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication,"Little is known about lifetime prevalence or age of onset of DSM-IV disorders.To estimate lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the recently completed National Comorbidity Survey Replication.Nationally representative face-to-face household survey conducted between February 2001 and April 2003 using the fully structured World Health Organization World Mental Health Survey version of the Composite International Diagnostic Interview.Nine thousand two hundred eighty-two English-speaking respondents aged 18 years and older.Lifetime DSM-IV anxiety, mood, impulse-control, and substance use disorders.Lifetime prevalence estimates are as follows: anxiety disorders, 28.8%; mood disorders, 20.8%; impulse-control disorders, 24.8%; substance use disorders, 14.6%; any disorder, 46.4%. Median age of onset is much earlier for anxiety (11 years) and impulse-control (11 years) disorders than for substance use (20 years) and mood (30 years) disorders. Half of all lifetime cases start by age 14 years and three fourths by age 24 years. Later onsets are mostly of comorbid conditions, with estimated lifetime risk of any disorder at age 75 years (50.8%) only slightly higher than observed lifetime prevalence (46.4%). Lifetime prevalence estimates are higher in recent cohorts than in earlier cohorts and have fairly stable intercohort differences across the life course that vary in substantively plausible ways among sociodemographic subgroups.About half of Americans will meet the criteria for a DSM-IV disorder sometime in their life, with first onset usually in childhood or adolescence. Interventions aimed at prevention or early treatment need to focus on youth.",0,0 +4189,"Intergenerational Transmission, Attitudes, and Post-Traumatic Stress Disorder in Times of War: A Comparison between Elderly People and Their Adult Offspring after the Second Lebanon War (2006) and Casting Lead Operation (2008)","Background: While the effects of war on individuals, age groups, and communities have been thoroughly studied, there has been relatively little mention in the literature regarding its differential effects on adult children and their elderly parents and grandparents. Methods: Three hundred thirty-eight participants (167 elderly parents and 171 adult offspring) living in the northern and southern regions of Israel, were interviewed after the Second Lebanon War (2006) and the Casting Lead Operation (2008). (A military operation took place at the Israeli southern border as a reaction to the 7 years of missiles bombing from the Gaza strip to the Israeli civilians.) The participants were sampled by a cluster sampling. Findings: Elderly population experiences higher levels of PTSD symptoms than their adult children do. Women experience higher levels of PTSD symptoms than men and Israeli Arabs and Druze more than Israeli Jews. Conclusions: A policy should be enacted among the local authorities and the governmental offices that would ensure accessibility to and the ability to provide proper care for the elderly population during times of war or terror events. In addition, it is important to setup local teams in every local community to deal with the level of mental and emotional preparedness of the home front and its inhabitants, in case the latter should again become part of the human casualties of the wars and terrorist events that occur in Israel.",0,0 +4190,"Traumatic experiences, alexithymia, and posttraumatic symptomatology: a cross-sectional population-based study in Germany","Previous studies have established an association between number of traumatic experiences and alexithymia. The present study examines this relationship in a large-scale representative sample of the German general population (N=2,507) and explores the potential mediating effects of posttraumatic symptomatology, particularly avoidance/numbing.Alexithymia was assessed with the German version of the Toronto Alexithymia Scale (TAS-20). Posttraumatic symptomatology was operationalized by the symptom score of the modified German version of the Posttraumatic Symptom Scale, and traumatic experiences were assessed with the trauma list of the Munich Composite International Diagnostic Interview. Two mediation analyses were conducted.Of the total sample, 24.2% (n=606) reported at least one traumatic experience, 10.6% (n=258) were classified as alexithymic, and 2.4% (n=59) fulfilled the criteria of posttraumatic stress disorder (PTSD). Participants who had survived five or more traumatic experiences had significantly higher alexithymia sum scores. The PTSD symptom cluster avoidance/numbing mediated the association between the number of traumatic experiences and alexithymia.Our findings illustrate an association between number of traumatic experiences and alexithymia and the influence of emotional avoidance and numbing within this relationship. The significant relationship between alexithymia and number of traumatic experiences in a general population sample further supports the concept of multiple and complex traumatization as associated with alexithymia. The results suggest the importance of further investigations determining the causal impact of alexithymia both as a potential premorbid trait and as consequence of traumatization. Lastly, future investigations are needed to clarify alexithymia as a distinct trauma-relevant characteristic for better diagnostics and specialized trauma-integrative therapy.",0,0 +4191,The Sensory Profile of People With Post-Traumatic Stress Symptoms,"Thirty participants with post-traumatic stress (PTS) symptoms and 30 healthy controls completed the Post-Traumatic Stress Disorder Symptom Scale (PSS-SR) and the Adolescent/Adult Sensory Profile (AASP). Participants with PTS symptoms vacillated between sensory sensitivity, sensation avoiding, and low registration. Sensation avoiding and low registration correlated with intrusive thoughts related to PTS. Discriminant Analysis classified 73% of the study group and 80% of the controls. PTS may be related to hypersensitivity and low registration. Further studies about the sensory profile of people with PTS symptoms may contribute to research and optimize evaluation and intervention for people with PTSD.",0,0 +4192,Disaster survivors in their third decade: Trajectories of initial stress responses and long-term course of mental health,en,1,0 +4193,Epidemiology of Hospitalizations and Deaths from Heat Illness in Soldiers,"Serious heat illness has received considerable recent attention due to catastrophic heat waves in the United States and Europe, the deaths of high-profile athletes, and military deployments.This study documents heat illness hospitalizations and deaths for the U.S. Army from 1980 through 2002. Hospitalization data were obtained from the Total Army Injury Health Outcomes Database (TAIHOD) coded according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). North Atlantic Treaty Organization Standardization Agreement codes were searched for heat injuries in an effort to detect cases that were not found during the ICD-9-CM search.Five-thousand two-hundred forty-six soldiers were hospitalized, and 37 died due to heat illness. Our results indicate: 1) approximately 60% reduction in hospitalization rates (fewer heat exhaustion cases) over the 22-yr period; 2) fivefold increase in heat stroke hospitalization rates (1.8 per 100,000 in 1980 to 14.5 per 100,000 in 2001); 3) heat stroke cases were associated with dehydration (17%), rhabdomyolysis (25%), and acute renal failure (13%); 4) lower hospitalizations rates among African and Hispanic Americans compared with Caucasians (incidence density ratio, 0.76 [95% confidence interval, 0.71-0.82]; 5) greater rates of hospitalizations and heat strokes among recruits from northern than southern states (incidence density ratio, 1.69 [95% confidence interval, 1.42-1.90]; and 6) greater rates of hospitalizations and heat strokes among women than men (incidence density ratio, 1.18 [95% confidence interval, 1.09-1.27]).Exertional heat illness continues to be a military problem during training and operations. Whereas the hospitalization rate of heat illness is declining, heat stroke has markedly increased.",0,0 +4194,Development and preliminary validation of a brief broad-spectrum measure of trauma exposure: The Traumatic Life Events Questionnaire.,"This article describes the development and preliminary validation of a brief questionnaire that assesses exposure to a broad range of potentially traumatic events. Items were generated from multiple sources of information. Events were described in behaviorally descriptive terms, consistent with Diagnostic and Statistical Manual of Mental Disorders IV posttraumatic stress disorder stressor criterion A1. When events were endorsed, respondents were asked if they experienced intense fear, helplessness, or horror (stressor criterion A2). In separate studies with college students, Vietnam veterans, battered women, and residents of a substance abuse program, most items possessed adequate to excellent temporal stability. In a study comparing questionnaire and structured-interview inquiries of trauma history, the 2 formats yielded similar rates of disclosure. Preliminary data on positive predictive power are also presented.",0,0 +4195,Sertraline in the Treatment of Co-occurring Alcohol Dependence and Posttraumatic Stress Disorder,"Background: Posttraumatic stress disorder (PTSD) frequently co-occurs with alcohol use disorders. This study investigated the use of sertraline, a serotonin reuptake inhibitor, in treating co-occurring symptoms of alcohol dependence and PTSD. Methods: A total of 94 individuals with current alcohol dependence and PTSD were randomly assigned to receive sertraline (150 mg/day) or placebo for 12 weeks. Post hoc cluster analysis of baseline characteristics was used to define subgroups of participants. Results: There was a significant decrease in alcohol use during the trial in both the sertraline and the placebo groups. Cluster analysis revealed significant medication group by cluster interactions for alcohol-related outcomes. Sertraline-treated participants with less severe alcohol dependence and early-onset PTSD had significantly fewer drinks per drinking day (p < 0.001). For participants with more severe alcohol dependence and later onset PTSD, the placebo group had significantly greater decreases in drinks per drinking day (p < 0.01) and average number of drinks consumed per day (p < 0.05). Conclusions: There may be subtypes of alcohol-dependent individuals who respond differently to serotonin reuptake inhibitor treatment. Further investigation of differential responders may lead to improvements in the pharmacological treatment of co-occurring alcohol dependence and PTSD.",0,0 +4196,What are the disruptive symptoms of behavioral disorders after traumatic brain injury? A systematic review leading to recommendations for good practices,"Behavioral disorders are major sequelae of severe traumatic brain injury. Before considering care management of these disorders, and in the absence of a precise definition for TBI-related behavioral disorder, it is essential to refine, according to the data from the literature, incidence, prevalence, predictive factors of commonly admitted disruptive symptoms. Systematic review of the literature targeting epidemiological data related to behavioral disorders after traumatic brain injury in order to elaborate good practice recommendations according to the methodology established by the French High Authority for Health. Two hundred and ninety-nine articles were identified. The responsibility of traumatic brain injury (TBI) in the onset of behavioral disorders is unequivocal. Globally, behavioral disorders are twice more frequent after TBI than orthopedic trauma without TBI (Masson et al., 1996). These disorders are classified into disruptive primary behaviors by excess (agitation 11–70%, aggression 25–39%, irritability 29–71%, alcohol abuse 7–26% drug abuse 2–20%), disruptive primary behaviors by default (apathy 20–71%), affective disorders – anxiety – psychosis (depression 12–76%, anxiety 0.8–24,5%, posttraumatic stress 11–18%, obsessive-compulsive disorders 1.2–30%, psychosis 0.7%), suicide attempts and suicide 1%. The improvement of care management for behavioral disorders goes through a first step of defining a common terminology. Four categories of posttraumatic behavioral clinical symptoms are defined: disruptive primary behaviors by excess, by default, affective disorders-psychosis-anxiety, suicide attempts and suicide. All these symptoms yield a higher prevalence than in the general population. They impact all of life's domains and are sustainable over time.",0,0 +4197,Perfusion deficits in patients with mild traumatic brain injury characterized by dynamic susceptibility contrast MRI,"Perfusion deficits in patients with mild traumatic brain injury (TBI) from a military population were characterized by dynamic susceptibility contrast perfusion imaging. Relative cerebral blood flow (rCBF) was calculated by a model-independent deconvolution approach from the tracer concentration curves following a bolus injection of gadolinium diethylenetriaminepentaacetate (Gd-DTPA) using both manually and automatically selected arterial input functions (AIFs). Linear regression analysis of the mean values of rCBF from selected regions of interest showed a very good agreement between the two approaches, with a regression coefficient of R = 0.88 and a slope of 0.88. The Bland-Altman plot also illustrated the good agreement between the two approaches, with a mean difference of 0.6 ± 12.4 mL/100 g/min. Voxelwise analysis of rCBF maps from both approaches demonstrated multiple clusters of decreased perfusion (p < 0.01) in the cerebellum, cuneus, cingulate and temporal gyrus in the group with mild TBI relative to the controls. MRI perfusion deficits in the cerebellum and anterior cingulate also correlated (p < 0.01) with neurocognitive results, including the mean reaction time in the Automated Neuropsychological Assessment Metrics and commission error and detection T-scores in the Continuous Performance Test, as well as neurobehavioral scores in the Post-traumatic Stress Disorder Checklist-Civilian Version. In conclusion, rCBF calculated using AIFs selected from an automated approach demonstrated a good agreement with the corresponding results using manually selected AIFs. Group analysis of patients with mild TBI from a military population demonstrated scattered perfusion deficits, which showed significant correlations with measures of verbal memory, speed of reaction time and self-report of stress symptoms.",0,0 +4198,EVIDENCE FOR A DISSOCIATIVE SUBTYPE OF PTSD BY LATENT PROFILE AND CONFIRMATORY FACTOR ANALYSES IN A CIVILIAN SAMPLE,"Dissociative symptoms are increasingly recognized in individuals with posttraumatic stress disorder (PTSD). The aim of this study was to investigate the prevalence of derealization and depersonalization symptoms via latent profile analyses (LPAs) in a civilian PTSD sample and examine the relationship between PTSD and dissociative symptoms via factor analytic methods.A civilian sample of individuals with PTSD predominantly related to childhood abuse (n = 134) completed a diagnostic interview for PTSD and comorbid psychiatric disorders. LPAs and confirmatory factor analyses (CFAs) were performed on the severity scores for PTSD, derealization, and depersonalization symptoms.LPAs extracted three groups, one of which was uniquely characterized by high derealization and depersonalization symptoms, and accounted for 25% of the sample. Individuals in the dissociative subgroup also showed a higher number of comorbid Axis I disorders and a more significant history of childhood abuse and neglect. CFAs suggested the acceptance of a five factor solution in which dissociative symptoms are distinct from but correlate significantly with the core PTSD symptom clusters.The results from LPAs and CFAs are concordant with the concept of a dissociative subtype in patients with PTSD and suggest that symptoms of derealization-depersonalization and the core symptoms of PTSD are positively correlated. Thought should be given to including a dissociative subtype of PTSD in the DSM-5.",0,0 +4199,Developmentally adapted cognitive processing therapy for adolescents and young adults with PTSD symptoms after physical and sexual abuse: study protocol for a randomized controlled trial,"Although childhood sexual and/or physical abuse (CSA/CPA) is known to have severe psychopathological consequences, there is little evidence on psychotherapeutic interventions for adolescents and young adults suffering from post-traumatic stress disorder (PTSD). Equally sparse are data on moderators of treatment response on PTSD-related epigenetic changes, health care costs and loss of productivity, alterations in cognitive processing, and on how successful interventions affect all of these factors. Early treatment may prevent later (co)morbidity. In this paper, we present a study protocol for the evaluation of a newly developed psychotherapeutic manual for PTSD after CSA/CPA in adolescents and young adults - the Developmentally Adapted Cognitive Processing Therapy (D-CPT).In a multicenter randomized controlled trial (RCT) D-CPT is compared to treatment as usual (TAU). A sample of 90 adolescent outpatients aged 14 to 21 years will be randomized to one of these conditions. Four assessments will be carried out at baseline, at end of treatment, and 3 and 6 months after end of therapy. Each time, patients will be assessed via clinical interviews and a wide range of questionnaires. In addition to PTSD symptoms and comorbidities, we will evaluate moderators of treatment response, epigenetic profiles, direct and indirect costs of this disorder, and neurophysiological processing of threat cues in PTSD and their respective changes in the course of these two treatments (D-CPT and TAU).The study will provide new insights in the understudied field of PTSD in adolescents and young adults. A newly developed intervention will be evaluated in this therapeutically underserved population. Results will provide data on treatment efficacy, direct and indirect treatment costs, as well as on associations of treatment outcome and PTSD intensity both to epigenetic profiles and to the neurobiological processing of threat cues. Besides, they will help to learn more about the psychopathology and possible new objective correlates of PTSD.Germanctr.de identifier: DRKS00004787.",0,0 +4200,Trajectories of stress reactions and somatization symptoms among war veterans: a 20-year longitudinal study,"Background There is considerable evidence that immediate and long-term stress reactions are associated with increased somatic symptomatology. However, because of the scarcity of long-term longitudinal studies, the trend of mutual change of these factors has not been assessed. This study examined the chronological inter-relationships between post-traumatic stress reactions and somatization symptoms among combatants over a 20-year period. Method Two groups of veterans were assessed 1, 2, 3 and 20 years after their participation in the 1982 Lebanon War: a clinical group of veterans who had been diagnosed with combat stress reaction (CSR) on the battlefield ( n =363), and a matched control group of veterans ( n =301). Results The CSR veterans reported higher initial levels of intrusion and avoidance and a steeper decline in those symptoms over time in comparison to the control group. The former also reported higher initial levels of somatization symptoms than the latter. In addition, over the years, stress reactions were positively associated with somatization symptoms. For both study groups, in the first years after the war, stress reaction symptoms predicted somatization symptoms. However, with time, the trend was reversed and somatization symptoms predicted stress reactions. Conclusions The findings suggest that CSR is a marker for future stress reactions and somatization symptoms, and indicate a long-term role for these symptoms in veterans' psychological distress.",0,0 +4201,Chronic Posttraumatic Stress Disorder and Diagnostic Comorbidity in a Disaster Sample,"Research has indicated significant comorbid psychopathology with chronic posttraumatic stress disorder (PTSD) in samples of war veterans. The present paper examines the issue of comorbidity in a disaster sample to learn whether findings from veterans generalized to this event. A total of 193 subjects exposed to the Buffalo Creek dam collapse of 1972 were examined 14 years later using diagnoses derived from the Structured Clinical Interview for DSM-III (SCID). Past and present PTSD was found in a significant portion of the sample. Major depression was the next most common diagnosis and was highly related to PTSD. Anxiety disorders were also common. The overlap with other diagnoses was quite similar to that found in a sample of Vietnam veterans we studied earlier, except that the disaster sample had fewer dysthymic disorders, substance abusers, and antisocial personality disorders. Possible explanations for comorbidity in chronic PTSD were discussed and it was suggested that the morphology of PTSD may be quite stable in at least some other nonveteran trauma populations.",0,0 +4202,Attending to the Mental Health of War-Affected Children: The Need for Longitudinal and Developmental Research Perspectives,,0,0 +4203,Mothers going to war: The role of nurse practitioners in the care of military mothers and families during deployment,"Purpose Many military women are being called to separate from their children to go to war. Most previous research has focused upon paternal, rather than, maternal, separation. The purpose of this article is to describe the experience of military mothers and their children during wartime deployments with clinical implications for nurse practitioners (NPs) in military or community settings. Data sources Using grounded theory methods, 37 active duty and reserve component military women participated in a one-time interview. Included were women who deployed for at least 4 months to Iraq or Afghanistan and had at least one child under the age of 12 during the separation. Conclusions Military families present unique challenges for NPs. Mother deployments offer opportunities for intervention and anticipatory guidance across the trajectory of the separation. Military women's emotional and physical health must be supported before, during, and following deployment. Implications for practice NPs are ideally positioned to support military families. During deployment, the NP's focus may shift to care of the children and their caregiver. Before and at reintegration, NPs are in a key position to intervene early for posttraumatic stress and support family readjustment.",0,0 +4204,Panic disorder following torture by suffocation is associated with predominantly respiratory symptoms,"Background. We previously reported that in panic disorder a history of near-suffocation is associated with predominantly respiratory panic attacks. It might be hypothesized that the near-suffocation experienced in certain kinds of torture is also associated with the development of predominantly respiratory panic attacks. Methods. A sample of patients who had experienced torture ( N =14) was drawn from an Anxiety Disorders Clinic in South Africa. Subjects were questioned about symptoms of panic disorder, post-traumatic stress disorder and depression. Results. Patients with a history of torture by suffocation were more likely than other patients to complain of predominantly respiratory symptoms during panic attacks. These patients also demonstrated higher levels of depressive symptoms. Conclusions. While various interpretations of the data can be made, it is possible that torture by suffocation is associated with a specific symptomatic profile. Were such an association to be replicated, this would perhaps support the suffocation alarm hypothesis of panic disorder and provide evidence that specific environmental factors play a role in the development of this alarm.",0,0 +4205,Wearable sensors can assist in PTSD diagnosis,Post-traumatic stress disorder (PTSD) currently is diagnosed via subjective reports of experiences related to the traumatic event. More objective measures are needed to assist clinicians in diagnosis. Physiological activity was recorded from 58 participants. Participants in the No Trauma/No PTSD group had no trauma exposure and no PTSD diagnosis. Trauma Exposed/No PTSD participants had experienced a traumatic event but did not have PTSD. PTSD participants had experienced a traumatic event and had PTSD. Baseline and emotionally evocative stimulus-related sensor data were collected. Features were extracted from each sensor stream and submitted to statistical analysis. Significant group differences were present during the viewing of two virtual reality videos. Features were submitted to discriminant function analysis to assess classification accuracy. Classification accuracy was between 89 and 92%. The results from this study suggest the utility of objective physiological measures obtained from wearable sensors in assisting with PTSD diagnosis.,0,0 +4206,"Traumatic events and post-traumatic stress disorder in the community: prevalence,risk factors and comorbidity","Lifetime and 12-month prevalence of traumatic events and DSM-IV post-traumatic stress disorder as well as risk factors and comorbidity patterns were investigated in a representative community sample (n = 3021, aged 14-24 years).Traumatic events and PTSD were assessed with the Munich Composite International Diagnostic Interview (CIDI).Although 26% of male subjects and 17.7% of female subjects reported at least one traumatic event, only a few qualified for a full PTSD diagnosis (1% of males and 2.2% of females). Traumatic events and PTSD were strongly associated with all other mental disorders examined. PTSD occurred as both a primary and a secondary disorder.The prevalence of PTSD in this young German sample is considerably lower than reported in previous US studies. However, the conditional probability for PTSD after experiencing traumas, risk factors and comorbidity patterns are quite similar. Traumatic events and full PTSD may increase the risk for other disorders, and vice versa.",0,0 +4207,Adult memories of childhood trauma: A naturalistic clinical study,"The clinical evaluations of 77 adult psychiatric outpatients reporting memories of childhood trauma were reviewed. A majority of patients reported some degree of continuous recall. Roughly half (53%) said they had never forgotten the traumatic events. Two smaller groups described a mixture of continuous and delayed recall (17%) or a period of complete amnesia followed by delayed recall (16%). Patients with and without delayed recall did not differ significantly in the proportions reporting corroboration of their memories from other sources. Idiosyncratic, trauma-specific reminders and recent life crises were most commonly cited as precipitants to delayed recall. A previous psychotherapy was cited as a factor in a minority (28%) of cases. By contrast, intrusion of new memories after a period of amnesia was frequently cited as a factor leading to the decision to seek psychotherapy. The implications of these findings are discussed with respect to the role of psychotherapy in the process of recovering traumatic memories.",0,0 +4208,Psychophysiological Response to Virtual Reality and Subthreshold Posttraumatic Stress Disorder Symptoms in Recently Deployed Military,"Subthreshold posttraumatic stress disorder (PTSD) has garnered recent attention because of the significant distress and functional impairment associated with the symptoms as well as the increased risk of progression to full PTSD. However, the clinical presentation of subthreshold PTSD can vary widely and therefore is not clearly defined, nor is there an evidence-based treatment approach. Thus, we aim to further the understanding of subthreshold PTSD symptoms by reporting the use of a virtual combat environment in eliciting distinctive psychophysiological responses associated with PTSD symptoms in a sample of subthreshold recently deployed US service members.Heart rate, skin conductance, electromyography (startle), respiratory rate, and blood pressure were monitored during three unique combat-related virtual reality scenarios as a novel procedure to assess subthreshold symptoms in a sample of 78 service members. The Clinician-Administered PTSD Scale was administered, and linear regression analyses were used to investigate the relationship between symptom clusters and physiological variables.Among the range of psychophysiological measures that were studied, regression analysis revealed heart rate as most strongly associated with Clinician-Administered PTSD Scale-based measures hyperarousal (R = 0.11, p = .035,) reexperiencing (R = 0.24, p = .001), and global PTSD symptoms (R = 0.17, p = .003).Our findings support the use of a virtual reality environment in eliciting physiological responses associated with subthreshold PTSD symptoms.",0,0 +4209,What are the risk factors for the comorbidity of posttraumatic stress disorder and depression in a war-affected population? a cross-sectional community study in South Sudan,"BackgroundLimited data exists on the association of war trauma with comorbid posttraumatic stress disorder (PTSD)-depression in the general population of low-income countries. The present study aimed to evaluate socioeconomic and trauma-related risk factors associated with PTSD, depression, and PTSD-depression comorbidity in the population of Greater Bahr el Ghazal States, South Sudan.MethodsIn this cross-sectional community study (n=1200) we applied the Harvard Trauma Questionnaire (HTQ) and MINI International Neuropsychiatric Interview (MINI) to investigate the prevalence of PTSD, depression, and PTSD-depression comorbidity. Multinomial logistic regression analyses were conducted to examine the association between these disorders, previous trauma exposure, sociodemographic, and socioeconomic factors.ResultsPTSD only was found in 331 (28%) and depression only in 75 (6.4%) of the study population. One hundred and twelve (9.5%) of the participants had PTSD-depression comorbid diagnosis. Exposure to traumatic events and socioeconomic disadvantage were significantly associated with having PTSD or PTSD-depression comorbidity but not with depression. Participants with a comorbid condition were more likely to be socioeconomic disadvantaged, have experienced more traumatic events, and showed higher level of psychological distress than participants with PTSD or depression alone.ConclusionsIn individuals exposed to war trauma, attention should be given to those who may fulfill criteria for a diagnosis of both PTSD and depression.",0,0 +4210,Posttraumatic stress symptoms mediate the relation between childhood sexual abuse and nonsuicidal self-injury.,"Prior research consistently has shown a strong relation between childhood abuse and nonsuicidal self-injury (NSSI), yet it is unclear why this relation exists. The authors examined 2 specific posttraumatic stress disorder (PTSD) symptom clusters as potential mechanisms through which childhood abuse may be related to NSSI. Participants were 86 adolescents (78% female, 22% male; 73% Caucasian, 27% other races/ethnicities; mean age = 17.03 years, range = 12-19 years) who completed measures of childhood abuse, Diagnostic and Statistical Manual of Mental Disorders (4th ed.) PTSD symptoms, and NSSI. Analyses revealed a significant relation between childhood sexual abuse in particular and the presence and frequency of NSSI. Moreover, data supported a theoretical model in which PTSD reexperiencing and avoidance/numbing symptoms independently mediate this relation. Future research must test the temporal relation between childhood sexual abuse, PTSD symptoms, and NSSI and identify additional pathways to engagement in NSSI.",0,0 +4211,A clinical profile of women with posttraumatic stress disorder and substance dependence.,"To assess the clinical characteristics of women with posttraumatic stress disorder (PTSD) and substance dependence, 28 women with both disorders were compared with 29 women with PTSD alone on a wide battery of lifetime and current clinical measures. The dual-diagnosis women consistently had a more severe clinical profile, including worse life conditions (e.g., physical appearance, opportunities in life), both as children and as adults; greater criminal behavior; a higher number of lifetime suicide attempts; a greater number having a sibling with a drug problem; and fewer outpatient psychiatric treatments. One discrepant finding, however, was their lower rate of major depression. Interestingly, the 2 groups did not differ in number or type of lifetime traumas, PTSD onset or severity, family history of substance use; coping style, functioning level, psychiatric symptoms, or sociodemographic characteristics. Treatment implications and methodological limitations are discussed.",0,0 +4212,Latent Class Analysis of Personality Disorders in Adults With Posttraumatic Stress Disorder,"Article AbstractObjective: To characterize predominant typologies of co-occurring personality disorders among adults with posttraumatic stress disorder (PTSD) and examine their relation to Axis I comorbidities, health-related quality of life, and course and treatment of PTSD. Method: Latent class analysis was conducted on the 10 DSM-IV personality disorders in a nationally representative sample of 2,463 adults with a lifetime diagnosis of PTSD from Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Results: Three latent classes of personality disorders were identified: a borderline-dysregulated class (11.4%), an obsessive-paranoid class (13.1%), and a no/low personality disorders class (75.5%). The borderline-dysregulated and obsessive-paranoid classes were more likely than the no/low personality disorder class to have a broad range of comorbid Axis I diagnoses and to have ever attempted suicide (ORs = 1.50-8.01), and they reported lower mental health-related quality of life. The borderline-dysregulated class was less likely than the no/low personality disorder class to have experienced remission of their most recent episode of PTSD (OR = 0.54; 95% CI, 0.38-0.75) and was more likely to have been prescribed medication for PTSD (OR = 1.65; 95% CI, 1.20-2.28) and to have used alcohol and drugs to mitigate their PTSD symptoms (OR = 2.77; 95% CI, 1.62-4.74). The obsessive-paranoid class was more likely than the no/low personality disorders class to report sexual assault as their worst trauma (OR = 2.22; 95% CI, 1.36-3.61) and had an earlier age at onset of PTSD symptoms compared to the other 2 classes. Conclusions: Among US adults with PTSD, the 10 DSM-IV personality disorders can be classified into 3 ""person-based"" typologies, which are differentially associated with comorbid Axis I disorders, mental health-related quality of life, and clinical and treatment characteristics of this disorder. These results suggest that comprehensive assessment of personality disorders may help inform etiologic models and treatment approaches for PTSD. J Clin Psychiatry © Copyright 2013 Physicians Postgraduate Press, Inc. Submitted: March 12, 2013; accepted July 15, 2013. Online ahead of print: December 10, 2013 (doi:10.4088/JCP.13m08466). Corresponding author: Jack Tsai, VA Connecticut Healthcare System, 950 Campbell Ave, 151D, West Haven, CT 06516 (Jack.Tsai@yale.edu).",0,0 +4213,"Stressful or traumatic life events, post-traumatic stress disorder (PTSD) symptoms, and HIV sexual risk taking among men who have sex with men","The present study assessed the presence of post-traumatic stress disorder (PTSD) symptoms in response to stressful or traumatic life events and their impact on HIV risk behaviors and associated psychosocial variables among men who have sex with men (MSM). Participants (n=189; 60% HIV-infected) who were recruited by notices posted in a community health clinic and via a modified respondent-driven sampling technique completed a behavioral assessment survey. Sixty percentage of participants screened positive for having PTSD symptoms using the startle, physiological arousal, anger, and numbness screening instrument. After controlling for race, sexual self-identification, and HIV status, multivariable logistic regression analyses revealed that screening in for having PTSD symptoms was significantly associated with having engaged in unprotected anal (insertive or receptive) sex in the past 12 months, over and above any effects of whether or not a traumatic/stressful event occurred during the year (adjusted odds ratio [OR] = 2.72; p<0.02; 95% confidence interval [CI] = 1.19-6.20). In addition, MSM with PTSD symptoms were more likely to have clinically significant depressive symptoms (adjusted OR = 3.50; p<0.001) and/or symptoms of social anxiety (adjusted OR = 2.87; p<0.01; 95% CI = 1.48-5.62). The current study, in the context of other research documenting the high rates of co-occurring psychosocial issues facing MSM, points to the importance of incorporating coping with these issues in HIV and sexually transmitted disease prevention and care interventions.",0,0 +4214,The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection.,"A 36-item short-form (SF-36) was constructed to survey health status in the Medical Outcomes Study. The SF-36 was designed for use in clinical practice and research, health policy evaluations, and general population surveys. The SF-36 includes one multi-item scale that assesses eight health concepts: 1) limitations in physical activities because of health problems; 2) limitations in social activities because of physical or emotional problems; 3) limitations in usual role activities because of physical health problems; 4) bodily pain; 5) general mental health (psychological distress and well-being); 6) limitations in usual role activities because of emotional problems; 7) vitality (energy and fatigue); and 8) general health perceptions. The survey was constructed for self-administration by persons 14 years of age and older, and for administration by a trained interviewer in person or by telephone. The history of the development of the SF-36, the origin of specific items, and the logic underlying their selection are summarized. The content and features of the SF-36 are compared with the 20-item Medical Outcomes Study short-form.",0,0 +4215,Interactive Stories for Health Interventions,"In recent years, there has been an increasing interest in exploring virtual environments and computer aided interactive stories as tools in developing health promotion and disease prevention interventions. Applications have been developed to address a range of health related conditions, including stress [1], risky behaviors [2] and post-traumatic stress disorder(PTSD) [3].",0,0 +4216,The Psychiatric Sequelae of Traumatic Injury,"Traumatic injury affects millions of people each year. There is little understanding of the extent of psychiatric illness that develops after traumatic injury or of the impact of mild traumatic brain injury (TBI) on psychiatric illness. The authors sought to determine the range of new psychiatric disorders occurring after traumatic injury and the influence of mild TBI on psychiatric status.In this prospective cohort study, patients were drawn from recent admissions to four major trauma hospitals across Australia. A total of 1,084 traumatically injured patients were initially assessed during hospital admission and followed up 3 months (N=932, 86%) and 12 months (N=817, 75%) after injury. Lifetime psychiatric diagnoses were assessed in hospital. The prevalence of psychiatric disorders, levels of quality of life, and mental health service use were assessed at the follow-ups. The main outcome measures were 3- and 12-month prevalence of axis I psychiatric disorders, levels of quality of life, and mental health service use and lifetime axis I psychiatric disorders.Twelve months after injury, 31% of patients reported a psychiatric disorder, and 22% developed a psychiatric disorder that they had never experienced before. The most common new psychiatric disorders were depression (9%), generalized anxiety disorder (9%), posttraumatic stress disorder (6%), and agoraphobia (6%). Patients were more likely to develop posttraumatic stress disorder (odds ratio=1.92, 95% CI=1.08-3.40), panic disorder (odds ratio=2.01, 95% CI=1.03-4.14), social phobia (odds ratio=2.07, 95% CI=1.03-4.16), and agoraphobia (odds ratio=1.94, 95% CI=1.11-3.39) if they had sustained a mild TBI. Functional impairment, rather than mild TBI, was associated with psychiatric illness.A significant range of psychiatric disorders occur after traumatic injury. The identification and treatment of a range of psychiatric disorders are important for optimal adaptation after traumatic injury.",0,0 +4217,Psychometric properties of the Posttraumatic Stress Checklist among young African-American men and women.,"Research has demonstrated the validity and reliability of the Posttraumatic Stress Checklist (PCL) in predominantly Caucasian samples. However, there has not been a study that examined the psychometric properties of the PCL specifically for African Americans. The present paper is an examination of the factor structure, internal stability, reliability, and predictive validity of the PCL among a sample of young African American men and women. Confirmatory factor analysis indicated better support for a two-factor model than for a three-factor model reflecting the three diagnostic symptom clusters of posttraumatic stress disorder. High internal consistency and marginal test-retest reliability were observed. The positive predictive power of the PCL in the present study was far lower than that observed in previous studies; several potential explanations for this finding are discussed. © 2011 American Psychological Association.",0,0 +4218,Psychosocial Adaptation to Disability Within the Context of Positive Psychology: Findings from the Literature,"Purpose This purpose of this article is to review of the trends of research that examined positive psychology constructs in the context of adapting to chronic illness and disability (CID). This article examines the empirical findings on the relationships between six selected positive psychology-associated constructs (optimism, hope, resilience, benefit-finding, meaning-making, and post-traumatic growth) and adaptation to disability. Methods Six positive psychology constructs were selected to represent the trends found in recent literature published on CID. The process of choosing these six variables included reviewing chapters on positive psychology and CID, reviewing the top rehabilitation journals that typically publish articles on psychosocial adaptation to CID, using search engines to find relevant journal articles published since the year 2000, and selecting the most important constructs based on the authors’ professional judgment. Conclusion The available evidence supports the unique benefits of these six positive psychology constructs in predicting successful adaptation to a range of disabling conditions. Based on the available findings, the authors offer four suggestions for occupational rehabilitation researchers. © 2015, Springer Science+Business Media New York (outside the USA).",0,0 +4219,Unconscious relational traumatic memory and its relevance to ‘everyday’ clinical psychiatry,"Objective: The aim of this paper is to demonstrate the relevance of the concept of unconscious relational traumatic memory to ‘everyday’ clinical psychiatry. Method: One clinical vignette and concepts from the Conversational Model of Psychotherapy are used to consider the potential relevance of this type of memory. Conclusions: The influence of modern classification systems and the dominance of the paradigm of ‘biological psychiatry’ over the last 30 years have together led to an emphasis on diagnosis and treatment by symptom cluster. This perspective may overlook both the patient’s current psycho-social context and their personal history. An understanding of unconscious relational traumatic memory may assist in both the conceptualisation and the treatment of many patients, particularly those adults who have been abused in childhood, where the link between the early experiences and the late manifestations are frequently lost.",0,0 +4220,Characteristics Associated With Use of Homeopathic Drugs for Psychiatric Symptoms in the General Population,"Abstract Objective To explore which patient characteristics are associated in naturalistic conditions with the lifetime use of homeopathic treatment for psychiatric symptoms. Method Lifetime use of psychotropic treatment was explored in a sample of 36,785 persons, participating in the Mental Health Survey in the General Population. Characteristics associated with use of homeopathic treatments, associated or not with conventional psychotropic drugs, were explored using multivariate analyses. Results Use of homeopathic treatment for psychiatric symptoms was reported by 1.3% of persons. Younger age, female gender and high educational level were associated with use of homeopathy. Half of homeopathy users presented at least one Mini International Neuropsychiatric Interview (MINI) diagnosis, most frequently anxiety disorders. Their diagnostic profile was similar to that of persons reporting use of anxiolytics or hypnotics. Compared to persons with no lifetime use of psychotropic drugs, persons using homeopathy were more likely to present with a diagnosis of mood disorder or anxiety disorder. Compared to those using conventional psychotropic drugs, they presented less frequently with psychiatric disorders, with the exception of anxiety disorders. Conclusion Homeopathic treatment for psychiatric symptoms appears to be used mainly to reduce anxiety symptoms in the general population.",0,0 +4221,"Prevalence of Mental Disorders in 6–16-Year-Old Students in Sichuan Province, China","To investigate the point prevalence of mental disorders in school students, multistage cluster stratified random sampling and two-phase survey methods were used to identify 40 primary and middle schools. The students were screened using the Chinese version of the Child Behavior Checklist and diagnosed using the Mini International Neuropsychiatric Interview. The prevalence of behavioral problems was 19.13%. The prevalence of behavioral problems significantly differed by sex, age, city of residence, and caretaker. The six-month prevalence of any mental disorder was 15.24% (95% CI: 15.49%-16.97%). Psychiatric disorders were more prevalent in boys (17.33%) relative to girls (13.11%; p < 0.01). The prevalence of mental disorders significantly differed by community and caretaker, and 36.46% of students exhibited comorbidity. Results demonstrated important mental health issues, with a high incidence of comorbidities, in this population. Students' mental health requires increased attention, particularly in poverty-stricken areas and left-behind children and adolescents.",0,0 +4222,BELONGING PROTECTS AGAINST POSTDEPLOYMENT DEPRESSION IN MILITARY PERSONNEL,"Depression among U.S. military personnel has received relatively little empirical attention compared to posttraumatic stress disorder, despite evidence that depression is associated with poor psychosocial outcomes and increased suicide risk. Even less is known about factors that protect against depression in military populations.A sample of 168 active duty Air Force convoy operators completed self-report measures of depression, posttraumatic stress, and sense of ""belonging"" before deploying to Iraq, and again at 1, 3, 6, and 12 months following their return. Linear growth modeling was used to test the associations of the variables over time.Mean depression scores remained low and stable across the deployment and 12-month follow-up period. Increased depression severity was significantly associated with low belonging (P < .001) and with posttraumatic stress symptoms (P < .001) at every time point.Relatively small, predominantly male sample utilizing self-report methods.A sense of belongingness may protect service members from depression at all stages of the deployment cycle, from predeployment preparations through deployment and postdeployment adjustment.",0,0 +4223,Impact of Event Scale: A Measure of Subjective Stress,"Clinical, field, and experimental studies of response to potentially stressful life events give concordant findings: there is a general human tendency to undergo episodes of intrusive thinking and periods of avoidance. A scale of current subjective distress, related to a specific event, was based on a list of items composed of commonly reported experiences of intrusion and avoidance. Responses of 66 persons admitted to an outpatient clinic for the treatment of stress response syndromes indicated that the scale had a useful degree of significance and homogeneity. Empirical clusters supported the concept of subscores for intrusions and avoidance responses.",0,0 +4224,Children exposed to warfare: A longitudinal study,"Following the 1991 Gulf War a group of 94 children in Iraq were interviewed at 6 months, 1 year, and 2 years after the war. The group was exposed to the bombing of a shelter where more than 750 were killed. Selected items from different inventories, including the Impact of Event Scale (IES) assessed children's reactions. Results reveal that children continue to experience sadness and remain afraid of losing their family. Although there was no significant decline in intrusive and avoidance reactions as measured by the IES from 6 months to 1 year following the war, reactions were reduced 2 years after the war. However, the scores were still high, indicating that symptoms persist, with somewhat diminished intensity over time.",0,0 +4225,“Dissociation in posttraumatic stress disorder part II: How theoretical models fit the empirical evidence and recommendations for modifying the diagnostic criteria for PTSD”: Correction to Dalenberg and Carlson (2012).,"Reports an error in ""Dissociation in Posttraumatic Stress Disorder Part II: How Theoretical Models Fit the Empirical Evidence and Recommendations for Modifying the Diagnostic Criteria for PTSD"" by Constance Dalenberg and Eve B. Carlson (Psychological Trauma: Theory, Research, Practice, and Policy, Advanced Online Publication, May 14, 2012, np). There was an error in the section, ""Models 5 and 5a: The Component and Subtype Models."" The paragraph that began, ""Taxometric studies of dissociation in PTSD are also relevant to the Subtype model . . ."" has been replaced with a paragraph that begins, ""One taxometric study of dissociation in PTSD is also relevant to the Subtype model . . ."" (The following abstract of the original article appeared in record 2012-12663-001.) The purpose of this article is to examine how closely six theoretical models fit the empirical evidence reviewed in Part 1 on the relationship between trauma and dissociation and to apply the resulting conclusions to make recommendations about diagnostic criteria for PTSD. We describe six models for the relationships among traumatic stress, dissociation, and PTSD, including models for fantasy-proneness, mediation, comorbidity, interactional comorbidity, component, and subtype. The research reviewed strongly supports component and subtype models of the relationship between dissociation and PTSD, and recommendations are made for including dissociative symptoms in the diagnostic criteria for PTSD in ICD-11 and DSM-5 and adding either a dissociative subtype or a complex PTSD diagnosis in both diagnostic systems. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4226,Co-morbid Post-traumatic Stress Disorder and Opioid Dependence Syndrome,"Post-traumatic stress disorder (PTSD) is common among patients with opioid dependence syndrome. The aim of this study was to find the prevalence of PTSD in patients with opioid dependence and to examine the relationship of PTSD with the severity of dependence on opioids in patients attending an outpatient clinic for drug treatment services. An interview using the Maudsley Addiction Profile, the Severity of Dependence Scale, the Impact of Events Scale, and ICD-10 clinical criteria was conducted in a large urban center for addiction treatment in the central United Kingdom. Seventy patients with opioid dependence syndrome were interviewed. On interview, 30% of the patients met ICD-10 criteria for PTSD. Clinically significant levels of intrusive (45.7%) and avoidant (65.7%) symptoms were reported. Participants with PTSD reported higher perceived rate of childhood threat to life including sexual abuse, physical abuse, and witnessing physical fights between parents. In adulthood, the main traumatic events were ...",0,0 +4227,Grief Counseling and Crisis Intervention in Hospital Trauma Units,"The demand for family counselors implementing crisis intervention and grief counseling in hospital trauma units continues to increase. Thus, this article provides a review of the nature of family counselors working with individuals and families affected by traumatic brain injury (TBI) and medical trauma in hospitals. Specifically, the article presents (a) unique aspects of crisis intervention and grief services provided in hospital trauma units, (b) effective rapport building strategies for family counselors working with families in crisis from TBI, (c) multidisciplinary collaboration in hospitals, (d) diagnostic approaches and common mental health disorders following TBI, (e) ethical issues working in hospitals, (f) family-focused grief therapy and stages of grief interventions, and (g) implications with a case example of a family counselor working with a family affected by TBI.",0,0 +4228,"Suicide-nearness assessed with PORT, the Percept-genetic Object-Relation Test: A replication and a reliability study","To determine the reliability and validity of a previously identified ""suicide cluster"" in the Percept-genetic Object-Relation Test (PORT), which test documents subliminal perception of object-relation pictures, 20 suicide attempters and 70 controls were investigated. The correspondence between scores assigned by two judges was 95%-100%. The suicide-cluster signs in PORT, notably ""lack of attachment relationships"" and ""Motor activity,"" were significant. Differences between the results of this and the previous study are discussed as is the role of psychiatric disorder in suicide.",0,0 +4229,Validation of the five-factor model of PTSD symptom structure among delinquent youth.,"This study compared the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM–IV–TR; American Psychiatric Association, 2000) diagnostic 3-factor structure of posttraumatic stress disorder (PTSD) symptoms with leading 4-factor models and the newly proposed 5-factor dysphoric arousal model in a sample of 1,363 juvenile-justice-involved adolescents (990 boys, 373 girls). Structural equation modeling suggested that the 5-factor dysphoric arousal model fit significantly better than each of the other models. The model fit better for girls than for boys, and girls evidenced stronger factor loadings for items on all but the Anxious Arousal factor. The factors of the 5-factor model were then tested as mediators of the association between interpersonal and noninterpersonal trauma and mental health problems. Interpersonal trauma was associated with PTSD symptoms for boys and girls, whereas noninterpersonal trauma exposure was only associated with PTSD symptoms for boys, despite equal levels of exposure across genders, suggesting that girls may be more sensitive to the effects of interpersonal, but not noninterpersonal, trauma. Patterns in mediation were moderated by gender, as girls’ data showed stronger paths leading to depression/anxiety, somatic complaints, and suicidal ideation through PTSD symptoms, whereas for boys, paths were stronger leading to anger/irritability symptoms. Mediation results suggested differential patterns of influence for dysphoric versus anxious arousal and also indicate the importance of numbing for delinquent youth. These results add to the evidence base supporting the 5-factor dysphoric arousal model in establishing developmentally sensitive criteria for the diagnosis of PTSD among traumatized youth.",0,0 +4230,A test of the assumptions of the transtheoretical model in a post-traumatic stress disorder population,"Prior reports suggest an ambivalence regarding treatment in individuals with Post-Traumatic Stress Disorder (PTSD). A model that accommodates such ambivalence is the Transtheoretical Model of Behavior Change (TTM, also known as the Stages-of-Change Model). Fifty veterans presenting for treatment completed self-report measures (94% response rate) that assessed disorder variables and constructs relating to the TTM. While the relationships between the components of each specific construct were found to be consistent with the findings of other studies and a number of predicted relationships between variables were confirmed, many results were inconsistent with the TTM. Notwithstanding questions about the suitability of the self-report measures, the unique characteristics of the veteran sample and the small sample size, the results suggest that the assumptions of the TTM were not met in veterans with PTSD. Copyright © 2005 John Wiley & Sons, Ltd.",0,0 +4231,Localization of Pain and Self-Reported Rape in a Female Community Sample,"Studies suggest that rape increases risk of medically unexplained pain in women. At present it is not clear whether rape is associated with pain at specific locations or at multiple locations. In this study we tested the hypothesis that rape was associated with a preferential increase in risk of pelvic pain that was not explained by pain at other sites.We relied on an existing community study that oversampled women with fibromyalgia and major depression. Localization was assessed by asking about pain at four sites: pelvic region; jaw/face; headache; and lower back. Three groups were identified using a structured telephone interview: Abuse Only (sexual/physical abuse excluding rape); Rape+Abuse (rape in addition to other sexual/physical abuse); and No Abuse.Compared with the No Abuse group, the Rape+Abuse group was eight times more likely to have pelvic pain and 3.7 times more likely to have jaw/face pain after we controlled for the effect of widespread pain. Rape was not associated with lower back pain or headache. The Abuse Only group did not show a preferential increase in risk of pain at any of the four locations that were assessed. After controlling for pain at other locations, we found that the Rape + Abuse group was 10 times more likely to report pelvic pain than the No Abuse group (P<0.005).In accord with the localization hypothesis, self-reported rape was uniquely associated with pelvic pain. Future efforts to account for pain in the aftermath of rape must specify a mechanism that can simultaneously cause widespread pain as well as increase risk of localized pain.",0,0 +4232,Diagnostic accuracy of the Posttraumatic Stress Disorder Checklist–Civilian Version in a representative military sample.,"This study aimed to assess the diagnostic accuracy of the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C; Weathers, Litz, Herman, Huska, & Keane, 1993) and to establish the most accurate cutoff for prevalence estimation of posttraumatic stress disorder (PTSD) in a representative military sample compared to a clinical interview. Danish soldiers (N = 415; 94.4% male, mean age 26.6 years) were assessed with the PCL-C and the Structured Clinical Interview for the DSM-IV (SCID; First, Spitzer, Gibbon, & Williams, 2002) 2.5 years after their return from deployment to Afghanistan. Diagnostic accuracy of the PCL-C was assessed through receiver operating characteristic curve analysis. The PCL-C displayed high overall accuracy (area under the curve = .95, confidence interval [.92, .98]) and performed well (sensitivity > .70 and specificity ≥ .90), with cutoff scores ranging from 37 to 44. When including sensitivity values a little below .70 (.69), the PCL-C performed well for cutoff levels up to 53. Prevalence of PTSD varied considerably with the application of different cutoff values and scoring methods. Our results show that the PCL-C is a relevant and valid tool for screening for probable PTSD in active military samples. However, it is of great importance that cutoff scores be chosen based on the sample and the purpose of the particular study or screening.",0,0 +4233,A college community's vicarious stress reaction to September 11th terrorism.,"This study examined the effects of vicarious exposure to the September 11 terrorist attacks in an academic community, just after the three-month period that delineates acute from chronic post-traumatic stress. An entire academic community of 1693 students, faculty, and staff was surveyed electronically regarding their perceived stress symptoms and coping behaviors. The survey yielded a 37 percent response rate. About 76 percent showed one or more substantial symptoms of stress, and 32 percent showed three or more. The most prominent symptom clusters involved persistent avoidance and persistent arousal. Respondents primarily relied on coping through optimism, reassessing priorities and relationships, giving and receiving support, and becoming better informed on terrorism-related topics. Differences in symptoms and coping preferences were found based on sex, group (student, faculty, staff), and exposure to previous crisis. This study indicates that despite time and distance from the site of the terrorism, all segments of a college community continue to experience some degree of distress. Such distress can interfere with academic performance, personal health, and relationship stability. Rather than rely on formal support service delivery, most appear to rely on established interpersonal relationships. This suggests that providing support to vicarious victims in the future might emphasize training for friends and family, rather than relying on established service delivery systems. Language: en",0,0 +4234,Physical Health Symptoms in Peacekeepers: Has the Role of Deployment Stress Been Overrated?,"Using a prospective design, physical health symptoms were examined in a sample of 198 peacekeepers. At pre-deployment, general life stressors and pre-deployment stress symptoms were significant predictors of physical health symptoms. At post-deployment, physical health symptoms were predicted by pre-existing physical health symptoms and stress symptoms reported before and after the mission; mission-related stressors were not associated with physical health symptoms. In addition, stress symptoms mediated the relationship between exposure and physical symptoms. Finally, the hyperarousal symptom cluster was a better predictor of physical health complaints than the other symptom clusters. Implications and limitations are discussed.",0,0 +4235,Exploring combat-related loss and behavioral health among OEF/OIF veterans with chronic PTSD and mTBI.,"While combat-related loss is likely to result in the development of lingering stress responses, little is known about its impact on behavioral health. The purpose of this study was to present preliminary results on war-related losses and behavioral health among Operations Enduring Freedom/Iraqi Freedomveterans. Veterans who suffered losses, to include noncombat losses (relationships back home) that occurred while the combatant was in the combat theater, reported more stress, depressive symptoms, and combat experiences. Outcomes were worse for veterans reporting two losses. Most notable was the decline in social support as losses increased. Also of note, avoidance and arousal symptom clusters were the most endorsed. While the pattern was more pronounced for those experiencing loss, results were consistent regardless of number of losses. Language: en",0,0 +4236,Typologies of Childhood Exposure to Violence: Associations With College Student Mental Health,"This study examined typologies of childhood violence exposure (CVE) and the associations of profiles with current demographic characteristics and mental health in emerging adulthood.The study evaluated a sample of college students from 2 US geographic regions (Midwest, n = 195; Southeast, n = 200).An online questionnaire (collected 2013-2014) assessed CVE and current mental health. Latent class analysis was used to identify typologies of CVE. Follow-up analyses were conducted to distinguish differences between typologies in demographic characteristics and mental health.Four distinct profiles emerged: High-Exposed, Domestic-Exposed, Community-Exposed, and Low-Exposed. High- and Domestic-Exposed groups were more likely to be first-generation college students and to experience symptoms of psychopathology.This study offers a unique presentation of CVE profiles and a nuanced interpretation of their differential relationship to current demographic characteristics and mental health. It may befit university mental health initiatives to engage first-generation students and utilize comprehensive assessments of previous victimization.",0,0 +4237,Post-traumatic stress disorder symptomatology among American Indian Vietnam veterans : mediators and moderators of the stress-illness relationship,"Results from the National Vietnam Veterans Readjustment Study (NVSRS) reported high rates of Post-traumatic Stress Disorder (PTSD) among Vietnam Theater veterans compared to rates in the Vietnam Era and others of the veterans' generation. Prevalence rates were even higher among minority groups, specifically Blacks and Hispanics. Results from the American Indian Vietnam Veterans Project (AIVVP) suggested that American Indian Vietnam veterans were also at increased risk for PTSD. However, not all American Indian veterans with high levels of trauma exposure developed PTSD, which suggests that other contributing factors specific to American Indian populations may also affect their vulnerability to PTSD outcomes. The objective of this study was to identify potential predictors of PTSD symptomatology across three military timeframes and to examine the relationships among personal resources, trauma, and PTSD symptomatology in American Indian Vietnam veterans. It was hypothesized that high levels of social support and ethnic identity may enhance one's psychosocial resilience to stress, resulting in positive health outcomes. This study was based on AIVVP data collected by the National Center for American Indian and Alaska Native Mental Health Research (NCAIANMHR) at the University of Colorado Health Sciences Center. Interviews with 621 American Indian Vietnam veterans living on or near their reservations assessed predisposing factors, characteristics of military service, military and nonmilitary trauma, personal resources, and PTSD symptomatology. The results of hierarchical linear regression analyses showed a strong relationship between social support and PTSD symptomatology across all time flames. Although results did not support the stress-buffering hypothesis, combat trauma and social support during the military interacted significantly. In addition, post-military social support appeared to mediate the relationship between trauma and PTSD symptomatology. Identifying a relationship between social support and PTSD has implications for the development of interventions used to treat PTSD in ethnic minorities. The impact of personal resources on PTSD symptomatology may be important for traumatic survivors and long-term strategies for victims of PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4238,Posttraumatic Stress Disorder and Functioning and Quality of Life Outcomes in a Nationally Representative Sample of Male Vietnam Veterans,"Although posttraumatic stress disorder (PTSD) is a highly prevalent and often chronic condition, the relationship between PTSD and functioning and quality of life remains incompletely understood.The authors undertook an archival analysis of data from the National Vietnam Veterans Readjustment Study. The study subjects consisted of the nationally representative sample of male Vietnam veterans who participated in the National Vietnam Veterans Readjustment Study. The authors estimated PTSD at the time of the interview with the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder. They examined the following outcomes: diminished well-being, physical limitations, bed day in the past 2 weeks, compromised physical health status, currently not working, and perpetration of violence. Logistic models were used to determine the association between PTSD and outcome; adjustment was made for demographic characteristics and comorbid psychiatric and other medical conditions.The risks of poorer outcome were significantly higher in subjects with PTSD than in subjects without PTSD in five of the six domains. For the outcome domains of physical limitations, not working, compromised physical health, and diminished well-being, these significantly higher risks persisted even in the most conservative logistic models that removed the shared effects of comorbid psychiatric and other medical disorders.The suffering associated with combat related-PTSD extends beyond the signs and symptoms of the disorder to broader areas of functional and social morbidity. The significantly higher risk of impaired functioning and diminished quality of life uniquely attributable to PTSD suggests that PTSD may well be the core problem in this group of difficult to treat and multiply afflicted patients.",0,0 +4239,Protecting Children from Violence,"Providing an evidence-based understanding of the causes and consequences of violence against children, experts in the field examine the best practices used to help protect children from violence. Various types of violence are reviewed including physical and sexual abuse, (cyber-)bullying, human trafficking, online predators, abductions, and war. In addition, it reviews the various perpetrators of such violence including parents and relatives, strangers, other children, and societal institutions. The possible outcomes of such violence including physical injuries, death, depression, anxiety, post-traumatic stress disorders, and damage to the social fabric of the local community are also explored. To enhance accessibility, each contributor addresses common themes: • Opening case studies dramatically illustrate the human cost of abuse and neglect • Empirically driven estimates of the scope of problem to better understand who is at risk and why • Empirically driven testing of interventions to maximize effectiveness of programs • How current research compares to public perception and the impact on public policy • The worldwide problem of violence against children • Evidence-based recommendations for reducing violence against children. The book opens with a review of the history of the problem, the methodological approaches used to study it, and current –best practice— prevention strategies. The methods used to identify peer victims are then explored. Next child eyewitness memory is examined including the most effective techniques for maximizing the retrieval of information. This is followed by the research on missing and abducted children including the effectiveness of recovery programs such as supermarket campaigns and forensic age profiles. Next how the Internet is used in the victimization of children is explored including tips to help protect children online. Public attitudes toward sex offender registration laws are then reviewed followed by vulnerabilities that include genetic, neuropsychological, temperamental, cognitive, perceptual and social factors. International perspectives on protecting children from violence and global health inequities are then addressed. The book concludes with recommendations for future research. Contributors are noted scholars from a broad range of disciplines. As such, the book appeals to researchers and advanced students in developmental, counseling, clinical, cognitive, evolutionary, and social psychology, as well as sociology, social work, criminal justice, education, and law enforcement. © 2010 by Psychology Press. All rights reserved.",0,0 +4240,Somatic symptoms and health-related quality of life among treatment-seeking Canadian Forces personnel with PTSD,"This study examined the association between somatic complaints and health-related quality of life (HR-QoL) in treatment-seeking Canadian military personnel with military-related Posttraumatic Stress Disorder (PTSD). Current and former Canadian Forces (CF) members attending the Parkwood Hospital Operational Stress Injury Clinic in London, Ontario (N=291) were administered self-report questionnaires assessing number and severity of somatic complaints, PTSD and depressive symptom severity, and mental and physical health-related quality of life (HR-QoL) prior to commencing treatment. Regression analyses were used to identify the role of somatic complaints on physical and mental HR-QoL, after controlling for PTSD symptom cluster and depressive symptom severity. Somatic symptom severity accounted for only a small amount of the variance in mental HR-QoL after accounting for PTSD symptom cluster and depressive symptom severity, but accounted for a larger proportion of the variance in physical HR-QoL after accounting for PTSD cluster and depressive symptom severity. Understanding the role of somatization in the symptom-presentation of military personnel with PTSD may provide additional avenues for treatment with this population.",0,0 +4241,Framing disaster resilience,"Purpose – To confront the increasingly devastating impacts of disasters and the challenges that climate change is posing to disaster risk management (DRM) there is an imperative to further develop DRM. The resilience approach is emerging as one way to do this, and in the last decade has been strongly introduced into the policy arena, although it is not new for DRM practitioners and researchers. Nevertheless, resilience is a highly contested issue, and there is no agreed definition of it, which has resulted in confusion for stakeholders when applying it to practice. Therefore, the purpose of this paper is to investigate how resilience is framed by researchers and DRM practitioners. Design/methodology/approach – The analytical framework used was Hajer's “social-interactive discourse theory”, combined with analysis of government documents, in-depth interviews with practitioners and observation of field and practices within the context of the Natural Disaster Resilience Program in Queensland, Australia. Findings – One of the key findings is that the idea of “bouncing back” is central to the resilience discourse but different interpretations of this idea results in real-world implications. Three different ways (storylines) in which practitioners construct the meaning of disaster resilience emerge from this study. Importantly the divergences between these storylines reveal possibilities for reframing to occur and these could lead to different policy options and practices. Originality/value – The results presented in this paper offer empirical evidence on how resilience is understood on the ground, contributing to extending resilience theory and informing DRM and resilience practice.",0,0 +4242,"Pain, coping, and adjustment in patients with burns: Preliminary findings from a prospective study","We prospectively examined the associations between procedural pain during hospitalization and coping and adjustment 1 month postdischarge in 43 patients treated at a major regional burn center for burns extensive enough to require at least 5 days of daily wound debridement procedures. Both patients and nurses provided ratings of patient pain, which were summarized and aggregated across a 5-day period. Results indicated that those subjects with higher pain scores also reported poorer adjustment as measured by scores on the Brief Symptoms Inventory and the Sickness Impact Profile. Moreover, these associations remained significant after partialling out the effects of preburn adjustment. Hierarchical regression analyses revealed evidence that seeking social support had a moderating effect on the association between pain and scores on a measure of posttraumatic stress disorder.",0,0 +4243,No PTSD-related differences in diurnal cortisol profiles of genocide survivors,"Posttraumatic stress disorder (PTSD) has been associated with reduced cortisol levels. Opposing results have been interpreted as resulting from methodological differences between studies. We investigated the diurnal profile of salivary cortisol in a population of highly traumatized adult males from Rwanda with and without PTSD, who spent the whole day of examination together under a maximally standardized schedule. Besides the detection of PTSD-related alterations in cortisol release we aimed at determining physiologically relevant effects of cumulative trauma exposure on HPA functioning in interaction with or independent of diagnosis. There were no differences in the diurnal pattern of cortisol release between subjects with and without PTSD. We observed an increasing prevalence of PTSD with increasing number of different traumatic event types experienced, replicating earlier results on a “building-block effect” of multiple traumatization. However, size of cumulative exposure was not related to any of the cortisol measures. The results suggest that besides methodological constraints also confounding factors not previously controlled for, e.g., sex differences or current life stress, might contribute to the diverging results of lowered, unchanged or enhanced cortisol secretion in PTSD. Future research should therefore closely monitor these possible confounds to optimize models for cortisol in research on stress-dependent illnesses.",0,0 +4244,"Post-traumatic stress disorder and traumatic brain injury: A review of causal mechanisms, assessment,and treatment","In this paper we explore the evidence for post-traumatic stress disorder (PTSD) after traumatic brain injury (TBI). We examine its possible mediating mechanisms after brain injury, the evidence for its occurrence, risk, and protective factors, and the implications for intervention and service demands. In the first section we review the current literature relevant to cause, maintenance, and treatment of PTSD in general, before addressing issues associated with the assessment and management of PTSD after TBI. It is argued that PTSD may occur after a brain injury, and can be, relatively, a common disorder. However, explanatory mechanisms for its occurrence may be speculative. In this context, we argue, assessment and treatment need to be carefully considered, and comprehensive.",0,0 +4245,"Prevalence of post-traumatic stress symptoms and associated factors in tuberculosis (TB), TB retreatment and/or TB–HIV co-infected primary public health-care patients in three districts in South Africa","High rates of tuberculosis (TB) and TB/HIV co-infection is often linked with mental health issues such as post-traumatic stress disorder (PTSD) symptoms, which is further associated with poor health outcomes. In a country such as South Africa where rates of these infectious diseases are high, it is concerning that there is limited/no data on prevalence rates of mental disorders such as PTSD and its associated factors. Therefore, the aim of this study was to establish the prevalence of PTSD symptoms and associated factors in TB, TB retreatment and/or TB-HIV co-infected primary public health-care patients in three districts in South Africa. Brief screening self-report tools were used to measure: PTSD symptoms, psychological distress (anxiety and depression) and alcohol misuse. Other relevant measures, such as adherence to medication, stressful life events and sexual risk-taking behaviours, were obtained through structured questions. A total of 4900 public primary care adult patients from clinics in high TB burden districts from three provinces in South Africa participated. All the patients screened positive for TB (either new or retreatment cases). The prevalence of PTSD symptoms was 29.6%. Patients who screened positive for PTSD symptoms and psychological distress were more likely to be on antidepressant medication. Factors that predicted PTSD symptoms were poverty, residing in an urban area, psychological distress, suicide attempt, alcohol and/or drug use before sex, unprotected sex, TB-HIV co-infected and the number of other chronic conditions. Health-care systems should be strengthened to improve delivery of mental health care, by focusing on existing programmes and activities, such as those which address the prevention and treatment of TB and HIV.",0,0 +4246,The Long-Term Impact of Physical and Emotional Trauma: The Station Nightclub Fire,"Survivors of physical and emotional trauma experience enduring occupational, psychological and quality of life impairments. Examining survivors from a large fire provides a unique opportunity to distinguish the impact of physical and emotional trauma on long-term outcomes. The objective is to detail the multi-dimensional long-term effects of a large fire on its survivor population and assess differences in outcomes between survivors with and without physical injury.This is a survey-based cross-sectional study of survivors of The Station fire on February 20, 2003. The relationships between functional outcomes and physical injury were evaluated with multivariate regression models adjusted for pre-injury characteristics and post-injury outcomes. Outcome measures include quality of life (Burn Specific Health Scale-Brief), employment (time off work), post-traumatic stress symptoms (Impact of Event Scale-Revised) and depression symptoms (Beck Depression Inventory). 104 fire survivors completed the survey; 47% experienced a burn injury. There was a 42% to 72% response rate range. Although depression and quality of life were associated with burn injury in univariate analyses (p<0.05), adjusted analyses showed no significant relationship between burn injury and these outcomes (p = 0.91; p = .51). Post-traumatic stress symptoms were not associated with burn injury in the univariate (p = 0.13) or adjusted analyses (p = 0.79). Time off work was the only outcome in which physical injury remained significant in the multivariate analysis (p = 0.03).Survivors of this large fire experienced significant life disruption, including occupational, psychological and quality of life sequelae. The findings suggest that quality of life, depression and post-traumatic stress outcomes are related to emotional trauma, not physical injury. However, physical injury is correlated with employment outcomes. The long-term impact of this traumatic event underscores the importance of longitudinal and mental health care for trauma survivors, with attention to those with and without physical injuries.",0,0 +4247,Psychologiczne reakcje członków rodzin chorych leczonych na oddziałach intensywnej terapii,"The environment of the intensive care unit (ICU) is burdensome to a patient and the patient's family. There is a higher risk of depression, anxiety and stress-related disorders in the ICU patients' family members. In relatives of critically ill patients, the cluster of adverse psychological reactions, such as: anxiety, acute stress disorder, posttraumatic stress disorder, depression and complicated grief, is called post-intensive care syndrome - family (PICS-F). These complications may affect the relatives' ability to perform the role of a caregiver and it can also hinder their daily functioning. Apart from negative psychological consequences experienced after a loved one's stay in the ICU, there are also some positive changes observed in patient's relatives called posttraumatic growth. In this review, the psychological repercussions in the ICU patient's family and the means to prevent their undesirable responses are discussed.",0,0 +4248,Rorschach Correlates of Sexual Abuse: Trauma Content and Aggression Indexes,"This study compared Rorschach records of nondissociative outpatients with histories of (a) definite sexual abuse (n = 22), (b) suspected but unconfirmed sexual abuse (n = 13), or (c) no sexual abuse (n = 43) on selected variables hypothesized to be associated with sexual abuse. As predicted, clients with definite sexual abuse scored significantly higher than clients known not to be sexually abused on Armstrong and Loewenstein's (1990) Trauma Content index (TC/R), with an effect size greater than 1 SD. Contrary to prediction, there was no significant difference in the frequency of their Aggressive Past (AgPast; Gacono & Meloy, 1994) scores. AgPast scores, however, did positively correlate with sexual abuse that was violent or sadistic. As a test of discriminant validity, we hypothesized that 2 Rorschach variables (PER and Sc) would be unrelated to sexual abuse. This was supported by our data. Although TC/R was strongly associated with the presence and severity of sexual abuse, it could not discriminate sexually abused from nonsexually abused clients with great accuracy. The TC/R score is 1 factor among many that can be used to assess the validity of clients' claims of past sexual abuse.",0,0 +4249,Former Combatants in Liberia: The Burden of Possible Traumatic Brain Injury Among Demobilized Combatants,"To provide a better understanding of any associations between Disarmament, Demobilization, and Reintegration, previous head injury, and mental health symptoms among former combatants in Liberia.A cluster-sampled national survey of the adult household-based Liberian population.Former combatants with reported head injury were more likely to experience major depressive disorder symptoms, suicidal ideation and attempts, and current substance abuse. Former combatants with head injury are 2.83 times more likely to have major depressive disorder symptoms, and those with suspected traumatic brain injury are five times more likely to have post-traumatic stress disorder.The poor mental health of former combatants in Liberia, both child and adult, might be mitigated if Disarmament, Demobilization, and Reintegration programming assessed participants for head trauma and traumatic brain injury using simple screening methods. The specific health and mental health needs of ex-combatants--a highly vulnerable group--will need to be addressed by Liberia. If left untreated, ex-combatants with high rates of suicidal ideation and post-traumatic stress disorder might be susceptible to re-recruitment into new conflicts in the region.",0,0 +4250,"Risk of lipid abnormality with haloperidol, olanzapine, quetiapine, and risperidone in a Veterans Affairs population","Second-generation antipsychotics can cause lipid elevations at a greater rate than older typical antipsychotics. This risk may not be equivalent amongst the second-generation antipsychotics. We conducted a computerized, retrospective, nonrandomized, case-control analysis of 6331 patients receiving antipsychotics. For each patient, the first prescription for at least 60 continuous days for four antipsychotics [haloperidol (HALD), olanzapine (OLANZ), quetiapine (QUET), or risperidone (RISP)] was analyzed for total cholesterol, low-density lipoprotein, high-density lipoprotein (HDL), and triglycerides (TGL). Mean HDL was lower during OLANZ treatment than with RISP (P = 0.03) or QUET (P = 0.001). TGL were higher during OLANZ (P = 0.0007) or QUET treatment (P = 0.006) than RISP. In dichotomous analyses, odds ratios on the percentage of participants having abnormal cholesterol (P = 0.0003), low-density lipoprotein (P = 0.001), or TGL (P = 0.0001) during medication were in the order: OLANZ > QUET > RISP > HALD. For HDL, the results were less robust but the percentage of participants were in the order: OLANZ>RISP = HALD = QUET. In treatment-emergent analyses of patients without lipid abnormalities during an unmedicated baseline period, there was a greater risk of developing new HDL abnormality with OLANZ than RISP (P<0.05). In conclusion, treatment with RISP or HALD was associated with a more favorable lipid profile than with OLANZ or QUET.",0,0 +4251,Longitudinal mental health impact among police responders to the 9/11 terrorist attack,"Background Among police responders enrolled in the World Trade Center Health Registry (WTCHR), Post-traumatic Stress Disorder (PTSD) was almost twice as prevalent among women as men 2–3 years after the 9/11 attacks. Methods Police participants in the WTCHR Wave 1 survey 2–3 years after 9/11/01, were reassessed for probable PTSD at Wave 2, 5–6 years after 9/11/01, using PCL DSM-IV criteria. Results Police participants in the Wave 2 survey included 2,527 men, 413 women. The prevalence of “Probable PTSD” was 7.8% at Wave 1 and 16.5% at Wave 2. Mean PCL scores increased from 25.1 to 29.9 for men and 28.6 to 32.2 for women. Prevalence of PTSD was higher for women than for men at Wave 1 (χ2 = 10.882, P = 0.002), but not Wave 2 (χ2 = 2.416, P = 0.133). Other risk factors included losing one's job after 9/11 and being disabled. Conclusions Prevalence of probable PTSD among police doubled between 2003–2004 and 2006–2007. After the 2-year time span, the gender difference was no longer significant; prevalence of PTSD symptoms increased and there was a substantial amount of co-morbidity with other mental health problems. Further development of prevention and intervention strategies for police responders with symptoms of PTSD is needed. The observed upward trend in PCL scores over time in police officers with PCL scores less than 44, suggests that PTSD prevention and intervention strategies should be applied to all police affected by the 9/11 attacks, not limited just to those with PTSD symptoms. Am. J. Ind. Med. 55:297–312, 2012. © 2011 Wiley Periodicals, Inc.",0,0 +4252,Trauma-related Structural Dissociation of the Personality,"Abstract Many traumatized individuals alternate between re-experiencing their trauma and being detached from, or even relatively unaware of the trauma and its effects. At first sight one may be inclined to conceptualize detachment from trauma and re-experiencing of trauma as mental states. However, on closer scrutiny it becomes apparent that in both cases a range or cluster of states rather than a singular state is involved. For example, being detached from trauma does not itself exclude being joyful, ashamed, sexually aroused, or curious at times, and re-experiencing trauma can encompass states such as fleeing, freezing, and being in pain or being analgesic. In this paper we relate detachment from trauma and re-experiencing trauma to emotional operating systems (Panksepp, 1998) and functional systems (Fanselow & Lester, 1988), briefly addressed as action systems. Action systems control a range of functions, but some are more complex than others. Reexperiencing trauma will be associated with the inborn and evolutionary derived defensive system that is evoked by severe threat, in particular threat to the integrity of the body. As a complex system, it encompasses various subsystems, such as flight, freeze, and fight. Detachment from trauma, in our view, is associated with several action systems (Panksepp, 1998), i.e., the ones that control functions in daily life (e.g., exploration of the environment, energy control), and the ones that are dedicated to survival of the species (e.g., reproduction, attachment to and care for offspring). In this context we will maintain that severe threat may provoke a structural dissociation of the premorbid personality (Van der Hart, 2000). In its primary form this dissociation is between the defensive system on one hand, and the systems that involve managing daily life and survival of the species on the other hand. To summarize the essence of the theory of structural dissociation of the personality, we argue (1) that traumatic experiences, especially when they occur early in life and involve severe threat to the integrity of the body, may activate psychobiological action systems that have been developed by evolution, and (2) that due to extreme stress levels and classical as well as evaluative conditioning to traumatic memories these systems may remain unintegrated to varying degrees.",0,0 +4253,Epidemiological investigation on major depressive disorder in the most heavily damaged areas from Wenchuan earthquake in 2008,"OBJECTIVE: To assess the prevalence, demographic characteristics, risk factors and protective factors on major depression disorder (MDD) among the affected people in the epicenter, 7 months after the 2008-earthquake in Wenchuan, China. METHODS: Stratified multistage cluster randomization was conducted to choose 14 503 subjects aged 15 years or over in the city of Dujiangyan, Beichuan county and Qingchuan county, Sichuan province. We used the general health questionnaire (GHQ-12) as the screening instrument, and the structured clinical interview for DSM-IV-TR axis I disorder-patient edition (SCID-I/P) as the tool for diagnosis. RESULTS: There were 180 persons diagnosed as MDD with other 13 asymptomatic ones. The point prevalence of MDD was 1.27% and the lifetime prevalence was 1.36%. Risk factors were including:being female (OR = 1.56, 95%CI: 1.136 ∼ 2.143, P 20 000 Yuan (OR = 2.54, 95% CI: 1.38 - 4.68, P Language: zh",0,0 +4254,Heterogeneity in clinical presentations of posttraumatic stress disorder among medical patients: Testing factor structure variation using factor mixture modeling,"The present study used factor mixture modeling to explore empirically defined subgroups of psychological trauma victims based on confirmatory factor analysis (CFA) and latent class analysis of posttraumatic stress disorder (PTSD) symptoms. We sampled 310 medical patients with a history of trauma exposure. Confirmatory factor analysis revealed that the 4-factor emotional numbing PTSD model yielded the best model fit. Using latent factor means derived from this model and the 4-factor dysphoria PTSD model (indexing severity on PTSD factors), 3 latent classes of participants were identified using factor mixture modeling. The 3-class model fit the data very well and was validated against external measures of anxiety and rumination.",0,0 +4255,The influence of pre-deployment cognitive ability on post-traumatic stress disorder symptoms and trajectories: The Danish USPER follow-up study of Afghanistan veterans,"New trajectories of PTSD symptoms have recently been identified in war exposed army veterans. The aim of this army veterans study was to examine whether pre-deployment cognitive ability is associated with the risk of developing PTSD symptoms or non-resilient PTSD trajectories.Follow up study in 428 Danish soldiers, deployed to Afghanistan in 2009, who were assessed at six occasions from pre-deployment to three years post-deployment. Pre-deployment vulnerabilities, deployment and homecoming stressors were measured. Pre-deployment cognitive test scores on Børge Priens Prøve (based on logical, verbal, numerical and spatial reasoning) were converted to a mean of 100 and with a standard deviation of 15.Higher pre-deployment cognitive ability scores were associated with lower risk of PTSD symptoms as assessed by the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) 2.5 years post-deployment (OR=0.97; 95% CI 0.95-1.00) after adjustment for educational length, baseline PCL-C score and perceived war-zone stress. Compared to a resilient trajectory, a non-resilient relieved-worsening trajectory (high baseline mental symptoms, being symptom free during deployment and a drastic increase in PTSD symptoms at the final assessments of PTSD symptoms) had significantly lower cognitive scores by a mean difference of 14.5 (95% CI 4.7-24.3). This trajectory (n=9) comprised 26.5% of soldiers with moderate-severe PTSD symptoms 2.5 years post-deployment.We confirmed an inverse association between pre-deployment cognitive ability and risk of PTSD symptoms, and observed significantly lower mean pre-deployment cognitive scores in one non-resilient PTSD trajectory. If replicated, this might inform relevant prevention efforts for soldiers at pre-deployment.",0,0 +4256,Conditioning and ethological models of anxiety disorders: stress-in-dynamic-context anxiety models.,"(from the chapter) argue that the central shortcoming of traditional behavioral models has been their failure to consider the dynamic context in which stressors occur in a person's life / by ignoring the powerful effect of dynamic contextual factors on the impact of those stressors, behavioral models have appeared to be much more simplistic than they need to be and to have far less explanatory power than we know they can have / refer to the more traditional models as Stress-in-Total-Isolation Anxiety models (SITIA models) / present an alternative model in which we show that stress must always be considered in a dynamic context rather than in isolation in determining the outcome of exposure to stress the relevant dynamic contextual factors that we will consider include constitutional factors such as temperament, past experiential history (including general factors such as a history of exposure to uncontrollable life events as well as specific factors such as prior traumatic conditioning events), current contextual factors at the time of a stressor (such as whether there are already reliable predictors of the stressor, or the nature of the conditioned stimulus relative to the nature of the unconditioned stimulus, or whether the stressor can be controlled), and future modification of the impact of the stressor (through processes such as forgetting and other memory modifications, as well as through later experiences with other stressors) / refer to these models as the Stress-in-Dynamic-Context Anxiety models (SIDCA models) specific phobias [vicarious conditioning of fears and phobias, sources of individual differences in the acquisition of fears and phobias, selective associations in the conditioning of fears and phobias, persistence of fears and phobias] / social phobia [preparedness and conditioning models of social phobia; direct traumatic conditioning, observational conditioning, and social phobia; temperamental variables and social phobia; uncontrollability and social phobia] / panic disorder and agoraphobia / generalized anxiety disorder / posttraumatic stress disorder (PTSD) / obsessive-compulsive disorder [animal models of compulsive behaviors, anxiety reduction theory, preparedness and the nonrandom distribution of obsessive thoughts and compulsive behaviors] (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4257,Anxiety and alcohol use disorders: comorbidity and treatment considerations.,"The co-occurrence of anxiety disorders and alcohol use disorders (AUDs) is relatively common and is associated with a complex clinical presentation. Sound diagnosis and treatment planning requires that clinicians have an integrated understanding of the developmental pathways and course of this comorbidity. Moreover, standard interventions for anxiety disorders or AUDs may need to be modified and combined in targeted ways to accommodate the unique needs of people who have both disorders. Optimal combination of evidence-based treatments should be based on a comparative balance that considers the advantages and disadvantages of sequential, parallel, and integrated approaches.",0,0 +4258,9/11: Mental Health in the Wake of Terrorist Attacks,"Does terrorism have a unique and significant emotional and behavioral impact among adults and children? In what way does the impact of terrorism exceed the individual level and affect communities and specific professional groups, and test different leadership styles? How were professional communities of mental health clinicians, policy-makers and researchers mobilized to respond to the emerging needs post disaster? What are the lessons learned from the work conducted after 9/11, and the implications for future disaster mental health work and preparedness efforts? Yuval Neria and his team are uniquely placed to answer these questions having been involved in modifying ongoing trials and setting up new ones in New York to address these issues straight after the attacks. No psychiatrist, mental health professional or policy-maker should be without this book.",0,0 +4259,"Factors impacting on psychological distress and recovery after the 2004 Niigata-Chuetsu earthquake, Japan: Community-based study","This study was undertaken 5 months after the 2004 Niigata-Chuetsu earthquake in Japan to assess factors that impacted on psychological distress and its recovery.Three thousand and twenty-six adult victims who lived in temporary shelter and in seriously damaged areas were evaluated by questionnaire. The questionnaire queried subject profile, degree of house damage, health status, and psychological distress using a 5-point scale before, immediately and 5 months after the earthquake.Immediately after the earthquake, 59.3% of the subjects had psychological distress. At 5 months after the earthquake, however, this percentage decreased to 21.8%. The psychological distress immediately after the earthquake was significantly serious in victims who: (i) were female; (ii) felt stronger fear of the earthquake and the aftershocks; (iii) lived at home or office after the earthquake; and (iv) were injured due to the earthquake or suffered from sickness after the earthquake. In contrast, the factors impairing psychological recovery 5 months after the earthquake were as follows: (i) being with unfamiliar member(s) during the night after the earthquake; (ii) serious house damage; (iii) living in temporary shelter or at a relative's home after the earthquake; and (iv) physical illness after the earthquake.Despite differences between disasters, these results were consistent with those in some previous studies and may be useful for long-term mental care support.",0,0 +4260,Prevalence of personality disorders among combat veterans with posttraumatic stress disorder,"Many combat veterans with PTSD have co-occurring symptoms of other forms of psychopathology; however, there have been limited studies examining personality disorders among this population. The few extant studies typically have assessed only two or three personality disorders or examined a small sample, resulting in an incomplete picture and scope of comorbidity. This study assessed all DSM-III-R personality disorders in 107 veterans in a specialized, inpatient unit. Using the Structured Clinical Interview for DSM-III-R Personality Disorders, 79.4% of the participants were diagnosed with at least one personality disorder: 29.9% received only one diagnosis, 21.5% had two, 15.9% had three, and 12.1% had four or more. The most frequent single diagnoses were Avoidant (47.2%), Paranoid (46.2%), Obsessive-Compulsive (28.3%), and Antisocial (15.1%) personality disorders.",0,0 +4261,Using Pattern Analysis Matching to Differentiate TBI and PTSD in a Military Sample,"Distinguishing between traumatic brain injury (TBI) residuals and the effects of posttraumatic stress disorder (PTSD) during neuropsychological evaluation can be difficult because of significant overlap of symptom presentation. Using a standardized battery of tests, an artificial neural network was used to create an algorithm to perform pattern analysis matching (PAM) functions that can be used to assist with diagnosis. PAM analyzes a patient's neuropsychological data and provides a best fit classification, according to one of four groups: TBI, PTSD, malingering/invalid data, or ""other"" (depressed/anxious/postconcussion syndrome/normal). The original PAM was modeled on civilian data; the current study was undertaken using a database of 100 active-duty army service personnel who were referred for neuropsychological assessment in a military TBI clinic. The PAM classifications showed 90% overall accuracy when compared with clinicians' diagnoses. The PAM function is able to classify detailed neuropsychological profiles from a military population with a high degree of accuracy and is able to distinguish between TBI, PTSD, malingering/invalid data, or ""other."" PAM is a useful tool to help with clinical decision-making.",0,0 +4262,Addictive profile in juvenile delinquents admitted to correctional institutions in relation to personality characteristics,"Introduction A strong correlation and connection has been observed between drug use and delinquency, as most youths in juvenile commitment programs are involved with drugs compared with nondelinquent youths. Aim of the study The aim of this study was to determine the relationship between substance use among delinquent adolescents and personality characteristics and its impact on mental health. Methods Fifty juvenile delinquent adolescents from among juveniles admitted to two correctional institutes as well as 50 control juveniles were selected. Informed consent was taken. Psychometric analyses were conducted using the Addiction Severity Index, the Eysenck Personality Questionnaire, and The Adolescent and Adult Psychological State Inventory. Results Of the juvenile delinquents, 28% were found to be using nicotine, 22% were using cannabis, and 24% were using polysubstances. They expressed more symptoms of adjustment disorder, generalized anxiety disorder, depression, phobia, post-traumatic stress disorder, attention deficiency hyperactivity disorder, and conduct disorder, and the difference was statistically significant between cases and controls. There were statistically significant differences between cases and controls as regards all the personality dimensions, including extraversion, neuroticism, and psychoticism. In all, 25% of juvenile delinquents suffered from moderate to severe problems with regard to employment, legal, psychiatric, and social problems, as assessed by the Addiction Severity Index. There were statistically significant differences between male and female delinquents as regards employment, psychiatric, and social problems as assessed by the Addiction Severity Index. Conclusion Community and correctional systems must be established to provide psychiatric services to the youth, as juvenile delinquents with psychiatric disorders pose a challenge for the juvenile justice system and, after their release, for the larger mental health system. © 2012 Okasha Institute of Psychiatry, Ain Shams University.",0,0 +4263,Randomized controlled trial of cognitive behaviour therapy for comorbid post-traumatic stress disorder and alcohol use disorders,"Aims This study aimed to test the efficacy of integrated cognitive behaviour therapy (CBT) for coexisting post traumatic stress disorder (PTSD) and alcohol use disorders (AUD). Setting Clinics across Sydney, Australia.Design Randomized controlled trial of 12 once-weekly individual sessions of either integrated CBT for PTSD and AUD(integrated therapy, IT; n = 33) or CBT for AUD plus supportive counselling (alcohol-support, AS; n = 29). Blind assessments were conducted at baseline and post-treatment and at 5 [standard deviation (SD) = 2.25] and 9.16(SD = 3.45) months post-treatment. Participants Sixty-two adults with concurrent PTSD and AUD. Measurements Outcomes included changes in alcohol consumption (time-line follow-back), PTSD severity [clinician-administered PTSD scale (CAPS)], alcohol dependence and problems, and depression and anxiety. Findings Reductions in PTSD severity were evident in both groups. IT participants who had received one or more sessions of exposure therapy exhibited a twofold greater rate of clinically significant change in CAPS severity at follow-up than AS participants [IT60%, AS 39%, odds ratio (OR): 2.31, 95% confidence interval (CI): 1.06, 5.01]. AS participants exhibited larger reductions than IT participants in alcohol consumption, dependence and problems within the context of greater treatment from other services during follow-up. Results lend support to a mutually maintaining effect between AUD and PTSD. Conclusions Individuals with severe and complex presentations of coexisting post-traumatic stress disorder(PTSD) and alcohol use disorders (AUD) can derive substantial benefit from cognitive behaviour therapy targeting AUD, with greater benefits associated with exposure for PTSD. Among individuals with dual disorders, these therapies can generate significant, well-maintained treatment effects on PTSD, AUD and psychopathology.",0,0 +4264,Substantial Symptom Changes in Naturalistic Recovery from Aversive Events,"Researchers have recommended examining trajectories of recovery from aversive events, including sudden gains and spikes. We examined rates, attributions for, and outcomes associated with substantial symptom improvements and brief exacerbations after aversive events.Sixty-three women completed questionnaire measures of mood, depression, and posttraumatic stress disorder symptoms. They used a Life History Calendar (LHC) to draw the trajectory of symptom levels from the event to the present, and were interviewed regarding the course of their symptoms. Based on the LHC and interview, we coded whether each participant experienced substantial improvements and/or brief exacerbations and reasons for them.Participants frequently experienced substantial improvements and brief exacerbations, most of which they attributed to external events. Substantial improvements-but not substantial brief exacerbations-were associated with significantly lower symptom levels.Substantial improvements are similar to sudden gains in therapy samples. Substantial improvements in avoidance and mood have positive, bidirectional effects on each other.",0,0 +4265,Post-traumatic growth in people living with a serious medical condition and its relations to physical and mental health: A systematic review,"The diagnosis of a life-threatening illness can be an extremely stressful, traumatic experience. However, many survivors report also various positive changes, referred in empirical literature as post-traumatic growth (PTG). Empirical studies that documented stress disorders and PTG in patients and survivors of life-threatening diseases are reviewed in three areas: Predictors of PTG, relationships between PTG and indicators of mental health and the impact of PTG on the process of convalescence.The literature review was completed by making use of three major databases - PsycINFO, PILOTS and Medline.The majority of the studies investigated PTG and its relationships to health indicators after the diagnosis of cancer, HIV/AIDS, cardiac disease, multiple sclerosis and rheumatoid arthritis. The review indicated that quality of social support, patients' coping strategies and several indicators of mental and physical health were consistently associated with post-traumatic growth. Associations between growth and health-related variables (e.g. physical deficits, pain, depression, anxiety) varied depending on different study design (cross-sectional versus longitudinal) and the sample composition (patients versus symptom-free survivors). Several findings are disease-specific.The results point to the potential adaptive significance of PTG. More research is needed to investigate specific disease-related profiles of PTG and the complex mechanisms, which underlie the relationships between PTG and the process of convalescence. This knowledge may help to foster the overall positive adjustment of chronically ill patients.",0,0 +4266,"Posttraumatic stress disorder, smoking, and cortisol in a community sample of pregnant women","The prevalence of posttraumatic stress disorder (PTSD) in the United States is higher among pregnant women than women generally. PTSD is related to adverse birth outcomes via physiological and behavioral alterations, such as smoking.We utilize salivary cortisol measures to examine how traumatic stress, smoking and the hypothalamic-pituitary-adrenal axis interact. Pregnant women (n=395) gave cortisol specimens as part of a cohort study of PTSD and pregnancy at three health systems in the Midwestern United States. Women were divided into three groups: nonsmokers, quitters (who stopped smoking during pregnancy), and pregnancy smokers. Mean cortisol values at three points, sociodemographics, trauma history, and PTSD were compared across groups. We assessed the association of smoking group and PTSD with late afternoon cortisol levels.Smokers, quitters, and nonsmokers differed on demographic risk factors and PTSD symptom load. Late afternoon and bedtime cortisol measures were significantly positively correlated with smoking in pregnancy, with smokers with PTSD presenting the highest cortisol levels. Regression analysis showed that smoking in pregnancy was associated with higher late afternoon cortisol in an additive manner with PTSD symptoms.Smoking appears to have a different relationship with cortisol level for those with and without PTSD. This is the first study to show additive effects of smoking and PTSD on cortisol levels in pregnant women. Since high cortisol, smoking, and PTSD have been shown to adversely affect perinatal outcomes, and since those continuing to smoke in pregnancy had the highest PTSD symptom load, PTSD-specific smoking cessation programs in maternity settings are warranted.",0,0 +4267,Alcohol use trajectories among adults in an urban area after a disaster: evidence from a population-based cohort study,"Alcohol use increased in the New York City (NYC) metropolitan area in the first months after the 11 September 2001 terrorist attacks.To investigate alcohol use trajectories in the NYC metropolitan area in the 3 years after 11 September and examine the relative contributions of acute exposure to the attacks and ongoing stressors to these trajectories.We used a population-based cohort of adults recruited through a random-digit-dial telephone survey in 2002; participants completed three follow-up interviews over 30 months.The NYC metropolitan area.A total of 2752 non-institutionalized adult residents of NYC.We used growth mixture models to assess trajectories in levels of total alcohol consumption and bingeing in the past 30 days, and predictors of these trajectories.We identified five trajectories of alcohol consumption levels and three bingeing trajectories. Predictors of higher levels of use over time included ongoing stressors, traumatic events and lower income. Ongoing exposure to stressors and low income also play a central role in bingeing trajectories.While point-in-time mass traumatic events may matter in the short term, their contribution subsides over time. Accumulated stressors and traumatic events, in contrast, lead to higher levels of consumption among respondents already vulnerable to high alcohol use. Interventions to mitigate post-disaster stressors may have substantial benefit in reducing alcohol abuse in the medium- to long term.",0,0 +4268,Expressive flexibility.,"Previous research has examined the consequences of either expressing or suppressing emotion using between-subjects designs. However, emotion theorists have argued that adaptation depends not so much on one regulatory process but rather on the ability to flexibly regulate emotion in accord with situational demands. To test this idea, Bonanno, Papa, Lalande, Westphal, and Coifman (2004) developed a within-subjects experimental paradigm to measure expressive flexibility (EF) and showed that EF predicted better self-reported adjustment over a 2-year period. The current investigation extends this research by (1) demonstrating the stability of EF across a 3-year period, (2) replicating the association between EF and positive adjustment using a more objective measure of adjustment (obtained from participants' close friends rather than based on self-report), and (3) by showing that the positive relation between EF and adjustment was particularly salient in the context of high levels of cumulative life stress when EF was measured under conditions of immediate threat (presence of a subliminal threat prime).",0,0 +4269,[Short-term psychological consequences of car accidents: an empirical study].,"AIM: Aim of this study is to investigate short-term (3 and 5 months) psychological consequences of severe motor-vehicle accidents. METHODS: The sample under investigation is composed of two groups: 8 survivors of severe motor-vehicle accidents with spinal cord injuries (SCI) hospitalized in a Spinal Cord Unit, and 6 survivors who did not require hospitalization. All subjects were assessed twice, three and five months after the accident, on a variety of measures including the CAPS and the BDI-SF. RESULTS: Prevalence of PTSD in the total sample was, 3 months after the accident, 14% with no significant differences between the two groups; some peculiarities in the symptomathological profile emerged as much as subjects with SCI experience avoidance of trauma-related stimuli more frequently. An overall decline in frequency and severity of post-traumatic symptoms between the two assessments was observed in the total sample, though some components (Criterion C symptoms) showed no relevant variations over time. Finally, depressive symptoms, which were characterized by higher severity in the SCI group, showed a significant decline between the two assessments. DISCUSSION: Our data, although based on a limited sample, might help in tailoring psychological interventions for prevention and treatment of PTSD in survivors of severe motor accidents. Language: it",0,0 +4270,A systematic review of probable posttraumatic stress disorder in first responders following man-made mass violence,"The current study was a systematic review examining probable posttraumatic stress disorder (PTSD) in first responders following man-made mass violence. A systematic literature search yielded 20 studies that fit the inclusion criteria. The prevalence rates of probable PTSD across all 20 studies ranged from 1.3% to 22.0%. Fifteen of the 20 articles focused on first responders following the September 11th terrorist attacks and many of the studies used the same participant recruitment pools. Overall, the results of the systematic review described here suggest that our understanding of PTSD in first responders following man-made mass violence is based on a very small set of articles that have focused on a few particular events. This paper is meant to serve as a call for additional research and to encourage more breadth in the specific incidents that are examined.",0,0 +4271,Predictors of PTSD trajectories following captivity: A 35-year longitudinal study,"Although war captivity is a potent pathogen for psychiatric illness, little is known about the long-term trajectories of post-traumatic stress disorder (PTSD) among ex-prisoners of wars (ex-POWs). This study aimed to assess the long-term trajectories of PTSD and their predictors following war captivity. Three follow-ups (1991, 2003, 2008) were conducted over 35 years of 164 Israeli ex-POWs and185 comparable combatants from the 1973 Yom Kippur War. Ex-POWs reported higher PTSD rates than controls at all three assessments. Four trajectories of PTSD were identified: chronic PTSD, delayed PTSD, recovery and resilience. The majority of POWs reported delayed PTSD, while the majority of controls were classified as resilient. While PTSD rates remained relatively stable over time among controls, a steep increase in rates was observed among POWs between 1991 and 2003, followed by stabilization in rates between 2003 and 2008. Finally, subjective experience of captivity was the variable that best distinguished between the resilience and PTSD groups of ex-POWs, followed by participation in previous wars and negative life events during childhood. War captivity carries long-lasting psychiatric implications, even decades after release. Aging processes, as well as unique stressors that exist in Israel, may account for the elevated PTSD rates found here.",0,0 +4272,Parenting Support and PTSD in Children of a War Zone,"The protective role of parenting factors on the mental well-being of children exposed to war trauma remains an under-researched area.To establish the relationship between perceived positive parenting support and post-traumatic stress disorder (PTSD) symptoms in children exposed to war trauma.A random sample of 412 children aged 12-16 years was selected from the Gaza Strip and was assessed using the Gaza Traumatic Events Checklist (GTEC), the SCID (DSM-IV) and the Perceived Parenting Support Scale (PPSS).Palestinian children were exposed to different types of war-traumatic events. The number of exposed traumatic events was independently associated with the severity of post-traumatic symptoms scores or the diagnosis of PTSD, while perceived parenting support was found to act as a protective factor in this association.Interventions in war zones need to ensure the minimal possible disruption to communities and family units, and to involve parents in preventive or treatment programmes for children exposed to trauma.",0,0 +4273,Single prolonged stress increases contextual freezing and the expression of glycine transporter 1 and vesicle-associated membrane protein 2 mRNA in the hippocampus of rats,"Rats subjected to single prolonged stress (SPS) show enhanced HPA negative feedback, exaggerated acoustic startle response, and enhanced contextual freezing 7 days after SPS, and accordingly, SPS is an animal model of PTSD. To elucidate the influence of contextual fear on gene expression in the hippocampus of SPS rats, we used cDNA microarray followed by real-time quantitative PCR analyses to compare the hippocampal gene expression profiles between rats that were or were not subjected to SPS during exposure to contextual fear. In the behavioral experiments, spontaneous locomotor activity was measured 7 days after SPS. Twenty-four hours after footshock conditioning (7 days after SPS), freezing behavior was measured during re-exposure to the chamber in which footshock was delivered. Based on the behavioral analysis, rats subjected to SPS exhibited a significant enhancement of contextual freezing compared to rats not subjected to SPS, without any changes in locomotor activity. Analyses using cDNA microarray and RT-PCR showed that the hippocampal levels of glycine transporter 1 (Gly-T1) and vesicle-associated membrane protein 2 (VAMP2) mRNA in rats subjected to SPS were significantly increased relative to sham-treated rats. Administration of SPS alone did not affect the expression of these 2 genes. These findings suggest that the upregulation of Gly-T1 and VAMP2 in the hippocampus may be, at least in part, involved in the enhanced susceptibility to contextual fear in rats subjected to SPS.",0,0 +4274,Sexual assault-characteristics effects on PTSD and psychosocial mediators: A cluster-analysis approach to sexual assault types.,"Using cluster analysis, we investigated the effects of assault characteristics (i.e., level of violence, subjective distress, alcohol consumption, perpetrator identity) on PTSD symptoms, and whether these effects are mediated by postassault social and psychological reactions. A large community sample of women sexual assault survivors completed 2 mail surveys at a 1-year interval. In line with prior research, cluster analyses revealed the existence of 3 general categories of sexual assault, which we described as ""high violence,"" ""alcohol-related,"" and ""moderate sexual severity."" Alcohol-related assaults resulted in fewer PTSD symptoms than high-violence assaults at Time 1, but not at Time 2. Alcohol-related and violent assaults resulted in more PTSD symptoms than moderate-severity assaults at both times. The effect of assault-characteristics clusters on Time 2 PTSD was mediated by Time 1 self-blame and turning against social reactions. The importance of considering effects of violence and alcohol consumption during the assault to better understand postassault PTSD, including implications for theory and practice, are discussed.",0,0 +4275,The SCID-II and DIB-R interviews: diagnostic association with poor outcome risk factors in Borderline Personality Disorder.,"This study assesses whether patients diagnosed with Borderline Personality Disorder (BPD) according to the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) or the Revised Diagnostic Interview for Borderlines (DIB-R) present differences in factors associated with risk of poor outcome. Three hundred fifty-two patients were evaluated with SCID-II and DIB-R. Patients diagnosed as BPD according to one or both instruments were compared in BPD poor outcome risk factors. The analysis was conducted on the participants who were assigned to SCID-II (n = 135) and SCID-II/DIB-R (n = 126) groups. The group diagnosed with BPD according the combined SCID-II/DIB-R interview showed a significantly greater association with risk of poor outcome predictors, such as total number of comorbid Axis II disorders, number of BPD criteria, presence of comorbid paranoid personality disorder, and worse occupational status. No differences between groups were found in the affective instability BPD criterion, self-reported impulsivity, post-traumatic stress disorder, major depressive disorder or presence of any cluster C comorbidity. The observed differences were large enough to advise caution in generalizing findings from studies without considering what measurement was used for the BPD diagnosis.",0,0 +4276,Commentary: Stalking risk profile.,"Paul Mullen and his colleagues have developed a Stalking Risk Profile that is the latest model for assessing and managing stalkers. The model includes an assessment of the nature of the relationship between the stalker and his victim; the stalker's motivations; the general psychological, psychopathological, and social realities of the stalker; the circumstances of the victim, and the legal and mental health context. The model is not an actuarial scale, but rather an assessment to be used on a case-by-case basis. It recommends certain standardized tests as part of the assessment. The Stalker Risk Profile is the most thorough risk assessment to date. It includes victim variables and provides specifics for assessment and specifics for treatment of the stalker.",0,0 +4277,Children and Disasters: Understanding Impact and Enabling Agency,"From a child rights perspective disaster impacts affect not only a child’s basic right to survival and development, but cut across their right to participate and for decisions to be made in their best interests. Child-centred approaches recognise the role and rights of children as citizens and agents of change, seeking to engage them in DRR/CCA (Disaster Risk Reduction/Climate Change Adaptation) decision-making and accountability processes and supporting child-centred community-based programmes of action. The research produced two papers, one on Undertanding Impacts of disasters on child welfare, and the second to identify the factors which create an enabling environment for children to engage in climate change and disaster risk reduction. This report synthesises the research outputs to produce a comprehensive report looking into the need both for child sensitive programmes to tackle disasters and climate change, but also at the need for child participation in programming and policy.",0,0 +4278,Salivary Oxytocin and Vasopressin Levels in Police Officers With and Without Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) is characterised by symptoms associated with maladaptive fear and stress responses, as well as with social detachment. The neuropeptides oxytocin (OT) and arginine vasopressin (AVP) have been associated with both regulating fear and neuroendocrine stress responsiveness and social behaviour. However, there is only limited evidence for dysregulated peripheral OT and AVP levels in PTSD patients. The present study aimed to investigate basal salivary OT and AVP levels in trauma-exposed male and female police officers with and without PTSD. Saliva samples were collected during rest and OT and AVP levels were determined using a radioimmunoassay. Men and women were analysed separately, having adjusted for differences in trauma history, and for hormonal contraception use in women. The results showed that male PTSD patients had lower basal salivary OT levels, and did not differ in AVP levels compared to male trauma-exposed healthy controls after adjusting for childhood emotional abuse. There were no significant differences in basal salivary OT and AVP levels in women. Our findings indicate potential dysfunctioning of the OT system in male PTSD patients. Future studies are needed to replicate these findings and to further unravel the relationship between the OT and AVP systems, sex, trauma history and PTSD.",0,0 +4279,Longitudinal measures of hostility in deployed military personnel,"Increases in anger and hostility are commonly found after military deployment. However, it is unknown how anger and hostility develop over time, and which veterans are more at risk for developing these complaints. Data of 745 veterans one month before deployment to Afghanistan and one, six, twelve and 24 months after deployment were analyzed in a growth model. Growth mixture modeling revealed four classes based on their growth in hostility. Most of the participants belonged to a low-hostile group or a mild-hostile group that remained stable over time. Two smaller groups were identified that displayed increase in hostility ratings after deployment. The first showed an immediate increase after deployment. The second showed a delayed increase between twelve and 24 months after deployment. No groups were identified that displayed a decrease of hostility symptoms over time. Multinomial logistic regression was applied to predict group membership by age, education, early trauma, deployment stressors and personality factors. This study gains more insight into the course of hostility over time, and identifies risk factors for the progression of hostility.",0,0 +4280,A pilot longitudinal study of hippocampal volumes in pediatric maltreatment-related posttraumatic stress disorder,"Adult posttraumatic stress disorder (PTSD) is associated with decreased hippocampal volumes; however, decreased hippocampal volumes were not seen in pediatric maltreatment-related PTSD. We examined hippocampal volumes longitudinally to determine if a history of childhood traumatic stress alters hippocampal growth during puberty.Magnetic resonance imaging was used to measure temporal lobes, amygdala, and hippocampal volumes in nine prepubertal maltreated subjects with pediatric maltreatment-related PTSD and nine sociodemographically matched healthy nonmaltreated yoked control subjects at baseline and after at least 2 years follow-up (during the later stages of pubertal development) using identical equipment and measurement methodology.Temporal lobe, amygdala and hippocampal volumes did not differ between groups at baseline, follow-up, or across time.Whereas these data are from a small sample, the results do not support hippocampal changes in pediatric maltreatment-related PTSD.",0,0 +4281,PTSD in Service Members and New Veterans of the Iraq and Afghanistan Wars: A Bibliography and Critique,,0,0 +4282,Investigating Subtypes of Child Development,"Two classification methods, latent class cluster analysis and cluster analysis, are used to identify groups of child behavioral adjustment underlying a sample of elementary school children aged 6 to 11 years. Behavioral rating information across 14 subscales was obtained from classroom teachers and used as input for analyses. Both the procedures and results were compared. The latent class cluster analysis uncovered three classes representing differing levels of children's behavioral adjustment (well adjusted, average adjustment, functionally impaired), whereas the cluster analysis uncovered seven groups of child behavior. Results show a high degree of overlap, and each procedure offers unique information toward classifying child behavior.",0,0 +4283,Deployment Risk Factors and Postdeployment Health Profiles Associated With Traumatic Brain Injury in Heavy Drinking Veterans,"Along with post-traumatic stress disorder (PTSD), mild traumatic brain injury (mTBI) is considered one of the ""signature wounds"" of combat operations in Iraq (Operation Iraqi Freedom [OIF]) and Afghanistan (Operation Enduring Freedom [OEF]), but the role of mTBI in the clinical profiles of Veterans with other comorbid forms of post-deployment psychopathology is poorly understood. The current study explored the deployment risk and postdeployment health profiles of heavy drinking OIF and OEF Veterans as a function of mTBI. Sixty-nine heavy-drinking OIF/OEF Veterans were recruited through a Veterans' Affairs Medical Center and completed questionnaires and structured interviews assessing war-zone experiences, postdeployment drinking patterns, and PTSD symptoms. Veterans with positive mTBI screens and confirmed mTBI diagnoses endorsed higher rates of combat experiences, including direct and indirect killing, and met criteria for PTSD at a higher rate than Veterans without a history of mTBI. Both PTSD and combat experiences independently predicted screening positive for mTBI, whereas only combat experiences predicted receiving a confirmed mTBI diagnosis. mTBI was not associated with any dimension of alcohol use. These results support a growing body of literature linking mTBI with PTSD.",0,0 +4284,Is legal status impacting outcomes of group therapy for posttraumatic stress disorder with male asylum seekers and refugees from Iran and Afghanistan?,"Abstract Background Legal status and other resettlement stressors are known to impact mental health of asylum seekers and refugees. However, the ways in which they interact with treatment of posttraumatic stress disorder (PTSD) with these populations is still poorly understood. The aim of this study was to examine whether legal status and other resettlement stressors influence outcomes of a trauma-focused group PTSD treatment within a day-treatment setting with asylum seekers and refugees. Methods Sixty six male Iranian and Afghan patients with PTSD residing in the Netherlands were assessed with self-rated symptom checklists for PTSD, anxiety and depression, and a demographic questionnaire one week before and two weeks after the treatment. Multivariate linear regression analysis was used to examine the impact of legal status and living arrangements on the treatment outcomes per symptom domain. Results The results suggest that both asylum seekers and refugees can be helped with their mental health complaints with a trauma-focused group therapy for PTSD regardless of their legal status. Obtaining a refugee status in a course of the treatment appears to improve the treatment outcomes. Conclusions Legal status is impacting outcomes of group therapy for PTSD with male asylum seekers and refugees. Asylum seekers may benefit from group treatment regardless of unstable living conditions.",0,0 +4285,Presence of Spontaneous Pain and Comorbid Pain Conditions Identifies Vulvodynia Subgroups,"The aims of the study were to define the heterogeneity of vulvodynia by determining data-driven subgroups within the vulvodynia diagnosis using exploratory cluster analysis and to characterize the subgroups identified.Included were participants in the longitudinal population-based study of vulvodynia in southeast Michigan who screened positive for vulvodynia at least once during the study. A cluster analysis using variables reflecting vulvar pain characteristics and comorbid pain conditions was conducted. Variables reflecting best separation of clusters were used to assign participants to subgroup categories. Demographic, psychiatric, general health, and other vulvar pain characteristics were summarized for each subgroup, followed by multinomial regression and pairwise comparisons of subgroups on these factors.Of 441 women screening positive for vulvodynia during the course of the study, 393 were eligible on the basis of data requirements. Cluster analysis suggested that best subgroup separation was based on the following 2 variables: (1) presence or absence of spontaneous vulvar pain and (2) presence or absence of other comorbid pain conditions. Subgroups did not differ by age or ethnicity. The subgroup having spontaneous pain and other comorbid conditions demonstrated greatest morbidity in general health measures, psychiatric disorders, and other vulvar pain measures. Primary versus secondary vulvodynia did not vary between subgroups and did not assist in subgroup separation in the cluster analysis.Subgroups based on exploratory cluster analysis demonstrated that presence of spontaneous pain and the presence of comorbid pain conditions resulted in best separation of groups. Presence of both spontaneous pain and other comorbid pain conditions identified the group with greatest morbidity.",0,0 +4286,Prevalence of Mental Health Symptoms in Dutch Military Personnel Returning from Deployment to Afghanistan: A 2-year Longitudinal Analysis,"Abstract Objective: Recent studies in troops deployed to Iraq and Afghanistan have shown that combat exposure and exposure to deployment-related stressors increase the risk for the development of mental health symptoms. The aim of this study is to assess the prevalence of mental health symptoms in a cohort of Dutch military personnel prior to and at multiple time-points after deployment. Methods: Military personnel ( n = 994) completed various questionnaires at 5 time-points; starting prior to deployment and following the same cohort at 1 and 6 months and 1 and 2 years after their return from Afghanistan. Results: The prevalence of symptoms of fatigue, PTSD, hostility, depression and anxiety was found to significantly increase after deployment compared with pre-deployment rates. As opposed to depressive symptoms and fatigue, the prevalence of PTSD was found to decrease after the 6-month assessment. The prevalence of sleeping problems and hostility remained relatively stable. Conclusions: The prevalence of mental health symptoms in military personnel increases after deployment, however, symptoms progression over time appears to be specific for various mental health symptoms. Comprehensive screening and monitoring for a wide range of mental health symptoms at multiple time-points after deployment is essential for early detection and to provide opportunities for intervention. Declaration of interest: This project was funded by the Dutch Ministry of Defence.",0,0 +4287,Adjustment disorders: prevalence in a representative nationwide survey in Germany,"ObjectivesThis is the first study to estimate the prevalence of adjustment disorder (AjD) in the general population. A new conceptualisation of AjD as a stress response syndrome was applied, which allowed AjD to be assessed directly from its symptom profile, including intrusive, avoidance and failure-to-adapt symptoms (Maercker et al., Psychopathology 40:135–146, 2007).MethodsPrevalence rates of distressing life events and AjD were estimated from a representative sample of the German general population (n = 2,512) with a broad age range (14–93 years). A questionnaire including a life events checklist and self-rating questions that assessed AjD symptoms and symptom duration were personally handed out by an interviewer.ResultsThe prevalence of AjD fulfilling the criterion of clinically significant impairment was 0.9%; a further 1.4% of the sample was diagnosed with AjD without fulfilling the impairment criterion. In ~72.5% of AjD cases, symptoms had developed 6–24 months prior to assessment. AjD was most often associated with acute events such as moving or chronic stressors such as serious illness, conflicts at the respondent’s job or with friends or neighbours (with ~5% conditional probability each).ConclusionsThe results correspond with the few other studies that have examined the prevalence of AjD, even though a new conceptualisation of the disorder was used. Explorative results regarding the duration of AjD syndromes and symptoms call for further redefinition and empirical investigation of this under-researched mental condition.",0,0 +4288,Exploring the Longitudinal Trajectories of Posttraumatic Stress Disorder in Injured Trauma Survivors,"Objective: The goal of this study was to examine the longitudinal trajectories of posttraumatic stress disorder (PTSD) symptoms in a sample of acutely injured hospitalized civilian trauma survivors who participated in a randomized clinical trial. Prior longitudinal descriptive research has shown that there are distinct trajectories of PTSD symptoms over time in trauma survivors. Limited clinical trial research exists that describes the patterns of the trajectories as well as the risk factors that influence the trajectories for seriously injured trauma-exposed patients. Method: Semiparametric, group-based approach trajectory modeling was used to examine four group trajectories of a subset of data obtained from a previous longitudinal clinical trial. Trajectories examined included resilience, recovery, relapsing/remitting, and chronic symptom patterns. One hundred and ninety-four patients who participated in the randomized clinical trial were assessed at baseline in the days and weeks after injury and then randomized. The associations between previously identified PTSD risk factors and the four trajectories were examined. Results: The risk factors of ethnocultural minority status, psychiatric history, additional life stressors, and depressive symptoms, as well as intervention versus control group status, were found to significantly affect the probability of trajectory group membership for PTSD symptom severity. Conclusions: These findings suggest that there is a need for early PTSD interventions that anticipate differences in injured patients' PTSD trajectory profiles. Stepped care intervention procedures may optimally address the diverse PTSD trajectory patterns observed in injured trauma survivors through the tailoring of intervention timing and dosing.",0,0 +4289,The association between posttraumatic stress symptoms and functional impairment during ongoing conflict in the Democratic Republic of Congo,"► Evaluated the impact of PTSD on perceived health and physical and social functioning. ► Data were collected from 93 adults living in Bunia, Eastern Democratic Republic of Congo. ► People with PTSD reported poor health and high disability scores compared to those without PTSD. ► Of the three PTSD symptom clusters, hyperarousal was most strongly associated with disability. ► People with PTSD had greater health problems, difficulty with social contact and functioning. The Democratic Republic of Congo (DRC) has suffered from a bloody conflict for more than a decade. More than 5,400,000 people died from war-related causes since 1998 and exposure to violence was wide-spread. This study investigated the impact of posttraumatic stress disorder (PTSD) symptoms on perceived health and physical and social functioning, filling an important gap in the current literature. Data were collected from a sample of 93 adults living in Bunia, Eastern Democratic Republic of Congo. Structured in-person interviews included the PTSD section of the Composite International Diagnostic Interview and the World Health Organization Disability Assessment Scale. Additional questions were included to assess social resources. Study recruitment was balanced to achieve equal representation of both sexes and each quarter of town. Forty percent met symptom criteria for probable PTSD. Individuals with PTSD reported poor perceived general health and had high disability scores compared to those without PTSD. Of the three PTSD symptom clusters, hyperarousal was most strongly associated with disability. Individuals with PTSD were significantly more emotionally affected by their health problems than those without PTSD (85% versus 41%), had more difficulties in activities involving social contact (54% versus 16%) and in doing their daily work (54% versus 20%). The impact of war-related violence on mental health is severe in the DRC. Psychosocial interventions developed in conflict areas might be best targeted primarily to supporting social functioning and reducing hyperarousal. Implications for clinical treatment and future directions are discussed.",0,0 +4290,Neuropsychological outcomes of army personnel following deployment to the Iraq war.,"The effects of war-zone deployment on neuropsychological health remain poorly understood. Neuropsychological performance deficits serve as sensitive measures of neural dysfunction and are often associated with psychosocial and occupational problems. Previous studies have not conducted objective neuropsychological assessments both before and after a major war-zone deployment.To examine objective neuropsychological outcomes of Iraq War deployment in a large military cohort.The Neurocognition Deployment Health Study, a prospective, cohort-controlled study conducted at military installations. This report centers on 961 male and female active-duty Army soldiers drawn from the larger cohort. Deploying Army soldiers (n = 654) were examined prior to deployment to Iraq (April-December 2003) and shortly after return (within a mean of 73 days [median, 75 days]; January-May 2005) from Iraq deployment. A comparison group of soldiers (n = 307) similar in military characteristics but not deploying overseas during the study was assessed in sessions timed to be as close as possible to the assessment of deployers. Military unit sampling procedures facilitated representation of combat, combat support, and combat service support functions among both deployers and nondeployers.Individually administered, performance-based neuropsychological tasks. Estimates (beta; the unstandardized parameter estimate) for the absolute differences in adjusted mean outcome scores between deployed and nondeployed groups were determined using generalized estimating equations.Multiple linear regression analyses adjusted for battalion membership revealed that Iraq deployment, compared with nondeployment, was associated with neuropsychological compromise on tasks of sustained attention (beta = 0.11; P<.001), verbal learning (beta = -1.51; P = .003), and visual-spatial memory (beta = -3.82; P<.001). Iraq deployment was also associated with increased negative state affect on measures of confusion (beta = 1.40; P<.001) and tension (beta = 1.24; P<.001). In contrast, deployment was associated with improved simple reaction time (beta = 4.30; P = .003). Deployment effects remained statistically significant after taking into account deployment-related head injury and stress and depression symptoms.Deployment to Iraq is associated with increased risk of neuropsychological compromise. Findings point to the need to investigate further the impact of deployment on neural functioning. Public health implications include consideration of neuropsychological compromise in health prevention and postdeployment clinical and occupational management.",0,0 +4291,Predictors of treatment response to an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder.,"Despite evidence for the efficacy of several treatments for deliberate self-harm (DSH) within borderline personality disorder (BPD), predictors of response to these treatments remain unknown. This study examined baseline demographic, clinical, and diagnostic predictors of treatment response to an adjunctive emotion regulation group therapy (ERGT) for DSH among women with BPD. A recent RCT provided evidence for the efficacy of this ERGT (relative to a treatment-as-usual only waitlist condition). Participants in this study include the full intent-to-treat sample who began ERGT (across treatment and waitlist conditions; n = 51). Baseline diagnostic and clinical data were collected at the initial assessment, and outcome measures of DSH and self-destructive behaviors, emotion dysregulation/avoidance, and BPD symptoms (among others) were administered at pretreatment, posttreatment, and 3- and 9-months posttreatment. Notably, both demographic variables and characteristics of participants' ongoing therapy in the community had minimal impact on treatment response. However, several indicators of greater severity in domains relevant to this ERGT (i.e., baseline emotion dysregulation and BPD criteria, lifetime and recent DSH, and past-year hospitalization and suicide attempts) predicted better responses during treatment and follow-up across the primary targets of treatment. Likewise, several co-occurring disorders (i.e., social phobia, panic disorder, and a cluster B personality disorder) predicted greater improvements in BPD symptoms during treatment or follow-up. Finally, although co-occurring generalized anxiety disorder, posttraumatic stress disorder, and cluster A and C personality disorders were associated with poorer treatment response during follow-up, most of these effects reflected a lack of continued improvements during this period (vs. worsening of symptoms).",0,0 +4292,Biomarkers of PTSD: Neuropeptides and immune signaling,"The biological underpinnings for participation of the immune system in the pathogenesis of Posttraumatic Stress Disorder (PTSD) include evidence for cross-talk between the stress and immune systems, as well as more recently discovered roles for immune system mediators in core behavioral functions such as adult neurogenesis, as well as in processes that underlay synaptic plasticity, such as learning and memory. This article reviews the expanding body of literature on immune system mediators in the periphery and the central nervous system (CNS) in chronic PTSD along with the evidence for increased peripheral inflammation, and excess morbidity and mortality. CNS inflammation has been implicated in the pathogenesis of depression. This literature is briefly reviewed, along with evidence for a possible role for CNS inflammation in PTSD symptoms, especially in individuals who have PTSD with co-morbid depression. Whether the immune system is involved in risk and resilience, or evolution of PTSD symptoms following a trauma event remains to be determined, although hypotheses have been advanced. This paper reviews the current evidence including the novel hypothesis that cellular immunity is implicated in PTSD risk and resilience. Potential research implications and directions are discussed. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0,0 +4293,An Overview of 9/11 Experiences and Respiratory and Mental Health Conditions among World Trade Center Health Registry Enrollees,"To date, health effects of exposure to the September 11, 2001 disaster in New York City have been studied in specific groups, but no studies have estimated its impact across the different exposed populations. This report provides an overview of the World Trade Center Health Registry (WTCHR) enrollees, their exposures, and their respiratory and mental health outcomes 2-3 years post-9/11. Results are extrapolated to the estimated universe of people eligible to enroll in the WTCHR to determine magnitude of impact. Building occupants, persons on the street or in transit in lower Manhattan on 9/11, local residents, rescue and recovery workers/volunteers, and area school children and staff were interviewed and enrolled in the WTCHR between September 2003 and November 2004. A total of 71,437 people enrolled in the WTCHR, for 17.4% coverage of the estimated eligible exposed population (nearly 410,000); 30% were recruited from lists, and 70% were self-identified. Many reported being in the dust cloud from the collapsing WTC Towers (51%), witnessing traumatic events (70%), or sustaining an injury (13%). After 9/11, 67% of adult enrollees reported new or worsening respiratory symptoms, 3% reported newly diagnosed asthma, 16% screened positive for probable posttraumatic stress disorder (PTSD), and 8% for serious psychological distress (SPD). Newly diagnosed asthma was most common among rescue and recovery workers who worked on the debris pile (4.1%). PTSD was higher among those who reported Hispanic ethnicity (30%), household income < $25,000 (31%), or being injured (35%). Using previously published estimates of the total number of exposed people per WTCHR eligibility criteria, we estimate between 3,800 and 12,600 adults experienced newly diagnosed asthma and 34,600-70,200 adults experienced PTSD following the attacks, suggesting extensive adverse health impacts beyond the immediate deaths and injuries from the acute event.",0,0 +4294,Symptoms of Trauma and Traumatic Memory Retrieval in Adult Survivors of Childhood Sexual Abuse,"We examined posttraumatic stress symptoms and the memory retrieval process in 2 groups of adult survivors of childhood sexual abuse: 29 participants who reported having memories of their abuse prior to entering therapy (PM) and 13 who reported no memories of abuse prior to therapy (NPM). Participants were asked to indicate on checklists symptoms of constriction, hyperarousal, and intrusion experienced (a) prior to entering therapy and (b) during the surfacing of a memory while in therapy. Overall, the findings indicate that for both groups the same cluster of posttraumatic stress symptoms occurred prior to therapy and during therapy and that there was a continuity of symptoms over time. Participants were also asked to fully describe details of their traumatic memories as these details emerged prior to and/or during therapy. We determined that (a) there were striking similarities in the detailed recall of trauma memories for both groups; (b) memories of abuse emerged in substantial perceptual, somatic, and emotional detail over time before developing into a narrative; (c) the amount of detail remembered increased in the PM group during therapy; (d) members of the NPM group were more kinesthetic than visual in their orientation to the world and may not have had access to the visual information that would associate their symptoms to their abuse; and (e) triggers of traumatic memories were largely the result of internal rather than external stimuli, and these triggers happened primarily outside of therapy sessions.",0,0 +4295,Impact of Evidence-Based Standardized Assessment on the Disability Clinical Interview for Diagnosis of Service-Connected PTSD: A Cluster-Randomized Trial,"Posttraumatic stress disorder (PTSD) is one of the fastest growing compensated medical conditions. The present study compared usual disability examiner practices for PTSD with a standardized assessment that incorporates evidence-based assessments. The design was a multicenter, cluster randomized, parallel-group study involving 33 clinical examiners and 384 veterans at 6 Veterans Affairs medical centers. The standardized group incorporated the Clinician Administered PTSD Scale and the World Health Organization Disability Assessment Schedule-II into their assessment interview. The main outcome measures were completeness and accuracy of PTSD diagnosis and completeness of functional assessment. The standardized assessments were 85% complete for diagnosis compared to 30% for nonstandardized assessments (p < .001), and, for functional impairment, 76% versus 3% (p < .001). The findings demonstrate that the quality of PTSD disability examination would be improved by using evidence-based assessment.",0,0 +4296,An analysis of the internalizing and externalizing behaviors of traumatized urban youth with and without PTSD.,"To test the differential validity of the posttraumatic stress disorder (PTSD) classification, 3 groups of youths (PTSD, traumatized PTSD negatives, and controls) were examined. Youth with major comorbid disorders were excluded. On the basis of an analysis of parent-derived Child Behavior Checklist (CBCL) ratings, significant variations in CBCL scores were associated with PTSD but not with exposure to exceptional stress in the absence of PTSD. The results also indicated that traumatic exposure without the development of PTSD was not associated with higher estimates of psychopathology.",0,0 +4297,MMPI-2 Patterns in Electrical Injury: A Controlled Investigation,"The psychological consequences of electrical injury (EI) are many. Depression, posttraumatic stress disorder, anxiety, and somatic preoccupation are often concomitant with this type of injury (Kelley, Pliskin, Meyer, & Lee, 1994). The present study utilized the MMPI-2 as a tool for characterizing profiles of psychological distress in EI. We examined MMPI-2 profiles in 79 EI patients and their relationship to both injury parameters (i.e., time since injury, LOC, voltage), and extra-diagnostic factors, such as litigation status. EI patient profiles were also compared to individuals with mild traumatic brain injury (TBI), and chronic pain sufferers (CP). Results indicated that in EI, clinical elevations (T > or = 65) were found on the Hs and Hy scales, and approached clinical levels on the D scale. The injury parameter of time since injury was predictive of a distinctive profile, with individuals in the post acute phase experiencing more distress. Compared to other clinical groups, MMPI-2 scores on the Hs and Hy scales were significantly higher within the EI cohort as compared with their CP peers, with higher scores on the Pd scale for CP than EI. No statistically significant differences emerged between the EI and TBI groups. However, TBI patients showed significant elevations on Hy and D compared to CP, and EI patients endorsed more somatic symptoms than CP patients. Implications of these findings and future directions will be discussed.",0,0 +4298,Abnormal Structure of Fear Circuitry in Pediatric Post-Traumatic Stress Disorder,"Structural brain studies of adult post-traumatic stress disorder (PTSD) show reduced gray matter volume (GMV) in fear regulatory areas including the ventromedial prefrontal cortex (vmPFC) and hippocampus. Surprisingly, neither finding has been reported in pediatric PTSD. One possibility is that they represent age-dependent effects that are not fully apparent until adulthood. In addition, lower-resolution MRI and image processing in prior studies may have limited detection of such differences. Here we examine fear circuitry GMV, including age-related differences, using higher-resolution MRI in pediatric PTSD vs healthy youth. In a cross-sectional design, 3 T anatomical brain MRI was acquired in 27 medication-free youth with PTSD and 27 healthy non-traumatized youth of comparable age, sex, and IQ. Voxel-based morphometry was used to compare GMV in a priori regions including the medial prefrontal cortex and amygdala/hippocampus. Compared with healthy youth, PTSD youth had reduced GMV but no age-related differences in anterior vmPFC (BA 10/11, Z=4.5), which inversely correlated with PTSD duration. In contrast, although there was no overall group difference in hippocampal volume, a group × age interaction (Z=3.6) was present in the right anterior hippocampus. Here, age positively predicted hippocampal volume in healthy youth but negatively predicted volume in PTSD youth. Within the PTSD group, re-experiencing symptoms inversely correlated with subgenual anterior cingulate cortex (sgACC, Z=3.7) and right anterior hippocampus (Z=3.5) GMV. Pediatric PTSD is associated with abnormal structure of the vmPFC and age-related differences in the hippocampus, regions important in the extinction and contextual gating of fear. Reduced anterior vmPFC volume may confer impaired recovery from illness, consistent with its role in the allocation of attentional resources. In contrast, individual differences in sgACC volume were associated with re-experiencing symptoms, consistent with the role of the sgACC in fear extinction. The negative relationship between age and hippocampal volume in youth with PTSD may suggest an ongoing neurotoxic process over development, which further contributes to illness expression. Future studies employing a longitudinal design would be merited to further explore these possibilities.",0,0 +4299,Factor analysis of treatment response in posttraumatic stress disorder,"Factor analysis is applied to the symptoms of posttraumatic stress disorder (PTSD) to reduce the multidimensional symptom space to 2 dimensions; 1 dimension strongly correlated with depressive symptoms and 1 independent dimension weakly correlated with depressive symptoms. These factors are used to assess whether the effectiveness of an antidepressant medication is due to its antidepressant effect. The treatment is shown to be effective in both dimensions. The factor analysis sheds light on the symptom structure of PTSD, supports PTSD as a distinct psychiatric disorder, and supports the current diagnostic criteria.",0,0 +4300,Using QMethodology to Identify Reasons for Distress in Burn Survivors Postdischarge,"Reasons for distress after burn injuries have not been codified based on any type of acceptable empirical or statistical technique. The unique design methodology proposed in this study can identify the most common reasons cited for causing distress in burn survivors after discharge. A Q-sort task was developed with the assistance of our burn advisory group. After identifying 50 possible reasons for distress after discharge, each reason was placed on a laminated game card. In compliance with Qmethodology, a game board was developed that allowed patients to rank order each reason from ""not causing distress"" to ""causing significant distress."" A total of 69 burn survivors were enrolled in the study at four different time points: 1 month, 6 months, 1 year and 2 years postdischarge. After factor analysis, four factors accounted for all of the participants across time points. This indicates that at least four distinct groups of people can be categorized according to themes raised in rating reasons for distress. This Q-sort technique allowed us to capture the complexity of conceptualizing human distress by categorizing clusters of reported problems into similar groups. This methodology shows great promise for developing interventions that target unique needs of burn survivors.",0,0 +4301,Guest Editorial—Introduction to the Special Issue,"This special issue in the Journal of Social Work Education is a forum for professional and scholarly discourse on military social work education initiatives developed to educate and train social work professionals and students for practice with military personnel, veterans, and their families across the micro–macro continuum. Special emphasis was given to educational and technological trends, innovations, and challenges related to educating the next generation of social workers to provide evidence-based services to a new generation of veterans that incorporate the CSWE’s (2010) advanced knowledge and practice behaviors in military social work and NASW’s (2012) practice standards. Additional focus was given to university–community and university–military partnerships, collaborations, and initiatives that involve community and military stakeholders. Quantitative, qualitative, mixed methods, and conceptual manuscripts from researchers, educators, and practitioners on military social work education and practice were solicited from the professional social work community. In this special issue we highlight select exemplars of the social work profession’s unique contributions to military social work education. The issue is divided into two sections: (1) discourse on the integration of military social work into professional social work education and (2) innovative military social work education and training programs for doctoral and master’s students, student veterans, and licensed social work professionals—many including program evaluation and other research components. Each section is described in following paragraphs, including a brief overview of representative manuscripts. Integration of Military Social Work Into Professional Social Work Education Four manuscripts highlight military social work as a field of practice requiring specialized knowledge and skills, teaching strategies based on the CSWE competencies and advanced practice behaviors in military social work, the inclusion of military and veteran culture in social work education curricula, and adapting social work field placements for training in military social work practice. Wooten presents a rationale for military social work as a specialized field of practice, the need for military social work education, and opportunities and challenges for professional social work education. She delineates foundation and advanced knowledge in military social work and concludes by proposing an integrated model of intellectual capital to guide strategic planning for professional military social work education in addition to professional infrastructure needed to develop intellectual capital in military social work. For social work educators unfamiliar with military and veteran culture, Daley provides examples of teaching strategies based on CSWE’s advanced practice behaviors in military social work for integration into social work courses, specifically focusing on their application to CSWE’s Educational Policy and Accreditation Standards (EPAS; CSWE, 2008). He identifies foundation and advanced year military social work educational goals based on EPAS 2.1.1 to 2.1.10 and suggests that the infusion of military social work across the social work curriculum will assist students and faculty in becoming more sensitive to the issues faced by military service members, veterans, and their families. Continuing the application of CSWE’s EPAS to military social work education, Canfield and Weiss proposes the inclusion of military-related material into the foundation courses of undergraduate and graduate social work education because social workers providing services in civilian settings not focused on military-related difficulties may encounter military personnel, veterans, and families who seek services outside of the DoD and VA. Key issues, military examples, and resources are recommended for the integration of military culture into human behavior in the social environment, generalist practice, research methods, and social policy core curricula. With a focus on field education as the signature pedagogy of social work education, Selber, Chavkin, and Biggs advance a promising field instruction model in military social work with the growing student veteran population on American campuses. This innovative approach to field education expands placement opportunities beyond the VA for professional training in service delivery to current and past military cohorts.",0,0 +4302,Clinical Presentation and Therapeutic Interventions for Posttraumatic Stress Disorder Post-Katrina,"It has been almost 2 years since Hurricane Katrina struck the Gulf Coast. These 2 years can be characterized by constant struggle and pain as the people try to reattain some semblance of life as they knew it before Katrina struck. Some have chosen to leave their ancestral homes, homes where they were raised and where they, in turn, raised their own families. Those who did leave are able, in some way, to reestablish some semblance of normality, but those who stayed showed manifestations of and dealt with psychological trauma. These manifestations include regression, inattentiveness, aggressiveness, somatic complaints, irritability, social withdrawal, nightmares, and crying. Longer lasting effects may include depression, anxiety, adjustment disorders, and interpersonal or academic difficulties. These postdisaster manifestations can linger or remain hidden until well after the traumatic event and could persist for years. This article presents issues about the effects of Katrina on the mental health of the people of New Orleans. It discusses the profile of posttraumatic stress disorder and presents evidence-based review of interventions the health care provider can implement to care for those who continue to suffer the effects of this horrific disaster.",0,0 +4303,Posttraumatic Stress Disorder and Motor Vehicle Accidents: A Multidisciplinary Overview,"Objective: Motor vehicle accidents (MVA) may result in intractable disability. This paper investigates posttraumatic stress disorder (PTSD) as a potential cause. Method: The literature was reviewed for recent studies on prevalence, symptom profile, and outcome of PTSD. Results: PTSD is prevalent in roughly 10% of survivors of MVAs during the first year. Comorbid depression and pain are common. Medical complications, psychophysiological reactivity, and possibly litigation may slow remission. Phobic symptoms can persist for years. Mood disturbance may augment the impact of pain on daily living and on self-perceived disability. Conclusion: Recently developed screening instruments, structured interviews, and behavioural approach tests yield quantitative and reliable assessments of symptom severity. Cognitive–behavioural intervention and antidepressants may improve coping, ease fear, and reduce the impact of pain.",0,0 +4304,Animal models of post-traumatic stress disorder and recent neurobiological insights,"Post-traumatic stress disorder (PTSD) is a complex psychiatric disorder characterized by the intrusive re-experiencing of past trauma, avoidant behavior, enhanced fear, and hyperarousal following a traumatic event in vulnerable populations. Preclinical animal models do not replicate the human condition in its entirety, but seek to mimic symptoms or endophenotypes associated with PTSD. Although many models of traumatic stress exist, few adequately capture the complex nature of the disorder and the observed individual variability in susceptibility of humans to PTSD. In addition, various types of stressors may produce different molecular neuroadaptations that likely contribute to the various behavioral disruptions produced by each model, although certain consistent neurobiological themes related to PTSD have emerged. For example, animal models report traumatic stress-induced and trauma reminder-induced alterations in neuronal activity in the amygdala and prefrontal cortex, in agreement with the human PTSD literature. Models have also provided a conceptual framework for the often-observed combination of PTSD and comorbid conditions such as alcohol use disorder. Future studies will continue to refine preclinical PTSD models in hope of capitalizing on their potential to deliver new and more efficacious treatments for PTSD and associated psychiatric disorders.",0,0 +4305,Assessing adolescent mental health in war-affected societies: the significance of symptoms,"To compare the use of self-report symptom checklists with qualitative methods for assessing adolescent psychological well-being in a war-affected society.A school-based sample of three hundred and thirty seven 13- to 15-year-olds from two communities on opposite sides of the Bosnian conflict (183 from Gorazde, 154 from Foca) completed the Hopkins Symptoms Checklist and the Harvard Trauma Questionnaire. A gender balanced sub-sample of 40 adolescents was selected on the basis of their combined checklist scores, including equal numbers of high and low scorers from each side. Over the following 6 months this sub-sample was assessed (blind to checklist scores) with qualitative methods that included narrative interviews of child and parent, and participant observation. School marks were taken as a measure of social function.QUALITATIVE: Some children identified as ""less well"" by qualitative methods denied having symptoms. Some children identified as ""well"" had symptoms with no pathological significance for them. The lifeline revealed that feeling ""less well"" could be more related to post-war circumstances than war events. QUANTITATIVE: The two symptom checklist items have shown good internal consistency and discriminant validity. However, comparison with the overall well being revealed that still in 9/40 of cases the reported presence or absence of symptoms did not correspond to the well being of the child. Items of the two questionnaires did not discriminate reliably between children identified as ""well"" and ""less well"" by other means.Self-report checklists may be useful as a public health measure to assess the prevalence of psychological distress in war affected areas, but they are not an adequate means of clinical screening. Checklists used in combination with other qualitative approaches make it possible to identify those in need and avoid unnecessary pathologizing.",0,0 +4306,Prior experience as a moderator of disaster impact on anxiety symptoms in older adults,"As participants in a panel study, 234 older adults were interviewed before, as well as after, serious flooding occurred in southeastern Kentucky. Floods are not uncommon in this area, but these were more widespread than most, and resulted in both previously exposed and newly exposed subsamples of disaster victims. Flood impact was measured at both personal and community levels. With preflood symptoms controlled, there were modest flood effects on both trait anxiety and weather-specific distress in older adults without prior flood experience, but no flood effects in older adults who had been in floods before. Thus, the study provides support for the ""inoculation hypothesis"" and other conceptualizations that emphasize the advantage of being familiar or experienced with a stressor that is at hand. An implication is that ""experienced"" victims could be a valuable resource in prevention efforts.",0,0 +4307,Assessment and treatment in polytrauma contexts: Traumatic brain injury and posttraumatic stress disorder.,"(from the chapter) Military personnel deployed to Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) return from combat with injuries that were fatal in previous wars. This is partially due to more rapid and sophisticated medical responses on the battlefield and partially to improved protective equipment, such as Kevlar vests (Sayer et al., 2008; Warden, 2006). Protective gear and armored vehicles protect soldiers from mortal internal injuries but not from bodily trauma or concussive brain injuries. Recent studies have found that the great majority of injuries were due to explosions, and many involve more than one area of the body (i.e., polytrauma; Sayer et al., 2008). Physical injury during deployment is associated with a higher prevalence of PTSD postdeployment (J. E. Kennedy et al., 2007; Stein & McAllister, 2009). In a recent survey, 9% of soldiers returning from deployment without physical injury screened positive for PTSD (Hoge et al., 2008); however, the rate was almost double (16%) among those reporting bodily injury during deployment. This rate is similar to an earlier study assessing the increased risk of PTSD due to combat-related injury (Koren, Norman, Cohen, Berman, & Klein, 2005). Finally, another postdeployment survey of veterans revealed that the incidence of PTSD increased with the number of injury mechanisms: 14% for one, 29% for two, and 51% for three or more (Schneiderman, Braver, & Kang, 2008). This chapter focuses on how to adapt the assessment and treatment of posttraumatic stress disorder (PTSD) to returning veterans with polytraumatic injuries, especially when the polytrauma involves a traumatic brain injury (TBI). We begin with a review of the empirical literature addressing the prevalence of PTSD in polytrauma populations and the degree to which polytrauma alters PTSD severity and treatment response. Although the evidence base regarding best models of clinical management of PTSD when accompanied by TBI is in its infancy, we present suggestions for assessment of polytrauma and outline techniques and tools useful in optimizing psychosocial and psychopharmacological PTSD treatment interventions in polytrauma contexts. (PsycINFO Database Record (c) 2015 APA, all rights reserved)",0,0 +4308,Mental health of Iraqi children,,0,0 +4309,Annual Research Review: Positive adjustment to adversity - trajectories of minimal-impact resilience and emergent resilience,"Background: Research on resilience in the aftermath of potentially traumatic life events (PTE) is still evolving. For decades, researchers have documented resilience in children exposed to corrosive early environments, such as poverty or chronic maltreatment. Relatively more recently, the study of resilience has migrated to the investigation of isolated PTE in adults. Methods: In this article, we first consider some of the key differences in the conceptualization of resilience following chronic adversity versus resilience following single-incident traumas, and then describe some of the misunderstandings that have developed about these constructs. To organize our discussion, we introduce the terms emergent resilience and minimal-impact resilience to represent trajectories of positive adjustment in these two domains, respectively. Results: We focused in particular on minimal-impact resilience, and reviewed recent advances in statistical modeling of latent trajectories that have informed the most recent research on minimal-impact resilience in both children and adults and the variables that predict it, including demographic variables, exposure, past and current stressors, resources, personality, positive emotion, coping and appraisal, and flexibility in coping and emotion regulation. Conclusions: The research on minimal-impact resilience is nascent. Further research is warranted with implications for a multiple levels of analysis approach to elucidate the processes that may mitigate or modify the impact of a PTE at different developmental stages.",0,0 +4310,Military Personnel With Traumatic Brain Injuries and Insomnia Have Reductions in PTSD and Improved Perceived Health Following Sleep Restoration: A Relationship Moderated by Inflammation,"Background: Up to one-third of deployed military personnel sustain a traumatic brain injury (TBI). TBIs and the stress of deployment contribute to the vulnerability for chronic sleep disturbance, resulting in high rates of insomnia diagnoses as well as symptoms of posttraumatic stress disorder (PTSD), depression, and declines in health-related quality of life (HRQOL). Inflammation is associated with insomnia; however, the impact of sleep changes on comorbid symptoms and inflammation in this population is unknown. Methods: In this study, we examined the relationship between reported sleep changes and the provision of the standard of care, which could include one or more of the following: cognitive behavioral therapy (CBT), medications, and continuous positive airway pressure (CPAP). We compared the following: (a) the group with a decrease in the Pittsburgh Sleep Quality Index (PSQI; restorative sleep) and (b) the group with no change or increase in PSQI (no change). Independent t tests and chi-square tests were used to compare the groups on demographic and clinical characteristics, and mixed between-within subjects analysis of variance tests were used to determine the effect of group differences on changes in comorbid symptoms. Linear regression models were used to examine the role of inflammation in changes in symptoms and HRQOL. Results: The sample included 70 recently deployed military personnel with TBI, seeking care for sleep disturbances. Thirty-seven participants reported restorative sleep and 33 reported no sleep changes or worse sleep. The two groups did not differ in demographic characteristics or clinical symptoms at baseline. The TBI + restored sleep group had significant reductions in PTSD and depression over the 3-month period, whereas the TBI + no change group had a slight increase in both PTSD and depression. The TBI + restored sleep group also had significant changes in HRQOL, including the following HRQOL subcomponents: physical functioning, role limitations in physical health, social functioning, emotional well-being, energy/fatigue, and general health perceptions. In a linear regression model using a forced entry method, the dependent variable of change in C-reactive protein (CRP) concentrations was significantly related to changes in PTSD symptoms and HRQOL in the TBI + restored sleep group, with R2 = 0.43, F33,3 = 8.31, p \textless .01. Conclusions: Military personnel with TBIs who have a reduction in insomnia symptoms following a standard-of-care treatment report less severe symptoms of depression and PTSD and improved HRQOL, which relate to decreased plasma concentrations of CRP. These findings suggest that treatment for sleep disturbances in this TBI + military population is associated with improvements in health and decreases in inflammation. The contributions of inflammation-induced changes in PTSD and depression in sleep disturbances in TBI + military personnel require further study. (PsycINFO Database Record (c) 2016 APA, all rights reserved)",0,0 +4311,Family functioning and posttraumatic stress disorder in adolescent survivors of childhood cancer.,"This study investigated family functioning and relationships between family functioning and posttraumatic stress disorder (PTSD) in adolescent survivors of childhood cancer. To assess family functioning, 144 adolescent cancer survivors 1 to 12 years post-cancer treatment (M = 5.3 years) and their parents completed the Family Assessment Device (FAD). To assess PTSD, adolescents were administered a structured diagnostic interview. Nearly half (47%) of the adolescents, one fourth (25%) of mothers, and one third (30%) of fathers reported poor family functioning, exceeding the clinical cutoff on 4 or more FAD subscales. Families in which the cancer survivor had PTSD (8% of the sample) had poorer functioning than other families in the areas of problem solving, affective responsiveness, and affective involvement. Three fourths of the adolescents with PTSD came from families with categorically poor family functioning. A surprisingly high rate of poor family functioning was reported in these families of adolescent cancer survivors. Adolescents with PTSD were more than 5 times as likely to emerge from a poorly functioning family compared with a well-functioning one. This study provides evidence that family functioning is related to cancer-related posttraumatic reactions in adolescent survivors.",0,0 +4312,Impaired psychological recovery in the elderly after the Niigata-Chuetsu Earthquake in Japan:a population-based study,"An earthquake measuring 6.8 on the Richter scale struck the Niigata-Chuetsu region of Japan at 5.56 P.M. on the 23rd of October, 2004. The earthquake was followed by sustained occurrence of numerous aftershocks, which delayed reconstruction of community lifelines. Even one year after the earthquake, 9,160 people were living in temporary housing. Such a devastating earthquake and life after the earthquake in an unfamiliar environment should cause psychological distress, especially among the elderly.Psychological distress was measured using the 12-item General Health Questionnaire (GHQ-12) in 2,083 subjects (69% response rate) who were living in transient housing five months after the earthquake. GHQ-12 was scored using the original method, Likert scoring and corrected method. The subjects were asked to assess their psychological status before the earthquake, their psychological status at the most stressful time after the earthquake and their psychological status at five months after the earthquake. Exploratory and confirmatory factor analysis was used to reveal the factor structure of GHQ12. Multiple regression analysis was performed to analyze the relationship between various background factors and GHQ-12 score and its subscale.GHQ-12 scores were significantly elevated at the most stressful time and they were significantly high even at five months after the earthquake. Factor analysis revealed that a model consisting of two factors (social dysfunction and dysphoria) using corrected GHQ scoring showed a high level of goodness-of-fit. Multiple regression analysis revealed that age of subjects affected GHQ-12 scores. GHQ-12 score as well as its factor 'social dysfunction' scale were increased with increasing age of subjects at five months after the earthquake.Impaired psychological recovery was observed even at five months after the Niigata-Chuetsu Earthquake in the elderly. The elderly were more affected by matters relating to coping with daily problems.",0,0 +4313,Topiramate in the treatment of trichotillomania: an open-label pilot study,"There is a need for an effective medication for the treatment of trichotillomania (TTM), which is an impulse control disorder characterized by chronic hair-pulling. Topiramate has shown promising results in the treatment of impulse-control disorders. The present open-label pilot study investigated the efficacy and safety of topiramate in 14 adults with TTM. Patients received 16 weeks of flexible dose treatment (50-250 mg/day), followed by a flexible dose taper over 2-4 weeks. The primary outcome measure was the Massachusetts General Hospital Hair-Pulling Scale (HPS), whereas secondary outcome measures were the Clinical Global Impression (CGI) Scale, the Montgomery-Asberg Depression Rating Scale, the Hamilton Rating Scale for Anxiety and the Disability Profile. A repeated measures analysis of variance on the intent-to-treat sample was implemented to evaluate treatment response. The primary outcome measure (HPS) indicated that the severity of hair-pulling in adults with TTM who completed the 16-week study (n=9) decreased significantly from baseline to the treatment endpoint (F=5.05; P=0.0002). Although the CGI-Improvement scores suggested that hair-pulling was not significantly reduced, six of nine trial completers were classified as responders. None of the other measures showed significant differences compared to baseline. Five patients dropped out owing to adverse effects. These results suggest that topiramate may be useful in the treatment of TTM. Future studies should investigate the efficacy of topiramate in an appropriately powered randomized placebo-controlled trial.",0,0 +4314,Detecting Alcoholism,,0,0 +4315,Subjective models of psychological disorders: Mental health professional's perspectives,"This exploratory study is an extension of previous studies which have applied personal construct theory (PCP) methodology toward a better understanding of the structure and dynamics of multidisciplinary mental (and physical) health care (Kirkcaldy and Pope, 1992; Kirkcaldy et al., 1993, 2000, 2005; Kirkcaldy and Siefen, 1999). In this study we wanted to use similar cluster statistical analyses, not unlike PCP analysis, to identify the diverse subjective models of psychological ailments such as anxiety, depression, psychosis, mania, obsessive compulsive disorder (OCD), post stress traumatic disorder (PTSD), etc., using not the idiosyncratic constructs generated by individual triadic element comparisons, but by selecting those constructs which have been clearly identified in various psychiatric and psychological rating scales (e.g. somatic preoccupation, social withdrawal, conceptual disorganization, hostility, disinhibition and controlling). Clinical experts (psychological psychotherapists, and medical psychotherapist and psychiatrist) each with over 25 years of clinical and research experience were required to complete the ratings of each disorder listed in terms of the pre-formulated behavioral, emotional and cognitive concepts. What emerged are several multivariate (grid) analyses based on mental health professionals' perception of diverse elements (disorders) and their interrelationship derived from the similarity of composite profiles of ill-related constructs. Overall, the analyses revealed clear associations between the subjective evaluations of psychological ailments suggesting some uniformity in mental health assessment of such disorders. The implications of these findings are discussed within the theoretical framework of improved mental health care.",0,0 +4316,PTSD onset and course following the World Trade Center disaster: findings and implications for future research,"We sought to identify common risk factors associated with posttraumatic stress disorder (PTSD) onset and course, including delayed, persistent, and remitted PTSD following a major traumatic exposure.Based on a prospective study of New York City adults following the World Trade Center disaster (WTCD), we conducted baseline interviews with 2,368 persons one year after this event and then at follow-up 1 year later to evaluate changes in current PTSD status based on DSM-IV criteria.Baseline analysis suggested that current PTSD, defined as present if this occurred in the past 12 months, was associated with females, younger adults, those with lower self-esteem, lower social support, higher WTCD exposure, more lifetime traumatic events, and those with a history of pre-WTCD depression. At follow-up, current PTSD was associated with Latinos, non-native born persons, those with lower self-esteem, more negative life events, more lifetime traumatic events, and those with mixed handedness. Classifying respondents at follow-up into resilient (no PTSD time 1 or 2), remitted (PTSD time 1, not 2), delayed (no PTSD time 1, but PTSD time 2), and persistent (PTSD both time 1 and 2) PTSD, revealed the following: compared to resilient cases, remitted ones were more likely to be female, have more negative life events, have greater lifetime traumatic events, and have pre-WTCD depression. Delayed cases were more likely to be Latino, be non-native born, have lower self-esteem, have more negative life events, have greater lifetime traumas, and have mixed handedness. Persistent cases had a similar profile as delayed, but were the only cases associated with greater WTCD exposures. They were also likely to have had a pre-WTCD depression diagnosis. Examination of WTCD-related PTSD at follow-up, more specifically, revealed a similar risk profile, except that handedness was no longer significant and WTCD exposure was now significant for both remitted and persistent cases.PTSD onset and course is complex and appears to be related to trauma exposure, individual predispositions, and external factors not directly related to the original traumatic event. This diagnostic classification may benefit from additional conceptualization and research as this relates to changes in PTSD status over time.",0,0 +4317,Use of antiepileptic drugs for nonepileptic conditions: Psychiatric disorders and chronic pain,"Antiepileptic drugs (AEDs) are commonly utilized for nonepileptic conditions, including various psychiatric disorders and pain syndromes. Evidence for their benefit in these nonepileptic conditions varies widely among different drugs, but there is, in general, a paucity of published multicenter randomized double-blind trials. Variable levels of evidence suggest that lamotrigine and the vagal nerve stimulator have antidepressant properties. Carbamazepine, valproate, lamotrigine, and oxcarbazepine appear to have mood stabilizing properties while gabapentin, pregabalin, and tiagabine have anxiolytic benefits. Barbiturates, topiramate, and possibly phenytoin may precipitate or exacerbate depression. Underlying depression and anxiety symptoms may be exacerbated by levetiracetam, while psychotic symptoms have rarely been reported with topiramate, levetiracetam, and zonisamide. Pregabalin, gabapentin, carbamazepine, and oxcarbazepine have been used to treat neuropathic pain such as postherpetic neuralgia, and diabetic polyneuropathy. Topiramate and divalproex sodium have utility in the prophylaxis or acute treatment of migraine. Further rigorous studies are needed to clarify the utility of AEDs in nonepileptic conditions.",0,0 +4318,Neurobehavioral sequelae of traumatic brain injury: evaluation and management,"Traumatic brain injury (TBI) is a worldwide public health problem. Over the last several decades, improvements in acute care have resulted in higher survival rates. Unfortunately, the majority of survivors of moderate and severe TBI have chronic neurobehavioral sequelae, including cognitive deficits, changes in personality and increased rates of psychiatric illness. These neurobehavioral problems are understandable in the context of the typical profile of regional brain damage associated with trauma. This paper presents an overview of the neurobehavioral sequelae of TBI and outlines issues to consider in the evaluation and management of these challenges.",0,0 +4319,Post-traumatic stress disorder: current status and future directions,"Provides an overview of current research in posttraumatic stress disorder (PTSD) to provide impetus for studies that will advance the understanding of the effects of high level stressors on individuals in society today. It is suggested that the most important factors that need to be studied in PTSD involve the biological, psychological, and social resources that interact with individuals' experiences of traumatic events. Research on reactions to different types of trauma and on other disorders that develop following exposure to extreme stress is reviewed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4320,Evaluation of an Early Risk Screener for PTSD in Preschool Children After Accidental Injury,"OBJECTIVES: To evaluate the effectiveness and most powerful selection of predictors of an early screening tool for posttraumatic stress disorder (PTSD) in a sample of 87 children ages 2 to 6 years after unintentional injury. METHODS: The examined screener was administered within 6 to 13 days post accident and consisted of an adapted version of the Pediatric Emotional Distress Scale (PEDS), the PEDS-ES (PEDS Early Screener), and questions on 5 additional risk factors (preexisting child behavioral problems, parental preexisting chronic mental or physical illness, pretraumatic life events in the family, parental feelings of guilt, parental posttraumatic stress). The PTSD Semi-structured Interview and Observational Record for Infants and Young Children served as criterion measure 6 months after the accident. A case was deemed positive when meeting criteria for full or partial PTSD. RESULTS: Use of the PEDS-ES without the additional risk factors performed best, with good sensitivity (85%) and moderate specificity (63%) for full or partial PTSD. CONCLUSIONS: The PEDS-ES allows for successful early screening of preschool-aged children after single accidental trauma. It may be used within a stepped-care model for early identification of individuals designated for possible secondary preventative interventions.",0,0 +4321,Latent Class Modeling with Covariates: Two Improved Three-Step Approaches,"Researchers using latent class (LC) analysis often proceed using the following three steps: (1) an LC model is built for a set of response variables, (2) subjects are assigned to LCs based on their posterior class membership probabilities, and (3) the association between the assigned class membership and external variables is investigated using simple cross-tabulations or multinomial logistic regression analysis. Bolck, Croon, and Hagenaars (2004) demonstrated that such a three-step approach underestimates the associations between covariates and class membership. They proposed resolving this problem by means of a specific correction method that involves modifying the third step. In this article, I extend the correction method of Bolck, Croon, and Hagenaars by showing that it involves maximizing a weighted log-likelihood function for clustered data. This conceptualization makes it possible to apply the method not only with categorical but also with continuous explanatory variables, to obtain correct tests using complex sampling variance estimation methods, and to implement it in standard software for logistic regression analysis. In addition, a new maximum likelihood (ML)—based correction method is proposed, which is more direct in the sense that it does not require analyzing weighted data. This new three-step ML method can be easily implemented in software for LC analysis. The reported simulation study shows that both correction methods perform very well in the sense that their parameter estimates and their SEs can be trusted, except for situations with very poorly separated classes. The main advantage of the ML method compared with the Bolck, Croon, and Hagenaars approach is that it is much more efficient and almost as efficient as one-step ML estimation.",0,0 +4322,"PTSD, depression, and their comorbidity in relation to suicidality: cross-sectional and prospective analyses of a national probability sample of women","A growing body of literature implicates major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) as risk factors for suicidal ideation (SI) and suicide attempts (SA), though research has not adequately examined their differential contributions to increasing suicide risk prospectively or cross-sectionally.The contribution of these disorders and their comorbidity to SI and SA was examined using a national household probability sample of women (N=3,085) and covarying for trauma history, substance abuse, and demographic variables.Cross-sectional analyses indicated that lifetime comorbidity of MDD and PTSD were associated with much higher prevalence of SI than either diagnosis alone; prevalence of SI was elevated and comparable for PTSD and MDD only. Comorbid diagnosis and PTSD only groups displayed greater prevalence of SA than those with MDD only. Lastly, a 2-year prospective analysis indicated that PTSD only at baseline was predictive of greater subsequent SI risk than MDD only, though comorbid diagnosis did not differ from either PTSD only or MDD only.PTSD appears to be a particularly strong predictor of SI and SA. Overall, only 16% of women with lifetime SA did not have a history of MDD or PTSD, highlighting the importance of assessing these variables when assessing suicide risk.",0,0 +4323,Mental Health Functioning in the Human Rights Field: Findings from an International Internet-Based Survey,"Human rights advocates play a critical role in promoting respect for human rights world-wide, and engage in a broad range of strategies, including documentation of rights violations, monitoring, press work and report-writing, advocacy, and litigation. However, little is known about the impact of human rights work on the mental health of human rights advocates. This study examined the mental health profile of human rights advocates and risk factors associated with their psychological functioning. 346 individuals currently or previously working in the field of human rights completed an internet-based survey regarding trauma exposure, depression, posttraumatic stress disorder (PTSD), resilience and occupational burnout. PTSD was measured with the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) and depression was measured with the Patient History Questionnaire-9 (PHQ-9). These findings revealed that among human rights advocates that completed the survey, 19.4% met criteria for PTSD, 18.8% met criteria for subthreshold PTSD, and 14.7% met criteria for depression. Multiple linear regressions revealed that after controlling for symptoms of depression, PTSD symptom severity was predicted by human rights-related trauma exposure, perfectionism and negative self-appraisals about human rights work. In addition, after controlling for symptoms of PTSD, depressive symptoms were predicted by perfectionism and lower levels of self-efficacy. Survey responses also suggested high levels of resilience: 43% of responders reported minimal symptoms of PTSD. Although survey responses suggest that many human rights workers are resilient, they also suggest that human rights work is associated with elevated rates of PTSD and depression. The field of human rights would benefit from further empirical research, as well as additional education and training programs in the workplace about enhancing resilience in the context of human rights work.",0,0 +4324,Axis-I Comorbidity in Female Patients With Dissociative Identity Disorder and Dissociative Identity Disorder Not Otherwise Specified,"The aim of this study was to investigate axis-I comorbidity in patients with dissociative identity disorder (DID) and dissociative disorder not otherwise specified (DDNOS). Using the Diagnostic Interview for Psychiatric Disorders, results from patients with DID (n = 44) and DDNOS (n = 22) were compared with those of patients with posttraumatic stress disorder (PTSD) (n = 13), other anxiety disorders (n = 14), depression (n = 17), and nonclinical controls (n = 30). No comorbid disorders were found in nonclinical controls. The average number of comorbid disorders in patients with depression or anxiety was 0 to 2. Patients with dissociative disorders averagely suffered from 5 comorbid disorders. The most prevalent comorbidity in DDNOS and DID was PTSD. Comorbidity profiles of patients with DID and DDNOS were very similar to those in PTSD (high prevalence of anxiety, somatoform disorders, and depression), but differed significantly from those of patients with depression and anxiety disorders. These findings confirm the hypothesis that PTSD, DID, and DDNOS are phenomenologically related syndromes that should be summarized within a new diagnostic category.",0,0 +4325,Prediction of the occurrence and intensity of post-traumatic stress disorder in victims 32 months after bomb attack,"Our objective was to identify factors that predict occurrence and severity of post-traumatic stress disorder (PTSD) after a terrorism attack.We evaluated 32 victims of a bomb attack in a Paris subway in December 1996 at 6 and 32 months.Sociodemographic characteristics, clinical data and physical injuries were used to predict PTSD occurrence and severity in 32 victims. The Watson's PTSD Inventory (PTSD-I) and the Impact of Event Scale (IES) by Horowitz were used to evaluate occurrence and severity of PTSD, respectively.Thirty-nine percent of participants met PTSD criteria at 6 months, 25% still had PTSD at 32 months. Women had PTSD 32 months after the bomb attack more frequently than men. Employment predicted PTSD severity at 32 months. PTSD scores assessed by PTSD-I at 6 months were significantly and positively associated with IES scores at 32-month follow-up (r = 0.55, P = 0.004). Psychotropic drug use before the bomb attack significantly predicted PTSD occurrence and severity at 6 and 32 months. In a linear regression model, physical injuries, employment status and psychotropic drug use before the bomb attack were independent predictors of severity of PTSD at 32 months.Bomb attack exposure resulted in persisting PTSD in a significant proportion of victims; the severity was predicted at 32 months by physical injuries and psychotropic drug use before the terrorism attack and by the PTSD score few months after the bomb attack.",0,0 +4326,"Association between posttraumatic stress, depression, and functional impairments in adolescents 24 months after traumatic brain injury","The degree to which postinjury posttraumatic stress disorder (PTSD) and/or depressive symptoms in adolescents are associated with cognitive and functional impairments at 12 and 24 months after traumatic brain injury (TBI) is not yet known. The current study used a prospective cohort design, with baseline assessment and 3-, 12-, and 24-month followup, and recruited a cohort of 228 adolescents ages 14-17 years who sustained either a TBI (n = 189) or an isolated arm injury (n = 39). Linear mixed-effects regression was used to assess differences in depressive and PTSD symptoms between TBI and arm-injured patients and to assess the association between 3-month PTSD and depressive symptoms and cognitive and functional outcomes. Results indicated that patients who sustained a mild TBI without intracranial hemorrhage reported significantly worse PTSD (Hedges g = 0.49, p = .01; Model R(2) = .38) symptoms across time as compared to the arm injured control group. Greater levels of PTSD symptoms were associated with poorer school (η(2) = .07, p = .03; Model R(2) = .36) and physical (η(2) = .11, p = .01; Model R(2) = .23) functioning, whereas greater depressive symptoms were associated with poorer school (η(2) = .06, p = .05; Model R(2) = .39) functioning.",0,0 +4327,An Examination of the CROPS and BASC-2-SRP-A among Adjudicated Youth,"This study explored the Behavior Assessment System for Children Second Edition Self Report of Personality-Adolescent (BASC-2-SRP-A) and the Child Report of Post-traumatic Stress (CROPS) profiles of a sample of adjudicated youth. Results were consistent with previous research, indicating that 56% of CROPS scores fell within the clinically significant range. Cronbach’s alpha indicated good internal consistency of the 26-item CROPS. In addition, Anxiety was found to contribute most to distinguishing between the clinically significant and clinically non-significant CROPS groups, followed by the Social Stress and Somatization subscales. Gender differences, implications, and future directions are discussed.",0,0 +4328,Emotion Regulation Difficulties in Trauma Survivors: The Role of Trauma Type and PTSD Symptom Severity,"Two different hypotheses regarding the relationship between emotion regulation and PTSD are described in the literature. First, it has been suggested that emotion regulation difficulties are part of the complex sequelae of early-onset chronic interpersonal trauma and less common following late-onset or single-event traumas. Second, PTSD in general has been suggested to be related to emotion regulation difficulties. Bringing these two lines of research together, the current study aimed to investigate the role of trauma type and PTSD symptom severity on emotion regulation difficulties in a large sample of trauma survivors (N=616). In line with the hypotheses, PTSD symptom severity was significantly associated with all variables assessing emotion regulation difficulties. In addition, survivors of early-onset chronic interpersonal trauma showed higher scores on these measures than survivors of single-event and/or late-onset traumas. However, when controlling for PTSD symptom severity, the group differences only remained significant for 2 out of 9 variables. The most robust findings were found for the variable ""lack of clarity of emotions."" Implications for future research, theoretical models of trauma-related disorders, and their treatment will be discussed.",0,0 +4329,Post-traumatic stress disorders in children and adolescents,"(from the chapter) Children and adolescents surviving a life-threatening disaster show a wide range of symptoms which tend to cluster around signs of re-experiencing the traumatic event, trying to avoid dealing with the emotions that this gives rise to, and a range of signs of increased physiological arousal. There may be considerable co-morbidity with depression, generalized anxiety or pathological grief reactions. Topics include: manifestations of stress reactions in children and adolescents; effects on younger children (risk and protective factors age, gender, ability and attainment, family factors, prevalence, single vs repeated or chronic stressors, objective factors, subjective factors, single vs multiple traumas, disorders of extreme stress not otherwise specified); developmental issues (case examples); assessing posttraumatic stress disorder (PTSD) in children; treatment of PTSD (critical incident stress debriefing, group treatments, individual treatment, contingency planning). (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4330,Portuguese version of the PTSD Checklist-Military Version (PCL-M)-I: Confirmatory Factor Analysis and reliability,"The PTSD Checklist-Military Version (PCL-M) is a brief self-report instrument widely used to assess Post-traumatic Stress Disorder (PTSD) symptomatology in war Veterans, according to DSM-IV. This study sought out to explore the factor structure and reliability of the Portuguese version of the PCL-M. A sample of 660 Portuguese Colonial War Veterans completed the PCL-M. Several Confirmatory Factor Analyses were conducted to test different structures for PCL-M PTSD symptoms. Although the respecified first-order four-factor model based on King et al.'s model showed the best fit to the data, the respecified first and second-order models based on the DSM-IV symptom clusters also presented an acceptable fit. In addition, the PCL-M showed adequate reliability. The Portuguese version of the PCL-M is thus a valid and reliable measure to assess the severity of PTSD symptoms as described in DSM-IV. Its use with Portuguese Colonial War Veterans may ease screening of possible PTSD cases, promote more suitable treatment planning, and enable monitoring of therapeutic outcomes.",0,0 +4331,Family Resilience Following a Physical Trauma and Efficient Support Interventions: A Critical Literature Review,"The concept of resilience was first associated with physics and engineering, but it has since held the interest of thinkers and researchers from many other fields, including ecology, economics, computer science, and social science. The definition has also been expanded to now include family and community. Thus, the concept of resilience has been modified according to the various contexts or fields of interest with which it is associated. From an etymological perspective, the term resilience is comprised of the prefix re, meaning again, and salire, meaning jump (Anaut, 2008; Poilpot, 2003). In physics, resilience refers to the capacity of a material to resist a shock (Murry, 2004), whereas in ecology, it refers to a species' or an ecosystem's capacity to return to normal functioning or development following a trauma (Holling, 1973). In economics, resilience is the capacity for an economy to get back on track following a crash or crisis (Richemond, 2003), and in computer science, it is the quality of a system that ensures it continues to function properly in spite of defects of one or several components (Collin, 2013). In psychology, individual resilience refers to the ability to succeed, live, and continue to grow despite adversity (Cyrulnik, 2002, 2003, 2006; Tisseron, 2007). Researchers in nursing, for their part, generally retain the same definition of resilience as those in psychology; specifically that individual resilience is the ability to successfully navigate changes and difficulties (Mandleco & Peery, 2000; Wagnild & Young, 1993). Definitions Several definitions of family resilience have been developed in the past few years, most of which seem to be inspired by individual resilience, but when studied in a family context the concept becomes more complex. For some authors, family resilience refers to the success of family members in overcoming difficulties in the wake of a trauma (Black & Lobo, 2008), or represents the strength a family taps into to change its dynamic in order to solve the problems encountered (Delage, 2004, 2008; Lee et al., 2004; McCubbin & McCubbin, 1988, Walsh, 2006). According to Michael Ungar (2010), family resilience necessarily includes interactions with the environment in which the family evolves. In other words, it is important to consider the family's environment when talking about resilience. Moreover, again according to Ungar (2010), family resilience is influenced by what transpired before, during, and after the trauma, hence the reference to a process. Recently, Genest (2012) studied the process of resilience, which she defined as complex and multidimensional, in order to develop a theoretical model of resilience in families grieving the loss of an adolescent who committed suicide. Genest defines family resilience as a process during which a family confronted with a traumatic situation, despite the psychological and physical suffering endured, overcame it. Without a doubt, the most important contribution of her research is its pragmatic aspect, which proposes intervention methods for health care professionals according to the different types of resilience observed in the families interviewed during this process. For his part, Gauvin-Lepage (2013) conducted an empirical study with the aim of co-constructing the elements of an intervention program that would support the resilience process of families of adolescents with a moderate or severe traumatic brain injury, involving both families and rehabilitation professionals. The research process allowed the author to define family resilience as: (...) a complex human process that is deployed when a family is confronted with a trauma. Thus, the family will undertake a fluctuating process of transformation, according to the meaning it ascribes to the situation. The interrelation of elements inherent to the family and its environment will influence this process, positively or negatively, to achieve a positive reconstruction of the life project. …",0,0 +4332,One Quintillion Ways to Have PTSD Comorbidity: Recommendations for the Disordered DSM-5,"Galatzer-Levy and Bryant (Perspect Psychol Sci 8:651-662, 2013) have calculated the number of ways that Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; American Psychiatric Association, 2013) posttraumatic stress disorder (PTSD) symptoms can be combined as over 600,000. They concluded that the amount is astounding and the category is rendered amorphous. PTSD often occurs in the context of polytrauma or comorbidity. The epidemiological literature indicates that the most common comorbid conditions in cases of PTSD include major depressive disorder (MDD), chronic pain, neurocognitive disorder due to traumatic brain injury (e.g., mild), and alcohol use disorder, with premorbid personality disorder possible, as well (which we consider as exacerbated due to the traumatic incident at issue, as in borderline personality disorder). We calculated the possible symptom combinations for each of these disorders and then in comorbid combination with PTSD (e.g., PTSD with MDD, but also when all six conditions are present). The number of symptom combinations in full polytrauma involving all six conditions listed is truly astounding, over one quintillion. Also, we reviewed the range of PTSD comorbidities, which adds to the symptom heterogeneity in cases. We make recommendations to prioritize symptoms in disorders as primary (e.g., unique, marker), secondary (e.g., core essential), and tertiary (e.g., common, cross-diagnostic). The latter tertiary type of symptoms in a disorder, if any, should be kept apart in its own criterion. This approach might help make the next version of the DSM more clinically useful both to clinicians and to court. © 2014 Springer Science+Business Media New York.",0,0 +4333,Which factors influence the development of post-traumatic stress disorder in patients with burn injuries? A systematic review of the literature,"This article aims to discover which variables influence the development of post-traumatic stress disorder in patients with burn injuries. It will also consider whether it is possible to predict which burns patients will develop PTSD.Post-traumatic stress disorder is an important psychopathology for burned patients as it can affect both physical outcomes and quality of life for those affected. Research states that PTSD may be identified in up to 30% of burns patients, making it relatively common.A systematic review of the literature was carried out using four databases. Eleven articles were identified from these searches, and were then analysed thematically to draw out common ideas.Gender, extraversion and neuroticism, attribution of blame, capacity for forgiveness, the event as a disaster or non-disaster, alcohol consumption and peri-traumatic emotional response were all found to influence burns patients' risk of developing PTSD.While it is possible to identify the factors that put burns patients are greater risk of developing PTSD, it is not possible to accurately predict who will go on to develop PTSD due to the interplay between variables and individual differences. Focus should instead be on screening for PTSD and timely recognition of intrusive symptoms.",0,0 +4334,Factors influencing social and health outcomes after motor vehicle crash injury: an inception cohort study protocol,"There is growing evidence that health and social outcomes following motor vehicle crash injury are related to cognitive and emotional responses of the injured individual, as well as relationships between the injured individual and the compensation systems with which they interact. As most of this evidence comes from other states in Australia or overseas, investigation is therefore warranted to identify the key determinants of health and social outcomes following injury in the context of the New South Wales motor accident insurance scheme.In this inception cohort study, 2400 participants, aged 17 years or more, injured in a motor vehicle crash in New South Wales will be identified though hospital emergency departments, general and physiotherapy practitioners, police records and a government insurance regulator database. Participants will be initially contacted through mail. Baseline interviews will be conducted by telephone within 28 days of the injury and participants will be followed up with interviews at 6, 12 and 24 months post-injury. Health insurance and pharmaceutical prescription data will also be collected.The study results will report short and long term health and social outcomes in the study sample. Identification of factors associated with health and social outcomes following injury, including related compensation factors will provide evidence for improved service delivery, post-injury management, and inform policy development and reforms.Australia New Zealand Clinical trial registry identification number--ACTRN12613000889752. Available at: ANZCTR Registered FISH Study.",0,0 +4335,"Childhood adversities: Social support, premorbid functioning and social outcome in first-episode psychosis and a matched case-control group","Objective: The establishment of childhood adversities as risk factors for non-affective psychosis has derived a need to consider alternative interpretations of several psychosis-related factors. This paper sought to examine premorbid adjustment trajectories and social outcome factors in relation to childhood adversities. Perceived support has been found to decrease the risk of post-traumatic stress disorder, and we wished to compare perceived support in people with first-episode psychosis to non-clinical control persons and explore its relation to childhood adversities. Method: Every individual presenting with a non-affective first-episode psychosis (F20–29, except F21) in Region Zealand over a 2-year period was approached for participation and the 101 consenting participants were matched to 101 people with no psychiatric disorders. Comprehensive demographic data were collected. Assessment instruments included the Premorbid Assessment Scale, the Global Assessment of Functioning scale and the Childhood Trauma Questionnaire. The latter represented the childhood adversities in addition to parental separation and institutionalization. Results: There were no associations between number of childhood adversities and different social or academic premorbid trajectories. Those with more adversities had lower global functioning the year prior to treatment start and reported lower rates of perceived support during childhood along with less current face-to-face contact with family members. Lack of peer support remained a significant predictor of psychosis when adversities were adjusted for; peer support diminished the risk of psychosis caused by childhood adversities by 10%. Conclusion: Childhood adversities may not predict specific premorbid trajectories, but have an effect on global functioning when the psychosis has begun. Perceived support, especially from peers, may be important in the development of psychosis, and those with more adversities may represent a vulnerable subgroup who need more assistance to increase and maintain supportive networks.",0,0 +4336,"Relationships Among Depression, PTSD, Methamphetamine Abuse, and Psychosis","Objective: Research suggests several possible associations among methamphetamine abuse, psychotic symptoms, depression, and posttraumatic stress disorder (PTSD), but the exact nature and clinical significance of these associations is unclear. Individuals who abuse methamphetamine increasingly present in hospital emergency rooms with acute psychiatric symptoms. The aim of this study was to identify patterns of depressive symptoms and explore predictors of acute versus sustained depressive symptoms in individuals who abuse methamphetamine and who have had psychotic symptoms. Methods: This longitudinal study, conducted in Vancouver, British Columbia, included 295 participants with methamphetamine use disorder who were seeking psychiatric help for depressive or psychotic symptoms, assessed at baseline and monthly for 6 months. Measures included substance use (including frequency, quantity, and route of administration), family history of psychosis and depression, trauma exposure, and PTSD symptoms. Results: Tr...",0,0 +4337,"Epigenetics and child abuse: Modern-day darwinism - The miraculous ability of the human genome to adapt, and then adapt again","It has long been recognized that early adversity can have life-long consequences, and the extent to which this is true is gaining increasing attention. A growing body of literature implicates Adverse Childhood Experiences, including physical, sexual, and emotional abuse, in a broad range of negative health consequences including adult psychopathology, cardiovascular, and immune disease. Increasing evidence from animal, clinical, and epidemiological studies highlight the critical role of epigenetic programing, such as DNA methylation and histone modification, in altering gene expression, brain structure and function, and ultimately life-course trajectories. This review outlines our developing insight into the interplay between our human biology and our changing environment, and explores the growing evidence base for how interventions may prevent and ameliorate damage inflicted by toxic stress in early life.",0,0 +4338,Numbing symptoms as predictors of unremitting posttraumatic stress disorder,"This prospective longitudinal study examined the ability of re-experiencing, avoidance, numbing, and hyperarousal symptoms to predict persistence of posttraumatic stress disorder (PTSD) in disaster workers followed for 2 years. Cluster analyses suggested that overall severity was the best predictor of PTSD at follow up, but for groups with PTSD of moderate severity, numbing symptoms were also associated with PTSD at the 2-year follow up. Regression analyses with all four symptom groups as independent variables found that only numbing and re-experiencing symptoms predicted PTSD at the 1 year follow up, and only numbing symptoms predicted PTSD at the 2-year follow up. Findings suggest that numbing symptom severity could be used as a risk index of very chronic PTSD, especially when the overall PTSD severity falls in the moderate range.",0,0 +4339,Discrepancy in Diagnosis and Treatment of Post-traumatic Stress Disorder (PTSD): Treatment for the Wrong Reason,"In primary care (PC), patients with post-traumatic stress disorder (PTSD) are often undiagnosed. To determine variables associated with treatment, this cross-sectional study assessed 592 adult patients for PTSD. Electronic medical record (EMR) review of the prior 12 months assessed mental health (MH) diagnoses and MH treatments [selective serotonin reuptake inhibitor (SSRI) and/or ≥1 visit with MH professional]. Of 133 adults with PTSD, half (49%; 66/133) received an SSRI (18%), a visit with MH professional (14%), or both (17%). Of those treated, 88% (58/66) had an EMR MH diagnosis, the majority (71%; 47/66) depression and (18%; 12/66) PTSD. The odds of receiving MH treatment were increased 8.2 times (95% CI 3.1-21.5) for patients with an EMR MH diagnosis. Nearly 50% of patients with PTSD received MH treatment, yet few had this diagnosis documented. Treatment was likely due to overlap in the management of PTSD and other mental illnesses.",0,0 +4340,"Linking Human Systems: Strengthening Individuals, Families, And Communities in the Wake of Mass Trauma","This article presents an overview of the philosophy and practical principles underlying the Linking Human Systems Approach based on the theory of resilience in individuals, families, and communities facing crisis, trauma, and disaster. The Link Approach focuses on tapping into the inherent strength of individuals and their families and emphasizes resilience rather than vulnerability. It has been successfully used in combating critical public health problems, such as addiction, HIV/AIDS, and recovery from major trauma or disaster. Also, three specific models of Link intervention aimed at the individual, family, and community levels are discussed, with special emphasis on the family-level intervention. These interventions are directed toward mobilizing resources for long-term physical, emotional, psychological, and spiritual healing.",0,0 +4341,Dimensions and Dissociation in PTSD in the DSM-5: Towards Eight Core Symptoms,"The article reviews the literature on the dimensional (factor) structure of posttraumatic stress disorder (PTSD) as presented in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; American Psychiatric Association, 2013). The DSM-5 PTSD diagnostic category contains 20 symptoms split into four factors. Also, the article considers the literature on the dissociative subtype, which is found in a minority of PTSD cases. The literature shows that the DSM (Diagnostic and Statistical Manual of Mental Disorders) over the years has moved from a three-dimensional structure in prior DSMs to one with four dimensions in the DSM-5. However, the research reviewed queries whether the DSM-5’s four dimensions are consistent with the empirical literature; in this regard, models with five and six dimensions were the first to suggest alternatives. Moreover, in the literature, the DSM-5 symptoms appear to group into as many as seven dimensions, which are as follows: re-experiencing, avoidance, negative affect, anhedonia, externalizing behavior, anxious arousal, and dysphoric arousal (Armour et al., Journal of Psychiatric Research 61: 106–113, 2015; Wang et al., Journal of Anxiety Disorders 31: 90–97, 2015). In particular, the two DSM-5 dimensions of negative alterations in cognitions and mood and alterations in arousal and reactivity appear to be subdivided into five dimensions. Generally, the 20 PTSD symptoms and their suggested factors that are found in the literature could prove unwieldy to clinicians. Moreover, they allow for much heterogeneity in symptom expression among PTSD cases. In response, the article presents a model of PTSD based on the seven-factor dimensional structure emerging in the literature, as well as another factor associated with the dissociation subtype, but with one core or primary symptom specified for each of the dimensions. The article considers forensic implications of the newer models on PTSD’s dimensional structure. © 2015, Springer Science+Business Media New York.",0,0 +4342,The List of Threatening Experiences: a subset of 12 life event categories with considerable long-term contextual threat,"In a survey of a random sample of the general population recent life events, collected and rated for long-term contextual threat according to the methods of Brown & Harris (1978), were also recorded where possible on an inventory of life event categories (Tennant & Andrews, 1977). Of the 82.5% of all events collected which were covered by the inventory, 12 of the 67 event categories accounted for 77% of life events with an aetiologicaly significant rating of marked or moderate long-term threat. Where practical and economic constraints oblige research workers to choose the inventory method, a brief list of event categories, such as the List of Threatening Experiences, is recommended in preference to much longer lists.",0,0 +4343,"Emotionality, emotion regulation, and adaptation among 5- to 8-year-old children.","This study investigated relations between emotionality, emotion regulation, and children's behavioral adaptation in a longitudinal design. Mothers rated emotionality and emotion regulation related to anger, fear, and positive emotions-exuberance for 151 children at age 5 and later at age 6 years 6 months. Emotionality and emotion regulation measures were modestly related. Preschool ratings at age 6 (n = 125), maternal ratings at age 6 years 6 months (n = 133), and elementary school ratings at age 8 (n = 135) of problems and competence were also collected. High anger emotionality and low regulation of positive emotions and exuberance predicted externalizing problem behavior and prosocial behavior. High fear emotionality and low fear regulation predicted internalizing problem behavior. There were few interactive effects of emotionality and regulation.",0,0 +4344,An examination of the structure of posttraumatic stress disorder in relation to the anxiety and depressive disorders,"The nature and structure of posttraumatic stress disorder (PTSD) has been the subject of much interest in recent times. This research has been represented by two streams, the first representing a substantive body of work which focuses specifically on the factor structure of PTSD and the second exploring PTSD's relationship with other mood and anxiety disorders. The present study attempted to bring these two streams together by examining structural models of PTSD and their relationship with dimensions underlying other mood and anxiety disorders. PTSD, anxiety and mood disorder data from 989 injury survivors interviewed 3-months following their injury were analyzed using a series of confirmatory factor analyses (CFA) to identify the optimal structural model. CFA analyses indicated that the best fitting model included PTSD's re-experiencing (B1-5), active avoidance (C1-2), and hypervigilance and startle (D4-5) loading onto a Fear factor (represented by panic disorder, agoraphobia and social phobia) and the PTSD dysphoria symptoms (numbing symptoms C3-7 and hyperarousal symptoms D1-3) loading onto an Anxious Misery/Distress factor (represented by depression, generalized anxiety disorder and obsessive compulsive disorder). The findings have implications for informing potential revisions to the structure of the diagnosis of PTSD and the diagnostic algorithm to be applied, with the aim of enhancing diagnostic specificity.",0,0 +4345,Differential responses to trauma: Migration-related discriminants of post-traumatic stress disorder among Southeast Asian refugees,"This study examined possible differentiating experiences between Post-Traumatic Stress Disorder (PTSD) and non-PTSD refugees, after matching them on certain demographic characteristics and exposure to trauma. Previous research on predictors of PTSD usually has not controlled for differences in trauma exposure between the comparison groups. By examining individuals who have had similar traumatic histories, this study more clearly identified some factors implicated in the development of PTSD among Southeast Asians. To increase comparability with previous PTSD research, all events were assessed with reference to three time frames involving premigration, migration, and postmigration periods. The role of anger reactions was also examined in view of previous findings from the veteranbased PTSD research. Finally, this study ascertained the influence of acculturation and cultural identity orientation because these variables often have been implicated in the adjustment of Asian Americans. Results from the present study indicate that respondents with PTSD appeared to experience and express much more anger and were more dependent on public assistance. They were also less engaged in maintaining their cultural traditions and ties. However, more life changes and a trend toward more separations and reunifications with family members were evidenced for those without PTSD. The implications of these findings in developing community intervention strategies for Southeast Asian refugees who have experienced trauma are discussed.",0,0 +4346,Early predictors of chronic post-traumatic stress disorder in assault survivors,"ABSTRACT Background Some studies suggest that early psychological treatment is effective in preventing chronic post-traumatic stress disorder (PTSD), but it is as yet unclear how best to identify trauma survivors who need such intervention. This prospective longitudinal study investigated the prognostic validity of acute stress disorder (ASD), of variables derived from a meta-analysis of risk factors for PTSD, and of candidate cognitive and biological variables in predicting chronic PTSD following assault. Method Assault survivors who had been treated for their injuries at a metropolitan Accident and Emergency (A&E) Department were assessed with structured clinical interviews to establish diagnoses of ASD at 2 weeks ( n =222) and PTSD at 6 months ( n =205) after the assault. Candidate predictors were assessed at 2 weeks. Results Most predictors significantly predicted PTSD status at follow-up. Multivariate logistic regressions showed that a set of four theory-derived cognitive variables predicted PTSD best (Nagelkerke R 2 =0·50), followed by the variables from the meta-analysis (Nagelkerke R 2 =0·37) and ASD (Nagelkerke R 2 =0·25). When all predictors were considered simultaneously, mental defeat, rumination and prior problems with anxiety or depression were chosen as the best combination of predictors (Nagelkerke R 2 =0·47). Conclusion Questionnaires measuring mental defeat, rumination and pre-trauma psychological problems may help to identify assault survivors at risk of chronic PTSD.",0,0 +4347,Increased Framingham 10-year risk of coronary heart disease in middle-aged and older patients with psychotic symptoms,"The Framingham 10-risk of coronary heart disease (CHD) has been a widely studied estimate of cardiovascular risk in the general population. However, few studies have compared the relative risk of developing CHD in antipsychotic-treated patients with different psychiatric disorders, especially in older patients with psychotic symptoms. In this study, we compared the 10-year risk of developing CHD among middle-aged and older patients with psychotic symptoms to that in the general population.We analyzed baseline data from a study examining metabolic and cardiovascular effects of atypical antipsychotics in patients over age 40 with psychotic symptoms. After excluding patients with prior history of CHD and stroke, 179 subjects were included in this study. Among them, 68 had a diagnosis of schizophrenia, 42 mood disorder, 38 dementia, and 31 PTSD. Clinical evaluations included medical and pharmacologic treatment history, physical examination, and clinical labs for metabolic profiles. Using the Framingham 10-year risk of developing CHD based on the Framingham Heart Study (FHS), we calculated the risk CHD risk for each patient, and then compared relative risk in each psychiatric diagnosis to the risks reported in the FHS.The mean age of entire sample was 63 (range 40-94) years, 68% were men. The Framingham 10-year risk of CHD was increased by 79% in schizophrenia, 72% in PTSD, 61% in mood disorder with psychosis, and 11% in dementia relative to the risk in general population from the FHS.In this sample of middle-aged and older patients with psychotic symptoms, we found a significantly increased 10-year risk of CHD relative to the estimated risk from FHS, with the greatest increased risk for patients with schizophrenia and PTSD. Development of optimally tailored prevention and intervention efforts to decrease different risk components in these patients could be an important step to help decrease the risks of CHD and overall mortality in this vulnerable population.",0,0 +4348,Aerobic Exercise Reduces Symptoms of Posttraumatic Stress Disorder: A Randomized Controlled Trial,"Evidence suggests aerobic exercise has anxiolytic effects; yet, the treatment potential for posttraumatic stress disorder (PTSD) and responsible anxiolytic mechanisms have received little attention. Emerging evidence indicates that attentional focus during exercise may dictate the extent of therapeutic benefit. Whether benefits are a function of attentional focus toward or away from somatic arousal during exercise remains untested. Thirty-three PTSD-affected participants completed two weeks of stationary biking aerobic exercise (six sessions). To assess the effect of attentional focus, participants were randomized into three exercise groups: group 1 (attention to somatic arousal) received prompts directing their attention to the interoceptive effects of exercise, group 2 (distraction from somatic arousal) watched a nature documentary, and group 3 exercised with no distractions or interoceptive prompts. Hierarchal linear modeling showed all groups reported reduced PTSD and anxiety sensitivity (AS; i.e., fear of arousal-related somatic sensations) during treatment. Interaction effects between group and time were found for PTSD hyperarousal and AS physical and social scores, wherein group 1, receiving interoceptive prompts, experienced significantly less symptom reduction than other groups. Most participants (89%) reported clinically significant reductions in PTSD severity after the two-week intervention. Findings suggest, regardless of attentional focus, aerobic exercise reduces PTSD symptoms.",0,0 +4349,Is Poor Sleep in Veterans a Function of Post-Traumatic Stress Disorder?,"Substantial research has demonstrated an association between post-traumatic stress disorder (PTSD) and quality of sleep, particularly in veteran populations. The exact nature of this relationship, however, is not clear. The possibility that poor sleep is a more general experience among veterans has not been explored to date, with most studies focusing only on veteran populations with PTSD. This pilot study aimed to explore whether sleep disturbance is common to veterans generally or simply those with PTSD. Data were collected from a community sample of 152 Australian Vietnam war veterans, 87 of whom did not meet criteria for PTSD. All those with PTSD and 90% of those without PTSD reported clinically significant sleep disturbance, indicating that serious sleep problems are common across the veteran population. Despite the limitations of this initial study, these results highlight the importance of ensuring that research into sleep disorders in veterans with PTSD pays attention to the potential etiological role of other military factors, including deployments.",0,0 +4350,A real-world study of the effectiveness of DBT in the UK National Health Service,"Objectives. Dialectical behavioral therapy (DBT) has gained widespread popularity as a treatment for borderline personality disorder (BPD), and its efficacy has been demonstrated in several trials. The aim of this study was to evaluate the effectiveness of DBT delivered by staff with a level of training readily achievable in National Health Service care settings for individuals with a Cluster B personality disorder. Design. Randomized control trial methodology was used to compare DBT to treatment as usual (TAU). Method. Forty-two participants entered the trial. Diagnostic and outcome measures were undertaken at assessment, at 6 months, and at 1 year. The clinical outcomes in routine evaluation – outcome measure (CORE-OM) were utilized as the primary outcome measure. Results. Both the DBT and TAU groups improved on the range of measures employed. The DBT group showed a slightly greater decrease in CORE-OM risk scores, suicidality, and post-traumatic stress disorder symptom severity. However, the TAU group showed comparable reductions in all measures and a larger decrease in para-suicidal behaviours and risk. Conclusions. DBT may be an effective treatment delivered by community outpatient services for individuals with a Cluster B personality disorder. Further studies are needed to consider the impact of experience and adherence to DBT in improving outcome.",0,0 +4351,Evidence-Based Practice with Women: Toward Effective Social Work Practice with Low-Income Women Evidence-based practice with women: Toward effective social work practice with low-income women,"This one-of-a-kind book presents evidence-based coverage of the assessment and treatment of the most common mental health disorders among women, particularly low-income women. For each disorder-depression, post-traumatic stress disorder and trauma (including sexual abuse), generalized anxiety disorder, substance use disorder, and borderline personality disorder-the authors include assessment instruments and detailed case examples that illustrate the assessment and treatment recommendations. © 2011 by SAGE Publications, Inc.",0,0 +4352,"Posttraumatic growth, posttraumatic stress disorder and resilience of motor vehicle accident survivors","Abstract Background Although some previous studies have suggested that posttraumatic growth (PTG) is comprised of several factors with different properties, few have examined both the association between PTG and posttraumatic stress disorder (PTSD) and between PTG and resilience, focusing on each of the factors of PTG. This study aimed to examine the hypothesis that some factors of PTG, such as personal strength, relate to resilience, whereas other factors, such as appreciation of life, relate to PTSD symptoms among Japanese motor vehicle accident (MVA) survivors. Methods This cross-sectional study was performed with 118 MVA survivors at 18 months post MVA. Data analyzed included self-reporting questionnaire scores on the Posttraumatic Growth Inventory (PTGI), the Impact of Event Scale- Revised (IES-R), and the Sense of Coherence (SOC) scale, which is one of the most widely used scales for measuring resilience. Correlations between scores on the PTGI and IES-R, the PTGI and SOC scale, and the IES-R and SOC scale were established by calculating Spearman's correlation coefficients. Results PTGI was positively correlated with both SOC and PTSD symptoms, in spite of an inverse relationship between SOC and PTSD symptoms. Relating to others, new possibilities, and personal strength on the PTGI were correlated positively with SOC, and spiritual change and appreciation of life on the PTGI were positively correlated with PTSD symptoms. Conclusions Some factors of PTG were positively correlated with resilience, which can be regarded as an outcome of coping success, whereas other factors of PTG were positively correlated with PTSD symptoms, which can be regarded as signifying coping effort in the face of enduring distress. These findings contribute to our understanding of the psychological change experienced by MVA survivors, and to raising clinicians' awareness of the possibility that PTG represents both coping effort coexisting with distress and outcome of coping success.",0,0 +4353,The traumatic stress response in child maltreatment and resultant neuropsychological effects,"Child maltreatment is a pervasive problem in our society that has long-term detrimental consequences to the development of the affected child such as future brain growth and functioning. In this paper, we surveyed empirical evidence on the neuropsychological effects of child maltreatment, with a special emphasis on emotional, behavioral, and cognitive process–response difficulties experienced by maltreated children. The alteration of the biochemical stress response system in the brain that changes an individual’s ability to respond efficiently and efficaciously to future stressors is conceptualized as the traumatic stress response. Vulnerable brain regions include the hypothalamic–pituitary–adrenal axis, the amygdala, the hippocampus, and prefrontal cortex and are linked to children’s compromised ability to process both emotionally-laden and neutral stimuli in the future. It is suggested that information must be garnered from varied literatures to conceptualize a research framework for the traumatic stress response in maltreated children. This research framework suggests an altered developmental trajectory of information processing and emotional dysregulation, though much debate still exists surrounding the correlational nature of empirical studies, the potential of resiliency following childhood trauma, and the extent to which early interventions may facilitate recovery.",0,0 +4354,Unique relations between counterfactual thinking and DSM–5 PTSD symptom clusters.,"Cognitive models of posttraumatic stress disorder (PTSD) propose that rumination about a trauma may increase particular symptom clusters. One type of rumination, termed counterfactual thinking (CFT), refers to thinking of alternative outcomes for an event. CFT centered on a trauma is thought to increase intrusions, negative alterations in mood and cognitions (NAMC), and marked alterations in arousal and reactivity (AAR). The theorized relations between CFT and specific symptom clusters have not been thoroughly investigated. Also, past work has not evaluated whether the relation is confounded by depressive symptoms, age, gender, or number of traumatic events experienced.The current study examined the unique associations between CFT and PTSD symptom clusters according to the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013) in 51 trauma-exposed treatment-seeking individuals.As predicted, CFT was associated with all PTSD symptom clusters. After controlling for common predictors of PTSD symptom severity (i.e., age, depressive symptoms, and number of traumatic life events endorsed), we found CFT to be significantly associated with the intrusion and avoidance symptom clusters but not the AAR or NAMC symptom clusters.Results from the present study provide further support for the role of rumination in specific PTSD symptom clusters above and beyond symptoms of depression, age, and number of traumatic life events endorsed. Future work may consider investigating interventions to reduce rumination in PTSD. (PsycINFO Database Record",0,0 +4355,"Posttraumatic stress disorder after a school shooting: effects of symptom threshold selection and diagnosis by DSM-III, DSM-III-R, or proposed DSM-IV","The purpose of the study was to investigate the effect of symptom threshold and criteria set selections on the diagnosis of posttraumatic stress disorder (PTSD) in adults and children exposed to a man-made disaster and determine how well DSM-III and its successors agree.Data gathered in the course of a voluntary clinical screening for PTSD in 66 adults and 64 children 6 to 14 months after exposure to a school shooting were analyzed according to DSM-III, DSM-III-R, and proposed DSM-IV criteria for PTSD diagnosis and cluster endorsement using liberal (occurring at least a little of the time), moderate (occurring at least some of the time), and conservative (occurring at least much or most of the time) symptom thresholds.Within DSM-III, DSM-III-R, and proposed DSM-IV, selection of liberal, moderate, and conservative symptom thresholds had robust effects on rates of diagnoses; liberal thresholds allowed the greatest frequencies of diagnosis. Compared with DSM-III and proposed DSM-IV, DSM-III-R generally diagnosed the fewest cases. Agreements between DSM-III-R and proposed DSM-IV were good, while agreements between DSM-III and its successors varied for children and adults.Diagnostic rates and agreements were complexly influenced by interactions among threshold and revisions in symptom clusters. The present study suggests that attempts to refine PTSD classification consider specification of symptom threshold intensity and supports the view that modification of criteria sets be undertaken with caution.",0,0 +4356,The General Self-Efficacy Scale: Multicultural Validation Studies,"General self-efficacy is the belief in one's competence to cope with a broad range of stressful or challenging demands, whereas specific self-efficacy is constrained to a particular task at hand. Relations between general self-efficacy and social cognitive variables (intention, implementation intentions, outcome expectancies, and self-regulation), behavior-specific self-efficacy, health behaviors, well-being, and coping strategies were examined among 1,933 respondents in 3 countries: Germany (n = 633), Poland (n = 359), and South Korea (n = 941). Participants were between 16 and 86 years old, and some were dealing with stressful situations such as recovery from myocardial events or tumor surgery. Perceived self-efficacy was measured by means of the General Self-Efficacy Scale (R. Schwarzer & M. Jerusalem, 1995). Meta-analysis was used to determine population effect sizes for four sets of variables. Across countries and samples, there is consistent evidence for associations between perceived self-efficacy and the variables under study confirming the validity of the psychometric scale. General self-efficacy appears to be a universal construct that yields meaningful relations with other psychological constructs.",0,0 +4357,"The relationship between anxiety and depression: A clinical comparison of generalized anxiety disorder, dysthymic disorder, panic disorder, and major depressive disorder","This study examined the relationship between the chronic disorders, generalized anxiety disorder (GAD) and dysthymic disorder (DD), and the more acute disorders, panic disorder (PD) and major depressive disorder (MDD) in 110 psychiatric outpatients with diagnoses of either PD, MDD, GAD, or DD. Pure, mixed, and early-/late-onset forms of the chronic disorders were compared with each other and then with PD and MDD on clinical measures and psychiatric history. Minimal differences were found between pure GAD and mixed GAD or between pure DD and mixed DD. The chronic disorders, DD and GAD, had distinct clinical symptom profiles when compared with each other and appeared more closely related to their parent disorders than to each other. However, despite these similarities, there were significant differences between DD and MDD in contrast to the minimal differences between GAD and PD, providing less support for GAD as a valid diagnostic category separate from PD. Comparisons of early-/late-onset DD and GAD showed more severe symptoms in late-onset DD, in contrast to more severe symptoms in early-onset GAD. These varying patterns of symptom severity may warrant study for further syndromal delineation.",0,0 +4358,Association of exposure to intimate-partner physical violence and potentially traumatic war-related events with mental health in Liberia,"Liberia's wars between 1989 and 2003 resulted in hundreds of thousands of casualties and millions of victims. Gender-based violence was widespread during the conflict. Since the end of the war, however, little attention has been paid to ongoing violence against women, especially within the household. This research examines the relationships between intimate-partner physical violence, war experiences, and mental health nearly ten years after the end of the war. The study is based on a nationwide cross-sectional, multistage stratified cluster random survey of 4501 adults using structured interviews during a six-week period in November and December 2010. The main outcome measures are prevalence of intimate-partner physical violence, exposure to potentially traumatic war-related events, symptoms of Post-Traumatic Stress Disorder (PTSD) and depression. Among adult women, 37.7% (95%CI, 34.9-40.5; n = 852/2196) reported lifetime exposure to intimate-partner physical violence and 24.4% (95%CI, 22.1-26.9; n = 544/2196) reported incidence of intimate-partner physical violence over a one-year recall period. Among men, 23.2% (95%CI, 20.8-25.9, n = 475/2094) reported having severely beaten their spouse or partner over their lifetime; the incidence over the one-year recall was 12.2% (95%CI, 10.4-14.2, n = 259/2094). Among adult residents in Liberia, 10.6% (95%CI, 9.5-11.7, n = 546/4496) met the criteria for symptoms of depression, and 12.6% (95% CI, 11.5-13.9, n = 608/4496) met the criteria for symptoms of PTSD. Intimate-partner physical violence as a victim and as a perpetrator was significantly associated with exposure to potentially traumatic war-related events, especially among men. Among women, experiencing intimate-partner physical violence was associated with symptoms of PTSD and depression. Among men, perpetrating intimate-partner physical violence was associated with symptoms of PTSD and depression after adjusting for exposure to potentially traumatic war-related events. These findings suggest that intimate-partner physical violence may be a continued stressor in post-war societies that needs to be recognized and addressed as part of the reconstruction effort.",0,0 +4359,Neuronal DNA Methylation Profiling of Blast-Related Traumatic Brain Injury,"Long-term molecular changes in the brain resulting from blast exposure may be mediated by epigenetic changes, such as deoxyribonucleic acid (DNA) methylation, that regulate gene expression. Aberrant regulation of gene expression is associated with behavioral abnormalities, where DNA methylation bridges environmental signals to sustained changes in gene expression. We assessed DNA methylation changes in the brains of rats exposed to three 74.5 kPa blast overpressure events, conditions that have been associated with long-term anxiogenic manifestations weeks or months following the initial exposures. Rat frontal cortex eight months post-exposure was used for cell sorting of whole brain tissue into neurons and glia. We interrogated DNA methylation profiles in these cells using Expanded Reduced Representation Bisulfite Sequencing. We obtained data for millions of cytosines, showing distinct methylation profiles for neurons and glia and an increase in global methylation in neuronal versus glial cells (p<10(-7)). We detected DNA methylation perturbations in blast overpressure-exposed animals, compared with sham blast controls, within 458 and 379 genes in neurons and glia, respectively. Differentially methylated neuronal genes showed enrichment in cell death and survival and nervous system development and function, including genes involved in transforming growth factor β and nitric oxide signaling. Functional validation via gene expression analysis of 30 differentially methylated neuronal and glial genes showed a 1.2 fold change in gene expression of the serotonin N-acetyltransferase gene (Aanat) in blast animals (p<0.05). These data provide the first genome-based evidence for changes in DNA methylation induced in response to multiple blast overpressure exposures. In particular, increased methylation and decreased gene expression were observed in the Aanat gene, which is involved in converting serotonin to the circadian hormone melatonin and is implicated in sleep disturbance and depression associated with traumatic brain injury.",0,0 +4360,"Attention-Deficit/Hyperactivity Disorder Diagnosis, Co-Morbidities, Treatment Patterns, and Quality of Life in a Pediatric Population in Central and Eastern Europe and Asia","Attention deficit/hyperactivity disorder (ADHD) is often poorly understood, and treatment practices are variable. This 12-month, prospective, observational study provides information about the diagnosis, co-morbidities, treatment patterns, and quality of life (QOL) of patients aged 6–17 years with ADHD symptoms from eastern Asia and central and eastern Europe. Here, we present baseline data for the 1068 enrolled and eligible patients in the study (median age 8 years, 82.2% male). Patients were grouped into two cohorts based on whether they were prescribed psycho- and/or pharmacotherapy (n = 794) or not (n = 274) at study entry. On average, patients receiving treatment were significantly older (9.1 vs. 8.4 years, p < 0.001), more severely ill (Clinical Global Impressions [CGI]-ADHD-S, 4.6 vs. 4.2, p < 0.001; Child Symptom Inventory-4 Parent Checklist (CSI-4) ADHD:C, 35.2 vs. 31.9, p < 0.001), and had significantly higher CSI-4 symptom severity scores relating to various co-morbidities than patients not receiving treatment. At study initiation, patient's health-related QOL was significantly impaired as measured on the Child Health and Illness Profile–Child Edition (CHIP-CE) rating scale, with significantly more impairment in the treated group of patients for the Comfort, Risks Avoidance, and Achievement domains. These results provide a description of ADHD and treatment practices in these regions and establish a baseline for gauging changes over time in the study sample.",0,0 +4361,Posttraumatic Stress Disorder and Posttraumatic Growth Among Adult Survivors of Wenchuan Earthquake After 1 Year: Prevalence and Correlates,"

Abstract

This study investigates the prevalence and predictors for posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) in adult survivors 1year after the 2008 Wenchuan earthquake. Questionnaires were used to collect the data. PTSD was assessed using the PTSD Check List-Civilian (PCL-C), and PTG was assessed using the Post Traumatic Growth Inventory (PTGI). A total of 2,300 individuals were involved in the survey with 2,080 completing the questionnaire, a response rate of 90.4%. The PTSD prevalence estimate in this study was found to be 40.1%, and the prevalence for PTG among the participants was measured at 51.1%. A bivariate correlation analysis indicated that there was a positive association between PTG and PTSD. In the conclusions, possible explanations for the findings and implications for future research are discussed.",0,0 +4362,Influences of Maternal and Paternal PTSD on Epigenetic Regulation of the Glucocorticoid Receptor Gene in Holocaust Survivor Offspring,"Differential effects of maternal and paternal posttraumatic stress disorder (PTSD) have been observed in adult offspring of Holocaust survivors in both glucocorticoid receptor sensitivity and vulnerability to psychiatric disorder. The authors examined the relative influences of maternal and paternal PTSD on DNA methylation of the exon 1F promoter of the glucocorticoid receptor (GR-1F) gene (NR3C1) in peripheral blood mononuclear cells and its relationship to glucocorticoid receptor sensitivity in Holocaust offspring.Adult offspring with at least one Holocaust survivor parent (N=80) and demographically similar participants without parental Holocaust exposure or parental PTSD (N=15) completed clinical interviews, self-report measures, and biological procedures. Blood samples were collected for analysis of GR-1F promoter methylation and of cortisol levels in response to low-dose dexamethasone, and two-way analysis of covariance was performed using maternal and paternal PTSD as main effects. Hierarchical clustering analysis was used to permit visualization of maternal compared with paternal PTSD effects on clinical variables and GR-1F promoter methylation.A significant interaction demonstrated that in the absence of maternal PTSD, offspring with paternal PTSD showed higher GR-1F promoter methylation, whereas offspring with both maternal and paternal PTSD showed lower methylation. Lower GR-1F promoter methylation was significantly associated with greater postdexamethasone cortisol suppression. The clustering analysis revealed that maternal and paternal PTSD effects were differentially associated with clinical indicators and GR-1F promoter methylation.This is the first study to demonstrate alterations of GR-1F promoter methylation in relation to parental PTSD and neuroendocrine outcomes. The moderation of paternal PTSD effects by maternal PTSD suggests different mechanisms for the intergenerational transmission of trauma-related vulnerabilities.",0,0 +4363,HIV-Related Posttraumatic Stress Disorder: Investigating the Traumatic Events,"This study examined the relationship between the experience of various HIV-related events (receiving the diagnosis, receiving treatment, experiencing physical symptoms, self-disclosing HIV positive status, and witnessing HIV-related death) and posttraumatic stress symptoms in a sample of 100 gay men living with HIV. Self-report data revealed that 65% met criteria for having experienced a traumatic event in accordance with the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR) posttraumatic stress disorder (PTSD) criterion A. The experience of shame, humiliation, or guilt during an event was measured but not found to be a significant indicator of having been traumatized. A total of 33% qualified for a PTSD diagnosis. Stepwise multiple regression analysis showed that receiving medical treatment, experiencing physical symptoms, and witnessing HIV-related death were most associated with HIV-related PTSD symptoms. Given that multiple HIV-related events are potentially traumatic, the screening, assessment and treatment for HIV-related PTSD may need to be considered by HIV services.",0,0 +4364,MACI Scores of African American Males in a Forensic Setting: Are We Measuring What We Think We Are Measuring?,"In this study, confirmatory factor analyses were used to examine scores on the Millon Adolescent Clinical Inventory (MACI) in adolescent, African American males in a forensic setting (N = 496; Mage = 15.96, SDage = 1.32). Results from the study do not support the model proposed by Millon and suggest the MACI may not yield valid or reliable scores in forensic populations of adolescent, African American males. Because MACI scores could be misleading in African American males, the authors argue that the MACI and other trait-scales not validated in this group be used with extreme caution—especially in settings where African Americans are disproportionately represented.",0,0 +4365,A Brief Overview of Traumatic Brain Injury (TBI) and Post-Traumatic Stress Disorder (PTSD) Within the Department of Defense,The current conflicts in the Middle East have yielded increasing awareness of the acute and chronic effect of traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). The increasing frequency of exposure to blast and multiple deployments potentially impact the probability that a service member may sustain one of these injuries. The 2008 International Conference on Behavioral Health and Traumatic Brain Injury united experts in the fields of behavioral health and traumatic brain injury to address these significant health concerns. This article summarizes current Department of Defense (DOD) initiatives related to TBI and PTSD.,0,0 +4366,Internalizing and externalizing classes in posttraumatic stress disorder: A latent class analysis,"Using latent class analysis (LCA) the typology of personality profiles of veterans with posttraumatic stress disorder (PTSD) was examined based on internalizing/externalizing dimensions of psychopathology. Latent class analysis on Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Personality Psychopathology-5 (PSY-5) scale data from 299 Australian combat veterans with PTSD supported the model, identifying an optimal 4-class solution, with PTSD externalizing class defined by aggressiveness and disconstraint, high and moderate internalizing classes differentiated on the extent of elevations in introversion and negative emotionality and elevation of psychoticism in the high internalizing class and a simple PTSD class with normal range scores. The model was validated using external self-report and psychiatric-interview-derived diagnoses. A second exploratory LCA using broader comorbidity indicators (MMPI-2 Restructured Clinical scales) demonstrated some support for, although limitations in, using nonpersonality measures to identify these classes directly.",0,0 +4367,Comorbidity of personality disorders and mental illnesses,"Abstract Mental illness and personality disorder often occur in the same person. Although concern has been expressed that this may be due to overlapping diagnostic criteria, many different studies have confirmed this finding. Various models have been proposed to explain the association, and it is likely that different models will be relevant to different associations. Associations between specific personality disorders and categories of mental illness include those between Cluster A personality disorders and schizophrenia, Cluster B personality disorders and substance misuse and post-traumatic stress disorder, and Cluster C personality disorders and depression, eating disorders and a number of neurotic disorders.",0,0 +4368,Distinct Hippocampal Expression Profiles of lncRNAs in Rats Exhibiting a PTSD-like Syndrome,"Posttraumatic stress disorder (PTSD) refers to a series of clinical syndromes, including symptoms such as nightmares, hallucinations, severe anxiety, fear, and trauma related to the environment. These symptoms tend to occur after intense psychological trauma or physiological stress. Long non-coding RNAs (lncRNAs) have been shown to play key roles in various biological processes, although it is unknown whether they have important functions in PTSD. Here, we present the first study exploring the connection between lncRNAs and a PTSD-like syndrome in rats. We find distinct expression profiles of lncRNAs between PTSD-like syndrome rats and a control group, which provides information for further research on the differentiation of PTSD and transdifferentiation between the PTSD-like syndrome and the control group. This information will be helpful for finding new therapeutic targets for the treatment of PTSD. © 2015 Springer Science+Business Media New York",0,0 +4369,Patterns of emotion regulation and psychopathology,"Emotion regulatory strategies such as higher expressive suppression and lower cognitive reappraisal may be associated with increased psychopathology (Gross & John, 2003). Yet, it is unclear whether these strategies represent distinct cognitive styles associated with psychopathology, such that there are individuals who are predominantly ""suppressors"" or ""reappraisers."" Using cluster analysis, we examined whether women with and without exposure to potentially traumatic events evidence distinct patterns of emotion regulation frequency, capacity, suppression, and cognitive reappraisal. Four patterns emerged: high regulators; high reappraisers/low suppressors; moderate reappraisers/low suppressors; and low regulators. Individuals who reported infrequently and ineffectively regulating their emotions (low regulators) also reported higher depression, anxiety, and posttraumatic stress disorder (PTSD). In contrast, individuals who reported frequently and effectively using reappraisal and low levels of suppression (high reappraisers/low suppressors) reported the lowest levels of these symptoms, suggesting that this specific combination of emotion regulation may be most adaptive. Our findings highlight that the capacity to regulate emotions and the ability to flexibly apply different strategies based on the context and timing may be associated with reduced psychopathology and more adaptive functioning.",0,0 +4370,Diagnostic Criteria for Postconcussional Syndrome After Mild to Moderate Traumatic Brain Injury,,0,0 +4371,Posttraumatic stress disorder and depressive symptoms: Joined or independent sequelae of trauma?,"The nature of co-morbidity between posttraumatic stress disorder (PTSD) and depression has been the subject of much controversy. This study addresses this issue by investigating associations between probable PTSD and depressive symptoms in a prospective, longitudinal sample of combat veterans. Symptoms of PTSD and depression were assessed at 3 points of time (i.e., 1991, 2003, 2008) over a period of 17 years utilizing the PTSD Inventory and the SCL-90 (Derogatis, 1977). Two groups of combat veterans, 275 former prisoners of war (ex-POWs) and 219 matched combatants (controls), were assessed. Data were analyzed using descriptive statistics, latent variable modeling, and confirmatory factor analysis. A series of χ 2 tests revealed that the prevalence proportions of depressive symptoms and probable PTSD were higher among ex-POWs compared to controls at all time points. The prevalence of depressive symptoms was higher than the prevalence of PTSD symptoms in both groups at the each of the times. Latent Trajectories Modeling (LTM) indicated that while ex-POWs' PTSD symptom severity increased over time, the severity of symptoms remained stable among controls. Parallel Process Latent Growth Modeling (PLGM) revealed a positive bi-directional relationship whereby PTSD symptoms mediated the affect of captivity on depressive symptoms and depressive symptoms mediated the affect of captivity on PTSD symptoms over time. Utilizing Confirmatory Factor Analysis (CFA), a single factor model emerged for depressive and PTSD symptoms. The findings suggest that while depression and PTSD seem to be different long-term manifestations of traumatic stress, accounted for in part by the severity of the trauma, they both may be parts of a common general traumatic stress construct. Clinical and theoretical implications of these findings are discussed.",0,0 +4372,A Practical Measure of Workplace Resilience,"To develop an effective measure of resilience at work for use in individual work-related performance and emotional distress contexts.Two separate cross-sectional studies investigated: (1) exploratory factor analysis of 45 items putatively underpinning workplace resilience among 397 participants and (2) confirmatory factor analysis of resilience measure derived from Study 1 demonstrating a credible model of interaction, with performance outcome variables among 194 participants.A 20-item scale explaining 67% of variance, measuring seven aspects of workplace resilience, which are teachable and capable of conscious development, was achieved. A credible model of relationships with work engagement, sleep, stress recovery, and physical health was demonstrated in the expected directions.The new scale shows considerable promise as a reliable instrument for use in the area of employee support and development.",0,0 +4373,Posttraumatic stress disorder symptom trajectories in Hurricane Katrina affected youth,"This study examined trajectories of posttraumatic stress disorder symptoms in Hurricane Katrina affected youth.A total of 426 youth (51% female; 8-16 years old; mean age=11 years; 75% minorities) completed assessments at 4 time points post-disaster. Measures included Hurricane impact variables (initial loss/disruption and perceived life threat); history of family and community violence exposure, parent and peer social support, and post-disaster posttraumatic stress symptoms.Latent class growth analysis demonstrated that there were three distinct trajectories of posttraumatic stress disorder symptoms identified for this sample of youth (resilient, recovering, and chronic, respectively). Youth trajectories were associated with Hurricane-related initial loss/disruption, community violence, and peer social support.The results suggest that youth exposed to Hurricane Katrina have variable posttraumatic stress disorder symptom trajectories. Significant risk and protective factors were identified. Specifically, youth Hurricane and community violence exposure increased risk for a more problematic posttraumatic stress disorder symptom trajectory, while peer social support served as a protective factor for these youth. Identification of these factors suggests directions for future research as well as potential target areas for screening and intervention with disaster exposed youth.The convenience sample limits the external validity of the findings to other disaster exposed youth, and the self-report data is susceptible to response bias.",1,0 +4374,Trajectory in obsessive-compulsive disorder comorbidities,"The main goal of this study is to contribute to the understanding of the trajectory of comorbid disorders associated with obsessive-compulsive disorder (OCD) according to the first manifested psychiatric disorder and its impact in the clinical course of OCD and subsequent psychiatric comorbidities. One thousand and one OCD patients were evaluated at a single time point. Standardized instruments were used to determine the current and lifetime psychiatric diagnoses (Structured Clinical Interview for DSM-IV Axis I and for impulse-control disorders) as well as to establish current obsessive-compulsive, depressive and anxiety symptom severity (Yale-Brown Obsessive-Compulsive Scale; Dimensional Yale-Brown Obsessive-Compulsive Scale, Beck Depression and Anxiety Inventories and the OCD Natural History Questionnaire). To analyze the distribution of comorbidities according to age at onset Bayesian approach was used. Five hundred eight patients had the first OC symptom onset till the age of 10 years old. The first comorbidity to appear in the majority of the sample was separation anxiety disorder (17.5%, n=175), followed by ADHD (5.0%, n=50) and tic disorders (4.4%, n=44). OCD patients that presented with separation anxiety disorder as first diagnosis had higher lifetime frequency of post-traumatic stress disorder (p=0.003), higher scores in the Sexual/Religious dimension (p=0.04), Beck Anxiety (p<0.001) and Depression (p=0.005) Inventories. OCD patients that initially presented with ADHD had higher lifetime frequencies of substance abuse and dependence (p<0.001) and worsening OCD course (p=0.03). OCD patients that presented with tic disorders as first diagnosis had higher lifetime frequencies of OC spectrum disorders (p=0.03). OCD is a heterogeneous disorder and that the presence of specific comorbid diagnoses that predate the onset of OCD may influence its clinical presentation and course over the lifetime.",0,0 +4375,"Conflict, violence, and health: Setting a new interdisciplinary agenda",,0,0 +4376,The Epidemiology of Post-traumatic Stress Disorder: A Focus on Refugee and Immigrant Populations,"(from the chapter) Despite of the great variability in study findings on rates and risks for posttraumatic stress disorder (PTSD) in general, PTSD has to be considered as a possible diagnosis in refugees and asylum seekers with suspected psychiatric symptoms, since these populations are particularly vulnerable groups which are more commonly and often repeatedly exposed to life's adversities preflight, while on flight and even after resettlement in another country, or when internally displaced in a stable part of the home country. The findings on prevalence rates of PTSD are quite heterogeneous and may also vary within the same population over time. Risk factors for PTSD may be more consistent over time and population group studied. Among the factors most frequently found to be associated with increased risk for PTSD is having a psychiatric history prior to the trauma. A meta-analysis by Brewin et al, (2000) also found childhood abuse and a family history of psychiatric disorders to be consistently associated with PTSD risk. The study further found low socioeconomic status, low level of education, low intelligence, life stress, lack of social support, trauma severity, adverse childhood and previous trauma to be consistently but to a differing degree related to an increased risk for PTSD. While protective effects of higher levels of intelligence have also been shown in a large prospective study in a cohort of adolescents independent of social and educational status, no explanatory model has yet been established. (PsycINFO Database Record (c) 2015 APA, all rights reserved)",0,0 +4377,Interfering with the reconsolidation of traumatic memory: sirolimus as a novel agent for treating veterans with posttraumatic stress disorder.,"Development of novel treatment approaches for combat-related posttraumatic stress disorder (PTSD) is critical, given the increasing prevalence of PTSD in veterans returning from war zone deployment. Established preclinical research using protein synthesis inhibitors (such as sirolimus) to interfere with fear memory reconsolidation provides a compelling rationale for investigation in humans.This double-blind, placebo-controlled translational pilot study examined the effects of pairing reactivation of a trauma memory with a single administration of sirolimus on the frequency and intensity of PTSD symptoms in male combat veterans.Primary analyses found no significant differences between treatment groups on any of the clinical or physiologic outcome measures. In an exploratory analysis of a subsample of post-Vietnam-era veterans who had more recent combat trauma, PTSD symptom scores fell significantly more in these veterans than in controls.The post-Vietnam-era veteran findings suggest that further investigation of this pairing of sirolimus with traumatic memory reactivation may be warranted. Theoretically, interference with the reconsolidation of fear memories could ameliorate military-related psychological trauma symptoms. Future research should focus on veterans of more recent eras whose traumatic memories may be less entrenched and more amenable to pharmacologic modification within this procedure.",0,0 +4378,Malignant Memories: PTSD in Children and Adults after a School Shooting,"Sixty-four children and 66 adults were screened for post-traumatic stress disorder 6 to 14 months after a school shooting. Although there were no differences in overall frequencies of DSM-III-R diagnoses or cluster endorsements, there were developmental influences. Post-traumatic stress disorder was associated more with emotional states recalled from the disaster than with proximity. Emotional states mediated the formation of malignant memories leading to symptomatology, suggesting that postdisaster intervention be offered on the basis of degree of emotional reaction as well as proximity.",0,0 +4379,Correlation between lipid profile and different types of aggressive behaviour in combatants,"Objectives At present there is a discussion whether cholesterol level, aggression and violence are connected for they are characteristic behavioral patterns in combatants suffering particularly from PTSD. Method With the help of the Aggressive Behaviour Assessment Scale we examined 337 combatants and 116 healthy people, also we held an additional investigation of serum concentration of lipid profile. Reliability of results was evaluated by the Mann-Whitney U-test. Also the correlation analysis (Spearman rank correlation coefficient) was carried out. Results Combatants showed an integrated overall index of aggression twice as much in comparison with the control group (2,44 ± 0,09 and 1,08 ± 0,08, Ð < 0,00001), impulsive aggression was five times greater (2,08 ± 0,12 and 0,39 ± 0,06, Ð < 0,00001), premeditated aggression was 1,7-fold (3,15 ± 0,11 and 1,78 ± 0,13, Ð < 0,00001). The highest points of emotional (impulsive, hostile) aggressive behaviour revealed negative links with concentrations of cholesterol (r = −0,109, Ð < 0,05), LDL total cholesterol (r = −0,109, Ð < 0,05), triglycerides (−0,137 ≥ r ≥ −0,108, Ð < 0,05). Certain positions of premeditated (instrumental) aggression positively correlated with level of total cholesterol (0,140 ≥ r ≥ 0,126, Ð < 0,01), LDL total cholesterol (0,141 ≥ r ≥ 0,161, Ð < 0,01). Conclusions Reduction of cholesterol level and its most atherogenic fractions increases intensity of impulsive aggression and diminishes instrumental aggression of aggressive behaviour whereas increase of lipid profile leads to opposite results. The obtained data can be of great importance for treatment and prophylaxis of cardio-vascular disorders which are so typical for combat veterans.",0,0 +4380,Diagnosis and management of post-traumatic stress disorder.,"Although post-traumatic stress disorder (PTSD) is a debilitating anxiety disorder that may cause significant distress and increased use of health resources, the condition often goes undiagnosed. The lifetime prevalence of PTSD in the United States is 8 to 9 percent, and approximately 25 to 30 percent of victims of significant trauma develop PTSD. The emotional and physical symptoms of PTSD occur in three clusters: re-experiencing the trauma, marked avoidance of usual activities, and increased symptoms of arousal. Before a diagnosis of PTSD can be made, the patient's symptoms must significantly disrupt normal activities and last for more than one month. Approximately 80 percent of patients with PTSD have at least one comorbid psychiatric disorder. The most common comorbid disorders include depression, alcohol and drug abuse, and other anxiety disorders. Treatment relies on a multidimensional approach, including supportive patient education, cognitive behavior therapy, and psychopharmacology. Selective serotonin reuptake inhibitors are the mainstay of pharmacologic treatment.",0,0 +4381,A lifespan perspective on terrorism: Age differences in trajectories of response to 9/11.,"A terrorist attack is an adverse event characterized by both an event-specific stressor and concern about future threats. Little is known about age differences in responses to terrorism. This longitudinal study examined generalized distress, posttraumatic stress responses, and fear of future attacks following the September 11, 2001 (9/11) terrorist attacks among a large U.S. national sample of adults (N = 2,240) aged 18-101 years. Individuals completed Web-based surveys up to 6 times over 3 years post 9/11. Multilevel models revealed different age-related patterns for distress, posttraumatic stress, and ongoing fear of future attacks. Specifically, older age was associated with lower overall levels of general distress, a steeper decline in posttraumatic stress over time, and less change in fear of future terrorist attacks over the 3 years. Understanding age differences in response to the stress of terrorism adds to the growing body of work on age differences in reactions to adversity.",0,0 +4382,Posttraumatic Stress Disorder and its Relationship with Attachment Styles and Dimensions,"Treatment studies for posttraumatic stress disorder (PTSD) consistently show a portion of participants with poor treatment outcomes. Bowlby.s attachment theory is one framework for understanding PTSD. Research has begun investigating relationships between PTSD and attachment and has found relationships between PTSD symptoms and attachment across attachment styles. The purpose of the current study was to extend this research by investigating relationships between a person.s own PTSD symptoms and attachment style and dimensions. The study used a correlational approach with a convenience sample of adults diagnosed with PTSD (N = 80). The research questions sought to (a) examine the relationships between a person.s predominating PTSD symptom cluster and their scores on the two attachment dimensions that combine to form attachment styles, and (b) accurately classify participants into their attachment style based on their three PTSD symptom cluster scores. Participants completed the Experiences in Close Relationships- Revised (ECR-R) and PTSD Checklist- Specific (PCL-S) via a secure website. MANOVA was used for the first research question and multiple discriminant analysis (MDA) for the second. MANOVA results were nonsignificant but MDA results classified participants at a greater-than-chance rate. The MDA classification results provide implications for positive social change by supplying preliminary evidence for relationships between a person.s own PTSD symptoms and attachment style, suggesting that personalizing PTSD treatment protocols according to a person.s attachment style may improve treatment outcomes for people with PTSD. More research is needed to determine mediating variables between these constructs as well as how attachment considerations may be most effectively implemented in treatment. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4383,Effects of Stress and MDMA on Hippocampal Gene Expression,"MDMA (3,4-methylenedioxymethamphetamine) is a substituted amphetamine and popular drug of abuse. Its mood-enhancing short-term effects may prompt its consumption under stress. Clinical studies indicate that MDMA treatment may mitigate the symptoms of stress disorders such as posttraumatic stress syndrome (PTSD). On the other hand, repeated administration of MDMA results in persistent deficits in markers of serotonergic (5-HT) nerve terminals that have been viewed as indicative of 5-HT neurotoxicity. Exposure to chronic stress has been shown to augment MDMA-induced 5-HT neurotoxicity. Here, we examine the transcriptional responses in the hippocampus to MDMA treatment of control rats and rats exposed to chronic stress. MDMA altered the expression of genes that regulate unfolded protein binding, protein folding, calmodulin-dependent protein kinase activity, and neuropeptide signaling. In stressed rats, the gene expression profile in response to MDMA was altered to affect sensory processing and responses to tissue damage in nerve sheaths. Subsequent treatment with MDMA also markedly altered the genetic responses to stress such that the stress-induced downregulation of genes related to the circadian rhythm was reversed. The data support the view that MDMA-induced transcriptional responses accompany the persistent effects of this drug on neuronal structure/function. In addition, MDMA treatment alters the stress-induced transcriptional signature.",0,0 +4384,The prevalence and latent structure of proposed DSM-5 posttraumatic stress disorder symptoms in U.S. national and veteran samples.,"The Diagnostic and Statistical Manual, Fourth Edition (DSM-IV) is currently undergoing revisions in advance of the next edition, DSM-5. The DSM-5 posttraumatic stress disorder workgroup has proposed numerous changes to the PTSD diagnosis. These include the addition of new symptoms, revision of existing ones, and a new four-cluster organization (Friedman, Resick, Bryant, & Brewin, 2011). We conducted two Internet-based surveys to provide preliminary information about how proposed changes might impact PTSD prevalence and clarify the latent structure of the new symptom set. We used a newly developed instrument to assess event exposure and lifetime and current DSM-5 PTSD symptoms among a nationally representative sample of American adults (N = 2,953) and a clinical convenience sample of U.S. military veterans (N = 345). Results from both samples indicated that the originally proposed DSM-5 symptom criteria (i.e., requiring 1 B, 1 C, 3 D, and 3 E symptoms) yielded considerably lower PTSD prevalence estimates compared with DSM-IV estimates. These estimates were more comparable when the DSM-V D and E criteria were relaxed to 2 symptoms each (i.e., the revised proposal). Confirmatory factor analyses (CFA) indicated that the factor structure implied by the four-symptom criteria provided adequate fit to the data in both samples, and a DSM-5 version of a dysphoria model (Simms, Watson, & Doebbeling, 2002) yielded modest improvement in fit. Item-response theory and CFA analyses indicated that the psychogenic amnesia and new reckless/self-destructive behavior symptom deviated from the others in their respective symptom clusters. Implications for final formulations of DSM-5 PTSD criteria are discussed.",0,0 +4385,Mood and anxiety disorders in females with the FMR1 premutation,"Fragile X syndrome (FXS) is a model for studying the relative contributions of genetic and environmental factors to psychiatric disorders in mothers of children with disabilities. Here, we examine the frequency and predictors of mood and anxiety disorders in mothers with the FMR1 premutation. Ninety-three females with the FMR1 premutation were in the study and were compared to 2,159 women from the National Comorbidity Survey Replication (NCS-R) dataset. Mood and anxiety disorders were assessed using the SCID-I. Our data reflect elevated lifetime major depressive disorder (MDD), lifetime panic disorder without agoraphobia and current agoraphobia without panic disorder in the FMR1 premutation sample. Also, we found a low frequency of lifetime social phobia, specific phobia, and post-traumatic stress disorders and current specific phobia in the FMR1 premutation sample. The profile of MDD in the FMR1 premutation sample was not episodic or comorbid with an anxiety disorder, as in the NCS-R dataset. Never having been married and smaller CGG repeat length were associated with increased likelihood of MDD while increased children with FXS in the family and greater child problem behaviors were associated with increased likelihood of an anxiety disorder in the FMR 1 premutation group. Major depression in females with the FMR1 premutation may not be characterized as an episodically chronic recurrent disorder as it is in community samples and may have a genetic basis given the relationship with CGG repeat length and lack of association with all child and most demographic factors.",0,0 +4386,Peritraumatic Distress Inventory as a predictor of post-traumatic stress disorder after a severe motor vehicle accident,"Aim: The aim of this study was to examine the utility of the Peritraumatic Distress Inventory (PDI) as a predictor of subsequent post-traumatic stress disorder (PTSD) in severe motor vehicle accident survivors. Methods: Patients consecutively admitted to the intensive care unit were assessed immediately and 1 month after accidents in this prospective study. The predictive value for post-traumatic stress symptoms at 1 month of the PDI at initial assessment was examined by using multivariate regression analysis. Moreover, the accuracy of the PDI as a predictor of PTSD was determined using receiver operator characteristic curve analysis. Post-traumatic stress symptoms were assessed using the Impact of Event Scale – Revised questionnaire, and PTSD was assessed using the Clinician-Administered PTSD Scale. Results: Seventy-nine patients completed the Impact of Event Scale – Revised questionnaire, and 64 patients participated in a structured interview. Of 64 patients, 13 met the diagnostic criteria of full or partial PTSD. The PDI was an independent predictor of post-traumatic stress symptoms (P = 0.003). The data indicated that a cut-off score of 23 maximized the balance between sensitivity (77%) and specificity (82%) in this study. Compared with negative predictive value (93%), positive predictive value was not high (53%). Conclusion: The study suggests the predictive usefulness of the PDI for subsequent PTSD in accident survivors. Its adequate usage should be further elaborated.",0,0 +4387,Fluvoxamine Reduces Physiologic Reactivity to Trauma Scripts in Posttraumatic Stress Disorder,"This study assessed the effect of open-label fluvoxamine treatment for posttraumatic stress disorder (PTSD), depressive symptoms, and physiologic arousal to trauma cues. Baseline psychometric ratings and physiologic assessments of heart rate and blood pressure responses to individualized, taped trauma scripts were determined for 16 patients with PTSD and 16 mentally healthy age- and gender-matched control subjects exposed to at least 1 serious trauma. Patients with PTSD had greater autonomic reactivity than control subjects at baseline, with physiologic measures correlating with the severity of the PTSD for the combined groups. Discriminant analyses indicated that systolic blood pressure best classified patients with PTSD (75% sensitivity) and control subjects (100% specificity), with a stepwise discriminant analysis showing that combined physiologic variables correctly classified 75% of patients with PTSD and 100% of control subjects. After 10 weeks of fluvoxamine treatment (100-300 mg/day), patients' PTSD, depression, and physiologic reactivity improved significantly. Medicated patients with PTSD could not be distinguished statistically from untreated control subjects in any physiologic measure. This dampening of autonomic reactivity after drug treatment corroborates subjective measures of improvement, validating the reported efficacy of fluvoxamine in this open trial.",0,0 +4388,Post-Traumatic Stress Disorder and Depression in Health Care Providers Returning from Deployment to Iraq and Afghanistan,"This study examines risk factors for post-traumatic stress disorder (PTSD), depression, and mental health care use among health care workers deployed to combat settings.Anonymous surveys were administered to previously deployed workers at a military hospital. PTSD and depression were assessed by using the PTSD Checklist and the Patient Health Questionnaire depression scale, respectively. Deployment exposures and perceived threats during deployment were also assessed.There were 102 respondents (36% response rate). Nine percent (n=9) met the criteria for PTSD and 5% (n=5) met the criteria for depression. Direct and perceived threats of personal harm were risk factors for PTSD; exposure to wounded or dead patients did not increase risk. Those who met the criteria for PTSD were more likely to seek mental health care after but not before their deployment.For health care workers returning from a warfare environment, threat of personal harm may be the most predictive factor in determining those with subsequent PTSD.",0,0 +4389,"Primary malignant brain tumours, psychosocial distress and the intimate partner experience: what do we know?","From the time of diagnosis of a primary malignant brain tumour (PMBT) and throughout the illness trajectory, the patient and intimate partner face many psychosocial challenges ranging from fear and uncertainty to hope and loss (Fox & Lantz, 1998; Janda et al., 2007; Kvale, Murthy, Taylor, Lee, & Nabors, 2009). While many patients diagnosed with cancer may go on to live with cancer as a chronic illness, this may not be said of individuals diagnosed with a PMBT, in particular those diagnosed with a glioma, the most common form of brain tumour (Gupta & Sarin, 2002). Gliomas are associated with a short disease trajectory and multiple deficits (functional, cognitive and psychiatric). What makes the PMBT experience unique from other cancers is that the intimate partner must not only deal with the diagnosis of cancer in their spouse, but also the accompanying personality, functional and behavioural changes wrought by the disease, as well as grieve the loss of the person they once knew (Sherwood et al., 2004). These multi-dimensional deficits are thought to place the intimate partner, as caregiver, at greater risk for adverse psychosocial effects such as anxiety, depression and post traumatic stress (Goebel, von Harscher, & Mehdorn, 2011; Keir, Farland, Lipp, & Friedman, 2009). The following discussion will provide an overview of the extant literature on the experience of living with a PMBT from the intimate partner (spouse) perspective with a particular emphasis on how intimate partners cope. The intimate partner is considered to be the heterosexual or same-sex, married or common-law partner of the patient. Highlights from the psychotherapy practice of the author will be used to further strengthen the need for more research, education and enhanced practice to more effectively meet the unique needs of this under-researched and supported population.",0,0 +4390,Posttraumatic stress disorder following traumatic injury: Narratives as unconscious indicators of psychopathology,"Current conventional assessment methodologies used to diagnose posttraumatic stress disorder (PTSD) rely heavily on symptom counts obtained from clinical interviews or self-report questionnaires. Such measures may underestimate the impact of traumatic events, particularly in individuals who deny or repress emotional distress. This case report illustrates the use of two methods of narrative analysis to assess unconscious representations of PTSD. Linguistic analysis and a computerized analysis of referential activity were able to capture unconscious aspects of the traumatic experience.",0,0 +4391,Patterns in Blame Attributions in Maltreated Youth: Association with Psychopathology and Interpersonal Functioning,"This investigation explored patterns of blame attributions in 128 youth, primarily (87%) female, with maltreatment histories. Second, the study also evaluated the relative variance in posttraumatic stress disorder (PTSD) symptom severity, emotional distress, and interpersonal functioning outcomes, accounted for by age, abuse characteristics, and blame attribution patterns. Cluster analyses revealed distinctive blame profiles: high perpetrator blame, moderate perpetrator blame, high self-blame, high perpetrator/high self-blame, and low perpetrator/low self-blame. Regression analyses yielded significant models, accounting for 15% to 34% of the variance of outcomes. Most notably, youth endorsing a high perpetrator/high self-blame (i.e., compounded blame) attribution pattern reported poorer outcomes as compared to youth presenting with other blame profiles. Maltreatment type and age differences were not demonstrated across clusters. Implications and limitations are discussed.",0,0 +4392,Loss and grief: the role of individual differences,"It is an unfortunate but inevitable fact of life that virtually all of us must face: people we are close to die. Despite this universality, researchers and theorists have long assumed that bereavement almost always results in significant, and sometimes incapacitating, distress. Curiously, the absence of distress after loss has itself been considered pathological and a likely harbinger of future difficulties (Middleton et al., 1993). When bereaved persons fail to display the expected distress reaction, some have maintained that they are suppressing their grief (Middleton et al., 1993) or lack an attachment to their spouse (Fraley & Shaver, 1999). Indeed, emotional expression following loss – particularly negative emotions – has long been considered cathartic, a necessary ingredient of healthy adjustment (Freud, 1957). Perhaps for this reason, bereaved people who appear outwardly resilient and who resume their lives with minimal disruptions have often been thought to possess extraordinary coping abilities. However, this idea has increasingly come under fire (Bonanno, 2004). In fact, most bereaved people experience relatively transient disruptions in their ability to function effectively. Furthermore, research increasingly shows that there is a marked diversity in how people respond to loss. Indeed, it appears that three primary patterns or trajectories adequately describe most people’s response to interpersonal loss. The largest category, usually from 50% to 60%, is characterized by stable, healthy levels of psychological and physical functioning relatively soon after a loss, or “resilience” (Bonanno, 2004; Mancini & Bonanno, 2006). A second category of bereaved persons (20–25%) displays more acute and persistent levels of distress but gradually they too recover their bearings and return to their former level of functioning. The most problematic reaction is found among those with a persistent syndrome of a sometimes incapacitating distress that may take years to resolve. This pattern, often described as “complicated grief” (Bonanno et al., 2007), is relatively rare, typically occurring in 10–15% of grievers (Bonanno & Kaltman, 2001). Two other types of bereavement response have also emerged recently, although they typically characterize only a small proportion of grievers. These include a chronic form of distress that predated the loss and is exacerbated in its aftermath (Bonanno et al., 2002; Mancini et al., 2011) and dramatic improvement following loss (A.D. Mancini, I. Galatzer-Levy, & G.A. Bonanno, unpublished data). Although each is quite uncommon (5–10%), these patterns have been confirmed using different methods and samples, suggesting that they are veridical. © Cambridge University Press 2011.",0,0 +4393,Classifying developmental trajectories over time should be done with great caution: a comparison between methods,"In the analysis of data from longitudinal cohort studies, there is a growing interest in the analysis of developmental trajectories in subpopulations of the cohort under study. There are different advanced statistical methods available to analyze these trajectories, but in the epidemiologic literature, most of those are never used. The purpose of the present study is to compare five statistical methods to detect developmental trajectories in a longitudinal epidemiological data set.All five statistical methods (K-means clustering, a ""two-step"" approach with mixed modeling and K-means clustering, latent class analysis [LCA], latent class growth analysis [LCGA], and latent class growth mixture modeling [LCGMM]) were performed on a real-life data set and two manipulated data sets. The first manipulated data set contained four different linear developments over time, whereas the second contained two linear and two quadratic developments.For the real-life data set, all five classification methods revealed comparable trajectories. Regarding the manipulated data sets, LCGA performed best in detecting linear trajectories, whereas none of the methods performed well in detecting a combination of linear and quadratic trajectories. Furthermore, the optimal solution for LCA and LCGA contained more classes compared with LCGMM.Although LCGA and LCGMM seem to be preferable above the more simple methods, all classification methods should be applied with great caution.",0,0 +4394,Narrative Focus Predicts Symptom Change Trajectories in Group Treatment for Traumatized and Bereaved Adolescents,"Growing evidence supports the effectiveness of Trauma and Grief Component Therapy for Adolescents (TGCT-A) in reducing posttraumatic stress disorder (PTSD) symptoms and maladaptive grief (MG) reactions. This pilot study explored whether the specific focus of students' narratives (i.e., focus on trauma vs. focus on loss) as shared by TGCT-A group members would predict initial pretreatment levels, as well as pre- to posttreatment change trajectories, of PTSD symptoms and MG reactions. Thirty-three adolescents from three middle schools completed a 17-week course of group-based TGCT-A. PTSD and MG symptoms were assessed at pretreatment, twice during treatment, and at posttreatment. The focus (trauma vs. loss) of each student's narrative was coded using transcripts of members' narratives as shared within the groups. The reliable change index showed that 61% of students reported reliable pre-post improvement in either PTSD symptoms or MG reactions. Students whose narratives focused on loss both reported higher starting levels and showed steeper rates of decline in MG reactions than students whose narratives focused on trauma. In contrast, students whose narratives focused on trauma reported higher starting levels of PTSD than students who narrated loss experiences. However, narrative focus was not significantly linked to the rate at which PTSD symptoms declined over the course of treatment. This study provides preliminary evidence that TGCT-A treatment components are associated with reduced PTSD symptoms and MG reactions. Loss-focused narratives, in particular, appear to be associated with greater decreases in MG reactions.",0,0 +4395,The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care.,"A method for comparing death rates of groups of injured persons was developed, using hospital and medical examiner data for more than two thousand persons. The first step was determination of the extent to which injury severity as rated by the Abbreviated Injury Scale correlates with patient survival. Substantial correlation was demonstrated. Controlling for severity of the primary injury made it possible to measure the effect on mortality of additional injuries. Injuries that in themselves would not normally be life-threatening were shown to have a marked effect on mortality when they occurred in combination with other injuries. An Injury Severity Score was developed that correlates well with survival and provides a numerical description of the overall severity of injury for patients with multiple trauma. Results of this investigation indicate that the Injury Severity Score represents an important step in solving the problem of summarizing injury severity, especially in patients with multiple trauma.",0,0 +4396,Treatment of nonepileptic seizures,"Studies on nonepileptic seizures (NES) provide dichotomous data sets: extensive observational findings, but a paucity of controlled treatment data. Psychosocial stressors, whose full impact may lie outside a patient's awareness, often underlie NES. These stressors, along with patient's learned patterns of coping, may bring forth or potentiate comorbid psychiatric disorders. Patients with NES often have dysfunction in emotion regulation and family dynamics, as well as unemployment/disability. High percentages of comorbid disorders such as major depressive disorder, post-traumatic stress disorder, and cluster B personality with impulsivity (all disorders associated with serotonin system function) also exist in the NES population. The preliminary observational evidence suggests that specific psychotherapies and pharmacotherapy directed at comorbid conditions may be the most effective treatment for NES.",0,0 +4397,Posttraumatic stress disorder in DSM-5: Estimates of prevalence and symptom structure in a nonclinical sample of college students,"We empirically investigated recent proposed changes to the posttraumatic stress disorder (PTSD) diagnosis for DSM-5 using a non-clinical sample. A web survey was administered to 585 college students using the Stressful Life Events Screening Questionnaire to assess for trauma exposure but with additions for the proposed traumatic stressor changes in DSM-5 PTSD. For the 216 subjects endorsing previous trauma exposure and nominating a worst traumatic event, we administered the original PTSD Symptom Scale based on DSM-IV PTSD symptom criteria and an adapted version for DSM-5 symptoms, and the Center for Epidemiological Studies-Depression Scale. While 67% of participants endorsed at least one traumatic event based on DSM-IV PTSD's trauma classification, 59% of participants would meet DSM-5 PTSD's proposed trauma classification. Estimates of current PTSD prevalence were .4-1.8% points higher for the DSM-5 (vs. the DSM-IV) diagnostic algorithm. The DSM-5 symptom set fit the data very well based on confirmatory factor analysis, and neither symptom set's factors were more correlated with depression.",0,0 +4398,,"Research has suggested that organized violence and torture have long-term psychological effects that persist throughout the lifespan. The present survey aimed at examining the prevalence of posttraumatic stress disorder (PTSD), and other disorders and symptoms, all present in old age, as long-term consequences of politically motivated violence in a comparison design.A group of former political detainees (N = 59, mean age 73.5 years) who had been arrested by the Romanian communist regime were compared to an age- and gender-matched control group (N = 39). PTSD was assessed using a structured clinical interview (CIDI). The investigation of the clinical profile was further accomplished by self-rating measures for anxiety, depression, and health-related functioning, as well as by clinician-administrated interviews for substance abuse, dissociation, and somatization symptoms.Lifetime prevalence of PTSD was 54%. In the case of participants left untreated, PTSD persisted, often over four decades, such that current PTSD was diagnosed still in a third of the survivors. Other clinical conditions such as somatization, substance abuse, dissociative disorders, and major depression were also common among the former political detainees and often associated with current PTSD.Our findings suggest that political detention may have long-term psychological consequences that outlast the changes in the political system.",0,0 +4399,Neural correlates of observation of disgusting images in subjects with first episode psychosis and post-traumatic stress disorder.,"The aim of this study was to analyze neural responses to disgusting images in individuals with first episode psychosis and post-traumatic stress disorder (PTSD). Although anhedonia is a common symptom in both disorders we expected that they would be associated with different neurophysiological abnormalities and patterns of activation. We recruited three groups of participants: 13 individuals with first episode psychosis, 10 individuals with PTSD who had survived the April 2009 L’Aquila earthquake and 25 healthy controls matched for age and education. All individuals participated in a functional imaging experiment in which they watched six alternating blocks of disgusting and scrambled images whilst undergoing scanning with a General Electric 1.5T whole-body scanner. We estimated individuals'’ beta-weights, extracting 22 clusters corresponding to 22 significant areas. Findings were consistent with other neuroimaging studies; the active areas (i.e. amygdala, insula, inferior and medial frontal gyrus) have consistently been associated with emotional experiences. Statistical analysis revealed important group differences in intensity and direction (positive or negative) of signal from baseline during disgusting condition. Although these results are preliminary they show that functional neuroimaging techniques may make a valuable contribution to differential diagnosis of first episode psychosis and PTSD.",0,0 +4400,Post-traumatic stress disorder symptoms following a head injury: does amnesia for the event influence the development of symptoms?,"There is controversy as to whether PTSD can develop following a brain injury with a loss of consciousness. However, no studies have specifically examined the influence of the memories that the individuals may or may not have on the development of symptoms.To consider how amnesia for the traumatic event effects the development and profile of traumatic stress symptoms.Fifteen hundred case records from an Accident and Emergency Unit were screened to identify 371 individuals with traumatic brain injury who were sent questionnaires by post. The 53 subsequent valid responses yielded three groups: those with no memory (n = 14), untraumatic memories (n = 13) and traumatic memories (n = 26) of the index event. The IES-R was used as a screening measure followed by a structured interview (CAPS-DX) to determine caseness and provide details of symptom profile.Groups with no memories or traumatic memories of the index event reported higher levels of psychological distress than the group with untraumatic memories. Ratings of PTSD symptoms were less severe in the no memory groups compared to those with traumatic memories.Psychological distress was associated with having traumatic or no memories of an index event. Amnesia for the event did not protect against PTSD; however, it does appear to protect against the severity and presence of specific intrusive symptoms.",0,0 +4401,The needs of primary care mental health service users: a Q-sort study.,"Background Within scientific and policy literature, the broader needs and preferences of the service user are usually described as being relatively homogenous for any particular condition. Additionally, despite common adult mental health problems being a huge burden to primary care services, there has been little research into the client's perspective of their needs regarding such difficulties. The aim of this research was thus to uncover the issues and preferences for this sample.Method The attitudes of 28 service users were explored through use of a Q-methodology approach. This procedure involves statistical analysis of the order that participants rank pertinent statements associated with the area of study.Results Five independent factors (clusters of preferences) were identified. These differed over issues associated with: relationships with service providers, access/barriers associated with services, information provision, stigma, choices associated with therapy and the care pathway, medication and complementary approaches, as well as social support.Discussion The study suggests that differing individual needs exist within diagnostic categories which, unless considered, may impede service engagement. Issues associated with the implications for service delivery for these differing clusters of perceived needs and viewpoints are outlined.",0,0 +4402,The Role of Temperament in the Development of Post-Traumatic Stress Disorder Amongst Journalists,"The literature indicates that journalists, who have been exposed to traumatic situations, risk developing Post-traumatic Stress Disorder (PTSD). Certain temperament traits, such as neuroticism and compulsiveness, have been found to increase vulnerability to the development of PTSD amongst police officers. Few research studies have investigated temperament and a sense of coherence as factors mediating occupational stress in journalists exposed to trauma. The aim of this study was to address this dearth by investigating whether differences in the experience of trauma, temperament traits and a sense of coherence amongst journalists will influence the degree of PTSD experienced. The Impact of Event Scale-Revised was used to divide journalists into three groups, namely, those with minor reactions ( n=10), moderate reactions ( n=24) and severe reactions of clinical importance ( n=16). Analyses of variance followed by Scheffé post hoc multiple comparisons technique indicated statistically significant differences between the three groups regarding experience of trauma as measured by the Trauma Questionnaire, temperament traits as measured by the Zuckerman-Kuhlman Personality Questionnaire and sense of coherence as measured by the Sense of Coherence Questionnaire. The results show that various factors could have an impact on how journalists deal with the traumatic stories they cover, as well as their personal outcomes after covering these stories. Journalists who develop severe PTSD differ in terms of their perceptions of the trauma, temperament profiles and sense of coherence, which impacts on their way of coping with the traumatic situations they face daily.",0,0 +4403,Acquisition of Resistance to Butyrate Enhances Survival after Stress and Induces Malignancy of Human Colon Carcinoma Cells,"Abstract Acquired resistance to apoptosis by tumor cells remains a major obstacle for cancer treatment, and hence the analysis of resistance to apoptosis constitutes a major goal in the development of antitumoral drugs. We have established a butyrate-resistant human colon adenocarcinoma cell line (BCS-TC2.BR2) from nontumorigenic BCS-TC2 cells to analyze whether the acquisition of such phenotype confers resistance to apoptosis and stress. Although BCS-TC2.BR2 cells exhibited a more differentiated phenotype than the parental BCS-TC2 cells, higher butyrate concentrations remained capable of additionally enhancing their differentiation without inducing apoptosis. Survival rates of BCS-TC2.BR2 cells after glucose deprivation and heat shock were higher than those of parental cells, revealing a stress-resistant phenotype. These findings were accompanied by key differences between parental and butyrate-resistant cells in gene expression profiles and the acquisition of in vivo tumorigenicity. In conclusion, cells gaining resistance to an endogenous physiological modulator of growth, differentiation, and apoptosis concurrently acquired resistance to other agents that influence cell survival.",0,0 +4404,Sertraline: the first SSRI to be approved for the specific treatment of post-traumatic stress disorder,"Sertraline is the first selective serotonin re-uptake inhibitor (SSRI) to be approved for the treatment of patients with post-traumatic stress disorder (PTSD). Sertraline 50 to 200mg once daily for 12 weeks has shown efficacy in 2 of 3 double-blind, placebo-controlled trials conducted in US civilians. Overall response rates were 53 and 60% for patients receiving sertraline compared with 32 and 39% for patients receiving placebo in the 2 positive studies. A post hoc analysis of these studies indicated that sertraline was effective at alleviating PTSD symptoms in women but efficacy in men was not clearly established. Sertraline also failed to show significant effects compared with placebo in 2 clinical trials conducted in patients with predominantly combat-induced PTSD. Sertraline is generally well tolerated showing an adverse event profile similar to other SSRIs. Adverse events occuring with greater frequency than placebo in controlled trials were insomnia, nausea and diarrhoea.",0,0 +4405,Effect of the Interplay between Trauma Severity and Trait Neuroticism on Posttraumatic Stress Disorder Symptoms among Adolescents Exposed to a Pipeline Explosion,"While numerous studies have explored relevant factors of posttraumatic stress disorder (PTSD) symptoms, there have been few joint investigations of trauma severity and trait neuroticism on the development of PTSD symptoms. This study aims to assess the involvement and interrelationship of trauma severity and neuroticism in the expression of PTSD symptoms among adolescents exposed to an accidental explosion.Six hundred and sixty-two adolescents were recruited from a junior middle school closest to the 2013 pipeline explosion site in China and were assessed using the Explosion Exposure Questionnaire, the NEO Five Factor Inventory-Neuroticism Subscale (FFI-N), and the PTSD Checklist-Civilian (PCL-C). A battery of hierarchical multiple regression analyses and two-way ANOVAs were performed to examine the effect of trauma severity and trait neuroticism on adolescent PTSD symptoms.Eighty-seven adolescents (13.1%) showed PTSD symptoms after the pipeline explosion. Correlation analysis showed that all the factors of explosion exposure and trait neuroticism were positively associated with adolescent PTSD symptoms. Being male and younger was linked to lower risk for PTSD symptoms. The regression models identified explosion exposure and neuroticism as independent risk factors for PTSD symptoms, and the interactions between trait neuroticism and trauma exposure (personal casualty, degree of influence, total traumatic severity) were related to PTSD symptoms.The results highlight the role of trauma exposure and trait neuroticism as risk factors for PTSD symptoms. Therefore, the combination of these two factors should be investigated in clinical settings due to an augmented risk for more severe PTSD symptoms.",0,0 +4406,Positive psychology in rehabilitation medicine: A brief report,"The field of positive psychology has grown exponentially within the last decade. To date, however, there have been few empirical initiatives to clarify the constructs within positive psychology as they relate to rehabilitation medicine. Character strengths, and in particular resilience, following neurological trauma are clinically observable within rehabilitation settings, and greater knowledge of the way in which these factors relate to treatment variables may allow for enhanced treatment conceptualization and planning.The goal of this study was to explore the relationships between positive psychology constructs (character strengths, resilience, and positive mood) and rehabilitation-related variables (perceptions of functional ability post-injury and beliefs about treatment) within a baseline data set, a six-month follow-up data set, and longitudinally across time points.Pearson correlations and supplementary multiple regression analyses were conducted within and across these time points from a starting sample of thirty-nine individuals with acquired brain injury (ABI) in an outpatient rehabilitation program.Positive psychology constructs were related to rehabilitation-related variables within the baseline data set, within the follow-up data set, and longitudinally between baseline positive psychology variables and follow-up rehabilitation-related data.These preliminary findings support relationships between character strengths, resilience, and positive mood states with perceptions of functional ability and expectations of treatment, respectively, which are primary factors in treatment success and quality of life outcomes in rehabilitation medicine settings. The results suggest the need for more research in this area, with an ultimate goal of incorporating positive psychology constructs into rehabilitation conceptualization and treatment planning.",0,0 +4407,Minnesota Multiphasic Personality Inventory-2 Validity Patterns: An Elucidation of Gulf War Syndrome,"The potential effects of psychological distress on physical symptoms observed in Persian Gulf War veterans were evaluated in 48 veterans using neuropsychological evaluation that included personality assessment (the Minnesota Multiphasic Personality Inventory-2). Cluster analysis of the validity scales resulted in a solution with two viable subgroups. Members of cluster 1 had significantly higher scores on five Minnesota Multiphasic Personality Inventory-2 clinical scales, a measure of trait anxiety, and a number of subjective complaints, as well as lower scores on a task of attention. Neuropsychological functioning did not otherwise differ between the groups, Contributions of personality style in coping with physical and mental health stressors were indicated. Experience of distress appeared to be attributable to individual differences rather than factors that have been associated with the elusive Gulf War syndrome. Persian Gulf War veterans' emotional reactions to clinical laboratory findings, perceptions of exposure risks, war experience, and stress may represent a variation of post-traumatic stress disorder.",0,0 +4408,The role of sleep disturbance in the relationship between post-traumatic stress disorder and suicidal ideation,"• PTSD symptoms indirectly predicted suicidal ideation via comorbid sleep disturbances, but had no direct effect. • Polyvictimization predicted sleep disturbances and suicidal ideation independently of PTSD or major depression . • No relationships were substantively altered after adjusting for comorbid major depression. We tested if the risk of suicidal ideation in individuals with PTSD symptoms was dependent on comorbid sleep disturbance. Our cross-sectional sample included 2465 participants with complete data from the 21 year follow-up of the Mater University Study of Pregnancy (MUSP), a birth cohort study of young Australians. Using structural equation modelling with indirect pathways we found that 12 month PTSD symptoms did not directly predict suicidal ideation at 21 when adjusting for major depression symptoms, polyvictimization and gender. However, PTSD symptoms had an indirect effect on suicidal ideation via past-month sleep disturbance. Our results suggest that increased suicidal ideation in those with PTSD may result from the fact that PTSD sufferers often exhibit other comorbid psychiatric conditions which are themselves known to predict suicidal behaviours. Sleep disturbance may be targeted in those who experience PTSD to help prevent suicidal ideation.",0,0 +4409,Optimism and Death,"The course of depression in relation to myocardial infarction (MI), commonly known as heart attack, and the consequences for mortality are not well characterized. Further, optimism may predict both the effects of MI on depression as well as mortality secondary to MI. In the current study, we utilized a large population-based prospective sample of older adults ( N = 2,147) to identify heterogeneous trajectories of depression from 6 years prior to their first-reported MI to 4 years after. Findings indicated that individuals were at significantly increased risk for mortality when depression emerged after their first-reported MI, compared with resilient individuals who had no significant post-MI elevation in depression symptomatology. Individuals with chronic depression and those demonstrating pre-event depression followed by recovery after MI were not at increased risk. Further, optimism, measured before MI, prospectively differentiated all depressed individuals from participants who were resilient.",0,0 +4410,Type and Severity of Abuse and Posttraumatic Stress Disorder Symptoms Reported by Women Who Killed Abusive Partners,"This study investigated the type, severity, and frequency of Posttraumatic Stress Disorder (PTSD) symptoms experienced by battered women prior to killing male partners. Eighteen women were assessed for frequency and severity of lifetime PTSD symptoms and type of abuse endured. Correlations were performed between clusters of PTSD symptoms and composites of violent experiences. It was found that before killing male partners, these battered women suffered moderate to high levels of PTSD symptom frequency and severity, except for an inability to recall important aspects of the trauma. Significant canonical correlations were found between the frequency and severity of PTSD symptoms and the severity of types of abuses inflicted.",0,0 +4411,Neuropsychological Effects of Self-Reported Deployment-Related Mild TBI and Current PTSD in OIF/OEF Veterans,"Current combat veterans are exposed to many incidents that may result in mild traumatic brain injury (mTBI) and/or posttraumatic stress disorder (PTSD). While there is literature on the neuropsychological consequences of PTSD only (PTSD-o) and mTBI alone (mTBI-o), less has been done to explore their combined (mTBI+PTSD) effect. The goal of this study was to determine whether Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) veterans with mTBI+PTSD have poorer cognitive and psychological outcomes than veterans with PTSD-o, mTBI-o, or combat exposure-only. The final sample included 20 OIF/OEF veterans with histories of self-reported deployment mTBI (mTBI-o), 19 with current PTSD (PTSD-o), 21 with PTSD and self-reported mTBI (mTBI+PTSD), and 21 combat controls (CC) (no PTSD and no reported mTBI). Groups were formed using structured interviews for mTBI and PTSD. All participants underwent comprehensive neuropsychological testing, including neurocognitive and psychiatric feigning tests. Results of cognitive tests revealed significant differences in performance in the mTBI+PTSD and PTSD-o groups relative to mTBI-o and CC. Consistent with previous PTSD literature, significant differences were found on executive (switching) tasks, verbal fluency, and verbal memory. Effect sizes tended to be large in both groups with PTSD. Thus, PTSD seems to be an important variable affecting neuropsychological profiles in the post-deployment time period. Consistent with literature on civilian mTBI, the current study did not find evidence that combat-related mTBI in and of itself contributes to objective cognitive impairment in the late stage of injury.",0,0 +4412,MCMI Characteristics of DSM-III Posttraumatic Stress Disorder in Vietnam Veterans,Compared the MCMI profiles of 25 veterans with a diagnosis of Posttraumatic Stress Disorder (PTSD) with those of 25 veterans carrying psychiatric disorders which typically cause problems in the differential diagnosis of PTSD. The PTSD group had higher elevations on nine of the 20 MCMI scales (all ps less than .05). Profiles were also significantly different in shape and scatter. A discriminant analysis accounted for 100% of the variance and correctly classified 88% of the patients. Resulting MCMI profiles appear to be consistent with DSM-III criteria for PTSD.,0,0 +4413,The Enhancement of Natural Resilience in Trauma Interventions,"Resilience following trauma is the rule, not the exception. The minority of individuals who go on to suffer chronic pathology such as posttraumatic stress disorder (PTSD) will likely benefit from a number of evidence-based treatments. The study of resilience provides a new framework to examine and build upon these existing therapies. This article outlines an evidence-based theoretical model for understanding psychotherapy for PTSD through the lens of resilience. Specifically, we explore three broad factors thought to underlie resilience: social support, returning to daily routine, and meaning making. We review the literature regarding the impact of these factors on natural recovery after a trauma as well as treatment response. We connect these processes to interventions and techniques used in several empirically supported therapies, highlighting compatibility and synergy with therapeutic goals. With this review, we aim to map our existing knowledge about resilience onto theoretical models of treatment efficacy to broaden our conceptualization of treatment mechanisms and spur new ideas to improve clinical outcomes for those suffering due to trauma.",0,0 +4414,Cortisol augmentation of a psychological treatment for warfighters with posttraumatic stress disorder: Randomized trial showing improved treatment retention and outcome,"Prolonged exposure (PE) therapy for post-traumatic stress disorder (PTSD) in military veterans has established efficacy, but is ineffective for a substantial number of patients. PE is also associated with high dropout rates. We hypothesized that hydrocortisone augmentation would enhance symptom improvement and reduce drop-out rates by diminishing the distressing effects of traumatic memories retrieved during imaginal exposure. We also hypothesized that in responders, hydrocortisone augmentation would be more effective in reversing glucocorticoid indices associated with PTSD than placebo augmentation.Twenty-four veterans were randomized to receive either 30 mg oral hydrocortisone or placebo prior to PE sessions 3-10 in a double-blind protocol. Glucocorticoid receptor sensitivity was assessed in cultured peripheral blood mononuclear cells (PBMC) using the in vitro lysozyme inhibition test and was determined before and after treatment. Intent-to-treat analysis was performed using latent growth curve modeling of treatment effects on change in PTSD severity over time. Veterans who no longer met diagnostic criteria for PTSD at post-treatment were designated as responders.Veterans randomized to hydrocortisone or placebo augmentation did not differ significantly in clinical severity or glucocorticoid sensitivity at pre-treatment. Hydrocortisone augmentation was associated with greater reduction in total PTSD symptoms compared to placebo, a finding that was explained by significantly greater patient retention in the hydrocortisone augmentation condition. A significant treatment condition by responder status interaction for glucocorticoid sensitivity indicated that responders to hydrocortisone augmentation had the highest pre-treatment glucocorticoid sensitivity (lowest lysozyme IC50-DEX) that diminished over the course of treatment. There was a significant association between decline in glucocorticoid responsiveness and improvement in PTSD symptoms among hydrocortisone recipients.The results of this pilot study suggest that hydrocortisone augmentation of PE may result in greater retention in treatment and thereby promote PTSD symptom improvement. Further, the results suggest that particularly elevated glucocorticoid responsiveness at pre-treatment may identify veterans likely to respond to PE combined with an intervention that targets glucocorticoid sensitivity. Confirmation of these findings will suggest that pharmacologic interventions that target PTSD-associated glucocorticoid dysregulation may be particularly helpful in promoting a positive clinical response to PTSD psychotherapy.",0,0 +4415,Enhanced cortisol suppression following administration of low-dose dexamethasone in first-episode psychosis patients,"Impaired regulation of the hypothalamic-pituitary-adrenal (HPA) axis and hyper-activity of this system have been described in patients with psychosis. Conversely, some psychiatric disorders such as post-traumatic stress disorder (PTSD) are characterised by HPA hypo-activity, which could be related to prior exposure to trauma. This study examined the cortisol response to the administration of low-dose dexamethasone in first-episode psychosis (FEP) patients and its relationship to childhood trauma.The low-dose (0.25 mg) Dexamethasone Suppression Test (DST) was performed in 21 neuroleptic-naïve or minimally treated FEP patients and 20 healthy control participants. Childhood traumatic events were assessed in all participants using the Childhood Trauma Questionnaire (CTQ) and psychiatric symptoms were assessed in patients using standard rating scales.FEP patients reported significantly higher rates of childhood trauma compared to controls (p = 0.001) and exhibited lower basal (a.m.) cortisol (p = 0.04) and an increased rate of cortisol hyper-suppression following dexamethasone administration compared to controls (33% (7/21) vs 5% (1/20), respectively; p = 0.04). There were no significant group differences in mean cortisol decline or percent cortisol suppression following the 0.25 mg DST. This study shows for the first time that a subset of patients experiencing their first episode of psychosis display enhanced cortisol suppression.These findings suggest there may be distinct profiles of HPA axis dysfunction in psychosis which should be further explored.",0,0 +4416,Functional status after intensive care: A challenge for rehabilitation professionals to improve outcome,"To examine restrictions in daily functioning from a rehabilitation perspective in patients one year after discharge from the intensive care unit, and to identify prognostic factors for functional status.Cross-sectional design.Consecutive patients who were admitted to the intensive care unit for more than 48 h (n = 255).One year after intensive care, functional status (Sickness Impact Profile) as primary outcome, and Quality of Life (SF-36), anxiety and depression (Hospital Anxiety Depression Scale), and post-traumatic stress disorder (Impact of Events Scale) were evaluated.Fifty-four percent of the patients had restrictions in daily functioning. Walking and social activities were most frequently restricted (30-60% of the patients). Quality of life was lower than the general Dutch population. Symptoms of anxiety and depression were found in 14%, and post-traumatic stress disorder in 18%. Severity of illness at admission and length of stay in the intensive care unit were identified as prognostic factors, although they explained only 10% of functional status.The high prevalence of long-lasting restrictions in physical, social and psychological functioning among patients who stayed in the intensive care unit for at least 2 days implies that these patients are a potential target population for rehabilitation medicine. Multidisciplinary therapies need to be developed and evaluated in order to improve outcome.",0,0 +4417,The importance of the peritraumatic experience in defining traumatic stress.,"In the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev., DSM-IV-TR; American Psychiatric Association, 2000), posttraumatic stress disorder (PTSD) Criterion A2 stipulates that an individual must experience intense fear, helplessness, or horror during an event that threatened the life or physical integrity of oneself or others to be eligible for the PTSD diagnosis. In considering this criterion, we describe its origins, review studies that have examined its predictive validity, and reflect on the intended purpose of the criterion and how it complements the mission of the DSM. We then assert that the predictive validity of Criterion A2 may not be an appropriate metric for evaluating its worth. We also note that the current Criterion A2 may not fully capture all the salient aspects of the traumatic stress response. To support this claim, we review empirical research showing that individuals adapt to extreme environmental events by responding in a complex and coordinated manner. This complex response set involves an individual's appraisal regarding the degree to which the event taxes his or her resources, as well as a range of other cognitions (e.g., dissociation), felt emotions (e.g., fear), physiological reactions (e.g., heart rate increase), and behaviors (e.g., tonic immobility). We provide evidence that these response components may be associated with the subsequent development of PTSD. We then describe the challenges associated with accurately assessing an individual's traumatic stress response. We conclude with a discussion of the need to consider the individual's immediate response when defining a traumatic stressor.",0,0 +4418,The coherence and correlates of intermittent explosive disorder amongst West Papuan refugees displaced to Papua New Guinea,"Questions remain about the nosological status of intermittent explosive disorder (IED) as a universal diagnosis. Cross-cultural studies are needed to establish whether IED symptoms form a coherent pattern and are distinguishable from other related symptom constellations. A study amongst a refugee population also allows further inquiry of the relationship between exposure to potentially traumatic events (PTEs) and other adversities with the IED constellation. In the present study amongst West Papuan refugees residing in Port Moresby, Papua New Guinea, we apply culturally adapted interview modules to assess symptoms of IED, post-traumatic stress disorder (PTSD), and depression, as well as the potentially traumatic events (PTEs) of conflict and ongoing adversity in the post-migration environment. Latent class analysis yielded a PTSD class (23%), a posttraumatic depressive class (14%), an IED class (12%), and a low/no symptom class (49%). Compared to the low/no-symptom class, the PTSD class had high levels of exposure to all PTE domains including childhood-related adversities, witnessing murder, human rights trauma, and traumatic losses, as well as ongoing adversity relating to displacement and separation from families, safety concerns, and lack of access to basic needs and health care. The posttraumatic depression class had greater exposure to traumatic losses and childhood-related adversities, higher levels of stress relating to material loss and deprivation, as well as to displacement and separation from families. In contrast, the IED class was distinguished only by the ongoing stress of displacement and separation from families in the homeland. Our findings provide support for the phenomenological distinctiveness of IED symptoms in this transcultural setting. Although not exclusive to IED, conditions of long-term displacement and separation appear to be a source of ongoing anger and explosive aggression amongst this population.",0,0 +4419,Cortisol Response to Social Stress in Parentally Bereaved Youth,"Parental bereavement is associated with increased risk for psychiatric illness and functional impairment in youth. Dysregulated hypothalamic-pituitary-adrenal (HPA) axis functioning may be one pathway through which bereaved children experience increased risk for poor outcomes. However, few studies have prospectively examined the association between parental bereavement and cortisol response while accounting for psychiatric disorders in both youth and their caregivers.One-hundred and eighty-one bereaved and nonbereaved offspring and their caregivers were assessed at multiple time points over a 5-year period after parental death. Offspring participated in an adaptation of the Trier Social Stress Task (TSST), and salivary cortisol samples were collected before and after exposure to social stressors. Mixed models for repeated measures were used to analyze the effects of bereavement status, psychiatric disorder in both offspring and caregiver, and demographic indices on trajectories of cortisol response.After controlling for demographic variables and offspring depression, bereaved offspring demonstrated significantly different trajectories of cortisol response compared with nonbereaved offspring, characterized by higher total cortisol output and an absence of cortisol reactivity to acute social stress. Within the bereaved group, offspring of parents who died by sudden natural death demonstrated significant cortisol reactivity to social stress compared with offspring whose parents died by suicide, who demonstrated more blunted trajectory of cortisol response.Parentally bereaved youth demonstrate higher cortisol output than nonbereaved youth but are less able to mount an acute response in the face of social stressors.",0,0 +4420,A factor analysis of the DSM-III post-traumatic stress disorder criteria,"The authors factor analyzed DSM-III-based post-traumatic stress disorder symptom ratings made on 131 Vietnam-veteran PTSD patients. Five factors--termed Intrusive Thoughts and Their Effects, Increased Arousal, Impoverished Relationships, Guilt, and Cognitive Interference--emerged. The factor structure gave more support to Laufer, Brett and Gallops' conceptualization of PTSD than to the Horowitz, DSM-III, or DSM-III-R systems. It also generated suggestions for future editions of the diagnostic manual.",0,0 +4421,A memory-based model of posttraumatic stress disorder: Evaluating basic assumptions underlying the PTSD diagnosis.,"In the mnemonic model of posttraumatic stress disorder (PTSD), the current memory of a negative event, not the event itself, determines symptoms. The model is an alternative to the current event-based etiology of PTSD represented in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000). The model accounts for important and reliable findings that are often inconsistent with the current diagnostic view and that have been neglected by theoretical accounts of the disorder, including the following observations. The diagnosis needs objective information about the trauma and peritraumatic emotions but uses retrospective memory reports that can have substantial biases. Negative events and emotions that do not satisfy the current diagnostic criteria for a trauma can be followed by symptoms that would otherwise qualify for PTSD. Predisposing factors that affect the current memory have large effects on symptoms. The inability-to-recall-an-important-aspect-of-the-trauma symptom does not correlate with other symptoms. Loss or enhancement of the trauma memory affects PTSD symptoms in predictable ways. Special mechanisms that apply only to traumatic memories are not needed, increasing parsimony and the knowledge that can be applied to understanding PTSD.",0,0 +4422,Psychological Resilience after Hurricane Sandy: The Influence of Individual- and Community-Level Factors on Mental Health after a Large-Scale Natural Disaster,"Several individual-level factors are known to promote psychological resilience in the aftermath of disasters. Far less is known about the role of community-level factors in shaping postdisaster mental health. The purpose of this study was to explore the influence of both individual- and community-level factors on resilience after Hurricane Sandy. A representative sample of household residents (N = 418) from 293 New York City census tracts that were most heavily affected by the storm completed telephone interviews approximately 13–16 months postdisaster. Multilevel multivariable models explored the independent and interactive contributions of individual- and community-level factors to posttraumatic stress and depression symptoms. At the individual-level, having experienced or witnessed any lifetime traumatic event was significantly associated with higher depression and posttraumatic stress, whereas demographic characteristics (e.g., older age, non-Hispanic Black race) and more disaster-related stressors were significantly associated with higher posttraumatic stress only. At the community-level, living in an area with higher social capital was significantly associated with higher posttraumatic stress. Additionally, higher community economic development was associated with lower risk of depression only among participants who did not experience any disaster-related stressors. These results provide evidence that individual- and community-level resources and exposure operate in tandem to shape postdisaster resilience.",0,0 +4423,[Application of the Children's Impact of Event Scale (Chinese Version) on a rapid assessment of posttraumatic stress disorder among children from the Wenchuan earthquake area].,"To explore the reliability and validity of the Children's Impact of Event Scale (Chinese version, CRIES-13) and to determine the value and the optimal cutoff point of the score of CRIES-13 in screening posttraumatic stress disorder (PTSD), so as to provide evidence for PTSD prevention and identify children at risk in Wenchuan earthquake areas.A total of 253 children experienced the Wenchuan earthquake were tested through Stratified random cluster sampling. The authors examined CRIES-13's internal consistency, discriminative validity and predictive value of the cut-off. PTSD was assessed with the DSM-IV criteria. Area under the curve while sensitivity, specificity and Youden index were computed based on the receiver operating characteristic curve analysis. Optimal cutoff point was determined by the maximum of Youden index.20.9% of the subjects were found to have met the DSM-IV criteria for PTSD 7 months after the Wenchuan earthquake accident. The Cronbach's coefficient of CRIES-13 was 0.903 and the mean inter-item correlation coefficients ranged from 0.283 to 0.689, the correlation coefficient of the three factors with the total scale scores ranged from 0.836 to 0.868 while the correlation coefficient among the three factors ranged from 0.568 to 0.718, PTSD cases indicated much higher scores than non-PTSD cases, the Youden index reached maximum value when the total score approached 18 in CRIES-13 with sensitivity and specificity as 81.1% and 76.5% respectively. Consistency check showed that there were no significant differences between the results of CRIES-13 score >/= 32 and clinical diagnosis (Kappa = 0.529) from the screening program.CRIES-13 appeared to be a reliable and valid measure for assessing the posttraumatic stress symptoms among children after the earthquake accident in the Wenchuan area. The CRIES-13 seemed to be a useful self-rating diagnostic instrument for survivors with PTSD symptoms as a clinical concern by using a 18 cut-off in total score. Consistency check showed that there was no significant difference between the screening result of CRIES-13 score >/= 32 and clinical diagnosis.",0,0 +4424,Decreased N-acetyl-aspartate levels in anterior cingulate and hippocampus in subjects with post-traumatic stress disorder: a proton magnetic resonance spectroscopy study,"The purpose of this study was to investigate the concentration of N-acetyl-aspartate (NAA) in the brain and its relationship with clinical characteristics in patients with post-traumatic stress disorder (PTSD). Proton magnetic resonance spectroscopy was performed in order to measure NAA concentrations in the anterior cingulate cortex (ACC) and bilateral hippocampus in 26 subjects with fire-related PTSD, who were survivors of a subway fire in South Korea, and 25 age- and sex-matched healthy comparison subjects. There were decreased NAA levels in the ACC (t = -3.88, d.f. = 49, P < 0.001) and bilateral hippocampus (right, t = -3.88, d.f. = 49, P < 0.001; left, t = -3.62, d.f. = 49, P < 0.001) in the PTSD group relative to the healthy comparison group. Also, NAA levels of the ACC (r = -0.43, n = 26, P = 0.027) and bilateral hippocampus (right, r = -0.48, n = 26, P = 0.013; left, r = -0.40, n = 26, P = 0.04) were negatively correlated with re-experience symptom scores in subjects with PTSD. In conclusion, our findings suggest that subjects with PTSD had decreased neuronal viabilities in the ACC and bilateral hippocampus, and that these deficits may play an important role in the pathophysiology of PTSD, especially regarding the re-experiencing of traumatic events.",0,0 +4425,Management of post traumatic stress disorder after childbirth: a review,"Prevalence and risk factors for the development of post traumatic stress disorder (PTSD) after childbirth is well described in the literature. However, its management and treatment has only begun to be investigated. The aim of this article is to describe the studies that examine the effects of interventions on PTSD after childbirth. MedLine, PILOTS, CINAHL and ISI Web of Science databases were systematically searched for randomised controlled trials, pilot studies and case studies using key words related to PTSD, childbirth, treatment and intervention. The reference lists of the retrieved articles were also used to supplement the search. A total of nine studies were retrieved. Seven studies that examined debriefing or counselling were identified; six randomised controlled trials and one pilot study. Also found were one case report describing the effects of cognitive behavioural therapy (CBT) on two women, and one pilot study of eye movement desensitisation and reprocessing (EMDR). Overall, there is limited evidence concerning the management of women with PTSD after childbirth. The results agree with the findings from the non-childbirth related literature: debriefing and counselling are inconclusively effective while CBT and EMDR may improve PTSD status but require investigation in controlled trials before conclusions could be drawn.",0,0 +4426,FACTORS ASSOCIATED WITH POSTTRAUMATIC STRESS DISORDER FOLLOWING MODERATE TO SEVERE TRAUMATIC BRAIN INJURY: A PROSPECTIVE STUDY,"This study prospectively examined the relationship between preinjury, injury-related, and postinjury factors and posttraumatic stress disorder (PTSD) following moderate to severe traumatic brain injury (TBI).Two hundred and three participants were recruited during inpatient admission following moderate to severe TBI. Participants completed an initial assessment soon after injury and were reassessed at 3, 6, and 12 months, 2, 3, 4, and 5 years postinjury. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-fourth edition was used to diagnose pre- and postinjury PTSD and other psychiatric disorders. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Inventory (QOLI) were used to evaluate functional and psychosocial outcome from 6 months postinjury.The frequency of PTSD ranged between 0.5 and 9.4% during the 5-year period, increasing throughout the first 12 months and declining thereafter. After controlling for other predictors, shorter posttraumatic amnesia duration (odds ratio = 0.96, 95% CI = 0.92-1.00), other concurrent psychiatric disorder (odds ratio = 14.22, 95% CI = 2.68-75.38), and lower GOSE (odds ratio = 0.38, 95% CI = 0.20-0.72) and QOLI scores (odds ratio = 0.97, 95% CI = 0.95-0.97) were associated with greater odds of having injury-related PTSD.The results of this study indicate that while shorter posttraumatic amnesia duration is associated with PTSD, greater TBI severity does not prevent PTSD from evolving. Patients with PTSD experienced high rates of psychiatric comorbidity and poorer functional and quality of life outcomes after TBI.There is a need to direct clinical attention to early identification and treatment of PTSD following TBI to improve outcomes.",0,0 +4427,Elevation of Urinary Norepinephrine/Cortisol Ratio in Posttraumatic Stress Disorder,"We have previously reported the unusual combination of low urinary free cortisol levels with high urinary norepinephrine excretion in posttraumatic stress disorder (PTSD) patients in comparison with four other patient groups: major depressive disorder, endogenous type; bipolar I, manic; paranoid schizophrenia; undifferentiated schizophrenia. Cortisol levels alone did not distinguish PTSD from paranoid schizophrenia patients and norepinephrine levels alone did not distinguish PTSD from bipolar I, manic, patients. In further consideration of these findings, we have found that combining the values for the two systems in a norepinephrine/cortisol (N/C) ratio provides a measure that significantly distinguishes PTSD from all the other patient groups throughout the hospitalization period. The N/C ratio was more than twice as high in the PTSD group than in all the other patient groups in the first sample following hospital admission, in the mean sample during hospitalization, and in the last sample before discharge. The mean N/C ratio for the PTSD group was 2.54, compared with a mean of .99 for the other four groups, which ranged from .81 to 1.18. The diagnostic sensitivity was 78% and the specificity was 94% for correct classification of PTSD in our sample. These preliminary findings yield further encouragement for exploring multivariate strategies, using hormonal ratios or profiles, in an effort to increase the diagnostic sensitivity of neuroendocrine criteria in the assessment of psychiatric patients.",0,0 +4428,Psychosocial adaptation to spinal cord injury as a function of time since injury,"The literature on the relationship between time since injury (TSI) and the clinical unfolding of psychosocial adaptation to disability has yielded mixed results. In this exploratory study we have attempted to compare two groups of people who sustained spinal cord injury (SCI)--namely, short-term TSI versus long-term TSI--on the patterns of psychosocial reactions to their medical condition. Using the initial pool of participants (n=317), two ""extreme'"" TSI groups were created (short-term TSI, composed of people whose injuries occurred within the last 4 years, and long-term TSI, comprising people whose injuries occurred 20 or more years ago). A two-group discriminant function analysis (DFA) applied to the eight subscales of the Reactions to Impairment and Disability Inventory (RIDI) yielded a significant function that was most closely associated with reactions of denial, shock and generalized anger, suggesting a non-acceptance of the condition among the more recently injured. Further analyses were then separately applied to the two groups of civilians and veterans with SCI. The resultant DFAs yielded functions suggesting somewhat different group patterns from the original one. Results are discussed within the context of the literature drawn from the fields of post-traumatic stress disorder (PTSD) and related traumatic experiences.",0,0 +4429,"Potentially Modifiable Pre-, Peri-, and Postdeployment Characteristics Associated With Deployment-Related Posttraumatic Stress Disorder Among Ohio Army National Guard Soldiers","To evaluate potentially modifiable deployment characteristics-- predeployment preparedness, unit support during deployment, and postdeployment support-that may be associated with deployment-related posttraumatic stress disorder (PTSD).We recruited a sample of 2616 Ohio Army National Guard (OHARNG) soldiers and conducted structured interviews to assess traumatic event exposure and PTSD related to the soldiers' most recent deployment, consistent with DSM-IV criteria. We assessed preparedness, unit support, and postdeployment support by using multimeasure scales adapted from the Deployment Risk and Resilience Survey.The prevalence of deployment-related PTSD was 9.6%. In adjusted logistic models, high levels of all three deployment characteristics (compared with low) were independently associated with lower odds of PTSD. When we evaluated the influence of combinations of deployment characteristics on the development of PTSD, we found that postdeployment support was an essential factor in the prevention of PTSD.Results show that factors throughout the life course of deployment-in particular, postdeployment support-may influence the development of PTSD. These results suggest that the development of suitable postdeployment support opportunities may be centrally important in mitigating the psychological consequences of war.",0,0 +4430,Mental health correlates of victimization classes among homeless youth,"Literature reports high rates of street victimization among homeless youth and recognizes psychiatric symptoms associated with such victimization. Few studies have investigated the existence of victimization classes that differ in type and frequency of victimization and how youth in such classes differ in psychiatric profiles. We used latent class analysis (LCA) to examine whether classes of homeless youth, based on both type and frequency of victimization experiences, differ in rates of meeting diagnostic criteria for major depressive episodes and posttraumatic stress disorder (PTSD) in a sample of homeless youth (N=601) from three regions of the United States. Results suggest youth who experience high levels of direct and indirect victimization (high-victimization class) share similarly high rates of depressive episodes and PTSD as youth who experience primarily indirect victimization only (witness class). Rates of meeting criteria for depressive episodes and PTSD were nearly two and three times greater, respectively, among the high victimization and witness classes compared to youth who never or rarely experienced victimization. Findings suggest the need for screening and intervention for homeless youth who report direct and indirect victimization and youth who report indirect victimization only, while prevention efforts may be more relevant for youth who report limited victimization experience.",0,0 +4431,Dissociative Depression Among Women with Fibromyalgia or Rheumatoid Arthritis,"The aim of this study was to inquire about the possible relations of childhood trauma, anger, and dissociation to depression among women with fibromyalgia or rheumatoid arthritis. Fifty female patients diagnosed as having fibromyalgia (n = 30) or rheumatoid arthritis (n = 20) participated in the study. The Childhood Trauma Questionnaire, Somatoform Dissociation Questionnaire (SDQ), Dissociation Questionnaire (DIS-Q), Beck Depression Inventory (BDI), Spielberger State-Trait Anger Expression Inventory, and Dissociative Disorders Interview Schedule were administered to all participants. Women with a lifetime diagnosis of depressive disorder had higher scores for somatoform and psychoform dissociation than the nondepressive patients. However, childhood trauma scores did not differ between the 2 groups. In regression analysis, current severity of depression (BDI) was predicted by psychoform dissociation (DIS-Q) and lower education, and lifetime diagnosis of major depression was predicted by somatoform dissociation (SDQ). Whereas childhood emotional neglect predicted somatoform dissociation, psychoform dissociation was predicted by childhood sexual abuse. Mental processing of anger seems to be 1 of the dimensions of psychodynamics in trauma-related depressive conditions. In the context of the perceived threat of loss of control due to expressed anger and mental disintegration, somatoform dissociation seems to contribute to overmodulation of emotions in dissociative depression. Among patients suffering from physical illness with possible psychosomatic dimensions, assessment of somatoform dissociation in addition to psychoform dissociation may be helpful to understand diverse psychopathological trajectories emerging in the aftermath of childhood adversities. The recently proposed category of ""dissociative depression"" (Sar, 2011) seems to be a promising concept for future research on psychosomatic aspects of traumatic stress.",0,0 +4432,"Trauma and women: course, predictors, and treatment.","Posttraumatic stress disorder (PTSD) resulting from aggravated assault, rape, or noncrime trauma affects over 4 million women in the United States, according to retrospective studies. Prospective studies reviewed here found that 3 months post assault the prevalence of PTSD was 48% in rape victims and 25% in nonsexual crime victims. Prolonged exposure treatment and stress inoculation training are both effective psychotherapeutic treatments for PTSD. Prolonged exposure involves having the patient relive the traumatic memory and recount the event in detail. This description is audiotaped and the patient is asked to listen to it as part of assigned homework. In vivo exposure to feared objects or situations is also assigned as homework. Stress inoculation training consists of teaching patients a variety of techniques for managing anxiety, including controlled breathing, deep muscle relaxation, thought-stopping, cognitive restructuring, preparation for stressors, covert modeling, and role-play. Both treatments have been proven to be effective alone and in combination in ameliorating chronic PTSD in women after traumatic sexual or nonsexual assault. This efficacy was maintained for 3 months of follow-up.",0,0 +4433,"The structure of acute posttraumatic stress symptoms: ‘Reexperiencing’, ‘Active avoidance’, ‘Dysphoria’, and ‘Hyperarousal’","Empirical data have challenged chronic posttraumatic stress disorder (PTSD) consisting of three dimensions. In the present study we aimed to determine the factor structure of acute posttraumatic symptoms in two recently traumatized samples. In sample 1, 203 civilian trauma survivors were administered the Davidson Trauma Scale (DTS) approximately 1 week posttrauma. In sample 2, 182 civilian treatment seeking trauma survivors completed the DTS at an average of 41.4 days posttrauma. Our confirmatory factor analyses indicated that a 4-factor intercorrelated model provided the best representation of the data in both samples. The four factors are best described as reexperiencing, active avoidance, dysphoria , and hyperarousal. For acute posttraumatic symptoms, the empirical data suggest to split the avoidance cluster into ‘Active avoidance’ and ‘Dysphoria’—confirming findings in studies on chronic PTSD. In future revisions of the DSM, the diagnostic criteria for PTSD may need to be adapted to fit the research findings.",0,0 +4434,"Reactions of Oklahoma City bombing survivors to media coverage of the September 11, 2001, attacks","This study explored the effects of media coverage of a terrorist incident in individuals remote from the location of a major attack who had directly experienced a prior terrorist incident.Directly-exposed survivors of the 1995 Oklahoma City bombing, initially studied six months after the incident, and indirectly-affected Oklahoma City community residents were assessed two to seven months after the September 11, 2001, attacks. Survivors were assessed for a diagnosis of bombing-related posttraumatic stress disorder (PTSD) at index and follow up, and emotional reactions and September 11 media behavior were assessed in all participants.Among the three investigated forms of media (television, radio, and newspaper), only television viewing was associated with 9/11-related posttraumatic stress reactions. Exposure to the Oklahoma City bombing was associated with greater arousal in relation to the September 11 attacks, and among survivors, having developed bombing-related PTSD was associated with higher scores on all three September 11 posttraumatic stress response clusters (intrusion, avoidance, and arousal). Although time spent watching television coverage of the September 11 attacks and fear-related discontinuation of media contact were not associated with Oklahoma City bombing exposure, discontinuing September 11 media contact due to fear was associated with avoidance/numbing in the full sample and in the analysis restricted to the bombing survivors.Surviving a prior terrorist incident and developing PTSD in relation to that incident may predispose individuals to adverse reactions to media coverage of a future terrorist attack.",0,0 +4435,Code Triage: Integrating the National Children's Disaster Mental Health Concept of Operations Across Health Care Systems,"This article describes the National Children's Disaster Mental Health Concept of Operations (“CONOPS”) model as a method to address discrepancies between research advances that have been made and the typical methods of providing mental health services to children after disasters. Three key CONOPS strategies are described: (1) the PsySTART Disaster Mental Health Triage System, (2) a child-focused Incident Action Plan (IAP), and (3) a continuum of risk stepped-care model that matches the level of evidence-based treatment interventions with the level of identified risk using a stepped-care framework. Together, these strategies provide an integrated “disaster systems of care” method for the needs of children. With the goal to strengthen the resilience of children, the CONOPS provides clear operational strategies to facilitate mental health care addressing the full continuum of risk and resilience in the child population. Adapting this tool to health care systems i s a vital step to improving mental health services and resilience outcomes for children after a disaster.",0,0 +4436,"Attachment typologies and posttraumatic stress disorder (PTSD), depression and anxiety: a latent profile analysis approach","Bartholomew (1990) proposed a four category adult attachment model based on Bowlby's (1973) proposal that attachment is underpinned by an individual's view of the self and others. Previous cluster analytic techniques have identified four and two attachment styles based on the Revised Adult Attachment Scale (RAAS). In addition, attachment styles have been proposed to meditate the association between stressful life events and subsequent psychiatric status.The current study aimed to empirically test the attachment typology proposed by Collins and Read (1990). Specifically, LPA was used to determine if the proposed four styles can be derived from scores on the dimensions of closeness/dependency and anxiety. In addition, we aimed to test if the resultant attachment styles predicted the severity of psychopathology in response to a whiplash trauma.A large sample of Danish trauma victims (N=1577) participated. A Latent Profile Analysis was conducted, using Mplus 5.1, on scores from the RAAS scale to ascertain if there were underlying homogeneous attachment classes/subgroups. Class membership was used in a series of one-way ANOVA tests to determine if classes were significantly different in terms of mean scores on measures of psychopathology.The three class solution was considered optimal. Class one was termed Fearful (18.6%), Class two Preoccupied (34.5%), and Class three Secure (46.9%). The secure class evidenced significantly lower mean scores on PTSD, depression, and anxiety measures compared to other classes, whereas the fearful class evidenced significantly higher mean scores compared to other classes.The results demonstrated evidence of three discrete classes of attachment styles, which were labelled secure, preoccupied, and fearful. This is in contrast to previous cluster analytic techniques which have identified four and two attachment styles based on the RAAS.In addition, Securely attached individuals display lower levels of psychopathology post whiplash trauma.",0,0 +4437,Is multi-impulsive bulimia a distinct type of bulimia nervosa: Psychopathology and EMA findings,"To determine if clinically defined multi-impulsive bulimia (MIB) can be validated using an empirical classification approach.One hundred and twenty-five women who met DSM-IV criteria for bulimia nervosa were interviewed and completed a two-week EMA protocol. Participants who reported at least three highly impulsive behaviors were compared to participants who did not report such impulsive behavior. Also, Latent Class Analysis (LCA) was conducted to determine if the MIB classification could be replicated empirically.LCA produced a two-class solution consistent with the traditional clinical approach to MIB classification. In both approaches, MIB was associated with higher levels of anxiety disorders, child abuse, and daily self-damaging behaviors than the non-MIB class.Clinical classification of MIB was empirically supported through LCA. Although the classes failed to differ in bulimic behavior, MIB appears to represent a group of bulimic individuals with significant trauma histories and associated psychopathology.",0,0 +4438,POSTTRAUMATIC STRESS DISORDER SYMPTOMS AND THEIR COMORBIDITY WITH OTHER DISORDERS IN ELEVEN TO SIXTEEN YEARS OLD ADOLESCENTS IN THE CITY OF BAM,"Objectives: The aim of this study was to assess the symptoms of Posttraumatic Stress Disorder (PTSD) and the comorbidity of depression, anxiety, anger and dissociation with PTSD based on gender difference between two groups of earthquake-stricken boys and girls in the city of Bam and comparing it with normal adolescents in Tehran. Method: One thousand 11-16 year old students (300 boys and 700 girls) in the city of Bam selected using multi-step cluster sampling in two educational levels as the experimental group, and 3042 eleven to sixteen year old students from Tehran as the control group were examined. Data were gathered using Syndrome Checklist for Children (form A) and Interview form of Post Trauma Stress Scale (interview form). Data were then analyzed using correlation, independent t, chi-square (2), and Kruskal Wallis. Results: Adolescents who had experienced the traumatic events showed higher levels of depression, anxiety, posttraumatic stress, anger and dissociation in comparison with normal adolescents (p < 0.01). In the group with PTSD, frequency of all PTSD symptoms except anger symptoms was higher in girls than in boys. However, the frequency of pathological syndromes (T > 65) was more evident in boys than in girls, but was non-significant. The prevalence of PTSD in the experimental group was 20%. Conclusion: There is a high comorbidity between symptoms of PTSD and other symptoms, which leads to a higher report of PTSD prevalence. Even though psychological vulnerability was higher in boys than in girls, it seems that gender role expectance in the expression of emotions and the method of describing the symptoms play a role in this issue. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0,0 +4439,[Intensification of post-traumatic stress disorder of Siberian deportees from the North-East region of Poland].,"AIM Presentation of Post-Traumatic Stress Disorder based on the approach of various authors concentrating, upon the concept of the American classification: DSM III (1980) and DSM IV (1994). We acknowledged the necessity of displaying empirical results of intensification of PTSD among the population in the region of North-East part of Poland. METHOD In our analysis, we stressed the importance of the distant in time, psychological consequences of dwelling in extremely difficult living conditions that often threatened the life of those who had been deported to Siberia between 1939 and 1956. 40 Siberian deportees (20 men and 20 women) were examined. The method of PTSD-Interview (PTSD-I) was used here in order to obtain, in each individual case, the indicatory number indispensable for the statistical analysis. RESULTS AND CONCLUSION An average result of PTSD intensification in the case of women reaches a very level and in the case of men it is even higher. The disparity between the average results of women and of men are statistically significant (p<0.05). This research has confirmed the assumptions that suffering from trauma in the early stage of development (within the age range of 8-15) leaves a permanent mark in the human psyche. Statistical analysis revealed a high level of intensification of PTSD among the population of the Siberian deportees from the North-East region of Poland.",0,0 +4440,Commonality and Specificity of Personality Disorder Profiles in Subjects with Trauma Histories,"Recently, attention has been drawn to a range of disturbances in personality functioning that commonly characterize individuals with a history of severe or prolonged trauma. Many of these features overlap with criteria for some of the Axis II personality disorders. The current study investigated the similarity of personality disorder features in different samples of patients with trauma histories, and specificity of such features compared to other psychiatric samples. Profiles of Axis II features, based on relative frequencies of individual disorder “diagnoses” derived from a common measure (Personality Diagnostic Questionnaire-Revised), were compared in three trauma samples: male Vietnam combat veterans with PTSD, female inpatients with a history of childhood sexual abuse, and female outpatients with a history of childhood sexual abuse. The PDQ-R derived profiles in each of the three trauma samples were then compared with similar PDQ-R derived profiles in published reports of psychiatric samples selected for other diagnoses. Each of the three Spearman rank correlations among the three trauma samples were significant, ranging from .72 to .94. There was a clear pattern of higher correlations within the trauma samples (average correlation of .81) than between the trauma and nontrauma samples (average correlations of. 11, .36, and .25 between the nontrauma samples and the combat sample, inpatient sexual abuse sample, and outpatient sexual abuse sample, respectively). The findings suggest that a pattern of personality disorder features may be distinctly associated with individuals with trauma histories, at least of the type examined here. Future studies using more clinically valid measures of personality features and including other types of trauma samples are needed to determine the generalizability of the current findings.",0,0 +4441,Psychosocial Effects of War Experiences Among Displaced Children in Southern Darfur,"This study focused on assessing the psychosocial effects of the long standing, high intensity, and guerrilla-style of warfare among displaced children in Southern Darfur. The goal was to better understand the etiology, prognosis, and treatment implications for traumatic reactions, depression, and grief symptoms in this population. Three hundred thirty-one children aged 6-17 from three IDP Camps were selected using a quota sampling approach and were administered a Demographic Questionnaire, Child Post Traumatic Stress Reaction Index, Child Depression Inventory, and the Expanded Grief Inventory. Forty-three percent were girls and 57% were boys. The mean age of the children was 12 years. Results found that children were exposed to a very large Dumber of war experiences with no significant differences between genders for types of exposure, including rape, but with older children (13-17 years) facing a larger number of exposures than younger children (6-12 years). Out of the 16 possible war experiences, the mean number was 8.94 (SD = 3.27). Seventy-five percent of the children met the DSM-IV criteria for PTSD, and 38% exhibited clinical symptoms of depression. The percentage of children endorsing significant levels of grief symptoms was 20%. Increased exposure to war experiences led to higher levels of: 1) traumatic reactions; 2) depression; and 3) grief symptoms. Of the 16 war experiences, abduction, hiding to protect oneself, being raped, and being forced to kill or hurt family members were most predictive of traumatic reactions. Being raped, seeing others raped, the death of a parent/s, being forced to fight, and having to hide to protect oneself were the strongest predictors of depressive symptoms. War experiences such as abduction, death of one's parent/s, being forced to fight, and having to hide to protect oneself were the most associated with the child's experience of grief. In addition to Total Grief, Traumatic Grief, Existential Grief, and Continuing Bonds were measured in these children, Although trauma, depression, and grief often exist as co-morbid disorders, the mechanisms and pathways of these is less understood. In this study we used Structural Equation Modeling to better understand the complex interaction and trajectories of these three symptoms evolving from war exposure and loss. This study is the first of its kind to assess the psychosocial effects of war experiences among children currently living in war zone areas within Sudan. It identifies some of the most prevalent war-related atrocities and their varying impact on the children's psychological well-being and overall adjustment. Implications for planning mental health interventions are discussed. (",0,0 +4442,Neuroendocrine response to CRF stimulation in veterans with and without PTSD in consideration of war zone era,"Alterations in hypothalamic–pituitary–adrenal (HPA) axis activity have been observed in Gulf War veterans with posttraumatic stress disorder (PTSD) which differ from those observed in other veteran groups, raising the possibility that there is a unique neuroendocrine profile in this group of veterans. This study seeks to further characterize the effects of PTSD, military cohort (Vietnam, 1991 Gulf War, Operations Enduring Freedom/Iraqi Freedom (OEF/OIF)), and their interaction on the neuroendocrine response to synthetic corticotrophin-releasing factor (CRF) stimulation. 51 male veterans were studied consisting of 21 from the Vietnam era, 16 from the Gulf War era, and 14 from the OEF/OIF era. 16 of these veterans were deployed to a war zone and had chronic PTSD (PTSD+), 25 were deployed to a war zone and did not have chronic PTSD (PTSD−), and 10 were not deployed to a war zone and did not have PTSD (non-exposed). The participants underwent the CRF stimulation test in the afternoon (approximately 2:00 p.m.), which measures the integrity and sensitivity of the pituitary–adrenal axis. Plasma cortisol and adrenocorticotropic hormone (ACTH) were measured at baseline and at intervals over a 2 h period following intravenous administration of 1 μg/kg of ovine CRF (o-CRF, max 100 μg). In a small subset of participants, dehydroepiandrosterone (DHEA) and cortisol binding globulin (CBG) were also assessed. There was a significant group by era interaction in the response of ACTH to CRF, in addition to a main effect of group (PTSD+, PTSD−, non-exposed). The interaction reflected that group differences were only evident in the Gulf War cohort; among Gulf War era veterans, the PTSD+ group had higher elevations in ACTH levels following CRF than the PTSD− group and the non-exposed group. Additionally, the peak change in ACTH was associated with a self-reported environmental exposure (pyridostigmine bromide ingestion) which has been found to be linked to the excess morbidity found in Gulf War veterans. Self-reported childhood trauma was greater in veterans of the Gulf War than Vietnam or OEF/OIF, but did not account for the observed differences. There was a significant effect of group on the cortisol response to CRF, reflecting greater responsivity in both of the deployed groups (PTSD+ and PTSD−) compared to the non-exposed group which could be accounted for by baseline differences in cortisol levels; unlike the ACTH response, the cortisol response did not differ by era. There were no effects of group, era, or their interaction on the DHEA and CBG response to CRF. A uniform pattern of PTSD-related alterations in the response to intravenous CRF was not found. Rather, PTSD-related alterations were found only in veterans of the 1991 Gulf War, and were characterized by an enhanced pituitary response to CRF which may reflect increased sensitivity of pituitary corticotrophs or CRF hyposecretion. Together with previous neuroendocrine findings, the data suggest the HPA axis is dysregulated in Gulf War veterans in unique ways which may reflect the long-term effects of environmental exposures in addition to disease effects. Further work is needed to characterize these effects and their impact on long-term psychological and medical outcomes.",0,0 +4443,The perceptions and experiences of people injured in motor vehicle crashes in a compensation scheme setting: a qualitative study,"The evidence that compensation related factors are associated with poor recovery is substantial but these measures are generic and do not consider the complexity of scheme design. The objectives of this study were to understand people's perceptions and experiences of the claims process after sustaining a compensable injury in a motor vehicle crash (including why people seek legal representation); and to explore ways to assist people following a compensable injury and improve their experience with the claims process.A qualitative study in a Compulsory Third Party (CTP) personal injury scheme covering the state of New South Wales (NSW), Australia. A series of five focus groups, with a total of 32 participants who had sustained mild to moderate injuries in a motor vehicle crash, were conducted from May to June 2011 with four to eight attendees in each group. These were audio-recorded and transcribed. The methodology was based on a grounded theory approach using thematic analysis and constant comparison to generate coding categories for themes. Data saturation was reached. Analyst triangulation was used to ensure credibility of the results.Five primary themes were identified: complexity of the claims process; requirement of legal representation; injury recovery expectations; importance of timely healthcare decision making; and improvements for injury recovery. Some participants struggled, finding the claims process stressful and subsequently sought legal advice; whilst others reported a straight forward recovery, helpful insurer interactions and no legal representation. Most participants were influenced by injury recovery expectations, and timely healthcare decision making. To assist with injury recovery, access to objective information about the claims process using online technology and social media was considered paramount.Participants had contrasting injury recovery experiences and their perceptions of the claims process differed and were influenced by injury recovery expectations, and timeliness of healthcare decision making. Improvements to the claims process are required, including: simplification or streamlining (possibly using online technology and/or social media to reduce paperwork); and providing access to objective information. There is a need to trial early interventions and new claims management policies that could improve injury recovery and satisfaction with the claims process.",0,0 +4444,"Coping and Personality as Predictors of Post-Traumatic Intrusions, Numbing, Avoidance and General Distress: A Study of Victims of the Perth Flood","Trauma symptoms, coping and personality were assessed in 44 victims of the Perth flood. The sample was characterized by high levels of intrusions, numbness, arousal and general emotional distress. General levels of symptomatology were predicted by two coping strategies: emotion-focused coping and thought suppression. Overall trauma symptoms and emotion-focused coping were associated with the personality trait of neuroticism. These data are consistent with the Wells and Matthews (1994a) model of affective disorders and stress. The model proposes that certain types of emotion-focused coping tend to lead to greater access to negative self-beliefs, and that thought suppression tends to prime subsequent intruding thoughts. A second personality trait, private self-consciousness, was associated with relatively greater levels of numbing symptoms, and relatively lower levels of arousal symptoms. This patterning of symptoms may result from use of ruminative coping strategies. Hence, intrusions of trauma-related material are not simply a function of automatic activation of a fear network, but are also influenced by the person's voluntary efforts to deal with the aftermath of the event.",0,0 +4445,Can We Influence the Trajectory of Psychological Consequences to Terrorism?,"This article makes two significant contributions to the field of disaster and emergency mental health. First, it contributes to the existing knowledge regarding response to, and recovery from, events involving large-scale trauma. It does so by confirming previous findings as well as adding new information. Second, the findings of the study raise both puzzling and intriguing challenges to the profession and the country as we struggle to expand our knowledge and come to grips with the “new normal” faced by the United States. In a field where research is not nearly as extensive and complete as it needs to be and where we are far too dependent on extrapolation from other types of traumatic events, any and all research directly on disasters and terrorism is welcome. Longitudinal studies, even with rather short periods between samples, are especially needed. This study contributes by replication earlier findings regarding such factors as exposure, the impact of status factors such as gender, and the importance of social support. Other findings are tantalizing in both what they tell us and what they do not. We learn for example that a significant number of people turn to alcohol, medications, or drugs to feel better. What we cannot know from the study is the extent to which this coping strategy is nonproblematic use or abuse. To what extent is the drug use licit or illicit? These distinctions are important not only from a scientific and intervention perspective but also from a public policy, program development, and funding perspective. The study also demonstrates a significant gap in the existing models of understanding and intervening with the largest of catastrophic events. The science, practice, and appreciation for the importance of emergency and disaster mental health response has, and continues, to grow. However, most of our models are based on events that are far more limited in scope than the psychosocial sequelae that this study tells us attend the events of September 11, 2001. We have models for natural disaster. We have models for smaller-scale violent events. We do not have models for understanding and providing response and recovery from national disasters. This study documents the national nature of fear, distress, and changed behavior brought on by these types of events. While we may Psychiatry 67(2) Summer 2004 164",0,0 +4446,"Anxious and Depressive Avoidance and Symptoms of Prolonged Grief, Depression, and Post-Traumatic Stress Disorder","Following loss, people can develop symptoms of depression, Post-Traumatic Stress Disorder (PTSD), or Complicated Grief (CG) – also termed Prolonged Grief Disorder (PGD). A recent cognitive-behavioural model has proposed that avoiding confrontation with the reality of the loss (called “anxious avoidance” [AA]) and refraining from activities that could foster adjustment (called “depressive avoidance” [DA]) both play a critical role in CG/PGD. The present study examined this assumption, using self-reported data from 161 mourners. Findings showed that items constituting AA and DA represented two distinct factors. Both factors were strongly correlated with other measures of bereavement-related avoidance and both accounted for a unique part of the explained variance in CG/PGD severity, beyond relevant background variables, negative cognitions, and concomitant symptom-levels of depression and PTSD. DA also explained unique variance in depression beyond these variables. Moreover, AA and DA mediated the linkages of neuroticism, attachment anxiety, and attachment avoidance with symptom-levels of CG/PGD.",0,0 +4447,Linking abuse and recovery through advocacy: an observational study,"Aims. High numbers of psychiatric service users experience domestic violence, yet limited interventions exist for these victims. We piloted a domestic violence intervention for community mental health services to explore the feasibility of a future cluster randomized controlled trial. Methods. Quasi-experimental controlled design within five Community Mental Health Teams (three intervention and two control teams). The intervention comprised domestic violence training for clinicians' and referral to domestic violence advocacy for service users. Clinicians' ( n = 29) domestic violence knowledge, attitudes and behaviours were assessed before and 6 months post-training. Service users' ( n = 34) safety behaviours, unmet needs, quality of life and frequency/severity of abuse were examined at baseline and 3 months follow-up. Process evaluation data were also collected. Results. Clinicians receiving the intervention reported significant improvements in domestic violence knowledge, attitudes and behaviours at follow-up ( p < 0.05). Service users receiving the intervention reported significant reductions in violence ( p < 0.001) and unmet needs at follow-up ( p < 0.05). Conclusions. Interventions comprising domestic violence training for clinicians and referral to domestic violence advocacy may improve responses of psychiatric services. Low rates of identification among teams not receiving training suggest that future trials using service user outcomes are unlikely to be feasible. Therefore, other methods of evaluation are needed.",0,0 +4448,Pharmaceuticals and personal care products: A critical review of the impacts on fish reproduction,"Research in environmental toxicology involving pharmaceuticals and personal care products (PPCPs) has increased greatly over the last 10-15 years. Much research has been focused on the endocrine-disrupting potential of PPCPs, as they relate to negative population impacts of aquatic organisms. This review assesses the current data on the reported effects of PPCPs on fish reproduction with an emphasis on fecundity, a predictor of population effects. Studies of both individual PPCPs and PPCP mixtures are presented. As the majority of individual PPCP studies reviewed demonstrate negative effects on fish fecundity, we relate these findings to detected surface water concentrations of these compounds. Very few studies involving PPCP mixtures have been conducted; however, the need for these types of studies is warranted as fish are most likely exposed to mixtures of PPCPs in the wild. In addition, laboratory and field assessments of wastewater treatment plant (WWTP) effluents, a major source of PPCPs, are reviewed. Much of the data provided from these assessments are variable and do not generally demonstrate negative impacts on reproduction, or the studies are unable to directly associate observed effects with WWTP effluents. Finally, future research considerations are outlined to provide an avenue into understanding how wild populations of fish are affected by PPCPs. These considerations are aimed at determining the adaptation potential of fish exposed to mixtures of PPCPs over multiple generations. As global use of PPCPs continually rises, the need to discern the effects of chronic exposure to PPCPs is greatly increased.",0,0 +4449,Problemas de Nervos: A Multivocal Symbol of Distress for Portuguese Immigrants,"This article outlines research on a previous unstudied form of suffering specific to the Portugese immigrant community: problemas de nervos. Thirty-two Portuguese immigrant women (in Waterloo, ON and Boston, MA) were interviewed and each completed a questionnaire. Cluster analysis demonstrated that problemas de nervos has many meanings. The study profiled symptoms, causes and therapies associated with four variations of this culture-specific form of distress: “ mal da cabeca” meaning problems with/in the head (e.g., lack of control, visions); “ aflição” meaning affliction (e.g., nervous attacks, heart problems); immigration stress (causing sleep disturbances); and, conflicts with others (resulting in pressure within the body). None of the symptom clusters reported matched criteria for a DSM-IV-TR diagnosis, suggesting that problemas de nervos represents an idiomatic rather than universal expression of distress.",0,0 +4450,Double-Blind Placebo-Controlled Pilot Study of Sertraline in Military Veterans With Posttraumatic Stress Disorder,"The efficacy of sertraline in the treatment of civilian posttraumatic stress disorder (PTSD) has been established by two large placebo-controlled trials. The purpose of the current pilot study was to obtain preliminary evidence of the efficacy of sertraline in military veterans suffering from PTSD. Outpatient Israeli military veterans with a DSM-III-R diagnosis of PTSD were randomized to 10 weeks of double-blind treatment with sertraline (50-200 mg/day; N = 23, 83% male, mean age = 41 years) or placebo (N = 19, 95% male, mean age = 38 years). Efficacy was evaluated by the Clinician-Administered PTSD Scale (CAPS-2) and by Clinical Global Impression Scale-Severity (CGI-S) and -Improvement (CGI-I) ratings. Consensus responder criteria consisted of a 30% or greater reduction in the CAPS-2 total severity score and a CGI-I rating of ""much"" or ""very much"" improved. The baseline CAPS-2 total severity score was 94.3 +/- 12.9 for sertraline patients, which is notably higher than that reported for most studies of civilian PTSD. On an intent-to-treat endpoint analysis, sertraline showed a numeric but not statistically significant advantage compared with placebo on the CAPS-2 total severity and symptom cluster scores. In the study completer analysis, the mean CGI-I score was 2.4 +/- 0.3 for sertraline and 3.4 +/- 0.3 for placebo (t = 2.55, df = 30, p = 0.016), CGI-I responder rates were 53% for sertraline and 20% for placebo (chi2 = 3.62, df = 1, p = 0.057), and combined CGI-I and CAPS-2 responder rates (>or=30% reduction in baseline CAPS-2 score) were 41% for sertraline and 20% for placebo (chi2 = 1.39, df = 1, p = 0.238). Sertraline treatment was well tolerated, with a 13% discontinuation rate as a result of adverse events. This pilot study suggests that sertraline may be an effective treatment in patients with predominantly combat-induced PTSD, although the effect size seems to be somewhat smaller than what has been reported in civilian PTSD studies. Adequately powered studies are needed to confirm these results and to assess whether continued treatment maintains or further improves response.",0,0 +4451,WFS1 gene as a putative biomarker for development of post-traumatic syndrome in an animal model,"Post-traumatic stress disorder (PTSD) is an anxiety disorder that may develop after the experiencing or witnessing of a life-threatening event. PTSD is defined by the coexistence of three clusters of symptoms: re-experiencing, avoidance and hyperarousal, which persist for at least 1 month in survivors of the event (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition). Using an established model of PTSD, we addressed the well-accepted clinical finding that only a minority (about 20%) of the individuals exposed to a traumatic event develop PTSD. Moreover, we followed individual rat behavior for up to a month, and then treated the PTSD-like animals with citalopram. Our data demonstrate high face (20% of rats exposed to a reminder of the stressor develop symptoms characteristic of PTSD) and predictive (response to citalopram) validities. Based on these validities we identified alterations in the Wolframin gene in the CA1 and amygdala regions, specifically in exposed PTSD-like rats, which were normalized after treatment with citalopram. We suggest the Wolframin gene as a putative biomarker for PTSD. Since Wolframin gene undergoes alternative splicing and has polymorphism in the population, it may serve a future marker for identification of the vulnerable population exposed to a traumatic event. © 2009 Nature Publishing Group All rights reserved.",0,0 +4452,Gender Differences in a Clinical Sample of Patients with Borderline Personality Disorder,"The aim of the study was to investigate gender differences and similarities in patients with borderline personality disorder (BPD) with respect to Axis I comorbidity, Axis II comorbidity, general psychopathology (Symptom Checklist 90-Revised), and dimensional personality traits (NEO-Personality-Inventory Revised [NEO-PI-R] and the Dimensional Assessment of Personality Profile Basic questionnaire [DAPP-BQ]). Fifty-seven men and 114 women with BPD were included in the study. Regarding Axis I and II disorders in an exploratory analysis, men with BPD more often fulfilled the diagnostic criteria for binge eating disorder, antisocial personality disorder, narcissistic personality disorder, and conduct disorder in childhood, whereas women had higher frequencies of bulimia nervosa, posttraumatic stress disorder, and panic disorder with agoraphobia. After correcting for multiple tests, only the gender differences in narcissistic and antisocial personality disorder remained significant. In the SCL-90-R profile, no significant gender differences could be identified. In the exploratory analysis of the dimensional personality traits, women showed higher rates on the NEO-PI-R main factors (Neuroticism and Agreeableness) compared to men. In the DAPP-BQ profile, men reached higher sores on the main factor, Dissocial Behavior. When correcting for multiple tests, gender differences still existed for Neuroticism and Dissocial Behavior. Our results argue for gender differences in Axis I and II comorbidity and dimensional personality traits in BPD. However, in general, more similarities than differences were shown in this study.",0,0 +4453,"The Course of PTSD, Major Depression, Substance Abuse, and Somatization After a Natural Disaster","Flood research has used a variety of methods, yielding inconsistent findings. Universal definitions of illness are paramount to the science of psychiatric epidemiology of disasters. St. Louis area survivors (N = 162) of the Great Midwestern Floods of 1993 received a structured diagnostic assessment at 4 and 16 months postdisaster, with 88% follow-up. The purpose of the assessment was to examine predisaster and postdisaster rates of disorders and symptoms. Flood-related posttraumatic stress disorder was diagnosed in 22% and 16% at index and follow-up, respectively. Comorbidity with major depression determined whether the posttraumatic stress disorder would have remitted by 1 year later. Nearly one half of the men in the sample had a pre-existing alcohol use disorder. Virtually no new substance abuse followed the floods, and hence, substance abuse did not develop in response to the disaster or as part of coping with its aftermath. Somatization disorder was not observed; new somatoform symptoms represented a fraction of postflood somatic complaints. Findings are inconsistent with causal attribution of floods in the etiology of alcohol abuse and somatization. Methodological differences may account for much of the apparent discrepancy of these findings, with recent reports of increased alcohol use and somatic symptoms observed after other disasters.",0,0 +4454,Children of Katrina: Lessons Learned About Postdisaster Symptoms and Recovery Patterns,"Trauma symptoms, recovery patterns, and life stressors of children between the ages of 9 and 18 (n = 387) following Hurricane Katrina were assessed using an adapted version of the National Child Traumatic Stress Network Hurricane Assessment and Referral Tool for Children and Adolescents (National Child Traumatic Stress Network, 2005). Based on assessments 2 and 3 years after the hurricane, most children showed a decrease in posttraumatic stress and depression symptoms over time. Students were also classified into outcome trajectories of stress resistant, normal response and recovery, delayed breakdown, and breakdown without recovery (A. S. Masten & J. Obradovic, 2008). Age, gender, and life stressors were related to these recovery patterns. Overall, the findings highlight the importance of building and maintaining supportive relationships following disasters.",0,0 +4455,Psychosocial profile of a sample of Egyptian children with rheumatic heart disease,"Objectives Early-onset physical morbidity is likely to affect the emotional balance and behavioral adaptation of children and adolescents. Few published studies have investigated psychological morbidity in children with rheumatic heart diseases (RHD). Our work aims to explore the psychiatric symptoms in addition to total competence and quality of life in a sample of Egyptian children with RHD in comparison with those with no RHD and with healthy controls. Participants and methods Children (age 6-18 years) with RHD (n=24), those with congenital or other heart diseases (non-RHD) (n=23), and healthy control children (n=28) were recruited. The Arabic version of the Child Behavior Checklist was completed by parents. Results After adjustment for different socioeconomic statuses, all children with heart diseases were found to show more internalizing problems and post-traumatic stress compared with healthy children. Non-RHD children showed more generalized and social anxiety, whereas those with RHD showed higher levels of obsessive-compulsive problems. Conclusion Children with heart diseases suffer from high internalizing psychological stress. More effort needs to be made for the early identification and management of psychological morbidity in children with RHD, especially for anxiety and obsessive compulsive symptoms. © 2015 Institute of Psychiatry, Ain Shams University.",0,0 +4456,"Normative Data for the Neurobehavioral Symptom Inventory (NSI) and Post-Concussion Symptom Profiles Among TBI, PTSD, and Nonclinical Samples","The Neurobehavioral Symptom Inventory (NSI) is a self-report measure of symptoms commonly associated with Post-Concussion Syndrome (PCS) that may emerge after mild traumatic brain injury (mTBI). Despite frequent clinical use, no NSI norms have been developed. Thus, the main objective of this study was to establish NSI normative data using the four NSI factors (i.e., vestibular, somatic, cognitive, and affective) identified by Vanderploeg, Silva, et al. ( 2014 ) among nonclinical epidemiological samples of deployed and non-deployed Florida National Guard members as well as a reference sample of Guard members with combat-related mTBI. In addition, NSI subscale profile patterns were compared across four distinct subgroups (i.e., non-deployed-nonclinical, deployed-nonclinical, deployed-mTBI, and deployed-PTSD). The deployed-nonclinical group endorsed greater PCS symptom severity than the non-deployed group, and the mTBI group uniformly endorsed more symptoms than both nonclinical groups. However, the PTSD group endorsed higher symptom severity relative to the other three subgroups. As such, this highlights the non-specificity of PCS symptoms and suggests that PTSD is associated with higher symptom endorsement than mTBI.",0,0 +4457,Post-Traumatic Stress Disorder (PTSD),"This article discusses the biomedical and the social constructionist models applied to response to trauma, presents the prevalence and the etiology of post-traumatic stress disorder (PTSD), and describes its biological and psychological correlates in children and adults. It concludes that future research might benefit from investigating factors that may protect people who have been exposed to an event likely to be traumatic from presenting with PTSD symptoms, and factors that may affect the longitudinal course of PTSD and treatment effectiveness.",0,0 +4458,Optimal Scoring of the Multidimensional Pain Inventory in a Chronic Pain Sample,"The Multidimensional Pain Inventory (MPI) is one of the most commonly used self-report instruments in pain settings. The MPI can be used to classify patients into three clusters or its nine scales can be treated as dimensions in efforts to understand patient heterogeneity. Previous research suggests the existence of a fourth cluster, whose members have been labeled 'repressors,' that emerges with the addition of a defensiveness scale to the MPI. The current paper compared the abilities of MPI cluster and dimensional models with and without a measure of defensiveness to capture variability in validating variables related to personality, psychopathology, physical functioning, and treatment outcome in a chronic pain sample. Results suggest that dimensional models consistently outperform cluster models in explaining variance in outcome variables, and that the addition of a measure of defensiveness increments the validity offered by the MPI scales. Implications for the assessment of pain patients are discussed. (",0,0 +4459,Altered cortisol awakening response in posttraumatic stress disorder,"An altered function of the hypothalamic-pituitary-adrenal axis is assumed to be characteristic for Posttraumatic Stress Disorder (PTSD), although there is inconsistent empirical evidence. Only few studies examined the awakening cortisol response and a daytime profile in PTSD. Salivary cortisol levels were measured at seven intervals from awakening until 8 PM in trauma-exposed subjects with (N=29) and without PTSD (N=19) and in 15 non-exposed controls. While the three groups did not differ with respect to their first cortisol level immediately after awakening, the expected cortisol increase to awakening 15-60 min later was significantly lower in PTSD patients compared to non-PTSD subjects and healthy controls. This effect remained stable when trauma-exposed subjects with comorbid major depression were excluded from the analysis. A significant negative correlation between the overall cortisol secretion (AUC(G)) and overall PTSD symptomatology and hyper-arousal symptoms was found. The findings are discussed in light of the hypothesis of a counterregulation of hyper-arousal symptoms and chronic stress in PTSD.",0,0 +4460,Concerns and perceptions immediately following Superstorm Sandy: ratings for property damage were higher than for health issues,"Governmental officials, health and safety professionals, early responders, and the public are interested in the perceptions and concerns of people faced with a crisis, especially during and immediately after a disaster strikes. Reliable information can lead to increased individual and community preparedness for upcoming crises. The objective of this research was to evaluate concerns of coastal and central New Jersey residents within the first 100 days of Superstorm Sandy's landfall. Respondents living in central New Jersey and Jersey shore communities were differentially impacted by the storm, with shore residents having higher evacuation rates (47% vs. 13%), more flood waters in their homes, longer power outages (average 23 vs. 6 days), and longer periods without Internet (29 vs. 6 days). Ratings of concerns varied both among and within categories as a function of location (central vs. coastal New Jersey), stressor level (ranging from 1 to 3 for combinations of power outages, high winds, and flooding), and demographics. Respondents were most concerned about property damage, health, inconveniences, ecological services, and nuclear power plants in that order. Respondents from the shore gave higher ratings to the concerns within each major category, compared to those from central Jersey. Four findings have implications for understanding future risk, recovery, and resiliency: (1) respondents with the highest stressor level (level 3) were more concerned about water damage than others, (2) respondents with flood damage were more concerned about water drainage and mold than others, (3) respondents with the highest stressor levels rated all ecological services higher than others, and (4) shore respondents rated all ecological services higher than central Jersey residents. These data provide information to design future preparedness plans, improve resiliency for future severe weather events, and reduce public health risk.",0,0 +4461,Clustering Asian and North African Countries According to Trend of Colon and Rectum Cancer Mortality Rates: an Application of Growth Mixture Models,"Colorectal cancer is the second most common cause of cancer death with half a million deaths per year. Incidence and mortality rates have demonstrated notable changes in Asian and African countries during the last few decades. In this study, we first aimed to determine the trend of colorectal cancer mortality rate in each Institute for Health Metrics and Evaluation (IHME) region, and then re-classify them to find more homogenous classes.Our study population consisted of 52 countries of Asia and North Africa in six IHME pre-defined regions for both genders and age-standardized groups from 1990 to 2010.We first applied simple growth models for pre-defined IHME regions to estimate the intercepts and slopes of mortality rate trends. Then, we clustered the 52 described countries using the latent growth mixture modeling approach for classifying them based on their colorectal mortality rates over time.Statistical analysis revealed that males and people in high income Asia pacific and East Asia countries were at greater risk of death from colon and rectum cancer. In addition, South Asia region had the lowest rates of mortality due to this cancer. Simple growth modeling showed that majority of IHME regions had decreasing trend in mortality rate of colorectal cancer. However, re-classification these countries based on their mortality trend using the latent growth mixture model resulted in more homogeneous classes according to colorectal mortality trend.In general, our statistical analyses showed that most Asian and North African countries had upward trend in their colorectal cancer mortality. We therefore urge the health policy makers in these countries to evaluate the causes of growing mortality and study the interventional programs of successful countries in managing the consequences of this cancer.",0,0 +4462,Post-traumatic stress disorder in children following road traffic accidents: a comparison of those with and without mild traumatic brain injury,"It is now recognized that post-traumatic stress disorder (PTSD) can occur following road traffic accidents, but controversy exists about the possibility of PTSD in people sustaining traumatic brain injury (TBI). The present investigation examined the frequency, course and comorbidity of PTSD in children with and without mild TBI after traffic accidents.Interviews were conducted with 43 children and their parents 6 weeks after a traffic accident,assessing PTSD and associated symptomatology. Fourteen children sustained mild TBI and 29 had no TBI. A sub-set (n=32) was re-interviewed 7 weeks later.Children both with and without TBI reported PTSD symptomatology, but no significant group differences were found. At initial assessment, 74% of children were classified as having clinically significant PTSD symptomatology (86% and 69% in groups with and without TBI, respectively), which was strongly associated with report of general anxiety. At follow-up, PTSD symptomatology decreased, but 44% remained symptomatic (38% and 46% for those with and without TBI, respectively). Child and parental report of PTSD symptomatology were not significantly correlated.Presence of mild TBI did not influence the likelihood of experiencing PTSD symptomatology following a traffic accident. Given that PTSD symptomatology is a common consequence of traffic accidents in children, there is a clear need for provision of systematic assessment and, where appropriate, the implementation of intervention strategies to treat children.",0,0 +4463,[Heat waves: health impacts].,"During the summer of 2003, record high temperatures were reported across Europe, causing thousands of casualties. Heat waves are sporadic recurrent events, characterised by intense and prolonged heat, associated with excess mortality and morbidity. The most frequent cause of death directly attributable to heat is heat stroke but heat waves are known to cause increases in all-cause mortality, specially circulatory and respiratory mortality. Epidemiological studies demonstrate excess casualties cluster in specific risk groups. The elderly, those with chronic medical conditions and the socially isolated are particularly vulnerable. Air conditioning is the strongest protective factor against heat-related disorders. Heat waves cause disease indirectly, by aggravating chronic disorders, and directly, by causing heat-related illnesses (HRI). Classic HRI include skin eruptions, heat cramps, heat syncope, heat exhaustion and heat stroke. Heat stroke is a medical emergency characterised by hyperthermia and central nervous system dysfunction. Treatment includes immediate cooling and support of organ-system function. Despite aggressive treatment, heat stroke is often fatal and permanent neurological damage is frequent in those who survive. Heat related illness and death are preventable through behavioural adaptations, such as use of air conditioning and increased fluid intake. Other adaptation measures include heat emergency warning systems and intervention plans and environmental heat stress reduction. Heat related mortality is expected to rise as a consequence of the increasing proportion of elderly persons, the growing urban population, and the anticipated increase in number and intensity of heat waves associated with global warming. Improvements in surveillance and response capability may limit the adverse health conditions of future heat waves. It is crucial that health professionals are prepared to recognise, prevent and treat HRI and learn to cooperate with local health agencies.",0,0 +4464,Conflict between current knowledge about posttraumatic stress disorder and its original conceptual basis,"The author's goal was to explore the historical, political, and social forces that have played a major role in the acceptance of the idea of trauma as a cause of the specific symptoms of posttraumatic stress disorder (PTSD) and to discuss the impact that current research findings have had on some of the initial conceptualizations of the disorder.The conceptual origins of PTSD are described, and the literature on the prevalence, longitudinal course, phenomenology, and neurobiology of PTSD is reviewed.Paradoxically, there are a series of findings that support the idea that PTSD is a distinct diagnostic entity, but these are different from those originally developed from psychosocial theory and stress research.PTSD has been a controversial diagnosis and is again at a vulnerable point. It is imperative that the field address how current findings challenge the original conceptualizations of this disorder so that the next generation of conceptual issues can be formulated.",0,0 +4465,Impaired fear inhibition learning predicts the persistence of symptoms of posttraumatic stress disorder (PTSD),"Recent cross-sectional studies have shown that the inability to suppress fear under safe conditions is a key problem in people with posttraumatic stress disorder (PTSD). The current longitudinal study examined whether individual differences in fear inhibition predict the persistence of PTSD symptoms. Approximately 2 months after deployment to Afghanistan, 144 trauma-exposed Dutch soldiers were administered a conditional discrimination task (AX+/BX-). In this paradigm, A, B, and X are neutral stimuli. X combined with A is paired with a shock (AX+ trials); X combined with B is not (BX- trials). Fear inhibition was measured (AB trials). Startle electromyogram responses and shock expectancy ratings were recorded. PTSD symptoms were measured at 2 months and at 9 months after deployment. Results showed that greater startle responses during AB trials in individuals who discriminated between danger (AX+) and safety (BX-) during conditioning, predicted higher PTSD symptoms at 2 months and 9 months post-deployment. The predictive effect at 9 months remained significant after controlling for critical incidents during previous deployments and PTSD symptoms at 2 months. Responses to AX+ or BX- trials, or discrimination learning (AX+ minus BX-) did not predict PTSD symptoms. It is concluded that impaired fear inhibition learning seems to be involved in the persistence of PTSD symptoms.",0,0 +4466,Childhood Adversity and Combat as Predictors of Depression and Post-Traumatic Stress in Deployed Troops,"Previous studies have shown a relationship between childhood adversity and health outcomes in adulthood. The military represents a segment of the young working population that faces unique hazards that may be worsened by previous adverse life experiences. To date, no comprehensive studies of childhood adversity have been conducted with military samples that have included combat troops before and after a combat deployment.Surveys were administered in 2003 to 4529 male soldiers who had not deployed to Iraq, and in 2004 to a separate group of 2392 male soldiers 3 months after returning from Iraq. The main predictor was adverse childhood experiences, an aggregated construct representing incremental exposure to six types of traumatic childhood experiences. This construct correlated with depression and post-traumatic stress disorder rates, as well as symptom scores. For the post-Iraq sample, analyses were conducted to assess whether individuals with childhood trauma were affected differently by exposure to combat.The likelihood of screening positive for depression and post-traumatic stress disorder was significantly higher for individuals reporting exposure to two or more categories of childhood adversity. Core analyses showed that adverse childhood experiences were a significant predictor of mental health symptoms, beyond the expected contribution of combat.This study confirms the high prevalence of adverse childhood experiences and the association of these experiences with key mental health outcomes. In addition, the results highlight the importance of considering pre-enlistment childhood traumatic experiences as well as the level of combat exposure in the treatment of military personnel returning from combat operations.",0,0 +4467,EMG biofeedback-assisted desensitization treatment for Vietnam combat veterans Post-Traumatic Stress Disorder.,"Employed an electromyogram (EMG) biofeedback-induced desensitization procedure (EMG-D) in the treatment of 8 Vietnam combat veterans with a 7-yr history of chronic post-traumatic stress disorder (PTSD) and frequent recurring nightmares and/or flashbacks that were anxiety-evoking events. 16 PTSD Ss (aged 29-42 yrs) were assigned to the EMG-D group or a control group. Analysis of forehead muscle tension over a 2 yr follow-up indicated that the Ss in the EMG-D condition had significantly reduced their muscle tension and showed continued improved functioning. Ss reported a few instances of recurrence of their nightmares and/or flashbacks; however, they were essentially anxiety-free episodes. No significant reduction in muscle tension, recurring nightmares, or flashbacks was found for Ss in the control group. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4468,"Atrocities exposure in Vietnam combat veterans with chronic posttraumatic stress disorder: Relationship to combat exposure, symptom severity, guilt, and interpersonal violence","Vietnam combat veterans (N = 151) with chronic posttraumatic stress disorder (PTSD) completed measures of atrocities exposure, combat exposure, PTSD symptom severity, guilt and interpersonal violence. PTSD symptom severity, guilt and interpersonal violence rates were similar to previously reported studies that examined treatment seeking combat veterans with PTSD. Controlling for combat exposure, endorsement of atrocities exposure was related to PTSD symptom severity, PTSD B (reexperiencing) symptoms, Global Guilt, Guilt Cognitions, and cognitive subscales of Hindsight-Bias/Responsibility and Wrongdoing. These results are discussed in the context of previous research conducted regarding atrocities exposure and PTSD.",0,0 +4469,Long-term mental health of Vietnamese refugees in the aftermath of trauma,"Background There is no long-term prospective study (> 20 years) of the mental health of any refugee group. Aims To investigate the long-term course and predictors of psychological distress among Vietnamese refugees in Norway. Method Eighty Vietnamese refugees, 57% of the original cohort previously interviewed in 1982 ( T 1 ) and 1985 ( T 2 ), completed a self-report questionnaire prior to a semi-structured interview. Mental health was measured using the Symptom Checklist–90–Revised (SCL–90–R). Results The SCL–90–R mean Global Severity Index (GSI) decreased significantly from T 1 to T 3 (2005–6), but there was no significant change in the percentage reaching threshold scores (GSI =1.00). Trauma-related mental disorder on arrival and the trajectory of symptoms over the first 3 years of resettlement predicted mental health after 23 years. Conclusions Although the self-reported psychological distress decreased significantly over time, a substantial higher proportion of the refugee group still remained reaching threshold scores after 23 years of resettlement compared with the Norwegian population. The data suggest that refugees reaching threshold scores on measures such as the SCL–90–R soon after arrival warrant comprehensive clinical assessment.",0,0 +4470,Trauma and posttraumatic stress symptoms predict alcohol and other drug consequence trajectories in the first year of college.,"College matriculation begins a period of transition into adulthood, one that is marked by new freedoms and responsibilities. This transition also is marked by an escalation in heavy drinking and other drug use as well as a variety of use-related negative consequences. Trauma and symptoms of posttraumatic stress disorder (PTSD) may affect alcohol and drug problems and, thus, may be a point of intervention. Yet, no studies have examined trauma, PTSD, and alcohol and drug problem associations during this developmental period. The present study provides such an examination.Matriculating college students (N = 997) completed surveys in September (Time 1) and at 5 subsequent time points (Time 2-Time 6) over their 1st year of college. With latent growth analysis, trajectories of alcohol- and drug-related consequences were modeled to examine how trauma (No Criterion A Trauma, Criterion A Only, No PTSD Symptoms) and PTSD (partial or full) symptom status predicted these trajectories.Results showed substantial risk for alcohol- and other drug-related negative consequences that is conferred by the presence of PTSD at matriculation. Those with both partial and full PTSD started the year with more alcohol and drug consequences. These individuals showed a steeper decrease in consequences in the 1st semester, which leveled off as the year progressed. Both alcohol and drug consequences remained higher for those in the PTSD group throughout the academic year. Hyperarousal symptoms showed unique effects on substance consequence trajectories. Risk patterns were consistent for both partial and full PTSD symptom presentations. Trajectories did not vary by gender.Interventions that offer support and resources to students entering college with PTSD may help to ameliorate problem substance use and may ultimately facilitate a stronger transition into college and beyond.",0,0 +4471,RORA and posttraumatic stress trajectories: main effects and interactions with childhood physical abuse history,"Longitudinal studies of posttraumatic stress (PTS) have documented environmental factors as predictors of trajectories of higher, versus lower, symptoms, among them experiences of childhood physical abuse. Although it is now well-accepted that genes and environments jointly shape the risk of PTS, no published studies have investigated genes, or gene-by-environment interactions (GxEs), as predictors of PTS trajectories. The purpose of this study was to fill this gap.We examined associations between variants of the retinoid-related orphan receptor alpha (RORA) gene and trajectory membership among a sample of predominantly non-Hispanic Black urban adults (N = 473). The RORA gene was selected based on its association with posttraumatic stress disorder (PTSD) in the first PTSD genome wide association study. Additionally, we explored GxEs between RORA variants and childhood physical abuse history.We found that the minor allele of the RORA SNP rs893290 was a significant predictor of membership in a trajectory of consistently high PTS, relatively to a trajectory of consistently low PTS. Additionally, the GxE of rs893290 with childhood physical abuse was significant. Decomposition of the interaction showed that minor allele frequency was more strongly associated with membership in consistently high or decreasing PTS trajectories, relative to a consistently low PTS trajectory, among participants with higher levels of childhood physical abuse.The results of the study provide preliminary evidence that variation in the RORA gene is associated with membership in trajectories of higher PTS and that these associations are stronger among persons exposed to childhood physical abuse. Replication and analysis of functional data are needed to further our understanding of how RORA relates to PTS trajectories.",0,0 +4472,Prevalence and Incidence of Traumatic Experiences Among Orphans in Institutional and Family-Based Settings in 5 Low- and Middle-Income Countries: A Longitudinal Study,"Policy makers struggling to protect the 153 million orphaned and separated children (OSC) worldwide need evidence-based research on the burden of potentially traumatic events (PTEs) and the relative risk of PTEs across different types of care settings.The Positive Outcomes for Orphans study used a 2-stage, cluster-randomized sampling design to identify 1,357 institution-dwelling and 1,480 family-dwelling orphaned and separated children in 5 low- and middle-income countries (LMICs) in sub-Saharan Africa and Asia. We used the Life Events Checklist developed by the National Center for Posttraumatic Stress Disorder to examine self-reported PTEs among 2,235 OSC ages 10-13 at baseline. We estimated prevalence and incidence during 36-months of follow-up and compared the risk of PTEs across care settings. Data collection began between May 2006 and February 2008, depending on the site.Lifetime prevalence by age 13 of any PTE, excluding loss of a parent, was 91.0% (95% confidence interval (CI) = 85.6, 94.5) in institution-dwelling OSC and 92.4% (95% CI = 90.3, 94.0) in family-dwelling OSC; annual incidence of any PTE was lower in institution-dwelling (23.6% [95% CI = 19.4, 28.7]) than family-dwelling OSC (30.0% [95% CI = 28.1, 32.2]). More than half of children in institutions (50.3% [95% CI = 42.5, 58.0]) and in family-based care (54.0% [95% CI = 50.2, 57.7]) had experienced physical or sexual abuse by age 13. Annual incidence of physical or sexual abuse was lower in institution-dwelling (12.9% [95% CI = 9.6, 17.3]) than family-dwelling OSC (19.4% [95% CI = 17.7, 21.3]), indicating statistically lower risk in institution-dwelling OSC (risk difference = 6.5% [95% CI = 1.4, 11.7]).Prevalence and incidence of PTEs were high among OSC, but contrary to common assumptions, OSC living in institutions did not report more PTEs or more abuse than OSC living with families. Current efforts to reduce the number of institution-dwelling OSC may not reduce incidence of PTEs in this vulnerable population. Protection of children from PTEs should be a primary consideration, regardless of the care setting.",0,0 +4473,Alterations in cognitive flexibility in a rat model of post-traumatic stress disorder,"Exposure to stressful or traumatic events is associated with increased vulnerability to post-traumatic stress disorder (PTSD). This vulnerability may be partly mediated by effects of stress on the prefrontal cortex (PFC) and associated circuitry. The PFC mediates critical cognitive functions, including cognitive flexibility, which reflects an organism's ability to adaptively alter behavior in light of changing contingencies. Prior work suggests that chronic or acute stress exerts complex effects on different forms of cognitive flexibility, via actions on the PFC. Similarly, PFC dysfunction is reported in PTSD, as are executive function deficits. Animal models that permit study of the effects of stress/trauma on cognitive flexibility may be useful in illuminating ways in which stress-linked cognitive changes contribute to PTSD. Here, we examined the behavioral effects of a rodent model of PTSD - single prolonged stress (SPS) - on performance of two forms of cognitive flexibility: reversal learning and strategy set-shifting. SPS did not impair acquisition of either a response or visual-cue discrimination but did cause slight impairments in the retrieval of the visual-cue rule. During response discrimination reversal, SPS rats made more perseverative errors. In comparison, during set-shifting from the visual-cue to response discrimination, SPS rats did not show enhanced perseveration, but did display increased never-reinforced errors, indicative of impairment in selecting a novel strategy. These data demonstrate that SPS leads to a complex and intriguing pattern of deficits in flexible responding and suggest that impairments in executive functioning associated with PTSD could, in part, be a neuro-cognitive consequence of trauma exposure.",0,0 +4474,"The impact of disaster work on community volunteers: The role of peri-traumatic distress, level of personal affectedness, sleep quality and resource loss, on post-traumatic stress disorder symptoms and subjective health","Disaster work has shown to cause PTSD symptoms and subjective health complaints in professional emergency personnel. However, very little is known about how disaster work affects community volunteers. This first time longitudinal study examined factors contributing to post-traumatic stress disorder symptoms (PTSD) and subjective health complaints in volunteers working in an earthquake setting. At six and eighteen months post disaster, a sample of 506 Indonesian Red Cross volunteers were assessed using the Impact of Event Scale-Revised and the Subjective Health Complaints Inventory. Factors analyzed in relation to the outcomes included: peri-traumatic distress, level of personal affectedness by the disaster, sleep quality and loss of resources as a consequence of the disaster. At 18 months post-disaster the findings showed high levels of PTSD symptoms and subjective health complaints. Quality of sleep was related to both outcomes but resource loss only to PTSD symptoms. Neither peri-traumatic distress nor level of affectedness by the disaster (external versus directly affected volunteers), were predictive of symptoms. This study indicates that characteristics of disaster work e.g. low quality of sleep, may be an important contributor to PTSD symptoms and subjective health complaints in volunteers.",0,0 +4475,Health concerns and perceptions of central and coastal New Jersey residents in the 100days following Superstorm Sandy,"Superstorm Sandy made landfall in New Jersey 29–30 October 2012 (130 km/h winds), and many residents were evacuated, were without power for days to several weeks, and suffered property damages or lost their homes. The objective of this study was to understand health concerns within 100 days of this devastating storm that might improve recovery, future preparedness, and resilience. We conducted a survey of New Jersey residents in central (N = 407) and shore communities (n = 347) about health concerns before, during, and after Superstorm Sandy . People were interviewed at public places, town hall and FEMA meetings, health and university centers, and other gathering places. 47% of shore and 13% of central Jersey respondents evacuated. Both populations were concerned about agents of destruction, survival needs, and possessions before and during the storm, but they were mainly concerned about survival needs thereafter. During the storm, medical issues were the greatest concern for shore respondents (23%) vs secure and safe food and water (29%) for central respondents. Medical concerns increased after the storm. In the future, 42% of shore respondents would prepare more, while 51% of central residents would buy more supplies; 20% (shore) and 11% (central) would heed future evacuation warnings. Before Sandy many residents did not heed warnings and evacuation orders, but worried about property damage, while during and after their major concerns were personal and community health. Prevention of future health and property impacts could be enhanced by stronger evacuation enforcement, better preparedness information, greater attention to the possibility of prolonged power outages, and more attention to medical needs during and after a storm. • Within 100 days of Superstorm Sandy 754 people in New Jersey were interviewed. • Nearly half of people living along the shore evacuated, and were without electricity for some time. • During the storm, the major concerns for shore residents were medical issues (23%). • Medical concerns increased following the storm for shore residents. • Stress, respiratory problems, and access to medications were major medical concerns.",0,0 +4476,Psychiatric Impairment Among Adolescents Engaging in Different Types of Deliberate Self-Harm,"This retrospective chart review study of 227 participants examined the psychiatric profiles of outpatient adolescents ages 12 to 19 years (M = 15.08 years, SD = 1.72 years) engaging in different types of deliberate self-harm (DSH) behaviors. Participants were divided into four groups: no deliberate self-harm (NoDSH; n = 119), nonsuicidal self-injury only (NSSI only; n = 30), suicide attempt only (n = 38), and suicide attempt plus NSSI (n = 40). Those who attempted suicide were more likely to have major depressive disorder and/or posttraumatic stress disorder than those who engaged in NSSI only. Those who engaged in any type of DSH were more likely to have features of borderline personality disorder than those who did not engage in DSH. The suicidal ideation levels of those in the NSSI group were similar to those in the NoDSH group. Findings offer empirical support for the importance of distinguishing between suicidal and nonsuicidal self-harm behaviors.",0,0 +4477,"Child physical abuse and neglect in Kenya, Zambia and the Netherlands: A cross-cultural comparison of prevalence, psychopathological sequelae and mediation by PTSS","This study compared the prevalence of self-reported childhood physical abuse and neglect and the associated psychopathological sequelae among Kenyan, Zambian, and Dutch university students. In addition, we sought to find out the differentiated role of posttraumatic stress symptoms (PTSS) in mediating the associations between childhood maltreatment experiences and psychopathology symptoms. The sample consisted of 862 university students from Kenya (n = 375), Zambia (n = 182), and The Netherlands (n = 305) who completed the Personal and Relationships Profile (PRP). Results showed that physical abuse was highly prevalent in Kenya (59%) and Zambia (40%), and that neglect was even more prevalent than physical abuse in Zambia and The Netherlands at 59%, 54%, and 42% for the Kenyan, Zambian, and Dutch samples respectively. Neglect was associated with psychopathological symptoms in all three samples, whereas physical abuse was associated with psychopathological sequelae in the Kenyan and Zambian samples only. PTSS mediated the association between neglect and psychopathology symptoms in the Dutch sample and between physical abuse and psychopathology symptoms in the Dutch and Kenyan samples. We conclude that physical abuse and neglect are associated with psychopathology symptoms independently of country and cultural context. However, the pathways through which physical abuse and neglect may lead to psychopathological sequelae may be dependent on perceptions of specific parental behavior in different sociocultural contexts.",0,0 +4478,Multiple session early psychological intervention to prevent and treat post-traumatic stress disorder,,0,0 +4479,Altered blood oxygen level-dependent signal variability in chronic post-traumatic stress disorder during symptom provocation,"Recent research suggests that variability in brain signal provides important information about brain function in health and disease. However, it is unknown whether blood oxygen level-dependent (BOLD) signal variability is altered in post-traumatic stress disorder (PTSD). We aimed to identify the BOLD signal variability changes of PTSD patients during symptom provocation and compare the brain patterns of BOLD signal variability with those of brain activation.Twelve PTSD patients and 14 age-matched controls, who all experienced a mining accident, underwent clinical assessment as well as fMRI scanning while viewing trauma-related and neutral pictures. BOLD signal variability and brain activation were respectively examined with standard deviation (SD) and general linear model analysis, and compared between the PTSD and control groups. Multiple regression analyses were conducted to explore the association between PTSD symptom severity and these two brain measures across all subjects as well as in the PTSD group.PTSD patients showed increased activation in the middle occipital gyrus compared with controls, and an inverse correlation was found between PTSD symptom severity and brain activation in the hippocampus and anterior cingulate cortex/medial prefrontal cortex. Brain variability analysis revealed increased SD in the insula, anterior cingulate cortex/medial prefrontal cortex, and vermis, and decreased SD in the parahippocapal gyrus, dorsolateral prefrontal cortex, somatosensory cortex, and striatum. Importantly, SD alterations in several regions were found in both traumatic and neutral conditions and were stratified by PTSD symptom severity.BOLD signal variability may be a reliable and sensitive biomarker of PTSD, and combining brain activation and brain variability analysis may provide complementary insight into the neural basis of this disorder.",0,0 +4480,Violent offending by UK military personnel deployed to Iraq and Afghanistan: a data linkage cohort study,"

Summary

Background

Violent offending by veterans of the Iraq and Afghanistan conflicts is a cause for concern and there is much public debate about the proportion of ex-military personnel in the criminal justice system for violent offences. Although the psychological effects of conflict are well documented, the potential legacy of violent offending has yet to be ascertained. We describe our use of criminal records to investigate the effect of deployment, combat, and post-deployment mental health problems on violent offending among military personnel relative to pre-existing risk factors.

Methods

In this cohort study, we linked data from 13 856 randomly selected, serving and ex-serving UK military personnel with national criminal records stored on the Ministry of Justice Police National Computer database. We describe offending during the lifetime of the participants and assess the risk factors for violent offending.

Findings

2139 (weighted 17·0%) of 12 359 male UK military personnel had a criminal record for any offence during their lifetime. Violent offenders (1369 [11·0%]) were the most prevalent offender types; prevalence was highest in men aged 30 years or younger (521 [20·6%] of 2728) and fell with age (164 [4·7%] of 3027 at age >45 years). Deployment was not independently associated with increased risk of violent offending, but serving in a combat role conferred an additional risk, even after adjustment for confounders (violent offending in 137 [6·3%] of 2178 men deployed in a combat role vs 140 (2·4%) of 5797 deployed in a non-combat role; adjusted hazard ratio 1·53, 95% CI 1·15–2·03; p=0·003). Increased exposure to traumatic events during deployment also increased risk of violent offending (violent offending in 104 [4·1%] of 2753 men with exposure to two to four traumatic events vs 56 [1·6%] of 2944 with zero to one traumatic event, 1·77, 1·21–2·58, p=0·003; and violent offending in 122 [5·1%] of 2582 men with exposure to five to 16 traumatic events, 1·65, 1·12–2·40, p=0·01; test for trend, p=0·032). Violent offending was strongly associated with post-deployment alcohol misuse (violent offending in 120 [9·0%] of 1363 men with alcohol misuse vs 155 [2·3%] of 6768 with no alcohol misuse; 2·16, 1·62–2·90; p<0·0001), post-traumatic stress disorder (violent offending in 25 [8·6%] of 344 men with post-traumatic stress disorder vs 221 [3·0%] of 7256 with no symptoms of post-traumatic stress disorder; 2·20, 1·36–3·55; p=0·001), and high levels of self-reported aggressive behaviour (violent offending in 56 [6·7%] of 856 men with an aggression score of six to 16 vs 22 [1·2%] of 1685 with an aggression score of zero; 2·47, 1·37–4·46; p=0·003). Of the post-traumatic stress disorder symptoms, the hyperarousal cluster was most strongly associated with violent offending (2·01, 1·50–2·70; p<0·0001).

Interpretation

Alcohol misuse and aggressive behaviour might be appropriate targets for interventions, but any action must be evidence based. Post-traumatic stress disorder, though less prevalent, is also a risk factor for violence, especially hyperarousal symptoms, so if diagnosed it should be appropriately treated and associated risk monitored.

Funding

Medical Research Council and the UK Ministry of Defence.",0,0 +4481,Effect of the incident at Columbine on students' violence- and suicide-related behaviors,This study examined the impact that the violent incident at Columbine High School may have had on reports of behaviors related to violence and suicide among U.S. high school students.Nationally representative data from the 1999 Youth Risk Behavior Survey (YRBS) were analyzed using logistic regression analyses.Students who completed the 1999 YRBS after the Columbine incident were more likely to report feeling too unsafe to go to school and less likely to report considering or planning suicide than were students who completed the 1999 YRBS before the incident.These results highlight how an extreme incident of school violence can affect students nationwide.,0,0 +4482,Subthreshold Posttraumatic Stress Disorder in the World Health Organization World Mental Health Surveys,"

Abstract

Background

Although only a few people exposed to a traumatic event (TE) develop posttraumatic stress disorder (PTSD), symptoms that do not meet full PTSD criteria are common and often clinically significant. Individuals with these symptoms sometimes have been characterized as having subthreshold PTSD, but no consensus exists on the optimal definition of this term. Data from a large cross-national epidemiologic survey are used in this study to provide a principled basis for such a definition.

Methods

The World Health Organization World Mental Health Surveys administered fully structured psychiatric diagnostic interviews to community samples in 13 countries containing assessments of PTSD associated with randomly selected TEs. Focusing on the 23,936 respondents reporting lifetime TE exposure, associations of approximated DSM-5 PTSD symptom profiles with six outcomes (distress-impairment, suicidality, comorbid fear-distress disorders, PTSD symptom duration) were examined to investigate implications of different subthreshold definitions.

Results

Although consistently highest outcomes for distress-impairment, suicidality, comorbidity, and PTSD symptom duration were observed among the 3.0% of respondents with DSM-5 PTSD rather than other symptom profiles, the additional 3.6% of respondents meeting two or three of DSM-5 criteria B–E also had significantly elevated scores for most outcomes. The proportion of cases with threshold versus subthreshold PTSD varied depending on TE type, with threshold PTSD more common following interpersonal violence and subthreshold PTSD more common following events happening to loved ones.

Conclusions

Subthreshold DSM-5 PTSD is most usefully defined as meeting two or three of DSM-5 criteria B–E. Use of a consistent definition is critical to advance understanding of the prevalence, predictors, and clinical significance of subthreshold PTSD.",0,0 +4483,Developmental trajectories of adiposity from birth until early adulthood and association with cardiometabolic risk factors,"Objective: To identify developmental trajectories of adiposity from birth until early adulthood, and to investigate how they relate with cardiometabolic risk factors at 21 years of age. Methods: Participants' weight and height measurements were obtained using the EPITeen cohort protocol at 13, 17 and 21 years of age, and extracted from child health books as recorded during health routine evaluations since birth. Blood pressure, triglycerides, cholesterol and insulin resistance (HOMA-IR) were assessed at 21 years. Trajectories were defined using 719 participants contributing 11 459 measurements. The individual growth curves were modelled using mixed-effects fractional polynomial, and the trajectories were estimated using normal mixture modelling for model-based clustering. Differences in cardiometabolic risk factors at 21 years according to adiposity trajectories were estimated through analysis of covariance (ANCOVA), and adjusted means are presented. Results: Two trajectories-'Average body mass index (BMI) growth' (80.7%) and 'Higher BMI growth' (19.3%)-were identified. Compared with those in 'Average BMI growth', 'Higher BMI growth' participants were more frequently delivered by caesarean section, mothers were younger and had higher BMI, and parental education was lower; and at 21 years showed higher adjusted mean systolic (111.6 vs 108.3mmHg, P < 0.001) and diastolic blood pressure (71.9 vs 68.4mmHg, P < 0.001), and lower highdensity lipoprotein cholesterol (53.3 vs 57.0 mg dl-1, P = 0.001). As there was a significant interaction between trajectories and sex, triglycerides and HOMA-IR were stratified by sex and we found significantly higher triglycerides, in males, and higher HOMA-IR in both sexes in 'Higher BMI growth' trajectory. All the differences were attenuated after adjustment for BMI at 21 years. Conclusions: In this long-term follow-up, we were able to identify two adiposity trajectories, statistically related to the BMI and cardiometabolic profile in adulthood. Our results also suggest that the impact of the adiposity trajectory on cardiometabolic profile is mediated by current BMI. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0,0 +4484,The Trauma Recovery Group: A Cognitive-Behavioral Program for Post-Traumatic Stress Disorder in Persons with Severe Mental Illness,"To address the problem of post-traumatic stress disorder (PTSD) in severe mental illness, the Trauma Recovery Group, a mixed gender cognitive-behavioral program, was developed and piloted at a community mental health center. The 21-week program includes breathing retraining, education about PTSD, cognitive restructuring, coping with symptoms, and making a recovery plan. Eighty clients were assessed at baseline and 41 provided follow-up data. Retention in the group was good: 59%. Treatment completers improved significantly in PTSD symptoms and diagnosis, depression, and post-traumatic cognitions, but dropouts did not. The results support the feasibility of the program and suggest it produces clinical benefits. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +4485,Pediatric Adverse Childhood Experiences: Implications for Life Course Health Trajectories,"lems have their origins early in life. 1 The timing, intensity, and cumulative burden of adversities, especially in the relative absence of protective factors, can affect gene expression, the conditioning of stress responses, and the development of immune system function. Individuals affected by a high burden of adverse experiences may adopt compensatory high-risk behaviors that can further erode their health and mental health. Not all adversity occurs in childhood(eg,military combat),but a highburden of cumulative intrafamilial (child maltreatment, domestic violence, impaired caregiving) and other adversities (income and food insecurity) in childhood can have profound lifelong effects unless mitigated by protective factors within the family or the community, or through specific interventions. Two of the articles in this issue indicate that the impact of intrafamilial adverse childhood experiences (ACEs) on health and mental health begin to manifest in childhood. Kerker et al 2 used the nationally representative longitudinal National Survey of Child and Adolescent Well-Being study toassessthe ACEscoresofchildrenunder theageof6years who remained at home after child protective investigation and found they were similar to those of children who were removed and placed in foster/kinship care. The authors also reported that higher ACE scores in this population were associated with more mental health (Child Behavior Checklist score >64) and chronic medical problems, and, for preschool children, lower social scores. Earlier studies of children informally placed with kinship caregivers after child welfare investigation showed a high prevalence of health problems, although fewer mental health problems, compared to children in nonrelative foster care, indicating that almost all children involved with child welfare are at high risk for poor outcomes that may be rooted in cumulative childhood trauma. 3 In a second article in this issue, Thompson et al 4 used LONGSCAN longitudinal data to",0,0 +4486,Modulation of stress by imidazoline binding sites: Implications for psychiatric disorders,"In this review, we present evidence for the involvement of imidazoline binding sites (IBS) in modulating responses to stress, through central control of monoaminergic and hypothalamo-pituitary-adrenal (HPA) axis activity. Pharmacological and physiological evidence is presented for differential effects of different IBS subtypes on serotoninergic and catecholaminergic pathways involved in control of basal and stress-stimulated HPA axis activity. IBS ligands can modulate behavioural and neuroendocrine responses in animal models of stress, depression and anxiety, and a body of evidence exists for alterations in central IBS expression in psychiatric patients, which can be normalised partially or fully by treatment with antidepressants. Dysfunction in monoaminergic systems and the HPA axis under basal and stress-induced activation has been extensively reported in psychiatric illnesses. On the basis of the literature, we suggest a potential therapeutic role for selective IBS ligands in the treatment of depression and anxiety disorders.",0,0 +4487,Factor structure of PTSD symptoms in opioid-dependent patients rating their overall trauma history,"The current standard for posttraumatic stress disorder (PTSD) diagnosis is a 3-factor model (re-experiencing, avoidance, and hyperarousal). Two 4-factor models of PTSD, the emotional numbing model (re-experiencing, avoidance, emotional numbing, and hyperarousal) and the dysphoria model (re-experiencing, avoidance, dysphoria, and hyperarousal), have considerable empirical support in the extant literature. However, a newer 5-factor model of PTSD has been introduced that is receiving interest. The 5-factor model differs from the four-factor models in its placement of three symptoms (irritability, sleep disturbance, and concentration difficulties) into a separate cluster termed dysphoric arousal. We empirically compared the theoretical factor structures of 3-, 4-, and 5-factor models of PTSD symptoms to find the best fitting model in a sample of opioid-dependent hospitalized patients.Confirmatory factor analyses were conducted on the 17 self-reported PTSD symptoms of the Posttraumatic Checklist - Civilian Version (PCL-C) in a sample of 151 men and women with opioid dependence.Both four-factor models fit the observed data better than the three-factor model of PTSD; the dysphoria model was preferred to the emotional numbing model in this sample. The recently introduced five-factor model fit the observed data better than either four factor model.PTSD is a heterogeneous disorder comprised of symptoms of re-experiencing, avoidance, numbing, and dysphoria. Three symptoms, irritability, sleep disturbance, and concentration difficulties, may represent a unique latent construct separate from these four symptom clusters in opioid-dependent populations who have experienced traumatic events.",0,0 +4488,A Longitudinal Examination of Overgeneral Memory and Psychopathology in Children Following Recent Trauma Exposure,"Summary This study represents the first longitudinal examination of the trajectory of overgeneral memory (OGM) in children and how this relates to psychopathology immediately after trauma exposure. We recruited fifty 7- to 17-year-olds who had experienced an accidental injury that resulted in hospital admission. Assessment of psychological symptoms, OGM and cognitive processes proposed to drive OGM was completed at three points over a 6-month period post-trauma. We found that OGM was not related to depressive symptoms and that time since trauma exposure moderated the relationship between post-traumatic stress disorder symptoms and OGM. Although no relationship was found in the first 3 months following trauma, OGM was protective against post-traumatic stress disorder symptoms at 6 months post-trauma. Despite models of OGM (e.g. Williams et al., 2007) emphasising the role of rumination and executive control in explaining OGM, we found no evidence that they were related to OGM. Copyright © 2014 John Wiley & Sons, Ltd.",0,0 +4489,Using Mental Health Indicators to Identify Postdisaster Gender-Based Violence among Women Displaced by Hurricane Katrina,"Assessment of gender-based violence (GBV) among internally displaced persons (IDPs) is at best difficult. In complex humanitarian disasters, GBV inquiry can sometimes be dangerous and may lead to underestimation of the true prevalence. We developed a method of identifying women who have greater odds of having been exposed to postdisaster GBV (PDGBV) using mental health indicators.We systematically random sampled IDPs living in travel trailer parks in Louisiana and Mississippi and interviewed respondents using a health needs assessment survey during an 8-week period in April and May 2006. Women (n = 194) were screened for GBV and symptoms of depression.Women were on average 43.3 years old (range 18-85). Of the nine symptoms assessed with the Patient Health Questionnaire-9 (PHQ-9), four were associated with PDGBV. Among women with sleep dysregulation, the odds of PDGBV were 2.5 times higher in comparison with women without sleep dysregulation (95% CI 1.2-5.1). Appetite dysregulation increased the odds by 3.8 (95% CI 1.4-10.3), low self-esteem increased the odds by 2.3 (95% CI 1.2-4.6), and suicidal ideation increased the odds by 2.7 (95% CI 1.1-6.7). The internal consistency reliability of this symptom cluster was higher among women with PDGBV. Women screening positive on all four symptoms were 2.7 times more likely to have experienced PDGBV (95% CI 1.03-7.1).Several but not all symptoms of depression indicated exposure to PDGBV. Sleeping dysregulation, appetite dysregulation, low self-esteem, and suicidal ideation should be considered secondary indicators useful for identifying the prevalence of PDGBV exposure among female IDPs. This model may be useful for identifying women with exposure to PDGBV in settings where direct questioning may not be safe and reliable.",0,0 +4490,Post-traumatic stress disorder moderates the relation between documented childhood victimization and pain 30 years later,"Cross-sectional designs and self-reports of maltreatment characterize nearly all the literature on childhood abuse or neglect and pain in adulthood, limiting potential for causal inference. The current study describes a prospective follow up of a large cohort of individuals with court-documented early childhood abuse or neglect (n=458) and a demographically matched control sample (n=349) into middle adulthood (mean age 41), nearly 30 years later, comparing the groups for risk of adult pain complaints. We examine whether Post-Traumatic Stress Disorder (PTSD) mediates or moderates risk of pain. Assessed prospectively across multiple pain measures, physically and sexually abused and neglected individuals generally showed a significant (p<.05) but notably small (η(2)=.01) increased risk of pain symptoms in middle adulthood. Although PTSD was associated with both childhood victimization (p<.01) and risk of middle adulthood pain (p<.001), it did not appear to mediate the relationship between victimization and pain. However, across all pain outcomes other than medically unexplained pain, PTSD robustly interacted with documented childhood victimization to predict adult pain risk: Individuals with both childhood abuse/neglect and PTSD were at significantly increased risk (p<.001, η(2) generally=.05-.06) of pain. After accounting for the combined effect of the two factors, neither childhood victimization nor PTSD alone predicted pain risk. Findings support a view that clinical pain assessments should focus on PTSD rather than make broad inquiries into past history of childhood abuse or neglect.",0,0 +4491,"[Influence of educational status, burn area and coping behaviors on the complication of psychological disorders in severely burned patients].","To discuss how the educational status, burn area and coping behaviors influence the psychological disorders in severely burned patients.Sixty-four severely burned patients hospitalized in Guangzhou Red Cross Hospital, Guangdong Provincial Work Injury Rehabilitation Center, and Guangdong General Hospital were enrolled with cluster random sampling method. Data of their demography and situation of burns were collected. Then their coping behavior, psychological disorders including anxiety, depression and post-traumatic stress disorder (PTSD) plus its core symptoms of flashback, avoidance, and hypervigilance were assessed by medical coping modes questionnaire, self-rating anxiety scale (SAS), self-rating depression scale (SDS), PTSD checklist-civilian version (PCL-C) respectively. Correlation was analyzed between demography, burn area, coping behavior and psychological disorders. The predictive powers of educational status, burn area and coping behaviors on the psychological disorders were analyzed. The qualitative variables were assigned values. Data were processed with t test, Spearman rank correlation analysis, and multiple linear regression analysis.(1) The patients scored (19.0 ± 3.4) points in confrontation coping behavior, which showed no statistically significant difference from the domestic norm score (19.5 ± 3.8) points (t = -1.13, P > 0.05). The patients scored (16.6 ± 2.4) and (11.0 ± 2.2) points in avoidance and resignation coping behaviors, which were significantly higher than the domestic norm score (14.4 ± 3.0), (8.8 ± 3.2) points (with t values respectively 7.06 and 7.76, P values both below 0.01). The patients' standard score of SAS, SDS, PCL-C were (50 ± 11), (54 ± 11), and (38 ± 12) points. Respectively 89.1% (57/64), 60.9% (39/64), 46.9% (30/64) of the patients showed anxiety, depression, and PTSD symptoms. (2) Four independent variables: age, gender, marital status, and time after burns, were correlated with the psychological disorders, but the correlativity was not statistically significant (with rs values from -0.089 to 0.245, P values all above 0.05). Educational status was significantly negatively correlated with anxiety, depression, PTSD and its core symptoms of flashback, avoidance (with rs values from -0.361 to -0.253, P values all below 0.05). Educational status was negatively correlated with hypervigilance, but the correlativity was not statistically significant (rs = -0.187, P > 0.05). Burn area was significantly positively correlated with the psychological disorders (with rs values from 0.306 to 0.478, P values all below 0.05). Confrontation coping behavior was positively correlated with the psychological disorders, but the correlativity was not statistically significant (with rs values from 0.121 to 0.550, P values all above 0.05). Avoidance coping behavior was correlated with the psychological disorders, but the correlativity was not statistically significant (with rs values from -0.144 to 0.193, P values all above 0.05). Resignation coping behavior was significantly positively correlated with the psychological disorder (with rs values from 0.377 to 0.596, P values all below 0.01). (3) Educational status had predictive power on the anxiety, PTSD and flash back symptoms of patients (with t values from -2.19 to -2.02, P values all below 0.05), but not on depression, avoidance and hypervigilance (with t values from -1.95 to -0.99, P values all above 0.05). Burn area had no predictive power on the psychological disorders (with t values from 0.55 to 1.78, P values all above 0.05). Resignation coping behavior had predictive power on the psychological disorders (with t values from 3.10 to 6.46, P values below 0.01). Confrontation and avoidance coping behaviors had no predictive power on the psychological disorders (with t values from 0.46 to 2.32 and -0.89 and 1.75 respectively, P values all above 0.05).The severely burned patients with lower educational status, larger burn area, and the more frequently adapted resignation coping behavior are more likely to suffer from anxiety, depression, and PTSD.",0,0 +4492,Quantitative forecasting of PTSD from early trauma responses: A Machine Learning application,"There is broad interest in predicting the clinical course of mental disorders from early, multimodal clinical and biological information. Current computational models, however, constitute a significant barrier to realizing this goal. The early identification of trauma survivors at risk of post-traumatic stress disorder (PTSD) is plausible given the disorder's salient onset and the abundance of putative biological and clinical risk indicators. This work evaluates the ability of Machine Learning (ML) forecasting approaches to identify and integrate a panel of unique predictive characteristics and determine their accuracy in forecasting non-remitting PTSD from information collected within 10 days of a traumatic event. Data on event characteristics, emergency department observations, and early symptoms were collected in 957 trauma survivors, followed for fifteen months. An ML feature selection algorithm identified a set of predictors that rendered all others redundant. Support Vector Machines (SVMs) as well as other ML classification algorithms were used to evaluate the forecasting accuracy of i) ML selected features, ii) all available features without selection, and iii) Acute Stress Disorder (ASD) symptoms alone. SVM also compared the prediction of a) PTSD diagnostic status at 15 months to b) posterior probability of membership in an empirically derived non-remitting PTSD symptom trajectory. Results are expressed as mean Area Under Receiver Operating Characteristics Curve (AUC). The feature selection algorithm identified 16 predictors, present in ≥ 95% cross-validation trials. The accuracy of predicting non-remitting PTSD from that set (AUC = .77) did not differ from predicting from all available information (AUC = .78). Predicting from ASD symptoms was not better then chance (AUC = .60). The prediction of PTSD status was less accurate than that of membership in a non-remitting trajectory (AUC = .71). ML methods may fill a critical gap in forecasting PTSD. The ability to identify and integrate unique risk indicators makes this a promising approach for developing algorithms that infer probabilistic risk of chronic posttraumatic stress psychopathology based on complex sources of biological, psychological, and social information.",0,0 +4493,"Traumatic Stress in Overview: Definition, Context, Scope, and Long-Term Outcomes","Trauma in the form of natural disasters, war, and other catastrophic events is ubiquitous. Exposure to traumatic events has been recognized as part of the human experience and has the potential to impact subsequent development across the life span, although individual responses to trauma vary widely. In this chapter, we discuss common sources of trauma and their long-term impacts from the perspective of conservation of resources (COR) theory. In brief, COR theory posits that traumatic stress is a dynamic psychological process that occurs in response to the rapid and often momentous loss of key valued resources. COR theory corollaries include the notions that loss is developmental and tends to occur in negative spirals, the impact of loss outweighs the positive impact of gain, and individuals with fewer reserves of resources are more sensitive to loss and gain (Hobfoll, Stress, culture, and community: The psychology and philosophy of stress, 2004). Common reactions to trauma such as posttraumatic stress disorder (PTSD) are introduced with an emphasis on how reactions unfold over time. Moreover, these reactions interact with the broader social context to produce cycles of loss observed at the individual, community, and cultural levels.",0,0 +4494,Stress and Disease: Is Being Female a Predisposing Factor?,"Does heightened stress sensitivity predispose an individual toward disease? Our Society for Neuroscience mini-symposium examines the link between stress and disease onset, exploring sex differences and whether there is an increased female predisposition. This session specifically addresses the",0,0 +4495,Protective factors for posttraumatic stress disorder symptoms in a prospective study of police officers,"Although police officers are frequently exposed to potentially traumatic incidents, only a minority will develop chronic posttraumatic stress disorder (PTSD). Identifying and understanding protective factors could inform the development of preventive interventions; however, few studies have examined this. In the present prospective study, 233 police officers were assessed during academy training and again following 2 years of police service. Caucasian race, less previous trauma exposure, and less critical incident exposure during police service as well as greater sense of self-worth, beliefs of greater benevolence of the world, greater social support and better social adjustment, all assessed during academy training, were associated with lower PTSD symptoms after 2 years of service. Positive personality attributes assessed during training with the NEO Five-Factor Personality Inventory were not associated with lower PTSD symptoms. In a hierarchical linear regression model, only Caucasian race, lower critical incident exposure during police service, greater assumptions of benevolence of the world and better social adjustment during training remained predictive of lower PTSD symptoms after 2 years of police service. These results suggest that positive world assumptions and better social functioning during training may protect police officers from critical incident related PTSD.",0,0 +4496,Intervening With Immigrant Families: An Integrative Systems Perspective,"Give me your tired, your poor,Your huddled masses yearning to breathe free.The wretched refuse of your teeming shore.Send these, the homeless, tempest-tossed to me.I lift my lamp beside the golden door!(Emma Lazarus, New Colossus, 1883; embossed on the plaque mounted inside the pedestal of the Statue of Liberty)One of the massive trends affecting a myriad of families that has accelerated around the world in the past three and a half decades is immigration—with scores of people leaving their homelands to move to countries they hope will be safer and provide a less turbulent environment in which to reside and raise their families. Such families often encounter enormous problems in their new and sometimes ethnocentric, uninviting, even to the point of hostile environments. In this article, some of the problems and issues encountered and ways therapists can enhance client families’ understanding of their situation, their feelings about it, and how better to cope and problem solve will be explored from an inte...",0,0 +4497,Longitudinal Analysis of Latent Classes of Psychopathology and Patterns of Class Migration in Survivors of Severe Injury,"Little research to date has explored the typologies of psychopathology following trauma, beyond development of particular diagnoses such as posttraumatic stress disorder (PTSD). The objective of this study was to determine the longitudinal patterns of these typologies, especially the movement of persons across clusters of psychopathology.In this 6-year longitudinal study, 1,167 hospitalized severe injury patients who were recruited between April 2004-February 2006 were analyzed, with repeated measures at baseline, 3 months, 12 months, and 72 months after injury. All patients met the DSM-IV criterion A1 for PTSD. Structured clinical interviews were used to assess psychiatric disorders at each follow-up point. Latent class analysis and latent transition analysis were applied to assess clusters of individuals determined by psychopathology. The Mini International Neuropsychiatric Interview (MINI) and Clinician-Administered PTSD Scale (CAPS) were employed to complete diagnoses.Four latent classes were identified at each time point: (1) Alcohol/Depression class (3 months, 2.1%; 12 months, 1.3%; and 72 months, 1.1%), (2) Alcohol class (3 months, 3.3%; 12 months, 3.7%; and 72 months, 5.4%), (3) PTSD/Depression class (3 months, 10.3%; 12 months, 11.5%; and 72 months, 6.4%), and (4) No Disorder class (3 months, 84.2%; 12 months, 83.5%; and 72 months, 87.1%). Latent transition analyses conducted across the 2 transition points (12 months and 72 months) found consistently high levels of stability in the No Disorder class (90.9%, 93.0%, respectively) but lower and reducing levels of consistency in the PTSD/Depression class (81.3%, 46.6%), the Alcohol/Depression class (59.7%, 21.5%), and the Alcohol class (61.0%, 36.5%), demonstrating high levels of between-class migration.Despite the array of psychiatric disorders that may develop following severe injury, a 4-class model best described the data with excellent classification certainty. The high levels of migration across classes indicate a complex pattern of psychopathology expression over time. The findings have considerable implications for tailoring multifocused interventions to class type, as well as flexible stepped care models, and for the potential development and delivery of transdiagnostic interventions targeting underlying mechanisms.",0,0 +4498,Does injury compensation lead to worse health after whiplash? A systematic review,"One might expect that injury would leave injured parties better off than they would otherwise have been, yet many believe that does more harm than good. This study systematically reviews the evidence on this compensation hypothesis in relation to compensable whiplash injuries. PubMed, CINAHL, EMBASE, PEDro, PsycInfo, CCTR, Lexis, and EconLit were searched from the date of their inception to April 2010 to locate longitudinal studies, published in English, comparing the health outcomes of adults exposed/not exposed to compensation-related factors. Studies concerning serious neck injuries, using claimants only, or using proxy measures of health outcomes were excluded. Eleven studies were included. These examined the effect of lawyer involvement, litigation, claim submission, or previous claims on pain and other health outcomes. Among the 16 results reported were 9 statistically significant negative associations between compensation-related factors and health outcomes. Irrespective of the compensation-related factor involved and the health outcome measured, the quality of these studies was similar to studies that did not find a significant negative association: most took some measures to address selection bias, confounding, and measurement bias, and none resolved the potential for reverse causality bias that arises in the relationship between compensation-related factors and health. Unless ambiguous causal pathways are addressed, one cannot draw conclusions from statistical associations, regardless of their statistical significance and the extent of measures to address other sources of bias. Consequently, there is no clear evidence to support the idea that and its related processes lead to worse health.",0,0 +4499,INTEGRATIVE ASSESSMENT OF BRAIN AND COGNITIVE FUNCTION IN POST-TRAUMATIC STRESS DISORDER,"The present study combined neuropsychological and electrophysiological measures to obtain a comprehensive profile of the everyday attentional and memory dysfunction reported in PTSD. The event-related potential (ERP) literature has consistently found abnormalities in late components (N2, P3) reflecting working memory (WM) function. However, the neuropsychological profile reported in the literature has considerable variation. The present study examined ERP activity in 33 PTSD participants and matched controls during a standard two-tone auditory oddball task. Neuropsychological assessment was carried out using a task battery assessing a wide range of cognitive functions. Consistent with previous work, the PTSD group showed delayed N2 latency and reduced P3 target amplitude, together with slower and less accurate target detection. Scalp topography provided evidence of widespread abnormality during WM function, but with strongest effects broadly over the left hemisphere. Neuropsychological testing found concomitant difficulties on factorial measures of verbal memory retention/access and sustained attention but enhanced performance on measures of immediate recall. This integrative pattern of effects reflects a specific impairment in the operation of working memory systems that guide ongoing, planned behavior and that facilitate the acquisition and retention of new memories.",0,0 +4500,HIV infection associated post-traumatic stress disorder and post-traumatic growth – A systematic review,"The phenomenon of post-traumatic stress has been well documented in the literature as a lasting mental health condition associated with exposure to traumatic life events. The diagnosis and experience of human immunodeficiency virus (HIV) disease may be such a trauma. On the other hand, the phenomenon of post-traumatic growth (PTG) has been described, whereby people show positive mental health growth in the face of such trauma. This systematic review was set out to explore post-traumatic stress disorder (PTSD) and PTG in people with HIV to monitor prevalence, measurement and efficacy of interventions to reduce stress and/or promote growth. Standardised review techniques were used to track reports on both PTSD and PTG. A total of 206 papers were retrieved from the PTSD and HIV searches, and 13 from the PTG and HIV searches. After reviewing the papers for inclusion according to adequacy and relevance criteria and to remove duplicates, 33 PTSD papers and three PTG were available for full coding. Prevalence of PTSD in HIV ranged from 5% to 74%, which were much greater than the 7-10% in the general population. Seven studies showed a relation between trauma and PTSD, while six showed a link between PTSD diagnosis and reduced antiretroviral treatment adherence. Women were more likely to be diagnosed with PTSD. Only three intervention reports were identified that fitted our inclusion criteria. All of these reported on psychological interventions for HIV+ individuals with trauma. The interventions utilised HIV education, training in coping techniques and support groups. Only coping interventions were shown to be effective. PTG was under researched but showed a promising avenue of study. There needs to be harmonised measurement and the evidence base would need strengthening in order to build on the understanding of the impact of PTSD and PTG over the course of HIV disease. There is good evidence to associate HIV diagnosis and experiences during the course of illness as traumatic. PTSD has been shown to be prevalent and there seems to be good evidence to incorporate standardised measures to track the course of the disorder. There is extremely limited evidence that interventions may affect the course of symptom experience. The evidence and insight into PTG show promise but is currently inadequate.",0,0 +4501,A Prospective Longitudinal Study of Posttraumatic Stress Disorder Symptom Trajectories After Burn Injury,"Psychologic problems are common after burns, and symptoms of posttraumatic stress disorder (PTSD) are some of the most prevalent. Risk factors for PTSD have been identified, but little is known about the onset and course of these symptoms. The objective was to investigate whether there are different PTSD symptom trajectories after burns.Ninety-five adults with burns were enrolled in a prospective study from in-hospital treatment until 12 months after burn. Symptoms of PTSD were assessed with the Impact of Event Scale-Revised and scores at 3, 6, and 12 months after the burn were used in a cluster analysis to detect trajectories. The trajectories were compared regarding known risk factors for PTSD using non-parametric analysis of variance.Four clusters were identified: (1) resilient, with low levels of PTSD symptoms that decreased over time; (2) recovery, with high levels of symptoms that gradually decreased; (3) delayed, with moderate symptoms that increased over time; and (4) chronic, with high levels of symptoms over time. The trajectories differed regarding several risk factors for PTSD including life events, premorbid psychiatric morbidity, personality traits, avoidant coping, in-hospital psychologic symptoms, and social support. The resilient trajectory consistently had fewer of the risk factors and differed the most from the chronic trajectory.There are subgroups among patients with burns that have different patterns of PTSD symptom development. These findings may have implications for clinical practice, such as the timing of assessment and the management of patients who present with these symptoms.",0,0 +4502,Amygdala response predicts trajectory of symptom reduction during Trauma-Focused Cognitive-Behavioral Therapy among adolescent girls with PTSD,"Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is the gold standard treatment for pediatric PTSD. Nonetheless, clinical outcomes in TF-CBT are highly variable, indicating a need to identify reliable predictors that allow forecasting treatment response. Here, we test the hypothesis that functional neuroimaging correlates of emotion processing predict PTSD symptom reduction during Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) among adolescent girls with PTSD. Thirty-four adolescent girls with PTSD related to physical or sexual assault were enrolled in TF-CBT, delivered in an approximately 12 session format, in an open trial. Prior to treatment, they were engaged in an implicit threat processing task during 3T fMRI, during which they viewed faces depicting fearful or neutral expressions. Among adolescent girls completing TF-CBT (n = 23), slopes of PTSD symptom trajectories during TF-CBT were significantly related to pre-treatment degree of bilateral amygdala activation while viewing fearful vs neutral images. Adolescents with less symptom reduction were characterized by greater amygdala activation to both threat and neutral images (i.e., less threat-safety discrimination), whereas adolescents with greater symptom reduction were characterized by amygdala activation only to threat images. These clinical outcome relationships with pre-treatment bilateral amygdala activation remained when controlling for possible confounding demographic or clinical variables (e.g., concurrent psychotropic medication, comorbid diagnoses). While limited by a lack of a control group, these preliminary results suggest that pre-treatment amygdala reactivity to fear stimuli, a component of neurocircuitry models of PTSD, positively predicts symptom reduction during TF-CBT among assaulted adolescent girls, providing support for an objective measure for forecasting treatment response in this vulnerable population.",0,0 +4503,Mental Health Problems in Juvenile Justice Populations,"The limited literature on mental health problems in juvenile justice population has reported that most youth in juvenile justice hold psychiatric pathology. Although conduct disorder and substance abuse are the most prevalent conditions in this population, many other diagnoses can be found at alarmingly high rates; research on other diagnoses (eg, autism, psychosis) is limited. This finding underscores the necessity of implementing adequate diagnostic assessment within forensic settings and of developing interventions programs that take into account the presence of psychiatric problems.",0,0 +4504,Factors associated with post-traumatic stress disorder and depression amongst internally displaced persons in northern Uganda,"The 20 year war in northern Uganda between the Lord's Resistance Army and the Ugandan government has resulted in the displacement of up to 2 million people within Uganda. The purpose of the study was to measure rates of post-traumatic stress disorder (PTSD) and depression amongst these internally displaced persons (IDPs), and investigate associated demographic and trauma exposure risk factors.A cross-sectional multi-staged, random cluster survey with 1210 adult IDPs was conducted in November 2006 in Gulu and Amuru districts of northern Uganda. Levels of exposure to traumatic events and PTSD were measured using the Harvard Trauma Questionnaire (original version), and levels of depression were measured using the Hopkins Symptom Checklist-25. Multivariate logistic regression was used to analyse the association of demographic and trauma exposure variables on the outcomes of PTSD and depression.Over half (54%) of the respondents met symptom criteria for PTSD, and over two thirds (67%) of respondents met symptom criteria for depression. Over half (58%) of respondents had experienced 8 or more of the 16 trauma events covered in the questionnaire. Factors strongly linked with PTSD and depression included gender, marital status, distance of displacement, experiencing ill health without medical care, experiencing rape or sexual abuse, experiencing lack of food or water, and experiencing higher rates of trauma exposure.This study provides evidence of exposure to traumatic events and deprivation of essential goods and services suffered by IDPs, and the resultant effect this has upon their mental health. Protection and social and psychological assistance are urgently required to help IDPs in northern Uganda re-build their lives.",0,0 +4505,A confirmatory factor analysis of the acute stress disorder interview,"Acute stress disorder (ASD) was introduced in 1994 to describe posttraumatic stress reactions that occur in the initial month after trauma exposure. Although it comprises the distinct symptom clusters of dissociation, reexperiencing, avoidance, and arousal, there have been no confirmatory factor analyses of the construct. In this study, 587 individuals admitted to five major hospitals after traumatic injury were administered the Acute Stress Disorder Interview. Forty-four participants met criteria for ASD. Confirmatory factor analysis based on the four symptom clusters described the Acute Stress Disorder Interview responses. These data provide the first confirmatory factor analysis of the ASD symptoms, and are discussed in terms of the 4-factor models repeatedly found in samples of chronic posttraumatic stress disorder.",0,0 +4506,Combat-Exposed War Veterans at Risk for Suicide Show Hyperactivation of Prefrontal Cortex and Anterior Cingulate During Error Processing,"Suicide is a significant public health problem. Suicidal ideation (SI) increases the risk for completed suicide. However, the brain basis of SI is unknown. The objective of this study was to examine the neural correlates of self-monitoring in individuals at risk for suicide. We hypothesized that combat veterans with a history of SI relative to those without such a history would show altered activation in the anterior cingulate cortex and related circuitry during self-monitoring.Two groups of combat-exposed war veterans (13 men with and 13 men without history of SI) were studied. Both the SI and non-SI participants had two or more of the following: a) current major depressive disorder, b) current posttraumatic stress disorder, and c) history of mild traumatic brain injury, and each subject performed a validated stop task during functional magnetic resonance imaging. Error-related activation was compared between the SI and non-SI groups.The SI group demonstrated more error-related activation of the anterior cingulate (8256 mm(3), t = 2.51) and prefrontal cortex (i.e., clusters >2048 mm(3), voxelwise p < .05). The SI and non-SI participants showed similar behavioral task performance (i.e., mean error rate, F values < 0.63, p values > .43; and mean reaction times, F = 0.27, p = .61).These findings suggest neural correlates of altered self-monitoring in individuals with a history of SI and may further suggest that functional magnetic resonance imaging could be used to identify individuals at risk for suicide before they engage in suicidal behavior.",0,0 +4507,The study of intensity and frequency of posttraumatic stress disorder (PTSD) resulting from war in Ilam city,"Post-traumatic stress disorder (PTSD) is a set of a person's reactions to stresses which are beyond one's mental capacity and precedes a severe stress. The aim of this Research was to study the intensity and frequency of posttraumatic stress disorder (PTSD) resulting from war in Ilam city. This descriptive- analytic study was investigated the PTSD among the residents of Ilam city who were involved directly or indirectly in the war issues. The sample size was 5110 people chosen through cluster sampling technique. Data were analyzed through statistical methods such as K2 test, t-test, linear regression test, and variance analysis in SPSS software. The results of the study revealed that 26 of the cases who had residence background in Ilam city during Iraqi war against Iran suffered from mental disorder (PTSD). Most of these patients were married, illiterate, or primary educated people and mostly the young and middle aged housewives. The war-induced posttraumatic stress disorder has had negative effects on different aspects of Ilam city residents' health. Therefore, identifying the vulnerable groups to apply medical treatment seemed important and necessary.",0,0 +4508,Predictors of Posttraumatic Stress Symptom Trajectories in Parents of Children Exposed to Motor Vehicle Collisions,"Following child trauma, parents are at risk of developing posttraumatic stress disorder (PTSD), either owing to their direct involvement or from hearing of their child's involvement. Despite the potential impact of a parent's development of PTSD on both the parent and child, little is known about what may place a parent at increased risk.PTSD symptoms were assessed ≤ 4 weeks, 6 months, and 3 years post-trauma, along with a range of potential risk factors, in a sample of parents of 2-10-year-old children who were involved in a motor vehicle collision.Two symptom trajectories were identified: Those parents whose symptoms remained low across all time points and those whose symptoms remained elevated at 6 months post-trauma and declined by 3 years. Subjective threat, thought suppression, and maladaptive cognitions about damage to the child were identified as key predictors of poorer outcomes.",1,0 +4509,Impact of Event Scale: psychometric properties,"Background For more than 20 years, the Impact of Event Scale (IES) has been widely used as a measure of stress reactions after traumatic events. Aims To review studies that evaluated the IES's psychometric properties. Method Literature review. Results The results indicated that the IES's two-factor structure is stable over different types of events, that it can discriminate between stress reactions at different times after the event, and that it has convergent validity with observer-diagnosed post-traumatic stress disorder. The use of IES in many psychopharmacological trials and outcome studies is supportive of the measure's clinical relevance. Conclusions The IES is a useful measure of stress reactions after a range of traumatic events, and it is valuable for detecting individuals who require treatment.",0,0 +4510,Psychophysiologic assessment of mental imagery of stressful events in israeli civilian posttraumatic stress disorder patients,"This study explored the physiological responses of posttraumatic stress disorder (PTSD) patients to reminders of a stressful event that had preceded the onset of their illness and was not related to its cause: the SCUD missile alarms of the Gulf War. A mental-imagery technique used in previous studies of PTSD was used. Three 30-second audiotapes were presented to each subject, including (1) the Gulf War's missile alarm, (2) a radio announcement of a terrorist attack, and (3) a standardized relaxing scene. Subjects were instructed to imagine each event as vividly as possible while heart rate (HR), skin conductance (SC), and left lateral frontalis electromyogram (EMG) responses were measured. The responses of 12 outpatients with PTSD were compared with those of panic disorder patients (n = 11), survivors of traumatic events who had not developed PTSD (n = 9), and mentally healthy subjects with no lifetime history of major trauma (n = 19). Multivariate analysis of variance (MANOVA) for the three physiological measures showed a significant group difference during imagery of the Gulf War alarm, with PTSD subjects showing higher SC and EMG responses than the others. The differences remained significant when age, level of distress during the war, and concurrent anxiety were controlled for. There were no group differences in responses to the other stimuli. We conclude that, PTSD patients may either acquire and maintain prolonged conditioned responses to various stressors during their life span or become sensitized to reminders of past traumata following the onset of their illness. Heightened conditionability may be expressed before the trauma in subjects who are liable to develop PTSD.",0,0 +4511,A Multisite Analysis of the Fluctuating Course of Posttraumatic Stress Disorder,"Delayed-onset posttraumatic stress disorder (PTSD) accounts for approximately 25% of PTSD cases. Current models do not adequately explain the delayed increases in PTSD symptoms after trauma exposure.To test the roles of initial psychiatric reactions, mild traumatic brain injury (MTBI), and ongoing stressors on delayed-onset PTSD.In this prospective cohort study, patients were selected from recent admissions to 4 major trauma hospitals across Australia. A total of 1084 traumatically injured patients were assessed during hospital admission from April 1, 2004, through February 28, 2006, and 785 (72.4%) were followed up at 3, 12, and 24 months after injury.Severity of PTSD was determined at each assessment with the Clinician-Administered PTSD Scale.Of those who met PTSD criteria at 24 months, 44.1% reported no PTSD at 3 months and 55.9% had subsyndromal or full PTSD. In those who displayed subsyndromal or full PTSD at 3 months, PTSD severity at 24 months was predicted by prior psychiatric disorder, initial PTSD symptom severity, and type of injury. In those who displayed no PTSD at 3 months, PTSD severity at 24 months was predicted by initial PTSD symptom severity, MTBI, length of hospitalization, and the number of stressful events experienced between 3 and 24 months.These data highlight the complex trajectories of PTSD symptoms over time. This study also points to the roles of ongoing stress and MTBI in delayed cases of PTSD and suggests the potential of ongoing stress to compound initial stress reactions and lead to a delayed increase in PTSD symptom severity. This study also provides initial evidence that MTBI increases the risk of delayed PTSD symptoms, particularly in those with no acute symptoms.",0,0 +4512,Posttraumatic Growth in Adolescent Survivors of Cancer and Their Mothers and Fathers,"To describe posttraumatic growth (PTG) following childhood cancer survival and its association with demographic and disease/treatment variables, perceived treatment severity and life threat, and posttraumatic stress symptoms (PTSS).Adolescent survivors of cancer (N = 150, ages 11-19), at least 1 year after treatment, and their mothers (N = 146) and fathers (N = 107) completed self-report measures of perceived treatment intensity and PTSS and a semistructured interview designed to identify posttraumatic responses and indicators of PTG including perceived positive changes for self, relationships, and life goals.A majority of adolescents and their mothers and fathers reported PTG. Greater perceived treatment severity and life threat, but not objective disease severity, was associated with PTG. PTG and PTSS were positively associated for the adolescent cancer survivors. Diagnosis after age 5 resulted in more perceived benefit and greater PTSS for adolescent survivors.Clarification of the concept and measurement of PTG after childhood cancer is warranted, as are prospective studies of the association of PTG and PTSS and the role of demographic variables and illness-specific appraisals.",0,0 +4513,Posttraumatic stress disorder and intimate relationship problems: A meta-analysis.,"The authors conducted a meta-analysis of empirical studies investigating associations between indices of posttraumatic stress disorder (PTSD) and intimate relationship problems to empirically synthesize this literature.A literature search using PsycINFO, Medline, Published International Literature on Traumatic Stress (PILOTS), and Dissertation Abstracts was performed. The authors identified 31 studies meeting inclusion criteria.True score correlations (ρ) revealed medium-sized associations between PTSD and intimate relationship discord (ρ = .38, N = 7,973, K = 21), intimate relationship physical aggression perpetration (ρ = .42, N = 4,630, K = 19), and intimate relationship psychological aggression perpetration (ρ = .36, N = 1,501, K = 10). The strength of the association between PTSD and relationship discord was higher in military (vs. civilian) samples, and when the study was conducted in the United States (vs. other country), and the study represented a doctoral dissertation (vs. published article). The strength of the association between PTSD and physical aggression was higher in military (vs. civilian) samples, males (vs. females), community (vs. clinical) samples, studies examining PTSD symptom severity (vs. diagnosis), when the physical aggression measure focused exclusively on severe violence (vs. a more inclusive measure), and the study was published (vs. dissertation). For the PTSD-psychological aggression association, 98% of the variance was accounted for by methodological artifacts such as sampling and measurement error; consequently, no moderators were examined in this relationship.Findings highlight a need for the examination of models explaining the relationship difficulties associated with PTSD symptomatology and interventions designed to treat problems in both areas.",0,0 +4514,Analysis of suicidal behaviour in Israeli veterans and terror victims with post-traumatic stress disorder by using the computerised Gottschalk–Gleser scales,"Abstract The primary objective of this study was to identify the vulnerability factors for suicide attempts in an Israeli sample, with the help of the Gottschalk–Gleser content analysis scales. The respondents were divided into four groups: suicide attempters; controls; post-traumatic stress disorder and depressed patients who did not report suicidal behaviour; and suicide ideators. The significant results represent conscious and unconscious psychological states, which suicide attempters have in common and can be seen as potential suicide risk factors. The main recurring risk-related themes are hopelessness, sickness, deterrents, frustrated dependency strivings, total anxiety and total depression.",0,0 +4515,Applications of Latent Growth Mixture Modeling and allied methods to posttraumatic stress response data,"Scientific research into mental health outcomes following trauma is undergoing a revolution as scientists refocus their efforts to identify underlying dimensions of health and psychopathology. This effort is in stark contrast to the previous focus which was to characterize individuals based on Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic status (Insel et al., 2010). A significant unresolved issue underlying this shift is how to characterize clinically relevant populations without reliance on the categorical definitions provided by the DSM. Classifying individuals based on their pattern of stress adaptation over time holds significant promise for capturing inherent inter-individual heterogeneity as responses including chronicity, recovery, delayed onset, and resilience can only be determined longitudinally (Galatzer-Levy & Bryant, 2013) and then characterizing these patterns for future research (Depaoli, Van de Schoot, Van Loey, & Sijbrandij, 2015). Such an approach allows for the identification of phenominologically similar patterns of response to diverse extreme environmental stressors (Bonanno, Kennedy, Galatzer-Levy, Lude, & Elfstom, 2012; Galatzer-Levy & Bonanno, 2012; Galatzer-Levy, Brown, et al., 2013; Galatzer-Levy, Burton, & Bonanno, 2012) including translational animal models of stress adaptation (Galatzer-Levy, Bonanno, Bush, & LeDoux, 2013; Galatzer-Levy, Moscarello, et al., 2014). The empirical identification of heterogeneous stress response patterns can increase the identification of mechanisms (Galatzer-Levy, Steenkamp, et al., 2014), consequences (Galatzer-Levy & Bonanno, 2014), treatment effects (Galatzer-Levy, Ankri, et al., 2013), and prediction (Galatzer-Levy, Karstoft, Statnikov, & Shalev, 2014) of individual differences in response to trauma.METHODological and theoretical considerations for the application of Latent Growth Mixture Modeling (LGMM) and allied methods such as Latent Class Growth Analysis (LCGA) for the identification of heterogeneous populations defined by their pattern of change over time will be presented (Van De Schoot, 2015). Common pitfalls including non-identification, over identification, and issues related to model specification will be discussed as well as the benefits of applying such methods along with the theoretical grounding of such approaches.LGMM and allied methods have significant potential for improving the science of stress pathology as well as our understanding of healthy adaptation (resilience).",0,0 +4516,Abuse and Neglect in Childhood: Relationship to Personality Disorder Diagnoses,"Childhood history of abuse and neglect has been associated with personality disorders and has been observed in subjects with lifetime histories of suicidality and self-injury. Most of these findings have been generated from inpatient clinical samples.This study evaluated self-rated indices of sustained childhood abuse and neglect in an outpatient sample of well-characterized personality disorder subjects (n=182) to determine the relative associations of childhood trauma indices to specific personality disorder diagnoses or clusters and to lifetime history of suicide attempts or gestures. Subjects met criteria for ~2.5 Axis II diagnoses and 24% reported past suicide attempts. The Childhood Trauma Questionnaire was administered to assess five dimensions of childhood trauma exposure (emotional, physical, and sexual abuse, and emotional and physical neglect). Logistic regression was employed to evaluate salient predictors among the trauma measures for each cluster, personality disorder, and history of attempted suicide and self-harm. All analyses controlled for gender distribution.Seventy-eight percent of subjects met dichotomous criteria for some form of childhood trauma; a majority reported emotional abuse and neglect. The dichotomized criterion for global trauma severity was predictive of cluster B, borderline, and antisocial personality disorder diagnoses. Trauma scores were positively associated with cluster A, negatively with cluster C, but were not significantly associated with cluster B diagnoses. Among the specific diagnoses comprising cluster A, paranoid disorder alone was predicted by sexual, physical, and emotional abuse. Within cluster B, only antisocial personality disorder showed significant associations with trauma scores, with specific prediction by sexual and physical abuse. For borderline personality disorder, there were gender interactions for individual predictors, with emotional abuse being the only significant trauma predictor, and only in men. History of suicide gestures was associated with emotional abuse in the entire sample and in women only; self-mutilatory behavior was associated with emotional abuse in men.These results suggest that childhood emotional abuse and neglect are broadly represented among personality disorders, and associated with indices of clinical severity among patients with borderline personality disorder. Childhood sexual and physical abuse are highlighted as predictors of both paranoid and antisocial personality disorders. These results help qualify prior observations of the association of childhood sexual abuse with borderline personality disorder.",0,0 +4517,Postconcussive Symptoms and Posttraumatic Stress Disorder after Mild Traumatic Brain Injury,"Postconcussive symptoms after mild traumatic brain injury (MTBI) may be exacerbated by anxiety associated with posttraumatic stress. The aim of this study was to investigate the relationship between postconcussive symptoms and posttraumatic stress disorder (PTSD) in an MTBI population. Survivors of motor vehicle accidents who either sustained an MTBI (N = 46) or no TBI (N = 59) were assessed 6 months posttrauma for PTSD and postconcussive symptoms. Postconcussive symptoms were more evident in MTBI patients with PTSD than those without PTSD, and in MTBI patients than non-TBI patients. Further, postconcussive symptoms were significantly correlated with PTSD symptoms. These findings indicate that postconcussive symptoms may be mediated by an interaction of neurological and psychological factors after MTBI.",0,0 +4518,PTSD SYMPTOMS ACROSS PREGNANCY AND EARLY POSTPARTUM AMONG WOMEN WITH LIFETIME PTSD DIAGNOSIS,"Little is known about trajectories of PTSD symptoms across the peripartum period in women with trauma histories, specifically those who met lifetime PTSD diagnoses prior to pregnancy. The present study seeks to identify factors that influence PTSD symptom load across pregnancy and early postpartum, and study its impact on postpartum adaptation.The current study is a secondary analysis on pregnant women with a Lifetime PTSD diagnosis (N = 319) derived from a larger community sample who were interviewed twice across pregnancy (28 and 35 weeks) and again at 6 weeks postpartum, assessing socioeconomic risks, mental health, past and ongoing trauma exposure, and adaptation to postpartum.Using trajectory analysis, first we examined the natural course of PTSD symptoms based on patterns across peripartum, and found four distinct trajectory groups. Second, we explored factors (demographic, historical, and gestational) that shape the PTSD symptom trajectories, and examined the impact of trajectory membership on maternal postpartum adaptation. We found that child abuse history, demographic risk, and lifetime PTSD symptom count increased pregnancy-onset PTSD risk, whereas gestational PTSD symptom trajectory was best predicted by interim trauma and labor anxiety. Women with the greatest PTSD symptom rise during pregnancy were most likely to suffer postpartum depression and reported greatest bonding impairment with their infants at 6 weeks postpartum.Screening for modifiable risks (interpersonal trauma exposure and labor anxiety) and /or PTSD symptom load during pregnancy appears critical to promote maternal wellbeing.",0,0 +4519,"Gender, victimization, and outcomes: Reconceptualizing risk.","Large-scale studies of gender differences in psychopathological reactions to victimization have focused on posttraumatic stress disorder, overlooking other trauma-related disorders. The present study expands this literature with a contextualized examination of interpersonal aggression exposure and sequelae. Using k-means cluster analysis on a sample of 16,000, the authors identified 8 distinct profiles of exposure to sexual violence, physical assault, stalking, and emotional abuse. Analyses of covariance then suggested links among victimization profile, gender, and mental and physical health. Results revealed no meaningful interactive effects of gender and interpersonal aggression on outcomes, once lifetime exposure to aggressive events was adequately taken into account. These findings argue against theories of female victims' greater vulnerability to pathological outcomes, instead linking risk to exposure history.",0,0 +4520,The Impact of Childhood Maltreatment on PTSD Symptoms Among Female Survivors of Intimate Partner Violence,"Objective: Intimate partner violence (IPV) survivors often report histories of childhood maltreatment, yet the unique contributions of childhood maltreatment on IPV survivors' distinct posttraumatic stress disorder (PTSD) symptoms remain inadequately understood. Method: Using interview and self-report measures, we examined IPV as a potential mediator of the association between childhood maltreatment and severity of PTSD symptom clusters (reexperiencing, avoidance, numbing, and hyperarousal) among a sample of 425 women seeking help for recent IPV. Results: Structural equation modeling demonstrated that while both childhood maltreatment and IPV were both positively associated with PTSD symptom clusters, IPV did not mediate the association between childhood maltreatment and severity of PTSD symptom clusters among acute IPV survivors. Conclusions: Childhood maltreatment has persistent effects on the PTSD symptoms of IPV survivors, suggesting that child maltreatment may need to be addressed in addition to IPV during PTSD treatment. © 2013 Springer Publishing Company.",0,0 +4521,Mental health pathways from interpersonal violence to health-related outcomes in HIV-positive sexual minority men.,"We examined mental health pathways between interpersonal violence (IPV) and health-related outcomes in HIV-positive sexual minority men engaged with medical care.HIV-positive gay and bisexual men (N = 178) were recruited for this cross-sectional study from 2 public HIV primary care clinics that treated outpatients in an urban setting. Participants (M age = 44.1 years, 36% non-White) filled out a computer-assisted survey and had health-related data extracted from their electronic medical records. We used structural equation modeling to test associations among the latent factors of adult abuse and partner violence (each comprising indicators of physical, sexual, and psychological abuse) and the measured variables: viral load, health-related quality of life (HRQOL), HIV medication adherence, and emergency room (ER) visits. Mediation was tested for the latent construct mental health problems, comprising depression, anxiety, symptomatology of posttraumatic stress disorder, and suicidal ideation.The final model demonstrated acceptable fit, chi(2)(123) = 157.05, p = .02, CFI = .95, TLI = .94, RMSEA = .04, SRMR = .06, accounting for significant portions of the variance in viral load (13%), HRQOL (41%), adherence (7%), and ER visits (9%), as well as the latent variable mental health problems (24%). Only 1 direct link emerged: a positive association between adult abuse and ER visits.Findings indicate a significant role of IPV and mental health problems in the health of people living with HIV/AIDS. HIV care providers should assess for IPV history and mental health problems in all patients and refer for evidence-based psychosocial treatments that include a focus on health behaviors.",0,0 +4522,Ten years follow-up of trauma-related psychological distress in a cohort of patients with acute traumatic hand injury,"Summary Though early psychological symptoms after an acute traumatic hand injury have been described, there remains a need for knowledge concerning the trajectory of the individual's response over time to the traumatic event. The purpose of this study was to describe psychological distress related to the traumatic experience in a cohort of patients with acute traumatic hand injury in a 10-year perspective. Patients were recruited consecutively at a hand surgery department. Data were collected by means of mailed questionnaires one week, three months, one year and 10years after the accident. Eighty-three patients participated in all four measurements. Their experience of psychological distress related to the trauma differed significantly during the 10years ( p",0,0 +4523,Psychiatric (axis I) and personality (axis II) disorders in patients with burning mouth syndrome or atypical facial pain,"Abstract Background and aims Burning mouth syndrome (BMS) and atypical facial pain (AFP) are often persistent idiopathic pain conditions that mainly affect middle-aged and elderly women. They have both been associated with various psychiatric disorders. This study examined current and lifetime prevalence of psychiatric axis I (symptom-based) and II (personality) disorders in patients with chronic idiopathic orofacial pain, and investigated the temporal relationship of psychiatric disorders and the onset of orofacial pain. Method Forty patients with BMS and 23 patients with AFP were recruited from Turku university hospital clinics. Mean age of the patients was 62.3 years (range 35–84) and 90% were female. BMS and AFP diagnoses were based on thorough clinical evaluation, and all patients had undergone clinical neurophysiological investigations including blink reflex and thermal quantitative tests. Current and lifetime DSM-IV diagnoses of axis I and II disorders were made on clinical basis with the aid of SCID-I and II-interviews. The detected prevalence rates and their 95% confidence intervals based on binomial distribution were compared to three previous large population-based studies. Results Of the 63 patients, 26 (41.3%) had had an axis I disorder that preceded the onset of orofacial pain, and 33 (52.4%) had had a lifetime axis I disorder. Rate of current axis I disorders was 36.5%, indicating that only about 16% of lifetime disorders had remitted, and they tended to run chronic course. The most common lifetime axis I disorders were major depression (30.2%), social phobia (15.9%), specific phobia (11.1%), and panic disorder (7.9%). Twelve patients (19.0%) had at least one cluster C personality disorder already before the emergence of orofacial pain. Patients with cluster C personality disorders are characterized as fearful and neurotic. None of the patients had cluster A (characterized as odd and eccentric) or B (characterized as dramatic, emotional or erratic) personality disorders. The most common personality disorders were obsessive–compulsive personality (14.3%), dependent personality (4.8%), and avoidant personality (3.2%). The majority of the patients (54%) had also one or more chronic pain conditions other than orofacial pain. In almost all patients (94%) they were already present at the onset of orofacial pain. Conclusions Our results suggest that major depression, persistent social phobia, and neurotic, fearful, and obsessive–compulsive personality characteristics are common in patients with chronic idiopathic orofacial pain. Most psychiatric disorders precede the onset of orofacial pain and they tend to run a chronic course. Implications We propose that the high psychiatric morbidity, and comorbidity to other chronic pain conditions, in chronic idiopathic orofacial pain can be best understood in terms of shared vulnerability to both chronic pain and specific psychiatric disorders, most likely mediated by dysfunctional brain dopamine activity.",0,0 +4524,The experience of chronic illness and post-traumatic stress disorder: the consequences of cumulative adversity,"In this paper the experiences of the chronically ill are examined to explore the impact of post-traumatic stress disorder (PTSD), accumulated burden of adversity and trauma spectrum disorder on subsequent illness and coping behaviors. Individuals experiencing chronic diseases have been studied with regard to depression, anxiety and a variety of coping maladaptions, but negligible attention has been given to the PTSD potential of chronic disease over the life course. Yet, growing evidence suggests that the traumatogenic potential of chronic diseases, some sudden and unexpected onsets, and the traumatogenic changes in life circumstance, may produce maladaptive illness coping over the life course. More importantly, attention needs to focus on the additive effect of co-morbid life events and the traumatic potential of invasive medical therapies. Consideration of PTSD and a continuum of cumulative adversity provide a more complex and fully drawn understanding of the circumstances surrounding chronic illness coping and reasons for maladaptive coping following invasive therapies and changes in the disease trajectory. The pathophysiology that produces a chronic diseases does not begin at symptom onset, and the psychosocial strategies to cope with a chronic illness, whether efficacious or maladaptive, also do not begin at symptom onset, but develops over the life course.",0,0 +4525,Patterns and Perceptions of Intimate Partner Violence Committed by Returning Veterans with Post-Traumatic Stress Disorder,"Data from a recent mixed-methods study conducted among Veterans of Iraq and Afghanistan diagnosed with Post-Traumatic Stress Disorder (PTSD) raise important questions regarding the occurrence of Intimate Partner Violence (IPV) in this population. Three case studies illustrate two main findings. First, Veterans and family members participating in the study described three patterns of partner violence-violence committed in anger; dissociative violence; and parasomniac/hypnopompic violence-suggesting that distinct patterns of IPV may emerge in relation to PTSD symptoms. Second, participants' descriptions suggest that common ideas about PTSD and war-related suffering can play an important role in influencing how Veterans and their partners respond to episodes of partner violence. It is important for those providing care to PTSD-diagnosed Veterans and their partners to understand when and how partner violence may occur, and how both parties may perceive and respond to it, in order to aid in developing appropriate plans for coping and safety-seeking. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +4526,Reactions to Rape: A Military Forensic Psychiatrist's Perspective,"Accusations of rape or sexual harassment are currently very high-profile in the military. This article discusses rape allegations in the military legal system from a psychiatric perspective. The original definition of ""rape trauma syndrome"" and subsequent psychiatric thinking about the diagnosis are briefly outlined. Common reactions seen in military victims in this era are described. A prototypical military case is presented. An adequate evaluation of an alleged victim is outlined. Credentials and preparation of an expert witness are also briefly discussed, with cautions about the use of expert testimony in cases of alleged sexual assault and rape trauma syndrome.",0,0 +4527,"Attachment, personality, and psychopathology among adult inpatients: Self-reported romantic attachment style versus Adult Attachment Interview states of mind","The present study examined self-reported romantic attachment style and Adult Attachment Interview (AAI) states of mind regarding early attachment relationships, personality dimensions, and psychopathology in a psychiatric sample of trauma survivors. Inpatients (N = 80) admitted to a hospital trauma treatment program were administered the Experiences in Close Relationships Scale, AAI, Millon Clinical Multiaxial Inventory-III, Dissociative Experiences Scale, and Dissociative Disorder Interview Schedule. Self-report and AAI attachment classifications were not related, and different results emerged for the two measures. Self-reported romantic attachment style was significantly associated with personality dimensions, with fearful adults showing the most maladaptive personality profiles. Findings suggested that self-report dimensions of self and other independently contribute to different forms of psychological dysfunction. AAI unresolved trauma was uniquely associated with dissociation and posttraumatic stress disorder, whereas unresolved trauma and unresolved loss jointly contributed to schizotypal and borderline personality disorder scores. The differences in findings between the two measures are discussed with a view toward the developmental and clinical implications.",0,0 +4528,Psychiatric morbidity and posttraumatic symptoms among earthquake victims in primary care clinics,"Three months after the devastating Chi-Chi earthquake (magnitude of 7.3 on the Richter scale) struck the central area of Taiwan, 663 victims were screened for psychiatric morbidity at a local general hospital in a community mental health program. The rate of psychiatric morbidity as defined by the 12-item Chinese Health Questionnaire as greater than 4, was 24.5%. Posttraumatic symptoms were still prevalent. The rate of posttraumatic stress disorder was 11.3%, and the rate of partial PTSD was 32.0%. Variables associated with the presence of psychiatric morbidity and posttraumatic symptoms included female gender, old age, financial loss, obsessive trait, and nervous trait. A disproportionate use of mental health services (18%) was found, suggesting an urgent need to deliver mental health care to disaster victims at local medical settings. In addition, health care professionals who work with the earthquake victims need to be promptly and efficiently trained in mental health crisis intervention.",0,0 +4529,Resilience and Other Reactions to Military Deployment: The Complex Task of Identifying Distinct Adjustment Trajectories,"of psychological resilience to the effects of military deployment and some insight into the factors underlying it. In addition, they present evidence of a wide array of other adjustment trajectories following military deployment. In relation to resilience, 78% of Danish soldiers experienced minimal posttraumatic stress disorder (PTSD) symptoms before deployment and up to 2.5 years after. These results are consistent with other recent investigations of soldiers’ capacity to weather the stress of war. For example, Bonanno and colleagues 2 found that 83% of American military personnel deployed to Iraq and Afghanistan showed low levels of posttraumatic stress symptoms both before and up to 5 years after their deployment. Similarly, Dickstein and colleagues, 3 in a longitudinal study of American peacekeepers in Kosovo, found that over 80% showed minimal PTSD symptoms before their deployment and no increase in distress after it. Indeed, there can be little doubt that the considerable majority of soldiers are able to return to their normal levels of functioning after deployment to a war zone. The human capacity to endure and even thrive under conditions of acute stress, once considered rare or a reflection of extraordinary coping abilities, is now increasingly recognized as normative, 4 the rule rather than the exception. In response to events as diverse as bereavement, traumatic injury, life-threatening disease, and even terrorist attack, 5 most people are able to",0,0 +4530,Insomnia and Symptoms of Post-traumatic Stress Disorder Among Women Veterans,"Women will account for 10% of the Veteran population by 2020, yet there has been little focus on sleep issues among women Veterans. In a descriptive study of 107 women Veterans with insomnia (mean age = 49 years, 44% non-Hispanic white), 55% had probable post traumatic stress disorder (PTSD) (total score ≥33). Probable PTSD was related to more severe self-reported sleep disruption and greater psychological distress. In a regression model, higher PTSD Checklist-Civilian (PCL-C) total score was a significant independent predictor of worse insomnia severity index score while other factors were not. Women Veterans preferred behavioral treatments over pharmacotherapy in general, and efforts to increase the availability of such treatments should be undertaken. Further research is needed to better understand the complex relationship between insomnia and PTSD among women Veterans.",0,0 +4531,Longitudinal associations between post-traumatic distress and depressive symptoms following a traumatic event: a test of three models,"Background Symptoms of post-traumatic stress disorder (PTSD) and depression are highly co-morbid following a traumatic event. Nevertheless, decisive evidence regarding the direction of the relationship between these clinical entities is missing. Method The aim of the present study was to examine the nature of this relationship by comparing a synchronous change model (PTSD and depression are time synchronous, possibly stemming from a third common factor) with a demoralization model (i.e. PTSD symptoms causing depression) and a depressogenic model (i.e. depressive symptoms causing PTSD symptoms). Israeli adult victims of single-event traumas ( n =156) were assessed on measures of PTSD and depression at 2, 4 and 12 weeks post-event. Results A cross-lagged structural equation modeling (SEM) analysis provided results consistent with the synchronous change model and the depressogenic model. Conclusions Depressive symptoms may play an important role in the development of post-traumatic symptoms.",0,0 +4532,Executive function and PTSD: Disengaging from trauma,"Neuropsychological approaches represent an important avenue for identifying susceptibility and resiliency factors relating to the development and maintenance of posttraumatic stress disorder (PTSD) symptoms post-trauma. This review will summarize results from prospective longitudinal and retrospective cross-sectional studies investigating executive function associated with PTSD. This research points specifically towards subtle impairments in response inhibition and attention regulation that may predate trauma exposure, serve as risk factors for the development of PTSD, and relate to the severity of symptoms. These impairments may be exacerbated within emotional or trauma-related contexts, and may relate to dysfunction within dorsal prefrontal networks. A model is presented concerning how such impairments may contribute to the clinical profile of PTSD and lead to the use of alternative coping styles such as avoidance. Further neuropsychological research is needed to identify the effects of treatment on cognitive function and to potentially characterize mechanisms of current PTSD treatments. Knowledge gained from cognitive and neuroscientific research may prove valuable for informing the future development of novel, more effective, treatments for PTSD. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0,0 +4533,Blood-based gene-expression predictors of PTSD risk and resilience among deployed marines: A pilot study,"Susceptibility to PTSD is determined by both genes and environment. Similarly, gene-expression levels in peripheral blood are influenced by both genes and environment, and expression levels of many genes show good correspondence between peripheral blood and brain. Therefore, our objectives were to test the following hypotheses: (1) pre-trauma expression levels of a gene subset (particularly immune-system genes) in peripheral blood would differ between trauma-exposed Marines who later developed PTSD and those who did not; (2) a predictive biomarker panel of the eventual emergence of PTSD among high-risk individuals could be developed based on gene expression in readily assessable peripheral blood cells; and (3) a predictive panel based on expression of individual exons would surpass the accuracy of a model based on expression of full-length gene transcripts. Gene-expression levels were assayed in peripheral blood samples from 50 U.S. Marines (25 eventual PTSD cases and 25 non-PTSD comparison subjects) prior to their deployment overseas to war-zones in Iraq or Afghanistan. The panel of biomarkers dysregulated in peripheral blood cells of eventual PTSD cases prior to deployment was significantly enriched for immune genes, achieved 70% prediction accuracy in an independent sample based on the expression of 23 full-length transcripts, and attained 80% accuracy in an independent sample based on the expression of one exon from each of five genes. If the observed profiles of pre-deployment mRNA-expression in eventual PTSD cases can be further refined and replicated, they could suggest avenues for early intervention and prevention among individuals at high risk for trauma exposure.",0,0 +4534,Personality and anxiety disorders,"Personality traits and most anxiety disorders are strongly related. In this article, we review existing evidence for ways in which personality traits may relate to anxiety disorders: 1) as predisposing factors, 2) as consequences, 3) as results of common etiologies, and 4) as pathoplastic factors. Based on current information, we conclude the following: 1) Personality traits such as high neuroticism, low extraversion, and personality disorder traits (particularly those from Cluster C) are at least markers of risk for certain anxiety disorders; 2) Remission from panic disorder is generally associated with partial ""normalization"" of personality traits; 3) Anxiety disorders in early life may influence personality development; 4) Anxiety disorders and personality traits are usefully thought of as spectra of common genetic etiologies; and 5) Extremes of personality traits indicate greater dysfunction in patients with anxiety disorders.",0,0 +4535,Beyond Categorical Classifications: The Importance of Identifying Posttrauma Symptom Trajectories and Associated Negative Outcomes,,0,0 +4536,"Posttraumatic Stress Disorder and Not Depression Is Associated with Shorter Leukocyte Telomere Length: Findings from 3,000 Participants in the Population-Based KORA F4 Study","A link between severe mental stress and shorter telomere length (TL) has been suggested. We analysed the impact of Posttraumatic Stress Disorder (PTSD) on TL in the general population and postulated a dose-dependent TL association in subjects suffering from partial PTSD compared to full PTSD.Data are derived from the population-based KORA F4 study (2006-2008), located in southern Germany including 3,000 individuals (1,449 men and 1,551 women) with valid and complete TL data. Leukocyte TL was measured using a quantitative PCR-based technique. PTSD was assessed in a structured interview and by applying the Posttraumatic Diagnostic Scale (PDS) and the Impact of Event Scale (IES). A total of 262 (8.7%) subjects qualified for having partial PTSD and 51 (1.7%) for full PTSD. To assess the association of PTSD with the average TL, linear regression analyses with adjustments for potential confounding factors were performed.The multiple model revealed a significant association between partial PTSD and TL (beta = -0.051, p = 0.009) as well as between full PTSD and shorter TL (beta = -0.103, p = 0.014) indicating shorter TL on average for partial and full PTSD. An additional adjustment for depression and depressed mood/exhaustion gave comparable beta estimations.Participants with partial and full PTSD had significantly shorter leukocyte TL than participants without PTSD. The dose-dependent variation in TL of subjects with partial and full PTSD exceeded the chronological age effect, and was equivalent to an estimated 5 years in partial and 10 years in full PTSD of premature aging.",0,0 +4537,Posttraumatic stress disorder's role in integrated substance dependence and depression treatment outcomes,"Posttraumatic stress disorder (PTSD) frequently co-occurs with depression and substance use disorder (SUD). This study investigates the impact of PTSD diagnosis on treatment outcomes of 178 veterans treated for depression and SUD, with Integrated Cognitive-Behavioral Therapy (ICBT) or 12-Step Facilitation Therapy (TSF). Percentage days abstinent (PDA) and Hamilton Depression Rating Scale total score (HDRS total) trajectories were created. PDA was similar through initial follow-up; however, by 18 months, ICBT participants without PTSD had better PDA (M = 91%) than those without PTSD in TSF (M = 76%) and those with PTSD in either group (M = 75%-77%). Across time, participants with PTSD had higher depression levels than those without PTSD but benefited similarly from treatment (main effect, p < .004). Both conditions demonstrated reductions in average HDRS at 18 months (M = 17%-29%). Findings highlight the need to assess for PTSD and to investigate how to treat concomitant SUD, depression, and PTSD.",0,0 +4538,Depletion of FKBP51 in Female Mice Shapes HPA Axis Activity,"Psychiatric disorders such as depressive disorders and posttraumatic stress disorder are a major disease burden worldwide and have a higher incidence in women than in men. However, the underlying mechanism responsible for the sex-dependent differences is not fully understood. Besides environmental factors such as traumatic life events or chronic stress, genetic variants contribute to the development of such diseases. For instance, variations in the gene encoding the FK506 binding protein 51 (FKBP51) have been repeatedly associated with mood and anxiety. FKBP51 is a negative regulator of the glucocorticoid receptor and thereby of the hypothalamic-pituitary-adrenal axis that also interacts with other steroid hormone receptors such as the progesterone and androgen receptors. Thus, the predisposition of women to psychiatric disorders and the interaction of female hormones with FKBP51 and the glucocorticoid receptor implicate a possible difference in the regulation of the hypothalamic-pituitary-adrenal axis in female FKBP51 knockout (51KO) mice. Therefore, we investigated neuroendocrine, behavioural and physiological alterations relevant to mood disorders in female 51KO mice. Female 51KOs and wild type littermates were subjected to various behavioural tests, including the open field, elevated plus maze and forced swim test. The neuroendocrine profile was investigated under basal conditions and in response to an acute stressor. Furthermore, we analysed the mRNA expression levels of the glucocorticoid receptor and corticotrophin release hormone in different brain regions. Overall, female 51KO mice did not display any overt behavioural phenotype under basal conditions, but showed a reduced basal hypothalamic-pituitary-adrenal axis activity, a blunted response to, and an enhanced recovery from, acute stress. These characteristics strongly overlap with previous studies in male 51KO mice indicating that FKBP51 shapes the behavioural and neuroendocrine phenotype independent of the sex of the individual.",0,0 +4539,Prospective Analysis of Factors Associated with Work Reentry in Patients with Accident-Related Injuries,"Introduction: The objective of this study was to investigate the influence of accidents, the physical and psychological consequences, the patient's predisposition as well as work-related cognitions on return to work (RTW) post accident. Despite the costs of time-off from work after accidental injuries, very few investigations have been carried out so far. Method: In a consecutive sample, 163 patients were investigated directly and 12 months after an accident. Results: 32% of the patients had a poor occupational integration 12 months after an accident. As predictors for return to work were found type of prior work: laborer (OR=4.34; 1.79-10.50 CI 95%), type of accident: recreational (OR=0.27; 0.11-0.69 CI 95%) and subjective perception of the accident severity (OR=0.98; 0.96-0.99 CI 95%). Conclusion: Laborers after a traffic or work accident, who estimate the accident as severe, are at greater risk of developping long-term disability. Future efforts should be conducted especially for this target group. © 2006 Springer Science+Business Media, Inc.",0,0 +4540,The Dissociative Subtype of PTSD Scale: Initial Evaluation in a National Sample of Trauma-Exposed Veterans,"The fifth edition of the Diagnostic and Statistical Manual includes a dissociative subtype of posttraumatic stress disorder, but no existing measures specifically assess it. This article describes the initial evaluation of a 15-item self-report measure of the subtype called the Dissociative Subtype of Posttraumatic Stress Disorder Scale (DSPS) in an online survey of 697 trauma-exposed military veterans representative of the U.S. veteran population. Exploratory factor analyses of the lifetime DSPS items supported the intended structure of the measure consisting of three factors reflecting derealization/depersonalization, loss of awareness, and psychogenic amnesia. Consistent with prior research, latent profile analyses assigned 8.3% of the sample to a highly dissociative class distinguished by pronounced symptoms of derealization and depersonalization. Overall, results provide initial psychometric support for the lifetime DSPS scales; additional research in clinical and community samples is needed to further validate the measure.",0,0 +4541,Early PTSD symptom sub-clusters predicting chronic posttraumatic stress following sexual assault.,"Contemporary models of PTSD disaggregate this disorder into sub-clusters that differentially impact functioning. Severity of different types of PTSD symptoms in the acute posttrauma period may be predictive of the course of PTSD over time. Few research studies, however, have examined the predictive utility of PTSD sub-clusters. This study sought to determine the relative predictive validity of 4 sub-clusters, namely reexperiencing, strategic avoidance, emotional numbing, and hyperarousal, assessed within 1 month of a sexual assault. Women (N=120) who had been sexually assaulted completed self-report measures at 1 and 4 months postassault. Linear regression analyses revealed that early reexperiencing and emotional numbing sub-clusters uniquely contributed to the prediction of PTSD symptoms at month 4 (strategic avoidance and hyperarousal did not). To help explain and contextualize these findings, we explored the extent to which posttraumatic cognitions mediated the relationship between acute reexperiencing and emotional numbing and later PTSD symptoms. Simultaneous multiple mediation analyses revealed that general negative cognitions about the self significantly mediated the relationship between both reexperiencing and emotional numbing and month 4 PTSD symptoms. These findings have significant clinical implications, pointing to the importance of targeting posttraumatic cognitions in the acute posttrauma phase.",0,0 +4542,A Realistic Perspective on Pattern Representation in Growth Data: Comment on Bauer and Curran (2003).,"D. J. Bauer and P. J. Curran (2003) cautioned that results obtained from growth mixture models may sometimes be inaccurate. The problem they addressed occurs when a growth mixture model is applied to a single, general population of individuals but findings incorrectly support the conclusion that there are 2 subpopulations. In an artificial sampling experiment, they showed that this can occur when the variables in the population have a nonnormal distribution. A realistic perspective is that although a healthy skepticism to complex statistical results is appropriate, there are no true models to discover. Consequently, the issue of model misspecification is irrelevant in practical terms. The purpose of a mathematical model is to summarize data, to formalize the dynamics of a behavioral process, and to make predictions. All of this is scientifically valuable and can be accomplished with a carefully developed model, even though the model is false.",0,0 +4543,Differentiating Post-Traumatic Stress Disorder (PTSD) from Major Depression (MDD) and Generalized Anxiety Disorder (GAD),"Questions about the differential diagnosis of Post-Traumatic Stress Disorder (PTSD) have been raised since this category was reformulated in DSM-III ( APA, 1980 ). Clinicians have reported difficulties distinguishing PTSD from other categories, particularly from Major Depressive and Generalized Anxiety Disorders (MDD and GAD). Diagnostic validity can be established in several ways (e.g., through clinical descriptive studies, laboratory experiments, family history studies, etc.). In this paper, we describe one approach to validation thus far not applied to PTSD: This approach centers directly on whether clinicians can distinguish PTSD from other diagnostic categories. Experienced clinicians were asked to rate the extent to which a common set of 90 symptom items characterized PTSD, MDD , and GAD. Ratings were analyzed with multivariate and univariate analyses of variance and covariance, multiple discriminant function analysis, and factor analysis; moreover, characteristics of raters were examined for possible influences. Results indicated that clinicians readily distinguish PTSD from MDD and GAD as well as MDD from GAD. Findings are presented in terms of univariate analyses, 34 best discriminating items, and factors specifying dimensions differentiating the syndromes of PTSD, MDD, and GAD. Rater characteristics did not influence diagnostic accuracy, although significant differences in magnitude of symptom intensity were found. © 1997 Elsevier Science Ltd",0,0 +4544,Reducing refugee mental health disparities: A community-based intervention to address postmigration stressors with African adults.,"Refugees resettled in the United States have disproportionately high rates of psychological distress. Research has demonstrated the roles of postmigration stressors, including lack of meaningful social roles, poverty, unemployment, lack of environmental mastery, discrimination, limited English proficiency, and social isolation. We report a multimethod, within-group longitudinal pilot study involving the adaptation for African refugees of a community-based advocacy and learning intervention to address postmigration stressors. We found the intervention to be feasible, acceptable, and appropriate for African refugees. Growth trajectory analysis revealed significant decreases in participants' psychological distress and increases in quality of life, and also provided preliminary evidence of intervention mechanisms of change through the detection of mediating relationships whereby increased quality of life was mediated by increases in enculturation, English proficiency, and social support. Qualitative data helped to support and explain the quantitative data. Results demonstrate the importance of addressing the sociopolitical context of resettlement to promote the mental health of refugees and suggest a culturally appropriate, and replicable model for doing so.",0,0 +4545,Assessing nonresponse bias at follow-up in a large prospective cohort of relatively young and mobile military service members,"BackgroundNonresponse bias in a longitudinal study could affect the magnitude and direction of measures of association. We identified sociodemographic, behavioral, military, and health-related predictors of response to the first follow-up questionnaire in a large military cohort and assessed the extent to which nonresponse biased measures of association.MethodsData are from the baseline and first follow-up survey of the Millennium Cohort Study. Seventy-six thousand, seven hundred and seventy-five eligible individuals completed the baseline survey and were presumed alive at the time of follow-up; of these, 54,960 (71.6%) completed the first follow-up survey. Logistic regression models were used to calculate inverse probability weights using propensity scores.ResultsCharacteristics associated with a greater probability of response included female gender, older age, higher education level, officer rank, active-duty status, and a self-reported history of military exposures. Ever smokers, those with a history of chronic alcohol consumption or a major depressive disorder, and those separated from the military at follow-up had a lower probability of response. Nonresponse to the follow-up questionnaire did not result in appreciable bias; bias was greatest in subgroups with small numbers.ConclusionsThese findings suggest that prospective analyses from this cohort are not substantially biased by non-response at the first follow-up assessment.",0,0 +4546,Assessment and validation of prognostic models for poor functional recovery 12 months after whiplash injury: A multicentre inception cohort study,"Uncertainty surrounds prognostic factors after whiplash injury. Previously we identified a prognostic model for 6-month pain-related disability in a cohort of 80 participants with acute whiplash. Predictors included initial disability, older age, decreased cold pain thresholds, decreased neck rotation movement, posttraumatic stress symptoms and decreased sympathetic vasoconstriction. The objective of this study was to externally validate this model. In a multicentre inception cohort study, 286 participants with acute whiplash (I, II or III) were assessed at <3 weeks and 12 months after injury. The Neck Disability Index (NDI) was the outcome. Observed and predicted NDI scores were generated using the published equation of the original model. Model discrimination between participants with no or mild disability from those with moderate to severe disability was examined by receiver operating characteristic curves. Initial NDI and cold pain threshold predicted current observed 12-month NDI scores (r(2) = 0.50, 95% confidence interval 0.42 to 0.58). There was a significant site effect, and the estimated marginal mean ± SE of 12-month NDI for Iceland (27.6 ± 1.79%) was higher than the other 3 sites (Melbourne 11.2 ± 5.03%, Canada 16.4 ± 2.36%, Brisbane 16.8 ± 1.17%). After adjusting for site, age and Impact of Events Scale scores regained significance (r(2) = 0.56, 95% confidence interval 0.48 to 0.64). The tested model was not precise in predicting NDI as a continuous variable. However, it found good accuracy to discriminate participants with moderate to severe disability at 12 months (area under the receiver operating characteristic curve 0.89 [95% confidence interval 0.84-0.94], P<.001) which is clinically useful.",0,0 +4547,Posttraumatic stress and depression symptoms as correlates of deliberate self-harm among community women experiencing intimate partnerviolence,"Deliberate self-harm (DSH) among women in the general population is correlated separately with posttraumatic stress, depression, and abuse during childhood and adulthood. The prevalence of these DSH correlates is particularly high among women exposed to intimate partner violence (IPV), yet few studies have examined DSH among this high-risk population and none have examined these correlates simultaneously. Two hundred and twelve IPV-victimized women in the community participated in a 2-h retrospective interview. One-third reported current or past DSH. Discriminant analysis was used to examine which posttraumatic stress and depression symptoms and types of current IPV and childhood abuse were uniquely associated with current DSH. Findings show that women who currently use DSH reported greater severity of posttraumatic stress numbing symptoms and more severe sexual IPV compared to women who used DSH only in the past. Examining factors that are associated with women's current DSH in this population is critical so that a focus on DSH can be integrated into the treatment plans of women who are receiving mental health care, but also so that women who are not receiving such care can be referred to adequate mental health services.",0,0 +4548,Routine Work Environment Stress and PTSD Symptoms in Police Officers,"This study examined the relationship between routine work environment stress and posttraumatic stress disorder (PTSD) symptoms in a sample of police officers (N = 180) who were first assessed during academy training and reassessed 1-year later. In a model that included gender, ethnicity, traumatic exposure prior to entering the academy, current negative life events, and critical incident exposure over the last year, routine work environment stress was most strongly associated with PTSD symptoms. We also found that routine work environment stress mediated the relationship between critical incident exposure and PTSD symptoms and between current negative life events and PTSD symptoms. Ensuring that the work environment is functioning optimally protects against the effects of duty-related critical incidents and negative life events outside police service.",0,0 +4549,Predictors of posttraumatic stress disorder among police officers: A prospective study.,"This prospective study examined risk and protective factors in the development of posttraumatic stress disorder (PTSD) in a sample of 83 police officers. Structured interviews were conducted in order to assess the most recent work-related traumatic event and establish diagnoses of acute stress disorder (ASD) and full or partial PTSD. Police officers were assessed between 5 and 15 days, and at 1 month, 3 months, and 12 months after the event. They also completed self-administered questionnaires assessing several potential predictors. Predictive analyses about the onset of PTSD were based on a 4-step nested random-effect linear regression. Overall, results showed that the modulation of PTSD symptomatology was associated with some pretraumatic (i.e., emotional coping strategies and number of children), peritraumatic (i.e., physical and emotional reactions and dissociation), and posttraumatic factors (i.e., ASD, depression symptoms, and seeking psychological help at the employee assistance program and at the police union between the event and Time 1). Clinical implications of these findings are discussed and key directions for future studies are proposed.",0,0 +4550,The Structure of Posttraumatic Stress Disorder,"Latent structure analysis of DSM-IV posttraumatic stress disorder (PTSD) can help clarify how persons who experience traumatic events might be sorted into clusters with respect to their symptom profiles. Classification of persons exposed to traumatic events into clinically homogeneous groups would facilitate further etiologic and treatment research, as well as research on the relationship of trauma and PTSD with other disorders.To examine empirically the structure underlying PTSD criterion symptoms and identify discrete classes with similar symptom profiles.Data on PTSD symptoms from trauma-exposed subsets of 2 community samples were subjected to latent class analysis. The resultant classes were studied in associations with trauma type and indicators of impairment.The first sample is from the Detroit Area Survey of Trauma (1899 trauma-exposed respondents with complete data) and the second is from a mid-Atlantic study of young adults conducted by The Johns Hopkins University Prevention Research Center, Baltimore, Md (1377 trauma-exposed respondents with complete data).Respondents in the 2 community samples who experienced 1 or more qualifying PTSD-level traumatic events.Number, size, and symptom profiles of latent classes.In both samples, analysis yielded 3 classes: no disturbance, intermediate disturbance, and pervasive disturbance. The classes also varied qualitatively, with emotional numbing distinguishing the class of pervasive disturbance, a class that approximates the subset with DSM-IV PTSD. Members of the pervasive disturbance class were far more likely to report use of medical care and disruptions in life or activities.The 3-class structure separates trauma-exposed persons with pervasive disturbance (a class that approximates DSM-IV PTSD) from no disturbance and intermediate disturbance, a distinction that also helps identify population subgroups with low risk for any posttrauma disturbance. The results suggest that the structure of PTSD is ordinal and configurational and that emotional numbing differentiates the class with pervasive disturbance. These results should motivate prospective research of persons who have experienced trauma to trace the emergence of posttrauma symptoms and the timing of emotional numbing relative to other symptoms.",0,0 +4551,The contribution of prior psychological symptoms and combat exposure to post Iraq deployment mental health in the UK military,"This study assessed the contribution of baseline psychological symptoms, combat exposure, and unit support in the etiology of posttraumatic stress disorder (PTSD), and psychological distress. From 2004-2006, 67% of a random sample of 2,820 participants who had been assessed for psychological symptoms in 2002 were reassessed. Baseline psychological symptoms, combat exposure, and unit support factors were associated with the outcomes and the effect sizes for combat exposure were marked for PTSD symptoms. Adjustment for baseline psychological symptoms did not modify the pattern of association of group cohesion and combat exposures. The authors concluded that combat exposure and group cohesion have an effect on mental health outcomes independent of previous mental health status, which explains why screening prior to deployment is ineffective.",0,0 +4552,Connectedness in the Lives of Children and Adolescents: A Call for Greater Conceptual Clarity,"Studies of the role of connectedness in the health and development of children and adolescents are accumulating rapidly. Although findings are uniformly consistent in documenting its correlation with a host of health indicators, the construct is in need of substantial conceptual clarification to maximize its research and applied utility. Current conceptualizations and operationalizations inconsistently span a wide spectrum of varied elements of social experience--including the quality of a relationship, the degree of liking an environment or relationship, the quality of performance in an environment or relationship, the possession of feelings or attitude states, and a combination of states and the behaviors that antecede them--resulting in an ability to adequately understand what the construct is and how, why, and when it is most protective. This paper documents this variability in an effort to sensitize researchers, practitioners, and policy makers to the complexity of the construct. It further describes one ongoing, multicultural research project that is currently informing international health initiatives as an illustration of one approach to addressing the complexity with goals of precision, parsimony, cultural sensitivity, and applied utility.",0,0 +4553,Asthma and Posttraumatic Stress Symptoms 5 to 6 Years Following Exposure to the World Trade Center Terrorist Attack,"The World Trade Center Health Registry provides a unique opportunity to examine long-term health effects of a large-scale disaster.To examine risk factors for new asthma diagnoses and event-related posttraumatic stress (PTS) symptoms among exposed adults 5 to 6 years following exposure to the September 11, 2001, World Trade Center (WTC) terrorist attack.Longitudinal cohort study with wave 1 (W1) enrollment of 71,437 adults in 2003-2004, including rescue/recovery worker, lower Manhattan resident, lower Manhattan office worker, and passersby eligibility groups; 46,322 adults (68%) completed the wave 2 (W2) survey in 2006-2007.Self-reported diagnosed asthma following September 11; event-related current PTS symptoms indicative of probable posttraumatic stress disorder (PTSD), assessed using the PTSD Checklist (cutoff score > or = 44).Of W2 participants with no stated asthma history, 10.2% (95% confidence interval [CI], 9.9%-10.5%) reported new asthma diagnoses postevent. Intense dust cloud exposure on September 11 was a major contributor to new asthma diagnoses for all eligibility groups: for example, 19.1% vs 9.6% in those without exposure among rescue/recovery workers (adjusted odds ratio, 1.5 [95% CI, 1.4-1.7]). Asthma risk was highest among rescue/recovery workers on the WTC pile on September 11 (20.5% [95% CI, 19.0%-22.0%]). Persistent risks included working longer at the WTC site, not evacuating homes, and experiencing a heavy layer of dust in home or office. Of participants with no PTSD history, 23.8% (95% CI, 23.4%-24.2%) reported PTS symptoms at either W1 (14.3%) or W2 (19.1%). Nearly 10% (9.6% [95% CI, 9.3%-9.8%]) had PTS symptoms at both surveys, 4.7% (95% CI, 4.5%-4.9%) had PTS symptoms at W1 only, and 9.5% (95% CI, 9.3%-9.8%) had PTS symptoms at W2 only. At W2, passersby had the highest rate of PTS symptoms (23.2% [95% CI, 21.4%-25.0%]). Event-related loss of spouse or job was associated with PTS symptoms at W2.Acute and prolonged exposures were both associated with a large burden of asthma and PTS symptoms 5 to 6 years after the September 11 WTC attack.",0,0 +4554,"Inflammation and Oxidative Stress Are Elevated in the Brain, Blood, and Adrenal Glands during the Progression of Post-Traumatic Stress Disorder in a Predator Exposure Animal Model","This study sought to analyze specific pathophysiological mechanisms involved in the progression of post-traumatic stress disorder (PTSD) by utilizing an animal model. To examine PTSD pathophysiology, we measured damaging reactive oxygen species and inflammatory cytokines to determine if oxidative stress and inflammation in the brain, adrenal glands, and systemic circulation were upregulated in response to constant stress. Pre-clinical PTSD was induced in naïve, male Sprague-Dawley rats via a predator exposure/psychosocial stress regimen. PTSD group rats were secured in Plexiglas cylinders and placed in a cage with a cat for one hour on days 1 and 11 of a 31-day stress regimen. In addition, PTSD group rats were subjected to psychosocial stress whereby their cage cohort was changed daily. This model has been shown to cause heightened anxiety, exaggerated startle response, impaired cognition, and increased cardiovascular reactivity, all of which are common symptoms seen in humans with PTSD. At the conclusion of the predator exposure/psychosocial stress regimen, the rats were euthanized and their brains were dissected to remove the hippocampus, amygdala, and pre-frontal cortex (PFC), the three areas commonly associated with PTSD development. The adrenal glands and whole blood were also collected to assess systemic oxidative stress. Analysis of the whole blood, adrenal glands, and brain regions revealed oxidative stress increased during PTSD progression. In addition, examination of pro-inflammatory cytokine (PIC) mRNA and protein demonstrated neurological inflammatory molecules were significantly upregulated in the PTSD group vs. controls. These results indicate oxidative stress and inflammation in the brain, adrenal glands, and systemic circulation may play a critical role in the development and further exacerbation of PTSD. Thus, PTSD may not be solely a neurological pathology but may progress as a systemic condition involving multiple organ systems.",0,0 +4555,Psychometric properties of an African symptoms check list scale: the Ndetei-Othieno-Kathuku scale,"To profile and quantify the psychometric properties of the NOK (Ndetei-Othieno-Kathuku) scale against internationally used Gold-standards and benchmarks for mild psychiatric disorders and post-traumatic stress disorders and to provide a potential easy to administer culture sensitive instrument for screening and assessing those with possible psychiatric disorders for the Kenyan and similar social-cultural situations.Cross-Sectional quantitative study.A psychiatric clinical consultation setting and Kyanguli Secondary School psychotrauma counselling clinical set-up.Survivors of the Nairobi USA Embassy bombing who were referred for psychiatric treatment and survivors of a fire disaster from a rural Kenyan school (Kyanguli School fire disaster) including students, parents of the diseased children and staff members.Positive correlation was found between the NOK and all the instruments. The highest correlations were between the NOK and the BDI and SCL-90 (r = 0.557 to 0.786). The differences between the NOK scores among the different groups were statistically significant (F ratio = 13.54 to 160.34, p < 0.01). The reliability coefficient (internal consistency) of the scale, alpha = 0.9733. Other item statistics and correlations of the scale are discussed.It is concluded that the NOK has high concurrent and discriminant validity as well as a high internal consistency and that it can be used for the rapid assessment of psychotrauma victims of all age groups; and stress in general in similar age groups in the local setting. It is culture appropriate and sensitive.",0,0 +4556,Shame-based identity and chronic post-traumatic stress disorder in help -seeking combat veterans,"The long-term effects of post-traumatic stress disorder (PTSD) have been previously investigated. However, developmental and identity issues around trauma and shame have been less extensively examined. For some combat veterans, relief from the primary symptoms of PTSD is a struggle for much of the postwar adjustment period. Moreover, secondary problems associated with living with trauma have substantial impact on veterans' sense of self, capacity for interpersonal relationships, and making meaning of their lives. The current investigation examined relationships between self-reported symptom distress and shame on postwar adjustment of combat veterans. Specifically, the study investigated how shame and sense of self were related to PTSD, depression, trait anxiety, vulnerability, self-handicapping, hope, and overall quality of life. This investigation used archival data that are part of a larger longitudinal study. Correlational, repeated measures, and multivariate analyses examined how symptom distress and resilience measures were related to premilitary, military, and postmilitary factors. Participants completed self-report symptom distress measures and family of origin and demographic questionnaires. Repeated measures on symptom distress were collected at baseline, 2 months, 6 months, and 12 months post-baseline. Twelve hypotheses were postulated regarding how chronic PTSD and shame were related to long term adjustment. Findings contributed substantive new information on relationships among shame, symptom distress, and psychological trauma. Correlational analyses showed significant and positive relationships between shame and symptom distress measures including depression, trait anxiety, vulnerability, PTSD, and self-handicapping. Shame was negatively associated with hope and quality of life. Longitudinal data showed chronic PTSD and shame were amenable to treatment. While treatment data showed initial improvement in all symptom distress measures, maintenance of treatment gains was difficult, with six and twelve month symptom measures returning to near baseline. Multivariate analyses yielded no differences on family factors of chaos, loss, and ethnicity. Socioeconomic status was associated with decreased hope and quality of life. Convergence among the findings indicated a reciprocal relationship between shame and PTSD which warrants continued empirical investigation. Implications for theory, research, and practice are discussed.",0,0 +4557,Characteristics of Patients with Multiple Personality and Dissociative Disorders on Psychological Testing,"We describe a new psychological testing procedure used on a consecutive series of 14 patients with multiple personality and dissociative disorders who met DSM-III-R and research criteria for dissociative disorders. Once dissociative phenomena were accounted for in testing, most patients displayed response patterns markedly different from those of schizophrenic and borderline patients. Patients showed striking variability on cognitive and projective tests, often related to posttraumatic intrusions. Rorschach protocols showed unusual thinking accompanied by psychological complexity and highly developed self-observing capacity. In contrast to classical conceptualizations about these patients, most subjects had personality profiles that were intellectualized, obsessive, and introversive, not histrionic or labile.",0,0 +4558,Partial posttraumatic stress disorder revisited,"It is thought that the decision rule for a positive diagnosis of Posttraumatic Stress Disorder (PTSD) may be too restrictive, leaving too many victims of a trauma out in the cold for care, compensation, etc. Several authors have proposed the concept of Subthreshold or Partial PTSD (PPTSD). This concept considers that a subject may present a number of symptoms below threshold for criteria C or D (subthreshold syndromes) and may even present without any symptom for one or more of the criteria B, C and D (partial syndromes).Data have been collected by means of the Composite International Diagnostic Interview (CIDI) PTSD-module, in a group exposed to two different traumatic events (130 fire victims and 55 car accident victims). The syndrome patterns has been assessed by means of hierarchical class analyses. Each of the criteria B, C and D has been analyzed separately, showing the symptom patterns as hierarchically order clusters.Depending on the threshold used for criterion C (i.e. 3 or 2 symptoms), 18.4 and 22.7% of the subjects respectively satisfy the criteria for PTSD. 8.7% of the subjects show subthreshold syndromes. 60.7% of the subjects show partial syndromes and 16.7% of the subjects have partial syndromes while fulfilling criterion F, i.e. a clinically significant impairment in functioning.The results show a considerable number of partial and subthreshold syndromes. It is argued that subthreshold syndromes and partial syndromes, which fulfill criterion F, should be regarded as specific nosological categories or as specified PTSD subcategories, i.e. subsyndromal or partial PTSD.",0,0 +4559,One-year trajectories of depression and anxiety symptoms in older patients presenting in general practice with musculoskeletal pain: A latent class growth analysis,"Distinguishing transient from persistent anxiety and depression symptoms in older people presenting to general practice with musculoskeletal pain is potentially important for effective management. This study sought to identify distinct post-consultation depression and anxiety symptom trajectories in adults aged over 50years consulting general practice for non-inflammatory musculoskeletal pain.Self-completion questionnaires, containing measures of anxiety and depressive symptoms, age, gender, pain status, coping and social status were mailed within 1week of the consultation and at 3, 6 and 12months. Latent class growth analysis was used to identify anxiety and depression symptoms trajectories, which were ascertained with cut-off score ≥8 on Hospital Anxiety and Depression Scale subscales. Associations between baseline characteristics and cluster membership were examined using multivariate multinomial logistic regression analysis (the 3-step approach).Latent class growth analyses determined a 3-cluster anxiety model (n=499) and a 3-cluster depression model (n=501). Clusters identified were: no anxiety problem (44.1%), persistent anxiety problem (33.9%) and transient anxiety symptoms (22.2%); no depression problem (74.1%), persistent depression problem (22.0%) and gradual depression symptom recovery (4.0%). Widespread pain, interference with valued activities, coping by increased behavioral activities, catastrophizing, perceived lack of instrumental support, age ≥70years, being female, and performing manual/routine work were associated with anxiety and/or depression clusters.Older people with non-inflammatory musculoskeletal pain are at high risk of persistent anxiety and/or depression problems. Biopsychosocial factors, such as pain status, coping strategies, instrumental support, performing manual/routine work, being female and age ≥70years, may help identify patients with persistent anxiety and/or depression.",0,0 +4560,Alexithymia and posttraumatic stress: subscales and symptom clusters,"This study examined the relationship between the emotion-regulating factor alexithymia and the occurrence of posttraumatic stress disorder (PTSD) after critical incidents in a nonclinical sample of 136 nurses and ambulance personnel working in military facilities. The results showed that alexythima accounts for variance in PTSD symptoms. Breaking PTSD into its 4 symptom clusters, alexithymia was found to predict numbing and hyperarousal symptoms but not avoidance or reexperiencing symptoms. Finally, the rarely investigated, but clinically relevant, distinctive subdimensions of alexithymia were examined in relation to the 4 PTSD clusters. The difficulty identifying feelings subscale contributed most to the numbing and hyperarousal PTSD subscales. Clinical implications and future research directions are discussed.",0,0 +4561,"Mental Health Status of World Trade Center Rescue and Recovery Workers and Volunteers—New York City, July 2002–August 2004","After the September 11, 2001, attacks on the World Trade Center (WTC), a comprehensive screening program was established to evaluate the physical and mental health of rescue and recovery workers and volunteers. Persons were eligible for this program if they participated in the WTC rescue or recovery efforts and met specific time criteria for exposure to the site. During July 16, 2002--August 6, 2004, the program evaluated 11,768 workers and volunteers. This report summarizes data analyzed from a subset of 1,138 of the 11,768 participants evaluated at the Mount Sinai School of Medicine during July 16--December 31, 2002. On the basis of one or more standardized screening questionnaires, approximately half (51%) of participants met threshold criteria for a clinical mental health evaluation. Continued surveillance is needed to assess the long-term psychological impact of the aftermath of the 9/11 attacks and to determine needs for continued treatment.",0,0 +4562,The Factor Structure of Traumatic Stress in Parents of Children With Cancer: A Longitudinal Analysis*,"To determine the factor structure of posttraumatic stress symptoms (PTSS) and assess its stability over time among parents of children diagnosed with cancer.Parents of children with cancer included in a longitudinal study completed the posttraumatic stress disorder (PTSD) Checklist-Civilian Version 2 weeks (n = 249) and 2 (n = 234) and 4 (n = 203) months after their child's diagnosis. Confirmatory factor analysis (CFA) was used to assess 3 models of the underlying dimensions of PTSD and invariance tests were used to assess stability over time.A longitudinal CFA with the factors reexperiencing, avoidance, dysphoria, and hyperarousal provided best fit to the data. Invariance testing suggested that the pattern and size of loadings were equivalent across the three assessments. Discussions Findings tentatively suggest that PTSS among parents of children with cancer consist of four factors. Implications for research and clinical practice are discussed.",0,0 +4563,The Child and Family Traumatic Stress Intervention: Secondary prevention for youth at risk of developing PTSD,"This pilot study evaluated the effectiveness of a four-session, caregiver-child Intervention, the Child and Family Traumatic Stress Intervention (CFTSI), to prevent the development of chronic posttraumatic stress disorder (PTSD) provided within 30 days of exposure to a potentially traumatic event (PTE).One-hundred seventy-six 7 to 17-year-old youth were recruited through telephone screening based on report of one new distressing posttraumatic stress symptom after a PTE. Of those, 106 youth were randomly assigned to the Intervention (n = 53) or a four-session supportive Comparison condition (N = 53). Group differences in symptom severity were assessed using repeated measures with mixed effects models of intervention group, time, and the interaction of intervention and time. Logistic regression analyses were performed to assess treatment condition and any subsequent traumas experienced as predictors for full and partial PTSD diagnosis at 3-month follow-up. An exploratory chi-square analysis was performed to examine the differences in PTSD symptom criteria B, C, and D at follow-up.At baseline, youth in both groups had similar demographics, past trauma exposures and symptom severity. At follow-up, the Intervention group demonstrated significantly fewer full and partial PTSD diagnoses than the Comparison group on a standardized diagnostic measure of PTSD. Also, there was a significant group by time interaction for Trauma Symptom Checklist for Children's Posttraumatic Stress and Anxiety Indices as the CFTSI group had significantly lower posttraumatic and anxiety scores than the Comparison group.The results suggest that a caregiver-youth, brief preventative early intervention for youth exposed to a PTE is a promising approach to preventing chronic PTSD.",0,0 +4564,Health and ill health of asylum seekers in Switzerland: an epidemiological study,"Although the focus of health care for people seeking asylum in Western European countries is usually on communicable diseases, there is little data about the general health care need of this population. In this study, we investigated the actual burden of disease among asylum seekers.Data were collected from a Swiss Health Maintenance Organisation (HMO; a type of managed care organization in which physicians act as gate keepers) that was set up specifically to provide health care for asylum seekers. The data included socio-demographic characteristics, international classification of diseases (ICD-10) diagnoses and number of clinic visits. Descriptive statistics were used to assess the types of health problems and the number of clinic visits. Logistic regression analysis was used to determine whether age, gender or country or region of origin was predictive in terms of incidence of disease as diagnosed by using ICD classifications.The total number of asylum seekers (mean age 22 years; 38% women) enrolled in the HMO from 2000 through 2003 was 979. Half of this group came from the former country of Yugoslavia. The remainder came primarily from sub-Saharan Africa, Turkey, Iraq and Sri Lanka. The most common health problems encountered in the population included musculoskeletal diseases, respiratory diseases, depression and post-traumatic stress disorder. The prevalence of all disease clusters was significantly associated with age. One-fifth of the population did not request health care at all during the time they were enrolled in the HMO. It is not known whether those who did not visit the medical clinic did not require health care or just chose not to request clinic services.The most frequent health problems encountered in the study population were chronic medical conditions, not communicable acute diseases. Although health care services provided to asylum seekers usually focus on episodic acute care, what this group actually needs is continuity of care.",0,0 +4565,Posttraumatic stress disorder and suicide in 5.9 million individuals receiving care in the veterans health administration health system,"Post-traumatic stress disorder (PTSD) confers risk for suicidal ideation and suicide attempts but a link with suicide is not yet established. Prior analyses of users of the Veterans health administration (VHA) Health System suggest that other mental disorders strongly influence the association between PTSD and suicide in this population. We examined the association between PTSD and suicide in VHA users, with a focus on the influence of other mental disorders.Data were based on linkage of VA National Patient Care Database records and the Centers for Disease Control and Prevention׳s National Death Index, with data from fiscal year 2007-2008. Analyses were based on multivariate logistic regression and structural equation models.Among users of VHA services studied (N=5,913,648), 0.6% (N=3620) died by suicide, including 423 who had had been diagnosed with PTSD. In unadjusted analysis, PTSD was associated with increased risk for suicide, with odds ratio, OR (95% confidence interval, 95% CI)=1.34 (1.21, 1.48). Similar results were obtained after adjustment for demographic variables and veteran characteristics. After adjustment for multiple other mental disorder diagnoses, PTSD was associated with decreased risk for suicide, OR (95% CI)=0.77 (0.69, 0.86). Major depressive disorder (MDD) had the largest influence on the association between PTSD and suicide.The analyses were cross-sectional. VHA users were studied, with unclear relevance to other populations.The findings suggest the importance of identifying and treating comorbid MDD and other mental disorders in VHA users diagnosed with PTSD in suicide prevention efforts.",0,0 +4566,Measuring post-traumatic stress: A psychometric evaluation of symptom- and coping questionnaires based on a Norwegian sample,"The purpose of this study was to evaluate the psychometric characteristics of the Norweigian versions of the Impact of Event Scale, the Post Traumatic Stress Scale-10 item version and General Coping Questionnaire-30 item version. A group of 40 male and 56 female medical students was tested one week and four months after having started dissection of cadavers for the first time. The results showed that all scales had good internal consistency and test-retest reliability. The student sample scored lower on the IES and PTSS-10 than comparable groups of traumatized subjects. A gender difference emerged, with female subjects scoring higher than male subjects. The factor analysis of the instruments indicated good construct validity for the symptom scales. The analysis of content validity related to DSM IV criteria indicated that the IES and PTSS-10 may have some limitations in their predictive validity of PTSD. Taken together, the three scales have shown good psychometric properties and could be used in future research and clinical work.",0,0 +4567,Meta-Analysis of the Efficacy of Treatments for Posttraumatic Stress Disorder,"Posttraumatic stress disorder (PTSD) is an important mental health issue in terms of the number of people affected and the morbidity and functional impairment associated with the disorder. The purpose of this study was to examine the efficacy of all treatments for PTSD.PubMed, MEDLINE, PILOTS, and PsycINFO databases were searched for randomized controlled clinical trials of any treatment for PTSD in adults published between January 1, 1980, and April 1, 2012, and written in the English language. The following search terms were used: post-traumatic stress disorders, posttraumatic stress disorder, PTSD, combat disorders, and stress disorders, post-traumatic.Articles selected were those in which all subjects were adults with a diagnosis of PTSD based on DSM criteria and a valid PTSD symptom measure was reported. Other study characteristics were systematically collected. The sample consisted of 137 treatment comparisons drawn from 112 studies.Effective psychotherapies included cognitive therapy, exposure therapy, and eye movement desensitization and reprocessing (g = 1.63, 1.08, and 1.01, respectively). Effective pharmacotherapies included paroxetine, sertraline, fluoxetine, risperidone, topiramate, and venlafaxine (g = 0.74, 0.41, 0.43, 0.41, 1.20, and 0.48, respectively). For both psychotherapy and medication, studies with more women had larger effects and studies with more veterans had smaller effects. Psychotherapy studies with wait-list controls had larger effects than studies with active control comparisons.Our findings suggest that patients and providers have a variety of options for choosing an effective treatment for PTSD. Substantial differences in study design and study participant characteristics make identification of a single best treatment difficult. Not all medications or psychotherapies are effective.",0,0 +4568,A Double-Blind Randomized Controlled Trial To Study the Efficacy of Topiramate in a Civilian Sample of PTSD,"To evaluate the efficacy and tolerability of topiramate in patients with posttraumatic stress disorder (PTSD).We conducted a 12-week double-blind, randomized, placebo-controlled study comparing topiramate to placebo. Men and women aged 18-62 years with diagnosis of PTSD according to DSM-IV were recruited from the outpatient clinic of the violence program of Federal University of São Paulo Hospital (Prove-UNIFESP), São Paulo City, between April 2006 and December 2009. Subjects were assessed for the Clinician-Administered Posttraumatic Stress Scale (CAPS), Clinical Global Impression, and Beck Depression Inventory (BDI). After 1-week period of washout, 35 patients were randomized to either group. The primary outcome measure was the CAPS total score changes from baseline to the endpoint.82.35% of patients in the topiramate group exhibited improvements in PTSD symptoms. The efficacy analysis demonstrated that patients in the topiramate group exhibited significant improvements in reexperiencing symptoms: flashbacks, intrusive memories, and nightmares of the trauma (CAPS-B; P= 0.04) and in avoidance/numbing symptoms associated with the trauma, social isolation, and emotional numbing (CAPS-C; P= 0.0001). Furthermore, the experimental group demonstrated a significant difference in decrease in CAPS total score (topiramate -57.78; placebo -32.41; P= 0.0076). Mean topiramate dose was 102.94 mg/d. Topiramate was generally well tolerated.Topiramate was effective in improving reexperiencing and avoidance/numbing symptom clusters in patients with PTSD. This study supports the use of anticonvulsants for the improvement of symptoms of PTSD.",0,0 +4569,Risk of stroke among patients with post-traumatic stress disorder: nationwide longitudinal study,"Background Previous evidence has shown positive associations between post-traumatic stress disorder (PTSD) and hypertension, dyslipidaemia and diabetes mellitus, which are all risk factors for stroke, but the role of PTSD in the subsequent development of stroke is still unknown. Aims To investigate the temporal association between PTSD and the development of stroke. Method Identified from the Taiwan National Health Insurance Research Database, 5217 individuals aged 18 years, with PTSD but with no history of stroke, and 20 868 age- and gender-matched controls were enrolled between 2002 and 2009, and followed up until the end of 2011 to identify the development of stroke. Results Individuals with PTSD had an increased risk of developing any stroke (hazard ratio (HR) 3.37, 95% CI 2.44–4.67) and ischaemic stroke (HR = 3.47, 95% CI 2.23–5.39) after adjusting for demographic data and medical comorbidities. Sensitivity tests showed consistent findings (any stroke HR = 3.02, 95% CI 2.13–4.28; ischaemic stroke HR = 2.89, 95% CI 1.79–4.66) after excluding the first year of observation. Conclusions Individuals with PTSD have an increased risk of developing any stroke and ischaemic stroke. Further studies are required to investigate the underlying mechanisms.",0,0 +4570,Multidimensional Personality Questionnaire profiles of veterans with traumatic combat exposure: Externalizing and internalizing subtypes.,"This study used the Multidimensional Personality Questionnaire (MPQ; A. Tellegen, in press) to identify personality-based subtypes of posttraumatic response. Cluster analyses of MPQs completed by combat veterans revealed subgroups that differed on measures relating to the externalization versus internalization of distress. The MPQ profile of the externalizing cluster was defined by low Constraint and Harmavoidance coupled with high Alienation and Aggression. Individuals in this cluster also had histories of delinquency and high rates of substance-related disorder. In comparison, the MPQ profile of the internalizing cluster was characterized by lower Positive Emotionality, Alienation, and Aggression and higher Constraint, and individuals in this cluster showed high rates of depressive disorder. These findings suggest that dispositions toward externalizing versus internalizing psychopathology may account for heterogeneity in the expression of posttraumatic responses, including patterns of comorbidity.",0,0 +4571,Cluster analysis of obsessive-compulsive spectrum disorders in patients with obsessive-compulsive disorder: clinical and genetic correlates,"Comorbidity of certain obsessive-compulsive spectrum disorders (OCSDs; such as Tourette's disorder) in obsessive-compulsive disorder (OCD) may serve to define important OCD subtypes characterized by differing phenomenology and neurobiological mechanisms. Comorbidity of the putative OCSDs in OCD has, however, not often been systematically investigated. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition , Axis I Disorders-Patient Version as well as a Structured Clinical Interview for Putative OCSDs (SCID-OCSD) were administered to 210 adult patients with OCD (N = 210, 102 men and 108 women; mean age, 35.7 ± 13.3). A subset of Caucasian subjects (with OCD, n = 171; control subjects, n = 168), including subjects from the genetically homogeneous Afrikaner population (with OCD, n = 77; control subjects, n = 144), was genotyped for polymorphisms in genes involved in monoamine function. Because the items of the SCID-OCSD are binary (present/absent), a cluster analysis (Ward's method) using the items of SCID-OCSD was conducted. The association of identified clusters with demographic variables (age, gender), clinical variables (age of onset, obsessive-compulsive symptom severity and dimensions, level of insight, temperament/character, treatment response), and monoaminergic genotypes was examined. Cluster analysis of the OCSDs in our sample of patients with OCD identified 3 separate clusters at a 1.1 linkage distance level. The 3 clusters were named as follows: (1) “reward deficiency” (including trichotillomania, Tourette's disorder, pathological gambling, and hypersexual disorder), (2) “impulsivity” (including compulsive shopping, kleptomania, eating disorders, self-injury, and intermittent explosive disorder), and (3) “somatic” (including body dysmorphic disorder and hypochondriasis). Several significant associations were found between cluster scores and other variables; for example, cluster I scores were associated with earlier age of onset of OCD and the presence of tics, cluster II scores were associated with female gender and childhood emotional abuse, and cluster III scores were associated with less insight and with somatic obsessions and compulsions. However, none of these clusters were associated with any particular genetic variant. Analysis of comorbid OCSDs in OCD suggested that these lie on a number of different dimensions. These dimensions are partially consistent with previous theoretical approaches taken toward classifying OCD spectrum disorders. The lack of genetic validation of these clusters in the present study may indicate the involvement of other, as yet untested, genes. Further genetic and cluster analyses of comorbid OCSDs in OCD may ultimately contribute to a better delineation of OCD endophenotypes.",0,0 +4572,Externalizing and Internalizing Subtypes of Posttraumatic Psychopathology and Anger Expression,"Subtypes of posttraumatic psychopathology were replicated and extended in 254 female veterans with posttraumatic stress disorder (PTSD). Cluster analyses on Minnesota Multiphasic Personality Inventory-2 and Personality Psychopathology Five scales (Harkness, McNulty, & Ben-Porath, ) yielded internalizing and externalizing psychopathology dimensions, with a third low psychopathology group (simple PTSD). Externalizers were higher than the internalizers and the simple PTSD groups on the antisocial, substance, and aggression scales; internalizers were higher on depression and anxiety scales. Further validation included an independent measure of psychopathology to examine anger (Buss-Durkee Hostility Inventory, [BDHI]; Buss & Durkee, ). Externalizers were higher on extreme behavioral anger scales (assault and verbal hostility); and externalizers and internalizers were higher than the simple PTSD subjects on other anger scales. Positive correlations between the BDHI scales and the PTSD symptom of ""irritability and anger outbursts"" were found across scales in the total sample (range: r = .19-.36), on the assault scale in externalizers (r = .59), and the verbal hostility scale in both internalizers (r = .30) and simple PTSD (r = .37) groups, suggesting the broad utility of the symptom in the diagnosis. The results demonstrate the generalizability of the internalizing/externalizing typology to the female veteran population and highlight clinically relevant distinctions in anger expression within PTSD.",0,0 +4573,Interdisciplinary rehabilitation of mild TBI and PTSD: A case report,"Prevalence of mild traumatic brain injury (mTBI) or concussion on the battlefield in Iraq/Afghanistan has resulted in its designation as a 'signature injury'. Civilian studies have shown that negative expectations for recovery may lead to worse outcomes. While there is concern that concussion screening procedures in the Veteran's Affairs Healthcare System and the Department of Defence could fuel negative expectations, leading to negative iatrogenic effects, it has been difficult to document this in clinical settings. The aim of this report is to describe the case of a veteran with comorbid mTBI/PTSD with persistent symptoms of unknown aetiology and the effects of provider communications on the patient's recovery.Case report of a veteran with reported mTBI, including provider communications, neuropsychological test results and report of functioning after changes in provider messages.Two-years post-mTBI, the patient attributed cognitive difficulties to his brain injury, but neuropsychological assessment found that his cognitive profile was consistent with psychological rather than neurological dysfunction. After providers systematically emphasized expectations of recovery, the patient's daily functioning improved.This case illustrates difficulties in mass screening for and treating mTBI. Recommendations for improvement include clinician training in effectively communicating positive expectations of recovery after concussion.",0,0 +4574,When a soldier returns home from Iraq and/or Afghanistan with post -traumatic stress disorder: The lived experience of the spouse,"This study takes a broad look at the effects of a soldier's post-traumatic stress disorder (PTSD) symptomology on the dependent spouse, including anger, emotional distancing, and sleep disturbances a discussed by the participants. Domestic violence in the relationship was suggested to be one of the major factors in the participant's decision-making process. This study can be used as a first step in the development of programs aimed at maintaining family unity as well as increasing the safety of family members. This study is designed to investigate feelings, experiences, and major decisions military dependent spouses make when their Army soldier returns from Iraq and/or Afganistan with PTSD. This study uses qualitative methodology to obtain rich descriptions of the feelings and experiences of military dependants due to the soldier's PTSD symptomology. This study is meant to give other researchers a foundation upon which to create treatment methods that will benefit the Army community. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4575,"The café fire on New Year's Eve in Volendam, the Netherlands: description of events","The café fire at Volendam occurred shortly after midnight on the first of January 2001 and resulted in one of the worst mass burn incidents in recent Dutch history. The aim of this study was to provide insight into medical and organisational requirements of a major burns incident.Shortly after the fire, two university hospitals and a burn center in the region of the accident developed a plan for evaluation of medical care given during and after this major burn incident. A multidisciplinary research group investigated the management of victims at the scene, in the emergency departments (ED) and during admission in the hospitals. All 245 casualties were included in this study.A brief severe fire occurred in a crowded cafe with around 350 young visitors on a small embankment of a relatively isolated town, resulting in a unusually high number of severely injured burn victims. Four died immediately. The ensuing rescue effort was hampered by poor access and chaotic circumstances. At the scene of the incident, mobile medical teams ensured orderly transport and treatment priority for the injured. There were 245 victims with a median total body surface area burned of 12%. Inhalation injury was present in 96 patients. A total of 182 victims were admitted, with 112 to intensive care. Ten patients died in the hospital. Seventy-eight patients were secondarily transported, many to specialised centers in the Netherlands and abroad. In total, 36 hospitals in three countries participated.An incident with high numbers of burn victims poses a challenge to any health care system. The difficult circumstances at the site demonstrated the need for robust organisational structures. The primary and secondary distribution of patients required coordination, general hospitals were able to provide initial medical care to these major burn casualties.",0,0 +4576,Lifetime manic–hypomanic symptoms in post-traumatic stress disorder: Relationship with the 18 kDa mitochondrial translocator protein density,"Initially explored in military settings, post-traumatic stress disorder (PTSD) has shown increasing prevalence in the general population. The high comorbidity rates between bipolar disorder (BD) and PTSD have raised the issue of whether some characteristics of BD could represent risk factors for PTSD. In combat-related PTSD, the 18 kDa mitochondrial translocator protein (TSPO), essential for steroid synthesis, was found to be decreased. Aims of the present study were: 1) the assessment of the TSPO mitochondrial density in lymphomonocytes from civilian patients with non-combat-related PTSD, without current or lifetime Axis I mood comorbidity, versus controls; 2) the exploration of the correlations between TSPO density and the presence of comorbid manic/hypomanic lifetime spectrum symptoms. Assessments included the Structured Clinical Interview for DSM-IV (SCID), the Impact of Event Scale (IES), and the lifetime Mood Spectrum Self-Report (MOODS-SR). Blood samples were processed to assess TSPO binding parameters in lymphomonocyte mitochondrial membranes. PTSD patients showed a significant decrease in TSPO density, without changes in mitochondrial citrate synthase activity. Further, TSPO density correlated with the number of lifetime manic/hypomanic spectrum symptoms. For the first time, TSPO density was found to be decreased in non-war-related PTSD and such decreases correlated with comorbid manic/hypomanic spectrum symptoms, indicating a possible role of sub-threshold bipolar comorbidity in PTSD-related neurobiological dysregulation.",0,0 +4577,A SAS Procedure Based on Mixture Models for Estimating Developmental Trajectories,"This article introduces a new SAS procedure written by the authors that analyzes longitudinal data (developmental trajectories) by fitting a mixture model. The TRAJ procedure fits semiparametric (discrete) mixtures of censored normal, Poisson, zero-inflated Poisson, and Bernoulli distributions to longitudinal data. Applications to psychometric scale data, offense counts, and a dichotomous prevalence measure in violence research are illustrated. In addition, the use of the Bayesian information criterion to address the problem of model selection, including the estimation of the number of components in the mixture, is demonstrated.",0,0 +4578,Initial Stress Responses in Relation to Outcome After Three Decades,"The present study aimed at predicting posttraumatic stress 5 and 27 years after the North Sea oil rig disaster. The predictions were based on the initial levels of stress responses and the early recovery as reported in 1980. The Posttraumatic Stress Scale (PTSS) was used at 3 measure points. From 1980, data from 69 survivors were used in latent growth modeling. Follow-up studies included 65 survivors and 85 matched unexposed oil-rig workers in 1985; and 47 and 62 in 2007. In 1985, the survivors had higher total PTSS scores and more frequent endorsements on most single PTSS-items than the comparison group. In 2007, a few single items remained different. The initial levels of stress responses and the early recovery rate predicted the long-term outcomes after 5 and 27 years. Initial screenings may be helpful in the early detection of posttraumatic stress in the very long-term perspective.",0,0 +4579,What Is the Typical Response to Sexual Assault? Reply to Bonanno (2013),"We respond to Bonanno's (2013) comment on our longitudinal evaluation of sexual assault survivors. Bonanno posits that minor disruption in functioning is the modal response to any stressor or trauma, yet most women we studied had marked initial symptoms in the immediate months following assault, which gradually improved over time. We argue that sexual violence is one example of intentional and malicious victimization, which differs from other experiences studied by Bonanno, such as spinal cord injury. Our study also differed from most previous studies in that it specifically examined the acute reactions period, which is the only period that can distinguish between resilience and recovery: Both trajectories ultimately involve good adaptation, but are distinguished by the degree of initial postevent disruption. We address Bonanno's contention that our results should be dismissed on methodological and statistical grounds. Our findings suggest that prior research about the frequency of resilience may in part be confounded by the degree and type of stress exposure.",0,0 +4580,The Dissociative Subtype of Posttraumatic Stress Disorder: Unique Resting-State Functional Connectivity of Basolateral and Centromedial Amygdala Complexes,"Previous studies point towards differential connectivity patterns among basolateral (BLA) and centromedial (CMA) amygdala regions in patients with posttraumatic stress disorder (PTSD) as compared with controls. Here we describe the first study to compare directly connectivity patterns of the BLA and CMA complexes between PTSD patients with and without the dissociative subtype (PTSD+DS and PTSD-DS, respectively). Amygdala connectivity to regulatory prefrontal regions and parietal regions involved in consciousness and proprioception were expected to differ between these two groups based on differential limbic regulation and behavioral symptoms. PTSD patients (n=49) with (n=13) and without (n=36) the dissociative subtype and age-matched healthy controls (n=40) underwent resting-state fMRI. Bilateral BLA and CMA connectivity patterns were compared using a seed-based approach via SPM Anatomy Toolbox. Among patients with PTSD, the PTSD+DS group exhibited greater amygdala functional connectivity to prefrontal regions involved in emotion regulation (bilateral BLA and left CMA to the middle frontal gyrus and bilateral CMA to the medial frontal gyrus) as compared with the PTSD-DS group. In addition, the PTSD+DS group showed greater amygdala connectivity to regions involved in consciousness, awareness, and proprioception-implicated in depersonalization and derealization (left BLA to superior parietal lobe and cerebellar culmen; left CMA to dorsal posterior cingulate and precuneus). Differences in amygdala complex connectivity to specific brain regions parallel the unique symptom profiles of the PTSD subgroups and point towards unique biological markers of the dissociative subtype of PTSD.",0,0 +4581,Understanding Resilience and Other Trajectories of Psychological Distress: a Mixed-Methods Study of Low-Income Mothers Who Survived Hurricane Katrina,"Recent longitudinal studies in the aftermath of natural disasters have shown that resilience, defined as a trajectory of consistently low symptoms, is the modal experience, although other trajectories representing adverse responses, including chronic or delayed symptom elevations, occur in a substantial minority of survivors. Although these studies have provided insight into the prototypical patterns of postdisaster mental health, the factors that account for these patterns remain unclear. In the current analysis, we aimed to fill this gap through a mixed-methods study of female participants in the Resilience in Survivors of Katrina (RISK) study. Latent class growth analysis identified six trajectories of psychological distress in the quantitative sample (n=386). Qualitative analysis of in-depth interviews with 54 participants identified predisaster, disaster-related and postdisaster experiences that could account for the trends in the quantitative data. In particular, preexisting and gains in psychosocial resources (e.g., emotion regulation, religiosity) and positive postdisaster impacts (e.g., greater neighborhood satisfaction, improved employment opportunities) were found to underlie resilience and other positive mental health outcomes. Conversely, experiences of childhood trauma, and pre and postdisaster stressors (e.g., difficulties in intimate partner relationships) were common among participants in trajectories representing adverse psychological responses. Illustrative case studies that exemplify each trajectory are presented. The results demonstrate the utility of mixed-methods analysis to provide a richer picture of processes underlying postdisaster mental health.",0,0 +4582,Short-term follow-up of post-traumatic stress symptoms in motor vehicle accident victims,"Ninety-eight victims of recent motor vehicle accidents (MVA), who sought medical attention as a result of the MVA, were followed up prospectively 6 months after the initial assessment, using Keller, Lavori, Friedman, Nielsen, Endicott, McDonald-Scott and Andreasen's (Archives of General Psychiatry, 44, 540-548, 1987) LIFE methodology so that month-by-month changes in post-traumatic stress disorder (PTSD) symptoms could be determined. For the 40 MVA victims who initially met the full criteria for PTSD, 10 no longer met the criteria 4 months after the initial assessment, a decrease significant at the P < 0.01 level, and 20 no longer met the full criteria at 6 months (P < 0.001). On a symptom-by-symptom basis, there were significant declines among the fraction of those who initially met the criteria for PTSD for all avoidance and numbing symptoms by the 6-month follow-up, whereas most of the hyperarousal symptoms did not show significant declines.",0,0 +4583,Chronicity of Psychological Strain in Occupational Settings and the Accuracy of the General Health Questionnaire.,"This article examines the proposition that the traditional scoring method of the General Health Questionnaire (GHQ) underestimates the number of respondents classified as ""cases."" A revised ""chronic"" scoring method (the CGHQ) is used and demonstrates superior construct validity and greater sensitivity. A comparison of the CGHQ and GHQ also shows the CGHQ to be a superior criterion measure. These claims are demonstrated by survey data gathered from 3 occupational samples (Ns=11,637, 2,253, and 2,124). Results show that the CGHQ is more appropriate as a screening instrument for psychological morbidity. Tests of construct validity also favor the CGHQ with only a slight advantage for predictive validity in terms of variance explained. The more desirable statistical properties of the CGHQ result in a reduction of significant interaction terms and are strongly recommended in future studies as a means of controlling Type I errors when tests of moderation are examined.",0,0 +4584,Clinical and Cognitive Correlates of Psychiatric Comorbidity in Delusional Disorder Outpatients,"Objectives: The aims of this study were to investigate the prevalence, as well as the clinical, cognitive, and functional correlates of psychiatric comorbidity in patients with delusional disorder (DD). Methods: Eighty-six outpatients with DSM-IV DD were evaluated for psychiatric comorbidity on Axis I disorders using the Mini International Neuropsychiatry Interview (MINI). The following instruments were administered: the Standardized Assessment of Personality (SAP), the Positive and Negative Symptom Scale (PANSS), the Montgomery-Asberg Depression Rating Scale (MADRS), a neuropsychological battery (consisting of measures for attention, verbal and working memory, and executive functions), the Sheehan Disability Inventory (SDI), and the Global Assessment of Functioning (GAF) scale. A socio-demographic and clinical questionnaire was also completed. Results: Forty-six percent of the subjects had at least one additional lifetime psychiatric diagnosis, the most common being depressive disorders (N = 16, 32.6%), followed by anxiety disorders (N = 8, 14%). DD with comorbid Axis I disorders (N = 40, 46.5%) was associated with a specific syndromic constellation (more common cluster C personality psychopathology, somatic delusions, olfactory and gustatory hallucinations, and suicide risk), and greater severity of the psychopathology, particularly as regards emotional dysregulation (total and general PANSS scales, MADRS, and perceived stress SDI scoring). In contrast, DD without psychiatric comorbidity – “pure” DD – (N = 46, 53.5%) was associated with worse overall neurocognitive performance, mainly in working memory. There were no differences in functionality between the two groups (as per the GAF and SDI total, work, social and family life disability scores). Conclusions: Our findings reveal one type of DD with associated psychiatric comorbidity with greater emotion-related psychopathology and another “pure” DD, without psychiatric comorbidity, related to worse global cognitive functioning. Treatment for DD should address both types of processes.",0,0 +4585,"Efficacy and Safety of Paroxetine Treatment for Chronic PTSD: A Fixed-Dose, Placebo-Controlled Study","This study evaluated the efficacy and safety of paroxetine for the treatment of patients with chronic posttraumatic stress disorder (PTSD).Outpatients with chronic PTSD according to DSM-IV criteria and a score of 50 or more on the Clinician-Administered PTSD Scale, part 2, were randomly assigned to take placebo (N=186), 20 mg/day of paroxetine (N=183), or 40 mg/day of paroxetine (N=182) for 12 weeks. Efficacy was assessed by examining the change in total score from baseline to endpoint on the Clinician-Administered PTSD Scale, part 2, and rates of response (""very much improved"" or ""much improved"") for global improvement on the Clinical Global Impression scale.Paroxetine-treated patients in both dose groups demonstrated significantly greater improvement on primary outcome measures compared to placebo-treated patients in the intent-to-treat analysis. Moreover, paroxetine treatment resulted in statistically significant improvement compared to placebo on all three PTSD symptom clusters (reexperiencing, avoidance/numbing, and hyperarousal), social and occupational impairment, and comorbid depression. Paroxetine was effective for both men and women. Treatment response did not vary by trauma type, time since trauma, or severity of baseline PTSD or depressive symptoms. Both doses were well tolerated.Doses of 20 and 40 mg/day of paroxetine are effective and well tolerated in the treatment of adults with chronic PTSD.",0,0 +4586,Systems biology approach to understanding post-traumatic stress disorder,This review paper presents known biological facts about PTSD and the mathematical/systems biology tools used to understand the underpinning molecular principles.,0,0 +4587,Personality Assessment Inventory internalizing and externalizing structure in veterans with posttraumatic stress disorder: Associations with aggression,"Posttraumatic stress disorder (PTSD) is associated with aggressive behavior in veterans, and difficulty controlling aggressive urges has been identified as a primary postdeployment readjustment concern. Yet only a fraction of veterans with PTSD commit violent acts. The goals of this study were to (1) examine the higher-order factor structure of Personality Assessment Inventory (PAI) scales in a sample of U.S. military veterans seeking treatment for PTSD; and (2) to evaluate the incremental validity of higher-order latent factors of the PAI over PTSD symptom severity in modeling aggression. The study sample included male U.S. Vietnam (n = 433) and Iraq/Afghanistan (n = 165) veterans who were seeking treatment for PTSD at an outpatient Veterans Affairs (VA) clinic. Measures included the Clinician Administered PTSD Scale, the PAI, and the Conflict Tactics Scale. The sample was randomly split into two equal subsamples (n's = 299) to allow for cross-validation of statistically derived factors. Parallel analysis, variable clustering analysis, and confirmatory factor analyses were used to evaluate the factor structure, and regression was used to examine the association of factor scores with self-reports of aggression over the past year. Three factors were identified: internalizing, externalizing, and substance abuse. Externalizing explained unique variance in aggression beyond PTSD symptom severity and demographic factors, while internalizing and substance abuse did not. Service era was unrelated to reports of aggression. The constructs of internalizing versus externalizing dimensions of PTSD may have utility in identifying characteristics of combat veterans in the greatest need of treatment to help manage aggressive urges. Aggr. Behav. 9999:XX-XX, 2014. Published 2014. This article is a U.S. Government work and is in the public domain in the USA. Language: en",0,0 +4588,Frequency and Severity of Comorbid Mood and Anxiety Disorders in Prescription Opioid Dependence,"Background and Objectives Comorbid substance use disorders and mood and anxiety disorders are associated with more severe psychiatric symptoms, social and occupational impairment, and economic burden. To date, the majority of research has focused on comorbidity in illicit drug users, rather than prescription drug users. To address this gap in the literature, the present cross-sectional study investigated the clinical profiles of individuals with prescription opioid dependence with or without comorbid mood and anxiety disorders. Methods Ninety individuals with prescription opioid use were recruited to participate in the study procedures. All participants completed a structured clinical interview and series of self-report measures. Results and Conclusions Of the 85 individuals with prescription opioid dependence, 47.1% (n = 40) were diagnosed with a comorbid mood or anxiety disorder. The findings showed that individuals with prescription opioid dependence and comorbid mood and anxiety disorders demonstrated significantly more severe alcohol use, psychiatric symptoms, and sleep impairment than individuals without comorbidity. Scientific Significance The findings highlight the frequency and severity of co-occurring mood and anxiety disorders in individuals with prescription opioid dependence and suggest that integrated interventions are needed to address these growing problems. (Am J Addict 2013; 22:261–265)",0,0 +4589,REM sleep behaviour disorder: Clinical profiles and pathophysiology,"Rapid eye movement (REM) sleep behaviour disorder (RBD) is a parasomnia characterized by the intermittent loss of electromyographic atonia normally present during REM sleep and the emergence of purposeful complex motor activity associated with vivid dreams. Rapid eye movement sleep behaviour disorder usually affects older males and can be either idiopathic or symptomatic of various underlying disorders, in particular neurodegenerative diseases; in the latter case, RBD may be a prodromal symptom of the neurological disease. Several brainstem regions have been implicated in RBD pathophysiology, although the exact mechanism of the disorder in humans remains to be clarified. On clinical grounds, differentiation of RBD should be made from several non-REM parasomnias and other aberrant behaviours occurring during sleep. Rapid eye movement sleep behaviour disorder can be diagnosed on the basis of a systematic medical, neurological and psychiatric evaluation of the patient, assisted by a standard polysomnographic recording that includes continuous overnight videotaping; a brain imaging study is mandatory when an underlying brain disease is being suspected. Clonazepam at bedtime is the treatment of choice for RBD; alternatively, melatonin or pramipexole can be administered when clonazepam is contraindicated.",0,0 +4590,Predictors of acute posttraumatic stress disorder symptoms following civilian trauma,"Posttraumatic stress disorder (PTSD) is associated with significant morbidity following injury. The incidence and risk factors for PTSD are not well described in the civilian trauma population. We proposed to screen all trauma patients in the outpatient trauma clinic for acute PTSD symptoms and identify risk factors for PTSD.We prospectively screened 1,386 injured patients who presented for follow-up in trauma clinic (January 2009 to September 2010) using an established PTSD screening test (PTSD Checklist-Civilian, PCL-C). A PCL-C score of ≥35, with a known sensitivity of >85% for PTSD, was considered screen-positive (PCL-C-POS). Backward stepwise logistic regression was used to determine independent risk factors for PCL-C-POS.Over 25% of trauma clinic patients met the threshold for positive PTSD screen (PCL-C-POS). The highest incidence (43%) was in patients who sustained assault (blunt or penetrating). Regression analysis revealed that age <55 years, female gender, motor vehicle collision, and assaultive mechanism (blunt or penetrating, excluding self-inflicted or accidental injury) were independent predictors of PCL-C-POS status. As the severity of symptoms increased (higher PCL-C scores), the risk associated with assaultive mechanism significantly increased in a dose-response fashion (p < 0.05).This study confirms the high incidence of acute PTSD symptoms in trauma patients and supports the feasibility of PTSD screening in the outpatient trauma clinic. Among all mechanisms of injury, patients who sustain interpersonal violence are at the highest risk of developing acute PTSD symptoms. These results suggest that PTSD screening in outpatient trauma clinic may allow early detection and referral of patients with PTSD.II.",0,0 +4591,[Factors affecting the diagnosis of post-traumatic stress disorder after a terrorist attack].,"On 3 January 2008 explosives placed in an automobile on a thoroughfare in Diyarbakir, southeastern Turkey exploded in a terrorist attack. The aim of this study was to determine the risk factors for the diagnosis of and the rate of post-traumatic stress disorder (PTSD) among individuals who were eye- or earwitnesses to the explosion 1 and 3 months after the explosion.Among the residents and workers in close proximity to the explosion site, 216 individuals who were eye- or earwitnesses to the explosion were included in the study. A sociodemographic data form and a traumatic stress symptom scale were administered to the participants 1 and 3 months following the explosion.In all, 12.5% of the participants were diagnosed with PTSD 1 month post-explosion versus 9.6% 3 months post-explosion. While history of psychiatric disorder and physical injury were risk factors for PTSD 1 month post-explosion, risk factors 3 months post-explosion was history of psychiatric disorder.PTSD occurs at high rates in individuals exposed to terrorist attacks. More studies following such events are required in Turkey. In light of these results it is advised that individuals at risk of PTSD receive therapeutic and preventive interventions provided by mental health professionals.",0,0 +4592,Identification of resilient individuals and those at risk for performance deficits under stress,"Human task performance is affected by exposure to physiological and psychological stress. The ability to measure the physiological response to stressors and correlate that to task performance could be used to identify resilient individuals or those at risk for stress-related performance decrements. Accomplishing this prior to performance under severe stress or the development of clinical stress disorders could facilitate focused preparation such as tailoring training to individual needs. Here we measure the effects of stress on physiological response and performance through behavior, physiological sensors, and subjective ratings, and identify which individuals are at risk for stress-related performance decrements. Participants performed military-relevant training tasks under stress in a virtual environment, with autonomic and hypothalamic-pituitary-adrenal axis (HPA) reactivity analyzed. Self-reported stress, as well as physiological indices of stress, increased in the group pre-exposed to socioevaluative stress. Stress response was effectively captured via electrodermal and cardiovascular measures of heart rate and skin conductance level. A resilience classification algorithm was developed based upon physiological reactivity, which correlated with baseline unstressed physiological and self-reported stress values. Outliers were identified in the experimental group that had a significant mismatch between self-reported stress and salivary cortisol. Baseline stress measurements were predictive of individual resilience to stress, including the impact stress had on physiological reactivity and performance. Such an approach may have utility in identifying individuals at risk for problems performing under severe stress. Continuing work has focused on adapting this method for military personnel, and assessing the utility of various coping and decision-making strategies on performance and physiological stress.",0,0 +4593,Direct and indirect predictors of traumatic stress and distress in orphaned survivors of the 1994 Rwandan Tutsi genocide,"Millions of children grow into adulthood having experienced severe war and ethnic conflict as children. One such group is orphaned child and adolescent survivors of the 1994 Rwandan Tutsi Genocide, in which one-seventh of the Rwandan population was murdered over the course of 100 days. After the genocide, many of these children took on the responsibility of caring and providing for other child survivors. Research has documented that child survivors of the genocide are at increased risk of mental health concerns (Dyregrov, Gupta, Gjestad, & Mukanoheli, 2000; Schaal & Elbert, 2006). However, differences in PTSD symptoms in Rwandan orphan survivors have not been fully explained by genocide exposure. This dissertation consists of two manuscripts that used path analysis to identify modifiable factors that contribute to mental health outcomes for orphaned heads of household (OHH) in Rwanda, over and above genocide exposure. Participants were 100 OHH who were members of a community organization. Data came from genocide testimonies that were given in 2002 and assessments of post-genocide mental health and risk factors that were collected in a 2008/2009 follow-up of 61 of the 100 original participants. The first manuscript used cognitive models of posttraumatic stress disorder (PTSD) as a framework for investigating whether linguistic components of genocide testimonies predict PTSD symptoms. Results were somewhat consistent with cognitive models and indicated that the way survivors described their genocide experiences predicted PTSD symptoms six years later. The second manuscript investigated whether post-genocide social-ecological risk factors predict distress and traumatic stress. Lack of education substantially predicted both distress and traumatic stress, lack of resources significantly predicted lower educational attainment, and social support predicted distress. After accounting for post-genocide risk factors, genocide experiences still directly predicted distress and traumatic stress. Implications for intervention and research are discussed. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +4594,"Trauma, posttraumatic stress disorder symptom clusters, and physical health symptoms in postabused women","The purpose of this retrospective, descriptive-correlational research was to examine the relationships between violent and nonviolent trauma, posttraumatic stress disorder (PTSD) and its symptom clusters of avoidance, intrusive/re-experiencing, and hyperarousal, and self-reported physical health symptoms in 50 postabused women. Results indicated: (1) PTSD hyperarousal and avoidance symptom clusters were positively associated with physical health symptoms, and (2) childhood physical abuse accounted for a significant and unique portion of the variance in physical health symptoms. The results highlight the need for health care practitioners in all settings to assess for a history of trauma in a woman's life.",0,0 +4595,Childhood maltreatment and post-traumatic stress disorder among incarcerated young offenders,"Young offenders have a high prevalence of mental illness and a large proportion report experiencing a number of traumatic events during childhood, but there is little research exploring this association. This study describes the prevalence of, and association between, child maltreatment and post-traumatic stress disorder (PTSD) among young offenders. The study uses data collected as part of the 2009 NSW Young People in Custody Health Survey which was conducted in nine juvenile detention centers. This paper reports on findings from the baseline questionnaires and 18-months of re-offending data. The analysis included 291 participants who were assessed for PTSD and child maltreatment. The sample was 88% male, 48% Aboriginal, with an average age of 17 years (range 13–21 years). One in five (20%) participants were diagnosed with PTSD, with females significantly more likely to have PTSD than males (40% vs. 17%, p < 0.05). Over half (60%) of young offenders reported any child abuse or neglect, with females nearly 10 times more likely to report three or more kinds of severe child maltreatment than males. The main correlate for a diagnosis of PTSD was having three or more kinds of severe child maltreatment (OR = 6.73, 95% CI: 1.06–42.92). This study provides evidence for the need to comprehensively assess child abuse and neglect among young offenders in order to provide appropriate treatment in custody and post-release.",0,0 +4596,A Longitudinal Analysis of PTSD Symptom Course: Delayed-Onset PTSD in Somalia Peacekeepers.,"Posttraumatic stress disorder (PTSD) typically follows an acute to chronic course. However, some trauma victims do not report significant symptoms until a period of time has elapsed after the event. Although originally dismissed as an artifact of retrospective methodologies, recent prospective studies document apparent instances of delayed-onset PTSD. Little is known currently about factors associated with the delayed onset of PTSD. This study was designed to examine the course of PTSD in a sample of 1,040 U.S. military peacekeepers who served in Somalia. A small but nontrivial subset of participants endorsed clinically significant levels of PTSD after a period of minimal distress, the magnitude of which cannot be ascribed to minor waxing and waning of symptoms. War-zone exposure and perceived meaningfulness of the mission, as rated by soldiers after returning to the United States, predicted symptom course over the next 18 months.",0,0 +4597,"Human rights, transitional justice, public health and social reconstruction","Mass violence, armed conflict, genocide, and complex humanitarian emergencies continue to create major social and public health disasters at the dawn of the 21st Century. Transitional justice, a set of policies designed to address the effects of war on traumatized communities and bring justice, lies at the nexus of public health, conflict, and social reconstruction. Despite the paucity of empirical evidence, advocates of transitional justice have claimed that it can alleviate the effects of trauma, deter future violence, and bring about social reconstruction in war-affected communities. Empirical evidence--including new data and analyses presented in this article--suggests a link between trauma, mental health and attitudes towards and responses to transitional justice programs, but there has been little theoretical discussion about the intersection between public health and transitional justice, and even less empirical research to generate discussion between these two fields. Yet, public health professionals have an important role to play in assessing the impact of transitional justice on communities affected by mass violence. In this paper, we offer a conceptual model for future research that seeks to examine the relationship between transitional justice programs and their potential value to the fields of medicine and public health and discuss the methodological issues and challenges to a comprehensive evaluation of this relationship. To illustrate the discussion, we examine new data and analyses from two cases of contemporary conflicts, eastern Democratic Republic of Congo (DRC) and northern Uganda.",0,0 +4598,Heart rate variability (HRV): an indicator of stress,"Heart rate variability (HRV) can be an important indicator of several conditions that affect the autonomic nervous system, including traumatic brain injury, post-traumatic stress disorder and peripheral neuropathy [3], [4], [10] & [11]. Recent work has shown that some of the HRV features can potentially be used for distinguishing a subject’s normal mental state from a stressed one [4], [13] & [14]. In all of these past works, although processing is done in both frequency and time domains, few classification algorithms have been explored for classifying normal from stressed RRintervals. In this paper we used 30 s intervals from the Electrocardiogram (ECG) time series collected during normal and stressed conditions, produced by means of a modified version of the Trier social stress test, to compute HRV-driven features and subsequently applied a set of classification algorithms to distinguish stressed from normal conditions. To classify RR-intervals, we explored classification algorithms that are commonly used for medical applications, namely 1) logistic regression (LR) [16] and 2) linear discriminant analysis (LDA) [6]. Classification performance for various levels of stress over the entire test was quantified using precision, accuracy, sensitivity and specificity measures. Results from both classifiers were then compared to find an optimal classifier and HRV features for stress detection. This work, performed under an IRB-approved protocol, not only provides a method for developing models and classifiers based on human data, but also provides a foundation for a stress indicator tool based on HRV. Further, these classification tools will not only benefit many civilian applications for detecting stress, but also security and military applications for screening such as: border patrol, stress detection for deception [3],[17], and wounded-warrior triage [12].",0,0 +4599,The influence of the dissociative subtype of posttraumatic stress disorder on treatment efficacy in female veterans and active duty service members.,"A dissociative subtype of posttraumatic stress disorder (PTSD) was recently added to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; American Psychiatric Association, 2013) and is thought to be associated with poor PTSD treatment response.We used latent growth curve modeling to examine data from a randomized controlled trial of prolonged exposure and present-centered therapy for PTSD in a sample of 284 female veterans and active duty service members with PTSD to test the association between the dissociative subtype and treatment response.Individuals with the dissociative subtype (defined using latent profile analysis) had a flatter slope (p = .008) compared with those with high PTSD symptoms and no dissociation, such that the former group showed, on average, a 9.75 (95% confidence interval [-16.94, -2.57]) lesser decrease in PTSD severity scores on the Clinician Administered PTSD Scale (Blake et al., 1995) over the course of the trial. However, this effect was small in magnitude. Dissociative symptoms decreased markedly among those with the subtype, though neither treatment explicitly addressed such symptoms. There were no differences as a function of treatment type.Results raise doubt about the common clinical perception that exposure therapy is not effective or appropriate for individuals who have PTSD and dissociation, and provide empirical support for the use of exposure treatment for individuals with the dissociative subtype of PTSD.",0,0 +4600,Age at onset in Canadian OCD patients: Mixture analysis and systematic comparison with other studies,"This study aimed to determine the distributions of the age at onset (AAO) using mixture analysis and better develop the understanding of AAO as a clinical feature of obsessive-compulsive disorder.Mixture analysis was used to identify sub-groups characterized by differences in AAO. Clinical features were analyzed for differences in AAO sub-groups using mixture analysis. Comparisons were made with AAO cut-offs used in previous studies using the 2-Sample Kolmogorov-Smirnov Test.Mixture analysis of our sample (n=196) yielded a combination of 2 normal theoretical distributions with means (SD) of 9.66 (3.12) for the early-onset sub-group and 21.1 (8.36) years for the late-onset sub-group. The sub-groups were divided by a cut-off of 15 years. As expected, a negative correlation was found between AAO and duration of illness. The early-onset subjects had significantly lower age at the time of the assessment and they tended to have more often panic attacks but were treated less often with benzodiazepines and other anti-anxiety medications. The comparison analysis showed significant difference in the AAO distribution between our sample and four other study samples.Our findings support the notion that different AAO sub-groups correspond with differences in clinical presentations of obsessive-compulsive disorder.",0,0 +4601,RESILIENCE AND RECOVERY IN AMERICAN SĀMOA: A CASE STUDY OF THE 2009 SOUTH PACIFIC TSUNAMI,"Case study methodology was used to explore the culturally situated response and recovery efforts following a tsunami in American Sāmoa. Data indicated that cultural mechanisms were effective in meeting physical needs but insufficient to manage the emotional trauma caused by such a large-scale event. Samoan cultural norms strongly discourage uncontrolled emotional expression outside of ritualized grieving events. Disruptions in social networks and activities, combined with a lack of available emotional support, resulted in significant psychological distress for many survivors. Sixteen months after the tsunami residents continued to exhibit numerous symptoms of posttraumatic stress. In response to this need for emotional support, some groups within American Sāmoa are setting an example of how their culture can adapt by forging new, culturally grounded methods for addressing emotional needs that arose in the wake of the tsunami. Findings are analyzed through the lens of the social support deterioration deterrence model and activity settings theory.",0,0 +4602,Mental Health and Health-Related Quality of Life Among Adult Latino Primary Care Patients Living in the United States With Previous Exposure to Political Violence,"Although political violence continues in parts of Central America, South America, and Mexico, little is known about its relationship to the health of Latino immigrants living in the United States.To determine (1) rates of exposure to political violence among Latino adult primary care patients who have immigrated to the United States from Central America, South America, and Mexico and its impact on mental health and health-related quality of life and (2) frequency of disclosure of political violence to primary care clinicians.Two-stage cluster design survey of a systematic sample of Latino immigrant adults in 3 community-based primary care clinics in Los Angeles, conducted from July 2001 to February 2002.Reports of exposure to political violence in home country before immigrating to the United States and communication with clinicians about political violence; self-reported measures of health-related quality of life using the Medical Outcomes Study Short Form 36 (MOS SF-36); symptoms of depression, anxiety, and alcohol disorders using the Primary Care Evaluation of Mental Disorders (PRIME-MD); and symptoms of posttraumatic stress disorder (PTSD) using the PTSD Checklist-Civilian Version (PCL-C).A total of 638 (69%) of 919 eligible patients participated. The nonresponse rates did not differ by age, sex, recruitment sites, or clinic sessions. In weighted analyses, 54% of participants reported political violence experiences in their home countries, including 8% who reported torture. Of those exposed to political violence, 36% had symptoms of depression and 18% had symptoms of PTSD vs 20% and 8%, respectively, among those not exposed to political violence. Controlling for age, sex, country, years lived in the United States, acculturation, income, health insurance status, and recruitment site in a subsample of 512 participants (56%), those who reported political violence exposure were more likely to meet symptom criteria for PTSD (adjusted odds ratio [AOR], 3.4; 95% confidence interval [CI], 1.4-8.4) and to have symptoms of depression (AOR, 2.8; 95% CI, 1.4-5.4) and symptoms of panic disorder (AOR, 4.8; 95% CI, 1.6-14.4) than participants not reporting political violence. Those exposed to political violence reported more chronic pain and role limitations due to physical problems, as well as worse physical functioning and lower perceptions of general health than those who were not exposed to political violence. Only 3% of the 267 patients who had experienced political violence reported ever telling a clinician about it after immigrating; none reported their current physician asking about political violence.Latino immigrants in primary care in Los Angeles have a high prevalence of exposure to political violence before immigrating to the United States and associated impairments in mental health and health-related quality of life.",0,0 +4603,Degrees of resilience: profiling psychological resilience and prospective academic achievement in university inductees,"University inductees may be increasingly vulnerable to stressors during transition into higher education (HE), requiring psychological resilience to achieve academic success. This study aimed to profile inductees' resilience and to investigate links to prospective end of year academic outcomes. Scores for resilience were based on a validated Connor Davison Resilience Scale (CD-RISC) drawn from 1534 inductees in a single UK university. A four-stage analysis revealed that incremental resilience was more facilitative of females' prospective academic attainment, but less functional and more convoluted for males. This large, distinctive study has implications for student support practices and highlights that the relationship between resilience and academic achievement requires further consideration in HE.",0,0 +4604,Post-traumatic stress symptoms among former child soldiers in Sierra Leone: follow-up study,"Background Former child soldiers are at risk of developing post-traumatic stress disorder (PTSD); however, the trajectory of symptoms has yet to be examined. Aims The risk and protective factors associated with PTSD symptom change among former child soldiers in Sierra Leone were investigated. Method Data from 243 former child soldiers (mean age 16.6 years, 30% female) were analysed. Results Self-reported rates of possible PTSD using standard cut-off points declined from 32% to 16% 4 years later ( P <0.05). Symptoms of PTSD at baseline were significantly associated with war experiences ( P <0.01) and post-conflict family abuse ( P <0.001). Reliable improvement in symptoms was reported by 30%. In growth models examining symptom change, worsening of symptoms was associated with death of a parent ( P <0.05) and post-conflict stigma ( P <0.001). Protective effects were observed for increases in family acceptance ( P <0.001). Conclusions The findings indicated improvement in PTSD symptoms among former child soldiers despite limited access to care. Family and community support played a vital part in promoting psychological adjustment.",0,0 +4605,Psychometric Properties of the Dissociative Experiences Scale,"The test-retest reliability of the Dissociative Experiences Scale (DES; Bernstein EM, Putnam FW [1986] Development, reliability, and validity of a dissociation scale. The Journal of Nervous and Mental Disease 174:727-735) in a clinical sample was found to be .93 for the total DES score and .95, .89, and .82 for the three subscale scores of amnesia, depersonalization-derealization, and absorption (dissociative identity disorder [DID], DSM-IV), respectively. Test-retest reliabilities within diagnostic groups of multiple personality disorder, dissociative disorder not otherwise specified, and a general other category of psychiatric diagnoses were obtained for total and subscale scores on the DES. These ranged from .78 to .96. Tests of mean scores across the two test sessions showed the total and subscale scores to be temporally stable. The DES was also found to be highly internally consistent: Cronbach's alphas of .96 and .97 were observed for the total DES scores taken at times 1 and 2, respectively. Construct validity of the DES was demonstrated by differentiation among the subscale scores in a repeated-measures analysis of variance (F[2,154] = 32.03, p < or = .001). Normality and general distribution issues were also addressed and provided a rationale for using the DES with parametric statistics. Reasons why the DES (as it was originally designed) is not appropriate as a dependent measure in outcome research are discussed, along with needed future research. Implications of the findings for the clinical usefulness of the DES as a diagnostic instrument are noted.",0,0 +4606,Posttraumatic stress disorder in the new zealand police: The moderating role of social support following traumatic stress,"It has been consistently demonstrated that social support affects psychological outcomes following the experience of trauma. Information processing theories of traumatic stress and empirical evidence suggest a model of social support and Posttraumatic Stress Disorder (PTSD) aetiology, in which emotional support and disclosure moderates the effects of trauma. This model was tested using survey data from 527 New Zealand Police officers. The results showed that all support variables had significant negative main effects on PTSD symptoms. Trauma was positively related to PTSD symptoms and this relationship was moderated by police officers' attitudes to expressing emotions at work and emotional support from peers. These results have implications for the provision of support for workers whose job places them at risk of experiencing multiple trauma.",0,0 +4607,Comorbidities and psychotic illness. Part 1: Philosophy and clinical consequences.,"This article aims at addressing the implications of defining 'comorbidity' within the field of psychiatry. We have looked at the standard definition of comorbidity and then discussed whether this definition can be applied to comorbidities in psychiatry. While comorbidities in physical illness are clearly the coexistence of two independent illnesses, Comorbidities in Mental illness are the result of the polygenic nature of mental illnesses, especially in psychotic illness whether schizophrenia or bipolar disorder. As a consequence, often the comorbidities of psychiatric illness are caused by two conditions which have in common the presence of particular single nucleotide polymorphisms (snps), which regulate the metabolism of neurotransmitters or the presence of neurotrophic factors . Thus inevitably, many such comorbidities are inextricably linked. We discuss the consequences of this form of comorbidity for the description, classification, and risk profile of mental illness.",0,0 +4608,"Trajectories of Boys' Physical Aggression, Opposition, and Hyperactivity on the Path to Physically Violent and Nonviolent Juvenile Delinquency","A semi-parametric mixture model was used with a sample of 1,037 boys assessed repeatedly from 6 to 15 years of age to approximate a continuous distribution of developmental trajectories for three externalizing behaviors. Regression models were then used to determine which trajectories best predicted physically violent and nonviolent juvenile delinquency up to 17 years of age. Four developmental trajectories were identified for the physical aggression, opposition, and hyperactivity externalizing behavior dimensions: a chronic problem trajectory, a high level near-desister trajectory, a moderate level desister trajectory, and a no problem trajectory. Boys who followed a given trajectory for one type of externalizing problem behavior did not necessarily follow the same trajectory for the two other types of behavior problem. The different developmental trajectories of problem behavior also led to different types of juvenile delinquency. A chronic oppositional trajectory, with the physical aggression and hyperactivity trajectories being held constant, led to covert delinquency (theft) only, while a chronic physical aggression trajectory, with the oppositional and hyperactivity trajectories being held constant, led to overt delinquency (physical violence) and to the most serious delinquent acts.",0,0 +4609,"Loss, Trauma, and Human Resilience: Have We Underestimated the Human Capacity to Thrive After Extremely Aversive Events?","Many people are exposed to loss or potentially traumatic events at some point in their lives, and yet they continue to have positive emotional experiences and show only minor and transient disruptions in their ability to function. Unfortunately, because much of psychology's knowledge about how adults cope with loss or trauma has come from individuals who sought treatment or exhibited great distress, loss and trauma theorists have often viewed this type of resilience as either rare or pathological. The author challenges these assumptions by reviewing evidence that resilience represents a distinct trajectory from the process of recovery, that resilience in the face of loss or potential trauma is more common than is often believed, and that there are multiple and sometimes unexpected pathways to resilience.",0,0 +4610,A qualitative analysis of posttraumatic stress among Mexican victims of disaster,"In unstructured interviews, 24 Mexicans described survivors' responses to disasters in Guadalajara, Jalisco (n = 9), Homestead, Florida (n = 6), and Puerto Angel, Oaxaca (n = 9). This analysis assessed the extent to which symptom descriptions corresponded to the 17 criterion symptoms of PTSD. Nineteen participants (79%) mentioned from 1 to 9 criterion symptoms. Event-related distress, hypervigilance, recurrent recollections, and avoiding reminders were described most often. Only 3 criterion symptoms were never described. Twenty participants (83%) provided 109 separate expressions that could not be classified specifically as criterion symptoms. These phrases were sorted by 9 independent Mexican volunteers and cluster analyzed. Clusters composed of ataques de nervios, depression, lasting trauma, and somatic complaints provided the best description of the data.",0,0 +4611,Longitudinal Interactions of Pain and Posttraumatic Stress Disorder Symptoms in U.S. Military Service Members Following Blast Exposure,"

Abstract

Military personnel returning from conflicts in Iraq and Afghanistan often endorse pain and posttraumatic stress disorder (PTSD) symptoms, either separately or concurrently. Associations between pain and PTSD symptoms may be further complicated by blast exposure from explosive munitions. Although many studies have reported on the prevalence and disability associated with polytraumatic injuries following combat, less is known about symptom maintenance over time. Accordingly, this study examined longitudinal interactive models of co-occurring pain and PTSD symptoms in a sample of 209 military personnel (mean age = 27.4 years, standard deviation = 7.6) who experienced combat-related blast exposure. Autoregressive cross-lagged analysis examined longitudinal associations between self-reported pain and PTSD symptoms over a 1-year period. The best-fitting covariate model indicated that pain and PTSD were significantly associated with one another across all assessment periods, χ2 (3) = 3.66, P = .30, Tucker-Lewis index = .98, comparative fit index = 1.00, root mean squared error of approximation = .03. PTSD symptoms had a particularly strong influence on subsequent pain symptoms. The relationship between pain and PTSD symptoms is related to older age, race, and traumatic brain injury characteristics. Results further the understanding of complex injuries among military personnel and highlight the need for comprehensive assessment and rehabilitation efforts addressing the interdependence of pain and co-occurring mental health conditions.

Perspective

This longitudinal study demonstrates that pain and PTSD symptoms strongly influence one another and interact across time. These findings have the potential to inform the integrative assessment and treatment of military personnel with polytrauma injuries and who are at risk for persistent deployment-related disorders.",0,0 +4612,Chronic Pain and Posttraumatic Stress Symptoms in Litigating Motor Vehicle Accident Victims,"There has been little research examining chronic pain and posttraumatic stress symptoms in persons injured in motor vehicle accidents. The purpose of this study was to evaluate differences in physical injury and impairment, psychological distress, and pain coping strategies in litigating chronic pain patients low and high in motor vehicle accident-related posttraumatic stress symptoms.A total of 160 consecutive chronic pain patients referred for psychological-legal assessment underwent semistructured interview and testing. The testing battery included the Minnesota Multiphasic Personality Inventory-2, the Multidimensional Pain Inventory, the Sickness Impact Profile, and the Coping Strategies Questionnaire. Using the sample-specific median split of 18 posttraumatic stress symptoms on the Minnesota Multiphasic Personality Inventory-2 Posttraumatic Stress Disorder scale, chronic pain patients were categorized as evidencing low or high levels of posttraumatic stress symptoms.The findings indicate that participants evidencing high posttraumatic stress symptoms had more physical impairment, psychological distress, and maladaptive pain coping strategies and were more likely to be treated with antidepressants, other medications, and psychological management than participants evidencing low posttraumatic stress symptoms. A discriminant function analysis was performed using the full combination of physical injury and impairment, psychological distress, and pain coping variables in the prediction of posttraumatic stress symptom-defined group membership. The resulting discriminant function accounted for 61% of the between-group variance and correctly classified 92% of participants who were low in posttraumatic stress symptoms and 88% of participants who were high in posttraumatic stress symptoms.Chronic pain and posttraumatic stress symptoms in litigating motor vehicle accident victims are associated with increased physical and psychological morbidity.",0,0 +4613,A Diathesis-Stress Approach to Post-Traumatic Stress Disorder Symptoms Associated with an HIV Diagnosis: Implications for Medication Non-adherence.,"Introduction. We fit a diathesis-stress model with childhood trauma and neuroticism as predictors of depressive and HIV-related PTSD symptomatology in a sample of HIV+ Latino men who have sex with men (MSM). We then examined the impact of depressive and HIV-related PTSD symptomatology on medication adherence. We hypothesized the primary stressor from the diathesis-stress model to be symptoms of dissociation at the time of being diagnosed with HIV. Method. We sampled 149 Latino adult MSM living with HIV at a local HIV treatment clinic in El Paso, Texas. We administered all surveys in paper-and-pencil form, with viral loads and CD4 cell counts extracted from medical charts. Specifically, data were collected on self-reported histories of childhood abuse, trait levels of neuroticism, acculturation to non-Latino culture, accumulated life stressors, depression, HIV and non HIV-related post-traumatic stress symptoms, resilience, functional impairment and medication adherence. All participants were interviewed in either English or Spanish and paid $30 for their participation. Interviews lasted approximately two hours. Results. We observed high levels of childhood sexual abuse (22%) and trauma overall, as well as high rates of mild-to-moderate symptoms of depression (30%). Self-reported medication adherence was high across all measures. We found support for our hypothesized path model as a test of the theoretical structure proposed by the diathesis-stress model. All fit indices were indicative of good model fit. In addition, we found support for the diathesis-stress interaction with dissociation symptoms at the time of diagnosis moderating the relationship between childhood trauma and HIV-related PTSD symptoms. As hypothesized, our regression analyses revealed depression to be negatively correlated with adherence. PTSD symptoms related to HIV were positively associated with adherence, the opposite direction of that hypothesized. Conclusion. The diathesis-stress framework adequately models the relationship among childhood trauma, current levels of psychological distress, and the stress of being diagnosed with HIV. Furthermore, psychological distress is negatively associated with adherence and overall quality of life. Implications for interventions are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0,0 +4614,"A 30-Month Prospective Follow-up Study of Psychological Symptoms, Psychiatric Diagnoses, and Their Effects on Quality of Life in Children Witnessing a Single Incident of Death at School","We explored the course of trauma-related psychological symptoms and psychiatric diagnoses in 167 children who, as fourth graders, witnessed death at school and assessed the long-term effects of their symptoms on quality of life and their parents' rearing stress.167 children were evaluated using diverse self-rating symptom scales at 2 days (T1: May 19, 2007), 2 months (T2: July 16, 2007), 6 months (T3: November 12-17, 2007), and 30 months (T4: November 16-21, 2009) after the accident. All children were interviewed with the Diagnostic Interview Schedule for Children-Version IV (DISC-IV) at T1. High-risk children were assessed with the DISC-IV at T3 and T4. Children's quality of life and parental stress were assessed in all children and parents using the Parenting Stress Index and the Child Health and Illness Profile at T4.The mean scores and prevalence of severe posttraumatic stress disorder (PTSD) and anxiety symptoms decreased significantly over time (P < .001), but depressive symptoms did not. Although the prevalence of DISC-IV-based diverse anxiety disorders decreased significantly over time, 45% of high-risk subjects evaluated with the DISC-IV met criteria for an anxiety or depressive disorder at T4. Linear and logistic regression analyses showed that depressive symptoms at 6 months predicted more severe parental stress (β = 0.51; odds ratio [OR] = 2.88), less satisfaction (β = -0.25; OR = 2.66), and lower achievement (β = -0.41; OR = 1.50) at 30 months. PTSD symptoms were not associated with parental stress or quality of life at T4.This study provides new evidence regarding the long-term course of trauma-related symptoms and diagnostic changes in children exposed to a single trauma. Children's depressive symptoms predicted lower children's quality of life and higher parental rearing stress after 2 years. Careful assessment and management of depressive symptoms can potentially reduce parental stress and improve quality of life of children.",0,0 +4615,Mild traumatic brain injury and posttraumatic stress disorder in returning veterans: Perspectives from cognitive neuroscience,"A significant proportion of military personnel deployed in support of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) has been exposed to war-zone events potentially associated with traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD). There has been significant controversy regarding healthcare policy for those service members and military veterans who returned from OEF/OIF deployments with both mild TBI and PTSD. There is currently little empirical evidence available to address these controversies. This review uses a cognitive neuroscience framework to address the potential impact of mild TBI on the development, course, and clinical management of PTSD. The field would benefit from research efforts that take into consideration the potential differential impact of mild TBI with versus without persistent cognitive deficits , longitudinal work examining the trajectory of PTSD symptoms when index trauma events involve TBI, randomized clinical trials designed to examine the impact of mild TBI on response to existing PTSD treatment interventions, and development and examination of potential treatment augmentation strategies.",0,0 +4616,The importance of looking credible: the impact of the behavioural sequelae of post-traumatic stress disorder on the credibility of asylum seekers,"Memory difficulties following traumatic experiences have been found to result in testimonial inconsistencies, which can affect credibility judgements in asylum decisions. No investigations have looked into how/whether the behavioural sequelae of post-traumatic stress disorder (PTSD) affect decisions. This study aimed to investigate this by looking at whether observable symptoms of PTSD can be confused with perceived cues to deception. An actor performed four versions of a fictional ‘asylum interview’ that contained differing levels of pre-defined ‘deception’ and ‘trauma’ behaviours. Four groups of students (total n = 118) each watched a different interview. They gave subjective ratings of credibility, plus quantitative and qualitative information about the factors that influenced their judgements. Despite the content of the interviews remaining the same, significant differences in credibility ratings were found between interviews; with the interview containing both ‘trauma’ and ‘deception’ behaviours bein...",0,0 +4617,"Clinical evaluation of paroxetine in post-traumatic stress disorder (PTSD): 52-week, non-comparative open-label study for clinical use experience","The present study was a 52-week, non-comparative, open-label study of flexible dose paroxetine (20-40 mg) in 52 Japanese post-traumatic stress disorder (PTSD) patients in order to obtain clinical experience regarding efficacy and safety in regular clinical practice.Efficacy was measured using the Clinician-Administered PTSD Scale One Week Symptom Status Version (CAPS-SX).The mean change from baseline in CAPS-SX total score was -19.1, -22.8 and -32.3 at weeks 4, 12 and 52, respectively, and that in the Clinical Global Impression (CGI) Severity of Illness score was -1.1 at week 12 and -1.7 at week 52. A total of 46.9% were CGI responders at week 12, while 67.3% were improved on the CGI at week 52. Of 52 subjects who entered into the drug treatment, 25 completed the study. Only one patient withdrew from the study due to lack of efficacy. In patients who were rated as 'moderately ill' or less at baseline, the proportion of CGI responders at end-point was higher at a dose of 20 mg/day than at higher doses, whereas in patients rated as 'markedly ill' or more, it was higher at 30 and 40 mg/day, suggesting that severely ill patients could benefit from higher doses.Paroxetine appeared generally tolerated in short- and long-term use, and the safety profile in this study was consistent with international trials and other Japanese populations (i.e. patients suffering from depression, panic disorder or obsessive-compulsive disorder). Although the study was not conducted in double-blind fashion, the current findings suggest that paroxetine may contribute to clinically meaningful improvement that is maintained during long-term use and is generally well tolerated.",0,0 +4618,Schutz- und Risikofaktoren für Traumafolgestörungen,"Theoretischer Hintergrund: Schutzfaktoren und Risikofaktoren tragen zur Prognose, Indikation und Interventionsplanung bei Menschen nach traumatischen Ereignissen bei. Bisherige systematische Reviews fassen die Befunde bis maximal 2007 zusammen und fokussieren auf Posttraumatische Belastungsstörungen. Fragestellung: Systematisches Review unter Einschluss der Befunde für die Jahre 2007 bis 2010 und Berücksichtigung weiterer Traumafolgestörungen. Methode: Analyse von 13 systematischen Reviews und 29 prospektiven Originalarbeiten zu Schutz- und Risikofaktoren für Traumafolgestörungen nach Typ-I-Traumata. Ergebnisse: Es werden Befunde zu prätraumatischen (Soziodemographie, Biographie, psychische Störungen, Persönlichkeitsfaktoren), peritraumatischen (Art und Schwere des Ereignisses, psychische Verfassung während des Ereignisses, peritraumatische Reaktion) und posttraumatischen Faktoren (akute psychische Symptome, Kognitionen, Coping, Vermeidungsverhalten, soziale Unterstützung, zusätzliche Stressoren) dargestellt. Schlussfolgerungen: Vor allem peri- und posttraumatische Schutz- und Risikofaktoren eignen sich für die Vorhersage von Traumafolgestörungen.",0,0 +4619,Identifying Trajectories of Depressive Symptoms for Women Caring for Their Husbands with Dementia,"To use an innovative statistical method, Latent Class Trajectory Analysis (LCTA), to identify and describe subgroups (called trajectories) of caregiver depressive symptoms in a national sample of wives providing informal care for their husbands with dementia.Longitudinal.Community.Respondents to the National Longitudinal Caregiver Survey were wife caregivers of veterans with dementia who were identified through Veterans Affairs hospitals nationally.Mean number of depressive symptoms as measured using the Center for Epidemiologic Studies Depression scale (CES-D, 20-item scale).Overall mean depressive symptoms of wife caregivers were 6.2 of 20, below the cutpoint (8 or 9/20) associated with clinical depression. Four distinct trajectories of caregiver depressive symptoms were identified. The trajectory with the highest number of symptoms (11.9 of 20), contained one-third of the sample. Another third had mean depressive symptoms virtually identical to the overall sample mean. The final third were divided between two trajectories, low depressive symptoms (mean CES-D, 3.0/20, 22% of sample) and very low (mean CES-D, 0.8/20, 14% of sample). Approximately two-thirds of the sample members were in a depressive symptom trajectory, with substantially higher or lower numbers of symptoms than the overall mean. Two subjective measures asked of wife caregivers (desire for more help, life satisfaction) were significantly associated with membership in the highest depressive symptom trajectory.LCTA identified important depressive symptom subgroups of wife caregivers. A population-averaging method identified a mean effect that was similar to the effect in one-third of the cases but substantially different from that in two-thirds of the cases.",0,0 +4620,Pharmacotherapy for Southeast Asian Psychiatric Patients,"Refugees have been demonstrated to be at high risk for developing major depressive and posttraumatic stress disorders, but are often not able to benefit from modern advances in psychopharmacology. Besides difficulties in cross-cultural psychiatric diagnosis, problems also arise from cultural differences in the expectation of drug effects and in compliance. Recent evidence has suggested that pharmacokinetic and pharmacodynamic profiles of various psychotropic medications may be different in Asians than in non-Asian patients, leading to differences in dosage requirements and side effect profiles. These issues and their relevance to the care of refugee patients are reviewed.",0,0 +4621,Growth Curve Trajectories of Distress in Burn Patients,"Psychological adjustment after a major burn injury is a significant concern to providers and patients alike. Although efforts have been made to identify associated risk factors, little is known about heterogeneity in the levels or trajectories of adjustment in this population. This study used a novel application of Growth Mixture Modeling to identify subgroups of patients based on their longitudinal self-reported distress using the Brief Symptom Inventory (BSI). Data were drawn from the database of the Burn Model Systems project, a prospective, multisite, cohort study of major burn injury survivors. The BSI was used to assess symptoms in-hospital and at 6, 12, and 24 months postburn. Participants' T scores on the BSIs Global Severity Index provided a continuous measure of psychological distress. Analyses were conducted using participants' Global Severity Index T scores to discern distinct classes of respondents with similar trajectories across the 2-year follow-up. Results from the Growth Mixture Modeling analysis produced an ordered four-class model of psychological recovery from a major burn. Groups represented the equivalent of high, subthreshold, mild, and minimal symptom severity. Covariates significantly affected the intercept and slope of each class, as well as prediction of group assignment. These analyses demonstrate differences between individual recoveries after a major burn. Psychological distress symptoms remain largely stable over time and highlight the psychological vulnerability of this patient population.",1,0 +4622,A process-based approach to characterizing the effect of acute alprazolam challenge on visual paired associate learning and memory in healthy older adults,"Objective Alprazolam is a benzodiazepine that, when administered acutely, results in impairments in several aspects of cognition, including attention, learning, and memory. However, the profile (i.e., component processes) that underlie alprazolam-related decrements in visual paired associate learning has not been fully explored. Methods In this double-blind, placebo-controlled, randomized cross-over study of healthy older adults, we used a novel, “process-based” computerized measure of visual paired associate learning to examine the effect of a single, acute 1-mg dose of alprazolam on component processes of visual paired associate learning and memory. Results Acute alprazolam challenge was associated with a large magnitude reduction in visual paired associate learning and memory performance (d = 1.05). Process-based analyses revealed significant increases in distractor, exploratory, between-search, and within-search error types. Analyses of percentages of each error type suggested that, relative to placebo, alprazolam challenge resulted in a decrease in the percentage of exploratory errors and an increase in the percentage of distractor errors, both of which reflect memory processes. Conclusions Results of this study suggest that acute alprazolam challenge decreases visual paired associate learning and memory performance by reducing the strength of the association between pattern and location, which may reflect a general breakdown in memory consolidation, with less evidence of reductions in executive processes (e.g., working memory) that facilitate visual paired associate learning and memory. Copyright © 2012 John Wiley & Sons, Ltd.",0,0 +4623,Trauma and post-traumatic stress disorder in a drug treatment community service,"Aims and method A cross-sectional study aiming to assess the prevalence of trauma and post-traumatic stress disorder (PTSD) in a community substitution treatment sample, and to assess and compare the characteristics of traumatic experience, substance use, and psychological and social factors in those with and without PTSD. All assessments were completed during the interview which took approximately 1.5 h. Results The prevalence for current PTSD was 26.2% and for lifetime PTSD 42.9%. Traumatic experiences were extremely common, with two or more reported by 92.9% of the sample. The two groups differed significantly on the majority of psychological functioning and social variables, with women experiencing higher rates of PTSD and the non-PTSD group having lower rates of psychological impairment. Clinical implications The research supported findings from previous studies. The very high incidence of traumatic experiences has not been reported before. Training and information about trauma and PTSD for substance misuse workers are therefore necessary so that PTSD can be more easily detected and treated.",0,0 +4624,"Psychological vulnerability, ventricular tachyarrhythmias and mortality in implantable cardioverter defibrillator patients: is there a link?","Implantable cardioverter defibrillator (ICD) therapy is the first-line treatment for the prevention of sudden cardiac death. Despite the demonstrated survival benefits of the ICD, predicting which patients will die from a ventricular tachyarrhythmia remains a major challenge. So far, psychological factors have not been considered as potential risk markers that might enhance the prediction of sudden cardiac death. This article evaluates the evidence for a link between psychological vulnerability, ventricular tachyarrhythmias and mortality and the pathways that might explain such a link. This review demonstrates that there is cumulative evidence supporting a link between psychological vulnerability and risk of ventricular tachyarrhythmias and mortality in ICD patients independent of disease severity and other biomedical risk factors. It may be premature to include psychological factors in risk algorithms, but information on the psychological profile of the patient may help to optimize the management and care of these patients in clinical practice.",0,0 +4625,Intervention effectiveness among war-affected children: A cluster randomized controlled trial on improving mental health,"We examined the effectiveness of a psychosocial intervention in reducing mental health symptoms among war-affected children, and the role of peritraumatic dissociation in moderating the intervention impact on posttraumatic stress symptoms (PTSS). School classes were randomized into intervention (n = 242) and waitlist control (n = 240) conditions in Gaza, Palestine. The intervention group participated in 16 extracurriculum sessions of teaching recovery techniques (TRT) and the controls received normal school-provided support. Participants were 10- to 13-year-old Palestinian girls (49.4%) and boys (50.6%). Data on PTSS, depressive symptoms, and psychological distress were collected at baseline (T1), postintervention (T2), and 6-month follow-up (T3). Peritraumatic dissociation was assessed only at baseline. Regression analyses that took regression to the mean and cluster sampling into account were applied. The results on intervention effectiveness were specific to gender and peritraumatic dissociation. At T2, the intervention significantly reduced the proportion of clinical PTSS among boys, and both the symptom level (R(2) = .24), and proportion of clinical PTSS among girls who had a low level of peritraumatic dissociation. The results have implications for risk-specific tailoring of psychosocial interventions in war conditions.",0,0 +4626,Psychosocial Stress in Marine Corps Officers,"Stress research in military populations has largely been devoted to specialized situations ""at risk"" for high levels of stress, such as combat, recruit training, sea duty, as well as post-traumatic stress in veterans. Though the armed forces continue to train for war during peacetime, military personnel also carry out administrative, executive, and technical job functions not directly related to combat preparations. Little data exists researching stress experienced in military non-combat environments. A study was conducted assessing levels of stress of 900 Marine Corps officers assigned to various headquarters and stations. Randomly selected participants completed the Derogatis Stress Profile (DSP). The study examined stress as a function of rank and the individual officer's perception of stress. Total stress levels of the subjects were compared to those used to norm the DSP.",0,0 +4627,Multi-disciplinary Care for the Elderly in Disasters: An Integrative Review,"Abstract Introduction Older adults are disproportionately affected by disaster. Frail elders, individuals with chronic diseases, conditions, or disabilities, and those who live in long-term care facilities are especially vulnerable. Purpose The purpose of this integrative review of the literature was to describe the system-wide knowledge and skills that multi-disciplinary health care providers need to provide appropriate care for the elderly during domestic-humanitarian and disaster-relief efforts. Data sources A systematic search protocol was developed in conjunction with a research librarian. Searches of PubMed, CINAHL, and PsycINFO were conducted using terms such as Disaster, Geological Processes, Aged, Disaster Planning, and Vulnerable Populations. Forty-six articles met criteria for inclusion in the review. Conclusions Policies and guidance regarding evacuating versus sheltering in place are lacking. Tenets of elderly-focused disaster planning/preparation and clarification of legal and ethical standards of care and liability issues are needed. Functional capacity, capabilities, or impairments, rather than age, should be considered in disaster preparation. Older adults should be included in disaster planning as population-specific experts. Implications for Practice A multifaceted approach to population-specific disaster planning and curriculum development should include consideration of the biophysical and psychosocial aspects of care, ethical and legal issues, logistics, and resources. Johnson HL , Ling CG , McBee EC . Multi-disciplinary care for the elderly in disasters: an integrative review . Prehosp Disaster Med . 2015 ; 30 ( 1 ): 1 - 8 .",0,0 +4628,A Longitudinal Study of Secondary Posttraumatic Growth in Wives of Ex-POWs.,"The current study aimed to investigate (a) ""secondary"" posttraumatic growth (PTG) in wives of former prisoners of war (ex-POWs) and its association to husbands' captivity, husbands' posttraumatic stress disorder (PTSD), and husbands' PTSD trajectories; and (b) the bidirectional relationships over time between wives' posttraumatic stress symptoms (PTSS) and PTG.The study compared 116 wives of Israeli ex-POWs from the 1973 Yom Kippur War with 56 wives of a matched control group of non-POW combat veterans. Wives were divided into groups according to husbands' captivity status, husbands' PTSD status, and husbands' PTSD trajectories; and ANOVAs and MANOVAs were conducted to assess group differences in PTSS and PTG, both cross-sectionally and longitudinally. Autoregressive cross-lag modeling was also used to assess bidirectional relationships between wives' PTSS and PTG over time.Wives of ex-POWs with PTSD reported significantly higher PTG compared with wives of ex-POWs without PTSD and wives of controls. While PTG and PTSS remained stable over time, importantly, the Time 1 (T1) level of PTG predicted avoidance symptoms at Time 2 (T2); the higher the wives' PTG at T1, the higher their avoidance symptoms at T2, but not vice versa.These findings support the notion that ""secondary PTG"" exists. They also strengthen the theory that growth and distress can co-occur. Finally, the finding that PTG predicted subsequent avoidance symptoms suggests that PTG does not prevent the future development of distress.",0,0 +4629,Coping with Missing Data,,0,0 +4630,Communication in Military Families Across the Deployment Cycle,,0,0 +4631,Post-traumatic stress symptoms in cancer survivors: relationship to the impact of cancer scale and other associated risk factors,"The purpose of this study was to determine the prevalence of post-traumatic stress symptoms in a sample of cancer survivors and to investigate their association with the impact of cancer, depressive symptoms, and social support.We administered a survey to participants in a cancer survivor registry. It included: Post-Traumatic Stress Disorder Checklist-Civilian version (PCL-C), Impact of Cancer Scale (IOC) v.2, and measures of social support, income, and long-term effects of cancer. We performed multivariate analyses to estimate associations between PCL-C and other variables. PCL-C score was examined as a continuous dependent variable and categorically.Responses were available from 162 cancer survivors. Mean age was 51 years (standard deviation (SD) 16); mean time since diagnosis was 11 years (SD 10). Mean PCL-C score was 27 (SD 9, range 17-64); 29% of the sample scored 30 and above, 13% scored 38 and above, 7% scored 44 and above. Linear regression indicated that PCL-C scores were significantly associated with the IOC negative impact summary scale (NIS) (p < 0.001), depressive symptoms (p = 0.003), less social support (p = 0.02), and lower income (p = 0.03). NIS subscale analyses showed that two subscales, life interference (LI) and worry (W), were significantly correlated with PCL-C score (LI: p < 0.001; W: p = 0.02).In this study, the IOC NIS was associated with endorsement of PTSD symptoms. Assessing survivors for PTSD symptoms with the PCL-C could detect those individuals in need of psychosocial support. The IOC may be useful for identifying target areas for interventions to reduce these symptoms among cancer survivors.",0,0 +4632,Quetiapine-induced peripheral edema,"Quetiapine fumarate is an atypical antipsychotic with relatively benign side-effect profile. Here we report a rare side-effect of quetiapine use. This is the second reported case of peripheral edema with quetiapine use. Unaware of this rare side-effect, patient had to endure extensive investigations.",0,0 +4633,"Post-traumatic stress disorder in children and adolescents one year after a super-cyclone in Orissa, India: exploring cross-cultural validity and vulnerability factors","It has been asserted that psychological responses to disasters in children and adolescents vary widely across cultures, but this has rarely been investigated. The objectives of the study were to clinically evaluate the construct of traumatic stress symptoms and disorder in children and adolescents after a super-cyclone in Orissa, India; to find out the prevalence at one year; compare the effect in high and low exposure areas and study the factors associated with it.Clinical examination of children and adolescents (n = 447) was done, supplemented by a symptoms checklist based on International Classification of Mental and Behavioural Disorders, Diagnostic Criteria for Research and a semi-structured questionnaire for disaster related experiences.A majority of children had post-traumatic symptoms. Post-traumatic stress disorder (PTSD) was present in 30.6% (95% confidence interval: 26.4 to 34.9), and an additional 13.6% had sub-syndromal PTSD. Parents or teachers reported mental health concerns in 7.2% subjects, who were a minor proportion (12.8%) of subjects with any syndromal diagnosis (n = 196). Significantly more (43.7%) children in high exposure areas had PTSD than that (11.2%) in low exposure areas (p < 0.001). Depression was significantly associated with PTSD. Binary logistic regression analysis indicated that high exposure, lower educational level and middle socioeconomic status significantly predicted the outcome of PTSD. Extreme fear and perceived threat to life during the disaster, death in family, damage to home, or staying in shelters were not significantly associated with PTSD.Following natural disaster PTSD is a valid clinical construct in children and adolescents in Indian set up; and though highly prevalent it may be missed without clinical screening. Its manifestation and associated factors resembled those in other cultures.",0,0 +4634,"Brain-derived neurotrophic factor in traumatic brain injury, post-traumatic stress disorder, and their comorbid conditions: role in pathogenesis and treatment","As US military service members return from the wars in Iraq and Afghanistan with elevated rates of traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD), attention has been increasingly focused on TBI/PTSD comorbidity, its neurobiological mechanisms, and novel and effective treatment approaches. TBI and PTSD, and their comorbid conditions, present with a spectrum of common clinical features such as sleep disturbance, depression, anxiety, irritability, difficulty in concentrating, fatigue, suicidality, chronic pain, and alterations in arousal. These TBI and PTSD disorders are also thought to be characterized by overlapping neural mechanisms. Both conditions are associated with changes in hippocampal, prefrontal cortical, and limbic region function because of alterations in synaptogenesis, dendritic remodeling, and neurogenesis. Neural changes in TBI and PTSD result from pathophysiological disturbances in metabolic, cytotoxic, inflammatory, and apoptic processes, amongst other mechanisms. Neurotrophins have well-established actions in regulating cell growth and survival, differentiation, apoptosis, and cytoskeleton restructuring. A body of research indicates that dysregulation of neural brain-derived neurotrophic factor (BDNF) is found in conditions of TBI and PTSD. Induction of BDNF and activation of its intracellular receptors can produce neural regeneration, reconnection, and dendritic sprouting, and can improve synaptic efficacy. In this review, we consider treatment approaches that enhance BDNF-related signaling and have the potential to restore neural connectivity. Such treatment approaches could facilitate neuroplastic changes that lead to adaptive neural repair and reverse cognitive and emotional deficits in both TBI and PTSD.",0,0 +4635,"The heritability of mental health and wellbeing defined using COMPAS-W, a new composite measure of wellbeing","Mental health is not simply the absence of mental illness; rather it is a distinct entity representing wellness. Models of wellbeing have been proposed that emphasize components of subjective wellbeing, psychological wellbeing, or a combination of both. A new 26-item scale of wellbeing (COMPAS-W) was developed in a cohort of 1669 healthy adult twins (18-61 years). The scale was derived using factor analysis of multiple scales of complementary constructs and confirmed using tests of reliability and convergent validity. Bivariate genetic modeling confirmed its heritability. From an original 89 items we identified six independent subcomponents that contributed to wellbeing. The COMPAS-W scale and its subcomponents showed construct validity against psychological and physical health behaviors, high internal consistency (average r=0.71, Wellbeing r=0.84), and 12-month test-retest reliability (average r=0.62, Wellbeing r=0.82). There was a moderate contribution of genetics to total Wellbeing (heritability h(2)=48%) and its subcomponents: Composure (h(2)=24%), Own-worth (h(2)=42%), Mastery (h(2)=40%), Positivity (h(2)=42%), Achievement (h(2)=32%) and Satisfaction (h(2)=43%). Multivariate genetic modeling indicated genetic variance was correlated across the scales, suggesting common genetic factors contributed to Wellbeing and its subcomponents. The COMPAS-W scale provides a validated indicator of wellbeing and offers a new tool to quantify mental health.",0,0 +4636,Posttraumatic stress disorder and psychiatric co-morbidity following stroke: The role of alexithymia,"More research is needed to further our understanding of posttraumatic stress disorder symptoms (PTSD) and psychiatric co-morbidity following stroke, especially the trajectories of such symptoms over time. Previous studies suggest that exposure to a traumatic experience such as stroke is not sufficient to explain the etiology of PTSD. Alexithymia may be involved, but its relationships with PTSD and psychiatric co-morbidity following stroke remains unclear. This study aims to address these knowledge gaps. While in hospital, stroke patients (n=90) completed questionnaires assessing PTSD symptoms, psychiatric co-morbidity, alexithymia and physical disability. PTSD symptoms and psychiatric co-morbidity were re-assessed approximately 3 months post-stroke (n=78). The severity of post-stroke PTSD did not change significantly over time, while psychiatric co-morbidity reduced significantly. Alexithymia, in particular difficulty in identifying feelings, was associated with severity of post-stroke PTSD and psychiatric co-morbidity at baseline, but after adjusting for these, there was no significance 3 months post-stroke. We suggest that patients' difficulty in identifying feelings had a role to play in influencing relatively short-term rather than long-term PTSD and co-morbid psychiatric symptoms. Alternatively, PTSD could be interpreted as driving the alexithymic characteristics.",0,0 +4637,Posttraumatic stress disorder symptom severity predicts aggression after treatment,"This study examined the relation between posttraumatic stress disorder (PTSD) severity and aggression (verbal, psychological, and physical aggression) in a longitudinal dataset. Participants were 175 males in PTSD residential treatment who were assessed at pre-treatment, post-treatment, and at 4-month follow-up. Post-treatment PTSD severity predicted aggression at post-treatment and 4-month follow-up, adjusting for age, pre-treatment PTSD severity, and pre-treatment aggression. When examining the relation between aggression and specific PTSD symptom clusters, post-treatment Reexperiencing, Avoidance/Numbing and Hyperarousal symptoms predicted aggression at posttreatment and 4-month follow-up. These results support the hypothesis that post-treatment PTSD severity may be an important marker of post-treatment aggression risk and may offer unique information important to clinicians and patients focused on the development and maintenance of adaptive, non-aggressive relationships after intensive PTSD treatment.",0,0 +4638,Paraphilia from a Dissociative Perspective,"A dissociative structural model of the psyche can account for a wide range of symptoms across many DSM-IV categories, including sexual compulsions and addictions. The model leads to a distinct overall plan of treatment and a set of operationalized interventions aimed at integration of the self, rather than suppression of impulses. The model could be tested first in epidemiological studies and later in treatment outcome studies.",0,0 +4639,Glucocorticoid Functioning in Male Combat Veterans with Posttraumatic Stress Disorder and Mild Traumatic Brain Injury,"Explored glucocorticoid functioning in male combat veterans with posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). Of the total sample of 122 male veterans, 32 reported one or more brain injuries with loss of consciousness lasting <10 min and were designated as having a history of mTBI. To evaluate the influence of PTSD and mTBI on neuroendocrine measures, a series of linear regression equations was estimated. Combat veterans with mTBI also tended to have less severe current and lifetime PTSD symptoms whether comorbid with PTSD or not. Veterans who reported a history of mTBI were rated as having lower current reexperiencing, hyperarousal, and total CAPS scores compared with veterans without prior history of mTBI. Follow-up analyses on the current CAPS intensity and frequency scores revealed that the lower reexperiencing and hyperarousal scores in people with mTBI were attributed to lower frequency, but not lower intensity. Insofar as PTSD has been shown to be associated with greater glucocorticoid sensitivity, the two conditions may have opposing effects when they are present in the same individual. Group contrasts comparing people with PTSD with people without PTSD on measures reflecting glucocorticoid receptor sensitivity may be diminished if the presence of TBI is not considered. (PsycINFO Database Record (c) 2015 APA, all rights reserved)",0,0 +4640,Psychosocial correlates of depression following spinal injury: A systematic review,"Spinal cord injury (SCI) studies have identified a range of psychosocial risk and protective factors for depression post-injury. This study presents the first systematic and quantitative review of this body of research.Twenty-four studies (N=3172 participants) were identified through electronic database searches. Studies were evaluated according to recommended guidelines on Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). The significance and magnitude of the relationships between standardised measures of depression and psychosocial outcome were examined using Pearson's effect size r, 95% confidence intervals and fail-safe Ns. Effect sizes were categorised according to the ICF psychosocial domains.STROBE ratings indicated discrepancies in procedural detail and statistical analyses. Individual personal variables including affective feelings, and thoughts and beliefs specific to SCI demonstrated the strongest relationship with depression self-ratings. Life satisfaction, disability acceptance, environmental supports and community participation had a medium to strong association, helping to reduce vulnerability to depression. Longitudinal studies revealed that symptoms of depression continued to impact on psychosocial outcome up to 10 years post-injury, although this was based on limited data.Assessment of psychosocial factors in the acute stages of SCI rehabilitation can inform evidence-based interventions to treat and manage depressive symptomatology in the short to longer-term. Future studies would benefit from adopting a unified approach to the measurement of depression post-SCI to help inform targeted treatment.",0,0 +4641,DO COGNITIVE AND EXPOSURE TREATMENTS IMPROVE VARIOUS PTSD SYMPTOMS DIFFERENTLY? A RANDOMIZED CONTROLLED TRIAL,"This study (part of a larger one whose main outcomes were reported by Marks, Lovell, Noshirvani, Thrasher, & Livanou, 1998) investigated the impact of exposure therapy and cognitive restructuring alone and combined on the individual symptoms of PTSD and on associated features. Exposure therapy was expected to act mainly on fear and avoidance, and cognitive restructuring mainly on detachment, restricted range of affect, and associated features of PTSD. Seventy-seven PTSD outpatients were randomly allocated to one of four treatments: 1) exposure alone; 2) cognitive restructuring alone; 3) combined exposure and cognitive restructuring; or 4) relaxation (placebo control). The active treatments were superior to relaxation in improving clusters of PTSD symptoms and associated features and some but not all individual symptoms and associated features of PTSD. Exposure and cognitive restructuring improved almost all individual symptoms similarly.",0,0 +4642,A prospective examination of delayed onset PTSD secondary to motor vehicle accidents.,"Seven participants who did not meet the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; American Psychiatric Association, 1987) criteria for posttraumatic stress disorder (PTSD) 1-4 months post- motor vehicle accident (MVA) and developed delayed onset PTSD during a 1-year follow-up interval were compared with 38 MVA controls who did not develop PTSD, as well as to 62 MVA participants who met criteria for acute onset PTSD on variables related to demographics, pre-MVA functioning, post-MVA functioning, and follow-up. The delayed onset participants were more symptomatic at the time of the initial interview than the controls. The delayed onset participants had poorer social support than the controls prior to and after the MVA. For the month prior to the MVA, the delayed onset participants had lower Global Assessment of Functioning scores than the controls.",0,0 +4643,Fluoxetine and norfluoxetine stereospecifically and selectively increase brain neurosteroid content at doses that are inactive on 5-HT reuptake,"It has recently become more clearly understood that in human brain pathophysiology, neurosteroids play a role in anxiety disorders, premenstrual syndrome, postpartum depression, posttraumatic stress disorder, and depression. In the treatment of major depression, recent clinical studies indicate that the pharmacological profiles of fluoxetine and fluvoxamine are correlated with the ability of these drugs to increase the brain and cerebrospinal fluid content of allopregnanolone (Allo), a potent positive allosteric modulator of gamma-aminobutyric acid (GABA) action at GABAA receptors. Thus, the neurosteroid-induced positive allosteric modulation of GABA action at GABA A receptors is facilitated by fluoxetine or its congeners (i.e., paroxetine, fluvoxamine, sertraline), which may not block 5-HT reuptake at the doses currently prescribed in the clinic. However, these doses are effective in the treatment of premenstrual dysphoria, anxiety, and depression. In socially isolated mice, we tested the hypothesis that fluoxetine, norfluoxetine, and other specific serotonin reuptake inhibitor (SSRI) congeners stereoselectively upregulate neurosteroid content at doses insufficient to inhibit 5-HT reuptake; although they potentiate pentobarbital-induced sedation and exert antiaggressive action. Very importantly, the inhibition of 5-HT reuptake lacks stereospecificity and requires fluoxetine and norfluoxetine doses that are 50-fold greater than those required to increase brain Allo content, potentiate the action of pentobarbital, or antagonize isolation-induced aggression. Based on these findings, it could be inferred that the increase of brain Allo content elicited by fluoxetine and norfluoxetine, rather than the inhibition selective of 5-HT reuptake, may be operative in the fluoxetine-induced remission of the behavioral abnormalities associated with mood disorders. Therefore, the term ""SSRI"" may be misleading in defining the pharmacological profile of fluoxetine and its congeners. To this extent, the term ""selective brain steroidogenic stimulants"" (SBSSs) could be proposed. (",0,0 +4644,Psychological Inflexibility and Psychopathology in 9-1-1 Telecommunicators,"Mental health in 9-1-1 telecommunicators has been understudied in comparison to other emergency responders. This study enrolled a sample of telecommunicators from across the United States (N = 808). As measured by self-report, the prevalence of current probable posttraumatic stress disorder (PTSD) was 17.6% to 24.6%; it was 23.9% for probable major depression. Structural equation modeling revealed a significant direct effect of psychological inflexibility on psychopathology (path coefficient = .32) when considered among duty-related distress and dissociation, neuroticism, anger, and emotion dysregulation. The results provided further evidence of the adverse psychological effects of duty-related trauma exposure, including exposure that is vicarious in nature. The results indicate a need for prevention and intervention in this population, with psychological inflexibility as a potential target in these efforts.",0,0 +4645,Post-traumatic stress disorder (PTSD) treatment experience in Bedford East - audit and reaudit.,"Post-traumatic stress disorder (PTSD) can develop following exposure to a stressful event of an exceptionally threatening or catastrophic nature. Symptoms experienced by PTSD suffers can include re-experiencing the trauma through intrusive 'flashbacks' and recurrent dreams or nightmares, avoidance of stimuli associated with the stressor, hyperarousal, emotional blunting and an inability to remember aspects of the period of exposure to the stressor. We performed an audit of the treatment of PTSD in patients under the care of the Bedford East Mental Health Team to examine the psychological and pharmacological treatments currently being used and compared these with data collected in 2008. In summary, in the last 2 years there has been an increase in the identification of PTSD patients in Bedford East. These patients are a group with high levels of comorbidities and risk factors, and are challenging to treat. As a result of this, a wide range of agents including antidepressants with augementation, mood stabilizers and antipsychotic agents are used in their treatment, many of which are outside of NICE guidelines. There appears to be less availability of psychological therapy in these patients than we would expect. We discuss reasons for this and suggest possible solutions.",0,0 +4646,Effects of the 1992 Los Angeles civil unrest: Post traumatic stress disorder symptomatology among law enforcement officers,"Abstract This study examined the psychological impact of the April 29, 1992 Los Angeles civil unrest on the stress levels of law enforcement officers. Levels of Post Traumatic Stress Disorder (PTSD) symptomatology in Los Angeles Police Department (LAPD) officers assigned to a major riot area were evaluated. Factors implicated in individual coping processes after a traumatic event were examined. Furthermore, police officers' perceptions of the event were examined. One hundred forty-one officers (123 males, 18 females) assigned to two South Central Los Angeles police precincts during the Los Angeles, April 1992 disturbances replied to the questionnaire. The questionnaire included four instruments: The Mississippi Scale for Combat-Related PTSD, Moos' Coping Responses Inventory, the Police Perception Survey, and a demographic survey. The results indicate that 17 percent of the officers who responded are experiencing stress symptomatology. Findings further indicate that these officers are twice as likely to use approximately twice the avoidance coping strategies than are their counterparts without symptomatology. Results indicate a positive relationship of PTSD symptomatology with cognitive avoidance, acceptance or resignation, and emotional discharge; and they suggest an inverse relationship between PTSD symptomatology and seeking support and information, and seeking alternative rewards.",0,0 +4647,Psychological morbidity associated with motor vehicle accidents,"Fifty victims of recent motor vehicle accidents (MVAs), who had sought medical attention after their accidents, were assessed for possible psychological morbidity as a result of the accident. Forty age, gender-matched controls were also assessed with the same instruments. Forty-six percent of the MVA victims met the criteria for current post-traumatic stress disorders (PTSD) as a result of the accident while 20% showed a sub-syndromal version (the reexperiencing symptom cluster plus either the avoidance/numbing cluster or the over-arousal cluster) of PTSD. Although all MVA victims showed some form of driving reluctance, only 1 S met the criteria for driving phobia. Those MVA victims who met the criteria for PTSD or sub-syndromal PTSD were significantly more likely to have experienced previous trauma, other than a serious MVA, and were more likely (P = 0.008) to have previously met the criteria for PTSD as a result of that trauma. Forty-eight percent of MVA victims who met the criteria for current PTSD also met the criteria for current major depression. Significantly more current MVA-PTSDs had suffered previous major depressive episodes.",0,0 +4648,"Children's risk and resilience following a natural disaster: Genetic vulnerability, posttraumatic stress, and depression","We examined children's risk and resilience following a natural disaster, evaluating the role of stress, social support, and two genetic markers: the short allele of the serotonin transporter gene (5-HTTLPR), and the met allele of the Brain-Derived Neurotrophic Factor (BDNF).Under high levels of hurricane exposure or hurricane-related stressors, we expected children displaying the markers would report greater symptoms of posttraumatic stress disorder (PTSD) and depression than children without these markers. Social support was explored as an additional moderating variable.Eight months after Hurricane Ike, 116 children (M age=8.85 years, SD=.89; 54% girls) residing in Galveston, Texas, provided saliva samples and completed measures of hurricane exposure and stress, and symptoms of PTSD and depression; 80 also completed a social support measure.For BDNF, analyses revealed several Gene by Environment interactions; greater stress was related to more symptoms of PTSD and depression, and this effect was stronger for children with the met allele. No findings emerged for 5-HTTLPR. Stressors and social support also were associated with children's PTSD and depressive symptoms.Findings should be tempered by the relatively small sample, especially for analysis that included social support.The met allele (BDNF) may play a role in children's disaster reactions. Further research should consider the complex interplay between genes, stressors, support, and psychological outcomes over time.",0,0 +4649,A Victim Typology of Sexual Harassment,"A clinical sample of 20 sexual harassment victims who were successful in obtaining damage awards for trauma through the judicial system were sources of this descriptive study. Ratings of physical coercion of the harassment, MMPI–2 scores, and ratings on DSM–IV symptoms were analyzed. The majority of subjects met the DSM–IV criteria of Post-Traumatic Stress Disorder. A cluster analysis identified four clusters of harassment victims, described as older-mature, younger-mature, anxious-guilty, and expressive-adaptive based on MMPI–2 scores and symptoms.",0,0 +4650,Post-traumatic stress disorder and medication adherence: Results from the Mind Your Heart Study,"Patients with post-traumatic stress disorder (PTSD) are at increased risk for adverse outcomes from comorbid medical conditions. Medication non-adherence is a potential mechanism explaining this increased risk.We examined the association between PTSD and medication adherence in a cross-sectional study of 724 patients recruited from two Department of Veterans Affairs Medical Centers between 2008 and 2010. PTSD was assessed using the Clinician Administered PTSD Scale. Medication adherence was assessed using a standardized questionnaire. Ordinal logistic regression models were used to calculate the odds ratios (ORs) for medication non-adherence in patients with versus without PTSD, adjusting for potential confounders.A total of 252 patients (35%) had PTSD. Twelve percent of patients with PTSD reported not taking their medications as prescribed compared to 9% of patients without PTSD (unadjusted OR 1.85, 95% CI 1.37-2.50, P<0.001). Forty-one percent of patients with PTSD compared to 29% of patients without PTSD reported forgetting medications (unadjusted OR 1.90, 95% CI 1.44-2.52, P<0.001). Patients with PTSD were also more likely to report skipping medications (24% versus 13%; unadjusted OR 2.01, 95% CI 1.44-2.82, P<0.001). The association between PTSD and non-adherence remained significant after adjusting for demographics, depression, alcohol use, social support, and medical comorbidities (adjusted OR 1.47, 95% CI 1.03-2.10, P=0.04 for not taking medications as prescribed and 1.95, 95% CI 1.31-2.91, P=0.001 for skipping medications).PTSD was associated with medication non-adherence independent of psychiatric and medical comorbidities. Medication non-adherence may contribute to the increased morbidity and mortality observed in patients with PTSD.",0,0 +4651,The Australian Vietnam Veterans Health Study: III. Psychological Health of Australian Vietnam Veterans and its Relationship to Combat,"Self-reported psychiatric status of Australian Vietnam war veterans was determined 20-25 years after the war and its relation to combat was investigated.A simple random sample of Australian Army Vietnam veterans was interviewed nationally using standardized interviews and self-completion tests to assess the prevalence of lifetime and current psychiatric illness and its relationship to combat. Army records were used to extract data on the cohort for use in regression-based adjustment for non-response.The conditions mainly affecting the Australian veterans were alcohol abuse or dependence, post-traumatic stress disorder, somatization disorder were significantly related to combat exposure but not with posting to a combat unit. Less than half of the current one-month diagnoses were related to combat, possibly because of low power conferred by the relative rarity of these conditions.The results confirm a range of psychological problems in former warriors may linger 20 or more years from their war exposure and may be directly affected by exposure to war trauma.",0,0 +4652,Predictors of General Health After Major Trauma,"Traumatic injury is a leading contributor to the global burden of disease, yet there has been little research on possible predictors of general health after major trauma. This study aims to explore possible predictors of general health after major physical trauma.A survey was performed of 731 surviving consecutive adult patients presenting to a major trauma center with accidental major trauma, between 1 year and 5 years postinjury. Data pertaining to general patient factors, injury severity factors, socioeconomic factors, and claim-related factors were abstracted from the hospital trauma database and the questionnaire. Multiple linear regression was used to develop a predictive model for the main outcome, the physical and mental component summaries of the SF-36 General Health Survey.One hundred and forty nine patients were excluded, 93 refused to participate, and 134 did not respond, leaving 355 participants. On multivariate analysis, better physical health was significantly associated with increasing time since the injury and lower Injury Severity Scores (p = 0.03 and 0.02, respectively). Having a settled compensation claim, having an unsettled compensation claim, and using a lawyer were independently associated with poor physical health (p = 0.02, 0.006, and <0.0001, respectively). Measures of injury severity or socioeconomic status were not associated with mental health. However, having an unsettled compensation claim was strongly associated with poor mental health (p < 0.0001).General health after major physical trauma is more strongly associated with factors relating to compensation than with the severity of the injury. Processes involved with claiming compensation after major trauma may contribute to poor patient outcomes.",0,0 +4653,Latent Class Growth Modelling: A Tutorial,The present work is an introduction to Latent Class Growth Modelling (LCGM). LCGM is a semi‐parametric statistical technique used to analyze longitudinal data. It is used when the data follows a pattern of change in which both the strength and the direction of the relationship between the independent and dependent variables differ across cases. The analysis identifies distinct subgroups of individuals following a distinct pattern of change over age or time on a variable of interest. The aim of the present tutorial is to introduce readers to LCGM and provide a concrete example of how the analysis can be performed using a real‐world data set and the SAS software package with accompanying PROC TRAJ application. The advantages and limitations of this technique are also discussed.,0,0 +4654,Reconsideration of Harm's Way: Onsets and Comorbidity Patterns of Disorders in Preschool Children and Their Caregivers Following Hurricane Katrina,"This study examined posttraumatic stress disorder (PTSD) and comorbid disorders in 70 preschool children (ages 3-6) and their caregivers following Hurricane Katrina. Children's rate of PTSD was 50.0% using age-modified criteria. The rate of PTSD was 62.5% for those who stayed in the city and 43.5% in those who evacuated. Of those with PTSD, 88.6% had at least one comorbid disorder, with oppositional defiant disorder and separation anxiety disorder being most common. Caregivers' rate of PTSD was 35.6%, of which 47.6% was new post-Katrina. No children and only 2 caregivers developed new non-PTSD disorders in the absence of new PTSD symptoms. Differences by race and gender were largely nonsignificant. Children's new PTSD symptoms correlated more strongly to caregivers with new symptoms compared to caregivers with old or no symptoms.",0,0 +4655,Alterations in the cortical thickness and the amplitude of low-frequency fluctuation in patients with post-traumatic stress disorder,"The core neuropsychological processes underlying post-traumatic stress disorder (PTSD) have yet to be elucidated, and the association between anatomical and functional deficits in PTSD remains largely unknown. The aim of our study was to investigate the alterations in cortical thickness and amplitude of low-frequency fluctuation (ALFF) in PTSD patients resulting from motor vehicle accidents (MVCs), and to explore the association of cortical thickness and ALFF with the severity of PTSD symptoms. A total of 20 PTSD patients and 20 healthy controls were recruited and examined by high-resolution structural MRI combined with resting-state fMRI. The results showed significant decrease in cortical thickness in the left BA10, BA32 and BA45 and the right superior temporal gyrus in PTSD patients. The ALFF value in PTSD patients increased significantly in the left BA10 and BA32 and the right cerebellum. Linear regression revealed that decreased cortical thickness and increased ALFF in the BA10 were associated with the increased PTSD scores. These findings suggest that the structural integrity and resting-state function in the BA10 play an important role in the pathogenesis of PTSD. ► PTSD patients had focal cortex thinning in the left BA10, BA32, BA45. ► PTSD patients had significantly increased ALFF in the left BA10, BA32 and right cerebellum. ► Cortical thickness and ALFF in the BA10 were associated with PTSD scores.",0,0 +4656,Cognitive–behavioral conjoint therapy for PTSD improves various PTSD symptoms and trauma-related cognitions: Results from a randomized controlled trial.,"Numerous studies document an association between posttraumatic stress disorder (PTSD) and impairments in intimate relationship functioning, and there is evidence that PTSD symptoms and associated impairments are improved by cognitive-behavioral conjoint therapy for PTSD (CBCT for PTSD; Monson & Fredman, 2012). The present study investigated changes across treatment in clinician-rated PTSD symptom clusters and patient-rated trauma-related cognitions in a randomized controlled trial comparing CBCT for PTSD with waitlist in a sample of 40 individuals with PTSD and their partners (N = 40; Monson et al., 2012). Compared with waitlist, patients who received CBCT for PTSD immediately demonstrated greater improvements in all PTSD symptom clusters, trauma-related beliefs, and guilt cognitions (Hedge's gs -.33 to -1.51). Results suggest that CBCT for PTSD improves all PTSD symptom clusters and trauma-related cognitions among individuals with PTSD and further supports the value of utilizing a couple-based approach to the treatment of PTSD.",0,0 +4657,"Effects of attribution of responsibility for motor vehicle accidents on severity of PTSD symptoms, ways of coping, and recovery over six months","In light of Delahanty et al.'s (1997) identification of attribution of responsibility for a motor vehicle accident (MVA) as a powerful determinant of initial level of distress from the trauma and of early remission of PTSD, we reexamined data from Blanchard and Hickling's (1997) prospective follow-up of 158 MVA survivors. Despite differences between the two samples (Delahanty sample recruited from hospitals 2-3 weeks post-MVA and predominantly male; our sample recruited from outpatient care 1-4 months post-MVA and predominantly female) we replicated Delahanty's findings: those with PTSD who blame themselves for the MVA are less symptomatic initially and recover more rapidly in the first 6 months than those with PTSD who blame another party for the accident.",0,0 +4658,"Outcome of occupational electrical injuries among French electric company workers: A retrospective report of 311 cases, 1996–2005","This study reviewed records of all electrical incidents involving work-related injury to employees Electricité de France (EDF) from 1996 through 2005 and analysed data for 311 incidents. The results are compared with 1231 electrical incidents that occurred during 1970-1979 and 996 incidents during 1980-1989. A total of 311 electrical incidents were observed. The medical consequences of electrical incident remain severe and particularly, the current fatality rate (3.2%) is similar to that recorded in the 1980s (2.7%) and 1970s (3.3%). Among individuals with non-fatal incidents, any change has occurred in the prevalence of permanent functional sequelae (23.6% in the 1970s vs. 27.6% in the 1980s and 32.5% currently). An increase in the incidence of neuropsychiatric sequelae (5.4% in the 1980s vs. 13% currently) has been observed and they are now the second most common type of sequelae after those directly related to burns. Among the neurological sequelae, peripheral nervous system disorders are the most common, as observed in the 1980s. Since the definition of post-traumatic stress disorder (PTSD) has changed between the two periods, we can only report that the current prevalence of PTSD is 7.6%. This study emphasises the need for specific management of neurological and psychological impairments after electrical injuries, including especially early recognition and initiation of effective treatment.",0,0 +4659,"Can physiologic assessment and side effects tease out differences in PTSD trials? A double-blind comparison of citalopram, sertraline, and placebo.","Effects of double-blind treatment of chronic posttraumatic stress disorder (PTSD) with 2 SSRIs and placebo on emotional symptoms and autonomic reactivity were assessed prospectively. PTSD subjects received citalopram (n=25), sertraline (n=23), or placebo (n=10) for 10 weeks, with psychophysiologic assessments performed before and after treatment. Intent-to-treat analysis showed that all treatment groups improved significantly in total symptoms of PTSD (as measured by the Clinician Administered PTSD Scale), all 3 PTSD symptom clusters, and sleep time. However, subtle differences in improvements in PTSD symptom clusters, physiologic reactivity, and reported adverse events were identified. Citalopram treated subjects significantly lowered systolic and diastolic blood pressures, while sertraline and placebo treated patients significantly lowered only systolic blood pressure reactivity to individualized trauma scripts. The sertraline group showed significantly more improvement in avoidance/numbing symptoms than both other groups. Considering side effects, subjects on sertraline reported more gastrointestinal problems, with early terminators having more insomnia. Early terminators on citalopram reported more fatigue and appetite changes than other treatment groups, with completers reporting more sexual dysfunction. Results support a class effect of SSRIs in treating PTSD symptoms, but suggest a possible differential effect of drugs on symptom clusters, physiologic parameters, and side effects that may have clinical relevance. Implications of symptom reduction noted in the smaller placebo group are discussed relative to recent concerns about increasing placebo response in clinical trials.",0,0 +4660,Neurobiological and clinical consequences of stress : from normal adaptation to post-traumatic stress disorder,"This groundbreaking volume is the most thorough and up-to-date exploration of the laboratory, clinical, and theoretical aspects of post-traumatic stress disorder (PTSD) and related stress disorders ever published. The book reviews the entire spectrum of stress responses--from normal to pathological reactions--and brings together the very latest results from basic and clinical research. It provides for the first time critical, authoritative information that will help in the diagnosis and treatment of PTSD. This comprehensive volume provides an invaluable historical and conceptual framework by which to understand post-traumatic stress disorder, emphasizing throughout the homology between the normal stress response and the pathophysiology of PTSD. The book is divided into four major sections that logically progress from basic neurobiological research on stress to neurobiological models of stress and PTSD to specific research on PTSD and clinical issues regarding diagnosis and treatment",0,0 +4661,Prolonged Exposure Therapy With Veterans and Active Duty Personnel Diagnosed With PTSD and Traumatic Brain Injury,"The present study used archival clinical data to analyze the delivery and effectiveness of prolonged exposure (PE) and ancillary services for posttraumatic stress disorder (PTSD) among Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans (N = 69) with histories of mild to severe traumatic brain injury (TBI). Data from standard clinical assessments of veterans and active duty personnel treated in both inpatient and outpatient programs at 2 Department of Veteran Affairs medical centers were examined. Symptoms were assessed with self-report measures of PTSD (PTSD Checklist) and depression (Beck Depression Inventory-II) before and throughout therapy. Mixed linear models were utilized to determine the slope of reported symptoms throughout treatment, and the effects associated with fixed factors such as site, treatment setting (residential vs. outpatient), and TBI severity were examined. Results demonstrated significant decreases in PTSD, B = -3.00, 95% CI [-3.22, -2.78]; t(210) = -13.5; p < .001, and in depressive symptoms, B = -1.46, 95% CI [-1.64, -1.28]; t(192) = -8.32; p < .001. The effects of PE treatment did not differ by clinical setting and participants with moderate to severe injuries reported more rapid gains than those with a history of mild TBI. The results provide evidence that PE may well be effective for veterans with PTSD and TBI.",0,0 +4662,"Post-traumatic Stress Disorder (PTSD), Life Satisfaction and Work Personality: Exploring the Relationship with Disability","This research focused on Post-traumatic Stress Disorder (PTSD) and its relationship to life satisfaction and developmental work personality. The participants were women of low socioeconomic status and consisted of three groups: women not seeking employment; women pursuing their GED prior to seeking employment; and women with disabilities in readiness to work programs. Significant correlations exist between both the Developmental Work Personality Scale (DWPS) and the Life Satisfaction Scale, and PTSD symptoms for the entire group. Separate analyses for each group indicated significant correlations for the women with disabilities between levels of PTSD symptoms, developmental work personality, and life satisfaction. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +4663,Expressed emotion and causal attributions in relatives of post-traumatic stress disorder patients,"This study investigates the relationship between expressed emotion (EE) and causal attributions in relatives of post-traumatic stress disorder (PTSD) patients, and examines the contributions of EE and attributions to patient outcomes. Thirty-eight relatives of patients with PTSD participating in a treatment trial were assessed on EE, causal attributions for patient problems and nature of attributions. Patients’ PTSD symptoms at 6 and 12 months were assessed. Criticism and hostility in relatives were associated with attributing problems to factors controllable by patients. Relatives with marked emotional over-involvement (EOI) had an attributional profile similar to low EE relatives. Deficits in normal behaviour (“negative symptoms”) were perceived as more controllable, internal and stable than were more obvious signs of an illness or mental health problem such as hypervigilance and intrusive thoughts and nightmares (“positive symptoms”). Irritability or anger was perceived as more controllable and personal than any other problem. Hostility was associated with less psychological understanding. EE (hostility) but not attributions was found to predict clinical outcome. The results are consistent with previous studies of relatives of schizophrenia patients. The study suggests a need for interventions, which focus on helping relatives to reappraise the impact of PTSD.",0,0 +4664,Pharmacology for sleep disturbance in PTSD,"Symptoms of sleep disturbance, particularly nightmares and insomnia, are a central feature of post-traumatic stress disorder (PTSD). Emerging evidence suggests that specific treatment of PTSD-related sleep disturbance improves other symptoms of the disorder, which in turn suggests that such disturbance may be fundamental to development and maintenance of the disorder. This mini-review focuses on pharmacological treatment of sleep disturbance in adult PTSD (specifically, studies testing the efficacy of antidepressants, adrenergic inhibiting agents, antipsychotics and benzodiazepine and non-benzodiazepine hypnotics). We conclude that only prazosin, an adrenergic inhibiting agent, has had its efficacy established by multiple randomised controlled trials. There is also high-level evidence supporting use of eszopiclone, as well as risperidone and olanzapine as adjunct therapy. Antidepressants such as sertraline, venlafaxine and mirtazapine, benzodiazepines such as alprazolam and clonazepam and non-benzodiazepine hypnotics such as zolpidem appear ineffective in treating PTSD-related sleep disturbance. Most studies that report reduced frequency of nightmares and insomnia also report decreases in overall symptom severity. Such findings suggest that (i) sleep disruption is central to PTSD; (ii) treating sleep disruption may be an effective way to address other symptoms of the disorder and (iii) PTSD symptoms tend to cluster together in predictable ways.",0,0 +4665,Verbal learning and memory impairments in posttraumatic stress disorder: The role of encoding strategies,"The present study examined mechanisms underlying verbal memory impairments in patients with posttraumatic stress disorder (PTSD). Earlier studies have reported that the verbal learning and memory alterations in PTSD are related to impaired encoding, but the use of encoding and organizational strategies in patients with PTSD has not been fully explored. This study examined organizational strategies in 21 refugees/immigrants exposed to war and political violence who fulfilled DSM-IV criteria for chronic PTSD compared with a control sample of 21 refugees/immigrants with similar exposure, but without PTSD. The California Verbal Learning Test was administered to examine differences in organizational strategies and memory. The semantic clustering score was slightly reduced in both groups, but the serial cluster score was significantly impaired in the PTSD group and they also reported more items from the recency region of the list. In addition, intrusive errors were significantly increased in the PTSD group. The data support an assumption of changed memory strategies in patients with PTSD associated with a specific impairment in executive control. However, memory impairment and the use of ineffective learning strategies may not be related to PTSD symptomatology only, but also to self-reported symptoms of depression and general distress.",0,0 +4666,Age differences in PTSD among Canadian veterans: age and health as predictors of PTSD severity,"ABSTRACT Background: To date, few studies have investigated age differences in posttraumatic stress disorder (PTSD) symptoms and none has examined age differences across symptom clusters: avoidance, re-experiencing, and hyperarousal. The first objective of this study was to investigate age differences in PTSD and its three symptom clusters. The second objective was to examine age and indices of health as predictors of PTSD symptom severity. Methods: Participants were 104 male veterans, aged 22 to 87 years, receiving specialized mental health outpatient services. Assessments included measures of health-related quality of life, pain severity, number of chronic health conditions, and symptoms of PTSD, both in total and on the symptom clusters. Results: There were significant age differences across age groups, with older veterans consistently reporting lower PTSD symptom severity, both in total and on each of the symptom clusters. Hierarchical regression analyses indicated that the inclusion of health indices accounted for significantly more variance in PTSD symptoms over and above that accounted for by age alone. Pain severity was a significant predictor of PTSD total and the three symptom clusters. Conclusions : This is the first study to report lower levels of PTSD severity among older veterans across symptom clusters. These findings are discussed in relation to age differences in the experiencing and processing of emotion, autobiographical memory, and combat experiences. This study also emphasizes the importance of assessing pain in those with symptoms of PTSD, particularly older veterans who are less likely to receive specialized mental healthcare.",0,0 +4667,"Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining ""whiplash"" and its management.",,0,0 +4668,"Stress Controversies: Post-Traumatic Stress Disorder, Hippocampal Volume, Gastroduodenal Ulceration*","Stress in mammals triggers a neuroendocrine response mediated by the hypothalamic-pituitary-adrenal axis and the autonomic nervous system. Increased activity of these two systems induces behavioural, cardiovascular, endocrine and metabolic cascades that enable the individual to fight or flee and cope with the stress. Our understanding of stress and stress-response mechanisms is generally robust. Here, however, we review three themes that remain controversial and perhaps deserve further scrutiny and investigation before they achieve canonical status. The themes are, first, hypocortisolaemia in post-traumatic stress disorder (PTSD). A reduction rather than a stress-induced increase in adrenal glucocorticoid levels, as seen in major depressive disorder (MDD), is puzzling and furthermore is not a consistent feature of PTSD. Overall, studies on PTSD show that glucocorticoid levels may be normal or higher or lower than normal. The second theme concerns the reduction in volume of the hippocampus in MDD attributed to the neurotoxicity of hypercortisolaemia. Again, as for hypocortisolaemia in PTSD, reduced hippocampal volume in MDD has been found in some but not all studies. Third, the discovery of a causal association between Helicobacter pylori and peptic ulcers apparently brought to an end the long-held view that peptic ulceration was caused predominantly by stress. However, recent studies suggest that stress can cause peptic ulceration in the absence of H. pylori. Predictably, the aetiological pendulum of gastric and duodenal ulceration has swung from 'all stress' to 'all bacteria' followed by a sober realisation that both factors may play a role. This raises the question as to whether stress and H. pylori interact, and if so how? All three controversies are of clinical significance, pose fundamental questions about stress mechanisms and offer important areas for future research.",0,0 +4669,Veterans’ PTSD symptoms and their partners’ desired changes in key relationship domains.,"There is a growing literature investigating the connection between veterans' posttraumatic stress disorder (PTSD) symptoms and intimate relationship problems. Little to no work, however, has examined the connection between veterans' PTSD symptoms and their partners' perceptions of specific relationship areas in need of change. We examined associations between overall PTSD symptoms and symptom cluster scores with partners' desired changes in the areas of intimacy, shared activities, and responsibilities. The sample consisted of 249 male veterans of different service eras and their female partners. Results indicated that veterans' PTSD symptoms were associated with greater desired changes from their partners in the veterans' intimacy behaviors and participation in shared activities. When examining the contribution of each symptom cluster individually, only the veterans' emotional numbing symptoms emerged as a significant unique predictor and were associated with partners' desired changes in intimacy. The findings suggest that intimacy and shared activities may be relevant areas to address in PTSD treatment for veterans and their partners and highlight the particular significance of emotional numbing symptoms to intimacy in veterans' relationships.",0,0 +4670,Undiagnosed post‐traumatic stress disorder following motor vehicle accidents,"OBJECTIVES: To determine the pattern of emergence of post-traumatic stress disorder (PTSD) among motor vehicle accident victims and to examine the influence of PTSD on subsequent levels of disability. DESIGN: A longitudinal study of motor vehicle accident victims one month and 18 months after the accident. SUBJECTS: Twenty-four motor vehicle accident victims admitted by the trauma team at the Royal Adelaide Hospital. A 52% response rate was achieved. MAIN OUTCOME MEASURES: Post-traumatic stress disorder as diagnosed by the Diagnostic Interview Schedule and disability as measured with the Sickness Impact Profile. RESULTS: Eighteen months after their accidents, six of the 24 subjects had clinically significant PTSD and one was considered borderline. None had been previously diagnosed or treated. The group with PTSD had higher scores on all measures of psychological distress one month after the accident and were more likely to use immature psychological defences. There was no association between physical outcome (measured with the modified Glasgow Outcome Scale) at six months and subsequent diagnosis of PTSD. However, the group with PTSD had higher levels of disability on assessment with the Sickness Impact Profile, particularly in the domain of social functioning. The results suggest PTSD was associated with work-related dysfunction equal to that associated with severe physical handicap. CONCLUSION: The data from this pilot study suggest that PTSD after motor vehicle accidents is an important cause of disability, which may also become the focus for damages in litigation. Thus, there is a need for further investigation of the early patterns of distress and to design preventive programs for victims of road accidents. Language: en",0,0 +4671,Trajectories of suicidal ideation and posttraumatic stress symptoms among former prisoners of war: A 17-year longitudinal study,"War captivity is one of the most severe human-inflicted traumatic experiences with wide and substantial long-term negative effects. However, only one retrospective study examined suicidal ideation (SI) among ex-prisoners of war (ex-POWs). This study aimed to prospectively assess SI among ex-POWs and its associations with posttraumatic stress disorder (PTSD) symptoms over a 17-year period. Two groups of male Israeli veterans from the 1973 Yom Kippur War were examined: ex-POWs and comparable veterans who were not taken captive. Both groups were assessed via self-report measures of SI and PTSD symptoms at three time points: T1 18 (1991), T2 30 (2003), and T3 35 (2008) years after the war. Latent growth curve modeling (LGM) results showed that ex-POWs reported higher levels of SI at T2 and T3 and a pattern of increase in SI levels trajectory over time, compared to control veterans. Furthermore, among ex-POWs, PTSD symptoms at T1 contributed to the increase in rate of change in SI overtime. In addition, PTSD symptoms affected SI at the same measurement, above and beyond above the trajectories of SI. Clinical implications of these findings for the relations between captivity trauma and suicidality are discussed.",0,0 +4672,Higher cerebrospinal fluid homovanillic acid levels in depressed patients with comorbid posttraumatic stress disorder,"Major depression and posttraumatic stress disorder (PTSD) are often comorbid, resulting in more impairment compared than with either diagnosis alone. Both major depression and PTSD are thought to be associated with monoamine transmitter abnormalities. This study compared clinical features and cerebrospinal fluid (CSF) monoamine metabolites in drug-free depressed subjects with a current major depressive episode (MDE) without comorbid PTSD, subjects with a current MDE and comorbid PTSD, and healthy volunteers. Depressed subjects with comorbid PTSD had higher CSF homovanillic acid (HVA) levels compared with depressed subjects without comorbid PTSD or healthy volunteers. Higher HVA was present after adjustment for sex, lifetime aggression severity and depression scores, alcoholism, tobacco smoking, comorbid cluster B personality disorder, reported childhood abuse, and psychosis. We found no group difference in CSF 5-hydroxyindolacetic acid (5-HIAA) and 3-methoxy-4-hydroxyphenylglycol (MHPG) levels. Higher dopaminergic activity may contribute to alterations in memory and other cognitive functions, anhedonia, and hypervigilance observed in PTSD.",0,0 +4673,"Comparison of Concussive Symptoms, Cognitive Performance, and Psychological Symptoms Between Acute Blast-Versus Nonblast-Induced Mild Traumatic Brain Injury","Blast-related head injuries are one of the most prevalent injuries among military personnel deployed in service of Operation Iraqi Freedom. Although several studies have evaluated symptoms after blast injury in military personnel, few studies compared them to nonblast injuries or measured symptoms within the acute stage after traumatic brain injury (TBI). Knowledge of acute symptoms will help deployed clinicians make important decisions regarding recommendations for treatment and return to duty. Furthermore, differences more apparent during the acute stage might suggest important predictors of the long-term trajectory of recovery. This study evaluated concussive, psychological, and cognitive symptoms in military personnel and civilian contractors (N = 82) diagnosed with mild TBI (mTBI) at a combat support hospital in Iraq. Participants completed a clinical interview, the Automated Neuropsychological Assessment Metric (ANAM), PTSD Checklist-Military Version (PCL-M), Behavioral Health Measure (BHM), and Insomnia Severity Index (ISI) within 72 hr of injury. Results suggest that there are few differences in concussive symptoms, psychological symptoms, and neurocognitive performance between blast and nonblast mTBIs, although clinically significant impairment in cognitive reaction time for both blast and nonblast groups is observed. Reductions in ANAM accuracy were related to duration of loss of consciousness, not injury mechanism.",0,0 +4674,Short communication: Genetic trends of milk yield under heat stress for US Holsteins,"Data included 90,242,799 test-day milk records from 5,402,484 Holstein cows in the first 3 parities and 9,326,754 animals in the pedigree. Additionally, daily temperature-humidity indexes from 202 weather stations were available. Analyses were done by a random regression model in which each parity was treated as a separate trait and that accounted for heat stress. The fixed effects included herd test-day, age at calving, milking frequency, and days in milk classes. Random effects included additive genetic, permanent environment, and herd-year effects, all fit as random regressions. Five covariates in the random regressions included linear splines with 4 knots at 5, 50, 200, and 305 DIM and a function of a temperature-humidity index (THI). Mixed model equations were solved by using an iteration on data approach with a preconditioned conjugate gradient algorithm. Genetic trends for daily milk yield in absence of heat stress (intercept) were 0.140 kg/yr, 0.172 kg/yr, and 0.168 kg/yr for the first, second, and third parity, respectively. Genetic trends for decline of milk yield at temperature of 5 degrees C THI over the threshold of sensitivity to heat stress were -0.002 kg/yr, -0.035 kg/yr, and -0.038 kg/yr, for first, second, and third parity, respectively. Genetic profiles were created by contrasting the 100 most and 100 least heat-tolerant bulls for the official proofs. The most heat-tolerant bulls transmitted lower production and dairy form but higher fertility, productive life, and type, especially udder and locomotion traits. In later parities, the type advantages were smaller. Test-day records capture only a fraction of information due to heat stress, and the real trends for heat stress may be stronger. Studies on heat stress for production should include records on later parities.",0,0 +4675,Psychopharmacological treatment in PTSD: a critical review,"Posttraumatic stress disorder (PTSD) is a prevalent psychiatric disorder that is heterogeneous in its nature, and often presents with other psychiatric comorbidities. As a result, empirical research on effective pharmacotherapy for PTSD has produced complex findings. This article reviews the existing research literature on pharmacological treatments for PTSD, identifies the most effective treatments, and where possible examines their mechanism of action with respect to the neurobiology of PTSD.We examined reports of clinical trials of psychotropic agents carried out with PTSD patients and published in peer-reviewed journals, as well as reports from presentations at scientific meetings between 1966 and 2001.Numerous medications are effective in treating PTSD. These include tricyclic antidepressants, monoamine oxidase inhibitors, and serotonin reuptake inhibitors. Considering reported overall efficacy and side effects profiles, selective serotonin reuptake inhibitors emerge as the preferred first line treatment for PTSD. Mood stabilizers, atypical neuroleptics, adrenergic agents, and newer antidepressants also show promise, but require further controlled trials to clarify their place in the pharmacopoeia for PTSD.There is clear evidence for effective pharmacotherapy of PTSD. Future improvements in the treatment of this disorder await further clinical trials and neurobiological research.",0,0 +4676,Peritraumatic Distress and the Course of Posttraumatic Stress Disorder Symptoms: A Meta-Analysis,"Objective: To examine how peritraumatic distress modulates the severity of posttraumatic stress disorder (PTSD) according to the timing of the PTSD symptom assessments. Method: A systematic literature review of English- and French-language studies having administered the Peritraumatic Distress Inventory (PDI) was conducted. Meta-analyses were performed on correlations relating PDI and PTSD symptom scores obtained from the sampled studies. The meta-analyses, which included calculations of regression slopes, took into consideration the time at which PTSD symptoms were assessed following the traumatic event and the timing of the PDI assessment. Results: The literature review yielded a total of 22 studies. The meta-analysis performed over all studies resulted in a pooled correlation coefficient of 0.55 between the PDI and PTSD symptom scores. Meta-regression analyses conducted over all data revealed no apparent decrease in the correlations according to the timing of the PTSD symptom assessments. However, there were numerical or statistically significant declines in regression slopes when the meta-regressions were separately conducted on studies having administered the PDI either within, or following, a 1-month period after a traumatic event. Conclusions: While PDI or PTSD symptom score correlations remain generally significant, they tend to decline as time elapses between the traumatic event and the PTSD assessment. This suggests there may be factors other than peritraumatic distress that increasingly account for the long-term trajectory PTSD symptoms.",0,0 +4677,Pharmacologic treatment of impulsive aggression with antiepileptic drugs,"Aggressive behavior is a major concern in mental health and criminal justice settings. Although pharmacotherapy is often used in the treatment of the violent individual, no medication is presently approved by the US Food and Drug Administration specifically for such use. In recent years, antiepileptic drugs (AEDs) have become increasingly popular for the management of impulsive (reactive) aggressive behavior. The research literature has implicated several neurobiologic deficits associated with impulsive aggression, including reduced central serotonergic functioning, executive dysfunction, and prefrontal deficits. It has been suggested that the neurobiologic deficits specific to impulsive aggressive behavior may serve as indicators of an ineffective behavioral control system. A review of the literature finds that AEDs, particularly those that block sodium channels and/or have GABA-related mechanisms of action, are effective in reducing the frequency and intensity of impulsive aggressive outbursts both when used as the primary agent of treatment and as an adjunct to ongoing pharmacotherapy. Strong evidence for efficacy in impulsive aggression exists from randomized controlled trials for most of the common AEDs (phenytoin, carbamazepine, oxcarbazepine, lamotrigine, valproate/ divalproex sodium, topiramate). Additional controlled studies are needed for tiagabine and gabapentin. Of the common AEDs, only levetiracetam has been shown to be ineffective in the treatment of impulsive aggression. It is important to note that the anti-aggressive effects seen with the AEDs appear to be specific to the impulsive form of aggression. Individuals who display premeditated aggression do not seem to benefit from this type of treatment. Clinically, we recommend phenytoin (initial dose 100 mg three times daily) as the AED of first choice for the treatment of impulsive aggressive outbursts. This recommendation is based on this drug's limited side effect profile (compared with the other AEDs) and the large amount of empiric data supporting its clinical efficacy in impulsive aggression. In the event that the impulsive aggressive individual does not respond to pharmacotherapy with phenytoin, carbamazepine (initial dose 150 mg three times daily) and valproate/divalproex sodium (initial dose 250 mg three times daily) have both proved to be effective secondary options. (",0,0 +4678,Anxio- depressive Syndrome – Biopsychosocial Model of Supportive Care,"Acute stress in patients experiencing cancer diagnosis and the post-traumatic stress disorder in cancer survivors results in impaired overall quality of life mainly due to associated psychological and physical alterations, including anxiety, depression, sleep disturbances, cognitive dysfunctions, fatigue, pain, cachexia and others. Recent studies revealed a new insight into molecular mechanisms contributing to the development of cancer-related co morbidities. It has been shown that adverse psychosomatic reactions including cancer depression to emotional cancer distress result from neuroendocrinne dysfunctions, disruption of the hypothalamus- pituitary-adrenal axis and sympathetic nervous system, serotonin-dopamine interactions and circadian sleep- wake rhythm disruption.The aim of the present study was to evaluate clinical studies oriented toward elucidation of the hypothesis that cancer-related anxio- depressive syndrome is the major disorder leading to the development of accompanying psychosomatic disruptions.The data of the biopsychosocial approach in the treatment of cancer presented in the current literature were collecting using appropriate electronic databases and were elaborated in the form of meta-analysis of 24 selected publications.According to relevant clinical studies, psychosocial interventions and psychopharmacological treatment has been shown to reduce cancer symptomatology and to improve the ability of patients to cope with the disease. Thus, one of the key pillars of supportive care in oncology is stress reduction. Cognitive- behavioral interventions and group psychosocial therapies have shown to reduce stress from the diagnosis and treatment, to palliate depression and to help in restoring the circadian rhythm. Psychopharamacological interventions are the most useful approaches in the reduction of stress-induced cancer comorbidities. In the presented study, a plausible role of stress reduction in the protection of cancer patients from posttraumatic and anxio- depressive syndrome, physical and psychical suffering, from decrease of patients quality of life, ability to cope with the disease and cooperate in cancer treatment has been analyzed.Implementation of the biopsychosocial model of cancer care needs further cooperation between behavioral scientists and clinical oncologists attempted to elucidate further possibilities of psychosocial and pharmacological interventions leading to the regulation of stress-induced alterations of the neurotransmitter system and neuroendocrinne dysfunctions reduction of cancer-related co morbidities and improvement of patients survival time.",0,0 +4679,Sex-based responses of plasma creatine kinase in broilers to thermoneutral constant and cyclic high temperatures,"1. The plasma creatine kinase (CK) activities of male and female broilers under different temperature regimens were studied to investigate the suitability of plasma CK as an indicator of muscle damage due to heat exposure (HE). 2. This study characterises the responses of plasma CK concentration of Arbor Acres broilers to thermoneutral (TN) constant (22°C) or warm cyclic (WC) temperatures (ranging from 27·9°C to 37·9°C). 3. The daily mean CK of the females tended to be higher than those of the males, and significant differences in plasma CK were observed between the genders during the first 5-d test period, namely 2-d TN constant and 3-d WC temperatures. 4. During a 5-d HE to the WC regimens, CK of both genders fluctuated with HE time but exhibited somewhat different profiles. Specifically, the daily mean CK of the females was significantly higher on d 5 of HE than any other daily means, whereas significant difference in daily CK of the males occurred on d 4 of HE. 5. Repetitive blood sampling over 5 d of HE had significant effects on the plasma CK of the females regardless of the number of repeated bleeding times. 6. Profiles of the plasma CK for each gender during d 1 of HE were similar to those under the TN condition, implying that heat stress affects the range of broiler plasma CK concentration but with a 1-d lag. 7. Plasma CK activities of female and male broilers showed a response to HE. However, both the gender and the time of blood sampling should be taken into account when plasma CK is used as an indicator of HE for market-size broilers.",0,0 +4680,Preliminary Evidence for the Effects of Morphine on Posttraumatic Stress Disorder Symptoms in One- to Four-Year-Olds With Burns,"This study tested the hypothesis that very young children who received more morphine for acute burns would have larger decreases in posttraumatic symptoms 3 to 6 months later. This has never before been studied in very young children, despite the high frequency of burns and trauma in this age group. Seventy 12- to 48-month-old nonvented children with acute burns admitted to a major pediatric burn center and their parents participated. Parents were interviewed at three time points: during their child's hospitalization, 1 month, and 3 to 6 months after discharge. Measures included the Child Stress Disorders Checklist - Burn Version (CSDC-B). Chart reviews were conducted to obtain children's morphine dosages during hospitalization. Mean equivalency dosages of morphine (mg/kg/d) were calculated to combine oral and intravenous administrations. Eleven participants had complete 3 to 6-month data on the CSDC. The correlation between average morphine dose and amount of decrease in posttraumatic stress disorder symptoms on the CSDC (r = -0.32) was similar to that found in studies with older children. The correlation between morphine dose and amount of decrease in symptoms on the arousal cluster of the CSDC was significant (r = -0.63, P < .05). Findings from the current study suggest that, for young children, management of pain with higher doses of morphine may be associated with a decreasing number of posttraumatic stress disorder symptoms, especially those of arousal, in the months after major trauma. This extends, with very young children, the previous findings with 6- to 16-year olds.",0,0 +4681,Predictors of Risk and Resilience for Posttraumatic Stress Disorder Among Ground Combat Marines: Methods of the Marine Resiliency Study,"The Marine Resiliency Study (MRS) is a prospective study of factors predictive of posttraumatic stress disorder (PTSD) among approximately 2,600 Marines in 4 battalions deployed to Iraq or Afghanistan. We describe the MRS design and predeployment participant characteristics. Starting in 2008, our research team conducted structured clinical interviews on Marine bases and collected data 4 times: at predeployment and at 1 week, 3 months, and 6 months postdeployment. Integrated with these data are medical and career histories from the Career History Archival Medical and Personnel System (CHAMPS) database. The CHAMPS database showed that 7.4% of the Marines enrolled in MRS had at least 1 mental health diagnosis. Of enrolled Marines, approximately half (51.3%) had prior deployments. We found a moderate positive relationship between deployment history and PTSD prevalence in these baseline data.",0,0 +4682,Confirmatory factor analysis of posttraumatic stress symptoms in Brazilian primary care patients: An examination of seven alternative models,"► The DSM-IV-TR postulates that PTSD symptoms are organized into 3 clusters. ► However, recent factor analytical studies tend to favor 4-factor, first-order models. ► 805 Brazilian primary care patients filled out the PCL-C and a CFA was conducted. ► A 4-factor, first-order solution including a numbing cluster provided the best fit. ► The results uphold the cross-cultural validity of the 4-factor, first-order model. The DSM-IV-TR postulates that PTSD symptoms are organized into 3 clusters. This assumption has been challenged by growing number of factor analytical studies, which tend to favor 4-factor, first-order models. Our objective was to investigate whether the clusters of PTSD symptoms identified in North American and European studies could be replicated in a Brazilian sample composed of 805 primary care patients living in hillside slums. Volunteers were asked to fill out the Brazilian version of the Posttraumatic Stress Disorder Checklist—Civilian Version and a confirmatory factor analysis of this scale was conducted with the software LISREL 8.80. Seven models were tested and a 4-factor, first-order solution including an emotional numbing cluster was found to provide the best fit. Although PTSD has been characterized by some critics as a Western culture-specific disorder lacking universal validity, our results seem to uphold the cross-cultural validity of the 4-factor, first-order model.",0,0 +4683,Longitudinal interplay between posttraumatic stress symptoms and coping self-efficacy: A four-wave prospective study,"Trauma-related coping self-efficacy (CSE), the perceived capability to manage one's personal functioning and the myriad environmental demands of the aftermath of potentially traumatic events (PTE), has been shown to affect psychological outcomes after these events. Aim of the present four-wave study was to examine the cross-lagged relationships between CSE and posttraumatic stress disorder (PTSD) symptoms following PTEs in order to examine direction of influence. Levels of CSE and PTSD symptoms were measured with 4-month intervals. In addition, prospectively assessed personality traits and general self-efficacy perceptions as well as peritraumatic distress were entered in the analyses. The study sample consists of adult respondents of a representative internet panel who experienced PTE in the six months before T1, and did not experience any new PTE or life event between T1 and T3 (N = 400). Respondents were administered the coping self-efficacy scale (CSE-7), impact of event scale (IES) and arousal items of IES-R at each wave (T1 through T3), as well as questions on peritraumatic stress and prospectively measured personality traits (T0). Results of structural equation modeling showed that the effect of CSE on subsequent PTSD symptom levels was dominant. CSE significantly predicted subsequent symptoms, over and above earlier symptom levels, with higher CSE associated with lower PTSD. Symptoms in turn, did not predict subsequent levels of CSE. Higher peritraumatic distress was associated with both higher initial PTSD symptoms and lower initial CSE levels. Higher levels of the personality traits of emotional stability and agreeableness were associated with higher initial CSE levels. This supports a model in which CSE perceptions play an important role in recovery from trauma.",0,0 +4684,Dimensional structure and course of post-traumatic stress symptomatology in World Trade Center responders,"Background Post-traumatic stress disorder (PTSD) in response to the World Trade Center (WTC) disaster of 11 September 2001 (9/11) is one of the most prevalent and persistent health conditions among both professional (e.g. police) and non-traditional (e.g. construction worker) WTC responders, even several years after 9/11. However, little is known about the dimensionality and natural course of WTC-related PTSD symptomatology in these populations. Method Data were analysed from 10 835 WTC responders, including 4035 police and 6800 non-traditional responders who were evaluated as part of the WTC Health Program, a clinic network in the New York area established by the National Institute for Occupational Safety and Health. Confirmatory factor analyses (CFAs) were used to evaluate structural models of PTSD symptom dimensionality; and autoregressive cross-lagged (ARCL) panel regressions were used to examine the prospective interrelationships among PTSD symptom clusters at 3, 6 and 8 years after 9/11. Results CFAs suggested that five stable symptom clusters best represent PTSD symptom dimensionality in both police and non-traditional WTC responders. This five-factor model was also invariant over time with respect to factor loadings and structural parameters, thereby demonstrating its longitudinal stability. ARCL panel regression analyses revealed that hyperarousal symptoms had a prominent role in predicting other symptom clusters of PTSD, with anxious arousal symptoms primarily driving re-experiencing symptoms, and dysphoric arousal symptoms primarily driving emotional numbing symptoms over time. Conclusions Results of this study suggest that disaster-related PTSD symptomatology in WTC responders is best represented by five symptom dimensions. Anxious arousal symptoms, which are characterized by hypervigilance and exaggerated startle, may primarily drive re-experiencing symptoms, while dysphoric arousal symptoms, which are characterized by sleep disturbance, irritability/anger and concentration difficulties, may primarily drive emotional numbing symptoms over time. These results underscore the importance of assessment, monitoring and early intervention of hyperarousal symptoms in WTC and other disaster responders.",0,0 +4685,Development of a brief cannabis use disorder screening tool: The CUDIT Short-Form,"Aims: The aim of the present study was to develop and test the diagnostic utility of a shortened 3-item version of the Cannabis Use Disorder Identification Test - Revised (CUDIT-R) for the purpose of brief and effective screening within primary care and other medical settings. Methods:Ashort form of the CUDIT-R was developed using Item Response Theory (IRT) and traditional statistical methods, with data from two community samples of cannabis users representing two countries. Four item selection methods (Rasch Regression, Test Characteristic Curve, Logistic Regression, Discriminant Function Analysis) were employed to identify the most optimal 3-item shortened version. The diagnostic ability of the short forms was evaluated using receiver operating characteristic curves. Results: Using a cut score of 2, the 3-item CUDIT-Short Form (reliability alpha = .66 sample 1; .80 sample 2) identified 78.26% of participants in sample 1 and 78.31% of participants in sample 2 who met DSM-5 criteria for CUD, with 98% agreement in sample 1 and 93% agreement in sample 2 with the full CUDIT-R on CUD classifications using a cut score of 13. Specificity was 76.70 and 78.00 in sample 1 and 2, respectively. Conclusions: The CUDIT-Short Form (CUDIT-SF) may be useful in busy clinical settings for a stepwise screening. Further validation of this shortened version with larger samples and in different settings is warranted.",0,0 +4686,Mental Health Among Reserve Component Military Service Members and Veterans,"Since 2001, the US military has increasingly relied on National Guard and reserve component forces to meet operational demands. Differences in preparation and military engagement experiences between active component and reserve component forces have long suggested that the psychiatric consequences of military engagement differ by component. We conducted a systematic review of prevalence and new onset of psychiatric disorders among reserve component forces and a meta-analysis of prevalence estimates comparing reserve component and active component forces, and we documented stage-sequential drivers of psychiatric burden among reserve component forces. We identified 27 reports from 19 unique samples published between 1985 and 2012: 9 studies reporting on the reserve component alone and 10 reporting on both the reserve component and the active component. The pooled prevalence for alcohol use disorders of 14.5% (95% confidence interval: 12.7, 15.2) among the reserve component was higher than that of 11.7% (95% confidence interval: 10.9, 12.6) among the active component, while there were no component differences for depression or post-traumatic stress disorder. We observed substantial heterogeneity in prevalence estimates reported by the reserve component. Published studies suggest that stage-sequential risk factors throughout the deployment cycle predicted alcohol use disorders, post-traumatic stress disorder and, to a lesser degree, depression. Improved and more standardized documentation of the mental health burden, as well as study of explanatory factors within a life-course framework, is necessary to inform mitigating strategies and to reduce psychiatric burden among reserve component forces.",0,0 +4687,Human brain evolution and the “Neuroevolutionary Time-depth Principle:” Implications for the Reclassification of fear-circuitry-related traits in DSM-V and for studying resilience to warzone-related posttraumatic stress disorder,"The DSM-III, DSM-IV, DSM-IV-TR and ICD-10 have judiciously minimized discussion of etiologies to distance clinical psychiatry from Freudian psychoanalysis. With this goal mostly achieved, discussion of etiological factors should be reintroduced into the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). A research agenda for the DSM-V advocated the “development of a pathophysiologically based classification system”. The author critically reviews the neuroevolutionary literature on stress-induced and fear circuitry disorders and related amygdala-driven, species- atypical fear behaviors of clinical severity in adult humans. Over 30 empirically testable/falsifiable predictions are presented. It is noted that in DSM-IV-TR and ICD-10, the classification of stress and fear circuitry disorders is neither mode-of-acquisition-based nor brain-evolution-based. For example, snake phobia (innate) and dog phobia (overconsolidational) are clustered together. Similarly, research on blood-injection-injury-type-specific phobia clusters two fears different in their innateness: 1) an arguably ontogenetic memory-trace-overconsolidation-based fear (hospital phobia) and 2) a hardwired (innate) fear of the sight of one's blood or a sharp object penetrating one's skin. Genetic architecture-charting of fear-circuitry-related traits has been challenging. Various, non-phenotype-based architectures can serve as targets for research. In this article, the author will propose one such alternative genetic architecture. This article was inspired by the following: A) Nesse's “Smoke-Detector Principle”, B) the increasing suspicion that the “smooth” rather than “lumpy” distribution of complex psychiatric phenotypes (including fear-circuitry disorders) may in some cases be accounted for by oligogenic (and not necessarily polygenic) transmission, and C) insights from the initial sequence of the chimpanzee genome and comparison with the human genome by the Chimpanzee Sequencing and Analysis Consortium published in late 2005. Neuroevolutionary insights relevant to fear circuitry symptoms that primarily emerge overconsolidationally (especially Combat related Posttraumatic Stress Disorder) are presented. Also introduced is a human-evolution-based principle for clustering innate fear traits. The “Neuroevolutionary Time-depth Principle” of innate fears proposed in this article may be useful in the development of a neuroevolution-based taxonomic re-clustering of stress-triggered and fear-circuitry disorders in DSM-V. Four broad clusters of evolved fear circuits are proposed based on their time-depths: 1) Mesozoic (mammalian-wide) circuits hardwired by wild-type alleles driven to fixation by Mesozoic selective sweeps; 2) Cenozoic (simian-wide) circuits relevant to many specific phobias; 3) mid Paleolithic and upper Paleolithic ( Homo sapiens -specific) circuits (arguably resulting mostly from mate-choice-driven stabilizing selection); 4) Neolithic circuits (arguably mostly related to stabilizing selection driven by gene–culture co-evolution). More importantly, the author presents evolutionary perspectives on warzone-related PTSD, Combat-Stress Reaction, Combat-related Stress, Operational-Stress, and other deployment-stress-induced symptoms. The Neuroevolutionary Time-depth Principle presented in this article may help explain the dissimilar stress-resilience levels following different types of acute threat to survival of oneself or one's progency (aka DSM-III and DSM-V PTSD Criterion-A events). PTSD rates following exposure to lethal inter-group violence (combat, warzone exposure or intentionally caused disasters such as terrorism) are usually 5–10 times higher than rates following large-scale natural disasters such as forest fires, floods, hurricanes, volcanic eruptions, and earthquakes. The author predicts that both intentionally-caused large-scale bioevent-disasters, as well as natural bioevents such as SARS and avian flu pandemics will be an exception and are likely to be followed by PTSD rates approaching those that follow warzone exposure. During bioevents, Amygdala-driven and locus-coeruleus-driven epidemic pseudosomatic symptoms may be an order of magnitude more common than infection-caused cytokine-driven symptoms. Implications for the red cross and FEMA are discussed. It is also argued that hospital phobia as well as dog phobia, bird phobia and bat phobia require re-taxonomization in DSM-V in a new “overconsolidational disorders” category anchored around PTSD. The overconsolidational spectrum category may be conceptualized as straddling the fear circuitry spectrum disorders and the affective spectrum disorders categories, and may be a category for which Pitman's secondary prevention propranolol regimen may be specifically indicated as a “morning after pill” intervention. Predictions are presented regarding obsessive-compulsive disorder (OCD) (e.g., female-pattern hoarding vs. male-pattern hoarding) and “culture-bound” acute anxiety symptoms (taijin-kyofusho, koro, shuk yang, shook yong, suo yang, rok-joo, jinjinia-bemar, karoshi, gwarosa, Voodoo death). Also discussed are insights relevant to pseudoneurological symptoms and to the forthcoming Dissociative-Conversive disorders category in DSM-V, including what the author terms fright-triggered acute pseudo-localized symptoms (i.e., pseudoparalysis, pseudocerebellar imbalance, psychogenic blindness, pseudoseizures, and epidemic sociogenic illness). Speculations based on studies of the human abnormal-spindle-like, microcephaly-associated ( ASPM ) gene, the microcephaly primary autosomal recessive ( MCPH ) gene, and the forkhead box p2 ( FOXP2 ) gene are made and incorporated into what is termed “The pre- FOXP2 Hypothesis of Blood-Injection-Injury Phobia.” Finally, the author argues for a non-reductionistic fusion of “distal (evolutionary) neurobiology” with clinical “proximal neurobiology,” utilizing neurological heuristics. It is noted that the value of re-clustering fear traits based on behavioral ethology, human-phylogenomics-derived endophenotypes and on ontogenomics (gene–environment interactions) can be confirmed or disconfirmed using epidemiological or twin studies and psychiatric genomics.",0,0 +4688,Soldier Dimensions and Operational Readiness in U.S. Army Forces Deployed to Kosovo,"Abstract : The impact of military deployments on soldiers has been assessed from combat to peacekeeping to humanitarian missions. In a recent study of U.S. Army units deployed to Kosovo in support of a multinational peacekeeping mission, soldier attitudes and health were surveyed on site, mid-way during a 6-month deployment. In all, 1,718 soldiers were surveyed, 53.0% were junior enlisted, 34.5% were non-commissioned officers, and 12.5% were officers. In addition, 15 focused soldier and leader interviews were conducted. Key findings included: (a) Soldiers in Kosovo experienced nearly four times the number of traumatic events had higher rates of depression, slept less and were under higher strain compared to soldiers who did not have such experiences. (b) Soldiers' attitude about peacekeeping missions and military deployments became more negative over the course of the Kosovo deployment. (c) Confidence in leadership was high, although it declined somewhat during the deployment. These findings indicate that deployments involving peacekeeping operations can impact readiness on a broad range of soldier dimensions. These effects, however, can be both positive and negative. Only by addressing and understanding both aspects of a deployment will we be able to ensure that soldier and unit readiness remains high.",0,0 +4689,"Mental Health Problems, Use of Mental Health Services, and Attrition From Military Service After Returning From Deployment to Iraq or Afghanistan","The US military has conducted population-level screening for mental health problems among all service members returning from deployment to Afghanistan, Iraq, and other locations. To date, no systematic analysis of this program has been conducted, and studies have not assessed the impact of these deployments on mental health care utilization after deployment.To determine the relationship between combat deployment and mental health care use during the first year after return and to assess the lessons learned from the postdeployment mental health screening effort, particularly the correlation between the screening results, actual use of mental health services, and attrition from military service.Population-based descriptive study of all Army soldiers and Marines who completed the routine postdeployment health assessment between May 1, 2003, and April 30, 2004, on return from deployment to Operation Enduring Freedom in Afghanistan (n = 16,318), Operation Iraqi Freedom (n = 222,620), and other locations (n = 64,967). Health care utilization and occupational outcomes were measured for 1 year after deployment or until leaving the service if this occurred sooner.Screening positive for posttraumatic stress disorder, major depression, or other mental health problems; referral for a mental health reason; use of mental health care services after returning from deployment; and attrition from military service.The prevalence of reporting a mental health problem was 19.1% among service members returning from Iraq compared with 11.3% after returning from Afghanistan and 8.5% after returning from other locations (P<.001). Mental health problems reported on the postdeployment assessment were significantly associated with combat experiences, mental health care referral and utilization, and attrition from military service. Thirty-five percent of Iraq war veterans accessed mental health services in the year after returning home; 12% per year were diagnosed with a mental health problem. More than 50% of those referred for a mental health reason were documented to receive follow-up care although less than 10% of all service members who received mental health treatment were referred through the screening program.Combat duty in Iraq was associated with high utilization of mental health services and attrition from military service after deployment. The deployment mental health screening program provided another indicator of the mental health impact of deployment on a population level but had limited utility in predicting the level of mental health services that were needed after deployment. The high rate of using mental health services among Operation Iraqi Freedom veterans after deployment highlights challenges in ensuring that there are adequate resources to meet the mental health needs of returning veterans.",0,0 +4690,"Genetic and environmental influences on the relationship among combat exposure, posttraumatic stress disorder symptoms, and alcohol use","The role of genetic and environmental influences on the relationship between combat exposure, posttraumatic stress disorder (PTSD) symptoms, and alcohol use were examined in 4072 male-male twin pairs who served in the United States military during the Vietnam era (1965-1975). Results indicate that the relationship between combat and alcohol use and between PTSD symptom factors and alcohol use were both substantially influenced by genetic factors. Findings are most consistent with a shared vulnerability model for the etiology of the association between PTSD symptoms and alcohol use. Specific unique environmental factors were more important than genetic factors for PTSD symptoms, and both factors were equally important for alcohol use. Further support is also found for the role of the unique environment in PTSD symptoms.",0,0 +4691,The course of mental health disorders after a disaster: Predictors and comorbidity,en,0,0 +4692,Post-traumatic stress disorder and the outcome of dialectical behaviour therapy for borderline personality disorder,"Individuals with borderline personality disorder (BPD) and comorbid post-traumatic stress disorder (PTSD) have a worse prognosis than individuals with BPD alone. A common view is that the emotional instability and impulsivity of BPD should be treated before attempting to address trauma. However, PTSD symptoms may interfere with patients' ability to benefit from such 'stabilizing' treatments.The effect of BPD-PTSD comorbidity on self-harm and BPD symptom outcomes was evaluated in 89 patients receiving dialectical behaviour therapy, using multilevel modelling.Patients with comorbid BPD-PTSD showed a trend towards elevated BPD symptoms throughout the treatment year (β = 2.12, 95% CI = -0.21-4.44, p = 0.07). There was a three-way interaction between PTSD comorbidity, treatment completion and time, whereby PTSD comorbidity was associated with less reduction in self-harm frequency over time, but only in those completing the full 12 months of treatment (incident risk ratio = 1.16, 95% CI = 1.04-1.30, p < 0.01).Patients with comorbid PTSD had a poorer outcome from dialectical behaviour therapy than those with BPD alone, possibly because of the negative impact of unaddressed trauma. The results provide further grounds for recently developed treatments targeting BPD traits and PTSD symptoms simultaneously.",0,0 +4693,Falling Forever: The Price of Chronic Shock,"Manifestations of chronic shock and annihilation anxiety-including autistic defenses, chaotic relationships, disorganized attachment, split-off affective states, and vulnerability to disintegration--exist side by side with apparent ego strength and high functioning, even in nonabused patients. Chronic shock stemming from uncontained distress and failed dependency during childhood can persist throughout the lifespan, creating ripples of dysfunction that mask as character distortion and contribute to therapeutic impasse. Patients rely on omnipotent defenses to provide a sense of ""having skin"" in the face of the fear of breakdown, striving to avoid vulnerability, and trying to insulate themselves from shock experience. Although the relinquishment of autistic defenses and subsequent integration of disowned affect states are overwhelming and painful, patients can emerge from this process with significant shifts in intrapsychic, interpersonal, and existential/spiritual functioning. Clinical material from one psychodynamic psychotherapy group tracks the group process and growth trajectories of seven group members struggling with chronic shock. The ability to recognize subtle dissociative states is a valuable tool in the repertoire of the group psychotherapist.",0,0 +4694,Heterogeneous depression responses to chronic pain onset among middle-aged adults: A prospective study,"Studies on depression response to chronic pain are limited by lack of clarification of different forms of response patterns and cross-sectional measures. The current study examined heterogeneous long-term patterns of depression response to chronic pain onset prospectively using the mixture modeling technique. Depression symptoms prior to and following pain onset over a course of six years were charted in a nationally representative middle-aged sample. Four distinct depression symptom trajectories emerged. The resilience (72.0%) trajectory describes a pattern of no/minimal depression symptoms prior to and following pain onset. The post-pain depression trajectory (11.4%) describes a pattern of low depression at baseline and increasing symptoms following pain onset. The chronic depression (6.8%) trajectory is characterized by persistently high depression symptoms irrespective of pain onset. The prior depression improved (9.8%) trajectory describes a pattern of high depression at baseline and gradually declining symptoms following pain onset. Self-rated health at both baseline and following pain onset predicted the resilience trajectory. Baseline self-rated health distinguished the post-pain depression and chronic depression trajectories. Individuals in the prior depression improved trajectory were older and had more chronic illnesses at baseline but fewer illnesses following pain onset, compared to those in the resilience or post-pain depression trajectory.",0,0 +4695,The Psychological Impact of a Catastrophic Earthquake,"Aim of the present study was to retrospectively assess the impact of a catastrophic earthquake in a sample of 121 survivors, 50 years after the event. Mean age +/- SD of the responders was 72.2 +/- 6.1 years. The majority of the victims (78%) acknowledged a strong overall impact of the earthquake on their lives, and almost all of them had intense recollection of the event at its anniversary. The most frequent symptom during the 6 months after the earthquake was persistent remembering or ""reliving"" of the event; women had considerably more often recurrent dreams of the earthquake and distress than did men. Women and young adults at the time of the earthquake appear to be the most vulnerable groups regarding the psychological effects of the event.",0,0 +4696,"Prolonged exposure therapy: past, present, and future","Depression and AnxietyVolume 28, Issue 12 p. 1043-1047 The Cutting Edge Prolonged exposure therapy: past, present, and future† Edna B. Foa Ph.D., Corresponding Author Edna B. Foa Ph.D. foa@mail.med.upenn.edu Center for the Treatment and Study of Anxiety, University of Pennsylvania, 3535 Market Street, 6th Floor, Philadelphia, PA 19104Center for the Treatment and Study of Anxiety, University of Pennsylvania, 3535 Market Street, 6th Floor, Philadelphia, PA 19104Search for more papers by this author Edna B. Foa Ph.D., Corresponding Author Edna B. Foa Ph.D. foa@mail.med.upenn.edu Center for the Treatment and Study of Anxiety, University of Pennsylvania, 3535 Market Street, 6th Floor, Philadelphia, PA 19104Center for the Treatment and Study of Anxiety, University of Pennsylvania, 3535 Market Street, 6th Floor, Philadelphia, PA 19104Search for more papers by this author First published: 01 December 2011 https://doi.org/10.1002/da.20907Citations: 157 † No conflict of interest was declared. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume28, Issue12December 2011Pages 1043-1047 RelatedInformation",0,0 +4697,An Increased Capacity for Adrenal DHEA Release is Associated with Decreased Avoidance and Negative Mood Symptoms in Women with PTSD,"We recently found increased adrenal cortisol responses to adrenocorticotropic hormone (ACTH)1-24 and increased pituitary ACTH and adrenal cortisol responses to corticotropin-releasing factor in premenopausal women with chronic post-traumatic stress disorder (PTSD) compared to healthy nontraumatized subjects. This pattern of hypothalamic-pituitary-adrenal axis (HPA) hyper-reactivity has been previously seen in healthy individuals treated with the antiglucocorticoid mifepristone. We therefore investigated whether endogenous plasma levels of antiglucocorticoids such as dehydroepiandrosteroine (DHEA) and progesterone were increased in premenopausal women with PTSD at baseline or in response to adrenal activation by ACTH1-24. The study revealed that DHEA responses to 250 microg ACTH1-24 were increased in 13 PTSD subjects compared to 13 healthy nontraumatized subjects, while DHEA levels were generally increased in the PTSD subjects compared to seven healthy traumatized subjects. Cortisol responses to ACTH1-24 were also higher in the women with PTSD, while progesterone levels and responses were not different among the three groups. In addition, among the PTSD subjects, the peak change in DHEA in response to ACTH1-24 was negatively correlated with the total Clinician Administered PTSD Scale score, while the peak DHEA to cortisol ratio was inversely associated with negative mood symptoms measured by the Profile of Mood States scale. This work suggests that an increased capacity for DHEA release in response to extreme adrenal activation may influence the pattern of HPA axis adaptation to extreme stress, as well as mitigate the severity of PTSD and negative mood symptoms in premenopausal women with PTSD.",0,0 +4698,A Constructivist Perspective on Post-Traumatic Stress in Children and Adolescents,"(from the chapter) It is clear from the extant literature that different types of trauma exposure can differentially impact children at different stages of development, and that professionals must take into account the full range of internalizing and externalizing symptoms that so often co-occur with symptoms of posttraumatic stress disorder (PTSD). Although symptom management and reduction are often a critical component of treatment, we agree with the propositions by Wood and colleagues that (1) trauma exposure and subsequent responses are best understood via a social/ecological framework, and (2) it is critical to conceptualize the exposure, reaction, and response as primarily disruptions to a child's sense of self-efficacy. Consistent with these propositions, we utilize a framework for approaching post-traumatic stress in children that allows the symptoms to be targeted while simultaneously addressing the child's disrupted identity and social embeddedness. In this chapter, we will present a constructivist framework for understanding and intervening with post-traumatic stress reactions in childhood and adolescence. Although we base much of our thinking on traditional personal construct psychology, the perspective has been extended and reformulated by other constructivist scholars, including ourselves. We will begin with a consideration of how personal constructs and personal identity develop in childhood. Next, we will consider adolescent development from a constructivist perspective. Then, we will turn attention to how traumatic experiences can serve to disrupt identity and personal functioning across these two developmental periods. Finally, we will present a constructivist approach to assisting children and adolescents in adapting to life after a traumatic disruption. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0,0 +4699,Pretraumatic Stress Reactions in Soldiers Deployed to Afghanistan,"Posttraumatic Stress Disorder is a diagnosis related to the past. Pre-traumatic stress reactions, as measured by intrusive involuntary images of possible future stressful events and their associated avoidance and increased arousal, have been overlooked in the PTSD literature. Here we introduce a scale that measures pre-traumatic stress reactions providing a clear future-oriented parallel to the posttraumatic stress reactions described in the diagnostic criteria for PTSD. We apply this pre-traumatic stress reactions checklist (PreCL) to Danish soldiers before, during, and after deployment to Afghanistan. The PreCL has good internal consistency and is highly correlated with a standard measure of PTSD symptoms. The PreCL as answered before the soldiers' deployment significantly predicted level of PTSD symptoms during and after their deployment, while controlling for baseline PTSD symptoms and combat exposure measured during and after deployment. The findings have implications for the conceptualization of PTSD, screening, and treatment.",0,0 +4700,From Postimpact to Reconstruction: Considerations When Treating Traumatized Child and Adolescent Clients,"Longitudinal data analyses have revealed that children and adolescents may encounter several distinct recovery stages and trajectories following exposure to a traumatic event. As recent dissemination efforts have increased the availability of training in various empirically-supported treatments, mental health service providers may struggle to identify among these approaches a treatment that is best suited to address the needs of an individual client. Treatment planning should take into consideration the severity of distress symptoms, as well as the timing, mode of delivery, and the setting of intervention. In this paper we provide an overview of assessment and emerging treatment approaches that can be used across various phases of recovery. We also identify a framework for making treatment decisions based on existing research. Finally, we propose next steps for research and practice in the area of treating traumatized children and adolescents.",0,0 +4701,Depression Subtypes in Pediatric Inflammatory Bowel Disease,"The association between inflammatory bowel disease (IBD) and depression provides a unique opportunity to understand the relation between systemic inflammation and depressive symptom profiles.Youth (n = 226) ages 9 to 17 years with comorbid IBD and depression underwent psychiatric assessment and evaluation of IBD activity. Latent profile analysis (LPA) identified depressive subgroups based on similar responses to the Children's Depression Rating Scale-Revised. Demographic factors, depression severity, anxiety, IBD activity, inflammatory markers, IBD-related medications, and illness perception were evaluated as predictors of profile membership.Mean age was 14.3 years; 75% had Crohn disease; 31% were taking systemic corticosteroids. Mean depressive severity was moderate, whereas IBD activity, which reflects inflammation, was mild. LPA identified 3 subgroups: Profile-1 (mild, 75%) had diverse low-grade depressive symptoms and highest quality of life; Profile-2 (somatic, 19%) had severe fatigue, appetite change, anhedonia, decreased motor activity, and depressed mood with concurrent high-dose steroid therapy and the highest IBD activity; and Profile-3 (cognitive, 6%) had the highest rates of self-reported depressive symptoms, ostomy placements, and anxiety with IBD symptoms in the relative absence of inflammation.Evidence was found for 3 depression profiles in youth with IBD and depression. Our analyses determined that patients with predominantly somatic or cognitive symptoms of depression comprised 25% of our cohort. These findings may be used to design subgroup-specific interventions for depression in adolescents with IBD and other physical illnesses associated with systemic inflammation.",0,0 +4702,"Building resiliency: a cross-sectional study examining relationships among health-related quality of life, well-being, and disaster preparedness","Worldwide, disaster exposure and consequences are rising. Disaster risk in New Zealand is amplified by island geography, isolation, and ubiquitous natural hazards. Wellington, the capital city, has vital needs for evacuation preparedness and resilience to the devastating impacts and increasing uncertainties of earthquake and tsunami disasters. While poor quality of life (QoL) is widely-associated with low levels of engagement in many health-protective behaviors, the relationships among health-related quality of life (HrQoL), well-being, and preparedness are virtually unknown.We hypothesized that QoL and well-being affect household evacuation preparedness. We performed a quantitative epidemiologic survey (cross-sectional design) of Wellington adults. Our investigation assessed health-promoting attributes that build resiliency, conceptualized as health-protective attitudes and behaviors. Multidimensional QoL variables were measured using validated psychometric scales and analyzed for associations with evacuation preparedness, and we determined whether age and gender affected these relationships.We received 695 survey responses (28.5% response rate; margin of error ±3.8%; 80% statistical power to detect true correlations of 0.11 or greater). Correlational analyses showed statistically significant positive associations with evacuation preparedness for spiritual well-being, emotional well-being, and life satisfaction. No associations were found for mental health, social well-being, or gender; physical health was weakly negatively associated. Evacuation preparedness increased with age. Regression analyses showed that overall health and well-being explained 4.6-6.8% of the variance in evacuation preparedness. Spiritual well-being was the only QoL variable that significantly and uniquely explained variance in preparedness.How well-being influences preparedness is complex and deeply personal. The data indicate that multidimensional readiness is essential, and meaningfulness is an important factor. Inadequate levels of tangible preparedness actions are accompanied by gaps in intangible readiness aspects, such as: 1) errors in perceived exposure to and salience of natural hazards, yielding circumscribed risk assessments; 2) unfamiliarity with the scope and span of preparedness; 3) underestimating disaster consequences; and 4) misinterpreting the personal resources required for self-managing disaster and uncertainty. Our results highlight that conceptualizing preparedness to include attitudes and behaviors of readiness, integrating well-being and meaningfulness into preparedness strategies, and prioritizing evacuation planning are critical for resiliency as a dynamic process and outcome.",0,0 +4703,"Alternate forms of adjustment in adult women survivors of CSA: The relationship between wellness, resilience, and post-traumatic growth","Women disproportionately experience victimization as children, with at least one in five women reporting a history of child sexual abuse. The short and long term effects, both physical and emotional, are significant, negative, and pervasive, making CSA a critical physical and mental health issue for a significant portion of women in the United States. However, while many survivors experience negative long-term effects, a significant portion do not. This study addressed the need for greater attention to factors which depathologize this population, particularly the experiences of survivorship and how these are expressed in terms of wellness, resilience and post-traumatic growth (PTG). A sample of 163 adult women survivors completed an online survey comprised of instruments measuring wellness, resilience, PTG, and post-traumatic stress. A series of correlations revealed positive relationships between wellness factors and resilience, and wellness factors and PTG. Negative correlations were found between PTS symptoms and Resilience, and PTS symptoms and Wellness. Resilience and PTG were negatively correlated, a finding contrary to the conceptualization in the literature. A MANOVA and a series of linear regressions analyzed factors that might contribute to the variance in the major constructs. The results of the MANOVA indicated that the relationship to the perpetrator only affected PTS symptoms: women abused by a relative had significantly higher PTS symptoms. The results of the linear regressions indicated that the variables (current age, additional childhood maltreatment, reported current impact of CSA, CSA severity, and age at onset of abuse) accounted for a very small percentage of the variance in Wellness (16%) and Resilience (10%), and a greater amount of variance in total PTS symptoms (39%). The variables did not account for a significant amount of variance in PTG. The largest contributor of the variance in Wellness, Resilience, and PTS symptoms was the current impact of CSA while CSA severity was a significant contributor to PTS symptoms. A series of t-tests were conducted to analyze the difference between the wellness of this sample and the wellness reported by the normative group. Results indicated that the women in this sample had significantly lower Creative Self, Social Self, and Essential Self wellness but had significantly higher Physical Self wellness. No significant difference was found for Total Wellness and Coping Self wellness. The results of the final analysis, a hierarchical linear regression, indicated that above and beyond demographic variables, Resilience by far, and PTG, to a much smaller degree, were significant predictors of the variance in wellness factors. Additional research is necessary in order to further explore the relationships between wellness factors, resilience, and PTG.",0,0 +4704,Psychophysiologic assessment of traumatic imagery in Israeli civilian patients with posttraumatic stress disorder,"This study used a script-driven imagery technique, previously used with combat veterans, to assess physiologic responses of Israeli survivors of noncombat traumas.Each subject had experienced an event meeting DSM-III-R criterion A for posttraumatic stress disorder (PTSD). The subjects were classified on the basis of the full DSM-III-R criteria into a current PTSD group (N = 13) and a non-PTSD group (N = 13). Thirty-second scripts describing each subject's personal traumatic event, as well as other events, were prepared. The scripts incorporated subjective visceral and muscular responses reported to have accompanied each experience. In the laboratory, the scripts were read one at a time to the subject, who was instructed to imagine each event portrayed as vividly as possible, while heart rate, skin conductance, and left lateral frontalis electromyogram levels were measured.Multivariate analysis of variance revealed that the physiologic responses of the PTSD subjects during imagery of their personal traumatic experiences were significantly greater than those of the non-PTSD subjects. This difference was not explained by age, gender, or rated severity of the traumatic event. A physiologic discriminant function derived from previously studied Vietnam veterans correctly classified nine of the 13 PTSD subjects (sensitivity = 69%) and 10 of the 13 non-PTSD subjects (specificity = 77%).These results replicate previous findings of heightened physiologic responses during personal combat imagery in male American war veterans and extend them to a group of male and female Israeli civilian victims of trauma, supporting the robustness of physiologic responding during personal traumatic imagery as a measure of PTSD.",0,0 +4705,"Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis","There has been debate regarding whether Complex Posttraumatic Stress Disorder (Complex PTSD) is distinct from Borderline Personality Disorder (BPD) when the latter is comorbid with PTSD.To determine whether the patterns of symptoms endorsed by women seeking treatment for childhood abuse form classes that are consistent with diagnostic criteria for PTSD, Complex PTSD, and BPD.A latent class analysis (LCA) was conducted on an archival dataset of 280 women with histories of childhood abuse assessed for enrollment in a clinical trial for PTSD.THE LCA REVEALED FOUR DISTINCT CLASSES OF INDIVIDUALS: a Low Symptom class characterized by low endorsements on all symptoms; a PTSD class characterized by elevated symptoms of PTSD but low endorsement of symptoms that define the Complex PTSD and BPD diagnoses; a Complex PTSD class characterized by elevated symptoms of PTSD and self-organization symptoms that defined the Complex PTSD diagnosis but low on the symptoms of BPD; and a BPD class characterized by symptoms of BPD. Four BPD symptoms were found to greatly increase the odds of being in the BPD compared to the Complex PTSD class: frantic efforts to avoid abandonment, unstable sense of self, unstable and intense interpersonal relationships, and impulsiveness.Findings supported the construct validity of Complex PTSD as distinguishable from BPD. Key symptoms that distinguished between the disorders were identified, which may aid in differential diagnosis and treatment planning.",0,0 +4706,Traumatic Stressors and Post-Traumatic Stress Disorder Symptoms in Headache Patients,"The aim of this study was to assess the prevalence of significant traumatic stressors and post-traumatic stress disorder (PTSD) symptoms in a headache population.Several recent publications have emphasized the relationship between life stressors and/or daily hassles and recurrent headaches. However, little is known about the prevalence and impact of major traumatic stressors in patients with recurrent headaches.Eighty patients with either migraine or tension-type headache completed a PTSD checklist. Data were compared with those from patients with chronic masticatory muscle pain of similar intensity and duration.Almost 64% of the headache patients reported one or more major traumatic stressors. This percentage was not significantly different from that of the comparison group, and fell within the broad range reported for exposure to traumatic stressors in epidemiologic studies with nonpatient populations. One out of 6 patients in the total headache sample, and 1 out of 4 of those reporting a traumatic stressor, reported symptoms suggestive of current PTSD. The prevalence of current PTSD-like symptomatology reported by the headache patients was comparable to that of the comparison group of the present study, but higher than that reported for the general population in the available literature printed in English. Traumatic stressors most often reported were not related to direct physical trauma, but rather associated with loss or serious illness of a loved one.Exposure to traumatic events in patients with a primary diagnosis of recurrent headaches is similar to that reported for chronic masticatory muscle pain patients or nonpatient populations. However, symptoms consistent with a diagnosis of current PTSD appear to be more frequent in patients with recurrent headaches than reported in the scientific literature printed in English for nonpatient populations. Screening for PTSD symptomatology is recommended as part of the routine clinical evaluation of headache.",0,0 +4707,"Acute Stress Disorder, Posttraumatic Stress Disorder, and Depression in Disaster or Rescue Workers","The events of Sept. 11, 2001, highlighted the importance of understanding the effects of trauma on disaster workers. To better plan for the health care of disaster workers, this study examined acute stress disorder, posttraumatic stress disorder (PTSD), early dissociative symptoms, depression, and health care utilization in disaster workers.Exposed disaster workers (N=207) and unexposed comparison subjects (N=421) were examined at 2, 7, and 13 months after an airplane crash.Exposed disaster workers had significantly higher rates of acute stress disorder, PTSD at 13 months, depression at 7 months, and depression at 13 months than comparison subjects. Those who were younger and single were more likely to develop acute stress disorder. Exposed disaster workers with acute stress disorder were 3.93 times more likely to be depressed at 7 months. Those with high exposure and previous disaster experience or who had acute stress disorder were more likely to develop PTSD. Similarly, those who were depressed at 7 months were 9.5 times more likely to have PTSD. Those who were depressed at 13 months were 7.96 times more likely to also meet PTSD criteria. More exposed disaster workers than comparison subjects obtained medical care for emotional problems at 2, 7, and 13 months. Overall, 40.5% of exposed disaster workers versus 20.4% of comparison subjects had acute stress disorder, depression at 13 months, or PTSD.Exposed disaster workers are at increased risk of acute stress disorder, depression, or PTSD and seek care for emotional problems at an increased rate.",0,0 +4708,Positive Psychological Factors are Associated with Lower PTSD Symptoms among Police Officers: Post Hurricane Katrina,"Following Hurricane Katrina, police officers in the New Orleans geographic area faced a number of challenges. This cross-sectional study examined the association between resilience, satisfaction with life, gratitude, posttraumatic growth, and symptoms of posttraumatic stress disorder in 84 male and 30 female police officers from Louisiana. Protective factors were measured using the Connor–Davidson Resilience scale, Satisfaction with Life Scale, the Gratitude Questionnaire, and the Posttraumatic Growth inventory. Symptoms of posttraumatic stress disorder were measured using the Posttraumatic Stress Disorder Checklist—Civilian (PCL-C). Potential associations were measured using linear regression and analysis of variance. Models were adjusted for age, sex, race, education, and alcohol. Mean PCL-C symptoms were 29.5 ± 14.5 for females and 27.8 ± 12.1 for males. Adjusted mean levels of PCL-C symptoms significantly decreased as quartiles of resilience (p < .001), satisfaction with life (p < .001), and gratitude (p < .001) increased. In contrast, PCL-C symptoms were not associated with posttraumatic growth in this sample. These results indicate that positive factors such as resilience, satisfaction with life, and gratitude may help mitigate symptoms of posttraumatic stress disorder. To further explore these relationships, longitudinal follow-up in a larger population would be of interest. Copyright © 2014 John Wiley & Sons, Ltd.",0,0 +4709,Diagnosis of probable psychogenic nonepileptic seizures in the outpatient clinic: Does gender matter?,"Psychogenic nonepileptic seizures (PNESs) are paroxysmal events of altered behavior that outwardly resemble epilepsy but are caused by psychiatric disease. The diagnosis of probable PNESs can be made in the outpatient clinic prior to video-EEG monitoring by identification of specific PNES predictors and specific elements of seizure semiology from the clinical history. Since psychiatric disease may have distinct mechanisms between women and men, the objective of this study was to determine if gender-specific differences exist in PNES predictors and PNES semiology. Such differences could be used to optimize the accuracy of outpatient diagnosis of probable PNESs. Medical records of male and female patients with video-EEG diagnosis of definite PNESs were retrospectively reviewed for occurrence of PNES predictors. In addition, PNES semiology was analyzed de novo from video-EEG records and categorized into previously established semiology clusters. Eighty-six patients were included in the analysis (59 women and 27 men). We found significantly lower rates of reported physical and sexual abuse, lower rates of previous psychiatric diagnosis, and lower rates of chronic pain in male patients with no significant differences in rates of other PNES predictors. Furthermore, we found no difference in PNES semiology between men and women, with both groups experiencing similar rates of major motor, minor motor, and nonmotor semiology. In conclusion, our results lend support to the idea that distinct risk factor criteria but similar semiology criteria should be used for the diagnosis of probable PNESs in the outpatient clinic in men and women.",0,0 +4710,MMPI Configural Interpretation as Applied to Posttraumatic Stress Disorder in Vietnam Veterans,"This study investigated the systems of Minnesota Multiphasic Personality Inventory (MMPI) configural interpretation of Skinner and Jackson (1978) and Kunce (1979) with Vietnam veterans with posttraumatic stress disorder (PTSD). MMPI profiles of four groups differing in combat exposure were compared on four MMPI configural variables from Kunce (1979) and Skinner and Jackson (1978). The four groups were (a) PTSD sufferers, (b) Vietnam combat veterans without PTSD, (c) Vietnam noncombat veterans, and (d) Vietnam era veterans. All groups were further divided into hospitalized versus nonhospitalized subgroups. Dependent variables were Skinner and Jackson's (a) sociopathic modal profile, (b) neurotic profile, (c) psychotic profile, and (d) Kunce's emotional expression (enthusiastic-reserved) dimension. Results indicated that hospitalized PTSD subjects had significantly higher scores on Skinner and Jackson's neurotic profile; both hospitalized and nonhospitalized PTSD subjects had higher scores on the psychotic profile and were more ""reserved"" on Kunce's emotional expression dimension. Results were interpreted in terms of configural MMPI interpretation systems and the adjustment of Vietnam veterans with PTSD. PTSD was viewed as exhibiting cognitive, somatic, and affective features.",0,0 +4711,PTSD severity and health perceptions in female victims of sexual assault,"In women with chronic posttraumatic stress disorder (PTSD), poor physical health may be related to their PTSD symptoms through an underlying negative affect or distress that accompanies the disorder, through the PTSD symptoms in general, or specifically through the chronic hyperarousal present in the disorder. The current study examined the relative contribution of these factors to reported physical symptoms in female victims of sexual assault. Seventy-six women with chronic PTSD were assessed, using measures of stressful life events, psychological difficulties, and perceived health. Negative life events, anger, depression, and PTSD severity were all related to self-reported physical symptoms; however, PTSD severity predicted self-reported physical symptoms beyond these other variables. Contrary to our hypothesis, the reexperiencing cluster of PTSD, and not the hyperarousal cluster, was related to self-reported physical symptoms.",0,0 +4712,What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study,"Concerns have been raised about the psychological effect of continued combat exposure and of repeated deployments. We examined the consequences of deployment to Iraq and Afghanistan on the mental health of UK armed forces from 2003 to 2009, the effect of multiple deployments, and time since return from deployment.We reassessed the prevalence of probable mental disorders in participants of our previous study (2003-05). We also studied two new randomly chosen samples: those with recent deployment to Afghanistan, and those who had joined the UK armed forces since April, 2003, to ensure that the final sample continued to be representative of the UK armed forces. Between November, 2007, and September, 2009, participants completed a questionnaire about their deployment experiences and health outcomes.9990 (56%) participants completed the study questionnaire (8278 regulars, 1712 reservists). The prevalence of probable post-traumatic stress disorder was 4.0% (95% CI 3.5-4.5; n=376), 19.7% (18.7-20.6; n=1908) for symptoms of common mental disorders, and 13.0% (12.2-13.8; n=1323) for alcohol misuse. Deployment to Iraq or Afghanistan was significantly associated with alcohol misuse for regulars (odds ratio 1.22, 95% CI 1.02-1.46) and with probable post-traumatic stress disorder for reservists (2.83, 1.23-6.51). Regular personnel in combat roles were more likely than were those in support roles to report probable post-traumatic stress disorder (1.87, 1.26-2.78). There was no association with number of deployments for any outcome. There was some evidence for a small increase in the reporting of probable post-traumatic stress disorder with time since return from deployment in regulars (1.13, 1.03-1.24).Symptoms of common mental disorders and alcohol misuse remain the most frequently reported mental disorders in UK armed forces personnel, whereas the prevalence of probable post-traumatic stress disorder was low. These findings show the importance of continued health surveillance of UK military personnel.UK Ministry of Defence.",0,0 +4713,Differential mediating effects of PTSD symptom clusters on alcohol use and sleep in university students with trauma experiences: A multi-group analysis,"This study investigates the differential mediating pathways of PTSD symptom clusters in the relationship between traumatic events and alcohol use or poor sleep quality in a sample of university students with traumatic life experiences using a path analysis. Gender difference was also examined using multi-group analysis. Male (N = 1471) and female (N = 528) university students completed an online mental health survey consisting of the Life Event Checklist, the Impact of Event Scale-Revised, the CAGE Questionnaire, and the Pittsburgh Sleep Quality Index. Results showed that traumatic events had a direct impact on both alcohol use and poor sleep quality. The indirect impact of traumatic events on alcohol use appeared to be through PTSD-avoidance, and the indirect impact of traumatic events on poor sleep quality appeared to be through PTSD-intrusion and PTSD-hyperarousal. A multi-group analysis showed that male students are 3.25 times more likely to use alcohol in response to traumatic stress than female students. Our findings suggest that there are differential mediating mechanisms of PTSD symptom clusters underlying alcohol use or poor sleep quality following traumatic events, indicating the importance of developing symptom-tailored therapeutic intervention.",0,0 +4714,Post-Traumatic Stress Disorder in Israeli Survivors of Childhood Cancer,"To investigate the prevalence, symptom severity, and risk factors associated with post-traumatic stress disorder (PTSD) in childhood cancer survivors.Descriptive, correlational study.Follow-up clinic in Petach Tikva, Israel.Convenience sample of 70 adult Israeli survivors of childhood cancer.Questionnaires (the Post-Traumatic Diagnostic Scale and the Multidimensional Scale of Perceived Social Support) were distributed to participants, and demographic and clinical data were obtained from medical records.Post-traumatic stress, social support, and clinical and demographic data.Twenty (29%) of the participants met the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for PTSD; 10% experienced mild, 40% moderate, and 50% moderate to severe symptoms. Only 16% of the sample did not experience any symptoms of PTSD. A statistically significant negative relationship was found between PTSD symptom scores and the current age of the respondent (r(s) = -0.27, p = 0.03) and time since medical treatment (r(s) = -0.34, p = 0.004) but not any other demographic or clinical variables or social support.Higher severity of PTSD symptoms was found, possibly because of local living conditions. Most clinical and demographic variables were not risk factors. This population should be studied further in an effort to prevent PTSD via early diagnosis.Oncology nurses should be aware of the potential risk factors (recent completion of treatment and younger current age) and the high prevalence and severity of PTSD among survivors of childhood cancer to identify patients at higher risk and develop programs that prevent, limit, and treat PTSD.",0,0 +4715,Dimensional structure of DSM-5 posttraumatic stress symptoms: Support for a hybrid Anhedonia and Externalizing Behaviors model,"Several revisions to the symptom clusters of posttraumatic stress disorder (PTSD) have been made in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Central to the focus of this study was the revision of PTSD's tripartite structure in DSM-IV into four symptom clusters in DSM-5. Emerging confirmatory factor analytic (CFA) studies have suggested that DSM-5 PTSD symptoms may be best represented by one of two 6-factor models: (1) an Externalizing Behaviors model characterized by a factor which combines the irritability/anger and self-destructive/reckless behavior items; and (2) an Anhedonia model characterized by items of loss of interest, detachment, and restricted affect. The current study conducted CFAs of DSM-5 PTSD symptoms assessed using the PTSD Checklist for DSM-5 (PCL-5) in two independent and diverse trauma-exposed samples of a nationally representative sample of 1484 U.S. veterans and a sample of 497 Midwestern U.S. university undergraduate students. Relative fits of the DSM-5 model, the DSM-5 Dysphoria model, the DSM-5 Dysphoric Arousal model, the two 6-factor models, and a newly proposed 7-factor Hybrid model, which consolidates the two 6-factor models, were evaluated. Results revealed that, in both samples, both 6-factor models provided significantly better fit than the 4-factor DSM-5 model, the DSM-5 Dysphoria model and the DSM-5 Dysphoric Arousal model. Further, the 7-factor Hybrid model, which incorporates key features of both 6-factor models and is comprised of re-experiencing, avoidance, negative affect, anhedonia, externalizing behaviors, and anxious and dysphoric arousal symptom clusters, provided superior fit to the data in both samples. Results are discussed in light of theoretical and empirical support for the latent structure of DSM-5 PTSD symptoms.",0,0 +4716,The Crisis Support Scale: psychometric qualities and further validation,"The objective of the present study was to provide a further validation of the Crisis Support Scale, which is a short scale for measuring social support after a crisis has occurred. The data from eleven trauma studies of 4213 subjects were used to investigate the psychometric properties of the scale and the differences that emerge due to age, gender, and type of trauma. The scale appears to be very robust. Some aspects of crisis support seem to decrease as time goes by while others increase. Women survivors report less support than men both right after the trauma and later on. The younger survivors tend to report the least support in the acute phase although this picture is reversed later on. The various types of trauma have different item profiles, which supports the concurrent validity of the scale.",0,0 +4717,"Post-traumatic Stress Disorder, Anxiety and Depression among the Elderly: A Survey of the Hard-hit Areas a Year after the Wenchuan Earthquake","Few studies to date have examined psychological sequelae of natural disasters among the elderly in China. The aim of this study was to investigate the prevalence rates of probable post-traumatic stress disorder (PTSD), anxiety and depression in the elderly survivors a year after the Wenchuan earthquake as well as to analyse related risk factors. The community-based sample of the study consisted of 284 elderly survivors (≥60 years). PTSD was assessed by the PTSD Checklist--Civilian version, and anxiety and depression were assessed by the Hopkins Symptoms Checklist. In total, the estimated prevalence rates of probable PTSD, anxiety and depression were 26.3%, 42.9% and 35.2%, respectively. Nearly a fifth of the elderly participants reported symptoms that meet the criteria for all three of these mental disorders. Results indicated that some factors associated with earthquake-exposure intensity, which included loss of livelihood, bereavement, injury and initial fear during the earthquake, were among the significant risk factors for these mental disorders. Women had a higher risk of suffering from probable anxiety as compared to men. Finally, the significance and limitations of this study were also discussed.",0,0 +4718,Chronic post-traumatic headache: clinical findings and possible mechanisms,"Chronic post-traumatic headache (CPTHA), the most frequent complaint after traumatic brain injury (TBI), dramatically affects quality of life and function. Despite its high prevalence and persistence, the mechanism of CPTHA is poorly understood. This literature review aimed to analyze the results of studies assessing the characteristics and sensory profile of CPTHA in order to shed light on its possible underlying mechanisms. The search for English language articles published between 1960 and 2013 was conducted in MEDLINE, CINAHL, and PubMed. Studies assessing clinical features of headache after TBI as well as studies conducting quantitative somatosensory testing (QST) in individuals with CPTHA and in individuals suffering from other types of pain were included. Studies on animal models of pain following damage to peripheral tissues and to the peripheral and central nervous system were also included. The clinical features of CPTHA resembled those of primary headache, especially tension-type and migraine headache. Positive and negative signs were prevalent among individuals with CPTHA, in both the head and in other body regions, suggesting the presence of local (cranial) mechanical hypersensitivity, together with generalized thermal hypoesthesia and hypoalgesia. Evidence of dysfunctional pain modulation was also observed. Chronic post-traumatic headache can result from damage to intra- and pericranial tissues that caused chronic sensitization of these tissues. Alternatively, although not mutually exclusive, CPTHA might possibly be a form of central pain due to damage to brain structures involved in pain processing. These, other possibilities, as well as risk factors for CPTHA are discussed at length.",0,0 +4719,Etiology of depression comorbidity in combat-related PTSD: A review of the literature,"Posttraumatic stress disorder is often diagnosed with other mental health problems, particularly depression. Although PTSD comorbidity has been associated with more severe and chronic symptomology, relationships among commonly co-occurring disorders are not well understood. The purpose of this study was to review the literature regarding the development of depression comorbid with combat-related PTSD among military personnel. We summarize results of commonly tested hypotheses about the etiology of PTSD and depression comorbidity, including (1) causal hypotheses, (2) common factor hypotheses, and (3) potential confounds. Evidence suggests that PTSD may be a causal risk factor for subsequent depression; however, associations are likely complex, involving bidirectional causality, common risk factors, and common vulnerabilities. The unique nature of PTSD-depression comorbidity in the context of military deployment and combat exposure is emphasized. Implications of our results for clinical practice and future research are discussed.",0,0 +4720,Sleep and post-traumatic stress disorder: A roadmap for clinicians and researchers,"The three reviews in this issue of Sleep Medicine Reviews present formulations based on emerging findings that relate to sleep disturbances in posttraumatic stress disorders (PTSD). This set of papers is a timely selection for Sleep Medicine Reviews. PTSD is now recognized to be a prevalent disorder that confers considerable distress and morbidity. Appreciation of the significance of the disorder is increasing in relation to recent and ongoing wars, acts of terrorism, and natural disasters. People who experience traumatic stress often have a strong and intuitive appreciation of the importance of sleep to their emotional adaptation and as a contributor to their distress. This awareness is conveyed to clinicians who treat PTSD who in turn recognize the importance of targeting disturbed sleep with their treatments. The past 20 years has seen burgeoning research in the neurobiology of PTSD with much of the emphasis being neuroendocrinology and brain imaging. Achieving a coherent characterization of sleep dysregulation in PTSD and its integration with models of PTSD pathogenesis has challenged the field. Progress toward these goals and the promise of achieving them are highlighted by these manuscripts. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4721,"Assessing posttraumatic stress disorder with or without reference to a single, worst traumatic event: Examining differences in factor structure.","The authors examined the effects of a methodological manipulation on the Posttraumatic Stress Disorder (PTSD) Checklist's factor structure: specifically, whether respondents were instructed to reference a single worst traumatic event when rating PTSD symptoms. Nonclinical, trauma-exposed participants were randomly assigned to 1 of 2 PTSD assessment conditions: referencing PTSD symptoms to their worst trauma (trauma-specific group, n = 218) or to their overall trauma history in general (trauma-general group, n = 234). A 3rd group of non-trauma-exposed participants (n = 464) rated PTSD symptoms globally from any stressful event. Using confirmatory factor analysis, the authors show that the 4-factor PTSD model proposed by D. W. King, G. A. Leskin, L. A. King, and F. W. Weathers (1998; separating effortful avoidance and emotional numbing) demonstrated the best model fit for trauma-general and non-trauma-exposed participants. The 4-factor PTSD model proposed by L. J. Simms, D. Watson, and B. N. Doebbeling (2002; emphasizing a general dysphoria factor) demonstrated the best model fit for trauma-specific participants. Measurement invariance testing revealed that non-trauma-exposed participants were different from both trauma-exposed groups on factor structure parameters, but trauma groups were not substantially different from each other.",0,0 +4722,Brief measure of posttraumatic stress reactions: Impact of Event Scale-6,"BACKGROUND: The Impact of Event Scale-revised (IES-R) is one of the most widely used measures of posttraumatic stress reactions. However, for some purposes, such as large epidemiological studies, there is a need for briefer instruments. The aim of this study was to develop and validate an abbreviated version of the IES-R that could capture the three current symptom clusters of posttraumatic stress disorder (PTSD). METHODS: Stepwise multiple regression was applied to abbreviate the IES-R in one sample. The abbreviated version was then tested in three separate samples of individuals exposed to different kinds of potentially traumatic events. Agreement with a reference measure of PTSD, the PTSD checklist (PCL), was calculated for the abbreviated and the full-scale versions of IES. RESULTS: The abbreviation procedure resulted in a subset of six items (the IES-6), which correlated highly (pooled correlation = 0.95) with the IES-R across samples. Correlations between the IES-6 and IES-R subscales were somewhat lower (r = 0.78-0.94). Both the IES-6 and IES-R were in high agreement with the PCL. CONCLUSION: The IES-6 appears to be a robust brief measure of posttraumatic stress reactions. It may be useful for research in epidemiological studies, and it may also have a role as a screening instrument in clinical practice.",0,0 +4723,The moderation of resilience on the negative effect of pain on depression and post-traumatic growth in individuals with spinal cord injury,"To determine the moderating effect of resilience on the negative effects of chronic pain on depression and post-traumatic growth.Community-dwelling individuals with SCI (n = 37) were recruited at short-term admission for yearly regular health examination. Participants completed self-rating standardized questionnaires measuring pain, resilience, depression and post-traumatic growth. Hierarchical linear regression analysis was performed to identify the moderating effect of resilience on the relationships of pain with depression and post-traumatic growth after controlling for relevant covariates.In the regression model of depression, the effect of pain severity on depression was decreased (β was changed from 0.47 to 0.33) after entering resilience into the model. In the final model, both pain and resilience were significant independent predictors for depression (β = 0.33, p = 0.038 and β = -0.47, p = 0.012, respectively). In the regression model of post-traumatic growth, the effect of pain severity became insignificant after entering resilience into the model. In the final model, resilience was a significant predictor (β = 0.51, p = 0.016).Resilience potentially mitigated the negative effects of pain. Moreover, it independently contributed to reduced depression and greater post-traumatic growth. Our findings suggest that resilience might provide a potential target for intervention in SCI individuals.",0,0 +4724,The Peritraumatic Behavior Questionnaire: development and initial validation of a new measure for combat-related peritraumatic reactions,"Abstract Background Posttraumatic stress disorder (PTSD) is one of the most commonly observed stress-related conditions following combat exposure and its effective prevention is a high health-care priority. Reports of peritraumatic reactions have been shown to be highly associated with PTSD among combat exposed service members. However, existing instruments measuring peritraumatic symptoms were not specifically developed to assess combat-related peritraumatic stress and each demonstrates a different peritraumatic focus. We therefore developed the Peritraumatic Behavior Questionnaire (PBQ), a new military-specific rating scale focused upon the wide range of symptoms suggestive of combat-related peritraumatic distress in actively deployed Service Members. This study describes the development of the PBQ and reports on the psychometric properties of its self-rated version (PBQ-SR). Methods 688 Marine infantry service members were retrospectively assessed by the PBQ-SR within the scope of the Marine Resiliency Study after their deployment to war zone. Participants have been additionally assessed by a variety of questionnaires, as well as clinical interviews both pre and post-deployment. Results The PBQ-SR demonstrated satisfactory internal consistency, convergent and discriminant validity, as well as high correlation with trait dissociation prior to deployment. Component analysis suggested a latent bi-dimensional structure separating a peritraumatic emotional distress and physical awareness factor. The PBQ-SR total score showed high correlation to general anxiety, depression, poorer general health and posttraumatic symptoms after deployment and remained a significant predictor of PTSD severity, after controlling for those measures. The suggested screening cut-off score of 12 points demonstrated satisfactory predictive power. Conclusions This study confirms the ability of the PBQ-SR to unify the underlying peritraumatic symptom dimensions and reliably assess combat-related peritraumatic reaction as a general construct. The PBQ-SR demonstrated promise as a potential standard screening measure in military clinical practice, while It’s predictive power should be established in prospective studies.",0,0 +4725,Longitudinal Course of Posttraumatic Stress Disorder and Posttraumatic Stress Disorder Symptoms in a Community Sample of Adolescents and Young Adults,"OBJECTIVE: Few studies have focused on the natural course of posttraumatic stress disorder (PTSD) and its determinants in samples of the general population. The authors examined determinants of remission and chronicity of PTSD and associations with other disorders in a prospective community sample. METHOD: The data were drawn from a prospective, longitudinal epidemiological study of adolescents and young adults (age 14–24 years) in Munich, Germany (N=2,548). The course of PTSD from baseline to follow-up 34–50 months later was studied in 125 respondents with DSM-IV PTSD or subthreshold PTSD at baseline. RESULTS: Although 52% of the PTSD cases remitted during the follow-up period, 48% showed no significant remission of PTSD symptoms. Respondents with a chronic course were more likely to experience new traumatic event(s) during follow-up (odds ratio=5.21, 95% confidence interval [CI]=1.95–13.92), to have higher rates of avoidant symptoms at baseline (odds ratio=10.16, 95% CI=1.73–59.51), and to report more help seeking (odds ratio=5.50, 95% CI=1.04–29.05), compared to respondents with remission. Rates of incident somatoform disorder (odds ratio=4.24, 95% CI=1.60–11.19) and other anxiety disorders (odds ratio=4.07, 95% CI=1.15–14.37) were also significantly associated with a chronic course. CONCLUSIONS: PTSD is often a persistent and chronic disorder. Specific symptom clusters—especially avoidant symptoms—might be associated with the course of PTSD. In addition, the occurrence of new traumatic events differentiates PTSD cases with a chronic course from those with remission.",0,0 +4726,Meta-analytical Comparison of Voxel-Based Morphometry Studies in Obsessive-Compulsive Disorder vs Other Anxiety Disorders,"Whether obsessive-compulsive disorder (OCD) is adequately classified as an anxiety disorder is a matter of considerable debate.To quantitatively compare structural brain changes in OCD and other anxiety disorders using novel voxel-based meta-analytical methods and to generate an online database to facilitate replication and further analyses by other researchers.The PubMed, ScienceDirect, and Scopus databases were searched between 2001 (the date of the first voxel-based morphometry study in any anxiety disorder) and 2009. All voxel-based morphometry studies comparing patients with any anxiety disorder and healthy controls were retrieved. Manual searches were also conducted. Authors were contacted soliciting additional data.Thirty-seven data sets were identified, of which 26 (including 639 patients with anxiety disorders and 737 healthy controls) met inclusion criteria.Coordinates were extracted from clusters of significant gray matter difference between patients and controls. Demographic, clinical, and methodological variables were extracted from each study or obtained from the authors.Patients with anxiety disorders (including OCD) showed decreased bilateral gray matter volumes in the dorsomedial frontal/anterior cingulate gyri. Individuals with OCD had increased bilateral gray matter volumes (vs healthy controls and vs individuals with other anxiety disorders) in the lenticular/caudate nuclei, while patients with other anxiety disorders (mainly panic and posttraumatic stress disorders) had decreased gray matter volumes in the left lenticular nucleus. The findings remained largely unchanged in quartile and jackknife sensitivity analyses. Controlling for potential confounders such as age or antidepressant medication had little impact on the results.The meta-analysis consistently revealed common as well as distinct neural substrates in OCD and other anxiety disorders. These results have implications for the current debate surrounding the classification of OCD in the DSM-V.",0,0 +4727,The contribution of psychological factors to recovery after mild traumatic brain injury: Is cluster analysis a useful approach?,"Outcomes after mild traumatic brain injury (MTBI) vary, with slow or incomplete recovery for a significant minority. This study examines whether groups of cases with shared psychological factors but with different injury outcomes could be identified using cluster analysis.This is a prospective observational study following 147 adults presenting to a hospital-based emergency department or concussion services in Christchurch, New Zealand. This study examined associations between baseline demographic, clinical, psychological variables (distress, injury beliefs and symptom burden) and outcome 6 months later. A two-step approach to cluster analysis was applied (Ward's method to identify clusters, K-means to refine results).Three meaningful clusters emerged (high-adapters, medium-adapters, low-adapters). Baseline cluster-group membership was significantly associated with outcomes over time. High-adapters appeared recovered by 6-weeks and medium-adapters revealed improvements by 6-months. The low-adapters continued to endorse many symptoms, negative recovery expectations and distress, being significantly at risk for poor outcome more than 6-months after injury (OR (good outcome) = 0.12; CI = 0.03-0.53; p < 0.01).Cluster analysis supported the notion that groups could be identified early post-injury based on psychological factors, with group membership associated with differing outcomes over time. Implications for clinical care providers regarding therapy targets and cases that may benefit from different intensities of intervention are discussed.",0,0 +4728,"Predictors of battered women's use of intimate partner violence (IPV): A focus on IPV exposure, post-traumatic stress disorder (PTSD) and threat appraisal (TA).","The purpose of this study was to examine the prevalence and motivations of battered women's use of intimate partner violence (IPV), as well as to identify predictors of battered women's use of IPV. Using logistic regressions, we examined the predictive utility of women's exposure to IPV, women's symptoms of post-traumatic stress disorder (PTSD) and women's threat appraisal (TA) in explaining women's use of IPV. Using a series of logistic regressions, we also examined PTSD and TA as mediators of the relationship between women's exposure to IPV and women's use of IPV. Women were recruited from various help-seeking sites, as part of a longitudinal study of battered women's experiences. Prevalence rates were reported for all women (n = 285) who completed the third follow-up interview, during which women's use of IPV was assessed. In addressing the hypotheses related to this study, the sample included responses form 152 women who continued to have contact with their abusive partners in the assessed three month period between the third and fourth follow-up interviews. Approximately 70% of women reported having used IPV at some point in their relationships, and approximately 90% of women cited self-defense as a motivation. Statistical analyses found that IPV exposure and TA predicted whether women used IPV, but PTSD was not a significant predictor. Further, TA was not found to mediate the relationship between women's exposure to IPV and women's use of IPV. Findings are discussed within the framework of social, legal and clinical implications. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4729,Posttraumatic stress disorder and major depression in veterans with spinal cord injury.,"Objective: To explore the relationship between posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) in veterans with spinal cord injury and to compare those results with results found in veterans who had sustained other traumatic injuries. Method: To investigate the relationship between PTSD and MDD in persons with spinal cord injury, the authors examined whether individuals endorsed overlapping items on measures of both disorders, evaluated the contribution of overlapping items to comorbid diagnosis, and conducted an exploratory factor analysis. Results: The overlapping symptoms between the 2 disorders did not fully explain the high rate of comorbidity, although participants who endorsed a symptom common to MDD and PTSD on 1 measure were likely to endorse the corresponding item on another measure. In both samples, items loaded on separate PTSD and MDD factors. Conclusion: MDD and PTSD appear to represent independent reactions to trauma in those individuals who had experienced either a nonspinal cord injury or a spinal cord injury. This research also provides an initial investigation of some of the possible ways that MDD and PTSD are related by addressing psychometric issues inherent in their measurement. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +4730,Predicting criminality from child maltreatment typologies and posttraumatic stress symptoms,"The associations between childhood abuse and subsequent criminality and posttraumatic stress disorder (PTSD) are well known. However, a major limitation of research related to childhood abuse and its effects is the focus on one particular type of abuse at the expense of others. Recent work has established that childhood abuse rarely occurs as a unidimensional phenomenon. Therefore, a number of studies have investigated the existence of abuse typologies.The study is based on a Danish stratified random probability survey including 2980 interviews of 24-year-old people. The sample was constructed to include an oversampling of child protection cases. Building on a previous latent class analysis of four types of childhood maltreatment, three maltreatment typologies were used in the current analyses. A criminality scale was constructed based on seven types of criminal behavior. PTSD symptoms were assessed by the PC-PTSD Screen.Significant differences were found between the two genders with males reporting heightened rates of criminality. Furthermore, all three maltreatment typologies were associated with criminal behavior with odds ratios (ORs) from 2.90 to 5.32. Female gender had an OR of 0.53 and possible PTSD an OR of 1.84.The independent association of participants at risk for PTSD and three types of maltreatment with criminality should be studied to determine if it can be replicated, and considered in social policy and prevention and rehabilitation interventions.",0,0 +4731,The effects of direct versus witnessed threat on emergency department healthcare workers: implications for PTSD criterion A.,"We compared post-traumatic stress disorder (PTSD) symptom severity and symptom cluster profiles in hospital emergency department (ED) medical staff (N=100) who experienced an emotionally distressing work event that presented either a direct threat to themselves or a witnessed threat to patients. The two groups displayed similar levels of PTSD symptoms, however, they differed on symptom profiles and work consequences. The direct threat group experienced significantly greater fear during the event, more ongoing arousal symptoms, and more job dissatisfaction than the witnessed threat group. The witnessed threat group was more likely to appraise their PTSD symptoms as reflecting personal weakness. Overall, the results point to the need for further research to identify distinctive features of responses to different types of traumatic stressors.",0,0 +4732,"The assessment of optimistic self-beliefs: Comparison of the Chinese, Indonesian, Japanese, and Korean versions of the general self-efficacy scale",,0,0 +4733,Fitting a linear–linear piecewise growth mixture model with unknown knots: A comparison of two common approaches to inference.,"A linear-linear piecewise growth mixture model (PGMM) is appropriate for analyzing segmented (disjointed) change in individual behavior over time, where the data come from a mixture of 2 or more latent classes, and the underlying growth trajectories in the different segments of the developmental process within each latent class are linear. A PGMM allows the knot (change point), the time of transition from 1 phase (segment) to another, to be estimated (when it is not known a priori) along with the other model parameters. To assist researchers in deciding which estimation method is most advantageous for analyzing this kind of mixture data, the current research compares 2 popular approaches to inference for PGMMs: maximum likelihood (ML) via an expectation-maximization (EM) algorithm, and Markov chain Monte Carlo (MCMC) for Bayesian inference. Monte Carlo simulations were carried out to investigate and compare the ability of the 2 approaches to recover the true parameters in linear-linear PGMMs with unknown knots. The results show that MCMC for Bayesian inference outperformed ML via EM in nearly every simulation scenario. Real data examples are also presented, and the corresponding computer codes for model fitting are provided in the Appendix to aid practitioners who wish to apply this class of models.",0,0 +4734,Functional correlates of military sexual assault in male veterans.,"Despite research findings that similar numbers of male and female veterans are affected by military sexual trauma (MST), there has been considerably less research on the effects of MST specific to male veterans. The aim of the present study was to provide preliminary data describing functional correlates of military sexual assault (MSA) among male Iraq/Afghanistan-era veterans to identify potential health care needs for this population. We evaluated the following functional correlates: posttraumatic stress disorder (PTSD) symptoms, depression symptoms, alcohol use, drug use, suicidality, social support, violent behavior in the past 30 days, incarceration, disability eligibility status, and use of outpatient mental health treatment. We compared 3 groups: (a) male veterans who endorsed a history of MSA (n = 39), (b) a general non-MSA sample (n = 2,003), and (c) a matched non-MSA sample (n = 39) identified by matching algorithms on the basis of factors (e.g., age, education, adult premilitary sexual trauma history, childhood sexual and physical trauma history, and race) that could increase veterans' vulnerability to the functional correlates examined. MSA in men was associated with greater PTSD symptom severity, greater depression symptom severity, higher suicidality, and higher outpatient mental health treatment, above and beyond the effects of vulnerability factors. These findings suggest that, for male veterans, MSA may result in a severe and enduring overall symptom profile requiring ongoing clinical management.",0,0 +4735,Grey matter reduction associated with posttraumatic stress disorder and traumatic stress,"In recent decades, many imaging studies have reported brain structural alterations in posttraumatic stress disorder (PTSD). However, due to differences in the selection of control subjects, it is difficult to conclude whether the observed alterations were related to disease or traumatic stress. The present study was to provide a quantitative voxelwise meta-analysis of grey matter (GM) changes in PTSD relative to either trauma-exposed controls without PTSD (TEC) or non-traumatised healthy controls (HC) separately and to conduct a systematic review of voxel-based morphometry (VBM) studies that compared trauma-exposed individuals with HC to explore the effect of traumatic stress. GM reduction was identified in the medial prefrontal cortex in PTSD compared to both TEC and HC. Additional GM reduction was also observed in PTSD in the left hippocampus, left middle temporal gyrus and right superior frontal gyrus compared with TEC. Additionally, GM decreased in the left occipital cortex in PTSD compared with HC. The present study delimited the significant differences among VBM results in PTSD research when different control groups were chosen.",0,0 +4736,Longitudinal course of anxiety sensitivity and PTSD symptoms in cognitive-behavioral therapies for PTSD,"Anxiety sensitivity (AS) has been conceptualized as trait-like vulnerability and maintenance factor for PTSD. Although recent literature has demonstrated its malleability during treatment, few have examined its influence on and effect from PTSD treatment. Using multilevel regression analyses we examined: (a) changes in AS during treatment and (b) whether pre-treatment AS predicted PTSD treatment response, in sample of female victims of interpersonal trauma receiving one of three treatments (cognitive processing therapy, cognitive processing therapy-cognitive, and written accounts). Participants exhibited reductions in total ASI scores from pre- to post-treatment. Growth curve modeling revealed slightly different trajectories of PTSD symptoms as a function of pre-treatment AS, and overall decreases in PTSD symptoms during treatment were not associated with pretreatment AS. Pretreatment AS dimensions impacted PTSD total scores and symptoms clusters differentially. Clinical and theoretical implications for these results are discussed.",0,0 +4737,Identification of gene markers based on well validated and subcategorized stressed animals for potential clinical applications in PTSD,"Post-traumatic stress disorder (PTSD) is a complex mental disorder that can develop in response to traumatic experiences. The molecular mechanisms underlying the pathology of PTSD are poorly understood, and this lack of knowledge hampers our ability to find superior therapeutic approaches to the treatment of this disorder. There are two main reasons for our lack of study in this area: here is no sufficiently validated animal model and lack of large-scale studies for the search of underlying molecular mechanisms. Thus, to promote research on PTSD (especially its molecular mechanisms) and to set molecular basis for searching novel medications of this disorder, large-scale, genome-wide interrogation of a significant amount of genes based upon a well validated animal model is demanded. We hypothesize that a significant number of genes are involved in PTSD. It is only with a large number of these genes identified in specific samples of PTSD-related population, and then it is possible for a sufficient understanding of the pathology at the molecular level of a PTSD, as well as for enhancing the PTSD's therapeutic and preventative strategies. Two prerequisites are needed for testing this hypothesis: (1) relative pure samples from a well validated animal model; and (2) genome-wide screening of PTSD molecular targets. For the animal model, we suggest to use the predator-exposure paradigm, in which rats are exposed to a predator, this model has previously been evaluated behaviorally well emulated the clinical symptoms of PTSD. For a better stringency, three criteria can be used to further validate this animal model: analogous (similarity of behavior), predictive (predictability of drug response) and biological mechanism (e.g., electrophysiological and pathological change in amygdala). For large-scale molecular target screening, the new microarray technology, which can profile expression of tens of thousands genes simultaneously, is the method of choice. The validity and practicability of this hypothesis and the strategy for its testing have been supported by our preliminary laboratory data.",0,0 +4738,Resilience in the aftermath of war trauma: a critical review and commentary,"The resilience construct has received a great deal of attention as a result of the long wars in Iraq and Afghanistan. The discourse about resilience, especially the promise of promoting it and mitigating risk for serious post-traumatic negative outcomes among service members and veterans, is hopeful and encouraging. Remarkably, most service members exposed to horrific war trauma are not incapacitated by the experience. Yet, resilience is elusive and fleeting for many veterans of war. In this paper, I address some of the complexities about resilience in the context of exposure to war stressors and I offer some assumptions and heuristics that stem from my involvement in the dialogue about resilience and from experiences helping prevent post-traumatic stress disorder among active-duty service members with military trauma. My goal is to use my observations and applied experiences as an instructive context to raise critical questions for the field about resilience in the face of traumatic life-events.",0,0 +4739,Posttraumatic Stress Disorder Comorbid With Major Depression: Factors Mediating the Association With Suicidal Behavior,"OBJECTIVE: The purpose of the study was to determine if patients with a history of major depressive episode and comorbid posttraumatic stress disorder (PTSD) have a higher risk for suicide attempt and differ in other measures of suicidal behavior, compared to patients with major depressive episode but no PTSD. In addition, to explore how PTSD comorbidity might increase risk for suicidal behavior in major depressive episode, the authors investigated the relationship between PTSD, cluster B personality disorder, childhood sexual or physical abuse, and aggression/impulsivity. METHOD: The subjects were 230 patients with a lifetime history of major depressive episode; 59 also had lifetime comorbid PTSD. The demographic and clinical characteristics of subjects with and without PTSD were compared. Multivariate analysis was used to examine the relationship between suicidal behavior and lifetime history of PTSD, with adjustment for clinical factors known to be associated with suicidal behavior. RESULTS: Patients with a lifetime history of PTSD were significantly more likely to have made a suicide attempt. The groups did not differ with respect to suicidal ideation or intent, number of attempts made, or maximum lethality of attempts. The PTSD group had higher objective depression, impulsivity, and hostility scores; had a higher rate of comorbid cluster B personality disorder; and were more likely to report a childhood history of abuse. However, cluster B personality disorder was the only independent variable related to lifetime suicide attempts in a multiple regression model. CONCLUSIONS: PTSD is frequently comorbid with major depressive episode, and their co-occurrence enhances the risk for suicidal behavior. A higher rate of comorbid cluster B personality disorder appears to be a salient factor contributing to greater risk for suicidal acts in patients with a history of major depressive episode who also have PTSD, compared to those with major depressive episode alone.",0,0 +4740,Dissociative Disorders,"The dissociative disorders, including “psychogenic” or “functional” amnesia, fugue, dissociative identity disorder (DID, also known as multiple personality disorder), and depersonalization disorder, were once classified, along with conversion disorder, as forms of hysteria. The 1970s witnessed an “epidemic” of dissociative disorder, particularly DID, which may have reflected enthusiasm for the diagnosis more than its actual prevalence. Traditionally, the dissociative disorders have been attributed to trauma and other psychological stress, but the existing evidence favoring this hypothesis is plagued by poor methodology. Prospective studies of traumatized individuals reveal no convincing cases of amnesia not attributable to brain insult, injury, or disease. Treatment generally involves recovering and working through ostensibly repressed or dissociated memories of trauma; at present, there are few quantitative or controlled outcome studies. Experimental studies are few in number and have focused largely on state-dependent and implicit memory. Depersonalization disorder may be in line for the next “epidemic” of dissociation.",0,0 +4741,Perceived cognitive impairment in Chinese patients with breast cancer and its relationship with post-traumatic stress disorder symptoms and fatigue,"Objective Clinical reports have shown that adjuvant chemotherapy has a negative impact on perceived cognitive impairment (PCI) of patients with breast cancer; however, evidence concerning the effects of psychological factors such as post-traumatic stress disorder (PTSD) symptoms on PCI is limited, especially in relation to Chinese patients with breast cancer. This research investigated the associations between psychological factors and PCI in Chinese women with breast cancer. Methods In total, 204 women with breast cancer were assessed for PCI, PTSD symptoms, fatigue, anxiety, and depression using self-report measures. Hierarchical linear regression was conducted to investigate the associations between the variables of interest and PCI. Results Two hundred and two women were included in the final analysis; two of those originally tested were excluded because of missing data. A univariate analysis showed that PCI was significantly related to education, PTSD symptoms (re-experience, avoidance, and hyperarousal), fatigue, depression, anxiety, and undergoing chemotherapy or radiotherapy. Hierarchical linear regression revealed that PTSD symptoms and fatigue (ΔR2 = 0.26, P < 0.001) independently accounted for PCI in Chinese women with breast cancer regardless of age, education level, chemotherapy and radiotherapy. Hyperarousal was the only contributing PTSD symptom to PCI (B = −1.24, SE = 0.33, β = −0.39, P < 0.001). Conclusions Besides chemotherapy, PTSD symptoms, especially hyperarousal, and fatigue are important risk factors for significant PCI and are therefore worthy of further investigation. Copyright © 2014 John Wiley & Sons, Ltd.",0,0 +4742,Anxiety Disorders of Childhood and Adolescence: A Critical Review,"The 1980s were a decade of advancement in the knowledge of anxiety disorders in children and adolescents; this sets the stage for research achievements in the 1990s. This review examines the anxiety disorders of childhood and adolescence (separation anxiety disorder, overanxious disorder, and avoidant disorder), including prevalence rates, demographic profiles, comparisons of clinical presentations in different developmental age groups, and comorbidity patterns. Fears and simple phobias, obsessive-compulsive disorder, post-traumatic stress disorder, and panic disorder in children and adolescents are also evaluated. The controversy of whether panic attacks occur in prepubertal children is addressed. A brief review of behavioral and pharmacological treatment studies is included. Future directions for research are suggested.",0,0 +4743,The influence of traumatic brain injury on acute stress disorder and post-traumatic stress disorder following motor vehicle accidents,"This study compared the acute stress disorder and post traumatic stress disorder PTSD symptom profiles in motor vehicle accident survivors who sustained a mild traumatic brain injury MTBI or no TBI. Consecutive adult patients who sustained a MTBI n=79 and no TBI n=92 were assessed for acute stress disorder within 1 month of their trauma and reassessed for PTSD MTBI: n=63; non TBI; n=72 6 months post trauma. Comparable rates of acute stress disorder and PTSD were reported in MTBI and non TBI patients. Intrusive memories and fear and helplessness in response to the trauma were reported less frequently by MTBI than non TBI patients at the acute phase. Six months post trauma fewer MTBI patients than non TBI reported fear and helplessness in response to the trauma. These findings suggest that, whereas impaired consciousness at the time of a trauma may reduce the frequency of traumatic memories in the initial month post trauma, MTBI does not result in a different profile of longer term PTSD.",0,0 +4744,Trajectories of post-traumatic stress disorder symptoms among youth exposed to both natural and technological disasters,"Theorists and researchers have demonstrated multiple trajectories of symptoms following disasters (Ecology and Society, 13, 2008, 9), highlighting the importance of obtaining more knowledge about exposed youth who demonstrate resilience as well as those who suffer chronic difficulties. This paper examines trajectories of post-traumatic stress disorder (PTSD) symptoms following exposure to hurricanes and the Deepwater Horizon Oil Spill to increase understanding of resilience and chronic reactions to both natural and technological disasters.A multiwave longitudinal design was used to follow N = 4,619 youth who were evaluated for PTSD symptoms, hurricane exposure, and oil spill exposure/stress at four time points over a period of 4 years. Trajectories were identified with cluster analyses and multilevel modeling.Individual trajectories were statistically identified consistent with theory. The largest group exhibited stable-low symptoms (52%), a second group showed steep declines following initial symptoms (21%), a third group exhibited increasing symptoms (18%), and a fourth group showed stable-high symptoms (9%). Both hurricane exposure and oil spill stress predicted trajectories and overall levels of PTSD symptoms.Results identified an effect of oil spill stress and hurricane exposure on symptom levels and trajectories of exposed youth. Results provide prospective data to support theories of multiple symptom trajectories following disasters and reinforce the importance of research that utilizes a developmental perspective to consider the long-term effects of disasters in youth. Findings highlight the importance of identifying symptoms and predictors of resilience as well as factors that contribute to resilience.",0,0 +4745,When Multiple Disasters Strike: Louisiana Fishers in the Aftermath of Hurricanes and the British Petroleum Deepwater Horizon Oil Spill,"Relatively few studies in the research literature on technological disasters include commercial fishers whose livelihood, culture, and way of life are all deeply tied to bayous and natural waterways for generations. In this chapter, we address the impact of the 2010 British Petroleum (BP) Deepwater Horizon oil spill on commercial fishers sampled from two coastal parishes (counties) in south Louisiana. The individuals who provided the qualitative interviews upon which this chapter is based were participants in a larger study on long-term recovery from Hurricanes Katrina and Rita that devastated the US Gulf Coast in 2005. All respondents were exposed to the 2005 Hurricanes Katrina and Rita, the 2008 Hurricanes Gustav and Ike, and most recently the 2010 BP oil spill. We begin with a brief review of the literature on the psychosocial impact of disasters and examine the related concept of cumulative adversity. Content analysis of qualitative data from interviews conducted at least 12 months after the oil spill yielded three emergent themes which we present here: (1) Troubled Present, Uncertain Future; (2) Environmental Devastation; and (3)The “Pileup” Effect After a Decade of Disasters. Implications for individuals and families who have been directly impacted by the BP oil spill are considered.",0,0 +4746,"Analyzing developmental trajectories: A semiparametric, group-based approach.","Carnegie Mellon UniversityA developmental trajectory describes the course of a behavior over age or time. Agroup-based method for identifying distinctive groups of individual trajectorieswithin the population and for profiling the characteristics of group members isdemonstrated. Such clusters might include groups of increasers. decreasers,and no changers. Suitably defined probability distributions are used to handle 3data types—count, binary, and psychometric scale data. Four capabilities are dem-onstrated: (a) the capability to identify rather than assume distinctive groups oftrajectories, (b) the capability to estimate the proportion of the population followingeach such trajectory group, (c) the capability to relate group membership probabil-ity to individual characteristics and circumstances, and (d) the capability to use thegroup membership probabilities for various other purposes such as creating profilesof group members.",0,0 +4747,"Examining the Overlap between Bipolar Disorder, Nonaffective Psychosis, and Common Mental Disorders Using Latent Class Analysis","While dimensional models of psychopathology have delineated two broad factors underlying common mental disorders--internalizing and externalizing--it is unclear where bipolar disorder and nonaffective psychoses fit in relation to this structure and to each other. Given their low prevalence rates in the general population, these disorders generally tend to be excluded from such models. The current study used the person-centered approach of latent class analysis (LCA) to evaluate this question.LCA of diagnostic data from an epidemiological sample, the National Comorbidity Survey (n = 5,877), was undertaken. Diagnoses utilized in analyses included mania, nonaffective psychoses, specific phobia, social phobia, agoraphobia, panic disorder, major depression, dysthymia, generalized anxiety disorder, post-traumatic stress disorder, alcohol dependence, drug dependence, and conduct disorder.Results indicated that a 5-class LCA model optimally fit the data. Four of the classes mirrored those found in dimensional models--a class with few disorders, and 3 others with primarily fear, distress, and externalizing disorders. However, the fifth class--which is not evident in dimensional models--was unique in that it was the only one in which individuals demonstrated significant probabilities of both manic episodes and nonaffective psychoses in addition to markedly high levels of internalizing and externalizing disorders.This finding has important implications for nosological classification of psychopathology.",0,0 +4748,Depression and Anxiety Among Coronary Heart Disease Patients: Can Affect Dimensions and Theory Inform Diagnostic Disorder-Based Screening?,"Objectives To examine the association between low positive affect, somatic anxiety and general distress with affective disorders, anxious misery, and visceral fear among coronary heart disease patients. Participants Patients awaiting a coronary revascularization procedure (N = 158; 20.9% female; median age = 65, interquartile range 58–73) underwent structured interview with the Mini-International Neuropsychiatric Interview. Patients completed a brief version of the Mood and Anxiety Symptom Questionnaire (i.e., Anxiety Depression Distress Inventory-27) and a measure of Type D personality. Results Somatic anxiety scores yielded an area under the curve (AUC) = .784 and 75.0% sensitivity and 68.5% specificity in relation to panic disorder. Low positive affect yielded AUC = .811 and 70.4% sensitivity and 77.1% specificity for major depression. General distress yielded AUC = .795 and 75.0% sensitivity and 72.5% specificity for generalized anxiety disorder. No affective dimension was optimally associated with the anxious misery or visceral fear cluster. Trait negative affect was not a suitable screener for any disorder. Conclusions The Anxiety Depression Distress Inventory-27 dimensions of low positive affect and somatic anxiety provided optimal detection of depression and panic disorder, respectively, as hypothesized, supporting discriminant validity.",0,0 +4749,"Some Thoughts on Trauma, Pain, Posttraumatic Stress Disorder and Traumatic Brain Injury","Aversive learning and memory processes are common in pain and post-traumatic stress disorder (PTSD) and involve some of the same brain areas such as the amygdala, the insula and the anterior cingulate cortex. It is very likely that the deficient extinction of fear or pain responses is the core deficit in these disorders rather than enhanced acquisition. There is a great need for comparative studies for these disorders and their combination and specifically for the analysis of neuropsychological and neurobiological mechanisms that may partially be overlapping between these disorders. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4750,Peritraumatic dissociation as a predictor of post-traumatic stress disorder: a critical review,"In psychiatric literature, dissociative reactions at the time of a traumatic event (i.e., peritraumatic dissociation) are considered to be risk factors for the development of post-traumatic stress disorder (PTSD). In this article, we critically review research concerned with the link between peritraumatic dissociation and PTSD. Our main point is that studies in this area heavily rely on retrospective reports of dissociative reactions during the trauma. We argue that this methodology has important limitations since people in general and PTSD patients in particular find it difficult to give accurate descriptions of past emotional states. Restrictive factors that play a role in this context have to do with forgetting, attribution, and malingering.",0,0 +4751,Risk factors for chronic post-traumatic stress disorder (PTSD) in SARS survivors,"Post-traumatic stress disorder (PTSD) is one of the most prevalent long-term psychiatric diagnoses among survivors of severe acute respiratory syndrome (SARS). The objective of this study was to identify the predictors of chronic PTSD in SARS survivors. PTSD at 30 months after the SARS outbreak was assessed by the Structured Clinical Interview for the DSM-IV . Survivors' demographic data, medical information and psychosocial variables were collected for risk factor analysis. Multivariate logistic regression analysis showed that female gender as well as the presence of chronic medical illnesses diagnosed before the onset of SARS and avascular necrosis were independent predictors of PTSD at 30 months post-SARS. Associated factors included higher-chance external locus of control, higher functional disability and higher average pain intensity. The study of PTSD at 30 months post-SARS showed that the predictive value of acute medical variables may fade out. Our findings do not support some prior hypotheses that the use of high dose corticosteroids is protective against the development of PTSD. On the contrary, the adversity both before and after the SARS outbreak may be more important in hindering recovery from PTSD. The risk factor analysis can not only improve the detection of hidden psychiatric complications but also provide insight for the possible model of care delivery for the SARS survivors. With the complex interaction of the biopsychosocial challenges of SARS, an integrated multidisciplinary clinic setting may be a superior approach in the long-term management of complicated PTSD cases.",0,0 +4752,End-of-Life Care and the Effects of Bereavement on Family Caregivers of Persons with Dementia,"Although family caregiving has been intensively studied in the past decade, little attention has been paid to the impact of end-of-life care on caregivers who are family members of persons with dementia or to the caregivers' responses to the death of the patient.Using standardized assessment instruments and structured questions, we assessed the type and intensity of care provided by 217 family caregivers to persons with dementia during the year before the patient's death and assessed the caregivers' responses to the death.Half the caregivers reported spending at least 46 hours per week assisting patients with activities of daily living and instrumental activities of daily living. More than half the caregivers reported that they felt they were ""on duty"" 24 hours a day, that the patient had frequent pain, and that they had had to end or reduce employment owing to the demands of caregiving. Caregivers exhibited high levels of depressive symptoms while providing care to the relative with dementia, but they showed remarkable resilience after the death. Within three months of the death, caregivers had clinically significant declines in the level of depressive symptoms, and within one year the levels of symptoms were substantially lower than levels reported while they were acting as caregivers. Seventy-two percent of caregivers reported that the death was a relief to them, and more than 90 percent reported belief that it was a relief to the patient.End-of-life care for patients with dementia was extremely demanding of family caregivers. Intervention and support services were needed most before the patient's death. When death was preceded by a protracted and stressful period of caregiving, caregivers reported considerable relief at the death itself.",0,0 +4753,Association of Trauma and PTSD Symptoms With Openness to Reconciliation and Feelings of Revenge Among Former Ugandan and Congolese Child Soldiers,"Tens of thousands of the estimated 250,000 child soldiers worldwide are abused or have been abused during the last decade in Africa's Great Lakes Region. In the process of rebuilding the war-torn societies, it is important to understand how psychological trauma may shape the former child soldiers' ability to reconcile.To investigate the association of posttraumatic stress disorder (PTSD) symptoms and openness to reconciliation and feelings of revenge in former Ugandan and Congolese child soldiers.Cross-sectional field study of 169 former child soldiers (aged 11-18 years) in rehabilitation centers in Uganda and the Democratic Republic of the Congo, conducted in 2005.Potentially traumatic war-related experiences assessed via a sample-specific events scale; PTSD symptoms assessed using the Child Posttraumatic Stress Disorder Reaction Index (CPTSD-RI), with a score of 35 or higher indicating clinically important PTSD symptoms; and openness to reconciliation and feelings of revenge assessed via structured questionnaires.Children participating in this study were a mean of 15.3 years old. These former child soldiers reported that they had been (violently) recruited by armed forces at a young age (mean [SD], 12.1 [2] years), had served a mean of 38 months (SD, 24 months), and had been demobilized a mean of 2.3 months before data collection (SD, 2.4 months). The children were exposed to a high level of potentially traumatic events (mean [SD], 11.1 [2.99]). The most commonly reported traumatic experiences were having witnessed shooting (92.9%), having witnessed someone wounded (89.9%), and having been seriously beaten (84%). A total of 54.4% reported having killed someone, and 27.8% reported that they were forced to engage in sexual contact. Of the 169 interviewed, 59 (34.9%; 95% confidence interval, 34.4%-35.4%) had a PTSD symptom score higher than 35. Children who showed more PTSD symptoms had significantly less openness to reconciliation (rho= -0.34, P < .001) and more feelings of revenge (rho= 0.29, P < .001).PTSD symptoms are associated with less openness to reconciliation and more feelings of revenge among former Ugandan and Congolese child soldiers. The effect of psychological trauma should be considered when these children are rehabilitated and reintegrated into civilian society.",0,0 +4754,"The structure of PTSD among two cohorts of returning soldiers: Before, during, and following deployment to Iraq.","Evidence suggests either a four-factor emotional numbing or dysphoria model likely reflects the underlying structure of posttraumatic stress disorder (PTSD). Questions remain as to which of these structures best represents PTSD, how the structure changes with time, the applicability of models to returning veterans, and the validity of the symptom clusters. The present study addresses these questions among two longitudinal samples of National Guard soldiers assessed prior to, during, and following a combat deployment to Iraq. Findings support a four-factor intercorrelated dysphoria model of PTSD that remains stable across samples and time points. Differential associations were observed among PTSD symptom clusters over time and between symptom clusters and both depression and combat exposure, supporting important distinctions between symptom clusters.",0,0 +4755,Risk factors for pediatric posttraumatic stress disorder after traumatic injury,"The purpose of this study was to identify risk factors that may be predictive of posttraumatic stress disorder (PTSD) in children after a traumatic injury. The study was a retrospective review of data collected from 337 pediatric trauma patients treated in a multidisicplinary outpatient clinic. Results from Chi-square and t-test analyses indicated that gender, ethnicity, age, and injury severity were not risk factors for PTSD. However, mechanism of injury, specifically a gun shot wound (p =.001), was associated with development of PTSD, as was body area of injury, specifically the abdomen (p =.001). Psychiatric screening of patients with gun shot wounds and wounds to the abdomen may help with the early identification and treatment of PTSD.",0,0 +4756,Health-related quality of life (HRQoL) in veterans with chronic posttraumatic stress disorder (PTSD) and tobacco dependence,"Posttraumatic Stress Disorder (PTSD) is a psychiatric condition in which the experience of a traumatic event results in symptoms including intrusive memories and/or nightmares related to the trauma, avoidance of stimuli associated with the trauma, emotional numbing, and increased vigilance and irritability from pre- to post-trauma. Health-Related Quality of Life (HRQoL) is a construct designed to measure the effect of disease on physical, social/role, psychological/emotional, and cognitive functioning. Tobacco use is associated with both PTSD and HRQoL. PTSD is associated with higher rates of smoking than the national average (45% versus 23%). Additionally, smokers have well-documented negative health outcomes, and smoking is a major predictor of poorer HRQoL in the general population across both physical and mental health domains. PTSD is not generally associated in the public opinion with negative health consequences in the way that cigarette smoking is. However, PTSD has been causally linked with negative health outcomes, namely cardiovascular disease and metabolic syndrome. There are a lack of studies that examine the relationship between tobacco dependence and HRQoL, specifically in a PTSD population. Studies examining the effect of quitting smoking on HRQoL in the chronic tobacco dependent, PTSD population are also lacking. The proposed study aimed to examine the effect of post-treatment smoking status on post-treatment HRQoL scores by testing whether the interaction between quitting smoking and changes in PTSD symptom severity and/or depression severity from pre- to post-treatment predicted improvement in physical HRQoL from pre- to post-treatment. Hypotheses were tested using hierarchical linear modeling. Results indicated that reductions in PTSD symptom severity, particularly the numbing and hyperarousal symptom clusters, from pre- to post-treatment predicted improvement in the SF-36 Vitality and General Health subscales from pre- to post-treatment. We also found that PTSD and depressive symptoms differentially predicted the SF-36 subscales, and achievement of prolonged abstinence was associated with higher physical HRQoL scores. Our findings provide further evidence of a strong relationship between PTSD, tobacco dependence, and poor physical health status and HRQoL. Clinically, it may be important to examine HRQoL as a PTSD and depression treatment outcome. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +4757,Traumatic Stress Disorder: Diagnostic and clinical issues in former prisoners of war,Examined are a variety of clinical issues in the diagnosis and treatment of Posttraumatic Stress Disorder (PTSD) of former prisoners of war (POWs). Difficulties and complexities in understanding and diagnosing PTSD in former POWs presenting symptomatic complaints associated with this disorder are explored. Data collected on former POWs complaining of PTSD and diagnosed by DSM-III-R criteria revealed Minnesota Multiphasic Personality Inventory (MMPI) and Millon Clinical Multiaxial Inventory (MCMI) clinical profiles appropriate for clinical application. Comparative data between German-held and Japanese-held POWs experiencing PTSD and adjustment-related stressors are discussed. Import on clinical strategies with diagnosed patients suggests both behavioral approaches to treatment and future directions in research.,0,0 +4758,Aripiprazole: A clinical review of its use for the treatment of anxiety disorders and anxiety as a comorbidity in mental illness,"Although anxiety disorders are common, optimal treatment is elusive. More than half of anxiety patients treated with an adequate course of antidepressants fail to fully improve: treatment resistance, residual symptoms, and recurrence/relapse remain a challenge. Recently, atypical antipsychotics have been considered for treatment-resistant anxiety disorders. This review will explore the available data for the role of aripiprazole in the treatment of anxiety.PubMed and conference abstracts were searched for randomized, double-blind studies that investigated the efficacy of aripiprazole in anxiety; its efficacy in bipolar disorder and depression was also explored for comparison.A number of studies have shown atypical antipsychotics to be effective in anxiety, and currently available data suggest that aripiprazole augmentation in patients with anxiety disorders is likely as effective as other atypical antipsychotic drugs. Although there have been no randomized, controlled trials, aripiprazole has been found to be effective in treating anxiety disorders in two open-label trials. This combined with the larger data base demonstrating its utility in bipolar disorder and depression, its safety profile and its unique mechanism of action, make aripiprazole for anxiety an intriguing avenue of exploration.Data from large randomized, controlled trials on the use of atypical antipsychotics for anxiety in general, and aripiprazole in particular, are currently lacking.The results of open-label trials of aripiprazole in anxiety provide enough support to warrant its further study. This, combined with a larger data base demonstrating its utility in bipolar disorder and depression, its safety profile and its unique mechanism of action, make aripiprazole for anxiety an intriguing avenue of exploration.",0,0 +4759,Traumatic Loss and Major Disasters: Strengthening Family and Community Resilience,"This article presents the core principles and value of a family and community resilience-oriented approach to recovery from traumatic loss when catastrophic events occur. In contrast to individually based, symptom-focused approaches to trauma recovery, this multisystemic practice approach contextualizes the distress in the traumatic experience and taps strengths and resources in relational networks to foster healing and posttraumatic growth. The intertwining of trauma and traumatic losses is discussed. Key family and social processes in risk and resilience in traumatic loss situations are outlined. Case illustrations, model programs, and intervention guidelines are described in situations of community violence and major disasters to suggest ways to foster family and community resilience.",0,0 +4760,Childhood trauma exposure in Iraq and Afghanistan war era veterans: Implications for posttraumatic stress disorder symptoms and adult functional social support,"This study examined the relationship among childhood trauma, posttraumatic stress disorder (PTSD) symptoms, and adult social support in a large sample of veterans who served in the military after 09/11/2001, with a specific focus on the potential role of the PTSD avoidance and numbing cluster as intervening in the association between childhood abuse and adult functional social support.Participants were 1,301 veterans and active duty soldiers who have served in the military since 09/11/2001; a subsample of these participants (n=482) completed an inventory of current functional social support. Analyses included linear regression and nonparametric bootstrapping procedures.After controlling for combat exposure, exposure to childhood trauma was associated with PTSD symptoms in adulthood. Further, PTSD symptoms, and particularly PTSD avoidance/numbing cluster symptoms, intervened in the relationship between childhood trauma and adult functional social support.Findings support the association of childhood trauma (both abuse related and other, non-abuse related trauma) with PTSD symptoms in military personnel and veterans, even after accounting for combat exposure. Additionally, the avoidance and numbing symptom cluster of childhood trauma-based PTSD may be particularly salient in compromising one's subsequent ability to garner functional social support in adulthood.",0,0 +4761,MPI Profile Classifications and Associated Clinical Findings Among Litigating Motor Vehicle Collision Patients,"The purpose of this study was to examine differences in precollision, pericollision, and postcollision clinical variables across litigating motor vehicle collision (MVC) patients who were classified as Dysfunctional (DYS), Interpersonally Distressed (ID), or Adaptive Copers (ACs) based on Multidimensional Pain Inventory (MPI) profile classifications.A sample of 240 MVC patients who sustained serious physical injuries and experienced MVC-related chronic pain completed the MPI and provided responses to a semistructured psycholegal interview designed to elicit injury-related and pain-related symptoms and treatments, determine the presence and impact of precollision experiences, and render psychiatric diagnoses and ratings of psychological disability.A significant multivariate effect of MPI profile group on postcollision variables was revealed, with the DYS and ID groups reporting more pain sites than the AC group and the DYS group receiving more recommendations for treatment than the AC group. Larger proportions of the DYS and ID groups were diagnosed as experiencing major depressive disorder than the AC group. A rating of total psychological disability was applied most often to members of the ID group, with partial psychological disability applied most often to members of the DYS group, and no psychological disability applied most often to members of the AC group.This study extends the MPI literature by establishing the usefulness of the measure in determining those reports of MVC-related pain and emotional distress that are most likely to be associated with postcollision psychological disability. The current study supports the usefulness of MPI profile classifications in identifying MVC patients who are likely to require and benefit from intensive psychological and other rehabilitative interventions.",0,0 +4762,Nonlinear developmental trajectory of fear learning and memory,"The transition into and out of adolescence is a unique developmental period during which neuronal circuits are particularly susceptible to modification by experience. Adolescence is associated with an increased incidence of anxiety disorders in humans, and an estimated 75% of adults with fear-related disorders met diagnostic criteria as children and adolescents. Conserved neural circuitry of rodents and humans has facilitated neurodevelopmental studies of behavioral and molecular processes associated with fear learning and memory that lie at the heart of many anxiety disorders. Here, we review the nonlinear developmental aspects of fear learning and memory during a transition period into and out of adolescence and provide a discussion of the molecular mechanisms that may underlie these alterations in behavior. We provide a model that may help to inform novel treatment strategies for children and adolescents with fear-related disorders.",0,0 +4763,Main and Interactive Effects of Mental Contamination and Tolerance of Negative Emotions in Relation to Posttraumatic Stress Symptoms Following Sexual Trauma,"Mental contamination, an internal sense of dirtiness that originates in the absence of physical contact with a stimulus, has been implicated in the exacerbation of posttraumatic stress (PTS) symptoms following sexual trauma. In addition, evidence suggests that associations between PTS-related risk factors and PTS symptoms may depend on the degree to which one can tolerate experiencing negative emotions. To better understand the association between mental contamination and PTS symptoms, we examined main and interactive effects of mental contamination and tolerance of negative emotions in relation to PTS symptoms, including specific symptom clusters, in a community sample of women who experienced sexual trauma (N = 101). Tolerance of negative emotions moderated the association between mental contamination and PTS symptoms (total symptom severity, intrusion cluster, and cognitive/mood alterations cluster). These results indicate that difficulties tolerating negative emotions may be a necessary condition for mental contamination to relate to PTS symptoms following sexual trauma.",0,0 +4764,Differential Patterns of HPA Activity and Reactivity in Adult Posttraumatic Stress Disorder and Major Depressive Disorder,"Despite a number of overlapping symptoms, individuals with posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) often display hypothalamic-pituitary-adrenal (HPA) profiles that appear quite different from one another. This review describes the patterns of HPA-axis activity and reactivity in healthy individuals compared to individuals with these two disorders. Measures of HPA-axis activity and reactivity include cortisol levels at rest, in response to the dexamethasone suppression test (DST), and in response to psychological stress. The research reviewed presents the possibility of diagnostic specificity with regard to HPA function. In particular, the differential response pattern to the DST suggests that, while it cannot be considered a pure diagnostic tool, it should be one measure taken into consideration during diagnosis.",0,0 +4765,Life outcomes influenced by war-related experiences during the Gulf crisis,"This study examined the life outcomes of children exposed to the Gulf crisis in 1990-1991. We expected war-trauma exposure and psychological distress symptoms to predict poorer educational and occupational outcomes. Participants were 151 Kuwaiti citizens who were assessed during childhood (in 1993; M age = 10.6 years), and who were reassessed 10 years later in young adulthood (in 2003; M age = 21.2 years). Participants completed measures of intelligence, war-trauma exposure, posttraumatic stress symptoms, anxiety symptoms, depressive symptoms, intervening life events, and life outcomes. Results indicated that war-trauma exposure negatively impacted children's educational and occupational outcomes as young adults. Boys with higher levels of war-trauma exposure were less likely to attend University. Posttraumatic stress and anxiety symptoms also predicted poorer educational and occupational outcomes. However, this relationship was not significant when we accounted for children's intelligence. Depressive symptoms were not predictive of children's educational or occupational outcomes. Results suggest that war-trauma exposure may have life-altering effects on children. Tailored, early interventions are needed for children exposed to war traumas.",0,0 +4766,"Psychological Distress among Adolescents in Chengdu, Sichuan at 1 Month after the 2008 Sichuan Earthquake","A devastating earthquake occurred on May 12, 2008 in Sichuan, China. This study investigated the prevalence and factors in association with psychological problems among secondary school students living in Chengdu (90 km away from the disaster epicenter) in June 2008. In a cross-sectional survey, 3,324 secondary students self-administered a structured questionnaire in classroom setting. Validated scales were used in this study. Among all respondents, 22.3% reported post-traumatic stress disorder (PTSD); 22.6% were probable depression cases; 10.6% reported suicidal ideation; and 14.1% would like to receive psychological counseling. No gender differences were found. While social/emotional support from teachers or peers (OR from 0.40 to 0.78) and exposure to positive news reports (OR from 0.59 to 0.62) were found protective, prior experience of severe mental distress (OR from 1.60 to 2.68) and corporal punishment (OR from 1.31 to 1.58), worry about future aftershocks (OR from 1.64 to 3.11), absence from school when it was not closed (OR from 1.38 to 1.48), exposures to scary or sorrowful disaster media coverage (OR from 1.39 to 2.07), post-disaster visits to affected sites (OR from 1.51 to 1.59), separation from parents (OR = 1.61), etc., were risk factors predictive of some of the aforementioned psychological problems. Negative mental health impacts were prevalent among the respondents. Teachers, parents, and the mass media are all important in maintaining good mental health among adolescents that are indirectly affected by the severe earthquake. The results have important implications for earthquake preparedness and relief work in the future.",0,0 +4767,"Lifetime experiences, the brain and personalized medicine: An integrative perspective","The aim of personalized medicine is to base medical prevention and therapy on the unique health and disease susceptibility profile of each individual. Starting from this idea, we briefly discuss the meaning of the word 'personalized' before analyzing the practical content of personalized healthcare. From a medical perspective, knowledge of a person encompasses both biological and biographical perspectives. The latter includes significant events and experiences throughout the person's lifespan, from conception to the present, in which epigenetic influences play an important role. In practice, we believe personalized medicine should emphasize the development and maintenance of a healthy nervous system. The neurobiological processes involved here depend heavily on the psychosocial environment, in particular the presence of responsible, caring adults and integration in a reasonably fair society. A healthy brain subsequently promotes good health throughout life, both through direct, favorable influences on the body's intrinsic biological pathways, and indirectly by enabling the person to engage in supportive relationships, make wise decisions and take good care of him/herself. From a public health perspective, we conclude that hi-tech personalized medicine based on detailed bio-molecular mapping, monitoring and tailored drug interventions holds promise only as part of a wider, socio-culturally informed approach to the person.",0,0 +4768,PTSD among Israeli former prisoners of war and soldiers with combat stress reaction: a longitudinal study,"The aim of this study was to assess the long-term impact of war captivity and combat stress reaction on rates of posttraumatic stress disorder (PTSD) in Israeli veterans of the 1973 Yom Kippur war.One hundred sixty-four former prisoners of war (POWs), 112 veterans who had had combat stress reaction, and 184 combat veteran comparison subjects filled out the PTSD Inventory, a self-report scale based on the DSM-III-R criteria for PTSD. The inventory diagnoses past and present PTSD, assesses its intensity, and provides a symptom profile.Thirty-seven percent of the veterans who had had combat stress reaction, 23% of the former POWs, and 14% of the comparison subjects had had diagnosable PTSD at some time in the past. The current rates were 13%, 13%, and 3%, respectively. The results showed different recovery rates over time: almost two-thirds of the veterans with combat stress reaction who had had PTSD in the past recovered, while less than one-half of the POW group showed this improvement.These findings indicate that small but significant proportions of the POWs and veterans with combat stress reaction were still suffering from PTSD almost two decades after the war. The different recovery rates in the two groups may reflect the differences in duration and severity of stressors, the impact of immediate intervention on long-term adjustment, or both.",0,0 +4769,Late-onset posttraumatic stress disorder following a disaster: A longitudinal study.,"In disaster survivors, the occurrence of mental health problems beyond the immediate aftermath of the disaster has repeatedly been reported. The aim of the present study was to evaluate the course of symptoms and mental health services (MHS) utilization in late-onset posttraumatic stress disorder (PTSD) four years following a disaster and to examine whether late-onset PTSD can be explained within a longitudinal framework of PTSD. Residents affected by a fireworks disaster (N 1083) participated in surveys 2–3 weeks (T1), 18 months (T2), and almost 4 years (T3) following the disaster. PTSD was assessed at T2 and T3. Participants endorsing disaster-related late-onset PTSD (PTSD at T3 only) were compared to participants endorsing persistent PTSD (at both T2 and T3), recovered PTSD (at T2 only), and no PTSD using latent growth modeling and multinomial logistic regression. Participants endorsing late-onset PTSD comprised 4% of the total sample. They reported high initial intrusion and avoidance and experienced progression of avoidance/numbing and hyperarousal symptoms. They were more likely than all other participants to use MHS at T3. Late-onset PTSD was associated with high education level, severe disaster exposure, number of reported stressful life events, and perceived lack of social support. These results suggest that individuals with late-onset PTSD are likely to endorse prodromal distress, but experience clinically relevant symptom progression leading to increased MHS utilization. Stressful life events and perceived lack of social support may contribute to PTSD symptom progression. Foreseeable stressors in the aftermath of a disaster may be a target for secondary prevention of late-onset PTSD.",0,0 +4770,The Impact of Adverse Life Events on Clinical Features and Interaction with Gene Variants in Mood Disorder Patients,"<b><i>Background:</i></b> Adverse life events are precipitating and maintenance factors for mood and anxiety disorders. However, the impact of such events on clinical features and treatment response is still unclear. <b><i>Sampling and Methods:</i></b> The aim of this study was to investigate whether specific adverse events (early parental loss and physical abuse) influence clinical features in a sample of 1,336 mood disorder patients, and whether genetic parameters interact with adverse events to influence treatment outcomes in a subsample of 252 subjects. Participants were collected in the context of a European multicenter study and treated with antidepressants at adequate doses for at least 4 weeks. We focused on two genes (BDNF and CREB1) due to prior evidence of association with treatment outcomes in the same sample. <b><i>Results:</i></b> Patients with a history of physical abuse had higher suicidal risk (including history of attempts), comorbid panic disorder, posttraumatic stress disorder and alcohol dependence compared to non-abused patients. Experience of early parental loss was a less detrimental type of life stressor. Treatment response was not affected by adverse events. No gene-environment interaction was found with genetic variations, using a corrected significance level. <b><i>Conclusions:</i></b> A limitation of the present study is that the subsample is too small for detecting gene-environment interactions. The clinical message of our findings is that mood disorder patients with a history of physical abuse showed a worse clinical profile, characterized by higher comorbid Axis I psychopathology and increased suicidal behavior.",0,0 +4771,"Association of trauma exposure with psychiatric morbidity in military veterans who have served since September 11, 2001","This study examined the association of lifetime traumatic stress with psychiatric diagnostic status and symptom severity in veterans serving in the US military after 9/11/01.Data from 356 US military veterans were analyzed. Measures included a standardized clinical interview measure of psychiatric disorders, and paper-and-pencil assessments of trauma history, demographic variables, intellectual functioning, posttraumatic stress disorder (PTSD) symptoms, depression, alcohol misuse, and global distress.Ninety-four percent of respondents reported at least one traumatic stressor meeting DSM-IV criterion A for PTSD (i.e., life threatening event to which the person responded with fear, helplessness or horror), with a mean of four criterion A traumas. Seventy-one percent reported serving in a war-zone, with 50% reporting occurrence of an event meeting criterion A. The rate of current psychiatric disorder in this sample was: 30% PTSD, 20% major depressive disorder, 6% substance abuse or dependence and 10% for the presence of other Axis I psychiatric disorders. After accounting for demographic covariates and combat exposure, childhood physical assault and accident/disasters were most consistently associated with increased likelihood of PTSD. However, PTSD with no comorbid major depressive disorder or substance use disorder was predicted only by combat exposure and adult physical assault. Medical/unexpected-death trauma and adult physical assault were most consistently associated with more severe symptomatology.Particular categories of trauma were differentially associated with the risk of psychiatric diagnosis and current symptom severity. These findings underscore the importance of conducting thorough assessment of multiple trauma exposures when evaluating recently post-deployed veterans.",0,0 +4772,Regional cerebral blood flow during auditory recall in 47 subjects exposed to assaultive and non–ssaultive trauma and developing or not posttraumatic stress disorder,"Objective: Psychological trauma leads to posttraumatic stress disorder (PTSD) in susceptible subjects. The aim of this study was to investigate the differences in regional cerebral blood flow (rCBF) between two groups of subjects exposed to different types of traumatic stressor either developing or not developing PTSD. Method: Twenty subjects developing (S) and 27 not developing (NS) PTSD after being exposed to either earlier person-under-the- train accident (NA) or being assaulted in the underground environment (A) were included in the study. 99mTc-HMPAO SPECT was performed and the uptake in 29 regions of the brain (VOIs), bilaterally, was assessed. rCBF distribution was compared, using analysis of variance (ANOVA), between groups (S/NS) and type (A/NA) during a situation involving an auditory evoked re-experiencing of the traumatic event. Discriminant analysis was applied to test the concordance between clinical diagnosis and SPECT findings. Results: In the general analyses significant differences were found between groups and types and there was a significant hemisphere null type interaction. S showed higher CBF than NS and so did A as compared to NA, particularly in the right hemisphere. Discriminant analysis correctly classified 66% of cases (p < 0001) in testing S/NS and 72% (p < 0001) in testing NA/A. Conclusions: Under recall of their traumatic experience we found higher relative CBF distribution values in S as compared to NS. CBF was higher in the right hemisphere and particularly in assaulted subjects. These findings underscore the role upon trauma recall of both the right hemisphere and the nature of the stressing event.",0,0 +4773,Frontal brain asymmetry in depression with comorbid anxiety: A neuropsychological investigation.,"The approach-withdrawal model posits that depression and anxiety are associated with a relative right asymmetry in frontal brain activity. Most studies have tested this model using measures of cortical brain activity such as electroencephalography. However, neuropsychological tasks that differentially use left versus right frontal cortical regions can also be used to test hypotheses from the model. In two independent samples (Study 1 and 2), the present study investigated the performance of currently depressed individuals with or without a comorbid anxiety disorder and healthy controls on neuropsychological tasks tapping primarily left (verbal fluency) or right (design fluency) frontal brain regions. Across both samples, results indicated that comorbid participants performed more poorly than depressed only and control participants on design fluency, while all groups showed equivalent performance on verbal fluency. Moreover, comorbid participants showed ""asymmetrical"" performance on these two tasks (i.e., poorer design [right frontal] relative to verbal [left frontal] fluency), whereas depressed only and control participants showed approximately symmetrical profiles of performance. Results from these two samples suggest an abnormal frontal asymmetry in neurocognitive performance driven primarily by right frontal dysfunction among anxious-depressed individuals and highlight the importance of considering comorbid anxiety when examining frontal brain functioning in depression.",0,0 +4774,Predictors of Posttraumatic Stress in Parents of Children Diagnosed with a Disorder of Sex Development,"The aims of the current study were twofold: (1) to assess the prevalence/severity of posttraumatic stress symptoms (PTSS) as well as cognitive and emotional responses in parents whose children were diagnosed with a disorder of sex development (DSD); and (2) to assess factors which contributed to PTSS. We hypothesized that parents would show elevated levels of PTSS and that negative cognitive and/or emotional responses would be predictive. Participants were parents of children diagnosed with a DSD. Thirty-six mothers and 11 fathers completed a measure of posttraumatic stress and reported difficulties in the domains of cognition (e.g.; confusion) and emotion (e.g.; grief). Using multiple regression, we determined factors contributing to parental PTSS. Reported PTSS was high: 31 % of mothers and 18 % of fathers met the threshold for caseness for Posttraumatic Stress Disorder. Regression included: child sex, parent sex, child age at diagnosis, years since diagnosis, genital ambiguity, father occupation, cognitive confusion, and emotional distress. Only cognitive confusion contributed significantly to variance in PTSS. Parents of children with DSD may experience the diagnosis as traumatic, evidenced by high rates of PTSS in the current report. Assessment of reactions to their children's diagnoses revealed that cognitive confusion, and not emotional distress, predicted PTSS. In this case, direct cognitive interventions may be applicable. Though psychological support is widely recommended, no detailed intervention has been offered. Our findings suggest that we may directly apply models successful in other areas of pediatrics, such as pediatric oncology. Future studies may assess the usefulness of such an intervention. © 2013 Springer Science+Business Media New York.",0,0 +4775,Memories of pain after burn injury—The patients’ experience,"Pain after burns is a major clinical problem and researchers continue to report that burn pain remains undertreated. Adequate pain management could contribute to the prevention of posttraumatic stress disorder and can give a growing sense of patient's self-confidence and strength. Freedom from pain might be unrealistic, but the objective should be to reduce pain as much as possible. The purpose of this study was to describe burn patient's experiences and memories of pain during burn care and to acquire a deeper understanding of how patients cope with the experience. The study method was qualitative and interviews were conducted with 12 adult burn patients (eight men and four women) 6 to 12 months postburn (mean = 7 months). The mean burn size for the group was 10.6% mean of TBSA and the mean stay in hospital was 16 days. The interviews were analyzed using Kvale's method for structuring analysis. The patient's experiences and memories of pain during the trajectory of care were clearly described by the informants during the interviews. Four themes were identified for pain: becoming aware of pain, allowing oneself to feel pain, different pain experiences, and fragile body surface. Four themes were identified for coping: pragmatic coping, allowing someone to care for you, carrying the pain, and perspectives on the trauma. Both good and bad memories were recorded during the care trajectory, and it is evident that the patient has to carry the pain experience by themselves to a large extent. © 2010 by the American Burn Association.",0,0 +4776,Post-traumatic stress disorder: A review for the general psychiatrist,"Post-traumatic stress disorder affects about one in every hundred of the population at any particular time. Aetiological factors include genetics, personality, a background of psychiatric problems, the personal meaning of the traumatic event, issues of proximity or intensity, childhood abuse, and the initial emotional response to stress. Many precipitants are known, ranging from combat through rape or torture to difficult parturition. Core symptoms are reflective of the traumatic precipitant. Prolonged symptoms are associated with prior psychiatric or physical problems, poverty, repeated assault, alcohol or drug abuse, and cultural factors. Co-morbidity is high, especially for depression, alcohol and drug misuse. Reduced hippocampal volume, corticosteroid abnormalities, and adrenergic overactivity have been described. The use of official criteria and specific measuring instruments help in differential diagnosis. Management needs to be tailored to the needs of the individual and the stage of the disorder, and includes psychotherapy, antidepressants, and the newer eye-movement desensitization and reprocessing approach. ( Int J Psych Clin Pract 2001; 5:11-18).",0,0 +4777,Assessing the Latent Factor Association Between the Dysphoria Model of PTSD and Positive and Negative Affect in Trauma Victims from India,"The recent release of the DSM-5 comes with the division of posttraumatic stress disorder (PTSD) symptoms across four symptom clusters (American Psychiatric Association, 2013). This division is based on the support garnered by two four-factor models; Emotional Numbing (King et al., 1998) and Dysphoria (Simms et al., 2002) and a five-factor model; Dysphoric Arousal (Elhai et al., 2011). Much debate centered on the validity of the Dysphoria factor as a non-specific factor of PTSD within the Dysphoria model. In line with this, we assessed relations between the four factors of the Dysphoria model (Simms et al., 2002) and positive (PA) and negative affect (NA) in natural disaster victims (N = 200) from Leh, India, using the PTSD checklist (PCL-S) and Positive and Negative Affect Schedule (PANAS short form). Confirmatory factor analysis was implemented to assess the best-fitting model for both the PCL (PTSD) and the PANAS (affect). Two optimal models (the Dysphoria model and a two-factor model for affect) were subsequently used to assess latent variable associations across constructs. It was hypothesized that differential associations between latent factors would be evident with the Dysphoria factor being highly correlated with negative affect compared to alternative PTSD factors. Significant correlations were found between factors of the Dysphoria model and NA (0.52-0.65, p < 0.001). Comparing the association of pairs of PTSD factors with NA and PA, Wald's tests revealed that no single PTSD factor was more related to NA than the other. Avoidance and Hyperarousal factors were correlated with PA. Results are discussed in line with literature questioning Dysphoria factor's unique association with general distress. © 2014 Springer Science+Business Media New York.",0,0 +4778,Attentional interference by threat and post-traumatic stress disorder: the role of thought control strategies.,"Attentional interference by threat is associated with PTSD, but the mechanisms of this relationship remain unclear. Attentional interference might be related to increased use of maladaptive thought control strategies, such as suppressing unwanted thoughts (thought suppression) or replacing threatening thoughts with everyday concerns (worry), which increase PTSD risk. Conversely, attentional interference might be associated with reduced use of adaptive strategies, such as talking about threatening thoughts (social control), which decrease PTSD risk. This study tested if thought control strategies mediate the relationship between attentional interference and PTSD. Sixty-one male Vietnam-era veterans completed measures of PTSD symptoms and thought control strategies. Participants also completed a Visual Search Task measuring attentional interference, which required participants to identify a target letter string among a group of threat or neutral words. Attentional interference by threat was related to PTSD symptoms, and mediation analyses revealed significant indirect effects of attentional interference through thought suppression and worry. Attentional interference was related to re-experiencing and avoidance, but not hyperarousal, symptom clusters. Thought suppression was a unique mediator for re-experiencing, whereas thought suppression and worry both mediated the relationship with avoidance. These results offer evidence for maladaptive thought control strategies as a mechanism linking attentional biases for threat to PTSD.",0,0 +4779,Antisocial behavior and the combat veteran. A review (with special reference to the Vietnam conflict).,"The popular image of the Vietnam veteran, reinforced by such movies as Rambo and sensational press reporting, is that of a poorly controlled, impulsively violent character with a criminal record and a history of heroin addiction and alcoholism. Such a profile has also been regularly described in clinical studies of veterans receiving psychiatric attention and is congruent with the prevailing attitude of suspicion and mistrust towards the returning warrior reported in the anthropological, psychoanalytic, and historical literatures. Defense lawyers have increasingly advanced allegedly war-caused psychiatric disturbances as a defense for their veteran-clients' criminal behaviors. However, there is now considerable evidence from controlled studies that Vietnam veterans' levels of drug addiction, alcoholism, violence, criminal convictions, and suicide are no different from those manifested by young men from similar socioeconomic backgrounds who have not seen military service. This paper reviews these studies and cautions that excessive attention paid by the medical and legal professions to the high profile deviant behavior of a small and atypical group of the veteran population will defect attention from the unobtrusive, but disabling, readjustment difficulties faced by many more of their peers.",0,0 +4780,Investigating the Construct of Trauma-Related Acquired Callousness Among Delinquent Youth: Differences in Emotion Processing,"This study tested theories regarding differences in emotion processing among youth characterized by primary versus acquired callous-unemotional (CU) traits in a sample of 417 detained adolescents (306 boys, 111 girls). Mixture modeling identified 2 groups of youth high in CU, but with different levels of posttraumatic stress symptoms consistent with theoretical conceptualizations of acquired CU as being linked to trauma. Differences between the 2 groups of youth were investigated regarding 3 dimensions of emotion processing: emotion regulation, numbing, and recognition. Compared to youth classified in the primary group, youth classified as acquired CU demonstrated greater difficulty with lack of clarity (OR = 0.53), and nonacceptance of emotions, (OR = 0.57), general numbing of emotions (OR = 0.87), and recognition of disgust (OR = 0.18). Differences in emotion processing reported by youth in the 2 groups are consistent with theories regarding acquired callousness as related to emotional detachment in the aftermath of posttraumatic distress. The results of the current study have implications for the classification of primary and acquired CU, as well as the clinical treatment of youth with these characteristics.",0,0 +4781,Symptom Profiles in Depersonalization and Anxiety Disorders: An Analysis of the Beck Anxiety Inventory,"Background: Depersonalization disorder (DPD) entails distressing alterations in self-experiencing. However, it has long been recognized that depersonalisation symptoms occur in other disorders, particularly anxiety and panic. One strand of research proposes that depersonalization phenomenology arises through altered autonomic arousal in response to stress. Sampling and Methods: We sought to examine profiles of anxiety symptoms through a secondary data analysis of individual items and factor subscales on the Beck Anxiety Inventory (BAI), comparing two relatively large patient samples with DPD or with a variety of anxiety conditions, respectively. The DPD sample (n = 106) had a lower overall BAI score than the combined anxiety disorders group (n = 525). Results: After controlling for this as well as for potential confounders such as age and gender, the DPD group presented significantly lower scores on the panic subscale, marginally lower scores on the autonomic subscale and significantly higher scores on the neurophysiological subscale of the BAI. Conclusions: These differences imply similarities between the cognitive components of DPD and anxiety disorders while physiological experiences diverge. The findings encourage future research looking at direct physiological measures and longitudinal designs to confirm the mechanisms underlying different clinical manifestations of anxiety.",0,0 +4782,Does Memory of a Traumatic Event Increase the Risk for Posttraumatic Stress Disorder in Patients With Traumatic Brain Injury? A Prospective Study,"The present study examined prospectively the relationship between memory of the traumatic event and subsequent development of posttraumatic stress disorder (PTSD). More specifically, the aims of this study were to 1) investigate the possibility that lack of memory of the traumatic event might be a protective factor; 2) assess whether memory of the traumatic event equally affects the three symptom clusters of PTSD: reexperiencing, avoidance, and hyperarousal; and 3) explore the predictive value of memory of the traumatic event for the development of subsequent PTSD in the immediate aftermath of the event.One hundred twenty subjects with mild traumatic brain injury who were hospitalized for observation were assessed immediately after the trauma and followed up 1 week, 3 months, and 6 months later. All participants underwent psychiatric evaluation and self-assessment of their memory of the traumatic event.Overall, 17 (14%) of the participants met full criteria for PTSD at 6 months. Subjects with memory of the traumatic event were significantly more likely to develop PTSD than those without memory of the traumatic event; the difference between the groups resulted primarily from the reexperiencing cluster. Logistic regression analysis revealed that memory of the traumatic event within the first 24 hours is a strong predictor of PTSD 6 months after the event.Our study indicated that memory of a traumatic event is a strong predictor and a potential risk factor for subsequent development of PTSD. Future studies are needed to show whether these findings can be generalized to other traumatic conditions.",0,0 +4783,Traumatic Stress after Childbirth: The Role of Obstetric Variables,"In a sample of 1550 recently delivered women, traumatic stress after childbirth was studied in relation to obstetric variables. A post-traumatic stress disorder (PTSD) symptom profile and traumatic stress symptoms were assessed by means of the Traumatic Event Scale (TES). Obstetric data comprised delivery mode, duration of the second stage of labor (the time from cervical dilation of 10 cm to partus) and the use of analgesia/anesthesia. Traumatic stress symptoms and having a PTSD symptom profile were both significantly related to the experience of an emergency cesarean section or an instrumental vaginal delivery. It is of clinical importance, however, that most women with a PTSD symptom profile were found in the normal vaginal delivery group (NVD). This implies that a normal vaginal delivery can be experienced as traumatic, just as an emergency cesarian section is not necessarily traumatic. Traumatic stress symptoms were neither substantially correlated to the duration of the second stage of labor, nor to the use of analgesia/anesthesia.",0,0 +4784,Attachment Bases of Emotion Regulation and Posttraumatic Adjustment.,,0,0 +4785,The Toronto General Hospital Transitional Pain Service: development and implementation of a multidisciplinary program to prevent chronic postsurgical pain,"Chronic postsurgical pain (CPSP), an often unanticipated result of necessary and even life-saving procedures, develops in 5-10% of patients one-year after major surgery. Substantial advances have been made in identifying patients at elevated risk of developing CPSP based on perioperative pain, opioid use, and negative affect, including depression, anxiety, pain catastrophizing, and posttraumatic stress disorder-like symptoms. The Transitional Pain Service (TPS) at Toronto General Hospital (TGH) is the first to comprehensively address the problem of CPSP at three stages: 1) preoperatively, 2) postoperatively in hospital, and 3) postoperatively in an outpatient setting for up to 6 months after surgery. Patients at high risk for CPSP are identified early and offered coordinated and comprehensive care by the multidisciplinary team consisting of pain physicians, advanced practice nurses, psychologists, and physiotherapists. Access to expert intervention through the Transitional Pain Service bypasses typically long wait times for surgical patients to be referred and seen in chronic pain clinics. This affords the opportunity to impact patients' pain trajectories, preventing the transition from acute to chronic pain, and reducing suffering, disability, and health care costs. In this report, we describe the workings of the Transitional Pain Service at Toronto General Hospital, including the clinical algorithm used to identify patients, and clinical services offered to patients as they transition through the stages of surgical recovery. We describe the role of the psychological treatment, which draws on innovations in Acceptance and Commitment Therapy that allow for brief and effective behavioral interventions to be applied transdiagnostically and preventatively. Finally, we describe our vision for future growth.",0,0 +4786,"Differentiating army suicide attempters from psychologically treated and untreated soldiers: A demographic, psychological and stress-reaction characterization","Suicide is the leading cause of death in most armies during peace-time. The recent dramatic rise in suicides in the US Army further focuses attention on the causes of suicidal behavior in the military.This study investigated demographic characteristics, psychological profile and stress-related risk factors associated with suicide attempts in Israelis aged 18-21 years, who served in the Army in 2009. Soldiers who attempted suicide (N=60) were compared to soldiers treated by a mental health professional, but reported no suicidal behavior (N=58), and to controls (N=50).Suicide attempters had lower socioeconomic status and less cognitive ability compared with treated soldiers and untreated control soldiers. Only 25% of the suicide attempters had received mental healthcare prior to the attempt. The majority of the attempts were non-lethal (86.2%), and only 5.2% used firearms. Attempters had more previous suicide attempts (37.9%) and deliberate selfharm incidents (19.3%), compared to almost no such behaviors in the other two groups. Following the suicide attempt, 77% were diagnosed with moderate to severe mental disorders, 44.8% personality disorders and 8.6% mood disorders. Attempters reported higher levels of general stress compared to their peers in the other two groups. Being away from home and obeying authority were especially more stressful in attempters.Young soldiers are less prone to seek mental health assistance, despite suffering from higher levels of stress. Screening is required to detect soldiers at risk for suicidal behavior and preventive intervention will require active outreach.",0,0 +4787,"Exposure therapy for post-traumatic stress disorder: Its relative efficacy, limitations and optimal application","Abstract Post-traumatic stress disorder (PTSD) is a very debilitating psychological disturbance that follows the experience of traumatic events. Exposure therapy has shown good treatment efficacy in earlier treatment outcome studies on PTSD. Only a few other behavioral treatments have shown equal effectiveness, and exposure is usually a necessary treatment component in the others. This paper presents a short review of controlled treatment outcome studies on PTSD. The relative efficacy of exposure therapy compared to other treatments is discussed and factors that can hinder and enhance its effectiveness are reviewed. In the discussion section some methodological pitfalls in the treatment outcome studies are discussed.",0,0 +4788,In-Person and Video-Based Post-Traumatic Stress Disorder Treatment for Veterans: A Location–Allocation Model,"Post-traumatic stress disorder (PTSD) is associated with poor health but there is a gap between need and receipt of care. It is useful to understand where to optimally locate in-person care and where video-based PTSD care would be most useful to minimize access to care barriers, care outside the Veterans Affairs system, and total costs. We developed a service location systems engineering model based on 2010 to 2020 projected care needs for veterans across New England to help determine where to best locate and use in-person and video-based care. This analysis determined specific locations and capacities of each type of PTSD care relative to patient home locations to help inform allocation of mental health resources. Not surprisingly Massachusetts, Connecticut, and Rhode Island are well suited for in-person care, whereas some rural areas of Maine, Vermont, and New Hampshire where in-patient services are infeasible could be better served by video-based care than external care, if the latter is even available. Results in New England alone suggest a potential $3,655,387 reduction in average annual total costs by shifting 9.73% of care to video-based treatment, with an average 12.6 miles travel distance for the remaining in-person care.",0,0 +4789,Elucidating dimensions of posttraumatic stress symptoms and their functional correlates in disaster-exposed adolescents,"The aim of this study was to elucidate the dimensional structure of posttraumatic stress disorder (PTSD) and potential moderators and functional correlates of this structure in disaster-affected adolescents. A population-based sample of 2000 adolescents aged 12-17 years (M = 14.5 years; 51% female) completed interviews on post-tornado PTSD symptoms, substance use, and parent-adolescent conflict between 4 and 13 months (M = 8.8, SD = 2.6) after tornado exposure. Confirmatory factor analyses revealed that all models fit well but a 5-factor dysphoric arousal model provided a statistically significantly better representation of adolescent PTSD symptoms compared to 4-factor dysphoria and emotional numbing models. There was evidence of measurement invariance of the dysphoric arousal model across gender and age, although girls and older adolescents aged 15-17 years had higher mean scores than boys and younger adolescents aged 12-14 years, respectively, on some PTSD dimensions. Differential magnitudes of association between PTSD symptom dimensions and functional correlates were observed, with emotional numbing symptoms most strongly positively associated with problematic substance use since the tornado, and dysphoric arousal symptoms most strongly positively associated with parent-adolescent conflict; both correlations were significantly larger than the corresponding correlations with anxious arousal. Taken together, these results suggest that the dimensional structure of tornado-related PTSD symptomatology in adolescents is optimally characterized by five separate clusters of re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal symptoms, which showed unique associations with functional correlates. Findings emphasize that PTSD in disaster-exposed adolescents is not best conceptualized as a homogenous construct and highlight potential differential targets for post-disaster assessment and intervention.",0,0 +4790,"AGE, CRIMINAL CAREERS, AND POPULATION HETEROGENEITY: SPECIFICATION AND ESTIMATION OF A NONPARAMETRIC, MIXED POISSON MODEL*","This article addresses three issues that are central to the criminal career debate. First, is the life course of individual offending patterns marked by distinctive periods of quiescence? Second, at the level of the individual, do offending rates vary systematically with age? In particular, is the age-crime curve single peaked or flat? Third, are chronic offenders different from less active offenders? Do offenders themselves differ in systematic ways? Using a new approach to the analysis of individual criminal careers—based on nested, mixed Poisson models in which the mixing distribution is estimated nonparametrically—we analyze a panel data set that tracks a sample of males for more than 20 years. Our results provide empirical evidence in support of some features of criminal propensity theory and some in support of conventional criminal careers theory. In support of latent-trait criminal propensity theory, the individual-level average offense rate (per unit of time) varies as a function of observable individual-level characteristics and unobservable heterogeneity among individuals, and the age trajectory of the offense rate is generally single peaked rather than flat. On the other hand, in support of conventional criminal careers theory, models that incorporate a parameter that permits periods of active as well as inactive offending across age have greater explanatory power than those that do not. In addition, the nonparametric, discrete approximation to the population distribution of unobservable heterogeneity in the individual-level mean offense rate facilitates identification of four classes of offenders—nonoffenders as well as individual-level characteristics that are unique to each group. Problems of theoretical explanation and empirical generalizability of these results are described.",0,0 +4791,Unmet mental health care need 10–11 years after the 9/11 terrorist attacks: 2011–2012 results from the World Trade Center Health Registry,"There is little current information about the unmet mental health care need (UMHCN) and reasons for it among those exposed to the World Trade Center (WTC) terrorist attacks. The purpose of this study was to assess the level of UMHCN among symptomatic individuals enrolled in the WTC Health Registry (WTCHR) in 2011-2012, and to analyze the relationship between UMHCN due to attitudinal, cost, and access factors and mental health symptom severity, mental health care utilization, health insurance availability, and social support.The WTCHR is a prospective cohort study of individuals with reported exposure to the 2001 WTC attacks. This study used data from 9,803 adults who completed the 2003-2004 (Wave 1) and 2011-2012 (Wave 3) surveys and had posttraumatic stress disorder (PTSD) or depression in 2011-2012. We estimated logistic regression models relating perceived attitudinal, cost and access barriers to symptom severity, health care utilization, a lack of health insurance, and social support after adjusting for sociodemographic characteristics.Slightly more than one-third (34.2%) of study participants reported an UMHCN. Symptom severity was a strong predictor of UMHCN due to attitudinal and perceived cost and access reasons. Attitudinal UMHCN was common among those not using mental health services, particularly those with relatively severe mental health symptoms. Cost-related UMHCN was significantly associated with a lack of health insurance but not service usage. Access-related barriers were significantly more common among those who did not use any mental health services. A higher level of social support served as an important buffer against cost and access UMHCN.A significant proportion of individuals exposed to the WTC attacks with depression or PTSD 10 years later reported an UMHCN, and individuals with more severe and disabling conditions, those who lacked health insurance, and those with low levels of social support were particularly vulnerable.",0,0 +4792,Parenting burn-injured children in India: A grounded theory study,"Burn injury is one of the major traumas that a child can experience. Parents of burn-injured children experience anxiety, depression, guilt and post traumatic stress disorders as they care for their burn-injured children. Such empirical evidence related to effects of burns on parents and parenting process is unavailable from low and middle income countries like India.The aim of the study was to discover the process of parenting burn-injured children in India. The objective of this paper is to present one of the substantive processes ""Enduring the Blame"" that emerged from the data.Constructivist grounded theory methodology was used to explore the experiences of parenting burn-injured children.The study was conducted through a tertiary hospital that provided advanced paediatric burn care in a town in South India.Nine mothers, nine fathers, three grandmothers and one aunt from 12 families of children who were 15 years or younger and had sustained greater than 20% total body surface burns were purposively included.Twenty-two semi structured individual or family interviews were conducted in Tamil over a period of one year. The interview started with an overview question and then was followed by trigger questions as the participants shared their experiences. Second interviews were conducted with three participants in three families for theoretical saturation purposes.Mothers and fathers encountered blame from family members, health professionals, strangers, and their burn-injured children along the burn injury trajectory. They suffered double trauma of their child's burn and the blame. Parenting their burn-injured child involved a process of ""Enduring the Blame."" Enduring the Blame included four stages: internalizing blame, submitting to blame, rising above blame, and avoiding blame.Encouraging and assisting parents in caring for their children instead of blaming is a vital component of paediatric burn care. Parents will benefit from ongoing assessment and psychological interventions that will provide emotional support. Studying the perceptions of health professionals and the burn-injured children will help in further clarification of blame related issues and developing a parenting theory.",0,0 +4793,Sex Differences in the Experience of Unwanted Sexual Attention and Behaviors During Childhood,"Girls receive considerable amounts of unwanted sexual attention (UWSA) and behaviors (UWSB). Less is known about boys' unwanted sexual experiences. The primary goal of this study was to obtain a descriptive profile of the types and perpetrators of childhood UWSA/B. Secondary goals were to examine sex differences in emotional reactions to UWSA/B and influence of perpetrator. As many as 100 male and 100 female undergraduates completed the Exposure to Sexual Attention Scale and the Emotional Reaction Checklist. Results indicated that the majority of participants experienced UWSA/B during childhood, with females reporting higher rates of UWSB than males. Sex differences were also observed regarding types of perpetrators and emotional reactions. Findings are discussed as they relate to the sociocultural norms in which children are reared.",0,0 +4794,Is prolonged grief distinct from bereavement-related posttraumatic stress?,"Prolonged grief disorder (PGD) (previously called complicated grief (CG)) is proposed as a distinct post loss syndrome, with its own core symptoms. A key issue concerning the diagnostic validity of PGD is whether it can reliably be distinguished from related psychiatric outcomes following bereavement. This study therefore sought to determine whether the core symptoms of PGD could be distinguished from those of bereavement-related anxiety, depression and posttraumatic stress disorder (PTSD). Data were derived from a community sample of 223 bereaved adults in Croatia. PGD symptomatology was measured using the Revised Inventory of Complicated Grief. Depression and anxiety symptoms were measured using the Beck Depression and Anxiety Inventories, respectively. The intrusion and avoidance symptoms of PTSD were assessed using the Revised Impact of Event Scale. The distinctiveness of the five symptom clusters was examined using principal component analysis (PCA). Symptoms of prolonged grief, depression, anxiety, PTSD-intrusion, and PTSD-avoidance clustered together into five distinct factors. These results support the phenomenological distinctiveness of prolonged grief symptoms, from those of bereavement-related anxiety, depression and, for the first time, PTSD.",0,0 +4795,Acute effects of trauma-focused research procedures on participant safety and distress,"The ethical conduct of research on posttraumatic stress disorder (PTSD) requires assessing the risks to study participants. Some previous findings suggest that patients with PTSD report higher distress compared to non-PTSD participants after trauma-focused research. However, the impact of study participation on participant risk, such as suicidal/homicidal ideation and increased desire to use drugs or alcohol, has not been adequately investigated. Furthermore, systematic evaluation of distress using pre- and post-study assessments, and the effects of study procedures involving exposure to aversive stimuli, are lacking. Individuals with a history of PTSD (n=68) and trauma-exposed non-PTSD controls (n=68) responded to five questions about risk and distress before and after participating in research procedures including a PTSD diagnostic interview and a behavioral task with aversive stimuli consisting of mild electrical shock. The desire to use alcohol or drugs increased modestly with study participation among the subgroup (n=48) of participants with current PTSD. Participation in these research procedures was not associated with increased distress or participant risk, nor did study participation interact with lifetime PTSD diagnosis. These results suggest some increase in distress with active PTSD but a participant risk profile that supports a favorable risk-benefit ratio for conducting research in individuals with PTSD.",0,0 +4796,Fully conditional specification in multivariate imputation,"The use of the Gibbs sampler with fully conditionally specified models, where the distribution of each variable given the other variables is the starting point, has become a popular method to create imputations in incomplete multivariate data. The theoretical weakness of this approach is that the specified conditional densities can be incompatible, and therefore the stationary distribution to which the Gibbs sampler attempts to converge may not exist. This study investigates practical consequences of this problem by means of simulation. Missing data are created under four different missing data mechanisms. Attention is given to the statistical behavior under compatible and incompatible models. The results indicate that multiple imputation produces essentially unbiased estimates with appropriate coverage in the simple cases investigated, even for the incompatible models. Of particular interest is that these results were produced using only five Gibbs iterations starting from a simple draw from observed marginal distributions. It thus appears that, despite the theoretical weaknesses, the actual performance of conditional model specification for multivariate imputation can be quite good, and therefore deserves further study. © 2006 Taylor & Francis.",0,0 +4797,Prevalence and correlates of heavy smoking in Vietnam veterans with chronic posttraumatic stress disorder,"A study was conducted to investigate smoking patterns in 445 Vietnam veterans with and without posttraumatic stress disorder (PTSD). Combat veterans with PTSD reported similar occurrence of smoking (53%) compared to combat veterans without PTSD (45%). For those who smoked, combat veterans with PTSD reported a significantly higher rate of heavy smoking (> or = 25 cigarettes daily): 28% of combat veterans without PTSD were heavy smokers and 48% of combat veterans with PTSD were heavy smokers. PTSD diagnosis and heavy smoking status were independently and differentially related to motives for smoking. In combat veterans with PTSD, heavy smoking status was positively related to total health complaints, lifetime health complaints, health complaints in the past year, negative health behaviors, total PTSD symptoms, DSM-IV C cluster (avoidance and numbing) and D cluster (hyperarousal) PTSD symptoms. Heavy smoking status was also associated with fewer positive health behaviors.",0,0 +4798,Posttraumatic stress disorder after motor vehicle accidents: 3-year follow-up of a prospective longitudinal study,"The paper presents a 3-year follow-up of a prospective longitudinal study of posttraumatic stress disorder (PTSD) after motor vehicle accidents (J. Abnormal Psychol., 107 (1998) 508). Participants were 546 patients who had been assessed when attending an emergency clinic shortly after a motor vehicle accident, and at 3 months and 1 year afterwards. The prevalence of posttraumatic stress disorder PTSD at 3 years was 11%. Maintaining psychological factors, i.e. negative interpretation of intrusions, rumination, thought suppression and anger cognitions, were important in predicting the persistence of PTSD at 3 years, as were persistent health and financial problems after the accident. Other predictors were female sex, hospital admission for injuries, perceived threat and dissociation during the accident, and litigation.",0,0 +4799,The trauma symptom inventory: Italian validation of an instrument for the assessment of post-traumatic symptoms,"Aim. The trauma symptom inventory (TSI; Briere, 1995) is a useful instrument for the assessment of post-traumatic and common trauma-related mental health symptoms. The purpose of the study was to validate the Italian version of the original TSI. Methods. Participants from non-clinical ( n = 285), clinical ( n = 110) and post-traumatic ( n = 30) samples completed the TSI as part of a battery that included self-report measures of trauma exposure [MMPI-2 PK scale and Impact of Event Scale-Revised (IES-R)] and of psychological symptoms [brief symptom inventory (BSI) and symptom questionnaire (SQ)]. TSI validity scales were compared with MMPI-2 validity scales in order to assess convergent validity. Results. The TSI Italian version showed adequate internal consistency reliability and a good convergent validity. Discriminant function analysis indicates a classification accuracy of TSI scales of 90% for true-positive and 91.4% for true-negative post-traumatic stress disorder (PTSD) cases. A revised three-factor structural model, which demonstrated an adequate and the best fit for the data, was proposed. Conclusions. The study extended the generalization and validity of TSI and provided some suggestions for eventually revisiting factorial structure of the questionnaire.",0,0 +4800,Sensitization and kindling: Implications for the evolving neural substrates of post-traumatic stress disorder.,"(from the chapter) suggest that some of the principles involved in laying down the differential memory traces of sensitization and kindling may be useful bridging structures for considering parallel processes in different neural substrates that could be occurring in the related processes of stress sensitization and memory ""branding"" in posttraumatic stress disorder (PTSD) / suggest that these [2 behavioral] models may provide a primitive template for considering how acute or repeated stressors may not only leave permanent memory traces, but also affect the biochemistry and microstructure of the brain, potentially by impacting immediate-early-gene and late-effector-gene expression / stress sensitization and kindling also have their own spatiotemporal unfolding of cascades of neurobiological events that may have important mechanistic and pharmacotherapeutic implications cocaine sensitization / kindling: evolving neural substrates revealed by in situ hybridization and pharmacology / implications of sensitization and kindling for development and evolution of PTSD (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4801,The Khmer ‘Weak Heart’ Syndrome: Fear of Death from Palpitations,"According to the Khmer conception, a person suffering ‘weak heart’ ( khsaoy beh daung) has episodes of palpitations on slight provocation (e.g. triggered by orthostasis, anger, a noise, worry, an odor or exercise) and runs the risk of dying of heart arrest during these periods of palpitations; too, the sufferer typically has other symptoms attributed to the purported cardiac dysfunction: fatigue, shortness of breath, and orthostatic dizziness. Many Khmer refugees suffer this cultural syndrome, an anxious–dysphoria ontology, most probably of French colonial provenance. The syndrome demonstrates considerable overlap with those Western illness categories that feature panic attacks, in particular post-traumatic stress disorder (PTSD) and panic disorder. In a psychiatric clinic survey, 60 percent (60/100) of those assessed believed themselves to currently suffer ‘weak heart’; 90 percent (54/60) of those considering themselves to suffer from ‘weak heart’ thought that palpitations (e.g., those resulting from a loud noise or orthostasis) might result in death. The article illustrates the profoundly culturally constructed nature of ‘cardiac sensations,’ located in a specific historical trajectory and episteme; too, the article suggests that trauma may result more in panic disorder than ‘PTSD’ when autonomic arousal symptoms (in the present case, palpitations) are considered potentially life-threatening.",0,0 +4802,Prevalence of and Factors Associated With Subclinical Posttraumatic Stress Symptoms and PTSD in Urban and Rural Areas of Montana: A Cross-Sectional Study,"Posttraumatic stress disorder (PTSD) is an important clinical problem, but little is known about PTSD in rural, nonclinical populations. To better understand PTSD in rural areas, we examined the prevalence and risk and protective factors in urban, rural, and highly rural communities in Montana for both subclinical posttraumatic stress symptoms (PTSS) and PTSD.We compared the prevalence of PTSS and PTSD in urban, rural, and highly rural communities in bivariate and multivariable regression analyses using self-reported cross-sectional survey data from the Montana Health Matters study (N = 3,512), a state-representative household-based survey done in 2010-2011. We also explore potential risk and protective factors for PTSS and PTSD and whether risk and protective factors for each differ by rurality.There were no differences in the level of PTSS by rurality in bivariate or multivariate models, and the bivariate relationship between rurality and PTSD became nonsignificant in a multivariate model. Only locus of control was predictive for PTSS; however, gender, age, marital status, income, employment status, community fit, locus of control, and religiosity were associated with PTSD. Some risk and protective factors operate differently by rurality.Although our findings are subject to weaknesses common to cross-sectional data and are based on questionnaire reports, it appears that there are different risk and protective factors for PTSS and PTSD, suggesting that PTSD may be qualitatively different from PTSS. Furthermore, differences in risk and protective factors across urban and rural communities suggest more attention is needed to understand PTSD in rural communities.",0,0 +4803,Personality-based latent classes of posttraumatic psychopathology: Personality disorders and the internalizing/externalizing model.,"Prior research using the Brief Form of the Multidimensional Personality Questionnaire (MPQ-BF; Patrick, Curtin, & Tellegen, 2002) has shown evidence of 3 temperament-based subtypes--termed internalizing, externalizing, and simple PTSD--among individuals with symptoms of posttraumatic stress disorder (PTSD; Miller, Greif, & Smith, 2003). This study sought to replicate and extend research in this area by conducting a latent profile analysis of higher order temperament scales from the MPQ-BF using a new sample of 208 veterans with symptoms of PTSD. Results suggest that a 3-class solution reflecting internalizing, externalizing, and simple subtypes of posttraumatic psychopathology provided the best fit to the data. The externalizing subtype was characterized by features of antisocial, borderline, histrionic, and narcissistic personality disorders on the International Personality Disorder Examination (Loranger, 1999) as well as low levels of constraint and high levels of negative emotionality on the MPQ-BF. In contrast, individuals in the internalizing class exhibited features of schizoid and avoidant personality disorders, low levels of positive emotionality, and high levels of negative emotionality. The simple subtype was defined by low levels of comorbid personality disorder features and relatively normal personality profiles. Findings support the reliability of this typology and support the relevance of the internalizing and externalizing model to the structure of personality disorders.",0,0 +4804,A Longitudinal Study of Emotional Distress Intolerance and Psychopathology Following Exposure to a Potentially Traumatic Event in a Community Sample,"This study focused on better understanding the association between anxiety sensitivity (AS), distress tolerance (DT), and psychopathology, including posttraumatic stress, depression, panic and suicidality, in the aftermath of a potentially traumatizing event. A community-based sample of 151 adults exposed to the Mount Carmel Forest Fire Disaster were assessed within 30-days of exposure (T1) and then at 3- (T2) and 6-month (T3) follow-up intervals. At T1, AS, DT, and psychopathology symptoms loaded on a single common latent factor reflecting Emotional Avoidance and Distress; whereas by T2 AS-DT and psychopathology symptoms diverged into distinct latent variables—Emotional Distress Intolerance and Distress Post-Trauma, respectively. Levels of Emotional Distress and Avoidance at T1 predicted levels of Emotional Distress Intolerance as well as Distress Post-Trauma at T2. Finally, levels of Emotional Intolerance at T2 predicted levels of Distress Post-Trauma at T3 above and beyond the strong stability effects of Distress Post-Trauma over time. Findings are discussed with respect to their theoretical and clinical implications for understanding and promoting resilience to, and recovery following, exposure to potentially traumatic events.",0,0 +4805,Posttraumatic Stress Disorder and the Risk of Respiratory Problems in World Trade Center Responders,"Posttraumatic stress disorder (PTSD) is associated with high medical morbidity, but the nature of this association remains unclear. Among responders to the World Trade Center (WTC) disaster, PTSD is highly comorbid with lower respiratory symptoms (LRS), which cannot be explained by exposure alone. We sought to examine this association longitudinally to establish the direction of the effects and evaluate potential pathways to comorbidity.18,896 responders (8466 police and 10,430 nontraditional responders) participating in the WTC-Health Program were first evaluated between 2002 and 2010 and assessed again 2.5 years later. LRS were ascertained by medical staff, abnormal pulmonary function by spirometry, and probable WTC-related PTSD with a symptom inventory.In both groups of responders, initial PTSD (standardized regression coefficient: β = 0.20 and 0.23) and abnormal pulmonary function (β = 0.12 and 0.12) predicted LRS 2.5 years later after controlling for initial LRS and covariates. At follow-up, LRS onset was 2.0 times more likely and remission 1.8 times less likely in responders with initial PTSD than in responders without. Moreover, PTSD mediated, in part, the association between WTC exposures and development of LRS (p < .0001). Initial LRS and abnormal pulmonary function did not consistently predict PTSD onset.These analyses provide further evidence that PTSD is a risk factor for respiratory symptoms and are consistent with evidence implicating physiological dysregulation associated with PTSD in the development of medical conditions. If these effects are verified experimentally, treatment of PTSD may prove helpful in managing physical and mental health of disaster responders.",0,0 +4806,Experiential Avoidance Mediates the Association Between Behavioral Inhibition and Posttraumatic Stress Disorder,"Despite the large body of research on the risk factors for posttraumatic stress disorder (PTSD), few studies have examined specific personality factors that may be associated with risk for PTSD or the potential mechanisms that may underlie the association between personality and PTSD. Thus, this study sought to examine the relation between the behavioral inhibition system (BIS), a motivational brain-based system associated with the experience of anxiety, and probable posttraumatic stress disorder (PTSD) status. Further, we examined the mediating role of experiential avoidance in the relation between BIS sensitivity and PTSD. Participants included 291 undergraduates who indicated they had experienced a potentially traumatic event at some point in their life. As expected, significant associations were found between BIS sensitivity, experiential avoidance, and probable PTSD status. Results indicated that BIS scores significantly predicted probable PTSD status above and beyond other relevant covariates, including anxiety symptom severity. Further, this association was found to be fully mediated by experiential avoidance. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +4807,"Further validation of the IDAS: Evidence of convergent, discriminant, criterion, and incremental validity.","The authors explicated the validity of the Inventory of Depression and Anxiety Symptoms (IDAS; D. Watson et al., 2007) in 2 samples (306 college students and 605 psychiatric patients). The IDAS scales showed strong convergent validity in relation to parallel interview-based scores on the Clinician Rating version of the IDAS; the mean convergent correlations were .51 and .62 in the student and patient samples, respectively. With the exception of the Well-Being Scale, the scales also consistently demonstrated significant discriminant validity. Furthermore, the scales displayed substantial criterion validity in relation to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) mood and anxiety disorder diagnoses in the patient sample. The authors identified particularly clear and strong associations between (a) major depression and the IDAS General Depression, Dysphoria and Well-Being scales, (b) panic disorder and IDAS Panic, (c) posttraumatic stress disorder and IDAS Traumatic Intrusions, and (d) social phobia and IDAS Social Anxiety. Finally, in logistic regression analyses, the IDAS scales showed significant incremental validity in predicting several DSM-IV diagnoses when compared against the Beck Depression Inventory-II (A. T. Beck, R. A. Steer, & G. K. Brown, 1996) and the Beck Anxiety Inventory (A. T. Beck & R. A. Steer, 1990).",0,0 +4808,Psychopathology in a sample of candidate patients for bariatric surgery,"The prevalence of morbid obesity and the popularity of bariatric surgery have grown in recent years. Many surgical protocols require that the candidates undergo a pre-operative psychological evaluation. We describe the psychopathological characteristics of both clinical syndromes (Axis I of the DSM-IV), as well as personality disorders (Axis II of the DSM-IV), in a sample of morbidly obese patients accepted as bariatric surgery candidates and who participate in a specific surgery preparatory programme, and we analyze its relationship with personality clusters.The Millon Clinical Multiaxial Inventory-III (MCMI-III) scores from 50 patients attending for bariatric surgery were cluster analyzed in hopes of identifying clinical subgroups corresponding to typical personality profiles.With regard to personality disorders, the highest prevalence was found in the histrionic disorder, followed by obsessive- compulsive disorder. Cluster analysis revealed three personality profiles, which were validated by examining demographics, morphological variables, scores on anxiety and depression psychometric scales, and MCMI-III clinical scales scores. Groups were different in virtually all the MCMI-III clinical scores, as well as in depression and trait anxiety, with Cluster 3 presenting the worst scores.These findings suggest that morbidly obese patients are heterogeneous in their psychological profiles, highlighting Cluster C disorders.",0,0 +4809,The Deepwater Horizon Oil Spill and the Mississippi Gulf Coast: Mental health in the context of a technological disaster.,"A significant percentage of disaster survivors experience negative psychological, physical, and social outcomes after a disaster. The current study advances the literature concerning the Deepwater Horizon Oil Spill (the Gulf Oil Spill) while addressing weaknesses of previous research. The current study includes a clinical sample of 1,119 adults receiving mental health services in the coastal counties of Mississippi after the Gulf Oil Spill. The levels of clinical symptoms reported on the Depression Anxiety Stress Scales (DASS-21) and PTSD Checklist (PCL-S) were examined in relation to other domains of functioning potentially affected by the spill (finances, social relationships, and physical health). Participants reported substantial worsening of their functioning across each life domain. Furthermore, chronic problems in living related to the Gulf Oil Spill were significantly associated with higher levels of psychological distress, although the pattern differed somewhat for persons living above and below the poverty line, with lower income individuals reporting a higher level of overall distress. These data support the perspective that the experience of the Gulf Oil Spill is strongly associated with a deleterious effect on mental health symptoms.",0,0 +4810,Co-occurring medical and mental illness and substance use disorders among veteran clinic users with spinal cord injury patients with complexities,"Longitudinal analysis of SCI registry merged with VHA administrative-data and Medicare claims files (FY1999-2002).To estimate the prevalence of mental illness (MI) and substance use disorders (SUDs) among veteran health administration (VHA) clinic users with spinal cord injuries (SCI) and examine subgroup variations by demographic, socioeconomic characteristics, and duration and level of SCI.VHA clinic users (N=8338) with SCI who were alive by the end of FY2002.ICD-9-CM codes were used to identify individual MI (anxiety disorders, bipolar, depressive disorders, psychoses, post-traumatic stress disorder (PTSD) and schizophrenia) and categories of SUDs (tobacco, alcohol and drug abuse). Chi-square tests and multinomial logistic regression were used to examine the demographic and socio-economic profile of VHA users with SCI and MI and/or SUD.Over a 2-year period, 46% VHA users with SCI had either a MI or SUDs: 20% had MI only; 12% had SUD only and 14% had both. The most common MI was depressive disorder (27%) and tobacco use was highly prevalent (19%). African-Americans (versus whites) were less likely to be diagnosed with MI only. Increased duration of SCI lowered the likelihood of MI and/or SUDs. Mood and anxiety disorders were highly prevalent in veterans with SCI with chronic physical conditions such as diabetes, heart disease, hypertension, and respiratory diseases.Mental illness and SUDs are highly prevalent in the VHA population with SCI and is complicated by the high rates of chronic physical conditions, presenting challenges in their healthcare management.",0,0 +4811,Comparability of Telephone and Face-to-Face Interviews in Assessing Patients with Posttraumatic Stress Disorder,"Structured clinical interviews are very important in the area of mental health research and services. Prior research comparing the reliability and validity of face-to-face and phone interviews has found high levels of agreement. This project compared the results of face-to-face and phone interviews for two widely used measures: The Clinician-Administered PTSD Scale (CAPS) for assessing posttraumatic stress disorder diagnostic status and symptom severity and the Hamilton Rating Scale for Depression (Ham-D) to determine the severity of major depressive disorder.Subjects were 34 veterans recruited from applicants to the PTSD Assessment and Intervention program at the Cincinnati VA Medical Center. Order of interview (in-person or phone) was determined using random assignment within a counterbalanced framework. After attaining satisfactory levels of interrater reliability, four clinicians independently and blindly evaluated the subjects.Pearson correlation coefficients between face-to-face and phone interviews revealed high consistency (CAPS r = 0.745, HAM-D r = 0.748). The level of agreement between the two methods was 82% for the CAPS and 85% for the HAM-D. Diagnostic thresholds for the CAPS and HAM-D, after adjusting for the interview order and time elapsed between interviews, did not differ between the two groups (p = 0.31 for the CAPS and p = 0.96 for the HAM-D). High levels of agreement were achieved between the two methods (kappa = 0.75 for the CAPS using a cutoff of 65 and 0.70 for the HAM-D). The high sensitivity, specificity, and predictive values support the reliability of the phone-interview method.Phone interviews are a reliable method of interviewing for use in assessing patients for posttraumatic stress disorder and major depressive disorder.",0,0 +4812,Losing the Symptoms: Weight Loss and Decrease in Posttraumatic Stress Disorder Symptoms,"Posttraumatic stress disorder (PTSD) has frequently been found to have an effect on the development of obesity, a relationship usually thought of as unidirectional. The purpose of this study was to examine whether the level of PTSD symptoms would decrease as a result of weight loss.In a repeated measures design, PTSD symptoms, depression symptoms, social support, and weight were assessed in obese participants during 16 weeks at a weight loss facility.The participants' body mass index decreased significantly, and concurrently, a significant decline in the level of PTSD symptoms and depression symptoms was observed.The beneficial effects of weight loss on depression are consistent with previous work. The decline in the level of PTSD symptoms simultaneously with weight loss is an important and positive effect that has not been reported previously.",0,0 +4813,The Aberfan disaster: 33-year follow-up of survivors,"Experiencing life-threatening events often contributes to the onset of such psychiatric conditions as post-traumatic stress disorder (PTSD). Children can develop PTSD; however, there is controversy over whether PTSD symptoms decrease or persist over time.To examine the long-term effects of surviving the 1966 Aberfan disaster in childhood.Survivors (n=41) were compared with controls (n=72) matched for age and background. All were interviewed using the Composite International Diagnostic Interview, measures of current health and social satisfaction, and the General Health Questionnaire. The survivor group also completed the Impact of Event Scale to assess current levels of PTSD.Nineteen (46%; 95% CI 31-61) survivors had had PTSD at some point since the disaster, compared with 12 (20%; 95% CI 10-30) controls (OR=3.38 (95% CI 1.40-8.47)). Of the survivors,12 (29%; 95% CI 15-43) met diagnostic criteria for current PTSD. Survivors were not at a significantly increased risk of anxiety, depression or substance misuse.Trauma in childhood can lead to PTSD, and PTSD symptoms can persist for as long as 33 years into adult life. Rates of other psychopathological disorders are not necessarily raised after life-threatening childhood trauma.",0,0 +4814,Longitudinal follow-up of the mental health of unaccompanied refugee minors,"Despite growing numbers of unaccompanied refugee minors (UMs) in Europe, and evidence that this group is at risk of developing mental health problems, there still remain important knowledge gaps regarding the development of UMs' mental health during their trajectories in the host country and, in particular, the possible influencing role of traumatic experiences and daily stressors therein. This study therefore followed 103 UMs from the moment they arrived in Belgium until 18 months later. Traumatic experiences (SLE), mental health symptoms (HSCL-37A, RATS) and daily stressors (DSSYR) were measured at arrival in Belgium, after 6 and 18 months. UMs reported generally high scores on anxiety, depression and post-traumatic stress disorder (PTSD). Linear mixed model analysis showed no significant differences in mental health scores over time, pointing towards the possible long-term persistence of mental health problems in this population. The number of traumatic experiences and the number of daily stressors leaded to a significant higher symptom level of depression (daily stressors), anxiety and PTSD (traumatic experiences and daily stressors). European migration policies need to reduce the impact of daily stressors on UMs' mental health by ameliorating the reception and care facilities for this group. Moreover, regular mental health screenings are needed, in combination with, if needed, adapted psychosocial and therapeutic care. © 2013 Springer-Verlag",0,0 +4815,Peritraumatic Heart Rate and Posttraumatic Stress Disorder in Patients With Severe Burns,"Previous studies have suggested a link between heart rate (HR) following trauma and the development of posttraumatic stress disorder (PTSD). This study expands on previous work by evaluating HR in burn patients followed longitudinally for symptoms of acute stress disorder (ASD) and PTSD.Data were collected from consecutive patients admitted to the Johns Hopkins Burn Center, Baltimore, Maryland, between 1997 and 2002. Patients completed the Stanford Acute Stress Reaction Questionnaire (n = 157) to assess symptoms of ASD. The Davidson Trauma Scale was completed at 1 (n = 145), 6 (n = 106), 12 (n = 94), and 24 (n = 66) months postdischarge to assess symptoms of PTSD. Heart rate in the ambulance, emergency room, and burn unit were obtained by retrospective medical chart review.Pearson correlations revealed a significant relationship between HR in the ambulance (r = 0.32, P = .016) and burn unit (r = 0.30, P = .001) and ASD scores at baseline. Heart rate in the ambulance was related to PTSD avoidance cluster scores at 1, 6, 12, and 24 months. In women, HR in the ambulance was correlated with PTSD scores at 6 (r = 0.65, P = .005) and 12 (r = 0.78, P = .005) months. When covariates (gender, β-blockers, Brief Symptom Inventory Global Severity Index score) were included in multivariate linear regression analyses, ambulance HR was associated with ASD and PTSD scores at baseline and 1 month, and the interaction of ambulance HR and gender was associated with PTSD scores at 6 and 12 months. Multivariate logistic regression results were similar at baseline and 12 months, which included an HR association yet no interaction at 6 months and a marginal interaction at 1 month.While peritraumatic HR is most robustly associated with PTSD symptom severity, HR on admission to burn unit also predicts the development of ASD. Gender and avoidance symptoms appear particularly salient in this relationship, and these factors may aid in the identification of subgroups for which HR serves as a biomarker for PTSD. Future work may identify endophenotypic measures of increased risk for PTSD, targeting subgroups for early intervention.",0,0 +4816,Examination of the trait facets of the five-factor model in discriminating specific mood and anxiety disorders,"Structural models of the mood and anxiety disorders postulate that each disorder has a shared component that can account for comorbidity and its own unique component that distinguishes it from others. The principal aim of the current study was to determine the extent to which the 30 facets of the Five-Factor Model (FFM), as measured by the Revised NEO Personality Inventory (NEO PI-R), contribute to the identification of the unique component in mood and anxiety disorders in treatment-seeking clinical samples. Participants (N=610) were psychiatric outpatients with principal DSM-IV diagnoses (Diagnostic and Statistical Manual-IV; American Psychiatric Association, 1994) diagnoses of major depressive disorder (MDD), post-traumatic stress disorder (PTSD), generalized social phobia (GSP), panic disorder with/without agoraphobia (PD; PD/A) or obsessive-compulsive disorder (OCD). Results suggest that approximately half of the variance in differences between these diagnoses is associated with specific characteristics represented by the FFM facets. Unique personality profiles for the MDD, GSP, PTSD and, to a lesser extent, OCD groups emerged. Broad traits of the FFM, when broken into more narrow components at the facet level, contribute significantly to the identification of unique aspects associated with specific mood and anxiety disorders. The integration of lower and higher levels of structural examination of the mood and anxiety disorders is discussed.",0,0 +4817,What determines post-traumatic stress disorder symptomatology for survivors of childhood sexual abuse?,"The aim of this paper was to ascertain which childhood abuse experiences are associated with post-traumatic stress disorder (PTSD) symptomatology for women survivors of childhood sexual abuse (CSA).Seventy-three women attending a Family Health Counselling Service's Sexual Abuse Program were invited to participate in a study looking at the effectiveness of sexual abuse counselling. Initially, the women completed a series of self-report questionnaires including a measure of PTSD symptoms, and were interviewed about childhood abuse experiences.PTSD symptoms were associated with higher levels of all psychopathology. However, more interestingly, the severity of PTSD symptoms was also associated with the extent of CSA which involved actual sexual intercourse. This association of repeated abuse involving sexual intercourse with PTSD symptoms was still significant (partial coefficient = .30, p, .000) even when controlling for general level of psychopathology.One of the long-term effects of child sexual abuse (CSA) is post-traumatic stress disorder (PTSD), and the women who reported multiple abusive episodes which involved sexual intercourse had increased symptoms of PTSD.",0,0 +4818,Chromatographic characterization of substance P endopeptidase in the rat brain reveals affected enzyme activity following heat stress,"This paper describes a study of substance P endopeptidase (SPE)-like activity in various regions of the brain from male rats subjected to heat stress (HS). The enzyme activity was found to be affected in several brain areas including cerebellum, cerebral cortex, hippocampus, hypothalamus[sol ]thalamus and the spinal cord following HS. Significant increases in SPE activity were observed in, for example, hippocampus and the spinal cord. SPE-containing extracts from hippocampus were pooled and subsequently purified by size exclusion chromatography (using a Superdex® 75 HR column) and by anion-exchange chromatography (using Resource Q® column). The gel permeation chromatography separated the SPE-like activity into two fractions, one of which was suggested to be identical to neutral endopeptidase owing to its molecular size and inhibitory profile. The other active enzyme fraction behaved in conformity with SPE, previously identified in human cerebrospinal fluid. The activity of the purified fraction of these two enzymes was found to be increased (27%) in HS-treated animals. Copyright © 2005 John Wiley & Sons, Ltd.",0,0 +4819,Twin studies of posttraumatic stress disorder: Differentiating vulnerability factors from sequelae,"Posttraumatic stress disorder (PTSD) is defined by one's response to an environmental event. However, genetic factors are important in determining people's response to that event, and even their likelihood of being exposed to particular traumatic events in the first place. Classical twin designs can decompose genetic and environmental sources of variance. Such studies are reviewed extensively elsewhere, and we cover them only briefly in this review. Instead, we focus primarily on the identical co-twin control design. This design makes it possible to resolve the ""chicken-egg"" dilemma inherent in standard case-control designs, namely, distinguishing risk from sequelae. Abnormalities that are present in both the twin with PTSD and the unaffected co-twin suggest pre-existing vulnerability indicators. These include smaller hippocampal volume, large cavum septum pellucidum, more neurological soft signs, lower general intellectual ability, and poorer performance in the specific cognitive abilities of executive function, attention, declarative memory, and processing of contextual cues. In contrast, abnormalities in a twin with PTSD that are not present in the identical co-twin suggest consequences of PTSD or trauma exposure. These include psychophysiological responding, higher resting anterior cingulate metabolism, event-related potential abnormalities associated with attentional processes, recall intrusions, and possibly some types of chronic pain. Most co-twin control studies of PTSD have been small and come from the same twin registry of middle-aged male veterans. Consequently, there is a great need for replication and extension of the findings, particularly in women and younger individuals. The creation of new twin registries would do much toward accomplishing this goal. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0,0 +4820,"Posttraumatic Stress Disorder, Gender, and Problem Profiles in Substance Dependent Patients","Patients with a chronic and severe substance-use disorder who also have a history of posttraumatic stress disorder (PTSD) are thought to have a unique set of problems. The present study assessed psychiatric disorders, psychosocial problems, and traumatic events with structured interviews in 747 men and 693 women enrolling in urban opioid substitution treatment programs from 1995 to 2001. Participants with versus without a history of PTSD were more likely to have a history of many other psychiatric disorders and demonstrated more current and historical medical, employment, family/social, and psychiatric problems. PTSD was generally unrelated to substance-use disorder severity or diagnoses, with the exception of an increased risk of alcohol dependence. Women were more likely than men to have experienced sexual assault, and less likely to have been physically assaulted, although these events precipitated PTSD at equivalent rates across gender. In contrast, witnessing or hearing about the death or injury of others was more likely to precipitate PTSD in women than men. Female gender, exposure to combat, sexual assault, or physical assault, and a history of major mood or anxiety disorder were the best predictors of PTSD in this group. Study limitations are noted.",0,0 +4821,Lessons learned about psychosocial responses to disaster and mass trauma: an international perspective,"At the 13th meeting of the European Society for Traumatic Stress Studies in 2013, a symposium was held that brought together international researchers and clinicians who were involved in psychosocial responses to disaster. A total of six disasters that occurred in five countries were presented and discussed. Lessons learned from these disasters included the need to: (1) tailor the psychosocial response to the specific disaster, (2) provide multi-dimensional psychosocial care, (3) target at-risk population groups, (4) proactively address barriers in access to care, (5) recognise the social dimensions and sources of resilience, (6) extend the roles for mental health professionals, (7) efficiently coordinate and integrate disaster response services, and (8) integrate research and evaluation into disaster response planning.",0,0 +4822,"Combat Experiences, Pre-Deployment Training, and Outcome of Exposure Therapy for Post-Traumatic Stress Disorder in Operation Enduring Freedom/Operation Iraqi Freedom Veterans","The association between exposure to multiple potentially traumatic events (PTEs) and subsequent increased risk of post-traumatic stress disorder (PTSD) is well established. However, less is known about the relation between exposure to numerous PTEs, as is typical with military service, and treatment outcome. Furthermore, there has been little research examining military specific protective factors, such as pre-deployment preparedness, on PTSD treatment response. The current study investigated combat exposure and potential moderators of treatment outcome for exposure therapy in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans with PTSD. One hundred and eleven OEF/OIF veterans diagnosed with PTSD participated in 8 weeks of exposure therapy. Results indicated that increased combat exposure was associated with a reduced rate of change in PTSD symptoms but not depression symptoms. These findings were consistent across two measures of combat exposure. There was preliminary support for the moderating effect of pre-deployment preparedness on the association between combat exposure and treatment response. Together, these findings suggest that increased combat exposure is associated with poor treatment response in veterans with PTSD; however, this can be reduced by elevated pre-deployment preparedness.",0,0 +4823,Identifying PTSD personality subtypes in a workplace trauma sample,"The authors sought to identify personality clusters derived from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Personality Psychopathology Five Scales in a sample of workplace claimants with posttraumatic stress disorder (PTSD). Three clusters—low pathology, internalizing, and externalizing were recovered similar to those obtained by M. W. Miller and colleagues (2003, 2004, 2007) in samples of combat veterans and sexual assault victims. Internalizers and externalizers scored comparably on measures of PTSD symptom severity, general distress, and negative affect. Internalizers were uniquely characterized by anhedonia and depressed mood; externalizers by antisocial behavior, substance abuse, and anger/aggression.",0,0 +4824,A novel locus in the oxidative stress-related gene ALOX12 moderates the association between PTSD and thickness of the prefrontal cortex,"Oxidative stress has been implicated in many common age-related diseases and is hypothesized to play a role in posttraumatic stress disorder (PTSD)-related neurodegeneration (Miller and Sadeh, 2014). This study examined the influence of the oxidative stress-related genes ALOX 12 and ALOX 15 on the association between PTSD and cortical thickness. Factor analyses were used to identify and compare alternative models of the structure of cortical thickness in a sample of 218 veterans. The best-fitting model was then used for a genetic association analysis in White non-Hispanic participants (n=146) that examined relationships between 33 single nucleotide polymorphisms (SNPs) spanning the two genes, 8 cortical thickness factors, and each SNP×PTSD interaction. Results identified a novel ALOX12 locus (indicated by two SNPs in perfect linkage disequilibrium: rs1042357 and rs10852889) that moderated the association between PTSD and reduced thickness of the right prefrontal cortex. A whole-cortex vertex-wise analysis showed this effect to be localized to clusters spanning the rostral middle frontal gyrus, superior frontal gyrus, rostral anterior cingulate cortex, and medial orbitofrontal cortex. These findings illustrate a novel factor-analytic approach to neuroimaging-genetic analyses and provide new evidence for the possible involvement of oxidative stress in PTSD-related neurodegeneration.",0,0 +4825,Correlates of post-traumatic stress symptoms and growth in cancer patients: a systematic review and meta-analysis,"Objective The aim of this study is to examine the relationships among demographic, medical, and psychosocial factors and post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG) in oncology populations. Method A systematic search identified k = 116 relevant studies published between 1990 and 2012. Meta-analyses synthesized results from studies that reported data on correlates of PTSS (k = 26) or PTG (k = 48). A meta-analysis was performed for k = 5 studies reporting the correlation between PTSS and PTG. Results Post-traumatic stress symptoms were associated with depression (r = 0.56), anxiety (r = 0.65), distress (r = 0.62), social support (r = −0.33), and physical quality of life (r = −0.44). PTG was associated with age (r = −0.08), gender (r = −0.15), distress (r = −0.16), depression (r = −0.06), social support (r = 0.30), optimism (r = 0.27), positive reappraisal (r = 0.46), spirituality (r = 0.33), and religious coping (r = 0.36). There was a small positive relationship between PTSS and PTG (r = 0.13). Conclusions Post-traumatic stress symptoms and PTG appear to be independent constructs, rather than opposite ends of a single dimension. This is reflected in a small relationship between these variables and different psychosocial correlates. PTSS were strongly associated with variables reflecting a general state of negative affect. Optimism, spirituality, and positive coping styles were associated with PTG. It remains unclear how they are associated with PTSS, given the lack of relevant studies. Longitudinal research is required to examine how psychosocial factors influence the relationship between PTSS and PTG. Copyright © 2014 John Wiley & Sons, Ltd.",0,0 +4826,The relative efficacy of bona fide psychotherapies for treating post-traumatic stress disorder: A meta-analysis of direct comparisons,"Psychotherapy has been found to be an effective treatment of post-traumatic stress disorder (PTSD), but meta-analyses have yielded inconsistent results on relative efficacy of psychotherapies in the treatment of PTSD. The present meta-analysis controlled for potential confounds in previous PTSD meta-analyses by including only bona fide psychotherapies, avoiding categorization of psychotherapy treatments, and using direct comparison studies only. The primary analysis revealed that effect sizes were homogenously distributed around zero for measures of PTSD symptomology, and for all measures of psychological functioning, indicating that there were no differences between psychotherapies. Additionally, the upper bound of the true effect size between PTSD psychotherapies was quite small. The results suggest that despite strong evidence of psychotherapy efficaciousness vis-à-vis no treatment or common factor controls, bona fide psychotherapies produce equivalent benefits for patients with PTSD.",0,0 +4827,Posttraumatic stress disorder and posttraumatic stress disorder-like symptoms and mild traumatic brain injury,"In this article, we review the literature on posttraumatic stress disorder (PTSD) and PTSD-like symptoms that can occur along with mild traumatic brain injury (TBI) and concussion, with specific reference to concussive injuries in the military. We address four major areas: (1) clinical aspects of TBI and PTSD, including diagnostic criteria, incidence, predictive factors, and course; (2) biological overlap between PTSD and TBI; (3) comorbidity between PTSD and other mental disorders that can occur after mild TBI; and (4) current treatments for PTSD, with specific considerations related to treatment for patients with mild TBI or concussive injuries.",0,0 +4828,Child anxiety symptoms related to longitudinal cortisol trajectories and acute stress responses: Evidence of developmental stress sensitization.,"Cross-sectional research suggests that individuals at risk for internalizing disorders show differential activation levels and/or dynamics of stress-sensitive physiological systems, possibly reflecting a process of stress sensitization. However, there is little longitudinal research to clarify how the development of these systems over time relates to activation during acute stress, and how aspects of such activation map onto internalizing symptoms. We investigated children's (n = 107) diurnal hypothalamic-pituitary-adrenal activity via salivary cortisol (morning and evening levels) across 29 assessments spanning 6+ years, and related longitudinal patterns to acute stress responses at the end of this period (age 9-10). Associations with child psychiatric symptoms at age 10 were also examined to determine internalizing risk profiles. Increasing morning cortisol levels across assessments predicted less of a cortisol decline following interpersonal stress at age 9, and higher cortisol levels during performance stress at age 10. These same profiles of high and/or sustained cortisol elevation during psychosocial stress were associated with child anxiety symptoms. Results suggest developmental sensitization to stress-reflected in rising morning cortisol and eventual hyperactivation during acute stress exposure-may distinguish children at risk for internalizing disorders.",0,0 +4829,"Depression, anxiety and major adverse cardiovascular and cerebrovascular events in patients following coronary artery bypass graft surgery: a five year longitudinal cohort study","Although depression and anxiety have been implicated in risk for major adverse cardiovascular and cerebrovascular events (MACCE), a theoretical approach to identifying such putative links is lacking. The objective of this study was to examine the association between theoretical conceptualisations of depression and anxiety with MACCE at the diagnostic and symptom dimension level.Before coronary artery bypass graft (CABG) surgery, patients (N = 158; 20.9 % female) underwent a structured clinical interview to determine caseness for depression and anxiety disorders. Depression and anxiety disorders were arranged into the distress cluster (major depression, dysthymia, generalized anxiety disorder, post-traumatic stress disorder) and fear cluster (panic disorder, agoraphobia, social phobia). Patients also completed the self-report Mood and Anxiety Symptom Questionnaire, measuring anhedonia, anxious arousal and general distress/negative affect symptom dimensions. Incident MACCE was defined as fatal or non-fatal; myocardial infarction, unstable angina pectoris, repeat revascularization, heart failure, sustained arrhythmia, stroke or cerebrovascular accident, left ventricular failure and mortality due to cardiac causes. Time-to-MACCE was determined by hazard modelling after adjustment for EuroSCORE, smoking, body mass index, hypertension, heart failure and peripheral vascular disease.In the total sample, there were 698 cumulative person years of survival for analysis with a median follow-up of 4.6 years (interquartile range 4.2 to 5.2 years) and 37 MACCE (23.4 % of total). After covariate adjustment, generalized anxiety disorder was associated with MACCE (hazard ratio [HR] = 2.79, 95 % confidence interval [CI] 1.00-7.80, p = 0.049). The distress disorders were not significantly associated with MACCE risk (HR = 2.14; 95 % CI .92-4.95, p = 0.077) and neither were the fear-disorders (HR = 0.24, 95 % CI .05-1.20, p = 0.083). None of the symptom dimensions were significantly associated with MACCE.Generalized anxiety disorder was significantly associated with MACCE at follow-up after CABG surgery. The findings encourage further research pertaining to generalized anxiety disorder, and theoretical conceptualizations of depression, general distress and anxiety in persons undergoing CABG surgery.",0,0 +4830,PTSD symptoms and marital adjustment among ex-POWs’ wives.,"This study prospectively assessed the implications of war captivity and former prisoners of war's (ex-POWs) posttraumatic stress disorder (PTSD) and PTSD trajectory on their wives' marital adjustment, adjusting for their secondary traumatization (ST). Results show that marital adjustment of the wives of ex-POWs with PTSD (N = 66) was lower compared to wives of ex-POWs (N = 37) and combat veterans (N = 55) without PTSD symptoms. Investigating the possible mechanism underlying the lower marital adjustment, via a mediating model, indicated that husbands' PTSD symptoms mediated the association between captivity and the wives' marital adjustment. Moreover, husbands' PTSD trajectories assessed over 17 years were implicated in their wives' marital adjustment; wives of ex-POWs with chronic PTSD reported lower marital adjustment compared to wives of resilient ex-POWs. The substantial novelty was revealed in prospective deterioration found in dyadic adjustment among wives of ex-POWs with delayed PTSD, but not for wives of chronic or resilient ex-POWs. Implications for research and practice are discussed.",0,0 +4831,Connecting combat-related mild traumatic brain injury with posttraumatic stress disorder symptoms through brain imaging,"Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) may share common symptom and neuropsychological profiles in military service members (SMs) following deployment; while a connection between the two conditions is plausible, the relationship between them has been difficult to discern. The intent of this report is to enhance our understanding of the relationship between findings on structural and functional brain imaging and symptoms of PTSD. Within a cohort of SMs who did not meet criteria for PTSD but were willing to complete a comprehensive assessment within 2 months of their return from combat deployment, we conducted a nested case-control analysis comparing those with combat-related mTBI to age/gender-matched controls with diffusion tensor imaging, resting state functional magnetic resonance imaging and a range of psychological measures. We report degraded white matter integrity in those with a history of combat mTBI, and a positive correlation between the white matter microstructure and default mode network (DMN) connectivity. Higher clinician-administered and self-reported subthreshold PTSD symptoms were reported in those with combat mTBI. Our findings offer a potential mechanism through which mTBI may alter brain function, and in turn, contribute to PTSD symptoms.",0,0 +4832,Community Assessment of Psychic Experiences (CAPE) and Trauma and Loss Spectrum (TALS) 12 months after an earthquake in Italy,"Methods Assessments included the Trauma and Loss Spectrum Self-Report and Community Assessment of Psychic Experiences (CAPE). Significant associations were seen between trauma-related measures and subclinical symptoms of psychosis and depression scores. Results Trauma related measures are associated with a weak increase in the subclinical positive and negative dimensions of psychosis, and a modest increase in the subclinical depressive dimension.",0,0 +4833,Rapastinel (GLYX-13) has therapeutic potential for the treatment of post-traumatic stress disorder: Characterization of a NMDA receptor-mediated metaplasticity process in the medial prefrontal cortex of rats,"Rapastinel (GLYX-13) is a NMDA receptor modulator with glycine-site partial agonist properties. It is a robust cognitive enhancer and shows rapid and long-lasting antidepressant properties in both animal models and in humans. Contextual fear extinction (CFE) in rodents has been well characterized and used extensively as a model to study the neurobiological mechanisms of post-traumatic stress disorder (PTSD). Since CFE is NMDA receptor modulated and neural circuitry in the medial prefrontal cortex (MPFC) regulates both depression and PTSD, studies were undertaken to examine the effects of rapastinel for its therapeutic potential in PTSD and to use rapastinel as a tool to study its underlying glutamatergic mechanisms. A 21-day chronic mild unpredictable stress (CUS) rat model was used to model depression and PTSD. The effects of CUS alone compared to No CUS controls, and the effects of rapastinel (3 mg/kg IV) on CUS-treated animals were examined. The effect of rapastinel was first assessed using CUS-treated rats in three depression models, Porsolt, sucrose preference, and novelty-induced hypophagia tests, and found to produce a complete reversal of the depressive-like state in each model. Rapastinel was then assessed in a MPFC-dependent positive emotional learning paradigm and in CFE and again a reversal of the impairments induced by CUS treatment was observed. Both synaptic plasticity and metaplasticity, as measured by the induction of long-term potentiation in rat MPFC slice preparations, was found to be markedly impaired in CUS-treated animals. This impairment was reversed when CUS-treated rats were administered rapastinel and tested 24 h later. Transcriptomic analysis of MPFC mRNA expression in CUS-treated rats corroborated the link between rapastinel's behavioral effects and synaptic plasticity. A marked enrichment in both the LTP and LTD connectomes in rapastinel-treated CUS rats was observed compared to CUS-treated controls. The effects of rapastinel on depression models, PEL, and most importantly on CFE demonstrate the therapeutic potential of rapastinel for the treatment of PTSD. Moreover, rapastinel appears to elicit its therapeutic effects through a NMDA receptor-mediated, LTP-like, metaplasticity process in the MPFC.",0,0 +4834,Long-term trajectories of PTSD or resilience in former East German political prisoners.,"Studies on the long-term consequences of traumatization found different diagnostic trajectories: chronic, recovered, delayed and resilient. This distinction, however, was never studied in victims of torture or severe political persecution. We aimed to verify the trajectory classes of PTSD empirically and to analyze potential predictors of such trajectories. Former political prisoners from East Germany, first interviewed in 1995, were re-assessed fourteen years later. In 1995, retrospective symptom reports dating back to shortly after the prisoners' release dates were assessed. Predictors of the four different trajectories were divided into pre-trauma, peri-trauma, and post-trauma factors. As a result, the four long-term trajectories were validated in the current sample with the following percentages: chronic (36%), resilient (27%), recovered (26%) and delayed (11%) trajectories. Trajectories were mainly distinguished by pre- and post-traumatic factors, e.g. pre-trauma education or post-trauma disclosure opportunities. We conclude that the four long-term trajectories of trauma sequelae deserve more attention to adequately deal with survivors of severe persecution. Furthermore, the specific predictors of long-term trajectory deserve more attention for re-integration or in rehabilitation.",0,0 +4835,Effects of a Behavioral Sleep Medicine Intervention on Trauma Symptoms in Adolescents Recently Treated for Substance Abuse,"This study tested whether improvement in sleep by an integrative, behavioral sleep intervention was associated with improvement in traumatic stress (TS) symptoms in a sample of 20 adolescents who were recently treated for substance abuse. Sleep was measured throughout the intervention via daily sleep diaries, and traumatic stress symptoms were assessed by the Global Appraisal of Individual Needs (GAIN) at baseline, post-intervention, 3-months post-intervention, and 12-months post-intervention. Individuals with more time in bed and more total sleep time at the beginning of the intervention had more improvement in TS symptom trajectories across the intervention and at the 12-month follow-up assessment. Interaction trends also emerged indicating that adolescents who, throughout the sleep intervention, went to bed later and fell asleep faster had greater improvements in TS symptoms over time. Overall, these results indicate that stimulus control, a therapy that encourages patients to attempt sleep only when they are sleepy, may be particularly helpful for adolescents with TS symptoms, sleep disturbances, and substance abuse histories.",0,0 +4836,What's in a name? The MMPI-2 PTSD scales,"The MMPI-2 post-traumatic stress disorder scales (PK and PS) were examined with a sample of 96 outpatient anxiety disorder and 97 outpatient traffic accident subjects. PK and PS correlated .96 and showed highly similar correlations with MMPI-2 validity, clinical, content and supplementary scales for both groups, which indicated that these scales are indices of MMPI first-factor variance. This was supported by separate principal components analyses for each group, in which PK and PS contributed the most variance to the first component. Although the groups showed different MMPI-2 mean profiles, neither PK nor PS contributed to discriminant function classification of group members. It is suggested that PK and PS are indices of general emotional distress and maladjustment; implications for their use in diagnosing post-traumatic stress disorder were discussed.",0,0 +4837,Neighborhoods and Violent Crime: A Multilevel Study of Collective Efficacy,"It is hypothesized that collective efficacy, defined as social cohesion among neighbors combined with their willingness to intervene on behalf of the common good, is linked to reduced violence. This hypothesis was tested on a 1995 survey of 8782 residents of 343 neighborhoods in Chicago, Illinois. Multilevel analyses showed that a measure of collective efficacy yields a high between-neighborhood reliability and is negatively associated with variations in violence, when individual-level characteristics, measurement error, and prior violence are controlled. Associations of concentrated disadvantage and residential instability with violence are largely mediated by collective efficacy.",0,0 +4838,Prevalence and factors associated with Posttraumatic Stress Disorder seven years after the conflict in three districts in northern Uganda (The Wayo-Nero Study),"Research on the prevalence of Posttraumatic Stress Disorder (PTSD) is still limited in low income countries yet PTSD can be a public health problem in post conflict areas. In order to respond to the burden of PSTD in northern Uganda, an area that experienced civil strife for over two decades, we need accurate data on its (PTSD) prevalence and the associated risk factors to facilitate public mental health planning.This study employed a cross-sectional study design and data collection was undertaken in three districts in northern Uganda: Gulu, Amuru and Nwoya. Respondents were aged 18 years and above and were randomly selected at community level. A total of 2400 respondents were interviewed using a structured questionnaire in the three study districts. In this study, multivariate logistic regression was employed to analyze the associations of socio-demographic factors, trauma related variables and the outcome of PTSD.The prevalence of Posttraumatic Stress Disorder (PTSD) in the study population was 11.8 % (95 % CI: 10.5 %, 13.1 %) with a prevalence of 10.9 % (95 % CI: 9.3 %, 12.5 %) among female respondents and 13.4 % (95 % CI: 11.2 %, 15.7 %) among male respondents. Quite a number of factors were strongly associated with PTSD. Overall, a respondent had experienced 9 negative life events. In a multivariate logistic regression, the factors that were strongly associated with PTSD were: exposure to war trauma events, childhood trauma, negative life events, negative copying style and food insecurity. The findings also indicate no association between sex, age and PTSD.The prevalence rate of PTSD in the study communities is unacceptably high. Quite a number of factors were associated with PTSD. Effective public mental health services are needed that combine treatment (medical) psychological and social welfare programs especially at community level to address the high burden of PTSD. Longitudinal studies are also recommended to continuously assess the trends in PTSD in the study communities and remedial action taken.",0,0 +4839,"Association of FKBP5, COMT and CHRNA5 polymorphisms with PTSD among outpatients at risk for PTSD","To the Editor: Several genetic components for posttraumatic stress disorder (PTSD) have been identified, including biologic pathways involving the hypothalamic–pituitary–adrenocortical, locus coeruleus/noradrenergic, and the limbic systems (Broekman, et al., 2007; Koenen, 2007; Rauch and Drevets, 2009). In our IRB-approved study, lifetime PTSD was assessed among adult outpatients with chronic, non-malignant pain, a condition commonly associated with PTSD (McFarlane, 2010). We assessed PTSD with an instrument widely used in previous epidemiologic studies (Boscarino et al., 2010). We examined genetic markers using a multivariate design that assessed single nucleotide polymorphisms (SNPs) located within the FK506 binding protein-5 (FKBP5), catechol-O-methyltransferase (COMT), and cholinergic receptor nicotinic alpha3/alpha-5 (CHRNA3/CHRNA5) gene clusters. SNPs were selected using agnostic LD tagging with consideration of prior evidence and functional annotation (Erlich, et al., 2010). The COMT gene is associated with anxiety disorders, psychosis, depression, and other conditions involving catecholamine pathway regulation (Craddock, et al., 2006; Montag et al., 2008). This gene is also associated with PTSD (Kolassa et al., 2010). The FKBP5 gene regulates glucocorticoid receptor sensitivity, is functionally involved in HPA stress axis activity, and is associated with PTSD (Binder, 2009; Gillespie, et al., 2009). The CHRNA3/5 gene cluster, which encodes components of the nicotinic acetylcholine receptor, is associated with nicotine dependence, smoking, and other substance misuse (Erlich, et al., 2010). PTSD is also associated with cigarette smoking and substance use (Boscarino et al., 2006; Fu et al., 2007). Using trained interviewers and following informed consent, we completed diagnostic interviews with 502 subjects and collected DNA to determine if FKBP5, COMT, and CHRNA3/5 SNPs were associated with PTSD (mean age = 55, S.D. = 13.4; PTSD = 15%, 95% CI = 11.7–18.1%). Non-Caucasian patients were excluded from this analysis. Genotyping was performed on an Applied BioSystems 7500 real-time PCR platform, using TaqMan kits. Using multivariate logistic regressions that included demographic (age, gender, income, education, and marital status) and environmental (trauma exposure, childhood adversity, and neuroticism) variables, 3 of 9 SNPs examined were associated with PTSD (p<0.05), including one within each of the FKBP5 (rs9470080), COMT (rs4680), and CHRNA5 (rs16969968) genes. A count of risk alleles in these 3 loci was also associated with PTSD (OR = 1.65, 95% CI = 1.25–2.16, p = 0.000426), suggesting that those with 4 or more PTSD risk alleles had ~ 7 times greater risk of PTSD, compared to those with no risk alleles (1.65 × 4 = 6.6). We also included opioid dependence, reported pain, number of pain prescriptions, and ancestry (Northern European, Eastern European, and Sothern European/Other) in the model as a final analysis step, but this did not alter the results. Examination of risk-allele counts by PTSD status suggested that the “AA” genotype of the rs16969968 (CHRNA5) and rs4680 (COMT), and the “TT” genotype of rs9470080 (FKBP5) are more common among PTSD cases. Since our logistic regression detected a complex interaction between allele count × trauma exposure × childhood adversity × neuroticism (p = 0.029), we used Answer Tree Chi-square Automatic Interaction Detection to examine these effects (SPSS, Chicago, IL). This confirmed interactions with risk-allele count, indicating that those with higher risk-allele counts and exposure to higher trauma, higher childhood adversity, and higher neuroticism, were at much greater risk for PTSD. Conversely, those with no risk alleles appeared highly resilient to PTSD, regardless of environmental exposures. This is the first study to report that SNP markers rs16969968, rs9470080, and rs4680, were each individually associated with PTSD and that a cumulative allele model using these SNPs was associated with higher PTSD risk. FKBP5 polymorphisms are known to regulate the cortisol-binding affinity and nuclear translocation of the glucocorticoid receptor and polymorphisms at this locus have been associated with PTSD. COMT polymorphisms have been found to affect fear extinction and are thought to play a role in anxiety disorders and PTSD. The CHRNA gene has been associated with nicotine dependence and PTSD is associated with cigarette smoking and other substance misuse. Additional research is recommended to confirm these findings. The involvement of the CHRNA gene in PTSD, fear circuitry, and stress regulation is biologically plausible and worthy of further investigation.",0,0 +4840,MMPI-2 As a Predictor of Change in PTSD Symptom Clusters: A Further Analysis of the Forbes et al. (2002) Data Set,"In this study, we reanalyzed the Forbes et al. (2002) data set to examine the Minnesota Multiphasic Personality Inventory (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) as a differential predictor of change across posttraumatic stress disorder symptom clusters following treatment in 141 Vietnam veterans. A series of partial correlation and linear multivariate regression analyses, controlling for initial symptom severity, identified several scales predictive of symptom change. None of the MMPI-2 scales, however, emerged as predictors of change in reexperiencing symptoms. Social alienation and marital distress were the most potent predictors for avoidance symptoms. Anger, alcohol use, and hypomania were the most potent predictors for the hyperarousal symptoms. Of the personality disorders, borderline personality was the strongest predictor of change in the avoidance and hyperarousal clusters. Further replication of the findings of this article and those reported by Forbes et al. (2002) is required.",0,0 +4841,Posttraumatic stress disorder in the emergency room: exploration of a cognitive model,"Ehlers and Clark (Behav. Res. Ther., 38 (2000) 319) recently proposed a cognitive model of posttraumatic stress disorder (PTSD). In this study, we examined two facets of this model, appraisal and peritraumatic dissociation, in the context of a hospital emergency room. Fifty-one emergency room personnel completed questionnaires measuring posttraumatic stress symptoms, interpretations of traumatic events experienced while working in the emergency room and subsequent intrusive recollections, and peritraumatic dissociation. Twelve percent of participants met formal diagnostic criteria for PTSD, and 20% met PTSD symptom criteria. As predicted, both negative appraisals of the trauma and of intrusive recollections were associated with increased PTSD severity. Although peritraumatic dissociation did not correlate with overall PTSD symptom severity, it was associated with the reexperiencing symptom cluster. Discussion focuses on the factors associated with PTSD in emergency room professionals and implications for intervention.",0,0 +4842,An Open-Label Study of Levetiracetam for the Treatment of Social Anxiety Disorder,"Social anxiety disorder is a disabling condition characterized by excessive fear and avoidance of social and performance situations. While a variety of effective pharmacotherapies exists, many patients do not fully respond to or tolerate available agents. Preclinical and early clinical experience with levetiracetam, a novel anticonvulsant agent, suggests that levetiracetam has anxiolytic properties and a favorable adverse event profile. Levetiracetam thus warrants systematic evaluation as a treatment option for anxiety disorders.Twenty adult outpatients who were recruited through advertisement and clinical referral and who met DSM-IV criteria for social anxiety disorder, generalized type, participated in this 8-week open-label, flexible-dose study from November 2002 to December 2003. Participants were required to have scores of >/= 50 on the Liebowitz Social Anxiety Scale (LSAS) and >/= 4 on the Clinical Global Impressions-Severity of Illness scale (CGI-S) at baseline. The presence of comorbid depression and anxiety disorders were permitted as long as social anxiety disorder was the primary disorder. Levetiracetam was initiated at 250 mg/day for the first week and flexibly titrated up to a maximum of 3000 mg/day (1500 mg b.i.d.). The primary outcome measure was change in the LSAS score at endpoint.There was a clinically significant 20.5-point decrease in LSAS scores in the intent-to-treat, last-observation-carried-forward analysis (t = 3.1; p <.01, N = 20). There were also significant reductions in CGI-S (p <.01) and Hamilton Rating Scale for Anxiety (p <.02) scores.This pilot study supports the safety and potential efficacy of a novel agent, levetiracetam, for the treatment of social anxiety disorder. Larger controlled trials are warranted to confirm these results.",0,0 +4843,Affective Dispositions and PTSD Symptom Clusters in Female Interpersonal Trauma Survivors,"Interpersonal trauma (IPT) against women can have dire psychological consequences including persistent maladaptive changes in the subjective experience of affect. Contemporary literature has firmly established heightened negative affect (NA) as a risk and maintenance factor for posttraumatic stress disorder (PTSD). However, the relationship between NA and PTSD symptoms is not well understood within IPT survivors, the majority of whom are female, as much of this research has focused on combat veterans. In addition, the connection between positive affect (PA) and PTSD symptoms has yet to be examined. With increased emphasis on ""negative alterations in cognitions and mood . . ."" as an independent symptom cluster of PTSD in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5), understanding the relationship between self-reported affectivity and the classic PTSD symptom clusters may be increasingly useful in differentiating symptom presentations of trauma-related psychopathology. The current study directly compared self-reported trait NA and PA with total severity and frequency cluster scores from the Clinician-Administered PTSD Scale (CAPS) in 54 female survivors of IPT who met criteria for PTSD. Results identify NA (but not PA) as a consistent predictor of total PTSD symptoms and, specifically, re-experiencing symptoms.",0,0 +4844,Transforming Trajectories for Traumatized Children,,0,0 +4845,Posttraumatic Stress in Survivors 1 Month to 19 Years after an Airliner Emergency Landing,"Posttraumatic stress (PTS) is common in survivors from life-threatening events. Little is known, however, about the course of PTS after life threat in the absence of collateral stressors (e.g., bereavement, social stigma, property loss) and there is a scarcity of studies about PTS in the long term. This study assessed the short- and long-term course of PTS, and the influence of gender, education and age on the level and course of PTS, in survivors from a non-fatal airliner emergency landing caused by engine failure at an altitude of 1 km. There were 129 persons on board. A survey including the Impact of Event Scale was distributed to 106 subjects after 1 month, 4 months, 14 months, and 25 months, and to 95 subjects after 19 years (response rates 64-83%). There were initially high levels of PTS. The majority of changes in PTS occurred from 1 to 4 months after the event. There were small changes from 4 to 25 months but further decrease in PTS thereafter. Female gender was associated with higher levels of PTS whereas gender was unrelated to the slope of the short- and long-term trajectories. Higher education was related to a quicker recovery although not to initial or long-term PTS. Age was not associated with PTS. The present findings suggest that a life-threatening experience without collateral stressors may produce high levels of acute posttraumatic stress, yet with a benign prognosis. The findings further implicate that gender is unrelated to trajectories of recovery in the context of highly similar exposure and few collateral stressors.",0,0 +4846,[The typology of chronic posttraumatic stress disorder].,"Psychopathological chronic posttraumatic stress disorder (PTSD) was studied in relation to clinical peculiarities of depression included in PTSD structure. One hundred and sixty-five patients, 124 men and 41 women, aged 25-48 years, were examined in general outpatient clinics. PTSD duration was from 6 to 24 months. A stress was caused by situations related to combat events (60.6%), close person's death (25.4%), assault with physical and moral violence (8.2%) and rape (5.8%). With regard to depression structure and dominating affect, 4 PTSD types--anxious (36.6%), dysphoric (26.1%), apathic (20%) and somatoform (17.7%), were distinguished. Also, their significance for the formation of patient's personality features is emphasized. A role of depression in syndrome formation in chronic PTSD is suggested.",0,0 +4847,Persistence of multiple illnesses in World Trade Center rescue and recovery workers: a cohort study,"More than 50,000 people participated in the rescue and recovery work that followed the Sept 11, 2001 (9/11) attacks on the World Trade Center (WTC). Multiple health problems in these workers were reported in the early years after the disaster. We report incidence and prevalence rates of physical and mental health disorders during the 9 years since the attacks, examine their associations with occupational exposures, and quantify physical and mental health comorbidities.In this longitudinal study of a large cohort of WTC rescue and recovery workers, we gathered data from 27,449 participants in the WTC Screening, Monitoring, and Treatment Program. The study population included police officers, firefighters, construction workers, and municipal workers. We used the Kaplan-Meier procedure to estimate cumulative and annual incidence of physical disorders (asthma, sinusitis, and gastro-oesophageal reflux disease), mental health disorders (depression, post-traumatic stress disorder [PTSD], and panic disorder), and spirometric abnormalities. Incidence rates were assessed also by level of exposure (days worked at the WTC site and exposure to the dust cloud).9-year cumulative incidence of asthma was 27·6% (number at risk: 7027), sinusitis 42·3% (5870), and gastro-oesophageal reflux disease 39·3% (5650). In police officers, cumulative incidence of depression was 7·0% (number at risk: 3648), PTSD 9·3% (3761), and panic disorder 8·4% (3780). In other rescue and recovery workers, cumulative incidence of depression was 27·5% (number at risk: 4200), PTSD 31·9% (4342), and panic disorder 21·2% (4953). 9-year cumulative incidence for spirometric abnormalities was 41·8% (number at risk: 5769); three-quarters of these abnormalities were low forced vital capacity. Incidence of most disorders was highest in workers with greatest WTC exposure. Extensive comorbidity was reported within and between physical and mental health disorders.9 years after the 9/11 WTC attacks, rescue and recovery workers continue to have a substantial burden of physical and mental health problems. These findings emphasise the need for continued monitoring and treatment of the WTC rescue and recovery population.Centers for Disease Control and Prevention and National Institute for Occupational Safety and Health.",0,0 +4848,Post-Traumatic Stress Disorder in Adults with Serious Mental Illness and Substance Abuse,"Post-Traumatic Stress Disorder continues to be under-diagnosed among individuals with severe mental illness and substance abuse. In a convenience sample of 64 patients with severe mental disorders being treated at an urban outpatient clinic, 24% met full criteria for PTSD based upon a comprehensive assessment protocol while only 3% were diagnosed with PTSD by clinicians in the medical record (Cochran's Q = 11.267, df 1, p <.001). In contrast, there was a high rate of diagnostic agreement for psychotic and affective illnesses as well as substance abuse. More attention needs to be given to systematically assessing PTSD among severely mentally ill and dually diagnosed individuals because even highly skilled diagnosticians miss the complex presentation of symptoms with which these patients present for treatment.",0,0 +4849,Different Neural Mechanisms Underlie Deficits in Mental Flexibility in Post-Traumatic Stress Disorder Compared to Mild Traumatic Brain Injury,"Mental flexibility is a core executive function that underlies the ability to adapt to changing situations and respond to new information. Individuals with post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) complain of a number of executive function difficulties, one of which is mental inflexibility or an inability to switch between concepts. While the behavioral presentation of mental inflexibility is similar in those with PTSD or mTBI, we hypothesized that the differences in their etiology would manifest as differences in their underlying brain processing. The neural substrates of mental flexibility have been examined with a number of neuroimaging modalities. Functional magnetic resonance imaging has elucidated the brain regions involved, whereas electroencephalography has been applied to understand the timing of the brain activations. Magnetoencephalography, with its high temporal and spatial resolution, has more recently been used to delineate the spatiotemporal progression of brain processes involved in mental flexibility and has been applied to the study of clinical populations. In a number of separate studies, our group has compared the source localization and brain connectivity during a mental flexibility set-shifting task in a group of soldiers with PTSD and civilians with an acute mTBI. In this article, we review the results from these studies and integrate the data between groups to compare and contrast differences in behavioral, neural, and connectivity findings. We show that the different etiologies of PTSD and mTBI are expressed as distinct neural profiles for mental flexibility that differentiate the groups despite their similar clinical presentations.",0,0 +4850,Full Information Estimation in the Presence of Incomplete Data,,0,0 +4851,Do People Turn to Religion in Times of Stress?,"This study examined the effect of health-related stress on changes in religiousness in a sample of elderly, medically ill patients. Patients admitted to Duke University Medical Center (N = 745) were interviewed at baseline and 3-month follow-up. Increases in illness severity (from baseline to follow-up) were associated with decreases in both organizational and private religiousness at follow-up. Effect of illness severity on organizational religiousness was statistically mediated by changes in physical activity, while its effect on private religiousness remained significant after controlling for physical activity. These findings encourage further research investigating causal relationships between stress and religion, as well as identifying measures of religiousness that may capture this construct in the medically ill population.",0,0 +4852,The mediating effect of self-efficacy in the relationship between social support and post-traumatic stress disorder symptoms among patients with central system tumors in China: a cross-sectional study,"Post-traumatic stress disorder (PTSD) is a disorder that can affect people following the experience of a traumatic event. Few studies have researched on PTSD symptoms of patients with central nervous system tumors. In this study, we aim to examine the association between social support and PTSD symptoms and to explore the mediating effect of self-efficacy in this relationship among patients with central nervous system tumors in China.Questionnaires consisting of the Post-traumatic Stress Checklist-Civilian Version, the Duke-UNC Functional Social Support Questionnaire, the General Self-Efficacy Scale, as well as demographic and clinical factors were used to collect information of patients with central nervous system tumors in Liaoning Province, China. A total of 222 patients (effective response rate of 66.1%) became our subjects. Hierarchical linear regression analyses were performed to explore the association between social support and PTSD symptoms and the mediating effect of self-efficacy.After adjusting for demographic characteristics and tumor type, social support was negatively associated with the total score of PTSD symptoms (β = -0.342, P < 0.01). Social support explained 8.8% of the variance in PTSD symptoms. Self-efficacy was found to partially mediate the relationship between social support and PTSD symptoms.Self-efficacy partially mediated the relationship between social support and PTSD symptoms. Interventions focusing on both social support and self-efficacy might be more useful than interventions only targeting either of them.",0,0 +4853,"Longitudinal analysis of the relationship between PTSD symptom clusters, cigarette use, and physical health-related quality of life","Purpose: Posttraumatic stress disorder (PTSD) symptoms, particularly numbing and hyperarousal symptoms, are related to poor physical health-related quality of life (HRQoL). Tobacco dependence is also associated with poor HRQoL, and individuals with PTSD may smoke at higher rates than the general population. Our study aimed to examine the impact of quitting smoking and changes in PTSD symptoms over time on changes in physical HRQoL. Methods: The study used archival data from enrollees (N = 943) in a smoking cessation clinical trial for veterans with PTSD (VA Cooperative study #519). Results: Two of the physical HRQoL domains were sensitive to changes in PTSD symptoms over time: General Health and Vitality. Conclusions: Our findings suggest that particular physical HRQoL domains may be subject to improvement if PTSD symptoms decrease over time. © 2012 Springer Science+Business Media Dordrecht.",0,0 +4854,Lifetime Victimization and Psychological Distress: Cluster Profiles of Out of Treatment Drug-Involved Women,K-means clustering techniques were used to identify four cluster profi les characterized by unique patterns of victimization and psychological distress and further differentiated by distinct patterns of risk and protection across multiple life domains among a sample of 149 crack-using women. Results of this study suggest that important differences exist in patterns of victimization and psychological distress among drug-involved women. Identifi cation of this variation can be used to tailor intervention strategies to the particular needs of different subgroups within the population of crack-using women. © 2010 Springer Publishing Company.,0,0 +4855,Elevated Risk for Autoimmune Disorders in Iraq and Afghanistan Veterans with Posttraumatic Stress Disorder,"Posttraumatic stress disorder (PTSD) is associated with endocrine and immune abnormalities that could increase risk for autoimmune disorders. However, little is known about the risk for autoimmune disorders among individuals with PTSD.We conducted a retrospective cohort study of 666,269 Iraq and Afghanistan veterans under age 55 who were enrolled in the Department of Veterans Affairs health care system between October 7, 2001, and March 31, 2011. Generalized linear models were used to examine if PTSD, other psychiatric disorders, and military sexual trauma exposure increased risk for autoimmune disorders, including thyroiditis, inflammatory bowel disease, rheumatoid arthritis, multiple sclerosis, and lupus erythematosus, adjusting for age, gender, race, and primary care visits.PTSD was diagnosed in 203,766 veterans (30.6%), and psychiatric disorders other than PTSD were diagnosed in an additional 129,704 veterans (19.5%). Veterans diagnosed with PTSD had significantly higher adjusted relative risk (ARR) for diagnosis with any of the autoimmune disorders alone or in combination compared with veterans with no psychiatric diagnoses (ARR = 2.00; 95% confidence interval, 1.91-2.09) and compared with veterans diagnosed with psychiatric disorders other than PTSD (ARR = 1.51; 95% confidence interval, 1.43-1.59; p < .001). The magnitude of the PTSD-related increase in risk for autoimmune disorders was similar in women and men, and military sexual trauma exposure was independently associated with increased risk in both women and men.Trauma exposure and PTSD may increase risk for autoimmune disorders. Altered immune function, lifestyle factors, or shared etiology may underlie this association.",0,0 +4856,"Nosological profile and prevalence of common mental disorders of patients seen at the Family Health Program (FHP) units in Petrópolis, Rio de Janeiro","OBJECTIVES: This study aims to detect the prevalence of common mental disorders among patients seen by doctors at family health program units in Petrópolis-RJ, and to establish their nosological profile. METHOD: The population of the study included all 18 to 65-year-old patient who attended any family health program units included in the study during a 30-day period, between August and December 2002 (n = 714). The prevalence of common mental disorders was assessed using the General Health Questionnaire, 12 item version. In order to establish the nosological profile, the Composite International Diagnostic Interview was administered to all common mental disorders positive patients who accepted to return (n = 215). RESULTS: At the cut-off point of 2/3 the common mental disorders prevalence was 56% and for 4/5, it was 33%. The most frequent nosological categories found among common mental disorders positive patients were depression and anxiety categories along with posttraumatic stress disorder, somatoform pain disorder and dissociative disorders. There was a high frequency of comorbidity, especially between anxiety, depression, somatoform and dissociative disorders. CONCLUSIONS: The common mental disorders prevalence and the nosological profile found in FHP were similar to those of other primary care studies in Brazil, but some disorders (posttraumatic stress disorder, somatoform pain disorder and dissociative disorders) that had not been previously studied in this context were also very frequent. The high common mental disorders prevalence found reinforces the urgent need for systematic inclusion of this level of care in mental health assistance planning.",0,0 +4857,Establishing a methodology to examine the effects of war-zone PTSD on the family: the family foundations study,"Military deployment may adversely affect not only returning veterans, but their families, as well. As a result, researchers have increasingly focused on identifying risk and protective factors for successful family adaptation to war-zone deployment, re-integration of the returning veteran, and the longer-term psychosocial consequences of deployment experienced by some veterans and families. Post-traumatic stress disorder (PTSD) among returning veterans may pose particular challenges to military and military veteran families; however, questions remain regarding the impact of the course of veteran PTSD and other potential moderating factors on family adaptation to military deployment. The Family Foundations Study builds upon an established longitudinal cohort of Army soldiers (i.e. the Neurocognition Deployment Health Study) to help address remaining knowledge gaps. This report describes the conceptual framework and key gaps in knowledge that guided the study design, methodological challenges and special considerations in conducting military family research, and how these gaps, challenges, and special considerations are addressed by the study.",0,0 +4858,Predictors of outcome following a short multimodal rehabilitation program for patients with whiplash associated disorders.,"Patients with whiplash associated disorders (WAD) may present with physical and psychological symptoms which persist long after the initial onset of pain. Several studies have shown that therapeutic exercise for motor and sensorimotor control combined with manual therapy in a multimodal rehabilitation (MMR) program is effective at improving pain and disability in patients with neck disorders. To date, no studies have investigated which self-reported physical or psychological symptoms are predictive of response to this MMR program.To determine which baseline features can predict outcome following a 3-week MMR program in patients with WAD.Observational prospective cohort study.Outpatient rehabilitation clinic.Thirty-seven patients aged >18 years with a diagnosis of WAD grade II or III.The MMR program included manual therapy, motor control and sensorimotor control training according to the clinical impairments of each patient. Patients were assessed before and after treatment for their physical and psychological symptoms by means of self-reported questionnaires. Regression models were estimated with pain intensity, disability and post-traumatic stress symptoms (PTSS) as outcomes.After treatment, patients exhibited significant improvements in all evaluated outcomes (all P<0.01). Regression models accounting for 35% and 36% of the variance in pain intensity outcomes included average pain intensity over the previous week and pain catastrophizing as significant predictors. Disability and pain catastrophizing were predictors of changes in disability following the MMR program explaining 49% of the variance in the model. Furthermore, higher PTSS at baseline was a significant predictor of PTSS after treatment, explaining 55% of the variance in the model.Improved outcomes on pain intensity, disability and PTSS following a MMR program could be partially predicted based on the patient's initial presentation.This knowledge may assist clinicians in predicting outcome following a MMR program inclusive of specific exercise therapy and manual therapy in patients with WAD.",0,0 +4859,Managing anger and aggression in patients with posttraumatic stress disorder.,"Posttraumatic stress disorder was categorized as a clinical entity in 1980 in response to assertions by trauma survivors (particularly Vietnam veterans) and their clinicians that existing diagnostic categories failed to adequately describe their symptoms. The diagnostic features of the current DSM-IV diagnosis have been expanded, and the concept of the disorder is still evolving. Posttraumatic stress disorder rarely occurs in ""pure"" form, and individuals suffering from the disorder commonly meet criteria for Axis I and Axis II disorders. Research is now emerging that supports the prevalence of aggression in posttraumatic stress disorder. Treatment approaches vary, but pharmacotherapy aimed at targeting individual symptoms or clusters can promote mood stabilization. This article discusses the evolving concept of posttraumatic stress disorder as a clinical entity, the association of anger and aggression with the disorder, and the psychopharmacologic approaches to treatment.",0,0 +4860,The Effect of Draft DSM-V Criteria on Posttraumatic Stress Disorder Prevalence,"This study was designed to examine the concordance of proposed DSM-V posttraumatic stress disorder (PTSD) criteria with DSM-IV classification rules and examine the impact of the proposed DSM-V PTSD criteria on prevalence.The sample (N = 185) included participants who were recruited for studies focused on trauma and health conducted at an academic medical center and VA medical center in the southeastern United States. The prevalence and concordance between DSM-IV and the proposed DSM-V classifications were calculated based on results from structured clinical interviews. Prevalence rates and diagnostic efficiency indices including sensitivity, specificity, area under the curve (AUC), and Kappa were calculated for each of the possible ways to define DSM-V PTSD.Ninety-five percent of the sample reported an event that met both DSM-IV PTSD Criterion A1 and A2, but only 89% reported a trauma that met Criterion A on DSM-V. Results examining concordance between DSM-IV and DSM-V algorithms indicated that several of the algorithms had AUCs above 0.90. The requirement of two symptoms from both Clusters D and E provided strong concordance to DSM-IV (AUC = 0.93; Kappa = 0.86) and a greater balance between sensitivity and specificity than requiring three symptoms in both Clusters D and E.Despite several significant changes to the diagnostic criteria for PTSD for DSM-V, several possible classification rules provided good concordance with DSM-IV. The magnitude of the impact of DSM-V decision rules on prevalence will be largely affected by the DSM-IV PTSD base rate in the population of interest.",0,0 +4861,Circulatory response to hyperthermia during acute normovolaemic haemodilution,"Cats anaesthetized with a mixture of chloralose and urethane were exposed to heat stress in two groups. In the first group (n=10) of control animals, the effect of heat stress on haemodynamic variables was recorded at control haematocrit (HCT) of 42.0±1.0%. In a second group, the effect of heat stress was studied after induction of acute normovolaemic haemodilution (HCT of 13.0±1.0%). Haemodilution was induced to a maximum of 60% replacement of blood with dextran (mol.wt. 150000). Heat stress was induced by surface heating and core body temperature was raised from 37° C to 42° C. The effect of heat stress and haemodilution on various haemodynamic variables, viz. left ventricular pressure (LVP), left ventricular contractility (LVdP/dtmax), heart rate (HR), cardiac output (CO), arterial blood pressure (ABP), right atrial pressure (RAP), and arterial blood PO2, PCO2 and pH was examined. Haemodilution produced significant (P<0.05) increases in HR and CO but there were no significant (P>0.05) changes in ABP, RAP, LVdP/dtmax and total peripherial resistance (TPR). Hyperthermia caused a significant fall (P<0.05) in TPR. However, the percentage fall in TPR was higher in the control group. On exposure to heat stress, there were significant (P<0.05I increases in HR and CO in both the groups; however, HR and CO values were significantly (P<0.05) higher in the haemodiluted group compared to the control. The latter findings could be due either to the higher basal values of these variables with the fall in HCT or to inefficient cardiovascular regulatory mechanisms. The lack of efficient regulatory control under such severe stress conditions makes the cardiovascular system of anaemic animals more vulnerable to heat stress. In conclusion, the results of the present study showed deleterious effects of heat stress in both the groups. The higher values of HR and CO in the haemodiluted group may be responsible for circulatory failure at low HCT values, indicating a higher risk in the haemodiluted group as compared to the control group. © ISB 1998.",0,0 +4862,The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories,"The psychometric properties of the Depression Anxiety Stress Scales (DASS) were evaluated in a normal sample of N = 717 who were also administered the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The DASS was shown to possess satisfactory psychometric properties, and the factor structure was substantiated both by exploratory and confirmatory factor analysis. In comparison to the BDI and BAI, the DASS scales showed greater separation in factor loadings. The DASS Anxiety scale correlated 0.81 with the BAI, and the DASS Depression scale correlated 0.74 with the BDI. Factor analyses suggested that the BDI differs from the DASS Depression scale primarily in that the BDI includes items such as weight loss, insomnia, somatic preoccupation and irritability, which fail to discriminate between depression and other affective states. The factor structure of the combined BDI and BAI items was virtually identical to that reported by Beck for a sample of diagnosed depressed and anxious patients, supporting the view that these clinical states are more severe expressions of the same states that may be discerned in normals. Implications of the results for the conceptualisation of depression, anxiety and tension/stress are considered, and the utility of the DASS scales in discriminating between these constructs is discussed.",0,0 +4863,Cross-sectional psychosocial evaluation of heart transplantation candidates,"Heart transplantation (HT) is a potentially life-saving procedure for people with terminal cardiac disease. In the last decades researchers of HT programs have attempted to identify the existence of psychosocial factors that might influence the clinical outcome before and after the transplantation. The main objective of this study was to describe epidemiological, psychiatric and psychological features of a large sample of HT candidates.Cross-sectional, observational and descriptive study. A psychiatric and psychological assessment of 125 adult patients was performed at the moment of being included in the HT waiting list, between 2006 and 2012. The assessment consisted in: Clinical, epidemiological and psychosocial form; Spanish version of Hospital Anxiety and Depression Scale; Structured Clinical Interview for DSM-IV axis I disorders; Coping questionnaire (COPE); Five Factors Inventory Revised (NEO-FFI-R); Apgar-Family questionnaire and the Multidimensional Health Locus of Control scale.Axis I diagnoses were present in a 30.4% of patients. COPE showed that this group of patients used most frequently engagement strategies. Personality factors profile of NEO-FFI-R were similar to general population and locus of control scale also presented similar scores compared with other chronic diagnostic groups. Statistically significant associations were found between personality factors and COPE scales/dimensions and psychopathology, mainly neuroticism and disengagement.This is the first study to assess systematically psychosocial factors in a large sample of HT candidates. We have found that around one third of these patients have a psychiatric disorder. Neuroticism and disengagement coping styles can serve as markers of emotional distress.",0,0 +4864,Identification of posttraumatic growth trajectories in the first year after breast cancer surgery,"Background Empirical studies of the relationship between posttraumatic growth (PTG) and adjustment outcomes reveal a fairly inconclusive picture. We argue that the inconsistent findings are likely due to the heterogeneity of the PTG experience over time. In this regard, we predicted that individuals with different PTG trajectories vary in the level of adjustment and the correlational patterns between PTG and adjustment. Methods Participants were 124 Taiwanese women who underwent surgery for breast cancer. Measures of PTG and adjustment variables, including positive affect, negative affect, mental and physical quality of life, anxiety, and depression, were assessed at 1 day and 3, 6, and 12 months after surgery. A group-based trajectory model was used to identify subpopulations of individuals who shared homogenous growth patterns. Then, we determined whether the trajectory predicted adjustment at 12 months after surgery. The correlations between PTG and adjustment outcomes were computed in each subpopulation across every time point. Results The patients were categorized into the following four groups, which showed very different patterns of PTG change over the first year after breast cancer surgery: stable high (27.4%), high decreasing (39.4%), low increasing (16.9%), and low decreasing (16.9%). Differences in the level of adjustment at 12 months and the patterns of the correlations across time were found among these latent subgroups Conclusions This study was the first longitudinal examination of PTG trajectories and their different levels of adjustment. The findings support our argument that identifying distinct PTG trajectories can better determine the nature of the relationship between PTG and adjustment. Copyright © 2014 John Wiley & Sons, Ltd.",0,0 +4865,Patterns of mental distress following the violent death of a child and predictors of change over time,"We observed 173 parents bereaved by the violent death of an adolescent or young adult child. Data were collected 4, 12, 24, and 60 months postdeath. Using latent growth modeling, we examined how initial levels of mental distress and the rate of change over time are influenced by nine predictors: parents' gender, self-esteem, three coping strategies, perceived social support, negative life stressors, posttraumatic stress disorder (PTSD) symptoms, and an intervention offered in the early bereavement period. The results support a multiple-risk and -protective factor model of loss accommodation. Parents' gender, self-esteem, and affective and repressive coping were predictive of changes in mental distress over time. Although parents' initial levels of PTSD were the best predictor of baseline mental distress, they did not predict reductions in distress 5 years later. Theoretical, empirical, and clinical implications are discussed.",0,0 +4866,PTSD symptom presentation across the deployment cycle,"Symptom-level variation in posttraumatic stress disorder (PTSD) has not yet been examined in the early post-deployment phase, but may be meaningful etiologically, prognostically, and clinically.Using latent class analysis (LCA), we examined PTSD symptom heterogeneity in a cohort of participants from the Marine Resiliency Study (MRS), a longitudinal study of combat Marines deployed to Iraq and Afghanistan (N=892). Typologies of PTSD symptom presentation were examined at one month pre-deployment and again one, five, and eight months post-deployment.Heterogeneity in PTSD symptom presentation was evident at each assessment point, and the degree of symptom heterogeneity (i.e., the number of classes identified) differed by time point. Symptom patterns stabilized over time from notable symptom fluctuations during the early post-deployment period to high, medium, and low symptom severity by eight months post-deployment. Hypervigilance and exaggerated startle were frequently endorsed by participants in the initial month post-deployment. Flashbacks, amnesia, and foreshortened future were infrequently endorsed. Greater combat exposure, lifespan trauma, and avoidant coping generally predicted worse outcomes.Data were self-report and may have limited generalizability due to our lack of women and inclusion of only combat Marines. Attrition and re-ranging of data resulted in significant missing data and affected the representativeness of the sample.Symptom-level variability is highest in the month following deployment and then stabilizes over time. Should post-deployment assessments occur too soon, they may capture common and transient early post-deployment reactions, particularly anxious arousal.",0,0 +4867,Longitudinal Study of Headache Trajectories in the Year After Mild Traumatic Brain Injury: Relation to Posttraumatic Stress Disorder Symptoms,"To examine headache trajectories among persons with mild traumatic brain injury (MTBI) in the year after injury and the relation of headache trajectory to posttraumatic stress disorder (PTSD) at 1 year postinjury.Prospective, longitudinal study.Participants were recruited through a university medical center and participated in follow-up assessments by telephone.Prospectively enrolled individuals (N=212) within 1 week of MTBI who were hospitalized for observation or other system injuries. Participants were assessed at baseline and 3, 6, and 12 months postinjury.Not applicable.Participants rated average headache pain intensity using the 0 to 10 numerical rating scale at each assessment period. The PTSD Checklist-Civilian Version was completed at 12 months postinjury.Latent class growth analysis produced a 4-trajectory group model, with groups labeled resolved, worsening, improving, and chronic. Multivariate regression modeling revealed that younger age and premorbid headache correlated with membership in the worse trajectory groups (worsening and chronic; P<.001). Univariate regression revealed a significant association between PTSD and membership in the worse trajectory groups (P<.001).Headache is common in the year after MTBI, with younger people, persons who previously had headaches, and persons with PTSD more likely to report chronic or worsening headache. Further research is needed to examine whether PTSD symptoms exacerbate headaches or whether problematic headache symptoms exacerbate PTSD.",0,0 +4868,Cognitive behaviour therapy for adolescent offenders with mental health problems in custody,"Many studies have identified high levels of mental health problems among adolescents in custody and there is increasing evidence that mental health problems in this population are associated with further offending and mental health problems into adulthood. Despite recent improvements in mental health provision within custodial settings there is little evidence of structured interventions being offered or of their effectiveness being evaluated. A cognitively based intervention was developed and offered to adolescents with a variety of mental health problems in different secure settings, and the outcomes compared with a control group. Although this small-scale study did not identify significant differences in outcomes for the two groups, both recruitment and retention in therapy were good, and potential candidates were not excluded on the basis of learning difficulties or co-morbidity. The study demonstrated the viability of a delivering cognitively based intervention for common mental health problems within secure settings.",0,0 +4869,Evaluation of a Bayesian Approach to Estimating Nonlinear Mixed-Effects Mixture Models,"The growth mixture model has become increasingly popular, given the willingness to acknowledge developmental heterogeneity in populations. Typically, linear growth mixture models, based on polynomials or piecewise functions, are used in substantive applications and evaluated quantitatively through simulation. Growth mixture models that follow inherently nonlinear trajectories, referred to as nonlinear mixed-effects mixture models, have received comparatively little attention—likely due to estimation complexity. Previous work on the estimation of these models has involved multistep routines (Kelley, 2008), maximum likelihood estimation (MLE) via the E-M algorithm (Harring, 2005, 2012), Taylor series expansion and MLE within the structural equation modeling framework (Grimm, Ram, & Estabrook, 2010), and MLE by adaptive Gauss–Hermite quadrature (Codd & Cudeck, 2014). This article proposes and evaluates the use of Bayesian estimation with OpenBUGS (Lunn, Spiegelhalter, Thomas, & Best, 2009), a free program, a...",0,0 +4870,Autism and Trauma: Autistic Post-traumatic Developmental Disorder,"(from the chapter) The author notes that autistic patients fall into natural sub-groupings with shared characteristics. The author's clinical attempts to reach these inaccessible children has led to conceptualizing sub-groupings on the basis of symptoms, which includes meta-psychological factors based on the author's experience of the way the children present. This chapter proposes an Autistic Post-Traumatic Developmental Disorder (APTDD) sub-group, drawing attention to a similarity between the nature of the symptomatology in a small sub-group of children with autism and the symptomatology of posttraumatic stress disorder (PTSD) in children who are not autistic. The author suggests that it is the impact of trauma in infancy which precipitates in an autistic withdrawal, leading to developmental delay, and thus proposes the term APTDD to describe the condition. Links are made to the work of neurobiologists, and clinical vignettes are given as illustrations, including those of 2 male children. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4871,"Poly-Victimization and Risk of Posttraumatic, Depressive, and Substance Use Disorders and Involvement in Delinquency in a National Sample of Adolescents","

Abstract

Purpose

Adolescents exposed to multiple forms of psychological trauma (""poly-victimization,"" Finkelhor et al. Child Abuse Negl 2007;31:7–26) may be at high risk for psychiatric and behavioral problems. This study empirically identifies trauma profiles in a national sample of adolescents to ascertain correlates of poly-victimization.

Methods

Latent Class analyses and logistic regression analyses were used with data from the National Survey of Adolescents to identify trauma profiles and each profile's risk of posttraumatic stress disorder, major depressive disorder, substance use disorders, and delinquency involvement and deviant peer group relationships. Poly-victimization classes were also compared to classes with trauma exposure of lesser complexity.

Results

Six mutually exclusive trauma profiles (latent classes) were identified. Four classes were characterized by high likelihood of poly-victimization, including abuse victims (8%), physical assault victims (9%), and community violence victims (15.5%). Poly-victimization class members, especially abuse and assault victims, were more likely than do youth traumatized by witnessing violence or exposure to disaster/accident trauma to have psychiatric diagnosis and (independent of psychiatric diagnoses or demographics) to be involved in delinquency with delinquent peers.

Conclusions

Poly-victimization is prevalent among adolescents and places youth at high risk for psychiatric impairment and for delinquency. Moreover, poly-victimized youths' risk of delinquency cannot be fully accounted for by posttraumatic stress disorder, depression, or substance use problems, suggesting that adolescent healthcare providers should consider poly-victimization as a risk for behavioral and legal problems even when PTSD, depression, or addiction symptoms are not clinically significant.",0,0 +4872,Aberrant EEG functional connectivity and EEG power spectra in resting state post-traumatic stress disorder: A sLORETA study,"The aim of the present study was to explore the modifications of EEG power spectra and EEG connectivity of resting state (RS) condition in patients with post-traumatic stress disorder (PTSD). Seventeen patients and seventeen healthy subjects matched for age and gender were enrolled. EEG was recorded during 5min of RS. EEG analysis was conducted by means of the standardized Low Resolution Electric Tomography software (sLORETA). In power spectra analysis PTSD patients showed a widespread increase of theta activity (4.5-7.5Hz) in parietal lobes (Brodmann Area, BA 7, 4, 5, 40) and in frontal lobes (BA 6). In the connectivity analysis PTSD patients also showed increase of alpha connectivity (8-12.5Hz) between the cortical areas explored by Pz-P4 electrode. Our results could reflect the alteration of memory systems and emotional processing consistently altered in PTSD patients.",0,0 +4873,"Predeployment, deployment, and postdeployment risk factors for posttraumatic stress symptomatology in female and male OEF/OIF veterans.","[Correction Notice: An erratum for this article was reported in Vol 120(4) of Journal of Abnormal Psychology (see record 2011-19996-001). In the article there was an error in the affiliation bylines for Rani Elwy and Susan Eisen. Their affiliations should have been listed as Edith Nourse Rogers Memorial Veterans Hospital and Department of Health Policy and Management, Boston University School of Public Health.] Prior research on risk factors for posttraumatic stress symptomatology (PTSS) in war-exposed Veterans has revealed both direct and indirect mechanisms of risk that span predeployment, deployment, and postdeployment timeframes. The aims of the present study were to identify the mechanisms through which previously documented risk factors contribute to PTSS in a national sample of 579 female and male Veterans deployed to Afghanistan for Operation Enduring Freedom (OEF) or to Iraq for Operation Iraqi Freedom (OIF), as well as to examine the extent to which results mirror associations observed among Vietnam Veterans (King, King, Foy, Keane, & Fairbank, 1999). Consistent with conservation of resources (COR) theory (Hobfoll, 1989, 2001), findings indicated that PTSS is accounted for by multiple chains of risk, many originating in predeployment experiences that place Veterans at risk for additional stress exposure, and foretell difficulty accessing resources in the face of subsequent stressors. Importantly, the majority of previously documented mechanisms were replicated in this study, suggesting key pathways through which risk factors may contribute to PTSS across different Veteran populations. Results also revealed a number of novel risk mechanisms for OEF/OIF female Veterans, particularly with respect to the role of deployment family relationships in risk for PTSS.",0,0 +4874,"Protocol for a prospective, longitudinal, cohort study of postconcussive symptoms in children: the Take C.A.Re (Concussion Assessment and Recovery Research) study","A substantial minority of children who sustain a concussion suffer prolonged postconcussive symptoms. These symptoms can persist for more than 1 month postinjury and include physical, cognitive, behavioural and emotional changes. Those affected can develop significant disability, diminishing their quality of life. The precise prevalence of postconcussive symptoms following child concussion is unclear, with heterogeneous and at times conflicting results published regarding factors that predict children at risk for developing long-lasting postconcussive symptoms. The aim of the Take C.A.Re (Concussion Assessment and Recovery Research) study is to provide an in-depth multidimensional description of the postconcussive recovery trajectories from a physical, neurocognitive and psychosocial perspective in the 3 months following concussion, with a focus on the early postconcussive period, and identification of factors associated with prolonged recovery.Take C.A.Re is a prospective, longitudinal study at a tertiary children's hospital, recruiting and assessing patients aged 5-<18 years who present to the emergency department with a concussion and following them at 1-4 days, 2 weeks, 1 month and 3 months postinjury. Multiple domains are assessed: postconcussive symptoms, balance and coordination, neurocognition, behaviour, quality of life, fatigue, post-traumatic stress symptoms, parental distress and family burden. 'Delayed recovery' is operationalised as the presence of ≥ 3 symptoms on the Post Concussive Symptoms Inventory rated as worse compared with baseline. Main analyses comprise analysis of variance (recovery trajectories, delayed vs normal recovery groups) and regression analyses of predictors of recovery (preinjury, acute and family factors).Ethical approval has been obtained through the Royal Children's Hospital Melbourne Human Research Ethics Committee (33122). We aim to disseminate the findings through international conferences, international peer-reviewed journals and social media.ACTRN12615000316505.",0,0 +4875,Before and after the 1999 Chi-Chi earthquake: Traumatic events and depressive symptoms in an older population,"Natural disasters, such as earthquakes, can have deleterious consequences for physical and psychological health. In this study, we investigate variability in resilience to depressive symptoms in the aftermath of a massive earthquake that struck Taiwan in 1999. We analyze data on 1160 older individuals from a national, longitudinal survey with interviews before and after the earthquake. This survey contains extensive information on physical and cognitive function, depressive symptoms, socio-demographic characteristics and earthquake-related exposure and experiences. We estimate regression models to identify risk factors associated with the presence of depressive symptoms after the disaster, controlling for health status and the presence of depressive symptoms beforehand. We pay special attention to how socio-demographic factors moderate the psychological impact of the earthquake. Results indicate that persons of low socioeconomic status (SES), socially isolated individuals, and women reported higher levels of depressive symptoms than their respective counterparts, as did persons who experienced damage to their homes. The psychological effects of damage were strongest among those aged 54-70. The findings suggest that people who experience damage to their home during a disaster are at risk of experiencing depressive symptoms, with the elderly being more resilient than the near-elderly.",0,0 +4876,Anger: Cause or Consequence of Posttraumatic Stress? A Prospective Study of Dutch Soldiers,"Many studies have shown that individuals with posttraumatic stress disorder (PTSD) experience more anger over time and across situations (i.e., trait anger) than trauma-exposed individuals without PTSD. There is a lack of prospective research, however, that considers anger levels before trauma exposure. The aim of this study was to prospectively assess the relationship between trait anger and PTSD symptoms, with several known risk factors, including baseline symptoms, neuroticism, and stressor severity in the model. Participants were 249 Dutch soldiers tested approximately 2 months before and approximately 2 months and 9 months after their deployment to Afghanistan. Trait anger and PTSD symptom severity were measured at all assessments. Structural equation modeling including cross-lagged effects showed that higher trait anger before deployment predicted higher PTSD symptoms 2 months after deployment (β = .36), with stressor severity and baseline symptoms in the model, but not with neuroticism in the model. Trait anger at 2 months postdeployment did not predict PTSD symptom severity at 9 months, and PTSD symptom severity 2 months postdeployment did not predict subsequent trait anger scores. Findings suggest that trait anger may be a pretrauma vulnerability factor for PTSD symptoms, but does not add variance beyond the effect of neuroticism.",0,0 +4877,Psychosocial predictors of chronic Post-Traumatic Stress Disorder in Sri Lankan tsunami survivors,"This study aimed to determine whether psychological factors associated with Post-Traumatic Stress Disorder (PTSD) identified in Western samples generalize to low Social-Economical-Status (SES) populations in an underdeveloped Asian country. The study included 113 survivors of the 2004-tsunami on the south coast of Sri Lanka, recruited from 4 preschools and 10 villages for displaced persons. With logistic regressions the relations between interview-based PTSD diagnosis and psychological factors were assessed, controlling for putative confounders. Fifteen months post-trauma the prevalence of PTSD was 52.2%. Multivariate analyses indicated that negative interpretation of tsunami-memories was significantly (P<0.005) related to PTSD. Of the putative confounders, gender and (non-replaced) lost work equipment were related to current PTSD (P<0.05). The results indicate that the relation between negative interpretation of trauma memories and PTSD is quite universal, suggesting that interventions focusing on this factor may be important in treatment of tsunami survivors who are suffering from chronic PTSD.",0,0 +4878,A Prospective Study of Posttraumatic Stress and Depressive Reactions Among Treated and Untreated Adolescents 5 Years After a Catastrophic Disaster,"This study evaluated 1) the natural course of posttraumatic stress and depressive reactions among untreated adolescents from two cities in an earthquake zone (Gumri and Spitak) and one at the periphery (Yerevan) who were differentially exposed to the 1988 Spitak earthquake in Armenia and 2) the effectiveness of brief trauma/grief-focused psychotherapy among adolescents from Gumri.One hundred twenty-five adolescents were assessed with the Child Posttraumatic Stress Disorder Reaction Index (CPTSD-RI) and the Depression Self-Rating Scale (DSRS) at 1.5 and 5 years postearthquake. At 1.5 years, trauma/grief-focused group and individual psychotherapy was provided over 6 weeks to a group of students in Gumri.CPTSD-RI scores among untreated adolescents from Gumri and Spitak subsided significantly but mildly at follow-up, with scores from Spitak, the city at the epicenter, remaining above the cutoff for a diagnosis of PTSD. DSRS scores increased mildly in both earthquake cities but only significantly in Gumri. Among treated adolescents in Gumri, improvement in CPTSD-RI scores was three times that of the untreated Gumri comparison group. The treated group also tended to improve on their DSRS scores, whereas these scores worsened significantly among untreated subjects.Untreated adolescents exposed to severe trauma are at risk for chronic PTSD and depressive symptoms. Brief trauma/grief-focused psychotherapy is effective in reducing PTSD symptoms and halting the progression of depression. This study supports the implementation of mental health intervention programs in schools after disasters to reduce trauma-related psychopathology.",0,0 +4879,Association Between Traumatic Brain Injury and Risk of Posttraumatic Stress Disorder in Active-Duty Marines,"Whether traumatic brain injury (TBI) is a risk factor for posttraumatic stress disorder (PTSD) has been difficult to determine because of the prevalence of comorbid conditions, overlapping symptoms, and cross-sectional samples.To examine the extent to which self-reported predeployment and deployment-related TBI confers increased risk of PTSD when accounting for combat intensity and predeployment mental health symptoms.As part of the prospective, longitudinal Marine Resiliency Study (June 2008 to May 2012), structured clinical interviews and self-report assessments were administered approximately 1 month before a 7-month deployment to Iraq or Afghanistan and again 3 to 6 months after deployment. The study was conducted at training areas on a Marine Corps base in southern California or at Veterans Affairs San Diego Medical Center. Participants for the final analytic sample were 1648 active-duty Marine and Navy servicemen who completed predeployment and postdeployment assessments. Reasons for exclusions were nondeployment (n = 34), missing data (n = 181), and rank of noncommissioned and commissioned officers (n = 66).The primary outcome was the total score on the Clinician-Administered PTSD Scale (CAPS) 3 months after deployment.At the predeployment assessment, 56.8% of the participants reported prior TBI; at postdeployment assessment, 19.8% reported sustaining TBI between predeployment and postdeployment assessments (ie, deployment-related TBI). Approximately 87.2% of deployment-related TBIs were mild; 250 of 287 participants (87.1%) who reported posttraumatic amnesia reported less than 24 hours of posttraumatic amnesia (37 reported ≥ 24 hours), and 111 of 117 of those who lost consciousness (94.9%) reported less than 30 minutes of unconsciousness. Predeployment CAPS score and combat intensity score raised predicted 3-month postdeployment CAPS scores by factors of 1.02 (P < .001; 95% CI, 1.02-1.02) and 1.02 (P < .001; 95% CI, 1.01-1.02) per unit increase, respectively. Deployment-related mild TBI raised predicted CAPS scores by a factor of 1.23 (P < .001; 95% CI, 1.11-1.36), and moderate/severe TBI raised predicted scores by a factor of 1.71 (P < .001; 95% CI, 1.37-2.12). Probability of PTSD was highest for participants with severe predeployment symptoms, high combat intensity, and deployment-related TBI. Traumatic brain injury doubled or nearly doubled the PTSD rates for participants with less severe predeployment PTSD symptoms.Even when accounting for predeployment symptoms, prior TBI, and combat intensity, TBI during the most recent deployment is the strongest predictor of postdeployment PTSD symptoms.",0,0 +4880,Risk of post-traumatic stress disorder following traumatic events in a community sample,"Aims. Post-traumatic stress disorder (PTSD) is typically associated with high-risk population groups, but the risk of PTSD that is associated with trauma experienced in the community, and effect of changes in diagnostic criteria in DSM-5 on prevalence in the general population, is unknown. Methods. Cross-sectional analysis of population-based data from 4558 adults aged 25–83 years resident in Caerphilly county borough, Wales, UK. Exposure to different traumatic events was assessed using categorisation of free-text descriptions of trauma. PTSD caseness was determined using items assessing Diagnostic and Statistical Manual IV (DSM-IV) and DSM-5 A criteria and the Traumatic Screening Questionnaire. Results. Of the 4558 participants, 1971 (47.0%) reported a traumatic event. The most common DSM-IV A1 qualifying trauma was life-threatening illnesses and injuries (13.6%). The highest risk of PTSD was associated with assaultive violence [34.1%]. The prevalence of PTSD using DSM-IV A criteria was 14.3% (95% confidence interval [CI] = 12.8, 15.9%). Using DSM-5 A criteria reduced the prevalence to 8.0 (95% CI = 6.9, 9.4%), primarily due to exclusion of DSM-IV A1 qualifying events, such as life-threatening illnesses. Conclusions. Nearly one-half of a general community sample had experienced a traumatic event and of these around one in seven was a DSM-IV case of PTSD. Although the majority of research has concentrated on combat, rape and assaultive violence, life threatening illness is a more common cause of PTSD in the community. Removal of this traumatic event in DSM-5 could reduce the number of cases of PTSD by around 6.0%.",0,0 +4881,"Development and utilization of a psychometric instrument for measuring quality of life in burn patients, 1976 to 1996.","Our Burn Specific Health Scale was initially developed in 1978. Using a number of existing health scales, including the sickness impact profile, a depression scale, and the activities of daily living scale, and a large number of burn specific items derived from staff and patients, we eventually developed an 80 item instrument. This instrument was divided into four domains each containing 20 items of equal weight. The instrument was validated sequentially with intrarater, interrater and global validation systems, and subsequently compared with a number of other health and mental scales during which it performed very well. We now have longitudinal data which link this measurement system of quality of life to pre-injury educational level, to post-injury, stress disorder and predictability of return to work. The results indicate that total burn size has little to do with quality of life after recovery, and that a number of other factors play a bigger role, which will be presented.",0,0 +4882,"Childhood Adversity, Mental Disorder Comorbidity, and Suicidal Behavior in Schizotypal Personality Disorder","Schizotypal personality disorder (SPD) is a serious and relatively common psychiatric disorder, yet remains understudied among the personality disorders. The current study examines the psychiatric correlates of SPD in a representative epidemiologic sample, utilizing data from the National Epidemiological Survey on Alcohol and Related Conditions (N = 34,653). Multiple logistic regression compared people with SPD to the general population across a broad range of childhood adversities, comorbid psychiatric disorders, and suicidal behavior. SPD was strongly associated with many adverse childhood experiences. After adjusting for confounding factors, SPD was independently associated with major depression and several anxiety disorders, including post-traumatic stress disorder. Interestingly, SPD was more strongly associated with borderline and narcissistic personality disorders than cluster A personality disorders. Individuals with SPD were also more likely to attempt suicide. As a whole, these results suggest that individuals with SPD experience significant morbidity and may be at increased risk of mortality.",0,0 +4883,Clinical Profile Differences Between PTSD-Diagnosed Military Veterans and Crime Victims,Few studies have conducted symptom comparisons across different trauma-exposed populations. Evidence linking different types of trauma to variations in clinical presentation would have potential implications for the assessment and treatment of trauma-related psychopathology. The current study evaluated whether military veterans (n = 187) and civilian crime victims (n = 47) diagnosed with posttraumatic stress disorder differ in their self-reported posttraumatic symptoms as measured by the Trauma Symptom Inventory. A multivariate profile analysis revealed that military-related trauma is associated with more severe posttraumatic symptoms than criminal victimization and suggested that these 2 types of trauma have statistically distinct symptom profiles. Some potential implications of these findings and considerations for future research are discussed.,0,0 +4884,Video Testimony of Long-Term Hospitalized Psychiatrically Ill Holocaust Survivors,"Many Holocaust survivors who have both psychotic disorders and residual symptoms of posttraumatic stress disorder (PTSD) remain chronically hospitalized in psychiatric institutions. This study investigated the clinical benefits of a therapeutic process facilitating a detailed videotaped account of traumatic experience (testimony method) in elderly long-term hospitalized Holocaust survivors.Twenty-four schizophrenia patients (mean age=72.2 years) who were chronically hospitalized in Israeli state psychiatric hospitals underwent assessment by blind rating with a battery of psychiatric rating scales before and 4 months after extensive videotaped interview. The rating scales included the Positive and Negative Syndrome Scale; Clinical Global Impression (CGI); Mini-Mental State Examination (MMSE); Clinician-Administered PTSD Scale, Form 2; and Structured Interview for Disorders of Extreme Stress. Full pre- and postinterview data were available for 21 patients.Thirty-eight percent of the patients met the criteria for PTSD at the first interview, compared with only 19% at the second interview. The patients had significant reductions in functional impairment and in the severity and intensity of all posttraumatic symptom clusters (intrusion, avoidance, hyperarousal); the avoidance cluster showed the most reduction. Eleven subjects had an improvement of 30% or more in total posttraumatic severity score. No differences in Positive and Negative Syndrome Scale, MMSE, Structured Interview for Disorders of Extreme Stress, and CGI total scores were noted postinterview or between the two preinterview evaluation batteries in the comparison group. Female patients had a higher prevalence of PTSD symptoms. Total Clinician-Administered PTSD Scale, Form 2, scores and total Positive and Negative Syndrome Scale scores were inversely correlated both at baseline and at follow-up.Study observations suggest clinical benefits of the testimony method in the alleviation of many posttraumatic symptoms, but not psychosis, in a cohort of psychiatrically ill Holocaust survivors, despite an interval of as many as 60 years since the traumatic events. The findings have implications for care and rehabilitation of patients many years after acute traumatic events.",0,0 +4885,The Influence of Posttraumatic Stress Disorder Numbing and Hyperarousal Symptom Clusters in the Prediction of Physical Health Status in Veterans With Chronic Tobacco Dependence and Posttraumatic Stress Disorder,"Smoking and PTSD are predictors of poor physical health status. This study examined the unique contribution of PTSD symptoms in the prediction of the SF-36 physical health status subscales accounting for cigarette smoking, chronic medical conditions, alcohol and drug use disorders, and depression. This study examined baseline interview and self-report data from a national tobacco cessation randomized, controlled trial (Veterans Affairs Cooperative Study 519) that enrolled tobacco-dependent veterans with chronic PTSD (N = 943). A series of blockwise multiple regression analyses indicated that PTSD numbing and hyperarousal symptom clusters explained a significant proportion of the variance across all physical health domains except for the Physical Functioning subscale, which measures impairments in specific physical activities. Our findings further explain the impact of PTSD on health status by exploring the way PTSD symptom clusters predict self-perceptions of health, role limitations, pain, and vitality.",0,0 +4886,Examining posttraumatic stress disorder's latent structure between treatment-seeking and non-treatment-seeking Filipinos,"The discourse of latent structure of posttraumatic stress disorder (PTSD) has been extensive in trauma literature. Although findings have been consistent in rejecting DSM-IV-TR's three-factor model, alternative models are still fervently argued. This study contributes to the discussion by examining and comparing PTSD factor structure of the three most validated models—numbing model (King et al., 1998), dysphoria model (Simms et al., 2002), and dysphoric arousal model (Elhai et al., 2011b)—and determining if these are generalizable across treatment-seeking and non-treatment-seeking Filipinos with exposure to trauma events.Filipino-Tagalog version of Harvard Trauma Questionnaire (HTQ; Mollica et al., 1992) was administered to a sample of 737 treatment-seeking (n=526) and non-treatment-seeking (n=211) Filipinos who experienced and witnessed varied trauma events. Confirmatory factor analysis (CFA) was conducted involving the three models in order to determine the best-fitting model and generalizability across samples.Results showed that all three models achieved excellent fit, with dysphoric arousal model slightly fitting better than numbing and dysphoria models in both treatment-seeking and non-treatment-seeking samples. Series of invariance testing, however, indicated that although dysphoric arousal model fits significantly better than dysphoria model, it did not significantly differ from numbing model. Results revealed that aside from the factor loadings, the two groups are noninvariant in all parameters. Treatment-seeking sample had larger intercepts, factor variances and covariances and factor means than non-treatment-seeking group.The findings strongly contribute to the literature by showing how the type of groupings (treatment-seeking vs. non-treatment-seeking) moderates PTSD latent structure. It affirms the suggestion of Biehn et al. (2012) to be cautious in concluding the generalizability of PTSD models in the context that type of participants moderates PTSD's factor structure.",0,0 +4887,Psychiatric and behavioral problems in aggressive drivers,"Motor vehicle accidents (MVAs) are a leading cause of accidental death and injury, and aggressive driving has been identified as a risk factor for MVAs. Assessing psychiatric and behavioral disturbances in aggressive drivers is germane to the development of prevention and intervention programs for this population. The present study compared the prevalence of psychiatric diagnoses and behavioral problems in young adult drivers with self-reported high driving aggression to that of drivers with low driving aggression. Aggressive drivers evidenced a significantly higher current and lifetime prevalence of Oppositional Defiant Disorder, Alcohol and Substance Use Disorders, and Cluster B Personality Disorders, and a significantly greater lifetime prevalence of Conduct Disorder, Attention-Deficit/Hyperactivity Disorder, and Intermittent Explosive Disorder. Aggressive drivers also had a significantly greater prevalence of self-reported problems with anger, as well as a greater family history of anger problems and conflict. The findings suggest that prevention and intervention programs designed to reduce aggressive driving may need to address the presence of psychiatric and behavioral problems that could potentially complicate treatment or impede responses to treatment.",0,0 +4888,A MULTIDIMENSIONAL APPROACH FOR EVALUATING VARIABLES IN ORGANIZATIONAL RESEARCH AND PRACTICE,"One of the most difficult tasks facing industrial-organizational psychologists is evaluating the importance of variables, especially new variables, to be included in the prediction of some outcome. When multiple regression is used, common practices suggest evaluating the usefulness of new variables by showing incremental validity beyond the set of existing variables. This approach assures that the new variables are not statistically redundant with this existing set, but this approach attributes any shared criterion-related validity to the existing set of variables and none to the new variables. More importantly, incremental validity alone fails to answer the question directly about the importance of variables included in a regression model—arguably the more important statistical concern for practitioners. To that end, the current article reviews 2 indices of relative importance, general dominance weights and relative weights, which may be used to complement incremental validity evidence and permit organizational decision makers to make more precise and informed decisions concerning the usefulness of predictor variables. We illustrate our approach by reanalyzing the correlation matrices from 2 published studies.",0,0 +4889,The vicarious experience of posttraumatic stress disorder or symptoms in family members of trauma patients: Differences between ICU and non-ICU families,"This dissertation is part of a larger study investigating the degree to which family members and trauma patients experience early symptoms of Posttraumatic Stress Disorder (PTSD/S). This data was gathered for a protocol approved by the Stanford University Medical Center Institutional Review Board, under the direction of principle investigator, Eve Carlson, PhD. This dissertation's primary question investigated the differences between family members of Intensive Care Unit (ICU) patients and family members of less critical inpatients with regard to Posttraumatic Stress Disorder symptoms (PTSD/S). Also examined were PTSD/S differences between males and females, those with advanced degrees and those without, those with happy childhoods and unhappy childhoods, and those who reported greater socioeconomic status and those who had less resources. Thirty-six family members of ICU patients and family members of less medically critical inpatients participated in this study. They completed self-report questionnaires; a demographic survey, the Posttraumatic Cognitions Inventory-revised (PTCI-R) and the Screen for Posttraumatic Stress Symptoms Questionnaire (SPTSS). Participants were not invited to participate if they were exceedingly distressed, did not speak English well enough to give or understand the consent form, or if their loved one was not expected to recover to pre-injury health. The main limitation for this dissertation was the small participant pool. Also the PTCI-R was revised again by the principle investigator, reducing generalizability from this sample to other groups. The data gathered pertaining to financial security, educational achievement, and childhood experiences came from the larger study's specific demographic questionnaire, and varied in sensitivity. Participants were assessed almost immediately after the traumatic event, making the term ""post traumatic stress"" somewhat inaccurate. More specific and valid measures may have been useful to increase the reliability of this dissertation's findings, as would multiple time points after the trauma. Clinical implications include the need for staff education about family members. ICU and non-ICU families endure similar levels of stress, despite vastly different medical prognoses of their loved ones. Also family history may be an important factor in individual resilience to acute stress. Future research in the field of vicarious trauma could benefit this and other previously overlooked populations exposed to traumas of others. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4890,Quantifying heterogeneity attributable to polythetic diagnostic criteria: Theoretical framework and empirical application.,"Heterogeneity within psychiatric disorders is both theoretically and practically problematic: For many disorders, it is possible for 2 individuals to share very few or even no symptoms in common yet share the same diagnosis. Polythetic diagnostic criteria have long been recognized to contribute to this heterogeneity, yet no unified theoretical understanding of the coherence of symptom criteria sets currently exists. A general framework for analyzing the logical and mathematical structure, coherence, and diversity of Diagnostic and Statistical Manual diagnostic categories (DSM-5 and DSM-IV-TR) is proposed, drawing from combinatorial mathematics, set theory, and information theory. Theoretical application of this framework to 18 diagnostic categories indicates that in most categories, 2 individuals with the same diagnosis may share no symptoms in common, and that any 2 theoretically possible symptom combinations will share on average less than half their symptoms. Application of this framework to 2 large empirical datasets indicates that patients who meet symptom criteria for major depressive disorder and posttraumatic stress disorder tend to share approximately three-fifths of symptoms in common. For both disorders in each of the datasets, pairs of individuals who shared no common symptoms were observed. Any 2 individuals with either diagnosis were unlikely to exhibit identical symptomatology. The theoretical and empirical results stemming from this approach have substantive implications for etiological research into, and measurement of, psychiatric disorders.",0,0 +4891,Differences on adolescent life goal profile scale between a clinical and non-clinical adolescent sample,"This study aimed to determine similarities and differences on perceived importance and perceived attainability of life goals between a clinical and non-clinical adolescent sample.244 students and 54 adolescent patients completed the Adolescent Life Goal Profile Scale (ALGPS). The ALGPS measures perceived importance and perceived attainability of four main life goal categories: Relations, Generativity, Religion, and Achievements. As a control, we used five measures of mental health, quality of life, and personality.There were no differences on perceived importance on the Generativity, Religion, and Achievement life goal factor, but patients perceived relation-oriented goals less important than non-patients. Perceived attainability of life goals factors was lower for patients on all life goals except for Generativity. Compared to non-patients, patients were less happy and satisfied and had lower sense of coherence and self-efficacy. Patients were also less emotionally stable, had lower conscientiousness, but higher intellect.Though patients appear less content with life in general than non-patients, chances are that they uphold their concern and care for others, remain devoted in their religious stand, and stay committed to their achievement-related goals. The lower perceived importance of relations within the patient group should be awarded clinical attention.",0,0 +4892,PTSD symptom trajectories: From early to chronic response,"This study aimed to identify posttraumatic stress disorder (PTSD) symptom trajectories across the first 12 months following traumatic injury. Three hundred and seven consecutively admitted injury survivors were assessed for severity of PTSD symptoms just prior to discharge, and at 3 and 12 months postinjury. Growth modeling was used to determine the curve that best fit the trajectory for each symptom cluster over the 12-month period. Individuals with 12-month PTSD showed significantly higher re-experiencing, arousal, and avoidance symptoms at eight days posttrauma relative to those without, and these symptoms escalated over time. Those without PTSD maintained their relatively low symptom levels. These findings highlight that individuals who will go onto develop PTSD have a distinctly different symptom course than those who recover.",0,0 +4893,Temporal Associations Among Chronic PTSD Symptoms in U.S. Combat Veterans,"The present study examined fluctuation over time in symptoms of posttraumatic stress disorder (PTSD) among 34 combat veterans (28 with diagnosed PTSD, 6 with subclinical symptoms) assessed every 2 weeks for up to 2 years (range of assessments = 13-52). Temporal relationships were examined among four PTSD symptom clusters (reexperiencing, avoidance, emotional numbing, and hyperarousal) with particular attention to the influence of hyperarousal. Multilevel cross-lagged random coefficients autoregression for intensive time series data analyses were used to model symptom fluctuation decades after combat experiences. As anticipated, hyperarousal predicted subsequent fluctuations in the 3 other PTSD symptom clusters (reexperiencing, avoidance, emotional numbing) at subsequent 2-week intervals (rs = .45, .36, and .40, respectively). Additionally, emotional numbing influenced later reexperiencing and avoidance, and reexperiencing influenced later hyperarousal (rs = .44, .40, and .34, respectively). These findings underscore the important influence of hyperarousal. Furthermore, results indicate a bidirectional relationship between hyperarousal and reexperiencing as well as a possible chaining of symptoms (hyperarousal → emotional numbing → reexperiencing → hyperarousal) and establish potential internal, intrapersonal mechanisms for the maintenance of persistent PTSD symptoms. Results suggested that clinical interventions targeting hyperarousal and emotional numbing symptoms may hold promise for PTSD of long duration.",0,0 +4894,Physical and emotional health of Gulf War veteran women.,"Numerous questions have been raised about the health consequences to veterans of the Gulf War but most particularly to issues concerning women, who were deployed in unprecedented numbers. Little is known about the health consequences to women of wartime stressors, in general, or the environmental and job-related exposures specific to the theater of the Gulf War.A stratified sample of 525 women participated in the study following the war and again in a follow-up study 2 yr later. The sampling frame was stratified on component of the U.S. Air Force (active, guard or reserve), deployment (in the theater or elsewhere), and parental status (parent or nonparent). Measures included items concerning general physical health, gender-specific health, the ""Gulf War Syndrome,"" and the emotional responses to war, including symptoms of post-traumatic stress disorder (PTSD).Multiple statistical analyses were used to describe women's physical and emotional health at two time points following the war. Women deployed to the theater reported significantly more general as well as gender-specific health problems than did women deployed elsewhere. A cluster of common health problems included: skin rash, cough, depression, unintentional weight loss, insomnia, and memory problems. Women serving in the theater also reported a significant increase in several gender-specific problems compared to women deployed elsewhere.Findings suggest the need for follow-up of a cluster of specific health effects, including those concerning gynecologic and reproductive health.",0,0 +4895,A Review of Transcranial Magnetic Stimulation as a Treatment for Post-Traumatic Stress Disorder,"Patients with post-traumatic stress disorder (PTSD) may fail to achieve adequate relief despite treatment with psychotherapy, pharmacotherapy, or complementary medicine treatments. Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation procedure that can alter neuronal activity through administration of various pulse sequences and frequencies. TMS may theoretically have promise in correcting alterations observed in patients with PTSD. While the precise treatment location and pulse sequences remain undefined, current evidence suggests two promising targets, the right dorsolateral prefrontal cortex and the medial prefrontal cortex. The beneficial effects may be due to the secondary or indirect regulation of other brain structures that may be involved in the mood regulatory network. TMS may be an effective part of a comprehensive treatment program for PTSD, although significant work remains to define optimal treatment parameters and clarify how it fits within a broader traditional treatment program.",0,0 +4896,Posttraumatic Stress Symptoms and Trajectories in Child Sexual Abuse Victims: An Analysis of Sex Differences Using the National Survey of Child and Adolescent Well-Being,"Very few studies have prospectively examined sex differences in posttraumatic stress symptoms and symptom trajectories in youth victimized by childhood sexual abuse. This study addresses that question in a relatively large sample of children, drawn from the National Survey of Child and Adolescent Well-Being, who were between the ages of 8-16 years and who were reported to Child Protective Services for alleged sexual abuse. Sex differences were examined using t tests, logistic regression, and latent trajectory modeling. Results revealed that there were not sex differences in victims' posttraumatic stress symptoms or trajectories. Whereas caseworkers substantiated girls' abuse at higher rates than boys' abuse and rated girls significantly higher than boys on level of harm, there were not sex differences in three more objective measures of abuse severity characteristics. Overall, higher caseworker ratings of harm predicted higher initial posttraumatic stress symptom levels, and substantiation status predicted shallower decreases in trauma symptoms over time. Implications for theory and intervention are discussed.",0,0 +4897,Prevalence and consequences of disaster-related illness and injury from hurricane ike.,"To explore the extent to which disasters may be a source of injury and disability in community populations, we examined the prevalence and short-term consequences of disaster-related illness and injury for distress, disability, and perceived needs for care.A random population survey was conducted 2-6 months after Hurricane Ike struck Galveston Bay on September 13, 2008.The sample was composed of 658 adults representative of Galveston and Chambers Counties, Texas.The prevalences of personal injury (4%) and household illness (16%) indicated that approximately 7,700 adults in the two-county area were injured, and another 31,500 adults experienced household-level illness. Risk for injury/illness increased with area damage and decreased with evacuation. In bivariate tests, injury or illness or both were related to all outcome measures. In multivariate analyses that controlled for co-occurring stressors representing trauma, loss, adversities, and community effects, injury or illness or both were associated with global stress, posttraumatic stress, dysfunction, days of disability, and perceived needs for care, but not with depression or anxiety.The associations of injury with distress and disability suggest that community programs should reach out to injured persons for early mental health and functional assessments and, where indicated, intervene in ways that reduce further disability and need for complex rehabilitative services. The results also point to the potential effectiveness of evacuation incentives with regard to the prevention of disaster-related injury and disability.",0,0 +4898,"Easy to remember, difficult to forget: The development of fear regulation","Fear extinction learning is a highly adaptive process that involves the integrity of frontolimbic circuitry. Its disruption has been associated with emotional dysregulation in stress and anxiety disorders. In this article we consider how age, genetics and experiences shape our capacity to regulate fear in cross-species studies. Evidence for adolescent-specific diminished fear extinction learning is presented in the context of immature frontolimbic circuitry. We also present evidence for less neural plasticity in fear regulation as a function of early-life stress and by genotype, focusing on the common brain derived neurotrophin factor (BDNF) Val66Met polymorphism. Finally, we discuss this work in the context of exposure-based behavioral therapies for the treatment of anxiety and stress disorders that are based on principles of fear extinction. We conclude by speculating on how such therapies may be optimized for the individual based on the patient's age, genetic profile and personal history to move from standard treatment of care to personalized and precision medicine.",0,0 +4899,Preface,"Humans are remarkably resilient in the face of crises, traumas, disabilities, attachment losses, and ongoing adversities. In fact, resilience to stress and trauma may be the norm rather than the exception. However, to date, most research in the field of traumatic stress has focused on neurobiological, psychological, and social factors associated with trauma-related psychopathology and deficits in psychosocial functioning. While much has been learned in these areas of research, particularly about post-traumatic stress disorder (PTSD), far less is known about resilience to stress and healthy adaptation to stress and trauma. The study of resilience is enormously challenging. The first hurdle involves definition. Currently, there is no single agreed-upon definition of resilience in the clinical or scientific literature. In a review of the published literature on risk, vulnerability, resistance, and resilience, Layne and colleagues (2007) described the lack of precision and numerous terminological inconsistencies in the meanings of these concepts, and identified at least eight distinct meanings for the term “resilience.” For example, definitions of resilience have ranged from symptom-free functioning following trauma exposure (Bonanno et al., 2006) to positive adaptation despite adversity (Garmezy, 1993), and even to enhanced psychobiological regulation of stress/fear-related brain circuitry, neurotransmitters, and hormones (Charney, 2004). The American Psychological Association (2010) has defined resilience as “the process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of threat.” © Cambridge University Press 2011.",0,0 +4900,Assessing Latent Level Associations Between PTSD and Dissociative Factors: Is Depersonalization and Derealization Related to PTSD Factors More So than Alternative Dissociative Factors?,"Posttraumatic stress disorder (PTSD) criteria in DSM-5 included a dissociative diagnostic subtype characterized by a depersonalization item and a derealization item. Researchers have queried whether this was too restrictive, as alternative dissociative symptomatology may also be characteristic of the subtype. The current study utilized data from 318 Northern Irish students, of which 165 were trauma exposed. Participants were assessed for PTSD symptomatology based on DSM-5 criteria via a modified version of the PTSD Symptom Scale-Self-Report (PSS-5) and dissociative experiences via the Dissociative Experiences Scale (DES). Confirmatory factor analysis of PTSD and DES models revealed an optimal four-factor DSM-5 PTSD model including reexperiencing, avoidance, negative alterations in mood and cognitions, and alterations in hyperarousal and reactivity factors, and an optimal three-factor DES model including absorption, amnesia, and depersonalization/derealization factors. When comparing the correlations between depersonalization/derealization and the four PTSD factors, significant Wald tests of parameter constraints revealed that depersonalization/derealization is more related to alterations in arousal and reactivity (r = .432) compared to avoidance (r = .289), χ 2 (1, N = 165) = 8.352, p = .004. We discuss whether the mechanism for comorbid PTSD and dissociation may be related to PTSD’s arousal factor.",0,0 +4901,Psychosocial outcomes of telephone-based counseling for adults with an acquired physical disability: A meta-analysis.,"The delivery of mental health services by telephone, referred to as telecounseling, has the potential to improve the health outcomes of adults with an acquired physical disability in a cost-effective way. However, the efficacy of this form of treatment requires further evaluation before it is used on a larger scale.This meta-analysis provides a critical and quantitative evaluation of the impact of telephone-administered psychological interventions on the psychosocial functioning of adults with an acquired physical disability caused by spinal cord injury, limb amputation, severe burn injury, stroke, or multiple sclerosis.A comprehensive search of eight electronic databases identified eight studies (N = 658 participants) that compared treatment efficacy to that of matched control groups. Differences in the psychosocial outcomes of treatment and control participants were examined using Cohen's d effect sizes. Fail-safe Ns and 95% confidence intervals were used to evaluate the significance of these results.Significant improvements in coping skills and strategies (overall d = 0.57), community integration (overall d = 0.45), and depression (overall d = 0.44) were observed immediately after telecounseling, with modest improvements in quality of life maintained at 12 months post-intervention (overall d = 0.37).The results suggest that telecounseling is an effective treatment modality for adults adjusting to a physical disability; however, further trials are needed to establish the long term psychosocial benefits.",0,0 +4902,Family Models of Posttraumatic Stress Disorder,"Abstract This chapter reviews the extant literature on the interpersonal aspects of posttraumatic stress disorder (PTSD), with a focus on couple and family models of PTSD. Topics include the association of PTSD with a variety of family relationship problems in a range of traumatized populations. The role of relevant interpersonal constructs in the development and maintenance of PTSD (e.g., social support, attachment) and the psychological effects of PTSD symptoms on family members and their relations are discussed. In addition, models that take into account a range of relationship variables and the likely bi-directional association between individual and family functioning in PTSD are presented. Future directions for theory and research, as well as the clinical implications of this work are outlined.",0,0 +4903,Confirmatory factor analysis of the PTSD Checklist and the Clinician-Administered PTSD Scale in disaster workers exposed to the World Trade Center Ground Zero.,"Although posttraumatic stress disorder (PTSD) factor analytic research has yielded little support for the DSM-IV 3-factor model of reexperiencing, avoidance, and hyperarousal symptoms, no clear consensus regarding alternative models has emerged. One possible explanation is differential instrumentation across studies. In the present study, the authors used confirmatory factor analysis to compare a self-report measure, the PTSD Checklist (PCL), and a structured clinical interview, the Clinician-Administered PTSD Scale (CAPS), in 2,960 utility workers exposed to the World Trade Center Ground Zero site. Although two 4-factor models fit adequately for each measure, the latent structure of the PCL was slightly better represented by correlated reexperiencing, avoidance, dysphoria, and hyperarousal factors, whereas that of the CAPS was slightly better represented by correlated reexperiencing, avoidance, emotional numbing, and hyperarousal factors. After accounting for method variance, the model specifying dysphoria as a distinct factor achieved slightly better fit. Patterns of correlations with external variables provided additional support for the dysphoria model. Implications regarding the underlying structure of PTSD are discussed.",0,0 +4904,Timing of Mental Health Treatment and PTSD Symptom Improvement Among Iraq and Afghanistan Veterans,"This study examined demographic, military, temporal, and logistic variables associated with improvement of posttraumatic stress disorder (PTSD) among Iraq and Afghanistan veterans who received mental health outpatient treatment from the U.S. Department of Veterans Affairs (VA) health care system. The authors sought to determine whether time between last deployment and initiating mental health treatment was associated with a lack of improvement in PTSD symptoms.The authors conducted a retrospective analysis of existing medical records of Iraq and Afghanistan veterans who enrolled in VA health care, received a postdeployment PTSD diagnosis, and initiated treatment for one or more mental health problems between October 1, 2007, and December 31, 2011, and whose records contained results of PTSD screening at the start of treatment and approximately one year later (N=39,690).At the start of treatment, 75% of veterans diagnosed as having PTSD had a positive PTSD screen. At follow-up, 27% of those with a positive screen at baseline had improved, and 43% of those with a negative screen at baseline remained negative. A negative PTSD screen at follow-up was associated with female gender, older age, white race, having never married, officer rank, non-Army service, closer proximity to the nearest VA facility, and earlier initiation of treatment after the end of the last deployment.Interventions to reduce delays in initiating mental health treatment may improve veterans' treatment response. Further studies are needed to test interventions for particular veteran subgroups who were less likely than others to improve with treatment.",0,0 +4905,Dissociative symptoms in acute stress disorder,"This study provides a profile of symptoms, and particularly dissociative symptoms, in the diagnosis of acute stress disorder (ASD) following motor vehicle accidents (MVAs). Consecutive adult non-brain-injured admissions to a major trauma hospital (N = 92) were assessed between 2 days and 4 weeks following an MVA. Presence of ASD was determined by a structured clinical interview. The occurrence of full and subsyndromal ASD was approximately 13% and 21%, respectively. The majority of those who met criteria for subsyndromal ASD did not meet the ASD criteria for dissociation. At least 80% of individuals who reported derealization also reported reduced awareness and depersonalization. This significant overlap between dissociative symptoms questions the discriminatory power and conceptual independence of the dissociative criteria. These findings suggest the need for a more refined conceptual and operational understanding of dissociative symptoms in the acute trauma stage.",0,0 +4906,Trajectories of trauma symptoms and resilience in deployed US military service members: Prospective cohort study,"Background Most previous attempts to determine the psychological cost of military deployment have been limited by reliance on convenience samples, lack of pre-deployment data or confidentiality and cross-sectional designs. Aims This study addressed these limitations using a population-based, prospective cohort of US military personnel deployed in support of the operations in Iraq and Afghanistan. Method The sample consisted of US military service members in all branches including active duty, reserve and national guard who deployed once ( n = 3393) or multiple times ( n = 4394). Self-reported symptoms of post-traumatic stress were obtained prior to deployment and at two follow-ups spaced 3 years apart. Data were examined for longitudinal trajectories using latent growth mixture modelling. Results Each analysis revealed remarkably similar post-traumatic stress trajectories across time. The most common pattern was low–stable post-traumatic stress or resilience (83.1% single deployers, 84.9% multiple deployers), moderate–improving (8.0%, 8.5%), then worsening–chronic posttraumatic stress (6.7%, 4.5%), high–stable (2.2% single deployers only) and high–improving (2.2% multiple deployers only). Covariates associated with each trajectory were identified. Conclusions The final models exhibited similar types of trajectories for single and multiple deployers; most notably, the stable trajectory of low post-traumatic stress pre- to post-deployment, or resilience, was exceptionally high. Several factors predicting trajectories were identified, which we hope will assist in future research aimed at decreasing the risk of post-traumatic stress disorder among deployers.",1,0 +4907,Coping and Social Support in Children Exposed to Mass Trauma,"The goal of this paper was to critically evaluate the literature on children coping with mass trauma published between the years 2011 and 2014 and to emphasize interesting and important findings with the aim of proposing a new comprehensive model for better understanding the process of coping with these events in this unique developmental stage. Using a variety of databases, 26 research papers were selected. The papers were divided into two main categories, natural and manmade disasters. The findings suggest that several areas in this context still lack foundational knowledge and should be further investigated. Thus, it has been suggested that future research should emphasize the developmental stage of the children, the cultural context and atmosphere in which the investigated children grow up and live, and the type of event (acute vs. chronic; natural vs. manmade). A more comprehensive coping model which addresses these omissions and combines main theories is suggested for use in future research as well. © 2015, Springer Science+Business Media New York.",0,0 +4908,Simulating Emotional Responses in Posttraumatic Stress Disorder: An fMRI Study,"This study tested the extent to which coached participants can simulate the neural responses of participants with posttraumatic stress disorder (PTSD) when they are presented with signals of fear. Functional magnetic resonance imaging (fMRI) was used to study blood oxygenation level-dependent signal during the presentations of fearful and neutral faces under both conscious and nonconscious (masked) conditions. Participants comprised 12 patients with PTSD and 12 trauma-exposed controls who were instructed to simulate PTSD. During conscious fear processing, simulators showed greater activation in the left amygdala and medial prefrontal cortex (MPFC) than PTSD participants. By contrast, during nonconscious processing, PTSD participants had greater MPFC activation than simulators. These findings suggest that coached simulators produce a profile of 'over-responding' to fear when controlled conscious processing is possible, but are not able to simulate the exaggerated medial prefrontal responses observed in PTSD participants under conditions of nonconscious processing. © 2010 Springer Science + Business Media, LLC.",0,0 +4909,"Locus of control and combat-related post-traumatic stress disorder: The intervening role of battle intensity, threat appraisal and coping","The study examined the role of control expectancies in the formation of posttraumatic stress disorder (PTSD) among Israeli soldiers combat stress reactions (battle shock) casualties of the Lebanon War (1982). A random sample of 104 soldiers who fought in the Lebanon War and were identified as combat stress reaction casualties were clinically interviewed and given a battery of self-report questionnaires a year after their participation in combat. In general, the components of Lazarus' stress-illness model were predictive of the severity of PTSD. Greater appraisal of threat, more negative emotions, and more emotion-focused coping were all found to predict a larger number of PTSD symptoms. Path analyses were performed separately for soldiers who reported that they were under high battle intensity and those who were under relatively low battle intensity. For low battle intensity, externals suffered more PTSD than internals. This relationship was due mainly to the indirect effects of locus of control via threat appraisal. These significant relationships were not found when battle intensity was high. The implications of the findings for the study of combat stress reactions and for the stress-illness model are discussed. The relative impact of generalized control expectancies and situational factors are examined for the various components of the model.",0,0 +4910,Childhood trauma among individuals with co-morbid substance use and post-traumatic stress disorder,"BACKGROUND: Little is known about the impact of childhood trauma (CT) on the clinical profile of individuals with co-occurring substance use disorder (SUD) and post traumatic stress disorder (PTSD). AIMS: To compare the clinical characteristics of individuals with SUD+PTSD who have a history of CT with SUD+PTSD individuals who have experienced trauma during adulthood only. METHOD: Data were collected on 103 individuals as part of a randomised controlled trial examining the efficacy of an integrated psychosocial treatment for SUD+PTSD. Participants were recruited from substance use treatment services, community referrals and advertising. Data were collected on demographic characteristics, substance use and treatment histories, lifetime trauma exposure, and current physical and mental health functioning. RESULTS: The vast majority (77%) of the sample had experienced at least one trauma before the age of 16, with 55% of those endorsing childhood sexual abuse. As expected individuals with a CT history, as compared to without, evidenced significantly longer duration of PTSD. Those with a CT history also had more extensive lifetime trauma exposure, an earlier age of first intoxication, and reported more severe substance use (e.g., a greater number of drug classes used in their lifetime, higher severity of dependence scores and greater number of drug treatment episodes). CONCLUSION: Individuals with co-morbid SUD+PTSD who have experienced CT present with a more severe and chronic clinical profile in relation to a number of trauma and substance use characteristics, when compared to individuals with adulthood only trauma histories. It is therefore important for SUD+PTSD treatment planning that CT be carefully assessed.",0,0 +4911,"Marital Status, Life Stressor Precipitants, and Communications of Distress and Suicide Intent in a Sample of United States Air Force Suicide Decedents","Life stressor precipitants and communications of distress and suicide intent were examined among a sample of United States Air Force (USAF) married versus unmarried suicide decedents. A total of 100 death investigations conducted by the Office of Special Investigations on active duty USAF suicides occurring between 1996 and 2006 were retrospectively reviewed. Married decedents were twice as likely 1) to have documented interpersonal conflict 24 hours prior to suicide and 2) to have communicated suicide intent to peers or professionals. Themes of distress communication for all decedents were intrapersonal (perceived stress, depression, psychological pain) and interpersonal (thwarted belongingness, rejection, loneliness). Suicide prevention programs and policies are encouraged to adapt efforts to the unique needs of married and unmarried individuals.",0,0 +4912,Patterns of comorbidity among mental disorders: a person-centered approach,"Abstract Objective Comorbidity poses a major challenge to conventional methods of diagnostic classification. Although dimensional models of psychopathology have shed some light on this issue, the reason for interrelationships among dimensions is unclear. The current study employed an alternative approach to characterizing patterns of comorbidity among common mental disorders by modeling them instead as clusters by using latent class analysis (LCA). Method Latent class analyses of Diagnostic and Statistical Manual of Mental Disorders diagnoses from two nationally representative epidemiological samples—the National Comorbidity Survey and National Comorbidity Survey–Replication datasets—were undertaken. Results Within each dataset, LCA yielded 5 latent classes exhibiting distinctive profiles of diagnostic comorbidity: a fear class (all phobias and panic disorder), a distress class (depression, generalized anxiety disorder, dysthymia), an externalizing class (alcohol and drug dependence, conduct disorder), a multimorbid class (highly elevated rates of all disorders), and a few-disorders class (very low probability of all disorders). Whereas some disorders were relatively specific to certain classes, others (major depression, posttraumatic stress disorder, social phobia) appeared to be evident across all classes. Profiles for the five classes were highly similar across the two samples. When bipolar I disorder was added to the LCA models, in both samples, it occurred almost exclusively in the multimorbid class. Conclusions Comorbidity among mental disorders in the general population appears to occur in a finite number of distinct patterns. This finding has important implications for efforts to refine existing diagnostic classification schemes, as well as for research directed at elucidating the etiology of mental disorders.",0,0 +4913,A Community Study of the Psychological Effects of the Omagh Car Bomb on Adults,"The main aims of the study were to assess psychological morbidity among adults nine months after a car bomb explosion in the town of Omagh, Northern Ireland and to identify predictors of chronic posttraumatic stress disorder symptoms.A questionnaire was sent to all adults in households in The Omagh District Council area. The questionnaire comprised established predictors of PTSD (such as pre-trauma personal characteristics, type of exposure, initial emotional response and long-term adverse physical or financial problems), predictors derived from the Ehlers and Clark (2000) cognitive model, a measure of PTSD symptoms and the General Health Questionnaire.Among respondents (n = 3131) the highest rates of PTSD symptoms and probable casesness (58.5%) were observed among people who were present in the street when the bomb exploded but elevated rates were also observed in people who subsequently attended the scene (21.8% probable caseness) and among people for whom someone close died (11.9%). People with a near miss (left the scene before the explosion) did not show elevated rates. Exposure to the bombing increased PTSD symptoms to a greater extent than general psychiatric symptoms. Previously established predictors accounted for 42% of the variance in PTSD symptoms among people directly exposed to the bombing. Predictors derived from the cognitive model accounted for 63%.High rates of chronic PTSD were observed in individuals exposed to the bombing. Psychological variables that are in principle amenable to treatment were the best predictors of PTSD symptoms. Teams planning treatment interventions for victims of future bombings and other traumas may wish to take these results into account.",0,0 +4914,"Trends in Probable PTSD in Firefighters Exposed to the World Trade Center Disaster, 2001–2010","ABSTRACT Objective: We present the longest follow-up, to date, of probable posttraumatic stress disorder (PTSD) after the 2001 terrorist attacks on the World Trade Center (WTC) in New York City firefighters who participated in the rescue/recovery effort. Methods: We examined data from 11 006 WTC-exposed firefighters who completed 40 672 questionnaires and reported estimates of probable PTSD by year from serial cross-sectional analyses. In longitudinal analyses, we used separate Cox models with data beginning from October 2, 2001, to identify variables associated with recovery from or delayed onset of probable PTSD. Results: The prevalence of probable PTSD was 7.4% by September 11, 2010, and continued to be associated with early arrival at the WTC towers during every year of analysis. An increasing number of aerodigestive symptoms (hazard ratio [HR] 0.89 per symptom, 95% confidence interval [CI] 0.86-.93) and reporting a decrease in exercise, whether the result of health (HR 0.56 vs no change in exercise, 95% CI 0.41-.78) or other reasons (HR 0.76 vs no change in exercise, 95% CI 0.63-.92), were associated with a lower likelihood of recovery from probable PTSD. Arriving early at the WTC (HR 1.38 vs later WTC arrival, 95% CI 1.12-1.70), an increasing number of aerodigestive symptoms (HR 1.45 per symptom, 95% CI 1.40–1.51), and reporting an increase in alcohol intake since September 11, 2001 (HR 3.43 vs no increase in alcohol intake, 95% CI 2.67-4.43) were associated with delayed onset of probable PTSD. Conclusions: Probable PTSD continues to be associated with early WTC arrival even 9 years after the terrorist attacks. Concurrent conditions and behaviors, such as respiratory symptoms, exercise, and alcohol use also play important roles in contributing to PTSD symptoms. ( Disaster Med Public Health Preparedness . 2011;5:S197-S203)",0,0 +4915,Post-Traumatic Stress Reactions in Victims of Motor Accidents,"This article assesses the incidence and types of PSTD, causes and symptoms of the condition, diagnosis and assessment, treatment and prediction of litigation as well as remission. Two questions of particular interest to the legal profession are considered: the length of time and other factors needed for the prediction of post-traumatic stress and the time elapsing before normal patterns of behaviour reoccur. Also discussed is the difference in the prevalence of PTSD in the sexes. Physical injuries both to the brain and to other parts of the body, specifically whiplash, are assessed. A number of case studies for post-traumatic stress are analysed and predictions for successfully applied treatment are provided. There is also a section dealing specifically with the effect of post-traumatic stress on children. (A)",0,0 +4916,“Black Saturday” and its Aftermath: Reflecting on Postdisaster Social Work Interventions in an Australian Trauma Hospital,"AbstractSocial workers at The Alfred, a major tertiary referral teaching hospital in Melbourne, Australia, played a key role in providing psychosocial support to patients and their families following the 2009 Black Saturday bushfires in the State of Victoria. Faced with the highest number of casualties ever admitted simultaneously, and the media and community involvement surrounding the national disaster, new practice challenges emerged that led to tensions when compared to everyday practice. This article examines three challenges identified in the team's critical reflections—managing privacy and publicity; negotiating the boundaries of professional practice; and managing the impact of the work. These practice challenges are considered in light of relevant trauma and disaster literature that addresses the importance of promoting self-efficacy, hope, and connectedness; forming collective narratives of survivorship and resilience; negotiating the ethical questions of service intimacy and intensity; and impl...",0,0 +4917,Social and ecological resilience: are they related?,"This article defines social resilience as the ability of groups or communities to cope with external stresses and disturbances as a result of social, political and environmental change. This definition highlights social resilience in relation to the concept of ecological resilience which is a characteristic of ecosystems to maintain themselves in the face of disturbance. There is a clear link between social and ecological resilience, particularly for social groups or communities that are dependent on ecological and environmental resources for their livelihoods. But it is not clear whether resilient ecosystems enable resilient communities in such situations. This article examines whether resilience is a useful characteristic for describing the social and economic situation of social groups and explores potential links between social resilience and ecological resilience. The origins of this interdisciplinary study in human ecology, ecological economics and rural sociology are reviewed, and a study of the impacts of ecological change on a resource-dependent community in contemporary coastal Vietnam in terms of the resilience of its institutions is outlined.",0,0 +4918,Posttraumatic stress disorder in elderly and younger adults after the 1988 earthquake in Armenia,"This study was undertaken 1 1/2 years after the 1988 earthquake in Armenia to assess the frequency and severity of posttraumatic stress reactions among elderly and younger adult victims and to assess the relation of exposure, age, sex, and death of a family member to these reactions.One hundred seventy-nine subjects of both sexes were evaluated with the Posttraumatic Stress Disorder (PTSD) Reaction Index. A subgroup of 60 individuals were also assessed for PTSD with the DSM-III-R criteria.There was a strong association between the presence of severe symptoms on the index and a DSM-III-R diagnosis of PTSD. Elderly and younger adult victims in cities closer to the epicenter (higher exposure) had significantly higher index scores than elderly and adult victims in more distant locations. In comparison with previous studies of natural disasters, much greater rates of chronic severe posttraumatic stress reactions were found among the highly exposed individuals. Although there was no difference in total mean score on the Posttraumatic Stress Disorder Reaction Index, a significant difference in symptom profile was found between the elderly and younger adults; the elderly scored higher on arousal symptoms and lower on intrusive symptoms. There was a positive correlation between loss of family members and severity of posttraumatic stress reaction.These findings indicate that after a major natural disaster with subsequent multiple adversities, a substantial proportion of the adult population may experience severe and chronic posttraumatic stress reactions. The risk factors identified in this study may prove useful in screening exposed individuals for appropriate treatment.",0,0 +4919,Post-traumatic stress disorder and depression co-occurrence: Structural relations among disorder constructs and trait and symptom dimensions,"Post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) in response to trauma co-occur at high rates. A better understanding of the nature of this co-occurrence is critical to developing an accurate conceptualization of the disorders. This study examined structural relations among the PTSD and MDD constructs and trait and symptom dimensions within the framework of the integrative hierarchical model of anxiety and depression.Study participants completed clinician-rated and self-report measures during a pre-treatment assessment.The sample consisted of 200 treatment-seeking individuals with a primary DSM-IV PTSD diagnosis. Structural equation modelling was used to examine the relationship between the constructs.The trait negative affect/neuroticism construct had a direct effect on both PTSD and MDD. The trait positive affect/extraversion construct had a unique, negative direct effect on MDD, and PTSD had a unique, direct effect on the physical concerns symptoms construct. An alternative model with the PTSD and MDD constructs combined into an overall general traumatic stress construct produced a decrement in model fit.These findings provide a clearer understanding of the relationship between co-occurring PTSD and MDD as disorders with shared trait negative affect/neuroticism contributing to the overlap between them and unique trait positive affect/extraversion and physical concerns differentiating them. Therefore, PTSD and MDD in response to trauma may be best represented as two distinct, yet strongly related constructs.In assessing individuals who have been exposed to trauma, practitioners should recognize that co-occurring PTSD and MDD appears to be best represented as two distinct, yet strongly related constructs. Negative affect may be the shared vulnerability directly influencing both PTSD and MDD; however, in the presence of both PTSD and MDD, low positive affect appears to be more specifically related to MDD and fear of physical sensations to PTSD, which is information that could be used by practitioners in the determination of treatment approach. Overall, these findings are clinically relevant in that they may inform assessment, treatment planning, and ultimately diagnostic classification.",0,0 +4920,Association of Sexual Violence and Human Rights Violations With Physical and Mental Health in Territories of the Eastern Democratic Republic of the Congo,"Studies from the Eastern Region of the Democratic Republic of the Congo (DRC) have provided anecdotal reports of sexual violence. This study offers a population-based assessment of the prevalence of sexual violence and human rights abuses in specific territories within Eastern DRC.To assess the prevalence of and correlations with sexual violence and human rights violations on residents of specific territories of Eastern DRC including information on basic needs, health care access, and physical and mental health.A cross-sectional, population-based, cluster survey of 998 adults aged 18 years or older using structured interviews and questionnaires, conducted over a 4-week period in March 2010.Sexual violence prevalence and characteristics, symptoms of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), human rights abuses, and physical and mental health needs among Congolese adults in specific territories of Eastern DRC.Of the 1005 households surveyed 998 households participated, yielding a response rate of 98.9%. Rates of reported sexual violence were 39.7% (95% confidence interval [CI], 32.2%-47.2%; n = 224/586) among women and 23.6% (95% CI, 17.3%-29.9%; n = 107/399) among men. Women reported to have perpetrated conflict-related sexual violence in 41.1% (95% CI, 25.6%-56.6%; n = 54/148) of female cases and 10.0% (95% CI, 1.5%-18.4%; n = 8/66) of male cases. Sixty-seven percent (95% CI, 59.0%-74.5%; n = 615/998) of households reported incidents of conflict-related human rights abuses. Forty-one percent (95% CI, 35.3%-45.8%; n = 374/991) of the represented adult population met symptom criteria for MDD and 50.1% (95% CI, 43.8%-56.3%; n = 470/989) for PTSD.Self-reported sexual violence and other human rights violations were prevalent in specific territories of Eastern DRC and were associated with physical and mental health outcomes.",0,0 +4921,Post-traumatic stress disorder in parents of children hospitalized in the neonatal intensive care unit (NICU): medical and demographic risk factors.,"Post-traumatic stress disorder (PTSD) among parents of neonates hospitalized in the Neonatal Intensive Care Units (NICU) stays an underestimated problem. We determined the incidence of PTSD in parents and pointed out medical and demographic risk factors for PTSD in neonates hospitalized in the NICU.The study involved 39 mothers and 27 fathers of 42 infants aged 1 to 16 months who were hospitalized in the NICU of a Children's University Hospital during the neonatal period. As a measure of PTSD we used the Polish version of the Impact of Event Scale-Revised (IES-R). The current level of stress was measured using the Perceived Stress Scale (PSS-10). The author's questionnaire contained demographic and medical information on the infants hospitalized in the NICU and their parents. Data were statistically analyzed.The incidence of PTSD and levels of stress did not differ in the group of mothers and fathers. There was a statistically significant difference in the severity of PTSD symptoms in general (p=0.006) and the severity of symptoms of intrusion (p=0.009) and arousal (p=0.015), which were more pronounced in mothers of children hospitalized in the NICU than in their fathers. In the multivariate models perceived stress was the only predictor that significantly affected the rate of PTSD symptoms in parents.Since PTSD is a very common problem in parents of children hospitalized in the NICU and estimating the risk of its occurrence on the basis of collected data is not possible, the parents of all those children should be considered at high risk.",0,0 +4922,A Bioecological Model of Deployment Risk and Resilience,"A deployment risk and resilience model is proposed to describe military service and deployment-related factors influencing post-deployment reintegration and post-deployment behavioral health. Adapted from the resiliency model, it is a multiphasic framework consistent with biopsychosocial and strengths-based perspectives by focusing on vulnerability, risk, and resilience resulting from military service, deployment experiences, and feedback loops that occur over the life course. The article is divided into three broad sections that discuss (1) theoretical underpinnings of the model, (2) key components of the model, and (3) future directions for military social work practice.",0,0 +4923,[The burn patient: factors associated with post-traumatic stress disorder and directions for intervention].,"AIM: Starting from the evidence that not all burn patients develop a post-traumatic stress disorder (PTSD), the aim of this overview was to describe variables, which favour the development of the disorder following to burn injury and to delineate directions for a treatment. METHODS: We searched articles in English related to PTSD in the population suffering from burns in the PubMed database, using the key word 'burn' in combination with: PTSD, traumatic event, trauma, ASD, and psychological factors. We concentrated our attention on articles published in the last decade (January 1998-March 2010). RESULTS: We found 32 articles. The risk factors concurring in the onset of PTSD are the presence of post-traumatic symptoms in the first following weeks to the burn, the avoidant coping, nevroticism, the presence of psychiatric disorder before the trauma, and the degree of disfigurement. The principal protective factors emerged from the review are the search of social or emotional support and extraversion. Information related to the treatment of these patients is scarce. CONCLUSIONS: The literature underlines the importance of the individual vulnerability to the development of PTSD in burn patients, besides the experience itself of a traumatic event. These patients must face peculiar and specific problems, therefore, with the purpose to odevelop a suitable intervention, it would be useful to appraise, besides the physical and psychosocial implications of the burn, the psychological characteristics of each patient, to articulate a treatment that may account for the complexity of the burn patient. Language: it",0,0 +4924,PTSD in the elderly: the interaction between trauma and aging,"ABSTRACT Background: Because an increasingly large cohort of individuals is approaching their elderly years, there is concern about how the healthcare system will cope with the greater demands placed upon it. One area of concern is the impact of trauma and post traumatic stress disorder (PTSD) in the aged. Although several reviews have highlighted the lack of knowledge and research on the topic, there still remain gaps in the literature. Nevertheless, some recent behavioral, endocrinological and neuroimaging studies may provide new insights into the discussion. The central aims of this paper are to summarize the etiological, epidemiological and clinical aspects of PTSD, trauma, and the elderly, and to integrate this knowledge with (i) what is known about PTSD in adults, and (ii) the behavioral, hormonal and cerebral changes associated with healthy aging. Methods: A comprehensive search was performed with ISI Web of Science and PubMed for articles pertinent to the psychology and biology of PTSD, trauma, and the elderly. Results: There exist both significant similarities and differences between adults and elderly with PTSD concerning cognitive and biological profile. Evidence suggests that PTSD in the elderly does not follow a simple clinical trajectory. Conclusions: PTSD in the elderly must be considered within the context of normal aging. Strong claims about an interaction between PTSD and aging are difficult to make due to sample heterogeneity, but it is clear that PTSD in this age group presents unique aspects not seen in younger cohorts. Further research must integrate their studies with the biological, psychological, and social changes already associated with the aging process.",0,0 +4925,Premenstrual Symptoms and Posttraumatic Stress Disorder in Japanese High School Students 9 Months after the Great East-Japan Earthquake,"On March 11, 2011, the Great East-Japan Earthquake occurred and a massive tsunami hit the northeastern coast of Japan. Catastrophic disasters such as earthquakes and war cause tremendous damage, not only physically but also mentally. Posttraumatic stress disorder (PTSD) is an anxiety disorder that occurs in the aftermath of a traumatic event. Premenstrual syndrome (PMS) is a cluster of psychological and somatic symptoms that are limited to the late luteal phase of the menstrual cycle. Premenstrual dysphoric disorder (PMDD) is considered a severe form of PMS. To determine the relationship between premenstrual symptoms and natural disaster-induced PTSD among Japanese adolescent girls, we conducted a cross-sectional study. Overall, 1489 high school students who belong to two high schools in Sendai, the largest city in northeastern Japan, were assessed 9 months after the earthquake. These schools are located inland, far from the seashore, and were not damaged by the tsunami. Premenstrual symptoms were assessed using the Premenstrual Symptoms Questionnaire, and PTSD symptoms were assessed using the Japanese-language version of Impact of Event Scale-Revised, which is a widely used self-assessment questionnaire about PTSD symptoms. We analyzed the data of 1,180 girls who completed the questionnaires and 118 girls (10.0%) were classified as having PTSD. The prevalence rates of PMDD and moderate to severe PMS increased according to the comorbidity of PTSD (p < 0.001), showing a correlation between the severity of PMS/PMDD and natural disaster-induced PTSD. The comorbidity of PMS/PMDD and PTSD may complicate the follow-up of both conditions.",0,0 +4926,"Trauma exposure characteristics, past traumatic life events, coping strategies, posttraumatic stress disorder, and psychiatric comorbidity among people with anaphylactic shock experience","This study investigated the interrelationship between trauma exposure characteristics, past traumatic life events, coping strategies, posttraumatic stress disorder (PTSD) symptoms, and psychiatric comorbidity among people after anaphylactic shock experience. The design was cross-sectional in that 94 people with anaphylactic shock experience responded to a postal survey. They completed the Posttraumatic Stress Disorder Checklist, the General Health Questionnaire 28, and the COPE Scale. They also answered questions on trauma exposure characteristics. The control group comprised 83 people without anaphylaxis. Twelve percent of people with anaphylactic shock experience fulfilled the diagnostic criteria for full PTSD. As a group, people with anaphylaxis reported significantly more past traumatic life events and psychiatric comorbidity than did the control. Partial least squares analysis showed that trauma exposure characteristics influenced postanaphylactic shock PTSD symptoms and psychiatric comorbidity, which, in turn, influenced coping strategies. People could develop PTSD and psychiatric comorbidity symptoms after their experience of anaphylactic shock. The way they coped with anaphylactic shock was affected by the severity of these symptoms. Past traumatic life events had a limited role to play in influencing outcomes.",0,0 +4927,Profiles of Connectedness: Processes of Resilience and Growth in Children With Cancer,"Identified patterns of connectedness in youth with cancer and demographically similar healthy peers.Participants included 153 youth with a history of cancer and 101 youth without a history of serious illness (8-19 years). Children completed measures of connectedness, posttraumatic stress symptoms (PTSS), and benefit-finding. Parents also reported on children's PTSS.Latent profile analysis revealed four profiles: high connectedness (45%), low connectedness (6%), connectedness primarily to parents (40%), and connectedness primarily to peers (9%). These profiles did not differ by history of cancer. However, profiles differed on PTSS and benefit-finding. Children highly connected across domains displayed the lowest PTSS and highest benefit-finding, while those with the lowest connectedness had the highest PTSS, with moderate PTSS and benefit-finding for the parent and peer profiles.Children with cancer demonstrate patterns of connectedness similar to their healthy peers. Findings support connectedness as a possible mechanism facilitating resilience and growth.",0,0 +4928,"Cumulative effect of multiple trauma on symptoms of posttraumatic stress disorder, anxiety, and depression in adolescents","Recent literature has indicated that exposure to multiple traumatic events in adults is associated with high levels of posttraumatic stress disorder (PTSD), anxiety, and depression. Against the backdrop of stressful life events and childhood abuse and neglect, we investigated the cumulative effect of multiple trauma exposure on PTSD, anxiety, and depression in an adolescent sample. One thousand one hundred forty 10th-grade learners from 9 Cape Town (South Africa) schools completed questionnaires on stressful life experiences; trauma exposure; and symptoms of anxiety, depression, and PTSD. Our population of interest for this study was adolescents between the ages of 14 and 18 years who had been exposed to serious, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition , qualifying traumatic events. The final sample size was thus 922. Rates of trauma exposure, PTSD, depression, and anxiety were high. Controlling for sex, stressful life experiences in the past year, and childhood adversity, we found an effect of cumulative trauma exposure effect on PTSD and depression, with an increase in the number of traumas linearly associated with an increase in symptoms of PTSD (F (4,912) = 7.60, P < .001) and depression (F (4,912) = 2.77, P < .05). We did not find a cumulative effect on anxiety. Our findings indicate that adolescents exposed to multiple traumas are more likely to experience more severe symptoms of PTSD and depression than those who experience a single event, with this effect independent of childhood adversity and everyday stressful life experiences. Exposure to multiple trauma, however, does not seem to be associated with more severe anxiety symptoms.",0,0 +4929,Different profiles of mental and physical health and stress hormone response in women victims of intimate partner violence,"To analyse the individual differences in the impact that intimate male partner violence (IPV) has on a woman's depressive and posttraumatic stress disorder (PTSD) symptomatology, and to determine the association of the different profiles of mental dysfunction with cortisol and dehydroepiandrosterone (DHEA) basal saliva levels as well as physical health symptoms. A cross-sectional study was carried out in which IPV victims ( n =73) and control non-abused ( n =31) women participated. Information was obtained through structured interviews and saliva samples were collected for hormonal assays under baseline conditions. There were three profiles of mental symptoms in IPV subjects: no symptoms ( n =19); with depressive symptoms ( n =36), and depressive/PTSD symptom ( n =18). None of the non-abused women had depressive or PTSD symptoms. The stress hormone response differed between groups. Only the IPV-depressive group had higher evening cortisol, and both morning and evening DHEA, but lower morning cortisol/DHEA ratio than non-abused women. Furthermore, there were differences between the IPV groups. The IPV-depressive group had lower morning cortisol and morning cortisol/DHEA ratio than the IPV-no symptoms and lower morning cortisol/DHEA ratio than the IPV-depressive/PTSD group. With respect to the physical symptoms there was an association between the mean of symptoms and the profile of mental health, the incidence being higher in the depressive/PTSD group than in the other groups. This study demonstrates that there are individual differences in the impact that IPV has on the stress response and health status in women victims.",0,0 +4930,Psychometric Properties of the Impact of Event Scale-Revised in Patients One Year After Burn Injury,"Burn injury can be a life-threatening and traumatic event. Despite considerable risk for psychological morbidity, few outcome measures have been evaluated. The aim of this study was to examine the psychometric properties of a Swedish version of the Impact of Event Scale-Revised (IES-R) in patients 1 year after burn injury (N = 147). A principal component analysis was performed, and the results supported the three-factor structure of the IES-R. High internal consistency and intelligible associations with concurrent psychological symptoms and known risk factors for distress after trauma indicate satisfactory psychometric properties. Thus, the study supports the use of the IES-R as a screening tool for measuring traumatic distress after burn.",0,0 +4931,Innovative Training with Virtual Patients in Transcultural Psychiatry: The Impact on Resident Psychiatrists’ Confidence,"Virtual patients are now widely accepted as efficient and safe training tools in medical education, but very little is known about their implementation in psychiatry, especially in transcultural clinical care of traumatized refugee patients.This study aimed at assessing the impact of training with a virtual patient on confidence in providing clinical care for traumatized refugee patients.The authors developed an educational tool based on virtual patient methodology portraying the case of ""Mrs. K"", a traumatized refugee woman with symptoms of PTSD and depression. A group (N=32) of resident psychiatrists tested the system and their confidence in different aspects of providing clinical care for this patient group was evaluated pre- and post-test by using a validated confidence questionnaire. Cronbach's α was calculated for all clusters. Changes between pre- and post-test were compared by using the matched-pair t-test, binomial distribution for exact significance test and a calculation of effect sizes (Cohen's d).A statistically significant improvement was exhibited in overall confidence (mean Δ: 0.34; p<0.0001; d: 0.89) as well as in four more specific domains of clinical care, with the area of identifying and evaluating trauma-related diagnoses and disability showing the most prominent improvement (mean Δ: 0.47; p<0.0001; d: 1.00).This VP-system can lead to physicians' improvement of confidence in providing transcultural clinical care for traumatized refugee patients. Further research is required to investigate improvement in actual performance and cognitive outcomes with several VPs and in a long-term effect perspective.",0,0 +4932,Time‐dependent Development of Social Stress Caused by Repeated Exposures to Aggressors Simulating Features of Post‐traumatic Stress Disorder (PTSD),"A utility criterion of a PTSD mouse model is recruiting a stressor with systematically variable intensity. An ideal stressor should maintain a 'dose-response relationship' with the subjects' behavioral shift. A typical PTSD model includes a brief exposure to foot or tail shock. We developed a model that involves repeated exposures (either 5-day or 10-day) to trained conspecific aggressors (Agg). A contextual reminder study evaluating a cluster of ethogram identified PTSD-like (acute- and persistent-) syndromes such as incubation, extinction and desensitization of fear responses. Pathophysiological consequences supported the model. This model reflects the combat-like situation where life-threatening events occur repeatedly and randomly. The direct relationship of PTSD-risk with deployment frequency further justifies the model. Agg induced stress intensity can only be elevated by prolonging the exposure. The risk of habituation can thereby defeat the 'dose-response' relationship. We addressed this concern by evaluating the time-dependent behavioral shift of the subject mice (C57BL/6j). Subsets of subject mice were withdrawn from the Agg-exposure (Agg-E) schedule at regular intervals and their psycho-patho-physiological characters were evaluated. A regression model elucidated the temporal relationship of Agg-E stress with the psychological alteration.",0,0 +4933,Comorbidity of personality disorders in anxiety disorders: A meta-analysis of 30 years of research,"A comprehensive meta-analysis to identify the proportions of comorbid personality disorders (PD) across the major subtypes of anxiety disorders (AD) has not previously been published.A literature search identified 125 empirical papers from the period 1980-2010 on patients with panic disorders, social phobia, generalised anxiety, obsessive-compulsive (OCD) and post-traumatic stress disorder (PTSD). Several moderators were coded.The rate of any comorbid PD was high across all ADs, ranging from .35 for PTSD to .52 for OCD. Cluster C PDs occurred more than twice as often as cluster A or B PDs. Within cluster C the avoidant PD occurred most frequently, followed by the obsessive-compulsive and the dependent PD. PTSD showed the most heterogeneous clinical picture and social phobia was highly comorbid with avoidant PD. A range of moderators were examined, but most were non-significant or of small effects, except an early age of onset, which in social phobia increased the risk of an avoidant PD considerably. Gender or duration of an AD was not related to variation in PD comorbidity.Blind rating of diagnoses was recorded from the papers as an indication of diagnostic validity. However, as too few studies reported it the validity of the comorbid estimates of PD was less strong.The findings provided support to several of the proposed changes in the forthcoming DSM-5. Further comorbidity studies are needed in view of the substantial changes in how PDs will be diagnosed in the DSM-5.",0,0 +4934,Post-traumatic stress disorder in DSM-5: Estimates of prevalence and criteria comparison versus DSM-IV-TR in a non-clinical sample of earthquake survivors,"The latest edition of DSM (DSM-5) introduced important revisions to PTSD symptomatological criteria, such as a four-factor model and the inclusion of new symptoms. To date, only a few studies have investigated the impact that the proposed DSM-5 criteria will have on prevalence rates of PTSD.An overall sample of 512 adolescents who survived the L'Aquila 2009 earthquake and were previously investigated for the presence of full and partial PTSD, using DSM-IV-TR criteria, were reassessed according to DSM-5 criteria. All subjects completed the Trauma and Loss Spectrum-Self Report (TALS-SR).A DSM-5 PTSD diagnosis emerged in 39.8% of subjects, with a significant difference between the two sexes (p<0.001), and an overall 87.1% consistency with DSM-IV-TR. Most of the inconsistent diagnoses that fulfilled DSM-IV-TR criteria but not DSM-5 criteria can be attributed to the subjects not fulfilling the new criterion C (active avoidance). Each DSM-5 symptom was more highly correlated with its corresponding symptom cluster than with other symptom clusters, but two of the new symptoms showed moderate to weak item-cluster correlations. Among DSM-5 PTSD cases: 7 (3.4%) endorsed symptom D3; 151 (74%) D4; 28 (13.7%) both D3 and D4; 75 (36.8%) E2.The use of a self-report instrument; no information on comorbidity; homogeneity of study sample; lack of assessment on functional impairment; the rates of DSM-IV-TR qualified PTSD in the sample was only 37.5%.This study provides an inside look at the empirical performance of the DSM-5 PTSD criteria in a population exposed to a natural disaster, which suggests the need for replication in larger epidemiological samples.",0,0 +4935,Review of sertraline in post-traumatic stress disorder,"Sertraline (Zoloft trade mark, Pfizer) is a selective serotonin re-uptake inhibitor (SSRI) with proven efficacy in the treatment of post-traumatic stress disorder (PTSD). PTSD is a serious, complex and often chronic mental illness that may follow exposure to a traumatic event. The high prevalence of traumatic events and PTSD in the general population and the resulting distress and dysfunction present a need for the systematic study of the efficacy and effectiveness of treatments for PTSD. Sertraline offers advantages over the older antidepressants, including demonstrated efficacy in PTSD, improved tolerability and low risk of lethality in overdose. Sertraline's efficacy, favourable tolerability profile and relatively weak effect on the cytochrome P450 system are factors that contribute to make it a first-line agent of choice in the treatment of PTSD.",0,0 +4936,Personality Assessment Inventory (PAI) Profiles of Male Veterans With Combat-Related Posttraumatic Stress Disorder,"The Personality Assessment Inventory (PAI; L. C. Morey, 1991) is a promising tool for the assessment of Posttraumatic Stress Disorder (PTSD), but few studies have examined the PAI profiles of individuals with the diagnosis. In this study, the PAI was administered to 176 combat veterans with PTSD. Results showed significant elevations on scales measuring depression, somatic complaints, anxiety, anxiety-related disorders, schizophrenia, and negative impression management. The Traumatic Stress subscale was the highest point in the mean score profile and was moderately correlated with several established measures of PTSD. Veterans with and without comorbid major depression differed on PAI scales assessing depression, anxiety, and warmth. Analysis of two-point codetypes for the PAI and the MMPI-2 revealed substantial heterogeneity in symptom endorsement on both instruments, suggesting that there may be no clear ""PTSD profile"" on either instrument. Results provide a reference point for future work with the PAI in PTSD samples. (",0,0 +4937,"The PTSD Checklist-Civilian Version: Reliability, Validity, and Factor Structure in a Nonclinical Sample","We examined the reliability, validity, and factor structure of the posttraumatic stress diorder (PTSD) Checklist-Civilian Version (PCL-C; Blanchard, Jones-Alexander, Buckley, & Forneris, 1996) among unselected undergraduate students.Participants were 471 undergraduate students at a large university in the Eastern United States and were not preselected based on trauma history or symptom severity.The PCL-C demonstrated good internal consistency and retest reliability. Compared with alternative measures of PTSD, the PCL-C showed favorable patterns of convergent and discriminant validity. In contrast to previous research using samples with known trauma exposure, we found support for both 1-factor and 2-factor models of PTSD symptoms.Overall, the PCL-C appears to be a valid and reliable measure of PTSD symptoms, even among nonclinical samples, and is superior to some alternative measures of PTSD. The factor structure among nonclinical samples may not reflect each of the PTSD symptom ""clusters"" (i.e., reexperiencing, avoidance/numbing, and hyperarousal).",0,0 +4938,Evidence for Response Set Effects in Structured Research Interviews,"The Addiction Severity Index and NIMH Diagnostic Interview Schedule data of 20 methadone-maintained subjects with ""fake bad"" invalid profiles on the Personality Assessment Inventory, 15 methadone-maintained subjects with ""fake good"" invalid profiles, and 158 methadone-maintained subjects with valid profiles were compared. The findings revealed a number of significant group differences on both measures with the highest scores for the fake bad subjects and lowest scores for the fake good subjects. These findings suggest that the response sets exhibited in response to the Personality Assessment Inventory questionnaire extended to performance during the two semi-structured interviews. There was no indication that interviewers were aware of misrepresentation. The limitations of the findings and alternative interpretations of the data are considered.",0,0 +4939,Profile of children investigated for sexual abuse: Association with psychopathology symptoms and services.,"Sexually abused children may have poor mental health because of their victimization as well as preexisting or co-occurring family problems. However, few studies consider psychopathology in relation to both abuse and other family experiences. This study uses data from the National Survey of Child and Adolescent Well-Being (NSCAW) to create latent subgroups of 553 children investigated for sexual abuse. The study investigates children's psychological symptoms and child welfare service (CWS) patterns to understand how children's needs relate to mental health services. Analyses were conducted by child age: 3-7, 8-11, and 12-14. Factor mixture modeling and regression analyses were used. Results show meaningful subgroups of children that relate to different symptom patterns. Among 3- to 7-year-olds, behavioral symptoms are associated with caregiver domestic violence and mental illness. Among 8- to 11-year-olds, depressive symptoms are associated with severe abuse and multiple family problems, whereas posttraumatic stress is associated with chronic, unresolved abuse. Although many children received mental health services, services are not well matched to children's needs--the substantiation status of the abuse explains services. Implications for CWS and mental health services are discussed.",0,0 +4940,Post Traumatic Stress Disorder: Cognitive Therapy with Children and Young People,"Post traumatic stress disorder develops after exposure to one or more terrifying events that have caused, or threatened to cause the sufferer grave physical harm. This book discusses how trauma-focused cognitive therapy can be used to help children and adolescents who suffer from post traumatic stress disorder. Cognitive therapy is frequently used to treat adults who suffer from PTSD with proven results. Post Traumatic Stress Disorder provides the therapist with instructions on how CT models can be used with children and young people to combat the disorder. Based on research carried out by the authors, this book covers: assessment procedures and measures formulation and treatment planning trauma focused cognitive therapy methods common hurdles. The authors provide case studies and practical tips, as well as examples of self-report measures and handouts for young people and their parents which will help the practitioner to prepare for working with this difficult client group. Post Traumatic Stress Disorder is an accessible, practical, clinically relevant guide for professionals and trainees in child and adolescent mental health service teams who work with traumatized children and young people.",0,0 +4941,The injury profile after the 2008 earthquakes in China,"The 8.0 magnitude earthquake that struck China on May 12, 2008, was the deadliest earthquake in 30 years. Most hospitals were destroyed and limited facilities were available for medical service in the earthquake regions. Over the first 5 days, three general hospitals and one children's hospital admitted 1770 injured individuals.We retrospectively collected data on 1770 injured subjects in three general hospitals (n=1723) and one children's hospital (n=47) in the quake-area during the first 5 days after the event. The diagnosis for the injuries was based on the final hospital diagnosis made by the physicians and classified by two-independent researchers using the International Statistical Classification of Diseases and Related Health Problems ICD-10 (WHO ICD-10 Code.1993). To ensure the accuracy of the information, any questionable data was reviewed by phone with hospital staff.In three general hospitals, 848 patients (48%) were male and 922 (52%) were female. Nine percent (n=84) of females and 8.8% (n=75) of males were over the age of 75. Four (0.4%) females and 5 (0.5%) males were less than 1-year old. The most common injuries were the injuries of the knee, lower leg, ankle and foot (36%), followed by head injuries (18%). In the children's hospital, 31 (65%) of the patients were males and 16 (35%) were females. 40% of the subjects were 10-14, while 21% were less than 1-year old. The most frequently seen injuries were also of the knee, lower leg, ankle or foot (19%), and of the abdomen, lower back, lumbar spine and pelvis, and hip and thigh (15%).We gathered information from resources in Chinese, which at the time contained more records on this event than any documents in English. The age of the patients ranged from 7 days to 84 years old. Subjects over age 75 and children between 10 and 14 were the largest population in their respective hospitals, indicating that these groups required the greatest medical resources. The injury profile presented here serves as a reference not only for present injury intervention but also for future earthquake disaster response.",0,0 +4942,Stressor characteristics and post-traumatic stress disorder symptom dimensions in war victims.,"To evaluate how the type of trauma is related to specific symptom patterns in patients with post-traumatic stress disorder (PTSD) according to the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) criteria.A total of 136 PTSD patients exposed to war-related traumatic experiences were divided in four groups: 79 veterans, 18 former prisoners (who witnessed or were subject to torture or frequent assaults), 15 victims of rape, and 24 refugees from Bosnia and Herzegovina. Each group was homogenous in regard to traumatic experiences.Significant inter-group differences were found in symptoms listed in the DSM-IV criteria, and under criteria C (avoidance) and D (arousal). No such differences were observed in symptoms listed under criterion B (intrusive symptoms). The results indicate that stressor characteristics may play a role not only in the variety of symptoms exhibited, but particularly in the number of avoidance and arousal symptoms. Victims of rape tended to present with more avoidance symptoms and fewer hyperarousal symptoms, whereas former prisoners and veterans tended to report more hyperarousal symptoms. Rape victims and former prisoners also reported more symptoms than the other groups.There is a strong indication that stressor characteristics influence the variety and number of exhibited intrusive, avoidance, and arousal symptoms. More research is needed to precisely define individual symptom dimensions possibly relating to particular stressor characteristics. Additional studies are needed to determine whether PTSD, as it is currently defined in the DSM-IV, is really a homogenous diagnostic category.",0,0 +4943,The Quality of Life of Young Children and Infants with Chronic Medical Problems: Review of the Literature,"The question ""what makes a good quality of life?"" is a philosophical one which could be thought immune to scientific investigations. However, over the last few decades there has been great progress in developing tools to quantify quality of life (QoL) to make comparisons between different health states, evaluate the effectiveness of medical interventions, and describe the life trajectories of individuals or groups. Using a series of vignettes, we explore and review the biomedical literature to demonstrate how QoL is affected by chronic health conditions in childhood, and how it evolves as individuals pass into adulthood. Individuals experiencing serious chronic illnesses generally have reduced health-related QoL: their health status has significant repercussions of their everyday life, but scores are usually much better than healthy individuals expect, and better than physicians predict. Global QoL is more than a health status concept. QoL is a complex relationship between objectivity and subjectivity; it requires substantial and valid facts, and it defines itself by an interpretation of health within different schemes of values: societal, medical, and those of the subject themselves. QoL is dynamic; purely physical influences diminish as individuals age, and psychosocial factors become much more important. Resilience frequently allows adaptation to adverse health states, leading to acceptable QoL for most children with disabilities.",0,0 +4944,Clarifying Heterogeneity of Daytime and Nighttime Symptoms of Posttraumatic Stress in Combat Veterans With Insomnia,"Daytime and nighttime symptoms of posttraumatic stress disorder (PTSD) are common among combat veterans and military service members. However, there is a great deal of heterogeneity in how symptoms are expressed. Clarifying the heterogeneity of daytime and nighttime PTSD symptoms through exploratory clustering may generate hypotheses regarding ways to optimally match evidence-based treatments to PTSD symptom profiles. We used mixture modeling to reveal clusters based on six daytime and nighttime symptoms of 154 combat veterans with insomnia and varying levels of PTSD symptoms. Three clusters with increasing symptom severity were identified (N1=50, N2=70, N3=34). These results suggest that, among veterans with insomnia, PTSD symptoms tend to exist on a continuum of severity, rather than as a categorical PTSD diagnosis. Hypotheses regarding possible targeted treatment strategies for veterans within each identified cluster, as well as ways to generalize these methods to other groups within the military, are discussed.",0,0 +4945,Using Longitudinal Complex Survey Data,"Common features of longitudinal surveys are complex sampling designs, which must be maintained and extended over time; measurement errors, including memory errors; panel conditioning or time-in-sample effects; and dropout or attrition. In the analysis of longitudinal survey data, both the theory of complex samples and the theory of longitudinal data analysis must be combined. This article reviews the purposes of longitudinal surveys and the kinds of analyses that are commonly used to address the questions these surveys are designed to answer. In it, I discuss approaches to incorporating the complex designs in inference, as well as the complications introduced by time-in-sample effects and by nonignorable attrition. I also outline the use and limitations of longitudinal survey data in supporting causal inference and conclude with some summary remarks.",0,0 +4946,Latent Growth Mixture Models to estimate PTSD trajectories,"No abstract available. (Published: 2 March 2015) Citation: European Journal of Psychotraumatology 2015, 6 : 27503 - http://dx.doi.org/10.3402/ejpt.v6.27503 This paper is part of the Special Issue: Estimating PTSD trajectories . More papers from this issue can be found at http://www.ejpt.net",0,0 +4947,"War exposure, daily stressors, and mental health in conflict and post-conflict settings: Bridging the divide between trauma-focused and psychosocial frameworks","This paper seeks to bridge the divisive split between advocates of trauma-focused and psychosocial approaches to understanding and addressing mental health needs in conflict and post-conflict settings by emphasizing the role that daily stressors play in mediating direct war exposure and mental health outcomes. The authors argue that trauma-focused advocates tend to overemphasize the impact of direct war exposure on mental health, and fail to consider the contribution of stressful social and material conditions (daily stressors). Drawing on the findings of recent studies that have examined the relationship of both war exposure and daily stressors to mental health status, a model is proposed in which daily stressors partially mediate the relationship of war exposure to mental health. Based on that model, and on the growing body of research that supports it, an integrative, sequenced approach to intervention is proposed in which daily stressors are first addressed, and specialized interventions are then provided for individuals whose distress does not abate with the repair of the social ecology.",0,0 +4948,Changes in PTSD symptomatology during acute and protracted alcohol and cocaine abstinence,"Previous research with substance users has demonstrated, across a variety of psychiatric disorders, significant decreases in psychological symptoms during early substance abstinence. To build on this literature, the current study prospectively assessed trauma symptomatology over 28 days during acute and protracted cocaine and alcohol abstinence. Participants were 162 male and female cocaine and/or alcohol dependent outpatients who reported a history of trauma. Trauma-related symptoms and substance use were assessed at 2, 5, 10, 14, 21, and 28 days following last substance use. For participants who were known to relapse, assessments began again after the last day of substance use. Latent growth modeling was employed to estimate changes in posttraumatic stress disorder (PTSD) symptoms. Consistent with studies of other psychiatric syndromes, PTSD symptoms declined across the 28-day study period regardless of withdrawal substance (i.e., cocaine or alcohol). The majority of change in trauma symptoms occurred within 2 weeks of last substance use. Moreover, while trauma symptoms for the PTSD participants were more severe than those reported by the non-PTSD participants, trauma symptoms declined across the study period at the same rate irrespective of PTSD status.",0,0 +4949,Behavioral couples therapy for comorbid substance use disorders and combat-related posttraumatic stress disorder among male veterans: An initial evaluation,"Outcomes after behavioral couples therapy (BCT) were compared for 19 dually diagnosed veterans with combat-related PTSD and a substance use disorder (SUD, primarily alcohol dependence) and 19 veterans with SUD only. Clients with and without comorbid PTSD had very similar pre-treatment clinical profiles on dimensions of substance misuse, relationship functioning, and psychological symptoms. Further, both PTSD and non-PTSD clients showed good compliance with BCT, attending a high number of BCT sessions, taking Antabuse, and going to AA. Finally, both PTSD and non-PTSD groups improved from before BCT to immediately after and 12 months after BCT. Specific improvements noted were increased relationship satisfaction and reductions in drinking, negative consequences of drinking, male-to-female violence, and psychological distress symptoms. Extent and pattern of improvement over time were similar whether the client had PTSD or not. The present results suggest that BCT may have promise in treating clients with comorbid SUD and combat-related PTSD.",0,0 +4950,Smallpox Vaccination: Comparison of Self-Reported and Electronic Vaccine Records in the Millennium Cohort Study,"In December 2002, the US Government implemented policy to immunize health workers, first responders, and military personnel against smallpox in preparation for a possible bioterrorist attack. Self-reported vaccination data are commonly used in epidemiologic research and may be used to determine vaccination status in a public health emergency. To establish a measure of reliability, the agreement between self-reported smallpox vaccination and electronic vaccination records was examined using data from the Millennium Cohort Study. Descriptive measures and a kappa statistic were calculated for data from 54,066 Millennium Cohort Study participants. Multivariable modeling adjusting for potential confounders was used to investigate vaccination agreement status and health metrics, as measured by the Short Form 36-Item Health Survey for Veterans (SF-36V) and hospitalization data. Substantial agreement (kappa =0.62) was found between self-report and electronic recording of smallpox vaccination. Of all participants with an electronic record of smallpox vaccination, 90% self-reported being vaccinated; and of all participants with no electronic record of vaccination, 82% self-reported not receiving a vaccination. There was no significant difference in hospitalization experience prior to questionnaire completion between vaccinated and unvaccinated participants. While overall scores on the SF-36V suggested a healthy population, participants whose self-reported vaccination status did not match electronic records had slightly lower adjusted mean scores for some scales. These results indicate strong reliability in self-reported smallpox vaccination and also suggest that discordant reporting of smallpox vaccination is not associated with substantial differences in health among Millennium Cohort participants.",0,0 +4951,Screening for Traumatic Exposure and Posttraumatic Stress Symptoms in Adolescents in the War-Affected Eastern Democratic Republic of Congo,"To explore adolescent mental health in the eastern Democratic Republic of Congo, scene of a complex emergency since 1996.Community cross-sectional data obtained using a cluster sample approach.From November 5, 2007, through February 5, 2008, we assessed 13 secondary schools in 4 selected health zones in the Ituri district.One thousand forty-six adolescents and young adults aged 13 to 21 years completed a self-report questionnaire.War-related traumatic events, posttraumatic stress symptoms, and sociodemographic variables.The Adolescent Complex Emergency Exposure Scale, specifically designed for this region, screened for exposure to potentially traumatic events, and the Impact of Event Scale-Revised measured symptoms of posttraumatic stress consistent with Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria.Among the 477 girls (45.6%) and 569 boys (54.4%) in the study, 95.0% reported at least 1 traumatic event. On average, adolescents were exposed to 4.71 traumatic events, with higher exposure rates reported in boys, older groups, rural and urban areas, and respondents whose mother or father was dead. Of 990 respondents, 52.2% met symptom criteria for posttraumatic stress disorder. Symptom scores were strongly related to cumulative trauma exposure; however, the strength of this relationship differed slightly across living area groups for girls.Adolescents in the eastern Democratic Republic of Congo are highly exposed to political violence, putting them at a considerable risk--mediated by living area and sex--to develop posttraumatic stress symptoms.",0,0 +4952,Acute Stress Disorder and Posttraumatic Stress Disorder in Children and Adolescents Involved in Assaults or Motor Vehicle Accidents,"OBJECTIVE: The authors investigated acute stress disorder and later posttraumatic stress disorder (PTSD) in children and adolescents who had been involved in assaults or motor vehicle accidents. METHOD: They interviewed 93 patients 10–16 years old who were seen in an emergency department for having been assaulted or involved in a motor vehicle accident within 4 weeks after the assault or accident to assess acute stress disorder. At 6 months, they reinterviewed 64 (68.8%) of the patients to assess PTSD. RESULTS: At initial interview, 18 (19.4%) of the 93 patients had acute stress disorder and 23 (24.7%) met all acute stress disorder criteria except dissociation. At 6 months, eight of the 64 patients (12.5%) had PTSD. Acute stress disorder and PTSD did not differ in prevalence between patients who had been assaulted and those who had been in accidents. Sensitivity and specificity statistics and regression modeling revealed that the diagnosis of acute stress disorder was a good predictor of later PTSD but that dissociation did not play a significant role. CONCLUSIONS: Acute stress disorder has merit as a predictor of later PTSD in children and adolescents, but dissociation has questionable utility.",0,0 +4953,Sexual Function Outcomes in Women Treated for Posttraumatic Stress Disorder,"This study examined dysfunctional sexual behavior and sexual concerns in women treated for posttraumatic stress disorder (PTSD). There were three objectives: to characterize the relationship between symptoms of PTSD and sexual outcomes, to examine the effect of treatment on sexual outcomes, and to examine the relationship between change in PTSD and change in sexual outcomes.Female veterans and active duty personnel with PTSD (n = 242), 93% of whom had experienced sexual trauma, were randomly assigned to receive 10 weekly sessions of either Prolonged Exposure or Present-Centered Therapy. PTSD and sexual outcomes were assessed before and after treatment and then 3 and 6 months later.At baseline, the reexperiencing, numbing, and hyperarousal symptom clusters were related to one or both sexual outcomes. Although prior analyses had shown that Prolonged Exposure resulted in better PTSD outcomes, there were no differences between treatments for either dysfunctional sexual behavior or sexual concerns. However, loss of PTSD diagnosis was associated with improvements in sexual concerns.The findings suggest that clinically meaningful improvements in PTSD are necessary in order to reduce sexual problems in traumatized women.",0,0 +4954,"Modeling PTSD Symptom Clusters, Alcohol Misuse, Anger, and Depression as They Relate to Aggression and Suicidality in Returning U.S. Veterans","Suicidal ideation and aggression are common correlates of posttraumatic stress disorder (PTSD) among U.S. Iraq and Afghanistan war veterans. The existing literature has established a strong link between these factors, but a more nuanced understanding of how PTSD influences them is needed. The current study examined the direct and indirect relationships between PTSD symptom clusters and suicidal ideation in general aggression (without a specified target) regarding depression, alcohol misuse, and trait anger. Participants were 359 (92% male) U.S. Iraq/Afghanistan war veterans. Path analysis results suggested that the PTSD numbing cluster was directly (β = .28, p < .01) and indirectly (β = .17, p = .001) related through depression. The PTSD hyperarousal cluster was indirectly related to suicidal ideation through depression (β = .13, p < .001). The PTSD reexperiencing cluster was directly related to aggression (β = .17, p < .05), whereas the PTSD numbing and hyperarousal clusters were indirectly related to aggression through trait anger (β = .05, p < .05; β = .20, p < .001). These findings indicate that adjunct treatments aimed at stabilizing anger, depression, and alcohol misuse may help clinicians ameliorate the maladaptive patterns often observed in veterans. These results also point to specific manifestations of PTSD and co-occurring conditions that may inform clinicians in their attempts to identify at risk veterans and facilitate preventative interventions.",0,0 +4955,"A selective neurokinin-1 receptor antagonist in chronic PTSD: A randomized, double-blind, placebo-controlled, proof-of-concept trial","The substance P-neurokinin-1 receptor (SP-NK(1)R) system has been extensively studied in experimental models of stress, fear, and reward. Elevated cerebrospinal fluid (CSF) SP levels were reported previously in combat-related PTSD. No medication specifically targeting this system has been tested in PTSD. This proof-of-concept randomized, double-blind, placebo-controlled trial evaluated the selective NK(1)R antagonist GR205171 in predominately civilian PTSD. Following a 2-week placebo lead-in, 39 outpatients with chronic PTSD and a Clinician-Administered PTSD Scale (CAPS) score ≥50 were randomized to a fixed dose of GR205171 (N=20) or placebo (N=19) for 8weeks. The primary endpoint was mean change from baseline to endpoint in the total CAPS score. Response rate (≥50% reduction in baseline CAPS) and safety/tolerability were secondary endpoints. CSF SP concentrations were measured in a subgroup of patients prior to randomization. There was significant improvement in the mean CAPS total score across all patients over time, but no significant difference was found between GR205171 and placebo. Likewise, there was no significant effect of drug on the proportion of responders [40% GR205171 versus 21% placebo (p=0.30)]. An exploratory analysis showed that GR205171 treatment was associated with significant improvement compared to placebo on the CAPS hyperarousal symptom cluster. GR205171 was well-tolerated, with no discontinuations due to adverse events. CSF SP concentrations were positively correlated with baseline CAPS severity. The selective NK(1)R antagonist GR205171 had fewer adverse effects but was not significantly superior to placebo in the short-term treatment of chronic PTSD. (ClinicalTrials.gov Identifier: NCT 00211861, NCT 00383786).",0,0 +4956,Symptom structure of posttraumatic stress disorder in a nationally representative sample,"Diagnostic criteria (e.g., Diagnostic and Statistical Manual of Mental Disorders , 4th ed.) for posttraumatic stress disorder (PTSD) posit three symptom clusters including reexperiencing, avoidance/numbing, and hyperarousal. Factor analytic studies have suggested several alternative models of PTSD symptomatology . It is uncertain whether these new models are widely generalizable as most studies have relied on relatively select treatment seeking samples (e.g., combat veterans). To address this limitation, confirmatory factor analysis was applied to symptom data from National Comorbidity Survey respondents with a lifetime history of PTSD ( n = 429). Several models were tested. The model comprised of four intercorrelated factors (reexperiencing, avoidance, numbing, and hyperarousal) received the strongest support, but did not meet all the goodness-of-fit criteria. A follow-up principal-components analysis yielded a four-factor solution, with factors representing dysphoria , cued reexperiencing and avoidance, uncued reexperiencing and hyperarousal, and trauma-related rumination. The theoretical and clinical implications of these findings are discussed.",0,0 +4957,Wagner's migraine and other stories . . .,,0,0 +4958,A Randomized Stepped Care Intervention Trial Targeting Posttraumatic Stress Disorder for Surgically Hospitalized Injury Survivors,"To test the effectiveness of a stepped care intervention model targeting posttraumatic stress disorder (PTSD) symptoms after injury.Few investigations have evaluated interventions for injured patients with PTSD and related impairments that can be feasibly implemented in trauma surgical settings.The investigation was a pragmatic effectiveness trial in which 207 acutely injured hospitalized trauma survivors were screened for high PTSD symptom levels and then randomized to a stepped combined care management, psychopharmacology, and cognitive behavioral psychotherapy intervention (n = 104) or usual care control (n = 103) conditions. The symptoms of PTSD and functional limitations were reassessed at 1, 3, 6, 9, and 12 months after the index injury admission.Regression analyses demonstrated that over the course of the year after injury, intervention patients had significantly reduced PTSD symptoms when compared with controls [group by time effect, CAPS (Clinician-Administered PTSD Scale): F(2, 185) = 5.50, P < 0.01; PCL-C (PTSD Checklist Civilian Version): F(4, 185) = 5.45, P < 0.001]. Clinically and statistically significant PTSD treatment effects were observed at the 6-, 9-, and 12-month postinjury assessments. Over the course of the year after injury, intervention patients also demonstrated significant improvements in physical function [MOS SF-36 PCS (Medical Outcomes Study Short Form 36 Physical Component Summary) main effect: F(1, 172) = 9.87, P < 0.01].Stepped care interventions can reduce PTSD symptoms and improve functioning over the course of the year after surgical injury hospitalization. Orchestrated investigative and policy efforts could systematically introduce and evaluate screening and intervention procedures for PTSD at US trauma centers. (clinicaltrials.gov identifier: NCT00270959).",0,0 +4959,The Role of Memory-related Gene WWC1 (KIBRA) in Lifetime Posttraumatic Stress Disorder: Evidence from Two Independent Samples from African Conflict Regions,"Posttraumatic stress disorder (PTSD) results from the formation of a strong memory for the sensory-perceptual and affective representations of traumatic experiences, which is detached from the corresponding autobiographical context information. Because WWC1, the gene encoding protein KIBRA, is associated with long-term memory performance, we hypothesized that common WWC1 alleles influence the risk for a lifetime diagnosis of PTSD.Traumatic load and diagnosis of current and lifetime PTSD were assessed in two independent African samples of survivors from conflict zones who had faced severe trauma (n = 392, Rwanda, and n = 399, Northern Uganda, respectively). Array-based single nucleotide polymorphism (SNP) genotyping was performed. The influence of WWC1 tagging SNPs and traumatic load on lifetime PTSD was estimated by means of logistic regression models with correction for multiple comparisons in the Rwandan sample. Replication analysis was performed in the independent Ugandan sample.An association of two neighboring SNPs in almost complete linkage disequilibrium, rs10038727 and rs4576167, with lifetime PTSD was discovered in the Rwandan sample. Although each traumatic event added to the probability of lifetime PTSD in a dose-dependent manner in both genotype groups, carriers of the minor allele of both SNPs displayed a diminished risk (p = .007, odds ratio = .29 [95% confidence interval = .15-.54]). This effect was confirmed in the independent Ugandan sample.This study reveals an association between two WWC1 SNPs and the likelihood of PTSD development, indicating that this memory-related gene might be involved in processes that occur in response to traumatic stress and influence the strengthening of fear memories.",0,0 +4960,Psychological distress in survivors of residential fires,This paper presents preliminary findings from an ongoing study of survivors of residential fires. The purpose of this study was to examine psychological distress and extent of loss in order to provide a psychological profile of survivors overtime. The sample (N = 69) was drawn consecutively from the database of residential fires available through the Philadelphia Fire Department. Levels of psychological distress were measured as well as reports of symptoms consistent with the diagnostic criteria for Post-traumatic Stress Disorder. The major findings indicate that residential fires caused significant and sustained distress. An agenda for further research and for services to survivors of these fires is presented.,0,0 +4961,"Post-traumatic stress is associated with verbal learning, memory, and psychomotor speed in HIV-infected and HIV-uninfected women","The prevalence of post-traumatic stress disorder (PTSD) is higher among HIV-infected (HIV+) women compared with HIV-uninfected (HIV-) women, and deficits in episodic memory are a common feature of both PTSD and HIV infection. We investigated the association between a probable PTSD diagnosis using the PTSD Checklist-Civilian (PCL-C) version and verbal learning and memory using the Hopkins Verbal Learning Test in 1004 HIV+ and 496 at-risk HIV- women. HIV infection was not associated with a probable PTSD diagnosis (17% HIV+, 16% HIV-; p = 0.49) but was associated with lower verbal learning (p < 0.01) and memory scores (p < 0.01). Irrespective of HIV status, a probable PTSD diagnosis was associated with poorer performance in verbal learning (p < 0.01) and memory (p < 0.01) and psychomotor speed (p < 0.001). The particular pattern of cognitive correlates of probable PTSD varied depending on exposure to sexual abuse and/or violence, with exposure to either being associated with a greater number of cognitive domains and a worse cognitive profile. A statistical interaction between HIV serostatus and PTSD was observed on the fine motor skills domain (p = 0.03). Among women with probable PTSD, HIV- women performed worse than HIV+ women on fine motor skills (p = 0.01), but among women without probable PTSD, there was no significant difference in performance between the groups (p = 0.59). These findings underscore the importance of considering mental health factors as correlates to cognitive deficits in women with HIV.",0,0 +4962,Trauma History and Psychopathology in War-Affected Refugee Children Referred for Trauma-Related Mental Health Services in the United States,"There is an increasing need to deliver effective mental health services to refugee children and adolescents across the United States; however, the evidence base needed to guide the design and delivery of services is nascent. We investigated the trauma history profiles, psychopathology, and associated behavioral and functional indicators among war-affected refugee children presenting for psychological treatment. From the National Child Traumatic Stress Network's Core Data Set, 60 war-affected refugee children were identified (51.7% males, mean age = 13.1 years, SD = 4.13). Clinical assessments indicated high rates of probable posttraumatic stress disorder (30.4%), generalized anxiety (26.8%), somatization (26.8%), traumatic grief (21.4%), and general behavioral problems (21.4%). Exposure to war or political violence frequently co-occurred with forced displacement; traumatic loss; bereavement or separation; exposure to community violence; and exposure to domestic violence. Academic problems and behavioral difficulties were prevalent (53.6% and 44.6%, respectively); however, criminal activity, alcohol/drug use, and self-harm were rare (all < 5.45%). These findings highlight the complex trauma profiles, comorbid conditions, and functional problems that are important to consider in providing mental health interventions for refugee children and adolescents. Given the difficulties associated with access to mental health services for refugees, both preventive and community-based interventions within family, school, and peer systems hold particular promise.",0,0 +4963,Psychiatric emergencies (part I): psychiatric disorders causing organic symptoms.,"Psychiatric emergencies are conditions that mostly destabilize the already frenetic activity of the Emergency Department. Sometimes the emergency is clearly referable to primitive psychiatric illness. Other times, psychiatric and organic symptoms can independently coexist (comorbidity), or develop together in different conditions of substance abuse, including alcohol and prescription drugs. Differentiating between substance induced and pre-existing psychiatric disorder (dual diagnosis) may be difficult, other than controversial issue. Finally, an organic disease can hide behind a psychiatric disorder (pseudopsychiatric emergency). In this review (part I), psychiatric disorders that occur with organic symptoms are discussed. They include: (1) anxiety, conversion and psychosomatic disorders, and (2) simulated diseases. The physiologic mechanisms of the stress reaction, divided into a dual neuro-hormonal response, are reviewed in this section: (1) activation of the sympathetic nervous system and adrenal medulla with catecholamine production (rapid response), and (2) activation of the hypothalamic-pituitary-adrenal axis with cortisol production (slow response). The concept of the fight-or-flight response, its adaptive significance and the potential evolution in paralyzing response, well showing by Yerkes-Dodson curve, is explained. Abnormal short- and long-term reactions to stress evolving toward well codified cluster of trauma and stressor-related disorders, including acute stress disorder, adjustment disorder and post-traumatic stress disorder, are examined. A brief review of major psychiatric disorder and related behaviour abnormalities, vegetative symptoms and cognitive impairment, according to DMS IV-TR classification, are described. Finally, the reactive psychic symptoms and behavioral responses to acute or chronic organic disease, so called ""somatopsychic disorders"", commonly occurring in elderly and pediatric patients, are presented. The specific conditions of post-operative and intensive care unit patients, and cancer and HIV positive population are emphasized.",0,0 +4964,How Prevalent Is Resilience Following Sexual Assault?: Comment on Steenkamp et al. (2012),"Steenkamp, Dickstein, Salters-Pedneault, Hofmann, and Litz (2012) analyzed latent trajectories of posttraumatic stress disorder (PTSD) symptoms on data obtained in the early months following a single-incident sexual assault. In contrast to previous studies of potentially traumatic events, they did not observe a trajectory of minimal symptoms or resilience, which they argued occurred because sexual assault involves more severe and direct trauma exposure than examined in previous studies. Although sexual assault is an aversive and challenging event, it seems highly unlikely that at least some sexual assault survivors would not be resilient. Steenkamp et al.'s failure to observe resilience can easily be explained on purely methodological grounds. Most notably, their findings were probably heavily influenced by sampling bias. Additionally, their sample size was too small and had too much missing data for the kinds of latent trajectory modeling they attempted.",0,0 +4965,Exploratory Factor Analysis of the Greek Adaptation of the PTSD Checklist—Civilian Version,"The Diagnostic and Statistical Manual of Mental Disorders (4th edition; DSM-IV) conceptualization of posttraumatic stress disorder (PTSD) includes three symptom clusters or sequelae: reexperiencing, avoidance/numbing, and hyperarousal. The PTSD Checklist–Civilian Version (PCL-C) is based on the DSM-IV criteria. In the current study, we conducted an exploratory factor analysis (EFA) of the PCL-C using a sample of 312 adults. We examined whether the Greek adaptation of the PCL-C evidenced the three-factor solution given by the DSM-IV symptom cluster or the four-factor solution implied in other studies. The EFA was used to extract three- and four-factor solutions. The EFA identified a three-factor solution that included reexperiencing, avoidance/numbing, and hyperarousal supporting the DSM-IV PTSD symptoms.",0,0 +4966,Therapeutic Action of Fluoxetine is Associated with a Reduction in Prefrontal Cortical miR-1971 Expression Levels in a Mouse Model of Posttraumatic Stress Disorder,"MicroRNAs (miRNA) are a class of small non-coding RNAs that have recently emerged as epigenetic modulators of gene expression in psychiatric diseases like schizophrenia and major depression. So far, miRNAs have neither been studied in patients suffering from posttraumatic stress disorder (PTSD) nor in PTSD animal models. Here, we present the first study exploring the connection between miRNAs and PTSD. Employing our previously established PTSD mouse model, we assessed miRNA profiles in prefrontal cortices (PFCs) dissected from either fluoxetine or control-treated wildtype C57BL/6N mice 74 days after their subjection to either a single traumatic electric footshock or mock-treatment. Fluoxetine is an antidepressant known to be effective both in PTSD patients and in mice suffering from a PTSD-like syndrome. Screening for differences in the relative expression levels of all potential miRNA target sequences of miRBase 18.0 by pairwise comparison of the PFC miRNA profiles of the four mouse groups mentioned resulted in identification of five miRNA candidate molecules. Validation of these miRNA candidates by reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) revealed that the therapeutic action of fluoxetine in shocked mice is associated with a significant reduction in mmu-miR-1971 expression. Furthermore, our findings suggest that traumatic stress and fluoxetine interact to cause distinct alterations in the mouse PFC miRNA signature in the long-term.",0,0 +4967,"Trends in Psychological/Psychiatric Injury and Law: Continuing Education, Practice Comments, Recommendations","This literature review of the major topics in the field of psychological/psychiatric injury and law is aimed at developing commentary for practice in the area. The field is a fast-developing one, with over ten major topics that it needs to integrate. In particular, the present review focuses current work on: law (evidence, tort); forensic psychology; assessment and testing; psychological injuries (posttraumatic stress disorder, chronic pain, traumatic brain injury, other); the APA DSM-5 draft (Diagnostic and statistical manual of mental disorders; American Psychiatric Association 2010); malingering; causality; multicultural considerations; disability; the American Medical Association (AMA) Guides to the evaluation of permanent impairment (Rondinelli et al. 2008); models; and treatment. At the end of each section of the article, practice comments introduce critical issues in applying the research to psychological work in the area. Whether undertaking tort evaluations, disability, and treatment plan assessments or treating individuals with psychological injuries, the professional needs state-of-the-art information in all the areas listed in order to remain scientifically informed, comprehensive, and impartial. The article concludes with recommendations for an integrated field in psychological/psychiatric injury and law, study in the field, research in its major areas, best practice policies, for example in assessment and treatment, and model building. © 2010 Springer Science + Business Media, LLC.",0,0 +4968,Anthrax Vaccination in the Millennium CohortValidation and Measures of Health,"Background In 1998, the United States Department of Defense initiated the Anthrax Vaccine Immunization Program. Concerns about vaccine-related adverse health effects followed, prompting several studies. Although some studies used self-reported vaccination data, the reliability of such data has not been established. The purpose of this study was to compare self-reported anthrax vaccination to electronic vaccine records among a large military cohort and to evaluate the relationship between vaccine history and health outcome data. Methods Between September 2005 and February 2006 self-reported anthrax vaccination was compared to electronic records for 67,018 participants enrolled in the Millennium Cohort Study between 2001 and 2003 using kappa statistics. Multivariable modeling investigated vaccination concordance as it pertains to subjective health (functional status) and objective health (hospitalization) metrics. Results Greater than substantial agreement (kappa=0.80) was found between self-report and electronic recording of anthrax vaccination. Of all participants with electronic documentation of anthrax vaccination, 98% self-reported being vaccinated; and of all participants with no electronic record of vaccination, 90% self-reported not receiving a vaccination. There were no differences between vaccinated and unvaccinated participants in overall measures of health. Only the subset of participants who self-reported anthrax vaccination, but had no electronic confirmation, differed from others in the cohort, with consistently lower measures of health as indicated by Medical Outcomes Study 36-Item Short Form Health Survey for Veterans (SF-36V) scores. Conclusions These results indicate that military members accurately recall their anthrax vaccinations. Results also suggest that anthrax vaccination among Millennium Cohort participants is not associated with self-reported health problems or broad measures of health problems severe enough to require hospitalization. Service members who self-report vaccination with no electronic documentation of vaccination, however, report lower measures of physical and mental health and deserve further research. In 1998, the United States Department of Defense initiated the Anthrax Vaccine Immunization Program. Concerns about vaccine-related adverse health effects followed, prompting several studies. Although some studies used self-reported vaccination data, the reliability of such data has not been established. The purpose of this study was to compare self-reported anthrax vaccination to electronic vaccine records among a large military cohort and to evaluate the relationship between vaccine history and health outcome data. Between September 2005 and February 2006 self-reported anthrax vaccination was compared to electronic records for 67,018 participants enrolled in the Millennium Cohort Study between 2001 and 2003 using kappa statistics. Multivariable modeling investigated vaccination concordance as it pertains to subjective health (functional status) and objective health (hospitalization) metrics. Greater than substantial agreement (kappa=0.80) was found between self-report and electronic recording of anthrax vaccination. Of all participants with electronic documentation of anthrax vaccination, 98% self-reported being vaccinated; and of all participants with no electronic record of vaccination, 90% self-reported not receiving a vaccination. There were no differences between vaccinated and unvaccinated participants in overall measures of health. Only the subset of participants who self-reported anthrax vaccination, but had no electronic confirmation, differed from others in the cohort, with consistently lower measures of health as indicated by Medical Outcomes Study 36-Item Short Form Health Survey for Veterans (SF-36V) scores. These results indicate that military members accurately recall their anthrax vaccinations. Results also suggest that anthrax vaccination among Millennium Cohort participants is not associated with self-reported health problems or broad measures of health problems severe enough to require hospitalization. Service members who self-report vaccination with no electronic documentation of vaccination, however, report lower measures of physical and mental health and deserve further research.",0,0 +4969,"Post-traumatic stress disorder, drug abuse and migraine: New findings from the National Comorbidity Survey Replication (NCS-R)","Post-traumatic stress disorder (PTSD) has been shown to be associated with migraine and drug abuse.This was an analysis of data from the National Comorbidity Survey Replication (NCS-R) to evaluate the association of PTSD in those with episodic migraine (EM) and chronic daily headache (CDH).Our sample consisted of 5,692 participants. Lifetime and 12-month prevalence rates of PTSD were increased in those with EM and CDH. After adjustments, the lifetime odds ratio (OR) of PTSD was greater in those with EM (OR 3.07 confidence interval [CI]: 2.12, 4.46) compared to those without headache; was greater in men than women with EM (men: OR 6.86; CI: 3.11, 15.11; women: OR 2.77; CI: 1.83, 4.21); and was comparable or greater than the association between migraine with depression or anxiety. The lifetime OR of PTSD was also increased in CDH sufferers. The OR of illicit drug abuse was not increased in those with EM or CDH unless co-occurring with PTSD or depression.The lifetime and 12-month OR of PTSD is increased in those with migraine or CDH, and is greater in men than women with migraine. The lifetime and 12-month OR of illicit drug abuse is not increased in those with migraine or CDH unless co-occurring with PTSD or depression.",0,0 +4970,Progress and Controversy in the Study of Posttraumatic Stress Disorder,"Research on posttraumatic stress disorder (PTSD) has been notable for controversy as well as progress. This article concerns the evidence bearing on the most contentious issues in the field of traumatic stress: broadening of the definition of trauma, problems with the dose-response model of PTSD, distortion in the recollection of trauma, concerns about “phony combat vets,” psychologically toxic guilt as a traumatic stressor, risk factors for PTSD, possible brain-damaging effects of stress hormones, recovered memories of childhood sexual abuse, and the politics of trauma.",0,0 +4971,Individual and Collective Dimensions of Resilience Within Political Violence,"Research has documented a link between political violence and the functioning of individuals and communities. Yet, despite the hardships that political violence creates, evidence suggests remarkable fortitude and resilience within both individuals and communities. Individual characteristics that appear to build resilience against political violence include demographic factors such as gender and age, and internal resources, such as hope, optimism, determination, and religious convictions. Research has also documented the protective influence of individuals’ connection to community and their involvement in work, school, or political action. Additionally, research on political violence and resilience has increasingly focused on communities themselves as a unit of analysis. Community resilience, like individual resilience, is a process supported by various traits, capacities, and emotional orientations toward hardship. This review addresses various findings related to both individual and community resilience within political violence and offers recommendations for research, practice, and policy.",0,0 +4972,Impact of Depression and Post-Traumatic Stress Disorder on Functional Outcome and Health-Related Quality of Life of Patients with Mild Traumatic Brain Injury,"The impact of disability following traumatic brain injury (TBI), assessed by functional measurement scales for TBI or by health-related quality of life (HRQoL), may vary because of a number of factors, including presence of depression or post-traumatic stress disorder (PTSD). The aim of this study was to assess prevalence and impact of depression and PTSD on functional outcome and HRQoL six and 12 months following mild TBI. We selected a sample of 1919 TBI patients who presented to the emergency department (ED) followed by either hospital admission or discharge to the home environment. The sample received postal questionnaires six and 12 months after treatment at the ED. The questionnaires included items regarding socio-demographics, the 36-item Short-Form Health Survey (SF-36), the Perceived Quality of Life Scale (PQoL), the Beck Depression Inventory, and the Impact of Event Scale. A total of 797 (42%) TBI patients completed the six-month follow-up survey. Depression and PTSD prevalence rates at both the six- and 12-month follow-up were 7% and 9%, respectively. Living alone was an independent predictor of depression and/or PTSD at six- and 12-month follow-up. Depression and PTSD were associated with a significantly decreased functional outcome (measured with Glasgow Outcome Scale Extended) and HRQoL (measured using the SF-36 and the PQoL). We conclude that depression and/or PTSD are relatively common in our sample of TBI patients and associated with a considerable decrease in functional outcome and HRQoL.",0,0 +4973,"Trajectories and associated factors of quality of life, global outcome, and post-concussion symptoms in the first year following mild traumatic brain injury","Purpose: To investigate the associated factors and change trajectories of quality of life (QoL), global outcome, and post-concussion symptoms (PCS) over the first year following mild traumatic brain injury (mTBI).Methods: This was a prospective longitudinal study of 100 participants with mTBI from neurosurgical outpatient departments in Chiayi County District Hospitals in Taiwan. The checklist of post-concussion syndromes (CPCS) was used to assess PCS at enrollment and at 1, 3, and 12 months after mTBI; the glasgow outcome scale extended (GOSE), the quality of life after brain injured (QOLIBRI), Chinese version, and the Short Form 36 Health Survey (SF-36), Taiwan version, were used to assess mTBI global outcome and QoL at 1, 3, and 12 months after mTBI.Results: Latent class growth models (LCGMs) indicated the change trajectories of QOLIBRI, PCS SF-36, MCS SF-36, GOSE, and PCS. Classes of trajectory were associated with age >40 years, unemployment at 1 month after injury, and educational level <12 years. Univariate analysis revealed that employment status at 1 month post-injury was correlated with the trajectories of QOLIBRI, PCS SF-36, MCS SF-36, and GOSE, but not PCS.Conclusions: Employment status was the most crucial associated factor for QoL in individuals with mTBI at the 1-year follow-up. Future studies should explore the benefits of employment on QoL of individuals with mTBI. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal abstract)",0,0 +4974,Select non-coding RNA in blood components provide novel clinically accessible biological surrogates for improved identification of traumatic brain injury in OEF/OIF Veterans.,"This study was designed to identify clinically accessible molecular biomarkers of mild traumatic brain injury (mTBI) that could be used to help identify returning Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) Veterans who are suffering from the effects of mTBI. While analyzing the expression profile of small non-coding RNAs in peripheral blood mononuclear cells (PBMCs) from an OEF/OIF veteran study cohort using a high throughput array chip platform, we identified 18 candidate small non-coding RNA biomarkers that are differentially regulated in PBMCs of mTBI compared to non-TBI control cases. Independent quantitative real-time polymerase chain reaction assays confirmed that 13 of these candidate small RNA biomarker species are, indeed, significantly down-regulated in PBMCs of mTBI compared to non-TBI control veteran cases. Based on unsupervised clustering analysis, we identified a 3-biomarker panel which was most able to distinguish mTBI from non-TBI control veteran cases with high accuracy, selectivity and specificity. The majority of mTBI cases in our biomarker study were co-morbid with Post-Traumatic Stress Disorder (PTSD), and thus our non-TBI control cases were selected to match PTSD diagnoses. Therefore, our identified panel of 3 small RNA biomarkers likely represents a biological index selective for mTBI. Outcomes from our studies suggest that additional applications of the clinically accessible small non-coding RNA biomarkers to current diagnostic criteria may lead to improved mTBI detection and more sensitive outcome measures for clinical trials. Future studies exploring the physiological relevance of mTBI biomarkers will also provide a better understanding of the biological mechanisms underlying mTBI and insights into novel therapeutic targets for mTBI.",0,0 +4975,"Affective personality type, post-traumatic stress disorder symptom severity and post-traumatic growth in victims of violence","The current study explored the differential association between affective personality type, post-traumatic stress disorder (PTSD) symptom severity, and post-traumatic growth (PTG) in victims of violence (N = 113). Relying on previous research, median cut off-scores on the Positive and Negative Affect Schedule Short Form were used to classify participants as high affective [i.e. high positive affectivity (PA) and high negative affectivity (NA)], self-actualizing (i.e. high PA and low NA), self-destructive (i.e. low PA and high NA) and low affective (i.e. low PA and low NA). Results indicated that the self-destructive and high affective personality styles were strongly associated with increased PTSD symptoms severity. High affective personality type was found to be the only significant predictor of PTG. Results, study limitations and directions for future research were discussed. Copyright © 2010 John Wiley & Sons, Ltd.",0,0 +4976,Assessing the psychometric properties of a supplementary PK Scale embedded in the Minnesota Multiphasic Personality Inventory -Adolescent (MMPI-A) in detecting post-traumatic stress disorder (PTSD),"This study explored the validity of the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A; Butcher et al., 1992) PK Scale (Cashel, Ovaert and Holliman, 2000) to assess symptoms of Post-Traumatic Stress Disorder (PTSD) within an inpatient adolescent sample. The present research sought to expand upon the Cashel et al. (2000) study by assessing the predictive and comparative validity of the MMPI-A PK Scale. Information was gathered from the archival data of 631 adolescents who were referred to the assessment service of Four Winds Hospital. Adolescents were 13-18 years old and predominantly female (57.9%). The MMPI-A PK Scale significantly related to the following self-reported traumas measured by the Children's Trauma Questionnaire (CTQ; Bernstein & Fink, 1998): emotional abuse (r = .31, p < .01), sexual abuse (r = .14, p < .01) and physical abuse (r = .08, p < .05), respectively. Significant negative relationships between emotional neglect (r = .23, p < .01) and physical neglect (r .09, p < .05) were also found. The MMPI-A PK Scale significantly related to the Trauma Content Index (TC/R; Armstrong & Loewenstein, 1990), which was applied to Rorschach protocols (r = .14, p < .01) scored using Exner's Comprehensive System (CS; Exner, 2003). The relationships between the MMPI-A PK Scale and features associated with the presence of trauma, as measured by the Trauma Symptom Checklist for Children (TSCC; Briere, 1996), were explored. The MMPI-A PK Scale correlated highest with the Depression (DEP) clinical scale of the TSCC (r = .69, p < .01). The relationship between the MMPI-A PK Scale and the Posttraumatic Stress (PTS) clinical scale of the TSCC (r = .59, p < .01) was also significant and indicative of a moderate correlation. As a measure of PTSD symptoms, the MMPI-A PK Scale evidenced low to typical predictive validity (AUC = .696) when compared to the PTS scale. Other significant relationships between the MMPI-A PK Scale and the clinical scales of the TSCC were discussed. The MMPI-A PK Scale, as a diagnostic measure, performed similarly to the PTS scale. ROC analyses compared both the MMPI-A PK Scale and the PTS to discharge chart diagnosis. Both measures evidenced low to typical predictive validity (AUC = .613 and AUC = .621, respectively). The sensitivity and specificity of the MMPI-A PK Scale was also reviewed and compared to the sensitivity and specificity of the other measures. Implications, limitations and additional directions for future research were discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +4977,"Nursing students’ post-traumatic growth, emotional intelligence and psychological resilience","Accessible summary Nursing students in the present sample who have experienced childhood adversity have a certain level of post-traumatic growth. If introduced into nursing curricula, emotional intelligence interventions may increase emotional coping resources and enhance social skills for nurses, which may benefit their long-term occupational health. As researchers consider personal resilience a strategy for responding to workplace adversity in nurses, resilience building should be incorporated into nursing education. This is a preliminary study that may guide future investigations of the curvilinear relationship rather than linear relationship between post-traumatic growth and positive factors in the special sample of nursing students. Abstract Resilience, emotional intelligence and post-traumatic growth may benefit nursing students’ careers and personal well-being in clinical work. Developing both their emotional intelligence and resilience may assist their individual post-traumatic growth and enhance their ability to cope with clinical stress. To investigate the relationships among post-traumatic growth, emotional intelligence and psychological resilience in vocational school nursing students who have experienced childhood adversities, a cross-sectional research design with anonymous questionnaires was conducted and self-report data were analysed. The Childhood Adversities Checklist (Chinese version), Posttraumatic Growth Inventory, Emotional Intelligence Scale and the 10-item Connor–Davidson Resilience Scale were used. Survey data were collected from 202 Chinese vocational school nursing students during 2011. Post-traumatic growth was associated with emotional intelligence and psychological resilience. Results indicated a curvilinear relationship between emotional intelligence and post-traumatic growth, and between psychological resilience and post-traumatic growth. Moderate-level emotional intelligence and psychological resilience were most associated with the greatest levels of growth. The results imply that moderate resilience and emotional intelligence can help nursing students cope with adversity in their future clinical work. This study first provided preliminary data suggesting the curvilinear relationship rather than linear relationship between post-traumatic growth and positive factors in the sample of nursing students.",0,0 +4978,Biological studies of post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) is the only major mental disorder for which a cause is considered to be known: that is, an event that involves threat to the physical integrity of oneself or others and induces a response of intense fear, helplessness or horror. Although PTSD is still largely regarded as a psychological phenomenon, over the past three decades the growth of the biological PTSD literature has been explosive, and thousands of references now exist. Ultimately, the impact of an environmental event, such as a psychological trauma, must be understood at organic, cellular and molecular levels. This Review attempts to present the current state of this understanding on the basis of psychophysiological, structural and functional neuroimaging, and endocrinological, genetic and molecular biological studies in humans and in animal models.",0,0 +4979,Dissociation and post-traumatic stress disorder: two prospective studies of road traffic accident survivors,"Dissociative symptoms during trauma predict post-traumatic stress disorder (PTSD), but they are often transient. It is controversial whether they predict chronic PTSD over and above what can be predicted from other post-trauma symptoms.To investigate prospectively the relationship between dissociative symptoms before, during and after a trauma and other psychological predictors, and chronic PTSD.Two samples of 27 and 176 road traffic accident survivors were recruited. Patients were assessed shortly after the accident and followed at intervals over the next 6 months. Assessments included measures of dissociation, memory fragmentation, data-driven processing, rumination and PTSD symptoms.All measures of dissociation, particularly persistent dissociation 4 weeks after the accident, predicted chronic PTSD severity at 6 months. Dissociative symptoms predicted subsequent PTSD over and above the other PTSD symptom clusters. Memory fragmentation and data-driven processing also predicted PTSD. Rumination about the accident was among the strongest predictors of subsequent PTSD symptoms.Persistent dissociation and rumination 4 weeks after trauma are more useful in identifying those patients who are likely to develop chronic PTSD than initial reactions.",0,0 +4980,Early trauma-focused cognitive-behavioural therapy to prevent chronic post-traumatic stress disorder and related symptoms: A systematic review and meta-analysis,"Early trauma-focused cognitive-behavioural therapy (TFCBT) holds promise as a preventive intervention for people at risk of developing chronic post-traumatic stress disorder (PTSD). The aim of this review was to provide an updated evaluation of the effectiveness of early TFCBT on the prevention of PTSD in high risk populations.We performed a systematic literature search in international electronic databases (MEDLINE, EMBASE, PsycINFO, CENTRAL, CINAHL, ISI and PILOTS) and included randomised controlled trials comparing TFCBT delivered within 3 months of trauma, to alternative interventions. All included studies were critically appraised using a standardised checklist. Two independent reviewers selected studies for inclusion and assessed study quality. Data extraction was performed by one reviewer and controlled by another. Where appropriate, we entered study results into meta-analyses.Seven articles reporting the results of five RCTs were included. All compared TFCBT to supportive counselling (SC). The study population was patients with acute stress disorder (ASD) in four trials, and with a PTSD diagnosis disregarding the duration criterion in the fifth trial. The overall relative risk (RR) for a PTSD diagnosis was 0.56 (95% CI 0.42 to 0.76), 1.09 (95% CI 0.46 to 2.61) and 0.73 (95% CI 0.51 to 1.04) at 3-6 months, 9 months and 3-4 years post treatment, respectively. A subgroup analysis of the four ASD studies only resulted in RR = 0.36 (95% CI 0.17 to 0.78) for PTSD at 3-6 months. Anxiety and depression scores were generally lower in the TFCBT groups than in the SC groups.There is evidence for the effectiveness of TFCBT compared to SC in preventing chronic PTSD in patients with an initial ASD diagnosis. As this evidence originates from one research team replications are necessary to assess generalisability. The evidence about the effectiveness of TFCBT in traumatised populations without an ASD diagnosis is insufficient.",0,0 +4981,Risking connection with our clients: Implications for the current state of the therapeutic relationship.,"In response to Hansen, Lambert, and Forman (2002), we discuss major caveats for research in which quantitative research methodology is applied to psychotherapy outcome studies. First, quantitative methodology fits more easily into a medical/disease model of mental illness than a truly psychological model of mental health. Second, results from quantitative outcome research are often misused when the findings are overgeneralized to individuals whose psychological profiles and treatment needs are dissimilar to the research samples. Third, quantitative studies fail to consider the therapeutic alliance as a critical factor in psychotherapy outcome. We describe Risking Connection, a training curriculum we coauthored with colleagues at the Traumatic Stress Institute, that highlights the centrality of healing relationships in psychotherapy with adult trauma survivors.",0,0 +4982,"Promoting “resilient” posttraumatic adjustment in childhood and beyond: “Unpacking” life events, adjustment trajectories, resources, and interventions",,0,0 +4983,Chronic fatigue syndrome/fibromyalgia: a “stress-adaptation” model,"Background: A symptom cluster consisting of ‘medically-unexplained’ chronic fatigue, effort intolerance and widespread pain is a complex and still poorly understood condition. Purpose: To demonstrate the theoretical and clinical value of a biopsychosocially-oriented ‘stress-adaptation’ model for this multi-symptom illness. Methods: Clinical observation and review of the relevant literature. Results: Symptoms and functional limitations of these patients may reflect a loss of normal physical, mental and emotional adaptability, primarily based on stress system dysregulation. Conclusions: The proposed stress-adaptation model may facilitate diagnosis, defy dualistic causal thinking, and offer tailor-made treatment options to help patients find a better balance in their lives",0,0 +4984,The Duration of Deployment and Sensitization to Stress,,0,0 +4985,Spatial Typologies of Care: Understanding the Implications of the Spatial Distribution of Off-Base Civilian Behavioral Health Providers Who Accept TRICARE Prime to Service Persons and Their Dependents,"Over the last decade, demand for services from military treatment facilities (MTFs) has frequently exceeded capacity resulting in increased usage of off-base civilian Tricare providers (OCTP). This capacity shortage has been particularly acute for mental health care. At many installations, OCTPs are the main source of mental health care for military personnel and their families. Utilizing data on the location of mental health OCTPs and demographic data, we examine the spatial accessibility of mental health OCTPs around five military installations. Variation exists in the spatial accessibility of mental health OCTPs depending on the geographic context of an installation. There is a mild correlation between the number of mental health OTCPs proximate to a base and the beneficiaries enrolled in an MTF. There is a strong correlation between the size of the general population proximate to an installation and the number of mental health OCTMPs present. Installations located in densely populated areas had high ratios of mental health OCTPs to the MTF beneficiary population but not when the civilian demand on these providers was accounted for. This study's findings open several avenues for future research and policy aimed at increasing the effectiveness of the mental health OCTP network.",0,0 +4986,The role of stress sensitization in progression of posttraumatic distress following deployment,"Purpose: Military personnel exposed to combat are at risk for experiencing post-traumatic distress that can progress over time following deployment. We hypothesized that progression of post-traumatic distress may be related to enhanced susceptibility to post-deployment stressors. This study aimed at examining the concept of stress sensitization prospectively in a sample of Dutch military personnel deployed in support of the conflicts in Afghanistan. Method: In a cohort of soldiers (N = 814), symptoms of post-traumatic stress disorder (PTSD) were assessed before deployment as well as 2, 7, 14, and 26 months (N = 433; 53 %) after their return. Data were analyzed using latent growth modeling. Using multiple group analysis, we examined whether high combat stress exposure during deployment moderated the relation between post-deployment stressors and linear change in post-traumatic distress after deployment. Results: A higher baseline level of post-traumatic distress was associated with more early life stressors (standardized regression coefficient = 0.30, p < 0.001). In addition, a stronger increase in posttraumatic distress during deployment was associated with more deployment stressors (standardized coefficient = 0.21, p < 0.001). A steeper linear increase in posttraumatic distress post-deployment (from 2 to 26 months) was predicted by more post-deployment stressors (standardized coefficient = 0.29, p < 0.001) in high combat stress exposed soldiers, but not in a less combat stress exposed group. The group difference in the predictive effect of post-deployment stressors on progression of post-traumatic distress was significant (χ2(1) = 7.85, p = 0.005). Conclusions: Progression of post-traumatic distress following combat exposure may be related to sensitization to the effects of post-deployment stressors during the first year following return from deployment. © 2013 Springer-Verlag Berlin Heidelberg.",0,0 +4987,Abnormal frontal and parietal activity during working memory updating in post-traumatic stress disorder,"This study used event-related potentials (ERPs) to investigate the timing and scalp topography of working memory in post-traumatic stress disorder (PTSD). This study was designed to investigate ERPs associated with a specific working memory updating process. ERPs were recorded from 10 patients and 10 controls during two visual tasks where (a) targets were a specific word or (b) targets were consecutive matching words. In the first task, nontarget words are not retained in working memory. In the second task, as in delay-match-to-sample tasks, a non-target word defines a new target identity, so these words are retained in working memory. This working memory updating process was related to large positive ERPs over frontal and parietal areas at 400-800 ms, which were smaller in PTSD. Estimation of cortical source activity indicated abnormal patterns of frontal and parietal activity in PTSD, which were also observed in regional cerebral blood flow [Clark, C.R., McFarlane, A.C., Morris, P., Weber, D.L., Sonkkilla, C., Shaw, M., Marcina, J., Tochon-Danguy, H., Egan, G., 2003. Cerebral function in posttraumatic stress disorder during verbal working memory updating: a positron emission tomography study. Biological Psychiatry 53, 474-481]. Frontal and parietal cortex are known to be involved in distributed networks for working memory processes, interacting with medial temporal areas during episodic memory processes. Abnormal function in these brain networks helps to explain everyday concentration and memory difficulties in PTSD.",0,0 +4988,Prevalence and Impact of Posttraumatic Stress Disorder-Like Symptoms on Patients With Fibromyalgia Syndrome,"Traumatic events can result in a set of symptoms including nightmares, recurrent and intrusive recollections, avoidance of thoughts or activities associated with the traumatic event, and symptoms of increased arousal such as insomnia and hypervigilance. These posttraumatic stress disorder (PTSD)-like symptoms are frequently observed in persons with chronic pain syndromes. Little is known about how these two phenomena interact with one another. The present study evaluated PTSD-like symptoms in patients with fibromyalgia syndrome (FMS) and examined the relation between PTSD-like symptoms and problems associated with FMS.Ninety-three consecutive patients underwent a comprehensive FMS evaluation and completed self-report questionnaires measuring PTSD-like symptoms, disability, and psychosocial responses to their pain condition. Subjects were divided in two groups based on level of self-reported PTSD-like symptoms.Approximately 56% of the sample reported clinically significant levels of PTSD-like symptoms (PTSD+). The PTSD+ patients reported significantly greater levels of pain (p < 0.01), emotional distress (p < 0.01), life interference (p < 0.01), and disability (p < 0.01) than did the patients without clinically significant levels of PTSD-like symptoms (PTSD-). Over 85% of the PTSD+ patients compared with 50% of the PTSD- patients demonstrated significant disability. Based on response to the Multidimensional Pain Inventory, a significantly smaller percentage of PTSD+ patients were classified as adaptive copers (15%) compared with the PTSD- group (48.2%).Results suggest that PTSD-like symptoms are prevalent in FMS patients and may influence adaptation to this chronic illness. Clinicians should assess the presence of these symptoms, as the failure to attend to them in treatment may impede successful outcomes.",0,0 +4989,Combat veterans with PTSD after mild TBI exhibit greater ERPs from posterior-medial cortical areas while appraising facial features.,"Posttraumatic stress disorder (PTSD) worsens prognosis following mild traumatic brain injury (mTBI). Combat personnel with histories of mTBI exhibit abnormal activation of distributed brain networks-including emotion processing and default mode networks. How developing PTSD further affects these abnormalities has not been directly examined. We recorded electroencephalography in combat veterans with histories of mTBI, but without active PTSD (mTBI only, n=16) and combat veterans who developed PTSD after mTBI (mTBI+PTSD, n=16)-during the Reading the Mind in the Eyes Test (RMET), a validated test of empathy requiring emotional appraisal of facial features. Task-related event related potentials (ERPs) were identified, decomposed using independent component analysis (ICA) and localized anatomically using dipole modeling. We observed larger emotional face processing ERPs in veterans with mTBI+PTSD, including greater N300 negativity. Furthermore, greater N300 negativity correlated with greater PTSD severity, especially avoidance/numbing and hyperarousal symptom clusters. This correlation was dependent on contributions from the precuneus and posterior cingulate cortex (PCC). Our results support a model where, in combat veterans with histories of mTBI, larger ERPs from over-active posterior-medial cortical areas may be specific to PTSD, and is likely related to negative self-referential activity.",0,0 +4990,"Posttraumatic Stress Disorder and HIV Risk Among Poor, Inner-City Women Receiving Care in an Emergency Department","Objectives. We examined the associations between posttraumatic stress disorder (PTSD) and HIV risk behaviors among a random sample of 241 low-income women receiving care in an urban emergency department. Methods. We recruited participants from the emergency department waiting room during randomly selected 6-hour blocks of time. Multivariate analyses and propensity score weighting were used to examine the associations between PTSD and HIV risk after adjustment for potentially confounding sociodemographic variables, substance use, childhood sexual abuse, and intimate partner violence. Results. A large majority of the sample self-identified as Latina (49%) or African American (44%). Almost one third (29%) of the participants met PTSD criteria. Women who exhibited symptoms in 1 or more PTSD symptom clusters were more likely than women who did not to report having had sex with multiple sexual partners, having had sex with a risky partner, and having experienced partner violence related to condom use in the preceding 6 months. Conclusions. The high rate of PTSD found in this sample and the significant associations between PTSD symptom clusters and partner-related risk behaviors highlight the need to take PTSD into account when designing HIV prevention interventions for low-income, urban women.",0,0 +4991,"An empirical exploration of the dynamics of anorexia nervosa: Representations of self, mother, and father.","Extensive clinical reports and a few empirical investigations indicate that a disrupted relationship with mother and a distorted sense of self are central to Anorexia Nervosa (AN). The present study explores these observations further using the Differentiation–Relatedness Scale (D–RS) to compare AN patients’ descriptions of mother, father, and self with those of matched general psychiatric (PC) and nonclinical controls (NC). Results indicate that the AN group is distinguished from the PC group by significantly lower D–R (Differentiation–Relatedness) for mother, and significantly higher D–R for self, as well as a tendency for greater DEQ Self–Criticism (p .05, one–tailed). Stepwise discriminant analysis indicates that an equation of D–R Self, D-R Mother, and DEQ Neediness, as well as the interaction of D–R Mother and DEQ Neediness, significantly (p .0001) discriminates 80.5% of the total sample (66.7% of the AN, 73.3% of the PC, and 87.2%",0,0 +4992,Victim and crime factors associated with the development of crime-related post-traumatic stress disorder,"This study examined the relationships between the development of Crime-Related Post-Traumatic Stress Disorder (CR-PTSD) and selected victim and crime characteristics. The sample consisted of 391 adult female residents of Charleston County, South Carolina, of whom 294 were crime victims assessed for CR-PTSD. Comparisons of CR-PTSD positive (n=82) and CR-PTSD negative (n=212) groups found significant differences on the variables of current age, years since most recent crime, experiencing a completed rape, perceiving a life threat during a crime, and sustaining physical injury during a crime. No differences existed on other assessed victim or crime variables. Hierarchical multiple regression analysis found that life threat, physical injury, and completed rape each made significant individual contributions to explaining CR-PTSD. Hierarchical discriminant function analysis correctly classified 80.6% of the respondents. Rape, life threat, and physical injury had a synergistic effect on CR-PTSD in that victims whose crime history included all three elements were 8.5 times more likely to have developed CR-PTSD than those with none of the three elements. Rape was associated with CR-PTSD after controlling for the effects of violence and dangerousness, suggesting that rape has other elements important to the development of CR-PTSD.",0,0 +4993,Characterizing time in longitudinal trauma research,"Despite the proliferation of longitudinal trauma research, careful attention to timing of assessments is often lacking. Patterns in timing of assessments, alternative time structures, and the treatment of time as an outcome are discussed and illustrated using trauma data.",0,0 +4994,SLC6A4 methylation modifies the effect of the number of traumatic events on risk for posttraumatic stress disorder,"Background: Posttraumatic stress disorder (PTSD) is a common and debilitating mental disorder that occurs following exposure to a traumatic event. However, most individuals do not develop PTSD following even a severe trauma, leading to a search for new variables, such as genetic and other molecular variation, associated with vulnerability and resilience in the face of trauma exposure. Method: We examined whether serotonin transporter (SLC6A4) promoter genotype and methylation status modified the association between number of traumatic events experienced and PTSD in a subset of 100 individuals from the Detroit Neighborhood Health Study. Results: Number of traumatic events was strongly associated with risk of PTSD. Neither SLC6A4 genotype nor methylation status was associated with PTSD in main effects models. However, SLC6A4 methylation levels modified the effect of the number of traumatic events on PTSD after controlling for SLC6A4 genotype. Persons with more traumatic events were at increased risk for PTSD, but only at lower methylation levels. At higher methylation levels, individuals with more traumatic events were protected from this disorder. This interaction was observed whether the outcome was PTSD diagnosis, symptom severity, or number of symptoms. Conclusions: Gene-specific methylation patterns may offer potential molecular signatures of increased risk for and resilience to PTSD. Depression and Anxiety, 2011. © 2011 Wiley-Liss, Inc.",0,0 +4995,"Latent trajectory studies: the basics, how to interpret the results, and what to report","In statistics, tools have been developed to estimate individual change over time. Also, the existence of latent trajectories, where individuals are captured by trajectories that are unobserved (latent), can be evaluated (Muthén & Muthén, 2000). The method used to evaluate such trajectories is called Latent Growth Mixture Modeling (LGMM) or Latent Class Growth Modeling (LCGA). The difference between the two models is whether variance within latent classes is allowed for (Jung & Wickrama, 2008). The default approach most often used when estimating such models begins with estimating a single cluster model, where only a single underlying group is presumed. Next, several additional models are estimated with an increasing number of clusters (latent groups or classes). For each of these models, the software is allowed to estimate all parameters without any restrictions. A final model is chosen based on model comparison tools, for example, using the BIC, the bootstrapped chi-square test, or the Lo-Mendell-Rubin test.To ease the use of LGMM/LCGA step by step in this symposium (Van de Schoot, 2015) guidelines are presented which can be used for researchers applying the methods to longitudinal data, for example, the development of posttraumatic stress disorder (PTSD) after trauma (Depaoli, van de Schoot, van Loey, & Sijbrandij, 2015; Galatzer-Levy, 2015). The guidelines include how to use the software Mplus (Muthén & Muthén, 1998-2012) to run the set of models needed to answer the research question: how many latent classes exist in the data? The next step described in the guidelines is how to add covariates/predictors to predict class membership using the three-step approach (Vermunt, 2010). Lastly, it described what essentials to report in the paper.When applying LGMM/LCGA models for the first time, the guidelines presented can be used to guide what models to run and what to report.",0,0 +4996,Emotional and behavioural difficulties in children referred to an early intervention program following child sexual abuse,"Many children suffer emotional and behavioural difficulties following trauma, however, children are not at equal risk for developing such difficulties following abuse (e.g., Kendell-Tackett, Williams, & Finkelhor, 1993). A detailed review of the literature indicated the need for an empirical investigation into the occurrence of Post Traumatic Stress Symptoms (PTSS) and other psychopathology in children and adolescents following Child Sexual Abuse (CSA). This project investigated the occurrence of psychopathology in children who experienced CSA. In particular, it examined the degree to which children and adolescents experience PTSS following CSA. Further, the study endeavoured to identify caregiver-related variables, abuse details, parenting behaviour, family functioning, and child coping strategies which predicted maladjustment following CSA. The first study (Chapter 4) involved 175 children aged between 8 and 16 years, and their primary caregivers. The purpose of this study was to develop and assess the psychometric properties of a measure of parenting behaviour that could be used in subsequent studies. As parenting behaviour has been linked with the development of psychopathology in children, an economical, reliable and valid measure of the dimensions of parenting behaviour of interest (parental support and overcontrol) was required. Based on existing measures of parenting behaviour, the Parent Support-Control Questionnaire (PSCQ) was developed. It was hypothesised that two central dimensions, namely parental warmth/support and overcontrol/protection, would be supported by factor analysis. The results of this study supported this hypothesis: a two-factor solution offered the most parsimonious explanation. Adequate internal and test-retest reliability, and convergent and discriminant validity were identified. The second study (Chapter 5) was conducted with 92 children (19 boys; 73 girls) aged 6 - 15 years who were referred and accepted into an early intervention program following the experience of sexual abuse. Children were accepted for the program if they had experienced sexual abuse within the previous three years, if the abuse had been formally substantiated, and if they had a primary caregiver willing to participate in the program. Children were excluded from the study if they continued to have regular contact with the perpetrator, had an IQ less than 70, or had a diagnosis of psychosis or pervasive developmental disorder. Assessment of children's emotional and behavioural adjustment as reported by children and their caregivers revealed that a significant majority of children experienced difficulties in the clinical range following CSA. Recent literature and findings in the current thesis indicate that there is considerable variability in symptom expression after CSA. A range of behaviours in the clinical range, including anxiety, depression, dissociation and post traumatic stress symptoms, were reported by caregivers and children. Despite previous reports that approximately 30% of children present as symptom free at the time of first assessment (e.g., Finkelhor & Berliner, 1995), only 2.2% of children in this sample were asymptomatic at initial presentation. In addition to general psychopathology, 31.4% of the sample reported PTSS indicative of a DSM-IV diagnosis of Post Traumatic Stress Disorder (PTSD). The three symptom clusters in the DSM-IV diagnostic criteria for PTSD (i.e., re-experiencing, avoidance, and hypervigilance) were not supported in preliminary analyses. Instead, it is suggested that PTSD can best be conceptualised as existing on a continuum for children following sexual abuse, with children showing elevations across the full spectrum of PTSD symptoms. This finding is more consistent with a single-dimension conceptualisation of PTSD. A discussion is offered about the developmental trajectory after trauma. Controversy surrounding the DSM-IV diagnostic criteria for PTSD is discussed, and modification of these criteria for use with children is recommended. A transactional model, based on the work of Spaccarelli (1994) was outlined in the third study (Chapter 7), as a basis for understanding differences in the occurrence of psychopathology following CSA. Specifically, it was hypothesised that poor adjustment following CSA is associated with abuse of high severity, a caregiver who has a history of abuse in her own childhood and high levels of psychopathology, a family environment with high levels of dysfunction, parenting behaviour characterised by low levels of support and high levels of control, and the child's reliance on avoidant coping strategies. The results of the current investigation provide some support for the model. Caregiver-reported anxiety and family dysfunction were significantly associated with child adjustment. Further, family functioning mediated the influence of caregiver anxiety on child adjustment. Contrary to prediction, parenting behaviour characterised by low support and high control was not significantly related to poor adjustment. Child-reported adjustment data revealed that an avoidant coping style was significantly associated with poor outcome following sexual abuse. Interestingly, the nature of the abuse was not related to child or parent report of difficulties following CSA. The results indicate that, following the experience of CSA, a high proportion of children experience psychopathology in the clinical range. Since affected children can continue to experience difficulties in adolescence and adulthood, early intervention is paramount. Of great clinical relevance is the finding that the factors significantly associated with poor adjustment, are those factors that are more amendable to change (e.g., coping style) rather than the characteristics of the abuse itself (e.g., frequency and duration of abuse). Findings are discussed in terms of identification of risk factors for poor adjustment following CSA, and presented as a guide clinicians could use in the selection of treatment goals for a particular case and in designing an individualised treatment program. Limitations associated with the present program of research are discussed. Recommendations are made for future research.",0,0 +4997,Identifying profiles of recovery from reward devaluation in rats,"In humans and other mammals, the unexpected loss of a resource can lead to emotional conflict. Consummatory successive negative contrast (cSNC) is a laboratory model of reward devaluation meant to capture that conflict. In this paradigm, animals are exposed to a sharp reduction in the sucrose concentration of a solution after several days of access. This downshift in sucrose content leads to behavioral responses such as the suppression of consumption and physiologic responses including elevation of corticosterone levels. However, response heterogeneity in cSNC has yet to be explored and may be relevant for increasing the validity of this model, as humans demonstrate clinically meaningful heterogeneity in response to resource loss. The current analysis applied latent growth mixture modeling to test for and characterize heterogeneity in recovery from cSNC among rats (N=262). Although most animals exhibited recovery of consummatory behavior after a sharp drop in consumption in the first postshift trial (Recovery class; 83%), two additional classes were identified including animals that did not change their consumption levels after downshift (No Contrast class; 6%), and animals that exhibited an initial response similar to that of the Recovery class but did not recover to preshift consumption levels (No Recovery class; 11%). These results indicate heterogeneity in recovery from reward loss among rats, which may increase the translatability of this animal model to understand diverse responses to loss among humans.",0,0 +4998,The Association of Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate With Anxiety Sensitivity and Electronic Diary Negative Affect Among Smokers With and Without Posttraumatic Stress Disorder,"Posttraumatic stress disorder (PTSD) is associated with increased smoking initiation, maintenance, and relapse. Dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS) are neurosteroids that have been associated with mood measures as well as smoking status, and nicotine is associated with increased DHEA and DHEAS levels. Given the difficulties with mood experienced by smokers with PTSD, the purpose of the current study was to evaluate the association between negative affect and anxiety sensitivity with DHEA and DHEAS levels. Ninety-six smokers with and without PTSD provided blood samples for neurosteroid analyses and completed self-report measures of anxiety sensitivity and electronic diary ratings of negative affect. As expected, PTSD smokers reported higher levels of anxiety sensitivity (F(1,94) = 20.67, partial η2 = 0.18, P < 0.0001) and negative affect (F(1,91) = 7.98, partial η2 = 0.08, P = 0.006). After accounting for age and sex, DHEAS was significantly inversely associated with both anxiety sensitivity (F(3,92) = 6.97, partial η2 = 0.07, P = 0.01) and negative affect (F(3,87) = 10.52, partial η2 = 0.11, P = 0.002) across groups. Effect sizes indicated that these effects are moderate to high. No significant interactions of diagnosis and DHEA(S) levels with mood measures were detected. Given that nicotine is known to elevate DHEA(S) levels, these results suggest that DHEAS may serve as a biomarker of the association between mood and nicotine among smokers. Implications for the results include (1) the use of DHEAS measurement across time and across quit attempts and (2) the potential for careful use of DHEA supplementation to facilitate abstinence during smoking cessation.",0,0 +4999,The predictive validity of the PTSD Checklist in a nonclinical sample of combat-exposed National Guard troops.,"After returning from an extended combat deployment to Iraq, 348 National Guard soldiers were administered the PTSD Checklist (PCL-M), and the Beck Depression Inventory II (BDI-II) followed, on average, 3 months later by structured diagnostic interviews including the Clinician-Administered PTSD Scale (CAPS) for the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). There were 6.5% of the soldiers who met diagnostic criteria for posttraumatic stress disorder (PTSD) based on structured interview. The predictive validity of the PCL was examined and contrasted with the predictive validity of the BDI-II in identifying soldiers meeting CAPS diagnosis for PTSD. The best identified PCL cut scores produced between 65% and 76% false positive errors when used as the sole source for identification of enduring PTSD. Comparison of prediction between the PCL and the BDI-II in identifying PTSD suggested that both instruments may be operating through tapping generalized distress rather than specific aspects of the disorder.",0,0 +5000,"An Exploratory Study of Neuroimaging, Neurologic, and Neuropsychological Findings in Veterans With Traumatic Brain Injury and/or Posttraumatic Stress Disorder","Seventy-two veterans with traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), or both participated in assessment procedures to evaluate between group differences. Half the sample was randomly selected for magnetic resonance imaging (MRI). Neurologic examinations were conducted using the Neurologic Rating Scale (NRS). Neuropsychological measures included the Paced Auditory Serial Addition Test (PASAT), Rey Auditory Verbal Learning Test (RAVLT), Conners' Continuous Performance Test II (CPT II), and Halstead Impairment Index (HII) including the Booklet Category Test (BCT). Data were analyzed using linear regression. Participants with moderate/ severe TBI were significantly more likely to have trauma-related imaging findings, and more severe TBI predicted lower scores on the NRS. No significant between-group differences were identified on the HII, PASAT, RAVLT, or CPT II. TBI group performance was significantly better on the BCT. More severe TBI predicted abnormal imaging findings and lower NRS scores. Hypothesized between-group differences on neuropsychological measures were not supported.",0,0 +5001,Gender differences in victims of war torture: Types of torture and psychological consequences,"Background/Aim. Torture for political reasons is an extreme violence in interpersonal relations resulting in not only acute psychiatric disorders but also very often in very severe and far reaching negative consequences for the overall psychosocial functioning of a victim. The aim of this study was to investigate gender differences in types of torture and psychological consequences in subjects who experienced war torture. Methods. A sample (410 men and 76 women) included clients of 'Centre for rehabilitation of torture victims - IAN, Belgrade' who experienced torture in prisons and concentration camps during civil wars in ex-Yugoslavia 1991-1995 and 1999. Types of Torture Questionnaire with 81 items was used for collecting data about forms of torture. Symptom Checklist 90-Revised (SCL-90- R) was used for assessing type and intensity of psychological symptoms, and Impact of Event Scale (IES) was used to estimate posttraumatic complaints. Results. A gender difference was found for 33 types of torture: 28 more frequent in men, and 5 in women. Factor analysis of torture types revealed three factors explaining 29% of variance: 'common torture', 'sadistic torture', and 'sexual torture'. Discriminant analysis revealed significant gender difference concerning the factors. 'Common torture' and 'sadistic torture' were more prominent in men, and 'sexual torture' was more present in women. Higher scores on depression, anxiety, somatization, interpersonal sensitivity and obsessive-compulsive dimensions on SCL-90-R were found in women. General score and scores of subscales (intrusion and avoidance) on IES were significantly higher in women. Conclusion. Women exposed to war torture experienced less torture techniques and shorter imprisonment than men, but had more frequent and severe symptoms of posttraumatic stress disorder and other psychological symptoms. Gender differences in posttraumatic symptomatology can not be explained exclusively by gender differences in types of torture found in this study.",0,0 +5002,The Association of Trauma and PTSD with the Substance Use Profiles of Alcohol- and Cocaine-Dependent Out-of-Treatment Women,The association of trauma and posttraumatic stress disorder (PTSD) with alcohol and cocaine use is explored to determine if there is additive risk associated with dual dependence. Data were collected from out-of-treatment women enrolled in an HIV-prevention study. Women who experienced a DSM-IV qualifying event (n = 791) were stratified into four substance use groups based on lifetime alcohol and cocaine use. Women with lifetime comorbid alcohol and cocaine dependence experienced significantly more traumatic events and had a higher prevalence of violent events and lifetime diagnosis of PTSD and PTSD-related impairment. There is added risk for associated trauma and subsequent PTSD among women who have dual substance dependence.,0,0 +5003,Health-related quality of life two years after injury due to terrorism.,"During the past few decades, terrorist acts have been an unfortunate reality worldwide. There is a striking paucity of research investigating the multitude of long-term outcomes after severe physical injury due to terrorist attacks, a unique subgroup of trauma patients. The purpose of this study was to provide a profile of the long-term health-related quality of life (HR-QOL) after injury due to terrorist attacks and to explore the relationships between Post Traumatic Stress Disorder (PTSD), occupational status and injury severity with HR-QOL.We included 35 survivors of terrorist attacks living in the community, two years on average after the injury, mean age at follow-up = 32.1 (±13.8), mean Injury Severity Score (ISS) = 27 (±14.2). The subjects were recruited from consecutive admissions to a rehabilitation department in a tertiary care center between September 2000 - June 2004. Most of the subjects suffered multiple trauma. The main outcome measures were the Short-Form Health Survey (SF-36), Post Traumatic Diagnostic Scale and return to work rates.The mean scores on 6/8 of the SF-36 subscales were significantly lower among the survivors compared to normative population norms. Post Traumatic Stress Disorder (PTSD) was found in 39% of the sample and 43% did not resume their main occupation two years after the injury. Multivariate analysis of variance of PTSD and occupational status (returned vs. did not return to work) on quality of life scores revealed significant main effects for both PTSD (p=. 000) and occupational status (p=. 005) with no interaction effect (p=. 476). No significant correlations were found between injury severity and the SF-36 scores.This study demonstrated the long-term impact of injury due to terrorism. Results showed independent effects of PTSD and occupational status on health related quality of life, two years after injury. These findings suggest that this group may benefit from intervention focusing on their emotional and occupational status in order to improve their quality of life.",0,0 +5004,Harvard Trauma Questionnaire Urdu translation: the only cross-culturally validated screening instrument for the assessment of trauma and torture and their sequelae.,"Violence is on the increase all over the world. The method, manner and quantum of such actions remain little explored. The common man has clearly received the message of power through the barrel of a gun. In Pakistan the major battle field of ethnic, political, sectarian and communal conflicts was Sindh and Punjab. Trauma and torture leaves a permanent scar on the survivor. It has physical, psychological and social sequelae. The two major psychiatric illnesses associated with trauma and torture are your major Depression and post traumatic stress disorder. The Harvard Trauma Questionnaire (HTQ) measures symptoms associated with diagnostic criteria for post-traumatic stress disorder as defined by DSMIII R manual and symptoms. Obtaining accurate knowledge of traumatic event and symptoms and properly classifying them into a diagnostic system is fundamental for providing effective treatment and good therapeutic intervention. Therefore an attempt is made to translate the HTQ, the only cross-culturally validated screening instrument for the assessment of trauma and torture related to mass violence and their sequelae [corrected].",0,0 +5005,Parental Alcohol History Differentially Predicts Offspring Disorders in Distinct Subgroups in Israel,"Objective: The association between alcoholism in parents and related disorders in their offspring is well established in cultures with intermediate/high alcohol consumption, but not in those with low consumption, such as Israel. This study investigated differences in parental transmission of alcohol problems and related psychopathology between immigrants from the former Soviet Union (FSU) to Israel and other Israelis—two Israeli subgroups with differing alcohol consumption behaviors and social norms. Method: A total of 1,347 adults from a household sample were interviewed. Regression analyses were used to examine associations between parental alcohol problems and participant disorders: alcohol, nicotine, and cannabis use disorders (AUD, NUD, CUD); antisocial personality disorder (ASPD); major depressive disorder (MDD); and posttraumatic stress disorder (PTSD). We also examined the associations of parental alcohol problems with participant disorders characterized with two latent factors: externalizing (EXT: AUD, NUD, CUD, ASPD) and internalizing (INT: MDD, PTSD). Differential parental transmission of alcohol problems in FSU (n = 315) and non-FSU (n = 1,032) Israelis was examined with statistical interaction. Results: Among emigrants from the FSU, parental alcohol problems predicted AUD, NUD, CUD, ASPD, PTSD, EXT, and INT (mean ratios = 1.38–4.83). In non-FSU Israelis, parental alcohol problems predicted only ASPD and PTSD (mean ratios = 1.08–4.09). Significant interactions were observed for AUD, CUD, PTSD, and EXT; each relationship was stronger in FSU Israelis and null (AUD, CUD, EXT) or less robust (PTSD) in other Israelis. Conclusions: Parental alcohol problems were related to substance use and psychiatric disorders differently in FSU and other Israelis, two groups with different alcohol consumption levels and drinking norms. We propose that, in social contexts that vary in the degree to which they constrain alcohol behavior, underlying genetic predispositions may manifest as different disorders.",0,0 +5006,Post-traumatic stress disorder and suicidal behavior: A narrative review,"There is a large literature investigating the underlying mechanisms, risk factors and demographics of suicidal thoughts and behaviors across a number of psychiatric disorders, such as, major depression , anxiety and schizophrenia. However, less research has focused on the relationship between Post-Traumatic Stress Disorder (PTSD) and suicide. There were two broad aims of this review. The first was to assess the extent to which PTSD is associated with suicide, and the second was to determine the effects of co-morbid disorders on this relationship. Overall, there was a clear relationship between PTSD and suicidal thoughts and behaviors irrespective of the type of trauma experienced. Very few studies directly examined whether depression was a mediating factor in the relationships reported. However, where this was investigated, the presence of co-morbid depression appeared to boost the effect of PTSD on suicidality . It was noteworthy that hardly any studies had investigated concepts thought to be key in other domains of research into suicidality, such as, feelings of entrapment, defeat and hopelessness.",0,0 +5007,World assumptions and the role of trauma in borderline personality disorder,"The present study tested whether borderline personality disorder (BPD) is characterized by specific worldviews as hypothesized by cognitive models, using Janoff-Bulman's [(1989) Social Cognition, 7, 113-136] world assumptive model of negative effects of trauma. A second aim of this study was to investigate the role of trauma in the content of worldviews of BPD patients. Fifteen BPD patients, 14 patients with Cluster C personality disorders (PD), 19 patients with axis-I psychopathology and 21 non-patients filled out the World Assumptions Scale, the Personality Disorder Belief Questionnaire, a childhood trauma checklist (assessing physical, emotional and sexual abuse) and the BPD Checklist (severity of BPD psychopathology). BPD patients appear to view the world as malevolent and perceive less luck independent of trauma but dependent of BPD psychopathology. Furthermore, BPD patients have low self-worth and persist in specific beliefs independent of trauma or severity of BPD psychopathology. Pretzer's theory of BPD can be largely supported through Janoff-Bulman's world assumptive model. World assumptions of BPD patients can better be explained by the severity of BPD psychopathology than by the presence of trauma.",0,0 +5008,Diagnostic mistakes in Post-Traumatic Stress Disorder. The problem of symptom overlap with Depression,"Cel The overlap between symptoms of PTSD and MDD is substantial. PTSD symptoms arise after a traumatic experience and the trauma is present in all of the diagnostic clusters. In individuals who have experienced a trauma a long time previously, it is difficult to establish the exact moment of onset of their symptoms in relation to the trauma suffered. We proposed to raise awareness among operators who may encounter this problem, with the aim of providing them with valuable help in order to achieve a correct differential diagnosis. Metoda A sample of subjects suffering from PTSD without comorbidity was assessed to confirm the diagnosis and the severity of post-traumatic symptoms. The Kruskal-Wallis test was used to compare any modifications in the parameters analyzed through the Davidson Trauma Scale with the presence and severity of depressive symptoms as evaluated by the Hamilton-D scale. Wyniki Half of the PSTD patients recruited showed values of HAM-D > 18, although an active Major Depressive Episode was clinically excluded. Symptom of ""numbing"", despite being different from the apathy experienced in depression, is identified as a depressive symptom by the HAM-D. Wnioski Giving prevalence to depressive symptoms may be misleading for diagnosis and ultimately result in inappropriate treatment.",0,0 +5009,Planning for Burn Disasters: Lessons Learned From One Hundred Years of History,"The terrorist attacks of September 11th have prompted interest in developing plans to manage thousands of burn casualties. There is little actual experience in the United States in managing disasters of this magnitude. As an alternative, lessons may be learned from the historical experiences of previous civilian burn or fire disasters occurring in this country. A review of relevant medical, fire service, and popular literature pertaining to civilian burn or fire disasters occurring in the United States between the years 1900 and 2000 was performed. In the 20th century, 73 major U.S. fire or burn disasters have occurred. With each disaster prompting a strengthening of fire regulations or building codes, the number of fatalities per incident has steadily decreased. Detailed examination of several landmark fires demonstrated that casualty counts were great but that most victims had fatal injuries and died on the scene or within 24 hours. A second large cohort comprised the walking wounded, who required minimal outpatient treatment. Patients requiring inpatient burn care comprise a small percentage of the total casualty figure but consume enormous resources during hospitalization. Burn mass casualty incidents are uncommon. The number of casualties per incident decreased over time. In most fire disasters, the majority of victims either rapidly die or have minimal injuries and can be treated and released. As a result, most disasters produce fewer than 25 to 50 patients requiring inpatient burn care. This would be a rational point to begin burn center preparations for mass casualty incidents. A robust outpatient capability to manage the walking wounded is also desirable.",0,0 +5010,Disaggregating the Relationship Between Posttraumatic Stress Disorder Symptom Clusters and Chronic Orofacial Pain: Implications for the Prediction of Health Outcomes with PTSD Symptom Clusters,"Research has established a significant relationship between posttraumatic stress disorder (PTSD) symptoms and pain; however, very little research has examined the differential role of PTSD symptom clusters on pain outcomes.(a) To confirm the most appropriate PTSD symptom factor structure for an orofacial pain population and (b) to test a model of prediction of pain outcomes with PTSD symptom clusters.The study was a cross-sectional, retrospective case series of 411 female patients with orofacial pain (mean 41.0 years, SD 13.1). A series of structural equation modeling analyses were conducted to examine five competing models of PTSD symptom clusters.Two four-factor models of PTSD symptom clusters fit the data reasonably well, and differing PTSD symptom clusters predicted different components of pain.To increase predictive utility for pain and for a wide range of health disorders, researchers should examine the unique predictive power of PTSD symptom clusters rather than examining a one-factor model of PTSD symptoms.",0,0 +5011,Risk Factors for Multisymptom Illness in US Army Veterans of the Gulf War,"This research study examined the prevalence of symptoms and identified risk factors for reported symptoms among a group of Army Gulf War (GW) veterans. A survey was mailed to all members of the Ft. Devens cohort in 1997, representing the third assessment of a group that consisted of 2949 US Army soldiers deployed to the Gulf, and was studied initially in 1991. A total of 1290 subjects responded to the mailed survey; aggressive follow-up methods to address non-response bias were employed. Subjects were classified as having multisymptom illness if they reported symptoms from at least two of three symptom categories (fatigue, mood-cognition, musculoskeletal). Sixty percent of the respondents met criteria for multisymptom illness. Female gender, lower levels of education, psychological symptoms, self-reported use of a medical clinic in the Gulf, ingestion of anti-nerve gas pills (pyridostigmine bromide), anthrax vaccination, tent heaters, exposure to oil fire smoke, and chemical odors were significantly related to multisymptom illness in logistic regression analyses. Analyses in which subjects were stratified by level of psychological symptoms revealed different sets of GW-service environmental exposures and suggest that subgroups of GW veterans may have different sets of risk factors.",0,0 +5012,Complex trauma of war captivity: a prospective study of attachment and post-traumatic stress disorder,"Background Victims of war captivity sometimes suffer from complex post-traumatic stress disorder (PTSD), a unique form of PTSD that entails various alterations in personality. These alterations may involve changes in attachment orientation. Method The sample comprised two groups of veterans from the 1973 Yom Kippur War: 103 ex-prisoners of war (ex-POWs) and 106 comparable control veterans. They were assessed at two points in time, 18 years and 30 years after the war. Results Ex-POWs suffered from more post-traumatic symptoms than controls at both measurements points and these symptoms increased only among ex-POWs from Time 1 to Time 2. In addition, both attachment anxiety and attachment avoidance increased with time among ex-POWs, whereas they decreased slightly or remained stable among controls. Finally, the increases in attachment anxiety and avoidance were positively associated with the increase in post-traumatic symptoms among both study groups. Further analyses indicated that early PTSD symptoms predicted later attachment better than early attachment predicted later PTSD symptoms. Conclusions The results suggest that: (1) complex traumas are implicated in attachment orientations and PTSD symptoms even many years after captivity; (2) there is an increase in attachment insecurities (anxiety, avoidance) and an increase in PTSD symptoms decades after the captivity; (3) and post-traumatic stress symptoms predict attachment orientations better than attachment orientations predict an increase in PTSD symptoms.",0,0 +5013,Measurement Differences From Rating Posttraumatic Stress Disorder Symptoms in Response to Differentially Distressing Traumatic Events,"The authors explored differences in posttraumatic stress disorder (PTSD) symptoms as a result of rating symptoms from two separate, differentially distressing traumatic events. In an initial sample of 400 nonclinical participants, the authors inquired through a web survey about previous psychological trauma, instructing participants to nominate their most distressing and second most distressing traumatic events experienced. Using the PTSD Checklist, participants rated their PTSD symptoms separately from these worst and second worst events. Using the four-factor emotional numbing PTSD model in confirmatory factor analysis, results demonstrated evidence supporting separation of PTSD symptom rating sets from two differentially distressing traumas—specifically, the worst and second worst events. Measurement invariance tests revealed that factor loadings did not vary between the worst and second worst event PTSD ratings; item thresholds (indexing symptom severity) differed. Results generally support the recommended PTSD assessment protocol instructing participants to rate PTSD symptoms from a single, worst index event.",0,0 +5014,The Role of Psychopathology and Personality in Rage-Type Homicide: A Review,"This article reviews the role of psychopathology and personality in offenders who have committed acts of rage-type murder. The possible role of depression, PTSD, psychotic disorders, intellectual functioning and alcohol/drug abuse are critically considered. It is argued that although some forms of psychopathology may be indicated in some cases, these still remain in the minority. This seems to be consistent with findings that describe such offenders as ‘apparently normal’. In an attempt to explain this further, the character profile and psychodynamics of personality are reviewed. A pattern of overcontrol is isolated as a key theme that best explains the ‘apparent normality’ of the rage-type offender. The relevance of the DSM-IV classification system of personality disorders for understanding this kind of criminal is considered. It is argued that a particular type of borderline personality organisation, not isolated by the DSM-IV system, best explains this character pattern.",0,0 +5015,Acute Stress Disorder and Posttraumatic Stress Disorder in Victims of Violent Crime,"OBJECTIVE: In a group of crime victims recruited from the community, the authors investigated the ability of both a diagnosis of acute stress disorder and its component symptoms to predict posttraumatic stress disorder (PTSD) at 6 months. METHOD: A mixed-sex group of 157 victims of violent assaults were interviewed within 1 month of the crime. At 6-month follow-up 88% were reinterviewed by telephone and completed further assessments generating estimates of the prevalence of PTSD. RESULTS: The rate of acute stress disorder was 19%, and the rate of subsequent PTSD was 20%. Symptom clusters based on the DSM-IV criteria for acute stress disorder were moderately strongly interrelated. All symptom clusters predicted subsequent PTSD, but not as well as an overall diagnosis of acute stress disorder, which correctly classified 83% of the group. Similar predictive power could be achieved by classifying the group according to the presence or absence of at least three reexperiencing or arousal symptoms. Logistic regression indicated that both a diagnosis of acute stress disorder and high levels of reexperiencing or arousal symptoms made independent contributions to predicting PTSD. CONCLUSIONS: This exploratory study provides evidence for the internal coherence of the new acute stress disorder diagnosis and for the symptom thresholds proposed in DSM-IV. As predicted, acute stress disorder was a strong predictor of later PTSD, but similar predictive power may be possible by using simpler criteria. (Am J Psychiatry 1999; 156:360–366)",0,0 +5016,"The factor structure of psychiatric comorbidity among Iraq/Afghanistan-era veterans and its relationship to violence, incarceration, suicide attempts, and suicidality","The present research examined how incarceration, suicide attempts, suicidality, and difficulty controlling violence relate to the underlying factor structure of psychiatric comorbidity among a large sample of Iraq/Afghanistan-era veterans (N=1897). Diagnostic interviews established psychiatric diagnoses; self-report measures assessed history of incarceration, difficulty controlling violence, suicide attempts, and suicidality. A 3-factor measurement model characterized by latent factors for externalizing-substance-use disorders (SUD), distress, and fear provided excellent fit to the data. Alcohol-use disorder, drug-use disorder, and nicotine dependence were indicators on the externalizing-SUD factor. Posttraumatic stress disorder and depression were indicators on the distress factor. Panic disorder, social phobia, specific phobia, and obsessive-compulsive disorder were indicators on the fear factor. Incarceration was exclusively predicted by the externalizing-SUD factor. Difficulty controlling violence, suicidality, and suicide attempts were exclusively predicted by the distress factor. Contrary to hypotheses, the path from the externalizing/SUD factor to difficulty controlling violence was not significant. Taken together, these findings suggest that the distress factor of psychiatric comorbidity is a significant risk factor for suicidality, suicide attempts, and difficulty controlling violence and could help to explain the frequent co-occurrence of these critical outcomes among returning Iraq/Afghanistan veterans.",0,0 +5017,Personality Profile of Parents of Children with Attention Deficit Hyperactivity Disorder,"Objectives. The present study was carried out aiming to identify the personality profile of parents of children with Attention Deficit Hyperactivity Disorder (ADHD). Methods. This study is of a descriptive, analytic, cross-sectional type in which parents of 6–12-year-old children with ADHD who were referred to the Bozorgmehr Psychiatric Clinic, affiliated with Tabriz University of Medical Sciences, were enrolled. ADHD was diagnosed according to the criteria of DSM-IV-TR and a quasi-structured diagnostic interview (K-SADS-PL). The personality profile of the parents was assessed with the Millon Clinical Multiaxial Inventory-III (MCMI-III). Results. According to the findings of this study, the most common personality problems based on the assessment scales in the MCMI-III belonged to the clinical patterns of depressive personality in 43 persons (25.3%), histrionic personality in 34 persons (20%), and compulsive personality in 29 persons (17.1%). According to discriminant analysis, four scales of somatoform, sadistic, dependence, and though disorder were direct and antisocial scale was reverse significant predictors of membership in the women group. Conclusion. According to the findings of this pilot study, personality disorders are prevalent in parents of ADHD children and mothers suffer from personality disorders more than fathers.",0,0 +5018,"Violence and post-traumatic stress disorder in Sao Paulo and Rio de Janeiro, Brazil: the protocol for an epidemiological and genetic survey","violence is a public health major concern, and it is associated with post-traumatic stress disorder and other psychiatric outcomes. Brazil is one of the most violent countries in the world, and has an extreme social inequality. Research on the association between violence and mental health may support public health policy and thus reduce the burden of disease attributable to violence. The main objectives of this project were: to study the association between violence and mental disorders in the Brazilian population; to estimate the prevalence rates of exposure to violence, post-traumatic stress disorder, common metal disorder, and alcohol hazardous use and dependence: and to identify contextual and individual factors, including genetic factors, associated with the outcomes.one phase cross-sectional survey carried out in Sao Paulo and Rio de Janeiro, Brazil. A multistage probability to size sampling scheme was performed in order to select the participants (3000 and 1500 respectively). The cities were stratified according to homicide rates, and in Sao Paulo the three most violent strata were oversampled. The measurements included exposure to traumatic events, psychiatric diagnoses (CIDI 2.1), contextual (homicide rates and social indicators), and individual factors, such as demographics, social capital, resilience, help seeking behaviours. The interviews were carried between June/2007 February/2008, by a team of lay interviewers. The statistical analyses will be weight-adjusted in order to take account of the design effects. Standardization will be used in order to compare the results between the two centres. Whole genome association analysis will be performed on the 1 million SNP (single nucleotide polymorphism) arrays, and additional association analysis will be performed on additional phenotypes. The Ethical Committee of the Federal University of Sao Paulo approved the study, and participants who matched diagnostic criteria have been offered a referral to outpatient clinics at the Federal University of Sao Paulo and Federal University of Rio de Janeiro.",0,0 +5019,Conceptualizing a Better Understanding of Diagnosing and Treating Posttraumatic Stress Disorder: A Review of Two Case Studies,"Clinical and epidemiological studies have supported the belief that human beings exposed to stressful life events are vulnerable to the symptomatology consistent with posttraumatic stress disorder (PTSD). However, early detection of symptoms consistent with PTSD oftentimes does not occur within the medicolegal arena. The importance of an early and accurate diagnosis is emphasized. Fortunately, the diagnosis of PTSD has become more clearly conceptualized in the DSM-IV criteria. Many of the characteristics consistent with this diagnosis are measured through the use of relatively recently developed and refined psychometric measures including the Posttraumatic Stress Diagnostic Scale, the Trauma Symptom Inventory, and the Personality Assessment Inventory-2. Additional measures including the Computerized Response Bias Test, the Word Memory Test, and the Validity Indicator Profile can detect exaggeration of symptoms without using specific tests for symptom validity. These measures, as well as biochemical determinations, are reviewed and presented along with the over-all structured clinical interviews and mental status examinations of two patients for a better understanding of the multimethod approach which establishes the reliability of the PTSD diagnosis.",0,0 +5020,Occupational Preferences of People Who Have Experienced Sexual Assault,"This study explored how individuals who have experienced sexual assault engage in occupations that require touch. Fifty-seven participants who reported a history of sexual assault and 347 participants who did not report such a history responded to a pilot instrument which was created to analyze college students’ engagement in occupations. Results were categorized into indices to isolate different types of touch. Results suggest that there is a statistically significant difference in the way these two groups go about their daily routines of engaging in occupations, particularly those that involve passive, unexpected, social, and light touch.",0,0 +5021,Clinical approaches to addressing spiritual struggle in veterans with PTSD.,"Trauma survivors often face difficult spiritual challenges as they attempt to reconcile the experience of trauma with their spiritual/religious beliefs. Spirituality has been found to be associated with a range of indices of well-being, and it is a component of many clients' coping skills and treatment strategies. However, many clinicians do not routinely assess or incorporate this domain of functioning in psychological services. This article describes a model for conceptualizing how trauma can impact spirituality by reviewing the possible consequences of each posttraumatic stress disorder (PTSD) symptom cluster on clients' belief systems and spiritual practices. Specific implications for treatment are described for each symptom cluster. A case study highlights many of the spirituality issues and intervention options described in this model. Ethical issues surrounding addressing spiritual factors in trauma survivors are considered, and clinicians are encouraged to further explore this domain with their clients. © 2015 American Psychological Association.",0,0 +5022,"Uncertainty, Posttraumatic Stress, and Health Behavior in Young Adult Childhood Cancer Survivors","Young adult survivors of childhood cancer are at risk for medical late effects, some of which can be managed through health promotion behaviors. However, chronic uncertainty about the future can lead to the development of posttraumatic stress symptoms (PTSS) that can interfere with health promotion behaviors.To test a mediating model for the relationships among uncertainty, PTSS, and health promotion behaviors in young adult survivors of childhood cancer.The design was cross-sectional correlational. A convenience sample was used, and the data were collected using a mailed survey. Study measures included the Mishel Uncertainty in Illness Scale-Community Form, the Posttraumatic Stress Disorder Index, and the Health Promoting Lifestyle Profile II.Forty-six (51.1%) of the eligible survivors responded to the invitation to participate in the study. The analysis was based on data from 45 survivors. The results show that the relationship between PTSS and health promotion behaviors was mediated by uncertainty.Uncertainty is a suitable target for theory-based nursing interventions used to boost health promotion behaviors in young adult survivors of childhood cancer.",0,0 +5023,Longitudinal trajectories of World Trade Center (WTC)-related PTSD symptoms in police and non-traditional WTC responders,"Background: Tens of thousands of traditional and non-traditional first responders were involved in rescue and recovery operations following the September 11th terrorist attacks. These responders endured unprecedented hazardous working conditions and psychological stressors while working at Ground Zero and/or the Staten Island landfill. Previous cross-sectional studies have examined the prevalence of posttraumatic stress disorder (PTSD) in WTC responders; however, little is known about longitudinal trajectories of PTSD symptoms in this population. In this study, we evaluated longitudinal trajectories of World Trade Center (WTC)-related PTSD symptoms in more than 10,000 police and non-traditional WTC responders; we then identified pre-, peri-, and post-9/11 determinants of these trajectories. Methods: Latent growth mixture modeling (LGMM) was utilized to characterize the nature of WTC-related PTSD symptom trajectories amongst 10,835 WTC responders, including 4,035 police responders and 6,800 nontraditional responders, who attended monitoring visits at the CDCestablished WTC Health Program (WTC-HP) an average of 3, 6, and 8 years post-9/11. Multinomial logistic regression analyses were then conducted to assess determinants of the WTC-related PTSD symptom trajectories. Results: LGMM analyses revealed that a 4-class solution optimally characterized longitudinal PTSD symptoms in police WTC responders: resistant (77.8%), delayed-onset (8.5%), recovering (8.4%), and severe chronic (5.3%). In non-traditional WTC responders, a 6-class solution was optimal: resistant (58.0%), recovering (12.3%), severe chronic (9.5%), subsyndromal increasing (7.3%), delayed-onset (6.7%), and moderate chronic (6.2%). A greater proportion of police responders manifested a resilient trajectory (77.8%) compared to non-traditional responders (58.0%). In both police and non-traditional responder groups, increased severity of WTC exposure, prior psychiatric history, greater number of WTC-related medical conditions, and Hispanic ethnicity were strongly associated with symptomatic PTSD trajectories. Family and work social support while working at the WTC site was a protective factor for both groups, while early arrival was protective among nontraditional responders. Conclusion: This study is the first of which we are aware to examine longitudinal trajectories of WTC-related PTSD trajectories in WTC responders. A greater proportion of police responders manifested a resilient trajectory compared to non-traditional responders, which is likely attributable to their greater training and disaster preparedness. These results suggest that greater training in disaster preparedness, as well as peri-disaster familial and work support may help protect against deleterious psychological outcomes in disaster responders, particularly those with risk factors such as prior psychiatric history, Hispanic ethnicity, greater severity of traumatic exposure, and any disaster-related medical co-morbidities.",0,0 +5024,Objective Neuropsychological Deficits in Post-Traumatic Stress Disorder and Mild Traumatic Brain Injury: What Remains Beyond Symptom Similarity?,"This exploratory study intends to characterize the neuropsychological profile in persons with post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) using objective measures of cognitive performance. A neuropsychological battery of tests for attention, memory and executive functions was administered to four groups: PTSD (n = 25), mTBI (n = 19), subjects with two formal diagnoses: Post-traumatic Stress Disorder and Mild Traumatic Brain Injury (mTBI/PTSD) (n = 6) and controls (n = 25). Confounding variables, such as medical, developmental or neurological antecedents, were controlled and measures of co-morbid conditions, such as depression and anxiety, were considered. The PTSD and mTBI/PTSD groups reported more anxiety and depressive symptoms. They also presented more cognitive deficits than the mTBI group. Since the two PTSD groups differ in severity of PTSD symptoms but not in severity of depression and anxiety symptoms, the PTSD condition could not be considered as the unique factor affecting the results. The findings underline the importance of controlling for confounding medical and psychological co-morbidities in the evaluation and treatment of PTSD populations, especially when a concomitant mTBI is also suspected.",0,0 +5025,Biological and psychological monitoring of training status during an entire season in top kayakers.,"The aim of this study was to analyze changes in selected biological and psychological variables in a group of top level kayakers along a 42-week training season.Eight top junior sprint kayakers (age=16.8±2.1) (5 men and 3 women) with international competitive experience participated in the research. During the 42-wk season the subjects were tested in three occasions: (T1) in the second week of the general training period, (T2) at the beginning of the specific training period, (T3) at the beginning of the competitive training period. Firstly, subjects were asked to complete the Recovery-Stress Questionnaire for Athletes (RESTQ-Sport) and the Profile of Mood States (POMS) questionnaires, and Borg´s rate of perceived exertion scale (RPE). Immediately after, blood samples were collected and white blood cells, creatine kinase (CK), C-reactive protein (CRP), myeloperoxidase protein levels (MPO) and glutathione status were determined. ANOVA with repeated measures was used to determine the differences between tests.From the hematological and biochemical measures only total leukocytes changed significantly, increasing at T3 when compared to T1. There were no differences along the entire season in both RESTQ-Sport and POMS scores or indices. Concerning performance, the group improved their maximal strength (+17.4% in bench-press 1RM) and their specific-distance time (+9.8%). The main finding of the present study was that training was well-balanced between stress and recovery because while specific performance increased, signs of overtraining were not found.Training monitoring in athletes should be performed in a multilevel approach using measurements of performance as well as biological or psychological parameters.",0,0 +5026,A prospective study of the relation between posttraumatic stress and physical health symptoms,"This ex post facto prospective study investigated whether symptoms of posttraumatic stress disorder (PTSD) are associated with increased physical health problems, while controlling for base-rates of symptoms and individual differences in neuroticism. Dutch army soldiers completed standardized questionnaires before they were deployed to Iraq (n = 479), and about 5 months (n = 382; 80%) and 15 months (n = 331; 69%) after their return home. PTSD-symptoms were evaluated by questionnaires and clinical interviews. The results showed that, on average, participants with PTSD at 5 months reported increased physical problems after deployment. PTSD-symptoms at 5 months predicted coexisting physical symptoms, after controlling for demographic variables, military factors, injury sustained on deployment, war-zone exposure on deployment, baseline physical problems, baseline PTSD-symptoms, and neuroticism. PTSD-symptoms at 5 months also predicted physical problems at 15 months, while controlling for physical symptoms at 5 months. The results suggest that posttraumatic stress contributes to physical symptoms. Clinicians are advised to be attentive to PTSD when individuals present with physical symptoms, and to pay attention to physical symptoms in patients diagnosed with PTSD.",0,0 +5027,The role of frontal EEG asymmetry in post-traumatic stress disorder,"Frontal alpha asymmetry, a biomarker derived from electroencephalography (EEG) recordings, has often been associated with psychological adjustment, with more left-sided frontal activity predicting approach motivation and lower levels of depression and anxiety. This suggests high relevance to post-traumatic stress disorder (PTSD), a disorder comprising anxiety and dysphoria symptoms. We review this relationship and show that frontal asymmetry can be plausibly linked to neuropsychological abnormalities seen in PTSD. However, surprisingly few studies (k = 8) have directly addressed frontal asymmetry in PTSD, mostly reporting that trait frontal asymmetry has little (if any) predictive value. Meanwhile, preliminary evidence suggest that state-dependent asymmetry during trauma-relevant stimulation distinguishes PTSD patients from resilient individuals. Thus, exploring links between provocation-induced EEG asymmetry and PTSD appears particularly promising. Additionally, we recommend more fine-grained analyses into PTSD symptom clusters in relation to frontal asymmetry. Finally, we highlight hypotheses that may guide future research and help to fully apprehend the practical and theoretical relevance of this biological marker.",0,0 +5028,Effect of maternal heat-stress on follicular growth and oocyte competence in Bos indicus cattle,"The objective was to determine whether exposure of Gir (Bos indicus) cows to heat-stress (HS) causes immediate and delayed deleterious effect on follicular dynamics, hormonal profile and oocyte competence. The cows were kept in tie-stalls for an adaptive thermoneutral period of 28 days (Phase I, Days -28 to -1). In Phase II (Days 0-28) cows were randomly allocated into control (CG, n=5) and HS (HS, n=5) treatments. The HS cows were placed in an environmental chamber at 38 degrees C and 80% relative humidity (RH) during the day and 30 degrees C, 80% RH during the night for 28 days. The CG group was maintained in shaded tie-stalls (ambient temperature) for 28 days. During Phase III (Days 28-147) animals were placed in tie-stalls (Days 28-42) followed by pasture (Days 42-147) under thermoneutrality. In each phase, weekly ovum pick up (OPU) sessions were to evaluate follicular development, morphology of cumulus-oocyte complexes (COCs), and developmental competence after in vitro maturation, fertilization, and culture. Serum concentrations of progesterone (P(4)) and cortisol were evaluated by radioimmunoassay. Exposure of Gir cows to HS had no immediate effect on reproductive function, but exerted a delayed deleterious effect on ovarian follicular growth, hormone concentrations, and oocyte competence. Heat-stress increased the diameter of the first and second largest follicles from Days 28 to 49. Indeed, HS increased the number of >9 mm follicles (characterized as follicular codominance) during this phase. Cows exposed to HS had longer periods of non-cyclic activity (P(4)<1 ng/mL), as well as shorter estrous cycles. However, HS did not affect cortisol concentration as compared to CG. Although HS had no significant effect on cleavage rate, it reduced blastocyst development during Phase III. In conclusion, long-term exposure of B. indicus cattle to HS had a delayed deleterious effect on ovarian follicular dynamics and oocyte competence.",0,0 +5029,"A study on the relationship between posttraumatic stress disorder in flood victim parents and children in Hunan, China.","To explore the relationship between posttraumatic stress disorder (PTSD) in flood victim parents and children in Hunan, China.Using the method of multistage cluster random sampling, we conducted a retrospective investigation on 3,698 families in Hunan, China who suffered from flooding in 1998. Investigators held face-to-face interviews with the parents and children of the families. The diagnosis of PTSD was made according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. The comparison of rate of PTSD positive in the groups of children with different characteristics was done by chi-square test. In the evaluation of the impact of parent PTSD on PTSD in their children, we used a multivariable logistic regression model to re-estimate the adjusted Odds Ratio and its confidence interval. We did this after the possible confounding variables were adjusted for. Additionally, the Odds Ratio and its confidence interval were estimated under the condition of a single variable.A total of 4,327 children and the parents of 3,292 families were included for analysis; 203 (4.7%) of 4,327 children and 740 (11.2%) of 6,584 parents were diagnosed with PTSD. We found that the PTSD positive rate is significantly higher in the children with disaster-related experience. The rate of beating their children in PTSD positive fathers (54.9%) was higher than that of PTSD negative fathers (51.2%). No correlation was found between mothers' PTSD and beating their children. The risk of developing PTSD is higher for children living in the families with PTSD parents.The rate of PTSD in 7-14-year-old children is 4.7% in areas in Hunan, China, who suffered from flooding in 1998. The possibility for children to develop PTSD is increased in families with PTSD parents.",0,0 +5030,The Factor Structure of Posttraumatic Stress Disorder Symptoms in Patients With Traumatic Spinal Cord Injuries,"The current study investigated the factor structure of posttraumatic stress disorder (PTSD) symptoms in a sample of 256 patients with traumatic spinal cord injuries (SCI) in China. The confirmatory factor analysis results showed that a five-factor model composed of intrusion, avoidance, emotional numbing, dysphoric arousal, and anxious arousal fits the data significantly better than the tripartite DSM-IV model and the two well-supported four-factor models, and the C3 symptom (inability to recall important aspect of the trauma) loaded weakly on its corresponding factor. Implications and limitations for the results are discussed.",0,0 +5031,Posttraumatic stress disorder in children exposed to intimate partner violence: the clinical picture of physiological arousal symptoms,"ABSTRACTIn recent years, researchers have focused on acquiring a better understanding of the development of posttraumatic stress disorder (PTSD) in children under the age of six following exposure to chronic trauma, such as intimate partner violence (IPV). Despite a number of empirical studies on early childhood PTSD, few have examined how children differ in the clinical presentation of PTSD symptomatology. There may be wide variability in the presentation of symptoms within the four clusters of PTSD symptoms: re-experiencing, alterations in physiological arousal, negative alterations in cognitions and mood, and avoidance. Symptoms of physiological arousal may be particularly difficult for parents and therapists to identify and report on because many of these symptoms are internal sensations (e.g. racing heart beat), and they are most often evaluated out of context (e.g. in reports of past behaviour). Thus, little is known about the presentation of these symptoms in preschoolers. To better identify physio...",0,0 +5032,Probable Posttraumatic Stress Disorder and Disability in Cambodia,"Millions of Cambodians suffered profound trauma during the Khmer Rouge era (1975 to 1979). A joint United Nations-Cambodian tribunal (the ""Khmer Rouge trials"") was empanelled in 2006 to prosecute top Khmer Rouge leaders and began substantive hearings in March 2009.To establish the prevalence of probable posttraumatic stress disorder (PTSD) among adult Cambodians and to assess correlates of PTSD symptoms and disability with perceived justice, desire for revenge, and knowledge of and attitudes toward the trials.A national probability sample of 1017 Cambodians was assembled using a multistage, stratified cluster design, including 813 adults older than 35 years who had been at least 3 years old during the Khmer Rouge era and 204 adults aged 18 to 35 years who had not been exposed to the Khmer Rouge era. Face-to-face interviews were conducted between December 2006 and August 2007.Prevalence of probable PTSD using the PTSD Checklist, Civilian version (cutoff score of 44), and mental and physical disability using the Medical Outcomes Study 12-item Short Form Health Survey.The prevalence of current probable PTSD was 11.2% (95% confidence interval [CI], 8.6%-13.9%) overall and 7.9% (95% CI, 3.8%-12.0%) among the younger group and 14.2% (95% CI, 11.0%-17.3%) in the older group. Probable PTSD was significantly associated with mental disability (40.2% vs 7.9%; adjusted odds ratio [AOR], 7.80; 95% CI, 3.90-15.60) and physical disability (39.6% vs 20.1%; AOR, 2.60; 95% CI, 1.26-5.39). Although Cambodians were hopeful that the trials would promote justice, 87.2% (n = 681) of those older than 35 years believed that the trials would create painful memories for them. In multivariate analysis, respondents with high levels of perceived justice for violations during the Khmer Rouge era were less likely to have probable PTSD than those with low levels (7.4% vs 12.7%; AOR, 0.54; 95% CI, 0.34-0.86). Respondents with high levels of desire for revenge were more likely to have probable PTSD than those with low levels (12.0% vs 7.2%), but the difference was not statistically significant in the multivariate analysis (AOR, 1.76; 95% CI, 0.99-3.11).Probable PTSD is common and associated with disability in Cambodia. Although Cambodians had positive attitudes toward the trials, most were concerned that the trials would bring back painful memories. Now that the trials have begun, longitudinal research is needed to determine the impact of the trials on Cambodians' mental health.",0,0 +5033,Salivary cortisol among American Indians with and without posttraumatic stress disorder (PTSD): Gender and alcohol influences,"Disruptions in hypothalamic-pituitary-adrenal regulation and immunity have been associated with posttraumatic stress disorder (PTSD). We examined the association of PTSD with diurnal rhythms in salivary cortisol in a convenience sample from a population-based study of male and female American Indians. Subjects with and without PTSD were identified from American Indians living on/near a Northern Plains reservation as part of a larger study. Over two days diurnal saliva samples were collected by staff at the University of Colorado Denver Clinical Research Center at waking, 30min after waking, before lunch, and before dinner. Generalized estimating equations linear regression models investigated the influence of PTSD on cortisol over time. The association of a lifetime diagnosis of PTSD with salivary cortisol level was assessed in subjects with complete data (PTSD: n=27; no PTSD n=32) for age, gender, and alcohol consumption in the past month. Subject mean age was 44 years, and 71% were women. When stratified by gender, women with a lifetime diagnosis of PTSD had significantly higher mean cortisol levels throughout the day than women without PTSD (p=0.01); but there was no significant association between PTSD and cortisol levels in men (p=0.36). The cortisol awakening response - the difference in cortisol levels from waking to 30min after waking - was not associated with PTSD in men or women. A lifetime diagnosis of PTSD may influence diurnal cortisol among American Indian women. These effects were independent of influences of current alcohol use/abuse. The unexpected elevation in cortisol in American Indian women with a lifetime diagnosis of PTSD may reflect acute anxiety associated with experiencing a number of novel tests in a strange location (e.g., cardiac imaging, medical, dental exams, etc.), or concurrent depression.",0,0 +5034,Family functioning predicts outcomes for veterans in treatment for chronic posttraumatic stress disorder.,"A longitudinal framework was used to examine the competing hypotheses of (a) whether family functioning predicts changes in posttraumatic stress disorder (PTSD) symptoms or (b) whether PTSD symptoms predict changes in family functioning. Veterans (N = 311) admitted to a treatment program completed a series of questionnaires at 3 time points: at intake, from intake to completion of a treatment program, and at the 6-month follow-up. Alcohol use and general mental health symptoms were also measured at intake. A cross-lagged panel model using structural equation modeling analyses indicated that family functioning was a moderate predictor of PTSD symptoms at posttreatment and at the 6-month follow-up. PTSD was not a significant predictor of family functioning across time and alcohol use, and general mental health symptoms did not affect the overall findings. Further analyses of PTSD symptom clusters indicated that the avoidance symptom cluster was most strongly related to family functioning. Targeting family relationships for treatment may be important in the future for veterans with PTSD.",0,0 +5035,BRAIN ACTIVATION TO FACIAL EXPRESSIONS IN YOUTH WITH PTSD SYMPTOMS,"Objective This study examined activation to facial expressions in youth with a history of interpersonal trauma and current posttraumatic stress symptoms (PTSS) compared to healthy controls (HC). Design and analysis Twenty-three medication-naive youth with PTSS and 23 age- and gender-matched HC underwent functional magnetic resonance imaging (fMRI) while viewing fearful, angry, sad, happy, and neutral faces. Data were analyzed for group differences in location of activation, as well as timing of activation during the early versus late phase of the block. Using SPM5, significant activation (P < .05 FWE [Family-Wise Error] corrected, extent = 10 voxels) associated with the main effect of group was identified. Activation from selected clusters was extracted to SPSS software for further analysis of specific facial expressions and temporal patterns of activation. Results The PTSS group showed significantly greater activation than controls in several regions, including the amygdala/hippocampus, medial prefrontal cortex, insula, and ventrolateral prefrontal cortex, and less activation than controls in the dorsolateral prefrontal cortex (DLPFC). These group differences in activation were greatest during angry, happy, and neutral faces, and predominantly during the early phase of the block. Post hoc analyses showed significant Group × Phase interactions in the right amygdala and left hippocampus. Conclusions Traumatic stress may impact development of brain regions important for emotion processing. Timing of activation may be altered in youth with PTSS.",0,0 +5036,"Fear of recurrence, sense of coherence and posttraumatic stress disorder in haematological cancer survivors","The diagnosis and treatment of cancer has been shown to precipitate posttraumatic stress disorder (PTSD) in some cancer survivors. However few studies have considered the links between cancer-related PTSD and theoretical models of PTSD. This study considers a cognitive model of PTSD by examining the relationship between sense of coherence, and fear of recurrence to posttraumatic stress symptomatology (PTSS) in haematological cancer survivors. Thirty-six participants completed the PTSD Checklist-Civilian Version (PCL-C), the Impact of Events Scale-Revised (IES-R), the sense of coherence scale and two measures of fear of recurrence. Two measures of fear of recurrence were included as no fear of recurrence measures had previously been assessed for reliability and validity on British populations. Seventeen percent of the sample met DSM-IV diagnostic criteria for PTSD. Statistically significant relationships were found between sense of coherence and fear of recurrence and PTSS, raising questions about the possibility of using this construct as a screening measure for vulnerability to PTSD. A relationship was also found between fear of recurrence and PTSS suggesting that cancer-related PTSS may fit within the theoretical model of PTSD considered. Further examination of factors affecting the onset, maintenance and treatment of PTSD in this population is required.",0,0 +5037,The Trauma Symptom Inventory: Factors Associated with Invalid Profiles in a Sample of Combat Veterans with Post-Traumatic Stress Disorder,"The assessment of combat-related post-traumatic stress disorder (PTSD) relies upon self-reported symptoms and the need for indicators of valid reporting is critical. The Trauma Symptom Inventory (TSI) is a testing instrument specific to PTSD which includes validity scales. In a pilot study examining the use of the TSI with combat veterans, 50 male veterans diagnosed with PTSD were administered the TSI. Nineteen percent of the profiles were invalid, all but one based on the Atypical Response Scale. Differences between veterans with valid and invalid TSI profiles are examined in terms of demographic and historical factors, TSI profiles, and individual scale items. The model best able to predict invalid profiles included high scores on subscales measuring dissociative experiences and tension reduction behaviors. Implications for the interpretation of TSI validity scales in assessing combat-related PTSD are discussed.",0,0 +5038,Millennium Cohort: The 2001–2003 baseline prevalence of mental disorders in the U.S. military,"

Abstract

Objectives

The 12-month prevalence of common mental illnesses in the United States is estimated to be 26%, accounting for an increasing fraction of all disability in the general population. The U.S. military is a unique group involved in response and defense during times of conflicts and disasters. The mental health of service members affects organizational productivity and effectiveness and is of great importance to the health of U.S. military members and public health in general.

Study Design and Setting

In the present report, the authors describe the baseline prevalence of mental disorders in a large U.S. military cohort, the Millennium Cohort, established for a 22-year longitudinal study of the health effects of military service. Using crude and weighted prevalence and multivariable logistic regression, the mental health morbidity of the Millennium Cohort is reported for various demographics.

Results

These analyses suggest that although the cohort compares favorably to other populations, there are military subpopulations, including women, younger, less educated, single, white, short-term service, enlisted, and Army members, who are at greater odds for some mental disorders.

Conclusion

With ongoing U.S. involvement in combat operations around the world, these baseline data are essential to assessing long-term mental health morbidity in U.S. military service members.",0,0 +5039,MMPI-2 data for Australian Vietnam veterans with combat-related PTSD,"Considerable attention has been devoted to the MMPI in the assessment of combat-related PTSD. To date, published data have focused almost exclusively on American Vietnam veterans. This study investigated MMPI-2 profiles of 100 Australian Vietnam veterans admitted to an intensive PTSD treatment program. Comparisons with United States (U.S.) data suggested strong similarities between the American and Australian populations in terms of F-scale elevations and typical 3-point code types (8-7-2). However, the American samples showed relatively higher elevations of Scales 4 and 6, suggesting social alienation and a tendency to externalize, while a subgroup of Australian veterans showed a greater propensity for somatization (Scale 1). The results provide overall support for the generalizability of American MMPI data to an alternative cultural group of combat veterans.",0,0 +5040,"Trauma, resilience and saliostasis: effects of treatment in post-traumatic stress disorder","There has been growing interest in the concept of resilience and the question as to whether psychotropic medications or psychosocial treatments might have resilience-enhancing effects. This pilot study investigates resilience in a sample of patients with post-traumatic stress disorder (PTSD) before and after treatment. Effects of treatment with tiagabine, fluoxetine, sertraline alone, and sertraline with cognitive behavioural therapy on resilience were assessed using the Connor-Davidson Resilience Scale (CD-RISC). Changes in resilience after treatment were measured and response to treatment was predicted from demographic, resilience and baseline disability measures. Changes in resilience following treatment were statistically significant. Items that showed the greatest change related to confidence, control, coping, knowing where to turn for help and adaptability. Items showing the least change related to religious and existential aspects of resiliency, effort, acting on a hunch, decision-making and goals. In linear and logistic regression models, gender, baseline CD-RISC score, baseline Sheehan Disability Scale score and an individual item from the CD-RISC scale, 'Sense of Humor', were significant predictors of response to treatment. Treatment of PTSD significantly improved resilience and reduced symptoms in this sample. Further controlled studies are indicated.",0,0 +5041,A cluster analysis of symptom patterns and adjustment in Vietnam combat veterans with chronic posttraumatic stress disorder,"This study investigated whether a subgroup of veterans with malignant posttraumatic stress syndrome, as described by Rosenheck (1985) and Lambert et al. (1996), could be identified via cluster analysis within two samples of Vietnam veterans with combat-related posttraumatic stress disorder (PTSD). In the initial subsample (n = 157), four clusters were identified, including a subgroup that scored consistently higher on measures of interpersonal violence and current physical problems. Similar results were found in the cross-validation subsample (n = 156). These results provide support for the theoretical concept of malignant PTSD and suggest that veterans with chronic PTSD are not homogenous. Whereas some manifest extreme levels of both functional impairment and PTSD symptomatology, others exhibit markedly less functional impairment despite manifesting clinically significant levels of PTSD. Clinicians can consider this heterogeneity in their treatment decisions.",0,0 +5042,Prediction of posttraumatic stress symptoms in children after Hurricane Andrew.,"The authors used an integrative conceptual model to examine the emergence of posttraumatic stress disorder (PTSD) symptoms in 568 elementary school- age children 3 months after Hurricane Andrew. The model included 4 primary factors: Exposure to Traumatic Events, Child Characteristics, Access to Social Support, and Children's Coping. Overall, 62% of the variance in children's self-reported PTSD symptoms was accounted for by the 4 primary factors, and each factor improved overall prediction of symptoms when entered in the analyses in the order specified by the conceptual model. The findings suggest that the conceptual model may be helpful to organize research and intervention efforts in the wake of natural disasters.",0,0 +5043,"Trauma exposure, posttraumatic stress disorder and the effect of explanatory variables in paramedic trainees","Abstract Background Emergency healthcare workers, including trainees and individuals in related occupations are at heightened risk of developing posttraumatic stress disorder (PTSD) and depression owing to work-related stressors. We aimed to investigate the type, frequency, and severity of direct trauma exposure, posttraumatic stress symptoms and other psychopathology amongst paramedic trainees. In order to create a risk profile for individuals who are at higher occupational risk of developing PTSD, we examined risk and resilience factors that possibly contributed to the presence and severity of posttraumatic symptomatology. Methods Paramedic trainees (n = 131) were recruited from a local university. A logistic regression analysis was conducted using the explanatory variables age, gender, population group, trauma exposure, depression, alcohol abuse, alcohol dependence, resilience and social support. Results 94% of paramedic trainees had directly experienced trauma, with 16% meeting PTSD criteria. A high rate of depression (28%), alcohol abuse (23%) and chronic perceived stress (7%) and low levels of social support was found. The number of previous trauma exposures, depression, resilience and social support significantly predicted PTSD status and depression had a mediating effect. Conclusion There is a need for efficient, ongoing screening of depressive and PTSD symptomatology in trauma exposed high risk groups so that early psychological supportive interventions can be offered.",0,0 +5044,"Posttraumatic Stress Disorder Symptom Clusters, Alcohol Misuse, and Women's Use of Intimate Partner Violence","Exploring how PTSD and alcohol misuse relate to women's use of intimate partner violence (IPV) is vital to develop our understanding of why some women may engage in IPV, which can serve to maximize intervention efforts for women. This study examined the extent to which posttraumatic stress disorder (PTSD) symptom clusters are directly and indirectly related to women's use of IPV through pathways involving alcohol misuse while controlling for severity of women's IPV victimization. The sample was comprised of substance-using, low socioeconomic status community women (N = 143) currently experiencing IPV victimization. The majority of the sample was African American (n = 115, 80.42%). This sample had an average annual household income of $14,368.68 (SD = $12,800.68) and the equivalent of a high school education (11.94 years, SD = 1.32). Path analyses indicated that the strongest statistical relationship emerged between women's use of IPV and women's IPV victimization. PTSD reexperiencing and numbing symptom severity was related to women's use of psychological, minor physical, and severe physical IPV; however, these relationships were indirect through alcohol misuse. Findings lend preliminary support for the application of the self-medication hypothesis to the study of PTSD, alcohol misuse, and IPV among women.",0,0 +5045,Hippocampus Function Predicts Severity of Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) is often accompanied by memory problems and abnormal brain structure, particularly within the hippocampus. We implemented a cross-species, hippocampal-dependent task--the virtual Morris Water task--to assess hippocampal function in people with PTSD and age-matched controls during functional magnetic resonance imaging (fMRI). Performance on the task was equivalent between the groups. However, when correlating fMRI-derived hippocampal activity during this task with PTSD severity, we observe a -0.84 correlation, indicating that those with reduced hippocampal activity show more severe PTSD symptoms. This correlation is not explained by differences in task performance, IQ, duration since trauma, nor time with PTSD. Hence, PTSD severity is predicted by functionally assessing the hippocampus using the virtual Morris water task, suggesting that this task may be used to identify those at risk for developing PTSD following a trauma.",0,0 +5046,PTSD comorbidity and suicidal ideation associated with PTSD within the Ohio Army National Guard.,"To study the relation between posttraumatic stress disorder (PTSD) psychiatric comorbidity and suicidal ideation in a representative sample of Ohio Army National Guard soldiers.Using retrospective data collected on the telephone from a random sample of 2,616 National Guard soldiers who enrolled in a 10-year longitudinal study (baseline data collected November 2008-November 2009), we examined (1) the prevalence of other psychopathologies among those with DSM-IV-diagnosed PTSD compared to those without PTSD and (2) the association between PTSD comorbidity and suicidal ideation (reporting thoughts of being better off dead or hurting themselves). All analyses were carried out using logistic regression.Of guard members with PTSD in the last year, 61.7% had at least 1 other psychopathology; 20.2% had at least 2 other co-occurring conditions. The most common co-occurring psychopathology was depression. While those with PTSD overall were 5.4 (95% CI, 3.8-7.5) times more likely to report suicidality than those without PTSD, those who had at least 2 additional conditions along with PTSD were 7.5 (95% CI, 3.0-18.3) times more likely to report suicidal ideation at some point in their lifetime than those with PTSD alone.Soldiers with PTSD were at increased risk for suicidality, and, among those with PTSD, those with at least 2 additional conditions were at the highest risk of suicidal ideation. Future research should address the mechanisms that contribute to multimorbidity in this population and the appropriate treatment methods for this high-risk group.",0,0 +5047,Trauma and Posttraumatic Stress Disorder Among Substance-Using Women Entering Cook County Jail,"In the United States, the number of incarcerated women continues to rise each year, with African American women having the highest incarceration rates. Many women enter prisons and jails with an extensive trauma history, though little is known about the percentage of these individuals suffering from posttraumatic stress disorder (PTSD) and specific trauma exposures they have had based on factors such as homelessness, degree of substance problems, and race. The present study examines a largely African American substance-using population of incarcerated women to determine the impact of various factors on specific traumas reported. We found that individuals reporting symptoms meeting criteria for PTSD had experienced the highest average number of traumas, and those who had ever been homeless also experienced many and varied trauma exposures compared with those who had never been homeless. Higher substance problems were also associated with more trauma exposure. Fewer than 10 percent of the sample met full cr...",0,0 +5048,"Breaking Bad: Two Decades of Life-Course Data Analysis in Criminology, Developmental Psychology, and Beyond","Studies of human development require longitudinal data analysis methods that describe within- and between-individual variation in developmental and behavioral trajectories. This article reviews life-course data analysis methods for modeling these trajectories, as well as their application in studies of antisocial behavior and of crime in childhood, in adolescence, and throughout life. We set the stage by introducing growth curve (hierarchical linear) models. We focus our review on finite mixture models for life-course data, known as group-based trajectory and growth mixture models. We then discuss how these models are applied within criminology and developmental psychology, recent controversies over their substantive use and interpretation, and important issues of statistical practice and the challenges they raise. Building on the critical literature, we offer several recommendations for the applied users of the models. Finally, we present the most recent method of examining behavioral trajectories in criminology, the unimodal curve registration (UCR) approach. We briefly contrast the UCR model with growth curve and finite mixture models for life-course data analysis.",0,0 +5049,Change in posttraumatic stress disorder symptoms: Do clinicians and patients agree?,"This study assessed the longitudinal association between clinician and patient ratings of posttraumatic stress disorder (PTSD) symptoms over the course of 2 different randomized clinical trials of veterans with chronic PTSD. One trial, the Department of Veterans Affairs Cooperative Study 420 (CSP 420; N = 360) compared trauma-focused and present-centered group therapies, and the 2nd trial compared cognitive processing theory and a waitlist control condition (N = 60). Linear mixed effects modeling revealed significant associations between clinician ratings (Clinician-Administered PTSD Scale; CAPS; D. D. Blake et al., 1990) and patient ratings (Posttraumatic Stress Disorder Checklist; PCL; F. W. Weathers, B. T. Litz, J. A. Herman, J. A. Huska, & T. M. Keane, 1993) in total and symptom clusters of PTSD. Contrary to hypothesis, the amount of change on the CAPS ranged from .75 to .82 standard deviations for every 1 standard deviation change on the PCL. The CAPS and PCL were more closely associated in the trauma-focused vs. present-centered treatment condition in CSP 420, and especially regarding hyperarousal symptoms. When comparing categorization of clinically significant change on the CAPS and PCL, the authors found no differences in the percentages of agreement between clinicians and patients in improvement and exacerbation. The value of multimodal assessment of PTSD treatment outcomes is discussed.",0,0 +5050,,"BACKGROUND: Peritraumatic response, as currently assessed by Posttraumatic Stress Disorder (PTSD) diagnostic criterion A2, has weak positive predictive value (PPV) with respect to PTSD diagnosis. Research suggests that indicators of peritraumatic autonomic activation may supplement the PPV of PTSD criterion A2. We describe the development and factor structure of the STRS (Shortness of Breath, Tremulousness, Racing Heart, and Sweating), a one page, two-minute checklist with a five-point Likert-type response format based on a previously unpublished scale. It is the first validated self-report measure of peritraumatic activation of the autonomic nervous system. METHODS: We selected items from the Potential Stressful Events Interview (PSEI) to represent two latent variables: 1) PTSD diagnostic criterion A, and 2) acute autonomic activation. Participants (a convenience sample of 162 non-treatment seeking young adults) rated the most distressing incident of their lives on these items. We examined the factor structure of the STRS in this sample using factor and cluster analysis. RESULTS: Results confirmed a two-factor model. The factors together accounted for 68% of the variance. The variance in each item accounted for by the two factors together ranged from 41% to 74%. The item loadings on the two factors mapped precisely onto the two proposed latent variables. CONCLUSION: The factor structure of the STRS is robust and interpretable. Autonomic activation signs tapped by the STRS constitute a dimension of the acute autonomic activation in response to stress that is distinct from the current PTSD criterion A2. Since the PTSD diagnostic criteria are likely to change in the DSM-V, further research is warranted to determine whether signs of peritraumatic autonomic activation such as those measured by this two-minute scale add to the positive predictive power of the current PTSD criterion A2. Additionally, future research is warranted to explore whether the four automatic activation items of the STRS can be useful as the basis for a possible PTSD criterion A3 in the DSM-V.",0,0 +5051,The presence of post-traumatic stress disorder symptoms in earthquake survivors one month after a mudslide in southwest China,"The psychological impact of a mudslide on survivors of the Wenchuan earthquake in China and the risk factors for development of disaster-related post-traumatic stress disorder (PTSD) were investigated. The study design was cross-sectional and included 1321 survivors who had endured both an earthquake and a mudslide. Participants filled out a self-report questionnaire. One month after the mudslide, the rate of PTSD symptoms was 18.7%. Females, the elderly, those with lower educational levels, those that lacked social support, those who did not take precautionary measures, those living with children below 6 years of age, and those who had higher exposure to traumatic events experienced a higher level of PTSD symptoms. Results indicated that timely rescue, abundant material help, and mental rehabilitation after a disaster play important roles in recovery, and that there are still some high-risk groups that need attention, care, and effective intervention from healthcare professionals and society.",0,0 +5052,Personal and familial correlates of bipolar (BP)-I disorder in children with a diagnosis of BP-I disorder with a positive child behavior checklist (CBCL)-severe dysregulation profile: A controlled study,"Although the DSM-IV provides explicit criteria for the diagnosis of BP-I disorder, this is a complex diagnosis that requires high levels of clinical expertise. Previous work shows children with a unique profile of the CBCL of high scores (2SD) on the attention problems (AP), aggressive behavior (AGG), and anxious-depressed (AD) (A-A-A) subscales are more likely than other children to meet criteria for BP-I disorder in both epidemiological and clinical samples. However, since not all BP-I disorder children have a positive profile questions remain as to its informativeness, particularly in the absence of an expert diagnostician.Analyses were conducted comparing personal and familial correlates of BP-I disorder in 140 youth with a structured interview and an expert clinician based DSM-IV diagnosis of BP-I disorder with (N=80) and without (N=60) a positive CBCL- Severe Dysregulation profile, and 129 controls of similar age and sex without ADHD or a mood disorder. Subjects were comprehensively assessed with structured diagnostic interviews and wide range of functional measures. We defined the CBCL-severe dysregulation profile as an aggregate cut-off score of ≥ 210 on the A-A-A scales.BP-I probands with and without a positive CBCL-severe dysregulation profile significantly differed from Controls in patterns of psychiatric comorbidity, psychosocial and psychoeducational dysfunction, and cognitive deficits, as well as in their risk for BP-I disorder in first degree relatives.Because the sample was referred and largely Caucasian, findings may not generalize to community samples and other ethnic groups.A positive CBCL-severe dysregulation profile identifies a severe subgroup of BP-I disorder youth.",0,0 +5053,Psychiatric Sequelae of Posttraumatic Stress Disorder in Women,"The risk for first-onset major depression, anxiety, and substance use disorders associated with prior posttraumatic stress disorder (PTSD) was estimated in a sample of women.The National Institute of Mental Health Diagnostic Interview Schedule, revised according to DSM-III-R, was used to measure lifetime psychiatric disorders in a stratified random sample of 801 mothers of children, who participated in a study of cognitive and psychiatric outcomes by level of birth weight. Cox proportional hazards models with time-dependent covariates were used to calculate the hazards ratios of first onset of other disorders following PTSD.The lifetime prevalence of traumatic events was 40% and of PTSD, 13.8%. Posttraumatic stress disorder signaled increased risks for first-onset major depression (hazards ratio, 2.1) and alcohol use disorder (hazards ratio, 3.0). The risk for major depression following PTSD was of the same magnitude as the risk for major depression following other anxiety disorders. Women with preexisting anxiety and PTSD had significantly increased risk for first-onset major depression. Additional analysis showed that preexisting major depression increased women's vulnerability to the PTSD-inducing effects of traumatic events and risk for exposure to traumatic events.Posttraumatic stress disorder influences the risk for first-onset major depression and alcohol use disorder. The causal explanation of these temporally secondary disorders is unclear and might involve the effect of PTSD or underlying vulnerabilities exposed by the traumatic experience.",0,0 +5054,Heterogeneous Patterns of Stress Over the Four Years of College: Associations With Anxious Attachment and Ego-Resiliency,"Objective A growing body of literature suggests that college students display alarming rates of psychological distress. However, studies of responses to significant life stressors in other contexts have found that people respond in heterogeneous ways and that attachment style and ego-resiliency mitigate the effects of stressors on mental health. Method Individual differences in distress among a cohort of students (N = 157; Mean age = 18.8 years, 62.6% female) across the four years of college were analyzed using latent class growth analysis. Trajectories were then regressed on levels of anxious and avoidant attachment and ego-resiliency. Results Four discrete patterns emerged characterized by healthy and maladaptive patterns of stress response, indicating that students respond to college in heterogeneous ways. Several patterns showed significant variability in distress by semester. Low levels of anxious but not avoidant attachment predicted membership in the stable-low distress or resilient class while ego-resiliency predicted membership in both the resilient and moderate distress classes. Conclusions Findings indicate that low levels of anxious attachment and the ability to flexibly cope with adversity may be associated with better mental health throughout college. Implications from stress response and developmental perspectives are discussed.",0,0 +5055,RISK FACTORS FOR ANXIETY DISORDERS: COMMON AND SPECIFIC EFFECTS IN A NATIONAL SAMPLE,"Anxiety disorders and major depressive disorder (MDD) often co-occur and share a broad range of risk factors. The goal of this study was to examine whether the co-occurrence of anxiety disorders and MDD could be explained by an underlying latent factor and whether the risk factors exert their effect exclusively through this factor, directly on each disorder, or through a combination of effects at both levels.Data were drawn from a large, nationally representative sample. Confirmatory factor analysis was used to identify the latent structure of anxiety disorders. A multiple indicators multiple causes (MIMIC) approach was used to assess the common and specific effects of risk factors for anxiety disorders.A one-factor model provided a good fit to the co-occurrence of anxiety disorders. Low self-esteem, family history of depression, female sex, childhood sexual abuse, White race, years of education, number of traumatic experiences, and disturbed family environment increased the risk of anxiety disorders and MDD through their effect on the latent factor. There were also several direct effects of the covariates on the disorders, indicating that the effect of the covariates differed across disorders.Risk for anxiety disorders and MDD appears to be mediated partially by a latent variable underlying anxiety disorders and MDD, and partially by disorder-specific effects. These findings may contribute to account for the high rates of comorbidity among disorders, identify commonalities in the etiologies of these disorders, and provide clues for the development of unified preventive interventions.",0,0 +5056,Selecting the appropriate psychotherapies for individuals with traumatic brain injury: What works and what does not?,"When traditional psychotherapy is provided to patients with traumatic brain injuries (TBIs), the primary focus is on treating mood changes such as depression, anxiety or anger. However, traditional psychotherapeutic methods developed specifically for mood changes fall short when treating most TBI patients. In large part, this is because the psychological adjustment difficulties that most TBI patients face are linked to life-altering changes that are interwoven with permanent physical, cognitive, and social sequelae. In addition, mood changes in TBI patients are also caused by vocational and financial losses.The sudden onset of these unfamiliar and interdependent problems necessitates a psychotherapeutic approach that acknowledges the inherent challenges of coping with multiple life-altering changes. For patients who experience a shattered sense of self, interventions need to be explored to make life meaningful following a TBI.An existentially-oriented approach is introduced in the following steps: (1) identifying pre-injury future expectations, (2) examining how the TBI has altered these expectations, (3) grieving the loss of the expected future, and (4) developing a realistic future that is existentially meaningful.Pivotal gains are achieved when patients rebuild their lives according to their own core values.TBI patients can benefit from existential psychotherapy.",0,0 +5057,Partial least squares based gene expression analysis in posttraumatic stress disorder.,"Posttraumatic stress disorder (PTSD) is an adverse psychological response to traumatic events. Microarray technology for large-scale gene expression analysis facilitates the identification of signatures that underlie the pathogenesis of PTSD. Previous studies mostly used variance/regression analysis without considering array specific factors. We aim to investigate the underlying mechanism of PTSD through partial least squares (PLS) based analysis.With a gene expression profile data set for 17 chronic PTSD patients and 16 controls recovered from psychological trauma from the Gene Expression Omnibus (GEO) database, we performed Partial Least Square (PLS) based analysis.We acquired 230 down-regulated genes and 335 up-regulated genes. Significantly increased representations of dysregulated genes in immune, endocrine and nervous pathways were identified. Among the top 5 hub genes in the network, PRKCA has been reported to be related with PTSD before. Three other genes, TP53, EP300 and CALM1 might also contribute to the pathogenesis of PTSD since they are all related with other neuronal disorders.Our findings shed light on expression signatures of PTSD with the hope to give further theoretical supports for future therapeutic study.",0,0 +5058,A Longitudinal Study of Retirement in Older Male Veterans.,"In this study, the authors examined the effect of retirement on psychological and physical symptoms in 404 older male veterans who were taking part in an ongoing longitudinal study. Hierarchical linear modeling was used to analyze symptom trajectories from preretirement, peri-retirement, and postretirement periods in veterans with either lifetime full or partial posttraumatic stress disorder (PTSD), trauma exposure only, or no traumatic exposure. As expected, the PTSD group experienced greater increases in psychological and physical symptoms during retirement, relative to the other groups. Retirement due to poor health in the PTSD group did not account for the findings regarding physical symptoms. Results indicate that clinicians should recognize and address the potential for older individuals with PTSD to experience difficulties during retirement.",0,0 +5059,Using the Excess Heat Factor (EHF) to predict the risk of heat related deaths,"Extremes of climate are not uncommon in Australia and heatwaves are not infrequent. Periods of high ambient temperature may result in clusters of heat related deaths, which may place strain on forensic facilities. This paper describes the formulation of the Excess Heat Factor using meteorological data to provide a means of predicting death resulting from periods of extreme heat stress. The 2009 South Australian heatwave had the highest ranked Excess Heat Factor in Adelaide's records. There were 58 heat related deaths, with the bulk of the heat related deaths following the peak Excess Heat Factor value (144 °C(2)). The 2008 heatwave had a lower peak Excess Heat Factor value (36 °C(2)); there was only one heat related death, which followed the peak in the Excess Heat Factor. It is proposed that calculation of the Excess Heat Factor from meteorological data could provide a means to predict and identify heat related deaths resulting from extreme weather conditions.",0,0 +5060,Differential Effects of Anxiety Sensitivity Components in the Relation Between Emotional Non-Acceptance and Post-traumatic Stress Symptoms Among Trauma-Exposed Treatment-Seeking Smokers,"Anxiety sensitivity (AS), defined as the extent to which individuals believe anxiety and anxiety-related sensations have harmful consequences, may play an important explanatory role in the relation between emotional non-acceptance and the expression of traumatic stress symptoms among trauma-exposed smokers. This investigation examined whether lower-order dimensions of AS (cognitive, physical, and social concerns) differentially explain the relation between emotional non-acceptance and post-traumatic stress (PTS) symptom clusters (re-experiencing, avoidance, hyperarousal) among trauma-exposed daily smokers (N = 169, 46% female; Mage = 41, SD = 12.3). AS and its lower-order facets of cognitive and social concerns were found to mediate the relations between emotional non-acceptance and avoidance and hyperarousal PTS symptoms. Using a multiple mediation model, the mediational effect of AS cognitive concerns for the relation between emotional non-acceptance and post-traumatic avoidance symptoms was found to be uniquely evident relative to social and physical concerns. All observed AS effects were evident above and beyond the variance accounted for by gender, number of traumatic event exposure types, negative affectivity, number of cigarettes smoked per day, and alcohol use problems. The present findings suggest cognitive-based AS concerns may play a mechanistic role in the relation between emotional non-acceptance and certain PTS symptoms among trauma-exposed daily smokers.",0,0 +5061,The latent structure of posttraumatic stress disorder: Different models or different populations?,"Factor analytic studies of the structure of self-reported posttraumatic stress disorder (PTSD) symptoms have consistently supported two 4-factor models; the ""Dysphoria"" and the ""Emotional Numbing"" model. The fit of both models has been satisfactory; however, it has been difficult to unequivocally determine which model is best. This study aimed to test the hypothesis that there is no single ""correct"" model, but rather that the models represent different subpopulations. A confirmatory factor 2-class mixture model was specified with the Dysphoria model in one class and the Emotional Numbing model in the other. This model was tested using data from participants from 4 trauma groups. This model fitted the data better than 1 and 2-class models of the Dysphoria, Emotional Numbing, and cross-factor loading model. It was concluded that the search for the ""correct"" model of PTSD based on the assumption of a single homogenous population may not be a worthwhile research endeavor.",0,0 +5062,Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample.,"The factor structure, reliability, and validity of the Depression Anxiety Stress Scales (DASS; S. H. Lovibond & P. F. Lovibond, 1995) and the 21-item short form of these measures (DASS-21) were examined in nonclinical volunteers (n = 49) and patients with Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) diagnoses of panic disorder (n = 67), obsessive-compulsive disorder (n = 54), social phobia (n = 74), specific phobia (n = 17), and major depressive disorder (n = 46). This study replicates previous findings indicating that the DASS distinguishes well between features of depression, physical arousal, and psychological tension and agitation and extends these observations to the DASS-21. In addition, the internal consistency and concurrent validity of the DASS and DASS-21 were in the acceptable to excellent ranges. Mean scores for the various groups were similar to those in previous research, and in the expected direction. The implications of these findings are discussed.",0,0 +5063,Posttraumatic stress disorder and psychosocial functioning within two samples of MVA survivors,"To examine criterion F variables of PTSD, the psychosocial functioning of two samples of motor vehicle accident (MVA) survivors was investigated. Within each sample, comparisons between MVA survivors with and without PTSD were conducted on four psychosocial functioning indices at three time points. In addition, the relationships between specific PTSD symptom clusters and psychosocial functioning indices were examined. The study revealed that, in general, MVA survivors with PTSD evidenced poorer psychosocial functioning than did survivors without PTSD. The emotional numbing symptoms of PTSD emerged as the most consistent predictors of the psychosocial functioning indices. The implications of these findings to the comprehensive treatment of PTSD are discussed.",0,0 +5064,Psychological Sequelae of the September 11 Terrorist Attacks in New York City,"The scope of the terrorist attacks of September 11, 2001, was unprecedented in the United States. We assessed the prevalence and correlates of acute post-traumatic stress disorder (PTSD) and depression among residents of Manhattan five to eight weeks after the attacks.We used random-digit dialing to contact a representative sample of adults living south of 110th Street in Manhattan. Participants were asked about demographic characteristics, exposure to the events of September 11, and psychological symptoms after the attacks.Among 1008 adults interviewed, 7.5 percent reported symptoms consistent with a diagnosis of current PTSD related to the attacks, and 9.7 percent reported symptoms consistent with current depression (with ""current"" defined as occurring within the previous 30 days). Among respondents who lived south of Canal Street (i.e., near the World Trade Center), the prevalence of PTSD was 20.0 percent. Predictors of PTSD in a multivariate model were Hispanic ethnicity, two or more prior stressors, a panic attack during or shortly after the events, residence south of Canal Street, and loss of possessions due to the events. Predictors of depression were Hispanic ethnicity, two or more prior stressors, a panic attack, a low level of social support, the death of a friend or relative during the attacks, and loss of a job due to the attacks.There was a substantial burden of acute PTSD and depression in Manhattan after the September 11 attacks. Experiences involving exposure to the attacks were predictors of current PTSD, and losses as a result of the events were predictors of current depression. In the aftermath of terrorist attacks, there may be substantial psychological morbidity in the population.",0,0 +5065,Avoidance symptoms and delayed verbal memory are associated with post-traumatic stress symptoms in female victims of sexual violence,"Victimization by sexual violence is strongly associated with the development of posttraumatic stress disorder (PTSD). While several psychological and cognitive factors are known to be associated with PTSD prognosis, multivariable analysis is scarce. This study examined factors affecting the severity of PTSD symptoms in early stage of traumatic experience of sexual violence, including initial post-traumatic symptoms and cognitive characteristics.Participants were recruited from the center for women and children victims of violence in a university hospital. Thirty-four sexual assault victims were assessed at the baseline and the second visit one to five months after the baseline. At the baseline, an array of posttraumatic symptoms and cognitive functions were measured: at follow-up, PTSD symptoms were determined by Clinician Administered PTSD Scale.Stepwise multiple regression showed that avoidance symptoms (β = 0.551, P < 0.01) and delayed verbal memory (β = -0.331, P < 0.05) at early stage of trauma predicted the severity of PTSD symptoms one to five month later. The regression model, factoring in avoidance and delayed verbal memory, showed a 34.9% explanatory power regarding the PTSD symptom severity.This study suggests that avoidance symptoms and verbal memory at the early stage of trauma are associated with later PTSD symptoms. It is also suggested that early intervention targeting avoidance symptoms may be beneficial in decreasing PTSD symptoms.",0,0 +5066,Post-traumatic stress disorder among adult survivors of the Wenchuan earthquake in China: a repeated cross-sectional study.,"The objective of the study was to examine trends in the prevalence of Posttraumatic Stress Disorder (PTSD) in Wenchuan, China, over the four-year period following its 2008 earthquake, and to explore the risk factors related to current PTSD. Chi-square analysis and multivariate logistic regression analysis were used to assess PTSD morbidity and identify associated risk factors. The results indicated that the prevalence of PTSD was 58.2% at two months, 22.10% at 8 months, 19.8% at 14 months, 19.0% at 26 months, and 8.0% at about 44 months after the earthquake. Female gender, being married, low education, non-drinking, and poor self-perceived health status were significantly associated with PTSD during the early period following the earthquake. Depression was significantly associated with survivors' PTSD throughout the study period.",0,0 +5067,Neuroendocrinology and psychiatric illness,"Evidence for a role of neurohormones in psychiatric disease is greatest for illnesses in the affective disorder spectrum, which we argue includes melancholic and atypical depression, anorexia nervosa, bulimia nervosa, posttraumatic stress disorder, and panic disorder. These illnesses are associated with signs of hypothalamic dysfunction and have similar profiles of neuroendocrine dysregulation. In contrast, the data are much less clear for an intrinsic role of neuroendocrine dysregulation in schizophrenia, obsessive-compulsive disorder, or other anxiety disorders. This difference may reflect the fact that schizophrenia and obsessive-compulsive disorder represent more 'structural' abnormalities, or it may reflect greater diagnostic heterogeneity, which makes the elucidation of specific alterations in neurohormonal systems impossible.",0,0 +5068,Questioning Psychosocial Resilience After Flooding and the Consequences for Disaster Risk Reduction,"This paper questions George Bonanno’s concept of resilience as “relatively stable, healthy levels of psychological and physiological functioning” (Bonanno in Am Psychol 59(1):20–28, 2004) following potentially traumatic events (PTE). It agrees with Bonanno’s claim that significant numbers of people may suffer from mental disorders following a PTE, but disagrees that the majority of people are resilient. Furthermore it argues that we should not see PTEs as one event, but as involving a number of stressors and having a variety of consequences. Drawing on fieldwork carried out in Rajni village, Bihar following the 2008 Kosi River flooding, it documents, 18 months post flood, that flood onset gave rise to symptoms related to Post Traumatic Stress Disorder (primarily re-experiencing). The villagers’ primary concern was livelihood loss which, together with their lack of hope for the future, led to symptoms of depression. It argues that mental health issues should be fully integrated into Disaster Risk Reduction plans and policies, which are likely to be included in the Post-2015 Millennium Development Goals. In addition to supporting mental health interventions, the paper suggests that deep socio-cultural changes are necessary to ensure improvements in mental health.",0,0 +5069,The Importance of Being Flexible,"Researchers have documented the consequences of both expressing and suppressing emotion using between-subjects designs. It may be argued, however, that successful adaptation depends not so much on any one regulatory process, but on the ability to flexibly enhance or suppress emotional expression in accord with situational demands. We tested this hypothesis among New York City college students in the aftermath of the September 11th terrorist attacks. Subjects' performance in a laboratory task in which they enhanced emotional expression, suppressed emotional expression, and behaved normally on different trials was examined as a prospective predictor of their adjustment across the first two years of college. Results supported the flexibility hypothesis. A regression analysis controlling for initial distress and motivation and cognitive resources found that subjects who were better able to enhance and suppress the expression of emotion evidenced less distress by the end of the second year. Memory deficits were also observed for both the enhancement and the suppression tasks, suggesting that both processes require cognitive resources.",0,0 +5070,Posttraumatic stress disorder and retrospectively reported stressor exposure: A longitudinal prediction model.,"There has been recent concern about the degree to which posttraumatic stress disorder (PTSD) symptomatology influences reports of prior exposure to highly stressful life events. In this longitudinal study of 2,942 male and female Gulf War veterans, the authors documented change in stressor reporting across 2 occasions and the association between change and PTSD symptom severity. A regression-based cross-lagged analysis was used to examine the relationship between PTSD symptom severity and later reported stressor exposure. Shifts in reporting over time were modestly associated with PTSD symptom severity. The cross-lagged analysis revealed a marginal association between Time 1 PTSD symptom severity and Time 2 reported stressor exposure for men and suggested that later reports of stressor exposure are primarily accounted for by earlier reports and less so by earlier PTSD symptomatology.",0,0 +5071,The valence of attentional bias and cancer-related rumination in posttraumatic stress and posttraumatic growth among women with breast cancer,"Objective: To examine the effects of self-reported attentional bias on posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG) through the potential mediator of cancer-related rumination. Design: A cross-sectional survey design was used and women with breast cancer (N=170) were recruited. Measures: Attentional biases, cancer-related ruminations, PTSD symptoms, and PTG were assessed. Results: Negative attentional bias and negative cancer-related rumination were positively related to PTSD symptoms following cancer diagnosis and treatments, but they were not related to PTG. Positive attentional bias and positive cancer-related rumination were positively related to PTG, but positive attentional bias was not related to PTSD symptoms. Findings showed that negative cancer-related rumination partially mediated the relationship between negative attentional bias and PTSD symptoms, while positive cancer-related rumination partially mediated the relationship between positive attentional bias and PTG. Conclusion: Findings support that there are differential trajectories to PTSD symptoms and PTG with respect to different valence of habitual attentional style and cancer-related rumination. They may serve as potential therapeutic leverages in the alleviation of PTSD symptoms and facilitation of PTG following cancer diagnosis and treatments. Copyright © 2010 John Wiley & Sons, Ltd.",0,0 +5072,A synopsis of recent influential papers published in psychiatric journals (2010–2011) from the Arab World,"Six recent and influential papers that have appeared in the three leading psychiatry journals from the Arab region are summarized in this review. The first paper examined the prevalence of eating disorders (EDs) in rural and urban secondary school girls in Sharkia; more EDs were found among urban than rural population. The second study reported the high prevalence of Post Traumatic Stress Disorder (PTSD) in primary school children in Iraq in context of the present situation in Iraq dominated by violence creating a traumatizing atmosphere for the population, especially children. The third paper reported that substance dependent patients manifest elevated traits of impulsivity; emotionally driven impulsivity in particular predicted substance related problems. The fourth study reported significant cognitive impairments at illness onset in a large sample of patients with a first psychotic episode. The fifth paper, investigated the cultural imprint on symptom profile of mood disorders. Culture effect on mood disorder was more prominent in depression than in mania. The last article examined the relations between social circumstances, medical morbidity, locus of control and depression in elderly patients suffering from medical conditions. Overall, the papers describe a wide spectrum of research initiatives in the Arab World that are likely to have implications for global mental health.",0,0 +5073,A one-year follow-up of post-traumatic stress disorder (PTSD) symptoms and perceived social support in cancer,"Aims Diagnosis of post-traumatic stress disorder (PTSD) symptoms in cancer patients fluctuates over the course of cancer according to the timing of assessment. In this longitudinal study, the prevalence of PTSD symptoms and the association between PTSD symptoms and the buffering variable of perceived social support were examined at one year follow-up.",0,0 +5074,Antidepressants: update on new agents and indications.,"A number of antidepressants have emerged in the U.S. market in the past two decades. Selective serotonin reuptake inhibitors have become the drugs of choice in the treatment of depression, and they are also effective in the treatment of obsessive-compulsive disorder, panic disorder, and social phobia. New indications for selective serotonin reuptake inhibitors include post-traumatic stress disorder, premenstrual dysphoric disorder, and generalized anxiety disorder. Extended-release venlafaxine has recently been approved by the U.S. Food and Drug Administration for the treatment of generalized anxiety disorder. Mirtazapine, which is unrelated to the selective serotonin reuptake inhibitors, is unique in its action--stimulating the release of norepinephrine and serotonin. The choice of antidepressant drug depends on the agent's pharmacologic profile, secondary actions, and tolerability. Sexual dysfunction related to the use of antidepressants may be addressed by reducing the dosage, switching to another agent, or adding another drug to overcome the sexual side effects. Augmentation with lithium or triiodothyronine may be useful in patients who are partially or totally resistant to antidepressant treatment. Finally, tapering antidepressant medication may help to avoid discontinuation syndrome or antidepressant withdrawal.",0,0 +5075,Borderline personality disorder subtypes: A factor analysis of the DSM-IV criteria,"This study examined the underlying factor structure of the DSM-IV criteria to determine whether the diagnosis could be classified into subtypes. It also sought to enhance the clinical interpretation of any identified subtypes by examining their relation to comorbid axis I and II disorders. In 95 treatment-seeking adults (82 women, 13 men), attending a psychiatric outpatient clinic principle components analysis yielded support for three subtypes: ‘affect dysregulation’, ‘rejection sensitivity’ and ‘mentalization failure’. Results of logistic regression analyses indicated that the affect dysregulation subtype was associated with the comorbid diagnosis of generalized anxiety and panic disorder and other cluster B and C personality disorders. The mentalization failure subtype was found to be predictive of posttraumatic stress disorder and other cluster B personality disorders. With further research, confirmation of these subtypes may inform diagnostic revisions and appropriate treatment regimes that are individually designed to target the patients' core symptoms. Copyright © 2012 John Wiley & Sons, Ltd.",0,0 +5076,Chronicity in Posttraumatic Stress Disorder and Predictors of the Course of Posttraumatic Stress Disorder Among Primary Care Patients,"The present study examined the course of posttraumatic stress disorder (PTSD) in a sample of 84 primary care patients. More specifically, this study investigated the role of Axis I comorbidity, psychosocial impairment, and treatment participation in the maintenance of an episode of chronic PTSD and whether patients at follow-up met criteria for PTSD (full remission) or continued to exhibit residual PTSD symptoms and impairment (partial PTSD). Diagnostic structured interviews established all clinical diagnoses and information on the course of anxiety disorder symptoms, psychosocial functioning, and treatment status. Using a prospective, longitudinal design, this study found that during the first 2 years of follow-up, the probability of no longer meeting full DSM-IV criteria for PTSD was .69, and .18 for full remission from PTSD. The number of comorbid anxiety disorders and degree of psychosocial impairment at intake were significantly related to remission status (i.e., full and partial PTSD). This study suggests that, in a primary care setting, PTSD is a persistent illness, and that many subjects who have recovered from PTSD continue to suffer from subthreshold symptoms of PTSD.",0,0 +5077,"Acute stress disorder in hospitalised victims of 26/11-terror attack on Mumbai, India.","The 26/11 terror attacks on Mumbai have been internationally denounced. Acute stress disorder is common in victims of terror. To find out the prevalence and to correlate acute stress disorder, 70 hospitalised victims of terror were assessed for presence of the same using DSM-IV TR criteria. Demographic data and clinical variables were also collected. Acute stress disorder was found in 30% patients. On demographic profile and severity of injury, there were some interesting observations and differences between the victims who developed acute stress disorder and those who did not; though none of the differences reached the level of statistical significance. This study documents the occurrence of acute stress disorder in the victims of 26/11 terror attack.",0,0 +5078,Sleep events among veterans with combat-related posttraumatic stress disorder,"Sleep disturbances are important features of posttraumatic stress disorder (PTSD); however, the published data characterizing PTSD sleep phenomena are limited. The authors report on the phenomenology and physiological correlates of symptomatic sleep events in PTSD.The study data included survey results that addressed sleep symptoms during the past month in combat veterans with and without PTSD (N = 58), sleep diary records of awakenings from combat veterans with PTSD hospitalized on an inpatient rehabilitation unit (N = 52), and overnight polysomnography recordings obtained from 21 medication-free combat veterans with PTSD and eight healthy comparison subjects not exposed to combat.Recurrent awakenings, threatening dreams, thrashing movements during sleep, and awakenings with startle or panic features represented the most prevalently reported sleep-related symptoms. Laboratory findings of longer time awake, micro-awakenings, and a trend for patients to exhibit body and limb movements during sleep are consistent with the subjectively reported symptom profile. Prospectively assessed symptomatic awakenings featured startle or panic symptoms or anxiety related to threatening dreams. Laboratory findings revealed a trend for the symptomatic awakenings (with and without dream recall) to be disproportionately preceded by REM sleep, and the two recorded awakenings with objective physiological arousal were preceded by REM.PTSD features intrusions into sleep of more highly aroused behaviors and states, which appear partially conditioned to REM sleep.",0,0 +5079,Is Trauma a Causal Agent of Psychopathologic Symptoms in Posttraumatic Stress Disorder?,"Article Abstract Objective: The diagnosis of posttraumatic stress disorder (PTSD) is unique in that its criteria are embedded with a presumed causal agent, viz, a traumatic event. This assumption has come under scrutiny as a number of recent studies have suggested that many symptoms of PTSD may not necessarily be the result of trauma and may merely represent general psychiatric symptoms that would have existed even in the absence of a trauma event but are subsequently misattributed to it. The current study tests this hypothesis. Method: A case-control twin study conducted between 1996-2001 examined psychopathologic symptoms in a national convenience sample of 104 identical twin pairs discordant for combat exposure in Vietnam, with (n = 50) or without (n = 54) combat-related PTSD (DSM-IV-diagnosed) in the exposed twin. Psychometric measures used were the Symptom Checklist-90-Revised, the Clinician-Administered PTSD Scale, and the Mississippi Scale for Combat-Related PTSD. If a psychopathologic feature represents a factor that would have existed even without traumatic exposure, then there is a high chance that it would also be found at elevated rates in the non-trauma-exposed, identical cotwins of trauma-exposed twins with PTSD. In contrast, if a psychopathologic feature is acquired as a result of an environmental factor unique to the exposed twin, eg, the traumatic event, their cotwins should not have an increased incidence of the feature. Results: Combat veterans with PTSD demonstrated significantly higher scores (P < .0001) on the Symptom Checklist-90-Revised and other psychometric measures of psychopathology than their own combat-unexposed cotwins (and than combat veterans without PTSD and their cotwins). Conclusions: These results support the conclusion that the majority of psychiatric symptoms reported by combat veterans with PTSD would not have been present were it not for their exposure to traumatic events. J Clin Psychiatry Submitted: March 17, 2010; accepted July 8, 2010. Online ahead of print: September 7, 2010 (doi:10.4088/JCP.10m06121blu). Corresponding author: Mark W. Gilbertson, PhD, Department of Research Service, Manchester VA Medical Center, 718 Smyth Rd, Manchester, NH 03104 (mark.gilbertson@va.gov).",0,0 +5080,Psychological distress related to patterns of family functioning among Japanese childhood cancer survivors and their parents,"Family functioning appears to be a predictor of psychological distress among childhood cancer survivors and their family members; however, relatively little is known about patterns in those families that are psychologically at-risk. The purpose of this study was to identify distinct clusters of families that include childhood cancer survivors, and to evaluate differences between the clusters with respect to anxiety, depression, and post-traumatic stress symptoms (PTSS).Childhood cancer survivors and their parents (247 individuals: 88 adolescent cancer survivors, 87 mothers, and 72 fathers) completed self-report questionnaires. Perceptions of family functioning were assessed using the Family Relationship Index and its three dimensions (cohesiveness, expressiveness, and conflict), and individuals were classified into groups via a cluster analytic approach. State-trait anxiety, depression, and PTSS were assessed to all of the participants.The individuals were classified into three types: One cluster featured high cohesiveness, high expressiveness, and low conflict ('Supportive-type', n=102); a second cluster featured low cohesiveness, low expressiveness, and high conflict ('Conflictive-type', n=32); and a third cluster had moderate cohesiveness, moderate expressiveness, and moderate conflict ('Intermediate-type', n=113). Among the three types, an analysis of variance revealed that 'Conflictive-type' members had the highest levels of PTSS, depression, and state-trait anxiety.These findings suggest that perceptions of family functioning are related to psychological distress in family members of childhood cancer survivors. A family-focused intervention might be a useful approach to targeting emotional distress in these families, particularly for families with a 'Conflictive-type' family member.",0,0 +5081,Perpetration of gross human rights violations in South Africa: association with psychiatric disorders.,"A nationally representative study of psychiatric disorders in South Africa provided an opportunity to study the association between perpetration of human rights violations (HRVs) during apartheid and psychiatric disorder. Prior work has suggested an association between perpetration and post-traumatic stress disorder (PTSD), but this remains controversial.Subjects reported on their perpetration of human rights violations, purposeful injury, accidental injury and domestic violence. Lifetime and 12-month prevalence of DSM-IV (Diagnostic and Statistical Manual, 4th edition) disorders were assessed with Version 3.0 of the World Health Organization Composite International Diagnostic Interview (CIDI 3.0). Socio-demographic characteristics of these groups were calculated. Odds ratios for the association between the major categories of psychiatric disorders and perpetration were assessed.HRV perpetrators were more likely to be male, black and more educated, while perpetrators of domestic violence (DV) were more likely to be female, older, married, less educated and with lower income. HRV perpetration was associated with lifetime and 12-month anxiety and substance use disorders, particularly PTSD. Purposeful and DV perpetration were associated with lifetime and 12-month history of all categories of disorders, whereas accidental perpetration was associated most strongly with mood disorders.Socio-demographic profiles of perpetrators of HRV and DV in South Africa differ. While the causal relationship between perpetration and psychiatric disorders deserves further study, it is possible that some HRV and DV perpetrators were themselves once victims. The association between accidental perpetration and mood disorder also deserves further attention.",0,0 +5082,Tiagabine in anxiety disorders,"GABA has been implicated in both the aetiology and treatment of anxiety. Tiagabine is currently the only selective GABA reuptake inhibitor available in US markets; it exerts its action via GAT-1 transporter blockade presynaptically, facilitating GABA neurotransmission. Preclinical studies and current human studies suggest tiagabine possesses anxiolytic properties. The anxiolytic properties of tiagabine have also been suggested in a number of case series, open-label studies and placebo-controlled studies in patients with different anxiety disorders. Throughout these studies, tiagabine has been reasonably tolerated; the most commonly reported adverse events include dizziness, headache and nausea. Tiagabine may be a useful addition to currently available drugs for anxiety; however, the data from small open-label investigations remain to be confirmed in larger controlled studies.",0,0 +5083,The structure of post-traumatic stress disorder and complex post-traumatic stress disorder amongst West Papuan refugees,"The validity of applying the construct of post-traumatic stress disorder (PTSD) across cultures has been the subject of contention. Although PTSD symptoms have been identified across multiple cultures, questions remain whether the constellation represents a coherent construct with an interpretable factor structure across diverse populations, especially those naïve to western notions of mental disorder. An important additional question is whether a constellation of Complex-PTSD (C-PTSD) can be identified and if so, whether there are distinctions between that disorder and core PTSD in patterns of antecedent traumatic events. Our study amongst West Papuan refugees in Papua New Guinea (PNG) aimed to examine the factorial structure of PTSD based on the DSM-IV, DSM-5, ICD-10 and ICD-11 definitions, and C-PTSD according to proposed ICD-11 criteria. We also investigated domains of traumatic events (TEs) and broader psychosocial effects of conflict (sense of safety and injustice) associated with the factorial structures identified.Culturally adapted measures were applied to assess exposure to conflict-related traumatic events (TEs), refugees' sense of safety and justice, and symptoms of PTSD and C-PTSD amongst 230 West Papuan refugees residing in Port Morseby, PNG.Confirmatory factor analysis (CFA) supported a unitary construct of both ICD-10 and ICD-11 PTSD, comprising the conventional symptom subdomains of intrusion, avoidance, and hyperarousal. In contrast, CFA did not identify a unitary construct underlying C-PTSD. The interaction of witnessing murders and sense of injustice was associated with both the intrusion and avoidance domains of PTSD, but not with the unique symptom clusters characterizing C-PTSD.Our findings support the ICD PTSD construct and its three-factor structure in this transcultural refugee population. Traumatic experiences of witnessing murder associated with a sense of injustice were specifically related to the intrusion and avoidance domains of PTSD. The unitary nature of C-PTSD across cultures remains in question.",0,0 +5084,The Relationship Between Posttraumatic Stress Symptoms and Suicide Ideation Among Child Survivors Following the Wenchuan Earthquake,"The association between posttraumatic stress disorder (PTSD) symptoms and suicide ideation was examined in a sample of 2,298 child survivors of the Wenchuan earthquake. Results indicated that intrusion, avoidance, hyperarousal symptom clusters, and PTSD total score were significantly associated with suicide ideation. Except for intrusion, other measures of PTSD remained as statistically significant correlates of suicide ideation even after controlling for age, gender, direct exposure, indirect exposure, and depression. Furthermore, results showed that PTSD symptoms had an indirect influence on suicide ideation that was mediated by depression. The findings suggest that avoidance and hyperarousal symptom clusters of PTSD may be two important indicators of suicide ideation among child survivors of the Wenchuan earthquake. Implications of the results for intervention and prevention of suicide behavior are discussed.",0,0 +5085,Symptoms of the Anxiety Disorders in a Perinatal Psychiatric Sample,"Symptoms of anxiety are a central feature of perinatal mental health, yet the anxiety disorders have received considerably less attention than depression in both perinatal research and practice. The present investigation involved a retrospective review of the clinical records of 334 patients seen at a psychiatric day hospital program serving pregnant and postpartum women. We examined the frequency with which the patients in this setting reported symptoms of anxiety, clinical correlates of elevated anxiety, and patterns of diagnosis in the clinical record. The results suggest that anxiety symptoms are very common in this population and that the presence of anxiety is associated with a more severe clinical profile, including higher rates of suicidality and increased use of psychotropic medications during pregnancy and postpartum. Although anxiety symptom levels were markedly elevated in this sample, anxiety disorders were diagnosed at relatively low rates. Implications for clinical practice, including discharge and treatment planning, are discussed.",0,0 +5086,The Impact of Chronic Hepatitis C and Comorbid Psychiatric Illnesses on Health-related Quality of Life,"To determine the relative impact of chronic hepatitis C (CHC) and comorbid psychiatric illness on the health-related quality of life (HRQoL).Psychiatric conditions are more common among patients with CHC but their relative influence on HRQoL is not well understood.We identified 864 veterans who had previously completed a veteran-specific HRQoL questionnaire (SF-36V) as part of the 1999 VA Large Health Survey with known HCV antibody (anti-HCV) status before the survey. For 201 anti-HCV(+) and 663 anti-HCV(-) patients, we compared the HRQoL status and the prevalence of 6 major psychiatric diagnoses. We conducted multiple regression analyses to measure the effect of anti-HCV status and psychiatric comorbidity.Compared with the anti-HCV(-) group, anti-HCV(+) veterans were more likely to have alcohol dependence (P<0.001), depression (P=0.01), or posttraumatic stress disorder (PTSD) (P<0.004). The anti-HCV(+) group also reported lower HRQoL on 4 of the 8 SF-36V subscales (P<0.01) and the mental component summary scale (P<0.001). Even after adjusting for demographic variables and comorbid psychiatric illness, anti-HCV(+) patients reported a significantly lower mental component summary score (P<0.01) than did anti-HCV(-) patients. Multiple regression analysis found that depression and PTSD predicted lower HRQoL scores for all 8 HRQoL subscales (P<0.01) and both the physical (P<0.001) and mental component (P<0.03) summary scales independent of anti-HCV status.The HRQoL is significantly impaired in veterans with CHC, particularly the mental health components of HRQoL. In contrast, comorbid depression and PTSD are associated with both lower physical and mental components of HRQol, independent of CHC.",0,0 +5087,"Gulf Coast Resilience Coalition: An Evolved Collaborative Built on Shared Disaster Experiences, Response, and Future Preparedness","For close to a decade, the Gulf Coast of the United States has been in almost constant disaster recovery mode, and a number of lessons have been learned concerning disaster recovery and behavioral health. The purpose of this report was to describe the natural development of a Gulf Coast Resilience Coalition (GCRC).The GCRC methods began with state-specific recovery goals following Hurricane Katrina in 2005 and transitioned to a shared multistate and multidiscipline coalition. The coalition's effectiveness is demonstrated through continuation, procurement of funding to provide response services, and increased membership to ensure sustainability.The coalition has enhanced response, recovery, and resilience by providing strategic plans for dissemination of knowledge; post-disaster surveillance and services; effective relationships and communication with local, state, and regional partners; disaster response informed by past experience; a network of professionals and community residents; and the ability to improve access to and efficiency of future behavioral health coordination through an organized response.The GCRC can not only improve readiness and response, but work toward a shared vision of improved overall mental and behavioral health and thus resilience, with beneficial implications for the Gulf South and other communities as well.",0,0 +5088,Clinical characteristics of depressed outpatients previously overdiagnosed with bipolar disorder,"The diagnosis of bipolar disorder in depressed patients requires the ascertainment of prior episodes of mania and hypomania. Several research reports and commentaries have suggested that bipolar disorder is underrecognized and that many patients with nonbipolar major depressive disorder have, in fact, bipolar disorder. In a previous article from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we reported the opposite phenomenon-that bipolar disorder is often overdiagnosed in psychiatric outpatients. An important question that has not been previously examined is whether there is a particular clinical or demographic profile associated with bipolar disorder overdiagnosis among depressed patients. Forty psychiatric outpatients with current major depressive disorder reported having been previously diagnosed with bipolar disorder, which was not confirmed when interviewed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID). Psychiatric diagnoses, clinical and demographic variables were compared in these 40 patients and 233 depressed patients who were not diagnosed with bipolar disorder. Patients were interviewed by a highly trained diagnostic rater who administered the SCID for DSM-IV Axis I disorders, the Structured Interview for DSM-IV Personality for DSM-IV Axis II disorders, and the Schedule for Affective Disorders and Schizophrenia for clinical features of depression. The depressed patients who were overdiagnosed with bipolar disorder were diagnosed with a significantly higher number of Axis I disorders and were more likely to be diagnosed with specific phobia, posttraumatic stress disorder, and drug abuse/dependence. The patients overdiagnosed with bipolar disorder were also significantly more likely to be diagnosed with a current personality disorder and were more chronically ill with greater psychosocial impairment. Thus, the results suggest that depressed outpatients who had previously been overdiagnosed with bipolar disorder were more chronically and severely ill than depressed outpatients who had not been overdiagnosed.",0,0 +5089,"Urban teens: Trauma, posttraumatic growth, and emotional distress among female adolescents.","Urban teens face many traumas, with implications for potential growth and distress. This study examined traumatic events, posttraumatic growth, and emotional distress over 18 months among urban adolescent girls (N = 328). Objectives were to (a) describe types of traumatic events, (b) determine how type and timing of events relate to profiles of posttraumatic growth, and (c) prospectively examine effects of event type and posttraumatic growth on short- and long-term emotional distress with controls for pre-event distress. Results indicate that type of event was related to profiles of posttraumatic growth, but not with subsequent emotional distress. When baseline emotional distress was controlled, posttraumatic growth was associated with subsequent reductions in short- and long-term emotional distress. Implications for future research and clinical practice with adolescents are addressed.",0,0 +5090,Posttraumatic Response and Children Exposed to Parental Violence,"Summary In this article some of the literature on children's responses to natural and person-created trauma are discussed. In addition, data relevant to children's posttraumatic response as a result of exposure to interparental violence are presented. Using a factor analytic procedure, the study attempted to examine how the DSM-IV symptom clusters for Posttraumatic Stress Disorder come together for this sample of children. General suggestions are made regarding possible intervention with exposed children experiencing posttraumatic symptoms.",0,0 +5091,A systematic and conceptual review of posttraumatic stress in childhood cancer survivors and their parents,"Recent years have witnessed a rapid acceleration in the recognition and documentation of posttraumatic stress disorder (PTSD) and posttraumatic stress symptomatology (PTSS) in childhood cancer survivors and their parents. However, applicability of PTSD both diagnostically and conceptually to cancer-related traumatic responses remains poorly articulated within the current literature. Following an outline of childhood cancer and PTSD, this paper critically examines the applicability of such a diagnosis to this clinical population. It then systematically reviews the current evidence base (24 studies) on PTSD and PTSS in childhood cancer survivors and their parents. Prevalence of PTSD and PTSS, as well as associated predictors, in this clinical population varies widely. Findings are considered in the light of a number of contemporary theories of PTSD. Limitations within current conceptualizations of PTSD are highlighted with respect to the nature of cancer as a traumatic event and the specific features of traumatic stress manifestations in childhood cancer survivors and their parents. Finally, a number of pertinent research areas are elucidated which are argued to warrant further investigation.",0,0 +5092,Clinical features of patients with treatment-emergent suicidal behavior following initiation of paroxetine therapy,"Understanding suicidal behavior is an important component of assessing suicidality in psychiatric patients. GlaxoSmithKline (GSK) conducted a meta-analysis of randomized, placebo-controlled trials to compare suicidality in adult patients treated with paroxetine vs. placebo. The goal was to identify emergent clinical characteristics of patients with definitive suicidal behavior (DSB: preparatory act, suicide attempt, completed suicide).The dataset comprised 14,911 patients from 57 placebo-controlled paroxetine trials. Possible cases of suicidality were identified and were blindly reviewed by an expert panel, which categorized cases as suicidal or non-suicidal. DSB incidences were compared between paroxetine and placebo. Clinical narratives and case report forms for major depressive disorder (MDD) and anxiety disorder patients with DSB were reviewed. For MDD, rating scale items relating to suicidality, insomnia, agitation, and anxiety were examined.Overall (all indications) there were no differences between paroxetine and placebo for DSB (50/8958 [0.56%] vs. 40/5953 [0.67%], respectively; OR=1.2 [CI 0.8, 1.9]; p=0.483). However, in patients with major depressive disorder (MDD), the incidence of DSB was greater for paroxetine (11/3455 [0.32%] vs. 1/1978 [0.05%], OR=6.7 [CI 1.1, 149.4]; p=0.058). Review of the 11 paroxetine MDD cases revealed common clinical features: symptomatic improvement; younger age (18-30 years); psychosocial stressors; overdose as method; and absent/mild suicidal ideation at the visit prior to the event. There was no evidence for a consistent adverse event profile or onset of akathisia/agitation or a manic/mixed state. Anxiety disorder patients with DSB had a heterogeneous clinical picture.Limitations to the study include the relatively small number of cases and the retrospective nature of the study.DSB incidence was similar between paroxetine and placebo overall, but a higher frequency of DSB was found for paroxetine in MDD patients, driven by young adults aged < or =30 years. Most MDD patients with DSB improved prior to the attempt and experienced a psychosocial stressor. Patients should receive careful monitoring for suicidality during paroxetine therapy.",0,0 +5093,Five-year outcome after mild head injury: a prospective controlled study,"To study the prevalence of post-concussion symptoms (PCS) 5-7 years after mild head injury (MHI) and to investigate whether patients suffer from more symptoms than the normal population.We conducted a 5- to 7-year follow-up of patients (n = 89) with MHI. Post-concussion symptoms were quantified with the Rivermead Post Concussion Symptoms Questionnaire (RPQ) and health-related quality of life (HRQL) was measured with the EuroQol-5D (EQ-5D). We also quantified subjective general health state with the EuroQol Visual Analogue Scale (EQ-VAS). An age- and sex-matched, but otherwise randomly chosen control group of 89 persons was recruited from the National Population Registry for a cross-sectional comparison. Twenty-eight patients (30%) and 27 (30%) controls responded.Patients reported significantly (P = 0.017) more PCS (median RPQ score 10, 95% CI 2-20) than controls (median 2, 95% CI 0-4). They also reported significantly (P = 0.008) lower HRQL (median EQ-5D score 0.866, 95% CI 0.796-1.000) than controls (1.000, 95% CI 1.000-1.000), but there was no difference between the groups in their subjective ratings of general health state.Patients reported significantly more PCS and lower HRQL 5 to 7 years after MHI than age- and sex-matched controls from the normal population.",0,0 +5094,Developing a function impairment measure for children affected by political violence: a mixed methods approach in Indonesia,"Practitioners in political violence-affected settings would benefit from rating scales that assess child function impairment in a reliable and valid manner when designing and evaluating interventions. We developed a procedure to construct child function impairment rating scales using resources available in low- and middle-income countries.We applied a mixed methods approach. First, rapid ethnographic methods (brief participant observation, collection of diaries and a focus group with children) were used to select daily activities that best represented children's functioning. Second, rating scales based on these activities were examined for their psychometric properties. Construct validity was assessed through a confirmatory factor analysis procedure.Central Sulawesi, Indonesia.Qualitative data were collected for 53 children and psychometric testing was done with 403 children [average age: 9.9 (SD = 1.21), 49% girls] and 385 parents.Using locally available resources, we developed separate child-rated and parent-rated scales, both containing 11 items. The child-rated scale evidenced good internal, test-retest and inter-rater reliability and acceptable convergent and discriminant validity. Construct validity was confirmed by fit of the theorized factor structure-a social-ecological clustering of daily activities.The procedure resulted in a reliable and valid rating scale to assess child function impairment in the context of political violence. Practitioners can apply this procedure to develop new locally adequate rating scales to strengthen epidemiological surveys, baseline assessments, monitoring and evaluation and eventually, interventions. Further research should address the importance of gender differences and criterion-related validity.",0,0 +5095,Vulnerability Factors in the Explanation of Workplace Aggression: The Construction of a Theoretical Framework,"Although workplace aggression is a well-known problem, research on workplace aggression merely focuses on perpetrators' typologies, and workplace-related victim research remains under-represented. In this article, we theoretically explore possible associations between victims' coping strategies, type-D personality, negative childhood experiences, attention-deficit/hyperactivity disorder, and posttraumatic stress disorder and work-related victimization. Through an intensive literature study and the incorporation of existing theories, under which is the precipitation theory, we develop a theoretical framework of vulnerability factors for experiencing workplace violence. Future directions of this theoretical framework and practical implications of the results after empirically exploring the theoretical pathways are suggested.",0,0 +5096,Exploration of a Factor Mixture-Based Taxonic-Dimensional Model of Anxiety Sensitivity and Transdiagnostic Psychopathology Vulnerability Among Trauma-Exposed Adults,"The aim of this study was to evaluate the associations between a factor mixture-based taxonic-dimensional model of anxiety sensitivity (AS) and posttraumatic stress, panic, generalized anxiety, depression, psychiatric multimorbidity, and quality of life among a young adult sample exposed to traumatic stress (N = 103, n (females) = 66, M (age) = 23.68 years, SD (age) = 9.55). Findings showed support for the conceptual and operational utility of the AS taxonic-dimensional model with respect to concurrent transdiagnostic vulnerability among trauma-exposed adults. Specifically, relative to the low-AS group, the high-AS group demonstrated elevated levels of panic, depressive, and posttraumatic stress symptom severity as well as greater psychiatric multimorbidity and poorer quality of life. Furthermore, past-month MDD, GAD, PTSD, and panic attacks occurred nearly exclusively among the high-AS group. Continuous AS physical and psychological concerns scores were found to be significantly related to levels of panic and posttraumatic stress symptom severity, psychiatric multimorbidity as well as panic attack status only among the high-AS group and not among the low-AS group. Findings are discussed with respect to their implications for the conceptual and operational utility of the FMM-based taxonic-dimensional model of AS, related vulnerability for psychopathology in the context of trauma, and the clinical implications of these findings for assessment and intervention.",0,0 +5097,Psychometric detection of fabricated symptoms of combat-related post-traumatic stress disorder: A systematic replication,Vietnam veterans with post-traumatic stress disorder (n = 11) and two other groups of Vietnam veterans (n = 24) instructed to fabricate symptoms of post-traumatic stress disorder completed the MMPI. A discriminant function analysis that used scale F and the post-traumatic stress disorder subscale correctly classified 91% of the subjects. This systematic replication supports the utility of the MMPI as a component in evaluating the validity of self-reported symptoms of post-traumatic stress disorder in Vietnam veterans.,0,0 +5098,Latent class differences explain variability in PTSD symptom changes during cognitive processing therapy for veterans.,"Despite demonstrated effectiveness of cognitive-behavioral psychotherapies for posttraumatic stress disorder (PTSD), there is limited research on the trajectory of PTSD symptom change during the course of these therapies. In addition, existent findings are mixed, making it difficult to know how individuals' PTSD symptoms will change from week to week during psychotherapy. The study presented here uses general growth mixture modeling (GGMM) to test the hypothesis that multiple latent classes will explain individual differences in PTSD symptom change during the course of cognitive processing therapy (CPT). Participants were 207 U.S. military veterans with PTSD who received CPT through an outpatient Veterans Affairs PTSD treatment program. Participants were mostly male (89%), White (81%), and averaged 42 years old. The PTSD Checklist (PCL), Clinician-Administered PTSD Scale (CAPS), and the Beck Depression Inventory-II (BDI-II) were administered at pre- and posttreatment; the PCL was also administered weekly to assess PTSD symptom changes during CPT. GGMM showed that a quadratic growth model with three distinct latent classes best explained the trajectory of PTSD symptom reductions during CPT. The following variables significantly predicted latent class membership: age; ethnicity; having combat as the worst trauma; and pretreatment PCL, CAPS, and BDI-II scores. In turn, class membership significantly predicted posttreatment PCL, BDI-II, and CAPS scores. This study is novel in showing that latent class differences in PTSD symptom reductions are useful in explaining why individuals exhibit variable rates of PTSD symptom change during psychotherapy and differing outcomes after psychotherapy. These findings may improve the ability to more accurately anticipate individual differences in PTSD symptom changes and responses to psychotherapy. © 2012 American Psychological Association.",0,0 +5099,Mental Health and Psychosocial Support after the Great East Japan Earthquake,"Since the Great East Japan Earthquake, Keio University School of Medicine has, at the request of the Tokyo Metropolitan Government, provided mental health and psychosocial support to those living in Soma City in Fukushima Prefecture. This report covers the types of support provided in Soma City and discusses previous studies that were used as the model for current support practice and the results gained from actual performance. Also included is a summary of the objectives that were or were not achieved for medical support compared with recommendations from previous studies. Furthermore, future directions for medical support are also discussed.",0,0 +5100,Factual memories of ICU: recall at two years post-discharge and comparison with delirium status during ICU admission - a multicentre cohort study,"Aims and objective. To examine the relationship between observed delirium in ICU and patients’ recall of factual events up to two years after discharge. Background. People, the environment, and procedures are frequently cited memories of actual events encountered in ICU. These are often perceived as stressors to the patients and the presence of several such stressors has been associated with the development of reduced health-related quality of life or post-traumatic stress syndrome. Design. Prospective cohort study using interview technique. Method. The cohort was assembled from 152 patients who participated in a previously conducted multi-centre study of delirium incidence in Australian ICUs. The interviews involved a mixture of closed- and open-ended questions. Qualitative responses regarding factual memories were analysed using thematic analysis. A five-point Likert scale with answers from ‘always’ to ‘never’ was used to ask about current experiences of dream, anxiety, sleep problems, fears, irritability and/or mood swings. Scoring ranged from 6 to 30 with a mid-point value of 18 indicating a threshold value for the diagnosis of post-traumatic stress syndrome. A P-value of <0·05 was considered significant for all analyses. Results. Forty-one (40%) out of 103 potential participants consented to take part in the follow-up interview; 18 patients (44%) had been delirious and 23 patients (56%) non-delirious during the ICU admission. The non-participants (n = 62) formed a control group to ensure a representative sample; 83% (n = 34) reported factual memories either with or without recall of dreaming. Factual memories were significantly less common (66% cf. 96%) in delirious patients (OR 0·09, 95%CI 0·01–0·85, p = 0·035). Five topics emerged from the thematic analysis: ‘procedures’, ‘staff’, ‘comfort’, ‘visitors’, and ‘events’. Based on the current experiences, five patients (12%, four non-delirious and one delirious) scored ≥18 indicative of symptoms of post-traumatic stress syndrome; this did not reach statistical significance. Memory of transfer out of ICU was less frequent among the delirious patients (56%, n = 10) than among the non-delirious patients (87%, n = 20) (p = 0·036). Conclusion. Most patients have factual memories of their ICU stay. However, delirious patients had significantly less factual recall than non-delirious patients. Adverse psychological sequelae expressed as post-traumatic stress syndrome was uncommon in our study. Every attempt must be made to ensure that the ICU environment is as hospitable as possible to decrease the stress of critical illness. Post-ICU follow-up should include filling in the ‘missing gaps’, particularly for delirious patients. Ongoing explanations and a caring environment may assist the patient in making a complete recovery both physically and mentally. Relevance to clinical practice. This study highlights the need for continued patient information, re-assurance and optimized comfort. While health care professionals cannot remove the stressors of the ICU treatments, we must minimize the impact of the stay. It must be remembered that most patients are aware of their surroundings while they are in the ICU and it should, therefore, be part of ICU education to include issues regarding all aspects of patient care in this particularly vulnerable subset of patients to optimize their feelings of security, comfort and self-respect.",0,0 +5101,Enhanced Dexamethasone Suppression of Plasma Cortisol in Adult Women Traumatized by Childhood Sexual Abuse,"A study was undertaken to determine if female survivors of childhood and/or adolescent sexual abuse (CSA) would exhibit hypothalamic-pituitary-adrenal (HPA) axis abnormalities characteristic of patients with combat-related posttraumatic stress disorder (PTSD)--i.e., enhanced cortisol suppression to low-dose dexamethasone and increased density of lymphocyte glucocorticoid receptors. Nineteen women who reported experiencing severe CSA and 21 nonvictimized women participated in a low-dose (0.5 mg) dexamethasone suppression test and donated blood for measurement of lymphocyte glucocorticoid receptor binding. Women with CSA had significantly enhanced suppression of plasma cortisol in response to 0.5 mg dexamethasone compared to the nonvictimized women. These observations are consistent with findings in male veterans with combat-related PTSD. They suggest that this pattern of HPA axis dysfunction may be a characteristic sequel of psychiatric disorders that occur following a range of traumatic experiences. This HPA axis profile is different than that associated with acute stress or with major depressive disorder.",0,0 +5102,"Emotional Distress Intolerance, Experiential Avoidance, and Anxiety Sensitivity: The Buffering Effect of Attentional Control on Associations with Posttraumatic Stress Symptoms","A number of individual difference factors, including emotional distress intolerance (EDI), experiential avoidance (EA), and anxiety sensitivity (ASI), have been implicated in the development and maintenance of posttraumatic stress (PTS) symptomatology. Attentional control (AC) has been shown to serve as a protective factor against the development of maladaptive psychological outcomes across a number of studies, even among those with outcome-specific vulnerabilities. The purpose of the present study was to examine AC as a moderator of the relations between three constructs pertaining to the way that people relate to their internal experiences (i.e., EDI, EA, AS) and PTS symptoms among a trauma exposed community sample (N = 903). As predicted, AC moderated the relations between each individual difference factor and PTS symptoms, such that as attentional control decreased, the strength of the association between each individual difference factor and PTS symptoms increased. Study results suggest that AC abilities may be one factor that differentiates those who recover from trauma from those who do not, even among those who may be vulnerable for developing PTS symptomatology. Clinical implications and results of a PTS cluster level analysis will be discussed.",0,0 +5103,The 2003 Heat Wave in France: Dangerous Climate Change Here and Now,"In an analysis of the French episode of heat wave in 2003, this article highlights how heat wave dangers result from the intricate association of natural and social factors. Unusually high temperatures, as well as socioeconomic vulnerability, along with social attenuation of hazards, in a general context where the anthropogenic contribution to climate change is becoming more plausible, led to an excess of 14,947 deaths in France, between August 4 and 18, 2003. The greatest increase in mortality was due to causes directly attributable to heat: dehydration, hyperthermia, heat stroke. In addition to age and gender, combinatorial factors included preexisting disease, medication, urban residence, isolation, poverty, and, probably, air pollution. Although diversely impacted or reported, many parts of Europe suffered human and other losses, such as farming and forestry through drought and fires. Summer 2003 was the hottest in Europe since 1500, very likely due in part to anthropogenic climate change. The French experience confirms research establishing that heat waves are a major mortal risk, number one among so-called natural hazards in postindustrial societies. Yet France had no policy in place, as if dangerous climate were restricted to a distant or uncertain future of climate change, or to preindustrial countries. We analyze the heat wave's profile as a strongly attenuated risk in the French context, as well as the causes and the effects of its sudden shift into amplification. Research and preparedness needs are highlighted.",0,0 +5104,Epidemiology of Trauma and Posttraumatic Stress Disorder in Mexico.,"Prevalence rates of trauma and posttraumatic stress disorder (PTSD) were estimated from a probability sample of 2,509 adults from 4 cities in Mexico. PTSD was assessed according to Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) criteria using the Composite International Diagnostic Interview (CIDI; WHO, 1997). Lifetime prevalence of exposure and PTSD were 76% and 11.2%, respectively. Risk for PTSD was highest in Oaxaca (the poorest city), persons of lower socioeconomic status, and women. Conditional risk for PTSD was highest following sexual violence, but nonsexual violence and traumatic bereavement had greater overall impact because of their frequency. Of lifetime cases, 62% became chronic; only 42% received medical or professional care. The research demonstrates the importance of expanding the epidemiologic research base on trauma to include developing countries around the world.",0,0 +5105,EMOTION REGULATION IN MOTHERS AND YOUNG CHILDREN FACED WITH TRAUMA,"The present study investigated maternal emotion regulation as mediating the association between maternal posttraumatic stress symptoms and children's emotional dysregulation in a community sample of 431 Israeli mothers and children exposed to trauma. Little is known about the specific pathways through which maternal posttraumatic symptoms and deficits in emotion regulation contribute to emotional dysregulation. Inspired by the intergenerational process of relational posttraumatic stress disorder (PTSD), in which posttraumatic distress is transmitted from mothers to children, we suggest an analogous concept of relational emotion regulation, by which maternal emotion regulation problems may contribute to child emotion regulation deficits. Child emotion regulation problems were measured using the Child Behavior Checklist-Dysregulation Profile (CBCL-DP; T.M. Achenbach & I. Rescorla, 2000), which is comprised of three subscales of the CBCL: Attention, Aggression, and Anxiety/Depression. Maternal PTSD symptoms were assessed by the Posttraumatic Diagnostic Scale (E.B. Foa, L. Cashman, L. Jaycox, & K. Perry, 1997) and maternal emotion regulation by the Difficulties in Emotion Regulation Scale (K.L. Gratz & L. Roemer, 2004). Results showed that the child's emotion regulation problems were associated with both maternal posttraumatic symptoms and maternal emotion dysregulation. Further, maternal emotion regulation mediated the association between maternal posttraumatic symptoms and the child's regulation deficits. These findings highlight the central role of mothers' emotion regulation skills in the aftermath of trauma as it relates to children's emotion regulation skills. The degree of mothers' regulatory skills in the context of posttraumatic stress symptoms reflects a key process through which the intergenerational transmission of trauma may occur. Study results have critical implications for planning and developing clinical interventions geared toward the treatment of families in the aftermath of trauma and, in particular, the enhancement of mothers' emotion regulation skills after trauma.",0,0 +5106,Longitudinal trajectories of post-traumatic stress disorder symptoms among adolescents after the Wenchuan earthquake in China,"Background This study examines the patterns and predictors of post-traumatic stress disorder (PTSD) symptom trajectories among adolescent survivors following the Wenchuan earthquake in China. Method A total of 1573 adolescent survivors were followed up at 6, 12, 18 and 24 months post-earthquake. Participants completed the Posttraumatic Stress Disorder Self-Rating Scale (PTSD-SS), Adolescent Self-Rating Life Events Checklist, Social Support Rate Scale, and the Simplified Coping Style Questionnaire. Distinct patterns of PTSD symptom trajectories were established through grouping participants based on time-varying changes of developing PTSD (i.e. reaching the clinical cut-off on the PTSD-SS). Multivariate logistic regressions were used to examine predictors for trajectory membership. Results PTSD prevalence rates at 6, 12, 18 and 24 months were 21.0, 23.3, 13.5 and 14.7%, respectively. Five PTSD symptom trajectories were observed: resistance (65.3% of the sample), recovery (20.0%), relapsing/remitting (3.3%), delayed dysfunction (4.2%) and chronic dysfunction (7.2%). Female gender and senior grade were related to higher risk of developing PTSD symptoms in at least one time point, whereas being an only child increased the possibility of recovery relative to chronic dysfunction. Family members’ injury/loss and witness of traumatic scenes could also cause PTSD chronicity. More negative life events, less social support, more negative coping and less positive coping were also common predictors for not developing resistance or recovery. Conclusions Adolescents’ PTSD symptoms showed an anniversary reaction. Although many adolescents remain euthymic or recover over time, some adolescents, especially those with the risk factors noted above, exhibit chronic, delayed or relapsing symptoms. Thus, the need for individualized intervention with these adolescents is indicated.",0,0 +5107,Splintered memories or vivid landmarks? Qualities and organization of traumatic memories with and without PTSD,"SUMMARY One hundred and eighty-one students answered a standardized questionnaire on Post-Traumatic Stress Disorder (PTSD): 25 reported trauma(s) and indicated a pattern of after-effects that matched a PTSD symptom profile, whereas 88 indicated trauma(s) but no PTSD symptom profile. Both groups answered a questionnaire addressing the recollective quality, integration and coherence of the traumatic memory that currently affected them most. Participants with a PTSD symptom profile reported more vivid recollection of emotion and sensory impressions. They reported more observer perspective in the memory (seeing themselves ‘from the outside’), but no more fragmentation. They also agreed more with the statement that the trauma had become part of their identity, and perceived more thematic connections between the trauma and current events in their lives. The two groups showed different patterns of correlations which indicated different coping styles. Overall, the findings suggest that traumas form dysfunctional reference points for the organization of other personal memories in people with PTSD symptoms, leading to fluctuations between vivid intrusions and avoidance. Copyright # 2003 John Wiley & Sons, Ltd.",0,0 +5108,Complex posttraumatic stress disorder: evidence from the primary care setting,"Sexual abuse is a common problem among female primary care medical patients. There is a wide spectrum of long-term sequelae, ranging from mild to the complex symptom profiles consistent with the theories of a posttraumatic sense of identity. Generally, the latter occurs in the context of severe, chronic abuse, beginning in childhood and often compounded by the presence of violence, criminal behavior, and substance abuse in the family of origin. In this study we search for empirical evidence for the existence of a complex posttraumatic stress syndrome in 99 women patients at 3 family practice outpatient clinics who report a history of sexual abuse. A structured interview was administered by trained female interviewers to gather data on family history and psychiatric symptoms and diagnoses. Empirical evidence from cluster analysis of the data supports the theory of a complex posttraumatic syndrome. The severity gradient based on symptoms roughly parallels the severity gradient based on childhood abuse and sociopathic behavior and violence in the family of origin, with the most severely abused subjects characterized by symptom patterns that fit the description of a complex posttraumatic stress syndrome.",0,0 +5109,Virtual Reality Exposure Therapy for Vietnam Veterans With Posttraumatic Stress Disorder,"Virtual reality (VR) integrates real-time computer graphics, body-tracking devices, visual displays, and other sensory input devices to immerse a participant in a computer-generated virtual environment that changes in a natural way with head and body motion. VR exposure (VRE) is proposed as an alternative to typical imaginal exposure treatment for Vietnam combat veterans with posttraumatic stress disorder (PTSD).This report presents the results of an open clinical trial using VRE to treat Vietnam combat veterans who have DSM-IV PTSD. In 8 to 16 sessions, 10 male patients were exposed to 2 virtual environments: a virtual Huey helicopter flying over a virtual Vietnam and a clearing surrounded by jungle.Clinician-rated PTSD symptoms as measured by the Clinician Administered PTSD Scale, the primary outcome measure, at 6-month follow-up indicated an overall statistically significant reduction from baseline (p = .0021) in symptoms associated with specific reported traumatic experiences. All 8 participants interviewed at the 6-month follow-up reported reductions in PTSD symptoms ranging from 15% to 67%. Significant decreases were seen in all 3 symptom clusters (p < .02). Patient self-reported intrusion symptoms as measured by the Impact of Event Scale were significantly lower (p < .05) at 3 months than at baseline but not at 6 months, although there was a clear trend toward fewer intrusive thoughts and somewhat less avoidance.Virtual reality exposure therapy holds promise for treating PTSD in Vietnam veterans.",0,0 +5110,Behavior and the Law Reconsidered: Psychological Syndromes and Profiles,"Recently, a new concept of behavior and the law has emerged which looks beyond the defendant's satisfaction of the elements which define the charge. This formulation, which considers not simply the objective facts but motive, intent, and circumstance, has marked a legal shift from diminished capacity to diminished responsibility. Still in evolution, this trend has challenged the relationship between law and the behavioral sciences, and prompted serious reconsideration of the role of each. This paper examines the landmarks of the movement, considers its implications, and looks to the future.",0,0 +5111,The validity of the Hospital Anxiety and Depression Scale,"To review the literature of the validity of the Hospital Anxiety and Depression Scale (HADS).A review of the 747 identified papers that used HADS was performed to address the following questions: (I) How are the factor structure, discriminant validity and the internal consistency of HADS? (II) How does HADS perform as a case finder for anxiety disorders and depression? (III) How does HADS agree with other self-rating instruments used to rate anxiety and depression?Most factor analyses demonstrated a two-factor solution in good accordance with the HADS subscales for Anxiety (HADS-A) and Depression (HADS-D), respectively. The correlations between the two subscales varied from.40 to.74 (mean.56). Cronbach's alpha for HADS-A varied from.68 to.93 (mean.83) and for HADS-D from.67 to.90 (mean.82). In most studies an optimal balance between sensitivity and specificity was achieved when caseness was defined by a score of 8 or above on both HADS-A and HADS-D. The sensitivity and specificity for both HADS-A and HADS-D of approximately 0.80 were very similar to the sensitivity and specificity achieved by the General Health Questionnaire (GHQ). Correlations between HADS and other commonly used questionnaires were in the range.49 to.83.HADS was found to perform well in assessing the symptom severity and caseness of anxiety disorders and depression in both somatic, psychiatric and primary care patients and in the general population.",0,0 +5112,Post-Traumatic Stress Disorder in U.S. Soldiers With Post-Traumatic Headache,"To determine the impact of post-traumatic stress disorder (PTSD) on headache characteristics and headache prognosis in U.S. soldiers with post-traumatic headache.PTSD and post-concussive headache are common conditions among U.S. Army personnel returning from deployment. The impact of comorbid PTSD on the characteristics and outcomes of post-traumatic headache has not been determined in U.S. Army soldiers.A retrospective cohort study was conducted among 270 consecutive U.S. Army soldiers diagnosed with post-traumatic headache at a single Army neurology clinic. All subjects were screened for PTSD at baseline using the PTSD symptom checklist. Headache frequency and characteristics were determined for post-traumatic headache subjects with and without PTSD at baseline. Headache measures were reassessed 3 months after the baseline visit, and were compared between groups with and without PTSD.Of 270 soldiers with post-traumatic headache, 105 (39%) met screening criteria for PTSD. There was no significant difference between subjects with PTSD and those without PTSD with regard to headache frequency (17.2 vs 15.7 headache days per month; P = .15) or chronic daily headache (58.1% vs 52.1%; P = .34). Comorbid PTSD was associated with higher headache-related disability as measured by the Migraine Disability Assessment Score. Three months after the baseline neurology clinic visit, the number of subjects with at least 50% reduction in headache frequency was similar among post-traumatic headache cases with and without PTSD (25.9% vs 26.8%).PTSD is prevalent among U.S. Army soldiers with post-traumatic headache. Comorbid PTSD is not associated with more frequent headaches or chronic daily headache in soldiers evaluated at a military neurology clinic for chronic post-traumatic headache. Comorbid PTSD does not adversely affect short-term headache outcomes, although prospective controlled trials are needed to better assess this relationship.",0,0 +5113,Risk factors in combat stress reaction--a study of Israeli soldiers in the 1982 Lebanon war.,"Identification des variables demographiques, militaires et de personnalite susceptibles d'etre predicteur de reactions de stress au combat. Les comparaisons des donnees concernant les blessures physiques et les atteintes psychiques lors de la guerre du Liban en 1982 indiquent qu'il existe des degres variables de vulnerabilite au stress du combattant. On esquisse un profil composite type du soldat a haut risque",0,0 +5114,I'll be working my way back: A qualitative synthesis on the trauma experience of children.,"Children who experience some kind of traumatic event, such as losing a sibling, witnessing war, or being the victim of abuse or an accident, all have the need to process this event. Few theories exist about the development of posttraumatic stress disorder, specifically in traumatized children. Therefore, a synthesis of qualitative research is conducted in which the available qualitative studies on the children’s perspective on traumatic experiences are integrated. A total of 17 English-language peer-reviewed articles were selected and a thematic synthesis was carried out. The core themes in the findings pertain to three domains: the individual, the family, and the community. We found a qualitative synthesis beneficial for creating a complete picture of children dealing with trauma and for strengthening the emerging theory. (aut. ref.)",0,0 +5115,Risk factors predict post-traumatic stress disorder differently in men and women,"About twice as many women as men develop post-traumatic stress disorder (PTSD), even though men as a group are exposed to more traumatic events. Exposure to different trauma types does not sufficiently explain why women are more vulnerable.The present work examines the effect of age, previous trauma, negative affectivity (NA), anxiety, depression, persistent dissociation, and social support on PTSD separately in men and women. Subjects were exposed to either a series of explosions in a firework factory near a residential area or to a high school stabbing incident.Some gender differences were found in the predictive power of well known risk factors for PTSD. Anxiety predicted PTSD in men, but not in women, whereas the opposite was found for depression. Dissociation was a better predictor for PTSD in women than in men in the explosion sample but not in the stabbing sample. Initially, NA predicted PTSD better in women than men in the explosion sample, but when compared only to other significant risk factors, it significantly predicted PTSD for both men and women in both studies. Previous traumatic events and age did not significantly predict PTSD in either gender.Gender differences in the predictive value of social support on PTSD appear to be very complex, and no clear conclusions can be made based on the two studies included in this article.",0,0 +5116,Estimating post-traumatic stress disorder in the community: lifetime perspective and the impact of typical traumatic events,"Background. Community surveys have assessed post-traumatic stress disorder (PTSD) in relation to traumatic events designated by respondents as the worst they have ever experienced. An assessment of PTSD in relation to all reported traumas would impose too great a burden on respondents, a considerable proportion of whom report multiple traumas. The ‘worst event’ method is efficient for identifying persons with PTSD, but may overestimate the conditional probability of PTSD associated with the entire range of PTSD-level traumas. In this report, we evaluate this potential bias. Method. The Detroit Area Survey of Trauma ( n =2181) estimated the PTSD risk from two samples of traumas: (1) a representative sample of traumas formed by selecting a random trauma from each respondent's list of traumas; and (2) traumas designated by respondents as the worst (the standard method). Results. Both estimation methods converged on key findings, including identifying trauma types with the highest probability of PTSD and sex differences in the risk of PTSD. Compared to the random events, the ‘worst event’ method yielded a moderately higher conditional probability for PTSD (0·136 v . 0·092). The bias was due almost entirely to the deviation of the distribution of the worst events from expected values, if all event types had equal prior selection probabilities. Direct adjustment, setting the distribution equal to expected values and applying the observed probabilities of PTSD associated with individual event types brought the estimate close to the unbiased estimate, based on the randomly selected traumas. Conclusions. Only the ‘worst event’ method can be used as a short-cut to assessing all traumas. The bias in the estimated risk of PTSD is modest and is attenuated by direct adjustment.",0,0 +5117,The effectiveness of anticonvulsants in psychiatric disorders,"Anticonvulsant drugs are widely used in psychiatric indications. These include mainly alcohol and benzodiazepine withdrawal syndromes, panic and anxiety disorders, dementia, schizophrenia, affective disorders, bipolar affective disorders in particular, and, to some extent, personality disorders. A further area in which neurology and psychiatry overlap is pain conditions, in which some anticonvulsants, and also typical psychiatric medications such as antidepressants, are helpful. From the beginning of their psychiatric use, anticonvulsants have also been used to ameliorate specific symptoms of psychiatric disorders independently of their causality and underlying illness, eg, aggression, and, more recently, cognitive impairment, as seen in affective disorders and schizophrenia. With new anticonvulsants currently under development, it is likely that their use in psychiatry will further increase, and that psychiatrists need to learn about their differential efficacy and safety profiles to the same extent as do neurologists.",0,0 +5118,DEATH ANXIETY AS A PREDICTOR OF POSTTRAUMATIC STRESS LEVELS AMONG INDIVIDUALS WITH SPINAL CORD INJURIES,"Because the onset of a spinal cord injury may involve a brush with death and because serious injury and disability can act as a reminder of death, death anxiety was examined as a predictor of posttraumatic stress levels among individuals with disabilities. This cross-sectional study used multiple regression and multivariate multiple regression to examine whether death denial and death awareness predicted posttraumatic stress disorder (PTSD) among veterans and civilians with spinal cord injuries (N = 313). The results indicated that death anxiety (after controlling for demographic and disability-related variables) predicted a significant amount of the total levels of posttraumatic stress reactions among individuals with spinal cord injuries. Further, death awareness, pain level, and spiritual/religious coping significantly predicted the posttraumatic stress clusters of reexperiencing, avoidance, and hyperarousal. Death denial significantly predicted only hyperarousal. Because death anxiety predicts various aspects of PTSD reactions, one possible therapeutic implication is that addressing death-related topics may help to reduce PTSD reactions. Further research is needed to better ascertain the possible causality among these variables.",0,0 +5119,Coping style use predicts posttraumatic stress and complicated grief symptom severity among college students reporting a traumatic loss.,"Problem-focused coping, and active and avoidant emotional coping were examined as correlates of grief and posttraumatic stress disorder (PTSD) severity among 123 college students reporting the unexpected death of an immediate family member, romantic partner, or very close friend. The authors administered to participants, via the Internet, 5 survey instruments that measured demographic characteristics, traumatic event exposure (Stressful Life Events Screening Questionnaire; L. Goodman, C. Corcoran, K. Turner, N. Yuan, & B. L. Green, 1998), complicated grief (CG) severity (Inventory of Complicated Grief-Revised-Short Form; A. E. Latham & H. G. Prigerson, 2004; H. G. Prigerson & S. C. Jacobs, 2001), PTSD severity (PTSD Checklist; F. W. Weathers, B. T. Litz, D. S. Herman, J. A. Huska, & T. M. Keane, 1993), and coping style use (Brief COPE; C. S. Carver, 1997). Results demonstrated that CG and PTSD severity were both significantly positively correlated with problem-focused, and active and avoidant emotional coping styles. The authors used path analysis to control for time since the loss and trauma frequency and found that only avoidant emotional coping remained significant in predicting CG and PTSD severity. Results are discussed in terms of their clinical implications for treating individuals with traumatic losses.",0,0 +5120,Age and emotional response to the Northridge earthquake: A longitudinal analysis.,"Cross-sectional studies have found older adults to have lower levels of emotional distress after natural disasters. The maturation hypothesis suggests that older adults are less reactive to stress events, whereas the inoculation hypothesis argues that prior experience with disaster is protective. One hundred and sixty-six adults aged 30 to 102 were interviewed regarding the 1994 Northridge earthquake. Longitudinal data were available on depressed mood before and after the earthquake. The maturation hypothesis was generally not supported. The young-old were least depressed; however, this age difference was present prior to the earthquake. The old-old showed lowest levels of earthquake-specific rumination, but age did not buffer the relationship between damage exposure and rumination. The inoculation hypothesis was supported for depressed mood. Prior earthquake experience was related to lower postearthquake depression scores.",0,0 +5121,Blood pressure among immigrants to Israel from areas affected by the Chernobyl disaster.,"OBJECTIVES: To validate and analyze apparent association of hypertension with exposures to radiation at Chernobyl among immigrants to Israel from the contaminated areas. METHODS: Data were collected in 1991 and 1994 from two samples of persons who immigrated to Israel from the contaminated zone around the Chernobyl nuclear power plant. The first sample were self-referred for evaluation in a clinic by whole-body cesium measurement, physical examination, and questionnaire (N = 756, 328 from less exposed and 438 from more exposed areas). The second wave data were collected in 1994 during home interviews for evaluation of psychosocial factors associated with their experience (N = 708, 121 from more exposed and 253 from less exposed areas). In the second study a referent group was included (n = 334) who were matched by age, sex, and year of immigration who immigrated from other areas outside of the contaminated zone. Estimates of exposure were based on the IAEA map of ground-level cesium isotope (137Cs) contamination. RESULTS: In the 1991 sample, 21% from high exposure areas and 16% from less exposed areas had elevated systolic blood pressure (> 140 mmHg). Elevated diastolic blood pressure (> 90 mmHg) had a similar difference between more and less exposed groups (21% and 16%). Age- and sex-specific analyses showed that statistically different levels were found in the older age groups. In the 1994 sample, we confirmed a relationship between exposure and elevated blood pressure. 33% of those from the more exposed areas and 34% of those from less exposed areas had elevated systolic blood pressure, compared with 23% of the comparison group, with a similar trend found in diastolic blood pressure. The relationship between exposure and blood pressure was accentuated in the group of respondents who had high scores on PTSD symptoms. Of the psychological variables analyzed, systolic blood pressure was most strongly related to cancer-related anxiety and somatization. A discriminant function analysis showed that three variables: age, reporting a significant loss from the Chernobyl accident, and fear of cancer correctly differentiated 72% of those with normal and high blood pressure. CONCLUSIONS: There is a relationship between exposure to Chernobyl and high blood pressure, partly due to the psychological reactions to the accident.",0,0 +5122,Sleep disturbances predict later trauma-related distress: Cross-panel investigation amidst violent turmoil.,"Sleep disturbances, including trouble falling and remaining asleep and recurrent nightmares, are symptoms of posttraumatic stress. A growing body of literature indicates that sleep disturbance may also convey vulnerability for the continuation of other symptoms of posttraumatic stress, including fear, anxiety, and heightened arousal. However, longitudinal research, which could help understand how these relationships unfold over time, has been limited.The longitudinal relationships between sleep disturbance and posttraumatic stress were investigated in 779 Palestinian adults randomly selected and interviewed twice during the period from April 2008 to November 2008, amid ongoing violent political turmoil. The recruitment method produced a representative sample and excellent retention. Cross-panel structural equation modeling was used to examine relationships between sleep and distress across two study periods.Results indicated that initial sleep problems were associated with increased posttraumatic stress disorder (PTSD), depression, and intrapersonal resource loss at follow-up 6 months later, but initial PTSD, depression, and intrapersonal resource loss were not associated with increased sleep problems at follow-up.Sleep problems may confer vulnerability to longer-term distress in the presence of ongoing political violence. Future research should examine whether interventions targeting trauma-related sleep problems may improve prevention and treatment for PTSD and related disorders.",0,0 +5123,Trajectory of post-traumatic stress following traumatic injury: 6-year follow-up,"Background Traumatic injuries affect millions of patients each year, and resulting post-traumatic stress disorder (PTSD) significantly contributes to subsequent impairment. Aims To map the distinctive long-term trajectories of PTSD responses over 6 years by using latent growth mixture modelling. Method Randomly selected injury patients ( n = 1084) admitted to four hospitals around Australia were assessed in hospital, and at 3, 12, 24 and 72 months. Lifetime psychiatric history and current PTSD severity and functioning were assessed. Results Five trajectories of PTSD response were noted across the 6 years: (a) chronic (4%), (b) recovery (6%), (c) worsening/recovery (8%), (d) worsening (10%) and (e) resilient (73%). A poorer trajectory was predicted by female gender, recent life stressors, presence of mild traumatic brain injury and admission to intensive care unit. Conclusions These findings demonstrate the long-term PTSD effects that can occur following traumatic injury. The different trajectories highlight that monitoring a subset of patients over time is probably a more accurate means of identifying PTSD rather than relying on factors that can be assessed during hospital admission.",1,0 +5124,Screening for post-traumatic stress disorder in female Veteran’s Affairs patients: validation of the PTSD checklist,"We evaluated the screening validity of a self-report measure for post traumatic stress disorder (PTSD), the PTSD Checklist (PCL), in female Veterans Affairs (VA) patients. All women seen for care at the VA Puget Sound Health Care system from October 1996-January 1999 (n=2,545) were invited to participate in a research interview. Participants (n=282) completed the 17-item PCL, followed by a gold standard diagnostic interview for PTSD, the Clinician Administered PTSD Scale (CAPS). Thirty-six percent of the participants (n=100) met CAPS diagnostic criteria for current PTSD. Receiver Operating Characteristic (ROC) analysis was used to evaluate the screening performance of the PCL. The area under the ROC curve was 0.86 (95% CI 0.82-0.90). A PCL score of 38 optimized the performance of the PCL as a screening test (sensitivity 0.79, specificity 0.79). The PCL performed well as a screening measure for the detection of PTSD in female VA patients.",0,0 +5125,Trauma-Focused Cognitive Behavioural Therapy for Children and Parents,"Trauma-focused cognitive behavioural therapy (TF-CBT) for children and parents is an evidence based treatment approach for traumatised children. Evaluation of TF-CBT includes several randomised controlled trials, effectiveness studies and ongoing studies for children experiencing sexual abuse, domestic violence, traumatic grief, terrorism, disasters and multiple traumas. The model of TF-CBT described here is a flexible, components-based model that provides children and parents with stress management skills prior to encouraging direct discussion and processing of children's traumatic experiences. TF-CBT components are summarised by the acronym PRACTICE: Psychoeducation, Parenting skills, Relaxation skills, Affective modulation skills, Cognitive coping skills, Trauma narrative and cognitive processing of the traumatic event(s), In vivo mastery of trauma reminders, Conjoint child-parent sessions, and Enhancing safety and future developmental trajectory. Currently this model of TF-CBT is being adapted and implemented both within the USA and internationally.",0,0 +5126,A Preliminary Study of DSM–5 PTSD Symptom Patterns in Veterans by Trauma Type,"Posttraumatic stress disorder (PTSD) has a primary etiology in experiencing psychological trauma and the subsequent psychological sequelae ( American Psychiatric Association, 2013). There are multi...",0,0 +5127,The Child PTSD Symptom Scale: An update and replication of its psychometric properties.,"The psychometric properties of the child PTSD Symptom Scale (CPSS) were examined in 2 samples. Sample 1 (N = 185, ages 6-17 years) consisted of children recruited from hospitals after accidental injury, assault, and road traffic trauma, and assessed 6 months posttrauma. Sample 2 (N = 68, ages 6-17 years) comprised treatment-seeking children who had experienced diverse traumas. In both samples psychometric properties were generally good to very good (internal reliability for total CPSS scores = .83 and .90, respectively). The point-biserial correlation of the CPSS with posttraumatic stress disorder (PTSD) diagnosis derived from structured clinical interview was .51, and children diagnosed with PTSD reported significantly higher symptoms than non-PTSD children. The CPSS demonstrated applicability to be used as a diagnostic measure, demonstrating sensitivity of 84% and specificity of 72%. The performance of the CPSS Symptom Severity Scale to accurately identify PTSD at varying cutoffs is reported in both samples, with a score of 16 or above suggested as a revised cutoff.",0,0 +5128,Disability associated with exposure to traumatic events: results from a cross-sectional community survey in South Sudan,"BackgroundThere is a general lack of knowledge regarding disability and especially factors that are associated with disability in low-income countries. We aimed to study the overall and gender-specific prevalence of disability, and the association between exposure to traumatic events and disability in a post-conflict setting.MethodsWe conducted a cross-sectional community based study of four Greater Bahr el Ghazal States, South Sudan (n = 1200). The Harvard Trauma Questionnaire (HTQ) was applied to investigate exposure to trauma events. Disability was measured using the Washington Group Short Measurement Set on Disability, which is an activity-based scale derived from the WHO’s International Classification of Disability, Functioning and Health.ResultsThe estimated prevalence of disability (with severe difficulty) was 3.6% and 13.4% for disability with moderate difficulties. No gender differences were found in disability prevalence. Almost all participants reported exposure to at least one war-related traumatic event. The result of a hierarchical regression analysis showed that, for both men and women, exposure to traumatic events, older age and living in a polygamous marriage increased the likelihood of having a disability.ConclusionsThe finding of association between traumatic experience and disability underlines the precariousness of the human rights situation for individuals with disability in low-income countries. It also has possible implications for the construction of disability services and for the provision of health services to individuals exposed to traumatic events.",0,0 +5129,Childbirth-related post-traumatic stress disorder and its treatment,"Abstract The phenomenon of childbirth-related post-traumatic stress disorder (PTSD) has become more widely recognised in recent years following changes in 1994 to the DSM criteria regarding how a traumatic event was defined. Emerging literature has predominately focused on prevalence rates and risk factors associated with this condition and on the use of debriefing techniques as an attempt to reduce or prevent the development of postnatal PTSD. However, little is known about the efficacy of psychological interventions that have been used to treat PTSD among postnatal women. This review summarises the limited evidence supporting the use of such treatments and discusses the significant challenges in developing and implementing psychological interventions for childbirth-related PTSD.",0,0 +5130,Morphine after Combat Injury and Post-Traumatic Stress Disorder,"Comments on an article by T. L. Holbrook et al. (see record 2010-00923-002). As medical providers currently deployed in Iraq, we read the article by Holbrook et al. with great interest. If confirmed, the association of morphine use with reductions in post-traumatic stress disorder (PTSD) would provide another important indication for the administration of morphine to battlefield casualties. We note that the investigators analyzed morphine use in level 1 or 2 facilities and that the morphine was administered intravenously in 98% of recipients. First, clinicians would benefit from knowing whether morphine was associated with adverse outcomes among patients treated at the facilities studied. Second, it is standard training for Navy corpsmen and Army medics to administer morphine and oral transmucosal fentanyl to patients before they reach these facilities. In addition, the ""fragments from blast - NOS [not otherwise specified]"" mechanism of injury was independently and strongly associated with the absence of PTSD in both models 1 and 2. Although we acknowledge that the numbers of injuries incurred through this mechanism were small, knowledge of the circumstances surrounding these injuries might lead to testable hypotheses for research aimed at elucidating factors associated with PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5131,The role of major depression in neurocognitive functioning in patients with posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) frequently co-occur after traumatic experiences and share neurocognitive disturbances in verbal memory and executive functioning. However, few attempts have been made to systematically assess the role of a comorbid MDD diagnosis in neuropsychological studies in PTSD.The purpose of the current study is to investigate neurocognitive deficits in PTSD patients with and without MDD. We hypothesized that PTSD patients with comorbid MDD (PTSD+MDD) would have significantly lower performance on measures of verbal memory and executive functioning than PTSD patients without MDD (PTSD-MDD).Participants included in this study were 140 treatment-seeking outpatients who had a diagnosis of PTSD after various single traumatic events and participated in a randomized controlled trial comparing different treatment types. Baseline neuropsychological data were compared between patients with PTSD+MDD (n=84) and patients with PTSD-MDD (n=56).The PTSD+MDD patients had more severe verbal memory deficits in learning and retrieving words than patients with PTSD alone. There were no differences between the groups in recall of a coherent paragraph, recognition, shifting of attention, and cognitive interference.The results of this study suggest that a more impaired neurocognitive profile may be associated with the presence of comorbid MDD, with medium-sized group differences for verbal memory but not for executive functioning. From a clinical standpoint, being aware that certain verbal memory functions are more restricted in patients with comorbid PTSD and MDD may be relevant for treatment outcome of trauma-focused psychotherapy.",0,0 +5132,The impact of housing displacement on the mental health of low-income parents after Hurricane Katrina,"Previous studies in the aftermath of natural disasters have demonstrated relationships between four dimensions of displacement - geographic distance from the predisaster community, type of postdisaster housing, number of postdisaster moves, and time spent in temporary housing - and adverse psychological outcomes. However, to date no study has explored how these dimensions operate in tandem. The literature is further limited by a reliance on postdisaster data. We addressed these limitations in a study of low-income parents, predominantly non-Hispanic Black single mothers, who survived Hurricane Katrina and who completed pre and postdisaster assessments (N = 392). Using latent profile analysis, we demonstrated three profiles of displacement experiences within the sample: (1) returned, characterized by return to a predisaster community; (2) relocated, characterized by relocation to a new community, and (3) unstably housed, characterized by long periods in temporary housing and multiple moves. Using regression analyses, we assessed the relationship between displacement profiles and three mental health outcomes (general psychological distress, posttraumatic stress, and perceived stress), controlling for predisaster characteristics and mental health indices and hurricane-related experiences. Relative to participants in the returned profile, those in the relocated profile had significantly higher general psychological distress and perceived stress, and those in the unstably housed profile had significantly higher perceived stress. Based on these results, we suggest interventions and policies that reduce postdisaster housing instability and prioritize mental health services in communities receiving evacuees.",0,0 +5133,Children's predisaster functioning as a predictor of posttraumatic stress following Hurricane Andrew.,"This study examined (a) children's predisaster behavioral and academic functioning as a predictor of posttraumatic stress (PTS) following Hurricane Andrew and (b) whether children who were exposed to the disaster would display a worsening of prior functioning. Fifteen months before the disaster, 92 4th through 6th graders provided self-reports of anxiety; peers and teachers rated behavior problems (anxiety, inattention, and conduct) and academic skills. Measures were repeated 3 months postdisaster; children also reported PTS symptoms and hurricane-related experiences (i.e., exposure). PTS symptoms were again assessed 7 months postdisaster. At 3 months postdisaster, children's exposure to the disaster, as well as predisaster ratings of anxiety, inattention, and academic skills, predicted PTS symptoms. By 7 months, only exposure, African American ethnicity, and predisaster anxiety predicted PTS. Prior anxiety levels also worsened as a result of exposure to the disaster. The findings have implications for identifying and treating children at risk for stress reactions following a catastrophic disaster.",0,0 +5134,Mental Health Problems Among Adults in Tsunami-Affected Areas in Southern Thailand,"On December 26, 2004, an undersea earthquake occurred off the northwestern coast of Sumatra, Indonesia. The tsunami that followed severely affected all 6 southwestern provinces of Thailand, where 5395 individuals died, 2991 were unaccounted for, and 8457 were injured.To assess the prevalence of symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression among individuals residing in areas affected by the tsunami in southern Thailand as part of a public health emergency response and rapid assessment.A multistage, cluster, population-based mental health survey was conducted from February 15 to 22, 2005, of random samples of displaced (n = 371) and nondisplaced persons in Phang Nga province (n = 322) and nondisplaced persons in the provinces of Krabi and Phuket (n = 368). Data were collected using an interviewer-administered questionnaire on handheld computers. A surveillance follow-up survey of the displaced persons (n = 371) and nondisplaced persons (n = 322) in Phang Na was conducted in September 2005.Medical Outcomes Study-36 Short-Form Health Survey SF-36 to assess self-perceived general health, bodily pain, and social and emotional functioning; the Harvard Trauma Questionnaire to assess tsunami-specific traumatic events; and the Hopkins Checklist-25 to detect symptoms of anxiety and depression.Participation rates for displaced and nondisplaced persons in the rapid assessment survey were 69% and 58%, respectively. Symptoms of PTSD were reported by 12% of displaced and 7% of nondisplaced persons in Phang Nga and 3% of nondisplaced persons in Krabi and Phuket. Anxiety symptoms were reported by 37% of displaced and 30% of nondisplaced persons in Phang Nga and 22% of nondisplaced persons in Krabi and Phuket. Symptoms of depression were reported by 30% of displaced and 21% of nondisplaced persons in Phang Nga and 10% of nondisplaced persons in Krabi and Phuket. In multivariate analysis, loss of livelihood was independently and significantly associated with symptoms of all 3 mental health outcomes (PTSD, anxiety, and depression). In the 9-month follow-up surveillance survey of 270 (73%) displaced and 250 (80%) nondisplaced participants in Phang Nga, prevalence rates of symptoms of PTSD, anxiety, and depression among displaced persons decreased to 7%, 24.8%, and 16.7%, respectively, and among nondisplaced persons, prevalence rates decreased to 2.3%, 25.9%, and 14.3%, respectively.Among survivors of the tsunami in southern Thailand, elevated rates of symptoms of PTSD, anxiety, and depression were reported 8 weeks after the disaster, with higher rates for anxiety and depression than PTSD symptoms. Nine months after the disaster, the rates of those reporting these symptoms decreased but were still elevated. This information is important for directing, strengthening, and evaluating posttsunami mental health needs and interventions.",0,0 +5135,"Suffering, hope, and entrapment: Resilience and cultural values in Afghanistan","A critical health-related issue in war-affected areas is how people make sense of adversity and why they show resilience in a high-risk environment. In Afghanistan, the burden of poor mental health arises in contexts of pervasive poverty, social inequality, and persistent violence. In 2006, we conducted face-to-face interviews with 1011 children (age 11-16) and 1011 adult caregivers, randomly selected in a school-based survey in three northern and central areas. Participants narrated their experiences as part of a systematic health survey, including an open-ended questionnaire on major life stressors and solutions to mitigate them. Responses were analysed using an inductive thematic approach and categorised for quantitative presentation, producing a conceptual model. For adults, the primary concern is repairing their ""broken economy,"" the root of all miseries in social, educational, governance, and health domains. For students, frustrations focus on learning environments as well as poverty, as education is perceived as the gateway to upward social and economic mobility. Hope arises from a sense of moral and social order embodied in the expression of key cultural values: faith, family unity, service, effort, morals, and honour. These values form the bedrock of resilience, drive social aspirations, and underpin self-respect and dignity. However, economic impediments, social expectations, and cultural dictates also combine to create entrapment, as the ability to realise personal and social aspirations is frustrated by structural inequalities injurious to health and wellbeing. This study contributes to a small but growing body of work on resilience in public health and conflict settings. It demonstrates that culture functions both as an anchor for resilience and an anvil of pain, and highlights the relevance of ethnographic work in identifying what matters most in formulating social and public health policies to promote a hopeful future.",0,0 +5136,Gender Differences in the Associations of PTSD Symptom Clusters With Relationship Distress in U.S. Vietnam Veterans and Their Partners,"Research has consistently linked symptoms of posttraumatic stress disorder (PTSD) with relationship distress in combat veterans and their partners. Studies of specific clusters of PTSD symptoms indicate that symptoms of emotional numbing/withdrawal (now referred to as negative alterations in cognition and mood) are more strongly linked with relationship distress than other symptom clusters. These findings, however, are based predominantly on samples of male veterans. Given the increasing numbers of female veterans, research on potential gender differences in these associations is needed. The present study examined gender differences in the multivariate associations of PTSD symptom clusters with relationship distress in 465 opposite-sex couples (375 with male veterans and 90 with female veterans) from the National Vietnam Veterans Readjustment Study. Comparisons of nested path models revealed that emotional numbing/withdrawal symptoms were associated with relationship distress in both types of couples. The strength of this association, however, was stronger for female veterans (b = .46) and female partners (b = .28), compared to male veterans (b = .38) and male partners (b = .26). Results suggest that couples-based interventions (e.g., psychoeducation regarding emotional numbing symptoms as part of PTSD) are particularly important for both female partners of male veterans and female veterans themselves.",0,0 +5137,Polysomnographically measured sleep abnormalities in PTSD: A meta-analytic review,"Although sleep complaints are common among patients with Posttraumatic stress disorder (PTSD), polysomnographic studies examining sleep abnormalities in PTSD have produced inconsistent results. To clarify discrepant findings, we conducted a meta-analytic review of 20 polysomnographic studies comparing sleep in people with and without PTSD. Results showed that PTSD patients had more stage 1 sleep, less slow wave sleep, and greater rapid-eye-movement density compared to people without PTSD. We also conducted exploratory analyses aimed at examining potential moderating variables (age, sex, and comorbid depression and substance use disorders). Overall, studies with a greater proportion of male participants or a low rate of comorbid depression tended to find more PTSD-related sleep disturbances. These findings suggest that sleep abnormalities exist in PTSD, and that some of the inconsistencies in prior findings may be explained by moderating variables.",0,0 +5138,Transitional Life Events and Trajectories of Cigarette and Alcohol Use During Emerging Adulthood: Latent Class Analysis and Growth Mixture Modeling,"Emerging adulthood (ages 18-25 years) has been associated with elevated substance use. Transitional life events (TLEs) during emerging adulthood in relation to substance use are usually examined separately, rather than as a constellation. The purposes of this study were (a) to explore distinct subgroups experiencing various TLEs during emerging adulthood, (b) to identify heterogeneous trajectories of cigarette and alcohol use during emerging adulthood, and (c) to examine the association of TLEs with cigarette and alcohol use trajectories.Five waves of longitudinal data (mean age range: 19.5-26.0 years) were used from a community-based drug prevention program (n = 946, 49.9% female). Distinct subgroups of emerging adults who experienced various TLEs were identified using latent class analysis. Cigarette and alcohol use were examined using a latent growth mixture model.A three-class model fit the data best in identifying TLE subgroups (new family, college attenders [NFCA]; uncommitted relationships, college attenders [URCA]; hibernators [HBN]). Three-trajectory models fit the data best for cigarette and alcohol use during emerging adulthood. The TLE categories were significantly associated with the cigarette (p < .05) and alcohol use groups (p < .001); specifically, the URCA and HBN groups were significantly more likely to be classified as accelerating cigarette users, relative to NFCA (ps < .05). The NFCA and HBN groups were significantly more likely to be classified as accelerating alcohol users, relative to URCA (ps < .01).To characterize an ""at-risk"" emerging adult group for cigarette and alcohol use over time, a range of life events during emerging adulthood should be considered. Interventions tailored to young adulthood may benefit from targeting the absence of these life events typifying ""independence"" as a potential marker for underlying substance use problems and provide supplemental screening methods to identify young adults with similar issues.",0,0 +5139,Risk Factors and Health Profiles of Recent Migrant Women Who Experienced Violence Associated with Pregnancy,"Background: Violence associated with pregnancy is a major public health concern, but little is known about it in recent migrant women. This study looked at (1) risk factors for violence associated with pregnancy among newly arrived migrant women in Canada and (2) if those who experienced violence associated with pregnancy had a different health profile or use of healthcare services for themselves or their infants during pregnancy and up to 4 months postpartum compared to other childbearing migrant women. Methods: Pregnant migrant women in Canada <5 years were recruited in 12 hospitals in 3 large cities between 2006 and 2009 and followed to 4 months postpartum. Data were collected on maternal background, migration history, violence associated with pregnancy, maternal and infant physical and mental health, and services used. Results: Of a total of 774 pregnant migrant women, 59 (7.6%) women reported violence associated with pregnancy. Migrant women who experienced violence, compared to those who did not, were at increased risk of violence if they lived without a partner, were asylum seekers, migrated <2 years ago, or had less than high school education. Women who reported violence were less likely to have up-to-date vaccinations, take folic acid before pregnancy, more likely to commence prenatal care after 3 months gestation and to not use contraceptives after birth. They were also more likely to have a history of miscarriage and report more postpartum pain and increased bleeding. They were also more likely to have inadequate social support and report more depression, anxiety, somatization, and posttraumatic stress disorder (PTSD) on standardized tests. No differences were found in the health status of the infants of women who experienced violence compared to those who did not. Conclusions: Clinicians should sensitively ask recent migrant women (asylum seekers, refugees, and nonrefugee immigrants) about violence associated with pregnancy and appropriately assess, treat, and refer them.",0,0 +5140,Police suicide--a Web surveillance of national data,"Considerable research has been done on suicide in police work. It appears that the volume of literature on this topic has led to considerable controversy concerning the accuracy and validity of police suicide rates. This topic has given rise to a wide variety of speculative, often wildly exaggerated figures being circulated in the law enforcement community and media, much of which is not based on verifiable research or gathered in an organized, useful manner that can be shared and scrutinized. Such figures have been taken at face value, translated into widely varying rates and profiles that, because they lack any substantiation, do little to help and much to impede the meaningful development of programs that can address the problems of police stress, trauma, posttraumatic stress, suicide, and the promotion of improved general health in the law enforcement community. This paper represents an empirical attempt to gather descriptive police suicide data from all fifty states in the U.S. for one year--2008--and record it in a cohesive manner that may be useful to researchers, police agencies, and program developers.",0,0 +5141,Going to war does not have to hurt: preliminary findings from the British deployment to Iraq,"We carried out a brief longitudinal mental health screen of 254 members of the UK's Air Assault Brigade before and after deployment to Iraq last year. Analysis of General Health Questionnaire (GHQ-28) scores before and after deployment revealed a lower score after deployment (mean difference=0.93, 95% CI 0.35-1.52). This indicated a highly significant relative improvement in mental health (P < 0.005). Moreover, only 9 of a larger sample of 421 (2%) exceeded cut-off criteria on the Trauma Screening Questionnaire. These findings suggest that war is not necessarily bad for psychological health.",0,0 +5142,Potential of eye movement desensitization and reprocessing therapy in the treatment of post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) continues to attract both empirical and clinical interest due to its complex symptom profile and the underlying processes involved. Recently, research attention has been focused on the types of memory processes involved in PTSD and hypothesized neurobiological processes. Complicating this exploration, and the treatment of PTSD, are underlying comorbid disorders, such as depression, anxiety, and substance use disorders. Treatment of PTSD has undergone further reviews with the introduction of eye movement desensitization and reprocessing (EMDR). EMDR has been empirically demonstrated to be as efficacious as other specific PTSD treatments, such as trauma-focused cognitive behavioral therapy. There is emerging evidence that there are different processes underlying these two types of trauma treatment and some evidence that EMDR might have an efficiency advantage. Current research and understanding regarding the processes of EMDR and the future direction of EMDR is presented.",0,0 +5143,Prevalence and Risk Factors of Posttraumatic Stress Disorder in Older Adults,"Posttraumatic stress disorder (PTSD) has scarcely been researched in the elderly. There is no population-based information on prevalence and risk factors in older persons. Patients with PTSD are often not recognized or incorrectly diagnosed. As the disorder has great implications for the quality of life, a correct diagnosis and treatment are crucial. Increased knowledge on vulnerability factors for PTSD can facilitate diagnostic procedures and health management in the elderly.PTSD cases were found following a two-phase sampling procedure: a random selection of 1,721 subjects were screened and in 422 subjects a psychiatric diagnostic interview was administered. Prevalence of PTSD and subthreshold PTSD were calculated. Vulnerability factors regarding demographics, physical health, personality, social factors, recent distress and adverse events in early childhood were assessed.6-month prevalence of PTSD and of subthreshold PTSD was 0.9 and 13.1%, respectively. The strongest vulnerability factors for both PTSD and subthreshold PTSD were neuroticism and adverse events in early childhood.This is the first population-based study on PTSD in older persons. With a 6-month prevalence of almost 1% the disease is not rare. Comparisons with younger populations suggest some accumulation of cases among older people reflecting the chronic risk factors, which are found in this study: neuroticism and adverse events in early childhood.",0,0 +5144,Psychogenic Lowering of Urinary Cortisol Levels Linked to Increased Emotional Numbing and a Shame-Depressive Syndrome in Combat-Related Posttraumatic Stress Disorder,"The purpose of the study was to search for the intrapsychic correlates of individual differences in cortisol levels in male Vietnam combat veterans with posttraumatic stress disorder.The study involved measurement of urinary cortisol levels and clinical assessment with a broad profile of psychometric tests during a single 48-hour period in 30 inpatients.The main finding by both correlation and t test analyses was a significant inverse relationship between urinary cortisol levels and a symptom complex composed of two closely interrelated clinical subgroupings, ""disengagement"" (principally involving emotional numbing) and ""shame-laden depression.""The findings support the concept that cortisol levels reflect the ongoing balance between the undifferentiated emotional arousal state of engagement (associated with higher cortisol levels) and opposing antiarousal disengagement defense mechanisms (associated with lower cortisol levels). It appears that the low cortisol levels often seen in patients with posttraumatic stress disorder are psychogenic and reflect a dominating effect of disengagement coping strategies, which represent secondary compensatory adaptations during the chronic course of this disorder to counteract primary arousal symptoms, especially those related to an intractable shame-laden depressive syndrome. The psychoendocrine findings suggest that the relatively inconspicuous clinical feature of shame resulting from both the primary and secondary traumatizations is a particularly powerful, preoccupying, and overwhelming source of emotional engagement. Shame may represent a ""sleeper"" that is worthy of greater attention in both research and clinical efforts to understand the pathogenesis and psychopathology of this devastating stress-related disorder.",0,0 +5145,Meaning-making appraisals relevant to adjustment for veterans with spinal cord injury.,"The purpose of the present study was to conduct a mixed-methods investigation of meaning-making appraisals generated from spinal cord injury survivors' narratives of their injury experience. The sample consisted of 79 participants from an urban midwestern Veterans Affairs facility. The study design was cross-sectional and incorporated semistructured, face-to-face interviews, taking approximately 1 hr to complete. Measures of posttraumatic stress disorder, depression, psychological well-being, and purpose in life were completed as part of the interview. A data analytic approach based on grounded theory that allowed qualitative themes to be transformed to quantitative data was employed. Seven salient meaning-making themes were identified. Significant relationships were identified between certain meaning-making themes (e.g., identity integration positively related to positive growth), and certain themes were also significantly related to postinjury psychological health and distress separately (e.g., perceived burden on others was significantly related to greater depression scores). Findings are discussed within the context of clinical interventions that foster positive posttrauma outcomes.",0,0 +5146,Hurt people who hurt people: Violence amongst individuals with comorbid substance use disorder and post traumatic stress disorder,"The association between substance use disorder (SUD) and the perpetration of violence has been well documented. There is some evidence to suggest that the co-occurrence of post traumatic stress disorder (PTSD) may increase the risk for violence. This study aims to determine the prevalence of violence perpetration and examine factors related to violence amongst individuals with comorbid SUD and PTSD.Data was collected via interview from 102 participants recruited to a randomised controlled trial of an integrated treatment for comorbid SUD and PTSD.The interview addressed demographics, perpetration of violent crime, mental health including aggression, substance use, PTSD, depression, anxiety and borderline personality disorder.Over half of participants reported committing violence in their lifetime and 16% had committed violence in the past month. Bivariate associations were found between violence perpetration and trait aggression, higher levels of alcohol and cannabis use, lower levels of other opiate use, and experiencing more severe PTSD symptoms, particularly in relation to hyperarousal. When entered into a backward stepwise logistic regression however, only higher levels of physical aggression and more severe PTSD hyperarousal symptoms remained as independent predictors of violence perpetration.These findings highlight the importance of assessing for PTSD amongst those with SUD particularly in forensic settings. They also indicate that it is the hyperarousal symptoms of PTSD specifically that need to be targeted by interventions aimed at reducing violence amongst individuals with SUD and PTSD.",0,0 +5147,A Village Possessed by “Witches”: A Mixed-Methods Case–Control Study of Possession and Common Mental Disorders in Rural Nepal,"In Nepal, spirit possession is a common phenomenon occurring both in individuals and in groups. To identify the cultural contexts and psychosocial correlates of spirit possession, we conducted a mixed-method study in a village in central Nepal experiencing a cluster of spirit possession events. The study was carried out in three stages: (1) a pilot study consisting of informal interviews with possessed individuals, observations of the possession spells, and video recording of possession events; (2) a case–control study comparing the prevalence of symptoms of common mental disorders in women who had and had not experienced possession; and (3) a follow-up study with focus group discussions and in-depth interviews with possessed and non-possessed men and women, and key informants. Quantitative results indicated that possessed women reported higher rates of traumatic events and higher levels of symptoms of mental disorder compared to non-possessed women (Anxiety 68 vs. 18 %, Depression 41 vs. 19 %, and PTSD 27 vs. 0 %). However, qualitative interviews with possessed individuals, family members, and traditional healers indicated that they did not associate possession states with mental illness. Spirit possession was viewed as an affliction that provided a unique mode of communication between humans and spirits. As such, it functioned as an idiom of distress that allowed individuals to express suffering related to mental illness, socio-political violence, traumatic events, and the oppression of women. The study results clearly indicate that spirit possession is a multi-dimensional phenomenon that cannot be mapped onto any single psychiatric or psychological diagnostic category or construct. Clinical and public health efforts to address spirit possession must take the socio-cultural context and systemic dynamics into account to avoid creating iatrogenic illness, undermining coping strategies, and exacerbating underlying social problems.",0,0 +5148,Links between child and adolescent trauma exposure and service use histories in a national clinic-referred sample.,"The National Child Traumatic Stress Network (NCTSN) is a federally funded child mental health service initiative designed to raise the standard of care and increase access to evidence-based services for traumatized children and their families across the United States. As part of the quality improvement goal, a Core Data Set (CDS) was established to standardize data collection and examine treatment outcomes across participating centers. This paper describes baseline demographic characteristics, prevalence of trauma exposure, and service use for children and adolescents served by a broad range of NCTSN service delivery centers. Data were collected from children 0–18 years (52% girls, 82% were 6–18 years old) who reported exposure to at least one trauma and who received trauma-related services (n 11,104). Approximately half the sample was White; more than three quarters reported exposure to multiple types of trauma. Sixty-three percent were eligible for state- or federally funded insurance. The two most commonly reported traumatic events were traumatic loss/separation/bereavement and domestic violence. Number and type of trauma exposure varied by gender and age. Type and number of services utilized prior to entering an NCTSN center varied by number of trauma exposures. Systematically assessing children’s trauma exposure provides clinically useful information, particularly for those exposed to multiple types of traumatic events. Identifying subgroups, and markers of risk for trauma-related sequelae, may inform policies, programs, and best practices to meet specific needs of children and families. Future research may clarify high-risk trauma profiles for coordinated utilization of systems of care.",0,0 +5149,Physiotherapy management of whiplash-associated disorders (WAD),[Sterling M (2014) Physiotherapy management of whiplash-associated disorders (WAD). Journal of Physiotherapy 60: 5–12],0,0 +5150,"Selecting a linear mixed model for longitudinal data: Repeated measures analysis of variance, covariance pattern model, and growth curve approaches.","With increasing popularity, growth curve modeling is more and more often considered as the 1st choice for analyzing longitudinal data. Although the growth curve approach is often a good choice, other modeling strategies may more directly answer questions of interest. It is common to see researchers fit growth curve models without considering alterative modeling strategies. In this article we compare 3 approaches for analyzing longitudinal data: repeated measures analysis of variance, covariance pattern models, and growth curve models. As all are members of the general linear mixed model family, they represent somewhat different assumptions about the way individuals change. These assumptions result in different patterns of covariation among the residuals around the fixed effects. In this article, we first indicate the kinds of data that are appropriately modeled by each and use real data examples to demonstrate possible problems associated with the blanket selection of the growth curve model. We then present a simulation that indicates the utility of Akaike information criterion and Bayesian information criterion in the selection of a proper residual covariance structure. The results cast doubt on the popular practice of automatically using growth curve modeling for longitudinal data without comparing the fit of different models. Finally, we provide some practical advice for assessing mean changes in the presence of correlated data.",0,0 +5151,Mental Health in Sumatra After the Tsunami,"Objectives. We assessed the levels and correlates of posttraumatic stress reactivity (PTSR) of more than 20000 adult tsunami survivors by analyzing survey data from coastal Aceh and North Sumatra, Indonesia. Methods. A population-representative sample of individuals interviewed before the tsunami was traced in 2005 to 2006. We constructed 2 scales measuring PTSR by using 7 symptom items from the Post Traumatic Stress Disorder (PTSD) Checklist–Civilian Version. One scale measured PTSR at the time of interview, and the other measured PTSR at the point of maximum intensity since the disaster. Results. PTSR scores were highest for respondents from heavily damaged areas. In all areas, scores declined over time. Gender and age were significant predictors of PTSR; markers of socioeconomic status before the tsunami were not. Exposure to traumatic events, loss of kin, and property damage were significantly associated with higher PTSR scores. Conclusions. The tsunami produced posttraumatic stress reactions across a wide region of Aceh and North Sumatra. Public health will be enhanced by the provision of counseling services that reach not only people directly affected by the tsunami but also those living beyond the area of immediate impact.",0,0 +5152,Urinary Catecholamine Excretion and Severity of PTSD Symptoms in Vietnam Combat Veterans,"In the present study, we replicated and extended our previous findings of increased 24-hour urinary catecholamine excretion in posttraumatic stress disorder (PTSD). Dopamine, norepinephrine, and epinephrine concentrations were measured in 22 male patients with PTSD (14 inpatients and eight outpatients) and in 16 nonpsychiatric normal males. The PTSD inpatients showed significantly higher excretion of all three catecholamines compared with both outpatients with PTSD and normal controls. Dopamine and norepinephrine, but not epinephrine, levels were significantly correlated with severity of PTSD symptoms in the PTSD group as a whole. In particular, these catecholamines seemed related to intrusive symptoms. None of the catecholamines were correlated with severity of depression. The findings support the hypothesis of an enhanced sympathetic nervous system activation in PTSD, and suggest that increased sympathetic arousal may be closely linked to severity of certain PTSD symptom clusters.",0,0 +5153,Reactions of Police Officers to Body-Handling after a Major Disaster a Before-and-After Comparison,"This study reports the results of an unusual opportunity to follow up a group of police officers who were involved in body-handling duties following the Piper Alpha disaster, and for whom there were available data from pre-disaster assessments. In addition, after these duties, the officers were compared with a matched control group of officers who had not been involved in such work. The comparisons failed to demonstrate high levels of post-traumatic distress or psychiatric morbidity. The results are interpreted in terms of issues such as the officers' own coping strategies, and major organisational and managerial factors.",0,0 +5154,"Well-being, posttraumatic growth and benefit finding in long-term breast cancer survivors","This study evaluates posttraumatic growth, benefit finding and well-being, and their mutual association in a random sample of disease-free 10-year breast cancer survivors. The population-based Eindhoven Cancer Registry (ECR) was used to select all women diagnosed with breast cancer in 1993 in six hospitals. Of the 254 breast cancer survivors, 183 (72%) returned a completed questionnaire. Measures included the Posttraumatic Growth Inventory (posttraumatic growth), the Perceived Disease Impact Scale (benefit finding) and the CentERdata Health monitor (life satisfaction, health status and psychological well-being). Self-reported health status and psychological well-being were similar in survivors compared to general population norms, whereas life satisfaction was significantly higher among survivors. In addition, posttraumatic growth was seen in the following domains: relationships with others, personal strength and appreciation of life. The number of patients reporting benefit finding was high (79%, N = 145). Benefit finding showed a moderately positive correlation with posttraumatic growth. In addition, women who stated that their satisfaction with life was high reported higher levels of posttraumatic growth in comparison to women who did not. Radiotherapy was negatively associated with posttraumatic growth. Women with a higher tumour stage at diagnosis experienced less benefit finding in comparison to women with a lower tumour stage at diagnosis. The above results can help to identify those patients who will probably experience posttraumatic growth and benefit finding after cancer. However, it is important to be aware that the positive effects of cancer on a patient's life do not occur in all cancer patients and all phases of the disease trajectory.",0,0 +5155,Cluster analysis of MCMI and MCMI-II on chronic PTSD victims,"A cluster analysis was used to identify groups of inpatients with confirmed post-traumatic stress disorder (PTSD) due to combat. In Study 1 the MCMI was administered to 256 subjects, in addition to the MMPI, PTSD measures, and background variables. Three clusters resulted: a Traumatic Personality (8-2), Schizoid Influence (8-2-1), and Antisocial Influence (8-6). Comparison on the MCMI symptom scales, MMPI, and PTSD scales showed that the Antisocial Influence cluster was ""healthier"" on all measures. The Schizoid Influence was most psychopathological. In Study 2 the MCMI-II was administered to 136 new subjects who met the same criteria as in Study 1. Four clusters resulted: Global (1-2-6A-6B-8A-8B), Subclinical (1), Aggressive (6A-6B-8A), and Detached/Self-defeating (1-2-8A-8B).",0,0 +5156,Affective and anxiety comorbidity in post-traumatic stress disorder treatment trials of sertraline,"Comorbidity of mood and anxiety disorders is common in patients suffering from post-traumatic stress disorder (PTSD). The current study evaluated the efficacy and tolerability of sertraline in a subgroup of PTSD patients suffering from anxiety or depression comorbidity. Two multicenter, 12-week, double-blind, flexible-dose US studies of adult outpatients from the general population with a DSM-III-R diagnosis of PTSD evaluated the safety and efficacy of sertraline (50 to 200 mg/d) compared to placebo in the treatment of PTSD. The total severity score of the Clinician-Administered PTSD Scale (CAPS-2) and the Davidson Trauma Scale (DTS) were used to examine the effect of comorbidity on treatment outcome. Among the combined 395 subjects enrolled in the two trials, 32.9% had a comorbid depressive diagnosis (no anxiety diagnosis), 6.3% had a comorbid anxiety disorder diagnosis (no depression), 11.4% had both a depression and anxiety disorder diagnosis, and 49.4% had no comorbidity. The correlation, at baseline, between Hamilton Depression Rating Scale (HAM-D) total score and the three CAPS-2 clusters was 0.37 for the re-experiencing/intrusion cluster, 0.52 for the avoidance/numbing cluster, and 0.45 for the hyperarousal cluster. Patients suffering from PTSD complicated by a current diagnosis of both depression and an anxiety disorder showed the highest baseline CAPS-2 cluster score severity. Patients treated with sertraline improved significantly (P <.05) compared to placebo on both the CAPS-2 and DTS whether or not they had a comorbid depressive or anxiety disorder. Sertraline was well tolerated. The presence of comorbidity was associated with a modest and mostly nonspecific increase in the side effect burden of approximately 10% to 20% on both study treatments. Patients suffering from dual depression and anxiety disorder comorbidity benefited from somewhat higher doses (147 mg v 125 mg; P =.08). Similarly, the presence of dual comorbidity resulted in a modest but nonsignificant increase in the mean time to response from 4.5 weeks to 5.5 weeks. We conclude that sertraline (50 to 200 mg/d) is effective and well tolerated in the treatment of PTSD for patients suffering from a current, comorbid depressive or anxiety disorders.",0,0 +5157,"Posttraumatic growth and its relationship to pre-, peri-, and post-surgical psychological factors","Depression and posttraumatic stress have been found to be important factors following cardiac surgery. Posttraumatic growth (PTG), however, has not been investigated following cardiac surgery, although it has been assessed regarding other health conditions. The current study assessed PTG at 3 to 6 years post coronary artery bypass graft (CABG) surgery among 31 participants (mean age 68.6, SD 10.9; 58.1% male and 41.9% female), and compared to data collected at the time of surgery (pre-surgical depression, trauma history, and posttraumatic stress; peri-surgical appraisals of fear, helplessness, and life-threat). PTG was also assessed among the full sample of 39 participants in relation to their post-surgical depression and surgery-related posttraumatic stress. Differences in the Post Traumatic Growth Inventory scores were compared to presurgical, peri-surgical, and post-surgical psychological factors. Participants with High PTG had higher levels of depression prior to heart surgery ( F (1, 29) = 4.20, p <.05). Participants with High PTG reported more fearfulness and perceived life threat in relation to the change in their cardiac condition (F (1, 28) = 4.49, p <.05) and (F (1, 28) = 4.97, p <.05), respectively. No differences were found between High and Low PTG groups on presurgical posttraumatic stress, nor were group differences found in regard to post-surgical depression or traumatic stress. Through investigation of a previously neglected population with regard to PTG, the current study supports previous findings that those with moderate psychological resources may have the most to gain from experiencing a traumatic event (McMillen et al., 1997) as well as findings that individuals who perceive more potential for harm develop more PTG (Linley and Joseph, 2004). (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5158,Posttraumatic Headache: A Review,"There has been intense controversy about postconcussion syndrome (PCS) since Erichsen's publication in 1866 on railway brain and spine. Headache as a result of trauma is one of the most common secondary headache types. Posttraumatic headache (PTH) remains a very controversial disorder, particularly with relation to chronic PTH following mild closed-head injury. PTH is one of several symptoms of PCS, and therefore may be accompanied by additional cognitive, behavioral, and somatic problems. PTH also is an important public health issue due to its associated disability and often refractory clinical course. While current awareness of PTH has become more prominent due to increased scrutiny given to both combat-related and sports-related head injuries, directed treatment remains a difficult challenge for physicians. Because of the frequently associated medicolegal aspects, PTH is one of physicians' least favorite types to treat. The article reviews both PCS and PTH.",0,0 +5159,"Returning home: forced conscription, reintegration, and mental health status of former abductees of the Lord's Resistance Army in northern Uganda","BackgroundSince the late 1980s, the Lord's Resistance Army (LRA), a spiritualist rebel group in northern Uganda, has killed and mutilated thousands of civilians and abducted an estimated 52,000 to 75,000 people to serve as soldiers, porters, and sex slaves for its commanders. This study examines the types of violence to which former abductees have been exposed and the extent to which these acts have affected their psychological well-being.MethodsThis is a cross-sectional study of 2,875 individuals selected through a multi-stage stratified cluster sampling design conducted in 8 districts of northern Uganda. Multivariate logistic regressions were performed with symptoms for Post-traumatic Stress Disorder (PTSD) and depression as the main outcome measures.ResultsOne-third of the respondents (33%) self-reported having experienced abduction (49% among the Acholi, the largest tribal group in northern Uganda). Over half (56%) of all the respondents and over two-thirds of those who experienced abduction met the criteria for symptoms of post-traumatic stress disorder (PTSD). Multivariate analysis shows that several factors increased the risk of former LRA abductees developing symptoms of PTSD. These factors included gender (females were more susceptible than males), being a member of the Acholi ethnic group, participating in or witnessing a cumulative number of traumatic events, and encountering difficulties re-integrating into communities after abduction. Factors associated with increased risk of meeting criteria for symptoms of depression included older age of males at the time of abduction, lower score on social relationship scale, high incidence of general traumatic event exposure, high incidence of forced acts of violence, and problems reintegrating into communities after abduction.ConclusionAbduction and forced conscription of civilians has affected the psychological well-being of a significant number of northern Ugandans. The sources of psychological trauma are multiple, ranging from witnessing to being forced to commit violent acts, and compounded by prolonged exposure to violence, often for months or years. Community-based mental health care services and reintegration programs are needed to facilitate the reintegration of former abductees back into their communities.",0,0 +5160,Two subjective factors as moderators between critical incidents and the occurrence of post traumatic stress disorders: Adult attachment and perception of social support,"This paper presents the result of a research which investigated the influence of the subjective factors ‘adult attachment style’ and ‘perception of social support’ in the occurrence of post traumatic stress disorders (PTSD) in a population of 544 subjects working for a security company and the Belgian Red Cross. The analysis of the results suggests that ‘adult attachment style’ and ‘perception of social support’ moderate between a critical incident and the occurrence of a PTSD. In other words, these independent variables differentiate between individuals who are more, and who are less prone, to suffer from a PTSD after having experienced a critical incident. The results of this research shed light on subjective risk factors related to PTSD. The findings can also suggest guidelines for the treatment of individuals suffering from a PTSD.",0,0 +5161,The Effect of Financial Compensation on Health Outcomes following Musculoskeletal Injury: Systematic Review,"The effect of financial compensation on health outcomes following musculoskeletal injury requires further exploration because results to date are varied and controversial. This systematic review identifies compensation related factors associated with poorer health outcomes following musculoskeletal injury. Searches were conducted using electronic medical journal databases (Medline, CINAHL, Embase, Informit, Web of Science) for prospective studies published up to October 2012. Selection criteria included: prognostic factors associated with validated health outcomes; six or more months follow up; and multivariate statistical analysis. Studies solely measuring return to work outcomes were excluded. Twenty nine articles were synthesised and then assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology to determine evidence levels. The results were mixed. There was strong evidence of an association between compensation status and poorer psychological function; and legal representation and poorer physical function. There was moderate evidence of an association between compensation status and poorer physical function; and legal representation and poorer psychological function. There was limited evidence of an association between compensation status and increased pain. In seven studies the association depended on the outcome measured. No studies reported an association between compensation related factors and improved health outcomes. Further research is needed to find plausible reasons why compensation related factors are associated with poorer health following musculoskeletal injury.",0,0 +5162,The validation of a self-report measure of posttraumatic stress disorder: The Posttraumatic Diagnostic Scale.,"The present article reports on the development and validation of a self-report measure of posttraumatic stress disorder (PTSD), the Posttraumatic Diagnostic Scale (PTDS), that yields both a PTSD diagnosis according to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994; DSM-IV) criteria and a measure of PTSD symptom severity. Two-hundred forty-eight participants who had experienced a wide variety of traumas (e.g., accident, fire, natural disaster, assault, combat) were administered the PTSD module of the Structured Clinical Interview (SCID; Spitzer, Williams, Gibbons, & First, 1990), the PTDS, and scales measuring trauma-related psychopathology. The PTDS demonstrated high internal consistency and test-retest reliability, high diagnostic agreement with SCID, and good sensitivity and specificity. The satisfactory validity of the PTDS was further supported by its high correlations with other measures of trauma-related psychopathology. Therefore, the PTDS appears to be a useful tool for screening and assessing current PTSD in clinical and research settings.",0,0 +5163,Traumatic Brain Injury in a Child Psychiatry Inpatient Population: A Controlled Study,"To extend our findings from child psychiatry outpatients to child psychiatry inpatients regarding the similarity of children with a history of traumatic brain injury (TBI), particularly mild TBI, to matched children without such a history.This is a chart review of patients consecutively admitted to a child psychiatry inpatient unit over a 5-year period. Children with TBI were matched by age, sex, race, and social class to children with no history of TBI. Axis I and II diagnoses and diagnostic clusters and use of special education services and IQ scores were compared.Fifty-six (8.1%) of 694 consecutive patients admitted had a definite TBI. Not one of more than 50 variables compared between TBI and control subjects was significantly different.In a child psychiatry inpatient unit, patients with a history of TBI were virtually indistinguishable from matched children without TBI. Caution should be exercised before attributing the child's problems, especially long-term problems, to the TBI unless the injury was severe or the child is exhibiting related phobic or posttraumatic stress symptomatology.",0,0 +5164,Disaster research methods: Past progress and future directions,"Published results for 225 disaster studies were coded on methodological variables, severity of effects, and event year. Methods varied greatly, but cross-sectional, after-only designs, convenience sampling, and small samples were modal. Samples that were assessed before the disaster, selected for reasons of convenience, or were large tended to show less severe effects than other samples. Developing countries were underrepresented overall, but not in recent years. Certain desirable study characteristics (longitudinal designs, representative samples) have been decreasing in prevalence over time, whereas others (early first assessment) have been increasing. Innovations such as latent trajectory modeling or hierarchical linear modeling might advance the field's ability to capture the complexity of disasters, but the field still needs to attend to the fundamentals of sound epidemiologic research.",0,0 +5165,To lump or to split? Comparing individuals with traumatic and nontraumatic limb loss in the first year after amputation.,"To compare individuals with traumatic (TE) vs. nontraumatic (NTE) amputation etiology on pain, psychological, and social variables over the first 12 months postamputation, and to explore changes in mean levels of and correlations between these variables over time.There were 111 adults with newly acquired limb loss.A VA medical center and a Level I trauma hospital in a large metropolitan area.Characteristic Pain Severity, Pain Interference, Patient Health Questionnaire depression module, Posttraumatic Stress Disorder Checklist, Social Constraints Scale, Aversive Emotional Support Scale, Centers for Disease Control and Prevention single item Social Support measure, single item loneliness measure.The NTE group was significantly older, had lower income, and had greater medical comorbidity, preamputation pain, and physical disability. The etiology groups did not differ significantly in mean levels of outcome variables except that the TE group reported greater aversive emotional support at 6 and 12 months. The TE group demonstrated a quadratic change in pain interference, with highest levels at 6 months and a linear increase in social constraints. Both etiology groups showed a linear increase in PTSD symptoms over time. Correlations between physical, psychological, and social distress were observed earlier in the year for the NTE group.Despite significant demographic and preamputation experience differences, few differences in outcomes emerged by etiology group in the first year after amputation. Findings suggest that the year after amputation may be a time of greater change for those with traumatic amputation compared to those with nontraumatic amputation.",0,0 +5166,Anger in the UK Armed Forces,"We assessed the strength of the association of several mental health problems, childhood difficulties, and combat role with anger, as well as the contribution of these factors to explain anger assessed by population attributable fraction (PAF). A total of 9885 UK service personnel, some of them deployed to Iraq and Afghanistan, participated in the study. There was a strong or intermediate association between cases and subthreshold cases of symptoms of posttraumatic stress disorder, psychological distress, multiple physical symptoms and alcohol misuse, having a combat role, childhood adversity, and childhood antisocial behavior with anger. The PAF for any mental health problem and combat role and childhood difficulties was 0.64 (95% confidence interval [CI], 0.56-0.70) and increased to 0.77 (95% CI, 0.69-0.83) if subthreshold cases were included. Anger is a frequent component of mental disorders; health care professionals need to be aware of the interference of anger in the management of mental illness and that anger infrequently presents as an isolated phenomenon.",0,0 +5167,The challenges of reintegration for service members and their families.,"The ongoing wars in Afghanistan and Iraq have posed a number of reintegration challenges to service members. Much of the research focuses on those service members experiencing psychological problems and being treated at the VA. In this article, we contend that much of the distress service members experience occurs following deployment and is a consequence of the difficulties encountered during their efforts to successfully reintegrate into their families and communities. We propose a new conceptual framework for intervening in this reintegration distress that is psycho-educational in nature as well as a new delivery model for providing such services. An example of this new intervention framework is presented.",0,0 +5168,Prevalence of Delayed-Onset Posttraumatic Stress Disorder in Military Personnel,"Delayed-onset posttraumatic stress disorder (PTSD) is defined as onset at least 6 months after a traumatic event. This study investigates the prevalence of delayed-onset PTSD in 1397 participants from a two-phase prospective cohort study of UK military personnel. Delayed-onset PTSD was categorized as participants who did not meet the criteria for probable PTSD (assessed using the PTSD Checklist Civilian version) at phase 1 but met the criteria by phase 2. Of the participants, 3.5% met the criteria for delayed-onset PTSD. Subthreshold PTSD, common mental disorder (CMD), poor/fair self-reported health, and multiple physical symptoms at phase 1 and the onset of alcohol misuse or CMD between phases 1 and 2 were associated with delayed-onset PTSD. Delayed-onset PTSD exists in this UK military sample. Military personnel who developed delayed-onset PTSD were more likely to have psychological ill-health at an earlier assessment, and clinicians should be aware of the potential comorbidity in these individuals, including alcohol misuse. Leaving the military or experiencing relationship breakdown was not associated.",0,0 +5169,Killing and latent classes of PTSD symptoms in Iraq and Afghanistan veterans,"Our goal was to better understand distinct PTSD symptom presentations in Iraq and Afghanistan Veterans ( N =227) and to determine whether those who killed in war were at risk for being in the most symptomatic class. We used latent class analysis of responses to the PTSD checklist and logistic regression of most symptomatic class. We found that a four-class solution best fit the data, with the following profiles emerging: High Symptom (34% of participants), Intermediate Symptom (41%), Intermediate Symptom with Low Emotional Numbing (10%), and Low Symptom (15%). The largest group of individuals who reported killing (45%) was in the High Symptom class, and those who killed had twice the odds of being in the most symptomatic PTSD class, compared to those who did not kill. Those who endorsed killing a non-combatant ( OR =4.56, 95% CI [1.77, 11.7], p<0.01) or killing in the context of anger or revenge ( OR =4.63, 95% CI =[1.89, 11.4], p<0.001) were more likely to belong to the most symptomatic PTSD class, compared to those who did not kill. The study was retrospective and cross-sectional. The results may not generalize to veterans of other wars. Killing in war may be an important indicator of risk for developing frequent and severe PTSD symptoms. This has implications for the mental healthcare of veterans, providing evidence that a comprehensive evaluation of returning veterans should include an assessment of killing experiences and reactions to killing.",0,0 +5170,"60,000 Disaster Victims Speak: Part I. An Empirical Review of the Empirical Literature, 1981–2001","Results for 160 samples of disaster victims were coded as to sample type, disaster type, disaster location, outcomes and risk factors observed, and overall severity of impairment. In order of frequency, outcomes included specific psychological problems, nonspecific distress, health problems, chronic problems in living, resource loss, and problems specific to youth. Regression analyses showed that samples were more likely to be impaired if they were composed of youth rather than adults, were from developing rather than developed countries, or experienced mass violence (e.g., terrorism, shooting sprees) rather than natural or technological disasters. Most samples of rescue and recovery workers showed remarkable resilience. Within adult samples, more severe exposure, female gender, middle age, ethnic minority status, secondary stressors, prior psychiatric problems, and weak or deteriorating psychosocial resources most consistently increased the likelihood of adverse outcomes. Among youth, family factors were primary. Implications of the research for clinical practice and community intervention are discussed in a companion article (Norris, Friedman, and Watson, this volume).",0,0 +5171,Evidence of symptom profiles consistent with posttraumatic stress disorder and complex posttraumatic stress disorder in different trauma samples,"The International Classification of Diseases, 11th version (ICD-11), proposes two related stress and trauma-related disorders, posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). A diagnosis of CPTSD requires that in addition to the PTSD symptoms, an individual must also endorse symptoms in three major domains: (1) affective dysregulation, (2) negative self-concepts, and (3) interpersonal problems. This study aimed to determine if the naturally occurring distribution of symptoms in three groups of traumatised individuals (bereavement, sexual victimisation, and physical assault) were consistent with the ICD-11, PTSD, and CPTSD specification. The study also investigated whether these groups differed on a range of other psychological problems.Participants completed self-report measures of each symptom group and latent class analyses consistently found that a three class solution was best. The classes were ""PTSD only,"" ""CPTSD,"" and ""low PTSD/CPTSD."" These classes differed significantly on measures of depression, anxiety, dissociation, sleep disturbances, somatisation, interpersonal sensitivity, and aggression. The ""CPTSD"" class in the three samples scored highest on all the variables, with the ""PTSD only"" class scoring lower and the ""low PTSD/CPTSD"" class the lowest.This study provides evidence to support the diagnostic structure of CPTSD and indicted that CPTSD is associated with a broad range of other psychological problems.",0,0 +5172,Parental Response to Child Injury: Examination of Parental Posttraumatic Stress Symptom Trajectories Following Child Accidental Injury,Trajectory analyses were used to empirically differentiate patterns of posttraumatic stress symptoms in parents following child accidental injury and explore the relationship between parent and child recovery patterns.Parent (n = 189) self-reported symptoms from acute to 2 years post accident were examined to (1) identify distinct parent symptom trajectories; (2) identify risk factors; and (3) explore the patterns of children and parents together.Analysis revealed three distinct symptom trajectory groups for parents: resilient (78%); clinical level acute symptoms that declined to below clinical level by 6 months (recovery 8%); and chronic subclinical (14%). Children of resilient parents were most likely to be resilient. Half of the children of parents with chronic subclinical trajectories were likely to have chronic trajectories.Clinicians cannot rely only on clinical level symptoms in parents to identify high risk families but include families where the parent has subclinical level symptoms.,1,0 +5173,Origin of chordate peptides by horizontal protozoan gene transfer in early metazoans and protists: Evolution of the teneurin C-terminal associated peptides (TCAP),"► The teneurin C-terminal associated peptides (TCAP) are a highly conserved signaling peptide family. ► TCAP and the teneurin–proprotein system play a major role in neurological development, processing and regulation of stress. ► The TCAP-teneurin system originated in the metazoan by a horizontal gene transfer event in a choanoflagellate. The teneurin C-terminal associated peptides (TCAP) are found at the extracellular face in C-terminal region of the teneurin transmembrane proteins. One of these peptides, TCAP-1 is independently transcribed as a smaller bioactive peptide that possesses a number of stress response-attenuating activities. The teneurin-TCAP system appears to be the result of a horizontal gene transfer from a prokaryotic proteinaceous polymorphic toxin to a choanoflagellate. In a basal metazoan, the TCAP region has been modified from a toxin to a soluble intercellular signaling system. New studies indicate that the teneurin-TCAP system form a complex signaling system associated with adhesion, cytoskeletal regulation and intracellular signaling. TCAP-1 is highly conserved in all vertebrates and in mammals, inhibits corticotropin-releasing factor (CRF)-associated stress. Using the TCAP-teneurin system as a model, it is likely that numerous peptide systems in the Chordata began as a result of horizontal gene transfer from prokaryotes early in metazoan ancestry.",0,0 +5174,Power of Latent Growth Curve Models to Detect Piecewise Linear Trajectories,"Latent curve models (LCMs) have been used extensively to analyze longitudinal data. However, little is known about the power of LCMs to detect nonlinear trends when they are present in the data. This simulation study was designed to investigate the Type I error rates, rates of nonconvergence, and the power of LCMs to detect piecewise linear growth and mean differences in the slopes of the 2 joined longitudinal processes represented by the piecewise model. The impact of 7 design factors was examined: number of time points, growth magnitude (slope mean), interindividual variability, sample size, position of the turning point, and the correlation of the intercept and the second slope as well between the 2 slopes. The results show that previous results based on linear LCMs cannot be fully generalized to a nonlinear model defined by 2 linear slopes. Interestingly, design factors specific to the piecewise context (position of the turning point and correlation between the 2 growth factors) had some effects on th...",0,0 +5175,Assessment of Accurate Self-Knowledge,"Despite ongoing theoretical interest in the accuracy of self-knowledge and its implications for mental health, few researchers have yet to tackle this topic directly. This may be due, in part, to several factors that make assessing individual differences in accurate self-knowledge especially difficult. In this article, we present a method for the assessment of accurate self-knowledge that relies on information gathered from the self, knowledgeable others, and observations of behavior in the laboratory, and we provide psychometric support for this newly developed assessment procedure. Specifically, we present evidence for internal consistency reliability, convergent and discriminant validity, and criterion-related validity. Other researchers interested in studying the accuracy of self-knowledge might wish to adopt this procedure in their own research endeavors.",0,0 +5176,Salivary Cortisol Lower in Posttraumatic Stress Disorder,"Altered cortisol has been demonstrated to be lower in those with posttraumatic stress disorder (PTSD) in most studies. This cross-sectional study evaluated salivary cortisol at waking and 30 minutes after, and at bedtime in 51 combat veterans with PTSD compared to 20 veterans without PTSD. It also examined the relationship of cortisol to PTSD symptoms using 2 classifications: the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV; American Psychiatric Association, 1994) and the more recent 4-factor classification proposed for DSM-5. The PTSD group had lower cortisol values than the control group, F(6, 69) = 3.35, p = .006. This significance did not change when adding age, body mass index, smoking, medications affecting cortisol, awakening time, sleep duration, season, depression, perceived stress, service era, combat exposure, and lifetime trauma to the model. Post hoc analyses revealed that the PTSD group had lower area-under-the-curve ground and waking, 30 min, and bedtime values; the cortisol awakening response and area-under-the-curve increase were not different between groups. The 4-factor avoidance PTSD symptom cluster was associated with cortisol, but not the other symptom clusters. This study supports the finding that cortisol is lower in people with PTSD.",0,0 +5177,Comorbidity and Labor Force Activity Among People With Psychiatric Disorders,"Comorbidity among people with psychiatric disorders with respect to other health conditions is extensive yet is rarely explored in-depth in occupational studies. We investigated how other ICD-10 comorbidity impacted on the labor force activity of people with psychiatric disorders.A secondary analysis of data files was conducted provided by the Australian Bureau of Statistics (ABS) from a 2003 population survey (N = 36,088). The reference group was working age community residents without long-term health conditions.Comorbidity with a broad range of ICD-10 health conditions can be characterized by both type and extent of comorbidity. Both dimensions are needed to explain impacts on labor force activity.Health professionals, policymakers, and administrators can utilize these results to identify people with psychiatric disorders and comorbidity profiles most likely to need more intensive vocational services.",0,0 +5178,Neurogenetics of emotional reactivity to stress in animals,"There is much evidence for the involvement of central monoaminergic systems, the key targets of stress, in the regulation of mood. Animal and human findings indicate that genetics play a role in the etiology of mood disorders, and so we selected divergent inbred rat strains according to their anxiety-related behaviors on exposure to novel environments. We compared these strains for psychoneuroendocrine response to stressors and/or antidepressants. Molecular genetic studies were also performed to localize the genomic regions associated with these strain-dependent anxiety profiles. We then examined human results indicating that allelic variations in the serotonin transporter (5-HTT) may play a role in the etiology of neuroticism and depression. Thus, we compared inbred rat strains for the 5-HTT, with regard to central and peripheral (platelet) protein expression and function, and the consequences of local application of a selective serotonin reuptake inhibitor (SSRI) on extracellular serotonin (5-HT) levels. Our results indicate that spontaneously hypertensive rats and Lewis rats (LEW) selectively diverge in terms of anxiety-related behaviors and that this divergence is located on chromosome 4. The use of social defeat in LEW and the analysis of its psychoneuroendocrine consequences strongly suggest that such a paradigm, which is sensitive to repeated SSRI treatment, models posttraumatic stress disorder. The Wistar-Kyoto rat may be an adequate model to study the consequences of a genetically driven hypersensitivity to stress and noradrenergic antidepressants. Our most recent findings show that the Fischer 344 and LEW strains differ in protein expression and function of hippocampal and platelet 5-HTT; the divergence in protein expression is not due to allelic variations in the gene-coding sequences and leads to marked differences in extracellular 5-HT levels under basal conditions or SSRI. These examples illustrate how the use of inbred rat strains may complement our knowledge on the genetics of behavior, in the same way as the use of transgenic mice.",0,0 +5179,"The impact of a natural disaster: under- and postgraduate nursing education following the Canterbury, New Zealand, earthquake experiences","While natural disasters have been reported internationally in relation to the injury burden, role of rescuers and responders, there is little known about the impact on education in adult professional populations. A 7.1 magnitude earthquake affected the Canterbury region of New Zealand on 4 September 2010 followed by more than 13,000 aftershocks in the three years to September 2013. As part of a larger study, a mixed method survey was used to explore factors impacting nurses engaged in education through polytechnic and university courses. This paper presents factors that were self-identified by students as supporting their ability to continue with education. Participants were recruited from three nursing settings: undergraduate nursing students, Registered Nurses (RNs) engaged in post-registration education and RNs engaged in postgraduate courses. A total of 290 participants took part in the study. A number of factors identified by participants could be addressed in pre-disaster course planning and curricu...",0,0 +5180,Integrating fragmented evidence by network meta-analysis: relative effectiveness of psychological interventions for adults with post-traumatic stress disorder,"Background. To summarize the available evidence on the effectiveness of psychological interventions for patients with post-traumatic stress disorder (PTSD). Method. We searched bibliographic databases and reference lists of relevant systematic reviews and meta-analyses for randomized controlled trials that compared specific psychological interventions for adults with PTSD symptoms either head-to-head or against control interventions using non-specific intervention components, or against wait-list control. Two investigators independently extracted the data and assessed trial characteristics. Results. The analyses included 4190 patients in 66 trials. An initial network meta-analysis showed large effect sizes (ESs) for all specific psychological interventions (ESs between −1.10 and −1.37) and moderate effects of psychological interventions that were used to control for non-specific intervention effects (ESs −0.58 and −0.62). ES differences between various types of specific psychological interventions were absent to small (ES differences between 0.00 and 0.27). Considerable between-trial heterogeneity occurred ( τ 2 = 0.30). Stratified analyses revealed that trials that adhered to DSM-III/IV criteria for PTSD were associated with larger ESs. However, considerable heterogeneity remained. Heterogeneity was reduced in trials with adequate concealment of allocation and in large-sized trials. We found evidence for small-study bias. Conclusions. Our findings show that patients with a formal diagnosis of PTSD and those with subclinical PTSD symptoms benefit from different psychological interventions. We did not identify any intervention that was consistently superior to other specific psychological interventions. However, the robustness of evidence varies considerably between different psychological interventions for PTSD, with most robust evidence for cognitive behavioral and exposure therapies.",0,0 +5181,Conceptual and methodological issues in developmental psychopathology research,,0,0 +5182,Use of Family Management Styles in Family Intervention Research,Family management styles (FMSs) explain some of the complexities embedded in a family with a child who has chronic illness. The FMS typologies provide descriptions of family adjustment and management of care. These 5 distinct patterns may be valuable in tailoring and evaluating family interventions in research.,0,0 +5183,Attitudes to emotional expression and personality in predicting post-traumatic stress disorder,"To test hypotheses derived from a suggestion of Williams (1989) that negative attitudes towards emotional expression act as a predisposing or maintaining factor for post-traumatic stress reactions following a traumatic event.The study employed a prospective design in which attitudes to emotional expression, the 'Big Five' personality factors (Costa & McCrae, 1992a) and initial symptoms and injury severity within 1 week of a road traffic accident were used to predict the development of post-traumatic stress disorder 6 weeks post-accident.Sixty victims of road traffic accidents randomly selected from attenders at a large A&E department were assessed by questionnaire and interview. Measures comprised a 4-item scale relating to emotional expression, standardized scales for intrusion and avoidance features of traumatic experiences, and for anxiety and depression and the NEO-FFI Five Factor Personality Inventory. Forty-five of these participants responded to a postal questionnaire follow-up. In this survey the battery was repeated and also included a self-report diagnostic measure of post-traumatic stress disorder (PTSD).The percentage of the sample meeting DSM-IV diagnostic criteria for PTSD at 6 weeks post-trauma was 30.8%. A small but significant relationship was found for negative attitudes to emotional expression at 1 week to predict intrusive symptoms and diagnosis at 6 weeks, over and above the independent relationships of initial symptoms, initial injury severity, personality and coping. The emotional expression measure was largely stable between the two points of measurement. More negative attitudes to emotional expression were related to less openness, extraversion and agreeableness personality domains.Some support for the hypotheses was found in relation to the development of PTSD and for the status of attitudes to emotion as a stable trait related to personality factors. The potential importance of attitudes to emotional expression in therapy and other work is discussed.",0,0 +5184,Parenting Stress and Parental Post-traumatic Stress Disorder in Families After Pediatric Heart Transplantation,"There has been little research on the stress experienced by parents of children who have undergone heart transplantation.Parents of 52 consecutive pediatric heart transplant recipients completed questionnaires assessing illness-related parenting stress and post-traumatic stress symptoms at a routine clinic visit. Medical charts were reviewed retrospectively to gather peri- and post-operative information.The average age of patients at transplant was 12 years (range 1 to 18 years), and participation occurred 3 months to 10 years post-transplant (median 2.5 years). Nearly 40% of parents indicated moderately severe to severe post-traumatic stress symptoms. Ten of the 52 participating parents met DSM-IV-TR clinical diagnostic criteria for current post-traumatic stress disorder. Parents also identified significant levels of illness-related parenting stress in the areas of communication around the child's illness, emotional distress, managing the child's medical care, and balancing role functions.Illness-related parenting stress and post-traumatic stress symptoms are significant concerns among parents of pediatric heart transplant patients. Parents' psychologic functioning post-transplant should be routinely assessed and addressed by transplant teams.",0,0 +5185,Associations of postdeployment PTSD symptoms with predeployment symptoms in Iraq-deployed Army soldiers.,"Prior to deployment, military personnel may experience a range of symptoms typically associated with posttraumatic stress disorder (PTSD); however, the relationship of specific preexisting symptoms characteristic of PTSD to postdeployment PTSD symptoms is not well understood. This prospective study examined (a) pre- to postdeployment changes in reexperiencing, avoidance, numbing, and hyperarousal symptoms among Iraq-deployed military personnel, and (b) pre- to postdeployment associations among these symptom groupings. Seven-hundred and seventy-four U.S. Army soldiers completed the PTSD Checklist pre- and postdeployment to Iraq. Participants demonstrated increases in reexperiencing, avoidance, and hyperarousal symptom severity but not in severity of numbing symptoms from pre- to postdeployment. Predeployment numbing was positively correlated with all postdeployment symptom clusters, and predeployment hyperarousal was positively correlated with postdeployment hyperarousal, reexperiencing, and numbing. Findings highlight the role of preexisting numbing and hyperarousal symptoms in the evolution of PTSD symptoms following trauma exposure. © 2012 American Psychological Association.",0,0 +5186,"The impact of gender, non-military trauma and combat exposure on the development of Post-Traumatic Stress Disorder (PTSD) in the Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MA-MIRECC)","Post-Traumatic Stress Disorder (PTSD) is a significant public health concern, both in the United States and internationally, as well as in civilian populations and among those who serve their country in the military. Those who are exposed to a number of different kinds of potentially traumatic events are at risk of developing Post-Traumatic Stress Disorder. A number of factors, however, have been identified that may put certain people at an increased risk for developing Post-Traumatic Stress Disorder. These factors include, but are not limited to, female gender, having been exposed to multiple traumatic events throughout one's life, being exposed to certain types of potentially traumatic events, and being exposed to military combat. The present study was a secondary analyses of a sample of veterans returning from serving in Operation Iraqi Freedom/Operation Enduring Freedom/Operation New Dawn, who were surveyed as part of the multisite Department of Veterans Affairs Mid-Atlantic VISN-6 Mental Illness Research, Education and Clinical Centers (MIRECC). The present study examined the role of gender in the development of Post-Traumatic Stress Disorder, whether those who have been exposed to potentially traumatic non-combat events, and combat, are more likely to experience Post-Traumatic Stress Disorder, and whether gender and non-combat trauma act synergistically in predicting Post-Traumatic Stress Disorder. When examined along with demographic factors, including age, race, marital status, working status, and education status, gender did not add to the prediction of PTSD above the contribution of demographic variables such as age race, marital status. When controlling for non-combat trauma and combat exposure, gender was found to significantly predict PTSD. And while these three variables independently predicted PTSD, the interaction of non-combat trauma and combat exposure did not vary meaningfully according to gender. Finally, when considering different levels of combat exposure, gender did not significantly predict PTSD based on the extent of combat experienced. Given the lack of consensus in the broader literature, the present study's findings have important implications regarding clarifying the relationship between gender and Post-Traumatic Stress Disorder and may increase understanding regarding the mechanisms behind any gender differences in Post-Traumatic Stress Disorder. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0,0 +5187,"If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans.","The notion that chronic stress fosters disease by activating the hypothalamic-pituitary-adrenocortical (HPA) axis is featured prominently in many theories. The research linking chronic stress and HPA function is contradictory, however, with some studies reporting increased activation, and others reporting the opposite. This meta-analysis showed that much of the variability is attributable to stressor and person features. Timing is an especially critical element, as hormonal activity is elevated at stressor onset but reduces as time passes. Stressors that threaten physical integrity, involve trauma, and are uncontrollable elicit a high, flat diurnal profile of cortisol secretion. Finally, HPA activity is shaped by a person's response to the situation; it increases with subjective distress but is lower in persons with posttraumatic stress disorder.",0,0 +5188,Relationship Between Acute Stress Disorder and Posttraumatic Stress Disorder Following Mild Traumatic Brain Injury,"The aim of this study was to index the frequency of occurrence of acute stress disorder following mild traumatic brain injury and to determine its utility in predicting posttraumatic stress disorder (PTSD).Consecutive adult patients who sustained a mild traumatic brain injury following a motor vehicle accident (N = 79) were assessed for acute stress disorder within 1 month of their trauma with the Acute Stress Disorder Inventory, a structured clinical interview based on DSM-IV criteria. Patients were followed up 6 months after the trauma (N = 63) and were administered the PTSD module of the Composite International Diagnostic Interview.Acute stress disorder was diagnosed in 14% of patients, and at follow-up 24% satisfied criteria for PTSD. Six months after the trauma PTSD was diagnosed in 82% of patients who had been diagnosed with acute stress disorder and in 11% of those who had not been diagnosed with acute stress disorder.These findings point to the frequency of PTSD following mild traumatic brain injury. While the criteria for acute stress disorder are useful in identifying those individuals who are at risk of developing chronic PTSD, the findings suggest that current criteria require modification in order to optimally predict PTSD following mild traumatic brain injury.",0,0 +5189,Postcancer Experiences of Childhood Cancer Survivors: How Is Posttraumatic Stress Related to Posttraumatic Growth?,"Understanding posttraumatic growth (PTG) and the factors associated with PTG among cancer survivors is important to improve their quality of life. This study examined PTG among 225 Korean adolescents and young adults between 15 years and 39 years of age who survived childhood cancer (58.5% males and 41.5% females). We explored the relationships between PTG and several sociodemographic and medical variables, and whether the relationships between PTG and posttraumatic stress disorder (PTSD) symptoms were linear or curvilinear. The Posttraumatic Stress Diagnostic Scale (PDS) and the Posttraumatic Growth Inventory (PTGI) were used to assess PTSD symptoms and PTG, respectively. In addition to the effects of sociodemographic and medical variables, there were linear effects of PDS on PTGI (R(2) change = .03, p = .008). No evidence of a curvilinear relationship between PDS and PTGI was found. Higher PDS scores were associated with lower PTGI scores (β = -.18). Older age (β = .41) and shorter time since diagnosis (β = -.42) were associated with greater PTGI. Understanding the factors that were associated with PTG among Korean adolescent and young adult survivors of cancer adds to the knowledge on PTG and may help develop services to promote PTG in this group.",0,0 +5190,A Cross-sectional Study on the Current Prevalence of Post-traumatic Stress Disorder in Adults Orphaned by Tangshan Earthquake in 1976,"Objectives:To investigate the current prevalence and risk factors of post-traumatic stress disorder in people orphaned by Tangshan earthquake in 1976.Methods:Two hundreds and sixty adults orphaned by the earthquake were interviewed to determine whether they were suffering from PTSD according to Chinese Classification and Diagnostic Criteria for Mental Disorder,the third Revised Edition(CCMD-3).All the subjects were divided into two groups,PTSD group and normal group.The assessed variables included subjective traumatic experiences during the earthquake,post-traumatic reactions,and current mental health status.Logistic regression analysis was conducted to identify risk factors of PTSD.Results:32(12.00%) cases were diagnosed as PTSD among 260 orphans.In comparison with orphans without PTSD,orphans with PTSD had significantly higher SAS(47.8±14.5/40.3±10.3),SDS(53.0±12.0/45.2±11.7)and SCL-90 total score(156.6±65.5/127.9±41.0),P0.05.In a stepwise logistic regression model,six risk factors were significantly correlated with the development of PTSD including age at the time of the earthquake(OR=4.5),EPQ-N score(OR=0.2),EPQ-E score(OR=5.5),strong posttraumatic spiritual pain(OR=3.5),recurrent nightmare(OR=5.4),and negative coping style(OR=3.9).Conclusions:30 years later the prevalence of PTSD in those orphaned survivors is still high and PTSD were significantly correlated with adolescence,severity of traumatic events,stressful reaction post earthquake,personality characteristics as well as negative coping style.",0,0 +5191,Diagnostic profiles of offenders in substance abuse treatment programs,"This study examined the association of Axis I and Axis II disorders among offenders who were in prison-based substance abuse treatment in a national multi-site study. Participants (N = 280) received a psychosocial assessment and a structured diagnostic interview in two separate sessions. Logistic regression models examined the association between lifetime mood and anxiety disorders with two personality disorders, and the relationship of Axis I and Axis II disorders (alone and in combination) to pre-treatment psychosocial functioning. Over two-thirds of the sample met criteria for at least one mental disorder. Borderline personality disorder was strongly associated with having a lifetime mood disorder (odds ratio = 7.5) or lifetime anxiety disorder (odds ratio = 8.7). Individuals with only an Axis II disorder, or who had both Axis I and Axis II disorders, had more severe problems in psychosocial functioning than those without any disorder. Clinical treatment approaches need to address this heterogeneity in diagnostic profiles, symptom severity, and psychosocial functioning.",0,0 +5192,Deployment stressors and physical health among OEF/OIF veterans: The role of PTSD.,"There is a large body of literature documenting the relationship between traumatic stress and deleterious physical health outcomes. Although posttraumatic stress disorder (PTSD) symptoms have been proposed to explain this relationship, previous research has produced inconsistent results when moderating variables such as gender or type of traumatic stressor are considered. Within a large sample of Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) Veterans, the current study examined if deployment stressors (i.e., combat stress, harassment stress) contributed unique variance to the prediction of physical health symptoms (i.e., pain, nonpain) beyond the effects of PTSD symptoms.A total of 2,332 OEF/OIF Veterans, with equal representation of women and men, completed a series of self-report measures assessing deployment stressors, PTSD symptoms, and physical health symptoms.RESULTS revealed that harassment, but not combat stress, added unique variance in the prediction of pain and nonpain symptoms after accounting for PTSD symptoms.This study extends the existing literature by demonstrating the unique influence of harassment stress on physical health outcomes. Specifically, the relationship between combat stress and physical health symptoms appears to be explained mainly by an individual's experience of PTSD symptoms, whereas the relationship between harassment stress and physical health symptoms is not fully explained by PTSD symptoms, suggesting that other variables may be involved in the pathway from harassment stress to physical health symptoms.",0,0 +5193,Mindfulness-Based Stress Reduction Among Breast Cancer Survivors: A Literature Review and Discussion,"To evaluate and discuss existing studies of mindfulness-based stress reduction (MBSR) among breast cancer survivors.Articles published from 1987-2009 were retrieved using MEDLINE®, CINAHL®, Ovid, and Scopus. Key words, including mindfulness-based stress reduction and mindfulness meditation, were combined with breast cancer.The search resulted in 26 articles that were narrowed down to 16 by selecting only quantitative studies of MBSR conducted with breast cancer (n = 7) or heterogeneous types of cancer in which the predominant cancer was breast cancer (n = 9). Most studies were one-group pre- and post-test design and examined the effect of MBSR on psychological outcomes. Overall, the studies had large effect sizes on perceived stress and state anxiety and medium effect sizes on symptoms of stress and mood disturbance. Four studies measured biologic outcomes and had small effect sizes, except cytokine production, which showed a large effect size at 6- and 12-month follow-ups.Future studies using randomized, control trials and longitudinal, repeated-measures designs are needed. Studies conducted with heterogeneous types of cancer and gender should be analyzed and the results reported separately.The comprehensive summary and critical discussion of existing studies of MBSR usage among breast cancer survivors provide essential information that can be used by nurses and others working in the healthcare setting.",0,0 +5194,Media exposure and dimensions of anxiety sensitivity: Differential associations with PTSD symptom clusters,"The present investigation examined the impact of anxiety sensitivity (AS) and media exposure on posttraumatic stress disorder (PTSD) symptoms. Reactions from 143 undergraduate students in Hamilton, Ontario were assessed in the Fall of 2003 to gather information on anxiety, media coverage, and PTSD symptoms related to exposure to a remote traumatic event (September 11th). Regression analyses revealed that the Anxiety Sensitivity Index (ASI; [Peterson, R. A., & Reiss, S. (1992). Anxiety Sensitivity Index manual, 2nd ed. Worthington, Ohio: International Diagnostic Systems]) and State-Trait Anxiety Inventory trait form (STAI-T; [Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970). State-trait anxiety inventory. Palo Alto, California: Consulting Psychologists Press]) total scores were significant predictors of PTSD symptoms in general. The ASI total score was also a significant predictor of hyperarousal and avoidance symptoms. Subsequent analyses further demonstrated differential relationships based on subscales and symptom clusters. Specifically, media exposure and trait anxiety predicted hyperarousal and re-experiencing symptoms, whereas the ASI fear of somatic sensations subscale significantly predicted avoidance and overall PTSD symptoms. Implications and directions for future research are discussed.",0,0 +5195,Pharmacokinetics and Metabolism of SRX246: A Potent and Selective Vasopressin 1a Antagonist,"SRX246 is a potent, highly selective, orally bioavailable vasopressin 1a receptor antagonist that represents a novel mechanism of action for the treatment of mood disorders. The compound previously showed efficacy in animal models of mood disorders and excellent safety and tolerability in healthy volunteers in phase I clinical trials. In this study, SRX246 was further characterized in rats and dogs. In vitro determinations of permeability, protein binding, hepatocyte metabolism, and cytochrome P450 enzyme inhibition and in vivo assessments of pharmacokinetics were conducted. In parallel artificial membrane permeability assay (PAMPA) and PAMPA-blood-brain barrier models, SRX246 was comparable to highly permeable, orally active pharmaceuticals. SRX246 hydrochloride salt was 95.5 ± 1.7%, 95.9 ± 1.3%, and 98.6 ± 0.4% bound to rat, dog, and human serum proteins, respectively, and was stable in serum after a 4 h incubation at 37°C. P450 enzyme inhibition results showed a very low potential for drug-drug interactions. Metabolism in primary hepatocytes demonstrated that SRX246 was stable in humans and moderately metabolized in dogs and rats. Plasma pharmacokinetics findings showed a half-life (T½ ) of 2 and 6 h in rat and dog, respectively. Rat brain levels following a single oral dose were approximately 20% of plasma values with a T½ of 6 h. The observed profile for SRX246 supports further development.",0,0 +5196,Post-traumatic stress symptoms and trauma exposure in youth with first episode bipolar disorder,"To examine the prevalence of trauma exposure as well as the rates and effects of post-traumatic stress disorder (PTSD) in adolescents with bipolar disorder following a first manic episode.Adolescents (12-18 years) with DSM-IV bipolar I disorder and experiencing their first manic or mixed episode were recruited. Participants underwent structured diagnostic interviews, completed the Trauma Symptom Checklist for Children (TSCC), and were prospectively evaluated using diagnostic, symptomatic and functional assessments over the course of 12 months.Seventy-six adolescents (14.9 +/- 1.7 years) completed the TSCC and 66% (50 individuals) reported exposure to traumatic events. Two (3%) subjects met DSM-IV criteria for PTSD, 11 (14%) had post-traumatic stress t-scores > or = 65, the threshold for clinically significant symptoms. Subjects with and without post-traumatic stress t-scores > or = 65 did not differ in demographic characteristics. When compared by t-score, TSCC subscores of the first episode bipolar adolescents were similar to normative data. Regression models incorporating TSCC subcomponents, did not predict syndromic recovery or recurrence or symptomatic recovery.Rates of PTSD were lower in this sample of bipolar adolescents at the time of their first hospitalization compared with rates in samples of bipolar adults. These differences coupled with the low incidence of PTSD and trauma symptoms in this young sample suggests that bipolar disorder may be a risk factor for the development of PTSD later in the course of illness or following recurrent affective episodes.",0,0 +5197,Emotion regulation difficulties and posttraumatic stress disorder symptom cluster severity among trauma-exposed college students.,"The present investigation examined the role of emotion regulation difficulties in predicting severity of the 3 posttraumatic stress disorder (PTSD) symptom clusters (i.e., reexperiencing, hyperarousal, avoidance) in a sample of undergraduates who reported exposure to at least 1 DSM-IV-TR Criterion A traumatic event (n = 297; 77.1% female, Mage = 20.46, SD = 4.64, range = 18-50 years). Results indicated that greater difficulties with emotional acceptance significantly predicted greater avoidance and hyperarousal symptom severity above and beyond the effects of number of trauma types endorsed and negative affect. Emotion regulation difficulties were not significantly predictive of reexperiencing symptom severity. Results from an exploratory analysis indicated that greater difficulties with emotional acceptance and greater difficulties accessing effective emotion regulation strategies when upset significantly predicted the DSM-5 negative alterations in cognitions and mood symptom cluster. These findings suggest that difficulties accepting one's emotional responses, in particular, may heighten emotional responding to and avoidance of trauma-related cues. Thus, individuals who experience such difficulties may be more likely to experience negative outcomes after experiencing a traumatic event.",0,0 +5198,Treatment of complex PTSD: Results of the ISTSS expert clinician survey on best practices,"This study provides a summary of the results of an expert opinion survey initiated by the International Society for Traumatic Stress Studies Complex Trauma Task Force regarding best practices for the treatment of complex posttraumatic stress disorder (PTSD). Ratings from a mail-in survey from 25 complex PTSD experts and 25 classic PTSD experts regarding the most appropriate treatment approaches and interventions for complex PTSD were examined for areas of consensus and disagreement. Experts agreed on several aspects of treatment, with 84% endorsing a phase-based or sequenced therapy as the most appropriate treatment approach with interventions tailored to specific symptom sets. First-line interventions matched to specific symptoms included emotion regulation strategies, narration of trauma memory, cognitive restructuring, anxiety and stress management, and interpersonal skills. Meditation and mindfulness interventions were frequently identified as an effective second-line approach for emotional, attentional, and behavioral (e.g., aggression) disturbances. Agreement was not obtained on either the expected course of improvement or on duration of treatment. The survey results provide a strong rationale for conducting research focusing on the relative merits of traditional trauma-focused therapies and sequenced multicomponent approaches applied to different patient populations with a range of symptom profiles. Sustained symptom monitoring during the course of treatment and during extended follow-up would advance knowledge about both the speed and durability of treatment effects.",0,0 +5199,Childhood sexual abuse: Effects on female sexual function and its treatment,"For many woman survivors of childhood sexual abuse, there are long-term sexual sequelae, such as hypersexual activity and avoidance, although the trajectory to each type of response remains unclear. Female survivors of childhood sexual abuse have problems with intimate relationships and some survivors may also complain of multiple health problems and use emergency room services at a higher rate than women who were not sexually abused. Although the health care provider is in a position to screen for childhood sexual abuse, care must be taken to maintain trust if referring the survivor for psychotherapy, specifically sex therapy, which can be the treatment of choice. This article reviews the effect of childhood sexual abuse in female sexual function and provides general treatment recommendations.",0,0 +5200,"Exploring the roles of emotional numbing, depression, and dissociation in PTSD","Some researchers consider emotional numbing a cardinal feature of posttraumatic stress disorder (PTSD). Others view numbing symptoms as representing an overlap between PTSD, depression, and dissociation. In this study, we examined the ability of early emotional numbing, depression, and dissociation symptoms to predict PTSD. One-hundred sixty-one women who were recent victims of sexual or nonsexual assault were assessed prospectively for 12 weeks. Emotional numbing, depression, and dissociation were each associated with initial PTSD severity. Notably, regression analyses revealed that after depression and dissociation were accounted for, early numbing contributed to the prediction of later PTSD.",0,0 +5201,Body Mass Index and Quality of Life: Examining Blacks and Whites With Chronic Pain,"Obesity contributes to several chronic pain conditions, negatively affecting quality of life (QOL). However, obesity's relationship with chronic pain is poorly understood. This prospective survey study examines obesity's role in chronic pain and subsequent impact on QOL. Black and white patients with chronic pain (N = 183, 18-50 years of age, 64% women, 50% black) were studied to determine predictors for the presence of body mass index (BMI) information in medical records, group BMI differences, and how BMI and pain contribute to mental/physical outcomes. BMI was calculated by using medical records nearest the enrollment date. Sociodemographic data, sleep, pain, functioning, disability, and depression were measured. BMI data were available for 143 subjects (78%), with blacks having a higher BMI (P = .002). Black (P = .08), people with higher pain (P < .01), affective distress (P < .01), and post-traumatic stress disorder scores (P = .07) were less likely to have their BMI recorded. Path analysis tested relationships between sociodemographics, BMI and pain with functioning, depression, and disability. BMI was positively associated with black race and age and predicted poorer physical functioning and greater disability. Pain was not predicted by race or age but was associated with all outcomes. These findings support assessing BMI when managing chronic pain and its negative impact on QOL, especially for minority patients.This study examines the relationships among sociodemographic factors, BMI, and QOL in chronic pain. Our results demonstrate significant racial disparity among chronic pain patients in assessing BMI and quality of pain care. These findings support obesity's negative impact on overall health and the importance of measuring BMI in patients with chronic pain, especially racial and ethnic minorities.",0,0 +5202,Functional independence in pediatric-onset spinal cord injury: Two levels of mediation.,"To test 3 models that examine the relationship of posttraumatic stress (PTS), family functioning (FF), and level of spinal cord injury (SCI) to functional independence (FI) among patients with pediatric-onset SCI.Participants were 109 pediatric spinal cord injury patients, ages 11-24 years, from 2 surgical and rehabilitation hospitals. Data from 2 previous cross-sectional studies included the Posttraumatic Diagnostic Scale, the Family Assessment Device, and the Pediatric Orthopedic Surgeons of North America Pediatric Musculoskeletal Functional Health Questionnaire. Path analyses were used to test 3 hypothesized models: that PTS would mediate the relationship between FF and FI, that PTS Avoidance symptoms would mediate the relationship between other PTS symptom clusters and FI, and that these 2 models would show adequate fit to the data when integrated into an overarching model to depict the interrelationship of level of SCI (tetraplegia v. paraplegia), FF, PTS symptom clusters, and FI.Results from the first model indicated that PTS mediated the relationship between FF and FI. In addition, the Avoidance symptom cluster of PTS mediated the relationships between PTS Reexperiencing symptoms and FI and between the PTS Arousal symptom cluster and FI. A third model integrated the previous 2 models and supported these 2 levels of mediation.Level of SCI related directly to FI, and PTS mediated the relationship between FF and FI; PTS Avoidance mediated the relationships between Intrusive Reexperiencing and FI and between PTS Arousal and FI.",0,0 +5203,"Associations Between Coerced Anal Sex and Psychopathology, Marital Distress and Non-Sexual Violence","There is a dearth of scientific data on anal intercourse in heterosexual relationships. Likewise, anal sex within marital relationships has yet to be fully explored.Among a representative sample of married women in the Iranian capital, Tehran, we aimed to determine the association of self-reported coerced anal sex with: (i) self-reported coerced vaginal sex; (ii) self-reported non-sexual violence; (iii) psychopathology; and (iv) marital attitude.The data presented here were obtained from the Family Violence Survey conducted in Tehran in 2007. A total of 230 married Iranian women were selected via a multi-cluster sampling method from four different randomized regions. The subjects' sociodemographic data, psychological distress (Symptom Check List; SCL-90-R), personality, and relationship characteristics (Personal and Relationships Profile), and marital attitude (Marital Attitude Survey) were gathered. In addition, the participants' self-reported histories of lifetime victimization through all types of violence by the husband, including coerced anal and vaginal sex as well as psychological and physical assault (Conflict Tactic Scales-Revised; CTS-2), were collected.There were associations between self-reported victimization through coerced anal and vaginal sex (P < 0.001), psychological (P < 0.001), and physical aggression (P < 0.001). Those reporting to have been forced into anal intercourse cited higher rates of paranoid and psychotic features, jealousy, attribution of problems to one's own behavior, conflict, and male dominance, as well as lower expectations of improvement in one's marital relationship.In marital relationships, women are at a higher risk of coerced anal sex if subjected to other types of sexual or non-sexual violence. Higher rates of psychopathology and poorer marital relationships are also allied to self-reported anal sexual coercion.",0,0 +5204,A prospective analysis of trauma exposure: The mediating role of PTSD symptomatology,"Trauma exposure has been associated with increased risk of exposure to additional traumatic events. Reactions to trauma exposure, specifically PTSD symptomatology, may mediate the link between trauma exposure and later traumatic events. Data from a longitudinal sample of Gulf War veterans (N = 2,949) were analyzed using a series of regression models. Higher levels of combat exposure were related to increased reports of PTSD symptomatology immediately upon return as well as increased reports of traumatic events in the 2 years following the Gulf War. PTSD symptomatology partially mediated the link between combat exposure and later trauma. Symptom clusters were also analyzed separately as potential mediators. Implications for the treatment of PTSD and prevention of exposure to multiple traumas are discussed.",0,0 +5205,"Attachment, Personality Characteristics, and Posttraumatic Stress Disorder in U.S. Veterans of Iraq and Afghanistan","U.S. veterans of Iraq and/or Afghanistan (N = 116) completed an Internet survey with questions related to attachment style in intimate relationships, personality factors, and posttraumatic stress disorder (PTSD). Participants completed the PTSD Checklist-Military, Experiences in Close Relationships Scale-Short Form, and the International Personality Item Pool Big Five Short Form Questionnaire. Most participants were male and Caucasian. Hierarchical linear regression analysis results indicated that emotional stability (β = −.46, p < .001) and attachment avoidance (β = .20, p < .05) were associated with PTSD symptom severity (adjusted R2 = .63). An interaction between conscientiousness and attachment anxiety was found (β = −.26, p < .001; ΔR2 = .06), with secure attachment moderating the relationship between conscientiousness and PTSD symptom severity. Results of this study indicate that emotional stability, conscientiousness, and secure relationship attachment styles (low attachment anxiety and avoidance) are important for postcombat mental health.",0,0 +5206,Comparison of the MMPI-PTSD subscale with PTSD and substance abuse patient populations,"War-related PTSD frequently presents as a dual disorder. Questions have been raised about whether the MMPI-PTSD subscale developed by Keane. Malloy, and Fairbank (1984) is identifying a separate PTSD syndrome or is a measure of generalized distress common to various diagnostic categories, including substance abuse. In this study, veterans with PTSD with and without substance abuse were compared to veterans with substance abuse only on the MMPI-PTSD subscale (n = 22 in each of the four categories). Results support the ability of the test to distinguish between groups of veterans with PTSD and those with substance abuse only. The findings lend indirect support to the validity of a distinct PTSD symptom cluster.",0,0 +5207,Function after Motor Vehicle Accidents: A Prospective Study of Mild Head Injury and Posttraumatic Stress,"Relationships among mild traumatic brain injury (MTBI), posttraumatic stress (PTS), and function were examined in 99 motor vehicle accident (MVA) admissions: 64 in an MTBI group and 35 in a no-MTBI comparison group. Assessments occurred within the first month and at 6 to 9 months. At follow-up, the sample was moderately disabled on the Sickness Impact Profile (SIP), 71% satisfied on the Reintegration of Normal Living Index (RNL), and 42% had returned to work. Only the SIP Psychosocial score was significantly different for MTBI groups; 24% of the sample showed definite symptoms of PTS. This group was significantly more disabled on the SIP, less satisfied on the RNL, and less likely to return to work. The proportion of variance in outcome explained in each model ranged from 32% (Physical SIP) to 44% (RNL). Results suggest the need for clinicians to be more aware of the strong influence of PTS on functional outcomes.",0,0 +5208,"Mental disorders, treatment response, mortality and serum cholesterol: a new holistic look at old data.","The importance of cholesterol for physical and psychological well-being has been recognized for several decades. Changes in serum cholesterol levels may have a direct impact on mental performance, behavior, treatment response, survival and expected lifetime duration.To examine the association between various mental disorders (schizophrenia, bipolar disorder, depression, generalized anxiety disorder, panic disorders, post-traumatic stress disorder and other mental disorders) and cholesterol levels, and to discuss the possible treatment implications.A MEDLINE search, citing articles from 1966 onward, supplemented by a review of bibliographies, was conducted to identify relevant studies. Criteria used to identify studies included (1) English language, (2) published studies with original data in peer-reviewed journals.Clinical investigations of cholesterolemia in patients with major mental disorders have produced very conflicting results. Hypercholesterolemia has been reported in patients with schizophrenia, obsessive-compulsive disorders, panic disorder, generalized anxiety disorder, PTSD. Low cholesterol level has been reported in patients with major depression, dissociative disorder, antisocial personality disorder, borderline personality disorder. It seems that both high and low serum total cholesterol may be associated with a higher risk of the premature death.Our current knowledge on the relation between cholesterolemia and mental disorders is poor and controversial. No definite or reliable insight into a pathophysiological link between cholesterol levels and mental disorders, treatment response and mortality rate is available. The lipoprotein profile, rather than total cholesterol levels, seems to be important.",0,0 +5209,"Unique Patterns of Substance Misuse Associated With PTSD, Depression, and Social Phobia","OBJECTIVES: This study investigated the relations between post-trauma psychopathology and substance abuse in a sample of trauma-exposed college students (n = 136) assigned to four groups based on primary diagnosis: posttraumatic stress disorder, depression, social phobia, or well-adjusted (participants who had low levels of distress). Groups were compared on a series of dimensions of substance use/abuse. RESULTS: Participants in the PTSD group evidenced greater substance use and abuse than those in the social phobia and well-adjusted groups on several dimensions and greater alcohol consumption than the depressed group. Correlation analyses suggested that most dimensions of substance abuse were related more strongly to avoidance and numbing (cluster C) symptoms than to reexperiencing and hyperarousal. CONCLUSIONS: The present findings suggest that trauma-related psychopathology may be associated with a more hazardous pattern of substance use than depression and social phobia.",0,0 +5210,Humiliation: the invisible trauma of war for Palestinian youth,"To investigate the influence of exposure to humiliation in war-like conditions on health status in 10th- and 11th-grade students living in the Ramallah District, West Bank, Occupied Palestinian Territory.A stratified single-stage cluster sample of 3415 students from cities, towns, villages and refugee camps of the Ramallah District.Survey questions were derived from the World Health Organization's Health Behaviour in School-aged Children Survey, the Gaza Community Mental Health Programme Traumatic Event Checklist, and focus group discussions with young people. The survey questionnaire was completed by students in their classrooms, under the supervision of a trained field worker.There was a significant association between a high number of subjective health complaints and demographic variables, particularly for females compared with males, and refugee camp dwellers compared with village dwellers. In addition, exposure to humiliation was significantly associated with an increased number of subjective health complaints. Students experiencing three forms of humiliation were found to be 2.5 times more likely to report a high number of subjective health complaints compared with those who had never been exposed to humiliation (52% vs 21%), while those experiencing four forms of humiliation were three times more likely to report a high number of subjective health complaints (62% vs 21%). A multiple logistic regression model revealed that humiliation was significantly associated with a high number of subjective health complaints, even after adjusting for sex, residence and other measures of exposure to violent events. The odds ratio of reporting a high number of subjective health complaints increased as the number of forms of humiliation increased, with values of 1.69, 2.67, 4.43 and 7.49 for reporting a high number of subjective health complaints when exposed to one, two, three or four forms of humiliation, respectively, compared with those who had never been exposed to humiliation.The results of this study demonstrate that humiliation induced by conflict and war-like conditions constitutes an independent traumatic event that is associated with negative health outcomes in its own right, regardless of exposure to other violent/traumatic events. Based on these findings, it is proposed that humiliation should be included as an indicator of mental health status in research that investigates the consequences of war and conflict on the health of populations.",0,0 +5211,"Tasco®, a Product of Ascophyllum nodosum, Imparts Thermal Stress Tolerance in Caenorhabditis elegans","Tasco(®), a commercial product manufactured from the brown alga Ascophyllum nodosum, has been shown to impart thermal stress tolerance in animals. We investigated the physiological, biochemical and molecular bases of this induced thermal stress tolerance using the invertebrate animal model, Caenorhabiditis elegans. Tasco(®) water extract (TWE) at 300 μg/mL significantly enhanced thermal stress tolerance as well as extended the life span of C. elegans. The mean survival rate of the model animals under thermal stress (35 °C) treated with 300 μg/mL and 600 μg/mL TWE, respectively, was 68% and 71% higher than the control animals. However, the TWE treatments did not affect the nematode body length, fertility or the cellular localization of daf-16. On the contrary, TWE under thermal stress significantly increased the pharyngeal pumping rate in treated animals compared to the control. Treatment with TWE also showed differential protein expression profiles over control following 2D gel-electrophoresis analysis. Furthermore, TWE significantly altered the expression of at least 40 proteins under thermal stress; among these proteins 34 were up-regulated while six were down-regulated. Mass spectroscopy analysis of the proteins altered by TWE treatment revealed that these proteins were related to heat stress tolerance, energy metabolism and a muscle structure related protein. Among them heat shock proteins, superoxide dismutase, glutathione peroxidase, aldehyde dehydrogenase, saposin-like proteins 20, myosin regulatory light chain 1, cytochrome c oxidase RAS-like, GTP-binding protein RHO A, OS were significantly up-regulated, while eukaryotic translation initiation factor 5A-1 OS, 60S ribosomal protein L18 OS, peroxiredoxin protein 2 were down regulated by TWE treatment. These results were further validated by gene expression and reporter gene expression analyses. Overall results indicate that the water soluble components of Tasco(®) imparted thermal stress tolerance in the C. elegans by altering stress related biochemical pathways.",0,0 +5212,When Epidemiology Meets the Internet: Web-based Surveys in the Millennium Cohort Study,"Almost 60% of American households were connected to the Internet in 2001, when the Millennium Cohort Study, the largest longitudinal study ever undertaken by the Department of Defense, was launched. To facilitate survey completion, increase data integrity, and encourage cohort retention while maintaining the highest standards of participant privacy, an online questionnaire was made available on the World Wide Web in addition to a traditional paper questionnaire sent via US mail. Over 50% of 77,047 participants chose to enroll in the study via the Web, affording substantial cost savings to the project. Using multivariable logistic regression, the authors compared the demographic and health characteristics of Web responders with those of paper responders. Web responders were slightly more likely to be male, to be younger, to have a high school diploma or college degree, and to work in information technology or another technical occupation. Web responders were more likely to be obese and to smoke more cigarettes and were less likely to be problem alcohol drinkers and to report occupational exposures. Question completion rates were 98.3%, on average, for both Web and paper responders. Web responders provided more complete contact information, including their e-mail addresses. These results demonstrate the value of survey research conducted over the Internet in concert with traditional mail survey strategies.",0,0 +5213,Post-traumatic stress disorder among patients with chronic pain and chronic fatigue,"Fibromyalgia (FM), a chronic pain condition of unknown aetiology often develops following a traumatic event. FM has been associated with post-traumatic stress disorder (PTSD) and major depression disorder (MDD).Patients seen in a referral clinic (N=571) were evaluated for FM and chronic fatigue syndrome (CFS) criteria. Patients completed questionnaires, and underwent a physical examination and a structured psychiatric evaluation. Critical components of the diagnostic criteria of FM (tender points and diffuse pain) and CFS (persistent debilitating fatigue and four of eight associated symptoms) were examined for their relationship with PTSD.The prevalence of lifetime PTSD was 20% and lifetime MDD was 42%. Patients who had both tender points and diffuse pain had a higher prevalence of PTSD (OR=3.4, 95% CI 2.0-5.8) compared with those who had neither of these FM criteria. Stratification by MDD and adjustment for sociodemographic factors and chronic fatigue revealed that the association of PTSD with FM criteria was confined to those with MDD. Patients with MDD who met both components of the FM criteria had a three-fold increase in the prevalence of PTSD (95% CI 1.5-7.1); conversely, FM patients without MDD showed no increase in PTSD (OR=1.3, 95% CI 0.5-3.2). The components of the CFS criteria were not significantly associated with PTSD.Optimal clinical care for patients with FM should include an assessment of trauma in general, and PTSD in particular. This study highlights the importance of considering co-morbid MDD as an effect modifier in analyses that explore PTSD in patients with FM.",0,0 +5214,Post-traumatic stress disorder in brain injury patients,"In the absence of the recognition of the emotional sequelae following traumatic brain injury (TBI), many patients are deprived of adequate treatment. The purpose of the current study is to evaluate the prevalence of post-traumatic stress disorder (PTSD) and explore the clinical picture among TBI patients. Twenty four outpatients with diagnosed head injuries following various traumas filled out standardized questionnaires, assessing post-traumatic residuals. Thirty-three per cent of these patients met criteria for PTSD diagnosis. The clinical picture of PTSD following TBI is somewhat distinguished from those following other traumatic events. Issues concerning the specific nature of the syndrome following TBI, and the difficulties in differentiating between PTSD and postconcussive syndrome, are discussed.",0,0 +5215,Posttraumatic stress disorder in DSM‐5: New criteria and controversies.,"The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) featured extensive changes to the posttraumatic stress disorder (PTSD) diagnosis. PTSD was moved out of the anxiety disorders into a new class of “trauma- and stressor-related disorders,” and the definition of what constitutes a traumatic experience was revised. Three new symptoms were added, existing ones were modified, and a new four-cluster organization and diagnostic algorithm were introduced. Finally, a new dissociative subtype was added to the diagnosis. We review these changes, discuss some of the controversies surrounding them, and then introduce a new debate involving a radically different conceptualization of PTSD proposed for International Classification of Diseases, 11th edition.",0,0 +5216,Trauma Reactions in Mothers and Fathers After Their Infant's Cardiac Surgery,"To investigate the prevalence and nature of trauma symptoms in mothers and fathers of infants who had cardiac surgery.Parents of infants who underwent cardiac surgery before 3 months of age were recruited at the time of surgery. 77 mothers and 55 fathers completed the Acute Stress Disorder Scale 1 month after their infant was discharged from hospital.26 of 77 (33.8%) mothers and 10 of 55 (18.2%) fathers satisfied criteria for acute stress disorder. For all symptom clusters, except dissociation, mothers had significantly higher mean scores (and therefore higher levels of symptoms) than did fathers, ps = .01, -.02. 83 percent of parents endorsed at least 1 trauma symptom and 11.4% endorsed only 1 symptom at a clinical level. Symptoms of dissociation were the most commonly endorsed by both parents, with each symptom in that cluster being endorsed at a clinical level by at least 26% of parents.Consistent with our hypotheses, approximately one-third of parents overall, as well as one-third of mothers and close to one-fifth of fathers, experienced trauma symptoms consistent with a diagnosis of acute stress disorder. Most parents experienced at least one symptom at a clinical level, with symptoms of dissociation being the most commonly endorsed symptom cluster. These findings highlight the need for clinical supports for parents.",0,0 +5217,Identification of anxiety sensitivity classes and clinical cut-scores in a sample of adult smokers: Results from a factor mixture model,"Anxiety sensitivity (AS), a multidimensional construct, has been implicated in the development and maintenance of anxiety and related disorders. Recent evidence suggests that AS is a dimensional-categorical construct within individuals. Factor mixture modeling was conducted in a sample of 579 adult smokers (M age=36.87 years, SD=13.47) to examine the underlying structure. Participants completed the Anxiety Sensitivity Index-3 and were also given a Structured Clinical Interview for DSM-IV-TR. Three classes of individuals emerged, a high AS (5.2% of the sample), a moderate AS (19.0%), and a normative AS class (75.8%). A cut-score of 23 to identify high AS individuals, and a cut-score of 17 to identify moderate-to-high AS individuals were supported in this study. In addition, the odds of having a concurrent anxiety disorder (controlling for other Axis I disorders) were the highest in the high AS class and the lowest in the normative AS class.",0,0 +5218,Occurrence of delayed-onset post-traumatic stress disorder: a systematic review and meta-analysis of prospective studies,"Post-traumatic stress disorder (PTSD) develops according to consensus criteria within the first 1-6 months after a horrifying traumatic event, but it is alleged that PTSD may develop later. The objective was to review the evidence addressing occurrence of PTSD with onset >6 months after a traumatic event (delayed-onset PTSD).Through a systematic search in PubMed, EMBASE, and PsycINFO, we identified 39 studies with prospective ascertainment of PTSD. A meta-analysis was performed in order to obtain a weighted estimate of the average proportion of delayed-onset PTSD cases, and meta-regression was used to examine effects of several characteristicsDelayed-onset PTSD was reported in all studies except one, and the average prevalence across all follow-up time was 5.6% [95% confidence interval (95% CI) 4.3-7.3%]. The proportion with delayed-onset PTSD relative to all cases of PTSD was on average 24.5% (95% CI 19.5-30.3%) with large variation across studies. In six studies with sub-threshold symptom data, delayed-onset PTSD seemed most likely an aggravation of early symptoms. The proportion with delayed-onset PTSD was almost twice as high among veterans and other professional groups compared to non-professional victims.Descriptive follow-up data suggest that PTSD may manifest itself >6 months after a traumatic event, delayed-onset PTSD most often, if not always, is preceded by sub-threshold PTSD symptoms, and a higher proportion of PTSD cases are delayed among professional groups. Contextual factors and biased recall may inflate reporting of PTSD and a cautious interpretation of prevalence rates seems prudent.",0,0 +5219,Are Effort Measures Sensitive to Cognitive Impairment?,"The basic premise of symptom validity tests (SVTs) is that appropriate effort can be assessed because the designs of SVT measures are thought to be insensitive to all but the most extreme forms of impairment of memory. In patients with mild traumatic brain injury in particular, it is thought that failure on effort measures consistently reflects poor effort or even conscious exaggeration of symptoms. This study examines the issue of SVT failure as a reflection of cognitive impairment and/or neuropsychiatric impairment by presenting cases of three patients who were given full neuropsychological batteries but in each case failed the Word Memory Test (WMT), a verbal recognition SVT measure. One patient who failed the WMT was probably in the early stages of dementia. The WMT fit the ""Genuine Memory Impaired Profile"". Two mild traumatic brain injury patients failed the WMT but their patterns of performance suggested that cognitive deficits influenced WMT performance. In determining the validity of neuropsychological test data in the individual case, it is recommended that the examiner consider whether cognitive impairment could affect performance on effort measures and the recommended cut score. Also, it is recommended that examiners use multiple indicators of effort.",0,0 +5220,Prevention of Heat Stress Disorders in the Workplace,"The intensive summer heat in Japan led to the death of 47 workers due to incidence of heat stroke in 2010. A notable cluster was observed during the first three days after the start of working in a hot environment. The construction industry accounted for 64% of all lethal cases, and the Wet Bulb Globe Temperature (WBGT) of 28°C or higher demonstrated an increasing tendency for lost workdays due to heat stress disorders. Lack of specific symptoms and signs strengthens the importance of prevention. Obedience to orders from employers in uncontrollable hot, humid environments requires thermoregulation dependent on sweating. Loss of lowconcentrated sodium in sweat causes temporary hypernatremia, followed by a shift in interstitial fluid to serum and secretion of arginine-vasopressin to adjust osmolarity; however, massive water intake sometimes leads to excessive serum dilution causing temporary hyponatremia, expressed as heat cramps. The complex risk of heat stroke in the workplace can be categorized into four principal causes: physical labor, hot and humid environment, long hours of work and short break times, and protective clothing. The Labour Standards Bureau, Ministry of Health, Labour and Welfare of Japan, noticed WBGT standard values based on ISO 7243 and ACGIH TLVs",0,0 +5221,Propranolol and central nervous system function: potential implications for paediatric patients with infantile haemangiomas,"Given its improved safety profile compared with systemic corticosteroids, propranolol has become the mainstay treatment of infantile haemangioma (IH) worldwide. There is evidence, mainly from adult volunteer studies, that propranolol use is associated with central nervous system (CNS) effects. Impairment to short- and long-term memory, psychomotor function, sleep quality and mood with relatively low doses and durations of treatment have been reported. The exact magnitude of CNS effects resulting from propranolol use, especially in the early developmental stages and for prolonged periods of use, is not currently known. These effects may not be readily recognizable and require specialized assessment of cognitive function not routinely performed. Furthermore, there may be a delay between exposure and cognitive defects. The evidence to date provides a strong rationale to proceed with caution when prescribing propranolol for IH: treatment should be used only when indicated (in the presence of ulceration, impairment of a vital function or risk of permanent disfigurement) and for a limited duration, and the benefits of treatment should be weighed carefully against potential adverse events before treatment is initiated. This narrative review describes the evidence for an effect of propranolol use on CNS function from volunteer and patient studies, including IH.",0,0 +5222,Familial vulnerability factors to post-traumatic stress disorder in male military veterans,"The question has been frequently raised about whether there are emotional disorders that predispose to post-traumatic stress disorder (PTSD). We do know that those with PTSD do have many comorbid disorders, but due to the difficulty in performing prospective studies it is hard to tell what is cause and what is effect. This study bypassed the problem caused by comorbidity by examining family history of four proband groups: PTSD, mixed anxiety disorders, coexisting anxiety and depressive disorders, and screened normal controls. Two questions were examined. First, whether family history predicted who experienced combat situations and second, whether the proband groups could be distinguished by family history. Logistic regression identified two variables that predicted the experience of combat: major depression (odds ratio 2.17) and the DSM-III dramatic personality disorder cluster (odds ratio 1.36). Although there was considerable overlap, family history variables distinguished PTSD from other proband groups. Overall, the pattern of psychopathology in the families of the PTSD probands most closely resembled that in the families of the coexisting anxiety and depressive disorders probands. We conclude that family history methods may be an addition to possible variables that predict who will be exposed to combat and also that family history variables may be able to distinguish a PTSD population from some other types of emotional disorders.",0,0 +5223,Epigenetic profiles associated with psychopathology in a community-based epidemiologic sample,"Background: Recent work suggests epigenetic differences may contribute to the etiology of psychiatric disorders. Here, we investigate whether methylation profiles can distinguish between individuals with and without lifetime psychopathology in a community-based epidemiologic sample. Methods: Using whole blood-derived genomic DNA from a subset (n = 100) of participants in the Detroit Neighborhood Health Study, we assessed genome-wide methylation microarray profiles in individuals affected by lifetime PTSD (n = 23) and lifetime depression (n = 33), respectively. Bioinformatic analyses were performed on the genes uniquely methylated and unmethylated in each group. Results: Individuals with PTSD showed epigenomic profiles characterized by decreased methylation in immune system-related genes and increased methylation in gene clusters involved in neurogenesis and sensory perception of sound. Among individuals with depression, epigenomic profiles were characterized by decreased methylation in lipoprotein-related gene sets and increased methylation in gene sets involved in brain development and tryptophan metabolism. For both disorders, epigenomic profiles were associated with disease classes predominated by psychopathologic conditions among the unmethylated gene sets identified from PTSD-and depression-free individuals, respectively, suggesting that individuals with these conditions possess higher methylation levels in these psychopathology-associated gene sets. Conclusion: Genome-wide methylation profiles distinguish individuals affected by psychopathology in a manner consistent with functions previously implicated in the etiology of these disorders.",0,0 +5224,"Longitudinal Evaluation of the Relationship Between Mindfulness, General Distress, Anxiety, and PTSD in a Recently Deployed National Guard Sample","Mindfulness has increasingly been shown to be a resilience-promoting factor against the negative effects of stress and anxiety. While there is considerable literature evidencing that higher levels of mindfulness are associated with decreased stress and anxiety in civilian cross-sectional studies, fewer studies have examined this relationship utilizing longitudinal designs with recently deployed National Guard soldiers. The present study examined the resilience-promoting effects of mindfulness on symptoms of post-traumatic stress disorder (PTSD), anxiety, and general distress with members of Aviation (N = 52) and Infantry (N = 146) battalions of the Army National Guard who recently returned from deployment. Each study participant completed measures at two time points (3 and 12 months post-deployment) to examine whether mindfulness predicted symptom reporting over time. Overall, findings suggest that time 1 mindfulness is a significant predictor of time 2 general distress, anxiety, and the hyperarousal symptom cluster, but not time 2 total PTSD. Consistent with previous studies, these findings suggest that mindfulness measures may be useful for identifying soldiers at risk and resilient for post-deployment psychological distress. The implications for different diagnostic frameworks and criteria are considered. © 2015, Springer Science+Business Media New York.",0,0 +5225,Minnesota multiphasic personality inventory profiles of Vietnam combat veterans with posttraumatic stress disorder and their children,"Forty children of 28 fathers who are Vietnam veterans with posttraumatic stress disorder (PTSD) completed the Minnesota Multiphasic Personality Inventory. Each of the fathers had at least one elevated clinical scale. Fathers averaged eight elevated clinical scales, and compared to more recent norms, fathers averaged seven elevated clinical scales. Seventy-eight percent of the children had at least one clinically elevated scale (averaging three elevated clinical scales). Compared to contemporary normal adolescents and adults, 65% of children had at least one clinically elevated scale (still averaging three elevated clinical scales). No consistent MMPI profile patterns emerged within or across the two groups. No gender differences were detected among child MMPI profiles. Forty percent of the children reported illegal drug use, and 35% reported behavior problems. Fifteen percent of children reported previous violent behavior. Eighty-three percent of the children reported elevated Cook-Medley hostility scores as compared to an age-matched national normative sample. Children with higher PK scores were also significantly more likely to report higher Cook-Medley hostility scores. Forty-five percent of children reported significant elevations on the PTSD/PK subscales.",0,0 +5226,Prevalence and trajectory of psychopathology among child and adolescent survivors of disasters: a systematic review of epidemiological studies across 1987–2011,"Aims: The goal of this paper was to systematically review evidence on (1) the potential magnitude of the psychopathological impacts of community-wide disasters on child and adolescent survivors, and (2) the long-term course or trajectory of disaster-induced psychopathology among children and adolescents. Methods: The PubMed/MEDLINE and PsycINFO databases were searched from their respective inception through December 2011. All of the resulting epidemiological studies of child and adolescent survivors following community-wide disasters were examined. Results: Sixty cross-sectional studies and 25 longitudinal or long-term follow-up studies were identified. The estimated rates of posttraumatic stress disorder (PTSD) and depression among child and adolescent survivors varied greatly across the included studies, ranging from 1.0 to 95 % and 1.6 to 81 %, respectively, while the reported rates of diagnosable PTSD according to the DSM-IV criteria and diagnosable depression ranged from 1.0 to 60 % and 1.6 to 33 %, respectively. The long-term courses of psychopathology among youthful survivors were summarized. Methodological issues with those studies were discussed. Conclusions: The empirical findings summarized in this review highlight the importance of psychosocial intervention at early postdisaster stages for child and adolescent survivors. The methodological flaws revealed by this review indicate the need for continued attempts to better understand the epidemiology and trajectory of psychopathological problems among youthful survivors. © 2013 Springer-Verlag Berlin Heidelberg.",0,0 +5227,Evaluation of the Efficacy of Pharmacotherapy and Psychotherapy in Treatment of Combat-Related Post-Traumatic Stress Disorder: A Meta-Analytic Review of Outcome Studies,"A meta-analysis was conducted to examine the relative effectiveness of the broad-based treatments for combat-related post-traumatic stress disorder (PTSD). The analysis includes 13 pharmacotherapy studies and 12 psychotherapy studies obtained from a PsychINFO database search and a reference search. Studies of pharmacotherapy treatment efficacy demonstrated a significantly greater decrease in reducing PTSD symptoms, t (22) = -2.74, p = 0.01, d = 0.05. A random coefficient analysis supports this finding with significance determined at p < 0.001 for the fixed effects in the models. A limited examination of depression as a frequently comorbid disorder indicated pharmacotherapy also demonstrated a significantly greater decrease than psychotherapy in depression symptoms, t (15.77) = -2.26, p = 0.04, d = 0.16. Differences between treatments are discussed as potentially reflective of assignment to treatments and assessment techniques as well as therapeutic effects.",0,0 +5228,Analysis of longitudinal data using latent variable models with varying parameters.,"Lt-fwt Latent Variable Growth Modeling with Multilevel Data Bengt Muthen * Graduate School of Education z B r y k & Raudenbush, 1992; Goldstein, 1987), less work has been done i n the area of latent variables. T h i s paper was presented at the U C L A conference Latent Variable Modelling with Applications to Causality, March 19-20, 1994. T h e research was supported by a grant from the Office of Educa- tional Research and Improvement, Department of Education to the National Center for Research on Evaluation, Standards, and Student Testing ( C R E S S T ) and grant A A 08651-01 from N 1 A A A . I thank Siek-Toon K h o o , Guanghan L i u , and Ginger Nelson GofT for helpful assistance. Ua^TdeU M^obJb^ l(",0,0 +5229,Probable Post-Traumatic Stress Disorder and Its Predictors in Disaster-Bereaved Survivors: A Longitudinal Study After the Sichuan Earthquake,"This study examined the trajectory of probable PTSD prevalence and severity, and analyzed the predictors for PTSD severity in bereaved survivors at 6 months and 18 months after the 2008 Sichuan earthquake. This was a longitudinal study with 226 bereaved survivors sampled at 6 months and 18 months post-earthquake. The instrument used in the study was the revised version of the Impact of Event Scale. The results showed that the prevalence of probable PTSD in bereaved survivors decreased significantly from 38.9% at 6 months to 16.8% at 18 months post-earthquake. Loss of a child, being directly exposed to the death of family members and property loss during the earthquake, and mental health services utilization after the earthquake were significant predictors for PTSD severity at both assessments. These findings can contribute to post-disaster psychological rescue work. The bereaved survivors at high risk for more severe PTSD should be particularly targeted.",0,0 +5230,Biological Factors Associated with Susceptibility to Posttraumatic Stress Disorder,"Because only a proportion of persons exposed to traumatic events develop posttraumatic stress disorder (PTSD), it has become important to elucidate the factors that increase the risk for the development of PTSD following trauma exposure as well as the factors that might serve to protect individuals from developing this condition. Putative risk factors for PTSD may describe the index traumatic event or characteristics of persons who experience those events. Recent data have implicated biological and familial risk factors for PTSD. For example, our recent studies have demonstrated an increased prevalence of PTSD in the adult children of Holocaust survivors, even though these children, as a group, do not report a greater exposure to life-threatening (Diagnostic and Statistical Manual of Mental Disorders [DSM-IV] Criterion A) events. These studies are reviewed. It is difficult to know to what extent the increased vulnerability to PTSD in family members of trauma survivors is related to biological or genetic phenomena, as opposed to experiential ones, because of the large degree of shared environment in families. In particular, at-risk family members, such as children, may be more vulnerable to PTSD as a result of witnessing the extreme suffering of a parent with chronic PTSD rather than because of inherited genes. But even if the diathesis for PTSD were somehow “biologically transmitted” to children of trauma survivors, the diathesis is still a consequence of the traumatic stress in the parent. Thus, even the most biological of explanations for vulnerability must at some point deal with the fact that a traumatic event has occurred.",0,0 +5231,Cognitive Transformation as a Marker of Resilience,"Individuals often report positive, transformative changes in response to adversity. Cognitive transformation involves a turning point in a person's life characterized by: (1) the recognition that coping with adversity resulted in new opportunities; and, (2) the reevaluation of the experience from one that was primarily traumatic or threatening to one that is growth-promoting. Cognitive transformation often signifies enhanced adaptation to adverse circumstances, and thus, is a marker of resilience. The present study examined the relationship of cognitive transformation to indicators of resilience among 35 acutely bereaved young adults and a nonbereaved comparison group. Findings strongly supported the hypothesis that transformation predicts resilience, and may reduce one's risk trajectory to enhance adaptation. Results are discussed in terms of their implications for research on resilience, and on recovery from acute or chronic adverse circumstances, including addiction.",0,0 +5232,Different profiles of acute stress disorder differentially predict posttraumatic stress disorder in a large sample of female victims of sexual trauma.,"This study aimed to test the dimensional structure of acute stress disorder (ASD). Latent profile analysis was conducted on scores from the Acute Stress Disorder Scale (Bryant, Moulds, & Guthrie, 2000) using a large sample of female victims of sexual trauma. Four distinct classes were found. Two of the classes represented high and low levels of ASD, and the high ASD class was associated with a high probability of subsequent posttraumatic stress disorder (PTSD). There were 2 intermediate classes that were differentiated by the number of arousal symptoms, and the class with high levels of arousal symptoms had a higher risk of PTSD. The results suggested that ASD is best described by qualitatively and quantitatively differing subgroups in this sample, whereas previous research has assumed ASD to be dimensional. This may explain the limited success of using ASD to predict subsequent PTSD. (PsycINFO Database Record (c) 2014 APA, all rights reserved).",0,0 +5233,Assessment of dysregulated children using the Child Behavior Checklist: A receiver operating characteristic curve analysis.,"Disorders of self-regulatory behavior are common reasons for referral to child and adolescent clinicians. Here, the authors sought to compare 2 methods of empirically based assessment of children with problems in self-regulatory behavior. Using parental reports on 2,028 children (53% boys) from a U.S. national probability sample of the Child Behavior Checklist (CBCL; T. M. Achenbach & L. A. Rescorla, 2001), the receiver operating characteristic curve analysis was applied to compare scores on the Posttraumatic Stress Problems Scale (PTSP) of the CBCL with the CBCL Dysregulation Profile (DP), identified using latent class analysis of the Attention Problems, Aggressive Behavior, and Anxious/Depressed scales of the CBCL. The CBCL-PTSP score demonstrated an area under the curve of between .88 and .91 for predicting membership in the CBCL-DP profile for boys and for girls. These findings suggest that the CBCL-PTSP, which others have shown does not uniquely identify children who have been traumatized, does identify the same profile of behavior as the CBCL-DP. Therefore, the authors recommend renaming the CBCL-PTSP the Dysregulation Short Scale and provide some guidelines for the use of the CBCL-DP scale and the CBCL-PTSP in clinical practice.",0,0 +5234,What can we learn from the first community-based epidemiological study on stalking in Germany?,"There is a lack of community-based studies on prevalence rates of stalking and the impact of stalking on victims in continental European countries. The authors published the first community-based epidemiological study on stalking in Germany. The purpose of this paper is to discuss possible implications of these epidemiological data for the mental health system, forensic psychiatry and legal regulations in Germany. For these reasons some data of our epidemiological study are outlined and reanalyzed. To examine lifetime and point prevalence rates of stalking, behavioural and psychological consequences for victims and the impact of stalking on current psychological well-being in a German community sample, a postal survey was conducted with 2000 inhabitants randomly selected from Mannheim (response rate 34.2%, n=679). The survey included a stalking questionnaire and the WHO-5 well-being scale. Almost 12% of the respondents reported having been stalked. This study identified a high lifetime prevalence of stalking in the community. Effects on victims' psychological health were significant and there was a high rate of physical (31%) and sexual (19%) violence in the context of stalking. Our data suggest that the phenomenon deserves more attention in future forensic psychiatric research and practice. Implications for forensic psychiatric assessment and treatment of stalkers as well as for management of stalking victims are discussed.",0,0 +5235,Mitochondrial peripheral-type benzodiazepine receptor and DHEAS levels in patients with post-traumatic stress disorder and combat complications,"Introduction: Post-Traumatic Stress Disorder (PTSD) is an highly invalidating anxiety disorder, which onset is related to the exposure to a traumatic event. First explored in military contexts, this disorder has recently shown increasing prevalence in the general population. In the last years, neurosteroids showed to be implicated in many psychiatric disorders, such as anxiety disorders. The Peripheral Benzodiazepine Receptor (PBR) is a mitochondrial protein that takes part in the constitution of a pore in the membrane, which opening has a crucial role in the regulation of neurosteroids synthesis. In stressful conditions, alterations in the levels of PBR expression and of some steroids were highlighted, particularly in patients with chronic PTSD combat related. Methods: Aim of the present study was to assess mitochondrial PBR density and serum neurosteroid DHEAS levels, in a sample of patients with PTSD or Traumatic Grief (LT) vs. healthy controls. All subjects were enrolled at the Clinica Psichiatrica 2(degrees) of the University of Pisa and assessed by SCID, Inventory of Complicated Grief and Impact of Event Scale. Results: Results of the present study show a significant reduction in lymphocyte PBR density in patients with PTSD vs. controls (p < 0.01). Reduced DHEAS levels, with respect to controls, were found in PTSD and TG subjects (in these latest p < 0.05). Conclusions: These data suggest PBR involvement in chronic PTSD related to non combat trauma. Moreover, patients with LT show a different PBR density profile with respect to that of patients with PTSD, suggesting a nosographic autonomy of these two clinical entities. The statistically significant alterations in serum DHEAS levels found in LT patients, vs. both PTSD patients and controls, further support this hypothesis.",0,0 +5236,Psychological Resilience Building in Disaster Risk Reduction: Contributions from Adult Education,"This article discusses three questions: What opportunities exist to enhance psychological resilience in adults? Why should psychological resilience promotion be considered an important disaster risk reduction strategy? What contribution can adult education make to such a strategy? Psychological resilience is presented as relational and somewhat malleable, even in adulthood. Although psychological resilience building is often overlooked in social-level disaster risk reduction efforts, it is a key strategy for social resilience building. Questions regarding the extent to which mental resilience can be improved and the techniques with which to do so may be answered by research in the field of adult education. Basic learning and teaching research fundamentals are suggested to create psychological resilience-building strategies in adults.",0,0 +5237,Offering the opportunity for family to be present during cardiopulmonary resuscitation: 1-year assessment,"Purpose: To evaluate the psychological consequences among family members given the option to be present during the CPR of a relative, compared with those not routinely offered the option. Methods: Prospective, cluster-randomized, controlled trial involving 15 prehospital emergency medical services units in France, comparing systematic offer for a relative to witness CPR with the traditional practice among 570 family members. Main outcome measure was 1-year assessment included proportion suffering post-traumatic stress disorder (PTSD), anxiety and depression symptoms, and/or complicated grief. Results: Among the 570 family members [intention to treat (ITT) population], 408 (72 %) were evaluated at 1 year. In the ITT population (N = 570), family members had PTSD-related symptoms significantly more frequently in the control group than in the intervention group [adjusted odds ratio, 1.8; 95 % confidence interval (CI) 1.1-3.0; P = 0.02] as did family members to whom physicians did not propose witnessing CPR [adjusted odds ratio, 1.7; 95 % CI 1.1-2.6; P = 0.02]. In the observed cases population (N = 408), the proportion of family members experiencing a major depressive episode was significantly higher in the control group (31 vs. 23 %; P = 0.02) and among family members to whom physicians did not propose the opportunity to witness CPR (31 vs. 24 %; P = 0.03). The presence of complicated grief was significantly greater in the control group (36 vs. 21 %; P = 0.005) and among family members to whom physicians did not propose the opportunity to witness resuscitation (37 vs. 23 %; P = 0.003). Conclusions: At 1 year after the event, psychological benefits persist for those family members offered the possibility to witness the CPR of a relative in cardiac arrest. © 2014 Springer-Verlag.",0,0 +5238,The role of social support in well-being and coping with self-reported stressful events in adolescents,"This study investigated the role that social support plays in well-being and in coping after a stressful event in a group of non-clinical adolescents. Furthermore, this study aimed at replicating the finding that adolescents who reported sexual abuse reported more symptoms and less adequate coping strategies than adolescents who reported another type of stressful event or no stressful episode.Eight hundred and twenty adolescents between 12 and 18 years of age filled out questionnaires assessing social support (Social Support Questionnaire, Sarason, Shearin, Pierce, & Sarason, 1987), trauma-related symptoms (Trauma Symptom Checklist for Children, Briere, 1996), behavior problems (Youth Self-Report, Achenbach, 1991), and coping (How I Cope Under Pressure Scale, Ayers, Sandler, West, & Roosa, 1996).42% of the adolescents reported a stressful experience, and 4.4% reported sexual abuse. Sexually abused adolescents reported more stress-related symptoms and used more avoidance and fewer support-seeking coping strategies than the other adolescents. The main-effect hypothesis of social support was sustained, but social support did not moderate the relation between a stressful event and coping. Yet, a trend was found suggesting that high support from the family was associated with less avoidance coping and more support-seeking in adolescents who reported a non-sexually abusive, stressful event.Our findings show that a highly perceived availability of social support is directly associated with fewer trauma-related symptoms, especially in adolescents who are non-sexually abused. For adolescents who reported a sexual or another type of stressful event, social support did not play a different role in coping.",0,0 +5239,"Posttraumatic Stress Symptoms, Aggression, and Substance Use Coping among Young Adults","This study examined how the symptom clusters of posttraumatic stress disorder (PTSD) were related to substance use and self-reported aggression in a college sample. There were 358 participants (ages 18–24) who completed surveys to assess PTSD symptoms, substance use as coping, and aggression. Hierarchical regressions tested for the effects of PTSD symptoms (total symptoms as well as cluster symptoms) on self-reported aggression, along with the main and interaction effects of substance use coping on these relationships. The hyperarousal cluster of PTSD was the only group of symptoms significantly related to aggression. There was an interaction between avoidance symptoms and substance use coping on aggression such that under conditions of high substance use coping, aggression increased regardless of avoidance symptoms; however, the relationship between avoidance and aggression was stronger under conditions of low substance use coping, with greater aggression as avoidance symptoms and low substance use copin...",0,0 +5240,"Acute Post-Rape Plasma Cortisol, Alcohol Use, and PTSD Symptom Profile among Recent Rape Victims",This study presents the acute post-rape plasma cortisol alcohol use and post-traumatic stress disorder (PTSD) symptom profile among 37 recent female rape victims. Subjects were victims of rape who reported the crime to the police and who received forensic medical examinations within 72 hours post-rape. A total of 15 (41%) women reported alcohol use not related to PTSD status. Cortisol was significantly negative associated with the time of post-rape. A nonsignificant association was seen for the main effect of alcohol use and in the interaction of alcohol use and prior history of assault. The association of history for assault with lower cortisol levels showed a significant effect for the history of assault. Apparent levels were found among newly assaulted women using alcohol. Women with assault histories irrespective of alcohol use showed low levels of cortisol. About 22 (71%) women met the cutoff criteria for PTSD. A main effect was observed in the presence of crime-related PTSD associated with cortisol showing a higher cortisol level. Basing from the results it can be concluded that alcohol use is associated with high levels of cortisol in women with no rape history. Moreover cortisol levels were lower in both alcohol users and nonusers which have been victimized.,0,0 +5241,School-Based Mental Health Intervention for Children Affected by Political Violence in Indonesia,"Little is known about the efficacy of mental health interventions for children exposed to armed conflicts in low- and middle-income settings. Childhood mental health problems are difficult to address in situations of ongoing poverty and political instability.To assess the efficacy of a school-based intervention designed for conflict-exposed children, implemented in a low-income setting.A cluster randomized trial involving 495 children (81.4% inclusion rate) who were a mean (SD) age of 9.9 (1.3) years, were attending randomly selected schools in political violence-affected communities in Poso, Indonesia, and were screened for exposure (> or = 1 events), posttraumatic stress disorder, and anxiety symptoms compared with a wait-listed control group. Nonblinded assessment took place before, 1 week after, and 6 months after treatment between March and December 2006.Fifteen sessions, over 5 weeks, of a manualized, school-based group intervention, including trauma-processing activities, cooperative play, and creative-expressive elements, implemented by locally trained paraprofessionals.We assessed psychiatric symptoms using the Child Posttraumatic Stress Scale, Depression Self-Rating Scale, the Self-Report for Anxiety Related Disorders 5-item version, and the Children's Hope Scale, and assessed function impairment as treatment outcomes using standardized symptom checklists and locally developed rating scales.Correcting for clustering of participants within schools, we found significantly more improvement in posttraumatic stress disorder symptoms (mean change difference, 2.78; 95% confidence interval [CI], 1.02 to 4.53) and maintained hope (mean change difference, -2.21; 95% CI, -3.52 to -0.91) in the treatment group than in the wait-listed group. Changes in traumatic idioms (stress-related physical symptoms) (mean change difference, 0.50; 95% CI, -0.12 to 1.11), depressive symptoms (mean change difference, 0.70; 95% CI, -0.08 to 1.49), anxiety (mean change difference, 0.12; 95% CI, -0.31 to 0.56), and functioning (mean change difference, 0.52; 95% CI, -0.43 to 1.46) were not different between the treatment and wait-listed groups.In this study of children in violence-affected communities, a school-based intervention reduced posttraumatic stress symptoms and helped maintain hope, but did not reduce traumatic-stress related symptoms, depressive symptoms, anxiety symptoms, or functional impairment.isrctn.org Identifier: ISRCTN25172408.",0,0 +5242,Children's symptoms of posttraumatic stress and depression after a natural disaster: Comorbidity and risk factors,"The current study examined rates of comorbidity among children's symptoms of posttraumatic stress (PTS) and depression after a natural disaster, Hurricane Ike. We also compared children with comorbid symptoms to children without comorbid symptoms, examining recovery, severity of symptoms, and risk factors.Children (n=277; 52% girls; 38% Hispanic, 28% White, 19% Black; grades 2-4) were assessed at 8 and 15 months postdisaster. Children completed measures of PTS and depressive symptoms at both time points and measures of exposure and recovery stressors at 8 months postdisaster.At 8 months postdisaster, 13% of children reported elevated PTS-only, 11% depression-only, and 10% comorbid symptoms of PTS and depression. At 15 months postdisaster, 7% of children reported elevated PTS-only, 11% depression-only, and 7% comorbid symptoms of PTS and depression. Children with comorbid symptoms of PTS and depression had poorer recovery, more severe symptoms, and they reported greater exposure and recovery stressors.We lacked information on children's predisaster functioning and diagnostic interview of psychological distress symptoms.Children with comorbid symptoms need to be identified early postdisaster. Levels of stressors should be monitored postdisaster, as highly stressed youth have difficulties recovering and may need help. Interventions should be tailored for children with comorbid symptoms of PTS and depression.",0,0 +5243,An Open-Label Study of Guanfacine Extended Release for Traumatic Stress Related Symptoms in Children and Adolescents,"The purpose of this open-label pilot study was to investigate the effectiveness and tolerability of guanfacine extended release (GXR) 1-4 mg given in the evening, on the symptoms of traumatic stress (reexperiencing, avoidance, overarousal), generalized anxiety, and functional impairment in children and adolescents with a history of traumatic stress with or without posttraumatic stress disorder (PTSD). As many of our sample had associated attention-deficit/hyperactivity disorder (ADHD) symptoms, we also assessed whether the presence of traumatic stress symptoms impaired the effectiveness of GXR in the treatment of comorbid ADHD symptoms.Participants were 19 children and adolescents 6-18 years of age, with current traumatic stress symptoms. In an 8 week open-label design, each patient's scores on parent-, child-, and clinician-reported symptom rating scales assessing traumatic stress symptoms, generalized anxiety, ADHD symptoms, functional impairment, and global symptom severity and improvement (n=17) were evaluated off and on GXR using χ(2) goodness-of-fit tests, paired t tests, and repeated measures analyses of variance (ANOVAs). To examine patterns of change in outcome measures across treatment, MPlus software was used to conduct linear growth curves modeled with individual-varying times of observation (i.e., random slopes).Using an average GXR daily dose of 1.19 mg±0.35 mg and an average weight-adjusted daily dose of 0.03 mg/kg±0.01 mg/kg, significant differences were found on all symptom severity measures. Parent reported UCLA Reaction Index scores assessing cluster B (reexperiencing), C (avoidant), and D (overarousal) symptoms significantly improved. In the presence of PTSD symptoms, children with ADHD experienced significantly improved ADHD symptom scores, suggesting that comorbidity does not attenuate an ADHD symptom response to GXR therapy. Medication was generally well tolerated.Within the limits of an open-label, hypothesis-generating pilot study, our results suggest that the α2A-adrenoceptor agonist GXR may have therapeutic effects in the treatment of PTSD symptoms in traumatically stressed children and adolescents. The effective dose may be lower than that found for ADHD. Our pilot study supports the need for further controlled research on the effects of GXR and other α2A-adrenoceptor agonists in pediatric disorders of traumatic stress.",0,0 +5244,Traumatisme psychique des victimes d’agressions sexuelles avec possible soumission chimique. Prise en charge UMJ,"Resume Chaque annee, de nombreuses personnes portent plainte pour agression sexuelle avec suspicion de soumission chimique. Les circonstances sont souvent les memes : un contexte festif avec une forte alcoolisation, puis une amnesie avec un reveil difficile et les stigmates d’une activite sexuelle. Les victimes attendent que l’examen effectue aux UMJ apporte la preuve de l’agression et de l’administration de produits a leur insu. Selon une etude menee aux UMJ de l’Hotel-Dieu, dans la majorite des cas, seule l’alcoolisation massive est responsable des symptomes, ce qui entraine un grand sentiment de culpabilite chez les plaignants. La plupart d’entre eux presentent une forte anxiete et des symptomes de psycho-traumatisme. La prise de conscience d’une certaine forme de responsabilite dans le deroulement des faits accroit leur desarroi. Chez les personnes rendues vulnerables par des antecedents traumatiques, le risque de passage a l’acte suicidaire peut etre accru. Une prise en charge empathique et chaleureuse des soignants des UMJ, ainsi qu’une plus juste repartition des responsabilites peuvent aider a la reconstruction des personnes qui seront alors orientees vers les professionnels du reseau pour une prise en charge globale medico-psycho-sociale.",0,0 +5245,Investigating the psychosocial determinants of child health in Africa: The Drakenstein Child Health Study,"Early life psychobiological and psychosocial factors play a key role in influencing child health outcomes. Longitudinal studies may help elucidate the relevant risk and resilience profiles, and the underlying mechanisms that impact on child health, but there is a paucity of birth cohort data from low and middle-income countries (LMIC). We describe the rationale for and present baseline findings from the psychosocial component of the Drakenstein Child Health Study (DCHS).We review the psychosocial measures used in the DCHS, a multidisciplinary birth cohort study in a peri-urban area in South Africa, and provide initial data on psychological distress, depression, substance use, and exposure to traumatic stressors and intimate partner violence (IPV). These and other measures will be assessed longitudinally in mothers in order to investigate associations with child neurodevelopmental and health outcomes.Baseline psychosocial data is presented for mothers (n=634) and fathers (n=75) who have completed antenatal assessments to date. The sample of pregnant mothers is characterized by multiple psychosocial risk factors, including a high prevalence of psychological distress and depression, high levels of substance use, and high exposure to traumatic stressors and IPV.These data are consistent with prior South African studies which have documented a high prevalence of a multitude of risk factors during pregnancy. Further longitudinal assessment of mothers and children may clarify the underlying psychobiological and psychosocial mechanisms which impact on child health, and so inform clinical and public health interventions appropriate to the South African and other LMIC contexts.",0,0 +5246,Animal model for PTSD: From clinical concept to translational research,"In humans, the diagnosis of PTSD is made only if an individual exhibits a certain number of symptoms from each of three quite well defined symptom clusters over a certain period of time. Animal behavioral studies, however, have generally tended to overlook this aspect and have commonly regarded the entire group of animals subjected to certain study conditions as homogeneous. Thus, in an attempt to develop animal models of long-term chronic behavioral responses to stress (i.e. PTSD) in a comparable manner to human diagnosis, we applied cut-off inclusion/exclusion criteria to behavioral data for a cohort of animals exposed to a stress paradigm. This grouped them as behaviorally affected or unaffected by the stress. This model takes into account the variability in degree of the individual's response to the stress paradigm, thereby modeling the fact that not all humans exposed to traumatic stress respond with affective disorder. This article will present and discuss findings from a series of studies employing a model of individual behavioral response classification. This article will discuss the concept of the model and its background and present a selection of studies employing and examining the model, alongside the underlying translational rationale of each. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0,0 +5247,Posttraumatic Stress Disorder and Cocaine Dependence: Order of Onset,"To investigate differences between patients whose posttraumatic stress disorder (PTSD) preceded their cocaine dependence and vice versa, 33 patients with comorbid PTSD and cocaine dependence were divided into two groups: one in which the traum and PTSD occurred before onset of cocaine dependence (primary PTSD) and one in which the PTSD occurred after cocaine dependence was established (primary cocaine). In the primary-PTSD group, the trauma was generally childhood abuse. In the primary-cocaine group, the trauma was generally associated with the procurement and use of cocaine. In the primary PTSD group, there were significantly more women, more other Axis I diagnoses, more Cluster B and C Axis II diagnoses, and more benzodiazepine and opiate use. In the primary-cocaine group, there was a trend toward more cocaine use in the previous month. Significant clinical differences between these two groups may warrant different types of treatment or differing treatment emphasis.",0,0 +5248,Effects of psychotherapy on hippocampal volume in out-patients with post-traumatic stress disorder: a MRI investigation,"Background. Magnetic resonance imaging (MRI) studies have especially reported smaller hippocampal volume in patients with post-traumatic stress disorder (PTSD), most of them war or sexual abuse victims. The present study compares the hippocampal volumes of out-patients with PTSD who had low co-morbidity rates to those of trauma-exposed control subjects without PTSD, and measures hippocampal volume changes in these patients after brief eclectic psychotherapy. We hypothesized that smaller hippocampal volumes are specific to PTSD and that hippocampal volume changes after effective psychotherapy would be measurable. Method. Eighteen patients with PTSD and 14 traumatized control subjects were examined with MRI. In a randomized clinical trial, the PTSD patients were assigned to treatment ( n =9) or waiting-list group ( n =9). After the former received psychotherapy for 4 months, the MRI was repeated on both PTSD groups. Three temporal lobe structures were manually segmented: hippocampus, amygdala, and parahippocampal gyrus. Volumetric analysis was used to measure grey matter, white matter, and cerebrospinal fluid. Results. PTSD patients had significantly smaller hippocampal volumes at baseline (total 13·8%, right 13·5%, left 14·1%) compared to the control subjects. After effective psychotherapy, however, no volume changes were found in the smaller hippocampi. Conclusions. We confirmed previous findings of smaller hippocampal volume in PTSD in a new population made up of out-patients who experienced different types of traumas, reducing co-morbidity to a minimum. Smaller hippocampal volumes did not change after effective psychotherapy, even while symptoms resolved.",0,0 +5249,MMPI-2 Assessment of Differential Post-Traumatic Stress Disorder Patterns in Combat Veterans and Sexual Assault Victims,"This study compared MMPI-2 profiles and trauma-specific subscales of the MMPI-2 in groups of combat veterans and sexual assault victims. Analyses indicated a trend toward externalizing symptoms for combat veterans and internalizing symptoms for sexual assault survivors. For diagnostic classification purposes, the PS scale was found to best differentiate post-traumatic stress disorder (PTSD) cases from non-PTSD cases for the combat group, whereas the F-2-8 standard decision rule best differentiated the sexual trauma group from comparisons. These results suggest that type of trauma experienced is a key variable in understanding the patient and dictates the need for different therapeutic focuses. In addition, the results suggest that the MMPI-2 PTSD scales provide a reasonable classification of PTSD status.",0,0 +5250,Factor Structure of the PTSD Checklist for DSM-5,"Scarce data are available regarding the dimensional structure of Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) posttraumatic stress disorder (PTSD) symptoms and how factors relate to external constructs. We evaluated six competing models of DSM-5 PTSD symptoms, including Anhedonia, Externalizing Behaviors, and Hybrid models, using confirmatory factor analyses in a sample of 412 trauma-exposed college students. We then examined whether PTSD symptom clusters were differentially related to measures of anger and impulsivity using Wald chi-square tests. The seven-factor Hybrid model was deemed optimal compared with the alternatives. All symptom clusters were associated with anger; the strongest association was between externalizing behaviors and anger (r = 0.54). All symptom clusters, except re-experiencing and avoidance, were associated with impulsivity, with the strongest association between externalizing behaviors and impulsivity (r = 0.49). A seven-factor Hybrid model provides superior fit to DSM-5 PTSD symptom data, with the externalizing behaviors factor being most strongly related to anger and impulsivity.",0,0 +5251,Prospective Trajectories of Posttraumatic Stress in College Women Following a Campus Mass Shooting,"In a sample with known levels of preshooting posttraumatic stress (PTS) symptoms, we examined the impact of a campus mass shooting on trajectories of PTS in the 31 months following the shooting using latent growth mixture modeling. Female students completed 7 waves of a longitudinal study (sample sizes ranged from 812 to 559). We identified 4 distinct trajectories (n = 660): (a) minimal impact-resilience (60.9%), (b) high impact-recovery (29.1%), (c) moderate impact-moderate symptoms (8.2%), and (d) chronic dysfunction (1.8%). Individuals in each trajectory class remained at or returned to preshooting levels of PTS approximately 6 months postshooting. The minimal impact-resilience class reported less prior trauma exposure (η(2) = .13), less shooting exposure (η(2) = .07), and greater emotion regulation skills than all other classes (η(2) > .30). The chronic dysfunction class endorsed higher rates of experiential avoidance prior to the shooting than the minimal-impact resilient and high impact-recovery classes (η(2) = .15), as well as greater shooting exposure than the high impact-recovery class (η(2) = .07). Findings suggest that preshooting functioning and emotion regulation distinguish between those who experience prolonged distress following mass violence and those who gradually recover.",1,0 +5252,The Prevalence of PTSD across War Eras and the Effect of Deployment on PTSD:a Systematic Review and Meta-analysis,,0,0 +5253,Women’s experiences of symptoms of posttraumatic stress disorder (PTSD) after traumatic childbirth: a review and critical appraisal,"This paper critically analyses nine studies on postnatal posttraumatic stress disorder (PTSD) following traumatic childbirth, in order to find common themes of PTSD symptoms, using the cognitive model of PTSD as a guide; it critically appraised one of the studies in depth and it attempted to explain the lived experience of women suffering from postnatal PTSD following traumatic childbirth and the suitability of cognitive behavioural therapy (CBT) for postnatal PTSD. This paper found that women following traumatic childbirth do experience postnatal PTSD; postnatal PTSD symptoms are similar to PTSD symptoms of other events and that CBT for PTSD of other events is just as effective for postnatal PTSD. Future recommendations include more qualitative studies with interpretative phenomenological approach in order to establish evidence-based CBT treatment for this client group, and more referrals need to be sent to the psychological services for CBT intervention.",0,0 +5254,Development of Child Posttraumatic Stress Disorder in Pediatric Trauma Victims: The Impact of Initial Child and Caregiver PTSD Symptoms on the Development of Subsequent Child PTSD,"Following a child's traumatic injury, both the child and his/her parents often report significant levels of posttraumatic stress disorder (PTSD) symptoms. Although many studies have identified predictors of PTSD at varying times post-trauma, few have longitudinally examined mechanisms through which child PTSD symptoms (PTSS) develop over time. Additionally, there is limited research on the interaction between caregiver and child PTSS. Determination of initial acute responses in both the caregiver and child that predict increased risk for persistent child PTSD will allow for greater specificity in identifying at-risk families and will inform the design of novel family-focused interventions. One hundred and eighteen child traumatic injury victims aged 8-18 years and their primary caregivers were interviewed in-hospital and at 2- and 6-weeks post-trauma to assess the development and maintenance of child PTSS. At each time point, depressive and PTSD symptomatology of both the child and caregiver were measured. Results revealed that child in-hospital levels of hyperarousal predicted child 2-week PTSS; however, child in-hospital levels of avoidance were found to predict child PTSS at 6-weeks post-trauma. Furthermore, post-hoc analyses revealed that high levels of child in-hospital re-experiencing symptoms and high levels of caregiver in-hospital avoidance symptoms significantly interacted to predict child 6-week PTSS, particularly in girls. The results of the current study underscore the importance of examining specific symptoms of PTSD and focus on the impact of familial distress on child post-traumatic adjustment. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5255,Psychobiology of posttraumatic stress disorder.,"(from the introduction) This volume summarizes the major findings and themes in the psychobiology of posttraumatic stress disorder (PTSD). One of the major points highlighted in this volume concerns the biological or pathophysiological differences between PTSD, stress, and other psychiatric disorders. The 1st section of this volume deals with the epidemiological and phenomenological studies that objectified the important clinical observations on the prevalence of trauma and its manifestations. The 2nd section represents the core of the psychobiological studies of chronic PTSD in adults. The 3rd section introduces an important framework that is becoming increasingly recognized in trauma studies-the developmental perspective. The 4th section deals with the biology of normal and traumatic memories in both animals and humans. The 5th section provides theoretical models to explain the way that traumatic experiences might be potentiated to pathological states. The 6th section provides an analysis of the influences of biological studies on the treatment of PTSD., (from the book) This volume is a result of a conference entitled Psychobiology of Posttraumatic Stress Disorder sponsored by the New York Academy of Sciences and held on September 7-10, 1996 in New York, New York. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5256,Prescribing Trends in Veterans With Posttraumatic Stress Disorder,"The revised Department of Veterans Affairs (VA) and Department of Defense Clinical Practice Guideline for Management of Post-Traumatic Stress recommends against long-term use of benzodiazepines to manage posttraumatic stress disorder (PTSD). An analysis of recent trends among veterans receiving care for PTSD in the VA noted a decreasing proportion receiving benzodiazepines. The authors examined prescribing patterns for other medications to better understand the general context in which the changes in benzodiazepine prescribing have occurred in the VA.Administrative VA data from fiscal years 1999 through 2009 were used to identify veterans with PTSD using ICD-9 codes extracted from inpatient discharges and outpatient encounters. Prescribing of antidepressants, antipsychotics, and hypnotics was determined for each fiscal year using prescription drug files.The proportion of veterans receiving either of the 2 Clinical Practice Guideline-recommended first-line pharmacotherapy treatments for PTSD, selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, increased from 49.7% in 1999 to 58.9% in 2009. In addition to reduced benzodiazepine prescriptions, the overall frequency of antipsychotic use declined 6.1%, from 20.0% in 1999 to 13.9% in 2009. Nonbenzodiazepine hypnotic prescribing tripled when zolpidem was added to the VA national formulary in 2008. Buspirone prescribing decreased steadily, while prazosin prescribing expanded nearly 7-fold.This work highlights several clinically important trends in prescribing over the past decade among veterans with PTSD that are generally consistent with the revised VA/Department of Defense Clinical Practice Guideline recommendations. However, the findings illustrate the limitations of administrative data and point to a need to supplement this work with a qualitative examination of PTSD prescribing from interviews with providers to better understand the strategies used to make medication management decisions.",0,0 +5257,PTSD and depression after the Madrid March 11 train bombings,"The March 11, 2004, train bombings in Madrid, Spain, caused the largest loss of life from a single terrorist attack in modern European history. We used a cross-sectional random digit dial survey of Madrid residents to assess the prevalence of posttraumatic stress disorder (PTSD) and major depression in the general population of Madrid 1 to 3 months after the March 11 train bombings. Of respondents 2.3% reported symptoms consistent with PTSD related to the March 11 bombings and 8.0% of respondents reported symptoms consistent with major depression. The prevalence of PTSD was substantially lower, but the prevalence of depression was comparable to estimates reported after the September 11 attacks in Manhattan. The findings suggest that across cities, the magnitude of a terrorist attack may be the primary determinant of the prevalence of PTSD in the general population, but other factors may be responsible for determining the population prevalence of depression.",0,0 +5258,Cannabinoids Prevent the Effects of a Footshock Followed by Situational Reminders on Emotional Processing,"Posttraumatic stress disorder (PTSD) can develop following exposure to a traumatic event. Hence, what we do in the first few hours after trauma exposure may alter the trajectory of PTSD. We examined whether cannabinoids can prevent the effects of a single footshock followed by situational reminders (SRs) on emotional processing. Rats were exposed to a footshock (1.5 mA, 10 s) on day 1 followed by exposure to SRs of the shock on days 3 and 5. The CB1/2 receptor agonist WIN55,212-2 or vehicle were injected intraperitoneally 2 h after the shock. After 1 week, PTSD-like symptoms were examined. Exposure to SRs exacerbated the effects of the shock as rats exposed to shock and SRs, but not shock alone, showed impaired extinction of the traumatic event, impaired plasticity in the hippocmapal-accumbens pathway, enhanced latency to startle, and altered expression of CB1 receptors (CB1r) and glucocorticoid receptors (GRs) in the CA1, basolateral amygdala (BLA) and prefrontal cortex (PFC). WIN55,212-2 prevented the effects of the shock and SRs on extinction, plasticity, and startle response. WIN55,212-2 normalized the shock/SR-induced upregulation in CB1r in the PFC, and CA1 and GRs in the CA1, with no effect on BLA downregulation of CB1r and GRs. Shock and SRs caused lasting (1 week) alterations in emotional processing associated with changes in GR and CB1r expression in brain areas related to PTSD. WIN55,212-2 administered after trauma exposure prevented these alterations via PFC- and CA1-CB1r and CA1-GRs.",0,0 +5259,Health-Related Outcomes Associated with Patterns of Risk Factors in Primary Care Patients,"It is important to find ways to identify prevalent co-occurring health risk factors to help facilitate treatment programming. One method is to use electronic medical record (EMR) data. Funderburk et al. (J Behav Med 31:525-535, 2008) used such data and latent class analysis to identify three classes of individuals based on standard health screens administered in Veterans Affairs primary care clinics. The present study extended these results by examining the health-related outcomes for each of these identified classes. Follow-up data were collected from a subgroup of the original sample (N = 4,132). Analyses showed that class assignment predicted number of diagnoses associated with the diseases that the health screens target and number of primary care behavioral health, and emergency room encounters. The findings illustrate one way an EMR can be used to identify clusters of individuals presenting with multiple health risk factors and where the healthcare system comes in contact with them. © 2013 Springer Science+Business Media New York (outside the USA).",0,0 +5260,"Mental Health, Social Functioning, and Attitudes of Kosovar Albanians Following the War in Kosovo","The 1998-1999 war in Kosovo had a direct impact on large numbers of civilians. The mental health consequences of the conflict are not known.To establish the prevalence of psychiatric morbidity associated with the war in Kosovo, to assess social functioning, and to identify vulnerable populations among ethnic Albanians in Kosovo.Cross-sectional cluster sample survey conducted from August to October 1999 among 1358 Kosovar Albanians aged 15 years or older in 558 randomly selected households across Kosovo.Nonspecific psychiatric morbidity, posttraumatic stress disorder (PTSD) symptoms, and social functioning using the General Health Questionnaire 28 (GHQ-28), Harvard Trauma Questionnaire, and the Medical Outcomes Study Short-Form 20 (MOS-20), respectively; feelings of hatred and a desire for revenge among persons surveyed as addressed by additional questions.Of the respondents, 17.1% (95% confidence interval [CI], 13.2%-21.0%) reported symptoms that met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for PTSD; total mean score on the GHQ-28 was 11.1 (95% CI, 9.9-12.4). Respondents reported a high prevalence of traumatic events. There was a significant linear decrease in mental health status and social functioning with increasing amount of traumatic events (PAbstract

Background

Research has examined how physical and sexual intimate partner violence (IPV) victimization increases sexual risk behavior, yet research is lacking on 1) the effect of psychological IPV on sexual risk behavior and 2) factors through which psychological IPV may be linked to sexual risk behavior.

Methods

The current study examined the relationship between psychological IPV and sexual risk behavior controlling for other forms of IPV (i.e., physical and sexual) in a sample of 186 human immunodeficiency virus (HIV)-negative community women currently experiencing IPV. Further, this study examined the potential mediating effects of four posttraumatic stress disorder (PTSD) symptom severity clusters (i.e., re-experiencing, avoidance, numbing, and hyperarousal) on this relationship.

Findings

Results revealed that greater severity of psychological IPV was uniquely and directly related to greater sexual risk behavior. Additionally, of the four PTSD symptom severity clusters, only avoidance symptom severity mediated the relationship between psychological IPV and sexual risk behavior.

Conclusion

Implications for addressing psychological IPV and PTSD to improve women's sexual health outcomes are discussed.",0,0 +5270,Resilience in the face of coping with a severe physical injury: A study of trajectories of adjustment in a rehabilitation setting.,"Despite the popularity of the concept of resilience, little research has been conducted on populations in physical rehabilitation settings. Our purpose was to identify three trajectories of psychological adjustment to an acquired severe physical injury characterized by resilience, recovery, or distress in a longitudinal design.Eighty inpatients with a severe injury at a rehabilitation hospital. The participants had spinal cord injury or multiple traumas.Classification into the three trajectories was based on symptoms of psychological distress (posttraumatic stress disorder, depression, anxiety, and negative affect) and participants' level of positive affect at admission to and discharge from the rehabilitation hospital.The most common trajectory was the resilience trajectory (54%), followed by the recovery trajectory (25%) and the distress trajectory (21%). The most interesting differences between the trajectories were the result of optimism, affect, social support, and pain. Trait negative and positive affect predicted classification into the trajectories.An adaptation pattern characterized by resilience was found to be the most common response to an acquired severe injury, and trait affect predicts the outcome pattern. Interventions based on resilience are discussed.",0,0 +5271,Military Personnel with Chronic Symptoms Following Blast Traumatic Brain Injury Have Differential Expression of Neuronal Recovery and Epidermal Growth Factor Receptor Genes,"Approximately one-quarter of military personnel who deployed to combat stations sustained one or more blast-related, closed-head injuries. Blast injuries result from the detonation of an explosive device. The mechanisms associated with blast exposure that give rise to traumatic brain injury (TBI), and place military personnel at high risk for chronic symptoms of post-concussive disorder (PCD), post-traumatic stress disorder (PTSD), and depression are not elucidated.To investigate the mechanisms of persistent blast-related symptoms, we examined expression profiles of transcripts across the genome to determine the role of gene activity in chronic symptoms following blast-TBI. Active duty military personnel with (1) a medical record of a blast-TBI that occurred during deployment (n = 19) were compared to control participants without TBI (n = 17). Controls were matched to cases on demographic factors including age, gender, and race, and also in diagnoses of sleep disturbance, and symptoms of PTSD and depression. Due to the high number of PCD symptoms in the TBI+ group, we did not match on this variable. Using expression profiles of transcripts in microarray platform in peripheral samples of whole blood, significantly differentially expressed gene lists were generated. Statistical threshold is based on criteria of 1.5 magnitude fold-change (up or down) and p-values with multiple test correction (false discovery rate <0.05).There were 34 transcripts in 29 genes that were differentially regulated in blast-TBI participants compared to controls. Up-regulated genes included epithelial cell transforming sequence and zinc finger proteins, which are necessary for astrocyte differentiation following injury. Tensin-1, which has been implicated in neuronal recovery in pre-clinical TBI models, was down-regulated in blast-TBI participants. Protein ubiquitination genes, such as epidermal growth factor receptor, were also down-regulated and identified as the central regulators in the gene network determined by interaction pathway analysis.In this study, we identified a gene-expression pathway of delayed neuronal recovery in military personnel a blast-TBI and chronic symptoms. Future work is needed to determine if therapeutic agents that regulate these pathways may provide novel treatments for chronic blast-TBI-related symptoms.",0,0 +5272,Genital heat stress in men of barren couples: a prospective evaluation by means of a questionnaire,"Exposure to genital heat stress among men of barren couples was evaluated in a prospective study. Five hundred and forty-two consecutive patients referred for andrological examination were asked to complete a specific questionnaire at their first visit. For 449 patients who answered all questions, the individual score values could be calculated by scoring each answer with points. Patients with 'idiopathic' oligoasthenoteratozoospermia had significantly higher score values when compared with men showing normozoospermia (P < 0.01), 'symptomatic' oligoasthenoteratozoospermia as a result of defined andrological disorders (P < 0.01), cryptozoospermia (P < 0.01) or other pathological semen profiles (P < 0.05). These data support the hypothesis that patients with 'idiopathic' oligoasthenoteratozoospermia are more exposed to genital heat stress than normozoospermic men. Moreover, in patients with a varicocele impairment semen quality was associated with significantly higher score values compared with the subgroup of men with normal semen profiles (P < 0.05). In contrast, the score values did not significantly differ between equivalent subgroups of men with a history of a retractile testis. Our observations indicate that the questionnaire used in the present study allows an integrative assessment of genital heat stress, which is superior to single factor analysis. Notably, the group of men with 'idiopathic' oligoasthenoteratozoospermia showed the highest mean score values for 10 of the 18 questions compared with the other groups. Prolonged sitting in a vehicle represented the only single factor with significantly different score values in patients with 'idiopathic' oligoasthenoteratozoospermia and those with normozoospermia (P < 0.05).",0,0 +5273,Advances in Group-Based Trajectory Modeling and an SAS Procedure for Estimating Them,"This article is a follow-up to Jones, Nagin, and Roeder (2001), which described an SAS procedure for estimating group-based trajectory models. Group-based trajectory is a specialized application of finite mixture modeling and is designed to identify clusters of individuals following similar progressions of some behavior or outcome over age or time. This article has two purposes. One is to summarize extensions of the methodology and of the SAS procedure that have been developed since Jones et al. The other is to illustrate how group-based trajectory modeling lends itself to presentation of findings in the form of easily understood graphical and tabular data summaries.",0,0 +5274,Paroxetine: current status in psychiatry,"Paroxetine is a selective serotonin reuptake inhibitor (SSRI) with antidepressant and anxiolytic properties. It is commercially available in both an immediate-release (paroxetine) and a controlled-release formulation (paroxetine CR). The latter product was developed to improve gastrointestinal tolerability. Paroxetine is the most potent inhibitor of the reuptake of serotonin among the available SSRIs. It has approved indications for the treatment of major depression, obsessive-compulsive disorder, panic disorder, generalized anxiety disorder, post-traumatic stress disorder and social phobia in adults. Paroxetine CR is approved for the treatment of major depression, social anxiety disorder, panic disorder and premenstrual dysphoric disorder in adults. While the overall efficacy of paroxetine appears to be comparable with other SSRIs in the treatment of major depression, it is approved for use in a wider variety of anxiety disorders than any other antidepressant. Long-term data suggest that paroxetine is effective in preventing relapse or recurrence of depression for up to 1 year. Limited data show that paroxetine maintains a therapeutic response over 1 year in obsessive-compulsive disorder and up to 6 months in panic disorder. The side-effect profile of paroxetine is largely similar to that of the other SSRIs, although paroxetine tends to be more sedating and constipating in some patients, perhaps due to its anticholinergic activity. The potential for discontinuation syndrome and weight gain appears to be slightly higher with paroxetine than with other SSRIs. This review focuses on the immediate release and controlled-release formulations of paroxetine. It summarizes the efficacy and tolerability data for both formulations, with a particular emphasis on paroxetine CR which was introduced in 2002. It also discusses emerging evidence in other clinical areas and recent data that have led to modifications in the safety profile of paroxetine.",0,0 +5275,"Psycho-Trauma, Psychosocial Adjustment, and Symptomatic Post-Traumatic Stress Disorder among Internally Displaced Persons in Kaduna, Northwestern Nigeria","In April 2011, a post election violent conflict in Northern Nigeria led to resettlement of internally displaced persons (IDPs) in a camp in Kaduna, the worst affected state. We set out to determine prevalence and socio-demographic factors associated with post-traumatic stress disorder (PTSD) among IDPs. We also determined types of psycho-trauma experienced by the IDPs and their psychosocial adjustment.Cross-sectional systematic random sampling was used to select 258 adults IDPs. We used Harvard trauma questionnaire to diagnose ""symptomatic PTSD,"" composite international diagnostic interview (CIDI) for diagnosis of depression, and communal trauma event inventory to determine exposure to psycho-trauma. We assessed social adjustment using social provision scale. Multiple logistic regression analysis was used to determine independent predictors of PTSD.Of the 258 IDPs, 109 (42.2%) had a diagnosis of PTSD, 204 (79.1%) had poor living conditions, and only 12 (4.7%) had poor social provision. The most frequent psycho-traumas were destruction of personal property (96.1%), been evacuated from their town (96%) and witnessing violence (88%). More than half (58%) of IDPs had experienced 11-15 of the 19 traumatic events. Independent predictors of PTSD among respondents were having a CIDI diagnosis of depression (adjusted odds ratios 3.5, 95% confidence interval 1.7-7.5; p = 0.001) and witnessing death of a family member (3.7, 1.2-11.5; p = 0.0259).We concluded that exposure to psycho-trauma among IDPs in Kaduna led to post conflict PTSD. Death of a family member and co-morbid depression were independent predictors of PTSD among IDPs. Though their living condition was poor, the IDPs had good psychosocial adjustment. We recommended a structured psychosocial intervention among the IDP targeted at improving living condition and dealing with the psychological consequences of psycho-trauma.",0,0 +5276,Posttraumatic stress disorder in primary care with special reference to personality disorder comorbidity.,"Posttraumatic stress disorder (PTSD) is a common and disabling disturbance in primary care. Few studies have been carried out in primary care samples and none have taken into consideration the association between PTSD and personality disorder.To describe prevalence and risk factors of PTSD and its comorbidity with personality disorder.General practice centre in Valencia (Spain).Patients who had experienced at least one traumatic event in their lives were selected from a random sample attending a primary healthcare centre in Valencia and blindly assessed by trained professionals. Patients suffering from PTSD were compared with those who were not. PTSD and personality disorder diagnoses were established using CIDI and SCID-II interviews respectively. Sex, age at the time of experiencing trauma, frequency, multiplicity and type of trauma, dissociative symptoms, personality disorder and severity of PTSD were subjected to multivariate analysis to estimate the probability of developing PTSD and its duration.Life prevalence rate was 14% and current prevalence 9%. Dissociative symptoms and personality disorder were significantly associated with PTSD. Cluster analysis based on age, frequency and type of trauma revealed the existence of one subgroup composed mainly of women who had experienced frequent body-contact trauma at an early age, developed severe PTSD and suffer from a variety of personality disorders, particularly paranoid personality disorder. Time to the complete disappearance of symptoms was only explained by the initial severity of PTSD.PTSD is a frequent disorder in general practice and it is often associated with personality disorder. Women who experienced high frequency body-contact traumatic events at an early age often suffer from personality disorder and present a particularly severe form of PTSD deserving referral to specialised care.",0,0 +5277,Post-traumatic stress disorder in serious accidental injury: 3-year follow-up study,"Background Long-term data on post-traumatic stress disorder (PTSD) following accidents are scarce. Aims To assess and predict PTSD in people 3 years after severe accidental injury. Method Severely injured patients were recruited consecutively from the intensive care unit ( n =121) and assessed within 1 month of the trauma. Follow-up interviews were conducted 6 months, 12 months and 36 months later; 90 patients participated in all four interviews. Symptoms were assessed using the Clinician-Administered PTSD Scale. Results Post-traumatic stress disorder was diagnosed in 6% of patients 2 weeks after the accident, in 2% after 1 year and in 4% after 3 years. Robust predictors of later PTSD symptom level were intrusive symptoms shortly after the accident and biographical risk factors. There were individual changes over time between the categories PTSD, sub-threshold PTSD and no PTSD. Whereas PTSD symptom severity was low or decreased for most of the patients, some of them showed an increase or a delayed onset. Patients with persisting PTSD symptoms at 6 months and patients with delayed onset of symptoms are at risk of long-term PTSD. Conclusions The prevalence of PTSD was low over the whole period of 3 years.",0,0 +5278,"The Harvard Trauma Questionnaire. Validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees.","There are no valid and reliable cross-cultural instruments capable of measuring torture, trauma, and trauma-related symptoms associated with the DSM-III-R diagnosis of posttraumatic stress disorder (PTSD). Generating such standardized instruments for patients from non-Western cultures involves particular methodological challenges. This study describes the development and validation of three Indochinese versions of the Harvard Trauma Questionnaire (HTQ), a simple and reliable screening instrument that is well received by refugee patients and bicultural staff. It identifies for the first time trauma symptoms related to the Indochinese refugee experience that are associated with PTSD criteria. The HTQ's cultural sensitivity may make it useful for assessing other highly traumatized non-Western populations.",0,0 +5279,Formation of an Anxious-Depressive State in an Experimental Model of Post-Traumatic Stress Disorder in Prenatally Stressed Female Rats,"The characteristics of the formation of a pathological state in an experimental model of post-traumatic stress disorder (PTSD) in adult female rats born to mothers subjected to daily restraint stress during the last third of pregnancy were studied. Both control and prenatally stressed female rats developed a pathological state after severe combined stress and subsequent restress, with long-lasting increases in anxiety and enhanced fast feedback inhibition of stress-related hypophyseal-adrenocortical system (HAS) activity. However, while development of the pathological state in control animals progressed to the anxiety type, prenatally stressed animals developed not only anxiety, but also increased depression-like behavior, i.e., an anxiety-depression disorder developed. These data are interpreted in the light of the interaction between the characteristics of HAS activity in prenatally stressed females and the predisposition of these animals to developing poststress pathology. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +5280,"Posttyphoon prevalence of posttraumatic stress disorder, major depressive disorder, panic disorder, and generalized anxiety disorder in a Vietnamese sample","In 2006, typhoon Xangsane struck Vietnam and disrupted a large-scale mental health needs analysis in the Da Nang province of Vietnam. Recruitment of new participants was halted, and the design of study was altered to that of a pre-/post-event investigation in which 798 of the original 4,982 participants were re-interviewed. This produced the first pre-post disaster epidemiological study. Specifically, risk and protective factors were evaluated with respect to probable mental health ""caseness"" on the bases of the World Health Organization Short Response Questionnaire (SRQ-20) 7/8 cutoff (i.e., scores of 8 or more). Caseness prevalence was 20.7% pre-disaster and 27.1% post-disaster. Specific risk factors associated with mental health caseness included poor health, extreme peri-disaster fear, and experienced injury. Religious affiliation appeared to be a protective factor. In contrast to US samples, gender was not predictive of outcome.",0,0 +5281,Coping Strategies in Daily Life as Protective and Risk Factors for Post Traumatic Stress in Motor Vehicle Accident Survivors,"To investigate the role of a general coping style in the development and maintainance of PTSD-like symptoms, we investigated 44 survivors of severe motor vehicle accidents. Coping was assessed using a German instrument. We also included personality traits such as neuroticism and extraversion, peritraumatic and cognitive factors that are linked to both PTSD and coping in daily life. Stepwise regressions were computed to explain overall PTSD symptoms and symptom clusters (intrusion, avoidance, hyperarousal). Extraversion and neuroticism, cognitive factors, and subjective trauma characteristics predicted total PTSD severity and the symptom clusters, respectively. Additionally, the results indicate that the coping of a person in daily life plays a role in the development and maintenance of PTSD symptoms. We identified both protective factors such as situation control and self-aggrandizement and risk factors such as avoidance and self-blame.",0,0 +5282,"Recurrent headache and interpersonal violence in adolescence: the roles of psychological distress, loneliness and family cohesion: the HUNT study","Recurrent headache is the most common and disabling pain condition in adolescence. Co-occurrence of psychosocial adversity is associated with increased risk of chronification and functional impairment. Exposure to interpersonal violence seems to constitute an important etiological factor. Thus, knowledge of the multiple pathways linking interpersonal violence to recurrent headache could help guide preventive and clinical interventions. In the present study we explored a hypothetical causal model where the link between exposure to interpersonal violence and recurrent headache is mediated in parallel through loneliness and psychological distress. Higher level of family cohesion and male sex is hypothesized to buffer the adverse effect of exposure to interpersonal violence on headache.The model was assessed using data from the cross-sectional, population-based Young-HUNT 3 study of Norwegian adolescents, conducted from 2006-2008. A cohort of 10 464 adolescents were invited. The response rate was 73% (7620), age ranged from 12 and 20 years, and 50% (3832) were girls. The study comprised self-report measures of exposure to interpersonal violence, loneliness, psychological distress and family cohesion, in addition to a validated interview on headache, meeting the International Classification of Headache Disorders criteria. Recurrent headache was defined as headache recurring at least monthly during the past year, and sub-classified into monthly and weekly headache, which served as separate outcomes.In Conditional Process Analysis, loneliness and psychological distress consistently posed as parallel mediating mechanisms, indirectly linking exposure to interpersonal violence to recurrent headache. We found no substantial moderating effect of family cohesion or sex.Loneliness and psychological distress seem to play crucial roles in the relationship between exposure to interpersonal violence and recurrent headache. To facilitate coping and recovery, it may be helpful to account for these factors in preventive and clinical interventions. Trauma-informed, social relationship-based interventions may represent a major opportunity to alter trajectories of recurrent headache.",0,0 +5283,Bereavement and Mental Health after Sudden and Violent Losses: A Review,"This paper reviews the literature on the psychological consequences of sudden and violent losses, including disaster and military losses. It also reviews risk and resilience factors for grief and mental health and describes the effects and possible benefit of psychosocial interventions. The review shows gaps in the literature on grief and bereavement after sudden and violent deaths. Still, some preliminary conclusions can be made. Several studies show that a sudden and violent loss of a loved one can adversely affect mental health and grief in a substantial number of the bereaved. The prevalence of mental disorders such as post-traumatic stress disorder (PTSD), major depressive disorder (MDD), and prolonged grief disorder (PGD, also termed complicated grief) varies widely, however, from study to study. Also, mental health disorders are more elevated after sudden and violent losses than losses following natural deaths, and the trajectory of recovery seems to be slower. Several factors related to the circumstances of the loss may put the bereaved at heightened risk for mental distress. These factors may be differentially related to different outcomes; some increase the risk for PTSD, others for PGD. Given the special circumstances, bereavement following sudden and violent death may require different interventions than for loss from natural death. Recommendations for future research and clinical implications are discussed.",0,0 +5284,A New Vulnerable Population? The Health of Female Partners of Men Recently Released from Prison,"Abstract Background Despite a growing literature on the consequences of having a romantic partner incarcerated on women's risk of contracting sexually transmitted infections, little research considers the broader health profile of the female partners of ever-imprisoned men. Methods We use data from the Relate Project ( n  = 332), a unique cross-sectional survey of recently released men and their female partners (2009–2011), to demonstrate that the female partners of recently released men suffer from a variety of health risks and conditions. We also examine the health conditions of females by their own incarceration history. Findings We find that these women engage in poor health behaviors including smoking, drug use, and excessive alcohol consumption and have high levels of health conditions including asthma, hypertension, anxiety, and depression. The vulnerability of women who had themselves been incarcerated in jails or prisons was especially acute. The number of risky background characteristics such as dropping out of high school (45%) and spending time in foster care or a group home (36%) were staggeringly high for ever-imprisoned women, as were their rates of anxiety (50%), depression (59%), and posttraumatic stress disorder (45%). Conclusions Results reveal that the health of the female partners of recently released men is at least as poor as that of their male partners, suggesting a degree of vulnerability that has yet to be considered in the medical or public health literature and a population that desperately needs medical attention with the full rollout of the Affordable Care Act in 2014.",0,0 +5285,Community integration after deployment to Afghanistan: a longitudinal investigation of Danish soldiers,"Methods: In a prospective, longitudinal study of Danish soldiers deployed to Afghanistan in 2009 (N = 743), we assessed community reintegration difficulties 2.5 years after home coming (study sample: N = 454). Furthermore, symptoms of posttraumatic stress disorder (PTSD) were assessed before, during, and after deployment. Trajectories of PTSD symptoms from a previously published latent growth mixture modeling analysis were used to address whether community reintegration difficulties differ as a result of course and level of PTSD symptoms. Objective: In the years following military deployment, soldiers may experience problems integrating into the community. However, little is known about the nature and prevalence of these problems and if they relate to posttraumatic symptomatology. Results: Between 3.6 and 18.0 % reported to have some, a lot, or extreme difficulties in reintegration domains such as interpersonal functioning, productivity, community involvement, and self-care. Mean level of reintegration difficulties differed significantly across six PTSD symptom trajectories (range 6.35–36.00); with more symptomatic trajectories experiencing greater community reintegration difficulties. Conclusions: Reintegration difficulties after deployment are present in less than 20 % of Danish soldiers who return from Afghanistan. Difficulties are greater in individuals who follow symptomatic PTSD trajectories in the first years following deployment than in those who follow a low-stable trajectory with no or few symptoms.",0,0 +5286,MMPI-2 profiles of Gulf and Vietnam combat veterans with chronic posttraumatic stress disorder,"The current study examined service era differences in a sample of 172 Gulf and Vietnam outpatient veterans with combat-related posttraumatic stress disorder (PTSD). Participants completed the MMPI-2 and several additional self-report measures of symptom severity (PTSD, depression, anxiety, hostility, and health complaints). Results indicated that MMPI-2 profiles differed significantly according to service era with Vietnam veterans scoring higher on scales 2, 8, and 0 and lower on scale 9 than did Gulf veterans. Examination of group means derived from parametric analysis of MMPI-2 data suggested a mean two-point code type of 2-8/8-2 for Vietnam veterans and 1-8/8-1 for Gulf veterans. In contrast, when the data were examined using descriptive techniques based on frequency counts of individual MMPI-2 profiles, the most frequently occurring two-point codetype was 7-8/8-7 for Vietnam veterans, and 6-8/8-6 for Gulf veterans. In addition, Gulf veterans reported a greater number of total health complaints than Vietnam veterans, whereas Vietnam veterans reported a greater number of physician-diagnosed physical conditions. Potential advantages of incorporating descriptive approaches versus parametric methods when examining profile data are also presented.",0,0 +5287,A clinical profile of 103 patients with secondary movement disorders: correlation of etiology with phenomenology,"Studying patients with secondary movement disorders (SMD) provides a unique opportunity to determine the correlation between the etiology and phenomenology of movement disorders.This was a prospective study of 103 patients (43 women, 60 men; age=28.7±17.3 years; range=2-70 years) with SMD, in a tertiary hospital over 4 years.The mean age of onset of SMD was 24.3±19.7 years, and duration of symptoms was 4.3±7.1 years (42 days to 40 years). Patients with pure tremor, pure dystonia (DYS), or a combination of tremor with dystonia had longest latency (10.9-18.5 months), whereas those with parkinsonism (PAR) and hemiballismus (HMB) had shorter latency (2.7-3.0 weeks). Pure dystonia was most prevalent (30.1%) followed by dystonia plus (13.6%), tremor (12.6%), PAR (11.7%), HMB (8.7%), mixed SMD (7.8%), tremor with dystonia (6.8%), myoclonus (5.8%), and chorea (2.9%). In approximately 60% of patients, the underlying etiologies were vascular (VAS), infections, and space-occupying lesions (SOL), and 25% had SMD following trauma or hypoxia (HYP). With reference to specific etiologies, the most frequent SMDs were tremor following SOL (46%), post-traumatic syndromes (25%), dystonia following HYP (56%), VAS lesions (50%), and infections (28%). With reference to specific SMDs, the most common etiologies were VAS for dystonia (39%), SOL for tremor (67%), and PAR (31%), and both SOL and trauma (37.5% each) for tremor with dystonia.Our study highlights the spectrum of SMDs and the lack of correlation between types of SMDs and underlying etiologies. Preventable causes such as infections, HYP, trauma, and kernicterus still play a major role in pathogenesis of SMD.",0,0 +5288,"Significant Improvements in Cognitive Performance Post-Transcranial, Red/Near-Infrared Light-Emitting Diode Treatments in Chronic, Mild Traumatic Brain Injury: Open-Protocol Study","This pilot, open-protocol study examined whether scalp application of red and near-infrared (NIR) light-emitting diodes (LED) could improve cognition in patients with chronic, mild traumatic brain injury (mTBI). Application of red/NIR light improves mitochondrial function (especially in hypoxic/compromised cells) promoting increased adenosine triphosphate (ATP) important for cellular metabolism. Nitric oxide is released locally, increasing regional cerebral blood flow. LED therapy is noninvasive, painless, and non-thermal (cleared by the United States Food and Drug Administration [FDA], an insignificant risk device). Eleven chronic, mTBI participants (26-62 years of age, 6 males) with nonpenetrating brain injury and persistent cognitive dysfunction were treated for 18 outpatient sessions (Monday, Wednesday, Friday, for 6 weeks), starting at 10 months to 8 years post- mTBI (motor vehicle accident [MVA] or sports-related; and one participant, improvised explosive device [IED] blast injury). Four had a history of multiple concussions. Each LED cluster head (5.35 cm diameter, 500 mW, 22.2 mW/cm(2)) was applied for 10 min to each of 11 scalp placements (13 J/cm(2)). LEDs were placed on the midline from front-to-back hairline; and bilaterally on frontal, parietal, and temporal areas. Neuropsychological testing was performed pre-LED, and at 1 week, and 1 and 2 months after the 18th treatment. A significant linear trend was observed for the effect of LED treatment over time for the Stroop test for Executive Function, Trial 3 inhibition (p=0.004); Stroop, Trial 4 inhibition switching (p=0.003); California Verbal Learning Test (CVLT)-II, Total Trials 1-5 (p=0.003); and CVLT-II, Long Delay Free Recall (p=0.006). Participants reported improved sleep, and fewer post-traumatic stress disorder (PTSD) symptoms, if present. Participants and family reported better ability to perform social, interpersonal, and occupational functions. These open-protocol data suggest that placebo-controlled studies are warranted.",0,0 +5289,Ethnic Differences in Personality Disorder Patterns among Women Veterans Diagnosed with PTSD,"Personality Disorders (PDs) impair the ability to function socially and occupationally. PD prevalence rates among veterans who have also been diagnosed with posttraumatic stress disorder (PTSD) range from 45%-79%. This study examined ethnic differences in PDs assessed with the Millon Clinical Multiaxial Inventory-III in 260 non-Hispanic white (64%), Hispanic (27%), and African American (9%), mostly single, women veterans in treatment for PTSD. After adjusting for covariates including number and sexual-nature of trauma, findings revealed the adjusted odds ratio of having a cluster A PD was almost three times higher for African Americans (p = 0.046) then the other two ethnic groups, which may be driven by the paranoid PD scale and potentially reflects an adaptive response to racial discrimination. In cluster designation analysis, the odds were twice as high of having a cluster B PD with childhood trauma (p = 0.046), and a cluster C PD with sexual trauma (p = 0.004), demonstrating the significance of childhood and sexual trauma on long-term chronic personality patterns in women veterans. These results highlight the importance of using instruments with demonstrated diagnostic validity for minority populations.",0,0 +5290,When range of motion is not enough: Towards an evidence-based approach to medico-legal reporting in whiplash injury,Whiplash injury medico-legal reporting has traditionally been focused upon identifying restrictions in range of motion and identifying the presence of tender areas in the cervical spine in an effort both to diagnose the condition and to offer a prognosis. There have been considerable advances in this field over the last decade however that calls into question such a diminutive approach. This paper reviews the contemporary evidence base for the medico-legal assessment of whiplash injury and identifies a body of literature that strongly implicates a Claimant's physiological and psychological stress response as a key medico-legal marker in predicting prognosis following whiplash injury.,0,0 +5291,Long-term psychological outcomes in older adults after disaster: relationships to religiosity and social support,"Natural disasters are associated with catastrophic losses. Disaster survivors return to devastated communities and rebuild homes or relocate permanently, although the long-term psychological consequences are not well understood. The authors examined predictors of psychological outcomes in 219 residents of disaster-affected communities in south Louisiana.Current coastal residents with severe property damage from the 2005 Hurricanes Katrina and Rita, and exposure to the 2010 British Petroleum Deepwater Horizon oil spill were compared and contrasted with former coastal residents and an indirectly affected control group. Participants completed measures of storm exposure and stressors, religiosity, perceived social support, and mental health.Non-organizational religiosity was a significant predictor of post-traumatic stress disorder (PTSD) in bivariate and multivariate logistic regressions. Follow-up analyses revealed that more frequent participation in non-organizational religious behaviors was associated with a heightened risk of PTSD. Low income and being a coastal fisher were significant predictors of depression symptoms in bivariate and multivariate models. Perceived social support had a protective effect for all mental health outcomes, which also held for symptoms of depression and GAD in multivariate models.People who experienced recent and severe trauma related to natural and technological disasters are at risk for adverse psychological outcomes in the years after these events. Individuals with low income, low social support, and high levels of non-organizational religiosity are also at greater risk. Implications of these data for current views on the post-disaster psychological reactions and the development of age-sensitive interventions to promote long-term recovery are discussed.",0,0 +5292,"Transcranial LED therapy for cognitive dysfunction in chronic, mild traumatic brain injury: two case reports","Two chronic, traumatic brain injury (TBI) cases are presented, where cognitive function improved following treatment with transcranial light emitting diodes (LEDs). At age 59, P1 had closed-head injury from a motor vehicle accident (MVA) without loss of consciousness and normal MRI, but unable to return to work as development specialist in internet marketing, due to cognitive dysfunction. At 7 years post-MVA, she began transcranial LED treatments with cluster heads (2.1” diameter with 61 diodes each – 9x633nm, 52x870nm; 12-15mW per diode; total power, 500mW; 22.2 mW/cm 2 ) on bilateral frontal, temporal, parietal, occipital and midline sagittal areas (13.3 J/cm 2 at scalp, estimated 0.4",0,0 +5293,AN INTERGENERATIONAL PERSPECTIVE ON RISK AND PROTECTIVE FACTORS IN MULTI-PROBLEM POOR FAMILES LIVING IN CAPE TOWN,At the time of the research the first author was employed as a social worker at a welfare organisation in the Cape Peninsula with a case load of over 300 clients. About 30 of these cases were multi-problem families who had been receiving social work services over at least three generations. The concern was that these multi-problem poor families seemed to be immobilised and found it difficult to break out of the cycle of poverty and welfare dependency,0,0 +5294,Prevalence and co-morbidity of psychiatric disorders 1–4 years after burn,"Currently, little is known about psychiatric disorders in the period following on the first year after burn. We examined the prevalence of DSM-IV Axis I disorders in burn patients 1-4 years after burn, using a standardized structured clinical interview and comparing findings with a representative general population sample.Ninety patients admitted to five burn centres were assessed with the 12-month Composite International Diagnostic Interview. Results were compared to an age and gender matched nation based norm group.Twelve-month prevalence for any DSM-IV study disorder was 39%. Prevalence for any after burn onset disorder was 28%. Most prevailing were major depression (10%), generalized anxiety disorder (10%), and PTSD (7%). The comorbidity-proportions for PTSD and generalized anxiety disorder where the highest. Fifty-seven percent of all burn onset disorders started within 1 year after the trauma and 21% within the next year. Burn patients had significantly higher prevalence rates for DSM-IV disorders than people from the general population sample.Psychiatric morbidity among burn patients, 1-4 years after burn, is considerable and higher than what may be expected in the general population. A 2-year follow-up for anxiety and depression disorder is warranted.",0,0 +5295,Genetic Components of Days Open Under Heat Stress,"A reaction norm approach was used to estimate the genetic parameters of days open (DO) with a model that accounted for heat stress. Data included DO records for Georgia, Tennessee, and North Carolina in the Southeastern United States. A fixed effect model included herd-year, month of calving (MOC), age of cow, and a regression on 305-d milk yield. The reaction norm model additionally included the effect of animal with random regression on a heat stress index (HI), calculated as the standardized solutions to MOC derived from the fixed effect model; the residual variance was assumed to be a function of the HI. The shape of the distribution of the HI was close to a sinusoidal function with the highest value in March/April and the lowest value in September. Genetic and residual variances and heritabilities were highest for spring calvings and lowest for fall calvings. The variance associated with the random regression of the highest level of HI was 33% of the genetic variance of the regular animal genetic effect. Genetic correlation between these effects was 0.67. As a validation, DO data were grouped into 4 seasons of calving and treated as different traits. A 4-trait mixed linear model that included the fixed effects listed above except MOC, was used to analyze the grouped data. In general, the estimates of genetic and residual variances of the multiple trait analyses followed those of the reaction norm model. Genetic correlations of spring with summer, and fall with winter were both 0.90. Genetic correlations between spring/summer and fall/winter were around 0.80. The reaction norm model for DO allows inexpensive genetic evaluation of fertility under heat stress. Results of such an evaluation may strongly depend on editing criteria and model specifications.",0,0 +5296,Target Identification for Stereotactic Thalamotomy Using Diffusion Tractography,"Stereotactic targets for thalamotomy are usually derived from population-based coordinates. Individual anatomy is used only to scale the coordinates based on the location of some internal guide points. While on conventional MR imaging the thalamic nuclei are indistinguishable, recently it has become possible to identify individual thalamic nuclei using different connectivity profiles, as defined by MR diffusion tractography.Here we investigated the inter-individual variation of the location of target nuclei for thalamotomy: the putative ventralis oralis posterior (Vop) and the ventral intermedius (Vim) nucleus as defined by probabilistic tractography. We showed that the mean inter-individual distance of the peak Vop location is 7.33 mm and 7.42 mm for Vim. The mean overlap between individual Vop nuclei was 40.2% and it was 31.8% for Vim nuclei. As a proof of concept, we also present a patient who underwent Vop thalamotomy for untreatable tremor caused by traumatic brain injury and another patient who underwent Vim thalamotomy for essential tremor. The probabilistic tractography indicated that the successful tremor control was achieved with lesions in the Vop and Vim respectively.Our data call attention to the need for a better appreciation of the individual anatomy when planning stereotactic functional neurosurgery.",0,0 +5297,Factor structure of posttraumatic stress among Western New York undergraduates following the September 11th terrorist attack on the World Trade Center,"The structure of posttraumatic stress is of both theoretical and clinical interest. In the present study, seven models of posttraumatic stress were compared using confirmatory factor analysis. A sample of 528 Western New York undergraduate students was assessed 1 and 3 months after the September 11th, 2001 terrorist attacks. At the Month 1 assessment, the current three-factor Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) model, which consists of Intrusions, Avoidance/Numbing, and Hyperarousal, did not provide a good fit to the data; however, a four-factor model consisting of factors labeled Intrusions, Avoidance, Dysphoria, and Hyperarousal did fit the data well and provided better fit than the three-factor model and other competing models. Importantly, Dysphoria spans symptoms from the traditional DSM Numbing and Hyperarousal clusters. The four-factor model continued to fit the data well at Month 3. These findings parallel the results of earlier studies which suggest that a four-factor model better reflects the nature of posttraumatic stress than do simpler models, including the DSM. The present work is consistent with a dimensional model of stress responses and calls for further longitudinal work in this area.",0,0 +5298,Cerebrospinal fluid and plasma β-endorphin in combat veterans with post-traumatic stress disorder,"Opioid-mediated analgesia develops in experimental animals following traumatic stress and increased opioid-mediated analgesia has been observed in combat veterans with post-traumatic stress disorder (PTSD). These observations have led to the hypothesis that increased central nervous system (CNS) opioidergic activity exists in patients with PTSD. However, direct CNS data on opioid peptide concentrations and dynamics in patients with PTSD are lacking. We withdrew cerebrospinal fluid (CSF) via a flexible, indwelling subarachnoid catheter over a 6-h period and determined hourly CSF concentrations of immunoreactive beta-endorphin (ir beta END) in 10 well-characterized combat veterans with PTSD and nine matched normal volunteers. Blood was simultaneously withdrawn to obtain plasma for ir beta END. PTSD symptom clusters, as measured by the CAPS, were correlated with neuroendocrine data. Mean CSF ir beta END was significantly greater in patients with PTSD compared with normals and there was a negative correlation between the ir beta END and PTSD intrusive and avoidant symptoms of PTSD. No intergroup difference between plasma ir beta END was found, nor was there a significant correlation between CSF and plasma ir beta END. Immunoreactive beta-lipotropin (ir beta LPH) and pro-opiomelanocortin (irPOMC), both precursors of beta END, were much more plentiful in human CSF than was beta-endorphin itself, as has been previously reported. It remains to be determined whether the increased CNS opioid concentrations predate traumatic stress, thereby conferring a vulnerability to dissociative states and PTSD itself, or result from the trauma. The negative correlation between CSF ir beta END and avoidant and intrusive symptoms suggests that CNS hypersecretion of opioids might constitute an adaptive response to traumatic experience. Poor correlation between CSF and plasma ir beta END limits use of plasma measures to assess CNS opioid activity.",0,0 +5299,Symptoms of posttraumatic stress disorder in young males diagnosed with testicular or lymphatic cancer,"Testicular and lymphatic cancers (Hodgkin's and non-Hodgkin's disease) are among the most common cancers in young males aged 18 to 45. It has recently been acknowledged that symptoms of posttraumatic stress disorder (PTSD) may be present following a cancer diagnosis, with incidence varying between 1.9% to 35.1% (Kangas, Henry & Bryant, 2002). This project aimed to explore the cancer related symptoms of PTSD and distress, to determine the frequency of PTSD symptoms in young male cancer patients, to establish a timeline for PTSD symptoms in the first year following a cancer diagnosis, to identify risk factors that were predictive of PTSD symptoms, and to report on the coping and posttraumatic growth experienced by survivors. In study 1, verbatim accounts of 22 survivors of either testicular or lymphatic cancer were collected retrospectively. Qualitative data was analyzed according to the Miles and Huberman (1984) approach. Survivors' appraisal of their diagnosis as a being a shock and a threat were common, as were and anxious anticipation, avoidance, and denial. In the treatment phase, despair and discouragement were most common. In the long-term, PTSD symptoms (increased presence of intrusions and avoidance) and delayed emotional reactions were reported. Optimism was common in early coping and many reported posttraumatic growth in the long-term survival phase. These findings were consistent with the social-cognitive transition model of adjustment (Brennan, 2001). In study 2, newly diagnosed cancer patients (n=92) and community controls (n=88) were recruited and followed prospectively over a period of 12 months. Severe PTSD symptoms were observed in up to 14.3% of cancer patients in the first year following diagnosis, compared to 5.7% of controls. Repeated measure analyses of variance (ANOVAs) revealed that cancer patients had higher levels of PTSD symptoms, at time 2 and 4 on the IES, at times 2, 3 and 4 on the PCL-C, at time 2 for depression, and at times 1 and 2 for anxiety than controls, but were not different in perceived stress, nor in quality of life. Furthermore, there was a significant increase in PTSD symptoms over time. Initial scores of PTSD were the only significant predictor of PTSD at time 4. Furthermore, there was a significant increase in PTSD symptoms over time for the cancer group, but not for controls. Taken together these results suggest that distress in the form of depression and anxiety was elevated but tended to diminish over time. Moreover, early manifestations of PTSD strongly predict later PTSD symptoms and there was an increase in PTSD symptoms over time. Avoidance and denial were common at the time of diagnosis, but intrusions gradually became more important. This may indicate that a form of cognitive processing of the stressful experience is taking place and allows some survivors to revisit their existing life assumptions and experience differing levels of posttraumatic growth. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5300,Psychometric Status and Clinical Utility of the MAYSI-2 with Girls and Boys in Juvenile Detention,"This study replicates and extends studies of the Massachusetts Youth Screening Instrument, Version 2 (MAYSI-2) in a sample of 479 urban, rural, and suburban 12-16 year old youths (68% boys; 41% African American, 23% Latino) consecutively admitted to juvenile detention centers. Six principal components replicated the MAYSI-2 factor-analytically-derived subscales except for Depression/Anxiety, and suggested modifications of specific items in each sub-scale. Findings supported the internal consistency and validity of the modified MAYSI-2 sub-scales. Few gender differences emerged, except that girls reported higher levels of hopelessness and trauma than boys. Five sub-groups were identified based on component profiles: (1) non-clinical, (2) addiction, somatic problems, and suicidality, (3) anger problems, (4) thought disturbance, and (5) addiction and traumatic stress. The findings support the validity of the MAYSI-2 for juvenile justice mental health screening while highlighting possible refinements in scoring in order to identify delinquent youths with distinctive psychosocial risks and needs. © 2007 Springer Science+Business Media, LLC.",0,0 +5301,"Complex trauma and intimate relationships: The impact of shame, guilt and dissociation","This study examined dissociation, shame, guilt and intimate relationship difficulties in those with chronic and complex PTSD. Little is known about how these symptom clusters interplay within the complex PTSD constellation. Dissociation was examined as a principle organizing construct within complex PTSD. In addition, the impact of shame, guilt and dissociation on relationship difficulties was explored.Sixty five treatment-receiving adults attending a Northern Irish service for conflict-related trauma were assessed on measures of dissociation, state and trait shame, behavioral responses to shame, state and trait guilt, complex PTSD symptom severity and relationship difficulties.Ninety five percent (n=62) of participants scored above cut-off for complex PTSD. Those with clinical levels of dissociation (n=27) were significantly higher on complex PTSD symptom severity, state and trait shame, state guilt, withdrawal in response to shame and relationship preoccupation than subclinical dissociators (n=38). Dissociation and state and trait shame predicted complex PTSD. Fear of relationships was predicted by dissociation, complex PTSD and avoidance in response to shame, while complex PTSD predicted relationship anxiety and relationship depression.The study was limited to a relatively homogeneous sample of individuals with chronic and complex PTSD drawn from a single service.Complex PTSD has significant consequences for intimate relationships, and dissociation makes an independent contribution to these difficulties. Dissociation also has an organizing effect on complex PTSD symptoms.",0,0 +5302,"A multivariate contextual analysis of torture and cruel, inhuman, and degrading treatments: Implications for an evidence-based definition of torture.","Current thinking on what constitutes torture in a detention/interrogation setting focuses solely on particular procedures, without regard for contextual factors that mediate traumatic stress. The present study examined stressor interactions that determined severity and psychological impact of captivity stressors in 432 torture survivors in former Yugoslavia countries and Turkey. A principal components analysis of 46 captivity stressors measured by an Exposure to Torture Scale identified meaningful stressor clusters, which suggested that multiple detention procedures were used in combination to maximize their impact. Perceived torture severity related to 'cruel, inhuman, and degrading' treatments (CIDT) but not to physical torture. Posttraumatic stress disorder related to war-related captivity, deprivation of basic needs, sexual torture, and exposure to extreme temperatures, isolation, and forced stress positions but not to physical torture. CIDT increased posttraumatic stress disorder risk by 71%. Fear- and helplessness-inducing effects of captivity and CIDT appear to be the major determinants of perceived severity of torture and psychological damage in detainees. Considerations on what constitutes torture need to take into account the contextual processes in a captivity setting that mediate these effects.",0,0 +5303,Clusters of Low18F-Fluorodeoxyglucose Uptake Voxels in Combat Veterans with Traumatic Brain Injury and Post-Traumatic Stress Disorder,"Individuals with mild traumatic brain injury (TBI) show diminished metabolic activity when studied with positron emission tomography (PET) with (18)F-fluorodeoxyglucose (FDG). Since blast injury may not be localized in the same specific anatomical areas in every patient or may be diffuse, significance probability mapping may be vulnerable to false-negative detection of abnormalities. To address this problem, we used an anatomically independent measure to assess PET scans: increased numbers of contiguous voxels that are 2 standard deviations below values found in an uninjured control group. We examined this in three age-matched groups of male patients: 16 veterans with a history of mild TBI, 17 veterans with both mild TBI and post-traumatic stress disorder (PTSD), and 15 veterans without either condition. After FDG administration, subjects performed a modified version of the California Verbal Learning Task. Clusters of low uptake voxels were identified by computing the mean and standard deviation for each voxel in the healthy combat veteran group and then determining the voxel-based z-score for the patient groups. Abnormal clusters were defined as those that contained contiguous voxels with a z-score <-2. Patients with mild TBI alone and patients with TBI+PTSD had larger clusters of low uptake voxels, and cluster size significantly differentiated the mild TBI groups from combat controls. Clusters were more irregular in shape in patients, and patients also had a larger number of low-activity voxels throughout the brain. In mild TBI and TBI+PTSD patients, but not healthy subjects, cluster volume was significantly correlated with verbal learning during FDG uptake.",0,0 +5304,Is there a recognizable post-incarceration syndrome among released “lifers”?,"It has been suggested that released prisoners experience a unique set of mental health symptoms related to, but not limited to, post-traumatic stress disorder. We sought to empirically assess whether there is a recognizable post-incarceration syndrome that captures the unique effects of incarceration on mental health. We conducted in-depth life interviews with 25 released ""lifers"" (individuals serving a life sentence), who served an average of 19 years in a state correctional institution. We assessed to what extent the symptoms described by the participants overlapped with other mental disorders, most notably PTSD. The narratives indicate a specific cluster of mental health symptoms: In addition to PTSD, this cluster was characterized by institutionalized personality traits, social-sensory disorientation, and alienation. Our findings suggest that post-incarceration syndrome constitutes a discrete subtype of PTSD that results from long-term imprisonment. Recognizing Post-Incarceration Syndrome may allow for more adequate recognition of the effects of incarceration and treatment among ex-inmates and ultimately, successful re-entry into society.",0,0 +5305,Predictors of the long-term course of comorbid PTSD: A naturalistic prospective study,"The study examined the long-term course of posttraumatic stress disorder (PTSD) by analyzing rates of recurrence and the predictive value of comorbid psychiatric disorders and psychosocial functioning.This study is based on diagnostic assessments administered at intake and subsequent follow-up interviews over a period of 15 years in a sample of 90 anxiety-disordered patients with comorbid PTSD who participated in the Harvard Brown Anxiety Research project (HARP). Kaplan-Meier life table analysis revealed a 0.20 probability of full remission during the 15 years of follow-up.Latent growth model (LGM) analysis revealed that the number of trauma exposures was a predictor of a worse course of PTSD but only during some intervals of the 15-year follow-up. Subjects with full social phobia were more likely to experience worsening of PTSD over time in comparison with subjects with less severe social phobia. Role functioning in the areas of household and employment was a significant predictor of a declining course of PTSD.These findings revealed the dynamic nature of the predictive value of traumatic experiences, the deleterious effect of social phobia and the long term effect of psychosocial functioning on the course of PTSD. Implications for treatment planning and development of interventions for PTSD are discussed.",0,0 +5306,Comorbidity of posttraumatic stress disorder and mild closed head injury in war veterans: Endocrinological and psychological profiles,"To determine the degree of psychological and endocrinological changes in war veterans with the diagnosis of Chronic Posttraumatic Stress Disorder (PTSD) regarding presence/absence of comorbid mild closed head injury (mCHI) caused by explosive devices.Two groups of PTSD inpatients, with (n = 37), and without (n = 86) sustained blast trauma followed by mCHI were formed during the psychiatric treatment. Participants were interviewed by experienced clinicians who used the PTSD Interview (PTSD-I). In addition, patients completed the Symptom Checklist-90-Revised (SCL-90-R). Serum levels of ten hormones were assessed: triiodothyronine, thyroxine, thyrotropin-stimulating hormone, prolactin, luteinizing hormone, follicle-stimulating hormone, and insulin, by radioimmunoassays and hydrocortisone, growth hormone and testosterone by fluoroimmunoassays.Veterans with comorbid mCHI and PTSD showed significantly higher level of amnesia for traumatic event as well as of somatization on the SCL-90-R. Significant differences of hormone levels were not found.The results didn't support the hypothesis on specific PTSD subgroup characterized by history of mCHI and consecutive postconcussion syndrome. The absence of differences in levels of hormones indicated the dominant role of psychogenic trauma in the etiology of hormone disbalance in chronic PTSD. Amnesia for traumatic event in war veterans with comorbid PTSD and mCHI was easily explained by neurogenic peritraumatic amnesia due to the blast trauma, but it did not affect either quality of intensity or posttraumatic symptoms as well as endocrinological parameters.",0,0 +5307,Factors Influencing Outcome After Orthopedic Trauma,"Background: Some recent studies have suggested that certain types of orthopedic trauma result in ongoing disability and that factors other than injury severity or location may influence outcome. This study aimed to evaluate outcome 12 months and 2 years after severe orthopedic trauma, as measured on the Short Form (SF)-36 Health Survey, relative to a control group, to examine change over time and to examine which demographic, injury-related and psychological factors are associated with persisting disability. Methods: One hundred thirteen orthopedic trauma patients, recruited during rehabilitation, and 61 demographically similar uninjured controls were followed up at 1 and 2 years postinjury. Measures included the SF-36 Health Survey, Symptom Checklist-90-R, Brief Pain Inventory, Hospital Anxiety and Depression Scales, and Posttraumatic Stress Disorder Checklist-Specific. Results: Results indicated presence of significant ongoing disability in all SF-36 physical and mental health domains, significant ongoing psychologic adjustment problems, including posttraumatic stress disorder (PTSD) symptoms, and pain, with little or no improvement between 1 and 2 years postinjury. The presence of ongoing pain, anxiety, depression or PTSD symptoms were the strongest predictors of outcome on most variables, with older age also contributing to negative outcomes. Injury severity and type did not predict outcome, although those with lower limb fractures had greater pain and poorer physical outcomes that those with fractures in other locations. Conclusions: This study has highlighted pain and PTSD symptoms as frequent and disabling factors after othropedic trauma. There is clearly a need to focus on alleviating these problems as part of the rehabilitation process.",0,0 +5308,Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples,"The psychometric properties of the Depression Anxiety Stress Scales (DASS) were evaluated in two studies using large clinical samples (N = 437 and N = 241). In Study 1, the three scales comprising the DASS were shown to have excellent internal consistency and temporal stability. An exploratory factor analysis (principal components extraction with varimax rotation) yielded a solution that was highly consistent with the factor structure previously found in nonclinical samples. Between-groups comparisons indicated that the DASS distinguished various anxiety and mood disorder groups in the predicted direction. In Study 2, the conceptual and empirical latent structure of the DASS was upheld by findings from confirmatory factor analysis. Correlations between the DASS and other questionnaire and clinical rating measures of anxiety, depression, and negative affect demonstrated the convergent and discriminant validity of the scales. In addition to supporting the psychometric properties of the DASS in clinical anxiety and mood disorders samples, the results are discussed in the context of current conceptualizations of the distinctive and overlapping features of anxiety and depression.",0,0 +5309,The structure of PTSD symptoms: A test of alternative models using confirmatory factor analysis,"This study aimed to examine the structure of self-reported post-traumatic stress disorder (PTSD) symptoms.Based on previous factor analytic findings and the DSM-IV formulation, six confirmatory factor models were specified and estimated that reflected different symptom clusters.The analyses were based on responses from 1116 participants who had suffered whiplash injuries and screened for full or subclinical PTSD using the Harvard Trauma Questionnaire.A correlated four-factor model with re-experiencing, avoidance, dysphoria and arousal factors fitted the data very well. Correlations with criteria measures showed that these factors were associated with other trauma related variables in a theoretically predictable way and showed evidence of unique predictive utility.These results concur with previous research findings using different trauma populations but do not reflect the current DSM-IV symptom groupings.",0,0 +5310,Analyzing developmental trajectories of distinct but related behaviors: A group-based method.,"This article presents a group-based method to jointly estimate developmental trajectories of 2 distinct but theoretically related measurement series. The method will aid the analysis of comorbidity and heterotypic continuity. Three key outputs of the model are (a) for both measurement series, the form of the trajectory of distinctive subpopulations; (b) the probability of membership in each such trajectory group; and (c) the joint probability of membership in trajectory groups across behaviors. This final output offers 2 novel features. First, the joint probabilities can characterize the linkage in the developmental course of distinct but related behaviors. Second, the joint probabilities can measure differences within the population in the magnitude of this linkage. Two examples are presented to illustrate the application of the method.",0,0 +5311,Real-World Barriers to Assessing and Treating Mental Health Problems With IPV Survivors,"Barriers to assessing and treating mental health problems with intimate partner violence (IPV) survivors were identified with qualitative responses from 62 IPV helping professionals who participated in an online survey question. Data were analyzed using a concept mapping approach, which resulted in following eight distinct clusters: (a) unsure, (b) limited IPV specific resources, (c) barriers to access, (d) systems-taboos, (e) immediate crisis needs, (f) fear-stigma, (g) offender’s control and (h) cultural concerns. The opinions expressed in these clusters help to better explain logistic, relational, and intrapersonal obstacles that can limit women IPV survivors’ ability to receive care for mental health conditions. Extending previous quantitative work by the authors (Simmons, Whalley, & Beck, 2014), the current portion of this project generates new ways of looking at barriers to service delivery, which can be used to develop theory and guide further research.",0,0 +5312,Posttraumatic stress disorder: Characteristics and pharmacological response in the veteran population,Abstract A retrospective chart review was conducted on all patients with the primary diagnosis of posttraumatic stress disorder (PTSD) admitted over a one-year period to a Veterans Administration Medical Center. The data base consisted of 14 Vietnam veterans and one World War II veteran. The purpose of the review was to compare the symptom profile of combat veterans to the established DSM III criteria for PTSD and to evaluate the efficacy of pharmacotherapy. The veterans' symptomatology was much more complex than described in DSM III and the currently employed drug therapy appears to be generally inadequate in treating combat-related PTSD.,0,0 +5313,The Mind Does Matter: Psychological and Physical Recovery After Musculoskeletal Trauma,"Posttraumatic psychopathology (PTP) is important to the orthopedic surgeon because it appears to be much more common than might have been suspected and may complicate the recovery from musculoskeletal injury. We have investigated the relationship between physical and psychological recovery in victims of musculoskeletal trauma.A prospective cohort of 200 patients with musculoskeletal injuries were studied, correlating development of psychopathology (measured by the General Health Questionnaire) and functional outcome (measured by Short Form-36, Sickness Impact Profile, and Musculoskeletal Function Assessment) 2 and 6 months after their injuries.Pre-existing psychological disturbance was found in 11% of our patients; this figure rose to 46% of patients at 2 months but fell to 22% at 6 months. The posttraumatic disturbance correlated strongly with impaired functional outcome as measured by all three outcomes measures (total and category scores) (p < 0.05).The strong correlation of PTP with impaired functional outcome after musculoskeletal trauma stresses that it is a significant problem. Further research is required to determine whether an approach that combines physical and psychological treatment can improve patient outcomes.",0,0 +5314,A short form of the metacognitions questionnaire: properties of the MCQ-30,"The metacognitions questionnaire (MCQ) measures individual differences in a selection of metacognitive beliefs, judgments and monitoring tendencies considered important in the metacognitive model of psychological disorders. The development and properties of a shortened 30-item version of the MCQ, the MCQ-30, are reported. Construct validity was evaluated by confirmatory and exploratory factor analysis. Overall, the fit indices suggested an acceptable fit to a five-factor model consistent with the original MCQ. Exploratory factor analysis supported a five-factor structure, which was almost identical to the original solution obtained in previous studies with the full MCQ. The five factors are cognitive confidence, positive beliefs about worry, cognitive self-consciousness, negative beliefs about uncontrollability of thoughts and danger, and beliefs about need to control thoughts. The MCQ-30 showed good internal consistency and convergent validity, and acceptable to good test–retest reliability. Positive relationships between metacognitions and measures of worry and obsessive–compulsive symptoms provided further support for the validity of the measure and the metacognitive theory of intrusive thoughts. The psychometric properties of MCQ-30 suggest that the instrument is a valuable addition to the assessment of metacognitions that has the advantage of being more economical to use compared with the original MCQ.",0,0 +5315,Immediate and Sustained Psychological Impact of an Emerging Infectious Disease Outbreak on Health Care Workers,"Objective: To assess the immediate and sustained psychological health of health care workers who were at high risk of exposure during the severe acute respiratory syndrome (SARS) outbreak. Methods: At the peak of the 2003 SARS outbreak, we assessed health care workers in 2 acute care Hong Kong general hospitals with the Perceived Stress Scale (PSS-10). One year later, we reassessed these health care workers with the PSS-10, the 21-Item Depression and Anxiety Scale (DASS-21), and the Impact of Events Scale-Revised (IES-R). We recruited high-risk health care workers who practised respiratory medicine and compared them with nonrespiratory medicine workers, who formed the low-risk health care worker control group. Results: In 2003, high-risk health care workers had elevated stress levels (PSS-10 score = 17.0) that were not significantly different from levels in low-risk health care worker control subjects (PSS-10 score = 15.9). More high-risk health care workers reported fatigue, poor sleep, worry about health, and fear of social contact, despite their confidence in infection-control measures. By 2004, however, stress levels in the high-risk group were not only higher (PSS-10 score = 18.6) but also significantly higher than scores among low-risk health care worker control subjects (PSS-10 score = 14.8, P < 0.05). In 2004, the perceived stress levels in the high-risk group were associated with higher depression, anxiety, and posttraumatic stress scores ( P < 0.001). Posttraumatic stress scores were a partial mediator of the relation between the high risk of exposure to SARS and higher perceived stress. Conclusions: Health care workers who were at high risk of contracting SARS appear not only to have chronic stress but also higher levels of depression and anxiety. Front-line staff could benefit from stress management as part of preparation for future outbreaks.",0,0 +5316,Narrative Methods in a Study of Trauma Recovery,"Multiple narrative perspectives can guide narrative research. The complexity of health narratives presents a significant challenge. Trauma recovery accounts are health narratives demonstrating successes as well as struggles. In this article, I describe a large-scale narrative study in which specific qualitative methods were combined to fit research aims, stories elicited, and emergent questions in the analysis process. Under my direction, an interdisciplinary team conducted this constructivist, feminist, narrative study describing the trauma recovery process. The study was focused on success or thriving in women surviving childhood maltreatment. I took an advocacy stance in favor of participants’ interests, as is commensurate with a critical feminist standpoint. Through initial analyses the research team constructed a trauma recovery process termed “becoming resolute.” Subanalyses were focused on key relationships, life trajectories, self-strategies, and perceptual changes. My purpose is to explain the various kinds and levels of analysis used here to provide options for others studying recovery narratives.",0,0 +5317,Posttraumatic growth in adolescence: Examining its components and relationship with PTSD,"To address gaps in the literature, this study examined the components of posttraumatic growth, and the relationship between growth and posttraumatic stress disorder (PTSD). Participants were from a pooled sample of 4,054 Israeli adolescents exposed to terror of whom 210 (5.5%) met criteria for PTSD. Measures included the Child Post-Traumatic Stress Reaction Index and Posttraumatic Growth Inventory. Principal components analysis showed two correlated components of outward and intrapersonal growth. Regression modeling showed that the relationship between the growth and PTSD measures was linear and curvilinear (inverted-U). These results replicated accounting for heterogeneity in PTSD, exposure and subsamples. Collectively, the results imply that posttraumatic growth in adolescence is characterized by two robust components, and is greatest at moderate posttraumatic stress levels.",0,0 +5318,Posttraumatic stress reactions among children following the Athens earthquake of September 1999,"The objective of the present study was to assess symptoms of posttraumatic stress disorder (PTSD), depression and anxiety among children 6 months after they had been exposed to an earthquake (EQ) affecting the north-western suburbs of Athens in September 1999. A total of 115 children attending two elementary schools located at the epicentre of the EQ were assessed. A group of 48 children not affected by the EQ attending a school not affected by the EQ were used as controls. The children and their parents completed a number of questionnaires. Overall, there was a high rate (78%) of severe to mild PTSD symptoms in the EQ exposed group. Additionally, a substantial proportion of these children scored above criteria (32%) for depression compared to the control group (12.5%). Severe or moderate symptoms of PTSD were associated with high scores of depression (p = 0.002). The relationship between PTSD symptoms and anxiety was limited to the ""avoidance"" factor of the anxiety questionnaire (p = 0.029). Those who were most likely to be affected were children alone at the time of the EQ, and children who sustained injuries. In summary, countries where EQs are frequent should be prepared to offer psychological support to a substantial proportion of children presenting with PTSD and depressive symptoms and should educate and prepare children to cope with these events.",0,0 +5319,Nonresponse to a population-based postdisaster postal questionnaire study,"We examined nonparticipation in a 2-year postdisaster mail survey of Norwegian tourists evacuated from countries affected by the 2004 tsunami. One hundred seventy-one persons out of a random sample of 330 nonparticipants were telephone interviewed concerning disaster exposure, current posttraumatic stress reactions, and reasons for not participating. Fewer nonparticipants than participants had been in a place directly affected by the tsunami. Nonparticipants reported less perceived threat of death and lower levels of posttraumatic stress reactions. Reasons for not participating were “lack of interest or time” (39.2%), “lack of relevant experiences” (32.2%), and “too personal or emotionally disturbing” (15.2%). Our findings suggest that postdisaster studies may be biased in the direction of more severe disaster exposure and pronounced posttraumatic stress reactions.",0,0 +5320,"Acceptance and Mindfulness Techniques as Applied to Refugee and Ethnic Minority Populations With PTSD: Examples From ""Culturally Adapted CBT""","Abstract In this article we illustrate how we utilize acceptance and mindfulness techniques in our treatment (Culturally Adapted CBT, or CA-CBT) for traumatized refugees and ethnic minority populations. We present a Nodal Network Model (NNM) of Affect to explain the treatment's emphasis on body-centered mindfulness techniques and its focus on psychological flexibility. We explain the definition of mindfulness that guides our treatment, and we outline a typology of mindfulness states and show how many of the techniques in our treatment can be analyzed by these categories. We argue that acceptance and mindfulness are therapeutic for refugees and minority populations for several reasons. These include their increasing psychological flexibility, decreasing somatic distress, decreasing rumination, serving as emotion regulation techniques, decreasing the attentional bias to threat, and forming part of a new adaptive processing mode (which in CA-CBT centers on psychological flexibility). We describe the specific ways we teach acceptance and mindfulness with Latino and Southeast Asian refugee populations and present case examples of the treatment of a traumatized Latino and Cambodian patient.",0,0 +5321,Effects of Schedule I drug laws on neuroscience research and treatment innovation,"Many psychoactive drugs are used recreationally, particularly by young people. This use and its perceived dangers have led to many different classes of drugs being banned under national laws and international conventions. Indeed, the possession of cannabis, 3,4.methylenedioxy-.N.methylamphetamine (MDMA; also known as ecstasy) and psychedelics is stringently regulated. An important and unfortunate outcome of the controls placed on these and other psychoactive drugs is that they make research into their mechanisms of action and potential therapeutic uses - for example, in depression and post-.traumatic stress disorder - difficult and in many cases almost impossible. © 2013 Macmillan Publishers Limited. All rights reserved.",0,0 +5322,"Hurricane-related exposure experiences and stressors, other life events, and social support: Concurrent and prospective impact on children's persistent posttraumatic stress symptoms.","We investigated the influence of hurricane exposure, stressors occurring during the hurricane and recovery period, and social support on children's persistent posttraumatic stress (PTS).Using a 2-wave, prospective design, we assessed 384 children (54% girls; mean age = 8.74 years) 9 months posthurricane, and we reassessed 245 children 21 months posthurricane. Children completed measures of exposure experiences, social support, hurricane-related stressors, life events, and PTS symptoms.At Time 1, 35% of the children reported moderate to very severe levels of PTS symptoms; at Time 2, this reduced to 29%. Hurricane-related stressors influenced children's persistent PTS symptoms and the occurrence of other life events, which in turn also influenced persistent PTS symptoms. The cascading effects of hurricane stressors and other life events disrupted children's social support over time, which further influenced persistent PTS symptoms. Social support from peers buffered the impact of disaster exposure on children's PTS symptoms.The effects of a destructive hurricane on children's PTS symptoms persisted almost 2 years after the storm. The factors contributing to PTS symptoms are interrelated in complex ways. The findings suggest a need to close the gap between interventions delivered in the immediate and short-term aftermath and those delivered 2 years or more postdisaster. Such interventions might focus on helping children manage disaster-related stressors and other life events as well as bolstering children's support systems.",0,0 +5323,Sleep Quality Among Low-Income Young Women in Southeast Texas Predicts Changes in Perceived Stress Through Hurricane Ike,"To document the time course of perceived stress among women through the period of a natural disaster, to determine the effect of sleep quality on this time course, and to identify risk factors that predict higher levels of perceived stress.Longitudinal study from 2006-2012.Community-based family planning clinics in southeast Texas.There were 296 women aged 18-31 y who experienced Hurricane Ike, September 2008.Cohen Perceived Stress Scale (PSS) was administered every 2 mo from 6 mo before to 12 mo after Hurricane Ike. Sleep quality was assessed 1 mo after Hurricane Ike using the Pittsburg Sleep Quality Index (PSQI). Good sleep was defined as a PSQI summary score < 5, and poor sleep as a score ≥ 5. Hurricane Ike stressors (e.g., property damage, subjective stressors) and pre-Ike lifetime major life events and emotional health (e.g., emotional dysregulation, self-control) were also assessed.Over the entire period of 18 mo (6 mo before and 12 mo after the hurricane), perceived stress was significantly higher among poor sleepers compared to good sleepers, and only good sleepers showed a significant decrease in perceived stress after Hurricane Ike. In addition, a higher level of perceived stress was positively associated with greater Ike damage among poor sleepers, whereas this correlation was not observed among good sleepers. In the final multivariate longitudinal model, Ike-related subjective stressors as well as baseline major life events and emotional dysregulation among poor sleepers predicted higher levels of perceived stress over time; among good sleepers, additional factors such as lower levels of self-control and having a history of a psychiatric disorder also predicted higher levels of perceived stress.Sleep quality after Hurricane Ike, an intense natural disaster producing substantial damage, impacted changes in perceived stress over time. Our findings suggest the possibility that providing victims of disasters with effective interventions to improve sleep quality could help to reduce their perceived stress over time.",0,0 +5324,Identification of Child Sexual Abuse Survivor Subgroups Based on Early Maladaptive Schemas: Implications for Understanding Differences in Posttraumatic Stress Disorder Symptom Severity,"Cognitive models have informed understanding of the development, maintenance, and treatment of posttraumatic stress disorder (PTSD). Limited research, however, has examined the relationship of early maladaptive schemas (EMS; Young in Cognitive therapy for personality disorders: A schema-focused approach (rev. ed.). Professional Resource Press, Sarasota, 1994) to PTSD among trauma survivors. The current study, using a sample of 127 female child sexual abuse (CSA) survivors, applied a model-based clustering procedure (Mclust; Fraley and Raftery in MCLUST Version 3 for R: Normal Mixture Modeling and Model-based Clustering, Technical Report No. 504, Department of Statistics, University of Washington, 2006) to the 15 subscales of the Young Schema Questionnaire-Short Form (YSQ-S; Young and Brown in Young Schema Questionnaire- short form. Cognitive Therapy Center, New York, 1994) and revealed three clusters differentiated primarily by level of schema elevation. Women in the cluster characterized by the highest schema scores reported the most severe PTSD symptoms. A discriminant analysis indicated that schemas of Mistrust/ Abuse, Vulnerability to Harm, and Emotional Deprivation contributed most to distinguishing women differentiated on the basis of presumptive PTSD diagnostic status. Results underscore the importance of cognitive factors in the development and/or maintenance of PTSD symptoms and suggest possible treatment targets for cognitive therapy with CSA survivors. ©Springer Science+Business Media, LLC 2011.",0,0 +5325,"The structure of distress following trauma: Posttraumatic stress disorder, major depressive disorder, and generalized anxiety disorder.","The current report used confirmatory factor analysis to examine the latent structures of both key features and associated symptoms of three disorders that commonly develop following a traumatic event: posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD). Participants were 228 motor-vehicle accident survivors who sought treatment for emotional difficulties. PTSD, MDD, and GAD were assessed with a combination of self-report and interview-based measures. The results of construct level analyses suggested that PTSD, MDD, and GAD are distinguishable but highly correlated disorders following a traumatic event. Symptom level analyses supported a model where the Reexperiencing, Avoidance, and Hypervigilance factors were subsumed under the PTSD construct. However, in this model the Dysphoria factor was a higher order construct correlated with the PTSD, MDD, and GAD factors, suggesting that the Dysphoria cluster may not be unique to PTSD. Diagnostic and theoretical implications of these results are discussed.",0,0 +5326,A meta-analysis of prevalence rates and moderating factors for cancer-related post-traumatic stress disorder.,e20557 Background: Systematic reviews highlight a broad range of PTSD prevalence estimates in cancer survivors. This meta-analysis was conducted to provide a general prevalence estimate of signific...,0,0 +5327,Prazosin in the Treatment of PTSD,"Posttraumatic stress disorder (PTSD) often follows a chronic course, and the disorder is resistant to treatment with antidepressants and cognitive-behavioral therapy in a proportion of patients. Prazosin, an a1-adrenoceptor blocker, has shown some promise in treating chronic PTSD. A review of this literature was conducted via a search of MEDLINE and SUMMON, using keywords such as PTSD, prazosin, treatment, and resistance. At least 10 clinical studies of prazosin in the treatment of PTSD, including open-label and randomized controlled trials, have been published. All of these studies support the efficacy of prazosin either for treating nightmares and improving sleep or for reducing the severity of PTSD. Treatment of PTSD with prazosin is usually initiated at a dose of 1 mg, with monitoring for hypotension after the first dose. The dose is then gradually increased to maintenance levels of 2-6 mg at night. Studies of military patients with PTSD have used higher doses (e.g., 10-16 mg at night). Prazosin has also been studied in younger and older adults with PTSD and in patients with alcohol problems, in whom it was found to reduce cravings and stress responses. Prazosin offers some hope for treating resistant cases of PTSD in which recurrent nightmares are problematic, with a relatively rapid response within weeks. It is suggested that large-scale civilian trials of prazosin be done, as well as studies concerning the use of prazosin in acute PTSD and as a potential preventive agent.",0,0 +5328,Posttraumatic growth and PTSD symptomatology among colorectal cancer survivors: a 3-month longitudinal examination of cognitive processing,"The experience of cancer can be understood as a psychosocial transition, producing both positive and negative outcomes. Cognitive processing may facilitate psychological adjustment.Fifty-five post-treatment, colorectal cancer survivors (M=65.9 years old; SD=12.7), an average of 13 months post-diagnosis, were recruited from a state cancer registry and completed baseline and 3-month questionnaires assessing dispositional (social desirability), cognitive processing (cognitive intrusions, cognitive rehearsal), and psychological adjustment variables (posttraumatic growth (PTG), posttraumatic stress disorder (PTSD) symptomatology, depression, anxiety, positive affectivity).PTSD symptomatology was positively associated with depression, anxiety, and negatively associated with positive affectivity. In contrast, PTG scores were unrelated to PTSD symptomatology, depression, anxiety, and positive affectivity. In addition, PTG was independent of social desirability. Notably, after controlling for age at diagnosis and education, multiple regression analyses indicated that cognitive processing (intrusions, rehearsal) was differentially predictive of psychological adjustment. Baseline cognitive intrusions predicted 3-month PTSD symptomatology and there was a trend for baseline cognitive rehearsal predicting 3-month PTG.Additional research is needed to clarify the association between PTG and other indices of psychological adjustment, further delineate the nature of cognitive processing, and understand the trajectory of PTG over time for survivors with colorectal cancer.",0,0 +5329,The Use of Transdermal Therapeutic Systems in Psychiatric Care: A Primer on Patches,"Numerous currently available medications that act in the central nervous system can be delivered transdermally. Such medications include cholinesterase inhibitors for dementia, methylphenidate (MPH) for attention-deficit hyperactivity disorder, monoamine oxidase inhibitors (MAOIs) for depression, dopamine agonists for Parkinson disease and restless leg syndrome, and clonidine for attention-deficit hyperactivity disorder and impulse-control disorders.This article aims to review the literature related to transdermal delivery systems from the perspective of clinical practice and research related to their use in the treatment of psychiatric conditions.Most of the currently available transdermal systems have psychotropic properties or utility in the behavioral health arena and, therefore, are of clinical relevance to consultation-liaison psychiatrists or practitioners of psychosomatic medicine. We discuss their efficacy and safety profiles. We provide a table of these agents and their uses.Transdermal delivery (i.e., patches) for medicines with psychotropic properties allows mental health providers to customize therapy for patients by altering the duration of therapy, minimizing first-pass metabolism and the potential for drug-drug interactions, and decreasing the risk for gastrointestinal irritation.",0,0 +5330,Are psychodynamic and psychoanalytic therapies effective? A review of empirical data,"There is a need for empirical outcome research in psychodynamic and psychoanalytic therapy. However, both the approach of empirically supported therapies (EST) and the procedures of evidence-based medicine (EBM) have severe limitations making randomised controlled trials (RCTs) an absolute standard. After a critical discussion of this approach, the author reviews the empirical evidence for the efficacy of psychodynamic psychotherapy in specific psychiatric disorders. The review aims to identify for which psychiatric disorders RCTs of specific models of psychodynamic psychotherapy are available and for which they are lacking, thus providing a basis for planning further research. In addition, results of process research of psychodynamic psychotherapy are presented. As the methodology of RCTs is not appropriate for psychoanalytic therapy, effectiveness studies of psychoanalytic therapy are reviewed as well. Studies of psychodynamic psychotherapy published between 1960 and 2004 were identified by a computerised search using Medline, PsycINFO and Current Contents. In addition, textbooks and journal articles were used. Twenty-two RCTs were identified of which 64% had not been included in the 1998 report by Chambless and Hollon. According to the results, for the following psychiatric disorders at least one RCT providing evidence for the efficacy of psychodynamic psychotherapy was identified: depressive disorders (4 RCTs), anxiety disorders (1 RCT), post-traumatic stress disorder (1 RCT), somatoform disorder (4 RCTs), bulimia nervosa (3 RCTs), anorexia nervosa (2 RCTs), borderline personality disorder (2 RCTs), Cluster C personality disorder (1 RCT), and substance-related disorders (4 RCTs). According to results of process research, outcome in psychodynamic psychotherapy is related to the competent delivery of therapeutic techniques and to the development of a therapeutic alliance. With regard to psychoanalytic therapy, controlled quasi-experimental effectiveness studies provide evidence that psychoanalytic therapy is (1) more effective than no treatment or treatment as usual, and (2) more effective than shorter forms of psychodynamic therapy. Conclusions are drawn for future research.",0,0 +5331,Acute versus chronic post-traumatic stress disorder,"A photographic lens and filter model is presented which outlines six steps between a person’s perception of stressful life events and their possible eventual development of an illness. Persons developing acute post-traumatic stress disorder differ markedly in their processing of early steps in the model compared to those who go on to suffer from chronic post-traumatic stress disorder. Persons with the acute disorder, with high likelihood of recovery, generally have had enriching early life experiences, use psychological defenses to a moderate degree, and demonstrate ample coping capabilities. Those going on to the chronic disorder, who frequently don’t recover, often report impoverished early life experiences, employ psychological defenses to an extreme degree, and show a paucity of coping skills. These differences are illustrated by histories from survivors of a terrorist bombing and by observations made by the author of returned prisoners of war and civilian hostages.",0,0 +5332,Effects of Stress Hormones on Traumatic Memory Formation and the Development of Posttraumatic Stress Disorder in Critically Ill Patients,"A majority of patients after intensive care treatment report traumatic memories from their stay in the intensive care unit (ICU). Traumatic memories can be associated with the development of posttraumatic stress disorder (PTSD) in a subpopulation of these patients. In contrast to other patient populations at risk for PTSD, patients in the ICU often receive exogenously administered stress hormones like epinephrine, norepinephrine, or cortisol for medical reasons and are extensively monitored. ICU patients therefore represent a suitable population for studying the relationship between stress hormones, traumatic memories, and the development of PTSD. Studies in long-term survivors of ICU treatment demonstrated a clear and vivid recall of different categories of traumatic memory such as nightmares, anxiety, respiratory distress, or pain with little or no recall of factual events. The number of categories of traumatic memory recalled increased with the total administered dosages of stress hormones (both catecholamines and cortisol), and the evaluation of these categories at different time points after discharge from the ICU showed better memory consolidation with higher dosages of stress hormones administered. However, the administration of stress doses of cortisol to critically ill patients resulted in more complex findings as it caused a significant reduction in PTSD symptoms measured after recovery. This effect can possibly be explained by a differential influence of cortisol on memory. Increased serum cortisol levels not only result in consolidation of emotional memory but are also known to cause a temporary impairment in memory retrieval which appears to be independent of glucocorticoid effects on memory formation. Disrupting retrieval mechanisms with glucocorticoids during critical illness may therefore act protectively against the development of PTSD by preventing recall of traumatic memories. Our findings indicate that stress hormones influence the development of PTSD through complex and simultaneous interactions on memory formation and retrieval. Our studies also demonstrate that animal models of aversive learning are useful in analyzing and predicting clinical findings in critically ill humans.",0,0 +5333,The common link between functional somatic syndromes may be central sensitisation,"Functional somatic syndromes are common and disabling conditions that all include chronic pain, and which may be related to central nervous system sensitisation. Here, we address the concept of central sensitisation as a physiological basis for the functional somatic syndromes.A narrative review of the current literature on central sensitisation and physiological studies in the functional somatic syndromes.Central sensitisation may be a common neurophysiological process that is able to explain non-painful as well as painful symptoms in these disorders. Furthermore, central sensitisation may represent an endophenotypic vulnerability to the development of these syndromes that potentially explains why they cluster together.Further research is needed to verify these findings, including prospective studies and the standardisation of combined methods of investigation in the study of central sensitisation in functional somatic syndromes. In turn, this may lead to new explanatory mechanisms and treatments being evaluated. Our conclusions add to the debate over the nomenclature of these syndromes but importantly also provide an explanation for our patients.",0,0 +5334,Heterogeneity in threat extinction learning: substantive and methodological considerations for identifying individual difference in response to stress,"Pavlovian threat (fear) conditioning (PTC) is an experimental paradigm that couples innate aversive stimuli with neutral cues to elicit learned defensive behavior in response to the neutral cue. PTC is commonly used as a translational model to study neurobiological and behavioral aspects of fear and anxiety disorders including Posttraumatic Stress Disorder (PTSD). Though PTSD is a complex multi-faceted construct that cannot be fully captured in animals PTC is a conceptually valid model for studying the development and maintenance of learned threat responses. Thus, it can inform the understanding of PTSD symptomatology. However, there are significant individual differences in posttraumatic stress that are not as of yet accounted for in studies of PTC. Individuals exposed to danger have been shown to follow distinct patterns: some adapt rapidly and completely (resilience) others adapt slowly (recovery) and others failure to adapt (chronic stress response). Identifying similar behavioral outcomes in PTC increases the translatability of this model. In this report we present a flexible methodology for identifying individual differences in PTC by modeling latent subpopulations or classes characterized by defensive behavior during training. We provide evidence from a reanalysis of previously examined PTC learning and extinction data in rats to demonstrate the effectiveness of this methodology in identifying outcomes analogous to those observed in humans exposed to threat. By utilizing Latent Class Growth Analysis (LCGA) to test for heterogeneity in freezing behavior during threat conditioning and extinction learning in adult male outbred rats (n = 58) three outcomes were identified: rapid extinction (57.3%), slow extinction (32.3%), and failure to extinguish (10.3%) indicating that heterogeneity analogous to that in naturalistic human studies is present in experimental animal studies strengthening their translatability in understanding stress responses in humans.",0,0 +5335,Potential Mediators of Post-Traumatic Stress Disorder in Child Witnesses to Domestic Violence,"The aim was to examine variables that might mediate the incidence of Post-Traumatic Stress Disorder (PTSD) in child witnesses to domestic violence. These variables included age, gender, locus of control, self-blame, perception of threat, active versus palliative coping style, maternal emotional health plus aspects of the violence witnessed (intensity, frequency, age of child when first witnessing violence, and time since the last violent episode).Following screening for other PTSD inducing experiences, a sample of 20 child witnesses to domestic violence, 15 matched control children, and their mothers were assessed using the following tools: The Straus Conflict Tactics Scale; the Child Post-Traumatic Stress Reaction Index; the Nowicki-Strickland Locus of Control Scale; the General Health Questionnaire, and a Screening Questionnaire designed to elicit qualitative information from both children and mothers including data about any other potential PTSD inducing stressor the subject child may have been exposed to.None of the factors under examination were found to contribute significantly to the severity levels of Post-Traumatic Stress Disorder in relation to witness status.The small sample size of the study necessitates that the results be interpreted with caution. Nevertheless the findings indicate that the impact of witnessing domestic violence, in terms of PTSD, is not mediated by factors such as maternal emotional well-being, age and gender of the child, or the child's style of coping with parental conflict. Evidence that variables specifically related to the violence witnessed did not mediate the impact suggests that all domestic violence may have severe and long-term impact on child witnesses.",0,0 +5336,"The relationship between post-traumatic stress disorder, depression and cardiovascular disease in an American Indian tribe","Background. Empirical findings suggest that psychiatric illness is associated with cardiovascular disease (CVD). The purpose of this study was to compare the strength of the association of lifetime post-traumatic stress disorder (PTSD) and lifetime major depression on CVD among Northern Plains American Indians. Method. A total of 1414 participants aged 18–57 years completed a structured interview that assessed psychiatric diagnoses, alcohol abuse/dependence, self-reported CVD, and traditional CVD risk factors including age, sex, education, diabetes, high blood pressure, and smoking. Logistic regression analyses compared the odds ratios of CVD in participants with and without diagnosed PTSD or major depression. Results. The rates of lifetime PTSD and major depression were 15% and 8% respectively. CVD was more commonly reported by participants with PTSD than by those without PTSD (12% v . 5%, p [les ]0·01). Likewise, more participants with major depression reported CVD than did their non-depressed counterparts (14% v . 6%, p [les ]0·05). PTSD was significantly associated with CVD even after controlling for traditional CVD risk factors and major depression (odds ratio 2·0, confidence interval 1·1–3·8). In contrast, the association of major depression with CVD was not significant after accounting for both traditional risk factors and PTSD. Conclusions. Rates of PTSD are high in American Indian communities. Rising CVD rates in this population may be better understood if PTSD is considered along with other traditional risk factors. Future research should examine the association and mechanisms of PTSD and CVD prospectively. Such data could lead to more effective CVD prevention efforts for American Indians.",0,0 +5337,Latent Variable Analysis: Growth Mixture Modeling and Related Techniques for Longitudinal Data,,0,0 +5338,Predictors of rape: Findings from the National Survey of Adolescents,"The current report examines data for 872 female adolescents obtained during the initial and follow-up interviews of the National Survey of Adolescents, a nationally representative sample. Lifetime prevalence of violence exposure reported was 12% and 13% for sexual assault, 19% and 10% for physical assault/punishment, and 33% and 26% for witnessing violence at Waves I and II, respectively. Racial/ethnic status, posttraumatic stress disorder (PTSD), childhood sexual abuse (CSA), and family drug problems emerged as significant predictors of new rape. Each of the PTSD symptom clusters significantly predicted new rape and analyses supported the mediational role of PTSD between CSA and new rape. African American or other racial identity was associated with lower risk.",0,0 +5339,Preliminary Examination of the Impact of Traumatic Brain Injury and Posttraumatic Stress Disorder on Self-Regulated Learning and Academic Achievement Among Military Service Members Enrolled in Postsecondary Education,"Delineate the effects of self-reported traumatic brain injury (TBI) or posttraumatic stress disorder (PTSD) on self-regulated learning and academic achievement for university-enrolled military Service members.Students (N = 192) from 8 regionally diverse universities, representing an estimated 6% of Service members enrolled across schools.Public universities that are members of the Servicemember Opportunity College consortium.Cross-sectional study evaluating the relationships between self-reported TBI, PTSD, and self-regulated learning variables and their contribution to academic achievement.Self-report of military service; symptoms of TBI and PTSD; self-regulation strategies including effort, time/environment regulation, and academic self-efficacy; and grade point average (GPA).There was no effect of self-reported TBI or PTSD on GPA, effort regulation, or time/environment regulation strategies; however, participants with TBI or PTSD reported significantly lower academic self-efficacy. Multiple regression analysis revealed self-efficacy was the strongest predictor of GPA among all participants, followed by military rank.The sample consisted of high achieving students responsive to a university administrator, which raises the possibility of sampling bias. Because of the low recruitment rate for this study and lack of published research on this subject, replicating the results is necessary before drawing generalizable conclusions about the population.",0,0 +5340,Sense of Coherence as a Determinant of Psychological Well-Being Across Professional Groups of Aid Workers Exposed to War Trauma,"The present study aims to test whether sense of coherence (SOC) acts as a determinant of positive psychological functioning in aid workers directly exposed to warfare. Specifically, we performed multiple regression analyses to compare different groups of aid workers in terms of the effects of SOC and cumulative trauma on their psychological distress. Palestinian helpers, both professional and non-professional ( N = 159) completed three self-reported measures: the General Health questionnaire, Sense of Coherence Scale, and Impact of Events Scale. The findings bear out the predictive power of SOC and posttraumatic stress disorder (PTSD) in relation to mental health across different professional groups. In particular, volunteers without a specific professional profile, psychiatrists, medical doctors, and less markedly counselors seemed to protect their mental health through a SOC. Clinical implications and recommendations for training and supervision are discussed.",0,0 +5341,Pain and post traumatic stress disorder – Review of clinical and experimental evidence,"Pain and Post Traumatic Stress Disorder (PTSD) are highly comorbid conditions. Patients with chronic pain have higher rates of PTSD. Likewise, patients with PTSD are often diagnosed with numerous chronic pain conditions. Despite the high pain-PTSD comorbidity, the neurobehavioral mechanisms underlying this phenomenon are incompletely understood and only recently researchers have started investigating it using experimental models. In this article, we systematically review the substantial clinical evidence on the co-occurrence of pain and PTSD, and the limited experimental evidence of pain processing in this disorder. We provide a detailed overview of the psychophysical and brain imaging experiments that compared somatosensory and pain processing in PTSD and non-PTSD populations. Based on the presented evidence, an extensive body of literature substantiates the clinical coexistence of pain and PTSD in patients but the limited experimental data show inconsistent results highlighting the need for well-controlled future studies. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0,0 +5342,Psychiatric Diagnoses in Historic and Contemporary Military Cohorts: Combat Deployment and the Healthy Warrior Effect,"Research studies have identified heightened psychiatric problems among veterans of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). However, these studies have not compared incidence rates of psychiatric disorders across robust cohorts, nor have they documented psychiatric problems prior to combat exposure. The authors' objectives in this study were to determine incidence rates of diagnosed mental disorders in a cohort of Marines deployed to combat during OIF or OEF in 2001-2005 and to compare these with mental disorder rates in two historical and two contemporary military control groups. After exclusion of persons who had been deployed to a combat zone with a preexisting psychiatric diagnosis, the cumulative rate of post-OIF/-OEF mental disorders was 6.4%. All psychiatric conditions except post-traumatic stress disorder occurred at a lower rate in combat-deployed personnel than in personnel who were not deployed to a combat zone. The findings suggest that psychiatric disorders in Marines are diagnosed most frequently during the initial months of recruit training rather than after combat deployment. The disproportionate loss of psychologically unfit personnel early in training creates a ""healthy warrior effect,"" because only those persons who have proven their resilience during training remain eligible for combat.",0,0 +5343,"Smoking patterns, symptoms of PTSD and depression: Preliminary findings from a sample of severely battered women","Intimate partner violence (IPV) is a public health problem that significantly impacts the physical and emotional well-being of women. In addition to the health risk associated with violence exposure, female victims of IPV are at increased risk of engaging in damaging health behaviors, including cigarette smoking. The present study examined patterns of cigarette smoking, using the Fagerström Test for Nicotine Dependence (FTND), and explored its association with sociodemographic factors, characteristics of physical, psychological, and sexual forms of IPV, symptoms of posttraumatic stress disorder (PTSD), and depression within 62 female victims of severe battering. Fifty-eight percent of the total sample reported that they were current smokers. Within the group of current smokers, women who evidenced greater symptoms of nicotine-related physical dependence (NRPD) were more likely to be unemployed, have less education, experience more recent violence, more severe IPV-related sexual coercion, more IPV-related dominance/isolation, and more severe symptoms of PTSD and depression. In addition, greater symptoms of NRPD were significantly and positively associated with PTSD clusters of reexperiencing and arousal. Implications for these preliminary findings were discussed and directions for future research were detailed.",0,0 +5344,"Social Support, Discrimination, and Coping as Predictors of Posttraumatic Stress Reactions in Youth Survivors of Hurricane Katrina","This study examined the influence of aspects of the post–Hurricane Katrina recovery environment (i.e., discrimination, social support) and coping behaviors on children's posttraumatic stress reactions (symptoms of posttraumatic stress disorder [PTSD], anxiety, and depression). Data corresponding to 46 youth (M = 11.43 years; 39% girls; 33% African American, 67% European American) revealed that greater helpfulness from extrafamilial sources of social support predicted lower levels of child-rated symptoms of PTSD, anxiety, and depression. A positive predictive relation was found between helpfulness from professional support sources and PTSD, perhaps suggesting that parents whose children were experiencing higher PTSD symptom levels sought professional support and reported it to be helpful. Youths' avoidant coping behaviors predicted both PTSD and anxiety symptoms. Discrimination, active coping, and familial support did not predict any of the posttraumatic stress reactions assessed in this study.",0,0 +5345,An examination of the construct validity of posttraumatic stress disorder with veterans using a revised criterion set,"Ongoing concerns exist in the literature regarding the construct of posttraumatic stress disorder (PTSD) and how to best conceptualize and measure this disorder. We compared the traditional DSM-IV PTSD symptom criteria (i.e., symptoms from clusters B, C, and D) to a revised criterion set that omits overlapping mood and other anxiety symptoms on PTSD prevalence, PTSD diagnostic caseness, associated psychiatric comorbidity, functional status, and structural validity using a cross-sectional, multi-site primary care sample of 747 veterans. After removing items theorized to overlap with mood and other anxiety disorders, PTSD prevalence was identical using both criterion sets (i.e., 12%). Overall, there were few statistically significant differences in PTSD caseness, associated psychiatric comorbidity, functional status, and structural validity across the two diagnostic criterion sets. These data provide further support that removing items that overlap with other psychiatric disorders does not significantly impact the prevalence of PTSD, its associated comorbidity and functional impairment, or its structural validity. Although the revised criterion set represents a more parsimonious model, the current study findings generally support the strong construct validity of PTSD. The implications of these study findings for research and clinical practice are discussed.",0,0 +5346,"Relationships among trauma exposure, chronic posttraumatic stress disorder symptoms, and self-reported health in women: Replication and extension","Fifty-two women who served during the Vietnam era were assessed for war-zone exposure, traumatic life events, post-traumatic stress disorder (PTSD), and self-reported health status. Symptoms of PTSD were examined as mediators in the relationship between traumatic exposure and subsequent reports of health problems. Results showed that PTSD symptoms accounted significantly for variance in health problems reported by women with prior traumatic stressor exposure. When the cardinal symptom domains of PTSD (re-experiencing, numbing, avoidance, hyper-arousal) were analyzed separately, the symptom cluster representing hyper-arousal accounted uniquely for the variance associated with health complaints, beyond that contributed by other symptom clusters. Discussion of the results focuses on mechanisms underlying the relationship between specific symptoms of PTSD and self-reported health. Implications for intervention within the medical system are also considered.",0,0 +5347,Cognitive Approaches to Posttraumatic Stress Disorder: The Evolution of Multirepresentational Theorizing.,"The evolution of multirepresentational cognitive theorizing in psychopathology is illustrated by detailed discussion and analysis of a number of prototypical models of posttraumatic stress disorder (PTSD). Network and schema theories, which focus on a single, explicit aspect/format of mental representation, are compared with theories that focus on 2 or more explicit representational elements. The author argues that the latter theories provide a more complete account of PTSD data, though are not without their problems. Specifically, it is proposed that at least 3 separate representational elements-associative networks, verbal/propositional representations, and schemas-are required to generate a comprehensive cognitive theory of PTSD. The argument that the development of multirepresentational cognitive theory in PTSD is a paradigm case for the development of similar theories in other forms of psychopathology is elaborated, and a brief agenda is proposed promoting 2 levels of theorizing-deep, formal theory alongside more localized, applied theory.",0,0 +5348,"Configurations of early risk and their association with academic, cognitive, emotional and behavioural outcomes in middle childhood","PURPOSE: Risk factors for children's development are multifarious and co-occur, having cumulative as well as individual impacts. Yet common configurations of early childhood risks remain little understood. The current study aimed to identify patterns of early risk exposure and to examine their relationship with diverse outcomes in middle childhood. METHODS: Using latent class analysis in a large, community-based, UK sample (N = 13,699), we examined 13 putative risk factors to identify patterns of exposure. RESULTS: Four risk configurations were identified: low (65 %), socio-demographic (14 %), family dysfunction (12 %), and multiple (9 %) risk classes. As expected, children in the low risk group fared best on all outcome measures, and those with multiple risk, worst. Importantly, specificity in associations with outcomes emerged, such that cognitive outcomes were predominantly linked with socio-demographic adversities, emotional difficulties with family dysfunction, and conduct problems increased across risk classes. CONCLUSIONS: Better understanding of configurations of childhood risk exposures may help to target resources for children in need.",0,0 +5349,Are cortisol profiles a stable trait during child development?,"Exposure to stressful experiences can increase vulnerability to adverse health outcomes. A potential neuroendocrine mechanism mediating the link between stress and health is the hypothalamic-pituitary-adrenal (HPA) system, with a key role attributed to the glucocorticoid hormone cortisol. Retrospective and cross sectional clinical studies of humans and experimental studies with nonhuman primates and rodents suggest that traumatic experiences during critical periods in development may have permanent effects on HPA regulation, which in turn can have deleterious effects on health. Here I report results from a continuous 20-year study (1988-2009) of children in a rural community on Dominica. Sequential data on cortisol levels, social stressors, and health in naturalistic, everyday conditions are examined to assess developmental trajectories of HPA functioning. Saliva aliquots were assayed for cortisol in concert with monitoring of growth, morbidity, and social environment. Analyses here include data from 1989 to 1999 for 147 children aged 3-16 years with >100 saliva samples each. Cortisol values were standardized by elapsed time since wake-up. Results do not support the hypothesis that traumatic stress during childhood causes permanent general elevation of cortisol levels.",0,0 +5350,Elucidating Posttraumatic Stress Symptom Profiles and Their Correlates Among Women Experiencing Bidirectional Intimate Partner Violence,"This study employed latent class analysis to identify profiles of women experiencing intimate partner violence (IPV) based on the severity of posttraumatic stress disorder (PTSD) symptoms.Self-report data from a sample of 369 women experiencing bidirectional IPV was used.A 3-class solution comprising low, moderate, and high PTSD severity profiles best fit the data. Profiles were differentially related to whether IPV victimization was considered traumatic (PTSD criterion A); whether functioning was impaired as a result of PTSD symptoms (PTSD criterion F); whether the woman met full diagnostic criteria for PTSD; depression symptom severity; and severity of psychological, physical, and sexual IPV victimization and use of IPV. An extremely high percentage of women in the high (96%) and moderate (88%) severity classes experienced functional impairment, although many did not meet full diagnostic criteria for PTSD.Findings support the need for interventions individually tailored to one's treatment needs based on the nature of one's traumatic stressor and the impact of PTSD on daily functioning.",0,0 +5351,Morphometric and Psychometric Comparisons between Non-Substance-Abusing Patients with Posttraumatic Stress Disorder and Normal Controls,"<i>Background:</i> Hippocampal decrease in size in response to posttraumatic stress disorder (PTSD) is still a subject of controversy. The aims of this study were to: (1) confirm previous hippocampus findings in PTSD patients compared to controls, using ethnically similar study groups where alcohol and drug abuse were non-existent; (2) test influence of disease duration as well as depression scores on possible morphological changes; (3) test whether the voxel-based morphometry (VBM) data confirm the group differences seen in the region of interest (ROI) analysis, and (4) test the associations between the cognitive test scores and the morphological changes. <i>Methods:</i> VBM and ROI-based analysis were applied in 23 patients and 17 healthy controls. Culture-neutral cognitive tests were used. <i>Results:</i> The ROI-based method showed significantly decreased gray matter volumes for global hippocampal volume, as in a separate analysis of left and right sides in the PTSD group. Total volume of the hippocampus was significantly decreased on the left side, as in the global assessment. A multiple regression VBM model showed significant voxel clusters for group affiliation in the right hippocampus, modelling lowering of gray matter associated with the PTSD group. Disease duration was shown to be negatively correlated to bilateral hippocampal volume and high depression score to bilateral gray matter parahippocampal volume. No significant correlations were found between hippocampal or parahippocampal volumes and cognitive functions. <i>Conclusion:</i> The present and previous studies showed that morphologic differences do not appear to be due to drug or alcohol abuse. The VBM data partially confirm the group differences seen in the ROI-based method in the medial temporal lobe. The fact that the significantly lower score on the short-term memory test in the PTSD group is not correlated to hippocampal volume may suggest a more general basis for such memory impairment.",0,0 +5352,The validity of the DSM-IV PTSD criteria in children and adolescents: A review,"Objective: DSM-V is on its way and doubts have been raised regarding the validity of pediatric PTSD. It is the goal of the current review to critically review the empirical literature on PTSD in youth. Method: A search of PsycINFO, PubMed and reference lists was conducted. Empirical information considered relevant regarding the validity of the criteria was collected. Results/Conclusions: The validity of the symptom criteria and clusters varies, with the Avoidance/Numbing cluster outperforming the Re-experiencing—and Arousal cluster. Factor analytic findings suggest that Arousal criterion D4 should be placed within the Re-experiencing cluster, and that the Avoidance/Numbing cluster should be split up. Some non-DSM-IV PTSD symptoms, among which guilt, have considerable validity in trauma-exposed youth and their inclusion in DSM-V PTSD should be considered. As for preschool children, alternative criteria are recommended that are more developmentally sensitive.",0,0 +5353,Feigning Combat-Related Posttraumatic Stress Disorder on the Personality Assessment Inventory,"This study examined whether individuals who were instructed on the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) criteria for posttraumatic stress disorder (PTSD) could feign PTSD on the Personality Assessment Inventory (PAI; Morey, 1991). The study also investigated whether PAI indexes of symptom exaggeration, the Negative Impression Management (NIM) scale and the Malingering index, could identify individuals feigning PTSD. The diagnostic rule for PTSD (Morey, 1991, 1996) was applied to the profiles of a group of 23 veterans with combat-related PTSD and 23 male undergraduates instructed to malinger PTSD. Seventy percent of the student malingerers produced profiles that received diagnostic consideration for PTSD. The NIM cutting score (> or = 8) was highly effective in detecting simulation of PTSD but resulted in the misclassification of a large number of true PTSD cases. There were no significant differences in the overall efficiency of the test with various validity criteria. We discuss the implications of these findings for the use of the PAI in the diagnosis of combat-related PTSD.",0,0 +5354,Use of self-report measures of crime-related posttraumatic stress disorder with substance use disordered patients,"Researchers have documented that approximately three-quarters of all patients in treatment for a substance use disorder (SUD) report a history of sexual or physical assault and that at least 25% of treatment-seeking SUD patients suffer from crime-related posttraumatic stress disorder (CR-PTSD). To address the pressing need to accurately evaluate symptoms associated with victimization, a battery of self-report instruments and a semi-structured interview were administered to 114 SUD patients. More than 90% of the SUD patients reported some type of victimization and approximately 38% met criteria for current CR-PTSD. The self-report battery correctly classified CR-PTSD status in 79% of the respondents with a sensitivity rate of 82% and a specificity rate of 74%. The results indicate that: (a) there is a high prevalence of CR-PTSD in SUD patients, (b) CR-PTSD should be evaluated in every SUD patient, and (c) the self-report battery utilized in the present study may serve as a valid tool for an initial CR-PTSD screening or to supplement a clinical interview.",0,0 +5355,Involvement in High-Profile Child Sexual Abuse Controversies: Costs and Benefits,"The costs and benefits associated with participation in conflicts around child sexual abuse are explored. Using qualitative data from interviews with 40 high-profile participants, findings suggest that professionals experience both positive and negative consequences as a result of their involvement. Costs identified include attacks and misrepresentations, harm to health or emotional well-being, and career losses or changes. Benefits included personal growth, a sense of personal satisfaction, and career enhancement. Women were found to have experienced more impacts overall than men. Psychological theories about stress and coping and sociological theories about social movement participation are used to explore why people remain committed despite the risks associated with participation. Material rewards, commitment to change, the development of a highly salient identity, and the support of social networks may be contributing factors.",0,0 +5356,Neuropsychiatric Disturbances Associated with Traumatic Brain Injury: A Practical Approach to Evaluation and Management,"Traumatic brain injury (TBI) causes a wide variety of neuropsychiatric disturbances associated with great functional impairments and low quality of life. These disturbances include disorders of mood, behavior, and cognition, and changes in personality. The diagnosis of specific neuropsychiatric disturbances can be difficult because there is significant symptom overlap. Systematic clinical evaluations are necessary to make the diagnosis and formulate a treatment plan that often requires a multipronged approach. Management of TBI-associated neuropsychiatric disorders should always include nonpharmacological interventions, including education, family involvement, supportive and behavioral psychotherapies, and cognitive rehabilitation. Pharmacological treatments include antidepressants, anticonvulsants, antipsychotics, dopaminergic agents, and cholinesterase inhibitors. However, evidence-based treatments are extremely limited, and management relies on clinical empiricism and resemblance of TBI neuropsychiatric symptom profiles with those of idiopathic psychiatric disorders. Although the understanding of TBI-associated neuropsychiatric disorders has improved in the last decade, further research is needed including prospective, longitudinal studies to explore biomarkers that will assist with management and prognosis as well as randomized-controlled studies to validate pharmacological and nonpharmacological treatments. The current review summarizes the available literature in support of a structured, systematic evaluation approach and treatment options as well as recommendations for further research directions.",0,0 +5357,Frequency and severity approaches to indexing exposure to trauma: The Critical Incident History Questionnaire for police officers,"The Critical Incident History Questionnaire indexes cumulative exposure to traumatic incidents in police by examining incident frequency and rated severity. In over 700 officers, event severity was negatively correlated (r(s) = -.61) with frequency of exposure. Cumulative exposure indices that varied emphasis on frequency and severity-using both nomothetic and idiographic methods-all showed satisfactory psychometric properties and similar correlates. All indices were only modestly related to posttraumatic stress disorder (PTSD) symptoms. Ratings of incident severity were not influenced by whether officers had ever experienced the incident. Because no index summarizing cumulative exposure to trauma had superior validity, our findings suggest that precision is not increased if frequency is weighted by severity.",0,0 +5358,Toward rational pharmacotherapy for posttraumatic stress disorder: an interim report,"There is growing evidence that medication can alleviate symptoms associated with posttraumatic stress disorder (PTSD). Recent research also suggests that PTSD has a unique biological profile consisting of alterations in sympathetic arousal, the neuroendocrine system, and the sleep/dream cycle. This profile distinguishes PTSD from both major depression and panic disorder. Medication appears to alleviate PTSD symptoms associated with sympathetic hyperarousal and intrusive recollections of the trauma but seems ineffective against avoidant symptoms. Pharmacotherapy alone is rarely sufficient to provide complete remission of PTSD. Symptom relief provided by medication facilitates the patient's participation in individual, behavioral, or group psychotherapy.",0,0 +5359,Acute episodes of predator exposure in conjunction with chronic social instability as an animal model of post-traumatic stress disorder,"People who are exposed to horrific, life-threatening experiences are at risk for developing post-traumatic stress disorder (PTSD). Some of the symptoms of PTSD include persistent anxiety, exaggerated startle, cognitive impairments and increased sensitivity to yohimbine, an alpha(2)-adrenergic receptor antagonist. We have taken into account the conditions known to induce PTSD, as well as factors responsible for long-term maintenance of the disorder, to develop an animal model of PTSD. Adult male Sprague-Dawley rats were administered a total of 31 days of psychosocial stress, composed of acute and chronic components. The acute component was a 1-h stress session (immobilization during cat exposure), which occurred on Days 1 and 11. The chronic component was that on all 31 days the rats were given unstable housing conditions. We found that psychosocially stressed rats had reduced growth rate, reduced thymus weight, increased adrenal gland weight, increased anxiety, an exaggerated startle response, cognitive impairments, greater cardiovascular and corticosterone reactivity to an acute stressor and heightened responsivity to yohimbine. This work demonstrates the effectiveness of acute inescapable episodes of predator exposure administered in conjunction with daily social instability as an animal model of PTSD.",0,0 +5360,Oxytocin improves compassion toward women among patients with PTSD,"Although impairments in social skills, including empathic abilities, are common in post-traumatic stress disorder (PTSD), the ability to feel compassion-a pro-social behavior that is based on empathy and drives us to help others-has never been assessed among these patients. The first aim of this study was to examine whether patients with PTSD suffer from deficits in compassion and to examine the association between the clusters of PTSD symptoms and these deficits. Furthermore, given that intranasal oxytocin (OT) has been suggested to possibly modulate social behaviors, the second aim of this study was to investigate whether intranasal OT may enhance compassion in these patients. Using a randomized, double-blind, placebo-controlled crossover design, we administered 24 IU of OT and placebo at a one-week interval to 32 patients with PTSD and to 30 matched healthy control participants. The results indicate that patients with PTSD exhibit deficits in compassion and that the numbing cluster emerged as the key predictor of those deficits. Moreover, the results indicate that a single intranasal dose of OT enhances compassion toward women (but not towards men), both in patients with PTSD and in controls. These results offer support for recent suggestions that intranasal OT may potentially be an effective pharmacological intervention for patients with PTSD.",0,0 +5361,Doing and Being Well (for the Most Part): Adaptive Patterns of Narrative Self-Evaluation During Bereavement,"Narrative self-evaluation patterns were studied in relation to longitudinal measures of adaptation to the death of a spouse in midlife. Narrative self-evaluations, identified in open-ended interview transcripts at 6 months post-loss, were coded as either positive or negative and as either doing-based (evaluations of ""what one does"") or being-based (evaluations of ""what one is""). These narrative variables were then compared with separate, clinical-interview measures of grief at 6, 14, and 25 months post-loss. Results confirmed 3 predictions. First, participants who made an optimal proportion of positive to negative self-evaluations (approximately a 5:1 positive-to-negative ratio) had lower grief levels over time than did those who made either higher or lower proportions. Second, the tendency to focus on evaluations of what one does rather than what one is predicted lower grief levels over time. Third, participants who directly integrated doing-based and being-based self-evaluations had lower grief levels over time than those who did not link the 2 evaluations. Implications for the narrative construction of personal meaning and identity in relation to adaptation are discussed.",0,0 +5362,Relationships between dissociation and posttraumatic stress disorder,"(from the chapter) A review of the relationship between dissociation and PTSD is discussed by Simeon in Chapter 4. She suggests that four models can be identified to account for the association. The first model (comorbidity) views PTSD and dissociation as separate entities that may co-occur because of the nosological link to a common etiological factor (i.e., traumatic stress). The second model (shared risk factors) suggests that the link between PTSD and dissociation is through a common psychological and/or biological vulnerability (i.e., a diathesis). The third model (shared pathogenesis) posits that PTSD and dissociation have common pathogenetic mechanisms that are activated by trauma. The final model (same disorder) suggests that PTSD and dissociation are inseparable, with the current nosology unnecessarily creating artificial distinctions between them. While acknowledging that no model effectively accounts for the relationship between PTSD and dissociation, Simeon concludes that the first model, comorbidity, best captures the current data. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5363,"Identifying trajectory clusters in breast cancer survivors’ supportive care needs, psychosocial difficulties, and resources from the completion of primary treatment to 8 months later","Purpose: This study aimed to chart patterns of simultaneous trajectories over 8 months in breast cancer survivors’ (BCS) supportive care needs, psychological distress, social support, and posttraumatic growth. Clusters of BCS among these trajectories were identified and characterized. Methods: Of 426 BCS study participants, 277 (65 %) provided full assessments in the last week of primary cancer treatment and 4 and 8 months later. Latent trajectories were obtained using growth mixture modeling for patients who responded to all scores for at least one time point (n = 348). Then, classification of BCS was performed by hierarchical agglomerative clustering on axes derived from a multiple factor analysis of trajectory assignments. Self-esteem, attachment security, and satisfaction with care were assessed at baseline. Results: Four trajectory clusters were identified, including two BCS subgroups (63 %) with low needs and low psychological distress. Two others (37 %) exhibited high or increasing needs and concerning levels of psychological distress. These latter clusters were characterized by higher insecure attachment, lower satisfaction with care, and either lower education or younger age, and having undergone chemotherapy. Conclusion: More than a third of BCS present unfavorable patterns in supportive care needs over 8 months after primary cancer treatment. Identified psychosocial and cancer care characteristics point to targets for enhanced BCS supportive care.",0,0 +5364,Dialectical Behaviour Therapy for Post-traumatic Stress Disorder after Childhood Sexual Abuse in Patients with and without Borderline Personality Disorder: A Randomised Controlled Trial,"<b><i>Background:</i></b> Post-traumatic stress disorder (PTSD) with co-occurring severe psychopathology such as borderline personality disorder (BPD) is a frequent sequel of childhood sexual abuse (CSA). CSA-related PTSD has been effectively treated through cognitive-behavioural treatments, but it remains unclear whether success can be achieved in patients with co-occurring BPD. The aim of the present study was to determine the efficacy of a newly developed modular treatment programme (DBT-PTSD) that combines principles of dialectical behaviour therapy (DBT) and trauma-focused interventions. <b><i>Methods:</i></b> Female patients (n = 74) with CSA-related PTSD were randomised to either a 12-week residential DBT-PTSD programme or a treatment-as-usual wait list. About half of the participants met the criteria for co-occurring BPD. Individuals with ongoing self-harm were not excluded. The primary outcomes were reduction of PTSD symptoms as assessed by the Clinician-Administered PTSD Scale (CAPS) and by the Posttraumatic Stress Diagnostic Scale (PDS). Hierarchical linear models were used to compare improvements across treatment groups. Assessments were carried out by blinded raters at admission, at end of treatment, and at 6 and 12 weeks post-treatment. <b><i>Results:</i></b> Under DBT-PTSD the mean change was significantly greater than in the control group on both the CAPS (33.16 vs. 2.08) and the PDS (0.70 vs. 0.14). Between-group effect sizes were large and highly significant. Neither a diagnosis of BPD nor the severity or the number of BPD symptoms was significantly related to treatment outcome. Safety analyses indicated no increase in dysfunctional behaviours during the trial. <b><i>Conclusion: </i></b>DBT-PTSD is an efficacious treatment of CSA-related PTSD, even in the presence of severe co-occurring psychopathology such as BPD.",0,0 +5365,Trauma and Stressor-Related Disorders,"This chapter focuses on gender differences in trauma exposure and the development of posttraumatic sequelae over the life course. First, we review the prevalence of trauma exposure and posttraumatic sequelae with particular attention to comorbidity and disability or impairment. Second, we review psychobiological processes that explain risk for various types of posttraumatic sequelae with a focus on gender and comorbidity. Third, we review the DSM-5 diagnostic criteria for various disorders associated with trauma exposure. Fourth, we review the best available instruments designed to assess these disorders. Fifth, we review the current best practices for treatment of these conditions including psychopharmacology, psychotherapy, and combined approaches designed to treat comorbid conditions. We conclude that despite a large body of research documenting gender differences in trauma exposure and trauma-related disorders much work remains to be done in this area. © Springer International Publishing Switzerland 2015.",0,0 +5366,"A mental health intervention for rural, foster children from methamphetamine-involved families: Experimental assessment with qualitative elaboration","Abstract This mixed method study describes the cultural adaptation, implementation and impact of a mental health intervention for individual rural children aged 7–17 from methamphetamine-involved families who are in foster care. Features of the culturally-shaped intervention include: 1) close collaboration with local professionals who provide the intervention over a seven month period; 2) provision of the intervention in and around children's homes; and 3) the use of local storytelling traditions in a narrative- and relationship-based intervention. As a group, children (N = 15) showed problematic levels of Childhood Behavior Checklist (CBCL) externalizing and total problem behaviors and symptoms of PTSD/dissociation during the pretest. Children were randomly assigned to an experimental group who received the intervention immediately (n = 8), or a wait-list control group (n = 7) who received the intervention at the end of the study. There was a significant interaction effect of time (pre and post test) and group on externalizing behavior with the trajectory of the experimental group improving while that of the control group worsened. Gains made by the experimental group were maintained over a seven month follow-up period. Comparative case studies, individual qualitative interviews and open-ended questionnaires provided rich elaboration of participants' experiences and illuminated complexities and challenges of the intervention.",0,0 +5367,Post-traumatic stress symptoms 5 years after military deployment to Afghanistan: an observational cohort study,"Deployment can put soldiers at risk of developing post-traumatic stress symptoms. Despite several longitudinal studies, little is known about the timing of an increase in post-traumatic stress symptoms relative to pre-deployment. Longitudinal studies starting pre-deployment, in which participants are repeatedly measured over time, are warranted to assess the timing of an increase in symptoms to ultimately assess the timing of an increase in treatment demand after deployment.In this large observational cohort study, Dutch military personnel who were deployed to Afghanistan as part of the International Security Assistance Forces between March, 2005, and September, 2008, were assessed for post-traumatic stress symptoms with the Self-Rating Inventory for Post-traumatic Stress Disorder (SRIP) questionnaire. Participants were assessed 1 month before deployment and followed up at 1 month, 6 months, 12 months, 2 years, and 5 years after deployment, with changes in SRIP scores compared with pre-deployment using a mixed model analysis. The primary outcome was the total score of post-traumatic stress symptoms measured with SRIP at pre-deployment and the five follow-up assessments, with a score of 38 used as the cutoff to indicate substantial post-traumatic stress symptoms.Between March, 2005, and September, 2008, 1007 participants were recruited to this study. The results show two important effects of deployment on post-traumatic stress symptoms. A short-term symptom increase within the first 6 months after deployment (symptom increase coefficient for SRIP score vs pre-deployment [β] 0·99, 95% CI 0·50-1·48); and a long-term symptom increase at 5 years after deployment (β 1·67, 1·14-2·20).This study underlines the importance of long-term monitoring of the psychological health of soldiers after deployment because early detection of symptoms is essential to early treatment, which is related to improved psychological health.Dutch Ministry of Defense.",1,0 +5368,Skin Conductance Response during Laboratory Stress in Combat Veterans with Post Traumatic Stress Disorder,"The primary objective was to assess skin conductance response (SCR) to a laboratory stressor in combat veterans with posttraumatic stress disorder (PTSD) compared to controls. The secondary objective was to evaluate the relationship between SCR and PTSD symptom clusters.15 combat/ PTSD, 15 combat/no PTSD, 15 no combat/no PTSD veterans had their SCR recording during aversive pictures from the International Affective Picture Scale.The groups had similar demographics and medical history (all p>.05). SCR was different between groups (F(2,42) = 4.34, p=.02). The combat/PTSD group had the highest response compared to both control groups. Numbing-avoiding was predictive of SCR (F(1,42)=12.72, p=.001), while re-experiencing and hyper-arousal were not (p's>.05).Increased SCR in the PTSD group validates previous studies. Numbing-avoiding PTSD cluster scores correlated with SCR values. These findings support current PTSD therapies that reduce avoidance behaviors.",0,0 +5369,Clinical presentations in combat veterans diagnosed with posttraumatic stress disorder,"This article investigated subtypes of symptom patterns among male combat veterans diagnosed with posttraumatic stress disorder (PTSD) through a cluster analysis of their Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Graham, Ben-Porath, Tellegen, Dahlstrom, & Kaemmer, 2001) clinical and validity scales. Participants were 126 veterans seeking outpatient treatment for combat-related PTSD at a Veterans Affairs Medical Center. Two well-fitting MMPI-2 cluster solutions (a four-cluster solution and a three-cluster solution) were evaluated with several statistical methods. A four-cluster solution was determined to best fit the data. Follow-up analyses demonstrated between-cluster differences on MMPI-2 ""fake bad"" scales and content scales, the Beck Depression Inventory (BDI; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961), Dissociative Experiences Scale (DES; Bernstein & Putnam, 1986), Mississippi Combat PTSD scale (M-PTSD; Keane, Caddall, & Taylor, 1988), and Clinician-Administered PTSD Scale (CAPS-1; Blake et al., 1990). Clusters also were different in disability-seeking status, employment status, and income. Implications for research and clinical practice using the MMPI-2 with combat veterans presenting with PTSD are briefly addressed.",0,0 +5370,"Prevalence of post-traumatic stress disorder in Sichuan Province, China after the 2008 Wenchuan earthquake","To estimate the prevalence of post-traumatic stress disorder (PTSD) and assess the associated risk factors among earthquake survivors in different areas after the Wenchuan earthquake in China.Cross-sectional multicluster sample surveys were employed using data collected from two counties.Surveys were conducted separately in Beichuan and Langzhong Counties in Sichuan Province, with a total of 1002 respondents. Beichuan County was damaged more severely than Langzhong County during the earthquake in May 2008. A total of 426 households were represented in the data, with a mean of 2.2 respondents per household. Data were collected using structured interviews and the Harvard Trauma Questionnaire.The prevalence of suspected PTSD was 45.5% (n=203) in Beichuan County (heavily damaged) and 9.4% (n=52) in Langzhong County (moderately damaged). Household income, living conditions (settlements), deaths in families and household damage were significantly related to the prevalence of suspected PTSD in heavily damaged areas.Interventions designed to reduce PTSD among populations affected by the May 2008 earthquake should focus on individuals with no household income, those living in shelters or temporary houses, those with damaged households, and those who experienced a death in the family. Governments should support income-generating activities and improve living conditions. Trained field personnel can assist with PTSD assessments and referrals, and existing rural healthcare services should be used to provide treatment for common psychiatric disorders.",0,0 +5371,"Remission in post-traumatic stress disorder (PTSD): effects of sertraline as assessed by the Davidson Trauma Scale, Clinical Global Impressions and the Clinician-Administered PTSD scale","Rates of remission were examined in two controlled 12-week studies of sertraline and placebo for post-traumatic stress disorder (PTSD). The performance of three scales was evaluated: the self-rated Davidson Trauma Scale (DTS), and two interviewer scales: the Clinician Administered PTSD Scale (CAPS) and Clinical Global Impressions (CGI). Sertraline proved significantly superior to placebo with respect to remission on all three ratings. Rates of remission were very similar for all scales, ranging from 23.1-26.3% for sertraline and 13.9-14.9% for placebo. Traditional thresholds for the CAPS and DTS were tested relative to the CGI and to each other. The CAPS and DTS thresholds of < 20 and < 18 were found to be valid.",0,0 +5372,The locomotor and behavioral patterns following both a singleinjection and double-injection rat model of subarachnoid hemorrhage,"Background and Goals of Study: Subarachnoid hemorrhage (SAH) has been described in humans to be associated with depression, anxiety and post-traumatic stress disorder. Yet, possibly due to the lack of experimental studies, little is known of the mechanism for post-SAH emotional and behavioral disturbances. Therefore, there is a great need for the development of animal models for post-SAH behavioral abnormalities. This study describes the neuro-behavioral profile of rats following both a single-injection and double-injection model of SAH. Materials and Methods: SAH was induced in 48 rats by 0.3 ml injection of autologous arterial blood into the cisterna magnum (single-injection model). Post-SAH vasospasm was induced in 24 of these rats by a second injection of blood into the cisterna magnum after 24 hours (double-injection model). 0.3 ml of saline was injected into the cisterna magnum of 24 additional rats (sham group). Neurological performance was measured at 24, 48 hours, 1, 2 and 3 weeks following SAH. 3 weeks after SAH, four behavioral tests were performed for the duration of 6 consequent days: open field test, sucrose preference test, elevated plus maze test and swimming test. Results and Discussion: There was impaired neurological performance by 24 hours following SAH (P< 0.0001). For the open field test, the double-injection model was associated with less total travel distance (P< 0.005), reduced mean velocity (P< 0.005), and less travel distance and time spent in the central part of the field (P< 0.05). Sucrose preference was impaired after SAH (P< 0.01). For the plus maze test, the single-injection model was associated with less open arm entries (P< 0.005), decreased time spent in open arms (P< 0.0005), decreased closed arm entries (P< 0.01), and decreased platform entries (P< 0.005). There was decreased time spent on the platform in rats after SAH (P< 0.005). There was more immobility time during the swimming test in both the single-injection (P< 0.005) and double-injection (P< 0.05) groups compared to the control group. Conclusions: The main finding of this study was that both, the single and double injection rat models of SAH, were associated with considerable behavioral disturbances including locomotor abnormalities, increased anxiety and depressive behavior.",0,0 +5373,Resilience Intervention for Young Adults With Adverse Childhood Experiences,"BACKGROUND: Adverse childhood experiences (ACEs) are correlated with risk behaviors of smoking, disordered eating, and alcohol and substance abuse. Such behaviors can lead to significant public health problems of chronic obstructive pulmonary disease, obesity, liver disease, and hypertension, yet some individuals do not appear to suffer negative consequences but rather bounce back. OBJECTIVE: To pilot the feasibility and potential efficacy of the Empower Resilience Intervention to build capacity by increasing resilience and health behaviors and decreasing symptoms and negative health behaviors with young adults in an educational setting who have had ACEs. DESIGN: A two-group pre–post repeated measures design to compare symptoms, health behaviors, and resilience and written participant responses. RESULTS: There was a statistically significant cohort by time interaction for physical activity in the intervention group. There was no significant change in risk behaviors or resilience score by cohort. Young adults in the intervention group reported building strengths, reframing resilience, and creating support connections. CONCLUSIONS: An increase in health behavior is theoretically consistent with this strengths-based intervention. Evaluating this intervention with a larger sample is important. Interrupting the ACE to illness trajectory is complex. This short-term empower resilience intervention, however, holds promise as an opportunity to reconsider the negative effects of the trauma of the past and build on strengths to develop a preferred future.",0,0 +5374,Heat acclimation and cross-tolerance against novel stressors: genomic–physiological linkage,"Heat acclimation (AC) is a ""within lifetime"" reversible phenotypic adaptation, enhancing thermotolerance and heat endurance via a transition to ""efficient"" cellular performance when acclimatory homeostasis is reached. An inseparable outcome of AC is the development of cross-tolerance (C-T) against novel stressors. This chapter focuses on central plasticity and the molecular-physiological linkage of acclimatory and C-T responses. A drop in temperature thresholds (T-Tsh) for activation of heat-dissipation mechanisms and an elevated T-Tsh for thermal injury development imply autonomic nervous system (ANS) and cytoprotective network involvement in these processes. During acclimation, the changes in T-Tsh for heat dissipation are biphasic. Initially T-Tsh drops, signifying the early autonomic response, and is associated with perturbed peripheral effector cellular performance. Pre-acclimation values return when acclimatory homeostasis is achieved. The changes in the ANS suggest that acclimatory plasticity involves molecular and cellular changes. These changes are manifested by the activation of central peripheral molecular networks and post-translational modifications. Sympathetic induction of elevated HSP 72 reservoirs, with faster heat shock response, is only one example of this. The global genomic response, detected using gene-chips and cluster analyses imply upregulation of genes encoding ion channels, pumps, and transporters (markers for neuronal excitability) in the hypothalamus at the onset of AC and down regulation of metabotrophic genes upon long term AC. Peripherally, the transcriptional program indicates a two-tier defense strategy. The immediate transient response is associated with the maintenance of DNA and cellular integrity. The sustained response correlates with long-lasting cytoprotective-signaling networks. C-T is recorded against cerebral hypoxia, hyperoxia, and traumatic brain injury. Using the highly developed ischemic/reperfused heart model as a baseline, it is evident that C-T stems via protective shared pathways developed with AC. These comprise constitutive elevation of HIF 1alpha and associated target pathways, HSPs, anti-apoptosis, and antioxidative pathways. Collectively the master regulators of AC and C-T are still enigmatic; however, cutting-edge investigative techniques, using a broad molecular approach, challenge current ideas, and the data accumulated will pinpoint novel pathways and provide new perspectives.",0,0 +5375,Effects of a dolphin interaction program on children with autism spectrum disorders – an exploratory research,"Interaction programs involving dolphins and patients with various pathologies or developmental disorders (e.g., cerebral palsy, intellectual impairment, autism, atopic dermatitis, post-traumatic stress disorder, depression) have stimulated interest in their beneficial effects and therapeutic potential. However, the true effects observed in different clinical and psycho-educational setups are still controversial.An evaluation protocol consisting of the Childhood Autism Rating Scale (CARS), Psychoeducational Profile-Revised (PEP-R), Autism Treatment Evaluation Checklist (ATEC), Theory of Mind Tasks (ToM Tasks) and a custom-made Interaction Evaluation Grid (IEG) to evaluate behavioural complexity during in-pool interactions was applied to 10 children diagnosed with Autism Spectrum Disorders. The ATEC, ToM Tasks and CARS results show no benefits of the dolphin interaction program. Interestingly, the PEP-R suggests some statistically significant effects on 'Overall development score', as well as on their 'Fine motor development', 'Cognitive performance' and 'Cognitive verbal development'. Also, a significant evolution in behavioural complexity was shown by the IEG.This study does not support significant developmental progress resulting from the dolphin interaction program.",0,0 +5376,Clinical evaluation of the Trauma Outcome Profile (TOP) in the longer-term follow-up of polytrauma patients,"No sufficiently validated disease-specific instrument is available to assess patient outcome after polytrauma. The aim of this investigation was to test the recently published Trauma Outcome Profile (TOP) in the longer-term outcome of multiply injured patients.Single centre validation study on the TOP in comparison with objective and subjective measures of patient, injury or treatment characteristics and longer-term outcome (e.g. medical outcomes study Short Form-36, SF-36; Nottingham Health Profile, NHP; working capacity), at least 2 years following trauma in 117 survivors of polytrauma (injury severity score, ISS>16), using comparative analysis and correlation testing of prospectively collected data.Patients' mean weighted self-rating with regard to the 10 single TOP dimensions of Health Related Quality of Life (HRQoL, 0-100) ranged from lowest values for mental functioning (52.6+33.5) to highest values for daily activities (79.0+27.5). The rate of persons who indicated an abnormal level of function or pain increased significantly from pre-injury status (2% and 5%, resp.) to 46% for both values at longer-term follow-up (p<0.001). Observed associations between single dimensions or TOP component summary scores with the corresponding values from general HRQol instruments, such as the SF-36, resulted in R (Pearson) up to 0.85. Survivors of polytrauma who presented with a reduced working capacity (RWC) at longer-term follow-up in all TOP dimensions included a significantly higher rate of patients conspicuous for a relevantly reduced outcome compared with those with a non reduced working capacity (NRWC) (posttraumatic stress disease, PTSD: p<0.05; all other dimensions: p<0.001). Patients with a RWC were characterised by an almost fivefold probability of reduced outcome with regard to the TOP dimensions 'social interaction' or 'satisfaction' (odds ratio, OR 12.4 (95% CI 5.1-30.1) and 12.5 (4.0-39.0), resp.).This first clinical and methodological evaluation in a well defined cohort of polytrauma patients found the TOP to be a reliable and well discriminating score covering both relevant general and trauma-specific aspects of longer-term outcome. Despite these promising primary results, until further validation, the TOP should be used together with already accepted HRQoL measures to allow adequate international comparison of data in the future.",0,0 +5377,Effect of trauma on quality of life as mediated by mental distress and moderated by coping and social support among postconflict displaced Ethiopians,"Objective: An understanding of how quality of life is affected by severe trauma and mental distress may facilitate better intervention strategies for postconflict internally displaced persons, by identifying mediators, moderators, and independent risk factors. We investigate the pathways involved in this process and also study the moderating roles of coping strategies and perceived social support. Method: A random sample of 1193 (62% women) internally displaced Ethiopian adults living in shelters in Addis Ababa were interviewed with instruments capturing the relevant concepts, including SCL-90-R and WHOQOL-BREF. Path analysis was employed to elaborate the mediating and moderating effects. Self-reported living conditions were also assessed. Results: Mental distress increased and quality of life decreased with age. Mental distress mediated the effects of trauma in reducing the quality of life, and some trauma also reduced quality of life directly. These effects remained after adjusting for living conditions. Living conditions were related to quality of life also on their own. Coping strategies and perceived social support influenced mental distress and quality of life directly as well as indirectly by moderation, in part gender specific. Conclusions: Intervention strategies aimed at reducing mental distress, modifying coping strategies, and encouraging social support may turn out to be useful in increasing the overall quality of life in postconflict situations, and are worth considering as complements to strategies that improve the living conditions. © 2007 Springer Science+Business Media B.V.",0,0 +5378,Two-Year Prospective Evaluation of the Relationship Between Acute Stress Disorder and Posttraumatic Stress Disorder Following Mild Traumatic Brain Injury,"To assess the ability of acute stress disorder to predict posttraumatic stress disorder (PTSD), the relationship between acute stress disorder and PTSD over the 2 years following mild traumatic brain injury was determined.Survivors of motor vehicle accidents who sustained mild traumatic brain injuries were assessed for acute stress disorder within 1 month of the trauma (N=79) and for PTSD at 6 months (N=63) and 2 years (N=50) posttrauma.Acute stress disorder was diagnosed in 14% of the patients. Among the patients who participated in all three assessments, 80% of the subjects who met the criteria for acute stress disorder were diagnosed with PTSD at 2 years. Of the total initial group, 73% of those diagnosed with acute stress disorder had PTSD at 2 years.This study provides further support for the utility of the acute stress disorder diagnosis as a predictor of PTSD but indicates that the predictive power of the diagnostic criteria can be increased by placing greater emphasis on reexperiencing, avoidance, and arousal symptoms.",0,0 +5379,"Epidemiologic Studies of Trauma, Posttraumatic Stress Disorder, and other Psychiatric Disorders","This paper reviews recent epidemiologic studies of posttraumatic stress disorder (PTSD) in the general population. Estimates of the prevalence of exposure to traumatic events vary with the method used to ascertain trauma exposure and the definition of the stressor criterion. Changes in the DSM-IV definition of ""stressor"" have increased the number of traumatic events experienced in the community that can be used to diagnose PTSD and thus, the number of PTSD cases. Risk factors for PTSD in adults vary across studies. The 3 factors identified as having relatively uniform effects are 1) preexisting psychiatric disorders, 2) a family history of disorders, and 3) childhood trauma. In civilian populations, women are at a higher risk for PTSD than are men, following exposure to traumatic events. Most community residents have experienced 1 or more PTSD-level traumas in their lifetime, but only a few succumb to PTSD. Trauma victims who do not succumb to PTSD are not at an elevated risk for the subsequent onset of major depression or substance use disorders, compared with unexposed persons.",0,0 +5380,Testing alternative factor models of PTSD and the robustness of the dysphoria factor,"This study first aimed to examine the structure of self-reported posttraumatic stress disorder (PTSD) symptoms using three different samples. The second aim of the paper was to test the robustness of the factor analytic model when depression scores were controlled for.Based on previous factor analytic findings and the DSM-IV formulation, six confirmatory factor models were specified and estimated that reflected different symptom clusters. The best fitting model was subsequently re-fitted to the data after including a depression variable.The analyses were based on responses from 973 participants across three samples. Sample 1 consisted of 633 parents who were members of 'The National Association of Infant Death' and who had lost a child. Sample 2 consisted of 227 victims of rape, who completed a questionnaire within 4 weeks of the rape. Each respondent had been in contact with the Centre for Rape Victims (CRV) at the Aarhus University Hospital, Denmark. Sample 3 consisted of 113 refugees resident in Denmark. All participants had been referred to a treatment centre which focused on rehabilitating refugees through treatment for psychosocial integration problems (RRCF: Rehabliterings og Revliderings Centre for Flygtninge). In total 500 participants received a diagnosis of PTSD/sub-clinical PTSD (Sample 1, N=214; 2, N=176; 3, N=110).A correlated four-factor model with re-experiencing, avoidance, dysphoria, and arousal factors provided the best fit to the sample data. The average attenuation in the factor loadings was highest for the dysphoria factor (M=-.26, SD=.11) compared to the re-experiencing (M=-.14, SD=.18), avoidance (M=-.10, SD=.21), and arousal (M=-.09, SD=.13) factors.With regards to the best fitting factor model these results concur with previous research findings using different trauma populations but do not reflect the current DSM-IV symptom groupings. The attenuation of dysphoria factor loadings suggests that dysphoria is a non-specific component of PTSD.",0,0 +5381,Investigation of the Relation Between PTSD Symptoms and Self-Compassion: Comparison Across DSM IV and DSM 5 PTSD Symptom Clusters,Self-compassion is posited to protect against posttraumatic stress disorder (PTSD) symptoms after exposure to traumatic events. Prior work has suggested self-compassion may only be related to avoidance symptoms using DSM IV criteria. Changes to the diagnosis in DSM 5 may have changed these relations. The current study examined the relation between self-compassion and PTSD symptoms using DSM IV and DSM 5 criteria. PTSD symptoms and self-compassion were evaluated in two trauma-exposed samples using measures that corresponded to DSM IV and DSM 5 criteria. Self-compassion was negatively correlated with aggregated PTSD symptoms for DSM IV and DSM 5. Self-compassion was correlated with avoidance symptoms for DSM IV but was correlated with all symptom clusters for the DSM 5. These results suggest that self-compassion may protect against PTSD symptoms using the most recent diagnostic criteria.,0,0 +5382,The Detection of Malingered Posttraumatic Stress Disorder with MMPI-2 Fake Bad Indices,"This investigation explored the effect of posttraumatic stress disorder (PTSD) simulation on Minnesota Multiphasic Personality Inventory-2 (MMPI-2) responses, to detect malingered from genuine PTSD. Sixty-four adult PTSD outpatients at a child sexual abuse (CSA) survivor treatment program were compared with 85 adult college students instructed and trained to malinger PTSD. MMPI-2 overreporting indices examined were F, F-Fb, F-K, F(p), Ds2, O-S, OT, and FBS. A stepwise discriminant analysis identified F(p), F-K, and O-S as the best malingering predictors. A predictive discriminant analysis yielded good hit rates for the model, with impressive cross-validation results. Cutoff scores were assessed for the model's predictors. Clinical implications for detecting malingered PTSD using the MMPI-2 are discussed.",0,0 +5383,"Posttraumatic stress disorder, hypnotizability, and imagery","Twenty-six Vietnam veterans were studied to determine the relationship between posttraumatic stress disorder and hypnotizability. The intensity of their posttraumatic stress disorder was measured by a self-report. Their hypnotizability scores, vividness of imagery scores, and symptomatic profiles were also ascertained. Veterans with low or no posttraumatic stress disorder scores had normal hypnotizability scores and normal imagery scores, whereas those with high posttraumatic stress disorder scores had high hypnotizability scores and high imagery scores. The authors conclude that either combat traumas enhanced hypnotic potential in some veterans or that veterans with excellent hypnotic potential to begin with were more susceptible to posttraumatic stress.",0,0 +5384,"Psychometric Properties of the Mobility Inventory for Agoraphobia: Convergent, Discriminant, and Criterion-Related Validity","Aims of this study were (a) to summarize the psychometric literature on the Mobility Inventory for Agoraphobia (MIA), (b) to examine the convergent and discriminant validity of the MIA's Avoidance Alone and Avoidance Accompanied rating scales relative to clinical severity ratings of anxiety disorders from the Anxiety Disorders Interview Schedule (ADIS), and (c) to establish a cutoff score indicative of interviewers' diagnosis of agoraphobia for the Avoidance Alone scale. A meta-analytic synthesis of 10 published studies yielded positive evidence for internal consistency and convergent and discriminant validity of the scales. Participants in the present study were 129 people with a diagnosis of panic disorder. Internal consistency was excellent for this sample, α=.95 for AAC and .96 for AAL. When the MIA scales were correlated with interviewer ratings, evidence for convergent and discriminant validity for AAL was strong (convergent r with agoraphobia severity ratings=.63 vs. discriminant rs of .10-.29 for other anxiety disorders) and more modest but still positive for AAC (.54 vs. .01-.37). Receiver operating curve analysis indicated that the optimal operating point for AAL as an indicator of ADIS agoraphobia diagnosis was 1.61, which yielded sensitivity of .87 and specificity of .73.",0,0 +5385,Suppressed monocyte gene expression profile in men versus women with PTSD,"There have been several attempts to use gene microarrays from peripheral blood mononuclear cells to identify new biological pathways or targets for therapy in Posttraumatic Stress Disorder (PTSD). The few studies conducted to date have yielded an unclear pattern of findings, perhaps reflecting the use of heterogeneous samples of circulating immune cells for analysis. We used gene microarrays on a homogeneous sample of circulating monocytes to test the hypothesis that chronic PTSD would be associated with elevated inflammatory activity and to identify new pathways dysregulated in the disorder. Forty-nine men (24 PTSD+ and 25 age-matched trauma-exposed PTSD- controls) and 18 women (10 PTSD+ and 8 age-matched PTSD- controls) were recruited. Gene expression microarray analysis was performed on CD14+ monocytes, immune cells that initiate and respond to inflammatory signaling. Male subjects with PTSD had an overall pattern of under-expression of genes on monocytes (47 under-expressed versus 4 over-expressed genes). A rigorous correction for multiple comparisons and verification with qPCR showed that of only 3 genes that were differentially expressed, all were under-expressed. There was no transcriptional evidence of chronic inflammation in male PTSD+ subjects. In contrast, preliminary data from our pilot female PTSD+ subjects showed a relatively balanced pattern of increased and decreased expression of genes and an increase in activity of pathways related to immune activation. The results indicate differential patterns of monocyte gene expression in PTSD, and the preliminary data from our female pilot subjects are suggestive of gender dimorphism in biologic pathways activated in PTSD. Changes in immune cell gene expression may contribute to medical morbidity in PTSD.",0,0 +5386,The Psychometric Properties of the Korean Version of the Verbal Abuse Questionnaire in University Students,"The aim of the present study was to examine the psychometric properties of the Korean Verbal Abuse Questionnaire (K-VAQ) that consists of 15 items related with life-time verbal aggression exposure.A total of 5814 university students who agreed to take part in the study completed the K-VAQ, the Korean version of the Life Event CheckList (LEC-K) and Impact of Event Scale-Revised (K-IES-R). Internal consistency was checked by using item-total item correlation and Cronbach's alpha coefficient. Exploratory and confirmatory factor analyses were performed, and convergent and concurrent validity levels were examined. Finally, a cluster analysis was conducted to verify the validity of the cutoff point of the K-VAQ.The Cronbach's alpha correlation coefficient was 0.9. The K-VAQ showed a single factor structure which explained 55.34% of the total variance. The K-VAQ was significantly associated with the LEC-K (r=0.24) and K-IES-R (r=0.28), indicating good convergent validity and concurrent validity. The cluster analysis provided four clusters of trauma experiences: high, moderate, low, and minimal, with K-VAQ ranges of 43-81, 20-42, 7-19, and 0-6, respectively. In a further investigation, a K-VAQ score of 40 was found to be the appropriate cutoff point to delineate the highly verbally abused group, as used in the previous studies. A sum of 36.5% of the highly verbally abused group reported to show substantial symptoms of PTSD (K-IES-R score >22).The present findings suggest that the K-VAQ has good psychometric properties for assessing verbal aggression among the Korean population.",0,0 +5387,The Children's Revised Impact of Event Scale (CRIES): Validity as a Screening Instrument for PTSD,"The Children's Revised Impact of Event Scale (CRIES) is a brief child-friendly measure designed to screen children at risk for Posttraumatic Stress Disorder (PTSD). It has good face and construct validity, a stable factor structure, correlates well with other indices of distress, and has been used to screen very large samples of at-risk-children following a wide range of traumatic events. However, few studies have examined the scale's validity against a structured diagnostic interview based on the DSM-IV criteria for PTSD. In the present study, the CRIES and the PTSD section of the Anxiety Disorders Interview Schedule-Child and Parent Version (ADIS-CP) were administered to a sample of children and adolescents ( n =63) recruited from hospital accident and emergency rooms and the validity of the CRIES as a screening tool evaluated. Cutoff scores were chosen from this sample with a low base-rate of PTSD (11.1%) to maximize sensitivity and minimize the likelihood that children with a diagnosis of PTSD would fail to be identified. Cutoff scores were then cross-validated in a sample of 52 clinically referred children who had a high base-rate of PTSD (67.3%). A cutoff score of 30 on the CRIES-13 and a cutoff score of 17 on the CRIES-8 maximized sensitivity and specificity, minimized the rate of false negatives, and correctly classified 75–83% of the children in the two samples. The CRIES-8 (which lacks any arousal items) worked as efficiently as the CRIES-13 (which includes arousal items) in correctly classifying children with and without PTSD. Results are discussed in light of the current literature and of the need for further development of effective screens for children at-risk of developing PTSD.",0,0 +5388,Olfactory anhedonia and negative olfactory alliesthesia in depressed patients,"The present study aimed to investigate olfactory anhedonia and olfactory negative alliesthesia in depressed patients. Two odorants, one with pleasant (vanillin), and one with unpleasant (butyric acid) hedonic valence were evaluated by 30 depressed inpatients and 30 controls (healthy subjects, matched by age and gender). Participants explored the hedonic valence, intensity (discrimination) and perceived quality (identification) of 16 different stimuli (3 concentrations of odorants, their 9 combinations, and 1 control containing distilled water). The hedonic perception showed that patients perceived the unpleasant odorant as significantly more unpleasant than controls (olfactory negative alliesthesia). Concerning the intensity ratings, controls were able to discriminate between all concentrations of odorants, while patients discriminated between the different concentrations only for the unpleasant component and not for the vanillin (olfactory anhedonia). Regarding the identification task in an iso-intense unmixed odorants mixture, patients perceived significantly less the pleasant odorant than the unpleasant one (olfactory anhedonia), whereas controls perceived both odorants equally well. These results support the notion of an olfactory perception impairment in depression. Further studies are needed to replicate these findings and to confirm that such olfactory anhedonia or/and olfactory negative alliesthesia could be a state or a trait of depression.",0,0 +5389,Growth mixture models in longitudinal research,"Latent growth curve models as structural equation models are extensively discussed in various research fields (Curran and Muthén in Am. J. Community Psychol. 27:567-595, 1999; Duncan et al. in An introduction to latent variable growth curve modeling. Concepts, issues and applications, 2nd edn., Lawrence Earlbaum, Mahwah, 2006; Muthén and Muthén in Alcohol. Clin. Exp. Res. 24(6):882-891, 2000a; in J. Stud. Alcohol. 61:290-300, 2000b). Recent methodological and statistical extension are focused on the consideration of unobserved heterogeneity in empirical data. Muthén extended the classic structural equation approach by mixture components, i. e. categorical latent classes (Muthén in Marcouldies, G. A., Sckumacker, R. E. (eds.), New developments and techniques in structural equation modeling, pp. 1-33, Lawrance Erlbaum, Mahwah, 2001a; in Behaviometrika 29(1):81-117, 2002; in Kaplan, D. (ed.), The SAGE handbook of quantitative methodology for the social sciences, pp. 345-368, Sage, Thousand Oaks, 2004). The paper discusses applications of growth mixture models with data on delinquent behavior of adolescents from the German panel study Crime in the modern City (CrimoC) (Boers et al. in Eur. J. Criminol. 7:499-520, 2010; Reinecke in Delinquenzverläufe im Jugendalter: Empirische Überprüfung von Wachstums- und Mischverteilungsmodellen, Institut für sozialwissenschaftliche Forschung e. V., Münster, 2006a; in Methodology 2:100-112, 2006b; in van Montfort, K., Oud, J., Satorra, A. (eds.), Longitudinal models in the behavioral and related sciences, pp. 239-266, Lawrence Erlbaum, Mahwah, 2007). Observed as well as unobserved heterogeneity will be considered with growth mixture models. Special attention is given to the distribution of the outcome variables as counts. Poisson and negative binomial distributions with zero inflation are considered in the proposed growth mixture models variables. Different model specifications will be emphasized with respect to their particular parameterizations. © 2011 Springer-Verlag.",0,0 +5390,Post-traumatic stress disorder following childbirth: an update of current issues and recommendations for future research,"Objective: This paper aimed to report the current status of research in the field of post-traumatic stress disorder following childbirth (PTSD FC), and to update the findings of an earlier 2008 paper. Background: A group of international researchers, clinicians and service users met in 2006 to establish the state of clinical and academic knowledge relating to PTSD FC. A paper identified four key areas of research knowledge at that time. Methods: Fourteen clinicians and researchers met in Oxford, UK to update the previously published paper relating to PTSD FC. The first part of the meeting focused on updating the four key areas identified previously, and the second part on discussing new and emerging areas of research within the field. Results: A number of advances have been made in research within the area of PTSD FC. Prevalence is well established within mothers, several intervention studies have been published, and there is growing interest in new areas: staff and pathways; prevention and early interven...",0,0 +5391,"Uses and abuses of the resilience construct: Loss, trauma, and health-related adversities",,0,0 +5392,"Social Support, Posttraumatic Stress, and Postpartum Depressive Symptomatology among Japanese Women","Background: In Japan, 13% of new mothers suffered from elevated postpartum depressive symptomatology (PPDS), and one-third of women had posttraumatic stress (PTS) symptoms following birth. Western researchers reported that women with elevated PPDS often had more PTS symptoms following birth. Although the importance of social support to alleviate PTS or PPDS has been reported, the role of social support in the relationship between PTS and PPDS is not known. Understanding how social support affects the relationship between PTS and PPDS is necessary to develop effective interventions to prevent elevated PPDS. Purpose: To examine the role of social support in the relationship between PTS and PPDS among Japanese women. Design and Methods: This study was a cross-sectional secondary data analysis. The study sample consisted of 207 Japanese women between one and three months after giving birth. Based on the Stress Process Model, two conceptual models (moderation and mediation), consisting of four study concepts (PPDS, PTS, social support, and maternal background factors) were examined, as well as the prediction model to examine the direct effect of each predictor on PPDS. PPDS was measured with the Postpartum Depression Screening Scale Short Form. PTS was measured with two items of posttraumatic stress disorder symptoms. Social support (by a partner/others) was measured with the adaptation of the Medical Outcomes Study Social Support Survey. Both multiple linear regressions and path analyses were used to examine the proposed models. Results: Ninety-seven (46.9%) women had elevated PPDS. One hundred two (49.3%) women experienced at least one PTS symptom. PTS following birth ( = .24), health promotion behaviors ( = -.31), partner support ( = -.15), others' support ( = - .14), physical health problems ( = .14), and parity ( = -.13) had significant direct effects on PPDS (R2 = .30). However, neither a moderating effect of social support on the relationship between PTS and PPDS nor a mediating effect of PTS on the relationship between social support and PPDS was supported in this study. Conclusions: Mental health care focusing on PTS following birth will contribute to preventing depressive symptoms. From the current study results, alternative moderation and mediation models that include coping or self-concepts are suggested for future study. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0,0 +5393,Regional homogeneity and resting state functional connectivity: Associations with exposure to early life stress,"Early life stress (ELS) confers risk for psychiatric illness. Previous literature suggests ELS is associated with decreased resting-state functional connectivity (rs-FC) in adulthood, but there are no studies of resting-state neuronal activity in this population. This study investigated whether ELS-exposed individuals demonstrate resting-state activity patterns similar to those found in PTSD. Twenty-seven adults (14 with at least moderate ELS), who were medication-free and without psychiatric or medical illness, underwent MRI scans during two 4-minute rest periods. Resting-state activity was examined using regional homogeneity (ReHo), which estimates regional activation patterns through indices of localized concordance. ReHo values were compared between groups, followed by rs-FC analyses utilizing ReHo-localized areas as seeds to identify other involved regions. Relative to controls, ELS subjects demonstrated diminished ReHo in the inferior parietal lobule (IPL) and superior temporal gyrus (STG). ReHo values were inversely correlated with ELS severity. Secondary analyses revealed decreased rs-FC between the IPL and right precuneus/posterior cingulate, left fusiform gyrus, cerebellum and caudate in ELS subjects. These findings indicate that ELS is associated with altered resting-state activity and connectivity in brain regions involved in trauma-related psychiatric disorders. Future studies are needed to evaluate whether these associations represent potential imaging biomarkers of stress exposure.",0,0 +5394,Prevalence and risk factors for posttraumatic stress disorder among chemically dependent adolescents,"OBJECTIVE: This study ascertained the prevalence of posttraumatic stress disorder (PTSD) among chemically dependent adolescents and identified factors that influence the risk of PTSD after a qualifying trauma. METHOD: The study group consisted of 297 adolescents aged 15-19 years who met the DSM-III-R criteria for dependence on alcohol or other drugs and who were receiving treatment in seven publicly funded Massachusetts facilities. PTSD and other axis I diagnoses were assessed by the Diagnostic Interview Schedule. Data on risk factors were collected by a specially constructed interview schedule. RESULTS: The lifetime prevalence of PTSD was 29.6% (24.3% for males and 45.3% for females), and the current prevalence was 19.2% (12.2% for males and 40.0% for females). These prevalences reflect a high occurrence of traumatic exposures and a high case rate among those who experienced trauma. The risk of PTSD varied with the nature of the trauma, the number of traumas experienced, psychiatric comorbidity, and familial characteristics. The higher rate of PTSD among females was due to a greater frequency of rape, which carries a high risk of PTSD development, and to a high rate of comorbid conditions. CONCLUSIONS: The lifetime prevalence of PTSD among these chemically dependent adolescents is five times that reported for a community sample of adolescents. This extremely high rate provides new understanding of the etiologic connection between PTSD and chemical dependence and has implications for their treatment.",0,0 +5395,Resilience to natural hazards: How useful is this concept?,"Resilience is widely seen as a desirable system property in environmental management. This paper explores the concept of resilience to natural hazards, using weather-related hazards in coastal megacities as an example. The paper draws on the wide literature on megacities, coastal hazards, hazard risk reduction strategies, and resilience within environmental management. Some analysts define resilience as a system attribute, whilst others use it as an umbrella concept for a range of system attributes deemed desirable. These umbrella concepts have not been made operational to support planning or management. It is recommended that resilience only be used in a restricted sense to describe specific system attributes concerning (i) the amount of disturbance a system can absorb and still remain within the same state or domain of attraction and (ii) the degree to which the system is capable of self-organisation. The concept of adaptive capacity, which has emerged in the context of climate change, can then be adopted as the umbrella concept, where resilience will be one factor influencing adaptive capacity. This improvement to conceptual clarity would foster much-needed communication between the natural hazards and the climate change communities and, more importantly, offers greater potential in application, especially when attempting to move away from disaster recovery to hazard prediction, disaster prevention, and preparedness.",0,0 +5396,Understanding implantable cardioverter defibrillator shocks and storms: Medical and psychosocial considerations for research and clinical care,"The experience of shock is the distinguishing feature for patients with implantable cardioverter defibrillators (ICDs) and is associated with diminished psychological functioning and quality of life. Multiple shocks and ICD storm are a relatively common event among patients with ICDs (10-20%) and may present specific challenging medical and psychological management for the attending health care providers. This paper examines the medical and psychological aspects of ICD shocks and storms and describes a model of biopsychosocial management for patients following the experience of ICD storm. Successful management of patients post shock includes the use of antiarrhythmic medications and careful attention to the causality of the shocks via stored electrograms. The psychological management includes specific attention to debriefing post-shock feelings and attributions, preventing avoidance behavior, and facilitating positive ""return to life"" actions. Preliminary research examining formal psychosocial treatment supports a cognitive behavioral strategy to reduce psychological distress and facilitate quality of life. Collectively, these data suggest that interdisciplinary management of patients with multiple ICD shocks or the experience of ICD storm is advised, and routine psychological consultation may be indicated for the patient post ICD storm to reduce the possibility of symptoms of post-traumatic stress.",0,0 +5397,Validity of PTSD in a sample of refugee children: can a separate diagnostic entity be justified?,"The objective of this study was to examine the construct validity of PTSD in a sample of refugee children from the Middle East – more specifically, to assess whether associations between traumatic events and specific PTSD symptoms were more outspoken than (1) the associations of PTSD symptoms with non-traumatic exposures, and (2) the associations of violent exposures with symptoms other than PTSD-symptoms. Parents of 311 refugee children from the Middle East were interviewed concerning their children's traumatic experiences and mental health symptoms. The specific PTSD symptoms did not cluster in a factor analysis. The PTSD symptom complex was significantly predicted not only by violent exposures (mother tortured, OR 8.2, p < 0.005; father disappeared OR 3.2, p < 0.05) but also by indicators of family interaction and parents' occupational situation. The two identified violent exposures had significant independent associations with a series of symptoms including symptoms other than those of PTSD (rs ranging from 0.25 to 0.44, p < 0.001). Thus it does not seem sufficient to focus solely on PTSD symptomatology when assessing the mental health needs of refugee children. Copyright © 2006 John Wiley & Sons, Ltd.",0,0 +5398,Factor Structure of the PTSD Checklist in a Sample of OEF/OIF Veterans Presenting to Primary Care: Specific and Nonspecific Aspects of Dysphoria,"Although DSM-IV-TR diagnostic criteria for posttraumatic stress disorder (PTSD) include three primary symptom clusters, recent evidence from confirmatory factor analyses suggest that the latent structure of PTSD is better represented by four factors, which will likely be reflected in the upcoming DSM-5. Given this likely transition from three to four clusters, the present study sought to examine specific and non-specific aspects of dysphoria in the factor structure of PTSD symptoms in a sample of OEF/OIF combat veterans presenting to a Veterans Affairs primary care clinic. PTSD symptoms were assessed using the PCL-M (Weathers et al. 1993). Results from confirmatory factor analyses suggested that a dysphoria factor involving a number of non-specific distress symptoms may be an important part of the PTSD symptom profile. After controlling for variance due to general psychological distress, we further found that factor loadings on the dysphoria factor were attenuated but continued to significantly load onto the factor, suggesting that dysphoria may be a specific part of the PTSD symptom constellation.",0,0 +5399,Consistent impaired verbal memory in PTSD: A meta-analysis,"Qualitative review papers have indicated that verbal memory impairment is found to be the most consistent cognitive impairment related to PTSD. These review papers have used qualitative methods to describe the effects, and consequently they have not been able to estimate the strength of the memory-PTSD association. This meta-analysis of 28 studies examined the empirical evidence for this relationship, and factors affecting the results. Overall, the results showed medium effect sizes in patients with PTSD compared to controls on verbal memory across studies. Marked impairment was found in the patient groups compared to healthy controls, while modest impairment was found compared to exposed non-PTSD controls. Meta-analyses found strongest effects in war veterans compared to sexual and physical assault related PTSD. Rather unexpectedly no effect was found for the sexually abused PTSD groups compared to exposed controls. The analyses further showed that the effect was dependent on the test procedures used. The studies using WMS and AVLT had stronger effects than studies using CVLT. Insufficient data were available to analyze a more complete attention–memory profile. This meta-analysis confirms that verbal memory impairment is present in adults with PTSD, and they are consistent across studies. This impairment should be the focus of work in clinical settings.",0,0 +5400,Acute Stress Disorder as a Predictor of Post-Traumatic Stress Disorder in Physical Assault Victims,"The authors’objective was to examine the ability of acute stress disorder (ASD) and other trauma-related factors in a group of physical assault victims in predicting post-traumatic stress disorder (PTSD) 6 months later. Subjects included 214 victims of violence who completed a questionnaire 1 to 2 weeks after the assault, with 128 participating in the follow-up. Measures included the Harvard Trauma Questionnaire, the Trauma Symptom Checklist, and the Crisis Support Scale. Twenty-two percent met the full PTSD diagnosis and 22% a subclinical PTSD diagnosis. Previous lifetime shock due to a traumatic event happening to someone close, threats during the assault, and dissociation explained 56% of PTSD variance. Inability to express feelings, hypervigilance, impairment, and hopelessness explained another 15% of PTSD variance. The dissociative, the reexperiencing, the avoidant, and the arousal criteria of the ASD diagnosis correctly classified 79% of the subsequent PTSD cases.",0,0 +5401,Individual and Group Factors that Affect Resilience and Mediate the Relationship between Resilience and the Development of Posttraumatic Stress Disorder in ICU Nurses,"The purpose of this research was to determine the significant individual and group characteristics that affected resilience in intensive care unit (ICU) nurses and whether those significant characteristics had a direct or indirect effect on the development of posttraumatic stress disorder (PTSD) mediated through resilience. An adaptation of the Nurse as Wounded Healer (N-WH) theory was also tested, which added resilience as a concept to facilitate self-healing, transformation and transcendence of trauma experienced in the ICU. This was a secondary database analysis that included 744 ICU nurses from around the United States. Participants were mailed a self-report survey that included demographic, anxiety, depression, PTSD and resilience measures. The factors that significantly affected resilience included: whether the ICU nurse had children, the number of years practicing, type of nursing degree, generational cohort affiliation, and type of unit the nurse was working in. Structural equation modeling (SEM) in MplusTM was used to model the direct and indirect effects of the significant variables on the development of PTSD mediated through resilience. Children and years practicing as an ICU nurse had direct effects on the development of PTSD. When compared with the medical ICU (MICU), the cardiac ICU, cardiothoracic surgery ICU and other ICUs had significant indirect effects on the development of PTSD mediated through the Personal Competence sub-scale of resilience. ICU nurses with a graduate degree had a significant indirect effect on the development of PTSD mediated through the Leadership sub-scale of resilience, when compared to ICU nurses with a bachelor degree of science in nursing (BSN). The results supported the adapted version of the NWH theory. Based on the findings of this research, having children, years practicing, type of nursing degree and ICU unit type had significant direct or indirect effects on the development of PTSD mediated through the Personal Competence and Leadership subscales of resilience. Future research is needed to describe the potentially unique characteristics of each unit type and to identify modifiable individual and organizational factors to help inform tailored resilience interventions in the ICU. (PsycINFO Database Record (c) 2015 APA, all rights reserved)",0,0 +5402,The relationship between response inhibition and posttraumatic stress symptom clusters in adolescent earthquake survivors: An event-related potential study,"Posttraumatic stress disorder (PTSD) patients experience impaired response inhibition. Little is known about the relationship between response inhibition abnormalities and distinct PTSD symptom clusters. This study investigated the relationship between response inhibition processing and a five-factor model of posttraumatic stress symptomatology in adolescents. The event-related potentials of 54 unmedicated adolescent earthquake survivors (age 15-18 years) were recorded as they completed a Go/NoGo task. The PTSD Checklist-Specific Stressor Version (PCL-S) was used to assess PTSD symptoms. Regression analyses were conducted to examine the associations between the five symptom-cluster model and response inhibition processing. The results revealed that the avoidance symptom cluster score, but not the numbing or other clusters' scores, was positively associated with NoGo-P3 latency. These results suggest that a specific PTSD symptom cluster--avoidance--has a distinct association with the slowed speed of the late step of response inhibition processing, i.e., decision or success of response inhibition in adolescent earthquake survivors.",0,0 +5403,DAILY CHARTING OF POSTTRAUMATIC STRESS SYMPTOMS: A PILOT STUDY,"This pilot study describes a prospective life-charting method for posttraumatic stress (PTS) symptoms. This method summarizes daily symptoms, functional impairment, life events, substance use, and treatment. Findings include experience with 17 cases over periods lasting from 3 to 25 months, with a description of 4 case examples that are characteristic of the pilot sample. People with posttraumatic stress disorder (PTSD) can complete day charting of their symptoms over an extended period of time. Some people reported that day charting distressed them mildly as they analyzed daily thoughts or feelings that they ordinarily avoided or pushed from awareness. Nonetheless, most people reported that they learned and benefited from daily symptom charting. In addition to enhancing patient self-understanding (or ""insight""), the method may prove useful in assessing treatments for PTSD. Finally, these preliminary findings have suggested hypotheses regarding the clinical phenomenology and course of PTSD. For example, PTS symptom cluster exacerbation, severity, and duration appear to be highly consistent within any given patient, but highly variable across patients. Daily charting of PTS symptoms over prolonged periods is feasible. This prospective PTSD symptom charting method may have therapeutic, clinical, and research potential for understanding individual and group patterns in PTSD over time.",0,0 +5404,Post-traumatic stress disorder in young people with intellectual disability,"Post-traumatic stress disorder (PTSD) is common and treatable. There is extensive research on people of average intelligence yet little on individuals with developmental disabilities.We report two people with intellectual disability (ID) who experienced PTSD. The relevance of their developmental difficulties, social and communication profiles, attentional skills, and causes of these, to their presentations is discussed.Both individuals have fragile X syndrome and severe ID. One has Diagnostic and Statistical Manual - 4th Edition (DSM-IV) autistic disorder; the other DSM-IV attention deficit-hyperactivity disorder. They experienced developmental and psychological regressions, new challenging behaviours and exacerbations of existing ones coincident with emotional trauma. PTSD symptoms and phenomena were identifiable despite intellectual and communicatory impairments.Presentation of PTSD is influenced by degree and cause of ID, social circumstances, social and communicatory skills, nature and timing of traumatic experience and subsequent management. The paucity of literature suggests it is missed frequently in individuals with ID who risk having problems misattributed to other causes with potential for inappropriate interventions.",0,0 +5405,Predictors of Psychosocial Adaptation Among People With Spinal Cord Injury or Disorder,"To examine the influence of disability-related medical and psychologic variables on psychosocial adaptation to spinal cord injury or disorder (SCI/D).A structural equation modeling design linking 3 sets of predictive variables to an outcome measure of adaptation.Two outpatient SCI clinics (1 veteran, 1 civilian) in Texas.Veterans (n=181) and civilians (n=132) with SCI/D.Not applicable.The adaptation outcome was measured by 2 subscales (acknowledgment, adjustment) of the Reactions to Impairment and Disability Inventory (RIDI) and by the Quality of Life Scale. The predictive variables were measured by a demographic questionnaire, 3 subscales (intrusion, re-experiencing, hyperarousal) of the Purdue Posttraumatic Stress Disorder-Revised scale, the McMordie-Templer Death Anxiety Scale, and 3 subscales (anxiety, depression, denial) of the RIDI.Goodness-of-fit indices suggested that a revised model of adaptation was a moderately good fit to the data. The revised model of adaptation indicated that there were medium total effects (direct plus indirect) on psychosocial adaptation by 2 latent variables (disability severity and impact, negative affectivity) and small total effects on psychosocial adaptation by disengagement coping. The latent factor of disengagement coping had the strongest direct effect on adaptation (although not statistically significant). Disability severity and impact had medium indirect effects and negative affectivity had small indirect effects on psychosocial adaptation. All of the aforementioned effects had a negative coefficient.Negative emotional responses (eg, depression, anxiety) to SCI/D, disengagement-type coping (eg, disability denial, avoidance), and the severity and impact of disability were related to lower levels of adaptation to SCI/D.",0,0 +5406,Posttraumatic stress disorder in an urban population of young adults: risk factors for chronicity,"Despite progress in epidemiologic research on posttraumatic stress disorder (PTSD), little is known about factors that distinguish chronic from nonchronic PTSD. In a previous report, the authors identified a set of personal predispositions associated with PTSD following traumatic events in a general population sample of young adults. The purpose of this analysis was to identify characteristics of chronic PTSD and examine whether any of the suspected risk factors for PTSD was associated specifically with chronic PTSD.A random sample of 1,007 21- to 30-year-old members of a large health maintenance organization in the Detroit area was interviewed, using the National Institute of Mental Health Diagnostic Interview Schedule (DIS), revised for DSM-III-R. The analysis was performed on data from 394 respondents who reported traumatic events, of whom 93 met criteria for PTSD. Chronic PTSD was defined as duration of symptoms for 1 year or more.Persons with chronic PTSD (N = 53) had, on the average, a significantly higher total number of PTSD symptoms and higher rates of overreactivity to stimuli that symbolized the stressor and interpersonal numbing than persons with nonchronic PTSD. The rates of one or more additional anxiety or affective disorders and a variety of medical conditions were higher in persons with chronic than nonchronic PTSD. Family history of antisocial behavior and female sex were associated specifically with chronic PTSD.The findings suggest that chronic PTSD may be associated with specific risk factors and clinical features. Longitudinal data on the course of PTSD are needed to determine whether the distinct features and the medical and psychiatric histories of persons with chronic PTSD are complications attendant on a chronic course or coexisting disturbances that inhibit recovery.",0,0 +5407,[Post-traumatic stress disorder (PTSD): the syndrome with multiple faces].,"We choose to discuss from the PTSD's point of view because this diagnostic reference is commonly used. We wish outline its restrictive sight which could prevent the professional from having a diagnosis of PTSD. We don't want to say there is a PTSD everywhere but it appears to us that a traumatic reading can be a precious advantage for the clinician to establish a real therapeutic relation with some patients. Post-traumatic syndrome differs from the majority of other diagnostic categories as it includes in its criteria the presumptive cause of the trauma (criterion A). In the case that this syndrome originates in war experiences, the presumed cause presents itself as an exceptional event overcoming the individual's resources. The notion of war traumatisation has been extended to other events such as catastrophes, physical attacks, rapes, child and wife battering, and sexual abuses. But the events which cause PTSD (Post-Traumatic Stress Disorder) are significantly more numerous. It can be seen that medical events such as giving birth, miscarriage, heart attack, cancer, or hospitalisation following resuscitation may give rise to PTSD. Further, people experiencing prolonged periods of distress may equally develop a post-traumatic syndrome without any particular event having occurred to surpass their defences. It's the case of the Prolonged Duress Stress Disorder (PDSD). The series of discontinuous stress ""waste"" the psychic balance and may give rise, at one moment, to posttraumatic symptoms described in DSM, without any specific stressful event. The existence of criterion A is therefore not a necessary prerequisite in establishing a diagnosis of PTSD. It is, in fact, very difficult to predict which events could cause a PTSD, and this, especially, as the subjective aspects count at least as much as the objective aspects. The clinician should have to carefully explore how the patient experienced the event or, how he apprehended the event itself and it's outcome, if he wants get the traumatic range of a life event. The feeling of deep distress, the feeling of being trapped, the loss of control, the collapse of basic beliefs, the feeling that one's life is in jeopardy, that the physical integrity is (really or in one's imagination) threatened, the feeling of helplessness, are quite as much clues for a possible PTSD which hides behind others clinical manifestations either psychological or somatic. Furthermore, the ""pure"" form described in the DSM and grouping together three further criteria (reliving events, avoiding stimuli associated with the trauma, hyper-reactivity) is extremely rare in the chronic form. An untreated post-traumatic syndrome evolves with time and may present, initially, with very different pathological symptoms giving rise to equally varied diagnoses. Different etiopathogenic models propose to account for the PTSD 's heterogeneous appearance and instability with time. The comorbidity concept sees the PTSD as an independent entity other independent pathologies coexist with. The typologic concept suggests that the PTSD is an independent entity which shows different clinical appearances based on symptomatic descriptions. The ""cascade"" concept suggests to see the PTSD as an independent entity which offers, with time, different symptomatic appearances, in evolution, because of events caused by after effects, in different areas of the PTSD itself. All of these concepts outline the transnosologic appearance of the PTSD which makes it hardly recognizable. The ""chronic"" syndrome is rarely diagnosed forming a real challenge to prevention. In effect, the present authors insist on the crucial nature of early detection of PTSD since the greater the time elapsed the more difficult it becomes due to the evolutionary aspect of the syndrome, which initially has more readily recognizable symptoms. The consequences of an unrecognised PTSD are serious and affect both the individual and his immediate family and friends, contributing further to the aggravation of the problems. When a PTSD is diagnosed, it can allow the clinician to further a more global care which will help the patient to get a better recovery. With patients who suffered an infarct, the treatment of PTSD which prevents their recovery will help to go back to the way they lived before the event. It has been showed how important could be the PTSD detection on the severe burned people's pain control. Thus it seems to be crucial for the clinician to keep this diagnosis in mind alongside any other.",0,0 +5408,The Role of Endogenous Opioids in the Placebo Effect in Post-Traumatic Stress Disorder,"The concept of the placebo effect has received a considerable attention over the past several decades. The placebo effect has been observed in different psychiatric disorders, including post-traumatic stress disorder (PTSD), a chronic and severe disorder precipitated by exposure to a psychologically distressing event. The placebo response rates in patients with PTSD range from 19% to 62%. A considerable number of research publications suggest that endogenous opioids are involved in the mechanisms of the placebo effect. Endogenous opioid peptides play an important role in stress response and in the pathophysiology of PTSD. Therefore, endogenous opioids may be involved in the neurobiology of the placebo effect in PTSD. Possibly, the endogenous opioid system mediates the effect of placebo on all 3 PTSD symptom clusters (re-experiencing symptoms, avoidance and numbing, and physiologic arousal). The placebo effect-related activation of the endogenous opioid system may result in an improvement in intrusive symptomatology and symptoms of increased arousal because the administration of exogenous opioids improve these symptoms. The placebo effect-related activation of the endogenous opioid system may have a mood-enhancing effect, and, consequently, diminish avoidance and numbing. Multiple neurotransmitter and neuroendocrine pathways may be involved in the mechanisms of the placebo effect in PTSD. Further studies of the neurobiology of the placebo effect on patients with PTSD and other psychiatric disorders may produce interesting and important results.",0,0 +5409,Latent Structure of the Mississippi Scale for Combat-Related Post-Traumatic Stress Disorder: Exploratory and Higher-Order Confirmatory Factor Analyses,"A series of factor analyses evaluated the dimensionality of the Mississippi Scale for Combat-Related Post-Traumatic Stress Disorder. Over 2,200 Vietnam theater and era veterans were divided into three random subsamples, each of which was used in a separate stage of analysis. Initial exploratory factor analyses suggested an underlying single-factor solution. In the second subsample, a second-order solution comprised of a general factor subsuming several first-order factors was supported using chi-square difference testing. This model was successfully replicated with the third subsample. Cumulative evidence suggests that the latent structure of the Mississippi Scale is best represented as an umbrella Post-Traumatic Stress Disorder (PTSD) factor leading to four subsidiary facets or dimensions.",0,0 +5410,The effect of intranasal oxytocin treatment on conditioned fear extinction and recall in a healthy human sample,"To improve outcomes for patients undergoing extinction-based therapies (e.g., exposure therapy) for anxiety disorders such as post-traumatic stress disorder (PTSD), there has been interest in identifying pharmaceutical compounds that might facilitate fear extinction learning and recall. Oxytocin (OT) is a mammalian neuropeptide that modulates activation of fear extinction-based neural circuits and fear responses. Little is known, however, about the effects of OT treatment on conditioned fear responding and extinction in humans.The purpose of the present study was to assess the effects of OT in a fear-potentiated startle task of fear conditioning and extinction.A double-blind, placebo-controlled study of 44 healthy human participants was conducted. Participants underwent a conditioned fear acquisition procedure, after which they were randomized to treatment group and delivered OT (24 IU) or placebo via intranasal (IN) spray. Forty-five minutes after treatment, participants underwent extinction training. Twenty-four hours later, subjects were tested for extinction recall.Relative to placebo, the OT group showed increased fear-potentiated startle responding during the earliest stage of extinction training relative to placebo; however, all treatment groups showed the same level of reduced responding by the end of extinction training. Twenty-four hours later, the OT group showed significantly higher recall of extinction relative to placebo.The current study provides preliminary evidence that OT may facilitate fear extinction recall in humans. These results support further study of OT as a potential adjunctive treatment for extinction-based therapies in fear-related disorders.",0,0 +5411,Factor mixture model of anxiety sensitivity and anxiety psychopathology vulnerability,"The purpose of the present study was to shed light on the latent structure and nature of individual differences in anxiety sensitivity (AS) and related risk for psychopathology.The present study evaluated the latent structure of AS using factor mixture modeling (FMM; Lubke and Muthén, 2005) and tested the relations between the observed FMM-based model of AS and psychopathology in a large, diverse adult clinical research sample (N=481; 57.6% women; M(SD)(age)=36.6(15.0) years).Findings showed that a two-class three-factor partially invariant model of AS demonstrated significantly better fit than a one-class dimensional model and more complex multi-class models. As predicted, risk conferred by AS taxonicity was specific to anxiety psychopathology, and not to other forms of psychopathology.The sample was not epidemiologic, self-report and psychiatric interview data were used to index AS and psychopathology, and a cross-sectional design limited inference regarding the directionality of observed relations between AS and anxiety psychopathology.Findings are discussed with respect to the nature of AS and related anxiety psychopathology vulnerability specifically, as well as the implications of factor mixture modeling for advancing taxonomy of vulnerability and psychopathology more broadly.",0,0 +5412,A Longitudinal Comparison of Posttraumatic Stress Disorder and Depression Among Military Service Components,"The purpose of this study was to longitudinally investigate PTSD and depression between Reserve, National Guard, and active duty continuously and dichotomously. The study consisted of Millennium Cohort Study participants and used self-reported symptoms. Repeated measures modeling assessed PTSD and depression continuously and dichotomously over time. A subanalysis among only recently deployed personnel was conducted. Of the 52,653 participants for the PTSD analysis, the adjusted PCL-C means were 34.6 for Reservists, 34.4 for National Guardsmen, and 34.7 for active duty members, respectively. Of the 53,073 participants for depression analysis, the adjusted PHQ-9 means were 6.8, 6.7, and 7.2, respectively. In dichotomous models, Reservists and National Guardsmen did not have a higher risk of PTSD or depression compared with active duty members. Among deployers, Reservists and National Guardsmen had higher odds (odds ratio = 1.16, 95% confidence limit [CL] [1.01, 1.34] and OR = 1.19, 95% CL [1.04, 1.36], resp...",0,0 +5413,Prevalence of Mental Health Problems and Functional Impairment Among Active Component and National Guard Soldiers 3 and 12 Months Following Combat in Iraq,"A growing body of literature has demonstrated the association of combat in Iraq and Afghanistan with postdeployment mental health problems, particularly posttraumatic stress disorder (PTSD) and depression. However, studies have shown varying prevalence rates of these disorders based on different case definitions and have not assessed functional impairment, alcohol misuse, or aggressive behavior as comorbid factors occurring with PTSD and depression.To (1) examine the prevalence rates of depression and PTSD using several case definitions including functional impairment, (2) determine the comorbidity of alcohol misuse or aggressive behaviors with depression or PTSD, and (3) compare rates between Active Component and National Guard soldiers at the 3- and 12-month time points following their deployment to Iraq.Population-based, cross-sectional study.United States Army posts and National Guard armories.A total of 18 305 US Army soldiers from 4 Active Component and 2 National Guard infantry brigade combat teams.Between 2004 and 2007, anonymous mental health surveys were collected at 3 and 12 months following deployment.Current PTSD, depression, functional impairment, alcohol misuse, and aggressive behavior.Prevalence rates for PTSD or depression with serious functional impairment ranged between 8.5% and 14.0%, with some impairment between 23.2% and 31.1%. Alcohol misuse or aggressive behavior comorbidity was present in approximately half of the cases. Rates remained stable for the Active Component soldiers but increased across all case definitions from the 3- to 12-month time point for National Guard soldiers.The prevalence rates of PTSD and depression after returning from combat ranged from 9% to 31% depending on the level of functional impairment reported. The high comorbidity with alcohol misuse and aggression highlights the need for comprehensive postdeployment screening. Persistent or increased prevalence rates at 12 months compared with 3 months postdeployment illustrate the persistent effects of war zone service and provide important data to guide postdeployment care.",0,0 +5414,Opioid Receptor Antagonists in Psychiatry,"Naltrexone has proved useful in a variety of psychopathological states, Mainly it has been used in long term therapy of heroin addicts. More recently it has been addressed to the treatment of alcoholics, Anecdoctical observations and research data suggest its use also in the field of Mental Illnesses (Eating disorders, Gilles de la Tourette syndrome and Obsessive Compulsive Disorder, Schizophrenia, Self Injuring Behaviours, Autism, Tricotillomania, Post-traumatic stress disorder). In this paper we will briefly discuss the use of opioid antagonists in drug addicts and then we will review the evidence for future development for other psychiatric illnesses. Examined data suggest that opioid antagonists be effective on symptomathologic clusters common to different clinical entities.",0,0 +5415,Patterns of Posttraumatic Stress Symptoms in Parents of Childhood Cancer Survivors.,"Posttraumatic stress (PTS) symptoms have been reported in mothers and fathers of childhood cancer survivors; however, little is known about patterns of PTS in these families. Cluster analysis was applied to the Posttraumatic Stress Disorder (PTSD) Reaction Index scores of 98 couples parenting adolescent childhood cancer survivors to describe patterns of PTS in families, yielding the following 5 clusters: Minimal PTS, Mothers Elevated, Disengaged, Fathers Elevated, and Elevated PTS. The clusters were validated using data from a structured psychiatric interview, an additional self-report measure of PTS, and an index of family functioning. These clinically meaningful patterns reveal that a majority of families had at least one parent with moderate to severe PTS, which supports development of family-based interventions for this population.",0,0 +5416,Predicting time to emergency department return for anxiety disorders and acute stress reactions in children and adolescents: a cohort study,"Purpose: While studies indicate that few children with anxiety disorders receive specialized mental health care, significant knowledge gaps exist for the mental health care trajectory outside of specialized care. We examined whether physician-based care after an emergency department (ED) visit for mental health care predicted time to ED return. Methods: We conducted a retrospective cohort study using administrative data from Alberta, Canada. Included in the cohort were 8075 children <18 years discharged from an ED (104 EDs in total), April 2002–September 2010, following a visit for an anxiety disorder or acute stress reaction. We used a multivariable Cox proportional hazards model to estimate time to ED return for mental health care (censored at 90 days). The variables of interest were: number and type of physician visits 30 days after index visit. We adjusted for sociodemographics, clinical acuity, comorbidity, and recent history of ED mental health care in the model. Results: Within 30 days of ED discharge, multiple physician follow-up visits were associated with shorter return time (adjusted HR 1.24, 95 % CI 1.08–1.43). A single physician follow-up visit was associated with longer return time (adjusted HR 0.68, 95 % CI 0.58–0.79). Physician follow-up visits for mental health care were associated with shorter return time (adjusted HR 2.5, 95 % CI 2.21–2.83). Conclusions: Following an index visit, ED return by children with anxiety disorders or acute stress reactions is associated with specific characteristics of subsequent physician visits. Improving physician use of evidence-based treatment and family access to coordinated services may reduce costly hospital-based care. © 2015, Springer-Verlag Berlin Heidelberg.",0,0 +5417,Typologies of posttraumatic stress disorder in treatment-seeking older adults,"ABSTRACT Background: While it is well known that posttraumatic stress disorder (PTSD) is characterized by heterogeneous symptom clusters, little is known about predominant typologies of PTSD symptoms in older adults. Methods: Latent profile analyses (LPAs) were employed to evaluate predominant typologies of PTSD symptoms in a sample of 164 treatment-seeking older adults with childhood war-related trauma. Multinomial logistic regressions were conducted to evaluate predictors of class membership. Results: LPAs revealed that a 3-class solution best fit the data. These included an Intermediate Disturbance class (50.0%) and two Pervasive Disturbance classes, which differed with respect to severity of avoidance symptoms (Pervasive Disturbance-Low Avoidance: 33.5%, Pervasive Disturbance-High Avoidance: 16.5%). A greater number of traumatic events predicted membership in the Pervasive Disturbance classes. The Pervasive Disturbance-Low Avoidance class had a higher level of education than the Pervasive Disturbance-High Avoidance class. Compared to the Intermediate Disturbance class, the Pervasive Disturbance classes had the highest levels of depression, anxiety and somatization symptoms. Conclusion: These results suggest that PTSD in treatment-seeking older adults may be characterized by three predominant typologies, which are differentiated by overall severity and avoidance symptoms, lifetime trauma burden, education level, and comorbid depression, anxiety, and somatization symptoms. These results underscore the importance of considering heterogeneity in the phenotypic presentation of PTSD in assessment and treatment approaches for this disorder in older adults.",0,0 +5418,"A preliminary examination of the relationships between posttraumatic stress symptoms and crack/cocaine, heroin, and alcohol dependence","High rates of co-occurrence between posttraumatic stress (PTS) and substance use disorders (SUDs) have led to the suggestion that substance use among individuals experiencing PTS symptoms might serve a self-medication function. However, research is still needed to provide a more comprehensive evaluation of the unique associations between PTS symptom clusters and substances (licit and illicit) with both anxiolytic/depressant and stimulant properties. Consequently, this study examined the relationship between severity of different PTS symptom clusters and heroin, crack/cocaine, and alcohol dependence among 48 treatment-seeking SUD patients with a history of traumatic exposure. No evidence was found for a relationship between PTS symptom clusters and crack/cocaine or alcohol dependence; however, results suggested a relationship between hyperarousal and avoidance (inversely related) symptoms and heroin dependence. Results are discussed in terms of their implications for understanding motivations underlying the substance of choice among individuals with PTS symptoms, as well as the development of treatments for co-occurring PTS and SUDs.",0,0 +5419,Low-Dose Risperidone as Adjunctive Therapy for Irritable Aggression in Posttraumatic Stress Disorder,"Increased aggressive behavior can occur in association with posttraumatic stress disorder (PTSD). This study tested the hypothesis that low-dose risperidone reduces aggression and other PTSD-related symptoms in combat veterans. Subjects were male combat veterans with PTSD who scored 20 or higher on cluster D (hyperarousal) of the Patient Checklist for PTSD-Military Version (PCL-M). Subjects were randomly assigned to either risperidone or placebo treatment groups. Drugs were administered over a 6-week treatment period in a double-blind manner. Subjects received either risperidone (0.5 mg/day; n = 7) or matched placebo (n = 8) tablets during the first 2 weeks of the treatment period. The dose of risperidone could then be increased up to 2.0 mg/day on the basis of response. Prerandomization psychotropic regimens were continued. Subjects were evaluated with the PCL-M and the Overt Aggression Scale-Modified for Outpatients (OAS-M). In comparison with placebo treatment, reductions in scores between baseline and the last week of treatment were significantly greater for OAS-M irritability and PCL-M cluster B (intrusive thoughts) subscales and on the PCL-M total scale. These results suggest that low-dose risperidone administration reduces irritability and intrusive thoughts in combat-related PTSD.",0,0 +5420,Psychological consequences of war trauma and postwar social stressors in women in Bosnia and Herzegovina.,"To assess the consequences of psychotrauma in civilian women in Herzegovina who were exposed to prolonged and repetitive traumatic war events and postwar social stressors.The study included a cluster sample of 367 adult women, divided into two groups. One group (n=187) comprised women from West Mostar who were exposed to serious war and posttraumatic war events. The other group (n=180) comprised women from urban areas in Western Herzegovina who were not directly exposed to war destruction and material losses, but experienced war indirectly, through military drafting of their family members and friends. Demographic data on the women were collected by a questionnaire created for the purpose of this study. Data on trauma exposure and posttraumatic stress disorder (PTSD) symptoms were collected by Harvard Trauma Questionnaire (HTQ)--Bosnia-Herzegovina version. General psychological symptoms were determined with Symptom Check List-90-revised (SCL-90-R). Data on postwar stressors were collected by a separate questionnaire.In comparison with the control group, women from Western Mostar experienced significantly more traumatic events (mean+/-standard deviation [SD], 3.3+/-3.2 vs 10.1+/-4.9, respectively, t=15.91; P<0.001) and had more posttraumatic symptoms (12.3+/-10.3 vs 21.2+/-10.9, respectively, t=8.42; P<0.001). They also had significantly higher prevalence of PTSD (4.4% vs 28.3%, respectively; chi(2)=52.56; P<0.001). The number of traumatic events experienced during the war was positively associated with postwar stressful events both in the West Mostar group (r=0.223; P=0.002) and control group (r=0.276; P<0.001). Postwar stressful events contributed both to the number and intensity of PTSD symptoms and all general psychological symptoms measured with SCL-90 questionnaire, independently from the number of experienced traumatic war events.Long-term exposure to war and postwar stressors caused serious psychological consequences in civilian women, with PTSD being only one of the disorders in the wide spectrum of posttraumatic reactions. Postwar stressors did not influence the prevalence of PTSD but they did contribute to the intensity and number of posttraumatic symptoms.",0,0 +5421,Post-traumatic stress disorder symptom clusters predicting substance abuse in adolescents,"The majority of studies exploring the mental health disorders, post-traumatic stress disorder (PTSD) and substance use disorders (substance abuse (SA) and dependence), have shown high co-morbidity rates in adolescents, indicating a well-established relationship. However, only a few studies have attempted to examine the functional mechanisms believed to underlie this common form of co-morbidity, and no studies have been carried out in adolescent samples. Knowledge is thus lacking on how specific PTSD symptom clusters may account for the development of specific types of problematic substance use in adolescents. Therefore, we studied this issue in relation to alcohol abuse (AA) and drug abuse (DA) in a probability sample of Danish 15–18-year-olds (n = 1988) in the form of an online survey using self-report questionnaires following the Diagnostic and statistical manual of mental disorders, fourth edition [DSM-IV; APA. (1994). Washington, DC: Author]. After demographic and substance-related variables were cont...",0,0 +5422,Characteristics of Heart Rate Variability in War Veterans with Post-Traumatic Stress Disorder after Myocardial Infarction,"The goal of the study was to evaluate differences in heart rate variability (HRV) among post-myocardial infarction (MI) patients, depending on their participation in the Croatian war and on established diagnoses of post-traumatic stress disorder (PTSD).The study included 34 male war veterans with diagnosed PTSD who had suffered a first MI and 34 age-matched post-MI patients without PTSD. Cardiac autonomic balance was evaluated through HRV analysis.There were no differences in the mean R-R interval or overall HRV between the analyzed groups. Post-MI patients with PTSD had lower values for the square root of the mean of squared successive differences in R-R intervals (p = 0.02), the percentage of R-R intervals that were > or =50 milliseconds different from the previous interval (p = 0.03), and the high-frequency component (p = 0.03) but had higher values for the low-frequency component (p = 0.01) and the low-frequency/high-frequency ratio (p = 0.02), compared with post-MI patients without PTSD.Post-MI patients with PTSD have higher sympathetic and lower parasympathetic heart rate modulation activity, compared with patients with MI and no PTSD.",0,0 +5423,Measurement Invariance of the Brief Symptom Inventory in Survivors of Torture and Trauma,"The United States accepts more refugees than any other industrialized nation. As refugee populations grow, mental health professionals must implement culturally and ethnically appropriate strategies to assess and treat individuals from diverse backgrounds. Culture can exert a powerful and often misunderstood influence on psychological assessment, and few structured measures have been demonstrated to have adequate cross-cultural validity for use with diverse and vulnerable populations such as survivors of torture. This study examined the factor structure and equivalency of underlying construct(s) of psychological distress as measured by the Brief Symptom Inventory (BSI) in three samples who had survived torture and other severe trauma from Tibet, West Africa and the Punjab region of India. Confirmatory factor analyses provided support for configural invariance of a two-factor model across the three samples, suggesting that the two latent factors of Complex Dysphoria and Somatic Distress were present in each subgroup. The data provide additional support for the strict invariance model in the West African–Tibetan dyad suggesting that scores are comparable across those two groups. Implications for research and treatment are discussed.",0,0 +5424,Daytime Prazosin Reduces Psychological Distress to Trauma Specific Cues in Civilian Trauma Posttraumatic Stress Disorder,"Persons with posttraumatic stress disorder (PTSD) whose trauma-related nightmares improve or resolve with bedtime administration of the alpha-1 adrenergic antagonist prazosin often continue to experience PTSD symptoms during the day. This study addressed whether daytime prazosin compared to placebo would alleviate psychological distress provoked experimentally by a trauma-related word list included in the emotional Stroop (E-Stroop) paradigm.Eleven persons with civilian trauma PTSD who continued to experience daytime PTSD symptoms despite a stable bedtime prazosin dose that suppressed trauma-related nightmares were studied. Prazosin and placebo were administered on two different occasions in the early afternoon followed two hours later by the E-Stroop. Effects of drug on psychological distress were assessed by the Profile of Mood States (POMS).POMS total score and an ""emotional distress"" POMS subscale score following trauma-related words were significantly lower in the prazosin than placebo condition. There were no treatment effects on E-Stroop completion time. In 10 subjects who continued open label daytime prazosin, there was a reduction in global PTSD illness severity at 2-week follow-up.Daytime prazosin pretreatment reduced psychological distress specifically to trauma cues. Adding daytime prazosin to bedtime prazosin may further reduce overall PTSD illness severity and distress.",0,0 +5425,A Qualitative Study of Mental Health Problems among Children Displaced by War in Northern Uganda,"While multiple studies have found that children affected by war are at increased risk for a range of mental health problems, little research has investigated how mental health problems are perceived locally. In this study we used a previously developed rapid ethnographic assessment method to explore local perceptions of mental health problems among children and adults from the Acholi ethnic group displaced by the war in northern Uganda. We conducted 45 free list interviews and 57 key informant interviews. The rapid assessment approach appears to have worked well for interviewing caretakers and children aged 10-17 years. We describe several locally defined syndromes: two tam/par/kumu (depression and dysthymia-like syndromes), ma lwor (a mixed anxiety and depression-like syndrome), and a category of conduct problems referred to as kwo maraco/gin lugero. The descriptions of these local syndromes were similar to western mood, anxiety and conduct disorders, but included culture-specific elements.",0,0 +5426,Post-traumatic stress disorder and traumatic brain injury,"Disentangling the effects of ""organic"" neurologic damage and psychological distress after a traumatic brain injury poses a significant challenge to researchers and clinicians. Establishing a link between traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) has been particularly contentious, reflecting difficulties in establishing a unique diagnosis for conditions with overlapping and sometimes contradictory symptom profiles. However, each disorder is linked to a variety of adverse health outcomes, underscoring the need to better understand how neurologic and psychiatric risk factors interact following trauma. Here, we present data showing that individuals with a TBI are more likely to develop PTSD, and that individuals with PTSD are more likely to develop persistent cognitive sequelae related to TBI. Further, we describe neurobiological models of PTSD, highlighting how patterns of neurologic damage typical in TBI may promote or protect against the development of PTSD in brain-injured populations. These data highlight the unique course of PTSD following a TBI and have important diagnostic, prognostic, and treatment implications for individuals with a dual diagnosis.",0,0 +5427,Treatment Improves Symptoms Shared by PTSD and Disordered Eating,"Eating disorders and posttraumatic stress disorder (PTSD) are debilitating conditions that frequently co-occur. Although the two disorders have different clinical presentations, they share associated features, including cognitive disturbances, emotion dysregulation, dissociation, and impulsivity. We hypothesized that reductions in PTSD symptoms following cognitive processing therapy (CPT) and its treatment components (CPT without the written account or the written account only) would be associated with improvements in symptoms common to PTSD and eating disorders. Participants in the current investigation included women with PTSD (N = 65) who reported a history of rape or physical assault, were in a randomized dismantling study of CPT, and completed the Eating Disorder Inventory-2 (EDI-2) at pre- and posttreatment. Latent growth modeling results indicated that decreases in PTSD symptom scores were significantly associated with reductions in the Impulse Regulation, Interoceptive Awareness, Interpersonal Distrust, Ineffectiveness, and Maturity Fears subscales of the EDI-2. Thus, PTSD treatment affected symptoms shared by PTSD and eating disorders. Currently, there are no clear guidelines for treatment of comorbid PTSD and eating disorders. Traditional CPT may impact symptoms common to both, but additional therapy may be needed for specific disordered eating attitudes and behaviors.",0,0 +5428,Predicting the development of posttraumatic stress disorder from the acute response to a traumatic event,"Posttraumatic stress disorder (PTSD) is a psychiatric condition that is directly precipitated by an event that threatens a person's life or physical integrity and that invokes a response of fear, helplessness, or horror. In recent years it has become clear that only a proportion of those exposed to fear-producing events develop or sustain PTSD. Thus, it seems that an important challenge is to elucidate aberrations in the normal fear response that might precipitate trauma-related psychiatric disorder. This paper summarizes the findings from recent studies that examined the acute and longer term biological response to traumatic stress in people appearing to the emergency room immediately following trauma exposure. In the aggregate, these studies have demonstrated increased heart rate and lower cortisol levels at the time of the traumatic event in those who have PTSD at a follow-up time compared to those who do not. In contrast, certain features associated with PTSD, such as intrusive symptoms and exaggerated startle responses, are only manifest weeks after the trauma. The findings suggest that the development of PTSD may be facilitated by an atypical biological response in the immediate aftermath of a traumatic event, which in turn leads to a maladaptive psychological state.",0,0 +5429,"Risk of trauma exposure and posttraumatic stress disorder: An examination of the separate and combined effects of race, gender, and social context","Posttraumatic Stress Disorder (PTSD) is a debilitating psychiatric disorder that affects approximately 7.7 million U.S. adults. A central criterion of a PTSD diagnosis is an exposure to an external traumatic stressor. Yet, surprisingly little research has focused on the role of the larger social context that shapes these exposures. Most PTSD research focuses on the separate effects of individual-level risk factors like gender and race, while the effects of macro-level factors like poverty are primarily used as control variables in regression models. Little is known about how the larger structural environment, and factors like racial residential and economic segregation impact PTSD risk, or whether examining the combined effects of risk factors like race, gender, and poverty might shift our understanding. The primary aims of this dissertation were two-fold: First, a stratified analysis was conducted to provide a fundamental understanding of race differences in trauma exposure/PTSD risk by examining within-group effects of gender, race, and poverty status, both alone and in combination, and testing for between-group differences in these effects. Second, discrete-time analysis and life-tables were used to examine the relationship between PTSD risk and incarceration, an exposure chosen to capture the effects of the U.S. macro-level social context due to its differential impact on the Black population. Study results showed the expected gender differences in PTSD risk. However, considerable variation in the pattern of risk was observed when the effects of race and gender were considered together, finding that African American females experienced greater disorder risk, and that non-Hispanic White males experienced greater risk when poverty status was considered. Prison exposure was found to be a significant predictor of lifetime PTSD, after accounting for the effects and timing of a comprehensive list of traumatic exposures. Race differences in the effect of incarceration exposure on PTSD risk were not found. These dissertation findings have implications for future PTSD research. Notably, these findings suggest that a better accounting of social contextual factors and the combined effects of sociodemographic and socioeconomic factors can improve our understanding of the disorder and those who are at most risk. (PsycINFO Database Record (c) 2015 APA, all rights reserved)",0,0 +5430,Compensation claim lodgement and health outcome developmental trajectories following whiplash injury: A prospective study,"This study aimed to identify distinctive trajectories for pain/disability and posttraumatic stress disorder (PTSD) symptoms following whiplash injury and to examine the effect of injury compensation claim lodgement on the trajectories. In a prospective study, 155 individuals with whiplash were assessed at <1month, 3, 6 and 12months post injury. Outcomes at each time point were Neck Disability Index (NDI) and the Posttraumatic Stress Diagnostic Scale (PDS). Group-based trajectory analytical techniques were used to identify outcome profiles. The analyses were then repeated after including third party compensation claim lodgment as a binary time-changing covariate. Three distinct NDI trajectories were determined: (1) Mild: mild or negligible pain/disability for the entire 12 months (45%), (2) Moderate: initial moderate pain/disability that decreased to mild levels by 3 months (39%) and (3) Chronic-severe: severe pain/disability persisting at moderate/severe levels for 12 months (16%). Three distinct PTSD trajectories were also identified: (1) Resilient: mild symptoms throughout (40%), (2) Recovering: initial moderate symptoms declining to mild levels by 3months (43%) and (3) Chronic moderate-severe: persistent moderate/severe symptoms throughout 12 months (17%). Claim submission had a detrimental effect on all trajectories (p<0.001) except for the Chronic-severe NDI trajectory (p=0.098). Following whiplash injury, there are distinct pathways of recovery for pain/ disability and PTSD symptoms. Management of whiplash should consider the detrimental association of compensation claim with psychological recovery and recovery of those with mild to moderate pain/disability levels. However, claim lodgement has no significant association with a more severe pain and disability trajectory.",1,0 +5431,Quality of life in Croatian Homeland war (1991-1995) veterans who suffer from post-traumatic stress disorder and chronic pain,"The aim of this study was to investigate the quality of life in Croatian homeland war veterans who suffer from post-traumatic stress disorder and chronic low back pain (LBP).A total of 369 participants were included, classified in four study groups: those with post-traumatic stress disorder (PTSD; N = 59), those with both PTSD and lower back pain (PTSD+LBP; N = 80), those with isolated LBP (N = 95) and controls (N = 135). WHOQOL-BREF survey was used in the estimation of quality of life. The data were analysed using statistical methods and hierarchical clustering.The results indicated a general pattern of lowering quality of life in participants with both psychological (PTSD) and physical (LBP) burden. The average overall quality of life was 2.82 ± 1.14 for the PTSD+LBP group, 3.29 ± 1.28 for the PTSD group, 4.04 ± 1.25 for the LBP group and 4.48 ± 0.80 for the controls (notably, all the pair-wise comparisons were significantly different at the level of P < 0.001, except for the pair LBP-controls, which was insignificant). This result indicated that quality of life was reduced for 9.9% in patients with LBP, 26.6% in patients with PTSD and 37.1% in PTSD+LBP, suggesting strong synergistic effect of PTSD and LBP. The analysis also identified several clusters of participants with different pattern of quality of life related outcomes, reflecting the complex nature of this indicator.The results of this study reiterate strong impact of PTSD on quality of life, which is additionally reduced if the patient also suffers from LBP. PTSD remains a substantial problem in Croatia, nearly two decades after the beginning of the 1991-1996 Homeland war.",0,0 +5432,Predictors of temporal patterns of psychiatric distress during 10 years following the nuclear accident at Three Mile Island,"The present study examines psychiatric symptom levels during a 10-year period in a community sample of mothers of young children. All were identified in the early aftermath of the 1979 Three Mile Island nuclear accident, and followed through the accident's 1989 anniversary. Cluster analysis was used to identify long-term distress profiles during the study period; women's temporal profiles were found to be either (a) stable and at low, clinically nonsignificant levels of distress across all measurement points or (b) at consistently elevated, clinically significant levels that varied with the timing of postaccident events such as the restart of the undamaged reactor and the 10th anniversary. Subsequent multivariate analyses indicated that preaccident characteristics, as well as parameters reflecting respondents' initial involvement with, and reactions to the accident, were important for distinguishing between women within the two temporal profile groups. Implications of the results for both policy formulation and continued research on significant environmental stressors is discussed.",0,0 +5433,Post-Traumatic Stress Disorder (PTSD) after Childbirth,"Background There has been discussion about the possible occurrence of post-traumatic stress disorder (PTSD) in mothers after difficult childbirth. Method Four cases with a symptom profile suggestive of PTSD commencing within 48 hours of childbirth are presented. Results The PTSD was in each case associated with the delivery. In each case, there was an associated depressive illness. All four had persistent disorders, and two had difficulties with mother/infant attachment. Conclusion As confirmed by other reports, the prevalence of PTSD associated with childbirth is a matter of concern.",0,0 +5434,Symptoms and Subjective Quality of Life in Post-Traumatic Stress Disorder: A Longitudinal Study,"Evidence suggests that post-traumatic stress disorder (PTSD) is associated with substantially reduced subjective quality of life (SQOL). This study aimed to explore whether and how changes in the levels of PTSD symptom clusters of intrusion, avoidance and hyperarousal are associated with changes in SQOL.Two samples with PTSD following the war in former Yugoslavia were studied, i.e. a representative sample of 530 people in five Balkan countries and a non-representative sample of 215 refugees in three Western European countries. They were assessed on average eight years after the war and re-interviewed one year later. PTSD symptoms were assessed on the Impact of Event Scale - Revised and SQOL on the Manchester Short Assessment of Quality of Life. Linear regression and a two-wave cross lagged panel analysis were used to explore the association between PTSD symptom clusters and SQOL.The findings in the two samples were consistent. Symptom reduction over time was associated with improved SQOL. In multivariable analyses adjusted for the influence of all three clusters, gender and time since war exposure, only changes in hyperarousal symptoms were significantly associated with changes in SQOL. The two-wave cross-lagged panel analysis suggested that the link between hyperarousal symptoms and SQOL is bidirectional.Low SQOL of patients with war-related PTSD is particularly associated with hyperarousal symptoms. The findings suggest a bidirectional influence: a reduction in hyperarousal symptoms may result in improved SQOL, and improvements in SQOL may lead to reduced hyperarousal symptoms.",0,0 +5435,Trauma Signature Analysis of the Great East Japan Disaster: Guidance for Psychological Consequences,"Abstract Objectives On March 11, 2011, Japan experienced the largest earthquake in its history. The undersea earthquake launched a tsunami that inundated much of Japan's eastern coastline and damaged nuclear power plants, precipitating multiple reactor meltdowns. We examined open-source disaster situation reports, news accounts, and disaster-monitoring websites to gather event-specific data to conduct a trauma signature analysis of the event. Methods The trauma signature analysis included a review of disaster situation reports; the construction of a hazard profile for the earthquake, tsunami, and radiation threats; enumeration of disaster stressors by disaster phase; identification of salient evidence-based psychological risk factors; summation of the trauma signature based on exposure to hazards, loss, and change; and review of the mental health and psychosocial support responses in relation to the analysis. Results Exposure to this triple-hazard event resulted in extensive damage, significant loss of life, and massive population displacement. Many citizens were exposed to multiple hazards. The extremity of these exposures was partially mitigated by Japan's timely, expert-coordinated, and unified activation of an evidence-based mental health response. Conclusions The eastern Japan disaster was notable for its unique constellation of compounding exposures. Examination of the trauma signature of this event provided insights and guidance regarding optimal mental health and psychosocial responses. Japan orchestrated a model response that reinforced community resilience. ( Disaster Med Public Health Preparedness . 2013;0:1-14)",0,0 +5436,DSM–5 posttraumatic stress disorder symptoms associated with suicide behaviors in veterans.,"A connection between suicidality and posttraumatic stress disorder (PTSD) has been consistently demonstrated; however, the underlying relationship between suicidality and PTSD remains unclear. The aim of this study was to examine patterns of DSM-5 PTSD symptom endorsement that differentiated veteran participants with and without a history of suicide behaviors. We enrolled 95 veterans, 32 of whom reported no suicide ideation (SI) or suicide attempts (SA). The 63 remaining participants reported a history of SI, with 28 of the 63 also reporting a historical SA. Participants completed a standardized diagnostic interview (Structured Clinical Interview for DSM-IV-TR; First, Spitzer, Gibbon, & Williams, 2002), structured interview of suicidal behaviors (Columbia-Suicide Severity Rating Scale; Posner et al., 2011), and selected clinical measures. Veterans who reported SI and/or SA were more likely to meet criteria for PTSD on DSM-5 than were veterans who reported neither SI nor SA. Participants who reported SA were more likely to meet criteria for clusters C and D. Finally, at the symptom level, those who reported SI were more likely to report experiencing feelings of alienation. Those who reported a SA were more likely to report avoidance of thoughts and feelings, inability to recall an important aspect of their trauma, persistent negative beliefs, diminished interest, and feelings of alienation. These findings suggest that targeting specific symptoms of PTSD may aid in treatment of suicidal thoughts and behaviors associated with PTSD.",0,0 +5437,Service use patterns and mental health symptoms among adolescents exposed to multiple types of trauma,"Few studies have explored how different trauma experiences influence service use. This study explores patterns of service use amongst 6483 adolescents aged between 13 and 18, and examines if such patterns are associated with trauma profiles, demographic variables, and mental health disorders. Data from the National Comorbidity Survey--Adolescent Supplement (NCS-A) were used. A latent class analysis identified four adolescent trauma sub-groups: 'high risk', 'sexual risk' 'non-sexual risk', and 'low risk'. Regression analysis was used to explore the relationship between service use, trauma classes, and mental health outcomes. Significant relationships were found between service use, trauma sub-groups, demographics and mental health outcomes. Despite the effectiveness of mental health services, only a minority of adolescents exposed to different traumas use such resources. However, this study may go some way towards providing an understanding of the trauma backgrounds, demographic predictors and mental health disorders associated with service use.",0,0 +5438,Exposure to Political Conflict and Violence and Posttraumatic Stress in Middle East Youth: Protective Factors,"We examine the role of family- and individual-level protective factors in the relation between exposure to ethnic-political conflict and violence and posttraumatic stress among Israeli and Palestinian youth. Specifically, we examine whether parental mental health (lack of depression), positive parenting, children's self-esteem, and academic achievement moderate the relation between exposure to ethnic-political conflict/violence and subsequent posttraumatic stress (PTS) symptoms. We collected three waves of data from 901 Israeli and 600 Palestinian youths (three age cohorts: 8, 11, and 14 years old; approximately half of each gender) and their parents at 1-year intervals. Greater cumulative exposure to ethnic-political conflict/violence across the first 2 waves of the study predicted higher subsequent PTS symptoms even when we controlled for the child's initial level of PTS symptoms. This relation was significantly moderated by a youth's self-esteem and by the positive parenting received by the youth. In particular, the longitudinal relation between exposure to violence and subsequent PTS symptoms was significant for low self-esteem youth and for youth receiving little positive parenting but was non-significant for children with high levels of these protective resources. Our findings show that youth most vulnerable to PTS symptoms as a result of exposure to ethnic-political violence are those with lower levels of self-esteem and who experience low levels of positive parenting. Interventions for war-exposed youth should test whether boosting self-esteem and positive parenting might reduce subsequent levels of PTS symptoms.",0,0 +5439,"Resilience, Trauma, Context, and Culture","This article reviews the relationship between factors associated with resilience, and aspects of the individual’s social ecology (environment) that promote and protect against the negative impact of exposure to traumatic events. It is shown that the Environment × Individual interactions related to resilience can be understood using three principles: (1) Resilience is not as much an individual construct as it is a quality of the environment and its capacity to facilitate growth (nurture trumps nature); (2) resilience looks both the same and different within and between populations, with the mechanisms that predict positive growth sensitive to individual, contextual, and cultural variation (differential impact); and (3) the impact that any single factor has on resilience differs by the amount of risk exposure, with the mechanisms that protect against the impact of trauma showing contextual and cultural specificity for particular individuals (cultural variation). A definition of resilience is provided that highlights the need for environments to facilitate the navigations and negotiations of individuals for the resources they need to cope with adversity. The relative nature of resilience is discussed, emphasizing that resilience can manifest as either prosocial behaviors or pathological adaptation depending on the quality of the environment.",0,0 +5440,Predicting Posttraumatic Distress in Hospitalized Trauma Survivors With Acute Injuries,"Each year approximately 2.5 million Americans are hospitalized after sustaining traumatic physical injuries. Few investigations have comprehensively screened for posttraumatic symptomatic distress or identified predictors of posttraumatic stress disorder (PTSD) in representative samples of surgical inpatients.The subjects were 101 randomly selected survivors of motor vehicle crashes or assaults who were interviewed while hospitalized and 1, 4, and 12 months after injury. In the surgical ward, inpatients were screened for PTSD, depressive, and dissociative symptoms, for prior trauma, for pre-event functioning, and for alcohol and drug intoxication. Patient demographic and injury characteristics were also recorded. Random coefficient regression models were used to assess the association between these clinical, injury, and demographic characteristics and PTSD symptom levels over the year after the injury.Of the 101 surgical inpatients, 73% screened positive for high levels of symptomatic distress and/or substance intoxication. At 1, 4, and 12 months after the injury, 30%-40% reported symptoms consistent with a diagnosis of PTSD. High ward PTSD symptom levels were the strongest and most parsimonious predictor of persistent symptoms over the course of the year. Greater prior trauma, stimulant intoxication, and female gender were also associated with higher symptom levels. Increasing injury severity, however, was not associated with higher PTSD symptom levels.Clinical and demographic characteristics readily identifiable at the time of surgical inpatient hospitalization predict PTSD symptoms over the year after injury. Effectiveness trials that test screening and intervention procedures for at-risk inpatients should be developed.",0,0 +5441,Sexual Orientation and Gender Identity/Expression Related Peer Victimization in Adolescence: A Systematic Review of Associated Psychosocial and Health Outcomes,"This article reviews research on psychosocial and health outcomes associated with peer victimization related to adolescent sexual orientation and gender identity or expression. Using four electronic databases and supplementary methods, we identified 39 relevant studies. These studies were published between 1995 and 2012 and conducted in 12 different countries. The studies were diverse in terms of their approaches to sampling participants, assessing participants' sexual orientation, operationalizing peer victimization, and with regard to the psychosocial and health outcomes studied in relation to peer victimization. Despite the methodological diversity across studies, there is fairly strong evidence that peer victimization related to sexual orientation and gender identity or expression is associated with a diminished sense of school belonging and higher levels of depressive symptoms; findings regarding the relationship between peer victimization and suicidality have been more mixed. Peer victimization related to sexual orientation and gender identity or expression is also associated with disruptions in educational trajectories, traumatic stress, and alcohol and substance use. Recommendations for future research and interventions are discussed.",0,0 +5442,Turn on and tune in to evidence-based psychedelic research,"For many people, words such as psychedelic and LSD (lysergic acid diethylamide) refer only to dangerous drugs of abuse. Less well known is that tens of thousands of patients were treated effectively with psychedelic drugs in the 1950s and 1960s,1 and that these drugs had almost become part of mainstream medicine by the time they became demonised and research was halted for 40 years.",0,0 +5443,Psychometric properties of the PTSD checklist (PCL),"The psychometric properties of the PTSD Checklist (PCL), a new, brief, self-report instrument, were determined on a population of 40 motor vehicle accident victims and sexual assault victims using diagnoses and scores from the CAPS (Clinician Administered PTSD Scale) as the criteria. For the PCL as a whole, the correlation with the CAPS was 0.929 and diagnostic efficiency was 0.900 versus CAPS. Examination of the individual items showed wide ranging values of individual item correlations ranging from 0.386 to 0.788, and with diagnostic efficiencies of 0.700 or better for symptoms. We support the value of the PCL as a brief screening instrument for PTSD.",0,0 +5444,Longitudinal investigation of interpersonal trauma exposure and alcohol use trajectories,"The current longitudinal study examined associations between interpersonal potentially traumatic events (PTEs; i.e., sexual or physical assault) and changes in alcohol consumption among incoming college students.1197 students (68% female) participating in a university-wide research study were included in analyses. Assessments were administered at three time-points and included measures of alcohol use, PTEs (Life Events Checklist), and a screener for possible PTSD symptoms (abbreviated Primary Care PTSD Screen). Linear growth curve models were fit to the three repeated measures of alcohol quantity and frequency to determine the role of pre-college and college-onset interpersonal PTEs and possible PTSD symptoms on patterns of alcohol use.Pre-college interpersonal PTE was associated with greater baseline alcohol use for female but not male students. College-onset interpersonal PTE predicted greater alcohol use at concurrent and future assessments for women but not men, beyond the effects of pre-college PTE. Pre-college possible PTSD symptoms did not predict baseline or change in alcohol use.There may be a stronger and longer-lasting impact of interpersonal PTE for college women compared to men on alcohol phenotypes, although replication in studies oversampling men endorsing interpersonal PTE is needed.",0,0 +5445,"Posttraumatic Stress Disorder in Adults: Impact, Comorbidity, Risk Factors, and Treatment","During the last 30 years, there has been a substantial increase in the study of posttraumatic stress disorder (PTSD). Several high-profile traumatic events, such as the wars in Afghanistan and Iraq, and the terrorist attacks of September 11 on the World Trade Center, have led to a greater public interest in the risk and protective factors for PTSD. In this In Review paper, I discuss some of the important advances in PTSD. The paper provides a concise review of the evolution of PTSD diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, impact of PTSD in the community, an overview of the established risk factors for developing PTSD, and assessment and treatment. Throughout the paper, controversies and clinical implications are discussed.",0,0 +5446,Exposure to high stress in the intensive care unit may have negative effects on health-related quality-of-life outcomes after cardiac surgery,"Up to 20% of patients do not show improvements in health-related quality of life (HRQL) after cardiac surgery, despite apparently successful surgical procedures. We sought to determine whether failed improvements in HRQL after cardiac surgery are associated with the development of traumatic memories and chronic stress states as a result of high perioperative stress exposure.Prospective cohort study.A 10-bed cardiovascular intensive care unit of a tertiary care university hospital.A total of 148 cardiac surgical patients.None.The patients were evaluated for traumatic memories from postoperative treatment in the cardiovascular intensive care unit (defined as the subjective recollection of pain, respiratory distress, anxiety/panic, and nightmares), symptoms of chronic stress, including those of posttraumatic stress disorder, and HRQL preoperatively (at baseline) and at 6 months after cardiac surgery. A state of chronic stress was defined as the development of posttraumatic stress disorder at 6 months after surgery. Factors predicting the decline in HRQL were determined by multivariable linear regression. Twenty-seven patients (18.2%) had posttraumatic stress disorder at 6 months after cardiac surgery; seven of these patients (4.8%) had evidence of preexisting posttraumatic stress disorder before undergoing cardiac surgery. Patients with new posttraumatic stress disorder at 6 months after cardiac surgery had a significantly higher number of traumatic memories from postoperative treatment in the cardiovascular intensive care unit (p =.01). A multiple regression model included the number of traumatic memories from the intensive care unit and stress symptom scores at 6 months after heart surgery as predictors for variations in physical HRQL outcome scores (R2 =.30, p <.04). Stress symptom scores were the most significant predictors of mental health HRQL outcomes (R2 =.52, p <.01).Exposure to high stress in the cardiovascular intensive care unit can have negative effects on HRQL outcomes of cardiac surgery.",0,0 +5447,Ten years after the genocide: Trauma confrontation and posttraumatic stress in Rwandan adolescents,"A decade after the 1994 Rwandan genocide, we interviewed a total of 68 Rwandan orphans about their war experiences and posttraumatic stress disorder (PTSD) symptoms. The two samples comprised youth living either in a child-headed household (CHH) or in an orphanage. All had been exposed to extreme levels of violence and 41% had witnessed the murder of their own mother or father. Of the sample, 44% had PTSD. PTSD vulnerability was greater for youth who at the time of the study lived in CHH than those in an orphanage; it was also higher in those aged 8 to 13 during the outbreak of the genocide than those aged 3 to 7 at the time. Furthermore, a significant relationship was found between the number of traumatic experiences and subsequent stress responses.",0,0 +5448,COMMUNITY NEEDS AMONG SERVICE MEMBERS AFTER RETURN FROM COMBAT DEPLOYMENT,"To build on research concerning the development of postdeployment community-based programs, we surveyed active duty soldiers from two Brigade Combat Teams (N = 693; N = 1,385) after return from a combat deployment. The Brigade Combat Teams were located on different installations in rural areas representing 2 large military communities. The survey included an assessment about a range of community services (social events, cultural integration opportunities, family, chaplain, and mental health services, etc.). We also examined whether ratings of services varied as a function of Posttraumatic Stress Disorder symptoms, deployment experiences, organizational leadership and support, and attitudinal variables related to mental health. Differences in ratings between the 2 communities suggest the measure detected perceptions of community needs that are idiosyncratic to the particular community, and may be useful for informing program planning and service needs.",0,0 +5449,Mental Health Care Needs among Recent War Veterans,"Fifteen percent or more of some populations of veterans of the Vietnam War and the 1991 Gulf War have received diagnoses of post-traumatic stress disorder (PTSD).1,2 Given this history and the fact that U.S. troops in Iraq and Afghanistan are serving for prolonged periods in a hazardous combat environment, we expect the mental health care needs of our newest veterans to be great. In a survey of 3671 Army soldiers and Marines who were involved in combat in Iraq and Afghanistan, up to 17 percent of those returning reported symptoms consistent with major depression, generalized anxiety, or PTSD.3 Since . . .",0,0 +5450,"Commentary: Key Issues, Concluding Thoughts, and Future Directions for the Study of Trauma and Child Health","Although the majority of children experience at leastone potentially traumatic event (PTE) by adolescence(Copeland, Keeler, Angold, & Costello, 2007;Costello, Erkanli, Fairbank, & Angold, 2002), previ-ous research offered little empirical foundation or con-ceptual guidance regarding relationships betweentrauma and child health. The papers included in thisSpecial Issue collectively offer informed directions andillustrate excellent examples of programs of researchseeking to elucidate the complex associations betweenchild traumatic stress and physical health. Preliminaryfindings and theoretical advances presented through-out this Special Issue underscore the importance ofcontinued efforts on this front.In the sections below, we consider each group ofstudies in this Special Issue, highlighting their key con-tributions. We also reflect on this Special Issue and of-fer recommendations for advancing science andpractice in this important area of child health.Maltreatment and VictimizationThe consequences of child maltreatment and victimiza-tion are a serious public health concern. Millions ofchildren experience maltreatment and victimization ev-ery year. Over 679,000 cases of abuse were confirmedin the United States in 2013 alone (U.S. Department ofHealth and Human Services & on Children, 2013), androughly 15–30% of youth report experiencing peer vic-timization (i.e., receiving physical or psychologicalharm from peers; Dinkes, Cataldi, Lin-Kelly, S Luxenberg, Limber, & Olweus, 2014).The considerable negative mental health consequencesof maltreatment and victimization are well documented(Banyard, Williams & Siegel, 2001; De Bellis et al.,2002; Landoll et al., 2015; Widom, Czaja, Wilson,Allwood, & Chauhan, 2013), but the impact of mal-treatment and victimization on child health are only be-ginning to be understood (Sachs-Ericsson, Blazer, Plant,A Springer, Sheridan, Kuo, & Carnes,2007). Several articles in this Special Issue build on thisimportant literature and reflect considerable progress inunderstanding key relationships between maltreatmentand victimization and child health.Importantly, it is currently unclear when adversephysical health effects of childhood maltreatment andvictimization emerge. Research has primarily focusedon the relationship between maltreatment and victimi-zation and adult health conditions (Afifi, Mota,MacMillan, & Sareen, 2013, Goodwin, Hoven,Murison, & Hotopf, 2003; Springer et al., 2007;seeArias, 2004 for a review). In a rare exception, in this is-sue, Gooding, Milliren, Austin, Sheridan, andMcLaughlin (2015) compared arterial pressure and cir-culation in adolescents who reported abuse with thosewho did not, and found that abused youth had higherresting diastolic blood pressure and blunted diastolicand systolic blood pressure reactivity to laboratorystressors. This study contributes to a growing body ofliterature documenting that the health effects of mal-treatment and victimization are evident in childhood(McLaughlin, Sheridan, Alves, & Mendes, 2014).An important next step is to understand whetherspecific types of maltreatment and victimization placeyouth at differential risk for adverse health outcomes.Past research has largely focused on the general impact",0,0 +5451,Changes in trauma-potentiated startle with treatment of posttraumatic stress disorder in combat Veterans,"Emotional Processing Theory proposes that habituation to trauma-related stimuli is an essential component of PTSD treatment. However, the mechanisms underlying treatment-related habituation are not well understood. We examined one psychophysiological measure that holds potential for elucidating the biological processes involved in treatment response: trauma-potentiated startle response. Seventeen OEF/OIF combat Veterans participated in the study and completed three assessments using a trauma-potentiated startle paradigm over PTSD treatment. Results revealed different patterns of trauma-potentiated startle across treatment for responders and nonresponders, but no differences in within task habituation. Responders showed an increase followed by a decrease in trauma-potentiated startle, whereas nonresponders showed a relatively flat response profile. Results suggested that PTSD patients who engage with emotional content as demonstrated by greater startle reactivity may be more likely to respond to PTSD treatment. Furthermore, trauma-potentiated startle shows promise as an objective measure of psychophysiological responses involved in PTSD recovery.",0,0 +5452,Support for a novel five-factor model of posttraumatic stress symptoms in three independent samples of Iraq/Afghanistan veterans: A confirmatory factor analytic study,"A large body of confirmatory factor analytic studies of posttraumatic stress disorder (PTSD) symptoms has demonstrated the superiority of 4-factor dysphoria and emotional numbing models over the DSM-IV model. Recently, a novel 5-factor model, which separates the DSM-IV hyperarousal symptom cluster into distinct dysphoric and anxious arousal clusters, has been identified. However, little research has evaluated the best-fitting representation of PTSD symptoms in veterans of the Iraq and Afghanistan wars.Confirmatory factor analyses were used to examine the factor structure of the PTSD Checklist in three independent samples of Iraq/Afghanistan veterans, including two community samples and a treatment-seeking sample.In all three samples, a novel model with five correlated factors reflecting symptoms of re-experiencing, avoidance, emotional numbing, dysphoric arousal, and anxious arousal provided a significantly better representation of PTSD symptoms than the DSM-IV, dysphoria, and numbing models. This model also showed evidence of ""excellent fit"" in the community samples according to empirically-defined benchmarks.These findings suggest that PTSD symptomatology in both community and treatment-seeking Iraq/Afghanistan veterans may be best represented by a 5-factor model that separates the DSM-IV PTSD hyperarousal symptom cluster into distinct dysphoric arousal and anxious arousal clusters.",0,0 +5453,Effects of early life trauma on affective executive control and white matter integrity in veterans with and without PTSD,"Background: Prior studies have illustrated the impact of early life trauma (ELT) and adult onset PTSD on affective executive control. We aimed at examining the interaction between a history of ELT and current PTSD diagnosis on performance on an affective executive control task and white matter integrity. Methods: 225 Veterans from TRACTS of the VABHS were grouped for current PTSD diagnosis (PTSD+ = 134 / PTSD- = 91) and for a history of ELT (ELT+ = 65, ELT- = 160). All subjects performed the Affective Go/No-Go task of the CANTAB and errors, as well as reaction time, were the variables of interest. Participants also underwent a diffusion-tensor imaging scan. Results: There was no significant interaction between ELT and PTSD on AGN. ELT+ subjects showed a significantly greater number of errors on the AGN [F (1,219) = 8.46, p. < .004]. There was no main effect of ELT on FA, however there was a significant interaction (p. <.05, corrected) between ELT and reaction time on FA for both positive (widespread clusters) and negative targets (left cingulate bundle). Conclusions: PTSD diagnosis is not associated with impaired performance in our study, though individuals with a history of ELT showed greater number of errors across both positive and negative valence. The interaction between FA and reaction time in the ELT group suggests altered neurodevelopmental trajectories leading to potential deficits in behavior. This may constitute a risk factor for later psychopathology.",0,0 +5454,Suicidality and posttraumatic stress disorder (PTSD) in adolescents: a systematic review and meta-analysis,"Purpose: There is growing evidence in the literature that a diagnosis of Posttraumatic Stress Disorder (PTSD) is an important contributory factor to suicidality in adolescents. However, there is no existing review of the literature examining the relationship between PTSD and suicidality in adolescents. This study aims to provide the first systematic review and meta-analysis of the association between PTSD and suicidality in adolescents. Methods: Five bibliographic databases (Medline, EMBASE, PsycINFO, Web of Science and PILOT) were screened for suitable articles. Twenty-eight studies (which provided 28 independent samples) were included in the review. The overall meta-analyses of the association between PTSD and suicidality were followed by subgroup and meta-regression analyses. Results: A highly significant positive association was found between PTSD and suicidality (d = 0.701, 95 % CI 0.555-0.848). The subgroup and meta-regression analyses showed that the association between PTSD and suicidality persisted whilst adjusting for various sources of between-study heterogeneity, such as, different levels of severity of suicidality, target groups, and methodological quality of the studies. Conclusions: Suicidality in adolescents with PTSD is a major problem which requires further research effort. The implications of these results are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0,0 +5455,"Conditioned Fear Associated Phenotypes as Robust, Translational Indices of Trauma-, Stressor-, and Anxiety-Related Behaviors","Posttraumatic stress disorder (PTSD) is a heterogeneous disorder that affects individuals exposed to trauma (e.g., combat, interpersonal violence, and natural disasters). It is characterized by hyperarousal, intrusive reminders of the trauma, avoidance of trauma-related cues, and negative cognition and mood. This heterogeneity indicates the presence of multiple neurobiological mechanisms underlying the development and maintenance of PTSD. Fear conditioning is a robust, translational experimental paradigm that can be employed to elucidate these mechanisms by allowing for the study of fear-related dimensions of PTSD (e.g., fear extinction, fear inhibition, and generalization of fear) across multiple units of analysis. Fear conditioning experiments have identified varying trajectories of the dimensions described, highlighting exciting new avenues of targeted, focused study. Additionally, fear conditioning studies provide a translational platform to develop novel interventions. The current review highlights the versatility of fear conditioning paradigms, the implications for pharmacological and non-pharmacological treatments, the robustness of these paradigms to span an array of neuroscientific measures (e.g., genetic studies), and finally the need to understand the boundary conditions under which these paradigms are effective. Further understanding these paradigms will ultimately allow for optimization of fear conditioning paradigms, a necessary step towards the advancement of PTSD treatment methods.",0,0 +5456,A Pilot Trial of Telephone-Based Collaborative Care Management for PTSD Among Iraq/Afghanistan War Veterans,"Collaborative care and care management are cornerstones of Primary Care-Mental Health Integration (PC-MHI) and have been shown to reduce depressive symptoms. Historically, the standard of Veterans Affairs (VA) collaborative care was referring patients with posttraumatic stress disorder (PTSD) to specialty care. Although referral to evidence-based specialty care is ideal, many veterans with PTSD do not receive such care. To address this issue and reduce barriers to care, VA currently recommends veterans with PTSD be offered treatment within PC-MHI as an alternative. The current project outlines a pilot implementation of an established telephone-based collaborative care model-Translating Initiatives for Depression into Effective Solutions (TIDES)-adapted for Iraq/Afghanistan War veterans with PTSD symptoms (TIDES/PTSD) seen in a postdeployment primary care clinic.Structured medical record extraction and qualitative data collection procedures were used to evaluate acceptability, feasibility, and outcomes.Most participants (n=17) were male (94.1%) and white (70.6%). Average age was 31.2 (standard deviation=6.4) years. TIDES/PTSD was successfully implemented within PC-MHI and was acceptable to patients and staff. Additionally, the total number of care manager calls was positively correlated with number of psychiatry visits (r=0.63, p<0.05) and amount of reduction in PTSD symptoms (r=0.66, p<0.05). Overall, participants in the pilot reported a significant reduction in PTSD symptoms over the course of the treatment (t=2.87, p=0.01).TIDES can be successfully adapted and implemented for use among Iraq/Afghanistan veterans with PTSD. Further work is needed to test the effectiveness and implementation of this model in other sites and among veterans of other eras.",0,0 +5457,Enhancing self-report assessment of PTSD: Development of an item bank,"The authors report results of work to enhance self-report posttraumatic stress disorder (PTSD) assessment by developing an item bank for use in a computer-adapted test. Computer-adapted tests have great potential to decrease the burden of PTSD assessment and outcomes monitoring. The authors conducted a systematic literature review of PTSD instruments, created a database of items, performed qualitative review and readability analysis, and conducted cognitive interviews with veterans diagnosed with PTSD. The systematic review yielded 480 studies in which 41 PTSD instruments comprising 993 items met inclusion criteria. The final PTSD item bank includes 104 items representing each of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association [APA], 1994), PTSD symptom clusters (reexperiencing, avoidance, and hyperarousal), and 3 additional subdomains (depersonalization, guilt, and sexual problems) that expanded the assessment item pool.",0,0 +5458,"The natural history of recovery for the healthcare provider ""second victim"" after adverse patient events","When patients experience unexpected events, some health professionals become ""second victims"". These care givers feel as though they have failed the patient, second guessing clinical skills, knowledge base and career choice. Although some information exists, a complete understanding of this phenomenon is essential to design and test supportive interventions that achieve a healthy recovery.The purpose of this article is to report interview findings with 31 second victims. After institutional review board approval, second victim volunteers representing different professional groups were solicited for private, hour-long interviews. The semistructured interview covered demographics, participant recount of event, symptoms experienced and recommendations for improving institutional support. After interviews, transcripts were analyzed independently for themes, followed by group deliberation and reflective use with current victims.Participants experienced various symptoms that did not differ by sex or professional group. Our analysis identified six stages that delineate the natural history of the second victim phenomenon. These are (1) chaos and accident response, (2) intrusive reflections, (3) restoring personal integrity, (4) enduring the inquisition, (5) obtaining emotional first aid and (6) moving on. We defined the characteristics and typical questions second victims are desperate to have answered during these stages. Several reported that involvement in improvement work or patient safety advocacy helped them to once again enjoy their work.We now believe the post-event trajectory is largely predictable. Institutional programs could be developed to successfully screen at-risk professionals immediately after an event, and appropriate support could be deployed to expedite recovery and mitigate adverse career outcomes.",0,0 +5459,The longitudinal course of PTSD among disaster workers deployed to the World Trade Center following the attacks of September 11th,"This study examined the long-term mental health outcomes of 2,960 nonrescue disaster workers deployed to the World Trade Center site in New York City following the September 11, 2001 (9/11) terrorist attacks. Semistructured interviews and standardized self-report measures were used to assess the prevalence of posttraumatic stress disorder (PTSD) and other psychopathology 4 and 6 years after the attacks. Clinician-measured rates of PTSD and partial PTSD 4-years posttrauma were 8.4% and 8.9%, respectively, in a subsample of 727 individuals. Rates decreased to 5.8% and 7.7% for full and partial PTSD 6 years posttrauma. For the larger sample, self-report scores revealed probable PTSD and partial PTSD prevalence to be 4.8% and 3.6% at 4 years, and 2.4% and 1.8% at 6 years. Approximately 70% of workers never met criteria for PTSD. Although PTSD rates decreased significantly over time, many workers remained symptomatic, with others showing delayed-onset PTSD. The strongest predictors of ongoing PTSD 6 years following 9/11 were trauma history (odds ratio (OR) = 2.27, 95% confidence interval (CI) [1.06, 4.85]); the presence of major depressive disorder 1-2 years following the trauma (OR = 2.80, 95% CI [1.17, 6.71]); and extent of occupational exposure (OR = 1.31, 95% CI [1.13, 1.51]). The implications of the findings for both screening and treatment of disaster workers are discussed.",0,0 +5460,Resiliencia en adultos: una revisión teórica,"The objective of this study is to make a theoretical review on resilience in adults between the year 2000 and 2011. A search of papers published in the databases Scopus, PsycInfo, Psicodoc, Web of Science and summaries Dialnet and ISOC (Social Sciences and Humanities) was performed. In total, 418 items were found that met the inclusion criteria. We conclude that in the studies published between 200 and 2011 on resilience in adults prevail cross-sectional studies, published in English, quantitative, and using samples from USA. Resilience is related psychological disorders. It is emphasized the need to include resilience in health education programs to improve ways of coping in the context of risk and adversity.",0,0 +5461,PTSD Symptom Patterns Following Traumatic and Nontraumatic Events,"This study extends research examining posttraumatic stress disorder symptoms following different types of potentially traumatic events. Specifically, the study examined and compared the symptom patterns observed in those who suffered a major accident, the unexpected death of a loved one, or sexual assault. Based on recent findings, this project also examines those who reported nontraumatic (but stressful) events, as well as comparing symptom patterns across gender. Findings suggest different types of traumas might be associated with differences in severity and patterns of symptoms for women (but not for men), suggesting symptom patterns manifest differently in men and women. Results also call into question the assumption that traumatic events demonstrate different symptom patterns than other types of events.",0,0 +5462,Unique PTSD Clusters Predict Intention to Seek Mental Health Care and Subsequent Utilization in US Veterans with PTSD Symptoms,"Many veterans return from deployment with posttraumatic stress disorder (PTSD), but most attend only a limited number of mental health care visits. Although global PTSD relates to seeking mental health care, it is unclear whether specific features of PTSD inform the low rates of mental health care utilization. This study examined PTSD cluster severities of avoidance, reexperiencing, dysphoria, and hyperarousal as predictors of intention to seek mental health care and prospective treatment utilization. US veterans with at least subthreshold PTSD (N = 189) completed a PTSD symptom measure and indicated whether they intended to seek mental health care. Prospective Department of Veterans Affairs mental health care utilization was extracted from the medical record. At the bivariate level, each cluster was positively associated with a positive intention to seek mental health care and prospective treatment utilization. In multivariate models, however, dysphoria severity (OR = 1.16, 95% CI [1.06, 1.26]) was uniquely and positively correlated with intention to seek mental health care, whereas higher avoidance severity (IRR = 0.86, 95% CI [0.76, 0.98]) predicted lower treatment utilization, and higher reexperiencing severity (IRR = 1.07, 95% CI [1.01, 1.14]) predicted greater treatment utilization. It is critical to tailor interventions to target specific features of PTSD and to meet patients where they are.",0,0 +5463,Association of Symptoms Following Mild Traumatic Brain Injury With Posttraumatic Stress Disorder vs Postconcussion Syndrome,"A proportion of patients experience long-lasting symptoms following mild traumatic brain injury (MTBI). The postconcussion syndrome (PCS), included in the DSM-IV, has been proposed to describe this condition. Because these symptoms are subjective and common to other conditions, there is controversy whether PCS deserves to be identified as a diagnostic syndrome.To assess whether persistent symptoms 3 months following head injury are specific to MTBI or whether they are better described as part of posttraumatic stress disorder (PTSD).We conducted a prospective cohort study of injured patients recruited at the adult emergency department of the University Hospital of Bordeaux from December 4, 2007, to February 25, 2009.At 3-month follow-up, we compared the prevalence and risk factors for PCS and PTSD. Multiple correspondence analyses were used to assess clustering of symptoms and their associations with the type of injury.We included 534 patients with head injury and 827 control patients with other nonhead injuries. Three months following the trauma, 21.2% of head-injured and 16.3% of nonhead-injured patients fulfilled the DSM-IV diagnosis of PCS; 8.8% of head-injured patients fulfilled the diagnostic criteria for PTSD compared with 2.2% of control patients. In multivariate analysis, MTBI was a predictor of PTSD (odds ratio, 4.47; 95% CI, 2.38-8.40) but not of PCS (odds ratio, 1.13; 95% CI, 0.82-1.55). Correspondence analysis suggested that symptoms considered part of PCS behave similarly to PTSD symptoms in the hyperarousal dimension. None of these 22 symptoms showed any pattern of clustering, and no clear proximity with head or nonhead injury status could be found.Persistent subjective symptoms frequently reported 3 months after MTBI are not specific enough to be identified as a unique PCS and should be considered part of the hyperarousal dimension of PTSD.",0,0 +5464,The social readjustment rating scale,"IN PREVIOUS studies [l] it has been established that a cluster of social events requiring change in ongoing life adjustment is significantly associated with the time of illness onset. Similarly, the relationship of what has been called ‘life stress,’ ‘emotional stress,’ ‘object loss,’ etc. and illness onset has been demonstrated by other investigations [2-131. It has been adduced from these studies that this clustering of social or life events achieves etiologic significance as a necessary but not sufficient cause of illness and accounts in part for the time of onset of disease. Methodologically, the interview or questionnaire technique used in these studies has yielded only the number and types of events making up the cluster. Some estimate of the magnitude of these events is now required to bring greater precision to this area of research and to provide a quantitative basis for new epidemiological studies of diseases. This report defines a method which achieves this requisite. METHOD",0,0 +5465,Psychophysiology of structural imagery in post-traumatic stress disorder.,"Discusses psychophysiological symptoms associated with posttraumatic stress disorder (PTSD), noting that an approach to PTSD involving a brain model can account for the paradoxical nature of disconnections of cognitive and affective processing in response to severe stress. The structural-imagery approach to PTSD capitalizes on the natural capacity of the equilibrium and nonequilibrium seeking processes of the unconscious brain and conscious mind to overcome the functional disconnection syndromes associated with extreme stress. A case example of a male accident victim suffering from an acute post-traumatic stress reaction is presented. (33 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5466,Psychiatry of whiplash neck injury,"The psychiatric outcome of whiplash neck injury is controversial.To describe outcomes and predictors as compared with other types of road accident injury.Consecutive emergency department attenders (n=1148; whiplash 278) assessed by self-report at baseline, 3 months, 1 year and 3 years.Moderate to severe pain was reported by 27% of whiplash sufferers at 1 year and by 30% at 3 years. Psychiatric consequences were common and persistent. Whiplash victims and those with bony injury were more likely to seek compensation. Accident and early post-accident psychosocial variables predicted the pain at 1 year. Claiming compensation at 3 months predicted the pain at 1 year for those with whiplash or bony injury.There is no special psychiatry of whiplash neck injury. Psychological variables and consequences are important following whiplash in a similar manner to other types of injury.",0,0 +5467,Helium Inhalation in Adolescents: Characteristics of Users and Prevalence of Use,"Although helium-related fatalities and concerns about potentially harmful effects of helium use have increased in recent years, virtually nothing is known about the epidemiology of helium inhalation in adolescents. This exploratory investigation examined the prevalence and correlates of helium inhalation in a large sample of at-risk youth. Study participants were 723 Missouri adolescents (M age = 15.5, SD = 1.2) in residential treatment for delinquent behavior. More than one-in-nine (N = 81, 11.5%) adolescents had inhaled helium with the intention of getting high, and one-third (N = 27, 34.2%) of helium users reported they actually did get high when they inhaled helium. Helium users were significantly more likely to be Caucasian, to live in rural/small town areas, and to have histories of mental illness, auditory hallucinations, and alcohol and marijuana use than nonusers. Helium users also reported significantly more current psychiatric distress, suicidality, traumatic life experiences, and antisocial attitudes, traits, and behaviors than nonusers. Helium inhalation was prevalent in this sample and many such users reported getting high while using helium. Helium users had psychosocial profiles similar to those of volatile solvent users, suggesting that they may be at substantial risk for a variety of adverse health outcomes.",0,0 +5468,"PTSD and TBI co-morbidity: Scope, clinical presentation and treatment options","Primary objective: To summarize the literature on post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) and their co-morbidity, focusing on diagnosis, clinical symptoms and treatment issues relevant to the clinician.Research design: Review of the literature.Methods and procedures: Pubmed searches were performed using the terms post-traumatic stress disorder, traumatic brain injury, sleep, cognitive, depression, anxiety, treatment and combinations of these terms. Those articles relevant to the objective were included.Main outcomes and results: This study presents pathophysiological, neuroimaging and clinical data on co-morbid PTSD and TBI. It reviews associated conditions, emphasizing the impact of cognitive and sleep problems. It summarizes the emerging literature on treatment effectiveness for co-morbid PTSD and TBI, including psychotherapy, pharmacotherapy and cognitive rehabilitation.Conclusions: Both PTSD and TBI commonly occur in the general population, both share some pathophysiological characteristics and both are associated with cognitive impairment and sleep disruption. PTSD and TBI present with a number of overlapping symptoms, which can lead to over-diagnosis or misdiagnosis. Both conditions are associated with co-morbidities important in diagnosis and treatment planning. More research is needed to elucidate what treatments are effective in PTSD and TBI co-morbidity and on factors predictive of treatment success.",0,0 +5469,Working memory training with tDCS improves behavioral and neurophysiological symptoms in pilot group with post-traumatic stress disorder (PTSD) and with poor working memory,"This pilot study investigated the feasibility of treating people suffering from both post-traumatic stress disorder (PTSD) and poor working memory by employing a combination of computerized working memory training and transcranial direct current stimulation (tDCS). After treatment, all four participants showed clinically significant improvements on a range of cognitive and emotional performance measures. Moreover, these improvements were accompanied by theoretically significant neurophysiological changes between pre- and post-treatment electroencephalographic (EEG) recordings. Specifically, the P3a component of participants' event related potentials (ERP) in response to novelty stimuli, characteristically abnormal in this clinical population, shifted significantly toward database norms. So, participants' initially slow alpha peak frequency (APF), theorized to underlie impaired cognitive processing abilities, also increased in both frequency and amplitude as a result of treatment. On the basis of these promising results, more extensive controlled studies are warranted.",0,0 +5470,The impact of maternal childhood abuse on maternal and infant HPA axis function in the postpartum period,"Early life trauma, particularly child abuse, has been associated with aberrations in hypothalamic–pituitary–adrenal (HPA) axis functioning in adulthood. However, the relationship of early abuse and later adult neuroendocrine changes may be moderated by additional factors such as comorbid psychopathology and recent life stress. Parental exposure to child abuse may have transgenerational effects, with offspring of abuse victims showing similar neuroendocrine profiles as their mothers. The majority of previous studies in this area focus on adult offspring, and the degree to which the effects of parental child abuse can be detected earlier in the development of the offspring remains obscure. The current study utilized a clinical sample of women with a history of MDD ( N = 126), to examine the effects of maternal early life sexual and physical abuse (Childhood Trauma Questionnaire (CTQ)) on both maternal and infant salivary cortisol levels during a laboratory stress paradigm at 6 months postpartum. Maternal child abuse was associated with steeper declines in cortisol in the mothers and lower baseline cortisol in their infants. Comorbid maternal PTSD, current maternal depressive symptoms, and recent life stressors were significant moderators of maternal cortisol change. Maternal abuse history was associated with increases in cortisol levels in those mothers who experienced these additional stressors. Similarly, a history of early maternal abuse and comorbid PTSD was associated with greater increases in infant cortisol levels. Maternal childhood abuse was associated with HPA axis function in both the mother and the infant during the postpartum period.",0,0 +5471,Does Posttraumatic Stress Disorder Affect Post-Treatment Methamphetamine Use?,"Although trauma is a well-established risk factor for substance use disorders, little is known about the association between posttraumatic stress disorder (PTSD) and treatment outcomes among methamphetamine users. In the present study, we examine the relationship between PTSD and post-treatment methamphetamine use outcomes, hospitalizations, and overall psychiatric impairment.Using data from 526 adults in the largest psychosocial clinical trial of methamphetamine users conducted to date, this study examined: (1) treatment outcomes of methamphetamine users with concomitant PTSD three years after psychosocial treatment for methamphetamine dependence; and (2) PTSD symptom clusters as risk factors for post-treatment relapse to methamphetamine use.PTSD was associated with poorer methamphetamine use outcomes; methamphetamine use frequency throughout the 3-year follow-up was significantly greater among individuals with a PTSD diagnosis, and those with PTSD had more than five times the odds of reporting methamphetamine use in the 30 days prior to the follow-up interview, OR= 5.2, 95% CI [2.0-13.3]. Additionally, higher levels of other Axis I psychopathology were observed among methamphetamine users with PTSD. Avoidance and arousal symptoms predicted post-treatment methamphetamine use.Addressing these high risk PTSD symptoms and syndromes in methamphetamine users may be helpful as a means of improving treatment outcomes in this population.",0,0 +5472,1H NMR based metabolomics approach to study the toxic effects of herbicide butachlor on goldfish (Carassius auratus),"Butachlor, one of the most widely used herbicides in agriculture, has been reported with high ecotoxicity to aquatic plants and animals. In this study, a (1)H NMR based metabolomics approach combined with histopathological examination and biochemical assays was applied to comprehensively investigate the toxic effects of butachlor on four important organs (gill, brain, liver and kidney) of goldfish (Carassius auratus) for the first time. After 10 days' butachlor exposure at two dosages of 3.2 and 0.64 μmol/L, fish tissues (gill, brain, liver and kidney) and serum were collected. Histopathological inspection revealed severe impairment of gill filaments and obvious cellular edema in livers and kidneys. The increase of glutathione peroxidase (GSH-Px) activity in gill and methane dicarboxylic aldehyde (MDA) level in four tissues reflected the disturbance of antioxidative system in the intoxicated goldfish. Serum lactate dehydrogenase (LDH) activity and creatinine (CRE) level were increased in butachlor exposure groups, suggesting liver and kidney injuries induced by butachlor. Orthogonal signal correction partial least-squares discriminant analysis (OSC-PLS-DA) of NMR profiles disclosed metabolic changes that were related to the toxic effects of butachlor including oxidative stress, disorder of energy metabolism and amino acids metabolism, and disturbance of neurotransmitter balance in butachlor exposed goldfish. This integrated metabolomics approach provided a molecular basis underlying the toxicity of butachlor and demonstrated that metabolomics was a powerful and highly effective approach to elucidate the toxicity and underlying mechanisms of herbicides and pesticides, applicable for their risk assessment.",0,0 +5473,Feasibility of a Screening Program for At-Risk Children Following Accidental Injury,en,0,0 +5474,Profile of 50 Women with Midlife-Onset Eating Disorders,"The aim of this study was to present a detailed profile of 50 women eating disorder (ED) inpatients who reported first ED onset at age 40 or above. We assessed patients' sociodemographics, severity-of-illness, comorbid diagnoses, personality profiles, and short-term treatment outcomes. Compared to patients of more traditional young adult ages, results revealed unique features of midlife-onset ED inpatients, including less severe and less common self-reported ED symptomology measured by the EDI-2; a predominance of pure restricting behaviors and rarity of bulimia; similar rates of co-occurring depression and anxiety but of less severity; fewer substance use disorders with a predominance of sedating/calming substance usage; many fewer Cluster C diagnoses on Axis II; substantially greater histories of sexual abuse; and different MMPI-2 profiles emphasizing much greater denial. The corresponding needs among midlife-onset ED inpatients for specialized assessment and treatment interventions are considered.",0,0 +5475,Psychopharmacology of topiramate: from epilepsy to bipolar disorder,"Topiramate (TPM) is one of the novel antiepileptic drugs and exhibits a wide range of mechanisms of action. Efficacy of TPM has been demonstrated in partial-onset seizures and primary generalized seizures in adults and children, as both monotherapy and adjunctive therapy. More recently, TPM has been proposed as an add-on treatment for patients with lithium-resistant bipolar disorder, especially those displaying rapid-cycling and mixed states. This paper reviews the multiple mechanisms of action and the tolerability profile of TPM in the light of its therapeutic potential in affective disorders. Studies of TPM in bipolar disorder are evaluated, and the efficacy and tolerability issues as a mood stabilizing agent are discussed.",0,0 +5476,Psychological Resilience in the Face of Terrorism,,0,0 +5477,Gender Group Differences in Coping with Chronic Terror: The Israeli Scene,"Gender group differences in terror-stress, cognitive appraisals, ways of coping with terror, and stress reactions were explored in a sample of Israeli adults following prolonged exposure to political violence. Data were gathered at the height of the Al-Aqsa Intifada uprising (May/July 2002) from a sample of 707 adult participants (60% women and 40% men) residing in Haifa and northern Israel. Israeli women reported that they were more distressed by political violence than the men did, and they also appraised the crisis situation as more threatening and less manageable. Women reported using more problem-focused as well as emotion-focused coping than men did; both men and women used a mixture of coping strategies. Compared to men, women reported that they experienced more somatic symptoms and more frequent posttraumatic stress symptoms than men did. Negative affectivity was found to mediate gender differences in appraisals, coping, and outcomes. Overall, the nexus of relations among key variables was found to be highly similar for men and women. These data suggest that women may be more reactive to chronic political violence situations than men are. The data are discussed and explicated in the context of stress and coping theory and prior research on political violence and community disasters. © 2006 Springer Science+Business Media, Inc.",0,0 +5478,"Regional economic resilience: concepts, empirics and a critical review","Abstract Regional (economic) resilience and resilient thinking have gained considerable attention in recent years. My aim with this work is to throw light on some of the underlying aspects of regional economic resilience and resilient thinking. In the current study I give an overview of the notion, key concepts, main empirical results and planning tasks concerning regional (economic) resilience as well as outlining some of the criticisms. Finally, I provide some suggestions for studies in resilience and resilient thinking for future research agendas. The main results of the study is my own belief in the concept of regional economic resilience, and an overview and comparison of regional (economic) resilience literature and empirics that lead me to highlight some of the shortcomings of the research topic.",0,0 +5479,Risk factors for post-traumatic stress disorder among UK Armed Forces personnel,"Background There is considerable interest in understanding further the factors that increase the risk of post-traumatic stress disorder (PTSD) for military personnel. This study aimed to investigate the relative contribution of demographic variables; childhood adversity; the nature of exposure to traumatic events during deployment; appraisal of these experiences; and home-coming experiences in relation to the prevalence of PTSD ‘caseness’ as measured by a score of ⩾50 on the PTSD Checklist (PCL) in UK Armed Forces personnel who have been deployed in Iraq since 2003. Method Data were drawn from the first stage of a retrospective cohort study comparing UK military personnel who were deployed to the 2003 Iraq War with personnel serving in the UK Armed Forces on 31 March 2003 but who were not deployed to the initial phase of war fighting. Participants were randomly selected and invited to participate. The response rate was 61%. We have limited these analyses to 4762 regular service individuals who responded to the survey and who have been deployed in Iraq since 2003. Results Post-traumatic stress symptoms were associated with lower rank, being unmarried, having low educational attainment and a history of childhood adversity. Exposure to potentially traumatizing events, in particular being deployed to a ‘forward’ area in close contact with the enemy, was associated with post-traumatic stress symptoms. Appraisals of the experience as involving threat to one's own life and a perception that work in theatre was above an individual's trade and experience were strongly associated with post-traumatic stress symptoms. Low morale and poor social support within the unit and non-receipt of a home-coming brief (psycho-education) were associated with greater risk of post-traumatic stress symptoms. Conclusions Personal appraisal of threat to life during the trauma emerged as the most important predictor of post-traumatic stress symptoms. These results also raise the possibility that there are important modifiable occupational factors such as unit morale, leadership, preparing combatants for their role in theatre which may influence an individual's risk of post-traumatic stress symptoms. Therefore interventions focused on systematic preparation of personnel for the extreme stress of combat may help to lessen the psychological impact of deployment.",0,0 +5480,The Relationship Between Quality of Life and Psychiatric Impairment for a Taiwanese Community Post-Earthquake,"This purpose of this study was to investigate the relationship between quality of life and psychiatric impairment in a Taiwanese community located near the epicenter of the 1999 earthquake, as assessed four to six months after the natural catastrophe. Trained assistants interviewed the 4223 respondents using the disaster-related psychological screening test (DRPST), an instrument specifically designed and validated by senior psychiatrists for assessment of psychiatric impairment after natural catastrophe. Additionally, the 36-Item Short-Form Health Survey (SF-36) was used to evaluate quality of life. The collected results were analyzed using Windows SPSS 10.0 software. Psychiatric impairment rated moderate to severe was assessed for 1448 (34.3%) of the responding residents. The 4223 respondents were divided into 4 psychiatric-impairment groups based on DPRST score: healthy (n = 952); mild impairment (n = 1823); moderate impairment (n = 1126); and, severe impairment (n = 322). The four groups were compared for a number of salient factors, including gender, age, current marital status and psychiatricimpairment score, to determine impact on quality of life. Respondents assessed as psychiatrically impaired tended to be older, female, divorced/widowed, and less educated, and they were more likely to have experienced major familial financial loss as an immediate consequence of the earthquake. Further, the greater the severity of the psychiatric impairment, the lower the scores for quality of life, for both the physical and mental aspects of this important general indicator.",0,0 +5481,Dissociative tendencies and dissociative disorders.,"Although dissociative disorders are relatively rare, dissociative experiences are rather common in everyday life. Dissociative tendencies appear to be modestly related to other dimensions of personality, such as hypnotizability, absorption, fantasy proneness, and some facets of openness to experience. These dispositional variables may constitute diathesis, or risk factors, for dissociative psychopathology, but more complex models relating personality to psychopathology may be more appropriate. The dissociative disorders raise fundamental questions about the nature of self and identity and the role of consciousness and autobiographical memory in the continuity of personality.",0,0 +5482,Genome-wide association study of posttraumatic stress disorder in a cohort of Iraq–Afghanistan era veterans,"Posttraumatic stress disorder (PTSD) is a psychiatric disorder that can develop after experiencing traumatic events. A genome-wide association study (GWAS) design was used to identify genetic risk factors for PTSD within a multi-racial sample primarily composed of U.S. veterans.Participants were recruited at multiple medical centers, and structured interviews were used to establish diagnoses. Genotypes were generated using three Illumina platforms and imputed with global reference data to create a common set of SNPs. SNPs that increased risk for PTSD were identified with logistic regression, while controlling for gender, trauma severity, and population substructure. Analyses were run separately in non-Hispanic black (NHB; n = 949) and non-Hispanic white (NHW; n = 759) participants. Meta-analysis was used to combine results from the two subsets.SNPs within several interesting candidate genes were nominally significant. Within the NHB subset, the most significant genes were UNC13C and DSCAM. Within the NHW subset, the most significant genes were TBC1D2, SDC2 and PCDH7. In addition, PRKG1 and DDX60L were identified through meta-analysis. The top genes for the three analyses have been previously implicated in neurologic processes consistent with a role in PTSD. Pathway analysis of the top genes identified alternative splicing as the top GO term in all three analyses (FDR q < 3.5 × 10(-5)).No individual SNPs met genome-wide significance in the analyses.This multi-racial PTSD GWAS identified biologically plausible candidate genes and suggests that post-transcriptional regulation may be important to the pathology of PTSD; however, replication of these findings is needed.",0,0 +5483,Introduction to Part I: Trauma and Juvenile Delinquency: Dynamics and Developmental Mechanisms,"This article introduces the first part of a two-part special issue featuring new directions in research on traumatized youth in the juvenile justice system. The articles in this issue focus on research devoted to investigating the underlying development mechanisms accounting for the associations among exposure to traumatic events, posttraumatic stress reactions, and delinquent behavior. The articles in this issue advance our understanding of these questions by expanding the scope of research to include the study of complex trauma as well as the differentiation between primary psychopathic traits among youth versus secondary psychopathy borne of trauma. In addition, studies are included targeting specific theoretically-derived mediators of the relations between childhood adversity and delinquency, including depressive cognitions, as well as specific symptom clusters of posttraumatic stress. The remaining articles shed light on the differential roles that trauma and demographic factors play in predicting recidivism and mental health functioning among youth involved in the juvenile justice system, including gender, ethnicity, age, and sexual minority status. Taken together, these studies suggest important directions for the development of effective interventions to target trauma-related sequelae among troubled youth and their families. © 2012",0,0 +5484,History and Future of the Multidisciplinary Association for Psychedelic Studies (MAPS),"This article describes the teenage vision of the founder of the Multidisciplinary Association for Psychedelic Studies (MAPS) that humanity's future would be aided by the therapeutic and spiritual potential of psychedelic substances. The article traces the trajectory of MAPS from inception in 1986 to its present, noting future goals with respect to research, outreach, and harm reduction. MAPS was created as a non-profit psychedelic pharmaceutical company in response to the 1985 scheduling of 3,4-methylenedioxymethamphetamine (MDMA). Overcoming many hurdles, MAPS developed the first double-blind, placebo-controlled trial of MDMA-assisted psychotherapy for posttraumatic stress disorder (PTSD) and plans for FDA prescription approval in 2021. MAPS' program of research expanded to include a trial of lysergic acid diethylamide (LSD)-assisted psychotherapy for anxiety when facing life-threatening illness, observational studies of ibogaine in the treatment of addiction, and studies of MDMA for social anxiety in people with autism spectrum disorders. MAPS meets the challenges of drug development through a clinical research team led by a former Novartis drug development professional experienced in the conduct, monitoring, and analysis of clinical trials. MAPS' harm-reduction efforts are intended to avoid backlash and build a post-prohibition world by assisting non-medical users to transform difficult psychedelic experiences into opportunities for growth.",0,0 +5485,Stress hormones and post-traumatic stress disorder in civilian trauma victims: a longitudinal study. Part II: The adrenergic response,"The aim of the study was to prospectively evaluate the association between the occurrence of post-traumatic stress disorder (PTSD) and the adrenergic response to the traumatic event, and additionally, to explore the link between PTSD and the initial norepinephrine:cortisol ratio. Plasma levels and urinary excretion of norepinephrine (NE) were measured in 155 survivors of traumatic events during their admission to a general hospital emergency room (ER) and at 10 d, 1 month and 5 months later. Symptoms of peri-traumatic dissociation, PTSD and depression were assessed in each follow-up session. The Clinician-Administered PTSD Scale (CAPS) conferred a diagnosis of PTSD at 5 months. Trauma survivors with (n=31) and without (n=124) PTSD had similar levels of plasma NE, urinary NE excretion, and NE:cortisol ratio in the ER. Plasma NE levels were lower in subjects with PTSD at 10 d, 1 month, and 5 months. There was a weak but significant positive correlation between plasma levels of NE in the ER and concurrent heart rate, and a negative correlation between NE in the ER and dissociation symptoms. Peripheral levels of NE, shortly after traumatic events, are poor risk indicators of subsequent PTSD among civilian trauma victims. Simplified biological models may not properly capture the complex aetiology of PTSD.",0,0 +5486,MMPI Scores of Female Victims,"Samples of MMPIs of women who were victims of abuse or manifested a Posttraumatic Stress Disorder were drawn from two private practice settings, one urban and one in a small town. Each PTSD sample included 21 persons. For comparison, two contrast samples of 15 persons each were drawn from the same populations. A cut-off point of T = 65 for PK yielded a 69% hit rate for classifying PTSD and contrast subjects. Since scores on PS and PK were so highly correlated, no independent analyses were warranted. Although the PTSD group yielded a more elevated mean profile, there were no characteristic 2-point codes. Therefore, PK is more useful in identifying Posttraumatic Stress Disorder than either profile elevation or configuration.",0,0 +5487,Peritraumatic dissociation and experiential avoidance as prospective predictors of posttraumatic stress symptoms.,"Peritraumatic dissociation (PD) and experiential avoidance (EA) have been implicated in the etiology of posttraumatic stress symptomatology (PTSS); however, the function of these two factors in the onset and maintenance of PTSS following a potentially traumatic event is unclear. The temporal relationships between EA, PD, and the four clusters of PTSS proposed by the Simms/Watson dysphoria model (Simms, Watson, & Doebbeling, 2002) were examined in a three-wave prospective investigation of 532 undergraduate women participating in an ongoing longitudinal study at the time of a campus shooting. Path analyses indicated that preshooting EA predicted greater PD, intrusions, and dysphoria symptoms approximately one month postshooting. PD was associated with increased symptomatology across all four clusters 1-month postshooting, while 1-month postshooting EA was associated with higher dysphoria and hyperarousal symptoms eight months postshooting. PD had a significant indirect effect on all four PTSS clusters eight months postshooting via 1-month postshooting symptom reports. The results suggest that both EA and PD show unique influences as risk factors for PTSS following a potentially traumatic event.",0,0 +5488,Aggression in war veterans suffering from posttraumatic stress disorder with co-morbid alcoholism.,"For thousands of years it has been known that aggression as a symptom appears in numerous psychiatric disorders and diseases. During the last decade the appearance of the aggressive behavior related to the posttraumatic stress disorder (PTSD) has been frequently investigated, often associated with war trauma. The goal of this study is to analyze the impact of alcoholism on a way war veterans suffering from chronic PTSD express and control aggression. The sample included 240 war veterans with chronic PTSD. The subjects were divided in two groups. PTSD group (n=147) and controlled group composed of those suffering from alcoholism in addition to PTSD (n=93). In this study, the following psychological instruments were used: The Harvard trauma questionnaire for PTSD diagnosis (HTQ); the questionnaire for self-evaluation of aggression (STAXI); The Profile Index Emotion (PIE); questionnaire for auto-diagnosis of alcoholism (CAGE). The obtained results indicate that subjects who have PTSD with co-morbid alcoholism are more deprived, aggressive (p < 0.001) and oppositional (p < 0.05) in comparison to subjects whose PTSD is not combined with alcoholism (PIE). The aggression is statistically more expressed in subjects with PTSD who have also been diagnosed with alcoholism on all subscales in comparison to subjects with PTDS who have not been diagnosed with alcoholism: the current state of aggression, the general state of aggression, aggression towards an unfair treatment, aggression directed inwards and outwards (p < 0.001); aggression towards nonspecific provocation and a general way of expressing aggression (p < 0.05) (STAXI). Subjects that had PTSD combined with alcoholism show a higher degree of aggression in comparison to subjects with PTDS who are not diagnosed with alcoholism.",0,0 +5489,Posttraumatic stress disorder: the burden to the individual and to society.,"Little is known about the total population prevalence and societal costs of posttraumatic stress disorder (PTSD); this report reviews relevant literature on these topics.A literature search of computerized databases for published reports on trauma and PTSD was conducted. This literature was reviewed to find data on general population exposure to trauma, conditional risk of PTSD among those exposed to trauma both in focused samples of trauma victims and in general population samples, and the adverse consequences of PTSD.PTSD was found to be a commonly occurring disorder that often has a duration of many years and is frequently associated with exposure to multiple traumas. The impairment associated with PTSD in U.S. samples, where the majority of research on these consequences has been carried out, is comparable to, or greater than, that of other seriously impairing mental disorders. Risk of suicide attempts is particularly high among people with PTSD. Available evidence suggests that the prevalence of PTSD and the adverse emotional and psychological consequences of PTSD are much greater in the many countries around the world that are in the midst of armed conflicts involving political, racial, or ethnic violence.PTSD is a highly prevalent and impairing condition. Only a minority of people with PTSD obtain treatment. Early and aggressive outreach to treat people with PTSD could help reduce the enormous societal costs of this disorder.",0,0 +5490,Posttraumatic stress disorder and major depressive disorder is common in parents of children with epilepsy,"The purpose of the study was to determine the prevalence of posttraumatic stress disorder (PTSD), posttraumatic stress symptoms (PTSS), and major depressive disorder (MDD) in parents of children with epilepsy.Parents (77 mothers and 3 fathers) of children with epilepsy were administered the Structured Clinical Interview for DSM-IV (SCID), PTSD and MDD modules, and the General Health Questionnaire (GHQ).The prevalence of both PTSD and MDD was 31.5%. Fifty-six percent (n = 14) of the participants with PTSD had a diagnosis of MDD. PTSD symptom clusters were very prevalent in the parents of children with epilepsy. Reexperiencing and arousal symptom clusters were more frequent (88.8 and 80% respectively) than the avoidance and numbing symptom cluster (32.5%).These findings suggest that a significant proportion of parents of children with epilepsy experience PTSD and MDD. Increased awareness of the clinical presentations of these disorders may help clinicians to develop preventive and intervention strategies for parents of children with epilepsy.",0,0 +5491,Longitudinal epigenetic variation of DNA methyltransferase genes is associated with vulnerability to post-traumatic stress disorder,"Epigenetic differences exist between trauma-exposed individuals with and without post-traumatic stress disorder (PTSD). It is unclear whether these epigenetic differences pre-exist, or arise following, trauma and PTSD onset.In pre- and post-trauma samples from a subset of Detroit Neighborhood Health Study participants, DNA methylation (DNAm) was measured at DNA methyltransferase 1 (DNMT1), DNMT3A, DNMT3B and DNMT3L. Pre-trauma DNAm differences and changes in DNAm from pre- to post-trauma were assessed between and within PTSD cases (n = 30) and age-, gender- and trauma exposure-matched controls (n = 30). Pre-trauma DNAm was tested for association with post-trauma symptom severity (PTSS) change. Potential functional consequences of DNAm differences were explored via bioinformatic search for putative transcription factor binding sites (TFBS).DNMT1 DNAm increased following trauma in PTSD cases (p = 0.001), but not controls (p = 0.067). DNMT3A and DNMT3B DNAm increased following trauma in both cases (DNMT3A: p = 0.009; DNMT3B: p < 0.001) and controls (DNMT3A: p = 0.002; DNMT3B: p < 0.001). In cases only, pre-trauma DNAm was lower at a DNMT3B CpG site that overlaps with a TFBS involved in epigenetic regulation (p = 0.001); lower pre-trauma DNMT3B DNAm at this site was predictive of worsening of PTSS post-trauma (p = 0.034). Some effects were attenuated following correction for multiple hypothesis testing.DNAm among trauma-exposed individuals shows both longitudinal changes and pre-existing epigenetic states that differentiate individuals who are resilient versus susceptible to PTSD. These distinctive DNAm differences within DNMT loci may contribute to genome-wide epigenetic profiles of PTSD.",0,0 +5492,A person-centred approach to modelling population experiences of trauma and mental illness,"Background: Exposure to traumatic events has been implicated in the onset and development of a range of psychiatric disorders. People can be exposed to multiple traumatic events and previous research suggests that traumatic experiences may cluster at the individual level. Methods: This study aimed to examine the distribution of traumatic experiences in a large nationally representative sample using latent class analysis, and estimate the relationship between these classes and a number of demographic and clinical variables. Data from the National Comorbidity Survey was used. Results: Four latent classes, each representative of a range of traumatic experiences were identified. The classes were labelled 'high risk' (class 1), 'exposure to non-sexual adult interpersonal/non-interpersonal trauma' (class 2), 'intermediate risk/sexual abuse' (class 3), and 'low risk' (class 4). Each of the latent classes was predicted by several of the demographic variables. In addition, membership of classes 1, 2, and 3 increased the risk of each of the clinical variables. Conclusions: The findings have clinical implications for the assessment of trauma histories across a range of psychiatric diagnoses. © 2010 Springer-Verlag.",0,0 +5493,Disaster severity and emotional disturbance: implications for primary mental health care in developing countries,"ABSTRACT Two months following the 1987 earthquakes in Ecuador, 150 patients in the primary health care clinics of the area were screened for emotional problems; 40% of them were emotionally distressed. Risk factors included not being married, reporting poor physical or emotional health, and having ill-defined physical complaints. The findings from this research are discussed in relation to a disaster of much greater intensity, whose victims were studied by the authors, utilizing the same instrument and research design. The comparison between these 2 groups of disaster victims revealed that: 1) the prevalence of emotional distress was smaller among the Ecuador victims, but the frequency of symptoms among the distressed was similar for both groups; 2) the symptom profiles were remarkably similar; and 3) the most frequent symptoms and the strongest predictors of emotional distress were very similar. These findings support a focused training of health care workers on selected emotional problems that are regularly present among victims of different disasters.",0,0 +5494,Implementation of integrated therapies for comorbid post-traumatic stress disorder and substance use disorders in community substance abuse treatment programs,"The high prevalence of trauma and post-traumatic stress disorder (PTSD) in individuals with substance use disorders (SUDs) presents a number of treatment challenges for community treatment providers and programs in the USA. Although several evidence-based, integrated therapies for the treatment of comorbid PTSD/SUD have been developed, rates of utilisation of such practices remain low in community treatment programs.The goal of this article was to review the extant literature on common barriers that prevent adoption and implementation of integrated treatments for PTSD/SUD among substance abuse community treatment programs.Organisational, provider-level and patient-level factors that drive practice decisions were discussed, including organisational philosophy of care policies, funding and resources, as well as provider and patient knowledge and attitudes related to implementation of new integrated treatments for comorbid PTSD and SUD.Understanding and addressing these community treatment challenges may facilitate use of evidence-based integrated treatments for comorbid PTSD and SUD.",0,0 +5495,Normal Grief and Complicated Bereavement Among Traumatized Cambodian Refugees: Cultural Context and the Central Role of Dreams of the Dead,"This article profiles bereavement among traumatized Cambodian refugees and explores the validity of a model of how grief and post-traumatic stress disorder (PTSD) interact in this group to form a unique bereavement ontology, a model in which dreams of the dead play a crucial role. Several studies were conducted at a psychiatric clinic treating Cambodian refugees who survived the Pol Pot genocide. Key findings included that Pol Pot deaths were made even more deeply disturbing owing to cultural ideas about “bad death” and the consequences of not performing mortuary rites; that pained recall of the dead in the last month was common (76 % of patients) and usually caused great emotional and somatic distress; that severity of pained recall of the dead was strongly associated with PTSD severity (r = .62); that pained recall was very often triggered by dreaming about the dead, usually of someone who died in the Pol Pot period; and that Cambodians have a complex system of interpretation of dreams of the deceased that frequently causes those dreams to give rise to great distress. Cases are provided that further illustrate the centrality of dreams of the dead in the Cambodian experiencing of grief and PTSD. The article shows that not assessing dreams and concerns about the spiritual status of the deceased in the evaluation of bereavement results in “category truncation,” i.e., a lack of content validity, a form of category fallacy.",0,0 +5496,Posttraumatic Stress and Depressive Reactions Among Nicaraguan Adolescents After Hurricane Mitch,"This study determined the severity of posttraumatic stress and depressive reactions among Nicaraguan adolescents after Hurricane Mitch and the relationship of these reactions to objective and subjective features of hurricane exposure, death of a family member, forced relocation, and thoughts of revenge.Six months after the hurricane, 158 adolescents from three differentially exposed cities were evaluated by using a hurricane exposure questionnaire, the Child Posttraumatic Stress Disorder Reaction Index, and the Depression Self-Rating SCALE:Severe levels of posttraumatic stress and depressive reactions were found among adolescents in the two most heavily affected cities. Severity of posttraumatic stress and depressive reactions and features of objective hurricane-related experiences followed a ""dose-of-exposure"" pattern that was congruent with the rates of death and destruction across cities. Level of impact (city), objective and subjective features, and thoughts of revenge accounted for 68% of the variance in severity of posttraumatic stress reaction. Severity of posttraumatic stress reaction, death of a family member, and sex accounted for 59% of the variance in severity of depression.After a category 5 hurricane, adolescents in heavily affected areas with extreme objective and subjective hurricane-related traumatic features of exposure experience severe and chronic posttraumatic stress and comorbid depressive reactions. The recovery of the severely affected Nicaraguan adolescents is vital to the social and economic recovery of a country ravaged by years of political violence and poverty. These findings strongly indicate the need to incorporate public mental health approaches, including systematic screening and trauma/grief-focused interventions, within a comprehensive disaster recovery program.",0,0 +5497,Substance Use and Mental Health Trends Among U.S. Military Active Duty Personnel: Key Findings From the 2008 DoD Health Behavior Survey,"Examine substance use and mental health issues among U.S. military personnel.Data were from the 2008 (and before) population-based Department of Defense Health Related Behavior Surveys. The sample size for the 2008 survey was 28,546 (70.6% response rate).Analyses examined substance use, stress, depression, post-traumatic stress disorder (PTSD), suicidal ideation and attempts, deployment, and job satisfaction. Trends show reductions in tobacco use and illicit drug use, but increases in prescription drug misuse, heavy alcohol use, stress, PTSD, and suicidal attempts. Deployment exacerbated some of these behavior changes. Despite the demanding lifestyle, job satisfaction was high.The military has shown progress in decreasing cigarette smoking and illicit drug use. Additional emphasis should be placed on understanding increases in prescription drug misuse, heavy alcohol use, PTSD, and suicide attempts, and on planning additional effective interventions and prevention programs. Challenges remain in understanding and addressing military mental health needs.",0,0 +5498,On Freedom and Induction,"Traumatizing events and traumatizing conflicts may lead to defense mechanisms which in the course of time become part of character formation. In psychosomatic medicine much attention has been paid in the past to the so-called psychosomatic character profiles. Though discussions about psychosomatic specificity have remained controversial, it still seems advisable to take into account the power of induction of specific defense strategies. In this paper special attention is paid to the fact that asthmatics, patients suffering from hypertension or coronary heart disease, as well as patients suffering from other psychosomatic syndromes, and even patients suffering from carcinoma may induce their own defense strategies in interviewers and therapists, who usually are not sufficiently aware of the fact of such transference phenomena. A distortion of the normal psychotherapeutic process is more often a result of induction processes than has been thought of.",0,0 +5499,Eficacia del MMPI-A en casos forenses de acoso escolar: Simulación y daño psicológico,"The efficacy of forensic evaluation of the psychological injury based on the MMPI-2 and a clinical interview has been continuously supported by literature. Nevertheless, there is no evidence of the efficacy of the MMPI for adolescents (MMPI-A) for bullying cases. To contrast the efficacy of the MMPI-A in bullying cases, 107 adolescents ranged from 14 to 18 years old (M = 14.85) endorsed the Spanish adaptation of the MMPI-A under standard and malingering instructions. The results showed a high adolescent ability (91.6% for posttraumatic stress disorder, ranging from 60 to 90% for comorbid posttraumatic stress disorders) to malinger both the direct (posttraumatic stress disorder) and indirect (depression, anxiety, psychosomatic problems, problems in interpersonal relationships) psychological injury. Four malingering strategies were identified in malingering protocols: indiscriminate symptom endorsement, symptom severity, obvious symptoms, and infrequent symptoms. The F, F1, F2 and K standard validity scales discriminated significantly and with a large effect size between genuine and malingered responding. Likewise, the F-K index and the L and K < 45 and F < 80 profile discriminated significantly and with a large effect size between genuine and malingered responding. The study of cases revealed excellent classification rates of the standard validity scales (K < 40) and indices for malingered (true positives) and honest (false positives) responding. Implications for forensic practice are discussed.",0,0 +5500,Childhood Maltreatment and Cluster B Personality Pathology in Female Serious Offenders,"The authors examined early maltreatment among serious female offenders at a maximum-security correctional facility, contrasting the maltreatment histories of inmates with and without Cluster B personality pathology. Women were interviewed regarding the frequency of 13 indicators of psychological or physical abuse perpetrated by maternal or paternal caregivers and the frequency of 10 types of sexual abuse perpetrated by persons at least 5 years older. Reports were based on inmates' recollected worst years of maltreatment before age 16. Women in both diagnostic groups reported substantial early maltreatment. Cluster B inmates reported higher levels and a greater variety of maternal and paternal physical and psychological abuse but were not distinguished from non—Cluster B inmates on levels of childhood sexual abuse. Inmates reported more physical and psychological abuse from maternal than paternal caregivers. The results document the high levels of childhood maltreatment of female prisoners and the relevance of this history to personality pathology.",0,0 +5501,Mindful Awareness and Non-judging in Relation to Posttraumatic Stress Disorder Symptoms,"The objective of this cross-sectional study was to assess group differences between veterans with and without posttraumatic stress disorder (PTSD) in mindful awareness and mindful non-judging. The relationships between mindfulness and PTSD symptom clusters were also evaluated. Three age and gender-matched groups, (1) 15 combat veterans with PTSD, (2) 15 combat veterans without PTSD, and (3) 15 non-combat veterans without PTSD, completed the Mindful Attention Awareness Scale and the Accept without Judgment Scale. PTSD status was determined with the Clinician Administered PTSD Scale and excluded disorders screened with the Structured Clinical Interview for DSM-IV. Mindfulness scale group differences were assessed with analysis of variance. Mindfulness and the PTSD symptom clusters relationships were assessed with hierarchical regression analysis. There were group differences on mindful non-judging (F(2,44) = 7.22, p = .002) but not mindful awareness (p > .05). Combat exposure accounted for significant variation in PTSD symptoms (hyper-arousal 47%; numbing-avoiding 32%; re-experiencing 23%). Mindfulness accounted for a significant percentage variance of PTSD symptoms (re-experiencing 32%; numbing-avoiding 19%, hyper-arousal 16%), beyond combat exposure effects, although only mindful non-judging was significant in the model. This study confirms in a clinical sample that mindful non-judging is associated with PTSD symptoms and could represent a meaningful focus for treatment.",0,0 +5502,Alcohol Use and Alcohol-Related Problems Before and After Military Combat Deployment,"High rates of alcohol misuse after deployment have been reported among personnel returning from past conflicts, yet investigations of alcohol misuse after return from the current wars in Iraq and Afghanistan are lacking.To determine whether deployment with combat exposures was associated with new-onset or continued alcohol consumption, binge drinking, and alcohol-related problems.Data were from Millennium Cohort Study participants who completed both a baseline (July 2001 to June 2003; n=77,047) and follow-up (June 2004 to February 2006; n=55,021) questionnaire (follow-up response rate = 71.4%). After we applied exclusion criteria, our analyses included 48,481 participants (active duty, n = 26,613; Reserve or National Guard, n = 21,868). Of these, 5510 deployed with combat exposures, 5661 deployed without combat exposures, and 37 310 did not deploy.New-onset and continued heavy weekly drinking, binge drinking, and alcohol-related problems at follow-up.Baseline prevalence of heavy weekly drinking, binge drinking, and alcohol-related problems among Reserve or National Guard personnel who deployed with combat exposures was 9.0%, 53.6%, and 15.2%, respectively; follow-up prevalence was 12.5%, 53.0%, and 11.9%, respectively; and new-onset rates were 8.8%, 25.6%, and 7.1%, respectively. Among active-duty personnel, new-onset rates were 6.0%, 26.6%, and 4.8%, respectively. Reserve and National Guard personnel who deployed and reported combat exposures were significantly more likely to experience new-onset heavy weekly drinking (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.36-1.96), binge drinking (OR, 1.46; 95% CI, 1.24-1.71), and alcohol-related problems (OR, 1.63; 95% CI, 1.33-2.01) compared with nondeployed personnel. The youngest members of the cohort were at highest risk for all alcohol-related outcomes.Reserve and National Guard personnel and younger service members who deploy with reported combat exposures are at increased risk of new-onset heavy weekly drinking, binge drinking, and alcohol-related problems.",0,0 +5503,Peripartum depression and anxiety as an integrative cross domain target for psychiatric preventative measures,"Exposure to high levels of early life stress has been identified as a potent risk factor for neurodevelopmental delays in infants, behavioral problems and autism in children, but also for several psychiatric illnesses in adulthood, such as depression, anxiety, autism, and posttraumatic stress disorder. Despite having robust adverse effects on both mother and infant, the pathophysiology of peripartum depression and anxiety are poorly understood. The objective of this review is to highlight the advantages of using an integrated approach addressing several behavioral domains in both animal and clinical studies of peripartum depression and anxiety. It is postulated that a greater focus on integrated cross domain studies will lead to advances in treatments and preventative measures for several disorders associated with peripartum depression and anxiety.",0,0 +5504,Symptoms of Post-Traumatic Stress Disorder in Bereaved Children and Adolescents: Factor Structure and Correlates,"This study investigated the factor structure and correlates of posttraumatic stress-disorder (PTSD) symptoms among children and adolescents confronted with the death of a loved one. Three hundred thirty-two bereaved children and adolescents (aged 8-18; 56.9 % girls) who all received some form of psychosocial support after their loss, completed self-report measures of PTSD, together with measures tapping demographic and loss-related variables, depression, prolonged grief, and functional impairment. Parent-rated indices of impairment were also collected. We first evaluated the fit of six alternative models of the factor structure of PTSD symptoms, using confirmatory factor analyses. Outcomes showed that the 4-factor numbing model from King et al. (Psychological Assessment 10, 90-96, 1998), with distinct factors of reexperiencing, avoidance, emotional numbing, and hyperarousal fit the data best. Of all participants, 51.5 % met DSM-IV criteria for PTSD. PTSD-status and scores on the PTSD factors varied as a function of age and gender, but were unrelated to other demographic and loss-related variables. PTSD-status and scores on the PTSD factors were significantly associated symptom-levels of depression, prolonged grief, and functional impairment. Findings complement prior evidence that the DSM-IV model of the factor structure of PTSD symptoms may not represent the best conceptualization of these symptoms and highlight the importance of addressing PTSD symptoms in children and adolescents seeking help after bereavement. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +5505,Analyzing small data sets using Bayesian estimation: the case of posttraumatic stress symptoms following mechanical ventilation in burn survivors,"Background : The analysis of small data sets in longitudinal studies can lead to power issues and often suffers from biased parameter values. These issues can be solved by using Bayesian estimation in conjunction with informative prior distributions. By means of a simulation study and an empirical example concerning posttraumatic stress symptoms (PTSS) following mechanical ventilation in burn survivors, we demonstrate the advantages and potential pitfalls of using Bayesian estimation. Methods : First, we show how to specify prior distributions and by means of a sensitivity analysis we demonstrate how to check the exact influence of the prior (mis-) specification. Thereafter, we show by means of a simulation the situations in which the Bayesian approach outperforms the default, maximum likelihood and approach. Finally, we re-analyze empirical data on burn survivors which provided preliminary evidence of an aversive influence of a period of mechanical ventilation on the course of PTSS following burns. Results : Not suprisingly, maximum likelihood estimation showed insufficient coverage as well as power with very small samples. Only when Bayesian analysis, in conjunction with informative priors, was used power increased to acceptable levels. As expected, we showed that the smaller the sample size the more the results rely on the prior specification. Conclusion : We show that two issues often encountered during analysis of small samples, power and biased parameters, can be solved by including prior information into Bayesian analysis. We argue that the use of informative priors should always be reported together with a sensitivity analysis.",0,0 +5506,"An Overview of SSR149415, a Selective Nonpeptide Vasopressin V1b Receptor Antagonist for the Treatment of Stress-Related Disorders","Vasopressin (AVP) and corticotropin-releasing factor (CRF) are key mediators in the organism's neuro-adaptive response to stress. Through pituitary and central vasopressin V(1b) receptors, AVP participates in the control of the hypothalamic-pituitary-adrenal axis (HPA) and is involved in various emotional processes. SSR149415 is the first selective, orally active vasopressin V(1b) receptor antagonist yet described. It is a competitive antagonist with nanomolar affinity for animal and human V(1b) receptors and displays a highly selective profile with regard to a large number of receptors or enzymes. In vitro, SSR149415 potently antagonizes functional cellular events associated with V(1b) receptor activation by AVP, such as intracellular Ca(2+) increase or proliferation in various cell systems. Pharmacological studies, performed by measuring ACTH secretion induced by various stimulants such as hormones (AVP or AVP + CRF) or physical stress (restraint or forced swimming stress and dehydration) in conscious rats or mice, confirm the antagonist profile of SSR149415 and its efficacy in normalizing ACTH secretion in vivo. SSR149415 is active by the oral route, at doses from 3 mg/kg, it potentiates CRF effect and displays a long-lasting oral effect in the different models. At 10 mg/kg p.o. its duration of action is longer than 4 h. This molecule also decreases anxiety and exerts marked antidepressant-like activity in several predictive animal models. The anxiolytic effects of SSR149415 have been demonstrated in various Generalized Anxiety Disorders (GAD) models (four-plate, punished drinking, elevated plus-maze, light dark, mouse defense test battery, fear-potentiated startle and social interaction tests). It is as effective as the benzodiazepine diazepam in the acute stress exposure test. SSR149415 has similar efficacy to the reference antidepressant drug, fluoxetine, in acute (forced-swimming) and chronic (chronic mild stress and subordination stress) situations in rodents. SSR149415 also reduces offensive aggression in the resident-intruder model in mice and hamsters. Depending on the model, the minimal effective doses are in the range of 1-10 mg/kg i.p. or 3-10 mg/kg p.o. SSR149415 is devoid of adverse effects on motor activity, sedation, memory or cognitive functions and produces no tachyphylaxis when administered repeatedly. It is well-tolerated in animals and humans and exhibits an adequate ADME profile. Thus, SSR149415 is a new dual anxiolytic/antidepressant compound, which appears to be free of the known side effects of classical anxiolytic/antidepressant drugs. Clinical trials are in progress, they will hopefully demonstrate its therapeutical potential for treating stress-related disorders.",0,0 +5507,Early fear as a predictor of avoidance in a rat model of post-traumatic stress disorder,"Exposure of humans and animals to an intensely fearful experience can lead to an enduring behavioral profile involving fear and avoidance. The present study examined if rats that show more fear to a novel tone one day after exposure to footshocks exhibit more avoidance-like responses over a 4-week period. Rats were exposed to an episode of moderately intense footshock (5×2s episodes of 1.5mA presented randomly over 3min). Shock rats that exhibited a high level of fear (HR) to a novel tone one day after the shock exposure showed more avoidance of open spaces and novel rats when compared to shock rats that exhibited a lower level of fear to the novel tone (LR). Similarly, HR emitted more ultrasonic vocalization in the dysphoric range (20-30kHz) when placed in a novel chamber or the chamber in which shock was given. This study highlights the importance of early fear as a contributing factor for the development of lasting changes in avoidance. These results also support the view that the presence of an intense peritraumatic stress response may be a predictor of the subsequent development of a lasting negative emotional state in humans exposed to trauma.",0,0 +5508,Post-traumatic stress disorder and smoking: A systematic review,"We conducted a systematic review of what is known about the relationship between post-traumatic stress disorder (PTSD) and smoking to guide research on underlying mechanisms and to facilitate the development of evidence-based tobacco treatments for this population of smokers. We searched Medline, PsychINFO, and the Cochrane Central Register of Controlled Trials and identified 45 studies for review that presented primary data on PTSD and smoking. Smoking rates were high among clinical samples with PTSD (40%-86%) as well as nonclinical populations with PTSD (34%-61%). Most studies showed a positive relationship between PTSD and smoking and nicotine dependence, with odds ratios ranging between 2.04 and 4.52. Findings also suggest that PTSD, rather than trauma exposure itself, is more influential for increasing risk of smoking. A small but growing literature has examined psychological factors related to smoking initiation and maintenance and the overlapping neurobiology of PTSD and nicotine dependence. Observational studies indicate that smokers with PTSD have lower quit rates than do smokers without PTSD. Yet a few tobacco cessation treatment trials in smokers with PTSD have achieved quit rates comparable with controlled trials of smokers without mental disorders. In conclusion, the evidence points to a causal relationship between PTSD and smoking that may be bidirectional. Specific PTSD symptoms may contribute to smoking and disrupt cessation attempts. Intervention studies that test behavioral and pharmacological interventions designed specifically for use in patients with PTSD are needed to reduce morbidity and mortality in this population.",0,0 +5509,"The relationship between neuroticism, pre-traumatic stress, and post-traumatic stress: a prospective study","Abstract The personality trait of Neuroticism has been repeatedly associated with symptoms of post-traumatic stress disorder (PTSD). However, the nature of this relationship is unclear. There are at least two possible interpretations: neuroticism might be a risk factor for PTSD symptoms, or, alternatively, the relationship might be based on content overlap in arousal symptoms. With a prospective design, this study tested both possibilities. About 1370 women volunteers completed questionnaires early in pregnancy, measuring neuroticism and ‘baseline’ arousal symptoms, and for every 2 months thereafter until 1 month after the due date of birth. Of these, 126 had a pregnancy loss, and most of them were assessed for PTSD symptoms 1 month later. The results showed that pre-trauma neuroticism strongly predicted PTSD symptoms, and particularly PTSD arousal symptoms, after pregnancy loss. However, neuroticism was also strongly related to pre-trauma arousal. After statistically controlling for pre-trauma arousal symptoms, the relationship between neuroticism and PTSD symptoms after pregnancy loss was no longer significant. In other words, neuroticism did not predict rises in these symptoms from pre to post-trauma. This suggests that PTSD arousal symptoms tap a specific aspect of neuroticism, and that content-overlap largely accounts for the relationship between neuroticism and PTSD symptoms.",0,0 +5510,Posttraumatic Stress Disorder Symptoms and Precombat Sexual and Physical Abuse in Desert Storm Veterans,"The purpose of this research was to study the association between precombat sexual and physical abuse and combat-related posttraumatic stress disorder (PTSD) symptoms in a clinical sample of male and female Desert Storm veterans. Two hundred ninety-seven veterans provided data on precombat sexual and physical abuse, precombat psychiatric problems, sociodemographics, Desert Storm combat exposure, and PTSD symptomatology using the Mississippi Scale. Men reported significantly higher levels of combat exposure, and women described significantly more frequent precombat abuse. Precombat-abused veterans reported more frequent precombat psychiatric histories. Analysis of covariance revealed that gender significantly modified the impact of precombat abuse on combat-related and other PTSD symptomatology after adjusting for precombat psychiatric history and level of combat exposure. Specifically, females describing precombat abuse reported much greater PTSD symptomatology than did females denying precombat abuse. These results in conjunction with previous research suggest that a relationship between precombat abuse and combat-related PTSD may exist. Prospective, longitudinal studies of both men and women are needed.",0,0 +5511,Post-traumatic stress disorder among recently diagnosed patients with HIV/AIDS in South Africa,"This study examined the prevalence of and factors associated with post-traumatic stress disorder in recently diagnosed HIV/AIDS patients in South Africa. One hundred and forty-nine (44 male, 105 female) recently diagnosed HIV/AIDS patients (mean duration since diagnosis = 5.8 months, SD = 4.1) were evaluated. Subjects were assessed using the MINI International Neuropsychiatric Interview (MINI), the Carver Brief COPE coping scale and the Sheehan Disability Scale. In addition, previous exposures to trauma and past risk behaviours were assessed. Twenty-two patients (14.8%) met criteria for PTSD. Current psychiatric conditions more likely to be associated with PTSD included major depressive disorder (29% in PTSD patients versus 7% in non-PTSD patients, p = 0.004), suicidality (54% versus 11%, p = 0.001) and social anxiety disorder (40% versus 13%, p = 0.04). Further patients with PTSD reported significantly more work impairment and demonstrated a trend towards higher usage of alcohol as a means of coping. Discriminant function analysis indicated that female gender and a history of sexual violation in the past year were significantly associated with a diagnosis of PTSD. Patients whose PTSD was a direct result of an HIV/AIDS diagnosis (8/22) did not differ from other patients with PTSD on demographic or clinical features. In the South African context, PTSD is not an uncommon disorder in patients with HIV/AIDS. In some cases, PTSD is secondary to the diagnosis of HIV/AIDS but in most cases it is seen after other traumas, with sexual violation and intimate partner violence in women being particularly important.",0,0 +5512,Traumatic events and post-traumatic stress disorder,"(from the chapter) Examines the role of traumatic events in the development of anxiety disorders in children, particularly posttraumatic stress disorder (PTSD), differentiating between single acute events and chronic and/or repeated ones. The relationships is placed between traumatic event and stress reaction within a developmental psychopathological context by looking at risk and protective factors in the etiology and maintenance of stress reactions. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5513,Relationship Between Peer Victimization and Posttraumatic Stress Among Primary School Children,"Peer victimization is a common stressor experienced by children. Although peer victimization has been studied extensively, few studies have examined the potential link between peer victimization and posttraumatic stress disorder (PTSD), and no studies of which we are aware have examined this link among children in primary school. The paucity of studies examining the link between PTSD and peer victimization in primary school is surprising because peer victimization occurs more frequently and is more likely to be physical among 7- and 8-year-old children. This study assessed the relationship between peer victimization and PTSD in a sample of 358 elementary school children (ages 6-11 years). Results indicated that peer victimization accounted for 14.1% of PTSD symptom severity among boys and 10.1% among girls. Additionally, we found gender differences in the types of peer victimization that were most associated with PTSD symptom severity (d = 0.38). The long-term developmental consequences that may be associated with peer victimization-linked PTSD symptomatology are discussed.",0,0 +5514,Development and validation of the Computerized Clinician Administered Post-Traumatic Stress Disorder Scale-1-Revised,"Synopsis A computer administered version of the clinician administered post-traumatic stress disorder (PTSD) scale-1 was developed to assess PTSD in subjects presenting with psychological symptoms following exposure to a traumatic event. Both forms were administered to 40 subjects who met the Diagnostic and Statistical Manual, third edition, revised (DSM-III-R) criteria for exposure to a significantly traumatic stressor. Inter-observer reliability was demonstrated with a kappa statistic of 0·90. The computer version had a sensitivity of 0·95 and a specificity 0·95. A correlation of 0·95 was found between the two versions and the mean score difference was non-significant. The computer form demonstrated adequate internal reliability and test–retest reliability. Overall results suggest the computer version is a valid and reliable measure of PTSD.",0,0 +5515,Prospective investigation of a PTSD personality typology among individuals with personality disorders,"This study investigated the replicability of a previously proposed personality typology of posttraumatic stress disorder (PTSD, and explored stability of cluster membership over a 6-month period. Participants with current PTSD (n = 156) were drawn from the Collaborative Longitudinal Personality Disorders Study (CLPS). The CLPS project tracked a large sample of individuals who met criteria for 1 of 4 target diagnoses (borderline, schizotypal, avoidant, and obsessive-compulsive) and a contrast group of individuals who met criteria for depression but no personality disorder. A cluster analysis using scales from the Schedule of Nonadaptive and Adaptive Personality yielded 3 clusters: ""internalizing,"" ""externalizing,"" and ""low pathology."" Using K-means cluster analysis, the results did not replicate previous work. Using Ward's method, the hypothesized 3-cluster structure was confirmed at baseline but did not demonstrate temporal stability at 6 months.",0,0 +5516,Relationship Between Post-traumatic Stress Disorder and Pain in Two American Indian Tribes,"To estimate the association of lifetime post-traumatic stress disorder (PTSD) and pain in American Indians, and determine if tribe, sex, cultural and psychosocial factors, or major depression influence the magnitude of this association.A cross-sectional probability sample survey completed between 1997 and 2000. A structured interview was conducted by trained, tribal members to gather information on demographic and cultural features, physical health status, psychiatric disorders, and functional status.General community.A total of 3,084 individuals randomly selected from the tribal rolls of a Southwestern (N = 1,446) and a Northern Plains (N = 1,638) tribal group who were 15-54 years of age and lived on or within 20 miles of their reservations.Bodily pain subscale of the Short Form-36. Linear regression models were fit to examine the association between lifetime PTSD and pain, adjusting for demographic, cultural, psychosocial features, painful medical conditions, and major depression.The prevalence of lifetime PTSD was 16% in the Southwestern and 14% in the Northern Plains; women were nearly twice as likely as men to have lifetime PTSD in both tribes. The final adjusted model demonstrated that mean Short Form-36 bodily pain subscale scores were lower (indicating more pain) among individuals with lifetime PTSD than those without lifetime PTSD. Effect modification by tribe, sex, and depression was not observed.Lifetime PTSD was strongly associated with bodily pain in this rural sample of American Indians. Clinicians should be aware of, and address, the link between physical pain syndromes and PTSD.",0,0 +5517,A Prospective Study of Coping After Exposure to a Mass Murder Episode,"In a study of 136 survivors of a mass murder spree, multidimensional scaling identified clusters of responses mapping from 75 coping behaviors described by victims. This powerful method identified three coping dimensions: (a) Active Outreach versus Passive Isolation, (b) Informed Pragmatism versus Abandonment of Control, and (c) Reconciliation/Acceptance versus Evading the Status Quo. These coping dimensions were used to predict change in psychiatric status prospectively assessed with structured diagnostic interviews at index 3-4 months after the event and follow-up assessments 1 and 3 years later. Statistically significant changes in the positive direction on each of the three dimensions in this study were associated with reductions of 47-79% of the odds for acute postdisaster major depression, posttraumatic stress disorder (PTSD), and any non-PTSD disorder. These findings suggest mechanisms for development of therapeutic techniques capitalizing on encouraging active outreach, informed focus and pragmatism, and reconciliation and acceptance, and reduction of passive and isolative behaviors, resignation of control, and avoidance of realities of the postdisaster situation.",0,0 +5518,"Event Trauma in Early Childhood: Symptoms, Assessment, Intervention","Expanding research over the last two decades has documented that very young children's responses to an event trauma will involve the same three basic categories of posttraumatic symptomatology observed in older children and adults that is, reexperiencing, numbing/avoidance, and hyperarousal. The ways in which these three symptom clusters will be manifested in very young children and recent progress in the establishment of developmentally sensitive and reliable criteria for the diagnosis of posttraumatic stress disorder (PTSD) in this age group are described. In addition to PTSD symptomatology, three additional factors that differentiate young children's responses to a trauma from those of older children and adults-their cognitive immaturity, their developmental vulnerability, and the relational context of early trauma given young children's dependence on caregivers-also are discussed. Principles of assessment and treatment are then described. These discussions emphasize the importance of normalizing traumatic responses, supporting the parent-child relationship and restoring trust, desensitizing the child's distress to traumatic reminders, helping the child and parents to process and develop a meaningful narrative of the traumatic event through expressive therapeutic techniques, and promoting effective strategies of restoration and repair.",0,0 +5519,The mental health of unaccompanied refugee minors on arrival in the host country,"Despite increasing numbers of unaccompanied refugee minors (UM) in Europe and heightened concerns for this group, research on their mental health has seldom included the factor ""time since arrival."" As a result, our knowledge of the mental health statuses of UM at specific points in time and over periods in their resettlement trajectories in European host countries is limited. This study therefore examined the mental health of UM shortly after their arrival in Norway (n = 204) and Belgium (n = 103) through the use of self-report questionnaires (HSCL-37A, SLE, RATS, HTQ). High prevalence scores of anxiety, depression and posttraumatic stress disorder (PTSD) symptoms were found. In addition, particular associations were found with the number of traumatic events the UM reported. The results indicate that all UM have high support needs on arrival in the host country. Longitudinal studies following up patterns of continuity and change in their mental health during their trajectories in the host country are necessary.",0,0 +5520,Evaluation of the Psychological Status in Chronic Low Back Pain: Comparison with General Population,"Multiple studies have documented a strong association between chronic low back pain and psychopathology including personality disorders, depressive disorders, anxiety, and somatoform disorders along with non-specific issues such as emotion, anger and drug dependency. However, depression, anxiety and somatization appear to be crucial. There are no controlled trials in interventional pain management settings. This study was designed to evaluate 40 individuals without pain or psychotherapeutic drug therapy, Group I, control group; and Group II, chronic low back pain group with 40 chronic low back pain patients. All the participants were tested utilizing Pain Patient Profile (P3). Significant differences were found among various clinical syndromes with generalized anxiety disorder, somatoform disorder, and depression, with 0% vs 20%, 0% vs 20%, and 5% vs 30% in Group I and Group II consecutively. This evaluation showed that clinical syndromes were seen in a greater proportion of patients with chronic low back pain emphasizing the importance of evaluation of the patients for generalized anxiety disorder, somatoform disorder, and for depression.",0,0 +5521,Rape-related psychotraumatic syndromes,"This study took place in a forensic center for rape victims. Our aims were: first, to explore the longitudinal course of post-traumatic stress disorder (PTSD) and prevalence of disorders over the 6-month period following rape, then second, to group these disorders into syndromes related to chronic PTSD whilst remaining distinct from it, and third, to establish some predictive factors for chronic PTSD.92 rape victims consecutively admitted to the center were regularly interviewed over a 6-month period by a psychiatrist.The paper confirms that rape leads to a high proportion of PTSD. Generally speaking, the psychopathology following rape is severe. PTSD at 6 months is associated with phobic and dissociative disorders. It is further associated with a cluster of symptoms arising after rape that we term borderline-like. Incestuous rape is a predictive factor for PTSD at 6 months.In the aftermath of rape several semiologically distinct psychotraumatic syndromes exist.",0,0 +5522,The Treatment of Post-Traumatic Stress Disorder Using Redecision Therapy,"This article describes the use of redecision therapy in the treatment of post-traumatic stress disorder. In traumatic situations, people make decisions that appear to increase their possibility of ...",0,0 +5523,Examining the dimensionality of combat-related posttraumatic stress and depressive symptoms in treatment-seeking OEF/OIF/OND veterans,"This study examined the factor structure of two of the most commonly used screening measures of posttraumatic stress disorder and depression in 164 treatment-seeking veterans who served in Operations Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND).Exploratory factor analysis was used to assess the dimensionality of items from the Posttraumatic Stress Disorder Checklist-Military Version (PCL-M) and the Patient Health Questionnaire-9 (PHQ-9). Regression analyses were then conducted to examine associations between factor scores of the resulting factor solution and measures of alcohol use, cognitive coping, psychological resilience, social support, and healthcare utilization.A four-factor solution was found that consisted of clusters of symptoms reflecting reexperiencing/avoidance, detachment/numbing, hopelessness/depression, and bodily disturbance. Scores on the detachment/numbing factor were uniquely related to alcohol use, whereas scores on the hopelessness/depression factor was uniquely associated with emergency room visits. Compared to conventional PCL-M and PHQ-9 total scores, the four-factor solution explained 2 to 10% more variance in scores on measures of alcohol use, cognitive coping, psychological resilience, social support, and healthcare utilization.This study was limited by a small sample size and cross-sectional design.Combat-related posttraumatic stress disorder and depressive symptoms in treatment-seeking OEF/OIF/OND veterans may be better conceptualized by four dimensions of reexperiencing/avoidance, detachment/numbing, hopelessness/depression, and bodily disturbance symptoms. This symptom structure may provide greater utility when examining other outcomes of interest in this population.",0,0 +5524,What predicts post-traumatic stress following spinal cord injury/,"Spinal cord injury (SCI) is a severe, traumatic event and recently research into the role of post-traumatic stress disorder (PTSD) subsequent to the injury has become of increasing interest. This study has been conducted in order to investigate potential risk factors for the development of post-traumatic stress disorder symptoms in those with SCI.This cross-sectional study used multiple regression analysis to look for associations between post-traumatic stress symptom severity, SCI-related factors and previously identified risk factors for PTSD such as dysfunctional cognitions, demographic factors and personality predispositions (neuroticism, alexithymia).A total of 102 participants with SCI completed measures of post-traumatic stress severity, acceptance of injury, post-traumatic cognitions, social support, neuroticism and alexithymia. In addition, information about type, level and cause of the SCI was assessed.High levels of post-traumatic stress symptoms were found. Potential risk factors for the development of PTSD were negative cognitions of self and neuroticism. Variables that added to the variance explained by the models included time since injury and difficulty identifying feelings. Acceptance of injury was mediated by negative cognitions of the self and neuroticism.The study highlights the need for services to be aware of the psychological difficulties experienced by this client group. An important finding is that the acceptance of the injury is mediated by negative cognitions of the self which need to be identified as potential risk factors in order to prevent the development of post-traumatic symptoms in this population.",0,0 +5525,Prospective Longitudinal Evaluation of the Effect of Deployment-Acquired Traumatic Brain Injury on Posttraumatic Stress and Related Disorders: Results From the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS),"Traumatic brain injury (TBI) is increasingly recognized as a risk factor for deleterious mental health and functional outcomes. The purpose of this study was to examine the strength and specificity of the association between deployment-acquired TBI and subsequent posttraumatic stress and related disorders among U.S. Army personnel.A prospective, longitudinal survey of soldiers in three Brigade Combat Teams was conducted 1-2 months prior to an average 10-month deployment to Afghanistan (T0), upon redeployment to the United States (T1), approximately 3 months later (T2), and approximately 9 months later (T3). Outcomes of interest were 30-day prevalence postdeployment of posttraumatic stress disorder (PTSD), major depressive episode, generalized anxiety disorder, and suicidality, as well as presence and severity of postdeployment PTSD symptoms.Complete information was available for 4,645 soldiers. Approximately one in five soldiers reported exposure to mild (18.0%) or more-than-mild (1.2%) TBI(s) during the index deployment. Even after adjusting for other risk factors (e.g., predeployment mental health status, severity of deployment stress, prior TBI history), deployment-acquired TBI was associated with elevated adjusted odds of PTSD and generalized anxiety disorder at T2 and T3 and of major depressive episode at T2. Suicidality risk at T2 appeared similarly elevated, but this association did not reach statistical significance.The findings highlight the importance of surveillance efforts to identify soldiers who have sustained TBIs and are therefore at risk for an array of postdeployment adverse mental health outcomes, including but not limited to PTSD. The mechanism(s) accounting for these associations need to be elucidated to inform development of effective preventive and early intervention programs.",0,0 +5526,"Comparative analysis of trends in paediatric trauma outcomes in New South Wales, Australia","

Abstract

Paediatric trauma centres seek to optimise the care of injured children. Trends in state-wide paediatric care and outcomes have not been examined in detail in Australia. This study examines temporal trends in paediatric trauma outcomes and factors influencing survival and length of stay. A retrospective review was conducted using data from the NSW Trauma Registry during 2003–2008 for children aged 15 years and younger who were severely injured (injury severity score>15). To examine trauma outcomes descriptive statistics and multivariable logistic and linear regression were conducted. There were 1138 children severely injured. Two-thirds were male. Road trauma and falls were the most common injury mechanisms and over one-third of incidents occurred in the home. Forty-eight percent of violence-related injuries were experienced by infants aged less than 1 year. For the majority of children definitive care was provided at a paediatric trauma centre, but less than one-third of children were taken directly to a paediatric trauma centre post-injury. Children who received definitive treatment at a paediatric trauma centre had between 3 and 6 times higher odds of having a survival advantage than if treated at an adult trauma centre. The number of severe injury presentations to the 14 major trauma centres in NSW remains constant. It is possible that injury prevention measures are having a limited effect on severe injury in NSW. This research provides stimulus for change in the provision and co-ordination in the delivery of trauma care for injured children.",0,0 +5527,Geographies of health and climate change,"Climate change presents significant challenges for human health and well-being and geography is contributing a growing field of knowledge relating to these processes. We outline here key dimensions of the debate, pointing to areas where human geographers can make a particularly strong contribution. These include: issues of adaptation and resilience; sustainability; environmental justice and socially unequal impacts of climate change; and psychological as well as physical impacts of environment on health. Key themes in the emerging research agenda include the significance of affect and emotion for the perception and communication of hazard and risk associated with the health impacts of climate change. Also, understanding exposure to health risks of climate change requires knowledge of complex and individually variable daily action spaces and residential mobility over the lifecourse. We argue for research that considers complex processes operating at various geographical scales, linking arguments about ‘global health’ with the more local and individual processes that contribute to health determinants. Much of the literature on health impacts of climate change demonstrates socially and geographically unequal effects, which often exacerbate existing health disparities. This highlights the links between this field of health geography and other geographical research concerned with sustainability and environmental justice.",0,0 +5528,Early Symptom Predictors of Chronic Distress in Gulf War Veterans,"Although there is evidence that specific early hyperarousal, avoidance, and emotional numbing symptoms are associated with later posttraumatic stress disorder (PTSD) symptomatology among veterans, little is known about predictors of later non-PTSD-related psychological symptoms. One and 2 years after serving in the Gulf War, 348 military reservists were assessed for severity of war zone stress, PTSD, psychological distress, and stress-mediated physical complaints. Overall PTSD symptomatology and emotional numbing and hyperarousal symptom clusters increased over time, whereas re-experiencing and avoidance symptoms showed no change. Emotional numbing and hyperarousal symptoms at 1 year predicted generalized distress, depression, anxiety, hostility, and somatic symptoms at 2 years, whereas re-experiencing and avoidance symptoms did not. Findings highlight the importance of targeting early emotional numbing and hyperarousal symptom clusters to reduce longer-term psychological distress.",0,0 +5529,Post-traumatic Stress Disorder (Traumatic War Neurosis) and Concurrent Psychiatric illness Among Australian Vietnam Veterans. A Controlled Study,"Depression, anxiety, irritability with unpredictable explosions of aggressive behaviour, impulsivity, suicidal actions and substance abuse have been repeatedly observed among ex-servicemen from World War II in psychiatric treatment settings. In the most recent American Psychiatric Association classification of mental disorders the category of Post Traumatic Stress Disorder (PTSD) was introduced, replacing the earlier Traumatic War Neurosis and the above cluster of symptoms were included as associated features of this disorder. Two recent uncontrolled studies on U.S. Vietnam veterans receiving psychiatric care supported the linkage of PTSD with these abnormalities. However, the present controlled study found these associated features occurred with equal frequencies among one group of psychiatrically hospitalised Australian Vietnam veterans with PTSD and another group not so afflicted. Reservations, then, should be harboured about ascribing all the presented psychopathology and behavioural abnormalities of ex-servicemen to the stress of their war service.",0,0 +5530,Genetics of glucocorticoid regulation and posttraumatic stress disorder—What do we know?,"CASTRO-VALE, I., E.F.C. van Rossum, J.C. Machado, R. Mota-Cardoso and D. Carvalho. Genetics of glucocorticoid regulation and posttraumatic stress disorder-What do we know? NEUROSCI. BIOBEHAV. REV. 43 (1) XXX-XXX, 2014 - Posttraumatic stress disorder (PTSD) develops in a small proportion of those who have been exposed to a traumatic event. Genetic factors are estimated to be responsible for 30% of the variance in PTSD risk. Dysfunction of the hypothalamic-pituitary-adrenal (HPA)-axis in PTSD has been found, particularly hypersensitivity of the glucocorticoid receptor (GR). In this review we aim to understand the genetic factors that influence glucocorticoid function in PTSD. Glucocorticoid action is regulated by a corticotrophin-releasing hormone, arginine vasopressin (AVP)/oxytocin pathway, GR, and regulators such as co-chaperone FKBP5. Single nucleotide polymorphisms (SNPs) in the GR gene, CRHR1 gene and FKBP5 gene affect HPA-axis sensitivity. The GR gene SNP BclI has been associated with hypersensitivity to glucocorticoids and PTSD symptoms. FKBP5 gene SNPs interacted with childhood adversity to moderate PTSD risk and in particular, the rs9470080 SNP was independently associated with lifetime PTSD. SNPs in the CRHR1 gene were also associated with PTSD risk. Gene-environment interaction studies have highlighted the importance of multifactorial vulnerability in PTSD, with epigenetic mechanisms contributing to the equation.",0,0 +5531,Post-Traumatic Stress Disorder and Suicide Risk: A Systematic Review,"There is a gap in the literature regarding suicide risk among traumatized individuals with post-traumatic stress disorder (PTSD) and this article aims to systematically review literature on the relationship between PTSD and suicidal behavior and ideation. A meta-analysis of 50 articles that examined the association between PTSD and past and current suicidal ideation and behavior was conducted. There was no evidence for an increased risk of completed suicide in individuals with PTSD. PTSD was associated with an increased incidence of prior attempted suicide and prior and current suicidal ideation. Controlling for other psychiatric disorders (including depression) weakened, but did not eliminate, this association. The evidence indicates that there is an association between PTSD and suicidality with several factors, such as concurrent depression and the pre-trauma psychiatric condition, possibly mediating this relationship. There are significant clinical implications of the reported relationship for suicide risk assessment and therapy, and further studies might help to understand the mediating pathways between PTSD and increased suicide risk.",0,0 +5532,Response to Psychotherapy for Posttraumatic Stress Disorder,"Neuropsychological studies have consistently demonstrated impaired verbal memory in posttraumatic stress disorder (PTSD). Trauma-focused treatment for PTSD is thought to rely on memory, but it is largely unknown whether treatment outcome is influenced by memory performance. The aim of the study, therefore, was to examine the relationship between verbal memory performance and treatment response to trauma-focused psychotherapy.Participants were referred to our outpatient clinic and recruited between December 2003 and January 2009 upon diagnosis of PTSD according to DSM-IV. Secondary analyses of a randomized controlled trial comparing eye movement desensitization and reprocessing therapy (n = 70) and brief eclectic psychotherapy (n = 70), a cognitive-behavioral intervention, are reported. Response to treatment was measured by self-reported PTSD symptom severity (Impact of Event Scale-Revised) over 17 weeks. Pretreatment verbal memory measures (California Verbal Learning Test, Rivermead Behavioral Memory Test) were included in the mixed linear model analyses in order to investigate the influence of memory on treatment outcome.Pretreatment encoding, short-term retrieval, long-term retrieval, and recognition performance were significantly associated with treatment response in terms of self-reported PTSD symptom severity for both treatments (P ≤ .013). Receiver operating characteristic curves predicting treatment response with pretreatment memory indices showed that 75.6% of the patients could be correctly classified as responder.Poor verbal memory performance represents a risk factor for worse treatment response to trauma-focused psychotherapy. Memory measures can be helpful in determining which patients are unable to benefit from trauma-focused psychotherapy. Future research should explore how treatment perspectives of patients with poor verbal memory can be improved.ISRCTN.com identifier: ISRCTN64872147.",0,0 +5533,EFFICACY OF A COGNITIVE-BEHAVIORAL TREATMENT FOR INSOMNIA AMONG AFGHANISTAN AND IRAQ (OEF/OIF) VETERANS WITH PTSD,"EFFICACY OF A COGNITIVE-BEHAVIORAL TREATMENT FOR INSOMNIA AMONG AFGHANISTAN AND IRAQ (OEF/OIF) VETERANS WITH PTSD By Skye Ochsner Margolies, M.A. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2011. Major Director: Scott Vrana, Ph.D. Professor Department of Psychology Sleep disturbances are a core and salient feature of PTSD and can maintain or exacerbate associated symptoms. Recent research demonstrates that cognitive-behavioral sleep-focused interventions improve sleep disturbances as well as PTSD symptoms. The present study is a randomized controlled trial comparing Cognitive Behavioral Therapy for Insomnia (CBT-I) to a waitlist control group. Conducted at a Veterans Affairs Medical Center, the study: 1) compared subjective outcome measures of sleep amongst veterans assigned to either a treatment group (CBT-I) or a waitlist control group; (2) examined the influence of the intervention on measures of PTSD, general mood and daytime functioning, comparing veterans in a treatment group to those in a waitlist control group and (3) examined the effect of the CBT-I intervention using objective measures of sleep for veterans included in the treatment arm of the study. Study participants were (n = 40) combat veterans who served in Afghanistan and/or Iraq (OEF/OIF). Participants were randomized to either a CBT-I treatment group or a waitlist control group. Those in the treatment condition participated in four CBT-I sessions over six weeks. CBT-I included sleep restriction, stimulus control, cognitive restructuring, sleep education, sleep hygiene and imagery rehearsal therapy. All participants completed subjective and objective measures at baseline and post-treatment. At six weeks post treatment, veterans who participated in CBT-I reported improved sleep, a reduction in PTSD symptom severity and PTSD-related nightmares, as well as a reduction in depression and distressed mood compared to veterans in the waitlist control group. When controlling for current participation in evidence-based PTSD treatment, veterans in the CBT-I group reported a reduction in PTSD symptom severity while their waitlist counterparts demonstrated an increase in these PTSD symptoms. Veterans in the treatment group also reported improved objectively measured sleep quality between baseline and posttreatment. These data suggest that CBT-I is an effective treatment for insomnia, nightmares and PTSD symptoms in OEF/OIF veterans with combat related PTSD and should be used as an adjunctive therapy to standard PTSD treatment.",0,0 +5534,Children's well-being after the war in Kosovo: survey in 2000.,"To assess special health and psychosocial needs of Albanian children in Kosovo shortly after the dramatic ethnic conflict in this part of former Yugoslavia in 1999.The survey included representative samples of school-age children (n=813), parents (n=41), and teachers (n=31) from six public schools in Prishtina and surrounding area. The measuring instruments included a standardized inventory of children's coping behavior in stressful situations (Ryan-Wegner Coping Style Inventory, SCSI), and survey questionnaires for children, parents, and school teachers, which were also used in a parallel study in Bosnia and Herzegovina (Sarajevo) on comparable survey samples. The study was accomplished in April 2000, ie, only a few months after the crisis in Kosovo.At the time of the survey, many children in Prishtina and surrounding area lived in unhealthy and dangerous physical environment. There were frequent lack of electricity (74%), lack of safe drinking water (68%), garbage on the streets (63%), and firearms, explosive devices, and mine fields in close environment (45%). Many of them showed signs and symptoms of ill health, including frequent headaches (60%), stomach ache (41%), frequent high fever (32%), and sleeplessness (18%). Most of them felt unsafe on the streets (61%). Many of them had rather unhealthy eating habits, such as not having breakfast regularly (16%) or not having a morning snack (60%). Three major groups of stressors were identified as having impact on children's health and psychosocial well-being in Kosovo, as follows: 1) lack of cultural and social security resources at home and in the community at large (20% of common variance explained); 2) poor physical and mental health conditions (14% of common variance); and 3) school-related stressors (11% of common variance). Similarly, parents and teachers also lived and worked under stressful life conditions. Many parents feared the impact of traumatic war experiences on children's health (54%), and school teachers noticed high rates of children's learning and behavioral disorders (84%). Factor analysis of the SCSI proved the hypothesis that in stressful situations children tend to use two major coping strategies: either active, ie, object-focused coping (13% of variance explained) or passive, ie, self-focused coping (10% of variance explained), the later being more typical for younger children. The pattern of stressors and coping behaviors were similar to stressors impacting physical and mental health of children in Sarajevo, although there were a number of culture-specific differences.Environmental, educational, and social conditions must be respected in assessing impact of war and conflict on children. Promotion of solidarity, tolerance, and mutual support among children from different ethnic and cultural backgrounds should be encouraged.",0,0 +5535,Baseline functioning among individuals with posttraumatic stress disorder and alcohol dependence,"Comorbid posttraumatic stress disorder (PTSD) and alcohol dependence (AD) may lead to a complicated and potentially severe treatment profile. Our study examined 167 individuals with both PTSD and AD compared with 105 individuals with PTSD without an alcohol use disorder (AUD) and 240 individuals with AD without PTSD on baseline psychosocial functioning. We hypothesized that individuals with PTSD/AD would be more socially and functionally impaired than individuals with only one disorder. Results indicated that participants with PTSD/AD were more likely to be unemployed, have less education, and report less income and were less likely to live with a partner than the participants with only a single disorder. However, they did not differ on symptom severity within these disorders (drinking frequency/quantity, PTSD, and anxiety symptoms) with the exception of depression and alcohol craving. This contradicts clinical lore that comorbid patients are more impaired at treatment initiation and adds support for concurrent treatment as not only feasible but also possibly ideal for these patients.",0,0 +5536,Cigarette Smoking and Military Deployment,"The stress of military deployment may compound occupational stress experienced in the military and manifest in maladaptive coping behaviors such as cigarette smoking. The current study describes new smoking among never-smokers, smoking recidivism among past smokers, and change in daily smoking among smokers in relation to military deployment.The Millennium Cohort is a 21-year longitudinal study. The current analysis utilized participants (N=48,304) who submitted baseline data (July 2001-June 2003) before the current conflicts in Iraq and Afghanistan and follow-up data (June 2004-January 2006) on health measures. New smoking was identified among baseline never-smokers, smoking recidivism among baseline past smokers, and increased or decreased daily smoking among baseline smokers. Analyses were conducted March 2007-April 2007.Among never-smokers, smoking initiation was identified in 1.3% of nondeployers and 2.3% of deployers. Among past smokers, smoking resumption occurred in 28.7% of nondeployers and 39.4% of those who deployed. Smoking increased 44% among nondeployers and 57% among deployers. Those who deployed and reported combat exposures were at 1.6 times greater odds of initiating smoking among baseline never-smokers (95% CI=1.2, 2.3) and at 1.3 times greater odds of resuming smoking among baseline past smokers when compared to those who did not report combat exposures. Other deployment factors independently associated with postdeployment smoking recidivism included deploying for >9 months and deploying multiple times. Among those who smoked at baseline, deployment was not associated with changes in daily amount smoked.Military deployment is associated with smoking initiation and, more strongly, with smoking recidivism, particularly among those with prolonged deployments, multiple deployments, or combat exposures. Prevention programs should focus on the prevention of smoking relapse during or after deployment.",0,0 +5537,Patterns of Multiple Victimization Among Maltreated Children in Navy Families,"The current study examined the cumulative risk associated with children's exposure to multiple types of parent-inflicted victimization. The sample was comprised of 195 children who were 7 to 17 years old (64.1% female and 48.2% non-White) at the time of referral to the United States Navy's Family Advocacy Program due to allegations of sexual abuse, physical abuse, or parental intimate partner violence. We conducted an exploratory latent class analysis to identify distinct subgroups of children based on lifetime victimization. We hypothesized that at least 2 classes or subgroups would be identified, with 1 characterized by greater victimization and poorer outcomes. Results indicated that 3 classes of children best fit the data: (a) high victimization across all 3 categories, (b) high rates of physical abuse and witnessing intimate partner violence, and (c) high rates of physical abuse only. Findings indicated that the high victimization class was at greatest risk for alcohol and substance use, delinquent behavior, and meeting criteria for posttraumatic stress disorder (PTSD) and/or depression 1 year later (odds ratio = 4.53). These findings highlight the serious mental health needs of a small but significantly high-risk portion of multiply victimized children entering the child welfare system.",0,0 +5538,"Distress, Coping, and Social Support Among Rural Women Recently Diagnosed with Primary Breast Cancer","This study examined distress, coping, and group support among a sample of rural women who had been recently diagnosed with breast cancer. We recruited 100 women who had been diagnosed with primary breast cancer at one of two time points in their medical treatment: either within a window up to 3 months after their diagnosis of breast cancer, or within 6 months after completing medical treatment for breast cancer. Their mean age was 58.6 years (SD = 11.6), and 90% were of white/European American ethnicity. Women completed a battery of demographic and psychosocial measures prior to being randomized into a psychoeducational intervention study, and then again 3 months later at a follow-up assessment. The focus of this article is on the women's self-reported psychosocial status at baseline. Many of the women experienced considerable traumatic stress regarding their breast cancer. However, this distress was not reflected in a standard measure of mood disturbance that is frequently used in intervention research (the Profile of Mood States). The average woman considered her diagnosis of breast cancer to be among the four most stressful life events that she had ever experienced. Also, women on average reported a high level of helplessness/hopelessness in coping with their cancer. On average, women felt that they ""often"" (but not ""very often"") received instrumental assistance, emotional support, and informational support. Women varied considerably in which kind of social group provided them with the most support, with as many reporting that they found the greatest support in spiritual/church groups or within their family units as with breast or general cancer groups. These results suggest that among these rural women with breast cancer, distress with the diagnosis of breast cancer must be carefully assessed, as women who are highly distressed about their breast cancer may not report general mood disturbance. Furthermore, the kinds of groups that rural women with breast cancer experience as most supportive need to be identified so that psychosocial interventions can be matched to breast cancer patients' individual needs.",0,0 +5539,Event-related potential patterns associated with hyperarousal in Gulf War illness syndrome groups,"An exaggerated response to emotional stimuli is one of the several symptoms widely reported by veterans of the 1991 Persian Gulf War. Many have attributed these symptoms to post-war stress; others have attributed the symptoms to deployment-related exposures and associated damage to cholinergic, dopaminergic, and white matter systems. We collected event-related potential (ERP) data from 20 veterans meeting Haley criteria for Gulf War Syndromes 1-3 and from 8 matched Gulf War veteran controls, who were deployed but not symptomatic, while they performed an auditory three-condition oddball task with gunshot and lion roar sounds as the distractor stimuli. Reports of hyperarousal from the ill veterans were significantly greater than those from the control veterans; different ERP profiles emerged to account for their hyperarousability. Syndromes 2 and 3, who have previously shown brainstem abnormalities, show significantly stronger auditory P1 amplitudes, purported to indicate compromised cholinergic inhibitory gating in the reticular activating system. Syndromes 1 and 2, who have previously shown basal ganglia dysfunction, show significantly weaker P3a response to distractor stimuli, purported to indicate dysfunction of the dopaminergic contribution to their ability to inhibit distraction by irrelevant stimuli. All three syndrome groups showed an attenuated P3b to target stimuli, which could be secondary to both cholinergic and dopaminergic contributions or disruption of white matter integrity.",0,0 +5540,Spotlight on Paroxetine in Psychiatric Disorders in Adults*,"Paroxetine is a selective serotonin reuptake inhibitor (SSRI), with antidepressant and anxiolytic activity. In 6- to 24-week well designed trials, oral paroxetine 10 to 50 mg/day was significantly more effective than placebo, at least as effective as tricyclic antidepressants (TCAs) and as effective as other SSRIs and other antidepressants in the treatment of major depressive disorder. Relapse or recurrence over 1 year after the initial response was significantly lower with paroxetine 10 to 50 mg/day than with placebo and similar to that with imipramine 50 to 275 mg/day. The efficacy of paroxetine 10 to 40 mg/day was similar to that of TCAs and fluoxetine 20 to 60 mg/day in 6- to 12-week trials in patients aged (greater-than or equal to)60 years with major depression. Paroxetine 10 to 40 mg/day improved depressive symptoms to an extent similar to that of TCAs in patients with comorbid illness, and was more effective than placebo in the treatment of dysthymia and minor depression. Paroxetine 20 to 60 mg/day was more effective than placebo after 8 to 12 weeks' treatment of obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder (social phobia), generalised anxiety disorder (GAD) and post-traumatic stress disorder (PTSD). Improvement was maintained or relapse was prevented for 24 weeks to 1 year in patients with OCD, panic disorder, social anxiety disorder or GAD. The efficacy of paroxetine was similar to that of other SSRIs in patients with OCD and panic disorder and similar to that of imipramine but greater than that of 2'chlordesmethyldiazepam in patients with GAD. Paroxetine is generally well tolerated in adults, elderly individuals and patients with comorbid illness, with a tolerability profile similar to that of other SSRIs. The most common adverse events with paroxetine were nausea, sexual dysfunction, somnolence, asthenia, headache, constipation, dizziness, sweating, tremor and decreased appetite. In conclusion, paroxetine, in common with other SSRIs, is generally better tolerated than TCAs and is a first-line treatment option for major depressive disorder, dysthymia or minor depression. Like other SSRIs, paroxetine is also an appropriate first-line therapy for OCD, panic disorder, social anxiety disorder, GAD and PTSD. Notably, paroxetine is the only SSRI currently approved for the treatment of social anxiety disorder and GAD, which makes it the only drug of its class indicated for all five anxiety disorders in addition to major depressive disorder. Thus, given the high degree of psychiatric comorbidity of depression and anxiety, paroxetine is an important first-line option for the treatment of major depressive disorder, OCD, panic disorder, social anxiety disorder, GAD and PTSD.",0,0 +5541,"Low-frequency, Repetitive Transcranial Magnetic Stimulation for the Treatment of Patients with Posttraumatic Stress Disorder: a Double-blind, Sham-controlled Study","Several studies have suggested that repetitive transcranial magnetic stimulation (rTMS) of the right prefrontal cortex may be useful in the treatment of posttraumatic stress disorder (PTSD). The aim of this study was to compare the effect of rTMS on the right prefrontal cortex with that of sham stimulation among patients with PTSD.In total, 18 patients with PTSD were randomly assigned to the 1-Hz low-frequency rTMS group or the sham group for 3 weeks. Primary efficacy measures were the Clinician-Administered PTSD Scale (CAPS) and its subscales, assessed at baseline and at 2, 4, and 8 weeks.All CAPS scores improved significantly over the study period. We found significant differences in the re-experiencing scores (F=7.47, p=0.004) and total scores (F=6.45, p=0.008) on the CAPS. The CAPS avoidance scores showed a trend toward significance (F=2.74, p=0.055), but no significant differences in the CAPS hyperarousal scores were observed.The present study showed low-frequency rTMS to be an effective and tolerable option for the treatment of PTSD. Trials using variable indices of rTMS to the right prefrontal cortex and explorations of the differences in the effects on specific symptom clusters may be promising avenues of research regarding the use of rTMS for PTSD.",0,0 +5542,"Indirect associations of combat exposure with post-deployment physical symptoms in U.S. soldiers: Roles of post-traumatic stress disorder, depression and insomnia","To characterize the indirect associations of combat exposure with post-deployment physical symptoms through shared associations with post-traumatic stress disorder (PTSD), depression and insomnia symptoms.Surveys were administered to a sample of U.S. soldiers (N = 587) three months after a 15-month deployment to Iraq. A multiple indirect effects model was used to characterize direct and indirect associations between combat exposure and physical symptoms.Despite a zero-order correlation between combat exposure and physical symptoms, the multiple indirect effects analysis did not provide evidence of a direct association between these variables. Evidence for a significant indirect association of combat exposure and physical symptoms was observed through PTSD, depression, and insomnia symptoms. In fact, 92% of the total effect of combat exposure on physical symptoms scores was indirect. These findings were evident even after adjusting for the physical injury and relevant demographics.This is the first empirical study to suggest that PTSD, depression and insomnia collectively and independently contribute to the association between combat exposure and post-deployment physical symptoms. Limitations, future research directions, and potential policy implications are discussed.",0,0 +5543,Effect of Sertraline on Glucocorticoid Sensitivity of Mononuclear Leukocytes in Post-Traumatic Stress Disorder,"This study examined the effects of sertraline (SER) on glucocorticoid sensitivity in mononuclear leukocytes (MNL) from eight subjects with current post-traumatic stress disorder (PTSD) and nine comparison subjects. In all, 60 ml of blood was withdrawn by venipuncture at 0800, and MNL were isolated from blood and divided into two portions: the first contained live cells incubated with a series of concentrations of dexamethasone (DEX); the second contained cells incubated with similar concentrations of DEX+2 muM SER. Group difference in the concentrations of DEX required to inhibit lysozyme activity by 50% were evaluated under conditions of DEX-only and DEX+SER using analysis of covariance (ANCOVA). A significant Group x Condition interaction reflected that SER altered the lysozyme IC(50-DEX) in the direction of decreasing sensitivity to glucocorticoids in PTSD while having no uniform effect in cells from comparison subjects. The data provide support for the idea that glucocorticoid receptors might be more responsive to antidepressants in PTSD than in persons without PTSD. Insofar as increased sensitivity to glucocorticoids has been linked with PTSD, the actions of SER on the lysozyme IC(50-DEX) suggest that this medication may target a biologic alteration associated with PTSD pathophysiology.",0,0 +5544,Genetic Polymorphisms Influence Recovery from Traumatic Brain Injury,"Traumatic brain injury (TBI) is a major public health concern in both civilian and military populations. Recently, genetics studies have begun to identify individual differences in polymorphisms that could affect recovery and outcome of cognitive and social processes following TBI. This review considers the potential for polymorphisms to influence six specific cognitive and social functions, which represent the most prominent domains of impairment following TBI: working memory, executive function, decision making, inhibition and impulsivity, aggression, and social and emotional function. Examining the influence of polymorphisms on TBI outcome has the potential to contribute to an understanding of variations in TBI outcome, aid in the triaging and treatment of TBI patients, and ultimately lead to targeted interventions based on genetic profiles.",0,0 +5545,"A Decade Later, How Much of Rwanda's Musculoskeletal Impairment Is Caused by the War in 1994 and by Related Violence?","In 1994 there was a horrific genocide in Rwanda following years of tension, resulting in the murder of at least 800,000 people. Although many people were injured in addition to those killed, no attempt has been made to assess the lasting burden of physical injuries related to these events. The aim of this study was to estimate the current burden of musculoskeletal impairment (MSI) attributable to the 1994 war and related violence.A national cross-sectional survey of MSI was conducted in Rwanda. 105 clusters of 80 people were selected through probability proportionate to size sampling. Households within clusters were selected through compact segment sampling. Enumerated people answered a seven-question screening test to assess whether they might have an MSI. Those who were classed as potential cases in the screening test were examined and interviewed by a physiotherapist, using a standard protocol that recorded the site, nature, cause, and severity of the MSI. People with MSI due to trauma were asked whether this trauma occurred during the 1990-1994 war or during the episodes that preceded or followed this war. Out of 8,368 people enumerated, 6,757 were available for screening and examination (80.8%). 352 people were diagnosed with an MSI (prevalence=5.2%, 95% CI=4.5-5.9%). 106 cases of MSI (30.6%) were classified as resulting from trauma, based on self-report and the physiotherapist's assessment. Of these, 14 people (13.2%) reported that their trauma-related MSI occurred during the 1990-1994 war, and a further 7 (6.6%) that their trauma-related MSI occurred during the violent episodes that preceded and followed the war, giving an overall prevalence of trauma-related MSI related to the 1990-1994 war of 0.3% (95% CI=0.2-0.4%).A decade on, the overall prevalence of MSI was relatively high in Rwanda but few cases appeared to be the result of the 1994 war or related violence.",0,0 +5546,"Exposure to traumatic events, prevalence of posttraumatic stress disorder and alcohol abuse in Aboriginal communities","Generations of Aboriginal people have been exposed to strings of traumatic events with devastating psychosocial health consequences, including psychiatric morbidities and mortalities, and medical complications. Posttraumatic Stress Disorder (PTSD) is a psychiatric morbidity directly linked to traumatic events. Despite research findings indicating traumatic exposure and resultant PTSD in Indigenous communities, little attention has been given to this condition in mental healthcare delivery. Consequently, clinical and psychosocial interventions are misguided and failed to deliver positive outcomes. The objective of this study is to explore the relationship between exposure to traumatic events, prevalence of PTSD and alcohol abuse in remote Aboriginal communities in Western Australia.A combination of structured clinical interview and multiple survey questionnaires - Composite International Diagnostic Interview (CIDI), and Impact of Events Scale (IES), Alcohol Use Disorder Identification Test (AUDIT) and Indigenous Trauma Profile (ITP) - were administered to 221 Indigenous participants aged 18 to 65 years.The overwhelming majority, 97.3% (n=215) of participants were exposed to traumatic events. Analysis of CIDI results using DSM-IV diagnostic criteria shows a life time prevalence of 55.2% (n=122) for PTSD, 20% (n=44) for major depression (recurrent) and 2.3% (n=5) for a single episode. A total of 96% (n=212) participants reported consuming a drink containing alcohol and 73.8% (n=163) met diagnostic criteria for alcohol use related disorders, abuse and dependence. Of participants who met the PTSD diagnostic criteria, 91% (n=111) met diagnostic criteria for alcohol use related disorders. Other impacts of trauma such as other anxiety disorders, dysthymic disorder and substances abuses were also identified.The rate of exposure to traumatic events and prevalence of PTSD are disproportionately higher in the communities studied than the national average and one of the highest recorded in survivors of specific traumatic events in the world. A very high rate of alcohol abuse and dependence in participants who met diagnostic criteria for PTSD demonstrates correlation between alcohol abuse and PTSD. It also suggests that alcohol is used as self-medication.",0,0 +5547,Hopefulness predicts resilience after hereditary colorectal cancer genetic testing: a prospective outcome trajectories study,"Genetic testing for hereditary colorectal cancer (HCRC) had significant psychological consequences for test recipients. This prospective longitudinal study investigated the factors that predict psychological resilience in adults undergoing genetic testing for HCRC.A longitudinal study was carried out from April 2003 to August 2006 on Hong Kong Chinese HCRC family members who were recruited and offered genetic testing by the Hereditary Gastrointestinal Cancer Registry to determine psychological outcomes after genetic testing. Self-completed questionnaires were administered immediately before (pre-disclosure baseline) and 2 weeks, 4 months and 1 year after result disclosure. Using validated psychological inventories, the cognitive style of hope was measured at baseline, and the psychological distress of depression and anxiety was measured at all time points.Of the 76 participating subjects, 71 individuals (43 men and 28 women; mean age 38.9 +/- 9.2 years) from nine FAP and 24 HNPCC families completed the study, including 39 mutated gene carriers. Four patterns of outcome trajectories were created using established norms for the specified outcome measures of depression and anxiety. These included chronic dysfunction (13% and 8.7%), recovery (0% and 4.3%), delayed dysfunction (13% and 15.9%) and resilience (76.8% and 66.7%). Two logistic regression analyses were conducted using hope at baseline to predict resilience, with depression and anxiety employed as outcome indicators. Because of the small number of participants, the chronic dysfunction and delayed dysfunction groups were combined into a non-resilient group for comparison with the resilient group in all subsequent analysis. Because of low frequencies, participants exhibiting a recovery trajectory (n = 3 for anxiety and n = 0 for depression) were excluded from further analysis. Both regression equations were significant. Baseline hope was a significant predictor of a resilience outcome trajectory for depression (B = -0.24, p < 0.01 for depression); and anxiety (B = -0.11, p = 0.05 for anxiety).The current findings suggest that hopefulness may predict resilience after HCRC genetic testing in Hong Kong Chinese. Interventions to increase the level of hope may be beneficial to the psychological adjustment of CRC genetic testing recipients.",0,0 +5548,The Moderating Effects of Maternal Psychopathology on Children's Adjustment Post–Hurricane Katrina,This study investigated the role of maternal psychopathology in predicting children's psychological distress in a disaster-exposed sample. Participants consisted of 260 children (ages 8-16) recruited from public schools and their mothers. These families were displaced from New Orleans because of Hurricane Katrina in 2005. Assessment took place 3 to 7 months postdisaster. Hierarchical regression analyses revealed that global maternal psychological distress and maternal posttraumatic stress disorder moderated the relation between child hurricane exposure and mother-reported child internalizing and externalizing symptoms.,0,0 +5549,Identifying latent profiles of posttraumatic stress and major depression symptoms in Canadian veterans: Exploring differences across profiles in health related functioning,"Posttraumatic stress disorder (PTSD) has been consistently reported as being highly comorbid with major depressive disorder (MDD) and as being associated with health related functional impairment (HRF). We used archival data from 283 previously war-zone deployed Canadian veterans. Latent profile analysis (LPA) was used to uncover patterns of PTSD and MDD comorbidity as measured via the PTSD Checklist-Military version (PCL-M) and the Patient Health Questionnaire-9 (PHQ-9). Individual membership of latent classes was used in a series of one-way ANOVAs to ascertain group differences related to HRF as measured via the Short-Form-36 Health Survey (SF-36). LPA resulted in three discrete patterns of PTSD and MDD comorbidity which were characterized by high symptoms of PTSD and MDD, moderate symptoms, and low symptoms. All ANOVAs comparing class membership on the SF-36 subscales were statistically significant demonstrating group differences across levels of HRF. The group with the highest symptoms reported the worst HRF followed by the medium and low symptom groups. These findings are clinically relevant as they demonstrate the need for continual assessment and targeted treatment of co-occurring PTSD and MDD.",0,0 +5550,"Clinical expression profiles of complex regional pain syndrome, fibromyalgia and a-specific repetitive strain injury: More common denominators than pain?","To systematically evaluate and compare the clinical manifestations, disease course, risk factors and demographic characteristics of Complex Regional Pain Syndrome type 1 (CRPS), fibromyalgia (FM) and a-specific Repetitive Strain Injury (RSI).A literature search was performed using terms related to the aforementioned topics and diseases. Only original clinical studies that included at least 20 subjects were eligible.Fifty-nine studies on CRPS, 73 on FM and 7 on a-specific RSI were identified. The diseases show similarities in age distribution, male-female ratio, pain characteristics and sensory signs and symptoms. Motor, autonomic and trophic changes are frequently reported in CRPS, but only occasionally in FM and RSI. Systemic symptoms are found in patients with CRPS and FM, and in a subgroup of patients with RSI. In all three disorders, symptoms usually start locally, but may spread to other body regions later, which, in the case of FM, is a prerequisite for diagnosis. Disease onset is always, usually, or occasionally of traumatic origin in RSI, CRPS and FM, respectively. Anxiety and depression are more frequent in patients compared to controls, but probably not very different from patients with other pain conditions or chronic diseases.Apart from some obvious differences between CRPS, FM and RSI, the similarities are conspicuous. The common features of CRPS, FM and a-specific RSI may suggest that a common pathway is involved, but until patients with these type of symptoms are assessed with a uniform assessment procedure, a thorough comparison cannot be made. A systematic evaluation of patients with a suspected diagnosis of CRPS, FM or RSI, may lead to a better appreciation of the differences and similarities in these diseases and help to unravel the underlying mechanisms.",0,0 +5551,Distinguishing between treatment efficacy and effectiveness in post-traumatic stress disorder (PTSD): Implications for contentious therapies,Research psychologists often complain that practitioners disregard research evidence whilst practitioners sometimes accuse researchers of failing to produce evidence with sufficient ecological validity. We discuss the tension that thus arises using the specific illustrative examples of two treatment methods for post-traumatic stress disorder: eye movement desensitisation and reprocessing and exposure-based interventions. We discuss the contextual reasons for the success or failure of particular treatment models that are often only tangentially related to the theoretical underpinnings of the models. We discuss what might be learnt from these debates and develop recommendations for future research.,0,0 +5552,Birth Outcomes in a Disaster Recovery Environment: New Orleans Women After Katrina,"To examine how the recovery following Hurricane Katrina affected pregnancy outcomes.308 New Orleans area pregnant women were interviewed 5-7 years after Hurricane Katrina about their exposure to the disaster (danger, damage, and injury); current disruption; and perceptions of recovery. Birthweight, gestational age, birth length, and head circumference were examined in linear models, and low birthweight (<2500 g) and preterm birth (<37 weeks) in logistic models, with adjustment for confounders.Associations were found between experiencing damage during Katrina and birthweight (adjusted beta for high exposure = -158 g) and between injury and gestational age (adjusted beta = -0.5 days). Of the indicators of recovery experience, most consistently associated with worsened birth outcomes was worry that another hurricane would hit the region (adjusted beta for birthweight: -112 g, p = 0.08; gestational age: -3.2 days, p = 0.02; birth length: -0.65 cm, p = 0.06).Natural disaster may have long-term effects on pregnancy outcomes. Alternately, women who are most vulnerable to disaster may be also vulnerable to poor pregnancy outcome.",0,0 +5553,Latent profile analysis and principal axis factoring of the DSM-5 dissociative subtype,"A dissociative subtype has been recognized based on the presence of experiences of depersonalization and derealization in relation to DSM-IV posttraumatic stress disorder (PTSD). However, the dissociative subtype has not been assessed in a community sample in relation to the revised DSM-5 PTSD criteria. Moreover, the 20-item PTSD Checklist for DSM-5 (PCL-5) currently does not assess depersonalization and derealization.We therefore evaluated two items for assessing depersonalization and derealization in 557 participants recruited online who endorsed PTSD symptoms of at least moderate severity on the PCL-5.A five-class solution identified two PTSD classes who endorsed dissociative experiences associated with either 1) severe or 2) moderate PTSD symptom severity (D-PTSD classes). Those in the severe dissociative class were particularly likely to endorse histories of childhood physical and sexual abuse. A principal axis factor analysis of the symptom list identified six latent variables: 1) Reexperiencing, 2) Emotional Numbing/Anhedonia, 3) Dissociation, 4) Negative Alterations in Cognition & Mood, 5) Avoidance, and 6) Hyperarousal.The present results further support the presence of a dissociative subtype within the DSM-5 criteria for PTSD.",0,0 +5554,Evolution of secure services for women in England,"Summary Patients detained at high and medium security reveal significant gender differences in the presentation of psychopathology, mental disorder and social and offending profiles. However, secure mental health services in England, like prisons, generally fail to recognise the core importance of the differing biopsychosocial development in women and the impact of life experiences on women's subsequent biopsychosocial functioning. As a consequence, women are often inadequately provided for in services dictated by the identified needs, risks and responsiveness of men. The lack of clinically appropriate facilities for women may account for the increased frequency with which women are readmitted to medium security and for their longer admissions to both high and medium secure care. New tertiary services are developing as a result of the lessons learnt while providing gender-blind care. However, further development is required to ensure that women receive services of the same quality, range and nature of those received by men.",0,0 +5555,Prolonged grief among traumatically bereaved relatives exposed and not exposed to a tsunami,"Numerous studies on the mental health consequences of traumatic exposure to a disaster compare those exposed to those not exposed. Relatively few focus on the effect of the death of a close relative caused by the disaster-suffering a traumatic bereavement. This study compared the impact on 345 participants who lost a close relative in the 2004 Indian Ocean tsunami, but who were themselves not present, to 141 who not only lost a relative, but also were themselves exposed to the tsunami. The focus was on psychological distress assessed during the second year after the sudden bereavement. Findings were that exposure to the tsunami was associated with prolonged grief (B = 3.81) and posttraumatic stress reactions (B = 6.65), and doubled the risk for impaired mental health. Loss of children increased the risk for psychological distress (prolonged grief: B = 6.92; The Impact of Event Scale-Revised: B = 6.10; General Health Questionnaire-12: OR = 2.34). Women had a higher frequency of prolonged grief. For men, loss of children presented a higher risk for prolonged grief in relation to other types of bereavement (B = 6.36 vs. loss of partner). Further long-term follow-up could deepen the understanding of how recovery after traumatic loss is facilitated.",0,0 +5556,Mobilizing Victim Services: The Role of Reporting to the Police,"Victim assistance programs have grown dramatically in response to the victim's rights movement and concern over difficulty navigating victim services. Evidence, however, indicates that very few victims seek assistance. The present study examined factors associated with victim service use including reporting to the police, the victim's demographic characteristics, the victim's injury, offender's use of a weapon, the victim's relationship to the offender, and the victim's mental and physical distress. Data came from a subset of the National Crime Victimization Survey 2008-2011 (N = 4,746), a stratified multistage cluster sample survey of persons age 12 years and older in the United States. Logistic regression models indicated that fewer than 10% of victims of violent crime sought help from victim services. Reporting to the police increased the odds of seeking services by 3 times. In addition, the odds of victims attacked by an intimate partner seeking services were 4.5 times greater than victims attacked by strangers. Findings suggest that additional exploratory work is needed in uncovering the mechanism of police involvement in linking victims to services. Specifically, do police understand what services are available to victims and why are police more likely to inform some types of victims about services more than others?",0,0 +5557,Workplace Violence: A Primer for Critical Care Nurses,"This review illustrates the various types of workplace violence nurses can encounter in critical care settings. Lack of a clear definition of workplace violence impedes research on the topic; however, the typology offered by the UIIPRC provides a framework to guide further studies of physical and nonphysical workplace violence. Further investigation of individual and organizational factors will assist nurses and agencies in identifying effective methods to manage, prevent, educate, and respond to each type of workplace violence. Fear, burnout, anxiety, depression, and acute and posttraumatic stress disorders are some of the sequelae that can occur after an incident of workplace violence. Debriefing strategies should be a fundamental component of workplace violence policies to prevent the development of longterm consequences. Additional research is needed on all types of workplace violence, as well as research addressing the needs of specialized setting, such as critical care unit. Critical care nurses have valuable insights regarding the risks they face on their units and should be part of a multidisciplinary team developing policies and workplace violence prevention and education programs.",0,0 +5558,Assessing the fit of the Dysphoric Arousal model across two nationally representative epidemiological surveys: The Australian NSMHWB and the United States NESARC,"Since the initial inclusion of PTSD in the DSM nomenclature, PTSD symptomatology has been distributed across three symptom clusters. However, a wealth of empirical research has concluded that PTSD's latent structure is best represented by one of two four-factor models: Numbing or Dysphoria. Recently, a newly proposed five-factor Dysphoric Arousal model, which separates the DSM-IV's Arousal cluster into two factors of Anxious Arousal and Dysphoric Arousal, has gathered support across a variety of trauma samples. To date, the Dysphoric Arousal model has not been assessed using nationally representative epidemiological data. We employed confirmatory factor analysis to examine PTSD's latent structure in two independent population based surveys from American (NESARC) and Australia (NSWHWB). We specified and estimated the Numbing model, the Dysphoria model, and the Dysphoric Arousal model in both samples. Results revealed that the Dysphoric Arousal model provided superior fit to the data compared to the alternative models. In conclusion, these findings suggest that items D1-D3 (sleeping difficulties; irritability; concentration difficulties) represent a separate, fifth factor within PTSD's latent structure using nationally representative epidemiological data in addition to single trauma specific samples.",0,0 +5559,Prognostic factors of whiplash-associated disorders: a systematic review of prospective cohort studies,"We present a systematic review of prospective cohort studies. Our aim was to assess prognostic factors associated with functional recovery of patients with whiplash injuries. The failure of some patients to recover following whiplash injury has been linked to a number of prognostic factors. However, there is some inconsistency in the literature and there have been no systematic attempts to analyze the level of evidence for prognostic factors in whiplash recovery. Studies were selected for inclusion following a comprehensive search of MEDLINE, EMBASE, CINAHL, the database of the Dutch Institute of Allied Health Professions up until April 2002 and hand searches of the reference lists of retrieved articles. Studies were selected if the objective was to assess prognostic factors associated with recovery; the design was a prospective cohort study; the study population included at least an identifiable subgroup of patients suffering from a whiplash injury; and the paper was a full report published in English, German, French or Dutch. The methodological quality was independently assessed by two reviewers. A study was considered to be of 'high quality' if it satisfied at least 50% of the maximum available quality score. Two independent reviewers extracted data and the association between prognostic factors and functional recovery was calculated in terms of risk estimates. Fifty papers reporting on twenty-nine cohorts were included in the review. Twelve cohorts were considered to be of 'high quality'. Because of the heterogeneity of patient selection, type of prognostic factors and outcome measures, no statistical pooling was able to be performed. Strong evidence was found for high initial pain intensity being an adverse prognostic factor. There was strong evidence that for older age, female gender, high acute psychological response, angular deformity of the neck, rear-end collision, and compensation not being associated with an adverse prognosis. Several physical (e.g. restricted range of motion, high number of complaints), psychosocial (previous psychological problems), neuropsychosocial factors (nervousness), crash related (e.g. accident on highway) and treatment related factors (need to resume physiotherapy) showed limited prognostic value for functional recovery. High initial pain intensity is an important predictor for delayed functional recovery for patients with whiplash injury. Often mentioned factors like age, gender and compensation do not seem to be of prognostic value. Scientific information about prognostic factors can guide physicians or other care providers to direct treatment and to probably prevent chronicity.",0,0 +5560,A clinical handbook/practical therapist manual for assessing and treating adults with post-traumatic stress disorder (PTSD).,"(from the preface) This ""Therapist Handbook/Manual"" arose out of a 7 yr intensive period during which [the author had] been deeply involved in work with clients (adults, adolescents, and children) who have been traumatized by natural and technological disasters and due to traumatic events of intentional human design. [The author's assessment and treatment of clients who experience posttraumatic stress disorder (PTSD) and in training both inpatient and outpatient mental health staff constitutes] the basis of the present manual on work with adults. . . . Each Section has a statement of objectives, section summaries, ""how to"" guidelines, critical evaluations of the field as well as a test of [one's] level of ""expertise."" (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5561,Treatment of Intimate Partner Violence Perpetration Among Male Veterans: An Example of a Comprehensive Approach,"Intimate partner violence (IPV) is a significant and enduring public health problem, affecting as many as 5 million women annually in the United States. As a microcosm of society, military families experience such violence at rates equal to or higher than civilian counterparts. IPV is a complex problem often fueled by an equally complex mixture of risk factors, including substance abuse, childhood abuse and trauma, PTSD, depression, personality disorders, and various other stressors. The United States Department of Veterans Affairs provides healthcare to nearly nine million Veterans annually, including for IPV and the related risk factors. This article describes the risk factors for IPV, as well as the challenges associated with effectively treating it. Given the complexity of the problem, the need for an interdisciplinary, comprehensive approach to treatment is emphasized. An example of such a program is described. © 2015, Springer Science+Business Media New York.",0,0 +5562,Validation of the French Version of the Brief Pain Inventory in Canadian Veterans Suffering from Traumatic Stress,"Although pain is a significant clinical problem in individuals suffering from post-traumatic stress disorder (PTSD), reliable and valid measures of pain for this population are lacking. The goal of this study was to validate the Brief Pain Inventory (BPI) in French-speaking veterans suffering from PTSD (n=130). We administered the BPI, as well as measures of PTSD, health status, quality of life, and social desirability, to veterans being assessed or treated for PTSD at a Veterans Affairs Canada clinic. The BPI showed strong internal consistency, as evidenced by Cronbach's alphas of 0.90 and 0.92 for the severity and interference subscales, respectively. Similar to previous findings, a two-factor structure (pain severity and pain interference) was found using an exploratory factor analysis. The two factors explained nearly 73% of the variance of the instrument. The BPI was also strongly correlated with health status and quality of life in the physical domain. In this veteran sample, nearly 87% of the veterans suffered from significant current pain. Veterans in our sample reported rates of pain severity that were similar to or higher than most of those reported by cancer patients and others with significant physical disability/illness. Overall, the French version of the BPI is a reliable, valid measure of pain in PTSD-suffering populations. Pain is a major issue in veterans with PTSD, and should be screened for with instruments such as the BPI.",0,0 +5563,From Memory Impairment to Posttraumatic Stress Disorder-Like Phenotypes: The Critical Role of an Unpredictable Second Traumatic Experience,"Arousal and stress critically regulate memory formation and retention. Increasing levels of stress produce an inverted U-shaped effect on cognitive performance, including the retention of explicit memories, and experiencing a severe stress during a traumatic event may lead to posttraumatic stress disorder (PTSD). The molecular mechanisms underlying the impairing effect of a severe stress on memory and the key contribution of traumatic experiences toward the development of PTSD are still unknown. Here, using increasing footshock intensities in an inhibitory avoidance paradigm, we reproduced the inverted U-shaped curve of memory performance in rats. We then show that the inverted U profile of memory performance correlates with an inverted U profile of corticosterone level in the circulation and of brain-derived neurotrophic factor, phosphorylated tropomyosin-receptor kinase B, and methyl CpG binding protein in the dorsal hippocampus. Furthermore, training with the highest footshock intensity (traumatic experience) led to a significant elevation of hippocampal glucocorticoid receptors. Exposure to an unpredictable, but not to a predictable, highly stressful reminder shock after a first traumatic experience resulted in PTSD-like phenotypes, including increased memory of the trauma, high anxiety, threat generalization, and resistance to extinction. Systemic corticosterone injection immediately after the traumatic experience, but not 3 d later, was sufficient to produce PTSD-like phenotypes. We suggest that, although after a first traumatic experience a suppression of the corticosterone-dependent response protects against the development of an anxiety disorder, experiencing more than one trauma (multiple hits) is a critical contributor to the etiology of PTSD.",0,0 +5564,"Posttraumatic Stress Disorder, Alcohol Use, and Perceived Safety After the Terrorist Attack on the Pentagon","The authors examined posttraumatic stress disorder (PTSD), alcohol use, and perceptions of safety in a sample of survivors of the September 11, 2001, terrorist attack on the Pentagon.Analyses were conducted to examine the effect of past traumatic experience, trauma exposure, initial emotional response, and peritraumatic dissociation on probable PTSD, substance use, and perceived safety among 77 survivors seven months after the attack.Eleven respondents (14 percent) had PTSD. Those with PTSD reported higher levels of initial emotional response and peritraumatic dissociation. Ten respondents (13 percent) reported increased use of alcohol. Women were more than five times as likely as men to have PTSD and almost seven times as likely to report increased use of alcohol. Persons with higher peritraumatic dissociation were more likely to develop PTSD and report increased alcohol use. Those with lower perceived safety at seven months had higher initial emotional response and greater peritraumatic dissociation and were more likely to have PTSD, to have increased alcohol use, and to be female.The association of perceived safety with gender, the presence of PTSD, and increased alcohol use among survivors of the terrorist attack on the Pentagon warrants further study.",0,0 +5565,Trajectories of perceived social support among low-income female survivors of Hurricane Katrina,"The purpose of this study was to explore trajectories of perceived social support among low-income women who survived Hurricane Katrina, and were surveyed prior to the hurricane and approximately one and four years thereafter ( N = 562). Latent class growth analysis provided evidence of the following four trajectories of perceived support: High Increasing (35.9%), High Decreasing (20.3%), Low Stable (41.1%), and Low Decreasing (2.7%). Bereavement was significantly predictive of membership in the Low Stable trajectory, relative to the High Increasing and High Decreasing trajectories. Higher psychological distress and indicators of greater social network size, density, and closeness were significantly predictive of membership in the Low Decreasing trajectory, relative to the High Increasing and High Decreasing trajectories.",0,0 +5566,Long-term effects of acute perinatal asphyxia on rat maternal behavior,"In this study we used a rat model of graded perinatal asphyxia to study the long-term consequences of this manipulation on rat maternal behavior at adulthood. Rats were delivered by cesarean (C) section and the pups, still in the uterus horns, were placed into a water bath at 37 degrees C for periods of 0 (controls) or 20 min (asphyxia). Subsequently, female pups were given to surrogate mothers, weaned at 21 days postnatally and then left undisturbed until adulthood, when they were mated. Once they gave birth, on postnatal days (Pnds) 1, 3, 5, 7, 9, 11 and 13 they were observed in the home cage five times per day to assess their maternal behavior in an undisturbed condition. In addition, maternal behavior was observed for 30 min in a novel cage on Pnds 4 and 8. Perinatal asphyxia affected maternal behavior in the home cage, hypoxic females being more often found outside the nest area and performing more often behaviors such as self-grooming. Principal component analysis confirmed a more 'active' behavioral profile for hypoxic females. Hypoxic mothers were characterized by a longer latency to perform on-nest behavior and by a reduced frequency of pup retrieval and licking in the novel cage. No significant differences in corticosterone secretion in response to an acute stressor were found in dams belonging to the different treatments or in the body weights of the offspring. These results are suggestive of an arousal deficit due to perinatal hypoxia and point to the dopaminergic system as a potential neurochemical target for an early hypoxic insult.",0,0 +5567,Assessment of social support among veterans with military-related post- traumatic stress disorder : a study of the Social Support Questionnaire,"Numerous studies in the past 20 years have found an inverse correlation between social support and post-traumatic stress disorder (PTSD). However, the social support literature is encumbered by a wide-spread inconsistency of social support measurement, with many studies not using existing validated measures. Identifying a valid social support measure with clinical utility among veterans diagnosed with war-related (PTSD) would be a helpful resource for clinicians. Using data from 689 veterans seeking treatment from a VA PTSD program, the reliability, factor structure, and construct validity of the Social Support Questionnaire (SSQ; Sarason, Levine, Basham, & Sarason, 1983) were evaluated. The hypothesis of this study was based on the theoretical assumption that social support (as measured by the SSQ), would be inversely correlated with severity of PTSD symptoms (as measured by the Mississippi Scale for War-related PTSD; Keane, Caddell & Taylor, 1988) and depression (as measured by the Beck Depression Inventory; Beck, 1961). In this study, the SSQ scores were found to inversely correlate at a low, but statistically significant level, with both PTSD and depression scores. Principal axes factor analysis found that the two subscales of the SSQ were each measuring one factor. The correlation between the SSQ ""N"" scores and ""S"" scores suggest that these subscales are measuring different components of social support. Numerous implications for research and clinical practice are discussed. This study is the first to psychometrically evaluate a measure of current social support for use among war veterans diagnosed with PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5568,A person-centered analysis of posttraumatic stress disorder symptoms following a natural disaster: Predictors of latent class membership,"The present study applied latent class analysis to a sample of 810 participants residing in southern Mississippi at the time of Hurricane Katrina to determine if people would report distinct, meaningful PTSD symptom classes following a natural disaster. We found a four-class solution that distinguished persons on the basis of PTSD symptom severity/pervasiveness (Severe, Moderate, Mild, and Negligible Classes). Multinomial logistic regression models demonstrated that membership in the Severe and Moderate Classes was associated with potentially traumatic hurricane-specific experiences (e.g., being physically injured, seeing dead bodies), pre-hurricane traumatic events, co-occurring depression symptom severity and suicidal ideation, certain religious beliefs, and post-hurricane stressors (e.g., social support). Collectively, the findings suggest that more severe/pervasive typologies of natural disaster PTSD may be predicted by the frequency and severity of exposure to stressful/traumatic experiences (before, during, and after the disaster), co-occurring psychopathology, and specific internal beliefs.",0,0 +5569,Subgroups of musculoskeletal pain patients and their psychobiological patterns – The LOGIN study protocol,"Pain conditions of the musculoskeletal system are very common and have tremendous socioeconomic impact. Despite its high prevalence, musculoskeletal pain remains poorly understood and predominantly non-specifically and insufficiently treated.The group of chronic musculoskeletal pain patients is supposed to be heterogeneous, due to a multitude of mechanisms involved in chronic pain. Psychological variables, psychophysiological processes, and neuroendocrine alterations are expected to be involved. Thus far, studies on musculoskeletal pain have predominantly focused on the general aspects of pain processing, thus neglecting the heterogeneity of patients with musculoskeletal pain. Consequently, there is a need for studies that comprise a multitude of mechanisms that are potentially involved in the chronicity and spread of pain. This need might foster research and facilitate a better pathophysiological understanding of the condition, thereby promoting the development of specific mechanism-based treatments for chronic pain. Therefore, the objectives of this study are as follows: 1) identify and describe subgroups of patients with musculoskeletal pain with regard to clinical manifestations (including mental co-morbidity) and 2) investigate whether distinct sensory profiles or 3) distinct plasma levels of pain-related parameters due to different underlying mechanisms can be distinguished in various subgroups of pain patients.We will examine a population-based chronic pain sample (n = 100), a clinical tertiary care sample (n = 100) and pain-free patients with depression or post-traumatic stress disorder and pain-free healthy controls (each n = 30, respectively). The samples will be pain localisation matched by sex and age to the population-based sample. Patients will undergo physical examination and thorough assessments of mental co-morbidity (including psychological trauma), perceptual and central sensitisation (quantitative sensory testing), descending inhibition (conditioned pain modulation, the diffuse noxious inhibitory control-like effect), as well as measurement of the plasma levels of nerve growth factor and endocannabinoids.The identification of the underlying pathophysiologic mechanisms in different subgroups of chronic musculoskeletal pain patients will contribute to a mechanism-based subgroup classification. This will foster the development of mechanism-based treatments and holds promise to treat patients more sufficient.",0,0 +5570,Fear of Hypoglycemia and Self Reported Posttraumatic Stress in Adults with Type I Diabetes Treated by Intensive Regimens,"This study investigated the prevalence of hypoglycemic fear (FH) and hypoglycemia-specific posttraumatic stress (PTS) among individuals with Type I diabetes. Over 25% of participants met diagnostic criteria for current PTSD. High percentages of participants endorsed PTS symptom clusters, suggesting that individuals may be experiencing distress without necessarily meeting diagnostic criteria. Hierarchical multiple regression analyses revealed that perceived threat of death from hypoglycemia and FH were significantly related to PTS. Number of recent hypoglycemic episodes did not predict PTS/PTSD. Depression and nonspecific anxiety did not contribute to the statistical prediction of PTSD, suggesting that symptomatology endorsed represents hypoglycemia-specific anxiety rather than global psychological distress. The hypothesis that greater PTS symptomatology would relate to poorer glycemic control was unsubstantiated. Perceived death-threat from hypoglycemia and nonspecific anxiety were the only variables that contributed to prediction of glycemic control, suggesting that PTS did not represent a significant barrier for glycemic control in this sample. © Springer Science+Business Media, LLC 2007.",0,0 +5571,"Trajectories of resilience, depression, and anxiety following spinal cord injury.","To investigate longitudinal trajectories of depression and anxiety symptoms following spinal cord injury (SCI) as well as the predictors of those trajectories.A longitudinal study of 233 participants assessed at 4 time points: within 6 weeks, 3 months, 1 year, and 2 years from the point of injury. Data were analyzed using latent growth mixture modeling to determine the best-fitting model of depression and anxiety trajectories. Covariates assessed during hospitalization were explored as predictors of the trajectories.Analyses for depression and anxiety symptoms revealed 3 similar latent classes: a resilient pattern of stable low symptoms, a pattern of high symptoms followed by improvement (recovery), and delayed symptom elevations. A chronic high depression pattern also emerged but not a chronic high anxiety pattern. Analyses of predictors indicated that compared with other groups, resilient patients had fewer SCI-related quality of life problems, more challenge appraisals and fewer threat appraisals, greater acceptance and fighting spirit, and less coping through social reliance and behavioral disengagement.Overall, the majority of SCI patients demonstrated considerable psychological resilience. Models for depression and anxiety evidenced a pattern of elevated symptoms followed by improvement and a pattern of delayed symptoms. Chronic high depression was also observed but not chronic high anxiety. Analyses of predictors were consistent with the hypothesis that resilient individuals view major stressors as challenges to be accepted and met with active coping efforts. These results are comparable to other recent studies of major health stressors.",0,0 +5572,"A comparison of gains after treatment at a psychiatric outpatient clinic in patients with cluster A+B, or cluster C personality disorders, and non-psychotic axis I disorders","Few studies exist on the outcome of patients with personality disorders (PDs) treated at ordinary outpatient clinics. This study examines the gains of such patients 2 years after treatment start at an outpatient clinic. Three patient groups were sampled: cluster A + B PDs, cluster C PDs and axis I disorders. Fifty-eight patients (53%) were amenable to follow-up, and they did not show less psychopathology than the non-compliers. All patients had structured interviews and filled in questionnaires. Patients in the PDs cluster A + B group showed considerable gains, while that was not found for the PDs cluster C and Axis I disorder groups. Since almost all patients received long-term psychotherapy sometimes combined with antidepressant drugs, the finding that such a treatment mainly shows gains in more severely disturbed PDs patients should be replicated in larger samples at ordinary psychiatric outpatient clinics.",0,0 +5573,Prevalence of epilepsy and comorbidity of psychiatric disorders in Iran,"To determine the lifetime prevalence of self- and other relative informants-reported epilepsy in nationwide study among Iranian adults of aged 18 years and over and to study the association of epilepsy with lifetime history of the psychiatric disorders.Twenty-five thousand one hundred and eighty individual were selected through a randomized clustered sampling method from all the Iranian households; interviewed and used epilepsy questionnaire face-to-face at home in year 2001. From 12,398,235 households residing in Iran, 7795 families selected from 1559 clusters, 997 clusters were in urban and 582 were in rural areas, each cluster with 5 households were studied. The response rate was 90%.The prevalence of epilepsy was 1.8%. Epilepsy was more common in females, unemployed and higher educational level. It was not significantly associated with the age group, marital status and residential areas. The most common psychiatric disorders in subjects with epilepsy were major depressive disorder and obsessive compulsive disorder. The rate of lifetime suicidal attempt was 8.1%.Lifetime prevalence of epilepsy in Iran is not low. As the other communities, it is more common in females and unemployed. However, in contrast with the other studies, it was not more common among some age groups and unmarried and low educated subjects.",0,0 +5574,Adverse childhood experiences in relation to mood and anxiety disorders in a population-based sample of active military personnel,"Background Although it has been posited that exposure to adverse childhood experiences (ACEs) increases vulnerability to deployment stress, previous literature in this area has demonstrated conflicting results. Using a cross-sectional population-based sample of active military personnel, the present study examined the relationship between ACEs, deployment related stressors and mood and anxiety disorders. Method Data were analyzed from the 2002 Canadian Community Health Survey – Canadian Forces Supplement (CCHS-CFS; n = 8340, age 18–54 years, response rate 81%). The following ACEs were self-reported retrospectively: childhood physical abuse, childhood sexual abuse, economic deprivation, exposure to domestic violence, parental divorce/separation, parental substance abuse problems, hospitalization as a child, and apprehension by a child protection service. DSM-IV mood and anxiety disorders [major depressive disorder, post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic attacks/disorder and social phobia] were assessed using the Composite International Diagnostic Interview (CIDI). Results Even after adjusting for the effects of deployment-related traumatic exposures (DRTEs), exposure to ACEs was significantly associated with past-year mood or anxiety disorder among men [adjusted odds ratio (aOR) 1.34, 99% confidence interval (CI) 1.03–1.73, p < 0.01] and women [aOR 1.37, 99% CI 1.00–1.89, p = 0.01]. Participants exposed to both ACEs and DRTEs had the highest prevalence of past-year mood or anxiety disorder in comparison to those who were exposed to either ACEs alone, DRTEs alone, or no exposure. Conclusions ACEs are associated with several mood and anxiety disorders among active military personnel. Intervention strategies to prevent mental health problems should consider the utility of targeting soldiers with exposure to ACEs.",0,0 +5575,Emotion-specific and emotion-non-specific components of posttraumatic stress disorder (PTSD): implications for a taxonomy of related psychopathology,"Many cognitive theories of posttraumatic stress disorder (PTSD), including our own SPAARS model, propose that one basis of the disorder is the cognitive system’s persistent failure to resolve discrepancies between trauma-related information and the content of pre-existing mental representations, such as schemas. This leads to the characteristic PTSD symptom pattern of re-experiencing and avoidance of trauma-related material. Furthermore, the nature of this unresolved discrepancy revolves around appraisals of threat and the corresponding emotion profile in PTSD is therefore predominantly intense fear and anxiety. This paper argues that this general framework can be extended to discrepancies around other appraisal dimensions such as loss, and consequently to other emotions such as sadness. A localized taxonomy is therefore proposed comprising emotional disorders that resemble PTSD in their basic patterns of re-experiencing and avoidance symptoms—what we call their ‘emotion-non-specific component’—but that differ from PTSD in terms of the core emotions involved—what we call their ‘emotion-specific component’. The clinical and nosological implications of this argument are discussed.",0,0 +5576,Interleukin-6 and soluble interleukin-6 receptor levels in posttraumatic stress disorder: Associations with lifetime diagnostic status and psychological context,"This study correlated lifetime PTSD diagnostic status with interleukin-6 (IL-6) and soluble IL-6 receptor (sIL-6R) levels, and tested whether these correlations are sensitive to psychological context. Midlife women attended two research visits where blood was drawn (beginning of visits) and saliva and oral mucosal transudate were collected (beginning and end of visits) to measure IL-6 and sIL-6R. Women were classified as PTSD-/- (past and current symptoms below subsyndromal levels), PTSD+/- (past symptoms at or above subsyndromal levels), or PTSD+/+ (past and current symptoms at or above subsyndromal levels). PTSD+/+ women, compared to the other women, showed more negative emotion at the beginning of the visits, higher salivary IL-6 levels at the beginning versus end of visits, and positive correlations between negative emotion, salivary IL-6, and plasma sIL-6R. Their plasma sIL-6R levels exceeded those of the PTSD+/- women. Overall, IL-6 sensitivity to anticipation and to negative emotions, and higher sIL-6R levels, differentiated persistent versus remitted PTSD.",0,0 +5577,Is DSM-IV criterion A2 associated with PTSD diagnosis and symptom severity?,"The diagnostic criteria for posttraumatic stress disorder (PTSD) have received significant scrutiny. Several studies have investigated the utility of Criterion A2, the subjective emotional response to a traumatic event. The American Psychiatric Association (APA) has proposed elimination of A2 from the PTSD diagnostic criteria for DSM-5; however, there is mixed support for this recommendation and few studies have examined A2 in samples at high risk for PTSD such as veterans. In the current study of 908 veterans who screened positive for a traumatic event, A2 was not significantly associated with having been told by a doctor that the veteran had PTSD. Those who endorsed A2, however, reported greater PTSD symptom severity in the 3 DSM-IV symptom clusters of reexperiencing (d = 0.45), avoidance (d = 0.61), and hyperarousal (d = 0.44), and A2 was significantly associated with PTSD symptom severity for all 3 clusters (R2 = .25, .25, and .27, respectively) even with trauma exposure in the model. Thus, although A2 may not be a necessary criterion for PTSD diagnosis, its association with PTSD symptom severity warrants further exploration of its utility.",0,0 +5578,Effects of melatonin on anxiety- like behaviors induced by post–traumatic stress disorder in rat,"Introduction: Post traumatic stress disorder (PTSD) is an anxiety disorder. This study was aimed to evaluate the effect of multiple injections of melatonin on anxiety like behaviors induced by PTSD. Materials and methods: PTSD induced in 60 male wistar rats, by combining the shock and single-prolonged stress method (S&SPS). Animals received electric shock (1 mA, 2s) for 5 days, and then on the day 6 they underwent three stages of SPS (restrained for 2 hours, forced swimming for 20 minutes and anesthetized by diethyl ether for 15 minutes). Seven days after PTSD induction, elevated plus maze (EPM) and open field tests were performed to measure anxiety profile. Animals received multiple subcutaneous injections of melatonin (5, 10, 15 mg/kg) or saline, within the 7 days after PTSD. Results: The control (saline) and treated (melatonin) groups showed significant differences in the percentage of time spent in open arms of the EPM. Melatonin, at dose of 15mg/kg, significantly increased the time spent in open arms of the EPM than the corresponding control group. Animals who received 10mg/kg melatonin showed a significant increase in crossing behavior in open field test than the corresponding control group. Conclusion: Our study showed that melatonin is able to reduce PTSD-induced anxiety-like behaviors in rats.",0,0 +5579,Response to Fergusson and Boden: The psychological impact of major disasters,,0,0 +5580,DSM-5 personality traits discriminate between posttraumatic stress disorder and control groups,"The relevance of personality traits to the study of psychopathology has long been recognized, particularly in terms of understanding patterns of comorbidity. In fact, a multidimensional personality trait model reflecting five higher-order personality dimensions-negative affect, detachment, antagonism, disinhibition, and psychoticism-is included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and represented in the Personality Inventory for DSM-5 (PID-5). However, evaluation of these dimensions and underlying personality facets within clinical samples has been limited. In the present study, we utilized the PID-5 to evaluate the personality profile elevation and composition of 150 control veterans and 35 veterans diagnosed with posttraumatic stress disorder (PTSD). Results indicated that veterans with PTSD endorsed significantly more personality pathology than control veterans, with scores on detachment and psychoticism domains most clearly discriminating between the two groups. When personality domain scores were considered as parts of each subject's personality profile, a slightly different picture emerged. Specifically, the PTSD composition was primarily characterized by detachment and negative affect, followed by disinhibition, psychoticism, and antagonism in that order of relative importance. The profile of the control group was significantly different, mostly accounted for differences in antagonism and psychoticism. Using these complementary analytic strategies, the findings demonstrate the relevance of personality pathology to PTSD, highlight internalizing features of PTSD, and pave the way for future research aimed at evaluating the role of shared maladaptive personality traits in underlying the comorbidity of PTSD and related disorders.",0,0 +5581,"Racial Discrimination, Post Traumatic Stress, and Gambling Problems among Urban Aboriginal Adults in Canada","Little is known about risk factors for problem gambling (PG) within the rapidly growing urban Aboriginal population in North America. Racial discrimination may be an important risk factor for PG given documented associations between racism and other forms of addictive behaviour. This study examined associations between racial discrimination and problem gambling among urban Aboriginal adults, and the extent to which this link was mediated by post traumatic stress. Data were collected via in-person surveys with a community-based sample of Aboriginal adults living in a mid-sized city in western Canada (N = 381) in 2010. Results indicate more than 80 % of respondents experienced discrimination due to Aboriginal race in the past year, with the majority reporting high levels of racism in that time period. Past year racial discrimination was a risk factor for 12-month problem gambling, gambling to escape, and post traumatic stress disorder (PTSD) symptoms in bootstrapped regression models adjusted for confounders and other forms of social trauma. Elevated PTSD symptoms among those experiencing high levels of racism partially explained the association between racism and the use of gambling to escape in statistical models. These findings are the first to suggest racial discrimination may be an important social determinant of problem gambling for Aboriginal peoples. Gambling may be a coping response that some Aboriginal adults use to escape the negative emotions associated with racist experiences. Results support the development of policies to reduce racism directed at Aboriginal peoples in urban areas, and enhanced services to help Aboriginal peoples cope with racist events. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +5582,Prediction of posttraumatic stress disorder among adults in flood district,"Flood is one of the most common and severe forms of natural disasters. Posttraumatic stress disorder (PTSD) is a common disorder among victims of various disasters including flood. Early prediction for PTSD could benefit the prevention and treatment of PTSD. This study aimed to establish a prediction model for the occurrence of PTSD among adults in flood districts.A cross-sectional survey was carried out in 2000 among individuals who were affected by the 1998 floods in Hunan, China. Multi-stage sampling was used to select subjects from the flood-affected areas. Data was collected through face-to-face interviews using a questionnaire. PTSD was diagnosed according to DSM-IV criteria. Study subjects were randomly divided into two groups: group 1 was used to establish the prediction model and group 2 was used to validate the model. We first used the logistic regression analysis to select predictive variables and then established a risk score predictive model. The validity of model was evaluated by using the model in group 2 and in all subjects. The area under the receiver operation characteristic (ROC) curve was calculated to evaluate the accuracy of the prediction model.A total of 2336 (9.2%) subjects were diagnosed as probable PTSD-positive individuals among a total of 25,478 study subjects. Seven independent predictive factors (age, gender, education, type of flood, severity of flood, flood experience, and the mental status before flood) were identified as key variables in a risk score model. The area under the ROC curve for the model was 0.853 in the validation data. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of this risk score model were 84.0%, 72.2%, 23.4%, and 97.8%, respectively, at a cut-off value of 67.5 in the validation data.A simple risk score model can be used to predict PTSD among victims of flood.",0,0 +5583,Consistency of retrospective reporting about exposure to traumatic events,"Lifetime exposure to traumatic events was assessed by means of a multimethod protocol applied to 76 male military veterans. Consistency of retrospective reporting was determined for physical and sexual assault and abuse, accidents, disasters, combat and warzone experiences, serious illness or injury, and hazardous duty. Findings demonstrate that respondents are generally consistent in reporting traumatic events, although the majority report more events upon reevaluation. Reporting about traumatic events shows some variation as a function of the life epoch in which events occurred, whether they were directly or indirectly experienced, and the type of trauma involved. Discussion addresses memory-related processes triggered by trauma evaluation or tied to characteristics of events themselves as potential sources of inconsistency.",0,0 +5584,Factors associated with outcome of cognitive-behavioural treatment of chronic post-traumatic stress disorder,"The study examined factors that were associated with outcome in the treatment of PTSD. A trial of cognitive therapy compared to imaginal exposure of chronic PTSD showed that although clinical improvements were obtained after treatment and at 6 month follow-up one type of treatment was not significantly superior to the other. Characteristics of the patient, the trauma and treatment and of pretreatment clinical measures were investigated as predictors of PTSD outcome. Eleven variables were significantly associated with the pre- to post-treatment change in CAPS severity scores. Of these, three (duration of therapy, gender and suicide risk) were selected into a step-wise multiple regression equation to explain 36.5% of the outcome. Similarly, nine variables were significant associated with the pretreatment to follow-up change with three variables (number of missed therapy sessions, residential status and co-morbid GAD) being selected into the equation and explaining 36.9% of the outcome. The best predictor of outcome was inconsistent attendance at therapy.",0,0 +5585,The course of PTSD in naturalistic long-term studies: High variability of outcomes. A systematic review,"With a lifetime prevalence of 8% posttraumatic stress disorder (PTSD) is one of the most common mental disorders; nevertheless, its longitudinal course is largely unknown.Our aim was to conduct a systematic review summarizing available findings on the prospective, naturalistic long-term course of PTSD and its predictors.Databases MEDLINE and PsycINFO were searched. Main selection criteria were: 1) naturalistic cohort study with a follow-up period of at least 3 years, 2) adult participants with observer-rated or probable PTSD at baseline.Twenty-four cohorts (25 studies) were retrieved (14 with observer-assessed, 10 with probable PTSD). In total, they comprised about 10,500 participants with PTSD at baseline that were included in the long-term follow-ups. Studies investigating patient populations with observer-assessed PTSD found that between 18% and 50% of patients experienced a stable recovery within 3-7 years; the remaining subjects either facing a recurrent or a more chronic course. Outcomes of community studies and studies investigating probable PTSD varied considerably (remission rates 6-92%). Social factors (e.g. support) as well as comorbid physical or mental health problems seem to be salient predictors of PTSD long-term course and special focus should be laid on these factors in clinical settings.Included studies differed notably with regard to applied methodologies. The resulting large variability of findings is discussed. More standardized systematic follow-up research and more uniformed criteria for remission and chronicity are needed to gain a better insight into the long-term course of PTSD.",0,0 +5586,Benzodiazepines in clinical practice: consideration of their long-term use and alternative agents.,"Despite increasing focus on the use of antidepressants and other agents for the treatment of anxiety, benzodiazepines have remained a mainstay of anxiolytic pharmacotherapy due to their robust efficacy, rapid onset of therapeutic effect, and generally favorable side effect profile. In this article, we examine issues related to the long-term use of benzodiazepines, including concerns about the development of therapeutic tolerance, dose escalation, and adverse cognitive effects. We also consider currently available alternatives to benzodiazepines and novel mechanisms of action that may prove fruitful in the development of future generations of anxiolytics.",0,0 +5587,Familial Linkage between Neuropsychiatric Disorders and Intellectual Interests,"From personality to neuropsychiatric disorders, individual differences in brain function are known to have a strong heritable component. Here we report that between close relatives, a variety of neuropsychiatric disorders covary strongly with intellectual interests. We surveyed an entire class of high-functioning young adults at an elite university for prospective major, familial incidence of neuropsychiatric disorders, and demographic and attitudinal questions. Students aspiring to technical majors (science/mathematics/engineering) were more likely than other students to report a sibling with an autism spectrum disorder (p = 0.037). Conversely, students interested in the humanities were more likely to report a family member with major depressive disorder (p = 8.8×10(-4)), bipolar disorder (p = 0.027), or substance abuse problems (p = 1.9×10(-6)). A combined PREdisposition for Subject MattEr (PRESUME) score based on these disorders was strongly predictive of subject matter interests (p = 9.6×10(-8)). Our results suggest that shared genetic (and perhaps environmental) factors may both predispose for heritable neuropsychiatric disorders and influence the development of intellectual interests.",0,0 +5588,ApoE isoform-dependent deficits in extinction of contextual fear conditioning,"The three major human apoE isoforms (apoE2, apoE3 and apoE4) are encoded by distinct alleles (ϵ2, ϵ3 and ϵ4). Compared with ϵ3, ϵ4 is associated with increased risk to develop Alzheimer's disease (AD), cognitive impairments in Parkinson's disease (PD), and other conditions. In contrast, a recent study indicated an increased susceptibility to the recurring and re-experiencing symptom cluster of Post-Traumatic Stress Disorder (PTSD), as well as related memory impairments, in patients carrying at least one ϵ2 allele. Contextual fear conditioning and extinction are used in human and animal models to study this symptom cluster. In this study, acquisition (day 1, training), consolidation (day 2, first day of re-exposure) and extinction (days 2–5) of conditioned contextual fear in human apoE2, apoE3 and apoE4 targeted replacement and C57BL/6J wild-type (WT) mice was investigated. Male and female apoE2 showed acquisition and retrieval of conditioned fear, but failed to exhibit extinction. In contrast, WT, apoE3 and apoE4 mice showed extinction. While apoE2 mice exhibited lower freezing in response to the context on day 2 than apoE3 and apoE4 mice, this cannot explain their extinction deficit as WT mice exhibited similar freezing levels as apoE2 mice on day 2 but still exhibited extinction. Elevating freezing through extended training preserved extinction in controls, but failed to ameliorate extinction deficits in apoE2 animals. These data along with clinical data showing an association of apoE2 with susceptibility to specific symptom clusters in PTSD supports an important role for apoE isoform in the extinction of conditioned fear.",0,0 +5589,Psychosocial Consequences of Bone Marrow Transplantation in Donor and Nondonor Siblings,"We investigated the psychosocial effects of bone marrow transplantation (BMT) on siblings of transplant recipients. We asked how donor siblings compared with nondonor siblings on quantitative measures of behavior, psychological distress, and sense of self. Participants included 44 siblings (21 donors and 23 nondonors, ages 6-18 yr) of surviving pediatric BMT patients. On self-report measures, donors reported significantly more anxiety and lower self-esteem than nondonors. On teacher-rated scales, donors showed significantly more adaptive skills in school. On these same scales, nondonors showed significantly more school problems than donors. One-third of the siblings in each group reported a moderate level of post-traumatic stress reaction. Exploratory multiple regression analyses point to factors that might influence sibling adjustment and suggest counseling strategies and avenues for future research.",0,0 +5590,Sudden Unexpected Versus Violent Death and PTSD Symptom Development,"Changes to posttraumatic stress disorder (PTSD) trauma criterion in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) have been an area of much scrutiny and debate. One of the proposed changes included removing sudden unexpected death (SUD) from the list of potentially traumatic events. This study tested the extent to which unexpected death differed from violent death and other traumas as measured by PTSD symptoms. Our results indicated a significant difference in symptom development between those experiencing sudden violent death and sudden unexpected, but nonviolent, death. Additional analyses at the DSM–IV symptom cluster level, as well as with Simms, Watson, and Doebbeling’s (2002) factor structure of PTSD symptoms, suggested further distinctions between event types and symptom development. The extent to which SUD should be included in the trauma criterion is considered.",0,0 +5591,Risk Factors Associated with Posttraumatic Stress Disorder Symptomatology in HIV-Infected Women,"This study examined risk factors for posttraumatic stress disorder (PTSD) symptomatology in a sample of 102 HIV-positive women. The magnitude of HIV-related PTSD symptoms was associated with a greater number of HIV-related physical symptoms, more extensive history of pre-HIV trauma, less perceived availability of social support, greater degree of perceived stigma, and greater degree of negative life events. Hierarchical multiple regression analysis revealed three individual predictors of PTSD symptomatology: total impact of negative life events, total stigma score, and total number of present symptoms. Stigma emerged as the strongest individual predictor. Social support failed to moderate relationships between PTSD symptomatology and HIV-related physical symptoms and negative life events. These findings may inform helping professionals about risk factors associated with PTSD symptomatology in HIV-positive women.",0,0 +5592,Life Threat and Posttraumatic Stress in School-age Children,"One hundred fifty-nine children (14.5% of the student body) were sampled after a fatal sniper attack on their elementary school playground. Systematic self-reports of posttraumatic stress disorder (PTSD) symptoms were obtained by use of a child PTSD Reaction Index. Analysis of variance revealed significant differences by exposure but not by sex, ethnicity, or age. Additional analyses were conducted of individual item response, overall severity of PTSD reaction, symptom grouping, and previous life events. The results provide strong evidence that acute PTSD symptoms occur in school-age children with a notable correlation between proximity to the violence and type and number of PTSD symptoms. Sampling at approximately one month after the trauma provided adequate delineation among exposure groups. The symptom profile of highly exposed children lends validity to the diagnosis of acute PTSD in childhood.",0,0 +5593,"A randomized, double-blind, placebo-controlled trial on the efficacy and tolerability of sertraline in Iranian veterans with post-traumatic stress disorder","Background Unlike civilian post-traumatic stress disorder (PTSD), the efficacy of sertraline for the treatment of combat-related PTSD has not yet been proven. The present study aimed to evaluate the clinical efficacy of sertraline against combat-related PTSD in a randomized, double-blind, placebo-controlled trial. Method Seventy Iranian veterans of the Iran–Iraq war who met the DSM-IV criteria for diagnosis of PTSD were randomized to receive either flexibly dosed sertraline (50–200 mg/day) ( n =35, completers=32) or placebo ( n =35, completers=30) for 10 weeks. Efficacy was evaluated by the Impact of Event Scale – Revised (IES-R) and the Clinical Global Impression scale – Severity (CGI-S) and Improvement (CGI-I) ratings. Responder criteria were defined as a ⩾30% reduction in the IES-R total score plus a CGI-I rating of ‘much’ or ‘very much’ improved. Results On both intention-to-treat (ITT) and per protocol (completer) methods of analysis, the mean reductions in the IES-R total and subscale (re-experiencing/intrusion, avoidance/numbing and hyperarousal) scores ( p <0.001) and also in the CGI-S score ( p <0.01) were significantly greater in the sertraline group than in the placebo group. For the CGI-I, the mean endpoint score was significantly lower in the sertraline group than in the placebo group ( p ⩽0.001). The number of responders in the sertraline group was significantly higher than in the placebo group (44% v . 3%, p ⩽0.001). Sertraline was well tolerated, with a 6% discontinuation rate as a result of adverse reactions. Conclusions The results of this study suggest that sertraline can be an effective, safe and tolerable treatment for combat-related PTSD in Iranian veterans.",0,0 +5594,"Mental health, educational and social needs of young offenders in custody and in the community","The purpose of this review is to highlight recent findings from research on mental health, educational and social needs of young offenders and the implications for key agencies that commission or provide services.Young offenders have high levels of morbidity in a number of areas, including mental health. A substantial number of young offenders have learning disabilities, which has implications for educational provision and delivering interventions. Other learning problems, such as low reading and comprehension ages, also have consequences for society in a number of areas, including occupational functioning and the associated development of a skilled workforce. There is some evidence that female offenders and persistent offenders are particularly at risk of psychosocial problems. Need is often unmet due to the lack of adequate assessment. Other reasons include inaccessibility of services and difficulties experienced in engaging young people in treatment. Young offenders in the community and those from ethnic minorities are particularly at risk of having poor access to services.Providing services for young offenders requires investment from all the agencies in prioritising their needs. Research can continue to contribute by informing policy and practice, although further understanding of the developmental trajectories of high-risk groups is still needed.",0,0 +5595,High hopes,"Psychedelic drugs fell from grace in the 1960s. Now, scientists are rediscovering them as potential treatments for a range of illnesses.",0,0 +5596,"Common Heritable Contributions to Low-Risk Trauma, High-Risk Trauma, Posttraumatic Stress Disorder, and Major Depression","Understanding the relative contributions of genetic and environmental factors to trauma exposure, posttraumatic stress disorder (PTSD), and major depressive disorder (MDD) is critical to developing etiologic models of these conditions and their co-occurrence.To quantify heritable influences on low-risk trauma, high-risk trauma, PTSD, and MDD and to estimate the degree of overlap between genetic and environmental sources of variance in these 4 phenotypes.Adult twins and their siblings were ascertained from a large population-based sample of female and male twin pairs on the basis of screening items for childhood sexual abuse and physical abuse obtained in a previous assessment of this cohort.Structured psychiatric telephone interviews.Total sample size of 2591: 996 female and 536 male twins; 625 female and 434 male nontwin siblings.Lifetime low- and high-risk trauma exposure, PTSD, and MDD.In the best-fitting genetic model, 47% of the variance in low-risk trauma exposure and 60% of the variance in high-risk trauma exposure was attributable to additive genetic factors. Heritable influences accounted for 46% of the variance in PTSD and 27% of the variance in MDD. An extremely high degree of genetic overlap was observed between high-risk trauma exposure and both PTSD (r = 0.89; 95% CI, 0.78-0.99) and MDD (r = 0.89; 95% CI, 0.77-0.98). Complete correlation of genetic factors contributing to PTSD and to MDD (r = 1.00) was observed.The evidence suggests that almost all the heritable influences on high-risk trauma exposure, PTSD, and MDD, can be traced to the same sources; that is, genetic risk is not disorder specific. Individuals with a positive family history of either PTSD or MDD are at elevated risk for both disorders and should be closely monitored after a traumatic experience for symptoms of PTSD and MDD.",0,0 +5597,Heat stress-responsive transcriptome analysis in heat susceptible and tolerant wheat (Triticum aestivum L.) by using Wheat Genome Array,"Abstract Background Wheat is a major crop in the world, and the high temperature stress can reduce the yield of wheat by as much as 15%. The molecular changes in response to heat stress are poorly understood. Using GeneChip ® Wheat Genome Array, we analyzed genome-wide gene expression profiles in the leaves of two wheat genotypes, namely, heat susceptible 'Chinese Spring' (CS) and heat tolerant 'TAM107' (TAM). Results A total of 6560 (~10.7%) probe sets displayed 2-fold or more changes in expression in at least one heat treatment ( f alse d iscovery r ate, FDR, α = 0.001). Except for heat shock protein (HSP) and heat shock factor (HSF) genes, these putative heat responsive genes encode transcription factors and proteins involved in phytohormone biosynthesis/signaling, calcium and sugar signal pathways, RNA metabolism, ribosomal proteins, primary and secondary metabolisms, as well as proteins related to other stresses. A total of 313 probe sets were differentially expressed between the two genotypes, which could be responsible for the difference in heat tolerance of the two genotypes. Moreover, 1314 were differentially expressed between the heat treatments with and without pre-acclimation, and 4533 were differentially expressed between short and prolonged heat treatments. Conclusion The differences in heat tolerance in different wheat genotypes may be associated with multiple processes and mechanisms involving HSPs, transcription factors, and other stress related genes. Heat acclimation has little effects on gene expression under prolonged treatments but affects gene expression in wheat under short-term heat stress. The heat stress responsive genes identified in this study will facilitate our understanding of molecular basis for heat tolerance in different wheat genotypes and future improvement of heat tolerance in wheat and other cereals.",0,0 +5598,Post-traumatic stress and age variation in amygdala volumes among youth exposed to trauma,"Theoretically, normal developmental variation in amygdala volumes may be altered under conditions of severe stress. The purpose of this article was to examine whether posttraumatic stress moderates the association between age and amygdala volumes in youth exposed to traumatic events who are experiencing symptoms of post-traumatic stress disorder (PTSD). Volumetric imaging was conducted on two groups of youth aged 9-17 years: 28 with exposure to trauma and PTSD symptoms (boys = 15, girls = 13) and 26 matched (age, IQ) comparison youth (Controls; boys = 12, girls = 14). There was a significant group by age interaction in predicting right amygdala volumes. A positive association between age and right amygdala volumes was observed, but only in PTSD youth. These associations with age remained when controlling for IQ, total brain volumes and sex. Moreover, older youth with PTSD symptoms had relatively larger right amygdala volumes than controls. Findings provide evidence that severe stress may influence age-related variation in amygdala volumes. Results further highlight the importance of utilizing age as an interactive variable in pediatric neuroimaging research, in so far as age may act as an important moderator of group differences.",0,0 +5599,Combat veterans' symptoms of PTSD and partners' distress: The role of partners' perceptions of veterans' deployment experiences.,"Romantic partners of combat veterans with posttraumatic stress disorder (PTSD) report elevated relationship and psychological distress. One recent study suggests that this association may be weaker when partners perceive that veterans experienced higher levels of traumatic deployment events, but such results have not yet been replicated. We replicated and extended these findings in a sample of 206 National Guard service members who deployed overseas since 2001 and their partners. We used multivariate structural equation models to explore whether partners' perceptions of service members' deployment experiences moderated the associations of severity of service members' overall PTSD and specific PTSD clusters with partners' psychological and relationship distress. The significant association of overall PTSD symptom severity with partners' distress was not moderated by partners' perceptions. When examining PTSD symptoms at the cluster level, only the numbing/withdrawal cluster was significantly associated with distress. However, this association was moderated by partners' perceptions of service members' deployment experiences, such that the associations weakened as these perceptions increased. These results are in line with research indicating that the avoidance cluster of PTSD symptoms is particularly detrimental for partners of those with PTSD. Furthermore, they indicate that such symptoms are associated with less distress in partners who perceive that service members experienced high levels of potentially traumatic deployment events. Such perceptions may be linked with external attributions for symptoms, which suggests that psychoeducation regarding the causes of PTSD and the totality of PTSD symptoms may be useful in intervening with such partners.",0,0 +5600,Predictors of trait aggression in bipolar disorder,"Although aggressive behavior has been associated with bipolar disorder (BD), it has also been linked with developmental factors and disorders frequently found to be comorbid with BD, making it unclear whether or not it represents an underlying biological disturbance intrinsic to bipolar illness. We therefore sought to identify predictors of trait aggression in a sample of adults with BD.Subjects were 100 bipolar I (n = 73) or II (n = 27) patients consecutively evaluated in the Bipolar Disorders Research Program of the New York Presbyterian Hospital-Payne Whitney Clinic. Diagnoses were established using the Structured Clinical Interview for the DSM-IV (SCID-I) and Cluster B sections of the SCID-II. Mood severity was rated by the Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS). Histories of childhood maltreatment were assessed via the Childhood Trauma Questionnaire (CTQ), while trait aggression was measured by the Brown-Goodwin Aggression Scale (BGA).In univariate analyses, significant relationships were observed between total BGA scores and CTQ total (r = 0.326, p = 0.001), childhood emotional abuse (r = 0.417, p < 0.001), childhood physical abuse (r = 0.231, p = 0.024), childhood emotional neglect (r = 0.293, p = 0.004), post-traumatic stress disorder (t = -2.843, p = 0.005), substance abuse/dependence (t = -2.914, p = 0.004), antisocial personality disorder (t = -2.722, p = 0.008) and borderline personality disorder (t = -5.680, p < 0.001) as well as current HDRS (r = 0.397, p < 0.001) and YMRS scores (r = 0.371, p < 0.001). Stepwise multiple regression revealed that trait aggression was significantly associated with: (i) diagnoses of comorbid borderline personality disorder (p < 0.001); (ii) depressive symptoms (p = 0.001); and (iii) manic symptoms (p < 0.001).Comorbid borderline personality disorder and current manic and depressive symptoms each significantly predicted trait aggression in BD, while controlling for confounding factors. The findings have implications for nosologic distinctions between bipolar and borderline personality disorders, and the developmental pathogenesis of comorbid personality disorders as predisposing to aggression in patients with BD.",0,0 +5601,A Multilevel Approach To Social Support As A Key Determinant Of Post-Traumatic Stress Disorder Onset And Trajectories After A Mass Traumatic Event,"Types of social support and the meaning attributed to each type vary across individuals, contexts and time. Widely studied across disciplines is the role of social support during periods of distress. Factors at multiple levels of social support (individual, network, and community) are often important predictors of psychopathology, including post-traumatic stress disorder (PTSD), in the aftermath of such events. The trajectory of PTSD after traumatic event exposure, in turn, varies markedly between individuals, differing with regards to onset, symptom patterns, recurrence, comorbidity, response to intervention, and recovery. Recent literature has considered how each of these levels may influence the development and persistence of PTSD. This dissertation is an attempt to bring together substantively overlapping, but disciplinarily siloed discussions related to how individual, network, and community levels of social support contribute to mental health functioning in the aftermath of a population-level disaster. The data demonstrate a clear association between individual (and not network) level social support covariates and PTSD onset as well as resilience/recovery and chronic PTSD. Delayed onset PTSD, on the other hand, was equally associated with network-level variables. Community level variables were excluded from the analyses as they did not show a robust pattern of association with PTSD trajectories in preliminary analyses. Given these findings, it is arguable that the history of defining social support simply as one's actual network or how one perceives of his/her network fails to capture the relational nature of social support as an exchange of resources between two or more unique individuals that can prove beneficial or harmful to the functioning of the recipient. Moreover, this paper argues that individual level social support, which includes individual characteristics and behaviors, is central to the successful exchange of resources (interpersonal and professional) and subsequently to health. Keywords: social support, posttraumatic stress disorder, resources, distress, disaster, trauma (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0,0 +5602,Factor Structure of the State-Trait Anger Expression Inventory for Middle-Aged Men and Women,"Recently, Forgays, Forgays, and Spielberger (in press) reported the first exploratory factor analysis of the total 44-item State-Trait Anger Expression Inventory (STAXI) by gender. The analyses were based on a sample of over 700 male and female university students and identified quite well six of the original STAXI scales and subscales. In addition, a seventh factor, ""Feel-Like-Expressing-Anger,"" emerged for women. In the present study, we examined the STAXI responses from a middle-aged adult population. Exploratory factor analyses replicated the majority of the original structure of the STAXI measure including a Feel-Like-Expressing-Anger factor for men and women. In addition, we employed confirmatory factor analyses and cross-validation procedures to test the validity of Spielberger's (1988) AHA! model. Based on these procedures, we found (a) that a seven-factor model provided a better fit than a six-factor solution for each gender and (b) evidence of robust gender differences for two factors: Feel-Like-Expressing Anger and State Anger. These gender differences are consistent with the social costs for anger expression in women and the social benefits for men.",0,0 +5603,The detection of psychiatric illness by questionnaire,,0,0 +5604,Predicting DSM‐III-R Disorders From the Youth Self‐Report: Analysis of Data From a Field Study,"To predict DSM-III-R diagnoses from Youth Self-Report (YSR) scores.The Diagnostic Interview Schedule for Children Version 2.1c (DISC-2.1c) and YSR were administered to 289 homeless adolescents. Stepwise discriminant analysis identified YSR scales contributing to predictions of DSM-III-R disorders. Paper-and-pencil prediction rules based on YSR ""borderline"" or ""clinical"" scores were evaluated.Statistically significant discriminant functions for disruptive disorders, depressive disorders, manic disorders, attention-deficit hyperactivity disorder, schizophrenia, and posttraumatic stress disorder, each based on a unique pair of YSR scales, produced overall hit rates of 0.66 to 0.90. Paper-and-pencil predictions produced comparable results. The weakest overall predictions were for the disruptive behaviors; the best rule (""IF Aggressive OR Delinquent is at least borderline THEN predict oppositional defiant disorder or conduct disorder"") produced a 0.72 hit rate. The strongest overall predictions were for schizophrenia; the best prediction rule (""IF [Thought Problems AND Delinquent are at least borderline] AND [at least one is clinical] THEN predict schizophrenia"") produced a 0.87 hlt rate.While the success rates reported here are specific to this sample, it appears that the YSR has good ability to predict DSM-III-R diagnoses as determined by the DISC. Furthermore, it was demonstrated that categorical diagnoses can be treated as locations or cluster sectors in a multidimensional space.",0,0 +5605,Psychiatric morbidity and comorbidity following accidental man-made traumatic events: incidence and risk factors,"The aims of this study were to examine the incidence and risk factors of major depression, bipolar disorder, psychoactive substance use, psychotic and anxiety disorders in relation to post-traumatic stress disorders (PTSD) in a study group exposed to two different traumatic events, i. e. 128 fire and 55 motor vehicle accident victims. Data have been collected 7–9 months after the traumatic event. The diagnosis of axis-I diagnoses, other than PTSD, was made according to DSM-III-R criteria using the Structured Interview according to the DSN-III-R. The incidence of new-onset major depression was 13.4%, generalised anxiety disorder (GAD) 12.6%, agoraphobia 10.2% and psychoactive substance use disorders 6%. Simple phobia, panic disorder and obsessive compulsive disorder had a much lower incidence (< 2.0%). Fifty-one percent of the victims with PTSD had one or more addition axis-I diagnoses, major depression (26.2%), agoraphobia (21.0%) and generalised anxiety disorder (24.6%) being the most common. Physical injury was the single best predictor for major depression. The best predictors for the development of new-onset anxiety disorders, other than PTSD, were: type and horror of the trauma, the extent of physical injury, the loss of control during the traumatic event, contextual stimuli, younger age and female sex. In conclusion: comorbid disorders, such as depression, GAD and agoraphobia, commonly occur within the first few months after man-made accidental traumata. Trauma variables, which are known to be related to the development of PTSD, are also related to the occurrence of these comorbid disorders.",0,0 +5606,Treatment of post-traumatic stress disorder in children using cognitive behavioural writing therapy,"This study evaluated the effectiveness of Cognitive Behavioral Writing Therapy (CBWT) in 23 children (age 8-18 years) in the Netherlands, who experienced a range of single and recurrent traumatic experiences. CBWT uses exposure, cognitive restructuring and social sharing.At pre-test, post-test and follow-up, post-traumatic stress disorder (PTSD) symptoms, depressive symptoms, trauma-related cognitions and general behavioural problems were assessed.At post-test there was a significant reduction of all symptoms, and this effect was maintained at 6 months follow-up. The mean amount of treatment sessions needed was 5.5.This study shows that short-term CBWT is a potentially effective intervention for clinically referred traumatized children. There is now a clear need of establishing the effectiveness of CBWT in a randomized, controlled trial.This first study indicates CBWT is a promising treatment, which can easily be used in clinical practice.",0,0 +5607,Post-traumatic stress and disability,"Post-traumatic stress is thought to account for significant disability. It is also known to be highly comorbid with other psychiatric conditions such as depression and alcohol dependence.To determine the relationship between post-traumatic stress, depression, alcohol dependence and disability.Seventy armed services personnel were assessed for DSM-IV diagnoses of post-traumatic stress disorder, major depressive disorder and alcohol dependence, and with continuous measures of symptoms of post-traumatic stress, depression and alcohol dependence following a traumatic event. These variables, as predictors of disability (using the Sheehan Disability Scale), were analysed using multivariate analysis of variance, analysis of covariance and multiple regression backward elimination models.No significant interaction was found for the diagnostic variables even after controlling for the continuous symptom measures. In the regression models, symptoms of depression were a significant predictor of total disability (R(2)=0.39). Symptoms of alcohol dependence and post-traumatic stress did not significantly predict disability.Since post-traumatic stress was not found to be associated with disability, its clinical importance may be questionable.",0,0 +5608,Neuropsychology and Psychology of MCS,"Neurological symptoms are frequently reported by patients with multiple chemical sensitivities (MCS). Methods to compare the psychiatric, personality, and neuropsychological function of patients with MCS, chronic fatigue syndrome (CFS), and normal controls are described. Increased rates of Axis I psychiatric diagnoses are observed in the literature for MCS and CFS subjects relative to controls. Findings on the MMPI-2 and the Toronto Alexithymia Scale reveal prof iles consistent with the tendency to report somatic rather than emotional symptoms in response to stress. However, many of the reported somatic symptoms also coincide with those found in neurologic disorders. The overall neuropsychological prof ile for MCS subjects does not reflect cognitive impairment. Relative to normal controls, the only difference in neuropsychological performance observed is reduced recognition of nontarget designs on a visual memory task. More fruitful areas for future psychological research will include measurement of the interaction between behavioral response styles and attentional processes in cognition, as well as observations under controlled challenge conditions.",0,0 +5609,Post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD), which is characterized by intrusive memories, marked avoidance of trauma reminders, affective numbing, and hyperarousal following a traumatic experience was introduced into the diagnostic nomenclature in 1980 with the publication by the American Psychiatric Association of DSM-III. Since then, a large body of research on the presentation and treatment of PTSD has been assembled. A number of efficacious cognitive–behavioral therapies (CBTs) are now offered, such as prolonged exposure and cognitive processing therapy (CPT; [3]), and the rates of successful treatment in a variety of populations are improving. Symptoms and diagnostic criteria In the DSM-IV-TR, there are six diagnostic criteria (Criterion A-F) that must be present for a diagnosis of PTSD. First, the individual must have experienced a traumatic event (Criterion A) during which: (1) the person experienced or witnessed an event or events that involved actual threatened death or serious injury, or a threat to the physical integrity of oneself or others; and (2) the person's reaction involved intense fear, helplessness, or horror (in children this may present as agitated or disorganized behavior). Examples of traumatic events include serious threats to life or physical integrity such as military combat, sexual assault, motor vehicle accidents, physical assault, natural or human-made disasters, or witnessing violence or severe human suffering. The symptoms of PTSD are categorized into three clusters in DSM-IV (Criterion B, C, and D): intrusive recollection, avoidance and numbing, and hyperarousal symptoms. © Cambridge University Press 2010.",0,0 +5610,"Resilience, traumatic brain injury, depression, and posttraumatic stress among Iraq/Afghanistan war veterans.","We examined the prospective influence of the resilient, undercontrolled, and overcontrolled personality prototypes on depression and posttraumatic stress disorder (PTSD) symptoms among Iraq/Afghanistan war veterans. After accounting for the possible influence of combat exposure, we expected that the resilient prototype would predict lower depression and PTSD over time and would be associated with adaptive coping strategies, higher social support, lower psychological inflexibility, and higher self-reported resilience relative to overcontrolled and undercontrolled prototypes, independent of traumatic brain injury (TBI) status.One hundred twenty-seven veterans (107 men, 20 women; average age = 37) participated in the study. Personality was assessed at baseline, and PTSD and depression symptoms were assessed 8 months later. Path analysis was used to test the direct and indirect effects of personality on distress.No direct effects were observed from personality to distress. The resilient prototype did have significant indirect effects on PTSD and depression through its beneficial effects on social support, coping and psychological inflexibility. TBI also had direct effects on PTSD.A resilient personality prototype appears to influence veteran adjustment through its positive associations with greater social support and psychological flexibility, and lower use of avoidant coping. Low social support, avoidant coping, and psychological inflexibility are related to overcontrolled and undercontrolled personality prototypes, and these behaviors seem to characterize veterans who experience problems with depression and PTSD over time. A positive TBI status is directly and prospectively associated with PTSD symptomology independent of personality prototype. Implications for clinical interventions and future research are discussed.",0,0 +5611,Pain symptomatology and pain medication use in civilian PTSD,"The comorbidity of pain syndromes and trauma-related syndromes has been shown to be high. However, there have been limited data, especially in civilian medical populations, on the role of trauma-related disorders such as posttraumatic stress disorder (PTSD) on chronic pain and pain medication use. We analyzed 647 general hospital patients in primary care and obstetrics and gynecological waiting rooms for the experience of trauma and PTSD-related stress disorders. PTSD symptoms were found to be significantly positively correlated with pain ratings (r=.282, P<0.001) and pain-related functional impairment (r=0.303, P<0.001). Those with a current PTSD diagnosis had significantly higher subjective pain and pain-related impairment ratings than those with no PTSD. Furthermore, those with a current diagnosis of PTSD were significantly more likely to have used opioid analgesics for pain control compared to those without a diagnosis of PTSD (χ(2)=8.98, P=0.011). When analyzing the separate PTSD symptom subclusters (re-experiencing, avoidance, and hyperarousal), all symptom clusters were significantly related to pain and pain-related impairment ratings, but only the avoidance cluster was significantly related to prior opioid pain medication use. We conclude that PTSD and trauma-related disorders are common in impoverished medical populations and that their presence should be examined in patients with pain syndromes. Furthermore, these data suggest that PTSD and pain may share a vulnerability pathway, including the endogenous opioid neurotransmission systems.",0,0 +5612,Habituation to stress and dexamethasone suppression in rats with selective basal forebrain cholinergic lesions,"Previous studies suggest a role for basal forebrain cholinergic neurons in enhancing the inhibitory influence of the hippocampus and medial prefrontal cortex (mPFC) on glucocorticoid stress responses mediated by the hypothalamic-pituitary-adrenocortical (HPA) axis. An inhibitory action of the basal forebrain cholinergic (BFC) system may occur through facilitation of stress-related information processing and maintenance of glucocorticoid receptor (GR) expression and negative feedback signaling in these target regions. The current study investigated the possibility that BFC input to the hippocampus contributes to habituation of the glucocorticoid response following repeated exposure to a stressor. Cholinergic lesions were made by microinjections of the immunotoxin 192 IgG-saporin into the medial septum/vertical limb of the diagonal band, and 3 weeks later rats were subjected to six daily sessions of restraint stress. Blood samples taken before, during and after acute stress revealed a significant increase in peak activation and protracted elevation of corticosterone in cholinergic lesioned rats. After 5 days of repeated stress, however, both groups habituated to the stressor, as indicated by similarly low corticosterone profiles throughout both the response and recovery period. Against that habituated background, rats were administered a dexamethasone challenge on day 6, so that feedback status could be examined. Dexamethasone-induced suppression of endogenous corticosterone before, during, and after stress was significantly attenuated in lesioned rats. The profile of dysfunction in glucocorticoid regulation after selective cholinergic lesions in young animals may be relevant to the adrenocortical hyperactivity and negative feedback deficits seen in conditions such as normal aging and Alzheimer's dementia, in which integrity of the basal forebrain cholinergic system is compromised. © 2004 Wiley-Liss, Inc.",0,0 +5613,Predictors of response in anxiety disorders,"Anxiety disorder variables such as duration, severity of illness, and comorbidity with other anxiety or mood disorders appear to identify individuals who are at the greatest risk of treatment nonresponse. Conversely, in accord with clinical experience, shorter periods of illness, less severe illness, being treatment naive, and the absence of comorbidity tend to identify patients who are likely to respond robustly to medication management. Symptom clusters in OCD and PTSD are promising as a means of stratifying those more likely to respond to standard pharmacologic treatment. The presence of hoarding or sexual obsessions seems to presage poorer response in OCD, while the presence of dissociative symptoms in PTSD has been linked to high nonspecific treatment response rates to placebo. Genotyping individuals with respect to genes that are thought to have an important role in the underlying disease process, such as the work with the 5HTTL-PR allele, is exciting and is perhaps the first glimmer of using genotyping to identify treatment strategies or to predict the likelihood or speed of response. The use of neuroimaging as a means of identifying individuals who may respond favorably to pharmacologic or neurosurgical intervention is still in its infancy. As a strategy, it may help combine symptom severity and response variables into a clear neurobiologic vulnerability model of illness. In the future, it may be possible to identify specific treatment interventions for specific patterns of abnormal metabolic rates in certain areas of the brain. However, it should be emphasized that such an approach has not been empirically demonstrated in a rigorous experimental context at this time.",0,0 +5614,"Neurocircuitry Models of Posttraumatic Stress Disorder and Extinction: Human Neuroimaging Research—Past, Present, and Future","The prevailing neurocircuitry models of anxiety disorders have been amygdalocentric in form. The bases for such models have progressed from theoretical considerations, extrapolated from research in animals, to in vivo human imaging data. For example, one current model of posttraumatic stress disorder (PTSD) has been highly influenced by knowledge from rodent fear conditioning research. Given the phenomenological parallels between fear conditioning and the pathogenesis of PTSD, we have proposed that PTSD is characterized by exaggerated amygdala responses (subserving exaggerated acquisition of fear associations and expression of fear responses) and deficient frontal cortical function (mediating deficits in extinction and the capacity to suppress attention/response to trauma-related stimuli), as well as deficient hippocampal function (mediating deficits in appreciation of safe contexts and explicit learning/memory). Neuroimaging studies have yielded convergent findings in support of this model. However, to date, neuroimaging investigations of PTSD have not principally employed conditioning and extinction paradigms per se. The recent development of such imaging probes now sets the stage for directly testing hypotheses regarding the neural substrates of fear conditioning and extinction abnormalities in PTSD.",0,0 +5615,Predictors of susceptibility and resilience in an animal model of posttraumatic stress disorder.,"Animal models of posttraumatic stress disorder (PTSD) are based on fear conditioning where innocuous cues elicit reactions that originally occur to traumatic events--a core feature of PTSD. Another core feature is hyperarousal--exaggerated reactions to stressful events. One limitation of animal models of PTSD is that group effects do not model the sporadic incidence of PTSD. We developed an animal model of PTSD in which rabbit nictitating membrane responses become exaggerated as a function of classical conditioning to a tone conditioned stimulus (CS) paired with a shock unconditioned stimulus (US). Exaggerated responses to the US are a form of hyperarousal termed conditioning-specific reflex modification (CRM) and occur in the absence of the CS. Inspecting data across several experiments, we determined 25% of our rabbits exhibit strong CRM despite all subjects having high levels of conditioning. To determine how prone rabbits were to CRM (susceptibility) or how resistant (resilience), we examined data from 135 rabbits analyzing for factors during CS-US pairings and during US prescreening that would predict CRM. We found the magnitude of CRM was correlated with the onset latency and area of conditioned responding during CS-US pairings and with the peak latency of a response during US pretesting. In an animal model of PTSD that more accurately reflects clinical prevalence, we can begin to predict susceptibility not only during responding to a stressful conditioning situation but also during a screening process before the stressful situation takes place. The results suggest relatively innocuous testing may help detect PTSD after trauma and screen for it before trauma occurs.",0,0 +5616,"A twin study of generalized anxiety disorder symptoms, panic disorder symptoms and post-traumatic stress disorder in men","Generalized anxiety disorder (GAD), panic disorder (PD) and post-traumatic stress disorder (PTSD) often co-occur. We investigated whether and to what degree genetic and environmental contributions overlap among symptoms of GAD, symptoms of PD and PTSD. Subjects were 3327 monozygotic and dizygotic male-male twin pair members of the Vietnam Era Twin Registry who participated in a 1992 telephone administration of the Diagnostic Interview Schedule Version 3 Revised (DIS3R). Genetic model fitting was performed to estimate the magnitude of genetic and environmental contributions to the lifetime co-occurrence of GAD symptoms, PD symptoms and PTSD. The liability for GAD symptoms was due to a 37.9% additive genetic contribution common to PD symptoms and PTSD. Liability for PD symptoms was due to a 20.7% additive genetic contribution common to GAD symptoms and PTSD, and a 20.1% additive genetic influence specific to PD symptoms. Additive genetic influences common to symptoms of GAD and PD accounted for 21.3% of the genetic variance in PTSD. Additive genetic influences specific to PTSD accounted for 13.6% of the genetic variance in PTSD. Remaining variance for all three disorders was due to unique environmental factors both common and specific to each phenotype. These results suggest that these disorders each have etiologically distinct components and also have significant genetic and unique environmental contributions in common.",0,0 +5617,"Comparison of Response to a Selective Serotonin Reuptake Inhibitor in Children, Adolescents, and Adults with Posttraumatic Stress Disorder","Although the pathophysiology of posttraumatic stress disorder (PTSD) is considered multifactorial, empirical evidence suggests that serotonergic dysregulation may characterize the disorder. The efficacy of the selective serotonin reuptake inhibitors (SSRIs) in treating essential symptoms (re-experiencing, avoidance, numbing, hyperarousal) in both adults and children is likely to involve potentiation of this neurotransmitter.This study compared outcome in an 8-week open trial of citalopram (an SSRI) in children/adolescents and adults with a Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnosis of PTSD.Twenty-four children/adolescents and 14 adults assessed for PTSD severity at baseline were followed up on citalopram treatment (20-40 mg/day) at two-weekly intervals over 8 weeks. The Clinician-Adminstered PTSD Scale (CAPS) and the Clinical Global Improvement Scale (CGI) were used as outcome measures.Although there were no significant differences in outcome measures between children/adolescents (n = 24) and adults (n = 14), both groups had significant reductions in mean CAPS total scores, symptom cluster scores, and CGI ratings at endpoint.Although the SSRIs have established efficacy and safety in the treatment of adult PTSD, literature on their use in child and adolescent PTSD is sparse. Controlled data are needed to support the clinical perception that SSRIs are agents of choice in the treatment of pediatric PTSD.",0,0 +5618,Personality disorders in treatment-seeking combat veterans with posttraumatic stress disorder,"Many patients with posttraumatic stress disorder (PTSD) appear to have co-occurring symptoms of character pathology; however, to date there have been no empirical studies of comorbid clinician-rated axis II personality disorders in war veterans with chronic PTSD. The authors' objective was to assess DSM-III-R personality disorders in treatment-seeking combat veterans with PTSD.They used the Personality Disorder Examination, a standardized diagnostic interview for DSM-III-R axis II disorders, to assess DSM-III-R personality disorders in 34 patients with PTSD; 18 of the subjects were inpatients and 16 were outpatients.A high rate of character pathology was observed in both inpatient and outpatient groups. The most frequent disorders for which criteria were met were borderline, obsessive-compulsive, avoidant, and paranoid personality disorders. Inpatients had a higher rate of nearly every personality disorder than did outpatients. Inpatients were significantly more likely to meet diagnostic criteria for paranoid, schizotypal, avoidant, and self-defeating personality disorders.War-related PTSD in treatment-seeking Vietnam veterans is often accompanied by diffuse, debilitating, and enduring impairments in character. Subtyping patients with PTSD on the basis of specific axis II profiles may aid in the selection of more specific and effective treatments.",0,0 +5619,Disentangling Mild Traumatic Brain Injury and Stress Reactions,"The study by Hoge and colleagues in this issue of the Journal provides an important profile of the sequelae of mild traumatic brain injury in military personnel after combat.1 The findings demonstrate that mild traumatic brain injury results in increased rates of psychological, health, and functional problems. Although the study provides strong evidence for impairments in military personnel serving in Iraq and Afghanistan, it also raises a number of critical questions concerning the impairments that may be attributed to mild traumatic brain injury. One striking finding from this study is that although mild traumatic brain injury predicted a range of . . .",0,0 +5620,Compulsive sexual behavior among male military veterans: Prevalence and associated clinical factors,"Compulsive sexual behavior (CSB) is highly prevalent among men, often co-occurring with psychiatric disorders and traumatic experiences. Psychiatric disorders and trauma are highly prevalent among military veterans, yet there is a paucity of research on CSB among military samples. The aim of this study was to examine the prevalence of and factors associated with CSB among male military veterans.Surveys were administered to veterans of Operations Iraqi Freedom, Enduring Freedom, or New Dawn at baseline (n = 258), 3 months(n = 194), and 6 months (n = 136). Bivariate analyses and Generalized Estimating Equations were utilized to estimate associations between CSB and the following variables: psychiatric co-morbidity, childhood physical or sexual trauma, pre- and post-deployment experiences, TV/ Internet usage, and sociodemographics. Associations between CSB and specific PTSD symptom clusters were also examined.CSB was reported by 16.7% of the sample at baseline. Several variables were associated with CSB in bivariate analyses; however, only PTSD severity, childhood sexual trauma, and age remained significant in multivariable GEE models. The PTSD symptom cluster re-experiencing was most strongly associated with CSB.This exploratory study suggests that CSB is prevalent amongst veterans returning from combat and is associated with childhood trauma and PTSD, particularly re-experiencing.Further study is needed to identify the mechanisms linking PTSD and CSB, define the context and severity of CSB in veterans, and examine the best ways to assess and treat CSB in VA clinical settings.",0,0 +5621,Evidence for low-grade systemic proinflammatory activity in patients with posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) may increase cardiovascular risk but the psychophysiological mechanisms involved are elusive. We hypothesized that proinflammatory activity is elevated in patients with PTSD as diagnosed by the Clinician Administered PTSD Scale (CAPS) interview. Plasma levels of proinflammatory C-reactive protein (CRP), interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α, and of anti-inflammatory IL-4 and IL-10 were measured in 14 otherwise healthy PTSD patients and in 14 age- and gender-matched healthy non-PTSD controls. Levels of TNF-α ( p = 0.038; effect size Cohen’s d = 0.58) and of IL-1β ( p = 0.075, d = 0.68) were higher in patients than in controls. CRP ( d = 0.10), IL-6 ( d = 0.18), IL-4 ( d = 0.42), and IL-10 ( d = 0.37) were not significantly different between groups. Controlling for traditional cardiovascular risk factors, mood, and time since trauma revealed lower IL-4 in patients than in controls ( p = 0.029) and rendered group differences in TNF-α and IL-1β insignificant. In all subjects, TNF-α correlated with total (frequency and intensity) PTSD symptom cluster of re-experiencing ( r = 0.49, p = 0.008), avoidance ( r = 0.37, p = 0.050), and hyperarousal ( r = 0.42, p = 0.026), and with PTSD total symptom score ( r = 0.37, p = 0.054). Controlling for time since trauma attenuated these associations. The correlation between IL-1β and total avoidance symptoms ( r = 0.42, p = 0.028) became insignificant when controlling for anxiety and depression. IL-4 correlated with total hyperarousal symptoms ( r = −0.38, p = 0.047), and after controlling for systolic blood pressure and smoking status, with PTSD total symptom score ( r = −0.41, p = 0.035). PTSD patients showed a low-grade systemic proinflammatory state, which, moreover, was related to PTSD symptom levels suggesting one mechanism by which PTSD could contribute to atherosclerotic disease.",0,0 +5622,Enduring sensorimotor gating abnormalities following predator exposure or corticotropin-releasing factor in rats: A model for PTSD-like information-processing deficits?,"A deficit in prepulse inhibition (PPI) can be one of the clinically observed features of post-traumatic stress disorder (PTSD) that is seen long after the acute traumatic episode has terminated. Thus, reduced PPI may represent an enduring psychophysiological marker of this illness in some patients. PPI is an operational measure of sensorimotor gating and refers to the phenomenon in which a weak stimulus presented immediately before an intense startling stimulus inhibits the magnitude of the subsequent startle response. The effects of stress on PPI have been relatively understudied, and in particular, there is very little information on PPI effects of ethologically relevant psychological stressors. We aimed to develop a paradigm for evaluating stress-induced sensorimotor gating abnormalities by comparing the effects of a purely psychological stressor (predator exposure) to those of a nociceptive physical stressor (footshock) on PPI and baseline startle responses in rats over an extended period of time following stressor presentation. Male Sprague-Dawley rats were exposed (within a protective cage) to ferrets for 5 min or left in their homecage and then tested for PPI immediately, 24 h, 48 h, and 9 days after the exposure. The effects of footshock were evaluated in a separate set of rats. The effects seen with stressor presentation were compared to those elicited by corticotropin-releasing factor (CRF; 0.5 and 3 μg/6 μl, intracerebroventricularly). Finally, the effects of these stressors and CRF administration on plasma corticosterone were measured. PPI was disrupted 24 h after ferret exposure; in contrast, footshock failed to affect PPI at any time. CRF mimicked the predator stress profile, with the lowdose producing a PPI deficit 24 h after infusion. Interestingly, the high dose also produced a PPI deficit 24 h after infusion, but with this dose, the PPI deficit was evident even 9d later. Plasma corticosterone levels were elevated acutely (before PPI deficits emerged) by both stressors and CRF, but returned to normal control levels 24 h later, when PPI deficits were present. Thus, predator exposure produces a delayed disruption of PPI, and stimulation of CRF receptors recapitulates these effects. Contemporaneous HPA axis activation is neither necessary nor sufficient for these PPI deficits. These results indicate that predator exposure, perhaps acting through CRF, may model the delayed-onset and persistent sensorimotor gating abnormalities that have been observed clinically in PTSD, and that further studies using this model may shed insight on the mechanisms of information-processing deficits in this disorder. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.",0,0 +5623,Posttraumatic Stress and Stigma in Active-Duty Service Members Relate to Lower Likelihood of Seeking Support,"Posttraumatic stress disorder (PTSD) is a common mental health concern for returning service members. Social support is a robust predictor of resiliency and recovery from PTSD; however, barriers to seeking support are understudied. PTSD and anticipated enacted stigma from family and friends were explored as correlates of the likelihood of seeking support among 153 Iraq/Afghanistan U.S. service members. Results showed that PTSD (r = -.31, p < .001) and anticipated enacted stigma (r = -.22, p ≤ .01) were negatively associated with likelihood of seeking support. Post hoc analyses showed that only dysphoria (r = -.32, p < .001) was significantly related to the likelihood of seeking support after accounting for anticipated enacted stigma and other PTSD clusters. Implications of these findings and ways to increase likelihood of seeking support are discussed.",0,0 +5624,"Post-traumatic stress disorder, emotional processing and Inappropriate Implantable Cardioverter-Defibrillator Shocks: clinical consideration by a single case report","Introduction. Even though an overwhelming amount of evidence supports the clinical efficacy and safety of the implantable cardioverter defibrillator (ICD), inappropriate shocks for atrial arrhythmias with rapid ventricular conduction or for abnormal sensing results in multiple adverse effects Presentation. In this study we present the case of a 59- year-old woman who was admitted to hospital for ICD implantation with a past medical history that was positive for non-ischemic dilated cardiomyopathy, congestive heart failure (NYHA class III), atrial fibrillation, essential hypertension and a recent episode of syncope. Since in the 18 months follow-up the patient suffered many inappropriate shocks, we investigated the association of the presence of a PTSD (Post- Traumatic-Stress-Disorder) prior to implantation and a specific profile of cognitive processing emotions, with the effectiveness of the ICD. Emotional distress states and cognitive thoughts preceding ICD shock inappropriate episode were recorded by structured mobile diary (eMotional-ICDiary©). We outlined how the presence of a highly traumatic event which had occurred 6 years previously was related to a recurrence of a combination of moderate distress and cognitive thoughts, associated with episodes of Inappropriate Shock. A psycho-diagnostic examination and the administration of the Emotional Processing Scale (EPS-25) and Emotional Regulation Questionnaire (ERQ) outlined that the patient presented a profile of cognitive processing of emotions characterized by elevated levels of unprocessed emotions, low appraisal and high suppression emotional regulation strategy. Conclusion. The observations gathered in this single case are a good starting point for further research in order to check if the post-traumatic stress disorder and a specific cognitive profile connected to the processing of emotions are associated with the presence of inappropriate ICD shocks. Further larger sample studies are required in this area.",0,0 +5625,"PTSD in Vietnamese Americans following Hurricane Katrina: Prevalence, patterns, and predictors","One year after Hurricane Katrina devastated New Orleans, we assessed 82 adults from a population-based sample of the Vietnamese American community who had participated in a larger study of immigration weeks before the disaster. Although 21% met criteria for partial posttraumatic stress disorder (PTSD), only 5% of the sample met all PTSD criteria. Avoidance/numbing symptoms did not form a coherent cluster and were seldom confirmed, but intrusion, arousal, and interference were common. Severity of exposure to the floodwaters, property loss, and subjective trauma were independently related to PTSD symptoms. Symptoms were highest among participants who were low in acculturation or who had high Katrina exposure in combination with prolonged stays in transition camps during emigration.",0,0 +5626,Long-Term Adjustment of Survivors of Ovarian Cancer Treated for Advanced-Stage Disease,"This study described the long-term adjustment of 42 ovarian cancer survivors diagnosed with advanced-stage disease with no evidence of recurrence, a mean of 6.1 years postdiagnosis. 64% of survivors' mental health was at or above the norm of medical outpatients (Mental Health Inventory-17). No patients reported post-traumatic stress disorder at a diagnosable level (Post-Traumatic Stress Disorder (PTSD) Checklist-Civilian). The majority of survivors (> or = 75%) reported a positive impact of cancer on their lives (Impact of Cancer Scale) and excellent social support (Medical Outcomes Study Social Support Survey). However, a subset of survivors reported needing more help than was received regarding emotional problems (28.9%).",0,0 +5627,"Psychological and health problems in a geographically proximate population time-sampled continuously for three months after the September 11th, 2001 terrorist incidents","This study assessed the mental and physical health status and psychological problems related to the September 11th terrorist incidents among a representative sample of adults living near New York City, using continuously time-sampled data collected throughout 2001. Prevalence estimates for poor mental or physical health after September 11th (October through December) were comparable to those for the entire year of 2001 (i.e. approximately 33%). Psychological problems related to the terrorist incidents were reported by more than half of the respondents, and appeared to peak in prevalence approximately two to three months following the incidents, followed by a decline in the next month and subsequent year. Poor mental health, female gender, media re-exposure, and ongoing or increased alcohol use were risk factors for psychological problems, while older age (65+ years old) and being married were protective factors. Risk factors for poor physical and mental health or psychological problems were generally stable over the three-month period following September 11th, but some changes were identified consistent with stage models of post-disaster psychological adjustment. Implications are discussed for using continuous time-sampling as a strategy to research patterns of relatively acute stress-related sequelae of terrorism in populations whose members are affected despite primarily not having been at the disaster epicenter.",0,0 +5628,Course and prognostic factors of whiplash: A systematic review and meta-analysis ☆,"We conducted a systematic review and meta-analysis of prospective cohort studies of subjects with acute whiplash injuries. The aim was to describe the course of recovery, pain and disability symptoms and also to assess the influence of different prognostic factors on outcome. Studies were selected for inclusion if they enrolled subjects with neck pain within six weeks of a car accident and measured pain and/or disability outcomes. Studies were located via a sensitive search of electronic databases; Medline, Embase, CINAHL, Cochrane database, ACP Journal club, DARE and Psychinfo and through hand-searches of relevant previous reviews. Methodological quality of all studies was assessed using a six item checklist. Sixty-seven articles, describing 38 separate cohorts were included. Recovery rates were extremely variable across studies but homogeneity was improved when only data from studies of more robust methodological quality were considered. These data suggest that recovery occurs for a substantial proportion of subjects in the initial 3 months after the accident but after this time recovery rates level off. Pain and disability symptoms also reduce rapidly in the initial months after the accident but show little improvement after 3 months have elapsed. Data regarding the prognostic factors associated with poor recovery were difficult to interpret due to heterogeneity of the techniques used to assess such associations and the way in which they are reported. There was also wide variation in the measurement of outcome and the use of validated measures would improve interpretability and comparability of future studies.",0,0 +5629,Anatomical and neuropsychological effects of cluster munitions,"The aim of this article is to investigate the effects of cluster munitions on the different environmental, anatomical and neuropsychological levels. We conducted a study to explore the effects of sub-munitions on Lebanese victims. The study included a total of 407 cases that have been subjected to the detonation of unexploded sub-munitions in Lebanon, between 2006 and 2011. In our series, 356 casualties were injured and 51 were dead. 382 were males and 25 were females. We recorded 83 cases of amputations, and injuries involving cranio-facial regions, thorax, abdomen, and upper and lower extremities. These injuries lead to loss of function, body disfiguration, and chronic pain caused by the injuries or the amputations, as well as post-traumatic stress disorder. The peripheral nervous system was mostly affected and patients suffered from significant psychosocial tribulations. Cluster munitions harm human beings and decrease biodiversity. Survivors suffer from physical and psychological impairments. Laws should be passed and enforced to ban the use of these detrimental weapons that have negative effects on ecosystem and societal levels. © 2013 Springer-Verlag Italia.",0,0 +5630,The Mental Health Status of Women in the Navy and Marine Corps: Preliminary Findings from the Perceptions of Wellness and Readiness Assessment,"The 1995 Perceptions of Wellness and Readiness Assessment was designed to provide baseline health and risk-factor information on the physical and mental health status of women in the U.S. Navy and Marine Corps and to make comparisons both within military subpopulations and with civilian populations. A population-based, multi-stage, cluster sample of 782 active duty Navy and Marine Corps women and men were administered a structured computerized telephone interview to make Diagnostic and Statistical Manual-III-R psychiatric diagnoses. Estimates were 40 and 21% for overall lifetime and 1-year prevalence of psychiatric disorders, respectively. Women had about five times the risk of experiencing post-traumatic stress disorder than men and about twice the risk of a major depressive episode. Of all personnel meeting diagnostic criteria for an active mental disorder, only 19% sought mental health care in the last year. Women generally sought treatment more readily than men.",0,0 +5631,"[The relationship between depression, anxiety and heart disease - a psychosomatic challenge].","Depressive and cardiological disorders present a major comorbidity. Their manifold interrelations may be best analysed within a biopsychosocial model of disease.A systematic research was done on empirical studies published during the last 15 years and dealing with epidemiological, etiopathogenetic and therapeutic dimensions of the comorbidity of depression, anxiety and heart disease.From an epidemiological perspective recurrent depressions are associated with a significantly increased risk of coronary heart disease. Depressive disorders play a major role in triggering critical cardiac events, e.g. myocardial infarction. The prevalence rates of depressive disorders in various cardiological conditions are significantly higher than the frequencies that can be expected in healthy general population. Depression shows a negative impact on the somatic morbidity and mortality during the further course of illness. Anxiety and posttraumatic stress disorders seem to be interrelated with cardiological conditions in quite a similar way, probably contributing even more negatively to critical and lethal cardiological events than depression. From an etiopathogenetic perspective some clusters of depressive symptoms seem to be linked to cardiotoxicity more closely than other, vital exhaustion, anhedonia, and hopelessness probably mediating a special risk. In any case, postmyocardial infarct depression that proves treatment-resistent indicates a negative prognosis of the prevailing cardiological condition. On a level of psychological and psychosocial constructs type-A personality, anger/hostility, type-D personality, and alexithymia have been explored regarding its proper pathogenetic role. Psychological and psychopathological variables have to be set into a context of psychosocial stressors on the one hand, and have to be simultaneously analysed with various underlying psycho- and neurobiological variables on the other. Above all, HPA- and sympathicomedullary dysfunctions, reduced heart rate variability, altered functions of thrombocytes, and increased proinflammatory processes have to be recognized as significantly contributing to the pathophysiology both of depression and of heart condition. Neurobiological aspects of anxiety and posttraumatic stress disorders must be interlinked with these underpinnings of depression. Differential effects on critical cardiological events must be supposed. From a therapeutic perspective several RCTs demonstrate that SSRIs may safely and efficiently treat depressive disorders in cardiological conditions, and may even improve the general somatic prognosis. Cognitive-behavioural psychotherapies have been empirically validated in treating depression and anxiety with cardiological patients. So far, however, a differential indication of psychopharmacological versus psychotherapeutic approaches has not been proved yet.Depression and anxiety disorders in patients with heart disease paradigmatically define a psychosomatic-somatopsychic challenge to any health delivery system. A psychosomatic perspective may best be practised within a Consultation-Liaison psychiatric service that cooperates continuously and closely with cardiological departments and experts.",0,0 +5632,The role of early pharmacotherapy in the development of posttraumatic stress disorder symptoms after traumatic injury: an observational cohort study in consecutive patients,"Pharmacological intervention during traumatic memory consolidation has been suggested to prevent posttraumatic stress disorder (PTSD). The aim of this study was to examine the association between prescription of early pharmacotherapy and the risk of developing PTSD symptoms following traumatic injury.The use of opiate analgesics, beta-adrenergic blockers, corticosteroids and benzodiazepines within 48 h postinjury was documented based on hospital charts for 629 Level 1 trauma center patients. PTSD symptoms were assessed using structured clinical interviews. Primary outcome was 6-week PTSD symptoms. Secondary outcomes were PTSD diagnoses at 6 weeks and during 1 year posttrauma.Linear regression analyses showed that opiate administration within 48 h was negatively associated with PTSD symptoms at 6 weeks (β=-0.14, P=.009) after controlling for demographic and injury-related characteristics and concurrent pharmacotherapy. Fewer patients with opiates had a PTSD diagnosis at 6 weeks (P=.047) and during 1 year posttrauma (P=.013) than patients with none of the specified pharmacotherapies. Low prescription frequency of beta-blockers (3.8%), corticosteroids (2.2%) and benzodiazepines (7.8%) precluded further examination of their role in the development of PTSD symptoms because of limited statistical power.This study suggests a possible beneficial influence of opiate administration within 48 h posttrauma on the development of PTSD symptoms. Future studies may evaluate the effectiveness of inhospital opiate analgesics compared to placebo in preventing PTSD and may focus on the mechanisms underlying the effect of opiates in preventing PTSD.",0,0 +5633,"Neurobehavioral, neuropathological and biochemical profiles in a novel mouse model of co-morbid post-traumatic stress disorder and mild traumatic brain injury","Co-morbid mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) has become the signature disorder for returning combat veterans. The clinical heterogeneity and overlapping symptomatology of mTBI and PTSD underscore the need to develop a preclinical model that will enable the characterization of unique and overlapping features and allow discrimination between both disorders. This study details the development and implementation of a novel experimental paradigm for PTSD and combined PTSD-mTBI. The PTSD paradigm involved exposure to a danger-related predator odor under repeated restraint over a 21day period and a physical trauma (inescapable footshock). We administered this paradigm alone, or in combination with a previously established mTBI model. We report outcomes of behavioral, pathological and biochemical profiles at an acute timepoint. PTSD animals demonstrated recall of traumatic memories, anxiety and an impaired social behavior. In both mTBI and combination groups there was a pattern of disinhibitory like behavior. mTBI abrogated both contextual fear and impairments in social behavior seen in PTSD animals. No major impairment in spatial memory was observed in any group. Examination of neuroendocrine and neuroimmune responses in plasma revealed a trend towards increase in corticosterone in PTSD and combination groups, and an apparent increase in Th1 and Th17 proinflamatory cytokine(s) in the PTSD only and mTBI only groups respectively. In the brain there were no gross neuropathological changes in any groups. We observed that mTBI on a background of repeated trauma exposure resulted in an augmentation of axonal injury and inflammatory markers neurofilament L and ICAM-1. Our observations thus far suggest that this novel stress-trauma-related paradigm may be a useful model for investigating further the overlapping and distinct spatio-temporal and behavioral/biochemical relationship between mTBI and PTSD experienced by combat veterans.",0,0 +5634,Quality of Life after Traumatic Injury: A Latent Trajectory Modeling Approach,"<b><i>Background:</i></b> It is largely unknown how quality of life (QoL) changes following accidental injuries. Equally, the mechanisms underlying such changes have not yet been identified in detail. This study of injured accident survivors aimed to: (1) detect a model of change which best explains the observed course of QoL, and (2) identify potential predictor variables. <b><i>Methods:</i></b> 323 injured accident survivors were interviewed within 2 weeks of the trauma, and followed up at 6 and 12 months. Latent trajectory modeling was used to analyze the fit of three potential trajectories regarding the observed course of general QoL as measured by the Questions on Life Satisfaction questionnaire. <b><i>Results:</i></b> The trajectory model adopting a negative square-root change fitted the observed data best, meaning that shortly after the accident, general QoL decreased strongly with diminishing negative changes occurring later on. Early and prolonged QoL impairment was largely attributable to the initial level of posttraumatic stress as measured by the Clinician-Administered PTSD Scale. To a lesser extent, depressive symptoms also predicted change in subjective QoL, while injury severity showed no direct effect; rather, its impact on QoL was mediated by initial posttraumatic stress. By contrast, reduced occupational functioning was attributable to injury severity rather than psychopathology. <b><i>Conclusions:</i></b> When treating injured accident survivors, clinicians should consider symptoms of posttraumatic stress and comorbid depression in order to prevent or mitigate negative changes in QoL.",0,0 +5635,Behavioral inhibition in childhood predicts smaller hippocampal volume in adolescent offspring of parents with panic disorder,"Behavioral inhibition (BI) is a genetically influenced behavioral profile seen in 15-20% of 2-year-old children. Children with BI are timid with people, objects and situations that are novel or unfamiliar, and are more reactive physiologically to these challenges as evidenced by higher heart rate, pupillary dilation, vocal cord tension and higher levels of cortisol. BI predisposes to the later development of anxiety, depression and substance abuse. Reduced hippocampal volumes have been observed in anxiety disorders, depression and posttraumatic stress disorder. Animal models have demonstrated that chronic stress can damage the hippocampal formation and implicated cortisol in these effects. We, therefore, hypothesized that the hippocampi of late adolescents who had been behaviorally inhibited as children would be smaller compared with those who had not been inhibited. Hippocampal volume was measured with high-resolution structural magnetic resonance imaging in 43 females and 40 males at 17 years of age who were determined to be BI+ or BI- based on behaviors observed in the laboratory as young children. BI in childhood predicted reduced hippocampal volumes in the adolescents who were offspring of parents with panic disorder, or panic disorder with comorbid major depression. We discuss genetic and environmental factors emanating from both child and parent that may explain these findings. To the best of our knowledge, this is the first study to demonstrate a relationship between the most extensively studied form of temperamentally based human trait anxiety, BI, and hippocampal structure. The reduction in hippocampal volume, as reported by us, suggests a role for the hippocampus in human trait anxiety and anxiety disorder that warrants further investigation.",0,0 +5636,Traumatic brain injury and PTSD screening efforts evaluated using latent class analysis.,"To empirically identify latent classes of service members according to persistent postconcussive symptom patterns and to characterize the identified classes relative to other postdeployment variables including posttraumatic stress disorder (PTSD) and mild traumatic brain injury (TBI) screening results. Such comparisons may directly inform policy regarding these routine assessments and translate to improved treatment decisions.Self-report data were obtained for 12,581 combat-exposed male U.S. Navy and Marine Corps personnel who returned from deployment in 2008-2009 and completed a Post-Deployment Health Assessment (PDHA) and an associated Post-Deployment Health Reassessment (PDHRA). Persistent postconcussive symptoms indicated on the PDHRA were used as manifest variables in a latent class analysis yielding 4 distinct classes: systemic, cognitive/behavioral, comorbid, and nonpresenting.Although the nonpresenting class endorsed few or no postconcussive symptoms, the systemic and cognitive/behavioral classes displayed elevated likelihoods of neurological and mental health symptoms, respectively. Members of the comorbid class had an increased probability of reporting a wide range of symptoms across both domains. Characterization of identified classes suggested that class membership may indicate the presence or absence of persistent conditions resulting from head injury and/or mental health issues. Under this assumption, estimated class membership probabilities implied a rate of probable neurological injury among this sample to be 17.9%, whereas the standard assessments aimed at identifying repercussions of mild TBI reported a positive screening rate of only 13.1%.Findings suggest that the routinely administered PDHA and PDHRA appear to underestimate the true prevalence of service members experiencing postdeployment health problems. Supplemental items or an alternative screening algorithm incorporating persistent postconcussive symptoms may enable identification of additional cases requiring treatment following return from deployment.",0,0 +5637,Resilience and Variability Following Oil Spill Disasters,"© 2012 Guilford Publications, Inc. George A. Bonanno, Ph.D., is Professor of Clinical Psychology in the Department of Counseling and Clinical Psychology at Columbia University in New York City. Address correspondence to George Bonanno, Deparatment of Counseling and Clinical Psychology, Teachers College Box 218, Columbia University, 525 W. 120th Street, New York, NY 10027. E-mail: Gab38@columbia.edu Commentary on “Lessons Learned from the Exxon Valdez Oil Spill” Bonanno",0,0 +5638,Peritraumatic dissociation and posttraumatic stress in male Vietnam theater veterans,"The aim of this study was to determine the reliability and validity of a proposed measure of peritraumatic dissociation and, as part of that effort, to determine the relationship between dissociative experiences during disturbing combat trauma and the subsequent development of posttraumatic stress disorder (PTSD).A total of 251 male Vietnam theater veterans from the Clinical Examination Component of the National Vietnam Veterans Readjustment Study were examined to determine the relationship of war zone stress exposure, retrospective reports of dissociation during the most disturbing combat trauma events, and general dissociative tendencies with PTSD case determination.The total score on the Peritraumatic Dissociation Experiences Questionnaire--Rater Version was strongly associated with level of posttraumatic stress symptoms, level of stress exposure, and general dissociative tendencies and weakly associated with general psychopathology scales from the MMPI-2. Logistic regression analyses supported the incremental value of dissociation during trauma, over and above the contributions of level of war zone stress exposure and general dissociative tendencies, in accounting for PTSD case determination.These results provide support for the reliability and validity of the Peritraumatic Dissociation Experiences Questionnaire--Rater Version and for a trauma-dissociation linkage hypothesis: the greater the dissociation during traumatic stress exposure, the greater the likelihood of meeting criteria for current PTSD.",0,0 +5639,Gender differences in posttraumatic stress disorder.,"One of the most consistent findings in the epidemiology of posttraumatic stress disorder (PTSD) is the higher risk of this disorder in women. Explanations reviewed within a psychobiological model of PTSD suggest that women's higher PTSD risk may be due to the type of trauma they experience, their younger age at the time of trauma exposure, their stronger perceptions of threat and loss of control, higher levels of peri-traumatic dissociation, insufficient social support resources, and greater use of alcohol to manage trauma-related symptoms like intrusive memories and dissociation, as well as gender-specific acute psychobiological reactions to trauma. This review demonstrates the need for additional research of the gender differences in posttraumatic stress. Recommendations are made for clinical practice.",0,0 +5640,"Work-related critical incidents in hospital-based health care providers and the risk of post-traumatic stress symptoms, anxiety, and depression: A meta-analysis","This meta-analysis reviewed existing data on the impact of work-related critical incidents in hospital-based health care professionals. Work-related critical incidents may induce post-traumatic stress symptoms or even post-traumatic stress disorder (PTSD), anxiety, and depression and may negatively affect health care practitioners' behaviors toward patients. Nurses and doctors often cope by working part time or switching jobs. Hospital administrators and health care practitioners themselves may underestimate the effects of work-related critical incidents. Relevant online databases were searched for original research published from inception to 2009 and manual searches of the Journal of Traumatic Stress, reference lists, and the European Traumatic Stress Research Database were conducted. Two researchers independently decided on inclusion and study quality. Effect sizes were estimated using standardized mean differences with 95% confidence intervals. Consistency was evaluated, using the I(2)-statistic. Meta-analysis was performed using the random effects model. Eleven studies, which included 3866 participants, evaluated the relationship between work-related critical incidents and post-traumatic stress symptoms. Six of these studies, which included 1695 participants, also reported on the relationship between work-related critical incidents and symptoms of anxiety and depression. Heterogeneity among studies was high and could not be accounted for by study quality, character of the incident, or timing of data collection. Pooled effect sizes for the impact of work-related critical incidents on post-traumatic stress symptoms, anxiety, and depression were small to medium. Remarkably, the effect was more pronounced in the longer than in the shorter term. In conclusion, this meta-analysis supports the hypothesis that work-related critical incidents are positively related to post-traumatic stress symptoms, anxiety, and depression in hospital-based health care professionals. Health care workers and their supervisors should be aware of the harmful effects of critical incidents and take preventive measures.",0,0 +5641,The relationship between substance use and posttraumatic stress disorder in a methadone maintenance treatment program,"Posttraumatic stress disorder (PTSD) is frequently linked with substance abuse. The self-medication hypothesis suggests that some people may use illicit substances in an attempt to self-treat psychiatric symptoms. This study explores the relationship between substance abuse and PTSD symptom clusters in a methadone maintenance population.Clients of a methadone maintenance program at a public Drug and Alcohol Service were invited to complete the PTSD Checklist-Civilian Version, a screening tool for PTSD. Information about their history of substance use was also collected.Eighty clients (43 female, 37 male), aged 35 ± 8.0 years (mean ± SD), participated in the study, of which 52.7% screened positive for PTSD. Severity of marijuana use was significantly associated with a number of reexperiencing and hyperarousal symptoms and with overall severity of PTSD symptoms. Opiate, amphetamine, and benzodiazepine use did not appear to be related to PTSD symptoms.In this sample, marijuana may be used to self-treat certain PTSD symptoms, supporting the self-medication hypothesis. Further research is required to confirm the association between a diagnosis of PTSD and substance use. Given the high prevalence of PTSD in the substance-using population, routine PTSD screening in the substance abuse treatment setting may be justified.",0,0 +5642,Evidence for a psychotic posttraumatic stress disorder subtype based on the National Comorbidity Survey,"Purpose This study assessed the distribution of posttraumatic stress disorder (PTSD) symptoms and psychosis indicators among a large sample of individuals with a lifetime diagnosis of PTSD. The identification of a psychotic PTSD subtype was also predicted. Method Using data from the National Comorbidity Survey a latent class analysis was conducted on the PTSD symptoms of intrusion, avoidance, and hyperarousal and the psychosis hallucination and delusion indicators. Results Results indicated four latent classes, two of which had relatively high probabilities of endorsing the hallucination and delusion indicators. These classes were associated with a broad range of traumatic experiences. One particular class had high probabilities of endorsing both the psychosis indicators and the PTSD symptoms and was associated with a broad range of comorbid psychiatric disorders. Conclusion There was a candidate class that met the characteristics expected to be evident in a psychotic PTSD subtype. © Springer-Verlag 2010.",0,0 +5643,L'automatisme psychologique,,0,0 +5644,"Prenatal stress induces long term stress vulnerability, compromising stress response systems in the brain and impairing extinction of conditioned fear after adult stress","Stress is a risk factor for the development of affective disorders, including depression, post-traumatic stress disorder, and other anxiety disorders. However, not all individuals who experience either chronic stress or traumatic acute stress develop such disorders. Thus, other factors must confer a vulnerability to stress, and exposure to early-life stress may be one such factor. In this study we examined prenatal stress (PNS) as a potential vulnerability factor that may produce stable changes in central stress response systems and susceptibility to develop fear- and anxiety-like behaviors after adult stress exposure. Pregnant Sprague-Dawley rats were immobilized for 1 h daily during the last week of pregnancy. Controls were unstressed. The male offspring were then studied as adults. As adults, PNS or control rats were first tested for shock-probe defensive burying behavior, then half from each group were exposed to a combined chronic plus acute prolonged stress (CAPS) treatment, consisting of chronic intermittent cold stress (4 °C, 6 h/d, 14 days) followed on day 15 by a single session of sequential acute stressors (social defeat, immobilization, cold swim). After CAPS or control treatment, different groups were tested for open field exploration, social interaction, or cued fear conditioning and extinction. Rats were sacrificed at least 5 days after behavioral testing for measurement of tyrosine hydroxylase (TH) and glucocorticoid receptor (GR) expression in specific brain regions, and plasma adrenocorticotropic hormone (ACTH) and corticosterone. Shock-probe burying, open field exploration and social interaction were unaffected by any treatment. However, PNS elevated basal corticosterone, decreased GR protein levels in hippocampus and prefrontal cortex, and decreased TH mRNA expression in noradrenergic neurons in the dorsal pons. Further, rats exposed to PNS plus CAPS showed attenuated extinction of cue-conditioned fear. These results suggest that PNS induces vulnerability to subsequent adult stress, resulting in an enhanced fear-like behavioral profile, and dysregulation of brain noradrenergic and hypothalamic-pituitary-adrenal axis (HPA) activity.",0,0 +5645,Flying therapy for flying phobia.,"Optimum treatment for aircrew who have developed anxiety associated with flight includes a flying phase for desensitization. However, standardized flight profiles are not found in the literature. In this study, a method of desensitization flying, which may increase the probability of a return to productive flying, was devised and assessed.Seven aircrew were referred for flying desensitization. Behavioral therapy (relaxation training, imaginary flying, and thought switching) was usually continued by the Medical Officer (Pilot) (MOP). These aircrewmen flew 2-16 sorties in the RAF IAM Hawk or Hunter aircraft with the MOP. Each flight was structured with three purposes: to approach by increments the flight conditions in each victim's anxiety hierarchy, to regulate the amount of low workload, anxiety-vulnerable time during each sortie, and to practice relaxation techniques in the air.In all referred aircrewmen, anxiety was controllable in flight at IAM. Somatic signs diminished and no sortie was terminated early. All returned to operational flying. Anxiety recurred in one fast jet pilot while flying solo, and in one navigator, both of whom requested a change to transports. A transport pilot had recurrent uncontrollable anxiety at high altitude and is grounded. At 9-24 months follow-up, 5/7 were flying comfortably with rare, controllable anxiety. We conclude that actual exposure to flying is usually necessary for aircrew to recover from anxiety associated with flight.",0,0 +5646,Comparative Study of Trauma-Related Phenomena in Subjects With Pseudoseizures and Subjects With Epilepsy,"The purpose of this study was to examine potential differences in measures of trauma-related phenomena between subjects with pseudoseizures and subjects with intractable epilepsy.Thirty-one adult subjects with pseudoseizures and 32 subjects with intractable epilepsy (confirmed by video-EEG) were recruited from the epilepsy unit of a tertiary care hospital. Each participant completed the Impact of Event Scale, the Davidson Trauma Scale, the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (PTSD), the Dissociative Experience Scale, and the Pittsburgh Sleep Quality Index, as well as demographic, seizure history, and family functioning measures.Subjects with pseudoseizures had significantly higher mean scores on the Davidson Trauma Scale, Mississippi Scale for Combat-Related PTSD, Impact of Event Scale, and Pittsburgh Sleep Quality Index than subjects with epilepsy. In addition, a significantly higher percentage of subjects with pseudoseizures had scores above the clinical cutoff level of 30 on the Dissociative Experience Scale.Subjects with pseudoseizures exhibited trauma-related profiles that differed significantly from those of epileptic comparison subjects and closely resembled those of individuals with a history of traumatic experiences. Interventions aimed at trauma-related issues may be beneficial for patients with pseudoseizures.",0,0 +5647,Non-termination of sickness behavior as precipitating factor for mental disorders,"Sickness behavior can be defined as a combination of coordinated behavioral and physiological changes that develop in response to any condition that elicits pro-inflammatory activity. It is an adaptational homeostasis initiated by the influence of pro-inflammatory cytokines on central nervous system neurohormonal functioning. This paper introduces the concept of non-termination of sickness behavior as a potential threat to mental health. In view of the similarities between the behavioral symptoms, the neuroendocrine and the cytokine profiles of sickness behavior and that of a number of mental disorders it is hypothesized that the inappropriate continuation of sickness behavior, (i.e., non-termination), after recovery from the initial disease, could form the basis for mental disturbances. This would be particularly relevant in individuals with alterations in stress vulnerability (altered activation threshold and impaired negative feedback), which may occur due to the combination of genetic disposition and priming by early life experiences.",0,0 +5648,"Prison Therapeutic Community Treatment for Female Offenders: Profiles and Preliminary Findings for Mental Health and Other Variables (Crime, Substance Use and HIV Risk)","ABSTRACT This random assignment study compared women in a prison Therapeutic Community (TC) program with those in a cognitive-behavioral intervention. Over two thirds of study subjects received a lifetime diagnosis of severe mental disorder, nearly one-half received a diagnosis of PTSD, and virtually all reported exposure to trauma. Preliminary analysis (n = 314) found significantly better six-month post-prison outcomes for the TC group on measures of mental health, criminal behavior and HIV-risk behavior. These findings suggest the short-term effectiveness of prison TC treatment for female offenders with substance use disorders, and underscore the importance of adapting treatment to address mental health.",0,0 +5649,Psychiatric disorders following return from combat duty during the twenty-first century,"Knowledge of the psychiatric consequences of combat deployment expanded rapidly during the late 20th century as large numbers of Vietnam veterans experienced substantial difficulties with readjustment upon return from deployment. Current warfare in Afghanistan and Iraq has resulted in the longest period of sustained combat exposure for United States forces since Vietnam. This article compares the nature of conflict, composition of deployed forces, combat exposures, and injuries in these deployment settings compared to late 20th century conflicts. It also reviews early findings on rates of psychiatric disorders among returning troops and compares these findings with those of studies of troops returning from prior conflicts. Evaluation and treatment approaches to posttraumatic stress disorder in combat veterans are then provided. Preliminary findings suggest that early assessment of veterans may not represent the long-term psychiatric needs of returning veterans and that ongoing surveillance and availability of psychiatric care will be needed for this population.",0,0 +5650,Associations Between Dimensions of Anxiety Sensitivity and PTSD Symptom Clusters in Active‐Duty Police Officers,"Prior studies have shown that anxiety sensitivity (AS) plays an important role in posttraumatic stress disorder (PTSD) symptom severity. The purpose of this study was to evaluate associations between empirically supported PTSD symptom clusters (i.e. reexperiencing, avoidance, numbing, hyperarousal) and AS dimensions (i.e. psychological concerns, social concerns, somatic concerns). Participants were 138 active-duty police officers (70.7% female; mean age = 38.9 years; mean time policing = 173.8 months) who, as a part of a larger study, completed measures of trauma exposure, PTSD symptoms, AS, and depressive symptoms. All participants reported experiencing at least one event that they perceived as traumatic, and 44 (31.9%) screened positive for PTSD. Officers with probable PTSD scored significantly higher on AS total as well as the somatic and psychological concerns dimensional scores than did those without PTSD. As well, a higher percentage of officers with probable PTSD scored positively on the AS-derived Brief Screen for Panic Disorder (Apfeldorf et al., 1994) compared with those without PTSD. A series of regression analyses revealed that depressive symptoms, number of reported traumas, and AS somatic concerns were significant predictors of PTSD total symptom severity as well as severity of reexperiencing. Avoidance was predicted by depressive symptoms and AS somatic concerns. Only depressive symptoms were significantly predictive of numbing and hyperarousal cluster scores. These findings contribute to understanding the nature of association between AS and PTSD symptom clusters. Implications for the treatment of individuals having PTSD with and without panic-related symptomatology are discussed.",0,0 +5651,"Current visual scanpath research: a review of investigations into the psychotic, anxiety, and mood disorders","The human visual system is comprised of an array of complex organs, which jointly decode information from visible light to construct a meaningful representation of the surrounding environment. The study of visual scanpaths transpired in a bid to enhance our understanding of the role of eye movements underpinning adaptive functioning as well as psychopathology and was further aided by the advent of modern eye-tracking techniques. This review provides a background to the nature of visual scanpaths, followed by an overview and critique of eye movement studies in specific clinical populations involving the psychotic, anxiety, and mood disorders, and concludes with suggested directions for future research. We performed a Medline and PsycInfo literature search, based on variations of the terms ""visual scanpath,"" ""eye-tracking,"" and ""eye movements,"" in relation to articles published from 1986 to the present. Eye-tracking studies in schizophrenia mostly concurred with the existence of a ""restricted"" scanning strategy, characterized by fewer number of fixations of increased durations, with shorter scanpath lengths, and a marked avoidance of salient features, especially in relation to facial emotion perception. This has been interpreted as likely reflecting dual impairments in configural processing as well as gestalt perception. Findings from the anxiety and mood disorders have conversely failed to yield coherent results, with further research warranted to provide corroborating evidence and overcome identified methodological limitations. Future studies should also look toward applying similar techniques to related disorders as well as conducting parallel neuroimaging investigations to elucidate potential neurobiological correlates.",0,0 +5652,The Role of Generalized Explicit and Implicit Guilt and Shame in Interpersonal Traumatization and Posttraumatic Stress Disorder,"Posttraumatic stress disorder (PTSD) and interpersonal traumatization are frequently associated with trauma-related guilt and shame. However, research on generalized guilt and shame in PTSD is lacking. The aim of this study was to investigate generalized explicit and implicit guilt and shame in interpersonal traumatization and PTSD. Interpersonally traumatized women either with PTSD (n = 28) or without PTSD (n = 32) and 32 nontraumatized women completed the Test of Self-Conscious Affect-3 and the Implicit Association Test to measure explicit and implicit guilt and shame. Explicit guilt and shame were significantly higher in women with PTSD than in traumatized women without PTSD. Traumatized women without PTSD showed significantly higher levels of explicit guilt and shame than nontraumatized women did. PTSD was associated with implicit guilt but not implicit shame. In addition to trauma-related guilt and shame, generalized explicit guilt and shame and implicit guilt seem to play a crucial role in PTSD.",0,0 +5653,Life events (Loss and traumatic) and emotional responses to them in acute catastrophe survivors and long-lasting heroin use disorder patients never exposed to catastrophic events,"Background. Symptoms of PTSD denote alterations in several neurobiological systems, including the opioid system. In a previous study on methadone-treated heroin use disorder (HUD) patients, we demonstrated strong correlations between the severity and progression of HUD and the subsequently greater severity of PTSD spectrum symptoms, so suggesting a unitary perspective. Methods. A comparative cross-sectional study was carried out to evaluate post-traumatic spectrum reactivity to loss and traumatic events in three groups: acute catastrophic event survivors experiencing (N=77) and the same number not experiencing PTSD (N=77), and a third group, of long-lasting HUD subjects who had never been exposed to catastrophic events (N=77). Results. To obtain an index of the magnitude of emotional response to losses and traumatic events, we conducted a preliminary ROC analysis on the TALS-SR total scores observed in our L’Aquila 2009 earthquake database, after having classified subjects as PTSD and No-PTSD (according to the SCID-questionnaire). That analysis determined the cut-off value required to ensure the best balance between sensitivity and specificity. The percentage of subjects who were over the threshold in the HUD group proved to be very similar to that observed in the PTSD earthquake survivors group [51 (66.2%) vs 56 (72.7%), Chi-square=0.49, p=.484], whereas it turned out to be significantly higher than that observed in the No-PTSD earthquake survivors group [51 (66.2%) vs 11 (14.3%), Chisquare= 41.07, p<.001]. Furthermore, the discriminant analysis utilizing TALS-SR domain scores as predictive variables failed to discriminate between the HUD group and the PTSD earthquake group, whereas it appears to clearly differentiate the No-PTSD earthquake group from the other two. Conclusions. This study, besides providing evidence of similarities in the type of reaction shown to loss and to traumatic events between HUD patients and earthquake survivors with PTSD, also supports the probable implication of the opioid system in the aetio(patho)logy of PTSD.",0,0 +5654,Intraclass correlations: Uses in assessing rater reliability.,"Reliability coefficients often take the form of intraclass correlation coefficients. In this article, guidelines are given for choosing among six different forms of the intraclass correlation for reliability studies in which n target are rated by k judges. Relevant to the choice of the coefficient are the appropriate statistical model for the reliability and the application to be made of the reliability results. Confidence intervals for each of the forms are reviewed.",0,0 +5655,"Predictors of emotional numbing, revisited: A replication and extension","Litz et al. (1997), theorizing that emotional numbing (EN) is the result of emotional depletion caused by chronic hyperarousal, demonstrated that a cluster of hyperarousal symptoms was a robust predictor of EN symptoms. In the present study, these findings were replicated and extended in two multiple regression analyses of data from a large, multisite investigation (T. M. Keane et al., 1998) of psychophysiological responding by male combat veterans. The arousal (D) cluster of symptoms was again the most robust predictor of EN symptoms, whereas physiological indices of arousal and reactivity accounted for negligible amounts of variance in both regression equations. These findings underscore the possible link between disturbances related to arousal and the capacity of traumatized individuals to express and experience pleasant feelings.",0,0 +5656,Psycho-oncology in Underserved and Minority Populations,,0,0 +5657,Post-traumatic stress disorder in childhood,"In the past two decades, post-traumatic stress disorder (PTSD) after exposure to a variety of traumatic or particularly threatening experiences has gained recognition as a significant contributor to morbidity in children. The basic features involve the development of impairing stress symptoms, including re-experiencing of the event in the form of “flashbacks” (distressing images, thoughts or perceptions) or nightmares, avoidance of thinking or talking about the event, of places or people associated with the event and of things that remind one of the event. Hyperarousal, or feeling on edge, irritability and exaggerated “startle” responses to stimuli, and emotional numbing (sufferers feeling cut off and detached) have also been described. PTSD in children was originally described after particularly traumatic events such as physical and sexual abuse1–3 and the witnessing of violence.4 It has been recognised following both natural5,6 and man-made7,8 disasters, and extensively documented in refugees,9,10 war situations11 and in response to terrorism-induced trauma.12 More recently, attention has focused on PTSD occurring as a consequence of a variety of paediatric conditions, some life threatening, including cancer,13 head injury14 and motor vehicle accidents15,16 as well as mild to moderate paediatric trauma,17 acute illnesses resulting in admission to paediatric intensive care units,18 children who undergo organ transplantation19 and after diagnosis of diabetes mellitus type 1.20 Stressful experiences related to serious paediatric illness in children may be expected to affect parents psychologically. Accordingly, high levels of symptoms of PTSD have been reported in parents of children with a variety of problems such as meningococcal infections requiring admission to paediatric intensive care units,21 in family members of adolescent cancer survivors22 and of children with newly diagnosed type 1 diabetes.23 Early identification and appropriate referral …",0,0 +5658,Risk and Protective Factors for Traumatic Stress Disorders,"Abstract This chapter provides an overview of risk and protective factors that may account for posttraumatic responses. In addition to risk and protective factors specifically for posttraumatic stress disorder (PTSD), the outcomes of resilience and posttraumatic growth are considered. Emphasis is placed on the importance of a longitudinal and especially a lifespan developmental framework to understand both the short- and long-term implications of trauma exposure and the factors that influence its consequences. A brief introduction to methodological approaches for documenting longitudinal change is presented, followed by suggestions for future research.",0,0 +5659,Trajectories of PTSD Symptoms and Predictive Factors of Trajectory Membership: A Step Toward Identifying Veterans at Risk,,0,0 +5660,The latent structure of post-traumatic stress disorder: tests of invariance by gender and trauma type,"Background Measurement invariance of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) post-traumatic stress disorder (PTSD) criterion symptoms was tested by gender and trauma type, assaultive and non-assaultive. Method Analysis was conducted using latent class analysis (LCA), based on findings that the three-class LCA model from Breslau et al . ( Archives of General Psychiatry 2005, 62 , 1343–1351) fits the data across the four groups best. The classes represent three levels of PTSD-related disturbance: no disturbance, intermediate disturbance and pervasive disturbance, with the last one approximating the DSM-IV PTSD diagnosis. Results Analysis of measurement invariance showed that, with respect to gender, there was no evidence of differential symptom reporting within the same disturbance class. DSM-IV symptom indicators represent the latent structure of PTSD equally in males and females. We found that more female than male victims of assaultive violence experienced pervasive disturbance. In the absence of measurement variability associated with gender, the finding is likely to reflect a gender difference in susceptibility. The analysis of measurement invariance detected evidence of variability associated with trauma type. Victims of assaultive violence in the pervasive disturbance class report more severe distress (especially emotional numbing) than do victims of non-assaultive violence in the same class. Conclusions The finding of measurement bias associated with type of trauma raises questions about the applicability of a single definition for PTSD associated with assaultive violence and PTSD associated with traumatic events of lesser magnitude.",0,0 +5661,Illegal Drugs Laws: Clearing a 50-Year-Old Obstacle to Research,"The United Nations drug control conventions of 1960 and 1971 and later additions have inadvertently resulted in perhaps the greatest restrictions of medical and life sciences research. These conventions now need to be revised to allow neuroscience to progress unimpeded and to assist in the innovation of treatments for brain disorders. In the meantime, local changes, such as the United Kingdom moving cannabis from Schedule 1 to Schedule 2, should be implemented to allow medical research to develop appropriately.",0,0 +5662,Post-traumatic stress disorder among Syrian refugees in Turkey: A cross-sectional study,"Refugees have had major challenges to meet their health care needs throughout history especially in war zones and natural disaster times. The health care needs of Syrian refugees have been becoming an increasingly important issue. We aimed to examine the prevalence of post-traumatic stress disorder (PTSD) and explore its relation with various socioeconomic variables among Syrian refugees, who sought asylum in Turkey.This cross-sectional study was conducted in a tent city. Sample size calculation yielded 352 and the participants of the study were determined randomly. Experienced and native Arabic speaking, psychiatrist evaluated the participants.The frequency of PTSD was 33.5%. Through the binary logistic regression analysis, we calculated that the probability of having PTSD among Syrian refugees in our sample was 71%, if they had the following features: with female gender; being diagnosed with psychiatric disorder in the past; having a family history of psychiatric disorder; and experiencing 2 or more traumas.The findings of our study suggest that PTSD among Syrian refugees in Turkey might be an important mental health issue in refugee camps especially among female refugees, who were exposed to 2 or more traumatic events and had a personal or family history of psychiatric disorder.",0,0 +5663,"Relationship between Early Abuse, Posttraumatic Stress Disorder, and Activity Levels in Prepubertal Children","To examine the relationship between early physical and sexual abuse, posttraumatic stress disorder (PTSD), major depression, and activity levels in prepubertal children.Nineteen unmedicated children with documented abuse (9.4 +/- 2.3 years; 6 girls, 13 boys) were compared with 15 healthy controls (8.3 +/- 1.9 years; 6 girls, 9 boys). Diagnoses were derived from structured interviews (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version). Motionlogger actigraphs collected activity data for 72 continuous hours in 1-minute epochs.Overall, abused children were 10% more active than normal children (p < .05) and displayed a paucity of periods of low-level daytime activity (p < .01). Abused children with PTSD were largely responsible for the increase in activity. Abused children with PTSD had a robust and normal circadian activity rhythm. Abused children in whom PTSD failed to develop had an attenuated circadian amplitude compared with subjects with PTSD (101% versus 93%, p < .01) and were phase-delayed by 61 minutes versus controls (p = .01). Early onset of abuse was significantly associated with greater likelihood of the development of PTSD and hyperactivity. Later age of abuse was associated with circadian dysregulation.These preliminary observations indicate that abused children with PTSD have activity profiles similar to those of children with attention-deficit hyperactivity disorder, while abused children without PTSD have activity profiles more similar to those of depressed children.",0,0 +5664,Childhood abuse and sexual revictimization in a female Navy recruit sample,"To examine effects of childhood abuse on adult rape, 1,887 female Navy recruits were surveyed. Overall 35% of recruits had been raped and 57% had experienced childhood physical abuse (CPA) and/or childhood sexual abuse (CSA). Controlling for CPA, rape was significantly (4.8 times) more likely among women who had experienced CSA than among women who had not. In contrast, CPA (controlling for CSA) was unrelated to likelihood of adult rape. Alcohol problems and number of sex partners were examined as mediators. Although both variabies predicted rape, their effects were independent of the effects of CSA. Finally, despite ethnic group differences in the prevalence of victimization, the predictors of rape did not differ significantly across ethnic groups.",0,0 +5665,The impact of sudden gains in cognitive behavioral therapy for posttraumatic stress disorder,"This study investigated sudden gains, i.e., rapid and stable improvements, in posttraumatic stress disorder (PTSD) symptoms that may occur in cognitive-behavioral therapy. Twenty-nine of 72 participants (39.2%) experienced a sudden gain during treatment. Mixed model ANOVAs analyzed sudden gains impact on clinician-rated PTSD symptom severity, patient-rated PTSD symptom severity, and patient-rated depressive symptom severity. Sudden gains in PTSD symptomology were associated with greater reductions in PTSD symptom severity for the avoidance/numbing and hyperarousal symptom clusters at posttreatment. By 6-month follow-up, the sudden gains group had maintained those reductions in symptoms, but the nonsudden gains group had achieved equal reductions in symptom severity. Participants experiencing sudden gains on PTSD measures had lower depression severity at posttreatment and follow-up.",0,0 +5666,Structure of posttraumatic stress disorder symptoms and psychosocial functioning in Veterans of Operations Enduring Freedom and Iraqi Freedom,"Posttraumatic stress disorder (PTSD) is one of the most prevalent psychiatric conditions in Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF-OIF), but little is known about the structure of PTSD symptoms, and associations between PTSD symptom clusters and psychosocial functioning in this population. A total of 272 OEF-OIF Veterans in Connecticut completed a mail survey containing measures of psychopathology, resilience, and psychosocial functioning. Confirmatory factor analyses revealed that the 4-factor dysphoria model, which is comprised of separate re-experiencing, avoidance, dysphoria, and hyperarousal symptom clusters, provided the best representation of PTSD symptom structure in this sample. Dysphoria symptoms were independently associated with a broad range of psychosocial measures, even after controlling for age, combat exposure, and other PTSD symptom clusters. Re-experiencing symptoms were associated with alcohol use problems, and avoidance symptoms were associated with increased psychosocial difficulties and decreased perceptions of postdeployment social support. These results suggest that dysphoria symptoms were strongly related to a broad range of psychosocial measures in this sample of OEF-OIF Veterans. Dysphoria symptoms may deserve special attention in the assessment and treatment of symptomatic OEF-OIF Veterans.",0,0 +5667,Finding patterns and groupings: II. Introduction to latent profile analysis and finite mixture models,"An latent class analysis (LCA) is a particular kind of mixture analysis. If we take the LCA concept and change it so that the dataset now comprises observed continuous variables; and the classes differ in their means on one or more variables; then the resulting model is called latent profile analysis (LPA). As with LCA, the model assumes that classes explain associations so that within classes the observed variables are now modeled as uncorrelated. A similar looking model to LPA, one which does not make the assumption of zero within-class correlations, is the finite mixture model (FMM) model, which tries to find underlying clusters of distributed data-univariate if there is only one variable, multivariate if there are two or more. The FMM typically assumes the data have a normal distribution. Depending on which assumptions you include it is easy to move between an LPA and an FMM and indeed obtain quite similar looking answers, but keep in mind that the conceptual models behind these are quite different. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +5668,Resilience in the Context of Chronic Stress and Health in Adults,"Over the past several decades, stress research has experienced a broadening of its pathologic focus to encompass the concept of resilience. There is a wealth of research on resilience but no general consensus regarding its conceptualization. Some define resilience as attaining eventual favorable outcomes following exposure to adversity. Others define it as specific relatively short-term responses characterized by a return to homeostasis after initial disruption due to a stressor, and still others refer to resilience as resources that enable the individual to withstand or recover from major stressors. Many of the existing conceptualizations of resilience are not applicable in the context of chronic stress which is particularly harmful to health. How do adults who experience chronic stress survive, manage, and thrive, and what resources enable them to do so? In this paper, we consider these questions by reviewing traditions of research and definitions of resilience in order to inform an understanding of resilience in general, and for the study of chronic stress in adults. Based on a review of the literature, we developed a taxonomy of resilience resources that can be applied broadly, and guide future research.",0,0 +5669,Traumatic Stress Symptoms in Adolescent Organ Transplant Recipients,"Symptoms of posttraumatic stress disorder (PTSD) after life-threatening medical illness have been found to predict poor outcome in preliminary studies of adults and children. However, these symptoms are rarely recognized in general medical or pediatric settings. Here we report on the first large investigation to assess prevalence and correlates of self-reported symptoms of posttraumatic stress in a nonreferred sample of adolescent liver, heart, and kidney transplant recipients.One hundred four adolescents, ages 12 to 20 years (mean: 15.7; SD: 2.1), completed and returned the University of California, Los Angeles, PTSD Index for the Diagnostic and Statistical Manual of Mental Disorders. All participants were at least 1 year post-initial transplant and were fluent speakers of English and/or Spanish.More than 16% of the adolescents met all symptom criteria for PTSD, and an additional 14.4% met 2 of 3 symptom-cluster criteria. Regression analysis indicated no effect of gender, ethnicity, age at interview, organ type, time since transplant, or age at transplant.As has been found with other life-threatening pediatric conditions, solid organ transplantation can precipitate symptoms of posttraumatic stress. Symptoms are not predicted by what would be considered objective factors increasing life threat, suggesting a greater salience of subjective appraisal of threat, as has been seen in studies of childhood cancer survivors.",0,0 +5670,"The impact of HIV status, HIV disease progression, and post-traumatic stress symptoms on the health-related quality of life of Rwandan women genocide survivors","We examined whether established associations between HIV disease and HIV disease progression on worse health-related quality of life (HQOL) were applicable to women with severe trauma histories, in this case Rwandan women genocide survivors, the majority of whom were HIV-infected. Additionally, this study attempted to clarify whether post-traumatic stress symptoms were uniquely associated with HQOL or confounded with depression.The Rwandan Women's Interassociation Study and Assessment was a longitudinal prospective study of HIV-infected and uninfected women. At study entry, 922 women (705 HIV+ and 217 HIV-) completed measures of symptoms of post-traumatic stress and HQOL as well as other demographic, clinical, and behavioral characteristics.Even after controlling for potential confounders and mediators, HIV+ women, in particular those with the lowest CD4 counts, scored significantly worse on HQOL and overall quality of life (QOL) than did HIV- women. Even after controlling for depression and HIV disease progression, women with more post-traumatic stress symptoms scored worse on HQOL and overall QOL than women with fewer post-traumatic stress symptoms.This study demonstrated that post-traumatic stress symptoms were independently associated with HQOL and overall QOL, independent of depression and other confounders or potential mediators. Future research should examine whether the long-term impact of treatment on physical and psychological symptoms of HIV and post-traumatic stress symptoms would generate improvement in HQOL.",0,0 +5671,Variations in Therapeutic Interventions for Cambodian and Chilean Refugee Survivors of Torture and Trauma: A Pilot Study,"The treatment of refugee survivors of torture and trauma has attracted increasing clinical attention. The present study surveyed therapists concerning the emphasis that was placed on disclosure of previous traumatic experiences in therapy with refugees from Chile and Cambodia. Significant differences were found between the two groups with trauma story discussion being judged by therapists to be more important to treatment outcome in Chilean patients. The problem of potential therapist bias limits definitive conclusions, however we suggest that differences in cultural preparedness for psychotherapy aimed at uncovering previous traumatic experiences may be the main reason for variations in styles of therapy offered to these distinctive ethnic groups. Other possible explanations are differences in diagnostic profiles and types of previous traumatic experiences.",0,0 +5672,Shaping the renaissance of psychedelic research,"Psychedelic drugs have a rich and vibrant history as clinical aids for psychiatry. For two decades after the discovery of lysergide (LSD) in the 1940s, psychedelics were extensively studied and clinical progress was good.1 But research collapsed rapidly in 1966 when LSD was made illegal, and there was a subsequent hiatus of psychedelic research. After 40 years, this pause is now coming to an end, with many new studies and a refreshing approach to the research of psychedelic drugs.2",0,0 +5673,Course and Prognostic Factors for Neck Pain in Whiplash-Associated Disorders (WAD),"Best evidence synthesis.To perform a best evidence synthesis on the course and prognostic factors for neck pain and its associated disorders in Grades I-III whiplash-associated disorders (WAD).Knowledge of the course of recovery of WAD guides expectations for recovery. Identifying prognostic factors assists in planning management and intervention strategies and effective compensation policies to decrease the burden of WAD.The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders (Neck Pain Task Force) conducted a critical review of the literature published between 1980 and 2006 to assemble the best evidence on neck pain and its associated disorders. Studies meeting criteria for scientific validity were included in a best evidence synthesis.We found 226 articles related to course and prognostic factors in neck pain and its associated disorders. After a critical review, 70 (31%) were accepted on scientific merit; 47 of these studies related to course and prognostic factors in WAD. The evidence suggests that approximately 50% of those with WAD will report neck pain symptoms 1 year after their injuries. Greater initial pain, more symptoms, and greater initial disability predicted slower recovery. Few factors related to the collision itself (for example, direction of the collision, headrest type) were prognostic; however, postinjury psychological factors such as passive coping style, depressed mood, and fear of movement were prognostic for slower or less complete recovery. There is also preliminary evidence that the prevailing compensation system is prognostic for recovery in WAD.The Neck Pain Task Force undertook a best evidence synthesis to establish a baseline of the current best evidence on the course and prognosis for WAD. Recovery of WAD seems to be multifactorial.",0,0 +5674,Virtual Natural Environments for Restoration and Rehabilitation in Healthcare,"AbstractFor over two decades, research and clinical projects have exploited Virtual Reality technologies in the treatment of numerous human conditions, from desensitisation régimes combating phobias to the use of distraction and exposure therapies for burns victims and those suffering from post-traumatic stress disorders. In contrast to previous “high-tech” interface and combat-oriented approaches to using VR in the psychological rehabilitation process, the present chapter advocates the use of virtual restorative environments (VREs)—the recreation of locations and scenes that, by virtue of their natural beauty and peacefulness, can significantly help to reduce the body’s reactivity to stress and restore cognitive or attentional capacities. The chapter also argues that VREs, suitably enhanced with more interactive and dynamic features, could offer significant benefits to patients in physical rehabilitation programmes. This is especially the case for amputees, for example, who, whilst awaiting the fitting of prosthetic limbs, could undertake competitive and motivational “virtual exercises”, thereby avoiding muscle atrophy and related reductions in residual limb capabilities. The report concludes that the exploitation of simulation technologies in psychological therapies is worthy of continued investigation, especially in the pursuit of enhancing patients’ recovery profiles following surgical procedures, from intensive care to the hospital recovery ward. VREs possess a range of important qualities, not least significant of which is real-time interaction and ease-of-editing, supporting the cost-effective generation of engaging and distributable scenarios that can be tailored relatively easily to meet the needs of individual patients.KeywordsVirtual realityRehabilitationRestorationHealthcareHuman factors",0,0 +5675,"Childhood maltreatment, juvenile disorders and adult post-traumatic stress disorder: a prospective investigation","Background We examine prospectively the influence of two separate but potentially inter-related factors in the etiology of post-traumatic stress disorder (PTSD): childhood maltreatment as conferring a susceptibility to the PTSD response to adult trauma and juvenile disorders as precursors of adult PTSD. Method The Dunedin Multidisciplinary Health and Development Study (DMHDS) is a birth cohort ( n = 1037) from the general population of New Zealand's South Island, with multiple assessments up to age 38 years. DSM-IV PTSD was assessed among participants exposed to trauma at ages 26–38. Complete data were available on 928 participants. Results Severe maltreatment in the first decade of life, experienced by 8.5% of the sample, was associated significantly with the risk of PTSD among those exposed to adult trauma [odds ratio (OR) 2.64, 95% confidence interval (CI) 1.16–6.01], compared to no maltreatment. Moderate maltreatment, experienced by 27.2%, was not associated significantly with that risk (OR 1.55, 95% CI 0.85–2.85). However, the two estimates did not differ significantly from one another. Juvenile disorders (ages 11–15), experienced by 35% of the sample, independent of childhood maltreatment, were associated significantly with the risk of PTSD response to adult trauma (OR 2.35, 95% CI 1.32–4.18). Conclusions Severe maltreatment is associated with risk of PTSD response to adult trauma, compared to no maltreatment, and juvenile disorders, independent of earlier maltreatment, are associated with that risk. The role of moderate maltreatment remains unresolved. Larger longitudinal studies are needed to assess the impact of moderate maltreatment, experienced by the majority of adult trauma victims with a history of maltreatment.",0,0 +5676,Posttraumatic Stress Disorder Symptoms Mediate the Relationship Between Traumatic Experiences and Drinking Behavior Among Women Attending Alcohol Serving Venues in a South African Township,"South Africa has high rates of traumatic experiences and alcohol abuse or dependence, especially among women. Traumatic experiences often result in symptoms of posttraumatic stress disorder (PTSD), and PTSD has been associated with hazardous drinking. This article examines the relationship between traumatic events and hazardous drinking among women who patronized alcohol-serving venues in South Africa and examines PTSD as a mediator of this relationship.A total of 560 women were recruited from a Cape Town township. They completed a computerized assessment that included alcohol consumption, history of traumatic events, and PTSD symptoms. Mediation analysis examined whether PTSD symptoms mediated the relationship between the number of traumatic event categories experienced (range: 0-7) and drinking behavior.The mean Alcohol Use Disorders Identification Test score in the sample was 12.15 (range: 0-34, SD = 7.3), with 70.9% reaching criteria for hazardous drinking (AUDIT > 8). The mean PTSD score was 36.32 (range: 17-85, SD = 16.3),with 20.9% meeting symptom criteria for PTSD (PTSD Checklist with 20.9% meeting symptom criteria for PTSD (PTSD Checklist-Civilian Version ≥ 50). Endorsement of traumatic experiences was high, including adult emotional (51.8%), physical (49.6%), and sexual (26.3%) abuse; childhood physical (35.0%) and sexual (25.9%) abuse; and other types of trauma (83%). All categories of traumatic experiences, except the ""other"" category, were associated with hazardous drinking. PTSD symptoms mediated 46% of the relationship between the number of traumatic categories experienced and drinking behavior.Women reported high rates of hazardous drinking and high levels of PTSD symptoms, and most had some history of traumatic events. There was a strong relationship between traumatic exposure and drinking levels, which was largely mediated by PTSD symptoms. Substance use interventions should address histories of trauma in this population, where alcohol may be used in part to cope with past traumas.",0,0 +5677,Missed bipolarity and psychiatric comorbidity in women with postpartum depression,"To investigate the diagnostic profile of women referred for postpartum depression.Fifty-six women seen consecutively with the referral diagnosis of postpartum depression were administered structured instruments to gather information about their DSM-IV Axis I diagnoses.In terms of frequency of occurrence, the primary diagnoses in this sample were: major depressive disorder (46%), bipolar disorder not otherwise specified (29%), bipolar II disorder (23%), and bipolar I disorder (2%). A current comorbid disorder, with no lifetime comorbidity, occurred among 32% of the sample; by contrast, lifetime comorbidity alone (i.e., with no currently comorbid disorder) was found among 27%. Both a lifetime and a current comorbidity were found among 18% of the women, and 23% had no comorbid disorder. The most frequently occurring current comorbid disorder was an anxiety disorder (46%), with obsessive-compulsive disorder (62%) being the most common type of anxiety disorder. For lifetime comorbidity, substance use (20%) and anxiety disorders (12%) were the two most common. Over 80% of patients who scored positive on either the Highs Scale or the Mood Disorder Questionnaire met the diagnostic criteria for a bipolar disorder.The results suggest that postpartum depression is a heterogeneous entity and that misdiagnosis of bipolar disorder in the postpartum period may be quite common. The findings have important clinical implications, which include the need for early detection of bipolarity through the use of reliable and valid assessment instruments, and implementation of appropriate prevention and treatment strategies.",0,0 +5678,Alcohol and stress in the military.,"Although research has independently linked stress experienced by military personnel to both alcohol use and posttraumatic stress disorder, more recently researchers have noted that there also is a significant overlap between stress reactions and alcohol use in veterans and active-duty service members. This overlap seems to be most understood in individuals who have experienced combat or military sexual trauma. This article will provide a brief review of some potential causal mechanisms underlying this relationship, including self-medication and genetic vulnerability models. It also addresses the possible implications for assessment and treatment of military personnel with co-occurring disorders.",0,0 +5679,The Challenge of Living On: Psychopathology and Its Mediating Influence on the Readjustment of Former Child Soldiers,"Current civil wars are characterized by the increasing involvement of civilian populations and the systematic employment of child soldiers. An example of such wars was the conflict in Northern Uganda, where the war-affected population is still challenged by the reintegration of formerly abducted children and youths. A cross-sectional, population-based survey, using a multistage cluster sampling approach of 1,113 Northern Ugandans aged between 12 and 25 in camps for internally displaced persons and locally validated instruments was conducted to assess symptoms and diagnoses of Posttraumatic Stress Disorder (PTSD) and probable Depression in war-affected, as well as formerly abducted individuals. Further objectives were to determine predictors of psychopathology and to relate indicators of maladjustment (i.e., impairments in daily and community functioning, somatic complaints, suicidality, aggressiveness and discrimination) to abduction, level of exposure to violence and psychopathology. 43% of the sample reported abduction by the rebel army. Exposure to violence among this group was higher than for non-abducted youths (t = 28.05; p<.001). PTSD point prevalence rates were 25% among former child soldiers and 7% among the comparison group. High suicidal ideation was present in 16% and 6% respectively. A higher amount of experienced and witnessed event-types (β = . 32. p<.001), loss of first-degree relatives (β = .13. p<.001) and the number of event-types involving forced perpetration (β = .23. p<.001) were identified as risk factors of PTSD symptoms in former child soldiers. The associations between abductee-status and indicators of maladjustment were fully mediated by level of trauma exposure and psychopathology. Results show that child soldiering and its psychological sequelae affect a substantial proportion of children and youths. After release or flight, their readjustment depends at least partly on their level of mental traumatization.",0,0 +5680,Patterns of psychological responses in parents of children that underwent stem cell transplantation,"Hematopoietic stem cell transplantation (HSCT) is curative in several life-threatening pediatric diseases but may affect children and their families inducing depression, anxiety, burnout symptoms, and post-traumatic stress symptoms, as well as post-traumatic growth (PTG). The aim of this study was to investigate the co-occurrence of different aspects of such responses in parents of children that had undergone HSCT.Questionnaires were completed by 260 parents (146 mothers and 114 fathers) 11-198 months after HSCT: the Hospital Anxiety and Depression Scale, the Shirom-Melamed Burnout Questionnaire, the post-traumatic stress disorders checklist, civilian version, and the PTG inventory. Additional variables were also investigated: perceived support, time elapsed since HSCT, job stress, partner-relationship satisfaction, trauma appraisal, and the child's health problems. A hierarchical cluster analysis and a k-means cluster analysis were used to identify patterns of psychological responses.Four clusters of parents with different psychological responses were identified. One cluster (n = 40) significantly differed from the other groups and reported levels of depression, anxiety, burnout symptoms, and post-traumatic stress symptoms above the cut-off. In contrast, another cluster (n = 66) reported higher levels of PTG than the other groups did.This study shows a subgroup of parents maintaining high levels of several aspects of distress years after HSCT. Differences between clusters might be explained by differences in perceived support, the child's health problems, job stress, and partner-relationship satisfaction.",0,0 +5681,Post traumatic stress disorder reactions in children of war: a longitudinal study,"To establish rates of posttraumatic stress disorder (PTSD) reactions and general mental health problems in children who had experienced war trauma.A longitudinal study in the Gaza strip with 234 children aged 7 to 12 years, who had experienced war conflict, at 1 year after the initial assessment, that is, during the peace process. Children completed the Child Post Traumatic Stress Reaction Index (CPTS-RI), while the Rutter A2 and B2 Scales were completed by parents and teachers.The rate of children who reported moderate to severe PTSD reactions at follow-up had decreased from 40.6% (N = 102) to 10.0% (N = 74). 49 children (20.9%) were rated above the cut-off for mental health problems on the Rutter A2 (parent) Scales, and 74 children (31.8%) were above the cut-off on the Rutter B2 (teacher) Scales. The total scores on all three measures had significantly decreased during the 1-year period. The total CPTS-RI score at follow-up was best predicted by the number of traumatic experiences recalled at the first assessment.PTSD reactions tend to decrease in the absence of further stressors, although a substantial proportion of children still present with a range of emotional and behavioral problems. Cumulative previous experience of war trauma constitutes a risk factor for continuing PTSD symptoms.",0,0 +5682,Patterns of treatment response in chronic posttraumatic stress disorder: An application of latent growth mixture modeling,"This study attempts to differentiate groups of individuals who exhibit different patterns of recovery following treatment for chronic posttraumatic stress disorder (PTSD) and describes these groups in terms of relevant characteristics at program intake. A sample of 2,219 Vietnam veterans who had completed a 12-week treatment program was followed up at 6, 12, and 24 months post admission using self-report measures. With change in PTSD symptoms over time as the focus, latent growth mixture modeling was used to assign individual veterans to subgroups. A three-group solution provided the best account of the data. Two groups showed moderate and consistent improvement over time although the larger group (n = 1,380) began treatment with more PTSD symptoms and improved more quickly over time. The smallest group (n = 87) showed a substantially different trajectory, with almost no net change in symptom levels over the 24-month period. The groups also varied significantly in terms of their characteristics, with symptom severity and improvements over time reflecting greater comorbidity and younger age. The results have both research and clinical implications.",0,0 +5683,"Trends and Risk Factors for Mental Health Diagnoses Among Iraq and Afghanistan Veterans Using Department of Veterans Affairs Health Care, 2002–2008","We sought to investigate longitudinal trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans.We determined the prevalence and predictors of mental health diagnoses among 289,328 Iraq and Afghanistan veterans entering Veterans Affairs (VA) health care from 2002 to 2008 using national VA data.Of 289,328 Iraq and Afghanistan veterans, 106,726 (36.9%) received mental health diagnoses; 62,929 (21.8%) were diagnosed with posttraumatic stress disorder (PTSD) and 50 432 (17.4%) with depression. Adjusted 2-year prevalence rates of PTSD increased 4 to 7 times after the invasion of Iraq. Active duty veterans younger than 25 years had higher rates of PTSD and alcohol and drug use disorder diagnoses compared with active duty veterans older than 40 years (adjusted relative risk = 2.0 and 4.9, respectively). Women were at higher risk for depression than were men, but men had over twice the risk for drug use disorders. Greater combat exposure was associated with higher risk for PTSD.Mental health diagnoses increased substantially after the start of the Iraq War among specific subgroups of returned veterans entering VA health care. Early targeted interventions may prevent chronic mental illness.",0,0 +5684,Mental Health Screening Outcomes Among Justice-Involved Youths Under Community Supervision,"The DISC Predictive Scales was administered to 812 New York City youths aged 10–19 placed under community supervision. Approximately half were indicated for possible mental health problems, most frequently mania and posttraumatic stress disorder. Girls were more likely than boys to flag on most disorders. Hierarchical Classes analysis produced five clusters: disruptive behavior, relational distress, marijuana, emotional dysregulation, and specific phobia. Posttraumatic stress disorder and mania were comorbid with all clusters except marijuana. Emotional dysregulation predicted higher, but relational distress predicted lower, risk for rearrest. Marijuana predicted failure to appear in court and receiving a final disposition of placement.",0,0 +5685,Development and validation of the Child Post-Traumatic Cognitions Inventory (CPTCI),"Negative trauma-related cognitions have been found to be a significant factor in the maintenance of post-traumatic stress disorder (PTSD) in adults. Initial studies of such appraisals in trauma-exposed children and adolescents suggest that this is an important line of research in youth, yet empirically validated measures for use with younger populations are lacking. A measure of negative trauma-related cognitions for use with children and adolescents, the Child Post-Traumatic Cognitions Inventory (CPTCI), is presented. The measure was devised as an age-appropriate version of the adult Post-Traumatic Cognitions Inventory (Foa et al., 1999).The CPTCI was developed and validated within a large (n = 570) sample, comprising community and trauma-exposed samples of children and adolescents aged 6-18 years.Principal components analysis suggested a two-component structure. These components were labelled 'permanent and disturbing change' and 'fragile person in a scary world', and were each found to possess good internal consistency, test-retest reliability, convergent validity, and discriminative validity. The reliability and validity of these sub-scales was present regardless of whether the measure was completed in the acute phase or several months after a trauma. Scores on these sub-scales did not vary with age.The CPTCI is a reliable and valid measure that is not specific to the type of trauma exposure, and shows considerable promise as a research and clinical tool. The structure of this measure suggests that appraisals concerning the more abstract consequences of a trauma, as well as physical threat and vulnerability, are pertinent factors in trauma-exposed children and adolescents, even prepubescent children.",0,0 +5686,Self-Embedding Behavior: A New Primary Care Challenge,"OBJECTIVE: The goal of this study was to define self-embedding behavior (SEB), develop a clinical profile of adolescents who engage in SEB, and emphasize the importance of rapid, targeted, and effective identification and intervention. METHODS: As part of a retrospective study with a database evaluating 600 patients percutaneously treated for soft-tissue foreign body removal, adolescents were identified with self-embedded soft-tissue foreign bodies. We describe patients' gender, age, and psychiatric diagnoses; SEB age of onset, frequency, and self-reported reasons; and the number, type, location of, and removal technique for objects. RESULTS: Eleven patients (9 females) who engaged in SEB were identified. Ten of the 11 patients were members of a group home or psychiatric facility at the time they engaged in SEB. All patients had previous and multiple psychiatric diagnoses. SEB mean age-of-onset was 16 years, and mean number of SEB episodes per patient was 1.9. The most common self-reported purpose for SEB was suicidal ideation (6 of 8 [75%]) versus nonsuicidal ideation (2 of 8 [25%]), with 3 cases lacking this documentation. The mean number of objects embedded in a single episode was 2.4, usually composed of metal and embedded in the arm. Seventy-six foreign bodies were percutaneously removed (using ultrasound or fluoroscopic guidance), including metal, glass, wood, plastic, graphite, and crayon. CONCLUSIONS: SEB is an extreme form of self-injury requiring aggressive and timely interdisciplinary assessment and treatment. An understanding of SEB allows medical professionals to pursue rapid, targeted, and effective intervention to interrupt the cycle of self-harm and institute appropriate long-term therapy.",0,0 +5687,The comparative effectiveness of levels of training and years of work experience in firefighters as determining factors in the development of posttraumatic stress disorder,"Posttraumatic Stress Disorder (PTSD) has been known by other names and not well studied prior to returning Vietnam veterans who suffered psychological dysfunction. However, the term PTSD became part of the Diagnostic and Statistical Manual for Mental Disorders in 1981. Since that time PTSD has been researched extensively in veterans. However, little attention has been given to firefighters who encounter trauma on a daily basis compared to veterans who may have experienced traumatic events during war or intermittently. Since firefighters are vital to society for rescue and recovery, it is salient that they remain mentally as well as physically fit for duty. PTSD can be debilitating and even result in early retirement or the change of occupation. Hence, determining the risk and resilience factors against the development of PTSD in firefighters may prevent premature retirement or job change. Although some form of brief intervention may be offered to firefighters after a traumatic event, more extensive counseling may be necessary. Knowing the risk factors prior to facing a distressful event may prompt additional counseling subsequent to trauma and ultimately prevent severe or chronic PTSD that may interfere with the duties of these emergency workers. This research compared levels of training and work experience in 127 male firefighters who ranged in age from 21 to 57 who were primarily Caucasian (63.8%). African-Americans comprised 26.8%, Asians 1.6%, Hispanics 1.6%, and Puerto Rican 0.8%. The researcher investigated the relationship between levels of training and work experience on self-efficacy and ultimately the effect self-efficacy has on the manifestation of PTSD symptoms. This study extends previous research that shows when self-efficacy increases, psychological dysfunctioning decreases (Heinrichs, Wagner, Schoch, Soravia, Hellhammer, & Ehlert, 2005). A retrospective causal-comparative design also referred to as an ex post facto design was employed to examine years of training and work experience and their association to self-efficacy. Next, self-efficacy was investigated to look at its effects on symptoms of PTSD. Findings from the study found no significant difference in the relationships between levels of training and self-efficacy or between years of work experience and self-efficacy. However, the study did support prior research that showed a statistical negative correlation between self-efficacy and symptoms of PTSD. Hence, when self-efficacy increased, symptoms of PTSD decreased. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5688,The clinical and cost effectiveness of group art therapy for people with non-psychotic mental health disorders: a systematic review and cost-effectiveness analysis,"The majority of mental health problems are non-psychotic (e.g., depression, anxiety, and phobias). For some people, art therapy may be a more acceptable alternative form of psychological therapy than standard forms of treatment, such as talking therapies. This study was part of a health technology assessment commissioned by the National Institute for Health Research, UK and aimed to systematically appraise the clinical and cost-effective evidence for art therapy for people with non-psychotic mental health disorders. Comprehensive literature searches for studies examining art therapy in populations with non-psychotic mental health disorders were performed in May 2013. A quantitative systematic review of clinical effectiveness and a systematic review of studies evaluating the cost-effectiveness of group art therapy were conducted. Eleven randomised controlled trials were included (533 patients). Meta-analysis was not possible due to clinical heterogeneity and insufficient comparable data on outcome measures across studies. The control groups varied between studies but included: no treatment/wait-list, attention placebo controls and psychological therapy comparators. Art therapy was associated with significant positive changes relative to the control group in mental health symptoms in 7 of the 11 studies. A de novo model was constructed and populated with data identified from the clinical review. Scenario analyses were conducted allowing comparisons of group art therapy with wait-list control and group art therapy with group verbal therapy. Group art-therapy appeared cost-effective compared with wait-list control with high certainty although generalisability to the target population was unclear; group verbal therapy appeared more cost-effective than art therapy but there was considerable uncertainty and a sizeable probability that art therapy was more cost effective. From the limited available evidence art therapy was associated with positive effects compared with control in a number of studies in patients with different clinical profiles. The included trials were generally of poor quality and are therefore likely to be at high risk of bias. Art therapy appeared to be cost-effective versus wait-list but further studies are needed to confirm this finding in the target population. There was insufficient evidence to make an informed comparison of the cost-effectiveness of group art therapy with group verbal therapy. HTA project no. 12/27/16; PROSPERO registration no. CRD42013003957 .",0,0 +5689,Internet-Based Early Intervention to Prevent Posttraumatic Stress Disorder in Injury Patients: Randomized Controlled Trial,"Posttraumatic stress disorder (PTSD) develops in 10-20% of injury patients. We developed a novel, self-guided Internet-based intervention (called Trauma TIPS) based on techniques from cognitive behavioral therapy (CBT) to prevent the onset of PTSD symptoms.To determine whether Trauma TIPS is effective in preventing the onset of PTSD symptoms in injury patients.Adult, level 1 trauma center patients were randomly assigned to receive the fully automated Trauma TIPS Internet intervention (n=151) or to receive no early intervention (n=149). Trauma TIPS consisted of psychoeducation, in vivo exposure, and stress management techniques. Both groups were free to use care as usual (nonprotocolized talks with hospital staff). PTSD symptom severity was assessed at 1, 3, 6, and 12 months post injury with a clinical interview (Clinician-Administered PTSD Scale) by blinded trained interviewers and self-report instrument (Impact of Event Scale-Revised). Secondary outcomes were acute anxiety and arousal (assessed online), self-reported depressive and anxiety symptoms (Hospital Anxiety and Depression Scale), and mental health care utilization. Intervention usage was documented.The mean number of intervention logins was 1.7, SD 2.5, median 1, interquartile range (IQR) 1-2. Thirty-four patients in the intervention group did not log in (22.5%), 63 (41.7%) logged in once, and 54 (35.8%) logged in multiple times (mean 3.6, SD 3.5, median 3, IQR 2-4). On clinician-assessed and self-reported PTSD symptoms, both the intervention and control group showed a significant decrease over time (P<.001) without significant differences in trend. PTSD at 12 months was diagnosed in 4.7% of controls and 4.4% of intervention group patients. There were no group differences on anxiety or depressive symptoms over time. Post hoc analyses using latent growth mixture modeling showed a significant decrease in PTSD symptoms in a subgroup of patients with severe initial symptoms (n=20) (P<.001).Our results do not support the efficacy of the Trauma TIPS Internet-based early intervention in the prevention of PTSD symptoms for an unselected population of injury patients. Moreover, uptake was relatively low since one-fifth of individuals did not log in to the intervention. Future research should therefore focus on innovative strategies to increase intervention usage, for example, adding gameplay, embedding it in a blended care context, and targeting high-risk individuals who are more likely to benefit from the intervention.International Standard Randomized Controlled Trial Number (ISRCTN): 57754429; http://www.controlled-trials.com/ISRCTN57754429 (Archived by WebCite at http://webcitation.org/6FeJtJJyD).",0,0 +5690,Latent Classes of PTSD Symptoms in Vietnam Veterans,"The authors examined heterogeneity in posttraumatic stress disorder (PTSD) symptom presentation among veterans ( n = 335) participating in the clinical interview subsample of the National Vietnam Veterans Readjustment Study. Latent class analysis was used to identify clinically homogeneous subgroups of Vietnam War combat veterans. Consistent with previous research, three classes emerged from the analysis, namely, veterans with no disturbance (61.4% of the cohort), intermediate disturbance (25.6%), and pervasive disturbance (12.5%). The authors also examined physical injury, war-zone stressor exposure, peritraumatic dissociation, and general dissociation as predictors of class membership. The findings are discussed in the context of recent conceptual frameworks that posit a range of posttraumatic outcomes and highlight the sizable segment of military veterans who suffer from intermediate (subclinical) PTSD symptoms.",0,0 +5691,Postconcussive Symptoms After Blast and Nonblast-Related Mild Traumatic Brain Injuries in Afghanistan and Iraq War Veterans,"Blast injury is common in current warfare, but little is known about the effects of blast-related mild traumatic brain injury (mTBI). Profile analyses were conducted investigating differences in self-reported postconcussive (PC) symptoms in 339 veteran outpatients with mTBI histories reporting current symptoms based on mechanism of injury (blast only, nonblast only, or both blast and nonblast), number of blast injuries, and distance from the blast. Veterans with any blast-related mTBI history were younger and reported higher posttraumatic stress symptoms than veterans with nonblast-related mTBI histories, with a marginally significant difference in posttraumatic stress symptom report between veterans reporting blast-related mTBI only and those reporting nonblast-related mTBI. The groups did not differ in terms of PC symptom severity or PC symptom cluster profiles. Among veterans with blast-related mTBI histories, PC symptom report did not vary by number of blast-related mTBIs or proximity to blast. Overall, posttraumatic stress symptoms accounted for a substantial portion of variance in PC symptom report. In veteran outpatients with remote mTBI histories who have enduring symptom complaints related to the mTBI, mechanism of injury did not clearly contribute to differential PC symptom severity or PC symptom cluster profile. Proximal rather than distal factors may be important intervention targets in returning symptomatic veterans with mTBI histories.",0,0 +5692,Expression profile of mRNAs from rat hippocampus and its application to microarray,"Stress refers to physiological or psychological stimuli that disrupt homeostasis and induce pathophysiological conditions due to maladaptive response, sometimes resulting in mental disorders including depression and post-traumatic stress disorder. Severe stress has been shown to induce neuronal atrophy and apoptosis, especially in the hippocampus, which is thought to be a region of the brain important in stress-related disorders. We have analyzed gene expression in rat hippocampus comprehensively to clarify the molecular mechanism of stress-related disorders. In the present study, we identified and catalogued 13,660 partial complementary DNA sequences (expressed sequence tags (ESTs)) of randomly selected clones from a cDNA library of rat hippocampus. Sequence analysis showed that these clones cluster into 7173 non-redundant sequences comprising 1794 clusters and 5379 singletons. As a result of nucleotide and peptide database search, 2594 were found to represent known rat sequences. Of the remaining 4579 genes, 599 non-redundant ESTs represent rat homologs of genes identified in other species or new members of structurally related families. In addition, we illustrate the use of these clone sets by constructing a cDNA microarray focused on genes categorized into ""cell/organism defense"". These ESTs and our own microarray thus provide an improved genomic source for molecular studies of animal models of stress-related disorders.",0,0 +5693,The way I make you feel: Social exclusion enhances the ability to manage others' emotions,"Abstract Original conceptions of social exclusion focused upon the negative impact of exclusion on intelligent thought (Baumeister, Twenge, & Nuss, 2002). We propose that although exclusion may impair cognitive forms of intelligence, exclusion should enhance more socially relevant forms of intelligence, such as emotional intelligence. Specifically, we examined whether exclusion would enhance performance in one branch of emotional intelligence: the ability to manage others' emotions. Social exclusion heightened the number and breadth of strategies that participants used for managing others' emotions when responding to hypothetical scenarios (Study 1) and when responding to online pen pals (Studies 3 and 4). Furthermore, excluded participants were more effective at energizing an interaction partner in a face-to-face coaching interaction (Study 2) and were rated as more effective at managing their pen pal's emotions in an online pen pal exchange (Studies 3 and 4). Although exclusion heightened the number and breadth of emotion management strategies generated in a social task, exclusion did not heighten the number or breadth of nonsocial strategies (creative uses for common household items) generated in a comparison task (Study 4). Lastly, we found preliminary evidence suggesting that this enhanced emotion management after exclusion may serve to facilitate reconnection; excluded participants were liked more by their interaction partners (Study 2) and were rated to be more likable by objective coders (Studies 3 and 4). Altogether, these findings suggest that individuals may be more effective at managing others' emotions following social exclusion, and this greater effectiveness may promote reconnection.",0,0 +5694,Psychological theories of posttraumatic stress disorder,"We summarize recent research on the psychological processes implicated in posttraumatic stress disorder (PTSD) as an aid to evaluating theoretical models of the disorder. After describing a number of early approaches, including social-cognitive, conditioning, information-processing, and anxious apprehension models of PTSD, the article provides a comparative analysis and evaluation of three recent theories: Foa and Rothbaum's [Foa, E. B. & Rothbaum, B. O. (1998). Treating the trauma of rape: cognitive behavioral therapy for PTSD. New York: Guilford Press] emotional processing theory; Brewin, Dalgleish, and Joseph's [Psychological Review 103 (1996) 670] dual representation theory; Ehlers and Clark's [Behaviour Research and Therapy 38 (2000) 319] cognitive theory. We review empirical evidence relevant to each model and identify promising areas for further research.",0,0 +5695,PTSD scale of the child behavior checklist: Concurrent and discriminant validity with non-clinic-referred sexually abused children,"Several assessment instruments include measures that are purported to assess characteristics of posttraumatic stress disorder (PTSD). Although these measures are used often by researchers and clinicians, few are supported by extensive validity data. The PTSD scale of the Child Behavior Checklist (CBCL) is one that has not yet encountered significant challenges to its validity. We examine the concurrent and discriminant validity of the CBCL-PTSD scale. Participants included 63 non-clinic-referred sexually abused (SA) children, 60 non-SA psychiatric outpatient children, and 61 non-SA, non-clinic-referred schoolchildren. Results revealed questionable concurrent validity for this scale, and suggest poor discriminant validity between SA children and non-SA psychiatric outpatients.",0,0 +5696,THE METHAMPHETAMINE AND PSYCHOSIS STUDY (MAPS) – INDIVIDUAL PROFILES AND TREATMENT NEEDS,"Background: Multiple studies are investigating the impact of substance abuse on early psychosis. Stimulants such as methamphetamines (MA), while known to precipitate psychosis, are understudied. The prevalence of MA abuse in young individuals showing signs of early psychosis is dramatically high in Western North America, as is the prevalence of psychosis in young MA abusers. MA lifetime use by youth diagnosed with psychosis ranges from 21-33%. Common reasons for drug misuse in first episode clients range from increased pleasure, reduced depression and anxiety, and enhanced social facilitation. Individuals who abuse drugs, particularly stimulants such as MA, tend to have their first hospitalization earlier than non-misusing peers with schizophrenia, present with more severe symptoms, and have more problems in areas of interpersonal relationships, motivation, role functioning and activities. For many people, the substance abuse may precede the onset of the illness, whereas for others MA abuse may coincide with the onset, or even follow the onset of psychosis. Sixty-90% of first episode psychosis youth have abused drugs prior to their first psychiatric contact, suggesting a strong connection between psychosis and substances. Recent studies suggest that MA users with psychosis are much more likely to experience psychotic symptoms again if they use MA, and are also more likely to have a psychotic relapse when confronted with stressful situations, even years after cessation of MA use. MA users with persistent or recurrent psychotic symptoms become vulnerable to stress and may benefit from antipsychotic medication the same way individuals with schizophrenia do. Method: Our study aimed at describing the profiles of individuals with MA abuse and psychotic symptoms. We also wished to determine patterns of abuse and psychotic symptoms over time. 295 participants were interviewed following at least one episode of acute psychotic symptoms linked to MA abuse, and followed with monthly measures of substance abuse and psychiatric symptoms for six months. Results: Most participants lived in transitional housing or were homeless. Only 13% had no family history of mental illness or substance abuse. Close to 70% had a previous diagnosis of a mental illness. Antisocial personality disorder (68%), depression (67%), and post-traumatic stress disorder (49%) were highly prevalent. Risk factors and trajectories of substance abuse and psychotic symptoms will also be presented. Treatment: Integrated dual-disorder treatment, where the mental health team works in collaboration with the substance abuse counsellors, is considered the evidenced-based treatment for individuals presenting with co-occurring substance abuse and severe mental illness. Such treatments include step-wise interventions, often using CBT and motivational interviewing components, and can be found in various settings, including assertive community treatments. However, only some of the difficulties presented by participants in our study are addressed in these programs. Our team is currently working on developing modular programs for people with early psychosis and various concurrent disorders. Some examples of these treatment modules will be presented.",0,0 +5697,Social cognition in borderline personality disorder,"Many typical symptoms of borderline personality disorder (BPD) occur within interpersonal contexts, suggesting that BPD is characterized by aberrant social cognition. While research consistently shows that BPD patients have biases in mental state attribution (e.g., evaluate others as malevolent), the research focusing on accuracy in inferring mental states (i.e., cognitive empathy) is less consistent. For complex and ecologically valid tasks in particular, emerging evidence suggests that individuals with BPD have impairments in the attribution of emotions, thoughts, and intentions of others (e.g., Preißler et al., 2010). A history of childhood trauma and co-morbid PTSD seem to be strong additional predictors for cognitive empathy deficits. Together with reduced emotional empathy and aberrant sending of social signals (e.g., expression of mixed and hard-to-read emotions), the deficits in attribution might contribute to behavioral problems in BPD. Given the importance of social cognition on the part of both the sender and the recipient in maintaining interpersonal relationships and therapeutic alliance, these impairments deserve more attention.",0,0 +5698,Effects of Sensory-Enhanced Yoga on Symptoms of Combat Stress in Deployed Military Personnel,"Abstract OBJECTIVE. We examined the effects of sensory-enhanced hatha yoga on symptoms of combat stress in deployed military personnel, compared their anxiety and sensory processing with that of stateside civilians, and identified any correlations between the State–Trait Anxiety Inventory scales and the Adolescent/Adult Sensory Profile quadrants. METHOD. Seventy military personnel who were deployed to Iraq participated in a randomized controlled trial. Thirty-five received 3 wk (≥9 sessions) of sensory-enhanced hatha yoga, and 35 did not receive any form of yoga. RESULTS. Sensory-enhanced hatha yoga was effective in reducing state and trait anxiety, despite normal pretest scores. Treatment participants showed significantly greater improvement than control participants on 16 of 18 mental health and quality-of-life factors. We found positive correlations between all test measures except sensory seeking. Sensory seeking was negatively correlated with all measures except low registration, which was insignificant. CONCLUSION. The results support using sensory-enhanced hatha yoga for proactive combat stress management.",0,0 +5699,The role of environmental hazard in mothers’ beliefs about appropriate supervision,"Understanding factors that influence mothers’ beliefs about appropriate levels of supervision for their children may assist in efforts to reduce child injury rates. This study examined the interaction of child (i.e. age, gender, and injury risk behavior) and maternal perception of environmental hazard (i.e. hazard level, injury likelihood, and potential injury severity) variables in predicting mothers’ beliefs about appropriate levels of supervision for their children. Participants were 58 mothers of 2- to 8-year-old community children who were interviewed about their beliefs regarding child injury risk and appropriate supervision. Results indicated that perceived environmental hazard level interacted with child age, gender, and injury risk behavior to predict mothers’ beliefs about supervision. Perceived injury likelihood also interacted with child injury risk behavior to predict beliefs about supervision. Findings underscore the complexity of factors influencing mothers’ beliefs about appropriate supervision and indicate the importance of environmental hazard level in such beliefs.",0,0 +5700,Outcome management in in-patient psychiatric care,"To delineate methods and to describe patient appraisal as well as effect of outcome management in in-patient psychiatric care.Two hundred and ninety-four adults with mental illness receiving in-patient treatment at a psychiatric hospital in rural Bavaria gave informed consent to participate in this cluster-randomised trial. Participants were asked to provide information on treatment outcome via weekly computerised standardised assessments. Patients and clinicians in the intervention group received continuous feedback of outcome.Patients were willing and able to regularly provide outcome data and valued feedback. However, use of feedback in conversations between patient and clinician was rare. Outcome management failed to impact on patient-rated outcome during in-patient treatment.Outcome management is feasible in people receiving in-patient psychiatric care, but failed to show an overall short-term effect. Strategies need to be developed to improve active use of routinely collected treatment outcome data in mental health care.",0,0 +5701,Considering PTSD from the perspective of brain processes: A psychological construction approach,"Posttraumatic stress disorder (PTSD) is a complex psychiatric disorder that involves symptoms from various domains that appear to be produced by the combination of several mechanisms. The authors contend that existing neural accounts fail to provide a viable model that explains the emergence and maintenance of PTSD and the associated heterogeneity in the expression of this disorder (cf. Garfinkel & Liberzon, 2009). They introduce a psychological construction approach as a novel framework to probe the brain basis of PTSD, where distributed networks within the human brain are thought to correspond to the basic psychological ingredients of the mind. The authors posit that it is the combination of these ingredients that produces the heterogeneous symptom clusters in PTSD. Their goal is show that a constructionist approach has significant heuristic value in understanding the emergence and maintenance of PTSD symptoms, and leads to different and perhaps more useful conjectures about the origins and maintenance of the syndrome than the traditional hyperreactive fear account.",0,0 +5702,The development and maintenance of post-traumatic stress disorder (PTSD) in civilian adult survivors of war trauma and torture: A review,"This review provides a comprehensive and critical summary of the literature as to the development and maintenance of post-traumatic stress disorder (PTSD) following civilian war trauma and torture. Prevalence rates are reviewed and predictors are discussed in terms of risk factors, protective factors, and factors that maintain PTSD. Most epidemiologically sound studies found relatively low rates of PTSD. There is good evidence of a dose-response relationship between cumulative war trauma and torture and development and maintenance of PTSD. There is also some evidence that female gender and older age are risk factors in development of PTSD. Some refugee variables may exacerbate symptoms of PTSD and contribute to their maintenance. Preparedness for torture, social and family support, and religious beliefs may all be protective against PTSD following war trauma and torture. Applicability of the concept of PTSD to non-western populations and areas for much needed further study are discussed.",0,0 +5703,Trajectories of PTSD symptoms following sexual assault: Is resilience the modal outcome?,"Theoretical frameworks positing qualitatively distinct trajectories of posttrauma outcome have received initial empirical support, but have not been investigated in cases of severe interpersonal trauma. To address this limitation, we conducted latent class growth analysis with longitudinal data collected from 119 female sexual assault survivors at 1-, 2-, 3-, and 4-months postassault. Participants' mean age was 33 years; 63% were White. We hypothesized that given the severity of exposure associated with sexual assault, resilience would not be the modal course of adaptation. Four distinct PTSD growth trajectories, representing unique latent classes of participants, best fit the data: a high chronic trajectory, a moderate chronic trajectory, a moderate recovery trajectory, and a marked recovery trajectory. Contrary to previous studies and recent theoretical models, resilience and resistance trajectories were not observed, as high levels of distress were evident in nearly all participants at 1-month postassault. These results suggest that theoretical models of posttrauma response positing resilience as the modal outcome may not generalize to cases of sexual assault.",1,0 +5704,Diseases among men 20 years after exposure to severe stress: Implications for clinical research and medical care,"OBJECTIVE Epidemiologic studies have linked exposure to severe environmental stress, such as natural disasters and combat operations, to the onset of specific psychiatric disorders. Some research also suggests that these exposures may be associated with the onset of chronic diseases as well. However, these chronic disease outcome studies often have been obscured by bias and confounding. METHOD The medical histories of 1399 male Vietnam veterans approximately 20 years after combat exposure (mean years = 17) were analyzed by lifetime posttraumatic stress disorder (PTSD) status (lifetime PTSD = 332 cases). These men were included in a national, random in-person study of United States Army veterans of the Vietnam War (study completion rate = 65%). RESULTS After controlling for preservice, in-service, and postservice factors (including intelligence, race, region of birth, enlistment status, volunteer status, Army marital status, Army medical profile, hypochondriasis, age, smoking history, substance abuse, education, and income), associations were found for reported circulatory [odds ratio (OR) = 1.62, p = .007], digestive (OR = 1.47, p = .036), musculoskeletal (OR = 1.78, p = .008), endocrine-nutritional-metabolic (OR = 1.58, p = .10), nervous system (OR = 2.47, p < .001), respiratory (OR = 1.54, p = .042), and nonsexually transmitted infectious diseases (OR = 2.14, p < .004) after military service. CONCLUSION Although this study has some limitations, it suggests that there is a direct link between severe stress exposures and a broad spectrum of human diseases. In the future, medical researchers and clinicians should focus more on the medical consequences of exposure to severe environmental stress and seek to better integrate psychobiologic models of disease pathogenesis.",0,0 +5705,Pretraumatic prolonged elevation of salivary MHPG predicts peritraumatic distress and symptoms of post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) is associated with elevated catecholamines and increased sympathetic arousal. However, it is unknown whether this condition is a pre-existing vulnerability factor for PTSD or an acquired result of either trauma exposure or the development of PTSD symptoms. We sought to examine if salivary 3-methoxy-4-hydroxy-phenylglycol (MHPG) in response to a laboratory stressor prior to critical incident exposure predicts the development of PTSD symptoms and if early childhood trauma influences this relationship. In a prospective cohort study, 349 urban police officers were assessed during academy training (baseline) and 243 were reassessed 12 months after the start of active duty (follow-up). At baseline, participants observed a video consisting of police critical incidents. Salivary MHPG was measured before and immediately after the challenge, and after 20min recovery. At follow-up, peritraumatic distress and PTSD symptoms were assessed in relationship to the worst critical incident during the past year. Participants with childhood trauma showed a trend towards higher MHPG increase to the challenge. Higher MHPG levels after 20min recovery were associated with both higher levels of peritraumatic distress and PTSD symptoms at follow-up. In a path analysis, elevated MHPG levels predicted higher peritraumatic distress which in turn predicted higher levels of PTSD symptoms while the direct effect of elevated MHPG levels on PTSD symptoms was no longer significant. Prolonged elevation of salivary MHPG in response to a laboratory stressor marks a predisposition to experience higher levels of peritraumatic distress and subsequently more PTSD symptoms following critical incident exposure.",0,0 +5706,What is the profile of post-traumatic reactions within medical literature? A survey of eight journals,"Abstract Objectives: The importance of traumatic events is recognised by the public but the profile of psychological sequelae such as Post-traumatic Stress Disorder (PTSD) within psychiatry and medicine is unclear. We aimed to establish the profile of PTSD within high impact medical journals and within psychiatric journals based in America and the United Kingdom, since the initial classification of PTSD in DSM-III in 1980 and, before and after classification of PTSD in ICD-10 in 1992. Method: A survey of all articles on post-traumatic reactions published in eight journals between 1980 and 2000. Results: The proportion of articles on PTSD was less in UK based psychiatric journals than their counterparts based in America. The proportion of articles published after the classification of PTSD in ICD-10 has increased in both psychiatric and medical journals. Conclusions: In UK based journals, there is an under-representation of articles on PTSD compared with disorders of similar prevalence.",0,0 +5707,Potential treatment mechanisms of counseling for children in Burundi: A series of n = 1 studies.,"Little is known about the impact and treatment processes of psychosocial counseling in low-income countries. This study aimed to generate hypotheses on key working mechanisms of counseling in Burundi. The authors carried out 11 empirically grounded n=1 studies with children (11-14years) screened for depression and anxiety who received counseling. The authors used quantitative (symptom scales) and qualitative instruments (treatment content and perceptions). Weekly measurements were taken preintervention (4 time points), during the intervention period (8-10 time points), and postintervention (4 time points). Five treatment mechanisms continua appeared associated with outcome trajectories: client centeredness, therapeutic alliance, active problem solving, trauma-focused exposure, and family involvement. Higher levels appeared associated with better outcomes. Contrarily, cases that demonstrated no change were characterized by a heavy focus on counselors' norms, containment and self-control, unstructured retelling and explicit avoidance, advice-oriented problem solving, and noninclusion of family members, respectively. The authors found a distinct clustering of outcome trends per therapist. The findings suggest that integrative counseling, which combines universal therapist variables with active use of specific therapeutic techniques and a systemic perspective, may be an adequate strategy to treat mental health symptoms of children in Burundi.",0,0 +5708,Association of Comorbid Posttraumatic Stress Disorder and Major Depression With Greater Risk for Suicidal Behavior,"Posttraumatic stress disorder (PTSD) increases the risk of suicidal behavior; a major depressive episode also increases the risk for suicidal behavior. The authors' goal was to examine the effect of comorbid PTSD and major depressive episode on suicidal behavior.Inpatients with a diagnosis of major depressive episode (N=156) were assessed for PTSD, suicidal behavior, and clinical risk factors for suicidal acts.Patients with comorbid major depressive episode and PTSD were more likely to have attempted suicide, and women with both disorders were more likely to have attempted suicide than men with both disorders. Cluster B personality disorder and PTSD were independently related to history of suicide attempts.The greater rate of suicide attempts among patients with comorbid PTSD and major depressive episode was not due to differences in substance use, childhood abuse, or cluster B personality disorders.",0,0 +5709,An Alternative AI Breeding Protocol for Dairy Cows Exposed to Elevated Ambient Temperatures before or after Calving or Both,"Our objective was to determine if a timed artificial insemination (AI) protocol (Ovsynch) might produce greater pregnancy rates than AI after a synchronized, detected estrus during summer. Lactating Holstein cows (n = 425) were grouped into breeding clusters and then assigned randomly to each of two protocols for AI between 50 and 70 days in milk. All cows were treated with GnRH followed 7 d later by PGF2alpha. Ovsynch cows then were treated with a second injection of GnRH 48 h after PGF2alpha and inseminated 16 to 19 h later. Controls received no further treatment after PGF2alpha and were inseminated after detected estrus. Pregnancy was diagnosed once by transrectal ultrasonography (27 to 30 d after AI) and again by palpation (40 to 50 d). Based on concentrations of progesterone in blood collected before each hormonal injection, only 85.4% of 425 cows were considered to be cycling. Although conception rates were not different between protocols at d 27 to 30, AI submission rates and pregnancy rates were greater after Ovsynch (timed AI) than after detected estrus. A temperature-humidity index > or = 72 was associated with fewer controls detected in estrus with lower conception than for controls detected in estrus when index values were < 72, whereas the reverse was true for cows after the Ovsynch protocol. We concluded that a timed AI protocol increased pregnancy rates at d 27 to 30 because its success was independent of either expression or detection of estrus. However, because of poorer embryonic survival in Ovsynch cows during heat stress only (39.5 vs. 69.2% survival for Ovsynch and control, respectively), pregnancy rates were not different by d 40 to 50 after timed AI.",0,0 +5710,Neurocognitive profiles of people with borderline personality disorder,"This review summarizes recent neurocognitive research to better delineate the nosology, prognostication and cause underlying borderline personality disorder (BPD).BPD had marked clinical heterogeneity with high comorbidity. Executive dysfunction in this disorder was linked to suicidality and treatment adherence, and may serve as an endophenotype. BPD was also characterized by cognitive distortions such as risky decision-making, deficient feedback processing, dichotomous thinking, jumping to conclusion, monocausal attribution and paranoid cognitive style. Social cognition deficits recently described in BPD include altered social inference and emotional empathy, hypermentalization, poorer facial emotional recognition and facial expressions. In electrophysiological studies, BPD was found to have predominantly right hemispheric deficit in high-order cortical inhibition. Reduced left orbitofrontal activity by visual evoked potential and magnetoencephalography correlated with depressive symptoms and functional deterioration. Brain structures implicated in BPD include the hippocampus, dorsolateral prefrontal cortex and anterior cingulate cortex. Abnormal anatomy and functioning of frontolimbic circuitry appear to correlate with cognitive deficits.Frontolimbic structural and functional abnormalities underlie the broad array of cognitive abnormalities in BPD. Further research should espouse broader considerations of effects of comorbidity and clinical heterogeneity, and include community samples and, possibly, longitudinal designs.",0,0 +5711,"Beginnings, Second Edition","Utilizing a decade’s worth of clinical experience gained since its original publication, Mary Jo Peebles builds and expands upon exquisitely demonstrated therapeutic approaches and strategies in this second edition of Beginnings. The essential question remains the same, however: How does a therapist begin psychotherapy? To address this delicate issue, she takes a thoughtful, step-by-step approach to the substance of those crucial first sessions, delineating both processes and potential pitfalls in such topics as establishing a therapeutic alliance, issues of trust, and history taking. Each chapter is revised and expanded to include the latest treatment research and modalities, liberally illustrated with rich case material, and espouse a commitment to the value of multiple theoretical perspectives. Frank and sophisticated, yet eminently accessible, this second edition will be an invaluable resource for educators, students, and seasoned practitioners of any therapeutic persuasion. © 2012 by Taylor & Francis Group, LLC.",0,0 +5712,Interpersonal Factors in Understanding and Treating Posttraumatic Stress Disorder,"Exposure to reminders of trauma underlies the theory and practice of most treatments for post-traumatic stress disorder (PTSD), yet exposure may not be the sole important treatment mechanism. Interpersonal features of PTSD influence its onset, chronicity, and possibly its treatment. The authors review interpersonal factors in PTSD, including the critical but underrecognized role of social support as both protective posttrauma and as a mechanism of recovery. They discuss interpersonal psychotherapy (IPT) as an alternative treatment for PTSD and present encouraging findings from two initial studies. Highlighting the potential importance of attachment and interpersonal relationships, the authors propose a mechanism to explain why improving relationships may ameliorate PTSD symptoms.",0,0 +5713,The Multidimensional Scale of Perceived Social Support,"The development of a self-report measure of subjectively assessed social support, the Multidimensional Scale of Perceived Social Support (MSPSS), is described. Subjects included 136 female and 139 male university undergraduates. Three subscales, each addressing a different source of support, were identified and found to have strong factorial validity: (a) Family, (b) Friends, and (c) Significant Other. In addition, the research demonstrated that the MSPSS has good internal and test-retest reliability as well as moderate construct validity. As predicted, high levels of perceived social support were associated with low levels of depression and anxiety symptomatology as measured by the Hopkins Symptom Checklist. Gender differences with respect to the MSPSS are also presented. The value of the MSPSS as a research instrument is discussed, along with implications for future research.",0,0 +5714,Emotion Regulation Strategy Use and Posttraumatic Stress Disorder: Associations Between Multiple Strategies and Specific Symptom Clusters,"A growing literature suggests that emotion regulation (ER) is associated with posttraumatic stress disorder (PTSD). However, most of the studies in this literature have one or more important limitations, including examining only a single ER strategy (e.g., thought suppression) rather than multiple strategies simultaneously, examining PTSD at the syndrome level rather than by symptom cluster, and failing to control for negative affect. The present study sought to address these limitations by using latent variable modeling to examine the associations between multiple ER strategies and individual PTSD symptom clusters while controlling for negative affect. Of the four measurement models of ER strategy use examined, the best-fitting model allowed items corresponding to each included strategy to load onto their independent factors. Of the four measurement models of PTSD symptoms examined, the best-fitting model was the five-factor dysphoric arousal model. Results of structural models indicated that thought suppression and experiential avoidance were associated with most PTSD symptom clusters, even after controlling for negative affect. However, most other included ER strategies were not associated with any symptom clusters. A number of issues regarding measurement of ER and PTSD are discussed, and several suggestions for future research are provided.",0,0 +5715,Relationship Distress in Partners of Combat Veterans: The Role of Partners’ Perceptions of Posttraumatic Stress Symptoms,"Partners of combat veterans with posttraumatic stress disorder report elevated relationship and psychological distress, but little is known about the mechanisms by which such distress develops. In two separate samples, we examined partners' perceptions of veterans' PTSD symptoms, with a specific focus on the simultaneous associations of partners' distress with their perceptions of veterans' reexperiencing, withdrawal/numbing, and hyperarousal symptom clusters. The first sample consisted of 258 partners of Operation Enduring- and Iraqi Freedom-era veterans who completed questionnaires. The second sample consisted of 465 partners of Vietnam-era veterans who completed interviews as part of the National Vietnam Veterans Readjustment Study. In both samples, path analyses revealed that, when examined simultaneously, partners' perceptions of withdrawal/numbing symptoms were associated with greater distress, but perceptions of reexperiencing symptoms were unrelated to psychological distress and significantly associated with lower levels of relationship distress. Given the cross-sectional nature of the data in both samples, there are multiple plausible interpretations of the results. However, the pattern is consistent with an attributional model of partner distress, whereby partners are less distressed when symptoms are more overtly related to an uncontrollable mental illness. Potential clinical implications are discussed.",0,0 +5716,Posttraumatic stress symptom clusters associations with psychopathology and functional impairment,"We examined posttraumatic stress symptom clusters associations with psychopathology and functional impairment in 899 Norwegian survivors of the 2004 South-East Asia tsunami six months post-disaster. Posttraumatic stress symptoms were assessed with the Impact of Event Scale-Revised (IES-R) with intrusion, avoidance, and hyper-arousal subscales. For criterion variables, we used 10 indicators of psychopathology and functional impairment, e.g. having mental health problems, seeing mental health professionals, and use of medication or sick leave. Hyper-arousal had stronger correlations than avoidance with all criterion variables (p values<0.001) and stronger correlations than intrusion with seven of the 10 criterion variables (p values<0.01). Also, intrusion had stronger correlations than avoidance with seven of 10 criterion variables (p values<0.05). Thus, our findings indicate that symptoms of hyper-arousal may be more closely linked to psychopathology and functional impairment than other symptoms of posttraumatic stress following a sudden onset, short duration, natural disaster event.",0,0 +5717,Open trial of citalopram in adults with post-traumatic stress disorder,"The selective serotonin reuptake inhibitors (SSRIs) are rapidly emerging as preferred first-line drugs in the pharmacological management of post-traumatic stress disorder (PTSD). Citalopram, an SSRI with highly potent and selective serotonin reuptake inhibition, may be a useful agent for treating the intrusive, avoidance, and arousal symptoms that characterize PTSD. Fourteen adult subjects (12 with civilian-related post-traumatic stress disorder, and 2 with combat-related post-traumatic stress disorder) were entered into an 8 wk, open- label, fixed-dose trial of citalopram, commencing with 20 mg/d, and increasing to 40 mg/d after 2 wk. Eleven subjects completed 8 wk treatment and were included in the data analysis. Based on the Clinician-Administered Post-traumatic Stress Disorder Scale (CAPS-2), there was significant reduction in all core PTSD symptoms (re-experiencing, hyperarousal, and avoidance) by week 8. Nine of the 11 completers were classified as 'responders' on Clinical Global Impression Improvement scores. Secondary measures of depression (Montgomery-Asberg Depression Rating Scale) and anxiety (Hamilton Anxiety Scale) also improved significantly by week 8. Citalopram was tolerated well, and there were no dropouts due to adverse effects. Data from this preliminary open trial suggests that citalopram, an SSRI, may be effective for reducing the key symptoms of PTSD, however, these findings need confirmation in double-blind, placebo-controlled trials.",0,0 +5718,No evidence of sleep disturbance in post-traumatic stress disorder: a polysomnographic study in injured victims of traffic accidents.,"Disturbed sleep is a common complaint among patients with PTSD. This complaint can be found in both the reexperiencing and hyperarousal symptom clusters in the DSM-IV. However, laboratory studies of sleep in PTSD have provided inconsistent evidence of objective sleep disturbances. Shortened REM latency, reduced sleep efficiency, restless sleep and increased prevalence of sleep apnea have been reported, but were not confirmed by all. A major shortcoming of most previous studies is the fact that they were done retrospectively in patients with chronic PTSD, often complicated by psychiatric comorbidity and drug abuse. Thus, little is known about the development of sleep disturbances in recently traumatized subjects.Eight injured victims of traffic accidents with PTSD and 6 injured victims without PTSD participated in a 3-night polysomnographic study one year after the accident.No significant differences between PTSD and non-PTSD patients were noted on any of the PSG measures. In addition, the two groups did not differ significantly from each other with respect to awakening thresholds during REM sleep.Considering that the present sample was free of active psychiatric comorbidity at the time of trauma and free of hypnotic medications, these results strengthen previous PSG studies suggesting that altered sleep perception, rather than sleep disturbance per se, may be the key problem in PTSD. More research is needed in order to examine whether this problem is specific to sleep or generalizes to other domains as well.",0,0 +5719,Prosocial coping by youth exposed to violence,"Chronic exposure to violence encourages youth to cope with challenges via a mixture of asocial, depressive and antisocial, aggressive tactics rather than prosocially in ways that benefit self without harming others. Youth exposed to violence are, therefore, not only at high risk for posttraumatic stress disorder (PTSD) but also for externalizing and internalizing behavior problems, school dropout, teen pregnancy, substance abuse, and delinquency. Despite violence exposure, high-risk youth may cope prosocially with controllable and uncontrollable life challenges if supported at school by a prosocial coping-skills program (PCS) that takes place each week for 45 minutes in small groups (6-8, members) with equal numbers of members skilled (competent) and less skilled (high-risk) at prosocial coping. Each PCS session: begins with information exchange among members about feelings, thoughts, and experiences; is structured by group rules that promote prosocial coping during sessions; includes activities that assess and rehearse prosocial coping with real-life emotional, social, and achievement challenges; is data driven and tailored to members' diverse skill levels. PCS may enable school-based prevention of behavior problems and adverse life outcomes from first grade through high school. © 1994 Human Sciences Press, Inc.",0,0 +5720,Psychiatric Comorbidity and PTSD in Addicted Prostitutes,"In the city of Rotterdam prostitution used to take place not only in sexclubs but also in and around a designated prostitution street-zone in the harbor area outside the city center. The group of sexworkers at this street-zone consisted primarily of severely addicted women. For a long period of time the harm reduction approach had been the major intervention for this socially marginalized group of women. From January 2003 to December 2004 184 of them could be interviewed and diagnosed according to DSM IV. Nearly all of them were addicted to heroin and cocaine and most of them also were dependent on alcohol and benzodiazepines. Psychiatric comorbidity was almost 100 %. Co-morbid conditions existed of cluster B and C personality disorders, psychotic disorders (26 %), affective disorders (31 %), acute PTSD (9 %) and adult-ADHD (8%). In 2006 the government had closed the prostitution street-zone and many of the women could be placed in therapeutic and protected homes. Now, 2 years later, we reinvestigate these women with respect to their actual social situation, their quality of life, psychiatric comorbidity and persisting (acute and chronic) PTSD. During the interviews we use the WHO Quality of life questionnaire and the KIP (clinical interview for PTSD). It is an ongoing study and the (preliminary) results will be presented during the symposium.",0,0 +5721,Treating post-traumatic stress disorder in the ‘real world’: evaluation of a specialist trauma service and adaptations to standard treatment approaches,"Aims and Method To evaluate the effectiveness of treatment at the Traumatic Stress Service (TSS) by comparing pre- and post-treatment scores on patient self-report measures. Through a questionnaire survey, to explore therapists' views of problems presenting in addition to post-traumatic stress disorder (PTSD) and how, as a result, they adapted their approach to trauma work. Results Therapists reported that their patients present with a range of complex problems, and self-report measures show that patients suffer particularly high levels of psychopathology. Therapists identified a number of adaptations to trauma-focused work to deal with these additional problems. Of the 112 patients who completed therapy, 43% filled in pre- and post-treatment questionnaire measures. Analysis showed clinically and statistically significant improvements in levels of PTSD, depression and social functioning. Clinical Implications The typical presentation of trauma survivors is often not ‘simple’ PTSD, but PTSD resulting from chronic and multiple traumas and complicated by additional psychological and social difficulties. Adaptations to trauma-focused work can successfully treat such ‘complex’ PTSD.",0,0 +5722,Prevalence and risk factors of post-traumatic stress disorder among adult survivors six months after the Wenchuan earthquake,"Exposure to earthquake has been associated with psychological distress, in particular, the development of posttraumatic stress disorder (PTSD). The aims of this study were to estimate the prevalence of PTSD, explore the associated risk factors among adult survivors 6 months after the Wenchuan earthquake in China, and compare the findings in our study to other studies about the Wenchuan earthquake and other earthquakes that occurred in the past. Multistage stratified random sampling methods were conducted in three severely affected areas in the Wenchuan earthquake. In this study, 14,798 individuals were identified with simple random selection methods at the sampling sites, 14,207 individuals were screened with the 12-item General Health Questionnaire(GHQ-12), and 3692 individuals were administered a Chinese version of the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV axis I disorders (SCID-I/P) by 180 psychiatrists. The prevalence of PTSD was 15.57%. The risk factors for PTSD included old age, female gender, living alone, buried in the earthquake, injured in the earthquake, operated on after the earthquake, witnessing someone get injured in the earthquake, witnessing someone get buried in the earthquake, witnessing someone die in the earthquake (P < 0.05, 95% CI). PTSD is common after a major disaster. Risk factors help people to identify the potential victims after disasters in time. Post-disaster mental health recovery interventions include early identification, sustained psychosocial support, governmental programs that provide social and economic support.",0,0 +5723,Perceived military organizational support and peacekeeper distress: A longitudinal investigation.,"Many professions vital to the safety of society require workers to face high magnitude and potentially traumatizing events. Because this routine exposure can cause high levels of stress in workers, it is important to investigate factors that contribute to both risk of posttraumatic stress disorder (PTSD), and healthy responses to stress. Although some research has found social support to mitigate the effects of posttraumatic stress symptoms, scant research has investigated organizational support. The aim of the present study is to investigate the temporal relationship between stress symptoms and perceived organizational support in a sample of 1,039 service members deployed to the peacekeeping mission to Kosovo. Participants completed self-report measures of stress symptoms and perceived organizational support at 4 study time points. Bivariate latent difference score structural equation modeling was utilized to examine the temporal relationship among stress and perceived organizational support. In general, across the 4 time points, latent PCL scores evidenced a salient and negative relationship to subsequent POS latent difference scores. However, no significant relationship was found between latent POS variables and subsequent PCL latent difference scores. Findings suggest that prior stress symptoms are influencing service member's perceptions of the supportiveness of their organization such that increased prior stress is associated with worsening perceptions of support. These results illustrate that targeting stress directly may potentiate the positive influence of organizational support and that institutional support programs should be adapted to better account for the negative biases increased distress may encourage.",0,0 +5724,Air Medical Evacuations from a Developing World Conflict Zone,"Somalia has been without effective government for close to two decades, with more than 1 million people internally displaced. The political unrest persists, with United Nations–backed African Union peacekeeping forces supporting the Transitional National government of Sharif Ahmed, struggling to maintain control of central Mogadishu from Islamist extremist groups, such as the reportedly Al-Qaeda–backed Al-Shabab. The African Union force of 5,000 troops is predominantly of Ugandan and Burundian origin, making up the African Mission in Somalia (AMISOM) effort. However, its mandate is limited to operations only in Mogadishu, and it is unauthorized to actively pursue insurgents. As with other ongoing high-profile conflicts, African Union troops face an enemy that blends into the civilian populace, fighting with a lethal mixture of improvised explosive devices and suicide bombers.",0,0 +5725,Predicting Posttraumatic Stress Following Pediatric Injury: A Systematic Review,"To review the recent empirical literature concerning development of posttraumatic stress symptoms following pediatric injury and summarize risk and predictive factors that will inform clinical practice and research.A systematic search of online databases such as PsycInfo, PILOTS, MedLine, and PubMed was performed. Further studies were identified through the reference lists of selected articles.Pre-injury psychological problems, the child's subjective experience of trauma severity/life threat, elevated heart rate immediately following the trauma, beliefs regarding initial symptoms, active thought suppression, and parental posttraumatic stress appear to be consistent predictors of persisting posttraumatic stress in children following injury.Specific variables may be useful in predicting posttraumatic stress following injury, which are discussed in terms of existing models of pediatric traumatic stress. Methodologies of included studies are also discussed.",0,0 +5726,Overgeneral autobiographical memory predicts changes in depression in a community sample,"This study investigated whether overgeneral autobiographical memory (OGM) predicts the course of symptoms of depression and anxiety in a community sample, after 5, 6, 12 and 18 months. Participants (N=156) completed the Autobiographical Memory Test and the Depression Anxiety Stress Scales-21 (DASS-21) at baseline and were subsequently reassessed using the DASS-21 at four time points over a period of 18 months. Using latent growth curve modelling, we found that OGM was associated with a linear increase in depression. We were unable to detect changes over time in anxiety. OGM may be an important marker to identify people at risk for depression in the future, but more research is needed with anxiety.",0,0 +5727,Ambulatory Medical Assistance - After Cancer (AMA-AC): A model for an early trajectory survivorship survey of lymphoma patients treated with anthracycline-based chemotherapy,"Cancer survivorship has emerged as an important aspect of oncology due to the possibility of physical and psychosocial complications. The purpose of this study was to assess the feasibility of the Ambulatory Medical Assistance for After Cancer (AMA-AC) procedure for monitoring lymphoma survivorship during the first year after chemotherapy.AMA-AC is based on systematic general practitioner (GP) consultations and telephone interventions conducted by a nurse coordinator (NC) affiliated to the oncology unit, while an oncologist acts only on demand. Patients are regularly monitored for physical, psychological and social events, as well as their health-related quality of life (HRQoL). Inclusion criteria were patients newly diagnosed with non-Hodgkin or Hodgkin lymphomas, who had been treated with anthracycline-based chemotherapy and were in complete remission after treatment.All 115 patients and 113 collaborating GPs agreed to participate in the study. For patients who achieved one year of disease-free survival (n = 104) their assessments (438 in total) were fully completed. Eleven were excluded from analysis (9 relapses and 2 deaths). The most frequent complications when taking into account all grades were arthralgia (64.3%) and infections (41.7%). About one third of patients developed new diseases with cardiovascular complications as the most common. Psychological disorders such as anxiety, depression and post-traumatic stress disorder were diagnosed in 42.6% of patients. The data collected showed that Hodgkin lymphoma patients, females, and patients with lower HRQoL (mental component) at study entry were at greater risk for developing at least one psychological disorder.This study showed that AMA-AC is a feasible and efficient procedure for monitoring lymphoma survivorship in terms of GP and patient participation rates and adherence, and provides a high quality of operable data. Hence, the AMA-AC procedure may be transferable into clinical daily practice as an alternative to standard oncologist-based follow-up.",0,0 +5728,A cross-sectional study of psychological complaints and quality of life in severely injured patients,"PurposeThe purpose of this study was to examine the incidence of psychological complaints and the relationship of these complaints with the quality of life (QOL) and accident- and patient-related factors among severely injured patients after the rehabilitation phase.MethodsPatients of 18 years or older with an injury severity score above 15 were included 15–53 months after their accident. Accident and patient characteristics were obtained from questionnaires and the trauma registry. Several questionnaires (Hospital Anxiety and Depression Scale, Impact of Events Scale, and Cognitive Failure Questionnaire) were used to determine the symptoms of psychological problems (anxiety or depression, post-traumatic stress disorder, or subjective cognitive complaints, respectively). The World Health Organization Quality of Life-Bref was used to determine QOL. A reference group of the Dutch general population was used for comparison of QOL scores.ResultsThe participation rate was 62 % (n = 173). At the time of the study, 30.1 % (n = 52) of the investigated patients had psychological complaints. No relation between psychological complaints and somatic severity or type of injury was found. Patients who were employed before the accident or resumed working reported less psychological complaints. Use of any medication before the accident and treatment for pre-accidental psychological problems were positively related to psychological complaints afterwards. QOL of severely injured patients was impaired in comparison with the general Dutch population, but only for those with psychological complaints.ConclusionsPsychological complaints seem to be an important and underestimated factor for a decreased QOL among severely injured patients.",0,0 +5729,Up Close and Personal: Temporal Variability in the Drinking of Individual College Students During Their First Year.,"Surveys have documented excessive drinking among college students and tracked annual changes in consumption over time. This study extended previous work by examining drinking changes during the freshman year, using latent growth curve (LGC) analysis to model individual change, and relating risk factors for heavy drinking to growth factors in the model. Retrospective monthly assessments of daily drinking were used to generate weekly estimates. Drinking varied considerably by week, apparently as a function of academic requirements and holidays. A 4-factor LGC model adequately fit the data. In univariate analyses, gender, race/ethnicity, alcohol expectancies, sensation seeking, residence, and data completeness predicted growth factors (ps <.05); gender, expectancies, residence, and data completeness remained significant when covariates were tested simultaneously. Substantive, methodological, and policy implications are discussed.",0,0 +5730,Trajectories of depression following spousal and child bereavement: A comparison of the heterogeneity in outcomes,"Our understanding of how individuals react to the loss of a close loved one comes largely from studies of spousal bereavement. The extent to which findings are relevant to other bereavements is uncertain. A major methodological limitation of current studies has been a reliance on retrospective reporting of functioning and use of samples of individuals who have self-selected for participant in grief research. To address these limitations, in the current study we applied Latent Growth Mixture Modelling (LGMM) in a prospective population-based sample to identify trajectories of depression following spousal and child bereavement in later life. The sample consisted of 2512 individual bereaved adults who were assessed once before and three times after their loss. Four discrete trajectories were identified: Resilience (little or no depression; 68.2%), Chronic Grief (an onset of depression following loss; 13.2%), Depressed-Improved (high pre-loss depression that decreased following loss; 11.2%), and Pre-existing Chronic Depression (high depression at all assessments; 7.4%). These trajectories were present for both child and spousal loss. There was some evidence that child loss in later life was associated more strongly with the Chronic Grief trajectory and less strongly with the Resilience trajectory. However these differences disappeared when covariates were included in the model. Limitations of the analyses are discussed. These findings increase our understanding of the variety of outcomes following bereavement and underscore the importance of using prospective designs to map heterogeneity of response outcomes.",0,0 +5731,Critical Body Temperature Profile as Indicator of Heat Stress Vulnerability,"Extreme climatic heat is a major health concern among workers in different occupational pursuits. People in the regions of western India confront frequent heat emergencies, with great risk of mortality and morbidity. Taking account of informal occupational groups (foundry and sheet metal, FSM, N=587; ceramic and pottery, CP, N=426; stone quarry, SQ, N=934) in different seasons, the study examined the body temperature profiling as indicator of vulnerability to environmental warmth. About 3/4th of 1947 workers had habitual exposure at 30.1-35.5°C WBGT and ~10% of them were exposed to 38.2-41.6°C WBGT. The responses of FSM, CP and SQ workers indicated prevailing high heat load during summer and post-monsoon months. Local skin temperatures (T(sk)) varied significantly in different seasons, with consistently high level in summer, followed by post-monsoon and winter months. The mean difference of T(cr) and T(sk) was ~5.2°C up to 26.7°C WBGT, and ~2.5°C beyond 30°C WBGT. Nearly 90% of the workers had T(cr) within 38°C, suggesting their self-adjustment strategy in pacing work and regulating T(cr). In extreme heat, the limit of peripheral adjustability (35-36°C T(sk)) and the narrowing down of the difference between T(cr) and T(sk) might indicate the limit of one's ability to withstand heat exposure.",0,0 +5732,Evaluation of the Atypical Response scale of the Trauma Symptom Inventory-2 in detecting simulated posttraumatic stress disorder,"This investigation evaluated the Atypical Response (ATR) scale of the Trauma Symptom Inventory - 2nd edition (TSI-2) in terms of its ability to distinguish genuine symptoms of posttraumatic stress disorder (PTSD) from simulated PTSD. Seventy-five undergraduate students were trained to simulate PTSD and were given monetary incentives to do so. Their responses on the PTSD Checklist (PCL), TSI-2 ATR, and Personality Assessment Inventory (PAI) validity scales were compared to responses of 49 undergraduate students with genuine symptoms of PTSD instructed to respond honestly on testing. Results indicate that the revised version of the ATR is superior to the original version in detecting malingered PTSD. Discriminant Function Analyses revealed correct classification of 75% of genuinely distressed individuals and 74% of PTSD simulators.",0,0 +5733,A role for cannabinoid CB1 receptors in mood and anxiety disorders,"Mood and anxiety disorders, the most prevalent of the psychiatric disorders, cause immeasurable suffering worldwide. Despite impressive advances in pharmacological therapies, improvements in efficacy and side-effect profiles are needed. The present literature review examines the role that the endocannabinoid system may play in these disorders and the potential value of targeting this system in the search for novel and improved medications. Cannabis and its major psychoactive component (-)-trans-delta9-tetrahydrocannabinol, have profound effects on mood and can modulate anxiety and mood states. Cannabinoid receptors and other protein targets in the central nervous system (CNS) that modulate endocannabinoid function have been described. The discovery of selective modulators of some of these sites that increase or decrease endocannabinoid neurotransmission, primarily through the most prominent of the cannabinoid receptors in the CNS, the CB1 receptors, combined with transgenic mouse technology, has enabled detailed investigations into the role of these CNS sites in the regulation of mood and anxiety states. Although data point to the involvement of the endocannabinoid system in anxiety states, the pharmacological evidence seems contradictory: both anxiolytic- and anxiogenic-like effects have been reported with both endocannabinoid neurotransmission enhancers and blockers. Due to advances in the development of selective compounds directed at the CB1 receptors, significant progress has been made on this target. Recent biochemical and behavioural findings have demonstrated that blockade of CB1 receptors engenders antidepressant-like neurochemical changes (increases in extracellular levels of monoamines in cortical but not subcortical brain regions) and behavioural effects consistent with antidepressant/antistress activity in rodents.",0,0 +5734,Differential accounts of refugee and resettlement experiences in youth with high and low levels of posttraumatic stress disorder (PTSD) symptomatology: A mixed-methods investigation.,"In recent years there has been increased debate and critique of the focus on psychopathology in general, and posttraumatic stress disorder (PTSD) in particular, as a predominant consequence of the refugee experience. This study was conducted to broaden the conceptualization and examination of the outcomes of the refugee experience by jointly examining how adaptive processes, psychosocial factors, and psychopathology are implicated. A mixed-methods approach was used to specifically examine whether adolescents' (N = 10) accounts of their refugee and resettlement experiences differed according to their level, ""high"" or ""low,"" of PTSD symptomatology. The superordinate themes of cultural belongingness and identification, psychological functioning, family unit functioning and relationships, and friendships and interpersonal processes, were identified as having particular relevance for the study's participants and in distinguishing between participants with high and low levels of PTSD symptomatology. Findings were characterized by marked differences between adolescents' accounts according to their symptomatology levels, and may thereby inform important avenues for future research as well as clinical prevention and intervention programs with refugee youth.",0,0 +5735,An Examination of the Latent Structure of the Difficulties in Emotion Regulation Scale,"The Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer, Journal of Psychopathology and Behavioral Assessment 26:41-54, 2004) is a popular multidimensional self-report measure of emotion regulation. The present study sought to examine the latent factor structure of the DERS. An examination of latent factor intercorrelations and a higher-order confirmatory factor analysis (CFA) suggested that the DERS-AWARENESS dimension may not represent the same higher-order emotion regulation construct as the other five DERS dimensions. Furthermore, findings supported the adequacy of a revised five-factor model of the DERS in which the AWARENESS dimension was removed. This revised DERS total scale did not diminish concurrent relations between the DERS and outcomes relevant to the emotion regulation domain (i.e., depression, anxiety, posttraumatic stress symptoms). Implications for the conceptualization and assessment of emotion regulation are discussed. © Springer Science+Business Media, LLC 2012.",0,0 +5736,"Mental health, social functioning, and feelings of hatred and revenge of Kosovar Albanians one year after the war in Kosovo","A cross-sectional cluster sample survey was conducted in June 2000 in Kosovo to assess the prevalence of mental health problems associated with traumatic experiences, feelings of hatred and revenge, and the level of social functioning among Kosovar Albanians approximately 1 year after the end of the war. Findings of the second cross-sectional survey were compared with those from our 1999 mental health survey in Kosovo. Included in the survey were 1399 Kosovar Albanians aged 15 years or older living in 593 randomly selected households across Kosovo. Twenty-five percent of respondents reported PTSD symptoms, compared with 17.1% in 1999. The MOS-20 social functioning score improved to 69.8 from 29.5 in 1999. In the 2000 survey 54% of men felt hatred toward the Serbs, compared with 88.7% in 1999.",0,0 +5737,An examination of a two-factor model of rumination and its impact on the relationship between posttraumatic growth and Posttraumatic Stress Disorder (PTSD),"Research indicates that over half the US population will experience a trauma at some point during their lifetime (Kessler et al., 1995). Following traumatic events, individuals frequently experience a range of intrusion, avoidance, and arousal symptoms that fall on a continuum and can occur with such frequency and intensity that they meet the criteria for Posttraumatic Stress Disorder (PTSD; American Psychiatric Association, 2001). However, though many people experience traumas, only a small percentage develop PTSD. Research shows that many trauma survivors actually report benefit finding, or posttraumatic growth, after trauma. Currently, there is no clear understanding of the relationship between PTSD symptoms and posttraumatic growth. The current study hypothesized that two very different types of cognitive processing - reflection and brooding - would moderate the relationship between PTSD symptoms and posttraumatic growth, with reflection strengthening the relationship (making it more positive), and brooding weakening the relationship. 270 University undergraduate students completed self-report questionnaires asking about their trauma history, PTSD symptoms, their use of reflection and brooding, and their perceptions of posttraumatic growth. Although reflection and brooding both moderated the relationship between PTSD symptoms and posttraumatic growth, both had the same antagonistic effects, switching the relationship between PTSD symptoms and posttraumatic growth from positive to negative. The current study concludes that: (1) Future studies should investigate the role of third variables in attempting to understand the relationship between PTSD symptoms and posttraumatic growth; (2) Cognitive processing variables appear to be excellent sources of information in this relationship; (3) Brooding and reflection may represent one way to investigate distinctions between adaptive and maladaptive forms of cognitive processing after trauma, if measurement tools are improved. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5738,Subgroups of US IRAQ and Afghanistan veterans: associations with traumatic brain injury and mental health conditions,"U. S. veterans of Iraq and Afghanistan are known to have a high prevalence of traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), and depression, which are often comorbid and share many symptoms. Attempts to describe this cohort by single diagnoses have limited our understanding of the complex nature of this population. The objective of this study was to identify subgroups of Iraq and Afghanistan veterans (IAVs) with distinct compositions of symptoms associated with TBI, PTSD, and depression. Our cross-sectional, observational study included 303,716 IAVs who received care in the Veterans Health Administration in 2010-2011. Symptoms and conditions were defined using International Classification of Diseases, Ninth Revision codes and symptom-clusters were identified using latent class analysis. We identified seven classes with distinct symptom compositions. One class had low probability of any condition and low health care utilization (HCU) (48 %). Other classes were characterized by high probabilities of mental health comorbidities (14 %); chronic pain and sleep disturbance (20 %); headaches and memory problems (6 %); and auditory problems (2.5 %). Another class had mental health comorbidities and chronic pain (7 %), and the last had high probabilities of most symptoms examined (3 %). These last two classes had the highest likelihood of TBI, PTSD, and depression and were identified as high healthcare utilizers. There are subgroups of IAVs with distinct clusters of symptom that are meaningfully associated with TBI, PTSD, depression, and HCU. Additional studies examining these veteran subgroups could improve our understanding of this complex comorbid patient population.",0,0 +5739,POSTTRAUMATIC STRESS DISORDER IS ASSOCIATED WITH HIGHER C-REACTIVE PROTEIN LEVELS,"Background: Posttraumatic stress disorder (PTSD) has been linked to cardiovascular disease. Increased inflammation, through disruption of neuroendocrine systems, could be implicated, but limited data are available on the link between PTSD and inflammation. In a twin study of military veterans we tested the hypothesis that twins with PTSD had higher plasma levels of inflammatory biomarkers than their twin brothers without PTSD after adjusting for cardiovascular and behavioral factors. Methods: We examined 510 monozygotic and dizygotic middle-aged male twins (255 pairs), mean age 55 yr (range 47-61) from the Vietnam Era Twin Registry. PTSD and other psychiatric diagnoses were assessed with the Structured Clinical Interview for DSM-IV. Plasma levels of C-reactive protein (CRP) and interleukin-6 (IL-6), and cardiovascular risk factors were measured. Analyses were conducted on log-transformed biomarker data using mixed effects regression to account for pair cluster and to separate between- and within-pair effects. Results: Of 510 twins, 69 had a lifetime diagnosis of PTSD and 35 had current PTSD. PTSD was associated with increasing CRP levels. Mean CRP levels were lowest in twins with no diagnosis of PTSD (2.5 mg/L) and highest in those with current PTSD (5.1 mg/L); those with lifetime, but no current PTSD, had a intermediate mean CRP level (3.7 mg/L) (p=0.005). Differences were attenuated but remained significant (p=0.02) after adjustment for traditional CVD risk factors, BMI, previous CVD, major depression, and history of substance abuse. Within 29 pairs discordant for current PTSD, after adjusting for the same factors, the twins with current PTSD had 69% higher CRP than their brother without PTSD (p=0.02). Results did not differ significantly by zygosity. There were no differences in IL-6 levels based on PTSD status. Conclusion: PTSD, particularly a current episode, is associated with elevated CRP. Enhanced inflammation may be a mechanism for increased risk of somatic disorders, including CVD, in persons with PTSD.",0,0 +5740,Acute Stress Masking the Biochemical Phenotype of Partial Androgen Insensitivity Syndrome in a Patient with a Novel Mutation in the Androgen Receptor,"Hypogonadism has traditionally been classified as either hypogonadotropic or hypergonadotropic based on serum gonadotropin levels. However, when hypothalamic suppression of GnRH secretion occurs, it can mask an underlying hypergonadotropic state. In this report we document the unusual case of a 61-yr-old man with androgen insensitivity and coincidental functional hypogonadotropic hypogonadism (HH). Although functional HH is not a well-recognized entity in the male, major stress has been reported to cause transient suppression of the hypothalamic-pituitary-gonadal axis in men. The patient in question was noted to have undervirilization, minimal pubertal development, hypogonadal testosterone, and low gonadotropin levels consistent with congenital HH during a hospital admission for myocardial infarction. However, the patient had also had surgery for hypospadias, a clinical feature not typically part of the phenotypic spectrum of congenital HH. We therefore hypothesized that the combination of acute stress and chronic glucocorticoid administration for temporal arteritis induced transient HH in a patient with a disorder of sexual differentiation in whom gonadotropin levels would have otherwise been elevated. Using clinical, molecular, and genetic studies, the patient was found to have partial androgen insensitivity syndrome (PAIS) caused by a novel mutation (Ser(740)Cys) in the ligand-binding domain of the androgen receptor. Subsequent studies of the patient confirmed the characteristic gonadotropin and sex steroid abnormalities of PAIS. We describe for the first time a patient with PAIS presenting with a reversible hypogonadotropic biochemical profile triggered by an acute illness and corticosteroid therapy. This case highlights the necessity for caution when interpreting gonadotropin levels during acute stress.",0,0 +5741,Information Processing in Posttraumatic Stress Disorder,"Abstract The chapter reviews the contribution of information processing models to understanding the development and maintenance of posttraumatic stress disorder. Individual differences in cognitive processing during the trauma and basic memory mechanism, such as priming and associative learning, may help explain why people with PTSD involuntarily re-experience parts of the trauma in a wide range of situations. Individual differences in how people remember traumatic events may influence the likelihood of developing PTSD. Attentional bias to trauma-related cues and threatening interpretations of the trauma or its aftermath help explain why people with PTSD have many symptoms of anxiety even though the trauma is over. Cognitive strategies people use to deal with memories of the trauma, such as effortful suppression of trauma memories and rumination, help explain why some develop chronic PTSD whereas many recover from trauma. Finally, there may be cognitive vulnerability factors that increase the probability of developing PTSD in response to trauma. Directions for future research are outlined.",0,0 +5742,The structure of post-traumatic stress disorder symptoms in three female trauma samples: A comparison of interview and self-report measures,"Empirical research increasingly suggests that post-traumatic stress disorder (PTSD) is comprised of four factors: re-experiencing, avoidance, numbing, and hyperarousal. Nonetheless, there remains some inconsistency in the findings of factor analyses that form the bulk of this empirical literature. One source of such inconsistency may be assessment measure idiosyncrasies. To examine this issue, we conducted confirmatory factor analyses of interview and self-report data across three trauma samples. Analyses of the interview data indicated a good fit for a four-factor model across all samples; analyses of the self-report data indicated an adequate fit in two of three samples. Overall, findings suggest that measure idiosyncrasies may account for some of the inconsistency in previous factor analyses of PTSD symptoms.",0,0 +5743,Psychometric Properties of the Life Events Checklist,"The Life Events Checklist (LEC), a measure of exposure to potentially traumatic events, was developed at the National Center for Posttraumatic Stress Disorder (PTSD) concurrently with the Clinician Administered PTSD Scale (CAPS) to facilitate the diagnosis of PTSD. Although the CAPS is recognized as the gold standard in PTSD symptom assessment, the psychometric soundness of the LEC has never been formally evaluated. The studies reported here describe the performance of the LEC in two samples: college undergraduates and combat veterans. The LEC exhibited adequate temporal stability, good convergence with an established measure of trauma history—the Traumatic Life Events Questionnaire (TLEQ)— and was comparable to the TLEQ in associations with variables known to be correlated with traumatic exposure in a sample of undergraduates. In a clinical sample of combat veterans, the LEC was significantly correlated, in the predicted directions, with measures of psychological distress and was strongly associated with PTSD symptoms.",0,0 +5744,Gender differences in the correlates of hazardous drinking among Iraq and Afghanistan veterans,"Despite increasing numbers of women veterans from the Iraq and Afghanistan conflicts, few studies have examined hazardous drinking in this group. The present study examined the prevalence of and risk and protective factors for hazardous drinking in a community-based sample of men and women veterans of Operations Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND).Veterans completed a structured survey that assessed hazardous drinking using the Alcohol Use Disorders Identification Test (AUDIT), and a broad range of demographic, life history, and psychopathology variables. Correlations and multivariate logistic regression analyses were conducted to examine risk and protective factors associated with hazardous drinking.A total 30.2% of male veterans and 16.3% of female veterans screened positive for hazardous drinking. In a multivariate analysis in male veterans, younger age, lifetime exposure to assaultive trauma, and conflict in interpersonal relationships were independently associated with hazardous drinking (p<.05). Among women veterans, younger age and posttraumatic stress disorder (PTSD) symptoms were independently associated with hazardous drinking in a multivariate analysis (p<.05). Secondary analyses of PTSD symptom clusters revealed that emotional numbing symptoms were independently related to hazardous drinking in women veterans (p<.05).Results of this study suggest that hazardous drinking is prevalent in both men and women OEF/OIF/OND veterans and is more likely to occur at younger ages. In addition, results indicate gender differences in the association between hazardous drinking and lifetime trauma history, PTSD symptoms, and interpersonal conflict, which may have important implications for the treatment of alcohol problems in men and women veterans.",0,0 +5745,Pre-traumatic personality as a predictor of post-traumatic stress disorder among undergraduate students exposed to a terrorist attack: A prospective study in Israel,"The present study addresses the issue of the role played by the pre-traumatic personality, as evaluated by Cloninger’s Tridimensional Personality Theory (1987), in predicting post-traumatic stress disorder (PTSD) following traumatic exposure. The initial sample consisted of 185 undergraduate students evaluated for a different aim two weeks prior to a terrorist explosion on a bus heading to their university. One week after the explosion, the sample was assessed to determine actual exposure: 81 reported being exposed and thus constituted the final cohort, re-evaluated at six months after the exposure both in terms of personality profile and to determine formal diagnosis of PTSD. A logistic regression analysis showed that age and the harm-avoidance personality dimension (i.e., avoiding novel stimuli) were positively associated with the risk for developing PTSD, and that the novelty-seeking dimension (i.e., seeking novel stimuli of excitement) was negatively associated with this risk.",0,0 +5746,Caught in a Web of Multiple Jeopardy: Post-Traumatic Stress Disorder and HIV-Positive Asylum Seekers in Scotland,"Many HIV-positive asylum seekers have experienced multiple traumas and human rights violations—circumstances that engender posttraumatic stress disorder (PTSD). This qualitative study examines the impact of PTSD symptoms among HIV-positive asylum seekers in Scotland. Data were collected from 19 participants, using open-ended interviews, and narrative analysis was used to develop significant themes. All respondents had significant traumatic experiences, such as physical and sexual assault, witnessing the beating and death of a loved one, and being forced to participate in the sex trade. Many experienced multiple symptoms of PTSD, including re-experiencing of intrusive thoughts, flashbacks, avoidance, and arousal. These symptoms met the duration and impairment requirements for DSM-5 diagnosis of PTSD. Their symptoms impacted their ability to tell their stories convincingly when interviewed by immigration officials. Legal processes for asylum seeking require individuals to tell their stories but ignore the impact of trauma on their ability to do so, thus increasing the likelihood of their applications being rejected. The findings indicate the need for asylum seekers to have routine assessment and treatment for PTSD and the provision of appropriate therapeutic and advocacy services.",0,0 +5747,PTSD symptom clusters in relationship to alcohol misuse among Iraq and Afghanistan war veterans seeking post-deployment VA health care,"Demographic factors, characteristics of military service, PTSD, and depression were examined as predictors of alcohol misuse in Iraq and Afghanistan War Veterans (N=287) presenting for post-deployment Veteran Affairs (VA) health care. Results indicated that alcohol misuse was more common among younger male Veterans who served in the Army or Marine Corps. Accounting for demographic factors and characteristics of service, Veterans who screened positive for PTSD or depression were two times more likely to report alcohol misuse relative to Veterans who did not screen positive for these disorders. The examination of specific PTSD symptom clusters suggested that emotional numbing symptoms were most strongly associated with alcohol misuse. The implications for interventions for alcohol misuse in returning Veterans are discussed.",0,0 +5748,Comparison of immediate-onset and delayed-onset posttraumatic stress disorder in military veterans.,"Differences in symptoms, trauma exposure, dissociative and emotional reactions to trauma, and subsequent life stress in war veterans reporting immediate-onset or delayed-onset posttraumatic stress disorder (PTSD) or no PTSD were investigated. The role of life stress in delayed-onset PTSD was also studied. Retrospective interviews were conducted with 142 United Kingdom veterans receiving a war pension for PTSD or physical disability. Immediate-onset and delayed-onset PTSD were similar in the number and type of symptoms reported at onset, but the delayed-onset group differed in showing a gradual accumulation of symptoms that began earlier and continued throughout their military career. They were more likely to report major depressive disorder and alcohol abuse prior to PTSD onset. Both groups described similar amounts of trauma exposure, but those in the delayed-onset group reported significantly less peritraumatic dissociation, anger, and shame. Veterans with delayed onsets were more likely than veterans with no PTSD to report the presence of a severe life stressor in the year before onset. In conclusion, the results suggest that delayed onsets involve a more general stress sensitivity and a progressive failure to adapt to continued stress exposure.",0,0 +5749,"Risk pathways among traumatic stress, posttraumatic stress disorder symptoms, and alcohol and drug problems: A test of four hypotheses.","The present study utilized longitudinal data from a community sample (n = 377; 166 trauma-exposed; 54% males; 73% non-Hispanic Caucasian; 22% Hispanic; 5% other ethnicity) to test whether pretrauma substance use problems increase risk for trauma exposure (high-risk hypothesis) or posttraumatic stress disorder (PTSD) symptoms (susceptibility hypothesis), whether PTSD symptoms increase risk for later alcohol/drug problems (self-medication hypothesis), and whether the association between PTSD symptoms and alcohol/drug problems is attributable to shared risk factors (shared vulnerability hypothesis). Logistic and negative binomial regressions were performed in a path analysis framework. Results provided the strongest support for the self-medication hypothesis, such that PTSD symptoms predicted higher levels of later alcohol and drug problems, over and above the influences of pretrauma family risk factors, pretrauma substance use problems, trauma exposure, and demographic variables. Results partially supported the high-risk hypothesis, such that adolescent substance use problems increased risk for assaultive violence exposure but did not influence overall risk for trauma exposure. There was no support for the susceptibility hypothesis. Finally, there was little support for the shared vulnerability hypothesis. Neither trauma exposure nor preexisting family adversity accounted for the link between PTSD symptoms and later substance use problems. Rather, PTSD symptoms mediated the effect of pretrauma family adversity on later alcohol and drug problems, thereby supporting the self-medication hypothesis. These findings make important contributions to better understanding the directions of influence among traumatic stress, PTSD symptoms, and substance use problems.",0,0 +5750,Post-traumatic stress disorder: diagnostic issues and epidemiology in adult survivors of traumatic events,This paper presents a review of the issues surrounding the diagnosis and epidemiology of post-traumatic stress disorder in adult survivors of traumatic events. The paper is presented in two section...,0,0 +5751,Reliability and validity of a brief instrument for assessing post-traumatic stress disorder,"This study examines the psychometric properties of two versions of the PTSD Sympton Scale (PSS). The scale contains 17 items that diagnose PTSD according to DSM-III-R criteria and assess the severity of PTSD symptoms. An interview and self-report version of the PSS were administered to a sample of 118 recent rape and non-sexual assault victims. The results indicate that both versions of the PSS have satisfactory internal consistency, high test-retest reliability, and good concurrent validity. The interview version yielded high interrater agreement when administred separately by two interviewers and excellent convergent validity with the SCID. When used to diagnose PTSD, the self-report version of the PSS was somewhat more conservative than the interview version.",0,0 +5752,Do Peritraumatic Emotions Differentially Predict PTSD Symptom Clusters? Initial Evidence for Emotion Specificity,"This study investigated whether specific peritraumatic emotions differentially predict PTSD symptom clusters in individuals who have experienced stressful life events. Hypotheses were developed based on the SPAARS model of PTSD. It was predicted that the peritraumatic emotions of anger, disgust, guilt, and fear would significantly predict re-experiencing and avoidance symptoms, while only fear would predict hyperarousal. Undergraduate students ( N = 144) participated in this study by completing a packet of self-report questionnaires. Multiple regression analyses were conducted with PCL-S symptom cluster scores as dependent variables and peritraumatic fear, guilt, anger, shame, and disgust as predictor variables. As hypothesized, peritraumatic anger, guilt, and fear all significantly predicted re-experiencing. However, only fear predicted avoidance, and anger significantly predicted hyperarousal. Results are discussed in relation to the theoretical role of emotions in the etiology of PTSD following the experience of a stressful life event.",0,0 +5753,"Outcome from Injury: General Health, Work Status, and Satisfaction 12 Months after Trauma","We evaluated outcomes 12 months after trauma in terms of general health, satisfaction, and work status.Two hundred forty-seven patients without severe neurotrauma were evaluated by interview during admission and by mailed self-report 6 and 12 months after trauma. Data were obtained from the Trauma Registry, interviews, and survey instruments. Baseline assessment was obtained with the Short Form 36 (SF36) and the Sickness Impact Profile (SIP) work scale. Outcome measures were the SF36, SIP work scale, Brief Symptom Inventory (BSI) depression scale, the Civilian Mississippi Scale for Posttraumatic Stress Disorder (PTSD), and a satisfaction questionnaire. Three regressions were determined for outcome. The dependent variables were general health and work status (linear) and satisfaction (logistic). Each regression controlled for baseline status and mental health, Injury Severity Score (ISS), and 12-month SF36 physical function before evaluating the effect of outcome mental health.Follow-up data were available for 75% of the patients at 6 months and 51% at 12 months. The mean age of patients was 37.2 +/- 0.9 years (+/-SEM), and 73% were male. Their average ISS was 13.9 +/- 0.6. Seventy percent of injuries were blunt force, 13.5 % were penetrating, and 16.5 % were burn injuries (mean total body surface area, 13.3 +/- 1.5%). Sixty-four percent of the patients had returned to work at 12 months. Follow-up SF36 mental health was associated with the dependent outcome in each regression. After controlling for baseline status and mental health, ISS, and outcome SF36 physical function, outcome mental health was associated with outcome SF36 general health (p < 0.001), SIP work status (p = 0.017), and satisfaction with recovery (p = 0.005). Outcome SF36 mental health was related to baseline mental health, 12-month PTSD and BSI depression scores, and increased drug and alcohol use.Twelve months after trauma, patients' work status, general health, and overall satisfaction with recovery are dependent on outcome mental health. This dependency persists despite measured baseline status, ISS, or physical recovery. The mental disease after trauma is attributable to poor mental health, the development of symptoms of PTSD and depression, and increased substance abuse. Trauma centers that fail to recognize, assess, and treat these injury-related mental health outcomes are not fully assisting their patients to return to optimal function.",0,0 +5754,Loss as a determinant of PTSD in a cohort of adult survivors of the 1988 earthquake in Armenia: implications for policy,"To study the relationship of post-traumatic stress disorder (PTSD) to severity of the disaster experience.A sample of 1785 adult participants of an epidemiological study initiated in the immediate aftermath of the 1988 earthquake in Armenia were interviewed about 2 years following the disaster based on the NIMH DIS-Disaster Supplement. All 154 cases of pure PTSD were compared with 583 controls without symptoms satisfying psychiatric diagnoses of interest.PTSD cases included more persons from areas with the worst destruction. Having the highest level of education compared to lowest (OR 0.6 [95% CI 0.4-0.9]), being accompanied at the moment of the earthquake (OR 0.6 [95% CI 0.4-0.9]) and making new friends after the earthquake (OR 0.6 [95% CI 0.5-0.8]) were protective for PTSD. PTSD risk increased with the total amount of loss to the family (OR for highest level of loss 4.1 [95% CI 2.3-7.5]).Based on this large population sample, we believe that early support to survivors with high levels of loss may reduce PTSD following earthquakes.",0,0 +5755,Blood-based gene-expression biomarkers of post-traumatic stress disorder among deployed marines: A pilot study,"The etiology of post-traumatic stress disorder (PTSD) likely involves the interaction of numerous genes and environmental factors. Similarly, gene-expression levels in peripheral blood are influenced by both genes and environment, and expression levels of many genes show good correspondence between peripheral blood and brain tissues. In that context, this pilot study sought to test the following hypotheses: (1) post-trauma expression levels of a gene subset in peripheral blood would differ between Marines with and without PTSD; (2) a diagnostic biomarker panel of PTSD among high-risk individuals could be developed based on gene-expression in readily assessable peripheral blood cells; and (3) a diagnostic panel based on expression of individual exons would surpass the accuracy of a model based on expression of full-length gene transcripts. Gene-expression levels in peripheral blood samples from 50 U.S. Marines (25 PTSD cases and 25 non-PTSD comparison subjects) were determined by microarray following their return from deployment to war-zones in Iraq or Afghanistan. The original sample was carved into training and test subsets for construction of support vector machine classifiers. The panel of peripheral blood biomarkers achieved 80% prediction accuracy in the test subset based on the expression of just two full-length transcripts (GSTM1 and GSTM2). A biomarker panel based on 20 exons attained an improved 90% accuracy in the test subset. Though further refinement and replication of these biomarker profiles are required, these preliminary results provide proof-of-principle for the diagnostic utility of blood-based mRNA-expression in PTSD among trauma-exposed individuals.",0,0 +5756,CINP 2000 - Collegium Internationale Neuro-Psychopharmacologicum 22nd Congress.,"At this large and varied meeting on neuropharmacotherapy, progress was reported on the newer more selective antipsychotics. The selective D(2) dopamine receptor partial agonist, aripiprazole (Otsuka Pharmaceutical Co Ltd) was recently proved effective over the medium term. The atypical antipsychotics generally, such as clozapine, have a good side effect profile and better patient compliance, even in Parkinson's disease (PD). Reboxetine (Pharmacia & Upjohn AB), having a far greater selectivity for norepinephrine reuptake inhibition than for serotonin or dopamine reuptake, is of particular value in treating depression. Paroxetine (Novo Nordisk A/S), a selective serotonin reuptake inhibitor (SSRI), has just completed a multicenter clinical trial, being effective in about 50% of cases of post-traumatic stress disorder. A meta-analysis of trials of other uptake inhibitors showed that ability to block serotonin (rather than norepinephrine) uptake correlated well with efficacy. Bipolar and other disorders were hoped to benefit from more selective agents in the future, the potential for which has been revealed through basic neurobiology, with, for example, only non-alpha7 nicotinic receptor subunits being expressed by those interneurons mediating nicotinic responses. An open label, 30-day study of a pyrrolopyrimidine, the corticotrophin releasing factor (CRF) type 1 receptor inhibitor, NBI-30775 (Neurocrine Biosciences Inc/Janssen Pharmaceutica NV) produced good antidepressant effects, but has had to be abandoned as a product due to indications of potential liver damage. Similarly, although glial-derived neurotrophic factor (GDNF) had proved ineffective in a 1999 trial for PD, due to failure to access the striatum, there was however much evidence to suggest that small molecule agonists of the TRK-B receptor should be effective. Of these, quinones such as L-783281 (Merck Research Laboratories) appear to activate all TRK subtypes by a common intracellular, rather than receptormediated action, which may limit their usefulness. Although such agents would have many potential applications, it is likely that highly selective receptor activation will be needed.",0,0 +5757,Post-traumatic growth in parents after a child’s admission to intensive care: maybe Nietzsche was right?,"OBJECTIVE: The aim of this prospective study was to establish the degree to which parents report post-traumatic growth after the intensive care treatment of their child. DESIGN: Prospective cross-sectional cohort study. SETTING: Paediatric Intensive Care Unit (PICU). SUBJECTS: A total of 50 parents of children, admitted to PICU for >12 h. MEASUREMENTS AND RESULTS: Parents provided stress ratings as their child was discharged from PICU and, 4 months later, completed postal questionnaires rating their anxiety, depression, post-traumatic stress and post-traumatic growth. As much as 44 parents (88%) indicated on the Posttraumatic Growth Inventory (PTGI) [1] that they had experienced a positive change to a great degree as a result of their experiences in PICU. Parents of children who were ventilated (P = 0.024) reported statistically higher post-traumatic growth as did parents of older children (P = 0.032). PTGI scores were positively correlated with post-traumatic stress scores at 4 months (P = 0.021), but on closer inspection this relationship was found to be curvilinear. CONCLUSIONS: Post-traumatic growth emerged as a salient concept for this population. It was more strongly associated with moderate levels of post-traumatic stress, than high or low levels.",0,0 +5758,Survey of domestic violence among young adolescents in Slovenia,"OBJECTIVE: It has been estimated that domestic violence is wide spread in Slovenia, but the lack of empirical data of domestic violence prevalence and its consequences, aggravate the precise knowledge on the extension of the phenomenon. The aim of the study was to assess the extensiveness and characteristics of domestic violence in the group of Slovenian adolescents. SUBJECTS: 1297 young adolescents (age 13-15 years) from 65 Slovenian primary schools participated in the study. METHODS: A questionnaire for domestic violence experience and help seeking screening, McMaster Family Functioning Scale, Buss/Perry Aggression Questionnaire and Trauma Symptom Checklist for Childrentrade mark (TSCCtrade mark) have been applied. RESULTS: 18.7% of participants experienced violence in their own family (38.3% males and 61.7% females). Different patterns of verbal violence, irritability and indirect violence predominated. In the most cases of domestic violence the adolescent's parents were involved as perpetrators and their close relatives (brothers, sisters). Victims displayed a significant profile that could be linked with their violence experience: dysfunctional family environmental, aggressiveness, anxiety, depression, anger and posttraumatic stress symptoms. CONCLUSIONS: Presented study confirmed that the phenomenon of domestic violence and abused adolescents is quite widespread in Slovenia and that in the future more attention on research and policy making level should be given to this phenomenon. Particularly the perceived gap between attitudes towards support and the actually given help could be the orientation for developing a better prevention strategies and screening procedures for domestic violence. A proper intervention and protection of the adolescent victims could effectively prevent the outburst of depression, suicide, behavioural problems and, spreading the aggressive behaviour patterns to the future generations. Language: en",0,0 +5759,Tailoring therapeutic strategies for treating posttraumatic stress disorder symptom clusters,"According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, posttraumatic stress disorder (PTSD) is characterized by three major symptom clusters following an event that elicited fear, helplessness, or horror. This review will examine each symptom cluster of PTSD separately, giving case study examples of patients who exhibit a preponderance of a given symptom domain. We use a translational approach in describing the underlying neurobiology that is relevant to particular symptoms and treatment options, thus showing how clinical practice can benefit from current research. By focusing on symptom clusters, we provide a more specific view of individual patient's clinical presentations, in order to better address treatment needs. Finally, the review will also address potential genetic approaches to treatment as another form of individualized treatment.",0,0 +5760,Unique patterns of comorbidity in posttraumatic stress disorder from different sources of trauma,"While there are many studies of comorbidity in combat veterans with posttraumatic stress disorder (PTSD), studies of PTSD from other sources of trauma (e.g., disasters, crimes, and civil violence) are just beginning to emerge. This is the first formal review comparing patterns of comorbidity in PTSD from different sources of trauma. Specific attention is given to the relative frequencies of substance abuse, depression, generalized anxiety, phobic, panic, somatization, psychotic, and personality disorders. The findings reveal that although similarities exist, the comorbidity profiles differ according to the type of trauma experienced and the population studied. Additionally, the evidence suggests that the associated psychiatric disorders are not truly comorbid, but are interwoven with the PTSD.",0,0 +5761,Assessing post-traumatic stress symptoms in a Latino prison population,"Purpose – The purpose of this paper is to assess the reliability and validity of the Spanish version of the Davidson trauma scale (DTS-S) and to determine the prevalence and correlates of post-traumatic stress disorder (PTSD) symptoms in a non-clinical random sample of prison inmates. Design/methodology/approach – Probabilistic samples of 1,179 inmates from 26 penal institutions in Puerto Rico were selected using a multistage sampling design. Population estimates and correlations were obtained for PTSD, generalized anxiety and depression. The reliability, factor structure, and convergent validity of the DTS-S were assessed. Cross-validation was employed to confirm the results of the factor analyses. Findings – Using the cut-offs adopted by the scale's author, 136 (13.4 percent) of the inmates are likely to have current PTSD and 117 (11.6 percent) reach the cut-off for sub-threshold PTSD. Confirmatory factor analysis generated two factors explaining 53 percent of the variance. High reliabilities were obtained for the total scale (α=0.95) and for the frequency and severity scales (α=0.90 and 0.91). Significantly higher DTS-S scores were found for females ( t =2.26, p <0.025), for inmates diagnosed with depression or anxiety ( t =2.02, p <0.05), and those reporting suicide attempts ( t =4.47, p <0.0001). Originality/value – Findings support that the DTS-S is a reliable and valid measure to assess PTSD symptoms in Latino inmate populations and to identify individuals at risk for the disorder that require confirmatory diagnosis and clinical interventions.",0,0 +5762,Reduced autobiographical memory specificity predicts depression and posttraumatic stress disorder after recent trauma.,"In this prospective longitudinal study, the authors examined the relationship between reduced specificity in autobiographical memory retrieval and the development of depression, posttraumatic stress disorder (PTSD), and specific phobia after injury in an assault. Assault survivors (N = 203) completed the Autobiographical Memory Test (J. M. G. Williams & K. Broadbent, 1986) at 2 weeks after the trauma as well as structured clinical interviews at 2 weeks and 6 months. Participants with acute stress disorder or major depression at 2 weeks, but not those with phobia, retrieved fewer specific autobiographical memories than those without the respective disorder. Reduced memory specificity at 2 weeks also predicted subsequent PTSD and major depression at 6 months over and above what could be predicted from initial diagnoses and symptom severity. Moderator analyses showed that low memory specificity predicted later depression in participants with prior episodes of major depression but not in those without prior depression. Mediation analyses suggested that rumination partly mediated and perceived permanent change fully mediated the effects of low memory specificity on posttrauma psychopathology at follow-up.",0,0 +5763,An examination of the structural link between post-traumatic stress symptoms and chronic pain in the framework of fear-avoidance models,"The tendency to respond with fear and avoidance can be seen as a shared vulnerability contributing to the development of post-traumatic stress disorder (PTSD) and chronic pain. Although several studies have examined which specific symptoms of PTSD (re-experiencing, avoidance, emotional numbing and hyperarousal) are associated with chronic pain, none has considered this association within the framework of fear-avoidance models.Seven hundred fourteen patients with chronic musculoskeletal pain were assessed. Of these, 149 patients were selected for the study based upon the following inclusion criteria: exposure to a traumatic event before the onset of pain (with scores equal to or higher than 8 points on the fear and hopelessness scales of the Stressful Life Event Screening Questionnaire Revised) and scores equal to or higher than 30 on the Davidson Trauma Scale.Structural equation modelling was used to test the association between PTSD symptoms and pain outcomes (pain intensity and disability) using the mediating variables considered in the fear-avoidance models. The results show that emotional numbing and hyperarousal symptoms, but neither re-experiencing nor avoidance, affected pain outcome via anxiety sensitivity (AS), catastrophizing and fear of pain. PTSD symptoms increased the levels of AS, which predisposes to catastrophizing and, in turn, had an effect on the tendency of pain patients to respond with more fear and avoidance.This study provides empirical support for the potential role of PTSD symptoms in fear-avoidance models of chronic pain and suggests that AS is a relevant variable in the relationship between both disorders.",0,0 +5764,Mental and physical disability after sepsis.,"Sepsis remains a major cause of admissions to Intensive Care Units (ICU) and has a high mortality rates and significant morbidity in survivors. There are physical, cognitive and psychological sequelae from severe sepsis that have a negative effect on the patients' health related quality of life in the longer term and a social care and humanitarian impact. Although muscle mass loss during the septic period happens very quickly, recovery takes a considerable time and requires the patient to commit to exercising and eating well to rebuild. Where cognitive impairment has resulted from the septic illness the patients' ability to look after themselves may be affected and this has financial and family implications for future care. Patients may also develop psychological problems such as anxiety, depression or post traumatic stress disorder (PTSD), which can have a profound effect on their everyday functioning and the possibility of returning to work. As yet there are no published studies of rehabilitation with patients surviving severe sepsis, although there is one in progress at the moment. The use of techniques such as ICU diaries to help patients to understand their illness and deal with delusional memories they may have from their ICU stay has been shown to aid psychological recovery in general ICU patients, a percentage of whom will have suffered from sepsis. The use of a self-guided manualised 6 week rehabilitation program, the ICU Recovery Manual, has been shown to accelerate physical recovery in general ICU patients. Considerable amounts of money are spent treating patients with severe sepsis in ICU and not completing the job of returning them to as close as possible to their normal functioning does not make financial sense.",0,0 +5765,"Stress doses of hydrocortisone, traumatic memories, and symptoms of posttraumatic stress disorder in patients after cardiac surgery: a randomized study","Traumatic experiences associated with cardiac surgery (CS) can result in traumatic memories and posttraumatic stress disorder (PTSD). Because it is known that subjects who develop PTSD often show sustained reductions in circulating cortisol concentrations, we performed a prospective, randomized study to examine whether exogenously administered stress doses of hydrocortisone during the perioperative period of CS reduces the long-term incidence of chronic stress and PTSD symptoms.Patients (n = 91) were prospectively randomized to receive either stress doses of hydrocortisone or standard treatment during the perioperative period of CS. Of 48 available patients at 6 months after CS, 26 had received stress doses of hydrocortisone and 22 standard treatment. Traumatic memories and PTSD symptoms were diagnosed with previously validated questionnaires.As compared with patients after standard therapy, patients from the hydrocortisone group had significantly lower chronic stress symptom scores (p <.05). There was no significant difference regarding the number or type of traumatic memories between the hydrocortisone and the standard treatment groups.Stress doses of hydrocortisone in patients undergoing CS are associated with a lower intensity of chronic stress and PTSD symptoms at 6 months after CS.",0,0 +5766,Traumatic experiences and post-traumatic stress disorder in Kurdistanian children and their parents in homeland and exile: An epidemiological approach,"The prevalence and correlates of post-traumatic stress disorder (PTSD) were assessed in random samples of school-aged Kurdistanian children and their parents in homeland and exile. Of the 376 eligible children at the two sites, 312 children and their parents (293 mothers and 248 fathers) completed the Harvard-Uppsala Trauma Questionnaire and Posttraumatic Stress Symptom interviews for children, and Harvard Trauma Questionnaire for parents. Unlike their children, fathers showed significantly higher PTSD frequencies in exile than in the homeland. The fathers' PTSD negatively correlated with the living standard and fathers' education, while child PTSD mostly correlated with maternal education and living in exile. Living in exile seems to have a negative impact on fathers' post-traumatic reactions, despite its positive influence on children. High drop-outs in exile limit the conclusions.",0,0 +5767,Complexities in Understanding the Role of Compensation-Related Factors on Recovery From Whiplash-Associated Disorders,"Focused discussion.To present some of the complexities in conducting research on the role of compensation and compensation-related factors in recovery from whiplash-associated disorders (WAD) and to suggest directions for future research.There is divergence of opinion, primary research findings, and systematic reviews on the role of compensation and/or compensation-related factors in WAD recovery.The topic of research of compensation/compensation-related factors was discussed at an international summit meeting of 21 researchers from diverse fields of scientific enquiry. This article summarizes the main points raised in that discussion.Traffic injury compensation is a complex sociopolitical construct, which varies widely across jurisdictions. This leads to conceptual and methodological challenges in conducting and interpreting research in this area. It is important that researchers and their audiences be clear about what aspect of the compensation system is being addressed, what compensation-related variables are being studied, and what social/economic environment the compensation system exists in. In addition, summit participants also recommended that nontraditional, sophisticated study designs and analysis strategies be employed to clarify the complex causal pathways and mechanisms of effects.Care must be taken by both researchers and their audiences not to overgeneralize or confuse different aspects of WAD compensation. In considering the role of compensation/compensation-related factors on WAD and WAD recovery, it is important to retain a broad-based conceptualization of the range of biological, psychological, social, and economic factors that combine and interact to define and determine how people recover from WAD.",0,0 +5768,"Longitudinal Relationships Between Neuroticism, Avoidant Coping, and Posttraumatic Stress Disorder Symptoms in Adolescents Following the 2008 Wenchuan Earthquake in China","The Wenchuan earthquake, which occurred in southwestern China in May 2008, was a source of severe psychological distress to adolescents. This study explored the developmental trajectory of posttraumatic stress disorder (PTSD) symptoms and the longitudinal relationships between neuroticism, avoidant coping, and PTSD symptoms measured at three time points: 1 year (T1), 1.5 years (T2), and 2 years (T3) after the earthquake. The participants included 636 adolescents from several high schools located in the areas that were most severely affected by the earthquake. Structural equation modeling results revealed bidirectional effects between neuroticism, avoidant coping, and PTSD symptoms. More severe PTSD symptoms predicted higher levels of avoidant coping at T1–T2 and T2–T3 but only predicted higher levels of neuroticism at T1–T2. Higher levels of neuroticism at T1 predicted more severe PTSD symptoms at T1–T2, while higher levels of avoidant coping at T1 predicted more severe PTSD symptoms at T2–T3.",0,0 +5769,Neurobehavioral Outcome of Children's Mild Traumatic Brain Injury,"Brain damage is underestimated as a public health and personal problem. The common belief in a good prognosis for childhood brain damage is unsubstantiated. It is based on lack of rigorous study and examiner satisfaction with a low response level. Occult brain trauma plagues victims into maturity. Above a rather low threshold of injury (even without focal neurologic findings), cognitive, personality, and adaptive dysfunctions are common and impairing. Child abuse signals were described. Brain lesions impair both matured functions and those expressed later. Dysfunctions were discussed for these neurobehavioral systems: consciousness, attention and tonic motor level; sensorimotor and body schema; neurophysiologic; cerebral personality; intelligence; memory; language; information processing; posttraumatic stress and mood; identity and insight; adaptivity in the community. Outcome evolves from complex pathologic, neurologic, anatomic, and personality parameters, the postinjury interval and child's age, the maturity and developmental trajectory of the function, social support, and emotional reaction to impairment. Assessment should study the entire range of functions, utilizing records, collaterals, observation, and qualitative and psychometric measurement. Complex, challenging, and ecologically relevant tasks are appropriate. There are several patterns of outcome: immediate permanent deficits; improvement through compensatory mechanisms, but with subclinical deficits; and initial progress with delayed expression (premature plateau of cognitive and personality maturity; physiologic developmental deficits). Confirmation of mild TBI may require several years of observation to determine late dysfunctions and deviation from preinjury or postinjury performance or expected level of development.",0,0 +5770,Post-traumatic stress disorder caused in mentally disordered offenders by the committing of a serious violent or sexual offence,"The aim of the study was to measure in a sample of mentally disordered offenders the frequency of post-traumatic stress disorder (PTSD) symptoms related to the committing of an offence and to consider what factors might be contributory to the onset and maintenance of these symptoms. The study was the first to investigate the incidence of PTSD in a primarily mentally ill population. A sample of 37 mentally disordered offenders was assessed for PTSD according to the Diagnostic and Statistical Manual of Mental Disorders (DSM III-R; American Psychiatric Association, 1987) and the Impact of Events Scale (IES; Horowitz, Wilner and Alvarez, 1979). Of this sample, 33% met diagnostic criteria for PTSD and 54% had significant PTSD symptomatology as indexed by the IES. The IES scores were greater in those who had committed violent offences than in those who had committed sexual offences, and in those who had an affective diagnosis. Frequency of PTSD symptoms was greater in those offenders who now felt regret for their actions. The high frequency of PTSD symptoms in this population may serve as a significant stressor and may exacerbate co-morbid psychiatric illness and contribute to poor treatment response and relapse. Many mental illnesses are exacerbated by stress and the presence of untreated PTSD symptoms may serve to prevent treatment gains for the primary mental disorder. If risk of future dangerous-ness is associated with unstable mental state, as is often the case in a mentally disordered population, then the development of PTSD post-offence may serve to prolong or increase risk of harm to both self and others.",0,0 +5771,Lifetime trauma and associated mental health symptoms in homeless women: Impulsivity as a feature of posttraumatic stress disorder and addiction,"This study aimed to provide a comprehensive assessment of the lifetime traumatic experiences of homeless women, and to explore the linkage between trauma, posttraumatic stress disorder (PTSD), and substance use problems. One hundred adult homeless women were assessed. Descriptive data on trauma histories show that three-quarters of the sample experienced some form of childhood trauma, and 58% experienced childhood sexual trauma. Trauma in childhood was predictive of trauma in adulthood. As hypothesized, indirect evidence of the self-medication hypothesis was provided by a path analysis showing a linear relationship between trauma and substance use consequences that was mediated by PTSD symptoms. Measures of future time perspective, and self-report and behavioral measures of impulsivity did not converge to indicate a single shared common factor, though the self-report measure of trait impulsivity was predictive of both PTSD and substance use consequences. This study suggests that homeless women have extensive trauma histories that often begin in childhood, they likely use substances to cope, and that trait impulsivity may itself represent a common factor of both PTSD and SUD. Clinical implications are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5772,"Trauma, attempted suicide, and morning cortisol in a community sample of adolescents","Individuals exposed to trauma or who have attempted suicide may show abnormal cortisol profiles; those exposed to significant trauma show reduced, while those who attempt suicide show increased cortisol output, although the evidence is inconsistent. This study explores the associations between morning cortisol, trauma, and suicide attempts or ideation among young people. In a community-based sample of 501 15-year-olds, using data from a DSM-IV-compatible interview on suicidal-behavior/ideation, trauma, and morning cortisol, we found no association between these factors and morning cortisol. A significant gender interaction was found for those threatened with a weapon-men showing a negative and women a positive association, suggesting that any cortisol/trauma association may be partially explained by coexisting behavioral problems and gender.",0,0 +5773,Developing and Implementing Randomized Effectiveness Trials in General Medical Settings.,"This article discusses the development of two mental health services research programs: one targeting depression treatment in primary care and the other early intervention for posttraumatic stress disorders in acute care. Both programs have used the randomized effectiveness trial to assess the delivery of empirically supported psychotherapeutic and psychopharmacologic interventions in these general medical settings. This article explores the fellowship training, clinical experiences, and conceptual frameworks that have informed the progression of the two research programs. Specific modifications to the traditional randomized clinical trial design employed in the effectiveness trials are discussed. This article concludes with reflection on intervention development trajectories and interdisciplinary team compositions that may facilitate the development of mental health interventions that both derive from the best scientific evidence and can be feasibly delivered in real-world treatment settings.",0,0 +5774,Effects of exogenous glucocorticoid on combat-related PTSD symptoms.,"Very few systematic human studies focus on changing the underlying traumatic memory after posttraumatic stress disorder (PTSD) has been established. Evidence from animal and human studies indicates that cortisol can be used to address traumatic memories. This translational pilot study is based on our previous rodent research in which extinction of fear memories was enhanced by glucocorticoids. The current study aims to assess the effectiveness of glucocorticoids in augmenting memory extinction and reducing clinical symptoms in veterans with combat-related PTSD.In a double-blind, placebo-controlled study, veterans with combat-related PTSD were exposed to a memory reactivation task using well established imagery and psychophysiology assessment technique followed by administration of either glucocorticoid or placebo.One week after glucocorticoid or placebo administration, participants who received the study medication showed significant PTSD-related symptom (cluster C) improvement compared with control participants who received placebo only. However, reduction of symptoms degraded at a 1-month postadministration assessment.These findings are consistent with a glucocorticoid-mediated enhancement of extinction to ameliorate PTSD symptoms. The use of traumatic memory reactivation temporally paired with glucocorticoid administration holds potential for developing a viable therapeutic option.",0,0 +5775,The unfairness of it all: Exploring the role of injustice appraisals in rehabilitation outcomes.,"A fundamental principle of rehabilitation psychology is that individual appraisals of the social and physical environment-including injury itself-have profound consequences for coping and adjustment. When core assumptions of a just and predictable world are violated and accompanied by ostensibly undeserved suffering and loss, perceptions of injustice can arise. Given the role of appraisal processes in adjustment to disability, mounting empirical support, and absence of targeted interventions, the current article considers perceptions of injustice regarding personal injury/disability as a fundamental appraisal affecting rehabilitation outcomes.The authors review theory underpinning the relevance of injustice appraisals and critically examine existing literature regarding the impact of perceived injustice and related constructs (i.e., attribution of blame, anger, and belief in a just world) on adjustment following injury.The authors bring attention to perceptions of injustice regarding personal injury/disability as a fundamental appraisal affecting rehabilitation outcomes. Dimensions of the social environment that have not received substantial attention in current research on condition-related injustice appraisals are highlighted.Perceived injustice is a potentially central appraisal process to physical and psychological outcomes in the context of rehabilitation. Research regarding the role of perceived injustice, related constructs, and potential social/environmental modulators of injustice perception is still in its infancy. Guided buy its foundational principles, the field of rehabilitation psychology can broaden and shape inquiry regarding perceived injustice. This article aims to guide future research, offer concepts for key areas of discourse, and consider potential interventions in the rehabilitation psychology domain.",0,0 +5776,Changes in Social Adjustment With Cognitive Processing Therapy: Effects of Treatment and Association With PTSD Symptom Change,"The current study sought to determine if different spheres of social adjustment, social and leisure, family, and work and income improved immediately following a course of cognitive processing therapy (CPT) when compared with those on a waiting list in a sample of 46 U.S. veterans diagnosed with posttraumatic stress disorder (PTSD). We also sought to determine whether changes in different PTSD symptom clusters were associated with changes in these spheres of social adjustment. Overall social adjustment, extended family relationships, and housework completion significantly improved in the CPT versus waiting-list condition, η(2) = .08 to .11. Hierarchical multiple regression analyses revealed that improvements in total clinician-rated PTSD symptoms were associated with improvements in overall social and housework adjustment. When changes in reexperiencing, avoidance, emotional numbing, and hyperarousal were all in the model accounting for changes in total social adjustment, improvements in emotional numbing symptoms were associated with improvements in overall social, extended family, and housework adjustment (β = .38 to .55). In addition, improvements in avoidance symptoms were associated with improvements in housework adjustment (β = .30), but associated with declines in extended family adjustment (β = -.34). Results suggest that it is important to consider the extent to which PTSD treatments effectively reduce specific types of symptoms, particularly emotional numbing and avoidance, to generally improve social adjustment.",0,0 +5777,Female Students and Cultures of Violence in Cities,,0,0 +5778,Epigenetics of Stress-Related Psychiatric Disorders and Gene × Environment Interactions,"A deeper understanding of the pathomechanisms leading to stress-related psychiatric disorders is important for the development of more efficient preventive and therapeutic strategies. Epidemiological studies indicate a combined contribution of genetic and environmental factors in the risk for disease. The environment, particularly early life severe stress or trauma, can lead to lifelong molecular changes in the form of epigenetic modifications that can set the organism off on trajectories to health or disease. Epigenetic modifications are capable of shaping and storing the molecular response of a cell to its environment as a function of genetic predisposition. This provides a potential mechanism for gene-environment interactions. Here, we review epigenetic mechanisms associated with the response to stress and trauma exposure and the development of stress-related psychiatric disorders. We also look at how they may contribute to our understanding of the combined effects of genetic and environmental factors in shaping disease risk.",0,0 +5779,"Compensation and Pension Evaluations: Psychotic, Neurotic, and Post-Traumatic Stress Disorder Millon Clinical Multiaxial Inventory II Profiles","The purpose of the present work was to provide an examination of the three major VA adjudication classifications (post-traumatic stress disorder [PTSD], psychotic, and neurotic) through objective psychological testing. During routine follow-up compensation and pension evaluations, 143 patients were given the Millon Clinical Multiaxial Inventory II (MCMI-II). Additionally, their current disability diagnoses as well as their current percentage of disability were coded. Discriminant function analysis revealed that the pivotal discriminatory variables were alcohol abuse for the PTSD patients, thought disorder for the psychotics, and anxiety for the neurotics. This is remarkably consistent with general clinical expectations. This should allow for more specific use of the MCMI-II in compensation and pension examinations by Department of Veterans' Affairs psychologists.",0,0 +5780,Childhood and Current Determinants of Heavy Drinking in Early Adulthood,"To explore the association of parental education, childhood living conditions and several adversities with heavy drinking in early adulthood, and to analyze the effect of the respondent's current circumstances on these associations.The analyses were conducted in a sample of 1234 adults aged 18-29 years participating in the Finnish Health 2000 Survey (65% of the original representative two-stage cluster sample, N = 1894). The outcome measure was heavy drinking measured by g/week for pure alcohol (for men >or=280 g/week and for women >or=140 g/week).8% of young adult men and 5% of women were heavy drinkers. In both genders, parental alcohol problems and other childhood adversities, poor own education, and unemployment status increased the risk of heavy drinking. The impact of childhood on heavy drinking was partly independent and partly mediated by adult characteristics, in particular, for both genders, low level of education.Childhood adversities are associated with heavy drinking in early adulthood among both genders. Childhood social circumstances as well as low educational level and unemployment should be taken into account in planning preventive policies to tackle the harms caused by excessive alcohol use at the individual and population level.",0,0 +5781,Cytokine production as a putative biological mechanism underlying stress sensitization in high combat exposed soldiers,"Combat stress exposed soldiers may respond to post-deployment stressful life events (SLE) with increases in symptoms of posttraumatic stress disorder (PTSD), consistent with a model of stress sensitization. Several lines of research point to sensitization as a model to describe the relations between exposure to traumatic events, subsequent SLE, and symptoms of PTSD. Based on previous findings we hypothesized that immune activation, measured as a high in vitro capacity of leukocytes to produce cytokines upon stimulation, underlies stress sensitization.We assessed mitogen-induced cytokine production at 1 month, SLE at 1 year, and PTSD symptoms from 1 month up to 2 years post-deployment in soldiers returned from deployment to Afghanistan (N=693). Exploratory structural equation modeling as well as latent growth models were applied.The data demonstrated significant three-way interaction effects of combat stress exposure, cytokine production, and post-deployment SLE on linear change in PTSD symptoms over the first 2 years following return from deployment. In soldiers reporting high combat stress exposure, both high mitogen-stimulated T-cell cytokine production and high innate cytokine production were associated with increases in PTSD symptoms in response to post-deployment SLE. In low combat stress exposed soldiers as well as those with low cytokine production, post-deployment SLE were not associated with increases in PTSD symptoms.High stimulated T-cell and innate cytokine production may contribute to stress sensitization in recently deployed, high combat stress exposed soldiers. These findings suggest that detecting and eventually normalizing immune activation may potentially complement future strategies to prevent progression of PTSD symptoms following return from deployment.",0,0 +5782,The Millennium Cohort Family Study: a prospective evaluation of the health and well-being of military service members and their families,"The need to understand the impact of war on military families has never been greater than during the past decade, with more than three million military spouses and children affected by deployments to Operations Iraqi Freedom and Enduring Freedom. Understanding the impact of the recent conflicts on families is a national priority, however, most studies have examined spouses and children individually, rather than concurrently as families. The Department of Defense (DoD) has recently initiated the largest study of military families in US military history (the Millennium Cohort Family Study), which includes dyads of military service members and their spouses (n > 10,000). This study includes US military families across the globe with planned follow-up for 21+ years to evaluate the impact of military experiences on families, including both during and after military service time. This review provides a comprehensive description of this landmark study including details on the research objectives, methodology, survey instrument, ancillary data sets, and analytic plans. The Millennium Cohort Family Study offers a unique opportunity to define the challenges that military families experience, and to advance the understanding of protective and vulnerability factors for designing training and treatment programs that will benefit military families today and into the future.",0,0 +5783,Assessing possible DSM-5 ASD subtypes in a sample of victims meeting caseness for DSM-5 ASD based on self-report following multiple forms of traumatic exposure,"Acute stress disorder (ASD) was introduced into the DSM-IV to recognize early traumatic responses and as a precursor of PTSD. Although the diagnostic criteria for ASD were altered and structured more similarly to the PTSD definition in DSM-5, only the PTSD diagnosis includes a dissociative subtype. Emerging research has indicated that there also appears to be a highly symptomatic subtype for ASD. However, the specific nature of the subtype is currently unclear. The present study investigates the possible presence of ASD subtypes in a mixed sample of victims meeting caseness for DSM-5 ASD based on self-report following four different types of traumatic exposure (N=472). The results of latent profile analysis revealed a 5-class solution. The highly symptomatic class was marked by high endorsement on avoidance and dissociation compared to the other classes. Findings are discussed in regard to its clinical implications including the implications for the pending the ICD-11 and the recently released DSM-5.",0,0 +5784,Post-Traumatic Stress Disorder in Turkish Child and Adolescent Survivors Three Years after the Marmara Earthquake,"The study investigated the emergence of post-traumatic stress disorder (PTSD) symptoms in child and adolescent survivors in Turkey three years after the 1999 Marmara Earthquake, with consideration of the severity of exposure and the survivors' gender and age. A representative sample of 293 young earthquake survivors (152 female and 141 male between the ages of 8 and 15) participated in the study. Participants' scores on the Post-Traumatic Stress Disorder Reaction Index for Children indicated that 31.4% reported moderate, 24.2% reported severe, and 3.8% reported very severe traumatic stress reactions. Analysis of the Revised Impact of Events Scale for Children scores revealed that 56% reported severe PTSD symptoms. While severity of exposure and gender were significantly associated with severity of PTSD symptoms, age was not related to PTSD symptoms. The results indicated a high need for addressing the mental health problems of the child and adolescent trauma survivors in Turkey.",0,0 +5785,"Five years after the accident, whiplash casualties still have poorer quality of life in the physical domain than other mildly injured casualties: analysis of the ESPARR cohort","This study aims to compare health status and quality of life five years after a road accident between casualties with whiplash versus other mild injuries, to compare evolution of quality of life at 1 and 5 years after the accident, and to explore the relation between initial injury (whiplash vs. other) and quality of life.The study used data from the ESPARR cohort (a representative cohort of road accident casualties) and included 167 casualties with ""pure"" whiplash and a population of 185 casualties with other mild injuries (MAIS-1). All subjects with lesions classified as cervical contusion (AIS code 310402) or neck sprain (AIS code 640278) were considered as whiplash casualties. Diagnosis was made by physicians, at the outset of hospital care, based on interview, clinical findings and X-ray. Whiplash injuries were then classified following the Quebec classification (grades 1 and 2). Quality of life was assessed on the WHOQoL-Bref questionnaire. Correlations between explanatory variables and quality of life were explored by Poisson regression and variance analysis.Between 1 and 5 years, global QoL improved for both whiplash and non-whiplash casualties; but, considering the two whiplash groups separately, improvement in grade 2 was much less than in grade 1. At 5 years, grade-2 whiplash casualties were more dissatisfied with their health (39.4%; p < 0.05) than non-whiplash (24.3%) or grade-1 whiplash casualties (27.0%). Deteriorated quality of life in the mental, social and environmental domains was mainly related to psychological and socioeconomic factors for both whiplash and other mildly injured road-accident casualties. While PTSD was a major factor for the physical domain, whiplash remained a predictive factor after adjustment on PTSD; unsatisfactory health at 5 years, with deteriorated quality of life in the physical domain, was observed specifically in the whiplash group, pain playing a predominant intermediate role.Deteriorated quality of life in the physical domain remained 5 years after the accident, specifically in the grade-2 whiplash group, pain playing a predominant intermediate role, which may be in line with the hypothesis of neuropathic pain.",0,0 +5786,Towards a multifaceted understanding of revenge and forgiveness,"Abstract We focus on two aspects: First, we argue that it is necessary to include implicit forgiveness as an additional adaptive behavioral option to the perception of interpersonal transgressions. Second, we present one possible way to investigate the cognitive-affective underpinnings of revenge and forgiveness: a functional MRI (fMRI) approach aiming at integrating forgiveness and revenge mechanisms into a single paradigm.",0,0 +5787,Assessing the co-occurrence of intimate partner violence domains across the life-course: relating typologies to mental health,"The inter-generational transmission of violence (ITV) hypothesis and polyvictimisation have been studied extensively. The extant evidence suggests that individuals from violent families are at increased risk of subsequent intimate partner violence (IPV) and that a proportion of individuals experience victimisation across multiple rather than single IPV domains. Both ITV and polyvictimisation are shown to increase the risk of psychiatric morbidity, alcohol use, and anger expression.The current study aimed to 1) ascertain if underlying typologies of victimisation across the life-course and over multiple victimisation domains were present and 2) ascertain if groupings differed on mean scores of posttraumatic stress disorder (PTSD), depression, alcohol use, and anger expression.University students (N=318) were queried in relation to victimisation experiences and psychological well-being. Responses across multiple domains of IPV spanning the life-course were used in a latent profile analysis. ANOVA was subsequently used to determine if profiles differed in their mean scores on PTSD, depression, alcohol use, and anger expression.Three distinct profiles were identified; one of which comprised individuals who experienced ""life-course polyvictimisation,"" another showing individuals who experienced ""witnessing parental victimisation,"" and one which experienced ""psychological victimisation only."" Life-course polyvictims scored the highest across most assessed measures.Witnessing severe physical aggression and injury in parental relationships as a child has an interesting impact on the ITV into adolescence and adulthood. Life-course polyvictims are shown to experience increased levels of psychiatric morbidity and issues with alcohol misuse and anger expression.",0,0 +5788,Traumatische Erfahrungen in der älteren deutschen Bevölkerung,"Background: World War II (WWII) is probably the most distressing and fatal historical event in Europe's recent past. Research on mental and physical health sequelae of these traumatic experiences from WWII has only started recently. Objectives: An overview on the findings from several population-based studies investigating the mental and physical health outcomes of traumatic experiences in the German elderly (born prior to 1946), especially from WWII, is given. Material and methods: The results presented here are based on several population-based representative studies regarding several aspects of mental and physical health in the elderly. Results: About 40-50 % of the elderly German population report at least one traumatic event, mostly from WWII. Traumatic experiences are related to higher rates of depressive and somatoform disorders, posttraumatic stress disorder, and physical morbidity, which are associated with increased health care utilization. Conclusion: The findings underline that the negative effects on health are long-term, manifold, and serious. Some of the elderly need psychotherapeutic interventions. Thus, a specific internet-based psychotherapeutic approach (ITT) is briefly presented. However, the majority of the elderly generally use other kinds of medical care, such as primary care, inpatient care, and geriatric care. It seems useful and necessary to pay more attention to the historical and biographical backgrounds of the patients to see and understand the current symptoms from this aspect. © 2014 Springer-Verlag Berlin Heidelberg.",0,0 +5789,Risperidone Treatment of Preschool Children with Thermal Burns and Acute Stress Disorder,"Pharmacologic treatment of acute stress disorder (ASD) is a novel area of investigation across all age groups. Very few clinical drug trials have been reported in children and adolescents diagnosed with ASD. Most of the available, potentially relevant, data are from studies of adults with posttraumatic stress disorder (PTSD). The atypical antipsychotic agents have been reported to be effective as an adjunctive treatment for adults with PTSD. There have been a limited number of studies published regarding atypical antipsychotic treatment of PTSD in children and adolescents, and there is no current literature available on the use of these agents for children with ASD. This report describes the successful treatment of three preschool-aged children with serious thermal burns as a result of physical abuse or neglect. Each of these children was hospitalized in a tertiary-care children's hospital and was diagnosed with ASD. In all cases, risperidone provided rapid and sustained improvement across all symptom clusters of ASD at moderate dosages. Minimal to no adverse effects were reported. These cases present preliminary evidence for the potential use of risperidone in the treatment of ASD in childhood.",0,0 +5790,Specificity of abnormal brain volume in major depressive disorder: A comparison with borderline personality disorder,"Abnormal brain volume has been frequently demonstrated in major depressive disorder (MDD). It is unclear if these findings are specific for MDD since aberrant brain structure is also present in disorders with depressive comorbidity and affective dysregulation, such as borderline personality disorder (BPD). In this transdiagnostic study, we aimed to investigate if regional brain volume loss differentiates between MDD and BPD. Further, we tested for associations between brain volume and clinical variables within and between diagnostic groups.22 Females with a DSM-IV diagnosis of MDD, 17 females with a DSM-IV diagnosis of BPD and without comorbid posttraumatic stress disorder, and 22 age-matched female healthy controls (HC) were investigated using magnetic resonance imaging. High-resolution structural data were analyzed using voxel-based morphometry.A significant (p<0.05, cluster-corrected) volume decrease of the anterior cingulate cortex (ACC) was found in MDD compared to HC, as opposed to volume decreases of the amygdala in BPD compared to both HC and MDD. Sensitivity and specificity of regional gray matter volume for a diagnosis of MDD were modest to fair. Amygdala volume was related to depressive symptoms across the entire patient sample.Potential limitations of this study include the modest sample size and the heterogeneous psychotropic drug treatment.ACC volume reduction is more pronounced in MDD with an intermediate degree of volume loss in BPD compared to HC. In contrast, amygdala volume loss is more pronounced in BPD compared to MDD, yet amygdala volume is associated with affective symptom expression in both disorders.",0,0 +5791,Modeling of Community Integration Trajectories in the First Five Years after Traumatic Brain Injury,"The aims of this study were to assess the trajectories of community integration in individuals with traumatic brain injury (TBI) through one, two, and five years post-injury and to examine whether those trajectories could be predicted by demographic and injury characteristics. A longitudinal cohort study was conducted with 105 individuals with moderate-to-severe TBI admitted to a trauma referral center in 2005-2007. Demographics and injury-related factors were extracted from medical records. At the one-, two- and five-year follow-ups, community integration was measured by the Community Integration Questionnaire (CIQ). A hierarchical linear model (HLM) examined whether longitudinal trajectories of community integration could be predicted by: time, sex, age, relationship status, education, employment status, occupation, acute Glasgow Coma Scale score, cause of injury, days in post-traumatic amnesia (PTA), computed tomography Marshall Score, and Injury Severity Score. CIQ scores improved across the three time-points (p<0.001). Additionally, higher trajectories of community integration were predicted by being single at the time of injury (p<.001), higher level of education (p=0.006), employment (p<0.001), and a shorter length of PTA (p<0.001). In a follow-up HLM with interaction terms, time*PTA was statistically significant (p<0.001), suggesting that participants with longer PTA increased in community integration more rapidly than those with shorter PTA. The longitudinal course of community integration described in this study may help rehabilitation professionals to plan more extensive follow-ups and targeted rehabilitation programs in the early stage of recovery for patients with specific demographic and injury characteristics.",0,0 +5792,Latent growth mixture models: an important new tool for developmental researchers,"This manuscript by Connell and Frye (Infant Child Dev 2006; 15(6): 609–621) provides a clear example of the application of latent growth mixture models (LGMM) to the development of antisocial behaviour in adolescence. The LGMM approach is discussed in the context of this example, and factors influencing the results achieved with these methods are highlighted. Overall, developmental psychologists have much to gain from the use of these new approaches. Copyright © 2006 John Wiley & Sons, Ltd.",0,0 +5793,The role of anger and ongoing stressors in mental health following a natural disaster,"Objective: Research has established the mental health sequelae following disaster, with studies now focused on understanding factors that mediate these outcomes. This study focused on anger, alcohol, subsequent life stressors and traumatic events as mediators in the development of mental health disorders following the 2009 Black Saturday Bushfires, Australia’s worst natural disaster in over 100 years. Method: This study examined data from 1017 (M = 404, F = 613) adult residents across 25 communities differentially affected by the fires and participating in the Beyond Bushfires research study. Data included measures of fire exposure, posttraumatic stress disorder, depression, alcohol abuse, anger and subsequent major life stressors and traumatic events. Structural equation modeling assessed the influence of factors mediating the effects of fire exposure on mental health outcomes. Results: Three mediation models were tested. The final model recorded excellent fit and observed a direct relationship between disaster exposure and mental health outcomes (b = .192, p < .001) and mediating relationships via Anger (b = .102, p < .001) and Major Life Stressors (b = .128, p < .001). Each gender was compared with multiple group analyses and while the mediation relationships were still significant for both genders, the direct relationship between exposure and outcome was no longer significant for men ( p = .069), but remained significant (b = .234, p < .001) for women. Conclusions: Importantly, anger and major life stressors mediate the relationship between disaster exposure and development of mental health problems. The findings have significant implications for the assessment of anger post disaster, the provision of targeted anger-focused interventions and delivery of government and community assistance and support in addressing ongoing stressors in the post-disaster context to minimize subsequent mental health consequences.",0,0 +5794,Resilience as process,"Abstract Resilience, the development of competence despite severe or pervasive adversity, is examined using data from a longitudinal study of high-risk children and families. The study is guided by an organizationaldevelopmental perspective. Resilience is conceived not as a childhood given, but as a capacity that develops over time in the context of person-environment interactions. Factors related to resilience in our study are examined in terms of this transactional process. From our studies, we have found emotionally responsive caregiving to mediate the effects of high-risk environments and to promote positive change for children who have experienced poverty, family stress, and maltreatment. The implications of these findings are discussed.",0,0 +5795,Family Presence during Cardiopulmonary Resuscitation,"The effect of family presence during cardiopulmonary resuscitation (CPR) on the family members themselves and the medical team remains controversial.We enrolled 570 relatives of patients who were in cardiac arrest and were given CPR by 15 prehospital emergency medical service units. The units were randomly assigned either to systematically offer the family member the opportunity to observe CPR (intervention group) or to follow standard practice regarding family presence (control group). The primary end point was the proportion of relatives with post-traumatic stress disorder (PTSD)-related symptoms on day 90. Secondary end points included the presence of anxiety and depression symptoms and the effect of family presence on medical efforts at resuscitation, the well-being of the health care team, and the occurrence of medicolegal claims.In the intervention group, 211 of 266 relatives (79%) witnessed CPR, as compared with 131 of 304 relatives (43%) in the control group. In the intention-to-treat analysis, the frequency of PTSD-related symptoms was significantly higher in the control group than in the intervention group (adjusted odds ratio, 1.7; 95% confidence interval [CI], 1.2 to 2.5; P=0.004) and among family members who did not witness CPR than among those who did (adjusted odds ratio, 1.6; 95% CI, 1.1 to 2.5; P=0.02). Relatives who did not witness CPR had symptoms of anxiety and depression more frequently than those who did witness CPR. Family-witnessed CPR did not affect resuscitation characteristics, patient survival, or the level of emotional stress in the medical team and did not result in medicolegal claims.Family presence during CPR was associated with positive results on psychological variables and did not interfere with medical efforts, increase stress in the health care team, or result in medicolegal conflicts. (Funded by Programme Hospitalier de Recherche Clinique 2008 of the French Ministry of Health; ClinicalTrials.gov number, NCT01009606.).",0,0 +5796,Methodological Challenges in Studying the Mental Health Consequences of Disasters,,0,0 +5797,Theoretical and empirical issues in the treatment of post-traumatic stress disorder in Vietnam veterans,"This article reviews the current status of research on the treatment of combat-related post-traumatic stress disorder (PTSD) in Vietnam veterans. Dynamic, behavioral, and biochemical models of treatment are presented, along with the findings of relevant treatment outcome studies. Examination of the treatment procedures employed in available studies revealed that direct therapeutic exposure to the memories of trauma emerged as the PTSD treatment technique common to all three theoretical models. The need for controlled investigations of the clinical efficacy of exposure-based interventions for combat-related PTSD is discussed. In addition, several other issues relevant to PTSD treatment research are presented and discussed, including the potential utility of studying untrained coping behavior in combat veterans; the effects of using heterogeneous subject samples in PTSD treatment research; and issues related to the measurement of treatment outcome.",0,0 +5798,Exposure to Political Violence and Political Extremism,"Exposure to political violence can lead to various political and psychological outcomes. Using the protracted Israeli-Palestinian conflict as a natural laboratory, we explore the way in which exposure to conflict violence leads to changes in citizens’ political attitudes and behavior, offering a model for a stress-based process of political extremism. This model encapsulates three basic components in a causal chain leading to political extremism: exposure to political violence, psychological distress, and enhanced perceptions of threat. We find that prolonged exposure to political violence increases psychological distress, which in turn evokes stronger perceptions of threat that foment political attitudes eschewing compromise and favoring militarism. This causal chain fuels a destructive cycle of violence that is hard to break. Understanding these psychological and political consequences of exposure to political violence can help to shed light on the barriers that too often stymie peacemaking efforts and contribute to the deterioration of intractable conflicts around the globe. Thus, this review offers insights applicable to conflict zones around the world and suggests policy implications for therapeutic intervention and potential pathways to conflict resolution.",0,0 +5799,The Role of Injury and Trauma-Related Variables in the Onset and Course of Symptoms of Posttraumatic Stress Disorder,"Posttraumatic stress disorder (PTSD) affects a minority of trauma-exposed persons and is associated with significant impairment. This longitudinal study examined risk factors for PTSD. We tested whether the presence of injuries resulting from trauma exposure predicted the course of PTSD symptoms. In addition, we tested whether gender, trauma type, perceived life threat, and peritraumatic dissociation predicted the onset of PTSD symptoms. 236 trauma-exposed civilians were assessed for PTSD symptoms with a structured interview at four occasions during 6 months posttrauma. Path analysis showed that a model in which the female gender, assault, perceived life threat, and peritraumatic dissociation predicted PTSD severity at 1 week, and injury predicted PTSD severity 8 weeks after the traumatic event showed the best fit. However, a similar model without injury showed comparable fit. It is concluded that injuries have a negligible effect on the course of PTSD. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0,0 +5800,Variation in the Profile of Anxiety Disorders in Boys with an ASD According to Method and Source of Assessment,"To determine any variation that might occur due to the type of assessment and source used to assess them, the prevalence of 7 anxiety disorders were investigated in a sample of 140 boys with an Autism spectrum disorder (ASD) and 50 non-ASD (NASD) boys via the Child and Adolescent Symptom Inventory and the KIDSCID Clinical Interview. Boys with an ASD were significantly more anxious than their NASD peers. Data collected from the boys with an ASD themselves showed differences in the severity and diagnostic criterion of anxiety disorders to data collected from the boys’ parents. There were age-related variations to the pattern of anxiety disorder differences across reports from the boys with an ASD and reports from their parents.",0,0 +5801,"On the Pervasiveness of Event-Specific Alcohol Use, General Substance Use, and Mental Health Problems as Risk Factors for Intimate Partner Violence","The aim of this study was to evaluate the role of demographic, mental health, and substance use as risk factors for intimate partner violence (IPV). Data were derived from Wave II of the National Epidemiological Survey on Alcohol and Related Conditions (2004-2005). Eligible participants ( N = 25,778) reported having an intimate partner 1 year before the survey. Clustered survey multivariate multinomial regression methods were used to assess risk factors for episodes of IPV. IPV victimization, perpetration, and both victims/perpetrators were assessed. Bivariate analyses indicated that African Americans, Hispanics, and women were more likely to be victims, perpetrators, or victim/perpetrators as compared with men and Whites. Multivariate analyses suggested that having a marijuana use disorder was strongly associated with IPV victimization (odds ratio [OR] = 2.61) and victim/perpetration (OR = 2.65). Post-traumatic stress disorder was consistently associated with all IPV typologies. Depression was associated with victimization (OR = 2.00) and IPV victim/perpetration (OR = 1.74). Antisocial Personality Disorder and Mania were both related to IPV perpetration (ORs = 2.53 and 2.32) and victim/perpetration (ORs = 3.15 and 2.31). Results also indicated that alcohol use during episodes of IPV is common (i.e., 35% of those who reported IPV also reported that alcohol was involved). Results indicate several substance- and mental health–related correlates of IPV. In addition, findings indicate that alcohol use by the victim and/or perpetrator is common during IPV events. Policy implications and directions for future research are discussed.",0,0 +5802,Neurobiological Models of Posttraumatic Stress Disorder,"(from the chapter) Focuses on two neurobiological systems that are critical for survival-the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis (HPA). Though most neurobiological research in posttraumatic stress disorder (PTSD) concentrates on these two systems, it is asserted that numerous other neurobiological systems are also involved in acute and chronic responses to stress, although far less is known about them as they relate to PTSD. Several new neurobiological models of PTSD are presented in an attempt to understand the current body of trauma-related neurobiological research. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5803,"Stress risk factors and stress-related pathology: Neuroplasticity, epigenetics and endophenotypes","This paper highlights a symposium on stress risk factors and stress susceptibility, presented at the Neurobiology of Stress workshop in Boulder, CO, in June 2010. This symposium addressed factors linking stress plasticity and reactivity to stress pathology in animal models and in humans. Dr. J. Radley discussed studies demonstrating prefrontal cortical neuroplasticity and prefrontal control of hypothalamo-pituitary-adrenocortical axis function in rats, highlighting the emerging evidence of the critical role that this region plays in normal and pathological stress integration. Dr. M. Kabbaj summarized his studies of possible epigenetic mechanisms underlying behavioral differences in rat populations bred for differential stress reactivity. Dr. L. Jacobson described studies using a mouse model to explore the diverse actions of antidepressants in brain, suggesting mechanisms whereby antidepressants may be differentially effective in treating specific depression endophenotypes. Dr. R. Yehuda discussed the role of glucocorticoids in post-traumatic stress disorder (PTSD), indicating that low cortisol level may be a trait that predisposes the individual to development of the disorder. Furthermore, she presented evidence indicating that traumatic events can have transgenerational impact on cortisol reactivity and development of PTSD symptoms. Together, the symposium highlighted emerging themes regarding the role of brain reorganization, individual differences, and epigenetics in determining stress plasticity and pathology.",0,0 +5804,Predictive factors of chronic Post-Traumatic Stress Disorder in rape victims,"This study aimed to investigate the psychological disorders following rape as well as the course of Post-Traumatic Stress Disorder (PTSD), and to determine clinical factors predictive of chronic PTSD. Seventy-three rape victims were observed in a systematic follow-up study over 1 year following rape using structured interview schedules. The frequency of PTSD was massive. The early disorders predicting PTSD 1 year after rape included somatoform and dissociative disorders, agoraphobia and specific phobias as well as depressive and gender identity disorders and alcohol abuse. Through stepwise logistic regressions, the following were found to be good models of prediction of chronic PTSD 1 year after rape: for the characteristics of the traumas, intrafamily rape, being physically assaulted outside rape, and added physical violence during rape; for the early psychological and behavioural attitudes, low self-esteem, permanent feelings of emptiness and running away; and for early mental disorders, agoraphobia and depressive disorders. Finally, among all these predictive factors, added physical violence during rape, low self-esteem, permanent feelings of emptiness and agoraphobia were shown to constitute a strong model of predictors. People presenting features such as the predictive factors of chronic PTSD found in the study should be asked about a history of rape and symptoms of PTSD.",0,0 +5805,The impact of resource loss and traumatic growth on probable PTSD and depression following terrorist attacks,"The authors interviewed by phone 2,752 randomly selected individuals in New York City within 6 to 9 months after the attacks of September 11, 2001 on the World Trade Center, and 1,939 of these were reinterviewed at a 12- to 16-month follow-up. It was hypothesized that resource loss would significantly predict probable posttraumatic stress disorder (PTSD) and probable depression since September 11, and that resource loss's impact would be independent of previously identified predictors relating to individuals' demographic characteristics, history of stressful event exposure, prior trauma history, peritraumatic experience, and social support. Second, it was predicted that reported traumatic growth would be related to greater, not lesser, psychological distress. The authors' findings supported their hypotheses for resource loss, but traumatic growth was unrelated to psychological outcomes when other predictors were controlled.",0,0 +5806,Patterns of DSM-5 posttraumatic stress disorder and depression symptoms in an epidemiological sample of Chinese earthquake survivors: A latent profile analysis,"Posttraumatic stress disorder (PTSD) and depression are highly comorbid in association with serious clinical consequences. Nevertheless, to date, no study using latent class or latent profile analysis (LCA/LPA) has examined patterns of co-occurring PTSD and depression symptoms among natural disaster survivors, nor has the distinctiveness of DSM-5 PTSD and depression symptoms been clarified in the aftermath of trauma. This study was primarily aimed at filling these gaps.LPA was used to examine self-reported PTSD and depression symptoms in an epidemiological sample of 1196 Chinese earthquake survivors.A 4-class solution characterized by low symptoms (53.9%), predominantly depression (18.2%), predominantly PTSD (18.9%) and combined PTSD-depression (9.0%) patterns fit the data best. Demographic characteristics and earthquake-related exposures were specifically or consistently associated with the non-parallel profiles varying in physical health impairment.A sample exposed to specific traumatic events was assessed by self-report measures.The distinctiveness of DSM-5 PTSD and depression symptoms following an earthquake suggests that PTSD and depression may be independent sequelae of psychological trauma rather than a manifestation of a single form of psychopathology. The current findings support the distinction between PTSD and depression constructs, and highlight the need for identifications of natural disaster survivors at high risk for PTSD and/or depression, and interventions individually tailored to one's symptom presentations.",0,0 +5807,"Trajectories of memory decline in preclinical Alzheimer's disease: results from the Australian Imaging, Biomarkers and Lifestyle Flagship Study of Ageing","Memory changes in preclinical Alzheimer's disease (AD) are often characterized by heterogenous trajectories. However, data regarding the nature and determinants of predominant trajectories of memory changes in preclinical AD are lacking. We analyzed data from 333 cognitively healthy older adults who participated in a multicenter prospective cohort study with baseline and 18-, 36-, and 54-month follow-up assessments. Latent growth mixture modeling revealed 3 predominant trajectories of memory change: a below average, subtly declining memory trajectory (30.9%); a below average, rapidly declining memory trajectory (3.6%); and an above average, stable memory trajectory (65.5%). Compared with the stable memory trajectory, high Αβ (relative risk ratio [RRR] = 2.1), and lower Mini-Mental State Examination (RRR = 0.6) and full-scale IQ (RRR = 0.9) scores were independently associated with the subtly declining memory trajectory; and high Αβ (RRR = 8.3), APOE ε4 carriage (RRR = 6.1), and greater subjective memory impairment (RRR = 1.2) were independently associated with the rapidly declining memory trajectory. Compared with the subtly declining memory trajectory group, APOE ε4 carriage (RRR = 8.4), and subjective memory complaints (RRR = 1.2) were associated with a rapidly declining memory trajectory. These results suggest that the preclinical phase of AD may be characterized by 2 predominant trajectories of memory decline that have common (e.g., high Αβ) and unique (e.g., APOE ε4 genotype) determinants.",0,0 +5808,Gender differences in childhood onset conduct disorder,"The present study tested several predictions related to the theory that girls with conduct disorder (CD) follow a single delayed onset pathway. The following hypotheses were tested among a high-risk, stratified random sample of youth who used public services during a 6-month period: boys will be more likely to have childhood onset CD (COCD) than girls; girls with COCD will be less common than girls with adolescent onset CD (AOCD); COCD girls. AOCD girls, and COCD boys will be similar in terms of risk profiles and AOCD boys will have a less severe risk profile than COCD girls; and risk factors that differentiate between COCD and AOCD among males will not differentiate between COCD and AOCD among females. Among those youth who met the criteria for CD, males were significantly more likely to have COCD than females. However, close to half of females with CD met the criteria for the COCD subtype. Of the seven risk factors that were examined, girls with COCD scored higher than COCD boys on three factors and higher than AOCD girls on four factors; however, only one significant difference was found between AOCD girls and COCD boys. Finally, risk factors appeared to differentiate between COCD and AOCD groups in a similar way among males and females. These findings suggest that COCD is not rare among females in public service sectors, COCD girls can be distinguished from AOCD girls in terms of risk factors, and risk factors for COCD among males are also relevant to females.",0,0 +5809,Expert opinions about the ICD-10 category of enduring personality change after catastrophic experience,"The inclusion of enduring personality change after catastrophic experience (EPCACE) as a diagnostic category in the ICD-10 represents a turning point in the evolution of the nosology of traumatic stress syndromes, yet many aspects of the diagnosis remain contentious. Given the absence of published research concerning this category, an exploratory survey of international experts was conducted using a questionnaire focusing on key aspects of the category, namely whether respondents used the diagnosis of EPCACE in their practice; which features were most salient in making a diagnosis of posttraumatic personality change; the types and characteristics of traumatic events that were judged to be most likely to cause EPCACE; and the possible limitations of the ICD-10 diagnosis. A response rate of 56.3% was obtained. A substantial portion of trauma experts working in the field of human-engendered violence recognize the possibility that certain traumas can result in personality change. However, questions were raised about the specificity of the criteria proposed for the category of EPCACE in ICD-10. A composite profile of proposed additional features suggests that a more comprehensive array of adaptational changes are recognized than are encompassed by EPCACE.",0,0 +5810,Gender differences in patients with posttraumatic stress disorder in a general psychiatric practice.,"This report examined gender differences in the clinical manifestations of current posttraumatic stress disorder (PTSD) in treatment-seeking patients.Outpatients with PTSD (N=138) were interviewed with the Structured Clinical Interview for DSM-IV.Compared with male patients, female patients experienced more reexperiencing symptoms and were more likely to meet criteria for current PTSD and to report sexual trauma as their index trauma. Men with PTSD were more likely than women with PTSD to meet criteria for a substance use disorder and for antisocial personality disorder. No gender differences were found in the frequency of other types of comorbid disorders, the number of comorbid disorders, or the presence of PTSD as a primary disorder.Overall, male and female patients with current PTSD present with fairly comparable clinical profiles.",0,0 +5811,Risk factors for PTSD and other diagnoses in a general sample of Vietnam veterans,"This study examined the contribution of premilitary, military, and postmilitary risk factors to posttraumatic stress disorder (PTSD) and other postwar diagnoses in a sample of Vietnam veterans. PTSD was explained primarily by war stressors, including threat to life and exposure to grotesque death, but premilitary and postmilitary factors also contributed to the likelihood of a current diagnosis of PTSD. Panic disorder was also highly predicted by war experiences, whereas prewar functioning played a stronger role in several non-PTSD diagnoses. The study supported the notion that PTSD is specifically linked to intense stressors. Mechanisms for interactions among risk factors are discussed.",0,0 +5812,Minimally adequate mental health care and latent classes of PTSD symptoms in female Iraq and Afghanistan veterans,"Female veterans of Operations Enduring and Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND) represent a growing segment of Department of Veterans Affairs (VA) health care users. A retrospective analysis used national VA medical records to identify factors associated with female OEF/OIF/OND veterans' completion of minimally adequate care (MAC) for PTSD, defined as the completion of at least nine mental health outpatient visits within a 15-week period or at least twelve consecutive weeks of medication use. The sample included female OEF/OIF/OND veterans with PTSD who initiated VA health care between 2007-2013, and were seen in outpatient mental health (N=2183). Multivariable logistic regression models examined factors associated with completing MAC for PTSD, including PTSD symptom expression (represented by latent class analysis), sociodemographic, military, clinical, and VA access factors. Within one year of initiating mental health care, 48.3% of female veterans completed MAC. Race/ethnicity, age, PTSD symptom class, additional psychiatric diagnoses, and VA primary care use were significantly associated with completion of MAC for PTSD. Results suggest that veterans presenting for PTSD treatment should be comprehensively evaluated to identify factors associated with inadequate completion of care. Treatments that are tailored to PTSD symptom class may help to address potential barriers.",0,0 +5813,Risk of False Positives When Identifying Malingered Profiles Using the Trauma Symptom Inventory,"The Trauma Symptom Inventory (TSI; Briere, 1995) is a 100-item self-report measure of posttraumatic symptomatology that includes an Atypical Response (ATR) validity scale designed to differentiate honest from malingered profiles. In this study, using an analogue design to experimentally manipulate honest and malingered responses on the TSI, we found that proposed ATR cut scores produce a significant risk of false positives. Furthermore, the functioning of proposed cut scores worsened when we used posttraumatic stress disorder relevant samples and low estimates of malingering base rates. In light of these findings, the TSI should be used with caution when assessing claims of posttraumatic stress in forensic or disability settings.",0,0 +5814,"Trauma, PTSD and personality: the relationship between prolonged traumatization and personality impairments","Chronic post-traumatic stress disorder (PTSD) has been associated with personality impairments involving externalized and internalized psychopathology. This study has explored the association between PTSD symptoms as consequences of prolonged torture experiences or early childhood trauma exposure and personality traits.One hundred and sixty-one men were included: 36 Iraqi men refugees (mean age = 43.9, SD = 8.7) who had longstanding torture experiences as adults; 42 Swedish prisoners (mean age = 33.8, SD = 7), with early childhood trauma exposure; 31 Arab men refugees (mean age = 41.8, SD = 8.9) without self-reported torture or violence experiences; 52 non-traumatized Swedish males (mean age = 39.3, SD = 5.5). They were assessed for symptoms of PTSD or PTSD hypothetical clusters. Personality profile was assessed by the Karolinska Scales of Personality (KSP). Factor analysis with varimax rotation was conducted and yielded three factors: externalized, internalized and avoidance domains.Individuals who suffered prolonged torture experiences or had early childhood trauma exposure showed impaired personality profiles in internalized and externalized domains. Individuals with or without PTSD showed significant differences p < 0.05 concerning: internalized, externalized and avoidance. ANOVA and post-hoc analysis according to Scheffé showed that the prolonged torture group > early childhood trauma exposure > nontraumatized group.Prolonged torture experiences or early trauma exposure may impair personality formation by enhancing the effects of cognitive, affective and behavioural vulnerabilities.",0,0 +5815,Comorbidity in posttraumatic stress disorder: a structural equation modelling approach,"Posttraumatic stress disorder (PTSD) is associated with high rates of psychiatric comorbidity. Existing theories consider comorbidity as a consequence of PTSD (model 1), PTSD and comorbidity as a consequence of shared factors of vulnerability (model 2), and comorbidity as a consequence of trauma-type specific mechanisms (model 3).To compare the explanatory value of these models, we assessed PTSD (model 1), sense of coherence (model 2) and satisfaction with health (model 3) and symptoms of anxiety and depression as indicators of comorbidity 5 days (t1) and 6 months (t2) postaccident in 225 injured accident survivors. Structural equation models representing models 1 to 3 were tested separately and combined.Combined, models 1 and 3 explained 82% of the variance of comorbid symptoms at t2. Posttraumatic stress disorder and satisfaction with health (t2) exerted strong influences on comorbid symptoms.Comorbidity besides PTSD is best described by an integration of competing explanatory models.",0,0 +5816,"Posttraumatic stress disorder symptoms, physiological reactivity, alcohol problems, and aggression among military veterans.","This study examined the association between posttraumatic stress disorder (PTSD) symptomatology and aggressive behavior among a sample of male Vietnam veterans (N = 1,328). Results indicated that the hyperarousal PTSD symptom cluster evidenced the strongest positive association with aggression at the bivariate level when compared with the other PTSD symptom clusters. When the PTSD symptom clusters were examined together as predictors, hyperarousal symptoms evidenced a significant positive relationship with aggression, and avoidance/numbing symptoms were negatively associated with aggression. Examination of potential mediators indicated that hyperarousal symptoms were directly associated with aggression and indirectly related to aggression via alcohol problems. Reexperiencing symptoms were associated with aggression only indirectly and through their positive association with physiological reactivity and negative association with alcohol problems. Study results highlight the complexity of the relationship between PTSD symptoms and aggression, and suggest possible mechanisms explaining this association.",0,0 +5817,Binary partitioning for continuous longitudinal data: categorizing a prognostic variable,"We investigate a binary partitioning algorithm in the case of a continuous repeated measures outcome. The procedure is based on the use of the likelihood ratio statistic to evaluate the performance of individual splits. The procedure partitions a set of longitudinal data into two mutually exclusive groups based on an optimal split of a continuous prognostic variable. A permutation test is used to assess the level of significance associated with the optimal split, and a bootstrap confidence interval is obtained for the optimal split.",0,0 +5818,Expression of locus coeruleus mineralocorticoid receptor and glucocorticoid receptor in rats under single-prolonged stress,"The pathogenesis of the post-traumatic stress disorder (PTSD) may involve dysfunction of several brain structures, such as the amygdala, locus coeruleus, hippocampus, noradrenergic system as well as the hypothalamic- pituitary-adrenal (HPA) axis. The cortisol and locus coeruleus dysfunction may affect the secretion of corticosterone. The present study was designed to examine the expression of mineralocorticoid receptor (MR) and glucocorticoid receptor (GR) in the locus coeruleus in the rats treated with single-prolonged stress (SPS). The results showed that the expression of MR had a sharp decline on day 1, but gradually increased on days 4, 7, 14, and 28. The expression of GR gradually increased on days 1, 4, and 7, but decreased on days 14 and 28, respectively.MR and GR in the locus coeruleus may have a role in the development of long-term persistent neuropsychological sequelae in PTSD. © 2011 Springer-Verlag.",0,0 +5819,Resilience to loss and chronic grief: A prospective study from preloss to 18-months postloss.,"The vast majority of bereavement research is conducted after a loss has occurred. Thus, knowledge of the divergent trajectories of grieving or their antecedent predictors is lacking. This study gathered prospective data on 205 individuals several years prior to the death of their spouse and at 6- and 18-months postloss. Five core bereavement patterns were identified: common grief, chronic grief, chronic depression, improvement during bereavement, and resilience. Common grief was relatively infrequent, and the resilient pattern most frequent. The authors tested key hypotheses in the literature pertaining to chronic grief and resilience by identifying the preloss predictors of each pattern. Chronic grief was associated with preloss dependency and resilience with preloss acceptance of death and belief in a just world.",0,0 +5820,Smoking status and exercise in relation to PTSD symptoms: A test among trauma-exposed adults,"The present investigation examined the interactive effect of cigarette smoking status (i.e., regular smoking versus non-smoking) and weekly exercise (i.e., weekly metabolic equivalent) in terms of posttraumatic stress (PTSD) symptom severity among a community sample of trauma-exposed adults. Participants included 86 trauma-exposed adults (58.1% female; Mage = 24.3). Approximately 59.7% of participants reported regular (≥ 10 cigarettes per day) daily smoking over the past year. The interactive effect of smoking status by weekly exercise was significantly associated with hyperarousal and avoidance symptom cluster severity (p ≤ .05). These effects were evident above and beyond number of trauma types and gender, as well as the respective main effects of smoking status and weekly exercise. Follow-up tests indicated support for the moderating role of exercise on the association between smoking and PTSD symptoms, such that the highest levels of PTSD symptoms were observed among regular smokers reporting low weekly exercise levels. Theoretical and clinical implications of the findings are discussed.",0,0 +5821,Latent profiles of DSM-5 PTSD symptoms and the “Big Five” personality traits,"Typologies of DSM-5 PTSD symptoms and personality traits were evaluated in regard to coping styles and treatment preferences using data from 1266 trauma-exposed military veterans of which the majority were male (n=1097; weighted 89.6%). Latent profile analyses indicated a best-fitting 5-class solution; PTSD asymptomatic and emotionally stable (C1); predominant re-experiencing and avoidance symptoms and less emotionally stable (C2); subsyndromal PTSD (C3); predominant negative alterations in mood/cognitions and combined internalizing-externalizing traits (C4); and high PTSD severity and combined internalizing-externalizing traits (C5). Compared to C5, C1 members were less likely to use self-distraction, denial, and substance use and more likely to use active coping; C2 and C4 members were less likely to use denial and more likely to use behavioral disengagement; C3 members were less likely to use denial and instrumental coping and more likely to use active coping; most classes were less likely to seek mental health treatment. Compared to C1, C2 members were more likely to use self-distraction, substance use, behavioral disengagement and less likely to use active coping; C3 members were more likely to use self-distraction, and substance use, and less likely to use positive reframing, and acceptance; and C4 members were more likely to use denial, substance use, emotional support, and behavioral disengagement, and less likely to use active coping, positive reframing, and acceptance; all classes were more likely to seek mental health treatment. Emotional stability was most distinguishing of the typologies. Other implications are discussed.",0,0 +5822,The characteristics of a cohort who tamper with prescribed and diverted opioid medications,"To describe the methods and baseline characteristics of a cohort of people who tamper with pharmaceutical opioids, formed to examine changes in opioid use following introduction of Reformulated OxyContin®.Participants were 606 people from three Australian jurisdictions who reported past month injecting, snorting, chewing or smoking of a pharmaceutical opioid and had engaged in these practices at least monthly in the past 6 months. Baseline interviews were conducted prior to introduction of Reformulated OxyContin® in April 2014. Patterns of opioid use and cohort characteristics were examined according to whether participants were prescribed opioid medications, or exclusively used diverted medication.The cohort reported high levels of moderate/severe depression (61%), moderate/severe anxiety (43%), post-traumatic stress disorder (42%), chronic pain or disability (past 6 months, 54%) and pain (past month, 47%). Lifetime use of oxycodone, morphine, opioid substitution medications and codeine were common. Three-quarters (77%) reported ICD-10 lifetime pharmaceutical opioid dependence and 40% current heroin dependence. Thirteen percent reported past year overdose, and 70% reported at least one past month opioid injection-related injury or disease. The cohort displayed complex clinical profiles, but participants currently receiving opioid substitution therapy who were also prescribed other opioids particularly reported a wide range of risk behaviors, despite their health service engagement.Findings highlight the heterogeneity in the patterns and clinical correlates of opioid use among people who tamper with pharmaceutical opioids. Targeted health interventions are essential to reduce the associated harms.",0,0 +5823,Post-Traumatic Stress Disorder and Functioning and Quality of Life Outcomes in Female Vietnam Veterans,"This investigation assessed whether current post-traumatic stress disorder (PTSD) was associated with impaired functioning in a nationally representative sample of female Vietnam veterans.Logistic models were used to determine the association between PTSD and outcome while adjusting for demographic characteristics and medical and psychiatric co-morbidities.PTSD was associated with significantly elevated odds of poorer functioning in five of the six outcome domains; only the association between perpetration of violence in the past year and PTSD did not achieve statistical significance. After adjusting for demographics and medical and psychiatric co-morbidities, PTSD remained associated with significantly elevated odds of bed days, poorer physical health, and currently not working.Among female Vietnam veterans PTSD is associated with a broad profile of functional impairment. The significantly increased odds of impaired functioning and diminished quality of life suggest that PTSD may be the core problem of the set of problems afflicting female Vietnam veterans.",0,0 +5824,The structure of posttraumatic psychopathology in veterans attending primary care,"This study attempted to extend research indicating that posttraumatic stress disorder (PTSD) factors of Re-experiencing, Avoidance and Hyperarousal are more related to Fear/phobic disorders, while PTSD Dysphoria is more related to Anxious-Misery disorders. Trauma exposure, PTSD and comorbidity data for 668 veteran patients were analysed using confirmatory factor analyses and relative strengths of the relationships between PTSD factors and the Fear and Anxious-Misery factors were assessed. Combining Simms, Watson, and Doebbeling's (2002) model of PTSD symptoms and Krueger's (1999) Fear/Anxious Misery model of mood and anxiety disorders fit the data well. Contrary to previous research, PTSD Re-experiencing, Avoidance and Hyperarousal did not correlate more with the Fear factor; nor did PTSD Dysphoria correlate more with Anxious-Misery. Hyperarousal was more closely related to Fear than was Re-experiencing; however, Avoidance was not. Dysphoria was more closely related to the Anxious-Misery factor than all other PTSD factors.",0,0 +5825,Influence of the Severity and Location of Bodily Injuries on Post-Concussive and Combat Stress Symptom Reporting after Military-Related Concurrent Mild Traumatic Brain Injuries and Polytrauma,"Traumatic brain injuries (TBI) sustained in combat frequently co-occur with significant bodily injuries. Intuitively, more extensive bodily injuries might be associated with increased symptom reporting. In 2012, however, French et al. demonstrated an inverse relation between bodily injury severity and symptom reporting. This study expands on that work by examining the influence of location and severity of bodily injuries on symptom reporting after mild TBI. Participants were 579 US military service members who sustained an uncomplicated mild TBI with concurrent bodily injuries and who were evaluated at two military medical centers. Bodily injury severity was quantified using a modified Injury Severity Score (ISSmod). Participants completed the Neurobehavioral Symptom Inventory (NSI) and the Posttraumatic Stress Disorder Checklist (PCL-C), on average, 2.5 months post-injury. There was a significant negative association between ISSmod scores and NSI (r=-0.267, p<0.001) and PCL-C (r=-0.273, p<0.001) total scores. Using linear regression to examine the relation between symptom reporting and injury severity across the six ISS body regions, three body regions were significant predictors of the NSI total score (face; p<0.001; abdomen; p=0.003; extremities; p<0.001) and accounted for 9.3% of the variance (p<0.001). For the PCL-C, two body regions were significant predictors of the PCL-C total score (face; p<0.001; extremities; p<0.001) and accounted for 10.5% of the variance. There was an inverse relation between bodily injury severity and symptom reporting in this sample. Hypothesized explanations include underreporting of symptoms, increased peer support, disruption of fear conditioning because of acute morphine use, or delayed expression of symptoms.",0,0 +5826,Childhood Post-Traumatic Stress Disorder: An Overview,"This article presents an overview of post-traumatic stress disorder (PTSD) as it relates to children and adolescents. The authors provide a critical review of the pediatric PTSD literature regarding the definition, epidemiology, clinical presentation, assessment, neurobiologic foundation, and treatment of PTSD. The importance of developmental and neurobiologic factors and the uniqueness of these factors to children are emphasized.",0,0 +5827,Female combat amputees have higher rates of posttraumatic stress disorder disability.,"The civilian trauma literature suggests that the sexes differ in physical and mental health outcomes following traumatic injury. In order to determine if the reaction to combat injury is different between the sexes in a specific war wounded population, service members with amputations, we examined the disability profiles of male and female amputees.All US combatants who sustained a major extremity amputation between October 2001 and July 2011 were examined for demographic and injury information from the Department of Defense Trauma Registry and for disability outcomes in the service specific Physical Evaluation Boards. The proportions of women versus men with various disabling conditions were compared using Fisher's Exact Test and the mean disability ratings for each condition were compared using student's t tests.Among 1,107 amputees, 21 were female. There was no difference in the average age, military rank, or Injury Severity Score between the sexes. While the most common military occupation of male amputees was infantry service, the most common occupation for the female amputee was military police. The overall disability ratings between females and males were not different (82% for females, 75% for males). Female amputees had more frequent disability from posttraumatic stress disorder (PTSD, 8/21 [38%] vs 168/818 [17%]). Disability ratings from PTSD tended to also be higher in women.Outside of variable occupational descriptions, both male and female amputees were exposed to explosions resulting in their injuries. Consistent with many civilian trauma and veterans' population studies, female amputees have higher frequencies of disability from PTSD. These results support the need for additional effort and attention directed towards optimizing physical and mental fitness following deployment in order to reduce disability and promote return to duty. Because certain conditions, such as PTSD, may be more or less common in men versus women veterans, postdeployment fitness may need to be tailored in a gender specific way.",0,0 +5828,Multiple Vantage Points on the Mental Health Effects of Mass Shootings,"The phenomenon of mass shootings has emerged over the past 50 years. A high proportion of rampage shootings have occurred in the United States, and secondarily, in European nations with otherwise low firearm homicide rates; yet, paradoxically, shooting massacres are not prominent in the Latin American nations with the highest firearm homicide rates in the world. A review of the scientific literature from 2010 to early 2014 reveals that, at the individual level, mental health effects include psychological distress and clinically significant elevations in posttraumatic stress, depression, and anxiety symptoms in relation to the degree of physical exposure and social proximity to the shooting incident. Psychological repercussions extend to the surrounding affected community. In the aftermath of the deadliest mass shooting on record, Norway has been in the vanguard of intervention research focusing on rapid delivery of psychological support and services to survivors of the “Oslo Terror.” Grounded on a detailed review of the clinical literature on the mental health effects of mass shootings, this paper also incorporates wide-ranging co-author expertise to delineate: 1) the patterning of mass shootings within the international context of firearm homicides, 2) the effects of shooting rampages on children and adolescents, 3) the psychological effects for wounded victims and the emergency healthcare personnel who care for them, 4) the disaster behavioral health considerations for preparedness and response, and 5) the media “framing” of mass shooting incidents in relation to the portrayal of mental health themes. © 2014, Springer Science+Business Media New York.",0,0 +5829,Social support and Quality of Life: a cross-sectional study on survivors eight months after the 2008 Wenchuan earthquake,"Abstract Background The 2008 Wenchuan earthquake resulted in extensive loss of life and physical and psychological injuries for survivors. This research examines the relationship between social support and health-related quality of life for the earthquake survivors. Methods A multistage cluster sampling strategy was employed to select participants from 11 shelters in nine counties exposed to different degrees of earthquake damage, for a questionnaire survey. The participants were asked to complete the Short Form 36 and the Social Support Rating Scale eight months after the earthquake struck. A total of 1617 participants returned the questionnaires. The quality of life of the survivors (in the four weeks preceding the survey) was compared with that of the general population in the region. Multivariate logistic regression analysis and canonical correlation analysis were performed to determine the association between social support and quality of life. Results The earthquake survivors reported poorer quality of life than the general population, with an average of 4.8% to 19.62% reduction in scores of the SF-36 (p < 0.001). The multivariate logistic regression analysis showed that those with stronger social support were more likely to have better quality of life. The canonical correlation analysis found that there was a discrepancy between actual social support received and perceived social support available, and the magnitude of this discrepancy was inversely related to perceived general health (rs = 0.467), and positively related to mental health (rs = 0.395). Conclusion Social support is associated with quality of life in the survivors of the earthquake. More attention needs to be paid to increasing social support for those with poorer mental health.",0,0 +5830,Childhood Posttraumatic Stress Disorder and Efforts to Cope After Hurricane Floyd,"The authors report on the level of posttraumatic stress disorder (PTSD) experienced by fourth-grade children 6 months after Hurricane Floyd and describe the children's efforts to cope with their stress. All of the children they studied were directly affected by the hurricane, secondary to the destruction of their school by floodwaters. The homes of 37% of these children were also flooded. Ninety-five percent of the children experienced at least mild symptoms of PTSD, and 71% had symptoms that were moderate to very severe. Children who reported that their homes were flooded were 3 times more likely to report symptoms than those whose homes were not flooded, and the girls were twice as likely as the boys to report symptoms. The high PTSD prevalence rates are comparable to findings from other studies involving violence in which 94% of the victims reported experiencing symptoms. For further analyses, the authors used symptom clusters of hyperarousal, numbing/avoidance, and reexperiencing symptoms.",0,0 +5831,Efficacy of group treatment for posttraumatic stress disorder symptoms: A meta-analysis.,"This study conducted a meta-analysis of published randomized clinical group trials for adult survivors of trauma to examine the efficacy of the group format. Effect sizes for posttraumatic stress disorder (PTSD) severity outcome were examined. Sixteen studies were included, with a total of 1686 participants. Results of a random effects model meta-analysis indicated that group treatments are associated with significant preto posttreatment reduction in PTSD symptom severity (within treatment d .71, 95% CI [.51, .91]), and result in superior treatment effects relative to a wait list comparison condition (d .56, 95% CI [.31, .82]). However, no significant findings were obtained for group interventions relative to active treatment comparison conditions (d .09, 95% CI [ .03, .22]). Moderator analyses also indicated that gender and type of trauma moderated treatment effects for PTSD outcome, with smaller effect sizes associated with males relative to females and combined gender samples, and smaller effect sizes for combat and child sexual assault trauma samples relative to mixed-trauma sample studies. Taken together, group treatment for trauma symptoms is better than no treatment but not better relative to comparison conditions that control for nonspecific benefits of therapy. Additional work is needed to identify effective group treatments for PTSD, especially for patients with repeated or chronic traumatization.",0,0 +5832,Race and Incarceration in an Aging Cohort of Vietnam Veterans in Treatment for Post-Traumatic Stress Disorder (PTSD),"Cross sectional studies have addressed the incarceration of Vietnam veterans with post-traumatic stress disorder (PTSD), but no studies have examined changes in incarceration as they age. This study examines patterns of incarceration among Vietnam veterans treated in specialized veterans affairs (VA) intensive PTSD programs over time. Data was drawn from admission data from the initial episode of treatment of Caucasian and African American Vietnam veterans entering VA specialized intensive PTSD programs between 1993 and 2011 (N = 31,707). Bivariate correlations and logistic regression were used to examine associations among race and incarceration over time and the potentially confounding influence of demographic and clinical covariates on this relationship. Rates of reported incarceration declined from 63 to 43 %. Over time, African American veterans were 34 % more likely than Caucasian veterans to have a lifetime history of incarceration while interaction analysis showed steeper declines for Caucasians than African Americans. Rates of incarceration among these Vietnam veterans declined as they aged. Furthermore, African American veterans were substantially more likely than Caucasian veterans to have been incarcerated and showed less decline as the cohort aged. While reduced, needs for clinical PTSD services remain among aging combat veterans. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0,0 +5833,Tolerating Distress After Trauma: Differential Associations Between Distress Tolerance and Posttraumatic Stress Symptoms,"Distress tolerance has been implicated in disorders of emotional regulation, such as eating disorders and borderline personality disorder; however, much less attention has been given to distress tolerance in the context of posttraumatic stress (PTS). Several conceptual linkages between distress tolerance and PTS exist. Low distress tolerance may increase negative appraisals, reducing an individual's propensity to deal with distressing mental symptoms immediately after a trauma. Relatedly, a perceived inability to cope with the distress brought on by trauma-related memories and cues may engender maladaptive coping strategies. The few published studies examining the relationship between distress tolerance and PTS have demonstrated that lower distress tolerance was associated with increased PTS symptomatology, including increased avoidance, hyperarousal, and re-experiencing. The current study sought to replicate and extend the emerging empirical base by examining the relationship between distress tolerance and the four distinct PTS symptom clusters, while controlling for time since the index trauma and depressive symptoms. Results indicated that distress tolerance accounted for significant unique variance in re-experiencing and avoidance but not negative emotionality and hyperarousal symptoms. There was also a strong positive association between the number of traumas endorsed by participants, depression, and PTS symptoms. Findings suggest that distress tolerance is associated with PTS, lending further support to the putative relationship between PTS and distress tolerance. Accordingly, developing treatment protocols designed to increase distress tolerance in individuals affected by PTS may reduce symptom severity and increase coping abilities. © 2014 Springer Science+Business Media.",0,0 +5834,Does repressive coping promote resilience? Affective-autonomic response discrepancy during bereavement.,"Traditional theories of coping emphasize the value of attending to and expressing negative emotion while recovering from traumatic life events. However, recent evidence suggests that the tendency to direct attention away from negative affective experience (i.e., repressive coping) may promote resilience following extremely aversive events (e.g., the death of a spouse). The current study extends this line of investigation by showing that both bereaved and nonbereaved individuals who exhibited repressive coping behavior--as measured by the discrepancy between affective experience and sympathetic nervous system response--had fewer symptoms of psychopathology, experienced fewer health problems and somatic complaints, and were rated as better adjusted by close friends than those who did not exhibit repressive coping. Results are discussed in terms of recent developments in cognitive and neuroimaging research suggesting that repressive coping may serve a protective function.",0,0 +5835,Best Practice in Responding to Critical Incidents and Potentially Traumatic Experience within an Organisational Setting,"This chapter addresses best practice for organisational support after critical incidents and traumatic events within social work. Critical incidents are situations and incidents within workplace settings or roles, which, whilst able to be anticipated and planned for, have the potential to create a sense of emergency, crisis, and extreme stress, or have a traumatic impact on those directly or indirectly affected. Alongside the notion of critical incidents are concepts of debriefing, psychological debriefing, Critical Incident Stress Debriefing (CISD), and Critical Incident Stress Management (CISM). Debate about debriefing models has concerned their effectiveness and safety; the terms being loaded with meaning and tensions between scientific and holistic paradigms and between academic and practitioner perspectives. The chapter suggests areas of research and exploration for agency managers and senior practitioners wishing to make sense of the debates and enables the reader to consider best practice for critical incident response within organisational settings.",0,0 +5836,"Physiotherapists' Beliefs About Whiplash‐associated Disorder: A Comparison Between Singapore and Queensland, Australia","Healthcare providers' beliefs may play a role in the outcome of whiplash-associated disorders (WAD), a condition which is proposed to be culturally dependent. Clinical practice guidelines recommend an active approach for the management of WAD, which is often delivered by physiotherapists. However, there is no data on physiotherapists' whiplash beliefs. Our primary objective was to determine physiotherapists' beliefs from Queensland (Australia) and Singapore, two cultures with differing prevalence of chronic musculoskeletal pain and chronic WAD.A pen and paper survey of musculoskeletal physiotherapists practicing in Queensland and Singapore was conducted. Participants completed questionnaires consisting of patient vignettes and statements inquiring knowledge and attitudes towards WAD. Chi-square tests of significance were used to compare the responses of physiotherapists from both samples.Ninety-one (response rate 45%) Queensland-based and 94 (response rate 98%) Singapore-based physiotherapists participated in the study. The beliefs in the management strategies for the patient vignettes were generally consistent with practice guidelines. A higher proportion of Queensland-based physiotherapists expected permanent disabilities for the patient vignette depicting chronic WAD (Queensland: 55% Singapore: 28% Pearson chi-sq 18.76, p < 0.005).Up to 99% of the physiotherapists from both samples believed in encouragement of physical activity, the effectiveness of exercise and multimodal physiotherapy for WAD. Significantly higher proportions of Singapore-based physiotherapists believed in ordering radiographs for acute WAD (Pearson chi-sq 41.98, p < 0.001) and also believed in a psychogenic origin of chronic WAD (Pearson chi-sq 22.57, p 0.001).The majority of beliefs between physiotherapists in Queensland and Singapore were similar but there were specific differences. Physiotherapists' whiplash beliefs in Queensland and Singapore did not clearly reflect the difference in prevalence of chronic musculoskeletal pain or chronic WAD in Queensland and Singapore.",0,0 +5837,Anger problem profiles among partner violent men: Differences in clinical presentation and treatment outcome.,"Cluster analysis of 139 partner violent men's self-reports on the State-Trait Anger Expression Inventory identified profiles reflecting pathological anger (PA), low anger control (LAC), and normal anger (NA). The PA group self-reported higher pretreatment partner abuse, interpersonal dysfunction, distress, and substance abuse and had lower treatment attendance than the NA and LAC groups. Collateral (victim) partners reported higher pretreatment abuse by the PA and LAC groups than the NA group. At posttreatment and 6-month follow-up, the PA group had the highest levels of physical assault and injury. The LAC group exceeded the NA group in physical assault at posttreatment and psychological aggression at posttreatment and follow-up. The recognition of distinct anger problem profiles may lead to new strategies for research and practice.",0,0 +5838,"The Comorbidity of Self-Reported Chronic Fatigue Syndrome, Post-Traumatic Stress Disorder, and Traumatic Symptoms","Background Data from primary care and community samples suggest higher rates of post-traumatic stress disorder (PTSD) among individuals with chronic fatigue syndrome (CFS). Objective This study investigated the co-occurrence of CFS, PTSD, and trauma symptoms and assessed the contribution of familial factors to the association of CFS with lifetime PTSD and current traumatic symptoms. Method Data on lifetime CFS and PTSD, as measured by self-report of a doctor's diagnosis of the disorder, and standardized questionnaire data on traumatic symptoms, using the Impact of Events Scale (IES), were obtained from 8544 female and male twins from the community-based University of Washington Twin Registry. Results Lifetime prevalence of CFS was 2% and lifetime prevalence of PTSD was 4%. Participants who reported a history of PTSD were over eight times more likely to report a history of CFS. Participants with scores ≥ 26 on the IES were over four times more likely to report CFS than those who had scores ≤ 25. These associations were attenuated but remained significant after adjusting for familial factors through within-twin pair analyses. Conclusion These results support similar findings that a lifetime diagnosis of CFS is strongly associated with both lifetime PTSD and current traumatic symptoms, although familial factors, such as shared genetic and environmental contributions, played a limited role in the relationship between CFS, PTSD, and traumatic symptoms. These findings suggest that future research should investigate both the familial and the unique environmental factors that may give rise to both CFS and PTSD.",0,0 +5839,Systematic Review: A Reevaluation and Update of the Integrative (Trajectory) Model of Pediatric Medical Traumatic Stress,"The objective of this systematic review is to reevaluate and update the Integrative Model of Pediatric Medical Traumatic Stress (PMTS; Kazak et al., 2006), which provides a conceptual framework for traumatic stress responses across pediatric illnesses and injuries.Using established systematic review guidelines, we searched PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and PubMed (producing 216 PMTS papers published since 2005), extracted findings for review, and organized and interpreted findings within the Integrative Model framework.Recent PMTS research has included additional pediatric populations, used advanced longitudinal modeling techniques, clarified relations between parent and child PMTS, and considered effects of PMTS on health outcomes. Results support and extend the model's five assumptions, and suggest a sixth assumption related to health outcomes and PMTS.Based on new evidence, the renamed Integrative Trajectory Model includes phases corresponding with medical events, adds family-centered trajectories, reaffirms a competency-based framework, and suggests updated assessment and intervention implications.",0,0 +5840,Factor structure of posttraumatic stress disorder symptoms in the Australian general population,"The tripartite model of posttraumatic stress disorder (PTSD) articulated in DSM-IV has received limited empirical support. Over the past decade, a burgeoning literature on PTSD symptom structure has accumulated suggesting several alternative models. Elucidating the latent structure of PTSD has important clinical and theoretical implications. This paper presents the first confirmatory factor analytic investigation of PTSD symptoms in an epidemiologically based trauma-exposed sample from Australia. Data from a subsample of respondents from the 2007 National Survey of Mental Health and Wellbeing (NSMHWB; n=2677) were submitted to confirmatory factor analysis and several alternative conceptual models were tested. Empirical support was found for an intercorrelated four-factor model reflecting re-experiencing, avoidance, dysphoria, and hyperarousal symptoms. Given that the DSM is currently under revision, research addressing structural validity concerns is especially timely. The present findings renew calls in the structural literature suggesting that the structure of PTSD should be revised in DSM-V.",0,0 +5841,Posttraumatic Stress Disorder and Other Psychological Sequelae Among World Trade Center Clean Up and Recovery Workers,"We assessed the health of workers exposed to the World Trade Center (WTC) site and of a comparison group of unexposed workers, by means of a mail survey. Exposed workers reported higher frequency of symptoms consistent with posttraumatic stress disorder (PTSD), depression, anxiety, and other psychological problems, approximately 20 months after the disaster. PTSD was positively associated with traumatic on-site experiences and with respiratory problems. These findings may have important clinical and public health implications.",0,0 +5842,"Beyond fear, helplessness, and horror: Peritraumatic reactions associated with posttraumatic stress symptoms among traumatized delinquent youth.","This study investigated associations among peritraumatic reactions, including the triad of fear, helplessness, and horror specified in Criterion A2 of the DSM-IV-R, and posttraumatic stress disorder (PTSD) diagnostic status and symptom severity among a sample of 555 juvenile justice-involved adolescents (188 girls and 367 boys). Results of hierarchical and logistic regression analyses indicated that, with the exception of helplessness, peritraumatic reactions beyond the DSM-IV-R triad, particularly disorganized behavior and confusion, were more strongly associated with PTSD diagnosis and symptoms among these youth than were the A2 criteria. Gender differences also emerged in the pattern of results, with disorganized behavior and dissociation associated more strongly with PTSD symptom levels among girls than boys. In addition, investigation of the relations between peritraumatic reactions and the recently proposed 5-factor model of PTSD symptom clusters showed that peritraumatic disorganization was the most consistently associated with PTSD symptoms, whereas peritraumatic helplessness was uniquely associated with Numbing among boys and Dissociation among girls. These results have implications for informing the DSM-5 as well as adding to the evidence base for deriving developmentally sensitive criteria for the diagnosis of PTSD among youth exposed to trauma.",0,0 +5843,Neuropsychological functioning of combat veterans with posttraumatic stress disorder and mild traumatic brain injury,"This study examined the neuropsychological performance of 125 outpatient Operation Enduring Freedom/Operation Iraqi Freedom combat veterans with posttraumatic stress disorder (PTSD) and nonacute mild traumatic brain injury (TBI) (n = 66) and PTSD (n = 59) across multiple cognitive domains to determine whether mild TBI results in greater impairment among those with PTSD. Profile analyses revealed that veterans with PTSD and mild TBI did not differ significantly from those with just PTSD across domains, suggesting that comorbid mild TBI does not result in an additive effect. A norms-based comparison also revealed that neither group demonstrated impaired performance on any of the objective neuropsychological measures examined. However, both groups endorsed moderately elevated symptoms of depression and anxiety, indicating that comorbid psychopathology may contribute to subjective cognitive complaints.",0,0 +5844,Second-generation structural equation modeling with a combination of categorical and continuous latent variables: New opportunities for latent class–latent growth modeling.,,0,0 +5845,Posttraumatic Stress Disorder and Psychosocial Functioning after Severe Traumatic Brain Injury,"The aim of this study was to investigate the influence of posttraumatic stress disorder (PTSD) on rehabilitation after severe traumatic brain injury (TBI). Ninety-six patients with severe TBI patients were assessed 6 months after hospital discharge with the Posttraumatic Stress Disorder Interview, the Functional Assessment Measure (FAM), the Community Integration Questionnaire (CIQ), the Overt Aggression Scale (OAS), the General Health Questionnaire (GHQ), the Beck Depression Inventory (BDI), and the Satisfaction with Life Scale (SWL). PTSD was diagnosed in 27% of patients. Patients with PTSD reported higher scores on the GHQ and BDI, and lower scores on the FAM, CIQ, OAS, and SWLS than those without PTSD. Effective rehabilitation after severe TBI may be enhanced by management of PTSD.",0,0 +5846,Responsivity to Stress in Chronic Posttraumatic Stress Disorder Due to Childhood Sexual Abuse,"The purpose of this study was to investigate psychological, cardiovascular, and neuroendocrine reactivity to standardized stress tests (orthostatic challenge, Stroop Color Word Test) in drug-free adult women with chronic PTSD due to repetitive childhood sexual abuse. At baseline, the 11 patients showed significantly higher mean scores on the Symptom Check List-90 and the Profile of Mood States than 13 healthy female controls, whereas baseline cardiovascular or hormonal parameters showed no differences between the groups. Also, no significant differences were found between the two groups in cardiovascular and hormonal responsivity to the stress tests. Thus, in the presence of robust psychological differences, the patients with chronic PTSD due to childhood sexual abuse did not show alterations in baseline values of neurobiological parameters, nor did they react differently to a physical and mental stress test when compared to healthy controls.",0,0 +5847,Mental health following traumatic injury: Toward a health system model of early psychological intervention,"In 2005, over 2 million people in the United States of America were hospitalised following non-fatal injuries. The frequency with which severe injury occurs renders it a leading cause of posttraumatic stress disorder and other trauma-related psychopathology. In order to develop a health system model of early psychological intervention for this population, we review the literature that pertains to mental health early intervention. The relevant domains include prevalence of psychopathology following traumatic injury, the course of symptoms, screening, and early intervention strategies. On the basis of available evidence, we propose a health system model of early psychological intervention following traumatic injury. The model involves screening for vulnerability within the hospital setting, follow-up screening for persistent symptoms at one month posttrauma, and early psychological intervention for those who are experiencing clinical impairment. Recommendations are made to facilitate tailoring early intervention psychological therapies to the special needs of the injury population.",0,0 +5848,Evaluation of the Dimensions of Anger Reactions-5 (DAR-5) Scale in combat veterans with posttraumatic stress disorder,"After a traumatic event many people experience problems with anger which not only results in significant distress, but can also impede recovery. As such, there is value to include the assessment of anger in routine post-trauma screening procedures. The Dimensions of Anger Reactions-5 (DAR-5), as a concise measure of anger, was designed to meet such a need, its brevity minimizing the burden on client and practitioner. This study examined the psychometric properties of the DAR-5 with a sample of 163 male veterans diagnosed with Posttraumatic Stress Disorder. The DAR-5 demonstrated internal reliability (α=.86), along with convergent, concurrent and discriminant validity against a variety of established measures (e.g., HADS, PCL, STAXI). Support for the clinical cut-point score of 12 suggested by Forbes et al. (2014, Utility of the dimensions of anger reactions-5 (DAR-5) scale as a brief anger measure. Depression and Anxiety, 31, 166-173) was observed. The results support considering the DAR-5 as a preferred screening and assessment measure of problematic anger.",0,0 +5849,MOSAIC (MOthers' Advocates In the Community): protocol and sample description of a cluster randomised trial of mentor mother support to reduce intimate partner violence among pregnant or recent mothers,"Intimate partner violence (IPV) is prevalent globally, experienced by a significant minority of women in the early childbearing years and is harmful to the mental and physical health of women and children. There are very few studies with rigorous designs which have tested the effectiveness of IPV interventions to improve the health and wellbeing of abused women. Evidence for the separate benefit to victims of social support, advocacy and non-professional mentoring suggested that a combined model may reduce the levels of violence, the associated mental health damage and may increase a woman's health, safety and connection with her children. This paper describes the development, design and implementation of a trial of mentor mother support set in primary care, including baseline characteristics of participating women.MOSAIC (MOtherS' Advocates In the Community) was a cluster randomised trial embedded in general practice and maternal and child health (MCH) nursing services in disadvantaged suburbs of Melbourne, Australia. Women who were pregnant or with infants, identified as abused or symptomatic of abuse, were referred by IPV-trained GPs and MCH nurses from 24 general practices and eight nurse teams from January 2006 to December 2007. Women in the intervention arm received up to 12 months support from trained and supported non-professional mentor mothers. Vietnamese health professionals also referred Vietnamese women to bilingual mentors in a sub-study. Baseline and follow-up surveys at 12 months measured IPV (CAS), depression (EPDS), general health (SF-36), social support (MOS-SF) and attachment to children (PSI-SF). Significant development and piloting occurred prior to trial commencement. Implementation interviews with MCH nurses, GPs and mentors assisted further refinement of the intervention. In-depth interviews with participants and mentors, and follow-up surveys of MCH nurses and GPs at trial conclusion will shed further light on MOSAIC's impact.Despite significant challenges, MOSAIC will make an important contribution to the need for evidence of effective partner violence interventions, the role of non-professional mentors in partner violence support services and the need for more evaluation of effective health professional training and support in caring for abused women and children among their populations.ACTRN12607000010493.",0,0 +5850,"Abuse‐Related Post‐Traumatic Stress, Coping, and Tobacco Use in Pregnancy","pregnancy cessation PTSD abuse coping ABSTRACT Objective: To examine the relationship between trauma history, posttraumatic stress disorder (PTSD), coping, and smoking in a diverse sample of pregnant women, some of whom are active smokers. Design: Secondary analysis from a prospective study on PTSD and pregnancy outcomes. Setting: Maternity clinics at three health systems in the midwestern United States. Participants: Women age 18 or older (1,547) interviewed at gestational age fewer than 28 weeks. Methods: Participants were classified at nonsmokers, quitters (stopped smoking during pregnancy), and pregnancy smokers. Demographic, trauma, and pregnancy factors, substance use, and use of tobacco to cope were compared across groups. Logistic regression assessed the influence of these factors on being a smoker versus a nonsmoker and a quitter versus a pregnancy smoker. Results: Smokers differed from nonsmokers on all demographic risk factors (being African American, being preg- nant as a teen, having lower income and less education, and living in high-crime areas), had higher rates of current and lifetime PTSD, and were more likely to report abuse as their worst trauma. Pregnancy smokers had lower levels of education, were more likely to classify their worst trauma as ''extremely troubling,'' and were more likely to exhibit PTSD hyperarousal symptoms. In regression models, smoking ''to cope with emotions and problems'' doubled the odds of continuing to smoke while pregnant even after accounting for several relevant risk factors.",0,0 +5851,Personality Profiles of Intimate Partner Violence Offenders With and Without PTSD,"Intimate partner violence (IPV) is a serious forensic and clinical problem throughout the United States. Research aimed at defining and differentiating subgroups of IPV offenders using standardized personality instruments may eventually help with matching treatments to specific individuals to reduce recidivism. The current study used a convenience sample of court-ordered IPV offenders to explore whether the presence of posttraumatic stress disorder (PTSD) can reliably differentiate this population in terms of personality characteristics and clinical symptoms. Profile analysis showed meaningful differences between PTSD (n = 22), non-PTSD (n = 43), and nontrauma (n = 13) groups on a variety of Millon Clinical Multiaxial Inventory and Personality Assessment Inventory personality and clinical scales. The PTSD group reported significantly less IPV than the non-PTSD and nontrauma groups, as well as endorsing greater overall distress, greater symptoms of anxiety, and greater symptoms of depression across instrum...",0,0 +5852,Symptom experience during acute coronary syndrome and the development of posttraumatic stress symptoms,"There is growing evidence for the development of posttraumatic stress symptoms as a consequence of acute cardiac events. Acute coronary syndrome (ACS) patients experience a range of acute cardiac symptoms, and these may cluster together in specific patterns. The objectives of this study were to establish distinct symptom clusters in ACS patients, and to investigate whether the experience of different types of symptom clusters are associated with posttraumatic symptom intensity at six months. ACS patients were interviewed in hospital within 48 h of admission, 294 patients provided information on symptoms before hospitalisation, and cluster analysis was used to identify patterns. Posttraumatic stress symptoms were assessed in 156 patients at six months. Three symptom clusters were identified; pain symptoms, diffuse symptoms and symptoms of dyspnea. In multiple regression analyses, adjusting for sociodemographic, clinical and psychological factors, the pain symptoms cluster (β = .153, P = .044) emerged as a significant predictor of posttraumatic symptom severity at six months. A marginally significant association was observed between symptoms of dyspnea and reduced intrusive symptoms at six months (β = -.156, P = .061). Findings suggest acute ACS symptoms occur in distinct clusters, which may have distinctive effects on intensity of subsequent posttraumatic symptoms. Since posttraumatic stress is associated with adverse outcomes, identifying patients at risk based on their symptom experience during ACS may be useful in targeting interventions.",0,0 +5853,Psychosocial treatment of posttraumatic stress disorder,"A review of the psychosocial treatment research literature indicates that several forms of therapy appear to be useful in reducing the symptoms of posttraumatic stress disorder (PTSD). Strongest support is found for the treatments that combine cognitive and behavioral techniques. Hypnosis, psychodynamic, anxiety management, and group therapies may also produce short-term symptom reduction. Still unknown is whether any approach produces lasting effects. Imaginal exposure to trauma memories and hypnosis are techniques most likely to affect the intrusive symptoms of PTSD, whereas cognitive and psychodynamic approaches may better address the numbing and avoidance symptom cluster. Treatment should be tailored to the severity and type of presenting PTSD symptoms, to the type of trauma experience, and to the many likely comorbid diagnoses and adjustment problems. © 1997 John Wiley & Sons, Inc.",0,0 +5854,Dissociation and Posttraumatic Stress Disorder: A Latent Profile Analysis,"The fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, ) contains a dissociative subtype for posttraumatic stress disorder (PTSD) characterized by significant depersonalization and derealization. In this study the PTSD dissociative subtype was examined using latent profile analysis in a sample of 541 trauma-exposed college students. Items from the PTSD Checklist and Multiscale Dissociation Inventory were used as latent class indicators. Results supported a 3-class solution including a well-adjusted class, a PTSD class, and a PTSD/dissociative class characterized by elevated symptoms of PTSD, depersonalization, and derealization. Significant class differences were found on a number of measures of related psychopathology with Cohen's d effect size estimates ranging from 0.04 to 1.86. Diagnostic and treatment implications regarding the dissociative subtype are discussed.",0,0 +5855,Epigenetic Signatures May Explain the Relationship between Socioeconomic Position and Risk of Mental Illness: Preliminary Findings from an Urban Community-Based Sample,"Low socioeconomic position (SEP) has previously been linked to a number of negative health indicators, including poor mental health. The biologic mechanisms linking SEP and mental health remain poorly understood. Recent work suggests that social exposures influence DNA methylation in a manner salient to mental health. We conducted a pilot investigation to assess whether SEP, measured as educational attainment, modifies the association between genomic methylation profiles and traumatic stress in a trauma-exposed sample. Results show that methylation × SEP interactions occur preferentially in genes pertaining to nervous system function, suggesting a plausible biological pathway by which SEP may enhance sensitivity to stress and, in turn, risk of posttraumatic stress disorder.[Supplementary materials are available for this article. Go to the publisher's online edition of Biodemography and Social Biology for the following free supplemental resource: Supplementary tables of full model and functional annotation clustering results.].",0,0 +5856,Ontogenetic Perspectives on the Neurobiological Basis of Psychopathology Following Abuse and Neglect,"Introduction The US Federal Child Abuse Prevention and Treatment Act defines child abuse and neglect as the recent act or failure of parents and caretakers resulting in physical or emotional injury, sexual exploitation, and/or death. According to national statistics on the prevalence of childhood abuse and neglect in the United States, 905,000 people under 18 years of age were victimized during 2006. Of these, 64.1% were neglected; 16.0% were physically abused; and 15.1% suffered abandonment, threats of harm, congenital drug addiction, or other forms of maltreatment. Furthermore, 8.8% were sexually abused; 6.6% were either emotionally or psychologically maltreated; and 2.2% were medically neglected. Childhood maltreatment is a major risk factor for the development of depression, drug and alcohol abuse, posttraumatic stress disorder (PTSD), bipolar disorder (BPD), personality disorders, and aggression. Depending on an individual's sex, genetic makeup, and age at insult, chronic childhood traumatic stress (CTS) alters the endocrine profile and gene-expression pattern, as well as the functional activity, hemispheric integration, and morphology of the brain. In this chapter, we offer a holistic portrayal of the pathways between maltreatment and adverse psychiatric outcomes, arguing that the impact of abuse and neglect is best understood in the context of normal ontogenetic processes relating to trajectories of brain development. Neuropsychiatric Effects Of Trauma Several studies have documented the consequences of exposure to CTS. One of the most compelling is the Adverse Childhood Experience (ACE) Study, led by Vincent Felitti and Robert Anda (Felitti et al., 1998). © Cambridge University Press 2010.",0,0 +5857,Long term course of chronic posttraumatic stress disorder in traffic accident victims: a three-year prospective follow-up study,"The purpose of the present study was to gather prospective longitudinal data on the long-term course and outcome of chronic posttraumatic stress disorder (PTSD). The target population for this study was 74 injured traffic accident victims who had been previously followed-up for one year after the trauma. Nineteen of the original 24 PTSD subjects (79%) and 39 of the original 50 Non-PTSD subjects (78%) were available for this study, which took place during the fourth year after the accident. Our results show that 10 (53%) of the 19 patients with PTSD at one-year still suffered from PTSD after another two-year follow-up interval, while 9 recovered from PTSD during this follow-up period. Only 2 of the 39 without PTSD at one year developed delayed onset PTSD. The best predictor of recovery from chronic PTSD was the initial level of posttraumatic reaction immediately after the accident. These results demonstrate that spontaneous recovery from PTSD can occur even among patients who are currently considered chronic. Severity of initial reaction to the trauma appears to be a major risk factor for non-remitting chronic PTSD.",0,0 +5858,A comparison of posttraumatic stress disorder and posttraumatic growth in *American and Israeli war veterans,"Over 50% of people experience a traumatic event during their lifetimes (Del, Kevin, Scotti, & Chen, 2006). These traumas may include, rape, a car accident, diagnosis of a chronic illness or military combat (Tedeschi & Calhoun, 2004). The trauma may have no impact on the individual, a negative effect, known as posttraumatic stress disorder (PTSD) or a positive effect, known as posttraumatic growth (PTG). The research has shown that positive and negative responses to a trauma may co-exist (Tedeschi & Calhoun 1995). Extensive research has been conducted examining the negative impact war has on veterans (Elder & Clipp, 1989; Erbes, Dikel, & Eberly, 2006; Solomon & Mikulincer, 1987). However, little research has focused on the positive outcomes veterans may exhibit due to their war experience. The purpose of the current study was to determine if there were significant differences in PTSD and PTG between war veterans in the United States of America and Israel. The current study focused on differences between the value systems of the two cultures and the amount of perceived social support within the two cultures as possible variables contributing to the differences in PTSD and PTG. Additionally, the current study examined veteran type, age, sex, marital status, branch of military served, years of military experience and employment status as possible predictor variables in the experience of PTSD and PTG. A total of 137 war veterans (70 America and 67 Israeli) participated in this study. Each participant completed several self-report questionnaires. The following measures were included: a demographics questionnaire, the Posttraumatic Stress Disorder Checklist-Military (PCL-M; Weathers, Litz, Herman, Huska & Keane, 1993), the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996), the Multidimensional Scale of Perceived Social Support (MSPSS; Zimet, Dahlem, Zimet, & Farley, 1988), and the Schwartz Value Scale (SVS; Schwartz, 1992). It was hypothesized that there would be a significant difference in the cultural values exhibited between American war veterans and Israeli war veterans. Results supported this hypothesis. However, further analyses demonstrated that veteran type (American or Israeli) was not a significant predictor in the experience of PTSD or PTG. In addition, perceived social support did not mediate the relationships between veteran type and PTSD and veteran type and PTG. Additional findings provided evidence for the experience of PTG in Israel in the same five-factor model found in the United States. Results indicated that within this study younger veterans were more likely to report higher levels of PTSD than older veteran and veterans with more years of military service were more likely to report higher levels of PTSD than veterans with less years of military service. Further, results demonstrated that female veterans were more likely to report higher levels of PTG than male veterans and that married veterans were more likely to report higher levels of PTG than single veterans. Results indicated veterans from the Air Force were less likely to experience PTSD and PTG than veterans from the other branches of military. Implications, limitations and directions for future research were presented. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5859,Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis.,,0,0 +5860,"Political violence, health, and coping among Palestinian women in the West Bank.","Political violence poses a considerable threat to the health of individuals. Protective factors, however, may help people to build resilience in the face of political violence. This study examined the influence of lifetime and past 30-day experiences of political violence on the mental and physical health of adult Palestinian women from the West Bank (N = 122). Two hypotheses were examined: (a) Reports of political violence exposure would be related to reports of poorer physical and mental health and (b) several coping variables (proactive coping; self-reliance; reliance on political, family, and religious support; and political or civic engagement) would function as moderators of the effects of political violence, buffering or weakening its effects on physical and mental health outcomes. Both lifetime and past 30-day measures of political violence were positively correlated with posttraumatic stress disorder symptoms. Proactive coping, reliance on self, and political or civic engagement significantly interacted with political violence to affect health in a counterintuitive direction; those with higher scores on these more internalized and individualistic coping strategies demonstrated worse health as political violence increased. Reliance on religious support, and, in particular, support from and participation in activities of religious institutions, emerged as a significant protective factor. Results underscore the importance of looking not only at whether political violence affects health, but also at how the relationships between political violence and health might occur, including the potential protective influence of resources within people's social environments.",0,0 +5861,Red/near-infrared light-emitting diode therapy for traumatic brain injury,"This invited paper reviews our research with scalp application of red/near-infrared (NIR) light-emitting diodes (LED) to improve cognition in chronic, traumatic brain injury 1. Application of red/NIR light improves mitochondrial function (especially hypoxic/compromised cells) promoting increased ATP, important for cellular metabolism. Nitric oxide is released locally, increasing regional cerebral blood flow. Eleven chronic, mTBI participants with closed-head injury and cognitive dysfunction received 18 outpatient treatments (MWF, 6 Wks) starting at 10 Mo. to 8 Yr. post-mTBI (MVA, sports-related, IED blast injury). LED therapy is non-invasive, painless, non-thermal (FDA-cleared, non-significant risk device). Each LED cluster head (2.1 diameter, 500mW, 22.2mW/cm2) was applied 10 min (13J/cm2) to 11 scalp placements: midline, from front-to-back hairline; and bilaterally on dorsolateral prefrontal cortex, temporal, and parietal areas. Testing performed pre- and post-LED (+1 Wk, 1 and 2 Mo post- 18th treatment) showed significant linear trend for LED effect over time, on improved executive function and verbal memory. Fewer PTSD symptoms were reported. New studies at VA Boston include TBI patients treated with transcranial LED (26J/cm2); or treated with only intranasal red, 633nm and NIR, 810nm diodes placed into the nostrils (25 min, 6.5mW, 11.4J/cm2). Intranasal LEDs are hypothesized to deliver photons to hippocampus. Results are similar to Naeser et al. (2014). Actigraphy sleep data show increased sleep time (average, +1 Hr/night) post-18th transcranial or intranasal LED treatment. LED treatments may be self-administered at home (Naeser et al., 2011). A shamcontrolled study with Gulf War Illness Veterans is underway.",0,0 +5862,A different kind of comorbidity: Understanding posttraumatic stress disorder and chronic pain.,"Many traumatic events leave lingering physical injuries and chronic pain in their wake, in addition to trauma-related psychopathology. In this review, we provide an overview of developments in the recent literature on co-morbid posttraumatic stress disorder (PTSD) and chronic pain. Starting with the conceptual models presented by Sharp and Harvey (2001) and Asmundson, Coons, Taylor, and Klatz (2002), this review summarizes newer studies that examine prevalence of these co-morbid conditions. Additionally, we present an updated synthesis of research on factors that may maintain both chronic physical pain and PTSD in trauma survivors. Consideration of the impact of this co-morbidity on psychosocial assessment and treatment also is discussed, with particular attention to issues that warrant additional research.",0,0 +5863,Growth Curve Analysis in Contemporary Psychological Research,"The term “growth curve” is used to describe data where: (1) the same entities are repeatedly observed, (2) the same procedures of measurement and scaling of observations are used, and (3) the timing of the observations is known. Growth curves are now common in many areas of psychological research, and some of these are presented here. The term “growth curve analysis” denotes the processes of describing, testing hypotheses, and making scientific inferences about the growth and change patterns in a wide range of time-related phenomena. In this sense, growth curve analyses are a specific form of the larger set of developmental and longitudinal research methods, but the unique features of growth data permit unique kinds of analyses. Formal models for the analysis of growth curves which have been developed in many different substantive domains are described here in five sections: (1) An introduction to growth curves, (2) linear models of growth, (3) multiple groups in growth curve models, (4) aspects of dynamic theory for growth models, and (5) multiple variables in growth curve analyses. We conclude with a discussion of future issues raised by the current growth models.",0,0 +5864,Tobacco use trajectories among a large cohort of treated smokers with posttraumatic stress disorder,"This study identified distinct tobacco use trajectories across 18months in 943 veteran smokers with posttraumatic stress disorder (PTSD) in order to describe quit and relapse patterns, examine associations between trajectory groups on baseline characteristics and cessation service utilization, and explore group differences in mental health outcomes.Veterans who participated in a multisite, randomized trial of integrated smoking cessation care were grouped using k-means clustering based on reported daily tobacco use between baseline and 18months. Four trajectory clusters were identified: no reduction (62%), temporary reduction (11%), late sustained reduction (9%) and early sustained reduction (18%).Median quit times in the early, late, temporary, and no reduction groups were 451, 141.5, 97, and 2days, respectively. Compared to the early reduction group, the temporary reduction group exhibited higher baseline depression (p<0.01) and anxiety (p<0.01), but did not differ in treatment received, with both groups attending significantly more cessation visits (p<0.001) and more likely to receive recommended pharmacotherapy (p<0.001) than the no reduction group between baseline and 6months. The early reduction group exhibited lower depression relative to the no reduction (p<0.01) and temporary reduction (p<0.01) groups across all assessments between baseline and 18months. Differences were not observed between groups in depressive or PTSD symptom change over time between baseline and 18months.Tobacco use trajectories among treated smokers with PTSD vary distinctly. Characteristics of identified subgroups may lead to targeted interventions among smokers with PTSD and potentially other psychiatric disorders.",0,0 +5865,Psychosocial Functioning and Health-Related Quality of Life Associated with Posttraumatic Stress Disorder in Male and Female Iraq and Afghanistan War Veterans: The VALOR Registry,"Iraq and Afghanistan war veterans suffer from high rates of posttraumatic stress disorder (PTSD). Given the growing number of women in the military, there is a critical need to understand the nature and extent of potential gender differences in PTSD-associated psychosocial functioning and health-related quality of life (HRQOL) in Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) veterans, which has not been studied to date.We used data from a gender-balanced national patient registry of warzone-deployed OEF/OIF veterans (Project VALOR: Veterans After-Discharge Longitudinal Registry) to determine the impact of gender on PTSD-related psychosocial functioning and HRQOL in 1,530 United States Iraq and Afghanistan war veterans (50% female) with and without PTSD. Overall psychosocial functioning was assessed with the Inventory of Psychosocial Functioning (IPF) and mental and physical HRQOL with the Veterans RAND 12-item Health Survey (VR-12) Mental and Physical Component Summary scores, respectively. Stratified linear regression models estimated gender-specific associations, controlling for demographic, deployment, and postdeployment factors. Interaction models tested for significant effect moderation by gender.In gender-stratified models, PTSD was strongly associated with higher IPF scores (greater functional impairment), with similar associations by gender. PTSD was also associated with lower Mental Component Summary scores (lower mental HRQOL) in both men and women, with no evidence of effect moderation by gender. PTSD was associated with lower Physical Component Summery scores in women but not men in adjusted models; however, interactions were not significant.PTSD among warzone-deployed OEF/OIF veterans is associated with significant impairments in both overall psychosocial functioning and HRQOL, with associations that are largely similar by gender. Findings support the need for thorough and continuous assessment of functional impairment and HRQOL during treatment of PTSD for both male and female OEF/OIF veterans.",0,0 +5866,Psychiatric and Cognitive Effects of War in Former Yugoslavia,"Although impunity for those responsible for trauma is widely thought to be associated with psychological problems in survivors of political violence, no study has yet investigated this issue.To examine the mental health and cognitive effects of war trauma and how appraisal of redress for trauma and beliefs about justice, safety, other people, war cause, and religion relate to posttraumatic stress responses in war survivors.A cross-sectional survey conducted between March 2000 and July 2002 with a population-based sample of 1358 war survivors who had experienced at least 1 war-related stressor (combat, torture, internal displacement, refugee experience, siege, and/or aerial bombardment) from 4 sites in former Yugoslavia, accessed through linkage sampling. Control groups at 2 study sites were matched with survivors on sex, age, and education.Semi-structured Interview for Survivors of War, Redress for Trauma Survivors Questionnaire, Emotions and Beliefs After War questionnaire, Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).The mean (SD) age was 39 (12) years, 806 (59%) were men, and 339 (25%) had high school or higher level of education. Participants reported experiencing a mean of 12.6 war-related events, with 292 (22%) and 451 (33%) having current and lifetime posttraumatic stress disorder (PTSD), respectively, and 129 (10%) with current major depression. A total of 1074 (79%) of the survivors reported a sense of injustice in relation to perceived lack of redress for trauma. Perceived impunity for those held responsible for trauma was only one of the factors associated with sense of injustice. Relative to controls, survivors had stronger emotional responses to impunity, greater fear and loss of control over life, less belief in benevolence of people, greater loss of meaning in war cause, stronger faith in God, and higher rates of PTSD and depression. Fear and loss of control over life were associated with PTSD and depression (odds ratio [OR], 2.91; 95% CI, 2.27-3.74 and OR, 2.30; 95% CI, 1.75-3.03, respectively), and emotional responses to impunity showed a relatively weaker association with PTSD (OR, 1.53; 95% CI, 1.16-2.02) and depression (OR, 1.39; 95% CI, 1.02-1.91). Appraisal of redress for trauma was not associated with PTSD or depression.PTSD and depression in war survivors appear to be independent of sense of injustice arising from perceived lack of redress for trauma. Fear of threat to safety and loss of control over life appeared to be the most important mediating factors in PTSD and depression. These findings may have important implications for reconciliation efforts in postwar countries and effective interventions for traumatized war survivors.",0,0 +5867,The burden of full and subsyndromal posttraumatic stress disorder among police involved in the World Trade Center rescue and recovery effort,"This study examined the prevalence, correlates, and perceived mental healthcare needs associated with subsyndromal PTSD in police involved in the World Trade Center (WTC) rescue and recovery effort.A total of 8466 police completed an interview/survey as part of the WTC Medical monitoring and Treatment Program an average of four years after 9/11/2001.The past month prevalence of full and subsyndromal WTC-related PTSD was 5.4% and 15.4%, respectively. Loss of someone or knowing someone injured on 9/11 (odds ratios [ORs]=1.56-1.86), pre-9/11 stressors (ORs=1.30-1.50), family support (ORs=0.83-0.94), and union membership (ORs=0.50-0.52) were associated with both full and subsyndromal PTSD. Exposure to the dust cloud (OR=1.36), performing search and rescue work (OR=1.29), and work support (OR=0.89) were additionally associated with subsyndromal PTSD. Rates of comorbid depression, panic disorder, and alcohol use problems (ORs=3.82-41.74), and somatic symptoms and functional difficulties (ORs=1.30-1.95) were highest among police with full PTSD, with intermediate rates among police with subsyndromal PTSD (ORs=2.93-7.02; and ORs=1.18-1.60, respectively). Police with full and subsyndromal PTSD were significantly more likely than controls to report needing mental healthcare (41.1% and 19.8%, respectively, versus 6.8% in trauma controls).These results underscore the importance of a more inclusive and dimensional conceptualization of PTSD, particularly in professions such as police, as operational definitions and conventional screening cut-points may underestimate the psychological burden for this population. Accordingly, psychiatric clinicians should assess for disaster-related subsyndromal PTSD symptoms in disaster response personnel.",0,0 +5868,Children’s Disaster Reactions: the Influence of Exposure and Personal Characteristics,"This paper reviews children's reactions to disasters and the personal and situational factors that influence their reactions. Posttraumatic stress disorder (PTSD) and posttraumatic stress reactions are the most commonly studied outcomes, though other conditions also occur including anxiety, depression, behavior problems, and substance use. More recently, traumatic grief and posttraumatic growth have been explored. New research has delineated trajectories of children's posttraumatic stress reactions and offered insight into the long-term consequences of their disaster experiences. Risk factors for adverse outcomes include pre-disaster vulnerabilities, perception of threat, and loss and life disruptions post-disaster. Areas in need of additional research include studies on the timing and course of depression and anxiety post-event and their interactions with other disorders, disaster-related functional and cognitive impairment, positive outcomes, and coping.",0,0 +5869,The presence of resilience is associated with a healthier psychological profile in intensive care unit (ICU) nurses: Results of a national survey,"ICU nurses are repeatedly exposed to work related stresses resulting in the development of psychological disorders including posttraumatic stress disorder and burnout syndrome. Resilience is a learnable multidimensional characteristic enabling one to thrive in the face of adversity. In a national survey, we sought to determine whether resilience was associated with healthier psychological profiles in intensive care unit nurses.Surveys were mailed to 3500 randomly selected ICU nurses across the United States and included: demographic questions, the Posttraumatic Diagnostic Scale, Hospital Anxiety and Depression Scale, Maslach Burnout Inventory and the Connor-Davidson Resilience Scale.Overall, 1239 of the mailed surveys were returned for a response rate of 35%, and complete data was available on a total of 744 nurses. Twenty-two percent of the intensive care unit nurses were categorized as being highly resilient. The presence of high resilience in these nurses was significantly associated with a lower prevalence of posttraumatic stress disorder, symptoms of anxiety or depression, and burnout syndrome (<0.001 for all comparisons). In independent multivariable analyses adjusting for five potential confounding variables, the presence of resilience was independently associated with a lower prevalence of posttraumatic stress disorder (p<0.001), and a lower prevalence of burnout syndrome (p<0.001).The presence of psychological resilience was independently associated with a lower prevalence of posttraumatic stress disorder and burnout syndrome in intensive care unit nurses. Future research is needed to better understand coping mechanisms employed by highly resilient nurses and how they maintain a healthier psychological profile.",0,0 +5870,Mild Traumatic Brain Injury and Posttraumatic Stress Disorder: Clinical and Conceptual Complexities,"The wars in Iraq and Afghanistan have raised public con-sciousness of traumatic brain injury (TBI) and posttraumaticstress disorder (PTSD), two of the most common healthconsequences of contemporary military deployment. TBI andPTSD may each in their own right exert a toll on affectedindividuals. Within the war zone, however, brain injury oftenoccurs within a broader context of extreme psychologicalstress (i.e., traumatic stress). Th e same dangerous circumstances(e.g., combat, encounters with improvised explosive devices)that lead to increased risk of TBI also place service membersat increased risk for PTSD. Therefore, the prevalence ofPTSD in returning war-zone veterans who have a history ofdeployment-related TBI are elevated, especially when thebrain injury falls at the milder end of the severity range,as is the case with the majority of deployment-relatedTBIs. For example, a RAND study estimated that almost20% of a representative sample of Operation EnduringFreedom/Operation Iraqi Freedom veterans screened positivefor history of mild TBI (mTBI), and that of those reportinga deployment mTBI, approximately 34% also screenedpositive for PTSD (Tanielian & Jaycox, 2008).The comorbidity of mTBI and PTSD is not limited, however,to war-zone veterans. Civilian events such as motor vehicleaccidents and interpersonal ass ault may also be associated withboth TBI and psychological traum a sufficiently severe to lead toPTSD. The prevalence of comorbid mTBI and PTSD is notwell-documented in civilians, but mTBI and/or PTSD eachaffect many civilians. The Centers for Disease Control andPrevention (2010) estimate that over 1.7 million people sustaina TBI each year, and that over 75% of these injuries are mild.A U.S. population-based survey estimated the prevalenceof PTSD in the general population to be at 7–8% (Kessler,Sonnega, Bromet, Hughes, & Nelson, 1995).Despite the relatively high rates of mTBI and PTSD inat-risk populations, much remains unknown about the clinicalconsequences in individuals who have both incurred anmTBI and experience PTSD. The sequelae of mTBI are oftenreferred to as post traumatic or post concussive symptoms.Some post traumatic symptoms (e.g., irritability, neurocog-nitive complaints) overlap with PTSD symptoms, makingdifferential diagnosis difficult. Other conditions commonlyco-occurring with TBI history and PTSD, such as chronicpain, depression, and substance abuse, may further complicatethe clinical presentation of patients with both history of mTBIand PTSD. As a result, considerablechallengesarise inregardsto both the assessment and clinical management of patientswith co-morbid mTBI and PTSD.The field of neuropsychology is well-positioned to tacklemany of the clinical and conceptual challenges posed bycomorbid mTBI and PTSD. This virtual special issue of theJournal of the International Neuropsychological Society (JINS)compiles eight papers on the topic of TBI and/or PTSD thatwere previously published in regular issues of JINS. The papersare for the first time grouped together with the goal of collec-tively addressing the issues con fronting clinicians who assessand care for patients with history of mTBI and PTSD.",0,0 +5871,Global Perspectives on Resilience in Children and Youth,"Global concerns about the consequences of disasters, political violence, disease, malnutrition, maltreatment, and other threats to human development and well-being have sparked a surge of international interest in resilience science. This article highlights progress and issues in research that aims to understand variations in human adaptation to adverse experiences. Two key questions are considered: Why is a new wave of global research on resilience important for developmental science? and Why is developmental science important for global resilience? The conclusion calls for developmental scientists to engage in international efforts to promote resilience.",0,0 +5872,Complex Comorbidity Clusters in OEF/OIF Veterans,"A growing body of research on US Veterans from Afghanistan and Iraq [Operations Enduring and Iraqi Freedom, and Operation New Dawn (OEF/OIF)] has described the polytrauma clinical triad (PCT): traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), and pain. Extant research has not explored comorbidity clusters in this population more broadly, particularly co-occurring chronic diseases.The aim of the study was to identify comorbidity clusters among diagnoses of deployment-specific (TBI, PTSD, pain) and chronic (eg, hypertension, diabetes) conditions, and to examine the association of these clusters with health care utilization and adverse outcomes.This was a retrospective cohort study.The cohort comprised OEF/OIF Veterans who received care in the Veterans Health Administration in fiscal years (FY) 2008-2010.We identified comorbidity using validated ICD-9-CM code-based algorithms and FY08-09 data, followed by which we applied latent class analysis to identify the most statistically distinct and clinically meaningful patterns of comorbidity. We examined the association of these clusters with process measures/outcomes using logistic regression to correlate medication use, acute health care utilization, and adverse outcomes in FY10.In this cohort (N=191,797), we found 6 comorbidity clusters. Cluster 1: PCT+Chronic Disease (5%); Cluster 2: PCT (9%); Cluster 3: Mental Health+Substance Abuse (24%); Cluster 4: Sleep, Amputation, Chronic Disease (4%); Cluster 5: Pain, Moderate PTSD (6%); and Cluster 6: Relatively Healthy (53%). Subsequent health care utilization patterns and adverse events were consistent with disease patterns.These comorbidity clusters extend beyond the PCT and may be used as a foundation to examine coordination/quality of care and outcomes for OEF/OIF Veterans with different patterns of comorbidity.",0,0 +5873,Sleep Problems Among Adolescent Survivors Following the 2008 Wenchuan Earthquake in China: A Cohort Study,"Objective: To examine sleep problems and associated risk factors among adolescent survivors following the 2008 Wenchuan earthquake, the deadliest earthquake to strike China in 30 years. Method: A cohort of students (N = 1,573) in the 7th and 10th grades from Dujiangyan City, 21 kilometers from the epicenter, was followed up periodically for 2 years. Participants were assessed at 12 months (n = 1,398; May 18-22, 2009), 18 months (n = 1,288; November 23-27, 2009), 24 months (n = 1,313; May 17-21, 2010), and 30 months (n = 1,038; November 22-26, 2010) after the earthquake. Adolescents were asked to complete the Pittsburgh Sleep Quality Index (PSQI; cutoff for sleep problems: total score of ≥ 8), Post-Traumatic Stress Disorder Self-Rating Scale (cutoff for probable posttraumatic stress disorder: ≥ 50), Depression Self- Rating Scale for Children (cutoff for depressive disorder: ≥ 15), Screen for Child Anxiety Related Emotional Disorders (cutoff for clinical anxiety: ≥ 25), Social Support Rate Scale, and Adolescent Self-Rating Life Events Checklist and provide demographic information. Trajectory analysis was used to examine sleep disturbance changes and associated risk factors. Results: Twelve months after the earthquake, 48.90% of participants reported sleeping less than 7 hours per night, 27.68% disclosed difficulties initiating sleep, 8.82% experienced problems staying sleep, 22.60% felt their sleep quality was poor, and 40.01% had difficulties functioning during daytime hours. Overall sleep problems, as assessed by the PSQI global scale, were stable from 18 months to 30 months following the earthquake, and the prevalence rates were between 28.79% and 30.18%. The risk of sleep issues was significantly increased in senior high school students (OR = 2.29) and in those who witnessed the tragic events directly (OR = 1.21). Depression (OR = 1.69), anxiety (OR = 1.57), poor social support (OR = 1.83), and negative life events (OR = 2.62) were also associated with increased risk and persistence of sleep problems. Conclusions: Sleep disturbances are common and persistent in adolescent earthquake survivors. Multiple demographic, psychosocial, and earthquake-related factors are associated with the increased risk of sleep difficulties. © 2012",0,0 +5874,Event-related potential dysfunction in posttraumatic stress disorder: the role of numbing,"The purpose of this study was to examine the relationship between disturbance in event-related potentials (ERPs) and symptom clusters in posttraumatic stress disorder (PTSD). ERPs were recorded in 17 unmedicated civilian PTSD patients and 17 age- and sex-matched controls during a conventional auditory oddball task. PTSD symptom clusters (re-experiencing, active avoidance, numbing, hyperarousal) were correlated with ERP measures. The PTSD group showed ERP disturbances to target stimuli (reduced P200 and P300 and increased N200 amplitude, increased N200 and P300 latency) and reduced P200 amplitude to common stimuli compared to the control group. A significant negative correlation was found between the intensity of numbing symptoms and parietal P300 amplitude. This study replicates findings of disturbed N200 and P300 components in PTSD, reflecting impairments in stimulus discrimination and attention. The finding that numbing was associated with reduced attention processing (P300) is consistent with models positing a relationship between disordered arousal and attention in PTSD.",0,0 +5875,Altered functional connectivity in posttraumatic stress disorder with versus without comorbid major depressive disorder: a resting state fMRI study.,"Posttraumatic stress disorder (PTSD) is an anxiety disorder that is often diagnosed with comorbid depressive disorder. Therefore, neuroimaging studies investigating PTSD typically include both patients with and without comorbid depression. Differences in activity of the anterior cingulate cortex (ACC) and insula have been shown to differentiate PTSD patients with and without major depressive disorder (MDD). Whether or not comorbid MDD affects resting state functional connectivity of PTSD patients has not been investigated to our knowledge. Here, resting state functional connectivity of PTSD patients with (PTSD+MDD; n=27) and without (PTSD-MDD; n=23) comorbid MDD was investigated. The subgenual ACC and insula were investigated as seed regions. Connectivity between the subgenual ACC and perigenual parts of the ACC was increased in PTSD+MDD versus PTSD-MDD. Reduced functional connectivity of the subgenual ACC with the thalamus was found in the PTSD+MDD group versus the PTSD-MDD group. These results remained significant after controlling for PTSD severity. In addition, the PTSD+MDD group showed reduced functional connectivity of the insula with the hippocampus compared to the PTSD-MDD group. However, this cluster was no longer significantly different when controlling for PTSD severity. Thus, resting state functional connectivity of the subgenual ACC may distinguish PTSD+MDD from PTSD-MDD. As PTSD patients with comorbid MDD are more treatment resistant, this result may be important for treatment development.",0,0 +5876,Evaluation of Cortical Thickness after Traumatic Brain Injury in Military Veterans,"Military service members frequently sustain traumatic brain injuries (TBI) while on active duty, a majority of which are related to explosive blasts and are mild in severity. Studies evaluating the cortical gray matter in persons with injuries of this nature remain scarce. The purpose of this study was to assess cortical thickness in a sample of military veterans with chronic blast-related TBI. Thirty-eight veterans with mild TBI and 17 veterans with moderate TBI were compared with 58 demographically matched healthy civilians. All veterans with TBI sustained injuries related to a blast and were between 5 and 120 months post-injury (M = 62.08). Measures of post-traumatic stress disorder (PTSD) and depression were administered, along with a battery of neuropsychological tests to assess cognition. The Freesurfer software package was used to calculate cortical thickness of the participants. Results demonstrated significant clusters of cortical thinning in the right hemispheric insula and inferior portions of the temporal and frontal lobe in both mild and moderate TBI participants. The TBI sample from this study demonstrated a high incidence of comorbid PTSD and depression symptoms, which is consistent with the previous literature. Cortical thickness values correlated with measures of PTSD, depression, and post-concussive symptoms. This study provides evidence of cortical thinning in the context of chronic blast-related mild and moderate TBI in military veterans who have comorbid psychiatric symptoms. Our findings provide important insight into the natural progression of long-term cortical change in this population and may have implications for future clinical evaluation and treatment.",0,0 +5877,Discrepancies between clinical needs and helpseeking behaviors in co-occurring posttraumatic stress and alcohol use disorders,"The aim of the study was to compare subjects dually diagnosed with posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) to those with only one or none of these conditions regarding helpseeking needs and behaviors.Data from a large community sample (N=3694) were used to assess the associations among lifetime PTSD and AUD, other psychiatric disorders, clinical characteristics and lifetime helpseeking behaviors derived from a semi-structured interview.Comorbid individuals had more severe clinical profiles and were more impaired than individuals with either PTSD or AUD alone or those with no/other psychiatric conditions. However, they did not differ in overall helpseeking behavior from any other group. Those with comorbid PTSD/AUD were even less likely than the other groups to seek help for depression and anxiety disorders through specific treatment facilities or the use of prescribed psychotropic drugs.Despite a greater need for treatment the comorbid group did not seek more help than the others. Their lower use of prescribed drugs supports the self-medication hypothesis, suggesting that those individuals relieve their symptoms through higher alcohol use instead. Our findings underline the need for health care facilities to encourage helpseeking behavior in the aftermath of stressful life events.",0,0 +5878,Consensus Document on European Brain Research,"Psychiatric and neurological diseases combined represent a considerable social and economic burden in Europe. A recent study conducted by the European Brain Council (EBC) quantified the 'cost and burden' of major brain diseases in Europe, amounting to €386bn per year. Considering that these costs will increase exponentially in the years to come due to ageing of the European population, it is necessary to act now in order to curb this increase and possibly reverse the trend. Thus, establishing a strong European platform supporting basic and clinical research in neuroscience is needed to confront the economic and social challenge posed by management of brain diseases in European countries. To setup a platform for discussion, EBC published in 2006 a Consensus Document on European Brain Research, describing needs and achievements of research in Europe and presenting proposals for future research programs. Since 2006, European research in neuroscience has advanced tremendously. The present document represents an update elaborated to reflect changes in research priorities and advances in brain research that have taken place since 2006. The same approach and format have been used here as in the previous version. Multinational and multidisciplinary teams have once again come together to express their views, not only on the current strengths in European research, but also on what needs to be done in priority, hoping that this update will inspire policy makers and stakeholders in directing funding for research in Europe.",0,0 +5879,Dream Dome: Do dreams shield the psyche in times of continuous stress?,"Results of analysis of 531 dreams, collected from 44 women living near the Gaza Strip in Israel under continuous rocket attacks, are presented. The most frequent themes found are 'Togetherness,' 'Being active,' 'Stress-related situation,' 'Fear and anxiety,' 'Helplessness,' and 'Masochism.' The participants were divided into 3 age groups-Young, Intermediate, and Old-and differences between the occurrence of dream themes in each group were examined. Results indicated high incidence of 'Togetherness' and 'Stress-related situation' themes in the young age group, whereas 'Symbolic' and 'No escape' themes were found to be significantly low in the same age group. On an unconscious level, the young age group seems to be the most vulnerable to the stress-related situation, the old age group is the least influenced by it, and the intermediate group makes the most psychological efforts at coping with it. © 2015 American Psychological Association.",0,0 +5880,Clinical Needs of In-treatment Pregnant Women with Co-occurring Disorders: Implications for Primary Care,"We investigated social vulnerability and behavioral health clinical profiles (symptom severity) of pregnant women with co-occurring disorders, defined as substance abuse, mental illness, and trauma at treatment entry compared to their nonpregnant counterparts and the role of interpersonal abuse in clinical presentation among pregnant women. Our objective was to provide primary health care providers with insight into the needs of pregnant patients with high behavioral health risks to serve them better during the critical window of opportunity for long-term impact. We conducted cross-sectional secondary analysis of baseline data from women enrolled in treatment programs in the Women, Co-occurring Disorders and Violence Study from nine sites across the United States. We used analysis of variance and Cochran-Mantel-Haenszel statistical analyses to compare means and frequencies of social vulnerability indicators and baseline Addiction Severity Index, Brief Symptom Inventory of mental health, and Posttraumatic Stress Diagnostic Scale scores between 152 pregnant and 2,577 nonpregnant women, and between pregnant women with and without current interpersonal abuse. Compared to nonpregnant women, pregnant women evidenced more social vulnerability but better behavioral health clinical profiles at treatment entry. Current interpersonal abuse was associated with increased mental health and trauma symptomatology but not with alcohol or drug abuse severity among pregnant women. The prenatal period is an important time for screening and intervention for factors such as social vulnerability and co-occurring disorders, known to affect pregnancy and infant outcomes; social and behavioral health services are particularly essential among pregnant women with co-occurring disorders. © 2014 Springer Science+Business Media New York.",0,0 +5881,Protective factors for intergenerational transmission of trauma among second and third generation Holocaust survivors.,"The current study explored whether differentiation of self and family communication styles were protective factors of secondary traumatic stress (STS). A sample of 215 Jewish Americans/Canadians whose families emigrated from Europe prior to or after World War II completed an online survey consisting of self-report measures. Four groups were created based on the participants’ Holocaust background and demographics: Second generation (2G; n 77) and third generation (3G; n 52), who self identified as having at least one parent or grandparent, respectively, who is/was a Holocaust survivor, and a matched control group for each generation (n 50; n 36, respectively) consisting of Jewish Americans/Canadians of European descent with no direct relatives who were Holocaust survivors. 2G and 3G referenced the Holocaust as the traumatic event on the STS measure, while the control group referenced non-Holocaust events. Results showed that levels of STS were generally within the normal range for all groups; however, 2G and 3G reported significantly higher levels of STS, lower levels of differentiation of self, and poorer family communication compared to their control groups. Greater differentiation of self and better family communication were associated with lower levels of STS. Differences between groups were consistent with other studies suggesting a mixture of resilience and vulnerability factors among 2G and 3G.",0,0 +5882,Classification of trauma and stressor-related disorders in DSM-5,"This review examines the question of whether there should be a cluster of disorders, including the adjustment disorders (ADs), acute stress disorder (ASD), posttraumatic stress disorder (PTSD), and the dissociative disorders (DDs), in a section devoted to abnormal responses to stress and trauma in the DSM-5. Environmental risk factors, including the individual's developmental experience, would thus become a major diagnostic consideration. The relationship of these disorders to one another is examined and also their relationship to other anxiety disorders to determine whether they are better grouped with anxiety disorders or a new specific grouping of trauma and stressor-related disorders. First how stress responses have been classified since DSM-III is reviewed. The major focus is on PTSD because it has received the most attention, regarding its proper placement among the psychiatric diagnoses. It is discussed whether PTSD should be considered an anxiety disorder, a stress-induced fear circuitry disorder, an internalizing disorder, or a trauma and stressor-related disorder. Then, ASD, AD, and DD are considered from a similar perspective. Evidence is examined pro and con, and a conclsion is offered recommending inclusion of this cluster of disorders in a section entitled ""Trauma and Stressor-Related Disorders."" The recommendation to shift ASD and PTSD out of the anxiety disorders section reflects increased recognition of trauma as a precipitant, emphasizing common etiology over common phenomenology. Similar considerations are addressed with regard to AD and DD.",0,0 +5883,Functional neuroimaging of emotionally intense autobiographical memories in post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) affects regions that support autobiographical memory (AM) retrieval, such as the hippocampus, amygdala and ventral medial prefrontal cortex (PFC). However, it is not well understood how PTSD may impact the neural mechanisms of memory retrieval for the personal past. We used a generic cue method combined with parametric modulation analysis and functional MRI (fMRI) to investigate the neural mechanisms affected by PTSD symptoms during the retrieval of a large sample of emotionally intense AMs. There were three main results. First, the PTSD group showed greater recruitment of the amygdala/hippocampus during the construction of negative versus positive emotionally intense AMs, when compared to controls. Second, across both the construction and elaboration phases of retrieval the PTSD group showed greater recruitment of the ventral medial PFC for negatively intense memories, but less recruitment for positively intense memories. Third, the PTSD group showed greater functional coupling between the ventral medial PFC and the amygdala for negatively intense memories, but less coupling for positively intense memories. In sum, the fMRI data suggest that there was greater recruitment and coupling of emotional brain regions during the retrieval of negatively intense AMs in the PTSD group when compared to controls.",0,0 +5884,Complex mental health sequelae of psychological trauma among women in prenatal care.,"Pregnancy is a critical time to identify and address maternal mental health problems, for the health of both mother and child. Pregnant women with histories of exposure to interpersonal psychological trauma may experience a range of mental health problems including but not limited to posttraumatic stress disorder (PTSD). In a community sample of 1,581 pregnant women, 25% reported symptoms consistent with at least one of six syndromes, including PTSD, major depressive disorder (MDD), generalized anxiety disorder (GAD), or clinically significant dissociation, somatization, or affect dysregulation. Six sub-groups with distinct mental health problem profiles were identified by cluster analysis. Controlling for sociodemographic risk factors, women with histories of interpersonal trauma were over-represented in four sub-groups characterized by: (1) PTSD comorbid with depression (childhood sexual abuse), (2) PTSD comorbid with affect/interpersonal dysregulation (childhood physical or emotional abuse), (3) somatization (adult abuse), and (4) GAD (foster/adoptive placement). Findings suggest risk relationships warranting further study between different types of interpersonal trauma exposure and psychiatric outcomes in pregnant women, including PTSD with two types of comorbidity.",0,0 +5885,"Posttraumatic Stress Symptom Clusters, Trauma History, and Substance Use among College Students","Previous research found associations between experiencing specific posttraumatic stress disorder (PTSD) symptom clusters and use of specific substances among combat veterans, women exposed to domestic violence, and an inpatient sample; however, research has not utilized a college sample when considering this association. This study assessed trauma history, PTSD symptoms, alcohol use, and nonexperimental use of depressants, stimulants, opioids, cannabinoids, hallucinogens, inhalants, and steroids in college students. Results indicate unique associations between the PTSD symptom cluster of reexperiencing and use of depressants, avoidance/numbing with use of depressants and opiates, and hyperarousal with use of opiates. Further, the individual subclusters of behavioral avoidance and emotional numbing were associated with use of depressants and avoidance was associated with hallucinogen use. Implications are discussed.",0,0 +5886,Validation of a Swedish version of the Impact of Event Scale-Revised (IES-R) in patients with burns,"The Impact of Event Scale (IES) and the Impact of Event Scale-Revised (IES-R) are often used as self-report instruments for symptoms of post-traumatic stress disorder (PTSD). However, there are few validations of the IES and the IES-R against structured clinical interviews. In this study the two scales, together with the three subscales of the IES-R, were assessed for their agreement with a diagnosis of PTSD in patients with burns 1 year after injury. Sixty patients with burns were evaluated 1 year after injury using the Structured Clinical Interview for the DSM-IV Axis I (SCID-I) psychiatric disorders and a Swedish version of the IES-R. The total score of the IES-R had the best discriminant ability (0.89) with a sensitivity of 1.0 and a specificity of 0.78. In conclusion, the total IES-R had good properties as a screening tool for PTSD and subsyndromal PTSD 1 year after burn injury.",0,0 +5887,Posttraumatic stress disorder in women,"This chapter discusses posttraumatic stress disorder (PTSD) in women. The clinical presentation in both men and women is often complex, with high levels of depression, anxiety, and substance use. Several epidemiological studies have indicated that, while men are more likely than women to be exposed to traumatic events, the prevalence of PTSD within the community is approximately twice as high for women. Few studies have investigated psycho physiological differences between men and women in acute reactions to threat that may serve as potential mediators for PTSD vulnerability. A mounting body of empirical research has supported the efficacy of certain types of psychotropic medication in the treatment of PTSD. Finally, while women may be at greater risk for the development of psychiatric sequelae following trauma, preliminary findings from treatment outcome studies indicate that they may benefit from PTSD interventions to a greater extent than men.",0,0 +5888,"Prevalence and predictors of posttraumatic stress symptoms in utility workers deployed to the World Trade Center following the attacks of September 11, 2001","Recent attention has begun to be focused on the effects of disaster recovery work on nonrescue workers. The goal of this study was to assess the prevalence and predictors of posttraumatic stress disorder (PTSD) and related symptoms in a population of utility workers deployed to the World Trade Center (WTC) site in the aftermath of 9/11.Utility workers deployed to the WTC site were screened at their place of employment between 10 and 34 months following the WTC attacks, utilizing both structured interviews and self-report measures. PTSD symptoms were assessed by the CAPS and the PCL; co-morbid disorders were also assessed. 2,960 individuals with complete CAPS and PCL data were included in the analyses.Eight percent of participants had symptoms consistent with full PTSD, 9.3% with subthreshold PTSD, 6% with MDD, 3.5% with GAD, and 2.5% with panic disorder. Although risk factors included psychiatric and trauma history, 51% of individuals with probable PTSD had neither; subjective perception of threat to one's life was the best predictor of probable PTSD. Extent of exposure predicted 89% of PTSD cases in those without a psychiatric or trauma history, but only 67% of cases among those with both.Nonrescue workers deployed to a disaster site are at risk for PTSD and depression. Extent of exposure affected the most vulnerable workers differently than the least vulnerable ones. These results suggest that the relationship among predictors of PTSD may be different for different vulnerability groups, and underscore the importance of screening, education, and prevention programs for disaster workers.",0,0 +5889,Brain-derived neurotrophic factor plasma levels in patients suffering from post-traumatic stress disorder,"In both animals and humans, stress has been demonstrated to reduce the expression of the Brain-Derived Neurotrophic Factor (BDNF), a neurotrophin (NT) which promotes the proliferation, survival and differentiation of neurons. Although traumatic events have been found to be associated with lower BDNF plasma levels in affective disorders, no study has explored this parameter in patients with post-traumatic stress disorder (PTSD). We, therefore, measured BDNF plasma level in 18 patients with PTSD and in 18 healthy control subjects. Diagnoses were assessed by the Structured Clinical Interview for DSM-IV, while the specific symptoms were examined in the patients by means of the Impact of Event Scale for PTSD and the traumas experienced were assessed by using the Life Events Checklist. BDNF plasma levels were evaluated by means of a standardized Elisa method. The results, while showing significantly lower BDNF levels in PTSD patients, as compared with those of healthy subjects (p=0.001), although obtained in a small sample size, would suggest that this NT may be involved in the pathophysiology of PTSD.",0,0 +5890,Personality disorder symptomatology among Vietnam veterans with combat-related PTSD.,"This research examined self-report personality profiles of 42 Vietnam veterans with combat-related posttraumatic stress disorder (PTSD) evaluated at an outpatient Veteran's Administration hospital PTSD clinic. Assessment was via the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev; DSM-III-R) Personality Disorders-II (SCID-II) self-report. Self-reported personality disorder symptomatology of PTSD patients was contrasted with that of 51 outpatients with a primary diagnosis of an anxiety disorder other than PTSD and with 16 patients with a primary diagnosis of major depressive disorder (MDD). Symptomatology from each of the 11 DSM-III-R categories and from the three personality disorder ""clusters"" was calculated in terms of percentage of possible traits endorsed, thus creating personality ""profiles"" for the three groups. PTSD veterans endorsed more traits overall than did both the mixed anxiety and MDD groups, particularly on the Cluster A, avoidant, and borderline scales. Results suggest a PTSD-related personality profile characterized by emotional lability/poor anger control, paranoia/suspiciousness, identity disturbance/confusion, social withdrawal/avoidance, and feelings of emptiness and boredom.",0,0 +5891,Factor Structure and Risk Factors for the Health Status of Homeless Veterans,"Homeless veterans have numerous health problems that have been previously characterized as falling into four major subgroups; addiction, psychosis, vascular disorders, and generalized medical and psychiatric illness. Comorbid conditions are common, often involving a combination of psychiatric and medical disorders. Using data from the same survey of homeless veterans that was used to establish these subgroups with cluster analysis, the present study examined the structure of these subgroup patterns through the use of factor analysis. This analysis yielded a five factor solution. They were named ""Cardiac"", Mood, Stress, Addiction, and Psychosis factors. Factor scores were computed and an odds ratio analysis was accomplished to determine the association between obtaining a high score on a given factor with a number of sociodemographic and homelessness related variables. It was concluded that health status of homeless veterans is a complex condition, but has a clear latent structure demonstrated by factor analysis. Scoring high or low on a particular factor is associated with numerous historical and sociodemographic considerations, notably age, ethnicity, and employment status. (",0,0 +5892,[Post-traumatic condition and psychological distress/well-being in a sample of inmates: a cluster analytic approach].,"AIM Researchers addressing the mental health needs of inmates reported that post-traumatic stress disorder (PTSD) was one of the most common disorders. This study examined the patterns of PTSD symptoms and their relation to the self-reported level of distress and psychological wellbeing in a sample of Italian inmates. METHODS Fifty inmates, 90% male, 54% aged 31-50 years, 70% awaiting trial, completed a battery of tests including the Davidson Trauma Scale (DTS), the Symptom Questionnaire (SQ), and the Psychological Well-Being Scales (PWBS). RESULTS Cluster analysis revealed three distinct clusters of respondents, which presents varying combination of PTSD symptoms, as measured with the three subscales of the DTS. Accordingly, these clusters were labeled Cluster 1--Traumatized (n = 18), Cluster 2--Non-traumatized (n = 18), and Cluster 3--Seriously traumatized (n = 14). Findings indicated that the three groups differed consistently across all the domains of the SQ and on the environmental mastery scale of the PWBS. Those in the Traumatized clusters, as compared to the Nontraumatized, demonstrated higher overall psychological distress and lower perceived environmental mastery. Moreover, independent of posttraumatic level, inmates showed poorer psychological wellbeing and higher distress than the normative population. DISCUSSION The patterns manifested in clusters 1 and 3 could become the focus of attention to deliver specific intervention aimed at reducing inmates' distress and encouraging their adjustment to prison life.",0,0 +5893,Multi-tier mental health program for refugee youth.,"We sought to establish that refugee youths who receive a multi-tiered approach to services, Project SHIFA, would show high levels of engagement in treatment appropriate to their level of mental health distress, improvements in mental health symptoms, and a decrease in resource hardships.Study participants were 30 Somali and Somali Bantu refugee youths in the English language learner classroom in a middle school in New England. Project SHIFA is a multi-tiered program including prevention and community resilience building for the community at large, school-based early intervention groups for at-risk students, and direct intervention using an established trauma model (trauma systems therapy) for those with significant psychological distress. Data were collected from students at time of enrollment, 6-month follow-up, and 12-month follow-up. Measures used were the War Trauma Screening Scale, Adolescent Post-War Adversities Scale-Somali version, UCLA PTSD Reaction Index for DSM-IV (Revision 1), and the Depression Self-Rating Scale.Students across all tiers of the program demonstrated improvements in mental health and resources. Resource hardships were significantly associated with symptoms of posttraumatic stress disorder over time, and the stabilization of resource hardships coincided with significant improvements in symptoms of depression and posttraumatic stress disorder for the top tier of participants.Project SHIFA is a promising model of treatment for young refugees.",0,0 +5894,New approaches to combining pharmacotherapy and psychotherapy for posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) is a complex disorder associated with an intricate biological and psychological symptom profile and various common comorbidities. Despite an existing myriad of evidence-based and experimental treatments, PTSD is often difficult to treat. This reality necessitates a discussion of the potential of emerging treatments.A literature search using PubMed and PsychInfo was done using the following keywords: randomized clinical trials, treatment guidelines, pharmacotherapy and psychotherapy, all in addition to PTSD. A comprehensive treatment review establishes that early intervention approaches have not yet been found to prevent PTSD in trauma survivors. However, psychotherapy research provides substantial support for cognitive behavioral therapies and eye movement desensitization and reprocessing for chronic PTSD, and psychopharmacological approaches are myriad - although at present there is FDA approval only for sertraline and paroxetine. However, the efficacy of these treatments varies and, unfortunately, not everyone will achieve remission.So far, the mental health field has tended to focus on either biological or psychological targets. We propose that maximizing treatment success may require an integrated approach that does not dichotomize biological and psychological aspects. Exciting new developments reflecting this perspective include psychopharmacologic augmentation strategies that enhance the mechanisms of psychotherapy.",0,0 +5895,Preclinical Evidence on the Psychotropic Profile of Fluvoxamine,"Serotonin (5-HT) reuptake inhibitors (SSRIs) such as fluvoxamine are interesting compounds. Initially launched as antidepressants, they have been found to be active in various psychiatric disorders besides depression, including obsessive-compulsive disorder, panic disorder, and eating disturbances. Preliminary data suggest their efficacy in alcohol and drug abuse, aggression, and posttraumatic stress disorder as well. Along with those clinical findings, new preclinical data have emerged. For example, fluvoxamine has demonstrated activity in various models of anxiety in rodents. Its anxiolytic activity can be clearly discriminated from that of the benzodiazepines. In the DRL 72-sec paradigm, fluvoxamine exhibits a good antidepressant profile, similar to those of imipramine and flesinoxan. Studies have shown that fluvoxamine does not down-regulate beta-adrenoceptors; apparently, that property is not a conditio sine qua non for antidepressant activity. Results of studies of the mechanism of action of fluvoxamine in which drug discrimination tests were performed with rats and pigeons suggest that the fluvoxamine stimulus is not (or is only to a very limited degree) dependent on activation of 5-HT1A receptors or 5-HT1B/1D receptors, or both. Experimentation is ongoing in those animal models.",0,0 +5896,Toward Animal Models of Post-Traumatic Stress Disorder,"(from the chapter) The development of animal models for PTSD and other traumatic stress related brain changes is an important part of advancing our neurobiological understanding of the disease process as well as recovery, resilience, and possible therapeutic targets. Although animal models for PTSD are limited to the assessment of measurable and observable behavioral parameters and cannot assess complex psychological symptoms such as intrusive thoughts, meaning and dreams, valid and reliable animal models offer a means for researching biomolecular, pathophysiological, and pharmacological features of the disorder in ways that are not feasible in human studies. Trauma/stress-based Models were developed in an attempt to induce in the animal a state similar to PTSD by exposing animals to an equivalent of a traumatic experience. Mechanism-based models were developed considering potential brain mechanisms that may underlay the disorder. The most studied are enhanced fear conditioning, impaired extinction and more recently, impaired contextualization. Another important line of research addresses the question of additional factors that contribute to the susceptibility to develop PTSD. Genetic background and environmental factors have been studied and have led to the recognition of the importance of individual differences in susceptibility to develop the disorder. This chapter presents and discusses findings from various animal models, with the understanding that no single model encompasses in full the complexity of the disorder but that each of these models contributes to our understanding of PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5897,PSYCHIATRIC AND PHYSICAL HEALTH RAMIFICATIONS OF TRAUMATIC EVENTS IN WOMEN,"All individuals are at some risk of experiencing a traumatic event and developing posttraumatic stress disorder (PTSD); however some individuals are at higher risk due to individual and environmental factors. This critical literature review focuses on women, as they are twice as likely as men to develop PTSD in their lifetimes. Should a woman develop PTSD, she is then at risk of developing psychiatric and physical health comorbidities that can further impact her quality of life. The strengths and limitations of current studies regarding this topic are discussed as are directions for future research and issues for nurses treating traumatized individuals.",0,0 +5898,Psychophysiological investigations of posttraumatic stress disorder imagery.,"Physiological responses to self-generated imagery of past traumatic combat experiences were assessed in medication-free Vietnam combat veterans, classified on the basis of DSM-III-R (American Psychiatric Association 1987) criteria into posttraumatic stress disorder (PTSD, n = 25), non-PTSD anxiety disorder (Anxious, n = 7), or no-mental-disorder (Healthy, n = 15) groups. ""Scripts"" describing each subject's combat experiences were read to him in the laboratory, and he was instructed to imagine the events the scripts portrayed, while heart rate, skin conductance, and frontalis electromyogram (EMG) were recorded. PTSD subjects' responses to their combat imagery were significantly higher than those of both control groups. A discriminant analysis identified 64 percent of PTSD subjects as physiological responders, and 100 percent of Anxious and 94 percent of Healthy subjects as nonresponders. A pilot study of imaginal flooding in three PTSD and two Healthy pilot subjects suggested that more prolonged, therapist-assisted imagery might increase the sensitivity of psychophysiological measures to PTSD, and that motor and endocrinological measures might also be of value in characterizing the disorder.",0,0 +5899,"Disentangling the Directions of Influence among Trauma Exposure, Posttraumatic Stress Disorder Symptoms, and Alcohol and Drug Problems","The present study utilized longitudinal data from a high-risk community sample (n= 377; 166 trauma-exposed; 54% males; 52% children of alcoholics; 73% non-Hispanic/Latino Caucasian; 22% Hispanic/Latino; 5% other ethnicity) to test a series of hypotheses that may help explain the risk pathways that link traumatic stress, posttraumatic stress disorder (PTSD) symptomatology, and problematic alcohol and drug use. Specifically, this study examined whether pre-trauma substance use problems increase risk for trauma exposure (the high-risk hypothesis) or PTSD symptoms (the susceptibility hypothesis), whether PTSD symptoms increase risk for later alcohol/drug problems (the self-medication hypothesis), and whether the association between PTSD symptoms and alcohol/drug problems is due to shared risk factors (the shared vulnerability hypothesis). This study also examined the roles of gender and ethnicity in these pathways. A series of logistic and negative binomial regressions were performed in a path analysis framework. A composite pre-trauma family adversity variable was formed from measures of family conflict, family life stress, parental alcoholism, and other parent psychopathology. Results provided the strongest support for the self-medication hypothesis, such that PTSD symptoms predicted higher levels of later alcohol and drug problems among non-Hispanic/Latino Caucasian participants, over and above the influences of pre-trauma family adversity, pre-trauma substance use problems, trauma exposure, and demographic variables. Results partially supported the high-risk hypothesis, such that adolescent substance use problems had a marginally significant unique effect on risk for assaultive violence exposure but not on overall risk for trauma exposure. There was no support for the susceptibility hypothesis, as pre-trauma adolescent substance use problems did not significantly influence risk for PTSD diagnosis/symptoms over and above the influence of pre-trauma family adversity. Finally, there was little support for the shared vulnerability hypothesis. Neither trauma exposure nor preexisting family adversity accounted for the link between PTSD symptoms and later substance use problems. These results add to a growing body of literature in support of the self-medication hypothesis. Findings extend previous research by showing that PTSD symptoms may influence the development of alcohol and drug problems over and above the influence of trauma exposure itself, preexisting family risk factors, and baseline levels of substance use. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +5900,Course of post-traumatic stress disorder following war in the Balkans: 1-year follow-up study,"Prevalence rates of post-traumatic stress disorder (PTSD) following the experience of war have been shown to be high. However, little is known about the course of the disorder in people who remained in the area of conflict and in refugees. Method We studied a representative sample of 522 adults with war-related PTSD in five Balkan countries and 215 compatriot refugees in three Western European countries. They were assessed on average 8 years after the war and reinterviewed 1 year later. We established change in PTSD symptoms, measured on the Impact of Events Scale - Revised (IES-R), and factors associated with more or less favourable outcomes.During the 1-year period, symptoms decreased substantially in both Balkan residents and in refugees. The differences were significant for IES-R total scores and for the three subscales of intrusions, avoidance and hyperarousal. In multivariable regressions adjusting for the level of baseline symptoms, co-morbidity with depression predicted less favourable symptom change in Balkan residents. More pre-war traumatic events and the use of mental health services within the follow-up period were associated with less improvement in refugees.Several years after the war, people with PTSD reported significant symptom improvement that might indicate a fluctuating course over time. Co-morbid depression may have to be targeted in the treatment of people who remained in the post-conflict regions whereas the use of mental health services seems to be linked to the persistence of symptoms among refugees.",0,0 +5901,"Rumination, post-traumatic growth, and distress: structural equation modelling with cancer survivors","Objective: Theoretical models of post-traumatic growth (PTG) have been derived in the general trauma literature to describe the post-trauma experience that facilitates the perception of positive life changes. To develop a statistical model identifying factors that are associated with PTG, structural equation modelling (SEM) was used in the current study to assess the relationships between perception of diagnosis severity, rumination, social support, distress, and PTG. Method: A statistical model of PTG was tested in a sample of participants diagnosed with a variety of cancers (N=313). Results: An initial principal components analysis of the measure used to assess rumination revealed three components: intrusive rumination, deliberate rumination of benefits, and life purpose rumination. SEM results indicated that the model fit the data well and that 30% of the variance in PTG was explained by the variables. Trauma severity was directly related to distress, but not to PTG. Deliberately ruminating on benefits and social support were directly related to PTG. Life purpose rumination and intrusive rumination were associated with distress. Conclusions: The model showed that in addition to having unique correlating factors, distress was not related to PTG, thereby providing support for the notion that these are discrete constructs in the post-diagnosis experience. The statistical model provides support that post-diagnosis experience is simultaneously shaped by positive and negative life changes and that one or the other outcome may be prevalent or may occur concurrently. As such, an implication for practice is the need for supportive care that is holistic in nature. Copyright © 2010 John Wiley & Sons, Ltd.",0,0 +5902,Postconcussive Symptom Complaints and Potentially Malleable Positive Predictors,"The purpose of this study was to examine the relationship between postconcussion symptom complaint (PCS) severity and positive coping factors (knowledge, self-efficacy, and attributions) in a sample of individuals who have sustained a mild TBI, above and beyond the demographic and psychiatric predictors that have been most commonly examined. Ninety-one people with a history of reported mild TBI were surveyed. Hierarchical regression analyses revealed that demographic variables and psychiatric symptom severity predicted PCS severity. Consistent with our hypotheses, knowledge, self-efficacy, and attributions, when taken together, made an independent and significant contribution to prediction of PCS severity (21% of additional variance). The most potent factor was attribution, or the extent to which one attributes symptoms to mild TBI versus other causes. Those who attribute their symptoms to TBI are more likely to report greater symptom severity overall. Taken together, knowledge, self-efficacy, and attributions contribute independently to PCS severity. Additional research is needed to determine if these factors are amenable to intervention.",0,0 +5903,"Anxiolytic-like effects of YL-IPA08, a potent ligand for the translocator protein (18 kDa) in animal models of post-traumatic stress disorder","Recently, the translocator protein (18 kDa) (TSPO), previously called peripheral benzodiazepine receptor (PBR) and both the starting point and an important rate-limiting step in neurosteroidogenesis, has received increased attention in the pathophysiology of post-traumatic stress disorder (PTSD) because it affects the production of neurosteroids, reinforcing the hypothesis that selective TSPO ligands could potentially be used as anti-PTSD drugs. As expected, we showed that chronic treatment with YL-IPA08 [N-ethyl-N-(2-pyridinylmethyl)-2-(3,4-ichlorophenyl)-7-methylimidazo [1,2-a] pyridine-3-acetamide hydrochloride], a potent and selective TSPO ligand synthesized by our institute, caused significant suppression of enhanced anxiety and contextual fear induced in the inescapable electric foot-shock-induced mouse model of PTSD and the time-dependent sensitization (TDS) procedure. These effects were completely blocked by the TSPO antagonist PK11195. Furthermore, YL-IPA08 could increase the level of allopregnanolone in the prefrontal cortex and serum of post-TDS rats, and these effects were antagonized by PK11195. In summary, the findings from the current study showed that YL-IPA08, a potent and selective TSPO ligand, had a clear anti-PTSD-like effect, which might be partially mediated by binding to TSPO and the subsequent synthesis of allopregnanolone.",0,0 +5904,The Association Between Childhood Physical and Sexual Abuse and Functioning and Psychiatric Symptoms in a Sample of U.S. Army Soldiers,"We examined associations between abusive childhood experiences and functioning and psychiatric symptoms in an active duty sample of U.S. Army soldiers.Cross-sectional survey of 204 soldiers stationed at a southern U.S. Army facility.Forty-six percent of individuals reported childhood physical abuse alone, whereas 25% reported both childhood physical and sexual abuse. Soldiers' work, role, and social functioning; physical functioning; depression severity; and severity of alcohol misuse did not differ significantly with childhood abuse status (p > 0.22 for all). However, individuals who reported both childhood physical and sexual abuse reported severer posttraumatic stress disorder symptoms than did soldiers who reported no childhood abuse or childhood physical abuse only (p = 0.007).Although abusive childhood experiences were common, soldiers with such experiences reported functioning as well as those soldiers without such experiences. Posttraumatic stress disorder symptoms were significantly elevated only in those who reported both childhood physical and sexual abuse.",0,0 +5905,Role of Zolpidem in the Management of Insomnia,"Insomnia is a common condition that affects one's ability to sleep comfortably and consequently to work effectively. Its etiology is multifactorial and involves plethora of risk factors. Consequences can vary from mild sleepiness to more sever psychiatric disturbances and ischemic stroke. Despite several diagnostic criteria it is poorly diagnosed and less often treated. Benzodiazepines formed the mainline therapy for many years till the advent of newer nonbenzodiazepine group of drugs including zolpidem. Zolpidem is an imidazo-pyridine compound that enhances the GABA(A) receptor function by interaction with Omega-1 receptor subtype. Its pharmacokinetic profile allows the patients to use it later in the night when having trouble falling asleep without any residual cognitive impairment the next morning. It has rapid onset of action, improves total sleep duration, and reduces night-time awakenings. Its adverse effect profile is satisfactory as it appears to have low addiction potential. This review will focus on the current role of zolpidem in the management of insomnia.",0,0 +5906,"Longitudinal Study of Posttraumatic Stress Disorder, Depression, and Changes in Traumatic Memories Over Time in Bosnian Refugees","This longitudinal study examined traumatic memory consistency over a 3-year period among a sample of highly traumatized Bosnian refugees, focusing on demographic factors, types of trauma, and posttraumatic stress disorder (PTSD) and depression. In 1996 and 1999, 376 Bosnian refugees were interviewed about 54 wartime trauma and torture events, and symptoms of PTSD and depression. Reports were compared for both time periods, and changed responses were analyzed for significance. Overall, there was consistency in reporting over time; when change occurred it was in the direction of decreased reports at follow-up. This downward trend was not associated with any particular diagnosis. However, PTSD alone, without comorbid symptoms of depression, was uniquely associated with the group that exhibited an upward trend. This implies that increased reporting is related specifically to the presence of PTSD symptoms, and that PTSD may be distinctly associated with the failed extinction of traumatic memories.",0,0 +5907,Psychological and Sleep Quality Differences between Chronic Daily Headache and Temporomandibular Disorders Patients,"The aim of this study was to investigate whether chronic daily headache (CDH) and temporomandibular disorders (TMD) patients present with different psychological and sleep quality characteristics. Sixty-seven patients diagnosed with CDH, according to classification criteria from Silberstein et al., were matched by age and sex with 67 patients who had a primary diagnosis of myofascial pain (MP) and 67 patients with a primary diagnosis of TMJ intracapsular pain (IC) according to the Research Diagnostic Criteria for TMD. The CDH group was comprised of three mutually exclusive diagnostic groups: chronic migraine ( n = 35); chronic tension-type headache ( n = 26); ‘other CDH’ ( n = 6). All patients completed a battery of psychological and sleep quality questionnaires. All CDH subgroups showed similar psychological and sleep quality profiles. Pain intensity and duration were controlled in the multivariate analyses (MANCOVA) by treating them as covariates. The CDH and MP groups revealed higher levels of psychological distress than the IC group on most psychological domains. The MP group also revealed numerically higher levels of psychological distress in most psychological domains than the CDH group, although these differences were generally not significant. We did not find significant differences between the three groups on post traumatic stress symptoms either. Sleep quality was significantly worse in the MP group than in the CDH and IC groups. These results are discussed in the context of multimodal patient evaluation and treatments that are often necessary for successful clinical management.",0,0 +5908,Prospective Risk Factors for Adolescent PTSD: Sources of Differential Exposure and Differential Vulnerability,"There are two types of risk factors for developing PTSD: factors that increase the likelihood of experiencing a potentially traumatizing event and factors that increase the likelihood of developing symptoms following such events. Using prospective data over a two-year period from a large, diverse sample of urban adolescents (n = 1242, Mean age = 13.5), the current study differentiates these two sources of risk for developing PTSD in response to violence exposure. Five domains of potential risk and protective factors were examined: community context (e.g.; neighborhood poverty), family risk (e.g.; family conflict), behavioral maladjustment (e.g.; internalizing symptoms), cognitive vulnerabilities (e.g.; low IQ), and interpersonal problems (e.g.; low social support). Time 1 interpersonal violence history, externalizing behaviors, and association with deviant peers were the best predictors of subsequent violence, but did not further increase the likelihood of PTSD in response to violence. Race/ethnicity, thought disorder symptoms, and social problems were distinctly predictive of the development of PTSD following violence exposure. Among youth exposed to violence, Time 1 risk factors did not predict specific event features associated with elevated PTSD rates (e.g.; parent as perpetrator), nor did interactions between Time 1 factors and event features add significantly to the prediction of PTSD diagnosis. Findings highlight areas for refinement in adolescent PTSD symptom measures and conceptualization, and provide direction for more targeted prevention and intervention efforts. © 2012 Springer Science+Business Media, LLC.",0,0 +5909,Sleep Complaints as Early Predictors of Posttraumatic Stress Disorder: A 1-Year Prospective Study of Injured Survivors of Motor Vehicle Accidents,"Disturbed sleep is a common complaint among patients with posttraumatic stress disorder (PTSD) that appears in the reexperiencing and hyperarousal symptom clusters in DSM-IV. The causal relationship between sleep complaints and PTSD is unclear.Self-reported insomnia and excessive daytime sleepiness were assessed in 102 victims of motor vehicle accidents and 19 comparison subjects 1 week and 1, 3, 6, and 12 months after the trauma. At 12 months the Structured Clinical Interview for DSM-III-R was administered to determine diagnoses of PTSD.Twenty-six of the accident victims but none of the comparison subjects met the criteria for PTSD. Logistic regression models indicated that sleep complaints from 1 month on were significant in predicting PTSD at 1 year.These results suggest that on the basis of sleep complaints as early as 1 month after the trauma, it is possible to detect subjects who will later develop chronic PTSD.",0,0 +5910,Mental Preparedness as a Pathway to Police Resilience and Optimal Functioning in the Line of Duty,"The idea of fostering ‘resilience’ among police and military personnel is a topic of growing interest (Andersen et al., 2015a; Cornum, Matthews, & Seligman, 2011; Reivich, Seligman, & McBride, 2011). This topic is particularly timely in light of recent media depictions of questionable use-of-force actions by police and the subsequent public retaliations against the police",0,0 +5911,Acclimatory-phase specificity of gene expression during the course of heat acclimation and superimposed hypohydration in the rat hypothalamus,"The induction of the heat-acclimated phenotype involves reprogramming the expression of genes encoding both constitutive and inducible proteins. In this investigation, we studied the global genomic response in the hypothalamus during heat acclimation, with and without combined hypohydration stress. Rats were acclimated for 2 days (STHA) or for 30 days (LTHA) at 34°C. Hypohydration (10% decrease in body weight) was attained by water deprivation. 32 P-labeled RNA samples from the hypothalamus were hybridized onto cDNA Atlas array (Clontech no. 1.2) membranes. Clustering and functional analyses of the expression profile of a battery of genes representing various central regulatory functions of body homeostasis demonstrated a biphasic acclimation profile with a transient upregulation of genes encoding ion channels, transporters, and transmitter signaling upon STHA. After LTHA, most genes returned to their preacclimation expression levels. In both STHA and LTHA, genes encoding hormones and neuropeptides, linked with metabolic rate and food intake, were downregulated. This genomic profile, demonstrating an enhanced transcription of genes linked with neuronal excitability during STHA and enhanced metabolic efficiency upon LTHA, is consistent with our previously established integrative acclimation model. The response to hypohydration was characterized by an upregulation of a large number of genes primarily associated with the regulation of ion channels, cell volume, and neuronal excitability. During STHA, the response was transiently desensitized, recovering upon LTHA. We conclude that hypohydration overrides the heat acclimatory status. It is notable that STHA and hypohydration gene profiles are analogous with the physiological profile described in the response to various types of brain injury.",0,0 +5912,Genomics and Pharmacogenomics of Brain Disorders,"CNS disorders are the third major problem of health in developed countries, with approximately 10% of direct costs associated with a pharmacological treatment of doubtful cost-effectiveness. There is an alarming abuse of psychotropic drugs worldwide and only 20-30% of patients with CNS disorders appropriately respond to conventional drugs. The pathogenesis of most CNS disorders is the result of the interplay of genetic and epigenetic factors with environmental factors leading to post-transcriptional changes and proteomic and metabolomic dysfunctions. It is estimated that genetics accounts for 20% to 95% of variability in drug disposition and pharmacodynamics, and about 25-60% of the Western population is defective in genes responsible for drug metabolism. In the European population only 25% of subjects are pure extensive metabolizers for the trigenic cluster integrated by the CYP2D6, CYP2C19 and CYP2C9 genes. About 50% of adverse drug events in CNS disorders might be attributed to pharmacogenomic factors. The rationale for practical pharmacogenomics and personalized therapeutics based on individual genomic profiles implies the management of different types of genes and their products including (i) genes associated with the mechanism of action of psychotropic drugs (neurotransmitters, receptors, transporters), (ii) genes encoding enzymes responsible for drug metabolism (phase I, phase II reactions), (iii) disease-specific genes associated with a particular pathogenic cascade, and (iv) pleiotropic genes with multilocative effects in metabolomic networks. The incorporation of genomic medicine procedures and pharmacogenomics into clinical practice, together with educational programs for the correct use of medication, must help to optimize therapeutics in CNS disorders.",0,0 +5913,White Matter Integrity in Highly Traumatized Adults With and Without Post-Traumatic Stress Disorder,"Prior structural imaging studies of post-traumatic stress disorder (PTSD) have observed smaller volumes of the hippocampus and cingulate cortex, yet little is known about the integrity of white matter connections between these structures in PTSD samples. The few published studies using diffusion tensor imaging (DTI) to measure white matter integrity in PTSD have described individuals with focal trauma rather than chronically stressed individuals, which limits generalization of findings to this population; in addition, these studies have lacked traumatized comparison groups without PTSD. The present DTI study examined microstructural integrity of white matter tracts in a sample of highly traumatized African-American women with (n=25) and without (n=26) PTSD using a tract-based spatial statistical approach, with threshold-free cluster enhancement. Our findings indicated that, relative to comparably traumatized controls, decreased integrity (measured by fractional anisotropy) of the posterior cingulum was observed in participants with PTSD (p<0.05). These findings indicate that reduced microarchitectural integrity of the cingulum, a white matter fiber that connects the entorhinal and cingulate cortices, appears to be associated with PTSD symptomatology. The role of this pathway in problems that characterize PTSD, such as inadequate extinction of learned fear, as well as attention and explicit memory functions, are discussed.",0,0 +5914,Medical Comorbidity of Full and Partial Posttraumatic Stress Disorder in US Adults,"This study examined associations between lifetime trauma exposures, PTSD and partial PTSD, and past-year medical conditions in a nationally representative sample of US adults.Face-to-face interviews were conducted with 34,653 participants in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression analyses evaluated associations of trauma exposure, PTSD, and partial PTSD with respondent-reported medical diagnoses.After adjustment for sociodemographic characteristics and comorbid Axis I and II disorders, respondents with full PTSD were more likely than traumatized respondents without full or partial PTSD (comparison group) to report diagnoses of diabetes mellitus, noncirrhotic liver disease, angina pectoris, tachycardia, hypercholesterolemia, other heart disease, stomach ulcer, human immunodeficiency virus seropositivity, gastritis, and arthritis (odds ratios [ORs] = 1.2-2.5). Respondents with partial PTSD were more likely than the comparison group to report past-year diagnoses of stomach ulcer, angina pectoris, tachycardia, and arthritis (ORs = 1.3-1.6). Men with full and partial PTSD were more likely than controls to report diagnoses of hypertension (both ORs = 1.6), and both men and women with PTSD (OR = 1.8 and OR = 1.6, respectively) and men with partial PTSD (OR = 2.0) were more likely to report gastritis. The total number of lifetime traumatic event types was associated with many assessed medical conditions (ORs = 1.04-1.16), reducing the magnitudes and rendering some of the associations between PTSD status and medical conditions nonsignificant.Greater lifetime trauma exposure and PTSD are associated with numerous medical conditions, many of which are stress-related and chronic, in US adults. Partial PTSD is associated with intermediate odds of some of these conditions.",0,0 +5915,Psychological Resilience After Disaster,"Research on adult reactions to potentially traumatic events has focused almost exclusively on post-traumatic stress disorder (PTSD). Although there has been relatively little research on the absence of trauma symptoms, the available evidence suggests that resilience following such events may be more prevalent than previously believed. This study examined the prevalence of resilience, defined as having either no PTSD symptoms or one symptom, among a large (n = 2,752) probability sample of New York area residents during the 6 months following the September 11th terrorist attack. Although many respondents met criteria for PTSD, particularly when exposure was high, resilience was observed in 65.1% of the sample. Resilience was less prevalent among more highly exposed individuals, but the frequency of resilience never fell below one third even among the exposure groups with the most dramatic elevations in PTSD.",0,0 +5916,Clinical utility of the selective serotonin reuptake inhibitors in the spectrum of anxiety,"The selective serotonin reuptake inhibitors (SSRIs) are now being employed in the treatment of the full spectrum of anxiety disorders. In comparative trials, the SSRIs are proving to be equal or superior in efficacy to traditional antianxiety medications. Due to their favorable side effect profile, safety, and tolerability, they are rapidly replacing older agents in the treatment of anxiety. Neuroanatomical pathways that may be important in the antianxiety effect of the SSRIs are outline and discussed, followed by a review of the clinical evidence supporting the efficacy of this class of medications in the treatment of anxiety disorders.",0,0 +5917,Trajectories of posttraumatic growth and depreciation after two major earthquakes.,"This study examined trajectories of posttraumatic growth or depreciation (i.e., positive or negative life change) in personal strength and relationships after 2 major earthquakes in Canterbury, New Zealand using group-based trajectory modeling. Participants completed questionnaires regarding posttraumatic growth or depreciation in personal strength and relationship domains 1 month after the first earthquake in September 2010 (N = 185) and 3 months (n = 156) and 12 months (n = 144) after the more severe February 2011 earthquake. Three classes of growth or depreciation patterns were found for both domains. For personal strength, most of the participants were grouped into a ""no growth or depreciation"" class and smaller proportions were grouped into either a ""posttraumatic depreciation"" or ""posttraumatic growth"" class. The 3 classes for relationships all reported posttraumatic growth, differing only in degree. None of the slopes were significant for any of the classes, indicating that levels of growth or depreciation reported after the first earthquake remained stable when assessed at 2 time points after the second earthquake. Multinomial logistic regression analyses examining pre- and postearthquake predictors of trajectory class membership revealed that those in the ""posttraumatic growth"" personal strength class were significantly younger and had significantly higher pre-earthquake mental health than those in the ""posttraumatic depreciation"" class. Sex was the only predictor of the relationship classes: No men were assigned to the ""high posttraumatic growth"" class. Implications and future directions are discussed.",0,0 +5918,A longitudinal study of changes in psychological responses to continuous terrorism.,"The impact of ongoing terror over time has received little attention. This study assesses longitudinally prevalence and predictors of posttraumatic stress symptoms' trajectories, namely resistance, resilience, late-onset and chronicity in the course of intensive and ongoing terror.Two surveys were performed at a two-year interval among 153 Jewish Israeli adults.Results show probable PTSD prevalence, number of traumatic stress related symptoms (TSRS), and rate of severe posttraumatic symptomatology (PTSS) to increase over time (from 18.2% to 31.2%). With this, many (66.7% of those with PTSD and 39.3% of those with PTSS at wave 1) recovered. Late-onset of severe PTSS (19.6% of the sample) was predicted by income reduction, a major lifetime traumatic event, sense of threat, dissociation, coping via disengagement and low mood. Chronicity was predicted by sense of threat, pessimism, dissociation and disengagement.Continuous exposure to terror has a strong negative impact on mental health. Secondly, even within a chronic situation of terror, a large proportion of individuals with elevated levels of posttraumatic symptomatology recover over time; third, prolonged exposure to terror may also exacerbate symptomatology, but not per-se trigger new PTSD cases.",0,0 +5919,The significance of experiences of war and migration in older age: long-term consequences in child survivors from the Dutch East Indies,"ABSTRACT Background: This study examines late consequences of war and migration in both non-clinical and clinical samples of child survivors of World War II. This is one of the very few studies on the mental health of children who were subjected to internment in camps, hiding, and violence under Japanese occupation in the Far East. It provides a unique case to learn about the significance of experiences of war and migration in later life. Methods: Long-term sequelae of the Japanese persecution in the Dutch East Indies (DEI) in child survivors were studied by analyzing sets of standardized questionnaires of 939 persons. Instruments dealt with post-traumatic responses, general health, and dissociation. Participants were recruited through community services and registers of clinical services. Discriminant analyses were conducted to evaluate the significance of early experiences in determining group belonging. Results: Compared with age-matched controls that lived through the German occupation in the Netherlands during World War II, the child survivors from the DEI reported both more trauma-related experiences and mental health disturbances in later life. In particular, the number of violent events during the war, among which especially internment in a camp, contributed to the variation among groups, in support of the significance of these disruptive experiences at older age. Conclusion: The results underline the long-term significance of World War II-related traumatic experiences in the population of elderly child survivors who spent their childhood in the former DEI.",0,0 +5920,"Effects of the CRF1 receptor antagonist, CP 154,526, in the separation-induced vocalization anxiolytic test in rat pups","CRF(1) receptor antagonists have been proposed as novel pharmacological treatments for depression, anxiety and stress disorders. The primary goal of the present study was to evaluate the effects of the CRF(1) receptor antagonist, CP 154,526, in the separation-induced vocalization (SIV) model of anxiety. Nine- to 11-day-old rat pups were separated from their litter and the effects of intraperitoneally administered test compounds on the elicited ultrasonic vocalizations were measured. Side-effect potential was assessed using a modified inclined plane test ('time on an inclined plane', or TIP), and using negative geotaxis. SIV was reduced by CP 154,526 at doses that did not affect TIP or negative geotaxis, a profile like that of the 5-HT(1A) partial agonist buspirone. The benzodiazepine anxiolytic, diazepam, decreased SIV but also produced significant side effects at one to three-fold higher doses. Additional pharmacological characterization of SIV demonstrated anxiolytic-like effects of the atypical antipsychotic, clozapine, but not the typical antipsychotic, haloperidol, and of the serotonin reuptake inhibitor, zimelidine, but not the norepinephrine reuptake inhibitor, desipramine. In summary, the data support the conclusion that selective CRF(1) receptor antagonists may have utility in anxiety and stress disorders. The data further support the use of separation-induced vocalizations for identifying mechanistically diverse compounds with anxiolytic actions in man.",0,0 +5921,Association between age of onset and mood in bipolar disorder: Comparison of subgroups identified by cluster analysis and clinical observation,"This study compared subgroups identified by cluster analysis and clinical observation by evaluating the association between the age of onset of bipolar disorder and self-reported daily mood ratings.Two hundred and seventy patients with bipolar disorder provided daily self-reported mood ratings for about 6 months returning 55,188 days of data. The age of onset subgroups were determined both using previously defined cutoff values based upon clinical observation (≤12 years, 13-19 years, 20-29 years, >29 years), and model-based cluster analysis. Demographic characteristics were compared in the age of onset subgroups. Univariate general linear models with age of onset subgroups and other demographic variables as fixed factors and covariates were used to analyze the percent of days depressed, euthymic and hypomanic/manic.Using the predetermined subgroups, demographic differences were found between the four subgroups in the diagnosis of bipolar I/II, years of illness, age and use of lamotrigine. Post-hoc pairwise comparison found that patients with an age of onset less ≤ 12 years spent more days hypomanic/manic: 16.4 percent versus 8.0 for patients with an age of onset between 13 and 19 years (p=0.006) and 8.2 percent for patients with an age of onset between 20 and 29 years (p = 0.031). The majority of the additional days of hypomania/mania occurred outside of an episode. Model-based cluster analysis found a mixture of 2 distributions of onset with peaks at age 15.1 years (SD = 4.7) and 27.5 years (SD = 10.2). Analysis of these two subgroups detected no significant differences in demographic characteristics or mood ratings.Age of onset subgroups arising from clinical observation may be more useful than those determined by cluster analysis.",0,0 +5922,Current status on behavioral and biological markers of PTSD: A search for clarity in a conflicting literature,"Extensive research has identified stereotypic behavioral and biological abnormalities in post-traumatic stress disorder (PTSD), such as heightened autonomic activity, an exaggerated startle response, reduced basal cortisol levels and cognitive impairments. We have reviewed primary research in this area, noting that factors involved in the susceptibility and expression of PTSD symptoms are more complex and heterogeneous than is commonly stated, with extensive findings which are inconsistent with the stereotypic behavioral and biological profile of the PTSD patient. A thorough assessment of the literature indicates that interactions among myriad susceptibility factors, including social support, early life stress, sex, age, peri- and post-traumatic dissociation, cognitive appraisal of trauma, neuroendocrine abnormalities and gene polymorphisms, in conjunction with the inconsistent expression of the disorder across studies, confounds attempts to characterize PTSD as a monolithic disorder. Overall, our assessment of the literature addresses the great challenge in developing a behavioral and biomarker-based diagnosis of PTSD.",0,0 +5923,Traumatic stress reactivity promotes excessive alcohol drinking and alters the balance of prefrontal cortex-amygdala activity,"Post-traumatic stress disorder (PTSD) and alcoholism are highly comorbid in humans and have partially overlapping symptomatic profiles. The aim of these studies was to examine the effects of traumatic stress (and stress reactivity) on alcohol-related behaviors and neuronal activation patterns. Male Wistar rats were trained to respond for alcohol, were exposed to predator odor (bobcat urine) paired with context and were tested for short- and long-term avoidance of the predator odor-paired context, alcohol self-administration and compulsivity of alcohol responding. Rats were re-exposed to the odor-paired context for western blot analysis of ERK phosphorylation in subregions of the medial prefrontal cortex (mPFC) and the amygdala. Rats that avoided the predator-paired chamber (Avoiders) exhibited persistent avoidance up to 6 weeks post conditioning. Avoiders exhibited increases in operant alcohol responding over weeks, as well as more compulsive-like responding for alcohol adulterated with quinine. Following re-exposure to the predator odor-paired context, Avoiders and Non-Avoiders exhibited unique patterns of neuronal activation in subregions of the mPFC and the amygdala, which were correlated with changes in avoidance and alcohol drinking. Furthermore, activity of upstream regions was differentially predictive of downstream regional activity in the Avoiders versus Non-Avoiders. An animal model for assessing the effect of traumatic stress on alcohol drinking reveals individual differences in neuronal activation patterns associated with re-exposure to traumatic stress-related stimuli, and may provide insight into the neural mechanisms underlying excessive alcohol consumption in humans with PTSD.",0,0 +5924,"Relationships among Dispositional Attributional Style, Trauma-Specific Attributions, and PTSD Symptoms","The learned helplessness model and its various revisions suggest that causal attributions influence responses to events. This study examined relationships among the 3-factor symptom clusters of posttraumatic stress disorder (PTSD) represented in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–IV; American Psychiatric Association, 1994) and the individual dimensions of dispositional attributional style and trauma-specific attributions (i.e., internal–external, stable–unstable, global–specific). Relationships among attributions and clusters of PTSD symptoms represented by the 4-factor dysphoria model were also examined. Trauma-specific attributions were most predictive of PTSD symptoms, with higher associations for avoidance and numbing symptoms compared to arousal symptoms in the three-factor model and higher associations for dysphoria symptoms compared to arousal and avoidance symptoms in the four-factor dysphoria model. Results suggest that cognitive vulnerabilities coul...",0,0 +5925,Brief Symptom Inventory symptom profiles of outpatients with borderline intellectual functioning and major depressive disorder or posttraumatic stress disorder: Comparison with patients from regular mental health care and patients with Mild Intellectual Disabilities,"In most countries, people with borderline intellectual functioning (BIF) are not considered a separate group in mental health care. There is little to no research on the impact of BIF on the presentation, nature and severity of mental health problems. The aim of the present exploratory study was to compare, in a naturalistic setting of patients referred to secondary care, symptom profiles of patients with BIF diagnosed with either major depressive disorder (MDD) or posttraumatic stress disorder (PTSD) to patients from regular mental health care (RMHC) and patients with Mild ID diagnosed with the same disorders.We used a cohort of adolescent and adult outpatients (aged 16-88) with or without BIF diagnosed with a primary diagnosis MDD or PTSD. Primary outcome was the nature and severity of psychopathological symptoms assessed at baseline using the Brief Symptom Inventory. All outcomes were adjusted for gender and age.Results showed that BIF patients with a primary diagnosis MDD reported less severe symptoms on BSI Total and the subscales Depression, Obsession-Compulsion and Psychoticism than patients from regular mental health care (RMHC). There were no statistically significant differences in reported symptom severity on BSI Total and the different BSI subscales between BIF patients with PTSD and either patients from RMHC or patients with Mild ID. Patients Mild ID, did report significantly less severe symptoms on the subscale Depression and on the subscale Psychoticism than patients from RMHC.Since there were no other published studies into symptom profiles in patients with BIF compared to either patients with higher or lower levels of cognitive functioning, the study was mainly exploratory in nature, providing direction for future research. Results indicate that symptom profiles did not widely differ, but that there might be some characteristics unique to patients BIF separating them as a group from both patients from RMHC and patients with Mild ID.",0,0 +5926,A meta-analytic clarification of the relationship between posttraumatic growth and symptoms of posttraumatic distress disorder,"Traumatic experiences can have a powerful impact on individuals and communities but the relationship between perceptions of beneficial and pathological outcomes are not known. Therefore, this meta-analysis examined both the strength and the linearity of the relationship between symptoms of posttraumatic stress disorder (PTSD) and perceptions of posttraumatic growth (PTG) as well as identifying the potential moderating roles of trauma type and age. Literature searches of all languages were conducted using the ProQuest, Wiley Interscience, ScienceDirect, Informaworld and Web of Science databases. Linear and quadratic (curvilinear) rs as well as βs were analysed. Forty-two studies (N = 11,469) that examined both PTG and symptoms of PTSD were included in meta-analytic calculations. The combined studies yielded a significant linear relationship between PTG and PTSD symptoms (r = 0.315, CI = 0.299, 0.331), but also a significantly stronger (as tested by Fisher's transformation) curvilinear relationship (r =0.372, CI = 0.353, 0.391). The strength and linearity of these relationships differed according to trauma type and age. The results remind those working with traumatised people that positive and negative post-trauma outcomes can co-occur. A focus only on PTSD symptoms may limit or slow recovery and mask the potential for growth.",0,0 +5927,A prospective study of leukocyte telomere length and risk of phobic anxiety among women,"We prospectively examined the relation of relative telomere lengths (RTLs), a marker of biological aging, to phobic anxiety in later-life. RTLs in peripheral blood leukocytes were measured among 3194 women in the Nurses' Health Study who provided blood samples in 1989/90. The Crown-Crisp Phobic Index (CCI, range=0–16) was assessed in 1988 and 2004. Only participants with CCI≤3 (consistent with no meaningful anxiety symptoms) in 1988 were included. We related baseline RTLs to odds ratios (ORs) of incident high phobic anxiety symptoms (CCI≥6). To enhance clinical relevance, we used finite mixture modeling (FMM) to relate baseline RTLs to latent classes of CCI in 2004. RTLs were not significantly associated with high phobic anxiety symptoms after 16 years of follow-up. However, FMM identified 3 groups of phobic symptoms in later-life: severe, minimal/intermediate, and non-anxious. The severe group had non-significantly shorter multivariable-adjusted mean RTLs than the minimal/intermediate and non-anxious groups. Women with shorter telomeres vs. longest telomeres had non-significantly higher likelihood of being in the severe vs. non-anxious group. Overall, there was no significant association between RTLs and incident phobic anxiety symptoms. Further work is required to explore potential connections of telomere length and emergence of severe phobic anxiety symptoms during later-life.",0,0 +5928,Postdisaster psychological intervention since 9/11.,"A wealth of research and experience after 9/11 has led to the development of evidence-based and evidence-informed guidelines and strategies to support the design and implementation of public mental health programs after terrorism and disaster. This article reviews advances that have been made in a variety of areas, including development of improved metrics and methodologies for conducting needs assessment, screening, surveillance, and program evaluation; clarification of risk and resilience factors as these relate to varying outcome trajectories for survivors and inform interventions; development and implementation of evidence-based and evidence-informed early, midterm, and late interventions for children, adults, and families; adaptation of interventions for cultural, ethnic, and minority groups; improvement in strategies to expand access to postdisaster mental health services; and enhancement of training methods and platforms for workforce development among psychologists, paraprofessionals, and other disaster responders. Continuing improvement of psychologists' national capacity to respond to catastrophic events will require more systematic research to strengthen the evidence base for postdisaster screening and interventions and effective methods and platforms for training. Policy decisions are clearly needed that enhance federal funding to increase availability and access to services, especially for longer term care. Traumatic bereavement represents a critical area for future research, as much needs to be done to clarify issues related to reactions and adaptation to a traumatic death.",0,0 +5929,Different Types of Postpartum Luteal Activity Affected by the Exposure of Heat Stress and Subsequent Reproductive Performance in Holstein Lactating Cows,"The aim of the present study was to determine the effect of heat stress on postpartum (PP) luteal activity and subsequent reproductive performance in lactating cows. Thirty Holstein-Friesian (HF, >or=75%) cows (hot season, n = 15 and cool season, n = 15) were studied over 60 days after calving. The changes of temperature-humidity index (THI) were monitored within both seasons. Body condition scores (BCS), uterine involution and the ovarian structures were recorded. Plasma samples were obtained three times a week for the analysis of progesterone (P4) and prostaglandin F(2 alpha) metabolite (PG metabolite). Subsequent reproductive performance of the cows, calved within the same period was also evaluated. The means of THI for hot and cool seasons varied between 84-87 and 78-83 respectively. A drop of the mean BCS was recorded at 5 weeks PP in the cows during hot season (p < 0.01), however a delay of uterine involution during early PP period in hot season was not clearly seen. The cows with normal PP ovarian cyclicity during hot and cool seasons were 4/15 (26.7%) and 9/15 (60.0%) respectively. A higher percentage of abnormal luteal activity was found in the cows during hot season (p = 0.07) and delayed luteal cyclicity/anovulation was the most pronounced atypical P4 profile. The levels of PG metabolite were not different between groups and the relationship between the levels of PG metabolite and the time of uterine involution was not evident (p > 0.05). The heat detection rates and the pregnancy rates were higher in the cows during cool season (p < 0.05). Additionally, the higher first AI conception rates during cool season were recorded (p = 0.06). In conclusion, heat stress conditions had negative effects on BCS and altered a normal process of ovarian resumption PP, consequently resulted in lower reproductive performance in a tropical dairy herd.",0,0 +5930,Does comorbid anxiety or depression affect clinical outcomes in patients with post-traumatic stress disorder and alcohol use disorders?,"Post-traumatic stress disorder (PTSD) is commonly comorbid with other psychiatric disorders, including substance use disorders. In spite of this, pharmacologic treatment trials for PTSD often exclude individuals with significant psychiatric comorbidity. This study is a post hoc analysis of a 12-week double-blind placebo-controlled trial investigating sertraline in the treatment of patients with comorbid PTSD and an alcohol use disorder. Individuals with additional anxiety and affective disorders were included. Patients (N = 93) were stratified into four groups depending on presence or absence of additional anxiety or depressive disorders and evaluated for the effects of comorbidity on PTSD symptoms, depressive symptoms, and drinking behaviors. We hypothesized that additional comorbidity would be associated with poorer outcomes. Patients in all four subgroups showed marked and clinically significant improvement in alcohol drinking behaviors over the course of the study. For the entire sample, over the course of the 12 weeks, mean drinks per drinking day fell from 13.0 +/- 8.4 (SD) to 3.0 +/- 5.0 (SD); t = 10.2, df = 92, P <.000. There were, however, no significant differences among groups. Patients in all four groups showed moderate improvement in Hamilton Depression Rating Scale (HAMD) scores and Clinician-Administered PTSD scale (CAPS) scores at endpoint. For the entire sample, mean CAPS scores fell from 59.3 +/- 19.4 (SD) to 40.8 +/- 26.0, t = 8.9, df = 92, P <.000. Mean HAMD scores fell from 17. 9 +/- 6.7 (SD) at baseline to 11.8 +/- 9.4 (SD) at endpoint; t = 6.7, df = 92, P <.000. There were, however, no significant differences among groups for change in HAM-D or CAPS scores. Hence, contrary to our hypothesis, having additional anxiety or mood disorder comorbidity did not decrease treatment response in individuals with comorbid PTSD and an alcohol use disorder.",0,0 +5931,Treatment of psychosis during pregnancy – a case report and a mini-review,"Nielsen RE. Treatment of psychosis during pregnancy – a case report and a mini-review. Objective: Describe clinical problems in treating a patient with psychotic symptoms during pregnancy by presenting a case report, and review the current evidence on antipsychotic drugs during pregnancy. Methods: The review consists of a non-systematic clinical review of current data on treatment with antipsychotics during pregnancy. The case, a 27 year old female initially diagnosed with posttraumatic stress disorder (PTSD) after a rape and emotionally unstable personality disorder, illustrates some of the common challenges a clinician meets. The patient initially discontinues all treatment as she is unsure if the drugs could have a teratogenic effect and is changed to a treatment that is regarded as safe during pregnancy. Results: The current data supports treatment with chlorpromazine although there is a risk of side effects, e.g. extrapyramidal symptoms and hypotension, but also treatment with olanzapine and risperidone. If the patient is currently treated with clozapine, this treatment should be continued, due to clozapines unique efficacy profile. Blood monitoring for six months after birth is recommended when the newborn has been exposed to clozapine treatment. Conclusion: Current evidence on treatment with antipsychotics during pregnancy is sparse, but not treating is associated with increased risks compared to treatment.",0,0 +5932,Examining factors that contribute to the process of resilience following spinal cord injury,"Cross-sectional survey.To examine factors that contribute to the process of positive adjustment, or resilience, in an adult community sample with spinal cord injury (SCI).South Australian Spinal Cord Injury Service, Hampstead Rehabilitation Centre, South Australia, AustraliaA postal survey comprising standardised measures of resilience (Connor-Davidson Resilience Scale-10 item), self-efficacy (Moorong Self-Efficacy Scale), locus of control (Locus of Control of Behaviour Scale) and psychological distress (Depression Anxiety Stress Scale--21 item).Of 60 respondents, 58% reported moderate to high levels of resilience. Resilience correlated significantly with high self-efficacy (r=0.68, P<0.01), internal locus of control (r=-0.52, P<0.01) and low psychological distress (depression r=-0.68, P<0.01; anxiety r=-0.55, P<0.01; stress r=-0.67, P<0.01). In comparison, resilience was not significantly influenced by degree of neuropathic pain (r=-0.23, P>0.05), time since injury (r=-0.14, P>0.05), gender (t(58)=-0.92, P>0.05), lesion completeness (t(57)=-0.86, P>0.05), or SCI diagnosis (t(58)=-1.21, P>0.05). A multiple regression indicated that psychological distress and self-efficacy were the only two variables that uniquely contributed to resilient behaviour.Resilience is an important psychological process in the longer-term management of SCI which can be promoted by targeting rehabilitation interventions towards mood management in addition to self efficacy beliefs. Larger-scale research will help to validate these results.",0,0 +5933,Residential Treatment for Combat-Related Posttraumatic Stress Disorder: Identifying Trajectories of Change and Predictors of Treatment Response,"Combat-related posttraumatic stress disorder (PTSD) can be a difficult condition to treat and has been associated with serious medical and economic issues among U.S. military veterans. Distinguishing between treatment responders vs. non-responders in this population has become an important public health priority. This study was conducted to identify pre-treatment characteristics of U.S. veterans with combat-related PTSD that might contribute to favorable and unfavorable responses to high value treatments for this condition.This study focused on 805 patients who completed a VHA PTSD residential program between 2000 and 2007. These patients completed the PTSD Clinical Checklist at pre-treatment, post-treatment, and a four-month follow-up assessment. Latent growth curve analysis (LCGA) was incorporated to determine trajectories of changes in PTSD across these assessments and whether several key clinical concerns for this population were associated with their treatment responses.LCGA indicated three distinct trajectories in PTSD outcomes and identified several clinical factors that were prospectively linked with changes in veterans' posttraumatic symptomatology. When compared to a group with high PTSD symptom severity that decreased over the program but relapsed at follow-up (41%), the near half (48.8%) of the sample with an improving trajectory had less combat exposure and superior physical/mental health. However, when compared to a minority (10.2%) with relatively low symptomatology that also remained somewhat stable, patients in the improving group were younger and also reported greater combat exposure, poorer physical/mental health status, and more problems with substance abuse before the start of treatment.Findings suggest that veterans are most likely to benefit from residential treatment in an intermediate range of symptoms and risk factors, including PTSD symptom severity, history of combat exposure, and comorbid issues with physical/mental health. Addressing these factors in an integrative manner could help to optimize the effectiveness of treatments of combat-related PTSD in many cases.",0,0 +5934,Predicting Posttraumatic Stress Disorder from Acute Reactions,"There is much interest in identifying people shortly after trauma exposure who will subsequently develop posttraumatic stress disorder (PTSD). This review outlines recent developments in early identification of trauma-exposed people who are at high risk for PTSD development, including the rationale, evidence, and limitations of the acute stress diagnosis as a predictor of chronic PTSD. The potential role of acute dissociative responses mediating development of PTSD is also reviewed. The available evidence suggests that whereas acute dissociation is an important factor in the acute stress response, many people develop PTSD in the absence of dissociative symptoms. The evidence suggests that dissociation needs to be considered in the context of other factors in the aftermath of trauma if optimal identification of high-risk individuals is to be achieved.",0,0 +5935,Psychosocial recovery after serious injury,"The 2010 iteration of the Global Burden of Disease statistics (Murray et al., 2012) points to the growing impact of injury and highlights the mounting burden of psychiatric disorder. It is essential to examine the intersection between these two contributors to disease burden.The Australian Injury Vulnerability Study collected data of over 1,000 injury patients from their initial hospitalization to 6 years post-injury. Structured clinical interviews were used to diagnose psychiatric disorder and self-report measures for disability and symptom severity.A wide range of psychiatric disorders developed following injury, which included posttraumatic stress disorder, agoraphobia, depression, and substance use disorders (Bryant, O'Donnell, Creamer, Silove, & McFarlane, 2010). Although prevalence rates for these disorders were generally consistent over time, examination of trajectory data showed that different people had the disorders at different times. Importantly, the data showed that early anxiety, depression, and PTSD symptoms played a significant role in the development of long term disability after injury (Carty, O'Donnell, Evans, Kazantzis, & Creamer, 2011; O'Donnell et al., 2013).These data support the view that transdiagnostic models for early intervention may be required to address the complex psychiatric disorder trajectories that develop after injury.",0,0 +5936,A meta‐analysis of prevalence rates and moderating factors for cancer‐related post‐traumatic stress disorder,"Objective Systematic reviews highlight a broad range of cancer-related post-traumatic stress disorder (CR-PTSD) prevalence estimates in cancer survivors. This meta-analysis was conducted to provide a prevalence estimate of significant CR-PTSD symptoms and full diagnoses to facilitate the psychological aftercare of cancer survivors. Methods A systematic literature search was conducted for studies using samples of cancer survivors by using validated clinical interviews and questionnaires to assess the prevalence of CR-PTSD (k = 25, n = 4189). Prevalence estimates were calculated for each assessment method using random-effects meta-analysis. Mixed-effects meta-regression and categorical analyses were used to investigate study-level moderator effects. Results Studies using the PTSD Checklist—Civilian Version yielded lower event rates using cut-off [7.3%, 95% confidence intervals (CI) = 4.5–11.7, k = 10] than symptom cluster (11.2%, 95% CI = 8.7–14.4, k = 9). Studies using the Structured Clinical Interview for Diagnostic and Statistical Manual, Fourth Edition (SCID), yielded low rates for lifetime (15.3%, 95% CI = 9.1–25, k = 5) and current CR-PTSD (5.1%, 95% CI = 2.8–8.9, k = 9). Between-study heterogeneity was substantial (I2 = 54–87%). Studies with advanced-stage samples yielded significantly higher rates with PTSD Checklist—Civilian Version cluster scoring (p = 0.05), and when assessing current CR-PTSD on the SCID (p = 0.05). The effect of mean age on current PTSD prevalence met significance on the SCID (p = 0.05). SCID lifetime prevalence rates decreased with time post-treatment (R2 = 0.56, p < 0.05). Discussion The cancer experience is sufficiently traumatic to induce PTSD in a minority of cancer survivors. Post-hoc analyses suggest that those who are younger, are diagnosed with more advanced disease and recently completed treatment may be at greater risk of PTSD. More research is needed to investigate vulnerability factors for PTSD in cancer survivors. © 2014 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.",0,0 +5937,"Screening of Current Post-Traumatic Stress Disorder in Patients with Substance Use Disorder Using the Depression, Anxiety and Stress Scale (DASS-21): A Reliable and Convenient Measure","<b><i>Background:</i></b> Several instruments have been developed and validated as screens for post-traumatic stress disorder (PTSD) in substance use disorder (SUD) patients. Unfortunately, many of these instruments have one or several disadvantages (e.g. low specificity, low sensitivity or high costs). No research has been conducted on instruments that screen simultaneously for other psychiatric disorders, which would be a potentially time-saving and cost-effective approach. In the current study we tested the psychometric properties of the Depression, Anxiety and Stress Scale (DASS) as a screen for PTSD. <b><i>Methods:</i></b> The DASS was assessed in an inpatient facility during intake with 58 patients and again 4 weeks after admission. Another 138 patients were assessed 4 weeks after admission only. The results were compared to the Clinician-Administered PTSD Scale (CAPS) that was also administered after 4 weeks of abstinence. <b><i>Results:</i></b> ROC curve analyses showed an area under the curve of 0.84 for the DASS at intake and 0.78 for the DASS after 4 weeks' abstinence. <b><i>Conclusion:</i></b> The DASS is therefore a reliable and convenient measure to use as a screen for PTSD in SUD patients.",0,0 +5938,Which symptoms of post-traumatic stress disorder are associated with suicide attempts?,"Individuals with post-traumatic stress disorder are at increased risk for suicide attempts. The present study aimed to determine which of the specific DSM-IV symptoms of post-traumatic stress disorder (PTSD) are independently associated with suicide attempts. Data came from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The NESARC has a sample size of N = 34653. The full sample size included in analyses was 2322 individuals with PTSD. Among individuals with lifetime PTSD, after adjusting for sociodemographic factors, as well as any mood, substance, personality, or anxiety disorder (excluding PTSD), increasing numbers of re-experiencing and avoidance symptoms were significantly correlated with suicide attempts. Of the specific symptoms, having physical reactions by reminders of the trauma, being unable to recall some part of it, and having the sense of a foreshortened future, were all associated with suicide attempts. These findings will help extend our understanding of the elevated risk for suicide attempts in individuals with PTSD.",0,0 +5939,Mediators and moderators of a psychosocial intervention for children affected by political violence.,"The authors examined moderators and mediators of a school-based psychosocial intervention for children affected by political violence, according to an ecological resilience theoretical framework.The authors examined data from a cluster randomized trial, involving children aged 8-13 in Central Sulawesi, Indonesia (treatment condition n = 182, waitlist control condition n = 221). Mediators (hope, coping, peer/emotional/play social support) and moderators (gender, age, family connectedness, household size, other forms of social support, exposure to political violence, and displacement) of treatment outcome on posttraumatic stress symptoms and function impairment were examined in parallel process latent growth curve models.Compared with the waitlist group, those receiving treatment showed maintained hope, increased positive coping, maintained peer social support, and increased play social support. Of these putative mediators, only play social support was found to mediate treatment effects, such that increases in play social support were associated with smaller reductions in posttraumatic stress disorder (PTSD) symptoms. Furthermore, the authors identified a number of moderators: Girls showed larger treatment benefits on PTSD symptoms; girls, children in smaller households, and children receiving social support from adults outside the household showed larger treatment benefits on function impairment.Findings provide limited evidence for an ecological resilience theoretical framework. On the basis of these findings, the authors recommend a stronger separation between universal prevention (e.g., resilience promotion through play) and selective/indicated prevention (e.g., interventions aimed at decreasing posttraumatic stress symptoms). Play-based interventions should be careful to exclude children with psychological distress. In addition, treatment effects may be augmented by selecting girls and socially vulnerable children.",0,0 +5940,Early and Delayed Onset of Response to Antidepressants in Individual Trajectories of Change During Treatment of Major Depression,"The timing and rate of improvement after the initiation of an antidepressant has implications for establishing the mechanism of antidepressant action and for answering the clinically relevant question of how long an appropriate trial of antidepressant medication should be. We explore the individual trajectories of relative change in depression severity to establish what proportion of individuals experience early and late onset of improvement.Longitudinal latent class analysis was applied in a secondary analysis of data obtained from the Genome-Based Therapeutic Drugs for Depression (GENDEP) study. In the GENDEP trial, conducted in 9 European academic psychiatry centers from July 2004 to June 2008, 811 treatment-seeking adult subjects with DSM-IV major depression received escitalopram or nortriptyline for 12 weeks. Montgomery-Asberg Depression Rating Scale measurements were taken weekly. The secondary analysis reported in this article was conducted in 2010.A model with 9 latent classes provided a good description of the individual trajectories of symptom change over time. These classes included 3 nonresponder classes, 3 classes with varying degrees of improvement concentrated in the first 3 weeks (early improvement), and 3 classes with varying degrees of improvement that was more prominent in the second 3 weeks than in the first 3 weeks (delayed improvement). More than half of the subjects who eventually reached remission showed a pattern of delayed improvement, and their eventual outcome could not be predicted from early time points. Early marked response occurred more frequently in subjects treated with nortriptyline than in those treated with escitalopram (12.9% vs 7.5%, χ² = 6.29, P = .01). Delayed complete remission occurred more frequently in subjects treated with escitalopram than in those treated with nortriptyline (13.6% vs 6.1%, χ² = 11.52, P = .0007).Both early and delayed improvement are common. Although early changes are maintained, the eventual outcome of 12-week antidepressant treatment can be accurately predicted only after 8 weeks.http://www.controlled-trials.com Identifier: ISRCTN03693000.",0,0 +5941,"Trajectories of Scores on a Screening Instrument for PTSD Among World Trade Center Rescue, Recovery, and Clean-Up Workers","The longitudinal course of posttraumatic stress disorder (PTSD) over 8-9 years was examined among 16,488 rescue and recovery workers who responded to the events of September 11, 2001 (9/11) at the World Trade Center (WTC; New York, NY), and were enrolled in the World Trade Center Health Registry. Latent class growth analysis identified 5 groups of rescue and recovery workers with similar score trajectories at 3 administrations of the PTSD Checklist (PCL): low-stable (53.3%), moderate- stable (28.7%), moderate-increasing (6.4%), high-decreasing (7.7%), and high-stable (4.0%). Relative to the low-stable group, membership in higher risk groups was associated with 9/11-related exposures including duration of WTC work, with adjusted odds ratios ranging from 1.3 to 2.0, witnessing of horrific events (range = 1.3 to 2.1), being injured (range = 1.4 to 2.3), perceiving threat to life or safety (range = 2.2 to 5.2), bereavement (range = 1.6 to 4.8), and job loss due to 9/11 (range = 2.4 to 15.8). Within groups, higher PCL scores were associated with adverse social circumstances including lower social support, with B coefficients ranging from 0.2 to 0.6, divorce, separation, or widowhood (range = 0.4-0.7), and unemployment (range = 0.4-0.5). Given baseline, exposure-related, and contextual influences that affect divergent PTSD trajectories, screening for both PTSD and adverse circumstances should occur immediately, and at regular intervals postdisaster.",1,0 +5942,Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis,"Background It is unclear how many children and adolescents develop post-traumatic stress disorder (PTSD) after trauma. Aims To determine the incidence of PTSD in trauma-exposed children and adolescents as assessed with well-established diagnostic interviews and to examine potential moderators of the estimate. Method A systematic literature search identified 72 peer-reviewed articles on 43 independent samples ( n = 3563). Samples consisting only of participants seeking or receiving mental health treatment were excluded. Main analyses involved pooled incidence estimates and meta-analyses of variance. Results The overall rate of PTSD was 15.9% (95% CI 11.5–21.5), which varied according to the type of trauma and gender. Least at risk were boys exposed to non-interpersonal trauma (8.4%, 95% CI 4.7–14.5), whereas girls exposed to interpersonal trauma showed the highest rate (32.9%, 95% CI 19.8–49.3). No significant difference was found for the choice of assessment interview or the informant of the assessment. Conclusions Research conducted with the best available assessment instruments shows that a significant minority of children and adolescents develop PTSD after trauma exposure, with those exposed to interpersonal trauma and girls at particular risk. The estimates provide a benchmark for DSM-5 and ICD-11.",0,0 +5943,New insights into secondary prevention in post-traumatic stress disorder,"Post-traumatic stress disorder (PTSD) is unique amongst psychiatric disorders in two ways. Firstly, there is usually a very clear point of onset- the traumatic event The second unique feature of PTSD is that it is characterized by a failure of the normal response to resolve. Given these two characteristics, PTSD appears a good candidate for secondary prevention, ie, interventions immediately after the trauma. Evidence available starting from current concepts and contemporary research of potential secondary prevention interventions are presented. Common practices in the aftermath of trauma such as debriefing and benzodiazepines need to be carefully considered, taking into account their potential harm to the spontaneous recovery process, and the trajectory of PTSD, and not only judging them according to their immediate (comforting) effects. A discussion of the balance required between aiding recovery but not interfering with the potent natural resolution of symptoms (that is expected in most cases), along with potential avenues of future research, are presented. Results of a small pilot study with a single intervention of hydrocortisone immediately after trauma appear to be promising, and clearly indicate the need for further studies.",0,0 +5944,Are traumatic events necessary to elicit symptoms of posttraumatic stress?,"A diagnosis of posttraumatic stress disorder (PTSD) has been conceptualized as being precipitated by a particularly traumatic (e.g., combat exposure, rape, and violent assault). Recent research suggests that common stressful events (e.g., relational problems, divorce, and expected death of a loved one) may also be capable of eliciting posttraumatic symptomatology. The current study replicated and extended these previous findings, examining three groups of exposure: those who reported experiencing only traumatic events in the past year, those who reported experiencing only significant stressful life events in the last year, and those who experienced both types of events. Consistent with previous findings, we found that all three groups of exposure, including those experiencing only stressful life events, experienced similar amounts of PTSD symptomatology across symptom clusters. These data add to the growing literature that suggests that the type of events that cause symptoms of PTSD may be broader than the current diagnostic criteria indicate, and as such calls for more rigorous research in this area to better understand the diagnostic implications of these findings. Since the formal inclusion of posttraumatic stress disorder (PTSD) into the Diagnostic and Statistical Manual of Mental Disorders (3rd ed.; DSM-III; American Psychiatric Association (APA), 1980), controversy has arisen with the diagnosis, much of it centered on Criterion A1 (the stressor criterion). In DSM-III, this criterion held that an individual had to experience an event that is outside the range of usual human experience and that would be markedly distressing to almost anyone (APA, 1980). One of the first critiques of PTSD came from Breslau and Davis (1987), who claimed that the connection between this criterion and the symptom constellation of the PTSD diagnosis had not been adequately tested in an empirical manner. An additional criticism of this early criterion concerned the definition of a traumatic as one that occurred rarely in the population. Epidemiological studies have shown that traumatic stressors are relatively common, with most people experiencing at least one traumatic within their lifetime (Breslau, Davis, Andreski, & Peterson, 1991). In addition to these early criticisms of PTSD as a construct, several research studies have documented that events not necessarily considered traumatic elicit the symptom constella- tion thought to be associated with PTSD, raising questions con- cerning the disorder's symptom specificity. A study conducted by Joseph, Mynard, and Mayall (2000) on English adolescents found a relationship between high scores on measures of posttraumatic stress symptoms and stressful life events that normally would not be classified as traumatic by the current PTSD inclusion criteria (e.g., parental separation, trouble with the police, and family member with a drug or alcohol prob- lem). Additionally, Mol and colleagues (2005) used a general population sample to examine whether stressful events could gen- erate symptoms of PTSD and found that those who identified a stressful life as their worst subjective experience endorsed higher levels of PTSD symptoms than did those whose worst experience was a traumatic event. Similarly, Gold, Marx, Soler- Baillo, and Sloan (2005) divided college undergraduate partici- pants into two groups: those who endorsed a traumatic consistent with the A1 criterion of PTSD and those who experi- enced a negative life not consistent with that criterion. Consistent with previous research, individuals who reported expe- riencing negative life events not consistent with the traumatic nature of the A1 criterion showed equal, if not more, posttraumatic symptomatology than did those who indicated the experience of a traumatic in their life. A more recent study using structured clinical interviews found similar results in a sample of people seeking treatment for major depression (Bodkin, Pope, Detke, & Hudson, 2007). These recent findings underscore a perceived problem with the construct of PTSD and the criterion that has received increased attention as we move closer to the release of DSM (5th ed.). These studies also highlight the importance of additional research in this area to further explore the A1 criterion of PTSD and the stressors that can lead to a posttraumatic stress symptom constellation.",0,0 +5945,Tachykinin Receptors as Therapeutic Targets in Stress-Related Disorders,"The first report demonstrating the therapeutic efficacy of an orally applied neurokinin-1 (NK1) receptor antagonist in depression was published 10 years ago. Although there were difficulties to reproduce this particular finding, a huge amount of data has been published since this time, supporting the potential therapeutic value of various tachykinin ligands as promising novel tools for the management of stress-related disorders including anxiety disorders, schizophrenia and depression. The present review summarizes evidence derived from anatomical, neurochemical, pharmacological and behavioral studies demonstrating the localization of tachykinin neuropeptides including substance P (SP), neurokinin A, neurokinin B and their receptors (NK1, NK2, NK3) in brain areas known to be implicated in stress-mechanisms, mood/anxiety regulation and emotion-processing; their role as neurotransmitters and/or neuromodulators within these structures and their interactions with other neurotransmitter systems including dopamine, noradrenaline and serotonin (5-hydroxytryptamine, 5-HT). Finally, there is clear functional evidence from animal and human studies that interference with tachykinin transmission can modulate emotional behavior. Based on these findings and on evidence of upregulated tachykinin transmission in individuals suffering from stress-related disorders, several diverse tachykinin receptor antagonists, as well as compounds with combined antagonist profile have been developed and are currently under clinical investigation revealing evidence for anxiolytic, antidepressant and antipsychotic efficacy, seemingly characterized by a low side effect profile. However, substantial work remains to be done to clarify the precise mechanism of action of these compounds, as well as the potential of combining them with established and experimental therapies in order to boost efficacy.",0,0 +5946,The psychological impact of the Israel–Hezbollah War on Jews and Arabs in Israel: The impact of risk and resilience factors,"Although there is abundant evidence that mass traumas are associated with adverse mental health consequences, few studies have used nationally representative samples to examine the impact of war on civilians, and none have examined the impact of the Israel-Hezbollah War, which involved unprecedented levels of civilian trauma exposure from July 12 to August 14, 2006. The aims of this study were to document probable post-traumatic stress disorder (PTSD), determined by the PTSD Symptom Scale and self-reported functional impairment, in Jewish and Arab residents of Israel immediately after the Israel-Hezbollah War and to assess potential risk and resilience factors. A telephone survey was conducted August 15-October 5, 2006, following the cessation of rocket attacks. Stratified random sampling methods yielded a nationally representative population sample of 1200 adult Israeli residents. The rate of probable PTSD was 7.2%. Higher risk of probable PTSD was associated with being a woman, recent trauma exposure, economic loss, and higher psychosocial resource loss. Lower risk of probable PTSD was associated with higher education. The results suggest that economic and psychosocial resource loss, in addition to trauma exposure, have an impact on post-trauma functioning. Thus, interventions that bolster these resources might prove effective in alleviating civilian psychopathology during war.",0,0 +5947,Follow-up of young road accident victims,The aim of this study was to follow-up a group of children and young people previously examined for psychological sequelae following road traffic accidents. The group was assessed 18-month postaccident to assess the severity of continuing symptoms and examine any emergence of delayed onset of posttraumatic stress reactions. Participants (N = 31) completed the Revised Impact of Event Scale and the Child Posttraumatic Stress Reaction Index. Parents completed the Child Behavior Check-List and participated in a semistructured interview. Symptoms of PTSD were noted in a quarter of participants as was delayed onset of symptoms. The role of avoidance in symptom reporting and continuing disorder is discussed.,0,0 +5948,Parental Stress Response to Sexual Abuse and Ritualistic Abuse Of Children in Day-Care Centers,"The purpose of this study was to examine the stress responses of parents to the sexual and ritualistic abuse of their children in day-care centers. Sixty-five mothers and 46 fathers of children sexually abused in day-care centers completed the Symptom Checklist-90-Revised (SCL-90-R), a measure of psychological distress. These scores were compared with a carefully matched comparison group of parents of 67 nonabused children. Parents of abused children also completed the Impact of Event Scale (IES), a measure which indexes symptoms that characterize posttraumatic stress disorder. Parents of sexually abused children reported significantly more psychological distress than parents of nonabused children, with parents of ritually abused children displaying the most severe psychological distress. Parents of abused children reported symptom profiles on the SCL-90-R and IES consistent with posttraumatic stress disorder.",0,0 +5949,Traumatic stress and psychopathology: experiences of a trauma clinic,"Objective: The study was undertaken to investigate the profile of individuals referred to the psychiatrist for assessment in terms of their demographic features, trauma experienced, diagnosis according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV), and recommendations made by the psychiatrist. Method: The trauma clinic, a key component of the Victim Empowerment Programme (VEP) of the Centre for the Study of Violence and Reconciliation (CSVR) in Johannesburg, South Africa is a multidisciplinary unit offering counselling and debriefing services to victims/survivors of violence. The staff consists of trained therapists (clinical, research and educational psychologists), social workers and a psychiatric nurse. Since 1998, a psychiatrist has been consulting at the clinic as well. A retrospective case review of all intake notes and progress notes of the clients was undertaken. The period of the survey was 1999-2002. Results: Of 3668 individuals presenting to the centre, 127 were referred to the resident psychiatrist for assessment. 119 were assessed. The majority were in the age range 15-45, unmarried and unemployed. Children under the age of 15 and refugees constituted 9.9% and 30% respectively. Major Depression was the most commonly diagnosed psychiatric condition (17.6%), with Post Traumatic Stress Disorder (PTSD), diagnosed less than expected (5.9%). Co- morbidity was common. Medication was prescribed for 66.4% of the sample, with a further 5.9% hospitalised. Conclusion: Not all individuals exposed to trauma develop PTSD, with mood disorders possibly being more common.",0,0 +5950,Quality of Life and Its Predictors in Adolescents after General Traumatic Injury,"Background: Injury is a leading cause of morbidity in adolescents in the United States, with almost 4 million 12- to 18-year olds experiencing non-fatal injury in 2009 alone. As survival rates improved, negative psychosocial outcomes were noted, including reduced health-related quality of life (HRQOL). Several variables have been investigated for association with worse HRQOL outcomes. However, no study has reported on the broader construct of quality of life (QOL) in this setting. The current project studied QOL in adolescents after general traumatic injury, specifically investigating whether it differed from a comparison group or changed over the year after injury. Factors potentially associated with poorer QOL outcomes were also evaluated, as they might serve as potential targets for intervention. Method: One-hundred eight 12- to 18-year-olds admitted to a level 1 trauma center after injury participated in this prospective cohort study with a population-based sampling frame. Data were collected within 30 days of injury and 2, 5, and 12 months after injury. The comparison sample was 116 12- to 18-year-olds without disability, mental health diagnosis or chronic illness. Adolescent posttraumatic stress disorder symptoms (PTSS), depressive symptoms, traumatic or stressful life events and parental PTSS were all considered for potential relationship to adolescent QOL. Analyses included descriptive statistics, paired comparisons, ANOVAs, mixed-model and linear regression and mediation analysis. Results: In general, injured adolescents reported normative QOL at injury and 2 months later and significantly better QOL at 5 and 12 months after injury. However, posttraumatic stress disorder was associated with significantly poorer QOL, and those with a higher number of postinjury traumatic or stressful life events had poorer QOL 1 year after injury. Depressive symptoms were also significantly correlated with lower QOL. Parental PTSS did not mediate the relationship between adolescent PTSS and QOL. Conclusions: Findings suggest points of intervention to improve QOL after adolescent injury. They further highlight a need for close communication between trauma center staff and primary care practitioners as well as education for primary providers. Future directions include attention to preinjury mental health and family functioning, investigations with younger children, and longer follow-up. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +5951,"Relationship between anger, alcoholism and symptoms of posttraumatic stress disorders in war veterans","Purpose: Studies among veterans indicate that veterans with posttraumatic stress disorder (PTSD) express anger, hostility and aggression as well as alcohol and substance abuse more then veterans without PTSD. The aim of this study was to analyze the relationship between anger, use of alcohol and symptoms of PTSD in war veterans in Bosnia and Herzegovina (B&H). Method: Comparing a group of veterans (n=54) with PTSD who use alcohol and a group of veterans (n=46) who do not use alcohol, the analyzed were dimensions of anger related to PTSD symptoms and alcohol usage. Medical records of patients treated at the Department for Psychiatry in Tuzla, B&H, Harvard Trauma Questionnaire (HTQ) – version for Bosnia and Herzegovina, State-Trait Anger Expression Inventory (STAXI), Structured Clinical Diagnostic Interview (SCID-I) were used in this study. The basic socio-demographic data were also collected. Results: A significant correlation is found between alcohol usage, and state and trait of anger (P",0,0 +5952,Prenatal Excess Glucocorticoid Exposure and Adult Affective Disorders: A Role for Serotonergic and Catecholamine Pathways,"Fetal glucocorticoid exposure is a key mechanism proposed to underlie prenatal ‘programming’ of adult affective behaviours such as depression and anxiety. Indeed, the glucocorticoid metabolising enzyme 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2), which is highly expressed in the placenta and the developing fetus, acts as a protective barrier from the high maternal glucocorticoids which may alter developmental trajectories. The programmed changes resulting from maternal stress or bypass or from the inhibition of 11β-HSD2 are frequently associated with alterations in the hypothalamic-pituitary-adrenal (HPA) axis. Hence, circulating glucocorticoid levels are increased either basally or in response to stress accompanied by CNS region-specific modulations in the expression of both corticosteroid receptors (mineralocorticoid and glucocorticoid receptors). Furthermore, early-life glucocorticoid exposure also affects serotonergic and catecholamine pathways within the brain, with changes in both associated neurotransmitters and receptors. Indeed, global removal of 11β-HSD2, an enzyme that inactivates glucocorticoids, increases anxiety- and depressive-like behaviour in mice; however, in this case the phenotype is not accompanied by overt perturbation in the HPA axis but, intriguingly, alterations in serotonergic and catecholamine pathways are maintained in this programming model. This review addresses one of the potential adverse effects of glucocorticoid overexposure in utero, i.e. increased incidence of affective behaviours, and the mechanisms underlying these behaviours including alteration of the HPA axis and serotonergic and catecholamine pathways.",0,0 +5953,Dynamic resolution of functionally related gene sets in response to acute heat stress,"Using a gene clustering strategy we determined intracellular pathway relationships within skeletal myotubes in response to an acute heat stress stimuli. Following heat shock, the transcriptome was analyzed by microarray in a temporal fashion to characterize the dynamic relationship of signaling pathways.Bioinformatics analyses exposed coordination of functionally-related gene sets, depicting mechanism-based responses to heat shock. Protein turnover-related pathways were significantly affected including protein folding, pre-mRNA processing, mRNA splicing, proteolysis and proteasome-related pathways. Many responses were transient, tending to normalize within 24 hours.In summary, we show that the transcriptional response to acute cell stress is largely transient and proteosome-centric.",0,0 +5954,Assessing acute stress disorder: Psychometric properties of a structured clinical interview.,"This study presents the development ofa structured clinical interview to diagnose acute stress disorder (ASD). The Acute Stress Disorder Interview (ASDI) is a 19-item, dichotomously scored interview schedule that is based on criteria from the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). It was validated against clinician-based diagnoses of ASD on 65 trauma survivors assessed between 1 and 3 weeks posttrauma. It possessed good internal consistency (r = .90), sensitivity (91%), and specificity (93%). Test-retest reliability was evaluated on 60 trauma survivors between 1 and 3 weeks posttrauma, with a readministration interval of 2 to 7 days. Test-retest reliability of ASDI severity scores was strong (r = .88), and diagnostic agreement for presence (88%) and absence (94%) of ASD diagnosis was high. The ASDI appears to be a useful tool to identify those individuals who suffer ASD and are at risk of long-term posttraumatic stress disorder.",0,0 +5955,Group-Based Trajectory Analysis Applications for Prognostic Biomarker Model Development in Severe TBI: A Practical Example,"Over the last decade, biomarker research has identified potential biomarkers for the diagnosis, prognosis, and management of traumatic brain injury (TBI). Several cerebrospinal fluid (CSF) and serum biomarkers have shown promise in predicting long-term outcome after severe TBI. Despite this increased focus on identifying biomarkers for outcome prognostication after a severe TBI, several challenges still exist in effectively modeling the significant heterogeneity observed in TBI-related pathology, as well as the biomarker-outcome relationships. Biomarker data collected over time are usually summarized into single-point estimates (e.g., average or peak biomarker levels), which are, in turn, used to examine the relationships between biomarker levels and outcomes. Further, many biomarker studies to date have focused on the prediction power of biomarkers without controlling for potential clinical and demographic confounders that have been previously shown to affect long-term outcome. In this article, we demonstrate the application of a practical approach to delineate and describe distinct subpopulations having similar longitudinal biomarker profiles and to model the relationships between these biomarker profiles and outcomes while taking into account potential confounding factors. As an example, we demonstrate a group-based modeling technique to identify temporal S100 calcium-binding protein B (S100b) profiles, measured from CSF over the first week post-injury, in a sample of adult subjects with TBI, and we use multivariate logistic regression to show that the prediction power of S100b biomarker profiles can be superior to the prediction power of single-point estimates.",0,0 +5956,White Matter Compromise in Veterans Exposed to Primary Blast Forces,"OBJECTIVE:: Use diffusion tensor imaging to investigate white matter alterations associated with blast exposure with or without acute symptoms of traumatic brain injury (TBI). PARTICIPANTS:: Forty-five veterans of the recent military conflicts included 23 exposed to primary blast without TBI symptoms, 6 having primary blast with mild TBI, and 16 unexposed to blast. DESIGN:: Cross-sectional case-control study. MAIN MEASURES:: Neuropsychological testing and diffusion tensor imaging metrics that quantified the number of voxel clusters with altered fractional anisotropy (FA) radial diffusivity, and axial diffusivity, regardless of their spatial location. RESULTS:: Significantly lower FA and higher radial diffusivity were observed in veterans exposed to primary blast with and without mild TBI relative to blast-unexposed veterans. Voxel clusters of lower FA were spatially dispersed and heterogeneous across affected individuals. CONCLUSION:: These results suggest that lack of clear TBI symptoms following primary blast exposure may not accurately reflect the extent of brain injury. If confirmed, our findings would argue for supplementing the established approach of making diagnoses based purely on clinical history and observable acute symptoms with novel neuroimaging-based diagnostic criteria that look below the surface for pathology. Language: en",0,0 +5957,Identification of Traumatic Stress Reactions in Women at Increased Risk for Breast Cancer,"It has been shown that the diagnosis and treatment of cancer may constitute a traumatic event that generates in patients and some of their family members traumatic reactions that are consistent with the symptom profile of posttraumatic stress disorder (PTSD). The present study was conducted to establish the degree to which women at increased familial risk for breast cancer showed such traumatic reactions and to establish which demographic or psychological variables may contribute to the experience of such traumatic reactions in at-risk individuals. Seventy-three women from the Revlon UCLA Breast Center High Risk Clinic were assessed for traumatic reactions that might be consistent with the DSM-IV criteria for PTSD. The results showed that women at increased risk for breast cancer exhibited traumatic responses similar to those reported by cancer patients. When the authors used a self-report instrument that maps onto DSM-IV criteria, 4% of the study subjects reported symptoms consistent with criteria for a potential diagnosis of PTSD, and an additional 7% of the subjects reported symptoms consistent with potentially subclinical levels of PTSD, according to DSM-IV criteria.",0,0 +5958,A voice-based automated system for PTSD screening and monitoring.,"Comprehensive evaluation of PTSD includes diagnostic interviews, self-report testing, and physiological reactivity measures. It is often difficult and costly to diagnose PTSD due to patient access and the variability in symptoms presented. Additionally, potential patients are often reluctant to seek help due to the stigma associated with the disorder. A voice-based automated system that is able to remotely screen individuals at high risk for PTSD and monitor their symptoms during treatment has the potential to make great strides in alleviating the barriers to cost effective PTSD assessment and progress monitoring. In this paper we present a voice-based automated Tele-PTSD Monitor (TPM) system currently in development, designed to remotely screen, and provide assistance to clinicians in diagnosing PTSD. The TPM system can be accessed via a Public Switched Telephone Network (PSTN) or the Internet. The acquired voice data is then sent to a secure server to invoke the PTSD Scoring Engine (PTSD-SE) where a PTSD mental health score is computed. If the score exceeds a predefined threshold, the system will notify clinicians (via email or short message service) for confirmation and/or an appropriate follow-up assessment and intervention. The TPM system requires only voice input and performs computer-based automated PTSD scoring, resulting in low cost and easy field-deployment. The concept of the TPM system was supported using a limited dataset with an average detection accuracy of up to 95.88%.",0,0 +5959,Effect of DHA Supplementation During Pregnancy on Maternal Depression and Neurodevelopment of Young Children,"Uncertainty about the benefits of dietary docosahexaenoic acid (DHA) for pregnant women and their children exists, despite international recommendations that pregnant women increase their DHA intakes.To determine whether increasing DHA during the last half of pregnancy will result in fewer women with high levels of depressive symptoms and enhance the neurodevelopmental outcome of their children.A double-blind, multicenter, randomized controlled trial (DHA to Optimize Mother Infant Outcome [DOMInO] trial) in 5 Australian maternity hospitals of 2399 women who were less than 21 weeks' gestation with singleton pregnancies and who were recruited between October 31, 2005, and January 11, 2008. Follow-up of children (n = 726) was completed December 16, 2009.Docosahexaenoic acid-rich fish oil capsules (providing 800 mg/d of DHA) or matched vegetable oil capsules without DHA from study entry to birth.High levels of depressive symptoms in mothers as indicated by a score of more than 12 on the Edinburgh Postnatal Depression Scale at 6 weeks or 6 months postpartum. Cognitive and language development in children as assessed by the Bayley Scales of Infant and Toddler Development, Third Edition, at 18 months.Of 2399 women enrolled, 96.7% completed the trial. The percentage of women with high levels of depressive symptoms during the first 6 months postpartum did not differ between the DHA and control groups (9.67% vs 11.19%; adjusted relative risk, 0.85; 95% confidence interval [CI], 0.70-1.02; P = .09). Mean cognitive composite scores (adjusted mean difference, 0.01; 95% CI, -1.36 to 1.37; P = .99) and mean language composite scores (adjusted mean difference, -1.42; 95% CI, -3.07 to 0.22; P = .09) of children in the DHA group did not differ from children in the control group.The use of DHA-rich fish oil capsules compared with vegetable oil capsules during pregnancy did not result in lower levels of postpartum depression in mothers or improved cognitive and language development in their offspring during early childhood.anzctr.org.au Identifier: ACTRN12605000569606.",0,0 +5960,Posttraumatic Stress Disorder after Traumatic Brain Injury and Interpersonal Relationships: Contributions from Object-Relations Perspectives,"Posttraumatic stress disorder (PTSD) has been identified in survivors of traumatic brain injury (TBI), sustained from road traffic accidents, assaults, or industrial accidents. This article reviews the small literature on this population, which is predominantly characterized by integrations of cognitive neuropsychology and cognitive behavior therapy. While these perspectives have been applied to identify etiological processes and treatment options, one insufficiently specified domain in this literature is the role of interpersonal relationships. This includes interpersonal etiological mechanisms and social outcomes, but also therapeutic process for PTSD after TBI. In response, object-relations psychoanalytic concepts of symbolizing (Segal, 1957) and containing–contained (Bion, 1962) mechanisms are applied. These concepts are used to consider the aforementioned factors while permitting close conceptual links to neurological and cognitive vulnerabilities for this clinical group. This article finishes with a...",0,0 +5961,The Influences of Event Centrality in Memory Models of PTSD,"Summary The consequences of events for well-being are influenced by individual and situational factors that are often studied in isolation. In the research reported here, a large (N = 489) nonclinical sample of college students reported their most traumatic event, posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, personality traits, and characteristics of their event memory. This study achieved three major goals. First, we identified the highest types of stress event types in this population as disruptions of interpersonal relationships, homicides/assaults on others, and assaults/accidents involving themselves. Second, we established that the effects of memory characteristics such as vividness, belief, and impact on PTSD symptoms are mediated by the centrality of the event to identity. Third, we affirmed the hypothesis that a structural model of the influence of personality factors on PTSD symptoms has a higher level of concurrent validity if event centrality is included as a mediator of those influences. Copyright © 2015 John Wiley & Sons, Ltd.",0,0 +5962,THE ROLE OF SOCIAL SUPPORT ON MENTAL HEALTH AFTER MULTIPLE WILDFIRE DISASTERS,"Disasters can erode mental health (MH), even if it does not reach mental illness. This study explored the direct or moderating role of social support on MH after multiple wildfires, with attention to evacuation status and participant sex. Participants (N = 402) responded to a random digit dial telephone survey about their disaster exposure, current MH, MH at the time of the fire, social support, and life stressors since the disaster. For the evacuated, social support moderated the relation of fire stress to MH at the time of the fire, with those with high social support having better MH. For current MH, social support had a direct relation to MH, and moderated the influence of life stressors since the disaster for the evacuated and women. For those with a life stressor, current MH was better with high social support, but worse under average or low social support. Social support had a relation to current MH for women, but not men.",0,0 +5963,Traumatic stress in parents of children admitted to the pediatric intensive care unit,"To measure the prevalence of parental acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) and to examine the relationship between ASD symptoms and PTSD symptoms in parents of infants and children admitted to the pediatric intensive care unit (PICU). To examine the correlation between parental perceptions of illness severity and objective measures. To assess the association among demographic, situational, and illness factors and the severity of ASD and PTSD.Prospective cohort study.Thirty-eight bed PICU at an urban children's hospital.The parents of 272 children admitted to the PICU for >48 hrs.ASD symptoms were assessed using the Acute Stress Disorder Scale during the child's admission. PTSD symptoms were assessed using the PTSD Checklist at least 2 months after discharge. The severity of illness was measured using the Pediatric Risk of Mortality (PRISM III) score.Of the 272 parents completing the initial assessment, 87 (32%) met symptom criteria for ASD. Of the 161 parents completing follow-up, 33 (21%) met symptom criteria for PTSD. PTSD symptoms at follow-up were associated with ASD symptoms assessed in the PICU, unexpected admission, parent's degree of worry that the child might die, and the occurrence of another hospital admission or other traumatic event subsequent to the index admission. Neither ASD nor PTSD responses were associated with objective measures of a child's severity of illness (PRISM III score).Traumatic stress symptoms are common among parents in the PICU and may persist long after discharge. There is strong support from these data for continued attention to supporting parents both during and after a child's PICU admission.",0,0 +5964,"Prevalence and Determinants of Intimate Partner Violence Against Women in Kazeroon, Islamic Republic of Iran","The aim of this study was to screen for and estimate the prevalence of intimate partner violence (IPV) among women in Kazeroon, Iran. In November 2007, multistage cluster sampling was employed to recruit 702 women to participate in the study. A descriptive, cross-sectional design was employed. The prevalence of physical, psychological, and sexual abuse against women was 43.7%, 82.6%, and 30.9%, respectively, and there was a significant relationship between IPV and family income, education level, and level of religious commitment in both women and husbands. The study suggests that major strategies for prevention of IPV are empowering women and improving their status in the society by promoting of sexual equality in all rights, especially in employment and education.",0,0 +5965,Nefazodone in the treatment of patients with post-traumatic stress disorder,"Post-traumatic stress disorder occurs in patients who have undergone a traumatic experience and manifests itself through a cluster of symptoms, including re-experiencing, avoidance and hyperarousal. Post-traumatic stress disorder is commonly found among veterans of war and victims of sexual trauma, natural disasters and accidents. Nefazodone is a medication that has an FDA-approved indication for treating depression. Nefazodone has also been reported to be efficacious in treating post-traumatic stress disorder. Despite recent reports of hepatotoxicity, when used appropriately, nefazodone is generally as well-tolerated as the medications currently FDA-indicated for post-traumatic stress disorder, the selective serotonin reuptake inhibitors. Through its mechanism inhibiting neuronal uptake of serotonin and norepinephrine and as a potent postsynaptic serotonergic antagonist, nefazodone has proven to be effective in treating post-traumatic stress disorder in several open-label trials. The results of such trials warrant its study in larger, double-blind, placebo-controlled clinical trials.",0,0 +5966,"The Impact of Repression, Hostility, and Post-Traumatic Stress Disorder on All-Cause Mortality: A Prospective 16-Year Follow-up Study","A common assumption is that repression of traumatic memories is harmful to health. To assess this, we examined all-cause mortality among a national random sample of 4462 male US Army veterans evaluated in 1985 and followed up in 2000. Our hypothesis was that repression on the Welsh R scale would be associated with increased future mortality. We also expected to find a repression x post-traumatic stress disorder (PTSD) interaction effect. Multivariate Cox regression results for all veterans and for theater veterans (Vietnam service) and era veterans (no Vietnam service) separately, revealed that while PTSD was significant in all models, no main or interaction effect was found for repression. In addition, for era veterans, higher repression symptoms were protective for future mortality (HR = 0.95, p = 0.03). For hostility symptoms, although no interaction effect was found by PTSD, a positive main effect was detected for hostility, but only for theater veterans (HR = 1.04, p = 0.034). Disease-specific results were nonsignificant. Similar to a recent study, we also found that repression symptoms were negatively correlated with PTSD symptoms (r = -0.109, p < 0.001), suggesting repression might be protective. Our study found no evidence that repression had an adverse health impact on men exposed to psychological trauma. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +5967,Post-Traumatic Stress Symptoms in Long-Term Non-Hodgkin's Lymphoma Survivors: Does Time Heal?,"Little is known about the trajectory of post-traumatic stress disorder (PTSD) symptoms in cancer survivors, despite the fact that such knowledge can guide treatment. Therefore, this study examined changes in PTSD symptoms among long-term survivors of non-Hodgkin's lymphoma (NHL) and identified demographic, clinical, and psychosocial predictors and correlates of PTSD symptomatology.Surveys were mailed to 682 NHL survivors who participated in an earlier survey and now were at least 7 years postdiagnosis. Information was obtained regarding PTSD symptoms, positive and negative perceptions of the cancer experience (ie, impact of cancer), and other potential correlates of PTSD.A total of 566 individuals participated (83% response rate) with a median of 12.9 years since diagnosis; respondents were 52% female and 87% white. Although half (51%) of the respondents reported no PTSD symptoms and 12% reported a resolution of symptoms, more than one-third (37%) reported persistence or worsening of symptoms over 5 years. Survivors who reported a low income, stage ≥ 2 at diagnosis, aggressive lymphoma, having received chemotherapy, and greater impact of cancer (both positive and negative) at the initial survey had more PTSD symptoms at follow-up. In multivariable analysis, income and negative impacts of cancer were independent predictors of PTSD symptoms.More than one-third of long-term NHL survivors experience persisting or worsening PTSD symptoms. Providers should be aware of enduring risk; early identification of those at prolonged risk with standardized measures and treatments that target perceptions of the cancer experience might improve long-term outcomes.",0,0 +5968,Can Psychosocial Intervention Improve Peer and Sibling Relations Among War-affected Children? Impact and Mediating Analyses in a Randomized Controlled Trial,"Social resources are considered important protectors in traumatic conditions, but few studies have analyzed their role in psychosocial interventions among war-affected children. We examined (1) whether a psychosocial intervention (teaching recovery techniques, TRT) is effective in improving peer and sibling relations, and (2) whether these potentially improved relations mediate the intervention's impacts on children's mental health. Participants were 428 Palestinian children [10–13 (mean = 11.29, standard deviation SD = .68)-year-old girls (49.4 percent) and boys (50.6 percent)], who were cluster-randomized into the TRT and wait-list control groups. They reported the quality of peer (friendship and loneliness) and sibling (intimacy, warmth, conflict, and rivalry) relations, and posttraumatic stress, depressive and psychological distress symptoms, as well as psychosocial well-being at baseline (T1), postintervention (T2), and six month follow-up (T3). Results showed gender-specific TRT intervention effects: Loneliness in peer relations reduced among boys and sibling rivalry reduced among girls. The TRT prevented the increase in sibling conflict that happened in the control group. The mediating hypothesis was partially substantiated for improved peer relations, and beneficial changes in sibling relations were generally associated with improved mental health.",0,0 +5969,Changes in mental disorder prevalence among conflict-affected populations: a prospective study in Sri Lanka (COMRAID-R),"BackgroundLongitudinal data are lacking on mental health trajectories following conflict resolution and return migration. COMRAID-R is a follow-up study of Muslims displaced by conflict from Northern Sri Lanka 20 years ago who are now beginning to return.MethodsOf 450 participants in displacement interviewed in 2011, 338 (75.1%) were re-interviewed a year later, and a supplementary random sample (n = 228) was drawn from return migrants with a comparable displacement history. Common mental disorder (CMD; Patient Health Questionnaire) and post-traumatic stress disorder (CIDI-subscale) were measured.ResultsA CMD prevalence of 18.8% (95%CI 15.2–22.5) at baseline had reduced to 8.6% (5.6–11.7) at follow-up in those remaining in displacement, and was 10.3% (6.5–14.1) in return migrants. PTSD prevalences were 2.4%, 0.3% and 1.6% respectively.ConclusionsWe observed a substantial decrease in CMD prevalence in this population over a short period, which may reflect the prospect of return migration and associated optimism following conflict resolution.",0,0 +5970,Military trauma and its sequel in families of Bedouin servicemen,"Posttraumatic responses of veterans have an adverse impact on the family unit. These impacts include a variety of psychiatric, emotional, and behavioral problems in the veteran's partner and children. Despite the increased attention given today to the central role of the family in the aftermath of trauma, studies in families of non-Western minority servicemen almost do not exist. The current study examined the associations between veterans’ posttraumatic symptoms and familial distress in an ethnic minority sample of 112 families of Bedouin members of the Israeli Defense Forces. Specifically, we have studied the relationship between the men's posttraumatic symptoms, wife's psychological symptoms, and maternal reports about children's wellbeing. Results showed that while fathers’ posttraumatic symptoms were related to their wives’ psychological distress, they were not related to maternal reports about children's problems. However, mothers with higher levels of depression and anxiety tended to report more em...",0,0 +5971,"Efficacy and acceptability of atypical antipsychotics for the treatment of post-traumatic stress disorder: A meta-analysis of randomized, double-blind, placebo-controlled clinical trials","As some evidences demonstrated that atypical antipsychotics (AA) may be efficacious in treating post-traumatic stress disorder (PTSD), we preformed a meta-analysis of randomized, double-blind, placebo-controlled clinical trials (RCTs) of AAs for the treatment of PTSD. Two hundred and fifty one papers were searched and screened. Eight RCTs met the inclusion criteria. AAs may be superior to placebo in the treatment of PTSD, as indicated by the changes in Clinician Administered PTSD Scale (CAPS) total scores (weighted mean differences (WMD)=−5.89, 95% confidence interval (CI) [−9.21, −2.56], P =0.0005) and also in CAPS subscale intrusion (WMD=−2.58, 95% CI[−3.83, −1.33], P <0.0001 ) and subscale hyperarousal (WMD=−2.94, 95% CI[−5.45, −0.43], P =0.02). The acceptability measured by dropout rates between AAs and placebo showed no statistical difference (OR=1.24, 95%CI [0.78, 1.97], P =0.36). PTSD symptom cluster, especially in intrusion and hyperarousal. However, we should be careful to generalize the conclusion because of the small number of included trails. We expect more RCTs will be done in the future so as to clarify the specific value of AAs for PTSD.",0,0 +5972,Collective efficacy and the contingent consequences of exposure to life-threatening violence.,"Neighborhood research has increasingly emphasized the potential for contextual characteristics to moderate the effects of youths' experiences on their outcomes. Drawing on collective efficacy theory, we examine the variable consequences of youths' exposures to life-threatening violence across neighborhoods. We argue that strong community normative orientations supporting the control of violence diminish the negative effect of exposure to severe violence on subsequent mental health among urban youth. We also consider the extent to which the consequences of exposure to violence vary by gender. Employing data from the Project on Human Development in Chicago Neighborhoods, we estimate a series of multivariate, multilevel linear models of internalizing and externalizing symptoms. Results indicate that, for girls, exposure to life-threatening violence (witnessing someone being attacked with a weapon or shot) increases both internalizing and externalizing symptoms. However, this effect achieves statistical significance only for girls who reside in neighborhoods with lower collective efficacy. For boys, our analyses offered weaker evidence of violence exposure effects on mental health. Implications for research on the social context of mental health are discussed.",0,0 +5973,Post-traumatic stress disorders,"When … you Think of Things, you find sometimes that a Thing which seemed very Thingish inside you is quite different when it gets out into the open and has other people looking at it. ([Winnie the Pooh] Milne, 2004; p. 99) Introduction Adjusting to a significant life event can be difficult for children and adults alike. A sudden bereavement, or bearing witness to violence or a tragic accident are experiences likely to be accompanied by complex, even debilitating feelings of fear or sadness. For the young child, making sense of traumatic events is complicated by limited life experiences, naïve understandings of the world and reliance on those around them. Their interpretation of events may be hindered by child-like language and reasoning. This chapter seeks to describe the impact of such events on children and portray the application of a model that can be used both to understand such reactions and guide interventions intended to help children by enabling them to confront their experiences, formulate a narrative and develop a helpful meaning of the event. Diagnosis Traumatic events can lead to a variety of psychological problems such as anxiety, depression, behavioural problems, substance abuse, self-harm and post-traumatic stress disorder (PTSD) (Perrin et al., 2000). In clinical practice, children’s reactions to traumatic events may be complex; those with symptoms of PTSD, who fail to meet the strict criteria for a diagnosis according to the current Diagnostic and Statistical Manual of Mental Disorders (DSM–IV–TR; American Psychiatric Association, 2000), may still be suffering from substantial distress and impairment (Carrion et al., 2002), which may respond to intervention. At the time of writing, the fifth edition of the DSM is in preparation and new criteria are likely to be introduced. © Cambridge University Press 1998, 2005, 2013.",0,0 +5974,Posttraumatic stress symptoms in OIF/OEF service members with blast-related and non-blast-related mild TBI,"To examine the proportion and severity of stress-related symptoms in U.S. service members with mild traumatic brain injuries (mTBI) received during deployment to Operation Iraqi Freedom (OIF) or Operation Enduring Freedom (OEF). Stress-related symptoms reported by service members with mTBI from explosive munitions are compared to symptoms reported by those with mTBI received from other mechanisms (i.e. falls, motor vehicle accidents).Posttraumatic stress, as measured by scores on the Posttraumatic Stress Disorder Checklist (PCL-C), for a sample of 586 OIF/OEF service members with blast-related mTBI was compared to a sample of 138 OIF/OEF service members with non-blast mTBI selected from retrospective review of research records.Re-experiencing symptoms such as flashbacks and nightmares were higher for the blast mTBI group than for the non-blast mTBI group. Symptoms on other PTSD clusters and total score did not significantly differ between groups. Equivalent proportions of the blast and non-blast groups endorsed severe PTSD symptoms, with total PCL-C scores greater than or equal to 50.Consistent with prior reports, high levels of posttraumatic stress symptoms occur in a substantial proportion of service members who experienced deployment-related blast and non-blast mTBI. Results suggest that the psychological rehabilitation of OIF/OEF service members with mTBI from explosive blast should include particular attention to addressing re-experiencing symptoms.",0,0 +5975,Acute posttraumatic stress symptoms but not generalized anxiety symptoms are associated with severity of exposure to war trauma: A study of civilians under fire,"Posttraumatic stress (PTSS) and generalized anxiety symptoms (GAS) may ensue following trauma. While they are now thought to represent different psychopathological entities, it is not clear whether both GAS and PTSS show a dose-response to trauma exposure. The current study aimed to address this gap in knowledge and to investigate the moderating role of subjects' demographics in the exposure-outcome associations. The sample included 249 civilian adults, assessed during the 2014 Israel-Gaza military conflict. The survey probed demographic information, trauma exposure, and symptoms. PTSS but not GAS was associated with exposure severity. Women were at higher risk for both PTSS and GAS than men. In addition, several demographic variables were only associated with PTSS levels. PTSS dose-response effect was moderated by education. These findings are in line with emerging neurobiological and cognitive research, suggesting that although PTSS and GAS have shared risk factors they represent two different psychopathological entities. Clinical and theoretical implications are discussed.",0,0 +5976,An Animal Model for Studying Therapeutic Drugs against Post-Traumatic Stress Disorder,"An animal model for the evolvement of post-traumatic stress disorder (PTSD) was developed by simulating the hormonal consequences of prolonged stress via the continuous administration of corticosterone by subcutaneously implanted sustained-release pellets. Behavioral, morphological, and biochemical effects were recorded and analyzed. This model has shown cognitive deficits as well as hippocampal damage in the rat similar to those found in PTSD patients. The model was also used to test a therapeutic treatment against stress-induced brain damages. Concomitant treatment with the L-type calcium channel blocker, nimodipine, protected young rats from corticosterone-induced morphological brain changes but not cognitive impairments. The proposed animal model may be useful for testing the efficacy of various neuroprotective drugs. Development of an effective drug treatment for use after a traumatic event and through the trauma period might prevent permanent brain damage and the development of PTSD.",0,0 +5977,"The DSM-5 dissociative-PTSD subtype: Can levels of depression, anxiety, hostility, and sleeping difficulties differentiate between dissociative-PTSD and PTSD in rape and sexual assault victims?","The DSM-5 currently includes a dissociative-PTSD subtype within its nomenclature. Several studies have confirmed the dissociative-PTSD subtype in both American Veteran and American civilian samples. Studies have begun to assess specific factors which differentiate between dissociative vs. non-dissociative PTSD. The current study takes a novel approach to investigating the presence of a dissociative-PTSD subtype in its use of European victims of sexual assault and rape (N=351). Utilizing Latent Profile Analyses, we hypothesized that a discrete group of individuals would represent a dissociative-PTSD subtype. We additionally hypothesized that levels of depression, anger, hostility, and sleeping difficulties would differentiate dissociative-PTSD from a similarly severe form of PTSD in the absence of dissociation. Results concluded that there were four discrete groups termed baseline, moderate PTSD, high PTSD, and dissociative-PTSD. The dissociative-PTSD group encompassed 13.1% of the sample and evidenced significantly higher mean scores on measures of depression, anxiety, hostility, and sleeping difficulties. Implications are discussed in relation to both treatment planning and the newly published DSM-5.",0,0 +5978,"Coping Flexibility, Potentially Traumatic Life Events, and Resilience: A Prospective Study of College Student Adjustment","College has been shown to be a particularly stressful time both due to unique emergent stressors and because of increased vulnerability for exposure to potentially traumatic events (PTEs). Both of these conditions are associated with heightened risk for the development of stress-related pathology. However, while this period may be particularly challenging, previous work shows most students adapt in a number of heterogeneous ways that result in little or no stress-related symptomatology over the four years of college. There is indication from the coping literature that the ability to flexibly move between multiple coping behaviors may foster resilient outcomes. In this study, we examined trajectories of distress, using Latent Growth Mixture Modeling, and whether flexible coping aids in adaption. Results showed that trajectories were not influenced by exposure to a PTE and that the common outcome was little or no distress over the four years of college. Flexible coping was strongly associated with a resilie...",0,0 +5979,Factors influencing outcome following mild traumatic brain injury in adults,"This study aimed to investigate outcome in adults with mild traumatic brain injury (TBI) at 1 week and 3 months postinjury and to identify factors associated with persisting problems. A total of 84 adults with mild TBI were compared with 53 adults with other minor injuries as controls in terms of postconcussional symptomatology, behavior, and cognitive performance at 1 week and 3 months postinjury. At 1 week postinjury, adults with mild TBI were reporting symptoms, particularly headaches, dizziness, fatigue, visual disturbance, and memory difficulties. They exhibited slowing of information processing on neuropsychological measures, namely the WAIS-R Digit Symbol subtest and the Speed of Comprehension Test. By 3 months postinjury, the symptoms reported at 1 week had largely resolved, and no impairments were evident on neuropsychological measures. However, there was a subgroup of 24% of participants who were still suffering many symptoms, who were highly distressed, and whose lives were still significantly disrupted. These individuals did not have longer posttraumatic amnesia (PTA) duration. They were more likely to have a history of previous head injury, neurological or psychiatric problems, to be students, females, and to have been injured in a motor vehicle accident. The majority were showing significant levels of psychopathology. A range of factors, other than those directly reflecting the severity of injury, appear to be associated with outcome following mild TBI.",0,0 +5980,Distributional Assumptions of Growth Mixture Models: Implications for Overextraction of Latent Trajectory Classes.,"Growth mixture models are often used to determine if subgroups exist within the population that follow qualitatively distinct developmental trajectories. However, statistical theory developed for finite normal mixture models suggests that latent trajectory classes can be estimated even in the absence of population heterogeneity if the distribution of the repeated measures is nonnormal. By drawing on this theory, this article demonstrates that multiple trajectory classes can be estimated and appear optimal for nonnormal data even when only 1 group exists in the population. Further, the within-class parameter estimates obtained from these models are largely uninterpretable. Significant predictive relationships may be obscured or spurious relationships identified. The implications of these results for applied research are highlighted, and future directions for quantitative developments are suggested.",0,0 +5981,The Historic Origins of Military and Veteran Mental Health Stigma and the Stress Injury Model as a Means to Reduce It,,0,0 +5982,Cognitive impairment and functioning in PTSD related to intimate partner violence,"Abstract Posttraumatic stress disorder (PTSD) has been associated with neuropsychological impairments across multiple domains, but consensus regarding the cognitive profile of PTSD has not been reached. In this study of women with PTSD related to intimate partner violence ( n = 55) and healthy, demographically similar comparison participants (NCs; n = 20), we attempted to control for many potential confounds in PTSD samples. All participants were assessed with a comprehensive neuropsychological battery emphasizing executive functioning, including inhibition, switching, and abstraction. NCs outperformed PTSD participants on most neuropsychological measures, but the differences were significant only on speeded tasks (with and without executive functioning components). The PTSD group’s mean performance was within the average range on all neuropsychological tests. Within the PTSD group, more severe PTSD symptoms were associated with slower processing speed, and more severe dissociative symptoms were associated with poorer reasoning performance. These results suggest that women with PTSD related to intimate partner violence demonstrate slower than normal processing speed, which is associated with the severity of psychiatric symptoms. We speculate that the cognitive slowing seen in PTSD may be attributable to reduced attention due to a need to allocate resources to cope with psychological distress or unpleasant internal experiences. ( JINS , 2009, 15 , 879–887.)",0,0 +5983,Germ Cell Origins of Posttraumatic Stress Disorder Risk: The Transgenerational Impact of Parental Stress Experience,"Altered stress reactivity is a predominant feature of posttraumatic stress disorder (PTSD) and may reflect disease vulnerability, increasing the probability that an individual will develop PTSD following trauma exposure. Environmental factors, particularly prior stress history, contribute to the developmental programming of the hypothalamic-pituitary-adrenal stress axis. Critically, the consequences of stress experiences are transgenerational, with parental stress exposure impacting stress reactivity and PTSD risk in subsequent generations. Potential molecular mechanisms underlying this transmission have been explored in rodent models that specifically examine the paternal lineage, identifying epigenetic signatures in male germ cells as possible substrates of transgenerational programming. Here, we review the role of these germ cell epigenetic marks, including posttranslational histone modifications, DNA methylation, and populations of small noncoding RNAs, in the development of offspring stress axis sensitivity and disease risk.",0,0 +5984,Emotional ambivalence and post-traumatic stress disorder (PTSD) in soldiers during military operations.,"This pilot study examined the extent to which a specific mechanism of emotion regulation - namely, ambivalence concerning the expressiveness of German soldiers' emotions - affects the severity of PTSD symptoms after a military operation.A survey was conducted at three points in time among 66 soldiers deployed on military crisis operations. The Harvard Trauma Questionaire (HTQ), the Ambivalence over Emotional Expressiveness Questionnaire (AEQ-G18), and a questionnaire on the particular stress of German soldiers during military operations were used.The study showed a significant correlation between emotional ambivalence and traumatization. Furthermore, it was shown that the subjective stress of soldiers leading up to deployment is more pronounced when emotional ambivalence is stronger in the context of military operations. This particular stress is greater before and during the military operation than after. Compared to a male control sample, the average AEQ-G18 scores of the soldier sample examined here are considerably lower.This pilot study clearly indicates that the AEQ-G18 could be a suitable predictor of the psychological burden on soldiers. The correlations between emotional ambivalence on the one hand and the particular and post-traumatic stressors on the other hand are not only statistically significant in the present pilot study, but may also be relevant as risk factors. It is, therefore, necessary to conduct more extensive studies on soldiers participating in military operations to verify the results of this pilot study.Zielsetzung: In dieser Pilotstudie wurde untersucht, inwiefern sich ein spezifischer Mechanismus der Emotionsregulation, nämlich die Ambivalenz gegenüber der Expressivität eigener Emotionen bei deutschen Soldaten auf die Ausprägung der Symptome einer PTBS nach dem Einsatz auswirkt.Methodik: Es wurde eine Befragung mit 66 Soldaten im Kriseneinsatz an drei Zeitpunkten durchgeführt. Dabei kamen neben dem Harvard Trauma Questionaire (HTQ), der Ambivalence over Emotional Expressiveness Questionnaire (AEQ-G18) sowie ein Fragebogen zur speziellen Belastung von Bundeswehrangehörigen in Kriseneinsätzen zum Einsatz.Ergebnisse: In der Studie zeigte sich ein signifikanter Zusammenhang zwischen emotionaler Ambivalenz und Traumatisierung. Des Weiteren konnte gezeigt werden, dass bei stärkerem Auftreten emotionaler Ambivalenz im Kontext von militärischen Einsätzen die subjektiven Belastungen von Soldaten zum militärischen Einsatz hin ausgeprägter sind. Diese speziellen Belastungen sind vor und während des Kriseneinsatzes höher als nach dem Kriseneinsatz, Im Vergleich zu einer männlichen Vergleichsstichprobe liegen die Mittelwerte bei dem AEQ-G18 der vorliegenden Soldatenstichprobe erheblich niedriger.Fazit: Die Pilotstudie weist deutlich darauf hin, dass die Diagnostik mit dem AEQ-G18 geeignet sein könnte, die psychischen Belastungen bei Soldaten vorherzusagen. Die Zusammenhänge zwischen emotionaler Ambivalenz einerseits und den speziellen sowie posttraumatischen Belastungen andererseits sind in der vorgelegten Pilotstudie nicht nur statistisch signifikant, sondern können als Risikofaktoren relevant sein. Daher ist es erforderlich weitere umfangreiche Studien bei Soldaten in Kriseneinsätzen durchzuführen, um die Ergebnisse der Pilotstudie zu überprüfen.",0,0 +5985,The contribution of childhood emotional abuse to teen dating violence among child protective services-involved youth,"For child protective services (CPS) youth who may have experienced more than one form of maltreatment, the unique contribution of emotional abuse may be over-looked when other forms are more salient and more clearly outside of accepted social norms for parenting. This study considers the unique predictive value of childhood emotional abuse for understanding adolescent post-traumatic stress disorder (PTSD) symptomatology and dating violence. Further, PTSD symptomatology is assessed as an explanatory bridge in the emotional abuse-teen dating violence link.A random sample of 402 youth from the active caseload of a large urban CPS catchment area participated as part of a larger longitudinal study on adolescent health behaviors. Mid-adolescent youth across types of CPS status were targeted. CPS youth reported on lifetime maltreatment experiences, PTSD symptomatology, and past year dating experiences, using published scales.Over 85% of CPS youth had begun dating. For dating youth, some level of dating violence was common: over half of females (63-67%) and nearly half of males (44-49%). Taking into account other forms of maltreatment, emotional abuse emerged as a significant predictor of both PTSD symptomatology and dating violence among males and females. PTSD symptomatology was a significant mediator of the male emotional abuse-perpetration and the female emotional/physical abuse-victimization links, indicating a gendered patterning to findings.These results indicate that: (1) CPS youth are a high priority group for dating violence and PTSD-linked intervention; and (2) CPS youth continue to experience the unique negative impact of childhood emotional abuse in their adolescent adjustment. All CPS children should be evaluated for emotional abuse incurred, and appropriate intervention attention be given as to how it specifically impacts on the child's approach to relating to themselves and to others.The present study directs practice implications in regards to: (1) the problem of teen dating violence, (2) the salience of childhood emotional abuse; and (3) the importance of targeting PTSD symptomatolgy among CPS youth. A substantial number of CPS youth report early engagement in violent romantic relationships and require support towards attaining the non-coercive relationship experiences of their non-CPS-involved age mates. The topic of dating, healthy dating relationships, and dating violence may need to be part of the regular casework, with a view towards supporting youths' conceptualization of and skill set for healthy, close relationships. Further, this knowledge needs to be translated to foster parents and group home staff. With regard to the impact of childhood emotional abuse, CPS workers need to be sensitive to its potential for long-term, unique impact impairing relationship development. Emotional abuse is (a) unique among genders (i.e., for females, it clusters with physical abuse) and (b) uniquely predictive of PTSD symptoms and dating violence. Finally, as is consistent with theory and biopsychosocial evidence, PTSD symptomatology is a key causal candidate for understanding maltreatment-related impairment. Attention to targeting PTSD symptoms may be preventative for dating violence; attention to targeting emotional abuse experiences may be preventative for PTSD symptoms. CPS youth are an important population to involve in research, as their inclusion adds to the evidence-base to achieve evidence-informed practice and policy within child welfare.",0,0 +5986,Reactive Aggression and Posttraumatic Stress in Adolescents Affected by Hurricane Katrina,"The current study tests a theoretical model illustrating a potential pathway to reactive aggression through exposure to a traumatic event (Hurricane Katrina) in 166 adolescents (61% female, 63% Caucasian) recruited from high schools on the Gulf Coast of Mississippi. Results support an association between exposure to Hurricane Katrina and reactive aggression via posttraumatic stress disorder (PTSD) symptoms and poorly regulated emotion. The proposed model fits well for both boys and girls; however, results suggest that minority youth in this sample were more likely to experience emotional dysregulation in relation to posttraumatic stress than Caucasian youth. Further, results indicate that hurricane exposure, PTSD symptoms, and poorly regulated emotion are associated with reactive aggression even after controlling for proactive aggression. These findings have implications for postdisaster mental health services. Researchers examining mental health problems in youth after a significant disaster have traditionally focused on the presence of internalizing problems such as anxiety, depression, and posttraumatic stress disorder (PTSD) symptoms, with very little empirical attention paid to the incidence of post-disaster externalizing problems such as aggression. Specific types of aggressive responses, particularly those that involve poorly regulated emotion (i.e., reactive aggression), have been shown to be associated with a history of trauma and thus may be especially common following a traumatic event such as a hurricane.",0,0 +5987,Urinary Catecholamine Excretion in Sexually Abused Girls,"The objective of this study was to examine urinary catecholamine excretion in a self-selected sample of sexually abused and demographically matched control girls recruited from a prospective, longitudinal study.Twenty-four--hour urinary catecholamine and metabolite concentrations of epinephrine, norepinephrine, dopamine, 3-methoxy-4-hydroxyphenylglycol, metanephrine, normetanephrine, vanillylmandelic acid, 3,4-dihydroxyphenylacetic acid, and homovanillic acid were measured in 12 sexually abused and 9 control girls, aged 8 to 15 years. Psychiatric profiles also were obtained.The abused subjects excreted significantly greater amounts of metanephrine, vanillylmandelic acid, homovanillic acid, and total catecholamine synthesis as measured by the sum of epinephrine, norepinephrine, dopamine, and their metabolites compared to values from control subjects. When the means of all significant biochemical measures were adjusted by the covariate effect of height, only homovanillic acid and group interaction remained significant. There were positive trends toward significantly higher urinary excretion of metanephrine, vanillylmandelic acid, and total catecholamine synthesis. Sexually abused girls also had a greater incidence of suicidal ideation, suicide attempts, and dysthymia than control girls.These findings support the idea that sexually abused girls show evidence of higher catecholamine functional activity compared with controls. The clinical significance of these findings in their similarity to the psychobiology of both post-traumatic stress disorder and major depressive disorder. Results from this pilot study may be of value in understanding the mechanisms of depressive and anxiety disorders and in the clinical treatment of maltreated children.",0,0 +5988,Safety of a New Oral Contraceptive Containing Drospirenone,"New chemical entities must undergo rigorous, and preferably independent, safety and efficacy assessments before entry into the market. This is also true for oral contraceptives (OCs) given their extensive usage by healthy women and the safety concerns highlighted by the so-called 'third generation pill scare' in Europe a decade ago. This scare heightened patient and physician awareness of the increased risk of thromboembolic complications (mainly venous thromboembolism [VTE]) associated with OC use. Yasmin(registered trademark) (ethinylestradiol 30(mu)g/drospirenone 3mg [EE/DRSP]) is a novel OC that was demonstrated in clinical phase I-III studies to be highly effective in preventing pregnancy and to have a good safety profile. Nonetheless, clinical trials are not usually sufficiently powered to detect rare adverse events such as VTE to enable comparison with other OCs, which could allay fears and concerns about their inherent risks. Therefore, an extensive assessment of the VTE risk associated with EE/DRSP has been undertaken by reviewing data from the clinical development programme, postmarketing surveillance and spontaneous worldwide reporting, as well as information from other sources. Spontaneous worldwide reporting has revealed a VTE reporting rate of 5.1/100 000 women-years with EE/DRSP use. In contrast, 3-year interim results from a large, controlled, prospective postmarketing surveillance study suggest a VTE rate of 61/100 000 women-years for EE/DRSP, which is similar to the rates of 60/100 000 and 73/100 000 women-years for levonorgestrel-containing OCs and other OCs, respectively. When placed in context with potential biases and confounding factors that would inflate the perceived risk of VTEs with a novel OC, the VTE rate with EE/DRSP does not highlight any safety concerns. Furthermore, the risk of VTE with EE/DRSP or other OCs is far less than that associated with pregnancy and delivery (up to 800/100 000 women-years) or than other risks of daily living. Available data indicate that EE/DRSP is not associated with any increased risk of other serious adverse events such as hyperkalaemia, cardiac arrhythmia or birth defects. Nonetheless, caution should be exerted in prescribing EE/DRSP to women with conditions that predispose to hyperkalaemia. Overall, the safety data with EE/DRSP and other OCs indicate that these products have no negative impact on the risk of VTE (and other adverse events) in women who receive OCs for contraception.",0,0 +5989,Profile Analyses of the Personality Assessment Inventory Following Military-Related Traumatic Brain Injury,"Personality Assessment Inventory (PAI) profiles were examined in 160 U.S. service members (SMs) following mild-severe traumatic brain injury (TBI). Participants who sustained a mild TBI had significantly higher PAI scores than those with moderate-severe TBI on eight of the nine clinical scales examined. A two-step cluster analysis identified four PAI profiles, heuristically labeled ""High Distress"", ""Moderate Distress"", ""Somatic Distress,"" and ""No Distress"". Postconcussive and posttraumatic stress symptom severity was highest for the High Distress group, followed by the Somatic and Moderate Distress groups, and the No Distress group. Profile groups differed in age, ethnicity, rank, and TBI severity. Findings indicate that meaningful patterns of behavioral and personality characteristics can be detected in active duty military SMs following TBI, which may prove useful in selecting the most efficacious rehabilitation strategies.",0,0 +5990,Post-traumatic growth as outcome of a cognitive-behavioural therapy trial for motor vehicle accident survivors with PTSD,"Treatment effects on post-traumatic growth (PTG) and its subdomains were investigated together with predictors of the Janus-face model of PTG.Effects were investigated within a randomized controlled trial of cognitive-behavioural therapy (CBT) for post-traumatic stress disorder (PTSD).Forty motor vehicle accident survivors were randomly assigned to a treatment or waiting condition. PTG was measured by the Post-traumatic Growth Inventory and complemented by its possible predictors (optimism, openness).The CBT treatment proved to be highly effective in terms of PTSD symptom reduction. In contrast to previous findings, however, there was no treatment effect on PTG in general. The CBT group showed, however, increases in PTG subdomains 'new possibilities' and 'personal strength'.The results of this study caution researchers to naively expect PTG as a uniformly positive outcome to evaluate treatment effectiveness.",0,0 +5991,A national population-based assessment of 2007–2008 election-related violence in Kenya,"Abstract Background Following the contested national elections in 2007, violence occurred throughout Kenya. The objective of this study was to assess the prevalence, characteristics, and health consequences of the 2007–2008 election-related violence. Methods A cross-sectional, national, population-based cluster survey of 956 Kenyan adults aged ≥ 18 years was conducted in Kenya in September 2011 utilizing a two-stage 90 x 10 cluster sample design and structured interviews and questionnaires. Prevalence of all forms of violence surrounding the 2007 election period, symptoms of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), and morbidity related to sexual and physical violence were assessed. Results Of 956 households surveyed, 916 households participated (response rate 95.8%). Compared to pre-election, election-related sexual violence incidents/1000 persons/year increased over 60-fold (39.1-2370.1; p < .001) with a concurrent 37-fold increase in opportunistic sexual violence (5.2-183.1; p < .001). Physical and other human rights violations increased 80-fold (25.0-1987.1; p < .001) compared to pre-election. Overall, 50% of households reported at least one physical or sexual violation. Households reporting violence were more likely to report violence among female household members (66.6% vs. 58.1%; p = .04) or among the Luhya ethnic group (17.0% vs. 13.8%; p = 0.03). The most common perpetrators of election-related sexual violence were reported to be affiliated with government or political groups (1670.5 incidents/1000 persons per year); the Kalenjin ethnic group for physical violations (54.6%). Over thirty percent of respondents met MDD and PTSD symptom criteria; however, symptoms of MDD (females, 63.3%; males, 36.7%; p = .01) and suicidal ideation (females, 68.5%; males, 31.5%; p = .04) were more common among females. Substance abuse was more common among males (males, 71.2%; females, 28.8%; p < .001). Conclusion On a national level in Kenya, politically-motivated and opportunistic sexual and physical violations were commonly reported among sampled adults with associated health and mental health outcomes.",0,0 +5992,An evidence-based approach to evaluating and managing suicidal emergencies,"This article presents a framework for making suicide risk estimations, as well as recommendations for the management of suicidal emergencies, that are useful to the practitioner. It provides a review of existing empirical data concerning factors significantly related to acute suicidal behaviors within high-risk diagnoses. Findings across studies are categorized into risk profiles (as proposed by Clark & Fawcett, 1992) that are meant to aid the clinician in the application of recent research. The profiles are intended as templates in development and clearly require continual updating and clarification as new studies are completed. The article then addresses related management issues such as the importance of viewing risk factors within a comprehensive suicide assessment and the impact of possible negative therapist reactions when working with high-risk patients.",0,0 +5993,"Suicidality, aggression, and other treatment considerations among pregnant, substance-dependent women with posttraumatic stress disorder","Posttraumatic stress disorder (PTSD) and other Axis I comorbidity among women with substance use disorders (SUDs) appear similarly prevalent and are associated with comparable negative clinical profiles and treatment outcomes. The relative contribution of comorbid PTSD vs other Axis I psychiatric disorders to clinical characteristics is largely unexamined, however, despite theory and empirical data indicating that PTSD and SUDs may have a unique relationship that confers specific risk for clinical severity and poor treatment outcome. In a sample of pregnant, opioid- and/or cocaine-dependent women entering substance abuse treatment, women with PTSD (SUD-PTSD; n = 23) were compared to those with other Axis I comorbidity (SUD-PSY; n = 45) and those without Axis I comorbidity (SUD-only; n = 37). Data were collected via face-to-face interviews and urinalysis drug assays. Although the study groups had similar substance use severity, the SUD-PTSD group was more likely to report suicidality, aggression, and psychosocial impairment than both the SUD-PSY and SUD-only groups. Findings indicate treatment considerations for substance-dependent women with PTSD are broader and more severe than those with other Axis I conditions or substance dependence alone.",0,0 +5994,Does “subthreshold” posttraumatic stress disorder have any clinical relevance?,"The present report examined the extent to which subthreshold posttraumatic stress disorder (PTSD) (without lifetime PTSD) and full PTSD are associated with impairment or distress, controlling for comorbidity (i.e., major depression and panic disorder) in a sample of treatment-seeking psychiatric patients. Patients were administered diagnostic interviews and assessed for psychosocial impairment and whether or not they desired treatment for their PTSD symptoms. No significant differences were found between patients with full PTSD (N = 156) and those with subthreshold PTSD (N = 56) in degree of impairment (i.e., social and work functioning, as well as number of suicide attempts). In contrast, those with full PTSD had significantly more psychiatric hospitalizations and worse global functioning and were more likely to want treatment for their PTSD symptoms compared to those with subthreshold PTSD, albeit the majority of patients with subthreshold PTSD wanted treatment for their PTSD symptoms. These findings, like past research, suggest that subthreshold PTSD is associated with levels of social and work morbidity comparable to full PTSD. However, the report also underscores the difficulties in identifying a set of clinical criteria that clearly delineates between full PTSD and subthreshold PTSD.",0,0 +5995,Comparison of Outcome between Homogeneous and Heterogeneous Treatment Environments in Combat-Related Posttraumatic Stress Disorder,"This study compared treatment outcome at discharge, and 4, 8, and 12 month follow-up between an inpatient program consisting of a mixture of Vietnam combat veterans with posttraumatic stress disorder (PTSD) and general psychiatric patients (N = 42), and the same program at a later period, consisting of only Vietnam combat veterans with PTSD (N = 33). Veterans rated the homogeneous environment higher in satisfaction, support, order, clarity, and amount of discussion of combat, and lower in hostility, than the heterogeneous condition. However, veterans showed no improvement in condition at 12 month follow-up, with the exception of decreased violence, replicating earlier studies. No differences in outcome were found between homogeneous or heterogeneous treatment environments. This study underscores the enduring nature of chronic posttraumatic stress disorder in the veteran population.",0,0 +5996,Associations between lifetime PTSD symptoms and current substance use disorders using a five-factor model of PTSD,"This paper aimed to extend the existing knowledge on the association between PTSD symptoms, alcohol use disorders (AUD) and nicotine dependence (ND) by distinguishing between anxious and dysphoric arousal PTSD symptoms and by considering the putative contribution of additional comorbidity. Data stem from a cross-sectional study in a stratified, representative sample of 1483 recently deployed soldiers using standardized diagnostic interviews. All lifetime PTSD symptom clusters (occurrence of any symptom and number of symptoms) were associated with current AUD and ND in crude models except that anxious arousal was not related to AUD. Associations were reduced in magnitude when controlling for comorbidity. Current ND was related to the occurrence of any emotional numbing and to the number of re-experiencing symptoms above the contribution of other symptom clusters and comorbidity. In conclusion, associations between PTSD symptoms, AUD and ND may be partially attributable to additional comorbidity. Findings also yield further evidence for a role of emotional numbing and re-experiencing symptoms in the comorbidity between PTSD and ND and for a distinction between dysphoric and anxious arousal PTSD symptoms.",0,0 +5997,"Cognitive Function, Mental Health, and Health-related Quality of Life after Lung Transplantation","Cognitive and psychiatric impairments are threats to functional independence, general health, and quality of life. Evidence regarding these outcomes after lung transplantation is limited.Determine the frequency of cognitive and psychiatric impairment after lung transplantation and identify potential factors associated with cognitive impairment after lung transplantation.In a retrospective cohort study, we assessed cognitive function, mental health, and health-related quality of life using a validated battery of standardized tests in 42 subjects post-transplantation. The battery assessed cognition, depression, anxiety, resilience, and post-traumatic stress disorder (PTSD). Cognitive function was assessed using the Montreal Cognitive Assessment, a validated screening test with a range of 0 to 30. We hypothesized that cognitive function post-transplantation would be associated with type of transplant, cardiopulmonary bypass, primary graft dysfunction, allograft ischemic time, and physical therapy post-transplantation. We used multivariable linear regression to examine the relationship between candidate risk factors and cognitive function post-transplantation.Mild cognitive impairment (score, 18-25) was observed in 67% of post-transplant subjects (95% confidence interval [CI]: 50-80%) and moderate cognitive impairment (score, 10-17) was observed in 5% (95% CI, 1-16%) of post-transplant subjects. Symptoms of moderate to severe anxiety and depression were observed in 21 and 3% of post-transplant subjects, respectively. No transplant recipients reported symptoms of PTSD. Higher resilience correlated with less psychological distress in the domains of depression (P < 0.001) and PTSD (P = 0.02). Prolonged graft ischemic time was independently associated with worse cognitive performance after lung transplantation (P = 0.001). The functional gain in 6-minute-walk distance achieved at the end of post-transplant physical rehabilitation (P = 0.04) was independently associated with improved cognitive performance post-transplantation.Mild cognitive impairment was present in the majority of patients after lung transplantation. Prolonged allograft ischemic time may be associated with cognitive impairment. Poor physical performance and cognitive impairment are linked, and physical rehabilitation post-transplant and psychological resilience may be protective against the development of long-term impairment. Further study is warranted to confirm these potential associations and to examine the trajectory of cognitive function after lung transplantation.",0,0 +5998,Relationship between emotional experience and resilience: An fMRI study in fire-fighters,"Resilience refers to the capacity to cope effectively in stressful situations or adversity. It may involve the ability to experience emotions matching the demands of environmental circumstances. The brain mechanisms underlying resilience remain unclear. In this study, we aim to investigate the relationship between the neural basis of emotional experience and resilience. Thirty-six fire-fighters were included. They performed an fMRI script-driven paradigm comprising relaxing and trauma-related scripts to evaluate the cerebral substrate of emotional experience (p<0.05, FDR-corrected). Correlations were examined between fMRI activations and the resilience DRS15 scale (p<0.05). Resilience was positively correlated with the right amygdala and left orbitofrontal activations when performing the contrast of trauma vs. relaxing script. The present study provides neural data on the mechanisms underlying resilience and their relationship with emotional reactivity, suggesting that appropriate emotional response in stressful situations is essential for coping with aversive events in daily life.",0,0 +5999,The combined effect of gender and age on post traumatic stress disorder: do men and women show differences in the lifespan distribution of the disorder?,"The aim of the study was to examine the combined effect of gender and age on post traumatic stress disorder (PTSD) in order to describe a possible gender difference in the lifespan distribution of PTSD.Data were collected from previous Danish and Nordic studies of PTSD or trauma. The final sample was composed of 6,548 participants, 2,768 (42.3%) men and 3,780 (57.7%) women. PTSD was measured based on the Harvard Trauma Questionnaire, part IV (HTQ-IV).Men and women differed in lifespan distribution of PTSD. The highest prevalence of PTSD was seen in the early 40s for men and in the early 50s for women, while the lowest prevalence for both genders was in the early 70s. Women had an overall twofold higher PTSD prevalence than men. However, at some ages the female to male ratio was nearly 3:1. The highest female to male ratio was found for the 21 to 25 year-olds.The lifespan gender differences indicate the importance of including reproductive factors and social responsibilities in the understanding of the development of PTSD.",0,0 +6000,Review of A clinical handbook/practical therapist manual for assessing and treating adults with post-traumatic stress disorder (PTSD).,"Reviews the book, A clinical handbook/practical therapist manual for assessing and treating adults with post-traumatic stress disorder (PTSD) by Donald Meichenbaum (see record 1995-97286-000). This text is a much needed addition in the burgeoning field that is coming to be called ""psychotraumatology,"" including critical incident debriefing and related phenomena. Few fields of psychopathology have been fortunate enough to attract the attention of practitioners with the level of skill that Don Meichenbaum shows in this Manual, and his sobering, careful analysis of the traumatology literature in several very controversial areas deserves kudos. The reality is that this Handbook/Manual is in fact both a relatively comprehensive overview of the Post-Traumatic Stress Disorder literature, as well as a guidebook for treatment intervention strategies. Moreover, it is replete with appropriate cautions about variables that can interfere with treatment progress, together with strategic suggestions for overcoming that interference. The Manual is not only tremendously diverse, but is exceptional in its standards of scholarship and its careful application of those scholarly standards even to the most controversial topics. The author is also extremely credible in his treatment of potential harm from clinical techniques, and the Manual is replete with several examples of documented pitfalls, whether from comorbidity, relapse with substance-abusing populations, or the potential for harm to some individuals from simple repetitions of traumatic experiences. All in all, the reviewer strongly encourages Psychotherapy readers to avail themselves of this extremely well-written and thoughtful text. Both the book itself and the topic of PTSD deserve the excellent coverage devoted to them by this outstanding psychotherapy clinician and researcher. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6001,Correlates of comorbid anxiety and externalizing disorders in childhood obsessive compulsive disorder,"The present study examines the influence of diagnostic comorbidity on the demographic, psychiatric, and functional status of youth with a primary diagnosis of obsessive compulsive disorder (OCD). Two hundred and fifteen children (ages 5-17) referred to a university-based OCD specialty clinic were compared based on DSM-IV diagnostic profile: OCD without comorbid anxiety or externalizing disorder, OCD plus anxiety disorder, and OCD plus externalizing disorder. No age or gender differences were found across groups. Higher OCD severity was found for the OCD + ANX group, while the OCD + EXT group reported greater functional impairment than the other two groups. Lower family cohesion was reported by the OCD + EXT group compared to the OCD group and the OCD + ANX group reported higher family conflict compared to the OCD + EXT group. The OCD + ANX group had significantly lower rates of tic disorders while rates of depressive disorders did not differ among the three groups. The presence of comorbid anxiety and externalizing psychopathology are associated with greater symptom severity and functional and family impairment and underscores the importance of a better understanding of the relationship of OCD characteristics and associated disorders. Results and clinical implications are further discussed.",0,0 +6002,Working with Dreams in a Clinical Setting,"A disturbed sleep pattern, nightmares, and anxiety-filled dreams form a cluster of symptoms belonging to the DSM- IV diagnosis of Post-traumatic Stress Disorder. A psychotherapeutic group approach aimed at reducing these symptoms was undertaken in the form of a workshop. The workshop was not a regular part of the treatment program, but an experimental endeavor, offered to the patients during special occasions in the year (around holidays). The therapist was primarily interested in investigating possibilities for improving the quality of sleep and influencing the patterns of recurring anxiety-filled dreams and nightmares. The method has both structured and psychodynamic elements. The work carried out during the dream group was embedded in the total treatment program. This was crucial to allow personal themes to be continued in the regular treatment program.",0,0 +6003,"Predictors of coping efficacy, negative moods and post-traumatic stress syndrome following major trauma","The purpose of the study was to test relationships among injury appraisals, coping, social support and outcomes of coping efficacy, mood states and post-traumatic stress syndrome. A purposive sample of 152 hospitalized patients a week following major trauma was recruited from two trauma centres. The measures included the modified Ways of Coping Scale; the brief Social Support Questionnaire; the brief Profile of Mood State; the Impact of Event Scale; and selected demographic and injury related variables. Data were analyzed by multivariate statistics. The results indicated that perceived controllability, satisfaction with social support, wishful-thinking coping and problem-focused coping were the significant predictors for coping efficacy; perceived stressfulness, problem-focused coping and wishful thinking explained a significant amount of variance in mood states; avoidance coping and wishful-thinking coping were predictors for post-traumatic stress syndrome. The moderating effects of emotion-focused coping at high and medium levels were identified.",0,0 +6004,"PTSD after deployment to Iraq: conflicting rates, conflicting claims.","Post-traumatic stress disorder (PTSD) has been called one of the signature injuries of the Iraq War. In this review prevalence estimates of PTSD are summarized and discrepancies are discussed in relation to methodological differences between studies.We searched for population-based studies with a minimum sample size of 300. Studies based on help-seeking samples were excluded. We identified 60 possible papers, of which 19 fulfilled the inclusion criteria. Prevalence estimates and study characteristics were examined graphically with forest plots, but because of high levels of heterogeneity between studies, overall estimates of PTSD prevalence were not discussed.The prevalence of PTSD in personnel deployed to Iraq varied between 1.4% and 31%. Stratifying studies by PTSD measure only slightly reduced the variability in prevalence. Anonymous surveys of line infantry units reported higher levels of PTSD compared to studies that are representative of the entire deployed population. UK studies tend to report lower prevalence of PTSD compared with many US studies; however, when comparisons are restricted to studies with random samples, prevalences are similar. US studies that have assessed personnel more than once since return from deployment have shown that PTSD prevalence increases over the 12 months following deployment.Differences in methodologies and samples used should be considered when making comparisons of PTSD prevalence between studies. Further studies based on longitudinal samples are needed to understand how the prevalence of PTSD changes over time.",0,0 +6005,The Effects of Stress Coping Strategies in Post-Traumatic Stress Symptoms Among Earthquake Survivors: An Explanatory Model of Post-Traumatic Stress,"event common to a sample of 304 people (Chile, earthquake February, 27 2010) was determined through the application of the Ways of Coping Questionnaire and the Davidson Scale of Trauma. The results show 4 significant Regression Multiple Linear models explaining the total and the 3 types of PTSD symptoms through WOC such as avoidance and problem solution. However, a first integrated model through structural equations did not attain good fit indexes. The study has been concluded with an alternative integrated model presenting very good adjustment indexes (CMIN/DF=.058, RMSEA=.000, NFI=.999, CFI=.999 and PNFI=.100). Finally, explanations based on neuroimages and covert conditioning are provided along with reflections on the prevention and prevalence of the PTSD.",0,0 +6006,Mitochondria-focused gene expression profile reveals common pathways and CPT1B dysregulation in both rodent stress model and human subjects with PTSD,"Posttraumatic stress disorder (PTSD), a trauma-related mental disorder, is associated with mitochondrial dysfunction in the brain. However, the biologic approach to identifying the mitochondria-focused genes underlying the pathogenesis of PTSD is still in its infancy. Previous research, using a human mitochondria-focused cDNA microarray (hMitChip3) found dysregulated mitochondria-focused genes present in postmortem brains of PTSD patients, indicating that those genes might be PTSD-related biomarkers. To further test this idea, this research examines profiles of mitochondria-focused gene expression in the stressed-rodent model (inescapable tail shock in rats), which shows characteristics of PTSD-like behaviors and also in the blood of subjects with PTSD. This study found that 34 mitochondria-focused genes being upregulated in stressed-rat amygdala. Ten common pathways, including fatty acid metabolism and peroxisome proliferator-activated receptors (PPAR) pathways were dysregulated in the amygdala of the stressed rats. Carnitine palmitoyltransferase 1B (CPT1B), an enzyme in the fatty acid metabolism and PPAR pathways, was significantly over-expressed in the amygdala (P < 0.007) and in the blood (P < 0.01) of stressed rats compared with non-stressed controls. In human subjects with (n = 28) or without PTSD (n = 31), significant over-expression of CPT1B in PTSD was also observed in the two common dysregulated pathways: fatty acid metabolism (P = 0.0027, false discovery rate (FDR) = 0.043) and PPAR (P = 0.006, FDR = 0.08). Quantitative real-time polymerase chain reaction validated the microarray findings and the CPT1B result. These findings indicate that blood can be used as a specimen in the search for PTSD biomarkers in fatty acid metabolism and PPAR pathways, and, in addition, that CPT1B may contribute to the pathology of PTSD.",0,0 +6007,Improving Our Understanding of Posttraumatic Trajectories,,0,0 +6008,Introduction: Psychosocial consequences of the war in the region of former Yugoslavia,"Editorials usually reflect research topics addressed in the articles which follow them as well as highlight central issues, providing an overview of the topic and sometimes outlining its historical development. Most of this is true for this editorial, but there is--unfortunately--an immediate connection to the current political situation as well: I am writing this two weeks after the attacks on the World Trade Center, and many people all over the world are afraid that war may now threaten countries not affected by war for many years. The threat of war makes us think more about the multiple medical and psychosocial consequences which follow it. Yet, there is no such thing as ""war."" Each war has its own profile of events which interact with the particular societies involved and with the people in the war region.",0,0 +6009,Psychological Distress and the Impact of Social Support on Fathers and Mothers of Pediatric Cancer Patients: Long-Term Prospective Results,"To explore the effects of social support on psychological distress of parents of pediatric cancer patients using a prospective design over a 5-year period.Parents of children diagnosed with cancer participated at diagnosis (T1), 6 months (T2), 12 months (T3), and 5 years later (T4). Instruments The General Health Questionnaire and the Social Support List (SSL) measuring amount of support, (dis)satisfaction with support, and negative interactions were administered.Psychological distress and amount of support received decreased significantly from diagnosis to T4. No significant change in (dis)satisfaction with support and negative interactions was found. Social support variables did not show any concurrent or prospective significant effect on mothers' distress at T4. Dissatisfaction with support showed a significant unique concurrent effect on fathers' distress at T4 and negative interactions had a prospective unique effect.Dissatisfaction with support and negative interactions that fathers experienced significantly affected their levels of psychological distress. No such effect was found for mothers.",0,0 +6010,"Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition , and the Impact of Events Scale-Revised","We read with great interest the article by Bienvenu et al1 in a recent issue of CHEST (July 2013) and would like to compliment them on the development and validation of the Impact of Events Scale-Revised (IES-R) for patients with posttraumatic stress disorder (PTSD) after acute lung injury. Psychiatric nosology and diagnostic classification systems are always dynamic and in a state of flux. The authors developed the screening questionnaire and validated it against the Clinician-Administered PTSD Scale (CAPS), which is based on Diagnostic and Statistical Manual of Mental Disorders (DSM), fourth edition, diagnostic criteria.",0,0 +6011,Beyond normality in the study of bereavement: Heterogeneity in depression outcomes following loss in older adults,"Studies of individual differences in bereavement have revealed prototypical patterns of outcome. However, many of these studies were conducted prior to the advent of sophisticated contemporary data analytic techniques. For example, Bonanno et al. (2002) used rudimentary categorization procedures to identify unique trajectories of depression symptomatology from approximately 3 years prior to 4 years following conjugal loss in a representative sample of older American adults. In the current study, we revisited these same data using Latent Class Growth Analysis (LCGA) to derive trajectories and test predictors. LCGA is a technique well-suited for modeling empirically- and conceptually-derived heterogeneous longitudinal patterns while simultaneously modeling predictors of those longitudinal patterns. We uncovered four discrete trajectories similar in shape and proportion to the previous analyses: Resilience (characterized by little or no depression; 66.3%), Chronic Grief (characterized by depression following loss, alleviated by 4 years post-loss; 9.1%), _Pre-existing Chronic Depression (ongoing high pre- through post-loss depression; 14.5%), and Depressed-Improved (characterized by high pre-loss depression that decreases following loss; 10.1%). Using this analytic strategy, we were able to examine multiple hypotheses about bereavement simultaneously. Health, financial stress, and emotional stability emerged as strong predictors of variability in depression only for some trajectories, indicating that depression levels do not have a common etiology across all the bereaved. As such, we find that identifying distinct patterns informs both the course and etiology of depression in response to bereavement.",0,0 +6012,Post traumatic stress disorder in children after tsunami disaster in Thailand: 2 years follow-up.,"On December 26, 2004, the tsunami destroyed many families, communities, and residential areas. Adverse psychological impact on children and adolescents due to a natural disaster of this magnitude has never been reported in Thailand's history particularly as Post-Traumatic Stress Disorder (PTSD).Investigate clinical symptoms and develop a 2-year monitoring and intervention program for PTSD in children affected by the December 26, 2004 tsunami natural disaster The study period started six weeks after the event and was completed after two years.One thousand six hundred and twenty five surviving students from two schools in Takuapa district, Phang-nga Province, were enrolled. Screening tests using Pediatric symptom checklists, Childhood depressive intervention (CDI), and Revised child impact of events scales (CRIES) were done. Psychiatric evaluations were done by child and adolescent psychiatrists. Post Traumatic Stress Disorder (PTSD) was diagnosed using criteria from Diagnostic and Statistical Manual of Mental Disorders, 4th edition.The prevalence of PSTD in the affected students were 57.3, 46.1, 31.6, 10.4, and 7.6% at 6 weeks, 6 months, 1 year, 1 1/2 years, and 2 years, respectively. The female: male ratio was 1.7:1. The peak age was 9-10 years old. Threatened situations were studied. Of the 176 students who risked their lives in the waves, 48 (27.3%) suffered from PTSD. Meanwhile, of the 1314 students who were not hit by the waves but were among affected friends and relatives, 42 students (3.1%) suffered from PTSD. The prevalence of PTSD in those hit by the waves were significantly higher than those who were not [p-value < 0.01, RR = 5.16 (4.04-.6.6)].The prevalence of PSTD in children who suffered from the tsunami disaster was as high as 57.3% at six weeks after the incident. It declined sharply at two years (7.6%) with the help of integrated welfare. The children continue to get financial, rehabilitation, and mental health support to prevent long-term adverse outcomes.",0,0 +6013,Early childhood factors associated with the development of post-traumatic stress disorder: results from a longitudinal birth cohort,"Background. Childhood factors have been associated with increased risk of developing post-traumatic stress disorder (PTSD). Previous studies assessed only a limited number of childhood factors retrospectively. We examined the association between childhood neurodevelopmental, temperamental, behavioral and family environmental characteristics assessed before age 11 years and the development of PTSD up to age 32 years in a birth cohort. Method. Members of a 1972–73 New Zealand birth cohort ( n =1037) who were assessed at ages 26 and 32 years for PTSD as defined by DSM-IV. Results. We identified two sets of childhood risk factors. The first set of risk factors was associated both with increased risk of trauma exposure and with PTSD assessed at age 26. These included childhood externalizing characteristics and family environmental stressors, specifically maternal distress and loss of a parent. The second set of risk factors affected risk for PTSD only and included low IQ and chronic environmental adversity. The effect of cumulative childhood factors on risk of PTSD at age 26 was substantial; over 58% of cohort members in the highest risk quartile for three developmental factors had PTSD as compared to only 25% of those not at high risk on any factors. Low IQ at age 5, antisocial behavior, and poverty before age 11 continued to predict PTSD related to traumatic events that occurred between the ages of 26 and 32. Conclusions. Developmental capacities and conditions of early childhood may increase both risk of trauma exposure and the risk that individuals will respond adversely to traumatic exposures. Rather than being solely a response to trauma, PTSD may have developmental origins.",0,0 +6014,"The effects of trauma types, cumulative trauma, and PTSD on IQ in two highly traumatized adolescent groups.","We investigated the relationship between trauma type, posttraumatic stress disorder (PTSD), and intelligence quotient (IQ) utilizing a development-based taxonomy of trauma in a sample of 390 African-American adolescents and Iraqi refugee adolescents. Utilizing structural equation modeling, we compared different “good-fitting” models that describe the specific relationships between different trauma types, PTSD cluster symptoms (i.e., re-experiencing, arousal, avoidance, and emotional numbness/dissociation), and IQ factors (i.e., perceptual reasoning, verbal comprehension, working memory, and processing speed). Our findings support the hypothesis that different trauma types have different influences, some positive and some negative. Whereas abandonment and personal identity trauma (e.g., sexual abuse) have direct negative effects, secondary trauma (e.g., parents’ involvement in war or combat) has a positive effect on IQ. Collective identity trauma (e.g., oppression) did not have either negative or positive effects on IQ. The PTSD components reexperiencing and arousal generally mediated some of the negative effects of traumas on IQ; avoidance and emotional detachment/dissociation generally mediated positive effects. In conclusion, trauma type differentially impacts IQ. However, cumulative trauma dynamics have total negative significant effects on all of the four IQ components: perceptual reasoning, working memory, processing speed, and verbal comprehension.",0,0 +6015,PTSD symptom cluster profiles of youth who have experienced sexual or physical abuse,"The research examined whether youth (6-17 years old) who were referred for treatment due to sexual, physical, or both types of abuse presented with distinct profiles of PTSD DSM-IV-TR symptom clusters. When examining data for the 749 youth participants, five PTSD symptom cluster profiles were identified with each profile representing approximately 20% of the youth. The five profiles were also differentiated with respect to being referred for physical or sexual abuse, age, parental ratings of internalizing symptoms, and self-reported depression. The youth referred for treatment in the aftermath of child sexual, physical, or both sexual and physical abuse presented with different profiles of PTSD symptom clusters thereby suggesting a need for individualized tailoring of evidenced-based treatments. Two cognitive behavioral approaches, designed for traumatized children and either their nonoffending or offending parents, were described for treating youth with the distinct PTSD profiles.",0,0 +6016,Trajectories of Internalizing Problems in War-Affected Sierra Leonean Youth: Examining Conflict and Postconflict Factors,"Three waves of data from a prospective longitudinal study in Sierra Leone were used to examine internalizing trajectories in 529 war-affected youth (ages 10-17 at baseline; 25% female). Latent class growth analyses identified 4 trajectories: A large majority of youth maintained lower levels of internalizing problems (41.4%) or significantly improved over time (47.6%) despite very limited access to care, but smaller proportions continued to report severe difficulties 6 years postwar (4.5%) or their symptoms worsened (6.4%). Continued internalizing problems were associated with loss of a caregiver, family abuse and neglect, and community stigma. Despite the comparative resilience of most war-affected youth in the face of extreme adversity, there remains a compelling need for interventions that address family- and community-level stressors.",0,0 +6017,The Longitudinal Course of Posttraumatic Stress Disorder Symptoms among Aging Military Veterans,"This study examined the longitudinal course of posttraumatic stress disorder (PTSD) among two samples of Dutch aging military veterans: 576 veterans with a military disability pension and 198 community sample veterans, who fought in World War II, the former Dutch East Indies, and Korea. Both samples were investigated in 1992 and in 1998 with a standardized and validated instrument measuring PTSD symptoms. In 1992, 27% of the veterans with a military disability pension met the criteria for a PTSD diagnosis; in 1998, this was 29%. Of the community sample veterans, 9% reported a PTSD diagnosis in 1992, in 1998 this was 8%. The results provide strong support for the long-term persistence of PTSD symptoms. In addition, PTSD caseness at one time point was associated with significantly elevated PTSD symptom severity at the time of no PTSD diagnosis. No evidence was found for an aggravation of PTSD due to stressors associated with aging.",0,0 +6018,Hypothalamic-Pituitary-Thyroid Axis Function in Women With a Menstrually Related Mood Disorder: Association With Histories of Sexual Abuse,"INTRODUCTION: We previously reported a unique hypothalamic-pituitary- thyroid (HPT) axis profile in women with a menstrually related mood disorder (MRMD) who also had a history of sexual abuse (SA). In the present study, we sought to extend that work by examining the association of an SA history with HPT-axis disturbance in both women with MRMD and women without MRMD. METHODS: Fifty-seven women met the prospective criteria for MRMD (23 with an SA history), and 52 women were non-MRMD (18 with an SA history). Thyroid-stimulating hormone, thyroxin (T4; total and free), and triiodothyronine (T3; total and free) were evaluated in serum, together with thyroid hormone ratios reflecting T4 to T3 conversion. RESULTS: Women with MRMD, compared with women without MRMD, had elevated T3/T4 ratios (p values ≤ .01; reflecting increased conversion of T4 to T3) and lower free and total T4 concentrations (p values = .01). Higher T3/T4 ratios and lower T4 concentrations predicted more severe premenstrual symptoms in all women. An SA history, irrespective of MRMD status, was associated with elevated thyroid-stimulating hormone concentrations (p = .03). However, in women with MRMD, an SA history was associated with elevated T3 concentrations (p = .049), whereas in women without MRMD, an SA history was associated with decreased T3 concentrations (p = .02). CONCLUSIONS: An MRMD and an SA history are associated with independent and interactive effects on the HPT axis. The evidence that an MRMD moderates the influence of SA on T3 concentrations contributes to a growing body of work suggesting that an SA history may identify a distinct subgroup of women with MRMD.",0,0 +6019,Prevalence and Determinants of Chronic Post-Traumatic Stress Disorder After Floods,"To explore the prevalence and determinants of chronic post-traumatic stress disorder (PTSD) among flood victims.A cross-sectional survey was carried out in 2014 among individuals who had experienced the 1998 floods and had been diagnosed with PTSD in 1999 in Hunan, China. Cluster sampling was used to select subjects from the areas that had been surveyed in 1999. PTSD was diagnosed according to DSM-IV criteria, social support was measured according to a Social Support Rating Scale, coping style was measured according to a Simplified Coping Style Questionnaire, and personality was measured by use of the revised Eysenck Personality Questionnaire Short Scale for Chinese. Data were collected through face-to-face interviews by use of a structured questionnaire. Multivariate logistic regression analysis was used to reveal the determinants of chronic PTSD.A total of 123 subjects were interviewed, 17 of whom (14.4%) were diagnosed with chronic PTSD. Chronic PTSD was significantly associated with disaster stressors (odds ratio [OR]: 1.74; 95% confidence interval [CI]: 1.22-2.47), nervousness (OR: 1.09; 95% CI: 1.01-1.17), and social support (OR: 0.85; 95 CI%: 0.74-0.98).Chronic PTSD in flood victims is significantly associated with disaster stressors, nervousness, and social support. These factors may play important roles in identifying persons at high risk of chronic PTSD.",0,0 +6020,"The Minnesota Multiphasic Personality Inventory-2, posttraumatic stress disorder, and women domestic violence survivors.","Empirical evidence and diagnostic decision rules for diagnosing Post-Traumatic Stress Disorder (PTSD) with Minnesota Multiphasic Personality Inventory - 2 were originally developed with a narrow and heterogeneous sample of trauma victims, Vietnam veterans. Relatively little empirical study has been given to the use of the MMPI-2 among domestic violence survivors, especially as it pertains to the issue of Post-Traumatic Stress Disorder. The utility and validity of prior empirical findings, based primarily on Vietnam veterans, cannot be extrapolated to other trauma victims without further empirical evidence supporting such application. In this study the MMPI-2 was administered to 93 women domestic violence survivors from domestic violence (a) shelters, (b) support groups, (c) outreach centers, and (d) other social service agencies. The Post-Traumatic Stress Diagnostic Scale (Foa, 1995) was used to identify which of 93 women survivors met diagnostic criteria for Post-Traumatic Stress Disorder. Multivariate analysis of variance, using nine MMPI-2 scales, found significant differences between women domestic violence survivors with and without PTSD on the F, K, 1(Hs), 2(D), 6(Pa), B(Sc), and PK-PTSD scales. Stepwise discriminant function analysis produced one significant discriminant function, including the K validity and the 1(Hs) scales, a 78% correct classification rate, and a sensitivity and specificity of 88% and 60%, respectively. The PK-PTSD scale correctly classified 68% of all cases, and a sensitivity and specificity of 81% and 45%, respectively, were found. Canonical correlation of MMPI-2 scales with sub-scales from Foa's (1995) Post-Traumatic Stress Diagnostic Scale revealed significant multiple correlations. Major findings suggest the MMPI-2 is sensitive to PTSD symptomatology and capable of discriminating between domestic violence survivors with and without PTSD. The MMPI-2 is as diagnostically efficient for assessing PTSD in domestic violence survivors as it is been found to be for Vietnam veterans. Implications for theory, research, practice, and limitations of this research are discussed.",0,0 +6021,Course-dependent response of brain functional alterations in men with acute and chronic post-traumatic stress disorder: A follow-up functional magnetic imaging study,"Introduction The aim of this study was to investigate the neurofunctional alterations in both acute and chronic post-traumatic stress disorder (PTSD) resulting from the same stress experience. Methods Brain responses to emotional trauma-related and neutral pictures with a symptom provocation task were measured using functional magnetic resonance imaging (fMRI). Twenty-four PTSD patients resulting from a mining accident and 14 controls exposed to the same accident without PTSD two months post-trauma were recruited. In the follow-up study 20 PTSD patients and 14 controls were also recruited after 24 months post-trauma. Correlations were conducted in PTSD between altered fMRI blood oxygenation level-dependent (BOLD) signals of areas extracted as regions of interest and three Clinician-Administered PTSD Scale (CAPS) subscores respectively. Results In response to picture stimulus (traumatic negative pictures versus neutral pictures), the acute PTSD group showed greater activation in the bilateral posterior cingulate gyri, left precuneus, right fusiform and left parahippocampal gyrus than the chronic PTSD group (P   20 voxels). In the acute PTSD group, BOLD signals of either posterior cingulate gyrus correlated positively with CAPS intrusion subscores. There was also no significant correlation between BOLD signals of five regions mentioned above in the chronic PTSD group and three CAPS subscores. Discussion These findings suggested that brain circuits affected in acute PTSD may be more extended than chronic PTSD. The reason may due to the formation of traumatic memory in the acute phase of PTSD.",0,0 +6022,"Deconstructing PTSD: Traumatic Experiences, Posttraumatic Symptom Clusters, and Mental Health Problems among Delinquent Youth","This study investigated interrelations among trauma exposure, posttraumatic stress disorder (PTSD) symptom clusters, and mental health problems among adjudicated adolescents. Girls scored higher than boys on measures of exposure to interpersonal trauma, PTSD symptom clusters, and mental health problems. Results of path analyses were consistent with the hypothesis that PTSD symptom clusters differentially mediate the relations between trauma exposure and mental health problems, with unique patterns of results for boys and girls. For all youth, avoidance mediated the association between trauma and internalizing symptoms whereas reexperiencing and arousal acted as mediators of externalizing. However, for boys only, noninterpersonal traumas also were related to PTSD symptoms, which in turn acted as mediators of internalizing. For girls only, reexperiencing and arousal acted as mediators of internalizing and associated symptoms of PTSD acted as a mediator of externalizing. © 2012",0,0 +6023,Post-traumatic growth in stroke carers: A comparison of theories,"This study examined variables associated with post-traumatic growth (PTG) in stroke carers and compared predictions of two models of PTG within this population: the model of Schaefer and Moos was compared to that of Tedeschi and Calhoun (1992, Personal coping: Theory, research, and application. Westport, CT: Praeger, 149; 1998, Posttraumatic growth: Positive changes in the aftermath of crisis. Mahwah, NJ: Lawrence Erlbaum, 99; 2004, Psychol. Inq., 15, 1, respectively).A cross-sectional survey design was employed.Carers of stroke survivors (N = 71) completed questionnaires measuring PTG, coping style, social support, survivor functioning, age, and carer quality of life. Correlation, multiple regression, and mediation analyses were used to test hypotheses.All carers completing the PTG measure (N = 70) reported growth, but average scores differed from cancer carers (Chambers et al., 2012, Eur. J. Cancer Care, 21, 213; Thombre et al., 2010, J. Psychosocial Oncol., 28, 173). PTG was positively correlated with deliberate and intrusive rumination, avoidance coping, social support, and quality of life. Regression analysis showed that factors identified by Tedeschi and Calhoun (deliberate rumination, intrusive rumination, social support, acceptance coping, survivor functioning) accounted for 49% of variance in PTG, whereas those identified by Schaefer and Moos (active coping, avoidance coping, social support, survivor functioning, and age) accounted for only 21%. Rumination, especially deliberate rumination, explained most variance in PTG and mediated the effect of social support on PTG.The findings add to the limited body of evidence suggesting that stroke carers experience growth. Deliberate rumination and social support are important in explaining growth, and the findings support the model proposed by Tedeschi and Calhoun over that of Schaefer and Moos.What is already known on this subject? Literature on caring for stroke survivors focuses on negative outcomes (Ilse, Feys, de Wit, Putman, & de Weerdt, 2008) to the exclusion of positive outcomes such as post-traumatic growth (PTG; Calhoun & Tedeschi, 1999). Studies of a variety of health conditions have demonstrated that PTG occurs in patients and carers after illness events and is associated with well-being (Gangstad, Norman, & Barton, 2006; Helgeson, Reynolds, & Tomich, 2006; Kim, Schulz, & Carver, 2007). Exploratory studies and studies of benefit finding have shown that PTG occurs in stroke carers (Bacon, Milne, Sheikh, & Freeston, 2009; Buschenfeld, Morris, & Lockwood, 2009; Haley et al., 2009; Thompson, 1991), but there are no studies using standard instruments to assess PTG in this population. Moreover, current theories posit different explanations for PTG (Schaefer & Moos, 1992, 1998; Tedeschi & Calhoun, 2004), and there is a need for empirical tests (Park, 2010). What does this study add? This study extends knowledge by measuring PTG with a standard instrument in a sample of UK stroke carers and investigating associated variables. The study also compared the predictive power of the models of PTG proposed by Tedeschi and Calhoun (2004) and Schaefer and Moos (1992, 1998). PTG was found in UK stroke carers, but levels differed from cancer carers in other countries. Factors associated with PTG were identified; Tedeschi and Calhoun's model best predicted PTG. Deliberate rumination had a direct effect on PTG and also mediated the effect of social support. Deliberate rumination is a possible target for therapeutic interventions to enhance PTG.",0,0 +6024,Assessing DSM-5 latent subtypes of acute stress disorder dissociative or intrusive?,"Acute Stress Disorder (ASD) was first included in the DSM-IV in 1994. It was proposed to account for traumatic responding in the early post trauma phase and to act as an identifier for later Posttraumatic Stress Disorder (PTSD). Unlike PTSD it included a number of dissociative indicators. The revised DSM-5 PTSD criterion included a dissociative-PTSD subtype. The current study assessed if a dissociative-ASD subtype may be present for DSM-5 ASD. Moreover, we assessed if a number of risk factors resulted in an increased probability of membership in symptomatic compared to a baseline ASD profile. We used data from 450 bank robbery victims. Latent profile analysis (LPA) was used to uncover latent profiles of ASD. Multinomial logistic regression was used to determine if female gender, age, social support, peritraumatic panic, somatization, and number of trauma exposures increased or decreased the probability of profile membership. Four latent profiles were uncovered and included an intrusion rather than dissociative subtype. Increased age and social support decreased the probability of individuals being grouped into the intrusion subtype whereas increased peritraumatic panic and somatization increased the probability of individuals being grouped into the intrusion subtype. Findings are discussed in regard to the ICD-11 and the DSM-5.",0,0 +6025,One-year prospective follow-up of motor vehicle accident victims,"One-hundred and thirty-two victims of motor vehicle accidents (MVAs), who sought medical attention as a result of the MVA, were assessed at three points in time: 1-4 months post-MVA, 6 months later, and 12 months later. Of the 48 who met the full criteria for Post-Traumatic Stress Disorder (PTSD) initially, half had remitted at least in part by the 6-month follow-up point and two-thirds had remitted by the 1-yr follow-up. Using logistic regression, 3 variables combined to correctly identify 79% of remitters and non-remitters at the 12-month follow-up point: initial scores on the irritability and foreshortened future symptoms of PTSD and the initial degree of vulnerability the subject felt in a motor vehicle after the MVA. Four variables combined to predict 64% of the variance in the degree of post-traumatic stress symptoms at 12 months: presence of alcohol abuse and/or an Axis-II disorder at the time of the initial assessment as well as the total scores on the hyperarousal and on avoidance symptoms of PTSD present at the initial post-MVA assessment.",0,0 +6026,Five Essential Elements of Immediate and Mid–Term Mass Trauma Intervention: Empirical Evidence,"Given the devastation caused by disasters and mass violence, it is critical that intervention policy be based on the most updated research findings. However, to date, no evidence-based consensus has been reached supporting a clear set of recommendations for intervention during the immediate and the mid-term post mass trauma phases. Because it is unlikely that there will be evidence in the near or mid-term future from clinical trials that cover the diversity of disaster and mass violence circumstances, we assembled a worldwide panel of experts on the study and treatment of those exposed to disaster and mass violence to extrapolate from related fields of research, and to gain consensus on intervention principles. We identified five empirically supported intervention principles that should be used to guide and inform intervention and prevention efforts at the early to mid-term stages. These are promoting: 1) a sense of safety, 2) calming, 3) a sense of self- and community efficacy, 4) connectedness, and 5) hope.",0,0 +6027,"Mental Health, Help Seeking, and Stigma and Barriers to Care Among 3- and 12-Month Postdeployed and Never Deployed U.S. Army Combat Medics","U.S. Army Combat Medic serves as both Soldier and provider of combat casualty care, often in the heat of battle and with limited resources. Yet little is known about their help-seeking behavior and perceived stigma and barriers to care. Participants were three groups of U.S. Army Combat Medics surveyed at 3- and 12-months postdeployment from assignment with line units vs. those Medics who had never deployed to combat. The primary data source was surveys of mental health service utilization, perceived stigma and barriers to care, and depression and post-traumatic stress disorder screens. Medics who received help in the past year from a mental health professional ranged from 18% to 30%, with 18% to 30% seeking mental health assistance from other sources. Previously deployed Medics were more likely to obtain assistance than those who never deployed. Those meeting a mental health screening criteria were more likely to report associated stigma and barriers to care. Findings indicate that Medics in need of assistance report greater perceived barriers to mental health care, as well as stigma from seeking treatment, and that depression may be a salient issue for Medics. The longitudinal nature of the ongoing study will help determine the actual trajectory and onset of depression and post-traumatic stress disorder.",0,0 +6028,Anxiety Disorders and PTSD,"INTRODUCTION This chapter reviews the literature on the prevalence and etiology of anxiety disorders, including posttraumatic stress disorder (PTSD), following disasters. We highlight that there is relatively little information about anxiety disorders other than PTSD; the paucity of data is due to the challenge of the shared phenomenology of these disorders and the difficulty of defining their boundaries. A further challenge is explored, namely, how disasters interact with background morbidity in a community. In considering the etiology of anxiety disorders, the differential role of threat is hypothesized to be differentiated from the more enduring effect of the losses sustained in disasters. Anxiety disorders have an enduring effect in the aftermath of disasters, and many issues remain to be examined in future research, especially in expanding beyond PTSD. To begin, however, it is important to understand the settings in which disasters occur and the anticipations that abound following these events, as these have the potential to bias a rational appraisal of the challenges that will impact the affected community. Managing the psychological impact of disasters is a critical public-health challenge in the aftermath of these events. Informed prevalence and incidence estimates are critical to effective service planning. Unfortunately, there is often dramatization of disaster impact immediately afterward, with fears expressed about the capacity of the population to function and manage effectively (de Ville de Goyet, 2007). © Cambridge University Press 2009.",0,0 +6029,The role of smoking expectancies in the relationship between PTSD symptoms and smoking behavior among women exposed to intimate partner violence,"Intimate partner violence (IPV) is a public health problem associated with negative health consequences, including higher rates of tobacco smoking. Smoking expectancies are related to motivation to quit and relapse. IPV-exposed women endorse higher rates of PTSD symptoms, which are related to smoking and smoking expectancies. The present study sought to examine the relationship among smoking behavior, smoking expectancies, and PTSD symptoms among IPV-exposed women. Participants were 83 women who reported experiencing IPV within the last month, smoked an average of 12 cigarettes per day, and reported moderate levels of nicotine dependence (FTND mean=4.4). Participants completed baseline and follow-up interviews. Multiple regression analyses assessed the relationships among smoking expectancies and PTSD symptoms to cigarettes smoked per day and nicotine dependence. Findings demonstrated that Stimulation/State Enhancement expectancies were positively related to cigarettes per day, whereas PTSD arousal symptoms were negatively related to cigarettes per day, p's<.05. Neither smoking expectancies nor PTSD symptoms were significantly related to nicotine dependence. Supplemental analyses revealed that PTSD re-experiencing symptoms were negatively related and PTSD avoidance/numbing symptoms were positively related to Stimulation/State Enhancement expectancies, p's<.05. This study extends findings regarding the association between PTSD symptoms and smoking among an understudied population - IPV-exposed women. The relationship between PTSD symptoms and smoking differed across PTSD symptom clusters and expectancy scales, which may have implications for treatment development. The fact that expectancies and PTSD symptoms are related to smoking behavior among IPV-exposed women may be important for enhancing prevention and intervention efforts.",0,0 +6030,Acute stress disorder and posttraumatic stress disorder in parents of injured children,"Acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) were examined in 334 parents of children with traffic-related injuries. In the first month after their child's injury, 12% of parents had ASD and another 25% had partial ASD. Among 251 parents assessed again approximately 6 months postinjury, 8% had PTSD and another 7% had partial PTSD. The ASD and PTSD severity were associated (r = .54), but ASD status was not a sensitive predictor of later PTSD. Independent predictors of ASD severity included prior trauma exposure, peritrauma exposure and perceptions of the child's pain and life threat, and child ASD severity. Independent predictors of PTSD severity included prior trauma exposure, parent ASD severity, and parent-rated child physical health at follow-up.",0,0 +6031,50 years of hurdles and hope in anxiolytic drug discovery,"Anxiety disorders are the most prevalent group of psychiatric diseases, and have high personal and societal costs. The search for novel pharmacological treatments for these conditions is driven by the growing medical need to improve on the effectiveness and the side effect profile of existing drugs. A huge volume of data has been generated by anxiolytic drug discovery studies, which has led to the progression of numerous new molecules into clinical trials. However, the clinical outcome of these efforts has been disappointing, as promising results with novel agents in rodent studies have very rarely translated into effectiveness in humans. Here, we analyse the major trends from preclinical studies over the past 50 years conducted in the search for new drugs beyond those that target the prototypical anxiety-associated GABA (γ-aminobutyric acid)-benzodiazepine system, which have focused most intensively on the serotonin, neuropeptide, glutamate and endocannabinoid systems. We highlight various key issues that may have hampered progress in the field, and offer recommendations for how anxiolytic drug discovery can be more effective in the future.",0,0 +6032,Faking it: incentives and malingered PTSD,"Purpose – The purpose of this paper is to address how context for malingering and the provision of incentives influence malingered symptom profiles of post-traumatic stress disorder (PTSD). Design/methodology/approach – A 2 (case context)×3 (incentive) factorial design was utilized. Participants ( n =298) were given an incentive (positive, negative, or no incentive), randomly assigned to a criminal or civil context, and asked to provide a fake claim of child abuse with corresponding malingered symptoms of PTSD. Under these conditions, participants completed several questionnaires pertaining to symptoms of trauma and PTSD. Findings – Results indicated that negative incentives were primarily associated with lower symptom scores. Therefore, “having something to lose” may result in more constrained (and realistic) symptom reports relative to exaggeration evidenced with positive incentives. Originality/value – These results have implications for forensic settings where malingered claims of PTSD are common and incentives for such claims (e.g. having something to gain or lose) frequently exist. Previous studies have failed to address incentives (positive and negative) in relation to a crime (i.e. abuse) that can span both criminal and civil contexts.",0,0 +6033,Mental Health Distress and Related Factors Among Prefectural Public Servants Seven Months After the Great East Japan Earthquake,"To develop an empirically informed support measure for workers, we examined mental health distress and its risk factors among prefectural public servants who were affected by the Great East Japan Earthquake and faced a demanding workload in the midterm of the disaster.We conducted a self-administered health survey of all public servants in the Miyagi prefectural government two and seven months after the Great East Japan Earthquake (3743 workers, 70.6% of all employees). We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for mental distress (defined as K6 score ≥10) in the domain of disaster-work-related stressors, work-related stressors, and disaster-related stressors.Among those with better levels of workplace communication, the only factor that increased the risk of mental distress was not taking a non-work day each week (adjusted OR 2.55, 95% CI 1.27-5.14). Among those with poorer levels of workplace communication, in addition to not taking a non-work day each week (adjusted OR 3.93, 95% CI 3.00-5.15), handling residents' complaints (adjusted OR 1.55, 95% CI 1.00-2.42), having dead or missing family members (adjusted OR 2.87, 95% CI 1.53-5.38), and living in a shelter more than two months after the disaster (adjusted OR 2.80, 95% CI 1.32-5.95) increased the risk of mental distress.All workers should be encouraged to take a non-work day each week. Among workers with poor workplace communication, special attention should be given to those who handle residents' complaints, have lost a family member(s), and are living in a shelter for a prolonged period of time.",0,0 +6034,Susceptibility to PTSD-like behavior is mediated by corticotropin-releasing factor receptor type 2 levels in the bed nucleus of the stria terminalis.,"Posttraumatic stress disorder (PTSD) is a debilitating disease, which affects 8-10% of the population exposed to traumatic events. The factors that make certain individuals susceptible to PTSD and others resilient are currently unknown. Corticotropin-releasing factor receptor type 2 (CRFR2) has been implicated in mediating stress coping mechanisms. Here, we use a physiological PTSD-like animal model and an in-depth battery of tests that reflect the symptomology of PTSD to separate mice into subpopulations of ""PTSD-like"" and ""Resilient"" phenotypes. PTSD-like mice are hypervigilant, hyperalert, insomniac, have impaired attention and risk assessment, as well as accompanying attenuated corticosterone levels. Intriguingly, PTSD-like mice show long-term robust upregulation of BNST-CRFR2 mRNA levels, and BNST-CRFR2-specific lentiviral knockdown reduces susceptibility to PTSD-like behavior. Additionally, using a BNST mRNA expression array, PTSD-like mice exhibit a general transcriptional attenuation profile, which was associated with upregulation of the BNST-deacetylation enzyme, HDAC5. We suggest PTSD to be a disease of maladaptive coping.",0,0 +6035,"Posttraumatic Stress, Heart Rate Variability, and the Mediating Role of Behavioral Health Risks","Posttraumatic stress disorder (PTSD) has been linked to reduced heart rate variability (HRV), which is in turn a risk factor for cardiovascular disease and death. Although hyperarousal and anxiety are thought to underlie this association, behavioral health risks, including smoking, alcohol dependence, obesity, and sleep disturbance, represent potential mechanisms linking PTSD and HRV.To test this hypothesis, short-term laboratory-based and 24-hour ambulatory measures of HRV were collected from 227 young adults (18-39 years), 107 of whom were diagnosed as having PTSD. Latent variable modeling was used to assess the relationship of PTSD symptoms with HRV along with potential behavioral health mediators.PTSD symptoms were associated with reduced HRV (β = -0.21, p = .002). However, this association was reduced in models that adjusted for cigarette consumption and history of alcohol dependence and was rendered nonsignificant in a model adjusting for sleep disturbance. Independent mediation effects were deemed significant via bootstrapping analysis. Together, the three behavioral health factors (cigarette consumption, history of alcohol dependence, and sleep disturbance) accounted for 94% of the shared variance between PTSD symptoms and HRV. Abdominal obesity was not a significant mediator.These results indicate that behavioral factors-specifically smoking, alcohol overuse, and sleep disturbance-mediate the association between PTSD and HRV-based indices of autonomic nervous system dysregulation. Benefits from psychiatric and psychological interventions in PTSD may therefore be enhanced by including modification of health behaviors.",0,0 +6036,Epidemiology of major depression in four cities in Mexico,"Analyses were conducted to estimate lifetime and current prevalence of major depressive disorder (MDD) for four representative cities of Mexico, to identify variables that influence the probability of MDD, and to further describe depression in Mexican culture. A multistage probability sampling design was used to draw a sample of 2,509 adults in four different regions of Mexico. MDD was assessed according to DSM-IV criteria by using the Composite International Diagnostic Interview collected by trained lay interviewers. The prevalence of MDD in these four cities averaged 12.8% for lifetime and 6.1% for the previous 12 months. MDD was highly comorbid with other mental disorders. Women were more likely to have lifetime MDD than were men. Being divorced, separated, or widowed (compared to married or never married) and having experienced childhood trauma were related to higher lifetime prevalence but not to current prevalence. In addition, age and education level were related to current 12-month MDD. Data on the profile of MDD in urban Mexico are provided. This research expands our understanding of MDD across cultures.",0,0 +6037,Prior Assault and Posttraumatic Stress Disorder After Combat Deployment,"Factors that make people vulnerable to or resilient against posttraumatic stress disorder (PTSD) following overwhelming stress are not well understood. The objective of this study was to prospectively examine the relation between prior assault and new-onset PTSD symptoms in a large US military cohort deployed in the wars in Iraq and Afghanistan.Data on exposures and health outcomes were collected in the Millennium Cohort study at enrollment (July 2001 to June 2003) and follow-up (June 2004 to February 2006) from over 55,000 participants. Of these, 5324 were deployed in Iraq and Afghanistan, reported combat exposures, and were free of PTSD at baseline (881 women and 4443 men). We used multivariable logistic regression analysis to model the odds of new-onset PTSD in relation to prior assault.New-onset PTSD symptoms or diagnosis among deployers reporting combat exposures occurred in 22% of women who reported prior assault and 10% not reporting prior assault. Among men reporting prior assault, rates were 12% and 6%, respectively. Adjusting for baseline factors, the odds of new-onset PTSD symptoms was more than 2-fold higher in both women and men who reported assault prior to deployment.Prior assault appears to confer increased vulnerability for, rather than resilience against, PTSD symptoms among military professionals deployed to recent combat operations.",0,0 +6038,Ecological Momentary Assessment of Posttraumatic Stress Disorder Symptoms During a Smoking Quit Attempt,"Smokers with posttraumatic stress disorder (PTSD) tend to lapse more quickly following a quit attempt, which might be explained by changes in PTSD symptoms during a quit attempt. The present study examines changes in PTSD symptoms, negative affect, and craving before and during a quit attempt.Participants in this study were 52 smokers with PTSD who completed random-alarm ecological momentary assessments of PTSD symptoms, negative affect, cigarette craving, and smoking behavior throughout a prequit phase of ad hoc smoking, a phase of abstinence from smoking, and a postlapse phase.Relative to the prequit phase, the abstinent phase was marked by decreases in PTSD reexperiencing, avoidance, and numbing clusters (ps ≤ .01). The odds of PTSD symptom or negative affect variability from one reading in the ecological momentary assessment (EMA)to the next reading was decreased in PTSD reexperiencing, avoidance, and numbing clusters (ps ≤ .02). Smoking cravings were also mildly decreased in the abstinent and postlapse phases (ps < .01), although some cravings in both phases were rated at the maximum intensity. Increased craving was predicted by the previous EMA reading of PTSD symptoms.Results suggested that smoking abstinence is not associated with exacerbation of PTSD symptoms, but PTSD symptoms during abstinence were related to craving levels during the quit attempt.",0,0 +6039,Salivary cortisol and dehydroepiandrosterone sulfate in adolescent rape victims with post traumatic stress disorder,"In chronic sexual abuse victims with post traumatic stress disorder (PTSD), the hypothalamic pituitary adrenal (HPA) axis can be dysregulated. In single rape victims, PTSD symptoms are hypothesized to function as a chronic stressor leading to similar HPA-axis dysregulation. The objective of the current study was to assess HPA-axis functioning in female adolescents with rape-related PTSD, but no prior sexual trauma, in comparison to non-victimized controls.Salivary cortisol and dehydroepiandrosterone sulfate (DHEAS) were measured in 52 female adolescent rape victims with PTSD and 37 healthy adolescents at 0, 15, 30, 45 and 60 min after awakening, both under basal conditions and after 0.5 mg dexamethasone administration.Compared to age-matched controls, adolescent rape victims with PTSD showed significantly reduced cortisol and DHEAS levels. No group differences for the effect of dexamethasone suppression were found. Both the event of rape and PTSD diagnosis, and not factors such as sleep duration, smoking, education or oral contraceptives, accounted for the neuroendocrine differences between rape victims and controls.The results show evidence for a dysregulated HPA-axis in female adolescent victims of single sexual trauma with PTSD. The finding of hypocortisolism is consistent with endocrine dysfunctioning in chronic sexual abuse victims and may have clinical implications with regard to treatment possibilities.",0,0 +6040,Examination of the Relationship Between PTSD and Distress Tolerance in a Sample of Male Veterans With Comorbid Substance Use Disorders,"Distress tolerance (DT), the perceived or actual ability to tolerate negative emotional or physical states, is inversely related to posttraumatic stress disorder (PTSD) symptoms in civilian, community samples. No studies to date have examined the relationship between DT and PTSD in clinical samples of veterans with a comorbid diagnosis of PTSD and a substance use disorder (SUD). Thus, the present study examined the relationship between DT and PTSD in a sample of predominately African American, male veterans (n = 75) diagnosed with comorbid PTSD and SUD (according to a structured clinical interview). Results of hierarchical linear regression models indicated that DT was inversely related to total PTSD symptom severity score, above and beyond depressive symptoms and SUD severity. Of the 4 symptom clusters, DT was inversely associated with intrusions and hyperarousal. These findings are discussed in light of previous work with civilian samples. Determining whether treatment incorporating DT skills would be useful for veterans undergoing PTSD treatment should be evaluated.",0,0 +6041,Replication and extension of a risk profile for Amerasian youth,"The relationship between number of risk factors and symptoms of anxiety and depression was examined in a cohort of Vietnamese Amerasians, replicating a study done with a previous cohort. One hundred forty seven subjects awaiting U.S. placement completed the Hopkins Symptom Checklist, the Vietnamese Depression Scale, and a questionnaire which included items found to be risk factors for psychological distress among Amerasians. Number of risk factors was linearly related to symptoms of both depression and anxiety. Results are consistent with previous findings of the relationship between risk factors and symptoms of psychological distress. The profile may be helpful in anticipating which refugees may be at risk for future psychological distress, and thus be useful in preventively allocating scarce treatment resources.",0,0 +6042,Salivary cortisol and posttraumatic stress disorder in a low-income community sample of women,"Studies of male combat veterans with posttraumatic stress disorder have demonstrated a profile of low cortisol. Studies with women with posttraumatic stress disorder (PTSD) have focused on childhood sexual abuse and holocaust survivors, both of whom experienced trauma during development, which could be different than adult trauma exposure.Using an epidemiologic sample of low-income women from an urban area in Michigan, we conducted structured psychiatric interviews and saliva cortisol collection on a subsample of women with exposure to trauma but never PTSD (n = 72), recent PTSD (n = 29), and past PTSD (n = 70). Saliva cortisol was collected at awakening, 30 minutes later, at bedtime, and during a clinic visit.Recent trauma exposure but not past trauma exposure led to an increase in saliva cortisol. Neither recent PTSD nor past PTSD resulted in any saliva cortisol changes compared with the trauma exposed, never PTSD group. Recent major depression (past 12 months) demonstrated a weak effect (p =.08) on bedtime saliva cortisol.While recent trauma exposure can increase saliva cortisol, neither recent nor past PTSD affected saliva cortisol in our community sample of women. Our data do not support saliva cortisol changes associated with PTSD.",0,0 +6043,Volunteers and professional rescue workers: Traumatization and adaptation after an avalanche disaster,"Objective: To compare the degree of traumatization and adaptation in professional and volunteer rescue workers after two snow avalanches. Method: Questionnaires including demographic questions, the Social Readjustment Rating Scale, the Rescue Workers Questionnaire, the General Health Questionnaire, the Impact of Event Scale, and the Coping Styles Questionnaire were answered by rescue workers (n = 168).Results: In several areas, professional rescuers had stronger fears than volunteers, all the same, volunteers were significantly more anxious and met criteria for PTSD caseness more often than professionals.Conclusion: The findings suggest that voluntary rescue workers suffer from post-traumatic stress disorder symptoms more often than professionals following demanding rescue missions.",0,0 +6044,TRAJECTORIES OF CHANGE IN ANXIETY SEVERITY AND IMPAIRMENT DURING AND AFTER TREATMENT WITH EVIDENCE-BASED TREATMENT FOR MULTIPLE ANXIETY DISORDERS IN PRIMARY CARE,"Coordinated Anxiety Learning and Management (CALM) is a model for delivering evidence-based treatment for anxiety disorders in primary care. Compared to usual care, CALM produced greater improvement in anxiety symptoms. However, mean estimates can obscure heterogeneity in treatment response. This study aimed to identify (1) clusters of participants with similar patterns of change in anxiety severity and impairment (trajectory groups); and (2) characteristics that predict trajectory group membership.The CALM randomized controlled effectiveness trial was conducted in 17 primary care clinics in four US cities in 2006-2009. 1,004 English- or Spanish-speaking patients age 18-75 with panic, generalized anxiety, social anxiety, and/or posttraumatic stress disorder participated. The Overall Anxiety Severity and Impairment Scale was administered repeatedly to 482 participants randomized to CALM treatment. Group-based trajectory modeling was applied to identify trajectory groups and multinomial logit to predict trajectory group membership.Two predicted trajectories, representing about two-thirds of participants, were below the cut-off for clinically significant anxiety a couple of months after treatment initiation. The predicted trajectory for the majority of remaining participants was below the cut-off by 9 months. A small group of participants did not show consistent improvement. Being sicker at baseline, not working, and reporting less social support were associated with less favorable trajectories.There is heterogeneity in patient response to anxiety treatment. Adverse circumstances appear to hamper treatment response. To what extent anxiety symptoms improve insufficiently because adverse patient circumstances contribute to suboptimal treatment delivery, suboptimal treatment adherence, or suboptimal treatment response requires further investigation.",0,0 +6045,Children Exposed to Disaster: II. Risk Factors for the Development of Post-Traumatic Symptomatology,"

ABSTRACT

Objective

To examine the influence of subject and exposure variables on the development of post-traumatic stress disorder (PTSD) symptoms and syndrome in children exposed to disaster.

Method

Three months after Hurricane Hugo, 5,687 school-aged children were surveyed about their experiences and reactions to the hurricane. Self-reports of PTSD symptoms were obtained by use of a PTSD Reaction Index.

Results

The presence of PTSD symptoms was strongly related to children's reported severity of the hurricane, degree of home damage sustained, and continued displacement; however, children's level of trait anxiety and their reported emotional reactivity during the hurricane were more strongly related to the presence of PTSD symptoms than were the exposure factors. Different sets of risk factors appeared to differentially influence the development of the three DSM-III-R PTSD symptom clusters. Little evidence for a differential effect of the risk factors between females and males and younger and older children was found.

Conclusions

Level of trait anxiety appears to be the single strongest risk for the development of severe post-traumatic reactions. The higher rate of post-traumatic symptoms in females and younger children in combination with the absence of differential reaction to the risk factors suggests that females and younger children are more likely to develop posttraumatic reactions following a disaster.",0,0 +6046,Longitudinal analysis of psychological resilience and mental health in Canadian military personnel returning from overseas deployment.,"The relationship between exposure to combat stressors and poorer postdeployment health is well documented. Still, some individuals are more psychologically resilient to such outcomes than others. Researchers have sought to identify the factors that contribute to resilience in order to inform resilience-building interventions. The present study assessed the criterion validity of a model of psychological resilience composed of various intrapersonal and interpersonal variables for predicting mental health among Canadian Forces (CF) members returning from overseas deployment. Participants included 1,584 male CF members who were deployed in support of the mission in Afghanistan between 2008 and 2010. Data on combat experiences and mental health collected through routine postdeployment screening were linked with historical data on the intrapersonal and interpersonal variables from the model. The direct and moderating effects of these variables were assessed using multiple linear regression analyses. Analyses revealed direct effects of only some intrapersonal and interpersonal resilience variables, and provided limited support for moderating effects. Specifically, results emphasized the protective nature of conscientiousness, emotional stability, and positive social interactions. However, other variables demonstrated unexpected negative associations with postdeployment mental health (e.g., positive affect and affectionate social support). Ultimately, results highlight the complexities of resilience, the limitations of previous cross-sectional research on resilience, and potential targets for resilience-building interventions. Additional longitudinal research on the stability of resilience is recommended to build a better understanding of how resilience processes may change over time and contribute to mental health after adverse experiences.",0,0 +6047,Simultaneous Treatment of Neurocognitive and Psychiatric Symptoms in Veterans with Post-Traumatic Stress Disorder and History of Mild Traumatic Brain Injury: A Pilot Study of Mindfulness-Based Stress Reduction,"Treating patient populations with significant psychiatric and neurocognitive symptomatology can present a unique clinical dilemma: progress in psychotherapy can be significantly fettered by cognitive deficits, whereas neurocognitive rehabilitation efforts can be ineffective because of psychiatric overlay. Application of mindfulness-based interventions to address either cognitive or psychiatric symptoms in isolation appears efficacious in many contexts; however, it remains unclear whether this type of intervention might help address simultaneous neurocognitive and psychiatric symptomatology. In a pre-post mixed methods design pilot study, nine Veterans with post-traumatic stress disorder (PTSD) and a history of mild traumatic brain injury with chronic cognitive complaints participated in Mindfulness-Based Stress Reduction (MBSR). Clinical interview, questionnaires, and attention and PTSD measures were administered immediately before, immediately after, and 3 months after MBSR completion. Qualitative and quantitative findings suggest high levels of safety, feasibility, and acceptability. Measurement of attention revealed significant improvement immediately following MBSR (p < 0.05, d = 0.57) and largely sustained improvement 3 months after completion of MBSR (p < 0.10, d = 0.48). Significant reduction in PTSD symptoms was found immediately after MBSR (p < 0.05, d = -1.56), and was sustained 3 months following MBSR completion (p < 0.05, d = -0.93). These results warrant a randomized controlled trial follow-up. Potential mechanisms for the broad effects observed will be explored.",0,0 +6048,Considering resilience in the rehabilitation of people with traumatic disabilities.,"Objectives: To provide discussion on (a) the construct of resilience in relation to people with traumaticinjuries, (b) potential research directions, and (c) reliable and valid measures of resilience. Conclusions:Resilience as a construct is part of the “positive psychology” movement that focuses on identifying thestrengths of an individual when faced with adversity rather than on his or her weaknesses (e.g.,depression, anxiety). Although a universal denition does not exist, resilience is generally considered amultidimensional construct consisting of behaviors, thoughts, and actions, which can be learned over-time. Consequently, there is a growing body of literature examining resilience in different populations(e.g., children, older adults). However, there is a paucity of literature examining the resilience ofindividuals who have experienced a traumatic injury. Potentially, resilience and rehabilitation is a veryfruitful line of research due to the extreme adversity individuals are faced with postinjury when dealingwith the trauma of the injury and resultant impairments.Keywords: resilience, rehabilitation, traumatic, injury",0,0 +6049,Is Partner Violence Worse in the Context of Control?,"M. P. Johnson’s (1995) proposal that there are two qualitatively distinct types of intimate partner violence—intimate terrorism and situational couple violence—has been an influential explanation for disparate findings on sex symmetry in domestic violence. This study examines whether this typology increases our ability to explain variations in the negative outcomes of partner violence as compared with the use of a continuous measure of violence. This study also considers whether the use of control to differentiate between types of violence helps to explain the negative consequences of partner violence. The results, based on analyses of data on 4,575 married women from National Violence Against Women survey, indicate mixed support for Johnson’s argument for a qualitative distinction between IT and SCV.",0,0 +6050,Posttraumatic stress disorder and prolonged grief in refugees exposed to trauma and loss,"BackgroundWhile a large proportion of conflict-affected populations have been dually exposed to trauma and loss, there is inadequate research identifying differential symptom profiles related to bereavement and trauma exposure in these groups. The objective of this study were to (1) determine whether there are distinct classes of posttraumatic stress disorder (PTSD) and prolonged grief disorder (PGD) symptoms in bereaved trauma survivors exposed to conflict and persecution, and (2) examine whether particular types of refugee experiences and stressors differentially predict symptom profiles.MethodsParticipants were 248 Mandaean adult refugees who were assessed at an average of 4.3 years since entering Australia following persecution in Iraq. PTSD, PGD, trauma exposure, adjustment difficulties since relocation, and English proficiency were measured. Latent class analysis was used to elucidate symptom profiles of PTSD and PGD in this sample.ResultsLatent class analysis revealed four classes of participants: a combined PTSD/PGD class (16%), a predominantly PTSD class (25%), a predominantly PGD class (16%), and a resilient class (43%). Whereas membership in the PTSD/PGD class was predicted by exposure to traumatic loss, those in the PGD class were more likely to have experienced adaptation difficulties since relocation, and individuals in the PTSD class were more likely to have experienced difficulties related to loss of culture and support.ConclusionsThis study provides evidence that specific symptom patterns emerge following exposure to mass trauma and loss. These profiles are associated with distinct types of traumatic experiences and post-migration living difficulties. These results have substantial public health implications for assessment and intervention following mass trauma.",0,0 +6051,The prevalence and correlates of adult separation anxiety disorder in an anxiety clinic,"Adult separation anxiety disorder (ASAD) has been identified recently, but there is a paucity of data about its prevalence and associated characteristics amongst anxiety patients. This study assessed the prevalence and risk factor profile associated with ASAD in an anxiety clinic.Clinical psychologists assigned 520 consecutive patients to DSM-IV adult anxiety subcategories using the SCID. We also measured demographic factors and reports of early separation anxiety (the Separation Anxiety Symptom Inventory and a retrospective diagnosis of childhood separation anxiety disorder). Other self-report measures included the Adult Separation Anxiety Symptom Questionnaire (ASA-27), the Depression, Anxiety, Stress Scales (DASS-21), personality traits measured by the NEO PI-R and the Work and Social Adjustment Scale. These measures were included in three models examining for overall differences and then by gender: Model 1 compared the conventional SCID anxiety subtypes (excluding PTSD and OCD because of insufficient numbers); Model 2 divided the sample into those with and without ASAD; Model 3 compared those with ASAD with the individual anxiety subtypes in the residual group.Patients with ASAD had elevated early separation anxiety scores but this association was unique in females only. Except for social phobia in relation to some comparisons, those with ASAD recorded more severe symptoms of depression, anxiety and stress, higher neuroticism scores, and greater levels of disability.Patients with ASAD attending an anxiety clinic are highly symptomatic and disabled. The findings have implications for the classification, clinical identification and treatment of adult anxiety disorders.",0,0 +6052,Posttraumatic Stress Symptoms in Parents of Children with Acute Burns,"To develop a model of risk factors for posttraumatic stress disorder (PTSD) symptoms in parents of children with burns.Immediately following the burn and 3 months later, parents reported on their children's and their own psychological functioning and traumatic stress responses.Approximately 47% of the parents reported experiencing significant posttraumatic stress symptoms 3 months after the burn. Our model indicates three independent pathways to PTSD symptoms (i.e., parent-child conflict, parents' dissociation, and children's PTSD symptoms). Additionally, parents' anxiety predicted increased parent-child conflict, conflict with extended family and size of the burn predicted parents' dissociation, and size of the burn and children's dissociation predicted children's PTSD symptoms.This study suggests that many parents of children with burns suffer from posttraumatic stress symptoms. Interventions that target factors such as family conflict, children's symptoms, and parents' acute anxiety and dissociation may diminish the risk for PTSD.",0,0 +6053,"Comorbidity of PTSD, Major Depression, and Substance Use Disorder Among Adolescent Victims of the Spring 2011 Tornadoes in Alabama and Joplin, Missouri.","The purpose of this study was twofold: (1) to estimate the prevalence of comorbid posttraumatic stress disorder (PTSD), major depressive episode (MDE), and substance use disorder (SUD); and (2) to identify risk factors for patterns of comorbidity among adolescents affected by disasters.A population-based sample of 2,000 adolescents (51% female; 71% Caucasian, 26% African American) aged 12 to 17 years (M = 14.5, SD = 1.7) and their parents was recruited from communities affected by the spring 2011 tornadoes in Alabama and Joplin, Missouri. Participants completed structured telephone interviews assessing demographic characteristics, impact of disaster, prior trauma history, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), symptoms of posttraumatic stress disorder (PTSD) and major depressive episode (MDE), and substance use disorder (SUD) symptoms. Prevalence estimates were calculated for PTSD + MDE, PTSD + SUD, MDE + SUD, and PTSD + MDE + SUD. Hierarchical logistic regression was used to identify risk factors for each comorbidity profile.Overall prevalence since the tornado was 3.7% for PTSD + MDE, 1.1% for PTSD + SUD, 1.0% for MDE + SUD, and 0.7% for PTSD + MDE + SUD. Girls were significantly more likely than boys to meet criteria for PTSD + MDE and MDE + SUD (ps < .05). Female gender, exposure to prior traumatic events, and persistent loss of services were significant risk factors for patterns of comorbidity. Parental injury was associated with elevated risk for PTSD + MDE. Adolescents should be evaluated for comorbid problems, including SUD, following disasters so that appropriate referrals to evidence-based treatments can be made.Results suggest that screening procedures to identify adolescents at risk for comorbid disorders should assess demographic characteristics (gender), impact of the disaster on the family, and adolescents' prior history of stressful events.",0,0 +6054,Paroxetine: safety and tolerability issues,"Paroxetine is a selective serotonin re-uptake inhibitor (SSRI) available in immediate release and controlled release (CR) formulations. Paroxetine is the most potent inhibitor of serotonin re-uptake among the now available SSRIs. Paroxetine has been approved for the treatment of major depressive disorder (MDD), obsessive-compulsive disorder, panic disorder (PD), generalised anxiety disorder, post traumatic stress disorder (PTSD), and social anxiety disorder (SAD) in adults, whereas paroxetine CR is approved for the treatment of MDD, SAD, PD and premenstrual dysphoric disorder in adults. The overall efficacy of paroxetine seems to be comparable to other SSRIs in the treatment of approved indications, although paroxetine treatment induces more sedation, constipation, sexual dysfunction, discontinuation syndrome and weight gain than other SSRIs. Recent data suggest that paroxetine treatment leads to increased rates of congenital malformations, although this evidence is not conclusive. Paroxetine and paroxetine CR are not indicated for use in the paediatric population and are categorised as Pregnancy Class D. In conclusion, whether the tolerability profile of paroxetine differs substantially from other new antidepressants (including other SSRIs) needs to be determined in adequately powered well-designed randomised controlled comparative clinical trials.",0,0 +6055,Trial of Trazodone for Posttraumatic Stress Disorder Using a Multiple Baseline Group Design,"Six patients with combat-related posttraumatic stress disorder (PTSD) entered a multiple-baseline trial of trazodone, beginning with 50 mg/day and increasing to 400 mg/day until response was maximal. Total Clinician-Administered PTSD Scale scores decreased from a mean of 92 at baseline to 79 at end point, and self-reported PTSD symptoms as measured by the Davidson Trauma Scale paralleled these results (mean of 102 at baseline to 88 at end point). Based on clinician global improvement scores, four patients were rated as much improved and two were rated to be minimally improved. Improvement in social and occupational functioning, and depression was minimal. Available follow-up scores for PTSD symptoms indicated that gains were maintained. Sleep was the first symptom to improve at 2 to 3 months. No dropouts during the treatment period occurred, and reported side effects were quite low. These preliminary data suggest that trazodone may be effective in reducing the three primary clusters of symptoms of PTSD. These findings should be confirmed by using a larger sample in a double-blind, placebo-controlled study.",0,0 +6056,New Findings on Alternative Criteria for PTSD in Preschool Children,"An alternative set of criteria for posttraumatic stress disorder (PTSD) for preschool children was analyzed for validity.Sixty-two traumatized children and 63 healthy controls, aged 20 months through 6 years, were assessed. The traumatic experiences included motor vehicle collisions, accidental injuries, abuse, and witnessing violence. The number of symptoms required for clusters C and D and the utility of proposed symptoms were systematically analyzed.No cases met the DSM-IV algorithm for PTSD. Cluster B was endorsed 67.9% of the time. The proportion of cases meeting the cluster C threshold was 2% when three symptoms were required, 11% when two symptoms were required, and 39% when one symptom was required. The rate of cluster D was 45% when two symptoms were required and 73% when one symptom was required. Four novel symptoms did not substantially add to the diagnostic validity of the criteria. The optimal algorithm (one cluster B symptom, one cluster C symptom, and two cluster D symptoms) diagnosed PTSD at a rate of 26%. Measures of comorbid symptoms concurrently provided convergent validation to support this revised algorithm.Revisions to the DSM-IV PTSD criteria continue to be supported so that highly symptomatic young children can be diagnosed.",0,0 +6057,The impact of torture on post-traumatic stress symptoms in war-affected Tamil refugees and immigrants,"The present study examines the effect of torture in generating post-traumatic stress disorder (PTSD) symptoms by comparing its impact with that of other traumas suffered by a war-affected sample of Tamils living in Australia. Traumatic predictors of PTSD were examined among a subsample of 107 Tamils (refugees, asylum seekers, and voluntary immigrants) who had endorsed at least one trauma category on the Harvard Trauma Questionnaire. Principal components analysis (PCA) yielded five trauma factors that were applied to predicting PTSD scores. Tamils exposed to torture returned statistically higher PTSD scores than other war trauma survivors after controlling for overall levels of trauma exposure. The torture factor identified by the PCA was found to be the main predictor of PTSD in a multiple regression analysis. Although limited by sampling constraints and retrospective measurement, the present study provides support for the identification of torture as a particularly traumatic event, even when the impact of other war-related trauma is taken into account.",0,0 +6058,Latent dimensions of posttraumatic stress disorder and their relations with alcohol use disorder,"Purpose: The objective of this study was to evaluate the relationship between factors of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) using confirmatory factor analysis (CFA) in order to further our understanding of the substantial comorbidity between these two disorders.Methods: CFA was used to examine which factors of PTSD's dysphoria model were most related to AUD in a military sample. Ohio National Guard soldiers with a history of overseas deployment participated in the survey (n = 1215). Participants completed the PTSD Checklist and a 12-item survey from the National Survey on Drug Use used to diagnosis AUD.Results: The results of the CFA indicated that a combined model of PTSD's four factors and a single AUD factor fit the data very well. Correlations between PTSD's factors and a latent AUD factor ranged from correlation coefficients of 0.258-0.285, with PTSD's dysphoria factor demonstrating the strongest correlation. However, Wald tests of parameter constraints revealed that AUD was not more correlated with PTSD's dysphoria than other PTSD factors.Conclusions: All four factors of PTSD's dysphoria model demonstrate comparable correlations with AUD. The role of dysphoria to the construct of PTSD is discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0,0 +6059,Characteristics of the first 1000 clients attending an anxiety clinic in South West Sydney,"This paper reports on the clinical and demographic characteristics of the first 1000 consecutive patients attending an anxiety disorders clinic at a district hospital in Sydney, Australia. Data from a large epidemiological study of the Australian population were used as a yardstick for broad comparison. Contrary to past research, a lower prevalence of comorbid anxiety and depression was found in the clinic, possibly because a portion of those patients were filtered out and referred elsewhere for treatment for depression. More female patients attended the clinic than the epidemiological study would predict. Greater numbers of patients with panic disorder, and fewer with posttraumatic stress disorder and social phobia were seen in the clinic than would be predicted by the epidemiological data. Although inferences are tentative because of the differing methods of diagnosis used, the findings indicate the value of comparing epidemiological and clinic profiles to identify those categories of anxiety patients that underutilise services.",0,0 +6060,Endocrine Levels at the Start of Treatment Are Associated With Subsequent Psychological Adjustment in Cancer Patients With Metastatic Disease,"This study examined the association between hormonal profiles at the start of cancer treatment and subsequent psychological symptomatology.Twenty-seven patients with metastatic renal cell carcinoma and 18 patients with metastatic melanoma completed three assessments during the course of treatment: at the start of treatment (baseline), at the end of treatment (3 weeks after baseline), and at a follow-up appointment 1 month later. Cortisol, norepinephrine, and epinephrine levels were measured at baseline using 15-hour urine samples. At each assessment, patients completed the Impact of Event Scale (IES) and the Brief Symptom Inventory (BSI).Patients reported moderate levels of distress throughout treatment as measured by the IES and BSI. Norepinephrine levels at the start of treatment were positively associated with IES total scores at the end of treatment and at follow-up, and cortisol levels were positively associated with IES total scores at follow-up after adjusting for baseline IES and overall distress scores. Norepinephrine levels were also positively associated with depression scores at follow-up, and cortisol levels were positively associated with depression scores at the end of treatment and at follow-up after adjusting for baseline depression and overall distress scores.Hormonal profiles at the start of cancer treatment are associated with subsequent psychological adjustment.",0,0 +6061,"Developing new treatments: on the interplay between theories, experimental science and clinical innovation","It is often argued that behaviour therapy and cognitive-behaviour therapy have a sound theoretical and experimental basis. In the early days of behaviour therapy, the learning theory accounts that were the basis of treatment made clear suggestions about the procedures that were likely to be effective in treatment. In contrast, more recent cognitive-behavioural models tend to specify targets for therapy, but not the procedures that might be optimal for changing the targets. As a consequence, a considerable amount of work has to be done in order to create an effective cognitive-behavioural treatment from a promising cognitive-behavioural model. The process by which cognitive-behavioural treatments are developed is rarely discussed in the literature. For this reason, the way in which one group has used a mixture of phenomenological, experimental and treatment development studies to create effective cognitive therapy programmes for anxiety disorders is described.",0,0 +6062,Effects of acute tryptophan depletion in serotonin reuptake inhibitor-remitted patients with generalized anxiety disorder,"BACKGROUND: Serotonergic antidepressants [selective serotonin reuptake inhibitor (SSRI)] are first-line treatments for generalised anxiety disorder (GAD); however, it is not known if synaptic serotonin (5-HT) availability is important for SSRI efficacy. The present study tested the hypothesis that temporary reduction in central 5-HT transmission, through acute tryptophan depletion (ATD), would reverse the therapeutic effect of the SSRIs in GAD patients. METHODS: Twelve patients (six males) with GAD, who showed sustained clinical improvement with SSRI treatment, underwent ATD in a double-blind, placebo-controlled, within-subjects design over 2 days, 1 week apart. At the peak time of depletion, the participants inhaled 7.5% CO2 and air in random order for at least 12 min each. Psychological responses were measured using the Spielberger State Anxiety Inventory (STAI-S) and GAD-symptom visual analogue scales (VASs; e.g., worry and tense) and Profile of Mood States. RESULTS: Free plasma tryptophan to large neutral amino acid (LNAA) ratio decreased by 92% on the depletion day and decreased by 2% on the control day. Irrespective of depletion condition, 7.5% CO(2) inhalation significantly increased STAI-S and GAD-related VAS scores (all p < 0.05) compared with air inhalation. ATD had no effect on any of these measures despite the substantial reduction in free tryptophan/LNAA ratio. CONCLUSIONS: Although SSRIs treat GAD effectively, the present results suggest that the mechanism of action is different to that seen in panic, social anxiety, and post-traumatic stress disorders. Successful SSRI treatment of GAD may involve long-term receptor changes or alterations in other neurotransmitter systems downstream of serotonin.",0,0 +6063,Agomelatine: mechanism of action and pharmacological profile in relation to antidepressant properties,"Agomelatine behaves both as a potent agonist at melatonin MT1 and MT2 receptors and as a neutral antagonist at 5-HT2C receptors. Accumulating evidence in a broad range of experimental procedures supports the notion that the psychotropic effects of agomelatine are due to the synergy between its melatonergic and 5-hydroxytryptaminergic effects. The recent demonstration of the existence of heteromeric complexes of MT1 and MT2 with 5-HT2C receptors at the cellular level may explain how these two properties of agomelatine translate into a synergistic action that, for example, leads to increases in hippocampal proliferation, maturation and survival through modulation of multiple cellular pathways (increase in trophic factors, synaptic remodelling, glutamate signalling) and key targets (early genes, kinases). The present review focuses on the pharmacological properties of this novel antidepressant. Its mechanism of action, strikingly different from that of conventional classes of antidepressants, opens perspectives towards a better understanding of the physiopathological bases underlying depression.",0,0 +6064,Behavioural sleep problems in children with attention-deficit/hyperactivity disorder (ADHD): protocol for a prospective cohort study,"Children with attention-deficit/hyperactivity disorder (ADHD) commonly experience behavioural sleep problems, yet these difficulties are not routinely assessed and managed in this group. Presenting with similar symptoms to ADHD itself, sleep problems are complex in children with ADHD and their aetiology is likely to be multifactorial. Common internalising and externalising comorbidities have been associated with sleep problems in children with ADHD; however, this relationship is yet to be fully elucidated. Furthermore, limited longitudinal data exist on sleep problems in children with ADHD, thus their persistence and impact remain unknown. In a diverse sample of children with ADHD, this study aims to: (1) quantify the relationship between sleep problems and internalising and externalising comorbidities; (2) examine sleep problem trajectories and risk factors; and (3) examine the longitudinal associations between sleep problems and child and family functioning over a 12-month period.A prospective cohort study of 400 children with ADHD (150 with no/mild sleep problems, 250 with moderate/severe sleep problems) recruited from paediatric practices across Victoria, Australia. The children's parents and teacher provide data at baseline and 6-month and 12-month post enrolment.Parent report of child's sleep problem severity (no, mild, moderate, severe); specific sleep domain scores assessed using the Child Sleep Habits Questionnaire; internalising and externalising comorbidities assessed by the Anxiety Disorders Interview Schedule for Children IV/Parent version.Multiple variable logistic and linear regression models examining the associations between key measures, adjusted for confounders identified a priori.Ethics approval has been granted. Findings will contribute to our understanding of behavioural sleep problems in children with ADHD. Clinically, they could improve the assessment and management of sleep problems in this group. We will seek to publish in leading paediatric journals, present at conferences and inform Australian paediatricians through the Australian Paediatric Research Network.",0,0 +6065,The use of psychosocial stress scales in preterm birth research,"Psychosocial stress has been identified as a potential risk factor for preterm birth. However, an association has not been found consistently, and a consensus on the extent to which stress and preterm birth are linked is still lacking. A literature search was performed with a combination of keywords and MeSH terms to detect studies of psychosocial stress and preterm birth. Studies were included in the review if psychosocial stress was measured with a standardized, validated instrument and if the outcomes included either preterm birth or low birthweight. Within the 138 studies that met inclusion criteria, 85 different instruments were used. Measures that had been designed specifically for pregnancy were used infrequently, although scales were sometimes modified for the pregnant population. The many different measures that have been used may be a factor that accounts for the inconsistent associations that have been observed.",0,0 +6066,Brain-derived neurotrophic factor and inflammatory markers in school-aged children with early trauma,"Objective The impact of childhood trauma (CT) on brain-derived neurotrophic factor (BDNF) and cytokines levels remains unclear. We investigated the association between CT and changes in BDNF and cytokines plasma levels in children. Method We recruited 36 children with trauma (CT+) and 26 children without trauma (CT-). The presence of CT was based on a clinical interview and by Criteria A of DSM-IV criteria for PTSD. Blood samples were drawn from all children to assess BDNF and cytokines. ancova was performed with psychiatric symptoms and BMI as covariates to evaluate group differences in plasma levels. Results CT+ showed increased levels of BDNF and TNF-α after excluding children with history of inflammatory disease (P < 0.05) when compared with those CT-. IL-12p70, IL-6, IL-8, IL-10, and IL-1β levels were not statistically different between groups. Conclusion CT+ showed increased BDNF and proinflammatory cytokines levels. The increase in BDNF levels may be an attempt to neutralize the negative effects of CT, while an increase in TNF-a levels be associated with a proinflammatory state after CT. How these changes associated with trauma relate to other biological changes and illness trajectory later in life remain to be further studied.",0,0 +6067,Factors associated with suicidal ideation in OEF/OIF veterans,"The purpose of this project was to examine factors associated with suicidal ideation in returning Iraq and Afghanistan war veterans.A cross-sectional review of 1740 veterans' initial mental health screening evaluations. One-hundred and thirteen (6.5%) OEF/OIF veterans reported active suicidal ideation at the time of the interview.Prior exposures of physical or sexual abuse and having a history of a prior suicide attempt(s) were associated with the presence of current suicidal ideation, as were having a diagnosis of a psychotic disorder, a depressive disorder, or posttraumatic stress disorder (PTSD). Deployment concerns related to training (protective), the deployment environment, family concerns, deployment concerns, post-deployment support (protective), and post-deployment stressors were also associated with current suicidal ideation. Logistic regression analysis revealed the major risk factors were having a prior suicide attempt, female gender, and a depressive disorder diagnosis; while more perceived current social support was a protective factor. Logistic regression analysis also revealed having comorbid PTSD and depression carried a higher odds ratio for risk than did having either PTSD or depression alone; and that the PTSD avoidance symptom-cluster was associated with more risk than either the re-experiencing or hyper-arousal symptom clusters for current suicidal ideation.As a cross-sectional retrospective medical chart review, limitations include limited generalizability and causal relationships cannot be evaluated.Further investigation of these risk factors is warranted to aid in suicide risk assessment and in the development of targeted interventions to mitigate the identified risk factors and bolster the identified protective factor.",0,0 +6068,Post-Traumatic Stress Disorder and Coronary Heart Disease,"Post-traumatic stress disorder (PTSD) is a mental health condition that occurs relatively commonly in people exposed to situations that cause severe psychological stress, such as natural disasters, combat, or physical attack. In this issue of the Journal , Vaccarino et al. [(1)][1] report that the",0,0 +6069,Mental health and general wellness in the aftermath of Hurricane Ike,"Exposure to natural disasters has been linked to a range of adverse outcomes, including mental health problems (e.g., posttraumatic stress symptoms [PTSS], depression), declines in role functioning (e.g., occupational difficulties), and physical health problems (e.g., somatic complaints). However, prior research and theory suggest that the modal postdisaster response in each of these domains is resilience, defined as low levels of symptoms or problems in a given outcome over time, with minimal elevations that are limited to the time period during the disaster and its immediate aftermath. However, the extent to which disaster survivors exhibit mental health wellness (resilience across multiple mental health conditions) or general wellness (resilience across mental health, physical health, and role functioning domains) remains unexplored. The purpose of this study was to quantify mental health and general wellness, and to examine predictors of each form of wellness, in a three-wave population-based study of Hurricane Ike survivors (N = 658). Latent class growth analysis was used to determine the frequency of resilience on four outcomes (PTSS: 74.9%; depression: 57.9%; functional impairment: 45.1%; days of poor health: 52.6%), and cross-tabulations were used to determine the frequency of mental health wellness (51.2%) and general wellness (26.1%). Significant predictors of both mental health and general wellness included lower peri-event emotional reactions and higher community-level collective efficacy; loss of sentimental possessions or pets and disaster-related financial loss were negative predictors of mental health wellness, and loss of personal property was a negative predictor of general wellness. The results suggest that studies focusing on a single postdisaster outcome may have overestimated the prevalence of mental health and general wellness, and that peri-event responses, personal property loss and collective efficacy have a cross-cutting influence across multiple domains of postdisaster functioning.",1,0 +6070,Treatment Processes of Counseling for Children in South Sudan: A Multiple n = 1 Design,"Studies into treatment processes in low-income settings are grossly lacking, which contributes to the scarcity of evidence-based psychosocial treatment. We conducted multiple n = 1 studies, with quantitative outcome indicators (depression-, PTSD- and anxiety- symptoms, hope) and qualitative process indicators (treatment- perceptions, content and progress) measured before, during and after counseling. We aimed to explore commonalities in treatment processes associated with change profiles within and between cases. The study was conducted in South Sudan with children aged between 10 and 15 years. Change profiles were associated with the quality of the counselor-client relationship (instilling trust and hope through self-disclosure, supportive listening and advice giving), level of client activation, and the ability of the counselor to match treatment strategies to the client's problem presentation (trauma- and emotional processing, problem solving, cognitive strategies). With limited time, due to restricted resources in low-income settings, training courses can now be better focused on key treatment processes. © 2013 Springer Science+Business Media New York.",0,0 +6071,"Anti- Diabetic effects of Crataegus's SPP Branchlet on Blood Lipids, Glucose and Anti-Oxidant Factors in Streptozotocin- Induced Diabetic Rats","Background and purpose: The epidemic of diabetes mellitus is one of the main concerns of the global health arena. This study investigated the effect of oral shoot Crateagus's SPP Branchlet on blood glucose, lipid profile, the level of oxidative stress in diabetic rats. Materials and methods: In this experimental study, we compared four groups of 15 teeth matched male rats: control, control treated with Crataegus's SPP Branchlet powder shoot, diabetic and diabetic treated with powder shoot. High blood glucose of 300 mg/dl and more was considered as an indicator of diabetes. Indicators of oxidative stress, including catalase, malonaldehyde, Superoxide Dismutase, glutathione peroxides and lipid parameters including triglycerides, total cholesterol, LDL, HDL, VLDL and also blood sugar and weight of rats were measured and reported using the mean and SD. Results: The statistical analysis of repeated measures analysis of variance showed that serum glucose, lipid profile (P<0.001) and the indicators of oxidative stress (PGPX, SOD, CAT, MDA< 0.001) were significantly affected with hawthorn. At significant level of 0.05, there is no difference between the treatment groups with control and diabetic groups for catalase. In diabetic rates, significant weight loss was achieved over time and compared with the control group (P<0.001). Conclusion: Based on our study, oral administration of Crataegus's SPP Branchlet in experimental diabetic male rats can improve blood sugar, lipids profile and oxidative stress disorders.",0,0 +6072,Psychological Characteristics of Wounded and Disabled Croatian War Veterans,"Abstract Objective: Evaluation of the psychological state of a group of 119 Croatian disabled war veterans who suffered grave traumatic war experiences during the war in Croatia (1991–1992). Methods: Semistructured Clinical Interview, Profile Index Emotions test, and Zung's Self-Rating Depression Scale were used to assess disabled war veterans accommodated in special institutions for rehabilitation. Results: Changes in psychological functioning were established in 63.8% of disabled war veterans, the most frequent among them being indisposition, irritability, anxiety, and fear. In nearly half of the veterans there were changes in their relationships with close persons, difficulties in accepting the reality of their situations, and increased aggressiveness. Higher average values on the depression index (0.52) were also established. Conclusion: The established change in the psychological profile of disabled Croatian war veterans was lower than expected. However, because of their great vulnerability, it is necessary to increase efforts to secure their complete psychosocial recovery.",0,0 +6073,β2 Nicotinic acetylcholine receptor availability in post-traumatic stress disorder,"Availability of nicotinic acetylcholine receptors containing beta2 subunits (beta2-nAChRs) was studied in unmedicated, symptomatic patients with post-traumatic stress disorder (PTSD) and healthy control subjects, all current non-smokers. A subgroup of participants had a history of smoking. Availability of beta2-nAChRs in the mesiotemporal cortex, prefrontal cortex, thalamus and striatum was determined using the radiotracer [123I]5-IA-85380 ([123I]5-IA) and single-photon emission computed tomography (SPECT). PTSD symptoms were assessed using the Clinician-Administered PTSD Scale (CAPS). Never-smoking PTSD patients compared to never-smoking healthy controls showed significantly higher [123I]5-IA binding in the mesiotemporal cortex (ANOVA: F=6.21, d.f.=1, 11, p=0.030). Among all PTSD patients, there was a significant correlation between the re-experiencing symptom cluster and thalamic [123I]5-IA binding (R2=0.66, p=0.019, Bonferroni corrected). These findings not only suggest an involvement of beta2-nAChRs in the pathophysiology of PTSD but also raise the possibility that this receptor may be a novel molecular target for drug development.",0,0 +6074,CHILDHOOD TRAUMA AND SUBCLINICAL PSYCHOTIC EXPERIENCES IN YOUNG ADULTHOOD: 20-YEAR LONGITUDINAL ANALYSES OF TWO COHORT STUDIES,"Subclinical psychotic experiences (SPE) can progress to serious psychotic disorder (most commonly schizophrenia). There is increasing recognition that people who have experienced childhood trauma have a higher rate of SPE, but these studies are generally retrospective. We report 20-year follow up data on two South Australian cohorts, involving 1339 participants, assessed as children then again as young adults. The first cohort consists of 529 participants exposed to bushfires as children and 464 matched controls. The second cohort consists of 346 participants who grew up in the lead-affected community of Port Pirie. Data collected during childhood for both cohorts included emotional, behavioural and developmental measures. In addition, maternal IQ, children's IQ and lead levels during childhood were assessed in the Port Pirie cohort. The adult evaluations included SPE, total lifetime traumas, and alcohol and cannabis use, collected using questionnaires and structured diagnostic interviews. Analysis of cohort 1 data showed an association between SPE and the total number of traumas experienced by participants. In addition, emotional disturbances and dysfunctional parenting, assessed during childhood, were more common in those with adult SPE. Participants with higher levels of SPE were 4 times more likely to be alcohol dependant and 1.4 times more likely to have symptoms of cannabis dependence. The Port Pirie cohort contained 149 males and 197 females. We looked specifically at gender differences in this cohort and found that trauma exposure during childhood and adolescence was associated with the frequency and distress of both positive and depressive SPE in females only. For male participants, the total number of traumas correlated with only with the level of distress about negative symptoms. Again, alcohol was a stronger predictor of SPE than the use of other drugs including cannabis. In the female Port Pirie participants only, higher cumulative lead levels were associated with greater frequency and distress related to positive SPE. In the male Port Pirie participants, there were relationships between poorer motor and social development at age 3 years and adult SPE. There was a significant negative correlation between maternal IQ and the frequency of SPE reported by the participant 20 years later. In the total Port Pirie sample, greater hyperactivity measured at 7 years was associated with lower frequency and less distress related to negative symptoms in adulthood. There were also associations between aggression and social withdrawal at ages 3-4 years and later SPE. Young people who have experienced a greater number of traumas are more likely to develop SPE. A dysfunctional family environment and childhood behavioural disturbances are also associated with later SPE. We found that alcohol was a stronger predictor of SPE than cannabis. The Port Pirie data shows that there may be gender differences in the pathways to SPE. These findings contribute to our understanding of the contributions of traumatic experiences, lead exposure, family environment and differing developmental trajectories to adult SPE.",0,0 +6075,"Alzheimer's Disease prevalence, costs, and prevention for military personnel and veterans","By 2050, more than 13 million Americans of all ages are estimated to be living with Alzheimer's disease (AD), and the aggregate costs of care will swell to approximately $1.2 trillion. The rapidly climbing number of those affected with AD includes a growing population of aging military veterans affected who may have an added risk for the disease as a consequence of traumatic brain injury, posttraumatic stress disorder, and/or service-related injuries. The increasing number of individuals, the long duration of disability, and the rising cost of care for AD and other dementia to our society are important public health challenges facing many older adults. These challenges are further compounded by a burgeoning military veteran population that is much younger, with an increased risk of AD and other dementia, and who may experience decades-long periods of disability and care. This outlook underscores the critical need for investments in research at the federal and international levels to accelerate the pace of progress in developing breakthrough discoveries that will change the trajectory of AD and related dementia.",0,0 +6076,Influence of Depression on State and Trait Anger in Veterans with Posttraumatic Stress Disorder,"Anger is one of the most important symptoms of posttraumatic stress disorder (PTSD), and is associated with many of the adverse correlates of PTSD. Researchers have proposed theories to explain the relationship between anger and PTSD, but no study to date has examined the mediating role of depression. The purpose of this study was to explore the mediating effects of current major depression disorder (MDD), as well as PTSD numbing and dysphoria symptom clusters (King et al. 1998; Simms et al. 2002) on the relationship between PTSD and anger. There were 98 participants in the study, and all were male veterans with combat-related PTSD taking part in a clinical trial. Results indicated that MDD partially mediated the relationship between PTSD and state anger, while numbing and dysphoria clusters partially mediated the relationships between other PTSD symptom clusters and trait anger. Implications for the treatment of anger in veterans with PTSD are discussed. © 2012 Springer Science+Business Media New York (outside the USA).",0,0 +6077,Responses of International Migrant Women to Abuse Associated With Pregnancy,"The current study aims to identify what newly arrived migrant women do, in the early months post-birth, to respond to abuse associated with pregnancy. Textual data from 59 migrant women were analyzed thematically to identify common responses to abuses. The most common response was to physically leave their countries of origin and move to Canada, or to move out of the shared dwelling. Other responses included taking legal action, remaining silent, reporting the abuse, seeking counseling, isolating themselves, and supporting anger management for the abuser. These results enhance our understanding of the decisions, including inaction, made by migrant women.",0,0 +6078,Plasma brain-derived neurotrophic factor levels in patients suffering from post-traumatic stress disorder,"A number of studies have been done to investigate the role of brain-derived neurotrophic factor (BDNF) in patients with post-traumatic stress disorder (PTSD). In this study we aimed to test the relationship between plasma BDNF levels and PTSD. We solicited 65 subjects having recently experienced road traffic accidents (RTA) conforming to screening criteria. They were given follow-up examinations after one month, three months, and six months. PTSD was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-R-TR, American Psychiatric Association, 2000) using the Mini International Neuropsychiatric Interview (MINI). All participants were divided into two groups: a group with PTSD and a group without PTSD. There were no significant differences in plasma BDNF levels between the two groups at either the 48h or six-month examination. Within the PTSD group, no significant differences were found in plasma BDNF levels between the two examinations. BDNF levels in those without PTSD showed a higher trend over time after trauma. Higher BDNF levels may be an important protective factor for the prevention of traumatized subjects from developing PTSD.",0,0 +6079,"Motor vehicle accidents and adolescents: An empirical study on their emotional and behavioral profiles, defense strategies and parental support","BACKGROUND: Research has limitedly focused on adolescents' emotional-behavioral functioning preceding road collisions and on the role of family support. OBJECTIVE: To verify whether the rates of motorbikes collisions among adolescents are associated with their emotional-behavioral functioning, their use of specific defense strategies and family support. METHOD: N = 150 adolescents who visited an emergency department for road accidents were selected and completed self-report questionnaires assessing emotional-behavioral functioning, difficulty in identifying and describing emotions, use of defense strategies and perceived family support. RESULTS: Higher rates of motorbike collisions are associated with more maladaptive emotional-behavioral functioning. Higher perceived family support is associated with lower rates of collisions. CONCLUSIONS: Recidivism of motor vehicle collision among adolescents can be considered as a form of acting-out caused by their psychological difficulties.",0,0 +6080,Research to practice: a disaster behavioral health framework,"Purpose – Research and experience following a variety of recent disasters has fostered the development of a range of disaster behavioral health interventions that can be used post‐disaster. Consensus documents recommend that five guiding principles be used to inform intervention efforts. These five essential elements, a sense of safety, calming, efficacy, connectedness, and hope, appear critical to the fostering of adaptation and resilience in affected communities. This paper aims to examine the use of these principles in practice.Design/methodology/approach – Translating these five evidence‐informed principles into practice requires dissemination, delivery and prioritizing and validation of the elements. Scholars identify actions for dissemination, delivery, and prioritization and validation, and this paper expands on the literature to identify processes that actualize the research into a framework for practice.Findings – This article describes how disaster behavioral health professionals in Colorado hav...",0,0 +6081,[Prophylaxis and therapy of post-traumatic stress disorder with propranolol: evidence and ethical analysis].,"The beta-antagonistic agent propranolol is increasingly being used in clinical trials for the prophylaxis and treatment of post-traumatic stress disorder (PTSD). This article discusses the evidence for the effectiveness of propranolol in the prophylaxis and treatment of PTSD and the ethical implications of research on these treatment approaches. The efficacy of a prophylactic or therapeutic use could not be shown during the last decade. Both treatment approaches raise ethical questions that should already be addressed during the clinical trials. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0,0 +6082,"Post-traumatic stress influences the brain even in the absence of symptoms: A systematic, quantitative meta-analysis of neuroimaging studies","Stress affects brain function, and may lead to post-traumatic stress disorder (PTSD). Considerable empirical data for the neurobiology of PTSD has been derived from neuroimaging studies, although findings have proven inconsistent. We used an activation likelihood estimation analysis to explore differences in brain activity between adults with and without PTSD in response to affective stimuli. We separated studies by type of control group: trauma-exposed and trauma-naive. This revealed distinct patterns of differences in functional activity. Compared to trauma-exposed controls, regions of the basal ganglia were differentially active in PTSD; whereas the comparison with trauma-naive controls revealed differential involvement in the right anterior insula, precuneus, cingulate and orbitofrontal cortices known to be involved in emotional regulation. Changes in activity in the amygdala and parahippocampal cortex distinguished PTSD from both control groups. Results suggest that trauma has a measurable, enduring effect upon the functional dynamics of the brain, even in individuals who experience trauma but do not develop PTSD. These findings contribute to the understanding of whole-brain network activity following trauma, and its transition to clinical PTSD.",0,0 +6083,"Arousal, numbing, and intrusion: symptom structure of PTSD following assault","This study investigated hypotheses concerning the importance of symptoms of numbing in posttraumatic stress disorder (PTSD).Symptoms of PTSD were assessed in 72 female rape victims and 86 female victims of nonsexual assault approximately 3 months after the crimes occurred. A principal-components factor analysis of subjects' symptoms was then undertaken.The analysis yielded three factors: arousal/avoidance, numbing, and intrusion. These were somewhat different from the symptom clusters in DSM-III-R, since effortful avoidance and numbing symptoms did not load on the same factor. Numbing symptoms appeared to be particularly important in identifying individuals with PTSD.The results imply that there are two patterns of posttrauma symptoms, one characterizing PTSD and the second characterizing a phobic reaction.",0,0 +6084,Manual for ASEBA School-Age Forms & Profiles,,0,0 +6085,Poly-victimization among juvenile justice-involved youths,"This study replicates and extends the research literature on poly-victimization with a vulnerable and under-served population, juvenile justice-involved youths.N=1959, 10-16 year old youths (76% male; 74% youth of color) consecutively newly admitted to juvenile detention facilities completed psychometric measures of trauma history, posttraumatic stress, affect regulation, alcohol/drug use, suicide risk, and somatic complaints.Using latent class analysis derived from 19 types of adversity, three unique classes best fit the data. A poly-victim class (49% female, 51% youth of color) accounted for 5% of the sample and reported a mean of 11.4 (SD=1.1) types. A relatively moderate adversity class (31% female, 70% youth of color) accounted for 36% of the sample and reported a mean of 8.9 (SD=0.3) types of adversity and 2.65 (SD=1.1) types of traumatic adversity. A low adversity class (59% of the sample; 17% female, 78% youth of color) reported a mean of 7.4 (SD=0.4) adversity types but only 0.3 (SD=0.45) types of traumatic adversity. The relatively moderate adversity class was comparable to poly-victims in endorsing extensive non-victimization traumatic adversity (e.g., accidental and loss trauma), but poly-victims were distinct from both moderate and low adversity class members in the likelihood of reporting all but one type of traumatic victimization, multiple types of traumatic victimization, and severe emotional and behavioral problems. Girls were at particularly high risk of poly-victimization, and African American and White youths also were at risk for poly-victimization.Although youth involved in the juvenile justice system typically have experienced substantial victimization, a poly-victimized sub-group, especially (but not exclusively) girls, warrants particular scientific, clinical, and rehabilitative attention in order to address the most severe behavioral and mental health problems and risks faced by this vulnerable population.",0,0 +6086,Chronic social defeat stress disrupts regulation of lipid synthesis,"Several psychiatric disorders increase the risk of cardiovascular disease, including posttraumatic stress disorder and major depression. While the precise mechanism for this association has not yet been established, it has been shown that certain disorders promote an unfavorable lipid profile. To study the interaction of stress and lipid dysregulation, we utilized chronic social defeat stress (CSDS), a mouse model of chronic stress with features of posttraumatic stress disorder and major depression. Following exposure to CSDS, mice were given access to either regular chow or a Western-style diet high in fat and cholesterol (HFD). The combination of social stress and HFD resulted in significant perturbations in lipid regulation, including two key features of the metabolic syndrome: increased plasma levels of non-HDL cholesterol and intrahepatic accumulation of triglycerides. These effects were accompanied by a number of changes in the expression of hepatic genes involved in lipid regulation. Transcriptional activity of LXR, SREBP1c, and ChREBP were significantly affected by exposure to HFD and CSDS. We present CSDS as a model of social stress induced lipid dysregulation and propose that social stress alters lipid metabolism by increasing transcriptional activity of genes involved in lipid synthesis.",0,0 +6087,DSM-5 posttraumatic stress disorder: Factor structure and rates of diagnosis,"Posttraumatic stress disorder (PTSD) is a significant problem among Iraq/Afghanistan-era veterans. To date, however, there has been only limited research on how the recent changes in DSM-5 influence the prevalence and factor structure of PTSD. To address this key issue, the present research used a modified version of a gold-standard clinical interview to assess PTSD among a large sample of Iraq/Afghanistan-era veterans ( N = 414). Thirty-seven percent of the sample met DSM-5 criteria for PTSD compared to a rate of 38% when DSM-IV diagnostic criteria were used. Differences in rates of diagnosis between DSM-IV and DSM-5 were primarily attributable to changes to Criterion A and the separation of the “avoidance” and “numbing” symptoms into separate clusters. Confirmatory factor analysis (CFA) was used to compare the fit of the previous 3-factor DSM-IV model of PTSD to the 4-factor model specified in DSM-5 , a 4-factor “dysphoria” model, and a 5-factor model. CFA demonstrated that the 5-factor model (re-experiencing, active avoidance, emotional numbing, dysphoric arousal, anxious arousal) provided the best overall fit to the data, although substantial support was also found for the 4-factor DSM-5 model. Low factor loadings were noted for two of the symptoms in the DSM-5 model (psychogenic amnesia and reckless/self-destructive behavior), raising questions regarding the adequacy of fit between these symptoms and the other core features of PTSD. Overall, findings suggest the DSM-5 model of PTSD is an improvement over the previous DSM-IV model of PTSD, but still may not represent the true underlying factor structure of PTSD. • We tested the prevalence and factor structure of DSM-5 posttraumatic stress disorder. • 37% of veteran sample met DSM-5 PTSD. • 38% of veteran sample met DSM-IV PTSD. • Confirmatory factor analysis supported DSM-5 symptom structure.",0,0 +6088,"Prolonged Grief Disorder, depression, and posttraumatic stress disorder are distinguishable syndromes","This study examined the distinctiveness of symptoms of Prolonged Grief Disorder (PGD), depression, and posttraumatic stress disorder (PTSD). We compared the fit of a one-factor model with the fit of four hierarchical models in which symptoms formed three distinct correlated higher-order dimensions, and PTSD-items were modeled in different ways.Self-reported data were available from two samples; 572 mourners recruited via the internet and 408 mourners recruited via healthcare workers.In Sample 1, the unitary model did not fit the data. The four hierarchical models all fit better. The model in which PTSD-items constituted four lower-order factors of reexperiencing, avoidance, dysphoria, and hyperarousal fit the data best. The fit was further improved, when one weak PGD-item and one weak PTSD-item were removed, and error-terms of similar items were allowed to correlate. Findings from Sample 1 were replicated in Sample 2.This study relied on self-reported data. Not all PGD-criteria and depression-criteria were assessed.This is the first confirmatory factor analysis study showing that symptoms of PGD, depression, and PTSD represent distinguishable syndromes. PGD-symptoms should be addressed in the assessment and treatment of bereaved people seeking treatment.",0,0 +6089,High-Lethality Status in Patients with Borderline Personality Disorder,"Recurrent suicidal behaviors in patients with Borderline Personality Disorder (BPD) are often considered communicative gestures; however, 10% complete suicide. This study seeks to identify risk factors for suicide within a BPD sample by comparing patients with High- and Low-Lethality attempts. BPD attempters (n = 113) were assessed on demographic, diagnostic, and personality variables: clinical symptoms, suicidal behaviors; childhood, family, and treatment histories; social adjustment; and recent life events. Forty-four High-Lethality attempters, defined by a score of 4 or more on Beck's Medical Lethality Scale, were compared to 69 Low-Lethality attempters. Discriminating variables were entered in a multivariate logistic regression model to define predictors of High-Lethality status. High-Lethality attempters were older, with children, less education, and lower socioeconomic class (SES) than Low-Lethality attempters. They were more likely to have Major Depressive Disorder (MDD), co-morbid Antisocial Personality Disorder (ASPD), and family histories of substance abuse. They reported greater intent to die, more lifetime attempts, hospitalizations, and time in the hospital. High-Lethality status was best predicted by low SES, co-morbid ASPD, extensive treatment histories, and greater intent to die. These characteristics resemble profiles of patients who complete suicide, are not specific for BPD, and do not include impulsivity, aggression, or severity of BPD criteria.",0,0 +6090,Stalking Behavior – An Overview of the Problem and a Case Report of Male-to-Male Stalking during Delusional Disorder,"Stalking is a widespread phenomenon describing a pattern of intrusive and threatening behavior leading to the victim's perception of being harassed and rendered fearful. This paper outlines relevant aspects of the stalking concept and reviews the historical development of this categorization, different typologies of stalking behavior, associated psychiatric diagnoses, frequency and demographic data, psychomedical impact on the victims and therapeutic approaches. Special gender aspects are discussed by presenting a case history of male-to-male stalking.",0,0 +6091,Cognitive change predicts symptom reduction with cognitive therapy for posttraumatic stress disorder.,"There is a growing body of evidence for the effectiveness of trauma-focused cognitive behavior therapy (TF-CBT) for posttraumatic stress disorder (PTSD), but few studies to date have investigated the mechanisms by which TF-CBT leads to therapeutic change. Models of PTSD suggest that a core treatment mechanism is the change in dysfunctional appraisals of the trauma and its aftermath. If this is the case, then changes in appraisals should predict a change in symptoms. The present study investigated whether cognitive change precedes symptom change in Cognitive Therapy for PTSD, a version of TF-CBT.The study analyzed weekly cognitive and symptom measures from 268 PTSD patients who received a course of Cognitive Therapy for PTSD, using bivariate latent growth modeling.Results showed that (a) dysfunctional trauma-related appraisals and PTSD symptoms both decreased significantly over the course of treatment, (b) changes in appraisals and symptoms were correlated, and (c) weekly change in appraisals significantly predicted subsequent reduction in symptom scores (both corrected for the general decrease over the course of therapy). Changes in PTSD symptom severity did not predict subsequent changes in appraisals.The study provided preliminary evidence for the temporal precedence of a reduction in negative trauma-related appraisals in symptom reduction during trauma-focused CBT for PTSD. This supports the role of change in appraisals as an active therapeutic mechanism.",0,0 +6092,"Mothers of adolescent and young adult survivors of childhood cancer: Health beliefs, post-traumatic stress, growth and caregiving practices","Mothers of adolescent and young adult (AYA) childhood cancer survivors often continue to experience psychosocial challenges related to their child's illness and treatment long after the successful treatment of cancer. Such challenges may affect mothers' personal wellbeing and caregiving practices. Three studies were conducted to explore mothers' beliefs regarding their current and future health concerns, how they manage medical issues, relationships, and health-promoting behaviors. A new self-report scale, the Parental Health Competence Beliefs Inventory (pHCBI), was developed (Study 1) to examine the relationship between these beliefs and mothers' psychological well-being (Study 2) and caregiving behavior (Study 3). Eighty-six mothers of AYA childhood cancer survivors were recruited during their child's regularly scheduled clinic visits. Mothers completed the pHCBI and measures of psychosocial wellbeing, including the Perception of Changes in Self questionnaire (PCS) and Posttraumatic Stress Checklist (PCL-C). Exploratory factor analyses (EFA) identified pHCBI scale factors (Study 1) and domains of posttraumatic growth (PTG) (Study 2). Correlational and regression analyses examined the relationships between beliefs, PTG, and posttraumatic stress (PTS). In Study 3, mixed method analyses were used to identify reasons for attending clinic with their child and to explore relationships between these reasons, mothers' beliefs, and demographic and medical variables. The Study 1 EFA revealed a 23-item four-factor solution for the pHCBI: (a) Social Competence, (b) Health Perceptions, (c) Satisfaction with Healthcare, and (d) Health Apprehension. In Study 2, EFA identified three domains of PTG: (a) Interpersonal Relationships, (b) Life Satisfaction, and (c) Life Outlook. Social Competence was correlated with PTG with respect to Interpersonal Relationships and Life Satisfaction. Health Apprehension moderated the linear relationship between PTS and PTG-Life Satisfaction. Qualitative data revealed 10 reasons mothers give for accompanying their child to their follow-up clinic visit (Study 3). Mothers who report lower Satisfaction with Healthcare continued to attend the survivorship clinic out of Concern for Their Child's Health and Wellbeing. The better understanding of mothers' health-related beliefs and caregiving provided by the results of these studies may be useful in promoting mothers' wellbeing and in helping them to adjust to their AYA survivors' growing independence. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0,0 +6093,Adding Missing-Data-Relevant Variables to FIML-Based Structural Equation Models,"Conventional wisdom in missing data research dictates adding variables to the missing data model when those variables are predictive of (a) missingness and (b) the variables containing missingness. However, it has recently been shown that adding variables that are correlated with variables containing missingness, whether or not they are related to missingness, can substantially improve estimation (bias and efficiency). Including large numbers of these auxiliary variables is straightforward for researchers who use multiple imputation. However, what is the researcher to do if 1 of the FIML/SEM procedures is the analysis of choice? This article suggests 2 models for SEM analysis with missing data, and presents simulation results to show that both models provide estimation that is clearly as good as analysis with the EM algorithm, and by extension, multiple imputation. One of these models, the saturated correlates model, also provides good estimates of model fit.",0,0 +6094,Latent classes of childhood trauma exposure predict the development of behavioral health outcomes in adolescence and young adulthood,"Background To develop latent classes of exposure to traumatic experiences before the age of 13 years in an urban community sample and to use these latent classes to predict the development of negative behavioral outcomes in adolescence and young adulthood. Method A total of 1815 participants in an epidemiologically based, randomized field trial as children completed comprehensive psychiatric assessments as young adults. Reported experiences of nine traumatic experiences before age 13 years were used in a latent class analysis to create latent profiles of traumatic experiences. Latent classes were used to predict psychiatric outcomes at age ⩾13 years, criminal convictions, physical health problems and traumatic experiences reported in young adulthood. Results Three latent classes of childhood traumatic experiences were supported by the data. One class (8% of sample), primarily female, was characterized by experiences of sexual assault and reported significantly higher rates of a range of psychiatric outcomes by young adulthood. Another class (8%), primarily male, was characterized by experiences of violence exposure and reported higher levels of antisocial personality disorder and post-traumatic stress. The final class (84%) reported low levels of childhood traumatic experiences. Parental psychopathology was related to membership in the sexual assault group. Conclusions Classes of childhood traumatic experiences predict specific psychiatric and behavioral outcomes in adolescence and young adulthood. The long-term adverse effects of childhood traumas are primarily concentrated in victims of sexual and non-sexual violence. Gender emerged as a key covariate in the classes of trauma exposure and outcomes.",0,0 +6095,Relations Among Peritraumatic Dissociation and Posttraumatic Stress: A Critical Review,"This paper critically reviews the empirical literature addressing the relationship of peritraumatic dissociation to posttraumatic stress. PSYCHLIT and MEDLINE literature searches were conducted to identify relevant studies. The list of articles generated was supplemented by a review of their bibliographies, which resulted in a total of 53 empirical studies. These studies were classified according to the type of potentially traumatizing event investigated and discussed. In the majority of studies, evidence was found for a positive association between peritraumatic dissociation and posttraumatic stress. However, research in this area is limited by several methodological differences and shortcomings with respect to study design, sample characteristics, measurement instruments, and control for moderating or mediating variables. In addition, research is also limited by conceptual problems and the lack of specific time parameters for the occurrence of peritraumatic dissociation. The literature is evaluated according to these methodological differences or shortcomings, and directions for future research are provided.",0,0 +6096,Psychological debriefing for preventing post traumatic stress disorder (PTSD),"Over approximately the last last fifteen years early psychological interventions such as psychological 'debriefing' have been increasingly used to treat psychological trauma. While these intervention have become popular and their use spread to several settings - efficacy had largely not been tested emprically. In 1997 a systmatic review of single session psychological ""debriefing"" was undertaken and this subsequently became a protocol and Cochrane Review published in 1998 (Issue2). This update forms the first substantive update of the original review.To assess the effectiveness of brief psychological debriefing for the management of psychological distress after trauma, and the prevention of post traumatic stress disorder.Electronic searching of MEDLINE, EMBASE, PsychLit, PILOTS, Biosis, Pascal, Occ. Safety and Health,SOCIOFILE, CINAHL, PSYCINFO, PSYNDEX, SIGLE, LILACS, CCTR, CINAHL, NRR, Hand search of Journal of Traumatic Stress. Contact with leading researchers.The inclusion criteria for all randomized studies was that they should focus on persons recently (one month or less) exposed to a traumatic event, should consist of a single session only, and that the intervention involve some form of emotional processing/ventilation by encouraging recollection/reworking of the traumatic event accompanied by normalisation of emotional reaction to the event.11 trials fulfilled the inclusion criteria. Quality was generally poor. Data from two trials could not be synthesised. Two trials involved the use of the intervention in an obstetric setting.Single session individual debriefing did not reduce psychological distress nor prevent the onset of post traumatic stress disorder (PTSD). Those who received the intervention showed no significant short term (3-5 months) in the risk of PTSD (odds ratio 1.22 (95% ci 0.60 to 2.46 )). At one year one trial reported that there was a significantly increased risk of PTSD in those receiving debriefing (odds ratio 2.88 (1.11 to 7.53))odds ratio 95%). There was also no evidence that debriefing reduced general psychological morbidity, depression or anxiety.There is no current evidence that psychological debriefing is a useful treatment for the prevention of post traumatic stress disorder after traumatic incidents. Compulsory debriefing of victims of trauma should cease.",0,0 +6097,"Trajectories of recovery among homeless adults with mental illness who participated in a randomised controlled trial of Housing First: a longitudinal, narrative analysis","This study used longitudinal, narrative data to identify trajectories of recovery among homeless adults with mental illness alongside the factors that contribute to positive, negative, mixed or neutral trajectories over time. We expected that participants who received Housing First (HF) would describe more positive trajectories of recovery than those who were assigned to Treatment as Usual (TAU; no housing or support provided through the study).Narrative interview data were collected from participants at baseline and 18 months after random assignment to HF or TAU.Participants were sampled from the community in Vancouver, British Columbia.Fifty-four participants were randomly and purposively selected from the larger trial; 52 were interviewed at baseline and 43 were reinterviewed 18 months after randomisation.Semistructured interviews were conducted at both time points. For each participant, paired baseline and follow-up narratives were classified as positive, negative, mixed or neutral trajectories of recovery, and thematic analysis was used to identify the factors underlying different trajectories.Participants assigned to HF (n=28) were generally classified as positive or mixed trajectories; those assigned to TAU (n=15) were generally classified as neutral or negative trajectories. Positive trajectories were characterised by a range of benefits associated with good-quality, stable housing (eg, reduced substance use, greater social support), positive expressions of identity and the willingness to self-reflect. Negative, neutral and mixed trajectories were characterised by hopelessness ('things will never get better') related to continued hardship (eg, eviction, substance use problems), perceived failures and loss.HF is associated with positive trajectories of recovery among homeless adults with mental illness. Those who did not receive housing or support continued to struggle across a wide range of life domains. Findings are discussed with implications for addressing services and broader social change in order to benefit this marginalised population.",0,0 +6098,Posttraumatic stress disorder and its comorbidity with depression and somatisation in the elderly – A German community-based study,"Even 60 years after World War II, the German elderly population is significantly more often affected by posttraumatic symptomatology compared to the younger cohorts. This study is addressing prevalence rates of posttraumatic symptomatology and its comorbidity with depression and somatisation.This study examines posttraumatic stress disorder (PTSD) according to DSM-IV, partial PTSD, depression and somatisation in a randomly selected sample of the German general population aged 60-85 years (N = 1.659) using self-rating instruments (Patient Health Questionnaire, PHQ; Post Traumatic Diagnostic Scale, PTDS).One-month prevalence rate was 4.0% for DSM-IV PTSD; another 12.2% fulfilled the criteria of partial PTSD. A significant increase across the age groups was found for partial PTSD. 11.5% of the persons affected by posttraumatic symptomatology fulfil the criteria of a somatoform syndrome, 8.6% fulfil the criteria of major depression and 10.4% fulfil the criteria of other depressive syndromes according to the PHQ. A current posttraumatic symptomatology is associated with increased prevalence rates of somatoform and depressive disorders. Moreover, traumatic experiences without a current PTSD are associated with increased rates of somatoform disorders.Posttraumatic symptomatology is a common phenomenon in the German elderly population. Especially, subsyndromal disorders are very common and increasing across the age groups. Posttraumatic symptomatology is associated with an increased risk of depressive and somatoform disorders. As posttraumatic symptoms are often neglected in geriatric health care, future effort should address the recognition and treatment of posttraumatic symptoms in elderly patients.",0,0 +6099,"An Open Trial of Paroxetine in Patients With Noncombat-Related, Chronic Posttraumatic Stress Disorder","The symptom overlap between posttraumatic stress disorder (PTSD) and other pharmacotherapy-responsive disorders suggests that pharmacotherapy might be effective. Nevertheless, of the eight published placebo-controlled trials investigating the pharmacotherapy of PTSD, only four found statistically significant efficacy for the treatment being studied. This literature possesses a number of methodologic limitations, including the fact that most studies have been conducted with war veterans, who may constitute a more treatment-refractory population. Several open trials and one controlled trial with selective serotonin reuptake inhibitors have reported improvement in some or all core PTSD symptoms (reexperiencing, avoidance, numbing, and hyperarousal). The authors hypothesized that paroxetine might be effective in PTSD, based on findings of its particular efficacy for anxiety and agitation in studies of depressed patients. The study presented here summarizes a 12-week, open-label trial of paroxetine among patients with noncombat-related, chronic PTSD. Outcome was assessed by an independent evaluator, the treating physician, and the patient, with the use of established rating scales for depression, anxiety, general symptoms, and PTSD core symptoms. A repeated-measures analysis of variance revealed highly significant improvement in all three symptom clusters, as well as in associated anxiety, depressive, and dissociative symptoms, with 11 of 17 (65%) patients rated as much or very much improved. The mean reduction in PTSD symptom scores was 48%. Exploratory analyses revealed that cumulative childhood trauma was negatively correlated with pharmacotherapy response (r = -0.52, p = 0.03). There was also significant variation in the time course of response across symptom clusters, which is suggestive of multiple mechanisms of response. Because paroxetine seems a highly promising treatment for all three symptom clusters of PTSD, a placebo-controlled clinical trial is warranted.",0,0 +6100,The management of traumatic stress disorder in infants,"The number of very young children exposed to trauma is under-represented. Trauma interferes with the organisation and development of brain structures and thus may have lasting effects on the individual's life. Traumatic stress disorder (TSD), which is the Axis I diagnosis used in the under-three patient population, encompasses four symptom clusters. Of note is the integral part of the Relationship Disorder Classification (Axis II) during this phase of life. The capacities needed to experience and recall early trauma are largely present from the beginning of life and rapidly develop during the first six months. The treatment of traumatic stress disorder rests on establishing a sense of safety, reducing the overwhelming affects evoked, helping the child to form a coherent narrative and thereby aiding the integration and psychological mastery of the traumatic event. The support of the attachment relationship with an adequate caregiver is pivotal.",0,0 +6101,The Neuropsychological Profile of Comorbid Post-Traumatic Stress Disorder in Adult ADHD,"Objective: ADHD and post-traumatic stress disorder (PTSD) are often comorbid yet despite the increased comorbidity between the two disorders, to our knowledge, no data have been published regarding the neuropsychological profile of adults with comorbid ADHD and PTSD. Likewise, previous empirical studies of the neuropsychology of PTSD did not control for ADHD status. We sought to fill this gap in the literature and to assess the extent to which neuropsychological test performance predicted psychosocial functioning, and perceived quality of life. Method: Participants were 201 adults with ADHD attending an outpatient mental health clinic between 1998 and 2003 and 123 controls without ADHD. Participants completed a large battery of self-report measures and psychological tests. Diagnoses were made using data obtained from structured psychiatric interviews (i.e., Structured Clinical Interview for DSM-IV, Schedule for Affective Disorders and Schizophrenia for School-Age Children Epidemiologic Version). Results: Differences emerged between control participants and participants with ADHD on multiple neuropsychological tests. Across all tests, control participants outperformed participants with ADHD. Differences between the two ADHD groups emerged on seven psychological subtests including multiple Wechsler Adult Intelligence Scale—Third edition and Rey-Osterrieth Complex Figure Test measures. These test differences did not account for self-reported quality of life differences between groups. Conclusion: The comorbidity with PTSD in adults with ADHD is associated with weaker cognitive performance on several tasks that appear related to spatial/perceptual abilities and fluency. Neuropsychological test performances may share variance with the quality of life variables yet are not mediators of the quality of life ratings.",0,0 +6102,Depression and Posttraumatic Stress Disorder at Three Months After Mild to Moderate Traumatic Brain Injury,"To investigate the frequency and risk factors of major depressive disorder (MDD) after mild to moderate traumatic brain injury (TBI), 69 TBI and 52 general trauma (GT) patients were prospectively recruited and studied at 3-months postinjury. There was a nonsignificant difference in the proportion of MDD patients in the TBI and GT groups. Therefore, a composite MDD group (TBI and GT patients) was compared to patients who were nondepressed. Female gender was related to MDD, but no other risk factors were identified. MDD was associated with disability (Glasgow Outcome Scale, Community Integration Questionnaire) and cognitive impairment. MDD was comorbid with posttraumatic stress disorder. Implications for postacute management of mild to moderate TBI are discussed.",0,0 +6103,Executive function in posttraumatic stress disorder (PTSD) and the influence of comorbid depression,"Posttraumatic stress disorder (PTSD) has been associated with neurocognitive deficits, such as impaired verbal memory and executive functioning. Less is known about executive function and the role of comorbid depression in PTSD. Recently, studies have shown that verbal memory impairments may be associated with comorbid depressive symptoms, but their role in executive function impairments is still unclear. To examine several domains of executive functioning in PTSD and the potentially mediating role of comorbid depressive symptoms in the relationship between executive function and PTSD. Executive functioning was assessed in 28 PTSD patients and 28 matched trauma-exposed controls. The Cambridge Neuropsychological Test Automated Battery (CANTAB) with subtests measuring response inhibition (SST), flexibility/set shifting (IED), planning/working memory (OTS) and spatial working memory (SWM) was administered in PTSD patients and trauma-exposed controls. Regression analyses were used to assess the predictive factor of PTSD symptoms (CAPS) and depressive symptoms (HADS-D) in relation to executive function when taking into account the type of trauma. Pearson’s correlations were used to examine the association between PTSD symptom clusters (CAPS) and executive function. The mediating effects of depression and PTSD were assessed using regression coefficients and the Sobel’s test for mediation. Our findings indicate that PTSD patients performed significantly worse on executive function than trauma-exposed controls in all domains assessed. PTSD symptoms contributed to executive functioning impairments (SST median correct, IED total errors, OTS latency to correct, SWM total errors and SWM strategy). Adding depressive symptoms to the model attenuated these effects. PTSD symptom clusters ‘numbing’ and to a lesser extent ‘avoidance’ were more frequently associated with worse executive function (i.e., IED total errors, OTS latency to correct and SWM total errors) than ‘reexperiencing’ and ‘hyperarousal’. Depressive symptoms mediated the relation between PTSD and executive function on some executive function measures (IED total errors and OTS latency to correct), whereas PTSD did not mediate the relation between depression and executive function. PTSD patients perform worse on executive function. The impairments seem to be mostly associated with the less specific PTSD symptom cluster of ‘numbing’. Depressive symptoms seem to mediate the relationship between PTSD and executive function. These findings may have clinical implications with regard to treatment indication and prognosis.",0,0 +6104,Stress-induced neuroplasticity: (Mal)adaptation to adverse life events in patients with PTSD – A critical overview,"Stress is an adaptive response to demands of the environment and thus essential for survival. Exposure to stress triggers hypothalamic-pituitary-adrenocortical (HPA) axis activation and associated neurochemical reactions, following glucocorticoid release from the adrenal glands, accompanied by rapid physiological responses. Stimulation of this pathway results in the activation of specific brain regions, including the hippocampus, amygdala and prefrontal cortex which are enriched with glucocorticoid receptors (GRs). Recent findings indicate that the activation of GRs mediates the regulation of the brain-derived neurotrophic factor (BDNF). BDNF is crucial for neural plasticity, as it promotes cellular growth and synaptic changes. Hence stress-induced activation of these pathways leads to neuroplastic changes, including the formation of long-lasting memories of the experiences. As a consequence, organisms can learn from stressful events and respond in an adaptive manner to similar demands in the future. Whereas an optimal stress level leads to enhancement of memory performance, the exposure to extreme, traumatic or chronic stressors is a risk factor for psychopathologies which are associated with memory impairment and cognitive deficits such as posttraumatic stress disorder (PTSD). In this review article, we will outline the implications of stress exposure on memory formation involving the role of glucocorticoids and BDNF. Within this context, potential adverse effects of neuroplastic alterations will be discussed using the example of PTSD.",0,0 +6105,Effects of psychotherapy on regional cerebral blood flow during trauma imagery in patients with post-traumatic stress disorder: a randomized clinical trial,"Background Functional brain-imaging studies in post-traumatic stress disorder (PTSD) have suggested functional alterations in temporal and prefrontal cortical regions. Effects of psychotherapy on these brain regions have not yet been examined. Method Twenty civilian PTSD out-patients and 15 traumatized control subjects were assessed at baseline using psychometric ratings. Cerebral blood flow was measured using trauma script-driven imagery during 99m technetium hexamethyl-propylene-amine-oxime single-photon emission computed tomography scanning. All 20 out-patients were randomly assigned to treatment or wait-list conditions. Treatment was brief eclectic psychotherapy (BEP) in 16 weekly individual sessions. Results At baseline, greater activation was found in the right insula and right superior/middle frontal gyrus in the PTSD group than in the control group. PTSD patients treated with BEP significantly improved on all PTSD symptom clusters compared to those on the waiting list. After effective psychotherapy, lower activation was measured in the right middle frontal gyrus, compared to the PTSD patients on the waiting list. Treatment effects on PTSD symptoms correlated positively with activation in the left superior temporal gyrus, and superior/middle frontal gyrus. Conclusions BEP induced clinical recovery in PTSD patients, and appeared to modulate the functioning of specific PTSD-related sites in the prefrontal cortical regions.",0,0 +6106,Posttraumatic stress in emergency settings outside North America and Europe: A review of the emic literature,"Mental health professionals from North America and Europe have become common participants in postconflict and disaster relief efforts outside of North America and Europe. Consistent with their training, these practitioners focus primarily on posttraumatic stress disorder (PTSD) as their primary diagnostic concern. Most research that has accompanied humanitarian aid efforts has likewise originated in North America and Europe, has focused on PTSD, and in turn has reinforced practitioners' assumptions about the universality of the diagnosis. In contrast, studies that have attempted to identify how local populations conceptualize posttrauma reactions portray a wide range of psychological states. We review this emic literature in order to examine differences and commonalities across local posttraumatic cultural concepts of distress (CCDs). We focus on symptoms to describe these constructs - i.e., using the dominant neo-Kraepelinian approach used in North American and European psychiatry - as opposed to focusing on explanatory models in order to examine whether positive comparisons of PTSD to CCDs meet criteria for face validity. Hierarchical clustering (Ward's method) of symptoms within CCDs provides a portrait of the emic literature characterized by traumatic multifinality with several common themes. Global variety within the literature suggests that few disaster-affected populations have mental health nosologies that include PTSD-like syndromes. One reason for this seems to be the almost complete absence of avoidance as pathology. Many nosologies contain depression-like disorders. Relief efforts would benefit from mental health practitioners getting specific training in culture-bound posttrauma constructs when entering settings beyond the boundaries of the culture of their training and practice.",0,0 +6107,Profiling Posttraumatic Functional Impairment,"Many individuals who have been exposed to psychological trauma suffer from impaired functioning, regardless of whether they have PTSD. Our purpose was to identify a subset of PTSD symptoms linked to functional impairment to a) improve the likelihood that individuals with posttraumatic impairment receive treatment, and b) offer a method to assess cost-burden of trauma history in epidemiological studies. We examined patterns of trauma-related symptoms in two independent community surveys (N=1002 and 630). Rank ordering of symptoms and their associations with impairment guided construction of an impairment-related profile in the first data set. The profile was then tested in the second data set. The derived symptom profile, consisting of intense recollections and/or emotional symptoms upon exposure to reminders, plus one or more of numbing/detachment, avoidance, sleep problems, concentration problems, or hypervigilance, detected the majority (88% and 74%) of persons with posttraumatic functional impairment. The symptom profile can help identify traumatized individuals who may benefit from treatment but do not necessarily meet criteria for PTSD.",0,0 +6108,"Multidimensional Assessment of Emotion Regulation and Dysregulation: Development, Factor Structure, and Initial Validation of the Difficulties in Emotion Regulation Scale","Given recent attention to emotion regulation as a potentially unifying function of diverse symptom presentations, there is a need for comprehensive measures that adequately assess difficulties in emotion regulation among adults. This paper (a) proposes an integrative conceptualization of emotion regulation as involving not just the modulation of emotional arousal, but also the awareness, understanding, and acceptance of emotions, and the ability to act in desired ways regardless of emotional state; and (b) begins to explore the factor structure and psychometric properties of a new measure, the Difficulties in Emotion Regulation Scale (DERS). Two samples of undergraduate students completed questionnaire packets. Preliminary findings suggest that the DERS has high internal consistency, good test-retest reliability, and adequate construct and predictive validity.",0,0 +6109,The “Thinking a Lot” Idiom of Distress and PTSD: An Examination of Their Relationship among Traumatized Cambodian Refugees Using the “Thinking a Lot” Questionnaire,"“Thinking a lot” (TAL)—also referred to as “thinking too much”—is a key complaint in many cultural contexts, and the current article profiles this idiom of distress among Cambodian refugees. The article also proposes a general model of how TAL generates various types of distress that then cause PTSD-type psychopathology, a model we refer to as the TAL–PTSD model. As tested in this Cambodian refugee sample, the model is supported by the following: (1) the close connection of TAL to PTSD as shown by odds ratio (OR = 19.6), correlation (r = .86), and factor loading; and (2) the mediation of most of the effect of TAL on PTSD by TAL-caused somatic symptoms, catastrophic cognitions, trauma recall, insomnia, and irritability. The questionnaire used in the present study is provided and can be used to examine TAL in other cultural and global contexts to advance the study of this commonly encountered distress form. [idioms of distress, “thinking a lot,” “thinking too much,” Cambodian refugees, PTSD]",0,0 +6110,Impact of Conjoined Exposure to the World Trade Center Attacks and to Other Traumatic Events on the Behavioral Problems of Preschool Children,"To examine the long-term behavioral consequences of exposure to the World Trade Center (WTC) attacks in preschool children and to evaluate whether conjoined exposure to disaster and to other traumatic events has additive effects.Retrospective cohort study.Lower Manhattan, New York.A total of 116 preschool children directly exposed to the WTC attacks. Main Exposures High-intensity WTC attack-related trauma exposure indexed by the child experiencing 1 or more of the following: seeing people jumping out of the towers, seeing dead bodies, seeing injured people, witnessing the towers collapsing, and lifetime history of other trauma exposure. Main Outcome Measure Clinically significant behavioral problems as measured using the Child Behavioral Checklist.Preschool children exposed to high-intensity WTC attack-related events were at increased risk for the sleep problems and anxious/depressed behavioral symptom clusters. Conjoined exposure to high-intensity WTC attack-related events and to other trauma was associated with clinically significant emotionally reactive, anxious/depressed, and sleep-related behavioral problems. Children without a conjoined lifetime history of other trauma did not differ from nonexposed children. Risk of emotionally reactive, anxious/depressed, and attention problems in preschool children exposed to conjoined high-intensity WTC attack-related events and other trauma increased synergistically.Conjoined other trauma exposure seems to amplify the impact of high-intensity WTC attack-related events on behavioral problems. Preschool children exposed to high-intensity events who had no other trauma exposure did not have increased clinically significant behavioral problems. The additive effects of trauma exposure are consistent with an allostatic load hypothesis of stress. More vigorous outreach to trauma-exposed preschool children should become a postdisaster public health priority.",0,0 +6111,Sertraline treatment of comorbid posttraumatic stress disorder and alcohol dependence.,"Posttraumatic stress disorder (PTSD) often co-occurs with alcohol dependence, yet little is known about treatment of this comorbidity. The serotonin selective reuptake inhibitors have been shown preliminarily to be effective in decreasing symptoms of PTSD but have not been studied in individuals with comorbid alcohol dependence. This is of particular interest as the SSRIs also have a modest effect in decreasing alcohol consumption.In this preliminary trial, nine subjects with comorbid PTSD and alcohol dependence were treated in an open-label trial with sertraline for a 12-week period. Symptoms of PTSD and depression were monitored monthly with the Impact of Event Scale and the Hamilton Rating Scale for Depression (HAM-D). Alcohol consumption was monitored by a self-report instrument (Time-Line Follow-Back).There were significant decreases in all three symptom clusters of PTSD measured by overall PTSD symptom scores (p < or = .001) and in HAM-D scores (p < or = .001) during the follow-up period. Days of abstinence increased and average number of drinks decreased during the follow-up period. Four subjects claimed total abstinence during the follow-up period.While limited by small sample size and the open-label, nonblinded study design, this study suggests that sertraline may be useful in the treatment of PTSD complicated by alcoholism. The medication was well tolerated and subjects showed improvement in PTSD symptoms as well as decreased alcohol consumption. A controlled trial of sertraline in this population would be of interest.",0,0 +6112,A group randomized trial of critical incident stress debriefing provided to U.S. peacekeepers,"In a group randomized trial of critical incident stress debriefing (CISD) with platoons of 952 peacekeepers, CISD was compared with a stress management class (SMC) and survey-only (SO) condition. Multilevel growth curve modeling found that CISD did not differentially hasten recovery compared to the other two conditions. For those soldiers reporting the highest degree of exposure to mission stressors, CISD was minimally associated with lower reports of posttraumatic stress and aggression (vs. SMC), higher perceived organizational support (vs. SO), and more alcohol problems than SMC and SO. Soldiers reported that they liked CISD more than the SMC, and CISD did not cause undue distress.",0,0 +6113,Disaster Aid Distribution and Social Conflicts,"Mainstream psychological coping theories that are predominantly individualistic and apolitical tend to neglect diverging interests and social conflicts. Sociological approaches to social conflicts and their resolution and social capital approaches are able to capture these universal features of post-disaster contexts. However, socioculturally distinctive features, specific imbalances of power, and diverging personal and shared ways of dealing with disasters and related aid probably contribute to a locally specific way of coping with disaster aid goods and associated social conflicts. For instance, does the social standard for maintaining harmony (rukun) counter the development of social bitterness? In what way may it hinder resolutions of social conflicts? This chapter explores contributing elements of conflict dynamics and subsequently demonstrates the variety of ways of coping with conflicts. Identified coping styles ranged on a continuum with confrontational, clarifying, and direct (assimilative) strategies on one pole, subversive strategies in the middle, and indirect, accommodative, accepting strategies on the other pole. Several situational elements, such as sense of entitlement, social standing within the community as well as timing issues, that is, the probability of whether justice may still be achieved or not in the short or long term, seemed to moderate which strategy is enacted. © 2014 Springer Science+Business Media, LLC. All rights are reserved.",0,0 +6114,Building child trauma theory from longitudinal studies: A meta-analysis,"Many children are exposed to traumatic events, with potentially serious psychological and developmental consequences. Therefore, understanding development of long-term posttraumatic stress in children is essential. We aimed to contribute to child trauma theory by focusing on theory use and theory validation in longitudinal studies. Forty studies measuring short-term predictors and long-term posttraumatic stress symptoms were identified and coded for theoretical grounding, sample characteristics, and correlational effect sizes. Explicit theoretical frameworks were present in a minority of the studies. Important predictors of long-term posttraumatic stress were symptoms of acute and short-term posttraumatic stress, depression, anxiety, and parental posttraumatic stress. Female gender, injury severity, duration of hospitalization, and elevated heart rate shortly after hospitalization yielded small effect sizes. Age, minority status, and socioeconomic status were not significantly related to long-term posttraumatic stress reactions. Since many other variables were not studied frequently enough to compute effect sizes, existing theoretical frameworks could only be partially confirmed or falsified. Child trauma theory-building can be facilitated by development of encouraging journal policies, the use of comparable methods, and more intense collaboration.",0,0 +6115,Development of the Arabic versions of the Impact of Events Scale‐Revised and the Posttraumatic Growth Inventory to assess trauma and growth in Middle Eastern refugees in Australia,The current study reports on the development of an Arabic version of the Revised version of the Impact of Events Scale (IES‐R). The IES‐R was developed to assist in exploring the relationship betwe...,0,0 +6116,Personal Growth After Severe Fetal Diagnosis,"The traumatic aspects of positive diagnosis of a severe fetal anomaly have garnered the most attention, but the personal growth in the aftermath of this event remains relatively unexplored. We used the five dimensions of growth and change from Posttraumatic Growth Inventory (PTGI) to analyze data generated from ethnographic interviews conducted with 15 women and 10 of their male partners in the aftermath of a severe fetal diagnosis. Eighteen (12 women and 6 men) of these 25 participants experienced positive change across these dimensions. Relating to others was the dimension that showed the most consistent early and prolonged change. Six of the 10 couples had congruent profiles of change. Negative change was evident in 2 women and 2 men. Recognizing the potential for growth allows nurses opportunities to promote it in the aftermath of severe fetal diagnosis.",0,0 +6117,Dysregulation of the Right Brain: A Fundamental Mechanism of Traumatic Attachment and the Psychopathogenesis of Posttraumatic Stress Disorder,"This review integrates recent advances in attachment theory, affective neuroscience, developmental stress research, and infant psychiatry in order to delineate the developmental precursors of posttraumatic stress disorder.Existing attachment, stress physiology, trauma, and neuroscience literatures were collected using Index Medicus/Medline and Psychological Abstracts. This converging interdisciplinary data was used as a theoretical base for modelling the effects of early relational trauma on the developing central and autonomic nervous system activities that drive attachment functions.Current trends that integrate neuropsychiatry, infant psychiatry, and clinical psychiatry are generating more powerful models of the early genesis of a predisposition to psychiatric disorders, including PTSD. Data are presented which suggest that traumatic attachments, expressed in episodes of hyperarousal and dissociation, are imprinted into the developing limbic and autonomic nervous systems of the early maturing right brain. These enduring structural changes lead to the inefficient stress coping mechanisms that lie at the core of infant, child, and adult posttraumatic stress disorders.Disorganised-disoriented insecure attachment, a pattern common in infants abused in the first 2 years of life, is psychologically manifest as an inability to generate a coherent strategy for coping with relational stress. Early abuse negatively impacts the developmental trajectory of the right brain, dominant for attachment, affect regulation, and stress modulation, thereby setting a template for the coping deficits of both mind and body that characterise PTSD symptomatology. These data suggest that early intervention programs can significantly alter the intergenerational transmission of posttraumatic stress disorders.",0,0 +6118,Analysis of neuropsychiatric adverse events during clinical trials of efavirenz in antiretroviral-naive patients: a systematic review.,"People with HIV infection have several risk factors for developing neuropsychiatric adverse events: preexisting conditions, HIV disease stage, and antiretroviral treatment. The most widely used system for assessing neuropsychiatric adverse events in clinical trials is the US Division of AIDS severity grading scale, from Grade 1 (mild) to Grade 4 (life-threatening). First-line treatment with efavirenz has been associated with higher rates of neuropsychiatric adverse events than several other antiretrovirals. A MEDLINE search identified 17 randomized clinical trials of first-line HAART with two nucleoside analogs plus efavirenz, of which 13 reported neuropsychiatric adverse events using the Grade 1-4 system. The percentage of patients with graded neuropsychiatric adverse events, and the system used for analysis, was compared across the trials. Of the 13 trials identified, there were five different methods used to report neuropsychiatric adverse events: Grade 1-4 all, Grade 1-4 drug related, Grade 2-4 all, Grade 2-4 drug related, Grade 3-4 all, Grade 3-4 drug related, and adverse events leading to discontinuation. In addition, three trials used questionnaire-based methods instead of the Division of AIDS grading system. There were a significantly higher percentage of patients with Grade 1-4 neurological or psychiatric adverse events in the efavirenz versus comparator arms in the DMP-006, TMC278-C204, and STARTMRK trials. There were generally too few patients with each individual neuropsychiatric adverse event to allow meaningful comparisons of treatment arms. There were no significant differences in Grade 3 or 4 neuropsychiatric adverse events between the treatment arms in the ACTG 5142 or 2NN trials. In summary, there is a wide range of different systems used to report neuropsychiatric adverse events in HIV clinical trials. Use of a standardized endpoint would improve the interpretability of results across clinical trials.",0,0 +6119,Treatment of Posttraumatic Stress Disorder by Exposure and/or Cognitive Restructuring,"Unanswered questions from controlled studies of posttraumatic stress disorder concern the value of cognitive restructuring alone without prolonged exposure therapy and whether its combination with prolonged exposure is enhancing.In a controlled study, 87 patients with posttraumatic stress disorder of at least 6 months' duration were randomly assigned to have 10 sessions of 1 of 4 treatments: prolonged exposure (imaginal and live) alone; cognitive restructuring alone; combined prolonged exposure and cognitive restructuring; or relaxation without prolonged exposure or cognitive restructuring.Integrity of audiotaped treatment sessions was satisfactory when rated by an assessor unaware of the treatment assignment. Seventy-seven patients completed treatment. The pattern of results was similar regardless of rater, statistical method, measure, occasion, and therapist. Exposure and cognitive restructuring, singly or combined, improved posttraumatic stress disorder markedly on a broad front. Gains continued to 6-month follow-up and were significantly greater than the moderate improvement from relaxation.Both prolonged exposure and cognitive restructuring were each therapeutic on their own, were not mutually enhancing when combined, and were each superior to relaxation.",0,0 +6120,Understanding resilience in armed conflict: Social resources and mental health of children in Burundi,"Little is known about the role of cognitive social capital among war-affected youth in low- and middle-income countries. We examined the longitudinal association between cognitive social capital and mental health (depression and posttraumatic stress disorder (PTSD) symptoms), functioning, and received social support of children in Burundi. Data were obtained from face-to-face interviews with 176 children over three measurement occasions over the span of 4-months. Cognitive social capital measured the degree to which children believed their community was trustworthy and cohesive. Mental health measures included the Depression Self-Rating Scale (DSRS) (Birleson, 1981), the Child Posttraumatic Symptom Scale (Foa et al., 2001), and a locally constructed scale of functional impairment. Children reported received social support by listing whether they received different types of social support from self-selected key individuals. Cross-lagged path analytic modeling evaluated relationships between cognitive social capital, symptoms and received support separately over baseline (T1), 6-week follow-up (T2), and 4-month follow-up (T3). Each concept was treated and analyzed as a continuous score using manifest indicators. Significant associations between study variables were unidirectional. Cognitive social capital was associated with decreased depression between T1 and T2 ( B = −.22, p < .001) and T2 and T3 ( β = −.25, p < .001), and with functional impairment between T1 and T2 ( β = −.15, p = .005) and T2 and T3 ( β = −.14, p = .005); no association was found for PTSD symptoms at either time point. Cognitive social capital was associated with increased social support between T1 and T2 ( β = .16, p = .002) and T2 and T3 ( β = .16, p = .002). In this longitudinal study, cognitive social capital was related to a declining trajectory of children's mental health problems and increases in social support. Interventions that improve community relations in war-affected communities may alter the trajectories of resource loss and gain with conflict-affected children. • Cognitive social capital was associated with less depression. • Cognitive social capital was associated with greater social support. • Change in cognitive social capital was unrelated to social support and depression. • Cognitive social capital is promising for mental health prevention and promotion.",0,0 +6121,What Does National Resilience Mean in a Democracy? Evidence from the United States and Israel,"Given various challenges to national security in democracies, such as terrorism and political violence, a growing need for reconceptualization of the term “resilience” emerges. The interface between national security and resilience is rooted in individuals’ perceptions and attitudes toward institutions and leadership. Therefore, in this article, we suggest that political–psychological features form the basis of citizens’ perceived definitions of national resilience. By comparing national resilience definitions composed by citizens of two democratic countries facing national threats of war and terrorism, the United States and Israel, we found that perceived threats, optimism, and public attitudes such as patriotism and trust in governmental institutions, are the most frequent components of the perceived national resilience. On the basis of these results, a reconceptualization of the term “national resilience” is presented. This can lead to validation of how resilience is measured and provide grounds for further examination of this concept in other democratic countries.",0,0 +6122,Psychological adjustment one year after the diagnosis of breast cancer: A prototype study of delayed post-traumatic stress disorder,"Objective. The utilization of a post-traumatic stress disorder (PTSD) diagnostic framework for categorizing the psychological adjustment of breast cancer (BC) patients has been debated. We wanted to study the prevalence of PTSD and predictors for PTSD. Design. The current study is a one-year follow-up of 64 early BC patients. Methods. PTSD, subclinical PTSD, delayed onset PTSD and several theory-driven predictive variables were examined. Results. Thirteen per cent of the patients showed full symptoms of disease-related PTSD compared with 7% at the initial study (6 weeks after diagnosis). Considerable changes were observed in all PTSD clusters (intrusion, avoidance, and arousal), in most cases representing a decrease in symptom level. Immature defence style, emotional coping, avoidant behaviour, and negative affectivity were all implicated as predicting variables in a hierarchical multiple regression analysis which explained 65% of the variability of PTSD severity one year after diagnosis. Conclusions. This study highlights the PTSD diagnosis as being highly relevant in oncology settings. Early screening for the above-mentioned four variables may help early identification of the patients most at risk of developing PTSD.",0,0 +6123,Avoidant symptoms in PTSD predict fear circuit activation during multimodal fear extinction,"Convergent evidence suggests that individuals with posttraumatic stress disorder (PTSD) exhibit exaggerated avoidance behaviors as well as abnormalities in Pavlonian fear conditioning. However, the link between the two features of this disorder is not well understood. In order to probe the brain basis of aberrant extinction learning in PTSD, we administered a multimodal classical fear conditioning/extinction paradigm that incorporated affectively relevant information from two sensory channels (visual and tactile) while participants underwent fMRI scanning. The sample consisted of fifteen OEF/OIF veterans with PTSD. In response to conditioned cues and contextual information, greater avoidance symptomatology was associated with greater activation in amygdala, hippocampus, vmPFC, dmPFC, and insula, during both fear acquisition and fear extinction. Heightened responses to previously conditioned stimuli in individuals with more severe PTSD could indicate a deficiency in safety learning, consistent with PTSD symptomatology. The close link between avoidance symptoms and fear circuit activation suggests that this symptom cluster may be a key component of fear extinction deficits in PTSD and/or may be particularly amenable to change through extinction-based therapies.",0,0 +6124,Witnessing Parental Violence as a Traumatic Experience Shaping the Abusive Personality,"Summary Previous work by Dutton and his colleagues has established a clinical profile on intimately abusive adult men that is quite similar to profiles of trauma victims in many essential clinical respects. Dutton (in press) showed that arousal modulation problems, affective monitoring, cognitive problem solving deficits, externalizing attributional styles, aggression and dissociative states are common to both groups. Furthermore, intimately abusive men demonstrate similar profiles as men diagnosed independently with PTSD on the MCMI-II. Dutton (1995a, 1995b) attributed the trauma to early assaults on the self through parental shaming, accompanied by insecure attachment and physical abuse victimization. Bowlby (1973) considered insecure attachment itself both a source and consequence of trauma. Since the infant turns to the attachment-object during periods of distress seeking soothing, a failure to obtain soothing maintains high arousal and endocrine secretion. Van der Kolk (1987) considered child abuse a...",0,0 +6125,The impact of motor vehicle injury on distress: Moderators and trajectories over time,"• Post-motor vehicle injury (MVI) distress increased over time, particularly for men. • Pre-MVI distress predicted post-MVI distress. • The link between pre-MVI alcohol and post-MVI distress varied with pre-MVI distress. • Those with partners experienced less distress than the unpartnered. Research reveals that motor vehicle injuries (MVIs) can result in severe and debilitating psychological distress. Yet, not every person who has sustained a MVI suffers psychologically. It appears that risk of distress varies by demographic and psychosocial characteristics. The present study aimed to explore the trajectories of post-MVI distress and the effect of pre-MVI psychological functioning on post-MVI distress. Hierarchical linear modeling was used to explore the longitudinal dataset from the Canadian National Population Health Survey. Participants were assessed up to nine years post-MVI. Post-MVI distress increased over time. Men experienced greater overall distress than women and a greater increase in distress over time. Pre-MVI distress predicted post-MVI distress. This relationship was strongest for those with greater pre-MVI alcohol consumption. At low levels of pre-MVI distress, greater pre-MVI alcohol consumption was related to lower post-MVI distress, but at high levels of pre-MVI distress, greater pre-MVI alcohol consumption predicted increased post-MVI distress. Those with partners experienced less distress than the unpartnered. This study supports the general findings of other post-MVI and post-trauma studies, although the current study’s main and interaction effects reveal more complex and nuanced relationships among variables in their prediction of post-MVI psychological distress.",0,0 +6126,Paradoxical Pain Perception in Posttraumatic Stress Disorder: The Unique Role of Anxiety and Dissociation,"Posttraumatic stress disorder (PTSD) and chronic pain often co-occur and exacerbate each other. Elucidating the mechanism of this co-occurrence therefore has clinical importance. Previously, patients with PTSD with chronic pain were found to demonstrate a unique paradoxical pain profile: hyperresponsiveness together with hyposensitivity to pain. Our aim was to examine whether 2 seemingly paradoxical facets of PTSD (anxiety and dissociation) underlie this paradoxical profile. Patients with PTSD (n = 32) and healthy control individuals (n = 43) underwent psychophysical testing and completed questionnaires. Patients with PTSD had higher pain thresholds and higher pain ratings to suprathreshold stimuli than control individuals. Pain thresholds were positively associated with dissociation levels and negatively associated with anxiety sensitivity levels. Experimental pain ratings were positively associated with anxiety sensitivity and negatively related to dissociation levels. Chronic pain intensity was associated with anxiety, anxiety sensitivity, and pain catastrophizing. It appears that reduced conscious attention toward incoming stimuli, resulting from dissociation, causes delayed response in pain threshold measurement, whereas biases toward threatening stimuli and decreased inhibition, possibly caused by increased anxiety, are responsible for the intensification of experimental and chronic pain. The paradoxical facets of PTSD and their particular influences over pain perception seem to reinforce the coexistence of PTSD and chronic pain, and should be considered when treating traumatized individuals.This article provides new information regarding the underlying mechanism of the coexistence of PTSD and chronic pain. This knowledge could help to provide better management of PTSD and chronic pain among individuals in the aftermath of trauma.",0,0 +6127,Afectaciones psicológicas de niños y adolescentes expuestos al conflicto armado en una zona rural de Colombia.,"Se determinaron las afectaciones psicológicas de 284 niños y adolescentes expuestos al conflicto armado en una zona rural colombiana, seleccionados mediante un muestreo aleatorio por afijación proporcional. Los instrumentos aplicados fueron: la Lista de chequeo de comportamiento infantil, el Auto-reporte de comportamientos de jóvenes, la Lista de síntomas postraumáticos, la Escala de estrategias de afrontamiento para adolescentes y la Escala de resiliencia para escolares. El 72% de la población presentó afectaciones psicológicas: el 64.4%, conductas internalizadas, el 47%, conductas externalizadas en rango clínico. El 32%, problemas somáticos; el 56%, se encontraba en riesgo de estrés postraumático, y el 93% consumía alcohol en grado moderado. La estrategia de afrontamiento más utilizada era dejar que las cosas se arreglaran solas. Se encontró una alta necesidad de atención en salud. Ser hombre constituyó un factor de riesgo de depresión, agresión y problemas sociales en los niños. A su vez, tener hasta doce años y estar cursando un grado escolar bajo, lo fue para los síntomas somáticos en adolescentes. Los resultados evidenciaron la afectación en la salud mental de los participantes.",0,0 +6128,Changes in PTSD and Depression During Prolonged Exposure and Client-Centered Therapy for PTSD in Adolescents,"Depressive symptoms are common among individuals with posttraumatic stress disorder (PTSD). Prolonged exposure therapy (PE) for PTSD has been found to alleviate both PTSD and depressive symptoms, but relatively little is known about the pattern of PTSD and depressive symptom change during treatment. This study aimed to investigate the relationship between changes in PTSD and depression during PE for adolescent (PE-A) and client-centered therapy (CCT). The moderating role of PE-A versus CCT and the possible differences across symptom clusters of PTSD were also examined. Participants were 61 female adolescents with sexual-assault-related PTSD randomized to PE-A (n = 31) or CCT (n = 30). Participants completed the Beck Depression Inventory and the Child PTSD Symptom Scale at pre-, mid-, and posttreatment and before each treatment session. Multilevel mediation analysis indicated a reciprocal but asymmetrical relationship between changes in PTSD and depression during treatment in the overall sample. Moderated mediation analysis showed that the reciprocal relation was observed only during PE-A. Reductions in PTSD led to reductions in depression to a greater extent (48.7%), 95% confidence interval [30.2, 67.2], than vice versa (22.0%), [10.6, 33.4]. For participants receiving CCT, reduction in PTSD led to reductions in depression (31.6%), [11.8, 51.4], but not vice versa (7.4%), [-7.1, 21.9]. The reciprocal relationship between PTSD and depression was also observed across different symptoms clusters of PTSD. Our findings suggest that changes in PTSD led to changes in depressive symptoms to a greater extent than vice versa across PE-A and CCT.",0,0 +6129,"Traumatic impact of a fire disaster on survivors—A 25-year follow-up of the 1978 hotel fire in Borås, Sweden","The objective of this study was to investigate the long-term psychological and mental health outcomes among survivors of a disastrous hotel fire. A 25-year follow-up investigation among adolescent and young adult survivors of a fire disaster was conducted in Borås, Sweden. A self-evaluation questionnaire and four self-rating scales - the IES-22, PTSS-10, GHQ-28 and SoC - were sent by mail to the participants. The results from the self-reported data showed low levels of psychiatric illness. Moreover, the respondents reported a low level of traumatic stress symptoms. More than 50% of the participants stated that the fire had a determining effect on their lives. Sixteen (21.3%) respondents indicated that the fire still had an impact on their daily lives. Differences between men and women were reported in most of the self-rating scales. The results indicate that a traumatizing experience (such as a fire disaster) still had a small effect on psychological health in a long-term perspective.",0,0 +6130,An evidence-based review of the clinical use of sertraline in mood and anxiety disorders,"Sertraline is a selective serotonin reuptake inhibitor that has been used and studied extensively throughout the world and found to be safe and well tolerated in numerous patient populations, including those with either psychiatric and/or medical comorbidities. Randomized clinical trials have shown that it is an effective treatment for depressive and anxiety disorders and its efficacy is unaffected by psychiatric comorbidity. In non-comorbid patients, sertraline is effective for the acute treatment of major depressive disorders and prevention of relapse or recurrence. It is effective for acute treatment and longer-term management of social anxiety disorder, posttraumatic stress disorder,panic disorder, and generalized anxiety disorder. In adults and in pediatric patients, it is an effective short-term and long-term treatment for obsessive compulsive disorder.Sertraline has a good tolerability profile and has low fatal toxicity. In summary, sertraline is as effective as other antidepressants over a wide range of indications but may offer tolerability benefits as well as efficacy in patients with psychiatric and/or medical comorbidities and certain subtypes of depression.",0,0 +6131,The factor structure of posttraumatic stress disorder symptoms among Rwandans exposed to the 1994 genocide: A confirmatory factor analytic study using the PCL-C,"The factor structure of posttraumatic stress disorder (PTSD) symptoms in Euro-American populations has been extensively studied, but confirmatory factor analytic studies from non-Western societies are lacking. Alternative models of DSM-IV symptoms were tested among Rwandan adults (N=465) who experienced trauma during the 1994 genocide. A cluster random survey was conducted with interviews held in Rwandan households. PTSD was assessed with the Posttraumatic Stress Disorder Checklist-Civilian version. Competing models were the DSM-IV, emotional numbing, dysphoria, aroused intrusion, and dysphoric arousal models. Results showed that the emotional numbing, dysphoria, and dysphoric arousal models had almost identical, good fit indices and fit the data significantly better than the other models. The emotional numbing and dysphoric arousal models also exhibited good construct validity. Results suggest that the latent structure of PTSD symptoms in Rwanda are comparable to that found in Euro-American samples, thereby lending further support to the cross-cultural validity of the construct.",0,0 +6132,The Geography of Mental Health and General Wellness in Galveston Bay After Hurricane Ike: A Spatial Epidemiologic Study With Longitudinal Data,"To demonstrate a spatial epidemiologic approach that could be used in the aftermath of disasters to (1) detect spatial clusters and (2) explore geographic heterogeneity in predictors for mental health and general wellness.We used a cohort study of Hurricane Ike survivors (n=508) to assess the spatial distribution of postdisaster mental health wellness (most likely resilience trajectory for posttraumatic stress symptoms [PTSS] and depression) and general wellness (most likely resilience trajectory for PTSS, depression, functional impairment, and days of poor health) in Galveston, Texas. We applied the spatial scan statistic (SaTScan) and geographically weighted regression.We found spatial clusters of high likelihood wellness in areas north of Texas City and spatial concentrations of low likelihood wellness in Galveston Island. Geographic variation was found in predictors of wellness, showing increasing associations with both forms of wellness the closer respondents were located to Galveston City in Galveston Island.Predictors for postdisaster wellness may manifest differently across geographic space with concentrations of lower likelihood wellness and increased associations with predictors in areas of higher exposure. Our approach could be used to inform geographically targeted interventions to promote mental health and general wellness in disaster-affected communities.",0,0 +6133,"Predictors of decline in overall mental health, PTSD and alcohol use in OEF/OIF veterans","This study identified predictors of worsening mental health (including PTSD and alcohol use) over a 6-month period following return from deployment to Iraq (OIF) or Afghanistan (OIF). Using a national sample of 512 OEF/OIF veterans surveyed within 12 months of return from deployment (T1), and 6 months later (T2), we obtained demographic and deployment characteristics, risk and resilience factors, mental health status, PTSD and alcohol abuse. We performed logistic regression analyses to identify predictors of worse mental health, PTSD or alcohol use between T1 and T2, controlling for initial levels. Of the sample, 14-25% showed clinically worse mental health, PTSD or alcohol use. Each outcome was associated with some shared and some unique predictors. For example, younger age and recent medical care were both associated with worse alcohol use. Lack of adequate deployment training was uniquely associated with worse PTSD symptoms.",0,0 +6134,Exposure to workplace bullying and post-traumatic stress disorder symptomology: the role of protective psychological resources,"To examine the relationship between nurses' exposure to workplace bullying and Post-Traumatic Stress Disorder symptomology and the protective role of psychological capital (PsyCap).Workplace bullying has serious organisational and health effects in nursing. Few studies have examined the relation of workplace bullying to serious mental health outcomes, such as Post-Traumatic Stress Disorder. Even fewer have examined the effect of intrapersonal strengths on the health impact of workplace bullying.A survey of 1205 hospital nurses was conducted to test the hypothesized model. Nurses completed standardized measures of bullying, Post-Traumatic Stress Disorder and PsyCap.A moderated regression analysis revealed that more frequent exposure to workplace bullying was significantly related to Post-Traumatic Stress Disorder symptomology regardless of the PsyCap level. That is, PsyCap did not moderate the bullying/PTSD relationship in either group. Bullying exposure and PsyCap were significant independent predictors of Post-Traumatic Stress Disorder symptoms in both groups. Efficacy, a subdimension of PsyCap, moderated the bullying/Post-Traumatic Stress Disorder relationship only among experienced nurses.Workplace bullying appears to be predictive of Post-Traumatic Stress Disorder symptomology, a serious mental health outcome.Workplace bullying is a serious threat to nurses' health and calls for programmes that eliminate bullying and encourage greater levels of positive resources among nurses.",0,0 +6135,"Accuracy of MMPI–2–RF Validity Scales for Identifying Feigned PTSD Symptoms, Random Responding, and Genuine PTSD","The Minnesota Multiphasic Personality Inventory-2-RF (MMPI-2-RF) validity scales were evaluated to determine accuracy when differentiating honest responding, random responding, genuine posttraumatic stress disorder (PTSD), and feigned PTSD. Undergraduate students (n = 109), screened for PTSD, were randomly assigned to 1 of 4 instructional groups: honest, feign PTSD, half random, and full random. Archival data provided clinical MMPI-2-RF profiles consisting of 31 veterans diagnosed with PTSD. Veterans were diagnosed with PTSD using a structured interview and had passed a structured interview for malingering. Validity scales working as a group had correct classification rates of honest (96.6%), full random (88.9%), genuine PTSD (80.7%), fake PTSD (73.1%), and half random (44.4%). Results were fairly supportive of the scales' ability to discriminate feigning and full random responding from honest responding of normal students as well as veterans with PTSD. However, the RF validity scales do not appear to be as effective in detecting partially random responding.",0,0 +6136,Trauma and resilience in young refugees: A 9-year follow-up study,"The aim of the present study was to assess and understand the long-term trajectory of psychological problems among young Middle Eastern refugees in Denmark. Participants were 131 young refugees from the Middle East (76 girls, 55 boys; mean age = 15.3 years) from 67 families. They were assessed first on arrival in Denmark in 1992-1993 and again 8-9 years later. The high prevalence of psychological problems at arrival was considerably reduced by the time of follow-up, but it was still somewhat higher than what has been found in most community studies using the same assessment tools. Groups of children differed in showing low levels of symptoms at arrival that were stable (spared) or increased (reacting) and high levels at arrival that persisted (traumatized) or decreased (adapted). The number of types of traumatic experiences before arrival distinguished the spared and the traumatized young refugees and the number of types of stressful events after arrival the adapted and the traumatized, also after corrections for age, sex, specific traumatic events, parents' education and health, and the social situation of the young refugees. The study emphasizes the importance of environmental factors for healthy long-term adaptation after traumatic experiences related to war and other organized violence.",0,0 +6137,Attendance and substance use outcomes for the Seeking Safety program: Sometimes less is more.,"This study uses data from the largest effectiveness trial to date on treatment of co-occurring posttraumatic stress and substance use disorders, using advances in statistical methodology for modeling treatment attendance and membership turnover in rolling groups.Women receiving outpatient substance abuse treatment (N = 353) were randomized to 12 sessions of Seeking Safety or a health education control condition. Assessments were completed at baseline and at 1 week, 3, 6, and 12 months posttreatment. Outcome measures were alcohol and cocaine use in the prior 30 days captured using the Addiction Severity Index. Latent class pattern mixture modeling (LCPMM) was used to estimate attendance patterns and to test for treatment effects within and across latent attendance patterns and group membership turnover.Across LCPMM analyses for alcohol and cocaine use, similar treatment attendance patterns emerged: Completers never decreased below an 80% probability of attendance, droppers never exceeded a 41% probability of attendance, and titrators demonstrated a 50% to 80% probability of attendance. Among completers, there were significant decreases in alcohol use from baseline to 1-week posttreatment, followed by nonsignificant increases in alcohol during follow-up. No differences between treatment conditions were detected. Titrators in Seeking Safety had lower rates of alcohol use from 1-week through 12-month follow-up compared with control participants. Droppers had nonsignificant increases in alcohol during both study phases. Cocaine use findings were similar but did not reach significance levels.The impact of client self-modulation of treatment dosage and group membership composition may influence behavioral treatment outcomes among this population.",0,0 +6138,Debating war-trauma and post-traumatic stress disorder (PTSD) in an interdisciplinary arena,"Researchers have tried to determine and verify the effects of violent conflicts on the mental health of those affected by focusing on war trauma, posttraumatic stress disorder (PTSD), and other trauma-related disorders. This, in turn, led to the development of different kinds of theories and aid programs that aim at preventing and treating the consequences of violence and mental health. Until now, there is no agreement on the public health value of the concept of PTSD and no agreement on the appropriate type of mental-health care. Instead, psychiatrists have engaged in sometimes fierce discussions over the universality of war trauma, PTSD, and other trauma-related disorders. The two most polar positions are those who try to validate PTSD as a universal and cross-culturally valid psychopathological response to traumatic distress which may be cured or ameliorated with (Western) clinical and psychosocial therapeutic measures, and those who argue that the Western discourse on trauma only makes sense in the context of a particular cultural and moral framework and, therefore, becomes problematic in the context of other cultural and social settings. Although these positions seem mutually exclusive, their debates have led to the development of less radical approaches toward war-trauma and PTSD. The purpose of this literature review is to analyse the discourses on and debates over war-trauma and PTSD in the psychiatric literature in order to establish a better understanding for the diverse conceptualizations, interpretations and proposed healing strategies. Moreover, I discuss the cultural construction and conceptualization of war-trauma and PTSD from an anthropological perspective and show how anthropologists contribute to psychiatric debates so as to ensure more sophisticated diagnoses and healing strategies in culturally diverse contexts.",0,0 +6139,"Adolescent Adjustment, Caregiver-Adolescent Relationships, and Outlook Towards the Future in the Long-Term Aftermath of the Bosnian War","Using a mixed-method design with Bosnian students (n = 63, ages 16–19) and their primary caregivers (n = 50), we explored the impact of post-war adversities on adolescent adjustment, adolescent-caregiver relationships, and future outlook 8 years after the 1992–1995 Bosnian civil war. Adolescents and caregivers identified themes linking the war and its aftermath to ongoing emotional adjustment difficulties, relationships challenges, and negative future outlook. Adolescents’ posttraumatic stress symptoms were positively correlated with self-report measures of interpersonal stressors, existential stressors, parental psychological control, and anxious/withdrawn symptoms. Parental psychological control partially mediated the association between interpersonal post-war adversities and posttraumatic stress symptoms. © 2015, Springer International Publishing.",0,0 +6140,Elaboration on posttraumatic stress disorder diagnostic criteria: a factor analytic study of PTSD exposure to war or terror.,"In societies facing prolonged exposure to war and terror, empirical research provides mixed support for the posttraumatic stress disorder (PTSD) symptom clusters groupings identified by the Diagnostic and Statistical Manual (DSM-IV-TR) as re-experiencing the event, avoidance and emotional numbing, and hyperarousal.This study examines the validity of the PTSD symptom clusters in elements of Israeli society exposed to man-made trauma. Survivors (N=2,198) of seven different war and terror-related traumas were assessed using a DSM-IV-TR based PTSD inventory. Four confirmatory factor analytic models were compared.The most acceptable model was a correlated model consisting of four factors of re-experiencing, avoidance, emotional numbing, and hyperarousal. DSM-IV-TR avoidance empirically split into active avoidance and emotional numbing. These results corroborate knowledge and suggest that in Israel, where stressors are ongoing, the PTSD symptom clusters may be reformulated in DSM-5 to consist of re-experiencing, active avoidance, emotional numbing and hyperarousal.",0,0 +6141,Diagnostic accuracy of three scoring methods for the Davidson Trauma Scale among U.S. military Veterans,"• Three scoring methods for the Davidson Trauma Scale were compared. • Subjects were 804 Afghanistan and Iraq war-era military Service Members and Veterans. • Adding a cut score to the symptom cluster method generally improved specificity. • Cut score in the range of 68–72 provided optimal diagnostic accuracy. Self-report questionnaires are frequently used to identify PTSD among U.S. military personnel and Veterans. Two common scoring methods used to classify PTSD include: (1) a cut score threshold and (2) endorsement of PTSD symptoms meeting DSM-IV-TR symptom cluster criteria (SCM). A third method requiring a cut score in addition to SCM has been proposed, but has received little study. The current study examined the diagnostic accuracy of three scoring methods for the Davidson Trauma Scale (DTS) among 804 Afghanistan and Iraq war-era military Service Members and Veterans. Data were weighted to approximate the prevalence of PTSD and other Axis I disorders in VA primary care. As expected, adding a cut score criterion to SCM improved specificity and positive predictive power. However, a cut score of 68–72 provided optimal diagnostic accuracy. The utility of the DTS, the role of baseline prevalence, and recommendations for future research are discussed.",0,0 +6142,Social support in Vietnam veterans with posttraumatic stress disorder: A comparative analysis.,,0,0 +6143,"Factor structure, internal consistency and reliability of the Posttraumatic Stress Disorder Checklist (PCL): an exploratory study","Posttraumatic stress disorder (PTSD) is an anxiety disorder resulting from exposure to traumatic events. The Posttraumatic Stress Disorder Checklist (PCL) is a self-report measure largely used to evaluate the presence of PTSD.To investigate the internal consistency, temporal reliability and factor validity of the Portuguese language version of the PCL used in Brazil.A total of 186 participants were recruited. The sample was heterogeneous with regard to occupation, sociodemographic data, mental health history, and exposure to traumatic events. Subjects answered the PCL at two occasions within a 15 days' interval (range: 5-15 days).Cronbach's alpha coefficients indicated high internal consistency for the total scale (0.91) and for the theoretical dimensions of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) (0.83, 0.81, and 0.80). Temporal reliability (test-retest) was high and consistent for different cutoffs. Maximum likelihood exploratory factor analysis (EFA) was conducted and oblique rotation (Promax) was applied. The Kaiser-Meyer-Olkin (KMO) index (0.911) and Bartlett's test of sphericity (χ² = 1,381.34, p < 0.001) indicated that correlation matrices were suitable for factor analysis. The analysis yielded three symptom clusters which accounted for 48.9% of the variance, namely, intrusions, avoidance, and numbing-hyperarousal.Our findings provide additional data regarding the psychometric properties of the PCL, including internal consistency, test-retest reliability, and factor validity. Results are discussed in relation to PTSD theoretical models.",0,0 +6144,DEVELOPMENT OF A GUIDED SELF-HELP (GSH) PROGRAM FOR THE TREATMENT OF MILD-TO-MODERATE POSTTRAUMATIC STRESS DISORDER (PTSD),"There is a shortage of suitably qualified therapists able to deliver evidence-based treatment for posttraumatic stress disorder (PTSD), precluding timely access to intervention. This work aimed to develop an optimally effective, feasible, and acceptable guided self-help (GSH) program for treatment of the disorder.The study followed Medical Research Council (MRC) guidance for the development of a complex intervention. A prototype GSH program was developed through an initial modeling phase. Systematic reviews of the literature informed a portfolio of up-to-date information for key stakeholders to consider and discuss in a series of focus groups and semistructured interviews, which included 10 mental health professionals with expertise in the fields of GSH and/or PTSD, and seven former PTSD sufferers. Data were analyzed through a process of Inductive Thematic Analysis and used to inform the content, delivery, and guidance of a GSH program for PTSD. The prototype was piloted with 19 PTSD sufferers in two pilot studies, and refined on the basis of their quantitative results and qualitative feedback.The final version was available online and in hardcopy. It included 11 modules, some being mandatory and others optional, allowing tailoring of the intervention to meet an individual's specific needs. Qualitative and quantitative results of the pilot studies supported its efficacy in terms of reducing traumatic stress symptoms and its acceptability to PTSD sufferers.Delivering psychological treatment in a GSH format shows promise as an effective and acceptable way of treating mild-to-moderate PTSD.",0,0 +6145,"Prewar, war-zone, and postwar predictors of posttraumatic stress in female Vietnam Veteran health care providers.","Using the National Vietnam Veterans Readjustment Study database, we explored predictors of current posttraumatic stress disorder (PTSD) symptom severity in 373 female Vietnam veteran health care pr...",0,0 +6146,Post-traumatic stress disorder screening test performance in civilian primary care,"we determined the test performance characteristics of four brief post-traumatic stress disorder (PTSD) screening tests in a civilian primary care setting.this was a cross-sectional cohort study of adults attending a family medicine residency training clinic in the southeastern USA. Four hundred and eleven participants completed a structured telephone interview that followed an index clinic visit. Screening tests included: PTSD Symptom Checklist-Civilian Version (17 items), SPAN (four items), Breslau's scale (seven items) and Primary Care PTSD screen (PC-PTSD) (four items). A modified Clinician-Administered PTSD Scale was used to determine past month PTSD for comparison. Receiver operating characteristic analysis based on area under the curve (AUC) was used to assess diagnostic efficiency (>0.80 desired). Cut-off scores were selected to yield optimal sensitivity and specificity (>80%).past month PTSD was substantial (women = 35.8% and men = 20.0%; P < 0.01). AUC values were PTSD Symptom Checklist (PCL) (0.897), SPAN (0.806), Breslau's scale (0.886) and PC-PTSD (0.885). Optimal cut-scores yielded the following sensitivities and specificities: PCL (80.0% and 80.7%; cut-off = 43), SPAN (75.9% and 71.6%; cut-off = 3), Breslau's scale (84.5% and 76.4%; cut-off = 4) and PC-PTSD (85.1% and 82.0%; cut-off = 3). Overall and gender-specific screening test performances were explored.results confirm: (i) PTSD was common, especially among women; (ii) all four PTSD screening tests were diagnostically adequate; (iii) Two of four PTSD screening tests showed adequate sensitivity and specificity (>80%) and (iv) The PC-PTSD screening test (four items) appeared to be the best single screening test. There are few studies to establish the utility of PTSD screening tests within civilian primary care.",0,0 +6147,A meta-analytic investigation of the structure of posttraumatic stress disorder symptoms.,"Converging lines of evidence have called into question the validity of conceptualizations of posttraumatic stress disorder (PTSD) based on the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association, 2000) and suggested alternative structural models of PTSD symptomatology. We conducted a meta-analysis of 40 PTSD studies (N = 14,827 participants across studies) that used a DSM-based measure to assess PTSD severity. We aggregated correlation matrices across studies and then applied confirmatory factor analysis to the aggregated matrices to test the fit of competing models of PTSD symptomatology that have gained support in the literature. Results indicated that both prominent 4-factor models of PTSD symptomatology yielded good model fit across subsamples of studies; however, the model comprising Intrusions, Avoidance, Hyperarousal, and Dysphoria factors appeared to fit better across studies. Results also indicated that the best fitting models were not moderated by measure or sample type. Results are discussed in the context of structural models of PTSD and implications for the diagnostic nosology.",0,0 +6148,"Modular Approach to Therapy for Anxiety, Depression, Trauma, or Conduct Problems in outpatient child and adolescent mental health services in New Zealand: study protocol for a randomized controlled trial","Mental health disorders are common and disabling for young people because of the potential to disrupt key developmental tasks. Implementation of evidence-based psychosocial therapies in New Zealand is limited, owing to the inaccessibility, length, and cost of training in these therapies. Furthermore, most therapies address one problem area at a time, although comorbidity and changing clinical needs commonly occur in practice. A more flexible approach is needed. The Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems (MATCH-ADTC) is designed to overcome these challenges; it provides a range of treatment modules addressing different problems, within a single training program. A clinical trial of MATCH-ADTC in the USA showed that MATCH-ADTC outperformed usual care and standard evidence-based treatment on several clinical measures. We aim to replicate these findings and evaluate the impact of providing training and supervision in MATCH-ADTC to: (1) improve clinical outcomes for youth attending mental health services; (2) increase the amount of evidence-based therapy content; (3) increase the efficiency of service delivery.This is an assessor-blinded multi-site effectiveness randomized controlled trial. Randomization occurs at two levels: (1) clinicians (≥60) are randomized to intervention or usual care; (2) youth participants (7-14 years old) accepted for treatment in child and adolescent mental health services (with a primary disorder that includes anxiety, depression, trauma-related symptoms, or disruptive behavior) are randomly allocated to receive MATCH-ADTC or usual care. Youth participants are recruited from 'mainstream', Māori-specific, and Pacific-specific child and adolescent mental health services. We originally planned to recruit 400 youth participants, but this has been revised to 200 participants. Centralized computer randomization ensures allocation concealment. The primary outcome measures are: (i) the difference in trajectory of change of clinical severity between groups (using the parent-rated Brief Problem Monitor); (ii) clinicians' use of evidence-based treatment procedures during therapy sessions; (iii) total time spent by clinicians delivering therapy.If MATCH-ADTC demonstrates effectiveness it could offer a practical efficient method to increase access to evidence-based therapies, and improve outcomes for youth attending secondary care services.Australian and New Zealand Clinical Trials Registry ACTRN12614000297628 .",0,0 +6149,Parent-child discrepancy in reporting children's post-traumatic stress reactions after a traffic accident,"This study examines possible parent-child discrepancies in the reporting of post-traumatic stress reactions in children after a traffic accident. Sixteen children exposed to the same traffic accident were interviewed about post-traumatic stress reactions at 5 weeks and at 6 months after the event, utilizing the Child Posttraumatic Stress Reaction Index (CPTS-RI). Independently, the parents' reported their child's degree of post-traumatic stress reactions on the CPTS-RI: Parent questionnaire, at the same two times. Clinicians also assessed the children's level of general functioning on the Children's Global Assessment Scale. The children reported significantly more post-traumatic stress reactions than observed by their parents 4 weeks after the accident. The parent-child discrepancy was more pronounced among younger children. The level of children's self-reported post-traumatic stress reactions decreased significantly from the first to the second assessment. At the second assessment, 6 months after the accident, there was no significant parent-child discrepancy observed. The children showed a normal level of functioning despite their post-traumatic stress reactions. The reported parent-child discrepancy indicates that information about children's post-traumatic stress reactions after an accident is best obtained directly from the children.",0,0 +6150,Ethnic/Racial Diversity and Posttraumatic Distress in the Acute Care Medical Setting,"Recent commentary has advocated for epidemiological investigation as a foundational science for understanding disparities in the delivery of mental health care and for the development of early trauma–focused interventions. Few acute care investigations have examined the diversity of ethnic/racial heritages or compared variations in early posttraumatic distress in representative samples of injured trauma survivors. Hospitalized injury survivors at two United States level I trauma centers were randomly approached in order to document linguistic and ethnic/racial diversity. Approximately 12% of patients approached were non–English speaking with 16 languages represented. English speaking, inpatients were screened for posttraumatic stress disorder, peritraumatic dissociative, and depressive symptoms. For 269 English speaking study participants, ethnic/racial group status was clearly categorized into one group for 72%, two groups for 25%, and three groups for 3% of participants. Regression analyses that adjusted for relevant clinical and demographic characteristics revealed that relative to whites, patients from American Indian, African American, Hispanic, and Asian heritages demonstrated significant elevations in one or more posttraumatic symptom clusters. A remarkable diversity of heritages was identified, and posttraumatic distress was elevated in ethnic/racial minority patients. Policy–relevant clinical investigations that combine evidence–based treatments, bilingual/bicultural care–management strategies, and support for trauma center organizational capacity building may be required in order to enhance the quality of mental health care for diverse injured trauma survivors.",0,0 +6151,"Metabolic, autonomic and immune markers for cardiovascular disease in posttraumatic stress disorder","Posttraumatic stress disorder (PTSD) has been associated with significantly greater incidence of heart disease. Numerous studies have indicated that health problems for individuals with PTSD occur earlier in life than in the general population. Multiple mechanistic pathways have been suggested to explain cardiovascular disese (CVD) risk in PTSD, including neurochemical, behavioral, and immunological changes. The present paper is a review of recent research that examines cardiovascular and immune risk profiles of individuals with PTSD. First, we address the relatively new evidence that the constellation of risk factors commonly experienced in PTSD fits the profile of metabolic syndrome. Next we examine the findings concerning hypertension/blood pressure in particular. The literature on sympathetic and parasympathetic responsivity in PTSD is reviewed. Last, we discuss recent findings concerning immune functioning in PTSD that may have a bearing on the high rates of CVD and other illnesses. Our primary goal is to synthesize the existing literature by examining factors that overlap mechanistically to increase the risk of developing CVD in PTSD.",0,0 +6152,Profiles of individuals seeking psychiatric help for psychotic symptoms linked to methamphetamine abuse – baseline results from the MAPS (methamphetamine and psychosis study),"Background: Methamphetamine psychosis (MAP) is commonly encountered in psychiatric emergency rooms (ERs) in North America, and little is known regarding the specific needs of this clientele. Aims: This study aimed at describing the psychiatric and socioeconomic profiles of individuals with co-occurring methamphetamine abuse and psychosis profiles. Method: Two hundred and ninety-five (295) individuals needing psychiatric help for MAP were assessed regarding their socioeconomic situation, their substance abuse patterns, family histories, past psychiatric diagnoses, childhood trauma, and co-occurring disorders of depression, PTSD and antisocial personality disorder. Results: Eighty-seven percent had a family history of mental illness or substance abuse and close to 70% had a previous diagnosis of a mental illness, although only 21% of a psychotic disorder. Antisocial personality disorder, depression, and post-traumatic stress disorder were highly prevalent in our sample. Cluster analyses on methamphetamine (...",0,0 +6153,A latent class analysis of adolescent adverse life events based on a Danish national youth probability sample.,"The aim of this study was to determine if there are meaningful clusters of individuals with similar experiences of adverse life events in a nationally representative sample of Danish adolescents. Latent class analysis (LCA) was used to identify such clusters or latent classes. In addition, the relationships between the latent classes and living arrangements and diagnosis of post-traumatic stress disorder (PTSD) were estimated. A four-class solution was found to be the best description of multiple adverse life events, and the classes were labelled ""Low Risk"", ""Intermediate Risk"", ""Pregnancy"" and ""High Risk"". Compared with the Low Risk class, the other classes were found to be significantly more likely to have a diagnosis PTSD and live with only one parent. This paper demonstrated how trauma research can focus on the individual as the unit of analysis rather than traumatic events.",0,0 +6154,Association of Combatant Status and Sexual Violence With Health and Mental Health Outcomes in Postconflict Liberia,"Liberia's wars since 1989 have cost tens of thousands of lives and left many people mentally and physically traumatized.To assess the prevalence and impact of war-related psychosocial trauma, including information on participation in the Liberian civil wars, exposure to sexual violence, social functioning, and mental health.A cross-sectional, population-based, multistage random cluster survey of 1666 adults aged 18 years or older using structured interviews and questionnaires, conducted during a 3-week period in May 2008 in Liberia.Symptoms of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), social functioning, exposure to sexual violence, and health and mental health needs among Liberian adults who witnessed or participated in the conflicts during the last 2 decades.In the Liberian adult household-based population, 40% (95% confidence interval [CI], 36%-45%; n = 672/1659) met symptom criteria for MDD, 44% (95% CI, 38%-49%; n = 718/1661) met symptom criteria for PTSD, and 8% (95% CI, 5%-10%; n = 133/1666) met criteria for social dysfunction. Thirty-three percent of respondents (549/1666) reported having served time with fighting forces, and 33.2% of former combatant respondents (182/549) were female. Former combatants experienced higher rates of exposure to sexual violence than noncombatants: among females, 42.3% (95% CI, 35.4%-49.1%) vs 9.2% (95% CI, 6.7%-11.7%), respectively; among males, 32.6% (95% CI, 27.6%-37.6%) vs 7.4% (95% CI, 4.5%-10.4%). The rates of symptoms of PTSD, MDD, and suicidal ideation were higher among former combatants than noncombatants and among those who experienced sexual violence vs those who did not. The prevalence of PTSD symptoms among female former combatants who experienced sexual violence (74%; 95% CI, 63%-84%) was higher than among those who did not experience sexual violence (44%; 95% CI, 33%-53%). The prevalence of PTSD symptoms among male former combatants who experienced sexual violence was higher (81%; 95% CI, 74%-87%) than among male former combatants who did not experience sexual violence (46%; 95% CI, 39%-52%). Male former combatants who experienced sexual violence also reported higher rates of symptoms of depression and suicidal ideation. Both former combatants and noncombatants experienced inadequate access to health care (33.0% [95% CI, 22.6%-43.4%] and 30.1% [95% CI, 18.7%-41.6%], respectively).Former combatants in Liberia were not exclusively male. Both female and male former combatants who experienced sexual violence had worse mental health outcomes than noncombatants and other former combatants who did not experience exposure to sexual violence.",0,0 +6155,Self-reported adverse health events following smallpox vaccination in a large prospective study of US military service members,"In December 2002, the Department of Defense re-instituted smallpox vaccination for US military forces following growing concerns that smallpox might be employed as a bioterrorist weapon. More than one million service members have been given the smallpox vaccine since 2002, although there have been concerns about the safety of the vaccine. Using a large self-reported prospective database, this analysis investigated a wide variety of self-reported health outcomes and possible association with smallpox vaccination. After confirming self-reported vaccination history with electronic vaccine data, 40,472 individuals were included in the analyses, 8,793 of whom received the smallpox vaccine and 31,679 who did not. No significant adverse associations between smallpox vaccination and self-reported health outcomes, including mental and physical functioning, cardiovascular diseases, and autoimmune disorders, were found. These findings complement studies that utilize other data sources, such as electronic hospitalization records, and may be reassuring to health care providers and those who receive the smallpox vaccination.",0,0 +6156,Predicting Stabilizing Treatment Outcomes for Complex Posttraumatic Stress Disorder and Dissociative Identity Disorder: An Expertise-Based Prognostic Model,"The purpose of this study was to develop an expertise-based prognostic model for the treatment of complex posttraumatic stress disorder (PTSD) and dissociative identity disorder (DID). We developed a survey in 2 rounds: In the first round we surveyed 42 experienced therapists (22 DID and 20 complex PTSD therapists), and in the second round we surveyed a subset of 22 of the 42 therapists (13 DID and 9 complex PTSD therapists). First, we drew on therapists' knowledge of prognostic factors for stabilization-oriented treatment of complex PTSD and DID. Second, therapists prioritized a list of prognostic factors by estimating the size of each variable's prognostic effect; we clustered these factors according to content and named the clusters. Next, concept mapping methodology and statistical analyses (including principal components analyses) were used to transform individual judgments into weighted group judgments for clusters of items. A prognostic model, based on consensually determined estimates of effect sizes, of 8 clusters containing 51 factors for both complex PTSD and DID was formed. It includes the clusters lack of motivation, lack of healthy relationships, lack of healthy therapeutic relationships, lack of other internal and external resources, serious Axis I comorbidity, serious Axis II comorbidity, poor attachment, and self-destruction. In addition, a set of 5 DID-specific items was constructed. The model is supportive of the current phase-oriented treatment model, emphasizing the strengthening of the therapeutic relationship and the patient's resources in the initial stabilization phase. Further research is needed to test the model's statistical and clinical validity.",0,0 +6157,Preventing Post-Traumatic Stress Disorder Resulting from Military Operations,"Military personnel are at high risk for developing post-traumatic stress disorder (PTSD), historically 10 to 50% of all casualties. The best treatment is to provide an opportunity for rest and ventilation of feelings and then to return the person to duty and to his or her peer group. Preventing the cycle of PTSD from starting and thus decreasing psychiatric casualties is feasible. This can be done by promoting unit cohesion and morale, ensuring that individuals know their jobs, inducing stress during training so individuals will be better prepared to cope, providing realistic information about what to expect in combat, and holding group debriefings immediately after any traumatic event. This paper discusses various models for preventing PTSD and examines future directions for the prevention of PTSD.",0,0 +6158,Post-traumatic stress disorder among survivors two years after the 2010 Mount Merapi volcano eruption: A survey study,"The Mount Merapi volcanic eruption in October 2010 was one of Indonesia's largest and most recent natural disasters. A cross-sectional study was undertaken to measure the psychosocial impact of the eruption on survivors in two locations in Yogyakarta, Java, Indonesia. The Impact of Event Scale Revised was used to assess participants' symptoms of post-traumatic stress disorder. Post-Traumatic Stress Disorder responses and demographic characteristics were compared in both locations by conducting bivariate analysis using Mann-Whitney and t tests. The relative contributions of demographic variables and psychosocial impact were examined using multiple linear regression analyses. Two years after the eruption, survivors from the area closest to the eruption had significantly higher Impact of Event Scale Revised scores than those in the comparison area. In particular, females, adults between the ages of 18 and 59, and people who owned their own home experienced the highest levels of psychosocial impact. Nurses and other health professionals need to be aware of the impact of natural disasters on survivors and develop interventions to help people adjust to the psychosocial impact of these events.",0,0 +6159,Suicide‐Bereaved Children and Adolescents: A Controlled Longitudinal Examination,"The current study examined emotional and behavioral sequelae in children who have experienced parental suicide by completing a secondary analysis of data from the Grief Research Study, a longitudinal study of childhood bereavement.Twenty-six suicide-bereaved (SB) children, aged 5 to 17 years, were compared with 332 children bereaved from parental death not caused by suicide (NSB) in interviews 1, 6, 13, and 25 months after the death. Children's emotional reactions to the death, psychiatric symptomatology, and psychosocial functioning after the parent's death were determined.Grief emotions were common in both groups. SB children were more likely to experience anxiety, anger, and shame than NSB children. SB children were more likely to have preexisting behavioral problems and more behavioral and anxiety symptoms throughout the first 2 years compared with NSB children. Indices of depression, suicidality, and psychosocial functioning differed minimally between groups.SB children experience some ""common"" elements of bereavement. In addition, they demonstrate some lifetime risk factors as well as subsequent pathology that suggests a negative behavioral trajectory. As these cohorts have not yet passed through the age of risk, long-term follow-up is critical.",0,0 +6160,Amygdala Transcriptome and Cellular Mechanisms Underlying Stress-Enhanced Fear Learning in a Rat Model of Posttraumatic Stress Disorder,"Severe stress or trauma can cause permanent changes in brain circuitry, leading to dysregulation of fear responses and the development of posttraumatic stress disorder (PTSD). To date, little is known about the molecular mechanisms underlying stress-induced long-term plasticity in fear circuits. We addressed this question by using global gene expression profiling in an animal model of PTSD, stress-enhanced fear learning (SEFL). A total of 15 footshocks were used to induce SEFL and the volatile anesthetic isoflurane was used to suppress the behavioral effects of stress. Gene expression in lateral/basolateral amygdala was measured using microarrays at 3 weeks after the exposure to different combinations of shock and isoflurane. Shock produced robust effects on amygdalar transcriptome and isoflurane blocked or reversed many of the stress-induced changes. We used a modular approach to molecular profiles of shock and isoflurane and built a network of regulated genes, functional categories, and cell types that represent a mechanistic foundation of perturbation-induced plasticity in the amygdala. This analysis partitioned perturbation-induced changes in gene expression into neuron- and astrocyte-specific changes, highlighting a previously underappreciated role of astroglia in amygdalar plasticity. Many neuron-enriched genes were highly correlated with astrocyte-enriched genes, suggesting coordinated transcriptional responses to environmental challenges in these cell types. Several individual genes were validated using RT-PCR and behavioral pharmacology. This study is the first to propose specific cellular and molecular mechanisms underlying SEFL, an animal model of PTSD, and to nominate novel molecular and cellular targets with potential for therapeutic intervention in PTSD, including glycine and neuropeptide systems, chromatin remodeling, and gliotransmission.",0,0 +6161,Assessment of PTSD symptoms in a community exposed to serial murder,"This study examined the presence of PTSD symptoms across time in a community exposed to serial murder. One hundred eighty four subjects (48% response rate) responded to the initial survey while 64 and 30 subjects, respectively, participated in the 9- and 18-month follow-up studies. Results indicated widespread endorsement of PTSD symptoms following the murders. The most severe reactions were found among residents demographically similar to the victims. PTSD symptoms, while not transient, appeared to decrease over time with few subjects still reporting symptoms at 18 months. These data suggest that violent acts such as serial murder can have far reaching psychological consequences for the community and result in vicarious victimization. © 1997 John Wiley & Sons, Inc. J Clin Psychol 53: 809–815, 1997",0,0 +6162,Prazosin for Military Combat-Related PTSD Nightmares: A Critical Review,"Military combat is a common trauma experience associated with posttraumatic stress disorder (PTSD). Trauma-related nightmares are a hallmark symptom of PTSD. They can be resistant to label-pharmacological PTSD treatment, and they are associated with a variety of adverse health outcomes. The purpose of this article is to review and evaluate prazosin therapy for combat-related PTSD nightmares. Consistent with available literature for all-causes PTSD nightmares, prazosin is an effective off-label option for combat-related PTSD nightmares. Future trials may further instruct use in specific combat-exposure profiles.",0,0 +6163,Does abortion increase women's risk for post-traumatic stress? Findings from a prospective longitudinal cohort study,"To prospectively assess women's risk for post-traumatic stress disorder (PTSD) and of experiencing post-traumatic stress symptoms (PTSS) over 4 ears after seeking an abortion, and to assess whether symptoms are attributed to the pregnancy, abortion or birth, or other events in women's lives.Prospective longitudinal cohort study which followed women from approximately 1 week after receiving or being denied an abortion (baseline), then every 6 months for 4 years (9 interview waves).30 abortion facilities located throughout the USA.Among 956 women presenting for abortion care, some of whom received an abortion and some of whom were denied due to advanced gestational age; 863 women are included in the longitudinal analyses.PTSS and PTSD risk were measured using the Primary Care PTSD Screen (PC-PTSD). Index pregnancy-related PTSS was measured by coding the event(s) described by women as the cause of their symptoms.We used unadjusted and adjusted logistic mixed-effects regression analyses to assess whether PTSS, PTSD risk and pregnancy-related PTSS trajectories of women obtaining abortions differed from those who were denied one.At baseline, 39% of participants reported any PTSS and 16% reported three or more symptoms. Among women with symptoms 1-week post-abortion seeking (n=338), 30% said their symptoms were due to experiences of sexual, physical or emotional abuse or violence; 20% attributed their symptoms to non-violent relationship issues; and 19% said they were due to the index pregnancy. Baseline levels of PTSS, PTSD risk and pregnancy-related PTSS outcomes did not differ significantly between women who received and women who were denied an abortion. PTSS, PTSD risk and pregnancy-related PTSS declined over time for all study groups.Women who received an abortion were at no higher risk of PTSD than women denied an abortion.",0,0 +6164,Health and environmental consequences of the world trade center disaster.,"The attack on the World Trade Center (WTC) created an acute environmental disaster of enormous magnitude. This study characterizes the environmental exposures resulting from destruction of the WTC and assesses their effects on health. Methods include ambient air sampling; analyses of outdoor and indoor settled dust; high-altitude imaging and modeling of the atmospheric plume; inhalation studies of WTC dust in mice; and clinical examinations, community surveys, and prospective epidemiologic studies of exposed populations. WTC dust was found to consist predominantly (95%) of coarse particles and contained pulverized cement, glass fibers, asbestos, lead, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and polychlorinated furans and dioxins. Airborne particulate levels were highest immediately after the attack and declined thereafter. Particulate levels decreased sharply with distance from the WTC. Dust pH was highly alkaline (pH 9.0-11.0). Mice exposed to WTC dust showed only moderate pulmonary inflammation but marked bronchial hyperreactivity. Evaluation of 10,116 firefighters showed exposure-related increases in cough and bronchial hyperreactivity. Evaluation of 183 cleanup workers showed new-onset cough (33%), wheeze (18%), and phlegm production (24%). Increased frequency of new-onset cough, wheeze, and shortness of breath were also observed in community residents. Follow-up of 182 pregnant women who were either inside or near the WTC on 11 September showed a 2-fold increase in small-for-gestational-age (SGA) infants. In summary, environmental exposures after the WTC disaster were associated with significant adverse effects on health. The high alkalinity of WTC dust produced bronchial hyperreactivity, persistent cough, and increased risk of asthma. Plausible causes of the observed increase in SGA infants include maternal exposures to PAH and particulates. Future risk of mesothelioma may be increased, particularly among workers and volunteers exposed occupationally to asbestos. Continuing follow-up of all exposed populations is required to document the long-term consequences of the disaster.",0,0 +6165,Psychiatric Comorbidity and Perceived Alcohol Stigma in a Nationally Representative Sample of Individuals with DSM-5 Alcohol Use Disorder,"Background Alcohol use disorder (AUD) is among the most stigmatized health conditions and is frequently comorbid with mood, anxiety, and drug use disorders. Theoretical frameworks have conceptualized stigma-related stress as a predictor of psychiatric disorders. We described profiles of psychiatric comorbidity among people with AUD and compared levels of perceived alcohol stigma across profiles. Methods Cross-sectional data were analyzed from a general population sample of U.S. adults with past-year DSM-5 AUD (n = 3,368) from the National Epidemiologic Survey on Alcohol and Related Conditions, which was collected from 2001 to 2005. Empirically derived psychiatric comorbidity profiles were established with latent class analysis, and mean levels of perceived alcohol stigma were compared across the latent classes while adjusting for sociodemographic characteristics and AUD severity. Results Four classes of psychiatric comorbidity emerged within this AUD sample, including those with: (i) high comorbidity, reflecting internalizing (i.e., mood and anxiety disorders) and externalizing (i.e., antisocial personality and drug use disorders) disorders; (ii) externalizing comorbidity; (iii) internalizing comorbidity; and (iv) no comorbidity. Perceived alcohol stigma was significantly higher in those with internalizing comorbidity (but not those with high comorbidity) as compared to those with no comorbidity or externalizing comorbidity. Conclusions Perceived stigma, as manifested by anticipations of social rejection and discrimination, may increase risk of internalizing psychiatric comorbidity. Alternatively, internalizing psychiatric comorbidity could sensitize affected individuals to perceive more negative attitudes toward them. Future research is needed to understand causal and bidirectional associations between alcohol stigma and psychiatric comorbidity.",0,0 +6166,An investigation of relations between crystal methamphetamine use and posttraumatic stress disorder,"Evidence documents elevated rates of various types of drug use among people with posttraumatic stress disorder (PTSD). However, relatively little research has specifically examined crystal methamphetamine (CM) use among individuals with PTSD. The present study examined the relation between PTSD diagnostic status, PTSD symptom severity within symptom type clusters, and CM use histories among traumatic event-exposed individuals with versus without PTSD. Consistent with expectations, individuals with PTSD were significantly more likely to report CM use than trauma-exposed individuals without PTSD. Additionally, CM users with PTSD reported a longer duration of CM use than trauma-exposed CM users without PTSD. Finally, PTSD avoidance and hyperarousal symptoms, but not re-experiencing, were related to CM use. The potential clinical and research implications of the findings are discussed.",0,0 +6167,Behavioral inhibition and PTSD symptoms in veterans,"Behavioral inhibition (BI), a temperamental bias to respond to novel stimuli with avoidance behaviors, is a risk factor for posttraumatic stress disorder (PTSD). It is unclear whether BI accounts for additional variance in PTSD symptom severity beyond that accounted for by general anxiety. Here, 109 veterans (mean age 50.4 years, 9.2% female) provided self-assessment of PTSD symptoms, state and trait anxiety, combat exposure, and current (adult) and retrospective (childhood) BI. Adult BI was correlated with anxiety and PTSD symptom severity, especially cluster C (avoidance) symptoms, but not with combat exposure. A regression model including adult BI, state and trait anxiety, and combat exposure was able to correctly classify over 80% of participants according to presence or absence of severe PTSD symptoms. Because avoidance behaviors are a core component of PTSD, self-assessments of BI may be an important tool in understanding PTSD and potentially assessing vulnerability to the disorder.",0,0 +6168,Diagnosing attention-deficit hyperactivity disorder (ADHD) in children involved with child protection services: are current diagnostic guidelines acceptable for vulnerable populations?,"Children involved with child protection services (CPS) are diagnosed and treated for attention-deficit hyperactivity disorder (ADHD) at higher rates than the general population. Children with maltreatment histories are much more likely to have other factors contributing to behavioural and attentional regulation difficulties that may overlap with or mimic ADHD-like symptoms, including language and learning problems, post-traumatic stress disorder, attachment difficulties, mood disorders and anxiety disorders. A higher number of children in the child welfare system are diagnosed with ADHD and provided with psychotropic medications under a group care setting compared with family-based, foster care and kinship care settings. However, children's behavioural trajectories change over time while in care. A reassessment in the approach to ADHD-like symptoms in children exposed to confirmed (or suspected) maltreatment (e.g. neglect, abuse) is required. Diagnosis should be conducted within a multidisciplinary team and practice guidelines regarding ADHD diagnostic and management practices for children in CPS care are warranted both in the USA and in Canada. Increased education for caregivers, teachers and child welfare staff on the effects of maltreatment and often perplexing relationship with ADHD-like symptoms and co-morbid disorders is also necessary. Increased partnerships are needed to ensure the mental well-being of children with child protection involvement.",0,0 +6169,Course of recovery for whiplash associated disorders in a compensation setting,"The detailed course of recovery following compensable whiplash associated disorders (WAD) is not well understood. Some people recover within months and others report symptoms for extended periods. Recent research identified distinct recovery pathways. Identifying recovery pathways for people with this condition in compensable settings could assist clinical and claim management.This study aimed to identify recovery trajectories based on disability, pain catastrophising and mental health and, secondly, to examine developmental linkages between the trajectories.A cohort of 246 people with compensable WAD were followed for 24 months after a motor vehicle related injury.Functional Rating Index (FRI), Pain Catastrophising Scale (PCS) and the SF36 Mental Component Score (SF 36 MCS).Group-based trajectory analytical techniques were used to identify distinct post-injury profiles. Multinominal logistic regression modelling identified factors associated with membership of different trajectories.246 people were enrolled a median of 72 days after injury. Three trajectories were identified for the measures used and their prevalences, respectively, were: for disability (FRI) they were mild (47%), moderate (31%), and severe (22%); for pain catastrophising (PCS) they were non-catastrophisers (55%), moderate-low catastrophisers (32%) and clinically significant catastrophisers (13%); and, for mental health (SF36 MCS) they were good mental health (40%), moderately low mental health (42%) and severely low mental health (18%). All groups showed no further recovery beyond 12 months after injury. The significant baseline predictors of the severe disability trajectory were: lower (that means worse) bodily pain scores (SF 36 BPS) (p≤0.01); high pain catastrophising (p≤0.01); and, self-reported fair or poor general health (p=0.03). Conditional probabilities for group membership showed that the three trajectories for both PCS and FRI were linked. Dual membership was high for the mild disability and mild pain catastrophising trajectories and, for the severe disability and clinically significant pain catastrophising trajectories.There is a strong and plausible association between severe disability, clinical levels of pain catastrophising and low mental health. Claimants can be identified at claim notification based on three estimated recovery trajectories. Claim and clinical interventions can be targeted to the profile within each recovery trajectory.",0,0 +6170,Coping with spinal cord injury: Tenacious goal pursuit and flexible goal adjustment,"To investigate the correlation of higher-order coping strategies of tenacious goal pursuit and flexible goal adjustment with adjustment after rehabilitation in spinal cord injury.Cross-sectional correlational study.All 397 eligible patients entered for spinal cord rehabilitation between 1999 and 2009 were contacted and 130 (33%) agreed to complete a self-report questionnaire.Partial correlations were computed between tenacious goal pursuit and flexible goal adjustment and affective and cognitive psychological adjustment. Demographics, spinal cord injury related variables, social support and coping were used as control variables.After controlling for relevant demographic, medical and social support indices, partial correlations between tenacious goal pursuit and indices of adaptation were not significant. Significant partial correlations were observed between flexible goal adjustment and each of the indices of adjustment (r = -0.33, -0.42, 0.51, -0.38, respectively, for depression, anxiety, acceptance, and helplessness) after controlling for all relevant variables in the model. Flexible goal adjustment explained significant additional proportions of variance for each of the adjustment indices (7%, 11%, 18%, and 7%, respectively).Flexible goal adjustment, but not tenacious goal pursuit, is associated with psychological adjustment in spinal cord injury. Further research is needed to understand the mechanisms of flexible goal adjustment. Interventions targeting flexible goal adjustment might be of benefit for the patient.",0,0 +6171,The Course of Serum Inflammatory Biomarkers Following Whiplash Injury and Their Relationship to Sensory and Muscle Measures: a Longitudinal Cohort Study,"Tissue damage or pathological alterations are not detectable in the majority of people with whiplash associated disorders (WAD). Widespread hyperalgisa, morphological muscle changes and psychological distress are common features of WAD. However little is known about the presence of inflammation and its association with symptom persistence or the clinical presentation of WAD. This study aimed to prospectively investigate changes in serum inflammatory biomarker levels from the acute (<3 weeks) to chronic (>3 months) stages of whiplash injury. It also aimed to determine relationships between biomarker levels and hyperalgesia, fatty muscle infiltrates of the cervical extensors identified on MRI and psychological factors. 40 volunteers with acute WAD and 18 healthy controls participated. Participants with WAD were classified at 3 months as recovered/mild disability or having moderate/severe disability using the Neck Disability Index. At baseline both WAD groups showed elevated serum levels of CRP but by 3 months levels remained elevated only in the moderate/severe group. The recovered/mild disability WAD group had higher levels of TNF-α at both time points than both the moderate/severe WAD group and healthy controls. There were no differences found in serum IL-1β. Moderate relationships were found between hyperalgesia and CRP at both time points and between hyperalgesia and IL-1β 3 months post injury. There was a moderate negative correlation between TNF-α and amount of fatty muscle infiltrate and pain intensity at 3 months. Only a weak relationship was found between CRP and pain catastrophising and no relationship between biomarker levels and posttraumatic stress symptoms. The results of the study indicate that inflammatory biomarkers may play a role in outcomes following whiplash injury as well as being associated with hyperalgesia and fatty muscle infiltrate in the cervical extensors.",0,0 +6172,Risk Factors for Psychological Maladjustment of Parents of Children With Cancer,"Objective To examine risk variables for future, more immediate, and persistent psychological distress of parents of pediatric cancer patients. Method Parents (n = 128) completed questionnaires at the time of diagnosis (T1) and 12 months later (T2). Multiple regression analyses were performed using the following as predictors: demographics, illness-related variables, other life events, personality, coping styles, and social support. Results Trait anxiety was the strongest predictor of both fathers' and mothers' future distress. Changes in trait anxiety during the year also accompanied changes in both parents' levels of distress. Additional prospective predictors for fathers were the coping style “social support-seeking” and dissatisfaction with support. Dissatisfaction with support also had short-term effects for fathers. An additional prospective predictor for mothers was the number of pleasant events they had experienced prior to diagnosis, while a short-term effect was found for performance in assertiveness. No predictors for the persistence of distress were found. Conclusions These results underscore the importance of personality anxiety in predicting parents' risk for adjustment difficulties associated with the experience of cancer in one's child. An additional risk factor for fathers was social support. For mothers, previously experienced life events and the frequency of assertive behavior were additional risk factors.",0,0 +6173,"Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001–05: an epidemiological survey","In China and other middle-income countries, neuropsychiatric conditions are the most important cause of ill health in men and women, but efforts to scale up mental health services have been hampered by the absence of high-quality, country-specific data for the prevalence, treatment, and associated disability of different types of mental disorders. We therefore estimated these variables from a series of epidemiological studies that were done in four provinces in China.We used multistage stratified random sampling methods to identify 96 urban and 267 rural primary sampling sites in four provinces of China; the sampling frame of 113 million individuals aged 18 years or older included 12% of the adult population in China. 63 004 individuals, identified with simple random selection methods at the sampling sites, were screened with an expanded version of the General Health Questionnaire and 16,577 were administered a Chinese version of the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV axis I disorders by a psychiatrist.The adjusted 1-month prevalence of any mental disorder was 17.5% (95% CI 16.6-18.5). The prevalence of mood disorders was 6.1% (5.7-6.6), anxiety disorders was 5.6% (5.0-6.3), substance abuse disorders was 5.9% (5.3-6.5), and psychotic disorders was 1.0% (0.8-1.1). Mood disorders and anxiety disorders were more prevalent in women than in men, and in individuals 40 years and older than in those younger than 40 years. Alcohol use disorders were 48 times more prevalent in men than in women. Rural residents were more likely to have depressive disorders and alcohol dependence than were urban residents. Among individuals with a diagnosable mental illness, 24% were moderately or severely disabled by their illness, 8% had ever sought professional help, and 5% had ever seen a mental health professional.Substantial differences between our results and prevalence, disability, and treatment rate estimates used in the analysis of global burden of disease for China draw attention to the need for low-income and middle-income countries to do detailed, country-specific situation analyses before they scale up mental health services.China Medical Board of New York, WHO, and Shandong Provincial Bureau of Health.",0,0 +6174,Retrieval and emotional processing of traumatic memories in posttraumatic stress disorder: Peripheral and central correlates,"Posttraumatic stress disorder (PTSD) is thought to be characterized by dysfunctional memory processes, i.e., the automatic re-experiencing of the traumatic event and the inability to consciously recall facts about the traumatic event, as well as altered emotional processing of trauma-relevant cues. The present study examined the cerebral mechanisms underlying the cued recall of trauma-specific memories and the emotional processing of the presented cues in 16 PTSD patients, 15 trauma-exposed subjects without PTSD and 16 healthy controls. Subjects received questions about their specific trauma as well as other disastrous and neutral events while the electroencephalogram and heart rate were measured. The PTSD patients showed no impairment in trauma-specific declarative memory compared to non-PTSD subjects but had some deficits in general declarative memory as assessed by the Wechsler Memory Scale-Revised. Compared to healthy control subjects, PTSD patients displayed increased P300 and late positive complex amplitudes to trauma-specific questions, indicating enhanced emotional processing of these cues. In line with their behavioral performance, both trauma-exposed groups showed decreased terminal contingent negative variation amplitudes to trauma-specific questions over frontal electrodes reflecting altered memory retrieval. Within-group comparisons revealed that only the PTSD group but not the other groups showed a differentiation between trauma-specific and neutral questions with respect to the LPC, tCNV and P300. Concordantly with previous studies, PTSD patients showed elevated resting heart rate compared to the healthy controls. These findings are discussed in the context of current models of the role of declarative memory in the development and maintenance of PTSD.",0,0 +6175,Characteristics of difficult-to-place youth in state custody: a profile of the Exceptional Care Pilot Project population.,"This study examines the characteristics of Texas youth designated as 'most difficult to place' recipients of service under the Exceptional Care Pilot Project (N = 46). Findings include, among others, high levels of comorbid psychiatric disturbance (> 3 diagnostic groupings), physical (78.3%) and sexual (88%) maltreatment, and placement breakdowns (m = 4.8 therapeutic placements). This initial profile of the population provides a base for helping other states identify and plan for the needs of their most troubled youth.",0,0 +6176,The role of shame and self-critical thinking in the development and maintenance of current threat in post-traumatic stress disorder,"There is increasing recognition of emotions other than fear in post-traumatic stress disorder (PTSD), and recent research has looked at the role of shame. Cognitive theory suggests that PTSD is caused by traumatic experiences being processed in a way that causes ongoing current threat. In this paper we suggest that shame might contribute to the creation/maintenance of ongoing current threat as it attacks an individual's psychological integrity. A correlational design was used to investigate some of the factors that might contribute to a shame response within a PTSD sample. It was hypothesized that individuals with PTSD who report higher levels of shame would be more prone to engage in self-critical thinking and less prone to engage in self-reassuring thinking than individuals with PTSD who report lower levels of shame. Data were gathered using self-report questionnaires, and results supported the hypotheses. It is suggested therapy for shame-based PTSD needs to incorporate strategies to help individuals develop inner caring, compassion and self-reassurance.",0,0 +6177,Toward a Typology of High-Risk Major Stressful Events and Situations in Posttraumatic Stress Disorder and Related Psychopathology,"The diagnosis of posttraumatic stress disorder (PTSD) was introduced in 1980 with the publication of the Diagnostic and Statistical Manual of the American Psychiatric Association, Third Edition (DSM-III). DSM-III put forward a novel syndrome consisting of intrusive, avoidance/numbing, and arousal symptoms as distinctive psychopathology following exposure to traumatic events. The traumatic stressors, although expanded in later editions published in 1987 (DSM-III-R) and 1994 (DSM-IV), focus on life-threatening events and situations. However, at least 12 studies, most of them recent, have found associations between the PTSD symptoms and the PTSD symptom syndrome with stressors, such as unemployment and divorce that would not qualify, even in the broadened DSM-IV diagnosis, as traumatic stressors. These findings challenge the basic assumption on which the PTSD diagnosis is based, the assumption that exposure to life-threatening stressors is the primary cause of a unique set of stress response symptoms. The purpose of this paper is to show how to confront this challenge by developing a typology of stressful situations and events that can be tested systematically for their relation to the PTSD symptom syndrome and other relevant variables. The typology includes but is not limited to the types of situations and events defined as “traumatic” in the DSMs.",0,0 +6178,No morning cortisol response in patients with severe global amnesia,"Activity of the hypothalamus pituitary adrenal (HPA) axis is characterized by a pronounced circadian rhythm. An acute increase in cortisol levels occurs after awakening in the morning with continuously declining levels over the course of the remaining day. The morning cortisol increase probably reflects an activational response of the HPA axis aimed at preparing the body for the day. Some studies found patterns of enhanced or blunted waking cortisol responses observed under chronic stress, burnout, or post traumatic stress disorder. The present study wanted to characterize the morning cortisol response and the circadian cortisol day profile in a sample of six male patients with severe amnesia due to hypoxia, herpes simplex encephalitis or closed head injury. Age and gender matched relatives or friends served as controls. Cortisol was measured from saliva samples collected at home on two consecutive days. The patients were woken up in the morning by their partners or caregivers. The morning cortisol increase typically observed in healthy subjects and also observed in the control group was absent in the amnesic patients. In contrast, a normal circadian day profile was found in the amnesic patients, with a pronounced circadian cortisol decrease. Further studies are needed to understand the neurological or psychological mechanisms leading to a missing morning cortisol response in amnesic patients.",0,0 +6179,Impact of childhood maltreatment on physical health-related quality of life in U.S. active duty military personnel and combat veterans,"Previous studies have found an association between childhood maltreatment (CM) and health-related quality of life (HRQoL), and to a lesser extent have considered whether psychiatric symptoms may explain the relationship. This study aimed to further our understanding of the link between CM and HRQoL by testing whether posttraumatic stress disorder (PTSD) or depressive symptoms mediate the relationship between childhood maltreatment and physical HRQoL. Mediation models were examined in a sample of male Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) active duty and combat veterans (n=249). PTSD and depressive symptoms mediated the relationship between CM and overall physical HRQoL, as well as participation in daily activities due to physical health, bodily pain, and social functioning. Mediation of the relationship between childhood maltreatment and physical and social functioning by depression and PTSD symptoms may lend support to neurobiological hypotheses that childhood maltreatment sensitizes the nervous system and after repeated trauma may lead to the development of psychiatric symptoms, which have a major impact on morbidity and mortality.",0,0 +6180,"PTSD in ICD-10 and proposed ICD-11 in elderly with childhood trauma: prevalence, factor structure, and symptom profiles","Background : The proposal for ICD-11 postulates major changes for posttraumatic stress disorder (PTSD) diagnosis, which needs investigation in different samples. Aims : To investigate differences of PTSD prevalence and diagnostic agreement between ICD-10 and ICD-11, factor structure of proposed ICD-11 PTSD, and diagnostic value of PTSD symptom severity classes. Method : Confirmatory factor analysis and latent profile analysis were used on data of elderly survivors of childhood trauma (>60 years, N =399). Results : PTSD rates differed significantly between ICD-10 (15.0%) and ICD-11 (10.3%, z =2.02, p= 0.04). Unlike previous research, a one-factor solution of ICD-11 PTSD had the best fit in this sample. High symptom profiles were associated with PTSD in ICD-11. Conclusions : ICD-11 concentrates on PTSD’s core symptoms and furthers clinical utility. Questions remain regarding the tendency of ICD-11 to diagnose mainly cases with severe symptoms and the influence of trauma type and participant age on the factor structure. Keywords: Latent class analysis; childhood abuse; World War II; institutional abuse; long term consequences; trauma severity (Published: 21 January 2016) Responsible Editor: Anke Ehlers, University of Oxford, United Kingdom. For the abstract or full text in other languages, please see Supplementary files in the column to the right (under ‘Article Tools’). Citation: European Journal of Psychotraumatology 2016, 7 : 29700 - http://dx.doi.org/10.3402/ejpt.v7.29700",0,0 +6181,Post-traumatic stress disorder in children exposed to violence.,"To investigate to what extent local children exposed to community violence develop post-traumatic stress disorder (PTSD), whether the symptom profile is typical or atypical, and how detection can be improved.A cross-sectional study of two samples of children with a high risk of past exposure to violence.Sixty Xhosa-speaking children aged 10-16 years; 30 from the Children's Home which serves Khayelitsha, and 30 from a school in a violent area of Khayelitsha.A shortened version of the Survey of Exposure to Community Violence (SECV) was administered to determine exposure to violence. Structured questionnaires and a clinical assessment were used to elicit symptoms and make psychiatric diagnoses.All 60 children reported exposure to indirect violence, 57 (95%) had witnessed violence, and 34 (56%) had experienced violence themselves. Twenty-four (40%) met the criteria for on or more DSM-III-R diagnoses and 13 (21.7%) met the criteria for PTSD.Community violence places children at a high risk of developing serious psychiatric disorders and many children develop PTSD. None of the children in the school sample had received intervention prior to the study, pointing towards an urgent need for increased community and professional awareness of children at risk.",0,0 +6182,Early predictors of posttraumatic stress disorder,The benefits of providing early intervention for people recently exposed to trauma have highlighted the need to develop means to identify people who will develop chronic posttraumatic stress disorder (PTSD). This review provides an overview of prospective studies that have indexed the acute reactions to trauma that are predictive of chronic posttraumatic stress disorder. Ten studies of the predictive power of the acute stress disorder diagnosis indicate that this diagnosis does not have adequate predictive power. There is no convergence across studies on any constellation of acute symptoms that predict posttraumatic stress disorder. A review of biological and cognitive mechanisms occurring in the acute posttraumatic phase suggests that these factors may provide more accurate means of predicting chronic posttraumatic stress disorder. Recommendations for future research to facilitate identification of key markers of acutely traumatized people who will develop posttraumatic stress disorder are discussed.,0,0 +6183,Predictors of PTSD in injured trauma survivors: a prospective study,"The aim of this study was to prospectively examine the relationship between immediate and short-term responses to a trauma and the subsequent development of posttraumatic stress disorder (PTSD).All patients consecutively admitted to a general hospital were screened for the presence of physical injury due to a traumatic event. Fifty-one eligible subjects were assessed 1 week and 6 months after the trauma. The initial assessment included measures of event severity, peritraumatic dissociation, and symptoms of intrusion, avoidance, depression, and anxiety. The follow-up assessments added the PTSD module of the Structured Clinical Interview for DSM-III-R--Non-Patient Version and the civilian trauma version of the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder.Thirteen subjects (25.5%) met PTSD diagnostic criteria at follow-up. Subjects who developed PTSD had higher levels of peritraumatic dissociation and more severe depression, anxiety, and intrusive symptoms at the 1-week assessment. Peritraumatic dissociation predicted a diagnosis of PTSD after 6 months over and above the contribution of other variables and explained 29.4% of the variance of PTSD symptom intensity. Initial scores on the Impact of Event Scale predicted PTSD status with 92.3% sensitivity and 34.2% specificity. Symptoms of avoidance that were initially very mild intensified in the subjects who developed PTSD.Peritraumatic dissociation is strongly associated with the later development of PTSD. Early dissociation and PTSD symptoms can help the clinician identify subjects at higher risk for developing PTSD.",0,0 +6184,Outcome of Head and Other Injuries among Israeli Children: Physical Limitations and Stress Symptoms,"BACKGROUND: Head injuries, especially in young children, are frequent and may cause long-lasting impairments. OBJECTIVES: To investigate the outcome of head and other injuries caused by diverse mechanisms and of varied severity. METHODS: The study population consisted of Jews and Arabs (n=792), aged 0-17 years old, hospitalized for injuries in six hospitals in Israel. Caregivers were interviewed during hospitalization regarding circumstances of the injury and sociodemographic variables. Information on injury mechanism, profile and severity, and length of hospitalization was gathered from the medical files. Five months post-injury the caregivers were interviewed by phone regarding physical limitations and stress symptoms. RESULTS: Head injuries occurred in 60% of the children, and of these, 22.2% suffered traumatic brain injury with loss of consciousness (type 1). Among the rest, 22% of Jewish children and 28% of Arab children remained with at least one activity limitation, and no statistically significant differences were found among those with head or other injuries. The odds ratio for at least two stress symptoms was higher for children involved in transport-related injuries (OR 2.70, 95% confidence interval 1.38-5.28) than for other mechanisms, controlling for injury profile. No association was found between stress symptoms and injury severity. CONCLUSIONS: Most children had recovered by 5 months after the injury. Residual activity limitations were no different between those with head or with other injuries. Stress symptoms were related to transport-related injuries, but not to the presence of TBI or injury severity. Language: en",0,0 +6185,Stress-induced alterations in anxiety-like behavior and adaptations in plasticity in the bed nucleus of the stria terminalis,"In vulnerable individuals, exposure to stressors can result in chronic disorders such as generalized anxiety disorder (GAD), major depressive disorder (MDD), and post-traumatic stress disorder (PTSD). The extended amygdala is critically implicated in mediating acute and chronic stress responsivity and anxiety-like behaviors. The bed nucleus of the stria terminalis (BNST), a subregion of the extended amygdala, serves as a relay of corticolimbic information to the paraventricular nucleus of the hypothalamus (PVN) to directly influence the stress response. To investigate the influence of the corticosteroid milieu and housing conditions on BNST function, adult C57Bl/6J were either acutely or chronically administered corticosterone (CORT, 25mg/kg in sesame oil) or vehicle (sesame oil) or were group housed or socially isolated for 1 day (acute) or 6-8 weeks (chronic). To ascertain whether these stressors could influence anxiety-like behavior, studies were performed using the novel open-field (NOF) and the elevated zero maze (EZM) tests. To investigate potential associated changes in plasticity, alterations in BNST function were assessed using ex vivo extracellular field potential recordings in the (dorsal-lateral) dlBNST and a high frequency stimulus protocol to induce long-term potentiation (LTP). Our results suggest that chronic CORT injections and chronic social isolation housing conditions lead to an increase in anxiety-like behavior on the EZM and NOF. Chronically stressed mice also displayed a parallel blunting of LTP in the dlBNST. Conversely, acute social isolation housing had no effect on anxiety-like behavior but still resulted in a blunting of LTP in the dlBNST. Collectively, our results suggest acute and chronic stressors can have a distinct profile on plasticity in the BNST that is not uniformly associated with an increase in anxiety-like behavior.",0,0 +6186,Methodological Basis of a Culture-Specific Coping Approach,"In mainstream psychology, rather specific (and therefore restrictive) research perspectives on coping with disaster dominate. Research uses quantitative methods to build knowledge about the mechanisms and conditions by which disasters affect mental health. The focus of analysis is on measures of individual differences with regard to experiences, coping strategies, and mental health outcomes. Developing generalizable and, potentially, universally applicable models is a major research interest. We argue that methodologies used in mainstream psychologies are not compatible with the purposes of our approach-that is, to describe sociocultural-specific personal and communal long-term coping dynamics after a disaster. We argue that a cultural-psychological approach implies specific propositions about human subjectivity, human agency, and research methods. Previously prominent, restrictive epistemological approaches to coping with disasters need to be broadened by rethinking research units, allowing for complex interrelations instead of assuming a linear causal process, being process-oriented, and including power-critical investigations. This chapter ends with a presentation of the methodological approach used in our case study, which we believe exemplifies alternatives to mainstream psychological research in disaster contexts. © 2014 Springer Science+Business Media, LLC. All rights are reserved.",0,0 +6187,African Americans and anxiety disorders research: Development of a testable theoretical framework.,"The past decade has witnessed a tremendous growth in the population of minorities in this country. As this segment of the population has grown, psychology has slowly begun to realize the need to examine the presentation of psychological symptoms among minorities as well as the response of minorities to traditional psychological treatment. While several investigations have been conducted to date, the results are far from consistent. Some studies have demonstrated marked differences in the symptom profiles and treatment responses of minorities as compared with Whites, while others have found little, if any, differences. A major contributing factor to such inconsistent results may be that research in this area has typically proceeded in the absence of a testable theoretical framework. This review examines research conducted with a specific minority population, African Americans, suffering with a DSM anxiety disorder. We first examine the epidemiological and treatment outcome studies in an effort to ascertain the consistencies and inconsistencies that exist within the literature. More importantly, we then provide a preliminary theoretical framework that not only accounts for the discrepant findings, but also allows investigators to generate testable hypotheses regarding the manifestation and presentation of anxious symptoms, and to evaluate the efficacy of psychological interventions among African Americans. We conclude with suggestions for future investigations in this area.",0,0 +6188,Annual Research Review: The experience of youth with political conflict - challenging notions of resilience and encouraging research refinement,"Drawing on empirical studies and literature reviews, this paper aims to clarify and qualify the relevance of resilience to youth experiencing political conflict. It focuses on the discordance between expectations of widespread dysfunction among conflict-affected youth and a body of empirical evidence that does not confirm these expectations.The expectation for widespread dysfunction appears exaggerated, relying as it does on low correlations and on presumptions of universal response to adversity. Such a position ignores cultural differences in understanding and responding to adversity, and in the specific case of political conflict, it does not account for the critical role of ideologies and meaning systems that underlie the political conflict and shape a young people's interpretation of the conflict, and their exposure, participation, and processing of experiences. With respect to empirical evidence, the findings must be viewed as tentative given the primitive nature of research designs: namely, concentration on violence exposure as the primary risk factor, at the expense of recognizing war's impact on the broader ecology of youth's lives, including disruptions to key economic, social, and political resources; priority given to psychopathology in the assessment of youth functioning, rather than holistic assessments that would include social and institutional functioning and fit with cultural and normative expectations and transitions; and heavy reliance on cross-sectional, rather than longitudinal, studies.Researchers and practitioners interested in employing resilience as a guiding construct will face such questions: Is resilience predicated on evidence of competent functioning across the breadth of risks associated with political conflict, across most or all domains of functioning, and/or across time? In reality, youth resilience amidst political conflict is likely a complex package of better and poorer functioning that varies over time and in direct relationship to social, economic, and political opportunities. Addressing this complexity will complicate the definition of resilience, but it confronts the ambiguities and limitations of work in cross-cultural contexts.",0,0 +6189,The Locus Coeruleus-Noradrenergic System and Stress: Implications for Post-Traumatic Stress Disorder,"Stress is associated with the activation of a number of central physiological systems, which act to enhance arousal and modulate attentional, memory, and other behavioral processes. The net consequence of these actions better permits the organism to contend with a challenging situation and react promptly and effectively when similar conditions are reencountered. It has long been known that stress is associated with a robust activation of the locus coeruleus and other noradrenergic systems. Moreover, evidence indicates a prominent involvement of central noradrenergic systems in a variety of behavioral and cognitive processes associated with stress, including arousal, memory, and attention. Under normal conditions, these actions are likely beneficial to the individual. However, under conditions of extreme stress/trauma, stressor-induced sensitization of noradrenergic systems and long-term actions of norepinephrine may well prove maladaptive. Consistent with this hypothesis, available evidence indicates a prominent involvement of noradrenergic systems in the behavioral pathology associated with various stress-related disorders, particularly post-traumatic stress disorder (PTSD). In particular, there is strong evidence for an involvement of noradrenergic systems in PTSD-related hyperarousal, intrusive memories, and sleep disturbances. Consistent with this, recent studies suggest that pharmacological disruption of noradrenergic neurotransmission may well be efficacious in treating these symptoms of PTSD. Combined, available information indicates that the central noradrenergic systems likely contribute to a broad spectrum of behavioral symptoms of PTSD and that pharmacological treatments targeting noradrenergic neurotransmission will prove clinically beneficial.",0,0 +6190,"Preliminary Evaluation of PTSD Coach, a Smartphone App for Post-Traumatic Stress Symptoms","PTSD Coach is a mobile application (app) designed to help individuals who have post-traumatic stress disorder (PTSD) symptoms better understand and self-manage their symptoms. It has wide-scale use (over 130,000 downloads in 78 countries) and very favorable reviews but has yet to be evaluated. Therefore, this study examines user satisfaction, perceived helpfulness, and usage patterns of PTSD Coach in a sample of 45 veterans receiving PTSD treatment. After using PTSD Coach for several days, participants completed a survey of satisfaction and perceived helpfulness and focus groups exploring app use and benefit from use. Data indicate that participants were very satisfied with PTSD Coach and perceived it as being moderately to very helpful with their PTSD symptoms. Analysis of focus group data resulted in several categories of app use: to manage acute distress and PTSD symptoms, at scheduled times, and to help with sleep. These findings offer preliminary support for the acceptability and perceived helpfulness of PTSD Coach and suggest that it has potential to be an effective self-management tool for PTSD. Although promising, future research is required to validate this, given study limitations.",0,0 +6191,Resilience Moderates the Relationship Between Exposure to Violence and Posttraumatic Reexperiencing in Mi’kmaq Youth,"This study is part of a school-based collaborative research project with a Nova Scotian Mi'kmaq community that hopes to shed light on the relationship between exposure to violence and mental health in First Nations youth. This particular study sought to examine how the multifaceted construct of resilience might act as a protective factor, buffering some students from the negative mental health consequences of exposure to violence. The present paper focuses on whether the construct of resilience, measured by the Child and Youth Resiliency Measure (CYRM; Ungar et al. 2008), has a moderating impact on the relationship between exposure to violence (emotional, physical, and sexual), measured by the Childhood Experience of Violence Questionnaire (CEVQ; Walsh, MacMillan, Trocmé, Jamieson, & Boyle, in press), and posttraumatic stress symptoms, measured by the Child PTSD Symptom Scale (CPSS, Foa et al. 2001). Results showed that the positive relationship between exposure to violence-measured as emotional, physical, and sexual abuse, and witnessing domestic violence-and the reexperiencing symptom cluster of PTSD was moderated by resilience, such that exposure to violence was only predictive of reexperiencing at lower levels of resilience. These findings not only help provide further cross-cultural validation for the CYRM as a measure, but provide support for an ecological conceptualization of resilience. © Springer Science + Business Media, LLC 2009.",0,0 +6192,Effects of early life stress on cognitive and affective function: an integrated review of human literature,"The investigation of putative effects of early life stress (ELS) in humans on later behavior and neurobiology is a fast developing field. While epidemiological and neurobiological studies paint a somber picture of negative outcomes, relatively little attention has been devoted to integrating the breadth of findings concerning possible cognitive and emotional deficits associated with ELS. Emerging findings from longitudinal studies examining developmental trajectories of the brain in healthy samples may provide a new framework to understand mechanisms underlying ELS sequelae.The goal of this review was twofold. The first was to summarize findings from longitudinal data on normative brain development. The second was to utilize this framework of normative brain development to interpret changes in developmental trajectories associated with deficits in cognitive and affective function following ELS.Five principles of normative brain development were identified and used to discuss behavioral and neural sequelae of ELS. Early adversity was found to be associated with deficits in a range of cognitive (cognitive performance, memory, and executive functioning) and affective (reward processing, processing of social and affective stimuli, and emotion regulation) functions.Three general conclusions emerge: (1) higher-order, complex cognitive and affective functions associated with brain regions undergoing protracted postnatal development are particularly vulnerable to the deleterious effects of ELS; (2) the amygdala is particularly sensitive to early ELS; and (3) several deficits, particularly those in the affective domain, appear to persist years after ELS has ceased and may increase risk for later psychopathology.",0,0 +6193,Peeking into the black box: Mechanisms of action for anger management treatment,"We investigated potential mechanisms of action for anger symptom reductions, specifically, the roles of anger regulation skills and therapeutic alliance on changes in anger symptoms, following group anger management treatment (AMT) among combat veterans with posttraumatic stress disorder (PTSD). Data were drawn from a published randomized controlled trial of AMT conducted with a racially diverse group of 109 veterans with PTSD and anger symptoms residing in Hawaii. Results of latent growth curve models indicated that gains in calming skills predicted significantly larger reductions in anger symptoms at post-treatment, while the development of cognitive coping and behavioral control skills did not predict greater symptom reductions. Therapeutic alliance had indirect effects on all outcomes mostly via arousal calming skills. Results suggest that generalized symptom reduction may be mediated by development of skills in calming physiological arousal. In addition, arousal reduction skills appeared to enhance one's ability to employ other anger regulation skills.",0,0 +6194,Finite Mixture Modeling with Mixture Outcomes Using the EM Algorithm,"This paper discusses the analysis of an extended finite mixture model where the latent classes corresponding to the mixture components for one set of observed variables influence a second set of observed variables. The research is motivated by a repeated measurement study using a random coefficient model to assess the influence of latent growth trajectory class membership on the probability of a binary disease outcome. More generally, this model can be seen as a combination of latent class modeling and conventional mixture modeling. The EM algorithm is used for estimation. As an illustration, a random-coefficient growth model for the prediction of alcohol dependence from three latent classes of heavy alcohol use trajectories among young adults is analyzed.",0,0 +6195,Predicting post-traumatic stress disorder in veterans: Interaction of traumatic load with COMT gene variation,"Because post-traumatic stress disorder (PTSD) by definition can occur only after exposure to a traumatic event, military veterans who are at high risk for trauma exposure are a particularly relevant population for studying the interaction of trauma with genetic factors that may predispose for the disorder. A number of studies have implicated specific genes as possible risk factors in developing PTSD, including the catechol-O-methyltransferase gene (COMT).Data from Iraq War veterans (n = 236) were used to examine the interaction between COMT and traumatic experiences in predicting later development of PTSD symptoms. Subjects were assessed for exposure to traumatic events both before and during deployment.The interaction between trauma load and COMT was a significant predictor of PTSD symptoms. Those with the heterozygous genotype (Val/Met) showed fewer symptoms associated with trauma exposure compared to those with either homozygous genotype. This interaction remained significant after controlling for other risk factors for PTSD, including personality dimensions of Internalizing and Externalizing.COMT genotype affects risk for development of PTSD symptoms following exposure to trauma.",0,0 +6196,Using a hybrid model to investigate the comorbidity and symptom overlap between social phobia and the other anxiety disorders and unipolar mood disorders,New hybrid models of psychopathology have been proposed that combine the current categorical approach with symptom dimensions that are common across various disorders. The present study investigated the new hybrid model of social anxiety in a large sample of participants with anxiety disorders and unipolar mood disorders to improve understanding of the comorbidity and symptom overlap between social phobia (SOC) and the other anxiety disorders and unipolar mood disorders. Six hundred and eighty two participants from a specialized outpatient clinic for anxiety treatment completed a semi-structured diagnostic interview and the Multidimensional Assessment of Social Anxiety (MASA). A hybrid model symptom profile was identified for SOC and compared with each of the other principal diagnoses. Significant group differences were identified on each of the MASA scales. Differences also were identified when common sets of comorbidities were compared within participants diagnosed with SOC. The findings demonstrated the influence of both the principal diagnosis of SOC and other anxiety disorders and unipolar mood disorders as well as the influence of comorbid diagnoses with SOC on the six symptom dimensions. These findings highlight the need to shift to transdiagnostic assessment and treatment practices that go beyond the disorder-specific focus of the current categorical diagnostic systems.,0,0 +6197,A prospective examination of post-traumatic stress disorder in rape victims,,0,0 +6198,Translational Fear Inhibition Models as Indices of Trauma-related Psychopathology,"Posttraumatic stress disorder (PTSD) is a debilitating psychiatric condition that arises from exposure to a traumatic event such as combat exposure, a vehicular accident, or an act of violence. The symptom clusters of PTSD include hyperarousal and re-experiencing of the traumatic event when exposed to trauma reminders, as well as avoidance of such reminders. The fear-and anxiety-related symptoms of PTSD can be conceptualized, and subsequently modeled, as the result of fear conditioning such that the traumatic event serves as an unconditioned stimulus and the environmental cues present at the time of the trauma serve as conditioned stimuli that can ultimately elicit conditioned fear responses (i.e., clinical symptoms) long after the trauma has occurred. Many of the most successful treatments for anxiety disorders such as PTSD are based on the principles of fear extinction in which the repeated presentation of a conditioned stimulus, without noxious consequences, reduces the frequency and intensity of a conditioned response. In the current review, we discuss the most widely employed psychophysiological protocols that have been used to study fear processing in human populations, both psychiatrically healthy and with PTSD. Special emphasis is placed on how translational clinical research can inform clinical practices and vice versa. © 2011 Bentham Science Publishers.",0,0 +6199,Climate change and thermal comfort in Hong Kong,"Thermal comfort is a major issue in cities and it is expected to change in the future due to the changing climate. The objective of this paper is to use the universal thermal comfort index (UTCI) to compare the outdoor thermal comfort in Hong Kong in the past (1971-2000) and the future (2046-2065 and 2081-2100). The future climate of Hong Kong was determined by the general circulation model (GCM) simulations of future climate scenarios (A1B and B1) established by the Intergovernmental Panel on Climate Change (IPCC). Three GCMs were chosen, GISS-ER, GFDL-CM2.1 and MRI-CGCM2.3.2, based on their performance in simulating past climate. Through a statistical downscaling procedure, the future climatic variables were transferred to the local scale. The UTCI is calculated by four predicted climate variables: air temperature, wind speed, relative humidity and solar radiation. After a normalisation procedure, future UTCI profiles for the urban area of Hong Kong were created. Comparing the past UTCI (calculated by observation data) and future UTCI, all three GCMs predicted that the future climate scenarios have a higher mode and a higher maximum value. There is a shift from 'No Thermal Stress' toward 'Moderate Heat Stress' and 'Strong Heat Stress' during the period 2046-2065, becoming more severe for the later period (2081-2100). Comparing the two scenarios, B1 exhibited similar projections in the two time periods whereas for A1B there was a significant difference, with both the mode and maximum increasing by 2 °C from 2046-2065 to 2081-2100. © 2012 ISB.",0,0 +6200,PTSD and Chronic Pain: Cognitive-Behavioral Perspectives and Practical Implications,"GH, a 40-year-old software engineer, was referred to the second author by his primary care physician for treatment of Posttraumatic Stress Disorder (PTSD) that developed subsequent to a road traffic collision 9 months earlier. A vehicle struck GH at moderate speed while he was cycling to work during rush-hour traffic and, as a result, he was flipped over the handlebars and thrown against a building wall. He hit his head, cracking the helmet he was wearing, and sustained multiple soft tissue injuries to his neck, upper back, and shoulders that were considered mild in nature. GH was deemed to be not at fault for the accident, and his insurance company replaced his bicycle and helmet and covered his hospital expenses and wage loss. He took 6 weeks off work and resumed fulltime employment after receiving a transfer 6 months after the accident. During his intake interview, GH reported having difficulty performing his job and being easily irritated by colleagues. On examination, he was found to meet diagnostic criteria for PTSD, with scores on various assessment instruments indicating his symptoms to be severe. He was also moderately depressed and was experiencing daily pain in his neck and back, which, although fluctuating in severity from mild to moderate, had persisted over the past 9 months.",0,0 +6201,"Fluoxetine in the acute treatment and relapse prevention of combat-related post-traumatic stress disorder: Analysis of the veteran group of a placebo-controlled, randomized clinical trial","The efficacy and safety of fluoxetine (20-80 mg) was compared with placebo in 144 veterans [36.2 years], diagnosed with combat-related post-traumatic stress disorder (PTSD) selected from a 12-week acute and 24-week relapse prevention PTSD trial. In the acute phase, improvements were greater with fluoxetine than placebo in the disease-specific outcome measures: Treatment Outcome PTSD (TOP-8) total scores (SE):-9.05 (0.90) and -5.20 (1.23), p = 0.001; Clinician Administered PTSD Scale (CAPS) total scores:-31.12 (2.72) and -16.07 (4.24), p < 0.001; all CAPS subscores; Davidson Trauma Scale (DTS) total scores; and other general outcome measures. In the maintenance phase, fluoxetine was superior to placebo in sustaining improvement in TOP-8 [-1.01 (0.91) and 1.56 (0.95)] and CAPS [-4.93 (3.54) and 5.48 (3.66)]. The risk of relapse in the placebo arm was significantly greater than in the fluoxetine arm (log-rank test chi 2 = 4.090, df = 1, p = 0.048). Fluoxetine was well tolerated at a mean daily dose of 65 mg.",0,0 +6202,Anxiety and post-traumatic stress symptoms following wisdom tooth removal,"The purpose of the present study was to determine the psychological impact of wisdom teeth removal and to identify the psychological risk factors for the development of dental anxiety and post-traumatic stress symptoms. Participants were 34 consecutive elective patients referred for surgical removal of a wisdom tooth under local anesthesia. Frequency of previous distressing dental events and general traumatic life events were assessed at baseline (t1), and emotional distress (pain, state anxiety and disturbance) immediately after treatment (t2). Post-traumatic stress responses were determined three days after treatment (t3), and at four weeks follow-up (t4), while severity of dental trait anxiety was assessed at t1 and at t4. Two patients (8%) met screening criteria for Post-Traumatic Stress Disorder (PTSD) at t4. Multivariate analysis revealed that previous exposure to distressing dental events and pre-operative anxiety level predicted anxiety level at t4, accounting for 71% of the variance. Severity of pain during treatment was a significant predictor variable of PTSD symptom severity at t4 (25% explained variance). The findings underline the importance of pain-free treatments and awareness of patients' individual predisposition to anxiety or trauma-related symptoms to reduce the risk of iatrogenic psychological harm.",0,0 +6203,The PRESERVE mortality risk score and analysis of long-term outcomes after extracorporeal membrane oxygenation for severe acute respiratory distress syndrome,"PurposeThis study was designed to identify factors associated with death by 6 months post-intensive care unit (ICU) discharge and to develop a practical mortality risk score for extracorporeal membrane oxygenation (ECMO)-treated acute respiratory distress syndrome (ARDS) patients. We also assessed long-term survivors’ health-related quality of life (HRQL), respiratory symptoms, and anxiety, depression and post-traumatic stress disorder (PTSD) frequencies.MethodsData from 140 ECMO-treated ARDS patients admitted to three French ICUs (2008–2012) were analyzed. ICU survivors contacted >6 months post-ICU discharge were assessed for HRQL, psychological and PTSD status.ResultsMain ARDS etiologies were bacterial (45 %), influenza A[H1N1] (26 %) and post-operative (17 %) pneumonias. Six months post-ICU discharge, 84 (60 %) patients were still alive. Based on multivariable logistic regression analysis, the PRESERVE (PRedicting dEath for SEvere ARDS on VV-ECMO) score (0–14 points) was constructed with eight pre-ECMO parameters, i.e. age, body mass index, immunocompromised status, prone positioning, days of mechanical ventilation, sepsis-related organ failure assessment, plateau pressure andpositive end-expiratory pressure. Six-month post-ECMO initiation cumulative probabilities of survival were 97, 79, 54 and 16 % for PRESERVE classes 0–2, 3–4, 5–6 and ≥7 (p < 0.001), respectively. HRQL evaluation in 80 % of the 6-month survivors revealed satisfactory mental health but persistent physical and emotional-related difficulties, with anxiety, depression or PTSD symptoms reported, by 34, 25 or 16 %, respectively.ConclusionsThe PRESERVE score might help ICU physicians select appropriate candidates for ECMO among severe ARDS patients. Future studies should also focus on physical and psychosocial rehabilitation that could lead to improved HRQL in this population.",0,0 +6204,OPRM1 and Diagnosis-Related Posttraumatic Stress Disorder in Binge-Drinking Patients Living with HIV,"Posttraumatic stress disorder (PTSD) has been linked to numerous negative outcomes in persons living with HIV (PLH) and there is evidence that PTSD symptoms may play a role in maintaining alcohol use problems. The opioid receptor mu-1 (OPRM1) gene may play a role in both PTSD and alcohol use. We examined the association between PTSD and drinking motives as well as variation in the OPRM1 as a predictor of both PTSD and drinking motives in a sample of 201 PLH reporting recent binge drinking. Self-reported PTSD symptom severity was significantly associated with drinking motives for coping, enhancement, and socialization. OPRM1 variation was associated with decreased PTSD symptom severity as well as enhancement motives for drinking.",0,0 +6205,Heart rate after trauma and the specificity of fear circuitry disorders,"Fear circuitry disorders purportedly include post-traumatic stress disorder (PTSD), panic disorder, agoraphobia, social phobia and specific phobia. It is proposed that these disorders represent a cluster of anxiety disorders triggered by stressful events and lead to fear conditioning. Elevated heart rate (HR) at the time of an aversive event may reflect strength of the unconditioned response, which may contribute to fear circuitry disorders.This prospective cohort study assessed HR within 48 h of hospital admission in 602 traumatically injured patients, who were assessed during hospital admission and within 1 month of trauma exposure for lifetime psychiatric diagnosis. At 3 months after the initial assessment, 526 patients (87%) were reassessed for PTSD, major depressive disorder, panic disorder, agoraphobia, social phobia, obsessive compulsive disorder and generalized anxiety disorder.At the 3-month assessment there were 77 (15%) new cases of fear circuitry disorder and 87 new cases of non-fear circuitry disorder (17%). After controlling for gender, age, type of injury and injury severity, patients with elevated HR (defined as ≥96 beats per min) at the time of injury were more likely to develop PTSD [odds ratio (OR) 5.78, 95% confidence interval (CI) 2.32-14.43], panic disorder (OR 3.46, 95% CI 1.16-10.34), agoraphobia (OR 3.90, 95% CI 1.76-8.61) and social phobia (OR 3.98, 95% CI 1.42-11.14). Elevated HR also predicted new fear circuitry disorders that were not co-morbid with a non-fear circuitry disorder (OR 7.28, 95% CI 2.14-24.79).These data provide tentative evidence of a common mechanism underpinning the onset of fear circuitry disorders.",0,0 +6206,Post-Treatment Lyme Syndrome and Central Sensitization,"Central sensitization is a process that links a variety of chronic pain disorders that are characterized by hypersensitivity to noxious stimuli and pain in response to non-noxious stimuli. Among these disorders, treatments that act centrally may have greater efficacy than treatments acting peripherally. Because many individuals with post-treatment Lyme syndrome (PTLS) have a similar symptom cluster, central sensitization may be a process mediating or exacerbating their sensory processing. This article reviews central sensitization, reports new data on sensory hyperarousal in PTLS, explores the potential role of central sensitization in symptom chronicity, and suggests new directions for neurophysiologic and treatment research.",0,0 +6207,The covariation of multiple risk factors in primary care: a latent class analysis,"There is a need to advance the quality of healthcare by increasing knowledge about multiple risk factors and how to intervene to improve health outcomes. In an effort to better describe the presentation of multiple risks, this study involved a database review to describe the prevalence and covariation of multiple risk factors in individuals presenting to primary care. Patients with a primary care encounter from January 1, 2005 to June 30, 2005 (N = 10,043) were identified from the Department of Veteran's Affair's medical database and information about the following risk factors was extracted: alcohol use, psychiatric distress, body mass, smoking status, blood pressure, and posttraumatic stress. Exploratory and confirmatory latent class analyses identified three classes of individuals. Class 1 consisted of individuals with an overall lower level of risk for health problems, but a moderately high likelihood of elevated blood pressure. Individuals in Class 2 appeared to have the greatest need for intervention because they had a moderate to high likelihood of reporting at risk alcohol use, smoking, depression, and posttraumatic stress. Class 3 consisted of individuals reporting the co-occurrence of at risk alcohol use, smoking, and elevated blood pressure. Similar to past research, the findings highlight the need for addressing multiple risk factors in primary care. In addition, this study expands on the literature by identifying specific patterns of covariation among different risk factors that suggest avenues for research and program development. (",0,0 +6208,Influence of RGS2 on Sertraline Treatment for Social Anxiety Disorder,"Only a minority of patients with social anxiety disorder (SAD) has a robust therapeutic response to evidence-based serotonin reuptake inhibitor (SSRI) treatment. To help improve the personalized medicine approach to psychiatric care, we evaluated several candidate genetic predictors of SSRI response in SAD. At the start of a randomized controlled trial (NCT00282828), 346 patients with SAD at three sites received protocol-driven, open-label treatment with sertraline, up to 200. mg/d over 10 weeks. Efficacy was determined using a continuous measure of outcome (Liebowitz Social Anxiety Scale (LSAS)) and dichotomous indicators of response (LSAS ≤ 50) and remission (LSAS ≤ 30). Predictors of efficacy were examined in multivariate regression models that included eight polymorphic variants in four candidate genes (four in RGS2, two in HTR2A, one in SLC6A2, and one in SLC6A4). Adjusting for genetic ancestral cluster and non-genetic predictors of response, all four single-nucleotide polymorphisms (SNPs) in RGS2 predicted change in LSAS over time, at study-wise significance (p=0.00833), with the minor allele associated with less improvement over time. After adjusting for genetic ancestral cluster and non-genetic predictors of remission, two of the four RGS2 SNPs predicted likelihood of remission at or just below study-wise significance (p=0.025): rs4606 (AOR=0.49 (95% CI=0.27-0.90), p=0.022) and rs1819741 (AOR=0.50 (95% CI=0.28-0.92), p=0.027). Variation in RGS2, a gene previously shown to be associated with social anxiety phenotypes and serotonergic neurotransmission, may be a biomarker of the likelihood of substantially benefiting from sertraline among patients with SAD.",0,0 +6209,Trajectory-based methods in clinical psychology: A person centred narrative approach,Abstract Life trajectories in clinical psychology research are often not treated as interactive trajectories but rather as static transversal variables. But developmental pathways are often cumulative and conditional and currently require sophisticated group-based modeling to tease out individual differences in trajectories. Clinical psychologists often require personal information on transitions and turning points in life which require eliciting information through qualitative life history approaches. A method is proposed for identifying life events within the person's narrative and describing trajectories as event spaces likely to reflect end-point psychopathology.,0,0 +6210,Is there a Gulf War Syndrome? Searching for syndromes by factor analysis of symptoms,"Objective. - To search for syndromes in Persian Gulf War veterans. Participants. - Two hundred forty-nine (41%) of the 606 Gulf War veterans of the Twenty-fourth Reserve Naval Mobile Construction Battalion living in 5 southeastern states participated; 145 (58%) had retired from service, and the rest were still serving in the battalion. Design. - Participants completed a standardized survey booklet measuring the anatomical distributions or characteristics of each symptom, a booklet measuring wartime exposures, and a standard psychological personality assessment inventory. Two-stage factor analysis was used to disentangle ambiguous symptoms and identity syndromes. Main Outcome Measures. - Factor analysis-derived syndromes. Results. - Of 249 participants, 175 (70%) reported having had serious health problems that most attributed to the war, and 74 (30%) reported no serious health problems. Principal factor analysis yielded 6 syndrome factors, explaining 71% of the variance. Dichotomized syndrome indicators identified the syndromes in 63 veterans (25%). Syndromes 1 ('impaired cognition,' characterized by problems with attention, memory, and reasoning, as well as insomnia, depression, daytime sleepiness, and headaches), 2 ('confusion-ataxia,' characterized by problems with thinking, disorientation, balance disturbances, vertigo, and impotence), and 3 ('arthro-myo-neuropathy,' characterized by joint and muscle pains, muscle fatigue, difficulty lifting, and extremity paresthesias) represented strongly clustered symptoms; whereas, syndromes 4 ('phobia- apraxia'), 5 ('fever-adenopathy'), and 6 ('weakness-incontinence') involved weaker clustering and mostly overlapped syndromes 2 and 3. Veterans with syndrome 2 were 12.5 times (95% confidence interval, 3.5-44.8) more likely to be unemployed than those with no health problems. A psychological profile, found in 48.4% of those with the syndromes, differed from posttraumatic stress disorder, depression, somatoform disorder, and malingering. Conclusion. - These findings support the hypothesis that clusters of symptoms of many Gulf War veterans represent discrete factor analysis-derived syndromes that appear to reflect a spectrum of neurologic injury involving the central, peripheral, and autonomic nervous systems.",0,0 +6211,Long-Term Pharmacotherapy for Post-Traumatic Stress Disorder,"This article reviews the literature on the long-term pharmacological treatment of post-traumatic stress disorder (PTSD). A PUBMED search was conducted; only studies on the effects of long-term (> 14-weeks) pharmacological treatment for PTSD in adults or children were considered. Our search identified three randomised, double-blind, placebo-controlled studies (one each for sertraline, fluoxetine and risperidone), four open-label studies (one each for sertraline, paroxetine, nefazodone and valproate), one retrospective case series (clozapine) and one pooled analysis (sertraline). All studies involved adult populations, with the exception of the study of clozapine. The studies demonstrate that long-term treatment of PTSD with SSRIs effectively maintains the previous treatment response and improvement in quality of life, converts more patients to responder status and accounts for one-third of overall treatment gains. Greater PTSD severity predicts a longer time to response to these drugs. Discontinuation of SSRI treatment after 12 weeks results in a greater risk of relapse and symptom exacerbation compared with extended treatment. In addition to improved PTSD symptoms, extended treatment with paroxetine improves verbal declarative memory and increases hippocampal volume. Long-term treatment of PTSD with atypical antipsychotics (risperidone and clozapine), non-SSRI antidepressants (nefazodone) and antiepileptic drugs (AEDs; valproate) also appears to result in significant improvements in PTSD symptoms. In conclusion, long-term treatment of PTSD with SSRIs improves the psychiatric and clinical outcome of patients with the disorder and prevents relapse and symptom exacerbation. The effect of other agents (atypical antipsychotics, AEDs and other psychotropic medications) requires further controlled study. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +6212,Family history of a mood disorder indicates a more severe bipolar disorder,"In the clinical setting, patients with bipolar disorder (BD) are often asked about potential family history (FH) of mood disorders. The aim of the present study was to examine differences between BD patients with FH of a mood disorder, and those without, on clinical, personality and social functioning characteristics, as well as on the symptomatic course of the disorder.Data was collected from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). For this report, we included 2600 patients, 1963 of those reported having a first-degree family member with a mood disorder, and 637 reported of no such FH. We investigated the impact of FH on socio-demographic, clinical, personality and quality of life variables, as well as on symptomatology during the first year of treatment.Patients reporting FH of a mood disorder had an earlier age at onset of depression/mania, more phases, rapid cycling and more suicide attempts. Across different assessments, patients with FH showed consistently elevated depressive symptoms, such as lower concentration and energy, higher suicidal ideation, as well as increased racing thoughts and distractibility within the manic spectrum of symptoms. Further, the FH group had lower quality of life, higher neuroticism and higher personality disorder scores compared to patients without FH.Information on FH was obtained through the proband.Overall, BD patients reporting FH of a mood disorder showed a worse clinical profile upon presentation for treatment and a more symptomatic course of the disorder.",0,0 +6213,"Expressive writing and post-traumatic stress disorder: Effects on trauma symptoms, mood states, and cortisol reactivity","This study investigates the boundary conditions (feasibility, safety, and efficacy) of an expressive writing intervention for individuals with post-traumatic stress disorder [PTSD].Randomized trial with baseline and 3-month follow-up measures of PTSD severity and symptoms, mood states, post-traumatic growth, and (post-only) cortisol reactivity to trauma-related stress.Volunteers with a verified diagnosis of PTSD (N=25) were randomly assigned to an experimental group (writing about their traumatic experience) or control group (writing about time management).Expressive writing was acceptable to patients with PTSD and appeared safe to utilize. No changes in PTSD diagnosis or symptoms were observed, but significant improvements in mood and post-traumatic growth were observed in the expressive writing group. Finally, expressive writing greatly attenuated neuroendocrine (cortisol) responses to trauma-related memories.The present study provides insight into several boundary conditions of expressive writing. Writing did not decrease PTSD-related symptom severity. Although patients continue to exhibit the core features of PTSD, their capacity to regulate those responses appears improved following expressive writing. Dysphoric mood decreased after writing and when exposed to traumatic memories, participants' physiological response is reduced and their recovery enhanced.",0,0 +6214,Psychopathology subtypes and symptom correlates among former prisoners of war,"Psychopathology and symptom patterns were studied in 60 former prisoners-of-war (POWs) by administering standardized tests including the Minnesota Multiphasic Personality Inventory (MMPI), an adjustment problem checklist, and a structured clinical interview. Most POWs showed marked psychological impairment, but modal profile analysis identified two prototypic MMPI patterns, which differed in pervasiveness and type of psychopathology. Profile subtypes were defined by unique clusters of clinical symptoms and differed in confinement stress severity. The typology of symptoms argues against a homogeneous conceptualization of stress-induced disorders and suggests the need for definition of the severity and subtype of stress phenomena and individual difference factors in responding to trauma. © 1986 Plenum Publishing Corporation.",0,0 +6215,Antidepressant Drugs in Dermatology,"Recent studies indicate that antidepressant medications may be effective treatments for dermatologic disorders such as chronic urticaria and angioedema, nocturnal pruritus in atopic eczema, and postherpetic neuralgia, even in the absence of coexisting psychopathologic conditions. Their efficacy may be related to their antihistaminic, anticholinergic, and centrally mediated analgesic effects and appears to be independent of their antidepressant effect. It is likely, therefore, that more dermatologists will be prescribing these drugs without a psychiatric consultation.",0,0 +6216,Are gender differences in post-traumatic stress disorder rates attenuated in substance use disorder patients?,"Abstract We review 15 studies that examined rates of post-traumatic stress disorder (PTSD) in substance use disorder (SUD) patients to determine whether the typical female-greaterthan-male gender difference in PTSD rates is attenuated in SUD samples. Since the majority of studies reviewed did not find a gender difference in PTSD rates, we critically examined methodological factors that might account for this attenuation, but none appeared to completely account for the variability in detection of gender differences across studies. Several factors may contribute to making rates of PTSD among SUD males equivalent to the high rates observed in SUD females: 1) the risky lifestyle associated with men's substance abuse may increase their exposure to traumatic events, 2) a history of more severe trauma characteristics may be apparent among men with SUDs, or 3) attenuated gender differences in rates of other comorbidities that increase PTSD risk (e.g., depression) may exist. Clinical implications are discussed. According to epidemiological studies, post-traumatic stress disorder (PTSD) is a highly comorbid condition among those with substance use disorders (SUDs; see review by Stewart, 1996). In the National Comorbidity Survey, a large-scale epidemiologic survey conducted in the U.S., Kessler and colleagues (1997) found that those with alcohol dependence were at 3-4 times increased risk of lifetime PTSD as compared to those without alcohol dependence. Moreover, the presence of comorbid PTSD among individuals being treated for SUDs is related to poorer treatment adherence (Hien, Nunes, Rudnick Levin, & Fraser, 2000) and outcomes, including higher relapse rates (e.g., Ouimette, Brown, & Najavits, 1998; Ouimette, Finney, & Moos, 1999). It has been suggested that if patients with comorbid SUD-PTSD were to receive trauma-specific treatment, they might avoid overutilizing or misusing expensive inpatient SUD treatments, thereby reducing the cost of clinical care (e.g., Brown, Recupero, & Stout, 1995). The delineation of gender variations in the presentation of this comorbidity may identify factors that will improve treatment outcomes (Sonne et al., 2003). A fairly consistent finding across epidemiologic studies on PTSD rates in the general adult population is that women are about twice as likely to have PTSD as men (e.g., Breslau, Chilcoat, Kessler, Peterson, & Lucia, 1999; Breslau, Davis, Andreski, & Peterson, 1991; Breslau, Davis, Andreski, Peterson, & Schultz, 1997; Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995). Moreover, women experience qualitatively different traumatic life experiences than do men. These findings have led to an interest in understanding gender differences in PTSD and their implications for etiology and treatment of the disorder (e.g., Kimerling, Ouimette, & Weitlauf, in press). Early research on comorbid PTSD-SUDs focused almost exclusively on male veterans whose pathology arose in the context of combat trauma; more recently, a focus has emerged on women with comorbid PTSD-SUDs (Najavits, Weiss, & Shaw, 1997). The major purpose of this article is to examine gender as an important individual difference variable with respect to trauma and PTSD among patients with SUDs. This brief review focuses on rates of trauma and PTSD among clinical samples of male and female SUD patients. Summaries of the methods and findings of the studies reviewed in this article are provided in Tables 1 and 2, for trauma exposure rates and PTSD rates, respectively. Gender Differences in Adult Samples Brown et al. (1995) studied the prevalence of trauma histories and comorbid PTSD among 84 adults (48 male; 36 female) seeking treatment at a private hospital inpatient substance-abuse treatment program. Participants completed self-report measures of lifetime trauma exposure and PTSD symptoms. Women were more likely than men to have been physically abused/assaulted (31% vs. …",0,0 +6217,Reactions to Combat Stress in Israeli Veterans Twenty Years After the 1982 Lebanon War,"During the war or shortly thereafter, the most common manifestation of combat induced psychopathology is combat stress reaction (CSR). The long-term consequences of CSR have so far received little scientific attention. The aim of this study was to examine whether CSR is a marker for long-term PTSD and other psychiatric comorbidities. Two groups of veterans from the 1982 Lebanon war were assessed 20 years after the war: one comprised 286 CSR casualties and the other comprised 218 matched non-CSR soldiers. Participants were assessed for PTSD, psychiatric symptomatology, social functioning, physical health, and postwar life events. Twenty years after the war, veterans with antecedent CSR reported more PTSD, psychiatric symptomatology and distress, social dysfunction, and health problems than did non-CSR veterans. We conclude that CSR should be seen as a marker for long-term psychiatric distress and impairment. In addition, the implications of combat-related trauma are broad and varied, and go beyond the narrow scope of PTSD.",0,0 +6218,Predicting Posttraumatic Stress Symptoms From Pretraumatic Risk Factors: A 2-Year Prospective Follow-Up Study in Firefighters,"Most studies focusing on risk factors for posttraumatic stress disorder (PTSD) have used retrospective study designs. Only a small number of studies have prospectively examined risk factors in the immediate aftermath of trauma exposure in predicting PTSD symptoms. The purpose of this study was to identify predictive risk factors for posttraumatic stress symptoms and comorbid psychopathological symptoms present during the time before exposure to traumatic stress in a high-risk population.Forty-three professional firefighters were assessed immediately after basic training (baseline) and at 6, 9, 12, and 24 months after entry into firefighter service. Subjects were screened for psychopathological symptoms, including symptoms of PTSD, depression, and anxiety. Subjects were also characterized with regard to personality traits such as self-efficacy, hostility, and alexithymia. Neuroendocrine activity was assessed by examination of awakening and diurnal salivary cortisol profiles and 24-hour urinary catecholamine excretion. Multiple linear regression analysis was used to analyze posttraumatic stress symptoms at 24-month follow-up as a function of pretraumatic characteristics.A high level of hostility and a low level of self-efficacy at baseline accounted for 42% of the variance in posttraumatic stress symptoms after 2 years. Subjects who had both risk factors at baseline showed a significant increase in measures of PTSD symptoms, depression, anxiety, general psychological morbidity, global symptom severity, and alexithymia during the 2-year period. Biological characteristics were not predictive of the development of psychopathological symptoms.These results suggest that specific personality traits may constitute markers of vulnerability to the development of psychopathological symptoms after trauma exposure. Early identification of preexisting risk factors is needed to provide effective prevention and intervention for individuals who are at risk of developing trauma-related disorders.",0,0 +6219,"Adaptation to Traumatic Stress: Resilient Traits, Resources, and Trajectories of Outcomes","The term resilience is too often poorly operationalized and loosely conceptualized. Historically, it has beendefined as a trait, characteristic, or collection of resources that facilitates healthy adjustment to a potentially traumaticevent (PTE) and has typically been measured at one point in time. More recently, it has been defined as an outcome, or asuccessful course of adaptation following exposure to a severe and overwhelming experience. Inherent in this definition isthe expectation that a cross-sectional evaluation will fall short; if resilience is an adaptation to an experience, it must thenunfold over time. Unfortunately, the absence of a single unifying paradigm of resilience has hindered progress in the field.In this review, we discuss the handful of characteristics that are most consistently linked to low levels of distressfollowing exposure to a PTE and describe several prototypic trait resilience measures for adults. We also describe andcritically evaluate research that has generated distinct typologies or groups with similar trajectories of adjustmentfollowing exposure to PTEs. Finally, we provide examples of several studies of interventions to promote resilience.Ultimately, for the field to advance, clinicians, researchers, and policy-makers need to isolate the factors that reliablypromote a successful adjustment across a broad range of domains, including emotional, physical, and occupationalfunctioning. Once known, prevention and intervention strategies need to be refined and tested so that suffering anddysfunction can be mitigated before chronic and debilitating distress become entrenched in those who do not recover ontheir own.",0,0 +6220,Post-Traumatic Stress Disorder Symptoms among Gulf War Veterans,"This study assessed the prevalence of risk for development of post-traumatic stress disorder (PTSD) symptoms among active duty and reserve veterans from Pennsylvania and Hawaii who either deployed (N = 1,524) or did not deploy (N = 2,727) to the Persian Gulf as a result of Operation Desert Storm. All participants anonymously completed a survey questionnaire that included the Impact of Event Scale and the Brief Symptom Inventory. Results indicate the likelihood of PTSD symptoms in approximately 8.0% of active duty veterans and 9.3% of reserve veterans who deployed to the Persian Gulf. PTSD risk comparisons are made with other active duty Army veterans assessed 1 year earlier. Sources of trauma are presented and implications for future military deployments on potential risks for developing PTSD are discussed.",0,0 +6221,Challenging Anxiety: A Focus on the Specificity of Respiratory Symptoms,"Physiological symptoms are characteristic features of anxiety states. Presumably, specific psychophysiological profiles differentiate between anxiety disorders, which would offer potential for diagnostic purposes. Abundant evidence points to a causal relationship between panic disorder and instability of respiratory regulation. However, the specificity of most measures that indicate aberrant functioning of the respiratory system in PD can be questioned. Possibly, the traditional measures of respiratory functioning are too restricted. The underlying respiratory vulnerability in PD seems to constitute a subtle, unstable trait, which calls for more sensitive and sophisticated measures of respiratory variability and chaos. To increase the probability of finding parameters with diagnostic specificity, the application of disorder specific challenge paradigms is recommended.",0,0 +6222,Viewing Suicide Risk Through a New Lens: The Benefits of Examining Symptom Trajectories,,0,0 +6223,,"The present study provided psychometric data on the KID-SAVE, an empirically based measure of children's exposure to community violence. The KID-SAVE was administered to 470 inner-city children in the third through seventh grades and demonstrated excellent reliability. Factor analysis yielded three subscales: Traumatic Violence, Indirect Violence, and Physical/Verbal Abuse. Initial investigation of construct validity suggested that the KID-SAVE successfully discriminated between groups of children reporting high and low levels of traumatic symptoms. The KID-SAVE appears to be a promising assessment tool and allows for quantification of the severity of violence exposure.",0,0 +6224,DSM-IV post-traumatic stress disorder among World Trade Center responders 11–13 years after the disaster of 11 September 2001 (9/11),"Background Post-traumatic symptomatology is one of the signature effects of the pernicious exposures endured by responders to the World Trade Center (WTC) disaster of 11 September 2001 (9/11), but the long-term extent of diagnosed Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) post-traumatic stress disorder (PTSD) and its impact on quality of life are unknown. This study examines the extent of DSM-IV PTSD 11–13 years after the disaster in WTC responders, its symptom profiles and trajectories, and associations of active, remitted and partial PTSD with exposures, physical health and psychosocial well-being. Method Master's-level psychologists administered sections of the Structured Clinical Interview for DSM-IV and the Range of Impaired Functioning Tool to 3231 responders monitored at the Stony Brook University World Trade Center Health Program. The PTSD Checklist (PCL) and current medical symptoms were obtained at each visit. Results In all, 9.7% had current, 7.9% remitted, and 5.9% partial WTC-PTSD. Among those with active PTSD, avoidance and hyperarousal symptoms were most commonly, and flashbacks least commonly, reported. Trajectories of symptom severity across monitoring visits showed a modestly increasing slope for active and decelerating slope for remitted PTSD. WTC exposures, especially death and human remains, were strongly associated with PTSD. After adjusting for exposure and critical risk factors, including hazardous drinking and co-morbid depression, PTSD was strongly associated with health and well-being, especially dissatisfaction with life. Conclusions This is the first study to demonstrate the extent and correlates of long-term DSM-IV PTSD among responders. Although most proved resilient, there remains a sizable subgroup in need of continued treatment in the second decade after 9/11.",0,0 +6225,Biological Perspectives: Detecting Malingering of Post-Traumatic Stress Disorder (PTSD) in Adults,"The issue of detecting malingering post-traumatic stress disorder (PTSD) is a difficult one. Given the complexity of PTSD and the current state of the art in making accurate diagnosis of various mental health conditions, it should be no surprise that detecting malingering in patients complaining of symptoms of possible PTSD is a difficult process. This article is intended to shed more light than darkness on this process. Clearly, the ideas and approaches that are suggested are meant as an introduction to developing a deeper understanding of the processes associated with detecting malingering of PTSD. In doing this, it is intended to make the process of attempting to detect the possible malingering of PTSD a clearer,more thoughtful, and more clinically useful endeavor. Certainly, such an effort is not free from controversy nor is it perfect. Also, the approaches that are described here are not unique and can be found elsewhere in the literature. Assessing PTSD and detecting possible malingering of PTSD is a difficult task. However, if a clinician takes a multimodal approach to the assessment of PTSD, then the process of detecting possible attempts to malinger this disorder is far less daunting. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +6226,"Pituitary response to metyrapone in Gulf War veterans: Relationship to deployment, PTSD and unexplained health symptoms","Gulf War deployment has been associated with a distinct neuroendocrine profile characterized by low 24h basal ACTH levels and enhanced cortisol and ACTH suppression to low-dose dexamethasone. The metyrapone stimulation test was performed to further characterize hypothalamic-pituitary activity in Gulf War veterans (GWV) and its relationship to unexplained medical symptoms and post-traumatic stress disorder (PTSD).Eleven GWV without PTSD, 18 GWV with PTSD and 15 healthy subjects not exposed to the Gulf War theater (non-exposed) underwent the metyrapone stimulation test, which inhibits cortisol synthesis, impairs cortisol-mediated negative feedback inhibition and in turn increases levels of ACTH and 11-deoxycortisol, a cortisol precursor. These hormones were measured at baseline (7:00 a.m.) and at intervals (from 8:00 a.m. to 4:00 p.m.) following the administration of metyrapone 750mg orally at 7:05 a.m. and at 10:05 a.m.There were group differences in the ACTH response despite similar cortisol and 11-deoxycortisol responses to metyrapone. GWV without PTSD had a significantly attenuated ACTH response compared to non-exposed subjects; GWV with PTSD had a significantly higher ACTH response than GWV without PTSD but did not differ from non-exposed subjects. Among GWV, unexplained medical health symptoms (e.g., neurological, musculoskeletal, cardiac, and pulmonary symptoms) and PTSD symptoms were significantly positively associated with the ACTH response to metyrapone.Gulf War deployment is associated with a substantially lower ACTH response to metyrapone. In contrast, unexplained health symptoms and PTSD in Gulf War veterans are associated with relatively greater hypothalamic-pituitary activity which may reflect increased CRF activity and is evident only in consideration of deployment effects. This pattern of differences suggests either that Gulf War deployment and its associated exposures results in enduring changes in pituitary function or that reduced hypothalamic-pituitary activity protects against the development of PTSD and other deployment-related health problems.",0,0 +6227,Sex differences in orbitofrontal connectivity in male and female veterans with TBI,"More female soldiers are now serving in combat theaters than at any other time. However, little is known about possible sex differences underlying the neuropathology and manifestation of one of modern war's signature injuries, traumatic brain injury (TBI). The paucity of information regarding sex differences in TBI is particularly evident when examining changes in executive function and emotion regulation associated with post concussive events. The current study objective was to observe whether patterns of orbitofrontal (OFC) functional connectivity would differ between female veterans with TBI and their male counterparts. The study further sought to determine whether OFC connectivity might be differentially associated with clinical measures of aggression and hostility. Seventeen female veterans and 24 male veterans, age 18 to 25, who met criteria for TBI completed resting state magnetic resonance imaging (MRI) and clinical assessment measures. Imaging data were analyzed using left and right seed regions of the OFC, and regression analyses were conducted to observe the relationship between resting state connectivity and self-reported aggression. Females and males in this study differed in OFC connectivity, with females demonstrating greater connectivity between left and right OFC and parietal and occipital regions and males demonstrating greater connectivity between left and right OFC and frontal and temporal regions. Significant associations between resting state connectivity and clinical measures were found only in male veterans. These findings suggest that TBI may interact with sex-specific patterns of brain connectivity in male and female veterans and exert divergent effects on clinical profiles of aggression post-injury.",0,0 +6228,Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) is an increasingly recognized and potentially preventable condition. Certain factors, especially the severity of the trauma, perceived lack of social support and peri-traumatic dissociation have been associated with its development. In recent years, a more robust evidence base regarding the management of individuals involved in traumatic events has emerged. Immediately after a traumatic event, simple practical, pragmatic support provided in a sympathetic manner by non-mental health professionals seems most likely to help. For individuals who develop persisting PTSD, trauma-focused cognitive behavioural therapy (TFCBT) may be beneficial within a few months of the trauma. For those who develop chronic PTSD, TFCBT and eye movement desensitization and reprocessing are best supported by the current evidence. Some anti-depressants appear to have a modest beneficial effect and are recommended as a second-line treatment. The current evidence base has allowed the development of guidelines that now require implementation. This has major implications in terms of planning and developing services that allow appropriately qualified and trained individuals to be available to cater adequately for the needs of survivors of traumatic events. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +6229,Posttraumatic stress disorder and family functioning in adolescent cancer,"Twenty three adolescents with a history of cancer, 27 physically abused adolescents, and 23 healthy, nonabused adolescents were administered structured posttraumatic stress disorder (PTSD) interviews and self-report questionnaires regarding family functioning. Thirty five percent of adolescent cancer subjects met criteria for lifetime PTSD as compared to only 7% of the abused adolescents: 17% of the cancer subjects and 11% of the abuse subjects met criteria for current PTSD. Adolescents with cancer viewed their mothers and fathers as significantly more caring and more protective than the comparison and abused adolescents. Cancer subjects who met criteria for lifetime PTSD saw their families as significantly more chaotic than those who did not have PTSD. Eighty three percent of cancer subjects who had lifetime PTSD also had mothers who had PTSD.",0,0 +6230,"Auditory verbal hallucinations in schizophrenia and post-traumatic stress disorder: common phenomenology, common cause, common interventions?","Auditory verbal hallucinations (AVH: 'hearing voices') are found in both schizophrenia and post-traumatic stress disorder (PTSD). In this paper we first demonstrate that AVH in these two diagnoses share a qualitatively similar phenomenology. We then show that the presence of AVH in schizophrenia is often associated with earlier exposure to traumatic/emotionally overwhelming events, as it is by definition in PTSD. We next argue that the content of AVH relates to earlier traumatic events in a similar way in both PTSD and schizophrenia, most commonly having direct or indirect thematic links to emotionally overwhelming events, rather than being direct re-experiencing. We then propose, following cognitive models of PTSD, that the reconstructive nature of memory may be able to account for the nature of these associations between trauma and AVH content, as may threat-hypervigilance and the individual's personal goals. We conclude that a notable subset of people diagnosed with schizophrenia with AVH are having phenomenologically and aetiologically identical experiences to PTSD patients who hear voices. As such we propose that the iron curtain between AVH in PTSD (often termed 'dissociative AVH') and AVH in schizophrenia (so-called 'psychotic AVH') needs to be torn down, as these are often the same experience. One implication of this is that these trauma-related AVH require a common trans-diagnostic treatment strategy. Whilst antipsychotics are already increasingly being used to treat AVH in PTSD, we argue for the centrality of trauma-based interventions for trauma-based AVH in both PTSD and in people diagnosed with schizophrenia.",0,0 +6231,Anhedonia and emotional numbing in combat veterans with PTSD,"We explored relationships between anhedonia and posttraumatic stress disorder (PTSD) symptom clusters, including their role in predicting psychiatric comorbidity. Our measure of anhedonia was derived from an examination of the latent structure of the Beck Depression Inventory. We found evidence for a two-factor solution, leading to anhedonia and undifferentiated, global depressive symptoms scales. In primary analyses, anhedonia had a unique positive relationship with PTSD's emotional numbing symptoms and minimal relationships with other PTSD symptoms. Upon examining the incremental validity of appetitive functioning (i.e., anhedonia, emotional numbing) over and above aversive functioning (i.e., re-experiencing, avoidance, and hyper-arousal PTSD symptoms) variables, greater emotional numbing increased the likelihood of being diagnosed with a major depressive disorder, and greater anhedonia increased the likelihood of being diagnosed with additional anxiety disorders and to a lesser extent, psychotic disorders. Results were consistent with research on the distinction of appetitive and aversive functioning, providing insight into the nature of PTSD.",0,0 +6232,An evaluation of competing models for the structure of PTSD symptoms using external measures of comorbidity,"Research on the structure of posttraumatic stress disorder (PTSD) symptoms has yielded support for two 4-factor models: the King (King, Leskin, King, & Weathers, 1998) and Simms/Watson models (Simms, Watson, & Doebbeling, 2002). This study evaluated them using data drawn from 1,128 Vietnam veterans by comparing associations with a latent internalizing comorbidity variable and five scales from the MMPI-2 Restructured Clinical (RC) Scales (Tellegen et al., 2003). The Simms/Watson dysphoria factor failed to show evidence of superior convergent or discriminant validity in association with external measures relative to the numbing or hyperarousal factors of the King model. Findings raise questions about proposals to abandon the distinction between numbing and hyperarousal symptoms in favor of a dysphoria-based model.",0,0 +6233,Correlation between traumatic events and posttraumatic stress disorder among North Korean defectors in South Korea,"The number of North Korean defectors entering South Korea has been increasing rapidly since 1994. Two hundred North Korean defectors in South Korea were studied to identify their experiences of traumatic events in North Korea and during defection, and the correlation with Posttraumatic Stress Disorder (PTSD). Researchers conducted face-to-face interviews and assisted defectors in performing a self-report assessment of this survey. The study questionnaire consisted of demographic characteristics, the Traumatic Experiences Scale for North Korean Defectors, and the PTSD part of the Structured Clinical Interview for DSM-III-R Korean version. Prevalence rate of PTSD in defectors was 29.5%, with a higher rate for women. In factor analysis, the 25 items of traumatic events experienced in North Korea were divided into three factors: Physical Trauma, Political-Ideological Trauma, and Family-Related Trauma. In addition, the 19 items of traumatic events during defection were grouped into four factors: Physical Trauma, Detection and Capture-Related Trauma, Family-Related Trauma, and Betrayal-Related Trauma. In multifactorial logistic regression analysis, Family-Related Trauma in North Korea had a significant odds ratio.",0,0 +6234,PTSD symptoms in children and adolescents 28 months after a flood: Age and gender differences,"The present study examined the prevalence and predictors of posttraumatic stress disorder symptoms (PTSD) in a sample of 533 students (aged 11 to 21), 28 months after the 1997 Flood in southwestern Poland. The results show that 18% of the participants met all diagnostic criteria for PTSD. Based on hierarchical multiple regression analyses, PTSD criteria symptoms were positively correlated with the degree of exposure to trauma experienced during the disaster. A three-way interaction of trauma, age, and gender showed that more PTSD symptoms were observed among the younger participants and girls than among the older boys. The results confirm the need of research testing culturally sensitive implementation of mental health programs for young victims of disasters, taking into account their age and gender.",0,0 +6235,Heterogeneity in the course of posttraumatic stress disorder: Trajectories of symptomatology,"Unconditional and conditional trajectories of posttraumatic stress disorder (PTSD) symptomatology were examined using a sample of U.S. soldiers deployed on a NATO-led peacekeeping mission to Kosovo. Data were collected at 4 time points, ranging from the weeks leading up to deployment to 9-months postdeployment. Latent class growth analysis revealed 4 unique symptom trajectories: resilience, recovery, delayed, and unrealized anxiety. Variables identified as significant predictors of trajectory class included previous traumatic events, combat exposure, peacekeeping daily hassles, depression, alcohol use, aggressive behavior, stress reactivity, and military rank. Results from this study add to the literature detailing the variability in PTSD course, as well as to the literature pertaining to predictors of PTSD onset and course.",1,0 +6236,Support for the location of negative posttraumatic cognitions in the diagnosis of posttraumatic stress disorder,"Abstract Objective To investigate the extent to which negative posttraumatic cognitions predict, and so can be best located within, the DSM-5 (APA, 2013) individual symptom clusters of posttraumatic stress disorder (PTSD). Method An online survey of traumatic experiences, featuring 528 adults. Results Negative posttraumatic cognitions seem best placed within the Numbing/Detachment symptom cluster. Negative posttraumatic cognitions relating to the self predict higher levels of symptoms across the clusters. While negative cognitions relating to the world contributed to most symptom groups, self-blame cognitions did not. Conclusions Our findings support the placement of posttraumatic cognitions as part of the Numbing/Detachment symptom cluster within the DSM-5rather than the Intrusion, Avoidance and Hyperarousal clusters.",0,0 +6237,The relationship between posttraumatic stress disorder symptoms and paternal parenting of adult children among ex-prisoners of war: A longitudinal study.,"The aversive impact of combat and combat-induced posttraumatic stress disorder (PTSD) on parenting of young children has been examined in a few studies. Nevertheless, the toll of war captivity on parenting and the long-term relations between posttraumatic symptoms and paternal parenting of adult children remains unknown. This longitudinal study examined paternal parenting of adult children among war veterans, some of whom were held in captivity. Furthermore, we examined the mediating role of PTSD symptoms in the association between captivity and parenting. The sample included two groups of male Israeli veterans from the 1973 Yom Kippur War: ex-prisoners of war (ex-POWs) and comparable veterans who had not been held captive. Both groups were assessed via self-report measures of PTSD at three time points: Time 1 (18 after the war), Time 2 (30 after the war), and Time 3 (35 after the war) years after the war. Results shows that ex-POWs reported lower levels of positive parenting compared to comparison group veterans at Time 3. Furthermore, PTSD symptoms at Time 1, Time 2, and Time 3 mediated the association between captivity experience and parenting at Time 3. In addition, it was found that increases in the levels of PTSD symptom clusters over time were associated with lower levels of positive parenting at Time 3.",0,0 +6238,Australian Guidelines for the Treatment of Adults with Acute Stress Disorder and Post-Traumatic Stress Disorder,"Over the past 2–3 years, clinical practice guidelines (CPGs) for post-traumatic stress disorder (PTSD) and acute stress disorder (ASD) have been developed in the USA and UK. There remained a need, however, for the development of Australian CPGs for the treatment of ASD and PTSD tailored to the national health-care context. Therefore, the Australian Centre for Posttraumatic Mental Health in collaboration with national trauma experts, has recently developed Australian CPGs for adults with ASD and PTSD, which have been endorsed by the National Health and Medical Research Council (NHMRC). In consultation with a multidisciplinary reference panel (MDP), research questions were determined and a systematic review of the evidence was then conducted to answer these questions (consistent with NHMRC procedures). On the basis of the evidence reviewed and in consultation with the MDP, a series of practice recommendations were developed. The practice recommendations that have been developed address a broad range of clinical questions. Key recommendations indicate the use of trauma-focused psychological therapy (cognitive behavioural therapy or eye movement desensitization and reprocessing in addition to in vivo exposure) as the most effective treatment for ASD and PTSD. Where medication is required for the treatment of PTSD in adults, selective serotonin re-uptake inhibitor antidepressants should be the first choice. Medication should not be used in preference to trauma-focused psychological therapy. In the immediate aftermath of trauma, practitioners should adopt a position of watchful waiting and provide psychological first aid. Structured interventions such as psychological debriefing, with a focus on recounting the traumatic event and ventilation of feelings, should not be offered on a routine basis.",0,0 +6239,Understanding comorbidity between ptsd and substance use disorders: Two preliminary investigations,"While there is high level of comorbidity of PTSD and substance use disorders (SUDs), little research has focused on the overlapping symptom constellation characteristic of both PTSD and substance use/withdrawal. This report describes two preliminary investigations that address this area. In the first study, the pattern of PTSD symptoms in a sample of women (n = 28) seeking treatment for a SUD and comorbid with PTSD was compared with the symptom pattern of a sample of women (n = 28) with PTSD only. The PTSD + SUD group evidenced significantly more symptoms in the avoidance and arousal symptom clusters than the PTSD-only group. At the individual symptom level, the PTSD + SUD group reported significantly more sleep disturbance than the PTSD-only group. It was also determined that the PTSD + SUD group reported greater traumatic-event exposure than the PTSD-only group. In the second study, PTSD symptoms were compared in a sample of alcohol- dependent and a sample of cocaine-dependent individuals with PTSD. The alcohol- dependent group exhibited significantly more arousal symptoms than the cocaine-dependent group. Implications of the results for the assessment of individuals with comorbid PTSD and SUDs are discussed.",0,0 +6240,Associations Between Post-Traumatic Stress Disorder Symptoms and Alcohol and Other Drug Problems: Implications for Social Work Practice,"This study examines the associations between alcohol and other drug problems (AOD) and post-traumatic stress disorder (PTSD) symptoms in 499 women recruited from outpatient treatment programmes for AOD problems and the general community in western New York. The women were divided into three groups: no-AOD, past-AOD, and current-AOD. The current-AOD group was further subdivided into groups based on alcohol, marijuana, and cocaine misuse. Group comparisons on PTSD symptoms revealed that the current-AOD group experienced more PTSD symptoms than the no-AOD and past-AOD groups. The alcohol and cocaine misuse groups experienced more PTSD symptoms overall and for each symptom cluster than the no-AOD and past-AOD groups, but did not differ from each other or the marijuana group on PTSD symptoms. These findings suggest that individuals who have AOD problems should be assessed for PTSD symptoms and provided with trauma-specific interventions when warranted. Trauma-informed care may benefit those in AOD treatment. Individuals who have PTSD symptoms should be assessed for AOD problems as well.",0,0 +6241,"Cumulative Trauma, Hyperarousal, and Suicidality in the General Population: A Path Analysis","Although trauma exposure and posttraumatic stress disorder (PTSD) both have been linked to suicidal thoughts and behavior, the underlying basis for this relationship is not clear. In a sample of 357 trauma-exposed individuals from the general population, younger participant age, cumulative trauma exposure, and all three Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, PTSD clusters (reexperiencing, avoidance, and hyperarousal) were correlated with clinical levels of suicidality. However, logistic regression analysis indicated that when all PTSD clusters were considered simultaneously, only hyperarousal continued to be predictive. A path analysis confirmed that posttraumatic hyperarousal (but not other components of PTSD) fully mediated the relationship between extent of trauma exposure and degree of suicidal thoughts and behaviors.",0,0 +6242,"Trauma exposure, resilience, social support, and PTSD construct validity among former prisoners of war","Background: The aim of this study was to investigate predictors of persistent symptoms of posttraumatic stress disorder (PTSD) and to examine the construct validity of PTSD in a national sample of 270 World War II and Korean Conflict prisoners of war (POWs). Method: POWs were interviewed at two points in time (1965 and 1990). Predictors included PTSD symptomatology measured in 1965 by items from the Cornell Medical Index (CMI), severity of captivity trauma, resilience factors, and post-trauma social support. The criterion, symptomatology in the early 1990s, was evaluated with the PTSD module of the Structured Clinical Interview for DSM (SCID). Results: The CMI provided only partial coverage of PTSD criteria and appeared to provide only a general index of distress. Clustering of SCID items in two-dimensional space via multidimensional scaling analysis offers some construct validation for the DSM's differentiation of PTSD symptoms into criterion groups, although there was not a perfect match. Trauma severity is best related to PTSD symptomatology experienced in 1990, mitigated in part by greater education level and age at the time of trauma exposure. Surprisingly, 1965 distress added only a modest amount to the prediction of current distress, while post-trauma social support added none. Conclusions: These findings support previous work showing the severe psychological sequelae of POW status 40-50 years after captivity, and indicate that trauma severity during captivity is the best predictor of current PTSD symptomatology. Results also add to our understanding of the conceptual differentiation of PTSD symptoms into separate and distinct symptom clusters.",0,0 +6243,Confirmatory Factor Analysis of the Posttraumatic Stress Disorder Checklist,"Several studies have employed confirmatory factor analysis (CFA) to examine the latent structure of the Posttraumatic Stress Disorder (PTSD) Checklist (PCL; Weathers, Litz, Herman, Huska, & Keane, 1993), a measure that assesses PTSD symptomatology. Findings have failed to support the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision [DSM–IV–TR]; American Psychiatric Association, 2000) PTSD model, consisting of reexperiencing, avoidance/numbing, and arousal factors, and no consensus has emerged regarding the best fitting alternative model. Additionally, most studies have utilized homogeneous trauma samples. This study used CFA to examine the PCL factor structure in a sample with exposure to various traumatic events. Superior fit was demonstrated by a model specifying reexperiencing, avoidance, dysphoria, and arousal factors.",0,0 +6244,Using therapeutic writing to deconstruct recovery from posttraumatic stress disorder (PTSD),"Exposure to physical and psychological trauma has produced a post-millennial epoch of posttraumatic stress disorder (PTSD), a debilitating anxiety disorder that occurs after exposure to an extreme stressor or prolonged victimization. After an extensive review of treatment protocols in 2008, the Institute of Medicine (IOM) exhorted clinicians to focus on defining the concept of recovery, concentrating on symptom reduction, removal of the PTSD diagnosis, and end-state function. Although the IOM report mobilized large-scale efforts to quantify treatments and standardize delivery of treatment protocols, PTSD recovery remains a concept that has been largely unexplored. The primary aim of this study was to answer the following question: What is the basic psychosocial process that men and women undergo in recovering from PTSD? The study also fulfilled some secondary aims: (a) identifying which, if any, elements of traditional therapy contributed to recovery and (b) establishing a realistic timeline for recovery. Charmaz's method of narrative analysis and grounded theory construction was used to generate the PTSD Recovery Model. The model was nonlinear and included six universal stages that occurred during PTSD recovery: Experiencing Trauma, Dominating Diagnosis, Seeking Solace, Surviving Symptoms, Marking Time, and Navigating Recovery. Support for the model came from research participants and experts. Participants (N=41) were predominantly white, female, and had earned college or graduate degrees. Almost half of the participants (47.5%) reported that it required five years or more for them to feel better or attain some degree of recovery after exposure to trauma. Intimate partner violence and child sexual and/or physical abuse were the most commonly reported traumatic events that had caused PTSD. Although participants stated that experienced mental health clinicians were the most helpful persons or treatment in seeking recovery, they also reported that recovery typically involved a combination of traditional and alternative therapies, often used simultaneously. Most participants who reported recovery were actively engaged in seeking beneficial therapies and saw themselves as architects of the healing process. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +6245,Perceived Control is a Transdiagnostic Predictor of Cognitive–Behavior Therapy Outcome for Anxiety Disorders,"Perceived control has been proposed to be a general psychological vulnerability factor that confers an elevated risk for developing anxiety disorders, but there is limited research examining perceived control during cognitive-behavioral therapies (CBT). The present study examined whether treatment resulted in improvements in perceived control, and the indirect effects of CBT on changes in symptoms of obsessive-compulsive disorder, social phobia, generalized anxiety disorder, and panic disorder via changes in perceived control. Participants (n = 606) were a large clinical sample presenting for treatment at an outpatient anxiety disorders clinic. Participants completed a series of self-report questionnaires and a structured clinical interview at an intake evaluation and at two follow-up assessments 12 and 24 months later, with the majority of participants initiating CBT between the first two assessments. Results of latent growth curve models indicated that individuals initiating CBT subsequently reported large increases in perceived control and significant indirect effects of treatment on intraindividual changes in each of the four anxiety disorders examined via intraindividual changes in perceived control. These results suggest that the promotion of more adaptive perceptions of control is associated with recovery from anxiety disorders. Furthermore, the consistent finding of indirect effects across the four anxiety disorders examined underscores the transdiagnostic importance of perceived control in predicting CBT outcomes.",0,0 +6246,Influencing factors of posttraumatic stress disorder in the shipwreck related military rescuers in Yantai.,"Studied the influential factors of posttraumatic stress disorder (PTSD) and the impact on the shipwreck related military rescuers. Ss were 39 military rescuers (aged 17-49 yrs) (38 males and 1 female) who participated in rescue work after a shipwreck in Yantai, China, December 24th, 1999. One mo later, Ss were assessed with the Self-Rating PTSD Scale (X. Liu, et al, 1998), the Chinese revised version of the SCL-90 (W. Wu), the revised Life Event Scale (M. Zhang), the Eysenck Personality Questionnaire (EPQ), and a self-developed questionnaire referring to demographic information, stress of life events, and social supports. The prevalence of PTSD was 17.95% (7 Ss with PTSD). Correlation analysis revealed the significant factors related to PTSD: economic support when disadvantaged, satisfaction with leaders' attitudes and methods in rescue work, satisfaction in dealing with problems and affairs after the accident, stress in the rescue process, the score of the LES, and the N score of the EPQ. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6247,Treatment response heterogeneity in the predominant negative symptoms of schizophrenia: Analysis of amisulpride vs placebo in three clinical trials,"The extent of heterogeneity in response to the psychopharmacological treatment of negative symptoms is unknown.To examine the extent of heterogeneity in response to the treatment of predominantly negative symptoms of schizophrenia.Data were analyzed from three clinical trials that compared placebo or amisulpride for up to 60days. Trial participants had predominantly negative symptoms of schizophrenia (n=485). Heterogeneity of percentage reduction on the Scale for the Assessment of Negative Symptoms (SANS) was examined with trajectory-group based modeling followed by descriptive statistics and the prediction of trajectory group membership with logistic regression modeling. Analyses were repeated separately for the placebo and amisulpride groups.Trajectory group-based modeling identified groups of non- (n=297, 61.2%), gradual-moderate (n=135, 27.8%) and rapid- (n=53, 10.9%) responders. At baseline compared to non-responders, rapid-responders had consistently significantly (p<.05) higher SANS total and subscale scores. Percent SANS improvement at endpoint was greatest for the rapid-responders group, a finding that replicated stratifying by placebo and amisulpride treatment groups. Similarly, in the total sample and stratifying by placebo and amisulpride groups, dropout was not significantly associated with trajectory group membership.Trajectories of treatment response to the psychopharmacological medication of the negative symptoms of schizophrenia demonstrate substantial heterogeneity. Approximately half of the patients included in our analysis showed little improvement, and the most severely ill at baseline responded the most.",0,0 +6248,Failure to detect fabricated posttraumatic stress disorder with the use of the MMPI in a clinical population,"The authors attempted to replicate previous studies that used the Frequency (F) scale and the posttraumatic stress disorder (PTSD) subscale of the MMPI to discriminate Vietnam veterans with PTSD from well-adjusted veterans and mental health professionals who feigned symptoms of PTSD. Profiles of veterans with PTSD were compared to those of veterans with non-PTSD psychiatric disorders and veterans with fabricated PTSD symptoms who sought treatment. Discriminant analysis of F scale and PTSD subscale scores correctly identified only 43.59% of the subjects, thus failing to support use of the MMPI in detecting fabricated symptoms of PTSD in a clinical population.",0,0 +6249,Determinants of psychological resistance and recovery among women exposed to assaultive trauma,"Women exposed to potentially traumatic events (PTEs) are at high risk for developing psychiatric disorders, including posttraumatic stress disorder (PTSD), general anxiety disorder (GAD), major depressive disorder (MDD), and substance-related disorders. However, this risk is not universal. Most women are resistant (i.e., remain asymptomatic), or recover following a brief symptomatic period. This study examined the psychological factors associated with resistant and recovered outcomes in a sample of high-risk women exposed to assault-related PTEs.One hundred and fifty-nine women completed the Life Events Checklist and were administered the Structured Clinical Interview for DSM-IV Axis I Disorders. This resulted in three groups: (1) no diagnosis (no past or current psychiatric disorder diagnosis; n = 56), (2) past diagnosis (a past psychiatric disorder diagnosis, but none currently; n = 31), and (3) current diagnosis (a current diagnosis of one or more psychiatric disorders; n = 72). Groups were compared on sociodemographics, PTE exposure, psychopathology, health-related quality of life (HRQOL), and psychological resilience-related factors.The majority of respondents (79%) did not develop chronic PTSD following assault exposure, and the most common psychiatric outcome was MDD (30%). High endorsement of mastery and social support were associated with the no diagnosis group; and greater reports of mastery and posttraumatic growth were associated with recovery from a past psychiatric disorder. Furthermore, both resilient groups (i.e., no diagnosis and past diagnosis) scored higher on HRQOL measures compared with the current diagnosis group (P < 0.001).Psychological resilience has ramifications to health and well-being, and identifying these factors has potential to inform preventive strategies and treatment interventions for assault exposed women.",0,0 +6250,Combat-related post-traumatic stress disorder etiology: Replicated findings in a national sample of Vietnam-era men,"To examine the generality of recent findings on PTSD etiology in help-seeking Vietnam combat veterans, replication was attempted with data from a national study of Vietnam-era men that included combat veterans. Use of a Guttman scaling technique for assessing combat exposure was found to be robust for use with a national nonclinical sample as well. In addition, multiple regression analysis was used to examine predictive relationships between premilitary adjustment, military adjustment, combat exposure, and post-traumatic stress disorder (PTSD). Results obtained from the national sample showed the same patterning as that reported from the smaller clinical sample. Combat exposure was related significantly to PTSD symptomatology, while premilitary adjustment was not. A previously identified discriminant function, composed of psychological symptoms not found in the DSM III criteria for PTSD, also was cross-validated.",0,0 +6251,The Association Between Parent PTSD/Depression Symptoms and Child PTSD Symptoms: A Meta-Analysis,"The present article presents a meta-analysis of studies examining the association between parent posttraumatic stress disorder (PTSD)/depression symptoms and child PTSD symptoms (PTSS) after a child's exposure to a traumatic event while considering multiple moderating factors to explain heterogeneity of effect sizes.35 studies were included: 32 involving the association between parent and child PTSS and 9 involving the association between parent depression and child PTSS.Across existing studies, both parent and child PTSS (r = 0.31) and parent depression and child PTSS (r = 0.32) yielded significant effect sizes. Parent gender, assessment type (interview vs. questionnaire), differences in assessment type for parents and children, and study design (cross-sectional vs. longitudinal) moderated the relationship between parent and child PTSS.The current findings confirm the associations between parental posttraumatic responses and child PTSS and highlight important moderating factors to include in future studies of child PTSS.",0,0 +6252,Does Knowledge of Predictors of Recovery and Nonrecovery Assist Outcomes After Whiplash Injury?,"Nonsystematic review.Review of prognostic indicators for outcome after whiplash injury and the implications for clinical practice and future research.The capacity to predict outcome after whiplash injury is important to guide the management of the condition. There have now been numerous cohort studies and several systematic reviews of prognosis. It is not clear if the current knowledge of prognostic indicators is useful for clinical practice and to improve outcomes after injury.Nonsystematic review of research investigating the prediction of chronic pain/disability and psychological outcomes after whiplash injury.There remains considerable uncertainty surrounding the identification of clear prognostic indicators after whiplash injury. All systematic reviews note the moderate or lower quality if primary cohort studies and only one systematic review performed meta-analysis. There have been no studies attempting validation of predictive models. At the present time, the knowledge base stands that higher initial pain levels are the most consistent predictor of poor functional recovery. Additional promising factors include physical factors of cold hyperalgesia and loss of neck range of movement, although the latter is inconsistent. Psychological factors of pain catastrophizing, symptoms of post-traumatic stress and recovery perceptions are also prognostic of poor recovery and the presence of depressed mood is inconsistent. Further research is needed to validate predictive models, investigate interactions between factors, and to determine whether modification of predictors is possible and leads to improved outcomes.The understanding of factors predictive of poor recovery after whiplash injury is evolving. Although more research is required to validate predictive models, some factors show consistent predictive capacity and could be used in clinical practice as potential indicators of poor recovery. It is not known if the specific targeting of modifiable prognostic indicators can be achieved or will lead to improved outcomes.",0,0 +6253,The efficacy of a brief internet-based self-help intervention for the bereaved,"Research so far has shown little evidence that written disclosure facilitates recovery from bereavement. There are good reasons to assume that written disclosure may only benefit those bereaved who are at risk for developing problems or who are experiencing significant psychological problems as a result of their loss, and only when appropriate writing instructions are used. Drawing on previous work in the area of post-traumatic stress, a writing intervention was designed to test these assumptions. Bereaved individuals, who were still significantly distressed by their loss, were randomly assigned to the intervention condition (N = 460) or a waiting-list control condition (N = 297). Both groups filled in questionnaires online at baseline, and 3 and 6 months later. The intervention was administered via e-mail immediately after baseline measurement. Results showed that writing decreased feelings of emotional loneliness and increased positive mood, in part through its effect on rumination. However, writing did not affect grief or depressive symptoms. Contrary to expectations, effects did not depend on participants' risk profile or baseline distress level. Implications of these findings are discussed.",0,0 +6254,Incidence and Prediction of Posttraumatic Stress Disorder Symptoms in Severely Injured Accident Victims,"This study was designed to assess the incidence of posttraumatic stress disorder (PTSD) in severely injured accident victims and to predict the presence of PTSD symptoms at a 12-month follow-up.A longitudinal, 1-year follow-up study was carried out with 106 consecutive patients with severe accidental injuries who were admitted to the trauma surgeons' intensive care unit at a university hospital. Patients were interviewed within 1 month and 12 months after the accident. Assessments included an extensive clinical interview, the Impact of Event Scale, the Clinician-Administered PTSD Scale, the Sense of Coherence questionnaire, and the Freiburg Questionnaire of Coping With Illness.A total of 13.4 days (SD=6.6) after the accident, five patients (4.7%) met all criteria for PTSD with the exception of the time criterion. A total of 22 other patients (20.8%) had subsyndromal PTSD. At the 1-year follow-up, two patients (1.9%) had PTSD, and 13 (12.3%) had subsyndromal PTSD. Multiple regression analysis explained 34% of the variance of PTSD symptoms 12 months after the accident. Biographical risk factors, the sense of a death threat, symptoms of intrusion, and problem-oriented coping each contributed significantly to the predictive model.In severely injured accident victims who were healthy before experiencing trauma, the incidence of PTSD was low. One-third of the variance of PTSD symptoms at 1-year follow-up could be predicted by mainly psychosocial variables.",0,0 +6255,Holocaust survivors coping with open heart surgery decades later: posttraumatic symptoms and quality of life,"History of prolonged traumatization has been associated with reduced quality of life (QoL) and difficulties in coping with major life-threatening conditions. We assessed the association between the impact of Holocaust experience (posttraumatic symptoms) and QoL of patients before and after an open heart surgery.Sixty-three Holocaust survivors were interviewed before open heart surgery (at admission), 52 at follow-up at 1 week, and 58 at follow-up at 6 months. The interview included background data, Impact of Event Scale (IES), Mastery scale, and QoL measured by the Nottingham Health Profile. Medical data were retrieved from the patients' charts.The total IES score indicate a high level of posttraumatic symptoms at all the time points (close to a mean of 18), but there was a clear trend of changes in the avoidance subscale: At admission, the patients manifested lower avoidance compared with the levels after the surgery and at the follow-up. No significant differences in IES were found by Holocaust experiences. Significant improvements in most components of QoL were found at the follow-up. In multivariate analyses at each time point, the findings show that those with higher levels of posttraumatic symptoms are more at risk for problems in pain and mobility domains of QoL at admission, for emotional reaction after the surgery, and at the follow-up, these associations are only at trend level, while lower sense of mastery became significant.The improvement in QoL despite persistence of the impact of the Holocaust may indicate that past severe prolonged traumatization does not necessarily reduce the survivors' ability to cope with and regain physical and psychosocial functioning after a severe life-threatening medical condition. This may be further generalized to other significant crisis situations in life, such as prolonged periods of stress, suffered by many populations throughout the world.",0,0 +6256,Profiles of emotion regulation: Understanding regulatory patterns and the implications for posttraumatic stress,"Trauma survivors often experience posttraumatic stress (PTS) and report concurrent difficulties with emotion regulation (ER). Although individuals typically use multiple regulatory strategies to manage emotion, no studies yet examine the influence of a constellation of strategies on PTS in a community sample. We assessed six ER strategies and investigated whether specific profiles of ER (i.e. the typical pattern of regulation, determined by how often each strategy is used) were related to PTS. A hierarchical cluster analysis indicated that four distinct profiles were present: Adaptive Regulation, Active Regulation, Detached Regulation, and Maladaptive Regulation. Further analyses revealed that an individual's profile was not related to frequency of past trauma, but had the power to differentiate symptom severity for overall PTS and each symptom cluster of posttraumatic stress disorder. These findings highlight how profiles characterising multiple regulatory strategies offer a more complete understanding of the ways ER can account for PTS.",0,0 +6257,Challenges in modelling the random structure correctly in growth mixture models and the impact this has on model mixtures,"Lifecourse trajectories of clinical or anthropological attributes are useful for identifying how our early-life experiences influence later-life morbidity and mortality. Researchers often use growth mixture models (GMMs) to estimate such phenomena. It is common to place constrains on the random part of the GMM to improve parsimony or to aid convergence, but this can lead to an autoregressive structure that distorts the nature of the mixtures and subsequent model interpretation. This is especially true if changes in the outcome within individuals are gradual compared with the magnitude of differences between individuals. This is not widely appreciated, nor is its impact well understood. Using repeat measures of body mass index (BMI) for 1528 US adolescents, we estimated GMMs that required variance–covariance constraints to attain convergence. We contrasted constrained models with and without an autocorrelation structure to assess the impact this had on the ideal number of latent classes, their size and composition. We also contrasted model options using simulations. When the GMM variance–covariance structure was constrained, a within-class autocorrelation structure emerged. When not modelled explicitly, this led to poorer model fit and models that differed substantially in the ideal number of latent classes, as well as class size and composition. Failure to carefully consider the random structure of data within a GMM framework may lead to erroneous model inferences, especially for outcomes with greater within-person than between-person homogeneity, such as BMI. It is crucial to reflect on the underlying data generation processes when building such models.",0,0 +6258,Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes.,"To explore the taxonomy of combat-related mild traumatic brain injury (mTBI) based on symptom patterns.Up to 1341 military personnel who experienced a combat-related mTBI within 2 years of evaluation.Neurobehavioral Symptom Inventory and PTSD Checklist-Civilian Version (PCL-C).Cluster analysis revealed the following 4 subtypes: primarily psychiatric (posttraumatic stress disorder) group, a cognitive group, a mixed symptom group, and a good recovery group. The posttraumatic stress disorder cluster (21.9% of the sample) reported symptoms related to hyperarousal and dissociation/depression with few complaints related to cognition or headaches. The cognitive group (21.5% of the sample) had primarily cognitive and headache complaints with few mood symptoms. The mixed profile cluster included 18.6% of the sample and was characterized by a combination of mood complaints (hyperarousal and dissociation/depression), cognitive complaints, and headaches. The largest cluster (37.8% of the sample) had an overall low symptom profile and was labeled the ""good recovery"" group.The results support a unique taxonomy for combat-related mTBI. The clinical differences among these subtypes indicate a need for unique treatment resources and programs.",0,0 +6259,Family history study of the familial coaggregation of borderline personality disorder with axis I and nonborderline dramatic cluster axis II disorders.,"The purpose of this study was to assess the familial coaggregation of borderline personality disorder (BPD) with a full array of axis I disorders and four axis II disorders (antisocial personality disorder, histrionic personality disorder, narcissistic personality disorder, and sadistic personality disorder) in the first-degree relatives of borderline probands and axis II comparison subjects. Four hundred and forty-five inpatients were interviewed about familial psychopathology using the Revised Family History Questionnaire-a semistructured interview of demonstrated reliability. Of these 445 subjects, 341 met both DIB-R and DSM-III-R criteria for BPD and 104 met DSM-III-R criteria for another type of personality disorder (and neither criteria set for BPD). The psychopathology of 1,580 first-degree relatives of borderline probands and 472 relatives of axis II comparison subjects was assessed. Using structural models for familial coaggregation, it was found that BPD coaggregates with major depression, dysthymic disorder, bipolar I disorder, alcohol abuse/dependence, drug abuse/dependence, panic disorder, social phobia, obsessive-compulsive disorder, generalized anxiety disorder, posttraumatic stress disorder, somatoform pain disorder, and all four axis II disorders studied. Taken together, the results of this study suggest that common familial factors, particularly in the areas of affective disturbance and impulsivity, contribute to borderline personality disorder.",0,0 +6260,Neurobiological Risk Factors and Predictors of Vulnerability and Resilience to PTSD,"The risk of developing PTSD following a traumatic experience depends on several vulnerability factors that may be classified into three distinct categories: Pre-traumatic, peri-traumatic, and posttraumatic vulnerability factors. Accordingly, while we attempted to create a profile of the high-risk PTSD patient, the following factors should be included, among others: Small hippocampus, previously altered HPA axis, vulnerable genetic profile, associated body injury, increased post-trauma noradrenergic activity. Some protective factors have been identified and included, but are not limited to coping, resources (e.g., social support, self-esteem, optimism), and finding meaning. Finally, human beings are resilient and in general are able to cope with adverse situations. Therefore, discovering possible resilience factors may assist in identifying the patients at risk and may contribute to developing the strategies to prevent the development of PTSD. © Springer Science+Business Media New York 2015.",0,0 +6261,Diabetes Among Refugee Populations: What Newly Arriving Refugees Can Learn From Resettled Cambodians,"A growing body of literature suggests that cardiometabolic disease generally and type 2 diabetes specifically are problems among refugee groups. This paper reviews rates of cardiometabolic disease and type 2 diabetes among refugees and highlights their unique risk factors including history of malnutrition, psychiatric disorders, psychiatric medications, lifestyle changes toward urbanization and industrialization, social isolation, and a poor profile on the social determinants of health. Promising interventions are presented for preventing and treating diabetes in these groups. Such interventions emphasize well-coordinated medical and mental health care delivered by cross-cultural and multidisciplinary teams including community health workers that are well integrated into the community. Finally, recommendations for service, policy, and research are made. The authors draw on local data and clinical experience of our collective work with Cambodian American refugees whose 30-year trajectory illustrates the consequences of ignoring diabetes and its risk factors in more recent, and soon to be arriving, refugee cohorts.",0,0 +6262,Voxel-based diffusion tensor analysis reveals aberrant anterior cingulum integrity in posttraumatic stress disorder due to terrorism,"Recent functional neuroimaging work has suggested that interregional functional connectivity between the anterior cingulate cortex (ACC), other limbic, and prefrontal regions may be involved in the pathophysiology of posttraumatic stress disorder (PTSD). However, less attention has been paid to the white matter network. Voxel-based analysis enables an exploration of morphological or functional changes throughout the entire brain. Here we undertook the first application of this technology to diffusion tensor data in patients with PTSD. Participants were 9 victims of the Tokyo subway sarin attack with PTSD and 16 matched victims of the same traumatic event without PTSD. The voxel-based analysis showed a significant fractional anisotropy increase in the left anterior cingulum, subjacent to the left ACC gray matter where we previously found a volume decrement, in PTSD subjects. Moreover, the severity was positively, but not significantly associated with the fractional anisotropy of the left anterior cingulum in the victims with PTSD, using the region of interest defined in the native space with the inverse normalization technique. The present study demonstrated further evidence of abnormalities of both the ACC, a structure that is pivotally involved in attention, emotional regulation, and fear conditioning, and of subjacent white matter in the pathology of PTSD.",0,0 +6263,Posttraumatic Stress Disorder in Injured Adults: Etiology by Path Analysis,"Posttraumatic Stress Disorder (PTSD) impairs outcome from injury. We present a path analysis of factors related to the development of PTSD in injured adults.A prospective cohort of 250 patients without severe neurotrauma was evaluated by interview during admission and by mailed self-report 6 months later. Data were gathered from the trauma registry (age, injury mechanism, and Injury Severity Score), social history (gender, income, education, and social support), and survey instruments. Baseline assessment used the Michigan Critical Events Perception Scale (peritraumatic dissociation and subjective threat to life), the Life Experience Survey (stressful exposure history), and the SF36 (general and mental health). PTSD at 6 months was identified with the civilian Mississippi Scale for PTSD. Data are listed as mean +/- SEM or percent (%). Path analysis was conducted by linear regression and significant (p<0.05) variables are shown. Factors are listed with the standardized beta. A negative beta suggests a protective effect.The 176 patients (72%) who completed the 6-month follow-up were 37.7+/-0.88 years old; 75% were men; and blunt (70%), penetrating (13.5%), and burn (16.4%) mechanisms caused the injuries. Assault was involved in 14.5% of the cases. Average income was $44,300+/-2,700/yr, education was 13.0+/-0.15 years, and Injury Severity Score was 13.9+/-0.50. A total of 42.3% of the patients developed PTSD. The 39.7% of the variance in PTSD explained by the model was due to intentional injury (beta = 0.27), male gender (beta = -0.21), age (beta = -0.20), peritraumatic dissociation (beta = 0.174), baseline mental health (beta = -0.21), and prior life-threatening illness (beta = -0.29). Peritraumatic dissociation was due to the patient's sense of threat to life (beta = -0.47), and threat was related to Injury Severity Score (beta = 0.2), assault(beta = 0.14), education (beta = -0.15), and age (beta = -0.19). Baseline SF36 mental health was related to social support (beta = 0.27) and income (beta = 0.21). Income was contingent on education (beta = 0.21).PTSD occurred in 42.3% of injured adults 6 months after trauma and was related to assault, dissociation, female gender, youth, poor mental health, and prior illness. By modeling PTSD, we may learn more of the etiology, risk stratification, and potentials for the treatment of this common and important morbidity of injury.",0,0 +6264,Confirmatory factor analysis of posttraumatic stress symptoms in emergency personnel: An examination of seven alternative models,"Recent studies into the underlying factor structure of posttraumatic stress symptoms often report factor structures that do not replicate the three symptom cluster of re-experiencing, avoidance and arousal symptoms as classified within the Diagnostic and Statistical Manual of Mental disorders (American Psychiatric Association, 1994, 2000). Data from 485 emergency service personnel who had experienced an occupational trauma were submitted to confirmatory factor analysis to test seven alternative factor models of posttraumatic stress symptoms. This study is one of the most comprehensive structural analyses of posttrauma symptoms to date. The model of best fit comprised four first-order factors including intrusion, avoidance, numbing and arousal alongside a general PTSD factor. This study highlighted the difference between the current DSM symptom groupings and those derived empirically.",0,0 +6265,Is Comorbidity of Posttraumatic Stress Disorder and Borderline Personality Disorder Related to Greater Pathology and Impairment?,"The authors examined whether patients with comorbid borderline personality disorder and posttraumatic stress disorder (PTSD) have a more severe clinical profile than patients with either disorder without the other.Outpatients with borderline personality disorder without PTSD (N=101), PTSD without borderline personality disorder (N=121), comorbid borderline personality disorder and PTSD (N=48), and major depression without PTSD or borderline personality disorder (N=469) were assessed with structured interviews for psychiatric disorders and for degree of impairment.Outpatients with diagnoses of comorbid borderline personality disorder and PTSD were not significantly different from outpatients with borderline personality disorder without PTSD, PTSD without borderline personality disorder, or major depression without PTSD or borderline personality disorder in severity of PTSD-related symptoms, borderline-related traits, or impairment.The additional diagnosis of PTSD or borderline personality disorder does little to augment the pathology or dysfunction of patients who have either disorder without the other.",0,0 +6266,Mapping evidence-based treatments for children and adolescents: Application of the distillation and matching model to 615 treatments from 322 randomized trials.,"This study applied the distillation and matching model to 322 randomized clinical trials for child mental health treatments. The model involved initial data reduction of 615 treatment protocol descriptions by means of a set of codes describing discrete clinical strategies, referred to as practice elements. Practice elements were then summarized in profiles, which were empirically matched to client factors (i.e., observed problem, age, gender, and ethnicity). Results of a profile similarity analysis demonstrated a branching of the literature into multiple problem areas, within which some age and ethnicity special cases emerged as higher order splits. This is the 1st study to aggregate evidence-based treatment protocols empirically according to their constituent treatment procedures, and the results point both to the overall organization of therapy procedures according to matching factors and to gaps in the current child and adolescent treatment literature.",0,0 +6267,War stressors and symptom persistence in posttraumatic stress disorder,"Abstract This study focused on delineating aspects of war stressors associated with risk for posttraumatic stress disorder in Vietnam veterans. Findings from 191 Vietnam war veterans are presented, addressing which elements of the war experience predicted PTSD in remission or persistent PTSD. Some experiences, like loss and injury, predicted having had PTSD symptoms in the past, while other experiences, such as exposure to grotesque death, predicted current (persistent) PTSD. Discriminant analysis showed that the more extreme/intense the stressor experiences, the higher the risk for developing PTSD and for persistent symptoms. These findings provide empirical support for the PTSD diagnosis and additional data for refining the PTSD stressor criterion.",0,0 +6268,"Somatoform Disorders and Trauma in Medically-Admitted Children, Adolescents, and Young Adults: Prevalence Rates and Psychosocial Characteristics","The purpose of this study is to describe past traumatic experiences in medically-admitted pediatric and young adult patients diagnosed with somatoform disorders and to explore the demographic, diagnostic, and psychosocial differences between those with and without trauma histories.Retrospective medical record reviews were performed for patients (aged 3-29 years) seen by the Psychiatry Consultation Service (2010-2011) at a pediatric medical hospital and diagnosed with a somatoform disorder. Clinical data collected included demographics, medical history, current physical symptoms, psychiatric diagnoses and history, trauma history, coping styles, family psychiatric and medical history, peer and family factors, psychiatric disposition after discharge, and service utilization.The mean age of the 180 identified patients was 15.1 years. Most patients were girls (75.0%) and White (71.7%). Somatoform diagnoses were primarily pain (51.4%) and conversion disorders (28.9%). Rates of trauma were similar to national norms (29.7%). Trauma history did not correlate with age, sex, race, income, length of hospitalization, or type of somatoform disorders. However, patients with trauma histories had significantly higher rates of psychiatric comorbidities (76.0% vs. 50.8%), past psychiatric treatment (81.1% vs. 59.1%), parent mental illness (69.8% vs. 38.6%), and family conflict (52.8% vs. 37.0%) and were more likely to require inpatient psychiatric hospitalization on discharge (18.9% vs. 6.3%).Prevalence of trauma in a sample of medically-admitted pediatric and young adult patients with somatoform diagnoses was similar to national norms. However, patients with a history of trauma had unique psychiatric and psychosocial profiles compared to those without a history of trauma.",0,0 +6269,Comorbidity of Psychiatric Disorders and Personality Profiles of American World War II Prisoners of War,"To characterize the effects of trauma sustained more than 40 years ago, prevalence of psychiatric disorders and personality dimensions were examined in a sample of 62 former World War II POWs. The negative effects of their experiences are reflected in their multiple lifetime diagnoses and in their current personality profiles. Fifty percent met DSM-III posttraumatic stress disorder (PTSD) criteria within 1 year of release; 18 (29%) continued to meet the criteria 40 years later at examination (chronic PTSD). A lifetime diagnosis of generalized anxiety disorder was found for over half the entire sample; in 42% of those who never had PTSD, 38% of those with recovery from PTSD, and 94% of those with chronic PTSD. Ten percent of those without a PTSD diagnosis had experienced a depressive disorder, as had 23% of those with recovery from PTSD and 61% of the POWs with chronic PTSD. The combination of depressive and anxiety disorders also was frequent in the total sample (61%). Current MMPIs of three groups with psychiatric diagnosis were compared with those of POWs who had no diagnoses and with a group of Minnesota normal men. Profile elevations for the groups, from highest to lowest, were: POWs with chronic PTSD, POWs with recovery from PTSD, POWs with other psychiatric diagnoses, POWs with no disorders, and Minnesota normal men. Symptoms of anxiety, depression, and somatic concerns combined with the personality styles of suppression and denial characterize the current adjustment of negatively affected POWs.",0,0 +6270,Release of gliotransmitters through astroglial connexin 43 hemichannels is necessary for fear memory consolidation in the basolateral amygdala,"Recent in vitro evidence indicates that astrocytes can modulate synaptic plasticity by releasing neuroactive substances (gliotransmitters). However, whether gliotransmitter release from astrocytes is necessary for higher brain function in vivo, particularly for memory, as well as the contribution of connexin (Cx) hemichannels to gliotransmitter release, remain elusive. Here, we microinfused into the rat basolateral amygdala (BLA) TAT-Cx43L2, a peptide that selectively inhibits Cx43-hemichannel opening while maintaining synaptic transmission or interastrocyte gap junctional communication. In vivo blockade of Cx43 hemichannels during memory consolidation induced amnesia for auditory fear conditioning, as assessed 24 h after training, without affecting short-term memory, locomotion, or shock reactivity. The amnesic effect was transitory, specific for memory consolidation, and was confirmed after microinfusion of Gap27, another Cx43-hemichannel blocker. Learning capacity was recovered after coinfusion of TAT-Cx43L2 and a mixture of putative gliotransmitters (glutamate, glutamine, lactate, d-serine, glycine, and ATP). We propose that gliotransmitter release from astrocytes through Cx43 hemichannels is necessary for fear memory consolidation at the BLA. Thus, the present study is the first to demonstrate a physiological role for astroglial Cx43 hemichannels in brain function, making these channels a novel pharmacological target for the treatment of psychiatric disorders, including post-traumatic stress disorder.",0,0 +6271,"Posttraumatic stress disorder, alcohol use, and life stress among African-American women","Robust data document the strong association between posttraumatic stress disorder (PTSD) symptoms and problematic alcohol use in female psychiatric patients. Reasons for this frequent co-morbidity remain unclear, highlighting the value of investigating factors common to both disorders to gain additional clarity. The current study examined whether the psychosocial factor, life stress, mediated the link between PTSD symptomatology and alcohol use in a sample of African-American women from low-income backgrounds with a history of intimate partner violence and suicidality (n = 143). Bootstrapping analysis demonstrated that life stress fully mediated the effect of PTSD symptoms on alcohol use. Consistent with the self-medication hypothesis of addiction, our findings indicate that life stress may be a causal mechanism in the development of subsequent alcohol problems among women with existing PTSD symptomatology. Prevention and treatment implications concerning the target population are discussed.",0,0 +6272,Family and peer social support and their links to psychological distress among hurricane-exposed minority youth.,"Experiencing a disaster such as a hurricane places youth at a heightened risk for psychological distress such as symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression. Social support may contribute to resilience following disasters, but the interrelations of different types of support, level of exposure, and different symptoms among youth is not well understood. This study examined associations among family and peer social support, level of hurricane exposure, and their links to psychological distress using both a large single-time assessment sample (N = 1,098) as well as a longitudinal sample followed over a 6-month period (n = 192). Higher levels of hurricane exposure were related to lower levels of social support from family and peers. Higher levels of family and peer social support demonstrated both concurrent and longitudinal associations with lower levels of psychological distress, with associations varying by social support source and psychological distress outcome. Findings also suggested that the protective effects of high peer social support may be diminished by high hurricane exposure. The results of this study further our understanding of the role of social support in hurricane-exposed youths' emotional functioning and point to the potential importance of efforts to bolster social support following disasters.",0,0 +6273,Surviving the Vajont Disaster,"The aim of the present study was to assess the chronic psychiatric consequences of the Vajont disaster in a group of survivors still living in the valley 36 years after the event. Thirty-nine subjects were assessed by means of a semistructured interview to investigate the extent of the traumatic experience and a structured diagnostic interview for the diagnoses of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). The degree of traumatic exposure significantly predicts the presence of PTSD. The lifetime frequency of full PTSD was 26%, and a further 33% of the sample displayed partial PTSD. Lifetime MDD was present in 28% of the subjects, and its prediction factors were female gender and number of losses of first-degree relatives in the disaster. Trauma-related fears are very common in the sample. A large-scale disaster, such as that of the Vajont valley, affects the psychological health of survivors for decades.",0,0 +6274,Resilience: A psychobiological construct for psychiatric disorders,"Understanding of psychopathology of mental disorder is evolving, particularly with availability of newer insight from the field of genetics, epigenetics, social, and environmental pathology. It is now becoming clear how biological factors are contributing to development of an illness in the face of a number of psychosocial factors. Resilience is a psychobiological factor which determines individual's response to adverse life events. Resilience is a human capacity to adapt swiftly and successfully to stressful/traumatic events and manage to revert to a positive state. It is fundamental for growth of positive psychology which deals with satisfaction, adaptability, contentment, and optimism in people's life. Of late, there has been a paradigm shift in the understanding of resilience in context of stress risk vulnerability dimension. It is a neurobiological construct with significant neurobehavioral and emotional features which plays important role in deconstructing mechanism of biopsychosocial model of mental disorders. Resilience is a protective factor against development of mental disorder and a risk factor for a number of clinical conditions, e.g. suicide. Available information from scientific studies points out that resilience is modifiable factor which opens up avenues for a number of newer psychosocial as well as biological therapies. Early identification of vulnerable candidates and effectiveness of resilience-based intervention may offer more clarity in possibility of prevention. Future research may be crucial for preventive psychiatry. In this study, we aim to examine whether resilience is a psychopathological construct for mental disorder.",0,0 +6275,Exploration of Delayed-Onset Posttraumatic Stress Disorder After Severe Injury,"The first aim of this work was to conduct a rigorous longitudinal study to identify rates of delayed-onset posttraumatic stress disorder (PTSD) in a sample of patients with severe injury. The second aim was to determine what variables differentiated delayed-onset PTSD from chronic PTSD.Randomly selected patients with injury who were admitted to four hospitals around Australia were recruited to the study (N = 834) and assessed in the acute care hospital, at 3 months, and at 12 months. A structured clinical interview was used to assess PTSD at each time point.Seventy-three patients (9%; n = 73) had PTSD at 12 months. Of these, 39 (53%) were classified as having delayed-onset PTSD. Furthermore, 22 (56%) patients with delayed-onset PTSD had minimal PTSD symptoms at 3 months (i.e., they did not have partial/subsyndromal PTSD at 3 months). The variables that differentiated delayed-onset PTSD from chronic PTSD were greater injury severity (odds ratio [OR] = 1.13; 95% confidence interval [CI] = 1.02-1.26), lower anxiety severity at 3 months (OR = 0.73; 95% CI = 0.61-0.87), and greater pain severity at 3 months (OR = 1.39; 95% CI = 1.06-1.84).Delayed-onset PTSD occurred frequently in this sample. Approximately half of the patients with delayed-onset PTSD had minimal PTSD symptoms at 3 months; therefore, their delayed-onset PTSD could not be accounted for by a small number of fluctuating symptoms. As we move toward DSM-V, it is important that research continues to explore the factors that underpin the development of delayed-onset PTSD.",0,0 +6276,Naturalistic Comparison of Models of Programmatic Interventions for Combat-Related Post-Traumatic Stress Disorder,"Objectives: Post-traumatic stress disorder (PTSD) is a difficult-to-treat sequel of combat. Data on effectiveness of alternate treatment structures are important for planning veterans’ psychiatric services. The present study compared clinical presentations and treatment outcomes for Australian veterans with PTSD who participated in a range of models of group-based treatment. Method: Participants consisted of 4339 veterans with combat-related PTSD who participated in one of five types of group-based cognitive behavioural programmes of different intensities and settings. Data were gathered at baseline (intake), as well as at 3 and 9 month follow up, on measures of PTSD, anxiety, depression and alcohol misuse. Analyses of variance and effect size analyses were used to investigate differences at intake and over time by programme type. Results: Small baseline differences by programme intensity were identified. Although significant improvements in symptoms were evident over time for each programme type, no significant differences in outcome were evident between programmes. When PTSD severity was considered, veterans with severe PTSD performed less well in the low-intensity programmes than in the moderate- or high-intensity programmes. Veterans with mild PTSD improved less in high-intensity programmes than in moderate- or low-intensity programmes. Conclusion: Comparable outcomes are evident across programme types. Outcomes may be maximized when veterans participate in programme intensity types that match their level of PTSD severity. When such matching is not feasible, moderate-intensity programmes appear to offer the most consistent outcomes. For regionally based veterans, delivering treatment in their local environment does not detract from, and may even enhance, outcomes. These findings have implications for the planning and purchasing of mental health services for sufferers of PTSD, particularly for veterans of more recent combat or peacekeeping deployments.",0,0 +6277,Increased co-morbidity of depression and post-traumatic stress disorder symptoms and common risk factors in intensive care unit survivors: A two-year follow-up study,"To investigate the long-term psychological impact of intensive care unit (ICU) hospitalization, as well as to establish risk factors which successfully discriminate patients at higher risk.The Medical Outcomes Study Short Form Survey (SF-36), the Center for Epidemiologic Studies for Depression (CES-D), and the Davidson Trauma Scale (DTS) questionnaires were obtained from 48 ICU survivors who were also interviewed and self-reported on several acknowledged risk factors.A high co-morbidity between depression and post-traumatic stress disorder (PTSD) cases was observed. Both CES-D and DTS scores correlated negatively with the SF-36 mental health subscale scores; although a causative relation cannot be attributed to this finding, it indicates a potential negative impact of depression and PTSD symptoms on the patients' quality of life even at 18- to 24-month post-ICU. The most important risk factor associated with a long-term impact on quality of life, depression and PTSD was lifetime history of any psychiatric disorder.During ICU admissions efforts should be made towards identifying and psychologically supporting those patients with a previous history of a psychiatric disease, as they are at considerably higher risk of suffering from the long-term psychological sequelae of ICU admission.",0,0 +6278,Validity and Reliability of the Persian Language Version of the Neuropsychiatry Unit Cognitive Assessment Tool,"<i>Background/Aims:</i> Only a limited number of cognitive screening tools are available for the Persian-speaking population, and we sought to translate and validate the Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG), a multidimensional cognitive screening tool. <i>Methods:</i> We used multiple language specialists to translate and then back-translate the NUCOG, and administered the Persian language NUCOG and Mini-Mental State Examination (MMSE) to 184 individuals: 60 controls and 124 patients, 33 of whom had dementia, 30 non-dementing neurological disorders and 61 a psychiatric illness. <i>Results:</i> The NUCOG outperformed the MMSE in differentiating the patient groups and controls. The ‘profile’ across the 5 NUCOG domains differentiated dementia subgroups such as senile dementia of the Alzheimer type (SDAT), frontotemporal dementia and mild cognitive impairment (MCI). Psychiatric patients with psychosis and posttraumatic stress disorder were more impaired than patients with affective disorders. The NUCOG reliably differentiated controls from patients with MCI (at 86.5/100, sensitivity of 83.3% and specificity of 87.5%) and SDAT (at 75/100, sensitivity and specificity of 100%) patients from controls. <i>Conclusions:</i> The Persian language NUCOG appears to perform strongly in an unselected population, reliably differentiating patients with dementia from controls, and detecting cognitive impairment in a range of clinical disorders.",0,0 +6279,"Post-traumatic stress disorder, social support and cognitive status in community-based older veterans","Objective: The present study investigated the relationships between structural and qualitative aspects of social support, combat-related post-traumatic stress disorder (PTSD) and cognitive status in a New Zealand veterans sample. Methods: A random sample of 232 New Zealand veterans completed a self-report questionnaire and participated in a face-to-face interview. Results: Regression analysis showed that when controlling for age, income, education, depression and general health, PTSD scores had a negative relationship with cognitive status. Those who reported having private, restricted social networks had poorer cognitive functioning. These relationships were independent of each other. Conclusions: The findings suggest that while social support might be a potential target for interventions in at-risk older adults, health professionals need to be aware of the concomitant possible influence of past trauma when dealing with this specific population.",0,0 +6280,Psychobiology of the acute stress response and its relationship to the psychobiology of post-traumatic stress disorder,"The literature to date that examines the biology of the acute stress reactions suggests that relatively lower baseline cortisol is associated with the development of PTSD. This is particularly informative because of the ongoing controversy surrounding baseline cortisol in PTSD. Studies have found low baseline cortisol, normal range, and elevated baseline cortisol in chronic PTSD, and it has been unclear whether this reflects methodologic differences across studies or true heterogeneity within the disorder. Thus, the few studies to date support the finding of low-normal baseline cortisol in chronic PTSD and suggest that it is a pre-existing functional trait. Whether it plays an etiologic role or is an epiphenomenon of some other process is unclear. What does seem clear, however, is that this characteristic is relatively nonspecific to PTSD, given the fact that low cortisol has been observed in multiple subject populations, including normal individuals under chronic stress as well as chronic medical conditions (for review see [23]). For example, it is possible that reduced baseline cortisol reflects the net result of input to the hypothalamus from cortical and subcortical regions of the brain linked to increased vigilance, sensitization to trauma because of prior traumatic experiences, or genetic factors. For example, primate studies have demonstrated persistent alterations in HPA axis functioning in animals reared by mothers living in moderately stressful conditions [24]. The development of PTSD is associated with sensitization of the startle response. Because the neurobiology of startle is well characterized, this finding implicates a role for specific neurocircuitry in PTSD [25]. Non-habituation of the startle response in PTSD appears related to sensitization specifically to contextual cues (i.e., the environment) that signal the presence of potential threat of danger-related fears [26]. This may be the neurobiological correlate to the over-generalization seen in PTSD that distinguishes the disorder from a simple trauma-induced phobia. The bed nucleus of the stria terminalis (BNST) is specifically implicated from preclinical research in the mediation of context-dependent cues [1]. Treatments that result in down-regulation of the BNST are therefore of particular interest in therapeutic models of prevention after trauma. The fact that a number of vulnerability factors associated with increased risk for developing PTSD are also likely to be biologically based (e.g., a genetic component, prior psychiatric history, prior family of history of psychiatric disorder), provides further evidence in support of a role for psychobiological factors in producing PTSD. Nevertheless, the considerable overlap on these measures between those who will develop PTSD, and those who eventually recover spontaneously, belies any attempt to identify any single or pathognomonic biological marker for risk. For now, the standard of care in predicting level of symptomatology and prognosis in the acute setting continues to be based on careful, informed, serial assessments of symptoms and functioning. Because the capacity to learn from and adapt to adverse conditions are essential to the survival of any species, understanding the neurobiological pathways that mediate learning from traumatic experiences in an adaptive way is as important as understanding the etiology of PTSD and other trauma-related maladaptive consequences. Biological models that trace the causal cascade of post-traumatic events in the brain and neuroendocrine systems may offer a multiplicity of possibilities for intervention. It is well established that conditioned responses are robust and persistent. Moreover, the primary mechanism of habituation is overlearning rather than extinction. Interventions that promote overlearning may therefore prove to be the most powerful and efficient preventative treatments. The therapeutics literature supports this hypothesis, in that brief psychosocial interventions based on sophisticated cognitive-behavioral models have proven effective in reducing suffering, symptom severity, and chronicity in individuals presenting with acute PTSD symptoms [27-29]. No acutely administered pharmacologic treatment to date has been shown effective in accelerating the process of recovery or in preventing the development of chronic PTSD. However, pharmacologic interventions that would prevent sensitization of circuits related to context-dependent threat perception, dysregulation of affect, and/or dysregulation of normal circadian rhythms are of theoretical interest and deserve further study.",0,0 +6281,Predictors of long-term prognosis of depression,"Many people with depression experience repeated episodes. Previous research into the predictors of chronic depression has focused primarily on the clinical features of the disease; however, little is known about the broader spectrum of sociodemographic and health factors inherent in its development. Our aim was to identify factors associated with a long-term negative prognosis of depression.We included 585 people aged 16 years and older who participated in the 2000/01 cycle of the National Population Health Survey and who reported experiencing a major depressive episode in 2000/01. The primary outcome was the course of depression until 2006/07. We grouped individuals into trajectories of depression using growth trajectory models. We included demographic, mental and physical health factors as predictors in the multivariable regression model to compare people with different trajectories.Participants fell into two main depression trajectories: those whose depression resolved and did not recur (44.7%) and those who experienced repeated episodes (55.3%). In the multivariable model, daily smoking (OR 2.68, 95% CI 1.54-4.67), low mastery (i.e., feeling that life circumstances are beyond one's control) (OR 1.10, 95% CI 1.03-1.18) and history of depression (OR 3.5, 95% CI 1.95-6.27) were significant predictors (p < 0.05) of repeated episodes of depression.People with major depression who were current smokers or had low levels of mastery were at an increased risk of repeated episodes of depression. Future studies are needed to confirm the predictive value of these variables and to evaluate their accuracy for diagnosis and as a guide to treatment.",0,0 +6282,A Neuropsychological Profile of Childhood Maltreatment Within an Adolescent Inpatient Sample,"Recent research has begun to identify the neurocognitive and psychological effects of childhood maltreatment, although information is limited on the neuropsychological presentation of maltreatment in psychiatrically hospitalized adolescents. This study examined the executive-functioning and language abilities as well as psychopathological presentation of childhood maltreatment victims in an adolescent psychiatric inpatient setting. The sample consisted of adolescent inpatients (ages 13-19 years old) who completed a neuropsychological/psychological assessment during hospitalization (n = 122). The sample was grouped based on childhood maltreatment history, with one group categorized by maltreatment history (n = 49) and the other group characterized by no maltreatment history (n = 73). Analyses revealed statistically significant differences (p < .01) between maltreatment groups on executive functioning, as well as on measures of self-reported depression and anxiety symptoms. No group differences remained after controlling for posttraumatic stress disorder. Further, distinct neuropsychological profiles were identified for specific types of maltreatment experienced. These findings suggest that while childhood maltreatment is associated with a range of neuropsychological impairments, the specific type of maltreatment experienced may have a significant influence on the type and severity of impairments. These findings contribute to the growing body of research on the significant consequences of childhood maltreatment.",0,0 +6283,Conditioned fear extinction and reinstatement in a human fear-potentiated startle paradigm,"The purpose of this study was to analyze fear extinction and reinstatement in humans using fear-potentiated startle. Participants were fear conditioned using a simple discrimination procedure with colored lights as the conditioned stimuli (CSs) and an airblast to the throat as the unconditioned stimulus (US). Participants were extinguished 24 h after fear conditioning. Upon presentation of unsignaled USs after extinction, participants displayed significant fear reinstatement. In summary, these procedures produced robust fear-potentiated startle, significant CS+/CS− discrimination, within-session extinction, and significant reinstatement. This is the first demonstration of fear extinction and reinstatement in humans using startle measures.",0,0 +6284,A confirmatory factor analysis of combined models of the Harvard Trauma Questionnaire and the Inventory of Complicated Grief-Revised: Are we measuring complicated grief or posttraumatic stress?,"The aim of this study was to assess the factorial structure of complicated grief (CG) and investigate the relationship between CG and posttraumatic stress disorder (PTSD) through the assessment of models combining both constructs. The questionnaire was completed by elderly, married respondents with a history of at least one significant, interpersonal loss (145 males and 147 females, 60–81 years). Confirmatory factor analysis (CFA) supported a two-factor model of separation and traumatic distress in CG. To investigate the relationship between CG and PTSD three combined models were specified and estimated using CFA. A model where all five factors, the two factors of CG and the three factors of PTSD, as defined by the DSM-IV, were allowed to correlate provided the best fit. The results indicated a considerable overlap between the dimensions of CG and PTSD, and complicated grief is construct that appears to be largely accounted for by especially the intrusive component of PTSD.",0,0 +6285,The Evolving Construct of Posttraumatic Stress Disorder (PTSD): DSM-5 Criteria Changes and Legal Implications,"In the DSM-5, the diagnosis of posttraumatic stress disorder (PTSD) has undergone multiple, albeit minor, changes. These changes include shifting PTSD placement from within the anxiety disorders into a new category of traumatic and stressor-related disorders, alterations in the definition of a traumatic event, shifting of the symptom cluster structure from three to four clusters, the addition of new symptoms including persistent negative beliefs and expectations about oneself or the world, persistent distorted blame of self or others, persistent negative trauma-related emotions, and risky or reckless behaviors, and the addition of a dissociative specifier. The evidence or lack thereof behind each of these changes is briefly reviewed. These changes, although not likely to change overall prevalence, have the potential to increase the heterogeneity of individuals receiving a PTSD diagnosis both by altering what qualifies as a traumatic event and by adding symptoms commonly occurring in other disorders such as depression, borderline personality disorder, and dissociative disorders. Legal implications of these changes include continued confusion regarding what constitutes a traumatic stressor, difficulties with differential diagnosis, increased ease in malingering, and improper linking of symptoms to causes of behavior. These PTSD changes are discussed within the broader context of DSM reliability and validity concerns.",0,0 +6286,Generalization of contextual fear depends on associative rather than non-associative memory components,"Posttraumatic stress disorder (PTSD) is characterized by the presence of three major symptom clusters: persistent fear memories, hyperarousal, and avoidance. With a passage of time after the trauma, PTSD patients show an increase in unspecific fear and avoidance, a phenomenon termed “fear generalization”. It is not clear whether fear generalization arises from the time-dependent growth of hyperarousal or changes in associative fear. The present study investigated behavioral and neuroanatomical correlates of non-associative and associative fear memory one week vs. one month after a trauma in a mouse model of PTSD with immediate vs. delayed foot shock application. The immediate shock procedure led to a lower contextual fear, but did not influence the hyperarousal (i.e. increased acoustic startle responses) assessed within the first week after the trauma. Only delayed shocked mice demonstrated generalization of contextual fear and an increase in generalized avoidance behavior, with no changes in hyperarousal one month after trauma. We observed the same increase in c-Fos expression following delayed and immediate shock presentation within the lateral, basolateral, central amygdala and CA1, CA3 and dentate gyrus of hippocampus, suggesting that all of these structures contribute to the development of hyperarousal. Only basolateral amygdala and dentate gyrus appeared to be additionally involved in encoding of contextual information. In summary, our results demonstrate the independence of associative and non-associative trauma-related fear. They support the hypothesis that generalized fear emerges in consequence of forgetting specific stimulus attributes associated with the shock context.",0,0 +6287,Developing a Consensus-based Definition of “Kokoro-no Care” or Mental Health Services and Psychosocial Support: Drawing from Experiences of Mental Health Professionals Who Responded to the Great East Japan Earthquake,"In this survey, we aimed to build consensus and gather opinions on 'Kokoro-no care' or mental health services and psychosocial support (MHSPSS) after a disaster, among mental health professionals who engaged in care after the Great East Japan Earthquake.We recruited mental health professionals who engaged in support activities after the Great East Japan Earthquake, which included local health professionals in the affected areas and members of mental health care teams dispatched from outside (n = 131). Adopting the Delphi process, we proposed a definition of 'Kokoro-no care', and asked the participants to rate the appropriateness on a 5-point Likert scale. We also solicited free comments based on the participants' experiences during the disaster. After Round 1, we presented the summary statistics and comments, and asked the participants to re-rate the definition that had been modified based on their comments. This process was repeated twice, until the consensus criterion of ≥ 80% of the participants scoring ≥ 4 on the statement was fulfilled.In Round 1, 68.7% of the respondents rated the proposed definition ≥ 4 for its appropriateness, and 88.4% did so in Round 2. The comments were grouped into categories (and subcategories) based on those related to the definition in general (Appropriate, Continuum of MHSPSS, Cautions in operation, Alternative categorisation of care components, Whether the care component should be categorised according to the professional involved, Ambiguous use of psychology, and Others), to mental health services (Appropriate, More specification within mental health services, More explicit remarks on mental health services, and Others), and to psychosocial support (Whether the care component should be categorised according to the professional involved, Raising concerns about the terms, and Others), and others.We achieved a consensus on the definition of 'Kokoro-no care', and systematically obtained suggestions on the concept, and practical advice on operation, based on the participants' experiences from the Great East Japan Earthquake. This collective knowledge will serve as reference to prepare and respond to future disasters.",0,0 +6288,"CRITICAL INCIDENT, ADULT ATTACHMENT STYLE, AND POSTTRAUMATIC STRESS DISORDER: A COMPARISON OF THREE GROUPS OF SECURITY WORKERS","In this paper the authors render the results of research investigating adult attachment and posttraumatic stress disorder (PTSD) in a sample of Belgian security workers. The sample contained 3 subsamples: 68 individuals who had directly experienced a critical incident, 67 individuals who indirectly went through a critical incident, and 77 individuals who had not experienced a critical incident in the last six months. The analysis of the research results shows that the secure attachment style and the three PTSD trauma symptom clusters in DSM-IV - intrusion, avoidance/numbing, and hyperarousal - discriminate between the three subsamples. In other words, security workers who were directly and actively confronted with a critical incident were significantly more insecurely attached and suffered significantly more from PTSD symptoms than the groups who had no or indirect experience of a critical incident. Furthermore, trauma-focused cognitive-behavioral therapy is widely and quite efficiently used in the treatment of PTSD. Interest has been expressed in medical approaches.",0,0 +6289,Update to an evaluation of ICD-11 PTSD and complex PTSD criteria in a sample of adult survivors of childhood institutional abuse by Knefel & Lueger-Schuster (2013): a latent profile analysis,"The World Health Organization (WHO) International Classification of Diseases, 11th version (ICD-11), has proposed a trauma-related diagnosis of complex posttraumatic stress disorder (CPTSD) separate and distinct from posttraumatic stress disorder (PTSD).To determine whether the symptoms endorsed by individuals who had experienced childhood institutional abuse form classes that are consistent with diagnostic criteria for ICD-11 CPTSD as distinct from PTSD.A latent profile analysis (LPA) was conducted on 229 adult survivors of institutional abuse using the Brief Symptom Inventory and the PTSD Checklist-Civilian Version to assess current psychopathological symptoms.The LPA revealed four classes of individuals: (1) a class with elevated symptoms of CPTSD (PTSD symptoms and disturbances in self-organization); (2) a class with elevated symptoms of PTSD and low disturbances in self-organization; (3) a class with elevated disturbances in self-organization symptoms and some elevated PTSD symptoms; and (4) a class with low symptoms.The results support the existence of a distinct group in our sample, that could be described by the proposed diagnostic category termed CPTSD more precisely than by normal PTSD. In addition, there seems to be a group of persons that do not fulfill the criteria for a trauma-related disorder but yet suffer from psychopathological symptoms.",0,0 +6290,Predictors of outcome of an Internet-based cognitive-behavioural therapy for post-traumatic stress disorder in older adults,"The aim of this study was to evaluate the role of resource-oriented variables such as self-efficacy, locus of control (LOC) and post-traumatic growth (PTG) in predicting treatment response in older adults with post-traumatic stress.Fifty-eight older adults with subsyndromal or greater severity of war-associated post-traumatic stress disorder (PTSD) symptoms completed a randomized controlled Internet-based cognitive-behavioural therapy (CBT) with immediate and delayed treatment groups. Assessments of PTSD severity and resource-oriented variables of self-efficacy, LOC and PTG were conducted at baseline, post-treatment and at a 6-month follow-up.Results revealed that pre-treatment scores on measures of internal LOC and PTG predicted PTSD symptom severity at post-treatment, even after controlling for initial PTSD. At a 6-month follow-up, internal LOC continued to predict PTSD symptom severity. In addition, repeated-measures analyses of variance revealed that, relative to older adults with low internal LOC and PTG, older adults with high internal LOC and PTG, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment.These findings suggest that greater locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Assessment of these constructs may be useful in identifying trauma survivors who are most likely to respond to CBT.Greater internal locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Older adults with initial high internal locus of control and post-traumatic growth, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. It could be assumed that patients with initial functional appraisals could benefit easier and faster from a trauma-focused cognitive-behavioural therapy compared to individuals with lower internal locus of control and post-traumatic growth.",0,0 +6291,"The Utility of the PAI and the MMPI-2 for Discriminating PTSD, Depression, and Social Phobia in Trauma-Exposed College Students","This study investigated the Minnesota Multiphasic Personality Inventory—Revised (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) and the Personality Assessment Inventory (PAI; Morey, 1991) with regard to each instrument's utility for discriminating post-traumatic stress disorder (PTSD) from depression and social phobia in a sample of college students with mixed civilian trauma exposure. Participants were 90 trauma-exposed undergraduates (16 male, 74 female) classified into one of four groups: PTSD, depressive disorders, social phobia, and well-adjusted. For both the PAI and the MMPI-2, profile analysis revealed that the groups differed in the elevation and shape of their profiles. The PAI Traumatic Stress subscale demonstrated good discriminant validity.",0,0 +6292,cis-3-Hexenol and trans-2-hexenal mixture prevents development of PTSD-like phenotype in rats,"Several green leaf volatiles have anxiolytic/antidepressant properties and attenuate adrenocortical stress response in rodents. However, it remains unknown whether a mixture of cis-3-hexenol and trans-2-hexenal so-called 'green odor (GO)' affects fear-associated post-traumatic stress disorder (PTSD)-like behavior. In the present study, fear memory of the initial conditioning stimulus was stably maintained by weekly presentation of conditioned tone. Examination of open field behavior, acoustic startle response, prepulse inhibition, and immobility in the forced swim test for 2 weeks after initial conditioning revealed that conditioned rats sustained anxiety, enhanced startle response, hypervigilance, depression-like behavior, and hypocortisolism, which is consistent with PTSD symptoms. Daily, not acute, GO presentation facilitated fear extinction and reduced PTSD-like behavioral and endocrinal responses. To further investigate the mechanism of effect of GO, we examined the effect of paroxetine (a selective serotonin reuptake inhibitor), p-chlorophenylalanine (PCPA, an irreversible serotonin synthesis inhibitor), alone or in combination of GO on PTSD-like phenotype. The alleviative effects of GO were masked by simultaneous paroxetine administration. PCPA-induced serotonin depletion abolished the effects of GO. Our results suggest that daily GO presentation facilitates fear extinction and prevents development of PTSD-like symptoms.",0,0 +6293,Psychophysiological Assessment of Stress in Chronic Pain: Comparisons of Stressful Stimuli and of Response Systems,"Due to disparate findings across the published studies, the stress-hyperactivity hypothesis has never been fully accepted as a causal mechanism for chronic muscle pain. Two recent comprehensive reviews of the psychophysiological studies of chronic pain came to opposite conclusions about the viability of the hypothesis, which stemmed from differing importance placed on the experimental methodology: the adequacy of stress manipulation. The present study tested the hypotheses that the adequacy of stress manipulation is influenced by stress stimuli type, degree of personal relevance, and selection of criterion for verification of stress experience, and that these factors have a measurable impact on the related physiological responses in a manner that is consistent with a theory of stress applicable to clinical stress disorders. The three factors investigated were: task (imagery, reaction time), relevance (high, low), and manipulation criterion (autonomic, self-report). The tasks were presented to 16 chronic pain patients while muscle, electrodermal, and self-report responses were recorded. Reaction-time tasks and high-relevance conditions led to high muscle and electrodermal responses. Only the high-relevance imagery, however, produced high self-reported distress. Consistent with other research, the present overall data demonstrated differing physiological profiles for different stimuli types. More importantly, these data suggest that the manipulation type and the manipulation criterion influence outcomes of experimental tests of stress on physiological systems, which may directly lead to contrasting conclusions about causal relations between stress and chronic pain conditions.",0,0 +6294,Implications of neuroscientific evidence for the cognitive models of post-traumatic stress disorder,"Brewin's dual representation theory, Ehlers and Clark's cognitive appraisal model, and Dalgleish's schematic, propositional, analogue and associative representational systems model are considered in the light of recent evidence on the neural substrates of post-traumatic stress disorder (PTSD). The models' proposals about the cognitive mechanism of memory dysfunction in PTSD are described and evaluated against current knowledge about the neural pathways and functions disrupted in PTSD. A dual pathway model of memory is consistent with neuroscience of memory. The appraisal model also provides an account of the top-down modulation of memory and arousal problems consistent with current neuroscientific evidence of PTSD. Dalgleish's model is less consistent with the evidence because it relies upon assumptions that cannot yet be tested neuroscientifically. All three models under-specify the causal and maintaining influence of hyperarousal relative to the role it plays in current neuroscientific models of PTSD. Implications of the evidence for improving treatment and prevention are discussed.",0,0 +6295,Psychiatric Comorbidity of Full and Partial Posttraumatic Stress Disorder Among Older Adults in the United States: Results From Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions,"

Objectives

To present findings on the prevalence, correlates, and psychiatric comorbidity of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition posttraumatic stress disorder (PTSD) and partial PTSD in a nationally representative sample of U.S. older adults.

Design, Setting, and Participants

Face-to-face interviews with 9,463 adults age 60 years and older in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions.

Measurements

Sociodemographic correlates; worst stressful experiences; comorbid lifetime mood, anxiety, substance use, and personality disorders; psychosocial functioning; and suicide attempts.

Results

Lifetime prevalences ± standard errors of PTSD and partial PTSD were 4.5% ± 0.25 and 5.5% ± 0.27, respectively. Rates were higher in women (5.7% ± 0.37 and 6.5% ± 0.39) than in men (3.1% ± 0.31 and 4.3% ± 0.37). Older adults with PTSD most frequently identified unexpected death of someone close, serious illness or injury to someone close, and their own serious or life-threatening illness as their worst stressful events. Older adults exposed to trauma but without full or partial PTSD and respondents with partial PTSD most often identified unexpected death of someone close, serious illness or injury to someone close, and indirect experience of 9/11 as their worst events. PTSD was associated with elevated odds of lifetime mood, anxiety, drug use, and borderline and narcissistic personality disorders and decreased psychosocial functioning. Partial PTSD was associated with elevated odds of mood, anxiety, and narcissistic and schizotypal personality disorders and poorer psychosocial functioning relative to older adults exposed to trauma but without full or partial PTSD.

Conclusions

PTSD among older adults in the United States is slightly more prevalent than previously reported and is associated with considerable psychiatric comorbidity and psychosocial dysfunction. Partial PTSD is associated with significant psychiatric comorbidity, particularly with mood and other anxiety disorders.",0,0 +6296,"Low specificity of symptoms on the post-traumatic stress disorder (PTSD) symptom scale: A comparison of individuals with PTSD, individuals with other anxiety disorders and individuals without psychopathology","Objectives Screening for post-traumatic stress disorder (PTSD) takes place in clinical and research settings where diagnostic interviews are not feasible, and typically relies on self-report instruments like the PTSD symptom scale (PSS). Concerns have been raised about the specificity of PTSD symptoms assessed by questionnaires. This study examined whether the PSS distinguishes between patients with PTSD and those with other anxiety disorders or healthy controls. Design A between-participants design was employed. Methods The participants were 65 individuals with PTSD, 40 individuals with other anxiety disorders and 40 healthy controls. They completed the PSS with respect to a range of stressful life-events. Results Using this instrument, 86% of individuals with PTSD and 5% of healthy controls endorsed sufficient symptoms to meet the PTSD diagnosis. This was also the case for 43% of individuals with other anxiety disorders, and self-reported symptoms related to traumatic events and aversive events that are generally not considered traumatic. Conclusions The findings suggest that many people screened positive for PTSD may actually be suffering from another anxiety disorder.",0,0 +6297,Differential neuroendocrine and immune responses to acute psychosocial stress in women with type 1 bipolar disorder,"Bipolar disorder (BD) has been associated with immune imbalance, including lymphocyte activation and increased pro-inflammatory cytokines. Immune activation is part of stress response, and psychosocial stress has been implicated in the pathogenesis of psychiatric disorders. Here, we investigated the neuroendocrine and immune responses to acute psychosocial stress challenge in BD. Thirteen euthymic participants with type 1 BD and 15 healthy controls underwent the Trier Social Stress Test protocol (TSST). Blood samples were collected before and after TSST. Lymphocytes were isolated and stimulated in vitro to assess lymphocyte activation profile, lymphocyte sensitivity to dexamethasone, mitogen-activated protein kinase (MAPK) and nuclear factor kappa B (NF-κB) signaling by flow cytometry. Heart rate and salivary cortisol levels were monitored across the task. BD participants exhibited blunted stress responses as shown by reduced heart rate and salivary cortisol levels in comparison to healthy controls. BD was also associated with reduction in the percentage of regulatory T cells, but with expansion of activated T cells. When compared to controls, patients showed increased lymphocyte MAPK p-ERK and p-NF-κB signaling after the stress challenge, but exhibited a relative lymphocyte resistance to dexamethasone. In conclusion, stress-related neuroendocrine responses are blunted, associated with increased immune activation and lower sensitivity to glucocorticoids in BD. An inability in reducing NF-κB and MAPK signaling following TSST could be underlying the immune imbalance observed in BD.",0,0 +6298,Psychophysiology and posttraumatic stress disorder symptom profile in pregnant African-American women with trauma exposure,"While female sex is a robust risk factor for posttraumatic stress disorder (PTSD), pregnant women are an understudied population in regards to PTSD symptom expression profiles. Because circulating hormones during pregnancy affect emotionality, we assessed whether pregnant women would have increased expression of the intermediate phenotypes of hyperarousal and fear-potentiated startle (FPS) compared to non-pregnant women. We examined PTSD symptom profiles in pregnant (n = 207) and non-pregnant women (n = 370). In a second study, FPS responses were assessed in 15 pregnant and 24 non-pregnant women. All participants were recruited from the obstetrics and gynecology clinic at a public hospital serving a primarily African-American, low socioeconomic status, inner-city population. Our results indicate that overall PTSD symptoms were not different between the groups of women. However, pregnant women reported being more hypervigilant (p = 0.036) than non-pregnant women. In addition, pregnant women showed increased FPS to a safety signal compared to non-pregnant women (p = 0.024). FPS to a safety signal in pregnant women was significantly correlated with PTSD hyperarousal symptoms (r = 0.731, p < 0.001). Furthermore, discrimination between danger and safety signals was present in non-pregnant women (p = 0.008), but not in pregnant women (p = 0.895). Together, these data suggest that pregnant women show clinical and psychophysiological hyperarousal compared to non-pregnant women, and support screening for PTSD and assessment of PTSD risk in pregnant women.",0,0 +6299,"Patterns of victimization, suicide attempt, and posttraumatic stress disorder in Greenlandic adolescents: a latent class analysis","Aim The current study had two main aims. The first was to identify groups of adolescents based on their similarity of responding across a number of victimizing and potentially traumatic events (PTEs). In doing so, we employed the statistical technique of Latent Class Analysis (LCA). The second aim was to assess the relationship between our resultant classes and the covariates of gender, suicide attempt, and PTSD. Methods Two hundred and sixty-nine Greenlandic school students, aged 12-18 (M = 15.4, SD = 1.84) were assessed for their level of exposure to PTEs. In addition, adolescents were assessed for the psychological impact of these events. A LCA was performed on seven binary indicators representing PTEs. Logistic regression was subsequently implemented to ascertain the relationships between latent classes and covariates. Results Three distinct classes were uncovered: a violence, neglect, and bullying class (class 1), a wide-ranging multiple PTE class (class 2), and a normative/baseline class (class 3). Notably, classes 1 and 2 were largely separated by the presence or absence of sexual PTEs. Individuals who reported having previously attempted suicide were almost six times more likely to be members of class 1 (OR = 5.97) and almost four times more likely to be members of class 2 (OR = 3.87) compared to the baseline class (class 3). Individuals who met the diagnostic criteria for PTSD were five times as likely to be members of class 1 and class 2 (OR = 5.09) compared to the baseline class. No significant associations were found between classes and gender. Conclusion The results underline the complexity of the interplay between multiple victimization experiences, traumatization, and suicide attempts. © 2014 Springer-Verlag Berlin Heidelberg.",0,0 +6300,Post-traumatic stress disorder in older adults: a systematic review of the psychotherapy treatment literature,"Older adults represent the fastest growing segment of the US and industrialized populations. However, older adults have generally not been included in randomized clinical trials of psychotherapy for post-traumatic stress disorder (PTSD). This review examined reports of psychological treatment for trauma-related problems, primarily PTSD, in studies with samples of at least 50% adults aged 55 and older using standardized measures.A systematic review of the literature was conducted on psychotherapy for PTSD with older adults using PubMed, Medline, PsychInfo, CINAHL, PILOTS, and Google Scholar.A total of 42 studies were retrieved for full review; 22 were excluded because they did not provide at least one outcome measure or results were not reported by age in the case of mixed-age samples. Of the 20 studies that met review criteria, there were: 13 case studies or series, three uncontrolled pilot studies, two randomized clinical trials, one non-randomized concurrent control study and one post hoc effectiveness study. Significant methodological limitations in the current older adult PTSD treatment outcome literature were found reducing its internal validity and generalizability, including non-randomized research designs, lack of comparison conditions and small sample sizes.Select evidence-based interventions validated in younger and middle-aged populations appear acceptable and efficacious with older adults. There are few treatment studies on subsets of the older adult population including cultural and ethnic minorities, women, the oldest old (over 85), and those who are cognitively impaired. Implications for clinical practice and future research directions are discussed.",0,0 +6301,Posttraumatic stress disorder in organ transplant recipients: a systematic review,"To summarize and critically review the existing literature on the prevalence of posttraumatic stress disorder (PTSD) following organ transplantation, risk factors for posttransplantation PTSD and the relationship of posttransplant PTSD to other clinical outcomes including health-related quality of life (HRQOL) and mortality.We conducted a systematic literature review using PubMed, CINAHL Plus, the Cochrane Library and PsycInfo and a search of the online contents of 18 journals.Twenty-three studies were included. Posttransplant, the point prevalence of clinician-ascertained PTSD ranged from 1% to 16% (n=738), the point prevalence of questionnaire-assessed substantial PTSD symptoms ranged from 0% to 46% (n=1024) and the cumulative incidence of clinician-ascertained transplant-specific PTSD ranged from 10% to 17% (n=482). Consistent predictors of posttransplant PTSD included history of psychiatric illness prior to transplantation and poor social support posttransplantation. Posttransplant PTSD was consistently associated with worse mental HRQOL and potentially associated with worse physical HRQOL.PTSD may impact a substantial proportion of organ transplant recipients. Future studies should focus on transplant-specific PTSD and clarify potential risk factors for, and adverse outcomes related to, posttransplant PTSD.",0,0 +6302,School-based mental health intervention for children in war-affected Burundi: a cluster randomized trial,"BackgroundArmed conflicts are associated with a wide range of impacts on the mental health of children and adolescents. We evaluated the effectiveness of a school-based intervention aimed at reducing symptoms of posttraumatic stress disorder, depression, and anxiety (treatment aim); and improving a sense of hope and functioning (preventive aim).MethodsWe conducted a cluster randomized trial with 329 children in war-affected Burundi (aged 8 to 17 (mean 12.29 years, standard deviation 1.61); 48% girls). One group of children (n = 153) participated in a 15-session school-based intervention implemented by para-professionals, and the remaining 176 children formed a waitlist control condition. Outcomes were measured before, one week after, and three months after the intervention.ResultsNo main effects of the intervention were identified. However, longitudinal growth curve analyses showed six favorable and two unfavorable differences in trajectories between study conditions in interaction with several moderators. Children in the intervention condition living in larger households showed decreases on depressive symptoms and function impairment, and those living with both parents showed decreases on posttraumatic stress disorder and depressive symptoms. The groups of children in the waitlist condition showed increases in depressive symptoms. In addition, younger children and those with low levels of exposure to traumatic events in the intervention condition showed improvements on hope. Children in the waitlist condition who lived on their original or newly bought land showed improvements in hope and function impairment, whereas children in the intervention condition showed deterioration on these outcomes.ConclusionsGiven inconsistent effects across studies, findings do not support this school-based intervention as a treatment for posttraumatic stress disorder and depressive symptoms in conflict-affected children. The intervention appears to have more consistent preventive benefits, but these effects are contingent upon individual (for example, age, gender) and contextual (for example, family functioning, state of conflict, displacement) variables. Results suggest the potential benefit of school-based preventive interventions particularly in post-conflict settings.Trial registrationThe study was registered as ISRCTN42284825",0,0 +6303,Rapid emotional processing in relation to trauma-related symptoms as revealed by magnetic source imaging,"Traumatic stress leads to functional reorganization in the brain and may trigger an alarm response. However, when the traumatic event produces severe helplessness, the predominant peri-traumatic response may instead be marked by a dissociative shutdown reaction. The neural correlates of this dissociative shutdown were investigated by presenting rapidly presented affective pictures to female participants with posttraumatic stress disorder (PTSD), and comparing responses to a Non-PTSD control group.Event-related-magnetic-fields were recorded during rapid visual serial presentation of emotionally arousing stimuli (unpleasant or pleasant), which alternated with pictures with low affective content (neutral). Neural sources, based on the L2-surface-minimum-norm, correlated with the severity of the symptom clusters: PTSD, depression and shutdown dissociation.For the early cortical response (60 to 110 ms), dissociation and PTSD symptom severity show similar spatial distributions of correlates for unpleasant stimuli. Cortical networks that could be involved in the relationships seem to be widespread.We conclude that shutdown dissociation, PTSD and depression all have distinct effects on early processing of emotional stimuli.",0,0 +6304,Psychological Sequelae Resulting From the 2004 Florida Hurricanes: Implications for Postdisaster Intervention,"Objectives. Data are limited regarding mental health effects of disasters such as hurricanes. We sought to determine the prevalence of and major risk factors associated with posttraumatic stress disorder (PTSD), generalized anxiety disorder, and major depressive episode 6 to 9 months after the 2004 Florida hurricanes. Methods. Random-digit dialing was used to recruit a representative population sample of 1452 hurricane-affected adults. Results. Posthurricane prevalence for PTSD was 3.6%, for generalized anxiety disorder was 5.5%, and for major depressive episode was 6.1%. Risk factors varied somewhat across disorders, with the exception of previous exposure to traumatic events, which increased risk of all negative outcomes. Conclusions. Storm exposure variables and displacement were associated primarily with PTSD. Notably, high social support in the 6 months preceding the hurricanes protected against all types of disorders.",0,0 +6305,Dysfunctional or hyperfunctional? The amygdala in posttraumatic stress disorder is the bull in the evolutionary China shop,"Our motivation in writing this Review arose not only from the great value in contributing to this special issue of the Journal of Neuroscience Research but also from the desire to express our opinion that the description of the amygdala as ""dysfunctional"" in posttraumatic stress disorder (PTSD) might not be appropriate. We acknowledge that excessive activation of the amygdala contributes to the cluster of PTSD symptoms, including hypervigilance, intrusive memories, and impaired sleep, that underlies the devastating mental and physical outcomes in trauma victims. The issue that we address is whether the symptoms of PTSD represent an impaired (dysfunctional) or sensitized (hyperfunctional) amygdala status. We propose that the amygdala in PTSD is hyperfunctional rather than dysfunctional in recognition of the fact that the individual has already survived one life-threatening attack and that another may be forthcoming. We therefore consider PTSD to be a state in which the amygdala is functioning optimally if the goal is to ensure a person's survival. The misery caused by a hyperfunctional amygdala in PTSD is the cost of inheriting an evolutionarily primitive mechanism that considers survival more important than the quality of one's life.",0,0 +6306,Interaction between the Cholecystokinin and Endogenous Cannabinoid Systems in Cued Fear Expression and Extinction Retention,"Post-traumatic stress disorder (PTSD) is thought to develop, in part, from improper inhibition of fear. Accordingly, one of the most effective treatment strategies for PTSD is exposure-based psychotherapy. Ideally, neuroscience would inform adjunct therapies that target the neurotransmitter systems involved in extinction processes. Separate studies have implicated the cholecystokinin (CCK) and endocannabinoid systems in fear; however, there is a high degree of anatomical colocalization between the cannabinoid 1 receptor (Cnr1) and CCK in the basolateral amygdala (BLA), a brain region critical for emotion regulation. Although most research has focused on GABA and GABAergic plasticity as the mechanism by which Cnr1 mediates fear inhibition, we hypothesize that a functional interaction between Cnr1 and CCKB receptor (CCKBR) is critical for fear extinction processes. In this study, systemic pharmacological manipulation of the cannabinoid system modulated cued fear expression in C57BL/6J mice after consolidation of auditory fear conditioning. Knockout of the CCKBR, however, had no effect on fear- or anxiety-like behaviors. Nonetheless, administration of a Cnr1 antagonist increased freezing behavior during a cued fear expression test in wild-type subjects, but had no effect on freezing behavior in CCKBR knockout littermates. In addition, we found that Cnr1-positive fibers form perisomatic clusters around CCKBR-positive cell bodies in the BLA. These CCKBR-positive cells comprise a molecularly heterogenous population of excitatory and inhibitory neurons. These findings provide novel evidence that Cnr1 contributes to cued fear expression via an interaction with the CCK system. Dysfunctional Cnr1-CCKBR interactions might contribute to the etiology of, or result from, fear-related psychiatric disease.",0,0 +6307,Six years after the wave. Trajectories of posttraumatic stress following a natural disaster,"The characteristics of long-term trajectories of distress after disasters are unclear, since few studies include a comparison group. This study examines trajectories of recovery among survivors in comparison to individuals with indirect exposure.Postal surveys were sent to Swedish tourists, repatriated from the 2004 Indian Ocean tsunami (n=2268), at 1, 3, and 6 years after the tsunami to assess posttraumatic stress (PTS) and poor mental health. Items were used to ascertain high and moderate disaster exposure groups and an indirect exposure comparison group.Long-term PTS trajectories were best characterized by a resilient (72.3%), a severe chronic (4.6%), a moderate chronic (11.2%) and a recovering (11.9%) trajectory. Trajectories reported higher levels of PTS than the comparison group. Exposure severity and bereavement were highly influential risk factors.These findings have implications regarding anticipation of long-term psychological adjustment after natural disasters and need for interventions after a single traumatic event with few secondary stressors.",1,0 +6308,Characterizing impulsivity profile in patients with obsessive–compulsive disorder,"Impulsivity represents a key dimension in obsessive-compulsive disorder (OCD), in relation to outcome and course. It can be assessed through the Barratt Impulsiveness Scale (BIS), which explores three main areas: attentional, motor, and nonplanning. Present study was aimed to assess level of impulsivity in a sample of OCD patients, in comparison with healthy controls, using the BIS.Seventy-five OCD outpatients, 48 of them having psychiatric comorbidities and 70 healthy controls, were assessed through the BIS, and their scores were analyzed using Student's t-test for independent samples, on the basis of demographic and clinical characteristics.BIS total scores were significantly higher (P: 0.01) in patients compared to controls, with no difference between pure and comorbid patients. Attentional impulsivity scores were significantly higher than controls in patients with pure (P < 0.001) and comorbid OCD (P < 0.001), without differences among them. Patients with multiple OC phenotypes showed higher, though statistically non significant, total and attentional scores, compared to single phenotype patients. In addition, patients with comorbid major depressive disorder had higher, though statistically non significant, total and attentional scores, compared to patients with comorbid bipolar disorder, generalized anxiety disorder, and other disorders.Present findings showed higher impulsivity levels in OCD patients versus controls, particularly in the attentional area, and ultimately suggest a potential cognitive implication.",0,0 +6309,Cortisol response to an experimental stress paradigm prospectively predicts long-term distress and resilience trajectories in response to active police service,"Heterogeneity in glucocorticoid response to experimental stress conditions has shown to differentiate individuals with healthy from maladaptive real-life stress responses in a number of distinct domains. However, it is not known if this heterogeneity influences the risk for developing stress related disorders or if it is a biological consequence of the stress response itself. Determining if glucocorticoid response to stress induction prospectively predicts psychological vulnerability to significant real life stressors can adjudicate this issue. To test this relationship, salivary cortisol as well as catecholamine responses to a laboratory stressor during academy training were examined as predictors of empirically identified distress trajectories through the subsequent 4 years of active duty among urban police officers routinely exposed to potentially traumatic events and routine life stressors (N = 234). During training, officers were exposed to a video vignette of police officers exposed to real-life trauma. Changes in salivary 3-methoxy-4-hydroxyphenylglycol (MHPG) and cortisol in response to this video challenge were examined as predictors of trajectory membership while controlling for age, gender, and baseline neuroendocrine levels. Officers who followed trajectories of resilience and recovery over 4 years mounted significant increases in cortisol in response to the experimental stressor, while those following a trajectory of chronic increasing distress had no significant cortisol change in response to the challenge. MHPG responses were not associated with distress trajectories. Cortisol response prospectively differentiated trajectories of distress response suggesting that a blunted cortisol response to a laboratory stressor is a risk factor for later vulnerability to distress following significant life stressors.",0,0 +6310,Hazardous alcohol use and treatment outcome in male combat veterans with posttraumatic stress disorder,"The relationship between alcohol problems and posttraumatic stress disorder (PTSD) remains unclear. Six hundred and eight combat veterans diagnosed with PTSD were assessed for PTSD symptoms and alcohol problems prior to group cognitive-behavioral treatment. They were reassessed 3 and 9 months after treatment. Participants were classified into low-risk and hazardous drinkers at each time point. Drinking status at intake did not predict PTSD symptoms at intake or follow-up. However, drinking status was associated with PTSD symptoms when both were assessed at follow-up. PTSD arousal symptoms were the only symptom cluster to differentiate drinking groups.",0,0 +6311,Mental health and functional impairment outcomes following a 6-week intensive treatment programme for UK military veterans with post-traumatic stress disorder (PTSD): a naturalistic study to explore dropout and health outcomes at follow-up,"Combat Stress, a UK national charity for veterans with mental health problems, has been funded by the National Health Service (NHS) to provide a national specialist service to deliver treatment for post-traumatic stress disorder (PTSD). This paper reports the efficacy of a PTSD treatment programme for UK veterans at 6 months follow-up.A within subject design.UK veterans with a diagnosis of PTSD who accessed Combat Stress.246 veterans who received treatment between late 2012 and early 2014.An intensive 6-week residential treatment programme, consisting of a mixture of individual and group sessions. Participants were offered a minimum of 15 individual trauma-focused cognitive behavioural therapy sessions. In addition, participants were offered 55 group sessions focusing on psychoeducational material and emotional regulation.Clinicians completed measures of PTSD and functional impairment and participants completed measures of PTSD, depression, anger and functional impairment.We observed significant reductions in PTSD scores following treatment on both clinician completed measures (PSS-I: -13.0, 95% CI -14.5 to -11.5) and self-reported measures (Revised Impact of Events Scale (IES-R): -16.5, 95% CI -19.0 to -14.0). Significant improvements in functional impairment were also observed (eg, Health of the Nation Outcome Scales (HONOS): -6.85, 95% CI -7.98 to -5.72). There were no differences in baseline outcomes between those who completed and those who did not complete the programme, or post-treatment outcomes between those we were able to follow-up at 6 months and those lost to follow-up.In a naturalistic study we observed a significant reduction in PTSD scores and functional impairment following treatment. These improvements were maintained at 6 month follow-up. Our findings suggest it may be helpful to take a closer look at combining individual trauma-focused cognitive behaviour therapy and group sessions when treating veterans with PTSD. This is the first UK study of its kind, but requires further evaluation.",0,0 +6312,Empirical Characterization of Heterogeneous Posttraumatic Stress Responses Is Necessary to Improve the Science of Posttraumatic Stress,"Article AbstractBecause this piece does not have an abstract, we have provided for your benefit the first 3 sentences of the full text.The concept of posttraumatic stress psychopathology is simple and intuitive: following a highly distressing event, some people develop sustained aversive responses that dominate their lives, causing overwhelming distress and havoc in their emotional, cognitive, behavioral, and interpersonal functioning. Despite the conceptual simplicity of posttraumatic stress, a decisive definition of the concept seems out of reach. The posttraumatic stress disorder (PTSD) diagnosis differs both between international standards (ie, International Classification of Diseases) and the US standards (Diagnostic and Statistical Manual of Mental Disorders ) and across iterations of these manuals.",0,0 +6313,Post-Traumatic Stress Disorder Related to the Cancer Experience,"Many healthcare professionals think about Post-Traumatic Stress Disorder (PTSD) in the context of soldiers returning from war zones, victims of abuse, or trauma survivors. Research literature supports a range of psychological stressors that are associated with a cancer diagnosis and subsequent treatment. Psychological responses of distress are most often reported at major transition points, such as diagnosis, treatment, conclusion of treatment, recurrence, and terminal disease, and include but are not limited to shock, denial, fear, anxiety, panic, sadness, depression, and appetite and sleep disturbances. A multimodal approach is needed to diagnose PTSD. This includes data that address social, cognitive, emotional, family, and occupational functioning. The human spirit is resilient. Many research studies have investigated positive life changes that individuals claim are a result of their cancer experiences. sources of posttraumatic growth will help all healthcare professionals foster the strength of the people they care for. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6314,Masculine gender role stress and posttraumatic stress disorder symptom severity among inpatient male crack/cocaine users.,"This study examined the association between masculine gender role stress (MGRS) and posttraumatic stress disorder (PTSD) symptom severity, above and beyond other factors previously found to be associated with PTSD symptoms (e.g., anxiety sensitivity and thought suppression) among 33 crack/cocaine-dependent patients in residential substance abuse treatment. Participants completed a series of questionnaires and were interviewed to determine current PTSD symptom severity. MGRS accounted for a significant amount of additional variance in PTSD symptom severity above and beyond other identified risk factors for PTSD. Results are discussed in terms of their implications for reducing PTSD risk among men following exposure to a potentially traumatic event. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0,0 +6315,"Intersection of Stress, Social Disadvantage, and Life Course Processes: Reframing Trauma and Mental Health","This paper describes the intersection of converging lines of research on the social structural, psychosocial, and physiological factors involved in the production of stress and implications for the field of mental health. Of particular interest are the stress sensitization consequences stemming from exposure to adversity over the life course. Contemporary stress sensitization theory provides important clinical utility in articulating mechanisms through which these multiple levels exert influence on mental health. Stress sensitization models (a) extend understanding of neurobiological and functional contexts within which extreme stressors operate and (b) make clear how these can influence psychologically traumatic outcomes. The value of interventions that are sensitive to current contexts as well as life course profiles of cumulative stress are illustrated through recent treatment innovations.",0,0 +6316,Post-tsunami stress: A study of posttraumatic stress disorder in children living in three severely affected regions in Sri Lanka,"At 3 to 4 weeks after the December 2004 tsunami disaster we assessed symptoms of posttraumatic stress disorder (PTSD) in 264 children who lived in severely affected coastal communities in Manadkadu (northern coast), Kosgoda (western coast), and Galle (southern coast) in Sri Lanka. The prevalence rate of tsunami-related posttraumatic stress disorder (PTSD) (ignoring the time criterion) ranged between 14% and 39% and an additional 5% to 8% had PTSD unrelated to the tsunami. The PTSD symptoms were explained by the severity of the trauma exposure and family loss, as well as previous traumatic events. The results confirm the relevance of the individual history of traumatic events for the genesis of PTSD and indicate a high need of mental health assistance among the tsunami-affected children in Sri Lanka.",0,0 +6317,Test Anxiety Prevention and Intervention Programs in Schools: Program Development and Rationale,"This paper (a) discusses the need for anxiety-focused prevention and intervention efforts, (b) discusses test anxiety interventions as an avenue toward building school partnerships to conduct anxiety-focused prevention and intervention efforts, and (c) provides a brief description of the University of New Orleans test anxiety program model and previously published findings. This paper also presents new data in support of our rationale from one of our screening assessments to highlight the linkages between test anxiety and anxiety problems more broadly and presents a brief summary of initial acceptability data. Data indicate that test anxiety was related to symptoms of anxiety disorders and depression. Moreover, among an initial wave of (n = 59) participants in a new intervention study, acceptability data are promising. For example, 96% indicating they were glad they participated and 70% of students showed substantial knowledge (at least 80% correct) of intervention content. Results are discussed in terms of how the data provide evidence for the importance of targeting test anxiety, future research directions, and applied implications.",0,0 +6318,Social support and stress: The role of social comparison and social exchange processes,"This paper first presents four different conceptualizations of social support: social integration, satisfying relationships, perceived helpfulness and enacted support. Then, classic and contemporary social comparison theory and social exchange theory are analysed as they are two theoretical perspectives that are particularly useful in understanding social support. These perspectives are employed to explain three seemingly paradoxical phenomena in the domain of social support: (1) the fact that support sometimes has negative effects; (2) the fact that the occurrence of stress itself can sometimes decrease the availability of support resources; and (3) the phenomenon that people believe that they give more support than they receive, and that there is more support available for them than for others.",0,0 +6319,Longitudinal Examination of PTSD Symptoms and Problematic Alcohol Use as Risk Factors for Adolescent Victimization,"The current study examined associations between posttraumatic stress disorder (PTSD) symptoms and future interpersonal victimization among adolescents, after accounting for the impact of early victimization exposure, gender, ethnicity, and household income. In addition, problematic alcohol use was tested as a mediator of the relation between PTSD symptoms and subsequent victimization. Participants included a national longitudinal sample of adolescents (N = 3,604) who were ages 12 to 17 at the initial assessment: 50% were male, and 67% were White, 16% African American, and 12% Hispanic. Cohort-sequential latent growth curve modeling was used to examine associations among the study variables. Baseline PTSD symptoms significantly predicted age-related increases in interpersonal victimization, even after accounting for the effects of earlier victimization experiences. In addition, alcohol problems emerged as a partial mediator of this relation, such that one fourth to one third of the effect of PTSD symptoms on future victimization was attributable to the impact of PTSD symptoms on alcohol problems (which, in turn, predicted additional victimization risk). Collectively, the full model accounted for more than half of the variance in age-related increases in interpersonal victimization among youth. Results indicate that PTSD symptoms serve as a risk factor for subsequent victimization among adolescents, over and above the risk conferred by prior victimization. This increased risk occurred both independently and through the impact of PTSD symptoms on problematic alcohol use. Based on these findings, it is hypothesized that the likelihood of repeated victimization among youth might be reduced through early detection and treatment of these clinical problems.",0,0 +6320,Incidence and associations of parental and child posttraumatic stress symptoms in pediatric patients,"Previous studies consistently found remarkable prevalence rates of posttraumatic stress symptoms (PTSS) and posttraumatic stress disorders (PTSD) in pediatric patients and their parents. Findings suggest a significant association between child and parent PTSS. The present study examined, in a sample of pediatric patients with different conditions, incidence rates and determinants of PTSS and PTSD in the patients, and their mothers and fathers. Also, associations of maternal, paternal and child PTSS and PTSD were analyzed.Two hundred and nine children (aged 6.5-14.5 years) were interviewed 5-6 weeks after an accident or a new diagnosis of cancer or diabetes mellitus type 1 by means of the Child PTSD Reaction Index. Their mothers (n = 180) and fathers (n = 175) were assessed with the Posttraumatic Diagnostic Scale.Children reported PTSS levels in the mild range. Sixteen percent of the fathers and 23.9% of the mothers met full DSM-IV diagnostic criteria for current PTSD. Type of trauma impacted differently on parents and children. In children, accident-related injury was associated with higher PTSS scores. Conversely, in parents, diagnosis of cancer in their child was associated with more symptoms. Functional status of the child was also found to be an important predictor of PTSS in children and parents. PTSS scores of mothers and fathers were significantly correlated with each other. However, child PTSS were not significantly related to PTSS of mothers and fathers. This was true for total scores as well as for DSM-IV symptom clusters.There is a need for careful evaluation of PTSS and PTSD in pediatric patients with accidental injuries or sudden onset of severe chronic diseases and in their respective parents. Importantly, children, their mothers, and their fathers should be assessed separately, because a significant association between child and parental PTSS may not exist.",0,0 +6321,Is Post-Traumatic Stress Disorder a helpful concept for adults with intellectual disability?,"Research using the concept of Post-Traumatic Stress Disorder (PTSD) with adults with intellectual disability (ID)assumes they perceive and react to traumatic events in a similar way to non-disabled adults. Reactions to trauma displayed by children may be relevant to adults with ID as well.Two focus groups were held with professionals and practitioners to explore the relevance of criteria from child as well as adult literature to adults with ID who experience trauma. Descriptive thematic analysis was carried out.Abuse, parental bereavement, and having children removed were considered common sources of trauma. Similarities identified between disabled and non-disabled adults were flashbacks and nightmares; distressed by reminders; avoidance; hypervigilance and increased arousal. Differences were the frequent occurrence of multiple rather than single events, which were considered significant in generating chronic problems similar to those described as PTSD; also the occurrence of physical health problems and behavioural re-enactments.Experienced professionals and practitioners considered most of the ideas from PTSD research with non-disabled adults to be relevant to adults with ID who experience trauma, but that some behaviour reported in research with children was also relevant. Topics and questions for use in clinical and research practice with individuals who have experienced trauma were proposed.",0,0 +6322,Assessing the impact of posttraumatic stress disorder (PTSD) among wives of veterans: A phenomenological study of life changing experiences of wives of war veterans diagnosed with PTSD,"Post Traumatic Stress Disorder is a chronic illness that not only destabilizes the victim, but also impacts the lives of family members and those close them by way of compassion fatigue or secondary traumatization. The purpose of this mixed-method, phenomenological study was to explore the lived experiences of a sample of 10 wives of Iraq and Afghanistan war veterans diagnosed with PTSD in order to assess the impact of the veterans' symptoms upon their wives, their marriage, and their family life. The setting was a local community close to Fort Jackson Military Cantonment in Columbia, South Carolina. Ten wives of war veterans diagnosed with PTSD were recruited on a voluntary basis from the local churches where they worshipped. A face-to-face semi-structured interview was conducted in order to explore the wives' lived experiences. Participant's mean score was 82.7 of a possible 85 as measured by the Secondary Traumatic Stress Scale. All participants experienced secondary trauma. African-American participants scored significantly higher than the White participants on the Avoidance and Arousal scales and on Total score. No significant differences were found for ethnicity on the Intrusion scale. Themes found in the interviews related to (1) fears and uncertainties about the future of their marriages; (2) determination to keep their marriage vows; (3) guilt and shame; (4) systemic change in lifestyle; (5) mental and emotional stress; (6) coping strategies, and (7) strength and empowerment. Further studies relating spouses' symptom severity with that of veterans, effectiveness of coping skills, and effects on children are called for. Including veterans' wives in conjoint therapy is recommended, as is the development of principles of marital therapy to help couples move beyond the diagnosis of PTSD and toward recovery. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6323,A French adaptation of the Posttraumatic Diagnostic Scale.,"The factor structure of a French adaptation of the Posttraumatic Diagnostic Scale (PDS-F) based on the original scale by Foa, Cashman, Jaycox, and Perry (1997) was examined in 287 community members. Confirmatory factor analysis evaluated three models: the three symptom clusters of Posttraumatic Stress Disorder (PTSD) defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM–IV; American Psychiatric Association, 1994), the 4-factor King, Leskin, King, and Weathers (1998) model and the 4-factor Simms, Watson, and Doebbelling (2002) model. The data’s fit to the DSM–IV model was unacceptable. Both 4-factor models demonstrated a good fit; however, the Simms et al. (2002) model with intrusions, avoidance, dysphoria, and hyperarousal factors showed the best fit. Scores calculated for the Simms et al. (2002) factors showed good reliability and validity. The study also examined lifetime stressful event reporting and PTSD severity. “Stressful” events not traditionally defined as “traumatic” (e.g., death of a loved one) were frequently endorsed as the respondent’s most stressful event (i.e., index event) and corresponded to a possible PTSD diagnosis. Furthermore, PTSD severity was associated with negative emotional appraisals of the index event (DSM–IV criterion A2 for PTSD) and lifetime cumulative stressful event intensity whereas PTSD severity was not associated with the degree of physical harm of the index event (criterion A1). Lifetime stressful experiences are discussed in light of evidence supporting a dysphoria component in PTSD.",0,0 +6324,Attentional bias for affective visual stimuli in posttraumatic stress disorder and the role of depression,"An attentional bias for trauma-related verbal cues was frequently demonstrated in posttraumatic stress disorder (PTSD) using variants of the emotional Stroop task (EST). However, the mechanisms underlying the Stroop-effect are ill-defined and it is yet unclear how the findings apply to different paradigms and stimulus modalities. To address these open questions, for the first time a spatial-cuing task with pictorial cues of different emotional valence was administered to trauma-exposed individuals with and without PTSD, and non-trauma-exposed controls. Groups did not show different response profiles across affective conditions. However, a group effect was evident when comparing depressed with non-depressed individuals: Those with depression showed delayed attending towards trauma-related cues and faster attending away from negative cues. In correlational analyses, attentional avoidance was associated with both depression and PTSD symptom severity. These findings highlight the need for research on trauma populations and anxiety in general to pay closer attention to depression as an important confound in the study of emotional information processing.",0,0 +6325,Evaluation of a classroom-based psychosocial intervention in conflict-affected Nepal: a cluster randomized controlled trial,"In situations of ongoing violence, childhood psychosocial and mental health problems require care. However, resources and evidence for adequate interventions are scarce for children in low- and middle-income countries. This study evaluated a school-based psychosocial intervention in conflict-affected, rural Nepal.A cluster randomized controlled trial was used to evaluate changes on a range of indicators, including psychiatric symptoms (depression, anxiety, posttraumatic stress disorder), psychological difficulties, resilience indicators (hope, prosocial behavior) and function impairment. Children (n = 325) (mean age = 12.7, SD = 1.04, range 11-14 years) with elevated psychosocial distress were allocated to a treatment or waitlist group.Comparisons of crude change scores showed significant between-group differences on several outcome indicators, with moderate effect sizes (Cohen d = .41 to .58). After correcting for nested variance within schools, no evidence for treatment effects was found on any outcome variable. Additional analyses showed gender effects for treatment on prosocial behavior (mean change difference: 2.70; 95% CI, .97 to 4.44), psychological difficulties (-2.19; 95% CI, -3.82 to -.56), and aggression (-4.42; 95% CI, -6.16 to -2.67). An age effect for treatment was found for hope (.90; 95% CI, -1.54 to -.26).A school-based psychosocial intervention demonstrated moderate short-term beneficial effects for improving social-behavioral and resilience indicators among subgroups of children exposed to armed conflict. The intervention reduced psychological difficulties and aggression among boys, increased prosocial behavior among girls, and increased hope for older children. The intervention did not result in reduction of psychiatric symptoms.",0,0 +6326,A Second-Order Growth Mixture Model for Developmental Research,"Growth mixture modeling, a combination of growth modeling and finite mixture modeling, is a flexible, exploratory method for identifying and describing between-person heterogeneity in change. In this article we introduce a second-order growth mixture model that combines a longitudinal common factor model, measurement invariance constraints, latent growth model, and mixture model. This approach capitalizes on the benefits of multivariate measurement and the flexibility of mixtures for representing heterogeneity. We describe the model and illustrate its use with multi-reporter longitudinal data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development tracking the development of children's externalizing behaviors through elementary school.",0,0 +6327,Confirmatory Factor Analysis of the Posttraumatic Growth Inventory in a Veteran Sample with Posttraumatic Stress Disorder,"The objective of this study was to conduct a confirmatory factor analysis (CFA) of the Posttraumatic Growth Inventory (PTGI) to determine if the factor structure is the same for a veteran sample with posttraumatic stress disorder (PTSD; N = 221) as compared to previous studies that have used more heterogeneous samples of subjects. Analyses were conducted in order to examine the best model fit between three broad dimensional factors, a five-factor structure, or a factor structure consisting of one higher-order “general” factor with five “lower-order” factors. Results of the CFA revealed adequate fits for the five-factor and five-factor higher-order models. The findings of this study support the use of the PTGI total and factor scores when interpreting results in veteran samples with PTSD.",0,0 +6328,Maternal Obesity in Pregnancy: Consequences for Brain Function in the Offspring,"It is perhaps not surprising that an inhospitable intrauterine environment can result in neurodevelopmental disorders, given the enormous changes in brain development that occur during gestation. Here we discuss: (1) Obesity is a state of low-grade inflammation and is thus a candidate for having an unfavorable impact on brain function in the offspring. (2) Maternal obesity has recently been associated with offspring attention deficit hyperactivity disorder and autism spectrum disorder. A recent study found differences in amniotic fluid mRNA for 20 genes in fetuses of obese versus lean women, and several of these genes impact on brain sculpting. (3) The balance between excitable and inhibitory neural function can be disturbed as a consequence of maternal obesity and can lead to hyperexcitability-linked cognitive decline later in life. (4) While most studies of brain development and function have focused on neurons, inflammation and oxidative stress have major effects on microglia and astrocytes, key cells in the sculpting of synapses, neural plasticity, and the formation of neural networks. (5) Animal models are, of necessity, widely used and the temporal trajectory of neurodevelopment to accommodate the requirements of the different species has recently been modeled. While detailed studies are essential for understanding mechanism, it is critical to test the outcomes of manipulating the system on behavior. In this regard considerable care is required to ensure that the most appropriate behavioral test and animal model are used. Thus, there is considerable scope for consolidating our understanding of the effects of maternal obesity on brain function in the offspring. © Springer Science+Business Media New York 2016.",0,0 +6329,Examining the relationship between coping strategies and suicidal desire in a sample of United States military personnel,"Suicidal desire in the military has been previously examined through the lens of the Interpersonal-Psychological Theory of Suicide (IPTS). However, no research has examined the impact of specific coping strategies on perceived burdensomeness, thwarted belongingness, and suicidal ideation in a large population of individuals serving in the US military. Furthermore, the factor structure of previously utilized coping clusters did not apply to our sample of military personnel. Therefore, we found a three-factor solution to be tested in this sample. We hypothesized that specific types of coping behavior clusters (Adaptive and Maladaptive) would predict both IPTS constructs and suicidal ideation. Results indicated that Adaptive and Maladaptive coping clusters predicted the IPTS constructs in the hypothesized directions. However, only the Maladaptive cluster predicted suicidal ideation. These findings implicate the need for further research and suicide prevention efforts focusing on coping strategies, specifically those that are maladaptive in nature, in relation to suicidal ideation in military members.",0,0 +6330,Neuropsychological impairments in panic disorder: A systematic review,"There is a growing body of literature investigating the neuropsychological profile of panic disorder (PD), some of which suggests potential cognitive dysfunction. This paper systematically reviews the existing literature on neuropsychological performance in PD.PsycINFO, EMBASE, MEDLINE and PsycARTICLES databases were searched to identify articles reporting on neuropsychological function in PD published in English during the time period 1980 to March 2012. 14 studies were identified.There was limited support for impairment in short term memory among individuals with PD, although this was not found across all studies. Overall, the reviewed studies did not support the presence of impairment in other areas of cognitive functioning, including executive function, long term memory, visuospatial or perceptual abilities and working memory.Studies with samples of fewer than 15 participants per group were excluded from this review. A limited amount of research has been published on this topic and small sample sizes (under 25 per group) have been used by many studies. Therefore, the current review is based on a small number of studies with limited power.There is limited evidence of specific neuropsychological impairments in participants with PD. Impairments in short term memory warrant further investigation to establish their relevance to clinical practice. Larger sample sizes and appropriate statistical adjustment for multiple comparisons in future studies is highly recommended.",0,0 +6331,Psychiatric comorbidity effects on compensatory cognitive training outcomes for veterans with traumatic brain injuries.,"To investigate the influence of posttraumatic stress disorder (PTSD) diagnosis, and PTSD and depression severity, on the postconcussive symptom trajectory over the course of a 1-year study period.Secondary analysis of a randomized controlled trial comparing veterans who received supported employment combined with compensatory cognitive training to those who received supported employment only. Assessments were conducted at baseline, 3- (postintervention), 6-, and 12-months. Participants were 50 Operation Enduring and Iraqi Freedom (OEF/OIF) veterans with a history of mild to moderate traumatic brain injury (TBI) who were unemployed, seeking work, and who had neuropsychological impairment. Of all participants, 74% met diagnostic criteria for PTSD. All participants received supported employment and half of the sample also received Cognitive Symptom Management and Rehabilitation Therapy (CogSMART), a 12-session, manualized compensatory cognitive training intervention.Veterans with PTSD and greater depression severity endorsed significantly more severe postconcussive symptomatology at all assessment time points. However, the rate of CogSMART-associated improvement in postconcussive symptoms did not differ as a result of psychiatric symptomatology.Study results suggest that for veterans with a history of mild to moderate TBI, presence of comorbid PTSD or depressive symptoms should not preclude participation in cognitive rehabilitation interventions.",0,0 +6332,Conducting applied research on Vietnam combat-related post-traumatic stress disorder,"A paradigmatic shift in post-traumatic stress disorder (PTSD) research is underway. Formistic and mechanistic research designs, characterized by single-category, single-cause, single-effect models, gradually are being replaced by contextual and organistic research designs that feature multi-category, multi-cause, and multi-effect interactional models. Such changes in diagnostic and treatment outcome research require solving many methodological issues in such areas as: measuring types of traumas and stressors; measuring PTSD symptoms and subtypes; measuring subject dispositional characteristics (such as ethnic differences); assessing concurrent and/or pre-existing psychiatric (Axis I) disorders; classifying personality styles and concurrent and/or pre-existing personality (Axis II) disorders; evaluating phase in the development of PTSD as a disorder; measuring current environmental stresses and interpersonal interactions; and assessing secondary gains and readiness for treatment. These and other methodological problems must be addressed as research on PTSD shifts to longitudinal measurement of subjects randomly assigned to treatment conditions.",0,0 +6333,The role of hyperarousal in the manifestation of posttraumatic psychological distress following injury.,"The authors examined the temporal relation among posttraumatic stress disorder symptom clusters, using data derived from a longitudinal study of survivors of orofacial injury (N = 264). They conducted cross-lagged panel analyses, with self-reported symptom data collected at 1, 6, and 12 months postinjury. Results demonstrate that hyperarousal was a potent predictor of subsequent symptoms of reexperiencing and avoidance as well as hyperarousal. By contrast, neither reexperiencing nor avoidance was significantly related to other symptom clusters other than themselves over time. These findings underscore the distinctive nature of hyperarousal in the manifestation of posttraumatic psychological distress over time. Implications for theory, clinical intervention, and future research are discussed.",0,0 +6334,Trajectories of Adjustment in Mothers of Children with Newly Diagnosed Cancer: A Natural History Investigation,"The objectives of this study were (a) to assess negative affectivity and posttraumatic symptomatology in mothers following the diagnosis of cancer in their children; (b) to examine sociodemographic and psychosocial variables associated with change in distress over time; and (c) to identify distinct subgroups of mothers whose patterns and trajectories of adjustment can be distinguished according to available predictor data.Two hundred and twelve mothers at seven sites were assessed just following their child's diagnosis, and again 3 months and 6 months later. Primary outcomes included measures of mood disturbance, depressive symptoms, and symptoms of posttraumatic stress.Overall, mothers demonstrated a pattern of mildly elevated negative affectivity and posttraumatic symptomatology initially, with steady improvements evident at 3- and 6-month follow-up. Distinct adjustment trajectories were evident within the sample as a whole, indicating subgroups of mothers with high-declining, moderate-stable, and low-stable distress levels.These findings highlight considerable resilience among mothers facing the stress of childhood cancer. Intervention efforts aimed at reducing maternal distress might best be targeted towards the subgroup of mothers who may be predicted to exhibit the highest level of distress.",0,0 +6335,Maintaining the Clinical Relevance of Animal Models in Translational Studies of Post-Traumatic Stress Disorder,"The diagnosis of Post-Traumatic Stress Disorder (PTSD) is conditional on directly experiencing or witnessing a significantly threatening event and the presence of a certain minimal number of symptoms from each of four symptom clusters (re-experiencing, avoidance, negative cognition and mood, and hyperarousal) at least one month after the event (DSM 5) (American Psychiatric Association 2013). Only a proportion of the population exposed develops symptoms fulfilling the criteria. The individual heterogeneity in responses of stress-exposed animals suggested that adapting clearly defined and reliably reproducible ""diagnostic"", i.e. behavioral, criteria for animal responses would augment the clinical validity of the analysis of study data. We designed cut-off (inclusion/exclusion) behavioral criteria (CBC) which classify study subjects as being severely, minimally or partially affected by the stress paradigm, to be applied retrospectively in the analysis of behavioral data. Behavioral response classification enables the researcher to correlate (retrospectively) specific anatomic, bio-molecular and physiological parameters with the degree and pattern of the individual behavioral response, and also introduces ""prevalence rates"" as a valid study-parameter. The cumulative results of our studies indicate that, by classifying the data from individual subjects according to their response patterns, the animal study can more readily be translated into clinical ""follow-up"" studies and back again. This article will discuss the concept of the model and its background, and present a selection of studies employing and examining the model, alongside the underlying translational rationale of each.",0,0 +6336,"Mental health profiles among married, never-married, and separated/divorced mothers in a nationally representative sample","Background: Several studies have found that married mothers compared to single mothers had better mental health (Cairney et al. in Soc Psychiatry Psychiatr Epidemiol 38:442-449, 2003; Cairney et al. in Can J Public Health 90:320-324, 1999; Davies et al. in J Marriage Fam 59:294-308, 1997; Lipman et al. in Am J Psychiatry 158:73-77, 2001; Wang in Soc Psychiatry Psychiatr Epidemiol 39:26-32, 2004). Although a relationship between family structure (single vs married mothers) and psychiatric disorders is well established, several questions remain. The present study addressed the question ""Are there differences in the prevalence of psychiatric disorders between married, never-married, and separated/divorced mothers?"" Methods: The present report examined the lifetime prevalence of anxious misery, fear, and externalizing disorders among mothers in relation to family structure (married, never-married, and separated/divorced) in the US National Comorbidity Survey (N=1,534). Results: Results indicated that never-married mothers appeared to be generally similar to married mothers in their mental health profiles. Separated/divorced mothers compared to married mothers had increased odds of having any anxious-misery disorder, depression, dysthymia, generalized anxiety disorder (GAD), posttraumatic stress disorder, any externalizing disorder, and antisocial personality disorder. Differences were found between never-married and separated/divorced mothers, with separated/divorced mothers having increased odds ratios of having any anxious-misery disorder, depression, and GAD. Conclusions: Results are discussed in light of the unique life contexts of married, never-married, and separated/divorced mothers and as further evidence for the case against combining the separated/divorced and never-married marital status into one ""single motherhood"" classification in mental health research. © Springer-Verlag 2006.",0,0 +6337,A study on the long-term effects of child sexual abuse: An empirical investigation of the post-traumatic stress disorder and traumagenic dynamic models.,"Recently, child sexual abuse (CSA) has become an issue of increasing interest and concern in the social and scientific domains. To date, research on CSA has focused on documenting the incidence, prevalence, and impact of sexual abuse, and the literature is in need of theoretically-driven studies. Accordingly, this study assessed the Post-traumatic Stress Disorder (PTSD) and Traumagenic Dynamics (TD) models of CSA. Participants were 603 adult women recruited from two University settings and the Internet, 205 (34%) of whom reported a history of CSA. They completed a series of questionnaires inquiring about their socio-demographic characteristics, childhood experiences and present experiences. The PTSD and TD perspectives were tested using hierarchical multiple regression; the results provide partial support for both formulations of CSA, and suggest that including non-sexual child abuse and parental relationship variables improves prediction in both models. The implications of these findings and future directions for the CSA literature are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6338,Quetiapine as an adjunctive treatment for post-traumatic stress disorder: an 8-week open-label study,"This study evaluated the effectiveness of quetiapine for subjects with post-traumatic stress disorder (PTSD) who were already on a stable dose of a selective serotonin reuptake inhibitor (SSRI) but had significant PTSD symptoms. Fifteen subjects were enrolled in an 8-week open-label trial for PTSD in which quetiapine was added to an SSRI. Subjects were on a stable dose of the SSRI for at least 6 weeks before study entry and had a Clincian-Administered PTSD Scale (CAPS) score of greater than or equal to 50 at study baseline. The mean age of subjects was 49 years (eight men and seven women). The average duration of PTSD was 29 years, one-third of subjects had combat-related PTSD, and two-thirds had noncombat PTSD. The mean dose prescribed in the study was 216 mg per day. The initial median CAPS score was 80, indicating severe PTSD. The addition of a modest dose of quetiapine provided significant relief from PTSD symptoms with a 42% overall improvement in PTSD symptoms based on the CAPS and significant improvement along each dimension of symptoms: re-experiencing (Z=-3.24, P=0.0012), hyperarousal (Z=-3.30, P=0.001) and avoidance (Z=-2.13, P=0.03). Subjects rated themselves as 45% improved on average on the Davidson Trauma Scale and reported a 44% decrease in their level of disability and impairment as reflected by the Sheehan Disability Scale. Subjects with PTSD who had significant PTSD symptoms when on an SSRI benefited from the addition of quetiapine. Patients improved significantly on all three clusters of PTSD symptoms: re-experiencing, hyperarousal and avoidance.",0,0 +6339,Combat Stress Reaction and Changes in Military Medical Profile,"This study examines changes in the military medical profile following participation in war. Two groups of Israeli soldiers who participated in the 1982 Lebanon War were studied: 360 soldiers who were treated for immediate combat stress disorder during the war, and a matched control group of 310 soldiers who participated in the same war and were not identified as combat stress reaction casualties. Significant lowering of the profile after the war was noted for both groups. These changes were much stronger for combat stress reaction casualties. The differences between the groups were especially pronounced with regard to the addition of the psychiatric impairment category to the military medical profile. No background characteristics differentiated between combat stress reaction casualties who lowered their profile and those who did not. The implications of the findings for further research and for military mental health policy are discussed.",0,0 +6340,"Latent profile analyses of posttraumatic stress disorder, depression and generalized anxiety disorder symptoms in trauma-exposed soldiers","Posttraumatic stress disorder (PTSD) is comorbid with major depressive disorder (MDD; Kessler et al., 1995) and generalized anxiety disorder (GAD; Brown et al., 2001). We aimed to (1) assess discrete patterns of post-trauma PTSD-depression-GAD symptoms using latent profile analyses (LPAs), and (2) assess covariates (gender, income, education, age) in defining the best fitting class solution. The PTSD Checklist (assessing PTSD symptoms), GAD-7 scale (assessing GAD symptoms), and Patient Health Questionnaire-9 (assessing depression) were administered to 1266 trauma-exposed Ohio National Guard soldiers. Results indicated three discrete subgroups based on symptom patterns with mild (class 1), moderate (class 2) and severe (class 3) levels of symptomatology. Classes differed in symptom severity rather than symptom type. Income and education significantly predicted class 1 versus class 3 membership, and class 2 versus class 3. In conclusion, there is heterogeneity regarding severity of PTSD-depression-GAD symptomatology among trauma-exposed soldiers, with income and education predictive of class membership.",0,0 +6341,Personality and trauma-related risk factors for traumatic exposure and for posttraumatic stress symptoms (PTSS): A three-year prospective study,"Abstract The aim of this prospective study was twofold: (1) to examine the role of pre-traumatic personality variables in the risk for exposure to trauma, and (2) to explore the role of pre-traumatic personality variables and subjective trauma-related variables – namely proximity to the trauma and its subjective experience – in the risk for developing posttraumatic stress symptoms (PTSS). The study included 1210 Israeli B.A. students assessed twice: at the start of their first academic year (t1), and at the end of their third academic year (t2). Over a period of three academic years, 439 (36%) of the 1210 participants had been exposed to trauma, showing increased PTSS. The findings show that (a) males without a history of psychiatric disorder, who are high in extraversion and openness, are at an elevated risk for traumatic exposure; (b) the subjective trauma-related variables – close proximity to the traumatic event and greater experience of the traumatic event as a threat – are predominant risk factors for PTSS; and (c) females with a history of psychiatric disorder, along with low tendencies of extraversion and openness and high levels of neuroticism, are at a higher risk for PTSS following traumatic exposure.",0,0 +6342,Personality disorders in previously detained adolescent females: A prospective study.,"This longitudinal study investigated the predictive value of trauma and mental health problems for the development of antisocial personality disorder (ASPD) and borderline personality disorder (BPD) in previously detained women. The participants were 229 detained adolescent females who were assessed for traumatic experiences and mental health problems (mean age = 15.5 years). Three to 6 years later (M = 4.5; SD = 0.6), ASPD and BPD were diagnosed with a semistructured interview. Forty percent of the women had a personality disorder (i.e., ASPD 15.8%, BPD 9.2%, or both ASPD and BPD 15.2%). Posttraumatic stress, depressive symptoms, and dissociation during detention increased the risk for BPD in adulthood. Surprisingly, neither conduct problems nor substance dependence predicted ASPD; these findings require further study because they add to the controversy surrounding ASPD in females. The high prevalence rates of personality disorders indicate the need for intervention programs that target these unwanted outcomes.",0,0 +6343,"Psychobiology of PTSD in the acute aftermath of trauma: Integrating research on coping, HPA function and sympathetic nervous system activity","Research on the psychobiological sequelae of trauma has typically focused on long-term alterations in individuals with chronic posttraumatic stress disorder (PTSD). Far less is known about the nature and course of psychobiological risk factors for PTSD during the acute aftermath of trauma. In this review, we summarize data from prospective studies focusing on the relationships among sympathetic nervous system activity, hypothalamic-pituitary-adrenal function, coping strategies and PTSD symptoms during the early recovery (or non-recovery) phase. Findings from pertinent studies are integrated to inform psychobiological profiles of PTSD-risk in children and adults in the context of existing models of PTSD-onset and maintenance. Data regarding bidirectional relations between coping strategies and stress hormones is reviewed. Limitations of existing literature and recommendations for future research are discussed.",0,0 +6344,The Indochinese Psychiatry Clinic: Trauma and Refugee Mental Health Treatment in the 1990s,"The Indochinese Psychiatry Clinic (IPC), located in Boston, was founded in 1981 to meet the special needs of traumatized Cambodian, Vietnamese, and Laotian refugees resettling in the Boston area. Over the past 16 years, IPC has pioneered the field of refugee mental health and the treatment of the psychological and social sequelae of mass violence and torture. IPC developed the bicultural model of psychiatric treatment of refugees suffering from trauma-related mental disorders, which utilizes a multidisciplinary, bicultural team approach that emphasizes understanding the patient's trauma history within the appropriate cultural, social, and political context. This article summarizes IPC's background, patient profile, clinical approach, service elements, and funding structure. Recent immigration and welfare reform legislation will have a harsh impact on the population of refugees who are disabled due to the psychosocial consequences of their traumatic experiences. This legislation and the restrictions on mental health care imposed by public managed care will also affect the providers of their mental health care.",0,0 +6345,Assessing a dysphoric arousal model of acute stress disorder symptoms in a clinical sample of rape and bank robbery victims,"Since the introduction of Acute Stress Disorder (ASD) into the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) research has focused on the ability of ASD to predict PTSD rather than focusing on addressing ASD's underlying latent structure. The few existing confirmatory factor analytic (CFA) studies of ASD have failed to reach a clear consensus regarding ASD's underlying dimensionality. Although, the discrepancy in the results may be due to varying ASD prevalence rates, it remains possible that the model capturing the latent structure of ASD has not yet been put forward. One such model may be a replication of a new five-factor model of PTSD, which separates the arousal symptom cluster into Dysphoric and Anxious Arousal. Given the pending DSM-5, uncovering ASD's latent structure is more pertinent than ever.USING CFA, FOUR DIFFERENT MODELS OF THE LATENT STRUCTURE OF ASD WERE SPECIFIED AND TESTED: the proposed DSM-5 model, the DSM-IV model, a three factor model, and a five factor model separating the arousal symptom cluster.The analyses were based on a combined sample of rape and bank robbery victims, who all met the diagnostic criteria for ASD (N = 404) using the Acute Stress Disorder Scale.The results showed that the five factor model provided the best fit to the data.The results of the present study suggest that the dimensionality of ASD may be best characterized as a five factor structure which separates dysphoric and anxious arousal items into two separate factors, akin to recent research on PTSD's latent structure. Thus, the current study adds to the debate about how ASD should be conceptualized in the pending DSM-5.",0,0 +6346,Tonic immobility mediates the influence of peritraumatic fear and perceived inescapability on posttraumatic stress symptom severity among sexual assault survivors,"This study evaluated whether tonic immobility mediates the relations between perceived inescapability, peritraumatic fear, and posttraumatic stress disorder (PTSD) symptom severity among sexual assault survivors. Female undergraduates (N = 176) completed questionnaires assessing assault history, perceived inescapability, peritraumatic fear, tonic immobility, and PTSD symptoms. Results indicated that tonic immobility fully mediated relations between perceived inescapability and overall PTSD symptom severity, as well as reexperiencing and avoidance/numbing symptom clusters. Tonic immobility also fully mediated the relation between fear and reexperiencing symptoms, and partially mediated relations between fear and overall PTSD symptom severity, and avoidance/numbing symptoms. Results suggest that tonic immobility could be one path through which trauma survivors develop PTSD symptoms. Further study of tonic immobility may inform our ability to treat trauma victims.",0,0 +6347,"Childhood adversity, adult stressful life events, and risk of past-year psychiatric disorder: a test of the stress sensitization hypothesis in a population-based sample of adults","Background Childhood adversity (CA) is associated with adult mental disorders, but the mechanisms underlying this association remain inadequately understood. Stress sensitization, whereby CA increases vulnerability to mental disorders following adult stressful life events, has been proposed as a potential mechanism. We provide a test of the stress sensitization hypothesis in a national sample. Method We investigated whether the association between past-year stressful life events and the 12-month prevalence of major depression, post-traumatic stress disorder (PTSD), other anxiety disorders, and perceived stress varies according to exposure to CA. We used data from the National Epidemiological Survey of Alcohol and Related Conditions (NESARC) ( n =34 653). Results Past-year stressful life events were associated with an increased risk of major depression, PTSD, anxiety disorders, and perceived stress. However, the magnitude of the increased risk varied according to respondents' history of CA. For example, past-year major stressors were associated with a 27.3% increase in the 12-month risk of depression among individuals with ⩾3 CAs and a 14.8% increased risk among individuals without CAs. Stress sensitization effects were present for depression, PTSD, and other anxiety disorders in women and men, although gender differences were found in the threshold of past-year stress needed to trigger such effects. Stress sensitization was most evident among individuals with ⩾3 CAs. Conclusions CA is associated with increased vulnerability to the deleterious mental health effects of adult stressors in both men and women. High levels of CA may represent a general diathesis for multiple types of psychopathology that persists throughout the life course.",0,0 +6348,Altered salivary alpha-amylase awakening response in Bosnian War refugees with posttraumatic stress disorder,"In posttraumatic stress disorder (PTSD), chronic activation of the sympathetic nervous system (SNS) has been suggested. No study so far has investigated diurnal secretion patterns of salivary alpha-amylase (sAA) in PTSD, a promising candidate for non-invasive assessment of SNS activity. We compared sAA diurnal profiles between a group of Bosnian War refugees with PTSD and a healthy control group, and further analyzed for associations with psychiatric symptoms and glucocorticoid (GC) sensitivity of inflammatory regulation. PTSD patients showed a sAA awakening response profile that was opposite to those seen in healthy controls, i.e. an increase instead of a sharp decrease. Patterns of sAA secretion were further positively associated with psychiatric symptoms of PTSD. Finally, higher sAA awakening responses were associated with higher GC sensitivity of inflammatory cytokine production. These findings are in line with altered SNS function in PTSD, and lend further support for employing assessment of diurnal sAA profiles as non-invasive biomarkers in stress-related disease.",0,0 +6349,An investigation of PTSD's core dimensions and relations with anxiety and depression.,"Posttraumatic stress disorder (PTSD) is highly comorbid with anxiety and depressive disorders, which is suggestive of shared variance or common underlying dimensions. The purpose of the present study was to examine the relationship between the latent factors of PTSD with the constructs of anxiety and depression in order to increase understanding of the co-occurrence of these disorders.Data were collected from a nonclinical sample of 186 trauma-exposed participants using the PTSD Checklist and Hospital Anxiety and Depression Scale. Confirmatory factor analyses were conducted to determine model fit comparing 3 PTSD factor structure models, followed by Wald tests comparing the relationships between PTSD factors and the core dimensions of anxiety and depression.In model comparisons, the 5-factor dysphoric arousal model of PTSD provided the best fit for the data, compared to the emotional numbing and dysphoria models of PTSD. Compared to anxious arousal, the dysphoric arousal and numbing factors of PTSD were more related to depression severity. Numbing, anxious arousal, and dysphoric arousal were not differentially related to the latent anxiety factor.The underlying factors of PTSD contain aspects of the core dimensions of both anxiety and depression. The heterogeneity of PTSD's associations with anxiety and depressive constructs requires additional empirical exploration because clarification regarding these relationships will impact diagnostic classification as well as clinical practice.",0,0 +6350,The structure of posttraumatic stress disorder symptoms in combat veterans: A confirmatory factor analysis of the impact of event scale,"There has been controversy over the most appropriate way to define symptom clusters for posttraumatic stress disorder (PTSD). We tested the factor structure of the Impact of Event Scale (IES) in a sample of 195 male combat veterans with chronic PTSD by using confirmatory factor analysis . The two-factor model including Intrusion (i.e., unwanted memories of the event) and Avoidance (i.e., attempts to avoid reminders and numbing of emotional responsiveness) deviated significantly from good fit. However, a four-factor model, including Intrusion and Effortful Avoidance subscales, as well as Sleep Disturbance and Emotional Numbing subscales, fit significantly better. Correlations with other PTSD measures are explored and implications for the conceptualization of PTSD are discussed.",0,0 +6351,Key Elements in Couples Therapy With Veterans With Combat-Related Posttraumatic Stress Disorder.,"If a client dealing with combat-related posttraumatic stress disorder (PTSD) presents for psychotherapy, should you consider including his or her partner in treatment? How could couples therapy be beneficial? What framework do you have to conceptualize the relational issues and potential treatment? Although clinicians have long been encouraged to include families in the treatment of combat-related PTSD, few specific couple-family therapies exist, and outcome research is scarce. Because of the adverse effects of PTSD on relationships, couples therapy can be a powerful adjunct treatment; however, few receive this service. A new framework for conceptualizing couples therapy organizes treatment around the 3 PTSD symptom clusters (reexperiencing, avoidance, and arousal). Relationship consequences of each symptom cluster are summarized, followed by useful treatment interventions and a case study.",0,0 +6352,"Mental Health and Childhood Adversities: A Longitudinal Study in Kabul, Afghanistan","To identify prospective predictors of mental health in Kabul, Afghanistan.Using stratified random-sampling in schools, mental health and life events for 11-to 16-year-old students and their caregivers were assessed. In 2007, 1 year after baseline, the retention rate was 64% (n = 115 boys, 119 girls, 234 adults) with no evidence of selection bias. Self- and caregiver-rated child mental health (Strengths and Difficulties Questionnaire), depressive (Depression Self-Rating Scale), and posttraumatic stress (Child Revised Impact of Events Scale) symptoms and caregiver mental health (Self-Report Questionnaire) were assessed. Lifetime trauma and past-year traumatic, stressful, and protective experiences were assessed.With the exception of posttraumatic stress, one-year trajectories for all mental health outcomes showed significant improvement (p < .001). Family violence had a striking impact on the Strengths and Difficulties Questionnaire data, raising caregiver-rated scores by 3.14 points (confidence interval [CI] 2.21-4.08) or half a standard deviation, and self-rated scores by 1.26 points (CI 0.50-2.03); past-year traumatic beatings independently raised self-rated scores by 1.85 points (CI 0.03-3.66). A major family conflict raised depression scores by 2.75 points (CI 0.89-4.61), two thirds of a standard deviation, whereas improved family life had protective effects. Posttraumatic stress symptom scores, however, were solely contingent on lifetime trauma, with more than three events raising scores by 5.38 points (CI 1.76-9.00).Family violence predicted changes in mental health problems other than posttraumatic stress symptoms in a cohort that showed resilience to substantial socioeconomic and war-related stressors. The importance of prospectively identifying impacts of specific types of childhood adversities on mental health outcomes is highlighted to strengthen evidence on key modifiable factors for intervention in war-affected populations.",0,0 +6353,Parent perspectives on family-based psychosocial interventions in pediatric cancer: a mixed-methods approach,"Family-based interventions in pediatric cancer face challenges associated with integrating psychosocial care into a period of intensive treatment and escalating stress. Little research has sought input from parents on the role of interventions delivered shortly after diagnosis. This mixed-methods study obtained parents' perspectives on the potential role of family-based interventions. Twenty-five parents provided feedback on the structure and timing of psychosocial interventions via focus groups and a questionnaire. Qualitative analyses resulted in three themes that were illustrative of a traumatic stress framework: (1) tension between focusing on child with cancer and addressing other family needs, (2) factors influencing parents' perception of a shared experience with other parents, and (3) the importance of matching interventions to the trajectory of parent adjustment. Quantitative data indicated that parents preferred intervention within 6 months of diagnosis, with almost half favoring within 2 months of diagnosis, and the majority wanted interventions targeted to parents only. Qualitative themes highlight the importance of using a traumatic stress framework to inform the development of family-based interventions for those affected by pediatric cancer.",0,0 +6354,Divalproex in the Treatment of Impulsive Aggression: Efficacy in Cluster B Personality Disorders,"Impulsive aggressive behavior is common in psychiatric disorders and accounts for significant morbidity and mortality. However, little systematic treatment data exist from placebo-controlled trials for this symptom domain. This was a multicenter, randomized, double-blind, placebo-controlled study in which outpatients with a score of > or =15 on the Aggression scale of the Overt Aggression Scale-Modified (OAS-M) and who fulfilled DSM-IV criteria for Cluster B personality disorder (n=96), intermittent explosive disorder (n=116), or post-traumatic stress disorder (n=34) were randomized to divalproex sodium or placebo for 12 weeks duration. Based on average OAS-M Aggression scores over the last 4 weeks of treatment, a treatment effect was not observed in the intent-to-treat data set (combined across the three psychiatric disorders), but was observed in both intent-to-treat and evaluable data sets for patients with Cluster B personality disorders. In the Cluster B evaluable data set, statistically significant treatment differences favoring divalproex were also observed for component items of the OAS-M Aggression score, including verbal assault and assault against objects, as well as OAS-M Irritability score, and Clinical Global Impression (CGI)-Severity at multiple time points throughout the study. No treatment group difference was noted for overall premature discontinuation rate; however, across psychiatric diagnoses, 21 (17%) patients in the divalproex group prematurely discontinued because of an adverse event, as compared to 4 (3%) patients in the placebo group (p <0.001). While a treatment effect was not observed when all diagnostic groups were combined, in a large subgroup of patients with Cluster B disorders, divalproex was superior to placebo in the treatment of impulsive aggression, irritability, and global severity.",0,0 +6355,War-related trauma and symptoms of posttraumatic stress disorder among adult Kosovar refugees,"Since 1999, almost 16,000 Kosovar refugees have entered the United States. Few studies have investigated trauma and symptoms of posttraumatic stress disorder (PTSD) in this population. We conducted a caseworker-assisted survey of 129 Kosovar refugees (aged 18 to 79 years, 55% male). Of these individuals, 78 (60.5%) showed the likely presence of PTSD. The mean number of war-related traumatic events reported was 15 (SD = 4.5). Higher PTSD scores were associated with more traumatic events and female gender.",0,0 +6356,The role of comorbid psychiatric conditions in health status in epilepsy,"Comorbid psychiatric conditions are highly prevalent in patients with epilepsy, yet the long-term implications across multiple mental health conditions are poorly understood. We examined the association between psychiatric diagnoses and self-reported health status in veterans with epilepsy. ANCOVA models were used to derive adjusted SF-36V scores for individuals with epilepsy alone (N=7379) or with additional psychiatric conditions (N=6320): depression, schizophrenia, bipolar disorder, anxiety disorder, substance abuse, and posttraumatic stress disorder (PTSD). Compared with patients with epilepsy alone, scores of veterans with comorbid psychiatric diagnoses averaged 21% lower across all domains. Role Limitation scales exhibited the greatest decrement across domains. A PTSD diagnosis consistently corresponded to lower scores, followed by depression. Schizophrenia contributed the least detriment to perceived health status. Comorbid psychiatric conditions impart significant emotional and physical burdens, requiring timely recognition and treatment of these disorders. Patients with epilepsy are uniquely at risk for high physical-psychiatric comorbidity profiles, with concomitant losses in perceived health status.",0,0 +6357,The Origin and Structure of the Abusive Personality,"Comparisons were made of 120 wife-assaultive men and 40 demographically matched controls. Discriminant functions correctly classified 90% (based on personality scores only) and 95% (personality and anger scores) of men into high and low categories for psychological abuse (as reported by a sample of their female partners). The measure correlated most highly with the discriminant function was borderline personality organization (BPO), but anger and other personality disorders also contributed to discriminatory power. Negativlstic (passive-aggressive + self-defeating) personality disorder was associated with the discriminant function for both emotional abuse and dominance/isolation, but narcissistic and aggressive-sadistic personality disorders were more associated with emotional abuse and avoidant personality disorder was more associated with dominance/isolation. The avoidant-negativistic profile (with associated borderline features) found for these men is also indicative of posttraumatic stress disorder. T...",0,0 +6358,Acute and Chronic Plasma Metabolomic and Liver Transcriptomic Stress Effects in a Mouse Model with Features of Post-Traumatic Stress Disorder,"Acute responses to intense stressors can give rise to post-traumatic stress disorder (PTSD). PTSD diagnostic criteria include trauma exposure history and self-reported symptoms. Individuals who meet PTSD diagnostic criteria often meet criteria for additional psychiatric diagnoses. Biomarkers promise to contribute to reliable phenotypes of PTSD and comorbidities by linking biological system alterations to behavioral symptoms. Here we have analyzed unbiased plasma metabolomics and other stress effects in a mouse model with behavioral features of PTSD. In this model, C57BL/6 mice are repeatedly exposed to a trained aggressor mouse (albino SJL) using a modified, resident-intruder, social defeat paradigm. Our recent studies using this model found that aggressor-exposed mice exhibited acute stress effects including changed behaviors, body weight gain, increased body temperature, as well as inflammatory and fibrotic histopathologies and transcriptomic changes of heart tissue. Some of these acute stress effects persisted, reminiscent of PTSD. Here we report elevated proteins in plasma that function in inflammation and responses to oxidative stress and damaged tissue at 24 hrs post-stressor. Additionally at this acute time point, transcriptomic analysis indicated liver inflammation. The unbiased metabolomics analysis showed altered metabolites in plasma at 24 hrs that only partially normalized toward control levels after stress-withdrawal for 1.5 or 4 wks. In particular, gut-derived metabolites were altered at 24 hrs post-stressor and remained altered up to 4 wks after stress-withdrawal. Also at the 4 wk time point, hyperlipidemia and suppressed metabolites of amino acids and carbohydrates in plasma coincided with transcriptomic indicators of altered liver metabolism (activated xenobiotic and lipid metabolism). Collectively, these system-wide sequelae to repeated intense stress suggest that the simultaneous perturbed functioning of multiple organ systems (e.g., brain, heart, intestine and liver) can interact to produce injuries that lead to chronic metabolic changes and disorders that have been associated with PTSD.",0,0 +6359,Post-traumatic growth among veterans in the USA: results from the National Health and Resilience in Veterans Study,"Background There is increasing recognition that, in addition to negative psychological consequences of trauma such as post-traumatic stress disorder (PTSD), some individuals may develop post-traumatic growth (PTG) following such experiences. To date, however, data regarding the prevalence, correlates and functional significance of PTG in population-based samples are lacking. Method Data were analysed from the National Health and Resilience in Veterans Study, a contemporary, nationally representative survey of 3157 US veterans. Veterans completed a survey containing measures of sociodemographic, military, health and psychosocial characteristics, and the Posttraumatic Growth Inventory-Short Form. Results We found that 50.1% of all veterans and 72.0% of veterans who screened positive for PTSD reported at least ‘moderate’ PTG in relation to their worst traumatic event. An inverted U-shaped relationship was found to best explain the relationship between PTSD symptoms and PTG. Among veterans with PTSD, those with PTSD reported better mental functioning and general health than those without PTG. Experiencing a life-threatening illness or injury and re-experiencing symptoms were most strongly associated with PTG. In multivariable analysis, greater social connectedness, intrinsic religiosity and purpose in life were independently associated with greater PTG. Conclusions PTG is prevalent among US veterans, particularly among those who screen positive for PTSD. These results suggest that there may be a ‘positive legacy’ of trauma that has functional significance for veterans. They further suggest that interventions geared toward helping trauma-exposed US veterans process their re-experiencing symptoms, and to develop greater social connections, sense of purpose and intrinsic religiosity may help promote PTG in this population.",0,0 +6360,Diagnosis and classification of disorders specifically associated with stress: proposals for ICD-11,"The diagnostic concepts of post-traumatic stress disorder (PTSD) and other disorders specifically associated with stress have been intensively discussed among neuro- and social scientists, clinicians, epidemiologists, public health planners and humanitarian aid workers around the world. PTSD and adjustment disorder are among the most widely used diagnoses in mental health care worldwide. This paper describes proposals that aim to maximize clinical utility for the classification and grouping of disorders specifically associated with stress in the forthcoming 11th revision of the International Classification of Diseases (ICD-11). Proposals include a narrower concept for PTSD that does not allow the diagnosis to be made based entirely on non-specific symptoms; a new complex PTSD category that comprises three clusters of intra- and interpersonal symptoms in addition to core PTSD symptoms; a new diagnosis of prolonged grief disorder, used to describe patients that undergo an intensely painful, disabling, and abnormally persistent response to bereavement; a major revision of ""adjustment disorder"" involving increased specification of symptoms; and a conceptualization of ""acute stress reaction"" as a normal phenomenon that still may require clinical intervention. These proposals were developed with specific considerations given to clinical utility and global applicability in both low- and high-income countries.",0,0 +6361,Research Review: Psychosocial adjustment and mental health in former child soldiers - a systematic review of the literature and recommendations for future research,"This article reviews the available quantitative research on psychosocial adjustment and mental health among children (age <18 years) associated with armed forces and armed groups (CAAFAG)--commonly referred to as child soldiers.PRISMA standards for systematic reviews were used to search PubMed, PsycInfo, JSTOR, and Sociological Abstracts in February 2012 for all articles on former child soldiers and CAAFAG. Twenty-one quantitative studies from 10 countries were analyzed for author, year of publication, journal, objectives, design, selection population, setting, instruments, prevalence estimates, and associations with war experiences. Opinion pieces, editorials, and qualitative studies were deemed beyond the scope of this study. Quality of evidence was rated according to the systematic assessment of quality in observational research (SAQOR).According to SAQOR criteria, among the available published studies, eight studies were of high quality, four were of moderate quality, and the remaining nine were of low quality. Common limitations were lack of validated mental health measures, unclear methodology including undefined sampling approaches, and failure to report missing data. Only five studies included a comparison group of youth not involved with armed forces/armed groups, and only five studies assessed mental health at more than one point in time. Across studies, a number of risk and protective factors were associated with postconflict psychosocial adjustment and social reintegration in CAAFAG. Abduction, age of conscription, exposure to violence, gender, and community stigma were associated with increased internalizing and externalizing mental health problems. Family acceptance, social support, and educational/economic opportunities were associated with improved psychosocial adjustment.Research on the social reintegration and psychosocial adjustment of former child soldiers is nascent. A number of gaps in the available literature warrant future study. Recommendations to bolster the evidence base on psychosocial adjustment in former child soldiers and other war-affected youth include more studies comprising longitudinal study designs, and validated cross-cultural instruments for assessing mental health, as well as more integrated community-based approaches to study design and research monitoring.",0,0 +6362,Psychological distress among victimized women on probation and parole: A latent class analysis.,"Latent class analysis was used to identify subgroups of victimized women (N = 406) on probation and parole differentiated by levels of general psychological distress. The 9 primary symptom dimensions from the Brief Symptom Inventory (BSI) were used individually as latent class indicators (Derogatis, 1993). Results identified 3 classes of women characterized by increasing levels of psychological distress; classes were further differentiated by posttraumatic stress disorder symptoms, cumulative victimization, substance use and other domains of psychosocial functioning (i.e., sociodemographic characteristics; informal social support and formal service utilization; perceived life stress; and resource loss). The present research was effective in uncovering important heterogeneity in psychological distress using a highly reliable and easily accessible measure of general psychological distress. Differentiating levels of psychological distress and associated patterns of psychosocial risk can be used to develop intervention strategies targeting the needs of different subgroups of women. Implications for treatment and future research are presented.",0,0 +6363,Sleepless nights in the ICU: the awaken family,"Having a loved-one in the ICU is a traumatic experience for family members that can lead to a cluster of psychological complications, recently defined as post-intensive care family syndrome. In a previous issue of Critical Care, Day and colleagues stressed the severe sleep disturbance and fatigue experienced by a majority of ICU patient family members. However, despite this burden being well characterised, the best preventive coping strategy remains undetermined.",0,0 +6364,Defining victims: a proposed typology for victims of war crimes and their need for reparation,"Born in the ashes of the Second World War, the field of victimology has grown tremendously in recent years, where we have seen much excellent empirical research done on victims. Much of the research deals with specific types of victimization (e.g., domestic violence, rape), empirical aspects of victimization in general (e.g., victimization surveys) and the consequences of victimization (e.g., post-traumatic stress disorder (PTSD)). However, despite the many empirical studies, relatively little attention has been paid to theoretical aspects of victimology. As Landau and Freeman-Longo point out, the dearth of theoretical work in victimology is surprising given that in a relatively new field problems of definition and boundary-setting would be an important starting point for further studies therein. Victimologists have not always shied away from theoretical work. Early victimologists, such as Hans von Hentig, Benjamin Mendelsohn, Marvin Wolfgang and Ezzat Fattah, were very active in developing theoretical victimology. Each developed their own typology of victims in order to better understand, explain and hence prevent victimization. By the early 1980s, under the influence of the victims’ movement, these typologies lost much of their original popularity, as victimology moved away from criminology and stopped trying to explain crime. As Ezzat Fattah observes, there was a shift ‘from victimology of the act to victimology of action’ as victimology became increasingly associated with victim support. © Cambridge University Press 2014.",0,0 +6365,US female veterans in VA primary care: post traumatic stress disorder symptoms and functional status,"We sought to examine the relationship between post traumatic stress disorder (PTSD) symptomatology, demographic variables, and functional status in US female veterans. One hundred ninety-one female veterans were identified from primary care clinics in four VA Medical Centers for participation in this study. The relationship between demographic variables, physical and mental health functional status on the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and PTSD severity on the PTSD Checklist (PCL) was examined using ANOVAs and simple and multiple linear regression modeling. After adjusting for other demographic covariates, PTSD severity was related to age (older patients reported less symptoms), and employment status (veterans who were not working due to disability reported significantly more PTSD symptoms than those who were working). Additionally, after adjusting for relevant demographic covariates, greater PTSD symptomatology was related to worse functioning across both physical and mental health domains on the SF-36. PTSD symptom severity was easily assessed in this primary care sample of female veterans using the PCL. Screening female veterans through primary care clinics is likely to identify women with PTSD who are not functioning as well as their peers and who are in need of specialized services. These findings are similar to those using men identified through VA primary care clinics. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +6366,Attachment Style in the Prediction of Recovery Following Group Treatment of Combat Veterans With Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) can be difficult to treat, with gains often particularly modest in combat veterans. Although group-based treatments are commonly delivered for veterans, little is known about factors influencing their outcomes. Attachment style is known to be associated with psychopathology after trauma and is critical to group-based interventions, but has not yet been investigated in relation to treatment outcome. A better understanding of factors that influence outcome is critical in optimizing the effectiveness of such interventions. This study investigated attachment style as a predictor of outcome for 103 veterans attending group-based treatment for combat-related PTSD. Measures included the Clinician Administered PTSD Scale, PTSD Checklist, and Relationship Styles Questionnaire. Path analyses indicated preoccupied attachment style strongly negatively predicted outcome following treatment. The preoccupied attachment style impedes recovery in group-based treatment for veterans with PTSD. Potential mechanisms underlying this finding are discussed. The results suggest that greater attention should be paid at initial assessment to attachment style of veterans before entering PTSD treatment, particularly group-based interventions.",0,0 +6367,Associations Between Functioning and PTSD Symptom Clusters in a Dismantling Trial of Cognitive Processing Therapy in Female Interpersonal Violence Survivors,"This study conducted secondary analyses of a published trial and sought to determine if different domains of psychosocial functioning (e.g., daily living, work, nonfamily relationships) improved following trauma-focused treatment for posttraumatic stress disorder (PTSD). Cognitive processing therapy (CPT), an empirically supported treatment that involves evaluating trauma-related beliefs and written trauma accounts, was compared to its components: CPT without the written accounts or written accounts only in a sample of 78 women with PTSD secondary to interpersonal violence. Overall and individual domains of functioning significantly improved with treatment and results were similar across treatment groups, Fs (2, 150) ≥ 11.87, ps < .001. Additionally, we investigated whether changes in different PTSD symptom clusters were associated with outcomes in domains of psychosocial functioning, after collapsing across treatment condition. Multiple hierarchical linear regression analyses revealed that overall clinician-assessed PTSD symptom reduction was associated with outcomes in all domains of functioning, βs = .44 to .68, ps < .001. Additionally, improvements in the emotional numbing symptom cluster were associated with outcomes in the nonfamily relationships domain, β = .42, p < .001, and improvements in the hyperarousal symptom cluster were associated with outcomes in the overall, daily living, and household tasks domains, βs = .34 to .39, ps < .01. Results suggest that it may be important to monitor improvements in emotional numbing and hyperarousal symptoms throughout treatment to increase the likelihood of changes in psychosocial functioning. Spanish Abstracts by the Asociación Chilena de Estrés Traumático (ACET) Este estudio condujo un análisis secundario de un ensayo publicado y buscó determinar si diferentes dominios de funcionamiento psicosocial (ej., vida diaria, trabajo, relaciones no familiares) mejoraron después de un tratamiento enfocado en el trauma para trastorno por estrés post-traumático (TEPT). La terapia de procesamiento cognitivo (TPC), un tratamiento respaldado empíricamente que involucra la evaluación de las creencias relacionadas al trauma y los relatos escritos del trauma, fue comparado con sus componentes: TPC sin los relatos escritos o solamente relatos escritos en una muestra de 78 mujeres con TEPT secundario a violencia interpersonal. Los dominios de funcionamiento generales e individuales aumentaron significativamente con el tratamiento y los resultados fueron similares a través de los grupos de tratamiento, Fs (2, 150) ≥ 11.87, ps < .001. Adicionalmente, investigamos si los cambios en los diferentes grupos de síntomas de TEPT se asociaron con resultados en dominios de funcionamiento psicosocial, después de colapsar a través de las condiciones de tratamiento. Un análisis de regresión linear múltiple jerárquica reveló que la reducción general de síntomas de TEPT evaluada por clínicos se asoció con los resultados en todos los dominios de funcionamiento βs = .44 to .68, ps < .001. Adicionalmente, mejorías en el grupo de síntomas de entumecimiento emocional se asociaron con los resultados del dominio de relaciones no familiares, β = .42,p < .001, y mejorías en el grupo de síntomas de hiperexcitabilidad se asociaron con los resultados generales en los dominios, de vida diaria y tareas domésticas βs = .34 to .39, ps < .01.Los resultados sugieren que puede ser importante monitorear las mejorías en los síntomas de entumecimiento emocional e hiperexcitabilidad a lo largo del tratamiento para aumentar la probabilidad de cambios en el funcionamiento psicosocial. Traditional and Simplified Chinese Abstracts by AsianSTSS 標題：人際暴力女倖存者接受認知處理療法的拆解試驗中功能和PTSD症狀羣的關係 撮要：本研究為一已刊登研究的二次分析，驗証治療創傷後壓力症(PTSD)的聚焦創傷法後心理社會功能中不同領域(如日常生活、工作、家庭以外關係)的改進。認知處理療法(CPT)是實証支持的治療，包括評估創傷相連信念和創傷筆記。CPT在研究中對照其中成份：即CPT除去創傷筆記，或只有創傷筆記，而樣本是78名因人際暴力而患上PTSD的婦女。綜合和個別功能領域在治療後明顯改進，而不同治療組別中結果相類，FS (2, 150) 11.87, ps < .001。我們亦檢測不同PTSD症狀羣變化在除去治療狀況因素後會否與心理社會功能領域結果相連。多重階層綫性分析顯示綜合臨床評估PTSD症狀減退與功能的所有領域結果相關，βS= .44至 .68, ps< .001。情感麻木症狀羣的改進和非家庭關係領域結果相連，β= .42, p< .001., 而過激症狀羣改進則與綜合、日常生活和家居事務領域有關係，βS= .34至.39, ps< .01。結論是在治療中監察情感麻木和過激症狀的改進增加心理社會功能改善的機會。 标题：人际暴力女幸存者接受认知处理疗法的拆解试验中功能和PTSD症状羣的关系 撮要：本研究为一已刊登研究的二次分析，验证治疗创伤后压力症(PTSD)的聚焦创伤法后心理社会功能中不同领域(如日常生活、工作、家庭以外关系)的改进。认知处理疗法(CPT)是实证支持的治疗，包括评估创伤相连信念和创伤笔记。CPT在研究中对照其中成份：即CPT除去创伤笔记，或只有创伤笔记，而样本是78名因人际暴力而患上PTSD的妇女。综合和个别功能领域在治疗后明显改进，而不同治疗组别中结果相类，FS (2, 150) 11.87, ps < .001。我们亦检测不同PTSD症状羣变化在除去治疗状况因素后会否与心理社会功能领域结果相连。多重阶层线性分析显示综合临床评估PTSD症状减退与功能的所有领域结果相关，βS= .44至 .68, ps< .001。情感麻木症状羣的改进和非家庭关系领域结果相连，β= .42, p< .001., 而过激症状羣改进则与综合、日常生活和家居事务领域有关系，βS= .34至.39, ps< .01。结论是在治疗中监察情感麻木和过激症状的改进增加心理社会功能改善的机会。",0,0 +6368,Personality Factors in the Anxiety Disorders,"This chapter describes a theoretical framework based on hierarchical models of personality and the anxiety disorders that is able to reflect both the DSM-IV organization of anxiety disorders as a distinct internalizing cluster (separate from mood disorders) as well as the diagnostic specificity within the category of anxiety disorders. The literature examining relationships between higher-order personality dimensions, such as Neuroticism and Extraversion, as well as lower-order facets of personality, such as self-criticism, perfectionism, and anxiety sensitivity, and the anxiety disorders is reviewed. Several mechanisms of interaction between personality factors and anxiety disorders are considered, specifically, vulnerability, scar, and pathoplasty models. Based on this literature, specific personality profiles associated with each anxiety disorder are proposed. © 2009 by Oxford University Press. All rights reserved.",0,0 +6369,Typology of post-traumatic stress disorder in children and adolescents,"Results obtained from clinical and psychopathological studies of 161 patients with post-traumatic stress disorder (PTSD) aged 3-18 years with symptom durations from one month to four years are presented. Four major clinical variants of the type of PTSD were identified in children and adolescents: insomniac (34.8%), phobic (23.6%), psychopathic-like (21.7%), and asthenic-depressive (19.9%). These variants, differing in terms of course and prognosis, occurred at different frequencies in different age and ethnic groups; there were no gender-related differences. © Springer Science+Business Media, Inc. 2007.",0,0 +6370,Posttraumatic Stress Disorder and the MCMI-II,"This study investigated the MCMI-II profile characteristics of 39 veterans diagnosed with Posttraumatic Stress Disorder. Characteristics of the mean group profile were similar to prior findings reported in the literature on the MCMI and Posttraumatic Stress Disorder with highest mean elevations found on the Avoidant, Passive-Aggressive, Schizoid, and Antisocial basic personality scales, the Borderline and Schizotypal pathological personality scales, and with elevations on the Anxiety, Dysthymia, Alcohol Dependence, Drug Dependence, and Major Depression clinical syndrome scales. A multivariate analysis of variance comparing the group with Posttraumatic Stress Disorder with a non-PTSD comparison group of 39 on the basic personality, pathological personality, and the clinical syndrome scales of the MCMI-II was not statistically significant. Nonetheless, univariate analyses of variance comparing the two groups on the individual modifier scales and the individual personality and clinical syndrome scales of the MCMI-II using a Bonferroni adjusted probability indicated significant differences on the Desirability and Histrionic scales. Response-style bias as a possible factor in MCMI-II profiles for the group with Posttraumatic Stress Disorder is also discussed.",0,0 +6371,"The Relations between Violence Exposure, Posttraumatic Stress Symptoms, Secondary Traumatization, Vicarious Post Traumatic Growth and Illness Attribution among Psychiatric Nurses","This study examined posttraumatic stress disorder symptoms (PTSD), secondary traumatization (ST) and vicarious posttraumatic growth (VG) among Israeli psychiatric nurses (PN) who were compared to community nurses (CN). Furthermore, we examined the contribution of PN perceptions of the etiology of their patients' mental illness to their PTSD, ST and VG. Results show that PN reported higher levels of both PTSD and ST symptoms, but lower levels of VG, as compare to CN. While ST symptoms were positively related to VG among CN, PTSD and ST symptoms were negatively associated among PN. Finally, exposure to patients' violence, PTSD or ST symptoms, and illness attribution dimensions of 'powerful others', predicted nurses' VG. PN are an at-risk population for work-related stress residues.",0,0 +6372,Technology-Enhanced Stepped Collaborative Care Targeting Posttraumatic Stress Disorder and Comorbidity After Injury: A Randomized Controlled Trial,"Posttraumatic stress disorder (PTSD) and its comorbidities are endemic among injured trauma survivors. Previous collaborative care trials targeting PTSD after injury have been effective, but they have required intensive clinical resources. The present pragmatic clinical trial randomized acutely injured trauma survivors who screened positive on an automated electronic medical record PTSD assessment to collaborative care intervention (n = 60) and usual care control (n = 61) conditions. The stepped measurement-based intervention included care management, psychopharmacology, and psychotherapy elements. Embedded within the intervention were a series of information technology (IT) components. PTSD symptoms were assessed with the PTSD Checklist at baseline prerandomization and again, 1-, 3-, and 6-months postinjury. IT utilization was also assessed. The technology-assisted intervention required a median of 2.25 hours (interquartile range = 1.57 hours) per patient. The intervention was associated with modest symptom reductions, but beyond the margin of statistical significance in the unadjusted model: F(2, 204) = 2.95, p = .055. The covariate adjusted regression was significant: F(2, 204) = 3.06, p = .049. The PTSD intervention effect was greatest at the 3-month (Cohen's effect size d = 0.35, F(1, 204) = 4.11, p = .044) and 6-month (d = 0.38, F(1, 204) = 4.10, p = .044) time points. IT-enhanced collaborative care was associated with modest PTSD symptom reductions and reduced delivery times; the intervention model could potentially facilitate efficient PTSD treatment after injury.",0,0 +6373,"Mental health survey among landmine survivors in Siem Reap province, Cambodia","Many survivors of the Khmer Rouge period in Cambodia and the subsequent war with Vietnam have now returned to Cambodia. In this two-stage household cluster survey in Siem Reap Province in Cambodia, we explored the mental health consequences on 166 landmine injury survivors selected from 1000 household in 50 clusters and an oversample of all landmine survivors. We found a prevalence of anxiety of 62% for all respondents, 74% for depression, and 34% for post-traumatic stress disorder (PTSD). These prevalences were statistically significantly higher than among the adult population who had not been injured by landmines. These data underscore the importance of providing mental health care services for the people in Siem Reap Province in Cambodia who have been injured by landmines.",0,0 +6374,Exercise augmentation compared to usual care for Post Traumatic Stress Disorder: A Randomised Controlled Trial (The REAP study: Randomised Exercise Augmentation for PTSD),"BackgroundThe physical wellbeing of people with mental health conditions can often be overlooked in order to treat the primary mental health condition as a priority. Exercise however, can potentially improve both the primary psychiatric condition as well as physical measures that indicate risk of other conditions such as diabetes mellitus and cardiovascular disease. Evidence supports the role of exercise as an important component of treatment for depression and anxiety, yet no randomised controlled trials (RCT's) have been conducted to evaluate the use of exercise in the treatment of people with post traumatic stress disorder (PTSD).This RCT will investigate the effects of structured, progressive exercise on PTSD symptoms, functional ability, body composition, physical activity levels, sleep patterns and medication usage.Methods and designEighty participants with a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnosis of PTSD will be recruited. Participants will have no contraindications to exercise and will be cognitively able to provide consent to participate in the study.The primary outcome measures will be PTSD symptoms, measured through the PTSD Checklist Civilian (PCL-C) scale. Secondary outcome measures will assess depression and anxiety, mobility and strength, body composition, physical activity levels, sleep patterns and medication usage. All outcomes will be assessed by a health or exercise professional masked to group allocation at baseline and 12 weeks after randomisation.The intervention will be a 12 week individualised program, primarily involving resistance exercises with the use of exercise bands. A walking component will also be incorporated. Participants will complete one supervised session per week, and will be asked to perform at least two other non-supervised exercise sessions per week. Both intervention and control groups will receive all usual non-exercise interventions including psychotherapy, pharmaceutical interventions and group therapy.DiscussionThis study will determine the effect of an individualised and progressive exercise intervention on PTSD symptoms, depression and anxiety, mobility and strength, body composition, physical activity levels, sleep patterns and medication usage among people with a DSM-IV diagnosis of PTSD.Trial Registration ACTRN12610000579099",0,0 +6375,Rebuild or Relocate? Resilience and Postdisaster Decision-Making After Hurricane Sandy,"Hurricane Sandy struck the east coast of the United States on October 29, 2012, devastating communities in its path. In the aftermath, New York implemented a home buyout program designed to facilitate the permanent relocation of residents out of areas considered to be at risk for future hazards. While home buyout programs are becoming popular as policy tools for disaster mitigation, little is known about what factors influence homeowners to participate in or reject these programs. This study used mixed methods to assess the relationship between community resilience and the relocation decision in two heavily damaged communities in which the majority of residents made different decisions regarding whether or not to pursue a buyout. The sample was composed of residents from Oakwood Beach and Rockaway Park, both working-class communities in New York City, who participated via a community survey (N = 133) and/or in-depth interviews (N = 28). Results suggested that community resilience moderated the relationship between community of residence and the buyout decision, leading to opposite responses on the buyout decision. Contextual community factors, including the history of natural disasters, local cultural norms, and sense of place, were instrumental in explaining these different responses. Implications for disaster policy are discussed.",0,0 +6376,Climate Change,"Health is inextricably linked to climate change. It is important for clinicians to understand this relationship in order to discuss associated health risks with their patients and to inform public policy.To provide new US-based temperature projections from downscaled climate modeling and to review recent studies on health risks related to climate change and the cobenefits of efforts to mitigate greenhouse gas emissions.We searched PubMed and Google Scholar from 2009 to 2014 for articles related to climate change and health, focused on governmental reports, predictive models, and empirical epidemiological studies. Of the more than 250 abstracts reviewed, 56 articles were selected. In addition, we analyzed climate data averaged over 13 climate models and based future projections on downscaled probability distributions of the daily maximum temperature for 2046-2065. We also compared maximum daily 8-hour average ozone with air temperature data taken from the National Oceanic and Atmospheric Administration, National Climate Data Center.By 2050, many US cities may experience more frequent extreme heat days. For example, New York and Milwaukee may have 3 times their current average number of days hotter than 32°C (90°F). High temperatures are also strongly associated with ozone exceedance days, for example, in Chicago, Illinois. The adverse health aspects related to climate change may include heat-related disorders, such as heat stress and economic consequences of reduced work capacity; respiratory disorders, including those exacerbated by air pollution and aeroallergens, such as asthma; infectious diseases, including vectorborne diseases and waterborne diseases, such as childhood gastrointestinal diseases; food insecurity, including reduced crop yields and an increase in plant diseases; and mental health disorders, such as posttraumatic stress disorder and depression, that are associated with natural disasters. Substantial health and economic cobenefits could be associated with reductions in fossil fuel combustion. For example, greenhouse gas emission policies may yield net economic benefit, with health benefits from air quality improvements potentially offsetting the cost of US and international carbon policies.Evidence over the past 20 years indicates that climate change can be associated with adverse health outcomes. Health care professionals have an important role in understanding and communicating the related potential health concerns and the cobenefits from policies to reduce greenhouse gas emissions.",0,0 +6377,Translationally relevant modeling of PTSD in rodents,"Post-traumatic stress disorder (PTSD) is clinically defined in DSM-4 by exposure to a significantly threatening and/or horrifying event and the presence of a certain number of symptoms from each of three symptom clusters at least one month after the event. Since humans clearly do not respond homogeneously to a potentially traumatic experience, the heterogeneity in animal responses might be regarded as confirming the validity of animal studies, rather than as representing a problem. A model of diagnostic criteria for psychiatric disorders could therefore be applied to animal responses to augment the validity of study data, providing that the criteria for classification are clearly defined, reliably reproducible and yield results that conform to findings in human subjects. The method described herein was developed in an attempt to model diagnostic criteria in terms of individual patterns of response by using behavioral measures and determining cut-off scores to distinguish between extremes of response or non-response, leaving a sizeable proportion of subjects in a middle group, outside each set of cut-off criteria. The cumulative results of our studies indicate that the contribution of animal models can be further enhanced by classifying individual animal study subjects according to their response patterns. The animal model also enables the researcher to go one step further and correlate specific anatomic, bio-molecular and physiological parameters with the degree and pattern of the individual behavioral response and introduces prevalence rates as a parameter. The translational value of the classification method and future directions are discussed. © 2013 Springer-Verlag Berlin Heidelberg.",0,0 +6378,Associations between self and other representations and posttraumatic adjustment among political prisoners,"The content and structure of self and other representations and their association with posttraumatic stress symptoms, somatic symptoms, and positive growth were studied among 117 Palestinian male political prisoners. Further, the associations between the representations and the severity of trauma and the post-detention conditions (such as education, place of residency and employment), and the role of representation patterns as a moderator between trauma exposure and symptoms was studied. Cluster analysis identified three representation patterns based on participants' descriptions of their spouse and themselves, and of childhood relationships with their mother and father. Representation patterns differed in negative vs. positive content and in the levels of differentiation and conceptual maturity: The Malevolent Others and Defeated Self representation pattern was characterized by very negative content, and poor differentiation and conceptual maturity in all descriptions; the Moderate Parents and Negative S...",0,0 +6379,Symptoms of post-traumatic stress: Intrusion and avoidance 6 and 12 months after TBI,"Primary objectives: (1) To examine survivors with traumatic brain injury (TBI) for symptoms of avoidance and intrusion, two dimensions of post-traumatic stress (PTS) at 6 and 12 months post-injury. (2) To identify risk factors associated with these symptoms.Research design: Prospective follow-up study.Methods and procedures: Georgia and North Carolina Model Brain Injury Systems participants (n = 198) with mild (19%), moderate (21%) and severe (60%) TBI were interviewed by telephone at 6 and 12 months post-injury. The Impact of Event Scale (IES) was used to identify intrusion and avoidance symptoms.Results: Symptoms consistent with severe PTS increased from 11% at 6 months to 16% 12 months post-injury (p < 0.003). African-Americans (p < 0.01) and women (p < 0.05) reported greater symptomatology at 12 months compared to their counterparts. TBI severity and memory of the event were not associated with PTS-like symptoms. Symptoms increased over time when examined by race, injury intent, gender and age (p < 0.05).Conclusions: Regardless of severity, survivors with TBI are at risk for developing symptoms consistent with PTS. Amnesia for the injury event was not protective against developing these symptoms. African-Americans appear to be at greatest risk.",0,0 +6380,Trajectory of Posttraumatic Stress Disorder Caused by Myocardial Infarction: A Two-Year Follow-up Study,"Objective: A substantial proportion of patients develop posttraumatic stress disorder (PTSD) following myocardial infarction (MI). Previous research on the trajectory over time of PTSD in post-MI patients is scant and refers to self-rated posttraumatic symptoms. The aim of this study was to investigate the longitudinal course of an interviewer-rated diagnosis of PTSD and PTSD symptom severity following MI. Methods: Study participants were 40 patients (78% men, mean age 54 α 8 years) who were diagnosed with PTSD using the Clinician-administered PTSD Scale (CAPS) after an average of 5 α 4 months (range 2–16 months) following an index MI. After a mean follow-up of 26 α 6 months (range 12–36 months), 24 patients underwent a second diagnostic interview. Results: Two-thirds of patients ( n = 16) still qualified for a diagnosis of PTSD at follow-up. In all 24 patients, total PTSD symptoms ( p = 0.001), re-experiencing symptoms ( p < 0.001), avoidance symptoms ( p = 0.015), and, with borderline significance, hyperarousal symptoms ( p < 0.06) had all decreased over time. However, in the subgroup of the 16 patients who had retained PTSD diagnostic status at follow-up, symptoms of avoidance ( p = 0.23) and of hyperarousal ( p = 0.48) showed no longitudinal decline. Longer duration of follow-up was associated with a greater decrease in avoidance symptoms ( p = 0.029) and, with borderline significance, in re-experiencing symptoms ( p < 0.07) across all patients. Conclusion: Although PTSD symptomatology waned over time and in relation to longer follow-up, two-thirds of patients still qualified for a diagnosis of PTSD 2 years after the initial diagnosis. In post-MI patients, clinical PTSD is a considerably persistent condition.",0,0 +6381,Rorschach indicators of chronic childhood sexual abuse in female borderline inpatients.,"Recent research indicates a high incidence of childhood sexual abuse and incest among female patients with a diagnosis of borderline personality disorder (BPD). The author investigated the detection and long-term aftereffects of this abuse using a constellation of Rorschach scores that were predicted to occur more frequently in borderline patients with extended sexual victimization before age 14. Sixty-two subjects were divided into two groups (33 with and 29 without such a history) and compared on the following features: color-dominated percepts, primary-process content, confabulation, activity versus passivity, and two new scores related to dissociative symptoms. Some subjects were also administered the Dissociative Experiences Scale and the DSM-III Structured Clinical Interview for posttraumatic stress disorder. The sexually abused group had significantly higher scores both on the Rorschach features and on the clinical measures. The author contends that the identified Rorschach constellation reflects symptoms associated with these trauma-related syndromes, which are more central to the profile of BPD, both on psychological tests and clinically, than is generally recognized.",0,0 +6382,Childhood Abuse Types and Physical Health at the Age of 24: Testing Health Risk Behaviors and Psychological Distress as Mediators,"This study examines whether adult psychological distress and health risk behaviors mediate the relationship between childhood abuse and physical health in adulthood. A randomly selected population-based sample, with oversampling to include a one-third subgroup of former child protection cases, completed a structured interview. Questions pertained to childhood exposure to abuse, adult psychological distress, physical health, and health risk behaviors. Previous research using this sample had identified three abuse typologies: emotional abuse, sexual abuse, and polyvictimization (physical abuse, emotional abuse, and neglect). All three typologies were significantly associated with poorer self-reported physical health. Psychological distress and health risk behaviors partially mediated the relationship between nonabuse, sexual abuse, polyvictimization, and physical health, and fully mediated the relationship between emotional abuse and physical health. The results of this study indicate that health risk behav...",0,0 +6383,Loss of social resources predicts incident posttraumatic stress disorder during ongoing political violence within the Palestinian Authority,"Exposure to ongoing political violence and stressful conditions increases the risk of posttraumatic stress disorder (PTSD) in low-resource contexts. However, much of our understanding of the determinants of PTSD in these contexts comes from cross-sectional data. Longitudinal studies that examine factors associated with incident PTSD may be useful to the development of effective prevention interventions and the identification of those who may be most at-risk for the disorder.A 3-stage cluster random stratified sampling methodology was used to obtain a representative sample of 1,196 Palestinian adults living in Gaza, the West Bank and East Jerusalem. Face-to-face interviews were conducted at two time points 6-months apart. Logistic regression analyses were conducted on a restricted sample of 643 people who did not have PTSD at baseline and who completed both interviews.The incidence of PTSD was 15.0 % over a 6-month period. Results of adjusted logistic regression models demonstrated that talking to friends and family about political circumstances (aOR = 0.78, p = 0.01) was protective, and female sex (aOR = 1.76, p = 0.025), threat perception of future violence (aOR = 1.50, p = 0.002), poor general health (aOR = 1.39, p = 0.005), exposure to media (aOR = 1.37, p = 0.002), and loss of social resources (aOR = 1.71, p = 0.006) were predictive of incident cases of PTSD.A high incidence of PTSD was documented during a 6-month follow-up period among Palestinian residents of Gaza, the West Bank, and East Jerusalem. Interventions that promote health and increase and forestall loss to social resources could potentially reduce the onset of PTSD in communities affected by violence.",0,0 +6384,Olanzapine treatment for post-traumatic stress disorder: an open-label study,"Post-traumatic stress disorder (PTSD) is a common and increasingly diagnosed mental illness. Recent pharmacotherapeutic research on treatments for this condition has focused on antidepressant drugs with serotonergic actions. However, the presence of intrusive, psychotic-like symptoms in a substantial portion of PTSD patients raises the possibility that antipsychotics with serotonergic properties might also prove useful in treating PTSD. We conducted an open-label 8-week study of olanzapine treatment in veterans with combat-induced PTSD. Primary outcome measures in this study were the Clinician Administered PTSD Scale (CAPS) and the Clinical Global Impressions Improvement scale. Secondary outcome measures included the Hamilton Rating Scales for Depression (HRSD) and Anxiety (HRSA). Forty-eight patients enrolled in the study, and 30 completed the 8-week trial. Results of intent-to-treat and completer analyses demonstrated that all outcome measures improved significantly during treatment. Secondary analyses indicate that improvement in the intrusive symptom cluster of the CAPS was independent of improvement on the HRSD and HRSA. In conclusion, the study indicates that olanzapine treatment is useful in alleviating the symptoms of combat-induced PTSD.",0,0 +6385,Evidence for a Dissociative Subtype of Post-Traumatic Stress Disorder Among Help-Seeking Childhood Sexual Abuse Survivors,"This study examined evidence for a dissociative subtype of post-traumatic stress disorder (PTSD) among women seeking psychotherapy for childhood sexual abuse (CSA). One hundred and twenty-two women seeking treatment for CSA completed a battery of questionnaires assessing PTSD, dissociative symptoms, and child maltreatment. Using signal detection analysis, we identified high and low dissociation PTSD subgroups. A constellation of three PTSD symptoms-hypervigilance, sense of foreshortened future, and sleep difficulties-discriminated between these two subgroups (OR = 8.15). Further evidence was provided by the finding of a nonlinear relationship between severity of childhood maltreatment and dissociation in the women with PTSD. These results provide support for a dissociative subtype of PTSD that may stem from more severe childhood experiences of neglect and abuse.",0,0 +6386,"The Goteborg discotheque fire: posttraumatic stress, and school adjustment as reported by the primary victims 18 months later","On October 29, 1998, around 400 young people were gathered in an old warehouse in Göteborg, Sweden, for a discotheque party. A fire erupted and spread explosively. Adolescents were exposed to dreadful scenes inside and outside the building. In all, 63 young people were killed and 213 physically injured. An 18-month follow-up with 275 adolescents (126 girls) who survived the fire, regarding the effects of the fire on symptoms of posttraumatic stress, school adjustment and performance, is reported.Impact of Events Scale (IES), Clinician Administered Posttraumatic Stress Scale (CAPS) and an interview concerning background factors and issues of public and personal support.The level of posttraumatic stress was generally high, and highest among adolescents with an immigrant background. In all, 25% of the participants met DSM-IV criteria for PTSD. Twenty-three percent of the participants reported having either dropped out of school or repeated a class because of the fire. Students' ratings of how their own school handled the situation, and school absenteeism, were related to ratings of their own performance in school as well as to the level of posttraumatic stress.Traditional talking cures were more sought out by girls than boys. Broad-scale interventions must be complemented with special treatment opportunities for the most severely afflicted. Victims who suffer from high levels of posttraumatic stress need special support for a long period of time to minimise the effects on scholastic achievement and adjustment. Studies of the effects of traumatic events on child and adolescent development should measure school-related effects better than has hitherto been the case.",0,0 +6387,Physical Impairments as Risk Factors for the Development of Posttraumatic Stress Disorder,"The case-control method, a retrospective design useful in studying the etiology of rare diseases, was utilized to examine the relative risk of posttraumatic stress disorder (PTSD) among individuals with six types of traumatic physical impairments. Odds ratios and associated confidence intervals were calculated for each impairment in a group of 45,320 veterans receiving medical services. Four of the six impairments were found to be risk factors for PTSD. Implications for rehabilitation counseling and research are discussed.",0,0 +6388,"Prevalence, comorbidity and course of trauma reactions in young burn-injured children","Infants, toddlers and preschoolers are the highest risk group for burn injury. However, to date this population has been largely neglected. This study examined the prevalence, onset, comorbidity and recovery patterns of posttrauma reactions in young children with burns.Parents of 130 unintentionally burned children (1-6 years) participated in the study. The Diagnostic Infant Preschool Assessment was conducted with parents at 1 and 6 months postinjury.The majority of children were resilient. However, 35% were diagnosed with at least one psychological disorder, there was a high rate of comorbidity with posttraumatic stress disorder, and 8% of children did not experience recovery in distress levels over the course of 6 months.These outcomes are likely to have serious repercussions for a young child's medical and psychosocial recovery as well as their normal developmental trajectories. It is recommended that screening, prevention and early intervention resources are incorporated into paediatric health care settings to optimise children's psychological adjustment following burn injury.",0,0 +6389,The validity of two versions of the GHQ in the WHO study of mental illness in general health care,"Background . In recent years the 12-item General Health Questionnaire (GHQ-12) has been extensively used as a short screening instrument, producing results that are comparable to longer versions of the GHQ. Methods . The validity of the GHQ-12 was compared with the GHQ-28 in a World Health Organization study of psychological disorders in general health care. Results are presented for 5438 patients interviewed in 15 centres using the primary care version of the Composite International Diagnostic Instrument, or CIDI-PC. Results . Results were uniformly good, with the average area under the ROC curve 88, range from 83 to 95. Minor variations in the criteria used for defining a case made little difference to the validity of the GHQ, and complex scoring methods offered no advantages over simpler ones. The GHQ was translated into 10 other languages for the purposes of this study, and validity coefficients were almost as high as in the original language. There was no tendency for the GHQ to work less efficiently in developing countries. Finally gender, age and educational level are shown to have no significant effect on the validity of the GHQ. Conclusions . If investigators wish to use a screening instrument as a case detector, the shorter GHQ is remarkably robust and works as well as the longer instrument. The latter should only be preferred if there is an interest in the scaled scores provided in addition to the total score.",0,0 +6390,"Coping, conversation tactics and marital interaction in persons with acquired profound hearing loss (APHL): Correlates of distress","This study investigated coping strategies, conversation tactics, and marital interaction in acquired profound hearing loss (APHL) and compared emotionally stable (n = 15) and emotionally distressed (n = 7) participants. Nominated family members were assessed on most measures. Comparisons were also made in the subgroup of married participants. A combined distress criterion was derived from scores on standardized measures of anxiety, depression, hearing handicap, and post-traumatic stress. Groups were compared on the Ways-of-Coping Checklist, a newly devised measure of conversation tactics, and on the Couple Behaviour Report. It was found that distressed APHL participants were more likely to cope through avoidance, self-blame, and wishful thinking, and they used more avoidant tactics in conversation. The coping profile of family members did not differentiate distress groups. However, there was some indication of greater employment of coercive tactics by family members of distressed participants. The results...",0,0 +6391,The effect of posttraumatic stress disorder psychoeducation on the nature and severity of traumatic stress symptoms in a Burundian sample,"Post-Traumatic Stress Disorder (PTSD) was recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980 as a syndrome associated with the experience of a traumatic event (ARA, 1980). In recent years, the diagnosis of PTSD has been increasingly applied to diverse cultural settings, even as the validity of the construct sparks controversy and debate. Argument continues over whether the symptoms of PTSD are more driven by universal biological response or cultural factors. A review of the literature that documents recent efforts to identify and treat posttraumatic stress symptoms in diverse populations is provided. Given evidence for the suggestive and iatrogenic effects of some PTSD treatment methods and other interventions, as well as the theoretical support for the presence of social influences germane to cross-cultural research and treatment, it was proposed that PTSD-specific psychoeducation in pre-industrialized settings might diminish otherwise beneficial treatment effects. The present project drew on an indigent, rural Burundian sample and used an experimental design to examine the influence of PTSD psychoeducation on the nature and severity of traumatic stress symptoms reported. Participants were randomized to three conditions: A reconciliation workshop with psychoeducation, a reconciliation workshop without psychoeducation, and a waitlist control. Results showed that participants in the psychoeducation condition experienced a diminished reduction of PTSD symptoms relative to other conditions. There was no differential effect by condition on more general symptoms of anxiety, depression, and somatization symptoms. Secondary hypotheses predicting relationships at baseline between prior exposure to trauma models developed in industrialized societies and the nature and severity of posttraumatic stress symptoms were not supported. The findings are discussed in terms of how they might inform intervention development for traumatic stress in non-industrialized cultural settings. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6392,Psychometric Properties of the Child’s Reaction to Traumatic Events Scale-Revised in English and Lugandan,"Brief and age-appropriate measures of trauma-related symptoms are useful for identifying children in need of clinical services. The current study examines the psychometric properties of the 23-item Child's Reaction to Traumatic Events Scale-Revised (CRTES-R). The CRTES-R includes subscales assessing hyperarousal, avoidance and intrusion. To date, no studies have examined the psychometric properties of this revised measure or cross-cultural differences in its factor structure. Two samples of (a) children (ages 6-21) who had experienced a hurricane in the USA or Grenada (N = 135), and (b) Ugandan children (ages 8-17) who had experienced a variety of traumatic events (N = 339) completed the CRTES-R in English or Lugandan. Confirmatory factor analysis supported an empirically adjusted model with three modified latent factors in both the English (χ2/df = 1.34, CFI = .90, RMSEA = .05) and Lugandan samples (χ2/df = 1.45, CFI = .93, RMSEA = .04). Although the analysis supported separate hyperarousal, avoidance and intrusion subscales, the items that loaded on each factor differed from the original CRTES-R subscales. The English version of the CRTES-R showed good concurrent validity with the Kauai Recovery Index measure of trauma symptoms. Those using the CRTES-R to assess children's experiences of the different symptom types should consider using the empirically-derived subscales described in this paper; however, those who wish to capture a broad spectrum of PTSD symptoms should consider using all the original CRTES-R items and calculating a total score.",0,0 +6393,Dividing Traffic Sub-areas Based on a Parallel K-Means Algorithm,"AbstractIn order to alleviate the traffic congestion and reduce the complexity of traffic control and management, it is necessary to exploit traffic sub-areas division which should be effective in planing traffic. Some researchers applied the K-Means algorithm to divide traffic sub-areas on the taxi trajectories. However, the traditional K-Means algorithms faced difficulties in processing large-scale Global Position System(GPS) trajectories of taxicabs with the restrictions of memory, I/O, computing performance. This paper proposes a Parallel Traffic Sub-Areas Division(PTSD) method which consists of two stages, on the basis of the Parallel K-Means(PKM) algorithm. During the first stage, we develop a process to cluster traffic sub-areas based on the PKM algorithm. Then, the second stage, we identify boundary of traffic sub-areas on the base of cluster result. According to this method, we divide traffic sub-areas of Beijing on the real-word (GPS) trajectories of taxicabs. The experiment and discussion show that the method is effective in dividing traffic sub-areas.KeywordsTraffic Sub-AreasGPS TrajectoriesK-MeansMapReduce",0,0 +6394,Prolonged exposure to post-traumatic stress disorder (PTSD) in an active substance abuser,"Effective treatments for post-traumatic stress disorder (PTSD) have been the focus of research studies for many years, with exposure therapy consistently emerging as the leading treatment for this disorder. However, for a variety of reasons most studies exclude individuals suffering from concurrent substance use disorders. In recent years, this omission has been addressed, and the belief that substance dependent individuals cannot benefit from trauma treatment until they are free from substances is losing favor. Early studies have demonstrated that prolonged exposure therapy can be effective for persons suffering from both disorders. The current case study seeks to provide information on the length of time and type of symptom change in an individual suffering from comorbid PTSD-substance abuse (PTSD-SA). Therefore, prolonged exposure was utilized to treat PTSD in an active abuser of both alcohol and marijuana. Pre- and post-treatment assessments demonstrate dramatic reductions in PTSD symptoms, general an...",0,0 +6395,Testing the number of components in a normal mixture,"We demonstrate that, under a theorem proposed by Vuong, the likelihood ratio statistic based on the Kullback-Leibler information criterion of the null hypothesis that a random sample is drawn from a k 0 -component normal mixture distribution against the alternative hypothesis that the sample is drawn from a k 1 -component normal mixture distribution is asymptotically distributed as a weighted sum of independent chi-squared random variables with one degree of freedom, under general regularity conditions. We report simulation studies of two cases where we are testing a single normal versus a two-component normal mixture and a two-component normal mixture versus a three-component normal mixture. An empirical adjustment to the likelihood ratio statistic is proposed that appears to improve the rate of convergence to the limiting distribution.",0,0 +6396,Trajectories of posttraumatic stress symptomatology in older persons affected by a large-magnitude disaster,"This study examined the nature and determinants of longitudinal trajectories of disaster-related posttraumatic stress disorder (PTSD) symptoms in older persons affected by a large-magnitude disaster. Two hundred six adults age 60 or older (mean = 69, range = 60-92) who resided in the Galveston Bay area when Hurricane Ike struck in September 2008 completed telephone interviews an average of 3-, 6-, and 15-months after this disaster. Latent growth mixture modeling was employed to identify predominant trajectories of disaster-related PTSD symptoms over time; and pre-, peri-, and post-disaster determinants of these trajectories were then examined. A 3-class solution optimally characterized PTSD symptom trajectories, with the majority (78.7%) of the sample having low/no PTSD symptoms over all assessments (i.e., resistant); 16.0% having chronically elevated symptoms (i.e., chronic); and 5.3% having a delayed onset course of symptoms (i.e., delayed-onset). Lower education, greater severity of Hurricane Ike exposure (i.e., Ike-related physical illness or injury and high level of community destruction), and greater number of traumatic and stressful life events after Hurricane Ike, particularly financial problems, were associated with a chronic PTSD trajectory. Greater number of traumatic and stressful life events, particularly financial problems after Hurricane Ike, was also associated with a delayed-onset trajectory. These findings suggest that there are heterogeneous trajectories of disaster-related PTSD symptoms in older adults and that these trajectories have common and unique determinants. They also underscore the importance of prevention efforts designed to mitigate the deleterious effects of post-disaster stressors, most notably financial distress, in older persons affected by disasters.",1,0 +6397,"Heart rate of motor vehicle accident survivors in the emergency department, peritraumatic psychological reactions, ASD, and PTSD severity: A 6-month prospective study","This small-scale study investigates the relationships between the heart rate of motor vehicle accident survivors presenting in the emergency department (ED) and acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) symptom severity. It also examines the relationships between the survivor's heart rate in the ED and peritraumatic dissociation and peritraumatic distress reported 2 weeks posttrauma. Fifty motor vehicle accident (MVA) survivors were assessed 2 weeks, 1 (N = 42), 3 (N = 37), and 6 months (N = 37) post-MVA. The heart rate in the ED predicted self-reported ASD symptom severity and clinician-rated PTSD symptom severity at 6 months but not at 1 or 3 months. Survivors' heart rate in the ED was significantly correlated with peritraumatic dissociation but not peritraumatic distress. These findings support the role of elevated ED heart rate as a predictor of both ASD and chronic PTSD symptom severity and may help to clarify the discrepant findings of previous research.",0,0 +6398,Post-traumatic stress disorder and chronic disease: open questions and future directions,"A large body of research has now firmly established that traumatic events, such as natural disasters, combat, sexual assault, and child abuse, are frequent occurrences throughout the world and that there are substantial consequences of traumatic event experiences. In most countries, the majority of adults report exposure to at least one traumatic event in their lifetime [1]. PTSD, the paradigmatic stress-related mental disorder, emerges in some persons in response to an unpredictable and uncontrollable traumatic event. PTSD is common with lifetime estimates ranging from 1.7 % in South Korea to 8.8 % in Northern Ireland, and past-year prevalences from a high of 3.8 % in Northern Ireland to a low of 0.2 % in China [2]. Separately, evidence shows that persons who experience traumatic events are more likely to report cardiovascular disease, respiratory disease, and other physical illness [3]. Researchers and health professionals commonly treat the brain and the body as if they are distinct entities, and this approach informs most of the scholarship about the consequences of traumatic events. However, recent advances in our understanding of the relation between PTSD and chronic diseases such as cardiovascular disease and type-2 diabetes suggest this approach is misguided. For example, a recent meta-analysis showed that PTSD and PTSD symptoms are associated with worse self-reported health and health-related quality of life [4]. Rigorous prospective studies have provided evidence that PTSD increases risk of first-onset cardiovascular disease and type-2 diabetes [5, 6]. This evidence, and a comparable body of literature, suggests that PTSD may have profound adverse effects on physical health over the life course. This opens up an important new perspective on the study of the consequences of PTSD and an emerging literature is now informing our understanding of how PTSD may be linked to physical illness.",0,0 +6399,Is it time to act? The potential of acceptance and commitment therapy for psychological problems following acquired brain injury,"Behaviour therapies have a well-established, useful tradition in psychological treatments and have undergone several major revisions. Acceptance and Commitment Therapy (ACT) and mindfulness-based approaches are considered a third wave of behavioural therapies. Emerging evidence for ACT has demonstrated that this paradigm has promising effectiveness in improving functionality and well-being in a variety of populations that have psychological disturbances and/or medical problems. In this review we first evaluate traditional cognitive behavioural therapy (CBT) interventions used to manage psychological problems in distressed individuals who have sustained an acquired brain injury (ABI). We provide an overview of the ACT paradigm and the existent evidence base for this intervention. A rationale is outlined for why ACT-based interventions may have potential utility in assisting distressed individuals who have sustained a mild to moderate ABI to move forward with their lives. We also review emerging evidence that lends preliminary support to the implementation of acceptance and mindfulness-based interventions in the rehabilitation of ABI patient groups. On the basis of existent literature, we recommend that it is an opportune time for forthcoming research to rigorously test the efficacy of ACT-based interventions in facilitating ABI patient groups to re-engage in living a valued and meaningful life, in spite of their neurocognitive and physical limitations. The promising utility of testing the efficacy of the ACT paradigm in the context of multimodal rehabilitation programmes for ABI populations is also addressed.",0,0 +6400,Presentation and prevalence of PTSD in a bipolar disorder population: A STEP-BD examination,"Co-occurring psychiatric diagnoses have a negative impact on quality of life and change the presentation and prognosis of bipolar disorder (BD). To date, comorbidity research on patients with BD has primarily focused on co-occurring anxiety disorders and trauma history; only recently has there been a specific focus on co-occurring PTSD and BD. Although rates of trauma and PTSD are higher in those with bipolar disorder than in the general population, little is known about differences across bipolar subtypes.Using the NIMH STEP-BD dataset (N=3158), this study evaluated whether there were baseline differences in the prevalence of PTSD between participants with bipolar disorder I (BDI) and bipolar disorder II (BDII), using the MINI and the Davidson Trauma Scale. Differences in PTSD symptom clusters between patients with BDI and BDII were also evaluated.A significantly greater proportion of participants with BDI had co-occurring PTSD at time of study entry (Χ(2)(1)=12.6; p<.001). BDI and BDII subgroups did not significantly differ in re-experiencing, avoidance, or arousal symptoms.The analysis may suggest a correlational relationship between PTSD and BD, not a causal one. Further, it is possible this population seeks treatment more often than individuals with PTSD alone. Finally, due to the episodic nature of BD and symptom overlap between the two disorders, misdiagnosis is possible.PTSD may be more prevalent in patients with BDI. However, the symptom presentation of PTSD appears similar across BD subtypes. Individuals should be thoroughly assessed for co-occurring diagnoses in an effort to provide appropriate treatment.",0,0 +6401,Examining minor and major depression in adolescents,"Research has shown that a large proportion of adolescents with symptoms of depression and substantial distress or impairment fail to meet the diagnostic criteria for a major depressive disorder (MDD). However, many of these undiagnosed adolescents may meet criteria for a residual category of the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revised (DSM-IV-TR), Depressive Disorder Not Otherwise Specified. Minor Depression (mDEP), an example of one of these categories, allows the inclusion of sub-threshold cases that fall below the diagnostic criteria of the five symptoms required for MDD. Minor depression in adolescence is important because it is significantly related to MDD in adulthood. The present study examines a number of risk factors, functional impairment, comorbidity and service utilization patterns associated with depression in community adolescents who met the DSM-IV criteria for mDEP and compares their profile to adolescents who met the criteria for MDD.Puerto Rican adolescents 11 to 17 years old were selected from an island-wide probability household sample of children ranging in age from 4 to 17. The Diagnostic Interview Schedule in Spanish (DISC IV), together with a structured protocol of risks and protective factors, and service utilization questionnaires were administered to primary caretakers and their children.Our findings indicate that youngsters with mDEP had significant impairment and used more mental health services than those with major depression. In addition, adolescents with mDEP had similar outcomes when compared to those meeting full criteria for MDD in terms of psychosocial correlates and comorbidity.The results, although not definitive, suggest a need for further research in order to determine the validity of the present DSM IV diagnostic criteria for mDEP in adolescents.",0,0 +6402,Distinguishing Trauma-Associated Narcissistic Symptoms from Posttraumatic Stress Disorder: A Diagnostic Challenge,"Individuals with trauma-associated narcissistic symptoms (referred to in this paper by the acronym TANS for simplicity) display a discrete cluster of psychological symptoms that can closely mimic those of PTSD. In TANS, the underlying vulnerability to traumatic stress usually stems from a narcissistic personality disorder or narcissistic personality traits. However, narcissistic symptoms associated with an external traumatic event may be reflexively and erroneously attributed to PTSD, no matter how small or insignificant the traumatic stressor. Mistaking TANS for PTSD usually results in treatment failure. In litigation, distinguishing between TANS and PTSD assists the trier of fact in determining causation and assessing damages.",0,0 +6403,"Posttraumatic stress disorder in a national sample of female and male Vietnam veterans: Risk factors, war-zone stressors, and resilience-recovery variables.","Relationships among pretrauma risk factors (e.g., family instability, childhood antisocial behavior), war-zone stressors (e.g., combat, perceived threat), posttrauma resilience-recovery variables (e.g., hardiness, social support), and posttraumatic stress disorder (PTSD) symptom severity were examined. Data from a national sample of 432 female and 1,200 male veterans were analyzed using structural equation modeling. For both genders, direct links to PTSD from pretrauma, war-zone, and posttrauma variable categories were found; several direct associations between pretrauma and posttrauma variables were documented. Although war-zone stressors appeared preeminent for PTSD in men, posttrauma resilience-recovery variables were more salient for women. Researchers, policymakers, and clinicians are urged to take a broad view on trauma and its sequelae, especially regarding possible multiple exposures over time and the depletion and availability of important resources.",0,0 +6404,Association of life threat and betrayal with posttraumatic stress disorder symptom severity,"The Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association [APA], 2000) emphasizes life threat as the defining feature of psychological trauma. Recent theoretical and empirical work, however, indicates the need to identify and evaluate other key aspects of trauma. Betrayal has been proposed as a pertinent, distinct, and complementary factor that can explain effects of trauma not accounted for by life threat alone. This study examined the relationship between injury, perceived life threat (PLT), and betrayal with posttraumatic stress disorder (PTSD) symptom severity. Trauma-exposed college students (N = 185) completed self-report measures of trauma exposure and PTSD, as well as items regarding life threat, betrayal, and level of medical care received. In hierarchical regressions incorporating injury, PLT, and betrayal, betrayal was associated with all PTSD symptom clusters and PTSD total severity (f2 = .08), whereas PLT was associated with hyperarousal (f2 = .05) and PTSD total (f2 = .03), and injury had no association with PTSD symptoms. In a revised model with trauma type as an additional variable, betrayal was associated with avoidance (f2 = .03), numbing (f2 = .04), and PTSD total (f2 = .03), whereas PLT was associated with reexperiencing (f2 = .04), hyperarousal (f2 = .04), and PTSD total (f2 = .03), and injury was associated with avoidance (f2 = .03). These findings support the idea that betrayal is a core dimension of psychological trauma that may play an important role in the etiology of PTSD.",0,0 +6405,Post-traumatic stress disorder among family physicians in Bosnia and Herzegovina,"The traumatic events experienced by thousands of people in Bosnia and Herzegovina during the 1992-1995 conflict may have a lasting effect on the mental health of the country, characterized by high rates of post-traumatic stress disorder (PTSD). A diagnosis of PTSD among family physicians could affect their ability to diagnose and treat patients for depression, anxiety and PTSD.The aim of the present study was to determine the prevalence of PTSD among family medicine physicians in Bosnia and Herzegovina.A self-administered questionnaire, including the PTSD Checklist-Civilian Version (PCL-C) which is a validated scale for PTSD screening, was distributed to family medicine residents and specialists in Bosnia and Herzegovina. The prevalence of PTSD was determined, and factors related to PTSD were considered.One hundred and thirty-three (90.5%) of the 147 physicians who were available to be surveyed completed the questionnaire. Of the 88% who had a traumatic experience during the war, 18% met the criteria for PTSD. The likelihood of meeting the criteria for PTSD was not affected by age, sex or whether the physician had worked in a field hospital during the war. However, a positive response to the question ""Do you think the traumatic event you experienced during the war still affects you today?"" was highly associated with the diagnosis of PTSD (odds ratio 7.26, 95% confidence interval: 1.57-33.60). Also, this question was shown to have a high degree of sensitivity and negative predictive value, and may be of use as a screening tool for ruling out the presence of PTSD after a traumatic war experience.",0,0 +6406,Cognitive therapy for post-traumatic stress disorder: development and evaluation,"The paper describes the development of a cognitive therapy (CT) program for post-traumatic stress disorder (PTSD) that is based on a recent cognitive model (Behav. Res. Therapy 38 (2000) 319). In a consecutive case series, 20 PTSD patients treated with CT showed highly significant improvement in symptoms of PTSD, depression and anxiety. A subsequent randomized controlled trial compared CT ( N = 14 ) and a 3-month waitlist condition (WL, N = 14 ). CT led to large reductions in PTSD symptoms, disability, depression and anxiety, whereas the waitlist group did not improve. In both studies, treatment gains were well maintained at 6-month follow-up. CT was highly acceptable, with an overall dropout rate of only 3%. The intent-to-treat effect sizes for the degree of change in PTSD symptoms from pre to post-treatment were 2.70–2.82 (self-report), and 2.07 (assessor-rated). The controlled effect sizes for CT versus WL post-treatment scores were 2.25 (self-report) and 2.18 (assessor-rated). As predicted by the cognitive model, good treatment outcome was related to greater changes in dysfunctional post-traumatic cognitions. Patient characteristics such as comorbidity, type of trauma, history of previous trauma, or time since the traumatic event did not predict treatment response, however, low educational attainment and low socioeconomic status were related to better outcome.",0,0 +6407,Assessing reliability and validity of the Arabic language version of the Post-traumatic Diagnostic Scale (PDS) symptom items,"Arab immigrant women are vulnerable to post-traumatic stress disorder (PTSD) because of gender, higher probability of being exposed to war-related violence, traditional cultural values, and immigration stressors. A valid and reliable screen is needed to assess PTSD incidence in this population. This study evaluated the reliability and validity of an Arabic language version of the symptom items in Foa et al.'s [Foa, E.B., Cashman, L., Jaycox, L., and Perry, K. 1997. The validation of a self report measure of posttraumatic stress disorder: the Posttraumatic Diagnostic Scale. Psychological Assessment 9(4), 445–451]. Post-traumatic Diagnostic Scale (PDS) in a sample of Arab immigrant women ( n = 453). Reliability was supported by Cronbach's alpha values for the Arabic language version (0.93) and its subscales (0.77–0.91). Results of group comparisons supported validity: Women who had lived in a refugee camp or emigrated from Iraq — a country where exposure to war and torture is common — were exhibiting depressive symptoms (Center for Epidemiological Studies-Depression Scale (CES-D) score above 18), or reported moderately to severely impaired functioning had significantly higher mean PDS total and symptom subscale scores than women who had not had these experiences or were not exhibiting depressive symptoms. Scores on the PDS and its subscales were also positively correlated with the Profile of Mood States (POMS) depression and anxiety subscales and negatively correlated with the POMS vigor subscale ( r = − .29 to− .39).",0,0 +6408,The association between alexithymia and posttraumatic stress symptoms following multiple exposures to traumatic events in North Korean refugees,"The present study aimed to investigate the effect of the interaction between the number of traumas experienced and alexithymia, on posttraumatic stress disorder (PTSD) symptoms.The sample comprised 199 North Korean refugees. Participants completed the Trauma Exposure Check List for North Korean Refugees, Impact of Event Scale-Revised (IES-R), Toronto Alexithymia Scale-20 (TAS-20), and Center for Epidemiological Studies-Depression Scale (CES-D).TAS-20 scores were positively correlated with IES-R scores (r=0.21, p<0.01), after controlling for gender, age, and CES-D scores. The number of traumas experienced was also positively correlated with IES-R scores (r=0.32, p<0.001), but not with TAS-20 scores, after controlling for gender, age, and CES-D scores. A hierarchical multiple regression analysis revealed a significant interaction between the number of traumas experienced and TAS-20 scores, for IES-R scores (t=2.10, p<0.05). Moderation analysis further revealed that TAS-20 scores moderate the relationship between the number of traumas experienced and IES-R scores (t=2.90, p<0.01). For refugees with higher TAS-20 scores, those who had experienced more traumas had higher IES-R scores. However, within refugees with lower TAS-20 scores, IES-R scores were not significantly different for those who had experienced a higher number of traumas compared with those who had experienced a lower, or average, number of traumas.The results of the current study suggest that, as individuals experience more traumatic events, clearly identifying and expressing emotions become more crucial for reducing PTSD symptoms.",0,0 +6409,"Post-traumatic stress disorder, drug dependence, and suicidality among male Vietnam veterans with a history of heavy drug use","This study examines the roles of post-traumatic stress disorder (PTSD) and drug dependence in non-fatal suicidality, i.e., suicidal ideation and suicide attempt, among Vietnam veterans in their adult years. The sample includes male veterans deployed to Vietnam, including an oversample of those who tested positive for opiates at their return ( n = 642). PTSD, substance abuse, suicidality, and other psychopathology are analyzed using three waves of survey and military data covering the time period from early adolescence to middle adulthood. Measures include the onset and recency of each of the lifetime DSM-IV PTSD symptom criteria, and yearly symptom measures of DSM-IV dependence for alcohol and eight classes of psychoactive substances. Survival and hazard models are applied to assess the effects of drug dependence, PTSD, and other psychopathology on the duration of suicidality. Longitudinal models estimate the casual relationships among PTSD, drug dependence, and suicidality over a 25-year period. Results show evidence of strong continuity of PTSD, drug dependence, and suicidality over time. The causal role of drug dependence on PTSD and suicidality is limited to young adulthood. Evidence is stronger for self-medication in later adulthood. The results indicate that a life course perspective is needed for the combined treatment of PTSD and drug dependence for severely traumatized populations.",0,0 +6410,A case of frontal neuropsychological and neuroimaging signs following multiple primary-blast exposure,"Blast-related traumatic brain injury (TBI) from the Afghanistan and Iraq wars represents a significant medical concern for troops and veterans. To better understand the consequences of primary-blast injury in humans, we present a case of a Marine exposed to multiple primary blasts during his 14-year military career. The neuropsychological profile of this formerly high-functioning veteran suggested primarily executive dysfunction. Diffusion-tensor imaging revealed white-matter pathology in long fiber tracks compared with a composite fractional-anisotropy template derived from a veteran reference control group without TBI. This study supports the existence of primary blast-induced neurotrauma in humans and introduces a neuroimaging technique with potential to discriminate multiple-blast TBI.",0,0 +6411,Motor vehicle accident trauma exposure: Personality profiles associated with posttraumatic diagnoses,"Abstract Personality profiles associated with diagnostically distinct posttraumatic responses were examined. Profiles were compared between three groups defined on the basis of posttraumatic diagnosis following motor vehicle accident (MVA) trauma exposure. The diagnostic groups were: Posttraumatic Stress Disorder (PTSD), Acute Stress Disorder (ASD) without progression to PTSD, and subclinical responses. Participants were male and female community volunteers aged 18 to 77 (N = 83) who had all been exposed to an MVA meeting the DSM-IV diagnostic criteria for a traumatic event. The Personality Assessment Inventory (Morey, 1991) was used to assess psychological variables in the framework of posttraumatic diagnostic groups. The PTSD group scored significantly higher than the ASD and subclinical groups on scales assessing somatic complaints, anxiety, anxiety related disorders, depression, non-psychotic symptoms of schizophrenia, and negative relationships. The profile of the ASD group was characterized by self ...",0,0 +6412,"The relationship between worry, rumination, and comorbidity: Evidence for repetitive negative thinking as a transdiagnostic construct","Repetitive negative thinking (RNT) increases vulnerability to multiple anxiety and depressive disorders and, as a common risk factor, elevated RNT may account for the high levels of comorbidity observed between emotional disorders. The aims of this study were to (a) compare two common forms of RNT (worry and rumination) across individuals with non-comorbid anxiety or depressive disorders, and (b) to examine the relationship between RNT and comorbidity.A structured diagnostic interview and measures of rumination, worry, anxiety, and depression were completed by a large clinical sample with an anxiety disorder or depression (N=513) presenting at a community mental health clinic.Patients without (n=212) and with (n=301) comorbid diagnoses did not generally differ across the principal diagnosis groups (depression, generalised anxiety disorder, social anxiety disorder, panic disorder) on worry or rumination. As predicted, comorbidity was associated with a higher level of RNT.Cross-sectional design precluded causal conclusions and findings may not generalize to excluded anxiety disorders.Consistent with the transdiagnostic hypothesis, RNT was associated with a range of anxiety disorders and depression and with comorbidity for those with a principal depressive disorder, supporting recent evidence that RNT is a transdiagnostic process. The presence of RNT, specifically worry and rumination, should be assessed and treated regardless of diagnostic profile. Future research may show that both pure and comorbid depressed or anxious patients receive incremental benefit from transdiagnostic protocols developed to treat core pathological processes of RNT traditionally associated with separate disorders.",0,0 +6413,Improvement of mood and sleep alterations in posttraumatic stress disorder patients by eye movement desensitization and reprocessing,"Posttraumatic stress disorder (PTSD) patients exhibit depressive and anxiety symptoms, in addition to nightmares, which interfere with sleep continuity. Pharmacologic treatment of these sleep problems improves PTSD symptoms, but very few studies have used psychotherapeutic interventions to treat PTSD and examined their effects on sleep quality. Therefore, in the present study, we sought to investigate the effects of Eye Movement Desensitization Reprocessing therapy on indices of mood, anxiety, subjective, and objective sleep. The sample was composed of 11 healthy controls and 13 PTSD patients that were victims of assault and/or kidnapping. All participants were assessed before, and 1 day after, the end of treatment for depressive and anxiety profile, general well-being and subjective sleep by filling out specific questionnaires. In addition, objective sleep patterns were evaluated by polysomnographic recording. Healthy volunteers were submitted to the therapy for three weekly sessions, whereas PTSD patients underwent five sessions, on average. Before treatment, PTSD patients exhibited high levels of anxiety and depression, poor quality of life and poor sleep, assessed both subjectively and objectively; the latter was reflected by increased time of waking after sleep onset. After completion of treatment, patients exhibited improvement in depression and anxiety symptoms, and in quality of life; with indices that were no longer different from control volunteers. Moreover, these patients showed more consolidated sleep, with reduction of time spent awake after sleep onset. In conclusion, Eye Movement Desensitization and Reprocessing was an effective treatment of PTSD patients and improved the associated sleep and psychological symptoms.",0,0 +6414,Gulf War Illness,"To further elucidate the nature of illness in veterans of the 1990 to 1991 Gulf War (GW) by examining the GW Illness (GWI) definition advanced by the Centers for Disease Control and Prevention, which specified caseness as having at least one symptom from two of the three factors: fatigue, mood-cognition, and musculoskeletal.A total of 311 male and female GW veterans drawn from across the nation were assessed in a survey-based study approximately 10 years after deployment.A total of 33.8% of the probability-weighted sample met GWI criteria. Multiple symptom profiles were found, with more than half of GWI cases endorsing a symptom on all the three factors, and almost all cases endorsing at least one mood-cognition symptom.Although the Centers for Disease Control and Prevention definition has some limitations that should be considered, it remains a useful tool for assessing the presence of illness in GW veterans.",0,0 +6415,Molecular and Therapeutic Potential and Toxicity of Valproic Acid,"Valproic acid (VPA), a branched short-chain fatty acid, is widely used as an antiepileptic drug and a mood stabilizer. Antiepileptic properties have been attributed to inhibition of Gamma Amino Butyrate (GABA) transaminobutyrate and of ion channels. VPA was recently classified among the Histone Deacetylase Inhibitors, acting directly at the level of gene transcription by inhibiting histone deacetylation and making transcription sites more accessible. VPA is a widely used drug, particularly for children suffering from epilepsy. Due to the increasing number of clinical trials involving VPA, and interesting results obtained, this molecule will be implicated in an increasing number of therapies. However side effects of VPA are substantially described in the literature whereas they are poorly discussed in articles focusing on its therapeutic use. This paper aims to give an overview of the different clinical-trials involving VPA and its side effects encountered during treatment as well as its molecular properties.",0,0 +6416,Resilience and post-traumatic stress disorder in the acute aftermath of rape: a comparative analysis of adolescents versus adults,"Rape trauma contributes significantly to the mental burden of disease, affecting resilience and vulnerabilities at every developmental life stage. Appropriate resilience-promoting strategies could potentially buffer or protect trauma-exposed individuals from psychopathology.This study aimed to assess and compare (using validated measuring instruments) resilience, post-traumatic stress disorder (PTSD) and other variables in the acute aftermath of rape, between adolescent and adult females and to assess associations with these variables.We conducted a comparative analysis of resilience, PTSD, prior trauma, demographic variables and psychiatric morbidity in 41 adolescent and 47 adult female rape survivors six weeks post-rape. We assessed the relationship of resilience to PTSD, demographic variables and prior trauma and investigated if resilience levels predicted PTSD after adjusting for prior trauma.We found no significant differences in resilience levels between the groups, but the adolescent PTSD rate (40%) was double that in adults (20%). In adults, a significant negative correlation was evident between resilience and PTSD symptoms scores.More knowledge of resilience versus stress susceptibility for PTSD throughout the lifespan is needed and can inform the development of more effective clinical assessment and resilience-promoting strategies.",0,0 +6417,Glutamatergic Systems and Anxiety,"Anxiety is a normal emotion experienced by humans and other mammalian species. However, anxiety also exists in pathological forms, and anxiety disorders are the most prevalent of psychiatric disorders. Prevalence rates vary with the diagnostic tools used to estimate them, and with study design, but the most extensive studies suggest that within the United States, 15.7 million people are affected yearly and 30 million at some point in their lives (1). In a US study, 6% of men and 13% of women had suffered from an anxiety disorder in the previous 6 mo (2).KeywordsNMDA ReceptorAnxiety DisorderAMPA ReceptorFear ConditioningMetabotropic Glutamate ReceptorThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.",0,0 +6418,"Psychosocial stress and strategies for managing adversity: measuring population resilience in New South Wales, Australia","Populations around the world are facing an increasing number of adversities such as the global financial crisis, terrorism, conflict, and climate change. The aim of this paper was to investigate self-reported strategies and sources of support used to get through ""tough times"" in an Australian context and to identify patterns of response in the general population and differences in potentially vulnerable subgroups.Data were collected through a cross-sectional survey of the New South Wales population in Australia. The final sample consisted of 3,995 New South Wales residents aged 16 years and above who responded to the question: ""What are the things that get you through tough times?""Respondents provided brief comments that were coded into 14 main subject-area categories. The most frequently reported responses were family and self (52%); friends and neighbors (21%); use of positive emotional and philosophical strategies (17%), such as sense of humor, determination, and the belief that things would get better; and religious beliefs (11%). The responses of four population subgroups were compared, based on gender, household income, level of psychological distress, and whether a language other than English was spoken at home. Women reported greater use of friends and neighbors and religious or spiritual beliefs for support, whereas men reported greater use of drinking/smoking and financial supports. Those with lower incomes reported greater reliance on positive emotional and philosophical strategies and on religious or spiritual beliefs. Those with high levels of psychological distress reported greater use of leisure interests and hobbies, drinking/smoking, and less use of positive lifestyle strategies, such as adequate sleep, relaxation, or work/life balance. Those who spoke a language other than English at home were less likely to report relying on self or others (family/friends) or positive emotional and philosophical strategies to get through tough times.Understanding strategies and sources of support used by the population to get through adversity is the first step toward identifying the best approaches to build and support strengths and reduce vulnerabilities. It is also possible to reflect on how large-scale threats such as pandemics, disasters, conflict, bereavement, and loss could impact individual and population resilience.",0,0 +6419,Prospective risk factors for new-onset post-traumatic stress disorder in National Guard soldiers deployed to Iraq,"Background National Guard troops are at increased risk for post-traumatic stress disorder (PTSD); however, little is known about risk and resilience in this population. Method The Readiness and Resilience in National Guard Soldiers Study is a prospective, longitudinal investigation of 522 Army National Guard troops deployed to Iraq from March 2006 to July 2007. Participants completed measures of PTSD symptoms and potential risk/protective factors 1 month before deployment. Of these, 81% ( n =424) completed measures of PTSD, deployment stressor exposure and post-deployment outcomes 2–3 months after returning from Iraq. New onset of probable PTSD ‘diagnosis’ was measured by the PTSD Checklist – Military (PCL-M). Independent predictors of new-onset probable PTSD were identified using hierarchical logistic regression analyses. Results At baseline prior to deployment, 3.7% had probable PTSD. Among soldiers without PTSD symptoms at baseline, 13.8% reported post-deployment new-onset probable PTSD. Hierarchical logistic regression adjusted for gender, age, race/ethnicity and military rank showed that reporting more stressors prior to deployment predicted new-onset probable PTSD [odds ratio (OR) 2.20] as did feeling less prepared for deployment (OR 0.58). After accounting for pre-deployment factors, new-onset probable PTSD was predicted by exposure to combat (OR 2.19) and to combat's aftermath (OR 1.62). Reporting more stressful life events after deployment (OR 1.96) was associated with increased odds of new-onset probable PTSD, while post-deployment social support (OR 0.31) was a significant protective factor in the etiology of PTSD. Conclusions Combat exposure may be unavoidable in military service members, but other vulnerability and protective factors also predict PTSD and could be targets for prevention strategies.",0,0 +6420,Randomised controlled trial of a cognitive narrative intervention for complicated grief in widowhood,"The implementation of bereavement interventions is frequently requested, and its effectiveness has been controversial. The aim of this study is to evaluate the effectiveness of a cognitive narrative intervention for complicated grief (CG) for controlling post-traumatic and depressive issues.The study is a randomised controlled trial and uses the Socio Demographic Questionnaire (SDQ), the Inventory of Complicated Grief (ICG), the Beck Depression Inventory (BDI) and the Impact of Events Scale-Revised (IES-R). There were three phases in the study: (1) The SDQ and CG evaluations were applied to bereaved elders (n = 82). The bereaved elders with the 40 highest ICG values (≥25) were randomly allocated into two groups: the intervention group (n = 20) and control group (n = 20); (2) participants were evaluated using the BDI and IES-R and the IG gave informed consent to participate in an intervention with four weekly 60-min sessions addressing recall, emotional and cognitive subjectivation, metaphorisation and projecting. (3) Two months later, the ICG, BDI and IES-R assessments were repeated.Outcome measures showed a statistically significant reduction of CG, depressive and traumatic symptoms compared to the controls. Very high effect sizes for the ICG, BDI and IES-R reflect the effectiveness of the intervention along the longitudinal profile.These results reinforce the importance of brief interventions that combine a reduced number of sessions with lower costs, which is reflected in an increased adherence to the programme along with high effectiveness.",0,0 +6421,"Heterogeneity of posttraumatic stress symptoms in a highly traumatized low income, urban, African American sample","Trauma is associated with a range of outcomes; identification of homogeneous profiles of posttrauma symptoms may inform theory, diagnostic refinement, and intervention. The present investigation applies a novel analytic technique to the identification of homogeneous subgroups of post-traumatic symptomatology in a large sample of African American adults reporting high levels of trauma. Latent profiles of posttraumatic stress disorder (PTSD) symptom severity were tested using latent profile analysis. Pseudo-class draws were used to characterize class differences across types of trauma, diagnostic comorbidities, and clinically-relevant features. Participants consisted of 2915 highly traumatized African Americans living in low income, urban setting and recruited from medical clinics in Atlanta, GA. Findings supported the presence of six distinct subgroups of posttraumatic stress symptom profiles described as resilient, moderate with amnesia, moderate with diminished interest, moderate without diminished interest and amnesia severe without amnesia, and severe overall. Observed subgroups differed across numerous historical and concurrent factors including childhood trauma, current and lifetime diagnoses of PTSD and major depression, lifetime substance use diagnosis, dissociation, depressive symptoms, emotional dysregulation, negative and positive affect, and history of hospitalization and suicidality. Posttraumatic stress disorder as currently defined is comprised of homogeneous subgroups with important differences in posttraumatic stress symptom endorsement as well as concomitant differentiation of associated diagnoses and clinically-relevant associated features.",0,0 +6422,Centrality of positive and negative deployment memories predicts posttraumatic growth in danish veterans.,"The purpose of the present study was to examine theoretically motivated predictors for the development of positive changes following potentially traumatic experiences (i.e., posttraumatic growth). Specifically, we wanted to examine the prediction that memories of highly negative and positive deployment events predict subsequent posttraumatic growth.A total of 251 Danish soldiers (7% female, mean age 26.4) deployed to forward operating bases in Afghanistan filled out questionnaires before, during, and after deployment. This allowed us to perform prospective as well as cross-sectional analyses of the data.The main findings were that the centrality of highly emotional memories from deployment predicted growth alongside openness to experience, combat exposure, and social support. Importantly, the centrality of both positive and negative memories predicted growth equally well.The perceived importance of both negative and positive events may play an important part in the development of posttraumatic growth.",0,0 +6423,Meta-Analysis of Risk Factors for Secondary Traumatic Stress in Therapeutic Work With Trauma Victims,"Revisions to the posttraumatic stress disorder (PTSD) diagnostic criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) clarify that secondary exposure can lead to the development of impairing symptoms requiring treatment. Historically known as secondary traumatic stress (STS), this reaction occurs through repeatedly hearing the details of traumatic events experienced by others. Professionals who work therapeutically with trauma victims may be at particular risk for this exposure. This meta-analysis of 38 published studies examines 17 risk factors for STS among professionals indirectly exposed to trauma through their therapeutic work with trauma victims. Small significant effect sizes were found for trauma caseload volume (r = .16), caseload frequency (r = .12), caseload ratio (r = .19), and having a personal trauma history (r = .19). Small negative effect sizes were found for work support (r = -.17) and social support (r = -.26). Demographic variables appear to be less implicated although more work is needed that examines the role of gender in the context of particular personal traumas. Caseload frequency and personal trauma effect sizes were moderated by year of publication. Future work should examine the measurement of STS and associated impairment, understudied risk factors, and effective interventions.",0,0 +6424,Single Photon Emission Computed Tomography (SPECT) in Obsessive–Compulsive Disorder Before and After Treatment with Inositol,"Inositol, a glucose isomer and second messenger precursor, regulates numerous cellular functions and has demonstrated efficacy in obsessive-compulsive disorder (OCD) through mechanisms that remain unclear. The effect of inositol treatment on brain function in OCD has not been studied to date. Fourteen OCD subjects underwent single photon emission computed tomography (SPECT) with Tc-99m HMPAO before and after 12 weeks of treatment with inositol. Whole brain voxel-wise SPM was used to assess differences in perfusion between responders and nonresponders before and after treatment as well as the effect of treatment for the group as a whole. There was 1) deactivation in OCD responders relative to nonresponders following treatment with inositol in the left superior temporal gyrus, middle frontal gyrus and precuneus, and the right paramedian post-central gyrus; 2) no significant regions of deactivation for the group as a whole posttreatment; and 3) a single cluster of higher perfusion in the left medial prefrontal region in responders compared to nonresponders at baseline. Significant reductions in the YBOCS and CGI-severity scores followed treatment. These data are only partly consistent with previous functional imaging work on OCD. They may support the idea that inositol effects a clinical response through alternate neuronal circuitry to the SSRIs and may complement animal work proposing an overlapping but distinct mechanism of action.",0,0 +6425,Considering PTSD for DSM-5,"This is a review of the relevant empirical literature concerning the DSM-IV-TR diagnostic criteria for PTSD. Most of this work has focused on Criteria A1 and A2, the two components of the A (Stressor) Criterion. With regard to A1, the review considers: (a) whether A1 is etiologically or temporally related to the PTSD symptoms; (b) whether it is possible to distinguish ""traumatic"" from ""non-traumatic"" stressors; and (c) whether A1 should be eliminated from DSM-5. Empirical literature regarding the utility of the A2 criterion indicates that there is little support for keeping the A2 criterion in DSM-5. The B (reexperiencing), C (avoidance/numbing) and D (hyperarousal) criteria are also reviewed. Confirmatory factor analyses suggest that the latent structure of PTSD appears to consist of four distinct symptom clusters rather than the three-cluster structure found in DSM-IV. It has also been shown that in addition to the fear-based symptoms emphasized in DSM-IV, traumatic exposure is also followed by dysphoric, anhedonic symptoms, aggressive/externalizing symptoms, guilt/shame symptoms, dissociative symptoms, and negative appraisals about oneself and the world. A new set of diagnostic criteria is proposed for DSM-5 that: (a) attempts to sharpen the A1 criterion; (b) eliminates the A2 criterion; (c) proposes four rather than three symptom clusters; and (d) expands the scope of the B-E criteria beyond a fear-based context. The final sections of this review consider: (a) partial/subsyndromal PTSD; (b) disorders of extreme stress not otherwise specified (DESNOS)/complex PTSD; (c) cross- cultural factors; (d) developmental factors; and (e) subtypes of PTSD.",0,0 +6426,Senescence alters blood flow responses to acute heat stress,"Renal and splanchnic sympathetic nerve discharge (SND) responses to heating are significantly reduced in senescent compared with young Fischer-344 (F344) rats (Kenney MJ and Fels RJ. Am J Physiol Regul Integr Comp Physiol 283: R513–R520, 2002). However, the functional significance of this finding is not known. We tested the hypothesis that blood flow distribution profiles to heating are altered in senescent (24 mo old) compared with mature (12 mo old) and young (3 mo old) F344 rats. Visceral organ, skeletal muscle, and tail blood flows were determined with the radionuclide-tagged microsphere technique before (control, 38°C) and during heating that increased body temperature to 41°C in anesthetized F344 rats. Vascular conductance in the kidney, stomach, large intestine, pancreas, spleen, and tail was significantly reduced during control before heating in senescent compared with young F344 rats. Heating significantly decreased kidney, stomach, small and large intestine, and pancreas vascular conductance in young and mature but not senescent F344 rats. Vascular conductance at 41°C in the kidney and small intestine was significantly lower and in the stomach tended to be lower in young compared with senescent rats. Splenic conductance increased during heating in young and senescent rats but was highest in young rats. Tail conductance during heating was significantly increased in young rats but remained unchanged in mature and senescent rats. These results demonstrate a marked attenuation in heating-induced vascular conductance changes in senescent rats, suggesting an important functional consequence for the attenuated SND responses to heating in aged rats.",0,0 +6427,Medical students’ experience and perceptions of their final rotation in psychiatry,"<p><strong>Background.</strong> Evaluation of specific courses, rotations or attachments in medical education is common practice.<strong> </strong></p><p><strong>Objective.</strong> To evaluate medical students’ perceptions of their final psychiatry rotation of 7 weeks. </p><p><strong>Methods.</strong> A questionnaire was developed for medical students to give feedback on their psychiatry rotation at Weskoppies Hospital in Tshwane, South Africa. Four scores were developed: (<em>i</em>) a clinical exposure score for psychiatric conditions encountered during the rotation; (<em>ii</em>) an ethics exposure score comprising confidentiality and informed consent; (<em>iii</em>) an admissions exposure score for different admission options; and (<em>iv</em>) a perception score related to students’ experience of the rotation. The evaluation took place over a period of 4 years, between 2006 and 2009.</p><p><strong>Results.</strong> Over the study period, 87% of 708 students completed the questionnaire. The higher number of female respondents (63%) was in accordance with the general student profile. The four resulting scores were: clinical exposure 67%; ethics exposure 78%; admissions exposure 86%; and perceptions 75%. The main strengths of the rotation were identified as the positive learning environment, exposure to patients, discussions and ward conferences, and approaches followed.</p><p><strong>Conclusions. </strong>The conceptualisation of the tool to elicit specific scores was useful for presenting the findings. The student feedback provided valuable information for the psychiatry curriculum planners and teachers, and led to further adaptations to the structure of the rotations and the learning opportunities provided.</p>",0,0 +6428,Social Anxiety Disorder Is Associated With PTSD Symptom Presentation: An Exploratory Study Within A Nationally Representative Sample,"Posttraumatic stress disorder (PTSD) and social anxiety disorder (SAD) demonstrate a high degree of comorbidity (ranging from 14.8% to 46.0%); however, little is known about the nature of this association. Contemporary research has largely focused on treatment-seeking or veteran samples, and may not generalize to the population as a whole. Large-scale epidemiological studies are needed to fill existing gaps in the literature and to clarify this association for the general population. The current study examined whether the presence of comorbid SAD influenced PTSD symptom presentation. The rate of individual PTSD symptoms was investigated among individuals with PTSD and SAD in comparison to those with PTSD alone. Data were obtained from Wave 2 of the National Epidemiological Survey of Alcohol and Related Conditions, a large, nationally representative survey of American adults (n = 34,653). Analyses revealed elevated rates of PTSD symptoms among those with comorbid PTSD and SAD across all symptom clusters, with significant odds ratios ranging from 1.5 to 4.87. Adjusting for depression and other Axis I disorders did not substantially alter study findings. Results suggest that the presence of SAD is associated with differences in the expression of PTSD symptoms.",0,0 +6429,Patients with chronic whiplash can be subgrouped on the basis of symptoms of sensory hypersensitivity and posttraumatic stress,"The lack of efficacy of rehabilitative approaches to the management of chronic whiplash-associated disorders (WAD) may be in part due to heterogeneity of the clinical presentation of this patient population. The aim of this study was to identify homogeneous subgroups of patients with chronic WAD on the basis of symptoms of PTSD and sensory hypersensitivity and to compare the clinical presentation of these subgroups. Successive k-means cluster analyses using 2, 3 and 4 cluster solutions were performed by using data for 331 (221 female) patients with chronic (>3 months) WAD. The 4 cluster solution was identified as the most clinically relevant, yielding 4 distinct clusters: no to mild posttraumatic stress symptoms and no sensory hypersensitivity (nPnH), no to mild posttraumatic stress symptoms and sensory hypersensitivity (nPH), moderate to severe posttraumatic stress and no sensory hypersensitivity (PnH) and moderate to severe posttraumatic stress and sensory hypersensitivity (PH). The nPnH cluster was the largest cluster, comprising 43.5% of the sample. The PH cluster had significantly worse disability, pain intensity, self-reported mental health status and cervical range of motion in comparison to the nPnH and nPH clusters. These data provide further evidence of the heterogeneity of the chronic WAD population and the association of a more complex clinical presentation with higher disability and pain in this patient group.",0,0 +6430,Weighing the Costs of Disaster,"Disasters typically strike quickly and cause great harm. Unfortunately, because of the spontaneous and chaotic nature of disasters, the psychological consequences have proved exceedingly difficult to assess. Published reports have often overestimated a disaster's psychological cost to survivors, suggesting, for example, that many if not most survivors will develop posttraumatic stress disorder (PTSD); at the same time, these reports have underestimated the scope of the disaster's broader impact in other domains. We argue that such ambiguities can be attributed to methodological limitations. When we focus on only the most scientifically sound research--studies that use prospective designs or include multivariate analyses of predictor and outcome measures--relatively clear conclusions about the psychological parameters of disasters emerge. We summarize the major aspects of these conclusions in five key points and close with a brief review of possible implications these points suggest for disaster intervention. 1. Disasters cause serious psychological harm in a minority of exposed individuals. People exposed to disaster show myriad psychological problems, including PTSD, grief, depression, anxiety, stress-related health costs, substance abuse, and suicidal ideation. However, severe levels of these problems are typically observed only in a relatively small minority of exposed individuals. In adults, the proportion rarely exceeds 30% of most samples, and in the vast majority of methodologically sound studies, the level is usually considerably lower. Among youth, elevated symptoms are common in the first few months following a high-impact disaster, but again, chronic symptom elevations rarely exceed 30% of the youth sampled. 2. Disasters produce multiple patterns of outcome, including psychological resilience. In addition to chronic dysfunction, other patterns of disaster outcome are typically observed. Some survivors recover their psychological equilibrium within a period ranging from several months to 1 or 2 years. A sizeable proportion, often more than half of those exposed, experience only transient distress and maintain a stable trajectory of healthy functioning or resilience. Resilient outcomes have been evidenced across different methodologies, including recent studies that identified patterns of outcome using relatively sophisticated data analytic approaches, such as latent growth mixture modeling. 3. Disaster outcome depends on a combination of risk and resilience factors. As is true for most highly aversive events, individual differences in disaster outcomes are informed by a number of unique risk and resilience factors, including variables related to the context in which the disaster occurs, variables related to proximal exposure during the disaster, and variables related to distal exposure in the disaster's aftermath. Multivariate studies indicate that there is no one single dominant predictor of disaster outcomes. Rather, as with traumatic life events more generally, most predictor variables exert small to moderate effects, and it is the combination or additive total of risk and resilience factors that informs disaster outcomes. 4. Disasters put families, neighborhoods, and communities at risk. Although methodologically complex research on this facet of disasters' impact is limited, the available literature suggests that disasters meaningfully influence relationships within and across broad social units. Survivors often receive immediate support from their families, relatives, and friends, and for this reason many survivors subsequently claim that the experience brought them closer together. On the whole, however, the empirical evidence suggests a mixed pattern of findings. There is evidence that social relationships can improve after disasters, especially within the immediate family. However, the bulk of evidence indicates that the stress of disasters can erode both interpersonal relationships and sense of community. Regardless of how they are affected, postdisaster social relations are important predictors of coping success and resilience. 5. The remote effects of a disaster in unexposed populations are generally limited and transient. Increased incidence of extreme distress and pathology are often reported in remote regions hundreds if not thousands of miles from a disaster's geographic locale. Careful review of these studies indicates, however, that people in regions remote to a disaster may experience transient distress, but increased incidence of psychopathology is likely only among populations with preexisting vulnerabilities (e.g., prior trauma or psychiatric illness) or actual remote exposure (e.g., loss of a loved one in the disaster). Finally, we review the implications for intervention. There is considerable interest in prophylactic psychological interventions, such as critical incident stress debriefing (CISD), that can be applied globally to all exposed survivors in the immediate aftermath of disaster. Multiple studies have shown, however, that CISD is not only ineffective but in some cases can actually be psychologically harmful. Other less invasive and more practical forms of immediate intervention have been developed for use with both children and adults. Although promising, controlled evaluations of these less invasive interventions are not yet available. The available research suggests that psychological interventions are more likely to be effective during the short- and long-term recovery periods (1 month to several years postdisaster), especially when used in combination with some form of screening for at-risk individuals. Such interventions should also target the maintenance and enhancement of tangible, informational, and social-emotional support resources throughout the affected community. Language: en",0,0 +6431,Who Develops Posttraumatic Stress Disorder?,"Nearly half of U.S. adults experience at least one traumatic event in their lifetimes, yet only 10% of women and 5% of men develop posttraumatic stress disorder (PTSD). Why this is so is among the most central questions in current PTSD research. This article reviews the current status of knowledge about who develops PTSD, discussing the strengths and weaknesses of the evidence. We describe the major models used to understand responses to traumatic events, as well as future research directions. We also propose that an exclusive focus on individual differences and individual intervention overlooks opportunities to reduce the prevalence of PTSD by modifying factors at the neighborhood, community, or national level.",0,0 +6432,Psychological assessment of aviators captured in World War II.,"Psychological assessments, including administration of the Minnesota Multiphasic Personality Inventory (MMPI) and structured interviews for Axis I mental disorders and posttraumatic stress disorder (PTSD) specifically, were used to describe 33 World War II (WWII) aviators who were held as prisoners of war (POWs) for an average of 14 months. Results showed more elevated MMPI profile patterns than expected given previous research with pilots (Butcher, 1994) and rates of current and lifetime PTSD at 33%, reasoned to derive from POW trauma. Despite this level of psychopathology, WWII aviator POW survivors were found to be more resilient to captivity effects than age-similar nonaviator WWII POW survivors characterized generally by less advantages in education, military rank, and other personal resources. Compared with aviator former POWs of the Vietnam War studied in their mid-life years (Ursano, Boydstun, & Wheatley, 1981), the present sample appeared to be less psychologically robust. Studies of former prisoners of war (POWs) have revealed that war captivity is associated with increased vulnerability to physical and psychological illnesses. Yet, some POW survivors do not exhibit psychological distress or mental disorders following trauma cessation (Kluznik, Speed, Van Valkenburg, & Magraw, 1986; Sutker, Allain, & Winstead, 1993; Ursano, Boydstun, & Wheatley, 1981). Of interest are studies of American servicemen, primarily aviators, held as prisoners in North Vietnam for periods extending up to 7 or 8 years. The Ursano et al. (1981) follow-up of 253 former POW aviators revealed that, in addition to the potent impact of stressor severity, such characteristics as rank at shoot down, college education, and status as pilots and navigators were associated with lessened risk for psychiatric morbidity, although 25% of these men were labeled with mental disorders. Ursano et al. (1981) described aviators as a well-educated, intelligent military subset, homogeneous in achievement needs and potentially resistant to mental disorders. Butcher (1994) published Minnesota Multiphasic Personality Inventory (MMPI) and MMPI-2 profile patterns of applicants for flight crew positions with a major airline. Results showed that airline pilots, many of whom had served military duty, minimized problems on psychological tests and presented themselves as psychologically robust. These studies shed light on the resilience of pilots generally and survivors of Vietnam POW captivity specifically, but little attention has been directed toward study of",0,0 +6433,"Conduct disorder, war zone stress, and war-related posttraumatic stress disorder symptoms in American Indian Vietnam veterans",This study examined whether conduct disorder (CD) was associated with war zone stress and war-related post-traumatic stress disorder (PTSD) symptoms in American Indian (AI) Vietnam veterans. Cross-sectional lay-interview data was analyzed for 591 male participants from the American Indian Vietnam Veterans Project. Logistic regression evaluated the association of CD with odds of high war zone stress and linear regression evaluated the association of CD and PTSD symptom severity. Childhood CD was not associated with increased odds of high war zone stress. Conduct disorder was associated with elevated war-related PTSD symptoms among male AI Vietnam Veterans independent of war zone stress level and other mediators. Future efforts should examine reasons for this association and if the association exists in other AI populations.,0,0 +6434,Gender Comparison of Exposed Trauma and Posttraumatic Stress Disorder in a Community Sample of Adolescents,"This study surveys the prevalence of exposed traumatic events and posttraumatic stress disorder among the high school students. A total of 735 students were selected by stratified cluster sampling. The self-report trauma checklists and Mississippi Scale were used. The most common traumatic experiences were ""witnessing or being in a bad car accident,"" ""getting some really bad news unexpectedly,"" and witnessing violence. The last 2 experiences were more common among girls. The rate of the subjects who scored more than the cutoff point in the Mississippi Scale was 27.2%. There is an extremely high rate of exposed trauma rate, and approximately one third of them have posttraumatic stress disorder symptoms.",0,0 +6435,Pilot Study of Psilocybin Treatment for Anxiety in Patients With Advanced-Stage Cancer,"Researchers conducted extensive investigations of hallucinogens in the 1950s and 1960s. By the early 1970s, however, political and cultural pressures forced the cessation of all projects. This investigation reexamines a potentially promising clinical application of hallucinogens in the treatment of anxiety reactive to advanced-stage cancer.To explore the safety and efficacy of psilocybin in patients with advanced-stage cancer and reactive anxiety.A double-blind, placebo-controlled study of patients with advanced-stage cancer and anxiety, with subjects acting as their own control, using a moderate dose (0.2 mg/kg) of psilocybin.A clinical research unit within a large public sector academic medical center.Twelve adults with advanced-stage cancer and anxiety.In addition to monitoring safety and subjective experience before and during experimental treatment sessions, follow-up data including results from the Beck Depression Inventory, Profile of Mood States, and State-Trait Anxiety Inventory were collected unblinded for 6 months after treatment.Safe physiological and psychological responses were documented during treatment sessions. There were no clinically significant adverse events with psilocybin. The State-Trait Anxiety Inventory trait anxiety subscale demonstrated a significant reduction in anxiety at 1 and 3 months after treatment. The Beck Depression Inventory revealed an improvement of mood that reached significance at 6 months; the Profile of Mood States identified mood improvement after treatment with psilocybin that approached but did not reach significance.This study established the feasibility and safety of administering moderate doses of psilocybin to patients with advanced-stage cancer and anxiety. Some of the data revealed a positive trend toward improved mood and anxiety. These results support the need for more research in this long-neglected field.clinicaltrials.gov Identifier: NCT00302744.",0,0 +6436,Quality of life two years after severe trauma: A single centre evaluation,"Trauma related injuries are a main cause for long-lasting morbidity and disability especially in younger patients with their productive years ahead. On a routine basis, we assessed health related quality of life two years after trauma of severely injured patients at our level-I trauma centre via posted survey.The posted survey included (1) POLO-Chart questionnaire with European Quality of Life (EuroQoL), Short Form Health Survey-36 (SF 36) and the recently developed and validated Trauma Outcome Profile (TOP) combined with (2) single centre data according to TraumaRegister DGU(®) data sets including trauma mechanism, injuries and initial treatment. Inclusion criteria were severely injured patients ≥ 18 years, treated between 2008 and 2010. Exclusion criteria were death, cognitive impairment, lack of German language and denial of participation.129 datasets were eligible for analysis reflecting a typical trauma collective with mean age 44 years, predominantly male (67%), mean ISS 22 and 98% blunt trauma. Two years after trauma, 62% of the patients reported of relevant remaining pain and 64% of severe functional deficit in at least one body region. Sixty-four percent of the patients suffered from decreased overall quality of life (EuroQoL≤0.8). Additionally, all domains of SF-36 were impaired compared to an age and gender adjusted cohort of healthy individuals, especially domains of pain and activity of daily living. These impairments were associated with decreased 'social functioning' and 'emotional role functioning'. TOP results confirmed these findings: Quality of life was decreased in almost every dimension. TOP additionally identified sequels especially in domains of ""Mental Functioning"" and impairments in psychological recovery including post-traumatic stress disorder, depression and anxiety. Socioeconomic impairments were frequent including further hospitalisations (62%), duration of inability to work ≥ 6 month (54%), financial disadvantages (45%) and work loss (26%).Our results demonstrate that multiple trauma patients two years after injury suffer from impairments including persisting pain, functional deficits, mental and socioeconomic deficits. The 'Trauma Outcome Profile' instrument seems a proper tool to discover impairments in trauma patients early on and guide proper rehabilitation resources to the best of the patient.",0,0 +6437,Mental Health Effects of Intimate Terrorism and Situational Couple Violence Among Black and Hispanic Women,"An important aspect of Johnson’s intimate terrorism (IT) and situational couple violence (SCV) typology is his assertion that victims experience different negative outcomes depending on which category of violence they endure. Anderson calls for reexamining this typology to highlight the importance of coercive control with or without physical violence present. Similar to most studies, Anderson’s research uses a sample that includes mostly White women. The current study employs Anderson’s methods and ordinary least squares (OLS) regression analyses, but uses a sample of predominately Black women and Latinas from the 1998 Chicago Women’s Health Risk Study.",0,0 +6438,Internalizing and Externalizing Subtypes in Female Sexual Assault Survivors: Implications for the Understanding of Complex PTSD,"This study replicated and extended findings of internalizing and externalizing subtypes of posttraumatic psychopathology (Miller, M. W., Greif, J. L., & Smith, A. A. (2003). Multidimensional Personality Questionnaire profiles of veterans with traumatic combat exposure: Internalizing and externalizing subtypes. Psychological Assessment , 15, 205–215; Miller, M. W., Kaloupek, D. G., Dillon, A. L., & Keane, T.M. (2004). Externalizing and internalizing subtypes of combat-related PTSD: A replication and extension using the PSY-5 Scales. Journal of Abnormal Psychology, 113, 636–645) to a female sample of rape survivors with chronic PTSD. Cluster analyses of Schedule for Nonadaptive and Adaptive Personality (Clark, L. A. (1996). SNAP—Schedule for Nonadaptive and Adaptive Personality: Manual for administration, scoring, and interpretation . Minneapolis: University of Minnesota Press.) temperament scale profiles from 143 women with PTSD partitioned the sample into a simple PTSD cluster, defined by normal range personality scores and moderate symptomatology, and 2 more “complex” clusters distinguished by more severe tendencies towards externalizing or internalizing psychopathology. Externalizers were characterized by disinhibition, substance dependence, and Cluster B personality disorder features; internalizers by low positive temperament, high rates of major depressive disorder, and elevations on measures of schizoid and avoidant personality disorder.",0,0 +6439,Post-traumatic stress disorder without the trauma,"Examples are reported of PTSD cases showing full symptomatology (intrusive imagery, avoidance behaviour, disordered arousal) in the absence of a single, acute, dramatic trauma of the kind required by the current DSM-III-R definition. Such trauma is thus not a necessary condition for PTSD, and other evidence shows it to be not a sufficient condition. It is suggested that the DSM-III-R Axis IV distinction between acute and enduring psychosocial stressors be incorporated into the definition to distinguish two pathways to stress disorder, post-traumatic (PTSD) and prolonged duress (PDSD). Differential treatment implications of the two routes are noted.",0,0 +6440,Traumatic Below-elbow Amputations,"Prehension, intelligence, and erect posture distinguish humans from lower animals. Hands are instrumental for our survival and welfare. We use our hands when we work, recreate, and communicate. A handshake, a touch, a sign, or signal has significant social and communicative meanings. Hands play a major role in defining the skill level of our activities and our level of social expression and integration. Indeed, refined psychomotor precision of hand function may distinguish some individuals among us, gifting society with its more skilled craftsmen, surgeons, artisans, musicians, athletes, and the like in a highly digital world. For others, their hands are critical in providing and caring for their families. Injury severity scores may identify the majority of patients that require amputation; however, injury severity scoring system predictions in individual patients may be problematic and should be used with caution. Amputees require comprehensive multidisciplinary treatment and compassion so that they can successfully overcome their losses. Ultimately, the patients must change, adjust, and adapt to successfully reintegrate themselves into their families, peer groups, job settings, and society as a whole. Early amputation may decrease the incidence and severity of phantom pain compared to amputation after the failure of reconstruction. Early prosthetic fitting, training, and physical rehabilitation; early psychological and sociological support; and early return to work facilitate successful functional recovery. Psychological recovery may be a more arduous and extended process than physical recovery. We must teach our amputees from the outset to use their losses as an incentive for success, assist them to regain their quality of life, and encourage them to act as role models for and to educate others.",0,0 +6441,Posttraumatic Stress Disorder Associated With Combat Service in Iraq or Afghanistan,"Studies of posttraumatic stress disorder (PTSD) prevalence associated with deployment to Iraq or Afghanistan report wide variability, making interpretation and projection for research and public health purposes difficult. This article placed this literature within a military context. Studies were categorized according to deployment time-frame, screening case definition, and study group (operational infantry units exposed to direct combat versus population samples with a high proportion of support personnel). Precision weighted averages were calculated using a fixed-effects meta-analysis. Using a specific case definition, the weighted postdeployment PTSD prevalence was 5.5% (95% CI, 5.4-5.6) in population samples and 13.2% (12.8-13.7) in operational infantry units. Both population-level and unit-specific studies provided valuable and unique information for public health purposes; understanding the military context is essential for interpreting prevalence studies.",0,0 +6442,Regular drinking may strengthen the beneficial influence of social support on depression: Findings from a representative Israeli sample during a period of war and terrorism,"Social support is consistently associated with reduced risk of depression. Few studies have investigated how this relationship may be modified by alcohol use, the effects of which may be particularly relevant in traumatized populations in which rates of alcohol use are known to be high.In 2008 a representative sample of 1622 Jewish and Palestinian citizens in Israel were interviewed by phone at two time points during a period of ongoing terrorism and war threat. Two multivariable mixed effects regression models were estimated to measure the longitudinal association of social support from family and friends on depression symptoms. Three-way interaction terms between social support, alcohol use and time were entered into the models to test for effect modification.Findings indicated that increased family social support was associated with less depression symptomatology (p=<.01); this relationship was modified by alcohol use and time (p=<.01). Social support from friends was also associated with fewer depression symptoms (p=<.01) and this relationship was modified by alcohol use and time as well (p=<.01). Stratified analyses in both models revealed that the effect of social support was stronger for those who drank alcohol regularly than those who did not drink or drank rarely.These findings suggest that social support is a more important protective factor for depression among regular drinkers than among those who do not drink or drink rarely in the context of political violence. Additional research is warranted to determine whether these findings are stable in other populations and settings.",0,0 +6443,Reversible and selective inhibitors of monoamine oxidase A in mental and other disorders,"The clinically tested reversiblc inhibitors of monoamine oxidase A (RIMAs) include brofaromine, moclobemide and toloxatone. Moclobemide has shown unequivocal antidepressant activity against serious deprcssivc illness in 4 placebo-controlled double-blind trials. It has been compared with amitriptyline, imipramine, clomipramine, desipramine, maprotiline, fluoxetine, fluvoxamine, tranylcypromine. toloxatone, mianserin and amineptine in the treatment of depressive disorders. Meta-analysis showed convincing evidence of moclobemide efficacy, comparable with the most potent antidepressants available. The efficacy of moclobemide has been demonstrated in psychotic and non-psychotic depression, in depression with and without melancholia, in endogenous depression (both unipolar and bipolar), in retarded depression and in agitated depression. The efficacy of moelobemide, allied to the unusually benign side effect profile, has led to exploration of its use in other disorders. Two small studies have given encouraging results in the treatment of attention-deficit hyperactivity disorder. Large placebo-controlled studies have shown the activity of moclobemide in the depression that accompanies dementia (such as senile dementia of Alzheimer type). The results also suggested that, in this patient population, cognitive ability improved in parallel. Social phobia has also been shown to improve on treatment with either moclobemide or brofaromine. Clinical trials are in progress on the effect of moclobemide in chronic fatigue syndrome. Moreover, there are encouraging results with the use of brofaromine and moclobemide in panic disorder. Other disorders in which treatment with RIMA is of interest include agoraphobia, bulimia, borderline personality disorder, post-traumatic stress disorder, compulsive hair pulling (trichotillomania), dysmorphophobia, kleptomania as well as various anxiety syndromes.",0,0 +6444,The interrelationships between trauma and internalizing symptom trajectories among adolescents in foster care,"Abstract This study examined the interrelationships between changes in trauma and internalizing symptoms among adolescents in foster care. Using three waves of data from the National Survey of Child and Adolescent Well-Being, growth-curve analyses were conducted with a sample of 155 adolescents aged 11–15 in out-of-home care. Findings indicated that the initial level of post-traumatic stress symptoms was significantly associated with the initial level of internalizing symptoms at Wave I and decreases in post-traumatic stress symptoms were significantly associated with decreases in internalizing symptoms from Wave I to Wave IV. Viewing trauma and internalizing symptoms as interrelated affords increased understanding of ways in which adolescents who have experienced high levels of stress express their needs. As such, it may be clinically beneficial to conduct an evaluation of trauma symptoms for adolescents in foster care, regardless of whether there has been a documented history of a traumatic event. Doing so may provide a more comprehensive view into the underlying influences of adolescent behaviors and help capture a broader clinical picture necessary for effective intervention.",0,0 +6445,Psychometric evaluation of Horowitz's impact of event scale: A review,"Despite being developed before the formal introduction of posttraumatic stress disorder (PTSD) within the diagnostic literature, the Impact of Event Scale (Horowitz, Wilner, & Alvarez, 1979) remains one of the most widely used self-report measures of posttraumatic stress. This paper presents an overview of research using the IES in an attempt to assess its psychometric status. It is concluded that the psychometric properties of the IES are satisfactory (although not as a PTSD diagnostic measure) and that continued use of the IES as a measure of intrusive and avoidant processes is warranted.",0,0 +6446,Social reactions as a predictor of PTSD symptom trajectories following sexual assault,"Introduction: Most research on the psychological impact of sexual assault has been cross-sectional. Using a longitudinal design, we examined the course of PTSD in a group of recent rape survivors. We found 4 distinct PTSD symptom trajectories that we labeled resilience, recovery, moderate chronicity, and high chronicity (Steenkamp et al, 2010). Studies have shown that negative social reactions to assault disclosure correlate with greater PTSD symptom severity (Borja, 2006; Ullman & Filipas, 2001) and can deter victims from seeking help (Ahrens, 2006). However, the extent to which social reactions to rape predict different symptom courses is unknown. Method: Sixty-nine sexual assault survivors completed online questionnaires monthly for the first 4 months following the assault. The Social Reactions Questionnaire (SRQ) assesses 7 types of positive and negative reactions to sexual assault disclosure (emotional support, treat differently, distraction, take control, informational support, victim blame, and egocentric; Ullman, 2000). PTSD symptom severity was assessed using the PTSD Checklist (PCL-C, Weathers et al, 1993). Results: An analysis of variance indicated that the moderate chronic group reported significantly more negative reactions than both the recovery (P = .008) and resilience (P = .04) groups. Specifically, negative reactions where the person treated the survivor differently or took control of the situation distinguished between the moderate chronic and the recovery/resilience groups. Blaming the victim or making the situation about the person instead of the survivor distinguished between the moderate chronic and the resilience groups. Discussion: Consistent with previous studies, negative social reactions to assault disclosure were associated with greater PTSD symptom severity. However, this is the first study demonstrating that social reactions after sexual assault predict distinct PTSD trajectories, with negative reactions predicting a chronic PTSD symptom course. This suggests that reactions of mental health providers, friends, and family may affect PTSD symptom trajectories in survivors and has implications for improving social reactions to sexual assault disclosure. Public Health Significance: In addition to interventions directly targeting survivors' distress and PTSD symptoms after sexual assault, it may be helpful to educate others on the impact of negative social reactions after sexual assault disclosure.",0,0 +6447,Post-traumatic stress disorder in different types of stress (clinical features and treatment),"Two types of stress situation were compared: involvement in combat actions and working in the post-Chernobyl atomic energy station clean-up. A total of 30 subjects involved in combat actions (combatants) and 33 clean-up workers were observed for 5-6 years and 15-17 years after involvement in stress situations. Mean ages in the two groups were 27.0 +/- 2.8 and 43.7 +/- 4.5 years respectively. Clinical features were analyzed in terms of the major criteria of post-traumatic stress disorder (PTSD)--""immersion"" in the experience, ""avoidance,"" ""hyperexcitability,"" and ""social functioning."" There were both common features in the two groups of subjects as well as individual characteristics dependent on the nature of the stress. Patients were treated with Coaxil at a dose of 37.5 mg/day for four weeks. In both groups of patients, Coaxil had the most favorable effects on immersion and hyperexcitability, which improved social adaptation. The ""avoidance"" symptom was more resistant. These studies lead to the conclusion that Coaxil is an effective agent for the treatment of different types of PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +6448,Clinical sleep disorder profiles in a large sample of trauma survivors: An interdisciplinary view of posttraumatic sleep disturbance,"Study Objectives: To examine the relationship between psychiatric symptoms and self-reported sleep, sleepiness, and nightmare complaints in a convenience sample of 437 trauma survivors. Method: Based on symptom severity reports, individuals were classified as having psychophysiological insomnia (PPI), chronic nightmare disorder (CND), and sleep-disordered breathing (SDB) profiles. Individuals with each symptom profile were compared to individuals without the respective profile on sleep indices, sleepiness-related impairment, and psychiatric distress (anxiety, depression, posttraumatic stress symptoms). Results: Individuals with PPI (76%), CND (79%), SDB (68%), or all three profiles (46%) had significantly worse sleep onset latency, sleep efficiency, total sleep time, sleep-related functional impairment, and psychiatric distress compared to those without each disorder profile. Conclusions: The majority of trauma survivors in this sample suffered from sleep complaints sufficiently severe to warrant independent clinical attention by sleep medicine specialists. Longitudinal studies are necessary to determine whether these disturbances are caused exclusively by PTSD or another sleep disorder comorbid with PTSD.",0,0 +6449,"Effects of Chronic Posttraumatic Stress Disorder on Metabolic Risk, Quality of Life, and Stress Hormones in Aging Former Refugee Children","It is still unclear whether the association between traumatic stress and physical disease is mediated by posttraumatic stress disorder (PTSD). Therefore, we examined the long-term consequences of PTSD on cardiovascular risk, stress hormones, and quality of life in a sample of former refugee children who were severely traumatized more than six decades ago. In 25 subjects with chronic PTSD and 25 trauma-controlled subjects, we measured the variables of metabolic syndrome supplemented by the ankle-brachial index and highly sensitive C-reactive protein. Quality of life was assessed using the 36-item Short-Form Health Survey. Cortisol, adrenocorticotropin-releasing hormone (ACTH), and dehydroepiandrosterone (DHEA) were measured using the low-dose-dexamethasone suppression test. In addition, salivary cortisol was assessed at 8:00 a.m., 12:00 p.m., 4:00 p.m., and 8:00 p.m. We found a significant group effect between participants with and without PTSD regarding quality of life but not in any metabolic parameter including the ankle-brachial index or cortisol, ACTH, and DHEA in plasma before and after dexamethasone or salivary cortisol. The postulated association between traumatic stress and physical illness does not appear to be mediated by PTSD in this population. Nevertheless, the search for subgroups of PTSD patients with childhood traumatization leading to different metabolic and endocrine long-term consequences in aging PTSD patients is needed.",0,0 +6450,Differential Predictors of Transient Stress Versus Posttraumatic Stress Disorder: Evaluating Risk Following Targeted Mass Violence,"Schools have become a common incident site for targeted mass violence, including mass shootings. Although exposure to mass violence can result in significant distress, most individuals are able to fully recover over time, while a minority develop more pervasive pathology, such as PTSD. The present study investigated how several pre- and posttrauma factors predict posttraumatic stress symptoms (PTSS) in both the acute and distal aftermath of a campus mass shooting using a sample with known levels of pretrauma functioning (N=573). Although the largest proportion of participants evidenced resilience following exposure to the event (46.1%), many reported high rates of PTSS shortly after the shooting (42.1%) and a smaller proportion (11.9%) met criteria for probable PTSD both in the acute and more distal aftermath of the event. While several preshooting factors predicted heightened PTSS after the shooting, prior trauma exposure was the only preshooting variable shown to significantly differentiate between those who experienced transient versus prolonged distress. Among postshooting predictors, individuals reporting greater emotion dysregulation and peritraumatic dissociative experiences were over four times more likely to have elevated PTSS 8months postshooting compared with those reporting less dysregulation and dissociative experiences. Individuals with less exposure to the shooting, fewer prior traumatic experiences, and greater satisfaction with social support were more likely to recover from acute distress. Overall, results suggest that, while pretrauma factors may differentiate between those who are resilient in the aftermath of a mass shooting and those who experience heightened distress, several event-level and posttrauma coping factors help distinguish between those who eventually recover and those whose PTSD symptoms persist over time.",0,0 +6451,Lifetime Prevalence of Psychiatric Disorders among Parents of Children with Bipolar I Disorder: Parental Difference,"Background . Evaluation of family system is an important area in the context of child and adolescent mental health. This study aimed to estimate psychiatric disorders in parents of children and adolescents with bipolar I disorder (BID). Methods and Materials . In this cross-sectional study, during 2012-2013, all of the children and adolescents diagnosed with BID based on Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version were included. All of the parents (both mother and father) were evaluated by Structured Clinical Interview for DSM-IV-TR . Statistical Analysis . Prevalence rates are reported and independent-sample t -test and chi-square test were used when appropriate. Results . A total of 108 families were interviewed. 25% of mothers and 33% of fathers met the criteria for at least one psychiatric disorder, with major depressive disorder, BMD, and cluster B personality disorder being more prevalent. Fathers were more likely to receive a dual psychiatric diagnosis. Cluster B personality disorder and substance dependence were more prevalent among fathers while major depressive disorder was more prevalent among mothers. Conclusion . This study confirmed a higher prevalence of psychiatric disorders in parents of children with BID and emphasizes parental evolution.",0,0 +6452,"Internalizing disorders and leukocyte telomere erosion: a prospective study of depression, generalized anxiety disorder and post-traumatic stress disorder","There is evidence that persistent psychiatric disorders lead to age-related disease and premature mortality. Telomere length has emerged as a promising biomarker in studies that test the hypothesis that internalizing psychiatric disorders are associated with accumulating cellular damage. We tested the association between the persistence of internalizing disorders (depression, generalized anxiety disorder and post-traumatic stress disorder) and leukocyte telomere length (LTL) in the prospective longitudinal Dunedin Study (n=1037). Analyses showed that the persistence of internalizing disorders across repeated assessments from ages 11 to 38 years predicted shorter LTL at age 38 years in a dose-response manner, specifically in men (β=-0.137, 95% confidence interval (CI): -0.232, -0.042, P=0.005). This association was not accounted for by alternative explanatory factors, including childhood maltreatment, tobacco smoking, substance dependence, psychiatric medication use, poor physical health or low socioeconomic status. Additional analyses using DNA from blood collected at two time points (ages 26 and 38 years) showed that LTL erosion was accelerated among men who were diagnosed with internalizing disorder in the interim (β=-0.111, 95% CI: -0.184, -0.037, P=0.003). No significant associations were found among women in any analysis, highlighting potential sex differences in internalizing-related telomere biology. These findings point to a potential mechanism linking internalizing disorders to accelerated biological aging in the first half of the life course, particularly in men. Because internalizing disorders are treatable, the findings suggest the hypothesis that treating psychiatric disorders in the first half of the life course may reduce the population burden of age-related disease and extend health expectancy.",0,0 +6453,Militærmedicinske erfaringer fra krigen mod terror,,0,0 +6454,Psychological Sequelae of the Station Nightclub Fire: Comparing Survivors with and without Physical Injuries Using a Mixed-Methods Analysis,"Surveying survivors from a large fire provides an opportunity to explore the impact of emotional trauma on psychological outcomes.This is a cross-sectional survey of survivors of The Station Fire. Primary outcomes were post-traumatic stress (Impact of Event Scale - Revised) and depressive (Beck Depression Inventory) symptoms. Linear regression was used to examine differences in symptom profiles between those with and without physical injuries. The free-response section of the survey was analyzed qualitatively to compare psychological sequelae of survivors with and without physical injuries.104 participants completed the study survey; 47% experienced a burn injury. There was a 42% to 72% response rate range. The mean age of respondents was 32 years, 62% were male, and 47% experienced a physical injury. No significant relationships were found between physical injury and depressive or post-traumatic stress symptom profiles. In the qualitative analysis, the emotional trauma that survivors experienced was a major, common theme regardless of physical injury. Survivors without physical injuries were more likely to experience survivor guilt, helplessness, self-blame, and bitterness. Despite the post-fire challenges described, most survivors wrote about themes of recovery and renewal.All survivors of this large fire experienced significant psychological sequelae. These findings reinforce the importance of mental health care for all survivors and suggest a need to understand factors influencing positive outcomes.",0,0 +6455,Post-traumatic stress disorder: An overview and its relationship to closed head injuries,"While exposure to traumatic psychological and physical trauma can produce posttraumatic stress disorder (PTSD), multiple factors determine whether a person will develop PTSD following trauma exposure. PTSD has a high rate of comorbidity with psychiatric, substance abuse, and somatization disorders. Persons with PTSD experience profound and persistent alterations in their physiological reactivity to internal and external stimuli which prevents them from utilizing their emotions to process incoming information. These patients have chronically high levels of sympathetic nervous system activity and low levels of glucocorticoids to cope with stress and modulate their catecholamine levels. Neuropsychological assessment of patients with PTSD depends to a large degree on the sensitivity of the measures which are utilized and a pre-existing history of learning disabilities, head trauma, and/or neurological disorders. While closed head injuries (CHI) are unlikely to produce PTSD symptoms, persons with CHI are likely to develop PTSD symptoms if they are exposed to trauma prior to the onset of retrograde amnesia or after the resolution of post-traumatic amnesia. If the traumatic event occurs while the patient with CHI is amnestic or unconscious, they are unlikely to develop PTSD symptoms. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6456,Predicting Treatment Outcome in PTSD: A Longitudinal Functional MRI Study on Trauma-Unrelated Emotional Processing,"In about 30-50% of patients with posttraumatic stress disorder (PTSD), symptoms persist after treatment. Although neurobiological research has advanced our understanding of PTSD, little is known about the neurobiology underlying persistence of PTSD. Two functional MRI scans were collected from 72 war veterans with and without PTSD over a 6- to 8-month interval, during which PTSD patients received trauma-focused therapy. All participants performed a trauma-unrelated emotional processing task in the scanner. Based on post-treatment symptom severity, a distinction was made between remitted and persistent patients. Behavioral and imaging measures of trauma-unrelated emotional processing were compared between the three groups (remitted patients, N=21; persistent patients, N=22; and combat controls, N=25) with repeated-measures (pre- and post-treatment) analyses. Second, logistic regression was used to predict treatment outcome. Before and after treatment, persistent patients showed a higher dorsal anterior cingulate cortex (dACC) and insula response to negative pictures compared with remitted patients and combat controls. Before treatment, persistent patients showed increased amygdala activation in response to negative pictures compared with remitted patients. The remitted patients and combat controls did not differ on the behavioral or imaging measures. Finally, higher dACC, insula, and amygdala activation before treatment were significant predictors of symptom persistence. Our results highlight a pattern of brain activation that may predict poor response to PTSD treatment. These findings can contribute to the development of alternative or additional therapies. Further research is needed to elucidate the heterogeneity within PTSD and describe how differences in neural function are related to treatment outcome. Such approaches are critical for defining parameters to customize PTSD treatment and improve treatment response rates.",0,0 +6457,The Comprehensive Assessment of Defense Style: Measuring Defense Mechanisms in Children and Adolescents,"This study introduces the Comprehensive Assessment of Defense Style (CADS), a new method to assess descriptively the defensive behavior of children and adolescents. Parents of 124 children and adolescents referred to a mental health clinic, of 104 nontreated children, and of 15 children whose fathers were treated for posttraumatic stress disorder completed the CADS. Factor analysis of 28 defenses yielded one mature factor, one immature factor of defenses expressed in relations with the environment (other-oriented), and one of defenses expressed in relations with the self (self-oriented). The CADS significantly discriminated between patients and nonpatients. Psychiatric patients used more immature and fewer mature defenses than control subjects, and adolescents used more mature and fewer other-oriented defenses than children. Girls used more mature and fewer other-oriented defenses than boys. The reliability and validity data of the CADS are encouraging. The three defense factors may be implemented for diagnostic and clinical purposes as well as for screening for psychopathology risk in untreated populations.",0,0 +6458,Cortical hyperexcitability in post-traumatic stress disorder secondary to minor accidental head trauma: a neurophysiologic study.,"We applied paired transcranial magnetic stimulation (pTMS) to patients with post-traumatic stress disorder (PTSD) secondary to minor accidental head trauma. Our purpose was to determine the potential abnormality of motor cortex excitability in this pathologic condition.pTMS stimulation, according to the conditioning-test paradigm employing interstimulus intervals (ISIs) of 1-6 ms, was used to investigate intracortical inhibition in control subjects and patients with PTSD. The study population consisted of 14 patients who had developed PTSD following minor head trauma, 12 healthy volunteers without a clinical history of head trauma and 11 healthy subjects who had reported accidental minor head trauma 1-4 months before the study. This clinical electrophysiologic study was performed at the Department of Neuroscience, University of Rome ""Tor Vergata.""All patients with PTSD exhibited a significantly lower motor evoked potential (MEP) inhibition than controls at 2 ms, 3 ms and 4 ms ISI. The statistical analysis of the pTMS protocol showed a significant effect (F2,36 = 25.63, p < 0.001) of the factor ""group,"" because patients with PTSD showed a mean conditioned MEP amplitude higher than that observed in both control groups for all 6 ISIs analyzed. The ""ISI"" factor was also significant (F5,180 = 89.85, Greenhouse-Geisser epsilon = 0.35; p < 0.001), with the mean conditioned MEP amplitude increasing from 22.5% to 127.8% as the ISI increased from 1 ms to 6 ms. Finally, the interaction of group with ISI was also significant (F10,180 = 8.97, p < 0.001), showing that the condition of PTSD secondary to head trauma was able to affect the MEP amplitude at different ISIs.Our results demonstrate that PTSD can give rise to abnormalities in intracortical inhibition. Our results provide further evidence that alterations in cortical inhibitory circuits may underlie specific forms of neuroticism in humans.",0,0 +6459,Low socioeconomic status and mental health outcomes in colorectal cancer survivors: disadvantage? advantage? … or both?,"The goal of this study is to examine the relationship between socioeconomic status (SES) and both positive and negative mental health (MH) outcomes in a population-based sample of colorectal cancer survivors. On the basis of theoretical conceptualizations of trauma and posttraumatic growth, low SES was hypothesized to be positively associated with both greater negative MH outcomes (e.g., distress) and greater positive MH outcomes (e.g., growth).Colorectal cancer survivors (n = 1300; 57% male; mean age 69.4 and 4.0 years post-diagnosis) were recruited using a regional, population-based cancer registry in the Netherlands and completed a questionnaire assessing current negative and positive MH outcomes. Low, medium, and high SES respondents were identified using an area-level indicator of SES based on aggregated individual fiscal data on monetary home value and household income.Analysis of covariance and logistic regression analyses indicated that low SES was a risk factor for greater negative MH outcomes. Relative to high SES survivors, low SES survivors reported poorer status on nine indices of MH, and high SES survivors were about 50% less likely to report clinically important levels of anxiety and depression. Results provided partial support for the hypothesis low SES was a 'risk' factor for greater positive MH outcomes. Relative to high SES survivors, low SES survivors reported greater positive MH outcomes on 2 of 5 positive MH indices examined (Positive Self-Evaluation, Meaning of Cancer).Study findings are the first to suggest that low SES might increase the likelihood of both greater negative as well as positive MH outcomes in cancer survivors.",0,0 +6460,Improving mental health is key to reduce violence in Israel and Gaza,"The prolonged and complex Israeli–Palestinian conflict profoundly affects the health and wellbeing of both Palestinians and Israelis.1 The present escalation between Hamas and Israel follows a well-worn pattern of confrontation. Superior Israeli military force means that Palestinians have more physical casualties. On both sides, however, many civilians are exposed to conflict-related stressors, and neither Israelis nor Palestinians are immune to their mental or physical health consequences.",0,0 +6461,Psychiatric disorders and functional impairment among disaster victims after exposure to a natural disaster: A population based study,"We aimed to examine psychiatric morbidity and functional impairment after a natural disaster.Norwegian tourists who survived the 2004 tsunami in Khao Lak (n = 63), a severely affected area in Thailand, were interviewed in person 2.5 years after the disaster. The examination included the Mini International Neuropsychiatric Interview, the PTSD module of the Structured Clinical Interview for DSM-IV Axis I disorders, the Work and Social Adjustment Scale (WSAS), the Global Assessment of Functioning function score (GAF-F), and questions covering background characteristics and disaster exposure.The most prevalent disorders were specific phobia (30.2%), agoraphobia (17.5%), social anxiety disorder (11.1%), PTSD (11.1%), major depressive disorder (MDD, 11.1%), and dysthymic disorder (DD, 11.1%). In 24 of the 40 respondents with a current psychiatric disorder, symptoms had originated after the tsunami. The post-tsunami 2.5 year incidence of PTSD and MDD was 36.5% and 28.6%, respectively. Multivariable regression analysis showed that the depressive disorders (MDD and DD) and PTSD were associated with self-reported functional impairment (WSAS), and the depressive disorders were associated with clinician assessed functional impairment (GAF-F).Small sample size and high education may limit the generalizability of the results.Depression and anxiety disorders were common among disaster victims 2.5 years after the 2004 tsunami. Psychiatric disorders other than PTSD, especially depressive disorders, are of clinical importance when considering long-term mental health effect of disasters.",0,0 +6462,Comparing the utility of homogeneous subtypes of cocaine use and related behaviors with DSM-IV cocaine dependence as traits for genetic association analysis,"Because DSM-IV cocaine dependence (CD) is heterogeneous, it is not an optimal phenotype to identify genetic variation contributing to risk for cocaine use and related behaviors (CRBs). We used a cluster analytic method to differentiate homogeneous, highly heritable subtypes of CRBs and to compare their utility with that of the DSM-IV CD as traits for genetic association analysis. Clinical features of CRBs and co-occurring disorders were obtained via a poly-diagnostic interview administered to 9,965 participants in genetic studies of substance dependence. A subsample of subjects (N = 3,443) were genotyped for 1,350 single nucleotide polymorphisms (SNPs) selected from 130 candidate genes related to addiction. Cluster analysis of clinical features of the sample yielded five subgroups, two of which were characterized by heavy cocaine use and high heritability: a heavy cocaine use, infrequent intravenous injection group and an early-onset, heavy cocaine use, high comorbidity group. The utility of these traits was compared with the CD diagnosis through association testing of 2,320 affected subjects and 480 cocaine-exposed controls. Analyses examined both single SNP (main) and SNP–SNP interaction (epistatic) effects, separately for African-Americans and European-Americans. The two derived subtypes showed more significant P values for 6 of 8 main effects and 7 of 8 epistatic effects. Variants in the CLOCK gene were significantly associated with the heavy cocaine use, infrequent intravenous injection group, but not with the DSM-IV diagnosis of CD. These results support the utility of subtypes based on CRBs to detect risk variants for cocaine addiction. © 2013 Wiley Periodicals, Inc.",0,0 +6463,Characterization of Post-traumatic Stress Disorder Using Resting-State fMRI with a Multi-level Parametric Classification Approach,"Functional neuroimaging studies have found intra-regional activity and inter-regional connectivity alterations in patients with post-traumatic stress disorder (PTSD). However, the results of these studies are based on group-level statistics and therefore it is unclear whether PTSD can be discriminated at single-subject level, for instance using the machine learning approach. Here, we proposed a novel framework to identify PTSD using multi-level measures derived from resting-state functional MRI (fMRI). Specifically, three levels of measures were extracted as classification features: (1) regional amplitude of low-frequency fluctuations (univariate feature), which represents local spontaneous synchronous neural activity; (2) temporal functional connectivity (bivariate feature), which represents the extent of similarity of local activity between two regions, and (3) spatial functional connectivity (multivariate feature), which represents the extent of similarity of temporal correlation maps between two regions. Our method was evaluated on 20 PTSD patients and 20 demographically matched healthy controls. The experimental results showed that the features of each level could successfully discriminate PTSD patients from healthy controls. Furthermore, the combination of multi-level features using multi-kernel learning can further improve the classification performance. Specifically, the classification accuracy obtained by the proposed framework was 92.5 %, which was an increase of at least 5 and 17.5 % from the two-level and single-level feature based methods, respectively. Particularly, the limbic structure and prefrontal cortex provided the most discriminant features for classification, consistent with results reported in previous studies. Together, this study demonstrated for the first time that patients with PTSD can be identified at the individual level using resting-state fMRI data. The promising classification results indicated that this method may provide a complementary approach for improving the clinical diagnosis of PTSD. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0,0 +6464,Assessing Positive and Negative Changes in the Aftermath of Adversity: Psychometric Evaluation of the Changes in Outlook Questionnaire.,"The Changes in Outlook Questionnaire (CiOQ; S. Joseph, R. Williams, & W. Yule, 1993) is a 26-item self-report measure that was designed to assess positive and negative changes in the aftermath of adversity. This article had 3 aims: 1st, to investigate the factor structure of the CiOQ; 2nd, to test for internal consistency reliability and convergent and discriminant validity; and, 3rd, to investigate the association between positive and negative changes in outlook, posttraumatic stress, and psychological distress. Three studies are reported. Study 1 provides evidence that positive and negative changes are statistically separable and that the 2-factor model is a better fit than the 1-factor model. Studies 2 and 3 provide evidence for internal consistency reliability, convergent and discriminant validity of the CiOQ, and its associations with posttraumatic stress and psychological distress. In conclusion, the CiOQ has much promise for research on responses to stressful and traumatic events.",0,0 +6465,Nursing Home Disaster Planning and Response: A Policy Perspective,"Nursing home residents are among the most vulnerable members of a community threatened by disaster. In the past, insufficient planning has resulted in preventable morbidity and mortality for nursing home residents during disasters. State and federal policies have evolved over the past decade to improve oversight of nursing home disaster planning. However, continued political advocacy is critically necessary to promote the safety of nursing home residents during potential emergencies and, especially, naturally occurring disasters. Opportunities exist to improve nursing home disaster response, including better preparation and training and dedicated resources for data management and oversight.",0,0 +6466,Testing the latent structure of posttraumatic stress disorder: A taxometric study of combat veterans,"Since the diagnosis of posttraumatic stress disorder (PTSD) first appeared in the psychiatric nomenclature in 1980, considerable debate has revolved around the nature of the condition. Specifically, is PTSD best conceptualized as one end of a continuum of human response to traumatic stress or does it represent a discontinuous latent category? Two taxometric procedures were used to investigate this issue in a random community sample of 692 Australian combat veterans, using structured interview and self-report instruments to assess PTSD symptomatology. Findings favored a dimensional model of PTSD, consistent with previous taxometric work on treatment-seeking samples (A. Ruscio, Ruscio, & Keane, 2002). Implications are drawn for the conceptualization, etiology, and assessment of PTSD.",0,0 +6467,Seeking Safety treatment for male veterans with a substance use disorder and post-traumatic stress disorder symptomatology,"To determine whether substituting Seeking Safety (SS), a manualized therapy for comorbid substance use disorders (SUD) and post-traumatic stress disorder (PTSD) for part of treatment-as-usual (TAU) improves substance use outcomes.Randomized controlled effectiveness trial.Out-patient Veterans Administration Health Care System SUD clinic.Ninety-eight male military Veterans with a SUD and co-occurring PTSD symptomatology.Drug and alcohol use and PTSD severity, measured on the first day of treatment, and 3 (i.e. the planned end of SS sessions) and 6 months following the baseline assessment. Treatment attendance and patient satisfaction were measured following treatment (3-month follow-up). Active coping was measured at treatment intake and following treatment.SS compared to TAU was associated with better drug use outcomes (P < 0.05), but alcohol use and PTSD severity decreased equally under both treatments (P's < 0.01). SS versus TAU was associated with increased treatment attendance, client satisfaction and active coping (all P's < 0.01). However, neither these factors nor decreases in PTSD severity mediated the effect of treatment on drug use.The manualized treatment approach for substance use disorder, Seeking Safety, is well received and associated with better drug use outcomes than 'treatment as usual' in male veterans with post-traumatic stress disorder. However, the mechanism of its effect is unclear.",0,0 +6468,Latent structure of the proposed ICD-11 post-traumatic stress disorder symptoms: Implications for the diagnostic algorithm,"Background The latent structure of the proposed ICD-11 post-traumatic stress disorder (PTSD) symptoms has not been explored. Aims To investigate the latent structure of the proposed ICD-11 PTSD symptoms. Method Confirmatory factor analyses using data from structured clinical interviews administered to injury patients ( n = 613) 6 years post-trauma. Measures of disability and psychological quality of life (QoL) were also administered. Results Although the three-factor model implied by the ICD-11 diagnostic criteria fit the data well, a two-factor model provided equivalent, if not superior, fit. Whereas diagnostic criteria based on this two-factor model resulted in an increase in PTSD point prevalence (5.1% v. 3.4%; z = 2.32, P <0.05), they identified individuals with similar levels of disability ( P = 0.933) and QoL ( P = 0.591) to those identified by the ICD-11 criteria. Conclusions Consistent with theorised reciprocal relationships between re-experiencing and avoidance in PTSD, these findings support an alternative diagnostic algorithm requiring at least two of any of the four re-experiencing/avoidance symptoms and at least one of the two hyperarousal symptoms.",0,0 +6469,The limits of resilience: Distress following chronic political violence among Palestinians,"We examined posttraumatic stress disorder (PTSD) and depression symptom trajectories during ongoing exposure to political violence, seeking to identify psychologically resilient individuals and the factors that predict resilience. Face-to-face interviews were conducted with a random sample of 1196 Palestinian adult residents of the West Bank, Gaza, and East Jerusalem across three occasions, six months apart (September 2007-November 2008). Latent growth mixture modeling identified PTSD, and depression symptom trajectories. Results identified three PTSD trajectories: moderate-improving (73% moderate symptoms at baseline, improving over time), severe-chronic (23.2% severe and elevated symptoms over the entire year); and severe-improving (3.5% severe symptoms at baseline and marked improvement over time). Depression trajectories were moderate-improving (61.5%); severe-chronic (24.4%); severe-improving (14.4%). Predictors of relatively less severe initial symptom severity, and improvement over time for PTSD were less political violence exposure and less resource loss; and for depression were younger age, less political violence exposure, lower resource loss, and greater social support. Loss of psychosocial and material resources was associated with the level of distress experienced by participants at each time period, suggesting that resource-based interventions that target personal, social, and financial resources could benefit people exposed to chronic trauma.",1,0 +6470,Underlying Dimensions of DSM-5 Posttraumatic Stress Disorder and Major Depressive Disorder Symptoms,"This study examined the relationship between the underlying latent factors of major depression symptoms and DSM-5 posttraumatic stress disorder (PTSD) symptoms (American Psychiatric Association, 2013). A nonclinical sample of 266 participants with a trauma history participated in the study. Confirmatory factor analyses were conducted to evaluate the fit of the DSM-5 PTSD model and dysphoria model, as well as a depression model comprised of somatic and nonsomatic factors. The DSM-5 PTSD model demonstrated somewhat better fit over the dysphoria model. Wald tests indicated that PTSD’s negative alterations in cognitions and mood factor was more strongly related to depression’s nonsomatic factor than its somatic factor. This study furthers a nascent line of research examining the relationship between PTSD and depression factors in order to better understand the nature of the high comorbidity rates between the two disorders. Moreover, this study provides an initial analysis of the new DSM-5 diagnostic criteria for PTSD.",0,0 +6471,Toward a visuospatial developmental account of sequence-space synesthesia,"Sequence-space synesthetes experience some sequences (e.g., numbers, calendar units) as arranged in spatial forms, i.e., spatial patterns in their mind's eye or even outside their body. Various explanations have been offered for this phenomenon. Here we argue that these spatial forms are continuous with varieties of non-synesthetic visuospatial imagery and share their central characteristics. This includes their dynamic and elaborative nature, their involuntary feel, and consistency over time. Drawing from literatures on mental imagery and working memory, we suggest how the initial acquisition and subsequent elaboration of spatial forms could be accounted for in terms of the known developmental trajectory of visuospatial representations. This extends from the formation of image-based representations of verbal material in childhood to the later maturation of dynamic control of imagery. Individual differences in the development of visuospatial style also account for variation in the character of spatial forms, e.g., in terms of distinctions such as visual versus spatial imagery, or ego-centric versus object-based transformations.",0,0 +6472,Cognitive processing therapy for veterans with posttraumatic stress disorder: A comparison between outpatient and residential treatment.,"Across the Veterans Affairs (VA) Healthcare System, outpatient and residential posttraumatic stress disorder (PTSD) treatment programs are available to veterans of all ages and both genders; however, no research to date has compared these treatment options. This study compared veterans who received outpatient (n = 514) to those who received residential treatment (n = 478) within a VA specialty clinic on demographic and pretreatment symptom variables. Further, the study examined pre- to posttreatment symptom trajectories across the treatment programs.All 992 veterans met diagnostic criteria for PTSD and attended at least 1 session of cognitive processing therapy (CPT) in either the outpatient or residential program. Bivariate analyses were utilized to investigate differences between samples on demographic variables and severity of pretreatment symptoms. Multilevel modeling (MLM) was used to investigate the change in symptomatology between the 2 samples from pre- to posttreatment.Analyses indicated that the samples differed on all demographic and pretreatment symptom variables, with residential patients reporting higher scores on all assessment measures. MLM results demonstrated that symptom scores improved for all veterans across time, with outpatients consistently reporting fewer symptoms at both time points. The time by program interaction was significant for PTSD-related symptom trajectories, but not for the depression-related symptom trajectory.This is the 1st study to compare pretreatment characteristics and treatment outcome between veterans receiving outpatient and residential PTSD treatment. Findings may help clinicians select appropriate care for their patients by identifying relevant pretreatment characteristics and generally informing expectations of treatment outcome.",0,0 +6473,"Altered gene expression of the innate immune, neuroendocrine, and nuclear factor-kappa B (NF-κB) systems is associated with posttraumatic stress disorder in military personnel","Whole transcriptome analysis provides an unbiased examination of biological activity, and likely, unique insight into the mechanisms underlying posttraumatic stress disorder (PTSD) and comorbid depression and traumatic brain injury. This study compared gene-expression profiles in military personnel with PTSD (n=28) and matched controls without PTSD (n=27) using HG-U133 Plus 2.0 microarrays (Affymetrix), which contain 54,675 probe sets representing more than 38,500 genes. Analysis of expression profiles revealed 203 differentially expressed genes in PTSD, of which 72% were upregulated. Using Partek Genomics Suite 6.6, differentially expressed transcription clusters were filtered based on a selection criterion of ≥1.5 relative fold change at a false discovery rate of ≤5%. Ingenuity Pathway Analysis (Qiagen) of the differentially expressed genes indicated a dysregulation of genes associated with the innate immune, neuroendocrine, and NF-κB systems. These findings provide novel insights that may lead to new pharmaceutical agents for PTSD treatments and help mitigate mental and physical comorbidity risk.",0,0 +6474,Typologies of posttraumatic stress disorder in the U.S. adult population,"Posttraumatic stress disorder (PTSD) is characterized by heterogeneous clusters of re-experiencing, avoidance, numbing, and hyperarousal symptoms. However, data are lacking regarding the predominant, population-based typologies of this disorder, and how they are linked to trauma-related characteristics, psychiatric comorbidities, and health-related quality of life.We used latent class analyses (LCAs) to evaluate predominant typologies of PTSD in a nationally representative sample of 2463 U.S. adults with PTSD. Multinomial logistic regression analyses were then conducted to evaluate trauma-related characteristics, psychiatric comorbidities, and health-related quality of life variables associated with these typologies.LCAs revealed three predominant typologies of PTSD-Anxious-Re-experiencing (weighted prevalence=32.2%), Dysphoric (32.8%), and High Symptom (35.0%). Compared to the Dysphoric class, the Anxious-Re-experiencing and High Symptom classes were more likely to report sexual assault, physical assault, and military combat as their worst traumatic events; had an earlier age of onset and longer duration of PTSD; and were more likely to be diagnosed with nicotine dependence and borderline personality disorder, to have attempted suicide, and had poorer physical health-related quality of life (HRQoL). The High Symptom class had increased odds of all disorders, suicide attempts, and the poorest HRQoL.Diagnoses were based on DSM-IV criteria and cross-sectional analyses preclude examination of how PTSD typologies are temporally related to other variables.PTSD in the general U.S. adult population is characterized by three predominant typologies, which are differentially linked to trauma and clinical characteristics. These findings underscore the importance of personalized approaches to the assessment, monitoring, and treatment of PTSD that take into consideration the heterogeneous manifestations of this disorder.",0,0 +6475,Mental health outcomes at the Jersey Shore after Hurricane Sandy.,"On October 29, 2012, Hurricane Sandy made landfall in the most densely populated region in the US. In New Jersey, thousands of families were made homeless and entire communities were destroyed in the worst disaster in the history of the state. The economic impact of Sandy was huge, comparable to Hurricane Katrina. The areas that sustained the most damage were the small- to medium-sized beach communities along New Jersey's Atlantic coastline. Six months following the hurricane, we conducted a random telephone survey of 200 adults residing in 18 beach communities located in Monmouth County. We found that 14.5% (95% CI = 9.9-20.2) of these residents screened positive for PTSD and 6.0% (95% CI = 3.1-10.2) met criteria for major depression. Altogether 13.5% (95% CI = 9.1-19.0) received mental health counseling and 20.5% (95% CI = 15.1-26.8) sought some type of mental health support in person or online, rates similar to those reported in New York after the World Trade Center disaster In multivariate analyses, the best predictors of mental health status and service use were having high hurricane exposure levels, having physical health limitations, and having environmental health concerns. Research is needed to assess the mental health status and service use of Jersey Shore residents over time, to evaluate environmental health concerns, and to better understand the storm's impact among those with physical health limitations.",0,0 +6476,A family study of PTSD : occurrence and correlates of internalizing disorders in children of OIF/OEF soldiers with combat posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) is one of the most common psychiatric disorders among U.S. combatants who are deployed to Operation Iraqi Freedom and Operation Enduring Freedom conflicts (OIF/OEF). Combat PTSD has been shown to be associated with impaired social, occupational, and physical functioning. An understudied area of research is how PTSD from combat affects interpersonal functioning at the family level. Of particular vulnerability to disruption in relational systems is the parent-child dyad. The present study focused on parental PTSD, child environment, and child psychological symptoms in order to begin delineating pathways connecting parent trauma to child psychopathology. The sample consisted of 21 dyads : Adult participants with and without combat-related PTSD and biological child participants (aged 6 - 17). Parents and children were administered structured diagnostic interviews and dimensional measures of anxiety, depression, and PTSD and home environment. Simple linear regression was used to test a predictive model between fathers' level of PTSD symptoms and child clinical symptoms. Multiple regression was used to test the mediation model of child home environment on the relationship between parent and child symptomatology. Results from descriptive analyses showed that level of fathers' combat exposure was a significant predictor at the alpha = 0.05 level for child anxiety, PTSD symptoms, oppositional, and conduct problems. However, level of fathers' combat exposure did not predict child depression, somatization, or withdrawn symptoms. Results showed no interaction effects. This pilot study demonstrates that the experiences of OIF/OEF combatants such as the nature of their combat exposure during deployment may be important in impacting the psychological outcomes of their offspring. Furthermore, the warzone experiences of OIF/OEF combatants during deployment appear to predict child anxiety, PTSD, and externalizing symptoms, but not child depression, withdrawn symptoms, or somatization. Results of this pilot study should be considered preliminary and the design should be replicated with a larger sample of OIF/OEF combatants. The current findings may be relevant in advancing our knowledge of etiological models of psychiatric illness in youths, identifying at-risk individuals during early life stages, and advancing mental health interventions for military families",0,0 +6477,Evaluating the dimensionality of PTSD in a sample of OIF/OEF veterans.,"Both categorical and dimensional models of mental disorders, including posttraumatic stress disorder (PTSD), are useful for diagnostic and heuristic purposes; however, few empirical studies have compared categorical and dimensional models of PTSD side-by-side or compared these models to a hybrid (dimensional and categorical) model. In the present study, the dimensionality of PTSD was examined by fitting latent profile analytic, confirmatory factor analytic, and factor mixture models in 271 Operation Iraqi Freedom/Operation Enduring Freedom veterans 6 months after return from deployment. Latent profile analysis was used to identify subgroups of individuals with similar PTSD symptom profiles and predictors of subgroup membership, confirmatory factor analysis was used to identify the underlying continuous structure of PTSD in this sample, and factor mixture modeling was used to test whether a hybrid categorical and continuous model of PTSD best fit our sample. A factor mixture model consisting of a 4-factor dysphoria model of PTSD with 2 classes characterized by low and moderate symptom severity was the best-fitting model. Dissociation and deployment concerns emerged as significant predictors of membership in the moderate symptoms class. Implications for PTSD diagnostic conceptualization and treatment planning are discussed.",0,0 +6478,Properties of Swedish posttraumatic stress measures after a disaster,"• The construct of chronic PTSD generally shows temporal invariance. • The dysphoric-arousal model provided better fit than four- and three-factor models. • The Swedish IES-R and the PCL work well as measures of chronic posttraumatic stress. This study evaluated the properties of Swedish versions of self-report measures of posttraumatic stress disorder (PTSD), with emphasis on the Impact of Event Scale-Revised (IES-R). Survey data from adult survivors 1, 3, and 6 years after the 2004 Indian Ocean tsunami ( n = 1506) included the IES-R (from which the IES-6 was derived) and the 12-item General Health Questionnaire (GHQ-12). The PTSD Checklist (PCL) was included in one survey. A structured clinical interview was performed after 6 years ( n = 142). Factor analyses of the IES-R and PCL indicated that a dysphoric-arousal model provided good fit invariant across assessments. Both measures were accurate in excluding PTSD while all measures provided poorer positive predictive values. The IES-R, but not the IES-6 and GHQ-12, evidenced stability across assessments. In conclusion, the Swedish IES-R and PCL are sound measures of chronic PTSD, and the findings illustrate important temporal aspects of PTSD assessment.",0,0 +6479,Giving Voice to the Unsayable: Repairing the Effects of Trauma in Infancy and Early Childhood,"The research on early trauma establishes conclusively that, although there are marked individual differences in how children in the first five years of life respond to and recover from trauma, they consistently show negative biological, emotional, social, and cognitive sequelae after enduring traumatic events. This evidence lends particular urgency to the development, evaluation and implementation of approaches to prevention and treatment that are both empirically supported and can be effectively adapted to mental health community programs and other service systems that serve traumatized children and their families. This article describes the clinical applications and community dissemination of child-parent psychotherapy (CPP), a relationship-based trauma treatment for young children and their families that has substantial empirical evidence of efficacy in decreasing symptoms of traumatic stress and restoring young children's normative developmental trajectories. Clinical illustrations are provided to demonstrate how this intervention is conducted and to consider how it might effect therapeutic change.",0,0 +6480,Mother and Child Reports of Hurricane Related Stressors: Data from a Sample of Families Exposed to Hurricane Katrina,"Families exposed to disasters such as Hurricane Katrina are at risk for numerous adverse outcomes. While previous literature suggests that the degree of disaster exposure corresponds with experiencing negative outcomes, it is unclear if parents and children report similar levels of disaster exposure.The purpose of this paper was to examine levels of disaster stressor agreement among mother-child dyads affected by Hurricane Katrina, and to examine whether discrepancies in disaster stressor reports are associated with higher levels of posttraumatic stress (PTS) symptoms.Participants in this study consisted of 353 dyads of mothers (age M = 38.79 years, SD = 7.52; 68% African American) and children (52% girls; age M = 11.61 years, SD = 1.57) exposed to Hurricane Katrina. Parents and children were assessed at two timepoints, 3 - 7 months and 14 - 17 months postdisaster. Parent and child responses to items regarding hurricane related stressor exposure and PTS symptoms were analyzed.Agreement on hurricane related exposures was predominately slight to moderate, with kappas ranging from κ = .19 to κ = .83. Polynomial regression analyses revealed that when mothers reported low levels of Immediate Loss/Disruption stressors and children reported high levels of these stressors, children reported higher levels of Time 2 PTS symptoms, b = -.72 (.33), p = .03.Overall, levels of mother-child response agreement were low. Discrepancies in mother and child reports predicted higher levels of child PTS symptoms. Clinicians may want to query both parents and children about their disaster experiences when working with families postdisaster.",0,0 +6481,Pharmaceutical Opioid Use and Dependence among People Living with Chronic Pain: Associations Observed within the Pain and Opioids in Treatment (POINT) Cohort,"There is increasing concern about the appropriateness of prescribing pharmaceutical opioids for chronic non-cancer pain (CNCP), given the risks of problematic use and dependence. This article examines pharmaceutical opioid dose and dependence and examines the correlates of each.Baseline data were obtained from a national sample of 1,424 people across Australia (median 58 years, 55% female and experiencing pain for a median of 10 years), who had been prescribed opioids for CNCP. Current opioid consumption was estimated in oral morphine equivalent (OME; mg per day), and ICD-10 pharmaceutical opioid dependence was assessed using the Composite International Diagnostic Interview.Current opioid consumption varied widely: 8.8% were taking <20 mg OME per day, 52.1% were taking 21-90 mg OME, 24.3% were taking 91-199 mg OME, and 14.8% were taking >= 200 mg OME. Greater daily OME consumption was associated with higher odds of multiple physical and mental health issues, aberrant opioid use, problems associated with opioid medication and opioid dependence. A significant minority, 8.5%, met criteria for lifetime ICD-10 pharmaceutical opioid dependence and 4.7% met criteria for past year ICD-10 pharmaceutical opioid dependence. Multivariate analysis found past-year dependence was independently associated with being younger, exhibiting more aberrant behaviors and having a history of benzodiazepine dependence.In this population of people taking opioids for CNCP, consumption of higher doses was associated with increased risk of problematic behaviors, and was more likely among people with a complex profile of physical and mental health problems.",0,0 +6482,"Disasters, Victimization, and Children’s Mental Health","In a representative sample of 2,030 U.S. children aged 2–17, 13.9% report lifetime exposure to disaster, and 4.1% report experiencing a disaster in the past year. Disaster exposure was associated with some forms of victimization and adversity. Victimization was associated with depression among 2- to 9-year-old disaster survivors, and with depression and aggression among 10- to 17-year-old disaster survivors. Children exposed to either victimization only or both disaster and victimization had worse mental health compared to those who experienced neither. More research into the prevalence and effects of disasters and other stressful events among children is needed to better understand the interactive risks for and effects of multiple forms of trauma.",0,0 +6483,Simple versus complex PTSD: A cluster analytic investigation,"A cluster analytic investigation was conducted on measures of PTSD associated features (e.g., personality pathology, dissociative tendencies) to investigate whether empirically-defined clusters correspond to Herman's [1992, Complex PTSD: a syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress, 5, 377-391; 1997, Trauma and recovery (Rev. ed.). New York: Basic Books] distinction between simple and complex PTSD. Results from a sample of 60 PTSD patients were broadly consistent with this distinction, although some inconsistencies were observed. Treatment outcome generally did not differ between the two clusters. Implications for classifying and treating PTSD are discussed.",0,0 +6484,Clustering of symptoms of mental disorder in the medium-term following conflict: An epidemiological study in Timor-Leste,"It is important to define subpopulations with mental health and psychosocial reactions in the medium-term following conflict to ensure that an appropriate array of services are provided to meet the diversity of needs. We conducted a latent class analysis (LCA) on epidemiological data drawn from an urban and rural sample of 1221 adults (581 men and 640 women, response 82%) in post-conflict Timor Leste 4 years after the cessation of violence. The prevalence of PTSD was 4.9%; severe distress 4.8%; anger attacks 38.3%; and paranoid-like symptoms 10.9%. The best fitting LCA yielded three classes comprising those with no or minimal symptoms (86%), a class with anger-paranoia (13%) and a comorbid mental disorder class (1.5%) characterized by PTSD (100%) and severe distress (98%). The comorbid mental disorder class had an over-representation of men, the unemployed, residents in the urban area and persons with the greatest exposure to human rights trauma, murder and health stress. The anger-paranoia class experienced moderate levels of trauma and had an over-representation of urban dwellers, women, and those with higher levels of education. The analysis assists in clarifying the populations with mental disorder and adverse psychosocial reactions in need of intervention in the medium-term following conflict.",0,0 +6485,"Psychiatric disorders in patients with psychogenic non-epileptic seizures, with and without comorbid epilepsy","The aim of this study is to describe similarities and differences in epidemiological, psychiatric and semiologic variables between patients with psychogenic none epileptic seizures (PNES) and comorbid epilepsy (mixed PNES), and patients with PNES without comorbid epilepsy (pure PNES).Forty-three patients with PNES diagnosed by Video-EEG were included. Twenty-four had pure PNES, and ninteen mixed PNES. Female population, age, duration of PNES, psychiatric institutionalization, psychopharmacotherapy, dissociative disorders and posttraumatic stress disorder (PTSD), were significantly higher in the pure PNES patients. Suicide attempts, antiepileptic therapy, conversive, affective and personality disorders were frequent in both groups. In the analysis of seizure semiology, the total lack of responsiveness was significantly higher in the mixed PNES group.Pure PNES patients showed similarities and differences in the psychiatric profile, with a greater prevalence of dissociative disorders and PTSD, factors related to psychiatric severity.",0,0 +6486,Post-Traumatic Stress Disorder (PTSD) Symptoms Predict Delay to Hospital in Patients with Acute Coronary Syndrome,"Increased delay to hospital presentation with acute coronary syndrome (ACS) is associated with poor outcomes. While demographic factors associated with this delay have been well described, scarce data are available on the role of modifiable factors, such as psychosocial disorders, on pre-hospital delay. Patients with symptoms of post-traumatic stress disorder (PTSD) often avoid stressful situations and may delay presenting for care when they experience cardiac symptoms. It is unknown, however, whether PTSD symptoms negatively impact the time to presentation during an ACS.We assessed the relationship between PTSD symptoms and pre-hospital delay in 241 adults with an ACS in the ongoing Prescription Use, Lifestyle, Stress Evaluation (PULSE) study.Overall, 66% of patients were male; 40% were Hispanic or Latino. The mean age was 61.9±11.6 years old. PTSD symptoms were present in 17.8% of patients. Pre-hospital delay was longer for patients with PTSD symptoms compared to those without [geometric mean: 25.8 hours (95% CI 13.8-44.8) vs. 10.7 hours (95% CI 8.3-13.8)]; P = 0.005. After multivariable adjustment for age, sex, ethnicity, depression, left ventricular ejection fraction and history of myocardial infarction, the mean pre-hospital delay was 173% (95% CI: 36%-450%) longer for patients with versus without PTSD symptoms.Among patients presenting with an ACS, PTSD symptoms were independently associated with longer pre-hospital delays. Future studies of pre-hospital delay should examine the mechanisms underlying this association.",0,0 +6487,Facets of pejorative self-processing in complicated grief.,"Complicated grief (CG) has been proposed as a psychiatric response to bereavement distinct from established mood and anxiety disorder diagnoses. Little is known about the nature of cognitive-affective processing in CG, nor any similarities or differences compared with the processing profiles associated with other emotional disorders. Three studies therefore investigated 3 broad facets of negative self-processing associated with either elevated symptoms of, or diagnosis of, CG--namely, self-related attributions or blame, self-devaluation, and cognitions about the future self.These self-processing domains were assessed using a variety of self-report and scenario-based measures either linked specifically to the bereavement or more general in their focus. Study 1 used a correlational design in a community bereaved sample. Study 2 employed an extreme-groups approach looking at individuals high versus low in CG symptoms, and Study 3 compared those with a CG diagnosis to healthy bereaved controls.The data revealed a profile of processing in CG characterized by significant relationships between CG symptoms or diagnosis and both self-devaluation and negative self-related cognitions about the future, but the data provided no support for a similar relationship with negative self-related attributions.These findings extend our understanding of self-related cognitive processing in CG. They also suggest that CG is characterized by a cognitive-affective processing profile that is distinct from that associated with other disorders, notably major depression, in the literature. This has potential implications for the psychological treatment of CG and for its nosological status as a post-loss syndrome distinct from depression.",0,0 +6488,Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after Hurricane Katrina.,"On the basis of theory and previous research, it was hypothesized that predisaster child trait anxiety would predict disaster-related posttraumatic stress symptoms and generalized anxiety disorder symptoms, even after controlling for the number of hurricane exposure events. Results support this hypothesis and further indicate that predisaster negative affect predicted disaster-related posttraumatic stress symptoms and generalized anxiety disorder symptoms. Also, Katrina-related posttraumatic stress disorder symptoms were predicted by the number of hurricane exposure events and sex (being female). Predisaster generalized anxiety disorder symptoms predicted postdisaster generalized anxiety disorder symptoms, and predisaster trait anxiety predicted postdisaster depressive symptoms. Findings are discussed in terms of their relevance for developing interventions to mitigate the impact of disasters in youths.",0,0 +6489,Piecewise Linear–Linear Latent Growth Mixture Models With Unknown Knots,"Latent growth curve models with piecewise functions are flexible and useful analytic models for investigating individual behaviors that exhibit distinct phases of development in observed variables. As an extension of this framework, this study considers a piecewise linear–linear latent growth mixture model (LGMM) for describing segmented change of individual behavior over time where the data come from a mixture of two or more unobserved subpopulations (i.e., latent classes). Thus, the focus of this article is to illustrate the practical utility of piecewise linear–linear LGMM and then to demonstrate how this model could be fit as one of many alternatives—including the more conventional LGMMs with functions such as linear and quadratic. To carry out this study, data ( N = 214) obtained from a procedural learning task research were used to fit the three alternative LGMMs: (a) a two-class LGMM using a linear function, (b) a two-class LGMM using a quadratic function, and (c) a two-class LGMM using a piecewise linear–linear function, where the time of transition from one phase to another (i.e., knot) is not known a priori, and thus is a parameter to be estimated.",0,0 +6490,‘Traumatisers or traumatised’: Trauma experiences and personality characteristics of Australian prisoners,"Post-traumatic stress disorder (PTSD) is over represented in the prisoner population and is predictive of violence and suicide. This raises issues in relation to prisoner management, as well as theoretical issues such as why there is a range of vulnerability for PTSD. The current study examines the relationship between PTSD and personality profiles of prisoners.Data from 1305 participants in the NSW survey of health in prisoners are examined to identify relationships between personality profiles derived from the Temperament and Character Inventory (TCI) and PTSD. Participants are grouped as experiencing no trauma; with a trauma history but no PTSD; and being diagnosed with PTSD. A logistic regression modelled significant predictors of PTSD. These data indicated that women prisoners report PTSD at twice the rate of males. An increased risk for PTSD is associated with high Harm Avoidance, low Self-Directedness, high Persistence and high Self-Transcendence.A combination of both temperament and character traits influences the trajectory towards PTSD development. Targeted treatment of these traits is needed in addressing the problems of prisoners with PTSD and managing the associated risks of violence and suicide.",0,0 +6491,"Mental Health, Social Functioning, and Disability in Postwar Afghanistan","More than 2 decades of conflict have led to widespread human suffering and population displacement in Afghanistan. In 2002, the Centers for Disease Control and Prevention and other collaborating partners performed a national population-based mental health survey in Afghanistan.To provide national estimates of mental health status of the disabled (any restriction or lack of ability to perform an activity in the manner considered normal for a human being) and nondisabled Afghan population aged at least 15 years.A national multistage, cluster, population-based mental health survey of 799 adult household members (699 nondisabled and 100 disabled respondents) aged 15 years or older conducted from July to September 2002. Fifty district-level clusters were selected based on probability proportional to size sampling. One village was randomly selected in each cluster and 15 households were randomly selected in each village, yielding 750 households.Demographics, social functioning as measured by selected questions from the Medical Outcomes Study 36-Item Short-Form Health Survey, depressive symptoms measured by the Hopkins Symptoms Checklist-25, trauma events and symptoms of posttraumatic stress disorder (PTSD) measured by the Harvard Trauma Questionnaire, and culture-specific symptoms of mental illness and coping mechanisms.A total of 407 respondents (62.0%) reported experiencing at least 4 trauma events during the previous 10 years. The most common trauma events experienced by the respondents were lack of food and water (56.1%) for nondisabled persons and lack of shelter (69.7%) for disabled persons. The prevalence of respondents with symptoms of depression was 67.7% (95% confidence interval [CI], 54.6%-80.7%) and 71.7% (95% CI, 65.0%-78.4%), and symptoms of anxiety 72.2% (95% CI, 63.8%-80.7%) and 84.6% (95% CI, 74.1%-95.0%) for nondisabled and disabled respondents, respectively. The prevalence of symptoms of PTSD was similar for both groups (nondisabled, 42.1%; 95% CI, 34.2%-50.1%; and disabled, 42.2%; 95% CI, 29.2%-55.2%). Women had significantly poorer mental health status than men did. Respondents who were disabled had significantly lower social functioning and poorer mental health status than those who were nondisabled. Feelings of hatred were high (84% of nondisabled and 81% of disabled respondents). Coping mechanisms included religious and spiritual practices; focusing on basic needs, such as higher income, better housing, and more food; and seeking medical assistance.In this nationally representative survey of Afghans, prevalence rates of symptoms of depression, anxiety, and PTSD were high. These data underscore the need for donors and health care planners to address the current lack of mental health care resources, facilities, and trained mental health care professionals in Afghanistan.",0,0 +6492,Perceived Safety in Disaster Workers Following 9/11,"The perception of being safe, perceived safety, is an important component of health and the ability to work after exposure to traumatic events of all kinds. The relationship of perceived safety to posttraumatic stress disorder and depression has rarely been examined. This study examined symptoms of posttraumatic stress disorder, depression, and perceived safety in disaster workers 2 weeks after the 9/11 terrorist attacks. Perceived safety was lower in those with greater exposure (e.g., those who felt they were in physical danger, worked with dead bodies, or witnessed someone being killed or seriously injured). Lower perceived safety was associated with greater symptoms of intrusion and hyperarousal but not avoidance. Safety was negatively correlated with depression and peritraumatic dissociation. Lowered perceptions of safety following terrorist events have implications for social and work-related behaviors that can affect long-term health, morale, and productivity in disaster workers and other first responders.",0,0 +6493,Mefloquine and psychotomimetics share neurotransmitter receptor and transporter interactions in vitro,"RationaleMefloquine is used for the prevention and treatment of chloroquine-resistant malaria, but its use is associated with nightmares, hallucinations, and exacerbation of symptoms of post-traumatic stress disorder. We hypothesized that potential mechanisms of action for the adverse psychotropic effects of mefloquine resemble those of other known psychotomimetics.ObjectivesUsing in vitro radioligand binding and functional assays, we examined the interaction of (+)- and (−)-mefloquine enantiomers, the non-psychotomimetic anti-malarial agent, chloroquine, and several hallucinogens and psychostimulants with recombinant human neurotransmitter receptors and transporters.ResultsHallucinogens and mefloquine bound stereoselectively and with relatively high affinity (K i = 0.71–341 nM) to serotonin (5-HT) 2A but not 5-HT1A or 5-HT2C receptors. Mefloquine but not chloroquine was a partial 5-HT2A agonist and a full 5-HT2C agonist, stimulating inositol phosphate accumulation, with similar potency and efficacy as the hallucinogen dimethyltryptamine (DMT). 5-HT receptor antagonists blocked mefloquine’s effects. Mefloquine had low or no affinity for dopamine D1, D2, D3, and D4.4 receptors, or dopamine and norepinephrine transporters. However, mefloquine was a very low potency antagonist at the D3 receptor and mefloquine but not chloroquine or hallucinogens blocked [3H]5-HT uptake by the 5-HT transporter.ConclusionsMefloquine, but not chloroquine, shares an in vitro receptor interaction profile with some hallucinogens and this neurochemistry may be relevant to the adverse neuropsychiatric effects associated with mefloquine use by a small percentage of patients. Additionally, evaluating interactions with this panel of receptors and transporters may be useful for characterizing effects of other psychotropic drugs and for avoiding psychotomimetic effects for new pharmacotherapies, including antimalarial quinolines.",0,0 +6494,Late-life adaptation in the aftermath of extreme stress.,,0,0 +6495,"Children's Coping Assistance: How Parents, Teachers, and Friends Help Children Cope After a Natural Disaster","Investigated the construct of coping assistance, defined as actions taken by significant others to help children cope with stressful events, in the aftermath of Hurricane Andrew. The Children's Coping Assistance Checklist (CCAC) was developed to assess three types of coping assistance (Emotional Processing, Roles and Routines, and Distraction) from three sources (Parents, Teachers, and Friends). The CCAC and measures of children's social support, coping, and posttraumatic stress disorder (PTSD) symptomatology were administered to 506 third through fifth graders 7 months after Hurricane Andrew. Roles and Routines coping assistance was reported most frequently, followed by Distraction and Emotional Processing. Coping assistance from parents and friends was reported more frequently than from teachers. Third graders reported significantly more Emotional Processing from parents and friends than fourth and fifth graders; no sex effects were found. As expected, children with more severe levels of PTSD symptomato...",0,0 +6496,The Post-Accident Syndrome: Variations in the Clinical Picture,"Three hundred and twenty-seven subjects involved in civil accident litigation and referred by solicitors for either plaintiff or defendant were examined. A precise psychiatric diagnosis was applicable in only a minority of subjects, although psychiatric symptoms, including pain, anxiety and depression, were prominent. Overall the clinical picture was an amorphous one. Cluster analysis was performed to examine a variety of clinical, demographic and historical variables. This showed four stable groups, which are here described as: stoic, depressive, phobic motor accident and prior claimants. It is suggested that the phenomenological approach taken here, paying particular attention to clinical sub-groups, may be a more useful route towards the understanding and treatment of post-accident psychiatric disturbance than is the existing but confused approach, in which motivation has been a prime focus of interest. The particular sub-groups demonstrated here, if replicated, could form the basis for such an approach.",0,0 +6497,Decreased regional cerebral blood flow in medial prefrontal cortex during trauma-unrelated stressful imagery in Vietnam veterans with post-traumatic stress disorder.,"Neuroimaging research has demonstrated medial prefrontal cortex (mPFC) hyporesponsivity and amygdala hyperresponsivity to trauma-related or emotional stimuli in post-traumatic stress disorder (PTSD). Relatively few studies have examined brain responses to the recollection of stressful, but trauma-unrelated, personal events in PTSD. In the current study, we sought to determine whether regional cerebral blood flow (rCBF) abnormalities in mPFC and amygdala in PTSD could be observed during the recollection of trauma-unrelated stressful personal events.Participants were 35 right-handed male combat veterans (MCVs) and female nurse veterans (FNVs) who served in Vietnam: 17 (seven male, 10 female) with current military-related PTSD and 18 (nine male, nine female) with no current or lifetime PTSD. We used positron emission tomography (PET) and script-driven imagery to study rCBF during the recollection of trauma-unrelated stressful versus neutral and traumatic events.Voxelwise tests revealed significant between-group differences for the trauma-unrelated stressful versus neutral comparison in mPFC, specifically in the anterior cingulate cortex (ACC). Functional region of interest (ROI) analyses demonstrated that this interaction in mPFC represented greater rCBF decreases in the PTSD group during trauma-unrelated stressful imagery relative to neutral imagery compared to the non-PTSD group. No differential amygdala activation was observed between groups or in either group separately.Veterans with PTSD, compared to those without PTSD, exhibited decreased rCBF in mPFC during mental imagery of trauma-unrelated stressful personal experiences. Functional neuroanatomical models of PTSD must account for diminished mPFC responses that extend to emotional stimuli, including stressful personal experiences that are not directly related to PTSD.",0,0 +6498,"Neighborhood Effects on Heat Deaths: Social and Environmental Predictors of Vulnerability in Maricopa County, Arizona","Background: Most heat-related deaths occur in cities, and future trends in global climate change and urbanization may amplify this trend. Understanding how neighborhoods affect heat mortality fills an important gap between studies of individual susceptibility to heat and broadly comparative studies of temperature–mortality relationships in cities.Objectives: We estimated neighborhood effects of population characteristics and built and natural environments on deaths due to heat exposure in Maricopa County, Arizona (2000–2008).Methods: We used 2000 U.S. Census data and remotely sensed vegetation and land surface temperature to construct indicators of neighborhood vulnerability and a geographic information system to map vulnerability and residential addresses of persons who died from heat exposure in 2,081 census block groups. Binary logistic regression and spatial analysis were used to associate deaths with neighborhoods.Results: Neighborhood scores on three factors—socioeconomic vulnerability, elderly/isolation, and unvegetated area—varied widely throughout the study area. The preferred model (based on fit and parsimony) for predicting the odds of one or more deaths from heat exposure within a census block group included the first two factors and surface temperature in residential neighborhoods, holding population size constant. Spatial analysis identified clusters of neighborhoods with the highest heat vulnerability scores. A large proportion of deaths occurred among people, including homeless persons, who lived in the inner cores of the largest cities and along an industrial corridor.Conclusions: Place-based indicators of vulnerability complement analyses of person-level heat risk factors. Surface temperature might be used in Maricopa County to identify the most heat-vulnerable neighborhoods, but more attention to the socioecological complexities of climate adaptation is needed.",0,0 +6499,Accounting for comorbidity in assessing the burden of epilepsy among US adults: results from the National Comorbidity Survey Replication (NCS-R),"Although epilepsy is associated with substantial role impairment, it is also highly comorbid with other physical and mental disorders, making unclear the extent to which impairments associated with epilepsy are actually due to comorbidities. This issue was explored in the National Comorbidity Survey Replication (NCS-R), a nationally representative household survey of 5692 US adults. Medically recognized epilepsy was ascertained with self-report, comorbid physical disorders with a chronic conditions checklist, and comorbid DSM-IV mental disorders with the Composite International Diagnostic Interview. Lifetime epilepsy prevalence was estimated at 1.8%. Epilepsy was comorbid with numerous neurological and general medical conditions and with a sporadic cluster of mental comorbidities (panic, PTSD, conduct disorder and substance use disorders). Although comorbid disorders explain part of the significant gross associations of epilepsy with impairment, epilepsy remains significantly associated with work disability, cognitive impairment and days of role impairment after controlling comorbidities. The net association of epilepsy with days of role impairment after controlling for comorbidities is equivalent to an annualized 89.4 million excess role impairment days among US adults with epilepsy, arguing that role impairment is a major component of the societal costs of epilepsy per se rather than merely due to disorders comorbid with epilepsy. This estimated burden is likely conservative as some parts of the effects of epilepsy are presumably mediated by secondary comorbid disorders.",0,0 +6500,Persistent mental health disturbances during the 10 years after a disaster: Four-wave longitudinal comparative study,"Although some studies have examined the long-term effects of disasters, very little is known about severe persistent symptoms following disasters. The aim of the present study was to examine persistent mental health problems and to what extent disaster exposure predicts long-term persistent disturbances.Following a major disaster, a four-wave study was conducted (surveys 2-3 weeks, 18 months, 4 years and 10 years after the event) that examined severe post-traumatic stress disorder (PTSD) symptomatology (Impact of Event Scale), anxiety and depression symptoms and sleeping problems (Symptom Check List-90-R), and use of physician-prescribed tranquilizers. Participants were affected adult Dutch native residents (n = 1083). At wave 2 and 3, a control group participated (n = 694). At wave 1, severity of disaster exposure was examined. Multiple imputation was used to target the problem of missing data across surveys due to non-response such as in the fourth wave (61%).In total, 6.7% (95% confidence interval [CI]: 5.1-8.2) developed persistent PTSD symptoms during the 10 years after the event. For anxiety, depression, sleeping problems these prevalences were 3.8% (95%CI: 2.7-5.0), 6.2% (95%CI: 4.7-7.6) and 4.8% (95%CI: 3.5-6.1) respectively. In total 1.3% (95%CI: 0.6-2.0) used tranquilizers at all waves. Approximately one out of 10 with severe symptoms 2-3 weeks after the event, developed persistent symptoms. Even in the long term, affected residents compared to controls had more often chronic anxiety symptoms and sleeping problems. High disaster exposure independently predicted persistent PTSD symptoms (adjusted odds ratio [adj. OR], 4.20; 95%CI: 2.02-8.74, P < 0.001), anxiety (adj. OR, 3.43; 95%CI: 1.28-9.20, P < 0.01), depression symptoms (adj. OR, 2.95; 95%CI: 1.26-6.93, P < 0.01), and sleeping problems (adj. OR, 3.74; 95%CI: 1.56-8.95, P < 0.001).Post-disaster mental health care should (also) target persistent mental health disturbances in the long term, especially PTSD, anxiety, depression symptoms, and sleeping problems. High disaster exposure may be an early marker for risk of persistent symptoms.",0,0 +6501,Borderline personality disorder as seen from an attachment perspective: a review,"There is increasing evidence that both borderline personality disorder and PTSD can be partly understood as damage to the attachment system. Research on primates has shown how severe are the effects of a damaged attachment system. Distress symptoms produced by separation are similar to those seen in narcotic withdrawal and involve aggressive behaviour. Chronic stress in children can cause dysregulation of the normal stress response and maladaptive brain activities. Secure, avoidant, anxious-ambivalent attachment in childhood can now be measured. Insecure children show needless aggression; avoidant children can become either abusers or victims. Disorganized attachment is a mixture of avoidant and anxious-ambivalent behaviour and may lead to adult borderline personality disorder. Patterns of attachment are self-perpetuating and may be transmitted across generations. PTSD is a syndrome resulting from a terrifying state of helplessness. Its manifestations are similar to those seen with disorganized attachment behaviours. Individuals can appear to cut themselves off from memories and feelings that are too painful to acknowledge. As a result trauma can become organized at a sensory and somatic level which is difficult to change. PTSD appears to alter neurophysiology and neuroanatomy. Traumatogenic stimuli may produce abnormal brain activity and, for example, an inability to speak. ‘Flips’ of mental state have been recorded both in patients who have been through childhood abuse and in borderline patients. The goal of treatment for borderline personality disorder should include the integration of dissociated self-states. Copyright © 1999 Whurr Publishers Ltd.",0,0 +6502,Gender differences in bipolar disorder type I and II,"We investigated gender differences in bipolar disorder (BD) type I and II in a representative cohort of secondary care psychiatric in- and out-patients.In the prospective, naturalistic Jorvi Bipolar Study of 191 secondary care psychiatric in- and out-patients, 160 patients (85.1%) could be followed up for 18 months with a life chart.After adjusting for confounders, no marked differences in illness-related characteristics were found. However, female patients with BD had more lifetime comorbid eating disorders (P < 0.001, OR = 5.99, 95% CI 2.12-16.93) but less substance use disorders (P < 0.001, OR = 0.29, 95% CI 0.16-0.56) than males. Median time to recurrence after remission was 3.1 months longer among men than women, female gender carrying a higher hazard of recurrence (P = 0.006, HR = 2.00, 95% CI 1.22-3.27).Men and women with type I and II BD have fairly similar illness-related clinical characteristics, but their profile of comorbid disorders may differ significantly, particularly regarding substance use and eating disorders. In medium-term follow-up, females appear to have a higher hazard of recurrence than males.",0,0 +6503,Temporal analysis of heart rate variability as a predictor of post traumatic stress disorder in road traffic accidents survivors,"Road Traffic Accidents (RTA) are most probably the leading cause of post traumatic stress disorder (PTSD) in developed countries. The autonomic nervous system (ANS) disturbances, due to psychological trauma, are part of the pathophysiology of PTSD. The aim of the present study was to determine whether early heart rate variability (HRV) measurement, a biomarker of the ANS function, could act as a predictor of PTSD development after a RTA.We prospectively investigated 35 survivors of RTA with both physical injury and psychological trauma. HRV data were obtained from 24-h Holter ECG monitoring, which was performed on the second day after the accident. Time domain analysis was applied to the inter-beat (RR) interval time series to calculate the various parameters of HRV. PTSD status was assessed 2 and 6 months after RTA.There was a global diminution of HRV measurements in the PTSD group at both 2 and 6 months. The variability index was the best predictor of PTSD with the area under the receiveroperating curve for discriminating PTSD at 6 months at 0.92 (95% CI: 0.785; 1.046). A cut-off at 2.19% yielded a sensitivity of 85.7% and a specificity of 81.8% for PTSD. Positive and negative predictive values were respectively 75% and 90%. However, initial heart rate (HR) data were relevant at 2 months but not at 6 months.RTA survivors exhibiting lower parasympathetic modulation of HR, indexed by temporal analysis of HRV, are more susceptible to developing PTSD as a short and long-term outcome.",0,0 +6504,The Performance of Post-Traumatic Stress Disorder Subjects in Verbal and Visual False Memory Tasks,"Introduction: The current study investigated verbal and visual false memories among post-traumatic stress disorder sufferers. Methods: This causal-comparative study recruited 20 patients suffering from PTSD according to the DSMIV-TR criteria, and 20 non-PTSD subjects who involved in the same trauma of PTSD as well as 20 normal subjects who were matched for age, sex, and socio-economic status. The instruments included Beck Depression Inventory, Beck Anxiety Inventory, Impact of Event Scale, WIAS (short version), plus the Visual and Verbal False Memory Tasks prepared according to Deese-Roediger-McDermott's (DRM) paradigm. Obtained data were analyzed using the analysis of variance (ANOVA) and Tukey's post-hoc test. Results: Our findings indicated that PTSD patients produced more false memories (both verbal and visual) than non-PTSD and healthy control subjects in both tasks. Conclusion: Such findings are interpretable within the framework of the cognitive theories of PTSD and other memory deficits of PTSD patients. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0,0 +6505,Trauma and bereavement:,"The intersection between trauma and bereavement has only recently been explored. Prior studies of bereavement have often neglected to measure posttraumatic stress disorder (PTSD) symptoms; the few that have offer equivocal findings concerning the role of PTSD symptomatology following loss. Few studies have explored the relationship between PTSD and the other psychological sequelae more commonly associated with loss. The current investigation assessed PTSD symptoms over time following the death of a spouse, using violence and the suddenness of the loss as potential outcome predictors. In addition, the relationship between PTSD and depression symptoms was assessed. Violent death predicted PTSD symptoms and the persistence of depression over time. The suddenness of the loss was not related to PTSD symptoms. This investigation suggests that violent death results in development of PTSD symptoms over and above the normal grief response and thus, may contribute to a more severe grief response.",0,0 +6506,Are Specific Emotion Regulation Strategies Differentially Associated with Posttraumatic Growth Versus Stress?,"Extremely few studies have examined emotion regulation strategies as predictors of posttraumatic growth (PTG). This study aimed to examine several specific emotion regulation strategies, along with meaning making, as predictors of PTG, as opposed to posttraumatic distress. Participants were 107 adult women who had experienced a very stressful or traumatic event within the past 3 years and completed questionnaires measuring emotion regulation, meaning making, distress, and PTG. Emotion suppression positively predicted distress, but not PTG. Meaning making positively predicted PTG and negatively predicted distress. Bootstrapped mediation models showed that emotional processing has a significant indirect effect on PTG and distress through its effect on meaning making. Results indicate that researchers should pay closer attention to emotional processes involved in etiological models of PTG. It might also be helpful to examine specific emotion regulation strategies, as these can point to ways to help people na...",0,0 +6507,Predicting posttraumatic stress symptoms in children following Hurricane Katrina: A prospective analysis of the effect of parental distress and parenting practices,en,0,0 +6508,Post Traumatic Stress Disorder: Psychobiological mechanisms of traumatic remembrance.,"(from the chapter) synthesize the findings from preclinical investigations of learning and memory processes and the neurochemical effects of stress with clinical studies of posttraumatic stress disorder (PTSD) to develop a set of hypotheses related to the role of traumatic remembrance in the pathogenesis and treatment of PTSD / discuss the possible mechanisms underlying memory distortion that occurs in PTSD patients / adopted a cognitive neuroscience perspective that assumed that the features of traumatic memories and dissociative states in PTSD are properties of the underlying neural and psychodynamic networks mediating these functions neural mechanisms of learning and memory: relevance to the reexperiencing symptoms of PTSD [fear conditioning, a possible failure of extinction in PTSD, behavioral sensitization and stress sensitivity in PTSD] / altered memory functions in PTSD [dissociation, declarative memory, encoding of traumatic memories, factors related to traumatic memory recall] / assessment and treatment of PTSD-related memory disturbances (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6509,Abnormalities in whole-brain functional connectivity observed in treatment-naive post-traumatic stress disorder patients following an earthquake,"Background Convergent studies have highlighted the dysfunction of the amygdala, prefrontal cortex and hippocampus in post-traumatic stress disorder (PTSD). However, only a few studies have investigated the functional connectivity between brain regions in PTSD patients during the resting state, which may improve our understanding of the neuropathophysiology of PTSD. The aim of this study was to investigate patterns of whole-brain functional connectivity in treatment-naive PTSD patients without co-morbid conditions who experienced the 8.0-magnitude earthquake in the Sichuan province of China. Method A total of 72 PTSD patients and 86 trauma-exposed non-PTSD controls participated in the resting-state functional magnetic resonance imaging study. All these subjects were recruited from the disaster zone of the 2008 Sichuan earthquake. Functional connectivities between 90 paired brain regions in PTSD patients were compared with those in trauma-exposed non-PTSD controls. Furthermore, Pearson correlation analysis was performed between significantly abnormal connectivities in PTSD patients and their clinician-administered PTSD scale (CAPS) scores. Results Compared with non-PTSD controls, PTSD patients showed weaker positive connectivities between the middle prefrontal cortex (mPFC) and the amygdala, hippocampus, parahippocampal gyrus and rectus, as well as between the inferior orbitofrontal cortex and the hippocampus. In addition, PTSD patients showed stronger negative connectivity between the posterior cingulate cortex (PCC) and the insula. The CAPS scores in PTSD patients correlated negatively with the connectivity between the amygdala and the mPFC. Conclusions PTSD patients showed abnormalities in whole-brain functional connectivity, primarily affecting the connectivities between the mPFC and limbic system, and connectivity between the PCC and insula.",0,0 +6510,Cerebral blood flow changes during retrieval of traumatic memories before and after psychotherapy: a SPECT study,"ABSTRACT Background Traumatic memory is a key symptom in psychological trauma victims and may remain vivid for several years. Psychotherapy has shown that neither the psychopathological signs of trauma nor the expression of traumatic memories are static over time. However, few studies have investigated the neural substrates of psychotherapy-related symptom changes. Method We studied 16 subthreshold post-traumatic stress disorder (PTSD) subjects by using a script-driven symptom provocation paradigm adapted for single photon emission computed tomography (SPECT) that was read aloud during traumatic memory retrieval both before and after exposure-based and cognitive restructuring therapy. Their neural activity levels were compared with a control group comprising 11 waiting-list subthreshold PTSD patients, who were age- and profile-matched with the psychotherapy group. Results Significantly higher activity was observed in the parietal lobes, left hippocampus, thalamus and left prefrontal cortex during memory retrieval after psychotherapy. Positive correlations were found between activity changes in the left prefrontal cortex and left thalamus, and also between the left prefrontal cortex and left parietal lobe. Conclusions Neural mechanisms involved in subthreshold PTSD may share neural similarities with those underlying the fragmented and non-verbal nature of traumatic memories in full PTSD. Moreover, psychotherapy may influence the development of a narrative pattern overlaying the declarative memory neural substrates.",0,0 +6511,A Clinical Approach to the Pharmacotherapy of Aggression in Children and Adolescents,"Overt aggression in its various forms is the most prevalent symptom presenting to pediatric mental health providers, regardless of setting. It is a behavior with a heterogeneous etiology and requires a comprehensive approach to evaluation and treatment. Evaluation of the aggressive child must assess medical, neurologic, psychiatric, psychosocial, familial, and/or educational contributions to behavioral dyscontrol. Multimodal treatment is generally required. At present, there is no single medication to recommend for the treatment of aggressive behavior. Multiple medications have clinically been used in a nonspecific fashion to target excessive childhood aggression. Although successful for some, this approach increases risk for ineffective interventions accompanied by side effects. Until a scientific understanding of the developmental neurobiology of aggression leads to more specific treatment, this review suggests the use of a diagnostic-based approach to the pharmacology of aggression (FIG. 1). Descriptive diagnostic techniques should be used to define the presence of any primary or comorbid psychiatric disorder that presents with aggression as an associated symptom. Treating aggression in the context of these psychiatric syndromes appears to be the most direct approach. Aggression occurring in the context of a medication-responsive psychiatric diagnosis appears most sensitive to pharmacologic intervention. Presently, evidence for efficacy is strongest for aggression in the context of ADHD, psychotic disorder, adolescent-onset bipolar disorder, and ictal aggression It remains less clear that medication can help aggression when it occurs independently of a pharmacologically treatable comorbid psychiatric disorder. Aggression may respond to a target symptom approach where discrete behavioral symptoms that contribute to aggression, such as irritability, explosiveness, fear, or impulsivity, may be modified by medication intervention (FIG. 1). When treatment is approached in this fashion, it is standard practice to use the least toxic and safest intervention first. Behavioral treatment based on contingency management principles could be initially recommended. Medication trials should first use medications that have demonstrated empiric efficacy in reducing aggression (TABLE 1) and that have a favorable safety profile. Neuroleptics to treat aggression in nonpsychotic psychiatrically referred youth should be kept to a minimum, secondary to their significant adverse risk profile. Alternative medications, such as selective serotonin reuptake-inhibiting antidepressants, buspirone, lithium, anticonvulsants, opiate blocking agents, propranolol, nadolol, and clonidine, deserve more clinical research in pediatric aggression. These medications may offer effective and less toxic alternatives in the pharmacologic treatment of inappropriate excessive childhood aggression.",0,0 +6512,Genetics of Posttraumatic Stress Disorder,"ABSTRACT Posttraumatic stress disorder (PTSD) is a prevalent anxiety disorder marked by behavioral, physiologic, and hormonal alterations. PTSD is disabling and commonly follows a chronic course. The etiology of PTSD is unknown, although exposure to a traumatic event constitutes a necessary, but not sufficient, factor. A twin study of Vietnam veterans has shown significant genetic contribution to PTSD. The fact that PTSD's underlying genotypic vulnerability is only expressed following trauma exposure limits the usefulness of family-based linkage approaches. In contrast to the other major psychiatric disorders, large studies for the search of underlying genes have not been described in PTSD to date. Complementary approaches for locating involved genes include association-based studies employing case-control or parental genotypes for transmission dysequilibrium analysis and quantitative trait loci studies in animal models. Identification of susceptibility genes will increase our understanding of traumatic stress disorders and help to elucidate their molecular basis. The current review provides an up-to-date outline of progress in the field of PTSD.",0,0 +6513,The Relationship between Body Mass Index and Mental Health Among Iraq and Afghanistan Veterans,"ABSTRACT BACKGROUND Obesity is a growing public health concern and is becoming an epidemic among veterans in the post-deployment period. OBJECTIVE To explore the relationship between body mass index (BMI) and posttraumatic stress disorder (PTSD) in a large cohort of Iraq and Afghanistan veterans, and to evaluate trajectories of change in BMI over 3 years. DESIGN Retrospective, longitudinal cohort analysis of veterans’ health records PARTICIPANTS A total of 496,722 veterans (59,790 female and 436,932 male veterans) whose height and weight were recorded at the Department of Veterans Affairs (VA) healthcare system at least once after the end of their last deployment and whose first post-deployment outpatient encounter at the VA was at least 1 year prior to the end of the study period (December 31, 2011). MAIN MEASURES BMI, mental health diagnoses. KEY RESULTS Seventy-five percent of Iraq and Afghanistan veterans were either overweight or obese at baseline. Four trajectories were observed: “stable overweight” represented the largest class; followed by “stable obese;” “overweight/obese gaining;” and “obese losing.” During the 3-year ascertainment period, those with PTSD and depression in particular were at the greatest risk of being either obese without weight loss or overweight or obese and continuing to gain weight. Adjustment for demographics and antipsychotic medication attenuated the relationship between BMI and certain mental health diagnoses. Although BMI trajectories were similar in men and women, some gender differences were observed. For example, the risk of being in the persistently obese class in men was highest for those with PTSD, whereas for women, the risk was highest among those with depression. CONCLUSIONS The growing number of overweight or obese returning veterans is a concerning problem for clinicians who work with these patients. Successful intervention to reduce the prevalence of obesity will require integrated efforts from primary care and mental health to treat underlying mental health causes and assist with engagement in weight loss programs.",0,0 +6514,A Prospective Study of Depression Following Combat Deployment in Support of the Wars in Iraq and Afghanistan,"Objective. We investigated relations between deployment and new-onset depression among US service members recently deployed to the wars in Iraq and Afghanistan. Methods. We included 40 219 Millennium Cohort Study participants who completed baseline and follow-up questionnaires and met inclusion criteria. Participants were identified with depression if they met the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire criteria for depression at follow-up, but not at baseline. Results. Deployed men and women with combat exposures had the highest onset of depression, followed by those not deployed and those deployed without combat exposures. Combat-deployed men and women were at increased risk for new-onset depression compared with nondeployed men and women (men: adjusted odds ratio [AOR] = 1.32; 95% confidence interval [CI] = 1.13, 1.54; women: AOR = 2.13; 95% CI = 1.70, 2.65). Conversely, deployment without combat exposures led to decreased risk for new-onset depression compared with those who did not deploy (men: AOR = 0.66; 95% CI = 0.53, 0.83; women: AOR = 0.65; 95% CI = 0.47, 0.89). Conclusions. Deployment with combat exposures is a risk factor for new-onset depression among US service members. Post-deployment screening may be beneficial for US service members exposed to combat.",0,0 +6515,Rates and symptoms of PTSD among cocaine-dependent patients.,"This study evaluated lifetime traumatic events and current posttraumatic stress disorder (PTSD) symptoms in a substance abuse sample.Participants in the study consisted of 558 (75.1% male) cocaine-dependent individuals who completed self-report measures of trauma and PTSD symptoms prior to entry into treatment.Results showed a high number of lifetime traumatic events, even among those without PTSD. General disaster was the most prevalent. Current PTSD was found in 10.9% of the participants, with a significantly higher rate among women (21.6%) than among men (7.2%). For those with PTSD, the most prominent PTSD symptom cluster was arousal, and the most common symptoms were restricted affect, detachment and irritability. Participants with PTSD endorsed a large number of symptoms, almost double that needed to meet diagnostic criteria; however, neither number of traumas nor type of trauma was associated with their level of PTSD symptoms. Even among those not meeting PTSD criteria, subthreshold symptoms were found, with avoidance the most prominent cluster. Sociodemographic and recent cocaine use variables did not differentiate the PTSD from non-PTSD groups.PTSD is present in a sizeable percentage of cocaine-dependent treatment-seeking patients, particularly women. Clinicians might address arousal symptoms in particular, which were the most prominent symptom cluster, and which may be exacerbated by cocaine use. Even among those without PTSD, lifetime trauma is substantial and subthreshold PTSD symptoms are common. Vulnerability to PTSD needs further study, as sociodemographic and cocaine use variables did not distinguish between PTSD and non-PTSD groups.",0,0 +6516,Post-Traumatic Stress Disorder,"

Abstract

Since the start of the wars in Afghanistan and Iraq, the U.S. military has implemented several population-based initiatives to enhance psychological resilience and prevent psychological morbidity in troops. The largest of these initiatives is the Army's Comprehensive Soldier Fitness (CSF) program, which has been disseminated to more than 1 million soldiers. However, to date, CSF has not been independently and objectively reviewed, and the degree to which it successfully promotes adaptive outcomes and prevents the development of deployment-related mental health disorders such as post-traumatic stress disorder (PTSD) is uncertain. This paper critically evaluates the theoretic foundation for and evidence supporting the use of CSF.",0,0 +6517,"Personality, Social Context and Cognitive Predictors of Post-Traumatic Stress Disorder in Myocardial Infarction Patients","The study investigated the relationship between two personality factors (alexithymia and negative affect), social support, the immediate cognitive and emotional response (importance, degree of emotional response, dissociation, fear) to a myocardial infarction and the frequency of post-traumatic stress disorder (PTSD) symptoms three months following a myocardial infarction (MI). Seventy five of eighty nine consecutive hospital admissions completed questionnaires both in hospital and three months subsequently. The study found a PTSD prevalence rate of sixteen percent three months following MI. There was a moderate reduction of intrusive memories of the MI and anxiety symptoms over time and a non-significant reduction in avoidance phenomena. Depressive symptoms did not reduce over time. Significant associations were found between PTSD symptoms at three months and initial intrusion and avoidance symptoms, negative affect, absence of confidant support, dissociation, fright and surprise. The percentage of the v...",0,0 +6518,"Relationships between impact on employment, working conditions, socio-occupational categories and symptoms of post-traumatic stress disorder after the industrial disaster in Toulouse, France","Objectives: The aims of this paper were (1) to analyze the prevalence of symptoms of post-traumatic stress disorder (S-PTSD) in a population of workers 1 year after an industrial disaster; and (2) to assess the role of factors of vulnerability such as the occupational impact of a disaster and economic conditions. Methods: A cross-sectional survey assessing the relationships between socio-occupational category, impact on employment and S-PTSD was conducted by the self-administered impact of event scale-revised. Results: The prevalence of S-PTSD in workers in the peripheral zone (<3 km around the explosion site) was 12% in men and 18% in women. Factors significantly associated with S-PTSD in men were non-managerial socio-occupational category: employees (ORa = 4.3; [2.3; 7.8]), factory workers/laborers (ORa = 3.7; [1.8; 7.6]), intermediate professions (ORa = 3.3; [1.9; 5.9]), and artisans (ORa = 3; [1.3; 7.7]); and layoff (ORa = 2.6; [1.5; 4.5]) or unusable workplace after the explosion (ORa = 1.8; [1.1; 2.8]). In women, factors significantly associated with S-PTSD were the socio-occupational categories of employees and factory workers (ORa = 2.2; [1.4; 3.5]), artisans (ORa = 2.7; [1.3; 5.7]) and intermediate professions, (ORa = 1.5; [1; 2.3]) and reporting of an occupational accident (ORa = 1.5; [1.1; 2.2]). Conclusion: Impact on the workplace and socioeconomic conditions were associated with S-PTSD. The epidemiological approach in disaster situations needs to be improved, particularly in the social and occupational dimension when economically active populations are involved. Vulnerable subgroups, defined by occupational impact and low socioeconomic category, should be taken into account. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +6519,"Hypnotizability, pain threshold, and dissociative experiences","There may be an association between pain threshold, hypnotizability, and dissociative experiences. The purpose of the present study was to examine this association.Forty-one healthy subjects were included in the study. Pain thresholds were determined using a manual algometer. The Dissociative Experiences Scale was administered to all subjects. Hypnotizability of the subjects was assessed by the eye roll sign of the Hypnotic Induction Profile. There were 14, 15, and 12 subjects in the Grade 1, 2, and 3 groups, respectively.Highly hypnotizable subjects had lower pain thresholds and were more likely to report dissociative experiences than the less hypnotizable subjects.There is an association between pain threshold, hypnotizability, and dissociative experiences. It may be suggested that dissociative and somatic symptoms may be integrally linked and related to hypnotic suggestibility.",0,0 +6520,Are We Winning the War Against Posttraumatic Stress Disorder?,"The most methodologically rigorous epidemiological study on American military personnel deployed to Iraq and Afghanistan found that 4.3% of troops developed posttraumatic stress disorder (PTSD). Among deployed combatants, 7.6% developed PTSD, whereas 1.4% of deployed noncombatants did so. The U.S. Department of Veterans Affairs has launched a program ensuring that all veterans with PTSD will receive evidence-based cognitive-behavioral therapy, and the Army has developed Battlemind postdeployment early interventions that reduce risk for the disorder.",0,0 +6521,Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders–Fifth Edition (PCL-5) in veterans.,"This study examined the psychometric properties of the posttraumatic stress disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5; Weathers, Litz, et al., 2013b) in 2 independent samples of veterans receiving care at a Veterans Affairs Medical Center (N = 468). A subsample of these participants (n = 140) was used to define a valid diagnostic cutoff score for the instrument using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5; Weathers, Blake, et al., 2013) as the reference standard. The PCL-5 test scores demonstrated good internal consistency (α = .96), test-retest reliability (r = .84), and convergent and discriminant validity. Consistent with previous studies (Armour et al., 2015; Liu et al., 2014), confirmatory factor analysis revealed that the data were best explained by a 6-factor anhedonia model and a 7-factor hybrid model. Signal detection analyses using the CAPS-5 revealed that PCL-5 scores of 31 to 33 were optimally efficient for diagnosing PTSD (κ(.5) = .58). Overall, the findings suggest that the PCL-5 is a psychometrically sound instrument that can be used effectively with veterans. Further, by determining a valid cutoff score using the CAPS-5, the PCL-5 can now be used to identify veterans with probable PTSD. However, findings also suggest the need for research to evaluate cluster structure of DSM-5. (PsycINFO Database Record",0,0 +6522,"Psychological Symptoms in Older Adults Following Natural Disaster: Nature, Timing, Duration, and Course","Using a prospective design with five follow-up intervals, the study addressed questions regarding the timing of onset, duration, course, and nature of psychological reaction to natural disaster. As participants in a statewide panel study, more than 200 older adults were interviewed both before and after two distinct floods occurred in southeastern Kentucky in 1981 and 1984. Exposure to these incidents, which differed in overall intensity, was assessed at both the individual and community levels. Personal loss was associated with short-term increases in negative affect, limited to one year postflood. Longer-term effects were more dependent on the level of community destruction. Exposure to high levels of community destruction was related to decreased positive affect up to two years postdisaster, whereas exposure to high levels of both community destruction and personal loss was predictive of increased negative affect for two years.",0,0 +6523,Complex partial epileptic signs as a continuum from normals to epileptics: Normative data and clinical populations,"Over a 10-year period, a total of 447 men and 624 women between 18 and 61 years of age were administered an inventory whose items describe experiences that are similar to those evoked by electrical stimulation of the temporal lobes. Empirically determined factors contained experiences of sensory enhancement, affective-dissociation, ego alien intrusions, and literary emphasis. Using this population as a reference, T scores for these clusters were calculated for special normal populations (poets, drama students, false pregnancies) and for clinical groups (post-traumatic stress, anxiety-depersonalization, exotic dissociations, and complex partial epilepsy). Whereas only mild elevations (50 < T < 65) in indicators of temporal lobe signs and symptoms were noted in the special groups, moderate (65 < T < 75) and severe (T > 79) elevations were noted in the clinical populations.",0,0 +6524,Chronic PTSD in Vietnam combat veterans: course of illness and substance abuse,"The purpose of this study was to measure the longitudinal course of specific symptoms of posttraumatic stress disorder (PTSD) and related symptoms of alcohol and substance abuse and the effects of alcohol and substances on the symptoms of PTSD.A structured interview for the assessment of PTSD and alcohol and substance abuse, as well as other factors such as life stressors and treatment, was administered to 61 Vietnam combat veterans with PTSD.Onset of symptoms typically occurred at the time of exposure to combat trauma in Vietnam and increased rapidly during the first few years after the war. Symptoms plateaued within a few years after the war, following which the disorder became chronic and unremitting. Hyperarousal symptoms such as feeling on guard and feeling easily startled developed first, followed by avoidant symptoms and finally by symptoms from the intrusive cluster. The onset of alcohol and substance abuse typically was associated with the onset of symptoms of PTSD, and the increase in use paralleled the increase of symptoms. Patients reported a tendency for alcohol, marijuana, heroin, and benzodiazepines to make PTSD symptoms better, while cocaine made symptoms in the hyperarousal category worse. There was no relationship between treatment interventions and the natural course of PTSD.These findings suggest that symptoms of PTSD begin soon after exposure to trauma, that hyperarousal symptoms are the first symptoms to occur, that the natural course of alcohol and substance abuse parallels that of PTSD, and that specific substances have specific effects on PTSD symptoms.",0,0 +6525,A 6-Year Follow-up Study of Cambodian Refugee Adolescents Traumatized as Children,"Seventy-three percent of a sample of 46 Cambodian youth interviewed in 1984 and 1987 were reinterviewed in 1990 as part of a pretest for a multisite study of Cambodian refugee trauma now under way. An additional sample of convenience of 38 youth were also interviewed to determine reliability and validity of the diagnostic instruments chosen for the larger study. The DSM-III-R diagnosis of post-traumatic stress disorder (PTSD) was found to persist, but the symptoms appeared less intense over time. In contrast, the prevalence of depression dropped markedly since 1987. Subjects remained largely free of comorbid conditions. Diagnostic reliability and validity were satisfactory. The follow-up sample appeared to be functioning well despite their PTSD profiles. The findings are discussed in light of several current controversies surrounding the concept and measurement of PTSD.",0,0 +6526,Sex differences in recovery from PTSD in male and female interpersonal assault survivors,"Men and women differ in exposure to trauma and the development of posttraumatic stress disorder (PTSD); however, research regarding sex differences in recovery from PTSD has been sparse. This study evaluated the treatment response trajectory for 69 male and female interpersonal assault survivors, using a modified Cognitive Processing Therapy (CPT) protocol that allowed survivors to receive up to18 sessions of CPT, with treatment end determined by therapy progress. Few sex differences were observed in trauma history, baseline PTSD and depressive severity, Axis I comorbidity, anger, guilt and dissociation. Women did report more sexual assault in adulthood and elevated baseline guilt cognitions, whereas men reported more baseline anger directed inward. Attrition and total number of sessions did not differ by sex. Over the course of treatment and follow-up, men and women demonstrated similar rates of change in PTSD and depressive symptoms. However, medium effect sizes on both of these primary outcomes at the 3-month follow-up assessment favored women. Several differences in the slope of change emerged on secondary outcomes such that women evidenced more rapid gains on global guilt, guilt cognitions, anger/irritability, and dissociation. Results suggest that male survivors may warrant additional attention to address these important clinical correlates.",0,0 +6527,Trends of Elevated PTSD Risk in Firefighters Exposed to the World Trade Center Disaster: 2001–2005,"Objectives. We identified trends in the prevalence of elevated posttraumatic stress disorder (PTSD) risk as determined by the Fire Department of the City of New York (FDNY)-modified PTSD Checklist in World Trade Center (WTC)-exposed firefighters. We also examined trends in relation to WTC exposure, social support, change in recreational activities, and functional health. Methods. We analyzed 16,826 questionnaires from 10,074 firefighters in yearly intervals, from September 12, 2001, to September 11, 2005. Results. The prevalence of elevated PTSD risk increased over time, from 9.8% in year 1 to 10.6% in year 4 ( p<0.0001). Earliest arrival at the WTC site (odds ratio [OR] = 6.0; 95% confidence interval [CI] 4.4, 8.3), prolonged work at the site (OR=2.0; 95% CI 1.8, 2.3), providing supervision without previous supervisory experience (OR=4.1; 95% CI 2.8, 6.1), and retirement due to a WTC-related disability (OR=1.3; 95% CI 1.1, 1.5) were associated with ever having elevated PTSD risk. Difficulty functioning at home was strongly associated with elevated PTSD risk (ORs ranged from 17.0 [95% CI 14.5, 20.0] in year 1 to 26.7 [95% CI 20.3, 35.2] in year 3), as was difficulty functioning at work (ORs ranged from 12.1 [95% CI 10.2, 14.2] in year 1 to 23.0 [95% CI 14.6, 36.3] in year 2). Conclusions. Elevated PTSD risk was associated with exposure to the WTC site as well as functional impairment, and remained largely unabated during the first four years of the study. Screening for elevated PTSD risk may be useful in identifying those who could benefit from interventions during long-term follow-up, as well as in the immediate aftermath of disasters.",0,0 +6528,"Psychiatric disorders, trauma, and MMPI profile in a Spanish sample of nonepileptic seizure patients","The aim of this study was to examine clinical characteristics in patients with psychogenic nonepileptic seizures and to analyze the Minnesota Multiphasic Personality Inventory (MMPI) profiles and their relation to psychopathology. Thirty patients with nonepileptic seizures confirmed through video-electroencephalography were included. A structured clinical interview (Structured Clinical Interview for DSM-III-R), a measure of personality variables (MMPI), and several structured interviews designed for collecting data on clinical and personal history were administered. Descriptive and comparative statistical methods were used. Of the sample, 67.7% met criteria for two or more simultaneous Axis I diagnoses, and 60% for an Axis II personality disorder. The most frequently elevated scales of the MMPI were Schizophrenia and Depression. There were multiple scale elevations in 12 profiles, the 91.7% of which had elevated ""neurotic"" and ""psychotic"" scales. The subgroup with personality disorders showed higher scores on the MMPI Paranoia and Hypomania scales, and the subgroup with traumatic experiences showed higher scores on the MMPI Hypomania scale. Our sample comprising patients with nonepileptic seizures showed a significant degree of psychopathology and absence of a unique character substrate. According to grades of clinical severity of pseudoseizures, several subgroups and different therapeutic implications may be defined.",0,0 +6529,Serotonin 5-HT1A Agonists,"In 1980, buspirone was found to have anxiolytic potential. This finding initiated the development of the azapirones — highly serotonin 5-HT1A agonists. The balance of evidence suggests that the azapirones act as partial agonists postsynaptically, but as full agonists presynaptically in the dorsal raphé. This review focuses mainly on agents for which there are published clinical trial data. Numerous studies have shown that buspirone, gepirone and ipsapirone are as effective as the benzodiazepines in the treatment of generalised anxiety. However, they have a slower onset of action. The azapirones have a completely different adverse reaction profile (dizziness and gastric complaints) compared with the benzodiazepines (sedation, memory loss and withdrawal dependency). Several controlled studies have shown that the azapirones are effective in depression, particularly of the melancholic type. They have an adverse effects profile similar to, but less severe than, the selective serotonin reuptake inhibitors and different to that of the tricyclic antidepressants. Buspirone has not yet proven to be effective in panic disorder. However, gepirone, ipsapirone and other azapirones may be more effective in this disorder. Early studies indicate promising results for buspirone in the treatment of obsessive-compulsive disorder. Clinical trials in alcoholism are equivocal. Further studies of this class of drugs in the treatment of social phobia, post-traumatic stress disorder, premenstrual syndrome, and compulsive and aggressive disorders are in progress. A principle drawback with this class of drug is their short half-life. However, sustained release preparations are being developed. © 1994, Adis International Limited. All rights reserved.",0,0 +6530,Posttraumatic stress disorder after childbirth: A cross sectional study,"The prevalence of having a posttraumatic stress disorder (PTSD) profile after childbirth and women's cognitive appraisal of the childbirth were studied cross sectionally in an unselected sample of all women who had given birth over a 1-year period in Linköping, Sweden. The PTSD profile was assessed by means of Traumatic Event Scale (TES), which is based on diagnostic criteria from Diagnostic and Statistical Manual of Mental Disorders , fourth edition ( DSM-IV ; American Psychiatric Association, 1994). The women's cognitive appraisal of the childbirth was measured by means of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ). Twenty-eight women (1.7%) of 1640 met criteria for a PTSD profile related to the recent delivery. A PTSD profile was related to a history of having received psychiatric/psychological counseling, a negative cognitive appraisal of the past delivery, mulliparity, and rating the contact with delivery staff in negative terms.",0,0 +6531,Ontogeny of dreaming: A review of empirical studies,"The examination of children's sleep-related mental experiences presents many significant challenges for researchers investigating the developmental trajectories of human dreaming. In contrast to the well-explored developmental patterns of human sleep, data from dream research are strikingly divergent with highly ambiguous results and conclusions, even though there is plenty of indirect evidence suggesting parallel patterns of development between neural maturation and dreaming. Thus results from studies of children's dreaming are of essential importance not only to enlighten us on the nature and role of dreaming but to also add to our knowledge of consciousness and cognitive and emotional development. This review summarizes research results related to the ontogeny of dreaming: we critically reconsider the field, systematically compare the findings based on different methodologies, and highlight the advantages and disadvantages of methods, arguing in favor of methodological pluralism. Since most contradictory results emerge in connection with descriptive as well as content related characteristics of young children's dreams, we emphasize the importance of carefully selected dream collection methods. In contrast nightmare-related studies yield surprisingly convergent results, thus providing strong basis for inferences about the connections between dreaming and cognitive emotional functioning. Potential directions for dream research are discussed, aiming to explore the as yet unraveled correlations between the maturation of neural organization, sleep architecture and dreaming patterns.",0,0 +6532,The Norwegian version of the PTSD Checklist (PCL): Construct validity in a community sample of 2004 tsunami survivors,"The PTSD Checklist (PCL) is a widely used self-administered measure of post-traumatic stress disorder (PTSD) and it has been validated in a variety of languages and cultures.Evaluate the diagnostic validity of the Norwegian version of a specific PCL (PCL-S) for detecting PTSD in epidemiological research.Participants were severely exposed Norwegian survivors from the 2004 South-East Asian tsunami. Of 75 individuals asked to participate, 63 responded (84%). PTSD was assessed by PCL-S and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). These instruments were compared to evaluate the diagnostic validity of the PCL. We used two different scoring methods to diagnose PTSD based on PCL. The first method was based on the dichotomized sum score (cut-off ≥ 50) and the second was based on the flowchart method following DSM-IV symptom criteria. Area under the curve (AUC), Cohen's kappa, sensitivity and specificity were used to evaluate the agreement between the PCL and SCID-I.According to the clinical interview, 11.3% of the participants met the diagnostic criteria for PTSD. The two scoring methods of PCL-S revealed similar results: according to both methods, 14.5% were categorized with PTSD. AUC was 0.98 (95% CI 0.93-1.00). For Cohen's kappa, the agreement was 0.71. Sensitivity was 0.86 and specificity 0.95. Agreement between PCL and SCID-I investigated for each of the three symptom clusters of PTSD and for the 17 individual items showed mostly a moderate to substantial agreement.The Norwegian version of the PCL-S performed well as a diagnostic instrument for detecting PTSD in epidemiological research.",0,0 +6533,Military Social Work: Opportunities and Challenges for Social Work Education,"Military social work is a specialized field of practice spanning the micro-macro continuum and requiring advanced social work knowledge and skills. The complex behavioral health problems and service needs of Iraq and Afghanistan veterans highlight the need for highly trained social work professionals who can provide militarily-relevant and culturally-responsive evidence-informed services. Responding to the military behavioral health workforce and service needs of recently returned veterans presents both opportunities and challenges for military social work education. This article discusses the rationale for a military social work specialization, the need for military social work education, and opportunities and challenges for social work education. An integrated model of intellectual capital is proposed to guide strategic planning for future military social work education.",0,0 +6534,Epigenetic Modification of the Glucocorticoid Receptor Gene Is Linked to Traumatic Memory and Post-Traumatic Stress Disorder Risk in Genocide Survivors,"Recent evidence suggests that altered expression and epigenetic modification of the glucocorticoid receptor gene (NR3C1) are related to the risk of post-traumatic stress disorder (PTSD). The underlying mechanisms, however, remain unknown. Because glucocorticoid receptor signaling is known to regulate emotional memory processes, particularly in men, epigenetic modifications of NR3C1 might affect the strength of traumatic memories. Here, we found that increased DNA methylation at the NGFI-A (nerve growth factor-induced protein A) binding site of the NR3C1 promoter was associated with less intrusive memory of the traumatic event and reduced PTSD risk in male, but not female survivors of the Rwandan genocide. NR3C1 methylation was not significantly related to hyperarousal or avoidance symptoms. We further investigated the relationship between NR3C1 methylation and memory functions in a neuroimaging study in healthy subjects. Increased NR3C1 methylation-which was associated with lower NR3C1 expression-was related to reduced picture recognition in male, but not female subjects. Furthermore, we found methylation-dependent differences in recognition memory-related brain activity in men. Together, these findings indicate that an epigenetic modification of the glucocorticoid receptor gene promoter is linked to interindividual and gender-specific differences in memory functions and PTSD risk.",0,0 +6535,The role of psychosocial factors in the course of pain—a 1-year follow-up study among women living in Sweden,"The understanding of the associations between psychosocial factors and persistent pain and their impact on the course of pain among women is crucial to identify risk populations and prevent long-term pain from developing. The aim of the study was to investigate the course of pain among women and the psychosocial factors associated with it. The study was a 1-year follow-up (FU) among 2,300 women in the general population of Sweden. Sociodemographic and psychosocial factors were analyzed in relation to the course of pain, assessed as the presence of pain during the last 3 months at baseline (BL) and at FU. Thirty-three percent of the women with no pain at BL and 77% of those with pain at BL reported pain at FU. Compared to the pain-free women, those who developed pain at FU reported lower social support and physical quality of life (QoL) and worse mental health. Women with sustained pain were older and reported worse mental health, lack of social support, and lower levels of QoL compared to those who recovered from pain. In the multiple logistic regression analyses, only post-traumatic stress symptoms were associated with the development of pain at FU. Number of pain locations and pain duration at BL and physical QoL were associated with sustained pain. Moreover, social support was identified as a protective factor against sustained pain. Pain is persistent or recurrent in a general female population. The results indicate that psychosocial factors do not work as primary predictors in the course of pain and might be better understood through indirect processes by limiting the individual's resources for handling pain in a functional manner.",0,0 +6536,Stability in Cognitive Function Over 18 Years: Prevalence and Predictors among Older Mexican Americans,"Numerous studies have examined the association of physical, behavioral and social factors with cognitive decline in older adults. Less attention has been placed on factors associated with long-term maintenance of intact cognition even into very old age. A greater understanding of those factors can inform the development of activities for maintaining cognitive strength.Using a sample from the Hispanic Established Populations for Epidemiologic Study of the Elderly, a population-based study of non-institutionalized Mexican Americans aged 65 and older from five Southwestern states (N = 2767), latent class mixture models were developed to identify subgroups of cognitive change over time.Three distinct trajectories of cognitive change were identified and characterized as stable, slow decline and rapid decline. Compared to the rapid decline group, a higher proportion of the stable cognition group were women, had high school education, were married and attended church one or more times per week. Regular church attendance had a significant positive impact in the stable group (β = 0.64, p <0.01), the slow decline group (β = 0.84, p <0.001) and the rapid decline group (β = 2.50, p <0.001). Activity limitations had a consistently negative association with cognition in the stable, slow decline and rapid decline groups (β = -0.37, p <0.001; β = -0.85, p <0.001; and β = -1.58, p <0.001 respectively).Substantial heterogeneity exists in rates of cognitive decline among older Mexican Americans. Interventions targeting cognitive maintenance may benefit from increased focus on factors associated with continued social engagement.",0,0 +6537,Morphine Use after Combat Injury in Iraq and Post-Traumatic Stress Disorder,"Post-traumatic stress disorder (PTSD) is a common adverse mental health outcome among seriously injured civilians and military personnel who are survivors of trauma. Pharmacotherapy in the aftermath of serious physical injury or exposure to traumatic events may be effective for the secondary prevention of PTSD.We identified 696 injured U.S. military personnel without serious traumatic brain injury from the Navy-Marine Corps Combat Trauma Registry Expeditionary Medical Encounter Database. Complete data on medications administered were available for all personnel selected. The diagnosis of PTSD was obtained from the Career History Archival Medical and Personnel System and verified in a review of medical records.Among the 696 patients studied, 243 received a diagnosis of PTSD and 453 did not. The use of morphine during early resuscitation and trauma care was significantly associated with a lower risk of PTSD after injury. Among the patients in whom PTSD developed, 61% received morphine; among those in whom PTSD did not develop, 76% received morphine (odds ratio, 0.47; P<0.001). This association remained significant after adjustment for injury severity, age, mechanism of injury, status with respect to amputation, and selected injury-related clinical factors.Our findings suggest that the use of morphine during trauma care may reduce the risk of subsequent development of PTSD after serious injury.",0,0 +6538,Blood Lactate and Heat Stress during Training in Rowers,"The purpose of the present study was to test the hypothesis that large increases in blood lactate concentration ([La] (b)) and/or body temperature may occur during an endurance training on a rowing ergometer and disrupt training. The influence of an increase in air convection on the capacity to perform a prolonged exercise was also explored. Ten trained oarsmen were asked to undergo twice, in control (C) and increased air ventilation (AV) conditions, two 30-min trainings on a rowing ergometer at a work rate corresponding to 2.5 mmol . L (-1) of [La] (b) determined during a previous incremental exercise (P (2.5)). Four subjects did not complete the training session in C despite a steady state in [La] (b) in two of them. In these four subjects, the end of the exercise was associated with the highest measured rectal temperatures (T (re), 39.4 +/- 0.1 degrees C) and rate of perceived exertion (RPE, 17.8 +/- 0.3). Regarding the six other subjects, their heart rate, oxygen uptake, RPE, T (re) and water loss values were lower (p < 0.05) in AV than in C. [La] (b) displayed the same profile in C and AV. This study suggests that i) high body temperature may constitute a significant factor of perceived exertion and disrupt indoor training session, and ii) capacity to perform an endurance training on a rowing ergometer was improved by increasing air convection.",0,0 +6539,The effect of persistent posttraumatic stress disorder symptoms on executive functions in preadolescent children witnessing a single incident of death,"We compared executive functions (EFs) of traumatized preadolescent children with and without marked posttraumatic stress disorder (PTSD) symptoms to the performance of a nontraumatized control group, and examined the relationships between EF deficits and functional status in traumatized preadolescent children. Fifty-one preadolescent children who had witnessed a death at school 30 months prior (26 with marked PTSD symptoms and 25 without) and 30 healthy controls who had not been traumatized participated. EFs were examined using the Comprehensive Attention Test (CAT). The functional state of traumatized children was measured by the Parent Report Form-Children's Health and Illness Profile-Children's Edition (PRF-CHIP-CE). The traumatized children, regardless of status of PTSD symptomatology, showed poorer working memory performance than nontraumatized healthy controls. The traumatized children with marked PTSD symptoms performed more poorly on measures of interference control compared to those children without marked PTSD symptoms. Lower levels of EFs were associated with lower risk avoidance and diminished academic achievement in traumatized children. These results indicate that an inhibitory control deficit is specifically associated with the current PTSD symptoms but not with trauma exposure per se.",0,0 +6540,Trauma and posttraumatic stress in users of the Anxiety Disorders Association of America Web site,"The Web site for the Anxiety Disorders Association of America (ADAA) receives more than 5 million visits per month and thus represents a unique medium for the study of anxiety disorders. ADAA Web site users from October 2002 to January 2003 were invited to complete a survey oriented toward trauma history and psychiatric sequelae. A diagnostic approximation of posttraumatic stress disorder (PTSD) was based on responses to the Trauma Questionnaire, the Davidson Trauma Scale, and questions about impairment. The Connor-Davidson Resilience Scale was also used. Variables were tested for their association with PTSD. Among 1558 participants, 87% had a history of trauma, and 38% had current PTSD. The population was comprised predominantly of white middle-class women, half of whom were married. More than 90% were first-time users of the site. Factors associated with PTSD included death of, or harm to, a loved one; personal history of incest, rape, or physical abuse; lower age; lower income; unemployment; missed work; increased medical care; dissatisfaction with psychotropic medication; depressive symptoms; and lower resilience. In this selective convenience sample, there were high rates of traumatization and PTSD. The demographics of this group are similar to those seen in previously studied populations that had contacted the ADAA. Furthermore, the factors associated with PTSD were like those in many community surveys. The ADAA Web site has the opportunity to benefit large numbers of highly distressed individuals.",0,0 +6541,Assessing the longitudinal course of depression and economic integration of south-east Asian refugees: an application of latent growth curve analysis,"This paper has both methodological and substantive application for mental-health researchers. Methodologically, it presents the latent growth curve (LGC) technique within a structural equation modelling (SEM) framework as a powerful tool to analyse change in depressive symptoms and potential correlates of such changes. The rationale for LGC analysis and subsequent elaboration of this statistical approach are presented. The limitations of traditional analytical methods are also addressed. Substantively, the paper considers socio-contextual factors as correlates of change in symptoms, and examines the dynamic systematic relationship with the degree of economic integration of south-east Asian immigrants in Canada over time. Using the LGC technique, this study also investigated how the longitudinal course of subclinical depression places individuals at risk for developing full-blown major depression. The LGC results provided strong evidence for the reciprocal influence between economic integration and subclinical depression of immigrants. The initial level of economic integration negatively influenced the rate of change in subclinical depression whereas the initial level of subclinical depression negatively influenced the rate of change in economic integration. Both initial level and the rate of change in subclinical depression placed individuals at risk for full-blown major depression. However, traditional auto-regressive models were not capable of revealing these dynamic associations. Thus, an investigation of within-individual change in symptoms and potential correlates of such changes is necessary to understand the process that results in full-blown mental disorder.",0,0 +6542,The economic consequences of post-traumatic stress disorder in clients of Veterans Affairs Canada,"Historically, post-traumatic stress disorder (PTSD) was questioned in regard to the ""reality"" of the clinical disorder. Largely during the post-Vietnam era, medical legitimacy pushed an agenda to study the condition, and contemporary interests shifted to cost-effective and effacious treatment identification. Although a priority for mental health, clinical approaches to care are not the only need for individuals who face diagnosis. I explore financial consequences of post-traumatic stress disorder in clients of Veterans Affairs Canada (VAC) to more specifically identify the economic vulnerabilities of veterans in an attempt to inform policy development. As a chronic condition, PTSD requires management over broad periods of time, often outside of the medical complex. Furthermore, a growing number of veterans are young and in search of gainful civilian employment, yet at risk of disrupted work lives as a result of their mental health status. This certainly carries implications for economic well-being. To better understand the relationship between PTSD and economic standing, I build upon current literature to develop two statistical analyses. The first project focuses on describing the relationship between PTSD and income and perceptions of financial security. This sample is marked with health disadvantage at the outset, through connection with VAC services. However, findings illustrate that PTSD holds significant association with economic well-being when other risk factors (including comorbidities) are controlled. This analysis informs caregivers (both medical and non-medical) about the importance of PTSD as a unique health problem with socioeconomic risk among veterans. The second analytic design assesses the specific symptom clusters of post-traumatic stress disorder as they relate to financial outcomes. Specifically, veterans experience symptoms of PTSD without meeting the clinical requirements for diagnosis, thus being left untreated. However, the findings illustrate that symptom clusters of PTSD maintain significant (and distinctive) relationships with various economic outcomes. This supports contemporary psychometric assessments that suggest the diagnostic criteria for PTSD require conceptual revisions. A reconfiguration of diagnostic criteria is supported in confirmatory factor analysis of my sample. I link these findings to targeted policy suggestions for VAC in regard to outreach for veterans with subclinical, yet meaningful, symptoms of post-traumatic stress. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +6543,Main and Interactive Effects of Anxiety Sensitivity and Physical Distress Intolerance with Regard to PTSD Symptoms Among Trauma-Exposed Smokers,"The present study examined the roles of anxiety sensitivity (AS; the tendency to misinterpret physical internal sensations of harmful) and distress tolerance (the capacity to tolerate aversive stimuli) in terms of the expression of posttraumatic stress disorder (PTSD) symptoms among a sample of trauma-exposed, treatment-seeking tobacco smokers (n = 137; Mage = 37.7 years, 48.2% female). It was hypothesized that higher AS and lower physical distress tolerance would interact to predict greater PTSD avoidance and hyperarousal symptoms. Results were partially consistent with this prediction. Specifically, there was a significant interactive effect of AS by physical distress tolerance in terms of PTSD hyperarousal symptom cluster severity. The form of the interaction was in the expected direction, with the highest levels of PTSD hyperarousal symptoms reported among smokers with higher levels of AS and a lower capacity to tolerate physical distress. Findings underscore the importance of considering AS and physical distress tolerance in terms of better understanding mechanisms underlying the expression of PTSD symptoms among trauma-exposed smokers.",0,0 +6544,Severity of injury does not have any impact on posttraumatic stress symptoms in severely injured patients,"Due to improved surgical techniques and more efficient decision making in treating severely injured patients, survival rates have increased over the years. This study was initiated to evaluate the incidence and identify risk factors for developing posttraumatic stress symptoms, using both extensive trauma-related data and data assessing the psychological trauma, in a population of severely injured patients.79 patients admitted to the Department of Multitrauma and Spinal Cord Injury at Sunnaas Rehabilitation Hospital from 2003 to 2005, prospectively completed semistructured psychological interviews and questionnaires, such as Impact of Event Scale-Revised. In addition, extensive injury-related data, such as injury severity score (ISS), new injury severity score (NISS), and probability of survival (PS) were collected.39% had multiple trauma, 34% had multiple injuries including spinal cord injuries, and 27% had isolated spinal cord injuries. Mean NISS was 31.5 (S.D. 13.7). 6% met diagnostic criteria for posttraumatic stress disorder (PTSD) and 9% met the criteria for subsyndromal PTSD. Injury-related data did not influence the prevalence of posttraumatic stress symptoms, however, some psychosocial variables did have a significant impact.We found a low incidence of PTSD and subsyndromal PTSD. No significant differences were found between the patients suffering from posttraumatic stress symptoms and the non-symptoms group in relation to injury-related data such as ISS/NISS, PS, or multiple trauma versus spinal cord injury. The most evident risk factors for developing posttraumatic stress symptoms were symptoms of anxiety, female gender and negative attitudes toward emotional expression.",0,0 +6545,Survivors of the Piper Alpha oil platform disaster: long-term follow-up study,"The long-term psychological effects of surviving a major disaster are poorly understood. We undertook a survey of survivors of the Piper Alpha oil platform disaster (1988).To examine the role of factors relating to the trauma, the survivors and the survivors' circumstances.Ten years after the disaster, 78% (46/59) of the survivors were located, of whom 72% (33/46) agreed to be interviewed. A further three individuals completed postal measures.The most stringent diagnostic criteria for post-traumatic stress disorder (PTSD) were met by 21% (7/33) of the survivors over 10 years after the disaster. Features such as physical injury, personal experience and survivor guilt were associated with significantly higher levels of post-traumatic symptoms.A narrow definition of factors affecting outcome will limit the potential for improving survivor well-being in the long-term after major disasters. Specific symptoms that are not included in the criteria for the diagnosis of PTSD, together with issues such as re-employment, need to be addressed.",0,0 +6546,"The Effects of Age, Gender, Hopelessness, and Exposure to Violence on Sleep Disorder Symptoms and Daytime Sleepiness Among Adolescents in Impoverished Neighborhoods","Although sleep problems are associated with negative outcomes among adolescents, studies have not focused on sleep disorder symptoms among adolescents living in impoverished neighborhoods and how sleep problems may be related to two factors common in those environments: hopelessness and exposure to violence. This study used data from the longitudinal Mobile Youth Survey (MYS; N = 11,838, 49 % female, 93 % African-American) to examine trajectories of sleep problems by age (10-18 years) among impoverished adolescents as a function of gender, feelings of hopelessness, and exposure to violence. The results indicate that sleep problems associated with traumatic stress decline with age, with four notable distinctions. First, the steepest decline occurs during the early adolescent years. Second, the rate of decline is steeper for males than for females. Third, exposure to violence impedes the rate of decline for all adolescents, but more dramatically for females than for males. Fourth, the rate of decline is smallest for adolescents with feelings of hopelessness who also had been exposed to violence. To explore the generalizability of these results to other types of sleep disorders, we analyzed cross-sectional data collected from a subsample of 14- and 15-year-old MYS participants (N = 263, 49 % female, 100 % African-American) who completed a sleep symptoms questionnaire. Four results from the cross-sectional analysis extend the findings of the longitudinal analysis. First, the cross-sectional results showed that symptoms of apnea, insomnia, nightmares, and restless legs syndrome or periodic limb movement disorder (RLS/PLMD), as well as daytime sleepiness, increase as a function of hopelessness. Second, symptoms of insomnia, RLS, and nightmares, as well as daytime sleepiness, increase as function of exposure to violence. Third, symptoms of insomnia and RLS/PLMD are greater under conditions of combined hopelessness and exposure to violence than for either condition alone. Fourth, symptoms of RLS/PLMD are worst for females who have been exposed to violence and experience hopelessness. Overall, the findings suggest that hopelessness and exposure to violence have negative independent and multiplicative effects on adolescent sleep, particularly for females. Understanding the causal factors associated with inadequate sleep in impoverished adolescents is important for three reasons. First, sleep is an important aspect of adolescent development. Second, inadequate sleep has severe consequences for adolescent morbidity, mortality, and overall quality of life. Third, impoverished adolescents are at the most severe risk for poor outcomes, and improvement in their sleep may produce large gains. © 2014 Springer Science+Business Media New York.",0,0 +6547,The long-term costs of traumatic stress: intertwined physical and psychological consequences,"The gradual emergence of symptoms following exposure to traumatic events has presented a major conceptual challenge to psychiatry. The mechanism that causes the progressive escalation of symptoms with the passage of time leading to delayed onset post-traumatic stress disorder (PTSD) involves the process of sensitization and kindling. The development of traumatic memories at the time of stress exposure represents a major vulnerability through repeated environmental triggering of the increasing dysregulation of an individual's neurobiology. An increasing body of evidence demonstrates how the increased allostatic load associated with PTSD is associated with a significant body of physical morbidity in the form of chronic musculoskeletal pain, hypertension, hyperlipidaemia, obesity and cardiovascular disease. This increasing body of literature suggests that the effects of traumatic stress need to be considered as a major environmental challenge that places individual's physical and psychological health equally at risk. This broader perspective has important implications for developing treatments that address the underlying dysregulation of cortical arousal and neurohormonal abnormalities following exposure to traumatic stress.",0,0 +6548,Acute Stress Symptoms in Children: Results From an International Data Archive,"

Objective

To describe the prevalence of acute stress disorder (ASD) symptoms and to examine proposed DSM-5 symptom criteria in relation to concurrent functional impairment in children and adolescents.

Method

From an international archive, datasets were identified that included assessment of acute traumatic stress reactions and concurrent impairment in children and adolescents 5 to 17 years of age. Data came from 15 studies conducted in the United States, United Kingdom, Australia, and Switzerland and included 1,645 children and adolescents. Dichotomized items were created to indicate the presence or absence of each of the 14 proposed ASD symptoms and functional impairment. The performance of a proposed diagnostic criterion (number of ASD symptoms required) was examined as a predictor of concurrent impairment.

Results

Each ASD symptom was endorsed by 14% to 51% of children and adolescents; 41% reported clinically relevant impairment. Children and adolescents reported from 0 to 13 symptoms (mean = 3.6). Individual ASD symptoms were associated with greater likelihood of functional impairment. The DSM-5 proposed eight-symptom requirement was met by 202 individuals (12.3%) and had low sensitivity (0.25) in predicting concurrent clinically relevant impairment. Requiring fewer symptoms (three to four) greatly improved sensitivity while maintaining moderate specificity.

Conclusions

This group of symptoms appears to capture aspects of traumatic stress reactions that can create distress and interfere with children's and adolescents' ability to function in the acute post-trauma phase. Results provide a benchmark for comparison with adult samples; a smaller proportion of children and adolescents met the eight-symptom criterion than reported for adults. Symptom requirements for the ASD diagnosis may need to be lowered to optimally identify children and adolescents whose acute distress warrants clinical attention.",0,0 +6549,Understanding the relationship between co-occurring PTSD and MDD: Symptom severity and affect,"How to best understand theoretically the nature of the relationship between co-occurring PTSD and MDD (PTSD+MDD) is unclear. In a sample of 173 individuals with chronic PTSD, we examined whether the data were more consistent with current co-occurring MDD as a separate construct or as a marker of posttraumatic stress severity, and whether the relationship between PTSD and MDD is a function of shared symptom clusters and affect components. Results showed that the more severe depressive symptoms found in PTSD+MDD as compared to PTSD remained after controlling for PTSD symptom severity. Additionally, depressive symptom severity significantly predicted co-occurring MDD even when controlling for PTSD severity. In comparison to PTSD, PTSD+MDD had elevated dysphoria and re-experiencing - but not avoidance and hyperarousal - PTSD symptom cluster scores, higher levels of negative affect, and lower levels of positive affect. These findings provide support for PTSD and MDD as two distinct constructs with overlapping distress components.",0,0 +6550,Reporting results of latent growth modeling and multilevel modeling analyses: Some recommendations for rehabilitation psychology.,"There has been a general increase in interest and use of modeling techniques that treat data as nested, whether it is people nested within larger units, such as families or treatment centers, or observations nested under people. The popularity can be witnessed by noting the number of new textbooks and articles related to latent growth curve modeling and multilevel modeling. This paper discusses both of these techniques in the context of longitudinal research designs, with the main purposes of highlighting some benefits and issues related to the use of these models and outlining guidelines for reporting results from studies using multilevel modeling or latent growth modeling.These longitudinal analytic techniques can be greatly beneficial to researchers conducting rehabilitation studies, but there are several issues related to their use and reporting that need to be taken into consideration.",0,0 +6551,"Clinical and psychological impact after surgical, medical or expectant management of first-trimester miscarriage - a randomised controlled trial","The management of first-trimester miscarriage has been studied extensively in recent years. However, relatively little attention has been focussed on woman's satisfaction and psychological impact from different treatment modalities.To investigate the clinical and psychological outcomes of surgical, medical and expectant management of first-trimester miscarriage.A prospective randomised controlled trial of 180 women suffering miscarriage managed by either surgical evacuation, medical evacuation or expectant management was conducted in a university-affiliated, tertiary referral hospital. The complete miscarriage rate, clinical symptomatology, complications, women's satisfaction and the psychological impact were evaluated.Women in surgical evacuation (98.1%) had a significantly higher complete miscarriage rate when compared with medical evacuation (70%) and expectant management (79.3%). Women who had surgical evacuation had significantly shorter duration of vaginal bleeding, but higher rate of infection. Women who had medical evacuation had significantly more gastrointestinal symptoms. Despite differences in efficacy and complication profile, there was no significant difference in satisfaction among groups. There were no significant differences in terms of psychological well-being, depression scores, anxiety level, fatigue symptoms as measured in General Health Questionnaire-12, Beck Depression Inventory, Spielberger's State Anxiety Inventory and fatigue scale at treatment and four weeks after treatment. However, women with active intervention had greater post-traumatic stress symptoms as measured in Chinese version of Impact of Event Scale-Revised at the time of treatment when compared with women in expectant management.Without substantial differences in the clinical and psychological impact between different treatment modalities, a more conservative approach with expectant management for miscarriage may be an option for women.",0,0 +6552,Preliminary Reliability and Validity of the Clinician-Administered PTSD Scale for Schizophrenia.,"This study provides preliminary psychometric support for a version of the Clinician-Administered Posttraumatic Stress Disorder (PTSD) Scale (CAPS; D. D. Blake et al., 1990) adapted for use with patients with schizophrenia (CAPS-S; J. S. Gearon. S. Thomas-Lohrman, & A. S. Bellack, 2001). Nineteen women with schizophrenia and co-occurring illicit drug use disorders were administered the CAPS-S, the Structured Clinical Interview for DSM-IV diagnoses (SCID). and scales measuring trauma-related psychopathology. The results indicate that the CAPS-S can distinguish between those with and without PTSD and that the symptom clusters measure unified constructs. Interrater and test-retest reliability were high for PTSD diagnosis and symptom clusters. Solid convergent validity was demonstrated between the CAPS-S and SCID-based PTSD diagnoses and the Impact of Event Scale. There is also preliminary evidence of discriminant validity. These results support the use of the CAPS-S in women with schizophrenia.",0,0 +6553,Violent behaviour and post-traumatic stress disorder,"Future research into violent behaviour and post-traumatic stress disorder will reveal the risk factors for this disorder, and try to explain what it is that, afterexposing an individual to psychological trauma, leads to post-traumatic stress disorder. Possible protective factors and mechanisms to prevent the occurence of post-traumatic stress disorder will be described.",0,0 +6554,Best practices for missing data management in counseling psychology.,"This article urges counseling psychology researchers to recognize and report how missing data are handled, because consumers of research cannot accurately interpret findings without knowing the amount and pattern of missing data or the strategies that were used to handle those data. Patterns of missing data are reviewed, and some of the common strategies for dealing with them are described. The authors provide an illustration in which data were simulated and evaluate 3 methods of handling missing data: mean substitution, multiple imputation, and full information maximum likelihood. Results suggest that mean substitution is a poor method for handling missing data, whereas both multiple imputation and full information maximum likelihood are recommended alternatives to this approach. The authors suggest that researchers fully consider and report the amount and pattern of missing data and the strategy for handling those data in counseling psychology research and that editors advise researchers of this expectation.",0,0 +6555,Assessing Covariates of Adolescent Delinquency Trajectories: A Latent Growth Mixture Modeling Approach,"Using data from a community sample of 1218 boys and girls (mean age at the first wave was 15.5 years), this longitudinal study examined several covariates--adjustment problems, poor academic achievement, negative life events, and unsupportive family environments--of distinctive trajectories of juvenile delinquency. Latent growth mixture modeling analysis revealed 6 trajectory groups: rare offenders, moderate late peakers, high late peakers, decreasers, moderate-level chronics, and high-level chronics. Several factors discriminated between more normative groups and high-level chronic offenders, including poor academic achievement, unsupportive family environments, life events, and substance use, whereas almost no differences were found between groups with more serious offending trajectories. Overall, there was more specificity in correlates of distinctive offending trajectories than expected by general theories of crime (e.g., Gottfredson, M. R., and Hirschi, T., 1990, A General Theory of Crime. Stanford University Press, Stanford, CA). (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +6556,Posttraumatic Stress Disorder Symptoms Might be Destroying your Intimacy: A Test of Mediational Models in a Community Sample of Couples,"The present research focused on the pathways through which the symptoms of posttraumatic stress disorder (PTSD) may negatively impact intimacy. Previous research has confirmed a link between self-reported PTSD symptoms and intimacy; however, a thorough examination of mediating paths, partner effects, and secondary traumatization has not yet been realized. With a sample of 297 heterosexual couples, intraindividual and dyadic models were developed to explain the relationships between PTSD symptoms and intimacy in the context of interdependence theory, attachment theory, and models of self-preservation (e.g., fight-or-flight). The current study replicated the findings of others and has supported a process in which affective (alexithymia, negative affect, positive affect) and communication (demand-withdraw behaviour, self-concealment, and constructive communication) pathways mediate the intraindividual and dyadic relationships between PTSD symptoms and intimacy; Moreover, it also found that the PTSD symptoms of each partner were significantly related; however, this was only the case for those dyads in which the partners had disclosed most everything about their traumatic experiences. As such, secondary traumatization was supported. Finally, although the overall pattern of results suggest a total negative effect of PTSD symptoms on intimacy, a sex difference was evident such that the direct effect of the woman's PTSD symptoms were positively associated with both her and her partner's intimacy. It is possible that the Tend-and-Befriend model of threat response, wherein women are said to foster social bonds in the face of distress, may account for this sex difference. Overall, however, it is clear that PTSD symptoms were negatively associated with relationship quality and attention to this impact in the development of diagnostic criteria and treatment protocols is necessary. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6557,Pathways to change: Trajectories following treatment in women with co-occurring PTSD and substance use disorders,"s / Drug and Alcohol Dependence 146 (2015) e118–e201 e185 Chi-squares & ANOVAs were used to compare dichotomous & continuous variables, respectively. Results: Incentives increased abstinence above control levels antepartum & postpartum: (late-pregnancy: 37% vs 11%; 2wk: 33% vs 15%; 4wk: 31% vs 12%; 8wk: 25% vs 10%; 12wk: 22% vs 7%; 24wk: 15% vs 3%; all p 16) at weeks 4–12 postpartum (all p< .05). Conclusions: In addition to increasing smoking abstinence, voucher-based incentives for smoking cessation decrease postpartum depression. This effect compliments the significant improvements in birth outcomes & breastfeeding duration reported previously with this intervention. Financial support: R01DA14028, R01HD075669, P20GM103644, T32DA07242. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.417 Pathways to change: Trajectories following treatment in women with co-occurring PTSD and substance use disorders Teresa Lopez-Castro1, M. Hu2, D.A. Hien1 1 The City College of New York, New York, NY, United States 2 NY State Psychiatric Institute, New York, NY, United",0,0 +6558,The Early Adolescent or “Juvenile Stress” Translational Animal Model of Posttraumatic Stress Disorder,"The diagnosis of posttraumatic stress disorder (PTSD) requires exposure to a major traumatic event. This criterion has influenced the thinking about causes of the disorder, approaches to treatment, and also how to establish an effective animal model of the disorder. Accordingly, the focus in animal models of PTSD is on what would establish an effective traumatic exposure that would lead to PTSD-related symptoms in the studied animal. However, the prevalence of PTSD among individuals exposed to a traumatic event suggests that the exposure to the trauma is not sufficient to induce PTSD, since most exposed individuals will not develop the disorder. The emphasis in translational animal models of PTSD should thus be on inclusion of relevant risk factors, that together with the exposure to a traumatic event will lead to the development of PTSD. Epidemiological studies indicate that childhood trauma predisposes individuals to develop stress-related disorders later in life. As a result of this finding, we developed an animal model in which exposing rats to early adolescence (postweaning, prepubertal, juvenile) stress was also found to induce a predisposition to develop PTSD following an exposure to an additional stress in adulthood. Within these pre-exposed animals, dissociation could be caused among individuals that exhibited more anxious or more depressive symptoms. This dissociation, which has been recognized also in human patients, required the development of a behavioral profiling approach that enabled grouping animals according to their clusters of symptoms. Interestingly, this approach also enabled the identification of new data on the influence of sex on long-term consequences of “Juvenile Stress.” These data reveal that whilst both male and female rats showed behavioral changes following exposure to a stressor at juvenility, the profile of effects differed between the sexes. Collectively, these findings indicate that the model presented here is an effective translational model for understanding of the etiology of trauma-related disorders and of relevant predisposing factors. © Springer Science+Business Media New York 2015.",0,0 +6559,Clinical meaning of the Keane PTSD scale,"A correlational study that included 82 male inpatient alcoholics was conducted to determine the clinical meaning of the Keane PTSD Scale of the MMPI. The PTSD Scale was correlated with the variables of the Shipley Institute of Living Scale, the Life Purpose Questionnaire, the Existential Depression Test, and the standard MMPI measures, plus the A, R, Es and MacAndrew Scales. The pattern of correlations suggested that the PTSD scale measures general psychological maladjustment and dysphoric feelings rather than any specifiable syndrome. The strong correlation with the Welch A, which measures a general level of maladjustment, suggests that the PTSD and Welch A scales are measuring the same factor. The PTSD scale, therefore, appears to provide very little information about this population beyond that available from the overall clinical profile and the Welch A scale.",0,0 +6560,Posttraumatic stress hyperarousal symptoms mediate the relationship between childhood exposure to violence and subsequent alcohol misuse in Mi'kmaq youth,"This study was part of a school-based collaborative research project with a Canadian Mi'kmaq community that examined the potential role of posttraumatic stress (PTS) symptom clusters in mediating the relationship between childhood exposure to violence (EV) and alcohol misuse in a sample of Mi'kmaq adolescents (N = 166). The study employed a cross-sectional design and used several well-validated self-report questionnaires. Path analytic results showed that when each PTS symptom cluster was independently investigated for mediating effects while controlling for depressive symptoms, age, and gender, only the PTS hyperarousal symptom cluster fully mediated the EV-alcohol misuse relationship. Results are discussed within the context of previous theory and research on the topic of PTS as a mediator between EV and alcohol misuse.",0,0 +6561,Cognitive-behavioral coping strategies associated with combat-related PTSD in treatment-seeking OEF–OIF Veterans,"Posttraumatic stress disorder (PTSD) is associated with intrusive trauma-related thoughts and avoidance behaviors that contribute to its severity and chronicity. This study examined thought control and avoidance coping strategies associated with both a probable diagnosis and symptom severity of combat-related PTSD in a sample of 167 treatment-seeking Operations Enduring Freedom and Iraqi Freedom (OEF-OIF) Veterans. Within one year of returning from deployment, Veterans completed a survey containing measures of combat exposure, coping strategies, psychopathology, and postdeployment social support. Veterans with a positive screen for PTSD scored higher than Veterans without a positive screen for PTSD on measures of worry, self-punishment, social control, behavioral distraction, and avoidance coping strategies. Worry and social avoidance coping were positively related to PTSD symptoms, and greater perceptions of understanding from others were negatively related to these symptoms. A structural equation model revealed that scores on a measure of postdeployment social support were negatively associated with scores on measures of maladaptive cognitive coping (i.e., worry, self-punishment) and avoidance coping (social and non-social avoidance coping) strategies, which were positively associated with combat-related PTSD symptoms. These results suggest that maladaptive thought control and avoidance coping may partially mediate the relation between postdeployment social support and combat-related PTSD symptoms in treatment-seeking OEF-OIF Veterans. Consistent with cognitive therapy models, these findings suggest that interventions that target maladaptive coping strategies such as worry, self-punishment, and social avoidance, and that bolster social support, most notably understanding from others, may help reduce combat-related PTSD symptoms in this population.",0,0 +6562,Utilizing correspondence analysis to characterize the mental health of cardiac patients with diabetes,"The aim of this study was to examine the mental health of cardiac patients with diabetes and whether symptoms varied by gender and/or age. Screening for depression and posttraumatic stress symptoms was conducted on 1003 patients with cardiovascular disease. Correspondence analysis was utilized to identify clinical core profiles. Results suggested that cardiovascular disease patients with diabetes, particularly males, experience high rates of depression, suicide ideation, and posttraumatic stress symptoms. Clinical implications of these findings include targeted mental health screening options as well as offering a closer look at the specific concerns of cardiovascular disease patients with diabetes.",0,0 +6563,Anxiety and prepulse inhibition of acoustic startle in a normative sample: The importance of signal-to-noise ratio,"Abstract Previous studies have used prepulse inhibition of the startle response (PPI) to investigate the anxiety spectrum, primarily in patient samples, with mixed results. The inconsistency in findings may be due, in part, to the use of non-optimal signal-to-noise ratios (SnRs: the difference between background noise intensity and prepulse intensity) in some studies. We proposed that, as SnR approaches +15 dB, anxiety spectrum variables will be negatively correlated with PPI, even in a normative sample. Thus, we used the MCMI-III to measure levels of trait anxiety, posttraumatic stress disorder (PTSD), and the three Cluster C personality disorders in a sample of 53 undergraduate females, and then correlated their scores with their PPI levels at SnRs of +5, +10, and +15 dB. All of the anxiety constructs except obsessive-compulsive personality disorder (OCPD) were correlated with PPI, but only in the +15 dB condition. Although OCPD symptomatology was not correlated with PPI, it was negatively correlated with PTSD and may have been indicative of adaptive functioning in this normative sample. The present study demonstrates that PPI is a sensitive index of anxiety symptomatology even in the normative range, and that a SnR near +15 dB may be necessary to reliably detect associations between PPI and these psychological variables.",0,0 +6564,Lasting Consequences of Traumatic Events on Behavioral and Skeletal Parameters in a Mouse Model for Post-Traumatic Stress Disorder (PTSD),"Post-traumatic stress disorder (PTSD) is an anxiety disorder that not only affects mental health, but may also affect bone health. However, there have been no studies to examine the direct relationship between PTSD and bone.We employed electric shocks in mice to simulate traumatic events that cause PTSD. We also injected the anxiogenic drug FG-7142 prior to electric shocks. Electric shocks created lasting conditioned fear memory in all mice. In young mice, electric shocks elicited not only behavioral response but also skeletal response, and injection of FG-7142 appeared to increase both types of response. For example in behavioral response within the first week, mice shocked alone froze an average of 6.2 sec in 10 sec tests, and mice injected with FG-7142 froze 7.6 sec, both significantly different (P<0.05) from control mice, which only froze 1.3 sec. In skeletal response at week 2, shocks alone reduced 6% bone mineral content (BMC) in total body (P = 0.06), while shocks with FG-7142 injection reduced not only 11% BMC (P<0.05) but also 6% bone mineral density (BMD) (P<0.05). In addition, FG-7142 injection also caused significant reductions of BMC in specific bones such as femur, lumbar vertebra, and tibia at week 3. Strong negative correlations (R(2) = -0.56, P<0.05) and regression (y = 0.2527-0.0037 * x, P<0.01) between freezing behavior and total body BMC in young mice indicated that increased contextual PTSD-like behavior was associated with reduced bone mass acquisition.This is the first study to document evidence that traumatic events induce lasting consequences on both behavior and skeletal growth, and electric shocks coupled with injection of anxiogenic FG-7142 in young mice can be used as a model to study the effect of PTSD-like symptoms on bone development.",0,0 +6565,"Improved Cognitive Function After Transcranial, Light-Emitting Diode Treatments in Chronic, Traumatic Brain Injury: Two Case Reports","Objective: Two chronic, traumatic brain injury (TBI) cases, where cognition improved following treatment with red and near-infrared light-emitting diodes (LEDs), applied transcranially to forehead and scalp areas, are presented. Background: Significant benefits have been reported following application of transcranial, low-level laser therapy (LLLT) to humans with acute stroke and mice with acute TBI. These are the first case reports documenting improved cognitive function in chronic, TBI patients treated with transcranial LED. Methods: Treatments were applied bilaterally and to midline sagittal areas using LED cluster heads [2.1″ diameter, 61 diodes (9 × 633 nm, 52 × 870 nm); 12–15 mW per diode; total power: 500 mW; 22.2 mW/cm2; 13.3 J/cm2 at scalp (estimated 0.4 J/cm2 to cortex)]. Results: Seven years after closed-head TBI from a motor vehicle accident, Patient 1 began transcranial LED treatments. Pre-LED, her ability for sustained attention (computer work) lasted 20 min. After eight weekly LED treatments, her sustained attention time increased to 3 h. The patient performs nightly home treatments (5 years); if she stops treating for more than 2 weeks, she regresses. Patient 2 had a history of closed-head trauma (sports/military, and recent fall), and magnetic resonance imaging showed frontoparietal atrophy. Pre-LED, she was on medical disability for 5 months. After 4 months of nightly LED treatments at home, medical disability discontinued; she returned to working full-time as an executive consultant with an international technology consulting firm. Neuropsychological testing after 9 months of transcranial LED indicated significant improvement (+1, +2SD) in executive function (inhibition, inhibition accuracy) and memory, as well as reduction in post-traumatic stress disorder. If she stops treating for more than 1 week, she regresses. At the time of this report, both patients are continuing treatment. Conclusions: Transcranial LED may improve cognition, reduce costs in TBI treatment, and be applied at home. Controlled studies are warranted.",0,0 +6566,Risk factors and posttraumatic stress disorder: are they especially predictive following exposure to less severe stressors?,"The diagnosis of posttraumatic stress disorder (PTSD) requires exposure to a traumatic stressor, as defined by Criterion A in the DSM criteria for PTSD. Yet, over the course of successive revisions of the diagnostic manual, the range of qualifying stressors has expanded considerably (e.g., watching terrorist attacks on television). Moreover, stressors that fall short of qualifying for even an expanded Criterion A can produce apparent PTSD. Taken together, these findings imply that people who do satisfy symptomatic criteria for PTSD following exposure to less severe stressors carry a heavy burden of risk factors.To test this hypothesis, we examined whether the association between the risk factor of lower intelligence and more severe PTSD and depression symptoms would be greater among women reporting less severe CSA (n = 15) relative to women who reported moderate (n = 54) or high (n = 31) severity CSA.The evidence was consistent with this hypothesis for subjects in the low and moderate severity groups, but less so for those in the high severity group.Lower intelligence was a more potent risk factor for posttraumatic distress among people exposed to less severe relative to moderately severe stressors.",0,0 +6567,Main and interactive effects of a nonclinical panic attack history and distress tolerance in relation to PTSD symptom severity,"The current study investigated the main and interactive effects of a nonclinical panic attack history and distress tolerance in relation to PTSD symptoms. The sample consisted of 91 adults (62.6% women; M(age)=23.45, SD=9.56) who met DSM-IV criteria for trauma exposure, 53.8% of whom met criteria for a recent (past 2 years) history of nonclinical panic attacks. Results indicated that distress tolerance, as measured by the Distress Tolerance Scale (Simons & Gaher, 2005), was significantly related to all PTSD symptom clusters, and a nonclinical panic attack history was significantly related to PTSD re-experiencing and hyperarousal symptoms. The interaction of a nonclinical panic attack history and distress tolerance significantly predicted unique variance in only PTSD hyperarousal symptoms. Implications and future directions are discussed for the role of nonclinical panic attacks and distress tolerance in PTSD symptom expression.",0,0 +6568,Posttraumatic Stress Disorder in Hospitalized Adolescents: Psychiatric Comorbidity and Clinical Correlates,"

ABSTRACT

Objective

To describe the diagnostic comorbidity and clinical correlates of posttraumatic stress disorder (PTSD) in adolescent psychiatric inpatients.

Method

Seventy-four adolescent inpatients were given a structured diagnostic interview, the revised version of the Diagnostic Interview for Children and Adolescents, and a battery of standard self-report measures to assess general trauma exposure, posttraumatic stress symptoms, suicidal behavior, dissociation, and depression.

Results

Ninety-three percent of subjects reported exposure to at least one traumatic event such as being a witness/victim of community violence, witnessing family violence, or being the victim of physical/sexual abuse. Thirty-two percent of subjects met diagnostic criteria for current PTSD, with sexual abuse cited as the most common traumatic stressor in 69% of PTSD cases. Girls were significantly more likely to develop PTSD than boys, although the total number of types of trauma did not differ by gender. Compared with psychiatric controls, male youngsters with PTSD were significantly more likely to have comorbid diagnoses of eating disorders, other anxiety disorders, and somatization disorder. Furthermore, male and female youngsters with PTSD were significantly more likely to have attempted suicide and report greater depressive and dissociative symptoms.

Conclusion

In clinical populations of hospitalized adolescents exposed to multiple forms of trauma, PTSD is a common, but highly comorbid disorder. Specific multimodal assessments and treatments targeted to both PTSD and its comorbidity profile are warranted. J. Am. Acad. Child Adolesc. Psychiatry, 1999, 38(4):385–392.",0,0 +6569,Reintegration Challenges in U.S. Service Members and Veterans Following Combat Deployment,"Although the majority of combat veterans reintegrate into civilian life without long-lasting problems, a sizable minority return from deployment with psychiatric or physical injuries that warrant medical attention. Even in the absence of diagnosable disorders, many experience functional problems that impede full reintegration into civilian life. Considerable resources have been allocated to studying, diagnosing, treating, and compensating combat-related disorders. This important work has resulted in significant improvements in healthcare for those with deployment-related difficulties. Nevertheless, many service members and veterans with reintegration difficulty may not receive needed help. Based on our review, we argue that in addition to treatment and compensation for diagnosable postdeployment problems, a comprehensive approach to reintegration is needed that includes partnership between the government, private sector, and the public.",0,0 +6570,Barriers to Receiving Early Care for PTSD: Results From the Jerusalem Trauma Outreach and Prevention Study,,0,0 +6571,White Matter Microstructure Alterations: A Study of Alcoholics with and without Post-Traumatic Stress Disorder,"Many brain imaging studies have demonstrated reductions in gray and white matter volumes in alcoholism, with fewer investigators using diffusion tensor imaging (DTI) to examine the integrity of white matter pathways. Among various medical conditions, alcoholism and post-traumatic stress disorder (PTSD) are two comorbid diseases that have similar degenerative effects on the white matter integrity. Therefore, understanding and differentiating these effects would be very important in characterizing alcoholism and PTSD. Alcoholics are known to have neurocognitive deficits in decision-making, particularly in decisions related to emotionally-motivated behavior, while individuals with PTSD have deficits in emotional regulation and enhanced fear response. It is widely believed that these types of abnormalities in both alcoholism and PTSD are related to fronto-limbic dysfunction. In addition, previous studies have shown cortico-limbic fiber degradation through fiber tracking in alcoholism. DTI was used to measure white matter fractional anisotropy (FA), which provides information about tissue microstructure, possibly indicating white matter integrity. We quantitatively investigated the microstructure of white matter through whole brain DTI analysis in healthy volunteers (HV) and alcohol dependent subjects without PTSD (ALC) and with PTSD (ALC+PTSD). These data show significant differences in FA between alcoholics and non-alcoholic HVs, with no significant differences in FA between ALC and ALC+PTSD in any white matter structure. We performed a post-hoc region of interest analysis that allowed us to incorporate multiple covariates into the analysis and found similar results. HV had higher FA in several areas implicated in the reward circuit, emotion, and executive functioning, suggesting that there may be microstructural abnormalities in white matter pathways that contribute to neurocognitive and executive functioning deficits observed in alcoholics. Furthermore, our data do not reveal any differences between ALC and ALC+PTSD, suggesting that the effect of alcohol on white matter microstructure may be more significant than any effect caused by PTSD.",0,0 +6572,Examining the role of grief in the etiology of Posttraumatic Stress Disorder (PTSD) symptoms in American Indian adolescents,"The prevalence of Posttraumatic Stress Disorder (PTSD) is reported to be comparatively high in child and adolescent populations (Reinherz, Gaiconia, Leftkowitz, Pakiz, & Frost,1993). However, recent research has suggested that there may be differing etiological factors, specifically, Child Traumatic Grief (CTG), that contributes to the development of PTSD symptoms in American Indian adolescents (Morsette, at al., 2007). First this study demonstrated that CTG symptoms predicted PTSD symptoms above and beyond that which was predicted by violence exposure. Second, it was found that CTG predicted depression above and that which was predicted by PTSD symptoms. Third, it found that grief was significantly correlated with PTSD symptoms. Similarly, grief was also significantly correlated with the depressive symptoms. Finally, using a two-tailed Pearson's Product mom$$ent correlation this study found there was no correlation between PTSD symptoms, grief symptoms, depressive symptoms, and American Indian student's Grade Point Average and absenteeism. However, a post-hoc analysis using a one-tailed Pearson's Product moment correlation indicated a statistical significant correlation between GPA and depression. Additional etiological models are explored. This study is the first to examine etiological factors of PTSD in American Indian adolescents. Additional qualitative research is necessary to better understand the contribution of grief in the development of PTSD symptoms.",0,0 +6573,Posttraumatic Stress Disorder in Children,"Children and psychic trauma: a brief review of contemporary thinking. Children traumatized by witnessing acts of personal violence: homicide, rape, or suicide behavior. Children traumatized in small groups. Children traumatized by catastrophic situations. Children traumatized by Central American warfare. Post-traumatic stress disorder in children with cancer. Children traumatized by physical abuse. Post-traumatic symptoms in incest victims. Interaction of trauma and grief in childhood.",0,0 +6574,Sex differences in objective measures of sleep in post-traumatic stress disorder and healthy control subjects,"A growing literature shows prominent sex effects for risk for post-traumatic stress disorder and associated medical comorbid burden. Previous research indicates that post-traumatic stress disorder is associated with reduced slow wave sleep, which may have implications for overall health, and abnormalities in rapid eye movement sleep, which have been implicated in specific post-traumatic stress disorder symptoms, but most research has been conducted in male subjects. We therefore sought to compare objective measures of sleep in male and female post-traumatic stress disorder subjects with age- and sex-matched control subjects. We used a cross-sectional, 2 × 2 design (post-traumatic stress disorder/control × female/male) involving83 medically healthy, non-medicated adults aged 19-39 years in the inpatient sleep laboratory. Visual electroencephalographic analysis demonstrated that post-traumatic stress disorder was associated with lower slow wave sleep duration (F(3,82) = 7.63, P = 0.007) and slow wave sleep percentage (F(3,82) = 6.11, P = 0.016). There was also a group × sex interaction effect for rapid eye movement sleep duration (F(3,82) = 4.08, P = 0.047) and rapid eye movement sleep percentage (F(3,82) = 4.30, P = 0.041), explained by greater rapid eye movement sleep in post-traumatic stress disorder females compared to control females, a difference not seen in male subjects. Quantitative electroencephalography analysis demonstrated that post-traumatic stress disorder was associated with lower energy in the delta spectrum (F(3,82) = 6.79, P = 0.011) in non-rapid eye movement sleep. Slow wave sleep and delta findings were more pronounced in males. Removal of post-traumatic stress disorder subjects with comorbid major depressive disorder, who had greater post-traumatic stress disorder severity, strengthened delta effects but reduced rapid eye movement effects to non-significance. These findings support previous evidence that post-traumatic stress disorder is associated with impairment in the homeostatic function of sleep, especially in men with the disorder. These findings suggest that group × sex interaction effects on rapid eye movement may occur with more severe post-traumatic stress disorder or with post-traumatic stress disorder comorbid with major depressive disorder.",0,0 +6575,"Differential effectiveness of tianeptine, clonidine and amitriptyline in blocking traumatic memory expression, anxiety and hypertension in an animal model of PTSD","Individuals exposed to life-threatening trauma are at risk for developing post-traumatic stress disorder (PTSD), a debilitating condition that involves persistent anxiety, intrusive memories and several physiological disturbances. Current pharmacotherapies for PTSD manage only a subset of these symptoms and typically have adverse side effects which limit their overall effectiveness. We evaluated the effectiveness of three different pharmacological agents to ameliorate a broad range of PTSD-like symptoms in our established predator-based animal model of PTSD. Adult male Sprague-Dawley rats were given 1-h cat exposures on two occasions that were separated by 10 days, in conjunction with chronic social instability. Beginning 24 h after the first cat exposure, rats received daily injections of amitriptyline, clonidine, tianeptine or vehicle. Three weeks after the second cat exposure, all rats underwent a battery of behavioral and physiological tests. The vehicle-treated, psychosocially stressed rats demonstrated a robust fear memory for the two cat exposures, as well as increased anxiety expressed on the elevated plus maze, an exaggerated startle response, elevated heart rate and blood pressure, reduced growth rate and increased adrenal gland weight, relative to the vehicle-treated, non-stressed (control) rats. Neither amitriptyline nor clonidine was effective at blocking the entire cluster of stress-induced sequelae, and each agent produced adverse side effects in control subjects. Only the antidepressant tianeptine completely blocked the effects of psychosocial stress on all of the physiological and behavioral measures that were examined. These findings illustrate the differential effectiveness of these three treatments to block components of PTSD-like symptoms in rats, and in particular, reveal the profile of tianeptine as the most effective of all three agents.",0,0 +6576,Suicide Attempts in Anorexia Nervosa,"To explore prevalence and patterns of suicidal attempts in persons with anorexia nervosa (AN).Participants were the first 432 persons (22 male, 410 female) enrolled in the NIH funded Genetics of Anorexia Nervosa Collaborative Study. All participants had current or lifetime AN. The participants ranged in age from 16 to 76 (mean = 30.4, SD = 11.3). Suicidal behavior and intent was assessed via the Diagnostic Interview for Genetic Studies. We compared frequency and severity of attempts across diagnostic subtypes and comorbidity, and personality features associated with the presence of suicide attempts in persons with AN.About 16.9% of those with AN attempted suicide. Significantly fewer persons with the restricting subtype (7.4%) reported at least one attempt than those with purging AN (26.1%), AN with binge eating (29.3%), and a mixed picture of AN and bulimia nervosa (21.2%). After controlling for major depression, suicide attempts were associated with substance abuse, impulsive behaviors and traits, Cluster B personality disorders, panic disorder, and post-traumatic stress disorder as well as low self-directedness and eating disorder severity.Suicide attempts in AN are not uncommon, are frequently associated with the intention to die, occur less frequently in persons with the restricting subtype of the illness, and after controlling for depression are associated with a constellation of behaviors and traits associated with behavioral and affective dyscontrol.",0,0 +6577,Can post-traumatic stress disorder be prevented?,"Abstract In the 20-odd years since the cluster of symptoms known as Post Traumatic Stress Disorder (PTSD) has been studied, we have learned a great deal about treating the distress that accompanies trauma in its many forms. We will only know whether or not we have succeeded in preventing the disorder when we have access to long-term studies of people who received intervention immediately following a traumatic event. We do know, however, much more about the impact of trauma on victims and witnesses of traumatic events, sometimes long past the event itself. We know, for example, that ‘triggers'-events reminiscent of the original event-play an extraordinarily important role in the development of symptoms. Removing those triggers is one method for alleviating distress. But a growing interest in the relationship between body, mind, and spirit points toward another possibility: counteracting the stressful triggers with equally powerful images that contain the seeds of recovery. Nurses are continually exposed to pain and suffering, stress and trauma, are themselves vulnerable to PTSD, and perhaps as much as the patients they care for, need hope and healing. We may not be able to prevent stress or distress. But we can alter the intensity and duration of stress related to trauma by naming our demons, daring to struggle with them, and by creating healing communities for ourselves as well as our patients.",0,0 +6578,Comparing the diagnosis of PTSD when assessing worst versus multiple traumatic events in a chronically mentally ill sample,"Despite interest in the nature of the traumatic event required to meet Criterion A for posttraumatic stress disorder (PTSD) as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994), little attention has been paid to the diagnostic ramifications of linking PTSD symptoms to a single traumatic event in the context of multiple trauma exposures. In this study, 67 dually diagnosed clients with at least 2 potential Criterion A traumatic events completed the Posttraumatic Stress Diagnostic Scale twice, in counterbalanced order: once regarding their worst event and once regarding all events. When responding regarding their worst trauma, 53.7% met probable PTSD criteria. This rose to 67.2% when considering all traumas. Although preliminary, these results suggest that linking PTSD symptoms to a single traumatic event excludes a meaningful number of cases who are otherwise indistinguishable based on symptom profile.",0,0 +6579,Perceptions of Trauma and Loss among Children and Adolescents Exposed to Disasters a Mixed-Methods Study,"The purpose of the current study was to extend knowledge of youth exposed to multiple disasters and the experience of cumulative childhood adversity by analyzing perceptions of trauma and loss in children and adolescents. A concurrent mixed-methods design was utilized to explore an ethnically diverse, predominantly low-income sample of youth (N = 4,154) aged 8–18 years from three parishes (counties) in Louisiana impacted by Hurricane Katrina and the Gulf Oil Spill. Youth completed assessments of posttraumatic stress symptoms (PTSS), hurricane exposure and oil spill stress, and responded to an open-ended question regarding lifetime trauma and loss. Independent coders assigned responses to 30 categories using a qualitative codebook based on both predetermined and emerging information. Codes were compared and contrasted for meaning and grouped into broader, organizing themes. Themes of trauma and loss included: death and loss of others, threats to life, family disruption, interpersonal trauma, and life transitions. Trauma and loss predicted PTSS when controlling for hurricane exposure and oil spill stress. Most trauma and loss conferred generalized risk regardless of event typology, although interpersonal trauma had unique effects. Findings improve understanding of the nature and extent of trauma and loss among youth exposed to multiple disasters. The use of a mixed-methods design clarifies prior findings in the broader trauma literature and child disaster studies. Through identification of vulnerable subgroups and patterns in perceptions of trauma and loss, findings have important implications for prevention and intervention strategies that promote long-term recovery. © 2015, Springer Science+Business Media New York.",0,0 +6580,Naive and Memory T Cell Subsets are Differentially Mobilized During Physical Stress,"This study examined the naive and memory phenotypic profiles of CD4+ and CD8hi T cells that were mobilized to the peripheral circulation during a combination of aerobic exercise and heat stress, determining expression of the adhesion molecules CD62L and CD11a on the recruited cells. Twelve recreationally active males (age 27.1 +/- 5.3 yr, height 1.77 +/- 0.08 m, mass 76.9 +/- 12.0 kg, VO2peak 43.9 +/- 6.7 mL x kg(-1) x min(-1)) completed a 40 min bout of cycle ergometry at 65 % of VO2peak while immersed to mid-chest in a water bath at 39 degrees C. Venous blood samples were collected before (T0), during (T40) and 30 min after (T70) exposure to combined exercise and heat stress. Specimens were analyzed by three-colour flow cytometry for CD4+ and CD8hi T cell expression of CD45RO, CD11a and CD62L. Some 80 % of the CD4+ T cells that were mobilized were of the CD45RO memory phenotype, with the numbers of CD11alo and CD62L+ cells increasing more than those of CD11ahi and CD62L- cells. For the CD8hi cells, there was a more equal recruitment of CD45RO- naive (43 %) and CD45RO+ memory (57 %) cells. The majority (84 %) of recruited CD8+ cells were CD11ahi; there was a trend to predominance of CD62L- cells (57 %) for the memory subset, but with almost equal recruitment of CD62L+/- for the naive subset. We conclude that the exercise + heat stress induced trend to an increase in CD4+ T cells is linked in some way to memory phenotype; it cannot be explained simply by a high density expression of CD11a and lack of the lymph node homing receptor (CD62L). Furthermore, although mobilization of CD8hi T cells is not linked to memory phenotype, a high density expression of CD11a and a lack of the lymph node homing receptor are important determinants of CD8hi T cell mobilization.",0,0 +6581,"Psychopathological, biological, and neuroimaging characterization of posttraumatic stress disorder in survivors of a severe coalmining disaster in China","On July 29, 2007, a severe coalmine-flooded disaster occurred in central China and 69 miners were trapped in an about 1400 m underground coal pit. Fortunately, all of them were rescued after 75 h of the ordeal. At 3 and 6 months after the disaster, psychopathological profiles, plasma levels of cortisol and adrenocorticotropic hormone (ACTH) were evaluated in 48 survivors for posttraumatic stress disorder (PTSD) and comorbid symptoms. Magnetic resonance imaging (MRI) study was performed at 6 months. The prevalence of PTSD was 35.4% (17/48) at 3 months and 31.3% (15/48) at 6 months post-disaster, with high rates of comorbid symptoms. Risk factors for PTSD included previous traumatic experience, less than 5 years of being a miner, in an extremely exhausted or sick during the disaster, poor interpersonal relationship and poor sleep quality experienced before the disaster. Mean plasma cortisol levels at 6 months, but not at 3 months, were significantly higher in PTSD-positive subjects than the negative, and positively correlated with the severity of several comorbid symptoms. Either whole or regional brain volumes of PTSD-positive subjects were not significantly different from PTSD-negative subjects, but PTSD subjects had significantly reduced fractional anisotropy values in the right posterior cingulum and bilateral hippocampal body compared to subjects without PTSD. These results suggest that traumatic exposure in severe coalmining disasters results in considerable psychological consequences, with highly prevalent PTSD and comorbid symptoms, which are associated with previous traumatic experience, shorter-length underground services, and poor interpersonal relationships and sleep quality experienced before the disaster. Baseline cortisol level may be a useful biological predictor for different phases of the development of PTSD. The aberrant connectivity of the hippocampus and the cingulum may represent an early pathological response to trauma exposure.",0,0 +6582,Documented combat exposure of US veterans seeking treatment for combat-related post-traumatic stress disorder,"Background There are concerns regarding the validity of combat exposure reports of veterans seeking treatment for combat-related post-traumatic stress disorder (PTSD) within US Veterans Affairs Medical Centers. Aims To verify combat exposure history for a relevant sample through objective historical data. Method Archival records were reviewed from the US National Military Personnel Records Center for 100 consecutive veterans reporting Vietnam combat in a Veterans Affairs PTSD clinic. Cross-sectional clinical assessment and 12-month service use data were also examined. Results Although 93% had documentation of Vietnam war-zone service, only 41% of the total sample had objective evidence of combat exposure documented in their military record. There was virtually no difference between the Vietnam ‘combat’ and ‘no combat’ groups on relevant clinical variables. Conclusions A significant number of treatment-seeking Veterans Affairs patients may misrepresent their combat involvement in Vietnam. There are implications for the integrity of the PTSD database and the Veterans Affairs healthcare system.",0,0 +6583,"Cortical/hippocampal monoamines, HPA-axis changes and aversive behavior following stress and restress in an animal model of post-traumatic stress disorder","Post-traumatic stress disorder (PTSD) is characterized by monoaminergic and hypothalamic–pituitary–adrenal (HPA)-axis abnormalities. Understanding monoamine-HPA-axis responses following stress and restress may provide a greater understanding of the neurobiology of PTSD and of its treatment. Hippocampal and frontal cortex serotonin, noradrenaline and dopamine, plasma corticosterone and aversive behavior were studied in rats on day 1 and day 7 post acute stress (AS = sequential restraint stress, swim stress and halothane exposure), and on day 1 and day 7 post restress (RS = swim stress). After AS, there was an early increase in both avoidant behavior and corticosterone (1 h after stress), with subsequent normalisation (day 7), suggesting an adequate adaptive response to the stressor. However, restress (RS) evoked a significant early HPA-axis hyporesponsiveness (1 h after RS) and a later significant increase in avoidant behavior on day 7 post RS. Hippocampal serotonin, noradrenaline and dopamine concentrations were unchanged 1 h post AS, but were significantly raised on day 7 post AS. Restress, however, reduced serotonin and noradrenaline levels 1 h after and on day 7 post RS, respectively, while dopamine was unchanged. In the frontal cortex only dopamine levels were altered, being significantly elevated 1 h after AS, and reduced on day 7 post RS. AS and RS thus differently effect the HPA-axis, evoking regional-specific brain monoamine changes that underlie maladaptive behavior and other post stress-related sequelae.",0,0 +6584,Chronic Kidney Disease in Central American Agricultural Communities: Challenges for Epidemiology and Public Health,"This paper contextualizes the chronic kidney disease epidemic and related burden of disease affecting Central American farming communities. It summarizes the two main causal hypotheses (heat stress and agrochemicals), draws attention to the consequences of dichotomous reasoning concerning causality, and warns of potential conflicts of interest and their role in manufacturing doubt. It describes some methodological errors that compromise past study findings and cautions against delaying public health actions until a conclusive understanding is reached about the epidemic's causes and underlying mechanisms. It makes the case for a comprehensive approach to the historical, social and epidemiological facts of the epidemic, for critically assessing existing studies and for enhanced rigor in new research.",0,0 +6585,Combat exposure and posttraumatic stress symptomatology among U.S. soldiers deployed to the Gulf War.,"Among the most stressful experiences soldiers encounter during combat is exposure to dead and wounded soldiers and civilians. This article examines the early (9 months postcombat) psychological reactions of U.S. Army soldiers deployed from Germany who served in frontline combat units during the Persian Gulf War. In particular, the article focuses on stress symptoms associated with soldiers' exposure to death and wounding during Operations Desert Shield and Desert Storm. Those soldiers exposed to casualties, especially U.S. casualties, had greater distress scores as measured by the Impact of Event Scale (IES) and a tripartite measure of posttraumatic stress (PTS) symptomatology modeled on the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1987) than did those without such exposure. Rank, type of casualty exposure, and current problems with coworkers and chain of command were additively related to explained variance in IES and PTS symptoma...",0,0 +6586,Bio-socio-demographic factors associated with post-traumatic stress disorder in a sample of postpartum Brazilian women,"Post-traumatic stress disorder (PTSD) is common among women. In the postpartum period, the prevalence is between 1% and 6%. The present study investigated PTSD in a sample of 400 Brazilian women between 2 and 26 weeks postpartum using the Mini-International Neuropsychiatric Interview and found a frequency of 5.3%. The factors associated with the occurrence of PTSD were low purchasing power, a history of psychiatric disorders, clinical disease, and the infant having experienced some complication (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +6587,"Ethnic Identity, Family Cohesion, and Symptoms of Post-traumatic Stress Disorder in Maltreated Youth","Post-traumatic stress disorder (PTSD) is prevalent among maltreated youth, but little empirical work exists regarding the role of ethnic identity and family cohesion as influential factors among different ethnic groups. This study included an ethnically diverse sample of adolescents affiliated with a state-administered residential facility for maltreated youth. Variables included ethnic identity and family cohesion, as well as symptoms of PTSD, depression, dissociation, and post-traumatic cognitions. The most prominent finding was that low family cohesion predicted greater PTSD symptoms, depression, dissociation, and post-traumatic cognitions. This finding was especially pronounced for multiracial youth. Results are discussed within the context of developmental pathways regarding ethnic identity development in multiracial youth.",0,0 +6588,The Effects of Traumatic Stressors and HIV-Related Trauma Symptoms on Health and Health Related Quality of Life,"The study identified relations among traumatic stressors, HIV-related trauma symptoms, comorbid medical conditions, and health related quality of life (HRQL) in individuals with HIV. Participants (N = 118) completed a structured clinical interview on HIV as a traumatic stressor and other severe traumatic stressors and completed the Impact of Event Scale to assess HIV-related trauma symptoms and the Medical Outcomes Study 36-item Short Form (SF-36) to assess HRQL. Medical chart reviews determined comorbid conditions. Path analysis findings indicated participants with prior severe traumatic stressors experienced their HIV diagnosis as traumatic and in turn were more likely to have current HIV-related trauma symptoms which were negatively related to HRQL. HIV as a traumatic stressor was related to coronary artery diseases and HRQL. Traumatic stressors and HIV-related trauma symptoms impact health in individuals with HIV and highlight the need for psychological interventions prior to diagnosis and throughout treatment.",0,0 +6589,PTSD among military personnel,"Although symptoms characteristic of post-traumatic stress disorder (PTSD) have been noted in military personnel for many centuries, it was not until 1980 that the disorder was formally recognized and became the focus of legitimate study. This paper reviews our current state of knowledge regarding the prevalence and course of this complex condition in past and present members of the defence forces. Although rates vary across conflicts and countries, there is no doubt that PTSD affects substantial numbers of personnel and results in considerable impairment in functioning and quality of life. The paper goes on to discuss recent attempts to build resilience and to promote adjustment following deployment, noting that there is little evidence at this stage upon which to draw firm conclusions. Finally, effective treatment for PTSD is reviewed, with particular reference to the challenges posed by this population in a treatment setting.",0,0 +6590,International disaster mental health,"This article distills key issues and controversies in the field of international disaster mental health. It offers perspectives from cross-cultural research and describes current controversies, including the appropriateness of bringing to bear Western structures of mental health and psychiatric diagnosis to non-Western settings. It reports early lessons learned from the field regarding what might best constitute assistance within a foreign culture and where to place emphasis. It recommends becoming involved within the relief establishment.",0,0 +6591,The effect of trauma on expressive language impairment in borderline personality disorder,"Borderline personality disorder (BPD) is a disorder with known expressive language impairments that may be activated in treatment through interpersonal cues to the trauma memory system of these patients. However, there are few BPD studies investigating this phenomenon empirically. Our previous research is the first known investigation revealing expressive language deficits using clinically relevant trauma-salient stimuli; the current study extends this to compare specific expressive language deficits on a neutral and emotive stimulus and relationships with trauma history. BPD and matched control (N = 24) verbalizations were analysed by computerized measures of language impairment and pause profiles. BPD subjects evidenced greater overall language impairment and reduced syntactic complexity, but not semantic complexity compared with controls. No such differences were found between the two groups on the neutral condition. BPD subjects utilized significantly higher proportions of pauses for both the emotive and neutral condition. BPD subjects used significantly greater proportions of pauses when generating adjectives related to early relationship with mother, not father. Presence of physical abuse history and PTSD related to some expressive language deficits. These results support neuroimaging findings demonstrating reduced activation of the pre-frontal cortex or anterior cingulate, alongside increased bilateral activation of the amygdala, during exposure to trauma-salient stimuli. Copyright © 2012 John Wiley & Sons, Ltd.",0,0 +6592,Mental health needs of children exposed to intimate partner violence seeking help from mental health services,"The aim of this study is to examine whether children and adolescents exposed to interparental physical and environmental violence have specific needs when seeking public mental health services compared to non-exposed outpatients. The witnessing of intimate partner violence (IPV), psychopathology, functional impairment, and several individual and family variables were assessed in 520 children aged 8 to 17 years. Results showed that living with violent parents at home increased the child's risk of posttraumatic stress disorder, dysthymia, self-harming behavior, and functional impairment. Exposed children's mothers were more likely to overprotect their sons, punish their daughters and report greater psychopathology, whereas fathers who engaged in marital violence displayed greater emotional distress and were more likely to punish and reject their children. The child's sex moderated the IPV effects on parenting, parental discipline, child's life events and health appraisal. Given the specific clinical profile of exposed children, mental health services should develop schedules to detect, assess, and treat these cases.",0,0 +6593,"Cells, biomarkers, and post-traumatic stress disorder: evidence for peripheral involvement in a central disease","Post-traumatic stress disorder (PTSD) is a complicated CNS syndrome. Looking beyond the CNS, recent studies suggest that peripheral blood mononuclear cells could cause and/or exacerbate PTSD. This review summarizes the literature, describes associations between circulating peripheral blood cells and PTSD, proposes a novel mechanism, and analyzes several biomarkers that appear to associate with PTSD symptoms. Several experimental animal models have shown that peripheral blood mononuclear cell activity can cause hippocampal volume loss and PTSD-like symptoms. Data from these models suggest that a traumatic event and/or traumatic events can trigger peripheral cells to migrate, mediate inflammation, and decrease neurogenesis, potentially leading to CNS volume loss. Biomarkers that associate with PTSD symptoms have the potential to differentiate PTSD from traumatic brain injury, but more work needs to be done. Research examining the mechanism of how traumatic events are linked to peripheral blood mononuclear cell functions and biomarkers may offer improved diagnoses and treatments for PTSD patients.",0,0 +6594,A meta-analysis on the impact of psychiatric disorders and maltreatment on cognition.,"Few studies have attempted to describe the range of cognitive impairments in individuals with psychiatric disorders who experienced maltreatment as children. The aims of this meta-analysis were to establish the impact of maltreatment and psychiatric disorders on cognition, and to examine the change in impact from childhood to adulthood.Twelve publications from 1970 to 2013 were included, with the following inclusion criteria: (a) individuals with a psychiatric disorder who experienced maltreatment, (b) use of at least 1 standardized neuropsychological measure, and (c) use of a control group without any psychiatric disorder or mistreatment. The majority of studies (10/12) were about posttraumatic stress disorder. Several effect sizes were calculated (Hedge's g) according to the cognitive domains.The results of the meta-analysis demonstrate that the combination of psychiatric disorders and childhood maltreatment has a negative impact on global cognitive performance, with a moderate effect size (g = -0.59). The most affected cognitive domains for individuals aged 7- to 18-years-old were visual episodic memory (g = -0.97), executive functioning (g = -0.90), and intelligence (g = -0.68). For individuals over the age of 18-years-old, the most affected cognitive domains were verbal episodic memory (g = -0.77), visuospatial/problem solving (g = -0.73), and attention (g = -0.72). The impact of maltreatment and psychiatric disorders was greater in children than in adults (slope = 0.008, p < .002).The results suggest that exposure to maltreatment and the presence of psychiatric disorders have a broad impact on cognition, with specific neuropsychological profile.",0,0 +6595,Panic Disorder and Agoraphobia in OCD patients: Clinical profile and possible treatment implications,"Panic Disorder (PD) and agoraphobia (AG) are frequently comorbid with obsessive-compulsive disorder (OCD), but the correlates of these comorbidities in OCD are fairly unknown. The study aims were to: 1) estimate the prevalence of PD with or without AG (PD), AG without panic (AG) and PD and/or AG (PD/AG) in a large clinical sample of OCD patients and 2) compare the characteristics of individuals with and without these comorbid conditions.A cross-sectional study with 1001 patients of the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders using several assessment instruments, including the Dimensional Yale-Brown Obsessive-Compulsive Scale and the Structured Clinical Interview for DSM-IV-TR Axis I Disorders. Bivariate analyses were followed by logistic regression models.The lifetime prevalence of PD was 15.3% (N=153), of AG 4.9% (N=49), and of PD/AG 20.2% (N=202). After logistic regression, hypochondriasis and specific phobia were common correlates of the three study groups. PD comorbidity was also associated with higher levels of anxiety, having children, major depression, bipolar I, generalized anxiety and posttraumatic stress disorders. Other independent correlates of AG were: dysthymia, bipolar II disorder, social phobia, impulsive-compulsive internet use, bulimia nervosa and binge eating disorder. Patients with PD/AG were also more likely to be married and to present high anxiety, separation anxiety disorder, major depression, impulsive-compulsive internet use, generalized anxiety, posttraumatic stress and binge eating disorders.Some distinct correlates were obtained for PD and AG in OCD patients, indicating the need for more specific and tailored treatment strategies for individuals with each of these clinical profiles.",0,0 +6596,The Epidemiology of Posttraumatic Stress Disorder,,0,0 +6597,Brain transcriptome profiles in mouse model simulating features of post-traumatic stress disorder,"Social-stress mouse model, based on the resident-intruder paradigm was used to simulate features of human post-traumatic stress disorder (PTSD). The model involved exposure of an intruder (subject) mouse to a resident aggressor mouse followed by exposure to trauma reminders with rest periods. C57BL/6 mice exposed to SJL aggressor mice exhibited behaviors suggested as PTSD-in-mouse phenotypes: intermittent freezing, reduced locomotion, avoidance of the aggressor-associated cue and apparent startled jumping. Brain tissues (amygdala, hippocampus, medial prefrontal cortex, septal region, corpus striatum and ventral striatum) from subject (aggressor exposed: Agg-E) and control C57BL/6 mice were collected at one, 10 and 42 days post aggressor exposure sessions. Transcripts in these brain regions were assayed using Agilent's mouse genome-wide arrays.Pathways and biological processes associated with differentially regulated genes were mainly those thought to be involved in fear-related behavioral responses and neuronal signaling. Expression-based assessments of activation patterns showed increased activations of pathways related to anxiety disorders (hyperactivity and fear responses), impaired cognition, mood disorders, circadian rhythm disruption, and impaired territorial and aggressive behaviors. In amygdala, activations of these pathways were more pronounced at earlier time-points, with some attenuation after longer rest periods. In hippocampus and medial prefrontal cortex, activation patterns were observed at later time points. Signaling pathways associated with PTSD-comorbid conditions, such as diabetes, metabolic disorder, inflammation and cardiac infarction, were also significantly enriched. In contrast, signaling processes related to neurogenesis and synaptic plasticity were inhibited.Our data suggests activations of behavioral responses associated with anxiety disorders as well as inhibition of neuronal signaling pathways important for neurogenesis, cognition and extinction of fear memory. These pathways along with comorbid-related signaling pathways indicate the pervasive and multisystem effects of aggressor exposure in mice, potentially mirroring the pathologic conditions of PTSD patients.",0,0 +6598,What can multiwave studies teach us about disaster research: An analysis of low-income Hurricane Katrina survivors,"Previous research on natural disasters has been limited by a lack of predisaster data and statistical analyses that do not adequately predict change in psychological symptoms. In the current study, we addressed these limitations through analysis of 3 waves of data from a longitudinal investigation of 313 low-income, African American mothers who were exposed to Hurricane Katrina. Although postdisaster cross-sectional estimates of the impact of traumatic stress exposure and postdisaster social support on postdisaster psychological distress were somewhat inflated, the general trends persisted when controlling for predisaster data (B = 0.88 and -0.33, vs. B = 0.81 and -0.27, respectively). Hierarchical linear modeling of the 3 waves of data revealed that lower predisaster social support was associated with higher psychological distress at the time of the disaster (β = -.16), and that higher traumatic stress exposure was associated with greater increases in psychological distress after the storm (β = .86). Based on the results, we suggest that the impact of traumatic stress on psychological trajectories cannot be accounted for solely by preexisting risk, and recommend more complex research designs to further illuminate the complex, dynamic relationships between psychological distress, traumatic stress exposure, and social support.",0,0 +6599,Risk Factors of Posttraumatic Stress Disorder among Survivors after the 512 Wenchuan Earthquake in China,"This study investigated the psychological reactions of survivors of the 512 Wenchuan earthquake in China and the risk factors associated with those reactions. The Impact of Event Scale-Revised (IES-R), Type D Scale-14 (DS14), a self-developed trauma experience questionniare, and a demographic questionnaire were administered to 956 earthquake survivors (389 males and 567 females) in Mianzhu, one of the cities most affected by the earthquake. The results showed that postraumatic stress disorder (PTSD) symptoms affected 84.8% of survivors one to two months after the earthquake. Significant risk factors associated with PTSD symptoms included: (1) being female; (2) older age; (3) higher exposure to traumatic events during the earthquake; and (4) negative affect in Type-D personality.",0,0 +6600,Utilizing pharmacodynamic properties of second-generation antipsychotics to guide treatment,"Second-generation antipsychotics (SGAs) are used for the treatment of multiple psychiatric disorders including schizophrenia, bipolar depression, bipolar mania, autism and major depressive disorder. Additionally, their off-label use has been expanding to include other disorders as well, including post-traumatic stress disorder, obsessive compulsive disorder, generalized anxiety disorder, eating disorders and personality disorders. All SGAs share common properties; however, each individual SGA has a unique pharmacodynamic profile that may be utilized to guide and individualize treatment.",0,0 +6601,"In search of links between social capital, mental health and sociotherapy: A longitudinal study in Rwanda","To date, reviews show inconclusive results on the association between social capital and mental health. Evidence that social capital can intentionally be promoted is also scarce. Promotion of social capital may impact post-conflict recovery through both increased social cohesion and better mental health. However, studies on community interventions and social capital have mostly relied on cross-sectional study designs. We present a longitudinal study in Rwanda on the effect on social capital and mental health of sociotherapy, a community-based psychosocial group intervention consisting of fifteen weekly group sessions. We hypothesized that the intervention would impact social capital and, as a result of that, mental health. We used a quasi-experimental study design with measurement points pre- and post-intervention and at eight months follow-up (2007-2008). Considering sex and living situation, we selected 100 adults for our experimental group. We formed a control group of 100 respondents with similar symptom score distribution, age, and sex from a random community sample in the same region. Mental health was assessed by use of the Self Reporting Questionnaire, and social capital through a locally adapted version of the short Adapted Social Capital Assessment Tool. It measures three elements of social capital: cognitive social capital, support, and civic participation. Latent growth models were used to examine whether effects of sociotherapy on mental health and social capital were related. Civic participation increased with 7% in the intervention group versus 2% in controls; mental health improved with 10% versus 5% (both: p < 0.001). Linear changes over time were not significantly correlated. Support and cognitive social capital did not show consistent changes. These findings hint at the possibility to foster social capital and simultaneously impact mental health. Further identification of pathways of influence may contribute to the designing of psychosocial interventions that effectively promote recovery in war-affected populations.Nederlands Trial Register 1120.",0,0 +6602,Reduced hippocampus volume in the mouse model of Posttraumatic Stress Disorder,"Some, but not all studies in patients with posttraumatic stress disorder (PTSD), report reduced hippocampus (HPC) volume. In particular it is unclear, whether smaller hippocampal volume represents a susceptibility factor for PTSD rather than a consequence of the trauma. To gain insight into the relationship of brain morphology and trauma exposure, we investigated volumetric and molecular changes of the HPC in a mouse model of PTSD by means of in vivo Manganese Enhanced Magnetic Resonance Imaging (MEMRI) and ex vivo ultramicroscopic measurements. Exposure to a brief inescapable foot shock led to a volume reduction in both left HPC and right central amygdala two months later. This volume loss was mirrored by a down-regulation of growth-associated protein-43 (GAP43) in the HPC. Enriched housing decreased the intensity of trauma-associated contextual fear, independently of whether it was provided before or after the shock. Beyond that, enriched housing led to an increase in intracranial volume, including the lateral ventricles and the hippocampus, and to an up-regulation of GAP43 as revealed by MEMRI and Western blot analysis, thus partially compensating for trauma-related HPC volume loss and down-regulation of GAP43 expression. Together these data demonstrate that traumatic experience in mice causes a reduction in HPC and central amygdala volume possibly due to a shrinkage of axonal protrusions. Enriched housing might induce trophic changes, which may contribute to the amelioration of trauma-associated PTSD-like symptoms at behavioural, morphological and molecular levels.",0,0 +6603,The association between adult attachment style and mental health in extreme life-endangering conditions,"Abstract This study examines the association between adult attachment style and psychopathology in extreme life-endangering conditions. A group of 40 Israeli Jewish settlers who lived within the Palestinian Authority territory (high-threat group) were asked to fill out an attachment style scale and psychiatric symptomatology measures. They were compared to a control group of Israeli Jewish persons who lived within the State of Israel. Findings showed higher symptomatology in the high-threat than control group. Secure attachment style was inversely related to symptomatology measures. In contrast, anxious–ambivalent and avoidant attachment styles were positively related to symptomatology measures. However, whereas the anxious–ambivalent attachment style was related to psychopathology in the two threat conditions, the avoidant style was related to psychopathology only in the high-threat group. Results were discussed in terms of attachment theory.",0,0 +6604,Treatment of substance abusing patients with comorbid psychiatric disorders,"To update clinicians on the latest in evidence-based treatments for substance use disorders (SUD) and non-substance use disorders among adults and suggest how these treatments can be combined into an evidence-based process that enhances treatment effectiveness in comorbid patients.Articles were extracted from Pubmed using the search terms ""dual diagnosis,"" ""comorbidity"" and ""co-occurring"" and were reviewed for evidence of effectiveness for pharmacologic and psychotherapeutic treatments of comorbidity.Twenty-four research reviews and 43 research trials were reviewed. The preponderance of the evidence suggests that antidepressants prescribed to improve substance-related symptoms among patients with mood and anxiety disorders are either not highly effective or involve risk due to high side-effect profiles or toxicity. Second generation antipsychotics are more effective for treatment of schizophrenia and comorbid substance abuse and current evidence suggests clozapine, olanzapine and risperidone are among the best. Clozapine appears to be the most effective of the antipsychotics for reducing alcohol, cocaine and cannabis abuse among patients with schizophrenia. Motivational interviewing has robust support as a highly effective psychotherapy for establishing a therapeutic alliance. This finding is critical since retention in treatment is essential for maintaining effectiveness. Highly structured therapy programs that integrate intensive outpatient treatments, case management services and behavioral therapies such as Contingency Management (CM) are most effective for treatment of severe comorbid conditions.Creative combinations of psychotherapies, behavioral and pharmacological interventions offer the most effective treatment for comorbidity. Intensity of treatment must be increased for severe comorbid conditions such as the schizophrenia/cannabis dependence comorbidity due to the limitations of pharmacological treatments.",0,0 +6605,MMPI profiles in PTSD as a function of comorbidity,"A sample of 135 Vietnam veteran inpatients with combat-related PTSD was sorted into three groups, depending upon the presence of concurrent psychiatric disorders: Depression (n = 68), Psychosis (n = 31), and Other (n = 36). Pairwise comparisons were made on the MMPI with respect to the validity indicators, clinical scales, four relevant Harris-Lingoes subscales, the Psychoticism content scale, and the MMPI-PTSD subscale. Results indicate variations in scale elevations as a function of comorbid diagnosis. Various items and scales appear to differentiate the Psychosis group due to greater psychopathology. In general, the results spotlight the heterogeneous aspects that comorbidity brings to PTSD assessment.",0,0 +6606,Readjustment of Urban Veterans: A Mental Health and Substance Use Profile of Iraq and Afghanistan Veterans in Higher Education,"To identify the prevalence of substance use and mental health problems among veterans and student service members/veterans (SSM/V) returning from Iraq and Afghanistan to New York City's low-income neighborhoods.A sample of 122 veterans attending college and 116 veterans not enrolled recruited using respondent-driven sampling.Logistic regression analysis of variation in characteristics of those veterans attending college; linear regression examining effects of college attendance on life satisfaction.Having a traumatic brain injury or disability was positively associated with college attendance. Being married, employed, or in college was predictive of overall life satisfaction. SSM/V were significantly less likely to screen positive for depression or drug use disorder. African American veterans were significantly less likely to attend college than white or Hispanic veterans.Substance use and some mental health disorders do not preclude inner-city veterans from entering higher education. This study contributes to the sparse literature on African American veterans and SSM/V.",0,0 +6607,Profiles of referrals to a psychiatric service: a descriptive study of survivors of the Nairobi US Embassy terrorist bomb blast.,"OBJECTIVE: To document the socio-demographic characteristics and psychiatric profiles of the survivors of the Nairobi United States Embassy terrorist bomb blast referred to a psychiatric and psychotherapy (counselling) service. METHOD: This was a descriptive cross-sectional study. Clinical interviews and structured questionnaires for post-traumatic stress disorder (PTSD) and stress were administered. Survivors of the bomb blast referred to a psychiatric and psychotherapy service one year or more after the bombing were included in the study. These survivors had been treated using psychopharmacotherapy and individualised (not group) therapy/counselling. RESULTS: Eighty-three consecutive referrals to a psychiatric service participated in this study. There were more males and the sample was generally well educated. The referrals made contact with the referring agency for a number of reasons including seeking psychological, financial and medical assistance. All the patients reported varying degrees of psychiatric symptoms and functional impairment on various aspects of social occupational functioning. High scores for PTSD and other related stress were recorded one or more years after the bombing. CONCLUSION: Although the survivors indicated that initial counselling following the blast had helped them, they still scored high on PTSD suggesting that clinically, the initial counselling had little, if any impact on the development of PTSD. There is need for a holistic approach to the management of psychotrauma in individuals. Language: en",0,0 +6608,Exploring the fit of Western PTSD models across three non-Western low- and middle-income countries.,"The purpose of this study was to examine the fit of existing Western posttraumatic stress disorder (PTSD) models across 3 non-Western low and middle income countries (LMIC). Secondary data analysis was conducted from studies among torture survivors in Northern Iraq, sexual violence survivors in the Democratic Republic of Congo (DRC), and Burmese refugees in Thailand. Confirmatory factor analyses were conducted on Harvard Trauma Questionnaire (HTQ) data to compare established Western PTSD models using (a) the 3-factor Diagnostic and Statistical Manual (DSM) 4th edition model, (b) the 4-factor “numbing” model, (c) the 4-factor “dysphoria” model, and (d) the 4- factor DSM-5 model. For both the DRC and Burma all models had adequate fit. Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) determined that the 4-factor “numbing” model was the best fit for the DRC and the 4-factor “dysphoria” model was the best fit for Burma. For Iraq, none of the models had adequate fit. Results support previous research which indicates inconsistency among Western models of PTSD among populations from LMIC. Further research should explore whether this is indicative of the context or potentially other factors.",0,0 +6609,A PSYCHO-PHYSIOLOGICAL COMPARISON OF POST-TRAUMATIC AND PROLONGED DURESS STRESS DISORDERS,"It has been proposed that post-traumatic stress disorder (PTSD) and so-called “prolonged duress stress disorder” (PDSD) have similar symptom profiles and differ only with regard to the presence or absence of a “traumatic event”. This single case experiment investigated whether PTSD can be distinguished from PDSD at the level of patho-physiology. The results indicate that both PTSD and PDSD imagery elicit physiological responses, but these are more readily and more strongly evoked by the former than the latter. These findings suggest that physiological response differences between PTSD and PDSD may be only a matter of degree. Implications are drawn for the psycho-physiological assessment of PDSD and recommendations for further research are made.",0,0 +6610,Olanzapine versus fluphenazine in an open trial in patients with psychotic combat-related post-traumatic stress disorder,"Rationale: Combat-related post-traumatic stress disorder (PTSD) is often complicated with other psychiatric comorbidities, and is refractory to treatment. Objective: The aim of an open, comparative 6-week study was to compare olanzapine and fluphenazine, as a monotherapy, for treating psychotic combat-related PTSD. Method: Fifty-five male war veterans with psychotic PTSD (DSM-IV criteria) were treated for 6 weeks with olanzapine (n=28) or fluphenazine (n=27) in a 5-10 mg/day dose range, once or twice daily. Patients were evaluated at baseline, and after 3 and 6 weeks of treatment, using Watson's PTSD scale, Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression Severity Scale (CGI-S), Clinical Global Impression Improvement Scale (CGI-I), Patient Global Impression Improvement Scale (PGI-I) and Drug Induced Extra-Pyramidal Symptoms Scale (DIEPSS). Results: At baseline, patient's data (age, duration of combat experience and scores in all measurement instruments) did not differ. After 3 and 6 weeks of treatment, olanzapine was significantly more efficacious than fluphenazine in reducing symptoms in PANSS (negative, general psychopathology subscale, supplementary items), Watson's PTSD (avoidance, increased arousal) subscales, CGI-S, CGI-I, and PGI-I scale. Both treatments affected similarly the symptoms listed in PANSS positive and Watson's trauma re-experiencing subscales. Fluphenazine induced more extrapyramidal symptoms. Prolongation of the treatment for 3 additional weeks did not affect the efficacy of either drug. Conclusions: Our data indicate that both fluphenazine and olanzapine were effective for particular symptom profile in psychotic combat-related PTSD. Olanzapine was better than fluphenazine in reducing most of the psychotic and PTSD symptoms, and was better tolerated in psychotic PTSD patients.",0,0 +6611,Long-term perspectives on posttraumatic growth in disaster survivors,"Findings on posttraumatic growth (PTG) and distress have not been consistent. This study examines the relationship in a very long-term perspective. The Posttraumatic Growth Inventory was completed by 46 survivors from a single disaster 27 years posttrauma. Posttraumatic stress was measured by the Impact of Event Scale (IES) immediately after the event, and after 1, 5, and 27 years. In the final follow-up, general mental health was also assessed. Strong positive associations were found between PTG and concurrent posttraumatic stress. Although weaker associations were found for the past, concurrent problems in general mental health clearly coexisted with PTG decades after a disaster, yet mediated by IES.",0,0 +6612,"Anger, hostility, and posttraumatic stress disorder in trauma-exposed adults: A meta-analysis.","This meta-analysis synthesizes the available data on the strength of association between anger and posttraumatic stress disorder (PTSD) and between hostility and PTSD, covering 39 studies with trauma-exposed adults. Effect sizes did not differ for anger and hostility, which could therefore be combined; effect sizes for anger expression variables were analyzed separately. The analyses revealed large effects. The weighted mean effect size (r) was .48 for anger-hostility, .29 for anger out, .53 for anger in, and -.44 for anger control. Moderator analyses were conducted for anger-hostility, showing that effect sizes were substantially larger with increasing time since the event and that effect sizes were larger in samples with military war experience than in samples that had experienced other types of traumatic events.",0,0 +6613,The adverse health effects of synthetic cannabinoids with emphasis on psychosis-like effects,"Cannabis use is associated with an increased risk of psychosis in vulnerable individuals. Cannabis containing high levels of the partial cannabinoid receptor subtype 1 (CB 1 ) agonist tetrahydrocannabinol (THC) is associated with the induction of psychosis in susceptible subjects and with the development of schizophrenia, whereas the use of cannabis variants with relatively high levels of cannabidiol (CBD) is associated with fewer psychotic experiences. Synthetic cannabinoid receptor agonists (SCRAs) are full agonists and often more potent than THC. Moreover, in contrast to natural cannabis, SCRAs preparations contain no CBD so that these drugs may have a higher psychosis-inducing potential than cannabis. This paper reviews the general toxicity profile and the adverse effects of SCRAs with special emphasis on their psychosis-inducing risk. The review shows that, compared with the use of natural cannabis, the use of SCRAs may cause more frequent and more severe unwanted negative effects, especially in younger, inexperienced users. Psychosis and psychosis-like conditions seem to occur relatively often following the use of SCRAs, presumably due to their high potency and the absence of CBD in the preparations. Studies on the relative risk of SCRAs compared with natural cannabis to induce or evoke psychosis are urgently needed.",0,0 +6614,Exploring the Clinical Course of Neck Pain in Physical Therapy: A Longitudinal Study,"To investigate the short-term trajectory of recovery from mechanical neck pain, and predictors of trajectory.Prospective, longitudinal cohort study with 5 repeated measurements over 4 weeks.Community-based physical therapy clinics.Convenience sample of community-dwelling adults (N=50) with uncomplicated mechanical neck disorders of any duration.Usual physical therapy care.Neck Disability Index (NDI), numeric rating scale (NRS) of pain intensity.A total of 50 consecutive subjects provided 5 data points over 4 weeks. Exploratory modeling using latent class growth analysis revealed a linear trend in improvement, at a mean of 1.5 NDI points and 0.5 NRS points per week. Within the NDI trajectory, 3 latent classes were identified, each with a unique trend: worsening (14.5%), rapid improvement (19.6%), and slow improvement (65.8%). Within the NRS trajectory, 2 unique trends were identified: stable (48.0%) and improving (52.0%). Predictors of trajectory class suggest that it may be possible to predict the trajectory. Results are described in view of the sample size.The mean trajectory of improvement in neck pain adequately fits a linear model and suggests slow but stable improvement over the short term. However, up to 3 different trajectories have been identified that suggest neck pain, and recovery thereof, is not homogenous. This may hold value for the design of clinical trials.",0,0 +6615,Bilateral hippocampal volume reduction in adults with post-traumatic stress disorder: A meta-analysis of structural MRI studies,"Over the last decade a significant number of studies have reported smaller hippocampal volume in individuals with symptoms of post-traumatic stress disorder (PTSD) relative to control groups, and in some cases hemispheric asymmetries in this effect have been noted. However these reported asymmetries have not been in a consistent direction, and other well-controlled studies have failed to observe any hippocampal volume difference. This paper reports a systematic review and meta-analysis of studies in which hippocampal volume was estimated from magnetic resonance images in adult patients with PTSD. After applying a variety of selection criteria intended to minimize potential confounds in pooled effect-size estimates, the meta-analysis included 13 studies of adult patients with PTSD that compared the patients to well-matched control groups, for a total of 215 patients and 325 control subjects. The studies varied with respect to participant age, gender distribution, source of trauma, severity of symptoms, duration of disorder, the nature of the control groups, and the methods employed for volumetric quantification. Despite these differences, pooled effect size calculations across the studies indicated significant volume differences in both hemispheres. On average PTSD patients had a 6.9% smaller left hippocampal volume and a 6.6% smaller right hippocampal volume compared with control subjects. These volume differences were smaller when comparing PTSD patients with control subjects exposed to similar levels of trauma, and larger when comparing PTSD patients to control subjects without significant trauma exposure. Such differences are consistent with the notion that exposure to stressful experiences can lead to hippocampal atrophy, although prospective studies would be necessary to unambiguously establish such a relationship. © 2005 Wiley-Liss, Inc.",0,0 +6616,Interventions with women offenders: a systematic review and meta-analysis of mental health gain,"Currently, a conjunction of policy, legislative change in health and social care and the criminal justice system, combined with funding for innovative services make it opportune to assess the evidence base for interventions with women offenders. Women offenders have a distinctive criminological, health and social profile and a gender specific approach to their difficulties is advocated. This systematic review and meta-analysis focus on mental health gain in adult women offenders in forensic health settings, criminal justice institutions and in the community, following therapeutic interventions. Interventions were assessed in terms of specific outcome measures of depression, trauma symptomatology and global mental health status. Comprehensive search strategies yielded 3018 articles, from which we obtained 199 full text articles. Seventeen articles were included in the final review, of which six were excluded from the meta-analysis as there was no comparator group. There is a modest, but increasing, body of...",0,0 +6617,Distinct intrinsic network connectivity patterns of post-traumatic stress disorder symptom clusters,"Objective Post-traumatic stress disorder (PTSD) is considered a multidimensional disorder, with distinct symptom clusters including re-experiencing, avoidance/numbing, hyperarousal, and most recently depersonalization/derealization. However, the extent of differing intrinsic network connectivity underlying these symptoms has not been fully investigated. We therefore investigated the degree of association between resting connectivity of the salience (SN), default mode (DMN), and central executive (CEN) networks and PTSD symptom severity. Method Using resting-state functional MRI data from PTSD participants (n = 21), we conducted multivariate analyses to test whether connectivity of extracted independent components varied as a function of re-experiencing, avoidance/numbing, hyperarousal, and depersonalization/derealization. Results Hyperarousal symptoms were associated with reduced connectivity of posterior insula/superior temporal gyrus within SN [peak Montréal Neurological Institute (MNI): −44, −8, 0, t = −4.2512, k = 40]. Depersonalization/derealization severity was associated with decreased connectivity of perigenual anterior cingulate/ventromedial prefrontal cortex within ventral anterior DMN (peak MNI: 8, 40, −4; t = −3.8501; k = 15) and altered synchrony between two DMN components and between DMN and CEN. Conclusion Our results are consistent with prior research showing intrinsic network disruptions in PTSD and imply heterogeneous connectivity patterns underlying PTSD symptom dimensions. These findings suggest possible biomarkers for PTSD and its dissociative subtype.",0,0 +6618,Synaptic correlates of fear extinction in the amygdala,"Anxiety disorders such as post-traumatic stress are characterized by an impaired ability to learn that cues previously associated with danger no longer represent a threat. However, the mechanisms underlying fear extinction remain unclear. We found that fear extinction in rats was associated with increased levels of synaptic inhibition in fear output neurons of the central amygdala (CEA). This increased inhibition resulted from a potentiation of fear input synapses to GABAergic intercalated amygdala neurons that project to the CEA. Enhancement of inputs to intercalated cells required prefrontal activity during extinction training and involved an increased transmitter release probability coupled to an altered expression profile of ionotropic glutamate receptors. Overall, our results suggest that intercalated cells constitute a promising target for pharmacological treatment of anxiety disorders.",0,0 +6619,Profiles of Resilience and Growth in Youth With Cancer and Healthy Comparisons,"Inconsistent links between posttraumatic stress symptoms (PTS) and posttraumatic growth (PTG) in youth following a stressful life event have been observed in previous literature. Latent profile analysis (LPA) provides a novel approach to examine the heterogeneity of relations between these constructs.Participants were 435 youth (cancer group=253; healthy comparisons = 182) and one parent. Children completed measures of PTS, PTG, and a life-events checklist. Parents reported on their own PTS and PTG. LPA was conducted to identify distinct adjustment classes.LPA revealed three profiles. The majority of youth (83%) fell into two resilient groups differing by levels of PTG. Several factors predicted youth's profile membership.PTS and PTG appear to be relatively independent constructs, and their relation is dependent on contextual factors. The majority of youth appear to be resilient, and even those who experience significant distress were able to find benefit.",0,0 +6620,Body change stress for women with breast cancer: The breast-impact of treatment scale,"Body change stress refers to subjective psychological stress that accompanies women's negative and distressing thoughts, emotions, and behaviors resultant from breast cancer and breast surgeries. Body change stress is manifest with traumatic stress-like symptoms.The development of the Breast-Impact of Treatment Scale (BITS) is described. The construct is assessed with 13 items that comprise a one-factor solution.Tests of convergent validity demonstrate the relationship, but not overlap, of the BITS with measures of stress, emotional distress, and sexuality. The BITS distinguishes between women receiving segmental mastectomy (lumpectomy) versus mastectomy. Incremental validity is shown with comparison to ratings of body satisfaction.An early psychometric foundation enables use of the BITS to assess a common and distressing quality of life outcome for women with breast cancer.",0,0 +6621,Posttraumatic Symptom Structure Across Age Groups,"The applicability of diagnostic criteria of Posttraumatic Stress Disorder to the pediatric population has been a focus of much debate (e.g., Carrion, Weems, Ray, & Reiss, 2002 ), informing changes in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5). The current study examined the factor structure of posttraumatic distress among adult versus pediatric samples using confirmatory factor analysis. The analysis was performed on the DSM-IV-adherent Posttraumatic Diagnostic Scale (Foa, Cashman, Jaycox, & Perry, 1997 ) and Child Posttraumatic Symptom Scale (Foa, Johnson, Feeny, & Treadwell, 2001 ). The sample included 378 adult and 204 child and adolescent victims of diverse single-event traumas. A series of models based on previous findings and DSM-IV specification were evaluated. A 4-factor model (Intrusions, Avoidance, Dysphoria, and Hyperarousal), similar to the DSM-5 model, best fit the data among adults, and a different 4-factor model (Intrusion, Avodiance, Numbing, and Hyperarousal) best fit the data among children and adolescents. Despite some similarity, the posttraumatic symptom profiles of pediatric and adult samples may differ. These differences are not fully incorporated into the DSM-5, and warrant further examination.",0,0 +6622,Crisis Intervention,,0,0 +6623,Peritraumatic dissociation and experiential avoidance as predictors of posttraumatic stress symptomatology,"This study examined whether peritraumatic dissociation serves as a proxy risk factor for experiential avoidance in its relationship with posttraumatic stress disorder (PTSD) symptomatology. One hundred eighty-five trauma survivors completed measures that assessed for peritraumatic dissociation, experiential avoidance, and PTSD symptom severity. The results indicated that peritraumatic dissociation and experiential avoidance were significantly related to PTSD symptomatology at baseline. However, after initial levels of PTSD symptomatology were taken into account, only experiential avoidance was related to PTSD symptoms both 4- and 8-weeks later. These results indicate that peritraumatic dissociation is not a proxy risk factor for experiential avoidance and contributes to the growing body of literature indicating that experiential avoidance is an important factor related to the psychological symptoms experienced by trauma survivors.",0,0 +6624,Paroxetine in the Treatment of Post Traumatic Stress Disorder: Our Experiences,"Posttraumatic stress disorder can develop after individual’s exposure or witnessing of life threatening events. It is characterized by three clusters of symptoms. The course of PTSD is often chronic and impedes individual’s functioning. Studies of PTSD treatment with paroxetine provide evidence for its efficacy in reducing symptoms and its favorable profile of side-effects. The objective of this work was to determine the efficacy of paroxetine in the treatment of PTSD.The sample consisted of 30 subjects with chronic PTSD. All subjects received treatment with paroxetine in therapeutic dose range for six months. Subjects were assessed prior to therapy and following six months of treatment with paroxetine with the use of following instruments: SCL 90-R, Mississippi Questionnaire, and CGI.The results indicate statistically significant reduction on all subscales of SCL 90-R following six months of treatment, P<0,05. The difference between two assessments with Mississippi Questionnaire was statistically significant, P< 0,05. PTSD rate in our sample was reduced from 100% before treatment to 64% after treatment. Paroxetine was administered in daily dose of 20 mg in 88% of the subjects, and 40 mg in the remaining 12%. Unwanted effects were registered in 16,7% of the subjects and they were mild. Objective improvement was registered in 84% of the sample, and subjective improvement was registered in 80%. Reduction of relapse symptoms was registered in 24% of the subjects.Paroxetine proved to be efficient and safe in treatment of symptoms of PTSD in this study.",0,0 +6625,"Living Conditions and Emotional Profiles of Cambodian, Central American, and Québécois Youth","To compare Cambodian and Central American adolescent refugees to Quebec with their Quebec-born peers in regard to emotional and behavioural problems, feelings of competence, and risk-behaviour profiles, and to examine relations between emotional variables and living conditions in the 3 groups.The sample consisted of 76 Cambodian, 82 Central American and 67 Québécois youth living in the Montreal area. The teenagers' internalization and externalization symptoms were assessed using the Child Behaviour Checklist (CBCL) and the Youth Self-Report (YSR); the YSR also provided a measure of their feelings of competence. Risk behaviour was reported by the teenagers. The socioeconomic status of the teenagers' households was taken into account in multiple regression analyses conducted for each group.The level of emotional and behavioural problems reported by teenagers was lowest in Central Americans and highest in Québécois; the latter group also reported more risk behaviours than did either refugee group. The socioeconomic status of the Cambodian and Central American refugee households was lower than that of the Québécois. Living conditions were not a major determinant of emotional distress in young Cambodians, but low annual income was associated with internalizing symptoms among Central American youth. The most powerful predictor of externalizing symptoms among the Québécois youth was having a single-parent household.This study underscores the contrast between the living conditions of young Cambodian and Central American refugees to Quebec and those of Quebec-born youth. These refugees' precarious socioeconomic status is not accompanied by an increase in adolescents' emotional and behavioural problems.",0,0 +6626,Elaboration and Content Analysis of Conceptual Structure in Posttraumatic Stress Disorder,"Three recent studies attempted to substantiate Sewell and Cromwell's (1990) theory of Posttraumatic Stress Disorder (PTSD; American Psychiatric Association, 1994) based on personal construct theory (Kelly, 1955). One crucial aspect of the model that was tested in each of the studies is elaboration, which is the process of bringing more of a person's repertoire of understanding (constructions) to a certain experience to give it meaning. Elaboration is representative of whether or not the individual is using an integrated set of constructs to deal with a traumatic event. A two-part study (1) reanalyzed existing data to assist in understanding discrepancies in past findings, and (2) content analyzed constructs given by subjects in all three studies. Findings concerning elaboration remained somewhat discrepant but suggested possible differences when investigating the emergent versus submerged poles of constructs.",0,0 +6627,Latent structure of posttraumatic stress disorder symptoms in an adolescent sample one month after an earthquake,"Increasing empirical studies suggest that the tripartite posttraumatic stress disorder (PTSD) model described in the DSM-IV does not accurately account for the underlying PTSD factor structure, and several alternative models have been proposed. The present study investigated a newly refined, five-factor model of PTSD symptoms in a sample of Chinese adolescent survivors of an earthquake. A total of 1198 middle school students (653 females, 526 males) with a mean age of 14.4 years (SD = 1.1, range: 11-18) participated in this study one month after an earthquake. The novel five-factor model comprised of intrusion, avoidance, numbing, dysphoric arousal, and anxious arousal demonstrated significantly better fit than two alternative four-factor models. Further analyses revealed differentiable relations between the PTSD factors and external measures of anxiety and depression. These findings provide empirical support for the robustness of five-factor model, and carry implications for further reorganization of PTSD criteria.",0,0 +6628,Utility of the Trauma Symptom Inventory’s Atypical Response Scale in Detecting Malingered Post-Traumatic Stress Disorder,"The authors examined the Trauma Symptom Inventory's (TSI) ability to discriminate 88 student post-traumatic stress disorder (PTSD) simulators screened for genuine PTSD from 48 clinical PTSD-diagnosed outpatients. Results demonstrated between-group differences on several TSI clinical scales and the Atypical Response (ATR) validity scale. Discriminant function analysis using ATR revealed 75% correct patient classification but only 48% correct simulator classification, with an overall correct classification rate of 59% (positive predictive power [PPP] = .71; negative predictive power [NPP] = .51). Individual ATR cutoff scores did not yield impressive classification results, with the optimal cutoff (T score = 61) correctly classifying only 61% of simulators and patients (PPP = .66, NPP = .54). Although ATR was not developed as a malingered PTSD screen, instead serving as a general validity screen, caution is recommended in its current clinical use for detecting malingered PTSD.",0,0 +6629,Emotional and Coping Responses to Serial Killings The Gainesville Murders,"Forensic experts have focused more on the psychological profile of a serial killer rather than on the pronounced effects on the community at large. Coping with a stressful event is thought to influence emotional states. However, little empirical understanding of this process exists. The present study examined changes in psychological factors 9 days after the occurrence of serial killings in a college community. Multivariate analyses of variance conducted on the variables of stress, anxiety, physical symptoms, and depression revealed a significant difference between the group tested after the murders and a cross-sectional cohort group. Univariate analyses revealed that the study class was significantly more depressed compared with the cohort group. The study class was also significantly more depressed compared with their own responses 1 year before the killings. For both classes, depression was significantly correlated with certain coping styles, including escape-avoidance and accept responsibility. Results have implications for certain coping behaviors (i.e., avoidant behaviors), such as that leaving the community may have been maladaptive and perhaps diverted attention from the more necessary active problem-solving behaviors (e.g., increasing security) in addition to increasing depression.",0,0 +6630,Pierre Janet and the breakdown of adaptation in psychological trauma,"In this reappraisal of the work of Pierre Janet at the centenary of the publication of L'automatisme psychologique, the authors review his investigations into the mental processes that transform traumatic experiences into psychopathology. Janet was the first to systematically study dissociation as the crucial psychological process with which the organism reacts to overwhelming experiences and show that traumatic memories may be expressed as sensory perceptions, affect states, and behavioral reenactments. Janet provided a broad framework that unifies into a larger perspective the various approaches to psychological functioning which have developed along independent lines in this century. Today his integrated approach may help clarify the interrelationships among such diverse topics as memory processes, state-dependent learning, dissociative reactions, and posttraumatic psychopathology.",0,0 +6631,Provision of evidence-based therapies to rural survivors of domestic violence and sexual assault via telehealth: Treatment outcomes and clinical training benefits.,"Rural survivors of sexual assault and domestic violence experience considerable difficulties accessing mental health services. Similarly, graduate psychology training programs located in rural locations have historically been limited in their ability to provide trainees with extensive exposure to specific client populations. With the advent of distal technologies–especially secure, encrypted videoconferencing capabilities—it is now possible to connect rural clients with specialized, mental health services provided by university-based training clinics. This article reviews mental health care needs and treatment barriers experienced by rural populations, and describes an innovative solution to begin to address these problems. Specifically, a partnership between a university-based mental health care clinic and 3 rural domestic violence/rape crisis centers is described, and preliminary treatment outcome data are presented. Training benefits reported by graduate student therapists and satisfaction ratings provided by crisis center staff and advocates are also presented and discussed.",0,0 +6632,Treatment of posttraumatic stress disorder in children and adolescents,"We review recent evidence regarding risk factors for childhood posttraumatic stress disorder (PTSD) and treatment outcome studies from 2010 to 2012 including dissemination studies, early intervention studies and studies involving preschool children.Recent large-scale epidemiological surveys confirm that PTSD occurs in a minority of children and young people exposed to trauma. Detailed follow-up studies of trauma-exposed young people have investigated factors that distinguish those who develop a chronic PTSD from those who do not, with recent studies highlighting the importance of cognitive (thoughts, beliefs and memories) and social factors. Such findings are informative in developing treatments for young people with PTSD. Recent randomized controlled trials (RCTs) confirm that trauma-focused cognitive behaviour therapy (TF-CBT) is a highly efficacious treatment for PTSD, although questions remain about effective treatment components. A small number of dissemination studies indicate that TF-CBT can be effective when delivered in school and community settings. One recent RCT shows that TF-CBT is feasible and highly beneficial for very young preschool children. Studies of early intervention show mixed findings.Various forms of theory-based TF-CBT are highly effective in the treatment of children and adolescents with PTSD. Further work is needed to replicate and extend initial promising outcomes of TF-CBT for very young children. Dissemination studies and early intervention studies show mixed findings and further work is needed.",0,0 +6633,Evaluation of a Family-Centered Preventive Intervention for Military Families: Parent and Child Longitudinal Outcomes,"This study evaluates the longitudinal outcomes of Families OverComing Under Stress (FOCUS), a family-centered preventive intervention implemented to enhance resilience and to reduce psychological health risk in military families and children who have high levels of stress related to parental wartime military service.We performed a secondary analysis of evaluation data from a large-scale service implementation of the FOCUS intervention collected between July 2008 and December 2013 at 15 military installations in the United States and Japan. We present data for 2,615 unique families (3,499 parents and 3,810 children) with completed intake and at least 1 postintervention assessment. Longitudinal regression models with family-level random effects were used to assess the patterns of change in child and parent (civilian and military) psychological health outcomes over time.Improvement in psychological health outcomes occurred in both service member and civilian parents. Relative to intake, parental anxiety and depression symptoms were significantly reduced postintervention, and these reductions were maintained at 2 subsequent follow-up assessments. In addition, we identified an improvement over time in emotional and behavioral symptoms and in prosocial behaviors for both boys and girls. We observed reductions in the prevalence of unhealthy family functioning and child anxiety symptoms, as well as parental depression, anxiety, and posttraumatic stress symptoms from intake to follow-up.Longitudinal program evaluation data show sustained trajectories of reduced psychological health risk symptoms and improved indices of resilience in children, civilian, and active duty military parents participating in a strength-based, family-centered preventive intervention.",0,0 +6634,Distinct quantitative sensory testing profiles in nonspecific chronic back pain subjects with and without psychological trauma,"Psychological trauma is associated with an increased risk for chronification of nonspecific chronic back pain (nsCLBP) independent of posttraumatic stress disorder (PTSD). However, the mechanisms underlying the role of psychological trauma in nsCLBP are less clear than in PTSD. Therefore, this study considered whether psychological trauma exposure (TE) is accompanied by specific alterations in pain perception. The study included 56 participants with nsCLBP and TE (nsCLBP-TE), 93 participants with nsCLBP without TE (nsCLBP-W-TE), and 31 pain-free controls. All participants underwent a thorough clinical evaluation. The standardized quantitative sensory testing protocol of the German Research Network on Neuropathic Pain was used to obtain comprehensive profiles on somatosensory functions in painful (back) and non-painful areas (hand). The protocol consisted of thermal and mechanical detection as well as pain thresholds, vibration thresholds, and pain sensitivity to sharp and blunt mechanical stimuli. Psychological trauma was validated by structured clinical interview. Trauma-associated symptom severity, anxiety, and depressive symptomatology were assessed by self-report questionnaires. Differences in somatosensory function were seen only for pressure pain thresholds. Compared with controls, nsCLBP-TE revealed hyperalgesia generalized in space with lower thresholds in painful and non-painful areas, whereas nsCLBP-W-TE demonstrated localized alterations with decreased thresholds only in the pain-affected area of the back (P ≤ 0.006). Our findings suggest an augmented central pain processing in nsCLBP-TE (alterations in painful and non-painful areas), whereas nsCLBP-W-TE show only local changes (alterations only in the painful area) suggesting regional sensitization processes. This finding might explain why TE without PTSD is associated with an increased prevalence of chronic pain.",0,0 +6635,Pre- and post-disaster negative life events in relation to the incidence and severity of post-traumatic stress disorder,"There is evidence suggesting that stressful life events may precede major psychiatric illness, such as major depression, and that the severity of a traumatic event outside the range of usual human experience may provoke post-traumatic stress disorder (PTSD). The present study was carried out to examine the effects of pre- and post-disaster stressful life events on the incidence rate of PTSD following two man-made traumatic events. An epidemiological study examining 127 victims of a flash fire in a ballroom and 55 motor vehicle accident (MVA) victims was undertaken. PTSD symptoms were assessed by means of the Composite International Diagnostic Interview and the pre- and post-disaster stressful life events by means of the Diagnostic Interview Schedule, Disaster Supplement. Binary logistic and multiple linear regression analyses were employed to examine the relationships between PTSD and pre- and post-disaster life events. There were no significant relationships between stressful life events the year prior to the traumatic event and the incidence or severity of PTSD. There were highly significant relationships between the cumulative number and event severity of post-disaster negative life events and the incidence rate and severity of PTSD. The post-disaster life events were significantly more related to the avoidance-depression dimension than to the anxiety-arousal dimension of PTSD. The most significant life events were: loss of job or income, broken relationships, serious illnesses or injuries in the victims and death or illness in close acquaintances. The results of this study show that the number and severity of additional stressful life events signal a higher risk to develop PTSD and a higher severity of the avoidance-depression dimension of PTSD symptomatology.",0,0 +6636,Posttraumatic stress disorder after liver transplantation,"Liver transplantation can lead to the development of posttraumatic stress disorder (PTSD), but the risk factors associated with this progression are not well understood. To study this syndrome in adult liver transplant recipients, a cross-sectional investigation of 296 recipients at our hospital was carried out between January and June 2010.Study participants completed two questionnaires [a PTSD self-rating scale (PTSD-SS) and a validated Chinese version of the Medical Outcomes Study Short Form-36 (SF-36)]. Clinical and demographic data were collected from the records of the Chinese Liver Transplant Registry and via questionnaires.The prevalence of full PTSD and partial PTSD (that met the criteria for 2 of the 3 symptom clusters) was 3.7% and 5.4%, respectively, for all transplant recipients. Significant differences between the recipients with no PTSD, partial PTSD, and full PTSD were found in all SF-36 domains except for physical functioning (P=0.466). In general, domain scores were the highest in the recipients who did not meet the criteria for PTSD and the lowest in the recipients who met the criteria for full PTSD. Greater severity of posttraumatic stress symptoms was correlated with poorer quality of life, especially in the bodily pain (P=0.004), social functioning (P=0.001), role-emotional (P=0.048), and mental health (P<0.001) domains. The model for end-stage liver disease (MELD) scores, complications, and educational status were identified by multiple regression analysis as risk factors for developing PTSD.PTSD occurred after liver transplantation and was significantly associated with decreased quality of life. Higher MELD scores and complications after transplantation were risk factors that contributed to PTSD, and higher education was a protective factor.",0,0 +6637,A Comparison of the Capacity of <em>DSM-IV]</em> and <em>DSM-5]</em> Acute Stress Disorder Definitions to Predict Posttraumatic Stress Disorder and Related Disorders,"This study addresses the extent to which DSM-IV and DSM-5 definitions of acute stress disorder (ASD) predict subsequent posttraumatic stress disorder (PTSD) and related psychiatric disorders following trauma.Patients with randomized admissions to 5 hospitals across Australia (N = 596) were assessed in hospital and reassessed for PTSD at 3 (n = 508), 12 (n = 426), 24 (n = 439), and 72 (n = 314) months using the Clinician-Administered PTSD Scale; DSM-IV definition of PTSD was used at each assessment, and DSM-5 definition was used at 72 months. The Mini-International Neuropsychiatric Interview (MINI) was used at each assessment to assess anxiety, mood, and substance use disorders.Forty-five patients (8%) met DSM-IV criteria, and 80 patients (14%) met DSM-5 criteria for ASD. PTSD was diagnosed in 93 patients (9%) at 3, 82 patients (10%) at 12, 100 patients (12%) at 24, and 26 patients (8%) at 72 months; 19 patients (6%) met DSM-5 criteria for PTSD at 72 months. Comparable proportions of those diagnosed with ASD developed PTSD using DSM-IV (3 months = 46%, 12 months = 39%, 24 months = 32%, and 72 months = 25%) and DSM-5 (43%, 42%, 33%, and 24%) ASD definitions. Sensitivity was improved for DSM-5 relative to DSM-IV for depression (0.18 vs 0.30), panic disorder (0.19 vs 0.41), agoraphobia (0.14 vs 0.40), social phobia (0.12 vs 0.44), specific phobia (0.24 vs 0.58), obsessive-compulsive disorder (0.17 vs 0.47), and generalized anxiety disorder (0.20 vs 0.47). More than half of participants with DSM-5-defined ASD had a subsequent disorder.The DSM-5 criteria for ASD results in better identification of people who will subsequently develop PTSD or another psychiatric disorder relative to the DSM-IV criteria. Although prediction is modest, it suggests that the new ASD diagnosis can serve a useful function in acute trauma settings for triaging those who can benefit from either early intervention or subsequent monitoring.",0,0 +6638,Disasters and youth: A meta-analytic examination of posttraumatic stress.,"Meta-analyze the literature on posttraumatic stress (PTS) symptoms in youths post-disaster.Meta-analytic synthesis of the literature (k = 96 studies; Ntotal = 74,154) summarizing the magnitude of associations between disasters and youth PTS, and key factors associated with variations in the magnitude of these associations. We included peer-reviewed studies published prior to 1/1/2009 that quantitatively examined youth PTS (≤ 18 years at event) after a distinct and identifiable disaster.Despite variability across studies, disasters had a significant effect on youth PTS (small-to-medium magnitude; rpooled = .19, SEr = .03; d = 0.4). Female gender (rpooled = .14), higher death toll (disasters of death toll ≤ 25: rpooled = .09; vs. disasters with ≥ 1,000 deaths: rpooled = .22), child proximity (rpooled = .33), personal loss (rpooled = .16), perceived threat (rpooled = .34), and distress (rpooled = .38) at time of event were each associated with increased PTS. Studies conducted within 1 year post-disaster, studies that used established measures, and studies that relied on child-report data identified a significant effect.Youths are vulnerable to appreciable PTS after disaster, with pre-existing child characteristics, aspects of the disaster experience, and study methodology each associated with variations in the effect magnitude. Findings underscore the importance of measurement considerations in post-disaster research. Areas in need of research include the long-term impact of disasters, disaster-related media exposure, prior trauma and psychopathology, social support, ethnicity/race, prejudice, parental psychopathology, and the effects of disasters in developing regions of the world. Policy and clinical implications are discussed.",0,0 +6639,Link between personality and cancer,"Personality refers to an individual’s enduring and pervasive personal motivation, emotion, interpersonal style, attitudes and behavior that are stable over a long time after young adulthood. In relation to the cancer trajectory, three basic and one other personality traits have been studied with some frequency, namely neuroticism, extraversion, conscientiousness and optimism. The considerable stability of personality over time makes it a potential long-acting etiological factor for the development of cancer. However, the studies performed so far do not give much support to personality as a causative factor for cancer. Some studies of cancer survival have found significant associations between lower optimism and higher neuroticism with shorter survival. More mental distress and fatigue and poorer quality of life is significantly associated with higher neuroticism and lower optimism at cancer screening, diagnosis and primary treatment, short- and long-term follow-up and towards the end of life. Neuroticism is a strong predictor of post-traumatic stress disorder triggered by cancer as a life-threatening experience eventually leading to negative personality changes. To what extent cancer leads to positive personality changes (post-traumatic growth) is currently unsettled. Basic personality traits are strongly associated with lifestyle, which is considered an important etiological factor for the development of cancer. The methodological problems in the study of personality and cancer are considerable, and many research designs used so far may have been too simplistic. Studies of potential biomarkers for personality traits combined with inflammation markers of cellular carcinogenesis in longitudinal designs could be promising for the future. High neuroticism is important for the clinical management of cancer patients and should gain more attention from oncologists in the future.",0,0 +6640,Respiratory and mental health effects of wildfires: an ecological study in Galician municipalities (north-west Spain),"BackgroundDuring the summer of 2006, a wave of wildfires struck Galicia (north-west Spain), giving rise to a disaster situation in which a great deal of the territory was destroyed. Unlike other occasions, the wildfires in this case also threatened farms, houses and even human lives, with the result that the perception of disaster and helplessness was the most acute experienced in recent years. This study sought to analyse the respiratory and mental health effects of the August-2006 fires, using consumption of anxiolytics-hypnotics and drugs for obstructive airway diseases as indicators.MethodsWe conducted an analytical, ecological geographical- and temporal-cluster study, using municipality-month as the study unit. The independent variable was exposure to wildfires in August 2006, with municipalities thus being classified into the following three categories: no exposure; medium exposure; and high exposure. Dependent variables were: (1) anxiolytics-hypnotics; and (2) drugs for obstructive airway diseases consumption. These variables were calculated for the two 12-month periods before and after August 2006. Additive models for time series were used for statistical analysis purposes.ResultsThe results revealed a higher consumption of drugs for obstructive airway diseases among pensioners during the months following the wildfires, in municipalities affected versus those unaffected by fire. In terms of consumption of anxiolytics-hypnotics, the results showed a significant increase among men among men overall -pensioners and non-pensioners- in fire-affected municipalities.ConclusionsOur study indicates that wildfires have a significant effect on population health. The coherence of these results suggests that drug utilisation research is a useful tool for studying morbidity associated with environmental incidents.",0,0 +6641,Pilot study to assess the viability of a rape trauma syndrome questionnaire.,"Studies have revealed that rape victims undergo a number of psychological symptoms following the attack, which constitute a specific syndrome termed the rape trauma syndrome (RTS). Evidence of the RTS has been admitted as scientific testimony in the prosecution of sexual offences and has been integral in their successful conviction. The present study aims to assess the viability of a questionnaire designed to identify the RTS in victims of alleged rape.A 77-item rape trauma syndrome questionnaire (RTSQ) was developed and administered to 30 women who reported rape and 57 nurses who formed the control group. The data were analysed using the Statistical Package for the Social Sciences (Windows Version 6.0).Statistical analysis suggested that the questionnaire was internally consistent and effective in uncovering significant differences between rape victims and controls in their experience of rape trauma symptoms. Rape victims scored significantly higher than controls on the RTS scale. Those who faked rape were also found to endorse a greater number of the rape trauma symptoms than actual rape victims, as well as a greater number of fictitious and unlikely symptoms.This pilot study confirmed the viability of the RTSQ and paves the way for a more rigorous examination of its reliability and validity. In the future, the questionnaire may be of use in ascertaining the veracity of victims' claims of rape in the conviction of sexual offences where circumstances are equivocal.",0,0 +6642,Impaired extinction of learned fear in rats selectively bred for high anxiety - evidence of altered neuronal processing in prefrontal-amygdala pathways,"The impaired extinction of acquired fear is a core symptom of anxiety disorders, such as post-traumatic stress disorder, phobias or panic disorder, and is known to be particularly resistant to existing pharmacotherapy. We provide here evidence that a similar relationship between trait anxiety and resistance to extinction of fear memory can be mimicked in a psychopathologic animal model. Wistar rat lines selectively bred for high (HAB) or low (LAB) anxiety-related behaviour were tested in a classical cued fear conditioning task utilizing freezing responses as a measure of fear. Fear acquisition was similar in both lines. In the extinction trial, however, HAB rats showed a marked deficit in the attenuation of freezing responses to repeated auditory conditioned stimulus presentations as compared with LAB rats, which exhibited rapid extinction. To gain information concerning the putatively altered neuronal processing associated with the differential behavioural response between HAB and LAB rats, c-Fos expression was investigated in the main prefrontal-amygdala pathways important for cued fear extinction. HAB compared to LAB rats showed an attenuated c-Fos response to repeated conditioned stimulus presentations in infralimbic and cingulate cortices, as well as in the lateral amygdala, but facilitated the c-Fos response in the medial part of the central amygdala. In conclusion, the present results support the notion that impaired extinction in high anxiety rats is accompanied by an aberrant activation profile in extinction-relevant prefrontal-amygdala circuits. Thus, HAB rats may represent a clinically relevant model to study the mechanisms and potential targets to accelerate delayed extinction processes in subjects with enhanced trait anxiety.",0,0 +6643,Posttraumatic stress disorder among three-generation families in times of war: A comparison between Israeli Jewish and Arabs after the Second Lebanon War (2006) and Cast Lead Operation (2009).,"There is little mention in the existing literature regarding the differential effects of wars or military operations on 3-generation families. Participants (n = 509; 167 elderly parents, 171 adult offspring, and 171 adult grandchildren) living in the northern and southern regions of Israel were interview after the Second Lebanon War (2006) and the Cast Lead Operation (2009). The participants were sampled by using a cluster sampling. Elderly parents experience higher levels of PTSD symptoms than their adult children or their adult grandchildren do. Women experience higher levels of PTSD symptoms than men and Israeli Arabs and Druze higher levels than Israeli Jews in all 3 generations. A policy should be enacted among the local authorities and the governmental offices that would ensure accessibility to and the ability to provide proper care especially for the elderly population during times of war, military operations, or terror events. In addition, it is important to set up local teams in every local community to deal with the level of mental and emotional preparedness of the homefront and its inhabitants, in case the latter should again become part of the human casualties of the wars and terrorist events that occur in Israel.",0,0 +6644,Comparison of psychiatric disability on the health of nation outcome scales (HoNOS) in resettled traumatized refugee outpatients and Danish inpatients,"Currently, the mental health issues of traumatized refugees are mainly documented in terms of posttraumatic stress disorder, depression, and anxiety. Importantly, there are no reports of the level of psychiatric disability in treatment seeking traumatized refugees resettled in the West. Insufficient acknowledgment of the collective load of bio-psycho-social problems in this patient group hinders effective psychiatric and social service utilization outside the specialized clinics for traumatized refugees.The level of psychiatric disability in traumatized refugees from Danish specialized clinics (N = 448) is documented using routine monitoring data from pre- and post-treatment on the Health of Nation Outcome Scales (HoNOS). Furthermore, the HoNOS ratings are compared with routine monitoring data from Danish inpatients with different diagnoses (N = 10.911).The routinely collected data indicated that despite their outpatient status, traumatized refugees had higher levels of psychiatric disability at pre-treatment compared to most inpatients. Moreover, the traumatized refugees had a HoNOS profile characterized by an overall high problem level in various psychiatric and social domains. The rate of pre- to post-treatment improvement on the HoNOS was smaller for the traumatized refugees than it was for the psychiatric inpatients.The level, and the versatile profile, of psychiatric disability on the HoNOS point to complex bio-psycho-social problems in resettled treatment seeking traumatized refugees. Thus, a broader assessment of symptoms and better cooperation between psychiatric, health care, and social systems is necessary in order to meet the treatment needs of this group.",0,0 +6645,Overview of post-traumatic stress.,"The purpose of this article is to provide an overview of the acute stress response with additional information on post-traumatic stress. There is an emphasis on the theoretical foundations and post-traumatic stress disorder symptoms. Risk factors, symptom clusters, and the diagnostic criteria for post-traumatic stress disorder are described as a foundation for clinical implications and a focused nursing assessment.",0,0 +6646,Posttraumatic stress avoidance symptoms as mediators in the development of alcohol use disorders after exposure to childhood sexual abuse in a Swiss community sample,"This study examined the role of posttraumatic stress disorder (PTSD) symptoms of re-experience, avoidance, and hyperarousal in the relationship between different types of trauma and alcohol use disorders (AUD). We used data from 731 trauma-exposed individuals who participated in the first wave of the PsyCoLaus-study. Trauma characteristics were assessed relatively to the occurrence of lifetime PTSD symptoms and AUD. The results suggest that lifetime and childhood sexual abuse as well as overall childhood trauma were directly linked to AUD and PTSD symptoms, in particular to avoidance symptoms. From single symptom clusters PTSD avoidance was found to specifically mediate the trauma-AUD pathway. Both childhood and sexual trauma strongly contribute to the comorbidity of PTSD and AUD and avoidance-type symptoms appear to play a central role in maintaining this association. Hence, the alleviation of avoidance symptoms might be an important target for therapeutic intervention among victims of sexual abuse before specific addiction treatment is initiated.",0,0 +6647,Comparison of Memory Function and MMPI-2 Profile between Post-traumatic Stress Disorder and Adjustment Disorder after a Traffic Accident,"Differential diagnosis between post-traumatic stress disorder (PTSD) and adjustment disorder (AD) is rather difficult, but very important to the assignment of appropriate treatment and prognosis. This study investigated methods to differentiate PTSD and AD.Twenty-five people with PTSD and 24 people with AD were recruited. Memory tests, the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and Beck's Depression Inventory were administered.There were significant decreases in immediate verbal recall and delayed verbal recognition in the participants with PTSD. The reduced memory functions of participants with PTSD were significantly influenced by depressive symptoms. Hypochondriasis, hysteria, psychopathic deviate, paranoia, schizophrenia, post-traumatic stress disorder scale of MMPI-2 classified significantly PTSD and AD group.Our results suggest that verbal memory assessments and the MMPI-2 could be useful for discriminating between PTSD and AD.",0,0 +6648,Influence of Bodily Injuries on Symptom Reporting Following Uncomplicated Mild Traumatic Brain Injury in US Military Service Members,": To examine the relations among bodily injuries, traumatic stress, and postconcussion symptoms in a sample of combat-injured US service members who sustained a mild traumatic brain injury.: One hundred and thirty-seven service members evaluated and treated at Walter Reed Army Medical Center following medical evacuation from the combat theater of Operation Enduring Freedom and Operation Iraqi Freedom. All had sustained an uncomplicated mild traumatic brain injury and concurrent bodily injuries.: Participants completed 2 symptom checklists within 3 months of injury. Severity of bodily injuries was quantified with a modified version of the Injury Severity Score that excluded intracranial injuries (ISSmod). Participants were classified into 4 ISSmod groups: minor (n = 17), moderate (n = 48), serious (n = 40), severe/critical (n = 32).: Neurobehavioral Symptom Inventory (NBSI) and the Posttraumatic Stress Disorder Checklist-Civilian version (PCLC).: There was a significant negative association between ISSmod scores and the NBSI and PCLC total scores. There were significant main effects across the 4 groups for the NBSI and PCLC total scores. The highest NBSI and PCLC scores were consistently found in the ISSmod minor group, followed by the moderate, serious, and severe/critical groups.: While it might be expected that greater comorbid physical injuries would be associated with greater symptom burden, in this study as the severity of bodily injuries increased, symptom burden decreased. Hypothesized explanations include: underreporting of symptoms; increased peer support; disruption of fear conditioning due to acute morphine use; or delayed expression of symptoms.",0,0 +6649,Latent class analysis of co-morbidity in the Adult Psychiatric Morbidity Survey in England 2007: implications for DSM-5 and ICD-11,"Psychiatric co-morbidity is complex and ubiquitous. Our aim was to describe the extent, nature and patterning of psychiatric co-morbidity within a representative sample of the adult population of England, using latent class analysis.Data were used from the 2007 Adult Psychiatric Morbidity Survey, a two-phase national household survey undertaken in 2007 comprising 7325 participants aged 16 years and older living in private households in England. The presence of 15 common mental health and behavioural problems was ascertained using standardized clinical and validated self-report measures, including three anxiety disorders, depressive episode, mixed anxiety depressive disorder, psychosis, antisocial and borderline personality disorders, eating disorders, post-traumatic stress disorder, attention deficit disorder, alcohol and drug dependencies, problem gambling and attempted suicide.A four-class model provided the most parsimonious and informative explanation of the data. Most participants (81.6%) were assigned to a non-symptomatic or 'Unaffected' class. The remainder were classified into three qualitatively different symptomatic classes: 'Co-thymia' (12.4%), 'Highly Co-morbid' (5.0%) and 'Addictions' (1.0%). Classes differed in mean numbers of conditions and impairments in social functioning, and these dimensions were correlated.Our findings confirm that mental disorders typically co-occur and are concentrated in a relatively small number of individuals. Conditions associated with the highest levels of disability, mortality and cost--psychosis, suicidality and personality disorders--are often co-morbid with more common conditions. This needs to be recognized when planning services and when considering aetiology.",0,0 +6650,PTSD Symptom Clusters Are Differentially Associated with Components of the Acquired Capability for Suicide,"Previous research has established the link between posttraumatic stress disorder (PTSD) and suicidal behavior. In the current study, constructs proposed to explain this relationship were examined, applying the framework of the interpersonal-psychological theory of suicide (IPTS). Relationships between acquired capability for suicide (ACS; i.e., fearlessness about death [FAD] and pain tolerance) and specific PTSD symptom clusters were explored. In a sample of 334 trauma-exposed undergraduates, anxious arousal and FAD were negatively associated, and numbing and pain tolerance were positively associated. Results establish a foundation for investigating the role of ACS in understanding observed relationships between suicidal behavior and PTSD symptoms.",0,0 +6651,Mental Disorders Associated With Subpopulations of Women Affected by Violence and Abuse,"Violence against women is a major public health problem associated with mental disorders. Few studies have examined the heterogeneity of interpersonal violence and abuse (IVA) among women and associated mental health problems. Latent class analysis was used to identify subpopulations of women with similar lifetime histories of IVA victimization and to examine 10 associated past-year mental disorders. Participants were 19,816 adult women who participated in Wave 2 of the National Epidemiologic Study on Alcohol and Related Conditions (NESARC). The 3-class model was best supported by the data. Class 1 (6.7%) had a high probability of witnessing domestic violence as a child. Class 2 (21.8%) had a low probability of all events except lifetime sexual assault. Class 3 (71.5%) had a low probability for all events. Mental disorders were more common among members of Classes 1 and 2 than Class 3. For example, members in Class 1 were approximately 8 and 9 times more likely than members in Class 3 to have had posttraumatic stress disorder or a drug use disorder, respectively, during the past year. Of the 10 mental disorders, 5 were more common among members of Class 1 than of Class 2. Findings suggest the mental health consequences of IVA among women are extensive and interventions should be tailored for distinct subpopulations affected by IVA.",0,0 +6652,Whiplash and post-traumatic stress disorder,This study examined the comorbidity of whiplash and post-traumatic stress disorder (PTSD) following motor vehicle accidents. A treatment strategy in cases with both disorders is proposed.A review of the literature on psychological consequences of motor vehicle accidents and on risk factors associated with developing chronic whiplash complaints is given. A case report is presented to illustrate the treatment strategy.Traffic accidents lead to psychological complaints more often than is realized in clinical practice. It is estimated that PTSD occurs in at least 25% of traffic accident victims who sustain physical injuries. This number is probably higher in patients with chronic whiplash complaints. The case report shows that improvement in relation with the post-traumatic stress symptoms can have a beneficial effect on coping with the chronic whiplash complaints.The psychotherapeutic treatment of patients with chronic whiplash complaints and PTSD should be aimed primarily at coping with the trauma and not at the chronic pain complaints.,0,0 +6653,How does the posttraumatic cognitions inventory fit in a four-factor posttraumatic stress disorder world? An initial analysis.,"The posttraumatic cognitions inventory (PTCI) has emerged as a well-supported measure of trauma-related cognitions and has been associated with overall posttraumatic stress disorder (PTSD) severity. The present study sought to contribute to the literature regarding the utility of this measure and importance of considering the role of trauma-related cognitions in relation to an emerging four-factor model of PTSD symptomatology. To address discrepancies in the previous literature, we first replicated prior research by investigating the relationship between the PTCI cognitions (self, world/other, and self-blame) and overall PTSD symptoms. Next, we used structural equation modeling to examine a model of the relationships between posttraumatic cognitions and a well-supported four-factor model of PTSD (including separate avoidance and numbing clusters). We assessed PTSD symptomatology using both clinician-administered and self-report instruments in a treatment-seeking sample of sexual assault survivors. Results largely supported the theorized model of relationships between posttraumatic cognitions and PTSD symptom clusters. Discrepancies were observed between the two PTSD measures, which may help to clarify previous conflicting reports. Clinical and theoretical implications are considered. © 2012 American Psychological Association.",0,0 +6654,Main and Interactive Effects of Distress Tolerance and Negative Affect Intensity in Relation to PTSD Symptoms among Trauma-Exposed Adults,"The present investigation evaluated the main and interactive effects of distress tolerance and negative affect intensity in relation to posttraumatic stress disorder (PTSD) symptom severity and symptom cluster severity. Participants were 190 trauma-exposed adults (52.6 % women; Mage=25.3 years, SD=11.4) recruited from the community. Distress tolerance (i.e., perceived ability to withstand distressing emotional states) demonstrated significant incremental associations with global PTSD symptom severity as well as Re-Experiencing, Emotional Numbing, and Hyperarousal symptom cluster severity. Negative affect intensity (i.e., perceived intensity of negative emotional responses) demonstrated significant incremental associations with each of the PTSD symptom outcomes. Moreover, the incremental interactive effect of distress tolerance and negative affect intensity was significantly associated with PTSD symptom severity as well as PTSD-Emotional Numbing symptom cluster severity. These incremental effects were evident after accounting for the variance explained by anxiety sensitivity (i.e., fear of anxiety-related sensations). Post hoc probing analyses supported the moderating role of negative affect intensity in the association between distress tolerance and PTSD symptom severity, such that low levels of distress tolerance, in the context of elevated levels of negative affect intensity, were associated with the greatest levels of PTSD symptoms.",0,0 +6655,Cognitive Factors in Persistent versus Recovered Post-Traumatic Stress Disorder after Physical or Sexual Assault: A Pilot Study,"Cognitive models have linked individual differences in the appraisal of traumatic events and their sequelae to the persistence of post-traumatic stress disorder (PTSD). A pilot study investigated this proposal with victims of assault. Eleven assault victims suffering from persistent PTSD and 9 victims who had recovered from PTSD were interviewed retrospectively and compared on potentially relevant cognitive factors. Groups were comparable in terms of characteristics of the assault, gender, age, and initial PTSD severity. Participants with persistent PTSD were less likely than those who had recovered to have engaged in mental planning during the assault and more likely to have experienced mental defeat, and to indicate negative appraisals of their actions during the assault, of others' reactions after the assault, and of their initial PTSD symptoms. They were also more likely to indicate global negative beliefs concerning their perception of themselves, their world or their future. These cognitive factors may maintain PTSD symptoms either directly or by motivating the individual to engage in behaviour that prevents change.",0,0 +6656,Posttraumatic and depressive symptoms in β-endorphin dynamics,"A disturbed beta-endorphin system can be a part of the post-traumatic stress disorder (PTSD) and depression allostasis. Study subjects (N=392) included those with PTSD and/or (stress-induced) depression, and healthy controls with and without traumas. The aim of the study was to examine the network of relations centered around plasma beta-endorphin. The network included anxiety (as a personality trait), traumatic events, pain, aggressiveness, depressive symptoms, and three clusters of PTSD symptoms: intrusions, avoidance, and hyperarousal. Beta-endorphin was represented by individual mean from 13 time points (BEmean), reflecting the total amount of the peripherally secreted hormone, and the coefficient of variation (BEvar), calculated as the ratio of standard deviation to the mean, reflecting the hormone׳s dynamics. BEvar correlated with all other variables, BEmean had no correlations. Structural equation modeling (SEM) was used to examine all interrelations (including their directions) of BEvar and the state/trait variables in the context of their entirety. The model revealed that hyperarousal and anxiety were the only direct agents of peripheral beta-endorphin fluctuations, mediating the effects of other variables. Traumatic events and intrusions act on BEvar via hyperarousal, while depressive symptoms, avoidance, and pain act via anxiety. Hyperarousal should be emphasized as the main agent not only because its effect on BEvar is larger than that of anxiety, but also because it increases anxiety itself (via avoidance and pain). All influences on BEvar are positive and they indicate long-term (sensitizing) effects (as opposed to direct stimulation, for example, by acute pain, anger, etc.). Relations apart from beta-endorphin are also discussed.",0,0 +6657,Group music therapy for patients with persistent post-traumatic stress disorder - an exploratory randomized controlled trial with mixed methods evaluation,"Objectives. Not all patients with post-traumatic stress disorder (PTSD) respond to cognitive behavioural therapy (CBT). Literature suggests group music therapy might be beneficial in treating PTSD. However, feasibility and effectiveness have not been assessed. The study objectives were to assess whether group music therapy was feasible for patients who did not respond to CBT, and whether it has an effect on PTSD symptoms and depression. Design. The study employed mixed methods comprising of an exploratory randomized controlled trial, qualitative content analysis of therapy, and patient interviews. Method. Patients with significant PTSD symptoms (n= 17) following completion of CBT were randomly assigned to treatment (n= 9) or control groups (n= 8). The treatment group received 10 weeks of group music therapy after which exit interviews were conducted. Control group patients were offered the intervention at the end of the study. Symptoms were assessed on the Impact of Events Scale-Revised and Beck Depression Inventory II at the beginning and end of treatment. Results. Treatment-group patients experienced a significant reduction in severity of PTSD symptoms (−20.18; 95% confidence interval [CI]: [−31.23, −9.12]) and a marginally significant reduction in depression (−11.92; 95%CI: [−24.05, 0.21]) at 10 weeks from baseline compared to the control. Patients viewed music therapy as helpful and reported experiences concur with current literature. Conclusions. Group music therapy appears feasible and effective for PTSD patients who have not sufficiently responded to CBT. Limitations include the small sample size and lack of blinding. Further research should address these limitations, test sustainability, and identify specific factors that address symptoms in treatment.",0,0 +6658,Longitudinal analysis of the relationship between symptoms and quality of life in veterans treated for posttraumatic stress disorder.,This study examined how change in posttraumatic stress disorder (PTSD) symptoms relates to change in quality of life. The sample consisted of 325 male Vietnam veterans with chronic PTSD who participated in a randomized trial of group psychotherapy. Latent growth modeling was used to test for synchronous effects of PTSD symptom change on psychosocial and physical health-related quality of life within the same time period and lagged effects of initial PTSD symptom change on later change in quality of life. PTSD symptoms were associated with reduced quality of life before treatment. There were synchronous effects of symptom change on change in quality of life but no significant lagged effects. Results indicate the importance of measuring quality of life in future investigations of PTSD treatment.,0,0 +6659,Cumulative Tertiary Appraisals of Traumatic Events Across Cultures: Two Studies,"Two studies compared the effects of cumulative trauma (CT) with those of cumulative negative (CNTA) and cumulative positive tertiary appraisals (CPTA). The first study was conducted with an adult clinical population in the U.S. (N = 399), while the second study was conducted with adolescent students in Gaza (N = 422). Among the effects found were that path analysis with comulative trauma, positive tertiary appraisal, and cumulative negative tertiary appraisals as independent variables and mental health measures as dependent variables, in both samples, found that CNTA and CPTA had direct positive and direct negative effects, respectively, on PTSD, depression, and anxiety. However, CT, independent from appraisals, had direct effects in producing the more complicated symptom clusters of cumulative trauma disorders.",0,0 +6660,Markers of Inflammation in Midlife Women with Intimate Partner Violence Histories,"Lifetime occurrence of intimate partner violence (IPV) in women has been associated with increased prevalence of aging-related chronic diseases, including those with a pathophysiology involving inflammation. To begin to identify potential biologic mediators of this relationship, this cross-sectional study examined associations between past IPV and circulating levels of C-reactive protein (CRP) and interleukin-6 (IL-6)-measures linked with emergence of aging-related diseases-along with in vitro IL-6 production by peripheral blood mononuclear cells (PBMC) stimulated with either phytohemagglutinin A (PHA) or lipopolysaccharide (LPS).Apparently healthy, midlife women with divorce histories were recruited from the community. Histories of intimate partner psychological aggression, physical assault, sexual coercion, and stalking were assessed, along with current depression, posttraumatic stress symptoms, and health-related characteristics. At two visits, blood was drawn for assessment of biologic measures; measures were averaged across visits.In this sample (n=68), a history of being stalked was significantly positively correlated with CRP levels; in a multiple regression analysis that included body mass index (BMI) and current symptoms, this association was attenuated by adjusting for BMI. Physical assault history was significantly negatively correlated with PHA-stimulated IL-6 production. This was most apparent for severe assault and was not accounted for by BMI or symptoms.IPV histories remitted for an average of 10 years were associated with biologic mediators of inflammation. The profile was not uniformly proinflammatory, suggesting that in situations of traumatic or chronic stress, different aspects of the inflammatory response are differentially regulated and subjected to diverse compensatory mechanisms.",0,0 +6661,Battlefield functioning and chronic PTSD: associations with perceived self efficacy and causal attribution,"This study has two aims: (1) to examine the associations between battlefield functioning and perceived self efficacy (PSE) and attributional style; (2) to examine the unique and cumulative contributions of battlefield functioning, PSE, and attributional style to long term PTSD . The subjects were three groups of Israeli veterans of the 1973 Yom Kippur, who differed in their battlefield functioning: 112 combat stress reaction (CSR) casualties, 98 veterans who received medals for bravery, and 189 controls. The subjects filled out a series of questionnaires that assessed PTSD, PCE, attributional style and PTSD, two decades after the war. CSR casualties exhibited the lowest level of PSE, decorated veterans the highest. The three groups also differed in locus of control , with different attribution for failure. Discriminant analysis of PTSD and non-PTSD veterans showed that sociodemographic background, battlefield performance, PSE and attributional style classified 81% of all veterans correctly. The implications of these findings are discussed.",0,0 +6662,Evidence of a disposition toward fearfulness and vulnerability to posttraumatic stress in dysfunctional pain patients,"Few investigations have addressed whether patient subgroups derived using the Multiaxial Assessment of Pain (MAP) [Turk, D. C., & Rudy, T. E. (1987). Towards a comprehensive assessment of chronic pain patients. Behaviour Research and Therapy, 25, 237-249; Turk, D. C., & Rudy, T. E. (1988). Toward an empirically derived taxonomy of chronic pain patients: integration of psychological assessment data. Journal of Consulting and Clinical Psychology, 56, 233-238.] differ with regard to fear and avoidance. It has, however, been reported that dysfunctional patients exhibit more pain-specific fear and avoidance than patients classified as interpersonally distressed or minimizers/adaptive copers [Asmundson, G. J. G., Norton, G. R., & Allerdings, M. D. (1997). Fear and avoidance in dysfunctional chronic back pain patients. Pain, 69, 231-236.]. We attempted to extend these findings by examining two fear constructs that are receiving increased attention in the chronic pain literature-anxiety sensitivity and PTSD. The sample comprised 115 patients with chronic pain. Of these, 14 (12.2%) were classified as dysfunctional, 21 (18.3%) as interpersonally distressed and 47 (40.8%) as minimizers/adaptive copers. Between-group differences were observed on the fear of cognitive and emotional dyscontrol dimension of anxiety sensitivity, total and symptom cluster scores on the PTSD measure, and depression. No differences were observed for the fear of somatic sensations dimension of anxiety sensitivity or agoraphobia, social phobia, and blood/injury fears. Dysfunctional patients generally exhibited elevated scores relative to one or both of the other MAP subgroups on fear of cognitive and emotional dyscontrol, depressed affect, PTSD symptom total score and PTSD symptom cluster scores. As well, a substantial proportion of dysfunctional and interpersonally distressed patients were classified as having PTSD (71.4 and 42.9%, respectively) when compared to minimizers/adaptive copers (21.3%). These results suggest that MAP subgroups differ with regard to their propensity to be(come) fearful and in their likelihood of having PTSD. Theoretical and clinical implications are discussed.",0,0 +6663,Longitudinal effects of PTSD on memory functioning,"Abstract Numerous studies have demonstrated explicit and working memory deficits related to posttraumatic stress disorder (PTSD), but few have addressed longitudinal changes in memory functioning. There is some evidence to suggest an interactive effect of PTSD and aging on verbal memory decline in Holocaust survivors (Yehuda et al., 2006). However, the longitudinal trajectory of neuropsychological functioning has not been investigated in Vietnam veterans, a younger but substantial population of aging trauma survivors. We administered tests of visual and verbal memory, and working memory to derive different dependent measures in veterans between the ages of 41 and 63, the majority of whom served in the Vietnam War. Twenty-five veterans with PTSD and 22 veterans without PTSD were assessed over two time points (mean age at follow-up = 54.0; mean inter-test interval = 34 months). The PTSD+ group, consisting of veterans with chronic, primarily combat-related PTSD, did not show a significant change in PTSD symptoms over time. Compared to veterans without PTSD, veterans with PTSD showed a greater decline in delayed facial recognition only, and this decline was extremely subtle. ( JINS , 2009, 15 , 853–861.)",0,0 +6664,Transdiagnostic and disorder-specific models of intergenerational transmission of internalizing pathology – ERRATUM,"Reports an error in ""Transdiagnostic and disorder-specific models of intergenerational transmission of internalizing pathology"" by L. R. Starr, C. C. Conway, C. L. Hammen and P. A. Brennan (Psychological Medicine, 2014[Jan], Vol 44[1], 161-172). In the original article, there were errors in Figure 1. The correct Figure 1 is present in the erratum. (The following abstract of the original article appeared in record 2013-44252-015). Background: Numerous studies have supported an association between maternal depression and child psychiatric outcomes, but few have controlled for the confounding effects of both maternal and offspring co-morbidity. Thus, it remains unclear whether the correspondence between maternal and offspring depressive and anxiety disorders is better explained by associations between shared features of maternal and offspring internalizing disorders or by specific effects exerted by unique aspects of individual disorders. Method: Pairs of mothers and offspring overselected for maternal depression (n = 815) were assessed at offspring age 15 years for anxiety and depressive disorders; 705 completed a follow-up at offspring age 20 years. For both mothers and offspring, structural equation modeling was used to distinguish transdiagnostic internalizing pathology - representing the overlap among all depressive and anxiety disorders - from diagnosis-specific forms of pathology. To discriminate between general versus specific pathways of intergenerational transmission of psychopathology, we examined (a) the general association between the maternal and offspring internalizing factors and (b) the correlations between maternal and offspring diagnosis-specific pathology for each disorder. Results: For mothers and offspring, a unidimensional latent variable model provided the best fit to the correlations among depressive and anxiety disorders. The maternal transdiagnostic internalizing factor strongly predicted the corresponding factor among offspring. In addition, the unique component of post-traumatic stress disorder among offspring was significantly related to the analogous unique component among mothers, but specific components of other maternal disorders, including depression, did not predict corresponding offspring pathology. Conclusions: Results suggest that intergenerational transmission of internalizing disorders is largely non-specific. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0,0 +6665,Phenomenology and psychological assessment of complex posttraumatic states,"The authors offer a framework for the assessment of psychological responses associated with exposure to early onset, multiple, or extended traumatic stressors. Six prominent and overlapping symptoms clusters are described: altered self-capacities, cognitive symptoms, mood disturbance, overdeveloped avoidance responses, somatoform distress, and posttraumatic stress. A strategy for the structured, psychometrically valid assessment of these outcomes is introduced, and specific recommendations for use of various generic and trauma-specific child and adult measures are provided. Implications of trauma assessment for treatment planning are discussed.",0,0 +6666,Longitudinal Analysis of Children's Internal States Language and Posttraumatic Stress Symptoms Following a Natural Disaster,"Summary Disclosure of internal states terms (e.g., emotions, cognitions, and perceptions) in traumatic event descriptions is thought to be associated with physical and mental health in adults, but studies with children have been mixed, and the interpretation of many findings is complicated by the lack of longitudinal data. Using data collected from 568 students (ages 7–12 years) attending schools in Miami-Dade County, Florida, this study examined the internal states language in participant's written descriptions of the ‘worst things that happened during the hurricane’ collected 3 and 7 months after Hurricane Andrew. Associations between these internal states and their posttraumatic stress symptoms (PTSS) 3, 7, and 10 months post-hurricane were evaluated using structural equation modeling. Patterns of association suggest that PTSS were not affected by internal states disclosure; rather, internal states language seemed to be a manifestation of PTSS. Implications for risk assessment, theory building, and treatment of PTSS in children are discussed. Copyright © 2014 John Wiley & Sons, Ltd.",0,0 +6667,Persistence of Posttraumatic Stress Symptoms 12 and 36 Months After Acute Coronary Syndrome,"To assess the prevalence and predictors of posttraumatic stress symptoms in patients at 12 and 36 months post hospital admission for an acute coronary syndrome (ACS). There is increasing recognition that posttraumatic stress may develop in the aftermath of an acute cardiac event. However, there has been little research on the longer-term prevalence of posttraumatic stress disorder (PTSD).Posttraumatic stress symptoms were assessed at 12 months in 213 patients with ACS and in 179 patients at 36 months. Predictor variables included clinical, demographic, and emotional factors measured during hospital admission.At 12 months post ACS, 26 (12.2%) patients qualified for a diagnosis of PTSD; 23 (12.8%) patients were identified with PTSD at 36 months. Posttraumatic symptoms at 12 months were associated with younger age, ethnic minority status, social deprivation, cardiac symptom recurrence, history of depression, depressed mood during admission, hostility, and Type D personality. In multiple regression, depressed mood during admission and recurrent cardiac symptoms were independent predictors of posttraumatic symptoms (R(2) = 0.507, p < .001). At 36 months, posttraumatic stress symptoms were independently predicted by posttraumatic symptom levels at 12 months and depressed mood during admission (R(2) = 0.635, p < .001).Posttraumatic stress symptoms persist for at least 3 years after an acute cardiac event. Early emotional responses are important in predicting longer-term posttraumatic stress. It is important to identify patients at risk for posttraumatic stress as they are more likely to experience reduced quality of life.",0,0 +6668,"Resilience, Vulnerability and the Course of Posttraumatic Reactions",,0,0 +6669,Anatomical and functional connectivity in the default mode network of post-traumatic stress disorder patients after civilian and military-related trauma,"Posttraumatic stress disorder (PTSD) is characterized by unwanted intrusive thoughts and hyperarousal at rest. As these core symptoms reflect disturbance in resting-state mechanisms, we investigated the functional and anatomical involvement of the default mode network (DMN) in this disorder. The relation between symptomatology and trauma characteristics was considered. Twenty PTSD patients and 20 matched trauma-exposed controls that were exposed to a similar traumatic event were recruited for this study. In each group, 10 patients were exposed to military trauma, and 10 to civilian trauma. PTSD, anxiety, and depression symptom severity were assessed. DMN maps were identified in resting-state scans using independent component analysis. Regions of interest (medial prefrontal, precuneus, and bilateral inferior parietal) were defined and average z-scores were extracted for use in the statistical analysis. The medial prefrontal and the precuneus regions were used for cingulum tractography whose integrity was measured and compared between groups. Similar functional and anatomical connectivity patterns were identified in the DMN of PTSD patients and trauma-exposed controls. In the PTSD group, functional and anatomical connectivity parameters were strongly correlated with clinical measures, and there was evidence of coupling between the anatomical and functional properties. Type of trauma and time from trauma were found to modulate connectivity patterns. To conclude, anatomical and functional connectivity patterns are related to PTSD symptoms and trauma characteristics influence connectivity beyond clinical symptoms. Hum Brain Mapp 37:589-599, 2016. © 2015 Wiley Periodicals, Inc.",0,0 +6670,Complex posttraumatic stress disorder in traumatised asylum seekers: a pilot study,"Complex posttraumatic stress disorder (cPTSD), a construct associated with early onset and repeated interpersonal trauma, has not previously been assessed in asylum seekers who have experienced major human rights violations. The aim of this pilot study was to describe the cPTSD symptom profile in asylum seekers, and to compare this profile between three groups of people who have experienced: human trafficking, domestic violence and/or torture. Methods: Over a period of eight weeks, clinicians working at the Helen Bamber Foundation charity invited 48 patients currently receiving psychotherapy to take part in the study, of whom 30 (62.5%) agreed. The structured interview for disorders of extreme stress (SIDES) was used to assess cPTSD in 29 asylum seekers, as one patient withdrew during the interview. Results: Participants originated from 18 countries, 72.4% were female, the median age at trauma onset was 17 years and the duration of trauma was ten years. Eight (27.6%) participants were found to have cPTSD, defined as having all six symptom clusters, and 15 (51.7%) had five or more cPTSD symptom clusters. Age at trauma onset, duration of trauma, last trauma experience, gender and trauma type were not found to be associated with cPTSD presence. Conclusions: Extensive cPTSD symptoms were common in all participants, regardless of the nature of the trauma experienced. Future research is needed to enable generalisability of cPTSD symptom profile in asylum seekers.",0,0 +6671,Women in prison: The central issues of gender characteristics and trauma history,"Insufficient attention is being paid to two key issues which are critical to a better understanding of what can be done to improve present services for women in prison. Firstly, the demographics, determinants and profiles of imprisoned women clearly show factors that should be central to any prison policy for women. Secondly, an analysis of the role of trauma history shows its strong influence on offending behaviour. Any modern approach to providing a more acceptable criminal justice policy for women must pay much greater attention to these two important issues.",0,0 +6672,Cognitive and emotional processing through writing among adolescents who experienced the death of a classmate.,"This study investigated how written emotional disclosure reflects the processes by which adolescents cope with a traumatic event they experienced collectively - the sudden death of a classmate. Twenty high school students wrote about their emotional reactions to the death on 3 consecutive days. The writings were coded using the Linguistic Inquiry and Word Count (LIWC) and analyzed using a mixed-methods software (T-LAB). A measure of posttraumatic stress symptoms (Impact of Events Scale-Revised) obtained at baseline (14 days after the death) and 1 week and 4 months' postwriting was used to classify the students into four adjustment trajectories: Delayed Distress, Recovery, Stable-Negative, and Stable-Positive. Textual analysis revealed a progressive elaboration of the traumatic event across the 3 writing days, moving from a factual perspective to the processing of emotions to an integrated emotional and cognitive restructuring of the event. The nature of the writing differed across adjustment trajectories. Specifically, students in the Stable-Positive and Recovery trajectories made greater mention of the deceased classmate and reflected greater cognitive processing of the trauma. Students in the Stable-Negative and Delayed Distress trajectories used more self-references and negative emotion words and showed a greater degree of inhibition. The results provide preliminary clues to adjustment processes in adolescent bereavement. © 2010 American Psychological Association.",0,0 +6673,"Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders","Anxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated.These guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology, diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980-2012). Treatment strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines.These guidelines are presented in 10 sections, including an introduction, principles of diagnosis and management, six sections (Sections 3 through 8) on the specific anxiety-related disorders (panic disorder, agoraphobia, specific phobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder), and two additional sections on special populations (children/adolescents, pregnant/lactating women, and the elderly) and clinical issues in patients with comorbid conditions.Anxiety and related disorders are very common in clinical practice, and frequently comorbid with other psychiatric and medical conditions. Optimal management requires a good understanding of the efficacy and side effect profiles of pharmacological and psychological treatments.",0,0 +6674,"Caregiver distress, shared traumatic exposure, and child adjustment among area youth following the 2013 Boston Marathon bombing","Disasters are associated with myriad negative outcomes in youth, including posttraumatic stress disorder and related psychopathology. Prior work suggests links between caregiver distress and child mental health outcomes following community traumas, but the extent to which caregiver distress is directly linked to post-disaster child functioning, or whether such associations may simply be due to shared traumatic exposure, remains unclear.The current study examined relationships among caregiver distress, caregiver-child shared traumatic exposure, and child outcomes in Boston-area families (N=460) during the six months following the 2013 Boston Marathon bombing. Parents completed surveys about their and their child׳s potentially traumatic experiences during the bombing and subsequent manhunt. Post-attack caregiver distress and child psychological functioning were also assessed.After accounting for caregiver-child shared traumatic exposure, significant associations were retained between caregiver distress and child functioning across several domains. Furthermore, after accounting for caregiver traumatic exposure, caregiver distress moderated relationships between child traumatic exposure and child posttraumatic stress and conduct problems, such that associations between child traumatic exposure and child posttraumatic stress and conduct problems were particularly strong among children of highly distressed caregivers.The cross-sectional design did not permit evaluations across time, and population-based methods were not applied.Findings clarify links between caregiver distress and child psychopathology in the aftermath of disaster and can inform optimal allocation of clinical resources targeting disaster-affected youth and their families.",0,0 +6675,Head and facial injuries due to cluster munitions,"Cluster munitions are weapons that scatter smaller sub-munitions intended to kill or mutilate on impact. They have been used by the Israeli army in the south of Lebanon and are now scattered over wide rural areas affecting its inhabitants. Because of their easily ""pickable"" nature, sub-munitions can inflict injuries to the head and face regions. In this study, we aimed to explore the head and face injuries along with their clinical features in a group of Lebanese patients who suffered from such injuries due to a sub-munition's detonation. The study included all the cases reported between 14 August 2006 and 15 February 2013, with head and face injuries related to cluster bombs. Injuries were classified into brain, eye, otologic and auditory impairments, oral and maxillofacial, and skin and soft-tissue injuries. Psychological effects of these patients were also examined as for post-traumatic stress disorder, major depressive disorder, generalized anxiety disorder and acute stress syndrome. During the study period, there were 417 casualties as a result of cluster munitions' blasts. Out of the total number of victims, 29 (7 %) were injured in the head and the face region. The convention on cluster munitions of 2008 should be adhered to, as these inhumane weapons indiscriminately and disproportionately harm innocent civilians, thereby violating the well-established international principles governing conflict and war today. © 2014 Springer-Verlag.",0,0 +6676,Psychiatric symptoms of noradrenergic dysfunction: A pathophysiological view,"What psychiatric symptoms are caused by central noradrenergic dysfunction? The hypothesis considered in this review is that noradrenergic dysfunction causes the abnormalities in arousal level observed in functional psychoses. In this review, the psychiatric symptoms of noradrenergic dysfunction were inferred pathophysiologically from the neuroscience literature. This inference was examined based on the literature on the biology of psychiatric disorders and psychotropics. Additionally, hypotheses were generated as to the cause of the noradrenergic dysfunction. The central noradrenaline system, like the peripheral system, mediates the alarm reaction during stress. Overactivity of the system increases the arousal level and amplifies the emotional reaction to stress, which could manifest as a cluster of symptoms, such as insomnia, anxiety, irritability, emotional instability and exaggerated fear or aggressiveness (hyperarousal symptoms). Underactivity of the system lowers the arousal level and attenuates the alarm reaction, which could result in hypersomnia and insensitivity to stress (hypoarousal symptoms). Clinical data support the hypothesis that, in functional psychoses, the noradrenergic dysfunction is in fact associated with the arousal symptoms described above. The anti-noradrenergic action of anxiolytics and antipsychotics can explain their sedative effects on the hyperarousal symptoms of these disorders. The results of animal experiments suggest that excessive stress can be a cause of long-term noradrenergic dysfunction.",0,0 +6677,Psychotic features and combat-associated PTSD,"Psychotic symptoms and psychotic disorder diagnoses have occasionally been reported in association with chronic posttraumatic stress disorder (PTSD). Although psychotic features may be related to core PTSD symptoms, i.e., part of the reexperiencing phenomena, it is possible that they are secondary to certain comorbid disorders which are also prevalent in this patient population, e.g. major depression or substance abuse. In a prospective study, combat associated PTSD patients (n = 25) were administered clinical ratings, including the Structured Clinical Interview for DSM-III-R with psychotic screen (SCID-P), Clinician Administered PTSD Scale (CAPS) and the Impact of Events Scale (IES). Thirty-six percent (n = 9) endorsed psychotic symptoms with associated comorbidity including: major depressive episode, bipolar disorder, alcohol or polysubstance abuse panic disorder, and phobias. All but one of the patients with psychotic features also met criteria for major depressive episode. None had a primary psychotic disorder diagnosis. There were no significant differences in total CAPS scores between patients with or without psychotic features (82.6 +/-0 17.6 versus 75.3 +/- 22.4, p ns), nor for the different symptom cluster subscales. There were also no differences in the IES scores between groups (34.8 +/- 10 versus 32.6 +/- 10 p ns). This suggests that these psychotic features may not necessarily reflect severity of PTSD symptoms. PTSD may share a common diathesis with mood disorders including psychotic depression. Further study is needed of these phenomena.",0,0 +6678,Validation of a brief measure of posttraumatic stress disorder: The Distressing Event Questionnaire (DEQ).,"The Distressing Event Questionnaire (DEQ) is a brief instrument for assessing posttraumatic stress disorder (PTSD) according to criteria provided in Diagnostic and Statistical Manual of Mental Disorders (4th ed.). The DEQ possesses high internal consistency and exhibited satisfactory short-term temporal stability in studies with Vietnam War combat veterans and battered women. In a sample of Vietnam War veterans and 4 separate samples of abused women (with histories of incest, rape, intimate partner abuse, or prostitution and abuse), the DEQ exhibited very good discriminative validity when judged against structured interview assessment of PTSD. The DEQ exhibited strong convergent validity with other PTSD measures and other indexes of adjustment and also exhibited strong convergent validity as a measure of PTSD across ethnic groups in both the veteran sample and the combined women's sample.",0,0 +6679,Current status of anxiolytic drugs,"Anxiety disorders commonly seen in primary care are characterized by psychological and physical symptoms of disabling anxiety. However, they are often unrecognized and under-diagnosed. Because of the dearth of trained therapists, pharmacotherapy remains the most widespread form of treatment. Newer anti-anxiety drugs have been developed that are more effective with a better side-effect profile. In this article, the various anxiety disorders are described together with their appropriate pharmacotherapy.",0,0 +6680,Gray Matter Correlates of Posttraumatic Stress Disorder: A Quantitative Meta-Analysis,"

Background

Since the inception of the diagnosis posttraumatic stress disorder (PTSD), attempts have been undertaken to understand why only a subpopulation of individuals exposed to trauma develops PTSD. Cerebral gray matter reductions have been suggested to be a crucial pathobiological marker of PTSD. However, a quantitative meta-analysis of whole-brain voxel-based morphometry studies is lacking.

Methods

Here, we investigated concurrence across voxel-based morphometry studies in PTSD compared with trauma-exposed individuals without PTSD (all together nine studies with 319 subjects) by means of activation likelihood estimation.

Results

We identified brain regions of consistent gray matter reduction in anterior cingulate cortex, ventromedial prefrontal cortex, left temporal pole/middle temporal gyrus, and left hippocampus in PTSD patients compared with individuals exposed to trauma without PTSD.

Conclusions

This is the first quantitative whole-brain meta-analysis showing brain structure deficits in traumatized subjects with PTSD compared with trauma-exposed healthy control subjects. The gray matter deficit profile overlaps with brain networks of emotion processing, fear extinction, and emotion regulation known to be affected in PTSD. Although the data cannot clarify if this is a predisposition or a consequence of the disease, the results may facilitate the need to control for structural characteristics in future functional brain studies.",0,0 +6681,Differential relationships of childhood abuse and neglect subtypes to PTSD symptom clusters among adolescent inpatients,"This article investigates whether childhood abuse and neglect subtypes (i.e., physical, sexual, and emotional abuse, and physical and emotional neglect) differentially predict the severity of individual posttraumatic stress disorder (PTSD) symptom clusters and overall posttraumatic stress. Eighty-nine patients admitted to the short-term adolescent treatment unit of a psychiatric hospital completed a battery of psychological assessments. Findings of multiple regression analyses showed that emotional and sexual abuse rather than physical abuse, emotional neglect, or physical neglect is related to individual symptom cluster severity and overall posttraumatic stress. Results suggested that a greater level of specificity is necessary when assessing child abuse and posttraumatic stress because each level provides more specific information about how to intervene to reduce the risk of negative outcomes.",0,0 +6682,"Enduring Mental Health Morbidity and Social Function Impairment in World Trade Center Rescue, Recovery, and Cleanup Workers: The Psychological Dimension of an Environmental Health Disaster","The World Trade Center (WTC) attacks exposed thousands of workers to hazardous environmental conditions and psychological trauma. In 2002, to assess the health of these workers, Congress directed the National Institute for Occupational Safety and Health to establish the WTC Medical Monitoring and Treatment Program. This program has established a large cohort of WTC rescue, recovery, and cleanup workers. We previously documented extensive pulmonary dysfunction in this cohort related to toxic environmental exposures.Our objective in this study was to describe mental health outcomes, social function impairment, and psychiatric comorbidity in the WTC worker cohort, as well as perceived symptomatology in workers' children.Ten to 61 months after the WTC attack, 10,132 WTC workers completed a self-administered mental health questionnaire.Of the workers who completd the questionnaire, 11.1% met criteria for probable post-traumatic stress disorder (PTSD), 8.8% met criteria for probable depression, 5.0% met criteria for probable panic disorder, and 62% met criteria for substantial stress reaction. PTSD prevalence was comparable to that seen in returning Afghanistan war veterans and was much higher than in the U.S. general population. Point prevalence declined from 13.5% to 9.7% over the 5 years of observation. Comorbidity was extensive and included extremely high risks for impairment of social function. PTSD was significantly associated with loss of family members and friends, disruption of family, work, and social life, and higher rates of behavioral symptoms in children of workers.Working in 9/11 recovery operations is associated with chronic impairment of mental health and social functioning. Psychological distress and psychopathology in WTC workers greatly exceed population norms. Surveillance and treatment programs continue to be needed.",0,0 +6683,A prospective study on paediatric traffic injuries: health-related quality of life and post-traumatic stress,"Objectives: To examine children's reports of their health-related quality of life (HRQoL) following paediatric traffic injury, to explore child and parental post-traumatic stress, and to identify children and parents with adverse outcomes. Design: Prospective cohort study. Assessments: shortly after the injury, three months and six months post injury. Setting: Department of Traumatology, University Hospital. Subjects: Fifty-one young traffic injury victims aged 8-15 years. Main measures: TNO-AZL Children's Quality of Life questionnaire and the Impact of Event Scale. Results: Short-term adverse changes in the child's HRQoL were observed for the child's motor functioning and autonomy. At three months, 12% of the children and 16% of the parents reported serious post-traumatic stress symptoms. Increased stress at three months, or across follow-up, was observed among hospitalized children, children with head injuries, and children injured in a motor vehicle accident. Parental stress was related to low socioeconomic status and the seriousness of the child's injury and accident (hospitalization, head injury, serious injury, motor vehicle involved, others injured). Conclusions: The children reported only temporary effects in their motor functioning and autonomy. Post-traumatic stress symptoms following paediatric traffic injury were not only experienced by the children, but also by their parents.",0,0 +6684,Applying suppression subtractive hybridization technique to investigate gene differential expression profiles in rats liver during the course of heat stress,"Aim: To explore the molecular mechanism of heat stress by isolating diff erentially expressed genes occurred during the course of heat stress and filtrat ing functional gene segments concerned with heat stress with Suppression Subtrac tive Hybridization technique. Methods: There were 2 groups in th e experiment: heat stress group and normal temperature control group. mRNAs were isolated from the liver tissue individually and then transcripted into cDNAs. A fter cut with endonuclease and ligation with adaptors, SSH was carried out with cDNAs of heat stress group as tester while cDNAs of control group as driver. Pro ducts were cloned into T/A vector to form recombined plasmids to transfect compe tence cells for filtration and appraisal. Results: mRNAs were ab undant and of high quality, cDNAs were reverse-transcripted and then cut into s egments about 500 bp successfully. Ligation efficiency was satisfied. The subtr active hybridization library was constructed successfully after effective hybrid ization and 180 segments were primarily isolated from it. Conclusion: Construction of heat stress differentially expressed genes subtractive lib rary has established the foundation of filtrating heat stress concerned genes, i t is of active significance for exploring functional genes that controlled heat stress.",0,0 +6685,A preliminary classification system for homeless veterans with mental illness.,"The purpose of this study was that of defining psychiatric profiles among veterans based on a structured interview of 3,595 individuals administered by outreach mental health clinicians to individuals who were presently or recently homeless. The interview included ratings of presence or absence of current psychiatric disorders; alcoholism, drug abuse, psychosis, mood disorders, personality disorders, PTSD, and adjustment disorders. We identified three subgroups using cluster analysis each showing different diagnostic profiles that were characterized as “addiction” (n 3,061), “psychosis” (n 218), and “personality” disorders (n 54). Cluster membership was related to demographic characteristics, living situation, length of homelessness, and symptoms and complaints including cognitive difficulties, suicidality, violence, and depression. Group comparison statistics were used to compare intercluster differences in demographics, homeless situation, symptoms, and subjective complaints. There were no major intercluster differences in socioethnic, demographic, and homeless situation variables. Differences occurred in complaints of depression, positive symptoms of psychosis, and suicidality. It was concluded that despite the disproportionate sizes of the clusters homeless veterans with mental illness are nevertheless heterogeneous with regard to their psychiatric profiles.",0,0 +6686,Acute stress disorder scale: A self-report measure of acute stress disorder.,,0,0 +6687,DSM-IV Personality Disorders and Their Axis I Correlates in the South African Population,"The prevalence of personality disorders (PD) in the South African population is largely unknown. Thus, we undertook to estimate prevalence, demographic correlates, co-morbidity and treatment rates of DSM-IV PD among South Africans.A three-stage probability sample design was used. Of the 4,433 interviews obtained, based on quality control criteria, 4,315 interviews were retained for analysis. All participants were screened for PD and axis I disorders with the World Health Organisation Composite International Diagnostic Interview. The multiple imputation method was then used to estimate prevalence.The multiple imputation prevalence estimate in the total sample was 6.8%. All three PD clusters were significantly co-morbid with each other and with other axis I disorders. Male gender was the only significant predictor of PD. Of note was the finding that less than one fifth of participants with a possible PD diagnosis had received treatment for a mental health or substance abuse problem in the previous 12 months.The high co-morbidity of PD with axis I disorders in South Africa is consistent with previous reports elsewhere. However, more research is indicated to determine the reasons for the higher prevalence of cluster A disorders than of cluster B and C disorders in this population.",0,0 +6688,The Role of Personality Traits and Profiles in Posttrauma Comorbidity,"Many service members experience symptoms of posttraumatic stress disorder (PTSD) after deployment. PTSD can vary widely in its presentation and associated features, such as comorbid conditions. Research has shown that veterans with PTSD and an internalizing personality profile are more likely to experience internalizing comorbidity (e.g., anxiety, depression), whereas veterans with PTSD and an externalizing personality profile are more likely to experience externalizing comorbidity (e.g., substance abuse, aggression). To date, however, this research has been limited by a focus on diagnosable disorders and personality categories. In a nonclinical sample of 224 National Guard/Reserve service members who had served since 2001, we explored whether personality traits (measured continuously) moderated associations of PTSD symptom severity with the severity of internalizing (depression, anxiety) and externalizing (alcohol abuse, aggression) symptoms. Results showed that the association of PTSD with anxiety was stronger when extraversion was lower (corresponding to an internalizing personality profile). Moreover, the association of PTSD with alcohol abuse was stronger when extraversion was high and conscientiousness was low (corresponding to an externalizing personality profile). Surprisingly, this association was also stronger when extraversion was low and conscientiousness was high. Results offer additional insights into prior research on personality and comorbidity.",0,0 +6689,Chronic Neurobehavioral Effects of Tokyo Subway Sarin Poisoning in Relation to Posttraumatic Stress Disorder,"Chronic neurobehavioral effects of acute sarin poisoning were evaluated in 9 male and 9 female patients who were exposed to sarin poisoning in the Tokyo subway incident in Japan. The investigators used nine neurobehavioral tests, as well as a posttraumatic stress disorder checklist, 6-8 mo after the poisoning occurred. Serum cholinesterase activity in patients on the day of poisoning (i.e., March 20, 1995) ranged from 13 to 131 IU/l (mean=72.1 IU/l). The results of analysis covariance, in which age, education level, alcohol consumption, and smoking status (covariates) were controlled in 18 sarin cases and in 18 controls, showed that the score on the digit symbol (psychomotor performance) test was significantly lower in the sarin cases than in controls. Nonetheless, the scores for the General Health Questionnaires, fatigue of Profile of Mood States, and posttraumatic stress disorder checklist were significantly higher in the sarin cases than controls. The investigators added posttraumatic stress disorder to the covariates, and only the score on the digit symbol test was significantly lower in sarin cases. In addition, the results of stepwise multiple regression analysis in 18 sarin cases revealed that scores for the General Health Questionnaires, fatigue of Profile of Mood States (i.e., fatigue, tension-anxiety, depression, and anger-hostility)-together with the paired-associate learning test-were associated significantly with posttraumatic stress disorder. The association did not remain significant for the digit symbol test score. Perhaps a chronic effect on psychomotor performance was caused directly by acute sarin poisoning; on the other hand, the effects on psychiatric symptoms (General Health Questionnaire) and fatigue (Profile of Mood States) appeared to result from posttraumatic stress disorder induced by exposure to sarin.",0,0 +6690,The effect of post-traumatic stress disorder on HIV disease progression following hurricane Katrina,"Post-traumatic stress disorder (PTSD) is a common psychological outcome of any disaster. The purpose of this study was to examine the effects of PTSD on disease progression among HIV-infected persons in metropolitan New Orleans post-hurricane Katrina. One-year post-storm, a convenience sample of 145 HIV-infected patients who returned to care at the HIV Outpatient Program clinic in New Orleans were interviewed. Clinical factors pre and one and two years post-disaster were abstracted from medical records and compared by PTSD status. Of the 145 participants, 37.2% had PTSD. Those with PTSD were more likely than those without PTSD to have detectable plasma viral loads at both follow-up time points post-disaster and more likely to have CD4 cell counts <200/mm(3) two years post-disaster. They were also more likely to have had medication interruptions immediately post-disaster. Our findings corroborate the findings of others that PTSD accelerates HIV disease progression. Disaster planners should consider the special counseling and medication safeguards needs of HIV-infected persons.",0,0 +6691,Blunted growth hormone response to clonidine in post-traumatic stress disorder,"Hyperactivity of the sympathetic and noradrenergic systems is thought to be a feature of post-traumatic stress disorder (PTSD). Assessment of noradrenergic receptor function can be undertaken by measuring the growth hormone (GH) response to the α 2 -agonist clonidine. The aim of this study was to examine whether subjects with combat-related PTSD (with or without co-morbid depression) have a blunted growth hormone response to clonidine, compared to a combat-exposed control group. Twenty-three Vietnam veterans suffering from PTSD alone, 27 suffering from PTSD and co-morbid depression, and 32 veteran controls with no psychiatric illness were administered 1.5 μg/kg clonidine i.v. Plasma growth hormone was measured every 20 min for 120 min. The growth hormone response to clonidine was significantly blunted in the non-depressed PTSD group compared to both the depressed PTSD group and the control group as measured by peak growth hormone, delta growth hormone and AUC growth hormone. Subjects with PTSD and no co-morbid depressive illness show a blunted growth hormone response to clonidine. This suggests that post-synaptic α 2 -receptors are subsensitive. This finding is consistent with other studies showing increased noradrenergic activity in PTSD.",0,0 +6692,Multi-chaperone-peptide-rich mixture from colo-carcinoma cells elicits potent anticancer immunity,"Chaperones play an important role in inducing anti-cancer immunity. To explore the probability of using chaperone-peptide-rich complexes extracted from colo-carcinoma cells as anti-cancer vaccine, we extracted and prepared chaperone-peptide-rich complexes from CT26 cells, which were subsequently investigated on anti-cancer efficacy.The crude extracts of the CT26 cells treated with heat and Trichosanthin were precipitated with salt and dialyzed to remove proteins below 50kDa and above 300kDa in molecular weight; the proteins with the molecular weights in 70kDa, 90kDa, 95kDa, 110kDa and 170kDa were collected through gel filtration and SDS-PAGE. After confirmation, the purified proteins were used to determine their effects on lymphocyte proliferation, the activities of NK and CTL, tumor suppression and the tumor-bearing mouse survival.The majority of the chaperone-peptides of anti-cancer immunity in CT26 cells, including HSP70-antigen peptide, HSP90-antigen peptide, gp96-antigen peptide, HSP-110 antigen peptide, HSP170-antigen peptide, was satisfactorily extracted that the multi-chaperone-peptide-rich mixtures were obtained. All the mixtures prepared could elicit lymphocyte proliferation, enhance the activities of CTL and NK, reinforce the tumor suppression and prolong the mouse survival.The multi-chaperone-peptide-rich mixtures could be prepared via dialysis and gel filtration combining with SDS-PAGE. Both the heat stress and Trichosanthin could induce and increase the mixtures, of which that treated by 42 degrees C heat and Trichosanthin was found to possess the strongest anti-cancer efficacy.",0,0 +6693,Post-deployment BATTLEMIND training for the UK Armed Forces: a cluster-randomised controlled trial,"Objectives Combat exposure can increase the risk of subsequent psychological ill-health in Armed Forces (AF) personnel. A US post-deployment psycho-educational intervention, Battlemind, has shown a beneficial effect on mental health in US military personnel exposed to high levels of potentially traumatic combat events. Our aim was to evaluate the efficacy of Battlemind in UK AF personnel. Methods Battlemind was compared with the UK standard post-deployment stress and homecoming brief in a cluster randomised controlled trial. 2443 UK AF personnel returning from Afghanistan via Cyprus completed a questionnaire about combat experiences and current mental health status before receiving their randomly allocated intervention, of these, 1616 (66%) completed follow-up approximately 6 months later. Primary outcomes were the General Health Questionnaire (GHQ-12) to measure common mental disorders, and the post traumatic stress disorder checklist (PCL-C) to measure probable PTSD. Secondary outcomes included alcohol misuse, assessed with the AUDIT. The two study arms were compared using mixed-effect models to take account of possible cluster effects. Results We did not find a difference in mental health or overall AUDIT score between Battlemind and the standard brief. Those who received Battlemind were less likely to be classified as binge drinkers than those receiving the standard brief (adjusted OR 0.73 (95% CI 0.58 to 0.92)). Conclusions UK post-deployment Battlemind did not improve mental health compared with the standard post-deployment brief. However, it had a modest impact on reported binge drinking. Alcohol misuse is problematic in the UK AF so an intervention that reduces binge drinking may be helpful.",0,0 +6694,Socially disorganized yet safe: Understanding resilience to crime in neighborhoods in New Zealand,"Abstract Purpose Drawing on theories from environmental criminology, this article identifies neighborhood-level characteristics that promote resiliency in neighborhoods in New Zealand with disadvantageous socioeconomic settings. Methods We used neighborhood-level crime (2008–2010) and socio-economic data to develop a Crime Resilience Index for New Zealand (CRINZ) to quantify neighborhood level resilience to crime across the country. We then examined relationships between the index and a suite of built and social neighborhood-level characteristics. Results Access to built environment factors generally decreased across neighborhoods stratified by resiliency. That is, resilient neighborhoods had decreased access to a range of healthcare, education, and living infrastructures. Very little difference was found in the social environment of high resilient and low resilient neighborhoods in New Zealand. Conclusions Understanding why communities respond differently in similar environments can enable communities to respond better or more effectively to such stressful environments and consequently build resilience. Identifying ‘place-specific’ resilience factors can be effective in reducing crime in neighborhoods.",0,0 +6695,Hurricane Katrina: Maternal Depression Trajectories and Child Outcomes,"The authors examined depression trajectories over two years among mothers exposed to Hurricane Katrina. Risk and protective factors for depression trajectories, as well as associations with child outcomes were analyzed.This study included 283 mothers (age at time 1, M = 39.20 years, SD = 7.21; 62% African American). Mothers were assessed at four time points over two years following Hurricane Katrina. Mothers reported posttraumatic stress symptoms, hurricane exposure, traumatic life events, and social support at time 1. Depressive symptoms were modeled at times 2, 3, and 4. Youth reported their distress symptoms (posttraumatic stress, depression, and anxiety) at time 4.Latent class growth analyses identified three maternal depression trajectories among mothers exposed to Hurricane Katrina: low (61%), resilient (29%), and chronic (10%). Social support was identified as a protective factor among mothers.Three main trajectories of maternal depression following Hurricane Katrina were identified. Social support was protective for mothers. Identified trajectories were not associated with children's distress outcomes. These results have implications for disaster responses, screening efforts, and interventions targeted towards families. Future studies warrant the investigation of additional risk and protective factors that can affect maternal and child outcomes.",0,0 +6696,Profiles of Women Who Have Mental Retardation With and Without a Documented History of Abuse,"Thirty-six women with mental retardation were divided into two groups on the basis of whether they had a documented history of abuse during the preceding 5 years. The women with this history were more likely than the women with no documented history of abuse to be employing passive/avoidant decision-making strategies, reporting higher levels of stress, having dual diagnoses, be receiving counseling, and relying on others to go out into the community. We recommend that special attention be paid to designing interventions that are tailored to the specific needs of these women.",0,0 +6697,"Post-Traumatic Stress Reactions before the Advent of Post-Traumatic Stress Disorder: Potential Effects on the Lives and Legacies of Alexander the Great, Captain James Cook, Emily Dickinson, and Florence Nightingale","Evidence is presented that Alexander the Great, Captain James Cook, Emily Dickinson, and Florence Nightingale each developed symptoms consistent with post-traumatic stress disorder in the aftermath of repeated potentially traumatizing events of differing character. Their case histories also varied with respect to background, premorbid personality style, risk factors, clinical presentation, and course of the illness, illustrating the pleomorphic character of the disorder, as well as the special problems in diagnosing it in historical figures.",0,0 +6698,When the Earth Stops Shaking: Earthquake Sequelae Among Children Diagnosed for Pre-Earthquake Psychopathology,"To examine risk and protective processes for posttraumatic stress reactions and negative sequelae following the Northridge earthquake (EQ) among youths diagnosed for pre-EQ psychopathology.Symptoms of posttraumatic stress disorder (PTSD), depression, general anxiety, and social impairment were evaluated using telephone interviews among 66 children participating in a family-genetic study of childhood-onset depression at the time of the EQ.Significant predictors of PTSD symptoms 1 year after the EQ included perceived stress and resource loss associated with the EQ, a pre-EQ anxiety disorder, and more frequent use of cognitive and avoidance coping strategies. PTSD symptoms were associated with high rates of concurrent general anxiety symptoms, depressive symptoms, and social adjustment problems with friends. The only significant correlation between sibling scores was on measures of sibling reports of objective exposure.Preexisting anxiety disorders represent a risk factor for postdisaster PTSD reactions. Postdisaster services need to attend to the needs of these youths as well as those of youths experiencing high levels of subjective stress, resource loss, and/or high exposure. That children within families show significant variation in postdisaster reactions underscores the need for attention to individual child characteristics and unshared environmental attributes.",0,0 +6699,Different Points of a Continuum? Cross Sectional Comparison of the Current and Pre-contact Psychosocial Problems among the Different Categories of Adolescents in Institutional Care in Nigeria,"The combination of adverse social indicators and a predominantly youthful population puts Nigeria, and indeed many countries of sub-Sahara Africa, at the risk of explosion in the number of youth coming in contact with the juvenile justice system. Despite this risk, custodial childcare systems in the region are still poorly developed with both juvenile offenders and neglected adolescents coming in contact with the systems being kept in the same incarcerating facility. The needs of these different groups of adolescents may be different. Knowing their common and unique needs can inform common prevention strategies and ensure that specific service-needs of different categories of adolescents in institutional custody are met.Data on the family background, pre-contact social circumstance, neurological and anthropometric profiles, and certain aspects of mental health of adolescents drawn from two juvenile justice institutions in Nigeria were obtained. The results for the adolescents on 'criminal code' and those admitted as a case of child neglect were compared using chi-square and odd ratios.Participants were 211 adolescents comprising of 158 on 'criminal code' and 53 declared as 'neglected'. A lot of similarities were found. For instance, the prevalence of parental separation, family transition, experience of street-life and lifetime exposure to traumatic events and posttraumatic stress was equally high among the two groups of adolescents. The adolescents on 'criminal code' however had significantly higher prevalence of conduct and alcohol/substance use disorders while the child neglect group had poorer anthropometric profiles and higher prevalence of neurological disorders.Child neglect and juvenile delinquency in Nigeria may truly be different points of a continuum. There are however fundamental differences that can warrant specific prevention strategies and tailor-made service provision while in custodial care.",0,0 +6700,The effect of compensation claims on outcomes after injury,,0,0 +6701,Notes on the practice of food justice in the U.S.: understanding and confronting trauma and inequity,"The lexicon of the U.S. food movement has expanded to include the term 'food justice.' Emerging after approximately two decades of food advocacy, this term frames structural critiques of agri-food systems and calls for radical change. Over those twenty years, practitioners and scholars have argued that the food movement was in danger of creating an 'alternative' food system for the white middle class. Alternative food networks drew on white imaginaries of an idyllic communal past, promoted consumer-oriented, market-driven change, and left yawning silences in the areas of gendered work, migrant labor, and racial inequality. Justice was often beside the point. Now, among practitioners and scholars we see an enthusiastic surge in the use of the term food justice but a vagueness on the particulars. In scholarship and practice, that vagueness manifests in overly general statements about ending oppression, or morphs into outright conflation of the dominant food movement's work with food justice (see What does it mean to do food justice? Cadieux and Slocum (2015), in this Issue). In this article, we focus on one of the four nodes (trauma/inequity, exchange, land and labor) around which food justice organizing appears to occur: acknowledging and confronting historical, collective trauma and persistent race, gender, and class inequality. We apply what we have learned from our research in U.S. and Canadian agri-food systems to suggest working methods that might guide practitioners as they work toward food justice, and scholars as they seek to study it. In the interests of ensuring accountability to socially just research and action, we suggest that scholars and practitioners need to be more clear on what it means to practice food justice. Towards such clarity and accountability, we urge scholars and practitioners to collaboratively document how groups move toward food justice, what thwarts and what enables them.",0,0 +6702,General growth mixture modeling for randomized preventive interventions,"This paper proposes growth mixture modeling to assess intervention effects in longitudinal randomized trials. Growth mixture modeling represents unobserved heterogeneity among the subjects using a finite-mixture random effects model. The methodology allows one to examine the impact of an intervention on subgroups characterized by different types of growth trajectories. Such modeling is informative when examining effects on populations that contain individuals who have normative growth as well as non-normative growth. The analysis identifies subgroup membership and allows theory-based modeling of intervention effects in the different subgroups. An example is presented concerning a randomized intervention in Baltimore public schools aimed at reducing aggressive classroom behavior, where only students who were initially more aggressive showed benefits from the intervention.",0,0 +6703,Informing the symptom profile of complicated grief,"Background: Complicated Grief (CG) is under consideration as a new diagnosis in DSM5. We sought to add empirical support to the current dialogue by examining the commonly used Inventory of Complicated Grief (ICG) scale completed by 782 bereaved individuals. Methods: We employed IRT analyses, factor analyses, and sensitivity and specificity analyses utilizing our full sample (n = 782), and also compared confirmed CG cases (n = 288) to noncases (n = 377). Confirmed CG cases were defined as individuals bereaved at least 6 months who were seeking care for CG, had an ICG≥30, and received a structured clinical interview for CG by a certified clinician confirming CG as their primary illness. Noncases were bereaved individuals who did not present with CG as a primary complaint (including those with depression, bipolar disorder, anxiety disorders, and controls) and had an ICG<25. Results: IRT analyses provided guidance about the most informative individual items and their association with CG severity. Factor analyses demonstrated a single factor solution when the full sample was considered, but within CG cases, six symptom clusters emerged: (1) yearning and preoccupation with the deceased, (2) anger and bitterness, (3) shock and disbelief, (4) estrangement from others, (5) hallucinations of the deceased, and (6) behavior change, including avoidance and proximity seeking. The presence of at least one symptom from three different symptom clusters optimized sensitivity (94.8%) and specificity (98.1%). Conclusions: These data, derived from a diverse and predominantly clinical help seeking population, add an important perspective to existing suggestions for DSM5 criteria for CG. Depression and Anxiety, 2011. © 2010 Wiley-Liss, Inc.",0,0 +6704,Postdeployment Battlemind training for the U.K. armed forces: A cluster randomized controlled trial.,"Combat exposure can increase the risk of subsequent psychological ill-health in armed forces (AF) personnel. A U.S. postdeployment psycho-educational intervention, Battlemind, showed a beneficial effect on mental health in U.S. military personnel exposed to high combat levels. We evaluated the effectiveness of an anglicized version of postdeployment Battlemind.Battlemind was adapted for the United Kingdom. The main amendments were to sections about carrying weapons, driving, and alcohol misuse. The anglicized Battlemind was compared with the U.K. standard postdeployment brief in a cluster randomized controlled trial. At baseline, 2,443 U.K. AF personnel returning from Afghanistan via Cyprus completed questionnaires about their combat experiences and mental health. Of these, 1,616 (66%) completed 6-month follow-up questionnaires. We used the Posttraumatic Stress Disorder Checklist (PCL-C) to measure probable posttraumatic stress disorder and the General Health Questionnaire (GHQ-12) to measure common mental disorders. Secondary outcomes included alcohol misuse, assessed with the Alcohol Use Disorders Identification Test (AUDIT), and binge drinking. Mixed-effects models were used to account for possible cluster effects.We did not find a difference in mental health or overall AUDIT score. Those who received Battlemind versus the standard brief were less likely to report binge drinking, although the effect size was small (adjusted odds ratio = 0.73, 95% CI [0.58, 0.92]).The anglicized Battlemind did not improve mental health but had a modest impact on the reporting of binge drinking. Alcohol misuse is problematic in military populations; therefore, an intervention that reduces binge drinking may be helpful.",0,0 +6705,White Matter Microstructural Changes as Vulnerability Factors and Acquired Signs of Post-Earthquake Distress,"Many survivors of severe disasters need psychological support, even those not suffering post-traumatic stress disorder (PTSD). The critical issue in understanding the psychological response after experiencing severe disasters is to distinguish neurological microstructural underpinnings as vulnerability factors from signs of emotional distress acquired soon after the stressful life event. We collected diffusion-tensor magnetic resonance imaging (DTI) data from a group of healthy adolescents before the Great East Japan Earthquake and re-examined the DTIs and anxiety levels of 30 non-PTSD subjects from this group 3-4 months after the earthquake using voxel-based analyses in a longitudinal DTI study before and after the earthquake. We found that the state anxiety level after the earthquake was negatively associated with fractional anisotropy (FA) in the right anterior cingulum (Cg) before the earthquake (r = -0.61, voxel level p<0.0025, cluster level p<0.05 corrected), and positively associated with increased FA changes from before to after the earthquake in the left anterior Cg (r = 0.70, voxel level p<0.0025, cluster level p<0.05 corrected) and uncinate fasciculus (Uf) (r = 0.65, voxel level p<0.0025, cluster level p<0.05 corrected). The results demonstrated that lower FA in the right anterior Cg was a vulnerability factor and increased FA in the left anterior Cg and Uf was an acquired sign of state anxiety after the earthquake. We postulate that subjects with dysfunctions in processing fear and anxiety before the disaster were likely to have higher anxiety levels requiring frequent emotional regulation after the disaster. These findings provide new evidence of psychophysiological responses at the neural network level soon after a stressful life event and might contribute to the development of effective methods to prevent PTSD.",0,0 +6706,"Stories of pre‐war, war and exile: Bosnian refugee children in Sweden","While standardized questionnaires produce counts of isolated events, a semi-structured interview derives a story, a complex narrative in time and place. Ninety Bosnian refugee children and adolescents (ages 1-20), resettled in Sweden, were assessed in a semi-structured clinical interview designed to identify and offer support to children at risk. A family-child account of traumatic exposure was analysed quantitatively and qualitatively. Type-stories or clusters of experience were identified for three distinct periods: prior to war, during war, and after war in exile. The extent of trauma-stress exposure during each of these periods proved unrelated. Pre-war experience presented as preponderantly good and safe. Differences in child exposure during war and exile could be understood in relation to identifiable socio-demographic factors; particularly ethnic background, social class, child age and family size. Further, the stories derived cast light on the equity of Swedish refugee reception, exposing both egalitarian and discriminatory tendencies.",0,0 +6707,Post traumatic stress disorder symptoms in a psychiatric population not presenting with trauma: a preliminary study,"Post Traumatic Stress Disorder (PTSD) is a diagnostic category used to describe symptoms arising from emotionally traumatic experience(s). Research suggests that PTSD may be under- diagnosed when trauma is not the presenting problem or when not the focus of clinical intervention. There is a dearth of South African information on the prevalence of PTSD in a psychiatric population. The aim of this study was to determine the prevalence and comorbidity of PTSD in a psychiatric population, not presenting on the basis of trauma.The study was cross sectional and conducted at a psychiatric outpatient clinic in the Durban Metropolitan area. The sample was obtained from patients seen at follow up over a period of twelve weeks. The researcher randomly selected prospective participants and at the end of their consultation the purpose of the study was explained and they were invited to participate. Demographic characteristics and diagnosis were recorded. Thereafter, the Zulu version of the Modified Posttraumatic Diagnostic Scale (MPDS) was administered and data collected.The study demonstrated that 22% of subjects reported symptoms of PTSD where the primary presentation was not trauma related.A significant number of psychiatric patients presenting for non-trauma related psychopathology report symptoms of PTSD when specifically questioned. The findings suggest that such questioning may be overlooked when dealing with psychiatric patients who do not specifically present on the basis of trauma.",0,0 +6708,"Potentially traumatic event exposure, posttraumatic stress disorder, and Axis I and II comorbidity in a population-based study of Norwegian young adults","Epidemiologic research on traumatic stress is limited in Norway. Prevalence and correlates of exposure to potentially traumatic events (PTEs) and posttraumatic stress disorder (PTSD), and patterns of comorbidity with DSM-IV Axis I and II disorders were examined in an epidemiologic sample.Demographics, PTEs and resulting PTSD, and comorbid DSM-IV diagnoses were assessed in 2,794 members of the Norwegian Institute of Public Health Twin Panel. The sample comprised 37% male, with an average age of 28.2 years (SD = 3.9).Approximately, one-quarter of participants had lifetime PTE exposure; most PTEs were more common in men than in women. Lifetime prevalence of PTSD was 2.6%, and was significantly more common in women than men. Being female and type of PTE (both interpersonal and accidental traumatic events) were associated with increased PTSD symptoms, whereas higher education was associated with lower symptoms. PTSD was related to increased odds of most Axis I and II conditions.PTE exposure and PTSD prevalence were lower than in the USA, but comparable to other European countries. Sex differences replicated previous research. The relationship between PTSD and borderline personality disorder was significantly stronger than the relationship between PTSD and any other Axis II conditions.",0,0 +6709,The role of fathers' psychopathology in the intergenerational transmission of captivity trauma: A twenty three-year longitudinal study,"The aversive impact of combat and parents' combat-induced posttraumatic stress disorder (PTSD) on young children has been examined in a few studies. However, the long-term toll of war captivity on the secondary traumatization (ST) of adult offspring remains unknown. This study aimed to assess the longitudinal associations between former prisoners of war (ex-POWs), PTSD, depressive symptoms and their adult offsprings ST.A sample of 134 Israeli father-child dyads (80 ex-POWs dyads and a comparison group of 44 veterans'dyads) completed self-report measures. The fathers participated in three waves of measurements following the Yom Kippur War (T1: 1991, T2: 2003, and T3: 2008), while the offspring took part in T4 (2013).Offspring of ex-POWs with PTSD at T3 reported more ST symptoms than offspring of ex-POWs without PTSD and controls. Ex-POWs' PTSD hyper-arousal symptom cluster at T3 was positively related to offsprings ST avoidance symptom cluster. Offspring of ex-POWs with chronic and delayed PTSD trajectories reported more ST symptoms than offspring of ex-POWS and controls with resilient trajectories. Ex-POWs' PTSD and depression symptoms at T1, T2 and T3 mediated the link between war captivity (groups) and offsprings ST in T4.The use of self-report measures that did not cover the entire span of 40 years since the war, might may bias the results.The intergenerational transmission of captivity related trauma following the Yom Kippur War was exemplified. ST symptoms among ex-POWs' adult offspring are closely related to their father' PTSD and related depressive symptom comorbidity.",0,0 +6710,"The impact of self-efficacy, alexithymia and multiple traumas on posttraumatic stress disorder and psychiatric co-morbidity following epileptic seizures: A moderated mediation analysis","This study investigated the incidence of posttraumatic stress disorder (PTSD) and psychiatric co-morbidity following epileptic seizure, whether alexithymia mediated the relationship between self-efficacy and psychiatric outcomes, and whether the mediational effect was moderated by the severity of PTSD from other traumas. Seventy-one (M=31, F=40) people with a diagnosis of epilepsy recruited from support groups in the United Kingdom completed the Posttraumatic Stress Diagnostic Scale, the Hospital Anxiety and Depression Scale, the Toronto Alexithymia Scale-20 and the Generalized Self-Efficacy Scale. They were compared with 71 people (M=29, F=42) without epilepsy. For people with epilepsy, 51% and 22% met the diagnostic criteria for post-epileptic seizure PTSD and for PTSD following one other traumatic life event respectively. For the control group, 24% met the diagnostic criteria for PTSD following other traumatic life events. The epilepsy group reported significantly more anxiety and depression than the control. Partial least squares (PLS) analysis showed that self-efficacy was significantly correlated with alexithymia, post-epileptic seizure PTSD and psychiatric co-morbidity. Alexithymia was also significantly correlated with post-epileptic seizure PTSD and psychiatric co-morbidity. Mediation analyses confirmed that alexithymia mediated the path between self-efficacy and post-epileptic seizure PTSD and psychiatric co-morbidity. Moderated mediation also confirmed that self-efficacy and PTSD from one other trauma moderated the effect of alexithymia on outcomes. To conclude, people can develop posttraumatic stress disorder symptoms and psychiatric co-morbidity following epileptic seizure. These psychiatric outcomes are closely linked with their belief in personal competence to deal with stressful situations and regulate their own functioning, to process rather than defend against distressing emotions, and with the degree of PTSD from other traumas.",0,0 +6711,A Distinct Pattern of Personality Disturbance following Exposure to Mixtures of Organic Solvents,"To assess systematically the pattern of psychologic distress in chemically exposed workers complaining of personality changes, we administered the Minnesota Multiphasic Personality Inventory to 22 men with a history of exposure to mixtures of organic solvents. Results indicated clinically significant profile elevations in more than 90% of the exposed workers. Moreover, a consistent response profile was noted, indicating a high rate of somatic disturbances, anxiety, depression, social isolation, and fear of losing control. In addition, those workers with the longest exposure duration had the highest elevations on the scale measuring disturbances of thinking, social alienation, poor concentration, and anxiety. Comparisons between these subjects and a group of former prisoners of war with posttraumatic stress disorder revealed strikingly similar clinical profiles. We present a case history that illustrates the nature of this psychologic disturbance.",0,0 +6712,Post-traumatic kyphosis of the thoracic and lumbar spine,"Assessing the initial post-traumatic situation is of imminent importance in choosing the most suitable approach for primary treatment of thoracic and lumbar spine fractures. Misjudging the static situation of the injured spine is a common reason for selecting an inadequate therapeutic procedure. The consequence is a defective spinal position with the corresponding symptoms, which usually requires a complicated surgical procedure. Our experience is based on 34 patients with a post-traumatic defective position of the thoracic and lumbar spine: 12 patients underwent primary surgical and 22 primary conservative treatment. The aim of our study was to demonstrate the initial situation and primary management as well as subsequent problems and the respective surgical procedure applied in our department for correcting and stabilizing the areas involved and to present intermediate results.",0,0 +6713,Smoking intensity and severity of specific symptom clusters in posttraumatic stress disorder,"Smoking prevalence among patients with posttraumatic stress disorder (PTSD) is over 40%. Baseline data from the VA Cooperative Studies Program trial of integrated versus usual care for smoking cessation in veterans with PTSD (N = 863) were used in multivariate analyses of PTSD and depression severity, and 4 measures of smoking intensity: cigarettes per day (CPD), Fagerström Test for Nicotine Dependence (FTND), time to first cigarette, and expired carbon monoxide. Multivariate regression analysis showed the following significant associations: CPD with race (B = -7.16), age (B = 0.11), and emotional numbing (B =0 .16); FTND with race (B = -0.94), education (B = -0.34), emotional numbing (B = 0.04), significant distress (B = -0.12), and PHQ-9 (B = 0.04); time to first cigarette with education (B = 0.41), emotional numbing (B = -0.03), significant distress (B = 0.09), and PHQ-9 (B = -0.03); and expired carbon monoxide with race (B = -9.40). Findings suggest that among veterans with PTSD, White race and emotional numbing were most consistently related to increased smoking intensity and had more explanatory power than total PTSD symptom score. Results suggest specific PTSD symptom clusters are important to understanding smoking behavior in patients with PTSD.",0,0 +6714,Coping responses and posttraumatic stress symptomatology in urban fire service personnel,"Emergency workers, including urban fire fighters and paramedics, must cope with a variety of duty-related stressors including traumatic incident exposures. Little is known about coping responses of emergency workers or whether their coping responses predict future mental health outcomes. The previously formulated Coping Responses of Rescue Workers Inventory (CRRWI) underwent a principal components analysis employing a sample (N = 220) of urban fire fighters and paramedics. Six empirically and theoretically distinct CRRWI components were identified which were relatively stable over a 6-month period. Scores on one of the CRRWI scales, but neither years of service nor their past half year's traumatic incident exposures, predicted future changes in self-reports of posttraumatic stress symptomatology.",0,0 +6715,"Reliability of Standard Health Assessment Instruments in a Large, Population-Based Cohort Study","The Millennium Cohort Study began in 2001 using mail and Internet questionnaires to gather occupational and environmental exposure, behavioral risk factor, and health outcome data from a large, population-based US military cohort. Standardized instruments, including the Patient Health Questionnaire, the Medical Outcomes Study Short Form-36 for Veterans, and the Posttraumatic Stress Disorder (PTSD) Checklist–Civilian Version, have been validated in various populations. The purpose of this study was to investigate internal consistency of standardized instruments and concordance of responses in a test-retest setting. Cronbach alpha coefficients were used to investigate the internal consistency of standardized instruments among 76,742 participants. Kappa statistics were calculated to measure stability of aggregated responses in a subgroup of 470 participants who voluntarily submitted an additional survey within 6 months of their original submission. High internal consistency was found for 14 of 16 health components, with lower internal consistency found among two alcohol components. Substantial test-retest stability was observed for stationary variables, while moderate stability was found for more dynamic variables that measured conditions with low prevalence. These results substantiate internal consistency and stability of several standard health instruments applied to this large cohort. Such reliability analyses are vital to the integrity of long-term outcome studies.",0,0 +6716,Posttraumatic stress disorder in response to HIV infection,"This study investigated the psychological impact of HIV infection through assessment of posttraumatic stress disorder in response to HIV infection. Sixty-one HIV-positive homosexual/bisexual men were assessed for posttraumatic stress disorder in response to HIV infection (PTSD-HIV) using a modified PTSD module of the DIS-III-R. Thirty percent met criteria for a syndrome of posttraumatic stress disorder in response to HIV diagnosis (PTSD-HIV). In over one-third of the PTSD cases, the disorder had an onset greater than 6 months after initial HIV infection diagnosis. PTSD-HIV was associated with other psychiatric diagnoses, particularly the development of first episodes of major depression after HIV infection diagnosis. PTSD-HIV was significantly associated with a pre-HIV history of PTSD from other causes, and other pre-HIV psychiatric disorders and neuroticism scores, indicating a similarity with findings in studies of PTSD from other causes. The findings from this preliminary study suggest that a PTSD response to HIV diagnosis has clinical validity and requires further investigation in this population and other medically ill groups. The results support the inclusion of the diagnosis of life-threatening illness as a traumatic incident that may lead to a posttraumatic stress disorder, which is consistent with the DSM-IV criteria.",0,0 +6717,Incidence of Posttraumatic Stress Disorder and Mild Traumatic Brain Injury in Burned Service Members: Preliminary Report,"Although sustaining physical injury in theater increases service members' risk for posttraumatic stress disorder (PTSD), exposure to explosive munitions may increase the risk of mild traumatic brain injury (mTBI). We hypothesized a higher incidence of PTSD and mTBI in service members who sustained both burn and explosion injuries than in nonexplosion exposed service members.A retrospective review of PTSD and mTBI assessments was completed on burned service members between September 2005 and August 2006. Subjects were divided into cohort groups: (1) PTSD and mTBI, (2) PTSD and no mTBI, (3) mTBI and no PTSD, (4) no mTBI and no PTSD. Specific criteria used for group classification were based on subjects' total score on Posttraumatic Stress Disorder Checklist, Military version (PCL-M), clinical interview, and record review to meet American Congress of Rehabilitation Medicine criteria for mTBI. Descriptive analyses were used.Seventy-six service members met the inclusion criteria. The incidence rate of PTSD was 32% and mTBI was 41%. Eighteen percent screened positive for PTSD and mTBI; 13% screened positive for PTSD, but not mTBI; 23% screened positive for mTBI but not PTSD; 46% did not screen positive for either PTSD or mTBI.Given the high incidence of these disorders in burned service members, further screening of PTSD and TBI appears warranted. Because symptom presentation in PTSD and mTBI is clinically similar in acute and subacute stages, and treatments can vary widely, further research investigating symptom profiles of PTSD and mTBI is warranted.",0,0 +6718,Differentiating PTSD symptomatology with the MMPI-2-RF (Restructured Form) in a forensic disability sample,"The current study was designed to explore models of assessing various forms of Post-Traumatic Stress Disorder (PTSD) symptomatology that incorporate both broad and more narrowly focused affective markers. We used broader markers of demoralization, negative activation, positive activation, and aberrant experiences to predict global PTSD scores, whereas more narrowly focused markers of positive and negative affect were used to differentiate between PTSD symptom clusters. A disability sample consisting of 347 individuals undergoing medico-legal psychological evaluations was used for this study. All participants completed symptom measures of PTSD and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) (from which MMPI-2-RF scores were derived). The results indicated that demoralization was the best individual predictor of PTSD globally, and that more narrowly focused MMPI-2-RF Specific Problems scales provided a differential prediction of PTSD symptom clusters. Theoretical and practical implications of these findings are discussed within contemporary frameworks of internalizing personality and psychopathology.",0,0 +6719,Understanding the relationship of perceived social support to post-trauma cognitions and posttraumatic stress disorder,"Poor social support in the aftermath of a traumatic event is a well-established risk factor for posttraumatic stress disorder (PTSD) among adult trauma survivors. Yet, a great deal about the relationship between social support and PTSD remains poorly understood. In this study, we analyzed data from 102 survivors of a serious motor vehicle accident (MVA) at 4 weeks (Time 1) and 16 weeks (Time 2) post-MVA. We assessed the role of perceived dyadic social support, positive dyadic interaction, and negative dyadic interaction in the development and maintenance of PTSD. In addition, we examined how these social support constructs work together with negative post-trauma cognitions to affect the maintenance of PTSD. Neither perceived social support nor the quality of social interaction (i.e., positive or negative) was associated with PTSD symptom severity at Time 1. However, among those with elevated PTSD symptom severity at Time 1, greater social support and positive social interaction and lower negative social interaction were each associated with reductions in PTSD symptom severity from Time 1 to Time 2. For social support and negative social interaction, this association ceased to be significant when jointly assessed with negative post-trauma cognitions, suggesting that perceived social support and negative dyadic interaction were associated with maintenance of PTSD symptom severity because of their association with negative post-trauma cognitions. These results provide support to models and treatments of PTSD that emphasize the role of negative post-trauma cognitions in maintenance of PTSD.",0,0 +6720,Psychiatric evaluation of physical rehabilitation patients,"We conducted a study to demonstrate the frequency and types of psychiatric/psychological symptoms. A Structured Interview according to the DSM-III-R was conducted which demonstrated that 46 (41.4%) of 111 rehabilitation inpatients met the criteria for some forms of psychiatric disorders: 34 patients for major depression, 10 for adjustment disorder with anxious mood, and 2 for posttraumatic stress disorder. The remaining 65 patients (58.6%) showed normal reactions to their diseases. Average length of hospital stay for patients with major depression was significantly longer than those with no or the other types of psychiatric disease. They were also tested with Zung's Self-Rating Anxiety Scale (SAS), Zung's Self-Rating Depression Scale (SDS), and Profile of Mood States (POMS). Three psychological tests were useful in detecting depression or adjustment disorder among rehabilitation patients; however, these tests are not always specific to the type of psychiatric disorders. Patients with higher scores in those three tests should be referred to a psychiatric consultant for detailed examinations and proper treatments, if necessary.",0,0 +6721,A descriptive analysis of PTSD chronicity in Vietnam veterans,"This study examined the chronicity of PTSD in 530 male and female Vietnam veterans who were drawn from 2 large, ethnically diverse samples. Delayed onset was common, as was a failure to fully remit: 78% of the 239 veterans with full or partial lifetime PTSD were symptomatic in the 3 months prior to assessment. Cluster analysis identified 4 subtypes of posttraumatic response, with women most likely to be in a delayed onset cluster, and minority men most likely to be in a severe chronic cluster. The extent of chronicity observed in this sample underscores the need for treatments that address the persistence of posttraumatic symptoms.",0,0 +6722,The Vasopressin V1b Receptor as a Therapeutic Target in Stress-related Disorders,"The complexity of the stress response would appear to provide multiple opportunities for intervention, but treatment strategies are often centered on the improvement of symptoms rather than attempting to “treat” the stress response. However, recent efforts have begun to focus on the development of pharmacological agents that can attenuate the stress response itself, rather than the symptoms associated with stress. Although CRF, which is the main regulator of the stress system, is the focus of current interest, there is an accumulating body of evidence suggesting that the vasopressinergic system may play an equal role in the regulation of the stress response, and that V1b receptor antagonists may be of potential therapeutic benefit. The availability of SSR149415, the first selective antagonist for the V1b receptor has allowed us to evaluate this hypothesis. SSR149415 is able to attenuate some but not all stress-related behaviors in rodents. While the antidepressant-like activity of the compound was comparable to that of reference antidepressants, the overall profile displayed in anxiety tests was different from that of classical anxiolytics, such as benzodiazepines. The latter were active in a wide range of anxiety models, whereas the V1b receptor antagonist showed clear-cut effects only in particularly stressful situations. It is important to note that SSR149415 is devoid of central depressant effects, even at high doses, and does not affect cognitive processes, suggesting a large therapeutic window. Altogether, these findings suggest that V1b receptor antagonists might be useful as a treatment for major depression and stress disorders that result from traumatic events.",0,0 +6723,Research and treatment of war neuroses at the Clinic for Nervous and Mental Diseases at the Jagiellonian University in Krakow before World War II in the context of psychiatry in Europe,"Celem artykułu jest przegląd badań dotyczących diagnostyki i leczenia nerwic wojennych w Klinice Neurologiczno-Psychiatrycznej Uniwersytetu Jagiellońskiego przed wybuchem II wojny światowej. Zaprezentowano również działalność profesora Jana Piltza ówczesnego kierownika Kliniki i jego najważniejsze dokonania naukowe. Opisywane w artykule publikacje pochodzą głównie z okresu I wojny światowej i obejmują analizy kliniczne następstw stresu doświadczanego na froncie, a także opis sposobów ich leczenia. Przedstawiono również inne najważniejsze doniesienia z obszaru nerwic wojennych, jakie ukazały się w Europie w tym samym czasie. W artykule zwrócono uwagę na bardzo współczesny i wybiegający ponad ówczesną przeciętność sposób myślenia o leczeniu nerwic wojennych prezentowany przez prof. Piltza i jego zespół. Nowatorskie spojrzenie na ich leczenie związane było przede wszystkim z dostrzeganiem przyczyny nerwicy we wcześniejszych zaburzeniach osobowości pacjentów, zaleceniem psychoterapii jako podstawowej metody leczenia, a także podkreślaniem konieczności dalszej rehabilitacji po zakończeniu leczenia szpitalnego. Przywiązywano także dużą wagę do konieczności indywidualnego opracowywania planów terapii dla każdego z pacjentów.",0,0 +6724,Psychopathology in children of Holocaust survivors: a review of the research literature.,"The literature on transgenerational transmission of Holocaust trauma has grown into a rich body of unique psychological knowledge with almost 400 publications. For the time being, however, the transgenerational effect of the Holocaust on the offspring remains a subject of considerable controversy. The main question involves the presence or absence of specific psychopathology in this population. Psychotherapists kept reporting various characteristic signs of distress while research failed to find significant differences between offspring and comparative groups. In an effort to settle this question, the present review of the research literature provides a summary of the findings of 35 comparative studies on the mental state of offspring of Holocaust survivors, published between 1973-1999. This extensive research indicates rather conclusively that the non-clinical population of children of Holocaust survivors does not show signs of more psychopathology than others do. Children of Holocaust survivors tend to function rather well in terms of manifest psychopathology and differences in the mental state of offspring and people in general are small according to most research. The clinical population of offspring, however, tend to present a specific ""psychological profile"" that includes a predisposition to PTSD, various difficulties in separation-individuation and a contradictory mix of resilience and vulnerability when coping with stress.",0,0 +6725,Role of selective serotonin reuptake inhibitors in psychiatric disorders: a comprehensive review,"The selective serotonin reuptake inhibitors (SSRIs) have emerged as a major therapeutic advance in psychopharmacology. As a result, the discovery of these agents marks a milestone in neuropsychopharmacology and rational drug design, and has launched a new era in psychotropic drug development. Prior to the SSRIs, all psychotropic medications were the result of chance observation. In an attempt to develop a SSRI, researchers discovered a number of nontricyclic agents with amine-uptake inhibitory properties, acting on both noradrenergic and serotonergic neurons with considerable differences in potency. A given drug may affect one or more sites over its clinically relevant dosing range and may produce multiple and different clinical effects. The enhanced safety profile includes a reduced likelihood of pharmacodynamically mediated adverse drug-drug interactions by avoiding affects on sites that are not essential to the intended outcome. SSRIs were developed for inhibition of the neuronal uptake pump for serotonin (5-HT), a property shared with the TCAs, but without affecting the other various neuroreceptors or fast sodium channels. The therapeutic mechanism of action of SSRIs involves alteration in the 5-HT system. The plethora of biological substrates, receptors and pathways for 5-HT are candidates to mediate not only the therapeutic actions of SSRIs, but also their side effects. A hypothesis to explain these immediate side effects is that 5-HT is increased at specific 5-HT receptor subtypes in discrete regions of the body where the relevant physiologic processes are regulated. Marked differences exist between the SSRIs with regard to effects on specific cytochrome P450 (CYP) enzymes, and thus the likelihood of clinically important pharmacokinetic drug-drug interactions. Although no clear relationship exists between the clinical efficacy, plasma concentration of SSRIs, nor any threshold that defines toxic concentrations, but therapeutic drug monitoring (TDM) may be useful in special populations, such as in elderly patients, poor metabolizers (PM) of sparteine (CYP2D6) or mephenytoin (CYP2C19), and patients with liver and kidney impairment. Several meta-analyses have reviewed the comparative efficacy of TCAs and SSRIs, and concluded that both TCAs and SSRIs have similar efficacy in the treatment of depression. SSRIs have demonstrated better efficacy and tolerability in the treatment of obsessive compulsive disorder (OCD). They have also been found to be effective in the treatment for social anxiety disorder both in reducing total levels of social anxiety and in improving overall clinical condition. The benefit of SSRIs in anorexia nervosa (AN) is apparently short-term unless medication is given in the context of nutritional or behavioral therapy. No single antidepressant can ever be recommended for every patient, but in a vast majority of patients, SSRIs should be considered as one of the first-line drugs in the treatment of depression.",0,0 +6726,"Postnatal depression and post‐traumatic stress after childbirth: Prevalence, course and co‐occurrence","Research relating to the postnatal mental health of women has tended to focus on postnatal depression. There have been increasing calls to consider the issue of post-partum anxiety disorders, including post-traumatic stress disorder (PTSD). This study sought to provide further evidence regarding the prevalence and longitudinal course of post-traumatic stress symptoms resulting from traumatic birth experiences. The study also investigated the extent to which symptoms of trauma and depression occur together in the postnatal period. Four hundred women were recruited from the maternity ward of a public hospital in South West Sydney. Symptoms of birth trauma and postnatal depression were assessed via questionnaires given at birth, 6 weeks, 6 months and 12 months post-partum. The prevalence of having a PTSD profile at 6 weeks post-partum was 2%. A further 10.5% of women reported experiencing significant distress related to childbirth and several symptoms of post-traumatic stress without meeting full diagnostic criteria. The prevalence of a PTSD profile remained relatively stable across the first 12 months post-partum, with estimates being 2.6% at 6 months and 2.4% at 12 months. The co-morbidity between post-traumatic stress and postnatal depression was high at all three time points. The study highlights the potentially chronic nature of PTSD after childbirth and the importance of viewing post-partum emotional distress in a broader context than simply postnatal depression.",0,0 +6727,"Communal Violence and Child Psychosocial Well-being: Qualitative Findings from Poso, Indonesia","This exploratory study examined the health care system in relation to communal violence-related psychosocial wellbeing in Poso, Indonesia, as preparation for conducting a cluster randomized trial of a psychosocial intervention. We employed focus groups with children ( N = 9), parents ( N = 11), and teachers ( N = 8), as well as semi-structured interviews with families affected by communal violence ( N = 42), and key informants ( N = 33). An interrelated set of problems was found that included poverty, an indigenized trauma construct, morally inappropriate behavior, inter-religious tensions, and somatic problems. Participants emphasized social-ecological interactions between concerns at different systemic levels, although problems were mainly addressed through informal care by families. The programmatic and research implications of these findings are discussed.",0,0 +6728,Functional connectivity reveals inefficient working memory systems in post-traumatic stress disorder,"We applied a covariance-based multivariate analysis to functional magnetic resonance imaging (fMRI) data to investigate abnormalities in working memory (WM) systems in patients with post-traumatic stress disorder (PTSD). Patients (n=13) and matched controls (n=12) were scanned with fMRI while updating or maintaining trauma-neutral verbal stimuli in WM. A multivariate statistical analysis was used to investigate large-scale brain networks associated with these experimental tasks. For the control group, the first network reflected brain activity associated with WM updating and principally involved bilateral prefrontal and bilateral parietal cortex. Controls' second network was associated with WM maintenance and involved regions typically activated during storage and rehearsal of verbal material, including lateral premotor and inferior parietal cortex. In contrast, PTSD patients appeared to activate a single fronto-parietal network for both updating and maintenance tasks. This is indicative of abnormally elevated activity during WM maintenance and suggests inefficient allocation of resources for differential task demands. A second network in PTSD, which was not activated in controls, showed regions differentially activated between WM tasks, including the anterior cingulate, medial prefrontal cortex, fusiform and supplementary motor area. These activations may be linked to hyperarousal and abnormal reactivity, which are characteristic of PTSD.",0,0 +6729,New onset and persistent symptoms of post-traumatic stress disorder self reported after deployment and combat exposures: prospective population based US military cohort study,"To describe new onset and persistence of self reported post-traumatic stress disorder symptoms in a large population based military cohort, many of whom were deployed in support of the wars in Iraq and Afghanistan.Prospective cohort analysis.Survey enrolment data from the millennium cohort (July 2001 to June 2003) obtained before the wars in Iraq and Afghanistan. Follow-up (June 2004 to February 2006) data on health outcomes collected from 50 184 participants.Self reported post-traumatic stress disorder as measured by the posttraumatic stress disorder checklist-civilian version using Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria.More than 40% of the cohort were deployed between 2001 and 2006; between baseline and follow-up, 24% deployed for the first time in support of the wars in Iraq and Afghanistan. New incidence rates of 10-13 cases of post-traumatic stress disorder per 1000 person years occurred in the millennium cohort. New onset self reported post-traumatic stress disorder symptoms or diagnosis were identified in 7.6-8.7% of deployers who reported combat exposures, 1.4-2.1% of deployers who did not report combat exposures, and 2.3-3.0% of non-deployers. Among those with self reported symptoms of post-traumatic stress disorder at baseline, deployment did not affect persistence of symptoms.After adjustment for baseline characteristics, these prospective data indicate a threefold increase in new onset self reported post-traumatic stress disorder symptoms or diagnosis among deployed military personnel who reported combat exposures. The findings define the importance of post-traumatic stress disorder in this population and emphasise that specific combat exposures, rather than deployment itself, significantly affect the onset of symptoms of post-traumatic stress disorder after deployment.",0,0 +6730,Current research on cognitive aspects of anxiety disorders,"Cognitive dysfunction is frequently reported in anxiety disorders. Our aim is to describe recent advances concerning these cognitive aspects.Cognitive dysfunction in anxiety disorders can be classified into four domains. The first concerns executive functions, mainly attentional processes. The second concerns memory, including deficits in working, episodic, and autobiographical memory. The third encompasses maladaptive cognitions, or thoughts and beliefs. Finally, a burgeoning area of research (mainly in obsessive-compulsive disorder and posttraumatic stress disorder) concerns metacognitions, or thoughts and beliefs about one's own thoughts and beliefs. All of these dysfunctions may contribute to maintain or aggravate anxiety disorders. When developing and implementing interventions, researchers and clinicians alike must consider these cognitive aspects, and may need to tailor their approaches accordingly.Advances have clearly been made in the elucidation of the cognitive functioning associated with anxiety disorders. It remains unclear if particular cognitive profiles can help to distinguish anxiety disorders from one another, although emerging evidence suggests this may be the case. Further clarification will add to our understanding of the development and maintenance of these disorders, and may provide targets for future therapy and endophenotypes.",0,0 +6731,Psychological Distress After Orthopedic Trauma: Prevalence in Patients and Implications for Rehabilitation,"Orthopedic trauma is an unforeseen life-changing event. Serious injuries include multiple fractures and amputation. Physical rehabilitation has traditionally focused on addressing functional deficits after traumatic injury, but important psychological factors also can dramatically affect acute and long-term recovery. This review presents the effects of orthopedic trauma on psychological distress, potential interventions for distress reduction after trauma, and implications for participation in rehabilitation. Survivors commonly experience post-traumatic stress syndrome, depression, and anxiety, all of which interfere with functional gains and quality of life. More than 50% of survivors have psychological distress that can last decades after the physical injury has been treated. Early identification of patients with distress can help care teams provide the resources and support to offset the distress. Several options that help trauma patients navigate their short-term recovery include holistic approaches, pastoral care, coping skills, mindfulness, peer visitation, and educational resources. The long-term physical and mental health of the trauma survivor can be enhanced by strategies that connect the survivor to a network of people with similar experiences or injuries, facilitate support groups, and social support networking (The Trauma Survivors Network). Rehabilitation specialists can help optimize patient outcomes and quality of life by participating in and advocating these strategies.",0,0 +6732,"Cardiac stability at differing levels of temporal analysis in panic disorder, post-traumatic stress disorder, and healthy controls","The panic disorder (PD) literature provides evidence for both physiologic rigidity and instability as pathognomonic features of this disorder. This ambiguity may be a result of viewing PD at differential levels of temporal analysis. We assessed cardiac variability across three levels of temporal scale in PD patients, post-traumatic stress disorder (PTSD) patients, and healthy controls. Sixteen healthy controls, 14 PD patients, 23 PTSD patients, and 16 PTSD + PD patients presented for a polysomnogram. Differences were assessed in respiratory sinus arrhythmia (RSA), autoregressive stability of heart rate (HR), and the number of nonspecific accelerations in HR over the night. No differences in RSA were found between groups; however, PD patients exhibited significantly lower autoregressive HR stability, and all patients had significantly more HR accelerations than controls. These data reinforce prior findings demonstrating physiologic instability in PD and indicate that prior equivocalities regarding physiologic variability in PD may be due to limited temporal scaling of measurements.",0,0 +6733,PTSD Symptoms in Intellectually Disabled Victims of Sexual Assault,"The high rates of sexual violence in the country suggest that people with intellectual disabilities (ID) are likely to be sexually victimised. Rape and sexual assault have negative consequences for survivors, with Post Traumatic Stress Disorder (PTSD) being the most common psychiatric diagnosis used to capture the reaction to this trauma. This study sought to investigate the presence of PTSD symptoms in a group of people with ID who had been sexually abused. The Child PTSD Checklist was administered to 54 individuals with ID — 27 with and 27 without a known history of sexual abuse. The Checklist was also administered to the care-givers of those who had been sexually abused. Higher rates of a PTSD diagnosis and a higher intensity of PTSD symptoms were found in the group with than in the group without a history of sexual abuse. There were no significant differences between self and care-giver reports with respect to the prevalence of a PTSD diagnosis, but there were differences on the different symptom clusters. The results indicate that survivors with ID should be asked directly about their internal subjective experiences, with care-giver reports being used as collateral information, and that therapeutic interventions following sexual abuse should be offered.",0,0 +6734,Using the Brief Resilience Scale to Assess Chinese People’s Ability to Bounce Back From Stress,"This study examined the utility of an adapted version of the Brief Resilience Scale (BRS) to measure Chinese undergraduates’ ability to bounce back from stress. The BRS together with measures tapping optimism, self-esteem, pessimism, and physical health were administered to 547 Hong Kong and 268 mainland Chinese undergraduates. The BRS was found to measure one single construct and exhibited convergent validity in both samples. Further analyses using a path analytic model showed that the BRS scores substantially mediated the link between the two positive traits (optimism and self-esteem) and physical health in the two samples. The results suggested that the BRS is a reliable and valid instrument for measuring Chinese undergraduates’ ability to bounce back from stress. The implications for further research related to resilience in Chinese people are discussed.",0,0 +6735,The Psychological Risks of Vietnam for U.S. Veterans: A Revisit with New Data and Methods,"In 1988, the National Vietnam Veterans Readjustment Study (NVVRS) of a representative sample of 1200 veterans estimated that 30.9% had developed posttraumatic stress disorder (PTSD) during their lifetimes and that 15.2% were currently suffering from PTSD. The study also found a strong dose-response relationship: As retrospective reports of combat exposure increased, PTSD occurrence increased. Skeptics have argued that these results are inflated by recall bias and other flaws. We used military records to construct a new exposure measure and to cross-check exposure reports in diagnoses of 260 NVVRS veterans. We found little evidence of falsification, an even stronger dose-response relationship, and psychological costs that were lower than previously estimated but still substantial. According to our fully adjusted PTSD rates, 18.7% of the veterans had developed war-related PTSD during their lifetimes and 9.1% were currently suffering from PTSD 11 to 12 years after the war; current PTSD was typically associated with moderate impairment.",0,0 +6736,Comparison of posttraumatic stress disorder symptom structure models in Hispanic and White college students.,"This study tested measurement invariance between Hispanic (n = 226) and White (n = 278) college students' responses to a well-validated measure of posttraumatic stress disorder (PTSD) symptoms. Participants completed the PTSD Checklist-Civilian Version (PCL-C; Weathers, Litz, Herman, Juska, & Keane, 1993); however, trauma histories were not assessed, nor were responses to the PCL-C indexed to a specific traumatic event. Eight models were tested using within-groups confirmatory factor analysis (CFA); 3 models (D. King, Leskin, King, & Weathers, 1998; Simms, Watson, & Doebbeling, 2002; Smith, Redd, DuHamel, Vickberg, & Ricketts, 1999) showed good fit for both ethnic groups, although differences in the degree of fit were observed between the 2 ethnic groups. Models that demonstrated good fit were then compared for equivalence using multiple group CFA. Factor loadings were equivalent between groups, but intercepts differed between groups in all 3 models. Mean item score differences between Hispanic and White groups were observed on items assessing emotional upset with reminders (Item B4) and emotional distancing (Item C5). D. King and colleagues (1998) model resulted in the best measurement invariance. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)",0,0 +6737,Lost in trans-lation: Interpreting systems of trauma for transgender clients.,"Transgender clients frequently experience multiple types of violence (Mizock & Lewis, 2008), including interpersonal (violence that occurs between, at least, two people), self-directed (violence that is self-inflicted), and collective (violence that is inflicted by larger groups of people/institutions; Krug et al., 2002). Transgender clients who experience any of these types of violence are at a higher risk for developing psychiatric symptoms that may require the attention of a mental health care provider (Mizock & Lewis, 2008). Thus, it is crucial that clinicians understand how transgender clients respond to such violence and how these reactions relate to the clinical needs of transgender clients (Lev, 2004). In this article, we will summarize and cluster the types of violence that have been documented in the transgender literature. We will then highlight PTSD and complex PTSD as conceptual frameworks for working with transgender clients. Furthermore, we will examine how the binary notion of gender ignor...",0,0 +6738,Posttraumatic Stress in U.S. Marines: The Role of Unit Cohesion and Combat Exposure,"Combat exposure is a consistent predictor of posttraumatic stress (PTS). Understanding factors that might buffer the effects of combat exposure is crucial for helping service members weather the stress of war. In a study of U.S. Marines returning from Iraq, hierarchical multiple regression analyses revealed that unit cohesion and combat exposure predicted PTS, depression, and anger. Furthermore, results indicated that unit cohesion may be an important buffer, possibly limiting the development of PTS and depression following combat exposure.",0,0 +6739,Commentaries,,0,0 +6740,"From concepts, theory, and evidence of heterogeneity of treatment effects to methodological approaches: a primer","Implicit in the growing interest in patient-centered outcomes research is a growing need for better evidence regarding how responses to a given intervention or treatment may vary across patients, referred to as heterogeneity of treatment effect (HTE). A variety of methods are available for exploring HTE, each associated with unique strengths and limitations. This paper reviews a selected set of methodological approaches to understanding HTE, focusing largely but not exclusively on their uses with randomized trial data. It is oriented for the ""intermediate"" outcomes researcher, who may already be familiar with some methods, but would value a systematic overview of both more and less familiar methods with attention to when and why they may be used. Drawing from the biomedical, statistical, epidemiological and econometrics literature, we describe the steps involved in choosing an HTE approach, focusing on whether the intent of the analysis is for exploratory, initial testing, or confirmatory testing purposes. We also map HTE methodological approaches to data considerations as well as the strengths and limitations of each approach. Methods reviewed include formal subgroup analysis, meta-analysis and meta-regression, various types of predictive risk modeling including classification and regression tree analysis, series of n-of-1 trials, latent growth and growth mixture models, quantile regression, and selected non-parametric methods. In addition to an overview of each HTE method, examples and references are provided for further reading.By guiding the selection of the methods and analysis, this review is meant to better enable outcomes researchers to understand and explore aspects of HTE in the context of patient-centered outcomes research.",0,0 +6741,Topiramate in the New Generation of Drugs: Efficacy in the Treatment of Alcoholic Patients,"Predicated upon a neuropharmacological conceptual model, there is now solid clinical evidence to support the efficacy of topiramate for the treatment of alcohol dependence. Topiramate treatment can be initiated whilst the alcohol-dependent individual is still drinking - just when crisis intervention is most likely to be needed by a patient with or without his or her family asking the health practitioner for assistance. Because topiramate can be paired with a brief intervention, there is now the exciting possibility of treating most alcohol- dependent individuals in office-based practice or generic treatment settings. Topiramate's additional effects on other impulsedyscontrol disorders make it a particularly interesting compound for the treatment of other comorbid drug or psychiatric disorders. Additionally, future studies should explore whether topiramate can be combined with other putative therapeutic agents to increase its efficacy. One notable clinical challenge in the development of topiramate as a pharmacotherapy to treat alcohol dependence is the determination of the smallest dose that can result in efficacy, thereby achieving the optimum balance between therapeutic benefit and adverse event profile. Animal data do provide support for topiramate's general anti-drinking effects but also indicate that its mechanisms of action might rely on several complex pharmacobehavioral changes. Additional preclinical studies are needed to elucidate more clearly the basic mechanistic processes that underlie topiramate's efficacy as a treatment for alcohol dependence. Preclinical information that topiramate may have differential effects based on genetic vulnerability opens up the possibility of future methods to optimize treatment.",0,0 +6742,Traumatic Brain Injury and Its Neuropsychiatric Sequelae in War Veterans,"The post–September 11, 2001 wars in and around Afghanistan and Iraq have increased awareness of traumatic brain injury (TBI), particularly blast-induced mild TBI. This article provides an overview of TBI and its neuropsychiatric sequelae in U.S. war veterans who participated in the current operations in and around Afghanistan and Iraq, with particular emphasis on blast-related mild TBI. Psychiatric disorders, particularly posttraumatic stress disorder, pain, and sensory impairments are prevalent in war veterans with TBI. Research is needed to more definitively characterize the epidemiology of TBI-related functional difficulties, the effects of blasts compared with other mechanisms of injury, recovery trajectories, and treatment outcomes in this population.",0,0 +6743,Onset of activity and time to response on individual CAPS-SX17 items in patients treated for post-traumatic stress disorder with venlafaxine ER: a pooled analysis,"This pooled analysis of data from two randomized, placebo-controlled trials of venlafaxine extended release (ER) assessed onset of activity and time to response on the 17 symptoms of post-traumatic stress disorder (PTSD) listed in DSM-IV and measured by the 17-item Clinician-Administered PTSD Scale (CAPS-SX17). The intent-to-treat (ITT) population comprised 687 patients (placebo, n=347; venlafaxine ER, n=340). Significant (p<0.05) separation between venlafaxine ER and placebo was observed on most CAPS-SX17 items, with earliest onset of activity and response (week 2) on items 5 (physiological reactivity on exposure to cues) and 14 (irritability or anger outbursts), and (week 4) items 1 (intrusive recollections) and 4 (psychological distress at exposure to cues). Onset of activity and response occurred later (generally, weeks 6-8) on items 9 (diminished interest/participation in activities), 10 (detachment or estrangement), 11 (restricted range of affect), 12 (sense of foreshortened future), all associated with numbing, 15 (difficulty concentrating), 16 (hypervigilance), 17 (exaggerated startle response), associated with hyperarousal, and 6 (avoidance of thoughts/feelings or conversations). Significant differences between venlafaxine ER and placebo were largely absent throughout the treatment period and at the primary week-12 end-point for items 2 (distressing dreams), 7 (avoidance of activities, places or people), 8 (inability to recall important aspect of trauma) and 13 (difficulty falling/staying asleep). These results indicate that symptoms of physiological reactivity and psychological distress in response to cues, and irritability/anger outbursts show early and robust improvement with venlafaxine ER treatment, while symptoms of numbing and hyperarousal take longer. The early and persistent effect of venlafaxine ER over placebo on anger/irritability is noteworthy in view of the clinical significance of these symptoms in PTSD.",0,0 +6744,Co-morbidity: Lessons learned about Post-Traumatic Stress Disorder (PTSD) from developing ptsd scales for the MMPI,"Results from efforts to develop and validate PTSD measures are promising, but a ""gold standard"" has not been achieved. Keane, Malloy, and Fairbank (1984) have developed an MMPI PTSD subscale that has been cross-validated with clinicians' classification of PTSD at acceptable levels of agreement, specificity, and sensitivity. There is, however, room for improvement. Empirical evidence is presented that indicates that the next round of efforts to increase reliability and validity of PTSD measures must account for the presence/absence of co-morbidity (i.e., the simultaneous occurrence of other psychiatric disorders). For example, differences are noted in MMPI group profiles and PTSD scales between psychiatric patients and substance abusers. Second, different MMPI items emerge as indicative of PTSD; these vary as a function of the presence of other Axis I disorders among groups of Vietnam combat veterans who seek treatment for substance abuse. Results substantiate that different MMPI items for classifying PTSD occur with groups that differ in co-morbidity. Improvements in PTSD scale development are more likely when the contributions of pre-existing or subsequently co-occurring psychiatric disorders are taken in account, as well as variations in level of personality maturity. The evidence suggests that a ""family"" of PTSD scales need to be developed that take into account co-morbidity differences.",0,0 +6745,Successful Aging Among Older Veterans in the United States,"

Objective

To develop a unidimensional latent model of successful aging and to evaluate sociodemographic, medical, psychiatric, and psychosocial correlates of this construct in a nationally representative sample of older veterans in the United States.

Methods

Data were analyzed from a cross-sectional web survey of 2,025 U.S. veterans aged 60 to 96 years who participated in the National Health and Resilience in Veterans Study. Self-report measures of sociodemographics; subjective physical, mental, and cognitive functioning; and psychosocial characteristics were used. Confirmatory factor analysis was used to construct a unidimensional latent factor of successful aging. Correlates of scores on this factor were then evaluated.

Results

Most older veterans (82.1%) rated themselves as aging successfully. A unidimensional latent factor composed of seven measures of self-rated successful aging, quality of life, and physical, mental, cognitive, and social functioning provided a good fit to the data. Physical health difficulties (β = −0.39) and current psychological distress (β = −0.33) were most strongly negatively related to scores on this latent factor of successful aging, while protective psychosocial characteristics (β = 0.22), most notably resilience, gratitude, and purpose in life, were most strongly positively related to these scores. Additional positive predictors of successful aging included White, non-Hispanic race, being married or living with partner, perceiving a positive effect of the military on one's life, active lifestyle, positive expectations regarding aging, and conscientiousness; additional negative predictors included substance abuse history.

Conclusion

Results of this study provide a dimensional approach to characterizing components and correlates of successful aging in older veterans. Interventions and policy initiatives designed to mitigate physical health difficulties and psychological distress and to enhance protective psychosocial characteristics such as resilience, gratitude, and purpose in life may help promote successful aging in this population.",0,0 +6746,"Resilience definitions, theory, and challenges: interdisciplinary perspectives","In this paper, inspired by the plenary panel at the 2013 meeting of the International Society for Traumatic Stress Studies, Dr. Steven Southwick (chair) and multidisciplinary panelists Drs. George Bonanno, Ann Masten, Catherine Panter-Brick, and Rachel Yehuda tackle some of the most pressing current questions in the field of resilience research including: (1) how do we define resilience, (2) what are the most important determinants of resilience, (3) how are new technologies informing the science of resilience, and (4) what are the most effective ways to enhance resilience? These multidisciplinary experts provide insight into these difficult questions, and although each of the panelists had a slightly different definition of resilience, most of the proposed definitions included a concept of healthy, adaptive, or integrated positive functioning over the passage of time in the aftermath of adversity. The panelists agreed that resilience is a complex construct and it may be defined differently in the context of individuals, families, organizations, societies, and cultures. With regard to the determinants of resilience, there was a consensus that the empirical study of this construct needs to be approached from a multiple level of analysis perspective that includes genetic, epigenetic, developmental, demographic, cultural, economic, and social variables. The empirical study of determinates of resilience will inform efforts made at fostering resilience, with the recognition that resilience may be enhanced on numerous levels (e.g., individual, family, community, culture).",0,0 +6747,Psychological Trajectories after Intraoperative Awareness with Explicit Recall,,0,0 +6748,Discriminant validity of the TSC-40 in an outpatient setting,"This study examines the discriminant validity of the Trauma Symptom Checklist (TSC-40) in a clinical sample. The TSC-40 was developed as a research instrument for assessing the impact of a history of sexual victimization. Previous validity studies used nonclinical samples of women (Elliott & Briere, 1992; Gold, Milan, Myall, & Johnson, 1994). In the present study, the TSC-40 was administered to 103 men and 79 women requesting services at two outpatient clinics. Information about sexual victimization was collected from the client during intake and from the therapist after the client had received 6 months of therapy. A history of CSA was associated both with high symptom levels across symptom dimensions, and, specifically, with elevation on the trauma subscale of the TSC-40. The findings support the view that, in a clinical setting, CSA is associated both with generalized distress and with PTSD symptoms.",0,0 +6749,Status of Glucocorticoid Alterations in Post-traumatic Stress Disorder,"The current status of glucocorticoid alterations in post-traumatic stress disorder (PTSD) will be described in this chapter. Emphasis will be placed on data that suggest that at least some glucocorticoid-related observations in PTSD reflect pretraumatic glucocorticoid status. Recent observations have provided some evidence that pretraumatic glucocorticoid alterations may arise from genetic, epigenetic, and possibly other environmental influences that serve to increase the likelihood of developing PTSD following trauma exposure, as well as modulate attendant biological alterations associated with its pathophysiology. Current studies in the field of PTSD employ glucocorticoid challenge strategies to delineate effects of exogenously administered glucocorticoids on neuroendocrine, cognitive, and brain function. Results of these studies have provided an important rationale for using glucocorticoid strategies in the treatment of PTSD.",0,0 +6750,Physical and psychological factors predict outcome following whiplash injury,"Predictors of outcome following whiplash injury are limited to socio-demographic and symptomatic factors, which are not readily amenable to secondary and tertiary intervention. This prospective study investigated the predictive capacity of early measures of physical and psychological impairment on pain and disability 6 months following whiplash injury. Motor function (ROM; kinaesthetic sense; activity of the superficial neck flexors (EMG) during cranio-cervical flexion), quantitative sensory testing (pressure, thermal pain thresholds, brachial plexus provocation test), sympathetic vasoconstrictor responses and psychological distress (GHQ-28, TSK, IES) were measured in 76 acute whiplash participants. The outcome measure was Neck Disability Index scores at 6 months. Stepwise regression analysis was used to predict the final NDI score. Logistic regression analyses predicted membership to one of the three groups based on final NDI scores (<8 recovered, 10-28 mild pain and disability, >30 moderate/severe pain and disability). Higher initial NDI score (1.007-1.12), older age (1.03-1.23), cold hyperalgesia (1.05-1.58), and acute post-traumatic stress (1.03-1.2) predicted membership to the moderate/severe group. Additional variables associated with higher NDI scores at 6 months on stepwise regression analysis were: ROM loss and diminished sympathetic reactivity. Higher initial NDI score (1.03-1.28), greater psychological distress (GHQ-28) (1.04-1.28) and decreased ROM (1.03-1.25) predicted subjects with persistent milder symptoms from those who fully recovered. These results demonstrate that both physical and psychological factors play a role in recovery or non-recovery from whiplash injury. This may assist in the development of more relevant treatment methods for acute whiplash.",0,0 +6751,Comparative Profiles Of Women With Ptsd And Comorbid Cocaine Or Alcohol Dependence,"This study examined differences in substance abuse severity, trauma history, posttraumatic stress disorder (PTSD) symptomatology and psychiatric comorbidity among treatment-seeking women (N= 74) with PTSD and either comorbid cocaine or alcohol dependence. Women in the cocaine/PTSD group, compared with the alcohol/PTSD group, demonstrated greater occupational impairment (e.g., greater severity on the employment subscale of the Addiction Severity Index, less monthly income, fewer days worked in past month), more legal problems (e.g., greater number of months incarcerated and arrests for prostitution), and greater social impairment (e.g., fewer number of close friends, less likely to be married). Women in the alcohol/PTSD group evidenced higher rates of exposure to serious accidents, other situations involving serious injury, and other extraordinarily stressful life events. Rates of major depression and social phobia were higher among the alcohol/PTSD group than the cocaine/PTSD group. Women in the alcohol/PTSD group scored higher on the CAPS avoidance, hyperarousal, and total subscale scores. The current findings enhance our understanding of the substance-specific profiles of women with PTSD and comorbid substance use disorders and may have important implications for the design of dual-diagnosis interventions.",0,0 +6752,A review on cognitive impairments in depressive and anxiety disorders with a focus on young adults,"There is growing evidence for cognitive dysfunction in depressive and anxiety disorders. Nevertheless, the neuropsychological profile of young adult patients has not received much systematic investigation. The following paper reviews the existing literature on cognitive impairments in depressive and anxiety disorders particularly among young adults. Additionally, the focus of young adult age group and the effect of confounding variables on study results are discussed.Electronic database searches were conducted to identify research articles focusing on cognitive impairments in depressive or anxiety disorders among young adults published in English during years 1990-2006.Cognitive impairments are common in young adults with major depression and anxiety disorders, although their nature remains partly unclear. Accordingly, executive dysfunction is evident in major depression, but other more specific deficits appear to depend essentially on disorder characteristics. The profile of cognitive dysfunction seems to depend on anxiety disorder subtype, but at least obsessive-compulsive disorder is associated with deficits in executive functioning and visual memory. The conflicting results may be explained by heterogeneity within study participants, such as illness status, comorbid mental disorders, and medication, and other methodological issues, including inadequate matching of study groups and varying testing procedures.The study is a comprehensive review, but not a formal meta-analysis, due to methodological heterogeneity.Cognitive impairments are common in major depression and anxiety disorders. However, more research is needed to confirm and widen these findings, and to expand the knowledge into clinical practice. Controlling of confounding variables in future studies is highly recommended.",0,0 +6753,Comorbid obsessive–compulsive personality disorder in obsessive–compulsive disorder (OCD): A marker of severity,"Comorbid obsessive-compulsive personality disorder (OCPD) is well-described in obsessive-compulsive disorder (OCD). It remains unclear, however, whether OCPD in OCD represents a distinct subtype of OCD or whether it is simply a marker of severity in OCD.The aim of this study was to compare a large sample of OCD subjects (n=403) with and without OCPD on a range of demographic, clinical and genetic characteristics to evaluate whether comorbid OCPD in OCD represents a distinct subtype of OCD, or is a marker of severity.Our findings suggest that OCD with and without OCPD are similar in terms of gender distribution and age at onset of OC symptoms. Compared to OCD-OCPD (n=267, 66%), those with OCD+OCPD (n=136, 34%) are more likely to present with the OC symptom dimensions which reflect the diagnostic criteria for OCPD (e.g., hoarding), and have significantly greater OCD severity, comorbidity, functional impairment, and poorer insight. Furthermore there are no differences in distribution of gene variants, or response to treatment in the two groups.The majority of our findings suggest that in OCD, patients with OCPD do not have a highly distinctive phenomenological or genetic profile, but rather that OCPD represents a marker of severity.",0,0 +6754,A comparison between survival from cancer before and after a physical traumatic injury: physical trauma before cancer is associated with decreased survival,"Prior traumatic experiences have been associated with poorer coping strategies, greater distress, and more posttraumatic stress disorder (PTSD) symptoms following a subsequent cancer diagnosis affecting their survival. However, the impact of prior physical traumatic injury on cancer survival has not been examined.The present study matched patients from the same Level 1 Trauma center who appeared in both the trauma and cancer registries. A total of 498 patients met the criteria between 1998 and 2014 who have experienced both a diagnosis of cancer and a physical traumatic injury. The survival between the patients who had physical trauma before cancer (TBC) versus those that had physical trauma after the cancer diagnosis (TAC) were compared.The TBC group had a higher percentage of males (48 % vs 33 % p = 0.001) and motor vehicle collisions (18 % vs 7 %, p < 0.001), than the TAC group. TBC patients were also significantly younger than TAC patients at the time of the physical traumatic event (68.7 ± 14.6 vs 76.2 ± 12.0 years, p < 0.001), and longer length of time between the cancer diagnosis and physical traumatic injury (2.9 ± 2.9 vs 1.7 ± 2.6 years, p < 0.001). The overall probability of survival for the entire sample was 68 %. Percent survival for the TBC (n = 251) and TAC (n = 247) groups was 56 and 80 % respectively (p < 0.001). Results were consistent regardless of stage of cancer at diagnosis (hazard ratio (HR (Standard Error)). After adjusting for comorbidities Charlson comorbidity index (CCI) (HR = 1.2 (0.06), p = 0.009)), cancer stage (HR = 2.8 (0.12), p < 0.001)), lung cancer (HR = 1.7 (0.25), p < 0.001) and bladder cancer (HR = 3.5 (0.55), p = 0.02), experiencing a prior physical traumatic injury was associated with an increased HR for mortality of 4.6 (0.93), p < 0.001).A physical traumatic episode before cancer diagnosis (TBC) increased the risk of death 4.6 fold compared to the TAC group even after adjusting for CCI, stage of cancer at diagnosis, lung cancer, and bladder cancer. These findings suggest considering a history of physical traumatic injury in cancer patients as a possible risk factor for faster cancer progression and mortality.",0,0 +6755,"Relationships Between Mobbing at Work and MMPI-2 Personality Profile, Posttraumatic Stress Symptoms, and Suicidal Ideation and Behavior","This study investigates the relationships between the experience of mobbing at work and personality traits and symptom patterns as assessed by means of the revised version of the Minnesota Multiphasic Personality Inventory (MMPI-2). Participants were 107 workers who had contacted mental health services because they perceived themselves as victims of mobbing. In line with previous research, the results showed that the MMPI-2 mean profile was characterized by a neurotic component as evidenced by elevations of Scales 1, 2, and 3 and a paranoid component as indicated by elevation of Scale 6. Contrary to previous research, a pattern of positive and significant correlations was found between the frequency of exposure to mobbing behaviors and the MMPI-2 clinical, supplementary, and content scales, including the posttraumatic stress scale. Only about half the participants showed a severity of posttraumatic stress symptoms indicative of a posttraumatic stress disorder. The frequency of exposure to mobbing predicted suicidal ideation and behavior, with depression only partially mediating this relationship. (",0,0 +6756,Neonatizid,"Background: The term neonaticide describes the act of killing a newborn child by a parent (mostly by the mother) within 24 h after birth. The aim of this study was to establish a classification of female perpetrators using psychopathological, mental, social and biographical characteristics and to make a comparison of the frequency between the old and new federal states in Germany. Material and methods: In this study a total of 63 female German perpetrators who killed at least one newborn between 1986 and 2009 are portrayed and classified by epidemiological and psychopathological characteristics and personality profiles. After obtaining consent from the public prosecutors responsible, data were collected from forensic psychiatric expert opinions and legally valid court verdicts. A questionnaire was established to answer the questions on the psychopathological, e.g. do the women suffer from a mental disease when killing their newborn(s), mental, e.g. can personality accentuations be elicited, social, e.g. are the women unemployed and biographical characteristics of the women, e.g. how old are the women? Finally, an investigation was carried out using significance tests to find out if there was a significant statistical difference in the frequency of neonaticide between the eastern and western federal states. Results: A cluster analysis based on the descriptive analysis was developed. The cluster analysis provided a foundation for a dichotomous classification of the perpetrators depending on five criteria. The first category contained 32 perpetrators who were on average 21 years old, who were primiparous and who hid, ignored or did not perceive their pregnancy. Most of them still lived with their parents. The perpetrators either did not have a mental disease or suffered from an acute stress disorder. The second category contained 31 perpetrators who were on average 25 years old, who were pluriparous, who hid their pregnancy and who lived with their partner. These women either did not have a mental disease or suffer from a personality disorder. A statistically significant higher incidence was found in the eastern federal states of Germany. Conclusion: The presented categorization of female perpetrators into two groups, where the features only show a small degree of overlap, should be taken into consideration in the assessment of the reasons for neonaticide. The typology of female perpetrators is more heterogeneous than previously assumed. The presented typologies and knowledge of conditional constellations involved in neonaticide achieve better prerequisites to be able to recognize persons at risk earlier and to instigate preventive measures. © 2015, Springer-Verlag Berlin Heidelberg.",0,0 +6757,Properties of patient-reported outcome measures in individuals following acute whiplash injury,"The aim of this study was to assess the acceptability, reliability, validity and responsiveness of the Short-Form Health Survey (SF-12) and its preference-based derivative (SF-6D), the EQ-5D and the Neck Disability Index (NDI) in patients recovering from acute whiplash injury.Data from the Managing Injuries of the Neck Trial of 3,851 patients with acute whiplash injury formed the basis of this empirical investigation. The EQ-5D and SF-12 were collected at baseline, and all three outcome measures were then collected at 4 months, 8 months and 12 months post-randomisation. The measures were assessed for their acceptability (response rates), internal consistency, validity (known groups validity and discriminant validity) and their internal and external responsiveness.Response rates were broadly similar across the measures, with evidence of a floor effect for the NDI and a ceiling effect for the EQ-5D utility measure. All measures had Cronbach's α statistics of greater than 0.7, indicating acceptable internal consistency. The NDI and EQ-5D utility score correlated more strongly with the physical component scale of the SF-12 than the mental component scale, whilst this was reversed for the SF-6D utility score. The smaller standard deviations in SF-6D utility scores meant there were larger effect sizes for differences in utility score between patients with different injury severity at baseline than for the EQ-5D utility measure. However, the EQ-5D utility measure and NDI were both more responsive to longitudinal changes in health status than the SF-6D.There was no evidence of differences between the EQ-5D utility measure and NDI in terms of their construct validity, discriminant validity or responsiveness in patients with acute whiplash injury. However, both demonstrated superior responsiveness to longitudinal health changes than the SF-6D.",0,0 +6758,Prevalence Estimates of Combat-Related Post-Traumatic Stress Disorder: Critical Review,"The aim of the present study was to provide a critical review of prevalence estimates of combat-related post-traumatic stress disorder (PTSD) among military personnel and veterans, and of the relevant factors that may account for the variability of estimates within and across cohorts, including methodological and conceptual factors accounting for differences in prevalence rates across nations, conflicts/wars, and studies. MEDLINE and PsycINFO databases were examined for literature on combat-related PTSD. The following terms were used independently and in combinations in this search: PTSD, combat, veterans, military, epidemiology, prevalence. The point prevalence of combat-related PTSD in US military veterans since the Vietnam War ranged from approximately 2% to 17%. Studies of recent conflicts suggest that combat-related PTSD afflicts between 4% and 17% of US Iraq War veterans, but only 3-6% of returning UK Iraq War veterans. Thus, the prevalence range is narrower and tends to have a lower ceiling among combat veterans of non-US Western nations. Variability in prevalence is likely due to differences in sampling strategies; measurement strategies; inclusion and measurement of the DSM-IV clinically significant impairment criterion; timing and latency of assessment and potential for recall bias; and combat experiences. Prevalence rates are also likely affected by issues related to PTSD course, chronicity, and comorbidity; symptom overlap with other psychiatric disorders; and sociopolitical and cultural factors that may vary over time and by nation. The disorder represents a significant and costly illness to veterans, their families, and society as a whole. Further carefully conceptualized research, however, is needed to advance our understanding of disorder prevalence, as well as associated information on course, phenomenology, protective factors, treatment, and economic costs.",0,0 +6759,Evidence-based pharmacotherapy of post-traumatic stress disorder (PTSD),"Post-traumatic stress disorder (PTSD) is a prevalent and disabling disorder. Recognition of neurobiological abnormalities associated with this condition suggests the potential efficacy of medication in its treatment. Nevertheless, questions regarding the efficacy of medications remain, despite general endorsement by clinical practice guidelines of selective serotonin reuptake inhibitors (SSRIs) as first-line agents in treating PTSD. This paper reviews evidence from randomized controlled trials (RCTs) for the efficacy of acute and long-term pharmacotherapy for PTSD, including the treatment of refractory PTSD. In addition, we conducted a systematic meta-analysis to compare the efficacy of different medications in treating PTSD. The effects of methodological study features (including year of publication, duration, number of centres) and sample characteristics (proportion of combat veterans, gender composition) were also tested. The largest body of evidence for short- and long-term efficacy of medication currently exists for SSRIs, with promising initial findings for the selective noradrenergic reuptake inhibitor venlafaxine and the atypical antipsychotic risperidone. Treatment effect was predicted by number of centres and recency of the study, with little evidence that sample characteristics predicted response. Evidence for the effectiveness of benzodiazepines is lacking, despite their continued use in clinical practice. Finally, the α1 antagonist prazosin and the atypical antipsychotics show some efficacy in treatment-resistant PTSD. Adequately powered trials that are designed in accordance with best-practice guidelines are required to provide conclusive evidence of clinically relevant differences in efficacy between agents in treating PTSD, and to help estimate clinical and methodological predictors of treatment response.",0,0 +6760,Early cognitive status and productivity outcome after traumatic brain injury: findings from the TBI model systems.,"To evaluate the contribution of early cognitive assessment to the prediction of productivity outcome after traumatic brain injury (TBI) adjusted for severity of injury, demographic factors, and preinjury employment status.Inception cohort.Six inpatient brain injury rehabilitation programs.A total of 388 adults with TBI whose posttraumatic amnesia (PTA) resolved before discharge from inpatient rehabilitation.Administered neuropsychologic tests during inpatient stay on emergence from PTA. Follow-up interview and evaluation. Predictor measures also determined.Productivity status at follow-up 12 months postinjury.Multiple logistic regression analysis revealed that preinjury productivity status, duration of PTA, education level, and early cognitive status each made significant, independent contributions to the prediction of productivity status at follow-up. When adjusted for all other predictors, persons scoring at the 75th percentile on early cognitive status (less impaired) had 1.61 times greater odds (95% confidence interval [CI], 1.07-2.41) of being productive follow-up than those scoring at the 25th percentile (more impaired). Without adjustment, persons scoring at the 75th percentile had 2.46 times greater odds (95% CI, 1.77-3.43) of being productive at follow-up.Findings support the utility of early cognitive assessment by using neuropsychologic tests. In addition to other benefits, early cognitive assessment makes an independent contribution to prediction of late outcome. Findings support the clinical practice of performing initial neuropsychologic evaluations after resolution of PTA.",0,0 +6761,"What are the determinants of post-traumatic stress disorder: age, gender, ethnicity or other? Evidence from 2008 Wenchuan earthquake","To estimate the prevalence of post-traumatic stress disorder (PTSD) and assess determinants related to PTSD symptoms among adult earthquake survivors after the 2008 Wenchuan earthquake in China.Cross-sectional multicluster sample surveys with data collected from four counties.Surveys were conducted separately in four counties in Sichuan Province, with a total of 2004 respondents. Beichuan County and Dujiangyan City were damaged more severely than Yaan County and Langzhong County during the earthquake. In total, 1890 households were represented, with a mean of 2.2 respondents per household. Data were collected using structured interviews, and the Harvard Trauma Questionnaire and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria were used to diagnose PTSD.The prevalence rates of suspected PTSD were 47.3% (n = 436) in heavily damaged areas and 10.4% (n = 93) in moderately damaged areas. The prevalence rates of PTSD symptoms among elderly, middle aged and young adults were 55.8%, 50.2% and 28.6% (P = 0.001), respectively, in heavily damaged areas. Older age, female gender, unmarried/divorced/widowed, ethnic minority, death of family member, no household income and damaged household were independent risk factors for PTSD symptoms in heavily damaged areas.Interventions designed to reduce PTSD among populations affected by the 2008 earthquake should focus on people without household incomes, those with damaged households and those who experienced the death of a family member. Effective, sustainable and culturally sensitive psychosocial interventions and mental health services are required, and attention should be directed to survivors who experienced the death of a family member, women and older adults following the devastating natural disaster. Governments should support income-generating activities and improve living conditions. Trained field personnel can assist with PTSD assessments and referrals, and existing rural healthcare services can be used to provide treatment for common psychiatric disorders.",0,0 +6762,IQ and Posttraumatic Stress Symptoms in Children Exposed to Interpersonal Violence,"Background: The literature is mixed as to the relationship between intelligence quotient (IQ) and Posttraumatic Stress Disorder (PTSD) symptomatology in adult populations. Even less is known about the relationship in children who have been traumatized. Methods: Fifty-nine children and adolescents (mean age = 10.6) with a history of interpersonal violence were evaluated with respect to PTSD symptomatology, number of traumas, and estimated Verbal, Performance and Full scale IQ scores. PTSD symptomatology included symptom levels for cluster B (re-experiencing), cluster C (avoidance and numbing), and cluster D (Hypervigilance) and criterion F, functional impairment. Results: Results indicated that Full scale and Verbal IQ were significantly associated with the number of traumas, re-experiencing symptoms, and impairment. Performance IQ was only associated with impairment. Regression analyses suggested that together PTSD symptomatology predicted Full scale and Verbal IQ but nor Performance IQ and impairment was the single best predictor of IQ generally. Conclusions: Findings provide support for an association between PTSD symptoms and IQ, particularly verbal IQ. Two possible reasons for this relationship are that higher levels of Verbal IQ may serve as a premorbid protective factor against the development of re-experiencing symptoms, or performance on post-trauma Verbal IQ measures may be negatively impacted by expression of PTSD symptoms. Longitudinal studies are needed to clarify which of these two possibilities explains the association. (",0,0 +6763,Short communication: Alterations in expression of gluconeogenic genes during heat stress and exogenous bovine somatotropin administration,"Study objectives were to evaluate hepatic gluconeogenic enzyme gene expression in recombinant bovine somatotropin (rbST)-treated lactating dairy cattle during heat stress (HS) or in thermal-neutral, pair-fed (PF) animals. Twenty-two multiparous (99 d in milk, 656 kg of BW) Holstein cows were subjected to 3 consecutive experimental periods (7 d each): (1) thermal neutral, (2) HS or PF, and (3) HS or PF with rbST (Posilac, administered on d 1 of period 3). Liver biopsies were obtained on the final day of each period. Heat stress conditions progressively decreased dry matter intake for the first 5 to 6 d during period 2 before stabilizing (a decrease of 6.15 kg; 30%) on d 6 and 7, and feed intake remained stable and not different from period 2 during period 3. Cytosolic phosphoenolpyruvate carboxykinase mRNA abundance increased during PF, but was unaffected by HS or bST. Pyruvate carboxylase gene expression increased during HS and PF, and administering bST decreased pyruvate carboxylase mRNA abundance during both HS and PF. Insulin-like growth factor-I gene expression increased following bST administration during HS and PF, confirming hepatic bST responsiveness. Exposure to HS leads to a change in hepatic gluconeogenic enzyme profile that appears to be dependent on plane of nutrition.",0,0 +6764,Ketamine and suicidal ideation in depression: Jumping the gun?,"Depression and suicide are known to be intricately entwined but the neurobiological basis underlying this association is yet to be understood. Ketamine is an N-methyl d-aspartate (NMDA) receptor antagonist used for induction and maintenance of general anaesthesia but paradoxically its euphoric effects lead to its classification under drugs of abuse. The serendipitous finding of rapid-onset antidepressant action of subanaesthetic dosing with ketamine by intravenous infusion has sparked many preclinical and clinical investigations. A remarkable suppression of suicidal ideation was also reported in depressed patients. This review focuses on the clinical trials on ketamine that reported remedial effects in suicidal ideation in depression and addresses also the molecular mechanisms underlying the antidepressant and psychotomimetic actions of ketamine. The neuropsychiatric profile of subanaesthetic doses of ketamine encourages its use in the management of suicidal ideation that could avert emergent self-harm or suicide. Finally, the need for neuroimaging studies in suicidal patients to identify the brain region specific and temporal effects of ketamine, and the possibility of employing ketamine as an experimental tool in rodent-based studies to study the mechanisms underlying suicidal behaviour are highlighted.",0,0 +6765,Cortical Thinning in Patients with Recent Onset Post-Traumatic Stress Disorder after a Single Prolonged Trauma Exposure,"Most of magnetic resonance imaging (MRI) studies about post-traumatic stress disorder (PTSD) focused primarily on measuring of small brain structure volume or regional brain volume changes. There were rare reports investigating cortical thickness alterations in recent onset PTSD. Recent advances in computational analysis made it possible to measure cortical thickness in a fully automatic way, along with voxel-based morphometry (VBM) that enables an exploration of global structural changes throughout the brain by applying statistical parametric mapping (SPM) to high-resolution MRI. In this paper, Laplacian method was utilized to estimate cortical thickness after automatic segmentation of gray matter from MR images under SPM. Then thickness maps were analyzed by SPM8. Comparison between 10 survivors from a mining disaster with recent onset PTSD and 10 survivors without PTSD from the same trauma indicates cortical thinning in the left parietal lobe, right inferior frontal gyrus, and right parahippocampal gyrus. The regional cortical thickness of the right inferior frontal gyrus showed a significant negative correlation with the CAPS score in the patients with PTSD. Our study suggests that shape-related cortical thickness analysis may be more sensitive than volumetric analysis to subtle alteration at early stage of PTSD.",0,0 +6766,PRENATAL REFLECTIVE FUNCTIONING IN PRIMIPAROUS WOMEN WITH A HIGH-RISK PROFILE,ar,0,0 +6767,"Subsyndromal depression in the United States: prevalence, course, and risk for incident psychiatric outcomes","Background Subsyndromal depression (SD) may increase risk for incident major depressive and other disorders, as well as suicidality. However, little is known about the prevalence, course, and correlates of SD in the US general adult population. Method Structured diagnostic interviews were conducted to assess DSM-IV Axis I and II disorders in a nationally representative sample of 34 653 US adults who were interviewed at two time-points 3 years apart. Results A total of 11.6% of US adults met study criteria for lifetime SD at Wave 1. The majority (9.3%) had <5 total symptoms required for a diagnosis of major depression; the remainder (2.3%) reported ⩾5 symptoms required for a diagnosis of major depression, but denied clinically significant distress or functional impairment. SD at Wave 1 was associated with increased likelihood of developing incident major depression [odds ratios (ORs) 1.72–2.05], as well as dysthymia, social phobia, and generalized anxiety disorder (GAD) at Wave 2 (ORs 1.41–2.92). Among respondents with SD at Wave 1, Cluster A and B personality disorders, and worse mental health status were associated with increased likelihood of developing incident major depression at Wave 2. Conclusions SD is prevalent in the US population, and associated with elevated rates of Axis I and II psychopathology, increased psychosocial disability, and risk for incident major depression, dysthymia, social phobia, and GAD. These results underscore the importance of a dimensional conceptualization of depressive symptoms, as SD may serve as an early prognostic indicator of incident major depression and related disorders, and could help identify individuals who may benefit from preventive interventions.",0,0 +6768,Clinician-administered PTSD scale: A review of the first ten years of research,"The Clinician-Administered PTSD Scale (CAPS) is a structured interview for assessing posttraumatic stress disorder (PTSD) diagnostic status and symptom severity. In the 10 years since it was developed, the CAPS has become a standard criterion measure in the field of traumatic stress and has now been used in more than 200 studies. In this paper, we first trace the history of the CAPS and provide an update on recent developments. Then we review the empirical literature, summarizing and evaluating the findings regarding the psychometric properties of the CAPS. The research evidence indicates that the CAPS has excellent reliability, yielding consistent scores across items, raters, and testing occasions. There is also strong evidence of validity: The CAPS has excellent convergent and discriminant validity, diagnostic utility, and sensitivity to clinical change. Finally, we address several concerns about the CAPS and offer recommendations for optimizing the CAPS for various clinical research applications.",0,0 +6769,"Posttraumatic Stress Disorder Following Ethnoreligious Conflict in Jos, Nigeria","In September 2001, ethnoreligious rioting occurred in Jos, Nigeria. Using a multistage cluster sampling technique, 290 respondents were recruited in Jos 7 to 9 months after the riots. Data were collected regarding demographics, exposure to traumatic events, and psychological symptoms. Resting pulse and blood pressure were recorded. A total of 145 (52.5%) witnessed or were victims of personal attacks, 165 (59.6%) lost their possessions, 56 (20.7%) had their homes burned, 44 (16.2%) witnessed relatives' deaths, and 8 (2.9%) were robbed. A total of 252 (89.7%) of the respondents met reexperiencing criteria, 138 (49.1%) met avoidance criteria, and 236 (84.0%) met arousal criteria for posttraumatic stress disorder (PTSD). A total of 116 (41%, 95% confidence interval [CI] = 36% to 47%) met all three categories for PTSD. Only personal attacks (adjusted odds ratio = 2.8, 95% CI = 1.7 to 4.7) and a heart rate of 90 beats/min or more (adjusted odds ratio = 2.8, 95% CI = 1.4 to 5.8) were significantly related to PTSD in a multivariate model.",0,0 +6770,Introduction to the Special Issue: Posttraumatic Stress Related to Pediatric Illness and Injury,"doi:10.1093/jpepsy/jsj052 Advance Access publication August 3, 2005 Journal of Pediatric Psychology vol. 31 no. 4 © The Author 2005. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oupjournals.org Introduction to the Special Issue: Posttraumatic Stress Related to Pediatric Illness and Injury",0,0 +6771,"Personality Characterizations of Outpatients With Schizophrenia, Schizophrenia With Substance Abuse, and Primary Substance Abuse","The study extended previous research on the relationship between personality traits and Axis I disorders. It examined personality differences between individuals diagnosed with schizophrenia and substance abuse and also included individuals dually diagnosed with both schizophrenia and substance abuse. Comparisons were made with respect to characteristics of both normal personality, as measured by the NEO Five-Factor Inventory (NEO-FFI), and disordered personality, as measured by the Millon Multiaxial Personality Inventory. On the NEO-FFI, all groups differed significantly from the NEO-FFI normative sample on at least three personality domains. As predicted, the dual diagnosis group showed the most personality deviance and pathology. The schizophrenia group was primarily distinguished by higher levels of agreeableness, whereas the substance abuse group was more extroverted and showed a prominence of Cluster B personality patterns. An unexpected finding was an interaction between diagnostic group and age, such that older relative to younger individuals in the single diagnosis groups showed greater personality adaptivity and moderation, whereas older individuals in the dual diagnosis group showed less.",0,0 +6772,Treatment and Prevention of Posttraumatic Stress Reactions in Children and Adolescents Exposed to Disasters and Terrorism: What Is the Evidence?,"Youth who are exposed to devastating natural disasters or terrorist attacks report high levels of posttraumatic stress (PTS) and may develop posttraumatic stress disorder (PTSD). This article summarizes evidence on the treatment of PTS reactions in these youth and describes interventions developed for the immediate aftermath of the event, the short-term recovery and rebuilding phase, or the long-term recovery phase. Psychological first aid and evidence-based psychoeducational materials show promise for the early phases of postdisaster recovery. For youth with persistent PTSD, cognitive-behavioral interventions appear promising but require further study. Children and adolescents exposed to disasters and acts of terrorism may need multicomponent interventions because their reactions are often multifaceted and often include other psychological problems.",0,0 +6773,Stress-related genomic responses during the course of heat acclimation and its association with ischemic-reperfusion cross-tolerance,"Acclimation to heat is a biphasic process involving a transient perturbed phase followed by a long lasting period during which acclimatory homeostasis is developed. In this investigation, we used cDNA stress microarray (Clontech Laboratory) to characterize the stress-related genomic response during the course of heat acclimation and to test the hypotheses that 1) heat acclimation influences the threshold of activation of protective molecular signaling, and 2) heat-acclimation-mediated ischemic-reperfusion (I/R) protection is coupled with reprogrammed gene expression leading to altered capacity or responsiveness of protective-signaling pathways shared by heat and I/R cytoprotective systems. Rats were acclimated at 34°C for 0, 2, and 30 days. 32 P-labeled RNA samples prepared from the left ventricles of rats before and after subjection to heat stress (HS; 2 h, 41°C) or after I/R insult (ischemia: 75%, 45 min; reperfusion: 30 min) were hybridized onto the array membranes. Confirmatory RT-PCR of selected genes conducted on samples taken at 0, 30, and 60 min after HS or total ischemia was used to assess the promptness of the transcriptional response. Cluster analysis of the expressed genes indicated that acclimation involves a “two-tier” defense strategy: an immediate transient response peaking at the initial acclimating phase to maintain DNA and cellular integrity, and a sustained response, correlated with slowly developed adaptive, long-lasting cytoprotective signaling networks involving genes encoding proteins that are essential for the heat-shock response, antiapoptosis, and antioxidation. Gene activation was stress specific. Faster activation and suppression of signaling pathways shared by HS and I/R stressors probably contribute to heat-acclimation I/R cross-tolerance.",0,0 +6774,Low platelet-poor plasma concentrations of serotonin in patients with combat-related posttraumatic stress disorder,"

Abstract

Background: Combat-related posttraumatic stress disorder (CR-PTSD) is associated with a dysregulation of various neurotransmitter systems. Methods: We assessed levels of platelet-poor plasma (PPP) norepinephrine (NE), and serotonin (5-HT), and 24-hour urinary excretion of NE, dopamine (DA), and homovanillic acid (HVA) in 17 male outpatients with untreated chronic CR-PTSD (age, 33.1 ± 7.4 years) and 10 normal control subjects (age, 35.8 ± 2.7 years). Results: Compared with the control subjects, the PTSD patients showed significantly lower PPP 5-HT levels, elevated PPP NE levels, and significantly higher mean 24-hour urinary excretion of all three catecholamines (NE, DA, and HVA). The 24-hour urinary HVA values of the CR-PTSD patients correlated significantly and positively with the total Impact of Event Scale scores and the avoidance symptoms cluster scores, and the PPP 5-HT levels correlated negatively with the Hamilton Anxiety Rating Scale scores. The PPP NE/5-HT ratio was significantly higher in the study group than in the control subjects. Conclusions: We believe this combined enhanced noradrenergic activity and diminished 5-HT activity may be relevant to the neurobiology of CR-PTSD.",0,0 +6775,A controlled study of internalizing symptoms in older adolescents with sickle cell disease,"Due to the ongoing medical challenges we hypothesized that older adolescents with sickle cell disease (SCD) would report greater rates of internalizing symptoms and diagnoses. This study is a follow-up to a previous study [1] that found few differences between the emotional well-being of children ages 8-15 with SCD and comparison peers. Our aim is to re-assess internalizing symptoms of youth with SCD and comparison peers at age 18.At follow-up, trained staff members administered semi-structured psychiatric interviews and widely use behavioral health questionnaires to adolescents with SCD (n = 48), their comparison peers (COMP; n = 51) and a caregiver. Mood, internalizing symptoms and diagnoses, were evaluated cross-sectionally at the follow-up (age 18).Psychiatric interview data showed that COMP reported more phobias relative to adolescents with SCD; no significant differences were reported for any other current symptoms (depression, anxiety, or mania). Questionnaire data showed all scores in the normal range with two significant differences: older adolescents with SCD reported more symptoms of tension-anxiety and fatigue-inertia. Both groups reported significant rates of internalizing disorders with 31% of youth with SCD and 35% of COMP having a DSM-IV diagnosis.Psychiatric interview data for both groups of older adolescents suggested considerable psychopathology; questionnaire data for both groups were in the normal range. We report few significant differences-more phobias in comparisons peers; more tension-anxiety and fatigue-inertia reported by youth with SCD. The overall findings suggest considerable resilience for youth with SCD, but both groups of adolescents report significant rates of psychopathology similar to national rates.",0,0 +6776,Beyond resilience and PTSD: Mapping the heterogeneity of responses to potential trauma.,"The formal acceptance of posttraumatic stress disorder (PTSD) as a legitimate diagnostic category in the1980 Diagnostic and Statistical Manual of Mental Disorders stimulated a torrent of research onpsychological trauma. Not surprisingly, PTSD and its treatment had dominated that research. Anothercommon approach has been to measure the average impact of different potentially traumatic events, aswell as the factors that inform that impact. In this article, we consider the limitations of these perspectivesand argue for a broader theoretical approach that takes into account the natural heterogeneity of traumareactions over time. To that end, we review recent attempts to identify prototypical patterns or trajectoriesof trauma reaction that include chronic dysfunction, but also delayed reactions, recovery, and psycho-logical resilience. We consider the advantages but also the limitations and ongoing controversiesassociated with this approach. Finally, we introduce promising new research that uses relative sophis-ticated advances in latent growth mixture modeling as a means of empirically mapping the heterogeneityof trauma responses and consider some of the implications of this approach for existing trauma theories.Keywords: resilience, PTSD, trauma trajections, grief",0,0 +6777,Neurobiology of Memory and Dissociation in Trauma Survivors,Abstract: This symposium examines the neurobiology of memory and dissociation in traumatized individuals. Several paradigms are presented that investigate the specific nature of differences in “remembering” in relation to neuroendocrine profiles among those with and without posttraumatic stress disorder (PTSD). These lines of research may help to clarify the paradox of distortion or absence of some memories and enhancement of others in PTSD.,0,0 +6778,Analysis of heart rate variability in posttraumatic stress disorder patients in response to a trauma-related reminder,"

Abstract

Background: Spectral analysis of heart rate variability has recently been shown to be a reliable noninvasive test for quantitative assessment of cardiovascular autonomic regulatory responses, providing a dynamic map of sympathetic and parasympathetic interaction. In a prior study exploring the state of hyperarousal characterizing the posttraumatic stress disorder (PTSD) syndrome, the authors described standardized heart rate analysis carried out in 9 PTSD patients at rest, which demonstrated clear-cut evidence of a baseline autonomic hyperarousal state. Methods: To examine the dynamics of this hyperarousal state, standardized heart rate analysis was carried out in 9 PTSD patients compared to a matched control group of 9 healthy volunteers. Twenty-minute recordings of electrocardiogram in response to a trauma-related cue as opposed to a resting state were performed and analyzed. The PTSD patients were asked to recount the presumed triggering traumatic event, and the control subjects recounted a significant stressful negative life event. Results: Our results show that, whereas the control subjects demonstrated significant autonomic responses to the stressogenic stimulus supplied by the recounting of a major stressful experience, the PTSD patients demonstrated almost no autonomic response to the recounting of the triggering stressful event. The PTSD patients demonstrated a degree of autonomic dysregulation at rest which was comparable to that seen in the control subjects' reaction to the stress model. Conclusions: The lack of response to the stress model applied in the study appears to imply that PTSD patients experience so great a degree of autonomic hyperactivation at rest, that they are unable to marshal a further stress response to the recounting of the triggering trauma, as compared to control subjects.",0,0 +6779,Adult sexual abuse is associated with elevated neurohormone levels among women with PTSD due to childhood sexual abuse,"Posttraumatic stress disorder (PTSD) has been associated with reduced, similar, or increased urinary cortisol levels. The authors identified a factor that might contribute to such variability when they obtained 24-hour urinary neurohormone profiles on 69 women with PTSD due to childhood sexual abuse. Half (n = 35) had subsequently experienced adult sexual abuse (ASA) while the other half (n = 34) had not. The ASA group had significantly elevated urinary cortisol, norepinephrine and dopamine levels in comparison to the non-ASA group. Neither a history of childhood or adult physical abuse nor other variables contributed to this finding. The results suggest that the psychobiological consequences of exposure to the same traumatic event may differ as a result of an interaction between age and the composite history of trauma exposure.",0,0 +6780,Role of GABA in anxiety and depression,"This review assesses the parallel data on the role of gamma-aminobutyric acid (GABA) in depression and anxiety. We review historical and new data from both animal and human experimentation which have helped define the key role for this transmitter in both these mental pathologies. By exploring the overlap in these conditions in terms of GABAergic neurochemistry, neurogenetics, brain circuitry, and pharmacology, we develop a theory that the two conditions are intrinsically interrelated. The role of GABAergic agents in demonstrating this interrelationship and in pointing the way to future research is discussed.",0,0 +6781,Posttraumatic Stress Symptoms after Exposure to Two Fire Disasters: Comparative Study,"This study investigated traumatic stress symptoms in severely burned survivors of two fire disasters and two comparison groups of patients with ""non-disaster"" burn injuries, as well as risk factors associated with acute and chronic stress symptoms. Patients were admitted to one out of eight burn centers in The Netherlands or Belgium. The Impact of Event Scale (IES) was administered to 61 and 33 survivors respectively of two fire disasters and 54 and 57 patients with ""non-disaster"" burn etiologies at 2 weeks, 3, 6, 12 and 24 months after the event. We used latent growth modeling (LGM) analyses to investigate the stress trajectories and predictors in the two disaster and two comparison groups. The results showed that initial traumatic stress reactions in disaster survivors with severe burns are more intense and prolonged during several months relative to survivors of ""non-disaster"" burn injuries. Excluding the industrial fire group, all participants' symptoms on average decreased over the two year period. Burn severity, peritraumatic anxiety and dissociation predicted the long-term negative outcomes only in the industrial fire group. In conclusion, fire disaster survivors appear to experience higher levels of traumatic stress symptoms on the short term, but the long-term outcome appears dependent on factors different from the first response. Likely, the younger age, and several beneficial post-disaster factors such as psychosocial aftercare and social support, along with swift judicial procedures, contributed to the positive outcome in one disaster cohort.",1,0 +6782,Assessing impact of differential symptom functioning on post-traumatic stress disorder (PTSD) diagnosis,"This article explores the generalizability of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic criteria for post-traumatic stress disorder (PTSD) to various subpopulations. Besides identifying the differential symptom functioning (also referred to as differential item functioning [DIF]) related to various background variables such as gender, marital status and educational level, this study emphasizes the importance of evaluating the impact of DIF on population inferences as made in health surveys and clinical trials, and on the diagnosis of individual patients. Using a sample from the National Comorbidity Study-Replication (NCS-R), four symptoms for gender, one symptom for marital status, and three symptoms for educational level were significantly flagged as DIF, but their impact on diagnosis was fairly small. We conclude that the DSM-IV diagnostic criteria for PTSD do not produce substantially biased results in the investigated subpopulations, and there should be few reservations regarding their use. Further, although the impact of DIF (i.e. the influence of differential symptom functioning on diagnostic results) was found to be quite small in the current study, we recommend that diagnosticians always perform a DIF analysis of various subpopulations using the methodology presented here to ensure the diagnostic criteria is valid in their own studies.",0,0 +6783,Long-Term Trajectories and Service Needs for Military Families,"The deployment of US military personnel to recent conflicts has been a significant stressor for their families; yet, we know relatively little about the long-term family effects of these deployments. Using data from prior military service eras, we review our current understanding of the long-term functioning and needs of military families. These data suggest that overseas deployment, exposure to combat, experiencing or participating in violence during war deployment, service member injury or disability, and combat-related post-traumatic stress disorder (PTSD) all have profound impacts on the functioning of military families. We offer several recommendations to address these impacts such as the provision of family-centered, trauma-informed resources to families of veterans with PTSD and veterans who experienced high levels of combat and war violence. Recent efforts to address the needs of caregivers of veterans should be evaluated and expanded, as necessary. We should also help military families plan for predictable life events likely to challenge their resilience and coping capacities. Future research should focus on the following: factors that mediate the relationship between PTSD, war atrocities, caregiver burden, and family dysfunction; effective family-centered interventions that can be scaled-up to meet the needs of a dispersed population; and system-level innovations necessary to ensure adequate access to these interventions. © 2013 Springer Science+Business Media New York.",0,0 +6784,Posttraumatic stress symptom severity and inflammatory processes in midlife women.,"This cross-sectional study examined associations between current (last 30 days) and past (worst lifetime episode) posttraumatic stress (PTS) symptom severity and two markers of inflammation - circulating C-reactive protein and interleukin-6 (IL-6) - along with in vitro IL-6 production by stimulated peripheral blood mononuclear cells. Healthy, midlife women attended two research visits where a blood draw was followed by either benign questionnaires (visit 1, baseline), or questionnaires and an interview to assess traumatic events and PTS symptoms (visit 2, trauma assessment). All women, but one, were negative for current syndromal posttraumatic stress disorder (PTSD); 13 women (20%) met criteria for past syndromal PTSD. There were no statistically significant associations between current PTS symptoms and biological measures. In contrast, there was a statistically significant past PTS symptom severity × Visit interaction for circulating IL-6 levels. At visit 1 only (baseline), past symptom severity was significantly, negatively associated with IL-6 levels. Further, when past symptom severity reached syndromal levels, IL-6 levels were significantly higher at visit 2 (trauma assessment) than visit 1 (baseline). These results contribute to an emerging literature showing that PTSD and its symptoms are not always associated with a proinflammatory profile. They also raise the possibility that, in the context of severe past PTS symptoms, circulating IL-6 levels may be sensitive to confronting trauma reminders. © 2012 American Psychological Association.",0,0 +6785,Does Acute Stress Disorder Predict Posttraumatic Stress Disorder Following Bank Robbery?,"Unfortunately, the number of bank robberies is increasing and little is known about the subsequent risk of posttraumatic stress disorder (PTSD). Several studies have investigated the prediction of PTSD through the presence of acute stress disorder (ASD). However, there have only been a few studies following nonsexual assault. The present study investigated the predictive power of different aspects of the ASD diagnosis and symptom severity on PTSD prevalence and symptom severity in 132 bank employees. The PTSD diagnosis, based on the three core symptom clusters, was best identified using cutoff scores on the Acute Stress Disorder scale. ASD severity accounted for 40% and the inclusion of other risk factors accounted for 50% of the PTSD severity variance. In conclusion, results indicated that ASD appears to predict PTSD differently following nonsexual assault than other trauma types. ASD severity was a stronger predictor of PTSD than ASD diagnosis.",0,0 +6786,Children in Poverty: Resilience Despite Risk,"Two objectives provided the focus for the Conference on Community Violence and Children's Development that was jointly sponsored by the National Institute of Mental Health and the John D. and Catherine T. MacArthur Foundation. One was to examine the evidence for deficit behaviors that characterized children reared in poverty; the second was to identify the characteristics of children who sustained their competencies despite being reared in comparable environments. These dual objectives took this form: ""What can we conclude from studies of children, their families, and environments about characteristics that predispose children to maladjustment following exposure to violence, and about characteristics that protect children from such adjustment problems following, or in the midst of, violence exposure?""",0,0 +6787,Posttraumatic stress disorder symptoms in cancer: psychometric analysis of the Spanish Posttraumatic Stress Disorder Checklist-Civilian version,"The PTSD Checklist-Civilian version (PCL-C) was used as a screening tool to assess the presence of PTSD symptoms. The aim of this study was to explore the factorial structure of the Spanish version of the PCL-C and calculate the correlation of PTSD symptoms with distress and health-related quality of life.The sample included 494 cancer outpatients. In order to validate the PCL-C, a principal component analysis was applied. The association between variable was measured by Pearson correlation.Findings evidenced three symptoms clusters on the PCL-C version, defined as Hyperarousal/Re-experiencing, Numbing and Avoidance. About 10% of the total sample met clinical PTSD symptoms. In addition, PTSD symptoms were related negatively to health-related quality of life and positively related with distress.The conceptualization of PTSD symptoms for cancer patients is supported by the specific symptom clusters identified on PCL-C.",0,0 +6788,Understanding the pattern of PTSD symptomatology: a comparison of between versus within-group approaches,"This report examines the influence of statistical approach on patterns of Posttraumatic Stress Disorder (PTSD). In this report, 114 women and 51 men were assessed using both the Clinician Administered PTSD Scale (CAPS) and the Posttraumatic Symptom Scale-Self Report measure (PSS-SR). Data were examined using both a between-group and a within-group design. In the between-group approach, three subsamples were formed, representing full syndrome PTSD (fPTSD), partial PTSD (pPTSD), and no PTSD. The fPTSD and pPTSD groups differed on total scores on both PTSD measures, although differences were noted between clinician and self-report measures in specific symptom clusters. In the within-group approach, curve estimation techniques were used to examine linear versus quadratic fit of the data, utilizing the sample as a whole, ranked according to a separate scale of clinical severity. A linear approach was noted for each measure. Results are discussed in light of current design choices in the literature and its impact on the understanding of post-trauma problems.",0,0 +6789,What explains post-traumatic stress disorder (PTSD) in UK service personnel: deployment or something else?,"Background In previous studies an association between deployment to Iraq or Afghanistan and an overall increased risk for post-traumatic stress disorder (PTSD) in UK armed forces has not been found. The lack of a deployment effect might be explained by including, in the comparison group, personnel deployed on other operations or who have experienced traumatic stressors unrelated to deployment. Methods The sample comprised 8261 regular UK armed forces personnel who deployed to Iraq, Afghanistan or other operational areas or were not deployed. Participants completed the PTSD CheckList – Civilian Version (PCL-C) and provided information about deployment history, demographic and service factors, serious accidents and childhood experiences. Results Deployment to Iraq or Afghanistan [odds ratio (OR) 1.2, 95% confidence interval (CI) 0.6–2.2] or elsewhere (OR 1.1, 95% CI 0.6–2.0) was unrelated to PTSD although holding a combat role was associated with PTSD if deployed to Iraq or Afghanistan (OR 2.7, 95% CI 1.9–3.9). Childhood adversity (OR 3.3, 95% CI 2.1–5.0), having left service (OR 2.7, 95% CI 1.9–4.0) and serious accident (OR 2.1, 95% CI 1.4–3.0) were associated with PTSD whereas higher rank was protective (OR 0.3, 95% CI 0.12–0.76). Conclusions For the majority of UK armed forces personnel, deployment whether to Iraq, Afghanistan or elsewhere confers no greater risk for PTSD than service in the armed forces per se but holding a combat role in those deployed to Iraq or Afghanistan is associated with PTSD. Vulnerability factors such as lower rank, childhood adversity and leaving service, and having had a serious accident, may be at least as important as holding a combat role in predicting PTSD in UK armed forces personnel.",0,0 +6790,Cyclic adenosine monophosphate responsive element binding protein in post-traumatic stress disorder,"The cyclic adenosine monophosphate responsive element binding (CREB) protein is a transcription factor involved in different neural processes, such as learning, neuroplasticity and the modulation of stress response. Alterations in the CREB pathway have been observed in the brains and lymphocytes of patients affected by depression and alcohol abuse. Given the lack of information, our study aimed at investigating the levels of total and activated CREB protein in lympho-monocytes of 20 drug-free patients suffering from post-traumatic stress disorders (PTSD), as compared with 20 healthy control subjects.Blood samples were collected from patients and healthy control subjects on the same time and lympho-monocytes were isolated according to standardized methods. CREB protein levels and activation were measured by means of immunoenzymatic techniques.The results showed that PTSD patients had statistically lower levels of total CREB protein in lympho-monocytes than healthy control subjects. On the contrary, no difference in the activated CREB protein was detected.These findings, albeit preliminary, would suggest that the CREB pathway might be involved in the pathophysiology of PTSD. Future studies should clarify if specific PTSD symptom clusters might be related to the CREB pathway.",0,0 +6791,Prospective investigation of the impact of cannabis use disorders on posttraumatic stress disorder symptoms among veterans in residential treatment.,"This investigation sought to provide the first prospective examination of the association between the presence of a current cannabis use disorder (CUD) diagnosis and changes in posttraumatic stress disorder (PTSD) symptoms over time after discontinuation, after accounting for the theoretically relevant effects of age, trauma severity, psychological distress, and co-occurring substance use disorders. The study was longitudinal and assessed clinical patients at two time points: residential PTSD treatment intake and discharge. The sample consisted of 260 male combat-exposed military veteran patients (Mage-52.57 years, SD-5.47) admitted to a Veterans Affairs residential rehabilitation program for PTSD between 2000 and 2008. Diagnoses were obtained using the Structured Clinical Interview for DSM-IV, and PTSD outcomes were determined by the PTSD Checklist-Military Version. Results indicate that the presence of a CUD diagnosis was significantly predictive of lower levels of change (between treatment intake and discharge) in PTSD symptom severity as well as PTSD avoidance-numbing and hyperarousal symptom cluster severity (all ps-.05). This study presents the first evidence of a prospective relation between problematic cannabis use and PTSD symptoms, indicating that individuals with a CUD are likely to experience lower levels of change in PTSD symptoms over time, within the context of discontinuation owing to residential PTSD treatment. © 2011 American Psychological Association.",0,0 +6792,Loving-Kindness in the Treatment of Traumatized Refugees and Minority Groups: A Typology of Mindfulness and the Nodal Network Model of Affect and Affect Regulation,"This article discusses how loving-kindness can be used to treat traumatized refugees and minority groups, focusing on examples from our treatment, culturally adapted cognitive-behavioral therapy (CA-CBT). To show how we integrate loving-kindness with other mindfulness interventions and why loving-kindness should be an effective therapeutic technique, we present a typology of mindfulness states and the Nodal Network Model (NNM) of Affect and Affect Regulation. We argue that mindfulness techniques such as loving-kindness are therapeutic for refugees and minority populations because of their potential for increasing emotional flexibility, decreasing rumination, serving as emotional regulation techniques, and forming part of a new adaptive processing mode centered on psychological flexibility. We present a case to illustrate the clinical use of loving-kindness within the context of CA-CBT.",0,0 +6793,"Anxiety disorders and major depression, together or apart","This paper will discuss the relationship between anxiety and depression. We will begin with a brief historical perspective. We will then move into the twentieth century, with a focus on the 1950s, at which time the introduction of pharmacological treatment options revolutionized the field of psychiatry. The use of psychiatric medications and the observation of treatment response provided an additional means of understanding the relationship between anxiety and depression. From the late 1970s to the 1990s, it became apparent that various medications possessed wider therapeutic profiles than were previously recognized. For example, many medications were found to be efficacious in both anxiety and depressive disorders. These expanded therapeutic profiles provided additional clues to fuel our thinking about the relationship between anxiety and depression. The two major objectives of this paper are, first, to describe and formalize a process of pharmacological dissection and, second, to consider how this process might contribute to our search for a better understanding of the relationship between anxiety and depression.",0,0 +6794,Posttraumatic Stress Symptoms in Children of Mothers Diagnosed with Breast Cancer,"There are inconsistent findings regarding whether a mother's diagnosis of cancer affects her child's psychological health. The aim of this study was to compare maternally perceived symptoms of posttraumatic stress disorder (PTSD) in children of women with and without breast cancer. Forty mothers with breast cancer (assessed within 8 weeks of diagnosis) and 39 mothers without breast cancer were administered the Child Behavior Checklist (CBCL/6-18), UCLA Post Traumatic Stress Disorder (PTSD) Index, and Patient Health Questionnaire (PHQ-9). Descriptive discriminant analysis revealed that mothers with cancer perceived their children to have significantly greater symptoms of PTSD and internalizing distress than the mothers without cancer. No significant difference was found in maternal perception of externalizing symptoms in their children. Results revealed the importance of the assessment of PTSD in children whose mothers have cancer and the discussion includes implications for future research and clinical interventions.",0,0 +6795,Allostasis: The emperor of all (trauma‐related) maladies.,"The construct of allostasis is defined as change in the functioning of biological systems as a result of prolonged exposure to stress. In this article, the construct of bio-behavioral allostasis is proposed to describe peri-traumatic, shorter-term, and chronic changes in neurobiological systems and behaviors that account for the development and long-term maintenance of posttraumatic stress disorder (PTSD) symptoms and associated clinical features. The conceptual framework of bio-behavioral allostasis is applied to generate hypotheses about how premorbid vulnerabilities in different neurobiological systems interact with allostasis to predict heterogeneity in PTSD clinical profiles and patterns of comorbidity likely to develop after trauma exposure. The model offers a means by which to integrate independent theories of PTSD etiology to more fully account for unique features of PTSD, thereby improving its diagnostic discriminant validity. It also enables the identification of symptoms common across disorders that develop during exposure to adverse environments. Conceptualizing PTSD as a process of dynamic allostasis can advance our understanding of trauma-related diagnostic syndromes and inform the development of comprehensive treatments.",0,0 +6796,"Posttraumatic Stress, Problem Drinking, and Functional Outcomes After Injury","Patients undergoing trauma surgery for injury who have subsequent posttraumatic stress disorder (PTSD) or problem drinking will demonstrate significant impairments in functional outcomes compared with patients without these disorders.Prospective cohort study.Level I academic trauma center.One hundred one randomly selected survivors of intentional and unintentional injuries were interviewed while hospitalized and again 1 year later. The investigation achieved a 73% 1-year follow-up rate.Posttraumatic stress disorder was assessed with the Post-traumatic Stress Disorder Checklist and problem drinking was assessed with the Alcohol Use Disorder Identification Test. Functional status was assessed with the Medical Outcomes Study 36-Item Short-Form Health Survey.One year after injury, 30% of patients (n = 22) met symptomatic criteria for PTSD and 25% (n = 18) had Alcohol Use Disorder Identification Test scores indicative of problem drinking. Patients with PTSD demonstrated significant adverse outcomes in 7 of the 8 domains of the Medical Outcomes Study 36-Item Short-Form Health Survey compared with patients without PTSD. In multivariate models that adjusted for injury severity, chronic medical conditions, age, sex, preinjury physical function, and alcohol use, PTSD remained the strongest predictor of an adverse outcome. Patients with problem drinking did not demonstrate clinically or statistically significant functional impairment compared with patients without problem drinking.Posttraumatic stress disorder persisted in 30% of patients 1 year after traumatic injury and was independently associated with a broad profile of functional impairment. The development of treatment intervention protocols for trauma patients with PTSD is warranted.",0,0 +6797,An examination of the synergy of pain and PTSD on quality of life: Additive or multiplicative effects?,"Although models have been proposed to explain common factors that maintain comorbid pain and PTSD [Sharp TJ, Harvey AG. Chronic pain and posttraumatic stress disorder: mutual maintenance? Clin Psychol Rev 2001; 21: 857-77], the exact nature of the relationship between these two conditions and their impact on quality of life (QOL) is unknown. The aim of the present investigation was to examine the unique and interactive effects of PTSD and pain on role functioning and life satisfaction--two important domains of QOL. The study utilized a help-seeking sample of motor vehicle accident (MVA) survivors whose accidents resulted in symptoms of comorbid PTSD and pain (N=192). Hierarchical regression models were used to examine the relationship between four PTSD symptom clusters, pain, and the interaction of each cluster and pain on role functioning and life satisfaction separately. Results of these analyses revealed a significant interaction of pain and emotional numbing on role functioning, suggesting a multiplicative effect on this domain of QOL. Decomposition of this interaction revealed a negative association between numbing and functioning at low levels of pain but no relationship at higher levels. A marginal interaction of pain and hyperarousal also was noted for life satisfaction. Decomposition of the interaction effect revealed a marginal association between hyperarousal and decreased satisfaction only at high levels of pain. A main effect of emotional numbing on decreased life satisfaction also was observed in this model, suggesting a unique influence of numbing. The results of the current research indicate that the synergistic relationship of pain and PTSD may vary across domains of QOL.",0,0 +6798,Initial Patterns of Clinical Care and Recovery From Whiplash Injuries,"Little is known about the most effective pattern of clinical care for acute whiplash. We designed a cohort study to determine whether patterns of early clinical care (involving visits to general practitioners, chiropractors, or specialists) were associated with different rates of recovery.We studied 2486 Saskatchewan adults with whiplash injuries. We defined 8 initial patterns of care that integrated type of provider and number of visits. We used multivariable Cox models to estimate the association between patterns of care and time to recovery while controlling for injury severity and other confounders.There was an independent association between the type and intensity of initial clinical care and time to recovery. We found that patients in the low-utilization general practitioner group had the fastest recovery, even after controlling for injury severity and other confounders. Compared with this group, the high-utilization general practitioner group experienced a 1-year rate of recovery that was 27% slower (adjusted hazard rate ratio [HRR], 0.73; 95% confidence interval [CI], 0.61-0.87); for the high-utilization chiropractic group it was 39% slower (HRR, 0.61; 95% CI, 0.46-0.81); for the high-utilization general practitioner plus chiropractic combined group it was 28% slower (HRR, 0.72; 95% CI, 0.57-0.91); and for those who consulted general practitioners and specialists, it was 31% slower (HRR, 0.69; 95% CI, 0.55-0.87).The type and intensity of clinical care initiated within the first month after the injury is associated with the rate of recovery from whiplash injuries. Our study does not support the hypothesis that early aggressive care promotes faster recovery.",0,0 +6799,EPIDEMIOLOGIC RESEARCH ON INTERPERSONAL VIOLENCE AND COMMON PSYCHIATRIC DISORDERS: WHERE DO WE GO FROM HERE?,"BACKGROUND Interpersonal violence is one of the major causes of death and disability worldwide.[1] For every death, many more people are exposed to nonfatal violence: for example, in national, population-based surveys, estimates of violence exposure before age 18 range from 14.0% for family violence,[2,3] 49.6–53.1% for physical assault, 6.7–8% for sexual victimization, and 24.8–29.7% for community violence.[4] Several major studies and reviews have identified interpersonal violence as a leading contributor to common forms of psychopathology, including depression, anxiety, and substance abuse.[5–7] In the past 20 years, longitudinal studies on violence and psychopathology have proliferated.However, important methodological issues remain that may affect the validity of inferences that may be drawn from the existing data, including confounding by previolence psychiatric disorders, selection bias, limitations to causal inference inherent to observational studies, and a need to consider the evolution of violence exposures and violence across key life stages. As we consolidate current evidence and consider how to move forward in research on the mental health implications of violence, it is worthwhile to examine how these methodological issues affect interpretations of the current literature. In this review, we examine current research on the relationship between interpersonal violence and three of the most common psychiatric disorders: depression, anxiety, and substance abuse. We focus on these disorders due to the important public health burden they place on the population: according",0,0 +6800,Application of the stressor vulnerability model to understanding posttraumatic stress disorder (PTSD) and alcohol-related problems in an undergraduate population.,"Research examining the comorbidity of posttraumatic stress disorder (PTSD) and alcohol-use disorder (AUD) suggests that individuals experiencing PTSD symptoms (PTSS) often drink alcohol as a means to self-medicate their trauma symptoms; however, little attention has been given to moderating variables that may make this association more likely. The stressor vulnerability model proposes that being male, relying on maladaptive forms of coping, and holding positive alcohol-outcome expectancies predispose individuals to engage in alcohol use when experiencing psychological distress. In the current study, sex, avoidance coping (AVC), tension-reduction expectancies (TRE), and emotional-relief drinking-refusal self-efficacy (ERDRSE) were examined as moderators of the relationship between PTSS and alcohol-related problems in a sample of 144 undergraduates. Results indicated that males reporting high levels of TRE exhibited a stronger positive relationship between PTSS and alcohol-related problems than was present for males reporting low levels of TRE and for females reporting either high or low levels of TRE. In addition, a significant positive relationship between PTSS and alcohol-related problems was observed for individuals reporting high levels of TRE and low levels of ERDRSE, but not for individuals reporting high levels of TRE and high levels of ERDRSE, low TRE-low ERDRSE, or low TRE-high ERDRSE. Assessment of these vulnerability factors in traumatized youth and young adults may serve as a useful means of identifying individuals at risk for the development of alcohol-related problems.",0,0 +6801,Racial disparities in traumatic stress in prostate cancer patients: secondary analysis of a National URCC CCOP Study of 317 men,"IntroductionAfrican American men have the highest rates of prostate cancer of any racial group, but very little is known about the psychological functioning of African American men in response to prostate cancer diagnosis and treatment.PurposeIn this secondary analysis of a national trial testing a psychological intervention for prostate cancer patients, we report on the traumatic stress symptoms of African American and non-African American men.MethodsThis analysis includes 317 men (African American: n = 30, 9%; non-African American: n = 287, 91%) who were enrolled in the intervention trial, which included 12 weeks of group psychotherapy and 24 months of follow-up. Using mixed model analysis, total score on the Impact of Events Scale (IES) and its Intrusion and Avoidance subscales were examined to determine mean differences in traumatic stress across all time points (0, 3, 6, 12, 18, and 24 months). In an additional analysis, relevant psychosocial, demographic, and clinical variables were added to the model.ResultsResults showed significantly higher levels of traumatic stress for African American men compared to non-African American men in all models independently of the intervention arm, demographics, and relevant clinical variables. African Americans also had a consistently higher prevalence of clinically significant traumatic stress symptoms (defined as IES total score ≥27). These elevations remained across all time points over 24 months.ConclusionsThis is the first study to show a racial disparity in traumatic stress specifically as an aspect of overall psychological adjustment to prostate cancer. Recommendations are made for appropriate assessment, referral, and treatment of psychological distress in this vulnerable population.",0,0 +6802,Psychosocial and psychological factors associated with post-traumatic stress disorder following traumatic brain injury in adult civilian populations: A systematic review,"Increasing support exists for the development of post-traumatic stress disorder (PTSD) after traumatic brain injury (TBI). Despite the psychological nature of PTSD, previous reviews have mainly focused on the injury-related and neurological characteristics of its presentation in TBI. Consequently, this review systematically examined the psychological and psychosocial variables associated with PTSD symptoms after TBI in civilian adults.Detailed searching retrieved 28 relevant articles which met the inclusion criteria. Each article underwent a thorough quality assessment procedure and data were extracted relevant to the review's aims.Results highlighted several psychological and psychosocial variables associated with PTSD after TBI, including historical factors and those which become relevant after the traumatic event. Furthermore, the results indicated that some factors were not associated with PTSD after TBI, despite a relationship existing with PTSD in the general population. The findings of the quality assessment were utilized throughout the formation of results.The review highlights the importance of addressing psychological and psychosocial factors within the assessment and treatment of PTSD after TBI. The limitations of the research are highlighted and the clinical and research implications discussed.",0,0 +6803,Psychological trauma and evidence for enhanced vulnerability for posttraumatic stress disorder through previous trauma among West Nile refugees,"BackgroundPolitical instability and the civil war in Southern Sudan have resulted in numerous atrocities, mass violence, and forced migration for vast parts of the civilian population in the West Nile region. High exposure to traumatic experiences has been particularly prominent in the Ugandan and Sudanese of the West Nile Region, representing an indication of the psychological strain posed by years of armed conflict.MethodsIn this study the impact of traumatic events on the prevalence and severity of posttraumatic stress disorder (PTSD) in a random sample of 3.339 Ugandan nationals, Sudanese nationals, and Sudanese refugees (1.831 households) of the West Nile region is assessed.ResultsResults show a positive correlation between the number of traumatic events and the number of endorsed PTSD symptoms. Of the 58 respondents who experienced the greatest number of traumatizing experiences, all reported symptoms which met the DSM-IV criteria for PTSD.ConclusionsThere is a clear dose-effect relationship between traumatic exposure and PTSD in the studied populations with high levels of traumatic events. In this context, it is probable that any individual could develop PTSD regardless of other risk-factors once the trauma load reaches a certain threshold.",0,0 +6804,Interactive Effect of Stressful Life Events and the Serotonin Transporter 5-HTTLPR Genotype on Posttraumatic Stress Disorder Diagnosis in 2 Independent Populations,"The 5-HTTLPR polymorphism in the promoter region of the serotonin transporter gene (SLC6A4) has been found to moderate several categories of emotional response after stressful life events. Previous studies generally focused on its effect on depressive symptoms; little is known about its moderation of the development of posttraumatic stress disorder (PTSD).To examine the effects of childhood adversity, adult traumatic events, 5-HTTLPR genotypes, and gene x environment interactions on the etiology of PTSD.A cross-sectional study in which participants in several studies investigating the genetics of substance dependence were also screened for lifetime PTSD. The triallelic system of 5-HTTLPR was genotyped. Logistic regression modeling was used in the analyses.General community.Five hundred eighty-two European American and 670 African American individuals who reported experiences of childhood adversity, adult traumatic events, or both. Main Outcome Measure Diagnosis of PTSD, defined by DSM-IV diagnostic criteria and assessed through the Semi-Structured Assessment for Drug Dependence and Alcoholism interview.Childhood adversity and adult traumatic events both predicted PTSD. Although the 5-HTTLPR genotype alone did not predict the onset of PTSD, it interacted with adult traumatic events and childhood adversity to increase the risk for PTSD, especially for those with high rates of both types of trauma exposure (European American: odds ratio [OR], 2.86; 95% confidence interval [CI], 1.50-5.45; P = .002; African American: OR, 1.88; 95% CI, 1.04-3.40; P = .04; pooled: OR, 2.31; 95% CI, 1.50-3.56; P < .001).Participants who had both childhood adversity and adult traumatic events were more likely to develop lifetime PTSD compared with those who experienced either type of adverse event. The risk was increased in individuals with 1 or 2 copies of the S' (S) allele compared with the L' (L) homozygotes. Our study provides additional direct evidence that PTSD is influenced by the interactive effect of environmental and genetic factors.",0,0 +6805,Managing the psychiatric morbidity of disasters.,"Predicting the morbidity from disasters requires clear conceptual frameworks about the different categories of victims and also the manner in which the consequences emerge over the passage of time. Disasters by their nature are events that create confusion and challenge the ordinary structures within a society to manage the basic needs of that social group. A clear conceptual map is of considerable help in minimising the sense of chaos and restoring the provision of needs. There is now a sufficient body of data about the psychological impacts of disasters to begin to think about these events from a broad conceptual framework. In essence, these are events where an environmental stressor can be conceived of in a similar way to a physical environmental toxin that creates a risk in those with differing degrees of exposure. The management response can be informed by using public health models for minimising the consequences of exposure and ensuring broad based approaches are applied.",0,0 +6806,Posttraumatic Stress Symptom Trajectories Among Children Exposed to Violence,"Little research has examined the developmental course of posttraumatic stress symptoms (PTSS) in children. The current study aimed to identify developmental trajectories of PTSS in childhood and to examine predictors of symptom presentation in 1,178 children from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) studies, a consortium of studies focusing on the causes and effects of child maltreatment. Most children had a history of documented reports with Child Protective Services (CPS) and all were identified as living in high-risk environments. Using group-based trajectory modeling, 3 unique developmental trajectories were identified: Resilient, Clinical-Improving (PTSS in the clinical range at baseline then declining over time), and Borderline-Stable (chronically subclinical PTSS). Children in the Clinical-Improving group were more likely than children in the Resilient group to have reports of physical abuse (RRR = 1.76), emotional abuse (RRR = 2.55), neglect (RRR = 1.57), and exposure to violence at home and in the community (RRR = 1.04). Children in the Borderline-Stable group were more likely than children in the Resilient group to have a CPS history of neglect (RRR = 2.44) and exposure to violence at home and in the community (RRR = 1.04). Many children living in high-risk environments exhibit resilience to PTSS, but exposure to witnessed violence and neglect appear to put children at chronic risk for poor adjustment. These children may require more intensive, integrated clinical services that attend to multiple adverse experiences.",0,0 +6807,Trait Dissociation Predicts Posttraumatic Stress Disorder Symptoms in a Prospective Study of Urban Police Officers,"The current study prospectively examines the predictive relationship of trait dissociation, assessed during academy training, to PTSD symptoms assessed at 12 months of active police duty in relatively young and healthy police academy recruits (N = 180). The roles of pre-academy trauma exposure, exposure to life-threatening critical incidents during police duty, and peritraumatic dissociation at the time of the officer's worst critical incident were also examined. Utilizing path analytic techniques, greater trait dissociation, assessed during academy training, was predictive of both peritraumatic dissociation, and PTSD symptoms assessed at 12 months of police service. Moreover, after accounting for trait dissociation and peritraumatic dissociation, the relationship of previous trauma to later PTSD symptoms was no longer significant, demonstrating that the effect of previous trauma on later vulnerability to PTSD symptoms in this sample may be mediated by both trait and peritraumatic dissociation.",0,0 +6808,Psychological Models of Posttraumatic Stress Disorder and Acute Stress Disorder,"This chapter first reviews early learning theories of posttraumatic stress disorder (PTSD). This section highlights the role of classical and operant conditioning, as these forms of conditioning are the basis for many of the contemporary theories of PTSD and still shape a preponderance of thought on the nature of the disorder. Yet, as is pointed out, these conditioning models fail to account for some of the complexities seen in PTSD. The next section reviews alternative conceptualizations regarding new learning theory models, information-processing models, and emotional processing models, forming the basis for more contemporary thought. The chapter concludes with a brief discussion of challenges in the conceptualization of trauma exposure and PTSD symptoms.",0,0 +6809,PTSD: A Disorder of Recovery?,"INTRODUCTION: A VIEW OF THE ETIOLOGY OF PTSD Posttraumatic stress disorder is the better researched consequence of traumatic events. In its current formulation (APA, 1994) the disorder is essentially linked to the triggering event: It cannot be diagnosed in the absence of a traumatic event, and its core symptoms of reexperiencing and avoidance must refer to the traumatic event. This perspective implies a causal link between the event and subsequent PTSD. Such a link is also intuitively appealing and frequently appears in survivors' narratives. For an external observer as well, the association between a traumatic event and PTSD appears to have some truth to it because many survivors' lives are dramatically changed by an encounter with extreme adversity or evil. Thus, from both the survivor's perspective and that of involved observers, the traumatic event is the cause of PTSD. From a scientific point of view, however, this is only half true because many trauma survivors do not develop PTSD. A traumatic event, accordingly, is a necessary , but certainly not a sufficient cause of PTSD. If so, then what are the alternatives? The oldest alternative to simple causation refers to individual differences in vulnerability. Historically, this mainly concerned predisposing factors, an attribution that often carried value judgments. The latter could extend from assuming a personality defect in those who broke down under stress to more understandingly relegating the causality to the wear and tear of the central nervous system by adverse living circumstances (e.g., McEwen, 2000) or birth circumstances (e.g., Meaney et al., 1991; see also Bagot et al., this volume).",0,0 +6810,Outcome following inpatient trauma treatment: Differential response based on pre-treatment symptom severity.,"The purpose of the current study was to examine the extent to which clients of a Stage 1 inpatient program for adult survivors of childhood trauma experienced improvements in their trauma-related symptoms during and following treatment. In addition, the study aimed to enhance our understanding of who benefited by examining trajectories of symptom change, and the extent to which pretreatment symptom severity differentiated the trajectory groups. We used a waitlist comparison methodology and a 6-month follow-up period to examine treatment outcome. We analyzed the data using linear mixed models and latent class growth modeling. Results indicated that the treatment group experienced significantly greater reduction in their trauma-related symptoms than the waitlist group, and this reduction was largely maintained 6-months following discharge. Examinations of group change trajectories indicated that there were 3 groups with distinct change patterns. Analyses examining pretreatment symptom severity in relation to change trajectories indicated that clients with a range of severities of trauma-related symptoms benefited from the program. Clients for whom the program was less effective in reducing trauma-related symptoms were those with severe anxiety and arousal symptoms at admission. The results support the efficacy of inpatient trauma treatment programs for adult survivors of childhood maltreatment, and suggest that modifications during and following treatment may assist a subset of clients in achieving similar gains. © 2011 American Psychological Association.",0,0 +6811,Similarity of prior trauma exposure as a determinant of chronic stress responding to an airline disaster.,"The cumulative effects of trauma were examined in 108 workers at the site of a major air disaster at 4 time points over a year following the crash. The influence of trauma history on chronic distress and physiological arousal associated with the crash were examined. Stress levels were expected to differ on the basis of the similarity of prior trauma exposure to work at the crash site. Prior traumatic exposure that was ""dissimilar"" to this type of work was associated with greater vulnerability to crash-related stress, that is, more distress and crash-related intrusions during the year following the crash. Accumulation of a variety of different traumatic experiences appeared to sensitize workers to the new stressor and to perpetuate chronic stress. Understanding the role of trauma history is important for improving intervention efforts aimed at alleviating stress following a trauma.",0,0 +6812,Symptoms of posttraumatic stress in children after Hurricane Andrew: A prospective study.,"The authors examined symptoms of posttraumatic stress in 3rd-5th grade children during the school year after Hurricane Andrew. From a conceptual model of the effects of traumatic events, 442 children were evaluated 3, 7, and 10 months postdisaster with respect to (a) their exposure to traumatic events during and after the disaster, (b) their preexisting demographic characteristics, (c) the occurrence of major life stressors, (d) the availability of social support, and (e) the type of coping strategies used to cope with disaster-related distress. Although symptoms of posttraumatic stress disorder (PTSD) declined over time, a substantial level of symptomatology was observed up to 10 months after the disaster. All 5 factors in the conceptual model were predictive of children's PTSD symptoms 7 and 10 months postdisaster. Findings are discussed in terms of the potential utility of the model for organizing thinking about factors that predict the emergence and persistence of PTSD symptoms in children.",0,0 +6813,Concurrent Validity of the Defense and Veterans Pain Rating Scale in VA Outpatients,"The purpose of this report is to investigate the concurrent validity of the Defense and Veterans Pain Rating Scale (DVPRS) with other validated self-report measures in U.S. veterans.This correlational study was conducted using two samples of outpatients at the Washington, DC Veterans Affairs Medical Center who completed self-report measures relevant to pain conditions, including pain disability, quality of life, and mental health. Study 1 and 2 consisted of n = 204 and n = 13 participants, respectively.Bivariate Spearman correlations were calculated to examine the correlation among total scores and subscale scores for each scale of interest. Multiple linear regressions were also computed in Study 1.In Study 1, the DVPRS interference scale (DVPRS-II) was significantly correlated with the Pain Disability Questionnaire (PDQ) (ρ = 0.69, P < 0.001) and the Veterans RAND 36-item Health Survey physical and mental component scales (ρ = -0.37, P < 0.001; ρ = -0.46, P < 0.001, respectively). When controlling for sex, age, and other self-report measures, the relationship between the DVPRS-II and PDQ remained significant. In Study 2, pain interference on the DVPRS and Brief Pain Inventory were highly correlated (ρ = 0.90, P < 0.001); however, the intensity scale of each measure was also highly associated with the interference summary scores.These findings provide preliminary evidence for the concurrent validity of the DVPRS as a brief, multidimensional measure of pain interference that make it a practical tool for use in primary care settings to assess the impact of pain on daily functioning and monitor chronic pain over time.",0,0 +6814,"Personality patterns among Black, White, and Hispanic combat veterans.","Little is known about racial and ethnic differences in personality pathology in combat veterans. Thisinvestigation explored the relationship between race, ethnicity, and personality disorders (PDs) in asample of 96 combat veterans. Ethnoracial group status was based on self-identification, and the groupswere mutually exclusive. PDs were assessed with the MCMI-III , posttraumatic stress disorder (PTSD)was assessed with the Clinician Administered PTSD scale, and combat exposure was assessed with theCombat Exposure Scale. The findings suggest that Hispanic veterans were more likely to have cluster APDs compared to non-Hispanic veterans, even after controlling for demographics, level of combatexposure, and current PTSD. Implications of the results for the research and treatment of culturallydiverse individuals with PDs are discussed.Keywords: personality disorder, combat veteran, race, ethnicity",0,0 +6815,Post-Traumatic Stress Disorder in Children and Adolescents,The past decade has seen a significant increase in our understanding of the unique impact that trauma may have on the developmental trajectory of children and adolescents. We examine the recent clinical and research literature regarding risk factors for post-traumatic stress disorder (PTSD) in childhood and the various manifestations in which PTSD may present in childhood and adolescence. Case vignettes are presented to elucidate issues that often emerge in the diagnosis and treatment of PTSD in childhood and adolescence.,0,0 +6816,Typology of adults diagnosed with mental disorders based on socio-demographics and clinical and service use characteristics,"Mental disorder is a leading cause of morbidity worldwide. Its cost and negative impact on productivity are substantial. Consequently, improving mental health-care system efficiency - especially service utilisation - is a priority. Few studies have explored the use of services by specific subgroups of persons with mental disorder; a better understanding of these individuals is key to improving service planning. This study develops a typology of individuals, diagnosed with mental disorder in a 12-month period, based on their individual characteristics and use of services within a Canadian urban catchment area of 258,000 persons served by a psychiatric hospital.From among the 2,443 people who took part in the survey, 406 (17%) experienced at least one episode of mental disorder (as per the Composite International Diagnostic Interview (CIDI)) in the 12 months pre-interview. These individuals were selected for cluster analysis.Analysis yielded four user clusters: people who experienced mainly anxiety disorder; depressive disorder; alcohol and/or drug disorder; and multiple mental and dependence disorder. Two clusters were more closely associated with females and anxiety or depressive disorders. In the two other clusters, males were over-represented compared with the sample as a whole, namely, substance abuses with or without concomitant mental disorder. Clusters with the greatest number of mental disorders per subject used a greater number of mental health-care services. Conversely, clusters associated exclusively with dependence disorders used few services.The study found considerable heterogeneity among socio-demographic characteristics, number of disorders, and number of health-care services used by individuals with mental or dependence disorders. Cluster analysis revealed important differences in service use with regard to gender and age. It reinforces the relevance of developing targeted programs for subgroups of individuals with mental and/or dependence disorders. Strategies aimed at changing low service users' attitude (youths and males) or instituting specialised programs for that particular clientele should be promoted. Finally, as concomitant disorders are frequent among individuals with mental disorder, psychological services and/or addiction programs must be prioritised as components of integrated services when planning treatment.",0,0 +6817,Lay mental health in the aftermath of disaster: preliminary evaluation of an intervention for Haiti earthquake survivors.,"In the year following the 2010 Haiti earthquake, local earthquake survivors trained as lay mental health workers implemented a culturally-adapted, psychosocial and trauma-focused group intervention for residents of camps for internally displaced peoples (IDPs). Analysis of evaluation data collected at three Port-au-Prince IDP camps revealed decreased self-reported posttraumatic distress (measured using the Harvard Trauma Questionnaire) associated with participation in this intervention. Improvement occurred across all three PTSD symptom clusters (re-experiencing, avoidance, and hyperarousal). Female participants reported higher baseline distress, were more likely to participate in the intervention, and benefitted more than did men. Results provide initial support for the effectiveness of train-the-trainer interventions utilizing local lay disaster survivors.",0,0 +6818,Relationship between post-traumatic stress disorder and diabetes among 105 180 asylum seekers in the Netherlands,"Several reports have demonstrated a relationship between post-traumatic stress disorder (PTSD) and type 2 diabetes (T2DM) mainly in combat veterans. The relationship between PTSD and T2DM has not been evaluated among vulnerable migrant populations. The main objective of this study was therefore to assess the relationship between PTSD and T2DM among asylum seekers in the Netherlands.Analysis of a national electronic database of the Dutch Community Health Services for Asylum seekers aged≥18 years (N=105,180).Asylum seekers with PTSD had a higher prevalence of T2DM compared with those without PTSD. The age-adjusted prevalence ratios (APR) were 1.40 (95% CI, 1.12-1.76) in men and 1.22 (95% CI, 0.95-1.56) in women compared with individuals without PTSD, respectively. There was an interaction between PTSD and comorbid depression (P<0.05) in men and women, indicating that the effect of PTSD and comorbid depression on T2DM differed. When the analyses were stratified by depression status, among non-depressed group, individuals with PTSD had a higher prevalence of T2DM compared with those without PTSD [APR=1.47 (95% CI, 1.15-1.87) in men and APR=1.27 (95% CI, 0.97-1.66) in women]. Among the depressed individuals, however, there was no association between PTSD and T2DM [APR=0.87 (95% CI, 0.43-1.76) in men, and APR=1.00, (95% CI, 0.54-1.83) in women].The findings suggest that history of PTSD is related to high levels of T2DM among asylum seekers independent of comorbid depression. Clinicians and policy makers need to take PTSD into account when assessing and treating diabetes among vulnerable migrant populations.",0,0 +6819,Preliminary Psychometric Properties of the Acceptance and Action Questionnaire–II: A Revised Measure of Psychological Inflexibility and Experiential Avoidance,"The present research describes the development and psychometric evaluation of a second version of the Acceptance and Action Questionnaire (AAQ-II), which assesses the construct referred to as, variously, acceptance, experiential avoidance, and psychological inflexibility. Results from 2,816 participants across six samples indicate the satisfactory structure, reliability, and validity of this measure. For example, the mean alpha coefficient is .84 (.78–.88), and the 3- and 12-month test–retest reliability is .81 and .79, respectively. Results indicate that AAQ-II scores concurrently, longitudinally, and incrementally predict a range of outcomes, from mental health to work absence rates, that are consistent with its underlying theory. The AAQ-II also demonstrates appropriate discriminant validity. The AAQ-II appears to measure the same concept as the AAQ-I ( r = .97) but with better psychometric consistency.",0,0 +6820,Neurobiology of Post-Traumatic Stress Disorder,"Post-Traumatic Stress Disorder (PTSD) is a common and severe psychiatric disorder precipitated by exposure to a psychologically distressing event. PTSD is associated with significant morbidity and mortality and is characterized by the presence of three distinct, but co-occurring, symptom clusters. Research evidence suggests that PTSD has a neurobiological basis. Current research on the neurobiology of PTSD include the utilization of functional brain imaging molecular genetic research; the incorporation of cross-system research including neuroendocrine, neurochemical, and neuroimmunological systems. This book examines the neurobiological basis of PTSD and the future research goals in regards to these findings. © 2010 by Nova Science Publishers, Inc. All rights reserved.",0,0 +6821,SYMPTOMATIC AND FUNCTIONAL ASSESSMENT OF SOCIAL ANXIETY DISORDER IN ADULTS,"There are several old and new tools for assessment of generalized SAD but few for nongeneralized SAD. Scales are available in both self-rated and interviewer-rated formats. Self-rated scales vary in appearance in length and specificity for SAD and psychometric properties. The best-studied self-rated scales are the FQ, FNE, SAAD, SPAI, and SPIN. The FQ is an early scale, with a subscale of social phobia with reasonable psychometric properties and has withstood the test of time. The FNE and SAAD are based on cognitive models of SAD but lack assessment of physiologic arousal symptoms--an important symptom cluster of SAD. The SPIN is a relatively new scale and shows potential especially with its three-item screener for generalized SAD. The two interviewer-rated scales, the LSAS and BSPS, are both widely used and demonstrate sound psychometric properties. Either one can be regarded as a satisfactory scale in the assessment of symptom severity and treatment response. The BSPS also measures several physical symptoms common in SAD. There are fewer validated tools available for nongeneralized SAD. It is a prevalent condition that may account for 25% or more of patients with SAD. More research is required on the epidemiology, recognition, assessment, and treatment of nongeneralized SAD. Education of patients and clinicians, and the use of improved and briefer tools in these settings, may help SAD patients to obtain appropriate help and improve their functioning and productivity. Few tools are available that can reliably assess disability due to SAD, and more research in this area is important and required.",0,0 +6822,Pathways to youth homelessness,"Research documents high levels of psychopathology among homeless youth. Most research, however, has not distinguished between disorders that are present prior to homelessness and those that develop following homelessness. Hence whether psychological disorders are the cause or consequence of homelessness has not been established. The aim of this study is to investigate causal pathways to homelessness amongst currently homeless youth in Australia. The study uses a quasi-qualitative methodology to generate hypotheses for larger-scale research. High rates of psychological disorders were confirmed in the sample 35 homeless youth aged 14-25. The rates of psychological disorders at the point of homelessness were greater than in normative samples, but the rates of clinical disorder increased further once homeless. Further in-depth analyses were conducted to identify the temporal sequence for each individual with a view to establishing a set of causal pathways to homelessness and trajectories following homelessness that characterised the people in the sample. Five pathways to homelessness and five trajectories following homelessness were identified that accounted for the entire sample. Each pathway constituted a series of interactions between different factors similar to that described by Craig and Hodson (1998. Psychological Medicine, 28, 1379-1388) as ""complex subsidiary pathways"". The major findings were that (1) trauma is a common experience amongst homeless youth prior to homelessness and figured in the causal pathways to homelessness for over half of the sample; (2) once homeless, for the majority of youth there is an increase in the number of psychological diagnoses including drug and alcohol diagnoses; and (3) crime did not precede homelessness for all but one youth; however, following homelessness, involvement in criminal activity was common and became a distinguishing factor amongst youth. The implications of these findings for future research and service development are discussed.",0,0 +6823,Stress Detection for PTSD via the StartleMart Game,"Computer games have recently shown promise as a diagnostic and treatment tool for psychiatric rehabilitation. This paper examines the positive impact of affect detection and advanced game technology on the treatment of mental diagnoses such as Post Traumatic Stress Disorder (PTSD). For that purpose, we couple game design and game technology with stress detection for the automatic profiling and the personalized treatment of PTSD via game-based exposure therapy and stress inoculation training. The PTSD treatment game we designed forces the player to go through various stressful experiences while a stress detection mechanism profiles the severity and type of PTSD via skin conductance responses to those in-game stress elicitors. The initial study and analysis of 14 PTSD-diagnosed veteran soldiers presented in this paper reveals clear correspondence between diagnostic standard measures of PTSD severity and skin conductance responses. Significant correlations between physiological responses and subjective evaluations of the stressfulness of experiences, represented as pair wise preferences, are also found. We conclude that this supports the use of the simulation as a relevant treatment tool for stress inoculation training. This points to future avenues of research toward discerning between degrees and types of PTSD using game-based diagnostic and treatment tools.",0,0 +6824,"Complexity of Childhood Sexual Abuse: Predictors of Current Post-Traumatic Stress Disorder, Mood Disorders, Substance Use, and Sexual Risk Behavior Among Adult Men Who Have Sex with Men","Men who have sex with men (MSM) are the group most at risk for HIV and represent the majority of new infections in the United States. Rates of childhood sexual abuse (CSA) among MSM have been estimated as high as 46 %. CSA is associated with increased risk of HIV and greater likelihood of HIV sexual risk behavior. The purpose of this study was to identify the relationships between CSA complexity indicators and mental health, substance use, sexually transmitted infections, and HIV sexual risk among MSM. MSM with CSA histories (n = 162) who were screened for an HIV prevention efficacy trial completed comprehensive psychosocial assessments. Five indicators of complex CSA experiences were created: CSA by family member, CSA with penetration, CSA with physical injury, CSA with intense fear, and first CSA in adolescence. Adjusted regression models were used to identify relationships between CSA complexity and outcomes. Participants reporting CSA by family member were at 2.6 odds of current alcohol use disorder (OR 2.64: CI 1.24-5.63), two times higher odds of substance use disorder (OR 2.1: CI 1.02-2.36), and 2.7 times higher odds of reporting an STI in the past year (OR 2.7: CI 1.04-7.1). CSA with penetration was associated with increased likelihood of current PTSD (OR 3.17: CI 1.56-6.43), recent HIV sexual risk behavior (OR 2.7: CI 1.16-6.36), and a greater number of casual sexual partners (p = 0.02). Both CSA with Physical Injury (OR 4.05: CI 1.9-8.7) and CSA with Intense Fear (OR 5.16: CI 2.5-10.7) were related to increased odds for current PTSD. First CSA in adolescence was related to increased odds of major depressive disorder. These findings suggest that CSA, with one or more complexities, creates patterns of vulnerabilities for MSM, including post-traumatic stress disorder, substance use, and sexual risk taking, and suggests the need for detailed assessment of CSA and the development of integrated HIV prevention programs that address mental health and substance use comorbidities.",0,0 +6825,Project VALOR: design and methods of a longitudinal registry of post-traumatic stress disorder (PTSD) in combat-exposed Veterans in the Afghanistan and Iraqi military theaters of operations,"Few studies have investigated the natural history of post-traumatic stress disorder (PTSD). Project VALOR (Veterans' After-discharge Longitudinal Registry) was designed as a longitudinal patient registry assessing the course of combat-related PTSD among 1600 male and female Veterans who served in Operation Enduring Freedom (OEF) in Afghanistan or Operation Iraqi Freedom (OIF). Aims of the study include investigating patterns and predictors of progression or remission of PTSD and treatment utilization. The study design was based on recommendations from the Agency for Healthcare Quality and Research for longitudinal disease registries and used a pre-specified theoretical model to select the measurement domains for data collection and interpretation of forthcoming results. The registry will include 1200 male and female Veterans with a recent diagnosis of PTSD in the Department of Veteran Affairs (VA) electronic medical record and a comparison group of 400 Veterans without a medical record-based PTSD diagnosis, to also allow for case-control analyses. Data are collected from administrative databases, electronic medical records, a self-administered questionnaire, and a semi-structured diagnostic telephone interview. Project VALOR is a unique and timely registry study that will evaluate the clinical course of PTSD, psychosocial correlates, and health outcomes in a carefully selected cohort of returning OEF/OIF Veterans.",0,0 +6826,Legislative Change Is Associated With Improved Health Status in People With Whiplash,"Interrupted time series.To assess whether a change in legislation improved health status and quality of life for people with whiplash.Whiplash was the most prevalent injury in a compulsory, fault based, third party motor vehicle insurance scheme in New South Wales, Australia. Legislative change removed financial compensation for ""pain and suffering"" for whiplash, introduced clinical practice guidelines for its treatment; and changed regulations to permit earlier acceptance of compensation claims, and earlier access to treatment, for all types of injury.Three independent groups of people with whiplash were identified from insurance data (before legislative change--the 1999 group and, after legislative change--the 2001 and 2003 groups). Health status was assessed 2 years after injury by a telephone interviewer blinded to the study hypotheses. The main outcome measure was disability, as assessed by the Functional Rating Index (FRI). Pain and health-related quality of life was also assessed.The mean FRI at 2 years after injury was 38.0% (SE, 1.9) for the 1999 group, 31.8% (SE, 2.1) for the 2001 group, and 30.1% (SE, 1.8) for the 2003 group (F = 5.0, P = 0.007). Improvement in secondary outcomes, including pain, also occurred.Health status of people with whiplash improved after legislative change. Design of compensation schemes should be undertaken with the understanding that the scheme structure may have substantial effects on the long-term health of injured people.",0,0 +6827,Measurement invariance of posttraumatic stress disorder symptoms among U.S. military personnel,"Studies have not examined the factor structure or measurement invariance of posttraumatic stress disorder (PTSD) symptomatology using population-based data. Confirmatory factor analysis of the PTSD Checklist-Civilian Version (PCL-C) was conducted in a representative sample of U.S. active duty military personnel (N = 15,593). Consistent with prior research, a 4-factor model consisting of reexperiencing, avoidance, emotional numbing, and arousal factors was superior to four alternative models. Measurement invariance was found for factor loadings, but not observed item intercepts when comparing personnel with and without a recent deployment (≤12 months). Findings indicate differences in the level of observed responses across deployment subgroups that exceed what would be expected for individuals with similar PCL latent factors scores. Implications of results are discussed.",0,0 +6828,The Relationship Between Course of PTSD Symptoms in Deployed U.S. Marines and Degree of Combat Exposure,"Large cohort studies suggest that most military personnel experience minimal posttraumatic stress disorder (PTSD) symptoms following warzone deployment, an outcome often labeled resilience. Very low symptom levels, however, may be a marker for low exposure, not resilience, which requires relatively high-magnitude or high-frequency stress exposure as a precondition. We used growth mixture modeling (GMM) to examine the longitudinal course of lifetime PTSD symptoms following combat exposure by disaggregating deployed U.S. Marines into upper, middle, and lower tertiles of combat exposure. All factor models fit the data well; Tucker-Lewis Index (TLI) and comparative fit index (CFI) values ranged from .91 to .97. Three distinct trajectories best explained the data within each tertile. The upper tertile comprised True Resilience (73.2%), New-Onset Symptoms (18.3%), and Pre-existing Symptoms (8.5%) trajectories. The middle tertile also comprised True Resilience (74.5%), New-Onset Symptoms (16.1%), and Pre-existing Symptoms (9.4%) trajectories. The lower tertile comprised Artifactual Resilience (86.3%), Pre-existing Symptoms (7.6%), and New-Onset Symptoms (6.1%) trajectories. True Resilience involved a clinically significant symptom increase followed by a return to baseline, whereas Artifactual Resilience involved consistently low symptoms. Conflating artifactual and true resilience may inaccurately create the expectation of persistently low symptoms regardless of warzone exposure.",1,0 +6829,Application of model-selection criteria to some problems in multivariate analysis,"A review of model-selection criteria is presented, with a view toward showing their similarities. It is suggested that some problems treated by sequences of hypothesis tests may be more expeditiously treated by the application of model-selection criteria. Consideration is given to application of model-selection criteria to some problems of multivariate analysis, especially the clustering of variables, factor analysis and, more generally, describing a complex of variables.",0,0 +6830,An integrated model of risk and protective factors for post-deployment PTSD symptoms in OEF/OIF era combat veterans,"Few attempts have been made to integrate the known risk factors for combat-related posttraumatic stress disorder (PTSD) into a comprehensive model. This study investigated relative contributions of combat experiences, post-battle experiences, and perceptions of threat to post-deployment PTSD symptoms, and also examined whether pre-deployment preparedness moderated associations among these variables.Two hundred seven troops deployed to the Middle East between 2001 and 2008 completed self-report measures. Data were analyzed using path analysis and regressions. A comprehensive model including additive effects, mediation, and moderation was examined.Perceptions of threat mediated the association of combat experiences with PTSD, but not that of post-battle experiences with PTSD. Sense of preparedness for deployment moderated the association of combat experiences with perceived threat, such that troops with low preparedness perceived high levels of threat regardless of combat exposure, whereas troops with high preparedness perceived levels of threat that were correlated with levels of combat.Data were cross-sectional, all assessment was retrospective self-report, and the sample was primarily White, male, and married.Combat and post-battle experiences appear linked to PTSD via separate pathways. Thus, PTSD prevention efforts may need to vary based on types of events experienced. Pre-deployment preparation mitigated perceived threat in the context of low combat exposure, but it did not moderate direct associations of risk factors with PTSD symptoms. Thus, pre-deployment training and preparation do not appear sufficient to protect against PTSD.",0,0 +6831,First steps towards the validation of the relations to others french scale (ERA: Echelle de relations avec les autres),"The aim of the paper is to describe the process of constructing and validating a new scale (called ERA) assessing relations to others. The ERA scale is designed to be all at once time-saving (only 16 items) and widely informative (covering 4 major domains of relations to others: Openness to others - relational distance - personal and relational insight - pleasure through and within the relationship), and can be administered to clinical and non clinical populations. The ERA scale has a good internal coherence, a good external validity, an excellent discriminant validity and a good test-retest reliability. The study of sensitivity to change is still in progress.",0,0 +6832,The Classification of Anxiety Disorders in ICD-10 and DSM-IV: A Concordance Analysis,"On the surface, the classifications of anxiety disorders in DSM-IV and ICD-10 appear quite similar. However, differences exist and are evident in four aspects of the diagnostic criteria: typology, identifying criteria, inclusion and exclusion criteria. The current study uses data from the Australian National Mental Health Survey to model the impact of these differences on the diagnosis of generalized anxiety disorder. The results show that the concordance between the current classifications would be improved with the removal of the criterion for uncontrollability from DSM-IV, a closer focus on the symptoms of hypervigilance and scanning as in DSM-IV and the removal of the clinical significance criterion from DSM-IV. Equivalency of the exclusion criteria between the two classification systems reduces the concordance, demonstrating that each classification systems is a set of <i>inter</i>dependent diagnoses, and to ultimately achieve concordance, all diagnoses must be considered together.",0,0 +6833,Empirical identification of Axis I and Axis II symptom subtypes of sex addiction using Latent Profile Analysis,"Sexual addiction is a disorder characterized by lack of control over sexual urges, pathological relationships and lack of intimacy, mood-altering experiences, and adverse consequences that tend to be disregarded by the person affected. Although not classified as a mental disorder in the Diagnostic Statistical Manual-IV-TR (DSM-IV-TR, APA, 2000) this distressful sexual manifestation is increasingly recognized as a clinical and public health problem. Previous studies suggest commonalities with addictive disorders and maladaptive personality traits. The purpose of the current study was to analyze personality configurations of individuals diagnosed as sex addicts and uncover specific subtypes or profiles associated to sexually addictive behaviors. The study used archival data from 222 individuals, mostly males, treated at a residential program for sex addiction. Latent Profile Analysis (LPA) was utilized to uncover latent classes by using scale scores from the Millon Clinical Multiaxial Inventory-III (MCMI-III) and the Personality Assessment Inventory (PAI). The statistical analyses identified four latent classes for Axis I and five classes for Axis II corresponding to homogeneous subgroups of participants, and determined class membership. Findings were followed up with multivariate and univariate analyses of variances and discriminant analysis to better understand qualitative and quantitative differences among groups. Results revealed significant relationships between class membership and symptoms of Axis I and Axis II disorders measured by other screening tests: the Sexual Addiction Screening Test-Revised (SAST- R), the Eating Disorder Inventory (EDI), Post Traumatic Stress Inventory (PTSI), and the Brief Symptom Inventory (BSI), as well as severity of sexually addictive behaviors, and specific types of behavioral manifestations of sexual addiction as measured by the Sexual Dependency Inventory (SDI-R). No relations were found with legal consequences of addictive behavior. Some implications for treatment of sexual addiction were also addressed. (PsycINFO Database Record (c) 2013 APA, all rights reserved)",0,0 +6834,"Cerebral dysfunction in type 1 diabetes: effects of insulin, vascular risk factors and blood-glucose levels","Type 1 diabetes can lead to several well-described complications such as retinopathy, nephropathy and peripheral neuropathy. Evidence is accumulating that it is also associated with gradually developing end-organ damage in the central nervous system. This relatively unknown complication can be referred to as ""diabetic encephalopathy"" and is characterised by electrophysiological and neuroradiological changes, such as delayed latencies of evoked potentials, modest cerebral atrophy and (periventricular) white matter lesions. Furthermore, individuals with type 1 diabetes may show performance deficits in a wide range of cognitive domains. The exact mechanisms underlying this diabetic encephalopathy are only partially known. Chronic metabolic and vascular changes appear to play an important role. Interestingly, the differences in the ""cognitive profile"" between type 1 and type 2 diabetes also suggest a critical role for disturbances of insulin action in the central nervous system.",0,0 +6835,PSYCHOLOGICAL RESILIENCE IN OLDER U.S. VETERANS: RESULTS FROM THE NATIONAL HEALTH AND RESILIENCE IN VETERANS STUDY,"Although a large body of empirical research has examined negative psychological outcomes in older veterans, relatively little is known about the prevalence and determinants of psychological resilience in this population.A nationally representative sample of 2,025 U.S. veterans aged 60 and older (mean = 71.0, standard deviation = 7.1, range = 60-96) completed a web-based survey as part of the National Health and Resilience in Veterans Study (NHRVS). Cluster analysis of measures of lifetime potentially traumatic events, and current PTSD, major depression, and generalized anxiety symptoms was used to classify psychological outcomes.A three-group solution best fit the data: Control (low number of lifetime traumas, low current psychological distress; 60.4%); Resilient (high number of lifetime traumas, low current psychological distress; 27.5%); and distressed (high number of lifetime traumas, high current psychological distress; 12.1%). Among older veterans with a high number of traumas, 69.5% were in the Resilient group. Compared to the Distressed group, the Resilient group was more likely to have college or higher level of education, and to be married or living with a partner. They also scored higher on measures of emotional stability, social connectedness (i.e., secure attachment style, social support), protective psychosocial characteristics (e.g., community integration, purpose in life), and positive perceptions of the military's effect on one's life; and lower on measures of physical health difficulties and psychiatric problems, and openness to experiences.Among older U.S. veterans who have endured a high number of traumas in their lifetimes, nearly 70% are psychologically resilient in later life. Prevention efforts targeted toward bolstering social connectedness, community integration, and purpose in life may help promote psychological resilience in older veterans who endured a significant number of traumas in their lives.",0,0 +6836,Influences of Comorbid Disorders on Personality Assessment Inventory Profiles in Women with Posttraumatic Stress Disorder,"The present study describes Personality Assessment Inventory (PAI) profiles for women with posttraumatic stress disorder (PTSD). Four groups of women were sampled: single Axis I diagnosis of PTSD; PTSD and major depressive disorder (MDD); PTSD, MDD, at least one other Axis I disorder; and controls with no Axis I disorder. Higher comorbidity rates were associated with higher mean profile elevations and broader range of endorsed symptoms. The group with the highest rate of comorbidity produced profiles most similar to previously published reports of patients with PTSD. This is in contrast to women with a single diagnosis of PTSD, who produced relative mean elevations only on subscales measuring distress caused by trauma and physiological symptoms of depression. Thus, published profiles may be more reflective of PTSD with comorbidity than a single diagnosis of PTSD.",0,0 +6837,Posttraumatic growth in Veterans of Operations Enduring Freedom and Iraqi Freedom,"A growing body of research has examined the prevalence and correlates of psychopathology, mild traumatic brain injury, and related problems in Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF-OIF). While these studies help characterize the deleterious effects of combat, no known study has examined factors that may enhance posttraumatic growth or positive changes experienced as a result of combat in this population. A total of 272 predominantly older Reservist/National Guard OEF-OIF Veterans completed an anonymous mail survey that assessed combat exposure, psychopathology, psychosocial functioning, social support, and posttraumatic growth. Seventy-two percent of the sample endorsed a significant degree of posttraumatic growth in at least one of the areas assessed, the most common of which were changing priorities about what is important in life (52.2%), being able to better appreciate each day (51.1%), and being better able to handle difficulties (48.5%). Hierarchical regression analysis revealed that younger age, greater posttraumatic stress disorder (PTSD) symptoms, and increased perceptions of unit member support and effort/perseverance were significantly associated with posttraumatic growth. Respondents with PTSD scored higher on an overall measure of posttraumatic growth and on items reflecting appreciation of life and personal strength. This study is limited by a relatively low survey return rate and employment of an abbreviated measure of posttraumatic growth. Results of this study suggest that interventions to bolster unit member support and to enhance perceptions of effort and perseverance may help promote posttraumatic growth in OEF-OIF Veterans.",0,0 +6838,Patterns of healthcare service utilisation following severe traumatic brain injury: An idiographic analysis of injury compensation claims data,"The rate and extent of recovery after severe traumatic brain injury (TBI) is heterogeneous making prediction of likely healthcare service utilisation (HSU) difficult. Patterns of HSU derived from nomothetic samples do not represent the diverse range of outcomes possible within this patient group. Group-based trajectory model is a semi-parametric statistical technique that seeks to identify clusters of individuals whose outcome (however measured) follows a similar pattern of change over time.To identify and characterise patterns of HSU in the 5-year period following severe TBI.Detailed healthcare treatment payments data in 316 adults with severe TBI (Glasgow Coma Scale score 3-8) from the transport accident compensation system in the state of Victoria, Australia was accessed for this analysis. A semi-parametric group-based trajectory analytical technique for longitudinal data was applied to monthly observation counts of HSU data to identify distinct clusters of participants' trajectories. Comparison between trajectory groups on demographic, injury, disability and compensation relevant outcomes was undertaken.Four distinct patterns (trajectories) of HSU were identified in the sample. The first trajectory group comprised 27% of participants and displayed a rapid decrease in HSU in the first year post-injury. The second group comprised 24% of participants and showed a sharp peak in HSU during the first 12 months post-injury followed by a decline over time. The third group comprised 32% of participants and showed a slight peak in HSU in the first few months post-injury and then a slow decline over time. The fourth group comprised 17% of participants and displayed a steady rise in HSU up to 30 months post-injury, followed by a gradual decline to a level consistent with that received in the first months post-injury. Significant differences were observed between groups on factors such as age, injury severity, and use of disability services.There is substantial variation in patterns of HSU following severe TBI. Idiographic analysis can provide rich information for describing and understanding the resources required to help people with TBI.",0,0 +6839,Efficacy of Stellate Ganglion Block in the Treatment of Anxiety Symptoms From Combat-Related Post-Traumatic Stress Disorder: A Case Series,Report the efficacious use of stellate ganglion blocks (SGBs) in treating the anxiety symptoms of four patients diagnosed with combat-related post-traumatic stress disorder (PTSD) and discuss possible mechanisms of action to explain these findings.Successful treatment of PTSD with SGB has been demonstrated and reported previously at Walter Reed Army Medical Center. An identical protocol was used at Tripler Army Medical Center to treat four service members diagnosed with combat-related PTSD.All patients reported received an SGB on the right side at the level of C6. The patient's PTSD symptoms were evaluated using the Post-traumatic Stress Disorder Checklist (PCL). This checklist was distributed one day before treatment and again the day following treatment. The patients were also given the PCL at subsequent follow-up visits to quantify sustained benefit.SGB showed acute benefit for the symptoms of PTSD by markedly reduced PCL scores after the procedure. Benefits were also sustained during close outpatient follow-up.Selective blockade of the right stellate ganglion at C6 is a minimally invasive procedure with an excellent safety profile that may provide sustained relief of PTSD symptoms. The procedure may also provide benefit for those who are resistant to psychotropic intervention.,0,0 +6840,Public Access Defibrillation: Psychological consequences in responders,"Adverse psychological reactions are relatively frequent in professional ambulance crews who attend traumatic events, yet appear unusual in lay persons who attempt resuscitation of victims of out of hospital cardiac arrest.To investigate the psychological profile of first responders to gain insight into possible factors that might protect them against such reactions.Qualitative study of first responders in a community scheme in Barry, South Wales. In depth semi-structured interviews with six subjects were analysed using Interpretive Phenomenological Analysis (IPA).The study identified a resilience phenomenon in first responders accounted for by certain enabling core beliefs about their role, their capacity, and about the meaning of negative and positive outcomes for themselves. A realistic appreciation of their own limitations, confidence in their ability to perform as trained and being able to handle positive and negative outcomes were prominent features. The ability to act with emotional detachment appears a further protective mechanism. This mindset, loosely described as 'a philosophy', protects against the development of adverse reactions to stress or from becoming unduly concerned about negative outcomes. The responders had altruistic motives for undertaking the role yet were capable of operating with a high degree of naturally occurring resilience to stress or undermining anxiety. It is the combination of being motivated by altruism coupled with an inherent resilience that appears to be the crucial protective mechanism.The group demonstrated an apparently innate resilience to the adverse psychological effects of responding with an AED in a PAD scheme. This enables them to operate optimally in stressful situations without experiencing the negative psychological consequences that might otherwise arise. This information may be used to raise awareness about the psychological requirements for the role and to assist screening or selection processes.",0,0 +6841,Event-based prospective memory among veterans: The role of posttraumatic stress disorder symptom severity in executing intentions,"Posttraumatic stress disorder (PTSD) has been linked with neuropsychological deficits in several areas, including attention, learning and memory, and cognitive inhibition. Although memory dysfunction is among the most commonly documented deficits associated with PTSD, our existing knowledge pertains only to retrospective memory. The current study investigated the relationship between PTSD symptom severity and event-based prospective memory (PM).Forty veterans completed a computerized event-based PM task, a self-report measure of PTSD, and measures of retrospective memory.Hierarchical regression analysis results revealed that PTSD symptom severity accounted for 16% of the variance in PM performance, F(3, 36) = 3.47, p < .05, after controlling for age and retrospective memory. Additionally, each of the three PTSD symptom clusters was related, to varying degrees, with PM performance.Results suggest that elevated PTSD symptoms may be associated with more difficulties completing tasks requiring PM. Further examination of PM in PTSD is warranted, especially in regard to its impact on everyday functioning.",0,0 +6842,Child Behavior Checklist Juvenile Bipolar Disorder (CBCL-JBD) and CBCL Posttraumatic Stress Problems (CBCL-PTSP) scales are measures of a single dysregulatory syndrome,"The Child Behavior Checklist Juvenile Bipolar Disorder (CBCL-JBD) profile and Posttraumatic Stress Problems (CBCL-PTSP) scale have been used to assess juvenile bipolar disorder (JBD) and posttraumatic stress disorder (PTSD), respectively. However, their validity is questionable according to previous research. Both measures are associated with severe psychopathology often encompassing multiple DSM-IV diagnoses. Further, children who score highly on one of these scales often have elevated scores on the other, independent of PTSD or JBD diagnoses. We hypothesized that the two scales may be indicators of a single syndrome related to dysregulated mood, attention, and behavior. We aimed to describe and identify the overlap between the CBCL-JBD profile and CBCL-PTSP scales.Two thousand and twenty-nine (2029) children from a nationally representative sample (1073 boys, 956 girls; mean age = 11.98; age range = 6-18) were rated on emotional and behavior problems by their parents using the CBCL. Comparative model testing via structural equation modeling was conducted to determine whether the CBCL-JBD profile and CBCL-PTSP scale are best described as measuring separate versus unitary constructs. Associations with suicidality and competency scores were also examined.The CBCL-JBD and CBCL-PTSP demonstrated a high degree of overlap (r = .89) at the latent variable level. The best fitting, most parsimonious model was one in which the CBCL-JBD and CBCL-PTSP items identified a single latent construct, which was associated with higher parental endorsement of child suicidal behavior, and lower functioning.The CBCL-JBD profile and CBCL-PTSP scale overlap to a remarkable degree, and may be best described as measures of a single syndrome. This syndrome appears to be related to severe psychopathology, but may not conform to traditional DSM-IV classification. These results contribute to the ongoing debate about the utility of the CBCL-JBD and CBCL-PTSP profiles, and offer promising methods of empirically based measurement of disordered self-regulation in youth.",0,0 +6843,DETERMINING THE COGNITIVE PORTS OF ENTRY AMONGST THE POST-TRAUMATIC STATES: TREATMENT IMPLICATIONS,"Post-traumatic stress disorder (PTSD) is one of a range of trauma responses and has claimed the most therapeutic attention, but other post-traumatic states are probably, collectively, as common and produce a comparable level of functional impairment. It is suggested that in accordance with the cognitive theory of emotional disorders (Alford & Beck, 1997) the post-traumatic states are distinguished by differing cognitive content. Further, it is suggested that PTSD clients have particular information processing biases and those with a chronic form of the condition have a cognitive profile similar to those with a personality disorder. The differing cognitive architecture amongst the post-traumatic states suggests different treatment focii (Scott & Stradling, 2001).",0,0 +6844,Intimate Relationship Distress and Combat-related Posttraumatic Stress Disorder,"Combat-related posttraumatic stress disorder (ptsd) has a significant deleterious effect on interpersonal relationships. Intimate partner relationships can play a crucial role in the mediation, amelioration, maintenance, or aggravation of combat-related ptsd. This chapter presents a case of relationship distress in a 28-year-old female spouse of an Operation Iraqi Freedom (OIF) combat veteran with ptsd. The spouse presents with impaired functioning in behavioral, cognitive, and affective domains specifically reactive to the unique symptom clusters of her husband s ptsd. She also reports associated psychosocial problems to include divorce, occupational difficulty, financial problems, caregiver burden, and mental health stigma. Treatment includes a thorough safety assessment, psychiatric evaluation, individual and couple-based cognitive behavioral psychotherapy, and referral to supportive services. Developing a greater understanding of the impact and complex interplay of combat-related ptsd on intimate relationships can be of great benefit to the mental health providers, the veterans, their intimate partners, and the family system. © Springer International Publishing Switzerland 2015.",0,0 +6845,Military-Related Posttraumatic Stress Disorder and Intimate Relationship Behaviors: A Developing Dyadic Relationship Model,"The protracted conflict in Iraq and Afghanistan and an all-volunteer military has resulted in multiple war zone deployments for many service members. While quick redeployment turnaround has left little time for readjustment for either the service member or family, dealing with the long-term sequelae of combat exposure often leaves families and intimate partners ill-prepared for years after deployments. Using a modified grounded theory approach, digitally recorded couple interviews of 23 couples were purposefully selected from a larger sample of 441 couples to better understand the impact of war zone deployment on the couple. The veteran sample was recruited from a randomly selected cohort of men in treatment for posttraumatic stress disorder (PTSD). Overall, it was found when veterans experiencing deployment-related PTSD reenter or start new intimate relationships they may bring with them a unique cluster of interrelated issues which include PTSD symptoms, physical impairment, high rates of alcohol and/or drug abuse, and psychological and physical aggression. These factors contributed to a dynamic of exacerbating conflict. How these couples approached relationship qualities of mutuality, balanced locus of control and weakness tolerance across six axes of caregiving, disability, responsibility, trauma, communication, and community impacted the couple's capacity to communicate and resolve conflict. This dyadic relationship model is used to help inform implications for clinical practice.",0,0 +6846,An epidemiological profile of cashiers holders carpal tunnel syndrome in a grocery store chain,"Occupational diseases are those acquired in the work. Statistics show an increase number of cases, victims like typists, telephone's operators, cashiers and many others with varied levels of involvement. It is composed of disorders affecting the upper limbs being recognized by the Ministry of Social Welfare. Among these diseases stands out for its high occurrence Carpal Tunnel Syndrome (CTS). It has been considered a disease of the century, because its incidence has increased in 40.8% of repetitive stress disorders, with prevalence in females, and predominant age ranging from 25 to 40 years. It is characterized by pain and paresthesia in the first four fingers and wrists, and arm pain, weakness, numbness in the territory of the median nerve, preserving or not the palmar sensation and numbness in the median sensory distribution. This study aims to assess functional capacity and severity of symptoms presented by cashiers diagnosed with CTS. It is a descriptive and quantitative in nature. The population consists of 13 grocery store cashiers of both sexes, with a workload of 42 hours. We will be used as an instrument called the Boston Carpal Tunnel Questionnaire. That purports to be an effective means of measuring the numbness and pain in hands and wrists. Exclusion criteria we consider the subjects who have other diseases associated with CTS. The collection is with the possibility of partial results to be entered in a spreadsheet in Microsoft Excel for data analysis and subsequent discussion and correlation with the current literature.",0,0 +6847,Association Between Exercise and Posttraumatic Stress Symptoms Among Trauma-Exposed Adults,"The present investigation examined associations between intensities of exercise involvement and posttraumatic stress (PTS) symptom cluster severity (reexperiencing, avoidance/numbing, and hyperarousal). The sample was comprised of 108 adults (54.6% women; M age = 23.9, SD = 10.22, range = 18–62), who endorsed exposure to a Diagnostic and Statistical Manual of Mental Disorders (Fourth edition, Text Revision) posttraumatic stress disorder Criterion A traumatic life event but did not meet criteria for any current Axis I psychopathology. After controlling for gender and lifetime number of trauma exposure types experienced, results indicated that vigorous-intensity exercise, but not light- or moderate-intensity exercise, was significantly inversely associated with hyperarousal symptom cluster severity. This study adds to the scarce, yet growing, body of exercise—PTS literature—by illuminating the inverse associations of vigorous-intensity exercise, specifically, and PTS hyperarousal symptom severity among trauma-exposed individuals.",0,0 +6848,Effects of initial resources on the development of strains during a stressful training situation: Some counterintuitive results,"Summary Resource theories of occupational stress argue that employees' personal and environmental resources protect them from too much distress or strain during stressful work experiences. We examined four resources (emotional stability, previous experience, low drain on pre-existing resources, and workgroup quality) available to soldiers at the beginning of a stressful 3-month training experience as predictors of the trajectories of their strains over that period of time. Based on conservation of resources theory and the job demands–resources model, we predicted that the trends of strains would be more favorable (would increase more slowly or decline more quickly) if participants started the training with greater resources. The resources, primarily emotional stability and lack of pre-existing resource drain, tended to be negatively related to strains, consistent with the idea that they can reduce strains. Significant interactions predicting trends were found predicting two of the three strains (post-traumatic stress symptoms and depression, but not reports of physical health). Contrary to expectations, however, the three resources that significantly predicted trends over time (emotional stability, previous experience, and low pre-existing resource drain) were associated with worsening rather than improving strains. Copyright © 2014 John Wiley & Sons, Ltd.",0,0 +6849,Psychosocial Outcomes in Informal Caregivers of the Critically Ill,"The objective of the review was to evaluate and synthesize the prevalence, risk factors, and trajectory of psychosocial morbidity in informal caregivers of critical care survivors.A systematic search of MEDLINE, PsychInfo, PubMed, CINAHL, Cochrane Library, Scopus, PILOTS, EMBASE, and Physiotherapy Evidence Database was undertaken between January and February 2014.Citations were screened independently by two reviewers for studies that investigated psychosocial outcomes (depression, anxiety, stress, posttraumatic stress disorder, burden, activity restriction, and health-related quality of life) for informal caregivers of critical care survivors (mechanically ventilated for 48 hr or more).Data on study outcomes were extracted into a standardized form and quality assessed by two independent reviewers using the Newcastle-Ottawa Scale, the Physiotherapy Evidence Database, and the National Health and Medical Research Council Hierarchy of Evidence guide. Preferred Reporting Items for Systematic Reviews guidelines were followed.Fourteen studies of 1,491 caregivers were included. Depressive symptoms were the most commonly reported outcome with a prevalence of 75.5% during critical care and 22.8-29% at 1-year follow-up. Risk factors for depressive symptoms in caregivers included female gender and younger age. The greatest period of risk for all outcomes was during the patient's critical care admission although psychological symptoms improved over time. The overall quality of the studies was low.Depressive symptoms were the most prevalent in informal caregivers of survivors of intensive care who were ventilated for more than 48 hours and persist at 1 year with a prevalence of 22.8-29.0%, which is comparable with caregivers of patients with dementia. Screening for caregiver risks could be performed during the ICU admission where intervention can be implemented and then evaluated. Further high-quality studies are needed to quantify anxiety, stress, caregiver burden, and posttraumatic stress disorder outcomes in informal caregivers of long-stay patients surviving ICU.",0,0 +6850,"Attachment Disruptions, IQ, and PTSD in African American Adolescents: A Traumatology Perspective","Attachment disruptions, other traumas, posttraumatic stress disorder (PTSD), and intelligence quotient (IQ) were measured in a sample of 181 African American adolescents. Path analysis was utilized to test the effects of different types of attachment disruptions on IQ and PTSD. Findings supported that mother and father abandonments and being in foster care are associated with decreased perceptual reasoning, processing speed, and working memory, and increased discrepancy between perceptual and verbal toward decreased perceptual reasoning. Such suppression and discrepancy contribute to poor academic achievement. Results validated the traumatology perspective on attachment disruptions as traumas that are associated with PTSD, suppression of most IQ potentials, and with potential brain hemispheric desynchronization. The ramifications of these results for helping African American adolescents are discussed.",0,0 +6851,Child development and family mental health in war and military violence: The Palestinian experience,"The article reviews developmental research among Palestinians living in Gaza. The aims are, first, to analyze how exposure to traumatic events associates with children's mental health and their cognitive, emotional and social development. Second, we aimed to model familial and symbolic processes that can either harm or protect the mental health of children. Third, we wanted to learn who the resilient children are in conditions of war and military violence. The reviewed research has been conducted in the context of a Palestinian non-governmental organization, the Gaza Community Mental Health Programme, during the political upheavals involving hopes for peace and intensive war and violence: the First Intifada (1987—1993), the Palestinian Authority rule (1994— ) and the Second Al Aqsa Intifada (2001— ). The results show that life threat, violence and losses form a risk for increased psychological distress. There are, however, a myriad of child, family and society related factors and psycho-socio-physiological processes that protect child development and mental health. They include, e.g. loving and wisely guiding parenting, children's flexible and high cognitive capacity, flexible and multiple coping strategies and narrative and symbolic nocturnal dreaming, as well as social support and good peer relations. Different models explain psychological distress and positive resources, including child resilience. Exposure to trauma is crucial in predicting distress, while familial and developmental issues are important in building resilience. Children's conscious and unconscious cognitive-emotional processes are crucial for underlying mental health and knowledge about them is important in tailoring evidence-based preventive interventions among war victims.",0,0 +6852,Prise en charge médicamenteuse de l’anxiété chez le patient souffrant de schizophrénie,"Anxiety is a major and frequent symptom of schizophrenia, which is associated with an increased risk of relapse, impaired functioning, lower quality of life and increased incidence of suicide attempts. Despite its clinical relevance, anxiety in schizophrenia remains poorly understood. In the prodromic phase, anxiety indicates a progression towards psychotic decompensation. After a first episode, it is an indicator of relapse.Two approaches have been used to investigate anxiety in schizophrenia: (i) categorical approach (comorbidity of schizophrenia and anxiety disorders) and (ii) dimensional approach (anxiety as a major symptom of the ""dysphoric"" dimension). Clinical categorical studies reported an increased frequency of comorbidity between schizophrenia and obsessive-compulsive disorder, panic disorder, social phobia, post-traumatic stress disorder, generalized anxiety disorder, agoraphobia, and specific phobia. The dimensional approach proposes that five different factors contribute to the structure of the Positive and Negative Syndrome Scale (PANSS), with anxiety as a major symptom of the ""dysphoria"" dimension. Concerning diagnosis, it is unclear whether psychotic and neurotic anxiety differs in nature or intensity. Nevertheless, both are frequently opposed.Psychotic anxiety is intense, profound and hermetic. In contrast to neurotic anxiety, it is associated with psychomotor disturbances, such as agitation and sideration. There is no specific tool to evaluate anxiety in schizophrenia. The dimensional approach usually runs an evaluation using items or factors extracted from the most widely-used scales, i.e. PANSS or Brief Psychiatric Rating Scale (BPRS) or from anxiety scales developed in non-schizophrenic populations, such as the Hamilton Anxiety Scale (HAMA). Recently, we developed a specific scale for hetero-evaluation (Échelle Anxiété Schizophrénie [EAS scale]). The EAS scale was recently validated and the study of its sensitivity is ongoing. THERAPEUTICAL ISSUES: Several studies have examined the effects of antipsychotics on the anxious/depressive cluster extracted from the PANSS, and some other studies have specifically evaluated the effect of antipsychotics on depressive symptoms using the Montgomery and Asberg Depression Rating Scale (MADRS) and Calgary Depression Scale for Schizophrenia (CDSS), but to our knowledge, no study has reported the effect of antipsychotics or other treatment on anxiety when using a schizophrenia-specific scale. There are no specific guideline treatments for anxiety in schizophrenia. Among phenothiazines, cyamemazine is frequently prescribed in France, because of its potent anxiolytic activity and good neurological tolerance. Some authors have suggested a specific treatment with benzodiazepines. However, benzodiazepines should be used with caution, due to undesirable actions such as dependence, rebound and potentiation of certain lateral effects.",0,0 +6853,Gulf War illness: a view from Australia,"Australia sent a small, mostly naval, deployment to the 1991 Gulf War. When papers and media concerns arose about unexplained Gulf War illnesses in Gulf War troops from other countries, Australia decided to undertake its own study of Australian veterans. Undertaking a later study, more than 10 years after the Gulf War, allowed us to incorporate some methodological improvements on previous research, such as the inclusion of a face-to-face health assessment where more objective health data could be collected in addition to using a postal questionnaire. Despite the different Gulf War experience for the mostly naval Australian group, there were remarkable consistencies in the patterns of multiple symptom reporting found in overseas studies, including the fact that no unique symptom clusters were identified. In general, this excess symptom reporting was not found to occur with excesses in more objective measures of physical health. These objective physical measures included a wide range of haematological, biochemical and serological markers, a physical examination, spirometry and a step test of fatigability. In contrast, several psychological disorders, including anxiety, post-traumatic stress disorder, depression and substance abuse, were found to occur in excess in the Australian Gulf War group and were associated with Gulf War psychological stressors. These findings have helped raise awareness in Australia of psychological health problems in deployed military personnel.",0,0 +6854,Latent profile analysis and comorbidity in a sample of individuals with compulsive buying disorder,"The aims of this study were to perform a latent profile analysis in a sample of individuals with compulsive buying, to explore the psychiatric comorbidity, and to examine whether or not more severe compulsive buying is associated with greater comorbidity. Compulsive buying measures and SCID data obtained from 171 patients with compulsive buying behavior who had participated in treatment trials at different clinical centers in the U.S. and Germany were analyzed. Latent profile analysis produced two clusters. Overall, cluster 2, included subjects with more severe compulsive buying, and was characterized by higher lifetime as well as current prevalence rates for Axis I and impulse control disorders. Nearly 90% of the total sample reported at least one lifetime Axis I diagnosis, particularly mood (74%) and anxiety (57%) disorders. Twenty-one percent had a comorbid impulse control disorder, most commonly intermittent explosive disorder (11%). Half of the sample presented with at least one current Axis I disorder, most commonly anxiety disorders (44%). Given the substantial psychiatric comorbidity, it is reasonable to question whether or not compulsive buying represents a distinct psychiatric entity vs. an epiphenomenon of other psychiatric disorders.",0,0 +6855,A Systematic Review of PTSD Prevalence and Trajectories in DSM-5 Defined Trauma Exposed Populations: Intentional and Non-Intentional Traumatic Events,"We conducted a systematic review of the literature to explore the longitudinal course of PTSD in DSM-5-defined trauma exposed populations to identify the course of illness and recovery for individuals and populations experiencing PTSD.We reviewed the published literature from January 1, 1998 to December 31, 2010 for longitudinal studies of directly exposed trauma populations in order to: (1) review rates of PTSD in the first year after a traumatic event; (2) examine potential types of proposed DSM-5 direct trauma exposure (intentional and non-intentional); and (3) identify the clinical course of PTSD (early onset, later onset, chronicity, remission, and resilience). Of the 2537 identified articles, 58 articles representing 35 unique subject populations met the proposed DSM-5 criteria for experiencing a traumatic event, and assessed PTSD at two or more time points within 12 months of the traumatic event.The mean prevalence of PTSD across all studies decreases from 28.8% (range =3.1-87.5%) at 1 month to 17.0% (range =0.6-43.8%) at 12 months. However, when traumatic events are classified into intentional and non-intentional, the median prevalences trend down for the non-intentional trauma exposed populations, while the median prevalences in the intentional trauma category steadily increase from 11.8% to 23.3%. Across five studies with sufficient data, 37.1% of those exposed to intentional trauma develop PTSD. Among those with PTSD, about one third (34.8%) remit after 3 months. Nearly 40% of those with PTSD (39.1%) have a chronic course, and only a very small fraction (3.5%) of new PTSD cases appears after three months.Understanding the trajectories of PTSD over time, and how it may vary by type of traumatic event (intentional vs. non-intentional) will assist public health planning and treatment.",0,0 +6856,Posttraumatic stress reactions after single and double trauma,"This study evaluated the severity and symptom profile of posttraumatic stress reactions of 202 adults exposed in 1988 to political violence in Azerbaijan and/or the earthquake in Armenia. High rates of severe posttraumatic stress reactions were found among the most highly exposed individuals, irrespective of the type of trauma. There was no difference in symptom profile for subjects exposed to earthquake versus violence. These similarities in severity and symptom profile may be attributable to common features of the exposures, which included experiencing life-threat and witnessing injury, multilation and death. Recent prior exposure to violence contributed to the severity of reaction to the earthquake. The high rates of chronic and severe posttraumatic stress reactions in Armenia constitute a major public mental health problem.",0,0 +6857,ASD and PTSD in Rape Victims,"In recent years, a number of studies have investigated the prediction of posttraumatic stress disorder (PTSD) through the presence of acute stress disorder (ASD). The predictive power of ASD on PTSD was examined in a population of 148 female rape victims who visited a center for rape victims shortly after the rape or attempted rape. The PTSD diagnosis based solely on the three core symptom clusters was best identified by a subclinical ASD diagnosis based on all ASD criteria except dissociation. However, a full PTSD diagnosis including the A 2 and F criteria was best identified by classifying victims according to a full ASD diagnosis. Regardless of whether cases were classified according to full PTSD status or according to meeting the criteria for the three PTSD core symptom clusters, the classification was correct only in approximately two thirds of the cases. A regression analysis based on ASD severity and sexual problems following the rape accounted for only 28% of the PTSD severity variance. In conclusion, the ASD diagnosis is not an optimal method for identifying those most at risk for PTSD. It remains to be seen whether a better way can be found.",0,0 +6858,A Comparison of the Acute Stress Reactions between the Han and Tibetan Ethnic Groups in Responding to Devastating Earthquakes,"Objective: The purpose of the present study was to investigate whether there were differences in the acute stress reaction (ASR) between the Tibetan and the Han ethnic groups after experiencing devastating earthquakes. Methods: One hundred twelve Han survivors of the Wenchuan earthquake and 112 Tibetan survivors of the Yushu earthquake were rated using the PTSD Checklist-Civilian (PCL-C) according to their trauma experiences, ages, genders, severity levels of injuries, and medical services received. Results: Injured Tibetans had lower scores across symptom clusters of avoidance, numbing, and the total score of PCL-C as compared to Hans. Among Tibetans, severe ASR was associated with a higher education level and earthquake experience, whereas only earthquake experience was associated with severe ASR among injured Hans. Conclusion: Cultural factors may play significant roles in the acute stress reaction of survivors with different cultural backgrounds following an earthquake.",0,0 +6859,Diagnosis and management of generalized anxiety disorder and panic disorder in adults.,"Generalized anxiety disorder (GAD) and panic disorder (PD) are among the most common mental disorders in the United States, and they can negatively impact a patient's quality of life and disrupt important activities of daily living. Evidence suggests that the rates of missed diagnoses and misdiagnosis of GAD and PD are high, with symptoms often ascribed to physical causes. Diagnosing GAD and PD requires a broad differential and caution to identify confounding variables and comorbid conditions. Screening and monitoring tools can be used to help make the diagnosis and monitor response to therapy. The GAD-7 and the Severity Measure for Panic Disorder are free diagnostic tools. Successful outcomes may require a combination of treatment modalities tailored to the individual patient. Treatment often includes medications such as selective serotonin reuptake inhibitors and/or psychotherapy, both of which are highly effective. Among psychotherapeutic treatments, cognitive behavior therapy has been studied widely and has an extensive evidence base. Benzodiazepines are effective in reducing anxiety symptoms, but their use is limited by risk of abuse and adverse effect profiles. Physical activity can reduce symptoms of GAD and PD. A number of complementary and alternative treatments are often used; however, evidence is limited for most. Several common botanicals and supplements can potentiate serotonin syndrome when used in combination with antidepressants. Medication should be continued for 12 months before tapering to prevent relapse.",0,0 +6860,The course of postraumatic stress in children: Examination of symptom trajectories following PICU admission,"Background and aims: Advances in modern medicine have increasingly improved survival rates of critically ill and injured children. Evidence suggests that there is a significant risk for posttraumatic stress symptoms (PTSS) for children following admission to the Paediatric Intensive Care (PICU), however few studies have explored individual recovery patterns, especially in children. Aims: This paper identifies patterns of PTSS in children aged from 1 year following PICU admission using group-based trajectory modelling. Methods: Following IRB approval, maternal reports of child distress from the acute stage and up to 2 years post-PICU admission (n = 272) were examined to: (1) assess the prevalence of distress in the child, (2) identify symptom trajectories, and (3) identify risk factors associated with poor child mental health outcomes following PICU admission. Results: Analysis identified three distinct symptom trajectories in the children. The majority were resilient (82%). A small group had very high symptoms in the acute phase but were below the clinical cut-off after 6 months (recovery 3%). A significant group of children had clinical level symptoms that did not appear to improve over time (chronic 15%). There was no evidence of delayed onset PTSS. Child age and gender do not predict trajectory patterns. Conclusions: There is growing evidence that significant distress in the peritrauma period is linked to continuing clinical level distress symptoms which have the potential to impact on child physical recovery and long term functioning. Research into early interventions for distressed children following critical illness is a matter of urgency.",0,0 +6861,Methodological issues and research recommendations for mild traumatic brain injury: the who collaborating centre task force on mild traumatic brain injury,"The WHO Collaborating Centre for Neurotrauma Task Force on Mild Traumatic Brain Injury performed a comprehensive search and critical review of the literature published between 1980 and 2002 to assemble the best evidence on the epidemiology, diagnosis, prognosis and treatment of mild traumatic brain injury. Of 743 relevant studies, 313 were accepted on scientific merit and comprise our best-evidence synthesis. The current literature on mild traumatic brain injury is of variable quality and we report the most common methodological flaws. We make recommendations for avoiding the shortcomings evident in much of the current literature and identify topic areas in urgent need of further research. This includes the need for large, well-designed studies to support evidence-based guidelines for emergency room triage of children with mild traumatic brain injury and to explore more fully the issue of prognosis after mild traumatic brain injury in the elderly population. We also advocate use of standard criteria for defining mild traumatic brain injury and propose a definition.",0,0 +6862,Longitudinal Determinants of Posttraumatic Stress in a Population-Based Cohort Study,"Posttraumatic stress disorder is a prevalent and disabling psychologic pathology. Longitudinal research on the predictors of posttraumatic stress symptomatology is limited.We recruited 2752 participants to a prospective, population-based cohort study by conducting a telephone survey of adult residents of the New York City metropolitan area in 2002; participants completed 3 follow-up interviews over a 30-month period. Censoring weights were estimated to account for potential bias. We used generalized estimating equation logistic regression models with bootstrapped confidence intervals to assess the predictors of posttraumatic stress over time in multivariable models.Predictors of posttraumatic stress over time included ongoing stressors (odds ratio [OR] = 1.91 per 1 unit increase in number of stressors, [95% confidence interval = 1.55-2.36]) and traumatic events (OR = 1.92 per 1 unit increase in number of traumatic events [CI = 1.71-2.22]), social support (compared with high levels, OR = 1.71 for medium [1.09-2.52]; OR = 1.57 for low [1.08-2.35]), low income (OR = 0.87 per $10,000 increase [0.81-0.92]), female sex (1.60 [1.11-2.23]), and Latino ethnicity (compared with white, OR = 1.74 [1.05-2.97]).These findings suggest that ongoing stressors play a central role in explaining the trajectory of posttraumatic stress over time, and that factors beyond the experience of stressors and traumas may account for sex and ethnic differences in posttraumatic stress risk. Interventions that focus on reducing ongoing adversity may help mitigate the consequences of traumatic events.",0,0 +6863,Trends of Probable Post-Traumatic Stress Disorder in New York City after the September 11 Terrorist Attacks,"The authors investigated trends in probable post-traumatic stress disorder (PTSD) prevalence in the general population of New York City in the first 6 months after the September 11 terrorist attacks. Three random digit dialing telephone surveys of adults in progressively larger portions of the New York City metropolitan area were conducted 1 month, 4 months, and 6 months after September 11, 2001. A total of 1,008, 2,001, and 2,752 demographically representative adults were recruited in the three surveys, respectively. The current prevalence of probable PTSD related to the September 11 attacks in Manhattan declined from 7.5% (95% confidence interval: 5.7, 9.3) 1 month after September 11 to 0.6% (95% confidence interval: 0.3, 0.9) 6 months after September 11. Although the prevalence of PTSD symptoms was consistently higher among persons who were more directly affected by the attacks, a substantial number of persons who were not directly affected by the attacks also met criteria for probable PTSD. These data suggest a rapid resolution of most of the probable PTSD symptoms in the general population of New York City in the first 6 months after the attacks. The psychological consequences of a large-scale disaster in a densely populated urban area may extend beyond persons directly affected by the disaster to persons in the general population.",0,0 +6864,"Post-traumatic stress disorder, depression, and anxiety among Gaza Strip adolescents in the wake of the second Uprising (Intifada)","Children and adolescents of the Gaza Strip have been subjected to continuous violence since the eruption of the second Intifada (Uprising). Little is known, however, about the psychological effects of this violence on children and adolescents of Gaza. Thus, the purpose of the present investigation was to evaluate and describe the psychological effects of exposure of war-like circumstances on this population.Participants for this study were 229 Palestinian adolescents living in the Gaza Strip who were administered measures of post-traumatic stress disorder (PTSD), depression, anxiety, and coping.Of the 229 participants, 68.9% were classified as having developed PTSD, 40.0% reported moderate or severe levels of depression, 94.9% were classified as having severe anxiety levels, and 69.9% demonstrated undesirable coping responses. A canonical discriminant analysis revealed that adolescents diagnosed with PTSD tended to be those who reported the highest levels of depression, anxiety, and positive reappraisal coping, and the lowest levels of seeking guidance and support coping.These results indicate that a significant proportion of Palestinian adolescents living in the Gaza Strip are experiencing serious psychological distress.",0,0 +6865,Emotional Reactivity to a Single Inhalation of 35% Carbon Dioxide and Its Association With Later Symptoms of Posttraumatic Stress Disorder and Anxiety in Soldiers Deployed to Iraq,"The identification of modifiable predeployment vulnerability factors that increase the risk of combat stress reactions among soldiers once deployed to a war zone offers significant potential for the prevention of posttraumatic stress disorder (PTSD) and other combat-related stress disorders. Adults with anxiety disorders display heightened emotional reactivity to a single inhalation of 35% carbon dioxide (CO(2)); however, data investigating prospective linkages between emotional reactivity to CO(2) and susceptibility to war-zone stress reactions are lacking.To investigate the association of soldiers' predeployment emotional reactivity to 35% CO(2) challenge with several indices of subsequent war-zone stress symptoms assessed monthly while deployed in Iraq.Prospective cohort study of 158 soldiers with no history of deployment to a war zone were recruited from the Texas Combat Stress Risk Study between April 2, 2007, and August 28, 2009.Multilevel regression models were used to investigate the association between emotional reactivity to 35% CO(2) challenge (assessed before deployment) and soldiers' reported symptoms of general anxiety/stress, PTSD, and depression while deployed to Iraq.Growth curves of PTSD, depression, and general anxiety/stress symptoms showed a significant curvilinear relationship during the 16-month deployment period. War-zone stressors reported in theater were associated with symptoms of general anxiety/stress, PTSD, and depression. Consistent with the prediction, soldiers' emotional reactivity to a single inhalation of 35% CO(2)-enriched air before deployment significantly potentiated the effects of war-zone stressors on the subsequent development of PTSD symptoms and general anxiety/stress symptoms but not on the development of depression, even after accounting for the effects of trait anxiety and the presence of past or current Axis I mental disorders.Soldiers' emotional reactivity to a 35% CO(2) challenge may serve as a vulnerability factor for increasing soldiers' risk for PTSD and general anxiety/stress symptoms in response to war-zone stressors.",0,0 +6866,A Mixed-Methods Study of Secondary Traumatic Stress in Certified Nurse-Midwives: Shaken Belief in the Birth Process,"Secondary traumatic stress (STS) is an occupational hazard for clinicians who can experience symptoms of posttraumatic stress disorder (PTSD) from exposure to their traumatized patients. The purpose of this mixed-methods study was to determine the prevalence and severity of STS in certified nurse-midwives (CNMs) and to explore their experiences attending traumatic births.A convergent, parallel mixed-methods design was used. The American Midwifery Certification Board sent out e-mails to all their CNM members with a link to the SurveyMonkey study. The STS Scale was used to collect data for the quantitative strand. For the qualitative strand, participants were asked to describe their experiences of attending one or more traumatic births. IBM SPSS 21.0 (Version 21.0, Armonk, NY) was used to analyze the quantitative data, and Krippendorff content analysis was the method used to analyze the qualitative data.The sample consisted of 473 CNMs who completed the quantitative portion and 246 (52%) who completed the qualitative portion. In this sample, 29% of the CNMs reported high to severe STS, and 36% screened positive for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnostic criteria for PTSD due to attending traumatic births. The top 3 types of traumatic births described by the CNMs were fetal demise/neonatal death, shoulder dystocia, and infant resuscitation. Content analysis revealed 6 themes: 1) protecting my patients: agonizing sense of powerlessness and helplessness; 2) wreaking havoc: trio of posttraumatic stress symptoms; 3) circling the wagons: it takes a team to provide support … or not; 4) litigation: nowhere to go to unburden our souls; (5) shaken belief in the birth process: impacting midwifery practice; and 6 moving on: where do I go from here?The midwifery profession should acknowledge STS as a professional risk.",0,0 +6867,Psychiatric morbidity following motor vehicle accidents: A review of methodological issues,"Motor vehicle accidents (MVAs), even those of a nonserious nature, appear to increase the risk of severe psychiatric morbidity in survivors. The present review examines the evidence indicating the levels of psychiatric morbidity in MVA survivors. Although no consistent profile has emerged, the most commonly reported symptoms are depression, anxiety, irritability, driving phobia, anger, sleep disturbances, and headache, with rates of posttraumatic stress disorder (PTSD) across studies of 0% to 100%. Variability in the type and severity of psychiatric outcomes may be due, in part, to methodological inadequacies in many studies, particularly the use of biased population samples, inclusion of subjects exposed to varied types of accidents, an absence of a clear definition of PTSD, a reliance on clinical judgment rather than the use of objective psychometric measures, the failure to include ratings of injury severity, and the absence of assessments for past exposure to traumatic events or preexisting posttraumatic reactions. The most important concern relates to the use of nonrepresentative samples, usually patients referred for medicolegal assessment in whom issues of compensation are of central importance. Gender and age differences distinguish the compensation group from the general population of MVA survivors, who therefore may also differ in the vulnerability to posttraumatic morbidity. It is argued that more systematic research on unselected subject samples is critical to establish epidemiological data on the true nature and extent of psychiatric morbidity following MVAs.",0,0 +6868,A systematic review of post-deployment injury-related mortality among military personnel deployed to conflict zones,"This paper reports on a systematic review of the literature on the post-conflict injury-related mortality of service members who deployed to conflict zones.Literature databases, reference lists of articles, agencies, investigators, and other sources were examined to find studies comparing injury-related mortality of military veterans who had served in conflict zones with that of contemporary veterans who had not served in conflict zones. Injury-related mortality was defined as a cause of death indicated by International Classification of Diseases E-codes E800 to E999 (external causes) or subgroupings within this range of codes.Twenty studies met the review criteria; all involved veterans serving during either the Vietnam or Persian Gulf conflict. Meta-analysis indicated that, compared with non-conflict-zone veterans, injury-related mortality was elevated for veterans serving in Vietnam (summary mortality rate ratio (SMRR) = 1.26, 95% confidence interval (95%CI) = 1.08-1.46) during 9 to 18 years of follow-up. Similarly, injury-related mortality was elevated for veterans serving in the Persian Gulf War (SMRR = 1.26, 95%CI = 1.16-1.37) during 3 to 8 years of follow-up. Much of the excess mortality among conflict-zone veterans was associated with motor vehicle events. The excess mortality decreased over time. Hypotheses to account for the excess mortality in conflict-zone veterans included post-traumatic stress, coping behaviors such as substance abuse, ill-defined diseases and symptoms, lower survivability in injury events due to conflict-zone comorbidities, altered perceptions of risk, and/or selection processes leading to the deployment of individuals who were risk-takers.Further research on the etiology of the excess mortality in conflict-zone veterans is warranted to develop appropriate interventions.",0,0 +6869,A prospective examination of PTSD symptoms as risk factors for subsequent exposure to potentially traumatic events among women.,"Previous research has suggested that both exposure to potentially traumatic events (PTEs) and emotional reactions to such events act as risk factors for subsequent exposure. Although some studies have implicated posttraumatic stress disorder (PTSD) symptoms as risk factors, extant research suffers from a number of methodological limitations, including the use of cross-sectional designs and student populations. The present study sought to address these limitations using a 2-year, 3-wave national probability household sample of 2,863 adult women. After controlling for demographic characteristics, prior exposure to PTEs, and Wave 1 depression and substance abuse, PTSD reexperiencing symptoms at Wave 1 predicted subsequent exposure to interpersonal violence victimization (IPVV) perpetrated by a nonintimate perpetrator; however, PTSD symptoms did not predict intimate partner IPVV. In addition, PTSD hyperarousal symptoms were unique predictors of subsequent exposure to other traumatic stressors. Findings suggest that efforts to prevent PTEs should focus attention on both prior exposure and PTSD symptoms in response to such exposure.",0,0 +6870,Psychological distress and resources among siblings and parents exposed to traumatic events,"We examined symmetries and asymmetries within family members' psychological distress and resources in general and when exposed to traumatic events in particular. PTSD and depressive symptoms indicated distress and resilient attitudes, and satisfaction with quality of life indicated resources. We also analysed potential complementary dynamics between family members and identified family types according to their distress and resources. Concerning trauma impact, we hypothesized that exposure to family military violence (FMV) and recent personal trauma (RPT) predict family members' psychological distress and resources differently, indicating asymmetry in family responses. The participants were 65 Palestinian families each consisting of a mother, a father and their 15-, 17and 19-year-old children. The within-family MANOVA results showed asymmetric in psychological distress and resources in sibling and spousal subsystems, for example older siblings reported a higher level of depressive symptoms than both parents, and mothers reported PTSD more often than fathers. The cluster analysis identified four family types, two with symmetric responses: In the “resilient families” all members showed low distress and high resources, and in the “ordeal families” all showed distress and low resources. In the asymmetric families either the children or the parents showed low distress and high resources, named the “children's strength families” and the “parental strength families”, respectively. Partial correlation analysis revealed complementary dynamics between children and their parents: If mothers reported high levels of psychological distress, the 15and 17-year-olds reported low or vice versa. Spousal complementary dynamics were found in psychosocial resources: If the mother showed highly resilient attitudes, the father showed low or vice versa. As hypothesized, exposure to traumatic events was differently associated with family members’ psychological distress and resources. Family military trauma (FMT) predicted depressive symptoms only among the youngest siblings, and recent personal trauma (RPT) was associated with dissatisfaction with quality of life only among the oldest sibling and fathers.",0,0 +6871,"Overextraction of Latent Trajectory Classes: Much Ado About Nothing? Reply to Rindskopf (2003), Muthén (2003), and Cudeck and Henly (2003).","The comments on D. J. Bauer and P. J. Curran (2003) share 2 common themes. The 1st theme is that model-checking procedures may be capable of distinguishing between mixtures of normal and homogeneous nonnormal distributions. Although useful for assessing model quality, it is argued here that currently available procedures may not always help discern between these 2 possibilities. The 2nd theme is that even if these 2 possibilities cannot be distinguished, a growth mixture model may still provide useful insights into the data. It is argued here that whereas this may be true for the scientific goals of description and prediction, the acceptance of a model that fundamentally misrepresents the underlying data structure may be less useful in pursuit of the goal of explanation.",0,0 +6872,Measurement of individualised quality of life amongst young people with indicated personality disorder during emerging adulthood using the SEIQoL-DW,"Purpose To examine both the feasibility of applying the Schedule for the Evaluation of Individual Quality of Life- Direct Weighting procedure (SEIQoL-DW) as a routine outcome measure within an early intervention service for young people with indicated personality disorder and the overall quality of life (QoL) in this population. Methods SEIQoL-DW was administered alongside the Standardised Assessment of Personality-Abbreviated Scale-Self-Report (SAPAS-SR), Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder Scale (GAD-7) and the Post-Traumatic Stress Disorder-Primary Care (PTSD-PC) as part of routine service evaluation over a 16-month period. Descriptive statistics were calculated for data reflecting use of the SEIQoL-DW alongside demographic and outcome variables. Results The SEIQoL-DW was administered to 52 young adults with indicated personality disorder, with 47 completing the measure, taking an average time of 27 min. Individual QoL was poor with a mean global index score of 55.07 (SD = 22.34). Individual QoL areas formed five main domains-'Aspects of Daily Living', 'Relationships', 'Social Life and Leisure', 'Family' and 'Emotional and Physical Wellbeing'. Conclusion This study further extends the application of the SEIQoL-DW for use as a routine outcome measure within a busy service setting, although ways to accommodate administration time need to be considered. Poor QoL highlights the need for continued development of services to meet the needs of young adults with indicated personality disorder. © Springer Science+Business Media B.V. 2012.",0,0 +6873,Attention to threat images in individuals with clinical and subthreshold symptoms of post-traumatic stress disorder,"Attention to general and trauma-relevant threat was examined in individuals with clinical and subthreshold symptoms of post-traumatic stress disorder (PTSD). Participants' eye gaze was tracked and recorded while they viewed sets of four images over a 6-s presentation (one negative, positive, and neutral image, and either a general threat image or a trauma-relevant threat image). Two trauma-exposed groups (a clinical and a subthreshold PTSD symptom group) were compared to a non-trauma-exposed group. Both the clinical and subthreshold PTSD symptom groups attended to trauma-relevant threat images more than the no-trauma-exposure group, whereas there were no group differences for general threat images. A time course analysis of attention to trauma-relevant threat images revealed different attentional profiles for the trauma-exposed groups. Participants with clinical PTSD symptoms exhibited immediate heightened attention to the images relative to participants with no-trauma-exposure, whereas participants with subthreshold PTSD symptoms did not. In addition, participants with subthreshold PTSD symptoms attended to trauma-relevant threat images throughout the 6-s presentation, whereas participants with clinical symptoms of PTSD exhibited evidence of avoidance. The theoretical and clinical implications of these distinct attentional profiles are discussed.",0,0 +6874,Clinical Utility and Psychometric Properties of the Traumatic Brain Injury Quality of Life Scale (TBI-QOL) in US Military Service Members,"To examine the clinical utility and psychometric properties of the Traumatic Brain Injury Quality of Life (TBI-QOL) scale in a US military population.One hundred fifty-two US military service members (age: M = 34.3, SD = 9.4; 89.5% men) prospectively enrolled from the Walter Reed National Military Medical Center and other nationwide community outreach initiatives. Participants included 99 service members who had sustained a mild traumatic brain injury (TBI) and 53 injured or noninjured controls without TBI (n = 29 and n = 24, respectively).Participants completed the TBI-QOL scale and 5 other behavioral measures, on average, 33.8 months postinjury (SD = 37.9).Fourteen TBI-QOL subscales; Neurobehavioral Symptom Inventory; Posttraumatic Stress Disorder Checklist-Civilian version; Alcohol Use Disorders Identification Test; Combat Exposure Scale.The internal consistency reliability of the TBI-QOL scales ranged from α = .91 to α = .98. The convergent and discriminant validity of the 14 TBI-QOL subscales was high. The mild TBI group had significantly worse scores on 10 of the 14 TBI-QOL subscales than the control group (range, P < .001 to P = .043). Effect sizes ranged from medium to very large (d = 0.35 to d = 1.13). The largest differences were found on the Cognition-General Concerns (d = 1.13), Executive Function (d = 0.94), Grief-Loss (d = 0.88), Pain Interference (d = 0.83), and Headache Pain (d = 0.83) subscales.These results support the use of the TBI-QOL scale as a measure of health-related quality of life in a mild TBI military sample. Additional research is recommended to further evaluate the clinical utility of the TBI-QOL scale in both military and civilian settings.",0,0 +6875,Trajectories of Self-Rated Health Among Veterans: A Latent Growth Curve Analysis of the Impact of Posttraumatic Symptoms,"To examine the effects of combat stress reaction (CSR) and posttraumatic stress symptoms (PTS) on the level and trajectories of self-rated health (SRH) over 20 years after war exposure.A total of 675 veterans comprising two groups, a CSR group (n = 369) and a matched control group without CSR (n = 306), were assessed in a prospective longitudinal design, 1, 2, 3, and 20 years after their participation in the 1982 Lebanon War. SRH and PTS were assessed repeatedly, at each point of measurement.The CSR participants showed more impaired initial SRH than the controls. Although the CSR group showed an improvement in SRH over time, its SRH level remained lower than that of the control group in all 4 points in time. Initial levels of PTS were associated with more impaired SRH and lower improvement over time. In addition, increased levels of PTS in the first follow-up period were related to poorer SRH, in comparison to the predicted trajectory on the basis of CSR and initial PTS.Stress reaction to war trauma affected the trajectory of SRH over a 20-year period. Although the differences between veterans who had shown acute stress reaction and those who had not persisted over the entire period, there was slow improvement in SRH over time among the more impaired CSR group. PTS in the first years after the war slowed this improvement and thus played a key role in the relationship between war trauma and physical health.",0,0 +6876,Abnormal functional architecture of amygdala‐centered networks in adolescent posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) is a prevalent, debilitating, and difficult to treat psychiatric disorder. Very little is known of how PTSD affects neuroplasticity in the developing adolescent brain. Whereas multiple lines of research implicate amygdala-centered network dysfunction in the pathophysiology of adult PTSD, no study has yet examined the functional architecture of amygdala subregional networks in adolescent PTSD. Using intrinsic functional connectivity analysis, we investigated functional connectivity of the basolateral (BLA) and centromedial (CMA) amygdala in 19 sexually abused adolescents with PTSD relative to 23 matched controls. Additionally, we examined whether altered amygdala subregional connectivity coincides with abnormal grey matter volume of the amygdaloid complex. Our analysis revealed abnormal amygdalar connectivity and morphology in adolescent PTSD patients. More specifically, PTSD patients showed diminished right BLA connectivity with a cluster including dorsal and ventral portions of the anterior cingulate and medial prefrontal cortices (p < 0.05, corrected). In contrast, PTSD patients showed increased left CMA connectivity with a cluster including the orbitofrontal and subcallosal cortices (p < 0.05, corrected). Critically, these connectivity changes coincided with diminished grey matter volume within BLA and CMA subnuclei (p < 0.05, corrected), with CMA connectivity shifts additionally relating to more severe symptoms of PTSD. These findings provide unique insights into how perturbations in major amygdalar circuits could hamper fear regulation and drive excessive acquisition and expression of fear in PTSD. As such, they represent an important step toward characterizing the neurocircuitry of adolescent PTSD, thereby informing the development of reliable biomarkers and potential therapeutic targets.",0,0 +6877,Perceived controllability and the development of posttraumatic stress disorder (PTSD) in crime victims,"This study evaluated the association between perception of controllability and the development of posttraumatic stress disorder (PTSD) following criminal assault. Factor analysis of a perceived controllability scale revealed three factors; perceived controllability felt during the assault, expected controllability over future assaults, and perceived controllability over aversive events more generally. Only the latter factor was associated with PTSD symptom severity. The hypothesis that perceived controllability would be negatively associated with assault severity was partially supported. Further analyses showed that the association between controllability and PTSD was not mediated or moderated by assault severity measures. The role of perceived controllability in the development of PTSD is discussed.",0,0 +6878,Autonomic dysregulation in panic disorder and in post-traumatic stress disorder: application of power spectrum analysis of heart rate variability at rest and in response to recollection of trauma or panic attacks,"Power spectral analysis (PSA) of heart rate variability (HRV) offers reliable assessment of cardiovascular autonomic responses, providing a 'window' onto the interaction of peripheral sympathetic and parasympathetic tone. Alterations in HRV are associated with various physiological and pathophysiological processes, and may contribute to morbidity and mortality. Previous studies of posttraumatic stress disorder (PTSD) found lower resting HRV in patients compared to controls, suggesting increased sympathetic and decreased parasympathetic tone. This article describes the analysis of HRV at rest and after psychological stress in panic disorder (PD) patients, in an enlarged sample of PTSD patients, and in healthy control subjects. Standardized heart rate (HR) analysis was carried out in 14 PTSD patients, 11 PD patients and 25 matched controls. ECG recordings were made while subjects were resting ('rest 1'), while recalling the trauma implicated in PTSD, or the circumstances of a severe panic attack, as appropriate ('recall'), and again while resting ('rest 2'). Controls were asked to recall a stressful life event during recall. While both patient groups had elevated HR and low frequency (LF) components of HRV at baseline (suggesting increased sympathetic activity), PTSD patients, unlike PD patients and controls, failed to respond to the recall stress with increases in HR and LF. HRV analysis demonstrates significant differences in autonomic regulation of PTSD and PD patients compared to each other and to control subjects. HRV analysis may augment biochemical studies of peripheral measures in these disorders.",0,0 +6879,Community Disaster Vulnerability,"Disaster vulnerability is rapidly increasing on a global scale, particularly for those populations which are the historical clients of the social work profession. These populations include the very young and very old, the poor, ethnic and racial minorities, and those with physical or mental disabilities. Social workers are increasingly providing services in disasters during response and recovery periods, and are using community interventions to reduce disaster vulnerability. There is a need for a cogent theory of vulnerability and research that addresses improved community disaster practice and community resilience. Community Disaster Vulnerability and Resilience provides a unifying theoretical framework backed by research which can be translated into knowledge for effective practice in disasters. © Springer Science+Business Media New York 2013. All rights are reserved.",0,0 +6880,"Clinicians' Posttraumatic Growth following Hurricane Katrina: The Influence of Life Events, Professional Quality of Life, and Primary and Secondary Traumatic Stress","This study was a secondary data analysis of 244 clinicians living and working in a post-Katrina environment. Using structural equation modeling, clinicians' trauma histories and primary and secondary traumatic stress were assessed in relationship to posttraumatic growth. It was expected that a greater number of traumatic life events would be related to higher levels of traumatic experience and growth. It was also expected that traumatic life experience would be associated with growth. Contrary to expectation, the initial evaluation of the path coefficients showed no significant paths between primary trauma and posttraumatic growth. A closer inspection of measures and model diagnostics revealed three distinct constructs pertaining to primary trauma, none of which were highly correlated. A revised model was then re-fit with the inclusion of two latent variables, primary trauma and posttraumatic growth, which yielded a better fit. The new model was statistically overidentified. The results showed that a greater number of traumatic life events were related to both primary and secondary traumatic stress but not growth. The latent variables revealed a statistically significant relationship between traumatic reexperiencing which related to greater posttraumatic growth in the domain, appreciation for life. Implications for theory development, clinical practice and policy, and future research are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6881,Efficacy of exposure therapy for Japanese patients with posttraumatic stress disorder due to mixed traumatic events: A randomized controlled study,en,0,0 +6882,Risk Factors of Posttraumatic Stress Disorder After an Earthquake Disaster,"This study sought to predict posttraumatic stress disorder (PTSD) from women's reproductive health events after an earthquake experience. Data on antenatal care, pregnancy outcomes, family planning, socioeconomic status, earthquake experiences, and mental health were collected from a random sample of 425 women of reproductive age using the Centers for Disease Control and Prevention Reproductive Health Assessment Toolkit and the Harvard Trauma Questionnaire. Data were analyzed using multivariate regression analysis to predict PTSD symptoms from posttrauma care variables and reproductive health events. Restricted social participation, use of temporary accommodation, pregnancy complications, and use of injectable contraceptives were significant risk factors of PTSD. These factors may be exacerbated by the social context of conservative societies, traditions about health care-seeking behavior, and access to health care. Antecedent reproductive health events influence women's reaction to major trauma including events such as an earthquake.",0,0 +6883,The concept of nomogenic disorders.,"The term 'nomogenic disorders' has been coined for psychopathological conditions created, enhanced, and perpetuated by the law and its application, and for the psychological and social consequences of the law and the way it affects the course of the disease process. Questions are raised regarding the diagnosis, prognosis and therapy of this cluster of disorders. Conditions paradigmatic of nomogenic disorder are presented. Emphasis is placed on the historical development of traumatic neuroses, as they are at present the most frequently encountered nomogenic condition. The clinical and theoretical importance of the concept of nomogenesis is discussed.",0,0 +6884,Pharmacological prevention of post-traumatic stress disorder and acute stress disorder: a systematic review and meta-analysis,"An increasing number of studies have investigated the pharmacological prevention of post-traumatic stress disorder (PTSD) and acute stress disorder (ASD). This is the first systematic review to examine the effects of pharmacotherapies (eg, β blockers, hydrocortisone, and selective serotonin re-uptake inhibitors) given within the first month after a traumatic or aversive event to prevent PTSD or ASD compared with no pharmacotherapy or placebo control.A systematic literature search in PubMed, PsycINFO, Embase, and the Cochrane database of randomised trials was done. Studies included randomised controlled trials, controlled clinical trials, and cohort studies; their overall quality was low to moderate. We computed the pooled incidence risk ratio (IRR): the risk of incidence of PTSD or ASD in the pharmacotherapy groups relative to the incidence of PTSD or ASD in the control groups. Additionally, we computed Hedges'g effect sizes for PTSD or ASD continuous outcomes.15 studies met inclusion criteria (1765 individuals). Pharmacotherapy was more effective in preventing PTSD or ASD than placebo or no intervention (14 studies, 1705 individuals, IRR 0·65, 95% CI 0·55-0·78; number needed to treat 11·36), although no effect was found when only randomised controlled trials were included (ten studies, 300 individuals, IRR 0·69, 95% CI 0·40-1·21). Hydrocortisone showed a large effect in reducing the risk of PTSD (five studies, 164 individuals, IRR 0·38, 95% CI 0·16-0·92).No firm evidence was found for the efficacy of all early pharmacotherapies in the prevention of PTSD or ASD, but hydrocortisone reduced the risk of developing PTSD. The small number of studies and their limited methodological quality cast uncertainty about the effects.None.",0,0 +6885,"Erratum to: Trends in Psychological/Psychiatric Injury and Law: Continuing Education, Practice Comments, Recommendations","This literature review of the major topics in the field of psychological/psychiatric injury and law is aimed at developing practice in the area. The field is a fast-developing one, with over ten major topics that it needs to integrate. In particular, the present review focuses on current work on: law (evidence, tort); forensic psychology; assessment and testing; psychological injuries (posttraumatic stress disorder, chronic pain, traumatic brain injury, other); the APA DSM-5 draft (Diagnostic and statistical manual of mental disorders; American Psychiatric Association 2010); malingering; causality; multicultural considerations; disability; the American Medical Association (AMA) Guides to the evaluation of permanent impairment (Rondinelli et al. 2008); models; and treatment. At the end of each section of the article, practice comments introduce critical issues in applying the research to psychological work in the area. Whether undertaking tort evaluations, disability, and treatment plan assessments or treating individuals with psychological injuries, the professional needs state-of-the-art information in all the areas listed in order to remain scientifically informed, comprehensive, and impartial. The article concludes with recommendations for an integrated field in psychological/psychiatric injury and law, study in the field, research in its major areas, best practice policies, for example in assessment and treatment, and model building.",0,0 +6886,From efficacy to effectiveness: the trajectory of the treatment literature for children with PTSD,"This review summarizes efficacious treatments for preschoolers, children and adolescents with post-traumatic stress disorder, with a focus on the advances made within the last 5 years. There is considerable support for the use of trauma-specific cognitive-behavioral interventions, in both individual and group formats. The research on psychopharmacological treatments lags behind that of psychotherapy and is currently inconclusive. Limitations of the studies are discussed and treatments that warrant further consideration are reviewed. The authors also review current advances in effectiveness and suggest future directions that are important in generalizing the interventions to underserved and hard to reach populations. The article concludes with the authors' projections for the evolution of the field within the upcoming 5 years.",0,0 +6887,The international humanitarian system and the 2004 Indian Ocean earthquake and tsunamis,"The December 2004 Indian Ocean earthquake and tsunamis were an exceptional event. So too was the scale of the response, particularly the level of international funding. Unprecedented donations meant that for once, an international emergency response was largely free of financial constraints. This removal of the funding constraint facilitated observation of the capacity and quality of international disaster aid. The Tsunami Evaluation Coalition conducted five independent thematic assessments in 2005—an impact study was planned, but never implemented. The five evaluations were supported by 44 sub-studies. Based on this work, this paper compares international disaster response objectives, principles and standards with actual performance. It reaches conclusions on four salient aspects: funding; capacity and quality; recovery; and ownership. It ends by proposing a fundamental reorientation of international disaster response approaches that would root them in concepts of sustainable disaster risk reduction and recovery, based on local and national ownership of these processes.",0,0 +6888,Attention-deficit/hyperactivity disorder comorbidity in a sample of veterans with posttraumatic stress disorder,"This study examined attention-deficit/hyperactivity disorder (ADHD) comorbidity in military veterans with a high prevalence of posttraumatic stress disorder (PTSD) and evaluated the relationships between the 2 disorders and exposure to traumatic events. The sample included 222 male and female military veterans who were administered structured clinical interviews based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Results show that 54.5% met the criteria for current PTSD, 11.5% of whom also met the criteria for current adult ADHD. Level of trauma exposure and ADHD severity were significant predictors of current PTSD severity. Evaluation of the underlying structure of symptoms of PTSD and ADHD using confirmatory factor analysis yielded a best-fitting measurement model that comprised 4 PTSD factors and 3 ADHD factors. Standardized estimates of the correlations among PTSD and ADHD factors suggested that the largest proportion of shared variance underlying PTSD-ADHD comorbidity is related to problems with modulating arousal levels that are common to both disorders (ie, hyperarousal and hypoarousal).",0,0 +6889,Twenty-One—Month Follow-up Study of School-Age Children Exposed to Hurricane Andrew,"To explore the 21-month course of posttraumatic stress symptomatology (PTSS) and psychological morbidity in 30 school-age children (7 to 13 years) after exposure to Hurricane Andrew.Pynoos' Posttraumatic Stress Disorder Reaction Index and Achenbach's Teacher's Report Form were administered at 8 and 21 months after Hurricane Andrew.At 21 months 70% of the children endorsed moderate-severe PTSS. The reduction in PTSS was greater for boys than girls. Psychopathology as measured by the Teacher's Report Form increased over the 19-month period. Boys demonstrated significant increases in internalizing symptoms and in Withdrawn, Anxious/Depressed, Social Problems, and Attention Problems scales, and girls showed a significant increase in the Anxious/Depressed scale.Twenty-one months after exposure to Hurricane Andrew, there were continuing high levels of PTSS and evidence of increasing emotional and behavioral problems. While girls sustained higher levels of PTSS, boys demonstrated higher indices of other psychopathology. The enduring effects of disaster associated with secondary stressors and ""traumatic reminders"" continue to be etiologically important for continuing psychological morbidity.",0,0 +6890,A factor analysis of posttraumatic stress disorder symptoms using data pooled from two venlafaxine extended‐release clinical trials,"Confirmatory factor analysis (CFA) of Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) three-factor posttraumatic stress disorder (PTSD) diagnostic criteria was conducted to determine fit for this patient population. An exploratory factor analysis (EFA) of alternate symptom structures was planned to identify symptoms that cluster in this population. The response of symptom factors to treatment with venlafaxine extended release (ER) was explored.Baseline 17-item Clinician-Administered PTSD Scale (CAPS-SX17) data were pooled from patients enrolled in two double-blind, randomized, placebo-controlled trials. The CFA was conducted using maximum likelihood and weighted, least-squares factor extraction methods. The EFA was performed using a polychoric correlation covariance matrix and Pearson correlation matrix.Data from a pooled population of 685 patients (venlafaxine ER: n = 339; placebo: n = 346) were analyzed. CFA rejected the DSM-IV three-factor structure. The EFA identified a different three-factor structure as the best fit: factor 1 included reexperiencing symptoms, factor 2 included symptoms of altered mood and cognition, whereas factor 3 comprised avoidance and arousal symptoms. All DSM-IV symptom factors and all factors in the identified three-factor model responded positively to venlafaxine ER treatment.Data are consistent with literature failing to confirm the three-factor structure of DSM-IV PTSD, and they support the DSM-5 inclusion of a symptom cluster addressing altered mood and cognition in PTSD. The efficacy of venlafaxine ER in reducing a range of symptom clusters in PTSD is consistent with its multiple mechanisms of action.",0,0 +6891,An exploration of the characteristics of post-traumatic stress disorder in reserve forces deployed during desert storm,"Post-traumatic stress disorder (PTSD), previously defined in Vietnam War veterans, was described in 251 Desert Storm reservists. The Mississippi Scale, Revised, was used with a brief demographic profile to survey Army, Marine, and Air Force personnel who had been deployed to Saudi Arabia. Age, sex, marital status, race, rank, duty, length of deployment, and branch of service were not found to be significantly related to PTSD symptoms. However, those surveyed within 3 to 6 months of homecoming reported significantly greater symptoms than those surveyed after 6 months. Five percent of subjects were found to have clinically diagnostic levels of PTSD symptoms 6 months after homecoming. Individuals who expressed difficulty discussing their experiences with more than one person also showed significantly higher PTSD scores. These findings indicate that readjustment reactions were prevalent during the first 6 months and that PTSD could be identified in 5% of the Desert Storm veterans.",0,0 +6892,"Blood Pressure in Firefighters, Police Officers, and Other Emergency Responders","Elevated blood pressure is a major risk factor for cardiovascular morbidity and mortality. Increased risk begins in the prehypertensive range and increases further with higher pressures. The strenuous duties of emergency responders (firefighters, police officers, and emergency medical services (EMS) personnel) can interact with their personal risk profiles, including elevated blood pressure, to precipitate acute cardiovascular events. Approximately three-quarters of emergency responders have prehypertension or hypertension, a proportion which is expected to increase, based on the obesity epidemic. Elevated blood pressure is also inadequately controlled in these professionals and strongly linked to cardiovascular disease morbidity and mortality. Notably, the majority of incident cardiovascular disease events occur in responders who are initially prehypertensive or only mildly hypertensive and whose average premorbid blood pressures are in the range in which many physicians would hesitate to prescribe medications (140-146/88-92). Laws mandating public benefits for emergency responders with cardiovascular disease provide an additional rationale for aggressively controlling their blood pressure. This review provides a background on emergency responders, summarizes occupational risk factors for hypertension and the metabolic syndrome, their prevalence of elevated blood pressure, and evidence linking hypertension with adverse outcomes in these professions. Next, discrepancies between relatively outdated medical standards for emergency responders and current, evidence-based guidelines for blood pressure management in the general public are highlighted. Finally, a workplace-oriented approach for blood pressure control among emergency responders is proposed, based on the seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.",0,0 +6893,Parents of Children With Cancer: At-Risk or Resilient?,"To examine adjustment in parents of children with cancer using a design that minimizes focusing effects and allows for direct comparison with parents of healthy children.Parents of 305 children with cancer and a demographically similar sample of 231 parents of healthy children were evaluated using diagnostic interviews for posttraumatic stress disorder (PTSD), and questionnaire measures of posttraumatic stress symptoms (PTSS) and psychological growth (PG), as well as measures of global psychological functioning.Rates of current and lifetime PTSD in parents of children with cancer were low, and did not differ from comparison parents. Likewise, levels of PTSS were not significantly different from comparison parents, but differed as a function of time since diagnosis, with parents of children who were ≥ 5 years from diagnosis reporting significantly lower PTSS than comparison parents. PG was higher in parents of children with cancer than in comparison parents regardless of time since diagnosis.Parents of children with cancer demonstrate resilience to this challenge.",0,0 +6894,Individual differences in fear: Isolating fear reactivity and fear recovery phenotypes,"Although different people respond differently to threatening events, animal research on the neural basis of fear tends to focus on typical responses. Yet there are substantial individual differences between animals exposed to identical behavioral procedures. In an effort to begin to understand the nature and causes of fear variability and resilience, we separated outbred Sprague-Dawley rats into high and low reactivity, and fast and slow recovery phenotypes, based on freezing levels during fear conditioning and extinction, respectively. Subsequent tests revealed stable differences in both measures, indicating that fear responses reflect trait-like phenotypes in outbred animals. Because clinical disorders may reflect extreme phenotypes, identification of the biological basis for these differences could provide insights into human individual differences in fear.",0,0 +6895,Emotional Responses of Mothers of Late‐Preterm and Term Infants,"ABSTRACT Objective To compare the emotional responses of mothers of late‐preterm infants (34 0/7 to 36 6/7 weeks gestation) with those of mothers of full‐term infants. Design A mixed method comparative study. Setting A southeastern tertiary academic medical center postpartum unit. Participants Sixty mothers: 29 mothers of late‐preterm infants and 31 mothers of full‐term infants. Methods Measures of maternal emotional distress (four standardized measures of anxiety, postpartum depression, posttraumatic stress symptoms, and worry about infant health) and open‐ended semistructured maternal interviews were conducted in the hospital following birth and by phone at one month postpartum. Results Mothers of late‐preterm infants experienced significantly greater emotional distress immediately following delivery, and their distress levels continued to be higher at one month postpartum on each of the standardized measures. Mothers of late‐preterm infants also discussed the altered trajectories in their birth and postpartum experiences and feeling unprepared for these unexpected events as a source of ongoing emotional distress. Conclusion Mothers of late‐preterm infants have greater emotional distress than mothers of term infants for at least one month after delivery. Our findings suggest that it may not be a single event that leads to different distress levels in mothers of late‐preterm and full‐term infants but rather the interaction of multiple alterations in the labor and delivery process and the poorer‐than‐expected infant health outcomes. In the future, researchers need to examine how and when mothers' emotional responses change over time and how their responses relate to parenting and infant health and development.",0,0 +6896,Posttraumatic stress in deployed Marines: Prospective trajectories of early adaptation.,"We examined the course of PTSD symptoms in a cohort of U.S. Marines (N = 867) recruited for the Marine Resiliency Study (MRS) from a single infantry battalion that deployed as a unit for 7 months to Afghanistan during the peak of conflict there. Data were collected via structured interviews and self-report questionnaires 1 month prior to deployment and again at 1, 5, and 8 months postdeployment. Second-order growth mixture modeling was used to disaggregate symptom trajectories; multinomial logistic regression and relative weights analysis were used to assess the role of combat exposure, prior life span trauma, social support, peritraumatic dissociation, and avoidant coping as predictors of trajectory membership. Three trajectories best fit the data: a low-stable symptom course (79%), a new-onset PTSD symptoms course (13%), and a preexisting PTSD symptoms course (8%). Comparison in a separate MRS cohort with lower levels of combat exposure yielded similar results, except for the absence of a new-onset trajectory. In the main cohort, the modal trajectory was a low-stable symptoms course that included a small but clinically meaningful increase in symptoms from predeployment to 1 month postdeployment. We found no trajectory of recovery from more severe symptoms in either cohort, suggesting that the relative change in symptoms from predeployment to 1 month postdeployment might provide the best indicator of first-year course. The best predictors of trajectory membership were peritraumatic dissociation and avoidant coping, suggesting that changes in cognition, perception, and behavior following trauma might be particularly useful indicators of first-year outcomes.",1,0 +6897,Posttraumatic stress disorder and somatic symptoms among child and adolescent survivors following the Lushan earthquake in China: A six-month longitudinal study,"To explore somatic conditions in a sample of 2299 child and adolescent survivors of an earthquake and their relationship to posttraumatic stress disorder (PTSD) symptoms.The Children's Revised Impact of Event Scale, the Patient Health Questionnaire (PHQ)-13 scale, a short version of PHQ-15 scale that omits two items involving sexual pain/problems and menstrual problems, and a project-developed questionnaire were administered to participants three and six months after the earthquake.Among child and adolescent survivors, the prevalence rates of probable PTSD were 37.4 and 24.2% three and six months, respectively, after the earthquake. The most common somatic symptoms were trouble sleeping (58.4 and 48.4%), feeling tired or having low energy (52.0 and 46.1%), and stomach pain (45.8 and 45.4%) after three and six months, respectively. Several specific somatic symptoms evaluated three months after the earthquake including trouble sleeping, headache, and shortness of breath were predictors of the overall PTSD symptoms evaluated six months after the earthquake. Additionally, the symptom of hyperarousal evaluated after three months could predict the overall somatic symptoms evaluated after six months.PTSD and somatic symptoms were common after the earthquake, and a longitudinal association between PTSD and somatic symptoms was detected among child and adolescent survivors. These findings have implications in China and possibly elsewhere.",0,0 +6898,Prevention of Post-Traumatic Stress Disorder After Trauma: Current Evidence and Future Directions,"Post-traumatic stress disorder (PTSD) is a frequent, tenacious, and disabling consequence of traumatic events. The disorder's identifiable onset and early symptoms provide opportunities for early detection and prevention. Empirical findings and theoretical models have outlined specific risk factors and pathogenic processes leading to PTSD. Controlled studies have shown that theory-driven preventive interventions, such as cognitive behavioral therapy (CBT), or stress hormone-targeted pharmacological interventions, are efficacious in selected samples of survivors. However, the effectiveness of early clinical interventions remains unknown, and results obtained in aggregates (large groups) overlook individual heterogeneity in PTSD pathogenesis. We review current evidence of PTSD prevention and outline the need to improve the disorder's early detection and intervention in individual-specific paths to chronic PTSD.",0,0 +6899,Measuring and maximizing coverage in the World Trade Center Health Registry,"The World Trade Center Health Registry (WTCHR) is a database for following people who were exposed to the disaster of 11 September 2001. Hundreds of thousands of people were exposed to the immense cloud of dust and debris, the indoor dust, the fumes from persistent fires, and the mental trauma of the terrorist attacks on the WTC on 9/11. The purpose of the WTCHR is to evaluate the potential short- and long-term physical and mental health effects of the disaster. The definitions of the exposed groups are broad and defined based on an understanding of which groups had the highest exposures to the WTC disaster and its aftermath. The four exposure groups include rescue and recovery workers, residents, students and school staff, and building occupants and passersby in Lower Manhattan. While one goal of the WTCHR was to maximize coverage overall and for each exposure group, another was to ensure equal representation within exposure groups. Because of the multiple sample types pursued, several approaches were required to determine eligibility. Estimates of the number of eligible persons in each of the exposed populations were based on the best available information including Census, entity-specific employment figures, and public and private school enrollment data, among other publicly available sources. To address issues of undercoverage and overcoverage a variety of methods were assessed or applied, including a capture-recapture analyses test of overlapping sample building list sources and automated deduplication of sample records. Estimates of the true eligible population indicate that over 400,000 unique individuals were eligible for the baseline health survey. Interviewer-administered surveys were completed with more than 71,000 persons, resulting in an overall enrollment rate of approximately 17 per cent. Coverage was highest among rescue and recovery workers, followed by residents, students and school staff, and building occupants. Both the accuracy of coverage estimates and the raw number and representativeness of enrollees were maximized by our approach to coverage. In designing a registry which relies on multiple pathways and sources of data to build the sample, it is important to develop a comprehensive approach that considers all sources of error and minimizes bias that may be introduced through the methodology.",0,0 +6900,Pervasive Trauma Exposure Among US Sexual Orientation Minority Adults and Risk of Posttraumatic Stress Disorder,"We assessed sexual orientation disparities in exposure to violence and other potentially traumatic events and onset of posttraumatic stress disorder (PTSD) in a representative US sample.We used data from 34 653 noninstitutionalized adult US residents from the 2004 to 2005 wave of the National Epidemiologic Survey on Alcohol and Related Conditions.Lesbians and gay men, bisexuals, and heterosexuals who reported any same-sex sexual partners over their lifetime had greater risk of childhood maltreatment, interpersonal violence, trauma to a close friend or relative, and unexpected death of someone close than did heterosexuals with no same-sex attractions or partners. Risk of onset of PTSD was higher among lesbians and gays (adjusted odds ratio [AOR] = 2.03; 95% confidence interval [CI] = 1.34, 3.06), bisexuals (AOR = 2.13; 95% CI = 1.38, 3.29), and heterosexuals with any same-sex partners (AOR = 2.06; 95% CI = 1.54, 2.74) than it was among the heterosexual reference group. This higher risk was largely accounted for by sexual orientation minorities' greater exposure to violence, exposure to more potentially traumatic events, and earlier age of trauma exposure.Profound sexual orientation disparities exist in risk of PTSD and in violence exposure, beginning in childhood. Our findings suggest there is an urgent need for public health interventions aimed at preventing violence against individuals with minority sexual orientations and providing follow-up care to cope with the sequelae of violent victimization.",0,0 +6901,"Posttraumatic Stress and Well-Being Following Relationship Dissolution: Coping, Posttraumatic Stress Disorder Symptoms From Past Trauma, and Traumatic Growth","This study investigated posttraumatic stress symptoms (PTSS) and psychological comorbidity following dating relationship dissolution. The roles of coping, posttraumatic growth, and posttraumatic stress disorder (PTSD) severity from past trauma were analyzed. Participants (n = 187) were recruited through an online survey. Emotion-focused coping and PTSD severity from past trauma were positively associated with higher levels of PTSS and psychological comorbidity. Posttraumatic growth was negatively associated with psychological comorbidity; problem-focused coping was negatively associated with PTSS. Emotion-focused coping and PTSD severity from past trauma appeared to be risk factors for psychological outcomes, while posttraumatic growth and problem-focused coping were found to be protective factors.",0,0 +6902,Emotion Modulation in PTSD: Clinical and Neurobiological Evidence for a Dissociative Subtype,"In this article, the authors present evidence regarding a dissociative subtype of PTSD, with clinical and neurobiological features that can be distinguished from nondissociative PTSD. The dissociative subtype is characterized by overmodulation of affect, while the more common undermodulated type involves the predominance of reexperiencing and hyperarousal symptoms. This article focuses on the neural manifestations of the dissociative subtype in PTSD and compares it to those underlying the reexperiencing/hyperaroused subtype. A model that includes these two types of emotion dysregulation in PTSD is described. In this model, reexperiencing/hyperarousal reactivity is viewed as a form of emotion dysregulation that involves emotional undermodulation, mediated by failure of prefrontal inhibition of limbic regions. In contrast, the dissociative subtype of PTSD is described as a form of emotion dysregulation that involves emotional overmodulation mediated by midline prefrontal inhibition of the same limbic regions. Both types of modulation are involved in a dynamic interplay and lead to alternating symptom profiles in PTSD. These findings have important implications for treatment of PTSD, including the need to assess patients with PTSD for dissociative symptoms and to incorporate the treatment of dissociative symptoms into stage-oriented trauma treatment.",0,0 +6903,Understanding the psychological impact of terrorism on youth: Moving beyond posttraumatic stress disorder.,"Comer and Kendall's (2007) comprehensive review of the impact of terrorism on youth organizes this important and burgeoning area of research. The present commentary focuses on youth outcomes associated with proximal contact with terrorist attacks, and highlights several important issues that merit attention. Specifically, the commentary emphasizes the importance of examining youths’ postattack outcomes broadly (in addition to posttraumatic stress disorder and its symptoms), assessing traumatic grief and bereavement when mass casualties occur, and evaluating issues of comorbidity and functional impairment. Future research on the impact of terrorism on youth would benefit from adopting a developmental psychopathology perspective in understanding variables that may influence and be influenced by youths’ reactions to terrorist events. Implications for research and clinical practice are discussed.",0,0 +6904,Validation of lay-administered mental health assessments in a large Army National Guard cohort,"To report the reliability and validity of key mental health assessments in an ongoing study of the Ohio Army National Guard (OHARNG). The 2616 OHARNG soldiers received hour-long structured telephone surveys including the post-traumatic stress disorder (PTSD) checklist (PCV-C) and Patient Health Questionnaire - 9 (PHQ-9). A subset (N = 500) participated in two hour clinical reappraisals, using the Clinician-Administered PTSD Scale (CAPS) and the Structured Clinical Interview for DSM (SCID). The telephone survey assessment for PTSD and for any depressive disorder were both highly specific [92% (standard error, SE 0.01), 83% (SE 0.02)] with moderate sensitivity [54% (SE 0.09), 51% (SE 0.05)]. Other psychopathologies assessed included alcohol abuse [sensitivity 40%, (SE 0.04) and specificity 80% (SE 0.02)] and alcohol dependence [sensitivity, 60% (SE 0.05) and specificity 81% (SE 0.02)].The baseline prevalence estimates from the telephone study suggest alcohol abuse and dependence may be higher in this sample than the general population. Validity and reliability statistics suggest specific, but moderately sensitive instruments.",0,0 +6905,"Relationships between sexual abuse in childhood, post-traumatic stress disorder (PTSD) and cognitive impairments","Current theoretical study shows relationships between sexual abuse during childhood, post-traumatic stress disorder (PTSD) and cognitive impairments. The cognitive perspective of sexual abuse effects and PTSD has been undertaken. Child sexual abuse against children is considered a risk factor in child development due to severe cognitive, emotional and behavioral sequences related to the event. The impact of sexual abuse involves short and long term effects and may be seen during adulthood. Review studies foreground the association between traumatic events (sexual abuse), PTSD, and alterations, structural and functional, in cerebral areas related to biological stress response systems. The necessity of future researches investigating the effects of stress and trauma in the child’s neurodevelopment will be discussed.",0,0 +6906,Challenges Faced by Former Child Soldiers in the Aftermath of War in Uganda,"

Abstract

Purpose

Warfare takes a profound toll of all layers of society, creating multiple and multilevel challenges that impinge on the psychosocial well-being of affected individuals. This study aims to assess the scope and salience of challenges confronting former child soldiers and at identifying additional challenges they face compared to non-recruited young people in war-affected northern Uganda.

Methods

The study was carried out with a stratified random sample of northern Ugandan adolescents (n = 1,008), of whom a third had formerly been recruited (n = 330). The mixed-method comparison design consisted of a constrained free listing task to determine the challenges; a free sorting task to categorize them into clusters; and statistical analysis of their prevalence among formerly recruited youth and of how they compare with those of nonrecruited youth.

Results

Altogether, 237 challenges were identified and clustered into 15 categories, showing that formerly recruited participants mainly identified ""emotional"" and ""training and skills""–related challenges. Compared with nonrecruited counterparts, they reported significantly more ""emotional"" and fewer ""social and relational"" challenges, with the exception of stigmatization. Overall, there was similarity between the challenges reported by both groups.

Conclusions

The challenges confronting formerly recruited youths reach well beyond the effects of direct war exposure and emerge mainly from multiple influence spheres surrounding them. These challenges are largely shared in common with nonrecruited youths. This multidimensional and collective character of challenges calls for comprehensive psychosocial interventions through which healing the psychological wounds of war is complemented by mending the war-affected surroundings at all levels and in all life areas.",0,0 +6907,Post-Traumatic Stress Symptoms and Post-Traumatic Growth: Evidence from a Longitudinal Study following an Earthquake Disaster,"The current longitudinal study aims to examine the bidirectional relationship between post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG).One hundred twenty-two adults in the most severely affected area were investigated by self-report questionnaires at 12 months and 18 months after the Wenchuan Earthquake occurred in China.The autoregressive cross-lagged structure equation analysis revealed that PTG at 12 months post-earthquake could negatively predict PTSS at 18 months post-earthquake above and beyond PTSS stability, whereas PTSS at 12 months post-earthquake could not significantly predict subsequent PTG. Moreover, PTG at 12 months post-earthquake could predict fewer subsequent intrusions, numbing and hyper-arousal symptoms but not avoidance symptoms.Growth can play a role in reducing long-term post-traumatic stress symptoms, and the implication of a positive perspective in post-trauma circumstance is discussed.",0,0 +6908,"Post-Homicide Reactions: Grief, Mourning and Post-Traumatic Stress Disorder following a Drunk Driving Fatality","This article examines the impact of gender, religious beliefs, subjective health status, individuals' past experience with death, social support, and time since the death on the extent of mourning, the extent of grieving, and Post-traumatic Stress Disorder (PTSD) symptomatology. It is proposed that the mode of death complicates the nature and course of bereavement after the death of a primary family member in a drunk driving collision. The unnecessary and violent nature of the death of drunk driving victims adds to the depth and extent of the psychological response to trauma. It is proposed that the models of grief utilized to conceptualize the grieving process are inadequate as a sole measure of the response of this type of death. Therefore, the inclusion of Post-traumatic Stress Disorder was provided for a more comprehensive understanding of this type of grief response. Survey data were collected on 171 primary family members of drunk driving victims (spouses, parents, siblings, or children) randomly selected from support groups and social service agencies throughout Texas. Results provide a greater understanding of the factor influencing the responses of the surviving family members after a drunk driving fatality and demonstrate that the grief and PTSD response share common predictors.",0,0 +6909,Guilt Among Ex-Prisoners of War,"The article explores guilt and its correlates among Israeli ex-prisoners of war (ex-POWs) of the 1973 Yom Kippur War (YKW; N = 119) and a matched group of veterans of the same war who were not held captive (N = 97). Results revealed that compared with controls, ex-POWs reported both more posttraumatic stress symptoms (PTSS) and more guilt, after adjusting for PTSS. Results also revealed a significant PTSS × Group interaction effect on guilt, wherein the association between PTSS and guilt was stronger among ex-POWs than among controls. Among ex-POWs, results showed that feelings of helplessness when falling captive, inwardly directed active coping, and a sense of loss of control during captivity contributed to the prediction of guilt. Support at homecoming made no contributions to variance, and circumstances of falling into captivity did not predict guilt. Results support the notion that guilt is a significant component of the psychological aftermath of war captivity, and highlight its correlates. Clinical...",0,0 +6910,Genetic and Environmental Influences on Posttrauma Adjustment in Children and Adolescents: The Role of Personality Constructs,"The prevalence of exposure to traumatic events in childhood and adolescence is high and is associated with a host of mental health difficulties. However, not all trauma-exposed youth develop mental health difficulties in the wake of trauma, suggesting that other factors, such as personality and genetic influences, may play a role in posttrauma adjustment. In the present article, we provide an overview of how personality factors influence posttrauma trajectories and how both personality and posttrauma adjustment may be influenced by genetic factors. We first review major personality constructs, with a focus on developmental and assessment considerations in trauma-exposed youth. Next, we provide a discussion of genetic influences on personality, exposure to traumatic events, and the development of mental health disorders following traumatic event exposure. Lastly, recommendations for future research are provided. © 2011",0,0 +6911,"Acute Stress Response and Posttraumatic Stress Disorder in Traffic Accident Victims: A One-Year Prospective, Follow-Up Study","OBJECTIVE: This study was designed to assess the natural course of posttraumatic symptoms formation, as well as the degree to which acute stress reactions predict later posttraumatic stress disorder (PTSD) in injured traffic accident victims. METHOD: A prospective, 1-year follow-up study was carried out on 74 injured traffic accident victims and a comparison group of 19 patients who were hospitalized for elective orthopedic surgery. Participants were interviewed within the first week following the accident, and follow-up interviews were performed 1, 3, 6, and 12 months after the accident. At 12 months, a structured clinical interview was administered to determine a formal DSM-III-R diagnosis of PTSD. RESULTS: Twenty-four (32%) of the 74 traffic accident victims, but none of the 19 comparison subjects, met DSM-III-R criteria for PTSD at 1 year. Traffic accident victims who developed PTSD had higher levels of premorbid and comorbid psychopathology. Levels of posttraumatic symptoms were significantly higher from the outset in the subjects who developed PTSD and worsened progressively over the first 3 months, in contrast to subjects without PTSD, who manifested gradual amelioration of symptoms during this time. Existence of posttraumatic symptoms immediately after the accident was a better predictor of later PTSD than was accident or injury severity. CONCLUSIONS: In this study, a significant portion of injured traffic accident victims manifested PTSD 1 year after the event. The development of PTSD at 1 year can be predicted as early as 1 week after the accident on the basis of the existence and severity of early PTSD-related symptoms. However, the first 3 months following the accident appear to be the critical period for the development of PTSD. (Am J Psychiatry 1999; 156:367–373)",0,0 +6912,Comparing posttraumatic stress disorder's symptom structure between deployed and nondeployed veterans.,"We tested two empirically validated 4-factor models of posttraumatic stress disorder (PTSD) symptoms using the PTSD Checklist: King, Leskin, King, and Weathers' (1998) model including reexperiencing, avoidance, emotional numbing, and hyperarousal factors, and Simms, Watson, and Doebbeling's (2002) model including reexperiencing, avoidance, dysphoria, and hyperarousal. Our aim was to determine which fit better in two groups of military veterans: peacekeepers previously deployed to a war zone (deployed group) and those trained for peacekeeping operations who were not deployed (nondeployed group). We compared the groups using multigroup confirmatory factor analysis. Adequate model fit was demonstrated among the nondeployed group, with no significant difference between King et al.'s (1998) model (separating avoidance and numbing) and Simms et al.'s (2002) similar model involving a dysphoria factor. A better fitting factor structure consistent with Simms et al.'s (2002) model was found in the deployed group. Comprehensive measurement invariance testing demonstrated significant differences between the deployed and nondeployed groups on all structural parameters, except observed variable intercepts (thus indicating similarities only in PTSD item severity). These findings add to researchers' understanding of PTSD's factor structure, given the revision of PTSD that will appear in the forthcoming 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2010)--namely, that the factor structure may be quite different between groups with and without exposure to major traumatic events.",0,0 +6913,Internal Verification and Corroboration of Traumatic Memories of Child Sexual Abuse,"ABSTRACT Based on clinical experience and review of the clinical and legal research literature, the author proposes that a cluster of several of six clinical findings is a potential indicator of internal corroboration that trauma occurred, especially that of child sexual abuse. These six clinical findings include: the presence of a high risk disorder or illness; post-traumatic stress disorder; age regression, flashbacks, abreactions or other re-experiencing of the trauma; repetitions, repetition compulsions or re-enactments; characteristics of the memories themselves; and other patterns, dynamics, and connections. The author welcomes the experience and feedback of clinicians who assist survivors of trauma, especially that of child sexual abuse.",0,0 +6914,Recovery from mild traumatic brain injury,"Fatigue is one of the most frequently reported symptoms after Mild Traumatic Brain Injury (MTBI). To date, systematic and comparative studies on fatigue after MTBI are scarce, and knowledge on causal mechanisms is lacking. To determine the severity of fatigue six months after MTBI and its relation to outcome. Furthermore, to test whether injury indices, such as Glasgow Coma Scale scores, are related to higher levels of fatigue. Postal questionnaires were sent to a consecutive group of patients with an MTBI and a minor-injury control group, aged 18–60, six months after injury. Fatigue severity was measured with the Checklist Individual Strength. Postconcussional symptoms and limitations in daily functioning were assessed using the Rivermead Post Concussion Questionnaire and the SF-36. A total of 299 out of 618 eligible (response rate 52%) MTBI patients and 287 out of 482 eligible (response rate 60%) minor-injury patients returned the questionnaire. Ninety-five MTBI patients (32%) and 35 control patients (12%) were severely fatigued. Severe fatigue was highly associated with the experience of other symptoms, limitations in physical and social functioning, and fatigue related problems like reduced activity. Of various trauma severity indices, nausea and headache experienced on the ED were significantly related to higher levels of fatigue at six months. In conclusion, one third of a large sample of MTBI patients experiences severe fatigue six months after injury, and this experience is associated with limitations in daily functioning. Our finding that acute symptoms and mechanism of injury rather than injury severity indices appear to be related to higher levels of fatigue warrants further investigation.",0,0 +6915,Panic disorder among Vietnamese refugees attending a psychiatric clinic: prevalence and subtypes,"This study surveys Vietnamese refugees attending two psychiatric clinics to determine both the prevalence of panic disorder (PD) as well as panic attack subtypes in those suffering PD. A culturally valid adaptation of the SCID-panic module (the Vietnamese Panic Disorder Survey or VPDS) was administered to 100 Vietnamese refugees attending two psychiatric clinics. Utilizing culturally sensitive panic probes, the VPDS provides information regarding both the presence of PD and panic attack subtypes during the month prior to interview. Of 100 patients surveyed, 50 (50%) currently suffered PD. Among the 50 patients suffering PD, the most common panic attack subtypes during the previous month were the following: ""orthostatic dizziness"" (74% of the 50 panic disorder patients [PDPs]), headache (50% of PDPs), wind-induced/temperature-shift-induced (24% of PDPs), effort-induced (18% of PDPs), gastro-intestinal (16% of PDPs), micturition-induced (8% of PDPs), out-of-the-blue palpitations (24% of PDPs), and out-of-the-blue shortness of breath (16% of PDPs). Five mechanisms are adduced to account for this high PD prevalence as well as the specific profile of subtypes: 1) a trauma-caused panic attack diathesis; 2) trauma-event cues; 3) ethnic differences in physiology; 4) catastrophic cognitions generated by cultural syndromes; and 5) a modification of Clark's spiral of panic.",0,0 +6916,Maladaptive cognitive appraisals mediate the evolution of posttraumatic stress reactions: A 6-month follow-up of child and adolescent assault and motor vehicle accident survivors.,"A prospective longitudinal follow-up study (n = 59) of child and adolescent survivors of physical assaults and motor vehicle accidents assessed whether cognitive processes predicted posttraumatic stress symptomatology (PTSS) at 6 months posttrauma in this age group. In particular, the study assessed whether maladaptive posttraumatic appraisals mediated the relationship between initial and later posttraumatic stress. Self-report measures of PTSS, maladaptive appraisals, and other cognitive processes, as well as structured interviews assessing for acute stress disorder and posttraumatic stress disorder (PTSD), were completed at 2-4 weeks and 6 months posttrauma. PTSS and PTSD at 6 months were associated with maladaptive appraisals and other cognitive processes but not demographic or objective trauma severity variables. Only maladaptive appraisals were found to associate with PTSS/PTSD after partialing out initial symptoms/diagnosis and to mediate between initial and later PTSS. It was argued that, on this basis, maladaptive appraisals are involved in the development and maintenance of PTSS over time, whereas other cognitive processes (e.g., subjective threat, memory processes) may have an effect only in the acute phase. The implications of this study for the treatment of PTSS in youths are discussed.",0,0 +6917,Ambulatory cardiovascular functioning in healthy postmenopausal women with victimization histories,"Criminal victimization is a prevalent stressor among women, with potentially long-lasting emotional consequences. The present study examined associations among severity of lifetime victimization, current posttraumatic stress disorder (PTSD) symptoms, and ambulatory blood pressure (ABP) and heart rate (AHR) levels and variability. Thirty-nine healthy post-menopausal women who endorsed a history of criminal victimization completed a measure of PTSD symptom severity and participated in an average of 18 h of ambulatory cardiovascular monitoring. PTSD symptom clusters were associated with AHR. Symptom clusters and lifetime victimization severity jointly predicted ABP, with ABP the highest among severely victimized women with high levels of current intrusions. Given the prevalence of criminal victimization, biopsychosocial research on women's cardiovascular disease risk may benefit from increased attention to this stressor and its psychological sequelae.",0,0 +6918,Couple adjustment and posttraumatic stress disorder symptoms in National Guard veterans of the Iraq war.,"Relationship adjustment and posttraumatic stress disorder (PTSD) symptoms were assessed across two time points in a sample of 313 married or partnered National Guard soldiers recently returned from combat duty in Iraq. Structural equation modeling using a four-factor model for PTSD found the latent variable dysphoria (reflecting generalized distress including aspects of emotional numbing and arousal) had the strongest independent contribution to predicting relationship adjustment at Time 1 and indirectly predicted poorer relationship adjustment at Time 2. Exploratory analysis of gender differences (n = 33 women; n = 280 men) suggested a different pattern of relations between PTSD factors and relationship adjustment among female soldiers at Time 1, with a trend toward trauma specific avoidance being more highly related to relationship adjustment. Clinical and research implications are discussed.",0,0 +6919,Racial differences in the physical and psychosocial health among black and white women with chronic pain.,"Gender-based differences in pain epidemiology, pain threshold, attitudes toward pain management, coping styles and social roles are well described, yet little is known about the chronic pain experience in women or the role race plays. A retrospective analysis of self-reported data using a secondary clinical database was performed to elucidate the relationship between race and pain severity, depression, physical disability, posttraumatic stress disorder (PTSD) as well as affective distress in women with chronic pain. White (n=1,088) and black (n=104) adult women were compared based on their responses to the McGill Pain Questionnaire, Beck Depression Inventory, Pain Disability Index, Posttraumatic Chronic Pain Test and items from the West-Haven Yale Multidisciplinary Pain Inventory. After accounting for sociodemographic, medical, psychological and physical confounders, there was no significant race effect for pain severity or affective distress. However, black women with chronic pain experience more physical impairments than white women with chronic pain (beta = 4.622; p<0.005). Except for the family/home responsibilities, similar differences were found on all PDI subscales. We also found that disability mediates the race-depression relationship such that black women are comparatively more vulnerable to depression as a result of higher disability. Due to the economic, social and emotional impact that disability has on women with chronic pain and their families, these findings have significant implications for chronic pain research as well as its management in black women.",0,0 +6920,Temporal pattern of cochlear nerve degeneration following compression injury: a quantitative experimental observation,"It has been empirically recognized that the cochlear nerve is highly vulnerable to traumatic stress resulting from surgical procedures; therefore, careful manipulation of the cochlear nerve is mandatory in preventing trauma-induced hearing loss during cerebellopontine angle (CPA) surgery. There is, however, no precise knowledge about the temporal pattern of cochlear nerve degeneration following trauma. This study was performed to determine the temporal pattern of injury that occurs after cochlear nerve trauma, knowledge of which is indispensable not only to neurosurgeons but also to all those who manage lesions involving the cochlear nerve.Right suboccipital craniectomies were performed in groups of rats with the aid of a surgical microscope, and the seventh and eighth cranial nerve trunks were identified at the internal auditory meatus. The cochlear nerve was quantifiably compressed while compound action potentials of the cochlear nerve were monitored and recorded. Following injury, one group of rats was killed for histological examination at the end of each week for 4 weeks. Data from this study disclosed that the degeneration of the compressed cochlear nerve progressed in a relatively rapid manner and was complete within 1 week after the insult. The main pathophysiological mechanisms responsible for cochlear neuronal death in this experimental setting appeared to be necrosis, and an apoptotic mechanism seemed to play a subsidiary role.Accurate knowledge about the temporal profile of trauma-induced cochlear nerve degeneration is closely linked with the problem of the therapeutic time window. The results of the present study indicated that any measures to ameliorate cochlear nerve degeneration following trauma should be started as early as possible (within 1 week) after an injury.",0,0 +6921,Cognitive-behavioural Group Intervention for PTSD Symptoms in Children Following the Athens 1999 Earthquake: A Pilot Study,"This study examined the effects of a short-term group cognitive-behavioural intervention in children who were experiencing PTSD symptoms following the Athens 1999 earthquake. Twenty children, aged 8-12 years, referred for treatment to a local child mental health team were assigned, depending on timing of referral to two groups - Group 1 ( N = 10), which started treatment 2 months after the earthquake and Group 2 ( N = 10), which started treatment at 4 months postearthquake. A statistically significant reduction in overall PTSD (Posttraumatic Stress Disorder) symptoms across the three PTSD symptom clusters - intrusion, avoidance, and arousal - as well as in depressive symptoms was reported immediately after the intervention. The treatment also produced a statistically significant improvement in children’s psychosocial functioning. Further significant improvement was reported in children at an 18-month follow-up. Treatment gains were maintained at a 4-year follow-up. Despite several limitations to this study, short-term group CBT (cognitive-behavioural therapy) was found to be a useful treatment approach, which can be offered in clinical settings, particularly if resources are limited.",0,0 +6922,Psychiatric Advanced Practice Nurses Contributions to Supporting Survivors and Caregivers Affected by the Boston Marathon Bombings,"The role of the psychiatric advanced practice nurse in promoting psychological health and resiliency for patients, their families and staff following the Boston Marathon bombings is reviewed.On April 15, 2013, 2 bombs exploded near the finish line at the Boston Marathon. Within minutes, 39 patients suffering from multiple injuries presented at a level I trauma center. The magnitude of this event and its effect on our hospital required a comprehensive response that would promote resiliency and healing.Lessons shared from responders to other tragedies were helpful in guiding our interprofessional efforts. The multiple layers of our response are reviewed to offer learnings that may inform others as they work to promote resiliency and healing following traumatic events.In response to this event, we utilized a trauma-informed care framework emphasizing physical, psychological, and emotional safety to assist staff, survivors, and families on their journey of healing.Emotional reactions were dramatic but were eased by the psychological care and education that our patients, their families, and staff received in the first days to weeks after the bombings.The psychiatric advanced practice nurse can influence positive outcomes by utilizing a trauma-informed care framework.",0,0 +6923,Differential symptom pattern of post-traumatic stress disorder (PTSD) in maltreated children with and without concurrent depression,"The present study attempted to examine specific differences in the Post-Traumatic Stress Disorder (PTSD) symptomatology among abused children with and without concurrent depression.PTSD and depressive symptoms were identified that discriminate between 98 children divided into three groups: (1) abused children with PTSD, (2) nonabused children who meet criteria for Major Depressive Disorder (MDD), and (3) abused children with both PTSD and MDD.Analyses revealed that nine items reflecting depressive symptomatology, primarily vegetative symptoms, differentiated the diagnostic groups (PTSD-only, MDD-only, and the combined group). A discriminant analysis revealed that the sum of responses to the nine significant items adequately predicted diagnostic classification for those with PTSD and depression, but did not correctly diagnose any in the combined group. Analyses also revealed that three post-trauma symptoms, including psychological amnesia, flashbacks/reenactments, and sleep difficulties, discriminated between the groups. The PTSD-only group reported more episodes of psychological amnesia while the PTSD and MDD group experienced more flashbacks.For the sample of abused children examined, these results illuminate differences with respect to PTSD symptom presentation for those children with PTSD who have a concurrent depressive disorder and their nondepressed counterparts. Children with PTSD who have a concurrent depression report greater levels of intrusive PTSD-related symptoms.",0,0 +6924,"Nepali Concepts of Psychological Trauma: The Role of Idioms of Distress, Ethnopsychology and Ethnophysiology in Alleviating Suffering and Preventing Stigma","In the aftermath of a decade-long Maoist civil war in Nepal and the recent relocation of thousands of Bhutanese refugees from Nepal to Western countries, there has been rapid growth of mental health and psychosocial support programs, including posttraumatic stress disorder treatment, for Nepalis and ethnic Nepali Bhutanese. This medical anthropology study describes the process of identifying Nepali idioms of distress and local ethnopsychology and ethnophysiology models that promote effective communication about psychological trauma in a manner that minimizes stigma for service users. Psychological trauma is shown to be a multifaceted concept that has no single linguistic corollary in the Nepali study population. Respondents articulated different categories of psychological trauma idioms in relation to impact on the heart-mind, brain-mind, body, spirit, and social status, with differences in perceived types of traumatic events, symptom sets, emotion clusters and vulnerability. Trauma survivors felt blamed for experiencing negative events, which were seen as karma transmitting past life sins or family member sins into personal loss. Some families were reluctant to seek care for psychological trauma because of the stigma of revealing this bad karma. In addition, idioms related to brain-mind dysfunction contributed to stigma, while heart-mind distress was a socially acceptable reason for seeking treatment. Different categories of trauma idioms support the need for multidisciplinary treatment with multiple points of service entry.",0,0 +6925,Post-traumatic stress disorder and alcohol use disorder,"Our clinical observations along with data in the literature have shown an increased incidence of alcohol use disorder in persons who suffer from post-traumatic stress disorder. In this work we examined alcohol use disorder in war veterans who were suffering from post-traumatic stress disorder (group 1) (n=52) and compared them with veterans who were traumatized but who had not developed a clinical picture of post-traumatic stress disorder (group 2) (n=29) and a sample from the general population (group 3) (n=30). The objective of this work was to establish the cluster symptoms of post-traumatic stress disorder that are related to alcohol use disorder and connected with depression. All of the respondents were males. The methods used were structured clinical interviews for the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders axis I disorders for addiction and post-traumatic stress disorder and Beck's scale for depression. The results obtained showed that there were no statistically significant differences in the incidence of alcohol use disorders between traumatized patients who had and those who had not developed post-traumatic stress disorder, but there was a significant statistical differencefor both groups 1 and 2 in relation to the control group. The variables that correlated positively with alcohol use disorder were the cluster symptoms of re-experiencing and the arousal symptom of the traumatized group and there was also increased depression in both groups examined (groups 1 and 2).",0,0 +6926,Mother–infant bonding impairment across the first 6 months postpartum: the primacy of psychopathology in women with childhood abuse and neglect histories,"Our goal was to examine the trajectory of bonding impairment across the first 6 months postpartum in the context of maternal risk, including maternal history of childhood abuse and neglect and postpartum psychopathology, and to test the association between self-reported bonding impairment and observed positive parenting behaviors. In a sample of women with childhood abuse and neglect histories (CA+, n = 97) and a healthy control comparison group (CA-, n = 53), participants completed questionnaires related to bonding with their infants at 6 weeks, 4 months, and 6 months postpartum and psychopathology at 6 months postpartum. In addition, during a 6-month postpartum home visit, mothers and infants participated in a dyadic play interaction subsequently coded for positive parenting behaviors by blinded coders. We found that all women, independent of risk status, increased in bonding with their infant over the first 6 months postpartum; however, women with postpartum psychopathology (depression and posttraumatic stress disorder [PTSD]) showed consistently greater bonding impairment scores at all timepoints. Moreover, we found that, at the 6-month assessment, bonding impairment and observed parenting behaviors were significantly associated. These results highlight the adverse effects of maternal postpartum depression and PTSD on mother-infant bonding in early postpartum in women with child abuse and neglect histories. These findings also shed light on the critical need for early detection and effective treatment of postpartum mental illness in order to prevent problematic parenting and the development of disturbed mother-infant relationships. Results support the use of the Postpartum Bonding Questionnaire as a tool to assess parenting quality by its demonstrated association with observed parenting behaviors.",0,0 +6927,"Validating female psychopathy subtypes: Differences in personality, antisocial and violent behavior, substance abuse, trauma, and mental health.","Recent empirical investigations utilizing male prisoners have begun to validate clinical conceptualizations of primary and secondary psychopathy subtypes. We extended this literature by identifying similar psychopathic subtypes in female prisoners on the basis of personality structure using model-based cluster analysis. Secondary psychopaths (n = 39) were characterized by personality traits of negative emotionality and low behavioral constraint, an early onset of antisocial and criminal behavior, greater substance use and abuse, more violent behavior and institutional misconduct, and more mental health problems, including symptoms of posttraumatic stress disorder and suicide attempts. Primary psychopaths (n = 31) exhibited few distinguishing personality features but were prolific criminals especially in regards to nonviolent crime, and exhibited relatively few mental health problems despite substantial exposure to traumatic events. The results support alternative etiological pathways to antisocial and criminal behavior that are evident in personality structure as well as gender similarities and differences in the manifestation of psychopathic personalities.",0,0 +6928,A study in contrasts: Inscriptions of posttraumatic stress disorder (PTSD) in two works of fiction,"This study investigates the depiction of Posttraumatic Stress Disorder (PTSD) in two works of fiction, The Bluest Eye, by Toni Morrison, and Ordinary People, by Judith Guest.In each text, the character struggling to mount a defense against the symptoms of PTSD is a child who must confront not only a single, precipitous event but also deleterious, ancillary conditions that threaten to impede the recovery process.This is a study in contrast that utilizes a comparative case analysis of two fictional characters.One child reconstructs an integrated self while the other deteriorates mentally and emotionally.These results suggest factors such as social supports, economic status, race and aesthetic self-image may play critical roles in a child's resiliency to the symptoms of PTSD.",0,0 +6929,Disparate prevalence estimates of PTSD among service members who served in Iraq and Afghanistan: Possible explanations,"The authors reviewed 29 studies that provide prevalence estimates of posttraumatic stress disorder (PTSD) among service members previously deployed to Operations Enduring and Iraqi Freedom and their non-U.S. military counterparts. Studies vary widely, particularly in their representativeness and the way PTSD is defined. Among previously deployed personnel not seeking treatment, most prevalence estimates range from 5 to 20%. Prevalence estimates are generally higher among those seeking treatment: As many as 50% of veterans seeking treatment screen positive for PTSD, though much fewer receive a PTSD diagnosis. Combat exposure is the only correlate consistently associated with PTSD. When evaluating PTSD prevalence estimates among this population, researchers and policymakers should carefully consider the method used to define PTSD and the population the study sample represents.",0,0 +6930,Do post-traumatic stress symptoms predict reactions of adaptation to disability after a sudden-onset spinal cord injury?,"Based on the perspective that post-traumatic stress disorder (PTSD) reflects a reaction of adaptation to trauma, the goal of this research was to examine the ability of PTSD symptom clusters (re-experiencing, avoidance, and hyperarousal) to predict eight reactions of adaptation to disability (shock, anxiety, denial, depression, internalized anger, externalized hostility, acknowledgment, and adjustment) among individuals with non-congenital spinal cord injuries. Individuals (all of whom attended either a specialized civilian or a veteran spinal cord injury clinic in Texas) completed two self-report questionnaires--the Reactions to Impairment and Disability Inventory (RIDI) and the Purdue Posttraumatic Stress Disorder Scale Revised (PPTSD-R). According to the statistical fit indices, five of the fit indices suggested that the revised model was a good fit to the data, whereas one fit index and the chi/df ratio indicated that the revised model fit the data poorly. The model provided information on the ability of PTSD clusters to predict reactions of adaptation, which suggested a specific pattern of vacillation of post-traumatic responses during the process of adaptation. These findings need replication before proposing interventions for post-traumatic stress responses after the onset of a spinal cord injury.",0,0 +6931,Elevated brain cannabinoid CB1 receptor availability in post-traumatic stress disorder: a positron emission tomography study,"Endocannabinoids and their attending cannabinoid type 1 (CB1) receptor have been implicated in animal models of post-traumatic stress disorder (PTSD). However, their specific role has not been studied in people with PTSD. Herein, we present an in vivo imaging study using positron emission tomography (PET) and the CB1-selective radioligand [(11)C]OMAR in individuals with PTSD, and healthy controls with lifetime histories of trauma (trauma-exposed controls (TC)) and those without such histories (healthy controls (HC)). Untreated individuals with PTSD (N=25) with non-combat trauma histories, and TC (N=12) and HC (N=23) participated in a magnetic resonance imaging scan and a resting PET scan with the CB1 receptor antagonist radiotracer [(11)C]OMAR, which measures the volume of distribution (VT) linearly related to CB1 receptor availability. Peripheral levels of anandamide, 2-arachidonoylglycerol, oleoylethanolamide, palmitoylethanolamide and cortisol were also assessed. In the PTSD group, relative to the HC and TC groups, we found elevated brain-wide [(11)C]OMAR VT values (F(2,53)=7.96, P=0.001; 19.5% and 14.5% higher, respectively), which were most pronounced in women (F(1,53)=5.52, P=0.023). Anandamide concentrations were reduced in the PTSD relative to the TC (53.1% lower) and HC (58.2% lower) groups. Cortisol levels were lower in the PTSD and TC groups relative to the HC group. Three biomarkers examined collectively--OMAR VT, anandamide and cortisol--correctly classified nearly 85% of PTSD cases. These results suggest that abnormal CB1 receptor-mediated anandamide signaling is implicated in the etiology of PTSD, and provide a promising neurobiological model to develop novel, evidence-based pharmacotherapies for this disorder.",0,0 +6932,Duration of Exposure and the Dose-Response Model of PTSD,A dose-response model underlies posttraumatic stress disorder (PTSD) and posits a relationship between event magnitude and clinical outcome. The present study examines whether one index of event magnitude—duration of exposure—contributes to risk of PTSD among female victims of sexual assault. Findings support a small but significant contribution of event duration to clinical status in the immediate aftermath of trauma but not at 3-month follow-up. The opposite pattern is obtained for subjective appraisals of threat. These findings add to a growing literature that suggests that a simple application of the dose-response model to objective event characteristics may be insufficient to explain the risk of PTSD.,0,0 +6933,Cortisol Level and Perinatal Outcome in Pregnant Women With Posttraumatic Stress Disorder: A Pilot Study,"Posttraumatic stress disorder (PTSD) affects 12% of women in the United States and could affect childbearing via behavioral and neuroendocrine mechanisms. This pilot study collected preliminary data about the extent to which the low cortisol profile found in patients with PTSD also occurs in the hormonal context of pregnancy, as well as the association between PTSD and less optimal processes and outcomes of pregnancy. Standardized psychiatric diagnostic telephone interviews, salivary cortisol assays, and medical records review were evaluated in a community sample of 25 women pregnant with their first child. Higher PTSD symptom counts correlated with worse overall perinatal outcomes summarized by an Optimality Index Score (n = 22; r = -.725; P < .001). The women whose symptoms met diagnostic criteria for PTSD or partial PTSD had lower peak basal salivary cortisol concentrations (n = 14; mean = .4584 versus .8123; P = .010). Further research on the effects of PTSD on pregnancy processes and outcomes is warranted. Differences in cortisol levels were consistent with the pattern seen in nonpregnant women with PTSD. This finding suggests that salivary cortisol would be a useful biological measure to include in perinatal research on PTSD and childbearing.",0,0 +6934,Problems in Statistical Analysis of Attrition in Randomized Controlled Clinical Trials of Antidepressant for Geriatric Depression,"Attrition from clinical trials is unavoidable in geriatric psychiatry and beyond. It results in incomplete data and consequently imposes three fundamental challenges: greater bias, reduced power, and less generalizability. In an effort to assess the extent of attrition and the relevance of statistical methods applied to analyze incomplete data in geriatric psychiatry, we reviewed 69 published antidepressant randomized clinical trials conducted since 1975. The median attrition rate estimated from these trials was 26.6%; nevertheless, we found that many trials lack data analytic strategies to address the problem of attrition. Most of the applied statistical analyses involved chi-square tests, t-tests, and analysis of variance (ANOVA), each of which assume that data are missing completely at random. Even when imputation for missing data due to attrition was attempted, only the last observation carried forward (LOCF) method was implemented. The LOCF imputation can actually increase bias of the results in the analysis of repeatedly measured outcomes. In addition, despite the longitudinal nature of repeatedly measured outcomes, the statistical methods used are for analysis of cross-sectional data. Thus, the data analytic strategies did not adequately meet the challenges arising from attrition. We encourage the use of mixed-effects models to reduce the impact of attrition on bias, power and generalizability in antidepressant RCTs for geriatric depression. For imputation, we recommend use of multiple imputation methods instead of LOCF.",0,0 +6935,Impact of comorbid depression on quality of life in male combat Veterans with posttraumatic stress disorder,"For Veterans with posttraumatic stress disorder (PTSD), depression is a highly comorbid condition. Both conditions have been associated with decreased quality of life, and research suggests that comorbid PTSD and depression may result in worse quality of life than PTSD alone. However, research is needed to elucidate the effect of comorbidity on a broader variety of quality of life domains. In this study, we used baseline data of 158 male combat Veterans taking part in a PTSD treatment trial and examined the unique relationships between quality of life domains and PTSD symptom clusters, major depressive disorder (MDD) diagnosis, and self-reported depressive symptoms. Veterans with comorbid PTSD-MDD reported significantly worse satisfaction-related quality of life than those with PTSD alone, although this finding was largely attributable to PTSD numbing symptoms. Subsequent analyses comparing the effect of numbing symptoms to depressive symptoms revealed that depression exerted a stronger influence, although numbing symptoms were still uniquely associated with quality of life. We discuss implications for treatment and research, as well as the need to address negative affect in Veterans with PTSD.",0,0 +6936,Integrating genomics and neuromarkers for the era of brain-related personalized medicine,"The harsh reality is that many medical treatments do not work as expected in a significant percentage of patients, and occasionally there are serious side effects. A new paradigm of personalized medicine is emerging, which proactively tailors treatment to each individual’s biological and psychological profile. The first proof-of-concept phase of personalized medicine has now been achieved. However, it has thus far focused on the use of genomic markers and on disorders of the body. The complexity of the brain is likely to require a shift from a single genetic marker focus to a more integrated approach in which additional brain-related information (neuromarkers) is taken into account. Codevelopment of genomic neuromarkers with new compounds in a personalized medicine approach will lead to increased drug R&D and treatment benefits. The emerging genomic neuromarker potential has begun to be incorporated into the template for the next version of the Diagnostic and Statistical Manual (DSM-V). The statistical power of large subject numbers in databases in general (and standardized databases in particular) provides an ideal source for elucidating the best genomic–neuromarker profiles (explaining most of the main-effects variance), which will empower a brain-related personalized medicine into mainstream clinical practice.",0,0 +6937,Post-traumatic stress disorder: a biopsychological perspective.,"This paper provides a critical review of the current explanatory models of the post-traumatic stress disorder (PTSD). Most of these models are incomplete and lack empirical confirmation. It is argued that unidimensional treatment modalities, derived from such models, fail to address the complex nature of the disorder and are likely to generate partial results. A broad hypothesis-testing approach, combining biological, psychological and psychosocial interventions, should be preferred in clinical practice. Rehabilitation should replace curative techniques and unrealistic goals in many cases.",0,0 +6938,[Analysis on factors affecting the severity of post-traumatic stress disorder in transferred casualty after Earthquake].,"OBJECTIVE: To investigated the related factors which affecting the severity degrees of post-traumatic stress disorder (PTSD) in transferred casualty after Wenchuan Earthquake. METHODS: Taking PTSD symptoms self-assessment scale (PCL-C) to involve 386 wounded who suffered 40 days after the earthquake disaster, from 11 hospitals and were transferred to Chongqing city. Multi-stage cluster sampling method was used. 354 valid questionnaires were recovered to explore the relevant factors affecting the severity on the symptoms of PTSD. RESULTS: This survey contains 354 subjects, with male 154 (43.6%), female 200 (56.4%), age 43.76 +/- 21.22, nation alities: Han people 236 (66.7%), Qiang people 114 (32.2%), others 4 (1.1%), and marriage status as unmarried 92 (26.1%), married 253 (71.7%), others 9 (2.2%). The wounded women PTSD have more serious symptoms than men, and there were differences between them in repeated and disturbing dreams of this stressful experience (t = 2.46, P = 0.014), a strong sense of psychological suffering annoyance (t = 2.02, P = 0.044), having difficulty concentrating (t = 2.04, P = 0.042), being super-alert (t = 2.465, P = 0.014) etc, also in the total scores (t = 2.489, P = 0.013) (P Language: zh",0,0 +6939,Etiologic factors in the development of posttraumatic stress disorder in children and adolescents,"Abstract This article presents an overview of the literature on potential etiological factors in the development of PTSD in children. An etiological model for PTSD is offered which generates hypotheses for identifying links between exposure to traumatic events and consequent symptoms, as well as testing relationships between exposure variables and other possible mediating factors. Three possible kinds of interaction between etiologic and mediating variables, leading to different levels of symptoms, are presented. Findings from 25 recent studies examining etiologic factors are considered to form an empirical basis for current knowledge about PTSD in children. Severity of trauma exposure and parental trauma-related distress have consistently produced positive correlations with PTSD symptoms. Length of time since trauma exposure is consistently negatively correlated with PTSD severity. Findings regarding relationships between PTSD risk, age and gender are inconsistent at this time. Other gaps in our current knowledge and understanding are identified, and implications for future clinical and research efforts are discussed.",0,0 +6940,The relationship between post traumatic stress disorder and post traumatic growth: gender differences in PTG and PTSD subgroups,"Purpose: This study investigated the post traumatic stress disorder (PTSD) and post traumatic growth (PTG) in 2,300 earthquake survivors 1 year after the 2008 Wenchuan earthquake. This study aimed to investigate the relationship between PTSD and PTG and also tested for the gender differences in PTSD and PTG subgroups. Methods: A stratification random sampling strategy and questionnaires were used to collect the data. The PTSD was assessed using the PTSD Check list-Civilian and the PTG was assessed using the Post traumatic growth inventory. 2,300 individuals were involved in the initial survey with 2,080 completing the final questionnaire, a response rate of 90.4 %. One-way ANOVA analyses were performed to investigate the gender differences in the PTSD and PTG subgroups. Results: One year following the earthquake, 40.1 and 51.1 % of survivors reported PTSD and PTG, respectively. A bivariate correlation analysis indicated that there was a positive association between PTG and PTSD. The PTG and PTSD variance analysis conducted on female and male subgroups suggested that women were more affected than men. Conclusions: Given the relatively high PTG prevalence, it was concluded that researchers need to pay more attention to the positive outcomes of an earthquake rather than just focusing on the negative effects. The surveys and analyses indicated that psychological intervention and care for the earthquake disaster survivors should focus more on females and older people, who tend to be more adversely affected. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0,0 +6941,Multiple Traumatic Experiences and the Development of Posttraumatic Stress Disorder,"This study assesses the differential and combined impacts of multiple lifetime stressors in the development and severity of posttraumatic stress disorder (PTSD) symptoms. One hundred and four clinical and 64 nonclinical participants were assessed for their exposure to four types of interpersonal trauma: physical and sexual abuse in childhood, lifetime community violence, and domestic violence in adulthood. PTSD symptomatology was assessed using the Los Angeles Symptom Checklist (LASC). Results indicated that exposure to lifetime multiple traumatic experiences was positively correlated with severity of PTSD symptoms. Clinical participants had experienced significantly more multiple traumas and had a higher rate of PTSD than the nonclinical participants. Results also suggested that adults who had experienced childhood sexual abuse were at higher risk for the development of PTSD related to interpersonal violence than adults who were not sexually abused as children.",0,0 +6942,Health in police officers: Role of risk factor clusters and police divisions,"Law enforcement is a stressful occupation associated with significant health problems. To date, most studies have focused on one specific factor or one domain of risk factors (e.g., organizational, personal). However, it is more likely that specific combinations of risk factors are differentially health relevant and further, depend on the area of police work.A self-selected group of officers from the criminal, community, and emergency division (N = 84) of a Swiss state police department answered questionnaires assessing personal and organizational risk factors as well as mental and physical health indicators.In general, few differences were observed across divisions in terms of risk factors or health indicators. Cluster analysis of all risk factors established a high-risk and a low-risk cluster with significant links to all mental health outcomes. Risk cluster-by-division interactions revealed that, in the high-risk cluster, Emergency officers reported fewer physical symptoms, while community officers reported more posttraumatic stress symptoms. Criminal officers in the high-risk cluster tended to perceived more stress. Finally, perceived stress did not mediate the relationship between risk clusters and posttraumatic stress symptoms.In summary, our results support the notion that police officers are a heterogeneous population in terms of processes linking risk factors and health indicators. This heterogeneity thereby appeared to be more dependent on personal factors and individuals' perception of their own work conditions than division-specific work environments. Our findings further suggest that stress-reduction interventions that do not target job-relevant sources of stress may only show limited effectiveness in reducing health risks associated with police work.",0,0 +6943,"Do cognitive models help in predicting the severity of posttraumatic stress disorder, phobia, and depression after motor vehicle accidents? A prospective longitudinal study.","The study investigated the power of theoretically derived cognitive variables to predict posttraumatic stress disorder (PTSD), travel phobia, and depression following injury in a motor vehicle accident (MVA). MVA survivors (N = 147) were assessed at the emergency department on the day of their accident and 2 weeks, 1 month, 3 months, and 6 months later. Diagnoses were established with the Structured Clinical Interview for DSM-IV. Predictors included initial symptom severities; variables established as predictors of PTSD in E. J. Ozer, S. R. Best, T. L. Lipsey, and D. S. Weiss's (2003) meta-analysis; and variables derived from cognitive models of PTSD, phobia, and depression. Results of nonparametric multiple regression analyses showed that the cognitive variables predicted subsequent PTSD and depression severities over and above what could be predicted from initial symptom levels. They also showed greater predictive power than the established predictors, although the latter showed similar effect sizes as in the meta-analysis. In addition, the predictors derived from cognitive models of PTSD and depression were disorder-specific. The results support the role of cognitive factors in the maintenance of emotional disorders following trauma.",0,0 +6944,Visual false memories in post-traumatic stress disorder (PTSD),"There is an ongoing debate whether or not patients with post-traumatic stress disorder (PTSD) are more prone to produce false memories. The present study investigated this question using a visual variant of the Deese-Roediger-McDermott (DRM) paradigm, additionally addressing underlying mechanisms of false memory production (e.g., depression, dissociation, emotional valence, arousal). The visual paradigm was administered to 48 traumatized individuals with (n=20) and without PTSD (n=28) and 28 non-traumatized controls. Groups did not differ with regard to memory performance and memory confidence. False memories were correlated with depression. We recommend that future studies employ trauma-related material to further explore memory aberrations in PTSD.",0,0 +6945,Relations among peritraumatic dissociation and posttraumatic stress: A meta-analysis,"A meta-analysis was performed on the empirical literature which addressed the relationship of peritraumatic dissociation to posttraumatic stress (PTS). Extensive literature searches were conducted to identify as many relevant studies as possible, and revealed 59 independent eligible studies. All studies were coded using a detailed code sheet that included effect measures, variables that indicated the methodological quality of the studies, and substantial variables that might theoretically affect the relationship between peritraumatic dissociation and PTS. A significant positive relation between peritraumatic dissociation and PTS was found. Differences in the methodological rigor between studies - time elapsed since peritraumatic dissociation, design, sample type, and study type - significantly and sufficiently explained the variability in effect sizes between studies. Theoretical variables did not explain such variability. Although results underline earlier findings, due to designs of the reviewed studies no conclusions could be drawn as to causal relations between peritraumatic dissociation and PTS.",0,0 +6946,Predicting post-traumatic symptoms in cardiac patients,"The purpose of this study was to identify correlates and predictors of the symptoms of post-traumatic stress disorder (PTSD) in a cohort of patients with myocardial infarction, while the patients were in hospital and 3 months after infarction.Longitudinal, consecutive referrals were used.From a possible 68 consecutive patients with a first myocardial infarction who completed questionnaires in hospital and survived to 3-month follow-up, 39 completed follow-up questionnaires.PTSD measures were taken in hospital and 3 months after discharge. Predictor variables were measures of mood taken in hospital and measures of the immediate cognitive and emotional reactions at the time of the infarct.Associations between the independent variables and PTSD symptoms were stronger at 3-month follow-up than while in hospital. At this time, the frequency of intrusive thoughts was predicted by the degree of fright at the time of the event (adjusted R(2) = 0.262; beta =.57; t = 3.30; P <.01) and positive affect scores (additional adjusted R(2) = 0.112; beta = -.37 t = -2.18; P <.05). The degree of physiologic arousal at the time of such flashbacks was predicted by levels of negative affect in hospital (adjusted R(2) = 0.174; beta =.46; t = 2.46; P <.05), which also predicted avoidance scores (adjusted R(2) = 0.203; beta =.48; t = 2.62; P <.05).Because many of the symptoms of PTSD are self-remitting, and intervening too early in the course of the disorder may exacerbate the disorder, it is important not to intervene too early or over-treat this disorder. Formal treatment may be useful if provided some months after discharge from hospital. If either secondary or primary care services are to treat myocardial infarction-related PTSD effectively, it is important to identify patients who are at risk for it. These data contribute to the development of a profile of patients at risk.",0,0 +6947,The somatic symptom paradox in DSM-IV anxiety disorders: suggestions for a clinical focus in psychophysiology,"Although DSM-IV criteria for anxiety disorders include physiological symptoms, these symptoms are evaluated exclusively by verbal report. The current review explores the background for this paradox and tries to demonstrate on theoretical and empirical grounds how it could be resolved, providing new insights about the role of psychophysiological measures in the clinic. The three-systems approach to evaluating anxiety argues that somatic measures as well as verbal and behavioral ones are indispensable. However, the low concordance between these domains of measurement impugns their reliability and validity. We argue that concordance can be improved by examining the relationship of variables less global than anxiety and by restriction to specific anxiety disorders. For example, recent evidence from our and other laboratories indicate a prominent role of self-reported and physiologically measured breathing irregularities in panic disorder. Nonetheless, even within a diagnosis, anxiety patients vary radically in which somatic variables are deviant. Thus, in clinical practice, individual profiles of psychological and physiological anxiety responses may be essential to indicate distinct therapeutic approaches and ways of tracking improvement. Laboratory provocations specific to certain anxiety disorders and advances in ambulatory monitoring vastly expand the scope of self-report and physiological measurement and will likely contribute to a refined assessment of anxiety disorders.",0,0 +6948,Family and Past History of Mental Illness as Predisposing Factors in Post-Traumatic Stress Disorder,"Family studies of post-traumatic stress disorder (PTSD) have given inconsistent results to date. Identifying predisposing factors in PTSD compared to anxiety disorders may help to clarify the classification of PTSD as a diagnostic entity.Retrospective case note study of 87 PTSD patients who participated in an RCT, and 51 PTSD patients and 87 agoraphobics treated routinely in outpatients.Compared to agoraphobics, PTSD patients had significantly less family history of anxiety disorder but not mental illness in general. They also had significantly less personal history of mental illness prior to the index episode.Trauma precipitated PTSD in subjects who had significantly fewer premorbid predisposing factors than did agoraphobics. Such factors may predispose agoraphobics to become psychiatrically ill after more minor trauma. Research is needed to systematically compare the events which precipitate PTSD as opposed to agoraphobia and other anxiety disorders.",0,0 +6949,Posttraumatic stress disorder in eating disorder patients: The roles of psychological distress and timing of trauma,"Exposure to traumatic events may be a risk factor for subsequent development of an eating disorder (ED). In a previous study, we showed that trauma exposure impacted symptom load in ED patients. We also saw an effect of trauma on general psychological distress. The aim of the present study was to investigate the association between Posttraumatic stress disorder (PTSD) and ED severity, to focus on the mediating role of psychological distress for the association, and to assess the role of timing of trauma in relation to emergence of ED. Participants were Swedish adult ED patients with a history of traumatic exposure (N=843, Mean age 27.2, 97.3% female). One fourth (24.1%) of the participants had a lifetime diagnosis of PTSD. PTSD had an impact on ED severity, but the impact was mediated by psychological distress. When stratifying the sample based on timing of trauma a significant effect was present only in those with trauma within a year of emergence of ED. The results suggest emotion regulation as a possible underlying factor of interest in future research.",0,0 +6950,Patterns and Predictors of Trajectories of Depression after an Urban Disaster,"To identify and understand the patterns and predictors of depressive symptom trajectories over time after mass traumatic events.Data were used from a prospective, representative sample of adult residents of the New York City metropolitan area (N=2,282) followed up across four survey waves between 2001 (after the September 11 attacks) and 2004. Semi-parametric group-based modeling was used to identify trajectories, as well as the time-fixed and time-varying predictors of distinct depressive trajectories.Five distinct trajectories of depression were characterized: minimal symptomatology at all time points (group 1, 39% of sample), mild delayed depression (group 2, 34% of sample), recovery (group 3, 6% of sample), severe delayed depression (group 4, 13% of sample), and chronic severe depression (group 5, 8% of sample). Among members of distinct trajectories, lower household income, exposure to ongoing stressors, and exposure to traumatic events were commonly associated with an increased number of depressive symptoms.Ongoing socioeconomic adversity appears to be centrally associated with a worse course of depression after exposure to traumatic events. Identifying distinct trajectories of depression and the preventable factors that are associated with them may facilitate the development of interventions that aim to promote better mental health.",0,0 +6951,"Neuropsychophysical optimization by REAC technology in the treatment of: sense of stress and confusion. Psychometric evaluation in a randomized, single blind, sham-controlled naturalistic study","Neuropsychophysical optimization by REAC technology in the treatment of: sense of stress and confusion. Psychometric evaluation in a randomized, single blind, sham-controlled naturalistic study Vania Fontani1, Lucia Aravagli1, Matteo Lotti Margotti2, Alessandro Castagna1, Piero Mannu1, Salvatore Rinaldi11Department of Neuro Psycho Physio Pathology, 2Department of Information Technology and Statistical Analysis, Rinaldi Fontani Institute, Florence, ItalyPurpose: The aim of this study is to investigate the effects of neuropsychophysical optimization (NPPO) protocol treatment by radioelectric asymmetric conveyer (REAC) technology in the management of sense of stress and confusion (SSC); an analysis of a single cluster of the psychological stress measure (PSM) test.Patients and methods: The PSM, a self-administered questionnaire, was used to measure psychological stress and SSC for a group of 888 subjects. Data were collected immediately prior to and following the 4-week REAC-NPPO treatment cycle.Results: This study demonstrates a significant reduction in scores measuring subjective perceptions of stress for subjects treated with one cycle of REAC-NPPO. At the end-point of the study, the number of treated subjects reporting symptoms of stress-related SSC on the PSM test was significantly reduced, whereas there was no difference in sham-treated subjects.Conclusion: One cycle of REAC-NPPO appears to reduce subjective perceptions of SSC measured by the PSM.Trial registration: This trial has been registered in the Australian New Zealand Clinical Trials Registry as ACTRN12607000497404.Keywords: stress disorders, adaptation disorders, REAC, NPPO",0,0 +6952,Increase of serum triiodothyronine concentration in soldiers with combat-related chronic post-traumatic stress disorder with or without alcohol dependence,"Background: Post-traumatic stress disorder (PTSD) is a relatively new psychiatric disorder with three clusters of symptoms: trauma re-experiencing, avoidance, and increased arousal. The condition develops after a person sees, is involved in, or hears of an extreme traumatic stressor such as war, torture, natural catastrophe, assault, rape, or serious accident. PTSD is also often comorbid with other psychiatric disorders, especially with alcohol dependence. Several hormonal alterations have been reported in veterans with combat-related PTSD, including elevations in certain thyroid hormones, e.g., total T3; however, previous studies have not controlled for alcohol dependence, a common comorbid psychiatric disorder in this population. Objective: The first aim of our study was to assess possible differences in basal serum levels of free triiodothyronine (FT3), total triiodothyronine (TT3), free thyroxine (FT4), total thyroxine (TT4), and thyroid stimulating hormone (TSH) in Croatian soldiers with combat-related chronic PTSD alone or comorbid with alcohol dependence and in healthy controls. The second purpose of the study was to determine any correlation between duration of combat activities, number of combat traumas, intensity and duration of PTSD symptoms, and serum levels of TT3, FT3, TT4, FT4, and TSH in this sample. Method: We analyzed basal serum FT3, TT3, FT4, TT4, and TSH concentrations in soldiers with combat-related chronic PTSD (N = 43), combat-related chronic PTSD comorbid with alcohol dependence (N = 41), and in healthy controls (N = 39) using a luminoimmunochemical assay. Results: Soldiers with chronic combat-related PTSD with or without comorbid alcohol addiction had significantly higher values of TT3 than the control group (F = 19.556, p < 0.01). There was a significant correlation between TT3 levels and number of traumatic events in both the PTSD group (r = 0.663, p < 0.01) and those with PTSD comorbid with alcohol dependence (r = 0.836, p < 0.01). There was also a significant correlation between TT3 levels and symptoms of increased arousal in both PTSD (r = 0.419, p < 0.01) and PTSD comorbid with alcohol dependence (r = 0.516, p < 0.01). Conclusion: Elevated concentrations of serum TT3 are associated with combat-related PTSD, regardless of its comorbidity with alcohol dependence, and also with the number of traumatic events and symptoms of increased arousal. Given that current pharmacotherapy for PTSD is inadequate, reduction of TT3 may be a new strategy for pharmacologic intervention that could contribute to more effective treatment of this disorder.",0,0 +6953,Complicated grief: implications for the treatment of post-traumatic stress disorder in couples,"Complicated grief has many interfaces with post-traumatic stress disorder (PTSD) including avoidance, flashbacks and shattered assumptions. Increasing use of cognitive behavioural therapy (CBT) models in grief work are drawing on lessons learned in PTSD treatment. However, models used in grief work, such as attachment, the Dual Process Model (Stroebe & Schut, 1999) and Psychosocial Transition Theory (Parkes, 1993), are less commonly applied to understanding and treating PTSD. This paper gives an overview of how these theories explain complicated grief and PTSD and considers implications they have on treatment of couples, based on literature review and clinical experience. Treatment implications include treating PTSD before traumatic grief, working with intra-couple coping style differences, promoting acceptance and forgiveness and taking a full attachment history.",0,0 +6954,A latent growth mixture modeling approach to PTSD symptoms in rape victims.,"The research literature has suggested that longitudinal changes in posttraumatic stress disorder (PTSD) could be adequately described in terms of one universal trajectory, with individual differences in baseline levels (intercept) and rate of change (slope) being negligible. However, not everyone who has experienced a trauma is diagnosed with PTSD, and symptom severity levels differ between individuals exposed to similar traumas. The current study employed the latent growth mixture modeling technique to test for multiple trajectories using data from a sample of Danish rape victims (N = 255). In addition, the analysis aimed to determine whether a number of explanatory variables could differentiate between the trajectories (age, acute stress disorder [ASD], and perceived social support). Results concluded the existence of two PTSD trajectories. ASD was found to be the only significant predictor of one trajectory characterized by high initial levels of PTSD symptomatology. The present findings confirmed the existence of multiple trajectories with regard to PTSD symptomatology in a way that may be useful to clinicians working with this population.",1,0 +6955,Vulnerability to PTSD: Psychosocial and Demographic Risk and Resilience Factors,"The risk of developing PTSD after a traumatic experience depends on several vulnerability factors that may be classified into three distinct categories—pre-traumatic, peri-traumatic, and posttraumatic. Accordingly, while attempting to draw the profile of the high-risk patient for PTSD, the following factors should be included, among others: The history of previous trauma, the history of previous psychiatric disorder, female gender, ethnic minority, high severity of initial posttraumatic symptoms (ASR), associated body injury, “high-risk” traumatic event (man-made trauma), and peri-traumatic dissociation. In contrast, various resilience factors may be protective and act to prevent the development of PTSD. Although resilience factors were generally not discussed in this chapter, future research should be designed to uncover resilience factors, in order to differentiate between high-risk and low-risk patients in order to identifying the patients at risk and to attempt to develop the strategies to prevent the development of PTSD. © Springer Science+Business Media New York 2015.",0,0 +6956,Murine model of repeated exposures to conspecific trained aggressors simulates features of post-traumatic stress disorder,"We evaluated repeated exposures of mice to a trained aggressor mouse as a model (adapted from ""social stress"" models of traumatic stress) for aspects of post-traumatic stress disorder (PTSD). Using a ""cage-within-cage resident-intruder"" protocol, subject C57BL/6J mice were exposed to aggressors for 6 h daily for 5 or 10 days. At one to three random times during each 6-h session, subjects were exposed directly to aggressor for 1 min or 10 bites, whichever came first. Behavioral, physiological, and histological changes associated with aggressor-exposure were assessed for up to 6 weeks. During aggressor exposure, subjects displayed less territorial behavior, gained weight, and increased body temperature. One day after the last aggressor exposure, inflammatory cardiac histopathologies were prevalent; after 10 days, only mild myocardial degeneration with fibrosis or fibroplasias was evident, while controls showed almost no cardiac abnormalities at any time. After 4 weeks, the medial prefrontal cortex of control mice showed increased dendritic spine density, but aggressor-exposed mice showed no increase. Behaviors affected by aggressor exposure were evaluated in a partition test wherein the subject mouse is separated from the aggressor by a fenestrated partition that permits sensory cues to pass but prevents direct physical interaction. For up to 4-6 weeks after the last aggressor exposure, subjects showed prolonged grooming, freezing, retarded locomotion and no tail rattling. PTSD and its co-morbidities are often consequent to repeated aggravated ""social"" assaults (e.g., combat) and manifest socially over time, suggesting the relevance of this repeated aggressor-exposure model to clinical aspects of PTSD.",0,0 +6957,Factors Affecting Exits From Homelessness Among Persons With Serious Mental Illness and Substance Use Disorders,"We sought to understand the housing trajectories of homeless consumers with serious mental illness (SMI) and co-occurring substance use disorders (SUD) and to identify factors that best predicted achievement of independent housing.Using administrative data, we identified homeless persons with SMI and SUD admitted to a residential rehabilitation program from December 2008 to November 2011. Our primary outcome measure was independent housing status. On a random sample (N = 36), we assessed a range of potential predictors of housing outcomes, including symptoms, cognition, and social/community supports. We used the Residential Time-Line Follow-Back (TLFB) Inventory to gather housing histories since exiting rehabilitation and to identify housing outcomes. We used Recursive Partitioning (RP) to identify variables that best differentiated participants by these outcomes.We identified 3 housing trajectories: stable housing (n = 14), unstable housing (n = 15), and continuously engaged in housing services (n = 7). In RP analysis, 2 variables (Symbol Digit Modalities Test [SDMT], a neurocognitive speed of processing measure, and Behavior and Symptom Identification Scale [BASIS-24] Relationships subscale, which quantifies symptoms affecting relationships) were sufficient to capture information provided by 26 predictors to classify participants by housing outcome. Participants predicted to continuously engage in services had impaired processing speeds (SDMT score < 32.5). Among consumers with SDMT score ≥ 32.5, those predicted to achieve stable housing had fewer interpersonal symptoms (BASIS-24 Relationships subscale score < 0.81) than those predicted to have unstable housing. This model explains 57% of this sample's variability and 14% of this population's variability in housing outcomes.Because cognition and symptoms influencing relationships predicted housing outcomes for homeless adults with SMI and SUD, cognitive and social skills training may be useful for this population.",0,0 +6958,Exposure to War Crimes and Implications for Peace Building in Northern Uganda,"Since the late 1980s, the Lord's Resistance Army has waged war against the Ugandan People's Democratic Army and the people of northern Uganda. Ending the conflict and achieving peace have proven to be challenges. In this context, it is important to examine population-based data on exposure to war crimes to understand how survivors perceive mechanisms aimed at achieving a lasting peace.To assess the level of exposure to war-related violence and the prevalence of posttraumatic stress disorder (PTSD) and depression symptoms in northern Uganda and to determine how these variables are associated with respondents' views about peace.Multistage, stratified, random cluster survey of 2585 adults aged 18 years or older conducted in villages and camps for internally displaced persons in 4 districts of northern Uganda in April and May 2005.Rates and patterns of exposure to trauma; symptom criteria for PTSD, assessed via the PTSD Checklist-Civilian Version with a total severity score of 44; symptoms of depression, assessed via the Johns Hopkins Depression Symptom Checklist with a cutoff of 42; and opinions and attitudes about peace.Among the respondents, 1774 of 2389 (74.3%) met PTSD symptom criteria and 1151 of 2585 (44.5%) met depression symptom criteria. Four patterns of exposure to trauma were distinguished: those with low exposure (group 1; 21.4%), witnesses to war-related violence (group 2; 17.8%), those threatened with death and/or physically injured (group 3; 16.4%), and those abducted (group 4; 44.3%). Respondents in groups 3 and 4, who experienced the most traumatic exposures, were more likely to have PTSD symptoms compared with group 1 (group 3 vs group 1: odds ratio [OR], 7.04 [95% confidence interval {CI}, 5.02-9.87]; group 4 vs group 1: OR, 6.07 [95% CI, 4.77-7.71]). Groups 3 and 4 were also more likely to meet depression symptom criteria (group 3 vs group 1: OR, 5.76 [95% CI, 4.34-7.65]; group 4 vs group 1: OR, 4.00 [95% CI, 3.16-5.06]). Respondents who met the PTSD symptom criteria were more likely to identify violence as a means to achieve peace (OR, 1.31; 95% CI, 1.05-1.65). Respondents who met the depression symptom criteria were less likely to identify nonviolence as a means to achieve peace (OR, 0.77; 95% CI, 0.65-0.93).Our study found high prevalence rates for symptoms of PTSD and depression in a conflict zone. Respondents reporting symptoms of PTSD and depression were more likely to favor violent over nonviolent means to end the conflict.",0,0 +6959,Dimensional structure and prospective evolution of posttraumatic stress symptomatology in World Trade Center responders,"Background: Posttraumatic stress disorder (PTSD) is an anxiety disorder characterized by heterogeneous clusters of re-experiencing, avoidance, numbing, and hyperarousal symptoms. A large body of confirmatory factor analytic (CFA) studies has demonstrated that four-factor dysphoria and emotional numbing models provide a better representation of PTSD symptom dimensionality compared to the three-factor DSM-IV model. Recently, CFA studies of various trauma-exposed samples have found that a novel five-factor model, which separates the DSM-IV hyperarousal symptom cluster into distinct dysphoric and anxious arousal clusters, provides a superior representation of PTSD symptom dimensionality. To date, however, no study of which we are aware has evaluated the best dimensional representation of PTSD symptoms in World Trade Center (WTC) responders, or how symptom clusters from this model are prospectively related. Methods: Confirmatory factor analyses (CFAs) were used to examine the factor structure of the PTSD Checklist in a cohort of 10,835 WTC responders, including 4,035 police responders and 6,800 non-traditional responders, who were evaluated an average of 3, 6, and 8 years after the WTC attacks. An autoregressive cross-lagged panel regression analysis was then conducted to evaluate interrelationships among PTSD symptom clusters over time. Results: CFAs revealed that a five-factor model comprised of intercorrelated clusters of re-experiencing, avoidance, emotional numbing, dysphoric arousal, and anxious arousal symptoms provided the best representation of PTSD symptoms in police and non-traditional WTC responders. In police responders, anxious arousal symptoms were most strongly prospectively linked to reexperiencing symptoms, and dysphoric arousal to numbing symptoms in the intermediate-term, while re-experiencing symptoms predominantly drove numbing symptoms in the long-term. In non-traditional responders, anxious arousal symptoms were most strongly prospectively linked to re-experiencing symptoms, while dysphoric arousal symptoms predominantly drove numbing symptoms over time. In both groups of responders, avoidance symptoms drove re-experiencing symptoms over time. Conclusions: A novel 5-factor model comprised of re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal symptoms best represented PTSD symptomatology in both traditional and non-traditional disaster responders. Prospective interrelationships among these symptom clusters suggest that targeting hyperarousal and avoidance symptoms early after disaster exposure may help reduce later symptoms of re-experiencing and numbing in disaster responders.",0,0 +6960,"It's all my fault: A mediational model of shame, guilt, posttraumatic stress disorder and depression in a sample of battered women","Feelings of shame and guilt have received increased attention in mental health research. Women who are victims of Intimate Partner Violence (IPV) experience a wide array of emotions and stigma associated with their status, which may impact their physical and mental health. A fairly common response to traumatic events such as IPV is for the victim to blame herself and experience feelings of responsibility, shame, and guilt. The current study examined the relationships between trauma-related factors, the social/emotional factors of shame and guilt, and symptoms of Posttraumatic Stress Disorder (PTSD), depression, and the comorbid condition in a sample of 137 battered women residing in domestic violence shelters. It was suggested that shame would be a predictor and mediator for depression, as both constructs are related to self-evaluation. Guilt was suggested as a predictor and mediator for PTSD, as both of these constructs are related to events or behaviors. Shame was found to be a significant mediator in the relationship between trauma-related factors and symptoms of depression. A combined shame and guilt score was found to significantly mediate comorbid symptoms. Guilt alone failed to demonstrate significant mediation of PTSD symptoms. Predictive models using trauma-related factors along with shame and guilt were found to account for a significant amount of variance in mental health symptoms. This research supports the importance shame and guilt, particularly in combination, and their contribution to mental health in female IPV victims. Future research on the interrelationships and distinction between shame and guilt as they impact psychopathology are needed, as well as refinements to these and other predictive models for use in early detection, treatment, and potentially prevention of mental health problems following IPV victimization. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +6961,An Investigation of Malingering Posttraumatic Stress Disorder on the Personality Assessment Inventory,"Utilizing the Personality Assessment Inventory (PAI; Morey, 1991), this study aimed to isolate a pattern of responding that is indicative of an attempt to malinger posttraumatic stress disorder (PTSD). The PAI profiles of 116 male participants were examined. Profiles of a group of 29 alcohol-abusing veterans with a primary Axis I (American Psychiatric Association, 1994) diagnosis of PTSD and a group of 30 alcohol-abusing veterans with no other diagnoses were compared to those of 27 undergraduate men instructed to feign PTSD. Control data were obtained from another group of 30 undergraduates. The student malingerers produced PAI profiles that were significantly different from the veterans with PTSD. Seven scales distinguished the malingerers from the veterans with an actual diagnosis of PTSD. Malingerers tended to overexaggerate pathology, inflating their scores on many clinical scales greater than the mean of the PTSD sample. Malingerers also scored higher on Morey's (1993) 8-item Malingering Index than either group of veterans and the controls. Only 2 scales reliably differentiated alcohol-abusing veterans with PTSD from those without the disorder. The implications of these findings in the diagnosis of PTSD are discussed.",0,0 +6962,Menstrual cycle and sex affect hemodynamic responses to combined orthostatic and heat stress,"Women have decreased orthostatic tolerance compared with men, and anecdotal evidence suggests women are more susceptible to orthostatic intolerance in warm environments. Because estrogen and progesterone affect numerous physiological variables that may alter orthostatic tolerance, the purpose of our study was to compare orthostatic tolerance across the menstrual cycle phases in women during combined orthostatic and heat stress and to compare these data with those of men. Eight normally menstruating women and eight males (22 +/- 4.0 and 23 +/- 3.5 yr, respectively) completed the protocol. Women were studied during their early follicular (EF), ovulatory (OV), and midluteal (ML) phases. Men were studied twice within 2-4 wk. Heart rate, cardiac output, blood pressure, core temperature (T(c)), and cutaneous vascular conductance (CVC) were measured during three head-up tilt tests, consisting of two tilts in the thermoneutral condition and one tilt after a 0.5 degrees C rise in T(c). There was no difference in orthostatic tolerance across the menstrual cycle phases, despite higher CVC in the ML phase after heating (EF, 42.3 +/- 4.8; OV, 40.1 +/- 3.7; ML, 57.5 +/- 4.5; P < 0.05). Orthostatic tolerance in the heat was greater in men than women (P < 0.05). These data suggest that although many physiological variables associated with blood pressure regulation fluctuate during the menstrual cycle, orthostatic tolerance in the heat remains unchanged. Additionally, our data support a clear sex difference in orthostatic tolerance and extend upon previous data to show that the sex difference in the heat is not attributable to fluctuating hormone profiles during the menstrual cycle.",0,0 +6963,Post-traumatic stress disorder among patients with orofacial pain.,"To examine the presence and impact of post-traumatic stress disorder (PTSD) in a sample of patients seeking treatment for orofacial pain.One hundred forty-one consecutive patients with an array of orofacial pain conditions were screened using a structured clinical interview for PTSD and the PTSD Symptom Checklist--Civilian Version (PCL), a brief PTSD self-report inventory. Additionally, participants received a clinical examination and self-report questionnaires to assess pain, coping styles, and presence of post-traumatic symptoms.Thirty-three (23%) patients received a full lifetime or current PTSD diagnosis, with an additional 11 patients receiving a partial PTSD diagnosis. Only 5 of these 44 patients had ever been previously diagnosed with PTSD. PTSD symptoms were associated with higher pain scores (P < .05) and affective distress (P < .01). Furthermore, discriminant function analyses suggested that the PCL accurately classified 89% of these cases (sensitivity = .85, specificity = .90, positive predictive power = 74%, negative predictive power = 95%).These results suggest that PTSD is prevalent in the orofacial pain setting and that PTSD symptomatology is associated with increased pain and affective distress that may complicate clinical presentation. Furthermore, PTSD can be accurately and efficiently assessed using a brief, self-report inventory.",0,0 +6964,The Experience of Disaster:,,0,0 +6965,Posttraumatic Stress in the Aftermath of Mass Shootings,"Recent mass shooting incidents in the USA include the 2007 shooting at Virginia Tech and the 2012 shootings at the Aurora, Colorado movie theatre and Sandy Hook elementary school in Newtown, Connecticut. Although these events generated much national attention, surprisingly, little research has evaluated mental health impacts of mass shootings, and no efforts to our knowledge have been made to synthesize the empirical findings. In this chapter, we review the extant literature on posttraumatic stress in the aftermath mass shootings. We identified 35 peer-reviewed articles, comprised of 19 independent samples in the aftermath of 14 mass shooting incidents. The prevalence of posttraumatic stress disorder in these studies ranged from 3 to 91 %. Several factors could underlie this wide variation, including differences in the assessment measures, criteria used to define cases, timing of assessment, and sample characteristics. Risk factors for more severe posttraumatic stress symptoms have been identified, including demographic and pre-incident characteristics (e.g., female gender, pre-incident psychological symptoms), event exposure (e.g., greater proximity to the attack, acquaintance with the deceased), and fewer psychosocial resources (e.g., emotion regulation difficulties, lower social support). Further research that draws on pre-incident and longitudinal data will yield important insights into the processes that exacerbate or sustain posttraumatic stress over time and provide important information for crisis preparedness and post-incident mental health interventions.",0,0 +6966,Hypohydration and acute thermal stress affect mood state but not cognition or dynamic postural balance,"Equivocal findings have been reported in the few studies that examined the impact of ambient temperature (T a) and hypohydration on cognition and dynamic balance. The purpose of this study was to determine the impact of acute exposure to a range of ambient temperatures (T a 10-40 C) in euhydration (EUH) and hypohydration (HYP) states on cognition, mood and dynamic balance. Thirty-two men (age 22 ± 4 years, height 1.80 ± 0.05 m, body mass 85.4 ± 10.8 kg) were grouped into four matched cohorts (n = 8), and tested in one of the four T a (10, 20, 30, 40 C) when EUH and HYP (-4 % body mass via exercise-heat exposure). Cognition was assessed using psychomotor vigilance, 4-choice reaction time, matching to sample, and grammatical reasoning. Mood was evaluated by profile of mood states and dynamic postural balance was tested using a Biodex Balance System. Thermal sensation (TS), core (T core) and skin temperature (T sk) were obtained throughout testing. Volunteers lost -4.1 ± 0.4 % body mass during HYP. T sk and TS increased with increasing T a, with no effect of hydration. Cognitive performance was not altered by HYP or thermal stress. Total mood disturbance (TMD), fatigue, confusion, anger, and depression increased during HYP at all T a. Dynamic balance was unaffected by HYP, but 10 C exposure impaired balance compared to all other T a. Despite an increase in TMD during HYP, cognitive function was maintained in all testing environments, demonstrating cognitive resiliency in response to body fluid deficits. Dynamic postural stability at 10 C appeared to be hampered by low-grade shivering, but was otherwise maintained during HYP and thermal stress. © 2012 Springer-Verlag Berlin Heidelberg (outside the USA).",0,0 +6967,Toll-like receptor expression and function in type I bipolar disorder,"Bipolar disorder (BD) has been associated with immune imbalance and low-grade inflammation. The underlying mechanisms remain largely obscure but may involve changes in cell signaling. Toll-like receptors (TLRs) are widely expressed by immune cells. Specific binding of TLRs to pathogen- or danger-associated signals leads to inflammatory responses. Here, we analyzed the frequencies of TLR-1, TLR-2, TLR-4, TLR-5 and TLR-6 in monocytes, regulatory T cells (Tregs) and activated T cells from type I BD euthymic patients and healthy controls (HCs). Monocytes were stimulated in vitro with specific TLR agonists (flagellin, LPS, LTA, BLP and PGN) and immunophenotyped. Cytokines (IL-8, IL-1beta, IL-6, IL-10, TNF-alpha and IL-12p70) were assessed with cytometric bead arrays. At baseline, increased percentages of TLR-1+ and TLR-2+ monocytes and reduced expression of TLR-5 were observed in BD. Following stimulation, the percentage of TLR-1+, TLR-2+, and TLR-6+ monocytes was higher in BD subjects than in HCs. Increased levels of IL-8, IL-12p70 and TNF were observed following stimulation with TLR-1, TLR-2 and TLR-6 agonists, suggesting increased signaling via these receptors in BD. In contrast to HCs, BD patients exhibited no changes in TLR-5 expression following stimulation. The percentage of TLR-2+ Treg cells as well as activated T cells expressing both TLR-2 and TLR-5 increased in BD patients. Given the importance of TLRs in triggering immune responses, our data indicate a role for these receptors in the low-grade inflammatory profile documented in BD.",0,0 +6968,A developmental psychopathology model of childhood traumatic stress and intersection with anxiety disorders,"

Abstract

Empirical findings regarding childhood traumatic stress are placed within a developmental life-trajectory model that incorporates a tripartite etiology of posttrauma distress. This approach recognizes an intricate matrix of child-intrinsic factors, developmental maturation and experience, life events, and evolving family and social ecologies. Of central developmental importance in the field of traumatic stress is the ontogenesis of appraisal, emotional response, emotional and physiological regulation, and consideration of protective action with regard to danger. The complexity of traumatic situations and their aftermath suggests the relevance of multiple stress diatheses in understanding individual variability in proximal and distal effects. Neurobiological systems that subserve danger mature over childhood and adolescence. Neurophysiological and neurohormonal studies among traumatized children and adolescents suggest potential neurodevelopmental stage-related vulnerabilities within these systems. Advances in child development and traumatic stress provide tools for investigating proximal and distal interplay of psychopathology, disturbances in the acquisition and maintenance of developmental competencies, and life-trajectory outcomes. A developmental psychopathology model suggests different avenues by which dangerous circumstances, childhood traumatic experiences, and posttraumatic stress disorder (PTSD) can intersect with other anxiety disorders over the life span.",0,0 +6969,"Prevalence and predictors of mental disorders among women in Sanliurfa, Southeastern Turkey","Mental health is one of the most important public health issues because of major contributor to the global burden of disease. In this study, we examined the prevalence and predictors of mental disorders among married women from 15 to 49 years of age and the need for mental health services in the primary health care settings.In this cross-sectional study, 270 women were selected using probability cluster sampling method at 95% confidence interval (91.5% response rate). The Structured Clinical Interview for DSM-IV (SCID-I) and women socio-demographic information form were used to collect data.Although the prevalence of mental disorder was 25.9% (8.5% with one diagnosis; 17.4% were two or more diagnoses), 4.7% of these women had contacted a carer in the last year for psychological reasons. According to the SCID-I assessment, the most prevalent diagnoses were major depressive disorder (7.3%), phobic disorder (4.8%) and posttraumatic stress disorder (3.6%). In this study, comorbid diagnoses were present in 67.2% of patients. Logistic regression analyses revealed that domestic violence, history of previous trauma, anemia and cutaneous leishmaniasis were significant predictors of any mental disorders (P < 0.05).These findings highlight the need for systematic development of community-based mental health services in conjunction with primary health care services for the screening, early identification and treatment of women suffering from mental disorders, and the improvement of anemia and cutaneous leishmaniasis control programme.",0,0 +6970,Post-traumatic stress disorder and depression prevalence and associated risk factors among local disaster relief and reconstruction workers fourteen months after the Great East Japan Earthquake: a cross-sectional study,"Many local workers have been involved in rescue and reconstruction duties since the Great East Japan Earthquake (GEJE) on March 11, 2011. These workers continuously confront diverse stressors as both survivors and relief and reconstruction workers. However, little is known about the psychological sequelae among these workers. Thus, we assessed the prevalence of and personal/workplace risk factors for probable post-traumatic stress disorder (PTSD), probable depression, and high general psychological distress in this population.Participants (N = 1294; overall response rate, 82.9%) were workers (firefighters, n = 327; local municipality workers, n = 610; hospital medical workers, n = 357) in coastal areas of Miyagi prefecture. The study was cross-sectional and conducted 14 months after the GEJE using a self-administered questionnaire which included the PTSD Checklist-Specific Version, the Patient Health Questionnaire-9, and the K6 scale. Significant risk factors from bivariate analysis, such as displacement, dead or missing family member(s), near-death experience, disaster related work, lack of communication, and lack of rest were considered potential factors in probable PTSD, probable depression, and high general psychological distress, and were entered into the multivariable logistic regression model.The prevalence of probable PTSD, probable depression, and high general psychological distress was higher among municipality (6.6%, 15.9%, and 14.9%, respectively) and medical (6.6%, 14.3%, and 14.5%, respectively) workers than among firefighters (1.6%, 3.8%, and 2.6%, respectively). Lack of rest was associated with increased risk of PTSD and depression in municipality and medical workers; lack of communication was linked to increased PTSD risk in medical workers and depression in municipality and medical workers; and involvement in disaster-related work was associated with increased PTSD and depression risk in municipality workers.The present results indicate that at 14 months after the GEJE, mental health consequences differed between occupations. High preparedness, early mental health interventions, and the return of ordinary working conditions might have contributed to the relative mental health resilience of the firefighters. Unlike the direct effects of disasters, workplace risk factors can be modified after disasters; thus, we should develop countermeasures to improve the working conditions of local disaster relief and reconstruction workers.",0,0 +6971,Emotional disorders: Cluster 4 of the proposed meta-structure for DSM-V and ICD-11,"Background The extant major psychiatric classifications DSM-IV, and ICD-10, are atheoretical and largely descriptive. Although this achieves good reliability, the validity of a medical diagnosis would be greatly enhanced by an understanding of risk factors and clinical manifestations. In an effort to group mental disorders on the basis of aetiology, five clusters have been proposed. This paper considers the validity of the fourth cluster, emotional disorders, within that proposal. Method We reviewed the literature in relation to 11 validating criteria proposed by a Study Group of the DSM-V Task Force, as applied to the cluster of emotional disorders. Results An emotional cluster of disorders identified using the 11 validators is feasible. Negative affectivity is the defining feature of the emotional cluster. Although there are differences between disorders in the remaining validating criteria, there are similarities that support the feasibility of an emotional cluster. Strong intra-cluster co-morbidity may reflect the action of common risk factors and also shared higher-order symptom dimensions in these emotional disorders. Conclusion Emotional disorders meet many of the salient criteria proposed by the Study Group of the DSM-V Task Force to suggest a classification cluster.",0,0 +6972,A 50-year prospective study of the psychological sequelae of World War II combat,"The authors took advantage of a 50-year prospective study of World War II veterans to examine the predictors and correlates of combat exposure, symptoms of posttraumatic stress disorder (PTSD), and trait neuroticism.The subjects were 107 veterans who had been extensively studied before and immediately after serving overseas in World War II. All served as members of the study until the present time, and 91 completed questionnaires of both PTSD symptoms and neuroticism.In this study group, variables associated with positive psychosocial health in adolescence and at age 65 predicted combat exposure. Combat exposure and number of physiological symptoms during combat stress--but not during civilian stress--predicted symptoms of PTSD in 1946 and 1988. Combat exposure also predicted early death and study attrition. Psychosocial vulnerability in adolescence and at age 65 and physiological symptoms during civilian stress--but not during combat stress--predicted trait neuroticism at age 65.Combat exposure predicted symptoms of PTSD but not nonspecific measures of psychopathology. Premorbid vulnerability predicted subsequent psychopathology but not symptoms of PTSD.",0,0 +6973,Estimating post-traumatic stress disorder in the community: lifetime perspective and the impact of typical traumatic events – Corrigendum,"Reports an error in ""Estimating post-traumatic stress disorder in the community: Lifetime perspective and the impact of typical traumatic events"" by N. Breslau, E.L. Peterson, L.M. Poisson, L.R. Schultz and V.C. Lucia (Psychological Medicine, 2004[Jul], Vol 34[5], 889-898). There was an error in the first sentence of the 'Data analysis' section on page 891. The correct version of the sentence is present in the erratum. (The following abstract of the original article appeared in record 2004-17343-013). Community surveys have assessed post-traumatic stress disorder (PTSD) in relation to traumatic events designated by respondents as the worst they have ever experienced. An assessment of PTSD in relation to all reported traumas would impose too great a burden on respondents, a considerable proportion of whom report multiple traumas. The 'worst event' method is efficient for identifying persons with PTSD, but may overestimate the conditional probability of PTSD associated with the entire range of PTSD-level traumas. In this report, we evaluate this potential bias. The Detroit Area Survey of Trauma (n = 2181) estimated the PTSD risk from two samples of traumas: (1) a representative sample of traumas formed by selecting a random trauma from each respondent's list of traumas; and (2) traumas designated by respondents as the worst (the standard method). Results showed that both estimation methods converged on key findings, including identifying trauma types with the highest probability of PTSD and sex differences in the risk of PTSD. Compared to the random events, the 'worst event' method yielded a moderately higher conditional probability for PTSD (0.136 v. 0.092). The bias was due almost entirely to the deviation of the distribution of the worst events from expected values, if all event types had equal prior selection probabilities. Direct adjustment, setting the distribution equal to expected values and applying the observed probabilities of PTSD associated with individual event types brought the estimate close to the unbiased estimate, based on the randomly selected traumas. Only the 'worst event' method can be used as a short-cut to assessing all traumas. The bias in the estimated risk of PTSD is modest and is attenuated by direct adjustment. (PsycINFO Database Record (c) 2014 APA, all rights reserved)",0,0 +6974,A Comparison of Multidimensional Health Profiles across Three Trauma-Exposed Diagnostic Groups,"Posttraumatic stress disorder has been associated with adverse health outcomes. The extent to which the health effects of PTSD differ from other diagnoses has not been explored empirically. The current study investigated the Multidimensional Health Profile (including both Psychosocial and Health factors), across three diagnostic groups and one group of well-adjusted participants (N=92) in a contrastedgroups design. Participants were all trauma-exposed and were assessed using structured clinical interviews. The PTSD and depression groups tended to differ from the social phobia and well-adjusted groups. Both the PTSD and depression groups demonstrated elevated profiles on variables assessing psychological distress, negative social exchange, and hypochondriasis. Results are consistent with prior research suggesting PTSD is associated with worse psychological and health functioning relative to trauma-exposed individuals without PTSD, although these health outcomes seem to differ little between those with PTSD and those with depression. © Springer Science+Business Media, LLC 2011.",0,0 +6975,Pathways to change: Use trajectories following trauma-informed treatment of women with co-occurring post-traumatic stress disorder and substance use disorders,"Introduction and Aims Despite advances towards integration of care for women with co-occurring substance use disorder (SUD) and post-traumatic stress disorder (PTSD), low abstinence rates following SUD/PTSD treatment remain the norm. The utility of investigating distinct substance use trajectories is a critical innovation in the detection and refining of effective interventions for this clinical population. Design and Methods The present study reanalysed data from the largest randomised clinical trial to date for co-occurring SUD and PTSD in women (National Drug Abuse Treatment Clinical Trials Network; Women and Trauma Study). Randomised participants (n = 353) received one of two interventions in addition to treatment as usual for SUD: (i) trauma-informed integrative treatment for PTSD/SUD; or (ii) an active control psychoeducation course on women's health. The present study utilised latent growth mixture models (LGMM) with multiple groups to estimate women's substance use patterns during the 12-month follow-up period. Results Findings provided support for three different trajectories of substance use in the post-treatment year: (i) consistently low likelihood and use frequency; (ii) consistently high likelihood and use frequency; and (iii) high likelihood and moderate use frequency. Covariate analyses revealed improvement in PTSD severity was associated with membership in a specific substance use trajectory, although receiving trauma-informed treatment was not. Additionally, SUD severity, age and after-care efforts were shown to be related to trajectory membership. Discussion and Conclusions Findings highlight the necessity of accounting for heterogeneity in post-treatment substance use, relevance of trauma-informed care in SUD recovery and benefits of incorporating methodologies like LGMM when evaluating SUD treatment outcomes. [López-Castro T, Hu M-C, Papini S, Ruglass LM, Hien DA. Pathways to change: Use trajectories following trauma-informed treatment of women with co-occurring post-traumatic stress disorder and substance use disorders. Drug Alcohol Rev 2015]",0,0 +6976,Toward Optimal Early Management After Whiplash Injury to Lessen the Rate of Transition to Chronicity,"Expert debate and synthesis of research to inform future management approaches for acute whiplash disorders.To identify a research agenda toward improving outcomes for acute whiplash-injured individuals to lessen the incidence of transition to chronicity.International figures are concordant, estimating that 50% of individuals recover from pain and disability within 3 to 6 months of a whiplash injury. The remainder report continuing symptoms up to 1 to 2 years or longer postinjury. As no management approach to date has improved recovery rates, new clinical/research directions are required for early management of whiplash-injured patients.A group of multidisciplinary researchers critically debated evidence and current research concerning whiplash from biological, psychological, and social perspectives toward informing future research directions for management of acute whiplash.It was recognized that effective treatments for acute whiplash are constrained by a limited understanding of causes of whiplash-associated disorders. Acute whiplash presentations are heterogeneous leading to the proposal that a research priority was development of a triage system based on modifiable prognostic indicators and clinical features to better inform individualized early management decisions. Other priorities identified included researching effective early pain management for individuals presenting with moderate to high levels of pain; development of best education/information for acute whiplash; testing the efficacy of stratified and individualized rehabilitation, researching modes of delivery considering psychosocial modulators of pain and disability; and the timing, nature, and mode of delivery of cognitive-behavioral therapies. Directions were highlighted for future biomechanical research into injury prevention.The burden of whiplash injuries, the high rate of transition to chronicity, and evidence of limited effects of current management on transition rates demand new directions in evaluation and management. Several directions have been proposed for future research, which reflect the potential multifaceted dimensions of an acute whiplash disorder.",0,0 +6977,PMTS and stress response sequences in parents of children with spina bifida,"To test the presence and progress of Pediatric Medical Traumatic Stress (PMTS) symptoms in parents of children with spina bifida (SB).Parents of 23 newborns with SB were interviewed prospectively and parents of 58 school-aged children with SB were interviewed retrospectively. PMTS symptoms were assessed with 17 DSM-IV criteria for the clusters Intrusion, Avoidance, and Increased Arousal.Within 3 months after the SB diagnosis, 75% of the parents met diagnostic criteria for symptoms of Intrusion and Increased Arousal, but not of Avoidance. In parents of school-aged children with SB, PMTS symptoms had declined in the first 4 years of the child's life and stabilized during the school years. Approximately 30% of the mothers and 20% of the fathers still met diagnostic criteria for Intrusion, Avoidance and Increased Arousal. In mothers of children with open SB, symptoms of Intrusion and Increased Arousal had decreased more slowly than in mothers of children with closed SB.An SB diagnosis initially provokes traumatic stress symptoms in three-quarters of the parents; however, in most of them, these symptoms diminish during the first 4 years of the child's life. In a minority of the parents, severe stress symptoms persist beyond middle childhood. Professional psychological help may need to be offered to this selective group of parents whose levels of stress do not decline after the child's preschool years. Longitudinal research is needed to further investigate and confirm the trends that were found in parents' psychological adjustment to SB.",0,0 +6978,The effects of childbirth-related post-traumatic stress disorder on women and their relationships: A qualitative study,"There is converging evidence that 1%-2% of women develop post-traumatic stress disorder (PTSD) as a result of childbirth. The current study aimed to explore the long-term effects of childbirth-related PTSD on women, their relationship with their partner and their relationship with their child. Semi-structured interviews were carried out with six women who reported clinically significant PTSD after birth, ranging from 7 months to 18 years beforehand. Interviews were transcribed and analysed using thematic analysis. Childbirth-related PTSD was found to have wide-ranging effects on women and their relationships. Women reported changes in physical well-being, mood and behaviour, social interaction, and fear of childbirth. Women reported negative effects on their relationship with their partner, including sexual dysfunction, disagreements and blame for events of birth. The mother-baby bond was also seriously affected. Nearly all women reported initial feelings of rejection towards the baby but this changed over time. Long-term, women seemed to have either avoidant or anxious attachments with their child. It is concluded that childbirth-related PTSD can have severe and lasting effects on women and their relationships with their partner and children. Further research is needed to compare this to normal difficulties experienced by women after having children.",0,0 +6979,The function of image control in the psychophysiology of posttraumatic stress disorder,"The physiological response to trauma-related stimuli of up to one third of participants with posttraumatic stress disorder (PTSD) cannot be discriminated from that of controls. Psychophysiological measures (heart rate and blood pressure) of 22 PTSD and 23 control civilian participants, all exposed to missile attacks during the Gulf War, were recorded while listening to five scripts. The physiological response of PTSD subjects with high image control (IC) was lower than that of PTSD participants with low IC and similar to that of non-PTSD subjects. The physiological response poorly discriminated high IC PTSD participants from controls, but was successful in discriminating low IC PTSD subjects from controls with 91% specificity and 92% sensitivity. Image control is proposed as a function influencing physiological response in PTSD.",0,0 +6980,Functional Neuroimaging Research in Posttraumatic Stress Disorder,"Neuroimaging research in posttraumatic stress disorder (PTSD) is only two decadesold, but is rapidly expanding and evolving in methodological sophistication (Pitmanet al. 2001; Hull 2002; Liberzon and Phan 2003). Earlier structural and symptom-provocation studies are giving way to hypothesis-driven cognitive activationstudies, longitudinal and treatment studies, and translationally driven integrativestudies. The focused review of functional neuroimaging research in PTSD that followsdiscusses findings to better understand the functional neuroanatomy underlyingPTSD symptoms and pathophysiology. We begin with a selective review of theresearch on functional neuroanatomy of emotions that is specifically relevant toPTSD. The ensuing discussion links the two bodies of literature in order to providea better understanding of the processing of threat-related emotions and how this informsour understanding of the brain mechanisms that subserve PTSD.PTSD is characterized by exposure to life-threatening event/s associated withintense emotional reactions. Symptom clusters consist of reexperiencing the trauma(such as nightmares and intrusive memories), avoidance and numbing (avoidingtrauma-related cues, feeling emotionally distant from loved ones), and hyperarousal(hypervigilance, sleep disturbances) (American Psychiatric Association 2000). Becausethese criteria are descriptive, atheoretical, and not confined to a specific diagnosis,it is possible that patients with different neurobiological subtypes will sharethe same diagnosis or that patients with similar neurobiological abnormalities maycross descriptive categorical boundaries. Neurobiological evidence does offer thepotential to identify findings specific to trauma exposure and/or to PTSD's symptomsand pathophysiology, thereby helping to differentiate, define, and treat thesedisorders in a more meaningful way.One powerful, noninvasive means of investigating brain function in PTSD is theuse of relatively new neuroimaging methods such as magnetic resonance imaging(MRI) and positron emission tomography (PET). MRI methodology relies on spinproperties of protons in human brain tissue to outline brain structures and estimate their volume. Functional MRI (fMRI) uses the paramagnetic properties of oxy- anddeoxyhemoglobin in conjunction with rapid acquisition sequences to create maps ofblood-oxygen level dependent (BOLD) signal activity, i.e., blood flow reflective ofneuronal firing, thereby allowing the study of neural processing of specific tasks.Single photon emission computed tomography (SPECT) and PET use radio-emittingisotopes of biologically relevant molecules to estimate blood flow, metabolicrate, receptor binding, and quantification and the assessment of pharmacologicalactivity in vivo.",0,0 +6981,Measuring Intrafamily Conflict and Violence: The Conflict Tactics (CT) Scales,"Development of research on intrafamily and violence requires both conceptual clarity and measures of the concepts. The introduction to this paper therefore seeks to clarifj and distinguish the concepts of conflict, conflict of interest, hostility, and violence. The main part qf the paper describes the Conflict Tactics (CT) Scales. The CT Scales are designed to measure the use qf Reasoning, VerbalAggression, and Violence within the family. Information is presented on the following aspects of this instrument: theoretical rational, acceptability to respondents, scoring, factor structure, reliability, validity, and norms for a nationally representative sample of 2,143 couples.",0,0 +6982,Incidence of Hospital-Treated Traumatic Brain Injury in the Oslo Population,"<i>Background:</i> The aim of this prospective, population-based study is to present the incidence of hospital-treated traumatic brain injury (TBI) in Oslo, Norway, and to describe the severity of brain injuries and outcome of the patients’ acute medical care. <i>Methods:</i> Data were obtained from hospital admission registers and medical records from May 2005 to May 2006. The initial severity of TBI was measured by the Glasgow Coma Scale. The region is urban with a population of 534,129. <i>Results:</i> The 445 patients identified represent an annual incidence of 83.3/100,000. The median age was 29 years. The male:female ratio was 1.8:1.0. The highest incidence of TBI hospitalizations was found in the elderly males and the youngest children. The most common causes of TBI were falls (51%) and transport accidents (29.7%). Intracranial lesions were found more often in the elderly. The case fatality rate was 2.0/100 hospitalized patients and was highest in the elderly. <i>Conclusions:</i> The incidence of hospital-treated TBI in this study is considerably lower than that found in previous studies from Norway and Scandinavia. Despite the apparent decline in TBI hospitalization rates, our findings should also draw attention to the need for more effective preventive programmes related to falls. Studies that assess long-term consequences of TBI in elderly patients are also needed.",0,0 +6983,Cognitive factors involved in the onset and maintenance of posttraumatic stress disorder (PTSD) after physical or sexual assault,"Cognitive factors hypothesised to influence the development and maintenance of PTSD were investigated. 92 assault victims completed questionnaires assessing a range of cognitive variables. Factors relating to onset of PTSD were investigated by comparing victims who did and who did not suffer PTSD. Factors relating to maintenance of PTSD were investigated by comparing victims who had recovered from PTSD with victims who had persistent PTSD. Cognitive factors associated with both onset and maintenance of PTSD were: appraisal of aspects of the assault itself (mental defeat, mental confusion, appraisal of emotions); appraisal of the sequelae of the assault (appraisal of symptoms, perceived negative responses of others, permanent change); dysfunctional strategies (avoidance/safety seeking) and global beliefs impacted by assault. Cognitive factors that were associated only with the onset of PTSD were: detachment during assault; failure to perceive positive responses from others and mental undoing. Relationships between the cognitive variables and PTSD remained significant when variations in perceived and objective assault severity were statistically controlled. The cognitive factors identified in the study may contribute to PTSD directly, by generating a sense of ongoing threat, or indirectly, by motivating cognitive and behavioural strategies that prevent recovery, or by affecting the nature of the traumatic memory.",0,0 +6984,Relationship between Persistent Post-traumatic Stress Disorder and Human Remains Exposure for Staten Island Barge and Landfill Recovery and Clean-up Workers After 9/11,"After the September 11, 2001 World Trade Center (WTC) disaster, recovery and clean-up efforts were concentrated at the WTC site and the Staten Island (SI) Fresh Kills landfill and barges. Research is limited regarding the long-term health effects of human remains exposure during clean-up and recovery work at the SI landfill and barges. We studied 1,592 WTC Health Registry enrollees who worked at the SI landfill, loading piers and barges after the 9/11/01 attacks to assess the relationship between remains exposure and persistent posttraumatic stress disorder (PTSD) 10-11 years later. A dose-response relationship was found between frequency of human remains exposure and persistent PTSD (adjusted odds ratio (AOR): every day (AOR) = 4.77; 95% confidence interval (CI): 2.00-11.52, almost every day (AOR) = 4.35; 95% CI: 1.75-10.80), and some days (AOR) = 2.98; 95% CI: 1.43-6.22). When exposed to human remains, sanitation workers had higher odds of persistent PTSD, compared to firefighters and police. In addition, respondents who scored lower on a social support scale had higher odds of persistent PTSD. The findings highlight the need for strategies to reduce the risk of PTSD associated with exposure to human remains in future disasters.",0,0 +6985,Chernobyl Clean-up Workers' Perception of Radiation Threat,"The goals of this study were: (1) to compare the psychometric profiles of male Chernobyl liquidators who met DSM-III-R criteria for current PTSD with those who did not, and (2) to explore liquidators' perception and assessment of the 'invisible' stressor of the radioactive hazard. Results of t-test comparisons between the PTSD and non-PTSD groups for the various psychometric measures are shown. Both diagnostic groups were similar in regard to their mean ages and education levels. The PTSD group scored significantly higher than the non-PTSD group on all the measures of PTSD and general psychiatric symptomatology, state and trait anxiety, depression. On the whole, results of this study demonstrate the determining role of individual perception and assessment of radioactive hazard in the development of post-traumatic stress and place this problem among the most important in studying the psychological consequences of experiencing radioactive threat. The real working conditions and the level of information also affected workers' estimate of the severity of the radiation hazard in Chernobyl.",0,0 +6986,Differences in patterns of depression after treatment for breast cancer,"Depression is a significant problem for some breast cancer survivors after the end of treatment. This study assessed depression using the CES-D for 84 breast cancer patients at the conclusion of radiation treatment, and at 3 and 6 months post-treatment. Based on the pattern of CES-D scores, patients were divided into five groups: (1) Stay Depressed (scores above clinical cutoff for depression at all timepoints); (2) Recover (above threshold at baseline, but below at follow-up); (3) Become Depressed (below threshold at baseline, but above at follow-up); (4) Never Depressed (below threshold at all times); and (5) Vacillate (none of the above patterns). This study examined the relationships between depression groups and a variety of medical, demographic, and psychological measures, including anxiety and quality of life (QOL). Number of children at home significantly distinguished the groups, with the Become Depressed group having more children and the Vacillate group having fewer children. Anxiety levels were different among the groups, with Recover and Never Depressed groups having consistently lower anxiety scores. QOL scores also distinguished the groups in that Never Depressed patients demonstrated better QOL than all other groups. The findings have implications for understanding resilience in cancer patients.",0,0 +6987,A cluster randomized controlled trial to determine the efficacy of Trauma Risk Management (TRiM) in a military population,"Trauma Risk Management is a peer-support program that aims to promote help-seeking in the aftermath of traumatic events. Prior to its implementation, the British military conducted a randomized controlled trial of Trauma Risk Management against standard care in 12 warships; 6 were randomized to use Trauma Risk Management after collecting baseline measurements. Follow up after 12–18 months found no significant change in psychological health or stigma scores in either group; however, the studied vessels only encountered low numbers of critical incidents. Additionally, measurements of organizational functioning were modestly better in the Trauma Risk Management ships. The authors conclude that within organizations using Trauma Risk Management may be beneficial and may, in time, lead to a valuable cultural shift.",0,0 +6988,Course of Alcohol Dependence Among Vietnam Combat Veterans and Nonveteran Controls*,"Identifying developmental trajectories of alcohol use is fundamental in building theories of alcoholism etiology and course. The purpose of this study was to replicate and generalize our previous finding that had been based on a twin sample drawn from the Vietnam Era Twin Registry. In this study, we made use of a nontwin sample of Vietnam veterans drawn from the Vietnam Era Study--a 25-year follow-up of the Vietnam Drug User Returns project that assessed the long-term medical and psychiatric consequences of substance abuse or dependence in Vietnam.Alcohol-related behaviors and psychiatric status were assessed in a sample of 839 individuals that comprised 323 veterans who tested positive for drugs (i.e., opiates, barbiturates, or amphetamines) on discharge from Vietnam, 319 veterans who tested negative for drugs at that time, and a nonveteran control sample (n = 197). Individuals with a lifetime diagnosis of alcohol dependence (n = 293) were selected for further analysis. Using detailed life history charts, in-person structured interviews were conducted, which entailed retrospective reports covering the 25 years since the 1972 survey. Measures of alcohol and drug use as well as psychiatric symptoms were obtained by assessing each year of the follow-up interval, beginning with 1972.Using latent growth mixture modeling, a four-class model was identified with trajectories that were parallel to those identified in our previous studies based on the Vietnam Era Twin Registry: severe chronic alcoholics, severe nonchronic alcoholics, late-onset alcoholics, and young-adult alcoholics.Present findings provide additional support for the replicability and generalizability of meaningful differences in the course of alcoholism from early adulthood to midlife.",0,0 +6989,Identifying experiences of physical and psychological violence in childhood that jeopardize mental health in adulthood,"This study examined associations between profiles of physical and psychological violence in childhood from parents and two dimensions of mental health in adulthood (negative affect and psychological well-being). Profiles were distinguished by the types of violence retrospectively self-reported (only physical, only psychological, or both psychological and physical violence), as well as by the frequency at which each type of violence reportedly occurred (never, rarely, or frequently).Multivariate regression models were estimated using data from the National Survey of Midlife in the U.S. (MIDUS). An adapted version of the Conflict Tactics Scales (CTS) was used to collect respondents' reports of physical and psychological violence in childhood from each parent. Respondents also reported on current experiences of negative affect and psychological well-being.Regarding violence from mothers, reports of frequent psychological violence-even when coupled with never or rarely having experienced physical violence-were associated with more negative affect and less psychological well-being in adulthood. Nearly all profiles of violence in childhood from fathers-with the exception of reports of rare physical violence only-were associated with poorer adult mental health.Results provide evidence that frequent experiences of psychological violence from parents-even in the absence of physical violence and regardless of whether such violence is from mothers or fathers-can place individuals' long-term mental health at risk. Moreover, frequent physical violence from fathers-even in the absence of psychological violence-also serves as a risk factor for poorer adult mental health.Findings provide additional empirical support for the importance of prevention and intervention efforts directed toward children who experience physical and psychological violence from parents, as well as among adults who reportedly experienced in childhood only one type of violence and especially psychological violence at high levels of frequency.",0,0 +6990,A Longitudinal Investigation of the Relationship between Posttraumatic Stress Symptoms and Posttraumatic Growth in a Cohort of Israeli Jews and Palestinians during Ongoing Violence,"OBJECTIVES: Meta-analytic evidence based on cross-sectional investigations between posttraumatic growth (PTG) and posttraumatic stress disorder (PTSD) demonstrates that the two concepts are positively related and that ethnic minorities report greater PTG. Few longitudinal studies have quantified this relationship so the evidence is limited regarding the potential benefit PTG may have on post-traumatic adjustment and whether differences between ethnic groups exist. METHODS: The current study attempts to fill a substantial gap in the literature by exploring the relationship between PTG and PTSD symptom clusters longitudinally using a nationally representative cohort of 1613 Israelis and Palestinian Citizens of Israel (PCI) interviewed via telephone on three measurement occasions during one year. Latent cross-lagged structural models estimated the relationship between PTG and each PTSD symptom cluster, derived from confirmatory factor analysis, representing latent and statistically invariant PTSD symptom factors, best representing PTSD for both ethnic groups. RESULTS: PTG was not associated with less PTSD symptom severity in any of the four PTSD clusters, for Jews and PCI. In contrast, PTSD symptom severity assessed earlier was related to later reported PTG in both groups. CONCLUSIONS: This study demonstrates that PTSD symptoms contribute to greater reported PTG, but that PTG does not provide a salutatory benefit by reducing symptoms of PTSD. Language: en",0,0 +6991,Millennium Cohort: enrollment begins a 21-year contribution to understanding the impact of military service,"

Abstract

Objective

In response to health concerns of military members about deployment and other service-related exposures, the Department of Defense (DoD) initiated the largest prospective study ever undertaken in the U.S. military.

Study Design and Setting

The Millennium Cohort uses a phased enrollment strategy to eventually include more than 100,000 U.S. service members who will be followed up through the year 2022, even after leaving military service. Subjects will be linked to DoD and Veterans Affairs databases and surveyed every 3 years to obtain objective and self-reported data on exposures and health outcomes.

Results

The first enrollment phase was completed in July 2003 and resulted in 77,047 consenting participants, well representative of both active-duty and Reserve/Guard forces. This report documents the baseline characteristics of these Cohort members, describes traditional, postal, and Web-based enrollment methods; and describes the unique challenges of enrolling, retaining, and following such a large Cohort.

Conclusion

The Millennium Cohort was successfully launched and is becoming especially relevant, given current deployment and exposure concerns. The Cohort is representative of the U.S. military and promises to provide new insight into the long-term effects of military occupations on health for years to come.",0,0 +6992,Clarifying the Relationship Between AS Dimensions and PTSD Symptom Clusters: Are Negative and Positive Affectivity Theoretically Relevant Constructs?,"The association between anxiety sensitivity (AS) and posttraumatic stress disorder (PTSD) has been established in contemporary literature; however, research is divided over the nature of specific relationships between AS dimensions and PTSD symptoms clusters. Further, a paucity of research has examined the AS and PTSD relationship while accounting for theoretically relevant variables, such as negative (NA) and positive affect (PA). The purpose of the current study was twofold: first, to clarify divergent findings regarding the contribution of AS dimensions to PTSD symptom clusters, and, second, to further assess the relevance of NA and PA within the AS/PTSD relationship. Hierarchal regression analyses showed that, beyond shared variance attributable to NA and PA, AS somatic concerns were significantly associated with three of four PTSD symptom (i.e., reexperiencing, numbing, hyperarousal), AS cognitive concerns were only associated with hyperarousal, and AS socially observable symptoms were not significantly associated with any PTSD symptom clusters. These findings suggest that AS somatic concerns are the most robust predictor of variance within the AS/PTSD relationship and further clarify the theoretical importance of NA and PA within this relationship. Comprehensive results, implication, and directions for future research are discussed.",0,0 +6993,"Epigenetics, brain, behavior, and the environment","Early experiences can modify regulatory factors affecting gene expression in such a way that, although the DNA sequence itself is not changed, the individual's physiology and behavior is substantially influenced. In some instances these epigenetic effects are exerted upon exposure, while in other instances they are transmitted across generations via incorporation into the germline. Examples of both types of epigenetic effects are presented. First, experience with siblings (littermates) organizes behaviors and their underlying neural substrates in such a way that, as adults, rats and knockout mice behave differently. Second, exposure to the fungicide vinclozolin early in pregnancy imprints the male lineage in such a manner that rats exhibit distinct behavioral profiles as well as unique patterns of gene expression in relevant brain regions. Taken together, this work demonstrates that present and past environments alike modify both social and affiliative related behaviors and their related metabolic activity in specific brain nuclei as well as influencing the abundance of specific genes altering the epigenome in the target brain areas.",0,0 +6994,Sedation of Critically Ill Patients Undergoing Mechanical Ventilation,"Achieving and maintaining an optimal level of comfort and safety in the ICU plays an integral part in caring for critically ill patients. In general, the choice of sedative agent used in ICU patients should be driven by the specific indications and goals of sedation for each patient and the clinical pharmacology of the sedative agent in a particular patient, including its onset and offset of effect and its side-effect profile. Utilizing standard rating scales and unit-based guidelines facilitates the proper use of sedation and analgesia. The triad of factors that lead to agitation include pain, delirium, and anxiety. These factors should be addressed in a stepwise manner and treatment should be focused to a specific indication. Use of sedative hypnotics should be limited to those patients requiring a deeper level of sedation to provide maximal comfort and safety for the patient, or in those in whom agitation is not controlled even after addressing the factors of the triad. © 2013, Lippincott Williams & Wilkins.",0,0 +6995,Behaviorally inhibited temperament is associated with severity of post-traumatic stress disorder symptoms and faster eyeblink conditioning in veterans,"Prior studies have sometimes demonstrated facilitated acquisition of classically conditioned responses and/or resistance to extinction in post-traumatic stress disorder (PTSD). However, it is unclear whether these behaviors are acquired as a result of PTSD or exposure to trauma, or reflect preexisting risk factors that confer vulnerability for PTSD. Here, we examined classical eyeblink conditioning and extinction in veterans self-assessed for current PTSD symptoms, exposure to combat, and the personality trait of behavioral inhibition (BI), a risk factor for PTSD. A total of 128 veterans were recruited (mean age 51.2 years; 13.3% female); 126 completed self-assessment, with 25.4% reporting a history of exposure to combat and 30.9% reporting current, severe PTSD symptoms (PTSS). The severity of PTSS was correlated with current BI (R(2) = 0.497) and PTSS status could be predicted based on current BI and combat history (80.2% correct classification). A subset of the veterans (n = 87) also completed the eyeblink conditioning study. Among veterans without PTSS, childhood BI was associated with faster acquisition; veterans with PTSS showed delayed extinction, under some conditions. These data demonstrate a relationship between current BI and PTSS, and indicate that the facilitated conditioning sometimes observed in patients with PTSD may partially reflect personality traits such as childhood BI that pre-date and contribute to vulnerability for PTSD.",0,0 +6996,"Traumatic Life Events and Psychopathology in a High Risk, Ethnically Diverse Sample of Young Children: A Person-Centered Approach","Studies of the association between traumatic experiences and psychopathology in early childhood have primarily focused on specific types of events (e.g., sexual abuse) or aggregated different types of events without differentiating among them. We extend this body of work by investigating patterns of traumatic event exposure in a high-risk, ethnically diverse sample of children ages 3-6 (N = 211; 51 % female) and relating these different patterns to parents' reports of child externalizing, internalizing, and post-traumatic stress symptomatology. Using latent class analysis, which divides a heterogeneous population into homogenous subpopulations, we identified three patterns of traumatic events based on parents' responses to an interview-based assessment of trauma exposure in young children: (1) severe exposure, characterized by a combination of family violence and victimization; (2) witnessing family violence without victimization; and (3) moderate exposure, characterized by an absence of family violence but a moderate probability of other events. The severe exposure class exhibited elevated internalizing and post-traumatic stress symptoms relative to the witness to violence and moderate exposure classes, controlling for average number of traumatic events. Results highlight the need for differentiation between profiles of traumatic life event exposure and the potential for person-centered methods to complement the cumulative risk perspective.",0,0 +6997,The influence of pre-deployment neurocognitive functioning on post-deployment PTSD symptom outcomes among Iraq-deployed Army soldiers,"Abstract This study evaluated associations between pre-deployment neurocognitive performance and post-deployment posttraumatic stress disorder (PTSD) symptoms in a sample of deployed active duty Army soldiers. As part of a larger longitudinal study, each participant completed baseline measures of memory, executive attention, and response inhibition, and baseline and post-deployment self-report measures of PTSD symptom severity. Data were subjected to multiple regression analyses that examined associations between baseline neurocognitive performances and longitudinal PTSD symptom outcome. Results revealed that pre-trauma immediate recall of visual information was associated with post-deployment PTSD symptom severity, even after controlling for pre-deployment PTSD symptom levels, combat intensity, age, gender, and test-retest interval. There was also an interaction between pre-deployment PTSD symptom severity and pre-deployment immediate visual recall and verbal learning, indicating that neurocognitive performances were more strongly (and negatively) associated with residualized post-deployment PTSD symptoms at higher levels of pre-deployment PTSD symptoms. These findings highlight the potential role of pre-trauma neurocognitive functioning in moderating the effects of trauma exposure on PTSD symptoms.( JINS , 2009, 15 , 840–852.)",0,0 +6998,The association between positive screen for future persistent posttraumatic stress symptoms and injury incident variables in the pediatric trauma care setting,"Posttraumatic stress (PTS) disorder after injury is a significant yet underaddressed issue in the trauma care setting. Parental anxiety may impact a child's risk of future, persistent PTS symptoms after injury. This study aimed to: (1) identify injury incident and demographic variables related to a positive screen for future, persistent PTS symptoms in children; and (2) examine the relationship between parental anxiety and a positive screen for future, persistent PTS symptoms in children.From November 2009 to August 2010, 124 patients were enrolled at a pediatric trauma center. Inclusion criteria were as follows: (1) age 7 years to 17 years; (2) hospitalized for at least 24 hours after physical trauma; and (3) English or Spanish speaking. State and trait anxiety were measured for both pediatric patients and their parents/guardians via the state trait anxiety inventory for children and state trait anxiety inventory, respectively. Risk for future, persistent PTS, among pediatric patients was assessed via the screening tool for early predictor of posttraumatic stress disorder (STEPP).Of 116 participants assessed via the STEPP, 32 (28%) screened positive for risk of future, persistent PTS symptoms. Motor vehicle collision and parental presence at injury were associated with a positive STEPP screen. The effect of parental presence on positive STEPP screen was modified by parental trait anxiety. Children of anxious parents present at injury were over 14 times as likely to screen positive for risk of future, persistent PTS, as those without a parent present.The risk of future, persistent PTS, after injury among the pediatric population is substantial. Parents with existing trait anxiety are shown to influence their child's risk for future, persistent PTS, particularly if present at the injury event. Further study of PTS prevention and control strategies are needed among this population within the trauma care setting.Epidemiological study, level II.",0,0 +6999,Confirmatory factor analysis of posttraumatic stress symptoms in cambodian refugees,"This study used confirmatory factor analysis to examine the factor structure of the Cambodian version of the Harvard Trauma Questionnaire in 488 Cambodian refugees residing in the United States. Five alternative conceptual models were compared. A model with four correlated factors reflecting symptoms of re-experiencing, avoidance, emotional numbing, and hyperarousal provided the best fit to these data. The avoidance and emotional numbing clusters demonstrated distinct associations with depression symptoms, providing some evidence of the construct validity of the four-factor solution.",0,0 +7000,The Dynamics of Posttraumatic Stress Disorder in South African Political Ex-Detainees,This paper explores the dynamic factors involved in the generation of the classical posttraumatic stress disorder (PTSD) in a population of Black South African political ex-detainees. A model is proposed of the evolution of inner psychic events in response to the detention-related trauma which result in the typical symptom cluster.,0,0 +7001,[PTSD as result of the 1997 flood--occurrence and display of distemper].,"The occurrence and course of PTSD in the countryside environment as the result of flood in 1997 has been described. The research was experimented around four villages by Nysa Kłodzka river-basin; the area was affected by disaster unexpectedly and extremely hard.97 people have been tested as the straightforward witnesses of flood. They had never been treated by a psychiatrist before 1997 and they haven't experienced any other stressful event that might have been an independent reason of the occurrence PTSD. The extent of trauma, risk of shock and the length of time that those examined were in danger was identical. None of the studied had received psychological or psychiatric support after the disaster. The research was carried out by one investigator (psychiatrist) 60-63 months after the flood at the victims' houses (the psychiatrist's visit was preceded by the phone appointment). The research instrument--Composite International Diagnostic Interview CIDI: section A (referred to demographic dates) and section N (referred to PTSD).PTSD diagnosis was made in 30.9% of the examined group. The distempered people are mostly educated at the lowest level (49.9% with the ground education) or unemployed (39.2%). Older people were more susceptible to PTSD. PTSD diagnosis was made more often for men (39.5%) than for women (25.4), what is directly related to the lower education and a worse material status of the examined men. Full symptomatic PTSD, remaining up to 60-63 months after the flood, was confirmed in 15.5% of the studied group.The frequency and profile of PTSD occurrence (lower educated, older and the poor people) in the examined group is consistent with the other studies done. The fact that PTSD diagnosis was more frequent amongst men (39.5% vs. 25.4% in women) has been mentioned and explained above. No person in the group has confirmed the short (lasting only up to one month) term of persistence of the symptoms what is tantamount to no acute stress disorder right after the flood. It might be probably caused by the permanence of flood destruction and the prolonged exposure to the stress factor.",0,0 +7002,Fertility of Lactating Dairy Cows Administered Recombinant Bovine Somatotropin During Heat Stress,"Administration of recombinant bovine somatotropin (bST) to lactating dairy cows during heat stress increases milk yield, but it also can increase body temperature and may therefore compromise fertility. However, it is possible that bST treatment could increase fertility during heat stress because it has been reported to increase fertility in lactating cows. In addition, bST increases secretion of insulin-like growth factor-I (IGF-I) that promotes embryo survival. The purpose of this study was to determine effects of bST on reproductive function in lactating dairy cows during heat stress. The experiment was conducted in southern Georgia from July to November 2005 using lactating Holstein cows (n = 276 for reproductive traits). For first service timed artificial insemination (TAI), cows were presynchronized with 2 injections of PGF(2alpha) given 14 d apart followed by a modified Ovsynch protocol (GnRH and insemination at 72 h following PGF(2alpha) ). Pregnancy was diagnosed by using ultrasonography on d 29 and reconfirmed by palpation between d 45 and 80 post-TAI. Nonpregnant cows were resynchronized with the modified Ovsynch protocol and received a second TAI. Treatment with bST started 1 wk before the start of Ovsynch and continued at 2-wk intervals. Blood samples were collected from a subset of cows to determine IGF-I profiles immediately before the first bST injection, 1 wk later, and at d 35 of bST treatment. Rectal temperatures were assessed on d 29 of bST treatment. Pregnancy rates (d 45 to 80 post-TAI) did not differ between bST and control cows for first- (16.7 vs. 15.2%) or second-service TAI (14.8 vs. 17.2%). Plasma concentrations of IGF-I and milk yield were greater for bST-treated cows following the initiation of bST treatment and bST increased rectal and vaginal temperatures. Body condition score was less for bST-treated cows. In conclusion, treatment with bST during heat stress increased IGF-I concentrations, milk yield over time, and rectal and vaginal temperatures without affecting first- or second-service pregnancy rates. Thus, at least under certain housing conditions, bST can be used to improve milk yield during heat stress without compromising fertility.",0,0 +7003,Multiple Traumatic Experiences and the Expression of Traumatic Stress Symptoms for Children and Adolescents,"In order to understand the differential presentation of trauma stress symptoms over the course of development from children to adolescents, a sample of more than 11,000 children and adolescents were studied who were identified as to whether they had experienced multiple trauma experiences prior to placement in child welfare custody. Six age groups were compared on their presentation of symptoms associated with traumatic experiences. Trauma stress symptoms were dramatically different for children and adolescents despite the similarity of trauma experiences. Implications for understanding and addressing multiple trauma experiences across a developmental trajectory are discussed.",0,0 +7004,Acute stress trajectories 1 year after a breast cancer diagnosis,"Purpose: The purpose of this study was to evaluate the longitudinal trajectories of acute stress reactions over the course of diagnosis, treatment, and follow-up assessments in a group of non-metastatic breast cancer patients during five different moments of the illness process, and to identify psychological predictors of the trajectories. Methods: The sample was formed by 102 non-metastatic breast cancer patients treated with adjuvant chemotherapy. Latent growth mixture models (LGMM) were used to identify latent classes, and we used multinomial logistic regression in a conditional model to examine predictors to differentiate between trajectories. Results: We identified four different groups according to their trajectories: (1) a resilient group, (44.5 %); (2) a mild acute stress group, (40.6 %); (3) a delayed–recovery group (11.9 %); and (4) a chronic acute stress group (2.9 %). Moreover, anxious preoccupation showed the strongest significant effects in predicting each class, whereas cognitive avoidance and type C personality had moderate effects for participants in the mild acute stress group. Conclusions: This study demonstrates that the majority of breast cancer patients in our study were resilient, with only a small percentage showing chronic acute stress. Because coping strategies, specifically anxious preoccupation, and not more stable variables played a main role in the prediction of acute stress trajectories, future preventive interventions should center in promoting more adaptive coping strategies in breast cancer patients. © 2015, Springer-Verlag Berlin Heidelberg.",1,0 +7005,The effects of insecure attachment orientations and perceived social support on posttraumatic stress and depressive symptoms among civilians exposed to the 2009 Israel–Gaza war: A follow-up Cross-Lagged panel design study,"A follow-up Cross-Lagged-design was used to test the effects of attachment orientations and perceived social support on posttraumatic stress disorder (PTSD) and major depressive disorder symptoms (MDD) in a sample of 135 Israeli students who were evacuated from a university campus located near the Israel–Gaza border in response to increased missile-fire in the area. An internet-based data collection procedure enabled the simultaneous survey of evacuees located up to 40 km from the border at war, both during the fighting and 4 months after the ceasefire. Proximity to the border did not affect levels of PTSD or MDD symptoms, attachment orientation, or levels of perceived social support. Analyses involving Cross-Lagged Panel Correlation (CLPC) path models revealed that Attachment–Anxiety had significant positive effects on PTSD, MDD, and perceived social support. Neither PTSD nor MDD nor perceived social support had any reciprocal follow-up effect on Attachment–Anxiety. These findings underscore the central role of individual trait personality differences in predicting changes in both mental health problems and interpersonal relations over time, following exposure to trauma.",0,0 +7006,Personality traits of the Five-Factor Model are associated with work-related stress in special force police officers,"Purpose: The police work is particularly stressful. The aim of this work was to clarify whether the personality factors are associated with perceived stress levels or reactivity to environmental stressors in a special body of police. Methods: The police officers in charge of guaranteeing public order at the L'Aquila G8 meeting were subjected to a control of their levels of work-related stress in anticipation of the event. Personality was assessed by the Italian version of the Five-Factor Model questionnaire, while stress was measured three times (during routine work in January 2009, preparation and imminence of the event, in April and July 2009, respectively) with the demand/control/support model of Karasek and the effort/reward imbalance model of Siegrist. A total of 289 of 294 officers took part in the survey. Results: Some personality traits of the Five-Factor Model were associated with stress levels and stress reactivity. Neuroticism (low emotional stability) showed the strongest associations with job strain (demand/control ratio) (β = 0.115, p < 0.05) and effort/reward imbalance (β = 0.270, p < 0.001) and was associated with most of the stress variables. High agreeableness was associated with low effort/reward imbalance (β = -0.157, p < 0.01). Conclusions: Personality factors may mitigate or increase the strain induced by environmental stressors. © 2013 Springer-Verlag Berlin Heidelberg.",0,0 +7007,"Temperature, stress, disorder, and crystallization effects in laser diodes: measurements and impacts","This paper reviews extensive Raman scattering, reflectance modulation and luminescence microprobe measurements made on GaInP/AlGaInP, GaAs/AlGaAs and InGaAs/AlGaAs ridge quantum well lasers to investigate (i) laser operating temperatures, (ii) built-in mechanical stress, (iii) atomic disorder in mirror facets, (iv) Si recrystallization effects in mirror coatings, and (v) correlations of these parameters with laser performance and reliability data. Mirror temperatures have been found to depend sensitively on mirror treatment, mirror structure design, the geometry of a deposited heat spreader, the type of coupling of the laser to a heat sink, the number of active quantum wells, the type of cladding layer, and the strength of lattice disorder at the mirror surfaces. Axial temperatures drop from the hot mirror side along the cavity to low constant values within typically 10 μm. Degradation processes have been observed in real time by continuously monitoring the mirror temperature. Dark line defects formed during laser operation exhibit a temperature gradually increasing with time. The mirrors suffer catastrophic optical damage within seconds after having reached a critical temperature. Temperature maps show a striking localized hot spot within the optical near-field pattern. Strong structural and compositional lattice disorder have been identified as potential root causes of strong mirror heating. Disorder strongly suppresses the catastrophic optical mirror damage power limit. Ridge waveguide lasers show a characteristic camel hump-like stress profile, i.e. high compressive strain levels of up to 5 kbar near the ridge slopes and reduced compressive stress or even low tensile stress fields towards the ridge center. The measured stress fields affect the formation of defects and the optical near-field pattern. Ion-beam deposited amorphous Si layers in mirror coating stacks rapidly recrystallize under high power exposure. This reduces the reflectivity of the coating and increases the transmitted power. Model experiments demonstrate that the recrystallization can modify the effective kink-free optical output power.",0,0 +7008,Resource Loss and Naturalistic Reduction of PTSD Among Inner-City Women,"Halting the process of psychosocial and material resource loss has been theorized as being associated with the reduction of posttraumatic stress disorder (PTSD). This study examines how the limiting of resource loss is related to alleviation of PTSD symptoms among 102 inner-city women, who originally met diagnostic criteria for PTSD after experiencing interpersonal traumatic events such as child abuse, rape, and sexual assault. Participants whose PTSD symptoms improve and become nondiagnostic for PTSD are compared with those who remain diagnostic. The two groups are not significantly different at pretest. However, at the 6-month time point, those who become nondiagnostic for PTSD report less resources loss in three of four domains. This pattern suggests that as PTSD symptoms decrease, women's material and psychosocial resource loss diminishes, which in turn, may aid their recovery process.",0,0 +7009,Remission from post-traumatic stress disorder in adults: A systematic review and meta-analysis of long term outcome studies,"Posttraumatic stress disorder (PTSD) is a frequent mental disorder associated with significant distress and high costs. We conducted the first systematic review and meta-analysis on spontaneous long-term remission rates, i. e., without specific treatment. Data sources were searches of databases, hand searches, and contact with authors. Remission estimates were obtained from observational prospective studies of PTSD without specific treatment. Remission was defined as the actual percentage of PTSD cases at baseline who are non-cases after a minimum of ten months. Forty-two studies with a total of 81,642 participants were included. The mean observation period was 40 months. Across all studies, an average of 44.0% of individuals with PTSD at baseline were non-cases at follow-up. Remission varied between 8 and 89%. In studies with the baseline within the first five months following trauma the remission rate was 51.7% as compared to 36.9% in studies with the baseline later than five months following trauma. Publications on PTSD related to natural disaster reported the highest mean of remission rate (60.0%), whereas those on PTSD related to physical disease reported the lowest mean of remission rate from PTSD (31.4%). When publications on natural disaster were used as a reference group, the only type of traumatic events to differ from natural disaster was physical disease. No other measured predictors were associated with remission from PTSD. Long-term remission from PTSD without specific treatment varies widely and is higher in studies with the baseline within five months following trauma.",0,0 +7010,"Trauma, Genes, and the Neurobiology of Personality Disorders","A model for personality dysfunction posits an interaction between inherited susceptibility and environmental factors such as childhood trauma. Core biological vulnerabilities in personality include dimensions of affective instability, impulsive aggression, and cognition/perceptual domains. For the dimension of impulsive aggression, often seen in borderline personality disorder (BPD), the underlying neurobiology involves deficits in central serotonin function and alterations in specific brain regions in the cingulate and the medial and orbital prefrontal cortex. The role of trauma in the development of personality disorder and especially for BPD remains unclear. Although recent studies suggest that BPD is not a trauma-spectrum disorder and that it is biologically distinct from posttraumatic stress disorder, high rates of childhood abuse and neglect do exist for individuals with personality dysfunction. Personality symptom clusters seem to be unrelated to specific abuses, but they may relate to more enduring aspects of interpersonal and family environments in childhood. Whereas twin and family studies indicate a partially heritable basis for impulsive aggression, studies of serotonin-related genes to date suggest only modest contributions to behavior. Gene-environment interactions involving childhood maltreatment are demonstrated in recent studies on antisocial behaviors and aggressive rhesus monkeys and highlight the need for further research in this important area.",0,0 +7011,Buprenorphine in the treatment of non-suicidal self-injury: a case series and discussion of the literature,"Abstract A global public health problem, non-suicidal self-injury (NSSI) is highly prevalent in both males and females, and tends to first occur in adolescence. NSSI is correlated with a history of childhood trauma, and with a variety of developmental and psychiatric disorders. NSSI is associated with increased risk of morbidity and premature death from suicide, accidents, and natural causes. Current treatment approaches are inadequate for a substantial number of people. Converging evidence for opioid system dysregulation in individuals with NSSI make this a promising area of investigation for more effective treatments. The pharmacological profile of buprenorphine, a potent μ-opioid partial agonist and κ-opioid antagonist, suggests that it may be beneficial. In this paper, we describe the successful treatment of severe NSSI with buprenorphine in six individuals, followed by discussion and further recommendations.",0,0 +7012,Mental illness and housing outcomes among a sample of homeless men in an Australian urban centre,"Objective: The over-representation of mental illness among homeless people across the globe is well documented. However, there is a dearth of Australian literature on the mental health needs of homeless individuals. Furthermore, longitudinal research examining the factors that contribute to better housing outcomes among this population is sparse. The aim of this research is to describe the mental illness profile of a sample of homeless men in an Australian urban centre (in Sydney) and examine the factors associated with better housing outcomes at 12-month follow-up. Methods: A longitudinal survey was administered to 253 homeless men who were involved in the Michael Project: a 3-year initiative which combined existing accommodation support services with assertive case management and access to coordinated additional specialist allied health and support services. A total of 107 participants were followed up 12 months later. The survey examined the demographics of the sample and lifetime mental disorder diagnoses, and also included psychological screeners for current substance use and dependence, psychological distress, psychosis, and post-traumatic stress. Results: Consistent with existing literature, the prevalence of mental illness was significantly greater amongst this sample than the general Australian population. However, mental illness presentation was not associated with housing situation at 12-month follow-up. Instead, type of support service at baseline was the best predictor of housing outcome, wherein participants who received short to medium-term accommodation and support were significantly more likely to be housed in stable, long-term housing at the 12-month follow-up than participants who received outreach or emergency accommodation support. Conclusions: This study provides evidence to support an innovative support model for homeless people in Australia and contributes to the limited Australian research on mental illness in this population.",0,0 +7013,Re-establishment of Anxiety in Stress-Sensitized Mice Is Caused by Monocyte Trafficking from the Spleen to the Brain,"Persistent anxiety-like symptoms may have an inflammatory-related pathophysiology. Our previous work using repeated social defeat (RSD) in mice showed that recruitment of peripheral myeloid cells to the brain is required for the development of anxiety. Here, we aimed to determine if 1) RSD promotes prolonged anxiety through redistribution of myeloid cells and 2) prior exposure to RSD sensitizes the neuroimmune axis to secondary subthreshold stress.Mice were subjected to RSD and several immune and behavioral parameters were determined .5, 8, or 24 days later. In follow-up studies, control and RSD mice were subjected to subthreshold stress at 24 days.Repeated social defeat-induced macrophage recruitment to the brain corresponded with development and maintenance of anxiety-like behavior 8 days after RSD, but neither remained at 24 days. Nonetheless, social avoidance and an elevated neuroinflammatory profile were maintained at 24 days. Subthreshold social defeat in RSD-sensitized mice increased peripheral macrophage trafficking to the brain that promoted re-establishment of anxiety. Moreover, subthreshold social defeat increased social avoidance in RSD-sensitized mice compared with naïve mice. Stress-induced monocyte trafficking was linked to redistribution of myeloid progenitor cells in the spleen. Splenectomy before subthreshold stress attenuated macrophage recruitment to the brain and prevented anxiety-like behavior in RSD-sensitized mice.These data indicate that monocyte trafficking from the spleen to the brain contributes re-establishment of anxiety in stress-sensitized mice. These findings show that neuroinflammatory mechanisms promote mood disturbances following stress-sensitization and outline novel neuroimmune interactions that underlie recurring anxiety disorders such as posttraumatic stress disorder.",0,0 +7014,Is Posttraumatic Stress in Youth a Culture-Bound Phenomenon? A Comparison of Symptom Trends in Selected U.S. and Russian Communities,"The cross-cultural applicability of the concept of posttraumatic stress was investigated by assessing symptom frequency and levels of comorbid psychopathology in adolescents from the United States and Russia.A self-report survey was conducted in representative samples of 2,157 adolescents 14 to 17 years old from urban communities of the United States (N=1,212) and Russia (N=945).In both countries, the levels of all three major clusters of posttraumatic symptoms (reexperiencing, avoidance, and arousal), as well as of internalizing psychopathology, increased along with the level of posttraumatic stress. Expectations about the future had a tendency to decrease with increasing posttraumatic stress. No differences between countries in significant interaction effects for symptom levels were found.The current findings suggest that posttraumatic symptoms and their associations with other adolescent mental health problems are not culture bound and that the psychological consequences of trauma follow similar dynamics cross-culturally.",0,0 +7015,Patients with Generalized Anxiety Disorder and a History of Trauma: Somatic Symptom Endorsement,"The authors investigated the types and rates of trauma exposure and differences in symptom endorsement in a clinical sample of patients diagnosed with generalized anxiety disorder (GAD). Fifty-eight patients with GAD were assessed using the Structured Clinical Interview (SCID) and Trauma Assessment for Adults. In order to explore the relationship between specific traumatic event(s) and clinical presentation, the presence of somatic symptoms associated with GAD, including muscle tension, autonomic hyperactivity, and vigilance/scanning clusters (using DSM-III-R criteria), were examined. Patients with a history of sexual assault before 18 years (25.9%) endorsed fewer somatic symptoms, specifically fewer motor tension and autonomic GAD symptoms, than patients with other types of trauma. These findings indicate that early exposure to serious trauma, specifically childhood sexual assault, may lead to a different clinical presentation in GAD patients.",0,0 +7016,"Compassion satisfaction, compassion fatigue, anxiety, depression and stress in registered nurses in Australia: study 1 results","Aim To explore compassion fatigue and compassion satisfaction with the potential contributing factors of anxiety, depression and stress. Background To date, no studies have connected the quality of work-life with other contributing and co-existing factors such as depression, anxiety and stress. Method A self-report exploratory cross sectional survey of 132 nurses working in a tertiary hospital. Result The reflective assessment risk profile model provides an excellent framework for examining the relationships between the professional quality of work factors and contributing factors within the established risk profiles. The results show a definite pattern of risk progression for the six factors examined for each risk profile. Additionally, burnout and secondary traumatic stress were significantly related to higher anxiety and depression levels. Higher anxiety levels were correlated with nurses who were younger, worked full-time and without a postgraduate qualification. Twenty percent had elevated levels of compassion fatigue: 7.6% having a very distressed profile. At-risk nurses' stress and depression scores were significantly higher than nurses with higher compassion satisfaction scores. Implications for nursing managers The employed nurse workforce would benefit from a psychosocial capacity building intervention that reduces a nurse's risk profile, thus enhancing retention.",0,0 +7017,"Prevalence, risk factors and aging vulnerability for psychopathology following a natural disaster in a developing country","Objectives This study explored the psychopathological reactions to a natural disaster and their respective risk factors among the elderly in Honduras and their vulnerability as compared to other adults. Study subjects and sample Eight hundred respondents of both genders aged 15 years and above, of which 103 were 60 and over, were selected from high, middle and low residential status areas in Tegucigalpa that had suffered high and low exposure to the devastating effects of Hurricane Mitch. Research instruments CIDI was used to diagnose PTSD and the Impact of Events Scale was administered as a measure of severity of post-traumatic reaction. Depression and alcohol misuse were examined using screening instruments. The SRQ was used as both a measure of emotional distress and dichotomized to screen for probable psychiatric disorder. Results PTSD, depression and SRQ-case were found, respectively in 13.6%, 18.8%, and 21.4% of the elderly. Their reactions did not differ in frequency than of those of younger adults. Among the elderly, pre-hurricane psychological problems and the intensity of exposure were associated with increased risk for all outcomes measured except for alcohol misuse. Conclusion No evidence was found for a differential vulnerability on the part of the elderly as compared with younger adults. Among the elderly increasing age was not a factor. Copyright © 2005 John Wiley & Sons, Ltd.",0,0 +7018,Lifetime Sexual and Physical Victimization among Male Veterans with Combat-Related Post-traumatic Stress Disorder,"Because of the high prevalence of post-traumatic stress disorder (PTSD) among veteran men and the limited research on victimization in this group, we recruited 133 male veterans with combat-related PTSD from a psychiatric inpatient unit and assessed them for lifetime physical and sexual trauma. Results indicated that 96% of the sample had experienced some form of victimization over their lifetimes; 60% reported childhood physical abuse, 41% childhood sexual abuse, 93% adulthood physical assault, and 20% adulthood sexual assault. In the preceding year alone, 46% experienced either physical or sexual assault. These findings support the need for routine inquiry into the histories of noncombat victimization in this cohort. Determining the lifetime history of trauma exposure may have implications for vulnerability to subsequent development of PTSD and the risk of future violence.",0,0 +7019,Personality Subgroups in an Inpatient Vietnam Veteran Treatment Program,"Millon Clinical Multiaxial Inventory personality profiles of 250 male inpatient Vietnam veterans were examined to locate subgroups within that population. Using a hierarchical cluster analysis to form relatively homogeneous groups, four clusters were identified which accounted for 98% of the population. Three clusters had Millon profiles suggestive of a stress reaction and one cluster had a profile indicative of an antisocial adjustment. As measured by a PTSD subscale of the Minnesota Multiphasic Personality Inventory two clusters are high stress groups and two clusters are lower stress groups. The two Millon personality profiles in the high stress category were an 8-2-1/6 group and a 2-8-1-3 group. The lower stress groups had profiles of /8-2 and 6/8-5. The high stress groups are considered Posttraumatic Stress Disorder groups and the lower stress groups are considered nonPosttraumatic Stress Disorder groups.",0,0 +7020,Externalizing and Internalizing Subtypes of Combat-Related PTSD: A Replication and Extension Using the PSY-5 Scales.,"This study replicated and extended prior findings of internalizing and externalizing subtypes of posttraumatic response (M. W. Miller, J. L. Greif, & A. A. Smith, 2003). Cluster analyses of the Minnesota Multiphasic Personality Inventory--2 Personality Psychopathology--Five (MMPI-2 PSY-5; A. R. Harkness, J. L. McNulty, Y. S. Ben-Porath, 1995) profiles obtained from 736 veterans with posttraumatic stress disorder (PTSD) partitioned the sample into a low pathology cluster defined by personality scores in the normal range, an externalizing cluster characterized by low constraint and high negative emotionality, and an internalizing cluster with high negative emotionality and low positive emotionality. Externalizers showed the highest rates of alcohol-related and antisocial personality disorders; internalizers, the highest rates of panic and major depressive disorder. These findings support the development of a personality-based typology of posttraumatic response designed to account for heterogeneity in the expression of PTSD and associated psychopathology.",0,0 +7021,PTSD in the armed forces: What have we learned from the recent cohort studies of Iraq/Afghanistan?,"Post-traumatic stress disorder (PTSD) was formally recognised as a psychiatric disorder in 1980, largely in response to America's attempts to make sense of the costs of the Vietnam war [Wessely, S., & Jones, E. (2004). Psychiatry and the 'lessons of Vietnam': What were they, and are they still relevant? War & Society, 22(1), 89-103.]. Interestingly, all of this occurred without much contribution from epidemiology, which came later (Wessely & Jones, 2004). This cannot be said of the current conflicts, where from the outset there has been a focus of attention on the epidemiology of PTSD in those who served in either Iraq or Afghanistan, even whilst the conflicts were ongoing. In this editorial, we focus on this recent epidemiological contribution to the understanding of PTSD in military personnel.",0,0 +7022,Erratum for “Posttraumatic stress after a motor vehicle accident: A six-month follow-up study utilizing latent growth modeling”,"Reports an error in ""Posttraumatic stress after a motor vehicle accident: A six-month follow-up study utilizing latent growth modeling"" by Kitty K. Wu and Mike W. L. Cheung (Journal of Traumatic Stress, 2006[Dec], Vol 19[6], 923-936). Mike W. L. Chueng's affiliation was incorrectly listed in the print version. The correct affiliation is: Department of Psychology, National University of Singapore, Singapore. (The following abstract of the original article appeared in record 2007-00025-016.) Features of posttraumatic stress disorder (PTSD) for 596 survivors of motor vehicle accidents were examined by self-report measures at 1 week, 1 month, 3 months, and 6 months after the motor vehicle accident (MVA). Latent growth modeling was utilized to study the trend and predictors of the level of distress. Results indicated that 5-20% of the participants reported to have a significant level of posttraumatic stress in one, two, or three of the PTSD symptom clusters within the period studied. Survivors with significant acute stress 1 week after the MVA had a higher risk for developing chronic posttraumatic stress. Although the severity of intrusive and hyperarousal symptoms decreased over time, the severity of avoidance symptoms remained unchanged. Factors predicting the course of PTSD after an MVA are identified. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +7023,"Organophosphate-induced brain damage: Mechanisms, neuropsychiatric and neurological consequences, and potential therapeutic strategies","Organophosphate (OP)-induced brain damage is defined as progressive damage to the brain, resulting from the cholinergic neuronal excitotoxicity and dysfunction induced by OP-induced irreversible AChE inhibition. This delayed secondary neuronal damage that occurs mainly in the cholinergic regions of the brain that contain dense accumulations of cholinergic neurons and the majority of cholinergic projection, might be largely responsible for persistent profound neuropsychiatric and neurological impairments (memory, cognitive, mental, emotional, motor and sensory deficits) in the victims of OP poisoning. Neuroprotective strategies for attenuating OP-induced brain damage should target different development stages of OP-induced brain damage, and may include but not limited to: (1) Antidote therapies with atropine and related efficient anticholinergic drugs; (2) Anti-excitotoxic therapies targeting attenuation of cerebral edema and inflammatory reaction, blockage of calcium influx, inhibition of apoptosis program, and the control of seizures; (3) Neuroprotective strategies using cytokines, antioxidants and NMDAR antagonists (a single drug or a combination of drugs) to slow down the process of secondary neuronal damage; and (4) Therapies targeting individual symptoms or clusters of chronic neuropsychiatric and neurological symptoms. These neuroprotective strategies may help limit or prevent secondary neuronal damage at the early stage of OP poisoning and attenuate the subsequent neuropsychiatric and neurological impairments, thus reducing the long-term disability caused by exposure to OPs.",0,0 +7024,Validity of the Type D personality construct in Danish post-MI patients and healthy controls,"Type D personality has been associated with increased risk of depression, vital exhaustion, social alienation, a higher number of reinfarctions, and higher mortality rates in patients with established coronary artery disease (CAD) independent of traditional biomedical risk factors. The construct was developed in Belgian cardiac patients, but little is known about its applicability in other nationalities. The objectives of the present article were to cross-validate the Type D Personality Scale-16 (DS16) in a Danish sample of patients with a first myocardial infarction and a random sample of healthy controls, and to investigate whether Type D is associated with posttraumatic stress disorder (PTSD). A questionnaire was given to 112 consecutive patients with a first myocardial infarction 4 to 6 weeks post infarction, and to 115 healthy controls selected randomly from the general population. The two-factor structure of the DS16 and the internal consistency of the Negative Affectivity ( α =.83) and Social Inhibition ( α =.76) subscales were confirmed. The construct validity of the DS16 was confirmed against scales that measure similar constructs, and the discriminant validity of the DS16 against measures of psychopathology . In a pooled sample of patients and healthy controls, comparison of both groups confirmed that Type D may be conceptualised as a marker of general emotional distress , with Type D persons scoring higher on depression, anxiety, and the PTSD symptom clusters arousal and avoidance compared with non-Type D persons. A regression analysis run in two steps showed that the inclusion of Type D in the model lead to an improvement in the level of prediction of PTSD above and beyond a model that included gender, age, MI, neuroticism , and extroversion. Type D (OR=4.46; 95% CI: 1.36 to 14.64), diagnosis of MI (OR=4.03; 95% CI: 1.43 to 11.35), and neuroticism (OR=1.32; 95% CI: 1.13 to 1.53) were independently associated with PTSD, adjusting for all other variables. These findings indicate that the Type D construct is equally applicable in Danish patients with CAD, and that Type D is associated with PTSD.",0,0 +7025,A TWIN REGISTRY STUDY OF FAMILIAL AND INDIVIDUAL RISK FACTORS FOR TRAUMA EXPOSURE AND POSTTRAUMATIC STRESS DISORDER,"This study examines the association of individual and familial risk factors with exposure to trauma and posttraumatic stress disorder (PTSD) in male twins (N = 6744) from the Vietnam Era Twin Registry. Independent reports of familial psychopathology from co-twins were used to avoid the potential biases of the family history method. Risk for exposure to traumatic events was increased by service in Southeast Asia, preexisting conduct disorder, preexisting substance dependence, and a family history of mood disorders whose effects appear to be partly genetic. Preexisting mood disorders in the individual were associated with decreased odds of traumatic exposure. Risk of developing PTSD following exposure was increased by an earlier age at first trauma, exposure to multiple traumas, paternal depression, less than high school education at entry into the military, service in Southeast Asia, and preexisting conduct disorder, panic disorder or generalized anxiety disorder, and major depression. Results suggest the association of familial psychopathology and PTSD may be mediated by increased risk of traumatic exposure and by preexisting psychopathology.",0,0 +7026,Psychosocial Concerns and Interventions for Cancer Survivors,"In light of the increasing population living with a history of cancer in the United States, it is important to attend to quality of life and health in this group, and to develop effective interventions to address psychosocial and physical concerns across the course of the cancer trajectory. The goals of this article are to document the need for attention to psychosocial domains; offer a brief overview of the current status of the empirical literature on effects of psychosocial interventions with cancer survivors, relying on systematic reviews and meta-analyses conducted in the last decade; highlight recent examples of randomized, controlled psychosocial intervention trials directed toward cancer survivors after the completion of primary medical treatments (ie, the re-entry phase and beyond); and identify directions for application and research.",0,0 +7027,"A Computerized, Self-Administered Questionnaire to Evaluate Posttraumatic Stress Among Firefighters After the World Trade Center Collapse","We sought to determine the frequency of psychological symptoms and elevated posttraumatic stress disorder (PTSD) risk among New York City firefighters after the World Trade Center (WTC) attack and whether these measures were associated with Counseling Services Unit (CSU) use or mental health-related medical leave over the first 2.5 years after the attack.Shortly after the WTC attack, a computerized, binary-response screening questionnaire was administered. Exposure assessment included WTC arrival time and ""loss of a co-worker while working at the collapse."" We determined elevated PTSD risk using thresholds derived from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, and a sensitivity-specificity analysis.Of 8487 participants, 76% reported at least 1 symptom, 1016 (12%) met criteria for elevated PTSD risk, and 2389 (28%) self-referred to the CSU, a 5-fold increase from before the attack. Higher scores were associated with CSU use, functional job impairment, and mental health-related medical leave. Exposure-response gradients were significant for all outcomes.This screening tool effectively identified elevated PTSD risk, higher CSU use, and functional impairment among firefighters and therefore may be useful in allocating scarce postdisaster mental health resources.",0,0 +7028,Risk indicators for post-traumatic stress disorder in adolescents exposed to the 5.12 Wenchuan earthquake in China,"In Chinese adolescents exposed to the Wenchuan earthquake, we used the Children's Revised Impact of Event Scale (CRIES) as the screening tool, and Post-traumatic Cognitions Inventory (PTCI) and the Social Support Rating Scale (SSRS) were used to assess the cognitive status and their social supports, to evaluate the prevalence and the predictors variables of post-traumatic stress disorder (PTSD) after the Wenchuan earthquake in China, which occurred on 12 May 2008. Subjects with a CRIES score greater than 30 were interviewed and assessed using the DSM-IV criteria for PTSD diagnosis by a trained psychiatrist with the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Lifetime version (Kiddie-SADS-L). We found the overall prevalence of PTSD was 2.5% in 3208 adolescents from the surrounding areas of the epicentre 6months after the earthquake. Risk factors for post-traumatic stress symptoms are as follows: being female, being buried/injured during the earthquake, having parents who were severely injured, having classmate(s) who died, having a house destroyed, and witnessing someone buried/wounded/dying during the earthquake. Individuals with better social support had significantly lower scores on the CRIES. There were significant differences in cognitive style between individuals at low risk for PTSD (CRIES<30) and those at high risk for PTSD (CRIES≥30). Post-traumatic cognition emerged as an important factor that was associated with PTSD reactions in children. Social support can lessen the impact of a natural disaster by affecting post-traumatic cognition.",0,0 +7029,Risk factors for PTSD-related traumatic events: a prospective analysis,"The authors previously identified suspected risk factors for traumatic events related to posttraumatic stress disorder (PTSD) on the basis of data gathered retrospectively. In this study, they tested that model prospectively.A random sample of 1,200 persons was drawn from all 21- to 30-year-old members of a large health maintenance organization. In 1989, 1,007 of these persons were interviewed, and suspected risk factors were measured. In 1992, 979 were reinterviewed, and the 3-year incidence of exposure to traumatic events was ascertained.Nineteen percent of the sample reported traumatic events during the 3-year follow-up. A history of past exposure to traumatic events signaled an increase in the liability to exposure during follow-up, independent of suspected risk factors. Two predictors of exposure, neuroticism and extroversion, identified retrospectively, also predicted exposure prospectively. The odds for exposure among males and persons with less than a college education were marginally significant. Early misconduct and a family history of psychiatric disorder-predictors of exposure in the retrospective data-were not significant predictors at 3-year follow-up. Blacks had a higher incidence of exposure during follow-up than whites. An exploratory reanalysis suggested that the discrepancy between the retrospective and prospective results may be explained by the inclusion of childhood exposure in the lifetime retrospective inquiry.The assumption that PTSD-related traumatic events are random phenomena was unsupported. Among young adults, those with less education, blacks, and those with high neuroticism and extroversion scores are more likely than others to be exposed to traumatic events and are thus at greater risk for PTSD.",0,0 +7030,Broadening the focus in supporting reintegrating Iraq and Afghanistan veterans: Six key domains of functioning.,"As the major ground troop presence in the Middle East is reduced, it is time to reflect, maximize lessons learned, and look forward to what lies ahead for the nearly 2.6 million service members of the United States military who have deployed in support of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn. A systematic review of the literature on postdeployment functioning of Iraq and Afghanistan troops was conducted. Findings are described and contextualized in terms of service members' ongoing strengths, needs, and challenges. The corpus of research on deployed personnel indicates that service members demonstrate resilience in the face of war-related stressors. However, postdeployment impairment in 6 functional domains emerged in the literature review, including mental health, social and role functioning, relationship functioning and family life, spirituality, physical health, and financial well-being. Although risk factors and future trajectories vary across these domains, psychiatric difficulties are a consistent predictor of a worsened course. Implications for clinical practice are described based on the review findings. To promote wellbeing in the years ahead, it is important that service members are supported in their various roles (such as in the classroom, the workforce, and the family). In addition, routine assessment of functioning across domains is highly recommended for postdeployment service members. (PsycINFO Database Record © 2015 APA, all rights reserved).",0,0 +7031,Molecular Events Triggered by Heat Shock in Y1 Adrenocortical Cells,"Several stimuli, including stress conditions, promote the activation of MAP kinases family members (ERK1/2, JNK, p38). In turn, these enzymes regulate several cellular functions. Given that MAPK activation requires the phosphorylation of these proteins, their inactivation depends on the activity of specific phosphatases. MAPK phosphatase-1 (MKP-1), a phosphatase specifically involved in the inactivation of MAPK family members, is induced by mitogenic stimuli and stress conditions. Here we describe the effect of heat shock (HS), 10 min, 45 degrees C, on MAPKs activities and MKP-1 mRNA and protein levels in Y1 adrenocortical cells. Western blot analysis performed with antibodies against the phosphorylated forms of ERK1/2 and JNK revealed that HS produced the rapid activation of these kinases. Their inactivation was also a rapid event and occurred together with the increase of MKP-1 protein levels detected by Western blot analysis. In addition, the effect of HS on MKP-1 protein levels seems to be exerted at the transcriptional level, since the amount of its mRNA in heat shocked cells was higher than in nonheated cells. Comparison of the temporal profiles of MKP-1 protein induction and MAPKs phospho-dephosphorylation suggests that MKP-1 induction could contribute to ERK1/2 and JNK inactivation after HS.",0,0 +7032,Measuring Secondary Traumatic Stress Symptoms in Military Spouses With the Posttraumatic Stress Disorder Checklist Military Version,"Little research to date has examined secondary traumatic stress symptoms in spouses of military veterans. This study investigated the presence and severity of posttraumatic stress symptoms in a sample of 227 Army National Guard veterans and secondary traumatic stress symptoms among their spouses. The veterans completed the posttraumatic stress disorder (PTSD) Checklist Military Version (PCL-M) (Weathers et al., 1993) to determine the probable prevalence rate of posttraumatic stress symptoms. A modified version of the PCL-M was used to assess secondary traumatic stress symptoms in the spouses. A confirmatory factor analysis showed that the modified version of the PCL-M used to assess secondary traumatic stress symptoms in spouses fits using the same four-factor PTSD structure as the PCL-M for veterans. This study provides initial evidence on the underlying symptom structure of secondary traumatic stress symptoms among spouses of traumatic event victims.",0,0 +7033,Trajectories of Posttraumatic Stress Among Urban Residents,"Urban residents experience a wide range of traumatic events and are at increased risk of assaultive violence. Although previous research has examined trajectories of posttraumatic stress (PTS) through latent class growth analysis (LCGA) among persons exposed to the same index events (e.g., a natural disaster), PTS trajectories have not been documented among urban residents. The aims of this study were to conduct LGCA with a sample of trauma survivors from Detroit, Michigan (N = 981), and to explore predictors of trajectory membership. Participants completed three annual telephone surveys, each of which included the posttraumatic stress disorder (PTSD) Checklist-Civilian Version. Four PTS trajectories were detected. Although the majority evidenced a trajectory of consistently few symptoms (Low: 72.5%), 4.6% were in a trajectory of chronic severe PTSD (High), and the remainder were in trajectories of consistently elevated, but generally subclinical, levels of PTS (Decreasing: 12.3%; Increasing: 10.6%). Socioeconomic disadvantage (e.g., lower income), more extensive trauma history (e.g., childhood abuse), and fewer social resources (e.g., lower social support) were associated with membership in higher PTS trajectories, relative to the Low trajectory. The results suggest that efforts to reduce PTS in urban areas need to attend to socioeconomic vulnerabilities in addition to trauma history and risk for ongoing trauma exposure.",0,0 +7034,Neurobiological indicators of disinhibition in posttraumatic stress disorder,"Deficits in impulse control are increasingly recognized in association with posttraumatic stress disorder (PTSD). To our further understanding of the neurobiology of PTSD-related disinhibition, we examined alterations in brain morphology and network connectivity associated with response inhibition failures and PTSD severity. The sample consisted of 189 trauma-exposed Operation Enduring Freedom/Operation Iraqi Freedom veterans (89% male, ages 19-62) presenting with a range of current PTSD severity. Disinhibition was measured using commission errors on a Go/No-Go (GNG) task with emotional stimuli, and PTSD was assessed using a measure of current symptom severity. Whole-brain vertex-wise analyses of cortical thickness revealed two clusters associated with PTSD-related disinhibition (Monte Carlo cluster corrected P < 0.05). The first cluster included portions of right inferior and middle frontal gyri and frontal pole. The second cluster spanned portions of left medial orbital frontal, rostral anterior cingulate, and superior frontal gyrus. In both clusters, commission errors were associated with reduced cortical thickness at higher (but not lower) levels of PTSD symptoms. Resting-state functional magnetic resonance imaging analyses revealed alterations in the functional connectivity of the right frontal cluster. Together, study findings suggest that reductions in cortical thickness in regions involved in flexible decision-making, emotion regulation, and response inhibition contribute to impulse control deficits in PTSD. Furthermore, aberrant coupling between frontal regions and networks involved in selective attention, memory/learning, and response preparation suggest disruptions in functional connectivity may also play a role.",0,0 +7035,Meta-analytic review of event-related potential studies in post-traumatic stress disorder,"In recent years there has been an accumulation of studies that have utilized the measurement of event-related potentials (ERP) to examine the neuroelectric correlates of hypothesized alterations in information processing in persons with post-traumatic stress disorder (PTSD). The objective of this meta-analysis was to summarize the findings of ERP PTSD research, including studies that have examined P50 auditory sensory gating, augmenting-reducing P200, and P300 in target detection oddball tasks. The results suggest that persons with PTSD exhibit alterations in the amplitude and latency of ERP within these paradigms that support the hypothesis that changes in information processing can accompany PTSD. The results were also consistent with recent cognitive neuropsychological findings in PTSD research.",0,0 +7036,Family satisfaction predicts life satisfaction trajectories over the first 5 years after traumatic brain injury.,"Examined the influence of functional impairment, stable marital status, and family satisfaction on life satisfaction trajectories for 609 individuals (435 men, 174 women) over the first 5 years after traumatic brain injury (TBI).Participants completed the Family Satisfaction Scale (FSS), Functional Independence Measure (FIM), and the Life Satisfaction Index (LSI) at years 1, 2, 4, and 5 after sustaining a TBI.Trajectory modeling revealed that higher family satisfaction was associated with increases in life satisfaction for individuals with less functional impairment. Stable marital status was not significantly associated with life satisfaction trajectories.Family satisfaction appears to have pronounced beneficial effects on life satisfaction for persons with less functional impairment after TBI regardless of marital status. In contrast, a stable marriage appears to have no apparent benefits to self-reported life satisfaction over the first 5 years post-TBI. Theoretical and clinical implications of these results are discussed.",0,0 +7037,PTSD and Depression Among Displaced Chinese Workers After the World Trade Center Attack: A Follow-up Study,"We conducted a follow-up assessment to assess the development of Posttraumatic Stress Disorder (PTSD) and depression among Chinese immigrants after the World Trade Center attack. Sixty-five Chinese displaced workers who were originally interviewed in May 2002 were re-interviewed in March 2003. Whereas depression scores decreased over time, average PTSD scores remained unchanged. The trajectory of posttraumatic stress symptoms was more complex, with an increasing number of individuals who show no or little emotional health problems and another increasing group of individuals with exacerbated posttraumatic stress symptoms. Although the mean values of the re-experiencing and hypervigilance cluster did not change over time, the mean value of the avoidance/numbing cluster increased significantly from time 1 (M= 4.60, SD = 4.98) to time 2 (M= 6.34, SD = 4.24), (F1.61=5.69,P= .02). A higher proportion of subjects met diagnostic criteria of PTSD at time 2 (27%) than at time 1 (21%). The study highlights the importance of ongoing mental health surveillance of diverse cultural and linguistic groups after a major traumatic event.",0,0 +7038,Responses to violence and trauma: the case of post-traumatic stress disorder,"Chapter 9 describes and evaluates the relatively recent mental health models of the impact of trauma, and discusses the ways that traumatic events affect people, the political and cultural effects of understanding these consequences as ‘disorder’, particularly as Post-traumatic Stress Disorder (PTSD), and concludes by looking at the relevance of the concept of PTSD to forensic populations.",0,0 +7039,Clustering of Trauma and Associations with Single and Co-Occurring Depression and Panic Attack over Twenty Years,"Individuals who experience one type of trauma often experience other types, yet few studies have examined the clustering of trauma. This study examines the clustering of traumatic events and associations of trauma with risk for single and co-occurring major depressive disorder (MDD) and panic attack for 20 years after first trauma. Lifetime histories of MDD, panic attack, and traumatic events were obtained from participants in an Australian twin sample. Latent class analysis was used to derive trauma classes based on each respondent's trauma history. Associations of the resulting classes and of parental alcohol problems and familial effects with risk for a first onset of single and co-occurring MDD and panic attack were examined from the year of first trauma to 20 years later. Traumatic events clustered into three distinct classes characterized by endorsement of little or no trauma, primarily nonassaultive, and primarily assaultive events. Individuals in the assaultive class were characterized by a younger age at first trauma, a greater number of traumatic events, and high rates of parental alcohol problems. Members of the assaultive trauma class had the strongest and most enduring risk for single and co-occurring lifetime MDD and panic attack. Assaultive trauma outweighed associations of familial effects and nonassaultive trauma with risk for 10 years following first trauma.",0,0 +7040,Patterns of violence against women: A latent class analysis.,"This study examined patterns of nine types of violence against women (VAW) and associated mental health problems. The following self-reported, lifetime violence victimization was examined among 1424 employed women: (1) childhood physical abuse, (2) childhood sexual abuse, (3) physical abuse between parents/guardians during childhood, (4) psychological intimate partner violence (IPV), (5) physical IPV, (6) sexual IPV, (7) adult physical or sexual assault by a non-intimate partner, (8) physical workplace violence, and (9) psychological workplace violence. Latent class analysis was used to identify homogenous patterns, called ""classes,"" of women's ""yes/no"" responses to experiencing these types of violence. The best model consisted of 4-classes characterized by the following probabilities: low violence (class 1: 63.1%), high psychological and physical IPV (class 2: 15.6%), high physical and psychological workplace violence (class 3: 12.4%), and moderate to high childhood abuse (class 4: 9.0%). When compared to class 1 (low violence), membership in classes 2 (IPV) and 4 (childhood abuse) was associated with screening positive for depression in the past week at baseline after controlling for the influence of demographic characteristics on class membership. Also, when compared to class 1 (low all), membership in class 2 (IPV) was associated with greater odds of screening positive for posttraumatic stress disorder in the past month at the six month follow-up assessment. Findings document distinct patterns of VAW and associated proximal and distal mental health outcomes. Implications for interventions aimed to improve employed women's health are discussed.",0,0 +7041,Psychogenic status epilepticus in children,"Epilepsy features, psychiatric profile, psychosocial factors, and outcome are described for six children (three males) aged 5-15 years (mean 12.1) with psychogenic status epilepticus (PSE), i.e., prolonged or repetitive psychogenic seizures (PSs), >30 minutes, simulating status epilepticus. They had epilepsy, they were on chronic anticonvulsants (ACVs), and some had other neurological deficits. All received intravenous and/or rectal ACVs prior to suspicion of PSE. PSE was confirmed via video/EEG, demonstrating no epileptogenic activity during alleged seizures. Provocation and placebo therapy techniques were used in two. Psychiatric assessment identified comorbid disorders such as depression, anxiety disorder, obsessive-compulsive disorder, obsessive-compulsive symptoms, and posttraumatic stress disorder. Psychosocial stressors were almost ubiquitous. Psychiatric intervention included psychotherapy, family therapy, and medical treatment in one patient. Outcome was monitored for an average of 3.6 years (3-5 years). PSE did not recur. PSs recurred in three. Psychiatric comorbidity improved in four, who accepted psychiatric intervention and whose epilepsy also improved. In conclusion, the occurrence of PSE in children and adolescents with epilepsy is stressed. Prompt diagnosis was often missed in the acute care setting, and this carries important implications for iatrogenic complications. PSE diagnosis resulted in identification and management of comorbid psychiatric disorders. This was probably important in reducing the predominating anxiety and affective disorders in most patients as well as PSE recurrence. Epilepsy severity and associated deficits were most likely important factors in determining outcome.",0,0 +7042,Posttraumatic Stress Disorder and Depression Following Trauma: Understanding Comorbidity,"Posttraumatic stress disorder (PTSD) and major depression occur frequently following traumatic exposure, both as separate disorders and concurrently. This raises the question of whether PTSD and depression are separate disorders in the aftermath of trauma or part of a single general traumatic stress construct. This study aimed to explore the relationships among PTSD, depression, and comorbid PTSD/depression following traumatic injury.A group of 363 injury survivors was assessed just prior to discharge from hospital and 3 and 12 months postinjury. Canonical correlations were used to examine the relationship between PTSD and depression symptom severity and a set of predictor variables. Multinomial logistic regression was used to identify whether the diagnostic categories of PTSD, depression, and comorbid PTSD/depression were associated with different groups of predictors.The majority of psychopathology in the aftermath of trauma was best conceptualized as a general traumatic stress factor, suggesting that when PTSD and depression occur together, they reflect a shared vulnerability with similar predictive variables. However, there was also evidence that in a minority of cases at 3 months, depression occurs independently from PTSD and was predicted by a different combination of variables.While PTSD and comorbid PTSD/depression are indistinguishable, the findings support the existence of depression as a separate construct in the acute, but not the chronic, aftermath of trauma.",0,0 +7043,Posttraumatic Stress Following Pediatric Injury,"After pediatric injury, transient traumatic stress reactions are common, and about 1 in 6 children and their parents develop persistent posttraumatic stress (PTS) symptoms that are linked to poorer physical and functional recovery. Meta-analytic studies identify risk factors for persistent PTS, including preinjury psychological problems, peritrauma fear and perceived life threat, and posttrauma factors such as low social support, maladaptive coping strategies, and parent PTS symptoms. There is growing prospective data indicating that children's subjective appraisals of the injury and its aftermath influence PTS development. Secondary prevention of injury-related PTS often involves parents and focuses on promoting adaptive child appraisals and coping strategies. Web-based psychoeducation and targeted brief early intervention for injured children and their parents have shown a modest effect, but additional research is needed to refine preventive approaches. There is a strong evidence base for effective psychological treatment of severe and persistent PTS via trauma-focused cognitive behavioral therapy; evidence is lacking for psychopharmacological treatment. Pediatric clinicians play a key role in preventing injury-related PTS by providing ""trauma-informed"" pediatric care (ie, recognizing preexisting trauma, addressing acute traumatic stress reactions associated with the injury event, minimizing potentially traumatic aspects of treatment, and identifying children who need additional monitoring or referral).",0,0 +7044,Posttraumatic Stress Disorder After Severe Traumatic Brain Injury,"This study indexed the profile of posttraumatic stress disorder (PTSD) after severe traumatic injury to the brain.Patients who sustained a severe traumatic brain injury (N=96) were assessed for PTSD 6 months after the injury with the PTSD Interview, a structured clinical interview based on DSM-III-R criteria.PTSD was diagnosed in 26 (27.1%) of the patients. While only 19.2% (N=5) of the patients with PTSD reported intrusive memories of the trauma, 96.2% (N=25) reported emotional reactivity. Intrusive memories, nightmares, and emotional reactivity had very strong positive predictive values for the presence of PTSD.These findings indicate that PTSD can develop after severe traumatic brain injury. The predominance of emotional reactivity and the relative absence of traumatic memories in patients with PTSD who suffered impaired consciousness during trauma suggest that traumatic experiences can mediate PTSD at an implicit level.",0,0 +7045,Cognitive and behavioural post-traumatic impairments: What is the specificity of a brain injury ? A study within the ESPARR cohort,"The variety and extent of impairments occurring after traumatic brain injury vary according to the nature and severity of the lesions. In order to better understand their interactions and long-term outcome, we have studied and compared the cognitive and neurobehavioral profile one year post onset of patients with and without traumatic brain injury in a cohort of motor vehicle accident victims.The study population is composed of 207 seriously injured persons from the ESPARR cohort. This cohort, which has been followed up in time, consists in 1168 motor vehicle accident victims (aged 16 years or more) with injuries with all degrees of severity. Inclusion criteria were: living in Rhone county, victim of a traffic accident having involved at least one wheel-conducted vehicle and having occurred in Rhone county, alive at the time of arrival in hospital and having presented in one of the different ER facilities of the county. The cohort's representativeness regarding social and geographic criteria and the specificities of the accidents were ensured by the specific targeting of recruitment. Deficits and impairments were assessed one year after the accident using the Neurobehavioral Rating Scale - Revised and the Trail-Making Test. Within our seriously injured group, based on the Glasgow Score, the presence of neurological deficits, aggravation of neurological condition in the first 72hours and/or abnormal cerebral imaging, we identified three categories: (i) moderate/severe traumatic brain injury (n=48), (ii) mild traumatic brain injury (n=89), and (iii) severely injured but without traumatic brain injury (n=70).The most frequently observed symptoms were anxiety, irritability, memory and attention impairments, depressive mood and emotional lability. While depressive mood and irritability were observed with similar frequency in all three groups, memory and attention impairments, anxiety and reduced initiative were more specific to traumatic brain injury whereas executive disorders were associated with moderate/severe traumatic brain injury.The presence and the initial severity of a traumatic brain injury condition the nature and frequency of residual effects after one year. Some impairments such as irritability, which is generally associated with traumatic brain injury, do not appear to be specific to this population, nor does depressive mood. Substantial interactions between cognitive, affective and neurobehavioral disorders have been highlighted.",0,0 +7046,"The Temporal Elements of Psychological Resilience: An Integrative Framework for the Study of Individuals, Families, and Communities","Psychological resilience has become a popular concept. Owing to that popularity, the word resilience has taken on myriad and often overlapping meanings. To be a useful framework for psychological research and theory, the authors argue, the study of resilience must explicitly reference each of four constituent temporal elements: (a) baseline or preadversity functioning, (b) the actual aversive circumstances, (c) postadversity resilient outcomes, and (d) predictors of resilient outcomes. Using this framework to review the existing literature, the most complete body of evidence is available on individual psychological resilience in children and adults. By contrast, the research on psychological resilience in families and communities is far more limited and lags well behind the rich theoretical perspective available from those literatures. The vast majority of research on resilience in families and communities has focused primarily on only one temporal element, possible predictors of resilient outcomes. Surpr...",0,0 +7047,A longitudinal follow-up of posttraumatic stress: from 9 months to 20 years after a major road traffic accident,"Although road traffic accidents (RTA) are a major cause of injury and a cause of posttraumatic stress (PTS) in the aftermath, little is known about the long-term psychological effects of RTA.This prospective longitudinal study assessed long-term PTS, grief, and general mental health after a bus carrying 23 sixth-grade schoolchildren crashed on a school outing and 12 children died. Directly affected (i.e., children in the crash) and indirectly affected children (i.e., all pupils in the sixth grade who were not in the crash) were surveyed at 9 months (N = 102), 4 years (N = 51), and 20 years (N = 40) after the event. Psychological distress was assessed by single items, including sadness, avoidance, intrusions, and guilt. After 20 years, PTS was assessed by the Impact of Event Scale-Revised.Stress reactions were prevalent 9 months after the event, with sadness (69%) and avoidance (59%) being highly represented in both directly and indirectly affected groups, whereas, nightmares (60%) and feelings of guilt (50%) were only frequent in those directly affected. The frequency of sadness and avoidance decreased after 4 years in the indirectly exposed (ps < .05). After 20 years, the directly affected had a higher prevalence of PTS (p = .003), but not decreased general mental health (p = .14), than those indirectly affected.The limitations preclude assertive conclusions. Nonetheless, the findings corroborate previous studies reporting traumatic events are associated with long-term PTS, but not with decreased general mental health.",0,0 +7048,"Single prolonged stress decreases glutamate, glutamine, and creatine concentrations in the rat medial prefrontal cortex","Application of single prolonged stress (SPS) in rats induces changes in neuroendocrine function and arousal that are characteristic of post traumatic stress disorder (PTSD). PTSD, in humans, is associated with decreased neural activity in the prefrontal cortex, increased neural activity in the amygdala complex, and reduced neuronal integrity in the hippocampus. However, the extent to which SPS models these aspects of PTSD has not been established. In order to address this, we used high-resolution magic angle spinning proton magnetic resonance spectroscopy (HR-MAS (1)H MRS) ex vivo to assay levels of neurochemicals critical for energy metabolism (creatine and lactate), excitatory (glutamate and glutamine) and inhibitory (gamma amino butyric acid (GABA)) neurotransmission, and neuronal integrity (N-acetylaspartate (NAA)) in the medial prefrontal cortex (mPFC), amygdala complex, and hippocampus of SPS and control rats. Glutamate, glutamine, and creatine levels were decreased in the mPFC of SPS rats when compared to controls, which suggests decreased excitatory tone in this region. SPS did not alter the neurochemical profiles of either the hippocampus or amygdala. These data suggest that SPS selectively attenuates excitatory tone, without a disruption of neuronal integrity, in the mPFC.",0,0 +7049,PATH: a program to build resilience and thriving in undergraduates,"We developed and tested a brief three-session program to build resilience (protection from depressive symptoms) and thriving (positive growth) in undergraduates by teaching adaptive explanatory styles. In Study 1, a pretest–posttest waiting list control experiment with 28 undergraduates found that our Program for Accelerated Thriving and Health (PATH) significantly increased optimistic and personal control explanatory styles (Attributional Style Questionnaire), resilience (Beck Depression Inventory-II), and thriving (Connor–Davidson Resilience Scale 10). In Study 2, a placebo control experiment with 63 undergraduates found a modified version of the program to significantly increase resilience. All effects were at least moderate in size. As predicted, a personal control explanatory style significantly predicted thriving in both studies. Predictors of resilience and thriving were discussed in terms of differentiating the constructs.",0,0 +7050,Paroxetine in the treatment of post-traumatic stress disorder: pooled analysis of placebo-controlled studies,"Post-traumatic stress disorder (PTSD) is increasingly understood to be a medical disorder characterised by particular psychobiological dysfunctions that respond to specific treatments. Paroxetine is a selective serotonin re-uptake inhibitor that has been found effective in the treatment of major depression as well as a range of anxiety disorders. This paper reviews data on the use of paroxetine for the treatment of adult PTSD. There have been three 12-week, placebo-controlled studies of paroxetine in PTSD. As these followed a partly similar design, a pooled analysis of the studies is possible and is reported here. Paroxetine is effective in the short-term treatment of PTSD, resulting in significantly better response and remission rates than placebo, improving sleep disturbance and reducing each of the symptom clusters of PTSD, as well as the disability associated with this condition. The medication is effective in both male and female PTSD patients and whether or not there are comorbid disorders such as depression.",0,0 +7051,The Missing Link in Resilience Research,"Bonanno, Romero and Klein (this issue) review many aspects of individual, family and community resilience studies, highlighting the fact that resilience is a multi-dimensional, complex construct wh...",0,0 +7052,Risk factors of severity of post-traumatic stress disorder among survivors with physical disabilities one year after the Wenchuan earthquake,"On May 12, 2008, a devastating earthquake measuring 8.0 on the Richter scale struck Wenchuan County and surrounding areas in China. This study aimed to assess post-traumatic stress disorder (PTSD) in the aftermath of the earthquake, and to evaluate factors of severity of PTSD symptoms among survivors with physical disabilities. We conducted a population-based cross-sectional survey and recruited 817 survivors with physical disabilities in three stricken areas. Assessment measures included the PTSD Checklist-Civilian Version (PCL-C) and the 12-item General Health Questionnaire (GHQ-12). Our study showed that 27.42% of the survivors with physical disabilities had PTSD symptoms one year after the Wenchuan earthquake. In the regression model, geographic location, female, suffering from paralysis following the earthquake, and going into a coma in the earthquake were associated with severe PTSD symptoms. Our findings suggest that a substantial proportion of physically disabled survivors of a big earthquake may have severe PTSD symptoms. The associated factors of PTSD identified in our study could inform the implementation of preventive programs for this population and give hint on the way to cope with this kind of disaster in the future.",0,0 +7053,"Clinical epidemiology in patients admitted at Mathari Psychiatric Hospital, Nairobi, Kenya","Background: Knowledge of types and co-morbidities of disorders seen in any facility is useful for clinical practice and planning for services. Aim: To study the pattern of co-morbidities of and correlations betweenpsychiatric disorders in in-patients of Mathari Hospital, the premier psychiatric hospital in Kenya. Study Design: Cross-sectional. Methods: All the patients who were admitted at Mathari Hospital in June 2004 and were well enough to participate in the study were approached for informed consent. Trained psychiatric charge nurses interviewed them using the Structured Clinical Interview for DSM-IV Axis I disorders Clinical Version (SCID-I). Information on their socio-demographic profiles and hospital diagnoses was extracted from their clinical notes using a structured format. Results: Six hundred and ninety-one patients participated in the study. Sixty-three percent were male. More than three quarters (78%) of the patients were aged between 21 and 45 years. More than half (59.5%) of the males and slightly less than half (49.4%) of the females were single. All the patients were predominantly of the Christian faith. Over 85% were dependants of another family member and the remainder were heads of households who supported their own families. Schizophrenia, bipolar I disorder, psychosis, substance use disorder and schizo-affective disorder were the most common hospital and differential diagnoses. Of the anxiety disorders, only three patients were under treatment for post-traumatic stress disorder (PTSD). Nearly a quarter (24.6%) of the patients were currently admitted for a similar previous diagnosis. Schizophrenia was the most frequent DSM-IV (Diagnostic and Statistical Manual of Mental Disorders' fourth edition) diagnosis (51%), followed by bipolar I disorder (42.3%), substance use disorder (34.4%) and major depressive illness (24.6%). Suicidal features were common in the depressive group, with 14.7% of this group reporting a suicidal attempt. All DSM-IV anxiety disorders, including obsessive-compulsive disorders, were highly prevalent although, with the exception of three cases of PTSD, none of these anxiety disorders were diagnosed clinically. Traumatic events were reported in 33.3% of the patients. These were multiple and mainly violent events. Despite the multiplicity of these events, only 7.4% of the patients had a PTSD diagnosis in a previous admission while 4% were currently diagnosed with PTSD. The number of DSM-IV diagnoses was more than the total number of patients, suggesting co-morbidity, which was confirmed by significant 2-tailed correlation tests. Conclusion: DSM-IV substance use disorders, major psychiatric disorders and anxiety disorders were prevalent and co-morbid. However, anxiety disorders were hardly diagnosed and therefore not managed. Suicidal symptoms were common. These results call for more inclusive clinical diagnostic practice. Standardized clinical practice using a diagnostic tool on routine basis will go a long way in ensuring that no DSM-IV diagnosis is missed. This will improve clinical management of patients and documentation. © Springer-Verlag 2008.",0,0 +7054,Linguistic Predictors of Post-Traumatic Stress Disorder Symptoms Following 11 September 2001,"Summary Prior research has linked content analysis drawn from text narratives to psychopathology in trauma survivors. This study used a longitudinal design to determine whether linguistic elements of narrative memories of first hearing about the events of 11 September 2001 predict later post-traumatic stress disorder (PTSD). Narratives and self-report PTSD symptoms were collected within 1 week and again 5 months after 9/11 in 40 undergraduates. People who used more “we” words at Time 1 had fewer acute PTSD symptoms. Use of more cognitive mechanism words, more religion words, more first-person singular pronouns, and fewer anxiety words at Time 1 were related to more chronic PTSD symptoms. Linguistic characteristics accounted for variance in chronic PTSD symptoms above and beyond acute PTSD symptoms. This study provides evidence that lasting PTSD symptoms can be predicted through language in the immediate aftermath of the trauma. Copyright © 2011 John Wiley & Sons, Ltd.",0,0 +7055,"Political violence, social integration, and youth functioning: Palestinian youth from the Intifada","Informed by social ecological, social capital, and social disorganization theories, this study tested an ecological model of youth experience in the Palestinian Intifada. The sample included 6,000 Palestinian 14 year olds, assessed in 1994 and 1995 after the end of the conflict. Data from retrospective self-reports of youth exposure to and involvement in political violence, and self-reports of current individual functioning (depression and antisocial behavior) and integration in several social contexts (family, peer relations, religion, education, and community), revealed: direct associations between Intifada experience and antisocial behavior and depression (females only); Intifada experience was positively associated with religiosity and unrelated to social integration in family, school, and peer relations; in some cases, social integration in family, education, religion, and peer relations significantly moderated the associations between Intifada experience and youth problems; integration in the several social contexts was directly related in predictable ways to youth problem behaviors, with neighborhood disorganization the most consistent and powerful predictor. The discussion centers around youth resilience to the effects of political violence, the role of psychological meaning children and adolescents can attach to political violence, and the overall salience of social integration in youth development. © 2001 John Wiley & Sons, Inc.",0,0 +7056,The temporal relationship between posttraumatic stress disorder and problem alcohol use following traumatic injury.,"Chronic alcohol abuse is a major public health concern following trauma exposure; however, little is known about the temporal association between posttraumatic stress disorder (PTSD) symptoms and problem alcohol use. The current study examined the temporal relationship between PTSD symptom clusters (re-experiencing, effortful avoidance, emotional numbing, and hyperarousal) and problem alcohol use following trauma exposure. This study was a longitudinal survey of randomly selected traumatic injury patients interviewed at baseline, 3 months, 12 months, and 24 months following injury. Participants were 1,139 injury patients recruited upon admission from 4 Level 1 trauma centers across Australia. Participants were assessed using the Clinician Administered PTSD Scale and Alcohol Use Disorders Identification Test. Results indicated that high levels of re-experiencing, effortful avoidance, and hyperarousal symptoms at 12 months were associated with greater increases (or smaller decreases) in problem alcohol use between 12 and 24 months. Findings also suggested that high levels of problem alcohol use at 12 months were associated with greater increases (or smaller decreases) in emotional numbing symptoms between 12 and 24 months. These findings highlight the critical importance of the chronic period following trauma exposure in the relationship between PTSD symptoms and problem alcohol use.",0,0 +7057,Mental health of workers and volunteers responding to events of 9/11: Review of the literature,"Background: Disaster workers responding to the events of September 11th were exposed to traumatic events. No study has systematically investigated the diverse mental health status and needs of the heterogeneous population of disaster workers responding to the events of September 11th. Methods: Using PubMed and Medline and the search terms of “September 11, 2001” or “September 11” or “9/11”or “WTC” or “World Trade Center”, the authors reviewed all articles that examined the mental health outcomes of workers at one of the three September 11th crash sites or the Fresh Kills landfill in New York City. Results: In total, 25 articles met study inclusion criteria, often using different methodologies. The articles described varying degrees of mental health symptomatology, risk factors for adverse mental health outcomes, and utilization of mental health services. Conclusions: The mental health needs of workers exposed to the events of September 11th ranged from little to no care to pharmacotherapy. A range of risk factors, including exposures at the WTC site and occupational activities, impacted on these needs but the role of specific mental health interventions was less clear. These findings suggest the need for a future program for disaster workers consisting of an accessible mental health treatment service supported by comprehensive postdisaster surveillance and emphasis on pre-disaster mental wellness. A number of areas for further consideration and study were identified, including the need for a more diverse exploration of involved responder populations as well as investigation of potential mental health outcomes beyond post-traumatic stress disorder (PTSD). Mt Sinai J Med 75:115–127, 2008 © 2008 Mount Sinai School of Medicine",0,0 +7058,An epidemiologic approach to the development of early trauma focused intervention,"Early, trauma-focused intervention development has emphasized unidirectional trajectories that begin with basic research and efficacy trials followed later by effectiveness and dissemination studies. In this article, the authors present methods derived from social and clinical epidemiology that constitute foundational research in the development of early trauma-focused intervention. They also describe how population-based practice research may serve to feed back and inform what has been conceptualized as earlier stages of intervention development such as efficacy trials. Examples of relevant epidemiologic research methods are presented to illustrate these points. The authors posit that the continued application of population-based methods may produce treatments that can be feasibly applied to the unique patient, provider, organizational, and community contexts relevant to early interventions for survivors of trauma.",0,0 +7059,Altered lipid peroxidation markers are related to post-traumatic stress disorder (PTSD) and not trauma itself in earthquake survivors,"The traumatic life events, including earthquakes, war, and interpersonal conflicts, cause a cascade of psychological and biological changes known as post-traumatic stress disorder (PTSD). Malondialdehyde (MDA) is a reliable marker of lipid peroxidation, and paraoxonase is a known antioxidant enzyme. The aims of this study were to investigate the relationship between earthquake trauma, PTSD effects on oxidative stress and the levels of serum paraoxonase 1 (PON1) enzyme activity, and levels of serum MDA. The study was carried out on three groups called: the PTSD group, the traumatized with earthquake exercise group, and healthy control group, which contained 32, 31, and 38 individuals, respectively. Serum MDA levels and PON1 enzyme activities from all participants were measured, and the results were compared across all groups. There were no significant differences between the PTSD patients and non-PTSD earthquake survivors in terms of the study variables. The mean PON1 enzyme activity from PTSD patients was significantly lower, while the mean MDA level was significantly higher than that of the healthy control group (p < 0.01 for both measurements). Similarly, earthquake survivors who did not develop PTSD showed higher MDA levels and lower PON1 activity when compared to healthy controls. However, the differences between these groups did not reach a statistically significant level. Increased MDA level and decreased PON1 activity measured in PTSD patients after earthquake and may suggest increased oxidative stress in these patients. The nonsignificant trends that are observed in lipid peroxidation markers of earthquake survivors may indicate higher impact of PTSD development on these markers than trauma itself. For example, PTSD diagnosis seems to add to the effect of trauma on serum MDA levels and PON1 enzyme activity. Thus, serum MDA levels and PON1 enzyme activity may serve as biochemical markers of PTSD diagnosis. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract)",0,0 +7060,Post-traumatic stress disorder: Issues of co-morbidity,"There is considerable controversy over whether or not post-traumatic stress disorder (PTSD) should be considered as a separate diagnostic entity. The present study utilized the Symptom Checklist-90 (SCL-90) in order to examine the degree of overlap between PTSD and the related diagnoses of anxiety, depression and obsession-compulsion in a group of Israeli Lebanon War PTSD casualties. We found that the SCL-90 was able both to identify and discriminate between the clinical groups. Multiple discriminant analysis showed that although there is overlap between PTSD and obsessive-compulsive disorder, PTSD is, in fact, discriminated from all the other patient groups.",0,0 +7061,"Psychophysiologic reactivity, subjective distress, and their associations with PTSD diagnosis.","Intense subjective distress and physiologic reactivity upon exposure to reminders of the traumatic event are each diagnostic features of posttraumatic stress disorder (PTSD). However, subjective reports and psychophysiological data often suggest different conclusions. For the present study, we combined data from five previous studies to assess the contributions of these two types of measures in predicting PTSD diagnosis. One hundred fifty trauma-exposed participants who were classified into PTSD or non-PTSD groups based on structured diagnostic interviews completed the same script-driven imagery procedure, which quantified measures of psychophysiologic reactivity and self-reported emotional responses. We derived four discriminant functions (DiscFxs) that each maximally separated the PTSD from the non-PTSD group using (1) psychophysiologic measures recorded during personal mental imagery of the traumatic event; (2) self-report ratings in response to the trauma imagery; (3) psychophysiologic measures recorded during personal mental imagery of another highly stressful experience unrelated to the index traumatic event; and (4) self-report ratings in response to this other stressor. When PTSD status was simultaneously regressed on all four DiscFxs, trauma-related psychophysiological reactivity was a significant predictor, but physiological reactivity resulting from the highly stressful, but not traumatic script, was not. Self-reported distress to the traumatic experience and the other stressful event were both predictive of PTSD diagnosis. Trauma-related psychophysiologic reactivity was the best predictor of PTSD diagnosis, but self-reported distress contributed additional variance. These results are discussed in relation to the Research Domain Criteria framework.",0,0 +7062,Alcohol Use Biomarkers Predicting Cognitive Performance: A Secondary Analysis in Veterans With Alcohol Dependence and Posttraumatic Stress Disorder,"We conducted a secondary analysis of baseline data from a recently completed pharmacological pilot clinical trial among 30 veterans with alcohol dependence and posttraumatic stress disorder (PTSD). This trial included baseline measures of alcohol use biomarkers, both indirect (carbohydrate-deficient transferrin, GGT [γ-glutamyltransferase], mean corpuscular volume, AST [aspartate aminotransferase], alanine aminotransferase) and direct (ethyl glucuronide, ethyl sulfate), as well as neurocognitive measures (Trail Making Test parts A and B, Hopkins Verbal Learning Test-Revised, Balloon Analogue Risk Task, Delay Discounting Task).Two regression models were estimated and tested for each neurocognitive measure (dependent measure). The first model included the alcohol use biomarker alone as the predictor. The second model included the alcohol use biomarker along with the following 3 additional predictors: Beck Depression Inventory, Clinician-Administered PTSD Scale, and receiving medications.In both models, the indirect biomarkers, such as GGT and AST, significantly predicted performance on the Hopkins Verbal Learning Test-Revised %Retention. GGT alone significantly predicted performance on the Trail Making Test part A.Indirect alcohol use biomarkers may have a specific role in identifying those veterans with alcohol dependence and PTSD who have impaired cognitive performance. However, direct alcohol use biomarkers may not share such a role.",0,0 +7063,Dimensions of Trauma and Specific Symptoms of Complex Posttraumatic Stress Disorder in Inner-City Youth: A Preliminary Study,"We examined relations of posttraumatic stress disorder (PTSD) symptoms with dimensions of trauma, including environment (Domestic vs. Community) and proximity (Indirect vs. Direct trauma) among inner-city youth. Participants (n = 65) reported traumatic events they had experienced on a version of the UCLA PTSD Reaction Index Trauma Exposure Screen, and reported PTSD symptoms with the PTSD Checklist--Civilian version (PCL-C). High rates of trauma and PTSD were found, consistent with other reports of inner-city youth. The 49% of youth surveyed met criteria for PTSD on the PCL-C symptom scale with a score cutoff of 35. Females reported elevated PTSD symptom scores and a higher incidence of Domestic trauma than did males but similar incidence of other trauma types. When males and females were combined, Domestic trauma significantly correlated with each of the PTSD symptom clusters of intrusions, numbing/avoidance, and hyperarousal. When participants with Community trauma were excluded from analyses to reduce confounding environmental influence, Domestic trauma marginally correlated with numbing/avoidance symptoms. Our findings suggest that Domestic trauma may result in more emotional numbing/avoidance symptoms than other types of trauma. Further analyses suggested that Community trauma may result in more intrusions and hyperarousal symptoms rather than emotional numbing. Environmental aspects of trauma, rather than the proximity of trauma, may have greater impact on presentation of PTSD. Future studies with larger samples are needed to confirm these findings.",0,0 +7064,Social relationships and PTSD symptomatology in combat veterans.,"The primary purpose of this study is to determine if recent combat veterans discriminate between different sources of social support, and then preliminarily investigate the relationship of social support source on posttraumatic stress disorder (PTSD) symptomatology. Participants included 83 married male combat veterans. Principal-axis factor analysis with equamax rotation observed four distinct latent factors for each source of support examined. ANOVAs were performed to determine the relationship of each source of support from the distinct latent factors on the level of PTSD. Results indicate that the level of PTSD is related to support received from a significant other, F(1, 81) 30.36, p .001, family, F(1, 81) 8.10, p .006, and military peers, F(1, 81) 6.70, p .011, but not friends, F(1, 81) 1.79, p .18. In general, higher levels of support from each category were associated with lower levels of PTSD in combat veterans. The results suggest that combat veterans distinguish between specific sources of social support, which may have a protective effect on the level of PTSD.",0,0 +7065,Regional differences in acute corticosterone-induced dendritic remodeling in the rat brain and their behavioral consequences,"Glucocorticoid released by stressful stimuli elicits various stress responses. Acute treatment with a single dose of corticosterone (CORT; predominant glucocorticoid of rats) alone has previously been shown to trigger anxiety behavior and robust dendritic hypertrophy of neurons in the basolateral amygdala (BLA). Neurons in the medial prefrontal cortex (mPFC) are also known to be highly sensitive to stress and regulate anxiety-like behaviors. Nevertheless, we know less about acute CORT-induced structural changes of other brain regions and their behavioral outcomes. In addition, the temporal profile of acute CORT effects remains to be examined. The current study investigates time course changes of dendritic architectures in the stress vulnerable brain areas, the BLA and mPFC, and their behavioral consequences after acute treatment with a single dose of CORT.Acute CORT treatment produced delayed onset of dendritic remodeling in the opposite direction in the BLA and mPFC with different time courses. Acute CORT induced dendritic hypertrophy of BLA spiny neurons, which was paralleled by heightened anxiety, both peaked 12 days after the treatment. Meanwhile, CORT-induced dendritic atrophy of mPFC pyramidal neurons peaked on day 6, concomitantly with impaired working memory. Both changed dendritic morphologies and altered behavioral outcomes were fully recovered.Our results suggest that stress-induced heightened anxiety appears to be a functional consequence of dendritic remodeling of BLA neurons but not that of mPFC. Instead, stress-induced dendritic atrophy of mPFC neurons is relevant to working memory deficit. Therefore, structural changes in the BLA and the mPFC might be specifically associated with distinct behavioral symptoms observed in stress-related mental disorders. Remarkably, stress-induced dendritic remodeling in the BLA as well as mPFC is readily reversible. The related behavioral outcomes also follow the similar time course in a reversible manner. Therefore, further studies on the cellular mechanism for the plasticity of dendrites architecture might provide new insight into the etiological factors for stress-related mental illness such as posttraumatic stress disorder (PTSD).",0,0 +7066,The Synthetic Evaluation Model for Analysis of Flooding Hazards,"Although many previous epidemiological studies have reported the incidence of diseases, mortality rate and economic losses after natural disasters, none of these studies has been comprehensive enough. Our aim was to establish a synthetic evaluation model (SEM) that can be used to analyze flood hazards.Initial evaluation indicators were selected using systematic and literature data analysis. These indicators were tested with single or multiple variable analyses. Final evaluation indicators and their weights were determined using the Delphi procedure. We established a SEM of flood hazards using the hierarchy method and tested the model using jack-knife analysis.The SEM on flood hazards consists of 6 first-rank indicators and 24 second-rank indicators. First-rank indicators were: direct casualties (w = 0.2123), the increased incidence and prevalence rate of the disease (w = 0.1715), excess mortality rate (w = 0.1745), mental injury (w = 0.1038), epidemic focus expansion (w = 0.1572) and economic loss (w = 0.1807). The agreement of the model reached 98.2% tested with the jack-knife analysis.A SEM of flood hazards was established with an agreement of 98.2%, which can be used to evaluate the hazards, and assist public health-care workers provide appropriate flood disaster management.",0,0 +7067,Post-deployment Multi-symptom Disorder rehabilitation: An integrated approach to rehabilitation,"Veterans and active duty service members returning from Operation New Dawn and those having returned from Operations Iraqi and Enduring Freedom frequently report the presence of overlapping, co-morbid symptom clusters consisting of chronic pain, mild cognitive complaints, and posttraumatic stress symptoms/disorder or mood disturbance. This presentation has been called Post-deployment Multi-symptom Disorder (PMD) and its implications not only impact various functional domains, but have also influenced a system/continuum of care to rise to meet the challenges of treating PMD. This continuum is based on innovation informed by evidence-based therapies, systemic limitations, and a focus on functional improvement rather than diagnostic classification.The purpose of this paper is to describe the symptomatic, functional and systemic challenges inherent to PMD conceptualization and treatment.The constituent clusters of PMD are defined and exemplified, its functional impact is illustrated, and a continuum of care at a large southeastern Veterans Affairs (VA) hospital offering an interdisciplinary approach to integrated rehabilitation is described. Three case examples are provided that that underscore the importance of vocation for improved behavioral health and quality of life.The case examples demonstrate how vocational rehabilitation services are an integral component of PMD treatment.}",0,0 +7068,Functional Impairment as a Variable in Adjustment Post-Combat,"This study examined how functional impairment relates to postcombat adjustment over time, controlling for the influence of combat exposure. Analyses used sequential random coefficient models to examine 2 hypotheses: a) combat exposure and functional impairment predict the change in posttraumatic stress, depression, and anger/aggression symptoms during the first year postcombat; and b) combat exposure and functional impairment at reintegration predict symptom scores at 1 year postdeployment. A Brigade Combat Team completed surveys at reintegration, 4 months, and 12 months after a 1-year deployment to Iraq. Soldiers reporting high functional impairment at reintegration had higher symptoms at both follow-up periods, and functional impairment was a significant predictor of symptoms at the last time point, even after accounting for the influence of combat exposure. There was also an interaction effect, such that functional impairment exacerbated the impact of combat exposure on posttraumatic stress and anger/a...",0,0 +7069,A Longitudinal and Retrospective Study of PTSD Among Older Prisoners of War,"The authors examined the longitudinal changes in posttraumatic stress disorder (PTSD) symptom levels and prevalence rates over a 4-year time period among American former prisoners of war (POWs) from World War II and the Korean War. Retrospective symptom reports by World War II POWs dating back to shortly after repatriation were examined for 1) additional evidence of changing PTSD symptom levels and 2) evidence of PTSD cases with a long-delayed onset.PTSD prevalence rates and symptom levels were measured by the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder. For the longitudinal portion of the study, participants were 177 community-dwelling World War II and Korean POWs. For the retrospective portion, participants were 244 community-dwelling World War II POWs.PTSD prevalence rates and symptom levels increased significantly over the 4-year measurement interval. Retrospective symptom reports indicated that symptoms were highest shortly after the war, declined for several decades, and increased within the past two decades. Long-delayed onset of PTSD symptoms was rare. Demographic and psychosocial variables were used to characterize participants whose symptoms increased over 4 years and differentiate participants who reported a long-delayed symptom onset.Both longitudinal and retrospective data support a PTSD symptom pattern of immediate onset and gradual decline, followed by increasing PTSD symptom levels among older survivors of remote trauma.",0,0 +7070,The “Cut-Off Behavioral Criteria” Method: Modeling Clinical Diagnostic Criteria in Animal Studies of PTSD,"Posttraumatic stress disorder (PTSD) is clinically defined by exposure to a significantly threatening and/or horrifying event and the presence of a certain number of symptoms from each of three symptom clusters at least one month after the event. The procedures involved in defining clinical diagnostic criteria for mental disorders are lengthy and quit stringent. The APA and WHO (responsible for the DSM and ICD, respectively) periodically review the diagnostic criteria, a process which engenders heated discussion in the literature, with the aim of refining and improving their clinical, epidemiological, and research validity.Animal behavioral studies, however, have generally tended to overlook this aspect and have commonly regarded the entire group of animals subjected to certain study conditions as homogeneous. The method to be described below was developed in an attempt to model diagnostic criteria in terms of individual patterns of response using behavioral measures and determining cut-off scores to distinguish between extremes of response or nonresponse, leaving a sizeable proportion of subjects in a middle group, outside each set of cut-off criteria. This chapter will discuss the concept of the model and its background, provide detailed protocols for each of its components, and present a selection of studies employing and examining the model, alongside the underlying translational rationale of each. © 2011 Springer Science+Business Media, LLC.",0,0 +7071,Substance abuse and post-traumatic stress disorder comorbidity,"This article reviews the extant literature on substance abusers with and without a comorbid diagnosis of post-traumatic stress disorder (PTSD) and reveals the discontinuity between clinical lore and empirical research. Included is an overview of PTSD-substance abuse theoretical models and comorbidity prevalence rates, as well as an evaluation of the comparative data on treatment outcome and psychosocial factors, such as coping skills, for PTSD versus non-PTSD substance abusers. In addition, we discuss the controversy surrounding sequential versus simultaneous treatment approaches for such 'dually-diagnosed' patients. We conclude by identifying gaps in current knowledge about the nature and impact of PTSD on substance abuse treatment outcome and outlining needs for future research.",0,0 +7072,The Link Between Post-traumatic Stress Disorder and Physical Comorbidities: A Systematic Review,"Context: Returning veterans from Afghanistan and Iraq will increase frequency of post-traumatic stress disorder (PTSD). Little is known about its impact on physical health. Objective: Systematic literature review focusing on the association between PTSD and specific physical disorders. Data Sources: An electronic search using PUBMED and hand search of four journals with an anxiety focus for studies published between January 1981 and July 2008, plus a manual search of article bibliographies. Study Selection: Original research reports focusing on PTSD and its association with physical health. Studies investigating only PTSD symptoms, trauma and physical disorders classified at the organ-system level were excluded. Eighty studies were reviewed and seven selected for final analysis. Data Extraction Specific physical-health diagnoses were organized by system and tabulated. They were considered positive only if results were statistically significant. Total number of positive and negative studies for each diagnosis was then calculated for review. Results: Seven studies examined the relationship between PTSD and specific physical disorders. Arthritis was associated with PTSD in most studies. Data conflicted regarding diabetes, coronary heart disease, and stroke. Conclusions: Few studies have examined the relationship between PTSD and physical health. Large, prospective epidemiological trials are needed. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)",0,0 +7073,A Prospective Study on the Association Between Caregiver Psychological Symptomatology and Symptom Clusters of Pediatric Posttraumatic Stress Disorder,"This study investigated the influence of caregiver psychological symptoms on posttraumatic stress disorder (PTSD) symptoms in traumatized children. One-hundred eleven children and caretakers were assessed in this study. Children (N = 59) with a history of exposure to interpersonal violence were evaluated for reexperiencing, avoidance/numbing, and hyperarousal symptom clusters using the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA). The 52 primary caregivers were evaluated using the Symptom Checklist-90-Revised (SCL-90-R) on 9 domains of psychological symptomatology: anxiety, depression, hostility, interpersonal sensitivity, obsessive-compulsive disorder, paranoid ideation, phobic anxiety, psychoticism, and somatization. At 14-month follow-up, 45 of the children were re-evaluated with the CAPS-CA. Caregiver psychological symptoms in the domains of anxiety, depression, interpersonal sensitivity, obsessive-compulsive disorder, and paranoid ideation were associated with less improvement in total pediatric PTSD symptoms. Analysis of PTSD symptoms by cluster showed that greater caregiver symptomatology in the domains of anxiety, depression, interpersonal sensitivity, and obsessive-compulsive disorder were associated with less improvement in the hyperarousal symptom cluster. These results suggest caregiver symptomatology may be specifically associated with hyperarousal symptoms in pediatric trauma.",0,0 +7074,Women Reentering the Community: Understanding Addiction and Trauma-Related Characteristics of Recidivism,"Women represent 26% of those arrested for serious crimes; many have posttraumatic stress and co-occurring substance use disorders, which may influence recidivism. This study examined 57 women residing in a community re-entry program after exiting prison. Participants completed the Trauma Symptom Inventory and Substance Abuse Subtle Screening Inventory. A discriminant function analysis accounted for 34% of between-group variability and provided a profile of women who recidivated. Women who recidivated had greater alcohol dependence and lower rates of sexual dysfunction and sexual concerns. Practitioners should consider potential links between substance abuse, trauma, and sexual behavior in treatment settings.",0,0 +7075,Serum triiodothyronine elevation in Israeli combat veterans with posttraumatic stress disorder: A cross-cultural study,"This study examines the thyroid hormonal profile in Israeli combat veterans with posttraumatic stress disorder (PTSD) and compares it with the previously reported profile in American Vietnam combat veterans with PTSD. Eleven male combat veterans with PTSD were compared with 11 normal subjects. Thyroid junction was evaluated by the measurement of serum total triiodothyronine (TT3), free triiodothyronine (FT3), total thyroxine (TT4), free thyroxine (FT4), thyroxine-binding globulin (TBG), and thyroid-stimulating hormone (TSH). The mean total T3 level in the Israeli PTSD patients (160.5 ng/dL) was significantly elevated (t = 2.53, p < .02) above that of the comparison group (135.5 ng/dL). Total T3 mean levels were not significantly different between the Israeli PTSD group and two American PTSD groups, but all three PTSD groups had significantly higher total T3 levels than both Israeli and American comparison groups. This preliminary study indicates that T3 elevation in combat-related PTSD may extend across cultures and suggests that further comparison of Israeli and American PTSD and normal groups may be useful in evaluating the significance and implications of the unusual alterations in the thyroid system in PTSD.",0,0 +7076,A cognitive model of posttraumatic stress disorder,"Posttraumatic stress disorder (PTSD) is a common reaction to traumatic events. Many people recover in the ensuing months, but in a significant subgroup the symptoms persist, often for years. A cognitive model of persistence of PTSD is proposed. It is suggested that PTSD becomes persistent when individuals process the trauma in a way that leads to a sense of serious, current threat. The sense of threat arises as a consequence of: (1) excessively negative appraisals of the trauma and/or its sequelae and (2) a disturbance of autobiographical memory characterised by poor elaboration and contextualization, strong associative memory and strong perceptual priming. Change in the negative appraisals and the trauma memory are prevented by a series of problematic behavioural and cognitive strategies. The model is consistent with the main clinical features of PTSD, helps explain several apparently puzzling phenomena and provides a framework for treatment by identifying three key targets for change. Recent studies have provided preliminary support for several aspects of the model.",0,0 +7077,Post-traumatic stress disorder symptoms form a traumatic and non-traumatic stress response dimension,"Objective: This study aims to determine whether symptoms of post-traumatic stress disorder (PTSD) form a latent dimension reflecting responsivity to life events and whether PTSD symptoms are specific to traumatic life events. Method: A 30-year longitudinal study of a general population sample of 987 individuals were assessed for PTSD symptoms, exposure to adverse life events, and a variety of psychosocial measures. PTSD symptoms were tested using a confirmatory factor model and a range of fitted models were used to identify significant predictors of latent PTSD symptoms. Results: The rate of DSM IV PTSD was 1.9%. However, subjects reported high rates of at least one significant traumatic or negative life event and PTSD symptoms. The PTSD symptoms conformed well to a single latent factor. There were strong linear associations between severity of PTSD symptoms and exposure to traumatic and non-traumatic life events. Factors contributing to latent PTSD symptoms were gender, childhood anxiety, neuroticism, self-esteem, and quality of parental care. Conclusion: Criteria for PTSD form an underlying dimension reflecting the individual’s level of responsivity to traumatic and non-traumatic stressful life events. PTSD symptoms form a continuum of severity with minor stress symptoms at one end and severe PTSD at the other.",0,0 +7078,Time does not heal all wounds: Quality of life and psychological distress of people who survived the Holocaust as children 55 years later,"The present study assessed posttraumatic stress disorder (PTSD) symptoms, psychological distress, and subjective quality of life (QoL) in a group of 43 child Holocaust survivors and a community sample of 44 persons who had not personally experienced the Holocaust. The participants were administered the PTSD-Scale, the SCL-90, and the WHOQOL-Bref. Results showed that the child survivors had higher PTSD symptom scores, higher depression, anxiety, somatization, and anger-hostility scores; and lower physical, psychological, and social QoL than did the comparison group. The findings suggest that the psychological consequences of being a child during the Holocaust can be long lasting.",0,0 +7079,In Search of an Effective Treatment for Combat-Related Post-Traumatic Stress Disorder (PTSD): Can the Stellate Ganglion Block Be the Answer?,"Notes that post-traumatic stress disorder (PTSD) is a common and intractable condition associated with severe stress and trauma. PTSD has been difficult to treat with conventional methods. A glimmer of hope for this condition may be found in the use of stellate ganglion block (SGB), a technique traditionally used for the treatment of chronic pain-anesthetic blockade of a sympathetic ganglion administered at C7. In this edition of Pain Practice, S. W. Mulvaney et al. (see record 2010-14345-013) describe a significant resolution of PTSD symptoms using SGB in a pilot study of Operation Iraqi Freedom veterans, leading to a subsequent complete weaning of the patients off their psychiatric drugs. (PsycINFO Database Record (c) 2012 APA, all rights reserved)",0,0 +7080,Frequency of trauma exposure and Post-Traumatic Stress Disorder in Italy: analysis from the World Mental Health Survey Initiative,"Epidemiological studies have examined the relative importance of Traumatic Events (TEs) in accounting for the societal burden of post-traumatic stress disorder (PTSD). However, most studies used the worst trauma experienced, which can lead to an overestimation of the conditional risk of PTSD. Although a number of epidemiological surveys on PTSD have been carried out in the United States, only a few studies in limited sample have been conducted in Italy. This study, carried out in the framework of the World Mental Health Survey Initiative, is a cross-sectional household survey of a representative sample of the Italian adult population. Lifetime prevalence of TEs and 12-month prevalence of PTSD were evaluated using the Composite International Diagnostic Interview (CIDI). Reports of PTSD associated with randomly selected TEs were weighted by the individual-level probabilities of TE selection to generate estimates of population-level PTSD risk associated with each TE. Network events was the most commonly reported class of TEs (29.4%). War events had the highest conditional risk of PTSD (12.2%). The TEs that contributed most to societal PTSD burden were unexpected death of a loved one (24.1%) and having seen atrocities (18.2%). Being female was related to high risk of PTSD after experiencing a TE. Exposure to network events is commonly reported among Italian adults, but two TEs are responsible for the highest burden associated with PTSD: the unexpected death of someone close and sexual assault. These results can help designing public health interventions to reduce the societal PTSD burden. • Prevalence of exposure to at least one lifetime traumatic event was 56.1%. • The TE contributing most to PTSD burden was unexpected death of a loved one. • Being female was related to high risk of PTSD after experiencing a TE.",0,0 +7081,"The Roles of Love, Attachment, and Altruism in the Adjustment to Military Trauma","Abstract This chapter summarizes research on the associations among love in the form of a secure adult attachment, posttraumatic stress disorder (PTSD), and altruism. The chapter is organized into five sections. The first section briefly reviews PTSD and its symptom clusters. The second section provides an overview of attachment theory and explores evidence that early childhood attachment patterns endure as adult attachment styles. The third section efforts to link attachment theory to the concept of adult love. The fourth section explores the relationship between attachment styles and the development of PTSD in those exposed to trauma, suggesting that love and secure attachment may protect against PTSD or ameliorate its course. The final section introduces altruistic intent into the adult attachment equation and examines the relationships among altruism, loving attachments, and PTSD.",0,0 +7082,Psychiatric disorders in patients with psychogenic nonepileptic seizures and drug-resistant epilepsy: A study of an Argentine population,"Epidemiological data show that up to 20-30% of patients with psychogenic nonepileptic seizures (PNESs), resembling drug-resistant epilepsy (DRE), are referred to tertiary epilepsy centers. Furthermore, both disorders present high psychiatric comorbidity, and video-EEG is the gold standard to make differential diagnoses. In this study, we described and compared the clinical presentation and the frequency of psychiatric disorders codified in DSM IV in two groups of patients, one with PNESs and the other with DRE, admitted in a tertiary care epilepsy center of Buenos Aires, Argentina. We included 35 patients with PNESs and 49 with DRE; all were admitted in the video-EEG unit in order to confirm an epilepsy diagnosis and determine surgical treatment possibilities. All patients underwent a neurological and psychiatric assessment, according to standardized protocol (SCID I and II; DSM IV criteria). Student's t test was performed to compare continuous variables and Chi square test to compare qualitative variables. In this study, 33 (67%) patients with DRE and 35 (100%) patients with PNESs met criteria for at least one disorder codified in Axis I of DSM IV (p=0.003). Differences in the frequency of psychiatric disorder presentation were found between groups. Anxiety disorders (16.32% vs 40%; p=0.015), trauma history (24.5% vs 48.57%; p=0.02), posttraumatic stress disorder (4.08% vs 22.85%; p=0.009), and personality cluster B disorders (18.37% vs 42.86%; p=0.02) were more frequent in the group with PNESs. Psychotic disorders were more frequent in the group with DRE (20.4% vs 2.85%; p=0.019). Depression was equally prevalent in both groups. Standardized psychiatric assessment provides information that could be used by the mental health professional who receives the referral in order to improve quality of care and smooth transitions to proper PNES treatment, which should include a multidisciplinary approach including neurology and psychiatry.",0,0 +7083,Dissociation and posttraumatic stress disorder in Vietnam combat veterans,"This study compared current dissociative symptoms and dissociation at the time of specific traumatic events in Vietnam combat veterans with posttraumatic stress disorder (PTSD) and Vietnam combat veterans without PTSD.Vietnam combat veterans who sought treatment for PTSD (N = 53) were compared to Vietnam combat veterans without PTSD (N = 32) who sought treatment for medical problems. Dissociative symptoms were evaluated with the Dissociative Experiences Scale. Dissociation at the time of a combat-related traumatic event was evaluated retrospectively with the modified Dissociative Experiences Questionnaire. The Combat Exposure Scale was used to measure level of combat exposure.There was a significantly higher level of dissociative symptoms, as measured by the Dissociative Experiences Scale, in patients with PTSD (mean = 27.0, SD = 18.0) than in patients without PTSD (mean = 13.7, SD = 16.0). This difference persisted when the difference in level of combat exposure was controlled with analysis of covariance. PTSD patients also reported more dissociative symptoms at the time of combat trauma, as measured retrospectively by the Dissociative Experiences Questionnaire (mean = 11.5, SD = 1.6) than non-PTSD patients (mean = 1.8, SD = 2.1).Dissociative symptoms are an important element of the long-term psychopathological response to trauma.",0,0 +7084,PTSD and Associated Mental Health Consequences of Motor Vehicle Collisions,"The frequency with which motor vehicle collisions (MVCs) occur makes them one of the greatest causes of posttraumatic psychopathology. While the physical injury associated with severe MVC is the focus of highly sophisticated hospital care services, the psychological injury that often accompanies surviving severe MVC is mostly overlooked. This chapter establishes the prevalence of posttraumatic stress disorder (PTSD) and other forms of psychopathology that occur following MVCs, outlining the course of MVC-related traumatic stress symptoms, and describing the impact of traumatic stress symptoms on the quality of life and functional status of traumatized individuals. For an MVC to be considered potentially traumatic, it must involve actual or threatened injury. This point is important in interpreting the literature because the majority of studies that have examined the prevalence of psychopathology following MVC have used injury survivors. The pretrauma, peritrauma, and posttrauma factors that are considered most predictive of posttrauma psychopathology are also reviewed.",0,0 +7085,The Minnesota Multiphasic Personality Inventory–2 Restructured Form in National Guard soldiers screening positive for posttraumatic stress disorder and mild traumatic brain injury.,"The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2 RF) was administered to 251 National Guard soldiers who had recently returned from deployment to Iraq. Soldiers were also administered questionnaires to identify posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). On the basis of responses to the screening instruments, the National Guard soldiers who produced a valid MMPI-2 RF were classified into four groups: 21 soldiers who screened positive for PTSD only, 33 soldiers who screened positive for mTBI only, 9 soldiers who screened positive for both conditions, and 166 soldiers who did not screen positive for either condition. Results showed that the MMPI-2 RF was able to differentiate across the groups with the MMPI-2 RF specific problem scale Anxiety adding incrementally to MMPI-2 Restructured Clinical scales in predicting PTSD. Both MMPI-2 RC1 (Somatic Complaints) and MMPI-2 RF head pain complaints predicted mTBI screen but did not add incrementally to each other. Of note, all of the MMPI-2 RF validity scales associated with overreporting, including Symptom Validity-Revised (FBS-r), were not significantly elevated in the mTBI group. These findings support the use of the MMPI-2 RF in assessing PTSD in non-treatment-seeking veterans. This further suggests that a positive screen for mTBI alone is not associated with significant emotional disturbance.",0,0 +7086,Emotion regulation profiles in psychogenic non-epileptic seizures,"

Abstract

Background

Psychogenic non-epileptic seizures (PNES) are frequently encountered in epilepsy referral centers, yet there is limited understanding of the emotion processing style in this psychiatrically heterogeneous population. Understanding profiles of emotion regulation in PNES will provide further evidence of the psychogenic nature of the disorder and will potentially inform psychotherapeutic interventions.

Methods

Fifty-five patients with PNES underwent a neuropsychiatric evaluation and completed self-report questionnaires that measured difficulties in emotion regulation, psychopathology severity and quality of life.

Results

Through the use of cluster analysis, two groups were identified; Cluster 1 represented a highly emotion dysregulated group while Cluster 2 represented a low emotion dysregulated group. Additional analyses revealed that each group significantly differed from normative data. Finally, Cluster 1 was significantly associated with several measures of psychiatric symptoms, higher rates of comorbid psychiatric diagnoses and impairment in quality of life.

Conclusions

These findings suggest that patients with PNES may be subject to high levels of emotion dysregulation, severe psychiatric symptomatology and impaired quality of life, or to low emotion dysregulation characterized by emotional unawareness or avoidance. These profiles clearly differ from normative data regarding emotion regulation and their identification may help tailor psychotherapeutic interventions.",0,0 +7087,Posttraumatic stress disorder after childbirth: Analysis of symptom presentation and sampling,"There is converging evidence that approximately 2% of women fulfill PTSD criteria following childbirth. This study examined the presentation and symptom structure of PTSD after birth and key risk factors in women from internet and community samples. PTSD was measured in 1423 women after birth recruited via the community ( n = 502) or internet ( n = 921). Demographic, obstetric, and trauma history variables were also measured. Full PTSD diagnostic criteria were endorsed by 2.5% of women from the community and 21% of women on the internet. Many more endorsed individual PTSD symptom criteria, suggesting this might be inflated by postnatal factors. Samples differed on demographic and obstetric characteristics. Factor analysis found two PTSD symptom clusters of re-experiencing and avoidance (RA) and numbing and arousal (NA). PTSD cases were predicted by parity, delivery type, NA and RA symptoms, and the interaction between sexual trauma and delivery type. This correctly identified 60% of PTSD cases. Questionnaire measurement of PTSD means prevalence rates may be over-estimated. Differences between samples suggest that internet samples over represent symptomatic women. Results emphasise the importance of measuring full diagnostic criteria in postnatal samples, as reports of symptoms may be inflated. In addition a few risk factors are identified that could be used to screen for women at risk.",0,0 +7088,Children’s Postdisaster Trajectories of PTS Symptoms: Predicting Chronic Distress,"There are no studies of the distinct trajectories of children's psychological distress over the first year after a destructive natural disaster and the determinants of these trajectories.We examined these issues using an existing dataset of children exposed to Hurricane Andrew, one of the most devastating natural disasters in US history.At 3-months postdisaster, 568 children (55 % girls; grades 3-5) residing in areas most directly affected by the hurricane completed measures of hurricane exposure and stressors, social support, coping, and general anxiety. Children also reported major life events occurring since the hurricane (at 7-months) and posttraumatic stress (PTS) symptoms at 3-, 7-, and 10-months postdisaster.Latent growth mixture modeling identified three trajectories of PTS reactions: resilient (37 %), recovering (43 %), and chronic distress (20 %). Predictors of the trajectories were examined. Odds ratios indicated that, compared to the resilient trajectory, girls were more likely to be in the recovering and chronically distressed trajectories, as were children reporting higher anxiety and greater use of coping strategies that reflected poor emotion regulation. Compared to the recovering trajectory, children in the chronically distressed trajectory had greater odds of reporting high anxiety, less social support, more intervening life events, and greater use of poor emotion regulation strategies.Hurricane exposure may be less effective in identifying children who develop chronic postdisaster distress than other child (anxiety, coping) and contextual variables (social support, life events). Effective screening after disasters is critical for identifying youth most in need of limited clinical resources.",1,0 +7089,Treatment of anxiety disorders with venlafaxine XR,"When venlafaxine was introduced in 1994, it was the first of the newer generation antidepressants to be classified as a serotonin norepinephrine reuptake inhibitor (SNRI). An extended release (XR) formulation of venlafaxine, introduced in 1997, subsequently received regulatory approval for treatment of three anxiety disorders: generalized anxiety disorder, social anxiety disorder and panic disorder. Although less extensively studied, venlafaxine XR also appears to have efficacy for two other anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder. In contrast to the treatment of depression, for which meta-analyses suggest an efficacy advantage relative to selective serotonin reuptake inhibitors (SSRIs), evidence of differential efficacy has not yet been established for any of the anxiety disorders. The overall tolerability profile of venlafaxine XR is generally comparable to that of the SSRIs, although there is greater incidence of noradrenergically mediated side effects (i.e., dry mouth and constipation), as well as a dose-dependent risk of treatment-emergent high blood pressure. Concerns about safety in overdose have also recently emerged. Despite these caveats, venlafaxine XR is an effective and generally well-tolerated option for treatment of anxiety disorders.",0,0 +7090,Disorder specificity despite comorbidity: Resting EEG alpha asymmetry in major depressive disorder and post-traumatic stress disorder,"The approach-withdrawal and valence-arousal models highlight that specific brain laterality profiles may distinguish depression and anxiety. However, studies remain to be conducted in multiple clinical populations that directly test the diagnostic specificity of these hypotheses. The current study compared electroencephalographic data under resting state, eyes closed conditions in patients with major depressive disorder (MDD) (N=15) and post-traumatic stress disorder (PTSD) (N=14) relative to healthy controls (N=15) to examine the specificity of brain laterality in these disorders. Key findings included (1) reduced left-frontal activity in MDD, (2) a positive correlation between PTSD severity and right-frontal lateralisation, (3) greater activity in PTSD patients relative to MDD within the right-parietotemporal region, and (4) globally increased alpha power in MDD. Findings partially support the diagnostic applicability of the theoretical frameworks. Future studies may benefit from examining task-driven differences between groups.",0,0 +7091,DIAGNOSIS OF POSTTRAUMATIC STRESS DISORDER AFTER SURGERY FOR PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT,"To investigate the prevalence of posttraumatic stress disorder (PTSD) in patients who underwent surgery for primary rhegmatogenous retinal detachment and to explore variables associated with the disorder.Subjects eligible for the study were patients aged 18 years or older, who underwent surgery for primary rhegmatogenous retinal detachment at the Goldschleger Eye Institute, from January 1, 2004, to December 31, 2009, and were followed for at least 1 month. Study patients were screened for the existence of PTSD symptoms via a telephone survey, and positively identified patients were asked to undergo a structured psychiatric interview. Posttraumatic stress disorder was assessed by the Clinician Administered PTSD Scale, and the 25-item National Eye Institute visual function questionnaire (NEI-VFQ-25) was used as a measure of vision-related quality of life. Objective clinical measures were obtained from the patient's medical records. Clinical variables were compared between PTSD-diagnosed patients, patients who were screened for PTSD but were found to be PTSD negative in the interview (false-positive group), and patients who were found negative for PTSD in the screening survey.Of the 547 eligible patients, 366 were enrolled in the study. Nine patients (2.5%) met the criteria for PTSD diagnosis. Posttraumatic stress disorder patients reported significantly more traumatic events in their past (P = 0.015), and for these patients, NEI-VFQ-25 composite score was significantly lower (P < 0.001). Clinical measures were not found as independent risk factors for PTSD prediction.Posttraumatic stress disorder may develop in the aftermath of primary rhegmatogenous retinal detachment. Previous traumatic events and NEI-VFQ-25 scores were found as independent risk factors for PTSD prediction.",0,0 +7092,"Performance, egg quality, and immune response of laying hens fed diets supplemented with mannan-oligosaccharide or an essential oil mixture under moderate and hot environmental conditions","In total, 432 thirty-six-week-old laying hens were fed a basal diet supplemented with mannan-oligosaccharide (MOS) or an essential oil mixture (EOM) from 36 to 51 wk of age. Hens were divided into 3 equal groups replicated 6 times with 24 hens per replicate. No significant difference was observed among the dietary treatments in terms of performance indices. Different from the dietary manipulation, high environmental temperatures negatively influenced all of the laying performance traits except the feed conversion ratio in association with the diminished feed consumption. The MOS, and particularly the EOM, tended to alleviate the deleterious effect of heat stress on BW gain. Mortality was higher in MOS-fed hens than with other treatments. A supplementation diet with MOS or EOM provided increments in eggshell weight (P < 0.01). Relative albumen weight was significantly decreased (P < 0.05) in response to EOM or MOS supplementation; however, this was not the case in the yolk weight rate. The MOS decreased albumen height and Haugh unit (P < 0.05). High environmental temperatures hampered entire egg quality characteristics except for the eggshell breaking strength and egg yolk weight. These results indicated that heat stress adversely affected both productive performance and egg quality. As for the results of this study, neither MOS nor EOM was efficacious in improving efficiency of egg production and stimulating humoral immune response in laying hens reared under moderate and hot climatic conditions. However, the ameliorative effect exerted by MOS and EOM on eggshell characteristics is conclusive.",0,0 +7093,Posttraumatic Stress Disorder in the National Comorbidity Survey,"Data were obtained on the general population epidemiology of DSM-III-R posttraumatic stress disorder (PTSD), including information on estimated life-time prevalence, the kinds of traumas most often associated with PTSD, sociodemographic correlates, the comorbidity of PTSD with other lifetime psychiatric disorders, and the duration of an index episode.Modified versions of the DSM-III-R PTSD module from the Diagnostic Interview Schedule and of the Composite International Diagnostic Interview were administered to a representative national sample of 5877 persons aged 15 to 54 years in the part II subsample of the National Comorbidity Survey.The estimated lifetime prevalence of PTSD is 7.8%. Prevalence is elevated among women and the previously married. The traumas most commonly associated with PTSD are combat exposure and witnessing among men and rape and sexual molestation among women. Posttraumatic stress disorder is strongly comorbid with other lifetime DSM-III-R disorders. Survival analysis shows that more than one third of people with an index episode of PTSD fail to recover even after many years.Posttraumatic stress disorder is more prevalent than previously believed, and is often persistent. Progress in estimating age-at-onset distributions, cohort effects, and the conditional probabilities of PTSD from different types of trauma will require future epidemiologic studies to assess PTSD for all lifetime traumas rather than for only a small number of retrospectively reported ""most serious"" traumas.",0,0 +7094,Alexithymia and PTSD symptoms in urban police officers: Cross-sectional and prospective findings,"The relationship of alexithymia to posttraumatic stress disorder (PTSD) symptomatology was examined cross-sectionally in 166 urban police officers surveyed between 1998 and 1999 and prospectively in 54 of these officers who participated in a follow-up survey after the September 11, 2001 (9/11) terrorist attacks. In cross-sectional analyses, alexithymia scores were positively associated with PTSD symptom levels and self-reported childhood emotional abuse--neglect, but not with cumulative level of critical incident exposure. Alexithymia scores accounted for 11.2% of the variance in PTSD symptoms prior to accounting for additional predictors, but did not retain significance in the final model. In prospective analyses, alexithymia scores significantly predicted 9/11-related PTSD symptom severity over and above pre-9/11 PTSD symptoms.",0,0 +7095,Brain cortical thickness in male adolescents with serious substance use and conduct problems,"Adolescents with substance use disorder (SUD) and conduct problems exhibit high levels of impulsivity and poor self-control. Limited work to date tests for brain cortical thickness differences in these youths.To investigate differences in cortical thickness between adolescents with substance use and conduct problems and controls.We recruited 25 male adolescents with SUD, and 19 male adolescent controls, and completed structural 3T magnetic resonance brain imaging. Using the surface-based morphometry software FreeSurfer, we completed region-of-interest (ROI) analyses for group cortical thickness differences in left, and separately right, inferior frontal gyrus (IFG), orbitofrontal cortex (OFC) and insula. Using FreeSurfer, we completed whole-cerebrum analyses of group differences in cortical thickness.Versus controls, the SUD group showed no cortical thickness differences in ROI analyses. Controlling for age and IQ, no regions with cortical thickness differences were found using whole-cerebrum analyses (though secondary analyses co-varying IQ and whole-cerebrum cortical thickness yielded a between-group cortical thickness difference in the left posterior cingulate/precuneus). Secondary findings showed that the SUD group, relative to controls, demonstrated significantly less right > left asymmetry in IFG, had weaker insular-to-whole-cerebrum cortical thickness correlations, and showed a positive association between conduct disorder symptom count and cortical thickness in a superior temporal gyrus cluster.Functional group differences may reflect a more nuanced cortical morphometric difference than ROI cortical thickness. Further investigation of morphometric differences is needed. If replicable findings can be established, they may aid in developing improved diagnostic or more targeted treatment approaches.",0,0 +7096,Symptom patterns associated with posttraumatic stress disorder among Vietnam veterans exposed to war trauma,"The authors tested whether the relationship between traumatic stress and posttraumatic stress disorder is captured more accurately by aggregating symptoms, as in DSM-III, or differentiating them into the subtypes of denial and reexperiencing. Their findings indicate that distinguishing between the responses of denial and reexperiencing is an alternative and potentially more useful approach for understanding posttraumatic stress disorder and its origins in war trauma than the comprehensive model proposed in DSM-III. The analysis suggests that biases in the current model of posttraumatic stress disorder may lead to underestimation of its prevalence. The authors conclude that reconsideration of what constitutes the disorder is warranted.",0,0 +7097,Drug use disorders and post-traumatic stress disorder over 25 adult years: Role of psychopathology in relational networks,"In traumatized populations, drug use disorders and post-traumatic stress disorder (PTSD) persist for many years. Relational factors that mediate this persistence have rarely been systematically examined. Our aim is to examine the relative effects of psychopathology in familial and non-familial networks on the persistence of both disorders over adulthood.We utilized longitudinal data from an epidemiologically ascertained sample of male Vietnam veterans (n=642). Measures included DSM-IV drug use disorders, other psychiatric disorders, network problem history and time-varying marital and employment characteristics. Longitudinal measures of veterans' psychopathology and social functioning were retrospectively obtained for each year over a 25 year period. We used generalized estimating equations (GEE) to estimate the relative effects of network problems on veteran's drug use disorders and PTSD after adjusting for covariates.Veterans' mean age was 47 years in 1996. Prevalence of illicit drug disorders declined from 29.8% in 1972 to 8.3% in 1996, but PTSD remained at 11.7% from 13.2% in 1972. While 17.0% of veterans reported a familial drug use problem, 24.9% reported a non-familial drug use problem. In full GEE models, a non-familial drug problem was a significant predictor of illicit drug use disorders over 25 years (OR=2.21, CI=1.59-3.09), while both familial depression (OR=1.69, CI=1.07-2.68) and non-familial drinking problem (OR=1.66, CI=1.08-2.54) were significant predictors of PTSD over 25 years.Familial and non-familial problems in networks differentially affect the persistence of drug use disorders and PTSD in traumatized male adults.",0,0 +7098,Posttraumatic Stress Disorders and Addiction,"Disorders related to stress or trauma are common among patients with substance use disorders (SUD). In clinical samples of patients with SUD, the prevalence of lifetime Posttraumatic Stress Disorder (PTSD) ranges from 26 % to 52 %, and from 15 % to 41 % for current PTSD. A substantial number of these patients suffer from the consequences of severe and prolonged interpersonal trauma usually referred to as “Complex PTSD”. Another common consequence of repeated interpersonal trauma in childhood are dissociative symptoms that may or may not co-occur with PTSD in SUD patients. While several hypotheses can explain the relationships between SUD and PTSD, the self-medication hypothesis has the strongest empirical support. Patients with both disorder have a more severe clinical profile than SUD patients without PTSD, poorer adherence to treatment, a shorter duration of abstinence, and worse outcomes across a variety of measures. Their clinical needs often make a treatment approach necessary that integrates SUD specific and trauma specific interventions. Several trauma treatments focusing on the present (i.e. providing skills training and psycho-education) and, more recently, also past-focused (i.e. exposure-based) treatments have been evaluated in SUD patients with co-occurring PTSD. Some of them outperformed SUD treatment-as-usual on PTSD and/or substance use outcomes. Findings on the effects of medication in patients with SUD and co-occurring PTSD are scarce and remain inconclusive. © Springer-Verlag Berlin Heidelberg 2015.",0,0 +7099,Estimating statistical power for open-enrollment group treatment trials,"

Abstract

Modeling turnover in group membership has been identified as a key barrier contributing to a disconnect between the manner in which behavioral treatment is conducted (open-enrollment groups) and the designs of substance abuse treatment trials (closed-enrollment groups, individual therapy). Latent class pattern mixture models (LCPMMs) are emerging tools for modeling data from open-enrollment groups with membership turnover in recently proposed treatment trials. The current article illustrates an approach to conducting power analyses for open-enrollment designs based on the Monte Carlo simulation of LCPMM models using parameters derived from published data from a randomized controlled trial comparing Seeking Safety to a Community Care condition for women presenting with comorbid posttraumatic stress disorder and substance use disorders. The example addresses discrepancies between the analysis framework assumed in power analyses of many recently proposed open-enrollment trials and the proposed use of LCPMM for data analysis.",0,0 +7100,An open trial of exposure therapy based on deconditioning for post-traumatic stress disorder,"Twenty-three patients who had experienced a major stressful event were given a debriefing session followed by eight weekly sessions of imaginal exposure and in vivo exposure. Patients recounted their traumatic experiences aloud, using the first person and the present tense, and included as much detail as possible. This account was audiotaped and patients were asked to listen to the tape between treatment sessions. There were reductions of 42 percent in the Impact of Events Scale (IES), of 61 percent in the General Health Questionnaire (GHQ), of 38 percent in the Symptom Checklist-90 (SCL-90) questionnaire, and of 35 percent in the Clinician Administered Post-Traumatic Stress scale (CAPS), all of which were statistically significant. The number of patients who satisfied the diagnostic criteria for post-traumatic stress disorder was halved.",0,0 +7101,"Brief Report: Pediatric Cancer, Parental Coping Style, and Risk for Depressive, Posttraumatic Stress, and Anxiety Symptoms","According to the stress and coping goodness of fit model, parents' risk for psychological symptoms was hypothesized to decrease as a function of using emotional regulation and problem appraisal strategies more frequently, and to increase as a function of using problem-solving and avoidant behaviors more frequently to cope with an uncontrollable stressor--pediatric cancer diagnosis.Parents (N = 150) completed measures of depression, PTSD, anxiety, and coping style.Regression analyses revealed that symptoms decreased as a function of using problem appraisal and an emotional regulation strategy (social support) more frequently; and increased as a function of using problem-solving strategies, avoidant coping (substance use), and another emotional regulation strategy (negative self-blame) more frequently.The findings provide some support for the model but suggest that the method of coping (e.g., social support) might be considered in addition to the focus of the coping strategy (e.g., emotional regulation).",0,0 +7102,The MMPI and the post-traumatic stress syndrome in vietnam era veterans,"MMPI profiles of Post-traumatic Stress outpatient and newly admitted Random Psychiatric inpatient veterans are practically identical, which indicates the severity of delayed response to stress in Vietnam veterans, especially those from urban, disadvantaged environments.",0,0 +7103,A Reevaluation of the Use of the MMPI in the Assessment of Combat-Related Posttraumatic Stress Disorder,"This study attempts to validate previously developed, empirically based Minnesota Multiphasic Personality Inventory (MMPI) decision rules (Keane, Malloy, & Fairbank, 1984) to aid in the diagnosis of combat-related posttraumatic stress disorder (PTSD). Four groups of 21 subjects each were identified: PTSD, psychotic, depressed, and chronic pain. A decision rule based on the standard clinical scales resulted in a correct classification rate (PTSD vs. non-PTSD) of 81% across the four-group sample. An empirically derived MMPI PTSD scale resulted in a correct classification rate of 77%. However, 43% of the PTSD subjects were incorrectly classified as non-PTSD by these rules. Independent, blind sorting of the 84 MMPI profiles by two doctoral-level clinical psychologists resulted in ""hit rates"" similar to the MMPI decision rules. The present results suggest that the previously derived, empirically based MMPI decision rules for PTSD do scarcely better than chance on correct classification of individuals with PTSD. We suggest that the differential diagnosis of PTSD is difficult because of the wide variety of symptoms in common with other diagnostic groups, and hence the variability of PTSD subjects on psychometric measures. We also suggest that the MMPI decision rules of Keane et al. (1984) may have utility in identifying subgroup(s) of combat-related PTSDs.",0,0 +7104,Cognitive behavioral therapy for the treatment of post-traumatic stress disorder: a review,"Post-traumatic stress disorder (PTSD) is a psychiatric sequel to a stressful event or situation of an exceptionally threatening or catastrophic nature. Cognitive behavioral therapy (CBT) has been used in the management of PTSD for many years. This paper reviews the effectiveness of CBT for the treatment of PTSD following various types of trauma, its potential to prevent PTSD, methods used in CBT, and reflects on the mechanisms of action of CBT in PTSD.Electronic databases, including PubMed, were searched for articles on CBT and PTSD. Manual searches were conducted for cross-references in the relevant journal sites.The current literature reveals robust evidence that CBT is a safe and effective intervention for both acute and chronic PTSD following a range of traumatic experiences in adults, children, and adolescents. However, nonresponse to CBT by PTSD can be as high as 50%, contributed to by various factors, including comorbidity and the nature of the study population. CBT has been validated and used across many cultures, and has been used successfully by community therapists following brief training in individual and group settings. There has been effective use of Internet-based CBT in PTSD. CBT has been found to have a preventive role in some studies, but evidence for definitive recommendations is inadequate. The effect of CBT has been mediated mostly by the change in maladaptive cognitive distortions associated with PTSD. Many studies also report physiological, functional neuroimaging, and electroencephalographic changes correlating with response to CBT.There is scope for further research on implementation of CBT following major disasters, its preventive potential following various traumas, and the neuropsychological mechanisms of action.",0,0 +7105,Correlates of Battered Women's Psychological Distress: Severity of Abuse and Duration of the Postabuse Period,"Although psychological disturbances among abused women are well documented, it is unclear whether such disturbances are a reaction to the abusive experience. The present study hypothesized that, if the disturbances are a reactive state, the severity of disturbance would be related to the time since the relationship ended as well as the severity of the psychological and physical abuse experienced. Participants were 50 abused women who completed valid MMPI-2s and revised Conflict Tactic Scales. The results indicated that MMPI-2 scores were significantly correlated with both types of abuse but not with duration of time since the abusive relationship was terminated. The MMPI-2 profiles of abused women and suggestions for research are discussed.",0,0 +7106,Transition and change: Prospective effects of posttraumatic stress on smoking trajectories in the first year of college.,"College matriculation begins a period of transition that is marked by new freedoms and responsibilities and by increases in a variety of risky behaviors, including smoking. Trauma and posttraumatic stress disorder (PTSD) are well-established risk factors for smoking outcomes, and thus may be a point of intervention for college smoking. Yet, no studies have examined associations among trauma, PTSD, and smoking in college students. The present study provides such an examination.Matriculating student smokers (N = 346) completed surveys in September (T1) and at 5 subsequent time points (T2-T6) over their first year of college. With latent growth analysis, we modeled smoking trajectories conditioned on PTSD symptom status (i.e., No PTSD Symptoms vs. Partial PTSD vs. Full PTSD).Results showed that although smoking tended to decline during the first semester for all groups, significant risk for escalation in smoking during the second semester was conferred specifically by the presence of PTSD at matriculation.Interventions that offer support and resources to students entering college with PTSD may help to prevent smoking behaviors from escalating and may ultimately prevent the adoption of daily smoking in later adulthood.",0,0 +7107,The effect of trauma onset and frequency on PTSD-associated symptoms,"Different trauma characteristics have been suggested to lead to distinct symptom profiles. This study investigates the effect of two trauma characteristics, age of onset and frequency, on PTSD symptom profiles.Trauma characteristics (childhood versus adulthood trauma and single versus multiple trauma), psychiatric diagnosis, PTSD severity, depressive symptoms, dissociation, guilt, shame, anger, and interpersonal sensitivity were assessed in 110 PTSD outpatients.Single versus multiple trauma and childhood versus adulthood trauma groups did not differ in depressive symptom and co-morbidity. Multiple trauma patients reported more dissociation, guilt, shame, and interpersonal sensitivity than those that experienced single trauma. Anger of multiple trauma patients was more often directed towards themselves, whereas anger in single trauma patients was more often directed towards others. Childhood trauma patients reported more dissociation and state anger than adulthood trauma patients. However, with the exception of multiple trauma patients having more dissociation and shame than those with single trauma, all differences disappeared after controlling for PTSD severity.This study is a first step in unraveling the impact of different trauma characteristics. Causal inferences are limited, though, because of the cross-sectional design.The results suggest that experiencing trauma at young age or multiple times may lead to different symptom profiles but these are, with the exception of dissociation and shame, dependent on PTSD severity. These results support the proposed DSM-V criteria in which these symptoms appear as part of the disorder, and stress the importance of early treatment.",0,0 +7108,Resilience following spinal cord injury: A prospective controlled study investigating the influence of the provision of group cognitive behavior therapy during inpatient rehabilitation.,"To examine change in resilience in people with spinal cord injury (SCI) when group cognitive behavior therapy (GCBT) was added to routine psychosocial rehabilitation (RPR).A prospective repeated-measures cohort design was used to determine the efficacy of the addition of GCBT (n = 50). The control group consisted of individuals receiving RPR, which included access to individual CBT (ICBT) when required (n = 38). Groups were assessed on 3 occasions: soon after admission, within 2 weeks of discharge, and 6-months postdischarge. Measures included sociodemographic, injury, and psychosocial factors. The outcome variable was resilience, considered an important outcome measure for recovery. To adjust for baseline differences in self-efficacy, depressive mood and anxiety between the 2 groups, these factors were entered into a repeated measures multivariate analysis of covariance (MANCOVA) as covariates. Latent class analysis was used to determine the best-fitting model of resilience trajectories for both groups.The MANCOVA indicated that the addition of GCBT to psychosocial rehabilitation did not result in improved resilience compared with the ICBT group. Trajectory data indicated over 60% were demonstrating acceptable resilience irrespective of group.Changes in resilience mean scores suggest the addition of GCBT adds little to resilience outcomes. Latent class modeling indicated both groups experienced similar trajectories of improvement and deterioration. Results highlight the importance of conducting multivariate modeling analysis that isolates subgroups of related cases over time to understand complex trajectories. Further research is needed to clarify individual differences in CBT intervention preference as well as other factors which impact on resilience.",0,0 +7109,Measuring psychological resilience to disasters: are evidence-based indicators an achievable goal?,"Despite rising interest on the concept of societal resilience and its measurement, little has been done to provide operational indicators. Importantly, an evidence-based approach to assess the suitability of indicators remains unexplored. Furthermore few approaches that exist do not investigate indicators of psychological resilience, which is emerging as an important component of societal resilience to disasters. Disasters are events which overwhelm local capacities, often producing human losses, injury and damage to the affected communities. As climate hazards and disasters are likely to increase in the coming decades, strengthening the capacity of societies to withstand these shocks and recover quickly is vital. In this review, we search the Web of Knowledge to summarize the evidence on indicators of psychological resilience to disasters and provided a qualitative assessment of six selected studies. We find that an evidence-based approach using features from systematic reviews is useful to compile, select and assess the evidence and elucidate robust indicators. We conclude that strong social support received after a disaster is associated with an increased psychological resilience whereas a female gender is connected with a decrease in the likelihood of a resilient outcome. These results are consistent across disaster settings and cultures and are representative of approximately 13 million disaster-exposed civilians of adult age. An approach such as this that collects and evaluates evidence will allow indicators of resilience to be much more revealing and useful in the future. They will provide a robust basis to prioritize indicators to act upon through intersectoral policies and post-disaster public health interventions.",0,0 +7110,"Health Care Utilization by United Nations Peacekeeping Veterans with Co-occurring, Self-Reported, Post-Traumatic Stress Disorder and Depression Symptoms versus Those Without","It remains to be determined whether patients with comorbid post-traumatic stress disorder (PTSD) and depression use more health care resources than do those without. United Nations peacekeeping veterans from Canada were divided into four groups, i.e., PTSD alone (n = 23), depression alone (n = 167), comorbid PTSD and depression (n = 119), and neither (n = 164), and compared with respect to total number of visits to any health care professional in the past year. Analysis of variance revealed that the groups significantly differed in total visits. Post hoc analyses indicated that veterans with co-occurring PTSD and depression symptoms had more visits than did those in the other groups and that veterans with PTSD symptoms alone and depression symptoms alone had more visits than did those with neither PTSD nor depression. Additional analyses revealed that veterans with co-occurring PTSD and depression symptoms made more visits to general practitioners, specialists, pharmacists, and mental health professionals than did the others. Future research directions and implications for treatment planning are discussed.",0,0 +7111,Risk factors for DSM–5 posttraumatic stress symptoms (PTSS) among Israeli civilians during the 2014 Israel-Hamas war.,"In light of current modifications in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria for posttraumatic stress disorder (PTSD), this study aimed to revalidate well-known PTSD risk factors related to terrorism and war in Israel, namely, proximity to the Gaza Strip, dissociative symptoms, acute stress disorder (ASD) symptoms, and social support. One hundred and sixty Israeli civilians were assessed during the 2014 Israel-Hamas war at 2 time points: 1 week after the beginning of the operation (t1) and 1 month after initial evaluation (t2), using the DSM-5 PTSD Symptom Levels Scale (PSLS; Gil, Weinberg, Or-Chen, & Harel, 2015). A paired t test analysis showed significant reduction in the respondents' posttraumatic stress symptoms (PTSS) 1 month after the initial assessment point. A structural equation model (SEM) showed that higher ASD symptoms at t1 and higher dissociative symptoms at t2 increased the risk for PTSS at t2. Conversely, higher peritraumatic dissociation at t1 decreased the risk for PTSS at t2. Proximity to the Gaza Strip, and social support, failed to demonstrate significant association with PTSS at t2. DSM-5 PTSS 1 month after prolonged traumatic exposure are strongly associated with high ASD symptoms at 1 week as a risk factor; high levels of peritraumatic dissociation at 1 week as a protective factor; and high levels of dissociative symptoms at 1 month as a risk factor. Theoretically and clinically the findings of the study further suggest that ongoing massive terrorism and war cannot be viewed or treated as identical to other traumas.",0,0 +7112,Risk Factors for Posttraumatic Stress Disorder in Female Help-Seeking Victims of Sexual Assault,"Posttraumatic stress disorder (PTSD) is common in the aftermath of rape and other sexual assault, but the risk factors leading to PTSD following rape have been shown to differ from those related to PTSD following nonsexual assault. This prospective study examined risk factors for PTSD severity in 148 female help-seeking victims of sexual assault. Approximately 70% of the victims experienced significant levels of traumatization, with 45% reporting symptoms consistent with a probable PTSD diagnosis. Regression analyses showed that relationship with the assailant, number of assailants, the nature of the assault, perceived positive social support, support satisfaction, feeling let down by others, and prior exposure to sexual trauma did not significantly predict PTSD severity at the final level of analysis. In accordance with suggestions by Dancu, Riggs, Hearst-Ikeda, and Shoyer (1996), it is suggested that this is partly caused by a very high degree of traumatization in the sample. Instead, previous nonsexual traumatic experiences and negative affectivity accounted for 30% of the variance in PTSD severity. Although more research is needed on risk factors of assault-related PTSD, these findings suggest that although sexual assault is associated with a high degree of PTSD severity, prior nonsexual victimization and high levels of negative affectivity appear to further increase the vulnerability toward developing symptoms of assault-related PTSD. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)",0,0 +7113,Contrasting models of posttraumatic stress disorder: Reply to Monroe and Mineka (2008).,"We address the four main points in Monroe and Mineka (2008)'s Comment. First, we first show that the DSM PTSD diagnosis includes an etiology and that it is based on a theoretical model with a distinguished history in psychology and psychiatry. Two tenets of this theoretical model are that voluntary (strategic) recollections of the trauma are fragmented and incomplete while involuntary (spontaneous) recollections are vivid and persistent and yield privileged access to traumatic material. Second, we describe differences between our model and other cognitive models of PTSD. We argue that these other models share the same two tenets as the diagnosis and we show that these two tenets are largely unsupported by empirical evidence. Third, we counter arguments about the strength of the evidence favoring the mnemonic model, and fourth, we show that concerns about the causal role of memory in PTSD are based on views of causality that are generally inappropriate for the explanation of PTSD in the social and biological sciences.",0,0 +7114,Chronic probable ptsd in police responders in the world trade center health registry ten to eleven years after 9/11,"Background Police enrolled in the World Trade Center Health Registry (WTCHR) demonstrated increased probable posttraumatic stress disorder (PTSD) after the terrorist attack of 9/11/2001. Methods Police enrollees without pre-9/11 PTSD were studied. Probable PTSD was assessed by Posttraumatic Stress Check List (PCL). Risk factors for chronic, new onset or resolved PTSD were assessed using multinomial logistic regression. Results Half of police with probable PTSD in 2003-2007 continued to have probable PTSD in 2011–2012. Women had higher prevalence of PTSD than men (15.5% vs. 10.3%, P = 0.008). Risk factors for chronic PTSD included decreased social support, unemployment, 2+ life stressors in last 12 months, 2+ life-threatening events since 9/11, 2+ injuries during the 9/11 attacks, and unmet mental health needs. Conclusion Police responders to the WTC attacks continue to bear a high mental health burden. Improved early access to mental health treatment for police exposed to disasters may be needed. Am. J. Ind. Med. 58:483–493, 2015. © 2015 Wiley Periodicals, Inc.",0,0 +7115,Genomic predictors of combat stress vulnerability and resilience in U.S. Marines: A genome-wide association study across multiple ancestries implicates PRTFDC1 as a potential PTSD gene,"Research on the etiology of post-traumatic stress disorder (PTSD) has rapidly matured, moving from candidate gene studies to interrogation of the entire human genome in genome-wide association studies (GWAS). Here we present the results of a GWAS performed on samples from combat-exposed U.S. Marines and Sailors from the Marine Resiliency Study (MRS) scheduled for deployment to Iraq and/or Afghanistan. The MRS is a large, prospective study with longitudinal follow-up designed to identify risk and resiliency factors for combat-induced stress-related symptoms. Previously implicated PTSD risk loci from the literature and polygenic risk scores across psychiatric disorders were also evaluated in the MRS cohort.Participants (N=3494) were assessed using the Clinician-Administered PTSD Scale and diagnosed using the DSM-IV diagnostic criterion. Subjects with partial and/or full PTSD diagnosis were called cases, all other subjects were designated controls, and study-wide maximum CAPS scores were used for longitudinal assessments. Genomic DNA was genotyped on the Illumina HumanOmniExpressExome array. Individual genetic ancestry was determined by supervised cluster analysis for subjects of European, African, Hispanic/Native American, and other descent. To test for association of SNPs with PTSD, logistic regressions were performed within each ancestry group and results were combined in meta-analyses. Measures of childhood and adult trauma were included to test for gene-by-environment (GxE) interactions. Polygenic risk scores from the Psychiatric Genomic Consortium were used for major depressive disorder (MDD), bipolar disorder (BPD), and schizophrenia (SCZ).The array produced >800K directly genotyped and >21M imputed markers in 3494 unrelated, trauma-exposed males, of which 940 were diagnosed with partial or full PTSD. The GWAS meta-analysis identified the phosphoribosyl transferase domain containing 1 gene (PRTFDC1) as a genome-wide significant PTSD locus (rs6482463; OR=1.47, SE=0.06, p=2.04×10(-9)), with a similar effect across ancestry groups. Association of PRTFDC1 with PTSD in an independent military cohort showed some evidence for replication. Loci with suggestive evidence of association (n=25 genes, p<5×10(-6)) further implicated genes related to immune response and the ubiquitin system, but these findings remain to be replicated in larger GWASs. A replication analysis of 25 putative PTSD genes from the literature found nominally significant SNPs for the majority of these genes, but associations did not remain significant after correction for multiple comparison. A cross-disorder analysis of polygenic risk scores from GWASs of BPD, MDD, and SCZ found that PTSD diagnosis was associated with risk sores of BPD, but not with MDD or SCZ.This first multi-ethnic/racial GWAS of PTSD highlights the potential to increase power through meta-analyses across ancestry groups. We found evidence for PRTFDC1 as a potential novel PTSD gene, a finding that awaits further replication. Our findings indicate that the genetic architecture of PTSD may be determined by many SNPs with small effects, and overlap with other neuropsychiatric disorders, consistent with current findings from large GWAS of other psychiatric disorders.",0,0 +7116,Similar factors predict disability and posttraumatic stress disorder trajectories after whiplash injury,"Distinct developmental trajectories for neck disability and posttraumatic stress disorder (PTSD) symptoms after whiplash injury have recently been identified. This study aimed to identify baseline predictors of membership to these trajectories and to explore their dual development. In a prospective study, 155 individuals with whiplash were assessed at or = 13° C (OR = 26.320, 95% CI = 4.981-139.09), initial pain level (VAS) (OR = 4.3, 95% CI = 4.98-139.1), and age (OR = 1.109, 95% CI = 1.043-1.180) predicted a chronic/severe disability trajectory. The same baseline factors also predicted chronic moderate/severe PTSD (CPT > or = 13° C, OR = 9.7, 95% CI = 2.22-42.44; initial pain level [VAS]: OR = 2.13, 95% CI = 1.43-3.17; age: OR = 1.07, 95% CI = 1.01-1.14). There was good correspondence of trajectory group for both disability and PTSD. These findings support the proposal of links between the development of chronic neck related disability and PTSD after whiplash injury. Developmental trajectories of disability and posttraumatic stress disorder (PTSD) after whiplash injury are mostly in synchrony, and similar factors predict their membership. This suggests links between the development of chronic neck pain-related disability and PTSD.",0,0 +7117,Cultural protection against traumatic stress: traditional support of children exposed to the ritual of female genital cutting,"This study explores the factors addressed in folk psychology in The Gambia for protecting the girl-child from the potential traumatic stress of female genital cutting (FGC). The type and quality of the psychological care was analyzed and compared with research on traumatic stress and principles for crisis and trauma intervention. Thirty-three qualitative indepth interviews were conducted with mothers who had supervised their daughters' FGC, women who had been circumcised, and professional circumcisers. The findings indicate that the girls have largely managed to handle the potentially traumatic event of FGC. The event is placed in a meaningful system of understanding, and the stress is dealt with in a traditional way that to a great extent follows empirically-based and evidence-based principles of crisis intervention. However, the approach tends to be culturally encoded, based on the local cultural belief system. This puts circumcised individuals in a potentially vulnerable position if they are living outside the homeland's supportive cultural context, with consequences for psychological and culturally competent FGC health care in exile.",0,0 +7118,Clinical challenges in the treatment of patients with posttraumatic stress disorder and substance abuse,"The aim of this article is to review the current literature on co-occuring posttraumatic stress disorder and substance-use disorder, with an emphasis on clinical aspects and emerging treatments.In clinical populations (focusing on either disorder), about 25-50% have a lifetime dual diagnosis of posttraumatic stress disorder and substance-use disorder. Patients with both disorders have a more severe clinical profile than those with either disorder alone, lower functioning, poorer well being, and worse outcomes across a variety of measures. In recent years, several promising treatment programs have been developed specifically for co-occuring posttraumatic stress disorder and substance-use disorder, with one model having been established as effective thus far.Comorbid posttraumatic stress disorder/substance-use disorder is a frequent diagnosis in clinical populations that severely affects course and outcome. Treatment approaches appropriate for this vulnerable population need to be evaluated further and implemented in routine practice.",0,0 +7119,Prevention of Posttraumatic Stress Disorder by Early Treatment,"Preventing posttraumatic stress disorder (PTSD) is a pressing public health need.To compare early and delayed exposure-based, cognitive, and pharmacological interventions for preventing PTSD.Equipoise-stratified randomized controlled study.Hadassah Hospital unselectively receives trauma survivors from Jerusalem and vicinity.Consecutively admitted survivors of traumatic events were assessed by use of structured telephone interviews a mean (SD) 9.61 (3.91) days after the traumatic event. Survivors with symptoms of acute stress disorder were referred for clinical assessment. Survivors who met PTSD symptom criteria during the clinical assessment were invited to receive treatment.Twelve weekly sessions of prolonged exposure (PE; n = 63), or cognitive therapy (CT; n = 40), or double blind treatment with 2 daily tablets of either escitalopram (10 mg) or placebo (selective serotonin reuptake inhibitor/placebo; n = 46), or 12 weeks in a waiting list group (n = 93). Treatment started a mean (SD) 29.8 (5.7) days after the traumatic event. Waiting list participants with PTSD after 12 weeks received PE a mean (SD) 151.8 (42.4) days after the traumatic event (delayed PE).Proportion of participants with PTSD after treatment, as determined by the use of the Clinician-Administered PTSD Scale (CAPS) 5 and 9 months after the traumatic event. Treatment assignment and attendance were concealed from the clinicians who used the CAPS.At 5 months, 21.6% of participants who received PE and 57.1% of comparable participants on the waiting list had PTSD (odds ratio [OR], 0.21 [95% CI, 0.09-0.46]). At 5 months, 20.0% of participants who received CT and 58.7% of comparable participants on the waiting list had PTSD (OR, 0.18 [CI, 0.06-0.48]). The PE group did not differ from the CT group with regard to PTSD outcome (OR, 0.87 [95% CI, 0.29-2.62]). The PTSD prevalence rates did not differ between the escitalopram and placebo subgroups (61.9% vs 55.6%; OR, 0.77 [95% CI, 0.21-2.77]). At 9 months, 20.8% of participants who received PE and 21.4% of participants on the waiting list had PTSD (OR, 1.04 [95% CI, 0.40-2.67]). Participants with partial PTSD before treatment onset did similarly well with and without treatment.Prolonged exposure, CT, and delayed PE effectively prevent chronic PTSD in recent survivors. The lack of improvement from treatment with escitalopram requires further evaluation. Trauma-focused clinical interventions have no added benefit to survivors with subthreshold PTSD symptoms. Trial Registration clinicaltrials.gov Identifier: NCT00146900.",0,0 +7120,Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study,"In the empirical and clinical literature, complex posttraumatic stress disorder (PTSD) and personality disorders (PDs) are suggested to be predictive of drop-out or reduced treatment effectiveness in trauma-focused PTSD treatment.In this study, we aimed to investigate if personality characteristics would predict treatment compliance and effectiveness in stabilizing complex PTSD treatment.In a randomized controlled trial on a 20-week stabilizing group cognitive behavioral treatment (CBT) for child-abuse-related complex PTSD, we included 71 patients of whom 38 were randomized to a psycho-educational and cognitive behavioral stabilizing group treatment. We compared the patients with few PD symptoms (adaptive) (N=14) with the non-adaptive patients (N=24) as revealed by a cluster analysis.We found that non-adaptive patients compared to the adaptive patients showed very low drop-out rates. Both non-adaptive patients, classified with highly different personality profiles ""withdrawn"" and ""aggressive,"" were equally compliant. With regard to symptom reduction, we found no significant differences between subtypes. Post-hoc, patients with a PD showed lower drop-out rates and higher effect sizes in terms of complex PTSD severity, especially on domains that affect regulation and interpersonal problems.Contrary to our expectations, these preliminary findings indicate that this treatment is well tolerated by patients with a variety of personality pathology. Larger sample sizes are needed to study effectiveness for subgroups of complex PTSD patients.",0,0 +7121,High dose hydrocortisone immediately after trauma may alter the trajectory of PTSD: Interplay between clinical and animal studies,"High-dose corticosteroids have been reported to reduce symptoms of acute stress and post-traumatic stress in polytrauma patients and in animal studies. The underlying mechanism of action remains largely unclear. These issues were addressed in parallel in the clinical and preclinical studies below. In this preliminary study, 25 patients with acute stress symptoms were administered a single intravenous bolus of high-dose hydrocortisone (100-140 mg) or placebo within 6 h of a traumatic event in a prospective, randomized, double-blind, placebo-controlled pilot study. Early single high-dose hydrocortisone intervention attenuated the core symptoms of both the acute stress and of subsequent PTSD in patients. High-dose hydrocortisone treatment given in the first few hours after a traumatic experience was associated with significant favorable changes in the trajectory of exposure to trauma, as expressed by the reduced risk of the development of PTSD post-trauma. In parallel, a comparative study of morphological arborization in dentate gyrus and its modulating molecules was performed in stress-exposed animals treated with high-dose hydrocortisone. Steroid-treated stressed animals displayed significantly increased dendritic growth and spine density, with increased levels of brain-derived neurotrophic factor (BDNF) and obtunded postsynaptic density-95 (PSD-95) levels. The animal study provided insights into the potential mechanism of this intervention, as it identified relevant morphological and biochemical associations to the clinical observations. Thus, evidence from clinical and animal studies suggests that there is a ""window of opportunity"" in the early aftermath of trauma to help those who are vulnerable to the development of chronic PTSD.",0,0 +7122,A factor analytic comparison of five models of PTSD symptoms,"This study examined the factor structure of PTSD symptoms in a sample of college students (n=344) reporting exposure to a range of traumatic events. The sample was randomly split and an exploratory factor analysis was conducted with half of the sample. The factor structure obtained in the exploratory analysis was evaluated against three other models using confirmatory factor analysis utilizing the second half of the sample. This series of factor analyses identified and confirmed a three-factor symptom structure consisting of intrusion/avoidance, dysphoria, and hyperarousal clusters. These results add to the body of literature which has found that PTSD includes a cluster of symptoms shared with other diagnoses (dysphoria) and a more specific factor related directly to the effects of encountering traumatic experiences.",0,0 +7123,Relationship between posttraumatic stress disorder symptoms and the course of whiplash complaints,"This study investigates the relationship between posttraumatic stress disorder (PTSD) symptoms (avoidance, reexperiencing, and hyperarousal) and the presence, severity, and duration of neck complaints after motor vehicle accidents. Individuals who had been involved in traffic accidents and had initiated compensation claim procedures with a Dutch insurance company were sent questionnaires (Q1) containing complaint-related questions and the Self-Rating Scale for PTSD. Of the 997 questionnaires that were dispatched, 617 (62%) were returned. Only car accident victims were included in this study ( n =240). Complaints were monitored using additional questionnaires that were administered 6 months (Q2) and 12 months (Q3) after the accident. PTSD was related to the presence and severity of concurrent post-whiplash syndrome. More specifically, the intensity of hyperarousal symptoms that were related to PTSD at Q1 was found to have predictive validity for the persistence and severity of post-whiplash syndrome at 6 and 12 months follow-up. Results are consistent with the idea that PTSD hyperarousal symptoms have a detrimental influence on the recovery and severity of whiplash complaints following car accidents.",0,0 +7124,Advances in genomics and epigenetic biomarkers for vulnerability and treatment response in mood and anxiety disorders,"Objective: Our current efforts in identifying reliable markers to stratify patients with mood and anxiety disorders into biologically relevant categories have so far not been highly successful. Here we will highlight approaches that combine genetic and environmental risk factors and epigenetic measures to identify subsets of patients that are likely biologically more homogeneous and may profit from similar treatment strategies. Methods: DNA methylation, gene expression and genotyping, combined with endocrine and neuroimaging measures as well as information on antidepressant treatment response from different studies will be presented. Results: Interaction of a specific functional polymorphism in the FKBP5 gene together with exposure to early trauma leads to epigenetic changes that further derepress the transcription of that gene. This interaction of two risk factors is on the one hand associated with a number of distinct psychiatric diagnoses, including depression, PTSD and psychosis. On the other hand, patients with this specific epigenetic profile represent a subgroup of patients with unique endocrine, gene expression and neuroimaging biomarkers. Preliminary evidence suggest that depressed patients with the FKBP5 risk allele and exposure to early trauma may preferentially respond to cognitive behavioral therapy (CBT). We will also present data from genome-wide genetic and epigenetic studies investigating pattern associated with differential antidepressive response to CBT vs. medication. Conclusion: This series of studies highlights that identifying subgroups of patients using epigenetic measures and integrating genetic and environmental factors could be useful for more targeted treatment approaches that make use of pathophysiologic findings that can transcend current diagnostic categories.",0,0 +7125,The endocannabinoid system as a possible target to treat both the cognitive and emotional features of post-traumatic stress disorder (PTSD),"Post-traumatic stress disorder (PTSD) is a psychiatric disorder of significant prevalence and morbidity, whose pathogenesis relies on paradoxical changes of emotional memory processing. An ideal treatment would be a drug able to block the pathological over-consolidation and continuous retrieval of the traumatic event, while enhancing its extinction and reducing the anxiety symptoms. While the latter benefit from antidepressant medications, no drug is available to control the cognitive symptomatology. Endocannabinoids regulate affective states and participate in memory consolidation, retrieval, and extinction. Clinical findings showing a relationship between Cannabis use and PTSD, as well as changes in endocannabinoid activity in PTSD patients, further suggest the existence of a link between endocannabinoids and maladaptive brain changes after trauma exposure. Along these lines, we suggest that endocannabinoid degradation inhibitors may be an ideal therapeutic approach to simultaneously treat the emotional and cognitive features of PTSD, avoiding the unwanted psychotropic effects of compounds directly binding cannabinoid receptors.",0,0 +7126,The modeling of internalizing disorders on the basis of patterns of lifetime comorbidity: Associations with psychosocial functioning and psychiatric disorders among first-degree relatives.,"Two broadband latent factors--internalizing and externalizing--have frequently been identified in studies of the hierarchical structure of psychopathology. In the present research, 3 competing measurement models of putative internalizing disorders (i.e., a parsimonious single-factor model, a model based on the Diagnostic and Statistical Manual of Mental Disorders [4th ed., American Psychiatric Association, 1994], and an alternative model proposed by Krueger, 1999, and Watson, 2005) were evaluated in terms of their ability to account for lifetime patterns of diagnostic comorbidity. Four diagnostic assessments were performed on an age-based cohort of 816 persons over a 15-year interval. Each of the 3 measurement models demonstrated adequate or good fit to the data and similar approximating abilities. Additional analyses, however, suggested that nonspecific aspects of lifetime mood/anxiety or distress/fear disorders (i.e., general negative affect) largely accounted for indicators of psychosocial functioning at age 30 as well as densities of specific psychiatric disorders among the 1st-degree relatives of probands. The relevance of these findings for theoretical and descriptive models of internalizing disorders is discussed.",0,0 +7127,Emerging roles for atypical antipsychotics in chronic post-traumatic stress disorder,"Post-traumatic stress disorder is an anxiety disorder that may occur after the individual is exposed to severe psychologic trauma such as combat, sexual assault, or childhood physical or sexual abuse. Chronic post-traumatic stress disorder may result in considerable psychologic pain and suffering for the individual in addition to significant functional impairment. In addition to the heterogeneity of symptoms that occur in post-traumatic stress disorder, there may also be extensive comorbidity with other anxiety disorders, mood disorders, psychotic disorders, and other psychiatric disorders. This complicates the treatment picture. Currently, accepted treatments for post-traumatic stress disorder include psychotherapy, in particular cognitive behavioral-based approaches and antidepressant medication. However, many patients are refractory to these initial treatments or have only a partial response. In light of this, may clinicians combine additional classes of psychotropic agents and different psychotherapeutic approaches to enhance treatment response. This article reviews the literature on the use of atypical antipsychotics in the treatment of post-traumatic stress disorder. Most of the research to date has involved combat veterans partially responsive or refractory to treatment, namely with antidepressants. Studies have shown improvement across post-traumatic stress disorder symptom clusters, as well as improvement in comorbid psychotic symptoms or disorders. More research is needed to confirm these recent findings and further delineate the role of atypical antipsychotics in the treatment of post-traumatic stress disorder. Currently, possible indications for their use include treatment-resistant post-traumatic stress disorder and post-traumatic stress disorder with comorbid psychotic features.",0,0 +7128,Distinguishing distress and psychopathology among survivors of the Oakland/Berkeley firestorm.,"Disaster mental health research has historically focused on assessment of psychopathology, using measures of psychiatric symptoms and disorders. The Oakland/Berkeley firestorm provided an opportunity to explore resilience among highly exposed survivors through consideration of psychiatric variables in the context of personality. The Diagnostic Interview Schedule/Disaster Supplement was administered to 62 firestorm survivors at approximately 4, 16, and 39 months and the Temperament and Character Inventory administered at 16 months postdisaster. Few individuals had postdisaster psychopathology (16% with any diagnosis, 5%with PTSD). There was considerable evidence of distress, however, indicated by an abundance of reported posttraumatic symptoms, functional impairments, and endorsement of emotional upset, all of which decreased substantially over time. Group C (avoidance/numbing) posttraumatic symptoms were relatively uncommon and were specifically associated with elevated Self-Transcendence. Groups B (intrusion) and D (hyperarousal) symptoms were prevalent and were associated with high Harm Avoidance and low Self-Directedness. The generally healthy personality profiles of these firestorm survivors reflected their psychological resilience. Examination of symptoms and distress in the context of psychiatric disorders after this disaster demonstrated that symptomatic distress is not inconsistent with psychological resilience. The choice of research focus and methods can provide very different portraits of outcomes post-disaster.",0,0 +7129,Treatment-Resistant Posttraumatic Stress Disorder: Strategies for Intervention,"Abstract The mainstay of treatment for chronic posttraumatic stress disorder (PTSD) is a combination of psychotherapy and medication treatments. The first-line medications for PTSD are antidepressants, with two selective serotonin reuptake inhibitors (sertraline and paroxetine) currently Food and Drug Administration-indicated for PTSD. However, many patients do not have an adequate response to antidepressants, therefore, combinations with other antidepressants or with other classes of psychotropic medication are often utilized to enhance the therapeutic response. Other agents that have been used include mood stabilizers, antiadrenergics, anxiolytics, and atypical antipsychotics. The heterogeneity of symptom clusters in PTSD as well as the complex psychiatric comorbidities (eg, with depression or substance abuse) further support the notion that combinations of medications may be needed. To date, there is a paucity of data to support specific strategies for augmenting antidepressants in PTSD. This review will address representative existing studies and discuss several potential pharmacologic strategies for patients suffering from treatment refractory PTSD.",0,0 +7130,"Comparative Study of Heart Rate Variability in Patients with Schizophrenia, Bipolar Disorder, Post-traumatic Stress Disorder, or Major Depressive Disorder","Heart rate variability (HRV) changes as a function of psychiatric illness. This study aimed to evaluate HRV among patients with various psychiatric disorders.The present study recruited patients with schizophrenia (n=35), bipolar disorder (n=41), post-traumatic stress disorder (PTSD; n=34), or major depressive disorder (n=34) as well as healthy controls (n=27). The time-domain analysis (the standard deviation of all RR intervals [SDNN] and the square root of the mean squared differences of successive normal sinus intervals [RMSSD]), the frequency-domain analysis (very low frequency, low frequency [LF], high frequency [HF], and total power [TP]), and a non-linear complexity measure the approximate entropy were computed.SDNN and HF were significantly reduced in patients with schizophrenia compared with healthy controls. SDNN, RMSSD, TP, LF, and HF were significantly reduced in bipolar patients compared with healthy controls. HF was significantly reduced in PTSD patients compared with healthy controls.Our findings indicate that HRV is not sufficiently powerful to discriminate among various psychiatric illnesses. However, our results suggest that HRV, particularly HF, could be used as a tool for discriminating between psychiatric patients and healthy controls.",0,0 +7131,All PTSD symptoms are highly associated with general distress: Ramifications for the dysphoria symptom cluster.,"This study used longitudinal data collected from two trauma-exposed samples, survivors of community violence (N = 294) and wildfire evacuees (N = 234), to examine a key claim underlying a proposed reformulation of the symptom structure of posttraumatic stress disorder (PTSD). This theory, which we term the PTSD-dysphoria model, posits that 8 of 17 symptoms of PTSD reflect dysphoria or general psychological distress and might be deemphasized to improve the utility of the PTSD construct (Simms, Watson, & Doebbeling, 2002). For each sample, we analyzed PTSD symptoms and measures of general distress administered at 2 time points. A consistent pattern of findings was observed across assessments for each sample: All 17 PTSD symptoms were highly associated with measures of general distress. Moreover, we found no evidence that dysphoria symptoms were more highly correlated than PTSD-specific symptoms with general distress. Results call into question both the conceptual basis and the clinical utility of differentiating between symptoms that appear to be relatively specific to PTSD and those that seem more broadly characteristic of general psychological distress.",0,0 +7132,Changes in Pain Catastrophizing Following Physical Therapy for Musculoskeletal Injury: The Influence of Depressive and Post-traumatic Stress Symptoms,"Purpose: The aim of the present study was to investigate the factors that influence the change in pain catastrophizing during the course of a physical therapy intervention for musculoskeletal injury. Methods: 187 clients enrolled in a 7-week physical therapy intervention were divided into four mutually exclusive groups on the basis of a pre-treatment assessment: (1) clients whose pre-treatment catastrophizing scores and measures of mental health problems were below clinical threshold, (2) clients whose pre-treatment catastrophizing scores were above clinical threshold but who scores on measures of mental health problems were below clinical threshold, (3) clients whose pre-treatment catastrophizing scores were above clinical threshold and whose scores on measures of mental health problems were also above clinical threshold, and (4) clients whose pre-treatment catastrophizing scores were below clinical threshold but whose scores on measures of mental health problems were above clinical threshold. Results: The most prevalent risk profile consisted of clients with high levels of pain catastrophizing and high mental health problems (37 %), followed by the low catastrophizing and low mental health problems profile (35 %), the high catastrophizing and low mental health problems profile (16 %), and low catastrophizing and high mental health problems profile (10 %). Clients were considered non-responders if their post-treatment catastrophizing score remained above clinical threshold following treatment. Chi square analyses revealed a significantly higher proportion of non-responders in the high catastrophizing and mental health problem group than in any other group. Conclusions: The presence of mental health symptoms markedly reduces the effectiveness of physical therapy for reducing catastrophizing scores. The 'risk value' of high catastrophizing scores thus appears to vary as a function of the presence or absence of mental health symptoms. The findings argue for the inclusion of measures of mental health problems in the routine screening of individuals treated in physical therapy. © 2013 Springer Science+Business Media New York.",0,0 +7133,Neurodevelopment and Behavior after Transcatheter versus Surgical Closure of Secundum Type Atrial Septal Defect,"To assess the neuropsychological and behavioral profiles of school-aged children treated for atrial septal defect, secundum type (ASD-II) with open-heart surgery or catheterization.Patients (n = 48; mean age, 9 years, 3 months) and a matched healthy group (mean age, 9 years, 2 months) were evaluated with a shortened intelligence scale (Wechsler Intelligence Scale for Children, third edition, Dutch version) and a developmental neuropsychological test battery (Developmental Neuropsychological Assessment, second edition, Dutch version). Parents completed behavioral checklists (Achenbach Child Behavior Checklist for Children aged 6-18). Hospitalization variables were retrieved from medical files for studying associations with long-term neurodevelopment.Compared with the healthy matched controls, patients treated for ASD-II had significantly lower scores on subtasks underlying such Developmental Neuropsychological Assessment, second edition, Dutch version domains as Attention and Executive Functioning, Language, Working Memory, Sensorimotor Functioning, Social Cognition, and Visuospatial Information Processing. Only subtle differences, mainly in Visuospatial Information Processing, were found between the surgical repair and transcatheter repair groups. Socioeconomic status, longer hospital stay, and larger defect size were associated with neurocognitive outcome measures. Parents of patients reported more thought problems, posttraumatic stress problems, and lower school performance compared with parents of healthy peers.After treatment for ASD-II, children display a range of neuropsychologic difficulties that may increase their risk for learning problems and academic underachievement. Differences related to treatment were not found. Our results suggest that neurodevelopmental and behavioral follow-up at school age is warranted in this group.",0,0 +7134,A Phase I Study of Low-Pressure Hyperbaric Oxygen Therapy for Blast-Induced Post-Concussion Syndrome and Post-Traumatic Stress Disorder,"This is a preliminary report on the safety and efficacy of 1.5 ATA hyperbaric oxygen therapy (HBOT) in military subjects with chronic blast-induced mild to moderate traumatic brain injury (TBI)/post-concussion syndrome (PCS) and post-traumatic stress disorder (PTSD). Sixteen military subjects received 40 1.5 ATA/60 min HBOT sessions in 30 days. Symptoms, physical and neurological exams, SPECT brain imaging, and neuropsychological and psychological testing were completed before and within 1 week after treatment. Subjects experienced reversible middle ear barotrauma (5), transient deterioration in symptoms (4), and reversible bronchospasm (1); one subject withdrew. Post-treatment testing demonstrated significant improvement in: symptoms, neurological exam, full-scale IQ (+14.8 points; p<0.001), WMS IV Delayed Memory (p=0.026), WMS-IV Working Memory (p=0.003), Stroop Test (p<0.001), TOVA Impulsivity (p=0.041), TOVA Variability (p=0.045), Grooved Pegboard (p=0.028), PCS symptoms (Rivermead PCSQ: p=0.0002), PTSD symptoms (PCL-M: p<0.001), depression (PHQ-9: p<0.001), anxiety (GAD-7: p=0.007), quality of life (MPQoL: p=0.003), and self-report of percent of normal (p<0.001), SPECT coefficient of variation in all white matter and some gray matter ROIs after the first HBOT, and in half of white matter ROIs after 40 HBOT sessions, and SPECT statistical parametric mapping analysis (diffuse improvements in regional cerebral blood flow after 1 and 40 HBOT sessions). Forty 1.5 ATA HBOT sessions in 1 month was safe in a military cohort with chronic blast-induced PCS and PTSD. Significant improvements occurred in symptoms, abnormal physical exam findings, cognitive testing, and quality-of-life measurements, with concomitant significant improvements in SPECT.",0,0 +7135,A longitudinal analysis of posttraumatic stress disorder symptoms and their relationship with Fear and Anxious-Misery disorders: Implications for DSM-V,"This paper examined the hypothesis that PTSD-unique symptom clusters of re-experiencing, active avoidance and hyperarousal were more related to the fear/phobic disorders, while shared PTSD symptoms of dysphoria were more closely related to Anxious-Misery disorders (MDD/GAD). Confirmatory factor and correlation analyses examining PTSD, anxiety and mood disorder data from 714 injury survivors interviewed 3, 12 and 24-months following their injury supported this hypothesis with these relationships remaining robust from 3-24 months posttrauma. Of the nine unique fear-oriented PTSD symptoms, only one is currently required for a DSM-IV diagnosis. Increasing emphasis on PTSD fear symptoms in DSM-V, such as proposed DSM-V changes to mandate active avoidance, is critical to improve specificity, ensure inclusion of dimensionally distinct features and facilitate tailoring of treatment.",0,0 +7136,An Introduction to Latent Class Growth Analysis and Growth Mixture Modeling,"In recent years, there has been a growing interest among researchers in the use of latent class and growth mixture modeling techniques for applications in the social and psychological sciences, in part due to advances in and availability of computer software designed for this purpose (e.g., Mplus and SAS Proc Traj). Latent growth modeling approaches, such as latent class growth analysis (LCGA) and growth mixture modeling (GMM), have been increasingly recognized for their usefulness for identifying homogeneous subpopulations within the larger heterogeneous population and for the identification of meaningful groups or classes of individuals. The purpose of this paper is to provide an overview of LCGA and GMM, compare the different techniques of latent growth modeling, discuss current debates and issues, and provide readers with a practical guide for conducting LCGA and GMM using the Mplus software.",0,0 +7137,Childhood physical abuse and combat-related posttraumatic stress disorder in Vietnam veterans,"Early trauma in the form of childhood physical or sexual abuse has been associated with adult psychopathology. The purpose of this study was to compare rates of childhood abuse in Vietnam veterans with and without combat-related posttraumatic stress disorder (PTSD).Premilitary stressful and traumatic events including childhood abuse and other potential predisposing factors were assessed in Vietnam combat veterans who sought treatment for PTSD (N = 38) and Vietnam combat veterans without PTSD who sought treatment for medical disorders (N = 28). Stressful and traumatic events including childhood physical abuse were assessed with the Checklist of Stressful and Traumatic Events and a clinician-administered interview for the assessment of childhood abuse. Level of combat exposure was measured with the Combat Exposure Scale.Vietnam veterans with PTSD had higher rates of childhood physical abuse than Vietnam veterans without PTSD (26% versus 7%). The association between childhood abuse and PTSD persisted after controlling for the difference in level of combat exposure between the two groups. Patients with PTSD also had a significantly higher rate of total traumatic events before joining the military than patients without PTSD (mean = 4.6, SD = 4.5, versus mean = 2.8, SD = 2.9).These findings suggest that patients seeking treatment for combat-related PTSD have higher rates of childhood physical abuse than combat veterans without PTSD. Childhood physical abuse may be an antecedent to the development of combat-related PTSD in Vietnam combat veterans.",0,0 +7138,Children with Multi-Trauma Histories: Special Considerations for Care and Implications for Treatment Selection,"The complex symptom profiles of young children with histories of trauma exposure underscore the importance of matching individual child characteristics and symptom needs with existing evidence-based treatment protocols. Children (N = 134) between the ages of 2–12 and their caregivers were administered the Child Behavioral Checklist, Trauma Symptom Checklist for Young Children, and the Trauma Symptom Checklist for Children-Alternate Version at baseline and end of treatment. ANCOVA analyses examined the relationships between the number of different types of trauma exposures, child gender, placement status, child age, type of treatment received, and end of treatment symptom scores. Child age at the start of treatment was found to influence externalizing and total problem scores at the end of treatment when baseline scale scores were held constant. Older children were found to have significantly higher levels of externalizing and total problem scores at the end of treatment compared to younger children in the sample. Significant improvements were found between baseline and termination outcome scores regardless of treatment type, however, results suggest that differences in severity of symptoms may vary by treatment type. Study findings suggest that latency age children and their caregivers may have differing trauma-related treatment needs compared to younger children and may benefit from an adjusted focus in treatment. The matching of individual child characteristics and need can help maximize emotional and behavioral outcomes and the addition of a cognitive-based treatment modality may be indicated for some children.",0,0 +7139,Possible cultural effects on the increments of somatic symptoms in subjectively resilient depressed patients,"Introduction While previous literatures have provided substantial evidence on the burden of somatic symptoms and the prognostic value of resilience in the treatment course of depression, little is speculated on the relationship between resilience and somatic symptoms in depressed patients. We aimed to clarify the relationship between resilience and somatic symptoms in depressed patients retrospectively. Methods Two hundred and fifty-four outpatients with depressive disorders participated in the study and completed self-administered questionnaires regarding demographic, clinical and psychological factors. We divided the patients into four groups based on their scores of Connor-Davidson Resilience Scale and Beck Depression Inventory. The partial correlation analysis was implemented to show the relationship between somatic symptoms and resilience after controlling for depression, and one-way analysis of variance was conducted to demonstrate the differences in somatization scores of Symptoms Checklist-90-Revised in the aforementioned four groups. Results After the correlation analysis, somatization was significantly correlated with resilience even after controlling for depressive symptoms. The one-way analysis of vairance and post-hoc analysis revealed statistically significant differences in somatization scores between the four groups, with the high Beck Depression Inventory, high Connor-Davidson Resilience Scale group having the highest somatization scores. Discussion Striving to be resilient during the peak of depression, cultural factors and positive illusions of depressed patients can result in high resilience scores and high somatization scores in depressed patients, and such clinical implications would help clinicians evaluate resilience and somatization in depressed patients with multidimensional aspects.",0,0 +7140,PTSD's underlying symptom dimensions and relations with behavioral inhibition and activation,"• We examined the relation between PTSD factors and BIS/BAS dimensions in a primary care sample. • PTSD's avoidance and dysphoria factor had a significantly greater association with BIS compared to BAS. • PTSD's re-experiencing factor related more to BIS than BAS. • PTSD's avoidance significantly mediated the relation between BIS/BAS and PTSD's dysphoria. Reinforcement sensitivity theory (RST) stipulates that individuals have a behavioral activation system (BAS) guiding approach (rewarding) behaviors ( Gray, 1971 , Gray, 1981 ), and behavioral inhibition system (BIS) guiding conflict resolution between approach and avoidance (punishment) behaviors ( Gray & McNaughton, 2000 ). Posttraumatic stress disorder (PTSD) severity overall relates to both BIS (e.g., Myers et al., 2012 , Pickett et al., 2011 ) and BAS ( Pickett et al., 2011 ). Using a more refined approach, we assessed specific relations between PTSD's latent factors ( Simms, Watson, & Doebbeling, 2002 ) and observed variables measuring BIS and BAS using 308 adult, trauma-exposed primary care patients. Confirmatory factor analysis and Wald chi-square tests demonstrated a significantly greater association with BIS severity compared to BAS severity for PTSD's dysphoria, avoidance, and re-experiencing factors. Further, PTSD's avoidance factor significantly mediated relations between BIS/BAS severity and PTSD's dysphoria factor.",0,0 +7141,Cognitive-behavioural interventions for mood and anxiety disorders in HIV: A systematic review,"Mood and anxiety disorders are highly prevalent and comorbid with HIV/AIDS. However, there is a paucity of research on the effectiveness of cognitive-behavioural interventions (CBI) for common mental disorders in HIV-infected adults. The present study sought to review the existing literature on the use of CBI for depression and anxiety in HIV-positive adults and to assess the effect size of these interventions.We did duplicate searches of databases (from inception to 17-22 May 2012). The following online databases were searched: PubMed, The Cochrane Central Register of Controlled Trials and PsychArticles.We identified 20 studies suitable for inclusion. A total of 2886 participants were enroled in these studies, of which 2173 participants completed treatment. The present review of the literature suggests that CBI may be effective in the treatment of depression and anxiety in individuals living with HIV/AIDS. Significant reductions in depression and anxiety were reported in intervention studies that directly and indirectly targeted depression and/or anxiety. Effect sizes ranged from 0.02 to 1.02 for depression and 0.04 to 0.70 for anxiety.Some trials included an immediate postintervention assessment but no follow-up assessments of outcome. This omission makes it difficult to determine whether the intervention effects are sustainable over time.The present review of the literature suggests that CBI may have a positive impact on the treatment of depression and anxiety in adults living with HIV/AIDS.",0,0 +7142,Substance use disorders among personality disordered patients admitted for day hospital treatment. Implications for service developments,"Personality disorders (PD) and substance use disorders (SUD) are highly comorbid conditions. However, their treatment services are often separated. The aims of this study was to investigate how extensive this separation was prior to a Norwegian health reform (2004) that promoted integration, and to discuss clinical challenges for an integrated treatment of PD and SUD. All patients with a diagnosis of PD (n=1783) admitted to 10 day hospital treatment programs (1993-2003) were examined. Diagnoses were assessed by Mini International Neuropsychiatric Interview and Structured Clinical Interview for DSM-IV interviews. Socio-demographic data, psychosocial functioning (Global Assessment of Functioning Scale), symptom distress (Symptom Check List-90-Revised), interpersonal problems (Circumplex of Interpersonal Problems) and treatment course were recorded. The majority of patients were females (72%) and the prevalence of SUD was low (14%). SUD occurred among all PD categories. Patients with borderline PD were over-represented and patients with cluster C disorders were under-represented in the SUD sample. The SUD sample contained more men and it was associated with more previous violence against self and others. The reported violence was partly explained by gender (males) and diagnoses (borderline and SUD). PD patients with SUD also displayed more aggression during treatment and dropped out more frequently. The findings demonstrate that the female dominated specialized psychiatric treatment services for PD to a large extent had excluded PD patients who also had SUD. The reasons are probably related to the surplus problems that characterized the SUD sample and gender issues. Implications for the development of the PD and SUD services with respect to an integrated treatment for these comorbid conditions are discussed.",0,0 +7143,Hemispheric asymmetry in non-linear interdependence of EEG in post-traumatic stress disorder,"While volumetric and metabolic imaging on post-traumatic stress disorder (PTSD) patients has been intensively performed, few studies using electroencephalograms (EEG) have been done as yet. The aim of the present study was to investigate abnormalities in functional connectivity of cortical networks in PTSD.Non-linear interdependence (NI), a measure of bidirectional, non-linear information transmission between two time series, was used. Resting EEG were recorded for 18 PTSD patients and 18 sex-matched healthy subjects on 16 channels with their eyes closed.The NI patterns in PTSD patients were hemisphere asymmetric: an increase in NI in the fronto-parieto-temporal regions of the left hemisphere (F7, F3, T3, C3, T5 and P3) and a decrease in the fronto-parieto-occipital regions of the right hemisphere (F4, C4, P4 and O2). The non-linearity of NI in EEG, estimated from the surrogate data method, exhibited an increase in the PTSD patients as compared with that of healthy subjects, particularly in the left hemispheric cortex.Abnormal functional connectivity in PTSD can be assessed using NI, a measure of multi-channel EEG.",0,0 +7144,Aripiprazole in the treatment of posttraumatic stress disorder: an open-label trial,"Post traumatic stress disorder is frequent in the general population (7.8%-lifetime-USA). The selective serotonin reuptake inhibitors are the first choice of treatment but result in low remission rates. This study aims to evaluate the effect of aripiprazole monotherapy for the treatment of post traumatic stress disorder.Thirty-two patients diagnosed with post traumatic stress disorder were included in a 16-week open label trial of aripiprazole. They were evaluated at baseline, week 8, and 16 with the Clinician-Administered PTSD Scale, Beck Depression Inventory, Beck Anxiety Inventory, Medical Outcome Study Short Form 36, and Social Adjustment Scale. Statistical analysis were performed with an intention-to-treat approach and last observation carried forward. A general linear model for repeated measures comparing the factor with 3 continuous measures from baseline, 8 and 16 weeks was used. A between-subject factor was includedNine patients discontinued the treatment. The mean aripiprazole dose was 9.6 (+/- 4.3) mg/day. The mean scores at baseline and endpoint for all measures were: Clinician-Administered PTSD Scale - 82.7 (+/- 23.1) and 51.4 (+/- 31.4) (F = 11.247, p = 0.001); Beck Anxiety Inventory - 31.7 (+/- 13.4) and 25.4 (+/- 18.2) (F = 8.931, p = 0.011); Social Adjustment Scale - 2.4 (+/- 0.45) and 2.27 (+/- 0.57) (F = 8.633, p = 0.012); Medical Outcome Study Short Form 36 - 76.6 (+/- 14.11) and 94.01 (+/- 25.06) (F = 10.127 p = 0.007); and Beck Depression Inventory - 26.06 (+/- 11.6) and 21.35 (+/- 12.6) (F = 1.580, p = 0.042). In all measurements, the differences were statistically significant.Patients achieved a good response to treatment with aripiprazole, but placebo-controlled studies are needed for more accurate results.",0,0 +7145,Posttraumatic stress disorder in older adults: an overview of characteristics and treatment approaches,"Posttraumatic stress disorder (PTSD) is a common and disabling condition following a traumatic event. Despite its high prevalence rates, relatively little is known about the manifestation and course of the disorder in older adults. Moreover, there has been little evaluation of the efficacy of psychotherapeutic treatment approaches for older patients.This overview aims to summarize available data on the prevalence and symptoms of late-life PTSD and to review the current treatment approaches for older adults.The course and severity of PTSD symptoms in older adults depend on the time the trauma occurred (early versus late life). In the case of acute traumatization, lower prevalence rates and symptom severities are generally observed in older than in younger populations. In the case of early-life traumatization, a decline in PTSD symptom severity can be observed over the life course. Research on treatment approaches has produced promising results, indicating that disorder-specific interventions (i.e., trauma confrontation and cognitive restructuring) can be effectively combined with an age-specific narrative life-review approach.Given the limited empirical evidence, caution is warranted in generalizing the reported findings. Nevertheless, it is possible to draw a number of conclusions concerning the characteristics and treatment of PTSD in older adults. Further research is needed to better understand the various presentations of PTSD in late life and to validate and improve the effectiveness of available treatment approaches.",0,0 +7146,N-glycosylation profiling of plasma provides evidence for accelerated physiological aging in post-traumatic stress disorder,"The prevalence of age-related diseases is increased in individuals with post-traumatic stress disorder (PTSD). However, the underlying biological mechanisms are still unclear. N-glycosylation is an age-dependent process, identified as a biomarker for physiological aging (GlycoAge Test). To investigate whether traumatic stress accelerates the aging process, we analyzed the N-glycosylation profile in n=13 individuals with PTSD, n=9 trauma-exposed individuals and in n=10 low-stress control subjects. Individuals with PTSD and trauma-exposed individuals presented an upward shift in the GlycoAge Test, equivalent to an advancement of the aging process by 15 additional years. Trauma-exposed individuals presented an intermediate N-glycosylation profile positioned between severely traumatized individuals with PTSD and low-stress control subjects. In conclusion, our data suggest that cumulative exposure to traumatic stressors accelerates the process of physiological aging.",0,0 +7147,Hippocampal volume in borderline personality disorder with and without comorbid posttraumatic stress disorder: A meta-analysis,"Abstract Background Several studies have found a reduction in hippocampal volume in borderline personality disorder (BPD) patients. Methods In order to investigate the degree to which comorbid posttraumatic stress disorder (PTSD) could account for reduction in hippocampal volume in these patients, we conducted a systematic review and meta-analysis of studies that compared hippocampal volume in BPD patients with and without PTSD relative to healthy controls. Results Seven articles, involving 124 patients and 147 controls, were included. We found a statistically significant reduction for the left and right hippocampus. Data from the four studies that discriminated BPD patients with and without PTSD indicate that hippocampal volumes were reduced bilaterally in BPD patients with PTSD, relative to healthy controls, but that results were mixed for BPD patients without PTSD, relative to healthy controls. Conclusions Results from this meta-analysis suggest that hippocampal volumes are reduced in patients with BPD, relative to healthy controls, but particularly in cases in which patients are diagnosed with comorbid PTSD.",0,0 +7148,Two Sides of the Same Coin: Cannabis Dependence and Mental Health Problems in Help-Seeking Adolescent and Young Adult Outpatients,"The aim of the current study was to delineate the psychiatric profile of cannabis dependent young people (14-29 years old) with mental health problems (N = 36) seeking treatment via a research study. To do so, the Structured Clinical Interview for DSM-IV-TR Axis I Disorders and the Structured Clinical Interview for DSM-IV Childhood Diagnoses were used to obtain DSM-IV diagnoses, while a modified Timeline Followback interview and self-reports were used to measure cannabis use, cannabis-related problems, and impairment. Most individuals had at least two Axis I disorders in addition to cannabis dependence. Anxiety disorders were common, with posttraumatic stress disorder, social phobia, and generalised anxiety disorder accounting for the majority of these diagnoses. On average, young people reported a moderate degree of dependence and functional impairment, and a substantial number of cannabis-related problems. Although both males and females reported using similar quantities of cannabis per month, females reported using cannabis more frequently than males. The current data suggest that young people who present for cannabis use treatment in the context of a mental health issue may have a variety of psychiatric problems that need addressed and that males and females may have slightly different profiles. If cannabis use treatments are to advance for this population, more attention needs to be paid to the complex issues that young people present to treatment with.",0,0 +7149,"Affective forecasts and the Valentine's Day shootings at NIU: People are resilient, but unaware of it","People overestimate the extent to which emotion-producing life events affect subsequent affect. However, research has yet to conclusively demonstrate that this phenomenon occurs following significant trauma affecting entire communities, or whether it applies to predictions of discrete emotions. Exploring such issues, student reports of emotion states were collected both before and after the oncampus Valentine's Day, 2008 shootings at Northern Illinois University (NIU). A separate group of students not on campus when the shootings occurred provided emotion state reports and predictions of the emotions they would expect to experience 2 weeks after a shooting occurred. Examination of these data suggests that: (1) emotion states of NIU students reflected resilience, and (2) students made affective forecasting errors indicating that this resilience was unexpected. These data confirm results of prior affective forecasting studies, extending them to cases of traumatic experiences, and suggest that such studies c...",0,0 +7150,Impact of Chronic Critical Illness on the Psychological Outcomes of Family Members,"The uncertain trajectory of chronic critical illness exposes the patient's family to heightened levels of psychological distress. Symptoms of psychological distress affect more than half of family members exposed to the patient's chronic critical illness. Although symptoms often dissipate over time, a significant proportion of family members will remain at moderate to high risk for psychological distress well after the patient's death or discharge from the intensive care unit. Family members of chronically critically ill patients are often involved in the decision making for the patients. Irrational or uninformed decision making can occur when family members experience high levels of psychological distress. Attention to the psychological needs and provision of support to family members enhance the formulation of treatment decisions consistent with the patient's preferences and mitigate unnecessary resource use. In this article, the impact of chronic critical illness on family members' risk for depression, anxiety, and posttraumatic stress disorder is described and a review of evidence-based strategies to support the psychological needs of family members coping with a patient's chronic critical illness is provided.",0,0 +7151,Characterizing the resilient officer: Individual attributes at point of entry to policing.,"Research investigating the process of adaptation in newly recruited police officers is scarce and has yielded mixed results. Some research highlights the incidence of difficulty in adjusting to the role of police officer such as predictors of elevated stress and symptoms of posttraumatic stress disorder (PTSD). Others have investigated why the majority of officers are resilient to the work and organizational challenges presented. This article examines personality, prior experience, and coping strategies of 94 newly recruited Australian police officers. The data provide a picture of police personnel who are not selected with personality profiling. Results demonstrated that the officers' personality profiles, as measured by the NEO Five-Factor Inventory, were consistent with U.S. adult norms, except for elevated levels of extraversion. Common coping strategies include positive reinterpretation, acceptance, and planning. Measures of PTSD and positive posttrauma changes were higher in recruits who had endured...",0,0 +7152,Prevention of Trauma and Stressor-Related Disorders: A Review,"Posttraumatic stress disorder (PTSD) is a common, frequently chronic, and disabling condition which, along with acute stress disorder (ASD), is categorized as a trauma- and stressor-related disorder by the DSM-5. These disorders are unique in requiring exposure to a severe stressor, which implies that potential sufferers could be identified and helped before developing a disorder. Research on prevention strategies for stress-related disorders has taken a number of avenues, including intervention before and after trauma and the use of both psychosocial and somatic approaches. Despite advances in neurobiological understanding of response to trauma, clinical evidence for preventive interventions remains sparse. This review provides an overview of prevention approaches and summarizes the existing literature on prevention of ASD and PTSD, including clinical and preclinical studies. Given the potential benefits to trauma survivors and society, the development of effective preventive interventions should be given greater priority. Resources should be directed to adequately test promising interventions in clinical trials, and research should be conducted according to translational research principles in which preclinical research informs the design of clinical studies.",0,0 +7153,Mixture or Homogeneous? Comment on Bauer and Curran (2003).,"D. J. Bauer and P. J. Curran (2003) raised some interesting issues with respect to mixture models of growth curves. Many useful lessons can be learned from their work, and more can be learned by extending the inquiry in related directions. These lessons involve the following issues: (a) what a mixture distribution looks like, (b) the meaning of the term homogeneous distribution, (c) the importance of model checking, (d) advantages and disadvantages of using mixtures and similar procedures to approximate complicated distributions, and (e) intrinsic versus nonintrinsic transformability.",0,0 +7154,Psychosocial Implications During Adolescence for Infant Heart Transplant Recipients,"As more heart transplant recipients survive into late adolescence, research addressing long-term psychosocial and neurodevelopmental outcomes is imperative. The limited literature available suggests risk for psychosocial difficulties and lower cognitive, academic, and neuropsychological functioning. This paper reviews topic-related literature and provides preliminary data examining psychosocial and neuropsychological functioning of adolescents who received their heart transplant during infancy.This paper offers a literature review AND presents preliminary data from studies conducted through Loma Linda University Children's Hospital (LLUCH). Study one examined psychosocial functioning and quality of life of adolescent infant heart transplant recipients. In study two, cognitive, academic, and neuropsychological data were analyzed.Study 1: Overall psychosocial functioning fell in the Average range, however, a significant percentage of participants presented with difficulties on one or more of the psychosocial domains. Quality of life was also within normal limits, though concerns with general health and bodily discomfort were noted. Study 2: Cognitive functioning was assessed to be Below Average, with 43-62% of the participants demonstrating significant impairments. Neuropsychological functioning yielded significant weakness on language functioning, and mild weakness on visual-motor integration and executive functioning.While the majority of the participants demonstrate psychosocial resiliency, a subgroup present with difficulties suggesting the need for intervention. Cognitive/neuropsychological functioning suggests poorer functioning with patterns similar to other high-risk pediatric populations. These results are preliminary and further research on long-term psychosocial and neuropsychological development of pediatric heart transplant recipients is needed to better understand and ameliorate developmental trajectories.",0,0 +7155,Posttraumatic stress disorder symptom severity and HIV-risk behaviors among substance-dependent inpatients,"Despite findings that the co-occurrence of posttraumatic stress disorder (PTSD) and substance use disorders (SUD) is associated with heightened risk for a variety of risky behaviors, few studies have examined behaviors linked to heightened risk for HIV infection and transmission in particular, or explored the unique associations between specific PTSD symptom clusters and these HIV-risk behaviors. Therefore, the goal of this study was to examine the associations between PTSD symptom severity and HIV-risk behaviors (i.e., risky sexual behavior [RSB] and injection drug use [INJ]) within an ethnically diverse sample of 85 SUD patients in residential SUD treatment. Participants completed a battery of questionnaires assessing PTSD symptom severity and HIV-risk behaviors, including RSB and INJ. Results demonstrated significant positive associations between PTSD symptom severity and RSB; however, no significant relationship between PTSD symptom severity and INJ was found. Furthermore, the severity of hyperarousal symptoms in particular was found to significantly predict RSB above and beyond age and all other PTSD symptom clusters. Results of this study suggest that PTSD symptoms (and, more specifically, the hyperarousal symptoms of PTSD) may heighten the risk for some forms of HIV-risk behaviors (RSB) but not others (INJ). Results highlight the importance of identifying and targeting hyperarousal symptoms in the treatment of SUD patients experiencing symptoms of PTSD in order to reduce HIV infection or transmission risk.",0,0 +7156,"Trauma Type and Gender Effects on PTSD, General Distress, and Peritraumatic Dissociation","This study examined the independent and interaction effects of trauma type and gender on posttraumatic stress disorder (PTSD), general psychopathology, and peritraumatic dissociation. We assessed 1,503 college students (58.3% female) who experienced a natural disaster, loss of a loved one, or interpersonal violence. Interpersonal violence survivors, those with multiple trauma histories, and women reported more PTSD symptoms, general psychopathology, and peritraumatic dissociation than other trauma group survivors, single trauma group survivors, and men. A trauma type by gender interaction was identified for peritraumatic dissociation. The results are discussed within the context of clinical practice and assessment.",0,0 +7157,Impaired Response Inhibition in Veterans with Post-Traumatic Stress Disorder and Mild Traumatic Brain Injury,"Abstract Combat veterans with post-traumatic stress disorder (PTSD) can show impairments in executive control and increases in impulsivity. The current study examined the effects of PTSD on motor response inhibition, a key cognitive control function. A Go/NoGo task was administered to veterans with a diagnosis of PTSD based on semi-structured clinical interview using DSM-IV criteria ( n = 40) and age-matched control veterans ( n = 33). Participants also completed questionnaires to assess self-reported levels of PTSD and depressive symptoms. Performance measures from the patients (error rates and reaction times) were compared to those from controls. PTSD patients showed a significant deficit in response inhibition, committing more errors on NoGo trials than controls. Higher levels of PTSD and depressive symptoms were associated with higher error rates. Of the three symptom clusters, re-experiencing was the strongest predictor of performance. Because the co-morbidity of mild traumatic brain injury (mTBI) and PTSD was high in this population, secondary analyses compared veterans with PTSD+mTBI ( n = 30) to veterans with PTSD only ( n = 10). Although preliminary, results indicated the two patient groups did not differ on any measure ( p > .88). Since cognitive impairments could hinder the effectiveness of standard PTSD therapies, incorporating treatments that strengthen executive functions might be considered in the future. ( JINS , 2012, 18 , 1–10)",0,0 +7158,Predicting post‐traumatic growth and post‐traumatic stress in firefighters,"Emergency service workers (e.g., firefighters, police, and paramedics) are exposed to elevated levels of potentially traumatising events through the course of their work. Such exposure can have lasting negative consequences (e.g., post‐traumatic stress disorder (PTSD)) and/or positive outcomes (e.g., post‐traumatic growth (PTG)). Research had implicated trauma, occupational and personal variables that account for variance in post‐trauma outcomes yet at this stage no research has investigated these factors and their relative influence on both PTSD and PTG in a single study. Based in Calhoun and Tedeschi's model of PTG and previous research, in this study regression models of PTG and PTSD symptoms among 218 firefighters were tested. Results indicated organisational factors predicted symptoms of PTSD, while there was partial support for the hypothesis that coping and social support would be predictors of PTG. Experiencing multiple sources of trauma, higher levels of organisational and operational stress, and utilising cognitive reappraisal coping were all significant predictors of PTSD symptoms. Increases in PTG were predicted by experiencing trauma from multiple sources and the use of self‐care coping. Results highlight the importance of organisational factors in the development of PTSD symptoms, and of individual factors for promoting PTG.",0,0 +7159,Mechanisms of change in cognitive behavioral therapy for panic disorder: The unique effects of self-efficacy and anxiety sensitivity,"The present study examined temporal dependencies of change of panic symptoms and two promising mechanisms of change (self-efficacy and anxiety sensitivity) during an 11-session course of cognitive-behavior therapy (CBT) for Panic Disorder (PD). 361 individuals with a principal diagnosis of PD completed measures of self-efficacy, anxiety sensitivity, and PD symptoms at each session during treatment. Effect size analyses indicated that the greatest changes in anxiety sensitivity occurred early in treatment, whereas the greatest changes in self-efficacy occurred later in treatment. Results of parallel process latent growth curve models indicated that changes in self-efficacy and anxiety sensitivity across treatment uniquely predicted changes in PD symptoms. Bivariate and multivariate latent difference score models indicated, as expected, that changes in anxiety sensitivity and self-efficacy temporally preceded changes in panic symptoms, and that intraindividual changes in anxiety sensitivity and self-efficacy independently predicted subsequent intraindividual changes in panic symptoms. These results provide strong evidence that changes in self-efficacy and anxiety sensitivity during CBT influence subsequent changes in panic symptoms, and that self-efficacy and anxiety sensitivity may therefore be two distinct mechanisms of change of CBT for PD that have their greatest impact at different stages of treatment.",0,0 +7160,Examining a Comprehensive Model of Disaster-Related Posttraumatic Stress Disorder in Systematically Studied Survivors of 10 Disasters,"Objectives. Using a comprehensive disaster model, we examined predictors of posttraumatic stress disorder (PTSD) in combined data from 10 different disasters. Methods. The combined sample included data from 811 directly exposed survivors of 10 disasters between 1987 and 1995. We used consistent methods across all 10 disaster samples, including full diagnostic assessment. Results. In multivariate analyses, predictors of PTSD were female gender, younger age, Hispanic ethnicity, less education, ever-married status, predisaster psychopathology, disaster injury, and witnessing injury or death; exposure through death or injury to friends or family members and witnessing the disaster aftermath did not confer additional PTSD risk. Intentionally caused disasters associated with PTSD in bivariate analysis did not independently predict PTSD in multivariate analysis. Avoidance and numbing symptoms represented a PTSD marker. Conclusions. Despite confirming some previous research findings, we found no associations between PTSD and disaster typology. Prospective research is needed to determine whether early avoidance and numbing symptoms identify individuals likely to develop PTSD later. Our findings may help identify at-risk populations for treatment research.",0,0 +7161,What we don't expect when expecting: Evidence for heterogeneity in subjective well-being in response to parenthood.,"A recent article in New York Magazine echoed what psychological studies of parenthood have consistently demonstrated since the 1970s: ""Most people assume that having children will make them happier. Yet a wide variety of academic research shows that parents are not happier than their childless peers, and in many cases are less so"" (Senior, 2010). There is consistent evidence that, as opposed to other life events that cause transient disruptions in life satisfaction, becoming a parent appears to cause harm to individual subjective well-being (Twenge, Campbell, & Foster, 2003), and that this harm is sustained over time (Clark, Diener, Georgellis, & Lucas, 2008). The current investigation was predicated on the concern that these findings may be the result of the methodology used to examine them. As the experience of parenthood does not represent a unified phenomenon, we employed a methodological approach that allows for the exploration of heterogeneity as well as its predictors. By modeling heterogeneous trajectories within a prospective design from 4 years prior to 4 years after the birth of a parent's first child, we find that the majority of individuals (84.2%) demonstrate no long-term effects on life satisfaction in response to childbirth. Only a small percentage demonstrate the sustained declines (7.2%), and a significant cohort, previously unobserved in the literature, demonstrate dramatic and sustained improvements in response to parenthood (4.3%), providing compelling evidence for heterogeneity in life satisfaction among parents. Key demographic covariates that distinguish between trajectories of response are also explored.",0,0 +7162,An Office Mental Status Examination for Complex Chronic Dissociative Symptoms and Multiple Personality Disorder,"Chronic complex dissociative symptoms can be readily inquired about in the diagnostic interview leading to a clinical diagnosis of MPD in many cases. It is most useful to begin with inquiry about amnesia, autohypnotic, posttraumatic, pseudopsychotic, and passive-influence symptoms, and childhood abuse or traumatization. As this proceeds, overt dissociation is commonly noted including spontaneous trances, age-regression, blending or overlap of states, or frank switching. When this occurs, the interviewer can pursue more detailed information about the patient's experiences. Tracking these processes may readily lead to the clear appearance of an alter personality or will help make the patient sufficiently comfortable that he or she will allow the full emergence of an alter if this is directly requested. In other cases, however, methods such as use of ideomotor signals, formal induction of trance, and even barbiturate-facilitated interviews may be necessary to permit the full emergence of an alter. The symptom-cluster method is a useful clinical diagnostic tool to elicit dissociative symptoms for the diagnosis of MPD. Combined with diagnostic tools such as the DES, the DDIS, and the SCID-D, this method can help the clinician make the diagnosis of MPD in a far more expeditious and rigorous fashion. In addition, all psychiatric patients should be screened for a history of blackouts, time loss, trance experiences, childhood trauma, and PTSD symptoms. This will improve case finding to help clinicians begin to treat the single largest preventable cause of mental illness: the sequelae of childhood abuse, trauma, and family violence.",0,0 +7163,Prediction of PTSD in Police Officers after Six Months – a Prospective Study,"The aim of this prospective study was to explore the predictors for the development of PTSD in police officers six months after encountering situations of a potentially traumatic nature. Fifty-nine police officers were studied immediately after the event (T1) and six months later (T2). At T2 PTSD was assessed using the Structured Clinical Interview for DSM-IV (SCID-I). PTSD was predicted by intrusions (Impact of Event Scale–Revised; IES-R), the impairment scale (is), global assessment of functioning scale (GAF), gender, age and sense of coherence scale (SOC). The diagnosis of an acute stress disorder (ASD) at T1 had a high specificity for identifying PTSD at T2. The strongest predictor for the development of PTSD was found to be the factor intrusions. Contrary to our expectations, age was not a significant predictive factor for PTSD. Thus, acute stress disorder (ASD) and a high degree of intrusions experienced immediately after a traumatic incident helped to identify early police officers at risk of developing chronic PTSD.",0,0 +7164,Long-Term Trajectories of PTSD in Vietnam-Era Veterans: The Course and Consequences of PTSD in Twins,"We estimated the temporal course of posttraumatic stress disorder (PTSD) in Vietnam-era veterans using a national sample of male twins with a 20-year follow-up. The complete sample included those twins with a PTSD diagnostic assessment in 1992 and who completed a DSM-IV PTSD diagnostic assessment and a self-report PTSD checklist in 2012 (n = 4,138). Using PTSD diagnostic data, we classified veterans into 5 mutually exclusive groups, including those who never had PTSD, and 4 PTSD trajectory groups: (a) early recovery, (b) late recovery, (c) late onset, and (d) chronic. The majority of veterans remained unaffected by PTSD throughout their lives (79.05% of those with theater service, 90.85% of those with nontheater service); however, an important minority (10.50% of theater veterans, 4.45% of nontheater veterans) in 2012 had current PTSD that was either late onset (6.55% theater, 3.29% nontheater) or chronic (3.95% theater, 1.16% nontheater). The distribution of trajectories was significantly different by theater service (p < .001). PTSD remains a prominent issue for many Vietnam-era veterans, especially for those who served in Vietnam.",0,0 +7165,Brief report: The relationship between post‐traumatic stress disorder symptoms and overgeneral autobiographical memory in older adults,The aim of this study was to investigate the relationship between post‐traumatic stress disorder (PTSD) symptoms and autobiographical memory specificity in older adults.Older adult trauma survivors...,0,0 +7166,Effects of Heat Stress and Sex on Pacing in Marathon Runners,"Recent research suggests that women tend to exhibit less of a precipitous decline in run velocity during the latter stages of a marathon than men when the covariates of age and run time are controlled for. The purpose of this study was to examine this sex effect with the added covariate of heat stress on pacing, defined as the mean velocity of the last 12.2 km divided by the mean velocity of the first 30 km. A secondary purpose of this investigation was to compare the pacing profiles of the elite men and women runners and the pacing profiles of the elite and nonelite runners. Subjects included 22,990 men and 13,233 women runners from the 2007 and 2009 Chicago marathons for which the mean ambient temperatures were 26.67° C and 2.77° C, respectively. Each 5-km split time was measured via an electronic chip worn on the participants' shoe. Multiple regression analysis indicated that age, sex, heat stress, and overall finish time (p < 0.01 for each) were simultaneous independent elements of pacing. Nonelite women were consistently better pacers than nonelite men in both marathons, and this sex difference was magnified from cold to warm race temperatures. No difference (p < 0.05) in pacing was found between elite men and women runners. Elite men and women had enhanced pacing over their nonelite counterparts. In hotter temperatures, coaches of novice runners should advise their athletes to implement a slower initial velocity to maintain or increase running velocity later in the race.",0,0 +7167,The relationship of peritraumatic dissociation and posttraumatic stress: Findings in female Vietnam theater veterans.,,0,0 +7168,"The Prevalence of Trauma and Childhood Adversity in an Urban, Hospital-Based Violence Intervention Program","Hospitals represent a promising locus for preventing recurrent interpersonal violence and its psychological sequella. We conducted a cross-sectional analysis to assess the prevalence of post-traumatic stress disorder (PTSD) and adverse childhood experiences (ACEs) among victims of interpersonal violence participating in a hospital-based violence intervention program. Participants completed PTSD and ACE screenings four to six weeks after violent injury, and data were exported from a case management database for analysis. Of the 35 program participants who completed the ACE and/or PTSD screenings, 75.0% met full diagnostic criteria for PTSD, with a larger proportion meeting diagnostic criteria for symptom-specific clusters. For the ACE screening, 56.3% reported three or more ACEs, 34.5% reported five or more ACEs, and 18.8% reported seven or more ACEs. The median ACE score was 3.5. These findings underscore the importance of trauma-informed approaches to violence prevention in urban hospitals and have implications for emergency medicine research and policy.",0,0 +7169,Dysfunctional meaning of posttraumatic intrusions in chronic PTSD,"The paper suggests that the negative idiosyncratic meaning of posttraumatic intrusions (e.g., 'I am going crazy') and cognitive strategies intended to control the intrusions play a major role in maintaining posttraumatic stress disorder. Two studies of 159 and 138 motor vehicle accidents survivors showed that the dysfunctional meaning of intrusions explained a proportion of the variance of the intrusion-related distress, strategies used to end the intrusions, and PTSD severity that was not explained by intrusion frequency, accident severity, or by general catastrophic thoughts when anxious. Rumination, thought suppression, and distraction when having intrusions showed substantial correlations with PTSD severity, as did avoidance of reminders of the accident. The results have implications for the treatment of chronic PTSD.",0,0 +7170,Mechanisms of Change in Written Exposure Treatment of Posttraumatic Stress Disorder,"Although the effectiveness of exposure therapy for PTSD is recognized, treatment mechanisms are not well understood. Emotional processing theory (EPT) posits that fear reduction within and between sessions creates new learning, but evidence is limited by self-report assessments and inclusion of treatment components other than exposure. We examined trajectories of physiological arousal and their relation to PTSD treatment outcome in a randomized controlled trial of written exposure treatment, a protocol focused on exposure to trauma memories. Hierarchical linear modeling was used to model reduction in Clinician Administered PTSD Scale score as a predictor of initial activation and within- and between-session change in physiological arousal. Treatment gains were significantly associated with initial physiological activation, but not with within- or between-session changes in physiological arousal. Treatment gains were associated with larger between-session reductions in self-reported arousal. These findings highlight the importance of multimethod arousal assessment and add to a growing literature suggesting refinements of EPT.",0,0 diff --git a/examples/prior_example/jobs.sh b/examples/prior_example/jobs.sh new file mode 100644 index 0000000..c0aba7a --- /dev/null +++ b/examples/prior_example/jobs.sh @@ -0,0 +1,35 @@ + + +# version 0.9.3.dev33+g89c72db + +# Create folder structure. By default, the folder 'output' is used to store output. +mkdir output +mkdir output/simulation +mkdir output/simulation/metrics +mkdir output/figures +mkdir output/tables/metrics +mkdir output/tables/time_to_discovery + +mkdir output/simulation/descriptives +python -m asreview data describe generated_data\dataset_with_priors.csv -o output/simulation/descriptives/data_stats_dataset_with_priors.json +python -m asreview data describe generated_data\dataset_without_priors.csv -o output/simulation/descriptives/data_stats_dataset_without_priors.json + +python -m asreview wordcloud generated_data\dataset_with_priors.csv -o output/figures/wordcloud_dataset_with_priors.png --width 800 --height 500 +python -m asreview wordcloud generated_data\dataset_with_priors.csv -o output/figures/wordcloud_relevant_dataset_with_priors.png --width 800 --height 500 --relevant +python -m asreview wordcloud generated_data\dataset_with_priors.csv -o output/figures/wordcloud_irrelevant_dataset_with_priors.png --width 800 --height 500 --irrelevant + +python -m asreview wordcloud generated_data\dataset_without_priors.csv -o output/figures/wordcloud_dataset_without_priors.png --width 800 --height 500 +python -m asreview wordcloud generated_data\dataset_without_priors.csv -o output/figures/wordcloud_relevant_dataset_without_priors.png --width 800 --height 500 --relevant +python -m asreview wordcloud generated_data\dataset_without_priors.csv -o output/figures/wordcloud_irrelevant_dataset_without_priors.png --width 800 --height 500 --irrelevant + +python -m asreview simulate generated_data\dataset_with_priors.csv -s output/simulation/state_files/sim_with_priors.asreview --seed 165 -m nb -e tfidf -q max -b double --n_instances 1 --stop_if min --prior_idx 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 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output/simulation/state_files/sim_without_priors.asreview --init_seed 535 --seed 165 -m nb -e tfidf -q max -b double --n_instances 1 --stop_if min +python -m asreview metrics output/simulation/state_files/sim_without_priors.asreview -o output/simulation/metrics/metrics_sim_without_priors.json + +# Generate plot and tables for dataset +python scripts/get_plot.py -s output/simulation/state_files/ -o output/figures/plot_recall_sim.png -l filename --hide_random +python scripts/merge_metrics.py -s output/simulation/metrics/ -o output/tables/metrics/metrics_sim.csv +python scripts/merge_tds.py -s output/simulation/metrics/ -o output/tables/time_to_discovery/tds_sim.csv +python scripts/merge_descriptives.py -s output/simulation/descriptives/ \ No newline at end of file diff --git a/examples/prior_example/scripts/get_plot.py b/examples/prior_example/scripts/get_plot.py new file mode 100644 index 0000000..92e037e --- /dev/null +++ b/examples/prior_example/scripts/get_plot.py @@ -0,0 +1,119 @@ +"""Script to get dataset sorted on the average time to discovery. + +Example +------- + +> python scripts/get_plot.py + +or + +> python scripts/get_plot.py -s asreview_files -o plot.png + + +Authors +------- +- Teijema, Jelle +""" + +# version 0.9.3.dev33+g89c72db + +import argparse +from pathlib import Path + +import matplotlib.pyplot as plt +from asreview import open_state + +from asreviewcontrib.insights.plot import plot_recall + + +def _set_legend(ax, state, legend_option, label_to_line, state_file, hide_random): + metadata = state.settings_metadata + label = None + + if legend_option == "filename": + label = state_file.stem + elif legend_option == "model": + label = " - ".join( + [ + metadata["settings"]["model"], + metadata["settings"]["feature_extraction"], + metadata["settings"]["balance_strategy"], + metadata["settings"]["query_strategy"], + ] + ) + elif legend_option == "classifier": + label = metadata["settings"]["model"] + else: + try: + label = metadata["settings"][legend_option] + except KeyError as err: + raise ValueError(f"Invalid legend setting: '{legend_option}'") from err # noqa: E501 + + if label: + line_index = -2 if not hide_random else -1 + # add label to line + if label not in label_to_line: + ax.lines[line_index].set_label(label) + label_to_line[label] = ax.lines[line_index] + # set color of line to the color of the first line with the same label + else: + ax.lines[line_index].set_color(label_to_line[label].get_color()) + ax.lines[line_index].set_label("_no_legend_") + +def get_plot_from_states(states, filename, legend=None, hide_random=False): + """Generate an ASReview plot from state files. + + Arguments + --------- + states: list + List of state files. + filename: str + Filename of the plot. + legend: str + Add a legend to the plot, based on the given parameter. + Possible values: "filename", "model", "feature_extraction", + "balance_strategy", "query_strategy", "classifier". + """ + states = sorted(states) + fig, ax = plt.subplots() + label_to_line = {} + + for state_file in states: + with open_state(state_file) as state: + plot_recall(ax, state, show_random = not hide_random) + if legend: + _set_legend(ax, state, legend, label_to_line, state_file, hide_random) + + if legend: + ax.legend(loc=4, prop={"size": 8}) + fig.savefig(str(filename)) + + +if __name__ == "__main__": + parser = argparse.ArgumentParser( + description="Generate an ASReview plot from the found state files." + ) + parser.add_argument("-s", type=str, help="States location") + parser.add_argument("-o", type=str, help="Output location") + parser.add_argument( + "--show_legend", + "-l", + type=str, + help="Add a legend to the plot, based on the given parameter.", + ) + parser.add_argument( + "--hide_random", + action="store_true", + help="Hide the random line.", + ) + args = parser.parse_args() + + # load states + states = list(Path(args.s).glob("*.asreview")) + + # check if states are found + if len(states) == 0: + raise FileNotFoundError(f"No state files found in {args.s}") + + # generate plot and save results + get_plot_from_states(states, args.o, args.show_legend, args.hide_random) diff --git a/examples/prior_example/scripts/merge_descriptives.py b/examples/prior_example/scripts/merge_descriptives.py new file mode 100644 index 0000000..30ea23b --- /dev/null +++ b/examples/prior_example/scripts/merge_descriptives.py @@ -0,0 +1,79 @@ +"""Script to merge descriptive files. + +Example +------- + +> python scripts/merge_descriptives.py + +or + +> python scripts/merge_descriptives.py -s data_descriptives + +or + +> python scripts/merge_descriptives.py -o my_table.json + +Authors +------- +- De Bruin, Jonathan +""" + +# version 0.9.3.dev33+g89c72db + +import argparse +import glob +import json +from pathlib import Path + +import pandas as pd + + +def create_table_descriptives(datasets): + """Merge dataset descriptives.""" + + stats = [] + + for ds in datasets: + with open(ds) as f: + data = json.load(f)["data"]["items"] + values = {} + for item in data: + values[item["id"]] = item["value"] + stats.append(values) + + df = pd.DataFrame(stats, index=[Path(ds).name for ds in datasets]) + return df + + +if __name__ == "__main__": + parser = argparse.ArgumentParser( + description="Merge descriptives of multiple files into single table." + ) + parser.add_argument( + "-s", + type=str, + default="output/simulation/*/descriptives/", + help="Datasets location", + ) + parser.add_argument( + "-o", + type=str, + default="output/tables/data_descriptives_all.csv", + help="Output table location", + ) + args = parser.parse_args() + + # load datasets + datasets = glob.glob(args.s + "data_stats_*.json") + + # check if states are found + if len(datasets) == 0: + raise FileNotFoundError("No datasets found in " + args.s) + + # merge results + result = create_table_descriptives(datasets) + + # store result in output folder + Path(args.o).parent.mkdir(parents=True, exist_ok=True) + result.to_csv(Path(args.o)) + result.to_excel(Path(args.o).with_suffix(".xlsx")) diff --git a/examples/prior_example/scripts/merge_metrics.py b/examples/prior_example/scripts/merge_metrics.py new file mode 100644 index 0000000..6071404 --- /dev/null +++ b/examples/prior_example/scripts/merge_metrics.py @@ -0,0 +1,84 @@ +"""Script to merge metric files. + +Example +------- + +> python scripts/merge_metrics.py + +or + +> python scripts/merge_metrics.py -s simulation_metrics + +or + +> python scripts/merge_metrics.py -o my_table.json + +Authors +------- +- De Bruin, Jonathan +""" + +# version 0.9.3.dev33+g89c72db + +import argparse +import glob +import json +from pathlib import Path + +import pandas as pd + + +def create_table_state_metrics(metric_files): + metrics = [] + + for metric in metric_files: + with open(metric) as f: + data = json.load(f)["data"]["items"] + values = {} + values["file_name"] = Path(metric).name + for item in data: + if item["id"] == "td": + continue + # check if value is a list + if item["value"] is not None and isinstance(item["value"], list): + for value in item["value"]: + values[item["id"] + "_" + str(value[0])] = value[1] + else: + values[item["id"]] = item["value"] + metrics.append(values) + + return pd.DataFrame(metrics) + + +if __name__ == "__main__": + parser = argparse.ArgumentParser( + description="Merge metrics of multiple states into single table." + ) + parser.add_argument( + "-s", + type=str, + default="output/simulation/*/metrics/", + help="states location", + ) + parser.add_argument( + "-o", + type=str, + default="output/tables/metrics_sim_all.csv", + help="Output table location", + ) + args = parser.parse_args() + + # load metric files + metric_files = glob.glob(args.s + "metrics_sim_*.json") + + # check if states are found + if len(metric_files) == 0: + raise FileNotFoundError("No metrics found in " + args.s) + + # merge results + result = create_table_state_metrics(metric_files) + + # store result in output folder + Path(args.o).parent.mkdir(parents=True, exist_ok=True) + result.to_csv(Path(args.o)) + result.to_excel(Path(args.o).with_suffix(".xlsx")) diff --git a/examples/prior_example/scripts/merge_tds.py b/examples/prior_example/scripts/merge_tds.py new file mode 100644 index 0000000..ed12f6a --- /dev/null +++ b/examples/prior_example/scripts/merge_tds.py @@ -0,0 +1,90 @@ +"""Script to merge td files. + +Example +------- + +> python scripts/merge_tds.py + +or + +> python scripts/merge_tds.py -s output/simulation/*/metrics_sim*.json + +or + +> python scripts/merge_tds.py -o output/my_table.json + +Authors +------- +- Teijema, Jelle +- De Bruin, Jonathan +""" + +# version 0.9.3.dev33+g89c72db + +import argparse +import glob +import json +from math import nan +from pathlib import Path + +import pandas as pd + + +def create_table_state_tds(metrics): + values = [] + file_counter = 0 + + for metric in metrics: + with open(metric) as f: + i = next(filter(lambda x: x["id"] == "td", json.load(f)["data"]["items"]))[ + "value" + ] + values.extend((item[0], item[1], file_counter) for item in i) + file_counter += 1 + + df = pd.DataFrame(values, columns=["record_id", "td", "metric_file"]) + pivoted = df.pivot_table( + index="record_id", + columns="metric_file", + values="td", + aggfunc="first", + fill_value=nan, + ) + pivoted.columns = [f"td_sim_{col}" for col in pivoted.columns] + return pivoted + + +def get_atd_values(df): + df["record_atd"] = df.mean(axis=1) + + df.loc["average_simulation_TD"] = df.iloc[:, :-1].mean(axis=0) + + return df + + +if __name__ == "__main__": + parser = argparse.ArgumentParser( + description="Merge tds of multiple metrics into single table." + ) + parser.add_argument("-s", type=str, required=True, help="metrics location") + parser.add_argument("-o", type=str, required=True, help="Output table location") + args = parser.parse_args() + + # load metric files + metric_files = glob.glob(args.s + "metrics_sim_*.json") + + # check if states are found + if len(metric_files) == 0: + raise FileNotFoundError("No metrics found in " + args.s) + + # check if output file has .csv extension + if Path(args.o).suffix != ".csv": + raise ValueError("Output file should have .csv extension") + + td_table = create_table_state_tds(metric_files) + atd_table = get_atd_values(td_table) + + # store table + Path(args.o).parent.mkdir(parents=True, exist_ok=True) + atd_table.to_csv(Path(args.o)) + atd_table.to_excel(Path(args.o).with_suffix(".xlsx"))